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Purpose: To evaluate the efficacy of liposomal amphotericin B (L?AMB) for the treatment of fungal keratitis. Methods: Patients with fungal keratitis confirmed by potassium hydroxide (KOH) smear and/ or confocal microscopy were administered topical L?AMB and randomized into three groups treated with three different formulations. The medication was administered two hourly till clinical improvement was achieved, followed by six hourly till complete resolution. The outcome measures were time to clinical improvement, resolution of epithelial defect, stromal infiltrate, hypopyon, extent and density of corneal opacity, neovascularization, and best corrected visual acuity (BCVA) at 3 months. Results: Mean age of the patients was 46.6 ± 14.8 years, and trauma with vegetative matter was the most common predisposing factor. Aspergillus flavus (36%) was the most common fungus cultured, followed by Fusarium (23%). Mean time to clinical improvement, time to resolution of epithelial defect, mean time to resolution of infiltrate, and time to resolution of hypopyon were 3.45 ± 1.38, 25.35 ± 8.46, 37.97 ± 9.94, and 13.33 ± 4.90 days, respectively, and they were comparable among the three groups. There was a significant difference between treatment failure and success cases in terms of days of presentation (P < 0.01), size of the epithelial defect (P?value 0.04), and infiltrate size at presentation (P?value 0.04). At 3 months follow?up, no statistically significant difference was noted in BCVA and mean scar size among groups. Conclusion: L?AMB in a gel form is an effective antifungal agent that promotes the healing of fungal ulcers with notably least vascularization and better tolerance.
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Purpose: To study the antifungal susceptibility of common corneal pathogenic fungi to antifungal agents in the North Indian population. Methods: Prospective study of the antifungal sensitivity testing (natamycin, amphotericin B, voriconazole, itraconazole, fluconazole, posaconazole, caspofungin, micafungin) of fungal isolates from 50 cases of culture positive fungal keratitis by using E test method. Details noted included demographic data, visual acuity, clinical details, grade of keratitis, healing time, and success in medical management. Results: Of 50 patients with fungal keratitis (mean age: 40.28 ± 16.77 years), 12 eyes healed within 3 weeks, 14 had a delayed healing response, and 24 had chronic keratitis. Among the 15 cases of Fusarium isolates, 93.3% were sensitive to natamycin, while 40% to amphotericin B; 66.6% to voriconazole, 13.4% to itraconazole and fluconazole each. 80% of Fusarium cases (n = 12) showed susceptibility to posaconazole. Among Aspergillus flavus isolates, 53.4% (n = 8) were sensitive to natamycin, with only 40% (n = 7) showing sensitivity to amphotericin B and good susceptibility to azoles. MIC against susceptible Fusarium spp. for natamycin was 3–16 ?g/mL, amphotericin B: 1–8 ?g/mL, voriconazole: 0.5–1.5 ?g/ mL, itraconazole: 0.5–12 ?g/mL, posaconazole: 0.094–1.5 ?g/mL. MIC against Aspergillus flavus was natamycin: 8–32 ?g/mL, amphotericin B: 0.5–16 ?g/mL, voriconazole: 0.025–4 ?g/mL, itraconazole: 0.125–8 ?g/mL, posaconazole: 0.047–0.25 ?g/mL; against Aspergillus niger isolates, to natamycin was 6 ?g/mL (n=1), amphotericin B 8–12 ?g/mL (n = 3), voriconazole: 0.125–0.19 ?g/mL (n = 3), itraconazole: 0.38–0.75 ?g/mL, posaconazole: 0.064–0.19 ?g/mL and against Aspergillus fumigatus (n = 1), was natamycin4 ?g/ mL, amphotericin B ? 8 ?g/mL, voriconazole 0.25 ?g/mL, itraconazole 1 ?g/mL, and posaconazole 0.19 ?g/mL. MIC against susceptible Acremonium spp. for natamycin was 1.5–16 ?g/mL, amphotericin B: 0.5–8 ?g/mL, voriconazole: 0.19–3 ?g/mL, itraconazole: 0.125 ?g/mL, posaconazole: 0.125–0.5 ?g/mL and against susceptible Curvularia was natamycin 0.75–4 ?g/mL, amphotericin B 0.5–1 ?g/mL, voriconazole 0.125–0.19 ?g/mL, itraconazole 0.047–0.094 ?g/mL, posaconazole 0.047–0.094 ?g/mL. MIC against Mucor spp.+ Rhizopus spp. (n = 1) was natamycin: 8 ?g/mL, amphotericin B: 0.75 ?g/mL, posaconazole: 1.5 ?g/ mL. MIC against of Alternaria (n = 1) was voriconazole: 0.19 ?g/mL, posaconazole: 0.094 ?g/mL. MIC against Penicillium (n=1) was natamycin: 8 ?g/mL, voriconazole: 0.25 ?g/mL, itraconazole: 0.5 ?g/mL, and Posaconazole: 0.125 ?g/mL. Conclusion: Our observations highlight the variations in susceptibility to antifungal agents. Posaconazole seems to be effective with low MIC against common corneal pathogenic fungal isolates
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Background: There are multiple protocols currently being followed worldwide for effective management of COVID-19 depending on the disease severity as a consequence, of which the prescribing patterns and therapeutic choices still remain unclear. Drug utilization studies provide insight into the current prescribing practices and help us in facilitating the rational use of drugs. Aim and Objectives: The aims of this study were to evaluate utilization pattern of medications used to treat COVID-19 in hospitalized patients with moderate disease as defined by Indian Council of Medical Research (ICMR) guidelines. Materials and Methods: Hospital-based prospective, observational, and cross-sectional study was conducted in Designated COVID Hospital, Bidar Institute of Medical Sciences, Bidar for 4 months from March 1, 2021, to June 31, 2021. Data were collected from patients, every 10th inpatient was randomly selected. Rationality of prescriptions was evaluated using the WHO core drug prescribing indicators. A total of 234 hospitalized patients aged more than 18 years with laboratory confirmed COVID-19 of moderate severity according to ICMR guidelines were included in the study. Results: In our study, we found average number of drugs per encounter as 7.29. Percentage of drugs prescribed by generic name as 89.05%. Percentage of encounters with antibiotic as 96.58%. Percentage of encounters with an injection prescribed as 100%. Percentage of drugs prescribed from essential drug list as 83.25%. Conclusion: Drug utilization in COVID-19 is diverse and is in accordance with the existing guidelines. Medications used are highly corresponding to the disease severity. Polypharmacy detected, here, is not irrational as it suppressed the COVID-related mortality. Steroids, anticoagulants and oxygen being the key determinants.
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Background: The fast-growing demand for platelet concentrates (PC) necessitates the storage of these blood products before transfusion. Platelets are prepared as concentrates from the whole blood or by plateletpheresis. Qualitative and quantitative assessment of these PCs is an important issue in transfusion medicine. To assess the qualitative, quantitative changes and bacteriological safety of 5 days of stored platelet concentrates (PC).Material & Methods:This prospective study was conducted at the department of Clinical Pathology in collaboration with the Department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from April 2008 to April 2009. A total of 65 healthy donors were included in the study as per the inclusion and exclusion criteria. Therefore, 65 platelet concentrates (bags/units) were prepared from the donors. Purposive sampling of the units was done. pH and platelet indices (PLT, MPV, PDW and P-LCR) were measured and Gram staining of PCs was performed on days 0 and 5. Statistical significant tests were done at a 95% confidence interval using the statistical package for social science (SPSS).Results:The mean (±SD) pH was 7.18±0.07 ranging from 7.0 to 7.3 during day 0. On day 5 the mean (±SD) pH was 6.77±0.11 and their range was from 6.5 to 7. The mean pH difference was statistically significant (p<0.05) between day 0 and day 5. The mean (±SD) PLT/unit was 70.56±15.56 x109/unit and it ranged from 38.01 to 110.6 x109/unit during day 0. On day 5 the mean (±SD) PLT/unit level was 68.46±15.52 x109/unit and it ranged from 36.82 to 107.2 x109/unit. The mean PLT/unit difference was statistically significant (p<0.05) between day 0 and day 5. The mean (±SD) MPV was 9.34±0.92 fl and it ranged from 7.5 to 11.5 fl during day 0. During day 5 the mean (±SD) MPV was 9.27±0.99 fl ranging from 7.0 to 11.2 fl. The mean (±SD) PDW was 10.07±1.61 fl and which ranged from 7.4 to 14.4 fl during day 0. During day 5 the mean (±SD) PDW was 10.72±1.71 fl ranging from 7.0 to 15.4 fl. The mean (±SD) PLCR was 18.28±5.67 % and it ranged from 8.0 to 32.5 % during day 0. During day 5 the mean (±SD) PLCR was 21.18±5.91 % and it ranged from 10.0 to 36.3 %. The mean PLT, PDW and PLCR differences were statistically significant (p<0.05) between day 0 and day 5 in the unpaired t-test, however, the mean MPV difference was not statistically significant (p<0.05) between day 0 and day 5. Gram staining of platelet concentrates on day 0 and day 5 found no bacteria.Conclusions:Storage-induced lesions take place in PCs when stored for 5 days in second-generation storage containers under the currently recommended conditions, but how far these changes are clinically relevant needs to be investigated.
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Background: The fast growing demand for platelet concentrates (PC) necessitates the storage of these blood products prior to transfusion. Platelets are prepared as concentrates from the whole blood or by plateletpheresis. Qualitative and quantitative assessment of these PCs are an important issue in transfusion medicine. Aim of the study: To assess the qualitative, quantitative changes and bacteriological safety of 5 days stored platelet concentrates (PC).Material & Methods:This prospective study was conducted at the department of Clinical Pathology in collaboration with the department of Transfusion medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka during April 2008 to April 2009. A total of 65 healthy donors were included for the study as per the inclusion and exclusion criteria. Therefore, 65 platelet concentrates (bags/units) were prepared from the donors. Purposive sampling of the units was done. pH and platelet indices (PLT, MPV, PDW and P-LCR) were measured and Gram staining of PCs were performed on day 0 and 5. Statistical significant tests were done at 95% confidence interval using statistical package for social science (SPSS).Results:The mean (±SD) pH was 7.18±0.07 ranging from 7.0 to 7.3 during day 0. During day 5 the mean (±SD) pH was 6.77±0.11 and their range was from 6.5 to 7. The mean pH difference was statistically significant (p<0.05) between day 0 and day 5. The mean (±SD) PLT/unit was 70.56±15.56 x109/unit and it ranged from 38.01 to 110.6 x109/unit during day 0. During day 5 the mean (±SD) PLT/unit level was 68.46±15.52 x109/unit and it ranged from 36.82 to 107.2 x109/unit. The mean PLT/unit difference was statistically significant (p<0.05) between day 0 and day 5. The mean (±SD) MPV was 9.34±0.92 fl and it ranged from 7.5 to 11.5 fl during day 0. During day 5 the mean (±SD) MPV was 9.27±0.99 fl ranging from 7.0 to 11.2 fl. The mean (±SD) PDW was 10.07±1.61 fl and which ranged from 7.4 to 14.4 fl during day 0. During day 5 the mean (±SD) PDW was 10.72±1.71 fl ranging from 7.0 to 15.4 fl. The mean (±SD) PLCR was 18.28±5.67 % and it ranged from 8.0 to 32.5 % during day 0. During day 5 the mean (±SD) PLCR was 21.18±5.91 % and it ranged from 10.0 to 36.3 %. The mean PLT, PDW and PLCR difference were statistically significant (p<0.05) between day 0 and day 5 in unpaired t-test, however the mean MPV difference was not statistically significant (p<0.05) between day 0 and day 5. Gram staining of platelet concentrates on day 0 and day 5 found no bacteria.Conclusions:Storage-induced lesions take place in PCs, when stored for 5 days in second generation storage containers under the currently recommended conditions, but how far these change are clinically relevant need to be investigated
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Purpose: To analyze the pattern of bacterial pathogens causing infective keratitis and their resistance to the recommended antibiotics over six years. Methods: It was a retrospective study of 9,357 cases of bacterial keratitis from January 2015 to December 2020, at a tertiary care ophthalmic center. A total of 9,547 corneal specimens were obtained from the study subjects. Demographic details of the patients, pathogenic bacteria isolated, and their antimicrobial susceptibility were noted and analyzed. Results: Bacterial pathogens were identified in 23.52% of the specimens. The most common isolates were coagulase?negative Staphylococci (60.75%), followed by Pseudomonas aeruginosa (14.23%), Staphylococcus aureus (13.92%), gram negative bacilli of the family Enterobacterales (8.64%), Streptococcus spp. (1.72%), Acinetobacter spp. (0.13%), and other non?fermenting gram?negative bacilli (0.57%). In Staphylococci, 55–80% of isolates were resistant to erythromycin, and 40–70% to fluoroquinolones, while no resistance was observed against vancomycin. 40–60% of isolates of P. aeruginosa were resistant to cephalosporins, 40–55% to fluoroquinolones, and 30–60% to aminoglycosides. Also, 40–80% of isolates of Enterobacterales were resistant to cephalosporins, and 50–60% to fluoroquinolones. Most gram?negative isolates were susceptible to carbapenems and polymyxin B. Conclusion: To the best of our knowledge, our study is the largest compilation of microbiological profile of bacterial keratitis from North India. It highlights the current trend of the bacterial pathogens that cause infectious keratitis. Staphylococci and Pseudomonas were found to be the most common pathogens. Increased resistance was seen against some of the commonly prescribed empirical antibiotics. Such evidence is useful for restructuring the empirical prescription practices from time to time.
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Background@#The use of euglycemic diabetic ketoacidosis (EDKA) related to sodium-glucose cotransporter 2 inhibitors (SGLT2i) use in people with diabetes has been increasingly reported. The causes are multifactorial, and dietary changes in SGLT2i users were observed to trigger EDKA. A ketogenic diet or very low-carbohydrate diet (VLCD) enhances body ketosis by breaking down fats into energy sources, causing EDKA. This study aimed to understand the patient specific risk factors and clinical characteristics of this cohort. @*Methods@#Several databases were carefully analyzed to understand the patients’ symptoms, clinical profile, laboratory results, and safety of dietary changes in SGLT2i’s. Thirteen case reports identifying 14 patients on a ketogenic diet and SGLT2i’s diagnosed with EDKA were reviewed. @*Results@#Of the 14 patients, 12 (85%) presented with type-2 diabetes mellitus (DM) and 2 (15%) presented with type-1 DM. The duration of treatment with SGLT2i before the onset of EDKA varies from 1 to 365 days. The duration of consuming a ketogenic diet or VLCD before EDKA onset varies from 1 to 90 days, with over 90% of patients hospitalized <4 weeks after starting the diet. At presentation, average blood glucose was 167.50±41.80 mg/dL, pH 7.10±0.10, HCO3 8.1±3.0 mmol/L, potassium 4.2±1.1 mEq/L, anion-gap 23.6±3.5 mmol/L, and the average hemoglobin A1c was 10%±2.4%. The length of hospital stay ranged from 1 to 15 days. None of the patients were reinitiated on SGLT2i’s, and 50% (2/4) of the patients reported were on the ketogenic diet or VLCD upon patient questioning. @*Conclusion@#Despite the popularity of the ketogenic diet and VLCD for weight loss, their use in diabetics taking SGLT2i’s is associated with EDKA. Physicians should educate patients with diabetes taking SGLT2i’s about the risk of EDKA. In addition, patients should be encouraged to include their physicians in any decision related to significant changes in diet or exercise routines. Further research is needed to address if SGLT2i’s should be permanently discontinued in patients with diabetes on SGLT2i and whether the ketogenic diet developed EDKA.
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@#Introduction: Humeral shaft fractures are the most common injury sustained in arm wrestling, and its various biomechanical, anatomical, kinematic and electromyographic aspects have been studied and reported. We present a series of six cases of humeral shaft fractures in the arm wrestlers and a review of basic science studies to determine the factors contributing to their causation. Materials and methods: Six humeral shaft fractures associated with arm wrestling were treated between December 2018 and January 2020. The medical records and radiographs were retrospectively reviewed. In addition, the characteristics of the patients, their opponents, and the fractures were noted in a pre-designed data sheet. Results: There were six men with an average age of 27.5 years (SD ± 8.9). All were amateurs who were occasional arm wrestlers. Three fractures each were sustained in the sitting and standing position, four in the losing phase, one in the winning phase, and one in the stalling phase. The dominant side humerus was involved in all but one case. The fracture types were 12-A1 (n=4); 12-B1 (n=1); 12-A2 (n=1). Three fractures were treated by open reduction and internal fixation, while three were treated conservatively with satisfactory healing. Conclusion: Humeral shaft fractures in arm wrestling are common in amateurs. There is no association of the fracture with the position of the players or the phase of the match. However, arm wrestlers should be aware of this complication and should receive proper guidance to reduce the risk of humeral shaft fractures.
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Background: Partograph use in labor has revolutionized the obstetric care. WHO recommends universal use of WHO modified partograph, which in clinical setup is less often used. Debdas (2006) proposed the paperless partogram which is designed for use by clinician/nurses/midwives as it is very simple and low skill method. The present study is proposed to evaluate the effectiveness of paperless partogram as a bedside tool and its comparison with WHO modified partograph.Methods: It was a prospective analytical study done in department of obstetrics and gynecology, JNMCH, AMU, Aligarh from September 2017 to July 2019 and included 400 pregnant women at term, divided into 2 groups of 100 each Group A (paperless partogram) and Group B (WHO modified partograph) and their labor events were followed.Results: Out of 200 women that were included in each group, maximum women were multigravida, 58.5% in group A and 61.5% women in Group B. Mean age in Group A was 24.68±3.8years and Group B was 24.93±3.75 years. The mean duration of labor in Group A was 3.57±2.20 hours and Group B was 3.40±2.03 hours. There were 87.5% of women who delivered before alert ETD, likewise in Group B; women who delivered before alert line are 88.5%. These differences were statically not significant. Perinatal outcome was also similar in both groups.Conclusions: In our study, the paperless study was found to be as efficient as WHO modified partograph for management of labor. The mean delivery time was 3.57 hours similar to WHO partograph of difference between alert and action line. Thus, for resource poor setting like India with overburdened population paperless partogram can be used as an alternative to WHO modified partograph which is complex and time consuming.
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Hyperreactio leuteinalis refers to pregnancy related enlargement of B/L ovaries rarely unilateral ovary, moderate to marked size due to multiple theca leutein cysts. It is a rare finding associated with pregnancy seen commonly in multiple gestation, GTDs and fetal abnormalities: viz hydrops. It is caused by elevated B-hcg level. We report a case of 28 years old female, primi with 13 spontaneously conceived weeks pregnancy who presented to ANC OPD for regular check-up and vague abdominal discomfort. USG revealed a large right sided ovarian mass, solid cystic in appearance pushing the uterus to left side and upwards. Staging laparotomy was done at 14 weeks viewing it to be a malignant mass. Unilateral right sided oophorectomy was done along with biopsy taken from left ovary. On microscopic histological examination diagnosis of hyperreactio leuteinalis unilateral ovary was made. Hyperreactio leuteinalis mimicking ovarian malignancy on USG results in unnecessary surgical intervention.
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Background: Oral submucous fibrosis (OSMF), a well-recognized oral potentially malignant disorder, results due to increased collagen production and reduced collagen degradation. Aims and Objectives: To qualitatively compare the staining properties of collagen in OSMF using two special stains based on their birefringent property using polarizing microscopy. The study also assessed the distribution and orientation of collagen fibers in different grades of OSMF. Materials and Methods: A total of 73 subjects with different clinical and histopathological staging of OSMF comprised the study population. Histopathological examination was done using hematoxylin and eosin stain, Van Gieson and picrosirius red. Collagen fibers were analyzed for polarization colors, distribution, and orientation. Results: Picrosirius red stained both thick and thin collagen fibers. Irrespective of the histopathological grades reddish orange and yellowish orange were the most predominant colors. Parallel arrangement of fibers was observed when stained with Van Gieson but picrosirius red stained sections showed a majority of parallel type I fibers with perpendicular type III fibers which increased with advancement in the histopathological grade. Yellowish orange and greenish yellow fibers were predominant in the lamina propria, while reddish orange fibers were predominant in the submucosa. Conclusion: Picrosirius red was found to be a better stain. Histopathological grading and polarization colors showed no association with each other. Collagen fibers were more thickly and tightly packed in the submucosa indicating that the process of fibrosis began there. The increase in perpendicular type III fibers with advancing histopathological grades suggested their role in fibrosis.
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Background: Intraarticular fracture distal end of the radius isone of the most common fracture of upper extremities. Here israndomised comparative study of the most effective treatmentmodality to deal with such fracture by external fixator vsbuttress plating.Method: Patients were randomly allocated into two groups of30 each (group A and group B). Patients treated with externalfixator was put in group A while those treated with buttressplating was kept in group B. At the end of 8 months of follow-upfinal assessment was done for fracture union and patients wereassessed for pain, wrist range of motion (ROM), grip strengthand activity and scored according to the Modified Green OBrien Scoring System. The mean duration of treatment and theoutcome were comparable.Results: In group A (external fixator) only 7 patients hadexcellent and 18 had good results while patient in group B(ORIF with plating) 14 patients had excellent and 11 had goodresult.Conclusion: We found that plating predominantly providesmore excellent results as long as the radiological parametersare met and fixation achieved as early as possible along withvigorous physiotherapy.Level of Evidence: Level II randomised comparative series.
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Objective:To evaluate the role of Nigella sativa in renoprotectionMaterial and Methods:This prospective, comparative study was completed in a tertiary care centre of north India in patients of Chronic Kidney Disease (CKD). Group I (Control) received conservative management of CKD and while Group II (Test) received conservative management along with Nigella sativa oil (2.5 mL, orally, once daily) for 12 weeks. Renal function tests were done at 0, 6 and 12 weeks of treatment.Results:There was more progressive improvement in biochemical values and clinical signs and symptoms in test group. There was decrement in blood urea, serum creatinine and 24-hour total urine protein (TUP). There was rise in glomerular filtration rate (GFR) and 24-hour total urine volume (TUV). Conclusion:Nigella sativa oil supplementation is effective and safe in prevention of progression of nephropathy.
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Introduction: Gymnosporia montana Benth. is a medicinal herb which has been valued in Ayurvedic medicine for its hepatoprotective effect. The plant has been studied for its pharmacological, antimicrobial, and antioxidant properties, but there are no reports on its genotoxicity. Aim: Hence, in the present study, two extracts of G. montana (70% methanolic and aqueous) at different concentrations were evaluated for the in vitro cytotoxicity and genotoxicity in Human peripheral blood lymphocyte cultures (PBLC) since these are well-established techniques for the analysis of the potentially mutagenic and carcinogenic chemicals. Methodology: The 3-(4,5-dimethylthiazol-2-yl) -2,5-diphenyltetrazolium bromide (MTT), Mitotic index (MI), Sister-chromatid exchanges (SCEs), Cell cycle proliferative index (CCPI), Average generation time (AGT) and Population doubling time (PDT) were scored in cultures set up from 10 different healthy donors. The treatment of the cell culture was done employing different extracts of G. montana at three concentrations (1.78µg/mL, 3.57µg/mL and 7.14µg/mL) with control and positive control (Ethyl methanesulfonate [EMS (1.93 mM)]). Results: The MTT results showed the cytotoxic effect in a concentration-dependent manner in both the methanol and aqueous extract and the IC50 value of methanol and aqueous extract was found to be 2.63 µg/mL and 3.63 µg/mL respectively. The MI (p<.001) and CCPI (p<.05) in both the extracts showed significant values at higher concentration, but at lower and mid concentrations both the extracts were non-significant and the total SCEs, AGT and PDT in all the concentrations showed non-significant results when compared with the control. Conclusion: These results indicate that the G. montana plant extracts at lower two concentrations showed no cytotoxicity and genotoxicity effects in cultured human peripheral blood lymphocytes. Therefore, we suggest that the plant extract is safe for use at the lower concentrations in traditional medicine.
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Background: Elevated plasma levels of low-density lipoproteins are an important risk factor for heart diseases and the premature start of atherosclerosis. Objectives: The aim of this study is to assess the correlation between lipid profile and platelets parameters of blood donors and to find out the association of platelet volume indices with heart diseases. Materials and methods: A cross-sectional study was done involving blood donors (n=80) from the Department of Transfusion Medicine, King George’s Medical University Lucknow (June 2015-December 2015). Medical history from blood donors by questionnaire was taken and lipid levels were analyzed by blood samples. Results: Out of 80 blood samples 30 were hyperlipidemic and 50 were normolipidemic. There was statistical significance in sex age and weight (p=0.05) in hyperlipidemic groups. Platelet parameters were also significantly higher in hyperlipidemic groups as well as a significant association was found between hyperlipidemia on the basis of the donor’s weight and platelet parameters (p=0.05). Conclusion: Elevated platelet volume indices are an increased risk of heart diseases with hyperlipidemia. Further studies on larger sample size need to establish the observation.
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Background: Many different treatment modalities have been advocated by different authors from time to time for lumbarspondylolisthesis. Many cases, the condition can be treated conservatively. However, when the symptoms persist, surgeryneeds to be performed. The principle of underlying surgery includes stabilization of the slipping vertebrae. Various operativemethods encompassing this principle include stabilization with pedicle screw fixation and fusion which can either posterolateralor interbody fusion, anterior lumbar interbody fusion, posterior lumbar interbody fusion, or transforaminal lumbar interbodyfusion. The objective of this study was to compare the surgical efficacy in terms of stability and fusion achieved using pediclescrew-rod instrumentation with posterolateral fusion and pedicle screw-rod instrumentation with interbody fusion in lumbarspondylolisthesis and to study THE functional and clinical recovery using the Revised Oswestry Disability Index score.Materials and Methods: A prospective study was carried out to compare the clinical and radiological outcomes between Pediclescrew-rod instrumentation with either posterolateral fusion and interbody fusion after adequate decompression in patient oflumbar spondylolisthesis. All patients as per the inclusion criteria were admitted, underwent surgery between March 2010 andMarch 2012, and were included in the study.Results: The total of 50 patients was included in our study. Both male and female patients were equally distributed in both thegroups, wherein postreolateral fusion had 13 female patients and those with interbody fusion had 13 male patients. Our studyshows marked improvement in Revised Oswestry Disability score postoperatively with good-to-excellent results in both thegroups. We achieved good solid radiological fusion earliest on the 3rd month in both the groups with good stability.Conclusion: Our results showed similar clinical and functional outcome in both the groups with no significant statistical differencefound. However, we conclude that in cases where reduction is required and there is instability affecting the three column ofspine interbody fusions with pedicle screws-rod instrumentation provide a more solid mechanical construct.
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Background: The prevalence of back pain has been reported between 49% and 80%. Except for cases that require immediatesurgical intervention, the first-line treatment involves medical choices. 90% of attacks of sciatica respond to conservativemanagement. Surgical intervention when indicated involves discectomy and various operative methods include laminectomydiscectomy, microlumbar discectomy, and microendoscopic discectomy. The objective of this study was to evaluate theadvantages and disadvantages and outcome of the above-mentioned surgical operations for lumbar disc herniation (LDH) andthen, specifically, the outcomes for each of them using Odom’s criteria.Materials and Methods: A prospective study was carried out between April 2015 and April 2017 to compare the advantages/disadvantages and outcome of various surgical interventions in LDH, namely laminectomy discectomy (Group A), microlumbardiscectomy (Group B), and microendoscopic discectomy (Group C) with each group consisting of 30 patients. All patients wereadmitted as per inclusion criteria.Results: In each group of our study, the mean age and sex distribution were comparable and statistically not significant. Ourstudy showed the post-operative hospital stay and the need for post-operative analgesia was low for microendoscopic surgery,but on long-term evaluation with Odom’s criteria, laminectomy achieved better outcomes than other methods.Conclusion: Our study showed that microlumbar discectomy and microendoscopic discectomy have a better short-term outcomeas compared to laminectomy discectomy. However, long-term results are comparable.
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No abstract available.
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Anticoagulants , Observational Study , Venous Thrombosis , WarfarinABSTRACT
Background: Hepatitis B virus is a partially double-stranded circular DNAvirus and is a member of the Hepadnaviridae family. The virus consists of a core capsid which contains viral DNA and this is surrounded by an envelope containing surface antigen (HBsAg). Both whole, incomplete virus particles, consisting entirely of HBsAg, are produced during replication of HBV. The HBsAg particles vary greatly in morphology and are found in high concentrations in early acute infection and continue to be produced in chronic disease.1 Objective: To evaluate the seroprevalence of hepatitis B surface antigen among patients in a tertiary care health centre of Kumaun region of Uttarakhand. Materials and methods:The prevalence of hepatitis B surface antigen (HBsAg) was studied in 37169 patients of all age groups and gender (19430 females and 17739 males) who required blood investigations for different medical reasons. Blood samples collected during January 2017 to August 2018, were tested for HBsAg using a sandwich ELISAbased immunochromatic test. Results: Of the 37169 patients tested, 719 (1.93%) were positive for HBsAg. Out of these, 387(53.82%) were females and 332 (46.18%) were males. The results revealed that hepatitis B infection was highest in age group of 21-30 years of age. Conclusion: This study demonstrates that screening tests can be pivotal in identifying HBsAg and it is advocated that a program for education, vaccination and prophylaxis must be implemented in all health care set ups.
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Wuchereria bancrofti is the most common parasite causing lymphatic filariasis. Microfilariae are demonstrated in the peripheral blood, body fluids, fine needle aspirates and in onchial ushings but it is an uncommon finding in the bone marrow. We report a case of a 45-year old male who presented with pyrexia of unknown origin and on peripheral blood and bone marrow examination found to have pancytopaenia with megaloblastoid changes in the bone marrow and W. bancrofti microfilariae.