Effects of intra articular steroids, hyaluronic acid and combination of both among patients with knee osteoarthritis

Background: Osteoarthritis (OA) is a common degenerative disorder of articular cartilage accompanied by hypertrophic changes of the bone. In the management of OA, though use of intra articular (IA) injection of steroids, hyaluronic acid (HA) separately plays an important role, their effects in terms of reducing pain, joint stiffness and movement restriction when it is used in combination remains a question. Hence this study was planned to assess the effects of HA and steroids alone with combination of both Ha and steroids.Methods: Prospective randomized comparative study, among patients with osteoarthritis knee attending the outpatient department of Orthopedics in a tertiary care hospital during January 2017 to May 2018, were included. Patients were randomized in three groups (steroids, HA and combination of both) and a total of 96 patients were included and the outcome was assessed by WOMAC scale. Statistical analysis was done using SPSS Version 20.Results: Pain and movement restriction, at the end of fourth week and pain, joint stiffness and movement restriction, were found to be statistically improved in combined steroids and HA group than the group with steroids alone. Similarly at the end of third month, pain and movement restriction were found to be statistically improved in combined steroids and HA group than HA group alone.Conclusions: This study demonstrates that HA together with corticosteroid provides pain relief, reduction of joint stiffness and helps in improving joint movements within three months after treatment.

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OBSERVATIONAL STUDY ON POISON CASES IN A TERTIARY CARE HOSPITAL

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2019v11i4.27603 ◽

2019 ◽

pp. 80-83

Author(s):

RAMYA A. ◽

ANDHUVAN G. ◽

RAGHUPATHI V.

Keyword(s):

Social Sciences ◽

Statistical Analysis ◽

Observational Study ◽

Severity Score ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Food Poisoning ◽

Common Type ◽

Cow Dung ◽

Care Hospital

Objective: To evaluate the prevalence, pattern, and cause of poisoning. To characterize the poisoning cases admitted in a tertiary care hospital; followed by the outcome and to observe the antidote given for the poison cases. Methods: This observational study was undertaken in emergency departments (EMD) and Medical Record Department (MRD). Totally 557 poison cases was recruited in this study. Grade of poison was assessed by using poison severity score. Statistical analysis was done by using Statistical Package for Social Sciences (SPSS). Results: A total of 557 poison cases were identified in 2, 39, 828 patients out of which 360(64%) were suicidal and 189(34) cases admitted were accidental. The patients who were admitted between 2-5 h after exposed to poison were found to be more followed by 0-1 hr,>1-2 h,>6-24 h,>24 h and>5-6 h. More number of cases were seen in the others (Synthetic cow dung powder and medicine) type of poison 296(53%) followed by household poisoning 93(17%), bites 86 (15%), insecticide poisoning 64(12%) and food poisoning 16(3%). Activated charcoal was the maximum used antidote. Conclusion: Through this study, it was found that suicidal poisoning was the most common type.

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First-Trimester Reference Intervals for Thyroid Function Testing among Women Screened at a Tertiary Care Hospital in India

Journal of Laboratory Physicians ◽

10.1055/s-0041-1736520 ◽

2021 ◽

Author(s):

Rachita Nanda ◽

Prasanta Kumar Nayak ◽

Suprava Patel ◽

Eli Mohapatra ◽

Sarita Agrawal

Keyword(s):

Statistical Analysis ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

First Trimester ◽

Reference Intervals ◽

Reference Ranges ◽

Care Hospital ◽

Maternal Weight ◽

Significant Difference ◽

Normally Distributed

Abstract Objectives Due to differences in the method of assay and population-specific factors, each laboratory needs to establish its own gestation-specific reference intervals (GRIs) for thyroid hormones. Materials and Methods Three-hundred forty-one women with less than 14 weeks gestation were screened at a tertiary care hospital in Chhattisgarh, India. Serum levels of thyroid-stimulating hormone (TSH), free thyroxine (fT4), and thyroid peroxidase antibody (anti-TPO) were measured using an ADVIA Centaur XP immunoassay.GRIs (2.5th and 97.5th percentiles) were determined for TSH and fT4. TSH and fT4 concentrations were converted to multiples of the median (MoM) values. Effect of maternal age, gestational age, and maternal weight was analyzed. Statistical Analysis Quantitative variables were expressed as means and standard deviations (SD), and qualitative variables were expressed as frequencies and percentages. Normality of the data was checked using the Kolmogorov–Smirnov test. Values that were normally distributed were expressed only as means and SD. Those that were not normally distributed were expressed as medians and interquartile range. For all statistical analysis, p < 0.05 was considered as statistically significant. Results First-trimester GRI was 0.245 to 4.971 mIU/L for TSH, 10.2 to 18.9 pmol/L for fT4, and 27.0 to 56.89 kIU/L for anti-TPO. There was no significant difference in the mean serum TSH (p = 0.920), fT4 (p = 0.714), or anti-TPO (p = 0.754) values among women in 4 to 7th week and 7 to 14th week of gestation. The 1st and 99th centile MoMs were 0.03 and 4.09 for TSH and 0.66 and 1.39 for fT4. There was a significant positive correlation between the maternal weight and TSH MoM values (p = 0.027, r = 0.120). Conclusion These laboratory- and first-trimester-specific GRI for TSH and fT4 shall help in proper diagnosis and treatment of subclinical thyroid dysfunctions. TSH and fT4 MoM values can be used to indicate high or low values in a quantitative manner independent of the reference ranges and may be used by other laboratories.

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Transfusion effect of random donor platelet and single donor platelet in thrombocytopenic patients at tertiary care hospital of South Gujarat

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20172983 ◽

2017 ◽

Vol 5 (7) ◽

pp. 3033

Author(s):

Chirag A. Unagar ◽

Snehal G. Patel ◽

Kamal A. Patel ◽

Amrish N. Pandya ◽

Mayur A. Jarag ◽

...

Keyword(s):

Statistical Analysis ◽

Platelet Transfusion ◽

Tertiary Care Hospital ◽

Platelet Rich Plasma ◽

Tertiary Care ◽

Care Hospital ◽

Single Donor ◽

The Mean ◽

Paired T Test ◽

Corrected Count Increment

Background: Platelet transfusion plays a key role in therapy for the patients with thrombocytopenia. Superiority of Single donor platelet (SDP) over Random donor platelet (RDP) transfusions is largely assumed, but unproven. Platelet Rich Plasma-Platelet concentrate (PRP-PC) and Apheresis-PC were prepared and their therapeutic efficacy were assessed in thrombocytopenic patients.Methods: This study included 60 transfusion episodes consisting of 30 SDP and 30 RDP (147units of RDP). The post transfusion efficacy of transfused platelets was assessed at 1 hour and 24 hours by corrected count increment (CCI) and percentage recovery (PR). Paired ‘t’-test was used for statistical analysis and a probability of p<0.05 was used to reject null hypothesis.Results: The mean platelet dose of SDP (n=30) and RDP (n=30) was 2.86±1.05 x 1011 and 2.36±0.54 x 1011 respectively. The mean platelet increments of SDP at 1 hour and 24 hours were 38±18.1 x 103/μl and 37.3±20.7x 103/μl. The mean platelet increments of RDP at 1 hour and 24 hours were 28.5±11.4 x 103/μl and 26 ±11.6 x 103/μl. The mean CCI of SDP at 1hour and 24 hours were 21.4 ±7.3 x 103/μl and 20.8±7.4 x 103/μl respectively. The mean CCI of RDP at 1hour and 24 hours were 18.5±6.3x 103/μl and 17.4±7.6 x 103/μl respectively.Conclusions: Post-transfusion increments were significantly higher in patients who received SDP as compared to RDP, but the CCI and PR were comparable in both groups of patients.

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Prevalence of imipenem resistant gram-negative bacteria in a tertiary care hospital of Dhaka, Bangladesh

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v21i1.56341 ◽

2022 ◽

Vol 21 (1) ◽

pp. 145-150

Author(s):

Rabeya Nahar Ferdous ◽

Md Atikur Rahman ◽

Md Anowar Hussain ◽

Nasrin Akhter ◽

Palash Chandra Banik ◽

...

Keyword(s):

Statistical Analysis ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Clinical Isolates ◽

Health Concern ◽

Diffusion Method ◽

Clinical Samples ◽

Gram Negative Bacteria ◽

Care Hospital ◽

Gram Negative

Objective: Imipenem resistant gram-negative bacteria (GNB) have become a major public health concern worldwide, including Bangladesh. The present study was performed to determine the frequency of imipenem resistant gram-negative bacteria (GNB), their antimicrobial susceptibility pattern. Materials and Methods: A total of three hundred and fifty clinical samples were collected from Bangladesh Institute of Health Sciences hospital (BIHS), Dhaka, Bangladesh, over a period of 12 months. Among 350 samples, 171 (48.86%) were from indoor patients, and 179 (51.14%) were from outdoor patients. The pathogens were isolated and identified by conventional methods and were screened for antibiotic susceptibility using the Kirby–Bauer disc diffusion method, including imipenem discs. A Chi-square test was employed for statistical analysis. Results and Discussion: Out of 350 clinical isolates, 246 showed resistance to imipenem (70.28%). Almost all of the imipenem resistant gram-negative bacteria showed the highest resistant pattern to cefepime (88.57%), amoxicillin (88.29%), cephalosporin (88.14%), cefoxitin (86%), tetracycline (84.42%), and the majority were resistant to levofloxacin (70.85%), doxycycline (70.57%), netilmicin (59.71%). But cotrimoxazole (13.42%) and tigecycline (11.43%) showed a lower resistance pattern. Statistical analysis exhibited imipenem resistant gram-negative isolates most commonly found in pus and urine samples, while Klebsiella spp (30.49%), Pseudomonas spp (26.83%) and E. coli (23.17%) were the most predominant pathogens. Conclusion: This is a retrospective study which study indicates a noteworthy rate of clinical isolates were imipenem resistant gram-negative bacteria in a well-defined tertiary care hospital, and most of these bacteria were also multidrug-resistant. Bangladesh Journal of Medical Science Vol. 21(1) 2022 Page : 145-150

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Clinicopathological profile of adnexal masses presenting to a tertiary-care hospital in Bhutan

South Asian Journal of Cancer ◽

10.4103/sajc.sajc_303_18 ◽

2019 ◽

Vol 08 (03) ◽

pp. 168-172

Author(s):

Rojna Rai ◽

Pema Choden Bhutia ◽

Ugyen Tshomo

Keyword(s):

Statistical Analysis ◽

Postmenopausal Women ◽

Adnexal Mass ◽

Tertiary Care Hospital ◽

Preoperative Evaluation ◽

Tertiary Care ◽

Care Hospital ◽

Ovarian Malignancy ◽

Adnexal Masses ◽

Common Malignancy

Abstract Context: Adnexal masses of ovarian origin are of growing concern due to high fatality associated with ovarian malignancy because they are diagnosed at advanced stage due to vague symptoms and absence of recommended screening tests. Aims: The aim was to study the prevalence of histopathologic types of adnexal masses in different age groups and to analyze the accuracy of preoperative evaluation in diagnosing ovarian malignancy. Settings and Design: This was a cross-sectional study carried out in the Department of Obstetrics and Gynecology of a tertiary care hospital in Bhutan with gynecologic-oncology services, from January to December 2017. Subjects and Methods: Women presenting with adnexal mass were evaluated and those meeting criteria were enrolled. They were evaluated preoperatively with complete history, examination, ultrasound, and tumor markers. Risk of malignancy index (RMI) was calculated for all patients. Following surgery, histopathology results were compared with preoperative evaluation. Statistical Analysis Used: Chi-square test, t-test, Cohen's Kappa, and receiver operating characteristic curve analysis were used for statistical analysis. Results: Of 165 patients evaluated, 127 fulfilling criteria were enrolled. Adnexal masses of ovarian origin were most common (n = 102, 80.3%), of which 12.7% were malignant. Epithelial ovarian malignancy was the most common malignant ovarian tumor, serous cystadenocarcinoma being the most common. Malignancy was significantly more in older, postmenopausal women with high RMI. Seven out of 11 women with high RMI were diagnosed in Stage 3 or 4. RMI score at cutoff of 200 was 54.6% sensitive and 85.7% specific. Conclusions: Adnexal mass of ovarian origin was the most common. Malignancy was significantly more in older, postmenopausal women with high RMI. RMI showed moderate correlation in diagnosing epithelial ovarian malignancies.

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