RESUMEN
A 63 years old male patient was admitted with complaints of acute pain in abdomen and nausea since 1 day. He had no history of chest pain, palpitations, shortness of breath, orthopnoea, paroxysmal nocturnal dyspnoea. There was no history of constipation or obstipation, vomiting’s, haematuria, or oliguria. Patient had a past history of systemic hypertension, diabetes, IHD since last 8 years. He was non-smoker, non-alcoholic. On examination, he was mesomorphic, febrile, had pulse rate of 146 bpm, irregularly irregular, his blood pressure was 134 / 86 mmHg. He had bilateral pitting oedema feet and on abdominal examination, there was diffuse tenderness in all the quadrants of abdomen. Guarding or rigidity over the abdomen was absent.ECG was suggestive of atrial fibrillation with fast ventricular rate as shown in figure 1. Haemoglobin 12.8 gm per dL, WBC - 24,900 cells / cumm, CKMB - 6, Troponin I was negative, serum cholesterol - 95 mg / dL, serum triglycerides - 91 mg / dL, LDL - 63 mg / dL, VLDL - 18 mg / dL, HDL - 14 mg / dL, serum LDH - 382 U / L, CRP - raised, D - dimer was positive, CHA2DS2 - VASC score was 4 and HAS - BLED score was 3. In view of persistent acute pain in abdomen, he underwent CECT abdomen which was suggestive of hepatosplenomegaly with hyper dense liver with multiple splenic and renal infarcts as shown in figure 2. 2D ECHO findings were dilated cardiomyopathy with congestive cardiac failure (ischemic) with 40 % left ventricular ejection fraction. He underwent coronary angiography, which revealed ischemic heart disease.
RESUMEN
Background: Dental caries is one of the most common chronic diseases of early childhood. Dental problems in early childhood have been shown to be predictive of future dental problems, growth and development by interfering with comfort, nutrition, concentration, and school participation. Aim: To find out the prevalence of Early childhood caries (ECC) among the children attending the Anganwadis of Wardha district, to determine the feeding habits and their relationship to early childhood caries. Materials and Methods: Community-based cross-sectional study among the selected Anganwadis children of 2-5 years of Wardha district. Result: A total 330 subjects, 105 children were found to be having ECC, 47 (30.92%) males and 58 (32.58%) females. Total 215 children belonged to 43-60 months age group. Out of these, 72 (33.48%) children were having ECC. A significant association was found between the history of bottle-feeding and ECC (P = 0.0218). Prevalence of ECC was more among those who were bottle-fed than those who were not bottle-fed. Conclusion: Future health promotion and education programs in Anganwadis should include oral health issues and the risk factors for ECC, and its consequences should be addressed. Public-funded oral health program should be started and targeted at children from lower socioeconomic status. Effective strategies should be developed to promote use of brush and paste for cleaning teeth and discouraging inappropriate bottle-feeding, discouraging on demand consumption of chocolates and sugars.
RESUMEN
Background :Antenatal care is essential to reduce morbidity and mortality among newborn babies and pregnant women. Aims: To study the pattern of utilization of antenatal services and to find out the potential predictors, their distributions and their association with antenatal care utilization and pregnancy outcomes. Settings and Design :A prospective longitudinal study was conducted in Deoli, a rural teaching area of a medical college of Wardha district, Maharashtra state. Materials and Methods : Medical social workers contacted all the registered 305 pregnant women in 1 month. A total of 274 women were included in the study. The response rate was 89.83%. Statistical Analysis Used : Percentages, rate ratio. Results : Mean age at marriage was 19.8±3.6 years, and the average age at first pregnancy was 21.6± 4.5 years. Of the 274 pregnant women, 156 (56.9%) were pregnant for the first time (gravida 1), and the remaining 118 (43.1%) pregnant women, gravida 2 and above, had an average of 2.1 living sons and 1.9 living daughters. Only 92 (33.6%) women had undergone the minimum recommended antenatal checkup during their current pregnancy, and 188 (68.6%) women had institutional deliveries. A large proportion of women in Deoli do not receive proper health care during pregnancy and childbirth. Conclusion : In Deoli, antenatal services, in spite of being essential to the care of pregnant women, are being poorly delivered.