JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH最新文献

{"title":"Quality Assessment of Hand Hygiene and Effectiveness of WHO 6 Step Training among Healthcare Personnel in a Tertiary Care Cancer Hospital in Trivandrum, India: A Cross-sectional Study","authors":"Deepthi J Prabhu, Munish Palliyalil Kakkolil, Divya V. Gladston, R. Koshy, J. Krishna, A. Mathew","doi":"10.7860/jcdr/2023/63108.18057","DOIUrl":"https://doi.org/10.7860/jcdr/2023/63108.18057","url":null,"abstract":"Introduction: World Health Organization (WHO) 6 steps for effective Hand Hygiene (HH) practice to prevent cross infections emphasises on coverage of all aspects of the hand with the Alcohol Based Hand Rub (ABHR). The quality of hand rubbing usually remains un-monitored among healthcare workers. Hence, interventions to ensure both compliance and quality combined with periodic training would fill the deficiency in these practices in the healthcare setting. Aim: To analyse the quality of HH using an Ultraviolet (UV) sensitive ABHR among healthcare workers in the Operation Theatre (OT) and post-surgical Intensive Care Unit (ICU). Materials and Methods: This cross-sectional study was conducted in Regional Cancer Centre, Trivandrum, Kerala, India. Study population included 104 healthcare providers in the OT and post-surgical ICU, over a period of two months, from June 2017 to July 2017. Participants were asked to disinfect their hands according to WHO 6 steps using an ABHR to which an UV light sensitive pigment was added, and then place them in an UV light sensitive cabinet. Digital images of both sides of their hands were recorded. Every area of the hand not covered by the hand rub appeared as a dark spot and was considered an error. Pass criteria allowed a maximum of two small uncovered areas (dark spots <0.6 cm2 ) on the dorsal side of the hand and no uncovered areas on the palmar aspect. Each hand was observed specifically at four areas and the most missed areas were identified. Statistical analysis was done by Fisher’sexact test using Statistical Package for Social Sciences (SPSS) version 28.0. Results: Out of the total 104 participants, 28 were doctors, 46 were nurses, 22 were nursing students and 8 were OT technicians. A total of 65 participants were males (62%) and 85 participants (82%) were in the 35-40 years age group. The HH was found to be better on the right hand in all the sub-groups studied. The difference in the hand rub coverage on all the four observed areas of the right hand was not significant. On the left-side, hygiene in between the fingers (p-value 0.012) and at the finger tips (p-value 0.007) was poorest. Among the groups studied, doctors performed better with a higher group score of 60.7% compared to 22.7% of that of nursing students (p-value 0.030). Conclusion: Quality of HH practice using ABHR among personnel involved in peri-operative care is poor and requires improvement with regular monitoring and training.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"5 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81429049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular Exercises as a Non Conventional Approach towards Tension-type Headache: A Narrative Review","authors":"P. M. Pachkhede, Rajat Manoj Singh","doi":"10.7860/jcdr/2023/60623.18251","DOIUrl":"https://doi.org/10.7860/jcdr/2023/60623.18251","url":null,"abstract":"Tension-type Headaches (TTH) are the most prevalent type of headache, with upto 78% of people experiencing them at some point in their lives. In comparison to migraine, TTH is more incapacitating and results in more lost workdays. TTH’s multifactorial aetiology is thought to involve both, hereditary and environmental elements. There are three types of TTH-episodic, chronic, and frequent episodic. Patients describe their headache as tightness around the head, pressing, and dull. Studies on the impact of eye movement have been conducted. Only top-notch experimental trials were applied in the study. Physiotherapy is one of the most effective but at the same time, not much preferred by people due to lack of awareness. By the present review, it would be helpful, as people will start to use physiotherapy approaches. A moderate risk of bias was detected in the quality critical appraisal. With the information at hand, only a narrative description could be included. The present research only identified a few low quality studies, but its results imply that, ocular exercises can effectively alleviate primary headache and symptoms. More rigorous methodological standards and high quality Randomised Control Study (RCTs) are needed to validate and further understanding of the effects of organised workouts aiming to reduce pain intensity and frequency, symptoms, and medication use, among other things, in the treatment of primary headaches.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"102 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84973490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synchronous Primary Carcinoma of Cervix and Ovary-A Rare Case Report","authors":"Abhijit G Bhanji, Pallavi Shah, Renuka Rajiv Kulkarni, Shailesh Sambhaji Desai","doi":"10.7860/jcdr/2023/60203.17528","DOIUrl":"https://doi.org/10.7860/jcdr/2023/60203.17528","url":null,"abstract":"Synchronous malignancies of female genital tract account for less than 3% of all genital tract neoplasms. Amongst synchronous tumours, ovarian with endometrial carcinoma accounts for 51.7% while ovarian with cervix accounts for less than 10% of them. Unusually, they have a favourable prognosis with 5 years survival rate being 73.3%. Authors hereby, present a case of 51-years-old female presented with bleeding per vagina and on examination cervical mass was detected. The cervical mass biopsy confirmed cribriform adenocarcinoma of cervix. Uterus and cervix could not be removed as it was FIGO (The International Federation of Gynecology and Obstetrics) stage III B (inoperable) thus was managed on chemotherapy and radiotherapy. A month later she presented with bilateral ovarian masses for which she had undergone bilateral oophorectomy and omentectomy. Histopathology confirmed moderately differentiated mucinous cystadenocarcinoma of bilateral ovaries. Thus a case of synchronous carcinoma of cervix and ovary was concluded. She tolerated all managements successfully.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"66 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85254262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Junk Food Consumption, Daily Screen Time and Daily Physical Activity with Overweight and Obesity among School Children Aged 8-10 Years- A Cross-sectional Case-control Study","authors":"Roshan Joseph John, L. Kailas, S. Pillai","doi":"10.7860/jcdr/2023/59066.17477","DOIUrl":"https://doi.org/10.7860/jcdr/2023/59066.17477","url":null,"abstract":"Introduction: The prevalence of obesity among school children in Kerala is on a steady rise. Consumption of food with high glycaemic index, change in sleep patterns, reduced physical activity and the use of screen has been linked to obesity in children. Published literature on this association is scarce from urban Thiruvananthapuram, hence, the present study. Aim: To identify the association of various risk factors such as frequency of junk food consumption, dietary preferences, physical activity and daily screen time and weight related disorders among school going children (8-10 years) in Thiruvananthapuram. Materials and Methods: The present cross-sectional casecontrol study was conducted in one Rural Government School (Venjaramoodu Government Upper Primary School) and one Urban Private School (S.N. Public School, Chenkottukonam) of Thiruvananthapuram, Kerala, India, and enrolled school going children aged 8-10 years with higher than recommended Body Mass Index (BMI) for age as cases, age and gendermatched children with normal BMI as controls. Participants with BMI above 23rd and below 27th adult equivalent for age and gender were considered overweight and those above 27th adult equivalent for age and gender were considered as obese. A structured questionnaire was sent home with the children, and the parents were requested to answer the questions along with written informed consent. Socio-demographic parameters, anthropometric measurements were obtained by trained staff, dietary habits, and details regarding physical activity and screen usage were collected. Variables were categorised according to the standard recommendations by World Health Organisation (WHO) and Indian Association of Paediatrics (IAP). Variables were expressed as frequencies and the tests of significance used were Chi-square test and Odds ratio, to express the strength of association between parameters. A p-value <0.05 was considered statistically significant. Results: The mean age of cases and controls was nine years. A total of 708 school children were screened and 352 participants (175 cases and 177 controls) were enrolled in the present study. The BMI of cases was 29.3 kg/m2 and of controls was 20.2 kg/ m2 . Higher than recommended screen time (p<0.001), more frequent junk food consumption (p<0.001) and lack of physical activity (p<0.001) were found to be significantly associated with obesity and overweight. Dietary preference was not associated with obesity or overweight and obesity and overweight was more common in children studying in private schools (p<0.001). Conclusion: Reducing screen time, reducing junk food consumption and increasing physical activity will help in reducing the prevalence of life style diseases among school children. Further evaluation is necessary to determine the factors contributing to the increased prevalence of these disorders in private schools.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"32 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85463752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Pressure Reference Values of Nigerian Full-term Neonates in the First Week of Life at a Nigerian Tertiary Hospital: A Cross-sectional Survey","authors":"A. Afolabi, J. Okeniyi, J. Owa, F. F. Fadero, B. A. Afolabi, O. Oyedeji","doi":"10.7860/jcdr/2023/52597.17408","DOIUrl":"https://doi.org/10.7860/jcdr/2023/52597.17408","url":null,"abstract":"Introduction: Knowledge of normative Blood Pressures (BP) is critical for appropriate neonatal care. Hypertension and hypotension are abnormalities of BP which could be a sign, outcome or complications of diseases or intervention carried out on neonates. Yet, there is a dearth of data on BP concerning Nigerian full-term neonates. Aim: To determine BP values of apparently healthy term Nigerian neonates in relation to their weight in the first eight days of life and also to determine the BP values of apparently healthy term neonates in the first eight days and also to correlate the BP with postnatal age, weight and to generate percentile of age/sex specific BP. Materials and Methods: This cross-sectional study was done from September 2012-April 2013, including 386 consecutive apparently healthy term newborns delivered at the UNIOSUN Teaching Hospital (UTH), Osogbo, Southwest Nigeria. Their weights and right arm Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Mean Arterial Pressure (MAP) BPs measured using oscillometric method on days 1, 3, 5 and 8. Student’s t-test and Pearson correlation coefficient was used to statistically analyse the data. Results: Out of 386 newborns studied, the mean birth weight were 3.10±0.38 Kg; {3.24±0.37 kg for boys and 2.97±0.33 kg for girls}. The mean values of SBP on day 1 were 67.3±5.6 mmHg; 71.0±6.0 mmHg on day 3; 73.8±5.2 mmHg on day 5 and 77.2±2.9 mmHg on day 8, respectively. A similar trend was also noticed in the mean values of DBP with 36.9±5.0 mmHg on day 1; 41.5±5.2 mmHg on day 3; 43.7±5.3 mmHg on day 5 and 46.4±4.7 mmHg on day 8, respectively, the rise being significant (p-value <0.001). There were a positive correlations between the weight and DBP on the 5th day (r=0.128; p-value =0.012), between weight and SBP at 49-72 hours and on day 8 (r=0.105; r=0.168, respectively) as well as weight and MAP on day 8 (r=0.166). Conclusion: Neonatal BP in the first eight days following birth correlated positively to weight and age without significant gender differences.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"36 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85629010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Central Corneal Thickness Measurement using Optical and Ultrasound Pachymetry in Primary Open Angle Glaucoma Patients","authors":"S. Akhil, Prakriti Chourasia, Sandeep Kumar","doi":"10.7860/jcdr/2023/60329.17319","DOIUrl":"https://doi.org/10.7860/jcdr/2023/60329.17319","url":null,"abstract":"Introduction: A thinner Central Corneal Thickness (CCT) is an important criterion in determining the probability of progression from Ocular Hypertension (OHT) to Primary Open Angle Glaucoma (POAG). The most common devices for measuring CCT are ultrasound and optical pachymeters. Ultrasound pachymetry is a quick and precise approach to quantify corneal thickness that is also portable and inexpensive. The advantages of optical method include operator independency and noninvasiveness. Aim: To compare central corneal thickness using optical and ultrasound pachymetry in patients with POAG. Materials and Methods: This cross-sectional study was conducted at the Department Ophthalmology, ESI Post Graduate Institute of Medical Sciences and Research, Basaidarapur, Delhi, India, from October 2020 to April 2022. There were 105 POAG patients (210 eyes), divided into three subgroups of 35 subjects each (70 eyes each), based on the number of anti-glaucoma medications being instilled, topically (one/two/three drugs), and 35 healthy antiglaucoma controls (70 eyes). Central corneal thickness measurements were taken by Ultrasonic Pachymeter (USP) TOMEY SP-100, and by CEM-530 Non Contact Specular Microscope (NCSM) (optical). Statistical analysis was performed by the Statistical Package for Social Sciences (SPSS) program for Windows, version 17.0 (SPSS, Chicago, Illinois). Results: The mean CCT taken with NCSM and USP was 540.83±35.51 µm and 538.74±36.22 µm, respectively, in Right Eyes (RE) of 35 glaucoma patients on one drug, (p-value=0.80). Similarly, Left Eyes (LE), mean CCT with NCSM was 544.17±33.98 µm, and with USP was 541.69±36.6 µm (p-value=0.76). Mean CCT taken with NCSM and USP was 539.83±30,85 µm and 537.66±30.5 µm, respectively in RT eyes of 35 glaucoma patients on two drugs (p-value=0.76). Left eyes, mean CCT was 541.91±29.79 µm with NCSM as compared to USP which was 540.11±29.89 µm (p-value=0.80). On comparing the mean CCT values of RE in glaucoma subjects who were controlled on three antiglaucoma drugs it was found to be 528.37±26.44 µm using NCSM and 527.09±26.17 µm using USP (p-value=0.84). The meanvalues of CCT for LE was 521.94±26.53 µm with NCSM and with USP was 520±26.52 µm, respectively (p-value=0.81). Comparison of mean CCT measurements using NCSM and USP in 35 age-matched controls RE eye was found to be 517.83±21.27 µm and 515.97±20.91 µm, respectively (p-value=0.71). Similarly, for LE mean CCT values were 518.8±24.21 µm and 516.8±24.37 µm, respectively (p-value=0.73). Conclusion: The CCT measured using NCSM was found to be higher than that measured using USP in POAG subgroups patients as well as healthy age-matched controls, however the difference was not statistically significant. There was highly significant linear correlation between the CCT measured using NCSM and USP in all POAG subgroups as well as healthy controls. This suggests that the devices could be used interchangeably in glaucoma patients as well as healthy subjects of similar a","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"37 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83151428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of PD-L1 in Microsatellite Instability High Tumours: A Retrospective Study","authors":"Dinisha Einstien, G. Thanigaimani, KS Mouleeswaran, A. Prathiba, G. Sarumathy, John Vergilin","doi":"10.7860/jcdr/2023/63627.18029","DOIUrl":"https://doi.org/10.7860/jcdr/2023/63627.18029","url":null,"abstract":"Introduction: Microsatellite Instability (MSI) is the hallmark of Lynch syndrome/Constitutional Mismatch Repair Deficiency (CMMRD) and is also found in many sporadic cancers like colorectal cancer, endometrial, gastric, small intestine, urothelial, central nervous system and sebaceous gland neoplasms. MSI is a predictive biomarker for immunotherapy and Immunohistochemistry (IHC) antibodies against four Mismatch Repair (MMR) proteins: MutL Homolog 1 (MLH1), MutS Homolog 2 (MSH2), MutS Homolog 6 (MSH6) and Postmeiotic Segregation increased 2 (PMS2) can identify the MSI status of the tumour. In addition to MSI, immune checkpoint programmed cell death protein 1 (PD-1) expression and its ligand PD-L1 are biomarkers that can predict response to immunotherapy. Considering this increasing interest to identify deficient MMR (dMMR) status in different cancers, authors have assessed the expression of PDL1 and status of MSI in various cancer types. Aim: To evaluate the expression of PD-L1 in MSI-high status tumours. Materials and Methods: This retrospective cross-sectional study was done in the Department of Pathology, Panimalar Medical College Hospital and Research Institute for a period of six months from July 2022 to December 2022. A total of 151 cases were identified for the period of three years from January 2020 to December 2022. The slides and blocks were retrieved from the archives. Tumour sections from the paraffin embedded tissues were deparaffinised and antigen retrieval was done. IHC using four antibodies (MLH1, MH2, MSH6 and PMS2) was performed on these slides to assess the MSI status. The slides were reviewed and were further subjected to PD-L1 IHC. PD-L1 expression on tumour cells was compared with the MSI status of different cancer types. The p-value was calculated using t-test and p&lt;0.5 was considered statistically significant. Statistical analysis was done using International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) software version 21.0. Results: A total of 151 cases were included in the present study. A positive nuclear stain for the four MMR proteins denote expression of wild type MMR proteins, hence MSI low status. A loss of nuclear expression denotes mutation of MMR proteins and hence MSI high (MSI-H) status. The MSI was high in nine out of 48 cases (18.75%) of colon cancer, three out of 15 cases (20%) of endometrial cancers, three out of 20 cases (15%) of gastric cancers. Rest were one out of sixteen cases of ovarian cancer, one out of two malignant melanoma and one out of three glioblastoma. Out of these, PD-L1 was positive in seven of the 18 MSI-H cases (38.88% of MSI-H cases). The MSI was low/ stable in the remaining 133 cases. The p-value of significance was 0.03 (statistically significant). Conclusion: This study shows a significant association of MSI-H with PD-L1 expression in tumours. Further large scale studies can help in assessing the role of PD-L1 as an effective therapeutic biomarker in MS","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"45 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85676505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Full Mouth Rehabilitation of a Post COVID-19 Mucormycosis Treated Patient using BarRetained Prosthesis: A Case Report","authors":"Archit Kapadia, S. Wankhade, A. Khalikar, Suryakant Deogade, Samiksha Lalsare","doi":"10.7860/jcdr/2023/64110.18011","DOIUrl":"https://doi.org/10.7860/jcdr/2023/64110.18011","url":null,"abstract":"During the second wave of Coronavirus Disease-2019 (COVID-19), the Indian subcontinent had witnessed a steep rise in the postCOVID mucormycosis cases with an alarming rate of about 70 times than that of the rest of the world. Maxillofacial defects amounted to various post-surgical hindrances such as difficulty in mastication, impaired speech, nasal regurgitation, mental despair and socially awkward situations. Dentists all over the world were challenged for fabricating a well-retained and functionally comfortable prosthesis that would contribute in improving the condition of a physiologically-debilitating and psychologically-impaired patient. Here the authors present a case of 65 years old male patient, full mouth rehabilitation of post-COVID mucormycosis treated patient wherein a bar-retained prosthesis was delivered which was not only non-invasive but highly retentive and even pocket-friendly for the patient. This case report also shows that through meticulous planning and execution of the treatment plan, one can achieve the desired results and meet the patient’s expectations.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"535 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85695093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Presentation and Categorisation of Chronic Low Back Pain: A Cross-sectional Analysis of 1000 Outpatients in Eastern India","authors":"Sanatan Behera, Tanmoy Mohanty, Chitrita Behera","doi":"10.7860/jcdr/2023/63367.18273","DOIUrl":"https://doi.org/10.7860/jcdr/2023/63367.18273","url":null,"abstract":"Introduction: Low back pain is one of the most common presenting symptom among patients seeking medical help, accounting for approximately 85% of the cases. It affects individuals of all age groups and genders. Predominantly back pain is non specific, lacking identifiable patho-anatomy, while a lesser-known type, specific low back pain, demonstrates identifiable aetiology and pathology. This poses a challenge for physicians, as they must not only determine the underlying cause but also formulate categorical treatments for Chronic Low Back Pain (CLBP). Aim: To assess the prevalence of different types of CLBP based on clinical examination, past history, age, and gender in the overall population of the study. Materials and Methods: A cross-sectional study was conducted at Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, Odisha, India, from August 2019 to July 2021. A total of 1,640 patients were examined in the orthopedics outpatient department, of which 1,000 patients aged between 20 and 60 years, with back pain lasting three months, were included in the study. All patients underwent a detailed clinical evaluation, including history and physical examination. The final type of CLBP was determined based on the predominant symptom. Data analysis was performed using Microsoft Excel software. Results: The male-to-female ratio was 1.23:1, and the average age was 43.1 years. The most common type of CLBP was neuropathic (n=473, 47.3%), followed by discogenic CLBP (n=255, 25.5%). The least common type was coccydynia (n=4, 0.4%). Facetogenic CLBP had the highest average age of presentation (57.3 years), while postural CLBP had the lowest average age (29.6 years). Conclusion: Neuropathic CLBP was the most common type, followed by discogenic CLBP, with sacroiliitis and coccydynia being less common. Detailed clinical evaluation aids in classifying different types of CLBP, which can help avoid unnecessary investigations, except for the neuropathic type and, to some extent, instability CLBP.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"18 86 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85850039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of Acute Appendicitis using Alvarado Score, Ultrasound Abdomen, and C-Reactive Protein in Different Combinations: A Prospective Observational Study","authors":"L. Meena, Vivek Rajan, N. Mangalhara, D. Mehta","doi":"10.7860/jcdr/2023/56469.17497","DOIUrl":"https://doi.org/10.7860/jcdr/2023/56469.17497","url":null,"abstract":"Introduction: Appendicitis is the most commonly encountered surgical emergency worldwide. Numerous diagnostic methods, including clinical scoring systems, radiological modalities, and laboratory markers have been suggested over time to diagnose appendicitis correctly, but a Negative Appendectomy Rate (NAR) of 20-30% is still maintained. Aim: To determine the effect of using all three modalities together i.e., a clinical modality {The Alvarado Score}, a radiological modality {Ultrasound (US)}, and a laboratory parameter {C-Reactive Protein (CRP)} in diagnosing acute appendicitis. Materials and Methods: This was a hospital-based, prospective observational study, carried out in the Department of General Surgery, SMS Medical College, Jaipur, Rajasthan, India, from March 2019 to June 2020. The three diagnostic modalities were arbitrarily categorised into different combinations: Combination 1: Alvarado score ≥5 with C-Reactive Protein (CRP) ≥0.8; Combination 2: Alvarado score ≥5 with US grade 4 with CRP ≥0.8; Combination 3: Alvarado score ≥5 with US grade 4 with CRP ≥4); and the individual modalities i.e., the alvarado score and the US abdomen were also categorised into four categories each. Each of the individual modalities along with their different combinations were tested for their sensitivities, specificities, Positive and Negative Predictive Values (PPV, NPV) etc. Chi-square and t-test, sensitivity test and Receiver Operating Characteristic curve (ROC) and, Analysis of Variance (ANOVA) was used. Results: Total 200 cases were analysed in this study with mean age 32.33±15.78 years. Alvarado score had a sensitivity and specificity of 95.83% and 75%, respectively. US had a sensitivity and specificity of 71.35% and 75%, respectively while CRP had the highest sensitivity with 98.96%, but very low specificity (37.5%). The sensitivity, specificity, PPV and NPV of the combination 1 were found to be 98.96, 37.50, 97.44, 60.00, and of combination 2 was found to be 70.83, 87.50, 99.27,11.11 and for combination 3 was 56.77, 100, 100, 8.79, respectively. Combination 2 also had the highest Area Under Curve (AUC) in Receiver Operating Characteristic (ROC) curve. (Combination 1- 0.661; combination 2- 0.742; combination 3- 0.727). Conclusion: The Combination 2 of three modalities proved to be the best diagnostic tool in the present study. It can pave the way, for a better diagnostic scoring system and future studies in this field.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"10 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86411663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}