scholarly journals Effect of thalidomide in patients with β–thalassemia major

2018 ◽  
Vol 6 (6) ◽  
Author(s):  
Shahzad Ali Jiskani ◽  
Sumair Memon
Keyword(s):  
Serum Ferritin ◽  
Ferritin Level ◽  
Treatment Options ◽  
Tertiary Care ◽  
Thalassemia Major ◽  
Hereditary Disease ◽  
P Value ◽  
Care Hospital ◽  
Female Ratio ◽  
Before And After

Introduction: Thalassemia is among the common hereditary disease, caused by synthesis of defective haemoglobin, leading to ineffective erythropoiesis, chronic haemolytic anaemia and certain clinical complications. Various treatment options are available for treatment of β–thalassemia major including regular blood transfusion, iron chelation therapy and hydroxyurea. Although complications and poor survival is still major problem in these patients. So treatment with alternative drugs can be helpful in management of these patients. Methods and materials: Prospective study, conducted at a tertiary care hospital. Study included 70 known cases of transfusion dependant thalassemia major. Age, gender, haemoglobin and serum ferritin levels were analyzed before and after treatment with thalidomide. All data were collected and analyzed in SPSS 21.0. P–value of <0.05 was considered as statistically significant. Results: Among 70 patients, 46 were males and 24 were females (male to female ratio=1.9:1). Mean age of the patients was 10.31±1.24years. Before and after treatment with thalidomide, mean haemoglobin was 8.93±1.04g/dL and 10.54±1.18g/dL respectively (p=0.011). Before and after treatment, mean serum ferritin level was 3125±143.51ng/mL and 1241±135.94ng/mL (p>0.001). Conclusion: Thalidomide proved to increased haemoglobin levels and reducing ferritin levels in patients with β–thalassemia major.

scholarly journals Risk factors, clinico-epidemiological profile of tuberculosis among children attending a tertiary care hospital: a two year study

2018 ◽  
Vol 5 (3) ◽  
pp. 851
Author(s):  
Ravikumar Tenali ◽  
Naveen Kumar Badri ◽  
Jithendra Kandati ◽  
Munilakshmi Ponugoti
Keyword(s):  
Risk Factors ◽  
Clinical Features ◽  
Tertiary Care ◽  
Epidemiological Surveillance ◽  
P Value ◽  
Tuberculous Lymphadenitis ◽  
Care Hospital ◽  
Female Ratio ◽  
Extra Pulmonary ◽  
Epidemiological Profile

Background: TB remains as the one among the top 10 causes of death worldwide. In 2016, 10.4 million people fell ill with TB, and 1.7 million died from the disease with 0.4 million with HIV. At least 1 million children become ill with TB each year. Children represent about 10-11% of all TB cases. Having knowledge of the risk factors for tuberculosis infection in children is important to evaluate the level of ongoing transmission of infection and to help adapt activities within national TB control programs. The main objective is to study the risk factors and their association and variable clinical features in cases of pulmonary and extra pulmonary tuberculosis.Methods: The main objective is to study the risk factors and their association and variable clinical features in cases of pulmonary and extra pulmonary tuberculosis.Results: 98 cases of TB were confirmed out of total 628 with a prevalence of 17.07% in the   study with 78 PTB cases and 20 EPTB. Females were more with male to female ratio of 0.7:1.5-9 years was the most common age group in the study. Statistically significant association was found between old history of ATT, HIV positivity, contact with an open case of TB and malnutrition (p value<0.05). TB meningitis was the most common EPTB (10/20 cases) followed by tuberculous lymphadenitis (5/20). 69.39% (68/98 cases) were smear positive, radiologically 59.18% of cases were positive and Tuberculin skin test was positive in 46.94%.Conclusions: Childhood tuberculosis is a neglected entity in developing countries due to underreporting and difficulties in diagnosis due to variable clinical picture in children. Hence epidemiological surveillance studies in children are required to determine the actual prevalence of pulmonary and extra pulmonary cases of tuberculosis. Increased efforts are required to isolate TB bacilli from body fluids to identify early the childhood cases and manage them to prevent disease burden in the community.

Increased frequency of fibromyalgia among patients with chronic pain presenting to internal medicine clinics of a tertiary care hospital: a cross sectional study

2022 ◽  
Vol 71 (12) ◽  
Author(s):  
Sana Javed ◽  
Muhammad Zaid ◽  
Sumera Imran ◽  
Ayesha Hai ◽  
Muhammad Junaid Patel
Keyword(s):  
Internal Medicine ◽  
Tertiary Care ◽  
Chronic Fatigue ◽  
Cross Sectional Study ◽  
National Language ◽  
P Value ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Ratio

Objective: To estimate the frequency of patients with fibromyalgia (by using the 2010 Modified Criteria for Fibromyalgia by American College of Rheumatology ( ACR ) presenting to Internal Medicine clinics  Methods: A cross-sectional study conducted in the department of Internal Medicine, the Indus Hospital, khi, Pakistan between December 2016 and March 2018. Patients who visited internal medicine clinics, met the selection criteria, were included in the study. After taking informed consent patients were assessed for fibromyalgia according to the new 2010 Fibromyalgia Diagnostic criteria questionnaire. The patients were asked the questions in the national language, Urdu. Data analyzed using SPSS version 21. P value of < 0.05 was considered significant. Results: Of the 267 patients presenting to the internal medicine clinics and consenting for participating in the study 149 (55.80%) met at least one of the 2010 Fibromyalgia Criteria. The prevalence of fibromyalgia as estimated in this study was 56% with no difference in gender. Mean age of patients with fibromyalgia was 42.3 ± 14.6 and patients without fibromyalgia was 38.9 ± 13.7 which was statistically significant (p-value = 0.05, 10% level of significance). Of the 267 patient 197 (73.8%) were female and 70 (26.2%) were males, a male to female ratio of 1:2.81.  Conclusion: All patients with generalized pain should be evaluated for fibromyalgia and a diagnosis made to reduce the cost of further referrals and investigations and delay in the management of this debilitating disorder. Keywords: Fibromyalgia, Chronic fatigue, Generalized Pain  

scholarly journals EFFECTIVENESS OF NEURAL MOBILIZATION AND STRETCHING EXERCISE FOR THE MANAGEMENT OF SCIATICA

2014 ◽  
Vol 3 (2) ◽  
pp. 11-15
Author(s):  
Sidra Zahid ◽  
Ghazala Noor Nizami
Keyword(s):  
Conventional Therapy ◽  
Controlled Trial ◽  
Treatment Options ◽  
Tertiary Care ◽  
P Value ◽  
Below The Knee ◽  
Pain Disability ◽  
Before And After ◽  
Group A ◽  
Group B

OBJECTIVE To find out the effectiveness of neural mobilization and stretching exercise for the management of sciatica BACKGROUND Sciatica is described as pain, radiating to the leg below the knee joint and caused by irritation of the sciatic nerve or nerve trunk. There are many treatment options for the management of sciatica, including stretching exercise and neural mobilization. MATERIAL AND METHODS This study was a Randomized Controlled Trial. 94 patients from physical therapy OPD of tertiary care hospitals, were participated in this study. Hence, 47 patients were randomly allocated into each group A and B. Before and after the nine treatment sessions, both groups were assessed with VAS, SLR ROM and Quebec back pain disability scale. In group A, neural mobilization with conventional therapy (heat and TENS) was applied, while stretching exercise with same conventional therapy was applied to group B. RESULTS It was observed that both treatments were helpful in reducing the symptoms. The analysis showed significant improvement (p-value <0.05) in the SLR to 60.851o±6.86oand Quebec score to 23.617±3.125, after the stretching exercise. Hence, both treatments were equally effective in reducing pain (p-value >0.05). CONCLUSION Stretching exercise is more effective in the improvement of SLR and disability. Furthermore, both techniques are helpful in the management of pain. KEY WORDS Sciatica, Stretching, Neural Mobilization, Straight Leg Raising, Visual Analogue Scale, TENS.

scholarly journals Relation of Left Ventricular Diastolic Dysfunction to Serum Ferritin in Thalassemia Major

2019 ◽  
pp. 224-233
Author(s):  
Aso Faeq Salih ◽  
Adnan M. Hamawandi
Keyword(s):  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Serum Ferritin ◽  
Ferritin Level ◽  
Serum Levels ◽  
Thalassemia Major ◽  
Left Ventricular ◽  
Lv Function ◽  
P Value ◽  
Lv Diastolic Function

A prospective study was conducted on 60 thalassemia major patients (33 males and 27 females ) in whom the LV function and its parameters where assessed by echocardiography in relation to serum ferritin during the period from 2nd October 2007 to 2nd February 2008, in Sulaimani pediatric teaching hospital. Patient and method: The age ranges of patients were ranged between 3 – 18 years old.  The diastolic function of LV was assessed by (M-mode, D-mode, and pulse dopplar study of mitral and pulmonary vein) done.  Among 60 patients seen, 25% shows normal LV diastolic function, the rest is 13% relaxation dysfunction, 27% shows Psuedonormal diastolic dysfunction and 35% shows restrictive pattern of LV diastolic dysfunction. Mean serum ferritin in normal and abnormal diastolic LV dysfunction was not so different. In addition nearly all LV parameters as ( LVEDD , LVESD , LA diameter , aortic root diameter , IVC , E ,A ,E/A ratio , A-E time , DT time , S,D,R  waves ) where non significantly related to serum ferritin level , this means that P value is less than 0.05 . This means that the level of serum ferritin has no relation with the above parameters in which 75% of those parameters were already abnormal in comparison to the age of the child. Another finding shows that 25% of normal diastolic function is seen in serum levels above 1500 ng/l, in addition, 50% of diastolic dysfunction will associate serum ferritin of less than 500ng/l . P value is more than 0,05 this means that its non-significant. In conclusion, there is a non-significant correlation between serum ferritin and LV diastolic function, so serum ferritin is not a dependant indicator for myocardial iron deposition.

Pubertal status and its relation with serum ferritin level in thalassemia major patients

2019 ◽  
Author(s):  
Morteza Alijanpour Aghamaleki MD ◽  
Ahmad Tamaddoni MD ◽  
Hassan Mahmoodi Nesheli MD ◽  
Mahmoud Hajiahmadi PhD ◽  
Motahareh Amouzadeh Samakoush MD ◽  
...  
Keyword(s):  
Serum Ferritin ◽  
Serum Ferritin Level ◽  
Ferritin Level ◽  
Hypogonadotropic Hypogonadism ◽  
Thalassemia Major ◽  
Careful Examination ◽  
Delayed Puberty ◽  
P Value ◽  
Cross Sectional ◽  
Pubertal Status

Background: Thalassemia major (TM) is one of the most common hereditary anemia with multiple endocrinopathies (especially hypogonadism). So, we evaluated the rate of delayed puberty (DP) and its relation with serum ferritin level in patients. Materials and Methods: This cross-sectional (descriptive-analytical) study was conducted on 100 patients with TM between 14-64 years old, admitted to Amirkola Thalassemia Center, Babol, Iran, in 2016. The pubertal status, (Marshall-Tanner scale), existance of DP, and its different types were evaluated. Mean serum ferritin level was measured and the data were classified to three groups of <1500, 1500-2500, and >2500 ng/ml. Data were analyzed using SPSS (version20). Results: Out of 100 patients, 64 (64%) and 36 (36%) were female and male, respectively. Considering age, 23, 77 patients (%) were under and over 20 years old, respectively. Totally, 69 (69%) of them had DP, of whom 64 (92.8%) ones had secondary (central) hypogonadotropic hypogonadism. Mean serum ferritin level (±SD) was 2707.94±1683.42 ng/ml. In addition, 26, 29, and 45 patients had ferritin level <1500, 1500-2500, and >2500 ng/ml, respectively. Thirty two patients with DP (46.4%) had ferritin level above 2500 ng/ml (p-value= 0.623). Conclusion: The results showed a high frequency of DP in TM patients, requiring careful examination and follow-up in terms of puberty for early diagnosis and proper treatment to improve their quality of life, and prevention of the complications like osteoporosis. We couldn't find any significant relationship between serum ferritin level and hypogonadism, even for cases who received enough iron chelators. Keywords: Delayed Puberty, Ferritin, Hypergonadotropic Hypogonadism, Hypogonadotropic Hypogonadism, Thalassemia Major    

scholarly journals Tympanoplasty Type-I using tragal perichondrium graft: Our experience

2019 ◽  
Vol 35 (4) ◽  
Author(s):  
Fazali Wahid ◽  
Sajid Rashid Nagra
Keyword(s):  
Tertiary Care ◽  
Case Series ◽  
Pure Tone Audiometry ◽  
Neck Surgery ◽  
Tympanic Membrane Perforation ◽  
P Value ◽  
Type I ◽  
Care Hospital ◽  
Female Ratio ◽  
Case Series Study

Objective: To determine the efficacy of tragal perichondrium graft used in tympanoplasty Type-I at a tertiary care hospital. Methods: This descriptive case-series study was performed at the department of E.N.T, Head and Neck Surgery, Medical Teaching Institution/Lady Reading Hospital (MTI/LRH), Peshawar, Pakistan from June 2017 to May 2018. After approved from IREB, a well informed consent was taken. Pure Tone Audiometry (PTA) was performed before surgery and post-operatively at three and six months interval. The mean ± SD Air-Bone Gap (ABG) was calculated in pre- and postoperative PTA. The data were analyzed using SPSS (version 20). Chi-square (X2) test of significance was used taking confidence interval at 95%. The p-value ≤0.05 was considered significant. Results: Total patients were 36; male 21 (58.3%), female 15(41.7%) with male: female ratio of 1.4:1. Mean ± SD age was 27.14 ± 7.49 years (Range 15 – 50Years). Tympanic membrane perforation was commonly found on right side 22 (61.1%), predominantly involving anterioinferior site 19 (52.8%) and medium sized perforation outnumbered 22 (61.1%). Mean pre-operative air-conduction of 49.72 dB was significantly reduced to 18.27 dB with pvalue of <0.05. Similarly the pre-operative mean air bone gap on PTA of 45.63 ± 8.35dB was also reduced to statistically significant level of 7.41 ± 3.51 dB on post-operative PTA with p-value of <.05. Graft was taken up well in 34 cases (94.4%). Conclusion: Tragal perichondrial graft is an effective grafting material used for tympanoplasty due to its possessing qualities. doi: https://doi.org/10.12669/pjms.35.4.421 How to cite this:Wahid FI, Nagra SR. Tympanoplasty type I using tragal perichondrium graft: Our experience. Pak J Med Sci. 2019;35(4):---------.  doi: https://doi.org/10.12669/pjms.35.4.421 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Study of lipid profile in β thalassemia major pediatric patients with multiple blood transfusion and its correlation with serum ferritin level in tertiary care hospital in Kolkata

2021 ◽  
Vol 8 (4) ◽  
pp. 1778
Author(s):  
Saikat Nandi ◽  
Sanjana Samanta ◽  
Tanushree Mondal ◽  
Sanjay Halder
Keyword(s):  
Blood Transfusion ◽  
Lipid Profile ◽  
Serum Ferritin ◽  
Serum Ferritin Level ◽  
Ferritin Level ◽  
Thalassemia Major ◽  
Care Hospital ◽  
Average Value ◽  
Multiple Blood Transfusion ◽  
Multiple Blood

Background: β-Thalassemia major is associated with iron overload toxicity. This study was done to investigate lipid profile abnormality in β-Thalassemia major patients and to establish their correlation with serum ferritin. Another motto of this study was to signify deleterious effect of multiple blood transfusion and facilitate to understand how it will affect the lipid profile parameters changes so that we can also prevent early dyslipidemia induced complications like atherogenesis by early detection of lipid profile abnormality and also to establish derangement of lipid profile as an indirect evidence of iron overload.Methods: 102 nos. β-Thalassemia major paediatric patients with multiple blood transfusion (≥10) in age group of 6 to12 years admitted in pediatric ward of tertiary care hospital (NRSMCH) were enrolled. Serum ferritin level and lipid profile were investigated and their correlation were assessed.Results: Among 102 β-Thalassemia major pediatric (6 to 12 years) patients 55.88% were male and 66.67% were Hindu by religion and 69.61% children came from lower socio-economic class. The average value of number of previous blood transfusion was 42.79±7.510. The mean value of serum ferritin was 2263.53±833.904 ng/ml. The average value of serum total cholesterol, LDL and HDL were 153.84±5.428 mg/dl and 97.16±3.982 mg/dl and 29.45±4.445 mg/dl respectively and their correlation with serum ferritin were negative (r=-0.941 and r=-0.964 and r=-0.751 respectively). Average value of serum triglyceride and VLDL were 206.22±67.407 mg/dl and 36.16±3.385 mg/dl respectively and their correlation with serum ferritin were positive (r=+0.606 and r=+0.973 respectively).Conclusions: There was significant lipid profile derangement. As the serum ferritin level increases, serum total cholesterol, HDL, LDL decreases and serum triglyceride, VLDL level increases.

scholarly journals CORRELATION BETWEEN HRCT SCORE AND SERUM FERRITIN IN COVID-19 PATIENTS WITH PNEUMONIA IN TERTIARY CARE HOSPITAL, MGM HOSPITAL AURANGABA

2021 ◽  
pp. 52-54
Author(s):  
Saurabh Govind Pad ◽  
Devidas Dahiph ◽  
Saurabh Kakani ◽  
Vimal Dugad
Keyword(s):  
Serum Ferritin ◽  
Pearson Correlation ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
The Social ◽  
Severe Group ◽  
Positive Correlations ◽  
Age Range

This study was aimed to correlate the HRCT score and serum ferritin in diagnosed cases of COVID19 patients with pneumonia.During the pandemic of COVID-19,there was sudden surge in the numbers of HRCT chest scans and along with this amongst the various laboratory investigations serum ferritin was done to observe the role of cytokines which helps in disease progression.The main purpose of this study was to correlate the severity of disease on HRCT chest scan with serum ferritin levels. Aim:To correlate the HRCT score and serum ferritin in diagnosed cases of COVID19 patients with pneumonia. Materials and methods: We included 59 patients (38 men, 21 women age range 18-78years) with documented COVID19 were reviewed. All patients underwent RTPCR tests and had a noncontrast HRCT scan done at presentation. Estimation of serum ferritin was analyzed by using chemiluminescence method.The subjects were divided into three groups:mild,moderate and severe on the basis of HRCT score. Each group's HRCT score correlated with serum ferritin. The details were recorded on a prestructured proforma. The Pearson correlation coefficient test was used for correlations, and p value less than 0.05 was defined as statistically significant.The data was analyzed using Statistical Package for the Social Sciences (SPSS). Results: Out of 59 patients,21 patients were included in the mild group,31 were included in the moderate group and 7 were included in the severe group.CT severity score was found to be positively correlated with ferritin levels (p < 0.001). Strong positive correlations were found between CT scores and serum ferritin in mild (r = 0.84),Moderate (r = 0.92) and severe group (r = 0.082)

scholarly journals Cerebral Hemodyanamics in Stable Preterm Infants Before and After Packed Cell Transfusion

2020 ◽  
Author(s):  
Chinmay Chetan ◽  
Nyein Zaw ◽  
Pradeep Suryawanshi ◽  
Nishant Banait ◽  
Prince Pareek ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Tertiary Care ◽  
Peak Systolic Velocity ◽  
Resistive Index ◽  
Interquartile Range ◽  
P Value ◽  
Care Hospital ◽  
Doppler Study ◽  
Diastolic Velocity ◽  
Before And After

Abstract BACKGROUND In a year around 3.5 million preterm deliveries occur in India alone. Some of these babies will require packed cell volume (PCV) transfusion. There is a paucity of robust data on effect of blood transfusions on the cerebral hemodynamic from India. This study was done to see the effect of PCV transfusion on blood flow velocities and resistive index (RI) of anterior cerebral artery (ACA) in stable preterm infants. METHOD A prospective observational study was conducted in a tertiary care hospital in Pune, India. All stable preterm infants (<37 weeks) receiving PCV transfusion were enrolled. USG Doppler study of ACA was done before and after PCV transfusion. Peak systolic velocity (PSV), end-diastolic velocity (EDV) and RI were measured pre and post PCV transfusion. RESULTS Thirty infants were included in the study, with median gestation age of 28.8 [interquartile range {IQR}, 27-30.55] weeks and median birth weight of 970 [interquartile range {IQR}, 869.5-1190] grams. There was a significant decrease in PSV pre and post PCV transfusion - 58.46 (±18.44) cm/sec and 46.34 (±13.93) cm/sec respectively (p value <0.001). Changes in RI and EDV were non-significant.CONCLUSION PCV transfusion significantly decreased PSV, reflecting improved cerebral oxygenation, and decreased cardiac output after correction of anaemia. Laboratory threshold for PCV transfusion in stable preterm infants are not known. USG Doppler study has the potential to provide one of the objective criteria for PCV transfusion in these infants though large scale randomized controlled trials are needed to prove its efficacy.

scholarly journals An Update on Secondary Bacterial and Fungal Infections and Their Antimicrobial Resistance Pattern (AMR) in COVID-19 Confirmed Patients at a Tertiary Care Hospital

2022 ◽  
Author(s):  
Sushma Yadav Boorgula ◽  
Sadhana Yelamanchili ◽  
Pragathi Kottapalli ◽  
Mohini D. Naga
Keyword(s):  
Antimicrobial Resistance ◽  
Fungal Infections ◽  
Treatment Options ◽  
Tertiary Care ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
P Value ◽  
Care Hospital ◽  
Stewardship Program ◽  
Secondary Infections

Abstract Introduction Since coronavirus disease 2019 (COVID-19) has limited treatment options, concern has been raised over secondary infections and antimicrobial resistance (AMR) patterns. It has been observed that patients who were infected with COVID-19 were predisposed to develop secondary infections. The purpose of the study is to ascertain the prevalence of the bacterial and fungal coinfections in COVID-19 patients, and also to assess the AMR patterns in the obtained isolates. Methods We have studied 200 clinical samples obtained from 122 COVID-19 positive patients. Pathogens were identified using Vitek 2 system. The demographic and clinical patterns were also observed. Results A total of 122 patients developed secondary infections. Patients aged more than 40 years were majorly affected (p-value < 0.0001). Respiratory samples (n = 96) were predominant. Klebsiella pneumoniae (n = 68) was the most common pathogen isolated followed by Acinetobacter baumannii (n = 54) and an overall 6% rise in the Carbapenem resistance was observed in the isolates. Conclusion To contain the secondary infections in COVID-19 patients, it is imperative to adhere to antimicrobial stewardship program and timely revise the empirical antibiotic policy.

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