International Journal of Advanced and Integrated Medical Sciences

1.Original Article

Assessment of Indian Public Health Standards in the Primary Health Centers in a District of Uttar Pradesh, India

Arshiya Masood, Anil K Singh, DS Martolia, Tanu Midha
[Year:2017] [Month:April-June] [Volume:2 ] [Number:2] [Pages No:53-60] [No. of Hits: 318]
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  • [Abstract]
  • [DOI : 10.5005/jp-journals-10050-10076]

ABSTRACT

Introduction: Primary health center (PHC) is a first port of call to a qualified doctor of the public sector in rural areas. Standards are the main driver for continuous improvement in quality. The performance of PHCs can be assessed against the Indian Public Health Standards (IPHS) recommended for PHCs in early 2007. The overall objective of IPHS for PHCs is to provide health care, i.e., quality oriented and sensitive to the needs of the community. These standards would also help monitor and improve the functioning of the PHCs.

Aims and objectives: This study was carried out to assess (1) the infrastructure, equipments, instruments, staffing, and other facilities; (2) the services being provided at PHCs; (3) to find out the reasons for nonutilization of health services and suggest remedial measures for the same.

Material and methods: T his w as a c ross-sectional s tudy at two PHCs, namely Thatiya and Umerda of Tirwa block of Kannauj District selected randomly for assessment. Health care providers, mainly medical officers, were interviewed using pretested, precoded pro forma. Descriptive analysis was used as per study requirements.

Results: It has been found that only outpatient department services were being provided with many missing components, such as one of the most important ones like maternal and child health and family planning. Physical infrastructure and facilities were inadequate at both the PHCs. Both of them were grossly underequipped and understaffed. Medical officers face their own problems; even basic amenities of life like water, electricity, canteen, etc., are lacking there.

Conclusion: Both the PHCs were not performing up to the expectations and standards of the Indian Public Health.

Keywords: Indian public health standards, Kannauj district, Primary health centers.

How to cite this article: Masood A, Singh AK, Martolia DS, Midha T. Assessment of Indian Public Health Standards in the Primary Health Centers in a District of Uttar Pradesh, India. Int J Adv Integ Med Sci 2017;2(2):53-60.

Source of support: Nil

Conflict of interest: None

2.From the Editor's Desk

From the Editor's Desk

Chander Mohan
[Year:2017] [Month:April-June] [Volume:2 ] [Number:2] [Pages No:iv] [No. of Hits: 252]
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ABSTRACT

I am indeed delighted to say that we have entered in the world of biomedical communication with our International Journal of Advanced and Integrated Sciences (IJAIMS), which is a multidisciplinary journal. Over the past one and a half year of this journey, the journal has not undergone major changes .

3.Original Article

Coagulation Profile in Liver Diseases: A Study of 300 Cases in a Tertiary Care Hospital in Uttarakhand, India

Gautam Bhatia, Sanjay Kaushik, Rajnish Kumar, Sanjeev Kishore, Umesh Bhatia
[Year:2017] [Month:April-June] [Volume:2 ] [Number:2] [Pages No:61-64] [No. of Hits: 307]
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  • [Abstract]
  • [DOI : 10.5005/jp-journals-10050-10077]

ABSTRACT

Background: The liver is the cornerstone of the coagulation system. The physiology of blood coagulation is closely linked to liver function as the liver synthesizes most of the factors of the coagulation cascade and fibrinolytic proteins.

Objective: The objective of this study was to evaluate coagulation abnormalities associated with chronic liver diseases and determine the coagulation abnormalities using various coagulation studies [prothrombin time (PT), activated partial thromboplastin time (APTT), bleeding time (BT), clotting time (CT), and platelet count].

Materials and methods: This study included 300 patients clinically diagnosed with liver disease and who were divided into three categories - cirrhosis, hepatitis, and other liver diseases. The coagulation tests PT, APTT, BT, CT, and platelet count were performed and the results were evaluated in groups.

Results: Out of the 300 patients, 156 were diagnosed with cirrhosis, 75 were of viral hepatitis, and 69 were of other liver diseases. About 62% (186/300) had prolonged PT. About 39.3% (118/300) had prolonged APTT. The BT was prolonged in 34% (102/300), while CT was prolonged in 10.6% (32/300). Thrombocytopenia was seen in 46% (138/300) patients.

Conclusion: We concluded that various abnormalities of coagulation tests vary greatly with different liver disorders, duration of the disorders, and their severity. Prolongation of PT and APTT in advancing liver cirrhosis indicates damage to the liver parenchyma resulting in decreased production of coagulation proteins with increased risk of bleeding tendencies, which can be detected before these ensue.

Keywords: Cirrhosis, Coagulation, Hepatitis.

How to cite this article: Bhatia G, Kaushik S, Kumar R, Kishore S, Bhatia U. Coagulation Profile in Liver Diseases: A Study of 300 Cases in a Tertiary Care Hospital in Uttarakhand, India. Int J Adv Integ Med Sci 2017;2(2):61-64.

Source of support: Nil

Conflict of interest: None

4.Original Article

A Clinical Comparative Study of Ondansetron, Palonosetron, Ramosetron, and Metoclopramide for Prevention of Postoperative Nausea and Vomiting in Patients undergoing Laparoscopic and ENT Surgery under General Anesthesia

Vartika Vinay, Anil P Agrawal, AP Verma, Gopal Krishan, Reehan Ahmad, Siddhartha Hanjura
[Year:2017] [Month:April-June] [Volume:2 ] [Number:2] [Pages No:65-69] [No. of Hits: 274]
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  • [Abstract]
  • [DOI : 10.5005/jp-journals-10050-10078]

ABSTRACT

Introduction: Postoperative nausea and vomiting (PONV) is a well-known entity following surgical procedures and may result in serious complications including aspiration of gastric contents, prolonged recovery period, and impaired surgical wound healing. Laparoscopic surgery is a known risk factor for PONV. Also, the incidence of vomiting after ear nose throat (ENT) surgeries is relatively high.

Aims and Objectives: Our aim of the study is to compare the effectiveness of ondansetron, palonosetron, ramosetron, and metoclopramide to prevent PONV in patients undergoing laparoscopic and ENT surgery under general anesthesia.

Materials and methods: The present study was conducted on 120 adult patients scheduled for elective laparoscopic cholecystectomy and ENT surgery under general anesthesia. All patients were randomized into four groups (O, P, R, and M) with 30 patients each and received injection ondansetron (4 mg), palonosetron (0.075 mg), ramosetron (0.3 mg), and metoclopramide (10 mg) intravenously during premedication. Patients were observed intraoperatively and 24 hours postoperatively for any episodes of nausea and vomiting. All the patients were observed for side effects, such as dizziness, headache, allergic reactions, etc.

Conclusion: Palonosetron is quite effective in prevention of PONV compared with ramosetron, ondansetron, and metoclopramide given intravenously for various surgical procedures under general anesthesia. Its effectiveness in PONV provides a new cost-effective agent to the present recital of antiemetic drugs.

Keywords: Laparoscopic and ENT surgery, Metoclopramide, Ondansetron, Palonosetron, Postoperative nausea and vomiting, Ramosetron.

How to cite this article: Vinay V, Agrawal AP, Verma AP, Krishan G, Ahmad R, Hanjura S. A Clinical Comparative Study of Ondansetron, Palonosetron, Ramosetron, and Metoclopramide for Prevention of Postoperative Nausea and Vomiting in Patients undergoing Laparoscopic and ENT Surgery under General Anesthesia. Int J Adv Integ Med Sci 2017;2(2):65-69.

Source of support: Nil

Conflict of interest: None

5.Original Article

A Morphological Study of First Rib Anomalies

S Rashia, SHH Zaidi
[Year:2017] [Month:April-June] [Volume:2 ] [Number:2] [Pages No:70-72] [No. of Hits: 281]
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  • [Abstract]
  • [DOI : 10.5005/jp-journals-10050-10079]

ABSTRACT

Aim: The present study was undertaken to observe the variations of the first rib and understand the significance of such variations.

Materials and methods: Fifty first ribs obtained from the Museum of Anatomy Department of Rohilkhand Medical College & Hospital, Bareilly, Uttar Pradesh, India, were studied to see if any anomaly was present and check its incidence in the Indian population sample and draw clinical and other significances of such variations.

Results: The findings are discussed and conclusions are drawn. Variations detected include absence of scalene tubercle, vascular groove on the superior surface, rudimentary head and tubercle of the rib, oblique ridge, and exostosis. Their incidence and significance are discussed.

Conclusion: The findings are of considerable clinical, regional, and racial significance.

Clinical significance: Structural malformations of first rib are common, and when present may lead to compression of the neurovascular bundle at the root of the neck. Awareness of such anomalies is important for anatomists, radiologists, and thoracic surgeons dealing with this region.

Keywords: First rib, Morphological study, Oblique ridge, Scalene tubercle, Vascular groove.

How to cite this article: Rashia S, Zaidi SHH. A Morphological Study of First Rib Anomalies. Int J Adv Integ Med Sci 2017;2(2):70-72.

Source of support: Nil

Conflict of interest: None

6.Original Article

Combined Spinal–epidural with Levobupivacaine or Ropivacaine with Fentanyl for Labor Analgesia: A Comparative Study

Yogesh K Sharma, Malti Agrawal
[Year:2017] [Month:April-June] [Volume:2 ] [Number:2] [Pages No:73-77] [No. of Hits: 252]
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  • [Abstract]
  • [DOI : 10.5005/jp-journals-10050-10080]

ABSTRACT

Introduction: Combined spinal-epidural analgesia to provide pain relief in labor has become the technique of choice. It provides benefits of both spinal analgesia and flexibility of an epidural catheter. In this study, we compared levobupivacaine with fetanyl and ropivacaine with fentanyl in terms of onset and duration of sensory blockade.

Materials and methods: This was a double-blind randomized study on 60 parturients of American Society of Anesthesiologists status 1 and 2, all primipara with singleton pregnancy in active labor, were allocated randomly into two groups of 30 each. Group L received 3 mg of levobupivacaine intrathecally with 25 μg fentanyl followed by epidural top-ups of 14 mL levobupivacaine 0.125% with fentanyl 30 μg, whereas group R received 4 mg of ropivacaine intrathecally with 25 μg of fentanyl followed by epidural top-ups of 14 mL ropivacaine 0.2% with fentanyl 30 μg. Sensory and motor characteristics, hemodynamics, maternal and fetal outcomes, side effects, and complications were observed and analyzed statistically using Student’s unpaired t-test and chi-squared test.

Results: A rapid onset of analgesia in group L (4.67 ± 0.35) as compared with group R (5.57 ± 0.27) was observed. Duration of analgesia was also prolonged in group B (116.83 ± 6.91) as compared with group R (88.87 ± 5.10). Patients remained hemodynamically stable, and side effects and complications were comparable in both groups.

Conclusion: Levobupivacaine with fentanyl combination was found to be more promising in terms of onset and duration of labor analgesia as compared with ropivacaine and fentanyl combination.

Keywords: Fentanyl, Labor analgesia, Levobupivacaine, Ropivacaine.

How to cite this article: Sharma YK, Agrawal M. Combined Spinal-epidural with Levobupivacaine or Ropivacaine with Fentanyl for Labor Analgesia: A Comparative Study. Int J Adv Integ Med Sci 2017;2(2):73-77.

Source of support: Nil

Conflict of interest: None

7.Original Article

Long-term Effectiveness and Tolerability Profile of Iloperidone in Patients of Psychosis

Shivangna Singh, Hariom K Singh, Abhinav Kuchhal, Alka Yadav, Imran Zaheer
[Year:2017] [Month:April-June] [Volume:2 ] [Number:2] [Pages No:78-84] [No. of Hits: 213]
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  • [DOI : 10.5005/jp-journals-10050-10081]

ABSTRACT

Aim: To evaluate the long-term efficacy, tolerability, and safety profile of iloperidone.

Materials and methods: A 12 month, prospective, interventional, open label, fl exible dose study was conducted on 50 drug naïve, first-episode patients aged 18 to 65 years, fulfilling the International Classification of Diseases-10 criteria for psychosis, for assessing long-term efficacy and adverse events, including biochemical parameters of iloperidone. Detailed clinical examination was carried out. Sociodemographic data and baseline parameters were recorded.

Results: Two patients dropped out during the course of therapy. M/F ratio was 1.77:1. Mean age of patients was 28.76 ± 10.28 [mean ± standard deviation (SD)] years. Rural/urban ratio was 2.84:1.25. Patients were illiterate, 18 belonged to low socioeconomic class. It was observed that iloperidone was fairly efficacious not only in preventing relapse or aggravation of symptoms but also well restored the patient to almost near-normal till the end point. After 3 months, 20/48 (41.66%) patients showed significant weight gain that was evident. Mean total weight gain from baseline to end point was 2.89 kg and was statistically significant. There was significant rise in body mass index (BMI) but no patient crossed the upper normal limit. Iloperidone did not cause significant rise (p < 0.6955) in fasting blood sugar (FBS), and no significant alterations in total cholesterol (TC), triglyceride, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol were recorded. Dizziness was one of the earliest adverse events appearing within 2 to 3 days; others were insomnia, weight gain, increased appetite, anxiety, headache, sedation, etc.

Conclusion: On long-term basis, iloperidone is fairly efficacious and has favorable tolerability profile with modest weight gain and practically no alteration in FBS, and lipid profile as well as absence of extrapyramidal side effects.

Keywords: Atypical antipsychotic, Efficacy, Metabolic profile, Tolerability.

How to cite this article: Singh S, HK Singh, Kuchhal A, Yadav A, Zaheer I. Long-term Effectiveness and Tolerability Profile of Iloperidone in Patients of Psychosis. Int J Adv Integ Med Sci 2017;2(2):78-84.

Source of support: Nil

Conflict of interest: None

8.Original Article

Psychiatric Morbidity and Quality of Life in Patients suffering from Psoriasis in a Tertiary Care Hospital

Rakesh Yaduvanshi, Arpit Jaiswal, CS Sharma, Santosh Kumar, Ramjan Ali, RK Shrivastava, PK Rathoure
[Year:2017] [Month:April-June] [Volume:2 ] [Number:2] [Pages No:85-90] [No. of Hits: 196]
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  • [Abstract]
  • [DOI : 10.5005/jp-journals-10050-10082]

ABSTRACT

Introduction: Psoriasis is an inflammatory skin disease, which may be persistent, disfiguring, and stigmatizing. The disease is frequent, with prevalence estimates ranging from 0.3 to 2.5%. It is characterized by thick, red, scaly lesion that may appear on any part of the body. Psoriasis is associated with significant psychological and psychiatric morbidity, experience of stigmatization, and decreased health-related quality of life (QOL).

Aims and Objectives: The aims of this study were to estimate psychiatric morbidity and QOL in patients with psoriasis and to study the specified demographic, psychological, social, and illness-related correlates of psychiatric morbidity and QOL.

Materials and methods: The study group consisted of 100 consecutive patients suffering from psoriasis and healthy controls. The assessment was done using General Health Questionnaire 12 items (GHQ-12), Psoriasis Area and Severity Index (PASI) scale, Hospital Anxiety and Depression Scale (HADS), and the World Health Organization Quality of Life BREF scale (WHOQOL-BREF). Patients were also subjected to clinical psychiatric examination. Only those subjects who scored .3 on GHQ-12 scale were administered HADS and WHOQOL-BREF.

Results: This study revealed statistically significant association between number of relapses and depression score and between severity of skin lesions (PASI score) and depressive score.

Keywords: Psoriasis, Psychiatric morbidity, Quality of life

Conclusion: Psoriasis markedly worsens the global well-being of patients and their cohabitants, who experienced an impairment of their QOL and higher levels of anxiety and depression.

How to cite this article: Yaduvanshi R, Jaiswal A, Sharma CS, Kumar S, Ali R, Shrivastava RK, Rathoure PK. Psychiatric Morbidity and Quality of Life in Patients suffering from Psoriasis in a Tertiary Care Hospital. Int J Adv Integ Med Sci 2017;2(2):85-90.

Source of support: Nil

Conflict of interest: None

9.Review Article

Founder of Modern Bacteriology: Robert Koch

VK Tiwari
[Year:2017] [Month:April-June] [Volume:2 ] [Number:2] [Pages No:91-96] [No. of Hits: 443]
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  • [Abstract]
  • [DOI : 10.5005/jp-journals-10050-10083]

ABSTRACT

The celebrated German doctor Robert Koch was one of the most important and influential bacteriologists in history. He is considered the founder of “modern bacteriology.” Koch is credited with developing many innovative and fundamental techniques - some of which are used today - and proving that microorganisms caused anthrax, cholera, and tuberculosis. His work was essential in proving the germ theory of disease and that such diseases were contagious. He was instrumental in applying the germ theory to community health and hygiene practices in order to prevent diseases in his native Germany and elsewhere. Koch won the Nobel Prize for Physiology/Medicine in 1905 and received many other medals and honors during his lifetime and after his death.

10.Review Article

Sterilization and Infection Control Measures in Dental Operatory

Sumit Mohan, Virender K Prajapati, Santosh K Verma
[Year:2017] [Month:April-June] [Volume:2 ] [Number:2] [Pages No:97-100] [No. of Hits: 411]
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  • [Abstract]
  • [DOI : 10.5005/jp-journals-10050-10084]

ABSTRACT

Increase in the incidence of serious transmissible diseases over the last few decades has enhanced major concern and impacted the treatment mode of all health care practitioners. Nowadays, more emphasis is made to assure the patients that they are well protected from risks of infectious disease. Infection control is the most important phase of any dental therapy that has helped to allay concerns of the health care personnel and in providing a safe environment for both patient and personnel. This study reviews different sterilization and infection control protocols in a dental operatory.

Keywords: Autoclave, Indicators, Infection control, Sterilization.

How to cite this article: Mohan S, Prajapati VK, Verma SK. Sterilization and Infection Control Measures in Dental Operatory. Int J Adv Integ Med Sci 2017;2(2):97-100.

Source of support: Nil

Conflict of interest: None

11.Case Report

Isolated Tuberculosis of Patella in a Child: A Case Report and Literature Review

Ganesh S Dharmshaktu, Pankaj Singh
[Year:2017] [Month:April-June] [Volume:2 ] [Number:2] [Pages No:101-103] [No. of Hits: 209]
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  • [Abstract]
  • [DOI : 10.5005/jp-journals-10050-10085]

ABSTRACT

The patella is an uncommon site for skeletal tuberculosis. Its incidence is limited to a few anecdotal case reports or series in the literature. The presence of this clinical entity in the pediatric age group is even rarer. A high index of suspicion and early clinicoradiological diagnosis are the mainstay of treatment coupled with compliant antitubercular treatment. The effective management also mitigates its spread to whole of the knee joint and subsequent arthrosis. A rare case of patella tuberculosis with effective management and good functional outcome in a 9-year-old male child is presented here with relevant details.

Keywords: Antitubercular Treatment, Child, Diagnosis, Knee Joint, Management, Musculoskeletal, Patella, Tuberculosis.

How to cite this article: Dharmshaktu GS, Singh P. Isolated Tuberculosis of Patella in a Child: A Case Report and Literature Review. Int J Adv Integ Med Sci 2017;2(2):101-103.

Source of support: Nil

Conflict of interest: None

12.Case Report

Tuberculosis of Middle Ear

Ankit Gulati, Vikas Kakkar, Chandni Sharma, Mohit Pareek, Surender Bishnoi
[Year:2017] [Month:April-June] [Volume:2 ] [Number:2] [Pages No:104-105] [No. of Hits: 197]
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  • [DOI : 10.5005/jp-journals-10050-10086]

ABSTRACT

A 32-year-old female presented with a history of otorrhea and hearing loss in her right ear since 2 years. On examination, external auditory canal was found to be filled with polypoidal tissue along with mucopurulent discharge. Audiometry showed mixed hearing loss of 50, 55, and 60 dB with air-bone gap of 30, 35, and 40 dB at frequencies of 0.5, 1, and 2 kHz respectively. She was operated for the same, and biopsy was sent for histopathological examination, which showed granulomatous inflammation. The patient was treated with antituberculous therapy, and she responded fully to the treatment.

Keywords: Otorrhea, Pale granulation tissue, Tuberculous otitis media.

How to cite this article: Gulati A, Kakkar V, Sharma C, Pareek M, Bishnoi S. Tuberculosis of Middle Ear. Int J Adv Integ Med Sci 2017;2(2):104-105.

Source of support: Nil

Conflict of interest: None