Amit Mandal, R. Iyyadurai, KFibi Ninan, Karthik Gunasekaran
Background and Aim: Hyperglycemia has a significant negative impact on the morbidity and mortality of patients presenting with acute myocardial infarction. This retrospective study was conducted to determine the short-term clinical outcomes (inhospital mortality, cardiogenic shock, acute heart failure, stroke, fatal arrhythmia, and length of stay) of patients with non-ST-elevation myocardial infarction (NSTEMI) patients and to compare the outcomes in NSTEMI patients with and without hyperglycemia on admission. We also wanted to identify the clinical profile and assess the mortality rates in patients with NSTEMI. Materials and Methods: This retrospective study was conducted over 7 years (April 1, 2014–July 31, 2021). The data were extracted from the inpatient medical records and it was analyzed. All adult patients requiring admission in a single medical unit with a diagnosis of NSTEMI were included in the study. Descriptive statistics were obtained for all variables and entered in MS Excel and analyzed with SPSS (SPSS for Windows, version 16.0, Chicago, IL, USA) in the study, and appropriate statistical tests like P value were employed to ascertain the significance. Factors that were significant in univariate analysis were tested by multivariate regression analysis to identify those that independently predicted poor outcomes. Results: Our study cohort consisted of 260 patients, 144 (55.4%) patients had hyperglycemia on admission (admission blood sugar >200 mg/dl), and 116 (44.6%) had normoglycemia. In our cohort, 166 (63.8%) were male. The most common comorbidity was diabetes mellitus 195 (75%) and 134 (68.7%) diabetic patients had hyperglycemia at presentation. The most common clinical outcome was acute heart failure in 225 (86.5%), followed by cardiogenic shock in 110 (42.3%) patients. Fifteen (5.8%) patients had acute cerebrovascular accident during the hospital stay and 39 (15%) had developed fatal arrhythmias. The mean ± standard deviation duration of hospital stay was of 7.09 ± 5.396 days. The mortality in this cohort was 67 (25.8%). The presence of hyperglycemia on admission was not found to have an effect on mortality (odds ratio [OR]: 0.61, 95% confidence interval [CI]: 0.34–1.10, P = 0.102); however, the presence of hyperglycemia on admission was an independent predictor of cardiogenic shock (OR: 2.18, 95% CI: 1.069–4.483, P = 0.032), acute heart failure (OR: 3.52, 95% CI: 1.44–8.59, P = 0.006), and acute cerebrovascular accident (OR: 13.76, 95% CI: 1.67–112.0, P = 0.015). Conclusions: The presence of hyperglycemia on admission is an independent predictor of short-term outcomes such as cardiogenic shock, acute heart failure, and acute cerebrovascular accident; however, it does not have an effect on inhospital mortality. NSTEMI is associated with significant mortality.
背景和目的：高血糖对急性心肌梗死患者的发病率和死亡率有显著的负面影响。本回顾性研究旨在确定非ST段抬高型心肌梗死（NSTEMI）患者的短期临床结果（住院死亡率、心源性休克、急性心力衰竭、中风、致命性心律失常和住院时间），并比较入院时伴有和不伴有高血糖的NSTEMI患者的结果。我们还想确定NSTEMI患者的临床特征并评估其死亡率。材料和方法：本回顾性研究历时7年（2014年4月1日至2021年7月31日）。这些数据是从住院患者的医疗记录中提取的，并进行了分析。所有被诊断为非ST段抬高型脊髓炎性脊髓炎性脑脊髓炎需要入住单一医疗单位的成年患者都被纳入研究。对所有变量进行描述性统计，并将其输入MS Excel中，并在研究中使用SPSS（SPSS for Windows，版本16.0，Chicago，IL，USA）进行分析，并使用适当的统计检验（如P值）来确定显著性。通过多元回归分析对单变量分析中显著的因素进行测试，以确定那些独立预测不良结果的因素。结果：我们的研究队列由260名患者组成，144名（55.4%）患者入院时出现高血糖（入院血糖>200 mg/dl），116名（44.6%）血糖正常。在我们的队列中，166人（63.8%）是男性。最常见的合并症是糖尿病195例（75%）和134例（68.7%）糖尿病患者出现高血糖。最常见的临床结果是225例（86.5%）的急性心力衰竭，其次是110例（42.3%）的心源性休克。15名（5.8%）患者在住院期间发生急性脑血管意外，39名（15%）患者出现致命心律失常。住院时间平均±标准差为7.09±5.396天。该队列的死亡率为67（25.8%）。入院时高血糖的存在对死亡率没有影响（比值比[OR]:0.61，95%置信区间[CI]:0.34-1.10，P=0.102）；然而，入院时高血糖的存在是心源性休克（OR:2.18，95%CI:1.069-4.483，P=0.032）、急性心力衰竭（OR:3.52，95%CI:1.44-8.59，P=0.006）的独立预测因素，和急性脑血管意外（OR:13.76，95%CI:1.67–112.0，P=0.015）。结论：入院时高血糖的存在是心源性休克、急性心力衰竭和急性脑动脉意外等短期结果的独立预测因素；然而，它对住院死亡率没有影响。NSTEMI与显著的死亡率相关。
{"title":"Prevalence of hyperglycemia on admission and its effect on short-term cardiovascular outcomes of non-ST elevation myocardial infarction: A retrospective study from a tertiary care center in South India","authors":"Amit Mandal, R. Iyyadurai, KFibi Ninan, Karthik Gunasekaran","doi":"10.4103/amhs.amhs_28_23","DOIUrl":"https://doi.org/10.4103/amhs.amhs_28_23","url":null,"abstract":"Background and Aim: Hyperglycemia has a significant negative impact on the morbidity and mortality of patients presenting with acute myocardial infarction. This retrospective study was conducted to determine the short-term clinical outcomes (inhospital mortality, cardiogenic shock, acute heart failure, stroke, fatal arrhythmia, and length of stay) of patients with non-ST-elevation myocardial infarction (NSTEMI) patients and to compare the outcomes in NSTEMI patients with and without hyperglycemia on admission. We also wanted to identify the clinical profile and assess the mortality rates in patients with NSTEMI. Materials and Methods: This retrospective study was conducted over 7 years (April 1, 2014–July 31, 2021). The data were extracted from the inpatient medical records and it was analyzed. All adult patients requiring admission in a single medical unit with a diagnosis of NSTEMI were included in the study. Descriptive statistics were obtained for all variables and entered in MS Excel and analyzed with SPSS (SPSS for Windows, version 16.0, Chicago, IL, USA) in the study, and appropriate statistical tests like P value were employed to ascertain the significance. Factors that were significant in univariate analysis were tested by multivariate regression analysis to identify those that independently predicted poor outcomes. Results: Our study cohort consisted of 260 patients, 144 (55.4%) patients had hyperglycemia on admission (admission blood sugar >200 mg/dl), and 116 (44.6%) had normoglycemia. In our cohort, 166 (63.8%) were male. The most common comorbidity was diabetes mellitus 195 (75%) and 134 (68.7%) diabetic patients had hyperglycemia at presentation. The most common clinical outcome was acute heart failure in 225 (86.5%), followed by cardiogenic shock in 110 (42.3%) patients. Fifteen (5.8%) patients had acute cerebrovascular accident during the hospital stay and 39 (15%) had developed fatal arrhythmias. The mean ± standard deviation duration of hospital stay was of 7.09 ± 5.396 days. The mortality in this cohort was 67 (25.8%). The presence of hyperglycemia on admission was not found to have an effect on mortality (odds ratio [OR]: 0.61, 95% confidence interval [CI]: 0.34–1.10, P = 0.102); however, the presence of hyperglycemia on admission was an independent predictor of cardiogenic shock (OR: 2.18, 95% CI: 1.069–4.483, P = 0.032), acute heart failure (OR: 3.52, 95% CI: 1.44–8.59, P = 0.006), and acute cerebrovascular accident (OR: 13.76, 95% CI: 1.67–112.0, P = 0.015). Conclusions: The presence of hyperglycemia on admission is an independent predictor of short-term outcomes such as cardiogenic shock, acute heart failure, and acute cerebrovascular accident; however, it does not have an effect on inhospital mortality. NSTEMI is associated with significant mortality.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41271821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and Aim: COVID-19, one of the deadliest pandemics, has taken a toll on physical and mental health alike. It has been noticed that there is a rise in psychiatric comorbidities in COVID-19 recovered cases. Various disorders such as posttraumatic stress disorder, anxiety, depression, and sleep disorders have been reported in COVID-19 survivors. The current study aims to estimate the prevalence of psychiatric disorders and their associated correlation in patients with a history of COVID-19. Materials and Methods: The study population comprised the patients referred to the psychiatry outpatient department (OPD) from the post-COVID-19 OPD over 3 months. Patients were assessed using a semi-structured pro forma, sociodemographic profile, treatment facility (institutional or home quarantined), duration of stay at the treatment facility, and medical and psychiatric diagnoses were recorded and analyzed using descriptive statistics. Results: One hundred and sixty patients were included and assessed of which 66.25% were male and 33.75% were female. The mean age was 38.8 years. The referral rate was found to be 15.9%. The most common psychiatric disorder was sleep disorder (25%), followed by Reaction to severe stress and adjustment disorder (16.25%), depression (11.25%), and anxiety disorder (10%). Conclusion: We would like to emphasize on vigilant approach and constant supervision of these patients so that an early diagnosis could be made and an add-on the burden to the mental health care system could be reduced. For this to be achieved screening of such patients should be increased.
{"title":"A study of post COVID-19 psychiatric disorders in a tertiary care hospital of central India","authors":"V. Mudgal, P. Rastogi, P. Jain, Partik Kaur","doi":"10.4103/amhs.amhs_12_23","DOIUrl":"https://doi.org/10.4103/amhs.amhs_12_23","url":null,"abstract":"Background and Aim: COVID-19, one of the deadliest pandemics, has taken a toll on physical and mental health alike. It has been noticed that there is a rise in psychiatric comorbidities in COVID-19 recovered cases. Various disorders such as posttraumatic stress disorder, anxiety, depression, and sleep disorders have been reported in COVID-19 survivors. The current study aims to estimate the prevalence of psychiatric disorders and their associated correlation in patients with a history of COVID-19. Materials and Methods: The study population comprised the patients referred to the psychiatry outpatient department (OPD) from the post-COVID-19 OPD over 3 months. Patients were assessed using a semi-structured pro forma, sociodemographic profile, treatment facility (institutional or home quarantined), duration of stay at the treatment facility, and medical and psychiatric diagnoses were recorded and analyzed using descriptive statistics. Results: One hundred and sixty patients were included and assessed of which 66.25% were male and 33.75% were female. The mean age was 38.8 years. The referral rate was found to be 15.9%. The most common psychiatric disorder was sleep disorder (25%), followed by Reaction to severe stress and adjustment disorder (16.25%), depression (11.25%), and anxiety disorder (10%). Conclusion: We would like to emphasize on vigilant approach and constant supervision of these patients so that an early diagnosis could be made and an add-on the burden to the mental health care system could be reduced. For this to be achieved screening of such patients should be increased.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48819843","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}
Clinical microbiology is fast expanding its horizons, not confined to the realms of laboratory alone, but stretching into the wards, intensive care units, and operation theaters. Preventive strategies such as proper hand washing, an unfailing compliance to device-related bundle care protocols, and antimicrobial stewardship guidelines are the need of the hour. Every bug in the laboratory needs to be seen in clinical context and for this to occur an active interaction between the clinician and microbiologist is of paramount importance. There is a definite need for more multidisciplinary approach and clinical case discussions.
{"title":"The clinician–microbiologist handshake: Need of the hour","authors":"E. Rajni, V. Garg","doi":"10.4103/amhs.amhs_21_23","DOIUrl":"https://doi.org/10.4103/amhs.amhs_21_23","url":null,"abstract":"Clinical microbiology is fast expanding its horizons, not confined to the realms of laboratory alone, but stretching into the wards, intensive care units, and operation theaters. Preventive strategies such as proper hand washing, an unfailing compliance to device-related bundle care protocols, and antimicrobial stewardship guidelines are the need of the hour. Every bug in the laboratory needs to be seen in clinical context and for this to occur an active interaction between the clinician and microbiologist is of paramount importance. There is a definite need for more multidisciplinary approach and clinical case discussions.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45469348","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}
R. Kulkarni, Rhea Singh, Himanshu Gohatre, Sabahat Ahmed, Palash Sangai, D. Ambike
Systemic lupus erythematosus (SLE) is an autoimmune disease-causing inflammatory tissue damage with multiple organ involvement. We report a 12-year-old girl who presented with 6-month history of high-grade intermittent fever and weight loss, psychiatric symptoms beginning 10 days before admission, and generalized tonic–clonic seizure 4 days before admission to our hospital. Investigation excluded infectious etiology. Immunological workup revealed high titer of antinuclear and anti-double-stranded DNA antibodies. She was treated with steroids and azathioprine and responded well to treatment. It is important to have a very high index of suspicion for the diagnosis of SLE for early diagnosis, treatment, and meticulous monitoring.
{"title":"Juvenile systemic lupus erythematosus with primary neuropsychiatric presentation","authors":"R. Kulkarni, Rhea Singh, Himanshu Gohatre, Sabahat Ahmed, Palash Sangai, D. Ambike","doi":"10.4103/amhs.amhs_24_23","DOIUrl":"https://doi.org/10.4103/amhs.amhs_24_23","url":null,"abstract":"Systemic lupus erythematosus (SLE) is an autoimmune disease-causing inflammatory tissue damage with multiple organ involvement. We report a 12-year-old girl who presented with 6-month history of high-grade intermittent fever and weight loss, psychiatric symptoms beginning 10 days before admission, and generalized tonic–clonic seizure 4 days before admission to our hospital. Investigation excluded infectious etiology. Immunological workup revealed high titer of antinuclear and anti-double-stranded DNA antibodies. She was treated with steroids and azathioprine and responded well to treatment. It is important to have a very high index of suspicion for the diagnosis of SLE for early diagnosis, treatment, and meticulous monitoring.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46920177","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}
MallikaS Shetty, Hasan Sarfaraz, Jeevika Darshan, Shazia Amreen
Background and Aim: Stomatitis being one of the most common oral complications of radiotherapy increases the mortality rates in patients with head and neck cancer. Providing preventive measures and cure for these side effects right after their onset is of primary importance. The aim of this study was to assess the effect of honey on radiation induced stomatitis in head and neck cancer patients. Materials and Methods: Thirty patients diagnosed with head-and-neck cancer requiring radiation or radiation combined with chemotherapy were divided into two groups. Patients of Group 1 were advised to mix 3 mL of chlorhexidine in 100 mL of water and rinse for about 1 min. Patients of Group 2 were advised to take 20 mL of honey in a glass of water and divide it into two equal parts and then rinse each part for about 30 s. Patients were evaluated at baseline, week 1, and week 2 for the development of radiation-induced stomatitis using the WHO Mucositis Scale. Results: The grade of stomatitis in head-and-neck cancer patients undergoing radiotherapy, treated with honey, was significantly lower than those treated with chlorhexidine (P < 0.05 for each). Conclusions: Topical application of honey is a simple and cost-effective treatment in radiation-induced stomatitis which needs further multicenter randomized trials to validate our finding. The results of the present study conducted on head-and-neck cancer patients will be useful in the administration of oral care. These findings are also important to the nurses who are assigned with the responsibility of stomatitis management.
{"title":"Assessment of the effect of honey and chlorhexidine on radiation-induced oral stomatitis with head-and-neck cancer patients","authors":"MallikaS Shetty, Hasan Sarfaraz, Jeevika Darshan, Shazia Amreen","doi":"10.4103/amhs.amhs_98_23","DOIUrl":"https://doi.org/10.4103/amhs.amhs_98_23","url":null,"abstract":"Background and Aim: Stomatitis being one of the most common oral complications of radiotherapy increases the mortality rates in patients with head and neck cancer. Providing preventive measures and cure for these side effects right after their onset is of primary importance. The aim of this study was to assess the effect of honey on radiation induced stomatitis in head and neck cancer patients. Materials and Methods: Thirty patients diagnosed with head-and-neck cancer requiring radiation or radiation combined with chemotherapy were divided into two groups. Patients of Group 1 were advised to mix 3 mL of chlorhexidine in 100 mL of water and rinse for about 1 min. Patients of Group 2 were advised to take 20 mL of honey in a glass of water and divide it into two equal parts and then rinse each part for about 30 s. Patients were evaluated at baseline, week 1, and week 2 for the development of radiation-induced stomatitis using the WHO Mucositis Scale. Results: The grade of stomatitis in head-and-neck cancer patients undergoing radiotherapy, treated with honey, was significantly lower than those treated with chlorhexidine (P < 0.05 for each). Conclusions: Topical application of honey is a simple and cost-effective treatment in radiation-induced stomatitis which needs further multicenter randomized trials to validate our finding. The results of the present study conducted on head-and-neck cancer patients will be useful in the administration of oral care. These findings are also important to the nurses who are assigned with the responsibility of stomatitis management.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135006727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and Aim: The low acceptance rate of the vaccine in rural India has been acting as a hurdle to achieving herd immunity against multiple active variants of coronavirus. A large section of the rural population is prone to COVID-19 infection due to their negative perception of vaccination and their inability to access it. Therefore, this study aims to evaluate acceptance rate of the vaccine along with the major factors determining the non-receptivity of the COVID-19 vaccine among rural people. Methods: A hospital-based cross-sectional study was conducted in rural Rajasthan from August to November 2021. Out of 138 participants, 110 rural adults from different villages who were not yet vaccinated were interviewed using a semi-structured schedule. The characteristics of participants and factors determining COVID-19 vaccination hesitancy were assessed using MS Excel 2021 and STATA 13.1. Results: The side effects of the COVID-19 vaccine were the major reason for hesitancy among respondents (71%). Many respondents (51%) reported that the vaccine portal was not user-friendly and not working properly; in addition, the volatility of the network makes slot booking more difficult. Due to the shortage of vaccines and the absence or low numbers of medical staff, some respondents (>40%) attributed the inefficacy of health care centers as a cause for not getting vaccinated. Fifty-three percentage of respondents rejected the vaccine due to political orientation, and ~40% believed that the vaccine was being tested first on poor rural people. Lack of awareness and ignorance led to half of the population postponing it. Thirty-five percentage of them argued that the vaccine does not cure COVID-19, and 37% feared that the vaccine could lead to death. Many women (56%) were dependent on men or elders for access to health care centers and considered it necessary for men only. Conclusion: The findings of this study highlight the major hurdles to ensuring the equitable coverage of vaccination in rural India, which reflect the urgent need for awareness campaigns and door-to-door vaccination to prevent community transmission among the rural population of India.
{"title":"COVID-19 vaccination hesitancy in rural setting of Western India: A cross-sectional study","authors":"Shardhanjali Sinha, Antriksha Sen, Astha Ranjan","doi":"10.4103/amhs.amhs_57_23","DOIUrl":"https://doi.org/10.4103/amhs.amhs_57_23","url":null,"abstract":"Background and Aim: The low acceptance rate of the vaccine in rural India has been acting as a hurdle to achieving herd immunity against multiple active variants of coronavirus. A large section of the rural population is prone to COVID-19 infection due to their negative perception of vaccination and their inability to access it. Therefore, this study aims to evaluate acceptance rate of the vaccine along with the major factors determining the non-receptivity of the COVID-19 vaccine among rural people. Methods: A hospital-based cross-sectional study was conducted in rural Rajasthan from August to November 2021. Out of 138 participants, 110 rural adults from different villages who were not yet vaccinated were interviewed using a semi-structured schedule. The characteristics of participants and factors determining COVID-19 vaccination hesitancy were assessed using MS Excel 2021 and STATA 13.1. Results: The side effects of the COVID-19 vaccine were the major reason for hesitancy among respondents (71%). Many respondents (51%) reported that the vaccine portal was not user-friendly and not working properly; in addition, the volatility of the network makes slot booking more difficult. Due to the shortage of vaccines and the absence or low numbers of medical staff, some respondents (>40%) attributed the inefficacy of health care centers as a cause for not getting vaccinated. Fifty-three percentage of respondents rejected the vaccine due to political orientation, and ~40% believed that the vaccine was being tested first on poor rural people. Lack of awareness and ignorance led to half of the population postponing it. Thirty-five percentage of them argued that the vaccine does not cure COVID-19, and 37% feared that the vaccine could lead to death. Many women (56%) were dependent on men or elders for access to health care centers and considered it necessary for men only. Conclusion: The findings of this study highlight the major hurdles to ensuring the equitable coverage of vaccination in rural India, which reflect the urgent need for awareness campaigns and door-to-door vaccination to prevent community transmission among the rural population of India.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135007003","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/amhs.amhs_141_23
Swati Raj, Neelima Bahal
Department of Pathology, Government Doon Medical College, Dehradun, Uttarakhand, India Address for correspondence: Dr. Swati Raj, 316/14 Vijay Park Extension, Dehradun, Uttarakhand, India. E-mail: [email protected] Received May 31, 2023 Received in revised form June 26, 2023 Accepted June 27, 2023
{"title":"Melamed–Wolinska bodies in urine cytology of an infant diagnosed with Wilm's tumor","authors":"Swati Raj, Neelima Bahal","doi":"10.4103/amhs.amhs_141_23","DOIUrl":"https://doi.org/10.4103/amhs.amhs_141_23","url":null,"abstract":"Department of Pathology, Government Doon Medical College, Dehradun, Uttarakhand, India Address for correspondence: Dr. Swati Raj, 316/14 Vijay Park Extension, Dehradun, Uttarakhand, India. E-mail: [email protected] Received May 31, 2023 Received in revised form June 26, 2023 Accepted June 27, 2023","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135008120","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/amhs.amhs_206_23
PratikB Kariya, AishwaryaVineshkumar Antala
Dental anxiety refers to the negative emotional response of fear or avoiding dental care, which is exhibited by cognitive, physiological, and motor reactions when related to dental visits or dental treatment. Diverse approaches have been put forth to manage these adverse reactions during dental treatment, with the main emphasis on nonpharmacological and pharmacological management or altering the environment. Animal-assisted therapy (AAT) has been suggested as an alternative to conventional methods that, according to prior research on human-animal interactions, has soothing benefits for individuals. Numerous articles have shown that activities involving pets help to lessen tension in dental practice. A trained animal is used in health care as a goal-oriented intervention to enhance interactions or lessen a patient's fear and discomfort. AAT appointments are arranged for a set time and duration to include an animal that has completed temperament testing, intensive training, and certification, in contrast to animal-assisted activities. The companion animal, which is available for the company throughout the dentist appointment, can assist in removing barriers to communication and enabling the patient to build a secure and soothing bond, minimizing treatment-related stress. By conducting this review, we would like to emphasize on benefits and obstacles of AAT for behavior management in pediatric dental procedures.
{"title":"Healing smiles: Enhancing pediatric dental care through animal-assisted therapy – A narrative review","authors":"PratikB Kariya, AishwaryaVineshkumar Antala","doi":"10.4103/amhs.amhs_206_23","DOIUrl":"https://doi.org/10.4103/amhs.amhs_206_23","url":null,"abstract":"Dental anxiety refers to the negative emotional response of fear or avoiding dental care, which is exhibited by cognitive, physiological, and motor reactions when related to dental visits or dental treatment. Diverse approaches have been put forth to manage these adverse reactions during dental treatment, with the main emphasis on nonpharmacological and pharmacological management or altering the environment. Animal-assisted therapy (AAT) has been suggested as an alternative to conventional methods that, according to prior research on human-animal interactions, has soothing benefits for individuals. Numerous articles have shown that activities involving pets help to lessen tension in dental practice. A trained animal is used in health care as a goal-oriented intervention to enhance interactions or lessen a patient's fear and discomfort. AAT appointments are arranged for a set time and duration to include an animal that has completed temperament testing, intensive training, and certification, in contrast to animal-assisted activities. The companion animal, which is available for the company throughout the dentist appointment, can assist in removing barriers to communication and enabling the patient to build a secure and soothing bond, minimizing treatment-related stress. By conducting this review, we would like to emphasize on benefits and obstacles of AAT for behavior management in pediatric dental procedures.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135008381","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}
R. Chacko, K. Priyadharsini, Mohamed Arif, T. Prasad
Background and Aim: Induced hypotension is advantageous in certain types of procedures like endoscopic surgeries in which it establishes a clear surgical field and simultaneously reduces surgical blood loss. The quest for an ideal hypotensive agent still continues in this modern era where many classes of antihypertensive drugs are being studied to provide a predictable and safe reduction in blood pressure with least side effect profile. In this study, we aimed to assess the efficacy of dexmedetomidine and labetalol in providing hypotensive anesthesia in patients undergoing ear, nose, and throat surgeries. Materials and Methods: This was a prospective, double-blinded, randomized controlled study. Fifty-eight individuals undergoing ear, nose, and throat surgeries were randomly divided into two groups (Groups A and B). Group A received an intravenous infusion of 0.25 mg/kg of labetalol as a bolus over a period of 10 min before induction of anesthesia and it was followed by a maintenance infusion of 30 mg/h till the end of surgery. Group B received a loading dose of 1 μg/kg of dexmedetomidine intravenously over a period of 10 min before induction of anesthesia and it was followed by a maintenance infusion of 0.4 μg/kg/h till the end of surgery. In both the groups, diastolic blood pressure (DBP), systolic blood pressure (SBP), mean arterial pressure (MAP), heart rate, and oxy-hemoglobin saturation (SpO2) were recorded. These study variables were recorded before the administration of the study drug, immediately after the administration of the bolus dose of study drug, at the time of induction of anesthesia, immediately after intubation, and then at regular intervals until the end of the surgery. In addition to the abovementioned study, variables blood loss, recovery time, and surgeon satisfaction were also recorded. Results: The heart rate was significantly lower in Group B when compared to Group A at various time intervals. There was no significant difference between the two groups in terms of DBP, SBP, MAP, and SpO2. The blood loss was lesser and the surgeon satisfaction was better in Group B when compared to Group A. The difference in blood loss and surgeon satisfaction was statistically significant between the two groups. However, the recovery time was faster in Group A and the difference was statistically significant. Conclusions: Patients in both the groups showed a reduction in blood pressure, but dexmedetomidine was associated with greater reduction in heart rate, lesser blood loss, and more surgeon satisfaction, whereas labetalol was associated with faster recovery from anesthesia.
{"title":"A randomized control trial to compare the efficacy of dexmedetomidine and labetalol for induced hypotensive anesthesia in ear, nose, and throat surgeries","authors":"R. Chacko, K. Priyadharsini, Mohamed Arif, T. Prasad","doi":"10.4103/amhs.amhs_34_23","DOIUrl":"https://doi.org/10.4103/amhs.amhs_34_23","url":null,"abstract":"Background and Aim: Induced hypotension is advantageous in certain types of procedures like endoscopic surgeries in which it establishes a clear surgical field and simultaneously reduces surgical blood loss. The quest for an ideal hypotensive agent still continues in this modern era where many classes of antihypertensive drugs are being studied to provide a predictable and safe reduction in blood pressure with least side effect profile. In this study, we aimed to assess the efficacy of dexmedetomidine and labetalol in providing hypotensive anesthesia in patients undergoing ear, nose, and throat surgeries. Materials and Methods: This was a prospective, double-blinded, randomized controlled study. Fifty-eight individuals undergoing ear, nose, and throat surgeries were randomly divided into two groups (Groups A and B). Group A received an intravenous infusion of 0.25 mg/kg of labetalol as a bolus over a period of 10 min before induction of anesthesia and it was followed by a maintenance infusion of 30 mg/h till the end of surgery. Group B received a loading dose of 1 μg/kg of dexmedetomidine intravenously over a period of 10 min before induction of anesthesia and it was followed by a maintenance infusion of 0.4 μg/kg/h till the end of surgery. In both the groups, diastolic blood pressure (DBP), systolic blood pressure (SBP), mean arterial pressure (MAP), heart rate, and oxy-hemoglobin saturation (SpO2) were recorded. These study variables were recorded before the administration of the study drug, immediately after the administration of the bolus dose of study drug, at the time of induction of anesthesia, immediately after intubation, and then at regular intervals until the end of the surgery. In addition to the abovementioned study, variables blood loss, recovery time, and surgeon satisfaction were also recorded. Results: The heart rate was significantly lower in Group B when compared to Group A at various time intervals. There was no significant difference between the two groups in terms of DBP, SBP, MAP, and SpO2. The blood loss was lesser and the surgeon satisfaction was better in Group B when compared to Group A. The difference in blood loss and surgeon satisfaction was statistically significant between the two groups. However, the recovery time was faster in Group A and the difference was statistically significant. Conclusions: Patients in both the groups showed a reduction in blood pressure, but dexmedetomidine was associated with greater reduction in heart rate, lesser blood loss, and more surgeon satisfaction, whereas labetalol was associated with faster recovery from anesthesia.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42647032","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}
There has been concern that patients with asthma may develop more severe disease as a result of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Recent studies towards the exploration of the clinical aspects of COVID-19 have opened up a new postulation citing that people with minor allergies particularly food allergies have reported to possess lower chances of being infected. This postulation is cited more specifically for food allergies and asthma. However, the research on the validity of the postulation has not been done significantly and therefore the currently available literature does not provide a vivid elucidation of this association. Thus, this article highlights the current gaps and loopholes present in the current literature to give an impetus to the future researches considering to establish the possible connection between the pathobiology of COVID with allergic problems. It also discusses the possible interventions of the postulation in detail in coordination with the currently available confirmations. It will help in understanding the susceptibility and risk factors associated with the SARS-Cov2 virus disease which would eventually lead to the development of novel treatments and therapeutics for allergic conditions and COVID-19 disease.
{"title":"COVID-19 and allergies: A mini review","authors":"K. Sharma","doi":"10.4103/amhs.amhs_5_23","DOIUrl":"https://doi.org/10.4103/amhs.amhs_5_23","url":null,"abstract":"There has been concern that patients with asthma may develop more severe disease as a result of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Recent studies towards the exploration of the clinical aspects of COVID-19 have opened up a new postulation citing that people with minor allergies particularly food allergies have reported to possess lower chances of being infected. This postulation is cited more specifically for food allergies and asthma. However, the research on the validity of the postulation has not been done significantly and therefore the currently available literature does not provide a vivid elucidation of this association. Thus, this article highlights the current gaps and loopholes present in the current literature to give an impetus to the future researches considering to establish the possible connection between the pathobiology of COVID with allergic problems. It also discusses the possible interventions of the postulation in detail in coordination with the currently available confirmations. It will help in understanding the susceptibility and risk factors associated with the SARS-Cov2 virus disease which would eventually lead to the development of novel treatments and therapeutics for allergic conditions and COVID-19 disease.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48300909","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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