Medical Collage Hospital Research Articles

To Study the Pattern of Anemia in Type 2 Diabetes Mellitus in Elderly Hospitalized Patients

Background: Anemia found in diabetes patients is often unrecognized like many other chronic diseases. Anemia is more common in people with diabetes due to a variety of causes. The aim of this study was to determine the severity and morphological types of anemia among type II diabetic elderly hospitalized patients. Methodology: The present study was a hospital based cross sectional study conducted at Father Muller Medical Collage Hospital, Mangalore Karnataka over a period of 6 months. The cases for the study included 129 elderly patients with having Type 2 Diabetes Mellitus (DM). 129 Hospitalized elderly patients over the age of 60 years who were confirmed to have type 2 DM patient’s demographic data and the blood samples are analyzed for Complete blood count, Peripheral smear for type of anemia, Random blood glucose, Glycated hemoglobin. Result: A total 129 Hospitalized elderly type 2 DM patients were included in the study. Out of 129 subjects, 55.03% were males and 44.97% were females. Of these 24.8% patients had mild anemia, 63.56% had moderate anemia and 11.64% had severe anemia according to clinical degree of anemia based on hemoglobin level. 67.76% patients had microcytic hypochromic anemia, and 30.24% patients had normocytic normochromic anemia. The prevalence of type 2DM is high in male than the female population. Conclusion: The study results exhibit a higher level of the prevalence of anemia in Type 2 DM subjects. The findings of our study suggest that moderate degree of anemia is a common finding, and morphologically, the leading type of anemia was normocytic normochromic anemia. Keywords: Diabetes Mellitus, Anemia, Hemoglobin, Hyperglycemia.

Patients’ Satisfaction Regarding Dietary Service at Tertiary Hospitals

Aim: Hospital diet is an integral part of the management of in-ward patients. Patient satisfaction is a key criterion by which the quality of dietary services can be evaluated. This study was conducted to assess the patients’ satisfaction regarding dietary service at tertiary hospitals.
 Methodology: The present cross-sectional study had been carried out among 247 dietary service receivers to assess the patients’ satisfaction regarding dietary service at tertiary hospitals. The study was conducted in Shaheed Suhrawardi Medical Collage Hospital and Dhaka Dental College Hospital, Bangladesh from January to December, 2022. Convenience sampling technique was adopted and a pre-tested structured questionnaire based on Acute Care Hospital Foodservice Patient Satisfaction Questionnaire (ACHFPSQ) was used for measuring patients’ satisfaction with dietary services.
 Results: The mean age of the service receivers was 39.24±13.09 years where more than half of the respondents (59%) were male and 65% of the respondents are from rural area. All of the respondents took hospital diet 3 times daily. Among the respondents 97.6% stated that they never had any option to choose their meal and 47.4% of them sometimes felt hungry between two meals. 87% of the respondents considered that the dietary staff always had good behavior. Among the respondent 41.30% had good satisfaction, 30.40% had moderate satisfaction and 22.70% had very good satisfaction regarding hospital dietary service.
 Conclusion: The study concluded that almost half of respondents had good satisfaction with the overall dietary service whereas about one third of the respondents rated dietary services as average. Hospitals should strengthen the ongoing dietary service by providing a menu with variety of food daily and improve the taste of supplied food.

A Comparison of Dissection Method and Diathermy Cauterization Tonsillectomies

Background: Tonsillectomy is one of the most common procedures performed by otolaryngologists. It is a surgical operationthat removes both Palatine tonsils from the tonsillar fossa. It is typically performed in youngsters for recurrent tonsillitis andtonsillar hypertrophy. Objective: To compared the dissection and diathermy methods of tonsillectomy and evaluate their advantages anddisadvantages during surgery and convalescence. Methods: This is was a retrospective analysis of 400 patients from January 2015 to January 2020 of otorhinolaryngologydepartment in Banga Bandhu Sheikh Mujib Medical Collage Hospital. Out of total 400 patients 200 patients underwenttonsillectomy by dissection method and rest 200 patients underwent electro cautery method. Data were generated through recordreview using a checklist. A total of 400 patients were analyzed in respect of operation methods, operation time, and amount ofblood loss, post operative complications, duration of hospital stay in addition to age & sex distribution separately for comparison. Results: The overall hospital stayinng in both types was 1-3 days. The average intra operative blood loss was 5-7 ml withcautery and average 50 ml with dissection method. The average operative time was 25-30 minutes with dissection method and10-15 minutes with cautery. We found higher amounts of blood loss and intra - operative time with dissection method thanelectrocautery. The Chance of Secondary haemorrhage was more in electro - cautery method than dissection method. Pain,Scar formation, odynophagia were more in cauterization method. Complete healing time was more in cauterization methodthan dissection method. There was no death in both methods.Conclusion: Although per- operative blood loss, operative time were less in cauterization method but post operative bleeding,pain, odynophagia and infection were more in electro cauterization method. In both methods, there were some advantages andsome disadvantages.

Diagnostic utility of cellblock technique in reporting body fluid cytology

Introduction: Body fluids are processed by routine cytology techniques like preparing a slide and staining it with PAP stain. By this method it is difficult to give definitive diagnosis particularly to the cases where some abnormal cells seen suspicious of malignancy. In our study we utilized cell lock technique for reporting body fluid cytology. Objectives: Our objective is to prepare cellblock from body fluid, to use it for diagnosis of benign and malignant lesions and also to check advantage and drawbacks of cell block technique over the conventional cytology examination. Materials and Method: This study was carried out in medical collage hospital in Department of Pathology. We selected total 52 body fluids with good cellularity for cell block preparation. Result: Out of 52 cases 45 were diagnosed as benign and 7 as malignant using cell block technique. Conclusion: We conclude with findings that cell block technique is better than routine cytology technique. By cell block technology tissue architecture can be well appreciated and definite diagnosis can be given. Also, we can utilize cell block for definitive diagnostic methods like Immunohistochemistry.

Comparison of early postoperative effects between anterior bladder and posterior bladder approaches in robotic assisted laparoscopic radical prostatectomy

Objective: To examine the effect of robotic assisted laparoscopic radical prostatectomy with different approaches on early postoperative effects. Methods: Totally 44 patients (average age of 65.9 years, range: 46 to 81 years) underwent robotic assisted laparoscopic radical prostatectomy by a single operator at Department of Urology, Peking Union Medical Collage Hospital from March 2018 to March 2020 were retrospectively analyzed. The mean age was 65.9 years (range: 46 to 81 years), including 24 cases in the anterior bladder approach group (anterior approach group) and 20 cases in the posterior bladder approach group (posterior approach group). The preoperative clinical data, perioperative related data and postoperative urinary control recovery were compared between the two groups by t test, χ2 test or Fisher exact test. Results: In terms of clinical data, there was no difference in age, prostate volume, preoperative prostate specific antigen and Gleason score(all P>0.05). There was no significant difference in operation time ((184±43) minutes vs. (193±42) minutes, t=-0.599, P=0.55), bleeding volume ((218±88) ml vs. (225±115) ml, t=-0.244, P=0.81), postoperative stage (T2/T3: 15/9 vs. 12/8, χ²=0.029, P=0.87) and positive rate of cutting edge (29.2% (7/24) vs. 30.0% (6/20), χ²=0.004, P=0.95). In terms of postoperative urinary control, patient rates who achieved urinary control immediately after extubation was significantly higher for the posterior approach group than the anterior approach group (30.0% (6/20) vs. 4.2% (1/24), P=0.04). There was no significant difference between two groups for those who achieved urinary control 3 months after operation (6 cases vs. 11 cases, P=0.06), 6 months after operation (20 cases vs. 19 cases, P=0.36) and those who achieved urinary control 12 months after operation (23 cases vs. 19 cases, P=1). Conclusion: For robotic assisted laparoscopic radical prostatectomy, the posterior approach does not prolong the operation time, does not increase the amount of bleeding, and improves the short-term postoperative urinary control.

Clinical Presentation and Surgical Outcome in Patients Presented with Peritonitis

Objective: To determine the surgical outcome in patients with peritonitis at tertiary care Hospital.
 Materials and Methods: This descriptive case series study was conducted in general surgery department of Peoples Medical Collage Hospital, Nawabshah (SBA). Study duration was two year from August 2014 to July 2016. All the patients aged more than 12 years and of both genders were included. Surgical management was done in all of the study subjects. Abdominal cavity was produced with midline incisions using grid iron as per investigations and clinical evaluation; the quantity and quality of intra-abdominal exudates were measured. Intestinal contents and pus were removed from peritoneal cavity with suction as well as by manual mopping, and full lavage was carried out with 3-5 liters of normal saline to all parts of the abdominal cavity. All the demographic data including clinical presentation and surgical outcome in terms of post-operative complications, Hospital stay and mortality were recorded via study proforma.
 Results: A total of 100 cases of peritonitis 75% patients were male and 25% patients were female. The mean age of patients was 36.21+12.32 years. Acute generalized abdominal pain was in all cases, followed by fever 91.0%, vomiting 66.0%, constipation 69.0% and 2.0% patients complained of passing blood per rectum. Generalized abdominal tenderness, including rebound tenderness 90%, abdominal rigidity 83%, dehydration 88%, abdominal distention 85%, absent gut sound 70%, shifting dullness was elicited in 64% of cases and jaundice in 1.0% of cases. According to post-operative complications 20.0% patients developed Septicemia and Fecal fistula, 40.0% had wound Infection only, 9.0% patients developed wound infection and septicemia, 4.0% patients developed septicemia without any wound infection. Most of the patients had prolonged Hospital stay and overall mortality rate was 16%.
 Conclusion: Surgical outcome of the peritonitis resulted poor in those cases who came late and there was huge contamination of peritoneal cavity when operated, these patients developed post-operative complications i.e. wound infection, septicemia, faecal fistula and there hospital stay was longer.

“Effect of Night Shift on Personal Health and Other Factors of Nurses at Rajshahi Medical Collage Hospital, Rajshahi, Bangladesh”

“Effect of Night Shift on Personal Health and Other Factors of Nurses at Rajshahi Medical Collage Hospital, Rajshahi, Bangladesh”

Programmed Death-1 Inhibitors-induced Bullous Pemphigoid in 21 Cases

Objective To investigate the clinical features and treatments of programmed death-1(PD-1)inhibitors-induced bullous pemphigoid(BP).Methods The clinicopathological and immunohistological data of patients with PD-1 inhibitors-induced BP from Peking Union Medical Collage Hospital and reported in the literature were retrospectively analyzed.Results Totally 21 cases(15 males and 6 females)were enrolled.The average age was(70.9±9.7)years(56-86 years).The most common primary malignancies were melanoma(38.10%)and lung cancer(33.33%).The average duration from onset of PD-1 inhibitors treatment to diagnosis of BP was(49.1±23.7)weeks.Typical dermatopathological features were sub-epidermal blisters(76.19%)with infiltration of eosinophils(88.24%).Direct immunofluorescence features were linear deposition of complement C3(95%)and IgG(75%)in the basement membrane zone.Anti-BP180-NC16A antibodies were positive in most cases(84.21%).Patients were mainly treated with systemic corticosteroids,whereas biologics such as rituximab and omazumab were also effective.Conclusions The risk of PD-1 inhibitors-induced BP should be recognized by dermatologists and oncologists.Early diagnosis and timely treatment of BP induced by PD-1 inhibitors are important to improve the prognosis.

Screening for Oral Cancers, Need for India: A Cross-Sectional Study in a Medical Collage Hospital in Maharashtra

Screening for Oral Cancers, Need for India: A Cross-Sectional Study in a Medical Collage Hospital in Maharashtra

EFFECTIVENESS OF HIGH GRADE MAITLAND MOBILIZATION TECHNIQUE IN PATIENT WITH IDIOPATHIC ADHESIVE CAPSULITIS OF SHOULDER JOINT.

25Aug 2019 EFFECTIVENESS OF HIGH GRADE MAITLAND MOBILIZATION TECHNIQUE IN PATIENT WITH IDIOPATHIC ADHESIVE CAPSULITIS OF SHOULDER JOINT. A. K. M rezwan , Selim hossain , Ashraful alam , Azmol hossain , Mizanur Rahman and Samia Jannat. Lecturer- GonoBishwabidyalayNolam, Savar, Dhaka. Rehab specialist-Centre for disability in development,Ulail, Savar, Dhaka. Chief consultant-PT,Eastern care hospital ltd, Dhaka. Consultant and HOD ?PT,Nightingale Medical Collage hospital,Dhaka, iris 820. Student of Physiotherapy (BPT)GonoBishwabidyalay. Savar .Dhaka.

Evaluation of efficacy and safety of crizotinib and its prognostic factors in patients with ALK-positive advanced non-small cell lung cancer

Objective To investigate the efficacy and safety of crizotinib in patients with advanced anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC), and focuse on analysis of its prognostic factors. Methods Fifty patients with advanced (stage ⅢB-Ⅳ) ALK-positive NSCLC confirmed by cytology or histology in Peking Union Medical Collage Hospital from January 2013 to September 2016 were collected. The relevant clinical information and treatment protocols were recorded. The efficacy and safety of crizotinib were followed up, and its prognostic factors were analyzed. Results At the end of follow-up, the median progression free survival (PFS) of progressed patients (n=24) was 9.6 months (95%CI: 8.3-10.9 months), of which five patients died. The median follow-up time of non-progressed patients (n=26) was 10.7 months. The most common adverse event was abnormal liver function (48.0%, 24/50). In the single factor analysis of Kaplan-Meier, younger or equal to 40 years old patients had a longer PFS (P=0.017), and the COX regression analysis (Enter method) also had statistical significance differences (HR=6.1, 95%CI: 1.4-27.5, P=0.018). However, gender (HR=0.8, 95%CI: 0.2-2.6, P=0.697), smoking history (HR=1.5, 95%CI: 0.4-5.6, P=0.524), pathology (HR=1.1, 95%CI: 0.3-4.2, P=0.922), tumor stage (HR=1.7, 95%CI: 0.4-8.4, P=0.502), epidermal growth factor receptor (EGFR) mutant type (HR=0.4, 95%CI: 0.4-4.3, P=0.461), EGFR unknown (HR=1.3, 95%CI: 0.3-6.1, P=0.727), Eastern Cooperative Oncology Group Performance Status (ECOG) PS score (HR=2.0, 95%CI: 0.6-6.8, P=0.290), the status of previous treatment (HR=0.6, 95%CI: 0.2-1.8, P=0.385) and brain metastasis (HR=0.7, 95%CI: 0.1-3.2, P=0.628) were not associated with disease progression. Conclusion Crizotinib has good efficacy and is safe and well-tolerated to advanced ALK-positive NSCLC patients, and age is the independent prognostic factor. Key words: Carcinoma, non-small-cell lung; Prognosis; Anaplastic lymphoma kinase; Crizotinib

Socio-demographic Factors and Puerperal Sepsis: Experiences from Two Tertiary Level Hospitals in Bangladesh

Introduction:Globally, puerperal sepsis is one of the leading causes of maternal mortality and morbidity. It is the 2nd leading cause of maternal deaths in Bangladesh. Objective:The study was designed to identify the common socio-economic and demographic factors related to puerperal sepsis presented at tertiary level hospitals in Bangladesh. Methodology:A case control study was conducted between April 2011 and December 2011 in two tertiary level hospitals (Dhaka Medical College Hospital and Sir Salimullah Medical Collage Hospital). 35 cases who met the criteria of WHO for puerperal sepsis was included in the study as the cases while 105 cases were selected from the same hospitals as control participants. Both cases and controls were between 15 to 40 years old. Frequency distributions and calculation of means, standard deviation and Odds Ratio were done. Chi-square test and logistic regression analysis was also performed to find out the association between independent and dependent variables. Results:Puerperal sepsis is significantly associated with the age

Influence of Chest Compressions on Circulation during the Peri-Cardiac Arrest Period in Porcine Models.

ObjectiveStarting chest compressions immediately after a defibrillation shock might be harmful, if the victim already had a return of spontaneous circulation (ROSC) and yet was still being subjected to external compressions at the same time. The objective of this study was to study the influence of chest compressions on circulation during the peri-cardiac arrest period.DesignProspective, randomized controlled study.SettingAnimal experimental center in Peking Union Medical Collage Hospital, Beijing, China.SubjectsHealthy 3-month-old male domestic pigs.Interventions44 pigs (28±2 kg) were randomly assigned to three groups: Group I (non-arrested with compressions) (n = 12); Group II (arrested with compressions only) (n = 12); Group III (ROSC after compressions and defibrillation) (n = 20). In Groups I and II, compressions were performed to a depth of 5cm (Ia and IIa, n = 6) or a depth of 3cm (Ib and IIb, n = 6) respectively, while in Group III, the animals which had just achieved ROSC (n = 18) were compressed to a depth of 5cm (IIIa, n = 6), a depth of 3cm (IIIb, n = 6), or had no compressions (IIIc, n = 6). Hemodynamic parameters were collected and analyzed.Measurements and FindingsHemodynamics were statistically different between Groups Ia and Ib when different depths of compressions were performed (p < 0.05). In Group II, compressions were beneficial and hemodynamics correlated with the depth of compressions (p < 0.05). In Group III, compressions that continued after ROSC produced a reduction in arterial pressure (p < 0.05).ConclusionsChest compressions might be detrimental to hemodynamics in the early post-ROSC stage. The deeper the compressions were, the better the effect on hemodynamics during cardiac arrest, but the worse the effect on hemodynamics after ROSC.

Anesthetic profile of patients undergoing lower limb surgeries

Local anesthetics are the commonest agents used for spinal anesthesia, but their relatively short duration of action may lead to early analgesic intervention in the postoperative period. The objective of the study was to study anesthetic profile of patients undergoing lower limb surgeries. Study was carried out at Narayana Medical Collage Hospital, Nellore from September 2012 to August 2014 among 50 patients undergoing lower limb surgeries. Patients aged 18-60 years, patients undergoing lower limb surgeries and consenting patients were included in the study. All patients were evaluated for history, physical examination and investigations. There is no statistically significant difference between the groups with regard to demographic data. The mean duration of surgery is higher in Group-A compared to Group - B. There is a significant difference between groups with regard to onset of sensory analgesia, with Group A having a rapid onset compared to B. There is significant difference between the groups in total duration of Sensory Analgesia with Group A having longer duration compared to Group B.

Pulse Oximetry: A Non-Invasive, Novel Marker for the Quality of Chest Compressions in Porcine Models of Cardiac Arrest.

ObjectivePulse oximetry, which noninvasively detects the blood flow of peripheral tissue, has achieved widespread clinical use. We have noticed that the better the quality of cardiopulmonary resuscitation (CPR), the better the appearance of pulse oximetry plethysmographic waveform (POP). We investigated whether the area under the curve (AUC) and/or the amplitude (Amp) of POP could be used to monitor the quality of CPR.DesignProspective, randomized controlled study.SettingAnimal experimental center in Peking Union Medical Collage Hospital, Beijing, China.SubjectsHealthy 3-month-old male domestic swine.Interventions34 local pigs were enrolled in this study. After 4 minutes of untreated ventricular fibrillation, animals were randomly assigned into two resuscitation groups: a “low quality” group (with a compression depth of 3cm) and a “high quality” group (with a depth of 5cm). All treatments between the two groups were identical except for the depth of chest compressions. Hemodynamic parameters [coronary perfusion pressure (CPP), partial pressure of end-tidal carbon dioxide (PETCO2)] as well as AUC and Amp of POP were all collected and analyzed.Measurements and FindingsThere were statistical differences between the “high quality” group and the “low quality” group in AUC, Amp, CPP and PETCO2 during CPR (P<0.05). AUC, Amp and CPP were positively correlated with PETCO2, respectively (P<0.01). There was no statistical difference between the heart rate calculated according to the POP (FCPR) and the frequency of mechanical CPR at the 3rd minute of CPR. The F CPR was lower than the frequency of mechanical CPR at the 6th and the 9th minute of CPR.ConclusionsBoth the AUC and Amp of POP correlated well with CPP and PETCO2 in animal models. The frequency of POP closely matched the CPR heart rate. AUC and Amp of POP might be potential noninvasive quality monitoring markers for CPR.

Study on Thyroid Dysfunction in Patients Attending Rama Medical Collage Hospital &amp; Research Centre, Kanpur (Uttar Pradesh)- A Hospital Based Study

Study on Thyroid Dysfunction in Patients Attending Rama Medical Collage Hospital &amp; Research Centre, Kanpur (Uttar Pradesh)- A Hospital Based Study

Gastroesophageal varices (bleeding) and splenomegaly: the initial manifestations of some pancreatic body and tail carcinoma.

Gastroesophageal varices (bleeding) and splenomegaly: the initial manifestations of some pancreatic body and tail carcinoma.

Potential clinical treatment for Ebola pandemic.

State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences; Department of Biochemistry and Molecular Biology, Peking Union Medical College, Tsinghua University; Beijing 100005, China; Department of Emergency Medicine, Peking Union Medical Collage Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China; Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China; Laboratory of Molecular Genetics of Aging & Tumor, Medical Faculty, Kunming University of Science and Technology, Chenggong Campus, Kunming 650500, China

Prevalence and aetiology of ocular hypertension in acute and chronic uveitis

AimsTo evaluate the prevalence and aetiology of intraocular hypertension (OHT) in granulomatous and non-granulomatous uveitisMethodsMedical records of 304 consecutive patients (484 eyes) with uveitis who visited the National Defense Medical...

Promoter methylation of DAPK1, RAR-β and MGMT in exfoliated cervical cytology and its clinical application

To assess the correlation of promoter methylation of DAPK1, RAR-β and MGMT with cervical lesions from cytology to histology, and to reveal the clinical value of DNA methylation in diagnosis of cervical intraepithelial neoplasia (CIN). A total of 103 random-selected cervical samples were collected from residual liquid-based cytology specimens after clinical use in cytopathological diagnosis in outpatient clinic of obstetrics and gynecology, Peking Union Medical Collage Hospital from March 2010 to October 2010. Informed consent was obtained from each woman before the initiation of the study. The methylation sensitive-high resolution melt (MS-HRM) assay was used to evaluate promoter methylation of three genes (DAPK1, RAR-β and MGMT) in 103 biopsy-confirmed liquid-based cervical cytology samples. Methylation levels and high-risk HPV DNA loading (HCII values) were analyzed in relation to both cytological and histological diagnosis. The methylation level of all three genes showed significant difference among the different cytological groups (P = 0.000, 0.011 and 0.002, respectively). The methylation level of DAPK1 and RAR-β showed significant difference among the different histological groups (P = 0.000 and 0.021), while there was no significant difference for MGMT. DAPK1 methylation levels was 1.47% in the CINII/high-grade precancerous lesions group, and 20.98% in the normal/CINI groups (P = 0.000), but there was no significant difference between CINII/high-grade precancerous lesions and normal/CINI groups for RAR-β and MGMT. The combination of DAPK1/HR-HPV loading showed a sensitivity of 0.825 and an area under the receiver operating characteristic curve (ROC) curve (AUC) of 0.695 as diagnostic methods for detecting CINII/high-grade precancerous lesions. DNA methylation such as DAPK1 and RAR-β, in combination with HR-HPV detection, may serve as biomarkers to detect CINII/high-grade precancerous lesions. Detection of methylated DNA from liquid-based cervical cytology specimens is technically feasible with the MS-HRM assay.