scholarly journals Assessment of Clopidogrel Resistance in Post Myocardial Infarction Patients after 24 to 48 Hours of Initiation of Treatment: A Cross-sectional Study

2021 ◽  
Author(s):  
Mayukh Mukherjee ◽  
Suhrita Paul ◽  
Manasi Basu Banerjee ◽  
Sayanti Ghatak ◽  
Santanu Guha ◽  
...  
Keyword(s):  
Platelet Aggregation ◽  
Cross Sectional Study ◽  
Light Transmittance ◽  
Categorical Variables ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Blood Samples ◽  
Clopidogrel Resistance ◽  
Medical College

Introduction: Clopidogrel is an antiplatelet agent used to prevent platelet aggregation and further blockage of coronary arteries in Acute Coronary Syndrome (ACS) patients. Inadequate response to clopidogrel has been demonstrated in some patients that might lead to re-infarction even when receiving standard doses of clopidogrel. Aim: To demonstrate the presence of resistance to standard oral doses of clopidogrel in a tertiary care hospital located in eastern India. Materials and Methods: It was a descriptive cross-sectional study conducted from January 2015 to June 2016, in Medical College Kolkata, (previously known as Calcutta Medical College), India. Total 32 patients, previously not on any antiplatelet therapy, presenting with biomarker positive ACS were evaluated. The patients were given clopidogrel (300 mg) along with aspirin (325 mg) on presentation followed by clopidogrel (75 mg) and aspirin (75 mg) once daily. Blood samples were collected after 24-48 hours of administering the above mentioned doses orally. A 3.2% citrate was used as anti-coagulant. Platelet Rich Plasma (PRP) and Platelet Poor Plasma (PPP) were prepared from this blood samples by centrifugation. Platelet aggregation was studied by adding 10 μM Adenosine Diphosphate (ADP) in that PRP and it was compared with PPP in Light Transmittance Aggregometer (LTA). Platelet aggregation ≥50% in presence of 10 μM ADP was termed as Clopidogrel Resistance (CR). Differences between groups were assessed with Chi-square test and Fisher-exact test for categorical variables. The p-value of <0.05 was considered to be statistically significant. Results: Mean age of the study participants was 60.7 years, and 23 (71.8%) out of 32 patients were male while 9 (28.2%) were female. Total 7 (21.8%) of the patients were found to be resistant to standard doses of clopidogrel. A 3 (60%) out of 5 patients with positive family history of Cardiovascular Diseases (CVD) showed CR (p-value=0.025). Incidences of CR was higher among women 3 (33.3%) and in patients receiving thrombolysis 4 (28.5%). Though these percentages were high but not statistically significant. Conclusion: In this study, 21.8% ACS patients showed resistance to the antiplatelet effects of clopidogrel in the conventional dose. A long term prospective Randomised Controlled Trials (RCT) with larger sample size is required to give an insight into this problem.

scholarly journals Leptospira spp. seroprevalence in humans involved in a cross-sectional study in Garissa and Tana River Counties, Kenya

2020 ◽  
Author(s):  
Arithi Mutembei ◽  
Festus K. Mutai ◽  
Damaris Mwololo ◽  
John Muriuki ◽  
Mark Obonyo ◽  
...  
Keyword(s):  
Case Fatality ◽  
Cross Sectional Study ◽  
Wilcoxon Test ◽  
Categorical Variables ◽  
P Value ◽  
Continuous Variables ◽  
Sectional Study ◽  
Test Statistic ◽  
Cross Sectional ◽  
Tana River

AbstractIntroductionLeptospirosis is a neglected bacterial zoonotic infection caused by spirochetes of Leptospira genus. Humans get infected through direct or indirect contact with urine of infected animals or environment. It accounts for more than 300,000 severe cases annually worldwide with case fatality rates of over 30%. Costs of diagnosis and treatment for human and animals, disruption of international trade of animals and products, reduced productivity and reproductivity in animals constitute economic importance. In Kenya, leptospirosis burden is significant but under-diagnosis and under-reporting affects the awareness of the disease. This study aimed to determine and compare the sero-prevalence and factors associated with Leptospira spp. in the two counties.MethodsWe conducted a cross-sectional study that involved apparently healthy people of at least 5 years of age in randomly selected households in Garissa and Tana River Counties. Blood samples were collected and tested for Leptospira spp antibodies using IgM ELISA. Standardized structured questionnaires were administered to collect socio-demographic and exposure information. We calculated frequencies and proportions for categorical variables and odds ratios (OR) and 95% confidence interval (CI) to evaluate association between sero-positivity and exposure factors. We used Wilcoxon test to evaluate statistical difference in sero-positivity for continuous variables and calculated test statistic (H) and p-value.ResultsA total of 952 subjects were recruited into the study – these included 482 persons from Garissa and 470 from Tana River. The overall sero-prevalence was 26% [(244/952); (CI: 23% to 29%)]. Garissa County had significantly higher Leptospira spp. seroprevalence (31%, n = 147; CI: 27% to 35%) compared to Tana River County (21 %, n = 97; CI: 17% to 25%). Being a female (OR=1.6, CI: 1.2-2.2) and engaging in pastoralism (OR=2.7, CI: 1.8-3.9) were significantly associated with higher odds of Leptospira spp. seropositivity compared to being a male or working in irrigated areas. The mean altitude of residence of sero-positive patients was 73m ± 21 SD (standard deviation) above sea level and that for sero-negative was 80m ± 22 SD (H=35, p-value = 0.00).ConclusionThis study determined the seroprevalence and risk factors for Leptospira spp. exposure in Garissa and Tana River Counties, Kenya. Females in pastoral communities experience high burden of the disease. Enhanced surveillance in humans and animals and further research is required to understand the complex and multifactorial drivers of leptospirosis transmission in the two Counties.

scholarly journals A cross sectional study on adequacy of blood transfusion and transfusion related infections in thalassemic patients attending a medical college hospital, West Bengal

2018 ◽  
Vol 5 (8) ◽  
pp. 3596
Author(s):  
Tarun Kumar Sarkar ◽  
Pulak Kumar Jana ◽  
Jasmine M. ◽  
Timiresh Kumar Das ◽  
Mrinmoy Adhikary ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
West Bengal ◽  
Ferritin Level ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
College Hospital ◽  
Cross Sectional ◽  
Blood Samples ◽  
Medical College ◽  
Study Participants

Background: Thalassemia is more prevalent in India. The main treatment of Thalassemia is blood transfusion. But the transfusion of blood has many side effects like iron overload, transfusion related infections etc. The objectives of the study were to assess the adequacy of blood transfusion for thalassemic patients and to determine the magnitude of transfusion transmitted infections among those patients.Methods: A cross sectional study was conducted in Murshidabad Medical College and Hospital, West Bengal for 1 month with the sample size of 116. The blood samples from the patients were taken from the patients attending for blood transfusion in transfusion centre of Murshidabad Medical College and Hospital for two weeks dated from 24.04.2017 to 05.05.2017 to check for the hemoglobin, ferritin level and hepatitis B, C and HIV infection.Results: Among the 116 patients, even after transfusion, 94% of the study participants have their hemoglobin levels below 7 gm/dl. Only 2 individuals got their hemoglobin levels more than 9 gm/dl and only 1 patient got HIV infection post transfusion which accounts for 0.9% of study population.Conclusions: Frequent Hb estimation will help to maintain the adequacy of blood transfusion and proper screening of the blood before transfusion can help in reducing these transfusion transmitted infections.

The Frequency of Mesio Buccal Second Canals in Permanent Maxillary First Molar Using Different Methods: A Cross-Sectional Study

JKCD ◽  
2019 ◽  
pp. 1-4
Author(s):  
Nadia Munir
Keyword(s):  
Sampling Technique ◽  
Cross Sectional Study ◽  
Diagnostic Methods ◽  
P Value ◽  
Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Medical College ◽  
Chi Square Test ◽  
Pro Forma

Objective: This study aimed to find out the fr equency of the MB2 canal in maxillary first molars, using different diagnostic methods. Materials & Methods: 106 patients, clinically diagnosed with irreversible pulpitis and exposed pulp, requiring endodontic treatment were selected via random non-probability purposive sampling technique for the study . This cross-sectional study was conducted for 12 weeks in the dentistry department of Ayub Medical College from August 2018 to October 2018. A detailed history was taken and documented in the pro-forma. After administration of Local anaesthesia and rubber dam application, the access cavity was prepared and floor of the pulp chamber visualized. MB2 Canal location was done with a naked eye and under magnification (x2.0 to x6.0) Magnification and confirmed by inserting size 08 K file. The data obtained were analyzed using SPSS version 20. Chi-square test was run to determine the association of the presence of the MB2 canal with other variables. P-value of 0.05 was considered to be significant.

scholarly journals Replacement Blood Donation Denials in Children: A Cross-sectional Study

2021 ◽  
Author(s):  
Muniba Alim ◽  
Rafey Abdul Rahman ◽  
Prabudh Goel
Keyword(s):  
Birth Order ◽  
Parental Education ◽  
Blood Donation ◽  
Sex Discrimination ◽  
Cross Sectional Study ◽  
Categorical Variables ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Ratio

Introduction: Developing countries like India still depend on Replacement Donors (RD) for their blood requirements. Healthcare providers in India often face Replacement Blood Donation (RBD) denials in children especially in rural areas. Aim: To find reasons for RBD denials in children. Materials and Methods: A cross-sectional study was done over six months at a tertiary care centre located in rural part of Northern India. Children requiring Blood Transfusion (BT) whose parents refused RBD were included in the study. Children were divided into three groups based on their age and data on various parameters were collected. Observation parameters included sex, birth order, number of siblings, disease for which admitted, duration between admission and need for transfusion, indication for transfusion, decision maker in the family, resistance to decision of denial by any other member of family, parental education, socio-economic status and reasons for denial. Data were analysed using SPSS software (Statistical Package for the Social Sciences, version 17.0, SPSS Inc, Chicago, Ill, USA). The p-values were computed for categorical variables using Chi-square (χ2) test. A p-value of less than 0.05 was considered statistically significant. Results: Out of 356 children requiring BT, parents and relatives of 130 children (36.51%) refused RBD. Of these 130 children, 84 were females and 46 were males with male-female ratio of 1:1.8. Females were more likely to be denied RBD (p-value=0.001). Of these 130 children, only 77 could be included in the study because of various reasons. Age of the study group ranged between 2 days to 15 years. Denials were significantly higher (p-value=0.0032) in children with 3rd or higher birth order. Little benefit in terms of life expectancy was the commonest reason for denials in neonates and was found statistically significant (p-value=0.00368). Fear of donation was the most common reason for denial in all the groups combined (38.9%). Considering themselves ineligible and religious beliefs were the other reasons for denials. Conclusion: RBD denial in children is common in India. Misconceptions, Illiteracy, poverty, sex discrimination and false beliefs are major contributory factors for denial.

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

Correlation between atopy and Covid-19: A cross sectional study

2021 ◽  
Vol 15 (5) ◽  
pp. 1485-1487
Author(s):  
M. Z. Anwar ◽  
A. F. Anjum ◽  
M. Ur Rehman ◽  
S. A. A. Gardezi ◽  
I. Rafique ◽  
...  
Keyword(s):  
Analysis Data ◽  
Cross Sectional Study ◽  
Ethical Review ◽  
P Value ◽  
Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Medical College ◽  
Health Related ◽  
And Gender

The whole world is facing one of the biggest health related disasters of the century. As a novel disease, Covid-19 has so many parameters yet to explore. Objectives: To explore any correlation between atopy and Covid-19 among residents of Gujrat and Kharian, Punjab, Pakistan. Study Design: Cross-sectional study. Methodology: This study with enrolled subjects (n=206) was carried out after ethical review committee’s (ERC) approval at Life Diabetes Centre, Gujrat and CMH Kharian Medical College (CKMC), over a period of 3 months, Kharian-Pakistan. Both male and female medical subjects were enrolled. Statistical analysis: Data was analyzed by SPSS software, version 17. Parameters like gender, allergy and treatment taken were presented as frequency and percentage. Chi square was applied to see the correlation with p-value <0.05 as significant. Results: Total 206 patients were randomly selected, 89 male and 117 females. Among 206, only 13 patients had allergy from different allergens. Only 2 patients required hospitalization and injectable treatment. Conclusion: We concluded that there is strong affiliation between atopy and Covid-19 presentations. Key Words: Covid-19, Atopy, Treatment and Gender.

scholarly journals Role of sleep and stress in metabolic syndrome: a community based cross sectional study in Rishikesh, Uttarakhand

2020 ◽  
Vol 7 (9) ◽  
pp. 3553
Author(s):  
Senkadhirdasan Dakshinamurthy ◽  
Vartika Saxena ◽  
Ranjeeta Kumari ◽  
Anissa Atif Mirza ◽  
Minakshi Dhar ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Cross Sectional Study ◽  
Categorical Variables ◽  
P Value ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Increased Risk

Background: Sleep disturbances and stress may intervene with the physiological processes in human body and act as a modulator of metabolic homeostasis. The aim and objectives of the study were to estimate the person’s average sleep propensity; to estimate the stress level in the study subjects; and to determine the association of sleep and stress with metabolic syndrome.Methods: A community based cross sectional study was conducted in an urban area of Rishikesh. Sample size was calculated to be 478. Data was entered and analyzed using SPSS Version 20.0. Chi-square test was used to examine the association between categorical variables. A p value of <0.05 was considered significant.Results: It was observed that different levels of stress did not have any significant association with metabolic syndrome (MetS) though the odds among individuals with moderate stress were 1.1 times (95% CI 0.6-2.2) higher than those with low stress. The overall sleepiness grading was not significantly associated with Metabolic Syndrome. However, people with mild excessive daytime sleepiness have 4.7 times (95% CI 1.2-18) higher odds of MetS as compared to those with low normal daytime sleepiness. Those with moderate excessive day sleepiness had 1.59 times (95% CI 0.3-8) higher odds of MetS, however it was not statistically significant.Conclusions: Mild excessive daytime sleepiness was associated with an increased risk of metabolic syndrome. People with perceived stress are having higher chance of getting MetS.

scholarly journals Burnout and Empathy: A Cross-Sectional Study among Resident Physicians in Public Sector Hospitals of a Developing Country

2021 ◽  
Vol 3 (4) ◽  
pp. 121-124
Author(s):  
Muhammad Hamza Khalid ◽  
Rafia Ishtiaq ◽  
Laiba Fatima ◽  
Hassaan Ahmed ◽  
Aqsa Masood ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Working Hours ◽  
Maslach Burnout Inventory ◽  
Cross Sectional Study ◽  
Categorical Variables ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Significant Difference ◽  
Resident Burnout

The main objective of our study was to determine the prevalence of burnout and to identify various socio-demographic factors which are associated with resident burnout. As a secondary objective, we aimed to assess levels of empathy among the residents. A descriptive cross-sectional study was performed among residents working in Holy Family Hospital, Benazir Bhutto Hospital, and District Headquarter Hospital, all of which are situated in district Rawalpindi of Punjab, Pakistan. Data were collected from January 2019 to April 2019 using a convenient sampling technique. The participants were requested to complete Maslach Burnout Inventory to measure burnout and Jefferson Scale of Physician Empathy to measure empathy from January 2019 to April 2019. For data analysis IBM SPSS © version 25.0 was used. Descriptive statistics were used to summarize the quantitative variables. Chi-square test was used to determine the association between burnout and categorical variables. Then, those independent variables with p-value < 0.05 were subjected to binary logistic regression to identify predictors of burnout. A P-value of < 0.05 was used as the criterion for statistical significance and OR with 95% confidence interval was used to indicate the strength of association. Independent sample t-test was used to assess empathy among the groups. The prevalence of burnout in our sample was 78%. The average burnout score of the sample was 81±13.45. Weekly working hours (p-value < 0.05) and the type of specialty (p-value < 0.05) were significantly associated with resident burnout. Residents working more than 80 hours were more prone to develop burnout [AOR 2.700(1.42-5.120)]. Medical residents were found to be at a higher risk of developing burnout as compared to surgical residents [(AOR 2.097(1.16-3.78)]. Residents working less than 80 hours per week had more empathy scores as compared to residents working more than 80 hours and this result was statistically significant (p-value < 0.05). However, no significant difference in empathy was found for age, gender, marital status, and posts. Therefore, weekly working hours should be reduced to diminish burnout and increase empathy, thereby, promoting the quality of care being delivered to the patient. Moreover, efforts should be made to reduce burnout in medicine residents so that we may promote the doctor-patient relationship.

scholarly journals RHEUMATOID ARTHRITIS;

2019 ◽  
Vol 26 (02) ◽  
Author(s):  
Khadija Kiran ◽  
Uzma Jamil ◽  
Amtul Huda Sobhi ◽  
Zuhair Bhatti
Keyword(s):  
Rheumatoid Arthritis ◽  
Oxidative Stress ◽  
Cross Sectional Study ◽  
Categorical Variables ◽  
Control Group ◽  
P Value ◽  
Continuous Variables ◽  
Healthy Individuals ◽  
Cross Sectional ◽  
Medical College

Objectives: Objective of our study is to measure the concentration and role of Malondialdehydein determining the oxidative stress in rheumatoid arthritis patients in comparison with healthy individuals. Study Design: Cross sectional study. Setting: Department of physiology Gujranwala Medical College and Shalamar Medical College, Lahore. Period: From October 2016 to October 2017. Methodology: 180 patients of age 49 to 70 years of either gender. The approval for conducting experimental study was taken from ethical committee and consent information was taken from the patient on prescribed Performa. Data was analyzed on SPSS Version 23 related to study. Continuous variables were presented as mean and standard deviation like age and serum MDA concentration. Categorical variables were presented as numbers and percentages like gender. Post operative chi square test was applied and p- value less than or equal to 0.05 was considered as significant. Results: Total 180 person (n=180) of either genderwere included in this study. The study group was divided into two equal groups. Group A (RA group) consists of 90 patients (n=90) based on clinically and laboratory based criteria while group B (control group) consists of 90 (n=90) normal healthy individuals. The serum MDA levels in the RA patients were 3.97±1.03 nmoles/ml and it was 1.59±0.32 n moles/ml in control patients. The difference was statistically significant (t=20.87, p=0.001). Conclusion: The observations of our study showed statistically significant raised serum Malondialdehyde level as compared to control group which shows that raised serum MDA is an indicator of oxidative stress in rheumatoid arthritis patients.  

scholarly journals Initial Psychological Response of Various Population Groups to COVID-19 Pandemic: A Cross Sectional Study

2021 ◽  
Vol 35 (4) ◽  
pp. 13-17
Author(s):  
Shahzaib Ahmad
Keyword(s):  
Cross Sectional Study ◽  
Categorical Variables ◽  
Economic Losses ◽  
P Value ◽  
Sectional Study ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Psychological Response ◽  
Lower Socioeconomic ◽  
The Impact

Introduction: The corona virus pandemic has brought with it psychological problems like anxiety, stress, and depression. Research studies are urgently required to generate data that would help formulate strategies to manage the ensuing psychiatric and psychological maladies at societal level. Aims & Objectives: The aim of our study is to better comprehend the initial psychological response of society to COVID-19 outbreak though a survey. Place and duration of study: This cross-sectional study was conducted in King Edward Medical University, Lahore from April 2020 to October 2020. Material & Methods: An online questionnaire comprising of 20 items including the Zung self-rating Anxiety Scale (SAS) was disseminated to three fifty (350) participants. Two hundred and seventy-one (n=271) responses were received. Collected data was entered and analyzed using the SPSS software version 20. Categorical variables were presented as frequencies and percentages. Relationships between categorical variables were tested by Chi square test. Regression analysis was conducted to investigate the effect of various variables on total stress score. A p-value of <0.05 was considered significant. Results: It was revealed that 85.2% of the respondents reported minimal psychological impact, 14.8% had mild to moderate anxiety levels and 0.4% reported marked to severe anxiety. The impact was 2.5 times greater in subjects belonging to lower socioeconomic status (p=0.02). Conclusion: Population belonging to lower socioeconomic class is more vulnerable to be impacted by psychological disturbances due to the pandemic owing to economic losses that are magnified in the population with fragile earning sources.

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