International Journal of Research in Medical Sciences

Journal Information
ISSN / EISSN: 23206071 / 23206012
Published by: Medip Academy
Total articles ≅ 7,033

Latest articles in this journal

Geraldine Menezes, Stella S. Peter, Girish K. Shanthaveeranna
International Journal of Research in Medical Sciences; https://doi.org/10.18203/2320-6012.ijrms20222390

Abstract:
Background: Critical value and urgent sample result notification is widely accepted in the diagnostic fraternity as an important factor, as it may affect patient care and safety. Timely release and notification of these test result as per the individual laboratory protocol becomes an internal part of quality reporting system. The present study was aimed at evaluating the effective implementation of the existing protocol of urgent clinical notification (UCN) in the clinical biochemistry laboratory of tertiary care hospital and evaluating the turnaround time for urgent samples and critical results listed under UCN protocol in the clinical biochemistry laboratory.Methods: A prospective, observational study was conducted in clinical biochemistry laboratory of a tertiary care hospital. Descriptive statistics was calculated for all the data by Mann-Whitney and Wilcoxon test. Results: Majority of the critical results were informed to the clinical personnel by the clinical laboratory. Out of 4687 critical results, 25.41% critical results were informed directly to the ward through telephonic communication. Documentation of critical values in the dedicated register and lab information system (LIS) was 25.41% and 40.28% respectively. 421 (9%) out of 4687 critical results were not notified. The median turnaround time for all urgent tests and critical results was found to be 72.33 minutes and 76.00 minutes respectively. Conclusions: This study highlighted various approaches to improve the critical value notification and its turnaround time and status of UCN in laboratory
Ramesh K. Mahato, Girish K. Shanthaveeranna, Anitha Devanath
International Journal of Research in Medical Sciences; https://doi.org/10.18203/2320-6012.ijrms20222391

Abstract:
Background: Phlebotomy or drawing of blood sample is one of the initial steps in processing of samples for various investigations of the patients in clinical laboratory. The sample for various investigation has to follow certain protocol or order of blood draw into different vacutainers by phlebotomist or the clinical person drawing the blood to avoid errors in test results. Hence awareness of order of blood draw among them is very essential. Methods: It is a cross sectional and observational study. Based on CLSI H3-A6 (clinical and laboratory standards institute) guidelines, a questionnaire consisting of 13 multiple choice questions was prepared after validation and distributed amongst the nurses, who were on duty during the study. The answers to the questionnaire were analysed using SPSS version 23. Descriptive statistics was done for all the data collected. Results: Total 120 nurses participated in this study in a tertiary care hospital. Nurses who were able to identify Color of the vacutainer with respective to additives (90%), correct order of draw (52%), volume of blood sample collected in vacutainer (62.9%), sample collected directly into vacutainer with vacuum suction (61.7%) was incomplete. Nurses also had wrong practices, where sample was transferred from one vacutainer to other (3.3%), collected the blood sample from the arm which had IV line (28%). Conclusions: In this study, it was found that awareness on the level of order of blood draw among nurses was found unsatisfactory. Frequent training and monitoring of work practices should be developed for nurses to reduce the errors in sample collection.
Mithilesh Nayak, Dixit Patel, Alok Chaturvedi, Ankita Shah
International Journal of Research in Medical Sciences; https://doi.org/10.18203/2320-6012.ijrms20222373

Abstract:
Background: The understanding of demographic patterns and the real-world management practices for patients with acute coronary syndrome (ACS) will facilitate optimizing the management strategies for ACS based on the patient’s clinical profile and the associated risk factors in Indian patients. Hence, this study determined the demographic details and the treatment patterns in Indian patients with ACS. Methods: The RECent trends in the pattern and lOng-term management stRategy of patients Diagnosed with acute coronary syndrome in India (RECORD ACS-2) study was a real-world, retrospective, cross-sectional, observational study conducted at various centres across India between 2021 and 2022. The study outcomes included the demographic profile and therapeutic management in patients with ACS. Results: A total of 9945 patients with a mean age of 59 years were included. The ACS was commonly observed in the age group of 41-70 years with highest incidence in the age group of 51-60 years. The ST-elevation myocardial infarction (STEMI) was most common (53.2%) presentation. Hypertension (37.2%) and dyslipidemia (29.3%) followed by diabetes (21.3%) were the most common comorbidities. Single vessel disease was the most common angiographic feature (58%). Percutaneous coronary intervention was the most preferred management strategy (57%). Ticagrelor was the most preferred loading (68.3%) as well as maintenance (71.2%) P2Y12 inhibitor in ACS patients. Most of the patients (81.8%) had received high intensity statin therapy for the secondary prevention of the disease. Conclusions: The prevalence of ACS was high between 51-60 years of age, more so in males, smokers, and physically less active patients. Associated comorbidities were hypertension, dyslipidemia and diabetes. Incidence of STEMI was high, and more than half of the patients underwent PCI. Ticagrelor was the most preferred P2Y12 inhibitor in ACS patients for loading as well as maintenance therapy.
Dhafer B. Alshehri
International Journal of Research in Medical Sciences; https://doi.org/10.18203/2320-6012.ijrms20222372

Abstract:
Background: The primary carrier of bile acids in humans is the bile salt export pump (BSEP). which are crucial for the digestion and absorption of fat. Type 2 progressive familial intrahepatic cholestasis (PFIC-2), which is brought on when BSEP is suppressed and causes a decrease in bile flow and a buildup of cytotoxic bile salts in the liver, is one of the main causes of cholestasis in Saudi Arabia. Elucidate the inhibitory potential with minimal or no adverse effects. Methods: The structure (6LR0) was downloaded from the PDB. Protein active sites were anticipated because these are pockets where ligands can bind and perform reactions to treat an infection. The PubChem zinc and mpd3 databases were used to get the ligands' structures. Molecular operating environment (MOE) was utilized to perform molecular docking of 1600 phytochemicals against BSEP. LigX was used to observe the docking hits for interaction analysis. Results: identification of 4 potential candidates for binding to the BSEP active site. then, Protox II-was used to forecast toxicity for the selected hits. Molecular dynamics simulations were also used to assess the binding complex's stability in water for 100 nanoseconds. The strong binding affinity of high-ranked drugs was predicted by our molecular docking and simulation. Conclusions: This approach could be useful in determining the efficiency of a therapeutic molecule in the therapy of the BSEP. The aim of this research is to identify novel -BSEP drug targets, and in future in vitro and in vivo research could prove its clinical efficiency.
Nishant Dalal, Dixit Patel, Alok Chaturvedi, Ankita Shah
International Journal of Research in Medical Sciences; https://doi.org/10.18203/2320-6012.ijrms20222375

Abstract:
Background: To understand the demographic profile of newly diagnosed type 2 diabetes mellitus (T2DM) patients and to evaluate the glycaemic status and initial treatment choices in this subset of T2DM patients. Methods: The ROD-IT-2 study was a real-world, retrospective, cross-sectional, observational study conducted at various centres across India between April 2021 and March 2022. The study outcomes included epidemiology, comorbidities, and management strategies preferred by Indian clinicians in these patients. Results: Data from 29,550 newly diagnosed T2DM patients were analyzed. The mean age of patients was 53.3 years, and majority were males (65%). Majority of patients (63.85%) were aged 40 to 60 years. More than half (53.11%) of the patients were either overweight (36.65%) or obese (16.76%). The mean glycated hemoglobin (HbA1c) was high (8.4%). Most (88.5%) patients had cardio-renal comorbidities. Hypertension was the most common comorbidity (45.7%) followed by dyslipidemia (32.1%). Chronic kidney disease (CKD) was also present in 31.2% patients. In the present study, 9.2% patients presented with microvascular complications at the time of diagnosis. Majority of newly diagnosed patients (79.7%) were treated with combination therapy. In patients who were prescribed dual drug combination therapy, metformin + dipeptidyl peptidase-4 inhibitor (DPP4i) was the preferred combination (42.71%) followed by metformin + sulfonylurea (31.37%). Conclusions: ROD-IT-2 study showed that mean HbA1c levels in T2DM patients still remain high in our population and cardio-renal comorbidities remain prevalent in newly diagnosed patients. Indian clinicians were found to prefer the combination therapy in newly diagnosed T2DM patients.
Samina Kausar Tabassum, Syed Imran Ahmed
International Journal of Research in Medical Sciences; https://doi.org/10.18203/2320-6012.ijrms20222374

Abstract:
Background: Dengue has emerged as a major public health concern throughout India because of the mortality and morbidity associated with it. It is the most common mosquito-borne viral disease of humans. Hence early and rapid laboratory diagnosis of dengue is crucial. This study aims to determine demographic, clinical and laboratory investigations of all the suspected cases of dengue fever and comparison of two commercial tests routinely useful in diagnosis of dengue fever. This study was conducted to determine seropositivity of dengue samples in patients suspected of dengue illness and to compare immunochromatographic card test (ICT) test and IgM ELISA test. Methods: A total of 702 serum samples from patients with suspected dengue infection were included and the study was undertaken at department of microbiology at a tertiary care hospital, Hyderabad from July to December 2021. All samples were subjected to rapid ICT and confirmed by dengue IgM-capture ELISA. Results: Out of 702 cases suspected of dengue, 85 (12%) samples were positive by IgM ELISA method. The most affected age group was 21-40 years with 55 cases (64.3%) were positive, followed by the age group 0f 0-20 years with 25% of the cases. Males were affected more than females with a percentage of 54% and 46% respectively. The highest number of suspected dengue patients admitted was in the month of September, i.e., 140 with 16 positive (14.81%) followed by August 122 samples (12.16%) and October 110 samples with 14 (11.03%) positive. The sensitivity and specificity of ICT was 95.5% and 100% when compared with IgM-ELISA. Conclusions: Dengue cases were more during August to November in the monsoon and post monsoon season which is useful to plan special preventive strategies. This study draws attention toward the male, young and adult age group. To conclude, in countries lacking infrastructure for the diagnostic labs especially in the rural and remote areas, the rapid dengue ICT tests can play a major role in diagnosis and in patient management of acute dengue infection. The rapid ICTs are very simple, easy to perform, and can be used as point of care tests. We suggest that the rapid ICT for dengue detection may be used in patients presenting with febrile illness.
Suraj Jadhao, B. L. Bairwa, Vinod Sharma, Sanjeev Chopra
International Journal of Research in Medical Sciences; https://doi.org/10.18203/2320-6012.ijrms20222347

Abstract:
Background: Traumatic brain injury (TBI) is the leading cause of death in trauma patients in various parts of the world including India. Coagulation cascade is affected in TBI. The severity of coagulopathy correlates with degree of primary injuries thus affecting the prognosis of geriatric patients. Since the prognosis of isolated TBI can be a challenge to predict at times. AIM: we wanted to study the potential of international normalized ratio (INR) test, prothrombin test (PT), platelet count as a prognostic tool in isolated TBI. Methods: INR, PT, platelet count reflects the coagulation status. In most trauma cases, it is a routine test as well. We collected the INR, PT, platelet count value at admission of 200 isolated geriatric TBI cases over a period of three months. Then, patients were followed-up and their outcome at three months from admission is scored using Glasgow outcome scale (GOS). The relationship of INR, PT, platelet count with GOS was studied. Results: From our limited study, we found that INR of 1.52, PT 17 sec or more and platelet count less than 1.10 lac predicts poor prognosis in cases of isolated geriatric TBI. Conclusions: It is important to early diagnose and early manage the coagulation abnormalities in isolated geriatric head injury patients.
Sadaf Choudhary, Sanjay Kai, Sachit Mahajan, Bhavna Sahni, Kiran Bala
International Journal of Research in Medical Sciences; https://doi.org/10.18203/2320-6012.ijrms20222342

Abstract:
Background: Uncorrected refractive errors are one of the major culprits of visual impairment among children in our country. Children included in school going age groups i.e., 6-16 years, represent 25% of population in developing countries. They fall in the category of preventable age group for correction of refractive errors. This paper describes the salient features and results of the cross-sectional study conducted to determine the prevalence of refractive errors and their association with socio demographic characteristics in pediatric population objective were to study the prevalence of refractive errors and their association with socio demographic characteristics in pediatric patients attending tertiary eye care centre. Methods: The cross-sectional study was conducted for a period of one year among children in 0-16 years age group and a total of 444 patients were included. All children were examined by ophthalmologists and refraction was done by optometrists. Data was analysed using web-based software open epi version 3.01. Results: Prevalence of refractive errors was found to be 29.5%. Amongst the socio demographic factors, there was a significant association of age and literacy with refractive errors whereas gender and residence were not found to be significant. Conclusions: Refractive errors are an important preventable cause of childhood ocular morbidity. Schools are an excellent platform to educate children and their parents regarding eye care and signs of ocular morbidity due to refractive errors. Health education activities in schools need to be intensified.
Shenaz G. A. Saifi, Mubeen Karikazi, Dev Shetty
International Journal of Research in Medical Sciences; https://doi.org/10.18203/2320-6012.ijrms20222360

Abstract:
Background: Abnormal growth of tissues in gynecologic pelvic organs like uterus, cervix or uterine adnexa are termed as female pelvic masses. Pelvic masses can be benign or malignant in nature. An efficient non-invasive treatment modality is essential for effective management and efficient treatment of pelvic masses. Current investigation is aimed towards estimating the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of ultrasonography in diagnosing pelvic masses and differentiating benign and malignant pelvic masses.Methods: Adescriptive study was conducted on 100 volunteers for 12 months at ultrasound department of radio-diagnosis in a tertiary care center. Patients were examined through transabdominal ultrasonography, covering entire pelvis. Morphology of pelvic lesions were examined in longitudinal and transverse planes through Doppler coupled with ultrasonography. Post-surgery histopathological examination reports were correlated with pre-operative imaging findings. Results: Majority of patients included in current study belonged to <40 years of age group and exhibited benign pelvic masses. Sensitivity and specificity of ultrasound in diagnosing benign masses was observed to be 87.5 and 70 respectively with PPV of 92.1 and NPV of 58.3. Majority of benign lesions were hypoechogenic, whereas malignant lesions were of mixed echogenicity. Most of the malignant lesions showed echogenic focus significantly different from malignant lesions. Conclusions: Ultrasonography was concluded to be primary modality and best screening tool for evaluation of pelvic masses with high sensitivity and specificity for correctly diagnosing and differentiating benign and malignant pelvic lesions. Ultrasonography coupled with color Doppler was efficient in determining the morphological characteristics of pelvic masses.
Dayananda S., Dinesh M. G., Prabhat Yaji, Ashok Kumar Moharana, Deepak T. S.
International Journal of Research in Medical Sciences, Volume 10, pp 1936-1942; https://doi.org/10.18203/2320-6012.ijrms20222268

Abstract:
Background: Medical gloves worn during patient examinations and procedures aids in the reduction of cross-contamination between healthcare professionals and patients. Gloves have to be strong enough to protect the wearer and comfortable enough not to choke the hand of the user. The aim of the study was to assess the incidence of allergic reactions, usability, and performance of Truskin gloves (Sterile latex surgical glove pre-powdered). Methods: The objective of this study was to evaluate the safety and performance of Truskin gloves by assessing the incidence of allergic reactions and usability in terms of manual dexterity, tactile sensitivity, handgrip strength, muscle activity, comfort level during usage and product complaints/issues. Consentwas obtained from all the participants (healthcare professionals from various hospitals across India) involved in the study. The questionnaire was distributed among healthcare professionals to provide their feedback and experience with use of Truskin gloves. Results: The clinical investigation was initiated on April 10, 2021 and completed on July 10, 2021. Responses from 472 participating health care professionals were considered for assessment of safety and performance of Truskin gloves. The results from the safety variables assessed in this study indicate that about 5.51% users had experienced allergic reactions typical of powdered latex surgical gloves. More than 80% users have responded with a score of 04 and 05 (most comfortable) for all the variables associated with comfort and convenience of usage of Truskin gloves. Conclusions: The results from this study demonstrates both the safety and performance of Truskin gloves.
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