scholarly journals Evaluation of TOPS score as predictor for outcome in sick newborns

2020 ◽  
Vol 7 (6) ◽  
pp. 1249
Author(s):  
Nirali Maheshbhai Sheth ◽  
Nimisha Pandya
Keyword(s):  
P Value ◽  
Efficient Score ◽  
Medical College ◽  
Multiple Parameters ◽  
Blood Glucose Reading ◽  
Study Population ◽  
Strength Of Association ◽  
Hypoxic Group ◽  
Glucose Reading

Background: Multiple parameters have been developed to prognosticate the outcomes of critically ill newborns admitted in NICUs. The objective of this study is to predict the outcome of newborns admitted in NICU using a simple but efficient score, TOPS score, involving alteration of physiological parameters. Aim of this study was to evaluate role of TOPS score in predicting mortality in sick neonates.Methods: The variables assessed under TOPS score on arrival for all subjects were: Temperature, Oxygen Saturation, Perfusion and blood glucose reading <45 mg/dl. All affected neonates were given treatment as per NICU protocol and outcome was assessed in terms of mortality or discharge using TOPS score. It was prospective study conducted at NICU, Department of Pediatrics, GMERS medical college and general hospital, Gotri, Vadodara. Study population was all admitted neonates aged <28 days at NICU.Results: Mean age of presentation of all cases was 2.8±3.58 days. Hypothermia on admission was observed in 63.3% cases. 40.8% cases had hypoxia. 26.5% neonates recorded poor perfusion. Mortality observed in hypoxic group was 51.7% followed by hypothermic group (46.9%). Highest strength of association was found for poor perfusion, mortality (87.5%) and OR-33.406.  TOPS score was observed to be statistically significant (X2 value is 63.27, p < 0.05) as predictor of mortality. Thus, mortality rate increased with increasing no. of altered TOPS parameters. Regression analysis showed three factors (hypothermia, hypoxia, prolonged CRT) which are consistently associated with p value ≤ 0.05 for each variable and can be used to predict mortality.Conclusions: All parameters in TOPS score are physiologically important and each parameter carries an independent risk associated with mortality. It is important to note that multiple parameters affected increases the risk. TOPS score is a simple, basic and effective tool to guide about the condition of new born at admission and outcome. of neonatal mortality. 

scholarly journals Role of Physiotherapy in Hospitalised Patients of COVID-19 disease

2021 ◽  
Vol 9 (3) ◽  
pp. 154-159
Author(s):  
Dr. Sanjay Kumar Bharty ◽  
◽  
Dr. Jitendra Kishore Bhargava ◽  
Dr. Brahma Prakash ◽  
Dr. Vikas Patel ◽  
...  
Keyword(s):  
Severity Index ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Medical College ◽  
Breathing Exercises ◽  
Hospitalised Patients ◽  
Before And After ◽  
Respiratory Physiotherapy

Introduction: Respiratory physiotherapy is one of the therapeutic methods in various respiratoryviral infections. Breathing exercises with other interventions, could enhance the total lung capacityand symptom alleviation in patients with virus-related acute respiratory distress syndrome (ARDS).Aim: To study the clinical evaluation of the role of physiotherapy in hospitalised patients of covid-19diseases. Method: This was an Observational (prospective, cross-sectional) study. 187 patientswere recruited and diagnosed as COVID-19 as per RTPCR at NSCB Medical College, Jabalpur (MP).Patients were randomised into the physiotherapy group and controlled group. Patients in thephysiotherapy group were undergone positional changes, prone ventilation, Breathing exercise,Resistive training, Passive joint motion, Muscle stretching, Bedside standing training, enduranceexercise by a specialized physiotherapist. Mean cough severity index, MMRC grade, respiration rateand peripheral blood saturation were recorded before and after intervention and compared with thecontrolled group. Result: There was significant improvement found in MMRC grade and respirationrate after physical therapy in the physiotherapy group (p-value < 0.05). Exertional dyspnoea andcough severity index significant deceased in physiotherapy group. The positive change was found inperipheral blood saturation. There was decreased in hospitalization stay in the physiotherapy groupas compared to the controlled group. Conclusion: Our study revealed the positive effect ofphysiotherapy on covid-19 disease in terms of symptoms and hospitalization duration among thephysiotherapy group. Physiotherapy exerts a beneficial role in the management of the covid-19disease.

scholarly journals Role of adenosine deaminase and lymphocyte/neutrophil ratio in the diagnosis of tuberculous pleural effusion in patients with exudative pleural effusion

2017 ◽  
Vol 6 (1) ◽  
pp. 144
Author(s):  
Bijaya K. Behera ◽  
Sathish K. TN
Keyword(s):  
Pleural Effusion ◽  
P Value ◽  
Age Group ◽  
College Hospital ◽  
Tuberculous Pleural Effusion ◽  
Medical College ◽  
Combined Use ◽  
Medical Wards ◽  
Exudative Pleural Effusion

Background: Present study was conducted with an objective to evaluate the role of ADA and lymphocyte/neutrophil ratio in the diagnosis of tuberculous pleural effusion in patients with exudative pleural effusion and to analyze the cause of non-tuberculous exudative pleural effusion.Methods: This hospital based observational study was conducted from August 2011 to September 2013 with a total number of 120 patients of exudative pleural effusion who were admitted in medical wards of MKCG Medical College Hospital, Berhampur, Odisha, India. Patients with transudative pleural effusion, age less than 12years and those who were haemodynamically unstable were excluded from the study. Statistical analysis was done using standard statistical techniques.Results: A total number of 120 patients with exudative pleural effusion were analyzed. 83 patients were males and 37 patients were females. Maximum no of patients were seen in the age group of 21-40 years. Total ADA was found to be >40 U/L in all cases of TB effusion. All cases of TB effusion were lymphocyte predominant with L/N ratio > 0.75. In case of exudative pleural effusion due to non-tuberculous etiology L/N ratio was <0.75. P Value <0.0001 was considered extremely significant for L/N ratio for TB effusion.Conclusions: ADA value more than 100 U/L was observed only in patients of tuberculous effusion. L/N ratio was >0.75 in 97 patients of tuberculous effusion and none of the non-tuberculous effusion. Combined use of ADA and L/N ratio is more efficient means for diagnosing tuberculous pleural effusion than the use of ADA alone.

scholarly journals Study on role of magnesium Sulphate as a Tocolytic agent in preventing preterm labour

2015 ◽  
Vol 22 (2) ◽  
pp. 179-184
Author(s):  
Lutfa Begum Lipi ◽  
Nasima Begum ◽  
Ummum Khair Alam ◽  
Rounak Jahan ◽  
Mohammed Mizanur Rahman ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Preterm Birth ◽  
Magnesium Sulphate ◽  
Preterm Labour ◽  
Medical College ◽  
Uterine Contractions ◽  
Tocolytic Agent ◽  
Study Population ◽  
A Prospective Study

A prospective study was done to assess the effectiveness of magnesium sulphate therapy given to women in preterm labour with the aim preventing preterm birth and its sequel. The place of study was the Department of Obstetrics & Gynecology, Sir Salimullah Medical College & Mitford Hospital, Dhaka. The study population were all primi and multigravida with preterm labour admitted in the above mentioned hospital, from January to December, 2009. Gestational age, maternal pulse, blood pressure, temperature, urine output, respiratory rate, uterine contractions, cervical effacement, dilatation and amniotic membrane status were elicited. Data were collected by questionnaire and analyzed with SPSS version 12.0. The results showed that magnesium sulphate injection is an effective method for tocolysis and appears to be safe for the mother and fetus and is a promising option for the treatment of preterm labour in a low resourced setting. DOI: http://dx.doi.org/10.3329/jdmc.v22i2.21538 J Dhaka Medical College, Vol. 22, No.2, October, 2013, Page 179-184

scholarly journals The Predictors of the Severity of Dengue Fever: A Cross-Sectional Study in a Tertiary Care Center of Bangladesh

2021 ◽  
Vol 29 (1) ◽  
pp. 77-82
Author(s):  
Mohammad Zaid Hossain ◽  
Nusrat Sultana ◽  
Afroza Akbar Sweety ◽  
Reaz Mahmud ◽  
Mohammed Masudul Hassan Khan ◽  
...  
Keyword(s):  
Platelet Count ◽  
Dengue Fever ◽  
Cross Sectional Study ◽  
Severe Dengue ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
Group I ◽  
Study Population

Background: Dengue is an endemic disease for Bangladesh with occasional outbreak. Little is known about the predictors of severe dengue. Methods: This cross sectional study was conducted in the medicine department of Dhaka Medical College from April 2019 to March 2020. Total 199 consecutive patients were enrolled in this study. For the purpose of the analysis, dengue fever was classified as group I and dengue hemorrhagic fever and dengue shock syndrome was classified as group II. Results: The mean (SD) age of the study population was 28.5(12.1) and 87.4% were less than 40 years of age. The male and female ratio was about 3:1. Among the total study population, 149(74.9%) patients had DF, 46 (23.1%) had DHF and only 4 (2%) had DSS on presentation. Baseline demography and clinical presentation did not significantly differ between classical dengue and severe dengue. Previous history of dengue had low association with severity (RR, 95%CI, phi, P value; 1.2, 1.04-1.40, 0.25, 0.001).Most of the laboratory parameters were similar between the groups. The number of platelet count was significantly lower in DHF and DSS [median (IQR) 43500(16500-95250], than DF [median (IQR) 65000(33000-1170000, p-value 0.01] Conclusion: Previous infection with dengue virus and decreasing platelet count are the predictors of the severe dengue. J Dhaka Medical College, Vol. 29, No.1, April, 2020, Page 77-82

scholarly journals STUDY TO EVALUATE THE SPECTRUM OF DIFFERENT CO-MORBIDITIES IN CHILDREN SUFFERING FROM SEVERE ACUTE MALNUTRITION WITH UNEXPECTED DYSELECTROLYTEMIA IN DIARRHEA

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Arunabh Kumar ◽  
Ashok Kumar ◽  
Manish Ranjan
Keyword(s):  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
P Value ◽  
Medical College ◽  
Institutional Ethics ◽  
Co Morbidity ◽  
Significant Difference ◽  
Study Population ◽  
Hiv 1 ◽  
Morbid Conditions

Aim: to evaluate the spectrum of co-morbidities in severe acute malnutrition with unexpected dyselectrolytemia in diarrhea. Material and methods: The study was an observational study which was carried in the Department of pediatrics, Darbhanga Medical College and Hospital, Laheriasarai, Darbhanga Bihar, India for 2 years.  after taking the approval of the protocol review committee and institutional ethics committee. Total 200 Children below 5 year age were included in this study. Various co morbid conditions in study population were identified. All the laboratory examination was done with standard method. Results: Total 200 cases were included in study of which 96% were associated co-morbid conditions in SAM. Majority of children with SAM were having co-morbidity in the form of Anaemia (88%), Diarrhoea (60%) followed by pneumonia (32%), Rickets (31%), Tuberculosis (14%), Otitis    media    (12%),    UTI    (11%),    Celiac   (4%), Hypothyroidism (2%), & HIV (1%). Mean age (SD) of the diarrheal cases was 25(6) months (95% C.I. 24.1- 25.8) of which 70 were male (58.33%). Mean age (SD) of non-diarrheal cases was 19(6). (95% C.I. 16.6 – 19.4) of which 45 were male(75%). 120 (60%) SAM children presented with diarrhea of which 117 had dysnatremia in the form of Hyponatremia in 117 cases (58.5%) & Hypernatremia in 3 cases (1.5%) No statistically significant difference was found with hyponatremia in diarrheal or non-diarrheal cases of SAM (P value of 0.07). It was found that 20% SAM children were having hypokalemia. Hypokalemia was found in 15% of diarrheal cases & 5% in non- diarrheal cases. A statistically significant difference was found with hypokalemia in SAM (P value of 0.019) between Diarrheal & Non diarrheal cases. Conclusion: Dyselectrolytemia is high in complicated SAM and mainly sodium disturbances in form of hyponatremia are common in different co-morbid conditions. Keywords: Co-morbidities, Dyselectrolytemia, Potassium, Severe acute malnutrition, Sodium

scholarly journals ENTEROCUTANEOUS HIGH OUTPUT FISTULAE

2010 ◽  
Vol 17 (04) ◽  
pp. 538-542
Author(s):  
GHULAM MUSTAFA ARAIN ◽  
MUHAMMAD REHMAN GULZAR ◽  
KUSH MUHAMMAD SUHO ◽  
Waseem Sadiq Awan
Keyword(s):  
Enterocutaneous Fistula ◽  
Study Groups ◽  
Spontaneous Closure ◽  
P Value ◽  
Medical College ◽  
Group I ◽  
Design Case Study ◽  
High Output

Enterocutaneous fistula is an abnormal communication between epithelial lined lumen of GI tract & epithelium of an adjacent viscous or skin. Objectives: To find out role of octreotide in the management of high enterocutaneous fistula. Design: Case study. Setting: Department of Surgery Unit-II Punjab Medical College & A & E Department of Jinnah Hospital /AIMC Lahore. Period: From Jan 2007 to Dec 2008. Patients & Methods: 479 laparotomies were carried out due to trauma. Out of these 21 i.e. 4.38% developed high out put enterocutaneous fistula. All patients were put on similar conservative management including, TPN, antibiotics, fluid electrolyte replacement and stoma care. Results: Patients were split into two groups alternatively. There were no statistical difference between the study groups with regard to the age (p-value=0.515). Group I contains 11 patients (octreotide) received additionally 100mg octreotide S/C 8 hourly, showed decrease of volume from 680 to 150ml within 10 days. Spontaneous closure was observed in 8(72.72%) patient & surgery was required in 2(18.18%) patients. Death was 1(9.09%). In Group II remaining 10 patients(without octreotide), fistula discharge volume decreased form 650mg to 150ml in 20 days. Spontaneous closure was noted in 5(50%) cases. Surgery was required in 3(30%), while death rate was 2(20%).Conclusions: It is concluded that Octreotide, an analogue of somatostatin with longer half life is effective in treatment of high output fistula.

scholarly journals Investigation of ATG16L1 rs2241880 Polymorphism with Cancer Risk: A Meta-Analysis

Medicina ◽  
2019 ◽  
Vol 55 (8) ◽  
pp. 425 ◽  
Author(s):  
Moazeni-Roodi ◽  
Tabasi ◽  
Ghavami ◽  
Hashemi
Keyword(s):  
Cancer Risk ◽  
Cancer Susceptibility ◽  
Meta Analysis ◽  
Genetic Models ◽  
Case Control Studies ◽  
Study Population ◽  
Cancer Types ◽  
The Impact ◽  
Strength Of Association

Background and Objectives: Previous studies have investigated the impact of the ATG16L1 rs2241880 (Thr300Ala) polymorphism on individual susceptibility to cancer, but the conclusions are still controversial. To get a more precise evaluation of the correlation between ATG16L1 rs2241880 polymorphism and cancer susceptibility, we performed a meta-analysis of the association of all eligible studies. Materials and Methods: Searches were performed in the Web of Science, PubMed, Scopus and Google Scholar databases up to November 2018. A total of 12 case-control studies from 9 articles comprising 2254 cases and 4974 controls were included. Statistical analysis was achieved by STATA 14.1 and Review Manager 5.3 software. The odds ratios (ORs) with 95% confidence intervals (95% CIs) under five genetic models were used to determine the strength of association among rs2241880 polymorphism and cancer susceptibility. Results: The findings did not support an association between the rs2241880 variant in either the overall study population or the subgroups, based on cancer types and ethnicity in any of the genetic models. As far as we know, our study is the first meta-analysis of the association between rs2241880 polymorphism and cancer risk. Conclusions: In conclusion, the findings of this meta-analysis proposes that the ATG16L1 rs2241880 polymorphism may not play a role in cancer development. Further well-designed studies are necessary to clarify the precise role of the ATG16L1 rs2241880 polymorphism on cancer risk.

scholarly journals Role of Spirometry in Early Diagnosis of COPD among Smokers

2019 ◽  
Vol 32 (1) ◽  
pp. 33-38
Author(s):  
Md Ansar Ali ◽  
Md Shahidul Islam ◽  
Samir C Majumdar ◽  
Md Azizul Haque ◽  
Amzad Hossain Sardar
Keyword(s):  
Pulmonary Disease ◽  
Early Stage ◽  
Chronic Obstructive ◽  
P Value ◽  
College Hospital ◽  
Obstructive Pulmonary Disease ◽  
Exact Test ◽  
Medical College ◽  
Study Population ◽  
The Difference

Chronic Obstructive Pulmonary Disease (COPD) is a major cause of chronic morbidity and mortality throughout the world. Many people suffer from this disease for many years and die prematurely from it or its complications. COPD is a preventable and treatable pulmonary disease. In early stage, diagnosis of COPD is difficult because sign & symptoms are minimum. Only history of mild dyspnea, cough and/or sputum production or prolong smoking, exposure to occupational dusts or biomass fuels are present without any sign. Spirometry is the tool to diagnose COPD. If we can diagnose COPD in early stage then it is treatable and can prevent progression of the disease. Spirometry is a simple tool to diagnose COPD at any health care level. So this study was done to diagnose COPD in early stage among smokers. This study was carried out in Department of Medicine (Indoor & outdoor) of Rajshahi Medical College Hospital from March, 2010 to February, 2011. 255 smoker having exposure to >10 pack year smoking fulfilling inclusion and exclusion criteria were included and 300 apparently healthy non-smoker also were included as control. Both male & female were included with age of the study population were from 30 years to 70 years. All of that study population was free from diseases which alter spirometric measurement. This exclusion was done by history, thorough clinical examination and relevant investigations. Among smokers, clinically 9(4.03%) were diagnosed to have COPD only and the spirometry also diagnosed these 9 smokers and other 32 smokers more to have COPD and thus diagnose 41(18.38%) smokers to have COPD. The difference between clinical and spirometric diagnosis of COPD is statistically highly significant. The test done was Fisher’s Exact Test, where p value is 0.000. So, spirometry is considered as a simple valuable instrument to diagnose COPD in early stage among smokers. TAJ 2019; 32(1): 33-38

scholarly journals The role of tibialis posterior tendon transfer in foot drop by circumtibial route and evaluation of the results according to criteria

2019 ◽  
Vol 6 (8) ◽  
pp. 2880
Author(s):  
R. K. Chaurasia
Keyword(s):  
Tendon Transfer ◽  
Foot Drop ◽  
Tibialis Posterior ◽  
P Value ◽  
Microsoft Excel ◽  
Tibialis Posterior Tendon ◽  
Medical College ◽  
The Difference ◽  
Tibialis Posterior Tendon Transfer

Background: The transfer of the tibialis posterior tendon to the anterior aspect of the ankle not only replaces the function of the paralyzed muscles, but also removes the deforming force on the medial aspect of the foot. This study was conducted to find the role of tibialis posterior tendon transfer in foot drop by circumtibial route and with evaluation of the results according to criteria.Methods: This study was conducted in MLB Medical College and Hospital, Jhansi. Patients of paralytic foot drop due to leprosy with a moderately strong tibialis posterior muscle were selected from the outpatient department of Orthopaedics and Leprosy reconstructive surgery units. After taking informed consent, detailed history was taken. Data was analyzed using Microsoft Excel and the difference was considered to be significant if ‘p’ value was <0.05.Results: Eleven patients were operated. Majority were males (82%). Eight patients (73%) had excellent and good results which were aged less than forty years. Two cases showed excellent results after corrective surgery that had deformities from 31 to 36 months before operation. Out of six patients who were taking antileprotic treatment, one (9.1%) showed excellent and three (27.3%) showed good results.Conclusions: Method of anterior transfer of tibialis posterior for correction of foot drop has given encouraging results in a fairly large percentage of cases. The greatest utility of such a transfer is that of allowing the freedom of normal mobility in comparison to bony stabilization. After correction of deformity and disability the patient’s mental health is improved.

scholarly journals Effectiveness of transabdominal ultrasonography in assessing benign versus malignant nature of prostatomegaly

2019 ◽  
Vol 7 (6) ◽  
pp. 2297
Author(s):  
Saad Shareef ◽  
Anil Joshi
Keyword(s):  
Prostate Gland ◽  
Specific Antigen ◽  
Invasive Technique ◽  
P Value ◽  
Transabdominal Ultrasound ◽  
Focal Lesions ◽  
Transabdominal Ultrasonography ◽  
Medical College ◽  
Ultrasound Evaluation ◽  
Study Population

Background: Benign prostatic hyperplasia is closely related with ageing. The present study was conducted to assess the ability of transabdominal ultrasonography in diagnosing benign and/or malignant hypertrophy of the prostate.Methods: An observational study was done in the Department of Radiology, Bharati Vidyapeeth Medical College and Hospital (Deemed to be University), Sangli, Maharashtra, India of patients who had prostatomegaly on transabdominal ultrasound examination and underwent histopathological confirmation of the lesions from 1 October 2018 till 31 December 2018. The prostate gland was assessed for volume, echotexture, morphology, focal lesions and median lobe.Results: Out of 155 patient’s benign prostatic disease was diagnosed in 116 patients, while malignancy was detected in the rest of the 39 cases. Prostate specific antigen levels were significantly higher among malignant cases (18.39±7.44 ng/ml) as compared to that of benign cases (7.51±3.22 ng/ml), p value <0.01. Benign lesions were predominantly inner glandular, while malignant cases were mainly peripheral. Moderate vascularity was found in 76.9% of the malignant cases. Focal vascular asymmetry was found in 74.4% of the malignant cases and only 12% of the benign cases. Sensitivity of transabdominal ultrasonography in diagnosing malignant prostatic lesions was 94.8%, specificity was 75% with an overall accuracy of using transabdominal ultrasonography in the diagnosis of malignant prostatic lesions in this study population was 80%.Conclusions: Transabdominal ultrasound evaluation of prostate is a simple, economical, non-invasive technique of choice due to its high accuracy in detecting size, nature of pathology as benign or malignant with fair accuracy.

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