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Histoid leprosy is an uncommon variant of leprosy with characteristic clinical, immunological and bacteriological features and is considered to be a polar variant of lepromatous leprosy. Coexistence of other immunologically diverse forms of leprosy in histoid end of spectrum is very rare. We report a rare case of histoid leprosy on multi-drug therapy for last 7 months shifting to borderline tuberculoid spectrum in type 1 reaction or Wade’s contamination, spectral shift
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In the past decade, the rate of cesarean sections has doubled leading to the more frequent occurrence of cesarean-related complications. Cesarean scar site diverticulum or isthmocele is one such complication that is defined as an outpouching of the anterior uterine wall at the cesarean scar site in continuity with the endometrial cavity, creating a wedge-shaped defect of variable depth. We report a case of a middle-aged female with secondary infertility for the last 11 years with one live issue 12 years back through a cesarean section at term. She had undergone an array of investigations for infertility for the past 5 years. She was diagnosed as having an isthmocele and managed with surgical repair of the defect at our hospital with subsequent assisted conception 8-month post-surgical repair. The importance of diagnosing a cesarean scar diverticulum cannot be understated not only because it is a surgically treatable cause of infertility but also because if such patients conceive, they may land in uterine rupture, placenta accreta, or scar ectopic pregnancy which can complicate into life-threatening situations.
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Background: The prevalence of Abdominal Obesity as well as of Generalized Obesity are high in India. Obesity can directly alter respiratory physiology through a variety of processes and can lead to reduction in lung function. The quantity and location of body fat alter the impact of obesity on pulmonary function. Waist circumference (WC) links to intra-abdominal and subcutaneous fat and it is a better scale of intra-abdominal fat. Aim and Objectives: (1) To determine the effect of anthropometric parameters like WC, waist-hip ratio (WHR) on timed vital capacity in adult. (2) To determine the difference in timed vital capacity between males and females. Materials and Methods: 150 apparently healthy adults aged 20� years were selected for the study. WC, Waist-hip ratio were measured. Pulmonary functions such as Forced Vital Capacity, Forced Expiratory Volume in one second, (FEV1/FVC%) were recorded using Computerized Spirometer (RMS HELIOS 401). Data were statistically analyzed by unpaired t-test, Karl Pearson抯 coefficient of correlation test, statistical significance was considered for P < 0.05. Results: FVC, FEV1 were significantly declined in both male and female subjects in the group II compared to group I in terms of both WC and WHR. FVC, FEV1were significantly higher in males when compared with females. Significant negative correlation observed between FVC and FEV1 values with Group II of WC and WHR. Conclusion: To conclude obesity even in the absence of specific pulmonary disease, alters the pulmonary function, that can lead to long-term consequences. Regular exercise, yoga, pranayama help to reduce weight and improve breathing by strengthening respiratory muscles.
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Knowledge of Ayurveda is based on specific fundamental principles. Dosha, Dhatu, Mala, Srotasa are some among them. Malas are the waste products which primarily generate after digestion of food. While Srotasa are the channels or pathways in the human body which carries Dosha, Dhatu, Mala and Mana. Sveda (sweat) is one of the waste product which forms after digestion of food or in the process of metabolism of adipose tissue. Formation, transportation and elimination of Sveda is carried out by Sveadavaha Srotasa and it helps to regulate body temperature, maintain skin moisture and excrete toxic substance from body. Detail description of concept Sveda, Svedavaha Srotasa, its normal mechanism, importance in manifestation of various diseases and its application in treatment is described in Ayurvedic texts. Thinking of this fact, for better acknowledgment of these concepts and its role in the practice this comprehensive review has been done.
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Introduction: Tackling of; the patients who had defaultedfor radiation therapy due to implementation of lockdownfollowing COVID-19 outbreak, new patients presenting toout-patient department(OPD) and continuing Radiotherapytreatment without postponing during this health crisis ischallenging. Study objective was to evaluate the outcomesof hypofractionated radiation therapy in the COVID-19 eraand to provide guidance on measures for preparedness in theDepartment of Radiation Oncology to continue the treatmentand tackling treatment breaks.Material and Methods: Patients reporting to the OPD,patients who defaulted for treatment during lockdown phaseand newly diagnosed patients awaiting treatment wereincluded in the study. Hypofractionated schedules were usedfor treatment to reduce the overall treatment time and durationof hospital stayResults: Clinical response evaluation was done at the end of 1month by RECIST criteria. In Head and neck cancer patients60%, 26% and 13.3% of the patients showed CompleteResponse (CR), Partial response (PR) and Progressive diseaserespectively in primary disease and 46%, 40%, 13.3% of thepatients showed CR, PR and progressive disease respectivelyin nodal disease. Among Cervical cancer patients: 75% and25% of the patients showed CR and PR respectively. All Breastcancer patient were disease free at the time of assessment.Conclusion: Hypofractionated radiotherapy schedules to beused wherever feasible reducing the overall treatment timeand the exposure of Cancer patients to COVID-19 and viraltransmission can be mitigated with best clinical practice ofsanitization, wearing masks, Face shield, PPE and Socialdistancing.
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Background: Dengue can result in high mortality. Several studies have shown an association of blood groups with the severity of dengue. In our study we attempt to associate the prevalence of blood groups with the known hematological prognosticators and thus derive its impact on the severity of dengue. We aim to study the patterns and prevalence of different ABO blood groups in dengue fever.Methods: A total of 100 serologically proven dengue cases over a month’s period in November 2016 were recruited for our study. Their relevant hematological data (obtained by automated haematology analyser and peripheral smears) and blood grouping results were recorded and analyzed.Results: The age range was 5 months to 65 years with a slight male predominance. Analysis of the blood group patterns showed prevalence of O group (42%) followed by A and B group (27% each). B group was more prevalent in children (34%) and females (31%) with dengue.The patients with B group showed increased derangement in hematological parameters namely higher number of cases with B group showed rise in haematocrit (59%), an increased number of cases with leucopenia (56%), higher proportion of cases with lymphocytosis (45%) and severe thrombocytopenia (74%) when compared to the other blood groups.Conclusions: Our study shows that blood groups can impact severity of dengue and that B group is a risk factor for severity hence, such individuals warrant close supervision especially in the presence of other risk factors.
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Cancer persists to be a major cause of hospitalization and death every year. With the passage of time, new formulations of anticancer drugs are being introduced to the market and are drawing the concern of healthcare professionals in terms of the superiority, toxicology, and cost-effectiveness of the new formulations in comparison to the conventional formulation of the same drugs. Doxorubicin, a highly potent chemotherapeutic agent, it comes with three formulations (pegylated liposomal, nonpegylated liposomal and non-liposomal conventional formulations). English-language literature of the three formulations of Doxorubicin has been reviewed to inform the healthcare professionals regarding the differences between these formulations. Liposomal Doxorubicin promotes better toxicology profile than non-liposomal conventional Doxorubicin with an increased cost. Due to very limited studies, the cost-effectiveness of liposomal Doxorubicin is not well defined. Apart from that, this review highlights the inter patient variability in regard to the clearance and volume of distribution following the administration of liposomal Doxorubicin. In conclusion, further studies regarding the superiority of liposomal formulation of Doxorubicin , efficacy and dose standardization of liposomal Doxorubicin should be sought in the near future in a more better way.
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Background: Drug utilization research is a part of Pharmacoepidemiology defined by the WHO as the study of marketing, distribution, prescription, and use of drugs in a society, with special emphasis on the resulting medical, social and economic consequences. Conducting periodic studies of pattern of drug use in our hospital setting is essential to critically analyse the current hospital drug policies and to make recommendations based on various guidelines to improve upon the current drug usage pattern. Aims and objectives of the study was to generate data on the drug utilization pattern in Medical ICU and to monitor antimicrobial usage in MICU.Methods: Patients who were admitted in medical ICU of Hassan institute of Medical Sciences were recruited based on inclusion-exclusion criteria. The study was conducted over a period of 3 months from April 2018 to June 2018. The demographic and clinical treatment data of patients were collected. The prescriptions were assessed as per the WHO indicators.Results: Common causes of admission were suicidal poisoning, snake bite, viral thrombocytopenia, myocardial infarction and stroke. The average duration of stay was 5.74 days and average number of drugs/patient was 5.26. Pantoprazole, Ranitidine, Ceftriaxone, Atropine, Pralidoxime, ASV, Ondansetron, and N-acetylcysteine were commonly prescribed drugs. 42.4% of drugs were prescribed by generic names and 84.2% of the drugs were prescribed from Essential Medicine List.Conclusions: This study will provide database to address prescription protocols and guide appropriate use of drugs in the ICU setting.
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Background: Depression is the most important neuropsychiatric complication in chronic kidney disease because it reduces quality of life and increases mortality. The beginning of dialysis treatment causes subtle changes in the life of CKD patients, mainly in the physical and social spheres. It affects the self-care of these patients which lead to poor adherence to dialysis. Hence, the present study was conducted to screen for depression.Methods: This was an observational study among 100 patients undergoing haemodialysis at HIMS, HASSAN. After taking informed consent, subjects were requested to complete Beck, depression Inventory, a 21-question multiple-choice self-report inventory for measuring the severity of depression. Descriptive statistics was applied to infer the findings.Results: The study population showed depression of mild (31%), borderline (10%), moderate (17%), severe (7%) and extreme (3%) grade and the remaining subjects did not show depressive symptoms (32%).Conclusions: Majority of patients undergoing hemodialysis were depressed. Major risk factors for depression were marital status of the patients, low literacy rate, gender and those started on dialysis recently.
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Background: SAM children have increased requirements for phosphorus during recovery. If requirements are not met, they may develop refeeding hypophosphatemia leading to increased morbidity and mortality. However, no much studies known about the effect of current therapeutic diets (F-75 and F-100) on serum phosphate in SAM children.Methods: Prospective observational study, in which measuring serum phosphate at admission, at end of stabilization phase and at discharge in SAM children between 6-59 months.Results: Among 35 children enrolled, mean serum phosphate was 4.3 '0.6 mg/dl at admission, 4.1' 0.8mg/dl at end of stabilization phase and 4.4'0.7mg/dl at discharge. 17% of children had hypophosphatemia at admission, 31% at end of stabilization phase and 17% at discharge. mean weight gain in hypophosphatemia and normophosphatemia groups are 1.3'1.46mg/kg/day and 2.51'2.63mg/kg/day (p=0.1) respectively. Mean duration of stay in hypophosphatemia and normophosphatemia groups are 11.6'1.26 and 10.26'1.54 days respectively (p=0.016).Conclusions: Hypophosphatemia was common among children with SAM at admission and increased at end of stabilization phase. Serum phosphate remains subnormal in about 1/5th of the children at discharge. This could be problematic for further recovery as phosphorus is needed for catch-up growth and bioavailability of phosphorus is low in local diets. Hence, authors suggest phosphorus supplementation in SAM children.
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Background: There is much debate regarding the importance of promoting the use of cheaper generic alternatives over brand-name drugs. While generic drugs have been noted to be comparable to brand-name drugs in their ability to treat conditions, significant debate surrounding their bioavailability or the concentration of the drug that reaches its site of action has arisen. Many experts continue to believe that generic and brand-name drugs are bioequivalent and equally viable options for effective drug treatment, as assumed in this review.Methods: Prices of commonly used branded and generic medicines in same concentration, dosage form and combination were compared with the help of Indian Drug Review, brochures of pharmaceuticals and pharmacies and Jan Aushadhi price list 2017. Mean of all the prices available of branded and generic medicine were calculated and the percentage difference in the mean costs of generic and branded medicines were calculated.Results: The mean cost of 47 branded medicines out of the selected 50 medicines was higher than their generic versions. Mean cost of 3 generic medicines was higher than branded ones. Percentage difference in the mean costs of branded and generic medicines varied from <10% to >70%.Conclusions: This study has shown a very noteworthy difference of prices between branded and generic drugs. Efforts should be taken to promote the generic medication. Misconception about low efficacy with generic drugs should be erased.
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Background: Chronic Kidney Disease (CKD) is a silent disease that is frequently diagnosed in advanced stages. The prevalence and incidence of chronic kidney disease (end-stage renal disease) are continuously increasing, particularly in elderly patients. Poor adherence to complex multimodal therapies is a widely recognized problem in the daily care of dialysis patients, contributing to excess morbidity and mortality of this population. Aims and objectives was to assess the adherence to medications among patients undergoing haemodialysis and to explore the factors affecting non adherence.Methods: After obtaining approval from Institutional Ethics Committee, a prospective observational study was carried out among 150 patients, who were on dialysis in a tertiary care hospital, Hassan. An eight item Morisky Medication adherence questionnaire was used to assess medication adherence. Chi-square test applied to assess statistics.Results: Adherence levels were 28%, 42% and 30% for high, medium and poor adherence respectively. The overall prevalence of non-adherence among respondents was 30%. Among them 77.77% were males, 44.44% belonged to age group of 41-60 years, 40% illiterate, 60% employed, 51.11% of patients with smoking and alcoholic habits were not adherent to Dialysis. Other reasons contributing to non-adherence to treatment were forget fullness (86.66%), inadequate knowledge about side effects (80%), unhappy clinical visits (71.11%) and lack of assistance (48.88%).Conclusions: In this study patient showed moderate adherence. This emphasizes the need for constant motivation and education at frequent intervals to ensure better adherence.
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Title: Short study on change in BP and BMI in obese and non obese young girl students. Introduction: High blood pressure (BP) is a major determinant of cardiovascular events in obesity. This study was undertaken to analyze the differences in certain well-defined cardiovascular parameters in obese and non-obese young girl students between age 17 to 21 with respect to their BMI. Aims and Objectives: To compare change in BP and BMI in obese and non obese young girls. Materials and methods: This study was conducted on 50 girl students of our medical college. The parameters studied were change in BP and BMI. They were divided in to 2 groups, obese and non obese. Their baseline BP, SBP after moderate exercise and their body mass index were noted. The values obtained were analyzed by unpaired t test and p value <0.05 considered as significant. Results: The mean and std dev of SBP after moderate exercise in obese and non obese young girls were 143.64±18.4184 and 132.08±12.6948 respectively and their p value is 0.0129. The mean and std dev of BMI in obese and non obese young girls were 25.7048±0.0578 and 20.8316±0.5185 respectively and their p value is 0.0001. The mean and std dev of change in BP in obese and non obese young girls were 32.6±18.5539 and 22.24±12.2925 respectively and their p value is 0.0242. Conclusion: There is a significant rise in SBP in obese girls with moderate exercise limiting their physical abilities.