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Results in Journal International Journal of Advanced Research in Medicine: 231

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Sunil Kumar Sharma
International Journal of Advanced Research in Medicine, Volume 3, pp 98-103; https://doi.org/10.22271/27069567.2021.v3.i2b.224

Abstract:
Background: Rhinocerebral mucormycosis is a complex and fatal infection typically affecting diabetic and/ or immunocompromised patients, but recently seen in large numbers during the second wave of corona infection. This dreadly infection was found typically in patients who were administered steroids and higher antibiotics. Usually, these kinds of manifestations are noticed due to inhalation of fungal spores. Fungi constitute a kingdom of ubiquitous eukaryotic organisms that actively replicate during decomposition and recycling of matter in the natural environment. About 50000 fungal species, of which only 400 are actually pathogenic for humans. Approximately a dozen of which are responsible for 90% of frequently encountered fungal infections. Material and methods: Survival rate of patients is moderately high 95% and Mortality rate is only 5% in our series due to early diagnosis and treatment with aggressive sugar control, repeated debridement antifungal therapy and regular follow up with MRI PNS Contrast. Results: In this case series, 156 cases with rhinocerebral mucormycosis were presented. The etiologic agents and other survival and Mortality factors of mucormycosis in 156 Patients were isolated and identified by sequence analysis and data were registered and presented. Conclusion: In patients with mucormycosis, early detection, surgical excision and appropriate debridement, suitable antifungal therapy, MRI Contrast and control of risk factors like, Covid patient on steroids and higher antibiotics, diabetes mellitus are the main parameters of successful management of this lethal infection.
Mohammed Azam
International Journal of Advanced Research in Medicine, Volume 3, pp 158-164; https://doi.org/10.22271/27069567.2021.v3.i2c.237

Abstract:
Background: Rickettsial diseases are one of the most re-emerging infections of the present time. They are generally incapacitating and difficult to diagnose. Untreated cases can have fatality rates as high as 30-35% but when diagnosed properly, they are often easily treatable. Rickettsial infections are one of the important causes of pyrexia of unknown origin (PUO) and this needs to be differentiated from other febrile illnesses. Rickettsial infections are grossly under- diagnosed in India. Objectives of The Study: To study the clinical profile and outcome of rickettsial infections in children aged less than 12 years Methods: It is a time bound prospective hospital based observational study conducted from 2019 to 2020. All children aged less than 12 years admitted in paediatric ward with fever without an identifiable source of infection and one or more of the following clinical features: rash, oedema, hepatosplenomegaly, Lymphadenopathy, an Eschar and a tick bite or tick exposure were suspected to have rickettsial infection. The purpose of the study was explained to the parents or guardians of the child and an informed consent was taken from them enrolling the child in study group. All suspected cases were subjected to rickettsial IgM/IgG ELISA test and tests to exclude other diseases.All rickettsial IgM/IgG positive cases were followed up through hospital stay and outcomes were noted. Results: The most common age group of presentation was between 1 and 5 yrs. The common symptoms in these children included fever (100%), rash (83.3%), edema of limbs (26.6%), puffiness of face (30%), generalised edema (23.3%), cough (23.3%), pain abdomen (16.6%), vomiting (13.3%), convulsions (10%), headache (3.33%) and arthralgia (3.33%). Signs like Hepatomegaly, facial puffiness, pedal edema, splenomegaly, ecchymosis present in 53.3%, 46.6%, 43.3%, 10% and 6.6% of the cases respectively, mimicking common illnesses. Thus warrants high index of suspicion. SCRUB Typhus and Indian Tick Typus Elisa Positive (mixed infection) noted in 14% of cases. Complications like meningoencephalitis (3.33%), shock (3.33%), DIC (3.33%) was observed in the study. There was good clinical response on initiation of doxycycline within 48hrs of initiation of treatment. Case fatality rate of rickettsial disease in this study was 6.66% (n=2). Conclusion: Indian tick typhus is the most common rickettsial fever noted in this part of Telangana. Rickettsial diseases are difficult to diagnose, unless suspected but treatment is easy, affordable and often successful with dramatic response to antimicrobials.
Madhumati Varma, Jaswant Goyal
International Journal of Advanced Research in Medicine, Volume 3, pp 130-132; https://doi.org/10.22271/27069567.2021.v3.i2c.226

Abstract:
Introduction: Now a days Diabetes Mellitus has highest prevalence rate in India and thyroid disease also increasing due to influence life style changes. Both endocrine diseases and thyroid problem are interlinked and effect each other as glucose high in blood which influence by insulin resistant and increase TSH level in pituitary gland feedback system due to low function of thyroid hormone secretion. When hypothyroidism glucose release from liver and dyslipidemia finally insulin resistant and causes type 2 diabetes and tis influence hypothyroidism. So, need to control both. Objective of study: To define interrelation of factors responsible for interlink between diabetes and thyroid disease development. Method and methodology: This study evaluates duration diseases of thyroid and diabetes with basic analysis like glucose, TSH Hba1c, lipid profile etc. and data analyses in excel software done, found diabetic develop first in highest prevalence followed by metabolic changes develops hypothyroidisms, second highest hypothyroidism and vise versa in “thyrobetes”. There were total thyrobetes 10.7% and DM type 2 52%, hypothyroidism 49%. P was significant
Divya Reddy Molugu, B Sreenivas Reddy, M Greeshma Reddy Molugu
International Journal of Advanced Research in Medicine, Volume 3, pp 165-168; https://doi.org/10.22271/27069567.2021.v3.i2c.238

Abstract:
Background: Deterioration of renal function that is both acute and potentially reversible causes the kidney to be ineffective to eliminate nitrogenous waste products and maintain fluid and electrolyte balance, resulting in Acute Kidney Injury.Objective: To study the Clinical profile of acute kidney injury in ICU patientsMethods: A total of 50 patients with acute kidney injury were included after meeting the inclusion exclusion criteria. After obtaining of written informed permission from the patients, a comprehensive medical history, general physical examination, systemic examination, and routine and specific lab investigations were performed to determine the underlying etiology, clinical characteristics, and result of AKI. All patients were clinically and biochemically monitored until they were discharged.Results: Male were predominant with 70% compared to females 30%.The Male: Female ratio was 2.3:1, Fever was the most common symptom observed in 54% of the cases followed by dyspnea. Around 30% of the urine cultures were positive. Escherichia coli, candida albicans, Klebsiella species, proteus mirabilis, and pseudomonas species were among the microorganisms discovered in urine culture. Patients with three or less ailments (82%) have a better probability of recovering, whereas those with four or more ailments (18%) have a larger risk of deteriorating. 78% of the patients had recovered from AKI, whereas AKI deteriorated in 22% of the patients.Conclusion: Acute Kidney Injury is a prevalent clinical issue in critically ill patients, particularly those in the medical ICU. Early identification and appropriate management are crucial for reducing AKI-related and all-cause death in critically ill patients.
Bottu Kalyani, P Chandra Varshini, Baddam Akshitha, Mamidi Rohini Reddy, Miryala Swamy
International Journal of Advanced Research in Medicine, Volume 3, pp 233-237; https://doi.org/10.22271/27069567.2021.v3.i2d.251

Abstract:
Background: Severe covid 19 disease is associated with multiorgan damage and mortality which is associated with dysregulated immune system with hyperactive inflammation, called as cytokine -release syndrome, for which IL 6 is considered to be the main culprit for the severity of the disease. Here we are observing the use of Tocilizumab, a monoclonal antibody against the IL 6 receptor in the treatment of severe COVID 19 patient. AIM: The aim of this study was to assess the role of tocilizumab in severe COVID -19 patients, clinical and laboratory outcome. Method: We did a retrospective, observational study on patients who were admitted in ICU with severe COVID-19 pneumonia who met the severity criteria were given Tocilizumab. Severity grading according to MoHFW were graded. The primary objective was to evaluate the effect of tocilizumab on mortality, length of hospital stay, trends of inflammatory markers and clinical progression of disease on day 10 of admission, compared with the similar group how were treated with standard treatment alone. Results: Out of (50 in tocilizumab group and 49 controls) patients, mortality was analysed showed 24% in tocilizumab group, 42.9% in control group. Mean length of hospital stay in tocilizumab and control group were compared i.e., 13.3 days and 14.27 days respectively. And there was significant reduction in inflammatory markers LDH, S FERRITIN, D DIMER, and CRP in tocilizumab group. Interpretation: Treatment with tocilizumab, might reduce the mortality in severe COVID-19 pneumonia patients. Since our study sample being small, a study with larger sample size may require predicting the outcome.
Isha Kohli
International Journal of Advanced Research in Medicine, Volume 3, pp 265-269; https://doi.org/10.22271/27069567.2021.v3.i2e.253

Abstract:
Aim: To assess the prevalence and risk of anemia in a population of subjects with documented D25 deficiency compared with those with normal D25 levels. Material and Methods: The present case control study was conducted among 100 subjects (50 were cases and 50 were controls) in the Christian Medical College, Ludhiana. Total serum 25(OH)D concentration was analyzed using commercially available ELISA kits. According to the manufacturer’s instructions, concentrations of 25(OH) D below 25 nmol/L were classified as a deficiency, and values of 25–75 nmol/L were considered a vitamin D insufficiency. Difference between two groups was determined using chi square test and student T test for categorical data and continuous data respectively. P-value of
Divya Reddy Molugu, B Sreenivas Reddy, M Greeshma Reddy Molugu
International Journal of Advanced Research in Medicine, Volume 3, pp 193-196; https://doi.org/10.22271/27069567.2021.v3.i2c.239

Abstract:
Background: Every year, myocardial infarction causes more deaths and disabilities than any other disease in the world, and In fact, it is the most prevalent form of a life-threatening chronic illness.Objectives: To study hyponatremia as a prognostic indicator in acute myocardial infarctionMethods: 100 patients with Acute Myocardial Infarction who were admitted to the ICU and the Department of Internal Medicine. All patients had a 12-lead ECG, with the right sided and posterior leads taken for inferior wall MI. A detailed history was collected, as well as a detailed clinical examination, as well as daily serum electrolytes and ECHO was done. An Ion selective electrode auto analyzer was used to determine the serum sodium concentration (Roche OMNIC).Results: In our study 64% were males and 36% were females. Males are more prone for ischemic heart diseases. The proportion of Diabetic, Smokers, hypertensives were more among patients with Hyponatremia. anterior wall MI was the most prevalent, followed by inferior wall MI. Killip class I is found in 74% of patients with normal sodium levels compared to 58% in hyponatremia groups, class II in 20% of patients compared to 24% in hyponatremia, class III in 6% of patients compared to 16% of hyponatremia patients, and class IV in 2% of hyponatremia patients whose sodium level was 130 or lower. Patients who developed hyponatremia had a greater mortality rate than those who had normal sodium levels.Conclusion: Asians are more likely to develop STEMI. The severe the Hyponatremia, the poorer the prognosis. Hyponatremia and a reduced ejection fraction are more common in anterior wall MI patients than those with normal sodium levels.
Dineshkumar Valjibhai Pandor
International Journal of Advanced Research in Medicine, Volume 3, pp 209-211; https://doi.org/10.22271/27069567.2021.v3.i2d.242

Abstract:
Background: Alcohol is known to produce toxic effects in all the systems of the body. Hence, understanding the effects of alcohol is necessary to plan perfect treatment strategies for management of alcohol dependent patient. Aim: The present study was undertaken to assess the incidence and profile of neurological diseases in alcohol dependents.Materials and Methods: The study recruited 50 alcohol dependence patients attended to the hospital OPD. The selection and assessment of the alcohol depended patients are using standard DSM-IV as mentioned in the literature. Demographic data was collected from the patients using standard methods. Neurological dysfunction was assessed through physical examination. Results: Maximum number of patients belongs to age group of 31-40 years. All the participants were males. Majority are married men who were alcohol dependents. Majority of alcohol dependents are unemployed. Majority of the patients consume country liquor. Dementia and hand tremor are most commonly observed neurological symptoms in the alcohol dependents.Conclusion: The present study adds to the existing knowledge about the neurological symptoms in the alcohol dependents. The most common features observed are hand tremors and dementia. There is a strong need to undertake further detailed studies in this area for better understanding and better planning of treatment strategies.
Madhu Kumar Mh, Sudeep Jayaram, Nirmal Kumar Sharma, Sourabh Chittora
International Journal of Advanced Research in Medicine, Volume 3, pp 01-04; https://doi.org/10.22271/27069567.2021.v3.i2a.206

Abstract:
A recent review of insulin resistance syndrome (IRS) revealed a rapid escalation of metabolic syndrome among Indians and that the prevalence of predominant component of metabolic syndrome varied from region to region in Indians. Studies on the pathophysiology of this syndrome revealed close to a six-fold increase in cardiovascular mortality. Standardized definition of MI and clinical outcome will be used. A final diagnosis of MI will be made in the presence of serial increases in serum biochemical markers of cardiac necrosis, associated with typical electrocardiographic changes and/or typical symptoms. 27.27% (20) of patients of MI with METS were obese (BMI ≥ 30kg/m2) compared to 2.74% (2) of the patients of MI without METS, which was statistically significant (p value
Eleni Laskou, Anastasios Kottaras, Paris Iakovidis, Dimitrios Lytras, Ioanna P Chatziprodromidou, Georgios Chasapis
International Journal of Advanced Research in Medicine, Volume 3, pp 76-78; https://doi.org/10.22271/27069567.2021.v3.i2b.217

Abstract:
Multiple sclerosis (MS) is a neurological disease characterized by the onset of movement disorders such as spasticity, fatigue, ataxia and pain. Hippotherapy helps to improve balance, endurance, increase orthostatic control, self-confidence and muscle strength. The aim of this review is to describe recent research data on the effects of hippotherapy in patients with MS. The PubMed and Google Scholar databases were searched with the following keywords: multiple sclerosis, hippotherapy, rehabilitation. This review included both clinical trials and systematic reviews. In conclusion, it seems that the application of hippotherapy both as an individual treatment and in combination with other physiotherapy methods can contribute to the improvement of motor disorders, mental health, quality of life and functioning in the performance of daily activities in people with MS.
Divax Oza, Sk Luhadia, Atul Luhadia, Rishi Kumar Sharma, Gaurav Chhabra, Shubhkaran Sharma, Amit Gupta, Deepak Shukla, ., Ronak Kankrecha, et al.
International Journal of Advanced Research in Medicine, Volume 3, pp 05-09; https://doi.org/10.22271/27069567.2021.v3.i2a.207

Abstract:
Objectives: We investigated the outcomes of Ivermectin-Doxycycline vs. Favipiravir therapy in mild to moderate COVID19 patients.Methods: Patients were divided randomly into two groups: Ivermectin 200µgm/kg single dose + Doxycycline 100mg BID for ten days in group A, and Favipiravir 1800mg for the first day, then 800mg BID for six days in group B (Control group). RT-PCR for SARS-CoV-2 infection was repeated in all symptomatic patients on the second day onward without symptoms. Repeat PCR was done every two days onward if the result found positive. Time to the negative PCR and symptomatic recovery was measured for each group. Results: All subjects in Group A reached a negative PCR, at a mean of 8.93 days, and reached symptomatic recovery, at a mean of 5.93 days, with 55.10% symptom-free by the fifth day. In group B, 96.36% reached a negative PCR at a mean of 9.33 days and were symptoms-free at 6.99 days. In group a 31.67% of patients expressed symptoms caused by medication, this was 46.43% in group B. Conclusion: The combination therapy of Ivermectin-Doxycycline showed a trend towards superiority to the combination of Favipiravir for mild to moderate COVID19 disease.
Vasileios Mylonas, Dimitrios Lytras, Paris Iakovidis, Anastasios Kottaras, Andreas Fotios Tsimerakis, Ioanna P Chatziprodromidou
International Journal of Advanced Research in Medicine, Volume 3, pp 18-20; https://doi.org/10.22271/27069567.2021.v3.i2a.210

Abstract:
Spinal cord injury (SCI) is a type of injury that presents a high degree of disability and causes motor and sensory deficits. Applying virtual reality (VR) therapy can help better rehabilitate patients with SCI by improving their balance and other functional parameters. The aim of this review is to describe recent research data on the efficacy of this method in improving balance in adult patients with SCI. The Google Scholar, PubMed, Scopus and PEDro databases were searched for articles published from 2015 to date in English with the following keywords: spinal cord injury, virtual reality, balance, rehabilitation. The review included 10 articles (five clinical trials and five systematic reviews). Discussion-Conclusions: The application of VR can significantly contribute to the improvement of static, postural and dynamic balance in patients with SCI. The results of this review show that approximately 20 sessions of 30-60 minutes each are able to improve balance in these patients. More clinical studies are needed to draw safer conclusions.
Aikaterini Bairaktaridou, Dimitrios Lytras, Anastasios Kottaras, Paris Iakovidis, Ioanna P Chatziprodromidou, Konstantinos Moutaftsis
International Journal of Advanced Research in Medicine, Volume 3, pp 21-24; https://doi.org/10.22271/27069567.2021.v3.i2a.211

Abstract:
Background: Cerebral palsy (CP) is the most common cause of paralysis in infancy and childhood. There is evidence that the integration of hydrotherapy in the treatment program can significantly contribute to the rehabilitation of children and young people with CP by improving their functional limitations and overall, their quality of life. The purpose of this review was to present recent research data on the contribution and efficacy of hydrotherapy in the rehabilitation of children and young adults with CP. The Google Scholar and PubMed databases were searched with the following keywords: cerebral palsy, hydrotherapy, rehabilitation. This review included 11 articles. The results of our research show that hydrotherapy, both as an individual treatment and in combination with a standard land-based exercise program, can significantly contribute to the improvement of gross mobility, the improvement of exercise endurance and the improvement of the quality of life of people with CP. Ideal dosage of hydrotherapy programs, according to the research included in the review is 2-3 sessions per week for more than six weeks. However, it should be noted that the literature is still limited and further research is needed.
Kavangal Dhananjay, Mamatha Pulloori
International Journal of Advanced Research in Medicine, Volume 3, pp 37-40; https://doi.org/10.22271/27069567.2021.v3.i2a.215

Abstract:
Nonalcoholic fatty liver disease (NAFLD) is emerging as an important cause of chronic liver disease in worldwide. Liver biopsy is a gold standard procedure in the diagnosis and staging of NAFLD, but there are several non-invasive diagnostic procedures have been emerged for the early diagnosis of liver fibrosis. The present study was designed to assess the efficacy of APRI to fibroscan as a marker for early fibrosis in cases with non-alcoholic fatty liver diseases. A total of 120 cases, which are newly diagnosed with non-alcoholic fatty liver disease attending OPD were recruited. Laboratory investigation results were obtained after overnight for evaluation of complete blood count, blood glucose levels, albumin, total bilirubin, platelet count, prothrombin time international normalized ratio, cholesterol, triglyceride (TG), serum urea, creatinine, HBsAg, HCV. Radiological evaluation was conducted by USG abdomen and fibroscan. The value of triglyceride was below 150mg/dl in 34.16% cases, between 150-200mg/dl in 45.83% cases and >200mg/dl in 20% cases. The fasting blood sugar was >100 in 40% cases and 0.7 would avoid the need for fibroscan.
Gaurishankar
International Journal of Advanced Research in Medicine, Volume 3, pp 15-17; https://doi.org/10.22271/27069567.2021.v3.i2a.209

Abstract:
Background: Caring of a child with bipolar disorder (BPAD) is a challenging job because of numerous illness-related and non-illness related factors – “securing appropriate treatment on long-term basis. The present study was conducted to evaluate maternal stress in mothers of adolescents with BPAD.Materials & Methods: 68 mothers of adolescent with bipolar disorder of both genders were included. The GHQ-12 was applied on mothers of bipolar disorder adolescent (Group I) and the mothers of normal adolescents (Group II). The Parenting Stress Index, Brief COPE Scale was recorded.Results: Adolescent age in group I was 15.2 years and in group II was 13.1 years, mother age was 38.4 years in group I and 36.2 years in group II and family size was 6.1 in group I and 5.5 in group II. The parental distress (PD) in group I was 41.4 and in group II was 35.2, parent child dysfunctional interaction (PDCI) in group I was 42.6 and in group II was 31.6, difficult child (DC) was 41.2 in group I and 31.8 in group II and total score was 125.2 in group I and 98.6 in group II. The difference was significant (P
Anastasia Sofia Mindouri, Anastasios Kottaras, Paris Iakovidis, Dimitrios Lytras, Ioanna P Chatziprodromidou, Georgios Chasapis
International Journal of Advanced Research in Medicine, Volume 3, pp 79-81; https://doi.org/10.22271/27069567.2021.v3.i2b.218

Abstract:
Background: Stroke is one of the most common central nervous system disorders. Early intervention through the Proprioceptive Neuromuscular Facilitation (PNF) technique can contribute to the better physiotherapy treatment of the person with stroke by improving the quality of their movement and reducing their functional limitations.Aim: The aim of this review is to describe recent research data on the efficacy of this method in improving functioning in patients with stroke.Method: The Google Scholar and PubMed databases were searched with the following keywords: stroke, PNF, rehabilitation. Results: This review included 10 articles. Discussion - Conclusions: The application of the PNF method seems to have a positive effect on the treatment of movement disorders in patients with stroke when compared to conventional physiotherapy. The results of this review show that the intensive initiation of the PNF method is able to improve the functional level of the person with stroke in their daily life.
Yadvendra Singh, Lalit Singh, Rajeev Tandon, Pradeep Nirala
International Journal of Advanced Research in Medicine, Volume 3, pp 66-75; https://doi.org/10.22271/27069567.2021.v3.i2b.216

Abstract:
The aim of our study was to evaluate the role of vital parameters and biomarkers in predicting the outcome of patients in Covid ICU. Material and Methods: In our study among 186 Covid-19 cases admitted in ICU we compared the vital parameters and levels of biomarkers on the day of admission and last day of hospitalisation among those who Expired (Group A) and the survivors (Group B). Results: The median values of vital parameters were significantly raised on the day of admission in comparison to last day of hospitalisation. Vital parameters worsened among those who expired (Group A) and improved in the survivors (Group B). The levels of biomarkers increased with the duration of hospitalisation among those who expired (Group A) and declined among the survivors (Group B). Conclusion: The worsening of vital parameters and raised levels of biomarkers is associated with poor outcome and higher mortality.
Nida Choudhry, Lalit Singh, Rajeev Tandon
International Journal of Advanced Research in Medicine, Volume 3, pp 25-29; https://doi.org/10.22271/27069567.2021.v3.i2a.212

Abstract:
Objectives: Aim of this study was to determine the Depression, Stress, and Anxiety level among COVID 19 positive healthcare workers working at a tertiary care center of Rohilkhand area during COVID-19 pandemic. Methods: This is a retrospective study was conducted using online survey from March 2020 till Jan 2021 at the Shri Ram Murti Smarak Institute of Medical Sciences Barielly (UP). Participants of the study were fulltime employees of hospital. Data were collected about several aspects of demographic factors, clinical symptoms, co-morbidities and mental health status. We assessed by using an online questionnaire and Depression, Anxiety and Stress - 21 (DASS-21) scale was used. Results: A total of 224 healthcare workers were included who came COVID 19 positive during their duties in SRMS IMS Bareilly, Out of which, 46 (20.5%) participants were suffered from moderate to severe depression, 20.1% (45) from moderate to severe anxiety, and 14.7% (33) from moderate to severe stress. Conclusion: A significant levels of depression, anxiety, and stress were noted with the major concerns of workplace exposure, increased risk of infection, and transmission to their families and friends.
Areti Pappa, Anastasios Kottaras, Dimitrios Lytras, Paris Iakovidis, Andreas Fotios Tsimerakis, Georgios Chasapis
International Journal of Advanced Research in Medicine, Volume 3, pp 82-84; https://doi.org/10.22271/27069567.2021.v3.i2b.219

Abstract:
Epilepsy is one of the most common diseases of the central nervous system, with significant effects on the health of individuals and especially in their daily activities, due to the fear of a possible seizure. The aim of this review was to collect data based on research that has been done on physiotherapy interventions, such as aerobic exercise and Yoga exercises, in the treatment of seizures. Th Scopus, PubMed, ScienceDirect, Google Scholar and EBSCO databases were searched. The results of the review led to the conclusion that physical exercise, whether intense or specific exercises such as Yoga, significantly help to reduce the incidence of seizures in both children and adults, while also being positively associated with reduced duration of seizures and recovery time at rest. Discussion-Conclusions: Other areas that have been studied in relation to the effect of exercise on epilepsy include the reduction of depression levels in people with epilepsy. Research in this area should be continued, with various diagnostic tools such as the electroencephalogram (EEG) during exercise, with the aim of introducing physical exercise and other physiotherapeutic methods in the treatment protocols.
P Chudamani
International Journal of Advanced Research in Medicine, Volume 3, pp 197-202; https://doi.org/10.22271/27069567.2021.v3.i2d.240

Abstract:
Background & Objectives: Homocysteine is a risk factor for atherosclerotic vascular disease, with adverse influence on endothelial cells, vascular smooth muscle cells, connective tissue, interactions with plasma lipoproteins and platelets. This study was conducted to study the association between levels of homocysteine and IHD, the clinical profile of subjects in relation to their lifestyle, and the socio-demographic profile of patients with established ischaemic heart disease. Methods: The data for this study was collected from patients who presented to NRI Medical College& Hospital Chinakakani from August 2017 to August 2019. 30 cases and 30 age and sex matched controls were taken. All cases taken were proven cases of IHD proved by 2D echocardiography. Homocysteine levels were compared between the two groups and the results drawn. Results: Homocysteine levels were found to be significantly higher in cases with IHD when compared to controls. Both cases and controls with dyslipidemia and other risk factors for IHD like age above 50 years, diabetes mellitus, hypertension and a history of CVA were found to have significantly higher homocysteine levels. Interpretation & Conclusion: A significant association was found between elevated serum homocysteine levels and both IHD and risk factors for IHD even in the absence of IHD. This suggests that elevated homocysteine levels are an independent risk factor for developing IHD.
Samina Tarannum
International Journal of Advanced Research in Medicine, Volume 3, pp 150-153; https://doi.org/10.22271/27069567.2021.v3.i2c.234

Abstract:
Background: Inadequate vitamin D affects about 50% of the world's population. Hypovitaminosis D pandemic may largely be attributed to lifestyles and environmental conditions which limit exposure to sun. Adequate exposure to sunlight is necessary for synthesis of ultraviolet-B (UVB) - induced vitamin-D in the skin. Objective: To study the correlation between the level of vitamin- D and the presence of essential hypertension in patients presenting to a hospital.Methods: The subjects were segregated into two groups: Group 1 (case group) - 50 patients with essential hypertension, Group 2 (control group) - 50 ostensibly healthy individuals. Each subject was interviewed and a standardized questionnaire was answered and completed, which included demographics, anthropometric profile, individual characteristics associated with major risk factors for cardiovascular disease, past medical history, sun exposure details (type of job and average time spent in the sun per day), and biochemical parameters. Hypertension was documented based on disclosure of known hypertensive patients self-reporting on out-patient visit or newly diagnosed hypertensives based on physician measurements. Vitamin D levels were measured from a venous sample taken at the time of hospital visit.Results: The control group comprised 50 patients, 34 of whom were male and 16 of whom were female, and 50 hypertensive patients, 36 of whom were male and 14 of whom were female. There was no significant difference in the gender distribution of the study and control groups (P=0.8272). The hypertensive group had an age of 58.7+9.3 years and the normotensive group 60.5+5.3 years. There was no statistically significant difference. The normotensive and hypertensive patients studied had no significant differences in height, weight, or BMI (p > 0.05). The normotensive group's systolic and diastolic blood pressures (114±5.89 and 75.0±5.0) were considerably lower than the hypertensive group's (162.10±16.5 and 95.90±9.30).Conclusion: Vitamin D and essential hypertension have an inverse relationship. When systolic and diastolic blood pressure were considered as continuous variables, a substantial relationship of high blood pressures corelating with low vitamin-D levels was observed. In addition, left ventricular hypertrophy was also shown to be correlated to hypovitaminosis D.
Sharat Kumar, Sheetal Sharma, Eshani, Sumit Singh Chauhan
International Journal of Advanced Research in Medicine, Volume 3, pp 85-87; https://doi.org/10.22271/27069567.2021.v3.i2b.220

Abstract:
Background: Pterygium is a wing-shaped ocular surface lesion traditionally described as an encroachment of bulbar conjunctiva onto the cornea. Hence; the present study was undertaken for comparing the efficacy of conjunctival autografts using sutures and fibrin glue in patients undergoing pterygium excision surgery. Materials & Methods: 40 patients presenting with the pterygia of various types were enrolled. Patients were divided into 2 groups with 20 patients in each group, for applying sutures and fibrin glue to one group each. Each eye of the patient was considered as one case. Screening of the patient by brief history and general physical examination was done. Diffuse torch light examination for details of the pterygium and to rule out any other gross ocular pathology. Follow-up was done and postoperative findings were compared. Results: Mean duration of surgery of the suture group and the glue group were 31.5 minutes and 18.4 minutes respectively. Significant results were obtained while comparing the mean duration of surgery. Patient discomfort was significantly less in the glue group in comparison to the suture group. Conclusion: From the above results, the authors concluded that the use of fibrin glue to attach the free conjunctival autograft in pterygium surgery produces shorter operating time and less post-operative discomfort as compared to sutures.
Sheetal Sharma, Sharat Kumar, Eshani, Sumit Singh Chauhan
International Journal of Advanced Research in Medicine, Volume 3, pp 88-90; https://doi.org/10.22271/27069567.2021.v3.i2b.221

Abstract:
Background: Acute and chronic superficial ocular inflammation of bacterial origin is a common problem characterized by irritation, itching, and burning of the eyelids. The present study was conducted to assess short-term bactericidal potential of a steroid-antibiotic combination versus steroid in the treatment of conjunctivitis. Materials & Methods: 68 patients of conjunctivitis of both genders were divided into 2 groups of 34 each. Group I patients were given combination of neomycin sulphate 3500 lU/mL, polymyxin-B sulphate 6000 lU/mL with dexamethasone 0.1% and group II were given 0.1% dexamethasone. The symptoms evaluated included foreign body sensation, lacrimation, photophobia, and itching. Materials & Methods: 68 patients of conjunctivitis of both genders were divided into 2 groups of 34 each. Group I patients were given combination of neomycin sulphate 3500 lU/mL, polymyxin-B sulphate 6000 lU/mL with dexamethasone 0.1% and group II were given 0.1% dexamethasone. The symptoms evaluated included foreign body sensation, lacrimation, photophobia, and itching. Conclusion: Use of a fixed dose combination steroid-antibiotic product was more effective for bacterial control and therapeutic efficacy in the treatment of conjunctivitis.
Kiran S, Gnanendra Dm, Prabhdeep Singh, Pp Bose, Parvesh Kumar Jain
International Journal of Advanced Research in Medicine, Volume 3, pp 140-142; https://doi.org/10.22271/27069567.2021.v3.i2c.231

Abstract:
Despite improved understanding of precipitants and physiology of underlying AKI in cirrhosis, considerable confusion still continues to surround its diagnosis due to arbitrary use of creatinine which is effected by several factors like diet, volume status, protein intake, muscle mass, interference with assays of creatinine by elevated bilirubin level making traditional criteria of AKI with serum creatinine greater than 1.5 gm/dl not suitable as diagnostic criteria as it can delay the detection of AKI, further delaying treatment & prognosis. All participating patients of either gender admitted in department of GASTROENTEROLOGY with age >18 years with either diagnosed or newly diagnosed case of cirrhosis of liver (Including both compensated & decompensated cases) admitted with acute kidney injury diagnosed according to International Club of Ascites Classification were enrolled in this study. 64.9% of patients with AKI in the study had MELD score between 16-30 followed by 23.4% & 11.7% in MELD > 30 & MELD
Mohammed Azam
International Journal of Advanced Research in Medicine, Volume 3, pp 154-157; https://doi.org/10.22271/27069567.2021.v3.i2c.236

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Pediatric respiratory disease remains an important cause of morbidity in both the developing and the developed world. It has become the most common reason parents cite for taking their children to see the general practitioner, and nutritional factors are a major reasons for ALRI. Objective: Acute respiratory infection is a leading cause of morbidity and mortality in fewer than five children worldwide especially in developing countries. Hence, the present study was undertaken to identify the serum zinc level in children’s hospitalized with acute lower respiratory tract infections (ALRI) in children aged 6 months to 5 yr. Methods: 100 cases fulfilling WHO criteria for pneumonia, in the age group 6 months to 5 yr were interrogated for potential nutritional risk factors as per a predesigned proforma and serum zinc level was measured. 100 healthy control children in the same age group were also interrogated and zinc level measured. Results: Significant low serum zinc level (p value
Samaleti Bharath Kumar, P Nikhil Raja Reddy, V Lavanya Chowdary, J Hari Kishan
International Journal of Advanced Research in Medicine, Volume 3, pp 270-273; https://doi.org/10.22271/27069567.2021.v3.i2e.254

Abstract:
Background: Pharmacological therapies of proven efficacy in corona virus disease 2019 are still lacking with no proven antiviral treatment. Impaired type I interferon activity may be responsible for severe disease in COVID-19 patient. We performed prospective, observational, open-label study to evaluate the efficacy and safety of a single dose of Pegylated IFN-α2b in addition to Remdesivir with moderate to severe COVID-19 cases. Aim: The aim of this study is to assess the role of synergistic effect of Remdesivir and Pegylated Interferon alfa 2 Beta in moderate to severe COIVID-19 disease. Materials and Methods: 24 subjects with moderate to severe covid disease are included. Subjects were given PEG IFN-α2b (1 μg/kg subcutaneous [SC] injection, single dose) plus Remdesivir and other standard treatment protocol (MoHFW).We observed oxygen saturation and respiratory rate at discharge and duration of hospital stay and the impact of comorbidities on the same. Results: In the study at admission mean SpO2 was 90.25 ± 2.454% and at discharge was 95.13 ± 1.872%.At admission mean RR was 23.00 ± 2.670 bpm and at discharge was 18.71 ± 1.546 bpm. Mean duration of illness was 7.88 ± 2.112 days. Mean HRCT score was 12.21 ± 2.889.Mean days of recovery was 7.29 ± 3.329 days. There was no significant change in o2 saturation respiratory rate and duration of illness with respect to co morbidities. Conclusions: This study provides evidence for the potential use of a single dose of 1 μg/kg PEG IFN-α2b in the treatment of moderate COVID-19 disease. The significant improvement in clinical status is likely due to faster viral reduction. Further confirmatory studies are required to support the data observed in this study.
Sireesha Gunnam, Shiva Nagendra Reddy Annapareddy
International Journal of Advanced Research in Medicine, Volume 3, pp 224-232; https://doi.org/10.22271/27069567.2021.v3.i2d.250

Abstract:
Aim and Objectives: To analyse frequency and spectrum of non diabetic renal disease (NDRD) in type 2 diabetes patients and also determine the clinical markers associated with NDRD. Methodology: Single centre based prospective observational study carried out during the period from M a y 2016 to September 2019. Type 2 DM patients with atypical clinical renal disease who underwent renal biopsy to rule out NDRD at King George Hospital, Visakhapatnam were included in the study. Results: In the present study, the overall prevalence of NDRD with or without underlying DN in our study was 71.7%. The prevalence rates of isolated NDRD, NDRD with DN and isolated DN were 51.2%, 20.5%, and 28.2% respectively. Shorter duration of diabetes, absence of retinopathy, presence of active urine sediment are markers associated with NDRD in type 2 diabetics and are strong indicators for biopsy. Isolated DN group patients suffer significantly with hypertension compared to NDRD group. Isolated NDRD group patients had low HbA1c (
Muni Bhavani Itha, Kalyan Chakravarthy V
International Journal of Advanced Research in Medicine, Volume 3, pp 136-139; https://doi.org/10.22271/27069567.2021.v3.i2c.230

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The majority of soft tissue tumors are present in the extremities; however, many other sites can be affected, including the retroperitoneum. Retroperitoneal tumors represent a rare entity, and sarcomas are the most commonly seen tumors. Sarcomas are mesenchymal in origin; they arise from skeletal and extra skeletal connective tissues, including the peripheral nervous system. In a population-based series reported in the SEER database, the average annual incidence of retroperitoneal sarcomas was approximately 2.7 cases per million populations. Leiomyosarcomas are second in frequency at this location and are also the most aggressive of the sarcomas. Here we reported a case of a 48-year-old female, who presented with a left-sided abdominal lump associated with pain. Abdominal imaging showed a retroperitoneal tumor-infiltrating the ureter. Histopathological examination of the excised mass showed features of malignant retroperitoneal tumor with the possible differential diagnosis included 1. Leiomyosarcoma, 2. Malignant Peripheral Nerve Sheath Tumor. Advised immunohistochemistry, for further evaluation and confirmation. Immunohistochemistry with a panel of antibodies confirmed the case as Retroperitoneal Leiomyosarcoma.
Mamatha Pulloori, Kavangal Dhananjay
International Journal of Advanced Research in Medicine, Volume 3, pp 30-33; https://doi.org/10.22271/27069567.2021.v3.i2a.213

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Serum uric acid levels are an ideal marker in sepsis cases to assess oxidative stress and to predict disease prognosis. Elevated serum uric acid levels are associated with chronic disease conditions such as chronic kidney disease (CKD), cardiovascular disease (CVD). The present study was designed to assess the correlation between Hyperuricemia and mortality and morbidity in cases with clinically diagnosed sepsis. A total of 94 cases with a working diagnosis of sepsis above 18 years of age were recruited. The duration of hospital stay, mechanical ventilation, acute respiratory syndrome and acute kidney injury was noted. Patient discharge or death was considered an outcome of the sepsis. The most prevalent comorbidity was type 2 diabetes (44.68%), followed by type 1 diabetes (8.5%), type 2 diabetes with systemic hypertension (4.25%), chronic kidney disease (3.19%), cerebrovascular accident (3.19%), severe pulmonary disease (2.12%) and malignancy (2.12%). 59% cases had uric acid levels 7mg/dl. The comparison of uric acid levels with comorbidities (p=0.022), duration of hospital stay (p=0.003) and associated complications (p=0.003) was statistically significant. Hyperuricemia on patient arrival to the MICU with sepsis was associated with poor clinical outcome. High mortality rate was associated in cases with elevated uric acid levels.
Andreas Fotios Tsimerakis, Anastasios Kottaras, Paris Iakovidis, Dimitrios Lytras, Ioanna P Chatziprodromidou, Konstantinos G Papanikolaou
International Journal of Advanced Research in Medicine, Volume 3, pp 34-36; https://doi.org/10.22271/27069567.2021.v3.i2a.214

Abstract:
In cerebral palsy (CP), severe dysfunction of the posture and voluntary movement is caused, due to some damage to the brain during childhood, before it is even completely formed. For this reason, the physiotherapy approach is a demanding and time-consuming affair. The application of Kinesio Taping (KT), in combination with other physiotherapy interventions, helps in the function of the trunk and lower limbs in children with CP. The aim of this review of the literature is through recent studies to outline the effect of KT application on the function of the trunk and lower limbs in children with CP. The Google Scholar and PubMed databases were searched in English with the following keywords: Efficacy, Kinesio taping, gait, trunk, posture, cerebral palsy. The review included randomized clinical trials and pilot studies. Of the 10 articles that were included in this review, seven were randomized clinical trials and three were pilot studies. Discussion-Conclusions: The results show that the application of KT in children with CP has positive results in terms of increasing the function of the trunk and lower limbs. In most cases, in fact, it seemed that this happens not immediately after application, but shortly after its removal. Additionally, the combination of KT together with other physiotherapy interventions leads to even better results. More studies will be needed to further investigate its efficacy.
Abhilash Am, Saritha Hm
International Journal of Advanced Research in Medicine, Volume 3, pp 10-14; https://doi.org/10.22271/27069567.2021.v3.i2a.208

Abstract:
Background: BERA is an objective study for assessing hearing loss on patients with inconsistent responses on pure tone audiogram. BERA is a non-invasive and the most cost-effective method for diagnosing retrocochlear lesion, not affected by sedation, anesthesia or age. Which helps to identify retrocochlear hearing loss. BERA is most accurate and sensitive for diagnosis of lesions in VIII nerve and auditory pathway in brainstem, especially in adults. Objectives: Screening tool for evaluating cases of sensorineural hearing loss due to suspected retrocochlear pathology. Objective test in cases of inconsistent response for pure tone audiometry. Role in evaluating brainstem lesions. Method and Aim: This is a cross sectional prospective cohortHospital based study, review of 50 patient subjected to BERA for SNHL in any age group referred to department of ENT Vijayanagara institute of medical sciences, Bellary. We aim to find Brainstem evoked response audiometry (BERA) andits applications in ENT. Result: In this study threshold and latency measures were obtained from 50 cases (100 ears) by brainstem evoked response audiometry. No restrictions were imposed on age, sex, degree of hearing loss, or audiometric configuration. The data was analyzed separately for pediatric age group (36 cases) and adults(16 cases). out of 36 pediatric cases screened 15 cases (41.7%) had normal hearing in 13 cases had profound hearing loss without any risk factors. 6 cases ( 16.7 %) hearing loss due meningitis. 2 cases (5.6%) hearing loss due to neonatal jaundice. In adult age group (14 cases) BERA was done to identify cases of retocochlear pathology and in cases of threshold estimation of hearing. Conclusion: BERA can be used to screen retrocochlear pathologies as seen in our study. Patients with hearing loss with tinnitus and giddiness screened and BERA performed had grossly degraded wave with identification of only wave I and absence of other waves and increased latencies and interaural difference in wave latencies suggests lesion in the auditory pathway. Depending on the absence of specific wave site of the lesion can also be made out. In our study 3 cases of retrocochlear pathology previously confirmed by MRI was taken and BERA was performed showing presence of only wave I and absence of remaining waves. BERA is screening test and should be confirmed by MRI.
The Role Of Aerobic Exercise In Improving Functioning, Treating The Symptoms Of Individuals With Multiple Sclerosis
International Journal of Advanced Research in Medicine, Volume 3, pp 91-94; https://doi.org/10.22271/27069567.2021.v3.i2b.222

Abstract:
Multiple sclerosis (MS) is a progressive long-term neurological disorder of the central nervous system (CNS) that directly affects the lives of individuals and their environment. Early intervention through the systematic application of aerobic exercise can help to better treat the symptoms in people with MS by improving their balance, quality of movement and reducing their functional limitations. The aim of this review is to describe recent research data on the efficacy of this method in improving the functioning and treatment of symptoms in people with MS. The Google Scholar and PubMed database were searched in English and Greek with the following keywords: multiple sclerosis, aerobic exercise, functional ability, rehabilitation. The review included 10 articles from clinical trials, systematic reviews and books. Discussion - Conclusions: The application of aerobic exercise seems to have a positive effect on the treatment of motor disorders in people with MS when compared to conventional physiotherapy. The results of this review show that aerobic exercise two to three times a week for more than six weeks is able to improve the functional level of people with MS.
Ch Amulya, Harsha S, Nemichandra Sc, Shastara P
International Journal of Advanced Research in Medicine, Volume 3, pp 203-208; https://doi.org/10.22271/27069567.2021.v3.i2d.241

Abstract:
Aim: To study the association of depression and anxiety in patients with chronic migraine leading to disability. Materials and methods: The index cases were obtained from patients attending the Neurology outpatient Department of JSS Hospital, who satisfied International Classification of Headache Disorder 3 beta criteria for diagnosis of chronic migraine. Patients were subjected to Hamilton depression and anxiety rating scales along with, Migraine Disability Assessment Questionnaire (MIDAS) for assessing disability. Results: A total of 60 patients were studied. The associated anxiety and depression symptoms were more prevalent in patients with chronic migraine which increases disability. As per MIDAS disability assessment 20% (n=12) had grade I disability, 13.3% (n=8) had grade II disability, 50% (n=30) had moderate disability and 16.7% (n=10) had severe disability. Conclusion: More prevalence of anxiety and depression was noted in patients with chronic migraine compared to international literature because of variations in study population. Treating co-existing depression and anxiety in patients with chronic migraine decreases disability and also progression to chronic migraine in patients with episodic migraine.
L Srinivasa Rao, B Madhava Rao, D Harshavardhan, M Rajasekhar Reddy
International Journal of Advanced Research in Medicine, Volume 3, pp 147-149; https://doi.org/10.22271/27069567.2021.v3.i2c.233

Abstract:
Background: Ischemic heart disease also known as Coronary artery disease is a most common condition in Indian population which allows inadequate supply of blood and oxygen to a portion of the myocardium. It stands as one of the primary causes of death in both men and women and hence need for clinical investigation of IHD in our population is important. Aim: The study is designed to know the clinical profile of female participants attending tertiary care hospital in south India. Materials and Methods: All participants included in the study are symptomatic to IHD and biochemical and electrocardiogram was performed to screen the participants and participant’s history is collected. Results: A total of 140 participants were considered for the study and 120 were identified as IHD positive. Mean age of participants was 55 and most of the incumbents reported chest pain as the major complication followed by other complications like hypertension and diabetes. Conclusion: The incidence of IHD is found to be highest in 53-57 year age group with diabetes, hypertension and Dyslipidaemia as the major risk factors. Lack of awareness in participants also delayed them in their arrival to hospital. Hence there is an immediate need to conduct awareness campaigns in rural areas of our democratic country.
Samina Tarannum
International Journal of Advanced Research in Medicine, Volume 3, pp 143-146; https://doi.org/10.22271/27069567.2021.v3.i2c.232

Abstract:
Background: Increased plasma concentrations of atherogenic lipoproteins, especially Lp (a) play an important role in the development of atherosclerosis leading to premature myocaridial infarction and stroke. Lp (a) is a novel risk factor for atherosclerosis, whose role in multiracial populations has been debated. The significance of different lipid variables in cardiovascular disease and cerebrovascular disease has been extensively studied but the role of Lp (a) in Indian population is yet to be determined. Objective: To determine the role of Lipoprotein (a) as a marker for ischemic stroke, with regard to Indian scenario. Design: This is a case-control study. Duration: One year (2019-2020). Setting: Department of Medicine, Osmania General Hospital, Hyderabad. Participants: Hundred patients admitted in Osmania General Hospital, Hyderabad. Methods: Diagnosis of ischemic stroke was based on clinical evidence of ischemic stroke and CT scan/MRI. Some exclusions were made. 50 age and sex matched healthy subjects were used as controls. In all patients, a detailed history, general physical examination, a detailed neurological examination and other risk factor variables were entered on a pre-designed proforma. SBP ≥140mm Hg, DBP ≥90mm Hg were considered hypertensive levels; any patient with FBS ≥126mg/dl (or) RBS ≥200mg/dl was defined diabetic. Each case underwent the investigations – Plasma Lipoprotein (a) Levels, Lipid Profile, Complete Hemogram, Complete Urine Examination, Blood Sugars, Renal Function Tests, Serum Electrolytes, ECG, Echocardiography*, X-Ray, CT-Brain*, MRI-Brain*. Lp (a) was measured by a Hitachi model 717 (7160) automated analyser using Lp (a) Latex DIACHI kit. *Denotes whenever required. Results: In the present study, cases of ischemic stroke (n = 100) had a mean plasma Lp (a) value of 38.034 mg/dl with a S.D. of 17.423, which was significantly higher (p = 0.001) than in healthy controls, in whom it was 24.308 mg/dl with a S.D. of 11.469, indicating that serum lipoprotein (a) levels are a risk factor of ischemic stroke. Conclusion: Elevated serum Lp (a) is an independent risk factor of ischemic stroke. Measurement of serum Lp (a) has to be considered as a screening tool for the risk of vascular events in patients with various known risk factors. It is imperative to strictly control additional risk factors in individuals with elevated Lp (a).
Madhumati Varma, Ashok Dutt Mathur
International Journal of Advanced Research in Medicine, Volume 3, pp 104-106; https://doi.org/10.22271/27069567.2021.v3.i2b.225

Abstract:
Diabetes and thyroid endocrine diseases which interlinked, function of one gland can affect other so it is really necessary to evaluate how they influence each other when not functioning well.There were done study on diabetic and thyroid patient, data collected basis of demographic, duration of diseases, analysis which important like Glucose, TSH etc., data analyze in excel software, found diabetes mellitus type 2 amongst more fallowed by hypothyroidism and” Thyrobetes” about 10.7%. Introduction: Diabetes and thyroid endocrine diseases which interlinked, function of one gland can affect other so it is really necessary to evaluate how they influence each other when not functioning well. Objective of study: To define interrelation of factors responsible for interlink between diabetes and thyroid disease development. Method and Methodology: This study evaluates duration diseases of thyroid and diabetes with basic analysis like glucose, TSH Hba1c, lipid profile etc. and data analyses in excel software done, found diabetes mellitus type 2 amongst more number and percentage of patients fallowed by hypothyroidism and” Thyrobetes” about 10.7% and DM type 2 52%, hypothyroidism 49%. P was significant
Darshak Salat, Vachan Mehta
International Journal of Advanced Research in Medicine, Volume 3, pp 95-97; https://doi.org/10.22271/27069567.2021.v3.i2b.223

Abstract:
Introduction: Vitamin D is a steroid hormone. It crosses the blood brain barrier and binds with receptors present in neurons and glial cells of various parts of central nervous system like hippocampus, cortex, sub-cortex etc. Due to its antioxidant property and regulating intra-neuronal calcium homeostasis, it can be hypothesized that vitamin D has a role to play in preventing age related cognitive decline. Materials and Methods: Total of 160 patients were included in the study. MMSE is useful for evaluating the subjects having dementia syndrome because these subjects cooperate well only for short duration. Mini Mental state examination score was used for the assessment of dementia. They were included in the study on the basis of serum vitamin D level and MMSE score. Results: The collected data showed that mean serum vitamin D levels were found to be lower in group A when compared to group B. After 3 months of treatment with supplements, the score of post treatment MMSE was found to be higher in group A as compared to group B. After 6 months of treatment with supplements, the score of post treatment MMSE was found to be higher in group A as compared to group B. Discussion & Conclusion: Vitamin D acts like a neurosteroid hormone in areas of neurotransmission and neuro-immunomodulation. Patients on medical therapy for dementia has also shown improve results with regulation of vitamin D. It has also exhibited neuro-protective properties against glutamate toxicity through antioxidant effects thus preventing apoptosis. The present study is one of on-going steps in the direction of establishing role of Vitamin D in prevention and treatment of senile dementia.
Suraj Dhankikar, Akansha Arewar
International Journal of Advanced Research in Medicine, Volume 3, pp 133-135; https://doi.org/10.22271/27069567.2021.v3.i2c.227

Abstract:
COVID19 usually presents as severe pneumonia. Though it is different for everybody and it can cause symptoms that last weeks or months after the infection have gone. This is sometimes called Post-COVID-19 syndrome or
R Venkat Naik, Chandulals
International Journal of Advanced Research in Medicine, Volume 3, pp 64-67; https://doi.org/10.22271/27069567.2021.v3.i1b.102

Abstract:
Atrial fibrillation (AF) is commonly encountered cardiac arrhythmia accounting for one-third of the total admissions for cardiac rhythm disturbances and is associated with significant morbidity and mortality. Echocardiography is the best method to find out the causes for the development of atrial fibrillation. This study was aimed to assess the clinical and echocardiographic profile of atrial fibrillation and its associated complications. A total of 120 cases of both genders (males 62 & females 58), clinically diagnosed with atrial fibrillation between age group 21-70 years were recruited. Study participants were subjected to detailed physical, systemic, radiological (chest X-ray PA view, transthoracic ECG) and laboratory investigations (blood glucose, thyroid function tests). Majority cases were in belonging to 4th and 5th decades of age. Dyspnea (90) was a common symptom followed by palpitation (39), fatigue (18), chest pain (10) and syncope (5). The CHA2DS2-VASc score was above 2 in 64.1%, which indicates a high risk for stroke occurrence. Among 54 RHD cases, 44.4% cases had mitral stenosis, followed by MS+MR in 24.07%, MS+AS+AR in 14.8% cases, MS+MR+AS+AR in 7.40% cases and S/P MVR in 9.25% cases. Rheumatic heart disease (45%) is the most common etiological factor associated with atrial fibrillation followed by hypertension (23.3%) and coronary artery disease (18.3%). The Left atrial enlargement was seen in study participants and a structural abnormality in echocardiography was observed.
Virendra Singh Saini, Anil Kumar Garg, Pragya Shakya, Ajeet Singh Chahar
International Journal of Advanced Research in Medicine, Volume 3, pp 78-82; https://doi.org/10.22271/27069567.2021.v3.i1b.106

Abstract:
Background: Dual anti-platelet therapy is cornerstone in the management of patients with acute coronary syndrome (ACS). The most commonly prescribed combination is aspirin (A) and clopidogrel (C). However, both drugs have the problem of drug resistance (5-40% and 30%, respectively), resulting into vascular events. Prasugrel (P), the newer antiplatelet agent is supposedly better because of different pharmacokinetic profile. However, it is not approved for use in patients with ACS not undergoing intervention. Aim: The present study was aimed at evaluating the effects of P and C on recurrent angina, MI, and stroke within 30 days in patients with ACS managed conservatively, with similar background therapy. Methods: This study was done on 63patients presenting with ACS, diagnosed on the basis of clinical history, ECG findings and cardiac enzymes changes, managed conservatively. The patients were randomized in a1:1 fashion in two groups. The group 1 patients received P (60 mg loading followed by 10 mg P.O. daily, dose was reduced to 30 mg loading and 5 mg maintenance dose in patients aged > 75 years and weight < 60 kgs) and the group 2 patients received C (300mg loading followed by 75 mg P.O. daily). Patient in both the groups received aspirin (325 mg loading followed by 75 mg P.O. daily), atorvastatin (40 mg P.O. daily), weight adjusted enoxaparin and antianginal therapy as appropriate. There were no significant demographic differences between patients in the two groups. Result: The study showed that patients on P responded better, irrespective of age, sex, presence or absence of diabetes, dyslipidemia, ECG changes, and troponin positivity. There was a relative risk reduction of 35.61% (relative risk (RR), 0.64; 95% confidence interval (CI), 0.44-1.01; P=0.05) in the incidence of composite of primary end points in the group receiving prasugrel. No major or minor bleeding episodes were seen in any patient. Although our study is under powered, it creates space for a larger study with prasugrel to find out the true significance of our observation. Conclusions: The present study concluded that prasugrel significantly reduces the incidence of composite of refractory ischemia, MI and CV death and non-significantly reduced refractory ischemia, MI and CV death in patients of ACS managed conservatively.
Faseeh Kak Mohiddina, Midhila Gopinath, Shivakumar Bangalore Raja, Mohammed Hafeez, Emad Mir Abbas, Pavan Raj Nagaraj
International Journal of Advanced Research in Medicine, Volume 3, pp 83-86; https://doi.org/10.22271/27069567.2021.v3.i1b.107

Abstract:
Introduction: Air pollution has been identified as a major health problem of concern. Bengaluru being a metropolitan city witnesses a steep increase in population and hence immersed in long hours of traffic congestion. Hence, traffic police officers bear the maximum impact on their health. Objective: This study aims to assess and understand the awareness and knowledge about the different respiratory problems that traffic police personnel are at risk of developing as well as the protective measures taken by them towards their prevention. Method: A cross sectional study was conducted in Bengaluru among the traffic police officers of the city, data collection was done using a questionnaire which was prepared prior. Results: Of the total 50 participants, 88% were aware of the vehicular emissions and their contribution to air pollution while 68% had known about ailments like lung cancer. 76% use mask during their work hours while 20% do not use any of the protective measures. Conclusion: Traffic police officers being at risk for development of respiratory ailments, should undergo regular check-ups apart from using all kinds of protective measures for a healthy and a disease-free life.
Amasa Viswanatha Reddy, Sindhuja M
International Journal of Advanced Research in Medicine, Volume 3, pp 90-93; https://doi.org/10.22271/27069567.2021.v3.i1b.109

Abstract:
ACLF is a distinct clinical entity and different from acute liver failure or chronic liver disease as here two simultaneous but different insults are operating: acute insult and chronic insult. Like acute liver failure ACLF is also associated with high mortality rate, liver support device are important therapeutic options for these patients to provide them additional time for recovery or to serve as a “bridge” to transplantation, whereas orthotopic liver transplantation remains the only definitive therapy who do not improve with supportive measures. Patients with acute-on-chronic liver failure (ACLF) admitted in Medicine or Hepatology ward were enrolled for the study. The most frequent symptoms reported by the patients with ACLF in our study were Jaundice 60(100%) and abdominal distension (ascites) 55 (91%). Other symptoms were altered sensorium (encephalopathy) 36(60%), anorexia 34(56%), fatigue 25(41%), pedal edema 20(33.3%), clinically palpable speen 22(36.6), fever 12(20%) abdominal pain & GI bleeding each 08(13.3%). Among the GI bleeding patients 2 patients had Hematemesis only, 6 patients had only malena & 1 patient had both. Among HE patients 13(21%) had grade 1-2 HE & remaining 23(38%) patients had grade 3-4 hepatic encephalopathy.
Shilpa A, Ayyali Ambresh
International Journal of Advanced Research in Medicine, Volume 3, pp 27-32; https://doi.org/10.22271/27069567.2021.v3.i1a.98

Abstract:
Background: Diabetes is one of the most common chronic hyperglycemic syndromes, affecting nearly 347 million people worldwide. Serum sialic acid levels correlate positively with albuminuria, hence serum levels are raised even before clinical nephropathy is diagnosed. Another biological marker of DN is fibrinogen. Hence, the present study was undertaken to estimate serum sialic acid & plasma fibrinogen levels in DM & DN and to know whether these levels could be used as early predictors of DN. Objectives: To estimate Serum SA, Plasma Fibrinogen levels, FBS, HbA1c, Lipid profile, atherogenic ratios, Blood Urea, Serum Creatinine, eGFR & Urine albumin/Creatinine ratio in type 2 DM, DN patients and healthy controls. To correlate Serum SA and Plasma Fibrinogen levels with FBS, HbA1c, Lipid profile, Blood Urea, Serum Creatinine, eGFR and urine A/C ratio in type 2 DM and DN patients. To find out whether the levels of Serum SA and Plasma Fibrinogen levels can be used as markers for the early diagnosis of DN. Methodology: A case control study includes total of 150 patients, of which 50 were diabetic without any complications, 50 were diabetic nephropathy patients and remaining 50 were age matched healthy controls. Results: The duration of diabetes in DN patients was greater and statistically significant when compared to DM without nephropathy. The mean SA & fibrinogen levels in DN patients were increased & statistically significant when compared to DM without nephropathy.
Madhu Kr, Ayyali Ambresh
International Journal of Advanced Research in Medicine, Volume 3, pp 20-23; https://doi.org/10.22271/27069567.2021.v3.i1a.96

Abstract:
Stroke is the second leading causes of death worldwide and one of the leading causes of disability. The most common cause of stroke is represented by cerebral ischemia and approximately 80% of strokes are due to ischemic cerebral infarction and 20% due to brain haemorrhage. Diabetes Mellitus is a very common metabolic disorder and it is an independent risk factor for stroke and is associated with 2 to 6 fold increased risk compared with non-diabetic subjects and worsens survival of patients with acute stroke. The rate of non-enzymic glycosylation of hemoglobin is believed to depend largely or solely on plasma glucose concentration. Hence this study is to correlate HbA1c levels with clinical profile and Infarct size in patients with Acute Ischemic stroke. Objectives: To see the levels of HbA1c in Acute Ischemic stroke patients. To calculate the infarct size and severity of stroke in Acute Ischemic stroke patients. To estimate the HbA1C levels and correlate HbA1C levels with clinical profile and size of infarct in Acute ischemic stroke patients. Methodology: This a cross sectional descriptive study. Results: This is an cross sectional study including 64 patients. Maximum number of patients were in the age group of 60-69 years, with mean age of 63.59±12.59 years. The male to female of 1.37: 1.There were 25 patients (39.1%) well controlled Diabetes patients, 16 (25.0%) fairly controlled and 23 (35.9%) were poorly controlled Diabetic patient. The common risk factors were Diabetes mellitus, hypertension, smoking, dyslipidemia, Rheumatic heart disease and Retroviral disease. The NIHSS score increased as the infarct size increased from well controlled to poorly controlled diabetes. Increased severity of stroke is seen in poorly controlled diabetes which correlates with the infarct size. Conclusion: HbA1c levels, NIHSS score correlates well with the infarct size. Patients with poorly controlled diabetes were found to have increased NIHSS score and increased severity of stroke. Severity of the stroke worsened from well controlled diabetes to poorly controlled diabetes. HbA1c should be considered as an independent risk factor for poor clinical outcome and worse prognosis. Early diagnosis and treatment of diabetes including lifestyle modification and periodic monitoring of HbA1c levels may reduce the development of stroke and morbidity and mortality associated with it.
Saritha Hm, Jagadeeswaran Vu
International Journal of Advanced Research in Medicine, Volume 3, pp 147-155; https://doi.org/10.22271/27069567.2021.v3.i1c.119

Abstract:
Background: Unilateral sensorineural hearing loss (USNHL) is important to be identified and diagnosed early. It is common and can be a symptom of a wide range of diseases. In our region, south India, the USNHL has not been studied before. In this study we report different causes of this entity.Method and Aim: This is a Prospective observational Hospital based study, review of 50 patient with USNHL in the age group above 18yrs. We aim to find the risk factors, causes, common presentationn of USNHL in the south India and comparing the result with a literature review.Result: It was found, 50 cases were presented with unilateral SNHL during the study period. It constitutes 15% of cases screened. Most of our cases had gradual onset of hearing loss. Tinnitus, vertigo and ear discharge were the most common associated symptoms respectively. On audiological assessment: PTA at time of investigation, severe hearing loss (46%). Etiologies of unilateral sensorineural hearing loss, Meniere's disease (28%), Metabolic (24%), Sudden SNHL (22%), idiopathic (20%), Acoustic neuroma (4%) and Left COM, squamosal disease (2%). MRI was done in all 50 cases with unilateral SNHL, in 4 cases it found to be abnormal. ENG was done in 35 of cases of which it is abnormal in 30 cases, Left Hypo active labyrinth (48.6%). Conclusion: All patients with USNHL need full audiological screening and early diagnosis. Regarding our study, we recommend MRI as part of their diagnostic workup. The choice of diagnostic laboratory tests should be directed by patient risk factors and exposures.
Vishwanath Vn, Karan Vn
International Journal of Advanced Research in Medicine, Volume 3, pp 226-228; https://doi.org/10.22271/27069567.2021.v3.i1d.144

Abstract:
CKD is associated with increased activity of the RAAS. There is reduced blood flow in peritubular capillaries downstream of sclerosed glomeruli. As a result of this reduced effective (perceived) blood flow, glomeruli in these regions hyper secrete renin, thereby increasing circulating angiotensin II levels. Angiotensin II has a direct vasoconstrictor effect, which increases systemic vascular resistance and BP. A pre-structured proforma was prepared be used to collect demographic data which included age, gender, occupation history of present illness, Past history, family history and personal history including history of smoking, alcohol. Pearsons correlation (two tailed with 95% CI) for CKD stage and hemoglobin levels shows significant negative correlation with r value of -0.6176analysis shows with a P value of
Tauqeer Anjum Mir, Hemesh Shewale, Rohan Roshan Nayak
International Journal of Advanced Research in Medicine, Volume 3, pp 386-388; https://doi.org/10.22271/27069567.2021.v3.i1g.166

Abstract:
Aim: To compare dexmedetomidine versus clonidine as the adjuvants with hyperbaric bupivacaine in subarachnoid block for lower limb orthopedic surgeries. Material and method: The present study included 160 patients undergoing lower limb orthopedic surgery under subarachnoid block at Department of anaesthesia, Mahatma Gandhi Missions Institute of Health Sciences, Navi Mumbai, Maharashtra. Randomization was a statistical procedure by which the participants have been allocated into 2 different groups i.e. Group C (Clonidine group) and Group D (Dexmedetomidine group). Time of onset of motor block was assessed using Bromage scale. Analgesia duration was observed and recorded following pain scoring system- Visual analogue score (VAS). Results: It was observed that there was statistically significant difference between the total duration of sensory and motor block of the patient in the both groups. The difference in VAS scores were found to be statistically significant among two groups (p
Ellabathini Hima Bindu
International Journal of Advanced Research in Medicine, Volume 3, pp 407-410; https://doi.org/10.22271/27069567.2021.v3.i1g.172

Abstract:
Background: Adverse Drug Reactions (ADRs) are a public health issue that health providers need to address. Health practitioners play a significant part in improving the healthcare environment, which is a cornerstone of the pharmacovigilance programme.Objective: To evaluate the awareness of pharmacovigilance expertise and practice among doctors in our college.Methods: A questionnaire with 15 pharmacovigilance questions has been created. Convenient and purposive sampling techniques were used, which contacted and invited doctors at our institute to engage in this research. This required participants to be recruited who were willing to provide pharmacovigilance information at our hospital.Results: It was found that doctors had excellent knowledge of the basic principles for pharmacovigilance in 20%, good in 38%, average in 14% and poor in 28%. 28% of people had low pharmacovigilance awareness, 7% of whom had no practical knowledge of pharmacovigilance, and had zero results in class A. The response was outstanding for 26 percent, good for 26 percent, average for 16 percent and poor for 32 percent. Out of 32 percent of respondents with inadequate expertise, 20 percent were unable to provide any productive advice or viewpoint on the pharmacovigilance improvement scheme and scored zero in Class D.Conclusion: This research concluded that awareness and practice on various aspects of pharmacovigilance among residents was increased after proper sensitization. Better perception may also eliminate misunderstandings, obstacles and barriers to a better healthcare system' s use of pharmacovigilance.
Adrama
International Journal of Advanced Research in Medicine, Volume 3, pp 140-141; https://doi.org/10.22271/27069567.2021.v3.i1c.116

Abstract:
TMJ malfunction is quiet common in swimmers. This study is done to understand the prevalence of the disorders associated with swimming in paediatric age group. According to previous studies there is a high demand on neck rotation and upper limb activities for the propulsion of the body inside the water and which negative synchronized activities of jaw and mastication structure. There is no studies have been attempted to find out the prevalence of TMD among competitive swimmers through there is a greater demand on TMJ structure due to their swimming mechanics.
Shreesh Kadur Jm, Sharvani S
International Journal of Advanced Research in Medicine, Volume 3, pp 314-317; https://doi.org/10.22271/27069567.2021.v3.i1f.155

Abstract:
Chronic kidney disease is commonly associated with increase in blood phosphate levels. In early stages phosphate levels are maintained in normal limits because of the hyperparathyroidism causing phosphaturia. With advancement in renal disease hyperphosphatemia becomes evident. As a consequence of same there will be worsening of hyperparathyroidism and predisposition to develop metastatic calcification. In this study we have analyzed the serum levels of Calcium, Phosphorous and Parathormone levels in chronic kidney disease patients who were evaluated in nephrourology centre over a period of one month. It was then evaluated to see the correlation between aforementioned parameters with cardiovascular disease in those patients. The study showed significant correlation between the serum phosphate levels with cardiovascular morbidity in study population but didn’t show significant relation with serum calcium and parathormone levels. From the study it can be concluded that a large percentage of end stage renal disease patients have high phosphate levels and this plays a significant role in cardiovascular morbidity in them.
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