Background: The aim of this study is to assess the influence of acute fasting on synaptic properties in the ventral tegmental area (VTA) with regards to the sex-dependent differences by use of male and female mice. The study aimed to unravel the intricate interplay between fasting, synaptic plasticity, and behavioural changes to enhance our understanding of the underlying mechanisms. Methods: This study carried out at a tertiary care centre, employed a 16-hour overnight fasting protocol in female rodents and male rodents to examine the effects on physiological parameters, feeding behaviour, and neuronal attributes in the VTA. Various assays, including measurements of blood glucose, ketones, corticosterone (CORT) levels, locomotor activity, and electrophysiological recordings of synaptic currents, were conducted to assess the physiological and synaptic responses to acute fasting. Results: The study found that acute fasting induced significant metabolic changes, including body mass decrease by about 10%. Altered food-seeking behaviour was evident, with male mice exhibiting a pronounced increase. Moreover, neuronal attributes in the midbrain or VTA showed gender-dependent responses: males displayed substantial 20% increase in the frequency of mEPSC onto the dopaminergic neurons in the midbrain post fasting, while females exhibited a 13% elevation in CORT levels, accompanied by a transient period of depression at stimulatory synapses onto dopaminergic neurons which was mediated by endocannabinoids. Notably, no significant changes were observed at restraining synapses in rodents of both genders. These findings highlight the nuanced influence of short-term fasting/starvation on the VTA's synaptic plasticity, emphasizing sex-specific responses and providing valuable insights into potential mechanisms influencing gender differences in neuropsychiatric conditions. Conclusions: The study reveals that acute fasting induces sex-specific synaptic changes in the VTA, shedding light on the intricate relationship between metabolism, food-seeking behaviour, and neural plasticity. These findings emphasize the importance of considering gender-specific responses in studies exploring the neurobiological effects of fasting and their relevance to mental health.
{"title":"Sex difference effects of acute starvation on excitatory and inhibitory synapses on dopamine neurons","authors":"Shazia Haque Arshad, Ajay Kumar Singh, Dayanand Prasad, Sarbil Kumari","doi":"10.18203/2320-6012.ijrms20240311","DOIUrl":"https://doi.org/10.18203/2320-6012.ijrms20240311","url":null,"abstract":"Background: The aim of this study is to assess the influence of acute fasting on synaptic properties in the ventral tegmental area (VTA) with regards to the sex-dependent differences by use of male and female mice. The study aimed to unravel the intricate interplay between fasting, synaptic plasticity, and behavioural changes to enhance our understanding of the underlying mechanisms.\u0000Methods: This study carried out at a tertiary care centre, employed a 16-hour overnight fasting protocol in female rodents and male rodents to examine the effects on physiological parameters, feeding behaviour, and neuronal attributes in the VTA. Various assays, including measurements of blood glucose, ketones, corticosterone (CORT) levels, locomotor activity, and electrophysiological recordings of synaptic currents, were conducted to assess the physiological and synaptic responses to acute fasting.\u0000Results: The study found that acute fasting induced significant metabolic changes, including body mass decrease by about 10%. Altered food-seeking behaviour was evident, with male mice exhibiting a pronounced increase. Moreover, neuronal attributes in the midbrain or VTA showed gender-dependent responses: males displayed substantial 20% increase in the frequency of mEPSC onto the dopaminergic neurons in the midbrain post fasting, while females exhibited a 13% elevation in CORT levels, accompanied by a transient period of depression at stimulatory synapses onto dopaminergic neurons which was mediated by endocannabinoids. Notably, no significant changes were observed at restraining synapses in rodents of both genders. These findings highlight the nuanced influence of short-term fasting/starvation on the VTA's synaptic plasticity, emphasizing sex-specific responses and providing valuable insights into potential mechanisms influencing gender differences in neuropsychiatric conditions.\u0000Conclusions: The study reveals that acute fasting induces sex-specific synaptic changes in the VTA, shedding light on the intricate relationship between metabolism, food-seeking behaviour, and neural plasticity. These findings emphasize the importance of considering gender-specific responses in studies exploring the neurobiological effects of fasting and their relevance to mental health.","PeriodicalId":14210,"journal":{"name":"International Journal of Research in Medical Sciences","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139852448","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}
Pub Date : 2024-02-08DOI: 10.18203/2320-6012.ijrms20240312
A. Saha, Sailendranath Biswas, Asish K. Das, Shreya Ganguly
Salivary duct carcinoma is a rare and aggressive salivary gland malignancy with a poor prognosis. Due to the paucity of literature, very little is known about this neoplasm. We have described such a case in this case report and highlighted the clinical and histopathological features associated with this disease. A sixty-year old male patient reported in the outpatient department of a regional dental college and hospital with a circular firm growth in the mandibular anterior region and mobility of adjacent mandibular teeth. An array of investigations including radiographic, tomographic, ultrasonographic as well as histopathological were performed. It was diagnosed as invasive salivary duct carcinoma with distant metastases in the shoulder joint, ribs as well as pelvic bones. Currently, no National Comprehensive Cancer Network guidelines for the specific treatment of salivary duct carcinomas exist. National Comprehensive Cancer Network guidelines recommend complete surgical excision of tumors for major salivary gland tumors without nodal involvement (N0) with or without neck dissection for high-grade and T3/T4 salivary gland tumors.
{"title":"Aggressive salivary duct carcinoma with widespread dissemination: a case report","authors":"A. Saha, Sailendranath Biswas, Asish K. Das, Shreya Ganguly","doi":"10.18203/2320-6012.ijrms20240312","DOIUrl":"https://doi.org/10.18203/2320-6012.ijrms20240312","url":null,"abstract":"Salivary duct carcinoma is a rare and aggressive salivary gland malignancy with a poor prognosis. Due to the paucity of literature, very little is known about this neoplasm. We have described such a case in this case report and highlighted the clinical and histopathological features associated with this disease. A sixty-year old male patient reported in the outpatient department of a regional dental college and hospital with a circular firm growth in the mandibular anterior region and mobility of adjacent mandibular teeth. An array of investigations including radiographic, tomographic, ultrasonographic as well as histopathological were performed. It was diagnosed as invasive salivary duct carcinoma with distant metastases in the shoulder joint, ribs as well as pelvic bones. Currently, no National Comprehensive Cancer Network guidelines for the specific treatment of salivary duct carcinomas exist. National Comprehensive Cancer Network guidelines recommend complete surgical excision of tumors for major salivary gland tumors without nodal involvement (N0) with or without neck dissection for high-grade and T3/T4 salivary gland tumors.\u0000 ","PeriodicalId":14210,"journal":{"name":"International Journal of Research in Medical Sciences","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139852667","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}
Background: The aim of this study is to assess the influence of acute fasting on synaptic properties in the ventral tegmental area (VTA) with regards to the sex-dependent differences by use of male and female mice. The study aimed to unravel the intricate interplay between fasting, synaptic plasticity, and behavioural changes to enhance our understanding of the underlying mechanisms. Methods: This study carried out at a tertiary care centre, employed a 16-hour overnight fasting protocol in female rodents and male rodents to examine the effects on physiological parameters, feeding behaviour, and neuronal attributes in the VTA. Various assays, including measurements of blood glucose, ketones, corticosterone (CORT) levels, locomotor activity, and electrophysiological recordings of synaptic currents, were conducted to assess the physiological and synaptic responses to acute fasting. Results: The study found that acute fasting induced significant metabolic changes, including body mass decrease by about 10%. Altered food-seeking behaviour was evident, with male mice exhibiting a pronounced increase. Moreover, neuronal attributes in the midbrain or VTA showed gender-dependent responses: males displayed substantial 20% increase in the frequency of mEPSC onto the dopaminergic neurons in the midbrain post fasting, while females exhibited a 13% elevation in CORT levels, accompanied by a transient period of depression at stimulatory synapses onto dopaminergic neurons which was mediated by endocannabinoids. Notably, no significant changes were observed at restraining synapses in rodents of both genders. These findings highlight the nuanced influence of short-term fasting/starvation on the VTA's synaptic plasticity, emphasizing sex-specific responses and providing valuable insights into potential mechanisms influencing gender differences in neuropsychiatric conditions. Conclusions: The study reveals that acute fasting induces sex-specific synaptic changes in the VTA, shedding light on the intricate relationship between metabolism, food-seeking behaviour, and neural plasticity. These findings emphasize the importance of considering gender-specific responses in studies exploring the neurobiological effects of fasting and their relevance to mental health.
{"title":"Sex difference effects of acute starvation on excitatory and inhibitory synapses on dopamine neurons","authors":"Shazia Haque Arshad, Ajay Kumar Singh, Dayanand Prasad, Sarbil Kumari","doi":"10.18203/2320-6012.ijrms20240311","DOIUrl":"https://doi.org/10.18203/2320-6012.ijrms20240311","url":null,"abstract":"Background: The aim of this study is to assess the influence of acute fasting on synaptic properties in the ventral tegmental area (VTA) with regards to the sex-dependent differences by use of male and female mice. The study aimed to unravel the intricate interplay between fasting, synaptic plasticity, and behavioural changes to enhance our understanding of the underlying mechanisms.\u0000Methods: This study carried out at a tertiary care centre, employed a 16-hour overnight fasting protocol in female rodents and male rodents to examine the effects on physiological parameters, feeding behaviour, and neuronal attributes in the VTA. Various assays, including measurements of blood glucose, ketones, corticosterone (CORT) levels, locomotor activity, and electrophysiological recordings of synaptic currents, were conducted to assess the physiological and synaptic responses to acute fasting.\u0000Results: The study found that acute fasting induced significant metabolic changes, including body mass decrease by about 10%. Altered food-seeking behaviour was evident, with male mice exhibiting a pronounced increase. Moreover, neuronal attributes in the midbrain or VTA showed gender-dependent responses: males displayed substantial 20% increase in the frequency of mEPSC onto the dopaminergic neurons in the midbrain post fasting, while females exhibited a 13% elevation in CORT levels, accompanied by a transient period of depression at stimulatory synapses onto dopaminergic neurons which was mediated by endocannabinoids. Notably, no significant changes were observed at restraining synapses in rodents of both genders. These findings highlight the nuanced influence of short-term fasting/starvation on the VTA's synaptic plasticity, emphasizing sex-specific responses and providing valuable insights into potential mechanisms influencing gender differences in neuropsychiatric conditions.\u0000Conclusions: The study reveals that acute fasting induces sex-specific synaptic changes in the VTA, shedding light on the intricate relationship between metabolism, food-seeking behaviour, and neural plasticity. These findings emphasize the importance of considering gender-specific responses in studies exploring the neurobiological effects of fasting and their relevance to mental health.","PeriodicalId":14210,"journal":{"name":"International Journal of Research in Medical Sciences","volume":" 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139792717","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}
Pub Date : 2024-02-08DOI: 10.18203/2320-6012.ijrms20240312
A. Saha, Sailendranath Biswas, Asish K. Das, Shreya Ganguly
Salivary duct carcinoma is a rare and aggressive salivary gland malignancy with a poor prognosis. Due to the paucity of literature, very little is known about this neoplasm. We have described such a case in this case report and highlighted the clinical and histopathological features associated with this disease. A sixty-year old male patient reported in the outpatient department of a regional dental college and hospital with a circular firm growth in the mandibular anterior region and mobility of adjacent mandibular teeth. An array of investigations including radiographic, tomographic, ultrasonographic as well as histopathological were performed. It was diagnosed as invasive salivary duct carcinoma with distant metastases in the shoulder joint, ribs as well as pelvic bones. Currently, no National Comprehensive Cancer Network guidelines for the specific treatment of salivary duct carcinomas exist. National Comprehensive Cancer Network guidelines recommend complete surgical excision of tumors for major salivary gland tumors without nodal involvement (N0) with or without neck dissection for high-grade and T3/T4 salivary gland tumors.
{"title":"Aggressive salivary duct carcinoma with widespread dissemination: a case report","authors":"A. Saha, Sailendranath Biswas, Asish K. Das, Shreya Ganguly","doi":"10.18203/2320-6012.ijrms20240312","DOIUrl":"https://doi.org/10.18203/2320-6012.ijrms20240312","url":null,"abstract":"Salivary duct carcinoma is a rare and aggressive salivary gland malignancy with a poor prognosis. Due to the paucity of literature, very little is known about this neoplasm. We have described such a case in this case report and highlighted the clinical and histopathological features associated with this disease. A sixty-year old male patient reported in the outpatient department of a regional dental college and hospital with a circular firm growth in the mandibular anterior region and mobility of adjacent mandibular teeth. An array of investigations including radiographic, tomographic, ultrasonographic as well as histopathological were performed. It was diagnosed as invasive salivary duct carcinoma with distant metastases in the shoulder joint, ribs as well as pelvic bones. Currently, no National Comprehensive Cancer Network guidelines for the specific treatment of salivary duct carcinomas exist. National Comprehensive Cancer Network guidelines recommend complete surgical excision of tumors for major salivary gland tumors without nodal involvement (N0) with or without neck dissection for high-grade and T3/T4 salivary gland tumors.\u0000 ","PeriodicalId":14210,"journal":{"name":"International Journal of Research in Medical Sciences","volume":" 44","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139792579","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}
Pub Date : 2024-01-30DOI: 10.18203/2320-6012.ijrms20240210
Tarun Arora, Samya Bhowmick, Jasbir Singh
Background: Antimicrobial resistance (AMR) is major problem in most of countries worldwide. Antimicrobial Stewardship program (AMSP) encourages both government and private hospitals in country to bring out guidelines regarding antimicrobial usage and hospital infection control (HIC). However, it is still in nascent stage. A retrospective study to generate lacking data about usage of antibiotics in inpatient settings in a government hospital. Methods: Retrospective records of antibiotic usage in adult patients before and after surgery admitted in department of surgery, LHMC and Smt. Sucheta Kriplani hospital, New Delhi. The prescribed doses were converted to a number as per WHO defined daily dose (DDD) of each antibiotic and presented as per ATC/DDD methodology. Results: The records of 121 patients admitted between June 2021 to February 2022 were retrieved. Ceftriaxone, was the leading choice of antibiotic both pre and post operatively, while co-amoxyclav was second most preferred antimicrobial. Mean ± SD for DDD pre-op and post-op was 3.345±1.602 with p<0.001 which was highly significant. Mean ± SD for average duration of stay pre-op and post-op was 3.041±1.179 with p<0.01 which was significant. Only 16 patients had complications before, during or after the procedure which prolonged their stay in hospital. There were no procedure related deaths till last follow up. Conclusions: Guidelines for selection of proper antimicrobial usage in peri-operative period were not consistent. We advocate evidence-based pre-operative and post-operative antibiotic prophylaxis practices and rational antibiotic usage depending on prevailing antibiogram.
{"title":"A comparative analysis of retrospective records of antibiotic usage in patients before and after surgery in a tertiary care government hospital in Delhi","authors":"Tarun Arora, Samya Bhowmick, Jasbir Singh","doi":"10.18203/2320-6012.ijrms20240210","DOIUrl":"https://doi.org/10.18203/2320-6012.ijrms20240210","url":null,"abstract":"Background: Antimicrobial resistance (AMR) is major problem in most of countries worldwide. Antimicrobial Stewardship program (AMSP) encourages both government and private hospitals in country to bring out guidelines regarding antimicrobial usage and hospital infection control (HIC). However, it is still in nascent stage. A retrospective study to generate lacking data about usage of antibiotics in inpatient settings in a government hospital.\u0000Methods: Retrospective records of antibiotic usage in adult patients before and after surgery admitted in department of surgery, LHMC and Smt. Sucheta Kriplani hospital, New Delhi. The prescribed doses were converted to a number as per WHO defined daily dose (DDD) of each antibiotic and presented as per ATC/DDD methodology.\u0000Results: The records of 121 patients admitted between June 2021 to February 2022 were retrieved. Ceftriaxone, was the leading choice of antibiotic both pre and post operatively, while co-amoxyclav was second most preferred antimicrobial. Mean ± SD for DDD pre-op and post-op was 3.345±1.602 with p<0.001 which was highly significant. Mean ± SD for average duration of stay pre-op and post-op was 3.041±1.179 with p<0.01 which was significant. Only 16 patients had complications before, during or after the procedure which prolonged their stay in hospital. There were no procedure related deaths till last follow up. \u0000Conclusions: Guidelines for selection of proper antimicrobial usage in peri-operative period were not consistent. We advocate evidence-based pre-operative and post-operative antibiotic prophylaxis practices and rational antibiotic usage depending on prevailing antibiogram.","PeriodicalId":14210,"journal":{"name":"International Journal of Research in Medical Sciences","volume":"60 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140485423","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}
Pub Date : 2024-01-30DOI: 10.18203/2320-6012.ijrms20240226
A. Ezeike, Idris M. Liman, R. Babandi, Elizabeth O. Austin-Amadi, Mfon Nehemiah
Successfully managing an unruptured ectopic pregnancy necessitates prioritizing the preservation of fertility as the primary objective. Medical management is traditionally considered to be more successful at lower ß- human chorionic gonadotropin (HCG) values. However, there is emerging evidence that successful treatment can be achieved with modification of dosage regimen in the presence of high β-HCG value. We reported the successful management of a case of unruptured repeat ectopic pregnancy in a patient with high β-HCG. Mrs PA is a 25-year-old G4P0+3 with previous right salpingectomy due to ruptured ectopic gestation who presented with an ultrasound diagnosis of unruptured left tubal ectopic gestation at a gestational age of 6 weeks. The pre-treatment quantitative β-HCG level was 7066 IU/l. She had multiple dose methotrexate therapy which was well tolerated with normalization of β-HCG levels within 44 days. Hysterosalpingography done six (6) months post-treatment demonstrated patent left fallopian tube. She subsequently had spontaneous conception of an intrauterine pregnancy 16-months post-treatment. The pregnancy was carried to term and culminated in successful delivery at term. Multiple-dose chemotherapy was successful in this patient with high β-HCG level with no reported adverse effect.
{"title":"Successful multiple-dose methotrexate therapy for unruptured repeat ectopic pregnancy with high β-human chorionic gonadotropin value: a case report","authors":"A. Ezeike, Idris M. Liman, R. Babandi, Elizabeth O. Austin-Amadi, Mfon Nehemiah","doi":"10.18203/2320-6012.ijrms20240226","DOIUrl":"https://doi.org/10.18203/2320-6012.ijrms20240226","url":null,"abstract":"Successfully managing an unruptured ectopic pregnancy necessitates prioritizing the preservation of fertility as the primary objective. Medical management is traditionally considered to be more successful at lower ß- human chorionic gonadotropin (HCG) values. However, there is emerging evidence that successful treatment can be achieved with modification of dosage regimen in the presence of high β-HCG value. We reported the successful management of a case of unruptured repeat ectopic pregnancy in a patient with high β-HCG. Mrs PA is a 25-year-old G4P0+3 with previous right salpingectomy due to ruptured ectopic gestation who presented with an ultrasound diagnosis of unruptured left tubal ectopic gestation at a gestational age of 6 weeks. The pre-treatment quantitative β-HCG level was 7066 IU/l. She had multiple dose methotrexate therapy which was well tolerated with normalization of β-HCG levels within 44 days. Hysterosalpingography done six (6) months post-treatment demonstrated patent left fallopian tube. She subsequently had spontaneous conception of an intrauterine pregnancy 16-months post-treatment. The pregnancy was carried to term and culminated in successful delivery at term. Multiple-dose chemotherapy was successful in this patient with high β-HCG level with no reported adverse effect.","PeriodicalId":14210,"journal":{"name":"International Journal of Research in Medical Sciences","volume":"176 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140480579","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}
Pub Date : 2024-01-30DOI: 10.18203/2320-6012.ijrms20240200
Abdul-Subulr Yakubu, A. Adam, D. Ahadzi
Background: There is an upsurge in chronic kidney disease incidence worldwide. Late presentation characterises chronic kidney disease in sub-Saharan Africa. Hypertension and proteinuria are independent risk factors for worsening kidney function, irrespective of the cause of the kidney disease. We assessed the prevalence and predictors of hypertension and proteinuria in an outpatient population in Northern Ghana. Methods: We retrospectively reviewed screening data among adults ≥18 years of age in two of Ghana’s Northern regions. The data retrieved included socio-demographic information, blood pressure recordings, urine dipsticks and fingerpick blood glucose levels. The data were analysed for the prevalence of hypertension and proteinuria in the participants. Binary logistic regression analysis was employed to identify the predictors of significant proteinuria in these participants. A p-value <0.05 was considered statistically significant. Results: Total 1018 participants were included in the study, comprising 50.5% males. The prevalence of uncontrolled hypertension was 28.1%, using a blood pressure cut-off value of ≥ 140/90 mmHg. Significant proteinuria (≥ 1+ or 30 mg/dl) was present in 10.7% of the participants. Hypertension (AOR 2.433, 95% CI 1.582-3.742, p<0.001) and hyperglycaemia (AOR 2.226, 95% CI 1.159-4.275, p=0.016) were independent predictors of the presence of significant proteinuria. Conclusions: Uncontrolled hypertension and proteinuria were common in this outpatient population in Northern Ghana. The cost-effectiveness of community-based screening for chronic kidney disease and its risk factors in low-resource settings like Ghana, with the aim to treat to improve outcomes, needs to be explored.
背景：全球慢性肾脏病发病率急剧上升。撒哈拉以南非洲地区的慢性肾病发病较晚。无论肾病的病因如何，高血压和蛋白尿都是导致肾功能恶化的独立风险因素。我们评估了加纳北部门诊人群中高血压和蛋白尿的患病率和预测因素：我们回顾性审查了加纳北部两个地区 18 岁以上成年人的筛查数据。检索的数据包括社会人口学信息、血压记录、尿液浸渍棒和指尖血糖水平。对数据进行了分析，以了解参与者中高血压和蛋白尿的发病率。采用二元逻辑回归分析来确定这些参与者出现明显蛋白尿的预测因素。P值小于0.05为具有统计学意义：研究共纳入 1018 名参与者，其中男性占 50.5%。未控制的高血压患病率为 28.1%，血压临界值≥ 140/90 mmHg。10.7%的参与者有明显的蛋白尿（≥ 1+ 或 30 mg/dl）。高血压（AOR 2.433，95% CI 1.582-3.742，p<0.001）和高血糖（AOR 2.226，95% CI 1.159-4.275，p=0.016）是出现明显蛋白尿的独立预测因素：在加纳北部的这一门诊人群中，未控制的高血压和蛋白尿很常见。在加纳这样的低资源环境中，以社区为基础筛查慢性肾病及其风险因素的成本效益有待探讨，目的是通过治疗来改善预后。
{"title":"Undiagnosed hypertension and proteinuria in an outpatient population in Northern Ghana","authors":"Abdul-Subulr Yakubu, A. Adam, D. Ahadzi","doi":"10.18203/2320-6012.ijrms20240200","DOIUrl":"https://doi.org/10.18203/2320-6012.ijrms20240200","url":null,"abstract":"Background: There is an upsurge in chronic kidney disease incidence worldwide. Late presentation characterises chronic kidney disease in sub-Saharan Africa. Hypertension and proteinuria are independent risk factors for worsening kidney function, irrespective of the cause of the kidney disease. We assessed the prevalence and predictors of hypertension and proteinuria in an outpatient population in Northern Ghana.\u0000Methods: We retrospectively reviewed screening data among adults ≥18 years of age in two of Ghana’s Northern regions. The data retrieved included socio-demographic information, blood pressure recordings, urine dipsticks and fingerpick blood glucose levels. The data were analysed for the prevalence of hypertension and proteinuria in the participants. Binary logistic regression analysis was employed to identify the predictors of significant proteinuria in these participants. A p-value <0.05 was considered statistically significant.\u0000Results: Total 1018 participants were included in the study, comprising 50.5% males. The prevalence of uncontrolled hypertension was 28.1%, using a blood pressure cut-off value of ≥ 140/90 mmHg. Significant proteinuria (≥ 1+ or 30 mg/dl) was present in 10.7% of the participants. Hypertension (AOR 2.433, 95% CI 1.582-3.742, p<0.001) and hyperglycaemia (AOR 2.226, 95% CI 1.159-4.275, p=0.016) were independent predictors of the presence of significant proteinuria.\u0000Conclusions: Uncontrolled hypertension and proteinuria were common in this outpatient population in Northern Ghana. The cost-effectiveness of community-based screening for chronic kidney disease and its risk factors in low-resource settings like Ghana, with the aim to treat to improve outcomes, needs to be explored.\u0000 ","PeriodicalId":14210,"journal":{"name":"International Journal of Research in Medical Sciences","volume":"236 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140483904","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}
Background: Cigarettes smoking is the principal cause of preventable disease, disability, and premature death in the world. Tobacco smoking affects multiple organ systems resulting in numerous tobacco-related diseases. The study aimed to investigate interrelationship of pulmonary functions between current smokers and never smokers. Methods: Asymptomatic, 50 males current tobacco smokers and 50 healthy never smokers aged between 25 to 50 years were selected as cases and controls. Detailed description of the subject’s selection, data collection and methods used for performing the test. Results: Maximum incidence was seen in >31 yrs of age with mean of 38.681±4.5. The study found that never smokers had significantly higher pulmonary functions as compared to current smokers:- FVC in liters (3.43±0.55 Vs 2.44±0.58; p<0.05); FEV1 in liters (2.86±0.57 Vs 1.76±0.32; p<0.05); FEV1/FVC in percentage (82.72±8.67 Vs 73.72±11.40; p<0.05); FEF 25-75 ratio in percentage (3.18±0.91 Vs 1.60±0.45; p<0.05); PEFR in liters per second (6.63±2.00 Vs 3.16±1.26; p<0.05); breath holding time in seconds (25.54±2.14 Vs 21.36±2.10; p<0.05); 40mm endurance test in seconds (22.36±1.58 Vs 17.70±2.01; p<0.05); MEP in mmHg (83.48±5.28 Vs 64.38±5.31; p<0.05) were found significant. Conclusions: The strong relationship between cigarette smoking and respiratory disease has been seen independent of the other risk factors in a number of well-designated epidemiologic studies. Spirometry is an excellent screening test to detect chronic airflow obstruction, but may be useful in detecting restrictive disorders as well to study the effect of tobacco smoking on pulmonary functions.
背景：吸烟是世界上可预防疾病、残疾和过早死亡的主要原因。吸烟影响多个器官系统，导致多种烟草相关疾病。本研究旨在调查目前吸烟者与从不吸烟者肺功能的相互关系：方法：选取无症状的 50 名男性吸烟者和 50 名健康的从不吸烟者作为病例和对照。详细描述了受试者的选择、数据收集和测试方法：年龄大于 31 岁者发病率最高，平均为 38.681±4.5。研究发现，与当前吸烟者相比，从未吸烟者的肺功能明显较高：FVC（以升为单位）（3.43±0.55 Vs 2.44±0.58；P<0.FEV1/FVC 百分比（82.72±8.67 Vs 73.72±11.40；p<0.05）；FEF 25-75 百分比（3.18±0.91 Vs 1.60±0.91；p<0.05）。91 Vs 1.60±0.45；P<0.05）；PEFR（升/秒）（6.63±2.00 Vs 3.16±1.26；P<0.05）；屏气时间（秒）（25.54±2.14 Vs 21.36±2.10；P<0.05）；40mm耐力测试（秒）（22.36±1.58 Vs 17.70±2.01；P<0.05）；MEP（mmHg）（83.48±5.28 Vs 64.38±5.31；P<0.05）均有显著性差异：在许多精心设计的流行病学研究中，吸烟与呼吸系统疾病之间的密切关系已被证实，而与其他风险因素无关。肺活量测定是检测慢性气流阻塞的绝佳筛查方法，也可用于检测限制性疾病，以及研究吸烟对肺功能的影响。
{"title":"Study of pulmonary functions in male current smokers and never smokers","authors":"Ashutosh Joshi, Asha Vagadiya, Vaishali Patel, Arti Muley, Paresh Ladumor, Anshuman Shahi","doi":"10.18203/2320-6012.ijrms20240212","DOIUrl":"https://doi.org/10.18203/2320-6012.ijrms20240212","url":null,"abstract":"Background: Cigarettes smoking is the principal cause of preventable disease, disability, and premature death in the world. Tobacco smoking affects multiple organ systems resulting in numerous tobacco-related diseases. The study aimed to investigate interrelationship of pulmonary functions between current smokers and never smokers.\u0000Methods: Asymptomatic, 50 males current tobacco smokers and 50 healthy never smokers aged between 25 to 50 years were selected as cases and controls. Detailed description of the subject’s selection, data collection and methods used for performing the test.\u0000Results: Maximum incidence was seen in >31 yrs of age with mean of 38.681±4.5. The study found that never smokers had significantly higher pulmonary functions as compared to current smokers:- FVC in liters (3.43±0.55 Vs 2.44±0.58; p<0.05); FEV1 in liters (2.86±0.57 Vs 1.76±0.32; p<0.05); FEV1/FVC in percentage (82.72±8.67 Vs 73.72±11.40; p<0.05); FEF 25-75 ratio in percentage (3.18±0.91 Vs 1.60±0.45; p<0.05); PEFR in liters per second (6.63±2.00 Vs 3.16±1.26; p<0.05); breath holding time in seconds (25.54±2.14 Vs 21.36±2.10; p<0.05); 40mm endurance test in seconds (22.36±1.58 Vs 17.70±2.01; p<0.05); MEP in mmHg (83.48±5.28 Vs 64.38±5.31; p<0.05) were found significant.\u0000Conclusions: The strong relationship between cigarette smoking and respiratory disease has been seen independent of the other risk factors in a number of well-designated epidemiologic studies. Spirometry is an excellent screening test to detect chronic airflow obstruction, but may be useful in detecting restrictive disorders as well to study the effect of tobacco smoking on pulmonary functions.","PeriodicalId":14210,"journal":{"name":"International Journal of Research in Medical Sciences","volume":"86 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140481933","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}
Pub Date : 2024-01-30DOI: 10.18203/2320-6012.ijrms20240215
S. Shanmugam, Pravenkumar R. R.
Background: Early postoperative mortality rates after pancreaticoduodenectomy are in the range of 2-5%. Nonetheless, morbidity rates are still at 30-50% calling for apt strategies. The goal of this study was to examine the outcomes in terms of postoperative morbidity and 30-day mortality while additionally reviewing the demographic, clinical and pathological features of patients undergoing Whipple procedure at our government institution and comparing the outcomes with literature. Methods: Data about demographic characteristics, intraoperative findings, postoperative histopathology, postoperative course, early post-operative outcomes, complications, and causes of postoperative death in patients who underwent pancreaticoduodenectomy for periampullary and pancreatic carcinoma between September 2006-August 2023 were collected and analysed. Results: 45 patients were analysed. Mortality rate was 15.6%. Seven patients died perioperatively; three from cardiac cause (myocardial infarction), two from bile leak and sepsis, one from pulmonary embolism, and one as a result of postoperative hemorrhage. The morbidity rate was 54%. The most common early postoperative complication was delayed gastric emptying (31%) followed by postoperative pancreatic fistula (22%). The median overall survival of 39 patients was 21±6.5 months. The 5-year survival was 17 months. Conclusions: Considering the fact that postoperative morbidity after Whipple procedure was similar to other centres, but the mortality rate being high, better knowledge about salvage techniques, improvements in perioperative care, use of interventional radiology, and running quality improvement projects to standardize postoperative recovery protocol could help in reducing the mortality and improve the outcome.
{"title":"Outcomes of Whipple procedure/pancreaticoduodenectomy- an eighteen-year experience at a tertiary cancer care centre in south India","authors":"S. Shanmugam, Pravenkumar R. R.","doi":"10.18203/2320-6012.ijrms20240215","DOIUrl":"https://doi.org/10.18203/2320-6012.ijrms20240215","url":null,"abstract":"Background: Early postoperative mortality rates after pancreaticoduodenectomy are in the range of 2-5%. Nonetheless, morbidity rates are still at 30-50% calling for apt strategies. The goal of this study was to examine the outcomes in terms of postoperative morbidity and 30-day mortality while additionally reviewing the demographic, clinical and pathological features of patients undergoing Whipple procedure at our government institution and comparing the outcomes with literature.\u0000Methods: Data about demographic characteristics, intraoperative findings, postoperative histopathology, postoperative course, early post-operative outcomes, complications, and causes of postoperative death in patients who underwent pancreaticoduodenectomy for periampullary and pancreatic carcinoma between September 2006-August 2023 were collected and analysed.\u0000Results: 45 patients were analysed. Mortality rate was 15.6%. Seven patients died perioperatively; three from cardiac cause (myocardial infarction), two from bile leak and sepsis, one from pulmonary embolism, and one as a result of postoperative hemorrhage. The morbidity rate was 54%. The most common early postoperative complication was delayed gastric emptying (31%) followed by postoperative pancreatic fistula (22%). The median overall survival of 39 patients was 21±6.5 months. The 5-year survival was 17 months.\u0000Conclusions: Considering the fact that postoperative morbidity after Whipple procedure was similar to other centres, but the mortality rate being high, better knowledge about salvage techniques, improvements in perioperative care, use of interventional radiology, and running quality improvement projects to standardize postoperative recovery protocol could help in reducing the mortality and improve the outcome.\u0000 ","PeriodicalId":14210,"journal":{"name":"International Journal of Research in Medical Sciences","volume":"199 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140480705","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}
Pub Date : 2024-01-30DOI: 10.18203/2320-6012.ijrms20240222
Yugal D. Jain, Ravi V. Patel
Background: In the study, we have tried to assess some preoperative factors (history, clinical and ultrasonographic factors) that might make the laparoscopic cholecystectomy difficult. Objective was to study the predictive scoring pattern in difficult laparoscopic cholecystectomy cases. Methods: It was a prospective observational study. Ninety cases of suspected cholecystitis were identified for study presented to Jehangir hospital, Pune with upper abdominal pain or vomiting or dyspepsia or jaundice. Such patients were studied in detail clinically, admitted and investigated. Ultrasound abdomen was done in all patients. Results: Out of 90 cases studied, 64 patients (71.1%) had pre op score between 0-5 i.e. easy level, 21 patients (23.3%) had pre-op score between 6-10 i.e. difficult level and 5 patients (5.6%) had pre-op score between 11-15 i.e. very difficult level against intra-op scoring of 57 patients (63.33%) being easy, 28 patients (31.1) difficult and 05 patient (5.6%) had very difficult surgery. Conversion rate in present study to open surgery was 5.6%. For predicting easy laparoscopic cholecystectomy, accuracy of preop score was 85.6% and for predicting very difficult lap cholecystectomy, accuracy of preoperative score was 95.6%. Conclusions: Strongly significant factors predicting difficult laparoscopic cholecystectomy were number of hospitalisations, impacted stone and obesity. This study demonstrated that a scoring system predicting the difficulty in laparoscopic cholecystectomy is feasible and easy way. Identification of these factors preoperatively might help to psychologically prepare the patients for open surgery and for prolonged convalescence.
{"title":"Can we predict difficult laparoscopic cholecystectomy preoperatively? A comprehensive study","authors":"Yugal D. Jain, Ravi V. Patel","doi":"10.18203/2320-6012.ijrms20240222","DOIUrl":"https://doi.org/10.18203/2320-6012.ijrms20240222","url":null,"abstract":"Background: In the study, we have tried to assess some preoperative factors (history, clinical and ultrasonographic factors) that might make the laparoscopic cholecystectomy difficult. Objective was to study the predictive scoring pattern in difficult laparoscopic cholecystectomy cases.\u0000Methods: It was a prospective observational study. Ninety cases of suspected cholecystitis were identified for study presented to Jehangir hospital, Pune with upper abdominal pain or vomiting or dyspepsia or jaundice. Such patients were studied in detail clinically, admitted and investigated. Ultrasound abdomen was done in all patients.\u0000Results: Out of 90 cases studied, 64 patients (71.1%) had pre op score between 0-5 i.e. easy level, 21 patients (23.3%) had pre-op score between 6-10 i.e. difficult level and 5 patients (5.6%) had pre-op score between 11-15 i.e. very difficult level against intra-op scoring of 57 patients (63.33%) being easy, 28 patients (31.1) difficult and 05 patient (5.6%) had very difficult surgery. Conversion rate in present study to open surgery was 5.6%. For predicting easy laparoscopic cholecystectomy, accuracy of preop score was 85.6% and for predicting very difficult lap cholecystectomy, accuracy of preoperative score was 95.6%.\u0000Conclusions: Strongly significant factors predicting difficult laparoscopic cholecystectomy were number of hospitalisations, impacted stone and obesity. This study demonstrated that a scoring system predicting the difficulty in laparoscopic cholecystectomy is feasible and easy way. Identification of these factors preoperatively might help to psychologically prepare the patients for open surgery and for prolonged convalescence.","PeriodicalId":14210,"journal":{"name":"International Journal of Research in Medical Sciences","volume":"205 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140484501","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}
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