Mahatma Gandhi Hospital Research Articles

Hysteroscopic Evaluation in Infertile Females: Hospital Based Prospective Study

A couple is generally considered infertile if they are unable to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Hysteroscopy is a valuable diagnostic and therapeutic modality in the management of infertility. Today, it is considered the gold standard for evaluating the uterine cavity. The aim of our study is to describe hysteroscopy findings in 200 infertile females and to compare its use in primary versus secondary infertility. A hospital based prospective cross-sectional study, was conducted in the department of Obstetrics and Gynaecology, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, from Jan 2019 to Nov 2019, which included 200 infertile females undergoing diagnostic hysteroscopy. Hysteroscopic abnormalities were noted and analysed using appropriate statistical test and if needed endometrial biopsy were send along with any operative procedure was done. Mostly no abnormality was detected on hysteroscopy in uterine cavity, internal os and endometrium in both patients of primary and secondary infertility. Most common uterine cavity abnormality in both groups was intrauterine adhesion along with congested endometrium. Most of the uterine abnormalities were treated either in the same or subsequent operating setting. Hysteroscopy is cost-effective, comprehensive and gold standard for evaluation of uterine cavity in infertility patients since it aids not only in diagnosing the pathology but also its simultaneous management.

Awareness and practices regarding menstrual hygiene among adolescent girls residing in the village of Rasulabad in Wardha district

Background: Menstruation and menstrual practices in rural areas are still a matter of concern. Knowledge and awareness about menstrual hygiene is lacking among rural adolescent girls. Increase in knowledge in their early childhood may help to mitigate sufferings of many women. With this background, this study was conducted in a small village of Wardha district. Aims and Objectives: The aims of this work were to study awareness and practices regarding menstrual hygiene among adolescent girls residing in a village of Wardha district, to assess the awareness about menarche, to find out the prevailing practices for menstrual hygiene, and to ascertain the association of awareness of menstruation before menarche and practices for menstruation hygiene with educational status of respondents and their mothers. Materials and Methods: A community-based cross-sectional study was conducted among adolescent girls in the age group 12–19 years, who were personally interviewed based on a predesigned structured questionnaire. Data for this survey were collected by house-to-house visits using a structured questionnaire through interviewing and observation during Community Health Check Program from Mahatma Gandhi Ayurveda College, Hospital & Research Centre. Results: Age of menarche of most of the girls was between 12 and 16 years. 63% girls were unaware about knowledge of menstruation before menarche. In this study, mothers were found to be the source of knowledge of 71% girls. 74% girls knew that menstruation is a physiological process. 79% girls used sanitary napkins. Conclusion: Many are still unaware about knowledge of menstruation before menarche and source of bleeding. There is a need to create awareness among young girls about menstruation hygiene and its process.

TO STUDY THE ETIOLOGICAL PROFILE IN CHRONIC KIDNEY DISEASE PATIENTS

Background: Chronic Kidney Disease (CKD) is determined by the presence of kidney injury and by the level of renal function, assessed according to the glomerular filtration rate.
 Methods: This observational case study will be conducted among patients of newly diagnosedor known cases of chronic kidney disease admitted or attending outdoor clinic at Mahatma Gandhi Hospital Jodhpur.
 Results: Twenty three patients out of 75 were diabetic, 19 patients had chronic kidney disease of unknown etiology and 12 had both DM and HTN, only one patient had CKD because of RCC.
 Conclusion: Most common etiologies of CKD patients on hemodialysis are Diabetic nephropathy.
 Keywords: Chronic Kidney Disease (CKD), Hypertension, Diabetes.

CT scan vs nasal endoscopy findings in the diagnosis of chronic rhinosinusitis: our experience

<p class="abstract"><strong>Background:</strong> Diagnostic nasal endoscopy and CT imaging are both widely used essential diagnostic tools for chronic rhinosinusitis (CRS). This study analyses their individual roles in the management of CRS as well as the degree of correlation between the two.</p><p class="abstract"><strong>Methods:</strong> A prospective observational comparative study was conducted in the Department of Otorhinolaryngology, Mahatma Gandhi Hospital, Jaipur from January, 2017 to June, 2018 on a sample size of 201 patients diagnosed with chronic rhinosinusitis, as per AAOHNS guidelines. DNE and CT PNS were done for all patients enrolled in the study, the findings of each were correlated and their individual sensitivity and specificity for each variable was calculated. </p><p class="abstract"><strong>Results:</strong> On Comparing CT findings with diagnostic nasal endoscopic findings, Polyps were seen in 91 patients’ CT scans as opposed to 124 on DNE. B/L Polyps on CT imaging vs bilateral ethmoidal polyps visualized during DNE revealed a highly significant “P” value; whereas for antrochoanal polyps or unilateral polyps there was no significant difference. Maxillary sinus involvement is the most commonly observed finding in CT scan of PNS in CRS while deviated nasal septum is the most common finding on a diagnostic nasal endoscopy, seen in 60.7%. For anatomical variants like concha bullosa and paradoxical middle turbinate, no significant difference was seen.</p><p class="abstract"><strong>Conclusions:</strong> CT scans and DNE are both key pre-operative diagnostic tools for patients of CRS and both are complementary to each other in detecting type and extent of pathology.</p>

To compare effect of daily and weekly vitamin D in adult trauma patients with vitamin D deficiency

Background: Daily and weekly vitamin D dose are frequently used in treatment of vitamin D deficiency. This study analyses their individual roles in the management of vitamin D deficiency. And also to know significance of Singh index in adult trauma patient.Material & Method: A Randomized Comparative Study was conducted in the Department of Orthopedics, Mahatma Gandhi Hospital, Jaipur from January, 2017 to June, 2018 on a sample size of 60 patients diagnosed with vitamin D deficiency. Singh index was calculated in all patients enrolled in the study.Results: On Comparing effect of daily and weekly dosing in vitamin D deficient patient, weekly dose was more effective at short term i.e. 3 months but both were equally effective after 9 months. There was no significant association between Singh index and vitamin D deficiency in adult trauma patients.Conclusion: Given the potential of vitamin D in fracture healing, the clinicians treating adult fracture patients should be aware of the frequent presence of vitamin D deficiency. Regular supplement of vitamin D therapy provided a favorable outcome in the trauma patients. Weekly and daily dosing are both effective to correct vitamin D deficiency but with weekly doses normal levels are achieved earlier.

Women donate, men receive: gender disparity among renal donors

In living donor kidney transplantation, a predominance of female-to-male donations has been observed. This gender disparity is more so in developing countries and requires targeted counseling and research to understand whether the cause is medical or sociocultural obstacles. The aim of this study was to analyze all living donor kidney transplants performed at a tertiary care center catering to patients of varied socioeconomic backgrounds. This was a retrospective cohort study of all 600 kidney donors who underwent donor nephrectomy at a single transplant center, Mahatma Gandhi Hospital, Jaipur, between 2013 and November 2018. Patient characteristics including gender, age, and relationship between donors and recipients were obtained. There was a significant increase in the amount of voluntary renal donations, almost doubling every year. Majority (78%) of the donors were females, whereas males contributed to 22% of renal donations. We observed that mothers were the highest number of donors accounting for 181 donations (n = 600), followed by wives who contributed to 102 of the renal donors (n = 600), and 98 (16.3%) fathers donated to their children. Fifteen percent of the donors donated kidney to their siblings. We found gender disparity in living donor kidney transplant in a single center that caters to a population of varied cultures and socioeconomic backgrounds. We anticipate these results will guide clinicians and living donor coordinators and lead to appropriate counseling for patients and potential donors.

Evaluation of Efficacy of Various Techniques of Cholecystectomy: A Comparative Study

Background: Open cholecystectomy has been the treatment of choice for more than a century since its introduction and the procedure is standardized among surgeons. Encouraged by the success of laparoscopic cholecystectomy, which has become the gold-standard treatment for gallstone disease in a short span of time, laparoscopic surgery has gained in popularity and found application in almost every surgical specialty. Aim of the study: To compare laparoscopic cholecystectomy and open cholecystectomy with acute cholecystitis. Materials & Methods: The present study was conducted in the Department of General Surgery of Mahatma Gandhi Hospital, Bhilwara, Rajasthan, India. . For the study, we retrospectively viewed the medical records of patients aged 30-65 years with acute cholecystitis who underwent Laparoscopic cholecystectomy (LC) and were compared patients who underwent open cholecystectomy (OC). A total of 44 (22 each for LC and OC) were selected. The analysis of preoperative, intra-operative, and postoperative parameters was done and was compared. Results: A total of 44 patients were included in the study. The surgical procedure for LC and OC were performed by experienced surgeons. The Male/Female ratio in LC and OC group was 14/8 and 12/10 respectively. The mean age of patients in LC group was 42.1+4.8 years and in OC group was 44.5+4.2 years. The mean body weight of LC and OC group was 60.2+9.3 kg and 58.6+8.3 kg respectively. The mean operative time period for LC was 66.8 minutes and for OC was 91.2 minutes. Blood loss more than 500 mL was seen in 2 patients for LC and 4 patients for OC. The nasogastric tube was employed in 8 patients in LC and 12 patients in OC. Conclusion: Laparoscopic cholecystectomy is safer procedure in comparison to open cholecystectomy. The postoperative stay at hospital was shorter with laparoscopic cholecystectomy.

Serum Magnesium Levels in Type II Diabetes Mellitus and Its Association with the Microvascular Complications

Background: Hypomagnesemia has been associated with type 2 diabetic mellitus and is known to be a risk factor for microvascular complications. This study aimed to evaluate serum magnesium levels in patients with type 2 DM and correlate them with microvascular complications. Materials & Methods: A hospital based cross-sectional study was conducted on150 patients with type 2 diabetes mellitus were admitted in the Mahatma Gandhi Hospital, Bhilwara, Rajasthan, India. Serum magnesium levels were assessed in all the diabetic patients and they were also tested for presence of microvascular complications. Results: In the present study majority of the patients (71.33%) were males and male to female ratio was 2.48:1. The commonest age group was > 60 years (50%) and the mean age was 60.38 ± 10.81 years. The duration of diabetes in 45.33% of the patients was between 6 to 10 years and mean duration was 7.43 ± 4.11 years. Hypomagnesemia was associated with microvascular complications including diabetic retinopathy, diabetic nephropathy and diabetic neuropathy (p<0.050). Also, association was found between serum magnesium levels glycaemic control and duration of diabetes (p<0.050). Conclusion: Hypomagnesemia is widely prevalent in patients with type 2 diabetes mellitus and a major risk factor for the development microvascular complications that is, diabetic retinopathy, nephropathy and neuropathy. Key words: Hypomagnesemia, Diabetic nephropathy, Diabetic neuropathy, Diabetic retinopathy, Microvascular complications, Type 2 diabetes mellitus

Perinatal and Maternal Outcome in Pregnant Women with Polyhydramnios: A Hospital Based Study

Background: Polyhydramnios is the term for abnormal increase in the amniotic fluid. It has been shown that AFI is quite reliable in determining normal or elevated volumes. The aim of this study to evaluated the perinatal and maternal outcome in pregnant women with polyhydramnios. Material & Methods: This analytical study was conducted on 300 unselected pregnancies attending in Mahatma Gandhi Hospital, Bhilwara, Rajasthan. Most of the cases of polyhydramnios were admitted in the hospital till they delivered, other patients were followed up as outpatient and they were admitted to the hospital for delivery. Pregnancy outcome were recorded for the patients who were classified as having an excess amount of amniotic fluid. Results: In our study showed that out 0f 300 patients, 168 (56%) were in the age group of 21-25 yrs, 62.3% cases were multigravida in our study. In our study 73% of the cases were delivered vaginally. Out of which 15% were induced and 58% were delivered spontaneously. 27% of the cases were delivered by LSCS, out of which 16% were emergency LSCS and 11% were elective LSCS. In our study there were many perinatal complications. Out of them preterm birth was the most common complication. Conclusion: The conclusion of this prospective study was occurrence of polyhydramnios is directly related to advanced maternal age with multigravida. Caesarean section as a mode of delivery was found to be higher in cases of polyhydramnios.

A study of hand hygiene technique in intensive care unit of a tertiary care hospital

Introduction: Hand hygiene (HH) has been characterized as the keystone and starting point in all infection control programs, with the hands of health-care faculty being the handler and advocates of infection in critically ill patients. Materials and Methods: This was a cross-sectional observational study using direct observation technique. A single observer collected all HH data. This single-observer study was conducted in the 45-bedded intensive care unit (ICU) of Mahatma Gandhi Hospital. HH compliance was monitored using the hand hygiene observation form developed by the World Health Organization. A nonidentified observer was used for monitoring compliance with HH. Results and Discussion: A total of 900 observations were recorded from health-care personnel in ICU. With respect to the personnel, the nursing department had the highest number of observations as 400 circulating nurses were sampled. There were also 110 senior consultants, 250 resident doctors, and 140 paramedical staffs. Of the total opportunities, nurses had the highest number of contacts (67%), followed by allied health-care workers (82.94%). The average compliance was about 75%, which differed significantly among health-care workers, with higher compliance among the nursing staff (82.9%) followed by allied staff (67%). Of the average overall compliance of 75%, maximum compliance was seen for moment 3, that is, the staffs were very careful after body fluid contact as it was perceived important for self-protection. The HH instances after patient contact (86.29%) also suggested similarly. The nurses' compliance was 64.40% before patient contact and 68.35% after touching surroundings. Conclusion: The observance of HH is still low in our local environment. Handwashing practices in our study show that health-care workers pay attention to HH, when it appears, there is a direct observable threat to their well-being. Educational programs need to be developed to address the issue of poor HH.

Acute intestinal obstruction: small intestine vs. large intestine: an analysis

Background: Bowel obstruction is one of the most common causes of acute abdomen and also a common surgical emergency.The causes of IO vary significantly depending on geographical location. The aim of this study was to identify the etiology, clinical presentation, management and outcomes of patients with acute mechanical IO presenting in Jodhpur, Rajasthan.Methods: A prospective study was conducted at Mahatma Gandhi Hospital and Mathura Das Mathur Hospital (associated with Dr. SN Medical College), Jodhpur, Rajasthan. 100 patients with acute intestinal obstruction were admitted and evaluated. Blood routine, X-Ray abdomen, USG abdomen and CECT (if required) were done. A pre-operative diagnosis was made. Intra-operative findings and Post-operative complications were noted and follow up was done till the patient was discharged from the hospital.Results: A total of 69 male and 31 female patients, presented with acute mechanical IO during the period of the study. Mean patient age was 48.5 years with peak incidence in those aged 31-45 years. The foremost signs and symptoms were abdominal distension (88%), obstipation (87%), abdominal pain (81%) and nausea/ vomiting (47%). Adhesions and bands (29%), hernia (13%), neoplasm (9%) and pseudo-obstruction (8%) were the leading causes of intestinal obstruction. The sensitivity of X-ray and USG in present study was 67% and 75% respectively. Most common complication associated was wound infection (17%) followed by paralytic ileus (7%) and respiratory tract infections (6%). Late presentation was associated with poor prognosis. 4 patients expired before surgery. Post-operative mortality was associated with 6 patients and was more common in cases which presented with gangrenous bowel.Conclusions: The most common causes of IO in this study were adhesions and bands, hernia, neoplasm and pseudo-obstruction. Presence of bowel gangrene was associated with higher morbidity and mortality.

Fine Needle Aspiration Cytology Of Cervical Lymphadenopathy: Is There Anything Different At South Coastal Region Of India?

Background : Cervical lymphadenopathy is one of the commonest clinical presentations of the patients in all age groups. FNAC is simple, inexpensive and minimally invasive procedure that can be used as an outpatient procedure for diagnosing lymphadenopathy cases. Aims and Objective: To assess the various causes of cervical lymphadenopathy through FNAC and to see the distribution of various lesions with respect to age and gender and to correlate with histopathological findings. Materials and Methods: The present Analytical cross-sectional study was conducted in the Department of Pathology, Mahatma Gandhi Medical College and Hospital, Pondicherry from January 2010 to July 2016.FNAC was done by standard procedure. All the slides were reviewed and diagnosis was rendered. Cytology findings were compared with histopathological diagnosis where-ever excision biopsy was done. Results: A total of 411 patients were included in the present study. Overall, female preponderance was seen. In benign non-neoplastic lesions, peak occurrence was seen in the 3 rd decade, whereas it was 7 th decade in metastatic lesions. Benign lymphadenopathies were diagnosed in 75.1% of cases, majority being chronic reactive lymphadenitis(34.6%) followed by granulomatous lymphadenitis(30%). The proportion of granulomatous lymphadenitis was more in our study as compared to other studies(p<0.0001).In neoplastic lesions, majority (88%)were metastatic deposits. In metastatic lesions, higher proportion of metastatic thyroid carcinoma (13.9%) was seen which was statistically significant (p<0.0001) as compared to other studies. Unpaired t test was used to prove statistical significance. Cyto-histopathology correlation was done in 54 cases and FNAC showed sensitivity of 97%,specificity 95%and diagnostic accuracy of 96%. Conclusion: FNAC is safe, simple, rapid, minimally invasive and inexpensive procedure to diagnosis cervical lymphadenopathy with high sensitivity, specificity and diagnostic accuracy. Higher frequency of granulomatous lesions was seen in non-neoplastic cases. In neoplastic lesions, metastatic thyroid carcinoma showed higher frequency in our study conducted at iodine sufficient south coastal region of India. DOI: 10.21276/APALM.1463

Apache II scoring in predicting surgical outcome in patients of perforation peritonitis

Background: Many scoring systems have been found useful in predicting the outcome in critically ill patients, amongst them acute physiology and chronic health evaluation score (APACHE II) appeared to be the most widely used and had a general acceptance in assessing the critically ill patients, for its easy applicability and ability to predict outcome.Methods: To predict the surgical outcome in patients of perforation peritonitis APACHE II scoring done in every diagnosed case of perforation peritonitis in a prospective study from January 2015 to June 2016 was done. 100 patients with perforation peritonitis fulfilling the inclusion and exclusion criterion underwent exploratory laparotomy in Mahatma Gandhi hospital, Dr. S.N. Medical college, Jodhpur, Rajasthan, India.Results: In current study, 69 patients were in the low risk group (apache score 0-5) and 24 patients were in the medium risk group (Apache score 6-10) and 7 patients were in the high-risk group (Apache score 11-16). Of these 100 % patients in low risk group and 95.8% patients in medium risk group were discharged in satisfactory manner and 100% patients expired in high risk group.Conclusions: APACHE II score correlated well with the outcome in current study, it also correlated well with the hospital and ICU stay.

Comparison of Alvarado and RIPASA scoring systems in diagnosis of acute appendicitis and correlation with intraoperative and histopathological findings

Background: Despite extraordinary advances in modern radiology and laboratory investigations an accurate diagnosis of acute appendicitis cannot be made in atypical cases. No single diagnostic aid can dramatically reduce the rate of negative appendicectomy.Methods: To reduce the rate of negative appendicectomies, application of RIPASA and Alvarado scoring done in every clinically diagnosed cases of appendicitis in a prospective study from January 2015 to January 2016 was done. 100 patients with right lower quadrant abdominal pain fulfilling the inclusion and exclusion criterion underwent appendicectomy in Mahatma Gandhi Hospital, Dr. S.N. Medical college, Jodhpur, Rajasthan, India.Results: The results of both scoring system were reported and were correlated with intraoperative and histopathological findings. Chi-square test was applied to calculate the p-value for the association between the variables of studied. The mean age was 24.86 years (10-80 years) and there were 61 males and 39 females in the study. Histopathological examination confirmed appendicitis in 95 patients with 5 negative appendicectomies. Negative appendicectomy rate for RIPASA and Alvarado score was 2.17% and 1.54% respectively. Accuracy for RIPASA and Alvarado score was 93% and 68% respectively.Conclusions: RIPASA score is a more valuable tool for diagnosing acute appendicitis with 93% accuracy, sensitivity 94.74% and specificity 60%; inspite of sophisticated investigations like CT, thus reducing the cost of treatment and minimize negative appendicectomy rate.

Bacteriological profile of burn patients and antimicrobial susceptibility pattern of burn wound isolates

Background: Infection is a common cause of morbidity and mortality in burn patients. Clinical diagnosis of bacteremia and/or sepsis in burn patients is difficult for a number of reasons. It could be symptomatic and/or asymptomatic as a result of immune deficiency secondary to thermal injury.Methods: A retrospective study was conducted at Mahatma Gandhi Hospital Burn Unit Associated with Dr. S. N. Medical College, Jodhpur, Rajasthan. Fifty burn patients were investigated for bacterial profile of burn wound infections. Specimens were collected on 3rd and 7th day of burns in the form of wound swabs. The organisms were isolated and identified by standard microbiological methods. Antimicrobial susceptibility test was done by Kirby -Bauer disc diffusion method.Results: Gram negative organisms were found to be more prevalent. The most common isolate was Pseudomonas aeruginosa (P. aeruginosa) -38%, followed by Staphylococcus aureus (S. aureus) -35%, Klebsiella spp.-8%, Acinetobacter spp -5%, Staphylococcus epidermidis - 5%, Proteus spp. -3% and Escherichia coli -1%.Conclusions: Pseudomonas was the commonest cause of infection in fire burn patients in our setting followed by S. aureus. About 82% of the isolates showed multiple resistances. In light of our findings, regular antibiotic resistance test has to be done for each patient in order to select an appropriate antimicrobial agent.

Cost Effective Cultivation of Centella Asiatica Linn. (Mandukparni) – A Pilot Study

Background: Centella asiatica is widely used in pharmaceutical companies in various Ayurvedic formulations. Although over exploitation of the species is now widespread due to high market demand and it's used as a substitute of Bacopa monnieri, no serious effort has been made for its planned cultivation. Aim: To create awareness in cultivation of medicinal plant, C. asiatica and whether its cultivation is cost effective as compare to traditional crops. Materials and methods: Cultivation of C. asiatica L. was done over 5000 square feet area of round type II- poly house.Mother plants were procured from the herbal garden, Mahatma Gandhi Ayurved College, Hospital and research Centre, Salod, Wardha, Maharashtra. Analysis of soil was done for the quantication of micronutrients showing Calcium, Magnesium, Sodium, Iron, Zinc, Copper, Salt, Organic carbon, Nitrogen, Phosphorus, Potassium and pH. The land was given thorough preparatory tillage. For cultivation, plant cuttings along with root were used. The cuttings were transplanted in wet soil at spacing of 30 cm. in dual row with in between space of 30 cm. in the month of December 2012. First irrigation was given just after transplantation and harvesting was done in the month of April 2013 i.e. after 4th month of cultivation. Later harvesting was done at an interval of 1-2 month throughout the year. Result: Cost-Prot Analysis of Mandukparni (Centella asiatica) was calculated for per acre/year. Excluding all expenditure, the Net income per acre/year was Rs. 1,20,600. Conclusion: Successful cultivation of this plant is economically eye-catching provided marketing is not a problem. Better management can results in much higher income and net prot as compare to traditional crop.

To find the Efficacy of Therapeutic Laser for Piriformis Syndrome

ABSTRACT Introduction Excessive static and dynamic muscle work/action of the piriformis causes Piriformis syndrome (PS). The sciatic nerve runs on bilateral side of posterior hip or thigh just closed to piriformis muscles or sometimes just passes through it. In case of PS, patients feel sharp radiating pain and paresthesia and muscle weakness in lower quadrants of limbs including low back, hip, and ankle. Aims and objectives The aim of the study was to compare and observe the effect of light amplification by stimulated emission of radiation (LASER) therapy and ultrasound therapy in case of PS. The purpose of this study was to investigate the effectiveness of laser therapy for the physiotherapy rehabilitation to restore range of motion (ROM) of lower limb and decrease pain and disability in PS. Materials and methods Thirty patients were taken for this study. The mean age in group I and group II were 28.2 ± 5.116 and 29.93 ± 4.793 respectively, and the patients were referred from orthopedic outpatient physiotherapy department of Mahatma Gandhi Hospital, Jaipur, Rajasthan, India. The duration of study was of 3 weeks. Baseline measurements of pain intensity, lower extremity functional disability, and ROM of all the subjects were measured using the visual analog scale (VAS), Lower Extremity Functional Scale, and goniometer respectively, and recorded as per test data for statistical analysis. Results and conclusion The results have shown that clinically there is a significant difference in the subjects treated with low-level laser and ultrasound efficient in treating pain, ROM, and function in subjects with PS. Between-the-group comparison of values of VAS readings for pain was found to be statistically significant (0.0001) for ROM, but was not found statistically significant for function. How to cite this article Ojha S, Jailiya C. To find the Efficacy of Therapeutic Laser for Piriformis Syndrome. J Mahatma Gandhi Univ Med Sci Tech 2017;2(1):14-17.

Patch Test Results in Patients with Suspected Contact Dermatitis at a Tertiary Care Hospital in a Semiurban Area in Rajasthan: A Cross-sectional Study

ABSTRACTContact dermatitis is an inflammatory condition of the skin after exposure to any exogenous substance. It can be classified as irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD). A cross sectional study was conducted in Mahatma Gandhi Hospital over a period of 3-month duration from March-May 2016 and total 68 patients with suspected contact dermatitis were subjected to patch test. Most common allergen found to be positive in both males and females was parthenium followed by fragrance mix.How to cite this articleGoyal P, Nijhawan M, Agrawal S, Jain S, Jangra R. Patch Test Results in Patients with Suspected Contact Dermatitis at a Tertiary Care Hospital in a Semiurban Area in Rajasthan: A Cross-sectional Study. J Mahatma Gandhi Univ Med Sci Tech 2016;1(1):1-4.

The QT dispersion and QTc dispersion in patients presenting with acute neurological events and its impact on early prognosis.

Aims:To find out and investigate whether the QT dispersion and QTc dispersion is related to type and prognosis of the acute stroke in patients presenting within 24 h of the onset of stroke.Settings and Design:This was a observational study conducted at Mahatma Gandhi Hospital, Dr. SN. Medical College, Jodhpur, during January 2014 to January 2015.Subjects and Methods:The patients presented within 24 h of onset of acute stroke (hemorrhagic, infarction, or transient ischemic event) were included in the study. The stroke was confirmed by computed tomography scan and magnetic resonance imaging. Patients with (i) altered sensorium because of metabolic, infective, seizures, trauma, or tumor; (ii) prior history of cardiovascular disease, electrocardiographic abnormalities’ because of dyselectrolytemia; and (iii) and patients who were on drugs (antiarrhythmic drugs, antipsychotic drugs, erythromycin, theophylline, etc.,) which known to cause electrocardiogram changes, were excluded from the study. National Institute of Health Stroke Score (NIHSS) was calculated at the time of admission and Modified Rankin Scale (MRS) at the time of discharge. Fifty age- and sex-matched healthy controls included.Statistical Analysis Used:Student's t-test, ANOVA, and area under curve for sensitivity and specificity for the test.Results:We included 52 patients (male/female: 27/25) and 50 controls (26/24). The mean age of patients was 63.17 ± 08.90 years. Of total patients, infarct was found in 32 (61.53%), hemorrhage in 18 (34.61%), transient ischemic attack (TIA) in 1 (1.9%), and subarachnoid hemorrhage in 1 (1.9%) patient. The QT dispersion and QTc dispersion were significantly higher in cases as compare to controls. (87.30 ± 24.42 vs. 49.60 ± 08.79 ms; P < 0.001) and (97.53 ± 27.36 vs. 56.28 ± 09.86 ms; P < 0.001). Among various types of stroke, the mean QT dispersion and QTc dispersion were maximum and significantly higher in hemorrhagic stroke as compared to infarct and TIA (P < 0.001). The mean QT dispersion and QTc dispersion was found significantly high in nonsurvivors (n = 16) as compared to survivors group (n = 36) (P < 0.05). The mean QT dispersion was directly correlated with the NIHSS and functional outcome score MRS. Patients with greater QT and QTc dispersion having high NIHSS had poor prognosis.Conclusion:We concluded that patients presenting with acute neurological events having increased QT dispersion and QTc dispersion is related to high mortality and poor functional outcomes on hospital discharge and if the values of dispersion score are very high we can predict for hemorrhagic stroke.

To evaluate and compare the Effectiveness of Sensorimotor Integration with that of Conventional Training for improving Balance and Gait in Stroke Hemiparesis: A Comparative Study

ABSTRACT Aim of the study To evaluate and compare the effectiveness of sensorimotor integration with that of conventional training for improving balance and gait in stroke hemiparesis. Materials and methods The study design used for this research will be comparative study. Data will be taken from Mahatma Gandhi Hospital and Medical College, Jaipur and Mumbai. Results When both the groups were compared using unpaired t-test, sensorimotor group showed significant improvement in all outcome measures (p &lt; 0.0001) except for MCTSIAB conditions 1 and 2 where the difference was not statistically significant. Conclusion Sensorimotor integration training is one of the novel treatment which can have a addictive effects along with the conventional training for balance. How to cite this article Agarwal G, Jain A. To evaluate and compare the Effectiveness of Sensorimotor Integration with that of Conventional Training for improving Balance and Gait in Stroke Hemiparesis: A Comparative Study. J Mahatma Gandhi Univ Med Sci Tech 2016;1(2):47-54.