Annals of International Medical and Dental Research (AIMDR)
Vol-8, Issue-1 | January-February 2022
Assessment of Effect of Exercise on Body Composition in Obese and Overweight
Reshma Shireesha1, Obulesu2*
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 1-6 | DOI: 10.53339/aimdr.2022.8.1.1
Assessment of Effect of Exercise on Body Composition in Obese and Overweight
L. Reshma Shireesha1, Obulesu2*
Abstract
Background: Aim: To assess the effect of exercise on body composition in obese and overweight.Methods:A total of seventy- two overweight subjects of either gender were enrolled for the study. Two groups were prepared. One group was experimental group (n=36) and the second group was control group (n=36). Parameter such as age, height and weight was recorded. On the basis of variables body mass Index and body fat percentage of every subject was determined. The experiment group were put on aerobic exercises spread over duration of four weeks.Results:The mean height in group I was 163.7 cm and 165.4 cm in group II. Weight was 65.2 kg and 63.5 kgs in group II, BMI (Kg/m2) was 29.4 and 29.1, body fat was 29.3% and 29.6% in group I and II respectively. A significant difference was observed (P< 0.05). The mean pre- test BMI was 29.6 and 38.5 and post- test value was 26.4 and 38.9 in group I and II respectively. A significant difference was observed (P< 0.05).Conclusions:Regular physical activity appears to confer a health benefit to the people. There was a positive relationship between aerobic exercises and overweight women in order to reduce the value of fat in the body.
Exercise, Obese, Overweight.
Prevalence of Depression among 6–15 Years of Age
Harshindar Kaur1*, Sukhmani Kaur2, Tejvir Singh Shimar3, Devina Singh4
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 07-11 | DOI: 10.53339/aimdr.2022.8.1.2
Prevalence of Depression among 6–15 Years of Age
Harshindar Kaur1*, Sukhmani Kaur2, Tejvir Singh Shimar3, Devina Singh4
Abstract
Background: Aim: To assess cases of depression in children. Methods:Eighty- nine children age ranged 6-15 years of either gender were included. The level of depression among children was determined with Patient Health Questionnaire (PHQ-9).Results:Age group 6-10 years had 24, 10-12 years had 30 and 12-15 years had 35 children. Boys were 55 and girls were 34. Residence was urban in 39 and rural in 50. Family type was joint in 52 and nuclear in 37. A significant difference was observed (P< 0.05). 35% not at all felt little interest or pleasure in doing things, 52% not at all felt down depressed, 46% not at all felt trouble falling or staying asleep, 34% not at all felt tired, 60% not at all felt bad about yourself, 68% not at all felt trouble concentrating on things, 70% not at all felt moving or speaking so slowly that other people could have noticed, 82% not at all felt thoughts that you would be better off dead or of hurting yourself in the some way. Level of depression was not at all in 12%, minimal in 35%, mild in 42%, moderate in 10% and severe in 1%. The difference was significant (P< 0.05).Conclusions:Most of the children had mild and minimal depression. Most of the children had feeling tired.
Children, Depression, Patient Health Questionnaire.
Imaging Findings of Knee Trauma on Magnetic Resonance Imaging
Poonam Ohri1, Shreeji Goyal2*, Niveditha3, Manasi Kohli4
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 12-23 | DOI: 10.53339/aimdr.2022.8.1.3
Imaging Findings of Knee Trauma on Magnetic Resonance Imaging
Poonam Ohri1, Shreeji Goyal2*, Niveditha3, Manasi Kohli4
Abstract
Background: Knee is one of the major joints involved in kinesis. With increasing involvement in sports related activities especially in young people, Trauma related knee pathologies have increased. An accurate diagnosis regarding the type and extent of injuries is essential for early operative as well as non-operative treatment. Methods:This prospective study included total of 82 cases. The patients were referred to the department of Radiodiagnosis from indoor and outdoor departments of Guru Nanak Dev Hospital, Amritsar with suspicion of internal derangement of the knee and with history of knee trauma.Results:The most common age group involved was young males between 15-34 years. In all age groups most of the patients were males. Most common ligament to be injured was Anterior Cruciate Ligament (ACL). Partial tears were more common than complete tears. Posterior Cruciate Ligament (PCL) tears were less common. Medial Collateral Ligament (MCL) tears outnumbered Lateral Collateral Ligament (LCL) tears and grade 2 tears were more common in both. Among the meniscal injuries Medial Meniscus (MM) tears were more common than LM and grade 3 signal was more common in both. Most of the patellar retinaculum injuries were associated with Anterior Cruciate Ligament ACL tears.Conclusions:Post-traumatic pre-arthroscopic MR imaging evaluation has proved to be cost-effective. MRI is an accurate imaging modality complementing the clinical evaluation and providing a global intra-articular and extra-articular assessment of the knee.
Knee, Trauma, Anterior Cruciate Ligament, Posterior Cruciate Ligament, Medial Collateral Ligament, Lateral Collateral Ligament, Meniscus
Rakesh Sharma1, Dharam Singh2*, Jagsir Singh3, Rajesh Kapila4
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 24-30 | DOI: 10.53339/aimdr.2022.8.1.4
Management of Comminuited Intra/Juxta Articular Fracture of Distal Radius Using Bridging External Fixator
Rakesh Sharma1, Dharam Singh2*, Jagsir Singh3, Rajesh Kapila4
Abstract
Background: Distal radius fractures are the third most common osteoporotic fractures and are frequently treated in emergency department. They have a trimodal peak of occurrence and there has been a significant increase in incidence of involvement in elderly females and young males. Management of these fractures comes with lots of treatment options and challenges to provide good functional outcome. This prospective study was done for the management of communited intra/juxta articular fractures of distal end radius using a bridging external fixator on 25 patients. The principle of ligamentotaxis was used for alignment of fracture fragments and wrist spanning external fixator was used to maintain the fracture reduction.Methods:25 patients of either sex with age group 16 to 80 years were taken from the orthopedic department. After proper primary care, cases were classified using Fernandez classification, and posted for surgery as soon as investigations and fitness were taken.Results:Patients involved in the study were in range of 16 to 78 years with 16 patients having dominant side with road traffic accident as leading cause.Radiological union was seen at an average of 7.3 weeks, 4 patients had superficial pin tract infection, 3 patients had stiffnes and a single case had malunion. Conclusions:Modified clinical scoring system of Green and O’Brien was used to evaluate the overall functional results which showed excellent to good results in 84% of cases. Hence, properly planned and executed bridging external fixator is an easy, cost-effective and reliable treatment modality through the “Principle of Ligamentotaxis”.
Distal radius fractures, ligamentotaxis, bridging external fixator.
Evaluation of Pathogens Causing Urinary Tract Infection and Their Sensitivity Pattern
Vijay Kumar1*, Swayambhu Shubham2, Satyendra Narayan Singh3
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 31-37 | DOI: 10.53339/aimdr.2022.8.1.5
Evaluation of Pathogens Causing Urinary Tract Infection and Their Sensitivity Pattern
Vijay Kumar1*, Swayambhu Shubham2, Satyendra Narayan Singh3
Abstract
Background: UTI constitute a major public health problem in India accounting 2nd most common infection next to respiratory tract infection. They are responsible for increasing treatment cost and significant morbidity.Aim:-To determine the incidence of UTI, evaluation of pathogens responsible and their antimicrobial susceptibility pattern in the population.Methods:Urine samples were collected from 300 patients attending the OPD Patna medical college, Patna during the period of 18 months (January 2017 to June 2018) Antimicrobial sensitivity testing was done for the bacterial isolates present in the sample by Kirby- Bauer disc diffusion method. Only those samples were taken into consideration which develops count equal to or greater than 1*105CFU/ml as indicated by Kass.Results:Out of 300 samples collected 146 (48.66%)) yielded bacterial growth. Out of 146 culture isolates E.Coli was the most common pathogen followed by klebsiella, CoNS and staphylococcus. Antibiotic sensitivity was performed on all the isolates. It was observed that highest sensitivity was 49.31% to amikacin, gentamycin (45.89%), nitrofurantoin (38.35%) meropenem (27.39%).Conclusions:It was observed that high grade of resistance to ampicillin, cotrimoxazole, ciprofloxacin, cefuroxime, chloramphenicol, cefotaxime, cefazolin, amoxicillin + clavulanic acid and gentamycin is present as a result of misuse or improper use of antibiotic in the community. Hence urine culture is necessary for the diagnostic screening of UTI before the treatment.
Urinary tract Infection (UTI), Coagulase Negative Staphylococcus (CoNS), Outdoor Patients Department (OPD), Antimicrobial Sensitivity Susceptibility Tests (AST).
Effectiveness of Functional Endoscopic Sinus Surgery in Surgical Management of Ethmoid Polyps
KumariRadha M. N1*, Anju Unnikrishnan2, Manju.N3
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 38-42 | DOI: 10.53339/aimdr.2022.8.1.6
Effectiveness of Functional Endoscopic Sinus Surgery in Surgical Management of Ethmoid Polyps
KumariRadha M. N1*, Anju Unnikrishnan2, Manju.N3
Abstract
Background: Aim: To assess efficacy of functional endoscopic sinus surgery in surgical management of ethmoid polyps.Methods:One hundred twelve adult patients age ranged 18- 38 years of either gender with ethmoid polyps underwent FESS under general anesthesia. The extent of surgery was decided based on the findings in pre-operative CT scan of paranasal sinuses. Anterior ethmoidectomy, posterior ethmoidectomy, middle meatus antrostomy and clearance of frontal recess were performed in all the patients. Five functional criteria were evaluated as nasalobstruction , anosmia, rhinorrhea, post nasal drip, head ache and facial pain.Results:Pre- operative nasal obstruction percentage was 3.42 and post- operative ercentage was 2.10, Anosmia percentage was 2.14 and 1.15, Rhinorrhea percentage was 3.56 and 2.08 and ocular problem in 1 and synechia in 4 cases.Conclusions:Functional endoscopic sinus surgery found to be effective in management of ethmoid polyps and hence can be the treatment of choice.
Functional endoscopic sinus surgery, ethmoid polyps, nasal obstruction, rhinorrhea
Study of Epilepsy and its Correlation with Neuroimaging and Drug Therapy
Bela Shah1, Dhara Gosai2, Sonu Akhani3, Mehul Jadav4*, Nirav Rathod5
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 43-49 | DOI: 10.53339/aimdr.2022.8.1.7
Study of Epilepsy and its Correlation with Neuroimaging and Drug Therapy
Bela Shah1, Dhara Gosai2, Sonu Akhani3, Mehul Jadav4*, Nirav Rathod5
Abstract
Background: Thousands of people in the world suffer from epilepsy. Inspite of modern advances, it can be controlled in only 80% of treated once. Diagnosis and treatment of epilepsy is still challenged. The present study is attempted to highlight the importance of clinical findings and role of EEG and CT scan and MRI in diagnosis of epilepsy2.Aim:To study the incidence and epidemiological profile, various types of epilepsy and correlation with MRI, CT SCAN, EEG and the effectiveness of various Anti epilepticdrugs in different types of epilepsy. Settings and Design: This is a prospective study carried out at Civil Hospital, Ahmedabad.Methods:All the patients having 2 and/or more unprovoked seizures and already enrolled patients in epilepsy clinic in 1 year duration from January 1,2020 to December 31,2020 were included.Results &Conclusions:Out of 6930 total admissions, 163 patients with epilepsy were enrolled in this study from age group of 1 month to 12 years. Out of 163 patients, 97 were male and 66 were female. Most common age group affected is of 1-5 years. 128 patients (78.62%) were of generalized epilepsy and 35 patients were of partial epilepsy. Most common precipitating factor in epilepsy is inadequate drug dosages (45%). 45 patients (22.7%) have developmental delay. Abnormal EEG findings were present in 123 patients (75.46%). Abnormal MRI findings were present in 37 patients (22.7%). CT scan was done in 56 patients, 20 were abnormal. 107 patients were on monotherapy and 56 patients were on polytherapy. Valproate is most commonly used drug (76.6%).
Epilepsy, Neuroimaging, Monotherapy.
The Laboratory Diagnostic Profile of SARS−CoV−2 (COVID−19) Patients & Associated Factors
Divmehar Kaur1, Inderpreet Kaur2, Ravinder Khaira3*, Sanjay Goel4, Maninder Kaur5
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 50-60 | DOI: 10.53339/aimdr.2022.8.1.8
The Laboratory Diagnostic Profile of SARS−CoV−2 (COVID−19) Patients & Associated Factors
Divmehar Kaur1, Inderpreet Kaur2, Ravinder Khaira3*, Sanjay Goel4, Maninder Kaur5
Abstract
Background: Severe Acute Respiratory Syndrome Corona Virus 2(SARS−CoV−2) is the novel corona virus first detected in Wuhan in 2019. nCOV belongs to the β-corona virus cluster. As the third most highly pathogenic corona virus, the clinical presentations of 2019-nCoV infection resemble those of the other two corona viruses, Severe Acute Respiratory Syndrome Corona Virus (SARS-CoV) and Middle East Respiratory Syndrome Corona Virus (MERS-CoV). The abnormalities in the laboratory indices particularly the Blood Biochemical parameters may be associated with the severity of multiple organ dysfunction seen in COVID-19. The aim of the present project was to analyze the laboratory diagnostic profile of sars−cov−2 (covid−19) patients & to study the associated factors.Methods: The present hospital – based cross sectional study was conducted on all the patients who had tested positive for COVID & were admitted in Rajindra Hospital, Patiala in the time period of the July 2020 to December 2020, during the declared Corona Virus Pandemic. All the Biochemical Parameters were estimated on the automatic Analysers.Results: The results of the present study show abnormalities in the Renal Function Tests, Liver Function Tests, Blood sugar levels and Serum Electrolytes. Blood sugar levels and Renal function tests are significantly deranged in the patients of Covid 19 having co-morbidities like Diabetes Mellitus, Hypertension, CAD, CKD, Hypothyroidism etc: Conclusions:Biochemical Laboratory parameters
COVID-19, Comorbidities, Biochemical Parameters.
A Review of Intubation Techniques in Anaesthetic Management of Temporomandibular Joint Ankylosis
Archna Sharma1, Manish Kumar Sharma2*
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 61-68 | DOI: 10.53339/aimdr.2022.8.1.9
A Review of Intubation Techniques in Anaesthetic Management of Temporomandibular Joint Ankylosis
Archna Sharma1, Manish Kumar Sharma2*
Abstract
Intubation of a patient with temporomandibular joint ankylosis is a challenge for every anaesthesiologist. Dependable anaesthetic technique is most desired by all anaesthesiologists. The purpose of the present article is to have a brief overview of temporomandibular joint ankylosis, its clinical features, management and to review literature demonstrating various intubation techniques available to an anaesthesiologist while managing patients with temporomandibular joint ankylosis.
Intubation technique, Temporomandibular joint ankylosis, Fiberoptic intubation, Blind nasal intubation, Retrograde intubation, Light wand aided intubation.
Cervical Necrotizing Fasciitis: An Uncommon Fulminant Disease Entity
Manish Kumar Sharma1, Archna Sharma2*
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 69-80 | DOI: 10.53339/aimdr.2022.8.1.10
Cervical Necrotizing Fasciitis: An Uncommon Fulminant Disease Entity
Manish Kumar Sharma1, Archna Sharma2*
Abstract
Cervical necrotizing fasciitis is an uncommon fulminant disease of single or polymicrobial infectious origin characterized by rapid necrosis of the subcutaneous tissue and fasciae. The disease has high mortality rate. Early identification, timely surgical debridement, broad spectrum antibiotic therapy, aggressive wound care and intensive medical care of the patient are of paramount importance for better prognosis. We present a case report and review of literature of cervical necrotizing fasciitis with a thorough insight into its epidemiology, etiology, pathogenesis, diagnosis and management.
Cervical necrotizing fasciitis, Fulminant infection, Odontogenic infection, Neck, Surgical debridement.
Assessment of Role of Platelet Aggregation in Metastatic Breast Cancer Patients
Ashwini Ramji1*, Shanmugan C V2
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 81-86 | DOI: 10.53339/aimdr.2022.8.1.11
Assessment of Role of Platelet Aggregation in Metastatic Breast Cancer Patients
Ashwini Ramji1*, Shanmugan C V2
Abstract
Background: To assess role of platelet aggregation in metastatic breast cancer patients.Methods:40 cases (Group I) of metastatic breast cancer patients and equal number of healthy control (Group II) subjects were included. Platelet aggregation studies in vitro using ADP and Thrombin were performed using an optical aggregometer. Detection of platelet aggregation was done by Chrono log series 490 dual and four channel optical aggregometer systems.Results:There were 4 subjects in group I and 12 in group II having ADP <60, 26 subjects in group I and 28 in group II with ADP 61-72 and 10 subjects in group I with ADP >72. Low thrombin <58 was seen in 8 in group II, normal thrombin between 61-72 was seen among 11 in group I and 32 in group II and high thrombin >82 among 29 in group I respectively. Amongst patients with normal platelet count, 14 patients had platelet aggregation with ADP in the normal range and 4 patients had platelet aggregation with ADP in the lower range. In patients with high platelet count, 12 showed aggregation in the normal range, and 10 patients showed aggregation in the higher range which was statistically significant (P< 0.05) (Table III, Graph II).Conclusion: Platelet aggregation has an important part to play in the tumor metastasis of breast cancer patients.
Breast cancer, Platelet aggregation, Tumor metastasis.
Ashwini Ramji1*, Shanmugan C V2
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 87-92 | DOI: 10.53339/aimdr.2022.8.1.12
Assessment of Utility of Immunohistochemical Marker Prostein for Evaluation of Primary and Metastatic Prostatic Carcinomas
Ashwini Ramji1*, Shanmugan C V2
Abstract
Background: To assess utility of immunohistochemical marker prostein for evaluation of primary and metastatic prostatic carcinomas.Methods:Fifty- six samples of clinically suspected carcinoma prostate was included. Immunohistochemistry (IHC) was performed for assessment of Prostein (P501S). The intensity of positivity was scored from 0 to 3 as follows: score 0 = non-stained; score 1 = weak; score 2 = moderate; and score 3 = strong. The percentage of positively stained cells for each staining intensity was estimated in the respective lesions.Results:Age group 18-28 years comprised of 6 patients, 28-38 years had 12, 38- 48 years had 16 and >48 years had 22 cases. Type of cases were normal prostatic epithelium in 11, benign prostate hyperplasia in 23, HGPIN in 10, primary prostatic adenocarcinoma in 7 and metastatic prostatic adenocarcinoma in 5 cases. Prostein expression was seen in 100% in normal prostatic epithelium with intensity score of 1.8-2.1, benign prostate hyperplasia having 2-2.7, HGPIN with 2-2.3, primary prostatic adenocarcinoma having 1-1.6 and metastatic prostatic adenocarcinoma with 0.8-1.4 intensity score. Conclusion:Prostein is a new prostate specific marker which showed 100% sensitivity and specificity to identify normal and prostatic lesions.
Benign prostate hyperplasia, Prostein, Primary prostatic adenocarcinoma.
Anxiety and Depression in School-going children with Epilepsy
Linus Francis1*, Davis Manuel2
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 93-97 | DOI: 10.53339/aimdr.2022.8.1.13
Anxiety and Depression in School-going children with Epilepsy
Linus Francis1*, Davis Manuel2
Abstract
Background: This study was designed to find the prevalence of anxiety and depression in school-going children with epilepsy.Methods:All the patients with epilepsy presenting during the study period underwent detailed clinical and EEG evaluation. Hospital Anxiety and Depression score (HADS) was used to screen for anxiety and depression.Results:We identified 190 patients with epilepsy during the study period. Out of these 30 (15.8%) were diagnosed as having treatment resistance epilepsy. Anxiety was diagnosed in 114 (60%) and depression in 62 (32.6%). Patients with drug resistant epilepsy were found to have statistically significant markers in the form of higher scores for depression and anxiety, and lower IQ scores. Frequency of GTCS (Generaized Tonic Clonic Seizures) showed inverse correlation with IQ scores and direct correlation to the anxiety/depression scores.Conclusion:We conclude that anxiety and depression in school-going children with epilepsy is common and that it has a correlation with treatment resistance.
Depression in School, Epilepsy.
Maulik S. Bhadania¹, Hasmukh B. Vora²*,Nikhil Jillawar³,Premal R. Desai4
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 98-105 | DOI: 10.53339/aimdr.2022.8.1.14
Objective Assessment of Superiority of Enteral Feeding by Traditional Home Kitchen-Based Feed V/S Commercial Formula Feed in Patients of Esophagogastric Corrosive Injury
Maulik S. Bhadania¹, Hasmukh B. Vora²*,Nikhil Jillawar³,Premal R. Desai4
Abstract
Background: Corrosive ingestion can cause severe chemical injury to upper gastrointestinal tract which leads to dysphagia, malnutrition and weight loss. Early nutritional assessment and support through feeding jejunostomy is important and it should be nutritionally optimum and economically balanced. The aim is to compare cost and nutritional status after nutritional support with traditional home kitchen made and commercial formula feed through feeding jejunostomy.Methods:A prospective study included patients on enteral nutrition based on traditional home kitchen feed (cohort-1) and on commercial formula feed (cohort-2). Patient’s body weight, BMI, haemoglobin, serum albumin, nutritional risk index, controlling nutritional status score were checked at the admission, 3rd and 6th month follow up.Results: In cohort 1 mean albumin and haemoglobin raised by 33.13% & 14.60% at 3rd month and 47.23% & 22.3% at 6th month respectively; In cohort 2 it was 9.12% & 2.69% at 3rd month and 17.62% & 6.53% at 6th month respectively. At 6th month in cohort 1 and 2 mean weight gain was 7.56% & 4.0%; mean increase in NRI was 34.78% & 11.5% respectively. Mean CONUT score at six months was better improved in cohort 1 which is 6 to 1 as compared to cohort 2 which was 6 to 3. Mean monthly cost of home-based feeds was significantly lower as compared to commercial feeds (62.14 Rs v/s 682-2354 Rs/day).Conclusions:In corrosive GI tract injury patient enteral nutrition with traditional home kitchen-based feeds is safe, cost effective and associated with better improvement in nutritional status objective parameters.
Corrosive injury, Enteral nutrition, Feeding jejunostomy, Traditional home kitchen-based feed, Commercial formula feed.
Rakesh Kumar Chanania1, Lakshay Goyal2, Shaina3, Sanjeev Gupta4*, Gagandeep Chanania5, Sahil Heer6
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 106-116 | DOI: 10.53339/aimdr.2022.8.1.15
An Audit on Gastrointestinal Perforation in a Tertiary Care Teaching Hospital Based in Northern Part of India: A Study of 100 Cases
Rakesh Kumar Chanania1, Lakshay Goyal2, Shaina3, Sanjeev Gupta4*, Gagandeep Chanania5, Sahil Heer6
Abstract
Background: A prospective study was conducted on 100 patients of perforation peritonitis: To find out the incidence of gastro intestinal perforation in various age groups, sex, riral or urban, socio economic status, To find out the various causes and sites of gastra intestinal perforartions, To determine various types of procedures being done to treat gastro intestinal perforations.Methods:The study population consisted of 100 patients of perforation peritonitis admitted at surgical wards of Rajindra Hospital, Patiala. Patients underwent necessary investigations such as Blood counts, biochemical analysis and urine analysis. X-ray Abdomen and chest / USG Abdomen/Pelvis CT-Abdomen (as and when required). All diagnosed patients were subjected to surgery. In all cases, operative findings and postoperative course were followed up for three months. Final outcome was evaluated on the basis of clinical, operative and radiological findings. In pre-pyloric and duodenal perforation, GRAHAM’S PATCH REPAIR carried out. In Ileal and Jejunal perforations, primary closure or exteriorization done depending upon the condition of the gut and duration of the symptoms. The patient outcome was assessed by duration of hospital stay, wound infection, wound dehiscence, leakage/entero-cutaneous fistula, intra-abdominal collection/abscess, ileostomy related complications and reoperation. Wound infection was graded as per SSI grading.Results:Most common age group for perforation was 21-40 years (50%) followed by 41-60 (33%) years in present study. Mean age of the patients is 37.91 + 13.15 years with male predominance (78%) in our study. 4% of the patients were of upper socio-economic status while 32% of the patients were of middle and 64% of the patients were of lower socio-economic status.Abdominal pain was seen in 100% of the patients while abdominal distension was present in 69% of the patients. Nausea/Vomiting was seen in 61% of the patients while Fever and Constipation was seen in 53% and 86% of the patients respectively. Diarrhoea was seen in 3% of the patients. Tenderness, guarding & rigidity, distension, obliteration of liver dullness and evidence of free fluid were present in 100% of the patients. Bowel sounds were not detected in all the patients. Most common perforations were Duodena(37%), Ileal (25%), Gastric (25%) followed by Appendicular (9%), Jejunal (4%) and Colonic perforation (2%). The most common etiology of gastrointestinal perforations was Peptic ulcer followed by
Typhoid, Appendicitis, Tuberculosis, Trauma, Malignancy and non-specific infection.In Gastric perforations, Peptic ulcer was the most common cause of perforation followed by Trauma. In Ileal perforations, Typhoid was the most common cause of perforation followed by Tuberculosis and non-specific infection. In Appendicular perforations, most common cause was Appendicitis. In Jejunal perforations, most common cause was Trauma. In Colonic perforations, most common cause was Malignancy.Conclusions:The incidence of gastrointestinal perforations was common in 21-40 years age group followed by 41-60 years age group with male preponderance in our study. The most common site of perforations was Gastro-duodenal followed by Ileal perforations and the most common cause for these perforations was peptic ulcer followed by typhoid. The most common procedure done to treat gastrointestinal perforations was primary closure, resection and anastomosis, appendectomy and stoma formation. However, small sample size and short follow up period were the limitations of the present study.
Gastrointestinal Perforation.
Vivek Ahuja1, Raghav Singhal2, Paraag Kumar3*
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 117-123 | DOI: 10.53339/aimdr.2022.8.1.16
Prospective Evaluation of Raised Liver Transaminases in Asymptomatic Patients Attending OPD in a Tertiary Care Hospital
Vivek Ahuja1, Raghav Singhal2, Paraag Kumar3*
Abstract
Background: Liver diseases are a cause of worldwide morbidity .The course is usually long and has no signs before the development of late stage disease. The only indicative markers are liver enzymes, such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma glutamyl transferase (GGT) during asymptomatic period. There is a paucity of data from our subcontinent regarding the prevalence, risk factors and etiology of asymptomatic chronically raised liver enzymes.The aim of the study was to determine the prevalence, risk factors and etiology associated with unexplained chronically raised liver transaminases in patients attending OPD in a tertiary care hospital.Methods:This was a prospective study conducted in the Department of Gastroenterology, MMIMSR, Mullana from July 2019-Dec 2020 in 50 patients who presented with chronically raised liver enzymes. Detailed comprehensive history, physical examination and investigation was done to identify etiology and risk factors associated with raised liver enzymes.Results:566 patients were screenedfor inclusion in the study. The prevalence of raised transaminases in asymptomatic patients was 9.4%. NAFLD was the most common etiology of raised liver transaminases, seen in 70 % of patients followed by Hepatitis C and Hepatitis B. Dyslipidemia was the most important risk factor associated with NAFLD.Conclusion:NAFLD should be kept in mind while dealing patients with unexplained transaminitis. Earlier detection could help halt the progression to chronic liver disease.
ALT, AST, NAFLD.
Clinical profile of patients with esophageal carcinoma: A multicentric study from North India
Saurabh Singh1, Paraag Kumar2*, Gurpreet Kaur Chawla3, Meenu Gupta4, Anuradha Kusum5
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 124-131 | DOI: 10.53339/aimdr.2022.8.1.17
Clinical profile of patients with esophageal carcinoma: A multicentric study from North India
Saurabh Singh1, Paraag Kumar2*, Gurpreet Kaur Chawla3, Meenu Gupta4, Anuradha Kusum5
Abstract
Background: Carcinoma esophagus is the 6th most common cancer in India with an incidence of 5.04% It most commonly affects older age individuals, with incidence peaking in seventh and eighth decades of life. Adenocarcinoma (AC) and Squamous cell carcinoma (SCC) are the two main histological variants. Our aim was to study the risk factors, clinical and epidemiological profile of patients diagnosed with Esophageal Cancer from two tertiary care centres located in North India.Methods:This was a retrospective study carried in departments of gastroenterology of two tertiary care hospitals North India. Data was collected from respective institutes for the previous 1 year i.e. from 1st October 2020 to 30th September 2021. All patients presenting to Gastroenterology OPD or emergency with dysphagia who were diagnosed as having Carcinoma esophagus were included in the study.Results:A total of 106 patients were included in this study. There were 44 females & 66 males. The most common presenting complaint was Dysphagia (48%) followed by Loss of weight (26.4%), Vomiting (in 23.6%) and Odynophagia (22.6%). Involvement of the lower one third of the oesophagus was the most common (37.7%). SCC (Squamous Cell Carcinoma) was the most common type of oesophageal carcinoma in this study, seen approximately in 80% of cases.Conclusion:Our study from North India suggested poor oral hygiene as a strong risk for carcinoma esophagus Males were more commonly affected and SCC was the predominant variant.
Carcinoma esophagus, Adenocarcinoma, Squamous Cell Carcinoma.
Management of Subtrochanteric Fracture Femur- by ProximalFemoralNailing
Amandeep Singh Bakhshi1, HarjitK Singh Chawla2, Sanjeev Arora3, Girish Sahni4*, Sahil Mehta5, Daljinder Singh6
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 132-140 | DOI: 10.53339/aimdr.2022.8.1.18
Management of Subtrochanteric Fracture Femur- by ProximalFemoralNailing
Amandeep Singh Bakhshi1, HarjitK Singh Chawla2, Sanjeev Arora3, Girish Sahni4*, Sahil Mehta5, Daljinder Singh6
Abstract
Background: Numerous variations of intramedullary nailing have been evolved over the years for stable fixation and early mobilisation of subtrochanteric fracture, out of which one is proximal femoral nail. Aims and objectives –We conducted this study with an objective to evaluate the results of internal fixation of subtrochanteric fractures of the femur with proximal femoral nail – AO type Design.Methods:This was a prospective study carried out at our tertiary care institute on 30 patients who had suffered subtrochanteric fracture and were subsequently treated with a proximal femoral nail (PFN). Proximal femoral nail was inserted through the tip of greater trochanter. All patients were followed up for a period of one year; at an interval of 3 months and during each follow-up visit for the functional outcome by modified Harris Hip Score, was assessed in the form of walking, squatting, sitting and rising from chair.Results:Modified Harris hip score was used for the evaluation of results in our study which showed excellent result in 21 patients (70%), good results in 3 cases(10%), fair results in 3 patient (10%) and poor results in 3 cases(10%). The mean Harris hip score in our study was 90.6.Conclusion:PFN is an intramedullary load sharing implant. Reduction and management of subtrochanteric fractures is challenging in traumatology. Proximal femoral nailing spanning whole femur with proximal and distal locking appears to be a satisfactory implant in management of fractures of subtrochanteric femur.
Fracture femur, closed reduction, Proximal femoral nail.
Our Management of Vestibular Schwannomas and Review of Literatures
Neizekhotuo Brian Shunyu1*, Suvamoy Chakraborty2, Zareen Lynrah3
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 141-148 | DOI: 10.53339/aimdr.2022.8.1.19
Our Management of Vestibular Schwannomas and Review of Literatures
Neizekhotuo Brian Shunyu1*, Suvamoy Chakraborty2, Zareen Lynrah3
Abstract
There is no a clear consensus provided in the literature and there remain controversial on the treatment especially for small to medium size Vestibular schwannomas (VSs). Thus the treatment technique and approach preference vary from centre to centre. This problem too exists in our centre. The purpose of this paper is to develop a consensus in our hospital among our colleagues on the treatment of our VSs patients. We have been treating VSs patient by translabyrinthine approach from time to time for the last 5 years and found it to be a very efficient approach. This approach gives the most direct route to the tumor with excellent exposure of the internal acoustic meatus, cerebropontine angle (CPA) area without the need to retract the brain with facial nerve totally in control early in the surgery. The only problem was, when there is large posterior fossa component of the tumor present. This approach is safe with direct exposure to CPA area and have minimum intraoperative or postoperative complications.
Vestibular schwannomas, management, translabyrinthine approach, facial nerve.
Narinder Singh1,Ab. Hamid Wani2*, Tippu Ishar3,Deepak Kumar4,Nasib Chand Digra5
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 149-158 | DOI: 10.53339/aimdr.2022.8.1.20
Preoperative Factors Affecting the Outcome of Single Stage Hypospadias Repair- An Observational Study
Narinder Singh1,Ab. Hamid Wani2*, Tippu Ishar3,Deepak Kumar4,Nasib Chand Digra5
Abstract
Background:Hypospadias is one of the commonest congenital anomaly in boys which requires either a single stage repair or staged repair. The success of the procedure depend upon the type, anatomy, experience of the surgeon, method of repair and preoperative hormonal stimulation. Aim: The aim of the study was to evaluate the various preoperative factors responsible for outcome of single stage repair in distal penile, mid penile and proximal penile hypospadias. Methods: There were 48 patients in this observational study which were divided into two groups. Group A comprised of 24 patients with glanular and coronal hypospadias while Group B comprised of 16 patients with distal penile, 5 mid penile and 3 proximal penile types with minimal chordae. All the 24 (50%) patients in group A underwent meatal advancement and glanuloplasty incorporated (MAGPI) repair while in group B 15 (31.25%) patients underwent Tabularized Incised Plate (TIP) repair and 9 (18.75%) patients underwent combined TIP and Mathieu’s repair. Results: Overall operative success rate observed in the study was 41 (85.41%) patients. In 7 (14.58%) patients urethrocutaneous fistula as a major complication occurred which included 1 patient in Group A and 2 patients with Distal Penile Hypospadias (DPH), 2 patients with Mid Penile Hypospadias (MPH) and 2 patients with Proximal Penile Hypospadias (PPH) in Group B. In 2 (4.16%) patients, mild meatal stenosis was noted which settled with meatal dilatation. Urethrocutaneous fistula (UCF) disappeared in 2 (4.16%) patients on follow up with regular urethral dilatation. Conclusion: MAGPI is the ideal procedure for glanular/coronal hypospadias. For distal penile hypospadias, TIP alone or combined TIP and Mathieu’s repair gives equally good results. Preoperative testosterone therapy reduces the incidence of complications in a single stage hypospadias repair.
Distal penile hypospadias(DPH), Meatal advancement and glanuloplasty incorporated (MAGPI), Tubularised incised plate urethroplasty (TIP), Mathieu’s repair, Urethrocutaneous fistula (UCF).
Predominancyof Coping Styles in Patients with Type II Diabetes in Low Socio Economic Status Groups
Selvakumar Jagannathan1*, Kannan Ramiah2,R. Valarmathy Selvakumar3
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 159-167 | DOI: 10.53339/aimdr.2022.8.1.21
Predominancyof Coping Styles in Patients with Type II Diabetes in Low Socio Economic Status Groups
Selvakumar Jagannathan1*, Kannan Ramiah2,R. Valarmathy Selvakumar3
Abstract
Background: Coping style is a person’s characteristic strategies used in response to life problems or traumas. Coping serves a protective function .This study aims to examine the impact of coping styles predominance in the training programme given to patients with type II diabetes of low socioeconomic status group.30 patients with type II diabetes of low socioeconomic status group were selected using purposive sampling from the diabetic clinic for the assessment of coping style. Coping style was assessed using “Coping styles of adults with Type 1 and Type 2 diabetes” by Karlsen and Bru (1998). Paired t-test was used to assess the effectiveness of coping styles enhancement training programme for patients with type II diabetes. The study revealed that there is significant increase in the level of coping styles of patients with type II diabetes due to coping styles enhancement training programme.Methods:?.Results:?.Conclusion:?.
Type II diabetes and coping styles.
Sumita Mohanty1, Sarat Chandra Jayasingh2, Asit kumar Sethi3, Sidharth Sraban Routray4*
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 168-174 | DOI: 10.53339/aimdr.2022.8.1.22
Transmuscular Quadratus Lumborum Block for Postoperative Analgesia in Laparoscopic Colorectal Surgery
Sumita Mohanty1, Sarat Chandra Jayasingh2, Asit kumar Sethi3, Sidharth Sraban Routray4*
Abstract
Background: Transmuscular Quadratus Lumborum Block (TQLB) is a newer modality for postoperative pain management. But, its efficacy after laparoscopic colorectal surgery is little researched. The aim of our trial was to access the analgesic efficacy of TQLB in colorectal surgery.Methods:This study was done in 64 patients posted for colorectal surgery who were divided into two groups of 32 each. TQLB was given bilaterally in group RQ with 20 ml of 0.375% ropivacaine and in group SQ with 20 ml saline. Patients were operated under general anesthesia and were examined for pain at different time points postoperatively. Time required for first analgesic demand was our primary endpoint. Secondary endpoints were total rescue analgesia (paracetamol) required in 24 hrs, pain scores, nausea, vomiting, sedation and any other complications.Results:The time required for first analgesic demand was 3.9± 0.8hrs in RQ group and 0.1± 0.2 hrs in group SQ which was statistically significant. The total paracetamol consumption in 24 hours was1.2± 0.4 gm in group RQ and 2.9± 0.7gm in group SQ ,the difference being remarkable.Conclusion:Transmuscular quadratus lumborum block can produce quality analgesia after laparoscopic colorectal surgery. TQLB not only improves the visual analogue scale (VAS) score but also decreases the rescue analgesic consumption without any complications.
Transmuscular quadratus lumborum block, laparoscopic, colorectal surgery, postoperative analgesia.
A Cadaveric Study of Palmaris Longus Muscle
Santosh Vaman Waghmode1, Sadiqali Abbasali Syed2*
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 175-179 | DOI: 10.53339/aimdr.2022.8.1.23
A Cadaveric Study of Palmaris Longus Muscle
Santosh Vaman Waghmode1, SadiqaliAbbasali Syed2*
Abstract
Background: Aim: To assess the palmaris longus muscle.Methods:40 formalin fixed cadavers of both genders were included. Routine dissection of the upper limb was carried following the Cunnigham’s Manual of Practical Anatomy. During the dissection of the anterior compartment of forearm, the Palmaris longus muscle was identified & carefully dissected.Results:Out of 40 cadavers, 22 were of males and 18 were of females. Morphology of Palmaris longus found to be normal in 18, agenesis in 6, fusiform in 4, hybrid in 6, bifurcated tendon in 5 and fleshy in 1 case. A significant difference was observed (P< 0.05).Conclusions:Surgeon must be aware of the variations of palmaris longus muscle. Morphology of Palmaris longus found to be normal, agenesis, fusiform, hybrid, bifurcated tendon and fleshy.
Palmaris longus, fusiform, hybrid, Fleshy.
Anatomical Variations of ProfundaFemoris Artery in Indian Population
Santosh Vaman Waghmode1, SadiqaliAbbasali Syed2*
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 180-184 | DOI: 10.53339/aimdr.2022.8.1.24
Anatomical Variations of ProfundaFemoris Artery in Indian Population
Santosh Vaman Waghmode1, SadiqaliAbbasali Syed2*
Abstract
Background: Aim: To assess anatomical variations of profundafemoris artery in Indian population.Methods:45 embalmed lower extremities adult human cadavers age range of 30–65 years were recruited for the study. The femoral triangles were dissected with proper care to identify the profundafemoris and circumflex femoral arteries. Their source of origin, position, and distance were noted with the mid-inguinal point (MIP) as a reference point.Results:Side of profundafemoris artery (PFA) was postero- lateral in 60%, posterior in 30%, lateral in 5% and absent in 5%. Medial circumflex femoral artery (MCFA) had 65%, 15%, 12% and 8% and lateral circumflex femoral artery (LCFA) had 80%, 15%, 5% and 0% respectively. Origin of profundafemoris artery (PFA) was FA in 90% and common trunk with medial circumflex femoral artery in 10%. Origin of Medial circumflex femoral artery (MCFA) was FA in 55%, PFA in 40% and FA with common trunk with MCFA in 5%. Origin of lateral circumflex femoral artery (LCFA) was femoral artery in 70%, PFA in 20% and FA with common trunk with PFA in 10%. A significant difference was observed (P< 0.05).Conclusions:A thorough knowledge of variation of profunda femoral artery is of great importance and to avoid complications.
Profunda Femoral Artery, Medial Circumflex Femoral Artery, Lateral Circumflex Femoral Artery.
Evaluation of the In Vitro Cytotoxicity of Silver Nanoparticles on PBMC Cells Using MTT Assay
Anish Stephen1, Mahesh Kumar D2*
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 185-191 | DOI: 10.53339/aimdr.2022.8.1.25
Evaluation of the In Vitro Cytotoxicity of Silver Nanoparticles on PBMC Cells Using MTT Assay
Anish Stephen1, Mahesh Kumar D2*
Abstract
Background: Silver Nanoparticles are extensively studied by the scientific community for therapeutic applications. With respect to the fundamental pillars of bioethics “Primum non nocere” equal emphasis should be given to evaluate the toxicological perspectives of Silver nanoparticles. This study aims at evaluating the InVitro cytotoxic effects of Silver nanoparticles synthesized using hesperidin. Aim: To study the In Vitro cytotoxicity of silver nanoparticles on PBMC cells using (3-(4,5-Dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. Methods: Synthesized silver nanoparticles at various concentrations are incubated with peripheral blood mononuclear cells (PBMC). After 24 hours MTT is added to the mixture to evaluate the cell viability post incubation. Yellow MTT (a tetrazole) which is reduced to purple formazan in the mitochondria of living cells. The absorbance of this colored solution can be quantified by measuring at 570 nm by a spectrophotometer. This reduction takes place only when mitochondrial reductase enzymes are active, and therefore conversion can be directly related to the number of viable (living) cells. Results: ?.Conclusion: Silver Nanoparticles do not exhibit any significant cytotoxicity on PBMCs and also there were no dose dependent trends in the results.
Silver Nanoparticles, Hesperidin, Cytotoxicity.
Anish Stephen1, Mahesh Kumar D2*
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 192-199 | DOI: 10.53339/aimdr.2022.8.1.26
Synthesis of Silver Nanoparticles Using Flavonoid Hesperidin and Pharmacological Evaluation of its Free Radical Scavenging Activity
Anish Stephen1, Mahesh Kumar D2*
Abstract
Background: Silver Nanoparticles are drawing significant attention from the scientific community to explore a wide range of its medical applications. Human body is under constant stress due to free radicals generated by the physiological and pathological conditions in the body. Scavenging systems or Antioxidants can help alleviate the damages caused by these radicals which can influence the course of progress in several chronic diseases with an inflammatory background. External antioxidants supplement and facilitate the overwhelmed scavenging systems in the body.Silver Nanoparticles can enhance the therapeutic effects of phytochemicals. Aim: To Synthesize silver nanoparticles using the phytochemical Hesperidin and studying its Free radical scavenging activity. Methods: Silver Nanoparticles are synthesized using chemical reduction method. The synthesis is confirmed using spectrophotometric studies. Free Radical scavenging activity is detected using 1, 1-diphenyl-2-picrylhydrazyl (DPPH •) free radical scavenging assay. Results: Silver nanoparticles were successfully synthesized which was confirmed by the change in color of the solution and peak absorbance peak at 420 nM on spectrophotometric studies.Hesperidin Silver Nanoparticles exhibited higher free radical scavenging activity when compared with pure hesperidin and standard Ascorbic acid. Conclusion: Hesperidin can ideally be used for the synthesis of silver nanoparticles and the synthesized Silver Nanoparticles enhances the free radical scavenging activity of Hesperidin which can further be evaluated by In Vivo studies.
Silver Nanoparticles, Hesperidin, Free Radical Scavenging activity.
The Creation of a Sustainability Index for Public Health Supply Chains
TawsifMd Faruquee1*, FerdousAra Begum2, EnamulHoqueKhan3, AnanyaPrithibi4, Juairia chowdhury5, Tahmeed Kamal6, MdIrfanul Islam7
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 200-204 | DOI: 10.53339/aimdr.2022.8.1.27
The Creation of a Sustainability Index for Public Health Supply Chains
TawsifMd Faruquee1*, FerdousAra Begum2, EnamulHoqueKhan3, AnanyaPrithibi4, Juairia chowdhury5, Tahmeed Kamal6, MdIrfanul Islam7
Abstract
Background: The large percentage of research in this area focuses on the triple-bottom line of sustainability, which entails understanding the economic, social, and environmental outcomes of supply chain process. A few sustainability measures have been proposed in the literature to recognize supply chain sustainability, assisting interested parties in making strategic decisions. Researchers and practitioners alike have become more aware of and interested in sustainable supply chain management. The majority of these studies, however, focus on supply chains in wealthy countries, with little research on sustainable supply chains in poor countries. Existing research focuses solely on the triple bottom line approach to supply chain sustainability, and more study is needed to identify and quantify additional components of supply chain sustainability. Although the lack of empirical evidence in the current conceptual study, it intends to propose this index to improve the evaluation and health coverage of public health supply chains. It will serve as a starting point for more study and will allow for actual testing of the index in public health supply chains.
Creation; Sustainability; Index; Public Health Supply Chains.
Comparative Study of Outcome of Tympanoplasty by Postauricular and Permeatal Approach
Mushfiqur Rahman1*, Kazi Atikuzzaman2
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 205-211 | DOI: 10.53339/aimdr.2022.8.1.28
Comparative Study of Outcome of Tympanoplasty by Postauricular and Permeatal Approach
Mushfiqur Rahman1*, Kazi Atikuzzaman2
Abstract
Background: As from time of residency, tympanoplasty is the most common operation performed by an otolaryngologist. Because of the continuing efforts of otologists all around the world to produce the maximum surgical outcome, significant improvements in this surgical method have developed during the middle ages. Objective: The aim of the study was to compare the outcome of Tympanoplasty in Postauricular and Permeatal Approach.Methods:A total of 74 patients between the age group 15 to 44 years who were attending the ENT OPD, suffering from Chronic Suppurative Otitis Media (CSOM) were selected on the basis of type of perforation and their workup was done to assess the candidature for tympanoplasty. Comparative analysis between the two groups were done based on analysis using SPSS 24 software version. The level of significance was set to 5% (p < 0.05).Results:A total of 74 patients were included in the study and the overall graft take was 76.92% in cases of Permeatal technique as compared to 91.66% in the case of postaural underlay technique. The complication of postaural approach higher than Permeatal approach. There was a difference in hearing improvement with majority of the cases improving to the range of 10-22 dB in Permeatal technique compared to 08-18 dB in Postaural Underlay technique.Conclusion:In terms of complications and hearing improvement, the Permeatal method outperforms the Postauricular Approach, however the graft takes a higher percentage in the Postauricular Approach than the Permeatal Approach.
Tympanoplasty; Postauricular; Permeatal; membrane healing.
Alamgir Ahmed1*, Mohiuddin Ahmed Khan2, Md.Nazrul Islam Chowdury3, Mohammad Mizanur Rahman4, Abu YousufMdNazim Uddin5
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 212-224 | DOI: 10.53339/aimdr.2022.8.1.29
Pattern of Cytogenetic Abnormality by Fluorescence in Situ Hybridization (FISH) in Multiple Myeloma Patients in a Tertiary Hospital
Alamgir Ahmed1*, Mohiuddin Ahmed Khan2, Md.Nazrul Islam Chowdury3, Mohammad Mizanur Rahman4, Abu YousufMdNazim Uddin5
Abstract
Background: Multiple myeloma is a plasma cell neoplasm with acquired genetic abnormalities of clinical and prognostic importance, with survival duration ranging from a few months to more than 10 years. Cytogenetic abnormalities (CA) detected by fluorescence in situ hybridization (FISH) are of major prognostic significance since e.g. patients with del(17p), t(4;14) or gain 1q21 show dismal outcome. Objective: To evaluate the cytogenetic patterns by fluorescence in situ hybridization (FISH) of clinically diagnosed cases of multiple myeloma.Methods:This cross-sectional study was conducted in Department of Haematology, Dhaka Medical College Hospital, Dhaka, from January 2018 to December 2018. A total number of 30 patients with multiple myeloma were analyzed cytogenetically by interphase fluorescence in situ hybridization (iFISH). The collected data were analyzed by using the Statistical Package for Social Science (SPSS-24) for windows version 10.0.Results:Out of 30 diagnosed Multiple Myeloma cases the mean age was 56.37±10.38 years and male to female ratio was almost 3:1. Sixteen (56.7%) of 30 patients. Among 30 cases of 8 cases were thyrogenicity positive of 7(23.3%) patients was detected del 13q positive. Isolated del 13q was found in 4 cases. 2 cases were found coexistence of del 13q and del 17p positive ;1 case was found coexistence of del 13q and t(4;14) positive and rest of 1 case had del 17 p positive. There was no detectable t (11; 14) and t(14;16) in any of 30 cases.Conclusion:FISH panel for Multiple Myeloma including del (13q); t(11;14); t(4;14), del(17p), t(14;16) is very important molecular test for the prognosis , risk stratification, treatment modality of the patient. On the basis of cytogenetic abnormality Multiple Myeloma risk stratification is modified now a day. This Revised International Staging system R-ISS is a simple and powerful prognostic staging system.
Cytogenetic; Fluorescence in Situ Hybridization, Myeloma, plasma.
Treatment of Infertility in Women with Polycystic Ovary Syndrome in a Single Center Study
Rehena Nasreen1*, Mohammad Kamrul Islam2, Sumon Kumar Sen3, Md. Mahamudul Hasan4
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 225-234 | DOI: 10.53339/aimdr.2022.8.1.30
Treatment of Infertility in Women with Polycystic Ovary Syndrome in a Single Center Study
Rehena Nasreen1*, Mohammad Kamrul Islam2, Sumon Kumar Sen3, Md. Mahamudul Hasan4
Abstract
Background: Anovulatory infertility is caused by polycystic ovarian syndrome in 80 percent of patients. Preconception guidelines, such as lifestyle modification (weight loss) to avoid fetal neural tube abnormalities, and quitting smoking and drinking alcohol, are all part of the early treatment. A clomiphene citrate medication for timed intercourse is the first-line pharmacological treatment for producing ovulation. Exogenous gonadotropins or laparoscopic ovarian surgery are two options for second-line pharmaceutical treatment (ovarian drilling). Ovulation induction using clomiphene citrate or gonadotropins is effective, with a 70 % cumulative live birth rate. When laparoscopy is necessary, ovarian drilling should be done; this operation is usually successful in around half of the instances. Finally, when the previous interventions have failed, a high-complexity reproduction treatment (in vitro fertilization or intracytoplasmic sperm injection) is recommended. There is no evidence that metformin should be used routinely in the treatment of infertility in anovulatory women with polycystic ovary syndrome. Aromatase inhibitors show promise, but more research is needed to confirm their safety.Methods:This study was conducted in Department of gynecology and obstetrics, Dhaka Medical College Hospital, Dhaka, from January 2019 to December 2019. A total number of 100 patients with multiple myeloma were analyzed cytogenetically by interphase fluorescence in situ hybridization (iFISH). The collected data were analyzed by using the Statistical Package for Social Science (SPSS-24) for windows version 24.0.Conclusion:PCOS is a frequent syndrome and the most frequent cause of infertility. PCOS is defined as a syndrome with at least two of three of the Rotterdam criteria. A complete evaluation of the infertility is needed to exclude other causes of infertility..
Polycystic Ovary Syndrome; Infertility; Clomiphene Citrate; Ovarian Drilling; In Vitro Fertilization..
Complications after Stapled Hemorrhoidectomy: A Single Center Experience
Md. Abdul Jalil1*, Md. Omar Faruk2, M.Mohibul Aziz3
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 235-242 | DOI: 10.53339/aimdr.2022.8.1.31
Complications after Stapled Hemorrhoidectomy: A Single Center Experience
Md. Abdul Jalil1*, Md. Omar Faruk2, M.Mohibul Aziz3
Abstract
Background: A circumferential strip of mucosa about 1.5 to 2 centimetres above the dentate line is removed in stapled hemorrhoidectomy, a new technique for haemorrhoids treatments. Objective: The aim of the study was to evaluate complications after stapled hemorrhoidectomy.Methods:A total of 101 patients between the age group 20 to 70 years were diagnosed with grade 3 and grade 4 haemorrhoids. Patients are included in stapled haemorrhoidectomy. The questionnaire focused on stapled hemorrhoidectomy procedures performed in the period July 2018 to June 2020. Descriptive analysis was done based on the student’s T-test using SPSS 24 software version. The level of significance was set at 5% (p < 0.05).Results:In the 2-years timeframe, out of 101 patients in the Immediate (within 1 week) complications of stapled hemorrhoidectomy, 84.16% were in None, 5.94% were severe pain, 3.96% were bleeding, 1.98% were Thrombosis, 0.99% were urinary retention, 1.98% were Anastomotic dehiscence 0.99% were Fissure, 0.99% were perineal intramural hematoma and 0.99% were submucosal abscess. Out of 90.09% were in none, 1.98% were Recurrent hemorrhoids, 0.99% were Severe pain, Stenosis, Fissure, Skin tag, Thrombosis, Staples problems, Intramural abscess and Intussusception.Conclusion:Although stapled hemorrhoidectomy appears to be promising, we believe that a multicenter randomized controlled trial with a long-term follow-up comparing stapled hemorrhoidectomy and banding is required before the treatment can be recommended. The majority of difficulties can be avoided by following the rectal wall anatomy during the surgery.
Stapled hemorrhoidectomy, Complications, hemorrhoids.
Evaluation of Epididymo-Orchtis-A Study of 100 Cases
Mohammad Kamrul Islam1*, Rehena Nasreen2, Sumon Kumar Sen3, Md. Mahamudul Hasan4
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 235-242 | DOI: 10.53339/aimdr.2022.8.1.32
Evaluation of Epididymo-Orchtis-A Study of 100 Cases
Mohammad Kamrul Islam1*, Rehena Nasreen2, Sumon Kumar Sen3, Md. Mahamudul Hasan4
Abstract
Background: Acute epididymo-orchitis is a common clinical problem in urological practice. It is not an uncommon disease in our country to cause work loss particularly in active group of people. Aim of the study: The aim of this study was to see the predisposing factors involved, aetiopathology and progression of disease process.Methods:This prospective study was conducted in department of surgery, Kumudini Women’s Medical College Hospital, Tangail from April 2008 to March 2009. Hundred patients of inflammation of epididymis and testis were included in this study.Results:Out of 100 patients, majority (48%) were in monogamous relationship. All patients (100%) had scrotal pain, 22% had scrotal swelling, 59% had fever, 32% had dysuria and 11% had urethral discharge. All patients presented with tenderness of the testis and epididymis and 82% cases had both epididymal and testicular swelling. Thirty two percent cases had urinary tract infection, trauma and promiscuous sexual contact were associated with the disease in 2% and 18% cases, respectively. History of masturbation was noted in 18% cases. By urine routine microscopy 28% had pus cell and 03% had RBC in urine, 16 cases were positive in urine culture, among 15% were E.coll and 01% were found Klebsiela. Forty patients were tested Chlamydial CFT and 16(40%) were found positive, out of 12 Filarial CFT tested 01(8.33 %) was found positive, Gram staining of urethral discharge revealed Neisseria gonorhhoae in 02(18.18%) cases. In maximum cases no actiological factor was found. Majority cases under 35 years were infected with Chlamydia and patients older than 35 years were mostly infected with E.coli.Conclusion:This study reflects that maximum of our study patients report to hospital nearly at right time with relatively better health status and outcome of available treatment facilities are satisfactory.
Evaluation and Epididymo-orchtis.
Outcome of Pertrochanteric Femur Fractures with Proximal Femur Locking Compression Plate
Iqbal Singh1, Manpreet Singh2*, Ranbir Singh3
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 253-260 | DOI: 10.53339/aimdr.2022.8.1.33
Outcome of Pertrochanteric Femur Fractures with Proximal Femur Locking Compression Plate
Iqbal Singh1, Manpreet Singh2*, Ranbir Singh3
Abstract
Background: Fractures of the proximal femur, including fractures affecting the pertrochanteric region, have become a public health problem. Owing to aging of the population, we have to operate on even more elderly patients who sometimes present with significant co-morbidities. Although conventional implants have given good results in stable peritrochanteric fractures, proximal femur locking compression plate (PFLCP) which has been recently introduced is better suited for comminuted, unstable pertrochanteric fractures and osteoporotic bones. In PF-LCP, bone-implantconstruct so formed is mechanically stable and fixation failure due to screw loosening in osteoporotic bone can be reduced. Materials &Methods: This prospective study was conducted in our institute and was approved by local ethical committee. Twenty-five consecutive patients of either sex with age more than 60 years (range, 60-84) having pertrochanteric fractures were operated upon with PFLCP. A.O classification was followed in the study and Singh’s index for osteoporosis was calculated. Operating time, blood loss and any technical difficulty with the implant were recorded. Patients were followed clinically and radiologically for union at fracture site and implant-related complications for a period of 24 months. The Harris Hip Score was used to document hip functions at final follow-up. Observations: Amongst the 25 patients, the average operation time in our study was 66.60±10.57 minutes. The average radiological union was 3.40±0.63 months (13.6 weeks). Average time for full weight bearing was 13.12±1.90 weeks. There were two cases of wound infection, one case of coxa vara and one case of a proximal screw back-out. There was no case of plate lift or screw breakage. There was no case of non-union. Conclusion: The PFLCP can be a feasible alternative to the treatment of peritrochanteric fractures. Treatment with PFLCP can provide good-to-excellent healing in osteoporotic bones having comminuted and unstable peritrochanteric fractures, with a limited occurrence of complications.
Pertrochanteric fractures, Osteoporosis, Internal fixation, PF-LCP.
An Assessment of 3.5mm Reconstruction Plate Fixation in Olecranon Fractures
Iqbal Singh1, Partap Singh2, Manpreet Singh3*
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 261-267 | DOI: 10.53339/aimdr.2022.8.1.34
An Assessment of 3.5mm Reconstruction Plate Fixation in Olecranon Fractures
Iqbal Singh1, Partap Singh2, Manpreet Singh3*
Abstract
Background: Olecranon process is a large, curved eminence comprising of the proximal and posterior part of the ulna. It lies subcutaneously which makes it more vulnerable to injury. Due to intra-articular extension of fractures, anatomical reduction and early mobilization should be achieved in every case and usually managed surgically. Aims and Objectives: To access the results of reconstruction plate in fracture olecranon.Materials &Methods: This was a prospective study consisted of 25 cases of olecranon fractures which were managed by open reduction and internal fixation using 3.5mm reconstruction plate. Patients were followed up every month till 6 months. At each follow up visit clinical and radiological parameters were assessed: Final assessment was done at 6 months using the Mayo Elbow Performance Score.Result: According to the AO classification, Type A-1 – 7 cases, A-3 – 1case, B-1 – 13 cases, B-3 – 1 case, C-1 – 1 case, C-2 – 1 case, C-3 – 1 case. An adequate reduction was maintained in all fractured olecranon until union. Average radiological union time was 12 weeks in 72% cases, 15 weeks in 16% cases, 18 weeks in 8% cases and > 18 weeks in 4% cases. The results were graded as per the criteria laid by Rogers et al as excellent in 84% cases, good in 12% and unsatisfactory in 4% cases. 2 cases developed superficial infection and 1 deep infection and 1 delayed union.Conclusion: Open reduction and internal fixation of fracture of olecranon with 3.5mm reconstruction plate is based on sound biomechanical principle with a good functional outcome and a low incidence of complications.
Olecranon Fracture, Fracture Configuration Contouring, 3.5mm Reconstruction Plate, Internal Fixation, Functional Outcome
Pattern Of Infections In Custodial Deaths – A Forensic Autopsy Study
Sanjeev Kumar1, Ashok Chanana2, Loveena Oberoi3, Kuldip Kumar4*
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 268-273 | DOI: 10.53339/aimdr.2022.8.1.35
Pattern Of Infections In Custodial Deaths – A Forensic Autopsy Study
Sanjeev Kumar1, Ashok Chanana2, Loveena Oberoi3, Kuldip Kumar4*
Abstract
Background: In a country like India, the prisoner cells are not well structured. For instance prisons are known to be a high risk environment for infections like tuberculosis (TB), HIV, HCV, HBV etc. due to overcrowding, low levels of nutrition, poor infection control and lack of accessible healthcare services. This study is an effort to know about the pattern of infections in custodial death cases detected during post mortem examination. Aims and Objectives: To determine the common infections and to know the mortality caused by infections among prisoners in custody, people in police custody and mentally ill patients in mental health institute in Punjab.Methods:This cross sectional study of 100 cases of custodial deaths from 1st Jan 2019 to 4thMay 2021, was carried out in the Forensic Medicine department in collaboration with department of Microbiology, Govt. Medical College, Amritsar.Results:Klebsiella Pneumoniae (37.5%) is more common in age group of 10-30 years while Staphylococcus Aureus (35.9%) infection was more common in the age group of 31 to 50 years. Incidence of positive growth of infections was slightly more in female inmates (76.9%) as compared to the males (75.9%). Inmates from urban area background showed more growth of Staphylococcus Aureus (35.7%) than from rural area background(25%).Conclusions:Timely medical diagnosis and treatment of each prisoner with availability of good doctors are the important issues relating to the healthcare of the individuals in custody.
Custodial deaths, Infections, Mental Hospital Deaths, Custody, Overcrowding.
Manjunath G N1*, Haritha C2
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 274-286 | DOI: 10.53339/aimdr.2022.8.1.36
Evaluation of Mood Changes AmongPeripartum Women at PKDAS Institute of Medical Science, Vaniyamkulam, Palakkad: A Prospective, Observational, Longitudinal Study
Manjunath G N1*, Haritha C2
Abstract
Background: The perinatal period is well established as an increased risk for development of serious mood disorders. Maternal mental health in developing countries gets less than its due attention. The present study was undertaken to evaluate mood changes in Peripartum period in our population and to identify demographic, obstetric, social and psychosocial risk factors associated with Peripartum depression using established scales.Material & Methods:A prospective, observational, longitudinal study conducted in PK das institute of medical science, vaniyamkulam, with 387 perinatal women for 12 months (February 2018– January 2019). Various scales EPDS (Edinburgh Postnatal Depression Scale), CMSS (Couple Marital Satisfaction Scale, IMS (Index of Marital Satisfaction), LES (Life Event Scale) were studied in Peripartum Period.Results:Among a total of 387 participants about half 189 (48.8%) were in 19-25 years of Age. Almost 30% and 40% had dissatisfied married life as per the CMS and IMS scales respectively. Just above 42% were screen positive for depression antenatally with EPDS & 39% (n = 151) in the immediate postpartum period. From these 151 screen positive cases in immediate postpartum period, 138 participants were followed up at 4-6 weeks (13 were lost to follow up) and up to 115 of 138 (83.3%) were screen positive for depression (N= 387, 29.7%), which was statistically significant (p<0.001). With EPDS during antenatal period there was no statistically significant relationship of depression with Education (p = 0.195), Occupation (p = 0.651) and pregnancy planned or unplanned (p = 0.223), whereas, Joint family, participants with dissatisfied marital relationship had increased risk of depression as evidenced by IMS and CMSS (p < 0.001). Participants with a previous male gender baby had less risk of developing depression (p< 0.001) & participants with previous 2 female children had increased risk of depression (p< 0.001).Conclusions:This study highlights importance of screening for maternal mental health problems during Peripartum period. Depression in immediate postpartum period is good predictor for increased risk of depression at 4-6 weeks postpartum.
Postpartum Depression, EPDS, Peripartum Stress & Anxiety, Marital Satisfaction.
Importance of Doppler study of Umbilical Artery and FoetalMiddle Cerebral Artery in PIH and IUGR
Manjunath G N1*, Haritha C2
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 287-295 | DOI: 10.53339/aimdr.2022.8.1.37
Importance of Doppler study of Umbilical Artery and FoetalMiddle Cerebral Artery in PIH and IUGR
Manjunath G N1*, Haritha C2
Abstract
Background: PIH is associated with increased vascular resistance and decreased utero -placental perfusion resulting in an increased incidence of foetal hypoxia and impaired foetalgrowth.The objective of this study was to assess the diagnostic performance of S/D ratio, resistance index(RI), pulsatility index (PI) and cerebro-placental ratio (CPR) in the prediction of adverse perinatal outcome in PIH and IUGR. Objective: is to determine S/D ratio, RI, PI, CPR and asses their diagnostic values in the prediction of adverse perinatal outcome.Material& Methods:50 pregnant patients with PIH and IUGR, beyond 28 weeks of gestation, were prospectively studied at P k das institute of medical college,vaniyamkulamand subjected for Doppler study of the umbilical artery and foetal middle cerebral artery. The abnormality of above parameters was correlated with the major adverse perinatal outcome.Results:Patients with abnormal Doppler parameters had a poor perinatal outcome, compared to those who had normal Doppler study. The cerebro-placental ratios(CPR) had the sensitivity and specificity, positive and negative predictive values of 95%,76%,73%,95% respectively with Kappa value of o .68(good agreement) and p value of .000 which was statistically significant, for the prediction of major adverse perinatal outcome.Conclusions:This study shows that Doppler study of umbilical and foetal middle cerebral artery can reliably predict the neonatal morbidity and helpful in determining the optimal time of delivery in complicated pregnancies. The CPR is more accurate than the independent evaluation of S/D, RI, PI, in identifying foetus with adverse perinatal outcome.
pregnacy induced hypertension(PIH),systolic-diastolicratio(S/D)ratio),Resistive index(RI).Pulsatilityindex(PI).CerebroplacentalRatio (CPR)
High Risk Foot Among Type-2 Diabetes Mellitus Patients in a Tertiary Care Hospital
M. Mohiuddin1*, Sayeqa Nasreen Khondker2, Tofail Ahmed3
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 296-309 | DOI: 10.53339/aimdr.2022.8.1.38
High Risk Foot Among Type-2 Diabetes Mellitus Patients in a Tertiary Care Hospital
M. Mohiuddin1*, Sayeqa Nasreen Khondker2, Tofail Ahmed3
Abstract
Background: Feet of diabetic persons are at a high risk of developing complications and their prevalence is very high. Uncontrolled diabetes i.e. hyperglycemia particularly chronic hyperglycemia plays the most critical role in developing all forms of macro and microvascular complications in foot. The “high risk foot” can be identified by simple clinical examination. A structured screening program for “High Risk Foot” integrated with all diabetic care units is essential. Objectives: The study was initiated to determine the frequency of “high-risk foot” among Type 2 diabetic patients.Methods:It was a cross-sectional observational study, conducted among 324 Type 2 diabetic patients attending BIRDEM General Hospital, Dhaka, Bangladesh. All participants were interviewed by an administered questionnaire, underwent clinical examination and review of medical records from the diabetic guide book of the patients and hospital records.Results:Among a total of 324 patients, 198(61%) patients were having high-risk feet. Of the diabetics with high risk foot- loss of protective sensation 73.2%; absent pedal pulse 23.2%; history foot ulcer 25.3%; limited joint mobility 15.2%; foot deformity 11.1% and previous foot amputation 3.5%. The study population had poor glycemic status (HbA1c 10.81+5.23%). Other variables age 55.43 (± 11.062) years; BMI: 25.33+5.7 kg/m²; duration of diabetes 14.24+7.25 years; sex ratio (M: F) 1.3:1; family history of DM 71.9%; hypertensive 53.1%; smoker 73.5%; dislipidemia 52.8%, albuminuria 58.6%, and retinopathy 53.7%. Males are significantly higher in the high-risk foot.Conclusion:This study documented a very high frequency of high risks foot in our diabetic population. Peripheral Neuropathy (PN) and PVD are two common forms of high risk foot and these are influenced by a longer duration of diabetes, the presence of albuminuria for PN, and retinopathy. Male sex, longer duration of diabetes, presence of hypertension and smoking for PVD. Regular foot examination and treatment to target patients will modify the modifiable risk factors and thereby prevent foot ulcers and amputation.
Diabetic foot, Type 2 Diabetes, High risk foot, Peripheral Neuropathy, Peripheral vascular disease.
Association of Non-Alcoholic Fatty Liver Disease with Metabolic Syndrome: A Single Center Study
Debasish Dutta1*, Seema Saha2, Goutam Kumar Ghosh3, Md. Iqbal Hossain4
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 310-317 | DOI: 10.53339/aimdr.2022.8.1.39
Association of Non-Alcoholic Fatty Liver Disease with Metabolic Syndrome: A Single Center Study
Debasish Dutta1*, Seema Saha2, Goutam Kumar Ghosh3, Md. Iqbal Hossain4
Abstract
Background: NAFLD is a condition defined by excessive fat accumulation in the form of triglycerides (steatosis) in the liver (> 5% of hepatocytes histologically). Non-alcoholic fatty liver disease is increasingly being recognized as a major cause of liver-related morbidity and mortality among 15-40% of the general population. Aim of the study: To evaluate the clinical profile of patients with non-alcoholic fatty liver disease and its association with metabolic syndrome.Methods:The present cross-sectional, retro-spective study was conducted as outdoor patient basis in the Department of Medicine, Jashore medical college hospital & a private diagnostic centre, Jashore.. A total of 74 cases were included for the study. All patients in the study underwent routine investigations including complete blood counts, blood sugar, liver function tests, HBsAg, anti-HCV, lipid profile andUSG of whole abdomen. The data was collected during OPD treatment and was recorded in predesigned and pretested proforma and analyzed.Results:Mean age of the patient was 53.70±7.22 years. On physical examination findings showed the mean BMI was 27.6±4.39 kg/m2, mean waist circumference was 74.22±7.44 cm. Mean diastolic blood pressure (mm Hg) was 92.87±6.25 and mean systolic blood pressure (mm Hg) 132.0±18.17. Maximum 52% patients had triglycerides >150 mg/dl while low serum HDL level was seen in 37% patients and increased waist circumference was found in 32% patients. Altered ALT ≥41 IU was observed in 10 (62.50%) of Grade II of patients with NAFLD with metabolic syndrome. Central obesity was observed in 12 (75.00%) of Grade II patients with NAFLD with metabolic syndrome. While 14 (87.50%) Grade II of patients with NAFLD with metabolic syndrome showed impaired fasting glucose (>110 mg/dl). Hypertriglyceridemia (>150 mg/dl) in 12 (70.58%) seen in Grade I of patients with NAFLD without metabolic syndrome.Conclusion:Higher prevalence of all the components of metabolic syndrome in cases of NAFLD was observed. It can be concluded that symptoms and signs of NAFLD are non-specific and occur later in the course of the disease hence the physician should have a high index of suspicion in order to detect NAFLD early in the course of the disease.
Metabolic Syndrome, NAFLD, Clinical Profile, Liver, Disease.
Ashis Kumar Halder1*, Syeeda Sultana2, Bikash Chandra Nag3, Md. Mahabub Alam4, Mehdi Pervez5, Mohammad Faisal Hasan Bhuiyan6, Tajmira Nasrin7
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 318-324 | DOI: 10.53339/aimdr.2022.8.1.40
Clinico-Epidemioogical and Radiological Profile of Broncholitis at Sher-E-Bangla Medical College Hospital in Barishal, Bangladesh
Ashis Kumar Halder1*, Syeeda Sultana2, Bikash Chandra Nag3, Md. Mahabub Alam4, Mehdi Pervez5, Mohammad Faisal Hasan Bhuiyan6, Tajmira Nasrin7
Abstract
Background: Bronchiolitis, caused mostly by Respiratory syncytial virus (RSV) virus is the leading cause of lower respiratory tract infection in infants. The disease is mostly presents with cough runny nose, fever, breathing difficulties and respiratory failure This infection usually affects children up to age of 24 months, with younger infants often more severely affected and is the most prevalent cause of hospitalization in infants under the age of 12 months. The treatment is supportive; therefore, epidemiology, clinical, laboratory, and radiologic findings can help to ensure appropriate diagnosis and proper treatment.Methods:This descriptive cross-sectional observation study was conducted at Paediatrics department of Sher-E-Bangla Medical College & Hospital (SBMCH), Barishal, Bangladesh between October 2018 to March 2019To find out the clinico-epidemiological and radiological profile of Bronchiolitis. Children below 24 months of age diagnosed as bronchiolitis were studied.Results:200 children were evaluated, including 150 boys and 50 girls; Infants below 6 months accounted for the highest proportion (60%). All the bronchiolitis patients had cough or cold with respiratory distress. Other symptoms were fever (98.0%), restlessness (63.0%), poor feeding (60%) and fast breathing. On examination lower chest indrawing and rhonchi were found in all cases. Hyperinflation was the most prevalent radiological finding (60%) and more than half (55%) patients had lymphocytosis on CBC.Conclusion:Most children present with typical clinical and radiological feature of bronchiolitis which can help the clinicians to clinically identify this disease more efficiently.
Bronchiolitis. Respiratory syncytial virus, wheezing.
Shaoli Sarker1*, Mustafa Mahbub2
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 325-332 | DOI: 10.53339/aimdr.2022.8.1.41
Short Term Outcome in Sleep Disturbance Intervention in Children with ASD in a Tertiary Care Hospital in Bangladesh
Shaoli Sarker1*, Mustafa Mahbub2
Abstract
Aim: The aim of this study was to identify the relationship between sleep patterns and behavioral difficulties in children with ASD using sleep disturbance treatments. Methods: We selected a total 41 children with sleep disorders as study population. The sleep services (behavioral sleep management techniques) were given by the child development center team of Dhaka Shishu Hospital comprising of physician , developmental therapist and psychologist. Children were split into eight groups and two gender divisions based on their age, and they were then studied over a period of 6 months . Sleep disorders were investigated both before and after intervention. Results: The results revealed that the children’s sleep dysfunction improved from before, with the lowest improvement percentage decreasing from 62.9 percent to 51.8 percent and the greatest improvement percentage increasing from 100 percent to 59.2 percent, whereas a sleep problem showed no change at all (sleepwalking). Conclusion: The study has tried and succeeded to an extent to intervene in the sleep dysfunction process of children with ASD in a tertiary care hospital. However, there is still much to learn about the clinical efficacy of these types of behavioral interventions in children with ASD who have sleep disruption.
Sleep, Children, ASD, Study, Percent, Disruption, Sleep issues.
Md. RashidoonNabi Khan1*
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 333-340 | DOI: 10.53339/aimdr.2022.8.1.42
An Observational Study on Idiopathic Intracranial Hypertension (IIH) in a Tertiary Care Hospital in Bangladesh
Md. RashidoonNabi Khan1*
Abstract
Background: Among the risk factors of cardiovascular diseases, hypertension is one of the major reason. Intracranial hypertension (IIH) is a pressure buildup around the brain. It can happen unexpectedly, as a result of a severe head injury, stroke, or brain abscess could be occurred. It could also be a chronic, long-term condition, known as IIH. It results in the signs and symptoms of a brain tumor. Which is also known as benign intracranial hypertension. Cerebrospinal fluid, or CSF, is the fluid that surrounds the spinal cord and brain. CSF can accumulate if too much fluid is produced or not enough is reabsorbed. This can induce symptoms similar to a brain tumor. Intracranial Hypertension can be classified into three categories, they are Acute, Chronic and Idiopathic. IIH is recognized when the increased intracranial pressure cannot be explained by any other underlying cause.Aim: The aim of the study was to observe idiopathic intracranial hypertension patients in a select tertiary care hospital of Bangladesh.Methods:This cross-sectional observational study was conducted at the Department of Neurosurgery, Sylhet M. A. G. Osmani Medical College Hospital, Sylhet, Bangladesh. The study duration was from January 2012 to December 2020. A total number of 47 participants had been recruited as study population.Results:Male: female ratio was 1:10.75, and 91% of the total participants were female. 40.43% of the participants were aged between 21-30 years. 46.81% were overweight and 34.04% were obese. Most common symptom was nausea, followed by visual impairment and double vision.Conclusion:The prevalence of Idiopathic Intracranial Hypertension is much higher among the female. Female and high BMI are significant risk factors of IIH. It is more prevalent among young adults, and results on various vision related symptoms.
Intracranial, Hypertension, Vision, BMI
Oxygen Saturation in Neonate after Birth
AjmerySultana Chowdhury1*, Tashmin Farhana2, Farhana Afroze3, Parisa Marjan4, Amena Akter5, M. A. Mannan6, Sharmin Akter7
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 341-349 | DOI: 10.53339/aimdr.2022.8.1.43
Oxygen Saturation in Neonate after Birth
AjmerySultana Chowdhury1*, Tashmin Farhana2, Farhana Afroze3, Parisa Marjan4, Amena Akter5, M. A. Mannan6, Sharmin Akter7
Abstract
Background: Oxygen saturation measures the quantity of haemoglobin in the blood that is saturated with oxygen. Hemoglobin is a component of red blood cells that binds oxygen and transports it to outlying tissues. Oxygen is commonly used throughout the world in neonatal units. Injudicious use of Oxygen may not maintain appropriate oxygen status rather can lead to hypoxemia or hyperoxemia, both of the conditions are injurious to neonatal health. Objective: To assess the oxygen saturation in neonate after birth.Methods:A cross-sectional study conducted in the Department of Neonatology BSMMU, Shahbag, Dhaka, Lab Aid Specialized Hospital, Dhaka, Bangladesh from October 2013 to March 2014. A total 317 patients were selected according to selection criteria. The parents were interviewed with a specific pre-designed and pre-tested questionnaire and some information were gathered by document review. All neonate both term and late preterm (˃34weeks) who would not be anticipated for resuscitation was included.Results:A total 317 neonate were selected according to selection criteria. Among the study subjects more than half were male (57.1%). Rests were female (42.9%). Average gestational age of the study subjects was 37.47± 1.16 (SD) with the range of 34-40. On the other hand average birth weight was 2.88±0.46 (SD) with the minimum birth weight 2.0 kg and maximum weight 4.2 kg. Illustrates the median (IQR) heart rate from one to ten min for preterm versus term births. At one to three minutes and at five minutes after birth preterm infants had significantly lower SpO2 measurements. From six to 10 minutes after birth and four minutes after birth there was no significant difference between SpO2 measurements for mode of delivery. Paired sample t test showed that average SpO2 was less in 1 minute[88.42±4.8(SD)] than in 5 minute [94.25±3.5(SD)] and statistically this differences were highly significant (t=24.44, p=0.000). Pearson correlation showed high positive correlation (p=0.000) and correlation co-efficient r=0.479. Correlation was significant at the 0.01 level.Conclusion:It is “normal” to have low oxygen saturation measurements in the first minutes after birth. It takes time for infants to reach oxygen saturation levels described as “normal” in the later postnatal period. Oxygen saturation increased with time i.e., it was more in 5 minutes than in 1 minute and similarly more in 10 minutes than in 5 minutes. Conversely heart rate was found more in one minute than to five and ten minutes. Oxygen saturation was ≥ 90% within 3 to 4 minutes. Significant changes were found in Oxygen saturation by mode of delivery in three minutes & in heart rate by two minutes after birth. At one to ten minutes after birth preterm infants had lower SpO2 measurements.
Pulse Oximetry, Oxygen Saturation, Newborn, Birth Weight.
Prostate Volume Measurement by Ultrasonography Over 40 Years Age of Bangladeshi Population
Towhida Naheen1*, Mizanur Rahman2, Mohammed Iqbal3, Nazmun Nahar4, KaziMd. Shahidur Rahman5
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 350-356 | DOI: 10.53339/aimdr.2022.8.1.44
Prostate Volume Measurement by Ultrasonography Over 40 Years Age of Bangladeshi Population
Towhida Naheen1*, Mizanur Rahman2, Mohammed Iqbal3, Nazmun Nahar4, KaziMd. Shahidur Rahman5
Abstract
Background: Benign prostatic hyperplasia (BPH) or benign prostatic hypertrophy, is a histologic diagnosis status characterized by proliferation of the ‘glandular elements’ of the prostate, which may lead to an enlarged prostate gland. In many studies, people over the age of 40 years found as the most vulnerable for BPH. Ultrasonography is a prominent method to determine prostate volume or size. Aim of the study: The aim of the present study was to evaluate the prostate volume measurement for the Bangladeshi population over the age of 40 years by ultrasonography.Methods:This prospective, observational study was conducted in the Department of Anatomy, Chattogram Medical College Hospital, Chattogram, Bangladesh during the period from January 2019 to December 2020. In total 157 suspected patients of benign prostatic hyperplasia were selected as the study population. All patients were clinically diagnosed for BPH, based on the present prostate symptoms and digital rectal examination. To measure the prostate volume, abdominal ultrasonography was performed for all the patients. After enucleation, another ultrasonogram was performed for all the patients to measure the existing sizes of the prostates of the patients. All the data were processed, analyzed, and disseminated by MS-word and SPSS programs as per need.Results:Finally, in this study in analyzing the volumes of the prostates of the participants according to the abdominal ultra-sonographic reports of pre-operative stage we observed, in 9%, 34%, 31%, 30%, 21% and 32% patients, the prostate sizes (In cc) were <20, 21-40, 41-60, 61-80, 81-100 and >100 cc respectively. On the other hand, after enucleation, in 11.46%, 24.20%, 28.66%, 27.39%, 7.01% and 1.27% patients, the prostate sizes (In cc) were found <20, 21-40, 41-60, 61-80, 81-100 and >100 cc respectively. The mean changes of prostate sizes between pre- and post-operative stages among the participant was not significant where the P value was found 0.464.Conclusion:The findings of this study support the applications of abdominal ultrasonographic evaluation for suspected benign prostatic hyperplasia patients to know about the exact volumes of their prostates for selecting the appropriate surgical approach.
Prostate gland, Volume, Benign prostatic hyperplasia, BPH, Ultrasonography.
Muhammad Abdul Halim Khan1*, Md. Farid Uddin2, M. A. Hasanat3, Jobaida Naznin4, Ashim Dhar5
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 358-367 | DOI: 10.53339/aimdr.2022.8.1.45
Determination of Serum Thyroglobulin Concentration in Simple Diffuse Goiter Patients with Known Iodine Status
Muhammad Abdul Halim Khan1*, Md. Farid Uddin2, M. A. Hasanat3, Jobaida Naznin4, Ashim Dhar5
Abstract
Background: Thyroglobulin (TG) seems to be a valuable indicator of thyroid function and iodine nutrition status. Aim of the study: The aim of the study was to observe the relationship between serum thyroglobulin and urinary iodine (UI) in simple diffuse goiter patients.Methods:This cross-sectional observational study was conducted at the Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. The study duration was 2 years, starting from May 2014 to March 2016. Total 87 patients with simple diffuse goiter attending the OPD Department of Endocrinology of BSMMU had been recruited as study population. A purposive sampling technique was followed for sample selection.Results:Serum thyroglobulin (ng/mL, mean±SD and median) was lowest in the age group 12-16 years (6.0±4.5, 5.16 ng/mL) followed by age>31 years (8.8±8.1, 6.16 ng/mL), whereas other age groups showed level around 13.0 and 10.0 ng/mL (p= 0.520). Mean (±SD) Urinary Iodine was not statistically different among age groups (347.4± 226.5 vs. 337.08±188.9 vs. 300.5± 95.37 vs. 337.7± 225.42 vs. 278.3± 105.7, µg/L; F 0.451, p=0.771) while median values were 325.26 vs. 355.68 vs. 325.80 vs. 338.86 and 300.90 µg/L respectively. Neither thyroglobulin (5.76±5.72 vs. 11.60± 13.50; 3.47 vs. 8.9 ng/mL, m±SD and median; p=0.294) nor Urinary Iodine (373.5± 44.5 vs. 317.2± 180.32; 378.1 vs. 308.9 µg/L, m±SD and median; p=0.450) were statistically different between the gender groups. Similarly, thyroglobulin and Urinary Iodine were also statistically similar for grade-1 and grade-2 goiter (thyroglobulin: 6.79±4.33 vs. 11.67±13.69 and 6.74 vs. 8.02 ng/mL, m±SD and median, p=0.319; Urinary Iodine: 361.33± 51.60 vs. 317.09± 182.44, 362.69 vs. 305.35 µg/L, m±SD and median, p=0.498).Conclusion:Thyroglobulin seems to have an inverse association in iodine deficiency state and positive association in over sufficient state with UI. There was no statistically significant difference of TG concentration between males and females nor between Grade-1 and Grade-2 goiter.
Goiter, Diffuse, Thyroglobulin, Iodine, Deficiency.
Nabir Hossain1, MhafuzeAra Begum2, Md. Ahsan Habib3
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 368-378 | DOI: 10.53339/aimdr.2022.8.1.46
HER2 Positive Gastric and Gastroesophageal Adenocarcinoma: A Tertiary Center Experience in (NICRH) Bangladesh
Nabir Hossain1, MhafuzeAra Begum2, Md. Ahsan Habib3
Abstract
Background: Gastric cancer is the fourth commonest cancer worldwide. It is also recognized as the second commonest cause of cancer related death in the global perspective. Although the incidence of gastric cancer has gradually decreased over the last half of the century, it varies among the different part of the world and different ethnic group. Mortality from gastric cancer extremely high, and it is second only to lung cancer. Gastric cancer occurs more frequently in men than in women. Aim of the study: Aim of the study was to find the clinic-profile outcome HER2 Positive Gastric and Gastroesophageal Adenocarcinoma.Methods:This cross sectional study was conducted in the Department of Surgical Oncology of National Institute of Cancer, Research and Hospital, Mohakhali, Dhaka. The study period was from March, 2014 to April, 2015. A total of 80 patients were included for the study. After receiving the gastrectomy specimen, it was fixed in 10% formaldehyde. Data were compiled and necessary statistical analysis were carried out using computer based software package for social science (SPSS 16.1). Ethical clearance was taken from the ethical committee of NICRH.Results:The highest patients were from 61-70 years’ age group and the lowest were from 71-80 years. The mean age of the patients was 59.71 (±10.19) years. The female to male ratio in this study was 1: 2.48. 66 (82.5%) patients were presented with anemia which was followed by 39 (48.75%) cases with dehydration. Most of the tumors were located in the distal part of the stomach (11.67%). Regarding staging 79(12.65%) patients were in the advanced stage of the disease. The correlation between HER2 overexpression and TNM staging has been tabulated below where it is shown that only Nodal (N) staging has the significant correlation with the HER2 overexpression.Conclusion:It is already mentioned that, in early history of immunohistochemistry, HER2 overexpression in case of carcinoma stomach was highly varied in different studies (from 9-92%). But recently, it was found around 9-32%, in several studies all over the world. It is necessary to conduct further studies with larger samples and long term follow-up in order to draw definite conclusions regarding the role of HER2/neu overexpression.
Gastric cancer, Expression, HER2, Epidermal, Prognosis.
A Forensic Autopsy Study of Dead Foetuses and Newborns
Jatinder Pal Singh1, Kuldip Kumar2, Sunny Basra3, Jaspinder Pratap Singh4*
Annals of International Medical and Dental Research (AIMDR)| Vol-8, Issue-1 | January-February 2022 | Page: 379-384 | DOI: 10.53339/aimdr.2022.8.1.47
A Forensic Autopsy Study of Dead Foetuses and Newborns
Jatinder Pal Singh1, Kuldip Kumar2, Sunny Basra3, Jaspinder Pratap Singh4*
Abstract
Background: The term abandonment refers to babies or foetuses which are found abandoned at various unwanted places such as gutter, rubbish dumps, railway tracts and bushes. It does not refer to live born babies left in places, such as hospitals where care can be given by someone other than the mother. Aims and Objectives: To find out the distribution of death cases of newborns/feotuses and to trace its probable reason and its relationship with female foeticide.Methods:A retrospective study of all the medico-legal autopsies of foetuses and newborns was conducted in Forensic medicine and Toxicology department, Government Medical College, Amritsar (Punjab) from Jan 1, 2014 to Jul 31, 2021. During this period, 46 cases of fetal and newborn deaths had been studied.Results:The dead bodies of known foetuses/newborns is 43.5% cases while total unknown cases were 56.5% cases. 32.6% cases were non viable foetuses while 10.8% cases died as a result of prematurity. All the unknown cases (56.5%) were found from the abandoned places like street, bushes, canal side, water bodies that mainly includes pond and railway tract.Conclusion:Despite, the problem is present in every corner of the nation, there is dearth of research studies on this issue. Stringent measures and strict checks are required against antenatal sex determination. The motive behind the abandonment of foetuses can be any, but this grave issue needs urgent attention.
Foeticide, Newborns, Abandonment, Viability, Concealment of Birth.