Pub Date : 2023-01-01DOI: 10.4103/injms.injms_92_22
V. Vadaga, Deepak Anil, Shabeena Akbar, M. Murthy, S. Doddaiah
Introduction: In 2018, the Government of India launched the Pradhan Mantri Jan Arogya Yojana (PM-JAY), a part of the Ayushman Bharat scheme as a progressive step toward universal health coverage. The scheme was intended to provide health insurance for the socioeconomically deprived population. This study was undertaken to assess the coverage of the scheme and to assess the reduction in medical out-of-pocket expenditure (OOPE). Methods: This was a cross-sectional study conducted among the urban slum dwellers in Mysuru. A semi-structured questionnaire was used for the study. Oral consent was taken from the participants before administering the questionnaire. Data were collected by face-to-face interviews. Statistical tests such as percentages and mean were calculated using SPSS software (Version 26, Licensed by JSSAHER). Results: The study was conducted among 104 individuals, of which 73% were females. Only 38 (33%) of the participants had PM-JAY cards while 59 (56.73%) did not have any health insurance. Thirty percentage (78.95%) of the card holders had utilized the insurance in the past 1 year and incurred an OOPE of Rs. 25,873/-. For all the cardholders, this amount was spent from their savings. Conclusion: The coverage of the scheme and OOPE reduction toward health care is still lacking. Greater measures need to be taken by medical officers, medicosocial workers, and other field workers to identify eligible households and help them avail the benefits of this scheme.
简介：2018年，印度政府推出了Pradhan Mantri Jan Arogya Yojana（PM-JAY），这是Ayushman Bharat计划的一部分，是迈向全民医疗保险的一个进步步骤。该计划旨在为社会经济贫困人口提供医疗保险。本研究旨在评估该计划的覆盖范围，并评估医疗自付支出（OOPE）的减少情况。方法：这是一项在迈苏鲁城市贫民窟居民中进行的横断面研究。本研究采用半结构化问卷。在进行问卷调查之前，获得参与者的口头同意。数据是通过面对面的访谈收集的。使用SPSS软件（26版，JSSAHER许可）计算百分比和平均值等统计测试。结果：研究对象为104人，其中73%为女性。只有38名（33%）参与者拥有PM-JAY卡，而59名（56.73%）参与者没有任何健康保险。30%（78.95%）的持卡人在过去一年中使用了保险，并产生了25873/-卢比的OOPE。对于所有持卡人来说，这笔钱都是从他们的储蓄中花掉的。结论：该计划的覆盖范围和减少OOPE对医疗保健的影响仍然不足。医务人员、医务工作者和其他现场工作人员需要采取更大的措施，以确定符合条件的家庭，并帮助他们享受该计划的福利。
{"title":"Assessing the coverage of the pradhan mantri jan arogya yojana scheme and out-of-pocket expenditure in Mysore Urban slum dwellers","authors":"V. Vadaga, Deepak Anil, Shabeena Akbar, M. Murthy, S. Doddaiah","doi":"10.4103/injms.injms_92_22","DOIUrl":"https://doi.org/10.4103/injms.injms_92_22","url":null,"abstract":"Introduction: In 2018, the Government of India launched the Pradhan Mantri Jan Arogya Yojana (PM-JAY), a part of the Ayushman Bharat scheme as a progressive step toward universal health coverage. The scheme was intended to provide health insurance for the socioeconomically deprived population. This study was undertaken to assess the coverage of the scheme and to assess the reduction in medical out-of-pocket expenditure (OOPE). Methods: This was a cross-sectional study conducted among the urban slum dwellers in Mysuru. A semi-structured questionnaire was used for the study. Oral consent was taken from the participants before administering the questionnaire. Data were collected by face-to-face interviews. Statistical tests such as percentages and mean were calculated using SPSS software (Version 26, Licensed by JSSAHER). Results: The study was conducted among 104 individuals, of which 73% were females. Only 38 (33%) of the participants had PM-JAY cards while 59 (56.73%) did not have any health insurance. Thirty percentage (78.95%) of the card holders had utilized the insurance in the past 1 year and incurred an OOPE of Rs. 25,873/-. For all the cardholders, this amount was spent from their savings. Conclusion: The coverage of the scheme and OOPE reduction toward health care is still lacking. Greater measures need to be taken by medical officers, medicosocial workers, and other field workers to identify eligible households and help them avail the benefits of this scheme.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"14 1","pages":"22 - 25"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49500467","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 : 2023-01-01DOI: 10.4103/injms.injms_130_22
Belfaiza Soukaina, M. Chatain, Benjelloul Fatiha
Primary sinonasal neuroendocrine carcinoma is a rare tumor of extreme malignancy. The diagnosis is often made at an advanced stage. The most recently documented treatment for nonmetastatic paranasal sinus neuroendocrine carcinoma consists of chemotherapy (cisplatin-VP16) followed by radiotherapy. Surgery is reserved for resectable tumors that do not respond well to chemotherapy. We report the case of a patient admitted for acute bilateral Retrobulbular optic neuropathy (RBON) revealing a sphenoethmoidal sinus neuroendocrine carcinoma.
{"title":"Acute bilateral retrobulbar optic neuritis revealing sphenoethmoidal sinus neuroendocrine carcinoma","authors":"Belfaiza Soukaina, M. Chatain, Benjelloul Fatiha","doi":"10.4103/injms.injms_130_22","DOIUrl":"https://doi.org/10.4103/injms.injms_130_22","url":null,"abstract":"Primary sinonasal neuroendocrine carcinoma is a rare tumor of extreme malignancy. The diagnosis is often made at an advanced stage. The most recently documented treatment for nonmetastatic paranasal sinus neuroendocrine carcinoma consists of chemotherapy (cisplatin-VP16) followed by radiotherapy. Surgery is reserved for resectable tumors that do not respond well to chemotherapy. We report the case of a patient admitted for acute bilateral Retrobulbular optic neuropathy (RBON) revealing a sphenoethmoidal sinus neuroendocrine carcinoma.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"14 1","pages":"60 - 62"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41922817","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 : 2023-01-01DOI: 10.4103/injms.injms_93_22
Divya Atray, S. Sheethal
Background: Lower respiratory tract infections (LRTIs) are one of the most frequent infections seen in humans. Bacterial etiology of these infections is one of the major causes of morbidity and mortality. The emergence of drug resistance among bacteria is increasing throughout the world causing more severe infections because of their continuous mutation and multidrug resistance nature. Objectives: This study was focused on obtaining a comprehensive insight into the Gram-negative bacillary profile of LRTIs, their prevalence, and their antibiotic susceptibility patterns. Materials and Methods: The study was conducted for a duration of 6 months. Samples were obtained from patients of all ages and both sexes presenting with symptomatology suggestive of LRTIs. Following conventional culture, the isolated organisms were identified by various preliminary identification methods and biochemical tests. Antimicrobial sensitivity testing of Gram-negative isolates was performed by standard methods as recommended by CLSI 2019. Results: Out of the 1724 LRT specimens evaluated, 307 (17.80%) were culture positive. Our study showed that Gram-negative bacilli are the predominant cause (97.70%) of LRTIs with Klebsiella pneumoniae (42%) as the major pathogen followed by Escherichia coli (31.66%), Pseudomonas aeruginosa (25.33%), and Acinetobacter baumannii (1%). Extended-spectrum beta-lactamase production was detected in 3.33% and metallo-beta-lactamase in 2% of the total GNB pathogens. Conclusion: For effective management of LRTIs, an ultimate and detailed bacteriological diagnosis along with antimicrobial susceptibility testing is required to overcome the global problem of antibiotic resistance.
{"title":"Bacteriological profile and antibiotic susceptibility patterns of Gram-negative bacilli isolated from lower respiratory tract infections","authors":"Divya Atray, S. Sheethal","doi":"10.4103/injms.injms_93_22","DOIUrl":"https://doi.org/10.4103/injms.injms_93_22","url":null,"abstract":"Background: Lower respiratory tract infections (LRTIs) are one of the most frequent infections seen in humans. Bacterial etiology of these infections is one of the major causes of morbidity and mortality. The emergence of drug resistance among bacteria is increasing throughout the world causing more severe infections because of their continuous mutation and multidrug resistance nature. Objectives: This study was focused on obtaining a comprehensive insight into the Gram-negative bacillary profile of LRTIs, their prevalence, and their antibiotic susceptibility patterns. Materials and Methods: The study was conducted for a duration of 6 months. Samples were obtained from patients of all ages and both sexes presenting with symptomatology suggestive of LRTIs. Following conventional culture, the isolated organisms were identified by various preliminary identification methods and biochemical tests. Antimicrobial sensitivity testing of Gram-negative isolates was performed by standard methods as recommended by CLSI 2019. Results: Out of the 1724 LRT specimens evaluated, 307 (17.80%) were culture positive. Our study showed that Gram-negative bacilli are the predominant cause (97.70%) of LRTIs with Klebsiella pneumoniae (42%) as the major pathogen followed by Escherichia coli (31.66%), Pseudomonas aeruginosa (25.33%), and Acinetobacter baumannii (1%). Extended-spectrum beta-lactamase production was detected in 3.33% and metallo-beta-lactamase in 2% of the total GNB pathogens. Conclusion: For effective management of LRTIs, an ultimate and detailed bacteriological diagnosis along with antimicrobial susceptibility testing is required to overcome the global problem of antibiotic resistance.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"14 1","pages":"31 - 36"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47186029","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 : 2023-01-01DOI: 10.4103/injms.injms_64_22
D. Mahapatra, N. Nair, Muhammad Ahsan Khan, V. Jha
Introduction: The Severe acute respiratory syndrome coronavirus 2 pandemic situation brings us the opportunity to test the strength and limitations of our health delivery system. Residents being the backbone of quality-health-delivery of any institute have taken the brunt. Materials and Methods: A cross-sectional self-administered questionnaire-based survey was used to assess the effect on medical training and stress of postgraduate residents in clinical specialties of armed forces institutions. Results: 266 valid responses were analyzed. Eighty-seven percent of residents felt their surgical/procedure-related training was affected. Bedside/clinical training was found to be affected by 92% and theoretical learning by 78%. A significant difference was found between residents in medical and allied specialties and residents in surgery and allied specialties (81% vs. 96.3%) with regard to the negative effect of the COVID-19 pandemic on surgical/procedural skills training (P < 0.05). There was a significant difference in the likelihood of being posted for COVID duties based on gender (P = 0.01) and year of the course (P = 0.004). Posting on COVID duties did not significantly affect surgical, clinical, or theoretical training. Of the respondents, 37%, 49%, and 14% had a mild, moderate, and severe increase in stress, respectively. 18%, 52%, and 30% experienced mild, moderate, and severe increased stress among family members. Gender, age, category, year of residency, or subject of specialization did not have any significant effect on the level of personal or family stress. Conclusion: This survey attempts to bring forth the effect of the pandemic on medical training schedules and stress among residents. Such surveys would enhance understanding and bring solutions to the problem that the pandemic has brought.
严重急性呼吸综合征(sars)冠状病毒大流行疫情为我们提供了检验卫生服务系统实力和局限性的机会。作为任何机构提供高质量医疗服务的支柱，住院医生首当其冲。材料与方法:采用横断面自填问卷调查的方法，对军队院校临床专科研究生住院医师的医学训练和心理压力的影响进行评估。结果:对266份有效问卷进行分析。87%的住院医生认为他们的外科相关培训受到了影响。研究发现，床边/临床培训受到92%的影响，理论学习受到78%的影响。在新冠肺炎大流行对外科/手术技能培训的负面影响方面，内科及专科住院医师与外科及专科住院医师的差异有统计学意义(81% vs. 96.3%) (P < 0.05)。根据性别(P = 0.01)和课程年份(P = 0.004)，被派去执行COVID职责的可能性存在显著差异。新冠肺炎值班对外科、临床或理论培训没有显著影响。在受访者中，分别有37%、49%和14%的人有轻度、中度和重度的压力增加。18%、52%和30%的家庭成员经历了轻度、中度和重度的压力增加。性别、年龄、类别、住院年份或专业科目对个人或家庭压力水平没有显著影响。结论:本调查旨在揭示疫情对住院医师医学培训时间和压力的影响。这种调查将增进了解，并为这一流行病带来的问题找到解决办法。
{"title":"Impact of severe acute respiratory syndrome-coronavirus-2 pandemic on postgraduate medical education in armed forces medical services institutions: A students' perspective","authors":"D. Mahapatra, N. Nair, Muhammad Ahsan Khan, V. Jha","doi":"10.4103/injms.injms_64_22","DOIUrl":"https://doi.org/10.4103/injms.injms_64_22","url":null,"abstract":"Introduction: The Severe acute respiratory syndrome coronavirus 2 pandemic situation brings us the opportunity to test the strength and limitations of our health delivery system. Residents being the backbone of quality-health-delivery of any institute have taken the brunt. Materials and Methods: A cross-sectional self-administered questionnaire-based survey was used to assess the effect on medical training and stress of postgraduate residents in clinical specialties of armed forces institutions. Results: 266 valid responses were analyzed. Eighty-seven percent of residents felt their surgical/procedure-related training was affected. Bedside/clinical training was found to be affected by 92% and theoretical learning by 78%. A significant difference was found between residents in medical and allied specialties and residents in surgery and allied specialties (81% vs. 96.3%) with regard to the negative effect of the COVID-19 pandemic on surgical/procedural skills training (P < 0.05). There was a significant difference in the likelihood of being posted for COVID duties based on gender (P = 0.01) and year of the course (P = 0.004). Posting on COVID duties did not significantly affect surgical, clinical, or theoretical training. Of the respondents, 37%, 49%, and 14% had a mild, moderate, and severe increase in stress, respectively. 18%, 52%, and 30% experienced mild, moderate, and severe increased stress among family members. Gender, age, category, year of residency, or subject of specialization did not have any significant effect on the level of personal or family stress. Conclusion: This survey attempts to bring forth the effect of the pandemic on medical training schedules and stress among residents. Such surveys would enhance understanding and bring solutions to the problem that the pandemic has brought.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"14 1","pages":"9 - 14"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47079009","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 : 2023-01-01DOI: 10.4103/injms.injms_107_22
S. Chandanwale, P. Patel, A. Verma, Nirali H. Patel
Gastrointestinal lipomatosis is less frequent condition and it differs from lipoma due to the lack of capsule. The most common location of gastrointestinal lipomatosis is colon, followed by the ileum and jejunum. Isolated lipomatosis of the appendix is rare. It can be diffuse, asymmetric, or focal. In the localized form, only few patients present with symptoms. Obstruction of the lumen of the appendix is thought to be the primary pathology of appendicitis. Various pathologies such as hard fecal mass, stones, lymphoid hyperplasia, and neoplasia have been implicated. Obstruction of the appendiceal lumen due to isolated submucosal lipomatosis of the appendix is extremely rare. It can be one of the causes of appendicitis. Although radiological modalities such as ultrasonography, computed tomography scan, and magnetic resonance imaging are used for diagnostic workups, definitive diagnosis requires histopathological examination.
{"title":"A focal submucosal lipomatosis: An extremely rare cause of appendicitis","authors":"S. Chandanwale, P. Patel, A. Verma, Nirali H. Patel","doi":"10.4103/injms.injms_107_22","DOIUrl":"https://doi.org/10.4103/injms.injms_107_22","url":null,"abstract":"Gastrointestinal lipomatosis is less frequent condition and it differs from lipoma due to the lack of capsule. The most common location of gastrointestinal lipomatosis is colon, followed by the ileum and jejunum. Isolated lipomatosis of the appendix is rare. It can be diffuse, asymmetric, or focal. In the localized form, only few patients present with symptoms. Obstruction of the lumen of the appendix is thought to be the primary pathology of appendicitis. Various pathologies such as hard fecal mass, stones, lymphoid hyperplasia, and neoplasia have been implicated. Obstruction of the appendiceal lumen due to isolated submucosal lipomatosis of the appendix is extremely rare. It can be one of the causes of appendicitis. Although radiological modalities such as ultrasonography, computed tomography scan, and magnetic resonance imaging are used for diagnostic workups, definitive diagnosis requires histopathological examination.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"14 1","pages":"45 - 46"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48810069","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 : 2023-01-01DOI: 10.4103/injms.injms_108_22
Chandragopal Dogne, J. Dudi, Nalini Dogne, S. Afrin, Abhay Singh, D. Raghunath, Salil Sakalle, V. Chellaiyan
Introduction: Quality of care in labor room and maternity operation theatre is crucial so that every pregnant woman receives the most appropriate care with dignity and respect, which is her fundamental right. The present study was attempted to assess the satisfaction of beneficiaries of both rural and urban areas visiting the public health facilities with regard to the quality of care and Respectful Maternal Care (RMC). Methodology: The present study was carried out in the Department of Community Medicine, MGM Medical College Indore to assess the satisfaction of beneficiaries of both rural and urban areas visiting the public health facilities with regard to the quality of care and Respectful Maternity Care (RMC) for 1 year from June 2020 to June 2021. A scoring system was used and based on the perception of the beneficiaries on different parameters on the scale of 1–5 where 1 – poor, 2 – satisfactory, 3 – good, 4 – very good, and 5 was considered excellent. Results: The majority of beneficiaries were in the age group of 21–30 years. Statistically significant difference between rural and urban areas in parameters of beneficiaries with regards to various aspects of post-natal care, in parameter of explanation of treatment procedure, maintenance of privacy efforts put to not allow to feel lonely and treatment with dignity and respect between rural and urban areas. Conclusion: When all the parameters and subparameters of the perception of beneficiaries of quality of care and respectful maternity care (RMC) were analyzed in both rural and urban areas, statistically significant difference was observed.
{"title":"Perception of beneficiaries regarding quality of care and respectful maternity care being provided in delivery room using LaQshya guidelines","authors":"Chandragopal Dogne, J. Dudi, Nalini Dogne, S. Afrin, Abhay Singh, D. Raghunath, Salil Sakalle, V. Chellaiyan","doi":"10.4103/injms.injms_108_22","DOIUrl":"https://doi.org/10.4103/injms.injms_108_22","url":null,"abstract":"Introduction: Quality of care in labor room and maternity operation theatre is crucial so that every pregnant woman receives the most appropriate care with dignity and respect, which is her fundamental right. The present study was attempted to assess the satisfaction of beneficiaries of both rural and urban areas visiting the public health facilities with regard to the quality of care and Respectful Maternal Care (RMC). Methodology: The present study was carried out in the Department of Community Medicine, MGM Medical College Indore to assess the satisfaction of beneficiaries of both rural and urban areas visiting the public health facilities with regard to the quality of care and Respectful Maternity Care (RMC) for 1 year from June 2020 to June 2021. A scoring system was used and based on the perception of the beneficiaries on different parameters on the scale of 1–5 where 1 – poor, 2 – satisfactory, 3 – good, 4 – very good, and 5 was considered excellent. Results: The majority of beneficiaries were in the age group of 21–30 years. Statistically significant difference between rural and urban areas in parameters of beneficiaries with regards to various aspects of post-natal care, in parameter of explanation of treatment procedure, maintenance of privacy efforts put to not allow to feel lonely and treatment with dignity and respect between rural and urban areas. Conclusion: When all the parameters and subparameters of the perception of beneficiaries of quality of care and respectful maternity care (RMC) were analyzed in both rural and urban areas, statistically significant difference was observed.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"14 1","pages":"26 - 30"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49109651","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 : 2023-01-01DOI: 10.4103/injms.injms_24_23
Maharshi Patel, Sourya Acharya, Sunil Kumar
Background: Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease. NAFLD has become the leading cause of liver disease globally. Hypothyroidism is a major factor in the development of NAFLD. Thus, the current investigation aimed to estimate the prevalence of NAFLD in individuals with hypothyroidism. Materials and Methods: This cross-sectional comparative study was conducted on 142 patients who qualified for the eligibility criteria. Proper history, examination, anthropometric measurements, and biochemical parameters were estimated. The collected data were entered in Excel and analyzed using the Statistical Package for Social Science 25 version developed by IBM (International Business Machine), IBM is a USA based company and the Student’s t-test and the Chi-square test were applied. Results: In this study, 12.6% of the treated subjects had fatty liver and 59.15% of the untreated subjects had fatty liver. From these untreated cases, fatty liver was found in 17.6% of subclinical hypothyroid subjects and 41.5% of overt hypothyroid subjects. There was a significant association between thyroid status and fatty liver (χ2 = 68.046, P < 0.001). Conclusions: We have found that NAFLD is more prevalent in untreated hypothyroid subjects. The severity of NAFLD is more in patients with overt hypothyroidism. Early treatment with thyroxine can prevent the progression of the fatty liver and grave consequences such as nonalcoholic steatohepatitis and cirrhosis.
背景:非酒精性脂肪性肝病(NAFLD)是慢性肝病最常见的病因之一。NAFLD已成为全球肝脏疾病的主要原因。甲状腺功能减退是NAFLD发展的主要因素。因此，本研究旨在估计NAFLD在甲状腺功能减退患者中的患病率。材料与方法:对142例符合入选标准的患者进行横断面比较研究。正确的病史，检查，人体测量和生化参数估计。收集到的数据在Excel中输入，并使用IBM(国际商业机器)开发的Statistical Package for Social Science 25版本进行分析，IBM是一家美国公司，使用学生t检验和卡方检验。结果:本研究中，治疗组肥胖率为12.6%，未治疗组肥胖率为59.15%。在这些未经治疗的病例中，17.6%的亚临床甲状腺功能减退患者和41.5%的明显甲状腺功能减退患者发现脂肪肝。甲状腺状态与脂肪肝有显著相关性(χ2 = 68.046, P < 0.001)。结论:我们发现NAFLD在未经治疗的甲状腺功能减退患者中更为普遍。伴有明显甲状腺功能减退的患者NAFLD的严重程度更高。早期用甲状腺素治疗可以预防脂肪肝的进展和严重后果，如非酒精性脂肪性肝炎和肝硬化。
{"title":"Prevalence of nonalcoholic fatty liver disease in hypothyroid subjects: A cross-sectional comparative study","authors":"Maharshi Patel, Sourya Acharya, Sunil Kumar","doi":"10.4103/injms.injms_24_23","DOIUrl":"https://doi.org/10.4103/injms.injms_24_23","url":null,"abstract":"Background: Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease. NAFLD has become the leading cause of liver disease globally. Hypothyroidism is a major factor in the development of NAFLD. Thus, the current investigation aimed to estimate the prevalence of NAFLD in individuals with hypothyroidism. Materials and Methods: This cross-sectional comparative study was conducted on 142 patients who qualified for the eligibility criteria. Proper history, examination, anthropometric measurements, and biochemical parameters were estimated. The collected data were entered in Excel and analyzed using the Statistical Package for Social Science 25 version developed by IBM (International Business Machine), IBM is a USA based company and the Student’s t-test and the Chi-square test were applied. Results: In this study, 12.6% of the treated subjects had fatty liver and 59.15% of the untreated subjects had fatty liver. From these untreated cases, fatty liver was found in 17.6% of subclinical hypothyroid subjects and 41.5% of overt hypothyroid subjects. There was a significant association between thyroid status and fatty liver (χ2 = 68.046, P < 0.001). Conclusions: We have found that NAFLD is more prevalent in untreated hypothyroid subjects. The severity of NAFLD is more in patients with overt hypothyroidism. Early treatment with thyroxine can prevent the progression of the fatty liver and grave consequences such as nonalcoholic steatohepatitis and cirrhosis.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135844884","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 : 2023-01-01DOI: 10.4103/injms.injms_39_23
AnshuGupta Devra, Gurleen Gill
The COVID-19 pandemic has changed the entire perspective of health-care scenario globally. Our fight against this virus is to enable ourselves to recognize early warning signs or biomarkers in those infected so that they can be allocated adequate health-care resources to decrease mortality and morbidity. It was for this reason that we analyzed the hematological parameter neutrophil-to-lymphocyte ratio (NLR) and inflammatory biomarker cytokine interleukin (IL)-6 to evaluate whether they can be used to predict the severity of COVID-19 infection and also to study if any significant association exist between the two. These parameters can be easily analyzed even in primary health-care setting to effectively triage patients requiring tertiary care/L-3 facilities. This study was conducted on 100 reverse transcription–polymerase chain reaction confirmed COVID-positive patients. The patients were then categorized into mild, moderate, and severe COVID at the time of admission according to the criteria laid down by symptoms and SpO2 levels at room air as defined by ICMR COVID guidelines by the Ministry of Health and Family Welfare[1] (MOHFW), Government of India, revised on January 14, 2022 – Mild disease – Upper respiratory tract symptoms and/or fever without shortness of breath or hypoxia Moderate disease – Any one of: Respiratory rate ≥24/min, SpO2: 90% to ≤93% on room air Severe disease – Any one of: Respiratory rate >30/min, SpO2 <90% on room air. For ease of comparison and to effectively evaluate high-risk patients, mild and moderate categories were clubbed together into nonsevere as they can be managed in L-2 facility. However, those falling in the severe category require L-3 facilities with advanced infrastructure and ICU facilities and are, therefore, categorized separately. Levels of IL-6 and NLR were compared between the two groups. NLR was derived by dividing the percentage of neutrophils to the percentage of lymphocytes after calculating differential leukocyte count taking the normal upper limit of NLR as 3.5, as identified by Forget et al.[2] for the adult nongeriatric population in good health.[2] The mean value of NLR in mild, moderate, and severe categories was 3.9, 3.1, and 6.7, respectively. On combining mild and moderate categories as nonsevere, the mean values of NLR obtained were 3.7, almost half of the NLR mean values observed in the severe category, i.e., 6.7. On applying the analysis of variance (ANOVA) t-test, a significant statistical correlation (P = 0.016) of NLR was found with clinical severity. Cytokine IL-6 is an inflammatory cytokine that has a role in different pathological conditions such as infections, inflammations, and in cancers. IL-6 is also considered the main culprit responsible for hyperinflammation, causing lung damage and eventually death in severe cases of COVID-19. The normal upper limit for IL-6 was set as 7 pg/ml. Out of 100 patients, those in the mild category had mean IL-6 levels of 30.8 pg/ml, moderate pat
{"title":"Role of interleukin-6 levels in predicting COVID severity: A single-center experience","authors":"AnshuGupta Devra, Gurleen Gill","doi":"10.4103/injms.injms_39_23","DOIUrl":"https://doi.org/10.4103/injms.injms_39_23","url":null,"abstract":"The COVID-19 pandemic has changed the entire perspective of health-care scenario globally. Our fight against this virus is to enable ourselves to recognize early warning signs or biomarkers in those infected so that they can be allocated adequate health-care resources to decrease mortality and morbidity. It was for this reason that we analyzed the hematological parameter neutrophil-to-lymphocyte ratio (NLR) and inflammatory biomarker cytokine interleukin (IL)-6 to evaluate whether they can be used to predict the severity of COVID-19 infection and also to study if any significant association exist between the two. These parameters can be easily analyzed even in primary health-care setting to effectively triage patients requiring tertiary care/L-3 facilities. This study was conducted on 100 reverse transcription–polymerase chain reaction confirmed COVID-positive patients. The patients were then categorized into mild, moderate, and severe COVID at the time of admission according to the criteria laid down by symptoms and SpO2 levels at room air as defined by ICMR COVID guidelines by the Ministry of Health and Family Welfare[1] (MOHFW), Government of India, revised on January 14, 2022 – Mild disease – Upper respiratory tract symptoms and/or fever without shortness of breath or hypoxia Moderate disease – Any one of: Respiratory rate ≥24/min, SpO2: 90% to ≤93% on room air Severe disease – Any one of: Respiratory rate >30/min, SpO2 <90% on room air. For ease of comparison and to effectively evaluate high-risk patients, mild and moderate categories were clubbed together into nonsevere as they can be managed in L-2 facility. However, those falling in the severe category require L-3 facilities with advanced infrastructure and ICU facilities and are, therefore, categorized separately. Levels of IL-6 and NLR were compared between the two groups. NLR was derived by dividing the percentage of neutrophils to the percentage of lymphocytes after calculating differential leukocyte count taking the normal upper limit of NLR as 3.5, as identified by Forget et al.[2] for the adult nongeriatric population in good health.[2] The mean value of NLR in mild, moderate, and severe categories was 3.9, 3.1, and 6.7, respectively. On combining mild and moderate categories as nonsevere, the mean values of NLR obtained were 3.7, almost half of the NLR mean values observed in the severe category, i.e., 6.7. On applying the analysis of variance (ANOVA) t-test, a significant statistical correlation (P = 0.016) of NLR was found with clinical severity. Cytokine IL-6 is an inflammatory cytokine that has a role in different pathological conditions such as infections, inflammations, and in cancers. IL-6 is also considered the main culprit responsible for hyperinflammation, causing lung damage and eventually death in severe cases of COVID-19. The normal upper limit for IL-6 was set as 7 pg/ml. Out of 100 patients, those in the mild category had mean IL-6 levels of 30.8 pg/ml, moderate pat","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135844878","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 : 2023-01-01DOI: 10.4103/injms.injms_28_23
Mansi Soni, Balaganapathy Muruganantham
Introduction: Physical activity is proven to have beneficial effects in the prevention and management of stroke. This makes it an important modifiable risk factor Stroke is a condition resulting in various functional deficits. The higher functional ability of stroke patients may result in their higher physical activity. Gait speed is a functional parameter to differentiate between the ability of mobility of patients with stroke. However, if it is reflected in the time spent in an activity needs to be explored. Objectives: This pilot study attempts to explore time spent in PA by ambulatory stroke patients and compare time spent in different activity levels based on gait speed. Subjects and Methods: This pilot study recruited 26 ambulatory patients with stroke after obtaining informed consent. Their PA was recorded with ActiGraph wGT3X-BT for 1 day. Differences in time spent in the different level of PA were compared between people with gait speed ≤0.49 m/s and >0.49 m/s. Results: The result of the study shows that patients with stroke having gait speed ≤0.49 m/s had higher time spent in sedentary (686.02 ± 80.35 min/day) and light activity (612 ± 69.84 min/day) as compared to those with >0.49 m/s (646.42 ± 137.52 min/day and 593.57 ± 119.95 min/day, respectively). While time spent in moderate activity was higher in patients with stroke having gait speed >0.49 m/s (199.73 ± 111.17 min/day) as compared to those whose gait speed was ≤0.49 m/s (141.84 ± 76.75 min/day). However, this difference failed to demonstrate statistical significance. Conclusion: Patients with stroke were less physically active as compared to recommendations. Gait speed-based comparison demonstrates a nonsignificant difference between both groups. This suggests that factors other than gait speed may contribute to ambulatory stroke patients’ time spent in PA.
{"title":"Time spent in physical activity by ambulatory stroke patients and its comparison based on gait speed – A pilot study","authors":"Mansi Soni, Balaganapathy Muruganantham","doi":"10.4103/injms.injms_28_23","DOIUrl":"https://doi.org/10.4103/injms.injms_28_23","url":null,"abstract":"Introduction: Physical activity is proven to have beneficial effects in the prevention and management of stroke. This makes it an important modifiable risk factor Stroke is a condition resulting in various functional deficits. The higher functional ability of stroke patients may result in their higher physical activity. Gait speed is a functional parameter to differentiate between the ability of mobility of patients with stroke. However, if it is reflected in the time spent in an activity needs to be explored. Objectives: This pilot study attempts to explore time spent in PA by ambulatory stroke patients and compare time spent in different activity levels based on gait speed. Subjects and Methods: This pilot study recruited 26 ambulatory patients with stroke after obtaining informed consent. Their PA was recorded with ActiGraph wGT3X-BT for 1 day. Differences in time spent in the different level of PA were compared between people with gait speed ≤0.49 m/s and >0.49 m/s. Results: The result of the study shows that patients with stroke having gait speed ≤0.49 m/s had higher time spent in sedentary (686.02 ± 80.35 min/day) and light activity (612 ± 69.84 min/day) as compared to those with >0.49 m/s (646.42 ± 137.52 min/day and 593.57 ± 119.95 min/day, respectively). While time spent in moderate activity was higher in patients with stroke having gait speed >0.49 m/s (199.73 ± 111.17 min/day) as compared to those whose gait speed was ≤0.49 m/s (141.84 ± 76.75 min/day). However, this difference failed to demonstrate statistical significance. Conclusion: Patients with stroke were less physically active as compared to recommendations. Gait speed-based comparison demonstrates a nonsignificant difference between both groups. This suggests that factors other than gait speed may contribute to ambulatory stroke patients’ time spent in PA.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"115 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135845190","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}
Hypotensive anesthesia in specific types of surgeries brings about certain advantages such as decreased blood loss as well as better surgeon satisfaction regarding the surgical field. Of the various modalities by which this can be achieved, one of the most popular is by introducing a hypotensive agent to bring about the desired hypotension. Here, we aim to review a few studies regarding the use of various hypotensive agents for hypotensive anesthesia and try to come to learn the various modes of action of these said drugs, their specific indications or situations where they may be preferred as well as the various advantages and disadvantages that accompany their use.
{"title":"Drugs for hypotensive anesthesia: A narrative review","authors":"TKrishna Prasad, RobinSajan Chacko, KSoundarya Priyadharsini","doi":"10.4103/injms.injms_18_23","DOIUrl":"https://doi.org/10.4103/injms.injms_18_23","url":null,"abstract":"Hypotensive anesthesia in specific types of surgeries brings about certain advantages such as decreased blood loss as well as better surgeon satisfaction regarding the surgical field. Of the various modalities by which this can be achieved, one of the most popular is by introducing a hypotensive agent to bring about the desired hypotension. Here, we aim to review a few studies regarding the use of various hypotensive agents for hypotensive anesthesia and try to come to learn the various modes of action of these said drugs, their specific indications or situations where they may be preferred as well as the various advantages and disadvantages that accompany their use.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135845192","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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