Category Archives: Research Articles

Risk Factor for malnutrition_Sweta Goyal

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Risk factors for severe acute malnutrition in Central India
Goyal S,1 Agarwal N

Assistant Professor1,2,

1Department of Pediatrics, Chirayu Medical College, Bhopal, Madhya Pradesh, India,2Department of Pediatrics, Gajara Raja Medical College, Gwalior, Madhya Pradesh, India
ABSTRACT
AIMTo identify risk factors for severe malnutrition in children <5 years age. mation is available on determinants of SAM.Background

Severe acute malnutrition (SAM) is a major cause of childhood morbidity and mortality in our country. However, little information is available on determinants of SAM.

Material Methods

This was a prospective study done over a period of one year at a tertiary care hospital. Children under five years of age with SAM were enrolled, and the risk factors leading to malnutrition were identified.

Results

The risk factors contributing to malnutrition were poor socioeconomic status, parental illiteracy, overcrowding, lack of immunization, lack of awareness among caregivers regarding appropriate child feeding practices.

Conclusion

To decrease the prevalence of malnutrition, it is essential to provide education to caregivers about appropriate feeding practices. g appropriate child feeding practices.

KEY WORDS
India, risk factors, severe acute malnutrition.

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Dermatoglyphic_Vijay Nayak

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Dermatoglyphic study of diabetes mellitus Type 2 in Maharashtrian population
Nayak V,1 Shrivastava U,2 Kumar S,3 Balkund K4

Assistant professor1,2,4,Professor & Head3

1,2Department of Anatomy, Chirayu Medical College & Hospital, Bhopal, Madhya Pradesh, India3Department of Anatomy, Armed Forces Medical College, Pune, Maharashtra, India4Department of Anatomy, Malabar Medical College, Calicut, Kerala, India
ABSTRACT
BackgroundDermatoglyphic patterns of the individual are genetically determined and once formed they remains constant throughout the life, prevalence of diabetes mellitus is increasing drastically in developing countries particularly in India, in the present study an attempt has been made to find an association of the dermatoglyphic patterns of the individual and diabetes mellitus Type 2.

Material Methods

This study was carried out on 50 patients of Type 2 diabetes mellitus confirmed by clinical and laboratory assessment obtained from outpatient department of Department of medicine from command hospital, Pune. The control group for study consists of 50 subjects and was obtained from local residents of Maharashtra, teaching and non-teaching staff from our hospital. Palmar and finger prints of both hands were taken using ink and pad method as described by Cummins and Midlow.

Results

In the present study analysis of loops, arches and whorls revealed that there is no significant difference in the no of radial and ulnar loops, number of arches, true and composite whorls between diabetes Type-2 patient and non-diabetic (normal) subjects. On the other hand, analysis of “a-t-d” angle revealed that angle was significantly increased in diabetic patients than control
subjects.

Conclusion

It can be concluded that qualitative fingertip parameters such as arches, radial loops, ulnar loops show fluctuating asymmetry and hence are not useful for prediction of diabetes. The only parameter, which does not show fluctuating asymmetry with previous studies is “a-t-d” angle. Hence, it can be concluded that this parameter is useful for pre detection of diabetes by dermatoglyphic studies.

KEY WORDS
Arches and whorls, ‘a-t-d’ angle, dermatoglyphics, diabetes mellitus, loops.

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PELOD Scoring_Ambey

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Modified PELOD Scoring System: A Feasible Tool in Pediatric Intensive Care Units

Ajay Gaur,1 Ravi Ambey,2 Anoop Sharma3

Associate Professor,1 Assistant Professor,2 Resident3

1-3Department of Pediatrics, G.R. Medical College, Gwalior, MP, India.

ABSTRACT
BackgroundPediatric logistic organ dysfunction (PELOD) score,which can predict mortality or multiple organ dysfunction syndrome (MODS) outcomes, has been validated for children. It is cumbersome to measure respiratory dysfunction variables included in original PELOD scoring, in ventilator and blood gas analysis limited setups, so all three variables included under respiratory dysfunction (i.e.PaO2/FiO2 ratio, PaCo2 and mechanical ventilation) in original PELOD score were replaced by three new variables (i.e. Respiratory rate, Chest retractions and Spo2). The present study aims to modify the PELOD score and make it more clinical and feasible to adopt in resource limited setups rather being dependent on sophisticated facilities.AimsEvaluation of modified PELOD scoring system to determine the prognosis of patients in Pediatric Intensive Care Units.

Method

The modified PELOD scoring system consists of physical and laboratory variables representing six organ systems namely neurological, cardiovascular, renal, respiratory, hematological and hepatic system. The score was calculated for the subjects during first 24 hours of admission in PICU. Patients were then followed until they were discharged from PICU or deceased .In each organ system, the highest score in any variable accounted was taken as the score for that organ system. The sum total of the 6 scores for each organ system gives modified PELOD score (range 0-71) which was used for looking at the association between modified PELOD score and mortality.

Results

The risk of mortality varies directly with the modified PELOD score of the patients. In those patients whose modified PELOD score was <10, mortality was 10.4%, whereas in patients whose modified PELOD score was >10, mortality increased significantly to 46.4% (χ2 = 12.000, P < 0.001).The mean (SD) modified PELOD score was considerably higher in those who died as compared to those who survived (16.25 (8.63) vs 7.68 (5.55); p<0.001).

Conclusion

The modified PELOD score can be used as a reliable prognostic predictor of mortality among PICU patients.

KEY WORDS
Modified PELOD Score, Prognosis, PICU.

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chloramphenicol_Khyati Jain

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Study on Chloramphenicol resistance pattern in Central India, Indore

Jain K,1 Tripathi S2

Assistant Professor,1 Professor2

1Department of Microbiology,Index Medical College Hospital & Research Centre, Indore, Madhya Pradesh, India

2Department of Pharmacology, Index Medical College Hospital & Research Centre, Indore, Madhya Pradesh, India

ABSTRACT
BackgroundChloramphenicol (CK) is drug of choice in many life threatening and serious bacterial infections. Due to development of resistance and toxicity associated with this drug, it is not in common use now days. This study was done to find out prevalence of CK resistance pattern.Material Methods100 consecutive pus samples from surgical site infections from various specialties of index medical college hospital and research center were studied in microbiology department during period of 1year. Results

Gram positive as well as Gram negative organisms had shown sensitivity to Chloramphenicol. Also organisms were resistant to commonly used higher antibiotics.

Conclusion

CK can be used for common serious IPD patients not having contraindication to this drug. Study also reinforces proper and rational use of antibiotics.

KEY WORDS
Chloramphenicol, drug resistance, gram positive and gram negative organism.

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Menstrual morbodities_Salve

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 A Study of Demographic Profile and Menstrual Morbidities amongst Adolescent Female Patients visiting a Tertiary Care CENTER

Bandkhadke G,1 Salvi P,2 Bhalerao A,3 Bhosale R,4 Chandanwale A5

Post Graduate Student,1 Assistant Professor,2 Associate Professor,3 Professor & Head,4 Dean5

1-5Department of Obstetrics and Gynaecology, B J Government Medical College, Pune, India.

ABSTRACT
Aim1) To study the demographic profile, prevalence and type of menstrual morbidities amongst 13-19 year adolescent females attending gynaecology OPD at a tertiary care government general hospital in an urban area. 2) To study the awareness on physical changes & menstruation in adolescent girls in urban area. 3) To assess their knowledge on contraceptive methods.4) To study hygiene practices followed during menstruation. 5) To Treat the patients and suggest suitable recommendations based on study findings, for the future. Background

The Latin word ‘Adolescere’ means to grow to maturity. One fifth of the world population is between 10-19 yrs old and 85% of them live in developing countries. There are very few studies on prevalence and pattern of gynaecological health morbidities amongst late adolescent female patients.

Material Methods

It is a Prospective Observational Clinical Study in a Tertiary care Centre and Teaching Institute in Urban India. Variables observed were socio-demography, menstrual morbidities and knowledge about contraception, in study patients. Chi square test of significance was applied where relevent.

Results

Out of 120, maximum patients were unmarried from low socioeconomic, large (more than 4) family. The literacy rate was 70%. Out of 120 patients, maximum (34%) attained menarche at 12 years, 62% had regular cycles and most of them used homemade cloth for hygiene during menses. The commonest menstrual morbidity was dysmenorrhoea (73%). The commonest premenstrual symptom was pain in abdomen. Thirty four percent patients had moderate to severe anaemia. Forty percent girls had some knowledge about contraception and most of them acquired it from Television. The most known method of contraception was OC pills and all patients with the knowledge felt it is available at all hospitals and chemists.

Conclusion

Adolescent Reproductive and Sexual Health(ARSH) OPD services are needed at all women care centres as these group of patients need special attention for their complaints and focused care and counseling of these young patients would be a great investment for future health of them & their families and the society & nation as a large.

KEY WORDS
Adolescent, Demographic, Morbidities, Menstruation, Contraception.

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Color Dopller_Pasupuleti

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Color Doppler evaluation of carotid vessels in patients with stroke

Pasupuleti BR,1 Narra RK,2 Kamraju SK,3 Jukuri NR,4 Sushmitha5

Professor,1,3 Associate Professor,2 Assistant Professor,4 Senior Resident5

1-5Department of Radiodiagnosis, Katuri Medical College Guntur, Andhra Pradesh, India

ABSTRACT
AimTo analyze the structure of carotid plaque morphology and quantify the percentage of carotid cerebrovascular disease is an important formidable health problem globally. The stroke syndrome consists of the rapid development of a focal neurological deficit that is usually localized to an area of the brain stenosis using high resolution color Doppler ultrasound machine in stroke patients. Background: Stroke or supplied by a specific artery.Materials and Methods

This study was carried out on all clinically suspected cerebrovascular insufficiency cases referred for color Doppler of carotid arteries to the Radiology Department of Katuri Medical College and Hospital, Guntur from 2011 to 2013. Various Doppler parameters such as characteristics of plaque, degree of stenosis, peak systolic velocity ratio, end diastolic velocity (EDV) of internal carotid artery, EDV ratios were studied.

Results

Totally 90 cases of cerebrovascular accident studied, 58 (64%) were males and 32 (36%) were females. The majority of male patients belonged to age group of 51-60 years (37.8%) and females 61-70 years (37.5%). The risk factors included hypertension, smoking, diabetes mellitus, and ischemic heart disease. The patient’s clinical symptoms included hemiparesis, hemiplegia, transient ischemic attack and altered sensorium.

Conclusion

Color Doppler of carotid artery plays an important role in the identification of plaques and quantification of degree of stenosis and identification of “at risk” patients who may develop further stroke.

KEY WORDS
Color Doppler, carotid vessels, common carotid artery, end diastolic velocity, internal carotid artery, peak systolic velocity, plaque, stroke.

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Diabetic risk_Hemlata Chaurasia

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To find out the diabetic risk in study population by subjecting them to Indian diabetic risk scale (IRDS)

Chourasia H,1 Chourasia  RS2

Assistant Professor1,2

1Department of Physiology, Sewakunj MIMS Medical College & Research Centre, Indore, MP, India

2Department of Anatomy, Index Medical College Hospital & Research Centre, Indore, MP, India

ABSTRACT
BackgroundDiabetes as a non-communicable disease is significant public health problem the prevalence rate all the world over is raising. Diabetes mellitus is one of the leading cause of long term complications and a major health hazard in a developing country like India. Indian Diabetes Risk Score (IRDS) developed by Dr. Mohan and his colleagues in 2005 is one of the strongest predictor of incident diabetes in India.Material MethodsThe present study entitled was conducted in the department of Physiology Gandhi Medical College and Associated Hamidia Hospital, Bhopal. 120 subjects in the age group range of 30-60 years attending the different medical OPDs.

Results

The mean age of the sixty subjects included in the control group was 42.61±8.70 years and sixty Prediabetic subjects were 45.43±8.77 years. Maximum numbers of Prediabetes were in the age group of 40 – 50 years.

Conclusion    

The results of the study will help to formulate strategies for future preventive efforts and delay the onset of type 2 diabetes.

KEY WORDS
Diabetes mellitus, Diabetic Risk Group, Indian Diabetic Risk Score.

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Pranayama_Ritu Bajpai

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Effect of Bhramari Pranayama and Yoganidra on cardiovascular hyper-reactivity to cold presser test

Bajpai R,1 Rajak C,2  Rampalliwar S3

Postgraduate Student,1 Professor,2 Associate Professor3

1-3Department of Physiology, Shyam Shah Medical College, Rewa, MP, India.

ABSTRACT
AimThe aim of this study was to investigate whether regular practice of Bhramari Pranayama and Yoganidra for 3 months can reduce cardiovascular hyper-reactivity to cold presser test in young healthy medical students.BackgroundA number of studies support the beneficial effect of Bhramari Pranayama and Yoganidra in hypertension. No study has been done to evaluate combined effect of pranayama and meditation in hyper-reactors to cold pressor test.

Material Methods

A total of 94 young medical students were selected who performed Bhramari Pranayama and Yoganidra for duration of three months. Cold presser test was done on each student before and after yoga.

Results

There was 79% reduction in hyper-reactivity to cold presser test as number of hyper-reactors reduced from 32 before the study to 7 after three months of yoga. Systolic rise of blood pressure to cold presser test reduced from 20.1 ± 3.5 mm Hg to 15.2 ± 3.7 mm Hg (p<0.001) and diastolic rise reduced from 13.81 ± 3.4 mm Hg to 10.37 ± 2.62 mm Hg (p<0.001) in hyper-reactors. Mean systolic blood pressure in all the 94 subjects reduced from 119.87 ± 12.01 mm Hg to 117.68 ± 11.89 mm Hg whereas mean diastolic blood pressure reduced from 77.08 ± 9.3 mm Hg to 75.11 ± 9.07 mm Hg (p<0.001).

Conclusion

Bhramari Pranayama and Yoganidra together can significantly alleviate stress induced changes in cardiovascular parameters.

KEY WORDS
Bhramari, Cold presser test, Hyper-reactors, Yoganidra.

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Lipid profile in Breast cancer_Haritwal

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A comparative study of serum lipid profile and glucose level between breast cancer patients and controls at tertiary care hospital in India

Haritwal AK 1,Chourasia RK 2, Ojha S3

Associate Professor 1,Associate Professor2, Assistant Professor3

1-4Department of Pathology, Chirayu Medical College, Bhopal, MP, India.

ABSTRACT
AimThe aim of this study is to compare serum lipid profiles: total-cholesterol (T-CHOL), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C) and serum glucose between breast cancer patients and control to evaluate their relationship with breast cancer.BackgroundThere are many researches which have reported positive as well as negative association of plasma/serum lipids and lipoproteins and serum glucose with different cancers. Increase levels of circulating lipids and serum glucose have been associated with breast cancer risk.

Material Methods

A total of 92 consecutive cases of histologically proven carcinoma breast along with same number of age matched, disease free controls were selected. Serum lipid and serum glucose levels of both cases and controls were estimated.

Results

The results of this study suggest that low (HDL-C) level and high (TG) levels are associated with risk of breast cancer in Indian women while serum glucose level does not show any association with breast cancer risk.

Conclusion

More studies are needed in future to explore common modifiable risk factors for development of breast cancer, so that its incidence can be reduced.

KEY WORDS
Breast cancer, lipid profiles, serum glucose, serum lipids.

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Leprosy_Mamata Tiwari

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Clinico-Histopathological correlation of leprosy: A retrospective study of skin biopsy specimens in Chitwan Medical College

Tiwari M,1 Ranabhat S,1 Maharjan S2


Associate Professor,1 Assistant Professor2

1-3Department of Pathology, Chitwan Medical College, Chitwan, Nepal

ABSTRACT
AimAim of this study was to find out cases of leprosy diagnosed in skin biopsy specimen and to study clinicohistopathological correlation in diagnosis of leprosy.

Background

Leprosy is caused by Mycobacterium leprae. There are various clinico-pathological forms of leprosy depending on the immune status of the host. Diagnosis of leprosy can be done by clinical, microbiological and histopathological examination. Histopathological examination is considered as
important for confirmatory diagnosis, for assessment of regression of the disease in patient under treatment and also for research purposes. Number of skin lesions in patients, Ridley and Jopling (RJ) classification and bacilliary index in histological sample all can be correlated for proper classification and treatment of leprosy cases.

Materials and Methods

This retrospective study included cases of leprosy diagnosed in skin biopsy specimen in the Department of Pathology of Chitwan Medical College from April 2009 to March 2014. Clinical diagnosis was correlated with that of histopathological diagnosis.

Results

In this study, male to female ratio was 1.4:1. Mean age of patients was
32.66 years. Most common lesion was hypopigmented macule (68%). On the basis of RJ scale, maximum cases (41%) were classified as borderline tuberculoid leprosy (BT) and least number (3.7%) as leprosy, and polar lepromatous leprosy. Maximum clinico-histopathological correlation was seen in borderline lepromatous leprosy (87.5%) followed by BT (68.1%). Fite ferraco stain was done in only 27 cases. It was 0-2 in tuberculoid spectrum and >2 in lepromatous spectrum.

Conclusion

Combining clinical, histopathological and microbiological diagnosis of leprosy is important for
proper treatment of the patient and prevention of complications.

KEY WORDS
Bacillary index, macules, Mycobacterium leprae, Ridley and Jopling classification

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