ABSTRACT
Limb loss to amputation is a major problem especially in developing countries where majority of the cases are preventable. It is a burden, not just for the patient, but also for their care givers which imposes tremendous financial and psychological burden upon them. The aim was to outline the patterns, indications and complications of lower limb amputations among patients admitted to MMIMSR, Mullana, Ambala, India, which is a tertiary care centre.METHODSThis was a prospective, observational study that was conducted at MMIMSR, Ambala, for a period of 18 months. 50 patients underwent lower limb amputations in our hospital during the study period.RESULTSThe age ranged between 23 to 85 years. Males outnumbered females by a ratio of 4.5:1. Toe disarticulations were the most common. Diabetes mellitus (DM) was the most common cause (62%) followed by Non-DM peripheral vascular disease (PVD) (22%). Two patients expired in the post-operative period. Infection of the stump was the most common local complication in the post-operative period. Hospital stay ranged from 6 days to 40 days.CONCLUSIONSAlthough trauma is still the most common cause of lower limb amputations (LLA) in the developing nations, amputations for complications of diabetes is on the rise and may be the leading aetiology in future. Diabetic gangrene followed by PVD were the common causes of amputation in our settings. The study shows that most of the causes are potentially avoidable. Community health education programmes that are primarily focussing on road safety measures, early presentation to the physician and good diabetic control are pivotal to decrease the incidence of amputations for preventable indications.
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Background: Burden of malnutrition is much higher in South Asia as compared to that in Africa and rest of the World. South Asia contributes to about 60% of the cases. Education of women has been seen to be the most effective in improving child's health. Present study is done to evaluate social demographic pattern in cases of severe acute malnutrition.Methods: Present study is prospective observational comparative study conducted at Department of Pediatrics included 175 cases after taking a informed written consent from the parent. Out of which 22 were lost to follow up and remaining 153 cases were analysed and further evaluated in the studyResults: Cases who were from 6 month to 24 months of age were 73.2% (n=112) and rest of them were above 24 months of age. Girls were 53.6 % and 46.4% were boys. Percentage of illiterate mother was 41.2%, till primary were 28.8% and Only 10.4% of mothers were graduate. Nearly 50% of the households had per capita income less than or equal to 1000.Conclusions: SAM was more common in children < 24 months of age, boys and girls were almost equally affected. Maternal literacy and low per capita income was an important factor associated with SAM patients.
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Objective : To evaluate the effectiveness of predischarge pulse oximetry as screening for critical congenital heart disease(CCHD) in Term and near term newborns. Methods : This was a prospective case control study conducted in the Neonatal intensive care unit and postnatal wards of a tertiary hospital ,Delhi.The study period was from june 2014 to November 2015,and followed up to 3 months. Inclusion criteria :-Healthy near term (35 to 37 completed weeks of gestation) and term (37 to 42 completed weeks of gestation) neonates .Exclusion criteria :-Neonates with any congenital malformation detected antenatally, Neonates requiring care in the neonatal intensive care unit., Severe IUGR and Maternal intake of drugs apart from the nutritional supplements. The pulse Oximetry Probes were applied to right upper limb (Preductal) and right lower limb (Postductal) in a calm /awake baby for about 3 min for saturations and their difference was recorded. Amean of three readings were taken. Oxygen saturation SPo2 <95% or differential saturation >3%was considered screen positive and sent for echocardiography for confirmation. Statistical analysis : Data was entered in a predesigned proforma in MicrosoftExcel. The data was then analyzed statistically using Stata software version 11(Stata Corp, College Station, TX). Continuous data with normal distribution was analyzed by student t test and non-normally distributed data by Wilcoxon rank sum test (Mann-Whitney). Categorical data was analyzed by chi-square or Fisher exact test. APvalue of <0.05 was taken as significant. Results : Of the 4100 term and near term neonates screened 427(10.4%) babies were screen positive and 3273(89.6%) babies screen negative with pulse oximetry. Total of 42 newborns screen positive for detection of CHD by SPO2 constituted 9.8% (42/427). out of 42 screen positive newborns for SPO2 . Echocardiography examination in these newborns revealed congenital heart disease in 59.5% (25/42). The sensitivity and specificity of SPO2 for detection of CCHD was 80% and 99% respectively ,whereas positive predictive value(PPV) and negative predictive value(NPV)was 9.5% and 100% respectively. Pvaluewas significant (<0.0001) . Conclusion :The technique of pulse oximetry is simple , reliable and an effective method of screening for detection of CCHD .
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Background: Obesity is a major modifiable cardiovascular risk factor as studied by American Heart Association. Aim of present study was to determine the prevalence of generalised and central body obesity among Medical Students and association of obesity measured by body mass index (BMI) and waist circumference (WC) with health risk factors. Material and methods: The present study was conducted on 200 medical students including 102 males and 98 females in the age group of 18-23 years in the Department of Physiology, Govt. Medical College, Amritsar. For generalised obesity (BMI> 25 kg/m2 and abdominal or central obesity (WC 94>cm in males and 80 >cm in females) were used. Results: The prevalence of generalised obesity in males and females was 75.51% (males 50.0%, females 25.51%) and abdominal or central obesity 82% (males 14% and females 68%). Isolated generalised obesity (BMI increased and WC normal) in males and female was 62.96% and 37.04% and isolated abdominal obesity (WC increased and BMI normal) in males and females 17.28% and 82.72%. Combined obesity (BMI and WC both increased) in males and females 40.12% and 59.88%. Conclusion: Prevalence of combined obesity was found high among both sexes. While isolated generalised obesity was more common in males and isolated abdominal obesity more common in females. However, these prevalence rates vary markedly depending on cut points used. WC is a better marker of obesity related risk than BMI.
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The phytochemical analysis and antimicrobial activities of in vitro grown callus and in D. stramonium plant were studied and compared. The crude extracts from D. stramonium were analysed for moisture, starch, carbohydrate, ascorbic acid, lipid, proline, crude protein, phenols, DNA, RNA, chlorophyll and carotenoid in plant parts and callus. The phytochemical content of naturally grown plant was comparatively higher than in vitro grown callus. The antimicrobial potential of the methanolic extracts of root, stem, leaves, fruits, callus and crude metabolite rich fractions were evaluated against Escherichia coli MTCC 1652, Staphylococus aureus MTCC 3160, Pseudomonas aeruginosa MTCC 847, Aspergillus flavus MTCC 2456, Aspergillus niger MTCC 282, Fusarium culmorum MTCC 349 and Rhizopus stolonifer MTCC 2591. The results indicated that methanolic leaf extract exhibited antimicrobial activity against S. aureus (IZ=18.2mm) and E. coli (IZ=19.8mm), P. aeruginosa (IZ=22.2mm), R. stolonifer (IZ=21.5mm), and callus exhibited antimicrobial activity against A. niger (IZ=12.1mm), F. culmorum (IZ=18.9mm) and A. flavus (IZ=12.8mm). The present study also revealed that antimicrobial activity was higher in naturally grown plant. In the metabolite rich fraction (flavonoids, phytosterols and alkaloids), greatest bactericidal and fungicidal activity was exhibited by flavonoids against P. aeruginosa (IZ=22.4mm) and A. flavus (IZ= 20.1mm).