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Chronic kidney disease (CKD), also known as chronic renal disease, is progressive loss in kidney function over a period of months or years. The symptoms of worsening kidney function are not specific, and might include feeling generally unwell and experiencing a reduced appetite. Chronic liver disease in the clinical context is a disease process of the liver that involves a process of progressive destruction and regeneration of the liver parenchyma leading to fibrosis and cirrhosis. "Chronic liver disease" refers to disease of the liver which lasts over a period of six months. It consists of a wide range of liver pathologies which include inflammation (chronic hepatitis), liver cirrhosis, and hepatocellular carcinoma. The entire spectrum need not be experienced. Lipid profile or lipid panel is a panel of blood tests that serves as an initial broad medical screening tool for abnormalities in lipids, such as cholesterol and triglycerides. The results of this test can identify certain genetic diseases and can determine approximate risks for cardiovascular disease, certain forms of pancreatitis, and other diseases. Aim of the present study To study the changes in Lipid Profile M. Madan Mohan Rao, Shivnath Nandan, G. Obulesu, Salma Mahaboob R. To study the changes in lipid profile induced after ingestion of single high-cholesterol test meal in subjects of chronic liver disease and chronic renal disease. IAIM, 2017; 4(1): 50-57. Page 51 Induced after Ingestion of Single High-Cholesterol Test Meal in Subjects of Chronic Liver Disease and Chronic Renal Disease. Materials and methods, present study was conducted in the department of General Medicine, RIMS, Kadapa, by taking 50 patients of both the sexes. Serum was separated within four hours by centrifugation and the tests are serum total cholesterol (STC), serum Triglycerides (STG), HDL-cholesterol, LDL-cholesterol and VLDL-Cholesterol. Statistical analysis of the data was done by using paired ‘t’ test and student ‘t’ test. As no such comparative prior studies have been done on COPD patients, it was strongly urged that further studies with larger sample groups be carried out to elucidate the quantitative and qualitative significance of these changes.
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Diabetes mellitus is the most prevalent metabolic non communicable disorder in the world. Diabetes mellitus type 2 is a long term metabolic disorder that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. Type 2 diabetes is typically a chronic disease associated with a ten-year-shorter life expectancy. This is partly due to a number of complications with which it is associated, including: two to four times the risk of cardiovascular disease, including ischemic heart disease and stroke. To study the prevalence of microvascular, macrovascular, nonvascular complications and associated risk facters such as dyslipidemia obesity and hypertention in newly diagnosrd type 2 diabetes patients.
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Background: Analgesia is meant to reduce the pain produced by surgery. To fulfil this requirement various drugs such as alcohol, opium, hashish and balladona have been used in the past by the Egyptians and Chinese for the control of pain during surgery when the anesthesia was not known. Glucose is a carbohydrate required for energy. During the process of metabolism of glucose the source storage come into play. Nervous influence, enzymatic action and hormonal involvement also have a significant role. Aim: The aim of the study was the study of blood glucose level changes during general anesthesia in patients under surgery. Materials and methods: The present study was done in the department of Anesthesiology during the year 2015-2016, 60 patients with age group of 25-65 years along with different sex distribution. Results: Regarding the anaesthesia group, there were 15 patients in the age group of 25-35 years and 36-45 years each.14 patients were in age group 46-55 years, while 16 patients in the age group of 56- G.V. Krishna Reddy, M. Madan Mohan Rao, G obulesu, R Salma Mahaboob. The study of blood glucose level changes during general anesthesia in patients undergoing surgery. IAIM, 2017; 4(1): 110-115. Page 111 65 years. Out of 60 patients 33 patients (55%) were male patients while remaining 27 patients (45%) were female patients. Conclusion: Present study showed that there is very highly significant rise in blood glucose level during the ether anesthesia while in case of relaxants there is only significant rise in blood glucose level.
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Background: Emergence agitation is a short lived phenomenon occurring commonly after nasal surgery. In this study we used dexmedetomidine infusion in that intraoperative period to decrease the incidence of emergence agitation in adult male and female patients posted for nasal surgery. Aim: Study the effect of dexmedetomidine on emergence agitation after nasal surgeries. Materials and methods: 110 adult patients (ASA I-II, 22-65 years posted for nasal surgery were randomly divided into two groups. Group D received infusion of dexmedetomidine 0.4mcg/kf/hr during the intraoperative period, and Group C received normal saline infusion as placebo. All patients were induced with fentanyl (1 mcg/kg) and propofol (1.5 mcg/kg) and maintained with isoflurane. Incidence of agitation, hemodynamics, pain scores, time to verbal commands and extubation were evaluated. Results: Incidence of emergence agitation was lower in Group D (26%) than Group C (50%). Group I showed more stable hemodynamics than Group II. Time to verbal response and extubation was more for Group D than Group C (p < 0.05) though it was not clinically significant. Conclusion: The use of dexmedetomidine as intraoperative infusion resulted in smooth emergence with more stable hemodynamics.
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Background: Cholecystectomy is one of the most frequently performed surgeries. The surgery is associated with many avoidable complications and hence requires a serious and cautious approach. Aim: The aim of this study was to know the outcome of post cholecystectomy biliary leaks and its management methods. Materials and methods: 10 cases of biliary leaks were studied from 100 open cholecystectomies and 100 laparoscopic cholecystectomies from 2013 January to 2014 January. Pre-operative workup with ultrasound abdomen, LFT and other biochemical investigations were done and diagnosis was established. The outcome of surgery and its most common post-operative complication - biliary leak was studied with following parameters: Post-operative diagnosis, Surgery - Lap or Open, Incision, Method of approach – Fundus or Classical method, CBD exploration, Intra-operative findings, Drains used, Post-operative symptoms, Amount of collections, Removal of drains, USG – Sub hepatic collections, ERCP etc. Results: In the present study of 10 cases, fundus first method was done in 3 cases of open cholecystectomies and none in laparoscopic cholecystectomies. Classical procedure was done in 7 cases out of which 3 cases were done in laparoscopy method and 16 cases in open method. Intraoperative detection of bile duct injury is noted in 3 cases of open cholecystectomies and non in laparoscopic method. In the present study, 56 % of the patients were treated conservatively who required no therapy and surgical placement of the drain itself was sufficient. P. Krishna Kishore, B. Manju Sruthi, G. Obulesu. Study of post cholecystectomy biliary leakage and its management. IAIM, 2016; 3(9): 222-227. Page 223 Conclusion: Pain abdomen, Jaundice, Nausea and Vomiting are the major complaints in case of bile leaks and fistulas. Pathologically, chronic cholecystitis is commonest cause of leaks after surgery mainly because of fibrosis at calots triangle. Incidence of Post-operative bile leaks is almost the same in open and laparoscopic cholecystectomy. Routine placement of drains is must because it permits post operative evacuation of serosanguineous exudates and monitoring of bleeding or leakage of bile. Abdominal collections, bilomas or sub-hepatic abscess are reported less with the placement of drains
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Background: The rectum serves the function of a temporary reservoir for faeces and unfortunately when hemorrhoids raise their ugly heads, the natural process of eliminating waste from the body causes discomfort to the patient. Aim: The aim of my dissertation topic was to compare stapler hemorrhoidectomy (MIPH) with open hemorrhoidectomy in the management of 3rd / 4th degree hemorrhoids with reference to complications like pain, retention of urine, bleeding and anal incontinence, comforts to the patient, comforts to the surgeon, Intra operative complications, hospital stay, cost of surgery. Materials and methods: Inclusion criteria were primary III and IV degree hemorrhoids. Exclusion criteria were patients with associated co-morbid conditions, associated gastrointestinal diseases, recurrent hemorrhoids. Parts of a PPH 03 stapler device: Icon hea, Anvi, Shaft of instrument, Handle with safety lock. Results: Most of the patients belong to age group 41-50 and above 67% of the patients are between the age group of 41-60. About 83% of patients where males; females accounted for only 17%. The average post-operative stay for patients who underwent stapler hemorrhoidectomy was 3 days, whereas for open hemorrhoidectomy 4.6 day. Out of 100 patients only 60 cases came for follow up. The period extended from 2 months to 30 months. Stenosis was more common after open P. Krishna Kishore, B. Manju Sruthi, G. Obulesu. Comparative study between stapler and open hemorrhoidectomy in the management of grade III/ IV hemorrhoids. IAIM, 2016; 3(9): 218-221. Page 219 hemorrhoidectomy whereas recurrence was more common after stapler hemorrhoidectomy. Conclusion: Hemorrhoids is a common problem worldwide, a penalty paid by human beings for their erect posture. Lack of fiber in diet and chronic constipation are the root causes for this problem. The common mode of presentation is painless bleeding, prolapsing pile mass and pain when complicate.
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Background: Hearing impairment is a major problem worldwide, significantly delaying acquisition of speech in children. Unfortunately delayed detection of hearing impairment especially in rural and remote areas, adds a significant burden to the society and the nation. Hence early detection of hearing impairment is imperative and the need of the hour lies in developing an easy, cost effective and reliable method for testing large number of neonates and infants. This study was to assess the effectiveness and utility of Tympanometry as a screening tool for assessment of middle ear pathology in neonates and infants. Middle ear disorders are significantly prevalent in young children. Aim: Investigating and comparing the results of visual inspection of the tympanic membrane to the results of Tympanometry with traditional probe tone (226 Hz) and high frequency probe tone (678 Hz) in” ears without effusion” and “ears with effusion” and to establish their sensitivity and specificity to detect middle ear disorders as a database in clinical practice. Materials and methods: Subjects were evaluated for the stable middle ear/ Eustachian tube function. Ears with no sign of effusion in the middle ear on otoscopy were labeled as “ears without effusion” and those who showed the presence of fluid in the middle ear were labeled as “ears with effusion”. Blinded to otoscopic ear exam results, Tympanometry was conducted with conventional probe tone of 226 Hz and high probe tone 678 Hz by audiologist using standard procedure. Results: Otoscopic examination results of ears for all age groups were evaluated and ears without effusion and with effusion were tabulated. Y. Kishore Kumar, Ajay Kumar Basod, G. Obulesu. Clinical study on low vs high probe tone frequency tympanometry in children: Rural population. IAIM, 2016; 3(10): 251-258. Page 252 Conclusion: The tympanometric parameters obtained with 226 Hz and 678 Hz probe tones have statistically significant differences in detecting the ears without effusion and with effusion. Compliance values also proved to be statistically different with the different probe tones.
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Introduction: Hearing impairment is one of the most common handicapping problems in this country. There are millions of individuals in this country with varying degrees and types of hearing impairment including children, adults and elders. Hearing is important for speech and language development. Even minor degrees of hearing impairment, especially pre-lingual can affect overall development. Aim: To correlate the different audiogram configurations in adults with acquired sensori-neural hearing loss with the self reported auditory difficulties (which rules out biased reports). Materials and methods: The research design was exploratory and the sampling was purposive. The sampling selection was prospective. All the subjects we selected were according to the following criteria. Inclusion criteria were the patients selected should have minimum 3 years of sensori-neural hearing loss, age range was between 18 to 60 years, pure-tone average (500, 1000 and 2000 Hz) hearing loss was > 25 dB HL and ˂70 dB. Results: Audiogram Pattern wereFlat Pattern, Gradual Sloping, Sharply sloping, Precipitously sloping. Conclusion: Irrespective of audiogram configurations speech intelligibility in noise is most severely affected and discrimination of sound is least severely affected. The patients with similar looking audiograms had similar perception of auditory difficulties (Flat and gradual sloping patterns had similar difficulties. Trough/ saucer and notch also had similar auditory difficulties).
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Reproductive failure is a significant public health concern. Recently, ROS have been shown to have an important role in the normal functioning of the reproductive system and in the pathogenesis of infertility in females. Oxidative stress affects both natural and assisted infertility. Treatment that reduces OS may help infertile women with the disease that is caused by imbalance between free radicals and antioxidants. MDA is an end product of lipid peroxidation which can be used as a biomarker to measure the level of oxidative stress. TAC measures the low molecular weight non enzymatic antioxidants. Increase in MDA and decrease in TAC indicates an increase in oxidative stress. In the present study, it was observed that there was a statistically significant increase in serum MDA levels in female factor infertility and unexplained infertility when compared to controls. There was a statistically significant decrease in serum TAC in female factor infertility and unexplained infertility when compared to controls and statistically significant increase in serum LDH in infertile women with unexplained infertility compared to the control group and female factor infertility signifying the apoptotic damage in the unexplained infertility
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Background: Tuberculous pleurisy is thought to be the result of a delayed hypersensitivity reaction in response to the presence of mycobacterial antigens in the pleural space. This Immunologic reaction causes the stimulation and differentiation of lymphocytes, which release lymphokines, which in turn activate macrophages for an enhanced bactericidal effect. Aim: To study the adenosine deaminase levels in the diagnosis of tuberculous pleural effusion. Materials and methods: Present study was done in the Department of Biochemistry, Fathima Institute of Medical Sciences, Kapada. Parameters studied were total cell count, differential cell count, glucose, total proteins, lactate dehydrogenase, and adenosine deaminase. Results: In our study, all the parameters were elevated in disease condition that was tuberculous pleural effusion compared to non-tuberculous pleural effusion. Conclusion: Study of these parameters is not enough to know about the tubercular plerural effusion. The adenosine deaminase levels were significantly raised in pleural fluid in tuberculous pleural effusion than non tuberculous pleural effusion.
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Introduction: Intra venous therapy for infusion of blood products, fluid and electrolytes, parenteral medications, hemodynamic monitoring, and for total parenteral nutrition (TPN) has become an essential feature of modern medical care. However, this is associated with the significant risk of infection of blood stream. Material and methods: Intravenous cannulae with complaint of shooting pain and tenderness associated with cannulae were chosen as subjects of study. Tips of the cannulae were cultured using the semiquantitative method described by Maki. Results: Among them, 32 (32%) cannulae were infected. Among the blood samples of these patients cultured, 14 (14%) were positive and 86 (86%) blood samples were sterile. Fourteen were Coagulase negative Staphylococci, ten were Coagulase positive Staphylococci and five were Micrococci. The others were Corynebacterium jeikeium (4), Candida parapilosis (2), Candida glabrata (2), Klebsiella pneumonia (2) and Pseudomonas aeruginosa (2). Conclusion: There is no significant increase in the percentage of positive cultures with increase in duration of intravascular stay of the cannulae, after 24 hours. Majority of isolates from both cannula and blood are Coagulase negative Staphylococci (34.14% and 35.75% respectively). Majority of blood culture isolates are sensitive to Vancomycin.
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Background: Over the last four decades Methicillin Resistant Staphylococcus aureus (MRSA) has spread throughout the world and has become highly endemic in many geographical areas. Materials and methods: Methicillin resistance was determined by 2 methods: Disk diffusion method using Oxacillin 1µg disk and MIC HiComb strips. Results: Out of 170 isolates 105 strains were Coagulase Positive and 65 strains Coagulase Negative Staphylococci. Most effective markers were Thermonuclease test and growth on high salt agar. 89 (84.76%) of the 105 isolates showed resistance to Penicillin, 54 (51.42%) to Amyoxyclav, 81 (77.14%) to Cefdinir, 61 (58.0%) to Cefepime, 86 (81.92%) to Gentamicin, 44 (41.9%) to Clindamycin, 40 (38.0%) to Amikacin, 82 (78.0%) to Erythromycin, 51 (48.57%) to Cotrimoxazole and 69 (65.71%) to Ofloxacin. Maximum resistance was seen for Penicillin and least to Amikacin. Oxacillin Disc diffusion method: Among 105 isolates 48 (45.7%) were susceptible to Oxacillin, 9 (8.57%) showed intermediate sensitivity and 48 (45.7%) were resistant to Oxacillin. MIC Determination by MIC HiComb strips: Among 105 isolates 59 (56.1%) showed MIC ≤ 2 µg indicating susceptible strains and 46 (43.8%) isolates showed MIC 4 > µg indicating Methicillin resistance. Conclusion: The antimicrobial resistance pattern in the present study gives serious reason for concern because majority of the strains are highly resistant to commonly available antibiotics. Surveillance studies should be carried out in every geographical area to detect the prevalence of MRSA strains and Animireddy Kishore, G. Obulesu. To determine antibiotic susceptibility pattern along with Methicillin Resistance in the isolated Staphyloccus aureus – A study in Fathima Hospital. IAIM, 2016; 3(7): 281-286. Page 282 appropriate infection control measures should be performed. In conclusion, considering the increasing occurrence of MRSA infections, highly reliable, accurate and rapid testing for Methicillin Resistance is essential for both antibiotic therapy and infection control regimens.
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Background: Among all the microbial organisms Enterococcus faecalis and Candida albicans were the most commonly seen and most resistant organisms in persistent or failing root canals. Even after chemomechanical preparations and treatment 40 to 70% of the microorganisms survive. Aim: This in vitro study was done to evaluate the antimicrobial efficacy of intra canal medicament in root canals charged with Enterococcus faecalis. Materials and methods: Forty eight extracted human single rooted teeth were taken. Biomechanical preparations and access preparations were done. Specimens were sterilized by autoclaving and later contaminated with Enterococcus faecalis and incubated for 24 hours. Confirmation of Enterococcus faecalis was done and then divided into 3 experimental and 2 control groups. Groups (n=12) A) Animireddy Kishore, G. Obulesu, Madhu Babu. Determination of Antimicrobial Efficacy of Calcium hydroxide, Ozonated sesame oil and their combination as intra canal medicament against Enterococcus faecalis – A Study in Fathima Institute of Medical Sciences, Kadapa. IAIM, 2016; 3(8): 219-227. Page 220 Ozonized Sesame Oil, B) Calcium Hydroxide, C) Calcium Hydroxide + Ozonised Sesame Oil. Control groups Group 1:- (n=6) Negative Control, Group 2:- (n=6) Positive Control. Intra canal medicament was placed in each root canal corresponding to the groups and incubated at 370C. First sampling was done after 24 hours and second or final sampling was done after 72 hours of placement of intra canal medicament. Microbial growth was checked by counting CFU (Colony Forming Units). Results: In the first sampling ozononised sesame oil was 100% efficient, next efficient was Calcium Hydroxide group, and combination of Ozonised sesame oil and Calcium Hydroxide also showed almost similar results. But in the second and final sampling after 72 hours Ozonised sesame oil was highly efficient when compared to other two groups. Calcium Hydroxide was moderately efficient whereas combination of both the drugs was least effective as it showed highest CFU/ml. Conclusion: Ozonised sesame oil was most effective for longer duration when compared to other groups and can be used as an alternative intra canal medicament.
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Background: Brain is a rich source of a variety of enzymes and any injury like stroke to brain tissue could similarly result in an increase in activity of these enzymes in cerebrospinal fluid and serum. It was in this context that the present study was done to assess the levels of enzymes like aspartate aminotransferase (AST), creatine kinase (CK) and Isoenzyme of creatine kinase (CK-MB) in serum. Evaluation of enzyme levels in serum has involved keen interest as a simple, economical, reliable and easily available method for the evaluation of severity, course, prognosis, and to some extent in the differential diagnosis of various types of cerebrovascular accidents. Aim: To study the serum enzymes in cerebrovascular accidents. Materials and methods: The present study was done in Fathima Institute of Medical Sciences, Kadapa, by taking 50 of samples and 30 are controls. Creatine Kinase (Total), Creatine Kinase-MB, Aspartate Transaminase, lipid profile, Fasting Blood Sugar were estimated in patients and control group also. Results: The biochemical parameters studied were fasting blood glucose, total cholesterol, triglycerides, LDL, VLDL, HDL, SGOT, CPK and CPK-MB. Serum CPK was grossly elevated in patients with stroke compared to controls which is statistically significant (P Value < 0.001). Conclusion: In the present study, all the parameters were elevated, for better understanding of serum enzymes in cerebrovascular accidents further investigations are needed
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In the present investigation, anti-Candida activity of three essential oils that is Betel leaf (Piper betel), Black cumin (Nigella sativa) and Curry leaf (Murraya koienigii) were screened against three human pathogenic species of Candida namely Candida albicans, Candida glabrata and Candida tropicalis. The minimum inhibitory concentration (MIC) values of the oils ranged between 14.80 and 236 µl/ml while studied through the dilution method. The oils retained their anti-Candida activities even after heat treatment (at 450C, 600C, 1000C for 1 hour) and also on autoclaving. Black cumin leaf oil showed better anti-Candida activity against Candida albicans, resulting in an irreversible damage to the cells. The anti-Candida activity of these essential oils could be attributable to the membrane inhibition mechanism. The activity of the cells is reported to be microbicidal.