International Journal of Medicine & Health Research (IJMHR) (ISSN 2395-3586)
International Journal of Medicine & Health Research, IJMHR (ISSN 2395-3586) is a peer-reviewed Indexed Journal. It publishes various categories of manuscripts in the areas of Medicine, Surgery, Dental Medicine, Nursing, Paramedical Sciences, Pharmacy, Drug Discovery, Public Health, Environmental health, Global Health, Policy, Translational Medicine, Evidence-Based Alternative Medicine, Food & Nutrition, Sports Medicine, Ayush medicines and all other relevant areas. Young authors including early career scientists, assistant professors, post-doctoral fellows, Ph.D., D.M., M.S. & M.D. students are highly encouraged to share their ideas about the latest topics in their scientific expertise. Area of Publication: Medicine: Anaesthesiology, , Biochemistry, Blood Banking & Immunohaematology, Community Medicine, Dermatology, Venereology & Leprosy, Emergency Medicine, Family Medicine, Forensic Medicine, General Medicine, Geriatrics, Hospital Administration, Immunohematology & Blood Transfusion, Microbiology, Nuclear Medicine, Paediatrics, Pathology, Pharmacology, Physical Medicine & Rehabilitation, Physiology, Psychiatry, Radio Diagnosis, Radiotherapy, Respiratory Medicine, Sports Medicine, Transfusion Medicine, ENT (Otorhinolaryngology), Aviation Medicine, and all other relevant areas. Surgery: General Surgery, Obstetrics & Gynaecology, Ophthalmology, Orthopaedics, Cardio-Thoracic Surgery, Gastrointestinal Surgery, Genitourinary Surgery, Gynaecological Oncology, Hand Surgery, Head & Neck Surgery, Neuro Surgery, Oncosurgery, Paediatric Surgery, Plastic Surgery, Reproductive Medicine, Surgical Oncology, Thoracic Surgery, Urology, Vascular Surgery, and all other relevant areas.
A Case on Posterior Shoulder Dislocation: The Hidden Injury
Introduction: Posterior shoulder dislocation (PSD) is a rare injury, accounting for a small proportion of glenohumeral dislocations, and is frequently missed at initial presentation due to subtle clinical signs and inconclusive standard radiographs. Delayed diagnosis may result in persistent instability, pain, and early degenerative changes, particularly when associated with osseous defects such as the reverse Hill-Sachs lesion (rHSL). Electrocution is a classic but often under-recognized mechanism leading to PSD because injury can occur without direct trauma. Case Presentation: We report the case of a 21-year-old male who presented with acute pain and restricted external rotation of the right shoulder following accidental electrocution. Clinical examination revealed the arm held in addition and internal rotation with limited external rotation. Plain radiographs demonstrated features suggestive of posterior dislocation, including the lightbulb and trough line signs. Following closed reduction, magnetic resonance imaging revealed an engaging reverse Hill-Sachs lesion involving approximately 30% of the humeral head, with an associated reverse Bankart lesion. Given the size and engagement of the defect, the patient underwent an arthroscopic modified McLaughlin procedure combined with posterior labral repair. Result: Postoperative rehabilitation resulted in a satisfactory range of motion and return to functional activity, with no evidence of instability at three-month follow-up. Conclusion: This case highlights the importance of maintaining a high index of suspicion for PSD following electrocution. Advanced imaging is essential for identifying rHSLs and guiding management. Arthroscopic defect-addressing procedures combined with capsulolabral repair provide a reliable, joint-preserving solution in young patients with engaging humeral head defects.
Posterior shoulder dislocation; Reverse Hill-Sachs lesion; Electrocution injury; Arthroscopic modified McLaughlin procedure; Reverse Bankart lesion; Shoulder instability
Copyright (c) 2026 International Journal of Medicine & Health Research (IJMHR) (ISSN 2395-3586)
Analysis of Caesarean Section Rates Using Robson's Group Classification
Introduction: The Caesarean section (CS) rate is steadily increasing worldwide, including in India. The overall CS rates are reported, but the women are classified. According to WHO, Robson ten ten-group classification is useful as a global standard for assessing, monitoring, and comparing caesarean section rates. Our objective was to classify women delivering in our hospital according to various categories as per the 10-group classification (Robson's classification) and to analyze the CS rate in each group. Material & Methods: This was a cross-sectional study conducted at Vitthal Rao Vikhe Patil Pravara Rural Hospital, Pravara Institute of Medical Sciences. The data was collected for all women delivering in the hospital from February 2023 to April 2023, and the women were classified according to Robson's 10-group classification. The proportion of women delivering in each group, the CS rate of each group, and the relative contribution to the CS rate from each group were calculated. Results: Among a total of 1506 women delivering during the study period, 37.9% of women were delivered by CS. The maximum no of pregnant women belonged to the primigravida group (groups 1 and 2), 40 %. Major contributors to the CS rate were Group 5 at 33.9%. The next contributors were group 2 and group 1 at 22.2% and 17.8% respectively. Overall, the three groups 1, 2, and 5 contributed 73.9 % of the CS rate, while the other group contributed to only 26.1% of the CS rate. Conclusions: Applying Robson's criteria to classify pregnant women allowed for easy classification to identify the category of women most likely to have CS. Reducing the primary CS rate and increasing VBAC rates will help to reduce the CS rate.
Cesarean section; Robson classification; Delivery outcomes; Maternal health; Primary cesarean rate; Tertiary care hospital
Copyright (c) 2025 International Journal of Medicine & Health Research (IJMHR) (ISSN 2395-3586)
Surgical Management of a Giant Papillary Thyroid Carcinoma: A Case Report
Introduction: Giant goitres are uncommon thyroid enlargements that may extend over decades, often resulting in compressive symptoms and aesthetic concerns. Although most long-standing goitres are benign, the potential for malignant transformation exists. Early diagnosis and timely surgical management are crucial to prevent complications and ensure optimal outcomes. Case Presentation: We report a case of a 63-year-old female who presented with a massive anterior neck swelling that had been progressively enlarging over a period of 20 years. Clinical evaluation and ultrasonography were performed, followed by fine needle aspiration cytology (FNAC), which suggested a follicular neoplasm. The patient was planned for surgical excision under general anesthesia. Results: Intraoperatively, a well-encapsulated, highly vascular thyroid mass was identified and successfully excised. The specimen weighed approximately 4 kg (8.81 lbs). Histopathological examination confirmed the diagnosis of papillary thyroid carcinoma with areas of cystic degeneration. The postoperative course was uneventful, and the patient recovered without complications. Conclusion: This case highlights the rarity of giant goitres and underscores the importance of early diagnosis, careful preoperative assessment, and meticulous surgical planning. Even in long-standing goitres presumed benign, the risk of underlying malignancy should be considered. Timely surgical intervention not only minimizes morbidity but also facilitates early detection and treatment of occult malignancies, thereby improving patient outcomes.
Giant goitre; Papillary thyroid carcinoma; Thyroidectomy; Airway management; Difficult airway
Study on Post Dated Pregnancy: Its Maternal and Foetal Outcome
Introduction: Post-dated pregnancy, defined as a pregnancy extending beyond 40 weeks of gestation, is associated with increased maternal and fetal risks. The incidence ranges from 4% to 14%. Complications include meconium-stained liquor, oligohydramnios, fetal distress, macrosomia, shoulder dystocia, and increased rates of operative deliveries. This study aims to evaluate the maternal and fetal outcomes in post-dated pregnancies to guide better clinical management and reduce morbidity. Materials & Methods: This descriptive longitudinal study was conducted at the Department of Obstetrics and Gynecology, Tezpur Medical College, Assam, from 2023 to July 2024. A total of 106 pregnant women with gestational age between 40–42 weeks were included based on strict inclusion and exclusion criteria. Data were collected using clinical examination, ultrasonography, biophysical profiling, and monitoring tools. Mode of delivery, perinatal morbidity, and maternal complications were recorded. Statistical analysis was performed using SPSS version 23 with chi-square tests; p < 0.05 was considered significant. Results: Among the 106 patients, the majority were aged 20–25 years. Spontaneous vaginal delivery occurred in a significant proportion, while cesarean section was required in many cases due to fetal distress and failed induction. Maternal complications included perineal tears, postpartum hemorrhage, and prolonged labor. Fetal complications observed were low Apgar scores, meconium aspiration syndrome, NICU admission, and the need for neonatal resuscitation. A statistically significant correlation was found between gestational age and increased perinatal complications. Conclusion: Post-dated pregnancy poses significant maternal and fetal risks. Early identification and timely induction, coupled with vigilant intrapartum monitoring, can improve outcomes. Regular antenatal care and accurate dating using first-trimester ultrasound are essential in minimizing complications associated with post-dated pregnancies.
Post-dated pregnancy Maternal outcome Maternal outcome Induction of labor Meconium aspiration syndrome
Study of Peripheral Smear Findings in Patients with Chronic Kidney Disease in a Tertiary Care Centre
Introduction: Chronic kidney disease (CKD) is a progressive disorder associated with significant hematological and biochemical alterations, particularly anemia, thrombocytopenia, and proteinuria. Peripheral smear examination, though simple and cost-effective, provides valuable insights into morphological spectrum of anemia and other blood abnormalities in CKD patients. This study aimed to evaluated the peripheral smear findings and correlate them with clinical and biochemical parameters in patients with CKD. Material & Methods: A cross-sectional study was conducted on 98 patients diagnosed with CKD at tertiary care centre. Detailed demographic, clinical, biochemical data were collected. Peripheral smear analysis was performed to assess red blood cell (RBC) morphology, leukocyte variations, platelet abnormalities. Serum urea, creatinine, and urine albumin were also evaluated to correlate hematological findings with renal function status. Results: The study population had a male predominance (60.20%) and most patients were aged 51–75 years (68.37%). Hypertension (39.80%) and diabetes mellitus (36.73%) were the leading comorbidities. Normocytic normochromic anemia was the most common finding (69.39%), followed by microcytic hypochromic anemia (7.14%). Thrombocytopenia was present in 35.71% of cases. Leukocyte abnormalities included neutrophilia (14.29%) and toxic granulations (8.16%). Biochemically, 94.90% of patients had elevated urea levels (>40 mg/dL), and 86.73% had creatinine levels between 1.2–8 mg/dL; 13.27% exceeded 8 mg/dL. Albuminuria was present in over 90% of patients, with 44.90% having 2+ proteinuria. Conclusion: The predominance of normocytic normochromic anemia and significant platelet and leukocyte abnormalities highlight the hematological burden of CKD. Elevated urea, creatinine, proteinuria confirmed advanced renal dysfunction. Peripheral smear remains an inexpensive yet powerful diagnostic tool, offering critical insights into disease severity and aiding timely interventions. Integrating smear analysis with standard renal function tests can improve CKD management, particularly in resource limited settings.
Chronic Kidney Disease Peripheral Smear Anaemia Haematological Abnormalities
Cervical Tuberculosis in a Young Reproductive age Female Mimicking Cervical Cancer: A Rare Differential Diagnosis
Introduction: Tuberculosis (TB) is a global health challenge, with extrapulmonary cases comprising up to 40%. Genital tract TB significantly impacts reproductive-age women, yet cervical involvement is exceedingly rare, representing only 0.1–0.65% of TB cases. When present, it closely mimics cervical carcinoma both clinically and radiologically, leading to serious diagnostic dilemmas and potential mismanagement, often resulting in unnecessary radical surgical interventions if histopathological confirmation is not pursued. Aim and Objectives: This case report emphasizes cervical tuberculosis as a rare differential diagnosis in reproductive-age women with malignant-appearing cervical lesions. Its objectives are to describe the clinical and diagnostic features of cervical TB and to highlight the importance of histopathology in distinguishing it from carcinoma, ensuring accurate diagnosis and appropriate management. Materials and Methods: A young multiparous woman with persistent vaginal discharge and post-coital bleeding underwent pelvic examination, baseline investigations, and cervical biopsy. Histopathological analysis including Ziehl–Neelsen staining was performed. Standard anti-tubercular therapy (ATT) was initiated, and clinical follow-up at six months was undertaken to assess response. Results: Per speculum examination revealed an irregular friable cervical growth resembling carcinoma. Routine investigations and chest X-ray were normal, and HIV serology was negative. Histopathology showed epithelioid granulomas with caseous necrosis, and Ziehl–Neelsen stain confirmed acid-fast bacilli, establishing cervical TB.After six months ofATT, the lesion completely regressed, confirming an excellent therapeutic outcome. Conclusion: Cervical tuberculosis, though rare, must be considered in the differential diagnosis of carcinoma-like cervical lesions in young women. Histopathology remains crucial for accurate diagnosis, and timely ATT ensures curative outcomes while preventing unnecessary radical surgery.
Cervical tuberculosis Carcinoma mimic Histopathology Anti-Tubercular therapy Reproductive age
A Study of Clinical Profile of Hypertension in Elderly Age Group in Tertiary Care Hospital
Introduction: Decompensated alcoholic liver disease (DALD) is a major cause of morbidity and mortality worldwide, with complications including ascites, hepatic encephalopathy, hepatorenal syndrome, and spontaneous bacterial peritonitis. Hyponatremia, defined as serum sodium <135 mEq/L, is common in cirrhosis and strongly influences prognosis. This study was conducted to evaluate the clinical significance of serum sodium levels and their correlation with disease severity in patients with DALD. Material & Methods: A prospective observational study was conducted at a tertiary care center from July 2023 to June 2025. A total of 180 male patients aged >18 years, diagnosed with DALD, were enrolled based on clinical, biochemical, and imaging findings. Patients with cardiac failure, chronic kidney disease, or on interfering medications were excluded. Clinical history, laboratory investigations, and imaging were recorded. Disease severity was assessed using Model for End-Stage Liver Disease (MELD), MELD-Na, and Child-Pugh scoring systems. Data were analyzed using SPSS, with p <0.05 considered significant. Results: Among 180 patients, the majority were aged 36–50 years (62.78%), with farming as the most common occupation (27.78%). Hyponatremia (<135 mEq/L) was present in 34.44%, normonatremia in 51.11%, and hypernatremia in 14.44%. Patients with sodium <135 mEq/L demonstrated higher MELD scores (27–31 in 13.89% cases) and were more frequently classified as Child-Pugh class C (22.78%). Hyponatremia was strongly associated with severe complications, including ascites, hepatic encephalopathy, and hepatorenal syndrome. Conclusion: Serum sodium is a simple, inexpensive, and reliable biomarker in DALD. Hyponatremia correlates with advanced disease severity and poor prognosis, emphasizing its utility in risk stratification. Integration of serum sodium into prognostic scoring systems like MELD-Na enhances predictive accuracy, supporting early intervention and improved patient management in tertiary care settings.
Decompensated alcoholic liver disease Serum sodium Hyponatremia MELD-Na score Child-Pugh classification
Introduction: Hypertension is a major cause of cardiovascular morbidity and mortality, with prevalence exceeding 60% in those above 60 years. Age-related vascular changes, sedentary lifestyle, and reduced renal function contribute to isolated systolic hypertension, making it a key public health concern. Aim and Objective: To study clinical profile, associated factors, and presentations of hypertension in elderly patients. Materials & Methods: A prospective observational study was conducted in the Department of General Medicine, a tertiary care hospital, from June 2023 to May 2025. A total of 180 hypertensive patients aged >60 years were enrolled. Data on demographics, comorbidities, lifestyle, and clinical/laboratory parameters (CBC, RFT, LFT, lipid profile, ECG, fundus exam, urine microscopy, and USG) were collected. Analysis was performed using SPSS with appropriate statistical tests; p<0.05 was considered significant. Results: Among 180 elderly hypertensive patients, most were 60–70 years, females, and from lower socioeconomic backgrounds. Obesity, physical inactivity, smoking, and alcohol use were common, along with comorbidities like diabetes and ischemic heart disease. Laboratory and imaging findings revealed dyslipidemia, renal impairment, ECG abnormalities, and fundus changes, indicating early end-organ damage. Conclusion: Elderly hypertension is strongly associated with modifiable risk factors and multiple comorbidities. Early screening, lifestyle interventions, and comprehensive geriatric care are essential for preventing complications in this vulnerable group.
Hypertension Elderly Risk factors Comorbidities End-organ damage Lifestyle modification Peripheral Smear Anaemia Haematological Abnormalities
Study of Clinical Profile of Cerebrovascular Accident in Tertiary Care Hospital
Introduction: Cerebrovascular accident (CVA) or stroke is a leading cause of morbidity and mortality worldwide, significantly affecting quality of life and posing a heavy socioeconomic burden. The present study was undertaken to analyzed clinical profile of stroke patients admitted to a tertiary care hospital, with a focus on demographic characteristics, risk factors, and clinical presentations. Material and Methods: This observational prospective study was conducted in the Department of General Medicine, including all patients >18 years admitted with CVA between July 2023 and June 2025. Diagnosis was established using clinical and radiological criteria. Patients with trauma-related stroke, transient ischemic attacks, unstable hemodynamic status, pregnancy were excluded. Demographic data, risk factors, clinical features were systematically recorded and analyzed. Results: A total of 180 patients were studied. The majority were aged 61–75 years (77.78%), with males comprising 60% of cases. The most common presenting complaint was weakness (31.67%), followed by visual disturbances (15.56%) and seizures (12.22%). Gradual onset of symptoms was reported in 65% of patients, while 35% presented with sudden onset. A positive family history of CVA was observed in 48.33%, and personal risk factors included smoking (30.56%) and alcohol consumption (26.67%). Hypertension was the most prevalent comorbidity, with 67.78% of patients showing elevated blood pressure. Neurological evaluation revealed 69.44% of patients were disoriented, 26.11% had non-fluent or fluent aphasia, and significant motor weakness was noted in the majority, with 62.22% showing 0–2/5 power. Conclusion: The study highlights that CVA predominantly affects elderly males, with hypertension, smoking, alcohol consumption being key risk factors. Weakness and visual disturbances were the most common presenting features. Early identification of risk factors and timely intervention remain crucial for reducing stroke incidence and improving outcomes.
Cerebrovascular accident Stroke Clinical profile Risk factors Hypertension
Efficacy of intramuscular electrical stimulation with dry needleover classical trigger point dry needling in non-traumaticshoulder pain and dysfunction–a randomized controlled pilotstudy
Background: Myofascial Pain Syndrome (MPS) is a common condition in most of the painful shoulder conditions and it is effectively treated with trigger point dry needling of shoulder muscles. Very few studies on Intra muscular electrical stimulation were docu-mented the effects of IMES with dry needle in treating MPS. This study was conducted to establish the clinical importance of IMES with dry needle in Myofascial pain syndrome of non traumatic shoulder disorders. Methods: 30 subjects with unilateral non-traumatic shoulder pain and dysfunction were selected and divided into two groups, 15 subjects in each group. Experimental group (7 male and 8 female subjects) treated with IMES with dry needle and control group (7 male and 8 female subjects) treated with classical trigger point dry needling twice in a week for consecutive 3 weeks. Pain, range of motion, and shoulder disability were assessed with VAS, Goniometry, and DASH-Questionnaire respectively at the end of 1st, 2nd, 3rd week, and end of 3rd month. Results: Descriptive characteristics of pre and post intervention VAS and DASH-Q, score and shoulder range of movements suggesting improvement in intramuscular electrical stimulation with dry needle. Within group comparison of VAS score and DASH-Q score in both groups in all observations shown the p value=.001 and between group comparison VAS score shown the mean 5.70 ± 1.02 standard deviation in the 1st week post intervention and DASH-Q score shown the mean 49.66 ± 9.69 standard deviation in the 1st week, mean 61.76 ± 7.30 standard deviation in the 2nd week intervention. Shoulder range of motion within group comparison was shown the p=.000 in both groups and between group comparison of shoulder abduction was shown the mean difference of 13.7 (p=.033) and 20.4 (p=.028) in the 1st and 2nd week and for shoulder external rotation shown the mean difference of 8.40 (p value= .01), and 9.60 (p=.01) in the 1st and 2nd week post intervention. Conclusion: This pilot study result suggests that both IMES with dry needle and classical trigger point dry needling are effective in treating pain and dysfunction. And subjects treated with IMES with dry Needle more effective in producing early recovery from pain and dysfunction of shoulder compared to the Classical Trigger Point Dry Needling in myofascial pain syndrome due to Non-Traumatic Shoulder pain and dysfunction.
Copyright (c) 2024 International Journal of Medicine & Health Research, IJMHR (ISSN 2395-3586)
BONE MARROW BIOPSY PICTURE IN A PATIENT WITHMARFANOID HABITUS AND ANOREXIA NERVOSA
Gelatinous marrow transformation (GMT) is a rare disorder of bone marrow characterized by deposition of extra cellular gelatinous material. There is atrophy of the marrow adipocytes and loss of hematopoietic elements. It is also called as osseous atrophy of the bone marrow. It is not a specific disease but it is seen associated with chronic illness like malnutrition, anorexia nervosa, HIV infection and administration of cytotoxic drugs. Here, we report a case of gelatinous transformation of bone marrow in a 17 year old female presented with severe weight loss and anemia
A RANDOMISED CONTROL STUDY ON EFFECT OF OCTREOTIDEIN MANAGEMNT OF ACUTE PANCREATITIS WITH VARYINGSEVERITIES
Background: Acute pancreatitis is an acute inflammatory process of the pancreas with variable involvement of other regional tissues or organ systems. Theories on pathogenesis of acute pancreatitis suggest that autodigestion of the gland and peripancreatic tissues by activated digestive enzymes is a key component. Octreotide is a potent inhibitor of pancreatic secretion, but the benefits of octreotide in acute pancreatitis in humans is still inconclusive. Aim: To study the effect of octreotide in acute pancreatitis with different severities. Method: 284 patients were assigned into two groups randomly, the study group comprising of 138 patients received inj octreotide 100 μg S.C. 8 hrly. The other aspects of the treatment protocol were similar in both groups. Severity of the disease was evaluated initially according to Ranson criteria, APACHE II SCORING, CRP values & Balthazar grading. Both the groups were observed prospectively and outcome of treatment was evaluated. Results: The results were analysed after dividing both the study and control group into 5 groups each according-to increased severities. The complication rate was 10% in group 1 and 28% in group 2 according to APACHE II among the study group, whereas it was 23% and 46% in the conrol group respectively. The values in patients stratified according to other criterias were also comparable. The results in cases of severe pancreatitis were poor, complication rates varying from 56% to 100% in the 3'd and 5th group according to Ranson criteria among the study group and 62% to 100% respectively among the control group. Mortality of the study and control group also did not show any significant changes. Conclusion: Inhibition of secretory function in the early course of the disease especially in mild and moderate cases of pancreatitis has been shown to improve final outcome. As in case of acute pancreatitis it is very difficult to estimate the severity and disease progress at the very onset, and as the majority of cases are mild to moderate in severity, it will be beneficial to start with octreotide in any treatment protocol along with supportive resuscitative measures.
HYPERTENSION AMONG WOMEN IN TIRAIRA MADANI, RURALSUDAN: PREVALENCE AND RISK FACTORS, 2014
Background Hypertension is a major risk factor for strokes, cardiovascular and kidney diseases worldwide and it has considerable variation in its prevalence across different geographic locations and ethnic groups. Objectives This study aimed to estimate the prevalence of hypertension and to determine its major risk factors among women. Methods A Descriptive cross-sectional community based study was conducted in Tirira Madani village –Sennar state- Sudan. A total of 255 women aged (15 – 75) years were interviewed using a structured questionnaire. Blood pressure was measured twice. Hypertension was taken as blood pressure ≥ 140 mmHg and/or ≥ 90 mmHg for systole and diastole respectively. Descriptive cross-tabulations and bivariate analyses were used. The statistical significance was tested using chi-square test. Predictor factors to hypertension were tested by logistic regression. Results Prevalence of hypertension among participants was 25.9%. Factors found to be associated with hypertension were; age, illiteracy, low salt intake, family history of hypertension, Coffee intake of more than two cups daily, fish consumption, low physical activity, and high socio-economic status. Certain ethnic groups were at increased risk compared to others (RR=2.11, 95%CI: 1.265 – 4.588). Logistic regression model showed age, ethnicity, physical activity level, education level and family history were predictors of hypertension (P-value <0.05).Conclusion Hypertension was prevalent in rural Sudan. Age, ethnicity, socio-economic status, level of education and family history of hypertension were the major risk factors of hypertension.
COMPARATIVE STUDY OF HEPATIC CHANGES IN PATIENTS OFMETABOLIC SYNDROME AND CHRONIC ALCOHOLISM
Aims and Objective: Comparative study of hepatic changes in patients of metabolic syndrome and chronic alcoholism. Material and Method: The material of the study included 30 metabolic syndrome patients and 30 chronic alcoholics selected from the medicine outdoor clinic (including diabetic clinic) and medicine indoor wards as well as from GI clinic of Postgraduate Department of Medicine, S.N. Medical College and Hospital Agra . Results: Most metabolic syndrome patients (60%) as well as chronic alcoholics (50%) were asymptomatic. Anorexia and fatigue/ malaise was present in 13.3% and 40% respectively in metabolic syndrome patients as compared to anorexia (30%) and fatigue / malaise (50%) in chronic alcoholics. Nausea / vomiting and right upper abdominal quadrant pain was present in 10% metabolic syndrome patients as compared Nausea / vomiting (40%) and Right upper abdominal quadrant pain(26.6%) in chronic alcoholics. Hepatomegaly and icterus was present in 23.3% and 10% respectively in metabolic syndrome patients as compared hepatomegaly (80%) and icterus (60%) in chronic alcoholics. Ascites and upper GI bleeding was present in 13.3% and 6.7% metabolic syndrome patients respectively as compared to ascites (50%) and upper GI bleeding (9%) in chronic alcoholics. Mean AST and ALT levels were 65.56 + 67.22 and 84.9 + 91.9 U/L respectively in metabolic syndrome patients. AST/ ALT ranged from 0.91 to 1.85 with mean of 0.98 + 0.26 while in chronic alcoholics mean AST and ALT levels were 98.4 and 48.2 .AST and ALT levels were statistically significant (p value<0.05) in chronic alcoholics and the AST/ ALT was 2.04. Gamma glutamyl transferase enzyme level was elevated in most (80%) chronic alcoholics while was near normal in metabolic syndrome patients. On ultrasonography most of chronic alcoholics (93.3%) had abnormal findings like fatty liver (80%), cirrhosis (13.3%) as compared to metabolic syndrome patients having NAFLD (33.3%), and cirrhosis (6.67%). On Histological examination metabolic syndrome patients had NAFLD in 33.3%, NASH in 41.6% and cirrhosis in 8.3% as compared to chronic alcoholic patients having fatty liver in 35.7%, alcoholic hepatitis in 49.9% and cirrhosis in 14.3%. Conclusions: a. Symptoms like anorexia, fatigue/malaise, nausea/vomiting, right upper abdominal pain and signs like hepatomegaly, icterus, Splenomegaly, ascites, UGI bleeding were compared and statistically significant (p value<0.05) Symptomatology and signs were found in chronic alcoholics as compared to metabolic syndrome patients. b. Statistically significant (p value <0.05) deranged liver function tests were found in chronic alcoholics as compared to metabolic syndrome patients. www.advancejournals.org Open Access Scientific Publisher International Journal of Medicine & Health Research IJM 35|Volume 1|Issue 1|2015 2 c. On Hepatic Ultrasonography statistically significant (p value <0.05%) hepatic changes in the form of fatty liver, cirrhosis were observed in 93.4% patients of chronic alcoholics as compared to metabolic syndrome patients (60%). d. Patients with hepatomegaly, abnormal liver function tests and abnormal ultrasonographic findings were observed as high risk cases. Histopathological assessment of high risk patients revealed significant changes in the form of NAFLD (33.3%), NASH (41.6%) and cirrhosis (8.3%) in metabolic syndrome patients as compared to chronic alcoholics in the form of alcoholic fatty liver (35.7%), alcoholic hepatitis (49.9%) and cirrhosis (14.3%). e. Statistically positive correlation of high risk group patients has shown abnormal ultrasonographic finding, abnormal liver function tests and the histopathological changes in the patients of both the groups. Though statistically (p value <0.05) significant changes were seen in chronic alcoholics as compared to metabolic syndrome patients
A CROSS-SECTIONAL PREVALENCE STUDY OF DISCDEGENERATION IN A RURAL POPULATION AND ITS RELATIONWITH AGE, BODY MASS INDEX AND BACK PAIN
The prevalence of degenerative discs (DD) in 59 male; 41 female patients belong to rural population of Anand district having mean age of 48.29 years; mean BMI (Body Mass Index) 22.196 kg/ m2 associated with pain, radiculopathies and neurological deficit presenting to the various in & out patient departments of Shree Krishna Hospital & Pramukh Swami Medical College, Karamsad, Gujarat. Magnetic resonance imaging (MRI) performed with a sagittal T2 image of the lumbar spine using closed type Superconductive 1.5 Tesla Magnetom Symphony Maestro (Manufactured by Siemens AG, Erlangen Company). Patients with sedentary life style had maximum number of degenerative disc pathologies; while had ambulatory life style had maximum percentage of infective/inflammatory disc pathologies. 98.3 % male patients had degenerative lesions while 92.5 % of female patient had degenerative changes. Age group 61-70 years to be maximum involved. In the lumbar region maximum changes were seen at L5-S1 level (25.7 %); cervical region at C5-C6 level (12.2 %) and at thoracic region at D12-L1 level (24.2 %). B.M.I. group II (18-25 kg/m2) to have maximum number of disco genic pathologies. All Congenital / developmental disc anomalies cases were associated with degenerative disc. It can be concluded that MRI is a highly sensitive imaging modality, which closely reflects histological changes. Grade III changes are mostly present in sedentary life style patient with high Body Mass Index
ANTERIOR ARTHRODESIS FOR TUBERCULOSIS OF THE SPINEUSING ZETA INSTRUMENTATION ON LATERAL SIDE
This is a prospective study of twelve patients who are diagnosed to have tuberculosis of spine with some form of neurological deficit. In the present study, the progression of kyphosis and the fate of the bone graft and final outcome over an average twelve month follow up after radical anterior debridement, bone grafting and application of Zeta Instrumentation on the lateral side of the vertebral body is performed. Supplementation with an implant to the procedure of bone grafting after radical debridement is a good choice as a primary procedure. It was noted that It is easy to place the implant on the lateral aspect of the bodies of the spine. There is no need of a second procedure in the form of posterior instrumentation and posterior fusion at a later date. Can be used by surgeons, where the facilities for pedicular screw fixation are not present. There is no progression of the deformity
TREATMENT OF CLOSED TIBIAL PILON FRACTURES WITHOPEN REDUCTION, INTERNAL FIXATION AND BONE GRAFTING.A STUDY OF 22 CASES COMPARING THE OBJECTIVE ANDSUBJECTIVE EVALUATION
The cases of twenty two fractures of the ankle joint that involved the tibial plafond were reviewed. The fractures were classified in to five types according to the severity of the injury. Open reduction and internal fixation was performed using one third tubular plate for fibula and recon plate for the tibia. Bone grafting was done to augment the fixation and maintain the reduction. For each fracture treated Objective and Subjective evaluation is done. The objective and subjective scores are compared. With this method we noticed that the Type III & IV fractures also had a good or excellent result
A CASE OF TYPE IIA HOMOZYGOUS FAMILIALHYPERCHOLESTROLEMIA WITH CUTANEOUS XANTHOMAS
Familial Hypercholestrolemia (FH) is characterized by presence of various types of cutaneous xanthomas with a deranged lipid profile. An 8 year old non-obese girl presented with multiple planes, tuberous and tendinous xanthomas and had associated abnormal lipid profile with elevated LDL cholesterol levels.
MENSTRUAL CHARACTERISTICS AND PREVALENCE OFDYSMENORRHOEA AMONG FEMALE PHYSIOTHERAPYSTUDENTS
Background: A common gynaecological problem encountered among female students is dysmenorrhoea, which also appears to be a leading cause of absenteeism from college. Hence arises a need to evaluate the menstrual characteristics and prevalence of dysmenorrhoea along with its severity among students. Materials and methodology: This cross-sectional study was conducted between March 2014 to July 2014 at SPB Physiotherapy College, Surat, Western India. The study group included 133 female students. The data was collected by general assessment form, questionnaires regarding menstrual characteristics and dysmenorrhoea, Visual analogue scale (VAS) and Verbal multidimensional scoring system (VMSS) for assessment of dysmenorrhoea severity. Percentages and Chi-square test were used for statistical analyses. Results: The average age of the participants was 20.8 ± 1.8 years (range 17–23 years).Prevalence of dysmenorrhoea was found to be 71.2%.There was an association between dysmenorrhea and coffee consumption, choclate consumption, menstrual bleeding duration days, menstrual cycle regularity, family history of dysmenorrhoea, any gynaecological diseases (P < 0.05, for each one). Among dysmennorhic respondents, visual analog scale (VAS) for pain of dysmenorrhoea was 1-3 (n=48), 4-7(n=19), 8-10 (n=22). Conclusion: Dysmenorrhoea is a very common problem among girls and it affects their quality of life. It can be better managed by mental preparation and by appropriate change in lifestyle like regular physical exercise and with assurance to the students. It is important to spread awareness about the causes and treatment of dysmenorrhoea to avoid undue sufferings causing absenteeism from work and studies.
AMYOTROPHIC LATERAL SCLEROSIS : A REVIEW
Amyotrophic lateral sclerosis (ALS) also called Lou Gehrig's disease is a rapidly progressive, invariably fatal neurological disease that attacks the nerve cells (neurons) that responsible for controlling voluntary muscles.several known ALS genes were fund to be associated and TBK1 (the gene encoding TANK binding kinase) was identified as an ALS gene. In the United States, more than 5,600 are diagnosed every year, and up to 30,000 Americans are currently affected. ALS is responsible for two deaths per 100,000 people per year. Smoking, Lead exposure & Heredity are the major factor for ALS. No cure has yet been found for ALS. However, the Food and Drug Administration (FDA) approved the first drug i.e. riluzole (Rilutek)—in 1995. Riluzole is believed to reduce damage to motor neurons by decreasing the release of glutamate. However, new medications or combinations of drugs would be beneficial for cure or prevention of diaease.
HEALTH AND SOCIAL WELLBEING OF THE WORKERS IN THESTONE QUARRYING AND CRUSHING INDUSTRY
Introduction: The quarryis an open excavation or a type of open pit mine, from which the stone is obtained by digging, blasting or cutting. The Indian quarries cater to the needs of railways, road construction and maintenance, housing and infrastructure building. The objectives of this were to assess the social wellbeing among quarry workers, to study the health issues peculiar to specific vulnerable population groups in the quarry, specifically under five children of quarry workers, women and the elderly and to enumerate if any health problems among workers, with specific reference to injuries and other work related morbidities. Methodology: This study was a cross sectional study done over a period of one year among people working in three quarries, situated in the peri-urban area of Bangalore. Predesigned and pretested tools were used to collect the data from various vulnerable groups working in quarries. Results and discussion: Social wellbeing, most of the workers were migrants from neighbouring states were dissatisfied with their job and isolated working conditions. Nutritional status of under five children, 95% of the children were undernourished. Status of women employees, the common health problems were musculoskeletal pain, menstrual disorders and substance abuses in the form of alcohol. Among the elderly, majority were employed, cataract and vision were the most common problems. Most common injuries were cuts and bruises on the lower limbs. The workers in quarry had lowered lung function test as measured by the mean PEFR when compared to the standard mean PEFR among Indians.
EMERGENCE OF DRUG RESISTANCE IN BACTERIAL ISOLATESFROM HOSPITAL WASTEWATER: A POTENTIAL HEALTHHAZARD
Introduction:Release of sewage effluent containing bacteria having elevated antibiotic resistance levels poses threat to environment. The antimicrobial selective pressure through indiscriminate use of antibiotics has played a significant role in enriching the MDRstrains in the hospital practice. Materials and methods: Study was conducted at the department of agricultural microbiology, Aligarh Muslim University, Aligarh, UP (India). Wastewater samples were collected from a drain of J. N. Medical College, Aligarh. Isolation of the enterobacteria was done. All isolates were tested for their sensitivity to antimicrobial agents by means of disc diffusion method [1] . Results:In the present study, a total of 50 enterobacteria were isolated from hospital wastewater. All the isolates were tentatively identified by morphological, cultural and biochemical characteristics. All the isolates were further tested for their antibiotic susceptibility (Table 2). A high level of resistance against penicillin-G (90%) was observed in strains isolated from hospital wastewater. Resistance against cloxacillin, novobiocin, nalidixic acid and polymixin Bwas 66%, 56%, 28%, 2% respectively (Table 3). All the isolates were sensitive to erythromycin, doxycycline, gentamycin, kanamycin and chloramphenicol. Majority of isolates from wastewater were found to be resistant to multiple drug/antibiotics. Among the fifteen antibiotics/drugs tested, sevendifferent resistance patterns were observed in enterobacteria isolated from hospital wastewater. Conclusion: Results of this study may be beneficial to design environment-friendly techniques for the removal of antibiotics from wastewater to overcome the problem of antibiotic resistance development in the aquatic environment.
ERGONOMICS AND MUSCULO-SKELETAL DISORDERS INDENTISTRY
In spite of recent advances in technologies, occupational health related problems are more prevalent in modern day dentistry. Musculo-skeletal disorders are one among them that frequently haunt and disable many of the contemporary dentists. The proportion of reporting of musculo-skeletal pain and seeking of medical intervention for the same are on an increase among the dentists and the dental staffs. Dental procedures, sometimes, might be laborious needing constant focus of work in areas of difficult, minimal or restrained access in oral cavity. Dental procedures involve use of potentially dangerous instruments and materials that require proper handling and disposal as well as a good assistance from patient and the supporting dental staffs apart from the dentists. Dentists have to adopt necessary safety measures as these risks cannot be engineered out of dental office always. While abstaining from such risks, dentists also face stiff challenge of maintaining proper working posture to avoid any strained muscles. Musculo-skeletal disorders potentially handicap the dentists' health and inadvertently affect the quality of the dental practice. Proper use of the dental resources is an absolute necessity for the dentists to keep such disorders at bay and avoid incurring considerable impact on economics and good will of dental practices. It is of paramount importance for dentists to be updated with information regarding tackling of these health problems and wise use of necessary innovations. By learning the art of coping strategies for prevention of musculo-skeletal disorders, dentists can tread a fine line between maintaining health, income, technical and professional standards.
PREVALENCE OF METABOLIC SYNDROME IN WOMEN OFDIFFERENT AGE GROUPS IN RURAL POPULATION OF ANDHRAPRADESH
Background & Objectives: The main objective of the study is to identify the prevalence of Metabolic syndrome as people with the Metabolic syndrome are at increased risk for developing diabetes mellitus, cardiovascular disease as well as increased mortality from cardiovascular disease risk factors. Materials & Methods: A total number of 60 female subjects participated in the study. The subjects were grouped into two different age groups i.e. 30-40 and 40-50 years age. The study was approved by the Institutional Ethics Committee. Lipid profile, Fasting blood glucose, Blood pressure, Height, Weight & Waist circumference were recorded in all the subjects. Results: We observed that the prevalence of metabolic syndrome was 20% in women of 30-40 age group and 63.33% in women of 40-50 years of age group based on the NCEP ATP-III criteria. Conclusion: Programs aimed at detection and treatment of dyslipidemia, hypertension, diabetes, and obesity may reduce the burden of Metabolic syndrome in our population. Metabolic Syndrome present in epidemic proportions among the elderly represents one of the major threats to longevity and healthy aging.
CLINICAL OUTCOMES IN ANGIOGRAPHIC DOCUMENTEDCORONARY ARTERY DISEASE MANAGED WITH OPTIMALMEDICAL THERAPY IN CURRENT ERA - ONE YEAR FOLLOW UP
Background The management of patients with coronary artery disease (CAD) is complex. There is no study from India showing clinical outcomes in angiographically documented coronary artery disease in ACS and stable coronary artery disease in the current era. In most of previous studies only stable CAD patients were enrolled. Therefore the study is planned in view of above points to assess the outcome in patients with angiographically proven CAD on optimal medical therapy. Methods We conducted Hospital based observational descriptive prospective study involving 106 patients who had objective evidence of myocardial ischemia and significant coronary artery disease in at least one major epicardial vessel and not willing for either CABG or PCI, presenting to department of Cardiology, SMS Medical College from march 2013 to nov. 2013 and one year follow up was done till nov.2014. The clinical outcomes were recorded at six month and 12 months follow up. Results Most of the patients were male with a mean age of total patients’ 58.93±11.49 years (range 32 to 83 years). Of these patients, 72 had diagnosis of previously stabilized ACS and 34 had stable coronary artery disease. The baseline characteristics of the patients were similar in the two groups. 45.28% of patients were symptomatic due to angina at 6 months. At 12 months, only 24.46% of patients had angina. There were no significant differences between the stabilized ACS group and non-ACS group in death (overall death 6.6%; 8.3% vs. 2.9%; P = 0.52); hospitalization for acute coronary syndrome (19.4% vs. 11.8%; P = 0.48); or myocardial infarction (overall MI 10.4%; 11.1% vs. 8.8%; P = 0.98), overall hospitalization rates (27.7%vs. 11.8% P=0.09). www.advancejournals.org Open Access Scientific Publisher International Journal of Medicine & Health Research IJMHR 46|Volume 1|Issue 2|2015 | 2 Conclusions Previously stabilized ACS as well as patients with stable coronary artery disease had similar outcomes with OMT so an initial management approach; optimal medical therapy can be implemented safely in the patients with previously Stabilized ACS as in patients with stable coronary artery disease
LACTATING MOTHERS’ WEANING PRACTICES IN LAMINGO, PLATEAU STATE,NIGERIA
Background: Weaning is the introduction of the first solid foods to infants and maintenance of breastfeeding by demand up to two years of age. The first months of infants’ life are characterized by rapid growth and development and cultural, occupational and educational factors could influence these various weaning practices. This descriptive, cross-sectional, community-based study among 219 breastfeeding mothers, in Lamingo assessed weaning practices among them. Methodology: The participants were selected using multistage sampling technique. Data was collected using pre-tested, semi- structured, interviewer-administered questionnaires and analysed using Epi-Info version 3.4.5 software. Results: Most 104(47.0%), of the respondents had a good knowledge on weaning practices. One hundred and sixty seven (76.3%) of them introduced weaning foods at the age of 6 months. Majority; 87(39.7%) of the respondents gave their children ‚gwete, a local porridge made from hungry rice with ‚vegetables‛ as the first food. The knowledge of weaning practices was significantly influenced by the mothers’ level of education (p=0.0045). Conclusion: This study showed that most of the respondents had good knowledge on weaning practices, but were ignorant on what weaning meant. Therefore, it was recommended that mothers should be educated on the importance of weaning to the growth and development of the child
A STUDY OF METABOLIC SYNDROME IN THE RURALPOPULATION OF HARYANA.
Metabolic Syndrome (MS) is the clustering of risk factors for cardiovascular disease. It is estimated that the burden due to cardiovascular disease (CVD) will markedly increase in developing countries particularly in the Indian subcontinent. Because both under nutrition and over nutrition are seen simultaneously in developing countries, the double burden of diseases makes the situation more difficult. The study included 100 subjects of the age group 20 -60 yrs attending the OPD of MMIMSR. The cross-sectional study was done for a period of 3 months from the month of January 2011 to April 2011. Simple Random sampling methods was adopted for the selection of subjects. According to NCEP definition, maximum overall percentage of MS was 20.5% and gender specific for males and females was 30.1% and 26.7% respectively. Prevalence of obesity and the metabolic syndrome has shown a rapid rise in developing countries in the past few decades and has led to increased risk of CVD and consequent morbidity and mortality.
IMPROVEMENT OF VITAMIN-D DEFICIENT RACHITISTREATMENT IN CHILDREN
Introduction:Significant changes of the highest fatty acids content were revealed in the blood serum in children ill with rachitis. The depth of changes of the highest fatty acids content depended on the degree of the pathologic process severity. The revealed disturbances of the highest fatty acids content was corrected by means of apricot oil and the results of therapy were presented. Efficacy of the presented method of treatment in children with rachitis was shown in optimal doses of apricot oil. Methods: 67 patients ill with Vitamin-D deficient rachitis and 10 practically healthy children of the control group were enrolled in the study. The 1 st degree of the disease was diagnosed in 30 (44,8%) and the 2 nd degree in 37 (55,2%) children.The content of the highest fatty acids in blood serum of the studied patients was determined by means of gas- liquid chromatography. For identification of separated methyl aether fatty acids the method of “witness” and “sorbentsorbat” method based on structural group contents were used. Results:67 babies were studied. In children with Vitamin-D deficient rachitis the content of such fatty acids as palmitinic, strearic and linolic acids increases and palmitoleinic, oleic, linoleic and arachidonic acids decreases and that is the evidence of lipid exchange disturbance in rachitis. It motivates the necessity to correct lipid exchange in this pathology and to add vegetable oils. In order to eliminate dysmetabolism of the highest fatty acids in children with rachitis it is recommended to administer apricot oil as therapeutic agent. Conclusion:In order to eliminate the highest fatty acids dysmetabolism in children ill with rachitis it is recommended to administer apricot oil that results in restoration of the highest fatty acids metabolism and provides high therapeutic effect.
EPIDEMIOLOGICAL STUDIES ON URINARY SCHISTOSMIASIS INILE OLUJI/OKE IGBO LOCAL GOVERNMENT AREA OF ONDOSTATE.
This study was carried out to determine the current prevalence of urinary schistosomiasis in relation to epidemiological factors in two communities in Ile Oluji/Oke Igbo Local Government Area (LGA) of Ondo state. A total of 760 individuals comprising 356 males and 404 females were examined and of the number examined, 126(16.6%) were infected with S. haematobium. Oke Igbo community had more infected individuals than Ile Oluji. Infection peaked at individuals in the age groups 10-19 and 20-29 years. The secondary school category with respect to the highest level of education had the highest prevalence. High prevalence was recorded among individuals who had knowledge of schistosomiasis and have had prior infection. Statistical analysis showed that age, sex, highest level of education, knowledge and history of schistosomiasis infection were significant demographic and socio economic factors. These findings show that the study area is endemic to urinary schistosomiasis despite school children chemotherapy.
BRAIN TUMOR WITH PREGNANCY A RARE ENTITY
A case of brain tumor with pregnancy in third trimester is reported. The literature is reviewed to show the effect of pregnancy on these tumors, the method of diagnosis and management. The presence of a brain tumor in pregnancy is a state of a diagnosis of scarce presentation in the medical practice. A high clinical suspicion on the part of the obstetrician is the key to timely diagnosis; as the symptoms of headache, vomiting and blurred vision are often encountered in pregnancy with or without pre-eclampsia.