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Retrospective study of occurrence of pressure ulcers among the patients admitted in rural tertiary care hospital and their outcome 农村三级医院住院患者压疮发生情况及预后的回顾性研究
Pub Date : 2023-10-15 DOI: 10.18231/j.ijirm.2023.022
Akshaya Narayan Shetti, Ch. Chandana Chowdary, Rachita Mustilwar
This retrospective study addresses the pivotal role of pressure ulcer prevention in evaluating the quality of care within critical care units. The incidence of pressure ulcers serves as a crucial indicator, impacting patient recovery and complicating treatment. In this data based retrospective study we assessed the prevalence of pressure ulcers for a duration of 6 years. In this data we included the patients from surgical, medical, respiratory and cardiac critical care units who were admitted between 01/06/16 to 01/06/22. All male and female patients aged above 18 years were included. Patients who got discharge within 48 hours were excluded. Total of 35 patients were noted to have bedsores in intensive care unit from June 2016-June 2022 admitted under both medical and surgical branches. Out of which 34.3% were in age group above 70yrs where 87.9% were male patients. Most commonly 1-2 bedsores (97.1%) were present involving mostly buttock area (82.9%) of 2-5cm size (45.7%). Most of the patients admitted under medical branch developed bedsores more often than surgical branch and appeared after admission (77.1%) with 15-30 days hospital stay (31.4%). This study has illuminated our path forward in improving patient care and preventing pressure ulcer development among patients admitted to our medical and surgical Intensive Care Units in our Rural Tertiary hospital. The findings have paved the way for targeted interventions, underlining our commitment to raising the standard of care for our critically ill patients.
这项回顾性研究解决了压疮预防在评估重症监护病房护理质量中的关键作用。压疮的发生率是影响患者康复和使治疗复杂化的关键指标。在这项基于数据的回顾性研究中,我们评估了持续6年的压疮患病率。在这个数据中,我们包括了在2016年6月1日至22年6月1日期间入院的外科、内科、呼吸和心脏重症监护病房的患者。所有年龄在18岁以上的男性和女性患者均被纳入。排除48小时内出院的患者。2016年6月至2022年6月,共有35名患者在内科和外科部门的重症监护病房被发现患有褥疮。70岁以上占34.3%,其中男性占87.9%。最常见的1-2褥疮(97.1%)主要累及2-5cm的臀部(82.9%)(45.7%)。内科分科患者褥疮发生率高于外科分科,多为住院后出现(77.1%),住院时间15 ~ 30 d(31.4%)。这项研究为我们在农村三级医院内科和外科重症监护室改善患者护理和预防压疮发展指明了前进的道路。这些发现为有针对性的干预铺平了道路,强调了我们对提高重症患者护理标准的承诺。
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引用次数: 0
Prevalence of hypersensitive pneumonitis specific IgG antibodies in the Indian population: A retrospective study 印度人群中过敏性肺炎特异性IgG抗体的流行:一项回顾性研究
Pub Date : 2023-10-15 DOI: 10.18231/j.ijirm.2023.019
Alap Christy, Flavia Almeida, Madhuri Bhosle, Raj Jatale, Shibani Ramchandran
Identifying the underlying antigen responsible for Hypersensitivity Pneumonitis (HP) in patients poses a significant challenge within the confines of a typical clinical environment. Our primary objective in this study was to investigate the distribution and prevalence of G antibodies among individuals diagnosed with HP, taking into account factors such as age, gender, and geographical location. A retrospective study spanning 5 years (from January 2018 to June 2023) was conducted, involving patients over the age of 18 who had undergone screening for HP. Data collected from 1087 patients was analysed, and the patients were categorized based on age, gender, location, and their antibody status. Out of the total cohort of 1087 patients, 62.47% were female, while 37.53% were male. The overall positivity rate for HP panel testing was determined to be 49.22%. Among the patients subjected to testing, 174 individuals (16.01%) tested positive for at least one specific antibody. Notably, among patients aged 18 to 30 years, Penicillium emerged as the most prevalent (48.28%), closely followed by fumigatus Fumigatus (44.83%). In contrast, for patients aged 31 to 45 years, Pigeon serum feathers exhibited the highest prevalence (39.69%). Moreover, the positivity rates varied across different regions in India. HP can be attributed to an array of agents commonly encountered in both workplace and home settings, encompassing microorganisms, animal and plant proteins, as well as organic and inorganic chemicals. Discerning the causative antigen not only holds immense value for physicians in optimizing patient treatment but also plays a pivotal role in pinpointing the source of exposure. Armed with this knowledge, physicians can provide patients with tailored advice to minimize their exposure risk, potentially leading to disease stabilization or even reversal. In summary, the successful identification of the etiologic antigen emerges as a formidable tool for enhancing the overall quality of patient care.
在典型的临床环境范围内,确定引起患者超敏性肺炎(HP)的潜在抗原是一项重大挑战。本研究的主要目的是在考虑年龄、性别和地理位置等因素的情况下,调查HP确诊患者中G抗体的分布和流行情况。一项为期5年(2018年1月至2023年6月)的回顾性研究,涉及18岁以上接受过HP筛查的患者。对1087例患者的数据进行分析,并根据年龄、性别、地点和抗体状态对患者进行分类。在1087例患者中,女性占62.47%,男性占37.53%。HP面板检测的总阳性率为49.22%。在接受检测的患者中,174人(16.01%)至少有一种特异性抗体检测呈阳性。值得注意的是,在18 ~ 30岁的患者中,青霉菌最多(48.28%),烟曲霉菌次之(44.83%)。31 ~ 45岁人群中,鸽血清羽患病率最高(39.69%)。此外,印度不同地区的阳性率也各不相同。HP可归因于工作场所和家庭环境中常见的一系列病原体,包括微生物、动物和植物蛋白质,以及有机和无机化学品。辨别致病抗原不仅对医生优化患者治疗具有巨大价值,而且在确定暴露源方面也起着关键作用。有了这些知识,医生可以为患者提供量身定制的建议,以尽量减少他们的暴露风险,可能导致疾病稳定甚至逆转。总之,病原抗原的成功鉴定成为提高患者护理整体质量的强大工具。
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引用次数: 0
The collaboration of ‘Active case finding campaign’ with the 'Leprosy case detection campaign': An important step towards tuberculosis elimination “积极病例发现运动”与“麻风病病例发现运动”的合作:朝着消除结核病迈出的重要一步
Pub Date : 2023-08-15 DOI: 10.18231/j.ijirm.2023.011
S. Yadav
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引用次数: 0
Immunomodulatory effect of Mesenchymal stem cells: A blessing to combat cytokine storm appeared during COVID-19 infection 间充质干细胞的免疫调节作用:抗击COVID-19感染期间出现的细胞因子风暴的福音
Pub Date : 2023-08-15 DOI: 10.18231/j.ijirm.2023.012
K. Mishra, Urvi Panwar
Whilst the manufacture of a safe and potent vaccine for SARS-CoV-2 is the ultimate goal of the COVID-19 response, research is also in progress to develop novel treatments that could facilitate infected patients in the meantime. Casualty in COVID-19 patients are connected with onset of acute respiratory distress syndrome (ARDS) due to its cytokine storm phenomenon resulting in abandoned systemic inflammatory response from the release of pro-inflammatory chemokines (CCL2, CCL3, CCL5, CXCL8, CXCL9, CXCL-10) and cytokines (TNF-α, TGF-β, IFN-α, IFNγ, IL-1β, IL-6, IL-12, IL-8, IL-33). This implies immune system is not capable to turn itself off once it has generated enough of a defense against the virus. An extended cytokine storm will finally shut down breathing completely, which may lead to death. In the context of COVID19, there is a likelihood possibility of treatment of patients by transplanting Mesenchymal Stem Cells (MSCs). MSCs are known to have an immune-regulatory role and MSCs have used in patients that have been affected by the cytokine storm may fine balance the immune system in order to stop the overreaction, without switching it completely off, so that the immune system can carry on to fight the infection. In this review, we have considered the research studies which have used MSCs for the treatment of COVID-19. The cohort study is needed to approve MSCs as therapy, although many clinical trials have been registered to apply MSCs as therapy for severely affected COVID-19 patients.
虽然制造一种安全有效的SARS-CoV-2疫苗是COVID-19应对措施的最终目标,但与此同时,开发可能有助于感染患者的新型治疗方法的研究也在进行中。COVID-19患者伤亡与急性呼吸窘迫综合征(ARDS)发病有关,其细胞因子风暴现象导致促炎趋化因子(CCL2、CCL3、CCL5、CXCL8、CXCL9、CXCL-10)和细胞因子(TNF-α、TGF-β、IFN-α、IFNγ、IL-1β、IL-6、IL-12、IL-8、IL-33)的释放导致全身性炎症反应放弃。这意味着一旦免疫系统产生了足够的防御病毒的能力,它就不能自我关闭。长时间的细胞因子风暴最终会完全停止呼吸,这可能导致死亡。在新冠肺炎疫情背景下,有可能通过移植间充质干细胞(MSCs)治疗患者。众所周知,间充质干细胞具有免疫调节作用,在受细胞因子风暴影响的患者中使用间充质干细胞可以很好地平衡免疫系统,以阻止过度反应,而不会完全关闭它,这样免疫系统就可以继续对抗感染。在这篇综述中,我们考虑了使用MSCs治疗COVID-19的研究。尽管许多临床试验已经注册将MSCs作为COVID-19严重感染患者的治疗方法,但仍需要队列研究来批准MSCs作为治疗方法。
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引用次数: 0
Levodropropizine: A promising peripherally acting antitussive agent 左旋丙哌嗪:一种很有前途的外周作用止咳剂
Pub Date : 2023-08-15 DOI: 10.18231/j.ijirm.2023.013
Amar Shirsat, A. Trailokya, S. Wankhede
Cough is one of the most frequent symptom for patients to seek medical attention. Cough can be associated with many disease processes and the ultimate treatment depends on determining the etiology and diagnosis. Antitussive agents with different mechanisms of action have been developed in the past, but there are still very few medications that seem to be effective without any side effects especially related to central nervous system (CNS). Levodropropizine is an antitussive agent which acts peripherally and is a non-opioid cough medication that is in use since many years as a symptomatic therapy for cough. Levodropropizine has potent antitussive activity mainly due to peripheral effects by inhibiting the activation of vagal C-fibers. In fact, levodropropizine has been proven effective in controlling cough and is devoid of the central depressant effect. Levodropropizine oral suspension (30mg/5ml) is approved by drug approval body of India, Drug Controller General of India (DCGI) for the management non-productive cough in adults. Levodropropizine is approved in some of the European countries and in Asian countries. It is widely used in Republic of Korea for the symptomatic treatment of cough in both adults and children above 2 years of age. Levodropropizine has the utmost level of benefit in comparison with central antitussive agents namely codeine and dextromethorphan for the patients with cough due to acute and chronic bronchitis.
咳嗽是患者就医最常见的症状之一。咳嗽可能与许多疾病过程有关,最终的治疗取决于确定病因和诊断。过去已经开发出不同作用机制的止咳药,但仍然很少有药物似乎有效而没有任何副作用,特别是与中枢神经系统(CNS)有关。左旋丙哌嗪是一种外周作用的止咳药,是一种非阿片类止咳药,作为咳嗽的对症治疗已使用多年。左旋丙哌嗪具有强效的止咳作用,主要是通过抑制迷走神经c -纤维的激活而产生外周效应。事实上,左旋丙哌嗪已被证明对控制咳嗽有效,而且没有中枢抑制作用。左旋丙哌嗪口服混悬液(30mg/5ml)经印度药品审批机构印度药品监督管理局(DCGI)批准用于治疗成人非生产性咳嗽。左丙哌嗪已在一些欧洲国家和亚洲国家获得批准。在韩国广泛用于成人和2岁以上儿童咳嗽的对症治疗。与可待因和右美沙芬等中枢止咳药相比,左旋丙哌嗪对急性和慢性支气管炎咳嗽患者的疗效最大。
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引用次数: 0
A study on clinical and arterial blood gas parameters before and after tube thoracostomy among cases of primary and secondary spontaneous pneumothorax 原发性和继发性自发性气胸插管开胸前后临床及动脉血气参数的研究
Pub Date : 2023-08-15 DOI: 10.18231/j.ijirm.2023.014
Subhajit Sen, S. Kundu, S. Chatterjee
Pneumothorax is a common respiratoryemergency that requires active interventions in many cases specially Tube thoracostomy. Objective of the present study is to find out changes in clinical and arterial blood gas parameters in primary and secondary pneumothorax following tube thoracostomy at different time intervals.Total 30 cases, Primary spontaneous pneumothorax (PSP) 11 and secondary spontaneous pneumothorax (SSP) 19. Clinical parameters: pulse rate, blood pressure, respiratory rates, oxygen saturation (SpO2). ABG analysis: pH, partial pressure of carbon dioxide (pCO2), partial pressure of oxygen (pO2), AaDO2. Time interval: pre tube thoracostomy, 1hour and 24hours after thoracostomy and after tube removal. PSP was found more in young patients (mean 34.18), SSP in older patient (mean 52.68), (P=0.001). Among clinical parameters statistically significant changes were seen in pulse rate, (P<0.001) respiratory rate (P<0.001) in both groups, in both cases tachycardia and tachypnea decreased. Diastolic blood pressure in SSP group (P<0.01), SO in SSP group (P<0.05). There is an increase in mean arterial pressure from pre thoracostomy compared to in 1hr, 24hr and at removal. Which statistically significant in SSP group.In PSP group hypoxaemia was present in 54.54% patients before giving chest tube, after 1 hour of tube thoracostomy only 18.18% cases had mild hypoxaemia. In SSP group 68.42% cases presented with hypoxaemia initially, after tube removal 26.31% cases had mild hypoxaemia.No significant changes in other blood gas parameters were seen in either groups. The impact of tube thoracostomy on primary and secondary pneumothorax are mainly reflected on clinical parameters rather than blood gas parameters.
气胸是一种常见的呼吸急症,在许多情况下需要积极干预,特别是气管开胸术。本研究的目的是了解导管开胸术后原发性气胸和继发性气胸的临床及动脉血气参数在不同时间间隔的变化。其中原发性自发性气胸11例,继发性自发性气胸19例。临床参数:脉率、血压、呼吸频率、血氧饱和度。ABG分析:pH、二氧化碳分压(pCO2)、氧气分压(pO2)、AaDO2。时间间隔:开胸前、开胸后1小时、开胸后24小时、拔管后。年轻患者多发于PSP(平均34.18),老年患者多发于SSP(平均52.68),差异有统计学意义(P=0.001)。两组患者的脉搏率、呼吸率变化均有统计学意义(P<0.001),两组患者的心动过速和呼吸急促均有所减轻。SSP组舒张压(P<0.01)、SO (P<0.05)。与取胸1小时、24小时和取胸时相比,开胸前的平均动脉压升高。SSP组差异有统计学意义。PSP组54.54%的患者在给予胸管前出现低氧血症,而插管开胸1 h后仅有18.18%的患者出现轻度低氧血症。SSP组68.42%患者术后出现低氧血症,拔管后26.31%出现轻度低氧血症。两组患者其他血气参数均无明显变化。管式开胸对原发性和继发性气胸的影响主要体现在临床参数上,而不是血气参数上。
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引用次数: 0
Reasons of exacerbation among children with reactive airway disease 反应性气道疾病患儿病情加重的原因
Pub Date : 2023-08-15 DOI: 10.18231/j.ijirm.2023.016
Anjusha Maheswari Nair, P. T, B. S
Reactive airway disease has a multifactorial aetiology, where genetic liabilities and environmental exposures interact in complex ways to cause reversible airway inflammation and obstruction and acute exacerbation can be life threatening. The present study was to assess the reasons of exacerbation among children with reactive airway disease which include infection, cold climate, lunar variations, discontinuation of metered dose inhaler and allergens and irritants. The study was conducted in a tertiary care centre Thiruvananthapuram among 101 caretakers of children with reactive airway disease. A structured interview schedule was used to assess the socio demographic data, clinical data of the child and the reasons of exacerbation. Among 101 children with reactive airway disease majority of children 67.3% the reason for exacerbation was cold climate, in 16.8% infection, 21.8% activity, 8.9% lunar variation, 10.9% discontinuation of metered dose inhaler and in 28.7% other factors of exacerbation include strong odour, pets, pollen, pests, smoke, mosquito repellents and dust. The study also revealed that 72.3% are having family history of allergic diseases and 27.7% do not have any family history of allergic diseases. Of the 73 children with family history of allergic disease 79.5% were having family history of asthma, 16.4% were having allergic rhinitis and 4.1% were having allergic dermatitis. Asthma is a chronic inflammatory disease of the airways. It is one of the most common chronic diseases of childhood, affecting more than 6 million children worldwide Advances in science have led to an increased understanding of asthma and its mechanisms as well as improved treatment approaches. Proper identification and elimination of triggers can reduce the exacerbation of asthma.
反应性气道疾病具有多因素病因学,其中遗传负担和环境暴露以复杂的方式相互作用,导致可逆性气道炎症和阻塞,急性加重可危及生命。本研究旨在评估儿童反应性气道疾病加重的原因,包括感染、寒冷气候、月球变化、停止使用计量吸入器以及过敏原和刺激物。该研究在Thiruvananthapuram三级保健中心对101名患有反应性呼吸道疾病儿童的看护人员进行。采用结构化访谈时间表评估儿童的社会人口学资料、临床资料和病情恶化的原因。在101例反应性气道疾病患儿中,绝大多数患儿(67.3%)的加重原因是寒冷气候,16.8%是感染,21.8%是活动,8.9%是月相变化,10.9%是停止使用计量吸入器,28.7%是其他加重因素包括强烈气味、宠物、花粉、害虫、烟雾、驱蚊剂和灰尘。研究还显示,72.3%的人有过敏性疾病家族史,27.7%的人没有过敏性疾病家族史。73例有变应性疾病家族史的儿童中,有哮喘家族史的占79.5%,有变应性鼻炎的占16.4%,有变应性皮炎的占4.1%。哮喘是呼吸道的慢性炎症性疾病。它是儿童最常见的慢性疾病之一,影响着全世界600多万儿童。科学的进步使人们对哮喘及其机制有了更多的了解,并改进了治疗方法。正确识别和消除诱发因素可以减少哮喘的恶化。
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引用次数: 0
Revolutionising TB treatment: Implications of the TRUNCATE-TB Trial on the Indian TB landscape 革命性的结核病治疗:TRUNCATE-TB试验对印度结核病景观的影响
Pub Date : 2023-08-15 DOI: 10.18231/j.ijirm.2023.010
Gyanshankar P. Mishra, Jasmin Mulani
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引用次数: 0
Exercise in chronic obstructive pulmonary disease 慢性阻塞性肺疾病的运动
Pub Date : 2023-08-15 DOI: 10.18231/j.ijirm.2023.015
A. R., M. M
Chronic Obstructive pulmonary disease is continuing as a major public health problem across the globe, causing significant morbidity and affecting the quality of life more commonly among the elderly. This aim of the study was to assess whether a regular, routine 20 minute walk will help improve the quality of life and symptoms in patients with COPD. Patients selected according to the inclusion and exclusion criteria and using a pretested questionnaire, were included in the study and data were collected. The questionnaire included information on basic demographic details, symptomatology, and smoking and alcohol habits. History, clinical examination, and selected investigations were done before and after a month of this exercise program. Qualitative data was analyzed using Chi-Square Test and Quantitative data using Paired T test The study population was mostly elderly males. Most of them gave history of smoking in the past and a few had biomass exposure. The most predominant symptom was dyspnea. After 2 months of regular exercise there was statistically significant change in CAT Score, mMRC score and six minute walk distance. The desaturation while doing Six minute walk test also improved after the exercise program. This study concluded that a regular physical activity can be considered as a possible alternative to pulmonary rehabilitation program for those who cannot afford the cost of consultations, transport for attending the program.
慢性阻塞性肺病仍然是全球一个主要的公共卫生问题,造成严重的发病率,并更普遍地影响老年人的生活质量。这项研究的目的是评估定期20分钟的步行是否有助于改善COPD患者的生活质量和症状。根据纳入和排除标准并使用预测问卷选择的患者被纳入研究并收集数据。调查问卷包括基本人口统计细节、症状、吸烟和饮酒习惯等信息。病史、临床检查和选定的调查在锻炼计划前后一个月完成。定性资料采用卡方检验,定量资料采用配对T检验。研究人群以老年男性为主。他们中的大多数人都有过去的吸烟史,少数人有生物物质暴露。以呼吸困难为主要症状。定期运动2个月后,CAT评分、mMRC评分和6分钟步行距离的变化具有统计学意义。进行6分钟步行测试时的去饱和度也在运动项目后有所改善。这项研究的结论是,对于那些负担不起咨询费用和交通费用的人来说,定期的体育活动可以被认为是肺部康复计划的一个可能的替代方案。
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引用次数: 1
Pulmonary rehabilitation care: Current perspective 肺康复护理:当前观点
Pub Date : 2023-05-15 DOI: 10.18231/j.ijirm.2023.003
Ankit Kumar, S. Kant
Pulmonary rehabilitation is a program that helps individuals with chronic respiratory diseases improve their physical function, quality of life, and overall well-being. The program typically involves a combination of exercise, education, and support to help patients manage their symptoms and improve their respiratory health.Exercise is a crucial component of pulmonary rehabilitation and can help improve cardiovascular health, increase lung function, and reduce shortness of breath. Aerobic exercise, resistance exercise, and flexibility exercise are all important types of exercise used in pulmonary rehabilitation, with patients gradually increasing the intensity and duration of their workouts over time.Breathing techniques are another essential component of pulmonary rehabilitation and can help patients manage their symptoms and improve their overall respiratory function. Techniques such as diaphragmatic breathing, pursed-lip breathing, and controlled coughing can help improve oxygenation, reduce shortness of breath, and improve overall respiratory function.In addition to exercise and breathing techniques, pulmonary rehabilitation programs may also include education and support to help patients better manage their condition. This may include education on medication management, nutrition, stress management, and other topics relevant to respiratory health.Overall, pulmonary rehabilitation is a comprehensive program that can help individuals with chronic respiratory diseases improve their physical function, reduce symptoms, and improve their overall quality of life. By incorporating exercise, breathing techniques, education, and support, pulmonary rehabilitation can help patients better manage their condition and achieve optimal respiratory health.
肺康复是一个帮助慢性呼吸系统疾病患者改善身体功能、生活质量和整体健康的项目。该项目通常包括锻炼、教育和支持相结合,以帮助患者控制症状并改善呼吸系统健康。运动是肺部康复的重要组成部分,可以帮助改善心血管健康,增加肺功能,减少呼吸短促。有氧运动、抗阻运动和柔韧性运动都是肺部康复中重要的运动类型,随着时间的推移,患者的运动强度和持续时间逐渐增加。呼吸技术是肺部康复的另一个重要组成部分,可以帮助患者控制症状并改善整体呼吸功能。膈式呼吸、抿嘴呼吸和控制咳嗽等技巧可以帮助改善氧合,减少呼吸短促,改善整体呼吸功能。除了运动和呼吸技术,肺康复计划还可能包括教育和支持,以帮助患者更好地管理他们的病情。这可能包括药物管理、营养、压力管理和其他与呼吸健康相关的主题的教育。总的来说,肺部康复是一个综合性的项目,可以帮助慢性呼吸系统疾病患者改善他们的身体功能,减轻症状,提高他们的整体生活质量。通过结合运动、呼吸技术、教育和支持,肺部康复可以帮助患者更好地管理他们的病情,达到最佳的呼吸健康。
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引用次数: 0
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IP Indian Journal of Immunology and Respiratory Medicine
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