Comparative study of efficacy of platelet rich plasma injection versus corticosteroid injection in conservative management of periarthritis shoulder

Analysis of eighty patients with periarthritis shoulder was done. Patients were thoroughly evaluated and were divided into two groups in a randomized trial. Forty patients were in group-A who received 3doses of injection of PRP (4ml) 2 weeks apart within a duration of 6weeks. Equal number of patients were in group-B. They received 2ml of Injection corticosteroid 2weeks apart within a duration of 6 weeks. All participants were advised to perform a home-based hot fomentation and 15min exercise therapy. One participant from group A and 2 from group B were lost to follow up. There were 35 male and 42 female who completed the study. Analysis of 77 subjects who completed the study was done. Participant were evaluated for range of motion of shoulder as main outcome measure. Visual Analogue Scale (VAS) and (Quick DASH) was used to measure pain and functions of the shoulder. The evaluation of Participants was done at 0,3,6 and 12 weeks. ANOVA test and Chi-square test, was repeatedly used to measure the differences.Participants who were given PRP injections showed significant improvements in active and passive range of shoulder motion as measured by VAS and Quick DASH over corticosteroid injection. This was also reflected statistically. No major adverse reactions were observed during 12 weeks of intervention.In our study, the injection of PRP showed marked improvement in the range of motion of shoulder over corticosteroid injection but it needs other study to be treatment of choice. It emerged as an option for treatment in diabetes patient and condition where steroid is contraindicated.

A retrospective study on management of bell\'s palsy in a tertiary care hospital

Bell's palsy is the most common facial nerve disorder. The clinical symptoms of Bell's palsy include facial muscle paralysis, difficulty in eating, drinking and talking. Bell's palsy management is still controversial. Many patients recover spontaneously; some require medicines like corticosteroids, antiviral drugs and other managements.To study the effectiveness of Bell's palsy management that has been followed in our institution.This analysis had carried out from June 2016 to June 2019at SRM Medical College Hospital and Research Institute, Chennai. Total of 30 patients with Bell's palsy who had admitted in the Department of Otorhinolaryngology had enrolled in this study. All the patients underwent thorough clinical examination and laboratory investigation, and the results were statistically analyzed and discussed.Out of 30 patients, 16(53%) patients were males, and 14(47%) patients were females. 53.3% of patients had onset of symptoms after 48 hours. There was a statistical significant improvement in House-Brackman scale on 6 months follow-up.The therapeutic measures for Bell's palsy if initiated within 72 hours of onset aids in bringing better outcome and improves the quality of life in patients.

Mid upper arm circumference in pregnant women and its relationship with birth weight

: Mid upper arm circumference (MUAC) is considered as a good indicator of maternal nutritional status in pregnant women. Very few studies have been done to establish a relationship between MUAC and birth weight of newborn. This study was carried out to analyze the relationship between MUAC and birth weight of newborn in a tertiary health care facility.This cross sectional study was conducted in 240term pregnant women. MUAC was measured to the nearest millimeters using a non-stretchable tape at the midpoint between acromian process and olecranon process. Newborn baby weight was measured within 24 hrs of birth. The association between MUAC and birth weight was established by linear regression analysis.The mean of MUAC among pregnant women delivering LBW was 21.68±2.27 cm which was significantly low (p<0.001) compared to women delivering normal babies (23.47±2.56 cm). There wasa positive correlation(r=0.32;p<0.05)between MUAC and birth weight of newborn.The cut off value of MUAC for the prediction of LBW in our study was found to be 22.59 cm with 62.77% sensitivity and 71.55% specificity.Among the various maternal factors for the prediction of LBW, mid-upper arm circumference (MUAC) can be correlated with birth weight outcome effectively.

Ki67 Protein expression and correlation with the histological grade and pTNM stage of colorectal carcinoma

: Colorectal cancer, is third most frequently encountered malignancy worldwide. Histological grade, stage, and proliferative index act as vital prognostic markers, playing a decisive role in patient care and prognosis. While histopathological examination can determine grade and stage, Ki67 protein expression by immunohistochemistry represents the proliferative capacity of the malignant cell population. : This Study was conducted to immunohistochemically analyze expression of Ki67 protein and its change with respect to different grades and stage of colorectal adenocarcinoma. : A total of 66 histologically diagnosed cases of colorectal carcinoma underwent histopathological examination followed by immunohistochemistry for Ki67 protein. : A statistically significant (p=0.04) correlation was obtained between Ki67 labelling index and histopathological grade, with higher values of Ki67 labelling index in poorly differentiated carcinomas (43.2±1.7). The Ki67 labelling index value was lowest in stage IV disease (11.4±2.4) with metastatic burden, with higher values in lower stage diseases, however this correlation was not found to be significant statistically (p=0.07). : The rate of cell division and proliferation measured by Ki-67 antibody is related to histological grade of the malignancy, demonstrating higher mitotic activity with loss of differentiation and anaplasia. Stage IV disease have lower mitotic activity, thus may be less amenable to cytostatic chemotherapy drugs, and require multimodality treatment with addition of radiotherapy and other drug regimes.

Bungee cord related ocular trauma: An avoidable cause of ocular morbidity

To study the mechanism and clinical features of ocular injury and its outcome associated with bungee cord related eye trauma. A retrospective review of medical records was performed at our tertiary care centre to identify patients presented with bungee cord related eye injury between March 2016 to February 2017. Data collected from medical records were age, sex, mechanism of injury, clinical features, therapeutic intervention, presenting visual acuity, final visual acuity and length of follow up. Total of thirteen patients with bungee cord related trauma were identified. Ten (77%) patients presented with closed globe injury and 3(23%) presented with open globe injury. All patients were male with mean age group of 30.15±7.38 years. Presenting visual acuity ranges from 6/12 to NPL. Only seven (54%) of patients were having final visual acuity of better than or equal to 6/18 in injured eye. Three patients (23.1%) with open globe injury had final visual acuity of counting fingers or worse. Main mechanism of injury being combination of blunt and high speed projectile injury due to slippage of metal or plastic hook while the cord is stretched. Trauma with bungee cord is usually affecting working age group male with injury resulting in loss of workable vision to loss of eye hence there is need of appropriate intervention like use of printed warning on package and modification of hook design to decrease the incidence of bungee cord related trauma.

A prospective clinico-etiological study of 100 cases of pancytopenia in a tertiary care hospital in Eastern India

Pancytopenia is a hematological entity which is relatively common. Its evaluation is important for arriving at an early and correct diagnosis, to aid in appropriate management.It was an observational study conducted in the Department of General Medicine and Clinical Hematology of our institute from June 2019 to May 2020. Clinical, hematological and biochemical parameters of 100 pancytopenic patients were evaluated and descriptive statistics was used. The age ranged from 18-75 years. The commonest presentation was easy fatigability and fever. Besides pallor, splenomegaly and hepatomegaly were the presenting signs. Megaloblastic anaemia was detected in 64% followed by aplastic anaemia in 12% and acute leukemia in 6% patients. Among infective etiologies, two cases of malaria (P. falciparum). And each case of HIV, tuberculosis and dengue were seen. Lowest Hb% of 1.8 gm/dl, lowest total leucocyte count (TLC) of 500cells/cmm and lowest total platelet count (TPC) of 4000 cells/cmm was noted in a case of aplastic anemia. Macrocytic anemia was predominant blood picture. Hypercellular marrow was noted in 70(70%) cases and common cause was megaloblastic anemia, followed by leukaemia. Hypocellular marrow was noted in 12(12%) patients with aplastic anemia being commonest cause. In our study diagnosis of pancytopenia and its causes were ascertained by hematological investigations. An early and prompt treatment was given according to the cause and severity. Most of the cases had good prognosis due to a treatable cause.

Seizure in children: How important is EEG & Neuroimaging?

Seizure in children are generally indicating a potentially serious underlying systemic or CNS disorders that require thorough clinical examination, investigation and management. It is therefore important to establish accurate diagnosis of seizure and its etiology to manage such patients appropriately. We carried out this study to evaluate different etiology of seizures and its correlation with abnormal EEG & abnormal neuroimaging in the age group of 2mo to 14 years. 200 children presented with seizure to our department from January 2019 to November 2020 were enrolled in this prospective hospital-based study. Detailed history, clinical examination, investigation with special emphasis to EEG & neuroimaging was done and different correlation was drawn by using SSPS 18.0 statistical analysis. Among 200 cases, 6 to 10yr. age group constituted maximum (49%) number of cases. Male to female ratio is 1.5:1. GTCS is the predominant pattern of seizure (60%) in all age groups. EEG abnormality is found in 45%, mostly in focal seizure type. Neuroimaging abnormality found in 29%. Maximum cases (30%) had infectious etiology. Childhood seizure needs detailed history taking and careful examination. Vedio recording shown by parents / caregivers really help towards differentiating seizure from seizure mimics. EEG has a role in specific seizure type; Neuroimaging at times helps in diagnosis. There are few studies that describe neuroimaging [Computed Tomography (CT) and Magnetic Resonance Imaging (MRI)] and Electroencephalogram (EEG) data in children who present with new-onset seizures. The EEG is recommended as a part of the neurodiagnostic evaluation of the child with an apparent first unprovoked seizure.

Study on bacteriological profile and antibiotic susceptibility in diabetic foot infection in a teaching hospital, Telangana

Diabetic foot is one of the most significant complications of diabetes, Chronic infections are caused by Enterococci, various Enterobacteriaceae obligate anaerobes, Pseudomonas aeruginosa. To study bacteriological profile and antibiotic susceptibility in diabetic foot infection. Cross sectional study was done in 110 diabetic foot infection cases in the Department of Microbiology, Prathima Institute of Medical Sciences, Nagunuru, Karimnagar, Telangana. The grading of diabetic foot ulcers was done according to Wagner’s Classification system. The samples were collected from the exudates and ulcers. Gram stain was done and standard protocol for culture and sensitivity was followed for all the cases.A total of 110 cases were studied. The patient age ranged from 35 to 75 years and the male to female ratio was 2:1. Out of 110 isolates, 72.7% isolates were Gram negative bacilli with P. aeruginosa 31.8% being the predominant followed by E.coli 27.2%, K.pneumoniae 10%, P.mirabilis 4.5%, S.aureus 12.7% was the predominant isolate followed by Enterococci spp 4.5% and Coagulase negative staphylococci (CONS) 4.5% and S. pyogenes were 5.4%. Both Gram positive cocci and Gram negative bacilli can cause dia­betic foot infections and this study showed a preponderance of Gram negative bacilli. Early culture and sensitivity test of the bacterial isolates helps in guiding the treatment plan

Hematological and coagulation profile of dengue infection in age group 1 to 12 years children in a tertiary care hospital

Dengue is an arboviral infection of public health problems in tropical and sub-tropical countries transmitted to humans through the bite of an infected mosquito of the Stegomyia family. It varies in severity, ranging from influenza-like self-limiting illness to life- threatening, which if left untreated, are associated with mortality as high as 20%. Find out hematological and coagulation profile in dengue infected children aged 1 to 12 years and association of hematological and coagulation profile with dengue severity. It is an Observational Cross- sectional study done on 100 dengue patients aged 1 to 12 years during the study period from March 2019 –February 2020. Among 100 dengue fever, 85 (85%) were categorized as dengue fever (DF), 11(11%) DF with warning signs and 4 (4%) were cases of severe dengue (DHF/DSS) according to revised World Health Organisation 2009. The most common age of presentation was above 6 years and females were afflicted more with dengue fever.100% dengue patients presented with fever. Persisting vomiting, pain abdomen, hepatomegaly and hypotension indicate progression towards severe dengue. Raised Hb% and PCV, low to normal values of WBC as well as predominantly decrease in platelet was seen in severe dengue cases however, both ESR and CRP were normal. The Liver function test was deranged SGOT>SGPT in almost all of the dengue patients and it was 3 to 4 times maximally in DFW and SD. PT, APTT prolongation, increased D- dimer and hypofibrinogenemia associated with the severity of dengue fever. Dengue is a common viral infection that may have serious consequences especially in children. There is clear difference in pattern of change of both haematological and biochemical parameters in non-severe dengue fever and severe dengue fever. Rising trend of Hb%, PCV, decreasing value of platelet count, raised transaminases (SGOT>SGPT), elevated D- dimer, PT and APTT and hypofibrinogenemia can be used as predictor of entry into critical phase

Clinico-Etiological profile of congestive heart failure (CHF) in children

Congestive heart failure (CHF) occurs when the heart doesn’t pump blood to meet the oxygen demand of the various organs. Usually congenital heart disease (CHD) like VSD, PDA, CoA, TGA physiology, ECD, Ebstein anomaly present with CHF before U5 age. In India most common cause of CHF from 5 to 15 yrs. age is due to Rheumatic Fever / RHD. We also get cases like pericardial effusion, constrictive pericarditis, DCM, AR in rheumatic disease, iron overload causing myocardial failure in Thalassemia and anemia presenting as CHF as in more than 5-year children. CHF cases contribute to about 10% of mortality in children.We conducted a Hospital based descriptive and cross-sectional study from November 2018 to October 2020 at Pediatric department of M.K.C.G Medical College Hospital, Berhampur. All pediatric patients with signs and symptoms of CHF as per clinical diagnosis in the age group of 1 month to 14 year were included in our study. The study population was 136. Out of the total cardiac cases, 57% were CHD, 43% were acquired. Among the total 105 cardiac cases of CHF, CHD were 60(57.2%). Out of the total CHD, acyanotic heart diseases were 46.7% and acquired heart diseases constituted 42.8%. Out of total 136 cases 87(63.2%) were discharged, 23(17.6%) died, 19 cases (14%) were referred to higher centre. After data collection detail analysis was made by SPSS software. An initiative regarding addressing the problematic Congestive heart failure along with its clinical management will definitely help the future generation and researchers.