International Journal of Medicine & Health Research (IJMHR) (ISSN 2395-3586)
International Journal of Medicine & Health Research, IJMHR (ISSN 2395-3586) is a peer-reviewed Indexed Journal. It publishes various categories of manuscripts in the areas of Medicine, Surgery, Dental Medicine, Nursing, Paramedical Sciences, Pharmacy, Drug Discovery, Public Health, Environmental health, Global Health, Policy, Translational Medicine, Evidence-Based Alternative Medicine, Food & Nutrition, Sports Medicine, Ayush medicines and all other relevant areas. Young authors including early career scientists, assistant professors, post-doctoral fellows, Ph.D., D.M., M.S. & M.D. students are highly encouraged to share their ideas about the latest topics in their scientific expertise.
The Association Between the Serum Sodium Level & Severity of Complications of Chronic Liver Disease - A Hospital-Based Observational Study
Introduction: Chronic liver disease (CLD) leads to cirrhosis and complications like ascites and encephalopathy. Hyponatremia, often resulting from impaired solute-free water clearance, is common in these patients. This study evaluates the association between serum sodium levels and the severity of complications in CLD. Aims & Objective: To evaluate the association between serum sodium levels and the severity of complications in CLD, establish hyponatremia as a prognostic marker, identify complications at different sodium levels, and estimate short-term survival rates. Materials & Methods: This hospital-based observational study was conducted at Tezpur Medical College and Hospital over one year (2024-2025) on 278 patients with liver cirrhosis. Diagnosis was confirmed by ultrasonography. Serum sodium levels were correlated with complications, severity scores (Child-Pugh, MELD), 28-day morbidity, and mortality using appropriate statistical tests. Results: A strong, statistically significant association was observed between lower serum sodium levels and increased severity of complications (p<0.001). Patients with sodium <130 mEq/L had the highest rates of severe complications (43%), Child-Pugh Class C (100%), and higher mean MELD scores (26.72±4.38). Hyponatremia was significantly associated with ascites, hepatorenal syndrome, variceal bleeding, SBP, and higher grades of hepatic encephalopathy (p<0.001 for all). Strong negative correlations were found between sodium and both the Child-Pugh (r = -0.84) and MELD (r = -0.81) scores. Twenty-eight-day morbidity (100%) and mortality (24%) were highest in the <130 mEq/L group. ROC analysis identified a serum sodium cut-off of 131.5 mEq/L for predicting 28-day mortality (AUC 0.67). Conclusion: Serum sodium is a simple, valuable prognostic marker in CLD. Hyponatremia is strongly associated with more severe complications, advanced liver disease, and higher short-term morbidity and mortality.
Chronic liver disease, Hyponatremia, Cirrhosis, Prognosis, MELD score, Child-Pugh score
Copyright (c) 2026 International Journal of Medicine & Health Research (IJMHR) (ISSN 2395-3586)
Utility of Revised Atlanta Classification using CT & BISAP Clinical Scoring System in Determining Severity of Acute Pancreatitis & Prediction of Clinical Outcome
Introduction: Acute pancreatitis ranges from mild disease to life-threatening complications. This study evaluates the Revised Atlanta CT classification and BISAP score, individually and combined, for predicting disease severity and clinical outcomes. Aim & Objective: To determine the value of the Revised Atlanta classification and the BISAP scoring system in predicting the severity and clinical outcome of acute pancreatitis, and to assess whether their combination improves predictive ability. Materials & Methods: A prospective observational study was conducted from May 2024 to November 2025 at Ramaiah Medical College hospitals, including 49 patients with first-episode acute pancreatitis who underwent CECT abdomen. Patients were classified according to the Revised Atlanta criteria and the BISAP scoring system. Clinical outcomes, including organ failure, infection, intervention requirement, duration of hospital stay, and mortality, were recorded and analyzed. Results: The cohort predominantly comprised males (79.6%) in the 40-60 years age group. Interstitial edematous pancreatitis (IEP) was the most common CT finding (57.1%). According to the Revised Atlanta classification, 59.2% had mild, 36.7% moderately severe, and 4.1% severe acute pancreatitis. A BISAP score ≥3 was seen in 6.1% patients. Significant associations were observed between severity grade and BISAP score (p<0.001), duration of stay (p<0.001), organ failure (p<0.001), and infection (p<0.001). Patients with BISAP ≥3 had significantly longer hospital stay (10.7 vs 7.0 days, p=0.042). Mortality rate was 0%. Conclusion: Both the Revised Atlanta CT classification and the BISAP scoring system effectively predict severity and clinical outcomes in acute pancreatitis. Their combination provides a comprehensive assessment, with BISAP identifying patients at risk for prolonged stay and organ failure, while the Revised Atlanta classification accurately grades morphological severity.
Acute Pancreatitis, Revised Atlanta Classification, BISAP Score, Severity Assessment
Association of Amount of Fatty Infiltration between Full-Thickness Tear & No Tear of Supraspinatus Tendon According to Goutallier Grading System: A Magnetic Resonance Imaging-Based Study in a Tertiary Care Hospital In Central Kerala
Introduction: Fatty infiltration of rotator cuff muscles is a key prognostic factor affecting surgical outcomes in supraspinatus tendon tears. Its severity, commonly assessed using the Goutallier grading system, plays an important role in determining tendon healing potential and functional recovery. Aim & Objective: This study aimed to evaluate the association between fatty infiltration and full-thickness supraspinatus tendon tears, assess tendon retraction using the Patte classification, and examine the relationship between retraction severity and fatty infiltration. Materials & Methods: A cross-sectional study was conducted on 60 patients undergoing shoulder MRI at a tertiary care center in Kerala. The study population included 30 patients with full-thickness supraspinatus tears and 30 without tears. Fatty infiltration was graded from 0 to 4 using the Goutallier classification, while tendon retraction was categorized into Patte grades I–III. Statistical analysis was performed using SPSS version 25. Results: Patients with full-thickness tears were significantly older compared to those without tears (mean age 60.83 vs. 52.53 years, p<0.001). Higher grades of fatty infiltration (Goutallier grades 3 and 4) were observed exclusively in the tear group (p<0.001). A significant difference in muscle atrophy severity was also noted between the two groups (p<0.001). Tendon retraction showed a strong positive correlation with Patte grading (ρ=0.71, p<0.001). However, no significant correlation was found between fatty infiltration grade and retraction distance (ρ=0.22, p=0.241). Conclusion: Full-thickness supraspinatus tears are strongly associated with increased fatty infiltration and muscle atrophy. Preoperative MRI evaluation using Goutallier and Patte classifications is crucial for surgical planning and outcome prediction.
Supraspinatus tear, Fatty infiltration, Goutallier grading, MRI shoulder, Rotator cuff, Tendon retraction.
The Scars of Syringes: A Case Report on Tramadol Dependence & Injection Site Complications
Introduction: Tramadol, a synthetic opioid analgesic, is widely used for moderate to severe pain. Although opioid dependence affects about 2% of the global population, its use in India is reportedly three times higher than the global average. Easy accessibility through over-the-counter sale, online sources, and illicit channels contributes to widespread misuse. Despite their therapeutic value, opioids are associated with significant adverse effects, including dependence, organ damage, and even death. Injection-related complications are rarely reported but can be severe. Aim & Objective: This case report aims to highlight a rare but serious complication of tramadol dependence ulceration at injection sites and to emphasize the need for strict monitoring and rational opioid prescribing practices. Case Presentation: A 48-year-old male farmer with uncontrolled diabetes and low socioeconomic status developed tramadol dependence after receiving it for chronic pain. He escalated self-administration from 1–2 to 8 ampules daily, also misusing chlorpheniramine maleate tablets to enhance effects. He presented with multiple infected, tender, indurated ulcers on both thighs and legs at injection sites. Laboratory findings showed leukocytosis and hyperglycemia. Result: The patient was managed with insulin therapy, appropriate antibiotics, and opioid substitution therapy using buprenorphine–naloxone. Significant clinical improvement and wound healing were observed over a two-month follow-up period. Conclusion: This case highlights the risk of opioid dependence and severe injection-related complications. It underscores the need for improved pain management training, early identification of substance misuse, and stricter regulatory control over opioid distribution and monitoring systems to prevent abuse.
Opioids, Tramadol, Dependence, Ulceration, Diabetes
Isoniazid-Induced Psychosis & Peripheral Neuropathy in a Middle-Aged Male with Pulmonary Tuberculosis: A Rare Case Report
Introduction: Isoniazid (INH) is a first-line antitubercular drug widely used in the treatment of tuberculosis. Although generally safe and effective, it may rarely cause neuropsychiatric adverse effects, including psychosis and peripheral neuropathy. The concurrent occurrence of both complications in a single patient is uncommon and may result in substantial psychological distress and functional impairment if not identified promptly. Aim & Objective: To highlight the rare occurrence of isoniazid-induced psychosis and peripheral neuropathy in the same patient and emphasize the importance of early recognition and multidisciplinary management of these adverse drug reactions. Case Presentation: A 53-year-old male receiving antitubercular therapy for pulmonary tuberculosis developed paranoid delusions, auditory hallucinations, agitation, and somatic preoccupation within two months of treatment initiation. Following completion of therapy, psychotic symptoms resolved spontaneously. Subsequently, he experienced persistent tingling, numbness, burning sensations in the limbs, sleep disturbances, and marked impairment in daily functioning. Due to severe psychological distress and persistent neuropathic symptoms, he attempted suicide on three occasions. Neurological examination revealed sensory deficits involving fine touch sensation. Routine laboratory investigations were largely normal except for vitamin D insufficiency, while MRI brain showed insignificant chronic small-vessel ischemic changes. Result: Based on the temporal association with antitubercular therapy, a diagnosis of isoniazid-induced psychosis (in remission) with peripheral neuropathy was made. Treatment with pyridoxine, vitamin B12, GABAergic agents, selective serotonin reuptake inhibitors, benzodiazepines, vitamin D supplementation, and transcutaneous electrical nerve stimulation (TENS) resulted in significant clinical improvement within one month. Conclusion: Early recognition and comprehensive management of isoniazid-related neuropsychiatric complications are essential to reduce morbidity, improve quality of life, and optimize treatment outcomes in patients receiving antitubercular therapy.
Isoniazid; Psychosis; Peripheral neuropathy; Tuberculosis; Pyridoxine deficiency; Antitubercular therapy; Neuropsychiatric adverse effects
Impact of Haemodialysis on Lipid Profile in Diabetic & Non-Diabetic Patients with End Stage Renal Disease
Introduction: End-Stage Renal Disease (ESRD) is associated with dyslipidaemia, contributing to increased cardiovascular morbidity and mortality. Lipid abnormalities often persist despite haemodialysis and are more pronounced in diabetic ESRD patients, further elevating cardiovascular risk. Aim & objective: The present study aimed to evaluate the impact of haemodialysis on lipid profiles among diabetic and non-diabetic ESRD patients. Material & Methods: This prospective cohort study was conducted in the Department of General Medicine at IGESIC Hospital, Jhilmil, Delhi, from August 2023 to December 2024. A total of 180 ESRD patients undergoing haemodialysis were included, comprising 90 diabetic and 90 non-diabetic patients. Patients aged above 18 years and receiving haemodialysis for at least three months were enrolled. Lipid profile parameters, including total cholesterol, LDL, HDL, and triglycerides, were assessed before and after dialysis. Statistical analysis was performed using paired and independent t-tests, with p<0.05 considered statistically significant. Results: Diabetic patients demonstrated higher pre-dialysis lipid levels compared to non-diabetic patients. Following haemodialysis, both groups showed reductions in total cholesterol, LDL, and triglycerides, along with slight increases in HDL levels. In diabetic patients, total cholesterol reduced from 220 mg/dL to 200 mg/dL, while triglycerides decreased from 200 mg/dL to 170 mg/dL. Similar improvements were observed in non-diabetic patients. Statistical analysis confirmed significant differences between pre- and post-dialysis lipid profiles (p<0.05). Conclusion: Haemodialysis significantly improves lipid profile parameters in ESRD patients; however, diabetic patients continue to exhibit comparatively poorer lipid profiles than non-diabetic patients. Regular lipid monitoring and appropriate therapeutic interventions are essential to reduce cardiovascular complications in ESRD patients undergoing haemodialysis.
End-Stage Renal Disease, Haemodialysis, Dyslipidaemia, Diabetes Mellitus, Lipid Profile
Dermoscopic Study of Palmoplantar Dermatoses in a Tertiary Care Centre
Introduction: Dermoscopy is a non-invasive diagnostic tool that enhances visualization of subsurface skin structures not visible to the naked eye. It improves diagnostic accuracy in dermatology, particularly in palmoplantar dermatoses, where clinical features are often atypical due to unique anatomical characteristics. Dermoscopy helps identify vascular patterns, scaling, adnexal changes, and disease-specific features, thereby supporting a systematic diagnostic approach and reducing unnecessary biopsies. Aim & Objective: To evaluate various palmoplantar dermatoses using dermoscopy in a tertiary care center, to classify these conditions based on their dermoscopic features, and to provide an updated overview of the dermoscopic patterns seen in common palmoplantar dermatoses. Materials & Methods: This 18-month descriptive observational study was conducted in the Department of Dermatology, Venereology and Leprosy at F.H. Medical College, Agra. Patients with clinically diagnosed palmoplantar dermatoses were included after informed consent. Detailed history, clinical examination, and dermoscopic evaluation using a handheld dermatoscope were performed. Dermoscopic parameters such as vascular patterns, scaling, follicular changes, and specific diagnostic clues were assessed and correlated with clinical diagnoses. Results: The study included patients aged 3 to 73 years. Dermoscopy revealed distinct and reproducible patterns across various palmoplantar dermatoses, aiding differentiation of clinically similar conditions. It improved diagnostic confidence and reduced the need for invasive procedures while assisting in biopsy site selection and treatment monitoring. Conclusion: Dermoscopy is a valuable adjunct in the evaluation of palmoplantar dermatoses, improving diagnostic accuracy, guiding biopsy decisions, and monitoring therapeutic response when correlated with clinical findings.
Dermoscopy, Palmoplantar dermatoses, Non-invasive diagnosis, Dermatology, Vascular patterns
Effectiveness of the “Arogya Ki Aur” Community based & Convergence-Driven Intervention to Improve Immunization Coverage in Tribal Areas: an Implementation Study from Central India
Introduction: Achieving equitable immunization coverage in tribal and hard-to-reach populations remains a major public health challenge in India. Conventional service delivery models often fail to address last-mile barriers, including geographic inaccessibility, socio-cultural resistance, and weak beneficiary tracking. Aim & Objectives: To evaluate the effectiveness of the “Arogya Ki Aur” model, a community-based and convergence-driven intervention, in improving immunization coverage in tribal areas of central India. Materials & Methods: A quasi-experimental pre–post implementation study was conducted across 124 low-immunization villages in Betul district, Madhya Pradesh, including 16 high-priority villages. A total of 1,045 children aged 0–5 years were assessed. The intervention integrated three components: SHG-led Arogya Sakhi tracking, Health–Forest Department convergence for improved access, and Udaan tribal counsellors for behavior change communication. Data were collected through household surveys, U-WIN, and HMIS records. Changes in coverage were analyzed using Chi-square tests, with effect sizes and 95% confidence intervals estimated. Results: Full immunization coverage increased significantly from 62.7% to 81.6% (absolute increase: 18.9%; 95% CI: 15.2–22.6; p<0.001). Dropout rates declined from 18.5% to 7.2%, and left-out children reduced from 11.9% to 6.1%. Greater improvements were observed in high-priority (+25.6%) and remote villages (+25.8%) compared to other areas. Equity gaps between remote and accessible populations reduced by 10.9 percentage points. The intervention demonstrated a relative coverage increase of 30.1% and a number needed to treat of approximately five. Conclusion: The Arogya Ki Aur model is an effective, scalable, and community-driven approach that improves immunization coverage and reduces inequities in underserved populations. Its integrated design offers a replicable framework for strengthening last-mile immunization delivery in similar settings.
Immunization coverage, Tribal health, Vaccine hesitancy, Community participation, Health systems strengthening
Efficacy of Platelet Rich Plasma vs Corticosteroid Injection in Chronic Plantar Fasciitis - A Comparative Study
Introduction: Chronic plantar fasciitis is a prevalent and often disabling condition characterized by persistent heel pain, significantly affecting daily activities and quality of life. It commonly results from repetitive strain and microtears of the plantar fascia. Corticosteroid injections have long been used as a conventional treatment due to their anti-inflammatory effects. However, platelet-rich plasma (PRP) therapy has recently gained attention as a regenerative approach that may promote tissue healing rather than merely reducing inflammation. Aims & Objectives: The primary aim of this study was to compare the effectiveness of PRP injections and corticosteroid injections in patients suffering from chronic plantar fasciitis. Outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score to assess functional improvement and the Visual Analog Scale (VAS) to measure pain intensity. Materials & Methods: This comparative study included 50 patients diagnosed with chronic plantar fasciitis. Participants were randomly divided into two groups: one group received three PRP injections (n=25), while the other received corticosteroid injections (n=25). Clinical outcomes were measured at baseline, 1 month, and 3 months post-treatment using AOFAS and VAS scoring systems. Results: Both treatment groups showed significant improvement from baseline values. At 1 month, the corticosteroid group demonstrated superior outcomes, with higher AOFAS scores and lower VAS scores compared to the PRP group. This trend continued at 3 months, with corticosteroid-treated patients maintaining better functional and pain scores. All observed differences at follow-up intervals were statistically significant (p<0.05). Conclusion: Corticosteroid injections provided significantly greater short-term benefits in reducing pain and improving function compared to PRP injections in patients with chronic plantar fasciitis.
Plantar Fasciitis, Platelet-Rich Plasma, Corticosteroid, Injection, AOFAS Score
Obstetric Outcomes & Its Association with First Trimester Glycosylated Haemoglobin In A Teritiary Care Centre In South Kerala
Introduction: The prevalence of abnormal glucose metabolism among women in Kerala is increasing steadily, posing significant concerns for maternal and the fetal health. Early maternal hyperglycemia has been associated with adverse obstetric outcomes and long-term metabolic risks in offspring. However, routine screening for Gestational Diabetes Mellitus (GDM) is typically performed later in pregnancy, potentially missing early risk indicators. First-trimester HbA1c has emerged as a promising early marker for identifying women at higher risk. Aims & Objective: This study aimed to determine the association between first-trimester glycosylated haemoglobin (HbA1c) levels and obstetric outcomes in women delivering at a tertiary care centre in Southern Kerala. Materials & Methods: A retrospective cohort study was conducted among 664 postpartum women at Pushpagiri Medical College Hospital. Participants were equally divided into two groups based on first-trimester HbA1c levels: <5.9% and ≥5.9%. Data regarding sociodemographic characteristics, clinical history, laboratory investigations, and obstetric outcomes were collected from medical records. Statistical analysis was performed using SPSS version 25, applying chi-square tests for categorical variables, independent t-tests for continuous variables, and calculation of relative risks. A p-value of less than 0.05 was considered statistically significant. Results: Women with HbA1c ≥5.9% showed significantly higher rates of GDM, gestational hypertension, earlier deliveries, increased likelihood of LSCS, adverse perinatal outcomes, and higher mean birth weight compared to those with lower HbA1c levels. No significant differences were observed in maternal age, pre-pregnancy BMI, or obstetric history. Conclusion: The elevated first-trimester HbA1c is strongly associated with adverse maternal and neonatal outcomes, supporting its role as an effective early screening tool for identifying high-risk pregnancies.
First-trimester HbA1c, Gestational Diabetes Mellitus, Obstetric Outcomes, Perinatal Outcomes
Beneath the Surface: Exploring the Complexities of Fibromyxoid Sarcoma
Introduction: Low-grade fibromyxoid sarcoma (LGFMS), or Evans tumor, is a rare soft tissue sarcoma with fibrous and myxoid areas, whorled pattern, and low cellularity. It comprises <5% of cases, commonly affecting trunk and extremities, and rarely the retroperitoneum or mediastinum. Aim & Objectives: To present a rare case of low-grade fibromyxoid sarcoma presenting as a pelvic mass mimicking a broad ligament fibroid and to highlight its diagnostic challenges and management. Case Presentation: A 50-year-old female (P2L2) presented with 2 months of amenorrhea and a history of T2DM and hypertension. Examination revealed a normal-sized anteverted uterus with a hard, non-tender right forniceal mass. Ultrasonography suggested a 78 × 62 mm hypoechoic pelvic lesion, likely a broad ligament or exophytic fibroid. Intraoperatively, a retroperitoneal mass (8 × 4 cm) above the right internal iliac vessels was identified, excised, and sent for histopathological examination. Results: Histopathological examination confirmed the diagnosis of low-grade fibromyxoid sarcoma. The tumor showed low to moderate cellularity with bland spindle-shaped (fusiform) cells arranged in a whorled pattern within a collagenized stroma, along with abrupt transition to myxoid areas. Immunohistochemistry typically shows MUC4 positivity, and cytogenetic analysis is associated with t(7;16) (q32–34; p11) translocation resulting in FUS–CREB3L2 fusion. Conclusion: Low-grade fibromyxoid sarcoma is a rare soft tissue tumor that can mimic a fibroid when arising in the retroperitoneum, leading to diagnostic difficulty. Accurate diagnosis relies on histopathology and immunohistochemistry. Complete surgical excision with wide margins remains the mainstay of treatment, with or without adjuvant radiotherapy.
Fibromyxoid sarcoma, Soft tissue tumour, Retroperitoneal
To Study the Relationship Between Perioperative Hyperglycemia & Postoperative Infections
Introduction: Perioperative hyperglycemia is a common metabolic disturbance in surgical patients and is a significant predictor of adverse postoperative outcomes. It impairs immune function, disrupts neutrophil activity, delays wound healing, and increases susceptibility to infections. This effect is observed in both diabetic and non-diabetic individuals, making perioperative glycemic control essential for improving surgical outcomes. Aim & Objective: To study the relationship between perioperative hyperglycemia and postoperative infections, to estimate the incidence of stress-induced hyperglycemia in previously euglycemic patients, and to compare diabetic and non-diabetic patients regarding perioperative glycemic changes and subsequent bacterial infections. Materials & Methods: This prospective observational study was conducted in the Department of General Surgery, Johal Multispeciality Hospital, Jalandhar, Punjab, from June 1, 2023 to May 31, 2024. One hundred adult patients undergoing elective or emergency surgery under general or spinal anesthesia were included. Perioperative random blood sugar was assessed preoperatively, intraoperatively, and at 6, 24, and 48 hours postoperatively. Patients were evaluated for postoperative infections and relevant laboratory parameters. Results: The mean age was 51.79 years, with male predominance (65%). Mean total leukocyte count increased significantly from 9373.43/mm³ preoperatively to 11668.27/mm³ postoperatively (p=0.0305). Hyperglycemic patients had significantly higher random blood sugar values than euglycemic patients at all perioperative stages (p<0.001). Stress hyperglycemia developed in 15.38% of initially euglycemic patients (p<0.001). Preoperative urinary abnormalities were also noted in a small subset. Postoperative infections were markedly more common among preoperative hyperglycemic patients than euglycemic patients. Conclusion: Perioperative hyperglycemia is a significant modifiable risk factor for postoperative infections. Early identification, close monitoring, and glycemic control may reduce infectious complications and improve surgical outcomes.
Perioperative hyperglycemia; Postoperative infections; Stress hyperglycemia; Surgical site infection; Glycemic control
Efficacy of Anterior Tucking vs Conventional Method of Type 1 Tympanoplasty: A Comparative Study
Introduction: Type I tympanoplasty is performed to reconstruct the tympanic membrane and restore middle ear function. Several surgical modifications have been proposed to enhance graft uptake and hearing outcomes, particularly in anterior quadrant and subtotal perforations. This study evaluates the effectiveness of the anterior tucking technique compared with the conventional method. Aim & Objective: To compare graft uptake rates and postoperative hearing outcomes between anterior tucking and conventional Type I tympanoplasty in patients with chronic suppurative otitis media (CSOM). Materials & Methods: This prospective observational study included 78 patients with CSOM, randomly allocated into two equal groups: Group I (anterior tucking technique, n = 39) and Group II (conventional technique, n = 39). Preoperative and postoperative audiological assessments including air conduction, bone conduction, and air–bone gap (ABG) were performed. Graft status was evaluated using otoendoscopy at 0, 6, and 12 weeks postoperatively. Statistical analysis was conducted using SPSS version 20. Results: Both groups were comparable in baseline demographic characteristics. Graft uptake was observed in 100% of patients in the anterior tucking group and 92.3% in the conventional group; however, the difference was not statistically significant (p = 0.241). Postoperative hearing improvement, assessed by ABG closure at 6 and 12 weeks, showed no statistically significant difference between the two groups (p > 0.05). Overall, 74.36% of patients demonstrated satisfactory hearing improvement, with no significant correlation between graft uptake and degree of hearing gain (p = 0.156). Conclusion: Anterior tucking and conventional Type I tympanoplasty techniques demonstrate comparable efficacy in terms of graft uptake and hearing outcomes. Surgical technique selection may therefore be guided by surgeon preference and intraoperative anatomical considerations without adversely affecting clinical results.
Tympanoplasty, Anterior Tucking, Graft Uptake, Hearing Improvement
A Case on Posterior Shoulder Dislocation: The Hidden Injury
Introduction: Posterior shoulder dislocation (PSD) is a rare injury, accounting for a small proportion of glenohumeral dislocations, and is frequently missed at initial presentation due to subtle clinical signs and inconclusive standard radiographs. Delayed diagnosis may result in persistent instability, pain, and early degenerative changes, particularly when associated with osseous defects such as the reverse Hill-Sachs lesion (rHSL). Electrocution is a classic but often under-recognized mechanism leading to PSD because injury can occur without direct trauma. Case Presentation: We report the case of a 21-year-old male who presented with acute pain and restricted external rotation of the right shoulder following accidental electrocution. Clinical examination revealed the arm held in addition and internal rotation with limited external rotation. Plain radiographs demonstrated features suggestive of posterior dislocation, including the lightbulb and trough line signs. Following closed reduction, magnetic resonance imaging revealed an engaging reverse Hill-Sachs lesion involving approximately 30% of the humeral head, with an associated reverse Bankart lesion. Given the size and engagement of the defect, the patient underwent an arthroscopic modified McLaughlin procedure combined with posterior labral repair. Result: Postoperative rehabilitation resulted in a satisfactory range of motion and return to functional activity, with no evidence of instability at three-month follow-up. Conclusion: This case highlights the importance of maintaining a high index of suspicion for PSD following electrocution. Advanced imaging is essential for identifying rHSLs and guiding management. Arthroscopic defect-addressing procedures combined with capsulolabral repair provide a reliable, joint-preserving solution in young patients with engaging humeral head defects.
Posterior shoulder dislocation; Reverse Hill-Sachs lesion; Electrocution injury; Arthroscopic modified McLaughlin procedure; Reverse Bankart lesion; Shoulder instability
Analysis of Caesarean Section Rates Using Robson's Group Classification
Introduction: The Caesarean section (CS) rate is steadily increasing worldwide, including in India. The overall CS rates are reported, but the women are classified. According to WHO, Robson ten ten-group classification is useful as a global standard for assessing, monitoring, and comparing caesarean section rates. Our objective was to classify women delivering in our hospital according to various categories as per the 10-group classification (Robson's classification) and to analyze the CS rate in each group. Material & Methods: This was a cross-sectional study conducted at Vitthal Rao Vikhe Patil Pravara Rural Hospital, Pravara Institute of Medical Sciences. The data was collected for all women delivering in the hospital from February 2023 to April 2023, and the women were classified according to Robson's 10-group classification. The proportion of women delivering in each group, the CS rate of each group, and the relative contribution to the CS rate from each group were calculated. Results: Among a total of 1506 women delivering during the study period, 37.9% of women were delivered by CS. The maximum no of pregnant women belonged to the primigravida group (groups 1 and 2), 40 %. Major contributors to the CS rate were Group 5 at 33.9%. The next contributors were group 2 and group 1 at 22.2% and 17.8% respectively. Overall, the three groups 1, 2, and 5 contributed 73.9 % of the CS rate, while the other group contributed to only 26.1% of the CS rate. Conclusions: Applying Robson's criteria to classify pregnant women allowed for easy classification to identify the category of women most likely to have CS. Reducing the primary CS rate and increasing VBAC rates will help to reduce the CS rate.
Cesarean section; Robson classification; Delivery outcomes; Maternal health; Primary cesarean rate; Tertiary care hospital
Copyright (c) 2025 International Journal of Medicine & Health Research (IJMHR) (ISSN 2395-3586)
Surgical Management of a Giant Papillary Thyroid Carcinoma: A Case Report
Introduction: Giant goitres are uncommon thyroid enlargements that may extend over decades, often resulting in compressive symptoms and aesthetic concerns. Although most long-standing goitres are benign, the potential for malignant transformation exists. Early diagnosis and timely surgical management are crucial to prevent complications and ensure optimal outcomes. Case Presentation: We report a case of a 63-year-old female who presented with a massive anterior neck swelling that had been progressively enlarging over a period of 20 years. Clinical evaluation and ultrasonography were performed, followed by fine needle aspiration cytology (FNAC), which suggested a follicular neoplasm. The patient was planned for surgical excision under general anesthesia. Results: Intraoperatively, a well-encapsulated, highly vascular thyroid mass was identified and successfully excised. The specimen weighed approximately 4 kg (8.81 lbs). Histopathological examination confirmed the diagnosis of papillary thyroid carcinoma with areas of cystic degeneration. The postoperative course was uneventful, and the patient recovered without complications. Conclusion: This case highlights the rarity of giant goitres and underscores the importance of early diagnosis, careful preoperative assessment, and meticulous surgical planning. Even in long-standing goitres presumed benign, the risk of underlying malignancy should be considered. Timely surgical intervention not only minimizes morbidity but also facilitates early detection and treatment of occult malignancies, thereby improving patient outcomes.
Giant goitre; Papillary thyroid carcinoma; Thyroidectomy; Airway management; Difficult airway
Study on Post Dated Pregnancy: Its Maternal and Foetal Outcome
Introduction: Post-dated pregnancy, defined as a pregnancy extending beyond 40 weeks of gestation, is associated with increased maternal and fetal risks. The incidence ranges from 4% to 14%. Complications include meconium-stained liquor, oligohydramnios, fetal distress, macrosomia, shoulder dystocia, and increased rates of operative deliveries. This study aims to evaluate the maternal and fetal outcomes in post-dated pregnancies to guide better clinical management and reduce morbidity. Materials & Methods: This descriptive longitudinal study was conducted at the Department of Obstetrics and Gynecology, Tezpur Medical College, Assam, from 2023 to July 2024. A total of 106 pregnant women with gestational age between 40–42 weeks were included based on strict inclusion and exclusion criteria. Data were collected using clinical examination, ultrasonography, biophysical profiling, and monitoring tools. Mode of delivery, perinatal morbidity, and maternal complications were recorded. Statistical analysis was performed using SPSS version 23 with chi-square tests; p < 0.05 was considered significant. Results: Among the 106 patients, the majority were aged 20–25 years. Spontaneous vaginal delivery occurred in a significant proportion, while cesarean section was required in many cases due to fetal distress and failed induction. Maternal complications included perineal tears, postpartum hemorrhage, and prolonged labor. Fetal complications observed were low Apgar scores, meconium aspiration syndrome, NICU admission, and the need for neonatal resuscitation. A statistically significant correlation was found between gestational age and increased perinatal complications. Conclusion: Post-dated pregnancy poses significant maternal and fetal risks. Early identification and timely induction, coupled with vigilant intrapartum monitoring, can improve outcomes. Regular antenatal care and accurate dating using first-trimester ultrasound are essential in minimizing complications associated with post-dated pregnancies.
Post-dated pregnancy Maternal outcome Maternal outcome Induction of labor Meconium aspiration syndrome
Study of Peripheral Smear Findings in Patients with Chronic Kidney Disease in a Tertiary Care Centre
Introduction: Chronic kidney disease (CKD) is a progressive disorder associated with significant hematological and biochemical alterations, particularly anemia, thrombocytopenia, and proteinuria. Peripheral smear examination, though simple and cost-effective, provides valuable insights into morphological spectrum of anemia and other blood abnormalities in CKD patients. This study aimed to evaluated the peripheral smear findings and correlate them with clinical and biochemical parameters in patients with CKD. Material & Methods: A cross-sectional study was conducted on 98 patients diagnosed with CKD at tertiary care centre. Detailed demographic, clinical, biochemical data were collected. Peripheral smear analysis was performed to assess red blood cell (RBC) morphology, leukocyte variations, platelet abnormalities. Serum urea, creatinine, and urine albumin were also evaluated to correlate hematological findings with renal function status. Results: The study population had a male predominance (60.20%) and most patients were aged 51–75 years (68.37%). Hypertension (39.80%) and diabetes mellitus (36.73%) were the leading comorbidities. Normocytic normochromic anemia was the most common finding (69.39%), followed by microcytic hypochromic anemia (7.14%). Thrombocytopenia was present in 35.71% of cases. Leukocyte abnormalities included neutrophilia (14.29%) and toxic granulations (8.16%). Biochemically, 94.90% of patients had elevated urea levels (>40 mg/dL), and 86.73% had creatinine levels between 1.2–8 mg/dL; 13.27% exceeded 8 mg/dL. Albuminuria was present in over 90% of patients, with 44.90% having 2+ proteinuria. Conclusion: The predominance of normocytic normochromic anemia and significant platelet and leukocyte abnormalities highlight the hematological burden of CKD. Elevated urea, creatinine, proteinuria confirmed advanced renal dysfunction. Peripheral smear remains an inexpensive yet powerful diagnostic tool, offering critical insights into disease severity and aiding timely interventions. Integrating smear analysis with standard renal function tests can improve CKD management, particularly in resource limited settings.
Chronic Kidney Disease Peripheral Smear Anaemia Haematological Abnormalities
Cervical Tuberculosis in a Young Reproductive age Female Mimicking Cervical Cancer: A Rare Differential Diagnosis
Introduction: Tuberculosis (TB) is a global health challenge, with extrapulmonary cases comprising up to 40%. Genital tract TB significantly impacts reproductive-age women, yet cervical involvement is exceedingly rare, representing only 0.1–0.65% of TB cases. When present, it closely mimics cervical carcinoma both clinically and radiologically, leading to serious diagnostic dilemmas and potential mismanagement, often resulting in unnecessary radical surgical interventions if histopathological confirmation is not pursued. Aim and Objectives: This case report emphasizes cervical tuberculosis as a rare differential diagnosis in reproductive-age women with malignant-appearing cervical lesions. Its objectives are to describe the clinical and diagnostic features of cervical TB and to highlight the importance of histopathology in distinguishing it from carcinoma, ensuring accurate diagnosis and appropriate management. Materials and Methods: A young multiparous woman with persistent vaginal discharge and post-coital bleeding underwent pelvic examination, baseline investigations, and cervical biopsy. Histopathological analysis including Ziehl–Neelsen staining was performed. Standard anti-tubercular therapy (ATT) was initiated, and clinical follow-up at six months was undertaken to assess response. Results: Per speculum examination revealed an irregular friable cervical growth resembling carcinoma. Routine investigations and chest X-ray were normal, and HIV serology was negative. Histopathology showed epithelioid granulomas with caseous necrosis, and Ziehl–Neelsen stain confirmed acid-fast bacilli, establishing cervical TB.After six months ofATT, the lesion completely regressed, confirming an excellent therapeutic outcome. Conclusion: Cervical tuberculosis, though rare, must be considered in the differential diagnosis of carcinoma-like cervical lesions in young women. Histopathology remains crucial for accurate diagnosis, and timely ATT ensures curative outcomes while preventing unnecessary radical surgery.
Cervical tuberculosis Carcinoma mimic Histopathology Anti-Tubercular therapy Reproductive age
A Study of Clinical Profile of Hypertension in Elderly Age Group in Tertiary Care Hospital
Introduction: Decompensated alcoholic liver disease (DALD) is a major cause of morbidity and mortality worldwide, with complications including ascites, hepatic encephalopathy, hepatorenal syndrome, and spontaneous bacterial peritonitis. Hyponatremia, defined as serum sodium <135 mEq/L, is common in cirrhosis and strongly influences prognosis. This study was conducted to evaluate the clinical significance of serum sodium levels and their correlation with disease severity in patients with DALD. Material & Methods: A prospective observational study was conducted at a tertiary care center from July 2023 to June 2025. A total of 180 male patients aged >18 years, diagnosed with DALD, were enrolled based on clinical, biochemical, and imaging findings. Patients with cardiac failure, chronic kidney disease, or on interfering medications were excluded. Clinical history, laboratory investigations, and imaging were recorded. Disease severity was assessed using Model for End-Stage Liver Disease (MELD), MELD-Na, and Child-Pugh scoring systems. Data were analyzed using SPSS, with p <0.05 considered significant. Results: Among 180 patients, the majority were aged 36–50 years (62.78%), with farming as the most common occupation (27.78%). Hyponatremia (<135 mEq/L) was present in 34.44%, normonatremia in 51.11%, and hypernatremia in 14.44%. Patients with sodium <135 mEq/L demonstrated higher MELD scores (27–31 in 13.89% cases) and were more frequently classified as Child-Pugh class C (22.78%). Hyponatremia was strongly associated with severe complications, including ascites, hepatic encephalopathy, and hepatorenal syndrome. Conclusion: Serum sodium is a simple, inexpensive, and reliable biomarker in DALD. Hyponatremia correlates with advanced disease severity and poor prognosis, emphasizing its utility in risk stratification. Integration of serum sodium into prognostic scoring systems like MELD-Na enhances predictive accuracy, supporting early intervention and improved patient management in tertiary care settings.
Decompensated alcoholic liver disease Serum sodium Hyponatremia MELD-Na score Child-Pugh classification
Introduction: Hypertension is a major cause of cardiovascular morbidity and mortality, with prevalence exceeding 60% in those above 60 years. Age-related vascular changes, sedentary lifestyle, and reduced renal function contribute to isolated systolic hypertension, making it a key public health concern. Aim and Objective: To study clinical profile, associated factors, and presentations of hypertension in elderly patients. Materials & Methods: A prospective observational study was conducted in the Department of General Medicine, a tertiary care hospital, from June 2023 to May 2025. A total of 180 hypertensive patients aged >60 years were enrolled. Data on demographics, comorbidities, lifestyle, and clinical/laboratory parameters (CBC, RFT, LFT, lipid profile, ECG, fundus exam, urine microscopy, and USG) were collected. Analysis was performed using SPSS with appropriate statistical tests; p<0.05 was considered significant. Results: Among 180 elderly hypertensive patients, most were 60–70 years, females, and from lower socioeconomic backgrounds. Obesity, physical inactivity, smoking, and alcohol use were common, along with comorbidities like diabetes and ischemic heart disease. Laboratory and imaging findings revealed dyslipidemia, renal impairment, ECG abnormalities, and fundus changes, indicating early end-organ damage. Conclusion: Elderly hypertension is strongly associated with modifiable risk factors and multiple comorbidities. Early screening, lifestyle interventions, and comprehensive geriatric care are essential for preventing complications in this vulnerable group.
Hypertension Elderly Risk factors Comorbidities End-organ damage Lifestyle modification Peripheral Smear Anaemia Haematological Abnormalities
Study of Clinical Profile of Cerebrovascular Accident in Tertiary Care Hospital
Introduction: Cerebrovascular accident (CVA) or stroke is a leading cause of morbidity and mortality worldwide, significantly affecting quality of life and posing a heavy socioeconomic burden. The present study was undertaken to analyzed clinical profile of stroke patients admitted to a tertiary care hospital, with a focus on demographic characteristics, risk factors, and clinical presentations. Material and Methods: This observational prospective study was conducted in the Department of General Medicine, including all patients >18 years admitted with CVA between July 2023 and June 2025. Diagnosis was established using clinical and radiological criteria. Patients with trauma-related stroke, transient ischemic attacks, unstable hemodynamic status, pregnancy were excluded. Demographic data, risk factors, clinical features were systematically recorded and analyzed. Results: A total of 180 patients were studied. The majority were aged 61–75 years (77.78%), with males comprising 60% of cases. The most common presenting complaint was weakness (31.67%), followed by visual disturbances (15.56%) and seizures (12.22%). Gradual onset of symptoms was reported in 65% of patients, while 35% presented with sudden onset. A positive family history of CVA was observed in 48.33%, and personal risk factors included smoking (30.56%) and alcohol consumption (26.67%). Hypertension was the most prevalent comorbidity, with 67.78% of patients showing elevated blood pressure. Neurological evaluation revealed 69.44% of patients were disoriented, 26.11% had non-fluent or fluent aphasia, and significant motor weakness was noted in the majority, with 62.22% showing 0–2/5 power. Conclusion: The study highlights that CVA predominantly affects elderly males, with hypertension, smoking, alcohol consumption being key risk factors. Weakness and visual disturbances were the most common presenting features. Early identification of risk factors and timely intervention remain crucial for reducing stroke incidence and improving outcomes.
Cerebrovascular accident Stroke Clinical profile Risk factors Hypertension
Efficacy of intramuscular electrical stimulation with dry needleover classical trigger point dry needling in non-traumaticshoulder pain and dysfunction–a randomized controlled pilotstudy
Background: Myofascial Pain Syndrome (MPS) is a common condition in most of the painful shoulder conditions and it is effectively treated with trigger point dry needling of shoulder muscles. Very few studies on Intra muscular electrical stimulation were docu-mented the effects of IMES with dry needle in treating MPS. This study was conducted to establish the clinical importance of IMES with dry needle in Myofascial pain syndrome of non traumatic shoulder disorders. Methods: 30 subjects with unilateral non-traumatic shoulder pain and dysfunction were selected and divided into two groups, 15 subjects in each group. Experimental group (7 male and 8 female subjects) treated with IMES with dry needle and control group (7 male and 8 female subjects) treated with classical trigger point dry needling twice in a week for consecutive 3 weeks. Pain, range of motion, and shoulder disability were assessed with VAS, Goniometry, and DASH-Questionnaire respectively at the end of 1st, 2nd, 3rd week, and end of 3rd month. Results: Descriptive characteristics of pre and post intervention VAS and DASH-Q, score and shoulder range of movements suggesting improvement in intramuscular electrical stimulation with dry needle. Within group comparison of VAS score and DASH-Q score in both groups in all observations shown the p value=.001 and between group comparison VAS score shown the mean 5.70 ± 1.02 standard deviation in the 1st week post intervention and DASH-Q score shown the mean 49.66 ± 9.69 standard deviation in the 1st week, mean 61.76 ± 7.30 standard deviation in the 2nd week intervention. Shoulder range of motion within group comparison was shown the p=.000 in both groups and between group comparison of shoulder abduction was shown the mean difference of 13.7 (p=.033) and 20.4 (p=.028) in the 1st and 2nd week and for shoulder external rotation shown the mean difference of 8.40 (p value= .01), and 9.60 (p=.01) in the 1st and 2nd week post intervention. Conclusion: This pilot study result suggests that both IMES with dry needle and classical trigger point dry needling are effective in treating pain and dysfunction. And subjects treated with IMES with dry Needle more effective in producing early recovery from pain and dysfunction of shoulder compared to the Classical Trigger Point Dry Needling in myofascial pain syndrome due to Non-Traumatic Shoulder pain and dysfunction.
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BONE MARROW BIOPSY PICTURE IN A PATIENT WITHMARFANOID HABITUS AND ANOREXIA NERVOSA
Gelatinous marrow transformation (GMT) is a rare disorder of bone marrow characterized by deposition of extra cellular gelatinous material. There is atrophy of the marrow adipocytes and loss of hematopoietic elements. It is also called as osseous atrophy of the bone marrow. It is not a specific disease but it is seen associated with chronic illness like malnutrition, anorexia nervosa, HIV infection and administration of cytotoxic drugs. Here, we report a case of gelatinous transformation of bone marrow in a 17 year old female presented with severe weight loss and anemia
A RANDOMISED CONTROL STUDY ON EFFECT OF OCTREOTIDEIN MANAGEMNT OF ACUTE PANCREATITIS WITH VARYINGSEVERITIES
Background: Acute pancreatitis is an acute inflammatory process of the pancreas with variable involvement of other regional tissues or organ systems. Theories on pathogenesis of acute pancreatitis suggest that autodigestion of the gland and peripancreatic tissues by activated digestive enzymes is a key component. Octreotide is a potent inhibitor of pancreatic secretion, but the benefits of octreotide in acute pancreatitis in humans is still inconclusive. Aim: To study the effect of octreotide in acute pancreatitis with different severities. Method: 284 patients were assigned into two groups randomly, the study group comprising of 138 patients received inj octreotide 100 μg S.C. 8 hrly. The other aspects of the treatment protocol were similar in both groups. Severity of the disease was evaluated initially according to Ranson criteria, APACHE II SCORING, CRP values & Balthazar grading. Both the groups were observed prospectively and outcome of treatment was evaluated. Results: The results were analysed after dividing both the study and control group into 5 groups each according-to increased severities. The complication rate was 10% in group 1 and 28% in group 2 according to APACHE II among the study group, whereas it was 23% and 46% in the conrol group respectively. The values in patients stratified according to other criterias were also comparable. The results in cases of severe pancreatitis were poor, complication rates varying from 56% to 100% in the 3'd and 5th group according to Ranson criteria among the study group and 62% to 100% respectively among the control group. Mortality of the study and control group also did not show any significant changes. Conclusion: Inhibition of secretory function in the early course of the disease especially in mild and moderate cases of pancreatitis has been shown to improve final outcome. As in case of acute pancreatitis it is very difficult to estimate the severity and disease progress at the very onset, and as the majority of cases are mild to moderate in severity, it will be beneficial to start with octreotide in any treatment protocol along with supportive resuscitative measures.
HYPERTENSION AMONG WOMEN IN TIRAIRA MADANI, RURALSUDAN: PREVALENCE AND RISK FACTORS, 2014
Background Hypertension is a major risk factor for strokes, cardiovascular and kidney diseases worldwide and it has considerable variation in its prevalence across different geographic locations and ethnic groups. Objectives This study aimed to estimate the prevalence of hypertension and to determine its major risk factors among women. Methods A Descriptive cross-sectional community based study was conducted in Tirira Madani village –Sennar state- Sudan. A total of 255 women aged (15 – 75) years were interviewed using a structured questionnaire. Blood pressure was measured twice. Hypertension was taken as blood pressure ≥ 140 mmHg and/or ≥ 90 mmHg for systole and diastole respectively. Descriptive cross-tabulations and bivariate analyses were used. The statistical significance was tested using chi-square test. Predictor factors to hypertension were tested by logistic regression. Results Prevalence of hypertension among participants was 25.9%. Factors found to be associated with hypertension were; age, illiteracy, low salt intake, family history of hypertension, Coffee intake of more than two cups daily, fish consumption, low physical activity, and high socio-economic status. Certain ethnic groups were at increased risk compared to others (RR=2.11, 95%CI: 1.265 – 4.588). Logistic regression model showed age, ethnicity, physical activity level, education level and family history were predictors of hypertension (P-value <0.05).Conclusion Hypertension was prevalent in rural Sudan. Age, ethnicity, socio-economic status, level of education and family history of hypertension were the major risk factors of hypertension.
COMPARATIVE STUDY OF HEPATIC CHANGES IN PATIENTS OFMETABOLIC SYNDROME AND CHRONIC ALCOHOLISM
Aims and Objective: Comparative study of hepatic changes in patients of metabolic syndrome and chronic alcoholism. Material and Method: The material of the study included 30 metabolic syndrome patients and 30 chronic alcoholics selected from the medicine outdoor clinic (including diabetic clinic) and medicine indoor wards as well as from GI clinic of Postgraduate Department of Medicine, S.N. Medical College and Hospital Agra . Results: Most metabolic syndrome patients (60%) as well as chronic alcoholics (50%) were asymptomatic. Anorexia and fatigue/ malaise was present in 13.3% and 40% respectively in metabolic syndrome patients as compared to anorexia (30%) and fatigue / malaise (50%) in chronic alcoholics. Nausea / vomiting and right upper abdominal quadrant pain was present in 10% metabolic syndrome patients as compared Nausea / vomiting (40%) and Right upper abdominal quadrant pain(26.6%) in chronic alcoholics. Hepatomegaly and icterus was present in 23.3% and 10% respectively in metabolic syndrome patients as compared hepatomegaly (80%) and icterus (60%) in chronic alcoholics. Ascites and upper GI bleeding was present in 13.3% and 6.7% metabolic syndrome patients respectively as compared to ascites (50%) and upper GI bleeding (9%) in chronic alcoholics. Mean AST and ALT levels were 65.56 + 67.22 and 84.9 + 91.9 U/L respectively in metabolic syndrome patients. AST/ ALT ranged from 0.91 to 1.85 with mean of 0.98 + 0.26 while in chronic alcoholics mean AST and ALT levels were 98.4 and 48.2 .AST and ALT levels were statistically significant (p value<0.05) in chronic alcoholics and the AST/ ALT was 2.04. Gamma glutamyl transferase enzyme level was elevated in most (80%) chronic alcoholics while was near normal in metabolic syndrome patients. On ultrasonography most of chronic alcoholics (93.3%) had abnormal findings like fatty liver (80%), cirrhosis (13.3%) as compared to metabolic syndrome patients having NAFLD (33.3%), and cirrhosis (6.67%). On Histological examination metabolic syndrome patients had NAFLD in 33.3%, NASH in 41.6% and cirrhosis in 8.3% as compared to chronic alcoholic patients having fatty liver in 35.7%, alcoholic hepatitis in 49.9% and cirrhosis in 14.3%. Conclusions: a. Symptoms like anorexia, fatigue/malaise, nausea/vomiting, right upper abdominal pain and signs like hepatomegaly, icterus, Splenomegaly, ascites, UGI bleeding were compared and statistically significant (p value<0.05) Symptomatology and signs were found in chronic alcoholics as compared to metabolic syndrome patients. b. Statistically significant (p value <0.05) deranged liver function tests were found in chronic alcoholics as compared to metabolic syndrome patients. www.advancejournals.org Open Access Scientific Publisher International Journal of Medicine & Health Research IJM 35|Volume 1|Issue 1|2015 2 c. On Hepatic Ultrasonography statistically significant (p value <0.05%) hepatic changes in the form of fatty liver, cirrhosis were observed in 93.4% patients of chronic alcoholics as compared to metabolic syndrome patients (60%). d. Patients with hepatomegaly, abnormal liver function tests and abnormal ultrasonographic findings were observed as high risk cases. Histopathological assessment of high risk patients revealed significant changes in the form of NAFLD (33.3%), NASH (41.6%) and cirrhosis (8.3%) in metabolic syndrome patients as compared to chronic alcoholics in the form of alcoholic fatty liver (35.7%), alcoholic hepatitis (49.9%) and cirrhosis (14.3%). e. Statistically positive correlation of high risk group patients has shown abnormal ultrasonographic finding, abnormal liver function tests and the histopathological changes in the patients of both the groups. Though statistically (p value <0.05) significant changes were seen in chronic alcoholics as compared to metabolic syndrome patients
A CROSS-SECTIONAL PREVALENCE STUDY OF DISCDEGENERATION IN A RURAL POPULATION AND ITS RELATIONWITH AGE, BODY MASS INDEX AND BACK PAIN
The prevalence of degenerative discs (DD) in 59 male; 41 female patients belong to rural population of Anand district having mean age of 48.29 years; mean BMI (Body Mass Index) 22.196 kg/ m2 associated with pain, radiculopathies and neurological deficit presenting to the various in & out patient departments of Shree Krishna Hospital & Pramukh Swami Medical College, Karamsad, Gujarat. Magnetic resonance imaging (MRI) performed with a sagittal T2 image of the lumbar spine using closed type Superconductive 1.5 Tesla Magnetom Symphony Maestro (Manufactured by Siemens AG, Erlangen Company). Patients with sedentary life style had maximum number of degenerative disc pathologies; while had ambulatory life style had maximum percentage of infective/inflammatory disc pathologies. 98.3 % male patients had degenerative lesions while 92.5 % of female patient had degenerative changes. Age group 61-70 years to be maximum involved. In the lumbar region maximum changes were seen at L5-S1 level (25.7 %); cervical region at C5-C6 level (12.2 %) and at thoracic region at D12-L1 level (24.2 %). B.M.I. group II (18-25 kg/m2) to have maximum number of disco genic pathologies. All Congenital / developmental disc anomalies cases were associated with degenerative disc. It can be concluded that MRI is a highly sensitive imaging modality, which closely reflects histological changes. Grade III changes are mostly present in sedentary life style patient with high Body Mass Index
ANTERIOR ARTHRODESIS FOR TUBERCULOSIS OF THE SPINEUSING ZETA INSTRUMENTATION ON LATERAL SIDE
This is a prospective study of twelve patients who are diagnosed to have tuberculosis of spine with some form of neurological deficit. In the present study, the progression of kyphosis and the fate of the bone graft and final outcome over an average twelve month follow up after radical anterior debridement, bone grafting and application of Zeta Instrumentation on the lateral side of the vertebral body is performed. Supplementation with an implant to the procedure of bone grafting after radical debridement is a good choice as a primary procedure. It was noted that It is easy to place the implant on the lateral aspect of the bodies of the spine. There is no need of a second procedure in the form of posterior instrumentation and posterior fusion at a later date. Can be used by surgeons, where the facilities for pedicular screw fixation are not present. There is no progression of the deformity
TREATMENT OF CLOSED TIBIAL PILON FRACTURES WITHOPEN REDUCTION, INTERNAL FIXATION AND BONE GRAFTING.A STUDY OF 22 CASES COMPARING THE OBJECTIVE ANDSUBJECTIVE EVALUATION
The cases of twenty two fractures of the ankle joint that involved the tibial plafond were reviewed. The fractures were classified in to five types according to the severity of the injury. Open reduction and internal fixation was performed using one third tubular plate for fibula and recon plate for the tibia. Bone grafting was done to augment the fixation and maintain the reduction. For each fracture treated Objective and Subjective evaluation is done. The objective and subjective scores are compared. With this method we noticed that the Type III & IV fractures also had a good or excellent result