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Myocardial infarction (MI) is characterized by plaque formation in the inner layer of arteries which occurs due to insufficient or complete cessation of oxygen supply in the myocardium. The common symptoms of MI are crushing or squeezing chest pain which radiates to the arms, shoulders, neck, or jaw, nausea, anxiety, restlessness, fear, heartburn, shortness of breath, cold sweat, fatigue, and dizziness. The treatment of this medical condition includes antiplatelet and thrombolytic therapy, painkillers (morphine or meperidine), diuretics and digitalis glycosides drugs. Moreover, nitroglycerin and antihypertensive drugs such as Beta-blockers, ACE inhibitors, or Calcium channel blockers may also be administered to reduce the blood pressure and improve the oxygen supply in the heart. Among them, beta blocker therapy has several beneficial properties such as it reduces myocardial oxygen demand, preventing arrhythmias, and improves ventricular remodeling, etc. However, there is no study on the role of only beta blocker therapy in the survival of MI patent is found to date. Thus, the present study focused on the evidence-based validation of Beta blocker therapy in the treatment and survival of MI patients. The retrospective study was conducted on 51 MI patients under the observation of medical practitioners. 100% of patients with MI showed a good recovery as well as survival percentage with Beta blocker therapy. This study finally concluded that beta blocker therapy is a safe and effective treatment for MI patients with negligible life-threatening medical conditions. Furthermore, a large group study is suggested with a number of health-related parameters for a better understanding of beta blocker as a first line of treatment for MI patients.
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Background: Alcohol-related chronic liver disease (ALD) and its complications are major causes of morbidity and mortality. Predisposing factors for ALD include the amount, type, duration of alcohol consumption, patient’s genetic predisposition, race, sex, and other comorbid conditions. Aims: To study the dose, duration, and type of alcohol consumption in ALD and the effect of these parameters on severity and outcome Methods: This was a prospective study conducted at the Department of Gastroenterology, SMS hospital, Jaipur, between December 2017 to December 2018. All patients with alcoholic liver disease admitted in the department were consecutively enrolled. Data relating to dose, duration, type, alcohol intake pattern, biochemical, ultrasonographic, and clinical parameters were analysed. Results: One hundred ten patients (age 43.5±9.9, all-male) were studied. Mean alcohol consumption was 130.47±35.37gm/day. Sixty-three (57.3%) patients consumed <120gm, 25(22.7%) between 120-239gm, while 22(20%) patients consumed =240gm of alcohol per day. The mean duration of alcohol consumption was 15.89±6.57 years. Fifty-nine (53.63%) patients consumed country-made spirit, 25 (22.72%) branded spirit, 23 (20.91%) mixed or variable type, while three (2.73%) patients consumed only wine. The occurrence of hepatic encephalopathy (HE) was significantly associated with dose (p <0.001) and type (p <0.001) of alcohol consumption. MELD Na score significantly correlated (r=0.48, p <0.001) with dose of alcohol. Conclusion: Our study found a dose-dependent relationship of alcohol intake with hepatic encephalopathy and MELD-Na score. The incidence of ALD did not change with the type of alcohol consumed. Low lymphocyte counts were significantly associated with dose and duration of alcohol intake.
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Introduction: Eye diseases incidence and prevalence varieswith the social and environmental factors. Present researchaimed to study the prevalence of various common eye diseasesat a Tertiary Care United Nations hospital.Material and methods: It is a retrospective study of all newpatients attending the eye OPD of a tertiary care UN hospitalduring three years period Sept 2007 to Aug 2012. All patientsunderwent a thorough routine eye examination involvingvision testing by Snellen’s chart, Refraction, Tonometry, Slitlamp examination of Anterior Segment, Fundus examinationand Color Vision. Cases were also subjected to automatedperimetry, laboratory and radiological investigations ifconsidered essential.Results: A total of 217 (401) new patients attended theeye clinic. Patients attending the eye clinic were of variednationality which included patients from India, Pakistan, SouthAfrica, Uruguay, Congo, England, Iraq, Italy, Bangladesh,Netherlands, Nepal, USA etc. The three most commoncauses of eye disorders were refractive error followed byallergic conjunctivitis and Presbyopia. However, cases ofOnchocerciasis were also seen especially in those belongingto Congo. Mostly the patients were in the age group of 30-40yrs (35.4%) and 40-50 yrs (41.01%) being active militarysoldiers. Presbyopia was more common in age group 40-50yrsof age (73.3%). Majority of patients were mainly extra ocularcases (95.4%).Conclusion: The pattern of prevalence of various oculardiseases is similar to other parts of world in this age groupand with a similar occupational profile. This study will go along way in ensuring optimum provisioning of eye health carepersonnel’s and equipment for efficient eye care services.
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Background: A Nutrient Foramen [NF] or vascular channel is a small tunnel in cortex of long bones which is apathway for the entry of nutrient artery. Nutrient artery has pivotal contribution of blood supply to long bonesand plays a major role in Orthopaedic Surgical procedures like bone transplantation, bone grafting thus avoidingavascular necrosis of fractured bonesAims: To determine morphological parameters (variation in number, location, direction) and morphometricparameters (variation in size and foraminal index [FI] ) of nutrient foramina in Humeri.Materials and methods: Present study was conducted on a total of 80 dried human adult Humeri of either sexesor sides which were obtained from fellow students and Department of Anatomy of ESIC medical college &PGIMSR, Bangalore. Infantometer was used to calculate length of humeri, hand held lens was used to detectnutrient foramen under adequate illumination. Hypodermic needles [18G to 26G, where G is gauge], were used tomeasure the size of NF. Foraminal index was also calculated.Results: In our study mean length of humerus was 29.95cm.FI ranged from 39.34 -81.02.Majority (62.50%) ofhumeri have one NF, (28.75%) have two NF,(7.5%) with three nutrient foramina and (1.25%) had no NF. Majority ofNF (43.43%) were present on antero-medial surface, (37.37%) on medial border, (14.14%) on posterior surface,(2.02%) on both anterolateral surface and anterior border, 1.01% in lateral border. (90.09%) of NF were locatedin Zone II (middle third), (8.08%) in Zone III (lower third) and (1.01%) in zone I (Upper third). Majority (41.41%)were of large gauge, (34.34%) of medium gauge and (24.24%) of small gauge. All NF directed towards distal endof humerus.Conclusion: For healing of fractures, blood supply plays a vital role. Awareness about variations in NF isimportant because damage to nutrient artery due to any cause like trauma, road traffic accidents will causeinadequate blood supply .Thus vascular and bone transplant surgeons can reconstruct damaged artery andavoid ischemia of graft during open reduction procedures and transplant surgeries.
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Background: Low level of education of the slum dwellers along-with poor socio- economic status and pathetic environmental conditions lead to their poor health indicators. Since the National Urban Health Mission (NUHM) was launched in 2013, the health services are still in their initial stages. Assessment of the availability as well as the utilization of health care services of the urban slums is the need of the hour.Methods: The cross-sectional study was conducted in randomly selected slum in Amritsar city. All the houses were enumerated and visited by the interviewer herself. The eldest adult member of the family was selected as key respondent and written, informed consent was obtained. Predesigned questionnaire was used to collect the data which was then compiled and analyzed using statistical tests.Results: Out of the total respondents, one third respondents had knowledge about the government health center nearby (statistically significant) while out of these, only one third utilized the services at the center (statistically non-significant). Almost half of the respondents had knowledge about the medical camps and out of these, two-thirds utilized the services at medical camps.Conclusions: Overall utilization of services is poor. More respondents were aware of the medical camps than the static government health facility and utilization of medical camps was also more. So the static health services under NUHM need to be further strengthened.
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Background: Slums are not new phenomenon. They are characterized by insanitary condition, crime, drug abuse etc. The male youth living in the slums, are prone to various health impacting conditions including substance use like alcohol consumption, smoking, tobacco chewing, drugs etc.Methods: Cross-sectional study was conducted in the four selected urban slums of Amritsar city. From each slum 250 male youth aged 15-24 years were included in the study, so total 1000 respondents were interviewed and required information was filled in pre-designed semi-structured proforma. Data was compiled, analysed and valid conclusions were drawn.Results: The overall prevalence of substance use among the respondents was 25.9% and as the age increases the prevalence of substance use also increases. Among substance users, tobacco (86.8%) was the most common substance consumed both in smoking form (52.1%) and smokeless form (34.7%), followed by the alcohol (72.2%) and then drugs (12%). Majority (62.1%) of respondents had initiated the substance use between 15-19 years of age. Factors like illiteracy, migration, joint family, married status and increased mental stress were significantly associated with substance use, however no association was found with socio economic status of the respondents.Conclusions: Government should take robust steps to improve the awareness and education status of the youth living in the slums. As the younger ages are most vulnerable ones, health education, IEC and BCC activities regarding the harmful effects of substance use along with life skills should be incorporated into the school curriculum.
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Background: Diabetes has become global issue due to premature illness and death due to its complications. Awareness about good health seeking practices are essential for prevention, early detection and management of diabetic complications. Objective of the study was to evaluate the health seeking practices among diabetics (>10 years of duration) in the field practice areas of Government Medical College, Amritsar.Methods: A community based cross-sectional study was conducted in rural and urban areas of district, Amritsar. A total of 200 diabetic patients who had diabetes equal to or more than 10 years of duration were interviewed using pretested and predesigned questionnaire. Data such collected was analysed at p<0.05.Results: Out of total 200 diabetic respondents, 50% (100) were from urban and 50% (100) were from the rural area. In both urban and rural areas, majority were literate i.e. 80% (161) and employed i.e. 51% (103). The mean age of diabetic respondents was 58.05 years with a male to female ratio of 1.1:1. The majority 82% (165) were diagnosed in the private sector and 99% (198) were on allopathic treatment. Oral hypoglycaemic agents were used by 77% (153) patients to manage their disease. 23% (45) were using both oral hypoglycaemic agents and insulin. About 48% (96) were monitoring their RBS regularly, 76% (151) were on regular treatment for diabetes and 55 (27%) were doing physical activity.Conclusions: Poor health seeking practices and less awareness about non pharmacological measures are main factors for development of complications among diabetics.
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Background: Health care expenses induced impoverishment in the poverty stricken strata of rural India is a major issue. The government of India has come up with various services in public health facilities, but there are various factors which curtail the utilization of available services and people have to visit some private health facility. The present study deals with the extent of utilization of services of government health facility and the factors impeding the utilization.Methods: The present cross sectional study was conducted in village Nagkalan, district Amritsar, where the eldest adult members present in the house at the time of the visit, and are interviewed using a semi-structured and predesigned questionnaire. A total of 1123 families were included in the final analysis. Data was compiled, analysed and valid conclusions drawn.Results: Almost all the respondents were aware about the existence of subsidiary health centre in the village. However, out of those who were aware, 40.8% never visited the centre. Utilization was more in the lower socio economic status. Immunization services followed by treatment for common ailments constituted the top two reasons for visiting the centre. Out of those visiting the centre, 80.7% were not satisfied with the current timings of the centre; only 20.2% were attended by the doctor and 33.3% reported that the prescribed medicines were never available at the centre.Conclusions: Regular supply of prescribed medicines, availability of the doctor and appropriate timings are critical for utilization of health care services at the government health facility.
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Background: Slums are most vulnerable and deprived areas within a city. The unhygienic and polluted environment, overcrowding, poor housing and absence of educational exposure affect youth in slums. Consequently, their health is affected adversely.Methods: This cross-sectional study was conducted in four slums, one each from four different directions (north, south, east and west) of Amritsar city. A total of 1000 respondents, 250 from each slum were interviewed by using pre-tested semi-structured questionnaire. Data was compiled and statistically analysed.Results: Out of total study population, 41.2% of the families had migrated from other states, Overcrowding was present in majority (92%) of the families, 20% of the respondents didn’t have latrine facility at their home, 44.4% respondents throw their garbage waste in the open space nearby their dwellings and 45% of population was not satisfied with the cleanliness of their slum, 54.6% of the respondents reported to have some kind of health problem during last three months. Educational status, socio-economic status and overcrowding were significant factors affecting their health.Conclusions: Important factor in causation of disease were found to be poor socio-economic status, lack of education and overcrowding. There is a strong need to intensify the IEC/BCC activities to raise the awareness about the health-related issues.
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Tuberculosis is the most common infectious cause of death worldwide. Young children especially infants usually are more susceptible to tuberculous infection. Disease usually develops within 1 year of infection. The present study has been conducted upon 41 children in whom Mantoux test was positive (n=41). These children were coming to our outpatient department, in a Teaching Hospital, Nizamabad, Telangana State with mild fever, cough, night sweats, anorexia, and loss of weight. The age group selected for this study was 1 to 12 year, and the period of study was from August, 2013 to December, 2015. Among the 41 children under study 13 children were 1 to 4 year and 28 were 5 to 12 year. Among the total 41 cases of Mantoux positive, 16 (39%) were found to be suffering from tuberculous disease and anti tuberculous drugs were started. In these cases 7 were 1 to 4 year (n=13), and 9 were 5 to 12 year (n=28). After 3 months follow up, all the children who were on ATT became free from their symptoms. It shows association between mantoux positivity and tuberculosis is more in children between 1 and 4 year than children between the age of 5 and 12 year. Most of the other children needed antipyretics, other symptomatic drugs and antibiotics only. But in 3 cases symptoms were not relieved either with antibiotics or with trial ATT. The factors for deciding tuberculosis are history of contact, clinical picture, CBP, ESR, chest- x- ray, Mantoux test, sputum for AFB, antibiotic trial, follow up, trial ATT. All these factors are put together and then only we will decide whether to start ATT or not.
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Background: The use of self-medication is highly prevalent in the community. Self-medication can be defined as obtaining and consuming one (or more) drug(s) without the advice of a physician either for diagnosis, prescription or surveillance of treatment. Aims and objectives: To study the prevalence and pattern of self-medication practices in rural area of Barabanki. Material and methods: A cross-sectional study was carried out in rural area of Barabanki to assess the knowledge, awareness and perception of self-medication practices by house-to-house survey during the period of October 2013 to March 2014. Results: Out of 235 participants enrolled, 168 responded (71.5%). A total of 67 (28.5%) participants were excluded in accordance with the exclusion criteria like incomplete information and not using self-medication. Out of 168 respondents, 117 (69.6%) reported self-medication within 1 year of recall period. Most common conditions/symptoms for self-medication in students were fever (72.6%), pain (64.3%) and respiratory symptoms (57.1%), followed by infections, headache and diarrhea, etc. Self-medication was the most common category of drugs used by all the participants except highly educated who used drugs prescribed by physician. Conclusion: Self-medication is an alarming sign for society.
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Despite of various nutritional health programmes, malnutrition among children remains the big health problem in India. Even after the universalization of ICDS, India has biggest burden of malnourished children in the world. Suboptimal utilization of services by mothers is a big challenge before all programmes. Utilization of services also depends upon the awareness regarding the service and its perceived usefulness among beneficiaries. Therefore, the present study was conducted to know the awareness about the growth chart and its determinants among rural mothers. Study was conducted on 186 mothers selected from three villages. Chi square test and F test were applied wherever necessary. Results showed low level of awareness (38.17%) among the mothers regarding growth charting. Majority of mothers reported peripheral health functionaries i.e. ASHA (36.62%) & Anganwari worker (39.44%) as source of information. Distance from Health facility did not affect the knowledge of mothers. However, socio economic status and educational level of mothers were significantly associated with presence of awareness among mothers.
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The objective of the study was to evaluate for antidepressant like activity of a methanolic extract of B. juncea leaves (BJ 100, 200, and 400 mg/kg/day, po), and Imipramine (15 mg/kg/day, po) in alloxan monohydrate (120 mg/kg, ip) induced diabetic and nondiabetic rodents, using behavioural despair, learned helplessness, and tail suspension tests for antidepressants and locomotor activity test for quantifying the behavioural effects of treatments. In addition, effects of BJ treatments on brain levels of norepinephrine, serotonin and dopamine were also estimated. Enhanced depressive states, and motility were observed in diabetic animals. Antidepressant and motor function depressing effects of BJ were apparent in all behavioural tests in diabetic rats and mice only. Decreased contents of dopamine, norepinephrine and serotonin in brain of diabetic rats were also dose dependently compensated by repeated daily BJ treatments. However, brain dopamine level of BJ treated normal rats was higher than that in control nondiabetic. The results suggest that BJ could be a nutritional alternative for combating exaggerated depression commonly associated with diabetes.
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Animales , Antidepresivos/uso terapéutico , Glucemia/efectos de los fármacos , Trastorno Depresivo/tratamiento farmacológico , Trastorno Depresivo/etiología , Diabetes Mellitus Experimental/complicaciones , Evaluación Preclínica de Medicamentos , Femenino , Masculino , Ratones , Planta de la Mostaza/química , Extractos Vegetales/uso terapéutico , Hojas de la Planta/química , RatasRESUMEN
Intra-thoracic manifestations of progressive systemic sclerosis [PSS] are not well known particularly the imaging features, which forms the basis of accurate and timely diagnosis. The aim of this study is to familiarize the physicians and radiologists with these features. The diagnosis can remain elusive because of the non-specific nature of symptoms which mimic many common conditions. Thus, the diagnosis of PSS can be missed leading to continuous morbidity if the correct imaging is not pursued. The authors examined the records of rheumatology patient referrals of over a 5 year period. A hundred and seventy patients with systemic sclerosis and mixed connective tissue disorders were chosen for detailed study of the imaging available, which form the basis of this review. The images included conventional chest radiographs, digital radiographs computed radiography [CT] and high resolution computed tomography [HRCT]. Where applicable computed pulmonary angiography [CTPA] and radionuclide scans were also interrogated
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Idiopathic gingival enlargement is a slowly progressive disease involving excessive collagen deposition, clinically characterized by a firm, painless enlargement of the gingiva. It may be congenital, hereditary or sporadic with no familial background. Various modalities of treatment have been proposed to provide functional and esthetic benefit to the patient. This report presents a case of idiopathic gingival enlargement with chronic periodontitis diagnosed on clinical, radiographic, histopathologic and serological assessment. Gingivectomy using electrosurgery proved to be treatment of choice, considering the generalized distribution and successfully restored proper oral function and esthetics
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BACKGROUND: Evidence for superior outcome by adhering to therapy guidelines is imperative to their acceptance and adaptation for the optimal management of disease variants. OBJECTIVE: Comparative study of prospective outcomes in simultaneous consideration of independent variables in groups of 150 patients of plaque psoriasis either treated adhering to or in digression of standard guidelines. METHODS: The psoriasis area severity index (PASI) and the dermatology life quality index (DLQI), prior to and after three months of uninterrupted therapy were examined in treatment groups among 150 patients. Recovery rates of 75% or more in PASI were compared. Independent variables were also examined for their bearing on the outcome. RESULTS: The vast majority was early onset disease phenotype. All three treatment regimens when administered in adherence to the guidelines yielded significantly superior rates of defined recovery both in PASI and DLQI. Compromise of the therapeutic outcome appeared in high stress profiles, obesity, female sex and alcohol, tobacco or smoking habit. CONCLUSION: Conventional drug therapy of plaque psoriasis yields superior outcome by adhering to the consensus guidelines. Psychiatric address to stress must be integral and special considerations for phenotypic/syndromic variants is emphasized for effective therapy of psoriasis.
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Femenino , Humanos , Consenso , Dermatología , Obesidad , Fenotipo , Estudios Prospectivos , Psoriasis , Calidad de Vida , Humo , Fumar , Nicotiana , UrsidaeRESUMEN
Thoracic sarcoidosis is a common disease, with well-described and recognizable radiographic features. Nevertheless, most physicians are not familiar with the rare atypical often-confusing manifestations of thoracic sarcoid. Although these findings have been previously reviewed, but more recent advances in imaging and laboratory science, need to be incorporated. We present a review of literature and illustrate the review with unpublished data, intended to provide a more recent single comprehensive reference to assist with the diagnosis when atypical radiographic findings of thoracic sarcoidosis are encountered. Thoracic involvement accounts for most of morbidity and mortality associated with sarcoidosis. An accurate timely identification is required to minimize morbidity and mortality. It is essential to recognize atypical imaging findings and relate these to clinical manifestations and histology
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Vitiligo is an acquired, progressive, common pigmentary disorder of the skin and hair characterized by well circumscribed milky white macules, devoid of identifiable melanocytes. From the Indian subcontinent the highest incidence has been reported in India. The aim of the study is to find the precipitating factor and clinical features of vitiligo patients in North India. Total of 275 subjects were enrolled for the study. The study was observational and was conducted over a two year period.118 were females while rest 82 were males. The most common type of vitiligo is vulgaris (45.5%). 78.5% cases had age of onset around the age of 40 years .40% cases were in 1-5 years duration of disease. Vitiligo does not show any significant association with any addiction. 22% patients are associated with the positive family history. 44% patients showed lower limb as a site of onset of vitiligo. There was no significant correlation with dietary habits in vitiligo. 59.5% cases belong to active vitiligo & rest of 40.5% is of stable category. 17.5% cases reported physical trauma as the precipitating factor. 12% patients were associated with thyroid disease. Majority of cases 68.5% were from urban areas. Clinoepidemiologic study in North India shows that vulgaris is the commonest subtype with female preponderance. Research on the presence of autoimmune disease; particularly thyroid disorder is of great interest.
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The aim of this review is to present a pictorial essay emphasizing the various patterns of calcification in pulmonary nodules [PN] to aid diagnosis and the pathogenesis where it is known. The imaging evaluation of PN is based on clinical history, size, distribution and the gross appearance of the nodule as well as feasibility of obtaining a tissue diagnosis. Imaging is instrumental in the management of PN and one should strive not only to identify small malignant tumors with high survival rates but to spare patients with benign PN from undergoing unnecessary surgery. The review emphasizes how to achieve these goals. One of the most reliable imaging features of a benign lesion is a benign pattern of calcification and periodic follow-up with computed tomography showing no growth for 2 years. Calcification in PN is generally considered as a pointer toward a possible benign disease. However, as we show here, calcification in PN as a criterion to determine benign nature is fallacious and can be misleading. The differential considerations of a calcified lesion include calcified granuloma, harmartome, carcinoid, osteosarcoma, chondrosarcoma and lung metastases or a primary bronchogenic carcinoma among others. We describe and illustrate different patterns of calcification as seen in PN on imaging