International Journal of Medical Research and Review

“A pre-experimental study to assess the effect of educational package on knowledge regarding haematopoietic stem cell transplantation among staff nurses working in selected hospital Bhopal, Madhya Pradesh”

Tripti Singh — 2021-03-25

Haematopoietic stem cell transplantation is a greater positive impact on the treatment of life-threatening diseases. Stem cell transplantation is a lifesaving procedure for several malignant and nonmalignant life-threatening diseases, more than 40,000 stem cell transplantations are being performed annually worldwide.

Methods: pre-experimental, one group pre-test post-test research design was used for conducting a study in a selected hospital of Bhopal, Madhya Pradesh. Subjects comprising of 60 staff nurses selected by non-probability purposive sampling technique, who fulfilled inclusion criteria.

Results: Mean post-interventional knowledge (27.0 ± 6.03) is higher than the mean pre-interventional knowledge (15.5 ± 5.74). The mean difference between pre- interventional knowledge and post-interventional knowledge is 11.5. The computed ‘t’ value 15.80, 2.00, P<0.05 shows that there is a significant difference between pre-interventional knowledge and post-interventional knowledge. There was a significant association found of demographic variables in terms of working area and years of clinical experience.

Conclusion: it was concluded that the educational package was effective in enhancing the knowledge of the staff nurses. The health care professional including staff nurses also having inadequate knowledge of stem cell therapy. The skilled educative session is one of the cost-effective intervention used for educating the nurses in various aspects. This type of studies emphasize the significance of the short term courses or in-service education for nurses in advanced knowledge on stem cell transplantation and making use of facilities available in the management of the patient in day to day activities.

Validity of Screening for Pre-Diabetes and Type2 DM in Patients Presenting with Oral Symptoms

Dr. T MuthuVel — 2021-04-23

Introduction: Type 2 DM is a major health problem in the present world with its high micro and macrovascular complications leading to increased mortality and morbidity. Our diagnosed T2DM represents the tip of the iceberg, where the hidden part places a vital challenge to the health care system.

Objectives: Various risk factors are identified to screen the population for diabetes which is still an incomplete list hence we aimed to identify the dental illness as a potent risk factor to screen T2DM and Prediabetes.

Methodology: This is an observational study in which 92 patients attending to dental clinic except for traumatic problems were screened for T2DM with random blood sugar and HbA1c.

Results: In our study we observed 22.8% pre-diabetic and 8.8% with newly diagnosed T2DM among the study population. Chronic periodontitis was accounting for more than 60% of the subjects presenting dental illness.

Conclusion: In our study we conclude that dental illness to be accounted as a potent risk factor for T2DM/Pre-Diabetes

A study to determine age at menarche in adolescent school girls of Indore city, M. P. India

Dr. Sunita Solanki — 2021-04-26

Background: Menarche is a significant milestone in women's life. It affects the reproductive health and well being of women. This study aims to find out the age at menarche of adolescent girls of Indore city and its relation to various factors.

Method: This was a cross-sectional study conducted in six schools of urban areas of Indore city the study group included 492 school girls of age 11 to 18 years. After taking written informed consent from the parents, data was collected on the date of birth, family size, birth order, dietary intake, social-economic status, menarcheal age. Anthropometric measurements were done and data was analyzed.

Results: Mean age at menarche was found to be 13.2+1.24 years. It was found to be significantly associated with socioeconomic status, BMI and birth order.

Conclusion: The mean age at menarche in this study is comparable to that found in other Indian studies. It is found to be significantly associated with BMI and socioeconomic status of the girls

Impact of Structured Lifestyle Intervention Program with Antigravity Exercise on Glycemic Control in People with T2DM

Dr. T MuthuVel — 2021-04-26

Introduction: Diabetes mellitus (DM) is a common endocrinopathy and assumes significance for its ability to adversely affect the various internal organs. It can also derail the immune system of the affected. Abnormal insulin secretion and/or utilization, leads to hyperglycemia which has adverse effects on the heart, blood vessels, kidney, nervous system, eye and skin. To assess the effectiveness of structured vs unstructured lifestyle modification therapy in glycemic control (change in HbA1c value from baseline to the end of the intervention) in people with T2DM.

Methods: This study is a randomized, controlled, parallel-group study with lifestyle modifications as intervention. Study was conducted for between Feb 2019 to Dec 2019 in the Department of General Medicine, Government Headquarters hospital, Tirupur.

Results: A total of 70 participants, 30 to 60-year-old, diagnosed with T2DM for more than a year with HbA1c levels > 6.5 %, on a background of oral antidiabetic agents were enrolled after obtaining the informed consent. Mean age of Group A and Group B found 49.17±7.42 and 51.92±9.1. Male were predominant in the study. Mean weight, Mean FBS, Mean PPBS and Mean HbA1c are statistically significant between groups (p<0.05) at baseline. Group B with unstructured physical activity with walking, was beneficial (HbA1c reduction 0.30 %; p = 0.024), but no significant decline in HbA1c, whereas, in Group A with structured antigravity exercise, is associated with a significant HbA1c decline of 1.2 %. (p = 0.07865).

Conclusion: Structured antigravity exercise training was more efficacious than unstructured physical activity in achieving controlled HbA1c levels. Although both structured and unstructured training provide benefits, only the former was associated with significant reductions in HbA1c levels. Hence, T2DM patients should be advised to follow structured antigravity exercise training & focused dietary intervention program.

Analysis of D-Dimer Levels among Covid -19 Positive Patients in a Tertiary Care Hospital in Bangalore

Dr. Manasa. S — 2021-05-01

Introduction: Pro-thrombotic changes are stimulated by Corona Virus as it has an affinity for endothelium and lung structures and this may explain its association with thrombotic events, reduction of pulmonary gas exchange, respiratory distress, and death. D-dimer is a specific marker of the breakdown of a fibrin clot and has been used as a diagnostic and prognostic marker in VTE and other coagulation disorders.

Objectives: The objective of this study was to assess the correlation of the D-Dimer levels and disease severity among COVID-19 patients.

Materials and methods: This is a retrospective study done over 6 months from July 2020 to December 2020 in a tertiary care hospital in Bangalore. All the COVID- 19 positive cases who were admitted to our hospital were audited regarding the D-dimer levels during admission and the course of the treatment.

Results: Coagulation disorder occurred at the early stage of COVID-19 infection, with 1066 (57.7%) patients having increased D-dimer levels. Out of 1846 COVID 19 patients 106 (5.7%)patients died due to complications. 106 patients who deceased, all the patients had an increased D dimer value either in the first lab test or in the consecutive tests. Among 106 patients 56(52.8%) patients had increased D-dimer at the first lab test, 32 (30.1%) had D-dimer increased at the second and 18(16.98%) in third lab tests. The increased D-dimer levels were closely associated with the progression of the disease and also the changes in the CT imaging.

Conclusion: The increase in D-Dimer levels also increased the complications in the COVID-19 patient. So it is necessary to continuously monitor D-dimer levels and labelled anticoagulation as management tools for COVID-19 disease to prevent complications and reduce interventions.

Evaluation of spectrum of MRI findings in children with Hypoxic Ischemic Encephalopathy and its comparison with transcranial sonography

Dr. Manoj Mathur — 2021-05-01

Background: Hypoxic ischemic encephalopathy is a serious concern among asphyxiated newborns due to the associated long term sequelae like cognitive impairment and cerebral palsy. Though the incidence of hypoxic injury remains higher in preterm babies due to incomplete brain maturation, it can occur in term babies as well despite institutional deliveries due to an array of unavoidable fetal, maternal and placental causes.

Aims: This study was conducted as an attempt to evaluate the risk factors, to study the correlation between the term of pregnancy with TCUS and MRI imaging findings in HIE and characterise patterns of CNS involvement.

Materials and methods: It was a cross-sectional study carried on 50 neonates with clinically diagnosed HIE presenting to the Department of Radiodiagnosis, Rajindra Hospital Patiala who were subjected to transcranial sonography and MRI.

Results and Conclusion: This study demonstrated term infants have significant involvement of basal ganglia thalamus type (central) pattern of involvement and preterm infants have periventricular leukomalacia type (white matter injury) of a pattern of involvement. The overall sensitivity and specificity of TCUS in detecting imaging findings in children with clinically diagnosed HIE compared to MRI was found to be 70.45% and 50% respectively, yielding the overall diagnostic accuracy of TCUS as 68% compared to MRI. TCUS can depict central and white matter abnormalities better than peripheral lesions. However MRI provides additional diagnostic information in many cases and can detect precisely the extent of brain injury.

Analysis of ease of insertions, its attempts and time taken to insert for i-gel and cLMA in paediatric cases.

Dr. Nimish Jain — 2021-04-30

Aim: Analysis of ease of insertions, its attempts and time taken to insert for i-gel and cLMA in paediatric cases.

Methods: We did a prospective, randomised single-blind study on Eighty patients of either sex belonging to American Society of Anaesthesiologists (ASA) physical status class I or II, between 6 months to 8 years of age, scheduled to undergo elective surgery for less than one and half hour duration under general anaesthesia. In this study we analysed the ease of insertion, attempts and time were taken to insert the supraglottic airway device.

Results: The ease of insertion observed was easy in 39(97.5%) in the i-gel group and 35(87.5%) in cLMA group in our study. The i-gel was placed successfully in 39 out of 40 (97.5%) patients in the first attempt, and achieved 100% insertion on the second attempt. Correct positioning of cLMA in the first attempt was seen in 35 out of 40 (87.5%) patients. The remaining 5 patients (12.5%) required a second attempt. The average insertion time of cLMA (12.88 ± 1.771 seconds) was longer than the average time of insertion of i-gel (9.48 ± 1.037 seconds), and these differences were highly significant statistically (p= 0.000).

Conclusion: To conclude, i-gel and cLMA is effective and safe devices for use in children. Both are easy to insert and have insignificant morbidity, however, time taken and attempts of insertions for i-gel was lesser than cLMA. Also, the ease of insertion was relatively easy for i-gel than cLMA in pediatric cases.