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Background : Upper Gastrointestinal Bleeding is a common emergency with varying degrees of severity. Haemorrhage is managed by Therapeutic Endoscopy, Radiological Intervention or Surgery and Blood Transfusion which are available only in Tertiary Care Centre. So, when patient presents in primary healthcare setting, it is important to recognize the patients who need this treatment. Glasgow-Blatchford Score is a score which is used for this purpose. The purpose of this research was to validate its reliability in identifying such high-risk patients. Materials and Methods : This study was prospective and observational, conducted in Medical College and Hospital, from December, 2017 to May, 2019. All adult patients presenting to Emergency Department with sudden onset Upper Gastrointestinal Bleeding were included. Glasgow-Blatchford Score was computed. Patients were followed up till their discharge (or death) from the hospital. The therapeutic management needed and its relationship with the score and treatment modalities were noted. Area under Receiver Operating Characteristic (ROC) Curve was calculated. Results : Total 100 patients were included in study. 85% were male and 15% were female. Glasgow-Blatchford Score was found as a good predictor in discriminating patients. Patients with score 14. Interventional radiology or surgery was never used. The area under ROC Curve was 0.738 suggesting fair reliability. Conclusion : Glasgow-Blatchford Score is good predicting tool in cases of Upper Gastrointestinal bleeding and patients with score >7 should be transferred to speciality centres
RESUMO
Background & objectives: Zinc is a crucial micronutrient in adolescence, required for promoting growth and sexual maturation. Adolescents of some tribes may be at high risk of zinc deficiency due to dietary inadequacy and poor bioavailability of zinc from plant-based diets. This study aimed to evaluate the risk of zinc deficiency by estimating prevalence of inadequate zinc intake, prevalence of low serum zinc and stunting among tribal adolescents. Methods: A cross-sectional community-based survey was conducted among adolescents (10-19 yr) in three purposively selected districts where Bhil, Korku and Gond tribes were in majority. Structured data collection instrument comprising information about sociodemographic characteristics and dietary recall data was used. Anthropometric assessment was conducted by standardized weighing scales and anthropometry tapes, and blood sample was collected from antecubital vein into trace element-free vacutainers. Serum zinc was estimated using an atomic absorption spectrophotometer. Results: A total of 2310 households were approached for participation in the study, of which 2224 households having 5151 adolescents participated. Out of these enlisted adolescents, 4673 responded to dietary recall (90.7% response rate). Anthropometry of 2437 participants was carried out, and serum zinc was analyzed in 844 adolescents. The overall prevalence of dietary zinc inadequacy was 42.6 per cent [95% confidence interval (CI) 41.2 to 44.1] with reference to the estimated average requirement suggested by International Zinc Nutrition Consultative Group (IZiNCG) and 64.8 per cent (95% CI 63.4 to 66.2) with Indian Council of Medical Research-recommended requirements. Stunting was observed in 29 per cent (95% CI 27.2 to 30.8) participants. According to IZiNCG cut-offs, low serum zinc was detected in 57.5 per cent (95% CI 54.1 to 60.8) of adolescents, whereas it was 34.4 per cent (95% CI: 31.2-37.5) according to the national level cut-off. Interpretation & conclusions: Risk of dietary zinc inadequacy and low serum zinc concentration amongst adolescents of the Gond, Bhil and Korku tribes is a public health concern.
RESUMO
Background:Abdominal masses always are mystery in clinical prac?ce. Improvements have taken place in fine needle aspira?on cytology with technical advances in imaging methods of ultrasound and CT. Aims:To study the u?lity of guided FNAC in the diagnosis of abdominal lesions and categories the abdominal lesions. To study cytological features of abdominal lesions and correlate with histopathological features wherever possible. Materials and methods: The study included 82 abdominal lesions. History, clinical features, radiological inves?ga?ons were obtained in each case. USG or CT guidance was used and the FNA procedure was done. Smears were stained with Giemsa and viewed under the microscope for diagnosis. Diagnos?c yield was 95%. Extra material obtained was given for cell block. Results: The age was from 14 years old to 82 years and majority of them were in the age group of 40 – 60 years. Male to female ra?o is 1:1.1. Among 82 cases, 45 cases (54.87%) were malignant, followed by 17 cases (20.74%) benign, 14 cases (17.08%) inflammatory, 04 cases (4.87%) suspicious of malignancy and 02 cases (2.44%) unsa?sfactory for evalua?on. Majority of the cases are in liver and hepatocellular carcinoma was the most common malignant lesion. In 60 cases histopathological correla?on was available and for these cases the diagnos?c accuracy is 95%, sensi?vity is 92.1%, specificity is 100% and p value is <0.001 which is highly significant. Conclusion:Abdominal fine needle aspira?on cytology is simple, cost effec?ve, rapid and repeatable procedure which helps in categorizing the abdominal lesions.
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Background: Worldwide Infertility rate prevails around 8-12% of all couples; approximately 80 million are infertile. In India 10-15% of couples are infertile. Investigating for infertility is to intervene into the modifiable/treatable causes. Therefore, the present study has been undertaken to investigate the morphological patterns of endometrial tissue in women with primary infertility.Methods: The study included 60 cases with complaints of infertility (primary). The premenstrual D and C was done to obtain endometrial biopsy. The present prospective study was a descriptive study and the values are mentioned in percentages.Results: In present study a total of 60 cases were studied. Out of which 36 cases (60%) belonged to the young adult age group. The predominant morphological pattern was that of secretory endometrium seen in 22 cases (36.66%) as opposed to proliferative, endometritic or tubercular pattern. The predominant menstrual pattern recorded was regular; seen in 41 cases (68.33%) as opposed to irregular or mennorhagic patterns.Conclusions: The endometrial biopsy has a great role in screening the cases of infertility as it helps to assess the information about ovulation, ripening of the endometrial tissue and other abnormal endometrial reaction, hormonal imbalance. This is the only method to label the diagnosis of endometrial tuberculosis in an apparently healthy female.
RESUMO
Background: This paper presents the prevalence of human immuno deficiency virus (HIV) infection among men who have sex with men (MSM) attending integrated counselling and testing Centres (ICTC) in selected districts of Karnataka.Methods: A cross sectional study was done at ICTCs. Men and transgenders coming with referral slips from targeted intervention (TI), non-government organizations (NGOs) were considered as MSMs. The basic demographic data, HIV test result and details of post- test counselling were collected in specific format. Data from 13 districts was obtained from April 2009 to March 2010 and comparing the prevalence of HIV among MSM in HIV sentinel surveillance (HSS).Results: Out of 8,276 MSMs in 13 districts, 2808 (33.9%) visited ICTCs with TI NGOs referral slips and were tested for HIV once in a year. The overall prevalence of HIV was 8.6%. Prevalence was highest (17.3%) among men in the age group of 41 to 45 years, illiterates (11.5%), unemployed (11.2%) and divorced and separated (13.3%) and widowed (13.6%) MSMs. Among those tested, 97.7% of MSM underwent post-test counselling and collected their report. The highest HIV prevalence was among MSMs from Mysore district (20.1%), followed by Udupi (19.9%) and Bagalkot (10.6%). Rest of all the other districts had less than 10% of HIV prevalence.Conclusions: The uptake of HIV testing among the MSM with referral slips was low in Karnataka. The prevalence level differs in various districts. There is need for more focused and effective counselling by peer educators for correct and consistent condom usage among illiterate, widowed and unemployed MSMs.