scholarly journals Profile of tuberculous pneumothorax and comparison with pulmonary tuberculosis without pneumothorax

2019 ◽  
Vol 7 (3) ◽  
pp. 658
Author(s):  
Gayatri D. Yellapu ◽  
Surya K. Vipparthi ◽  
Rohini K. Vangara
Keyword(s):  
Pulmonary Tuberculosis ◽  
Hospital Stay ◽  
Past History ◽  
Financial Burden ◽  
Tertiary Care ◽  
Control Group ◽  
P Value ◽  
Care Hospital ◽  
Common Cause ◽  
The Mean

Background: Tuberculosis is the most common cause of secondary spontaneous pneumothorax (SSP) in India. The prevalence of SSP in patients with pulmonary tuberculosis (PTB) is between 1- 3%. There were only few studies in the literature that specifically analyze tuberculous PNTX. In a study from this hospital, author found PTB was the most common cause of SSP. Now, author aimed at studying the clinical profile of tuberculosis associated PNTX cases and compared with pulmonary tuberculosis cases without PNTX.Methods: This was a single centre prospective observational case control study done at a tertiary care hospital. Fifty patients of tuberculous pneumothorax as cases, and 100 patients of pulmonary tuberculosis without pneumothorax were taken as control. The demographic data, clinical presentation, and radiologic presentation, outcomes after treatment were recorded in both the groups. The data was analyzed using statistical software (SPSS) using appropriate statistical tools.Results: The mean age of patients in the PNTX group was 38.18±14.132, where as in the control group it was 45.29±14.89 (p-value of 0.0052). Past history of tuberculosis was present in 27 (54%) cases of PNTX group and in 41 (41%) cases in the control group (p-value of 0.091). The mean duration of length of hospital stay in PNTX group was 16.5±11.865 days and in non-pneumothorax group was 6.2±2.54 days (p-value was 0.0001).Conclusions: Tuberculous pneumothorax was more common between 30-40 yrs age group. Gender and smoking have no association with PNTX. Tuberculous pneumothorax was more common in previously treated cases of TB. Patients with tuberculous PNTX have prolonged hospital stay and complications resulting in increased morbidity, financial burden and mortality.

scholarly journals Profile of Amblyopia and Outcome of Occlusion Therapy in Amblyopic Patients Attending Tertiary Care Hospital of Kathmandu

2021 ◽  
Vol 23 (2) ◽  
pp. 94-101
Author(s):  
Srijana Karmacharya ◽  
Pranisha Singh ◽  
Aparna Rizyal ◽  
Aditya Prasad Rijal
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Visual Outcome ◽  
Common Type ◽  
Care Hospital ◽  
Common Cause ◽  
Occlusion Therapy ◽  
Initial Visual Acuity ◽  
The Mean ◽  
Final Visual Outcome

Amblyopia is a common cause of visual impairment in children. The aim of this study was to assess the profile of amblyopia and the outcome of occlusion therapy in amblyopic children attending the eye department of a tertiary care hospital. This was a hospital based prospective interventional study. Sixty-five eyes of 47 patients fulfilling the inclusion criteria were included in the study. Occlusion therapy was started for the diagnosed amblyopic cases after refractive adaptation of 4 weeks. The mean age of presentation was 8.8 ±3.2 years. 29(61.7%) cases had unilateral amblyopia, 18(38.3%) cases had bilateral amblyopia. Ametropic amblyopia (52.3%) was the most common type of amblyopia followed by Anisometropia (23.1%). Refractive error was the most common cause of amblyopia with compound myopic astigmatism seen among 30.8% and hypermetropia among 29.2% of patients. There was no significant association between initial visual acuity with age of presentation and types of amblyopia respectively (P=0.1, P=0.5). The final visual outcome after therapy was better among patients with Ametropic amblyopia than other types (P=0.02). There was significant association between final visual outcome with age, initial visual acuity, type and severity of amblyopia respectively (P<0.001, P<0.001, P=0.02, P=0.02). In conclusion, Ametropia was the most common type of amblyopia. The mean age of presentation was 8.8 years, which was beyond the critical period affecting the outcome of treatment. Uncorrected refractive error was the most common amblyogenic factor. Age of presentation, types and severity of amblyopia are the important contributing factors for the outcome of occlusion therapy. Therefore, early detection and management of amblyopia is important to reduce visual impairment among children.

scholarly journals A STUDY TO ASSESS THE CONTRAST SENSITIVITY OF THE HUMAN VISUAL SYSTEM IN PATIENTS WITH OR WITHOUT DIABETES IN A TERTIARY CARE HOSPITAL

2020 ◽  
pp. 24-26
Author(s):  
NIKITA RAJGADIA ◽  
BINDU BHASKARAN ◽  
N. DIVYA ◽  
V. PANIMALAR A. VEERAMANI ◽  
SYEDA SADIYA IKRAM
Keyword(s):  
Visual Acuity ◽  
Visual Impairment ◽  
Contrast Sensitivity ◽  
Tertiary Care ◽  
Dependent Diabetes Mellitus ◽  
Control Group ◽  
P Value ◽  
Care Hospital ◽  
Type Ii ◽  
Department Of Ophthalmology

Objective: The objective of our study was to assess the variations in contrast sensitivity values of normoglycemic subjects and that of type II diabetic subjects of the same age group. It was also aimed at finding the visual acuities and study the associations of it with contrast sensitivity if any. Methods: It was a hospital-based comparative cross-sectional descriptive study conducted in the out-patient department of the Department of Ophthalmology, Saveetha Medical College, Hospital, Chennai. Visual Acuity and Contrast Sensitivity of 50 Type II Diabetic individuals and 50 age-equivalent control group subjects were measured using the Snellen’s chart and Pelli-Robson chart, respectively, during the months of January to March 2020. Results: Contrast Sensitivity measurements from 50 subjects with Non-Insulin dependent Diabetes Mellitus (NIDDM) were obtained. The subjects were the ones who had minimal or no diabetic retinopathy. It was observed that there is a significant association between reduced contrast sensitivity and Diabetes (P value<.00008). We also noted that CS may be reduced without corresponding loss of Visual Acuity. Hence, both visual acuity and contrast sensitivity measurements are helpful in the assessment of visual impairment due to diabetic eye disease. Conclusion: The contrast sensitivity can be seen as an early marker for visual impairment in diabetic eye care.

scholarly journals Effect of Taping of Thoracic and Abdominal Muscles on Pelvic Alignment and Forward Reach Distance Among Stroke Subjects: A Randomized Controlled Trial

2019 ◽  
Vol 26 (3-4) ◽  
pp. 10-16
Author(s):  
Megha Mehta ◽  
Abraham M. Joshua ◽  
Suruliraj Karthikbabu ◽  
Zulkifli Misri ◽  
Bhaskaran Unnikrishnan ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Control Group ◽  
P Value ◽  
Abdominal Muscles ◽  
Care Hospital ◽  
Physiotherapy Treatment ◽  
Short Term ◽  
Randomized Controlled ◽  
Conventional Physiotherapy ◽  
Experimental Group

Introduction: The objective of this study was to find the immediate as well as short-term effect on pelvic alignment and forward arm reach distance in sitting among stroke patients following thoracic spine and abdominal muscles taping along with conventional therapy. Methods: Thirty subjects with stroke attending the physiotherapy programme at Department of Physiotherapy at a tertiary care hospital underwent this randomized controlled experimental study. Subjects in the experimental group received taping, along with conventional physiotherapy treatment, for restricting thoracic kyphosis and facilitating abdominal muscles. Subjects in the control group received only conventional physiotherapy treatment. To assess the change in pelvic alignment and forward arm reach distance while sitting, Palpation MeterTM (PALMTM) and sit and reach test were used, respectively. Results: In the experimental group, pelvic obliquity was corrected (4.1 ± 0.94) and anterior pelvic tilt revealed improvement (4.9 ± 2.1, p value < 0.001). In the control group, no improvement in pelvic alignment was recorded. Improvement in forward arm reach distance was similar in both groups ( p value = 0.804). Conclusion: Taping as an adjunctive treatment method to physiotherapy can cause immediate as well as short-term improvement of pelvic alignment in sitting, following stroke. It also, immediately improves the sit and reach distance in the same population.

scholarly journals EFFECT OF DIABETES MELLITUS ON RIFAMPICIN PEAK SERUM CONCENTRATION

2016 ◽  
Vol 8 (10) ◽  
pp. 149
Author(s):  
Saranya P. ◽  
Parthasarathy V. ◽  
Hariprasad B. ◽  
Shobha Rani H.
Keyword(s):  
Diabetes Mellitus ◽  
Serum Concentration ◽  
Pulmonary Tuberculosis ◽  
Tertiary Care ◽  
Peak Serum Concentration ◽  
Peak Serum ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Significant Difference ◽  
The Mean

<p><strong>Objective: </strong>To comparatively analyze the peak serum concentration (Cmax) of rifampicin and to determine the incidence of decreased Cmax between diabetic and non-diabetic adult pulmonary tuberculosis patients.</p><p><strong>Methods: </strong>A cross-sectional observational study was carried out in the chest and tuberculosis (TB) department of a tertiary care hospital after the approval of the institutional ethics committee. Five millilitre (ml) of blood was withdrawn by venipuncture from each patient at a time point of 2 h post dose administration at steady state concentration (C<sub>ss</sub>). The separated serum was centrifuged at a rate of 3500 rotations per minute (rpm) for a period of fifteen minutes and the resultant serum was stored at-70 ° C until analysis. Estimation of rifampicin concentration was carried out in Thermo TSQ Ultra (MS/MS) with Shimadzu 20 AD UFLC LC-MS.</p><p><strong>Results: </strong>The mean (Standard Deviation (SD)) age of the study population was 46.8 (14.2) years. The mean serum C<sub>max</sub> of rifampicin was significantly less in diabetic patients with pulmonary tuberculosis (p=0.0305).<strong> </strong>Statistically, a significant difference in the incidence of a decrease in C<sub>max </sub>was found between diabetic and non-diabetic patients (p=0.0335). Diabetes mellitus was found to be the predominant factor that affects rifampicin C<sub>max</sub>.</p><p><strong>Conclusion: </strong>In this study, an effect of diabetes mellitus (DM) on the peak serum concentration of rifampicin was observed. Patients with hyperglycemia levels had significantly reduced levels of rifampicin serum concentrations, thus showing an inversely proportional relationship between blood glucose and rifampicin serum levels.</p>

scholarly journals Prostatic lesions: Histopathological study in a tertiary care hospital

2018 ◽  
Vol 4 (1) ◽  
pp. 12-19
Author(s):  
S. Bhatta ◽  
S. Hirachan
Keyword(s):  
Histopathological Examination ◽  
Benign Lesion ◽  
Tertiary Care ◽  
Histopathological Study ◽  
P Value ◽  
Care Hospital ◽  
Significant Difference ◽  
Nodular Hyperplasia ◽  
Malignant Lesions ◽  
The Mean

Background: Prostatic lesions like Nodular hyperplasia of prostate, inflammation and carcinoma are common causes of morbidity and mortality in males. The incidence of these lesions increases with age. This study was conducted with the objective of evaluating histopathological pattern of prostatic lesions.Methods: This was a retrospective study conducted at KIST Medical College from Jan 2014 to Jan 2018. The study included ninety six prostatic specimens received in department of pathology. Hematoxylin and Eosin stained slides were retrieved and reviewed. The specimens and slides were analyzed according to type of specimen, age of patient, histopathological pattern and final diagnosis. Results were analyzed using Statistical Package for Social Science (SPSS, version 21) for Windows. Independent t test was used to correlate the mean age between patients with benign and malignant lesions. P value less than 0.05 was considered as statistically significant.Results: The most common benign lesion was nodular hyperplasia of prostate 86(89.58%). Malignant lesions comprised 8 (8.34%) cases of all prostatic lesions. All the cases of prostate carcinoma were adenocarcinoma. The most frequent Gleason score was 9. Mean age for benign and malignant lesions were 69.6 ± 8.1 years and 72.9 ± 5.2 years respectively. There was no significant difference in the mean age between patients with benign and malignant lesions (p value 0.27).Conclusion: Benign lesions of prostate are more common than malignant lesions. Histopathological examination of prostate specimens have important role in diagnosing various benign and malignant lesions, especially to rule out incidental carcinoma.JMMIHS.2018;4(1):12-19

scholarly journals Assessing the Learning environment of major Specialty PGRs in a tertiary care Hospital by Health Education Learning Environment Survey (HELES)”

2020 ◽  
Vol 3 (1) ◽  
pp. 53-58
Author(s):  
Qamar Ashfaq Ahmad
Keyword(s):  
Health Education ◽  
Learning Environment ◽  
Personal Development ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Three Dimensions ◽  
P Value ◽  
Care Hospital ◽  
System Maintenance ◽  
The Mean

Background: There are many surveys available to quantify educational climate of postgraduate residents but these are lacking in validity and theoretical background. Health education learning environment survey (HELES) with 35 questions in six subscales is used in undergraduates with good results. Objectives: To quantify current health education learning environment of our Post graduate residents of FCPS/MS/MD in Surgery, Medicine and Gynae & Obs in a tertiary care hospital by using HELES tool. This quantification will help Supervisors, Hospital administrators to monitor their programs, suggest and bring improvement.     Methods: A cross sectional study was done in Services Institute of Medical Sciences Lahore from 10th Sep to 1st Oct 2019. A sum of 90 residents in FCPS/MS/MD program with 30 each from Surgery, Medicine and Gynae & Obstetrics were selected.  A predesigned HELES proforma with 35 questions subdivided in 6 factors and 3 main dimensions was used. In “Personal development “a mean score of 34 and above was taken as positive score. In “Relationship” and in “System maintenance” dimension a mean score of 48 and above was taken as positive. Data was analyzed using SPSS 22 and p value of 0.05 was taken as significant. Results: Out of 90 residents, 57 (63.3%) were males and 33 (36.7%) were females without any significant difference between gender. The mean age was 27.4 ± 3.6 years. The mean score of all the residents in Surgery, Medicine and Gynae & Obs in all the three dimensions remained below the average reference values, which implies that our postgraduates are not content with the learning environment they live in.  The comparison of means among different specialties was 0.02 which was statistically significant. Resident’s response in all the three dimensions with their year of training was significant with a p value of < 0.05. 2nd year residents of all specialties scored comparatively high in all the three dimensions Conclusion:  PGRs in the 3 major specialties were dissatisfied with their health education learning environment. Maximum were discontent in Relationship dimension especially in Faculty relationship factor, then in System maintenance and then in Personal development dimension. Residents of Gynae & Obstetrics exhibited significantly low score in System Maintenance dimension.   Key words: Health, education, learning, environment, residents

scholarly journals Comparative study of serum urea, creatinine and C-reactive protein level in chronic kidney disease patients with healthy subjects

2017 ◽  
Vol 5 (4) ◽  
pp. 1480 ◽  
Author(s):  
Dileep Singh Nirwan ◽  
R. K. Vyas ◽  
Sunil Jain
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tertiary Care ◽  
Age Groups ◽  
Control Group ◽  
P Value ◽  
Care Hospital ◽  
Serum Urea ◽  
C Reactive Protein ◽  
Reactive Protein

Background: Chronic diseases are a leading cause of morbidity and mortality in India. Globally, chronic kidney disease is the 12th cause of death and the 17th cause of disability, respectively. CKD is defined as kidney damage or glomerular filtration rate (GFR) <60 mL/min/1.73 m2 for 3 months or more, irrespective of cause. The present study aimed to find out correlation between serum urea, creatinine and C-reactive protein (CRP) level among patients suffering from chronic kidney disease in an urban based tertiary care hospital in Bikaner, western Rajasthan, India.Methods: This study was conducted at Sardar Patel Medical College and Associated Hospitals at Bikaner, Rajasthan from August 2015 to December 2016. There were 50 cases and 50 controls in the age groups from 10 to 60 yearrs. We took fresh samples and performed required tests following standard protocol. CRP has been done by Antigen Antibody reaction (latex method). RFT has been performed on semi-automatic analyzer.Results: Levels of serum urea and creatinine were significantly raised in CKD patients (p-value<0.005) and CRP level was raised in 52% cases. While 48% cases having normal level %), which requires further study.  Renal function tests were significantly higher in cases than controls.Conclusions: Serum creatinine and urea level were significantly higher in cases as compared to control group.

scholarly journals Video assisted thoracoscopic surgery in the management of acute fibrinopurulent empyema in paediatric patients

2020 ◽  
Vol 7 (6) ◽  
pp. 1847
Author(s):  
Arti S. Mitra ◽  
Nilesh G. Nagdeve ◽  
Simran R. Khatri ◽  
Unmed A. Chandak
Keyword(s):  
Hospital Stay ◽  
Thoracoscopic Surgery ◽  
Bronchopleural Fistula ◽  
Tertiary Care ◽  
Pleural Empyema ◽  
Care Hospital ◽  
Age Group ◽  
Video Assisted ◽  
The Mean ◽  
Video Assisted Thoracoscopic Surgery

Background: Empyema is the presence of pus in the pleural space that usually follows an episode of pneumonia in pediatric age group. The aim of this study was to assess the efficacy of management of acute fibrinopurulent stage of empyema by early video assisted thoracoscopic surgery (VATS) in paediatric patients.Methods: The study was carried out at a tertiary care hospital in India. It was a prospective interventional observational study. The study included 40 children between age group 0-12 years attending the surgery in-patient department referred for further management of parapneumonic effusions who had clinical and radiological evidence of empyema and thoracocentesis confirmed purulent exudate in pleural cavity, were subjected to early VATS after thorough pre-operative workup.Results: The mean age was 7.22 years. Average operative time was 135.5 minutes. The mean duration of hospital stay was 7.5 days. Few complications were bleeding, superficial wound infection, bronchopleural fistula, pneumothorax, recurrence of empyema and incomplete expansion of lung.Conclusions: VATS facilitates the management of fibrinopurulent and organised pyogenic pleural empyema with less post-operative discomfort and complications and reduced hospital stay. However larger sample size study is required to come to a definitive conclusion.

scholarly journals Comparison of subtalar mobilization with conventional physiotherapy treatment for the management of planter fasciitis

2021 ◽  
pp. 1-12
Author(s):  
Muhammad Kashif ◽  
Abdulaziz Aoudh Albalwi ◽  
Ahmed Abdullah Alharbi ◽  
Humaira Iram ◽  
Nosheen Manzoor
Keyword(s):  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Care Hospital ◽  
Control Groups ◽  
Physiotherapy Treatment ◽  
Clinical Trial Registry ◽  
The Mean ◽  
Conventional Physiotherapy ◽  
And Control

Objective: To compare the effectiveness of subtalar mobilization with movement (Mulligan technique) with conventional physiotherapy treatment for the management of planter fasciitis. Material and Methods: A single blinded randomized trial was conducted at the Prime Care Hospital, Faisalabad, Pakistan from January 2017 to August 2017. Sixty Participants were divided into intervention and control groups through a computerized random numbers. Intervention group was treated with subtalar mobilization with movement (Mulligan technique), and control group was given conventional physiotherapy for three-weeks. SPSS 20 was used for data analysis.   Results: The mean age of the participants in the intervention group was 32.40 ± 8.02 years and the control group 32.59 ± 7.00 years. The mean BMI in intervention and control groups was 25.35 and 25.67, respectively. The result of our study showed that there were significant differences (P-value <0.05) between the VAS values before and after the intervention in the 3rd week between the intervention and the control group. Moreover, the intervention group showed more reduction in disability (p=0.03) compared to the control group.   Conclusion: Our study concluded both methods to demonstrate benefits. However, Subtalar mobilization with movement (Mulligan technique) plus rigid tapping reduced pain and disability more effectively than conventional physiotherapy plus rigid tapping in patients with planter fasciitis. All protocols for this clinical study were registered with WHO recognized Clinical Trial Registry, with the registration number RCT20200221046567N2.  Key Words: Heel pain, plantar fasciitis, physiotherapy, mobilization, mulligan technique, taping.

scholarly journals Brixia Chest X-ray Scoring System in Critically Ill Patients with COVID-19 Pneumonia for Determining Outcomes

2021 ◽  
Author(s):  
Nishant Agrawal ◽  
Samruddhi Dhanaji Chougale ◽  
Prashant Jedge ◽  
Shivakumar Iyer ◽  
John Dsouza
Keyword(s):  
Scoring System ◽  
Early Stage ◽  
Tertiary Care ◽  
Categorical Variables ◽  
P Value ◽  
Care Hospital ◽  
X Ray ◽  
Lung Abnormalities ◽  
Chest X Ray ◽  
The Mean

Introduction: In early stage of disease of Coronavirus Disease 2019 (COVID-19) infection chest Computed Tomography (CT) imaging is considered as the most effective method for detecting lung abnormalities. A Brixia Chest X-ray (CXR) scoring system which uses an 18-point severity scale to grade lung abnormalities due to COVID-19 was developed to improve the risk stratification for infected patients. Aim: To ascertain the validity of Brixia scoring system and to measure the outcome in COVID-19 patients. Materials and Methods: A retrospective study was conducted from 1st April 2020 to 31st July 2020, at a tertiary care hospital in India. Baseline CXR of COVID-19 patients were scored based on Brixia scoring system. The lungs were divided into six equal zones. Subsequently, scores (from 0-3) were assigned to each zone, based on lung abnormalities. A group comparison was implemented using Chi-Square test for categorical variables. Whereas an independent t-test was applied for continuous variables that followed normal distribution. Results: The study included 130 patients. The mean age was 57.09±13.73 years, 70.8% patients included were males. Out of 130 patients, 79 patients died. Among patients who died the mean CXR score was calculated to be 12.13±2.50. The mean CXR score was calculated to be 11.18±2.30 in patients who recovered and got discharged. During the process of comparison of CXR scores with the outcomes, the t-value came out to be 2.20 and the resulting p-value was 0.03 (statistically significant). Conclusion: Brixia score more than 12 was associated with increased mortality due to COVID-19, with p-value of 0.03.

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