Pub Date : 2024-06-01DOI: 10.3126/ajms.v15i6.63532
Aishwarya Sudan, P. Palatty, Mamatha Jayachandran³, Sabarish Balachandran, Junior Resident, Dr. Princy Louis, Professor and Head Palatty
Background: In a developing country such as India, intentional poisoning is associated with a high degree of morbidity and mortality. Historically, the use of agricultural poisons for attempted deliberate self-harm (DSH) has taken precedence. However, urbanization and stringent laws governing sale of agricultural chemicals, in recent years, may have shifted the focus of seekers toward commercially available therapeutic medications. Further, urbanization, high health-care seeking behavior, and poor regulation on sale of medicines, in Kerala, provide a conducive environment for such attempts. Aims and Objectives: The objective of this study was to determine the contribution of therapeutic medication toward acute poisoning as a means of DSH and the factors contributing to the same. Materials and Methods: Patients who obtained treatment for acute poisoning after DSH, between 2017 and 2023, were screened, those who employed therapeutic medication for the same were further determined. Sociodemographic details, clinical profile, and history of previous such attempts and treatment history including toxicological screening report were gathered and analyzed. Results: In our study of 154 patients arriving at the emergency department with history of DSH, 41% used therapeutic medicines for the same. Majority were women (75%) and most had a high school education (64%) or above. The most common agents were determined as paracetamol (23%) and benzodiazepine (10.6%). Tox screen was performed for 45% of patients. Organ failure developed in 36% patients with drug levels above and 42% of those with levels below the therapeutic range. However, 48% of those who did not undergo toxicological screening developed organ failure. Organ failure developed in 42% of patients, with acute liver injury being the most common culprit (25%). Management was symptomatic unless an antidote was available. Conclusion: Prescription drugs utilization for DSH was common in women and patients with higher educational status. Over-the-counter drugs and psychiatric medication were frequently used. Lack of prompt access to healthcare may contribute to organ failure. Tox-screen is recommended for drug detection.
{"title":"Determining the factors which impact management of acute poisonings due to therapeutic medicines","authors":"Aishwarya Sudan, P. Palatty, Mamatha Jayachandran³, Sabarish Balachandran, Junior Resident, Dr. Princy Louis, Professor and Head Palatty","doi":"10.3126/ajms.v15i6.63532","DOIUrl":"https://doi.org/10.3126/ajms.v15i6.63532","url":null,"abstract":"Background: In a developing country such as India, intentional poisoning is associated with a high degree of morbidity and mortality. Historically, the use of agricultural poisons for attempted deliberate self-harm (DSH) has taken precedence. However, urbanization and stringent laws governing sale of agricultural chemicals, in recent years, may have shifted the focus of seekers toward commercially available therapeutic medications. Further, urbanization, high health-care seeking behavior, and poor regulation on sale of medicines, in Kerala, provide a conducive environment for such attempts.\u0000Aims and Objectives: The objective of this study was to determine the contribution of therapeutic medication toward acute poisoning as a means of DSH and the factors contributing to the same.\u0000Materials and Methods: Patients who obtained treatment for acute poisoning after DSH, between 2017 and 2023, were screened, those who employed therapeutic medication for the same were further determined. Sociodemographic details, clinical profile, and history of previous such attempts and treatment history including toxicological screening report were gathered and analyzed.\u0000Results: In our study of 154 patients arriving at the emergency department with history of DSH, 41% used therapeutic medicines for the same. Majority were women (75%) and most had a high school education (64%) or above. The most common agents were determined as paracetamol (23%) and benzodiazepine (10.6%). Tox screen was performed for 45% of patients. Organ failure developed in 36% patients with drug levels above and 42% of those with levels below the therapeutic range. However, 48% of those who did not undergo toxicological screening developed organ failure. Organ failure developed in 42% of patients, with acute liver injury being the most common culprit (25%). Management was symptomatic unless an antidote was available.\u0000Conclusion: Prescription drugs utilization for DSH was common in women and patients with higher educational status. Over-the-counter drugs and psychiatric medication were frequently used. Lack of prompt access to healthcare may contribute to organ failure. Tox-screen is recommended for drug detection.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":"73 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141278490","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: Rivaroxaban is a widely used anticoagulant, but its impact on renal function, particularly at varying plasma concentrations, remains a critical area of investigation. This study examines the relationship between rivaroxaban concentration and renal impairment in elderly patients. Aims and Objectives: The aim of the study was to investigate the relationship between rivaroxaban plasma concentrations and the incidence of renal impairment in elderly patients. Materials and Methods: A retrospective observational study was conducted on 100 elderly patients prescribed rivaroxaban for atrial fibrillation or venous thromboembolism prevention. Patients were categorized based on their rivaroxaban plasma concentrations into three groups: Low (<50 ng/mL), medium (between 50 and 200 ng/mL), and high (>200 ng/mL). Renal impairment was characterized as having an estimated glomerular filtration rate <60 mL/min/1.73 m². The analysis of the data consisted of Chi-square testing and multivariable logistic regression, with adjustments made for age, gender, baseline renal function, and treatment indication. Results: The incidence of renal impairment escalated with increasing rivaroxaban concentrations, 20%, 40%, and 60% in low, medium, and high concentration groups, respectively. Statistical analysis revealed a significant association between rivaroxaban concentration and renal impairment (χ2=10.57, P=0.005). Patients with high concentrations had 2.8-fold higher odds of developing renal impairment compared to the low concentration group. Cox proportional hazards analysis showed a 2.2 times higher hazard of renal impairment in high versus low concentration groups over 18 months. Conclusion: Higher trough plasma concentrations of rivaroxaban are associated with an increased risk of renal impairment in elderly patients. This finding highlights the importance of monitoring rivaroxaban levels to mitigate renal risks.
{"title":"Assessing the link between rivaroxaban concentration and the onset of renal impairment in elderly patients: A retrospective observational study","authors":"Motakatla Usha Rani, Chitra Karuppiah, Penupothu Sree Nagamani","doi":"10.3126/ajms.v15i6.65229","DOIUrl":"https://doi.org/10.3126/ajms.v15i6.65229","url":null,"abstract":"Background: Rivaroxaban is a widely used anticoagulant, but its impact on renal function, particularly at varying plasma concentrations, remains a critical area of investigation. This study examines the relationship between rivaroxaban concentration and renal impairment in elderly patients.\u0000Aims and Objectives: The aim of the study was to investigate the relationship between rivaroxaban plasma concentrations and the incidence of renal impairment in elderly patients.\u0000Materials and Methods: A retrospective observational study was conducted on 100 elderly patients prescribed rivaroxaban for atrial fibrillation or venous thromboembolism prevention. Patients were categorized based on their rivaroxaban plasma concentrations into three groups: Low (<50 ng/mL), medium (between 50 and 200 ng/mL), and high (>200 ng/mL). Renal impairment was characterized as having an estimated glomerular filtration rate <60 mL/min/1.73 m². The analysis of the data consisted of Chi-square testing and multivariable logistic regression, with adjustments made for age, gender, baseline renal function, and treatment indication.\u0000 Results: The incidence of renal impairment escalated with increasing rivaroxaban concentrations, 20%, 40%, and 60% in low, medium, and high concentration groups, respectively. Statistical analysis revealed a significant association between rivaroxaban concentration and renal impairment (χ2=10.57, P=0.005). Patients with high concentrations had 2.8-fold higher odds of developing renal impairment compared to the low concentration group. Cox proportional hazards analysis showed a 2.2 times higher hazard of renal impairment in high versus low concentration groups over 18 months.\u0000Conclusion: Higher trough plasma concentrations of rivaroxaban are associated with an increased risk of renal impairment in elderly patients. This finding highlights the importance of monitoring rivaroxaban levels to mitigate renal risks.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":"50 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141275370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diabetes mellitus (DM) is a significant global health issue that affects nearly 537 million of people, with Type 2 DM (T2DM) accounting for the majority of cases. Death is frequently the result of diabetes-related complications, particularly cardiovascular illnesses, neuropathy, retinopathy, and nephropathy. Type 2 diabetes and cardiovascular events, such as coronary heart disease (CHD), are linked to a greater likelihood of creating when C-reactive protein (CRP), a representative acute phase inflammation response protein, is elevated. The purpose of this systematic review is to examine how T2DM adults’ cardiovascular risk is affected by highly sensitive CRP (hsCRP). The information found through searches of digital sources such as EBSCO, EMBASE, PubMed, Scopus, and Web of Science. The investigator separately reviewed each abstract and title in comparison to predetermined inclusion and exclusion standards. Google Scholar was used for further research. Using terms, a thorough search plan was created. The terms “hs-CRP,” “Type 2 diabetes mellitus,” and “cardiovascular disease” have been utilized. To translate the results for other databases, the original search was done in PubMed. To find additional pertinent papers, reference lists of the research included and previously released reviews were also examined. The findings state that people with DM have a higher risk of developing heart disease. Due to their elevated carbohydrate intake, unhealthy diet, and genetic disposition, Asian Indians are at a high risk of developing cardiovascular disease and DM. Diabetes patients’ cardiovascular risk is primarily determined by insulin sensitivity, which can be assessed using the markers hsCRP and tumor necrosis factor-. Lipid profile is important in cardiovascular diseases because high blood glucose levels encourage the body’s production of cholesterol, which increases the risk of heart malfunction in obese diabetic patients.
糖尿病（DM）是一个重大的全球健康问题，影响着近 5.37 亿人，其中 2 型糖尿病（T2DM）患者占大多数。死亡往往是糖尿病相关并发症造成的，尤其是心血管疾病、神经病变、视网膜病变和肾病。当具有代表性的急性期炎症反应蛋白 C 反应蛋白（CRP）升高时，2 型糖尿病和心血管事件（如冠心病）发生的可能性更大。本系统综述旨在研究高敏CRP（hsCRP）如何影响T2DM成人的心血管风险。研究人员通过对 EBSCO、EMBASE、PubMed、Scopus 和 Web of Science 等数字资源的检索找到了相关信息。研究人员对照预先确定的纳入和排除标准，分别审查了每篇摘要和标题。Google Scholar 用于进一步研究。通过使用术语，制定了详尽的搜索计划。使用了 "hs-CRP"、"2 型糖尿病 "和 "心血管疾病 "等术语。为了将结果转化到其他数据库，最初的搜索是在 PubMed 上进行的。为了找到更多相关论文，还研究了收录研究的参考文献目录和之前发布的综述。研究结果表明，糖尿病患者患心脏病的风险较高。由于碳水化合物摄入量高、饮食不健康以及遗传因素，亚洲印第安人患心血管疾病和糖尿病的风险很高。糖尿病患者的心血管风险主要由胰岛素敏感性决定，而胰岛素敏感性可以用 hsCRP 和肿瘤坏死因子来评估。血脂状况对心血管疾病很重要，因为高血糖会促进体内胆固醇的生成，从而增加肥胖糖尿病患者心脏功能失常的风险。
{"title":"Effect of highly sensitive C-reactive protein on cardiovascular risk of Type 2 diabetes mellitus adults: A systematic review","authors":"Benoy Upreti, Mingma Lhamu Sherpa, Karma Lakhi Bhutia","doi":"10.3126/ajms.v15i6.63068","DOIUrl":"https://doi.org/10.3126/ajms.v15i6.63068","url":null,"abstract":"Diabetes mellitus (DM) is a significant global health issue that affects nearly 537 million of people, with Type 2 DM (T2DM) accounting for the majority of cases. Death is frequently the result of diabetes-related complications, particularly cardiovascular illnesses, neuropathy, retinopathy, and nephropathy. Type 2 diabetes and cardiovascular events, such as coronary heart disease (CHD), are linked to a greater likelihood of creating when C-reactive protein (CRP), a representative acute phase inflammation response protein, is elevated. The purpose of this systematic review is to examine how T2DM adults’ cardiovascular risk is affected by highly sensitive CRP (hsCRP). The information found through searches of digital sources such as EBSCO, EMBASE, PubMed, Scopus, and Web of Science. The investigator separately reviewed each abstract and title in comparison to predetermined inclusion and exclusion standards. Google Scholar was used for further research. Using terms, a thorough search plan was created. The terms “hs-CRP,” “Type 2 diabetes mellitus,” and “cardiovascular disease” have been utilized. To translate the results for other databases, the original search was done in PubMed. To find additional pertinent papers, reference lists of the research included and previously released reviews were also examined. The findings state that people with DM have a higher risk of developing heart disease. Due to their elevated carbohydrate intake, unhealthy diet, and genetic disposition, Asian Indians are at a high risk of developing cardiovascular disease and DM. Diabetes patients’ cardiovascular risk is primarily determined by insulin sensitivity, which can be assessed using the markers hsCRP and tumor necrosis factor-. Lipid profile is important in cardiovascular diseases because high blood glucose levels encourage the body’s production of cholesterol, which increases the risk of heart malfunction in obese diabetic patients.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":"29 51","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141233058","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.v15i6.62572
Himanshu Sharma, Ishrat Khan, Varsha Porwal, Haneef Khan, Dr. Himanshu Sharma
Background: Autonomic function tests play a crucial role in the diagnosis and prognosis of clinical conditions. Although there are multiple autonomic function tests available, there is still a need for rapid and less expensive tests for the benefit of the general population. The pupil-to-limbus diameter (PLD) ratio is one such test that is simple and cost-effective. It uses the principle of pupil dilation and constriction due to the influence of the autonomic neurons’ activity. Aims and Objectives: The present study aimed to observe a correlation between PLD ratio with blood pressure and pulse rate in young adults. Materials and Methods: The present study was conducted at the Department of Physiology, Jhalawar Medical College, Jhalawar. The present study was an observational study conducted among 1st-year medical students in the age group of 18–24 years. PLD ratio was measured by the two-box method as described in the literature. After providing 3–5 min of rest, blood pressure and pulse were recorded in the right arm in the sitting position by a digital blood pressure monitor. Results: Positive correlation was observed between the PLD ratio of right eye and pulse rate (r=0.9696). There is a weak negative correlation exists between the PLD ratio of right eye and systolic blood pressure (r value=−0.3802). Conclusion: The study concludes that the PLD ratio correlates with autonomic activity. However, there is a need for a study with large population to confirm the correlation. Furthermore, there is a study to assess the autonomic responses in female participants in different phases of menstrual cycle.
{"title":"Relationship between pupil to limbus diameter ratio with blood pressure and pulse rate in young adults: An observational study","authors":"Himanshu Sharma, Ishrat Khan, Varsha Porwal, Haneef Khan, Dr. Himanshu Sharma","doi":"10.3126/ajms.v15i6.62572","DOIUrl":"https://doi.org/10.3126/ajms.v15i6.62572","url":null,"abstract":"Background: Autonomic function tests play a crucial role in the diagnosis and prognosis of clinical conditions. Although there are multiple autonomic function tests available, there is still a need for rapid and less expensive tests for the benefit of the general population. The pupil-to-limbus diameter (PLD) ratio is one such test that is simple and cost-effective. It uses the principle of pupil dilation and constriction due to the influence of the autonomic neurons’ activity.\u0000 Aims and Objectives: The present study aimed to observe a correlation between PLD ratio with blood pressure and pulse rate in young adults.\u0000Materials and Methods: The present study was conducted at the Department of Physiology, Jhalawar Medical College, Jhalawar. The present study was an observational study conducted among 1st-year medical students in the age group of 18–24 years. PLD ratio was measured by the two-box method as described in the literature. After providing 3–5 min of rest, blood pressure and pulse were recorded in the right arm in the sitting position by a digital blood pressure monitor.\u0000Results: Positive correlation was observed between the PLD ratio of right eye and pulse rate (r=0.9696). There is a weak negative correlation exists between the PLD ratio of right eye and systolic blood pressure (r value=−0.3802).\u0000Conclusion: The study concludes that the PLD ratio correlates with autonomic activity. However, there is a need for a study with large population to confirm the correlation. Furthermore, there is a study to assess the autonomic responses in female participants in different phases of menstrual cycle.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":"126 36","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141282005","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.v15i6.63565
Vijay Anand M, Logeshwaran K, Srenivas A, Sathiya Suresh R
Background: Children who develop cytopenias present with several etiological causes, posing diagnosis, and management difficulties for both physicians and pathologists. With these in mind, we assessed the clinical profile and etiology of children who attended a healthcare facility in South India with bicytopenia or pancytopenia. Aims and Objectives: (1) The primary objective of this study was to find out the clinical and etiological spectrum in children with bicytopenia and pancytopenia who were admitted to the Institute of Child Health and Research Center, Government Rajaji Hospital, Madurai. (2) The secondary objective of this study is to follow-up children with bicytopenia and pancytopenia to find out the outcome and prognosis. Materials and Methods: This study was in the Department of Pediatrics at the Government Rajaji Hospital in Madurai, Madurai Medical College’s Institute of Child Health and Research Center, which is where we carried out the study. Two hundred and sixty-four patients with bicytopenia and 36 patients with pancytopenia were included in this study. Once in 2 weeks, all children with bicytopenia and pancytopenia were assessed in our Saturday hematology outpatient clinics. Results: Fever was the most prevalent sign of both pancytopenia and bicytopenia in this investigation. Etiological variables among cases of pancytopenia, cancer, infections, non-infections, and idiopathic causes were recorded in 11%, 58%, 17%, and 14% of cases, respectively. Similarly, bicytopenia, malignancy, infections, non-infections, and idiopathic causes were found in 23%, 70%, 4%, and 3% of cases, respectively. According to the prognosis, 28%, 33%, 6%, and 33% of cases with pancytopenia recovered, passed away, were lost to follow-up, or were undergoing treatment, respectively. Similar to those individuals, 67%, 11%, 4%, and 18% of bicytopenia cases were treated, recovered, or lost to follow-up, respectively. Conclusion: In children, there is a wide etiological range of cytopenias. Infections and dangerous diseases like acute leukemia are among the reasons. The geographical location of the hospital, the frequency of malnutrition, and the regional presence of certain diseases such as malaria and enteric fever determine the causes reported in a hospital environment.
{"title":"Children with bicytopenia and pancytopenia – clinical picture, etiological spectrum, and outcome","authors":"Vijay Anand M, Logeshwaran K, Srenivas A, Sathiya Suresh R","doi":"10.3126/ajms.v15i6.63565","DOIUrl":"https://doi.org/10.3126/ajms.v15i6.63565","url":null,"abstract":"Background: Children who develop cytopenias present with several etiological causes, posing diagnosis, and management difficulties for both physicians and pathologists. With these in mind, we assessed the clinical profile and etiology of children who attended a healthcare facility in South India with bicytopenia or pancytopenia.\u0000Aims and Objectives: (1) The primary objective of this study was to find out the clinical and etiological spectrum in children with bicytopenia and pancytopenia who were admitted to the Institute of Child Health and Research Center, Government Rajaji Hospital, Madurai. (2) The secondary objective of this study is to follow-up children with bicytopenia and pancytopenia to find out the outcome and prognosis.\u0000Materials and Methods: This study was in the Department of Pediatrics at the Government Rajaji Hospital in Madurai, Madurai Medical College’s Institute of Child Health and Research Center, which is where we carried out the study. Two hundred and sixty-four patients with bicytopenia and 36 patients with pancytopenia were included in this study. Once in 2 weeks, all children with bicytopenia and pancytopenia were assessed in our Saturday hematology outpatient clinics.\u0000Results: Fever was the most prevalent sign of both pancytopenia and bicytopenia in this investigation. Etiological variables among cases of pancytopenia, cancer, infections, non-infections, and idiopathic causes were recorded in 11%, 58%, 17%, and 14% of cases, respectively. Similarly, bicytopenia, malignancy, infections, non-infections, and idiopathic causes were found in 23%, 70%, 4%, and 3% of cases, respectively. According to the prognosis, 28%, 33%, 6%, and 33% of cases with pancytopenia recovered, passed away, were lost to follow-up, or were undergoing treatment, respectively. Similar to those individuals, 67%, 11%, 4%, and 18% of bicytopenia cases were treated, recovered, or lost to follow-up, respectively.\u0000Conclusion: In children, there is a wide etiological range of cytopenias. Infections and dangerous diseases like acute leukemia are among the reasons. The geographical location of the hospital, the frequency of malnutrition, and the regional presence of certain diseases such as malaria and enteric fever determine the causes reported in a hospital environment.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":"75 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141280662","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.v15i6.62811
Radhika B, Vijayasri BSS, Vidyasagar V, Jyothi Prakash Raju S
Background: Neonatal sepsis is a leading cause of neonatal morbidity and mortality globally, with variations in causative bacteria and treatment efficacy across health-care facilities. Aims and Objectives: The aims and objectives of the study are to analyze the bacterial pathogens causing neonatal sepsis and the effectiveness of their treatment in diverse hospital environments. By highlighting the differences in treatment success rates, antibiotic resistance profiles, and the pathogens involved, this study demonstrate the impact of health-care practices and infrastructure on the management of neonatal sepsis. Materials and Methods: The study encompassed 100 neonates with sepsis, evenly distributed across the three hospital types. It involved identifying bacterial pathogens through blood cultures, assessing antibiotic sensitivity, and examining treatment outcomes such as success rate, mortality, hospital stay duration, and complication rates. Statistical methods were employed to evaluate differences in outcomes among the settings. Results: Seventy percent of neonates tested positive for bacterial pathogens, with a 60% predominance of Gram-positive over Gram-negative bacteria (40%). Staphylococcus aureus (22%) and Streptococcus agalactiae (18%) were the leading pathogens. Notably, resistance was high against ampicillin (65%) and gentamicin (40%) but lower for cephalosporins and vancomycin. The overall success rate of treatments was 80%, with the tertiary care hospital achieving an 88% success rate, significantly outperforming the private hospitals (72%). The mortality rate was 10%, and 30% of the cases developed complications, predominantly respiratory distress syndrome. Conclusion: Hospital setting significantly influences the management and outcomes of neonatal sepsis, with tertiary care centers showing better results. These findings highlight the need for focused antimicrobial stewardship and the adoption of sophisticated care protocols in less advanced settings to improve neonatal sepsis outcomes.
{"title":"Bacterial pathogens and treatment outcomes in neonatal sepsis: A comparative observational study across various hospital settings","authors":"Radhika B, Vijayasri BSS, Vidyasagar V, Jyothi Prakash Raju S","doi":"10.3126/ajms.v15i6.62811","DOIUrl":"https://doi.org/10.3126/ajms.v15i6.62811","url":null,"abstract":"Background: Neonatal sepsis is a leading cause of neonatal morbidity and mortality globally, with variations in causative bacteria and treatment efficacy across health-care facilities.\u0000Aims and Objectives: The aims and objectives of the study are to analyze the bacterial pathogens causing neonatal sepsis and the effectiveness of their treatment in diverse hospital environments. By highlighting the differences in treatment success rates, antibiotic resistance profiles, and the pathogens involved, this study demonstrate the impact of health-care practices and infrastructure on the management of neonatal sepsis.\u0000Materials and Methods: The study encompassed 100 neonates with sepsis, evenly distributed across the three hospital types. It involved identifying bacterial pathogens through blood cultures, assessing antibiotic sensitivity, and examining treatment outcomes such as success rate, mortality, hospital stay duration, and complication rates. Statistical methods were employed to evaluate differences in outcomes among the settings.\u0000Results: Seventy percent of neonates tested positive for bacterial pathogens, with a 60% predominance of Gram-positive over Gram-negative bacteria (40%). Staphylococcus aureus (22%) and Streptococcus agalactiae (18%) were the leading pathogens. Notably, resistance was high against ampicillin (65%) and gentamicin (40%) but lower for cephalosporins and vancomycin. The overall success rate of treatments was 80%, with the tertiary care hospital achieving an 88% success rate, significantly outperforming the private hospitals (72%). The mortality rate was 10%, and 30% of the cases developed complications, predominantly respiratory distress syndrome.\u0000Conclusion: Hospital setting significantly influences the management and outcomes of neonatal sepsis, with tertiary care centers showing better results. These findings highlight the need for focused antimicrobial stewardship and the adoption of sophisticated care protocols in less advanced settings to improve neonatal sepsis outcomes.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":"34 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141276003","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.v15i6.62810
Divangini Yadav, Junior Resident
The aim of this study was to present the spectrum of radiological findings in patients with intrauterine contraceptive device (IUCD). The study was conducted over a period of 14 months (June 2022–August 2023) in the Department of Radiodiagnosis, M.L.B. College, Jhansi. A prospective study was conducted in the Department of Radiology in MLB Medical College Jhansi in 120 cases with IUCD, referred from various departments. These patients were primarily evaluated on transabdominal and transvaginal sonography (3D, 4D) (ultrasound machine-Medison sono Ace-X8, Vivid T8, and Hitachi Aloka SSDF-31), which is the first-line imaging for the evaluation of IUCD position. Out of 120 cases, in 100 cases, findings were confirmed on USG and the rest cases require further radiological modalities such as X-ray, CT scan, and MRI which were used accordingly the presenting symptoms of the patient and findings of ultrasound. As in one of our case, X-ray pelvis has shown completely inverted IUCD.
{"title":"A study on clinicoradiological correlation in patients with intrauterine contraceptive device","authors":"Divangini Yadav, Junior Resident","doi":"10.3126/ajms.v15i6.62810","DOIUrl":"https://doi.org/10.3126/ajms.v15i6.62810","url":null,"abstract":"The aim of this study was to present the spectrum of radiological findings in patients with intrauterine contraceptive device (IUCD). The study was conducted over a period of 14 months (June 2022–August 2023) in the Department of Radiodiagnosis, M.L.B. College, Jhansi. A prospective study was conducted in the Department of Radiology in MLB Medical College Jhansi in 120 cases with IUCD, referred from various departments. These patients were primarily evaluated on transabdominal and transvaginal sonography (3D, 4D) (ultrasound machine-Medison sono Ace-X8, Vivid T8, and Hitachi Aloka SSDF-31), which is the first-line imaging for the evaluation of IUCD position. Out of 120 cases, in 100 cases, findings were confirmed on USG and the rest cases require further radiological modalities such as X-ray, CT scan, and MRI which were used accordingly the presenting symptoms of the patient and findings of ultrasound. As in one of our case, X-ray pelvis has shown completely inverted IUCD.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":"64 40","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141277301","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: Sino nasal mass (SNM) is a common clinical entity in the ENT outpatient department. It affects all age groups. SNMs are mainly non-neoplastic inflammatory polyp, benign tumor, and malignant tumor, out of which inflammatory polyp is the most common entity. Radiological investigation plays a major role in SNM. Surgery is the treatment of choice in almost all cases. Functional endoscopic sinus surgery (FESS) is the most commonly employed approach for surgery. Aims and Objectives: The aim of the current study is to analyze the clinicopathological aspects and enumerate the various management strategies of SNMs in patients attending the department of ENT in a tertiary care hospital in the upper Assam region. Materials and Methods: The present study was conducted in Assam Medical College between May 2022 and October 2023. During the period of this prospective observational study, 100 patients presented with SNMs. Results: Total 100 patients were reviewed, out of which 59 patients were male and 41 females. Overall, the most common affected age group was 31–40 years. Seventy-seven cases were non-neoplastic sinonasal polyps, 16 cases were benign tumors and seven were malignant tumors. Sixty-four patients had undergone FESS, 20 patients had endoscopic sinus surgery with or without medial maxillectomy and eight patients had lateral rhinotomy. Malignant cases were managed by radiotherapy and chemoradiation mainly. Conclusion: Sinonasal polyp is a very common entity among all SNMs. Computed tomography scan is the main diagnostic tool. FESS is the most commonly used surgical procedure with less complication.
{"title":"Clinicopathological spectrum and management of sinonasal masses – A prospective observational study in a tertiary care center","authors":"Mohsina Siddique, Debajit Sarma, Mridusmita Gohain, Rupanjita Sangma","doi":"10.3126/ajms.v15i6.62581","DOIUrl":"https://doi.org/10.3126/ajms.v15i6.62581","url":null,"abstract":"Background: Sino nasal mass (SNM) is a common clinical entity in the ENT outpatient department. It affects all age groups. SNMs are mainly non-neoplastic inflammatory polyp, benign tumor, and malignant tumor, out of which inflammatory polyp is the most common entity. Radiological investigation plays a major role in SNM. Surgery is the treatment of choice in almost all cases. Functional endoscopic sinus surgery (FESS) is the most commonly employed approach for surgery.\u0000Aims and Objectives: The aim of the current study is to analyze the clinicopathological aspects and enumerate the various management strategies of SNMs in patients attending the department of ENT in a tertiary care hospital in the upper Assam region.\u0000Materials and Methods: The present study was conducted in Assam Medical College between May 2022 and October 2023. During the period of this prospective observational study, 100 patients presented with SNMs.\u0000Results: Total 100 patients were reviewed, out of which 59 patients were male and 41 females. Overall, the most common affected age group was 31–40 years. Seventy-seven cases were non-neoplastic sinonasal polyps, 16 cases were benign tumors and seven were malignant tumors. Sixty-four patients had undergone FESS, 20 patients had endoscopic sinus surgery with or without medial maxillectomy and eight patients had lateral rhinotomy. Malignant cases were managed by radiotherapy and chemoradiation mainly.\u0000Conclusion: Sinonasal polyp is a very common entity among all SNMs. Computed tomography scan is the main diagnostic tool. FESS is the most commonly used surgical procedure with less complication.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":"51 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141232089","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: Hypertensive disorders of pregnancy are becoming the leading cause of maternal morbidity and mortality worldwide and are responsible for 9–25% of deaths 1. They are believed to occur due to an imbalance between pro-angiogenic factors, like placental growth factor (PlGF) and anti-angiogenic factors, like soluble fms-like tyrosine kinase-1 (sFLT-1). Aims and Objectives: The aim of the study was to evaluate the role of the sFLT-1/PlGF ratio along with uterine artery Doppler for the prediction of pre-eclampsia (PE). Materials and Methods: The current study was a prospective case–control study conducted at Sri Ramachandra Medical College and Hospital, Chennai, from 2018 to 2020. Blood samples for sFLT-1 and PlGF and uterine artery Doppler were done in 100 pregnant mothers who are at 16–20-week gestation attending antenatal outpatient department in the Department of Obstetrics and Gynecology. Results: We found that the mean sFLT-1 in high-risk group was 826.17 ng/L (standard deviation [SD]±251.31) compared to 924.69 ng/L (SD±360.61) in low-risk groups. The mean PlGF in the high-risk group was 23.07 ng/L (SD±4.68) compared to 27.43 ng/L (SD±5.62) in low-risk group. The mean sFLT-1/PlGF ratio was increased in high-risk group of about 39.68 (SD±22.77) compared to 35 (SD±16.98) in low-risk group. Women with high resistance uterine artery Doppler have 8.5 odds of getting PE compared to those with normal uterine artery Doppler. Conclusion: According to our study, the sFLT-1/PlGF ratio carries more sensitivity (90%) and negative predictive value (74.19%) if we keep the value as 32.25 along with uterine Doppler rather than their individual values for the prediction of PE.
{"title":"Role of soluble fms-like tyrosine kinase-1/placental growth factor ratio along with uterine artery Doppler for the prediction of pre-eclampsia – A case–control study","authors":"Sathya Jagdish, Kiruthiga T, Shruthi Prashanth, Jaya Vijayaraghavan, Sinduja Thirumanagalam Palanisamy","doi":"10.3126/ajms.v15i5.62900","DOIUrl":"https://doi.org/10.3126/ajms.v15i5.62900","url":null,"abstract":"Background: Hypertensive disorders of pregnancy are becoming the leading cause of maternal morbidity and mortality worldwide and are responsible for 9–25% of deaths 1. They are believed to occur due to an imbalance between pro-angiogenic factors, like placental growth factor (PlGF) and anti-angiogenic factors, like soluble fms-like tyrosine kinase-1 (sFLT-1).\u0000Aims and Objectives: The aim of the study was to evaluate the role of the sFLT-1/PlGF ratio along with uterine artery Doppler for the prediction of pre-eclampsia (PE).\u0000Materials and Methods: The current study was a prospective case–control study conducted at Sri Ramachandra Medical College and Hospital, Chennai, from 2018 to 2020. Blood samples for sFLT-1 and PlGF and uterine artery Doppler were done in 100 pregnant mothers who are at 16–20-week gestation attending antenatal outpatient department in the Department of Obstetrics and Gynecology.\u0000Results: We found that the mean sFLT-1 in high-risk group was 826.17 ng/L (standard deviation [SD]±251.31) compared to 924.69 ng/L (SD±360.61) in low-risk groups. The mean PlGF in the high-risk group was 23.07 ng/L (SD±4.68) compared to 27.43 ng/L (SD±5.62) in low-risk group. The mean sFLT-1/PlGF ratio was increased in high-risk group of about 39.68 (SD±22.77) compared to 35 (SD±16.98) in low-risk group. Women with high resistance uterine artery Doppler have 8.5 odds of getting PE compared to those with normal uterine artery Doppler.\u0000Conclusion: According to our study, the sFLT-1/PlGF ratio carries more sensitivity (90%) and negative predictive value (74.19%) if we keep the value as 32.25 along with uterine Doppler rather than their individual values for the prediction of PE.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":"85 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141045737","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 : 2024-05-01DOI: 10.3126/ajms.v15i5.62756
Tirupati Nath, Snigdha Sen, Himanshu Kumar Yadav, Dinesh Kumar Yadav, Dr. Dinesh Kumar, Junior Yadav, Resident
Background: Globally, it is expected that 111 million people will have glaucoma by 2040. Intraocular pressure (IOP) is the most crucial clinical risk factor for glaucoma onset and/or progression. Aims and Objectives: The aim of the study is to compare 0.4% ripasudil, 0.02% netarsudil, and 0.5% timolol in combination with 0.005% latanoprost in the medical management of primary open-angle glaucoma (POAG) or ocular hypertension (OHT). Materials and Methods: The prospective randomized clinical study was conducted on patients with mild-to-moderate POAG or OHT on a single prostaglandin analog (e.g., latanoprost) not achieving target IOP. Patients with narrow-angle glaucoma, any ocular surgery, and advanced glaucoma were excluded from the study. Patients were followed up at 15 days, 1 month, 2 months, and 3 months for a complete ophthalmic examination. Results: The maximum number of patients showed 41–60 years of age group. The male–female ratio was 1.8:1. A mild-to-moderate adverse event in the form of conjunctival hyperemia was seen in all groups. The mean reduction in IOP (mmHg) from baseline to 3 months in Groups A, B, and C is 5.7±0.923, 7.11±0.832, and 6.83±0.707 mmHg, respectively. Conclusion: When given in combination with 0.005% latanoprost and comparing IOP reduction in terms of efficacy, 0.4% ripasudil and 0.02% netarsudil are almost similar, but ripasudil was well tolerated and showed minimal ocular adverse effects; hence, ripasudil is better in comparison to netarsudil.
{"title":"A comparative study of 0.4% ripasudil, 0.02% netarsudil, and 0.5% timolol in combination with 0.005% latanoprost in the medical management of primary open-angle glaucoma or ocular hypertension","authors":"Tirupati Nath, Snigdha Sen, Himanshu Kumar Yadav, Dinesh Kumar Yadav, Dr. Dinesh Kumar, Junior Yadav, Resident","doi":"10.3126/ajms.v15i5.62756","DOIUrl":"https://doi.org/10.3126/ajms.v15i5.62756","url":null,"abstract":"Background: Globally, it is expected that 111 million people will have glaucoma by 2040. Intraocular pressure (IOP) is the most crucial clinical risk factor for glaucoma onset and/or progression.\u0000Aims and Objectives: The aim of the study is to compare 0.4% ripasudil, 0.02% netarsudil, and 0.5% timolol in combination with 0.005% latanoprost in the medical management of primary open-angle glaucoma (POAG) or ocular hypertension (OHT).\u0000Materials and Methods: The prospective randomized clinical study was conducted on patients with mild-to-moderate POAG or OHT on a single prostaglandin analog (e.g., latanoprost) not achieving target IOP. Patients with narrow-angle glaucoma, any ocular surgery, and advanced glaucoma were excluded from the study. Patients were followed up at 15 days, 1 month, 2 months, and 3 months for a complete ophthalmic examination.\u0000Results: The maximum number of patients showed 41–60 years of age group. The male–female ratio was 1.8:1. A mild-to-moderate adverse event in the form of conjunctival hyperemia was seen in all groups. The mean reduction in IOP (mmHg) from baseline to 3 months in Groups A, B, and C is 5.7±0.923, 7.11±0.832, and 6.83±0.707 mmHg, respectively.\u0000Conclusion: When given in combination with 0.005% latanoprost and comparing IOP reduction in terms of efficacy, 0.4% ripasudil and 0.02% netarsudil are almost similar, but ripasudil was well tolerated and showed minimal ocular adverse effects; hence, ripasudil is better in comparison to netarsudil.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":"189 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141049975","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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