RESUMO
Background: Methyl alcohol poisoning or deaths from drinking illegally brewed cheap alcohol which is often spiked with chemicals to increase its potency are frequent in India. Many outbreaks from different parts of the country have been reported from time to time. A total of 11,830 lives were lost between 2006 and 2015 due to the consumption of spurious liquor in the country. The symptoms can range from mild to severe depending upon factors like the amount of exposure and time of presentation. Aims and objectives: The present study was designed to describe the clinical presentation, management, and outcome of the patients during a recent methanol outbreak that can form a basis for diagnosis and management. This study also highlights the salient autopsy findings and their correlation with clinical features. Materials and methods: It is a retrospective, descriptive study discussing clinical features of patients with methanol intoxication, their outcome, and the clinical correlation with autopsy findings of patients who succumbed to death. The study was conducted at King George’s Medical University, Lucknow. The patients were enrolled from a methanol intoxication outbreak in Barabanki district on 28th May 2019 followed by a similar outbreak in Sitapur district two days later. Results: A total of 33 patients were included in this study based on predefined clinical characteristics. The average amount of alcohol consumed was about 223 mL (range: 100–300 mL). The majority of patients had onset of symptoms between 12 and 24 hours. All patients had gastrointestinal symptoms, 97% of patients had visual disturbances, 91% of patients had central nervous system manifestation while frank coma was observed in 15% of patients. Decreased urine output was reported in 6% of patients. About 90% of patients had metabolic acidosis. Out of 33 patients included in this study, 30 patients were discharged in stable condition while two died and one absconded. Autopsy findings revealed marked cerebral edema and hyperemia, hyperemic heart, and congested lungs in all the patients. One patient showed putaminal necrosis which is characteristic of methanol poisoning. Kidneys in two cases were hyperemic and show parenchymal degeneration which co-relates with both patients being anuric. Conclusion: Methanol intoxication is a serious problem in developing countries like ours. Timely intervention is an important factor in reducing mortality among these patients. The study highlights the very important fact that methanol intoxication can be managed at the very ground level with minimal resources (as available) if intervened and recognized in time.
RESUMO
Background: Premature ovarian failure (POF) is cessation in the normal functioning of the ovaries in women younger than age 40 years. It is estimated to affect1% of women younger than 40 years and 0.1% of those under 30 years. Premature ovarian failure is a common cause of infertility in women.Methods: Patient attending outpatient Department of Obstetrics and Gynecology with age less than 40 years and complaint of menstrual disturbances, symptoms of menopause were enrolled for the study for duration of 1year. This study is planned to calculate the incidence, risk factors, relation to BMI and infertility in patients attending outpatient department at Geetanjali medical college and hospital, Udaipur for all enrolled patient coming with complaints of menstrual disturbances. FSH levels were send for all the patients and those with FSH level more than 20 at day 2/3 for menstruating women and random FSH level for amenorrhea patient more than 20 were classified in to study group and all those women with FSH less than 20 are taken as control group.Results: Present study strongly suggests that simple laboratory test FSH and symptoms of missed and irregularity of menstrual cycle help in early and prompt diagnosis of premature ovarian failure. And early diagnosis helps in avoiding unnecessary medications and helps in improving long term morbidity.Conclusions: Disturbances in menstrual cycle like amenorrhea and infrequent cycles are the symptoms which are associated with premature ovarian failure after ruling out pregnancy and other hormonal and structural causes.
RESUMO
Introduction: Communicative skills in medical education are inadequately met. Research has shown that poor communication can contribute to improper diagnosis and lack of understanding of patient's problems, investigations, and treatment options. Poor communication can lead to poor compliance to treatment and dissatisfaction among patients Objective: Assessment of the improvement in the communication skills after the training programme workshop Method: The interns posted in the department of community medicine were pre-tested using Kalamazoo Essential Elements Communication Checklist (Adapted) [KEECCA] who then underwent focused training by the trained faculty members. Two weeks following completion of training, all participants were subjected to a post-test and comparison between the pre-test and post-test scores was done using Wilcoxon Signed-Rank Test. The test was two sided and a p value less than 0.05 was considered as statistically significant. In order to know the effect of sensitization programme, feedback of the students and the faculty members as the assessors was taken after the completion of the posting Results: On the application of wilcoxon signed rank test, it was found that the difference between the pre and post test scores of assessment on kalamazoo scale after the training of interns on communication skills was found to be statistically significant as the t-value was 4.072 with the pvalue less than 0.001 that is also highly statistically significant Conclusions: The incorporation of communication skills in the medical curriculum will not only improve the doctor patient relationship but also help in arriving at the proper diagnosis through improved skills
RESUMO
ipomas are the common benign tumors of adipose tissue, but sometimes clinically and grossly they simulate malignancy. Lipomas can also occur in deep soft tissues. One of its rare subtype is Intramuscular lipoma which arise within the skeletal muscle fibers. Most common site is trunk, but can also occur in thigh and head and neck. 20 % recur due to incomplete excision. Histopathology is must for confirmation of the diagnosis. Prognosis of intramuscular lipoma is very good and marginal excision is the treatment of choice. We report a case of a 23 Year old female, who presented in surgery OPD with chief complaint of swelling at upper right side of back since 1 year. She got operated for the same 8 months back but presented with similar complaint at same site after 4 months. Excision of the swelling was done and sent for histopathology. On gross examination skin covered soft tissue piece, grayish brown in color was received. Histopathology revealed Infiltrating intramuscular lipoma. The case was reported because of its rarity.
RESUMO
Background: Poverty is a multi-faced wretched state of deprivation of basic need and facilities. There are different levels to its adverse influence on the individual, family and the community. Thus a Rashtriya Swasthaya Bima Yojana (RSBY) was launched to help these poverty stricken individuals. This study explores into the utilization of Rashtriya Swasthaya Bima Yojana card and their satisfaction. Aims & Objective: Our study explore the awareness level of RSBY beneficiaries with the aims and objective, (1) To analyze the socio-demographic profile and services utilized by beneficiaries; (2) To identify the problems experienced by the beneficiaries and measure the satisfaction level; and (3) Out of pocket expenditure of beneficiaries. Material and Methods: 198 patients were registered between the periods of 01/11/2012 to 28/02/2013 due to some reason 180 beneficiaries were telephonically interviewed about their experience by a pre-tested and pre-designed Performa. The data was collected and analyzed in epi info 7. Results: Male: Female ratio of beneficiaries is 1.4:1. Mean age of beneficiary was around 36 years. 80% beneficiaries were fully satisfied with the services. All the beneficiaries reported that they got the card easily without any hassle. They were not aware about all the benefits of RSBY so they had to spend out of pocket money for some services. Conclusion: RSBY beneficiaries were mostly satisfied with the services provided but there was a major lag in their knowledge regarding the benefits provided under RSBY. They were unaware regarding all benefits under RSBY which they can avail from the scheme. Thus IEC activities should be enhanced to increase the awareness among the RSBY card holders so that they can use better service for themselves and their families.
RESUMO
Background: Now a day’s mental and behavioural disorders are common in the community. Globally, some 450 million persons suffer from a mental or behavioural disorder contributing to 13% of global burden of disease.1TheServices are provided by psychiatric hospitals where assessments are carried out by psychiatrists, clinical psychologists and sometimes psychiatric social workers, using various methods but often relying on observation and questioning. Even this is done in the community. Thus on the basis of these observations we have drawn the conclusion of epidemiological variants among the patients. Aims & Objective: To assess the frequency of various epidemiological trends in patients in mental hospital and to study associated risk factors in them. Material and Methods: 118 patients out of 237 in mental hospital were selected on random basis. On predesigned Performa, various details were noted and the data was analyzed in epi info 7. Results: There were 48.3% females and 51.7% males. There were 87 cases of schizophrenia and 19 case of bipolar disorder in manic phase. The 57.98% of patients present with behaviour abnormality and 43.45% of patients have the abnormal BMI and 24.25% of patients of patients have primary education level. The 81.21% of people were not working. Conclusion: Resources and service for the mental disorder are comparatively low as compared to the burden of the disease. Thus by studying the various epidemiological correlations we can plan certain preventive measures so that mental disease burden could be decrease. Looking to the etiopathology, found in our study it is recommended that counselling should also be a part of management and importance should be given to environmental or social factors like education living standards etc. for prevention of mental disorders.