scholarly journals Morphometric analysis of pre and post operative facial angles following rhinoplasty

2021 ◽  
Vol 3 (3) ◽  
pp. 72-76
Author(s):  
Renu Rajguru ◽  
Anubhav Singh ◽  
Garima Rajguru ◽  
Dibya Jyoti Boruah

Facial aesthetic surgery requires a thorough preoperative analysis of face and identification of problems to frame a comprehensive surgical plan. The conceptions of an attractive face must be analyzed beforehand. Powell and Humphrey had defined facial angles and had formulated range which would be perceived as attractive. To compare the change in pre- and post-operative nasolabial, nasofrontal and nasofacial angles in patients undergoing Rhinoplasty. A prospective observational study was conducted from October 2014 to October 2019 in ENT department of a tertiary care hospital. Twenty-one patients undergoing Rhinoplasty and fulfilling the inclusion criteria were considered as study population. Their pre- and post-operative profile photographs were taken for morphometric analysis. The nasolabial, nasofrontal and nasofacial angles were measured and compared, before and one month after the surgery in profile pictures. A significant change in the nasolabial and nasofacial angles were seen following Rhinoplasty. The mean nasofrontal angle showed an increase following Rhinoplasty but was not found significant. Rhinoplasty results in significant change in nasofacial and nasolabial angles and in expert hands, is expected to restore the various facial angles to their acceptable range.

2017 ◽  
Vol 18 (1) ◽  
pp. 27-29 ◽  
Author(s):  
Sarmistha Biswas ◽  
ABM Abu Sufian ◽  
Prodip Kumar Sarkar ◽  
Mostofa Kamal Chowdhury ◽  
Joybaer Anam Chowdhury ◽  
...  

Background: Proton pump inhibitors (PPIs) are the drugs used to treat and prevent acid peptic conditions. Their efficacy and safety profile has led to injudicious prescription of these drugs exposing patients to various potential risks and increased healthcare expenditure.Methodology: A retrospective observational study was done from 10th January to 24th January, 2015 in Medicine Indoor in a tertiary care hospital to determine the trend of prescribing PPIs on discharge of Medical inpatients.Result: We found 117 patients were discharged in the study period; 83 were male and 34 were female. Among them 102 (87.17%) were prescribed PPIs on their discharge. Mean age was 44.79 years. Among the study population only 29 patients (28.5%) truly needed PPIs during their discharge. The mean duration of prescribed PPIs was 28 days.Conclusion: Amore rational prescription of PPI during discharge will have better impact on patient safety and health care expenditure.J MEDICINE January 2017; 18 (1) : 27-29


Author(s):  
Shailander Singh ◽  
Swetha K.

Background: Drug interaction occurs when presence of one drug affects the activity of another when, both are co-administered. 6-30% of adverse events (AEs) with significant hospitalizations or death are by drug-drug interactions(DDI). There is increased possibility to prevent the potential drug-drug interactions (pDDIs), if their prevalence and pattern are determined accurately before their occurrence. Hence this study aimed to evaluate the prevalence of pDDIs in ICU patients at BRIMS tertiary care hospital, Bidar.Methods: This prospective observational study included 30 patients admitted in ICU of BRIMS hospital for >24hrs of either gender, aged >18yrs. The study was conducted for a period of 3 months. Data was collected from the case records of patients on the predesigned proforma. Potential drug-drug interactions were classified based on their severity and the risk of Potential drug-drug interactions was estimated by Lexicomp, inc.version; 3.0.1.drug interact android mobile application.Results: Out of 35 patients admitted in the ICU, 30 cases were included in the study. The mean age of study population was 56.3years. The study population was exposed to a total of 330 medicines during the hospital stay with an average of 11.7 drugs per patient. The prevalence of pDDI was 93.3% (28) with an average of 9.75 pDDI per patient. According to Lexicomp drug interact android mobile application majority (63%) of pDDI were found to be moderate in their severity, 67% belonged to type C risk.Conclusions: The study showed higher prevalence of pDDI among ICU patients due to the complexity of the pharmacotherapies administered.


2021 ◽  
pp. 55-57
Author(s):  
Shivesh Sahai ◽  
Mainak Mukhopadhyay ◽  
Auriom Kar ◽  
Manoranjan Mandal ◽  
Sukanya Banerjee

INTRODUCTION: Cardiovascular diseases are one of the leading cause of death in the world. Several factors have led to the increase in vascular disorders, including the aging population, unhealthy lifestyles, increasing rates of diabetes and raised lipids, and further risk factors resulting in inammation and calcication of the vascular endothelium. Activated platelets in damaged blood vessels can trigger arterial thrombus formation, leading to vascular occlusion with subsequent organ hypoperfusion and clinical manifestation of myocardial infarction, stroke, or peripheral artery disease.AIMS AND OBJECTIVES: To evaluate platelet function in patients of Acute Coronary Syndrome 12hrs after loading dose of dual antiplatelet agents and evaluate platelet function in patients of Acute Coronary Syndrome on maintenance dose of dual anti-platelet agents in steady state. MATERIALS AND METHODS: 41 Adult Patients of both sexes admitted in Department of Cardiology, NRS Medical College and Hospital, a tertiary care hospital from 1ST FEBRUARY 2016 TO 31ST JULY 2017 (18months). RESULTAND ANALYSIS: In our study 51.2% were hypertensive. The study population were varied when it comes to occupation. Our study population consisted of 56.1% smokers and 43.9% non-smokers. The mean height of the study population was 165.8 cm. The maximum height was 180cm. The minimum height was 150cm. The mean weight of the study population was 61.36kg. The maximum weight was 76kg. The minimum weight was 49kg. The mean BMI was 22.36. The maximum was 27.77. The minimum was 18.56. Our study population consisted of 51.2% patients of Type II Diabetes Mellitus. CONCLUSION: This study was undertaken to assess the extent of Aspirin and Clopidogrel non-resposiveness in patients of Acute Coronary Syndrome. If non-responders are detected early particularly Clopidogrel non-responders, we can change the outcome with change of P2Y12 receptor antagonist at an early stage. Although most of the recent guidelines do not recommend routine platelet function testing but almost all studies show a strong association.


2021 ◽  
Vol 8 (39) ◽  
pp. 3448-3453
Author(s):  
Adnan Siddique P. ◽  
Prateek Chandak M. ◽  
Sasikumar Sasidharan

BACKGROUND Fractures of both proximal and distal metaphyses with small distal fragment of tibia are not uncommon. Internal fixation using intramedullary nails alone could lead to misalignment. Using blocking screws (Poller screws) in addition to intramedullary nails would help in narrowing the medullary cavity and decreases the degree of misalignment and chances of displacement. The present study was conducted to evaluate functional and radiological outcome of blocking screws with intramedullary nail in the treatment of proximal and distal metaphyses fractures of tibia with short distal fragment. METHODS A prospective observational study of 34 patients with proximal and distal tibial metaphyses fractures was treated with statically locked intramedullary nailing with supplementary blocking screws. The study was conducted from January 2018 to December 2020 with a maximum follow up of 18 months. Medullary canal diameter was measured at the levels of fracture and isthmus. RESULTS Among the 34 patients, 29 (85.29 %) were males and 05 (14.70 %) were females with a male to female ratio of 5.8 : 1. The mean age was 34.97 ± 3.10 years. The mean healing period was 20 ± 1.45 weeks. 25/34 (73.52 %) of the patients showed Karlstrom and Olerud functional grading score of excellent. The fracture varus/valgus alignment was 1.9 ± 0.3 degrees. The mean antecurvatum/recurvatum alignment was 0.3 degrees. CONCLUSIONS Blocking screws act as reduction tools, help in reducing the medullary lumen of distal metaphyses and prevent failures in initial reduction. They extend the indication of intramedullary nailing to the distal segment of tibia and minimize the misalignment in terms of varus /valgus and/or antecurvatum/recurvatum. KEYWORDS Tibia, Intramedullary, Blocking Screws, Internal Fixation and Misalignment


2021 ◽  
Vol 8 (3) ◽  
pp. 61-69
Author(s):  
Nagarjuna Reddy Pogula Nagarjuna Reddy

Background : Acute pyelonephritis is a bacterial infection that affects the renal parenchyma that can be life-threatening and often leads to renal scarring. It usually ascended from the lower urinary tract, and also reach the kidney via the bloodstream. Early diagnosis and management of acute pyelonephritis have a better impact on patient outcomes. Acute pyelonephritis is one of the severe conditions with high mortality and morbidity. It represents the most severe form of urinary tract infection. Acute pyelonephritis is the most common cause of communityonset bacteremia in elderly patients1. Aim: To study the microbiological profile in patients with acute pyelonephritis admitted in a tertiary care hospital. Materials and Methods: A Hospital-based Prospective study was conducted in the Department of Medicine, Santhiram medical college & general hospital for a 2 year period.Universal Sampling Technique was used for the selection of study subjects.The study population included patients admitted with fever, flank pain, and positive urine or blood cultures in the department of general medicine in Santhiram medical college and general hospital.The final sample size was 50 subjects. Results: In the present study, 50 participants were selected as the study population. The mean age of the study population was 57.48 ± 11.21. The majority of participants (70%) were distributed in a 50 to 69-year age group. Majority of participants were females (60%) and males (40%).In the current study among participants, in the current study, urine culture was positive in 29 patients (58%) of the study population. In 29(58%) of the subjects who had a culture-positive infection, the most predominant infectious agent in the present study group was Escherichia. coli and was reported in 22 (44%) of the study subjects. Other causative organisms include, Klebsiella pneumonia was reported in 2(4%) subjects. Candida albicans, Citrobacter, Enterococcus faecalis, and Pseudomonas were isolated in 1 (2%) subject each. One subject had a dual infection with Escherichia coli and Candida.In current study, among the 29 culture isolates, none of them were resistant to Cefperazone plus Sulbactum or Piperacillin plus tazobactam. The highest proportion of resistance was reported for Ampicillin as 82.1% of isolates were resistant. Levofloxacin resistance was found in 67.9% of isolates. Gentamicin and Amikacin resistance was found 17.86% and 3.6% of the isolates. Nitrofurantoin resistance was found in 2 (7.1%) of isolates. Conclusion: The mean age of the study population was 57.480 ± 11.2072 years in the study population, and there was a slight female preponderance in the occurrence of APN.The majority of participants (78%) were distributed ina 50 to 69-year age group.Diabetes, hypertension, ureteric calculus, and past history of UTI were the common risk factors identified in the study population.In.More than half (58%) of the study population had a culture-positiveinfection.TheThe most common organism isolated in the study population was E.Coli, responsible for 44% of the cases. None of them were resistant to Cefoperazone plus Sulbactum or Piperacillin plus tazobactam. The other antimicrobials, which have not shown any resistance, were Meropenem and Colistin.The highest proportion of resistance was reported for Ampicillin in 82.1%, followed by Levofloxacin in 67.9% of isolates. ICU admission rate was higher in culture-positive cases (63.6%), as compared to culture-negative cases (36.4%)None of the study subjects had hospital mortality


2016 ◽  
Vol 15 (1) ◽  
pp. 52-60
Author(s):  
Binod Raut ◽  
Anjan Khadka ◽  
Rabindra Nath Borah

Introduction: Antimicrobial drugs are one of the most commonly prescribed drugs in hospital. Overuse and irrational use of antimicrobials is a key factor behind rapidly spreading antimicrobial resistance in microorganisms. Use of irrational and unnecessary antimicrobials remains common in the developing countries.  This study was conducted to analyze the prescription pattern of antimicrobials in the department of internal medicine of tertiary care hospital. Methods: Antimicrobials are among the most commonly prescribed drugs in hospital. Overuse and irrational use of antimicrobials is a key factor behind rapidly spreading antimicrobial resistance in microorganisms. Use of irrational and unnecessary antimicrobials remains common in the developing countries.  This study was conducted to analyze the prescription pattern of antimicrobials in the department of internal medicine of tertiary care hospital. Results: The mean duration of hospitalization among the study population was 5 days. Of the 460 medicines prescribed, mostly indicated for respiratory infections, and the most common antibiotic was from the group cephalosporin 209 (69.7 %).  55 % of prescriptions include only one drug, 39 % with two drugs and 6% with three or more than three drugs. Conclusion: The mean duration of hospitalization among the study population was 5 days. Of the 460 medicines prescribed, mostly indicated for respiratory infections, and the most common antibiotic was from the group cephalosporin 209 (69.7 %). 55 % of prescriptions include only one drug, 39 % with two drugs and 6% with three or more than three drugs.


Author(s):  
Md. Amirunnisa Begum ◽  
B. Krishna Sowmya ◽  
D. Shailendra

Background: Pregnancy is a physiological condition during which immune system is weakened. Therefore, most women are prone to develop infections during this period for which antimicrobials are prescribed. Drugs used during pregnancy may lead to teratogenicity. Therefore, this study was done with the following objectives: 1.to determine the type of infections encountered, 2.to assess the prescription profile of antimicrobials and 3.to assess FDA categories of antimicrobials used in pregnant women in a tertiary care center in Telangana, India.Methods: This was a prospective observational study conducted on pregnant women attending antenatal clinic (ANC) at Mediciti Institute of Medical Sciences (MIMS) from 1st January 2018 to 30th June 2018.Results: Out of a total of 165 cases enrolled, 57 (34.5%) cases were prescribed antimicrobials and 108 (65.5%) were treated symptomatically. The mean (SD) age of women who were prescribed antimicrobials was 22.9 (2.97) years. Of the conditions encountered, respiratory tract infections (RTIs) accounted for 31%, followed by urinary tract infections (UTIs) 26% and gastroenteritis 25%. Most prevalent infections which required antimicrobials prescription were UTIs (36.84%), followed by Gastroenteritis (17.54%). Majority of the antimicrobials prescribed were from Betalactams (40.34%), followed by Nitrofuranes (29.82%), Nitroimidazoles (17.54%) and Antifungals (8.77%). Antimicrobials prescription was more in the 3rd trimester (63.1%), followed by 2nd trimester (31.6%) and 1st trimester (5.3%). Majority of the antimicrobials were administered orally (75.44%), followed by injections (15.79%) and per vaginal route (8.77%). Antimicrobials were mostly prescribed from FDA Category B (96%).Conclusions: RTIs were the most common among the conditions encountered. However, UTIs were the leading cause for antimicrobial prescriptions. Antimicrobials prescription was more during 3rd trimester. Most antimicrobials prescribed were safe as they were from FDA Category B.


Author(s):  
Mathur S. L. ◽  
Agrawal Harish ◽  
Hakim Afzal ◽  
Jain Arvind ◽  
Kishoria Naveen ◽  
...  

Background: COVID – 19 is a pandemic that originated from Wuhan, China in the end of 2019. The objective of the present study is to report the epidemiological and clinical features of COVID-19 patients of tertiary care hospital of Western Rajasthan, India.Methods: A total of 1632 cases of COVID-19 were investigated. The patients tested positive by RT-PCR assay were included in the study. The data was obtained from medical record forms of the patients.Results: Out of total patients, 63.42% patients were male and 81.06% of patients were below age of 50 years. The mean of age was 34.93 ±17.61 years and median of age was 32 years. Asymptomatic patients or patients with mild symptoms constituted 66.66% of the study population and 35% of patients had comorbidities. The major comorbidities included diabetes mellitus (2.81%), hypertension (1.59%) and pulmonary diseases (1.04%). Total 40 deaths occurred so the overall CFR was 2.45%. Among the 40 deaths, the mean of age was 57.57±15.67 years. Patients over 50 years of age had the highest CFR among the age groups (18.93%). The CFR for males was 2.34% and for females 2.68%. A total of 14 (35.00%) of patients had multiple comorbidities.Conclusions: The findings of our study emphasize the significant impact of old age and multiple comorbidities on the risk of mortality among COVID-19 patients. It is suggested to take adequate preventative measures more seriously in elderly patients. Also regarding medical care, it is vital to pay special attention to elderly patients with comorbidities. 


BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e049944
Author(s):  
Sarah K Schäfer ◽  
Robert Fleischmann ◽  
Bettina von Sarnowski ◽  
Dominic Bläsing ◽  
Agnes Flöel ◽  
...  

IntroductionStroke is the leading neurological cause of adult long-term disability in Europe. Even though functional consequences directly related to neurological impairment are well studied, post-stroke trajectories of functional health according to the International Classification of Functioning, Disability and Health are poorly understood. Particularly, no study investigated the relationship between post-stroke trajectories of activities of daily living (ADL) and self-rated health (SRH). However, such knowledge is of major importance to identify patients at risk of unfavourable courses. This prospective observational study aims to investigate trajectories of ADL and SRH, and their modifying factors in the course of the first year after stroke.Methods and analysisThe study will consecutively enrol 300 patients admitted to a tertiary care hospital with acute ischaemic stroke or transient ischaemic attack (TIA; Age, Blood Pressure, Clinical Features, Duration of symptoms, Diabetes score ≥3). Patient inclusion is planned from May 2021 to September 2022. All participants will complete an interview assessing ADL, SRH, mental health, views on ageing and resilience-related concepts. Participants will be interviewed face-to-face 1–5 days post-stroke/TIA in the hospital; and will be followed up after 6 weeks, 3 months, 6 months and 12 months via telephone. The 12-month follow-up will also include a neurological assessment. Primary endpoints are ADL operationalised by modified Rankin Scale scores and SRH. Secondary outcomes are further measures of ADL, functional health, physical activity, falls and fatigue. Views on ageing, social support, resilience-related concepts, affect, frailty, illness perceptions and loneliness will be examined as modifying factors. Analyses will investigate the bidirectional relationship between SRH and ADL using bivariate latent change score models.Ethics and disseminationThe study has been approved by the institutional review board of the University Medicine Greifswald (Ref. BB 237/20). The results will be disseminated through scientific publications, conferences and media. Moreover, study results and potential implications will be discussed with patient representatives.Trial registration numberNCT04704635.


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