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COVID-19 patients commonly present with lower respiratory symptoms with other systemic involvement. Haematological manifestation such as low haemoglobin, thrombocytopenia, lymphocytopenia also common in COVID19 patients. In this study, we investigated prevalence, association with serum ferritin in post COVID-19 anaemic patients, after human umbilical cord blood transfusion in relation to control group. Among 155 COVID-19 RT-PCR positive patients 36 (23%) was anaemic. In our study 18 patients was transfused human umbilical cord blood, 12 patients were treated with haematinics and 6 patients denied taking any of the above. In most cases anaemia was moderate to severe that may be due to inflammation or due to pre-existing iron deficiency.Umbilical cord blood transfusion to post COVID -19 patients for the treatment of anaemia because of the unique composition of UCB. Haematological analysis and serum ferritin estimation reflecting the treatment out come in post COVID-19 anaemic patients. There was a difference between the dependent variable's serum ferritin (p <.001) in anaemic COVID-19 patients. In conclusion, our result highlight serum ferritin is widely used in diagnosis and monitoring of COVID-19 disease.
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Earlier researches have pointed about the accumulation of peroxynitrite modified proteins and their aggregates in the etiopathogenesis of many age-related neurodegenerative and several autoimmune diseases. Human serum albumin (HSA) is present in abundance in plasma and is susceptible to modification by peroxynitrite. In this study, HSA modified with peroxynitrite (nitroxidized-HSA) formed aggregate besides other gross structural changes. Aggregation or assembly of aberrant proteins is responsible for increase in production of reactive species and is often correlated with toxicity in neurodegenerative diseases. However, lack of literature on the cytotoxicity of aggregated nitroxidized-HSA led us to explore its toxicity using human peripheral blood lymphocytes. Elevated protein carbonyl coupled with decreased protein thiol, and release of antioxidant enzymes and lactate dehydrogenase (LDH) were observed upon incubation of lymphocytes with nitroxidized-HSA. Trypan blue exclusion and MTT assays indicated nitroxidized-HSA induced injury/death of lymphocytes. This may be attributed to the observed reactive oxygen species generation during the interaction of nitroxidized-HSA with lymphocytes. Moreover, the analysis of the cellular morphology by dual staining, fluorescence and confocal microscopy further confirms the cytotoxicity of nitroxidized-HSA. Since various age-related degenerative diseases are characterized by deposition of protein aggregates, the demonstrated toxicity of nitroxidized-HSA may be an important driver in the pathophysiology of neurodegenerative diseases.
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The fractures of proximal tibia particularly plateau fractures are more difficult to treat due to complexity of configuration and associated soft tissue injuries. AO 41C fractures are high energy fractures often accompanied by other injuries and complications, such as postoperative inflammation, wound problems and infections. Aim and objectives: functional outcome of intra-artcular proximal tibia fractures (41C) treated with dual plate osteosynthesis. Methods: The study will be conducted over a period of 19 months in department of Orthopaedics, BMCH.All cases attending OPD and emergency >18years of age with intra articular fracture proximal tibia (41C) will be assessed by clinically and radiologically .Clinically assessment will be done by Rasmussen’s score treated with open reduction internal fixation with dual plate osteosynthesis of intra-articular proximal tibia fractures , and those followed up at 2,6,10,14,20,24 weeks for any complications and morbidity. Results: The mean age among patients was 31.38+-11.37 years. The male: female ratio was 2.33.Among 10 patients; 2 had Diabetes Meliteus while 1 had hypertension. Mean duration of surgery from time of injury was 7.89 ±3.98 days. Mean hospital stay in patients was 18.16 ±3.69 days. Mean time for union in patients was 12.18±4.83 weeks. Radiographic results Rasmussen anatomic outcome (immediately postoperatively) was excellent in 6, good in 3, and fair in 1 patients. Conclusion: Dual plate osteosynthesis is the best , effective and simple procedure in treatment of complex inta-articular proximal tibia fractures (41C).
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Globally, the epidemic of obesity in children and young adults is on a constant rise over the past decade. Obesity makes individual highly susceptible to a variety of chronic diseases and their complications. An altered autonomic response in the form of enhanced baseline sympathetic activity, feeble response to sympathetic stimuli and compromised parasympathetic activity is observed in obesity. We have assessed potentially perturbed autonomic responses in young overweight/obese first year medical students. Methods: This cross sectional analytical study was undertaken in the research lab of the Department of Physiology, M.K.C.G. Medical College over a period of 12 months on 300 students (both males and females) to determine sympathetic and parasympathetic responses to stress using hand-grip dynamometer and sinus arrhythmia test respectively. Independent ‘t’ test, Pearson’s correlation coefficient and multiple linear regression analysis in SPSS 20.0 was used to statistically ascertain the differences for the aforementioned parameters between obese and non-obese adults. Results: Weight, Body mass index (BMI), waist hip ratio (WHR), Pulse rate (PR), baseline systolic blood pressure (BSBP) & baseline diastolic blood pressure (BDBP) is significantly greater in obese than in non-obese. BMI shows positive correlation with BSBP & BDBP (r=0.660**; p<0.001 & 640**; p<0.001) and negative correlation with ΔDBP, and E/I Ratio. A negative correlation is appreciated amongst ΔDBP and BMI (R2 = 39.6). A similar negative correlation is again seen between E/I ratio and BMI (R2 = 37.2). Conclusion: Obesity potentially alters autonomic balance with increased sympathetic and reduced parasympathetic tone posing elevated risk of cardiovascular and cerebrovascular accidents.
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Total knee replacement (TKR) is a surgical procedure with predictable outcomes. This observational study intended to review the outcome of total knee replacements performed in osteoarthritis knee patients and evaluate the postoperative clinical, functional and radiological results in the replaced knees and the preoperative and postoperative lower limb alignment correction achieved and the incidence of early complications. Methods: We selected 20 people (20 knees) from the outdoor clinic who gave their informed consent for the study and satisfied our criteria. They were evaluated using the knee society score (KSS), preoperatively and postoperatively at the 6 months follow up and the data was analysed. Results: In our study we observed that the mean knee society score improved from 27.4 to 81 and the mean functional score improved from 30 to 79.3. The knee flexion range increased from 50* to 125*. Postoperatively all the varus knees were aligned except 3 knees. Complication rate was 5%. We found a significant increase in the knee society score after total knee replacement compared to the preoperative scores. Conclusion: We conclude that total knee replacement is a reliable and safe modality of treatment and can be performed with results comparable to the other global studies.
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In recent years, the coamorphous drug delivery system has been established as a promising formulation approach for delivering poorly water-soluble drugs. The coamorphous solid is a single-phase system containing an active pharmaceutical ingredient (API) and other low molecular weight molecules that might be pharmacologically relevant APIs or excipients. These formulations exhibit considerable advantages over neat crystalline or amorphous material, including improved physical stability, dissolution profiles, and potentially enhanced therapeutic efficacy. This review provides a comprehensive overview of coamorphous drug delivery systems from the perspectives of preparation, physicochemical characteristics, physical stability, and performance. Furthermore, the challenges and strategies in developing robust coamorphous drug products of high quality and performance are briefly discussed.
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Background: Osteonecrosis of the femoral head is one of the common causes of painful hip in more than 50yrs of age. At this age is associated with high functional demand. Osteonecrosis may have a devastating effect on the quality of life. The natural course of this disease is one of relentless progression with eventual collapse of the femoral head followed by secondary osteoarthritic changes in the hip. The management depends upon many factors including severity and location of necrotic lesion, patient factors and probability of collapse. Total hip replacement (THR) is needed in cases of collapse of femoral head, severe pain, osteoarthritis or destruction of hip joint. Moreover the factors like functional outcome after surgery implant longevity and need for revision surgeries must be considered while doing cemented total hip arthroplasty. In this context we conducted this prospective observational study to find out the clinical and functional outcomes of cemented THR in patients with of osteonecrosis of femoral head. Methods: The treatment period were january 2017 to june 2018 and sample size 20.we did our cemented total hip replacement through posterior approach (moore ) of hip and follow up was done at 4 ,6, 8 weeks and thereafter every 3 months. pre and post operative radiological and functional outcome has been compared. Results: In this study 18 patients (90%) had excellent results while 1 (5%) had good functional outcome and 1(5%) had poor outcome after cemented total hip replacement in osteonecrosis of femoral head. Conclusion: The mean HHS and number of patients with good to excellent result in our study..
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Background: Ten (10) cases of old fracture neck femur were treated by internal fixation and posterior muscle pedicle bone grafting of quadratus femoris and quadrate tubercle bone block. Methods: The treatment periodwere from January 2017 - June 2018 (approx18 months) at Burdwan Medical College Hospital. We did this procedure by open reduction and internal fixation by cannulated hip screws and muscle pedicle bone grafting. Follow up period was 1 to 1.5 years (average 14 months). Results: Evaluation parameter were union, non union collapse of neck, osteonecrosis of femoral head, pain, range of movement and functional activities and over all satisfaction of patient. The results of fracture healing rate was good (7), fair (2) and poor (1). The technique is simple, rewarding and easy access of fixation and muscle pedicle bone grafting. Conclusion: Bone graft was placed by making a gutter at fracture site and maintained by a screw or prolin suture.
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Objective: To quantify the increase in workload associated with multidisciplinary team meetings for radiologists in a tertiary care hospital over a period of 15 months
Methods: Data was collected prospectively regarding number of multidisciplinary team meetings, number of clinical cases discussed, number of individual imaging studies reviewed, and preparation time of residents, senior registrar and consultants and the delivery time of meeting
Results: Total 223 meetings were held over 15 months [April 2014 to June 2015] for 12 clinical specialty areas. There were 1120 clinical case discussions and a total of 2759 documented individual imaging studies reviewed. Resident's preparation time was 74.6 hours/month, senior registrar's preparation time was 47.93 hours/month, consultant's preparation time was 18.67 hours/month and the total duration time for meetings was 18 hours/month
Conclusion: Multidisciplinary team meetings now represent a significant workload of radiology and has reduced the time for other academic activities within the department
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Background: Prehypertension exhibits approximately 62% of cardiovascular disease and 49% of ischemic heart disease (IHD) global morbidity burden. Heart Rate Variability (HRV) is a fundamental noninvasive technique to assess the autonomic influence on cardiovascular system using time domain and frequency domain methods. We explored the effects of family history of hypertension, prehypertension and hypertension on autonomic functions amongst natives of Uttarakhand region. Methodology: This cross sectional analytical study was designed to explore effects of family history of hypertension, pre-hypertension and hypertension on autonomic functions on 100 subjects divided in four groups using HRV analysis. Results: Autonomic function Analysis of our results showed an increased sympathetic activity among family history of hypertension, pre-hypertension and hypertension as evident by a significant increase in Low frequency normalized unit (LFnu), an increased LF/HF ratio and a significantly reduced High frequency Normalized unit (HFnu) and E/I ratio (p<0.05). Conclusion: Thus, altered cardiac autonomic functions are one of the early manifestations of raised blood pressure and can potentially be used in predicting hypertension at an early stage.
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Background: Knowledge of the normal and variant anatomy and anomalies of coronary circulation is an increasingly vital component in the management of congenital and acquired heart disease. Anatomical variations in relation to coronary artery and its branches will help cardiac surgeons for refining imaging techniques and coronary artery bypass grafting. The current study is aimed at understanding the normal patterns of coronary arteries with reference to its predominance, branching pattern, variations and anomalies. Methods: Heart specimen for this study were obtained from Department of Anatomy, SIMS Hapur and GFIMSR Ballabhgarh. The cadaveric human hearts were dissected to observe the coronary arteries and its branches. Results: The diameter of right and left coronary orifices were measured. The distance of the orifices from the supravalvular ridge was also measured. The length and the diameter of the coronary arteries and its branches were measured and statistical significance was determined. Conclusion: The present study revealed that, ostium diameter of left coronary artery is larger than the right coronary artery. The outer diameter of the left coronary artery is larger than the right coronary artery. The mean lumen circumference of left coronary artery, anterior interventricular artery, right coronary artery and circumflex artery is more in males as compared to female. This knowledge is important for interpretation of the coronary angiography and surgical myocardial revascularization and paramount to cardiac surgeons for proper diagnosis and treatment of cardiac ailments and radiologists to refine image interpretation.
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Background: Comparative histology not only provides information regarding tissues of different mammals but also gives insight to understand human features in the background of informations on tissue of lower mammals. Methods: Splenic tissues from five mammals i.e., human, buffalo, goat, rabbit and rat were processed for histomorphometric study on capsule, trabeculae, lymphoid follicle and central arteriole. Result: Buffalo was one mammal having highest values for all the parameters while rat having lowest. Values in human splenic tissues are in between aforementioned maximum and minimum readings. Conclusion: Teaching materials are available in histology labs from lower mammals in medical colleges might give an insight for understanding human tissues if literature on comparative histology is made available.
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Pre-hypertensives are at increased risk for rise in blood pressure and cardio vascular morbidities. Autonomic dysfunction is both a cause and effect of high blood pressure. Considering its serious prognosis the current study was undertaken with an aim to assess autonomic functions in pre-hypertensive young adult males. Male volunteers of 20-40 years were divided into normotensives (n=44) and clinically healthy pre-hypertensives (n=44). They were subjected to anthropometric measurements, Heart Rate variability (HRV) analysis along with Standard Isometric Handgrip Test (HGT) and Sinus arrhythmia test. Analysis showed a significant increase in sympathetic activity among prehypertensives characterized by lower rise in DBP (mmHg) in response to HGT: [11.27±3.76 mmHg vs 23.95±6.29 mmHg, (p<0.05)]. Parasympathetic activity was significantly decreased among prehypertensives (HFnu: 30.02±14.43 vs 41.62±14.91, p<0.05); E/I ratio: 1.20±0.10 vs 1.32±0.10, p<0.05). Sympathovagal balance showed prominent sympathetic activity (2.85±1.78 vs 1.75±0.98; (p<0.01) among prehypertensives. Salt intake among prehypertensives was significantly higher than normotensives (21.2±1.2 gm/day vs 9.0±0.5 gm/day: P<0.001). Conclusion: Autonomic dysfunction is evident in prehypertensives with an enhanced sympathetic activity, decreased parasympathetic activity and an altered sympathovagal balance in prehypertensives, salt intake was found on a higher side. Thus lifestyle changes in the form of balanced diet and moderate exercise may be advised to attenuate the risk progression of prehypertension to hypertension.
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Background: Stroke is a disease, which has a complex multi-factorial etiology. Non-modifiable risk factors are genetics, familial history, age, sex, ethnicity and race, whereas smoking, drinking, physical activity and diet can be modified to reduce the risk of stroke significantly. Aims: The aim of the present study was to see the association between climate variations and incidence of stroke in Scotland. Methods: We have obtained the stroke data as SMR01 (Scottish Morbidity Record 01) as 1,57,639 incident stroke hospitalization in Scotland between 1986 and 2005. To observe for variation in weather parameter, with first stroke incidences per day, daily mean temperature, total rainfall and average daily atmospheric pressure were compared with the frequency of incident strokes per day using ANOVA (Analysis of Variance). Result: An overall meteorological analysis of incident strokes per day reveals an inverse statistically significant relationship for average daily temperature (P<0.001) whereas total daily rainfall (P=0.03) and average daily atmospheric pressure (P=0.05) exhibit borderline significance. Correlation of low temperature with stroke might be due to the concurrent occurrence of respiratory infections. We suggest some precautionary measures to minimize the chance of stroke i.e. protection from cold weather, decrease alcohol consumption and maintaining blood pressure within a safe range during winter season. Conclusion: Overall, high stroke incidence during winter season is a combined effect of temperature, rainfall, atmospheric pressure.
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Background: Neuropathy is one of the most common complications affecting individuals with diabetes mellitus. The best evidence indicates that the etiology of neuropathy is multifactorial and is a key area of current research. Hence, this study was undertaken to test the hypothesis of alteration in MNCV (motor nerve conduction velocity) of nerves before the actual manifestation of neuropathy in type II diabetic patients and also to analyze the effect of smoking on MNCV in diabetic subjects. Methods: In the present study, 120 diagnosed diabetics were taken as cases while 30 non diabetic healthy subjects were taken as controls. Case group was divided into diabetic non-smokers and diabetic smokers. Diabetic smokers were further subdivided into light, moderate and heavy smokers, according to smoking index. After detailed history and physical examination MNCV of median and ulnar nerve in upper limb and common peroneal nerve in lower limb was performed. Result: The MNCV of median and ulnar nerves in upper limb showed no significant bilateral decreased in diabetic non-smokers and subgroup of diabetic smokers when compared with control. However, there was a significant bilateral decrease in MNCV of common peroneal nerves in the lower limb of diabetic heavy smokers when compared with control. A negative, but statistically non-significant correlation was found between MNCV and smoking index. The decrease in MNCV was dependent on smoking index by 3%, 1%, 1%, 1%, 3% and 1% in median nerve (right), median nerve (left), ulnar nerve (right), ulnar nerve (left), common peroneal nerve (right) and common peroneal nerve (left) respectively. Conclusion: The present study indicates that MNCV is more resistant to hyperglycemia induced local metabolic and microvascular changes. However, the coalition of diabetes and smoking can augment their effects many folds and can lead to motor neuropathy, reiterating the fact that smoking itself is an independent risk factor for diabetic neuropathy.
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Background: In the recent years, increase in the incidence of Diabetes Mellitus in developing countries has been associated with complications resulting in mortality and morbidity. This research determined the Lipid profile abnormalities in diabetes mellitus which is one of the leading cause of complications of diabetes mellitus. The incidence of type 2 diabetes mellitus (Type 2 DM) with altered lipid profile in one of the main causes of cardiovascular disease. Methods: 100 diabetic and 100 non diabetic patients enrolled in our hospital were included in the study. Biochemical tests for blood sugar levels, glycated hemoglobin, Total cholesterol, triglycerides, LDL, VLDL and HDL were performed. Results: The high levels of Total cholesterol, TGL and LDL were seen more among females than in males. Elevated levels of lipids were seen more among the diabetics than normal controls. Conclusion: Since high lipids with diabetes is a very dangerous combination, people should be educated properly towards the risk of this so that proper action can be taken maintain normal lipid levels.
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Background: Prolonged use of methotrexate in juvenile arthritis and multisystem involvement due to its toxicity prompted us to find out detailed histo-morphometric study after exposure to drug. The concern became alarming because of reported gonadal damage due its direct effect on fertility. Methods: Methotrexate was injected in both male and female rats (1mg/kg, intraperitoneally), weekly for 6 weeks. Thin sections of testis and ovary of both control and experimental groups were stained with H/E stains for light microscopic examination. Results: Histomorphometric observations on seminiferous tubules included, external diameter, thickness of the wall and the diameter of the lumen. Such observations for ovarian tissue included diameters of ovarian follicles and their ova. Highly significant changes in both testicular and ovarian microscopic parameters confirmed the damage of tissue in experimental groups. Conclusion: The study suggests that utmost precaution should be taken while using methotrexate in younger patients.
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Background: Density of bone is directly affected by mineralization, which makes visualization by ultrasonography possible to follow foetal growth from early gestation to term. Clavicle being the first bone to ossify and the only bone to transmit upper limb weight to the axial skeleton, receives special attention by the scientists. Methods: Forty-nine foetal clavicles were divided into five groups. Statistically densities of the clavicles were measured and values between groups were compared. Results: Density was constant in all the groups and both in males and females. Conclusion: It was concluded that matrix formation in clavicles keeps pace with their mineralization during 2nd and 3rd trimesters.