Shah Medical College Research Articles

A study on type of emergencies brought to C. U. Shah Medical College and Hospital by 108 and awareness regarding the services in the general population of Surendranagar, Gujarat

Background: Emergency response service (ERS) is associated with medical, police emergency and fire. In the Indian context, a much discussed and successful public-private partnership (PPP) model for ERS is the 108 emergency service being managed and operationalized by EMRI. The World Health Organization has projected that by 2020 road crashes will be a major killer in India. It is a well-accepted fact that a patient who receives basic care from trained professionals and transported to the nearest healthcare facility within 15-20 minutes of an emergency has the greatest chance of survival and terms like ‘The Golden Hour’ and the ‘Platinum Ten Minutes’ that imply the importance of it.Methods: A cross sectional study was carried out in Surendranagar district. Out of 10 talukas of district 4 talukas were selected randomly; out of them one village was selected from each taluka. 20 houses were selected randomly from each village; one adult male and one adult female from selected house were included for the study.Results: 100% respondents knew that 108 could be used for medical emergencies where as 3.57% and 6.43% of respondents, respectively, knew that it also could be used for police and fire type of emergencies. Awareness regarding ‘108’ services and literacy status of respondents showed statistically significant association.Conclusions: Although people were aware about ‘108’ service and had faith in the service, there is large gap in knowledge as to how and when to utilize it including police and fire emergencies.

Perforation peritonitis: a clinical study regarding etiology, clinical presentation and management strategies

Background: Generalized peritonitis as a result of gastrointestinal perforation is a common surgical emergency in India. The present study was conducted to understand the spectrum of perforation peritonitis in terms of etiology, clinical presentation, site of perforation, surgical treatment, postoperative complications, and mortality encountered at Shyam Shah Medical College and Sanjay Gandhi Memorial Hospital Rewa (M.P.) India.Methods: The study was a prospective observational study conducted from July 2018 to June 2019 in the Department of General Surgery, S. S. Medical College and Sanjay Gandhi Memorial Hospital Rewa (M.P.). A total of 280 patients with perforation peritonitis were included in the study and underwent exploratory laparotomy.Results: Out of 280 patients, there were 234 males (83.57%) and 46 females (16.43%). Most common affected age group was 21 to 30 years (19.64%). Doudenal perforation was the most common type (35%), which were mainly due to Acid peptic disease (48.92%) followed by Jejunal and Ileal perforations (34.95%). In our study, a variety of operative procedures were performed depending on the patients general condition, peritoneal contamination, site of perforation, gut viability, and surgeon’s decision. Wound infection was the most common complication (29.64%). Mortality rate was 7.5% (21 patients).Conclusions: Perforation is diagnosed on clinical grounds immediately as patient reaches emergency department, time lost due to delayed hospitalization affects the outcome of standard surgical procedure. Selection of appropriate surgical procedure and postoperative care is helpful in early and uneventful recovery.

Clinical profile of venrnal keratoconjunctivitis in a tertiary care hospital

Clinical profile of venrnal keratoconjunctivitis in a tertiary care hospital - IJCEO- Print ISSN No: - 2395-1443 Online ISSN No:- 2395-1451 Article DOI No:- 10.18231/j.ijceo.2019.117, Indian Journal of Clinical and Experimental Ophthalmology-Indian J Clin Exp Ophthalmol

A study of demographic profile of HIV positive patients attending ART centre SGMH Rewa, Madhya Pradesh

Background: Caused by Human Immuno-deficiency virus, leading the patient’s immune system vulnerable to various infections and neurological disorder, AIDS have transformed into a socioeconomic and developmental concern. With the increasing population of India, the HIV epidemic will soon be a major cause of concern. The objective of the present study was to observe the demographic profile of HIV positive patients attending ART Centre at the Department of Medicine at Sanjay Gandhi Memorial Hospital & Shyam Shah Medical College, Rewa (M.P.) in year 2012-2014. Material & Methods: This was a data-based study. In this study total 1224 cases of all age group were taken, these patients were registered in ART center in between Jan. 2010 to Dec.2012. A pre-formed questionnaire (proforma) was made to enquire about socio-demographic-economic variables. The patient and their spouse were interviewed, examined and investigated according to pre-designed proforma with special reference to their occupation, spouse HIV status and high-risk behaviour. Results: In this study total number of ART attendees (patients) were 1224 and out of these total patients, 7.27% (n=89) were children ( 15 years). Out of 89 children, 5.15% (n=63) were male and 2.12% (n=26) were female and out of 1135 adult patients, 53.26% (n=652) were male and 39.46% (n=483) were female. M/F ratio in children was 2.4/1 and M/F ratio in adult patients was 1.3/1. Conclusion: As the present study was done in rural area, where hygiene was poor and sanitation was bad and environment was dusty, that is why infectious complications were more common in the present study.

Evaluation of outcomes after management of metacarpal and phalangeal fractures of hand

Background: Fracture and dislocation of hand most frequently encounter in orthopaedics injuries fracture of phalanges and metacarpal are approximately 10% of all fracture of skeleton system phalangeal fracture comprise 46% of hand fractures, metacarpal fractures 38% and fifth metacarpal fracture 9.7%, distal phalangeal fractures are most commonly encounter fracture of the hand. The annual incidence of phalangeal fracture in hand is 1% in normal population. And these injuries account for between. 2% and 3% of all patient visiting in accident and emergency unit thumb and middle finger are most frequently injured because they extend most distally during work activity. Aim & Objectives: To evaluate the structural and functional outcomes and the results of operative and conservative management of metacarpal and phalangeal fractures of hand. Methods: The present study comprises of 62 patients of closed fractures of metacarpal and phalanx treated in the Department of Orthopaedic Surgery, Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital Rewa (M.P.) in a span of two years. Evaluation of outcomes after management of metacarpal and phalangeal fractures of hand was done. Results: We achieved 24 (85.7%) excellent and good results in conservative method for metacarpal fractures and 10 (83.33%) operative methods. In Phalangeal fractures 09 (90.0%) excellent and good results were achieved in conservative method and 10 (83.34%) in operative methods. Excellent and good grip strength was noted in 53 (85.33%) cases. Single digit involvement had better TAM then multiple digits involvement. Poor results were noted in metacarpal fractures in 04 (14%) in conservative series and 02 (16.0%) in operative series. Poor results were seen in phalangeal fractures in 01 (10%) in conservative series and 02 (16.66%) in operative series. Most common complication was finger stiffness in conservative method and pin site infection in operative methods. Conclusion: Both conservative and operative methods (surgical stabilization) for metacarpal and phalangeal fractures of hand gave good functional outcomes, depending on the fracture pattern for treatment option, single digit involvement are important determinants to achieve a better grade of total active range of motion.

Comparison of Lichtenstein versus laparoscopic total extra peritoneal method in inguinal hernia surgery: a retrospective study

Background: Inguinal hernias is known to be most common form of abdominal wall hernias and research studies suggested that 3 out of 4 patients of abdominal wall hernias are diagnosed with inguinal hernia. Inguinal hernioplasty is considered to be second most common general surgical operation worldwide and it accounts approximately 15% of all operations. This retrospective study is designed with aim that to compare open Lichtenstein hernia repair and laparoscopic totally extraperitoneal (TEP) hernia repair in patients with inguinal hernias. The result of the study helps to general surgeons to select the better method to treat inguinal hernias.Methods: This was a retrospective study which was carried out at General Surgery department, Dr. M.K. Shah Medical College and Research Centre, Ahmedabad. Total 100 patients’ data were included in the study that has fulfilled inclusion and exclusion criteria of the study.Results: In present study majority of the patients of both the group are in their 5th decade of their age. It was found that majority of the cases had right side hernia as compare to left side hernia. It was found that mean operative time for bilateral hernia is comparatively higher in Lichtenstein as compared to TEP.Conclusions: Lichtenstein procedure has less postoperative complications like abdominal distension, seroma and urinary infections. Laparoscopic TEP procedure is having less operative time particularly in bilateral hernia, less postoperative pain, early mobilization and early return to work.

Utility of automated hematology analyzer in diagnosis of malarial parasite

Introduction: Malaria is the most common infectious disease that affecting many people worldwide. Microscopic method is remain gold standard method for diagnosis but Hemazoin pigments produced by malaria are also scatter the laser light and producing abnormal scattergrams during CBC analysis & thus we have conducted this study to prove usefulness of 5-part automated hematology analyzer (LH-750) in presumptive diagnosis of malaria. Materials and Methods: This prospective study was done at pathology department of C.U. Shah Medical college & hospital, Surendranagar from November 2013 to April 2014. 2 ml of EDTA blood samples were collected and blood analysis was done on hematology analyzer (5-part LH – 750). Thick and thin blood films were prepared and stained with giemsa stain in all cases. Results: Among 100 positive cases out of 2710 samples, 63 cases were positive for plasmodium vivax and 37 cases were positive for plasmodium falciparum. Among 100 malaria positive cases, abnormal scattergram pattern was observed in 65 cases. In P.vivax group (n=63 cases), 50 cases showed abnormal scattergram out of 63 cases, having sensitivity of 79.36%. In P. falciparum group (n=37 cases), 15 cases showed abnormal scattergram out of 37 cases with having sensitivity of 40.54%. Various abnormalities found on WBC-DIFF scattergrams in patients of malaria were merging & graying of neutrophils & eosinophils clusters, prominent blue coded events below neutrophils clusters.(in RBC ghost region). Conclusion: Automated hematology analyzer is very important diagnostic tool for malaria with scattergram abnormalities are helpful in presumptive diagnosis of malaria. All such cases should be confirmed by gold standard method. Keywords: Malaria, Scattergram, Pseudo eosinophilia.

Study of serum lactate dehydrogenase level as diagnostic and prognostic indicator of megaloblastic anemia

Background: Megaloblastic anaemia is the hematologic manifestation of faulty proliferation of blood cell precursors. The present study was done to facilitate the diagnosis prior to performing any bone marrow aspirate by estimation of the value of serum LDH in the diagnosis of megaloblastic anaemia.Methods: The cases were selected from patients attended the OPD and admitted in Sanjay Gandhi Memorial Hospital & Gandhi Memorial Hospital, Shyam Shah Medical College, Rewa, Madhya Pradesh. Following investigations were then done to classify anaemia and to establish the diagnosis of megaloblastic anaemia like Haemoglobin estimation by cyanmethaemoglobin method, PCV, RBC count and absolute values, general blood picture, reticulocyte count, bone marrow examination and serum LDH estimation before and after treatment.Results: Of the 100 cases, 50 cases (50%) of the cases were microcytic hypochromic anaemia. 15 cases (15%) were normocytic normochromic anaemia; 35 cases (35%) were macrocytic anaemia on the basis of general blood picture and absolute values. The incidence of megaloblastic anaemia in Indian adults was 20%. Maximum number of cases (90%) of the cases had serum LDH level of more than 1000 U/L. Range of serum LDH level was 520 U/L to 4520 U/L. Thus, there was 2 to 20-fold of highest reference value (240 U/L at37 C) rise in serum LDH level in megaloblastic anaemia.Conclusions: Megaloblasatic anaemia is not uncommon in Indian adults and serum LDH levels provide an important means of diagnosis. It is a non-invasive procedure, safe, and does not require any expertise.

Ulna: A tool to estimate stature

Identity is utmost important in both civil and criminal cases. In many cases, manmade disaster or natural disaster, accidental cases and homicidal cases forensic experts collect evidences to fix identity of an unknown dead body. Forensic expert job become very difficult when dis-membranous or mutilated body or only a bone or a bundle of bones brought for post-mortem examination. Stature is one of the key factor for fixing identity of an individual. Many study have been conducted to formulate regression formula from different long bones for different groups of race, ethnic and regions. This study aims at formulate a regression formula to estimate stature from percutaneous length of ulna of native of Gujarat. This study was carried out in Department of Forensic Medicine, C. U. Shah Medical College, Surendranagar, Gujarat. Total 800 participants (400 male & 400 Female) were included in study. Their stature and percutaneous length of ulna were estimated with standard methods and manner. Results are analysed and studied. This study shows that there is highly significant in mean length of ulna and stature in both male and female participants (P Keywords: Ulna length, Stature, Identification.

A study of cervical pap smears in a tertiary care hospital of Ahmedabad, Gujarat, India

Background: Cervical cancer is the fourth leading cause of death in females worldwide. In India and other developing countries cervical cancer is the leading cause of morbidity and mortality. Repetitive cytological screening with Pap smear help to diagnose cervical cancer in pervasive stage. Aims and Objectives: To evaluate the use of Pap smear screening method for detection of precancerous lesions of cervix. To increase awareness about screening program among women.Materials and Methods: Study is carrying out by taking 487 Pap smear from patients attending gynecology OPD at Dr. M.K. Shah Medical College and Research Centre from January 2016 to March 2019. Smears were reported as per the 2014 Bethesda system. Results: Total 487 patients were screened. Out of 487, 194 were having normal cytology and 262 cases with inflammatory changes. 25 cases were unsatisfactory. 1 case of ASCUS, 2 cases of SCC and 1 case of HSIL, 1 case of LSIL were observed. Conclusion: Pap smear test is a very simple, safe, noninvasive, economical OPD based procedure to detect pervasive cervical epithelial lesions. Every women should undergo Pap test at least once in her life before the age of 45 years. Timely screening of pervasive lesion allows presentation from invasive cervical smear.

Effect of education and socio-economic status on parenting among pre-school and school going children

Background: Parenting is the process of promoting and supporting the physical, emotional, social and intellectual development of a child from infancy to adulthood. Parenting is a complex activity that includes much specific behavior that works individually or together to influence child’s outcomes.Methods: It is prospective observational study carried out in the Department of Pediatrics, Shyam Shah Medical College and associated Gandhi Memorial Hospital, Rewa, Madhya Pradesh, India during the period from July 2008 to June 2010. Parents were interviewed with predesigned proforma. Parenting was graded in to three grades (1, 2 and 3) according to the performance of parents in various aspects of parenting.Results: In this study, 60 parents had 155 children constituting 2.5 children per family and male to female ratio was 1.18:1. We observed that literate parents performed well in all aspects of parenting (i.e. behavioral, physical, emotional, mental, spiritual, nutritional), but illiterate parents could not score on these points especially in spiritual and nutritional aspects. 33% graduate parents fulfilled the criteria for grade 3 parenting in nutritional aspects, 55% intermediate passed parents in nutritional aspects were in grade 3, whereas there were more than 50% parents in behavioral, physical and emotional aspects who had education level up to primary class.Conclusions: Educational status of parents has a positive impact on almost all aspects of parenting and the educational status of mothers appeared to be even more influential. Socioeconomic status of parents and residential area have a great influence on all aspects of parenting.

Gender preference and its impact on families: a cross sectional study

Background: Despite tremendous economic progress made through liberalization and globalization, gender preference for children remains a major issue in any society throughout the globe. The aim of the study was to determine the gender preference for children and its impact on family among study population.Methods: A cross sectional study was carried out between October-2013 to December-2013 in the urban (Ratanpar) and rural (Khodu village) field practice area of C U Shah Medical College Surendranagar, Gujarat. Total 377 study participants were selected by using systematic random sampling. Data was collected using pre designed and pre tested questionnaire and analyzed using SPSS.Results: Out of total study population, about 78.8% were completed their family and 21.2% had desire for child in near future. Those who had completed their family, nearly two third of them were blessed with both male and female child (62%). Among those who had desire for child (n=80), about two fifth (41.2%) wished to have male child. At parity one, 52% had desire for only male child as next child and also strong preference for male child was observed at parity two and above among those having only female children.Conclusions: Study revealed that most of the couples wish to have at least one son in the family hence perception of parents towards desired gender of child to be born must be gravitated in favor of daughters.

Comparative study of efficacy of glycolic acid (50%) peel and lactic acid (92%) peel in the treatment of melasma

<p class="abstract"><strong>Background:</strong> Melasma is difficult to treat in Fitzpatrick skin type IV-VI and recurrence is a big problem.It causes emotional distress to the patient. There is paucity of controlled trials comparing efficacy of two chemical peels Glycolic acid (50%) Vs Lactic acid (92%) with Hydroquinone 2% cream in melasma treatment.Our goal was to determine efficacy and safety of these peels in melasma.</p><p class="abstract"><strong>Methods:</strong> A total 50 newly diagnosed patients of melasma were included in the study, over a duration of 1 year in department of Skin and V.D, M.P. Shah Medical college, Guru Gobindsingh Government Hospital, Jamnagar. All patients were advised daily application of Hydroquinone (2%) cream at night for priming. Patients were divided into two groups.Group1 had 2 weekly lactic acid (LA) peel, while Group 2 had 2weekly Glycolic acid (GA) peel with standard application method. Overall severity was assessed via the pre and post treatment melasma area and severity index (MASI) score. Evaluation for clinical improvement was done by graded score.<strong></strong></p><p class="abstract"><strong>Results:</strong> It was seen in study that at the end of 6 sittings, grade 4 improvement, that is reduction in MASI score by >60% was seen in 27.27% patients in GA peel while 22.72% in LA peel. Amongst the complication noted, in GA peel burning was most common (72.72%) followed by erythema (45.45%). In LA peel only 18.18% showed erythema.</p><p class="abstract"><strong>Conclusions:</strong> Lactic acid peel has almost equal efficacy to Glycolic acid peel, but LA peel has much lesser side effects, leads to increasing the patient compliance, hence making it new peeling agent of choice for treatment of melasma.</p>

Study of knowledge attitude and practice amongst interns, residents and para-medical staff regarding transmission and prevention of hepatitis-B of C. U. Shah Medical College and Hospital, Surendranagar

Background: Hepatitis B is global infectious diseases with estimated two billions of the world population have contracted the infection, of them there are 350 million with chronic infection. Hepatitis B disease may lead to state of chronic carrier, liver cirrhosis and failure or hepatocellular carcinoma.Methods: This was a cross-sectional study which involved 100 intern, 100 resident doctors, and 100 paramedical staff; data collection was performed by a suitable self-administered, close-ended questionnaire.Results: Medical staff members had better knowledge about hepatitis B than the paramedical staff in the study. More than 50% of the paramedical staff didn’t know the correct mode of hepatitis b transmission. Attitude towards vaccination was seen significantly high in interns and resident doctors, as more than 88% had taken hepatitis b vaccine as compared to only 57% from paramedical staff had taken vaccine. Only 55% of paramedical staff had strictly followed universal precautions which was statistically significant in medical and paramedical staff.Conclusions: This study highlights the dissimilarities in knowledge, attitude as well as practices amongst different categories of healthcare personnel regarding hepatitis B infection. The most distressing situation was of paramedical staff that was at the lowest strata in terms of both knowledge and practices and therefore was at highest risk of hepatitis B infection.

A study to assess the knowledge, attitude and practice regarding biomedical waste management among health care personnel of C. U. Shah Medical College and Hospital, Surendranagar

Background: Healthcare generates a large amount of healthcare waste, which is complex to manage because of its variety and potential to create health and safety hazards if improperly handled. Inadequate management of biomedical waste can be associated with risks to healthcare workers, patients, communities and their environment. The aims and objectives of the study were to assess the knowledge, attitude and practice of health care personnel in C. U. Shah Hospital, Surendranagar regarding Biomedical Waste Management (BMW).Methods: This hospital based cross-sectional study was conducted in C. U. Shah Medical College, Surendranagar from February 2017 to March 2017. The study consisted of 300 Health Care Workers as participants, which included 100 doctors, 100 resident doctors and 100 paramedical staff. The data was collected using a predesigned, semi structured questionnaire containing questions on KAP regarding bio-medical waste management.Results: The awareness regarding legislation and disposal of BMW as per color coded bags was found in 79% and 85% of the participants respectively. Only 54% of the respondents knew that BMW should not be stored beyond 48 hours and 91.7% participants are agreed that needle stick injury is a major concern. All the participants are following the practice of not recapping the used needle. 75% respondents disposed sharp materials in translucent bag.Conclusions: Knowledge regarding biomedical waste management among doctors is satisfactory as compared to other health care workers. This has led to the poor practice of biomedical waste handling and management, hence exposing themselves and the public in general to health and environment hazards.

Retrospective study of inguinal hernia repair without drainage

Background: A common method for treatment of inguinal hernia is surgical repair using prosthesis. Aim of this study is to evaluate that whether there is need for post-operative drainage of hernia wound or not and various complications of putting drain into hernia wound.Methods: A case study of 50 patients with predominant complain of inguinal swelling fulfilling the required selection criteria which were admitted in Guru Govind Singh Hospital, M P Shah Medical College, Jamnagar, during period of 2014 to 2016 are studied retrospectively. Drain were not put in any of the patient and findings were recorded.Results: It is found that most of patient recover well, only 8%of patients had wound infection and 2 patients having seroma.Conclusions: It reflects that there is no need to put drain routinely in inguinal hernia surgery.

A one year case control study on oxytocin use in labor and its effect on maternal: fetal outcomes

Background: Oxytocin is a drug commonly administered drug to a pregnant lady during labor, nowadays even without an indication, in the hope that the progress of labor can be improved and the need for cesarean delivery may be reduced. This study emphasizes the need for using safeguards like use of checklists before starting oxytocin augmentation, therefore ensuring its rational use to minimize maternal and neonatal complications when augmenting labor with oxytocin, including rigorous indications, use of minimal useful dose and careful efficacy evaluation.Methods: This is a retrospective, Case-Control, descriptive and analytical study. Study population included women delivering in labor room of Gandhi Memorial Hospital associated with Shyam Shah Medical College, Rewa, from July 2015 to June 2016, then after data were compiled and assessed in department of pharmacology G.R. Medical College, Gwalior.Results: Results show that the use of oxytocin in labor stimulation can be detrimental to both the mother and the newborn, since they indicate that the use of oxytocin is associated with increased cesarean section rates both in primiparous and multiparous. Furthermore, it was also observed, a significant association between stimulation with oxytocin and low Apgar scores at 1 and 5 minutes both, of the newborns.Conclusions: Therefore, it may conclude that stimulation with oxytocin should not be used without any indication, but only in very specific cases, in which its use is particularly necessary. These results provide to health professionals a better understanding of the effects of the use of oxytocin during labor, which can be useful for decision-making in clinical practice.

Study of outcomes of the proximal humerus fractures treated by various modalities

Introduction: The proximal humerus fracture is of great importance when it affects the young and middle age groups of the population as it leads to temporary disability and loss of working hours. Restoration of the function of the limb becomes the primary goal of its treatment. Principle of fixation is reconstruction of the articular surface, including the restoration of the anatomy, stable fixation, with minimal injury to the soft tissues preserving the vascular supply. The present study was conducted to analyze the occurrence, mechanism of injury and displacement of various types of proximal humerus fractures and further evaluate the functional outcome of different modalities of its management. Methods: The following study was conducted at C U Shah Medical College and Hospital, Surendranagar, Gujarat during the period of June 2012 to June 2014. Total 50 patients, 22 males and 28 females with proximal humerus fractures treated with different modalities were selected for the study and assessed by Constant and Murley scoring system with at least 1 year follow up. Results: The average age of patients was 55.6 years out of which 56% were female. Domestic fall was the most common mode of injury (64% patients). Two part surgical neck fractures (Neer’s) accounted maximum number of the patients (34%). All One parts and most of the two part fractures treated conservatively. Most of the three part fracture treated with Open reduction and proximal humerus anatomical locking plates. Most common complication was malunion whereas one patient had implant loosening as complication. The average constant score at final follow up for all conservatively treated patients was 75.69, for patients treated by close reduction and percutaneous K wire fixation was 82.79 and for patients treated by open reduction and internal fixation with anatomical locking plate was 73.6. Conclusion: Early Open Reduction and Internal fixation prevents complications like shoulder stiffness, malunion, and late osteoarthritis. Open reduction and rigid internal fixation with proximal humerus plates becomes the choice of treatment for young adults with displaced fractures, whereas fractures in old aged patients with osteoporosis gave good outcome with conservative modality of management. There is also a direct relationship between displaced proximal humerus fractures, fracture severity and eventual results.

Morphometric analysis of hard palate and its clinical importance

Abstract Background & aim: The study ofhard palate is important because of its role in speech articulation. The aim of the present study was to determine the palatine length, breadth and position of greater palatine foramen[GPF]. Material and Method : 50 dried, unsexed skulls from C U Shah Medical College, Surendranagar were studied. Palatine length, breadth & distance of Greater palatine foramen[GPF] to middle maxillary sutures[MMS] were measured with help of vernier caliper. Result : Mean palatine length and breadth were 47.10±3.34mm & 36.26±2.55mm respectively. The distance ofGPF from MMS was 16.55 mm & 16.57 mm on right and left side respectively. The palatine index showed that 68% of the skulls had narrow [Leptostaphyline ], 20% intermediate [Mesostaphyline] & 12% wide [Brachystaphyline] palates. Conclusions : These observations would be helpful for anatomists, anthropologists and also to surgeons for various surgical procedures on hard and soft palates.

Diagnostic Significance of Serum Ascites cholesterol to Differentiate Malignant and non Malignant Ascites

Background: Ascitic fluid usually forms slowly as a result of obstruction of proximal vascular systems (Venous, lymphatic). It may also form directly in response to disease involving the peritoneum. Differentiation between malignancy related and non-malignantascites is a challenge that is not always met satisfactorily. Both malignant and tuberculous ascites are exudative in nature with lymphocytic predominance and low Serum Ascitic Fluid Albumin Gradient values can not be differentiated easily form each other. Studies have shown that parameters like ascitic fluid cholesterol have been superior to the conventional method of ascitic fluid analysis in discriminating ascites caused by malignancy from others. Method: This study was conducted in the Department of Pathology, Shyam Shah Medical College, Rewa during the period from May 2009 to October 2011. The study comprised of 100 patients with different causes of ascites admitted to wards of S.G.M.H. Rewa. Result: Cases were divided in to 3 groups. Groups I consists of patents(39 male and 31 female) with ascites due to chronic liver disease and other non tubercular and non neoplastic diseases, Group II consists of 20 patients (4 male and 16 female) with ascites due to tuberculosis, Group III consists of 10 patients (4 male and 6 female) with ascites due to malignant diseases. Ascitic fluid cholesterol level was found to be 32.9571±7.1183mg%,0.05±9.047gm%, 74.1±16.1707mg% in Group I, Group II and Group III respectively. On comparing Group III with I and II values were found to be highly significant (p 0.05). The value of ascitic fluid cholesterol level found in Group III was comparatively higher (>54.5mg%) than Group I and Group II with an exception in one case, where we found a higher level of cholesterol. Conclusion: In our study we found a significant raised cholesterol level (74.1 ±16.1707mg%) well above the cut off value (54.5mg%) and it has got a good differentiating potential for determining malignant ascites from non-malignant ascites. DOI: 10.21276/APALM.1371