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Trauma is a global challenge and India has one of the highest trauma deaths in the world. Despite the United Nations’ target to halve the global number of deaths and injuries from road traffic crashes by 2030, death tolls from road traffic injuries (RTI) are rising in India. In the pediatric age group, falls from height add to the burden of trauma. Uncontrolled bleeding from exsanguination on scene is estimated to account for nearly 40% of RTI trauma related mortality. Stopping the bleeding in the first few minutes is crucial for meaningful survival and hence the role of training lay public who can reach the scene in minutes. Active bleeding control (ABC) pilot research project to simulation train the bystanders to stop the bleed showed promising outcomes in Hyderabad, India. This paper describes the ABC project and discusses the role of pediatricians in training the public to reduce morbidity and mortality from uncontrolled bleeding at the trauma scene.
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Background: In the act of medical practice, referral is the transfer of a patient’s care from one physician or clinician to another. Appropriate referral is an integral part of a complete quality health care management. At present, patients can visit any level of health care irrespective of severity of their health condition and most of the burden of these patients is on tertiary centers. This study was done to describe the Referral Pattern of Patients Coming to Mandya Institute of Medical Sciences, Mandya.Methods: It was a cross sectional study conducted from October 2017 to November 2017 with sample size of 400, p=50%. Sampling technique used was convenient sampling and data was collected by interview using the semistructured questionnaire.Results: Among the study population 197 (49.3%) were males and 203 (50.7%) were females, 392 (82.3%) had BPL card. Mean distance travelled by them to MIMS was 17.7±14.8 km. Medicine department n=80 (20%) followed by ophthalmology department n=64 (16%) were the most frequently visited departments. Mean distance to the nearest health center from their place of residence was 3.2%±2.9 km. 148 (37.0%) visited the health center near their place of residence before coming to MIMS and 253 (63.0%) did not visit.Conclusions: Most of the patients visited tertiary healthcare center (MIMS) without visiting health center near to them, though the distance is more and availability of specialists and low cost of treatment were the main reasons for visiting MIMS.
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Introduction:Posterior urethral valves (PUV) constitute a rather rare congenital disorder with membranous obstruction of the male posterior urethra. This form of infravesical obstruction is potentially seriously detrimental to the more proximal urinary system already prenatally. The aim of study is to study patients with posterior urethral valve and their Biochemical parameters, imaging studies and urodynamic measurements for diagnosis and identifying complications of the disease. Materials and Methods:This study includes a retrospective study of 35 consecutive patients who were admitted in Pediatric Surgery Department of our institute from January 2015 to January 2017.All the patients were admitted and underwent biochemical and radiological investigations. Depending in the results the definitive treatment was planned. All the patients after discharge were kept on regular follow-up. Most of our pateints presented at 1 year or less of age.RESULT: Vesicoureteric reflux was seen in 23 patients(65.71%), comprising of 32 units. (9 patients had bilateral reflux, left sided reflux was present in 8 patients and right sided reflux was present in 6 patients) 12 patients did not have reflux. The urine examination showed infection in 33 patients(94.28%) and presence of albumin in 10(28.57%). S. Creatinine and blood urea were raised in 25(71.42%) case presentation. Out of the 35 patients, 34 patients underwent cystourethroscopy. In all patients cystourethroscopy showed presence of classicalType -I PUV. There was no case of Type III PUVin our study.Conclusion:With availability of renal scan and urodyanamic study, more and more patients of bladder dysfunction and secondary upper tract changes are likely to be diagnosed and evaluated. Increasing awareness and facility for antenatal diagnosis in early gestational age, allows us to terminate pregnancy for the fetus with adverse sonographic findings secondary to posterior urethral valves.Keywords:Posterior urethral valve,PUV,lower urinar
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Background: Estimation of adiponectin levels in diabetic and non-diabetic fatty liver and healthy controls. Methods: We studied 25 subjects for diabetic fatty liver, 25 subjects for non-diabetic fatty liver and 25 healthy controls. Clinical evaluation included anthropometric measurements, BMI, biochemical investigations and adiponectin estimation by ELISA. Results: There were 15 males (60%) and 10 (40%)females subjects in the DFL group, 18 males (72%) and 7 females (28%) subjects in the NDFL group and 13 males (52%) and 12 females (48%) subjects in the control group. 80% (20) of the DFL patients and 72% (18) subjects of NDFL group had BMI >25kg/m2. 80% (12 males and 8 females) of subjects in the DFL group and 68% (12 males and 5 females) had a waist circumference that indicated central obesity as per Indian cut-offs (>90 cm for females and >80 cm for males). The mean adiponectin (μg/ml) ± SD levels in DFL were 4.03 ± 0.43, NDFL was 5.01 ± 0.55 and in controls was 7.63 ± 0.66, the difference being statistically significant with P <0.001. The difference in the adiponectin levels was statistically significant between each of the three groups with P <0.001. There was no difference in serum adiponectin levels between males and females in all three groups. Conclusion: The chief conclusion of this study are that serum adiponectin levels are lower in subjects with NAFLD than those without it; adiponectin levels are inversely related to the degree of steatosis in NAFLD, with the lowest levels in more severe forms of steatosis.
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Formation of an aneurysm in the sinus of Valsalva of the aortic root is usually due to an area of congenital weakness in its wall. This aneurysm may progressively dilate and rupture into any of the cardiac chambers or into the pericardial cavity. Though this is conventionally treated by surgery, interventional therapy using various closure devices is becoming more common. Embolization of these closure devices may occur. We report a case of embolization of such a device into the left pulmonary artery which during surgical retrieval, unmasked the hidden ventricular septal defect (VSD). Therefore one has to be cautious while making a diagnosis of rupture of the sinus of Valsalva of right coronary sinus without VSD.
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Aneurisma , Seno Coronario , Diagnóstico , Defectos del Tabique Interventricular , Arteria Pulmonar , Rotura , Seno AórticoRESUMEN
Pneumocytoma is a rare benign tumor of the lung that usually presents as a solitary pulmonary nodule. It is believed to arise from the primitive undifferentiated respiratory epithelium. We report a case of pulmonary pneumocytoma that was suspected on needle aspiration smears and confi rmed histologically. This case describes the cytological features of pneumocytoma that are rarely described in textbooks.
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The diuretic activity of Benincasa hispida fruit rind extract (outer thick pericarp) was investigated and its activity was compared to control (normal saline) and standard diuretic hydrochlorothiazide in albino rats. Total of 54 adult male Sprague-Dawley rats were taken whose weights ranged from 175-225 gm. The rats were divided into three groups of 18 rats each (control, standard and test). Control group received 0.9% normal saline 25ml/kg orally. Standard group received hydrochlorothiazide 2.5mg/kg body weight orally along with normal saline keeping the volume of the fluid administered constant. Test group received aqueous extract of rind of Benincasa hispida at the dose of 100mg/kg orally along with normal saline 25ml/kg. Urine was collected for a period of 5 hours by placing the animals in metabolic cages. The urinary volume, pH, and urinary excretion of sodium, potassium and chloride were measured and compared. The extract produced significant increase (p<0.001) in urine volume, sodium and chloride levels, and significant decrease (p<0.001) in potassium excretion. Benincasa hispida rind extract possesses significant diuretic activity.
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A coverage evaluation survey was conducted in Mandya and Koppal districts of Karnataka state following the Japanese Encephalitis (JE) vaccination campaign. The purposes of the survey were to assess coverage of children in target age group by JE vaccination and to assess adverse events following immunisation against JE, the knowledge of health care providers and community about JE & mass vaccination for JE. The study design consisted of both quantitative and qualitative methods. The quantitative data was used to know the coverage levels for children. The qualitative data collected through interviews of head of the family in the sample households, selected health care workers using a structured pretested questionnaire. The standard cluster sampling method was used for selecting the sample of children to be evaluated. In Mandya district the evaluation showed 92 % coverage in the selected sample of 313 children against the reported 83.85 %. In Koppal district the evaluation showed 70 % coverage, among the selected sample of 251 children, against the reported coverage of 69.8 %. The incidence of adverse events was 4% in Mandya sample and 6.37 % in Koppal sample. In Mandya district, about 42 % of households had knowledge of JE. About 68 % of households had prior knowledge of the immunization day. In Koppal district, the survey has revealed that only 19.85 % of the heads of household had the knowledge of JE and 48.53% had the knowledge of JE vaccination before the day of vaccination campaign.