DocumentsDate added
Case report:- Microbiology
Chitralekha S1, Kiran M2, Lakshmi K3*
1Professor, 2Associate Professor, 3Assistant Professor, Department of Microbiology, Sree Balaji Medical College and Hospital, Chennai, India.
Abstract:- Rhinosporidiosis is an infectious disease primarily affecting the nasal mucosa, conjunctiva and urethra. It is endemic in some Asian countries, especially India, affecting people of any age. It affects both sexes. Its clinical manifestation is a polypoid mass growing inside the affected cavity and the only treatment is surgical excision of the mass. Rhinosporidium seeberi is considered as the aetiological agent. A 10 year-old boy from India, resident of Orissa, presented with a history of nasal obstruction of three months duration. Anterior rhinoscopic examination revealed an erythematous mass obstructing the right nasal cavity which was about 2 cm in diameter. Microscopic examination of the mass revealed rhinosporidiosis. Rhinosporidiosis is a rare condition which should not be missed out when the patients from endemic countries present with nasal masses.
Keywords:- Nasal cavity, Rhinosporidiosis.
Research article:- Medicine,
Krithika D Muralidhara1*, Prabha Adhikari2, Kotian MS3 & Muralidhara DV4
1MBBS, MD, (Senior Registrar), Fr Muller Medical College, Mangalore, India.
2MBBS, MD, Professor of Medicine, Kasturba Medical College, Mangalore, India.
3MSc, Asst Professor, Dept of Community Medicine, Kasturba Medical College, Mangalore, India.
4PhD, Professor of Physiology, Faculty of Medicine and Health Sciences, University Sultan Zainal Abidin, Kuala Terengganu, Malaysia.
Abstract:- Polycystic ovarian syndrome (PCOS) is considered as a multisystem endocrinopathy. The present investigation on eighty five (85) patients diagnosed with PCOS revealed that 78% of them were overweight or obese on the basis body mass index. This fact was also partly supported by higher waist circumference in a majority of them indicating central obesity. Body weight gain at puberty was reported by over 80% of the subjects and elevated blood pressure was associated with abnormal lipid profile in a large number. Overweight/obese subjects had slightly higher fasting blood sugar levels. Metabolic syndrome features were thus evident in 33% of the subjects. However, only 4% of the subjects were infertile. Clinically, almost all subjects had developed hirsuitism and 40-70% of them had Cushingoid features. Hormonal functions such as insulin, LH/FSH ratio, male hormones, particularly dehydroepiandrosterone sulfate was higher in a considerable number of patients. 40% of the patients had hypothyroid features. The findings of study thus also support the idea that PCOS may be a manifestation of metabolic syndrome as suggested by others.
Key words:- Polycystic ovary syndrome, metabolic syndrome, obesity.
Research article:-
Saravanan D1*, Ranganathan.S1, Harikumar.S1 & Sumathi.K2.
1Department of Anaesthesia,2Department of Biochemistry, Shree Balaji Medical College and Hospital, Chennai (Bharath University).
Abstract:- Background: Esmolol and Lignocaine attenuates cardiovascular response during laryngoscopy and intubation. The aim of the study is to compare Lignocaine versus Esmolol to observe the effect on cardiovascular response to laryngoscopy and endotracheal intubation. Materials and Methods: Fifty elective surgical patients of active age group (16 -60 years) American Society of Anesthesiologist physical status I & II irrespective of surgical procedure were randomly assigned to one of the two groups (A and B). Group A received injection Esmolol 0.5mg/kg injected slowly over a period of 2 minutes followed by maintenance injection 0.2mg/kg/min till intubation was completed. Patients in group B received injection Lignocaine 1 mg/kg injected slowly over a period of 2 minutes followed by maintenance injection 0.4mg/kg/ min till intubation was completed. Hemodynamic parameter i.e. blood pressures (systolic blood pressure, diastolic blood pressure and mean blood pressure), heart rate, rate were monitored after bolus, after administration of induction agents, after intubation, and at 2minutes and 10 minutes after intubation. Results: There were statistically significant (p<0.001) fall in blood pressures, heart rate and in group A i.e. pretreatment with intravenous Esmolol and remained so after 10 minutes. On the other hand there were no statistically significant (p>0.01)fall in heart rate, blood pressures and rate pressure product in group B, where pretreatment done with Lignocaine. Conclusion: The study showed that pretreatment with Esmolol 0.5mg/kg injected slowly over a period of 2 minutes followed by maintenance injection 0.2mg/kg/min till intubation suppresses the cardiovascular response due to laryngoscopy and intubation.
Key words:- Cardiovascular response, laryngoscopy, Esmolol, Lignocaine.
Research article:- Pulmonology and Critical Care
Rakesh K Gupta*
*Assistant Professor, Department of Pulmonology and Critical Care, King Fahd Hospital of University , University of Dammam, Kingdom of Saudi Arabia.
Abstract: Background: In recent years non-invasive ventilator modalities have been developed to improve alveolar ventilation and oxygenation with-out the need for an artificial airway. It is found to be an effective modality for the treatment of hypercapnic as well as hypoxic respiratory failure. In some patients however noninvasive ventilation is inadequate and invasive ventilation cannot be avoided. Failure of initial trial of NIPPV may lead to a delay in intubation and associated with significant increase in mortality.
Objectives: To find the base line parameters associated with failure of NIPPV so that individual could be identified who are likely to fail to respond to NIPPV either before or shortly after a trial of therapy.
Methods: Prospective observational study was conducted including hypoxic and hypercapnic respiratory failure and put on NIPPV. The patients ECG, oxygen saturation, blood pressure and respiratory rate were continuously monitored. Arterial blood gas level measured on admission, 1, 4, 12, 36 hours after starting NIPPV.
Result: It was observed that among the hypoxemic patients unsuccessful group had significantly higher heart rate (128±9.98 Vs 115±14.4, p = 0.43) than successfully treated group. ADL score was also found to be significantly low in failure group (1.50±0.54 Vs 2.35±0.67, p = 0.009) in comparison to success group. After 1 hr of administration of NIPPV respiratory rate (27±4.73) and PaO2 (94.2±21.6) in success group improved significantly. In hypercapnic group baseline heart rate (134±8.36 Vs 105±12.3) and respiratory rate (37.4±3.95 Vs 33.5 ±2.32) was significantly higher in failure patients as compared to successful ones. After 1hr of NIPPV trial pH, HR and RR improve significantly in success group as compared to failure group 7.36±0.04 Vs 7.30±7.99, 93±15.1 Vs 135±7.99, 27.9±5.83 Vs 37.1±3.98 respectively.
Conclusion: NIPPV may be useful for avoiding intubation in patients with acute respiratory failure but data available at the time of initiation of NIPPV and after a short period can predict the likelihood of success or failure. So that any delay in intubation can be avoided which itself is associated with significant mortality.
Research article:- Obstetrics and Gynaecology.
Mangal Puri1*, Anita Singh2, Meenal Patvekar1, Stuty Tyagi1, Pratima Sharma1 & Smita S. Singhania1.
*1Professor, Department of Obstetrics and Gynaecology. Pad. Dr.D.Y. Patil Medical College, hospital and research centre.Dr.D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India.
2Professor and Head, Department of Obstetrics and Gynaecology. Gian Sagar Medical College, Ramnagar , Banur.Patiala, Punjab, India.
Abstract: Background: Vaginal route of hysterectomy is preferred than abdominal, which has increased the chances of vault collection leading to postoperative morbidity. Present study is done to evaluate the prevalence of ultrasonologically detectable vault hematoma after vaginal hysterectomy (VH) and its correlation with postoperative morbidity and to study whether routine postoperative ultrasound following VH can help to reduce it. Materials and Methods: A group of 100 women who underwent vaginal hysterectomy at tertiary care centre and teaching hospital, for benign causes and utero-vaginal prolapse were selected. Transabdominal and transperineal or transvaginal ultrasound examinations were carried out on 3rd, 7th and 9th postoperative days to assess the presence of vault hematomas. Ultrasound findings were correlated with clinical data regarding postoperative morbidity. Results: The incidence of vault hematoma was found to be 8% in present study, 37% had febrile morbidity and 50% patients had postoperative drop in haemoglobin. Association with intra and post operative haemorrhage was noted. Large sized hematomas were drained vaginally under anaesthesia, while all small and medium sized hematomas were managed by anti-fibrinolytics and antibiotics successfully. Conclusion: Postoperative ultrasound need not be a routine procedure but that helps to reduce morbidity in selected patients.
Key Words: Vault hematoma, vaginal hysterectomy, ultrasound evaluation.