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Background: The altered spectrum of diseases in geriatric age group and atypical manifestations of these conditions make geriatric health care truly unique. The challenge ahead for health care in the coming years is to ensure the quality of life to a large group of the elderly population. In spite of the recognition that the elderly has specific medical conditions, a dedicated health care policy to improve geriatric health care is yet to be developed India. Objectives: To study the disease pattern, hospital stay and outcome among the geriatric patients based on age, gender and other variables. Materials and methods: An observational prospective study done after permission of human research ethics committee. All patients aged 60 years and over admitted to the wards were included into the study. Detailed information about current admission and other history was noted. Thorough clinical evaluation was done by physical examination and investigations and noted in the case record form. Observations: Total 100 participants included in the study. They were divided into two groups 60-64 years and ? 65 years. Nearly 90% patients had more than one aliments or diagnosis. Non-communicable diseases like Cardiovascular disease (48%) was the commonest reason for admission, followed by Respiratory disease (42%), renal disease (40%), gastrointestinal disease, neurological disease and endocrine disease in descending order of frequency. Conclusion: Non-communicable diseases are common cause of morbidity and mortality with infection are adding the morbidity as well as mortality among the elder population.
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Abstracts: Background: Anaemia or anaemia is usually defined as a decrease in the amount of red blood cells (RBCs) or the amount of haemoglobin in the blood.1,2 It can also be defined as a lowered ability of the blood to carry oxygen. There are three main types of anaemia; due to blood loss, due to decreased red blood cell production, and due to increased red blood cell breakdown. Methodology: The material for this study was obtained from children aged 6 months to 12 years. These were the children who either attended outpatient department or were those who were admitted to paediatrics ward of our hospital. Haemoglobin percentage was estimated in all cases diagnosed clinically as anaemic. Those, whose haemoglobin level was below 10gm percent, were taken to be anaemic for the purpose of the study. Results: The incidence of anaemia was high in children below 3 years of age. The maximum incidence was between 1-3 years. In older children anaemia was less frequently seen. The mean haemoglobin values were higher in younger children as compared to older children, the difference however, was not very significant (0.4gm%). Conclusion: Primary prevention of Iron deficiency Anaemia is recommended; the role of secondary prevention through screening programs remains inconclusive but recommended by some professional organizations. Treatment of children identified with IDA includes both dietary counselling and oral iron supplementation.
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Background: Gonioscopy is a traditional method of measurement of anterior chamber of eye and Optical Coherence Tomography (OCT) is newer method. Aims & Objective: To compare the anterior chamber angle on gonioscopy & optical coherence tomography as well as evaluating the nerve fiber layer thickness & ganglion cell layer thickness in glaucoma patients. Material and Methods: Fifty patients who had bilateral glaucoma under treatment were selected randomly for this study. They all had controlled IOP i.e. less than 21 mm of Hg by Schiotz Tonometry. Complete anterior segment evaluation done including lids, lashes, conjunctiva, sclera, cornea, anterior chamber, iris, pupil, lens and eye movements, Posterior segment evaluation included cup disc ratio, disc pallor, neuro retinal rim, haemorrhages on disc margin; Gonioscopy with Volk four mirror goniolens was performed and diagnosis of glaucoma confirmed. The closed angles were defined as non-visibility of posterior trabecular meshwork on gonioscopy; On OPTOVUE RTVue optical coherence tomography machine patient was examined for retinal nerve fiber layer and ganglion cell complex. Descriptive statistics was used and values were shown as mean and percentages. Results: Angle closed in > / = 1 quadrants by was observed in 47.5% by gonioscopy and 70% by OCT. In all quadrants (superior, inferior, lateral and medial) closed angle was more in OCT as compared to gonioscopy. Average retinal fiber thickness in the case of primary open angle glaucoma was 89.86μm while in the case of primary closed angle glaucoma it was 77.12μm. Average ganglionic cell thickness in the case of primary open angle glaucoma was 94.16 and in the case of primary angle closure glaucoma it was 87.08. Average central corneal thickness in open angle glaucoma was 533.96 μm and closed angle glaucoma it was 535.25 μm. Conclusion: Anterior segment OCT is a rapid noncontact method of imaging angle structures. Anterior segment OCT tended to detect more closed ACAs than gonioscopy, particularly in the superior and inferior quadrants.
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Background: Blunt abdominal trauma is one of the most common causes among solid organ injuries. Morbidity and mortality in blunt abdominal injuries is major cause of concern for surgeons. Aims & Objective: This study was carried out to analyse patient profile, investigations and management of such patients. Material and Methods: 50 patients, who admitted to civil hospital Surat were studied prospectively. Age and gender distribution, Mode of injury, clinical presentation, solid organs injured, and investigations carried out, length of hospital stay, management – conservative or operative and their outcome were studied. Results: Out of 50 patients 46 were male, and 4 female patients. 60% patients are from 20-40 year age group. Majority are due to road traffic accidents (54%), and abdominal pain is the most common mode of presentation. Spleen (46%) and liver (38%) are the 2 most common organs involved. 88% patients are managed conservatively, remaining have to undergo laparotomy. Length of hospital stay (1-10 days in 37 patients) is lower patients who are managed by conservative management in comparison to operative management (11-20 days in 4 patients). 54% patients required 1 or more units of blood during hospital stay. Conclusion: Non penetrating abdominal injuries are major cause of concern. Ultrasonography and CT scan play major role in detecting solid organ injuries. Conservative management is safer and reliable mode of management in solid organ injuries due to blunt abdominal trauma.
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Now day diabetes is very common world wild disease. Basically two type of diabetes: Type-I and Type-II. Various short term complications like diabetec ketoacidosis, hyperosmolar nonketotic coma and hypoglycemia and long term complication like diabetec neuropathy, diabetec retinopathy, diabetec nepheropathy, diabetec microangiopathy, heart disease and stroke occur due to diabetes mellitus. Cardiovascular complication mainly occurs by either increase of glucose by activation of protein kinase, rennin angeotensin system, advance glycation endproduct theory i.e. AGE-RAGE or by metabolic syndrome and insulin resistance mechanism which precipitates obesity, physical inactivity and genetic susceptibility. Insulin secretion is decreases with advancing age which may be accelerate by genetic factor. Insulin resistance led to onset of Type-II diabetes mellitus and is commonly associated with other cardio vascular risk factors like dysbetalipidema, hypertension and prothombic factor. Evaluation of these major risk factors is very necessary. Predisposing risk factors are body weight and fat distribution in the body, physical activity and family history. Detection of clinical and sub clinical cardiovascular disease in diabetic patient. Evaluation of factor such as a stress testing for coronary heart disease, non-invasive evaluation of cardiac function, evaluation of autonomic dysfunction, detection of sub clinical cardio vascular disease and it treated by changing life style or by using insulin matrix.