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Background: Removal of teeth causes pain, swelling, and difficulty in opening the mouth. The present study was conducted to assess pain experience after simple tooth extraction.Material & Methods:90 patients undergoing extraction of both genders were recorded. Pain assessment was recorded on the 10-mm NS (“No pain” to “Worst pain possible”). The character of pain was indicated (yes/no) using 4 descriptors according to the McGill Pain Questionnaire: constant pain, shooting pain, dull pain, and pain when chewing or biting.Results:Out of 90 patients, males were 40 and females were 50. Pain characters was constant in 30, shooting in 15, mild in 12, when chewing in 8 and none in 25 cases. The difference was significant (P< 0.05). Pain occurred in 52 chronically inflamed teeth and 38 grossly decayed teeth. The difference was significant (P< 0.05).Conclusions:Pain after tooth extraction is common and hence use of analgesics and anti- inflammatory is recommended.
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Varicose veins are a common condition that the current paper elaborates the features of the condition in a local Indian population. This prospective clinical study of surgical management of varicose vein was conducted to study the age, sex and occupational distribution of varicose veins of lower limb. Evaluations of clinical features and surgical methods of treatments that were in practice in the management of varicose veins in terms of recurrence and symptoms improvement were also studied. Methods: Two years prospective study was conducted in our institution from April 2016 to March 2018. During this period 68 cases of varicose veins of lower limbs were admitted to our hospital of which 60 cases were selected and were studies in detail. After thorough clinical examination and relevant investigation they are all subjected to surgical management. Results: Out of 60 cases studied, 31 (62%) had only long saphenous vein involvement, 7 (14%) had short saphenous vein involvement and in 5 (10%) cases both short and long saphenous system were involved. In addition to long saphenous vein involvement, incompetent perforators were present in 17 (34%) cases. Among them prominent veins and pain were the main complain in 38 (78%) patients. Itching and pigmentation were present in 4 (8%) patients. Ankle edema was present in 6 (12%) patients. Pain and ulceration of lower leg were present in 2 (4%) patients. After clinical assessment appropriate surgical procedures were followed for each of patients. These cases were followed for 3 year durations. Out of 60 patients 7 (14%) patients had recurrence of varicose vein. 7 (14%) patient complained of recurrence of pain after 2 years of surgery but no appearance of varicose vein. One patient complained of persistence of pigmentation after surgery. 2 patients complained of persistence of ankle edema and there was complete healing of ulcer which was present earlier. Conclusion: Commonest age group of varicose vein of lower limb was 20 to 40 years. Definite relationship exists between the occupation and the incidence of varicose veins. The patients were in the occupation which required standing for long time had the higher chances of varicose vein. Severity of the symptoms is not proportional to the duration of varicose veins. The involvement of long saphenous vein is more common than the short saphenous vein. Since our study shows very low percentage of recurrence and symptoms related to varicose vein the surgical line of treatment is an ideal treatment for varicose vein. For incompetent perforators, sub-fascial ligation appears to be a better method of treatment than extra fascial ligation. Because in the former all the perforators could be visualized and dealt with, while in the latter there were chances of missing one or two perforators. If cases are selected properly with good operative technique the complications are negligible.
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Introduction: Clinical benign prostatic hyperplasia (BPH)is one of the most common cause of lower urinary tractsymptoms in ageing men. Gold standard for BPH now days,is transurethral resection of the prostate (TURP). Hence; thepresent study was planned to prospectively analyse 500 TURPcases.Material and methods: 500 patients who underwent TURPafter failed medical therapy for BPH or with absoluteindication for TURP were anlayzed. All patients underwentultrasonography for post void residual urine and prostatesize, Serum PSA, DRE and uroflowmetry. Urine routineand culture along with renal function test was done in allpatients. Urodynamic study was done in patients suspectedfor neurogenic bladder. Data in relation to intraoperativeparameters and postoperative follow-up were analysed.Results: In the present study, data of a total of 500 patientswas analysed. Fever, haematuria and clot retention was foundto be present in 20, 25 and 18 patients respectively. Deathoccurred in 1 patient due to cardiac complication. Bloodtransfusion was required in 50 patients. Stricture and bladderneck contracture was seen in 16 and 9 patients respectively asa manifestation of late complication. Incontinence was foundto be present in 1 patients.Conclusion: TURP is one of the best minimally invasivetreatment for BPH. Along with being cost-effective, it isalso associated with significantly shorter hospital stay andminimum morbidity
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Background: HIV continues to be a major global public health issue. In 2014 an estimated 36.9 million people were living with HIV, a global prevalence of 0.8 %. The clinical spectrum of HIV infection encompasses a spectrum ranging from an acute syndrome associated with primary infection to a prolonged symptomatic state to an advanced cardiac disease in HIV affected patients is becoming more prevalent as therapy and longevity improve Infection HIV is one of the causes of acquired heart disease in these patients. With advances in the management of patients living with HIV and AIDS (PLHA), not only survival has increased but manifestations of late stage HIV infection are encountered more often including cardiovascular complications. Aims and Objectives: To determine the prevalence and characteristics of cardiac manifestations in patients with HIV infection and to evaluate their correlation with CD4 count. Methods: During the period of 1 year from July 2015 to September 2016, total 100 cases of HIV/AIDS were included. The occurrence of cardiac involvement in HIV/AIDS cases was determined based on cardiac enzymes, ECG findings & 2D Echocardiography findings. An attempt was made to correlate various cardiac findings with CD4 T cell count. Results: Male to female ratio was 3:1. Common clinical symptoms were fever (68%), cough (44%) & extertional breathlessness (33%) Echocardiographic abnormalities were seen in 54.3% of patients. Reduced ejection fraction (below 50%) and fractional shortening below 30% were the most common cardiac abnormality (46.3%) followed by pericardial effusion (16.66%), pulmonary artery hypertension (11.11%), dilated cardiomyopathy (9.25%), diastolic dysfunction (9.25%), regional wall motion abnormality (1.85%) and valvular regurgitation (5.55%) respectively. Significant statistical positive correlation was observed between low CD4 count and echocardiographic abnormalities (p < 0.001). Pericardial effusion was seen more in patients with CD4 count below 200 (p < 0.05). Maximum number of echocardiographic abnormalities was seen in WHO clinical stage IV. Conclusion: Echocardiographic abnormalities are more prevalent in HIV/AIDS patients and their prevalence increases as the CD4 count falls andoccur more in advanced stage of the disease. So we should aim at starting ART early in HIV infected patients so as to improve the quality of life of people living with HIV/AIDS.
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Background & objectives: Metabolic syndrome (MS) comprises several cardio-metabolic risk factors, which include obesity, hypertension, hyperglycaemia, hypertriglyceridaemia and decreased HDL cholesterol. Leaf extract of Gymnema sylvestre has been shown to possess glucose lowering activity in animal models. This study was carried out to evaluate the efficacy of deacyl gymnemic acid (DAGA), active constituent of G. sylvestre, in a rat model of MS. Methods: Six groups consisting of six wistar rats in each, were studied. Group I received the normal diet, while the remaining five groups received high fructose diet (HFD ) for 20 days to induce MS. HFD was continued in these five groups for the next 20 days along with group II received vehicle solution, group III received pioglitazone and groups IV- VI received DAGA in variable doses. Systolic blood pressure (SBP) was measured using tail-cuff method. Oral glucose tolerance test (OGTT) was done at baseline and at days 20 and 40. Blood samples were collected for glucose, insulin and lipid profile. Results: Administration of HFD for 20 days resulted in weight gain (>10%), increase in SBP, fasting plasma glucose (FPG) and triglycerides fulfilling the criteria for MS. Administration of DAGA (200 mg/kg) reduced SBP and significantly improved the FPG and HOMA-IR (homeostatis model assessment-insulin resistance) with modest improvement in lipid profile without decrease in body weight similar to pioglitazone. Interpretation & conclusions: Our findings show that DAGA decreases SBP and improves parameters of glucose-insulin homeostasis in a rat model of MS induced by HFD. Further studies are required to elucidate the mechanism of action.