International Journal of Research in Medical Sciences
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    Iron pill associated duodenitis: a less recognised clinical entity

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    Iron supplementation is a widely prescribed treatment for anemia, but its association with gastrointestinal complications, specifically duodenitis, remains inadequately acknowledged in clinical practice. One of the common oral iron preparations to treat iron deficiency anemia is ferrous sulphate. Iron preparations have been known to cause gastric side effects, including gastritis and duodenitis. This case report explores the emerging concern of iron pill-associated duodenitis, shedding light on the potential adverse effects of oral iron supplementation on the duodenal mucosa. Existing literature and clinical cases are reviewed to highlight the connection between iron pill consumption and duodenal inflammation. From asymptomatic cases to severe symptoms like abdominal pain and gastrointestinal bleeding, the clinical spectrum is diverse. Histopathological analysis of endoscopic biopsies reveals characteristic features of duodenitis linked with iron deposits, raising concerns about long-term consequences. In conclusion, this case underscores the significance of recognizing iron pill-associated duodenitis as a distinct clinical entity, necessitating further investigation for optimized patient care and the safe administration of iron supplements in managing anemia.

    Evaluation of hematological parameters and platelet yield in voluntary blood donors by plateletpheresis: a one-year study at the blood centre in a teaching hospital

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    Background: The present study was planned to compare of pre and post donation hematological parameters in healthy donors by plateletpheresis. Also to assess the platelet yield following plateletpheresis procedure with its correlation to pre donation platelet count. Methods: This is a retrospective cross-sectional study carried out in the Blood Centre of a tertiary care hospital in Haryana, India between January to December 2022. Plateletpheresis was done on Trima Accel Automated Collection System with ACD‐A as an anticoagulant. The data was collected from the hospital for hematological parameters (Hb, hematocrit, Total WBC count, total platelet count) pre and post donation. Categorical data is presented as frequency, percentage, mean±SD range. Correlation was established between the pre donation platelet count and the platelet yield. Results: A total of 125 donors were included in the study with majority of the donors 69 (55.2%) in the age group 21-30 years. Mean age of the donors included in the study was 31.58±7.5 years. The levels of hemoglobin dropped from 14.16±0.95 to 13.92±1.002 gm/dl, hematocrit dropped from 41.19±1.33 to 40.91±2.89%, total WBC count reduced from 7.64±1.38 to 7.61±1.36 103/ l and platelet count dropped from 279.5±62.96 to 259.9±58.38 lac/ l. There was a significant drop in the levels of platelet post donation by 7.01% compared to pre donation levels. majority of the donors (44%) had a mean platelet yield 2.49±0.33 with a platelet count between 1.5-2.5x1011/l. The maximum platelet yield was 4.93±0.34 in 6% donors with pre-donation platelet count of >4.5 5x1011/l. A linear significant relationship was established between the platelet count and the platelet yield (r=0.99). Conclusions: There were significant changes in the pre donation and post donation hematological parameters among the donors. It was concluded that donors with a high pre-donation platelet count can be considered for better platelet yield. Background: The present study was planned to compare of pre and post donation hematological parameters in healthy donors by plateletpheresis. Also to assess the platelet yield following plateletpheresis procedure with its correlation to pre donation platelet count. Methods: This is a retrospective cross-sectional study carried out in the Blood Centre of a tertiary care hospital in Haryana, India between January to December 2022. Plateletpheresis was done on Trima Accel Automated Collection System with ACD‐A as an anticoagulant. The data was collected from the hospital for hematological parameters (Hb, hematocrit, Total WBC count, total platelet count) pre and post donation. Categorical data is presented as frequency, percentage, mean±SD range. Correlation was established between the pre donation platelet count and the platelet yield. Results: A total of 125 donors were included in the study with majority of the donors 69 (55.2%) in the age group 21-30 years. Mean age of the donors included in the study was 31.58±7.5 years. The levels of hemoglobin dropped from 14.16±0.95 to 13.92±1.002 gm/dl, hematocrit dropped from 41.19±1.33 to 40.91±2.89%, total WBC count reduced from 7.64±1.38 to 7.61±1.36 103/ l and platelet count dropped from 279.5±62.96 to 259.9±58.38 lac/ l. There was a significant drop in the levels of platelet post donation by 7.01% compared to pre donation levels. majority of the donors (44%) had a mean platelet yield 2.49±0.33 with a platelet count between 1.5-2.5x1011/l. The maximum platelet yield was 4.93±0.34 in 6% donors with pre-donation platelet count of >4.5 5x1011/l. A linear significant relationship was established between the platelet count and the platelet yield (r=0.99). Conclusions: There were significant changes in the pre donation and post donation hematological parameters among the donors. It was concluded that donors with a high pre-donation platelet count can be considered for better platelet yield.

    Psychosocial correlates of depression in paediatric patients with epilepsy in a teaching hospital in Nigeria

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    Background: Seizures are the most common paediatric neurological disorder with most children suffering at least one seizure before the age 16yr. The psychosocial comorbidities which adversely affect quality of life especially depression, are often neglected. This study sorts to highlight the psychosocial correlates of depression among these children. Methods: Recruitment was in a paediatric neurology clinic in a tertiary-level hospital. Children were eligible for recruitment if aged 9-18 and had a diagnosis of epilepsy as confirmed by a neurologist, in care for a period of more than 3 months, and parents gave consent. Children who met the study inclusion criteria were subjected to a two- stage interview process using CES and DICA-1V tools, designed to screen and confirm depression. These instruments have previously been validated on a Nigerian population. The study was cross section and descriptive, with psychometric evaluation p-values<0.05, statistically significant. Results: A total of 400 children were offered participation, and 380 were recruited, among them, 117 (30.8%) met the clinical criteria for major depression with 40 (10%) of them in need of urgent medical attention. Males were more depressed, p=0.000, OR: 0.861, respondents aged 9-11yr showed a strong association with depression p=0.001, OR: 1.911. Living arrangements of patients, p=0.001, OR: 0.632, family size (siblings), p=0.004, marital status of mothers, p=0.001, OR: 2.373, turned out significant with mothers’ marital status showing a strong association. Duration of illness and frequency of seizures, showed a very strong association with depression p=0.023, OR:1.203, and p=0.001, OR:1.411 respectively. Conclusions: The study highlights a strong association between effects of epilepsy and psychosocial wellbeing of children and the high risk posed by unstable family settings on children’s health

    Prevention and risk factors associated with incidence of central line associated bloodstream infection: a narrative review

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    Central line-associated bloodstream infections (CLABSI) are a critical concern in healthcare settings, associated with high mortality rates and substantial financial burdens. This article highlights the various risk factors contributing to CLABSI, emphasizing both intrinsic and extrinsic factors, such as patient age, gender, underlying medical conditions, and catheterization duration. The prevention of CLABSI is addressed through a comprehensive bundle of evidence-based interventions, including hand hygiene, proper catheter insertion, skin preparation, catheter kits, selection of catheters, and maintenance bundles. Antimicrobial lock and flush solutions are crucial in eradicating microbes within catheter lumens. Furthermore, chlorhexidine bathing is recommended to reduce skin contaminants. Implementing these strategies collectively can significantly reduce the incidence of CLABSI, enhancing patient safety and reducing healthcare expenditure

    Clinico-pathological profile of breast cancer patients in a radiation therapy centre

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    Background: The aim of the study was to evaluate the clinico-pathological characteristics of patients with breast cancer at the Radiation Center of Bangabandhu Sheikh Mujib Medical University (BSMMU), a tertiary‑care cancer center in Dhaka, Bangladesh.   Methods: This descriptive study was conducted from March 2021 to February 2022 where patients receiving radiotherapy for breast cancer were included. Data were collected from face-to-face interviews with patients and from their investigation reports. Data regarding age, presenting symptoms, histological type, tumor size, involvement of regional nodes, hormonal receptor status, and human epidermal growth factor receptor 2 (HER2) amplification were recorded and then analyzed. Results: The mean age of the patients was 52.53 years. Most of the patients (93%) were multiparous and 62.24% were postmenopausal. The most common symptom was breast lump (91.6%). Infiltrating ductal carcinoma and lobular carcinoma were seen in 136 (95.1%) and 7 (4.9%) cases respectively. The TNM stage distribution was stage I, 6 (4.2%); stage II, 52 (36.36%); stage III, 76 (53.15%); and stage IV, 9 (6.29%). Locally advanced breast cancer constituted 42.66% of the cases. Among the patients 90 (62.94%) patients were ER/PR positive and 42 (29.37%) patients were HER2 positive. Triple negative breast cancer (TNBC) constituted 25.17% (36) of the study population. All receptors were positive in 25 patients (17.48%). Conclusions: Majority of our patients receiving breast radiotherapy at our center are middle aged and have advanced disease. TNBC and HER2 positive breast cancer are more common in our population

    Riding under the influence: unravelling substance abuse patterns among motorcyclists in South-Eastern Nigeria

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    Background: Drug and substance abuse has been outlined as a worldwide problem that is wreaking havoc on both social and public health across many nations. It is a global problem that affects both developed and developing countries. The objective of this study was to assess substance abuse among Okada riders in Nnewi, Anambra State, Eastern Nigeria. Methods: Drug and substance abuse has been outlined as a worldwide problem that is wreaking havoc on both social and public health across many nations. It is a global problem that affects both developed and developing countries. The objective of this study was to assess substance abuse among Okada riders in Nnewi, Anambra State, Eastern Nigeria. Results: About 221 Okada riders were assessed. Majority of them were middle aged. The mean age of the respondents were 39.5±11.1 years, with a range of 19-65 years. About 100% of the respondents were aware of substance abuse. Overall 73.3% of the respondents abuse at least a substance, with alcohol recording the highest use with 93.8% prevalence. About 77.2% of the abusers have taken these drugs before driving, and 65.2% have been involved in an accident, however only 5.4% admitted it was as a result of substance used. Conclusions: The prevalence of substances use among Okada riders in Nnewi was high. There was however a high awareness of the negative consequences of use of substance. Non-governmental organizations should target Okada riders for interpersonal communication interventions to help mitigate the use of substances

    Carotid intima-media thickness in patients with non-alcoholic fatty liver disease: a study from eastern part of India

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    Background: Carotid intima-media thickness (CIMT) is a reliable marker of atherosclerosis and cardiovascular events. Association between CIMT with non-alcoholic fatty liver disease (NAFLD) is well known; however, such data are limited from India. This study aimed to assess CIMT in NAFLD patients compared to the healthy control, its relationship with other metabolic covariates, and predators of increased CIMT. Methods: In an observational study, involving 150 subjects (84 NAFLD and 66 healthy controls), B-mode ultrasound was used for the evaluation of CIMT. Results: The mean CIMT was significantly higher in NAFLD patients compared to the control group: 0.77±0.27 versus 0.57±0.11 mm on left side, p<0.001 and 0.79±0.22 versus 0.54±0.12 mm on right side, p<0.001. The difference was significant even after adjustment of metabolic confounders. Eight NAFLD patients had carotid plaques compared to none in the controls. The mean CIMT did not differ significantly between lean, overweight and obese subjects. A progressive increase in mean CIMT was noted with increasing grades of hepatic steatosis. High CIMT values (>95th percentile value in controls, 0.79 mm) were found in 52.3% of NAFLD. On multivariate regression analysis, age [odds ratio (OR) 1.42, p<0.001], serum HDL cholesterol [OR 0.92), p=0.02] and NAFLD [OR: 3.5, p<0.001] were found to be independently associated with high CIMT. Conclusions: NAFLD was significantly associated with CIMT which increased progressively with increasing grades of hepatic steatosis. Over half of NAFLD had increased CIMT, and NAFLD along with higher age and lower HDL- cholesterol independently predicted high CIMT values

    Role of histopathological and microbiological investigations for a definitive diagnosis of benign sinonasal masses: a tertiary care institute study

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    Background: This research aimed to study the clinical presentation of various sino nasal masses (SNM), to study the importance of Histopathological and microbiological investigations in making diagnosis of SNM and to study the correlation between clinical, radiological, histopathological, and microbiological findings of SNM. Methods: In the present study 50 patients attending the ENT outpatient department with clinical evidence of nasal mass were selected based on inclusion and exclusion criteria. Patients were examined clinically and radiologically followed by surgical intervention. Histopathological and microbiological examination was done to make a definitive diagnosis. Results: Majority of cases were from 21-40 years age group (66%) with male preponderance. Nasal obstruction was most common symptom 45 (90%) followed by nasal discharge 43(86%). On histopathology highest incidence was of inflammatory polyps 22 (44%) followed by allergic polyps 14(28%) and non-invasive fungal sinusitis (NIFS) 11 (22%) respectively. Microscopically in KOH, fungal elements, yeast and hyphae were seen in total 11 (22%) cases and with SDA, Aspergillus niger was seen in 7 (14%) cases, Candida albicans in 3 (6%) and both in 1 (2%) case. Correlation of provisional diagnosis with HPE was found to be highly significant. Conclusions: It was observed that histopathological and microbiological examination is irreplaceable as both are the “GOLD STANDARD” for making a definitive diagnosis

    Bacterial vaginosis and the role of prebiotics and probiotics: current practices

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    Bacterial vaginosis (BV) is characterized by overgrowth of opportunistic bacteria and a decrease in the levels of Lactobacilli. BV is commonly encountered by gynaecologists practicing in India. The opinions of 21 gynaecologists across India regarding diagnosis and management of BV were sought via focussed group discussions. In Indian women, BV is more common in the reproductive age group, perimenopausal women, women with polycystic ovarian disease (PCOD), pregnant women, and in teenagers/pubertal age group. BV is often underestimated as it is not diagnosed by family physicians. The panel of experts opined that they preferred to conduct screening for BV in all high-risk pregnant cases, women with bad obstetric history such as premature abortions and women with a history of tuberculosis. One challenge faced by clinicians in the real-world setting is recurrent infections of BV in their patients. For the treatment of BV, antibiotics can be prescribed along with pre-probiotics to avoid dysbiosis and to prevent recurrence of BV. Pre-probiotics should be administered in sufficient amounts for adequate management of BV. More than 80% of Lactobacilli species should be present in an ideal pre-probiotic to ensure adequate production of acid and bacteriocins for the destruction of unhealthy bacteria and prevention of microfilm formation. The results with the pre-probiotics used will depend on the quality of the formulation and the maintenance of the cold chain. Prebiotic -probiotic supplementation may be considered a new adjuvant treatment for BV

    A rare case of symptomatic bilateral pheochromocytoma

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    Pheochromocytoma with reported incidence of 2-8 per million, is a rare and special tumor with its own unique clinical and pathological features, originating from the amazingly intelligent neuroendocrine cells of chromaffin cells of the adrenal medulla. It may behave as ‘great masquerader’ and be sweet and predictable as a child, while at times act as a ‘treacherous murderer’ crashing and tearing everything in its path with fierce rage, the main cornerstone of the disease being surgical excision. Here, we report a rare case of middle aged female presenting with hypertensive crisis which necessitates intensive care unit (ICU) management where she responded well to anti-hypertensives and radiological investigations were suggestive of bilateral pheochromocytoma. The course of treatment consisted of array of investigations to ascertain the diagnosis before embarking on bilateral adrenalectomy keeping in mind the consequences of absence of adrenal and subsequent possibility of Nelsons syndrome, which we were able to treat successfully. Here we want to highlight the consideration of bilateral adrenal tumors as a differential diagnosis for suprarenal growths, subsequent surgical course and post-operative medical treatment highlighting the importance of mineralocorticoids and glucocorticoids for day to day functioning

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