Journal of Medical and Allied Sciences最新文献

{"title":"Study of clinical presentation, laboratory profile, transfusion requirements and transfusion-related infectious complications in adult patients of congenital hemolytic anemia in a tertiary care center","authors":"Sarang Kotrange, Dhirendra Yadav, Niteen Karnik, Namita Padwal","doi":"10.5455/jmas.49972","DOIUrl":"https://doi.org/10.5455/jmas.49972","url":null,"abstract":"Congenital hemolytic anemia (CHA) especially hemoglobinopathies is quite prevalent in certain ethnic groups in India and commonly seen in pediatric age group. Adult presentations are being seen due to better treatment options and increased life span. This study was conducted to determine the clinical profile, laboratory parameters, transfusion requirements, and transfusion-related infectious complications of adult patients with CHA. A total of 84 patients of CHA aged more than 12 years were enrolled and studied over 18 months period. 63% patients were males with mean age of 19.98±4.99 SD years and maximum (57%) in the age group of 13-20 years. Family history of CHA was present in 19 (22.61%) patients and consanguinity in 16 (19.04%) cases which were statistically significant (P<0.05). Easy fatigability (76.19%) was the most common symptom followed by dyspnea on exertion (36.19%), whereas pallor (98.80%) was the commonest finding on examination followed by spleenomegaly (40.47%). The mean average (mean±SD) values for hemoglobin was 7.37±1.23gm/dl, Red blood cell count was 4.71±0.44 million/μL, Mean Corpuscular Volume was 77±5.05 fL, Mean Corpuscular Hemoglobin concentration was 33±1.38 g/dl, Mean Corpuscular Hemoglobin was 23±1.22 pg and mean Mentzer’s index was 16.59±2.24. The most common type of CHA in our study was β thalassemia major (58%), followed by β thalassemia intermedia (17%) and Sickle cell homozygous (13%). 45% of CHA patients required monthly transfusion (p <0.05) especially sickle cell homozygous (90%) and thalassemia major (65%) patients. 24 (28.57%) patients were Hepatitis C virus-positive and 1 was HIV virus-positive. Among adult patients with CHA, β thalassemia major, intermedia and sickle cell anemia were predominant diagnoses. Consanguinity played a role in one-fifth of patients. A majority of the patients had monthly blood transfusion requirements. The high prevalence of hepatitis C virus infection is a major concern.","PeriodicalId":16176,"journal":{"name":"Journal of Medical and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135502504","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":"Prescription pattern of depressive and anxiety disorders in patients attending Psychiatry outpatient department of a tertiary hospital in Telangana","authors":"Jagathi Nagari, Kavitha Mudavath, Sangeeta Jairaj, Neilofor Hussain","doi":"10.5455/jmas.36852","DOIUrl":"https://doi.org/10.5455/jmas.36852","url":null,"abstract":"Depression and anxiety are the most common mental illnesses encountered in patients visiting psychiatry outpatient clinics. The relative safety of majority of antidepressants and anxiolytics has increased their routine use. However, limited data is available on the prescribing patterns of these drugs, especially from the state of Telangana. The aim of this study was to assess the prescription pattern in depression and anxiety disorders in patients attending Psychiatry outpatient department of a tertiary care teaching hospital in Telangana. A prospective observational study was conducted in Psychiatry outpatient department in Government General Hospital (GGH), Nalgonda over a period of 6 months (March 2021 to August 2021). A total of 45 patients suffering from anxiety and depression, based on International Classification of Diseases-10th edition (ICD-10), were selected. Data was collected using a semi-structured proforma and analyzed. A total of 103 drugs were prescribed and the average number of drugs per prescription was 2.29. It was found that majority of patients were in 15-35 years age group (60%), female (62.22%), married (60%) and from urban background (82.2%). In the study population, 55.55% were suffering from anxiety disorders, out of which 31.11% had Generalized anxiety disorder. Among the depressive disorders (44.45%) majority had Severe depressive episode (26.67%) followed by Moderate depressive episode (17.78%). The duration of illness was less than 6 months in majority of patients (75.56%). Selective serotonin reuptake inhibitors (SSRIs) were the most common group of drugs prescribed. 41 prescriptions (91.11%) contained SSRIs, and Sertraline was the most common drug followed by Escitalopram. 93.33% of the prescriptions also included Benzodiazepines (Clonazepam). 35.55% of the prescriptions had fixed dose combinations, commonest being Escitalopram 10mg + Clonazepam 0.5mg.","PeriodicalId":16176,"journal":{"name":"Journal of Medical and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134888901","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":"Nutrition practices in COVID-19 patients","authors":"S. Saseedharan, Romasha Gupta, Chandrima Pramanik","doi":"10.5455/jmas.40414","DOIUrl":"https://doi.org/10.5455/jmas.40414","url":null,"abstract":"The COVID-19 pandemic posed a huge challenge to the healthcare system worldwide. India being a developing country, was pushed to the brim of its capabilities due to exhaustion of manpower and financial resources. Currently there are very few studies linked to nutrition in COVID-19 in Indian scenario. In this study we aim to study the nutrition practices among hospitalised Covid-19 patients from tier I and tier II cities of India. An online survey was conducted among 70 COVID hospitals of India from both government and private sector. The data was collected by the use of cloud-based spreadsheet function in googledocs of the selected 70 hospitals. 63 out of 70 respondents used height, weight and BMI criteria to calculate calorie protein requirement of the patients. With the remaining 7, two respondents from government and private hospitals used direct calorimetry and three private hospitals used indirect calorimetry (IC) method. It was observed that the number of patients on EN was higher than PN in wards as well as in ICU. 38 respondents initiated EN within 24 hours, 18 respondents did within 24-36 hrs, of patient’s ICU admission. 39 respondents checked Gastric Residual Volume in patients in prone position on ventilator as part of monitoring. As nutrition is considered equally important in treating COVID-19 patients, it is suggestive that one common government body can be formed which can formulate an India specific standardised nutrition protocol for all the practicing dieticians and health care workers.","PeriodicalId":16176,"journal":{"name":"Journal of Medical and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70824536","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":"An outcome of acute kidney injury during pregnancy: An observation and prospective study from tertiary care hospital","authors":"Priyadarshi Mandal, Sucheta Biswas, Debasish Char, Mrittika Roy, Sangeeta Chhaya","doi":"10.5455/jmas.43027","DOIUrl":"https://doi.org/10.5455/jmas.43027","url":null,"abstract":"To study the management and outcome of Pregnancy-related Acute Kidney Injury (PRAKI) in obstetrics. This observational and prospective study was conducted in 9270 deliveries including 79 cases of AKI in pregnancy at a tertiary medical college and hospital for the duration of one year. All pregnant and postpartum women attending out patient department (OPD) and emergency as booked and unbooked cases were included in our study. A detailed analysis of all investigations, management and outcome were recorded. Diagnostic criteria of AKI include (a) sudden in onset oliguria (24hrs urine output <400 ml) or anuria (b) serum creatinine level >1.5mg/dl. In the present study the creatinine values during admission or during diagnosis ranged between 1.5 to 18.2 mg/dl with a mean of 4.53±3.24 mg/dl. Majority (51.9%) of the patients have values less than 4 mg/dl. Out of 79 cases, 38 patients required hemodialysis that comes up to 48.1%. Most of the sepsis patients (17 out of 32) required hemodialysis. Case fatality rate due to AKI was 16.46% in our study. Sepsis was responsible for more maternal death, 15.6% in this study. Total 59 patients (74.68%) were discharged in stable conditions.","PeriodicalId":16176,"journal":{"name":"Journal of Medical and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70824591","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":"Evaluation of inflammatory markers in COVID-19 positive patients and their correlation with age","authors":"Priyanka Singh, Anjana Singh, V. Verma, P. Trivedi, Arshad Ikram","doi":"10.5455/jmas.93907","DOIUrl":"https://doi.org/10.5455/jmas.93907","url":null,"abstract":"The global widespread of Corona virus disease is still having a catastrophic impact on mankind. COVID-19 has depicted its uncertain adversity in all age groups and the coexistence of co-morbidities have further shown a critical aspect of disease which has additionally ravaged the health status of the patients. The inflammatory markers have exhibited potential usefulness in predicting the outcome of the disease. The Aim of this study is to evaluate the correlation of inflammatory markers in COVID-19 positive patients among various age groups. The study was done on 225 COVID-19 patients, admitted to Mayo Institute of Medical Sciences, Barabanki, Uttar Pradesh India, between 1st April-15th June 2021 categorizing into two groups based on their age (≤45 years and >45 years) and then values of various markers were gathered and compared. Among the 225 admitted COVID-19 patients, 78(34.6%) were ≤45 years, while the remaining 147(65.4%) were >45 years. Between these two age groups the aberrant values of inflammatory makers like Neutrophil count (p=0.0001), Lymphocyte count (p=0.0001), Neutrophil to Lymphocyte Ratio (NLR) (p=0.0091), Serum CRP level (p=0.0437), Lymphocyte to C-reactive protein ratio (LCR) (p=0.0007) as well as Serum Ferritin level (p=0.0097) were found to be statistically significant whereas the remaining parameters like Total leucocyte count (TLC) (p=0.0905), Platelet count (p=0.8202) and Platelet to lymphocyte ratio (PLR) (p=0.1513) were statistically insignificant. The results conclude that there was a significant correlation between the age and the inflammatory markers in these patients. Patients with > 45 years had elevated/deranged levels of inflammatory markers, which were associated with the severity and poor prognosis of the disease. Thus, age can be considered as one of the important key risk factor for the severity of COVID-19 in both sexes and hence more clinical attention should be given to elderly age group.","PeriodicalId":16176,"journal":{"name":"Journal of Medical and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70825070","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":"Clinico-laboratory profile and treatment outcome of persistent diarrhea in under 5-year children of a tertiary care hospital in North India","authors":"Hanshika Srivastava, Manisha Maurya, S. Siddiqui, Nandita Mishra, A. Shrivastava","doi":"10.5455/jmas.88304","DOIUrl":"https://doi.org/10.5455/jmas.88304","url":null,"abstract":"Persistent diarrhea (PD) accounts for a third of all deaths due to diar-rhea in under 5 children. Its etiology and treatment are poorly under-stood. So, we aimed to study various host and environmental risk fac-tors, clinical profile and treatment outcome of PD in children below 5 years of age. 60 children having PD who came to our institute were studied. History taking, clinical examination and investigations were done. Relevant data was collected in form of socio-demographic pro-file, infant and young child feeding (IYCF) indices, anthropometry, in-fections, micronutrient deficiency and secondary lactose intolerance (SLI). The treatment protocol consisted of stepwise diet plan along with supportive measures. All patients were started with diet plan A (low lactose diet), which was prepared by cheap and locally available items. Those who did not respond, were shifted to diet plan B (lactose free diet) and then to diet plan C (monosaccharide-based diet). Successful outcome was defined as decrease in stool frequency along with ade-quate food intake and weight gain. The risk factors associated with PD were found to be age < 2 years, malnutrition, SLI, micronutrient defi-ciency and previous history of infections. Out of total children (n=60), severe acute malnutrition, prior history of diarrhea/pneumonia in past 2 months and anemia were found in 58.3%, 60% and 52% of the PD children respectively. Concomitant enteric and systemic infections were found in 30% and 28.3% of PD children. SLI was observed in 61% of cases and most of the children (75%) improved on diet A only. Proper rehydration, screening and treatment of infections and enteral nutrition-al rehabilitation (both macro and micronutrient) are critical in manage-ment of children with PD.","PeriodicalId":16176,"journal":{"name":"Journal of Medical and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70825270","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":"Changing trends in medical education during pandemic: our experiences on E learning","authors":"Massarat Begum, P. Chalam","doi":"10.5455/jmas.81559","DOIUrl":"https://doi.org/10.5455/jmas.81559","url":null,"abstract":"The COVID 19 pandemic has lead not just to a social and economic uncertainty but also created historic challenges to the continuity of education process globally. Online teaching and learning has come to the forefront to prevent loss of learning time for students during this period. An observational cross sectional study was conducted on the implementation of online teaching program in a medical college during the period of COVID 19 pandemic. All the synchronous and asynchronous teaching learning activities across all the phases of MBBS were observed and reviewed. The challenges, limitations and opportunities in the implementation process were analyzed. Appropriate solutions were found for most of the challenges including the implementation of competency based undergraduate curriculum for phase 1 MBBS students. Feedback was taken from the undergraduate medical students to know their perceptions on e learning and its use as a teaching learning method. The questionnaire included both closed and open ended questions to know the learning experiences and preferences of the students. The data was subjected to descriptive statistics and computed as frequency percentages. The study presents the challenges in the implementation of online teaching like providing the required infrastructure and training the faculty. It also reveals its limitations in providing clinical experience and conducting assessments for students. The study also shows that though the medical students perceived various features of e learning to be useful but believed traditional classroom to be a better learning environment. The study highlights that e learning has provided the opportunity to promote self directed learning for students and to develop technological skills of both the faculty and the students, suggesting its potential role in the future of medical education.","PeriodicalId":16176,"journal":{"name":"Journal of Medical and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70825118","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":"A comparative account using student feedback on diverse modules of e-learning used during COVID-19 lockdown for undergraduate medical teaching","authors":"F. Shaikh, K. Naseeruddin, M. Ahmed, Nabila Afsar, Naseem Begum, Madhipati Krishna, A. Chandrasekhar","doi":"10.5455/jmas.54405","DOIUrl":"https://doi.org/10.5455/jmas.54405","url":null,"abstract":"Need has been the mother of innovation and with the global pandemic of the highly infectious disease COVID 19, there has been a paradigm shift from conventional teaching to digital mode of virtual teaching methods. This task has been achieved by using various platforms available on the digital network, the internet. This work describes the change in medical education, using student feed-back on various modules used in teaching during that period. The feedback survey was conducted online by using the available platforms. The Google forms were used as a survey tool for conducting this survey. The responses were collected from all implied consenting students attending the various teaching sessions across different years of training, belonging to our medical institution. All the participants were adult students attending a medical college. The response rate among the participants was 54%. The respondents were majority 184 (76%) female gender. Nearly 90% opted for Google Meet/classroom as a preferred online module. The choice of selecting this module among the students was found to be statistically significant as compared to other options. The selection was based on the virtue of attributes such as user-friendly application, user satisfaction, beneficial, appealing, less technically challenging, convenient and cost-effective nature. Hence to conclude we may imply to say that this study was unique in assessing the mind of the medical students against this novel e-learning based online mode of education which has taken them by surprise. Though the method is good, there is a lacking that it has; as compared to the conventional means of teaching. This may be used to revise and consolidate the teaching process but not as to replace the classical method rather it should complement it.","PeriodicalId":16176,"journal":{"name":"Journal of Medical and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70824735","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":"MRI evaluation of meniscal injuries of knee with arthroscopy correlation: A comparative study in a tertiary care hospital","authors":"Anil Nethikoppula, vijaypavankumar Dasaraju, S. Tadivaka, Madhavi Gundamaraju, Himaja Gollu, Pavani Kandikanti, Naveen Tirumalasetti","doi":"10.5455/jmas.138402","DOIUrl":"https://doi.org/10.5455/jmas.138402","url":null,"abstract":"Among various osseous, ligamentous structures around knee meniscus play important role in decreasing load on articular cartilage, smooth movement, reducing friction between opposing articular surfaces of femur, tibia during movement. An accurate diagnosis regarding site, type, grade of meniscal tear along with other associated injury is essential for early operative treatment or non-operative conservative management. This was a descriptive retrospective comparative study to determine the role of MRI in evaluating spectrum and grading of meniscal injuries of knee joint and correlate the findings with arthroscopy. A total of 30 patients clinically suspected of having meniscal injury were evaluated over a period of 1 ½ year from July 2018 to December 2019. Clinical evaluation for meniscal injury with emphasis on medial and lateral joint tenderness, McMurrey test, Appley grinding test were performed by experienced an orthopedician. MRI was performed on 1.5 tesla machine followed by arthroscopy in all patients. Taking arthroscopy as gold standard; sensitivity, specificity, PPV, NPV, accuracy of MRI was determined. In our study, most common meniscal injury was medial meniscal injury (63.3%). Lateral meniscal injury comprised of 33.3%, both menisci were injured in 3.3% of cases. Most common type of tear was longitudinal tear and Grade III tear was most common in both medial and lateral menisci. The sensitivity, specificity, PPV, NPV accuracy of MRI for medial meniscal injury was 94.4%, 83.3%, 89.5%, 90.5%, 90.5%. The sensitivity, specificity, PPV, NPV accuracy of MRI for lateral meniscal injury was 90.0%, 95.0%, 90.0%, 95.0%, 93.3%. There is a good correlation between MRI and arthroscopy findings for meniscal injuries thus supporting MRI as excellent primary non invasive diagnostic tool prior to any invasive arthroscopy.","PeriodicalId":16176,"journal":{"name":"Journal of Medical and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70823515","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":"Onychomadesis, a post infectious sequelae of Hand-Foot-and-Mouth disease: A case report","authors":"Bushra Butul, Neda Fatima, S. Fathima, M. Uddin","doi":"10.5455/jmas.61243","DOIUrl":"https://doi.org/10.5455/jmas.61243","url":null,"abstract":"Onychomadesis is an idiopathic shedding of a proximal part of the nail as a result of the temporary suspension of a nail matrix function. It is seen in fingernails, toenails, or both. Various underlying causes like systemic illness, drug reactions, Viral diseases, and bullous diseases have been associated with Onychomadesis. However, the mechanism of any such association remains unclear. Here we present a case of On-ychomadesis and Beau lines in the fingernails of a 13-month-old girl following Hand, foot, and mouth disease.","PeriodicalId":16176,"journal":{"name":"Journal of Medical and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70824426","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}