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Coronavirus disease 2019 pandemic has disrupted the antenatal care in low? and middle?income countries such as India. Telemedicine was introduced for the first time in India for continuing antenatal care. Hence, a questionnaire?based descriptive cross?sectional study is done to assess the outcomes of teleconsultation services, factors influencing it, and patient’s perceived satisfaction. Three hundred and fifty?five women who delivered the following teleconsultation from July 2020 to October 2020 were included in the study. Thirty?two percent were high?risk pregnancies and 15% of the babies required neonatal intensive care unit admission. Ninety?eight percent could convey their health concerns, 18% had a referral to other departments, and 25% had visited casualty. Sixty?three percent procured medicine through e?prescription. Seventy?six percent were happy with teleconsultation overcrowded clinic, 82% were happy about saving travel expenditure, whereas overall satisfaction was 50%. Fourteen percent did not have access to smartphone and 9% did not receive the call at scheduled time. Telemedicine has a vital role in managing pregnancy concerns during this pandemic.
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Leprosy is an infectious disease associated with fear, aversion and social stigma, mostly due to crippling deformities. As prevalence of leprosy decreases, so does the experience with disease, especially for younger physicians. Leprosy can have a significant impact on the quality of life (QOL) of the affected person owing to the chronic nature, disabilities and deformities associated with the disease. A high degree of social stigma in a conservative place like Kashmir further complicates the problem. This has necessitated the need to revisit realms of disabilities in leprosy in our region. Aim of study was to understand the profile of leprosy patients, categorize the pattern of disabilities and assess its impact on the QOL of persons affected with leprosy in our region. This cross-sectional study was conducted in a tertiary care hospital, over a period of 7 years. All patients diagnosed with leprosy were included in the project following an Institutional ethical committee clearance. Detailed history followed by a meticulous examination was done in all patients with distinctive attention to recording of disabilities. Grading of disabilities was done using the world health organization (WHO) grading of 1988. The assessment of QOL was done using WHOQOL-BREF scale. Out of the 90 cases, 42 patients (46.67%) were found to suffer from a total of 72 disabilities with majority suffering from more than one, averaging 1.7 disabilities per person. 48 patients (53.33%) did not have any disability. Fourteen cases (15.56%) had grade 1 disability while grade 2 and grade 3 disability were seen in 23 (25.56%) and 5 (5.55%) cases respectively. The assessment of QOL using WHOQOL-BREF scale demonstrated the quality of life to be worst for the physical domain (median 42) followed by environmental (median 48), global (median 49), psychological (median 56) and social relations domain (median 57). Disabilities and deformities are commonly encountered in our leprosy patients and can have a significant physiological, psychological, economic and social impact on the patient. The disease has a significant impact on the QOL of patients contrary to previous beliefs. Our data also indicates the need for community level studies and interventions to overcome the problem of late diagnosis and proper management as well as proper after care for deformities/ disabilities.
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Spontaneous pneumothorax leading to pneumomediastinum, pneumopericardium and surgical emphysema is a benign condition. Progression to the development of epidural pneumatosis is rare. We report a 19-year-old man who presented with dyspnoea and swelling of the chest wall following a bout of cough. Bilateral subcutaneous emphysema was palpated on the anterior chest wall from the sternum to the midaxillary regions. His chest X-ray revealed subcutaneous emphysema and pneumopericardium. His computed tomography of the thorax to rule out life-threatening conditions revealed bilateral subcutaneous emphysema, pneumomediastinum, pneumo-pericardium and pneumothorax. He was transferred to the intensive care unit. An intercostal drainage tube was inserted in the left pleural cavity. The patient was followed up with repeat chest X-rays. The patient’s symptom got relieved and was discharged after day 9. Diagnosis of pneumomedia-stinum may not be as lamentable as it is seen. Close cardio-pulmonary monitoring is mandatory for complications and accompanying conditions. Most patients with uncomplicated spontaneous pneumomediastinum respond well to oxygen and conservative management. In this case, the patient’s symptoms and severe tachypnoea prompted the insertion of an intercostal drainage tube.
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Background: AUB is a common and debilitating condition and it is one of the main gynaecological reasons for hysterectomy. Ultrasonography can be as good as histopathology (HPE) in the diagnosis of abnormal uterine bleeding. Hence, our study was conducted to validate the ultrasonographic findings with HPE findings in diagnosis of AUB.Methods: A hospital based cross-sectional analytical study was conducted among 86 patients with abnormal uterine bleeding in the department of Obstetrics and Gynaecology in collaboration with department of Pathology, RIMS, Imphal from September 2017 to March 2019. The clinical history and socio demographic profile were collected using a pre-designed proforma. General physical examination, pelvic examination and ultrasonagraphy was carried out and the hysterectomy specimens were subjected to histopathological examination.Results: Fibromyoma was diagnosed by ultrasound in 62.8% of the patients and it was the common diagnosis in this study. The sensitivity, specificity, positive predictive value, negative predictive value and kappa statistics of USG for diagnosing leiomyoma was 92.9%, 93.3%, 96.3%, 87.5% and 84.9% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and kappa statistics of USG for diagnosing adenomyosis was 53.8%, 98.6%, 87.5%, 92.3% and 62.3% respectively.Conclusions: The study provides an evidence that ultrasonography has good diagnostic accuracy as histopathology in the diagnosis of fibroid in patients with abnormal uterine bleeding. However, as with all the diagnostic procedures, the utility of ultrasound in the diagnosis of adenomyosis is questionable, since it has a low sensitivity amidst good specificity.
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Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health. It may even affect mental health also. Obesity also plays a role in academics; it may be disadvantageous to some of the students. Previous studies have found that obesity could influence academic performance. So this study concerned preparing questions and circulating among the students (school and college). The aim of this study is to determine the awareness level of association between obesity and academic performance. The purpose of the study was clearly explained to the students. A total of 100 responses were received. All the responses were taken into consideration and the statistical analysis paired t test was made using SPSS software for the representation of pie charts and bar graphs (association graphs). According to the results, 67% students answered that the rough weight of the topper of their class would be 45-65 kgs, 25% of them said that it would be 65-80 kgs and the rest 8% said that it would be 80-90 kgs. 37% of students responded that obesity is disadvantageous towards academics, another 63% disagree with it. Most of the students of this survey responded that obesity does not cause any adverse effects on academics. But the care should be taken by the obese students towards their health and academics
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Introduction: Ashwagandha (Withania somnifera) is a spice utilized in Ayurveda, the conventional medication of India. Its root has a horsey smell (in Sanskrit, ashva signifies "horse" and gandha signifies "smell") and is said to present the quality and virility of a pony. Different pieces of the plant are utilized, yet the most well-known in supplements is a concentrate of its underlying foundations. Aim: aim of this study is to compare and assess the awareness among people on the effects of ashwagandha on blood sugar levels. Materials and Methods: A well structured questionnaire containing 10 questions was circulated among Indian population. The questionnaire has covered basic demographic data such as age, gender, weight, blood pressure and about the awareness of effects of ashwagandha on blood sugar levels Conclusion: From the above outcomes, it might be presumed that the Withania somnifera root extract can reduce blood sugar levels. It's mindfulness among individuals must be expanded
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This review is generally focussed on lipid-based excipients in solid oral formulations which increase its bioavailability. Several approaches have been used to deliver the drug efficiently in the body, and lipid excipients are one of the promising drug delivery systems which address challenges like solubility and bioavailability of water-soluble drugs. Lipids excipients can be tailored to meet a wide range of product requirements like disease indication, route of administration, stability, toxicity, and efficacy. This review discusses novel lipids like Compritol 888 ATO, Dynasan 114, and Precirol ATO 5 and how these can be employed for devicing efficient drug delivery models and thereby have used in cosmetic and pharmaceutical industries.
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Climate change is posing a great threat to agriculture and food security, especially in the agriculture oriented and developing countries like India. The present study was carried out to critically study the impact of climate change on productivity of major cereal and commercial crops by statistically analyzing the time series data. The analysis inferred that crop production of both food and commercial crops in India has increased since 1960-61. It was observed that major food crops (rice & wheat) were adversely affected by increase in maximum temperature and decrease in rainfall. The alternative measures such as area under cultivation, irrigation, fertilizer and pesticide consumption were observed to be nullifying that negative impact of climate change by enhancing the overall production. However, the commercial crops were observed to be positively affected by the increasing temperature. The study suggested that although the agriculture sector is able to withstand the adverse impact of climate change till now, but in near future this situation can become reversed. This necessitates the implementation of appropriate adaptation and mitigation measures to deal with the problems of climate change and to ensure the food security and food safety along in long run.
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Background: Changes in thyroid function in normal pregnancy are well-documented but in complicated pregnancy like preeclampsia, very little is known. Studies have shown evidences of hypothyroidism in preeclampsia necessitating thyroid function tests to be done in preeclampsia. The study was done to analyze the fetomaternal outcome of preeclampsia with coexisting thyroid dysfunction.Methods: A cross-sectional analytical study was done over 18 months on 95 preeclamptic patients admitted at the antenatal ward and fetomaternal outcomes were analyzed according to thyroid status.Results: Out of 95 patients with preeclampsia, 42 (44.2%) had thyroid dysfunction. Among these 42 patients, 37 (38.9%) patients had subclinical hypothyroidism, 4 (4.2%) had overt hypothyroidism and 1 (1%) had hyperthyroidism. Severe preeclampsia was seen in 64.3% of the patients with thyroid dysfunction compared with 39.6% in euthyroid patients. The mean thyroid stimulating hormone (TSH) level was significantly higher and means free thyroxine (fT4) level was significantly lower in severe preeclampsia compared with non-severe preeclampsia. Complications like abruption, intrauterine fetal death (IUD), intrauterine growth restriction (IUGR), oligohydramnios, preterm deliveries, postpartum hemorrhage (PPH), low birth weight babies, birth asphyxia in babies and subsequent neonatal intensive care unit (NICU) admissions were significantly higher (p <0.05) in the preeclampsia patients with thyroid dysfunction in comparison with euthyroid ones.Conclusions: Hypothyroidism may be a modifiable risk factor for preeclampsia. Thyroid screening early in pregnancy may be helpful in predicting the occurrence of preeclampsia and timely thyroid hormone administration can reduce the maternal and perinatal morbidity and mortality associated with preeclampsia.
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Background: Dental caries is a preventable multi factorial disease which shows increase in prevalence over last five decades in India. In order to reduce its magnitude and for effective prevention and control, the risk factors and distribution should be well known. This study was planned with the objective of assessing the prevalence and determinants of dental caries among primary school children in an Urban area of Kancheepuram district, Tamil Nadu, India. Methods: This school based cross sectional study was carried out between November 2017 and February 2018 using a sample size of 430 selected from two schools by simple random sampling. Data were collected using a pre-tested, structured questionnaire, which were analyzed using SPSS version 16.0 and presented using descriptive and analytical statistics. Results: Among the study participants, 52.9% had dental caries. Plaque accumulation was noted in 46.2%. About 74% were taking junk foods daily. About 47.1% children were rinsing their mouth daily and 34.6% were brushing more than once daily. Factors found to be protective against dental caries were high socio economic class and daily mouth rinsing habit. Odds of getting dental caries was more among children with visible dental plaque, daily junk foods intake, brushing once daily and failing to brush after foods. Conclusions: Dental caries is a high prevalent, preventable disease affecting both young and old aged individuals that can be mitigated by health education activities. Proper oral hygiene can prevent dental caries. Hence more importance should be given for oral hygiene and behavioral changes in dietary habits.
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Background: Population aging is a major health issue in most countries, sleep is one of the significant factors affecting aging and elderly people’s quality of life. The present study was done to assess sleep quality and its contributing factors among elderly people.Methods: This cross-sectional study was conducted in 2018 on 227 elderly people aged fifty five or more participants were selected from the urban field practice area Chidambaram. Data collection tools were a demographic questionnaire, pittsburg sleep quality index and five point depression scale. The collected data were entered into SPSS software (V-22) and analysed using chi-square test at the significance level of less than 0.5.Results: Among 227 elderly people most of them were between the age group of 55 to 60 years (44.9%) and majority of them were females (59%), literacy (69.6%) married (60.5%), house wives (43.6%). Among the population 34.8% had their PSQI value <5 which suggest good sleep quality and whereas 65.2% had PSQI ?5 suggesting poor sleep quality.Conclusions: The finding of their study indicates that elderly population in this area, have a fairly good quality. The most important factors contributing to their sleep quality are gender, dependency in doing daily activities, other health problems, marital status and their habitual sleep efficiency.
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Introduction: Collagen is an endogenous substance, which forms an important structural component in connective tissue andis of special importance in the skin. The importance of collagen in healing has been appreciated for many years for the simplereason that the end result of wound healing is always a scar which is composed of collagenous fibers.Aims: This prospective randomized controlled study was designed to compare the effectiveness of collagen dressing and silversulfadiazine dressing in partial-thickness burns.Materials and Methods: This study was conducted at Government Royapettah Hospital, Chennai. A total of 60 patients withpartial-thickness burn wounds were included in this study, and they are divided into two groups. Group 1 consisted of 30 patientsin whom collagen dressing was done. Group 2 consisted of 30 patients in whom silver sulfadiazine dressing was done. Thevariables analyzed were pain score, infection rate, the rate of healing of the wound, resultant scar, and patient compliance.Patients with partial-thickness burns involving <40% of the total body surface area and wounds not older than 24 h are inclusioncriteria in the study, whereas patients with full-thickness burns, burns involving >40% of the total body surface area, woundsolder than 24 h, and facial burns are the exclusion criteria for this study.Results: The average pain score in the range of 0–10 was 7.10 in the silver sulfadiazine group and 2.87 in the collagen group.Infection was present in 40% of the patients in the silver sulfadiazine group, whereas it was only 13.3% in the collagen group. Insilver sulfadiazine group, healing was achieved on an average of 17.77 days, whereas in the collagen group, it took 11.80 days.Conclusion: Collagen sheet promotes early healing, decreases the need for analgesics, and reduces the incidence of associatedcomplications such as infection. The morbidity of the patients is reduced as the resultant scar is better in the majority of thepatients using collagen. Due to the simple application and good tolerance of the membrane, collagen can be advocated as atemporary biological dressing material in partial-thickness burns.
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Thyrotoxicosis denotes the clinical syndrome that results from tissue exposure to excess circulating free thyroid hormones e thyroxine (3,5,30 ,50 -tetraiodo-L-thyronine; T4) and/or triiodothyronine (3,5,30 -triiodo-L-thyronine; T3). Aim: To study the clinical presentation and etiopathogenesis of thyrotoxicosis. Methods: Thyroid profile, x-ray neck and ECG were taken for the cases. Radio-Isotope study was not done since facilities are not available in our hospital. Surgery was the modality of treatment offered to all patients. Results: Most of the patients who were diagnosed to have thyrotoxicosis were in the age group 31-45 years. The incidence of thyrotoxicosis in females was high and the male. All the patients had a goiter. The most significant clinical features were palpitation, weight loss, diarrhea, sleep disturbances, excitability and heat intolerances in the order of frequency. Conclusion: From the evidence it is clear that after adequate control of toxicity with anti-thyroid drugs, surgery is the modality of treatment that can be safely offered to patients with thyrotoxicosis.
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Background: DKA is the most common serious and life-threatening acute complication of diabetes. The mortality rate is currently estimated at 2% to 10% for patients hospitalized with DKA. Mortality is predominantly due to underlying morbidities, such as sepsis or acute myocardial infarction, but deaths also occur as a result of hypokalemia induced arrhythmias and cerebral edema. Aim of the study: To compare arterial and venous blood gas values in the initial evaluation of patients with Diabetic Ketoacidosis (DKA). Materials and methods: The study was conducted in the division of emergency medicine at Rajah Muthiah Medical College and Hospital, Chidambaram in the year 2017 August to February 2018. Totally 61 patients were included in the study. Both sex in the age group of 14 to 70 years whose Capillary Blood Glucose equal to or greater than 250 mg/dl, Urine ketonuria (+) were included in the study. Results: 37% of patients had >12 urine ketone levels of the patients of patients were 2+ (15 mg/dl) which was 41.0%. 39.3% of patients were 1+ (5 mg/dl) and 19.7% of patients were 3+ (40 mg/dl). All G. Balaji, R. Devi. Comparative study on arterial and venous blood gas values in the initial evaluation of patients with diabetic ketoacidosis who are visiting the Emergency Department of Rajamutaiah Medical College and Hospital. IAIM, 2019; 6(5): 160-165. Page 161 patients were ketone positive. ABG pH valune in which 60.7% of patients were between the level of 7.01 – 7.4, 39.3% of them were from 6.7 – 7.0. ABG PCO2 value in which 44.3% of patients had values from 16-25, 21.3% of patients had values between 5-15 as well as 26-35 and 13.1% of patients had values from 36-45. In which about 65.7% of patients had HCO3 levels between 12.01-17, 15.2% of patients had HCO3 levels between 7.01-12 14.1 % of patients had levels between 17.01 – 18 and 5% of them between 2-7. VBG pH in DKA, in which, 57.4% were in between 7.01 – 7.41. 41% of patients had a pH from 6.7 – 7.0 and 1.6% were between 6.03 - 6.6. VBG HCO3 in which, 62.3% of patients had HCO3 levels from 12.01-17, 24.6% had from 7.01 – 12, 11.5% were in between 2-7 and 1.6% were showing levels in between 17.01-18. Conclusion: Venous blood gas measurements accurately and fairly demonstrate the degree of acidosis in the initial evaluation of patients with Diabetic Ketoacidosis in the Emergency Department in comparison with Arterial blood gas values.
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Inverted papilloma is a benign tumour of nasal cavity arising from lateral wall of nose, septum or anywhere in nasal cavity and sinuses. Pathogenesis is unknown even though many causes are explained like viral infection by HPV, HSV, chronic rhinosinusitis. These have capacity of malignant transformation 10 to 15%.Epstein–Barr virus (EBV), smoking, occupational, environmental and industrial exposures, cell cycle related proteins, angiogenic factors and chronic inflammation.Aims : To findout prevalence of inverted papilloma among nasal massesTo evaluate the sex incidence among these casesTo know symptomatology compared to other nasal massesMethods –ASRAM Medical College, Eluru, Dept of ENT.This is a prospective study over 2 years period ( 2015 Sept to 2017 August)Sample size – total no of 50 cases with nasal mass was studiedMethodology – All the patients having nasal masses were taken for the study. All the malignant masses were excluded from the study. Thorough clinical examination and investigations were done and data were analyzed.Results • The incidence of nasal mass to be higher in Males (58%). Especially males majority seen in inverted papilloma (5cases) and 1 female.nd• Most common nasal mass is nasal polyp,followed by 2most common is inverted papilloma.
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Background: Mucormycosis of the gastrointestinal tract is a rare fungal infection ofneonates. Case characteristics: 48-hours-old term neonate presented with intestinalobstruction and perforation. No significant risk factors were present. Histopathologicalexamination of the resected gangrenous bowel revealed mucormycosis. Cutaneousinvolvement due to systemic spread led to dermal necrosis in toes. Outcome: Thoughcutaneous lesions responded promptly to antifungal therapy, gastrointestinalmanifestations required multiple antifungal therapy for prolonged period apart from surgicaldebridement. Message: Precise histopathological diagnosis and early appropriate therapycan prevent dismal outcomes in neonatal mucormycosis.
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The aqueous and ethanolic extracts of Acorus calamus was evaluated for antibacterial activity against clinically important bacteria viz.. Bacillus subtilis (MTCC 441), Staphylococcus aureus (MTCC 96), Escherichia coli (MTCC 443), Proteus mirabilis (MTCC 1429), Pseudomonas aeruginosa (MTCC 424). The in-vitro antibacterial activity was performed by agar well diffusion method. The ethanolic extracts of A. calamus was active against all the investigated bacterial strains while aqueous extract was totally inactive against the studied gram negative bacterial strains (E. coli, P. mirabilis and P. aeruginosa) and showed moderate antibacterial activity against gram positive bacteria B. subtilis and Stap. aureus only at high concentration (200ml). However, further works are needed to identify the chemical nature of the active substances as well as their modes of actions on the bacterial cells and their roles in disease curing.
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Birth weight is an important determinant for child development and survival. Birth weight has been reported to be increasing with the passing years. There is no such accurate documentation from the state of Manipur. This cross sectional study has been attempted to see the birth weight pattern in the largest referral hospital in Manipur. Birth weights of four reference years in the last 15 years have been extracted from the records and analysed. There were 19478 singleton deliveries in the four reference years. The mean birth weight showed a gradual increase in these years. There was a gain of 88.9 g in 2000 since 1986 in term deliveries. There were significant differences in the mean birth weights among the four years, even after stratifying for gestation. However, there was no significant decrease in the percentage of low birth weight babies in these years. Low birth weight showed significant association with parity, age of the mother, booking status, haemoglobin level, and literacy of the mother. Since there was no significant decrease in low birth weight babies in spite of increasing birth weight, there is a need for continued and committed effort to realize the goals of RCH.