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Aims and objectives: AIM of this study was to observe and correlate clinical and laboratory profile of patients with adrenal mass. The objective was to study clinical and laboratory profile of patients with adrenal mass with the secondary objective to establish the etiological diagnosis with adrenal mass Methods: This observational study was carried out at tertiary care government hospital in north India from Jul 2020 to June 2022. Based on prevalence 4.4 of the disease as per previous study sample size for 95% confidence level & 5% precision works out 43. The inclusion Criteria were patients detected to have adrenal mass or symptoms related with adrenal mass. The exclusion criteria were any pre-existing known malignancy other than adrenal gland. Subsequent to enrolment the demographic data, clinical data, laboratory data, hormonal assays and radiological data was recorded as per predesigned proforma. The adrenal CT imaging protocol consists of three phases together are used for calculating absolute percentage washout and/or relative percentage washout to differentiate lipid-poor adenomas from primary carcinoma and metastases. Results: The mean age was 39± 15.41. Majority of patients were males 35(77.8%). 86.7% subjects had no comorbidity, 7.9 % had HTN. 6.7% patients were noted to have clinical cushings whereas in 4.4% subject acanthosis nigricans and goiter was seen. On Overnight dexamethasone suppression test, 16/45 patients were observed with value higher than <2.01 ug/dl, similar was the case with low dose dexamethasone suppression test. There was a significant rise in the mean plasma free metanephrine and urinary metanephrine noted in 12/ 45 patients. The minimum size of adrenal mass detected in the USG abdomen was 2.5 cm. The minimum size of adrenal mass detected in the CT abdomen was 1.21 cm. There is a significant association noted between absolute percentage washout (APW) outcome and hormonal activity with p-value <0.001. Conclusion: 6.7 % had features of cushing's disease and 4.4 % had acanthosis nigricans. On hormonal assays elevated metanephrine levels were seen in 26% subjects. On hormonal assays of ONDST and LDDST 35.5 % subjects were seen with elevated levels. Other hormonal assays aldosterone, renin and ACTH were normal. CECT was sensitive to identify a small adrenal mass up to 0.633 cm. 34 % of adrenal mass were hyper functional and 2 % were found malignant in this study.
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Background: In 2015, there will be an estimated 155,000 new cases of breast cancer and about 76,000 women in India are expected to die of the disease. By the time a breast lump becomes palpable for clinical detection, it is usually advanced. We conducted a study to compare the status of axillary lymph node between the radiologicaland histopathological finding with the clinically negative lymph mode in carcinoma breast in order to limit the axillary lymph node dissection.Methods:This prospective study 50 female patients of carcinoma breast freshly detected and those with non-palpable axillary lymph admitted in S.C.B M.C.H, Cuttack, were included in the study.Results:The mean age of the patients was 51.26 years with standard deviation of 12.26 years with a range of 20 to 80 years. All 50 cases included in the study was done mammography of both breast and among them BIRADS IV 18 cases, BIRADS V 19 cases, BIRADS VI 5 cases and 08 cases were benign. 44 (88%) patients had Karnofsky performance score of 90-100 and 6 (12%) patients had score of 80-90. None (0.00%) of the patients had <80 performance score. Out of the 50 cases enrolled in the study, 04 were underwent wide local excision, 09 were breast conservation surgery and 37 were modified radical mastectomy along with axillary clearance.Conclusions: Higher sensitivity due to axillary ultrasound helps to reduce surgery time as patients with positive axillary lymph nodes directly get an Axillary Lymph Node Dissection (ALND) without preceding Sentinel lymph node biopsy (SLNB).
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Background: The application of controlled levels of negative pressure has been shown to accelerate debridement and promote healing in many different types of wounds. Vacuum assisted closure (VAC) has proved its efficacy for wound dressing leading to faster wound healing and shorter hospital stay. The aim of the study was to determinethe advantage of vacuum assisted closure over conventional dressing in SCBMCH hospital.Methods:The study was conducted at general surgery wards of SCB Medical College hospital. After debridement of the wound vacuum assisted dressing was applied. Control group was given conventional dressing.Results:In the study sample 10% patients were less than 40 years,76% belonged to 41-60 age group and 7% were more than 61 years of age, 60% male and 40% female. Wounds were located in the foot 27 (54%), leg 19 (38%), sole 2 (4%) and forearm 2 (4%). Patients with sterile pre (VAC), culture and sensitivity was not turning non sterile after VAC, but 90% non-sterile turns sterile after vacuum assisted dressing. In 5 days 25% of granulation tissue formed in VAC dressing whereas only 10% in case control. Similarly, in 10 days it was 40% for VAC and 25% in case of control. Finally, in 15 days it was 70% in case of VAC and 40% in case of control.Conclusions:VAC results in better healing, with few serious complications, and a promising alternative for the management of various wounds.
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Background: Morbidity in children is a major public health concern as this adversely affects their physical and mental growth. Moreover, poor health along with poor nutrition and disability can be barriers to attending school and to learning. Poor health and malnutrition may impair both the growth and cognitive development of primary school children. There is growing evidence of considerable burden of morbidity and mortality due to infectious diseases and malnutrition in school children. Methods: The cross sectional study was done among the children of 8 Elementary schools in Vijayawada among students of age group 6 - 11 years. 664 students were included. A Child was subjected for thorough clinical examination in good day-light. Examination included thorough clinical scrutiny including anthropometric measurements and assessment of morbidity pattern. Results: Majority of the children belongs to the age group of 6-7 years (35.5%), followed by 8-9 years (33.0%) and 10-11 years (31.5%). Girls constituted 60.2% of the study population and boys constitute 39.8% of the study population. Majority of the girls are in 8-9 age group and boys in 6-7 age group. Obesity was found in 8(1.2%) children. Severe stunting was found in 15(2.3%) children. Severe underweight was found in 14(2.5%) children. The most common morbidities among the study population were Dental caries present in 32.5% children, defective vision in both eyes 28.5% children, Diarrhea was reported in 24.7% children in the last three months, Acute respiratory infections in 21.5% children in the last three months, ear wax in 20.9% children, dandruff in hair in 19.0% children, tonsil enlargement in 11.9% children & pale conjunctiva in 10.1% children. Most of the children (81.8%) had one or the other morbidity. Conclusions: Morbidity was more among lower age group, boys, Muslim religion, Nuclear family, illiterate fathers, literate mothers, upper lower class of socio-economic status, children who passed worms in stool and children with poor personal hygiene.
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PURPOSE@#Road traffic accidents (RTAs) are a public health issue and cost a lot to individuals, families, communities and nations. Trauma care systems in India are at a nascent stage of development. There is gross disparity between trauma services available in various parts of the country. Rural area in India has inefficient services for trauma care, due to the varied topography, financial constraints, and lack of appropriate health infrastructure. The present study is to study the trends of occurrence of RTA cases by month, week and time of accident occurrence as well as to research the types of vehicle involved in accidents and other various risk factors related to them.@*METHODS@#During 1st January 2017 to 31st December 2017, a hospital-based and cross-sectional study of RTA victims was conducted. The patients were admitted in emergency department of Uttar Pradesh University of Medical Sciences, Saifai, Etawah, when stabilized, they were shifted to the orthopaedics and surgery ward.@*RESULTS@#In the study, 654 road accident victims were included, of which the majority were males (77.5%) and the most of them belonged to rural (67%). RTA victims according to the month of occurrence majority were found in January (12.5%) and evening was time of a day with maximum accidents (32.1%). Mortality cases of RTA victims based on type of road user and it shows decreasing trend of mortality of motorcyclists (54.2%) followed by pedestrian (25.1%).@*CONCLUSION@#There should be control over people driving vehicles under the influence of alcohol and drivers over-speeding and rash driving on urban roads as well as rural village roads.
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Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Accidental Injuries , Epidemiology , Mortality , Accidents, Traffic , Automobile Driving , Cross-Sectional Studies , Emergency Service, Hospital , Risk Factors , Seasons , Tertiary Care Centers , TimeABSTRACT
Background: Type2 diabetes is characterized by a long asymptomatic period commonly to be diagnosed when complications appear. The risk factors associated with diabetes are age, hypertension, dyslipidemia, smoking, alcohol, obesity & others. The role of early detection and adequate treatment of diabetes and related complications patients and health services is the basis for present study.Methods: The present study was conducted at S.N. Medical College, Agra, India on 86 consecutive newly diagnosed cases of type 2 diabetes. All individuals aged ≥ 20 years of age, who were not known diabetic, presenting to medicine department were included in the study for the targeted and opportunistic screening duration of January 2011 to June 2012.Results: The prevalence rates of vascular complications in this study group were analyzed statistically. The findings are the mean age was 54.27±9.27 years. 72.09% of newly diagnosed type 2 diabetes patients were aged above 50 years. Maximum number of patients were overweight (37.20%) followed by obese (32.55%). Hypertension was present in 30.23%, prevalence of CAD was 9.30%, and none had evidence of PVD and Cerebrovascular disease.Conclusions: Macrovascular complications were present in 9.30% of asymptomatic newly diagnosed type 2 diabetes patients. In the study present study found that there was a significant association of these risk factors were identified and treated as early as possible to decrease the progression of vascular complications.
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Background: Chronic non-communicable diseases (CNCDs) are the leading cause of death in the world. Accounting for around 60% of all deaths and 44% of premature deaths worldwide. The objective of the study was to assess the prevalence of risk factors for non-communicable diseases among allopathic doctors in Vijayawada. Methods: A cross-sectional survey was conducted on allopathic practicing doctors who were working in the various Hospitals, clinics, Nursing Homes within the corporation limits of Vijayawada city. Results: Out of the 720 study subjects, 498 doctors (69.2%) were males and 222 doctors (30.8%) were females. majority of the doctors 515 (71.5%) were with educational qualification of master degrees (MS/MD/MDS). Doctors in clinical specialty are more 565 (78.5%) compared with non-clinical 133 (18.4%) and dental 22 (3.1%). With regarding working sector, nearly one third of doctors were working in private sector 532 (73.9%). Conclusions: Because of more exposure to unhealthy life styles like smoking, alcohol, unhealthy dietary habits like high intake of salt, inadequate use of fruits and vegetables, oil fries and by leading a sedentary life and high risk factors like overweight/obesity, hypertension and diabetes a large number of the doctor’s population were at increased risk for chronic non-communicable diseases.
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Background: Individuals with type 2 diabetes display features of low-grade inflammation. Mediators of inflammation such as IL-6 have been proposed to be involved in the events causing as well as progression of diabetes. Diabetic nephropathy is one of the commonest causes of chronic kidney failure throughout the world. Although diabetic nephropathy is traditionally considered a non-immune disease, accumulating evidence now indicates that immunologic and inflammatory mechanisms play a significant role in its development and progression.Methods: This cross sectional study was conducted in the department of medicine, UPUMS, Saifai. The study was conducted from June 2018 to February 2019. A total of 80 type 2 diabetes patients were included in the study. After informed consent, patients were recruited. FBS, PPBS, HbA1C, 24 Hrs Urinary protein and interleukin-6 levels were measured. The data was analysed using SPSS 23. Pearson co relation co efficient was determined between IL -6, HbA1c and Urinary protein.Result: A total of 80 type 2 diabetes patients were studied. The study subjects were divided into 3 groups based on the urinary protein level into normo-albuminuria, Micro- albuminuria and macro- albuminuria. FBS, PPBS, HBA1c, 24 Hrs Urinary protein and Interleukin – 6 were significantly associated with proteinuria (p<0.001). Urinary protein was positively correlated with IL-6 (R2=0.57, p<0.01). The blood glucose was positively correlated with IL-6 (R2=0.413, p-0.01).Conclusion: Raised IL-6 levels in diabetics revealed the presence of inflammation. Our study showed positive correlation between IL-6, HBA1c and Urinary protein.
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Background: Diabetes Mellitus comprises a group of metabolic disorder leading to hyperglycaemia. Vitamin D deficiency plays a role in Type 2 Diabetes Mellitus pathogenesis. Vitamin D appears to affect several metabolisms that have been associated with coronary artery disease. Vitamin D level has been recently considered as an adjustable risk factor of cardiovascular diseases, in individuals with type 2 Diabetes.Methods: This case control study was conducted in the Department of Medicine, UPUMS. 100 diabetic individuals with low Vitamin D level were taken as cases and 100 diabetic individuals with normal vitamin D level as control. History and examination with necessary investigations were done. Patients with positive history were subjected to investigations to diagnose CAD.Results: The proportion of case and controls had no significant difference in age distribution. The risk of coronary artery disease was 2.76 times higher among diabetes mellitus patients with vitamin D deficiency (1.36-5.59). The risk of CAD was adjusted for various risk factors (age, sex, hypertension, smoking, physical activity, and lipid profile) Odds ratio was found to be 2.8 (95% CI-1.19-6.94, p-0.018).Conclusions: Vitamin D deficiency among diabetes patients was found to be an independent risk factor for CAD after adjusting other risk factors emphasizing that vitamin D can be a potential risk factor for development of coronary artery disease.
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Background: HIV presently accounts for the highest number of deaths attributable to any single infective agent. Opportunistic infections (OIs) and associated complications account for a considerable proportion of such mortality. Diarrhoea is among the most common symptom of HIV infection. During the natural course of HIV infection, there is a progressive loss of CD4 T cells. Autors’ aim is to study the prevalence of enteric pathogens in HIV patients with chronic diarrhea and their relationship with CD4 count.Methods: We analysed 186 HIV positive patients out of which 126 had chronic diarrhea and 60 patients presenting without diarrhea as controls. The faecal samples were subjected to microscopic examination. Zeihl Neelson’s Stain for mycobacterium, Kinyoun’s acid fast stain for microsporodia, stool culture for salmonella and shigella. All patients had barium meal contrast studies, USG of abdomen and pelvis. FNAC of peripheral lymph nodes and finally CD4+ Tcell count using BD FACS.Results: Total of 68,10,01 patients of HIV diarrhoea with identifiable cause had CD4 <200, 200-250 and >350 respectively. Among HIV diarrhoea without any identifiable cause 22, 17, 08 patients had CD 4 <200, 200-250 and >350 respectively. All diarrhoeal stool samples with Isopora had CD 4 <200, M. tuberculosis 26 patients CD4 <200, 12 had 200-350 and 03 had >350. Microsporodium 03 patients had CD4 >350. Finally, among stool samples with Cyclospora, E. histolytica, Giardia and Strongyloides all patients had CD 4<200.Conclusions: The present study highlights the importance of testing intestinal pathogens in HIV. Chronic diarrhoea was more common in patients with low CD4 counts.
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Aims:The study aims to estimate the lipid parameters among Plasmodium vivaxand mixed malaria (P.falciparum and P. vivax) infected patients. Study Design:This was a prospective observational and comparative study.Place and Duration of Study:The present study was undertaken in the Departments of Medicine and Biochemistry at A.J. Institute of Medical Sciences and Research (AJIMS), Mangaluru, Karnatakabetween Dec 2017 and May 2018.Methods:It was a prospective observational comparative study. A total of 100 patients (50 P. vivaxand 50 mixed malaria cases) were consecutively taken in the study. The lipid profiles of the cases were compared with that of100 healthy volunteers (control group). Data was collected and analysed. Results:Serum total cholesterol, High-Density Lipoprotein (HDL) and Low-Density Lipoprotein (LDL) levels were significantly low(p<0.001) in cases and serum Triglycerides (TG) andVery Low-Density Lipoprotein levels (VLDL) were higher in cases (p<0.001) than in control. There were no significant changes in mean serum lipids profiles between P. vivaxand Mixed Malaria groups. Conclusion:The derangement in lipid profiles in falciparum malaria was characteristic and specific for the disease. Characteristic changes were lower HDL, LDL and total cholesterol levels with higher TG and VLDL levels in comparison to control groups. These findings may be of diagnostic and prognostic value.
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The present investigation was undertaken to examine the genetic divergence in 50 mungbean germplasm lines for 13 characters using Mahalanobis D2 statistics. The genotypes grouped into eight clusters. Cluster VII had maximum intra-cluster distance while inter-cluster distance was highest between clusters V and VII. Cluster means indicated that none of the clusters was superior for all the characters studied. Therefore, hybridization between genotypes belonging to different clusters is suggested for development of superior genotypes. 10 SSR primers were used for molecular study of which only one gave slight difference among 19 mungbean genotypes. The quality and quantity of DNA used for amplification by PCR is the key to reproducible results and success of genotyping. Especially, DNA purity is extremely crucial for obtaining clear and discriminate patterns. DNA extraction from mungbean is difficult due to presence of contaminants such as phenols. Therefore, the present study was under taken to obtain high quality and pure DNA in mungbean. With few modifications four different DNA extraction protocols were tried in the present study to obtain high quality and pure DNA viz., (I) Doyle and Doyle (1987), (ii) Method of Murray and Thompson (1980), (iii) Porebski et al.(1997), and (iv) Lin et al. (2001). Out of the four methods tried for DNA extraction, the method of Lin et al. (2001) was found most efficient, as the DNA obtained through this protocol was relatively pure which gave amplyfying products in the PCR. The genotype used for the standardization was MGG -361. Molecular characterization of 19 randomly chosen mungbean genotypes was attempted with the eight standardized primers. None of the primers showed scorable polymorphism. The primers VR4, VR5 and VR9, exhibited non specific bands, in addition to the monomorphic bands.
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Ameloblastoma is a benign odontogenic neoplasm which frequently affects the mandible. The term ameloblastoma includes several clinico-radiological and histological types. Apart from the most commonly encountered clinico- pathologic models there are few variants, whose biological profile is unknown or not elicited. The reason for lack of understanding is the scarcity of case report published in the literature. Among the types, unicystic ameloblastoma is the least encountered either it presents as unilocular or multilocular radiolucency, but peculiar radiographic presentation of multilocular radiolucency in posterior mandible with unilocular radiographic appearance crossing the midline is extremely rare, which has not been reported yet. Here we report a distinctive case of mural unicystic ameloblastoma of mandible in a 17-year- old- girl with the radiographic presentation as mentioned above.
El ameloblastoma es un tumor odontogénico benigno que frecuentemente afecta a la mandíbula. El término ameloblastoma incluye varias características clínico-radiológicas y tipos histológicos. Aparte de los modelos clínicopatológicos que se encuentran con frecuencia existen algunas variantes, cuyo perfil biológico es desconocido o aún no elucidado. La razón de la falta de comprensión es la escasez de informes de casos publicados en la literatura. Entre los tipos, el ameloblastoma uniquístico es el menos frecuente y puede presentarse como una radiolucidez unilocular o multilocular, pero la peculiar presentación radiográfica de radiolucidez multilocular en el posterior de la mandíbula con aspecto radiográfico unilocular que cruza la línea mediana es extremadamente rara, y aún no se ha reportado. Se presenta un caso de ameloblastoma uniquístico mural de la mandíbula en una paciente de 17 años con la presentación radiográfica anteriormente descrita.
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Female , Ameloblastoma , Mandibular Neoplasms , Ameloblastoma/pathology , Mandibular Neoplasms/pathology , Odontogenic Tumors , Radiography, PanoramicABSTRACT
Orthodontic elastic bands are an important iatrogenic etiologic factor in the causation of periodontal attachment apparatus breakdown. Appropriate diagnosis and a well constructed treatment plan tailor-made to suit the requirements of the particular patient is imperative for management of periodontal lesions induced by subgingival retention of rubber band. There are conflicting reports regarding the reattachment and regeneration of lost periodontal supporting tissues in such cases. The present case report highlights the spontaneous reversal and correction of periodontal destruction due to iatrogenic orthodontic elastic band displacement deep into the subgingival tissues.
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Etoricoxib, a non-steroidal anti-inflammatory drug, is used to Osteoarthritis, Rheumatoid arthritis and Acute Gouty arthritis. Etoricoxib is practically insoluble in water; hence present study was carried out to enhance dissolution properties of Etoricoxib through the preparation of Solid Dispersions using PEG 6000 as carrier at various proportions by using different techniques like Physical mixtures, Kneading Method and Solvent Evaporation Method. The drug release profile was studied in 0.1N HCl containing 1 % SLS. U.V. Spectrophotometric method was selected for assay as well as in-vitro dissolution studies at 234nm.All the solid dispersions exhibited superior dissolution than pure drug. The drug dissolution studies followed first order kinetics. Solvent evaporation method was found to be superior to other methods.
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The diuretic activity of Benincasa hispida fruit rind extract (outer thick pericarp) was investigated and its activity was compared to control (normal saline) and standard diuretic hydrochlorothiazide in albino rats. Total of 54 adult male Sprague-Dawley rats were taken whose weights ranged from 175-225 gm. The rats were divided into three groups of 18 rats each (control, standard and test). Control group received 0.9% normal saline 25ml/kg orally. Standard group received hydrochlorothiazide 2.5mg/kg body weight orally along with normal saline keeping the volume of the fluid administered constant. Test group received aqueous extract of rind of Benincasa hispida at the dose of 100mg/kg orally along with normal saline 25ml/kg. Urine was collected for a period of 5 hours by placing the animals in metabolic cages. The urinary volume, pH, and urinary excretion of sodium, potassium and chloride were measured and compared. The extract produced significant increase (p<0.001) in urine volume, sodium and chloride levels, and significant decrease (p<0.001) in potassium excretion. Benincasa hispida rind extract possesses significant diuretic activity.
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Phaeohyphomycosis, caused by heterogeneous group of phaeoid fungi causes both subcutaneous and systemic infections. The disease is more of a histopathological than a clinical entity. We present a case of phaeohyphomycosis in a 29-year-old male who presented with the complaint of painful swelling of the right eye of 1-year duration. Computed tomography (CT) scan showed an abnormal hyper dense enhancing soft tissue in the extra coronal aspect of the right orbit along the superolateral and superomedial aspect. A provisional clinical diagnosis of lymphoma or fungal infection was entertained. Histopathology revealed granulomas with numerous multinucleated giant cells and fungal hyphae within and in between the giant cells. Per-iodic acid Schiff (PAS stain) was used to confirm the presence of hyphae. Based on the clinical, CT and histopathological features, a diagnosis of Phaeohyphomycosis was given.