Tertiary Care Hospital Of Assam Research Articles

Unusual Dyslipidemia in Patients with Chronic Kidney Diseases.

Chronic Kidney Disease (CKD) is a major and globally increasing health problem in the general population arising from a spectrum of diseases. Majority of the patients die even before reaching End Stage Renal Disease (ESRD) due to cardiovascular complications which arise due to altered lipoprotein compositions. Present study was aimed at evaluating the serum lipid profile in CKD patients and to find the pattern of its alteration in both haemodialyzed and conservatively treated CKD patients. Seventy one randomly selected CKD patients attending a tertiary care hospital of Assam during one year of time frame (40 haemodialyzed and 31 conservatively treated) along with 50 apparently healthy controls were included in the study. Test for serum lipid profile, urea creatinine, FBS, PPBS, total protein and albumin were carried out in all the cases and controls. The results were analyzed and compared with the controls using Microsoft Excel software. Triglyceride Level (TGL) of CKD group 157.88±61.82, controls 96.98±37.52, Very Low Density Lipoprotein (VLDL) of CKD group 31.58±12.36, controls 19.39±7.50 was marginally elevated and High Density Lipoprotein (HDL) of CKD group 33.40±9.06, controls 45.95±10.35 was significantly reduced in the patient group as compared to the controls and the results were statistically highly significant with p-value<0.001. Total cholesterol (CKD group 128.2±53.57, controls 142.53±31.44) and LDL (CKD group 63.23±46.47, controls 77.35±26.81) were lower in the patient group as compared to the controls, however the difference was statistically not significant (p value 0.09 and 0.059 respectively). There was no statistically significant difference of lipid profile between hemodialyzed and conservatively treated CKD groups and there was no gender related variation of lipid profile too. Increased TGL and reduced HDL, rather than increased total cholesterol and increased LDL are responsible for the high incidence of cardiovascular complications in CKD patients. Hypolipidemic drugs and low fat diet may be helpful in impeding the progression of cardiovascular complications and decrease mortality and morbidity in those patients.

Thyroid Status in Patients with Dysfunctional Uterine Bleeding in a Tertiary Care Hospital of Assam

ABSTRACT Background Dysfunctional uterine bleeding (DUB) is a major form of abnormal uterine bleeding, seen in at least 10% of all new outpatient department patients. The thyroid gland is known to play an important role in maintaining a healthy menstrual cycle. Aims To assess the thyroid hormone status in apparently euthyroid patients with DUB and to correlate it with incidence of DUB. Materials and methods Fifty DUB patients were selected on the basis of clinical history, examination, and relevant investigations. Equal numbers of age-matched women with normal menstrual cycle were taken as controls. Thyroid hormones, viz., thyroid-stimulating hormone, total triiodothyronine and tetraiodothyronine, were estimated by radioimmunoassay. Statistical analysis of the data was performed by using Microsoft Excel software. Results The most common menstrual abnormality was menorrhagia (48%) followed by metrorrhagia and polymenorrhea (14% each). Hypothyroidism was more prevalent among cases (85.7%) as compared with controls (14.3%). In patients with menorrhagia, 33.3% of patients had hypothyroidism. Conclusion Hypothyroidism occurs in DUB patients commonly. There is a need for mandatory thyroid screening in all patients with menstrual irregularities to help in early detection of the cause and treatment of DUB patients to avoid surgery. How to cite this article Phukan JK, Saharia GK, Goswami R. Thyroid Status in Patients with Dysfunctional Uterine Bleeding in a Tertiary Care Hospital of Assam. Indian J Med Biochem 2016;20(1):11-15.

Utilization of antenatal care services and correlates of anaemia among pregnant women attending a tertiary care hospital in Assam, India

Background: Anaemia is one of the most commonly encountered medical disorders during pregnancy. As per NFHS-3 Assam 72% pregnant women are anaemic. Besides many adverse effects on mother and foetus, anaemia contributes significantly high maternal mortality. Early Antenatal booking and regular follow-up provides opportunities for delivering timely and essential interventions to the pregnant women. This study aims to explore the socio-demographic factors influencing the pattern of antenatal care services utilization and also to estimate the burden of anaemia in Assam. Methods: A cross-sectional hospital based study was carried out for three months, from November 2011 to February 2012 in Jorhat Medical College Hospital using a predesigned, pretested proforma. A total of 1845 women admitted in the postnatal ward were studied. Results: Only 9.51% were illiterate, 64.89% were primigravidae, 70.09% had no previous living issues. All were registered for ANC, of whom 57.62% were registered in the first trimester; 57.98% had adequate ANC; 65.97% received full course of IFA tablets. Adequate ANCs were availed in the younger age groups, the primigravidae and up to two living children. A total of 61.69% pregnant women were found to be anaemic; 46.80% mildly, 12.85% moderately and 2.03% severely anaemic. Most participants in 20-25 years age group (63.7%) and lower socio-economic class (62.63%) were found to be anaemic. Participants who registered for ANC after 12th week (83.4%), attended inadequate number of ANCs (70.06%), and failed to take IFA tablets (60%) were found anaemic. Conclusions: A total of 61.69% pregnant women were found to be anaemic. Early detection and effective management of anaemia in pregnancy can contribute substantially to reduction in maternal mortality.

A study on prescribing pattern of antihypertensives in adult patients attending in a tertiary care hospital of Assam, India

Background: Hypertension is one of the most common chronic medical problems prompting visits to health care providers. It has been estimated that hypertension accounts for 13% of deaths worldwide. The main objective of the present study was to assess the pattern of drug utilisation and to evaluate whether the prescribing patterns for anti-hypertensive in our institution is in adherence with JNC 8 guidelines for treatment of hypertension. Methods: A prospective, observational, non-interventional, hospital based study was carried out for the period of three months in an out-patient department. Adult patients of either sex who have been diagnosed with hypertension as per JNC-8 guidelines without co morbidities and patients receiving or prescribed with antihypertensive drugs were included. The analysis of the prescription frequency, proportion of the different antihypertensive classes of drugs as monotherapy as well as combination therapy was done. Results: The most common drug classes involved in the study was angiotension II receptor antagonists followed by calcium channel blocker. The most common anti-hypertensive fixed dose combination therapy involved in the study was angiotensin II receptor antagonist+thiazide diuretic. 67% of the cases received monotherapy whereas remaining 33% received combination therapy. Conclusions: Our study shows that the most commonly prescribed drug classes involved were angiotensin II receptor antagonists followed by calcium channel blocker and the anti-hypertensive drug combinations among hypertensive patients were considerable and this practice positively impacted on the overall blood pressure control.

Study of mullerian duct anomalies using magnetic resonance imaging technique in a tertiary care hospital of Assam

Background: Mullerian duct anomalies (MDA) consist of a set of structural malformations resulting from abnormal development of the paramesonephric or Mullerian ducts. Mullerian duct is the embryonic structure that develops into the female reproductive tract, including the oviduct, uterus, cervix and upper vagina. The most widely accepted classification system of different mullerian anomalies was established by the American Fertility Society in 1988. This classification chart divides anomalies into seven classes: class I to class VII. Aim: Magnetic Resonance Imaging (MRI) study of the mullerian duct anomalies with different age groups, religions, different classes established by American Fertility Society and associated other anomalies. Materials and Methods: Patients with positive history coming to Radiology Department of Guwahati Medical College and Hospital, Guwahati were included in the study. After preliminary suspected ultrasonography (USG), MRI was done for all the cases. Results: 31 cases of mullerian duct anomalies were included in the study and out of which 70.97% were of class I and 9.67% were of class II and IV mullerian duct anomalies. 48.39% of the cases of mullerian duct anomalies were in age group of 15 years to less than 20 years. 27.27% cases of class I mullerian duct anomaly were associated with other anomalies like renal agenesis, ectopic kidney and ectopic ovary. Conclusion: Class I MDA is found to be most common variety; 15-20 years of age are commonly affected group and Renal anomalies are the commonly associated anomaly. Keywords: Mullerian duct, Paramesonephric duct, Anomaly

Drug resistance in Enterococcus species in a tertiary level hospital in Assam, India

Drug resistance in Enterococcus species in a tertiary level hospital in Assam, India

A Bacteriological and Mycological Study of Cases of Corneal Ulcer in a Tertiary Care Hospital of Assam with Reference to Antimicrobial Susceptibility

A Bacteriological and Mycological Study of Cases of Corneal Ulcer in a Tertiary Care Hospital of Assam with Reference to Antimicrobial Susceptibility

Evaluation of Serum Zinc Status and Glycated Hemoglobin of Type 2 Diabetes Mellitus Patients in a Tertiary Care Hospital of Assam

The present study was undertaken to find out any correlation between serum zinc concentration and HbA1C% in patients with type 2 diabetes mellitus (DM). The study was carried out on 50 newly diagnosed patients of type 2 diabetes and controls in the Department of Biochemistry, Assam Medical College and Hospital, Dibrugarh. Analyses of blood glucose (fasting and postprandial), glycated hemoglobin (HbA1c), serum zinc, urea, and creatinine concentrations were performed by standard methods. Concentrations of fasting and postprandial blood glucose were significantly higher in the diabetic group than controls (P < 0.001) and the mean HbA1c% was also higher in cases (8.32% ±1.58%). The mean serum zinc concentration in cases was found to be significantly lower than controls (79.85 ± 13.4 vs. 109.74 ± 9.72 μg/dL) and P < 0.001 with correlation coefficient r = –0.804. Present study revealed an inverse relationship between HbA1C% and serum zinc concentration in patients with type 2 DM, substantiated by regression analysis.

The prevalence of nasal carriage of Staphylococcus aureus among healthcare workers at a tertiary care hospital in assam with special reference to MRSA.

The recent years have witnessed the increasing resistance of Staphylococcus aureus to many antimicrobial agents. The most notable example is the emergence of Methicillin-resistant Staphylococcus aureus (MRSA), which was reported just one year after the launch of methicillin. The ecological niches of the S. aureus strains are the anterior nares. The identification of Staphylococcus aureus by using a proper antibiogram and the detection of methicillin resistant Staphylococcus aureus greatly contribute towards the effective treatment of the patients. To isolate Staphylococcus aureus from the nasal swabs of healthcare workers (HCWs) and to study their antimicrobial susceptibility patterns, which include methicillin resistance. Nasal swabs were collected from the healthcare workers of various clinical departments of the hospital over a period of one year. The isolation of Staphylococcus aureus and their antimicrobial susceptibility patterns were carried out by standard bacteriological procedures. Staphylococcus aureus was isolated in 70 cases (22.22%). The prevalence of the S.aureus nasal carriage was higher among the male HCWs (54.28%) than among the female HCWs (45.71%). The carriage rate was the highest in the orthopaedics department, followed by those in the surgery and the gynaecology departments. All the Staphylococcus aureus isolates were sensitive to vancomycin and linezolid (100%). Penicillin and ampicillin were the most resistant, (90% and 88.6%) respectively. Methicillin resistance was seen in11.43% of the S.aureus isolates, both by the disc diffusion test and by the Oxacillin Resistance Screen Agar (ORSA) test. The compliance with the sanitary and the antibacterial guidelines of the health professionals is the single most important factor in preventing nosocomial infections. Simple preventive measures like hand washing before and after the patient examination, the use of sterile aprons and masks in the postoperative wards, awareness during the examination of the immunocompromised patients, and avoiding touching one's nose during work, can reduce the disease transmission rate considerably.