Observational Study on Thyroid Function Status in Patients attending a Tertiary Care Hospital

Thyroid disorders constitute the commonest endocrine abnormality. 42 million people in India are suffering from thyroid disorders. Methods: The present hospital-based study was conducted upon 136 patients reporting to OPD of VIMS, Pawapuri to evaluate their thyroid function status. Detailed history was taken along with blood sample collection after overnight fast for estimation of thyroid hormones. Results: Majority of the patients belonged to the age group of 20-40 years (47.8%). Male: female ratio was 3.69. 71.3% of the patients were euthyroid. 19.8% patients were hypothyroid of which 13.2% were clinically euthyroid, 3.7% suffered from subclinical hypothyroidism and 2.9% had primary hypothyroidism. 9.4% were hyperthyroid of which 5.1% had central hyperthyroidism, 2.9% suffered from primary hyperthyroidism, and 0.7% each had subclinical hyperthyroidism and T3 thyrotoxicosis. Conclusion: Hypothyroidism is alarmingly high in this region with higher prevalence in women.

Assessment of menstrual hygiene management practices and associated socio-cultural restrictions among adolescent school girls in a rural area of North India

Background: There is inadequate information on menstrual hygiene management practices and socio-cultural restrictions among adolescent girls in developing countries. The objective of the present study was to assess the menstrual hygiene management practices and associated socio-cultural restrictions among adolescent school girls.Methods: This descriptive cross-sectional study was carried out among adolescent school girls 10 to 19 years of age, who had attained menarche, in a rural area of district Barabanki. Total 640 adolescent girls were included in the study, and information was recorded on a predesigned and pretested interview schedule. Relevant statistical analysis was done and significant associations were found.Results: 60.5% of the girls were using sanitary pads, and 71.4% took bath during their periods. 41.3% of the girls used to change pads during schools. Unsatisfactory menstrual hygiene management practices were significantly high among girls who were from lower socioeconomic class (p<0.001) and had illiterate mothers (p<0.001). 82.8% of the girls faced religious restriction.Conclusions: Significant associations were found between menstrual hygiene management practices of adolescent school girls with their mother’s education level and socio economic status. A proper menstrual hygiene management practice is very important for every young girl to lead a healthy life and should be achieved at the beginning of their menarche by enhanced information education and communication (IEC) programmes.

A study of efficacy of phage amplification technique in diagnosis of pulmonary and extra-pulmonary tuberculosis

Background: Tuberculosis (TB) is a leading infectious disease in India. Diagnosis of TB has always been a problem due to slow rate of growth of Mycobacterium tuberculosis. In this study, author had compared the conventional tools for diagnosis of TB with the new Fast Plaque TBTM.Methods: The study was conducted at Dr. ML Chest Hospital, Department of Tuberculosis and Respiratory Diseases, G.S.V.M. Medical College, Kanpur. Specimens were collected after taking informed consent from patients attending outpatient and indoor patients admitted in the hospital. Study consisted of cases having suspected tuberculous exudation both pulmonary and extra pulmonary.Results: Most of the patients in this study were between 21-40years of age. Most of them were male (78%). Most of the patients came from urban areas and middle socioeconomic strata. Among them 68% were smokers and 32% were non-smokers. Comparison of phage assay with clinical evidence of disease has been done and results were sensitivity 85.7%, specificity 100%, PPV 100%, NPV 84.6% found.Conclusions: Delay in diagnosis resulting in further delay to initiate drug therapy. In these circumstances the rapid detection of mycobacteria by phage amplification technique could lead to earlier institution of antitubercular treatment.

A Comparative Study On Post-Operative Analgesia With Clonidine And Dexmedetomidine As An Adjuvant To Ropivacaine Under Ultrasound Guided Fascia Iliaca Compartment Block In Patients Scheduled For Hip And Femur Surgeries: A Randomized, Double Blind, Control Trial

Background: Fascia iliaca is one of the most commonly performed and safest block. Local anaesthetic diffuses under the fascia ilIiaca to block femoral nerve, lateral cutaneous femoral nerve, and obturator nerves. Clonidine, α2-adrenergic receptor agonist, has potent central and peripheral antinociceptive properties. Dexmedetomidine, is a potent α2-adrenoceptor agonist with dose dependent α2 receptor sensitivity. Receptors for α2 are found in the peripheral and central nervous system, platelets, and a variety of organs, such as the liver, pancreas, kidney, and eye. It exhibited dose dependent protection against brain matter loss in vivo and improved the neurologic functional deficit induced by the hypoxic ischemic insult. Aim: To compare clonidine and dexmedetomidine as an adjuvant to ropivacaine under ultrasound guided fascia iliaca for post-operative analgesia scheduled for hip and femur surgeries under subarachnoid block. Methods: It was a Randomized controlled trial study. The patients were allocated one of the three groups which are group R (n=30), Control group – 40 ml of 0.25% Ropivacaine in fascia iliaca compartment block, group RC (n=30) Clonidine group– 40ml of 0.25% Ropivacaine+ 0.5μg/kg Clonidine in fascia iliaca compartment block and group RD (n=30) Dexmedetomidine group – 40ml of 0.25% Ropivacaine + 0.5μg/kg Dexmedetomidine in fascia iliaca block by random number chart. 90 patients of both sexes in the age group of 20-60 years were taken in the study. This study was conducted in the department of Anesthesiology, Dr. R.P.G.M.C, Tanda at Kangra, Himachal Pradesh. Results: Time to first rescue analgesia was maximum in RD group as compared to RC group followed by R group and it was statistically significant amongst groups. Mean of total number of rescue analgesic i.e. inj. diclofenac required was 2.60 ± 0.50 (dose) in R group as compared to 1.50 ± 0.51 in RC group and 1.03 ± 0.18 in (RD) group. There was statistically significant difference in need for analgesia amongst R, RC and RD groups (P<.001). Conclusion: It is recommended that dexmedetomidine in a dose of 0.5μgm/kg can be used as an adjunct to ropivacaine (less cardio toxic) under ultrasound guided fascia iliaca compartment block, for better postoperative pain relief and prolonged duration of postoperative analgesia. It reduces the postoperative rescue analgesic requirement with arousable sedation and without any adverse effect.

Exposure to Passive Smoke among Residents of a Rural Population in a District of Northern India

Background: Exposure to environmental tobacco smoke (ETS) is associated with considerable morbidity and mortalityassociated with non communicable diseases like lung cancers, asthma, respiratory infection etc. Therefore the present study was conducted to study the exposure of passive smoke among residents (non smokers) in a rural population of Barabanki district, Uttar Pradesh. Methods: A community based cross-sectional study was conducted among 1346 adults non smokers aged 25 years and above residing in rural areas. Multistage random sampling was done. Equal number of study subjects were enrolled from six randomly selected villages of Satrikh block in Barabanki district. A pre-designed questionnaire was used for collecting data regarding socio-demographic characteristics and passive exposure to tobacco smoke in home and work places. Results: About 33.1% of study participants at home and 28.4% at workplaces were exposed passively to tobacco smoke. The association between exposure to passive smoke both at home and workplace was found to be significantly associated with younger age group, other backward caste category, educational status and low socioeconomic status (p<0.05). The exposure at workplace was significantly found to be more among males and those who were laborer/ agriculture worker or shopkeeper by occupation (p<0.05). Conclusions: Exposure of passive smoke among adult non-smoker population was found to be quite common both at home and workplaces. This emphasized the importance of need based specific interventions to reduce the risk of exposure and forthcoming smoking related morbidities and mortalities due to passive smoke inhalation.

Drug utilization study and prescribing patterns in psychiatry patients at a tertiary care hospital

Background: The Drug utilization research (DUR) compares drug use between different countries and regions and is used to assess the rationality of prescribing pattern of the drug therapy. With this background we decided to evaluate antipsychotic drugs prescribing pattern in the psychiatric patients in a tertiary care hospital.Methods: The study was carried out at Department of Psychiatry, DSMCH. It was open label, cross - sectional, prescribed Documents based study. Duration of the study was one month (May-2017). Out-Patient number, age, sex, diagnosis, prescribed generic name, brand name, dose, route of administration, duration of therapy obtained from the Prescription register of Out - Patient Department of the Psychiatry.Results: The clinical experiences of the Psychiatrist I, II and III were 17 years, 35 years and 10 years respectively. The Psychiatrist I, II and III prescribed treatment for 36 (31.9%), 61 (54%) and 16 (14.2%) patients respectively. Among overall (n=113) patients (average age 38.9 years), male n=56 (49.6%) and female=57 (50.4%) were treated by all the three psychiatrists. The percentage of prescription of various drugs used were: Escitalopram (15.7%), Clonazepam (14.6%), Sertraline (8.7%), Risperidone (7.5%), Propranolol (6.7%), Olanzapine (6.3%), Quetiapine (5.9%), Trihexyphenidyl (5.5%), Amitriptyline (5.1%) and Other prescribed drugs, were between (0.4 to 2.8%).Conclusions: From this study, it can conclude that rational usage of drugs were followed in this study. All three prescribers (Psychiatrist I, II, and III) prescriptions were found to be rationale.

Estimation of Serum Potassium in Patients Undergoing Laparoscopic Cholecystectomy.

Background: The cardiovascular implications due to CO2 insufflation during laparoscopic surgeries have been a subject of research. Animal studies have reported life threatening increase in serum potassium levels during rise in intra-abdominal pressure. Methods: Induction of 30 patients undergoing laproscopic cholecystectomy was done by giving Thiopentone sodium 5 mg/kg and orotracheal intubation was facilitated by 0.1 mg/kg of vecuronium bromide. Blood samples for potassium were taken at pre-induction, pre insufflation, every 20 minutes during insufflations, immediate post exsufflation and immediately after extubation. Results: Serum potassium increased significantly (p<0.01) after insufflation of carbon dioxide (pre-induction 3.9 ± 0.3 vs. 4.5 ± 0.3 at 40 minutes of insufflation). The haemodynamics i.e blood pressure and pulse rate remained fairly (p>0.05) throughout the study period. Conclusion: Based on the findings of this study, we recommend that monitoring of serum potassium should be done in patients undergoing laparoscopic procedures of prolonged duration.

Perception of sex workers of Lucknow City, Uttar Pradesh, India towards sexually transmitted infections.

The prevention, control, and management of sexually transmitted infections/reproductive tract infection (STI/RTI) are well-recognized cost-effective strategies for controlling the spread of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). A cross-sectional descriptive study was done over a period of 1 year to assess the prevalence of STI, knowledge level about STI, and the STI-HIV link among the female sex workers (FSWs) of Lucknow city, Uttar Pradesh, India along with their biosocial characteristics. Most of the FSWs were illiterate, married, Hindus, and belonged to general category. The prevalence rates of STI among street-based and home-based FSWs were 50.6% and 29.8%, respectively. Knowledge about the role of condom in prevention of STI and the STI-HIV link was significantly less among home-based FSWs than those who are street-based. There is a great lack in the awareness among FSWs regarding STI and their prevention. Behavior change communication (BCC) and advocacy strategy were developed, especially for the home-based group, to strengthen their knowledge regarding the STI-HIV link.

Study on role of rural health training centre (RHTC) as a supporting component to a primary health care system for NRHM programme in district Muzaffarnagar (UP).

Background: The role of RHTC set up under MCI requirement of medical colleges is rising in implementation of NRHM phase 2 programme (2012 onwards); as private medical colleges are expanding in India and they can be an important supporter in public-private partnership for national health programmes. Objective of current study was to assess the role of rural health training centre as a supporting component to a primary health care system for NRHM programme. Methods: The present study was carried out by comparative evaluation of the rural health and training centre of a private medical college with a sub-centre (Muzaffarnagar) on key RCH services of NRHM: a) Family planning materials distribution, b) ANC services and c) Immunization services. Inclusion criteria: Proper ethical approval from both primary health care system and private medical college authorities were obtained for the study. Study design: Prospective evaluation based study on ANM in SC & SN in RHTC in NRHM programme for 1 year duration from 1st January 2013 to 31st December 2013. Data analysis: The statistical data was analysed by Epi-info version 7.1.3. Results: The ANC services, family planning services and immunization services delivered under NRHM programme was found to statistically significantly contributed (P <0.05) by SN of RHTC as compared to ANM of SC in area of Bilaspur, Muzaffarnagar (Uttar Pradesh). Conclusion: RHTC of a private medical college in Muzaffarnagar (UP) is significantly contributing and supporting in RCH services of NRHM programme for primary health care system. RHTC of medical colleges can be an asset for public private partnership in NRHM programme.

Microbiological Evaluation of Soy Fortified Shrikhand by Using Response Surface Methodology.

Soy fortified shrikhand samples were prepared with various levels of soymilk, cane sugar and yoghurt culture (Lactobacillus delbrueckii subsp. bulgaricus and Streptococcus thermophilus in the ratio of 1:1) examined for selective enumeration of health beneficial microorganisms. The present investigation was carried out to optimize the process for manufacturing of soy fortified shrikhand by its response with employing the 3-factor Central Composite Rotatable Design (CCRD). The formulated soy fortified shrikhand with 45.0% soymilk, 30.0% cane sugar and 3.0% yoghurt culture was found highly suitable (P<0.05) for obtaining the maximum viable count of Lactobacillus delbrueckii subsp. bulgaricus and Streptococcus thermophilus whereas the desirability index was 0.985.

Study of rural health centre services utilization by adolescents in district Muzaffarnagar (Uttar Pradesh-India).

Background: Currently adolescents mortality and morbidity in rural areas is featured by many causes such as communicable as well as non-communicable diseases apart from accidents, suicides etc which lead to illness or premature death later in their life and their usage of rural health centre services is also emerging to be a new issue. That’s why it is important to study this area critically. Aims & Objective: To study the rural health centre services utilization by adolescents. Materials and Methods: This was prospective study carried out from 1st January 2013 to 31st December 2013. The study was carried out at the rural health and training center (RHTC), Bilaspur of Muzaffarnagar Medical College, Muzaffarnagar (UP) which covers 6 villages. All adolescents attending OPD in year 2013 according to the WHO defined criteria of adolescents (10-19 years) and who gave consent were included and enrolled in this study. Adolescents who did not attend OPD and those who did not give consent for participation in study at RHTC Bilaspur were excluded. Results: The study found that the majority of female patients utilized OPD services of RHTC (53.3%) but main health care service utilized among adolescents was Medical Problem (20.5%) whereas Obstetrical & Gynaecology problems were least (13.8%). Among the other services; most common utilized were dressing for injuries (11.3%) and least utilized were, immunization services (0.8%). Conclusion: The usage of health services utilization of RHTC suggests that there are emerging problems in different health specialties among adolescents, so this area needs further research in future studies.

Karyotypic findings in chronic myeloid leukemia cases undergoing treatment.

BACKGROUND: Chronic myeloid leukemia (CML) is a clonal myeloproliferative expansion of primitive hematopoietic progenitor cells. MATERIALS AND METHODS: In the present study, CML samples were collected from various hospitals in Amritsar, Jalandhar and Ludhiana. RESULTS: Chromosomal alterations seen in peripheral blood lymphocytes of these treated and untreated cases of CML were satellite associations, double minutes, random loss, gain of C group chromosomes and presence of marker chromosome. No aberrations were observed in control samples. Karyotypic abnormalities have also been noted in the Ph-negative cells of some patients in disease remission. CONCLUSION: This is a novel phenomenon whose prognostic implications require thorough and systematic evaluation.

Client satisfaction with immunization services in urban slums of Lucknow District.

Objective. To assess the satisfaction of parents with the immunization services and its association with their sociodemographic characteristics. Methods. The study was a part of the coverage evaluation survey conducted using the WHO 30 cluster sampling methodology in the Urban slums of Lucknow district, north India. Analysis for a total of 388 respondents of completely or partially immunized children, was done to assess the level of satisfaction and its determinants. Results.The overall satisfaction was more than 90% in the respondents of both the categories of the children, however the difference between the satisfaction rates was found to be significant. Also the satisfaction with accessibility (p<0.04) and information given by the health worker (p<0.00) differed significantly between completely and partially immunized. Most of the sociodemographic factors were not found to have a significant association with the satisfaction related to different parameters of the immunization services. Conclusion. The dissatisfaction regarding the various aspects of immunization services emphasizes the imperative need to intervene, for the achieving the goal of universal immunization.

Pyknodysostosis: visceral manifestations and simian crease.

Pyknodysostosis is a rare autosomal recessive osteosclerosing skeletal disorder caused by mutations in the CTSK gene situated at 1q21 that codes for cathepsin K - a lysosomal cysteine protease. Mutations in this gene affect the metabolism of skeletal system. This causes problems in bone resorption and remodelling and craniofacial abnormalities. In this article we report a case of 12 year old female from Punjab with pyknodysostosis having hepatosplenomegaly and simian crease.

Sex determination from pulpal tissue.

It is a well known fact that the sex can be determined from the pulp tissue in living as well as dead, but up to what postmortem interval it can be determined accurately is still a matter of controversy amongst different authors. An attempt has been made in this regard, keeping in view the effect of environment i.e. Role of temperature and humidity on pulp tissue after the extraction of teeth.