A prospective study of trauma patients at Gandhi Medical College and associated hospital emergency department, Bhopal, analysing anatomical and physiological scoring systems to predict mortality

Background: Trauma, in a developing country like India, is a leader together with non-communicable diseases, when measured in terms of disability adjusted life years (DALYs) lost. Trauma scoring systems have been shown to decrease the number of preventable deaths caused by trauma. The aim of this study is to compare the various physiological and anatomical scoring systems.Methods: Two hundred and sixty two cases of trauma of adult age group admitted in Gandhi Medical College and Hamidia Hospital, Bhopal, Madhya Pradesh, India from 1 July 2014 to 1 December 2014.Results: Out of the 262 patients included in the study, 242 were discharged alive while 20 (7.6%) died. In our study, in of the patients who died it was observed that RTS was significantly low (/=25 for ISS and >/=50 for TRISS).Conclusions: Of all the scoring system TRISS has got the best sensitivity, specificity and positive predictive value of 83.3% and also miscalculation rate of 1.5 as per the MOTS norms as compared to RTS, which has sensitivity of 90% but low specificity, and ISS which has sensitivity and specificity comparable to TRISS but low positive predictive value

EFFECT OF DICLOFENAC SODIUM ON GLYCOGEN CONTENT OF ZEBRA FISH DANIO RERIO

Number of pharmaceuticals are commonly used now-a-days for the treatment of various ailments. Among them, Diclofenac sodium is used to relief pain and joint stiffness but the residual part of it exerts various side effects. It has been shown that the residue of diclofenac reaches in considerably high amounts in aquatic environment which causes toxicity to aquatic animals especially in fishes. Therefore, the aim of this experimental work is to observe the effect of diclofenac sodium in the glycogen content of zebra fish in three different tissues i.e. liver, gills and muscles. LC50 at 24 hours exposure of diclofenac sodium estimated by direct interpolation method was found to be 26.25mg/l. To observe the effect of diclofenac sodium on glycogen content, the fishes were divided into 4 groups. Group 1 served as untreated control. Group 2 was treated with 24hrs LC50 of diclofenac. Group 3 & 4 received 1/5th conc. of 24hrs LC50 for 7 and 15 days respectively. Fishes were sacrificed after lethal and sub lethal exposure. Liver, gills and muscles were separately analysed to study the glycogen content by Anthrone reagent test. It was observed that glycogen content drastically decreased within 24 hours of diclofenac treatment & then gradually increased in 7 & 15 days treatment. Thus, this study indicates that level of glycogen can greatly be altered in response to the toxic effects caused by diclofenac in zebra fish. KEY WORDS: Diclofenac, Zebra fish, glycogen, LC50

Two dimeric flavonoids from <i style="">Bauhinia purpurea</i>

2604-2607Bauhinia purpurea leaves yield two new dimeric flavonoids namely bis [3',4'-dihydroxy-6-methoxy-7,8-furano-5',6'-mono­methyl­allyloxy ]-5-C-5-biflavonyl 1 and (4'-hydroxy-7-methyl 3-C- -L-rhamnopyranosyl)-5-C-5- (4'-hydroxy-7-methyl-3-C--D-glucopyranosyl) biflavonoid 2 with protein precipitating capacity 214.4 and 199.24 g BSA /g, respectively. Their identity has been established on basis of spectroscopic data and chemical reactions

Effectiveness of intravenous ferric carboxy maltose(FCM ) in improving hemoglobin level amongst postpartum women with moderate to severe anemia in a tertiary care hospital

Background: Postpartum Anemia (PPA)has been defined as hemoglobin(Hb)of &lt;10 gm% during the postpartum period. The most common cause of anaemia in the world is iron deficiency. Each ml of blood loss results in loss of 0.5 mg iron. Because FCM has a neutral pH and physiological similarity, it can be given in high doses over a short period of time with minimal danger of hypersensitive reactions, and no test dosage is necessary. The safety and efficacy of IV FCM in the treatment of postpartum iron deficient anaemia are assessed in this study. Aims &amp; objectives: Present study was done to estimate the changes in Hb level 6 weeks after IV FCM administration in postpartum women with Hb level of 5–9 g/dl who delivered at our tertiary care institute. Materials &amp; methods: This was a prospective observational study conducted at MGMMC &amp; MY Hospital Indore's Department of Obstetrics and Gynecology (MP).Study was conducted after taking ethical clearance. Total 100 patients were included in present study. Patients received single dose of 1 gm IV FCM. Hb, PCV, RBC indices, Serum ferritin and reticulocyte count were reassessed on day 42 of the treatment. The data was analysed statistically. A p value of&lt; 0.05 was considered significant for all statistical purposes. Results: In this study most common age group was 21-25 years(47%),patients with parity 2 were most common (39%).(53%)study patients had vaginal delivery,(42%)had Caesarean delivery &amp; (5%) had instrumental delivery. Statistically significant difference was noted between baseline &amp; day 42 values of Hb, Serum ferritin, &amp; RBC indices. Conclusion: Administration of single dose of IV FCM offers a promising treatment for pregnant women with moderate to severe iron defeciency anemia

Different techniques for management of pier abutment: Reports of three cases with review of literature

This teaching image highlights the CT abdominal imaging finding of 'crocodile jaw sign' which should raise concern about the presence of an incomplete annular pancreas which causes partial encasement of the duodenum

Hypertension in Cancer Survivors

PURPOSE OF REVIEW: With increasing survival after cancer treatment, there is a need for long-term management of risk factors and chronic medical conditions to realize the full benefit of improvement of outcomes. Hypertension is a major risk factor for cardiovascular disease and has a higher prevalence in cancer survivors compared to the general population. In this review article, we discuss the burden of hypertension in cancer survivors and how this impacts their long-term outcomes and risk of cancer recurrence. We then discuss the latest concepts regarding the pathophysiology of hypertension in cancer survivors in detail. There is a focus on inflammation and the role it plays in cancer and hypertension followed by a brief discussion on clonal hematopoiesis of indeterminate potential (CHIP) and associated hypertension. There is a brief review of various cancer therapies associated with development and worsening of hypertension control and the underlying mechanisms behind this. We conclude the review article by giving recommendations on blood pressure control in this unique patient population. RECENT FINDINGS: A lot of newer anti-cancer therapies have been implicated in the development or worsening of hypertension. We summarize the latest data, explore associations between these therapies and hypertension, and review the latest understanding of the underlying mechanisms driving this process. Hypertension is a major risk factor for cardiovascular disease in cancer survivors and must be recognized and treated promptly

Leadership Training for Nursing Professionals in India: A Workshop Evaluation

Introduction: Nurses are the backbone of the healthcare system, and an attempt can be made to improve the quality of care if every individual is empowered with leadership skills. While several leadership workshops and seminars have been conducted to sensitize doctors in India, there have hardly been any for nurses. A two-day workshop for orientation on leadership for nurses was conducted using multimedia presentations, talks by accomplished speakers and activities like role plays.Objective: The current study was undertaken to determine the impact of the workshop on the self-reported competence of nurses; with a secondary objective of evaluating the workshop and suggesting modifications for the future.Methodology: A pre- and post-workshop questionnaire (Crohnbach’s alpha: 0.874) was used to assess the impact of the workshop in self-reported competence. Self-administered structured questionnaires were used to evaluate the relevance of each session and suggestions for improvement. Paired t-test was used to assess difference in pre- and post-workshop competence. Weighted scores were used to rank sessions, and responses of qualitative data were grouped in suitable themes.Results: A total of 29 nurses participated in the workshop. There was a significant rise in knowledge in all the domains of the competence (p-value <0.05). The greatest increase in knowledge was in understanding the relevance of interpersonal skills. Maximum number of participants learnt the importance of effective communication (38%). Almost all the sessions were marked as relevant, and “conflict management” was the highest-ranking session, while the session on “planning and evaluation” was the least favored. The most popular suggested theme for further training was on stress management.Conclusion: The two-day workshop has been successful in raising self-reported competence of nursing professionals, and with minor modifications, regular trainings may go a long way in empowering nurses with leadership qualities

Isolated native tricuspid valve endocarditis presenting as PUO in a young adult male without any risk factors

A 28-year-old male presented to our hospital with high-grade fever and weight loss for 4 months. Clinical examination was non-contributory and there was no history of any high-risk behavior or prolonged skin or dental infections. Native tricuspid-valve endocarditis may rarely present in these settings and high index of suspicion is essential for early diagnosis

Maternal and fetal outcome in vaginal misoprostol induced patient

Aim: To study the effect of low dose vaginal misoprostol (25 µg) in induction of labour, To study the maternal and fetal outcome. Design: Retrospective case control study at Kamla Raja Hospital, GRMC, Gwalior from 01 Jan. 2018 to 31 Aug. 2019. Methods: Total of 200 Primi gravida women were randomized into 2 groups. Women induced with misoprostol 25 mg for cervical ripening labour induction and control group with no&nbsp; induction and watch for spontaneous progress of labour. BISHOP's prelabour scoring system was used to assess whether the cervix was favourable for induction of labour or not. Every 4th hour per vaginal examination was done to note the progress of labour in terms of dilatation, effacement and descent of the presenting part. Results: The conclusion of the study, in present study, majority of the cases in the age group 18-24 years of age, case group mostly had unfavorable cervix and Bishop Score ≤ 6. There was a significant difference seen in induction to start of active labour in both groups (p &lt;0.05). The maximum number of patients who go in active labour with in 6 hours more in case group i.e. improvement bishop score after induction, while in 6-12 hrs interval for induction to start of labour is more in control group (as there bishop score was higher at the admission) (Χ2 = 26.56&nbsp; p value = 0.000008). Induction to delivery interval was statistically significant found in both group. Most of the patients delivered within 24 hours of induction in the both groups. Case group with in 6-12 hrs. interval 72 cases (who had poor bishop score and got improve after induction), control group &lt; 6 hrs. 68 cases (there bishop score was higher at the admission) (Χ2 = 72.19 p value = 0.000001). Conclusion: Misoprostol is an effective priming and labour inducing agent. Though incidence of meconium stained liquor is higher in misoprostol induced labour among women with unfavourable cervix thereby increasing the rate of cesarean delivery for meconium stain liquor and increasing maternal as well as fetal morbidity and mortality. Keywords: Induction of labour, Bishop Score, Misoprostol, Cervical ripening