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Background: In today’s era lifestyle related diseases like diabetes mellitus, have emerged as a major public health problem. Diabetes mellitus, a common metabolic disorder, which accounts for a high incidence of morbidity leads to various events including micro and macro vascular complications. This study aims to assess the baseline levels of (KAP) knowledge, attitude and practices of general population of Vadodara. Materials and methods: The present cross sectional study was carried out on general population of Vadodara with the help of a suitably designed and validated KAP questionnaire. The questionnaire was pretested and verified for errors. The data was analyzed statistically. Results: Altogether, 60.12 % of respondents scored 100% in the questions related with knowledge. However 23.54% scored 100% in the attitude questions and12.80% scored 100% in practice questions. Conclusions: We can conclude that the responders had good knowledge but poor attitude and practice towards diabetes. We can overcome this by increasing quality of health education and improving applicability of scope of health education at all level.
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Background: Scientific study of lip prints as lines and fissures in form of wrinkles and grooves on labial mucosal surface of upper and lower lip which developed since sixth week of intra uterine life is called as Cheiloscopy. Materials and methods: The present study was done among total 121 2nd MBBS students after obtaining their informed written consent and ethical approval. Lip prints were collected, developed and analyzed with use of red/pink lipstick (Persona®: non-metallic, non-glossy, non-persistent), white paper, cellophane tape, scanner, hand magnifying glass, scissors, Adobe Photoshop CS5 Software etc. Results: Out of 73 male students, most common lip pattern was II (branched) in 45.21%, followed by I (long vertical) in 27.4%, IA (short vertical) in 15.6%. Out of 48 female students, most common lip pattern was II (branched) in 44.64%, followed by I (vertical) in 25.62%, IA (short vertical) in 13.22%. Out of total 121 students, most common lip pattern was II (branched) in 44.64% and least common was V (mixed indefinite) in 1.65%. Conclusion: It was found that type II (branched) was most common type of lip print observed among students while type V (mixed indefinite) was the least common among students.
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Introduction: Organophosphorus compound (OPC) poisoning has assumed alarming proportions and it is primarily a problem of the developing countries. Serum cholinesterase levels are easier to estimate and usually depressed after OP poisoning. Peradeniya OP poisoning scale has not been studied much in Indian scenario. So, we decided to have first hand information and hence conducted this study. Aim and objectives: To find out severity of patients with OP poisoning by calculating Peradeniya OP Poisoning score, level of plasma and RBC cholinesterase level of patients of OP poisoning on admission before any treatment, and correlate the level with severity and outcome of patients and requirement of ventilator support with OP poisoning. Material and methods: All patients who presented to emergency department with history of poisoning with known compound were taken as study subjects. A detailed history, clinical examination and relevant biochemical investigations were performed. Peradeniya OP poisoning scale Patel P, Patel VP, Patel H, Rathod GB. Study of prognostic value of serum and RBC acetyle cholinesterase level in organophosphorus poisoning and its correlation with the outcome. IAIM, 2016; 3(3): 147-157. Page 148 was applied to all study subjects and the severity of OP poisoning was graded as mild, moderate, severe. In all study subjects, 3 ml of plain blood was collected on admission before administration of atropine and plasma cholinesterase and RBC cholinesterase was estimated. Results: Most of the patients consumed poison with a suicidal intent. Majority had consumed poison orally. Most patients had consumed 50 – 100 ml of poison. Quantity of poison consumed did not correlate with severity of poisoning. In this study, requirement of ventilatory support was seen in 16% of patients. Mortality in our study was 9%. Pseudo cholinesterase levels were significantly depressed in patients who required ventilatory support and correlated with mortality. Miosis, Bradycardia, increased respiratory rate, impaired level of consciousness, all correlated well with need for ventilatory support and increased mortality. Peradeniya OP poisoning score of more than 8 correlated in predicting the need for ventilatory support and mortality. RBC and Plasma cholinesterase levels estimation in conjunction with Peradeniya OP poisoning score is a useful parameter for grading severity of OP poisoning and in predicting the need for ventilatory support and mortality. Conclusion: The POP scale and RBC Che and plasma cholinesterase levels both showed a significant association in predicting the need for ventilatory support and outcome. Lower grade of poisoning had a better outcome whereas higher severity of poisoning had a poorer outcome.
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Introduction: Anemia is a common finding in diabetes. Number of factors contributes to an increased prevalence of anemia in diabetes. Aim: To determine the prevalence of anemia in our patients with diabetes. Material and methods: The present study was conducted at the Gayatri Hospital, Gandhinagar. The subjects for the study included 200 adult patients with age more than 30 years and having diabetes mellitus type 2, attending the outdoor patient department (OPD) or admitted in ward as indoor patient department (IPD) of Gayatri Hospital. Blood specimens were collected and processed for determination of blood glucose, serum creatinine, and hemoglobin, HbA1C. Results: Anemia was present in 18% patients of diabetes. The prevalence of anemia was almost similar between women (18.60%) and men (17.54%). 74% of anaemic patients had a serum creatinine <110 μmol/l and 72% of anaemic patients had a calculated creatinine clearance of >60 ml/min. Conclusion: Every fifth individual in a population of diabetes mellitus could be anemic. Identifying and treating anemia would make a great impact in managing various complications of diabetes mellitus.
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Background: Negligence is defined as doing something which reasonably competent people not suppose to do or not doing something which reasonably competent persons suppose to do. Materials and methods: Present study was undertaken with aim to assess knowledge and awareness of general population towards medical negligence at Valsad. Total 100 people from general population were subjected to pre-tested and pre-validated questionnaire related to medical negligence after obtaining their informed written consent. Questionnaire contain 10 questions related to medical negligence with responses based on Likert’s scale varied from strongly disagree to strongly agree. Responses obtained were tabulated in MS Excel sheet and analyzed via SPSS software. Results: Out of 100 participants, 37% were between 31-40 years age group, 65% were male and 73% were married. Total 55% were agreed upon that failure to maintain a medical record by hospital is negligence. 33% were not sure about that doctor, nurse and management staff of hospital – anyone can be liable for negligence. 71% were agreed upon that performing operation without informed written consent is negligence. 31% were agreed upon that treating a patient without his consent is negligence. 48% were strongly agreed upon that carelessly leaving an instrument in patient’s body after operation is negligence. 31% were disagreed upon that refusing to attend patient in emergency is negligence. 36% were agreed about that performing or helping for euthanasia is negligence. 72% were agreed upon that death due to negligence is punishable by court. 44% were agreed upon that compensation for negligence can be claimed in consumer court. 55% were agreed about that wrong diagnosis followed by wrong treatment is considered as negligence Conclusion: Present study reflected that general population has quite a good knowledge regarding medical negligence which may increase gradually over a period of time due to news papers, internet Parmar P, Rathod GB. Knowledge and awareness among general population towards medical negligence. IAIM, 2016; 3(7): 250-254. Page 251 and other resources. Training programs should be conducted for them to bring true knowledge and awareness regarding medical negligence which indeed helps to them as well as practitioners.
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Introduction: Ovarian neoplasm is the most fascinating tumor of women in terms of its histogenesis, clinical behavior and malignant potential. The ovary is the third most common site of primary malignancy in female genital tract after cervix and endometrium accounting for 30% of all cancers of female genital tract. Aim and objectives: To study frequency and distribution of different histological types of ovarian tumors and to analyse age distribution of these tumors and to find out frequency of benign and malignant neoplasms of ovary. Material and methods: The present study was based on histopathological evaluation of 97 cases of ovarian neoplastic lesions received at the Department of Histopathology, B.J. Medical College, Ahmedabad during October 2012 to October 2013. The gross specimens received were fixed in 10 percent formalin for 24 hours and multiple sections from each specimen were taken to include the representative area for histological examination. Sections were processed by routine paraffin method, blocks were cut at five micron thickness and the sections were stained with conventional Haematoxylin and Eosin (H&E) stain. The lesions were then classified and studied according to WHO Classification of ovarian tumors. (ICD - 9 th edition). Results: A total number of 97 cases were studied. Among these, 82 cases (84.5%) were benign, 2 cases (2.1%) were borderline and 13 cases (13.4%) were malignant tumors. Benign neoplasms were most commonly seen in 3rd to 5th decade, whereas malignant neoplasms were commonly seen in 5th decade. Serous cystadenoma (52.7%) was the commonest benign tumor followed by Mucinous Modi D, Rathod GB, Delwadia KN, Goswami HM. Histopathological pattern of neoplastic ovarian lesions. IAIM, 2016; 3(1): 51-57. Page 52 cystadenoma (28.4%). Among the malignant surface epithelial tumors, serous cystadenocarcinomas (8.1%) were most common followed by Mucinous cystadenocarcinomas (4.1%). Conclusion: Benign ovarian tumors were more common than malignant ones for all age groups. Surface epithelial tumors were the most common class of tumors. Serous cystadenoma was the most common ovarian tumor overall as well as the most common benign tumor, whereas serous cystadenocarcinoma was the most common ovarian malignancy. Malignant ovarian tumors were more common above 40 years.
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Introduction: Cervical cancer is the third most common type of cancer among women worldwide, following breast cancer and colon cancer. The micronucleus test is a simple and widely used technique to evaluate genetic damage due to exposure to carcinogenic or mutagenic agents. We undertook this study to compare the MN (micronucleus)score in the whole spectrum of cervical lesions Materials and methods:In this retrospective study, we had compared the MN score in the whole spectrum of cervical lesions which comprised of seven different groups like normal (20), inflammatory (30), ASC-US (20), ASC-H (13), LSIL (20), HSIL (10) and IC (19) over aperiod of 1year (January 2014 to December 2014)which includeda total of 132 cases.Results:In the present study,there was a stepwise gradual increase in MN count from inflammatory to ASC-US to LSIL to HSIL group, followed by a slight increase in IC. The mean MN count was most significant in the LSIL and HSIL group. Thus micronucleated cells as well as the total number of micronuclei show increasing trend towards malignization.Conclusion:Our study showed that MN counting can be a helpful screening tool in conjunction with conventional Pap test for screening of cervical cancer.
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Background: The international association for the study of pain has defined pain as unpleasant and emotional experience associated with actual or potential tissue damage or described in terms of such damage. Spinal anesthesia was first produced by Corning in 1885 and first used deliberately by Bier in 1898. Glucose containing solution for spinal anesthesia was introduced by Barker in 1907. Since then hyperbaric solutions are in use for spinal anesthesia. All these advantages of spinal anesthesia are offset by complain of postoperative pain when effect of local anesthesia wears off due to relatively shorter duration of action of local anesthetic drug. Aim: The present study was designed to evaluate the effect of intrathecal bupivacaine 0.5% heavy 3.0 ml (15 mg) with neostigmine 5 mcg and bupivacaine 0.5% heavy 3.0 ml (15 mg) with neostigmine 5 mcg and nitroglycerin patch (5 mg/24 hour) in various surgeries divided 2 groups, 25 patients in each group. The objectives of study were to observe onset and duration of sensory and motor blockade, to observe duration of post operative analgesia, to observe perioperative hemodynamic stability, to observe perioperative complications. Patel VP, Patel P, Mehta SS, Rathod GB. Effect of transdermal nitroglycerin patch on intrathecal neostigmine with bupivacaine for post operative analgesia. IAIM, 2016; 3(2): 31-40. Page 32 Materials and methods: The study was conducted by taking 50 randomly selected patients for various surgeries. Patients belonged to ASA Grade I/II aged 18 to 60 years were included. Patients were divided into 2 groups. Group - A: 0.5% heavy bupivacaine 3 ml (15 mg) + preservative free neostigmine 5 mcg. Group - B: 0.5% heavy bupivacaine 3 ml (15 mg) + preservative free neostigmine 5 mcg + transdermal nitroglycerin patch (5 mg/24 hours), applied on a non anaesthetised area after 20 minutes. All the patients were evaluated preoperatively and those having history of allergy to any drug, having any contraindications to spinal anesthesia, any neurological disorder and psychiatric illness were excluded from the study. Detailed preoperative history of past and present illness was taken. Systemic and general examination was done and back of patients were examined to rule out any spinal deformity and infection at local site. Patients were investigated for laboratory investigations like complete blood count, blood Sugar, renal function test, serum electrolytes, serum bilirubin and chest X-Ray, ECG were reviewed. Results: In our study of 50 patients we observed that intrathecal neostigmine 5 mcg with bupivacaine 15 mg with transdermal nitroglycerin patch (5 mg/day) markedly prolong duration of post operative analgesia than intrathecal neostigmine with bupivacaine alone. Intra-operative complication like bradycardia do occur but it was not significant, and other complication like hypotension occur with both groups but more in group B which requires monitoring . Conclusion: Transdermal nitroglycerin patch increases post-operative analgesia of low dose intrathecal neostigmine with bupivacaine in spinal anesthesia with less side effects.
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Introduction: Breast carcinomas are one of the leading causes of cancer in women. Fine Needle Aspiration Cytology (FNAC) is one of the important tools for the pre-operative diagnosis of breast lesions. Materials and methods: A total of 200 breast aspirates were studied. Histo-cytopathological correlations were obtained in all cases. All the aspirates were stained with Hematoxylin and Eosin (H and E) stain. Results: Among 200 patients, 195 were females and 5 were males. Benign breast lesions were found in 120 cases; among which fibroadenoma (34%) was the commonest lesion which was observed. Malignancy was observed in 80 cases; among them, ductal carcinoma was the predominant. Conclusion: We can conclude that FNA is widely accepted as a reliable technique in the initial evaluation of palpable breast lumps. It is simple, safe, cost-effective, minimally invasive, rapid and as sensitive as biopsy.
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Background: Thalassemias are a group of congenital anemias that have in common deficient synthesis of one or more of the globin subunits of normal human haemoglobins. They are one of the commonest inherited hemolytic disorders. Materials and methods: Present study was done at a teaching hospital in Ahmedabad between August 2005 and September 2007. Blood samples of patients attending Thalassemia Clinic and Pediatric Department were tested. Total 93 patients were tested for HIV, HBsAg and HCV as and when they came for transfusion. Results: 4 Patients were found HIV positive. All of them were male. The increased seropositivity coincided with increased no of transfusions. Incidence of HIV positivity is 4.3%. Two of them were also HCV reactive and one HBSAg reactive. Out of 93 thalassemic children 4 were found HBsAg positive. All of them were male and non - vaccinated. Incidence of HBsAg positivity is calculated as 4.356. The low incidence of HBsAg positivity can be correlated with high proportion of the children getting vaccinated. 72 patients (77.4%) are vaccinated or undergoing vaccination. 19 Patients were found anti - HCV antibody positive showing an incidence of 20.4%. 13 of them were male and 6 female Conclusion: Thalassemic children receiving multiple transfusions are at high risk of acquiring transfusion transmitted infections (TTIs). Incidence of HIV positively has decreased due to mandatory screening of all blood bags. Ideally all patients should complete vaccination for hepatitis B before starting transfusion or as soon as possible thereafter. At present HCV infection has higher incidence in Modi D, Rathod GB, Delwadia KN, Goswami HM. Study of seroprevalence in thalassemic patients. IAIM, 2016; 3(4): 57- 65. Page 58 thalassemics as there is no vaccination available. Now a thalassemic with optimum transfusion and chelation has life expectancy like non thalassemics.
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Background: A spectrum of pathological bone lesions can be presented in any form from inflammatory to neoplastic conditions. Diagnosis of all bone lesions is made by radiological modalities like plain X-ray, CT scan, MRI and bone scintigraphy. Aim and Objectives: To study histopathological features of bone lesions and correlate them with age, site and type of lesions. Material and Methods: The study was carried out at tertiary care center from April 2013 to November 2013. A total of 102 bone lesions were analyzed. Bone biopsy was performed after detailed clinical and radiological examination. After fixation, decalcification, processing and H&E staining, histopathological diagnosis was made. Results: Out of all 102 cases, 44.11% bone lesions were found between 25-50 years with male predominance. The incidence of non neoplastic lesions was 74.5% and neoplastic lesions were 25.4%. Amongst neoplastic lesions, incidence of benign tumors was 17.64% and malignant tumors were 7.8%. The Tuberculous Osteomyelitis was most common non neoplstic lesion while giant cell tumor and osteochondroma were common among benign tumors and osteosarcoma and Secondary metastasis were common among malignant bone tumors. Conclusion: Though Bone tumors are less common, if viewed in perspective of clinico radiology and histopathology, correct diagnosis can be made.
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Background: Informed consent is way of providing necessary information to the patients and helping them for decision making. All the pros and cons of procedure must be explained to the patients in the language he or she can understand. Just taking signature of patient on consent form without proper explanation and understanding of him is violating entire process of informed consent. Materials and methods: A cross sectional, observational study was conducted over 121 patients aged 18 years and above who came to Gayatri Hospital, Gandhinagar after obtaining their informed written consent for participation in survey regarding informed consent. All participants were subjected to pretested and validated questionnaire (Likert type scale) regarding legal aspects of informed consent. Results: Out of 121 participants, only 100 participants’ responses were included for analysis. Among 100 participants 73 were male and 27 were female. 78% agreed that informed consent is must for any procedure. 61% agreed that signing consent form is just a formality. 91% believed that informed consent is protective shield for doctors. 88% believed that informed consent is legally necessary. Only 52% agree that consent form is meant to protect patients’ rights. 77% felt that signing consent form Parmar P, Rathod GB, Rathod S, Parikh A. Consent in medical practice – Perceptions of patients towards legal aspects of informed consent. IAIM, 2016; 3(4): 105-110. Page 106 eliminate patients’ right to compensation. 82% wanted to know everything but letting decision left on doctor. Conclusion: The study concluded that there is a vide gap between actual concept of informed consent and perceptions of patients for the same. Patient awareness programs must be conducted by appropriate authority with help of media and television to improve their knowledge and preserve their rights.
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Background: Investigation of the structure and biosynthesis of glycosylated Hemoglobin (HbA1c) in the past decade have provided a means to objectively access the average level of glycemia in diabetic patient. The use of Glycosylated hemoglobin level as integrated index of long term blood glucose level, represent a significant tool in our research and therapeutic armamentarium. In this study, we have estimated glycosylated Hemoglobin (HbA1c) in diabetic and non diabetic person and its relationship with fasting and post prandial blood sugar levels. Materials and methods: In present study, Glycosylated hemoglobin levels were estimated by using cation exchange resin method. The study was conducted from November 2012 to October 2014. Measurement of total HbA1c and blood sugar were carried out at Diabetic research laboratory, Tertiary care centre, Teaching Institute. 110 Non diabetic persons studied as a control, which were proved to be Non diabetic from history, FBS, PPBS, Urine sugar. Persons with family history of diabetes were not included in control group (Group: X). 350 diabetic patients which included new and old cases, IDDM and NIDDM cases, complicated and non complicated cases, among them 241 were having NIDDM and 109 were having IDDM type of diabetes (Group: Y+Z). All cases thoroughly studied and details about personal data, history, clinical examination, laboratory investigations, complication of diabetes and type of treatment were noted. Results: In IDDM, there was higher value of mean GHb (13.13%), than in NIDDM (mean GHB 11.89%). Patients having Insulin therapy had higher value of GHb (13.08%) than with on oral hypoglycemic agents (11.91%) and patients on dietary modification had level 9.44%. There was no Modi D, Rathod GB, Delwadia KN, Goswami HM. Study of significance of glycosylated hemoglobin in diabetic patient. IAIM, 2016; 3(4): 1-10. Page 2 significant difference in GHb among patients with complication (12.26%) and patients without complications (12.29%). Conclusion: Glycosylated hemoglobin assay defines an end point as the fuel of diabetic therapy and provides a powerful stimulus to the patients to improve their compliance. Glycosylated hemoglobin assay may provide an alternative method of screening for diabetes.