Pub Date : 2024-03-15DOI: 10.18231/j.pjms.2024.054
S. Bhuvana, P Kanimozhi, Arun Sekar, N. Latha
Endotracheal intubation is one of the most common procedures, and anesthesiologists play an important role in patient care. During laryngoscopy and intubation, the patient can experience rapid and drastic hemodynamic changes that are potentially fatal. The purpose of this study is to know the efficacy of ivabradine in attenuating the hemodynamic response to laryngoscopy and endotracheal intubation. In this prospective randomised double-blinded study, fifty patients belonging to ASA 1 and 2 were randomised to group A - ivabradine 5mg (first dose on the evening before the day of surgery and the second dose one hour before intubation). Patients in group B received tablet MVT (placebo) (first dose on the evening before the day of surgery and the second dose one hour before intubation). Patients in group A showed attenuation of heart rate during laryngoscopy and intubation till 10minutes after intubation. Patients in group B showed a rise in blood pressure during laryngoscopy and intubation till 10 minutes after intubation. Patients in group A and group B showed no significant difference in hemodynamics when monitored intraoperatively. All patients recovered fully from anaesthesia and had no complications such as severe bradycardia. Ivabradine effectively attenuates the hemodynamic stress response without a fall in blood pressure and without severe bradycardia.
{"title":"Attenuation of hemodynamic response to laryngoscopy and endotracheal intubation using oral ivabradine – Randomised controlled trial","authors":"S. Bhuvana, P Kanimozhi, Arun Sekar, N. Latha","doi":"10.18231/j.pjms.2024.054","DOIUrl":"https://doi.org/10.18231/j.pjms.2024.054","url":null,"abstract":"Endotracheal intubation is one of the most common procedures, and anesthesiologists play an important role in patient care. During laryngoscopy and intubation, the patient can experience rapid and drastic hemodynamic changes that are potentially fatal. The purpose of this study is to know the efficacy of ivabradine in attenuating the hemodynamic response to laryngoscopy and endotracheal intubation. In this prospective randomised double-blinded study, fifty patients belonging to ASA 1 and 2 were randomised to group A - ivabradine 5mg (first dose on the evening before the day of surgery and the second dose one hour before intubation). Patients in group B received tablet MVT (placebo) (first dose on the evening before the day of surgery and the second dose one hour before intubation). Patients in group A showed attenuation of heart rate during laryngoscopy and intubation till 10minutes after intubation. Patients in group B showed a rise in blood pressure during laryngoscopy and intubation till 10 minutes after intubation. Patients in group A and group B showed no significant difference in hemodynamics when monitored intraoperatively. All patients recovered fully from anaesthesia and had no complications such as severe bradycardia. Ivabradine effectively attenuates the hemodynamic stress response without a fall in blood pressure and without severe bradycardia.","PeriodicalId":30643,"journal":{"name":"PANACEA JOURNAL OF MEDICAL SCIENCES","volume":"21 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140240721","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 : 2024-03-15DOI: 10.18231/j.pjms.2024.041
Sameer Kiro, Subhas Chandra Majhi, Himansu Nayak, M. Murmu, Gyana Ranjan Sahoo, Shitanshu Kumar Meher, Sanjukta Panda
Encephalitis is an important cause of morbidity, mortality and neurological sequelae in children globally. Causes are diverse and include viral and non-viral etiology as well as autoimmune processes. In the west autoimmune encephalitis are now most common than any single infectious cause, but in India infectious causes are still most common. It is critical to evaluate the immediately to reduce mortality and sequalae in Acute Encephalitis Syndrome (AES) patients. This study has been done to find out different predictors of mortality in outcome of AES at the end of hospital stay. To find out the predictors of mortality in children with acute encephalitis syndrome between age group of 1 month to 14 years. This was a cross sectional analytical study conducted over a period of two years. A total of 310 subjects were included in the study. Different clinical and laboratory parameters were taken to know the different significant predictors of mortality. A total of 310 cases were taken for the study from the age group of 1 month to 14 years. Out of these AES cases 22.5% cases died and 77.5% patients were discharged. Higher mortality was seen in 11-14 years of age group and females had higher mortality as compared to males. Only 5 variables that is refractory seizure, GCS<8, features of raised ICT, shock and requirement of ventilatory support were found to be significant (p<0.05) in predictors of mortality. Other variables like age, sex, socioeconomic status, fever altered sensorium, seizure, meningeal sign, laboratory investigations like serum sodium, total leucocyte count, serum creatinine, duration of hospitalisation were not found to be significant(p>0.05). AES is a disorder of multiple and varying etiology with significant mortality and morbidity. Early diagnosis, appropriate investigation, prompt management go a long way in reducing mortality and sequalae in AES. Refractory seizure, Glasgow Coma Score<8, features of raised Intracranial Tension, Shock and requirement of ventilatory support prognosticate the outcome of Acute Encephalitis Syndrome.
{"title":"Predictors of mortality in acute encephalitis syndrome in children","authors":"Sameer Kiro, Subhas Chandra Majhi, Himansu Nayak, M. Murmu, Gyana Ranjan Sahoo, Shitanshu Kumar Meher, Sanjukta Panda","doi":"10.18231/j.pjms.2024.041","DOIUrl":"https://doi.org/10.18231/j.pjms.2024.041","url":null,"abstract":"Encephalitis is an important cause of morbidity, mortality and neurological sequelae in children globally. Causes are diverse and include viral and non-viral etiology as well as autoimmune processes. In the west autoimmune encephalitis are now most common than any single infectious cause, but in India infectious causes are still most common. It is critical to evaluate the immediately to reduce mortality and sequalae in Acute Encephalitis Syndrome (AES) patients. This study has been done to find out different predictors of mortality in outcome of AES at the end of hospital stay. To find out the predictors of mortality in children with acute encephalitis syndrome between age group of 1 month to 14 years. This was a cross sectional analytical study conducted over a period of two years. A total of 310 subjects were included in the study. Different clinical and laboratory parameters were taken to know the different significant predictors of mortality. A total of 310 cases were taken for the study from the age group of 1 month to 14 years. Out of these AES cases 22.5% cases died and 77.5% patients were discharged. Higher mortality was seen in 11-14 years of age group and females had higher mortality as compared to males. Only 5 variables that is refractory seizure, GCS<8, features of raised ICT, shock and requirement of ventilatory support were found to be significant (p<0.05) in predictors of mortality. Other variables like age, sex, socioeconomic status, fever altered sensorium, seizure, meningeal sign, laboratory investigations like serum sodium, total leucocyte count, serum creatinine, duration of hospitalisation were not found to be significant(p>0.05). AES is a disorder of multiple and varying etiology with significant mortality and morbidity. Early diagnosis, appropriate investigation, prompt management go a long way in reducing mortality and sequalae in AES. Refractory seizure, Glasgow Coma Score<8, features of raised Intracranial Tension, Shock and requirement of ventilatory support prognosticate the outcome of Acute Encephalitis Syndrome.","PeriodicalId":30643,"journal":{"name":"PANACEA JOURNAL OF MEDICAL SCIENCES","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140241260","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 : 2024-03-15DOI: 10.18231/j.pjms.2024.027
T. P. Kiranmai, Sharada Munagavalasa, K. Bhargavi, P. Sujatha, CH Sangeetha
Pregnant women at risk of preterm birth may be easily identified and sent to tertiary care centres for further therapy. Numerous biomarkers are being investigated for their ability to predict preterm labour; serum ferritin is one of these indicators. It is an intracellular protein that has a role in iron storage and is also an acute phase reactant that is increased during acute and chronic infections. To evaluate serum ferritin levels in preterm labour and perinatal outcome in a tertiary care centre during 2 years.A case control study was conducted in collaboration with the Department of Obstetrics and Gynecology at Osmania Medical College, Hyderabad, from 2019 to 2022. After receiving permission, one hundred participants with an average age of 25 years who visit Niloufer hospital are included in the research and separated into case (Group 1) and control (Group 2) groups. Group 1 consists of women who had spontaneous preterm labour, whereas Group 2 consists of pregnant women of the same gestational age who are considered controls. Among 50 instances of preterm labour, 39 (78.0 percent) were classified as preterm (32 to 36 weeks), whereas 11 (22.0 percent) were classified as very preterm (28 to 32 weeks). The majority of the 50 patients included in the research, 31 (62.0 percent), were born by normal vaginal delivery, while 19 (38.0 percent) were delivered using emergency LSCS. CRP was positive in two patients (4.0 percent). The mean WBC levels in cases were much greater than those in controls, and the difference is statistically significant. Serum ferritin levels were 40.298 19.64 in cases and 20.343 6.82 in controls. Serum ferritin levels were substantially higher in cases than in controls on average. The mean WBC levels were greatest in extremely preterm infants, followed by preterm infants; however, this difference was determined to be statistically insignificant. Ferritin levels are much higher in preterm labour patients than in low-risk women of the same gestational age. Serum ferritin levels may be utilised as a biomarker in high-risk premature labour.
{"title":"Study of serum ferritin levels in preterm labour and its perinatal outcome in tertiary care centre","authors":"T. P. Kiranmai, Sharada Munagavalasa, K. Bhargavi, P. Sujatha, CH Sangeetha","doi":"10.18231/j.pjms.2024.027","DOIUrl":"https://doi.org/10.18231/j.pjms.2024.027","url":null,"abstract":"Pregnant women at risk of preterm birth may be easily identified and sent to tertiary care centres for further therapy. Numerous biomarkers are being investigated for their ability to predict preterm labour; serum ferritin is one of these indicators. It is an intracellular protein that has a role in iron storage and is also an acute phase reactant that is increased during acute and chronic infections. To evaluate serum ferritin levels in preterm labour and perinatal outcome in a tertiary care centre during 2 years.A case control study was conducted in collaboration with the Department of Obstetrics and Gynecology at Osmania Medical College, Hyderabad, from 2019 to 2022. After receiving permission, one hundred participants with an average age of 25 years who visit Niloufer hospital are included in the research and separated into case (Group 1) and control (Group 2) groups. Group 1 consists of women who had spontaneous preterm labour, whereas Group 2 consists of pregnant women of the same gestational age who are considered controls. Among 50 instances of preterm labour, 39 (78.0 percent) were classified as preterm (32 to 36 weeks), whereas 11 (22.0 percent) were classified as very preterm (28 to 32 weeks). The majority of the 50 patients included in the research, 31 (62.0 percent), were born by normal vaginal delivery, while 19 (38.0 percent) were delivered using emergency LSCS. CRP was positive in two patients (4.0 percent). The mean WBC levels in cases were much greater than those in controls, and the difference is statistically significant. Serum ferritin levels were 40.298 19.64 in cases and 20.343 6.82 in controls. Serum ferritin levels were substantially higher in cases than in controls on average. The mean WBC levels were greatest in extremely preterm infants, followed by preterm infants; however, this difference was determined to be statistically insignificant. Ferritin levels are much higher in preterm labour patients than in low-risk women of the same gestational age. Serum ferritin levels may be utilised as a biomarker in high-risk premature labour.","PeriodicalId":30643,"journal":{"name":"PANACEA JOURNAL OF MEDICAL SCIENCES","volume":"39 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140237615","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 : 2024-03-15DOI: 10.18231/j.pjms.2024.002
B. K. Behera, Aditi Ava Rath, Loknath Sahoo, Bibhudatta Dash, Debashree Priyadarshini
Foreign body (FB) ingestion in adult and children population is not uncommon but accidental. Same is rare in neonates and infants. Many of FB ingestion go unnoticed or unexpressed if baby is preverbal. Most of the foreign bodies pass spontaneously per anal. Only the larger size or sharp FBs get stuck in places of gastro intestinal tract and presented on emergency Department. Similarly corrosive and toxic FB also invites immediate attention. Literature on the clinical aspects of the foreign body ingestion among neonates and infants was searched electronically through PubMed and individual study. Relevant articles were reviewed thoroughly and summarized. Instances of foreign body ingestion (FBI) in neonate and adult are in ascending trend over last several years. Imaging and identification of radiolucent FBs become challenging for surgeons. Conservative treatment for spontaneous evacuation, endoscopic retrieval and surgical removal are the modalities for FBI management. Two relevant rare reports are appended as the case study. Where the reported FBs are gold fingering and sharp open safety pin in infants. One was managed conservatively for per anal evacuation and other needed endoscopic retrieval with general anesthesia.
{"title":"Oral ingestion of foreign body in neonates and infants: A review","authors":"B. K. Behera, Aditi Ava Rath, Loknath Sahoo, Bibhudatta Dash, Debashree Priyadarshini","doi":"10.18231/j.pjms.2024.002","DOIUrl":"https://doi.org/10.18231/j.pjms.2024.002","url":null,"abstract":"Foreign body (FB) ingestion in adult and children population is not uncommon but accidental. Same is rare in neonates and infants. Many of FB ingestion go unnoticed or unexpressed if baby is preverbal. Most of the foreign bodies pass spontaneously per anal. Only the larger size or sharp FBs get stuck in places of gastro intestinal tract and presented on emergency Department. Similarly corrosive and toxic FB also invites immediate attention. Literature on the clinical aspects of the foreign body ingestion among neonates and infants was searched electronically through PubMed and individual study. Relevant articles were reviewed thoroughly and summarized. Instances of foreign body ingestion (FBI) in neonate and adult are in ascending trend over last several years. Imaging and identification of radiolucent FBs become challenging for surgeons. Conservative treatment for spontaneous evacuation, endoscopic retrieval and surgical removal are the modalities for FBI management. Two relevant rare reports are appended as the case study. Where the reported FBs are gold fingering and sharp open safety pin in infants. One was managed conservatively for per anal evacuation and other needed endoscopic retrieval with general anesthesia.","PeriodicalId":30643,"journal":{"name":"PANACEA JOURNAL OF MEDICAL SCIENCES","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140238828","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 : 2024-03-15DOI: 10.18231/j.pjms.2024.023
Devadatta Poddar, Rohit Chauhan, Prateek Lohchab
Liver abscess is a collection of purulent material in the liver most commonly seen in the tropical countries. It can sometimes lead to significant morbidity and mortality if not treated timely and adequately. Through this study we wish to put light upon the current status of clinical aspects, laboratory features, and outcomes of liver abscess. The study was conducted at a tertiary care hospital in Northern India in the period of August 2020 to July 2021. All patients diagnosed with liver abscess of size >5 cm or left lobe liver abscess of any size were included in the study. All relevant laboratory investigations were conducted. The outcomes were noted and data was entered in MS Excel sheet. Analysis was done using SPSS version 26. Sixty-three patients were included in the study. A male predominance was noted. Mean age at presentation was 37.8 years. Most patients were part of the lower socioeconomic class. Pain abdomen and fever were the most common presenting symptoms. Amoebic liver abscess was much more frequently seen than pyogenic liver abscess. Deranged coagulation profile was seen in 88.9% patients. 85.7% patients were amenable to treatment with minimal intervention. Mortality as an outcome was seen in 9.5% patients Significant correlation was found between various laboratory parameters and outcomes such as length of hospital stay and mortality. Early diagnosis and treatment is crucial in management of patients with liver abscess even today.
{"title":"Epidemiology and factors associated with amoebic liver abscess at a tertiary care hospital in Northern India","authors":"Devadatta Poddar, Rohit Chauhan, Prateek Lohchab","doi":"10.18231/j.pjms.2024.023","DOIUrl":"https://doi.org/10.18231/j.pjms.2024.023","url":null,"abstract":"Liver abscess is a collection of purulent material in the liver most commonly seen in the tropical countries. It can sometimes lead to significant morbidity and mortality if not treated timely and adequately. Through this study we wish to put light upon the current status of clinical aspects, laboratory features, and outcomes of liver abscess. The study was conducted at a tertiary care hospital in Northern India in the period of August 2020 to July 2021. All patients diagnosed with liver abscess of size >5 cm or left lobe liver abscess of any size were included in the study. All relevant laboratory investigations were conducted. The outcomes were noted and data was entered in MS Excel sheet. Analysis was done using SPSS version 26. Sixty-three patients were included in the study. A male predominance was noted. Mean age at presentation was 37.8 years. Most patients were part of the lower socioeconomic class. Pain abdomen and fever were the most common presenting symptoms. Amoebic liver abscess was much more frequently seen than pyogenic liver abscess. Deranged coagulation profile was seen in 88.9% patients. 85.7% patients were amenable to treatment with minimal intervention. Mortality as an outcome was seen in 9.5% patients Significant correlation was found between various laboratory parameters and outcomes such as length of hospital stay and mortality. Early diagnosis and treatment is crucial in management of patients with liver abscess even today.","PeriodicalId":30643,"journal":{"name":"PANACEA JOURNAL OF MEDICAL SCIENCES","volume":"66 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140238211","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}
In this study, we wanted to determine the incidence and prevalence of AKI in admitted patients of our institution in relation to their age, sex and clinical conditions. We also wanted to study the various aetiologies causing acute kidney injury in children, its severity in admitted patients, the time interval of onset of disease and onset of AKI, it’s mode of management and outcomes in children.This study was conducted in the paediatric ward of a tertiary care hospital in Eastern India. Total 147 cases of hospitalized AKI patients were studied.The incidence of AKI was found to be 1.27% in all hospitalized children. Maximum no. of cases were found in the age group >10 years (44.2%). Male children outnumbered female children by a ratio of 2:1. Fever (72.8%) and Oliguria/anuria (72.1%) were the most common presenting features. Pallor was the most common presenting sign in 66% followed by oedema (42.2%), encephalopathy (31.9%) and respiratory distress (16.3%). 32% of cases presented within 24hrs with an H/O oliguria/anuria and 64% in within 72hrs. Most patients were managed with conservative management (53%) but 36.7% were managed with HD and 10.3% were managed with PD.Acute Kidney Injury cases were more common in children of age group >10 years, males being affected more. Fever and oliguria/anuria were the commonest mode of presentations with malaria as the most frequent clinical condition associated with AKI followed by sepsis. The renal type was the commonest type of AKI. There was a moderate derangement of kidney function in the majority of cases with hyperkalaemia in a significant group of patients. 47% of patients required dialytic support and case fatality was 13%. The presence of dysnatremia, hyperkalaemia, encephalopathy and shock were poor predictors of the outcome of AKI.
在这项研究中，我们希望确定本院住院病人急性肾损伤的发病率和流行率与他们的年龄、性别和临床状况的关系。我们还想研究导致儿童急性肾损伤的各种病因、入院患者急性肾损伤的严重程度、发病与发生急性肾损伤的时间间隔、处理方式以及儿童的预后。所有住院患儿的 AKI 发病率为 1.27%。年龄大于 10 岁的病例最多（44.2%）。男性患儿与女性患儿的比例为 2:1。发热（72.8%）和少尿/无尿（72.1%）是最常见的发病特征。苍白是最常见的症状，占 66%，其次是水肿（42.2%）、脑病（31.9%）和呼吸困难（16.3%）。32%的病例在24小时内出现H/O少尿/无尿，64%的病例在72小时内出现H/O少尿/无尿。大多数患者接受保守治疗（53%），但有 36.7% 的患者接受了 HD 治疗，10.3% 的患者接受了 PD 治疗。急性肾损伤病例多见于年龄大于 10 岁的儿童，男性患者较多。发热和少尿/无尿是最常见的发病方式，疟疾是与急性肾损伤相关的最常见的临床症状，其次是败血症。肾型是最常见的缺氧性肾损伤类型。大多数病例的肾功能出现中度失调，相当一部分患者出现高钾血症。47%的患者需要透析支持，病死率为13%。出现血钠潴留、高钾血症、脑病和休克是预测急性肾功能缺损结局的不良指标。
{"title":"Pediatric acute kidney injury – Prevalence, clinical spectrum and outcome in a tertiary care institute of Eastern India","authors":"Bibhu Prasad Nayak, Dinesh Kumar Naik, Simanta Das, Bipsa Singh, Arati Behera","doi":"10.18231/j.pjms.2023.122","DOIUrl":"https://doi.org/10.18231/j.pjms.2023.122","url":null,"abstract":"In this study, we wanted to determine the incidence and prevalence of AKI in admitted patients of our institution in relation to their age, sex and clinical conditions. We also wanted to study the various aetiologies causing acute kidney injury in children, its severity in admitted patients, the time interval of onset of disease and onset of AKI, it’s mode of management and outcomes in children.This study was conducted in the paediatric ward of a tertiary care hospital in Eastern India. Total 147 cases of hospitalized AKI patients were studied.The incidence of AKI was found to be 1.27% in all hospitalized children. Maximum no. of cases were found in the age group >10 years (44.2%). Male children outnumbered female children by a ratio of 2:1. Fever (72.8%) and Oliguria/anuria (72.1%) were the most common presenting features. Pallor was the most common presenting sign in 66% followed by oedema (42.2%), encephalopathy (31.9%) and respiratory distress (16.3%). 32% of cases presented within 24hrs with an H/O oliguria/anuria and 64% in within 72hrs. Most patients were managed with conservative management (53%) but 36.7% were managed with HD and 10.3% were managed with PD.Acute Kidney Injury cases were more common in children of age group >10 years, males being affected more. Fever and oliguria/anuria were the commonest mode of presentations with malaria as the most frequent clinical condition associated with AKI followed by sepsis. The renal type was the commonest type of AKI. There was a moderate derangement of kidney function in the majority of cases with hyperkalaemia in a significant group of patients. 47% of patients required dialytic support and case fatality was 13%. The presence of dysnatremia, hyperkalaemia, encephalopathy and shock were poor predictors of the outcome of AKI.","PeriodicalId":30643,"journal":{"name":"PANACEA JOURNAL OF MEDICAL SCIENCES","volume":"350 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138996802","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 : 2023-12-15DOI: 10.18231/j.pjms.2023.127
Saravanasankar P, D. Sangeetha, S. Sangeetha
To demonstrate the critical function of Visually Evoked Potential (VEP) in the prompt detection of indirect optic neuropathy. 60 patients suspected of having traumatic optic nerve injury underwent VEP testing in < eight hours of traumatic experience. Baseline visual acuity was revealed to be the most imperative prognosticator of eventual visual outcome. The VEP was instrumental in the primary detection as well as validation of ITON. Additionally, VEP aided in predicting prognosis and follow-up for patients with IITON. Visual recovery is impossible in the absence of recordable VEP waves. The manifestation of orbital fractures wasn't associated with a preliminary or ultimate visual perception decrease. Patients who present < 8 hours following ITON with normal initial visual acuity, VEP alterations, and lower RAPD grades may have a greater chance of recovering final visual perception when treated with an instantaneous high steroid dosage. The above-mentioned prognostic markers in patients with ITON may be beneficial in predicting visual prognosis and determining the need for surgical therapy in patients who experience vision loss following head trauma.
{"title":"Role of visual evoked potential (VEP) in indirect traumatic optic nerve (ITON) injuries and assessment of the visual outcome","authors":"Saravanasankar P, D. Sangeetha, S. Sangeetha","doi":"10.18231/j.pjms.2023.127","DOIUrl":"https://doi.org/10.18231/j.pjms.2023.127","url":null,"abstract":"To demonstrate the critical function of Visually Evoked Potential (VEP) in the prompt detection of indirect optic neuropathy. 60 patients suspected of having traumatic optic nerve injury underwent VEP testing in < eight hours of traumatic experience. Baseline visual acuity was revealed to be the most imperative prognosticator of eventual visual outcome. The VEP was instrumental in the primary detection as well as validation of ITON. Additionally, VEP aided in predicting prognosis and follow-up for patients with IITON. Visual recovery is impossible in the absence of recordable VEP waves. The manifestation of orbital fractures wasn't associated with a preliminary or ultimate visual perception decrease. Patients who present < 8 hours following ITON with normal initial visual acuity, VEP alterations, and lower RAPD grades may have a greater chance of recovering final visual perception when treated with an instantaneous high steroid dosage. The above-mentioned prognostic markers in patients with ITON may be beneficial in predicting visual prognosis and determining the need for surgical therapy in patients who experience vision loss following head trauma.","PeriodicalId":30643,"journal":{"name":"PANACEA JOURNAL OF MEDICAL SCIENCES","volume":"320 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138996823","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}
: Diabetes is associated with alterations in the structure and functions of corneal endothelial cells. Current research has been carried out to compare the central corneal thickness and endothelial cell density in patients with diabetic retinopathy (DR) and non-diabetic (ND) individuals. : A Cross Sectional comparative research was carried out in a tertiary eye care hospital, over the period of two years from April 2021 to March 2023. Among 160 study participants, 80 cases with diabetic retinopathy (DR) and 80 non-diabetic (ND) cases as age matched control have been selected. Thorough Ophthalmic assessment was done. We have included only retinopathy cases as they have longer duration of diabetis and poorer metabolic control, for better comparison of the endothelium parameters with non-diabetics. Specular microscopy has been done in all cases for endothelial cell count evaluation and thickness of cornea has been estimated by Pachymeter. Statistical analysis was carried out by students‘t’ test by comparing the variables between two groups. : P-value was not significant for the mean age and sex distribution in the two groups. Mean endothelial cell density was lesser (2512.12±260.23cells/mm2) in DR than in ND group (2699.10±95.68cells/mm2). Mean central corneal thickness was greater (522.65±36.56μm) in DR than in ND group (486.50±18.67μm) (P<0.05). Also, the Co-efficient of variation percentage was more whereas the percentage of hexagonality was found to be statistically less in DR than ND group. Among DR patients, endothelial cell density was significantly reduced and central corneal thickness considerably raised when compared with ND. Our results also suggest that poor metabolic control and advanced Diabetic Retinopathy are risk factors for developing keratopathy.
{"title":"Comparison of central corneal thickness and endothelial cell count among diabetic retinopathy and non-diabetic cases","authors":"Pranati Chaudhury, Anita Misra, Niranjan Puthal, Sasmita Sahoo, Bichismita Jena, Rajesh Panda","doi":"10.18231/j.pjms.2023.116","DOIUrl":"https://doi.org/10.18231/j.pjms.2023.116","url":null,"abstract":": Diabetes is associated with alterations in the structure and functions of corneal endothelial cells. Current research has been carried out to compare the central corneal thickness and endothelial cell density in patients with diabetic retinopathy (DR) and non-diabetic (ND) individuals. : A Cross Sectional comparative research was carried out in a tertiary eye care hospital, over the period of two years from April 2021 to March 2023. Among 160 study participants, 80 cases with diabetic retinopathy (DR) and 80 non-diabetic (ND) cases as age matched control have been selected. Thorough Ophthalmic assessment was done. We have included only retinopathy cases as they have longer duration of diabetis and poorer metabolic control, for better comparison of the endothelium parameters with non-diabetics. Specular microscopy has been done in all cases for endothelial cell count evaluation and thickness of cornea has been estimated by Pachymeter. Statistical analysis was carried out by students‘t’ test by comparing the variables between two groups. : P-value was not significant for the mean age and sex distribution in the two groups. Mean endothelial cell density was lesser (2512.12±260.23cells/mm2) in DR than in ND group (2699.10±95.68cells/mm2). Mean central corneal thickness was greater (522.65±36.56μm) in DR than in ND group (486.50±18.67μm) (P<0.05). Also, the Co-efficient of variation percentage was more whereas the percentage of hexagonality was found to be statistically less in DR than ND group. Among DR patients, endothelial cell density was significantly reduced and central corneal thickness considerably raised when compared with ND. Our results also suggest that poor metabolic control and advanced Diabetic Retinopathy are risk factors for developing keratopathy.","PeriodicalId":30643,"journal":{"name":"PANACEA JOURNAL OF MEDICAL SCIENCES","volume":"31 122","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138998983","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 : 2023-12-15DOI: 10.18231/j.pjms.2023.125
Veena Melwani, M. Tomar, Anshuli Trivedi
This study aimed to assess the hematological abnormalities in CLD patients and to study the association of hematological abnormalities with type and severity of CLD. This study was conducted as a facility based cross-sectional study at tertiary care centre on confirmed cases of chronic liver disease. Detailed clinical history along with clinical examination findings were recorded. All patients were then subjected to investigations. Mean age of patients with CLD was 48.8±16.9 years and majority of patients were males (76%). Anemia was observed in 71% cases with CLD whereas leukocytopenia and thrombocytopenia were noted in 21% and 56% cases respectively. Mean MCV, MCH, serum bilirubin and iron were significantly higher in cases with alcoholic liver disease whereas TIBC was significantly lower in ALD cases as compared to NALD cases (p<0.05). Mean hemoglobin, platelet levels, MCV, albumin and iron levels were significantly lower in cases with severe liver disease (Child Pugh Class C). However, serum bilirubin, prothrombin time and TIBC levels increased significantly with increase in severity of CLD (p<0.05). Hematological abnormalities particularly normocytic normochromic anemia and thrombocytopenia are common in cases with CLD, which might affect the prognosis of patients with CLD. Assessing the severity and type of anaemia is a useful tool for early initiation of the treatment in patients of CLD for reducing the morbidity and mortality. Early detection and treatment of haematological changes can prevent complications and reduce the mortality in CLD patients.
{"title":"Hematological abnormalities in chronic liver disease and their association with severity and types of chronic liver disease","authors":"Veena Melwani, M. Tomar, Anshuli Trivedi","doi":"10.18231/j.pjms.2023.125","DOIUrl":"https://doi.org/10.18231/j.pjms.2023.125","url":null,"abstract":"This study aimed to assess the hematological abnormalities in CLD patients and to study the association of hematological abnormalities with type and severity of CLD. This study was conducted as a facility based cross-sectional study at tertiary care centre on confirmed cases of chronic liver disease. Detailed clinical history along with clinical examination findings were recorded. All patients were then subjected to investigations. Mean age of patients with CLD was 48.8±16.9 years and majority of patients were males (76%). Anemia was observed in 71% cases with CLD whereas leukocytopenia and thrombocytopenia were noted in 21% and 56% cases respectively. Mean MCV, MCH, serum bilirubin and iron were significantly higher in cases with alcoholic liver disease whereas TIBC was significantly lower in ALD cases as compared to NALD cases (p<0.05). Mean hemoglobin, platelet levels, MCV, albumin and iron levels were significantly lower in cases with severe liver disease (Child Pugh Class C). However, serum bilirubin, prothrombin time and TIBC levels increased significantly with increase in severity of CLD (p<0.05). Hematological abnormalities particularly normocytic normochromic anemia and thrombocytopenia are common in cases with CLD, which might affect the prognosis of patients with CLD. Assessing the severity and type of anaemia is a useful tool for early initiation of the treatment in patients of CLD for reducing the morbidity and mortality. Early detection and treatment of haematological changes can prevent complications and reduce the mortality in CLD patients.","PeriodicalId":30643,"journal":{"name":"PANACEA JOURNAL OF MEDICAL SCIENCES","volume":"62 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138999091","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}
Hypothyroidism is an endocrinopathy eventuate due to destruction of thyroid cells incapacitating synthesis of thyroid hormones. HS which is a gas signaling molecule that might protect synthesis and secretion of thyroid hormone by upregulating the expression levels of thyroid hormone synthesis-related proteins and promotingting Thyroid peroxidase (TPO) activity through S-sulphydration of sirtuin-1 (SIRT-1). Depending on this fact we measured the HS level in a group of hypothyroid patient. The plasma H S level in case in our study was 33.95 ± 4.14 micromol/l with the range from 27.82 to 43.94 micromol/l. This was significantly (P< 0.001) lower than age/sex matched healthy controls which was 64.67±4.25 micromol/l, with a range from 49.81 to 80.02 micromol/l. this study also elucidated that plasma HS levels were significantly correlated with level of diagnostic parameters of hypothyroidism.
甲状腺功能减退症是由于甲状腺细胞遭到破坏而导致甲状腺激素无法合成的一种内分泌疾病。HS是一种气体信号分子，可通过上调甲状腺激素合成相关蛋白的表达水平和促进甲状腺过氧化物酶（TPO）的活性来保护甲状腺激素的合成和分泌。根据这一事实，我们测量了一组甲状腺功能减退患者的 HS 水平。在我们的研究中，患者的血浆 H S 水平为 33.95 ± 4.14 微摩尔/升，范围在 27.82 至 43.94 微摩尔/升之间。这项研究还表明，血浆HS水平与甲状腺功能减退症的诊断指标水平明显相关。
{"title":"An observational study to determine relationship of serum hydrogen sulphide level in hypothyroid patients in a medical college in Kolkata","authors":"Pinaki Saha, Ankita Bhattacharya, Sadajit Banerjee, Ipsita Bhattacharyya, D. Sanyal, Indira Bhaskar Biswas","doi":"10.18231/j.pjms.2023.150","DOIUrl":"https://doi.org/10.18231/j.pjms.2023.150","url":null,"abstract":"Hypothyroidism is an endocrinopathy eventuate due to destruction of thyroid cells incapacitating synthesis of thyroid hormones. HS which is a gas signaling molecule that might protect synthesis and secretion of thyroid hormone by upregulating the expression levels of thyroid hormone synthesis-related proteins and promotingting Thyroid peroxidase (TPO) activity through S-sulphydration of sirtuin-1 (SIRT-1). Depending on this fact we measured the HS level in a group of hypothyroid patient. The plasma H S level in case in our study was 33.95 ± 4.14 micromol/l with the range from 27.82 to 43.94 micromol/l. This was significantly (P< 0.001) lower than age/sex matched healthy controls which was 64.67±4.25 micromol/l, with a range from 49.81 to 80.02 micromol/l. this study also elucidated that plasma HS levels were significantly correlated with level of diagnostic parameters of hypothyroidism.","PeriodicalId":30643,"journal":{"name":"PANACEA JOURNAL OF MEDICAL SCIENCES","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138998015","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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