Narayana Medical College Hospital Research Articles

A Study to Assess the Knowledge Regarding Care of Unconscious Patients among Staff Nurses at NMCH, Nellore, Andhra Pradesh

<strong>Background:</strong> Nursing the unconscious patient can be a challenging experience. Unconscious patients have no control over themselves or their environment and thus are highly dependent on the nurse. The skills required to care for unconscious patients are not specific to critical care and theatres as unconscious patients are nursed in a variety of clinical settings. Nursing such patients can be a source of anxiety for nurses. <strong>Aim:</strong> The aim of the study was to assess the level of knowledge regarding care of unconscious patients among staff nurses. <strong>Objectives:</strong> 1. To determine the level of knowledge regarding physical examination among staff nurses. 2. To associate the level of knowledge with selected demographic variables. <strong>Methodology:</strong> 100 staff nurses working at Narayana Medical College Hospital were selected by using purposive sampling method.<strong> Results:</strong> Regarding the level of knowledge among staff nurses, 17 (17%) had adequate knowledge, 76(76%) had moderate knowledge and 7(7%) had inadequate knowledge regarding care of unconscious patients.

A study to assess the awareness regarding health care services available for antenatal mothers at Narayana medical college hospital, Nellore

A study to assess the awareness regarding health care services available for antenatal mothers at Narayana medical college hospital, Nellore

A study to assess the knowledge regarding standard safety precautions in labour ward among nursing students posted at Narayana medical college hospital, Nellore, Andhra Pradesh

A study to assess the knowledge regarding standard safety precautions in labour ward among nursing students posted at Narayana medical college hospital, Nellore, Andhra Pradesh

A study to assess the knowledge regarding emergency drugs among nurses in Narayana medical college hospital, Nellore

A study to assess the knowledge regarding emergency drugs among nurses in Narayana medical college hospital, Nellore

A study to assess the knowledge regarding fire accidents among nurses working at Narayana Medical College Hospital, Nellore, Andhra Pradesh

A study to assess the knowledge regarding fire accidents among nurses working at Narayana Medical College Hospital, Nellore, Andhra Pradesh

Analysis of emergency laboratory parameters of various poisonings in tertiary care teaching hospital

Aim: India is predominantly an agricultural country; pesticides and insecticides are abundantly used during cultivation. The adult mortality rate due to mixed drug poisoning in rural south India is 0.97/1000 persons/year. Only 70%–80% of patients admitted to hospitals survive. The present study is undertaken to identifying the association of laboratory parameters with different poisoning etiologies which may help in predicting the need for ventilator support to reduce the mortality by timely entry into emergency department (ED). Materials and Methods: A prospective study on the mixed poisoning of 964 cases was done in the ED at Narayana Medical College Hospital, Nellore, Andhra Pradesh, for 8 years (from 2009 to Jan 2016). Clinical and laboratory data were recorded for all patients on admission (time 0) and 24 h later (time 24). The severity of patients graded according to the Glasgow Coma Scale (GCS) classification. Results: Among 964 patients, in the present study, the majority of the patients in the study group were males, and higher age group affected was 40–50 years. Agricultural farmers and rural residents were highly consumed pesticides. In the study, ingestion poisoning 95% had common occurrences than inhalation poisoning 5%. In severity categorization, we observed that 28.4% of patients were in mild condition, 55.6% in moderate, and 16% in severe. Mean, GCS scoring system was statistically significant between time 0 and time 24 in the survivors. Low GCS at admission was vulnerable for ventilator support. Cholinesterase activity was measured significantly depressed in the Grade 1, 2, and 3. Conclusions: The present study concludes that the need for ventilatory support in organophosphoros poisoning was significantly more in patients who consumed chlorpyrifos methyl parathion compounds, airway edema secondary to hair dye poisoning, presence of cholinergic crisis, GCS score of

Study of clinical profile of meconium aspiration syndrome in relation to gestational age and birth weight and their immediate outcome at Narayana Medical College Hospital, Nellore, India

Background: Meconium staining of the amniotic fluid occurs in approximately 13% of live births; this percentage increases with increasing gestational age at delivery. MAS occurs in approximately 5% of infants born through MSAF. This study was undertaken to understand the factors causing MAS and clinical profile of meconium aspiration syndrome in relation to gestational age and birth weight and their immediate outcome.Methods: The present study is a prospective study of 58 neonates admitted to NICU fulfilling the criteria of MAS were included in the study over a period of 2 years. The babies who were born with meconium stained liquor, suctioning was done by the obstetricians first at the delivery of shoulder and then handed over to pediatrician and depending upon whether the meconium is present below the vocal cords or not and whether baby is vigorous or not, endotracheal intubation and bag and tube ventilation was given. The babies with clinical features MAS were admitted to NICU and were observed for their immediate outcome in the hospital.Results: During the study period, out of 4994 deliveries, 882 (17.6%) babies had meconium stained liquor and out of these 882 babies, 58 (6.5%) babies had MAS. Out of 426 cases of respiratory distress admitted to NICU, 58 (13.6%) cases diagnosed of MAS. MAS occurred most commonly in babies having fetal distress and in mothers with history of PIH. It is seen more commonly in babies born through caesarean section and in term babies with mean gestational age of 38-40 weeks of gestation and mean birth weight of 2.68 Kg. It was most commonly associated with babies who were depressed at birth and most common cause of mortality was due to birth asphyxia contributing 37.5% of cases of MAS.Conclusions: MAS is an entity which is commonly seen in term and post term babies with birth weight >2.5 Kg.

A Study to Assess the Knowledge Regarding Prevention of Anemia among Women’s in Narayana Medical College Hospital, Nellore

A Study to Assess the Knowledge Regarding Prevention of Anemia among Women’s in Narayana Medical College Hospital, Nellore

Study comparing the efficacy of platelet rich plasma versus steroid versus placebo in lateral epicondylitis

<p><strong>Background: </strong>Lateral epicondylitis is seen more commonly in non-athletes than athletes. Non-operative methods are the mainstay of treatment being effective in more than 95% of cases. Platelet rich plasma (PRP) has shown promising results in many studies as compared to steroid injection & other modes of conservative management. Hence, this study was done to evaluate PRP efficacy in our clinical setup and in the people of age group most commonly being affected.<strong></strong></p><p><strong>Methods: </strong>This randomized study was conducted at Narayana Medical College Hospital, Nellore, for a period of two years from December 2014 to June 2016 on 150 consenting patients diagnosed as suffering from lateral epicondylitis. Using lottery method for randomization the patients were divided into three groups, based on which the treatment was received. Group –N with 50 patients received 3 ml of normal saline as placebo. Group –P with 50 patients received 3 ml of extracted PRP injection. Group –S with 50 patients received depot preparation of 40 mg of methyl prednisiolone injected into the affected area. The data collected and recorded in the appropriate proforma. Post therapy assessment was done using with Oxford elbow score.</p><p><strong>Results: </strong>The overall mean ages of the patients in the three groups (Group P, Group S and Group N) are 38.62±7.53, 37.82±7.79 and 36.3±6.93 respectively. Female preponderance was observed in all the groups. Most common presenting complaint was elbow pain seen in 100% of cases. Most common side involved was the dominant side, right side involvement was seen in 136 cases and left side in 14 cases. The Oxford elbow score pre-treatment in all the groups was not statistically significant and the Oxford elbow score at the end of 12 weeks and 24 weeks treatment showed that PRP and steroid was better than normal saline in control of pain.<strong></strong></p><p><strong>Conclusion: </strong>Lateral epicondylitis or tennis elbow is a painful debilitating condition of elbow, which creates disturbance in functional activities. A single injection of PRP at the site of the elbow pain resulted in relief of pain in patients with longer duration as compared to local steroids to other conservative treatments.</p>

A prospective study to analyze the outcome of proximal humerus fracture managed with proximal humerus locking plate

<p><strong>Background:</strong> The incidence of proximal humerus fractures has increased in last few years due to changes in life style and increase in road traffic accidents. Hence, the challenge of the modern day treatment was to get accurate reductions anatomically, fast healing and early restoration of function. Proximal humerus locking plate revolutionized the treatment without compromising fracture union. The present study aimed to evaluate the functional and radiological outcome of proximal humerus fracture managed with proximal humerus locking plate.</p><p><strong>Methods:</strong> This prospective study was conducted at Narayana Medical College Hospital for a period of two years from December 2014 to June 2016. 30 cases of proximal humerus fractures in adults after meeting inclusion criteria were participated and treated surgically with proximal humerus locking plate technique. Consent form was taken from all the patients. The final functional outcome was assessed by radiography and DASH scoring system.</p><p><strong>Results:</strong> Proximal humerus fractures were found to have high incidence in the 40 to 45 age group which had 37% of the study population. Males predominated over females in our study. Ratio of males to female was 2:1. Right sided fractures are more in the present study in both the sexes. The most common mechanism of injury was fall on the outstretched hand from a standing height or less with minor trauma seen in 34% of patients. High energy trauma was more frequently involved in younger patients (30%). According to Neer’s classification two part fractures constituted the most common type 16 (54%) in this study. The collected data was analyzed using SPSS software version 23.0. A ‘p’ value less than 0.05 was considered significant.</p><strong>Conclusions:</strong> The proximal humerus locking plate method for proximal humerus fracture emerges to be safe, effective, reliable fixation with minimal complications.

Assess the knowledge regarding temporary contraceptive methods among reproductive age group of women in Narayana Medical College hospital; Nellore

Assess the knowledge regarding temporary contraceptive methods among reproductive age group of women in Narayana Medical College hospital; Nellore

Knowledge Regarding Care of Patients Undergoing Radiation Therapy among Staff Nurses And Nursing Students

Introduction: Radiation therapy is constituent of two words “radio” and “therapy”. Radio mean “rays of radium”, therapy means “curative treatment”. Radiation therapy means treatment by x-rays, by emission and propagation of energy through space through a material medium in the form of waves. Objectives: This study aimed to assess the level of knowledge regarding care of patient undergoing radiation therapy among staff nurses and nursing students. Materials & Methods: Quantitative research approach and descriptive design was used for the study, which was conducted in Narayana medical College Hospital, NELLORE, Andrapradesh. A total of 30 samples in those 15 staff nurses and 15 nursing students were studied, by non probability convenience sampling technique. Structured questionnaire was used to collect the data. Data was analyzed by using descriptive and inferential statistics. Percentage of categorical variables was computed. Results: The results reveal that with regard to level of knowledge among 30 samples, 2(13%) have adequate knowledge, 3(20%) have moderately adequate knowledge, 10(67%) have inadequate knowledge. Among nursing students, 6(40%) have adequate knowledge, 3(20%) have moderately adequate knowledge, 6(40%) has inadequate knowledge. Regarding the association between the level of knowledge regarding care of patients undergoing radiation therapy among staff nurses and nursing students with demographic variables. Total professional experience has significant association at α = 0.05 level. Other variables are non significant. Conclusion: The findings of study revealed that majority of staff nurses 10(67%) have inadequate knowledge, nursing students 6(40%) have adequate and inadequate knowledge.

Vitamin D Receptor fok I Gene Polymorphism in Angiographically Proven Coronary Artery Disease Subjects: Case - Control Study

Aims: Coronary artery disease (CAD) is multifactorial disease resulting from modifiable and non modifiable risk factors. Gene polymorphism is one of the non modifiable risk factors, which may contribute to disease susceptibility. Identifying genetic polymorphisms is essential for better understanding of pathophysiology and treatment strategies for a particular disease. The objective of our study was to evaluate the association of vitamin D receptor (VDR) fok I polymorphism with CAD. . Place and Duration of the Study: The study samples were collected at Narayana Medical College Hospital, Nellore and genetic analysis done at Sri Ramachandra University, Chennai, India, from Nov 2013 to June 2014. Materials and Methodology: The study included 40 angiographically proven CAD subjects as Original Research Article Sowjanya et al.; BJMMR, 8(7): 612-617, 2015; Article no.BJMMR.2015.487 613 cases and 40 normal healthy controls .VDR fok I polymorphism was analysed by PCR-RFLP method. Chi Square and odds ratio was used to find the association. Results: F allele frequency is 66.25% in CAD vs 52.5% in controls. There is no significant association of FF (p= 0.099), Ff (p= 0.851), ff (p= 0.138) with CAD. Conclusion: There is no significant association of VDR fok I polymorphism with CAD in south Indian population. According to our study F allele frequency is more in CAD than in controls.

MERS Outbreak: Is India Prepared?

Dr. CVM Naresh Kumar1*, P Sreenivasulu Reddy2 and K Ramalingam3 1Clinical Virology Lab, Central Clinical Laboratory, Narayana Super Speciality Hospital, Nellore, Andhra Pradesh, India 2Department of Microbiology, Narayana Medical College, Nellore, Andhra Pradesh, India 3Department of Biochemistry, Narayana Medical College and Super speciality Hospital, Nellore, Andhra Pradesh, India *Corresponding author: Dr. CVM Naresh Kumar, Clinical Virology Lab, Central Clinical Laboratory, Narayana Super Speciality Hospital, Nellore, Andhra Pradesh, India, Tel: +91 8106330817; E-mail: cvmnareshkumar@gmail.com Received date: Dec 01, 2015; Accepted date: Dec 3 2015; Published date: Dec 7, 2015

Unusual Cause of Bilateral Pleural Effusion.

Unusual Cause of Bilateral Pleural Effusion.

Study of the incidence, mechanism, various modes of presentation and factors responsible for the development of lens-induced glaucomas

Objectives: The present study undertaken to study the factors responsible for the development of lens-induced glaucomas (LIGs), factors, and various modes of presentation in LIGs. Methodology: A minimum of 50 cases of LIG were selected based on simple random sampling, who attended the Department of Narayana Medical College Hospital and were diagnosed with LIG. Based on the clinical findings, etiological diagnosis of LIG was made. Results: Out of the 50 cases, 34 cases (68%) were diagnosed as phacomorphic glaucoma, 12 cases (24%) were of phacolytic glaucoma, two each (4%) were lens-particle glaucoma and glaucoma secondary to subluxation/dislocation of lens. Conclusion: There was no influence of sex, religion, or occupation on the incidence or occurrence of LIGs. Majority of the patients had good vision in the other eye as a result of which they neglected the affected eye till they developed LIG leading to pain during the time of presentation. Hence, it is important to advice the patients regarding the early surgical treatment of cataract before they develop complications.

Community-Acquired Pseudomonas Ventriculitis Causing Shunt Malfunction in a Child

Department of Neurosurgery Narayana Medical College Hospital Chinthareddypalem, Nellore Andhra Pradesh, India [email protected] Department of Pediatrics Narayana Medical College Hospital Chinthareddypalem, Nellore Andhra Pradesh, India The authors have no funding or conflicts of interest to disclose.

Retained intraventricular shunt catheter: A rare cause of cerebrospinal fluid fistula

*Department of Neurosurgery, Narayana Medical College Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, IndiaReceived 17 April 2014; accepted 9 May 2014Dear Sir,A non-functioning intraventricular shunt catheter althoughbeing considered dormant has been shown rarely to act as asite of bacterial colonization, leading to a progressive chronicinfection and abscess formation.

A study to evaluate the effectiveness of biblio therapy on level of depression among patients with depression admitted in psychiatric ward, NMCH, Nellore.

Feelings and emotions are correlated to each other. The both are experienced in every one’s life .Depressed mood is not only a psychiatric disorder. It is a normal reaction to certain life events, a symptom of some medical conditions, and a side effect of some medical treatment. Depression is the common cold of mental disorders - most people will be affected by depression in their lives either directly or indirectly, through a friend or family member.This study aims to evaluate the effectiveness of biblio therapy on level of depression among patients with depression admitted in psychiatric ward at NMCH, Nellore.A quantitative research approach was used with a pre experimental- one group pre test post test design. The study was conducted in Narayana medical college hospital, Nellore, Andhra Pradesh. Sample are The patients with depression admitted in psychiatric ward. Non probability convenience sampling technique was adopted to conduct the study with the sample size 60. The study concluded that the biblio therapy was effective in decreasing the level of depression among depressive patients.

Incidence of kerato conjunctivo uveitis caused by traditional eye medications in a teaching hospital of Andhra Pradesh

Traditional eye medications (TEM) usage is still a common practice as most patients in India consult a traditional healer. Poverty, socio-cultural beliefs, poor health-seeking behavior, and lack of access to health facilities are reasons for the persistence of this practice. [1],[2] Fifty patients with kerato conjunctivo uveitis who used TEM, especially some leaf extract for 3 days, visited ophthalmology clinic, Narayana Medical College Hospital during June 2012. Ocular complications included purulent conjunctivitis in 25 subjects, keratitis in 15 subjects, corneal ulcer in 1 subject, and iridocyclitis in 9 subjects respectively. All patients' disease condition was reversed by the local application of steroid drops, topical antibiotics, anti-allergic drops, and artificial tears. The use of TEM is harmful, further leads to blindness. Proper health education to the public can reduce the prevalence of preventable blindness.