Background: Spinal anesthesia often causes more post-operative nausea and vomiting (PONV). Cesarean-section patients have a significantly more PONV rate. Therefore, evidence-based knowledge about PONV prevention and care for high-risk individuals is urgently needed to reduce the consequences. Aims and Objectives: The aim of the study was to compare the efficacy and safety of granisetron with that of ondansetron in the prevention of PONV in patients undergoing cesarean section under spinal anesthesia. Materials and Methods: A total of 86 pregnant women with American Society of Anesthesiologists grade I–II scheduled for cesarean delivery under spinal anesthesia were enrolled. Patients were divided into two equal groups (n=43): Ten minutes before spinal anesthesia, patients in group B (granisetron) received 2 mg granisetron intravenously diluted to 10 mL with normal saline, whereas patients in group A (ondansetron) received 4 mg ondansetron. Results: There was no significant difference between Groups A and B in terms of the number of vomiting episodes between 0 and 6 h. Group A had significantly more episodes of nausea after 2 h than Group B after 0–2 h. After 2–6 h, however, the nausea was similar in all groups. Of the patients in Group A, 4 (9.3%) required antiemetic medication, in Group B, it was 2 (4.7%). In Group A, 8 patients (18.6%) and 6 patients (14%) complained of headache and dizziness, respectively; in Group B, 3 patients (7.0%) and (0%), respectively. Dizziness was significantly more pronounced in Group A than in Group B. Conclusion: The results of the study show that granisetron (2 mg) was more effective than ondansetron (4 mg) in minimizing PONV episodes in women undergoing spinal anesthesia for cesarean section. There were no significant side effects and both drugs were comparatively safe.
背景：脊髓麻醉通常会引起更多的术后恶心和呕吐（PONV）。剖腹产患者的 PONV 发生率明显更高。因此，迫切需要以证据为基础的 PONV 预防知识和对高危人群的护理，以减少后果：该研究旨在比较格拉司琼和昂丹司琼对脊柱麻醉下剖宫产患者预防 PONV 的有效性和安全性：共招募了86名美国麻醉医师协会I-II级孕妇，计划在脊柱麻醉下进行剖宫产。患者被平均分为两组（43 人）：在脊髓麻醉前十分钟，B组（格拉司琼）患者静脉注射用生理盐水稀释至10毫升的2毫克格拉司琼，而A组（昂丹司琼）患者则注射4毫克昂丹司琼：结果：A 组和 B 组在 0 至 6 小时内的呕吐次数没有明显差异，但 A 组在 2 小时后的恶心次数明显多于 B 组。在 A 组患者中，有 4 人（9.3%）需要服用止吐药，B 组为 2 人（4.7%）。在 A 组中，分别有 8 名患者（18.6%）和 6 名患者（14%）抱怨头痛和头晕；在 B 组中，分别有 3 名患者（7.0%）和 0 名患者（0%）抱怨头痛和头晕。A 组头晕症状明显比 B 组明显：研究结果表明，格拉司琼（2 毫克）比昂丹司琼（4 毫克）更能有效减少剖宫产椎管麻醉妇女的 PONV 发作。两种药物都没有明显的副作用，相对安全。
{"title":"The efficacy and safety of granisetron with ondansetron for the prevention of post-operative nausea and vomiting in patients undergoing cesarean section under spinal anesthesia","authors":"Supriya Singh, Sanni Deyol Gautam, Narendra Singh Bafila, Rajesh Kumar","doi":"10.3126/ajms.v15i6.63091","DOIUrl":"https://doi.org/10.3126/ajms.v15i6.63091","url":null,"abstract":"Background: Spinal anesthesia often causes more post-operative nausea and vomiting (PONV). Cesarean-section patients have a significantly more PONV rate. Therefore, evidence-based knowledge about PONV prevention and care for high-risk individuals is urgently needed to reduce the consequences.\u0000Aims and Objectives: The aim of the study was to compare the efficacy and safety of granisetron with that of ondansetron in the prevention of PONV in patients undergoing cesarean section under spinal anesthesia.\u0000Materials and Methods: A total of 86 pregnant women with American Society of Anesthesiologists grade I–II scheduled for cesarean delivery under spinal anesthesia were enrolled. Patients were divided into two equal groups (n=43): Ten minutes before spinal anesthesia, patients in group B (granisetron) received 2 mg granisetron intravenously diluted to 10 mL with normal saline, whereas patients in group A (ondansetron) received 4 mg ondansetron.\u0000Results: There was no significant difference between Groups A and B in terms of the number of vomiting episodes between 0 and 6 h. Group A had significantly more episodes of nausea after 2 h than Group B after 0–2 h. After 2–6 h, however, the nausea was similar in all groups. Of the patients in Group A, 4 (9.3%) required antiemetic medication, in Group B, it was 2 (4.7%). In Group A, 8 patients (18.6%) and 6 patients (14%) complained of headache and dizziness, respectively; in Group B, 3 patients (7.0%) and (0%), respectively. Dizziness was significantly more pronounced in Group A than in Group B.\u0000Conclusion: The results of the study show that granisetron (2 mg) was more effective than ondansetron (4 mg) in minimizing PONV episodes in women undergoing spinal anesthesia for cesarean section. There were no significant side effects and both drugs were comparatively safe.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141275670","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: Estimation of the risk of future atherosclerotic cardiovascular (CV) events is an important step in the primary prevention of CV events. However, the relative accuracy of the various currently available CV risk scores is not validated in Indians. Aims and Objectives: The study was done to compare the accuracy of three clinically relevant CV risk assessment algorithms in the South Indian population and to validate the risk scores by correlating with the measures of subclinical atherosclerosis. Materials and Methods: This cross-sectional study was conducted among patients attending a chest pain clinic at a Tertiary care center in South India. The study included subjects ≥30 years of age, with no previous coronary artery disease (CAD) and major cardiac illness. Totally 110 subjects were included in the study. Detailed clinical evaluation and routine investigations were done. The 10-year CV risk for each subject was calculated using the three risk scores – Framingham, American College of Cardiology/American Heart Association (ACC/AHA), and Q risk score. The risk scores of all patients were then correlated with their corresponding carotid intima-media thickness (CIMT) measured using carotid Doppler and coronary angiography results. Results: The mean age of the study population was 51.45±9.01 years and the majority of them were females (57.2%). CAD patients demonstrated significantly increased CIMT. There was a significant positive correlation (P<0.001) between all three risk scores and carotid intimal medial thickness. As the carotid intimal medial thickness increases, the risk scores also increased (as shown by Pearsons’s correlation coefficient). Similarly, all three risk scores also showed a significant positive correlation (P<0.001) with the severity of CAD as assessed by CAG (as shown by one-way analysis of variance). The ACC/AHA score was the best score with a slightly higher accuracy of 69.9% than that of Q risk score (69.5%). The accuracy of Framingham’s score was found to be 68.3%. Conclusion: ACC/AHA and Q risk score may be the most appropriate CV risk assessment algorithm for use in Indian populations at present. However, large-scale prospective studies are needed to confirm these findings.
{"title":"Cardiovascular risk score predictive accuracy and subclinical atherosclerosis correlation in the Indian population: A cross-sectional study","authors":"Elanchezhian Selvaprakash, Kannan Kumaresan, Narendran Mani, Viswanathan Narasimhan","doi":"10.3126/ajms.v15i6.63983","DOIUrl":"https://doi.org/10.3126/ajms.v15i6.63983","url":null,"abstract":"Background: Estimation of the risk of future atherosclerotic cardiovascular (CV) events is an important step in the primary prevention of CV events. However, the relative accuracy of the various currently available CV risk scores is not validated in Indians.\u0000Aims and Objectives: The study was done to compare the accuracy of three clinically relevant CV risk assessment algorithms in the South Indian population and to validate the risk scores by correlating with the measures of subclinical atherosclerosis.\u0000Materials and Methods: This cross-sectional study was conducted among patients attending a chest pain clinic at a Tertiary care center in South India. The study included subjects ≥30 years of age, with no previous coronary artery disease (CAD) and major cardiac illness. Totally 110 subjects were included in the study. Detailed clinical evaluation and routine investigations were done. The 10-year CV risk for each subject was calculated using the three risk scores – Framingham, American College of Cardiology/American Heart Association (ACC/AHA), and Q risk score. The risk scores of all patients were then correlated with their corresponding carotid intima-media thickness (CIMT) measured using carotid Doppler and coronary angiography results.\u0000Results: The mean age of the study population was 51.45±9.01 years and the majority of them were females (57.2%). CAD patients demonstrated significantly increased CIMT. There was a significant positive correlation (P<0.001) between all three risk scores and carotid intimal medial thickness. As the carotid intimal medial thickness increases, the risk scores also increased (as shown by Pearsons’s correlation coefficient). Similarly, all three risk scores also showed a significant positive correlation (P<0.001) with the severity of CAD as assessed by CAG (as shown by one-way analysis of variance). The ACC/AHA score was the best score with a slightly higher accuracy of 69.9% than that of Q risk score (69.5%). The accuracy of Framingham’s score was found to be 68.3%.\u0000Conclusion: ACC/AHA and Q risk score may be the most appropriate CV risk assessment algorithm for use in Indian populations at present. However, large-scale prospective studies are needed to confirm these findings.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141278976","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 : 2024-06-01DOI: 10.3126/ajms.v15i6.62443
Shobitha Rao, R. Bilagi, Radhe B K, R. Hiregoudar, Vishnu Narayanan
Background: Asthma is a chronic inflammatory disorder arising from heterogenic geneenvironment interactions. Obesity is one of the risk factors for asthma. Evidence shows that several inflammatory markers are active in obese and overweight patients. There is growing evidence that obesity can affect the course and control of asthma. Aims and Objectives: The study was done to compare clinical characteristics, spirometry variables, and quality of life among obese and non-obese asthmatics. Materials and Methods: The study was a crosssectional comparative study conducted in a tertiary care hospital using a semi-structured pre-tested questionnaire. Detailed history and examination, quality of life using AQLQ score, and spirometry severity were assessed. Results: A total of 80 patients, 40 obese asthmatics and 40 non-obese asthmatics were included in the study. The study found that most subjects belonged to the age group of 31–40 years and body mass index of 30.89±1.94 among the obese group and 23.19±3.77 in non-obese, respectively. The majority had symptoms of breathlessness and wheezing in both groups. The mean forced expiratory volume in 1 s was similar in both groups. However, the mean forced vital capacity was lower in the obese group. The asthma control test (ACT) score was poorer in obese group as compared to nonobese group (7 in obese vs. 15 in non-obese). The dosage of inhaled steroids was higher in the obese group. Conclusion: The symptomatology was similar among the two groups. Restrictive abnormalities, higher asthma symptoms with lower ACT scores, and higher dosages of medications were seen in obese asthmatics as compared to non-obese patients.
{"title":"A comparative study of clinical characteristics and quality of life between obese and non-obese asthmatics","authors":"Shobitha Rao, R. Bilagi, Radhe B K, R. Hiregoudar, Vishnu Narayanan","doi":"10.3126/ajms.v15i6.62443","DOIUrl":"https://doi.org/10.3126/ajms.v15i6.62443","url":null,"abstract":"Background: Asthma is a chronic inflammatory disorder arising from heterogenic geneenvironment interactions. Obesity is one of the risk factors for asthma. Evidence shows that several inflammatory markers are active in obese and overweight patients. There is growing evidence that obesity can affect the course and control of asthma.\u0000Aims and Objectives: The study was done to compare clinical characteristics, spirometry variables, and quality of life among obese and non-obese asthmatics.\u0000Materials and Methods: The study was a crosssectional comparative study conducted in a tertiary care hospital using a semi-structured pre-tested questionnaire. Detailed history and examination, quality of life using AQLQ score, and spirometry severity were assessed.\u0000Results: A total of 80 patients, 40 obese asthmatics and 40 non-obese asthmatics were included in the study. The study found that most subjects belonged to the age group of 31–40 years and body mass index of 30.89±1.94 among the obese group and 23.19±3.77 in non-obese, respectively. The majority had symptoms of breathlessness and wheezing in both groups. The mean forced expiratory volume in 1 s was similar in both groups. However, the mean forced vital capacity was lower in the obese group. The asthma control test (ACT) score was poorer in obese group as compared to nonobese group (7 in obese vs. 15 in non-obese). The dosage of inhaled steroids was higher in the obese group.\u0000Conclusion: The symptomatology was similar among the two groups. Restrictive abnormalities, higher asthma symptoms with lower ACT scores, and higher dosages of medications were seen in obese asthmatics as compared to non-obese patients.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141274236","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 : 2024-06-01DOI: 10.3126/ajms.v15i6.63414
Preeti, M. H. Khan, S. Mittal, Vikram Singh Dhapola, Dr. Vikram Singh Dhapola
Background: The internet, computers, smartphones, and other electronic device’s use has increased suddenly over recent decades. Although this increase has benefits to the users, but also excessive use often leads negative health consequences. Aims and Objectives: The objective of this study was to measure the prevalence of internet addiction (IA) and stress among undergraduate medical students. Materials and Methods: A descriptive cross-sectional study was conducted among 299 undergraduate medical students enrolled in the government medical college, Almora. A 20-item Young’s IA test which is a Likert scale-based interview schedule was used to measure the prevalence of IA and the perceived stress scale 14 scale is used to assess stress among them. Results: Among the 299 study subjects, 49.5% were males and 50.5% were females. Males were more addicted to the internet than females. The prevalence of IA among the study subjects in the present study was 45.4% mild, 13.8% moderate, while 40.8% of students reported normal internet usage. Conclusion: IA is a growing health problem among medical students these days, thus necessary preventive and therapeutic interventions are very important to promote healthy and safe usage of the internet.
{"title":"The prevalence of internet addiction and associated factors among undergraduate medical students in government medical college, Almora","authors":"Preeti, M. H. Khan, S. Mittal, Vikram Singh Dhapola, Dr. Vikram Singh Dhapola","doi":"10.3126/ajms.v15i6.63414","DOIUrl":"https://doi.org/10.3126/ajms.v15i6.63414","url":null,"abstract":"Background: The internet, computers, smartphones, and other electronic device’s use has increased suddenly over recent decades. Although this increase has benefits to the users, but also excessive use often leads negative health consequences.\u0000Aims and Objectives: The objective of this study was to measure the prevalence of internet addiction (IA) and stress among undergraduate medical students.\u0000Materials and Methods: A descriptive cross-sectional study was conducted among 299 undergraduate medical students enrolled in the government medical college, Almora. A 20-item Young’s IA test which is a Likert scale-based interview schedule was used to measure the prevalence of IA and the perceived stress scale 14 scale is used to assess stress among them.\u0000 Results: Among the 299 study subjects, 49.5% were males and 50.5% were females. Males were more addicted to the internet than females. The prevalence of IA among the study subjects in the present study was 45.4% mild, 13.8% moderate, while 40.8% of students reported normal internet usage.\u0000Conclusion: IA is a growing health problem among medical students these days, thus necessary preventive and therapeutic interventions are very important to promote healthy and safe usage of the internet.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141279244","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 : 2024-06-01DOI: 10.3126/ajms.v15i6.64125
Gayathri Elango, Varsha AP, Ganga Muruga Bharathi
Background: Statins are widely prescribed for the management of hyperlipidemia and the prevention of cardiovascular diseases. Atorvastatin and rosuvastatin are among the most commonly used statins, with varying impacts on lipid profiles, side effect profiles, patient adherence, and health-care costs. Understanding these differences within specific populations can inform more tailored and cost-effective treatment strategies. Aims and Objectives: This study aimed to evaluate the differences in side effect management, patient outcomes, and health-care costs between atorvastatin and rosuvastatin therapies in a cohort from Coimbatore, Tamil Nadu, India. Materials and Methods: An observational study was conducted with 100 patients at the Karpagam Faculty of Medical Sciences and Research, evenly split between atorvastatin (n=50) and rosuvastatin (n=50) groups. Data on demographic characteristics, side effects, low-density lipoprotein (LDL) cholesterol reduction, medication adherence, and health-care costs were collected and analyzed. Results: The cohort had an average age of 62 years, with a higher prevalence of males (57%). Socioeconomic analysis showed 30% from low-income, 50% from middle-income, and 20% from high-income backgrounds. Side effects were more common in the atorvastatin group (35%) compared to the rosuvastatin group (28%), with muscle pain and gastrointestinal issues being predominant. Rosuvastatin treatment resulted in higher adherence rates (90%) and more significant LDL cholesterol reduction but incurred higher annual health-care costs (INR 28,000) versus atorvastatin (INR 25,000) (P=0.04). Conclusion: Both statins effectively reduced LDL cholesterol; however, rosuvastatin demonstrated higher patient adherence but at an increased cost. These findings underscore the need for individualized statin therapy that considers both clinical outcomes and economic constraints, particularly in settings with limited health-care resources.
{"title":"Impact of side effect management, patient outcomes, and health-care costs in atorvastatin and rosuvastatin therapy: An observational study","authors":"Gayathri Elango, Varsha AP, Ganga Muruga Bharathi","doi":"10.3126/ajms.v15i6.64125","DOIUrl":"https://doi.org/10.3126/ajms.v15i6.64125","url":null,"abstract":"Background: Statins are widely prescribed for the management of hyperlipidemia and the prevention of cardiovascular diseases. Atorvastatin and rosuvastatin are among the most commonly used statins, with varying impacts on lipid profiles, side effect profiles, patient adherence, and health-care costs. Understanding these differences within specific populations can inform more tailored and cost-effective treatment strategies.\u0000Aims and Objectives: This study aimed to evaluate the differences in side effect management, patient outcomes, and health-care costs between atorvastatin and rosuvastatin therapies in a cohort from Coimbatore, Tamil Nadu, India.\u0000Materials and Methods: An observational study was conducted with 100 patients at the Karpagam Faculty of Medical Sciences and Research, evenly split between atorvastatin (n=50) and rosuvastatin (n=50) groups. Data on demographic characteristics, side effects, low-density lipoprotein (LDL) cholesterol reduction, medication adherence, and health-care costs were collected and analyzed.\u0000Results: The cohort had an average age of 62 years, with a higher prevalence of males (57%). Socioeconomic analysis showed 30% from low-income, 50% from middle-income, and 20% from high-income backgrounds. Side effects were more common in the atorvastatin group (35%) compared to the rosuvastatin group (28%), with muscle pain and gastrointestinal issues being predominant. Rosuvastatin treatment resulted in higher adherence rates (90%) and more significant LDL cholesterol reduction but incurred higher annual health-care costs (INR 28,000) versus atorvastatin (INR 25,000) (P=0.04).\u0000Conclusion: Both statins effectively reduced LDL cholesterol; however, rosuvastatin demonstrated higher patient adherence but at an increased cost. These findings underscore the need for individualized statin therapy that considers both clinical outcomes and economic constraints, particularly in settings with limited health-care resources.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141234421","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 : 2024-06-01DOI: 10.3126/ajms.v15i6.63345
M. Prashanthi, Santa Kumari, Abdul Raoof, Omer Siddiqui, Mudassir Mirza
Background: Hypertension (HTN) incidence and progression are monitored by regular blood pressure (BP) measurement; one of the most ignored components of regular check-up is the measurement of inter-arm difference (IAD) in BP. Aims and Objectives: The objective of this study was to estimate the prevalence of IAD in BP among offspring of hypertensive parents compared to normotensive parents. Materials and Methods: This cross-sectional study was conducted on 100 male students at Osmania Medical College, Hyderabad, Telangana for a period of 6 months. After IEC clearance, the subjects were divided into two groups, 50 students in each group: Group I had offspring with hypertensive parents and Group II had offspring with normotensive parents. Age, height, weight, and body mass index (BMI) were recorded. IAD was calculated as the difference between BP (Systolic BP [SBP] and diastolic BP [DBP]) in the right arm and left arm. Subjects with a history of structural, functional cardiovascular disease disorders, endocrine disorders, Diabetes mellitus, and addictions such as smoking and alcohol were excluded from the study. Data were statistically analyzed using Microsoft Excel software. Results: Among 100 subjects, Group I and II IAD in SBP was 8.68±6.02 and 5.00±3.24 (P<0.0002), respectively, and Group I and II IAD in DBP was 5.12±4.48 4.79±3.56 (P<0.7117), respectively. BMI of the two groups is almost within the similar range (23.44±4.04, 22.098±3.15, respectively) and not statistically significant (P=0.0694), a positive correlation of 0.12, 011 was found between BMI, systolic IAD,and diastolic IAD, respectively. Conclusion: The above results show a significant association between IAD in systolic BP and family history of HTN.
背景：通过定期测量血压来监测高血压（HTN）的发生和发展；定期体检中最容易被忽视的一项内容是测量血压的臂间差（IAD）：本研究的目的是估算高血压父母的后代与正常血压父母的后代相比，血压臂间差（IAD）的发生率：这项横断面研究在特兰甘纳邦海德拉巴市奥斯曼尼亚医学院的 100 名男生中进行，为期 6 个月。在通过 IEC 审查后，受试者被分为两组，每组 50 人：I 组的后代父母患有高血压，II 组的后代父母血压正常。记录受试者的年龄、身高、体重和体重指数（BMI）。IAD 以右臂和左臂血压（收缩压 [SBP] 和舒张压 [DBP]）之差计算。有结构性、功能性心血管疾病史、内分泌失调、糖尿病以及吸烟和酗酒等不良嗜好的受试者不在研究范围内。数据使用 Microsoft Excel 软件进行统计分析：100名受试者中，I组和II组IAD的SBP分别为（8.68±6.02）和（5.00±3.24）（P<0.0002），DBP分别为（5.12±4.48）和（4.79±3.56）（P<0.7117）。两组的 BMI 值几乎在相似范围内（分别为 23.44±4.04、22.098±3.15），无统计学意义（P=0.0694），BMI 值与收缩压 IAD、舒张压 IAD 之间的正相关性分别为 0.12、011：上述结果表明，收缩压中的 IAD 与高血压家族史之间存在明显关联。
{"title":"Cross-sectional study of the prevalence of inter-arm blood pressure difference in offspring of normotensive and hypertensive parents among students of tertiary care teaching hospital, Hyderabad","authors":"M. Prashanthi, Santa Kumari, Abdul Raoof, Omer Siddiqui, Mudassir Mirza","doi":"10.3126/ajms.v15i6.63345","DOIUrl":"https://doi.org/10.3126/ajms.v15i6.63345","url":null,"abstract":"Background: Hypertension (HTN) incidence and progression are monitored by regular blood pressure (BP) measurement; one of the most ignored components of regular check-up is the measurement of inter-arm difference (IAD) in BP.\u0000Aims and Objectives: The objective of this study was to estimate the prevalence of IAD in BP among offspring of hypertensive parents compared to normotensive parents.\u0000Materials and Methods: This cross-sectional study was conducted on 100 male students at Osmania Medical College, Hyderabad, Telangana for a period of 6 months. After IEC clearance, the subjects were divided into two groups, 50 students in each group: Group I had offspring with hypertensive parents and Group II had offspring with normotensive parents. Age, height, weight, and body mass index (BMI) were recorded. IAD was calculated as the difference between BP (Systolic BP [SBP] and diastolic BP [DBP]) in the right arm and left arm. Subjects with a history of structural, functional cardiovascular disease disorders, endocrine disorders, Diabetes mellitus, and addictions such as smoking and alcohol were excluded from the study. Data were statistically analyzed using Microsoft Excel software.\u0000Results: Among 100 subjects, Group I and II IAD in SBP was 8.68±6.02 and 5.00±3.24 (P<0.0002), respectively, and Group I and II IAD in DBP was 5.12±4.48 4.79±3.56 (P<0.7117), respectively. BMI of the two groups is almost within the similar range (23.44±4.04, 22.098±3.15, respectively) and not statistically significant (P=0.0694), a positive correlation of 0.12, 011 was found between BMI, systolic IAD,and diastolic IAD, respectively.\u0000Conclusion: The above results show a significant association between IAD in systolic BP and family history of HTN.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141277285","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 : 2024-06-01DOI: 10.3126/ajms.v15i6.63106
Sabina Adhikari
Classic polyarteritis nodosa (PAN) is an uncommon form of aggressive systemic vasculitis involving small-to-medium sized arteries usually of renal vasculature and other visceral organs but characteristically sparing the lung vasculature. Cutaneous PAN (c-PAN) is still a rare type of small-to-medium vessel vasculitis with involvement of skin without any systemic or visceral involvement. However, extracutaneous features such as arthritis, arthralgia, myopathy, and myositis can co-exist with the cutaneous features. c-PAN can be confirmed histopathologically by the presence of polymorphonuclear leukocytes around the medium-sized vessels with evidence of fibrinoid necrosis and luminal thrombi at the bifurcations. While c-PAN has a benign but chronic course and can be managed with low doses of short-course oral steroids or anti-inflammatory drugs, systemic involvement has an aggressive course and needs adequate and prompt immunosuppression with high dose oral steroids, cyclophosphamide, rituximab, or other immunosuppressive. We present a case of a 33-year-old male who landed in our OPD with features of c-PAN and on further investigative workup was found to have a renal infarct.
{"title":"Classic polyarteritis nodosa presenting initially as a case of cutaneous polyarteritis nodosa: A case report","authors":"Sabina Adhikari","doi":"10.3126/ajms.v15i6.63106","DOIUrl":"https://doi.org/10.3126/ajms.v15i6.63106","url":null,"abstract":"Classic polyarteritis nodosa (PAN) is an uncommon form of aggressive systemic vasculitis involving small-to-medium sized arteries usually of renal vasculature and other visceral organs but characteristically sparing the lung vasculature. Cutaneous PAN (c-PAN) is still a rare type of small-to-medium vessel vasculitis with involvement of skin without any systemic or visceral involvement. However, extracutaneous features such as arthritis, arthralgia, myopathy, and myositis can co-exist with the cutaneous features. c-PAN can be confirmed histopathologically by the presence of polymorphonuclear leukocytes around the medium-sized vessels with evidence of fibrinoid necrosis and luminal thrombi at the bifurcations. While c-PAN has a benign but chronic course and can be managed with low doses of short-course oral steroids or anti-inflammatory drugs, systemic involvement has an aggressive course and needs adequate and prompt immunosuppression with high dose oral steroids, cyclophosphamide, rituximab, or other immunosuppressive. We present a case of a 33-year-old male who landed in our OPD with features of c-PAN and on further investigative workup was found to have a renal infarct.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141278510","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 : 2024-06-01DOI: 10.3126/ajms.v15i6.63670
Zulfiqar Ali, Iqra Nazir, Shahid Ahmad Mir, Zoya Sehar, Aymen Masood, Eman Aftab, Muqtashid Rashid
Background: Agitation is frequently encountered in patients recovering from traumatic brain injury (TBI) in the intensive care unit (ICU). The etiopathology for agitation is multifactorial. Melatonin has been widely used to study the effects of delirium in ICU, however, its effect on agitation is not well studied. Aims and Objectives: The aim of this study was to assess the effect of melatonin administration on the prevalence of agitation and length of stay in patients with severe TBI, managed conservatively, or undergoing decompressive craniectomy. Materials and Methods: A retrospective observational study with 70 patients undergoing various decompressive craniotomy or managed conservatively, and admitted to neurosurgical ICU was included in the study. Thirty-six patients were recruited from the control group and 34 patients received melatonin during their stay in the ICU. In this study, records of 70 patients who had suffered isolated TBI with no associated injuries were analyzed. The patients had a Glasgow coma score of 3–14 on admission to ICU. The patients were managed as per the standard protocols, as per the existing guidelines, and based on TBI guidelines. Results: A non-significant decreasing trend of agitation and reduced duration of ICU stay was noted in patients who received melatonin compared with the control group. The prevalence of agitation observed on modified Ramsay scale (Mean±SD) in patients who received melatonin on Day 3, Day 4, Day 5, Day 6, Day 7, Day 8, and Day 9 were −1.67±3.01; −1.61±2.82; −1.2±2.55; −1.23±2.51; −1.23±2.11; −1.05±2.09; and 0.76±2.03, respectively. These scores were slightly lower than observed in the control group on Day 3, Day 4, Day 5, Day 6, Day 7, Day 8, and Day 9 as −1.58±3.16; −1.33±2.72; −1.08±2.46; −1.13±2.25; −0.94±1.87; −0.52±1.7; and 0.52±1.36, respectively. The mean±SD duration of stay in ICU of patients receiving melatonin (13.14±3.37) and not receiving melatonin (14.52±3.73) was comparable (P=0.1). Conclusion: Although there was a decreased prevalence of agitation and a decrease in the mean duration of the ICU stay in patients who received oral melatonin, these beneficial effects did not show any statistical significance once compared with the control group.
{"title":"Effects of administration of melatonin on agitation and duration of stay in patients of traumatic brain injury admitted to neurosurgical intensive care unit – A retrospective study","authors":"Zulfiqar Ali, Iqra Nazir, Shahid Ahmad Mir, Zoya Sehar, Aymen Masood, Eman Aftab, Muqtashid Rashid","doi":"10.3126/ajms.v15i6.63670","DOIUrl":"https://doi.org/10.3126/ajms.v15i6.63670","url":null,"abstract":"Background: Agitation is frequently encountered in patients recovering from traumatic brain injury (TBI) in the intensive care unit (ICU). The etiopathology for agitation is multifactorial. Melatonin has been widely used to study the effects of delirium in ICU, however, its effect on agitation is not well studied.\u0000Aims and Objectives: The aim of this study was to assess the effect of melatonin administration on the prevalence of agitation and length of stay in patients with severe TBI, managed conservatively, or undergoing decompressive craniectomy.\u0000Materials and Methods: A retrospective observational study with 70 patients undergoing various decompressive craniotomy or managed conservatively, and admitted to neurosurgical ICU was included in the study. Thirty-six patients were recruited from the control group and 34 patients received melatonin during their stay in the ICU. In this study, records of 70 patients who had suffered isolated TBI with no associated injuries were analyzed. The patients had a Glasgow coma score of 3–14 on admission to ICU. The patients were managed as per the standard protocols, as per the existing guidelines, and based on TBI guidelines.\u0000Results: A non-significant decreasing trend of agitation and reduced duration of ICU stay was noted in patients who received melatonin compared with the control group. The prevalence of agitation observed on modified Ramsay scale (Mean±SD) in patients who received melatonin on Day 3, Day 4, Day 5, Day 6, Day 7, Day 8, and Day 9 were −1.67±3.01; −1.61±2.82; −1.2±2.55; −1.23±2.51; −1.23±2.11; −1.05±2.09; and 0.76±2.03, respectively. These scores were slightly lower than observed in the control group on Day 3, Day 4, Day 5, Day 6, Day 7, Day 8, and Day 9 as −1.58±3.16; −1.33±2.72; −1.08±2.46; −1.13±2.25; −0.94±1.87; −0.52±1.7; and 0.52±1.36, respectively. The mean±SD duration of stay in ICU of patients receiving melatonin (13.14±3.37) and not receiving melatonin (14.52±3.73) was comparable (P=0.1).\u0000Conclusion: Although there was a decreased prevalence of agitation and a decrease in the mean duration of the ICU stay in patients who received oral melatonin, these beneficial effects did not show any statistical significance once compared with the control group.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141278978","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 : 2024-06-01DOI: 10.3126/ajms.v15i6.62766
A. Rajkonwar, Upam Kumar, S. Sonowal, Arpita Nath, Hiranya Saikia, Gautam Hazarika
Background: Chronic myeloid leukemia (CML) is a hematologic malignancy characterized by excessive growth of myeloid cells and their progenitors. The incidence of CML is approximately 1–2/100,000 population per year. Aims and Objectives: The aims and objectives of the study are to determine the clinicopathological features of patients with CML and their risk stratification by the Sokal score at a tertiary care hospital in North-East India. Materials and Methods: This was a single-center prospective study conducted for 5 years (2018–2022). A total of 109 cases diagnosed with CML by qualitative analysis of BCR-ABL1 transcript reverse transcription-polymerase chain reaction were included in the study. The Sokal score was calculated using previously published formulae to classify the patients into different risk groups. The outcome (dead or alive) of CML patients was compared with their individual risk groups using Fisher’s exact test. Results: Out of 109 CML patients, 73 were males and 36 were females. At the end of the study, 85 patients were alive whereas 24 died. The mean age at presentation was 42.08±15.06 years. The pediatric age group comprises 1.84% of total cases. The percentages of death were higher (79.17%) in patients aged 18–59 years, followed by 20.83% in ≥60 years age group, whereas no death was recorded in the pediatric age group (<18 years). The abdominal hard lump was the most common clinical presentation, followed by abdominal fullness, weakness, and pain abdomen. The Sokal score assigns the majority (66.06%) of patients to the intermediate risk (IR) category, followed by 25.69% and 8.26% in the high-risk (HR) and low-risk (LR) categories, respectively. It was observed that the majority (28.57%) of patients died in the HR group, followed by 20.83% in the IR group and 11.11% in the LR group. Conclusion: The mean age of CML patients is lower than that observed in many Western countries. The Sokal score assigns the majority of patients to IR category and the maximum death were seen in the HR group.
{"title":"Clinicopathological features and risk stratification by the sokal score of patients with chronic myeloid leukemia at a tertiary care hospital in North-East India: A prospective study","authors":"A. Rajkonwar, Upam Kumar, S. Sonowal, Arpita Nath, Hiranya Saikia, Gautam Hazarika","doi":"10.3126/ajms.v15i6.62766","DOIUrl":"https://doi.org/10.3126/ajms.v15i6.62766","url":null,"abstract":"Background: Chronic myeloid leukemia (CML) is a hematologic malignancy characterized by excessive growth of myeloid cells and their progenitors. The incidence of CML is approximately 1–2/100,000 population per year.\u0000Aims and Objectives: The aims and objectives of the study are to determine the clinicopathological features of patients with CML and their risk stratification by the Sokal score at a tertiary care hospital in North-East India.\u0000Materials and Methods: This was a single-center prospective study conducted for 5 years (2018–2022). A total of 109 cases diagnosed with CML by qualitative analysis of BCR-ABL1 transcript reverse transcription-polymerase chain reaction were included in the study. The Sokal score was calculated using previously published formulae to classify the patients into different risk groups. The outcome (dead or alive) of CML patients was compared with their individual risk groups using Fisher’s exact test.\u0000Results: Out of 109 CML patients, 73 were males and 36 were females. At the end of the study, 85 patients were alive whereas 24 died. The mean age at presentation was 42.08±15.06 years. The pediatric age group comprises 1.84% of total cases. The percentages of death were higher (79.17%) in patients aged 18–59 years, followed by 20.83% in ≥60 years age group, whereas no death was recorded in the pediatric age group (<18 years). The abdominal hard lump was the most common clinical presentation, followed by abdominal fullness, weakness, and pain abdomen. The Sokal score assigns the majority (66.06%) of patients to the intermediate risk (IR) category, followed by 25.69% and 8.26% in the high-risk (HR) and low-risk (LR) categories, respectively. It was observed that the majority (28.57%) of patients died in the HR group, followed by 20.83% in the IR group and 11.11% in the LR group.\u0000Conclusion: The mean age of CML patients is lower than that observed in many Western countries. The Sokal score assigns the majority of patients to IR category and the maximum death were seen in the HR group.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141279611","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 : 2024-06-01DOI: 10.3126/ajms.v15i6.64850
Usha Ramakrishna N, Radhika Potnuri, Raj Kumar Sahu, Hitesh Chavda
Background: Laparoscopic cholecystectomy (LC) is a common surgical procedure, the difficulty of which can vary significantly based on pre-operative factors. Identifying these factors can improve surgical planning, patient counseling, and outcomes. Aims and Objectives: To develop a predictive scoring system for assessing the difficulty of LC preoperatively based on individual patient parameters. To employ operative time and intra-operative events to validate the accuracy of the scoring system in reflecting the technical difficulty of LCs. Materials and Methods: This prospective study enrolled 104 patients scheduled for LC, assessing them with a pre-operative scoring system to predict operative difficulty. Patients were categorized into groups indicating expected levels of difficulty: Easy, difficult, and very difficult. Demographic information, clinical characteristics, and operative outcomes were analyzed to validate the scoring system’s predictive accuracy. Results: Of the patients assessed, 68.3% were predicted to have an easy LC (scores 0–5), whereas 31.7% were anticipated to face a difficult LC (scores 6–10). Key predictors of operative difficulty included age, sex, history of previous hospitalization for acute cholecystitis, body mass index (BMI), the presence of an abdominal scar, palpable gallbladder (GB), thickened GB wall, pericholecystic collection, and impacted stone. The study found that operative outcomes closely aligned with pre-operative predictions, confirming the scoring system’s moderate predictive accuracy (area under the curve of 0.798). Conclusion: The pre-operative scoring system demonstrated moderate effectiveness in predicting LC difficulty, with significant predictors including a history of hospitalization, BMI, palpable GB, and thickened GB wall. These findings can aid in pre-operative planning and optimizing patient outcomes.
{"title":"A prospective study of various pre-operative factors and the development of a scoring system in predicting difficult laparoscopic cholecystectomy","authors":"Usha Ramakrishna N, Radhika Potnuri, Raj Kumar Sahu, Hitesh Chavda","doi":"10.3126/ajms.v15i6.64850","DOIUrl":"https://doi.org/10.3126/ajms.v15i6.64850","url":null,"abstract":"Background: Laparoscopic cholecystectomy (LC) is a common surgical procedure, the difficulty of which can vary significantly based on pre-operative factors. Identifying these factors can improve surgical planning, patient counseling, and outcomes.\u0000Aims and Objectives: To develop a predictive scoring system for assessing the difficulty of LC preoperatively based on individual patient parameters. To employ operative time and intra-operative events to validate the accuracy of the scoring system in reflecting the technical difficulty of LCs.\u0000Materials and Methods: This prospective study enrolled 104 patients scheduled for LC, assessing them with a pre-operative scoring system to predict operative difficulty. Patients were categorized into groups indicating expected levels of difficulty: Easy, difficult, and very difficult. Demographic information, clinical characteristics, and operative outcomes were analyzed to validate the scoring system’s predictive accuracy.\u0000Results: Of the patients assessed, 68.3% were predicted to have an easy LC (scores 0–5), whereas 31.7% were anticipated to face a difficult LC (scores 6–10). Key predictors of operative difficulty included age, sex, history of previous hospitalization for acute cholecystitis, body mass index (BMI), the presence of an abdominal scar, palpable gallbladder (GB), thickened GB wall, pericholecystic collection, and impacted stone. The study found that operative outcomes closely aligned with pre-operative predictions, confirming the scoring system’s moderate predictive accuracy (area under the curve of 0.798).\u0000Conclusion: The pre-operative scoring system demonstrated moderate effectiveness in predicting LC difficulty, with significant predictors including a history of hospitalization, BMI, palpable GB, and thickened GB wall. These findings can aid in pre-operative planning and optimizing patient outcomes.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141234777","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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