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JAYPEE JOURNALS
International Scientific Journals from Jaypee
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1.  ORIGINAL RESEARCH
A Clinical Audit of Quality Indicators in Anesthesia Practice
Maya Nadakarni, Desi Prakruthi, Sahajananda H
[Year:2015] [Month:July-September] [Volume:1 ] [Number:3] [Pages:14] [Pages No:47-51] [No of Hits : 1188]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0014 | FREE

ABSTRACT

Background: To measure and monitor the quality of care in anesthesia, which is lacking in India. The objective of this audit was to formulate a set of quality indicators and use them to audit our daily anesthetic practice.

Materials and methods: We applied eight quality indicators to audit 4,147 medical records of our hospital. We measured the quality of anesthesia care in the preoperative, intraoperative, and postoperative period by collecting and analyzing the various data.

Results: We found out the weaker areas where quality of anesthesia care could be improved. In 160 (3.85%) patients, preanesthetic check-up was lacking; in 569 (13.72%) patients, anesthesia plan was modified on the day of surgery. A total of 378 (9.11%) patients were ventilated following anesthesia. A total of 123 (2.96%) patients were in recovery room for more than the normal expected time and 187 (4.50%) patients were shifted to the ICU for further intensive care. There was no mortality in our audit findings.

Conclusion: In this audit, we found several areas where improvements could be done. In future, the quality of anesthesia services will be monitored by quality assurance programs using quality indicators, which will improve the perioperative outcome. A dramatic change is expected in anesthesia practice for the betterment of patient care. At present we should try to adopt these practices and improve anesthesia delivery services.

Keywords: Anesthesia, Monitoring, Quality indicators.

How to cite this article: Nadakarni M, P Desi, H Sahajananda. A Clinical Audit of Quality Indicators in Anesthesia Practice. J Med Sci 2015;1(3):47-51.

Source of support: Nil

Conflict of interest: None

 
2.  BRIEF COMMUNICATION
Management of Breast Hypertrophy: Our Experience
Prema Dhanraj, MS Mahesh, N Naveen, K Ramesh Babu, Rajashekar Jade
[Year:2015] [Month:January-March] [Volume:1 ] [Number:1] [Pages:25] [Pages No:21-25] [No of Hits : 753]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0007 | FREE

ABSTRACT

Breast hypertrophy and sagging of the breast are two different benign disorders of breast that can occur during various stages of women’s life from adolescence to menopause. A woman can seek a plastic surgeon for breast reduction for reasons both physical and psychological. Breast reduction surgery or reduction mammoplasty is a plastic surgical procedure by which the sizes of large breasts are reduced. During this procedure, excess skin, fat and breast tissue are removed. The procedure recreates a breast with the desired appearance, contour and volume. Breast lift operation/mastopexy is a procedure where only skin is removed with repositioning of the nipple higher on the chest wall and is the procedure of choice in small but sagging breast.
We present a series of five cases, two presenting with virginal hypertrophy, one with gestational hypertrophy and other two with postmenopausal sagging and hypertrophy. Four patients underwent reduction mammoplasty and one patient underwent mastopexy. None of our patients complained of any problems and were satisfied with the results.

Keywords: Breast hypertrophy, Reduction mammoplasty, Mastopexy.

How to cite this article: Dhanraj P, Mahesh MS, Naveen N, Babu KR, Jade R. Management of Breast Hypertrophy: Our Experience. J Med Sci 2015;3(1):21-25.

Source of support: Nil

Conflict of interest: None

 
3.  Case Report
Anesthetic Management of a Parturient with Congenital Complete Heart Block posted for Emergency Lower Segment Cesarean Section
R Mamatha, MJ Sowmya, KT Venkateshmurthy, H Sahajananda, GS Karthik
[Year:2015] [Month:October-December] [Volume:1 ] [Number:4] [Pages:17] [Pages No:74-76] [No of Hits : 653]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0022 | FREE

ABSTRACT

Pregnancy complicated with complete heart block is rare and usually required termination of pregnancy in the past. Improvement in medical technology in the form of cardiac pacing has allowed taking these women to term. Overall, maternal and fetal outcome is not affected in asymptomatic cases. We report here an unbooked, pregnant patient presented at 38+ weeks with complete heart block and pregnancy-induced hypertension for emergency lower segment cesarean section (LSCS). Emergency LSCS was performed under general anesthesia. Maternal and fetal outcome was good.

Keywords: Complete heart block, Pacemaker, Temporary pacemaker.

How to cite this ar ticle: Mamatha R, Sowmya MJ, Venkateshmurthy, Sahajananda H, Karthik GS. Anesthetic Management of a Parturient with Congenital Complete Heart Block posted for Emergency Lower Segment Cesarean Section. J Med Sci 2015;1(4):74-76.

Source of support: Nil Conflict of interest: None

 
4.  CASE REPORT
Hereditary Elliptocytosis
PS Sharmila, Kannupriya, MF Paul
[Year:2015] [Month:April-June] [Volume:1 ] [Number:2] [Pages:19] [Pages No:41-43] [No of Hits : 570]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0012 | FREE

ABSTRACT

Hereditary elliptocytosis (HE) is a group of disorders characterized by the presence of elliptical-shaped erythrocytes on peripheral blood smear. Hereditary elliptocytosis and its related disorders are characterized by clinical, biochemical, and genetic heterogeneity. Manifestations range from the asymptomatic carrier state to severe, transfusion dependent hemolytic anemia. Abnormalities of various membrane protein defects contribute to mechanical defects of the erythrocyte membrane skeleton. We present a rare case of HE, an incidental finding without any clinical symptoms related to it. We also discuss on pathophysiology and being.

Keywords: Elliptocytes, Erythrocyte, Hemolysis.

How to cite this article: Sharmila PS, Kannupriya, Paul MF. Hereditary Elliptocytosis. J Med Sci 2015;1(2):41-43.

Source of support: Nil

Conflict of interest: None

 
5.  CASE REPORT
Neurocysticercosis
Arigala Ganesh, Mamatha B Patil
[Year:2015] [Month:January-March] [Volume:1 ] [Number:1] [Pages:25] [Pages No:14-16] [No of Hits : 557]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0005 | FREE

ABSTRACT

Neurocysticercosis (NCC), the most common parasitic brain disease worldwide, is endemic in countries with poor sanitation, and is increasingly being reported in developed countries due to globalization and immigration. One of the most intriguing aspects of NCC is that presumably a high percentage of the individuals harboring NCC remains asymptomatic. It has also been stated that almost any neurological symptomatology may be found, ranging from mild headache or treatable acute seizures to very severe neurological manifestations, such as intracranial hypertension (ICH), dementia or even death.
We are reporting a case of NCC who presented with various clinical manifestations of brain parenchymal lesions, which got cured with treatment. It was confirmed with repeat computed tomography (CT).

Keywords: Extraparenchymal neurocysticercosis, Leptomeninges, Neurocysticercosis.

How to cite this article: Ganesh A, Patil MB. Neurocysticercosis. J Med Sci 2015;3(1):14-16.

Source of support: Nil

Conflict of interest: None

 
6.  CASE REPORT
Stroke in a Young Adult Secondary to Vitamin B12 Deficiency induced Hyperhomocysteinemia
LS Yashaswini, Mamatha B Patil
[Year:2015] [Month:January-March] [Volume:1 ] [Number:1] [Pages:25] [Pages No:10-13] [No of Hits : 521]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0004 | FREE

ABSTRACT

Stroke in young adults is less frequent than in older population but has major impact on individual and society. Stroke in young justifies an extensive etiologic work up-both common and uncommon. Pernicious anemia is characterized by lack of intrinsic factor in gastric mucosa which is essential for absorption of vitamin B12. Deficiency of vitamin B12 contributes to hyperhomocysteinemia which promotes both arterial and venous thrombosis. We present a rare case of stroke in young adult caused by hyperhomocysteinemia secondary to vitamin B12 deficiency.

Keywords: Homocysteine, Pernicious anemia, Stroke, Vitamin B12.

How to cite this article: Yashaswini LS, Patil MB. Stroke in a Young Adult Secondary to Vitamin B12 Deficiency induced Hyperhomocysteinemia. J Med Sci 2015;3(1):10-13.

Source of support: Nil

Conflict of interest: None

 
7.  CASE REPORT
Uterine Necrosis following B-Lynch and Gunasheela’s Global Stitch Sutures for Primary Postpartum Hemorrhage
BS Punya, MPA Sailakshmi, Suhasini Akash, R Nagarathnamma
[Year:2015] [Month:April-June] [Volume:1 ] [Number:2] [Pages:19] [Pages No:38-40] [No of Hits : 512]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0011 | FREE

ABSTRACT

Uterine atony causing postpartum hemorrhage (PPH) is one of the leading causes of maternal morbidity and mortality. Here by reporting a case of 22-year-old woman who underwent full-term vaginal delivery followed by atonic PPH, for which emergency laparotomy was done and stepwise devascularization along with B-Lynch and Gunasheela’s global brace sutures over the uterus. On postoperative day 9, she developed features suggesting sepsis and magnetic resonance imaging (MRI) showed area of avascularity and features of abscess formation in the uterine wall. She underwent subtotal hysterectomy and histopathology showed uterine necrosis.

Keywords: B-Lynch suture, Gunasheela’s global stitch, Postpartum hemorrhage, Uterine necrosis.

How to cite this article: Punya BS, Sailakshmi MPA, Akash S, Nagarathnamma R. Uterine Necrosis following B-Lynch and Gunasheela’s Global Stitch Sutures for Primary Postpartum Hemorrhage. J Med Sci 2015;1(2):38-40.

Source of support: Nil

Conflict of interest: None

 
8.  BRIEF COMMUNICATION
Pregnancy Outcome in Uterine Anomalies
R Nagarathnamma, Thingujam James, Nagendra Prasad
[Year:2017] [Month:January-March] [Volume:3 ] [Number:1] [Pages:33] [Pages No:31-33] [No of Hits : 267]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0052 | FREE

ABSTRACT

Maternal with congenitial anomalies are known to have higher incidence of infertility, intrauterine growth restriction, fetal malposition, preterm labor, preterm premature rupture of membrane and increased cesaerean section rate.

Study Design: This is retrospective study, the pregnancies with uterine anomaly confirmed by ultrasound between Jan 2016 to jan 2017 at our hospital was taken and its outcome is observed.

Reults: The majority of preterm delivery in our study are mainly associated with septate and bicornuate uterus. Cesaerean section comprised of 80% and its major indication is due to fetal malpresentation (breech) .Thus Pregnancy outcomes of individual depending on the type of uterine anomalies.

Keywords: Malpresentation, Preterm birth, Preterm premature rupture of the membranes, Uterine anomalies.

How to cite this article: Nagarathnamma R, James T, Prasad N. Pregnancy Outcome in Uterine Anomalies. J Med Sci 2017;3(1):31-33.

Source of support: Nil

Conflict of interest: None

 
9.  ORIGINAL ARTICLE
Comparative Study of Efficacy between Platelet-rich Plasma vs Corticosteroid Injection in the Treatment of Lateral Epicondylitis
Madhuram Chowdry, KM Gopinath, BNR Kumar, TR Kanmani
[Year:2017] [Month:January-March] [Volume:3 ] [Number:1] [Pages:33] [Pages No:1-5] [No of Hits : 203]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0045 | FREE

ABSTRACT

Introduction: Tennis elbow is a common condition with unpromising several modalities of treatment. Many of these are not aimed at treating the disease process. Platelet-rich plasma (PRP) contains biological healing factors and shows promising results in tendinopathies.
In this study, our aim was to evaluate the efficacy of autologous PRP vs steroid injection in the treatment of chronic recalcitrant lateral epicondylitis.

Materials and methods: A prospective randomized control trial was conducted in our tertiary care hospital. Sixty patients with chronic lateral humeral epicondylitis, not responding to oral medications, tennis elbow belt, and physiotherapy, aged between 18 and 60 years were included in the study. Patients were randomized into PRP or steroid injection group based on a computer-generated block randomization chart. All patients had a baseline assessment including visual analog pain scores, Disability assessment of Shoulder and Hand score (DASH), and Nirschl (Injury, Prevention, Cure and Care - Nirschl Pain Phase Scale of Athletic Overuse Injuries) scores, and the same was repeated at 2 weeks, 6 weeks, 3 months, and 6 months postintervention.

Results: Steroid treatment shows better outcome in shortterm (p < 0.001) and PRP shows better outcome in long-term (p < 0.001) follow-up. All three scores - visual analog score (VAS), DASH, Nirschl - showed significant linear improvement with PRP treatment, whereas with steroid injection initially there was significant improvement up to 3 months and later recurrence of symptoms. No complications were noted with PRP injection.

Conclusion: Use of autologous PRP injections for the management of lateral epicondylitis has better long-term outcomes compared with steroid injection in terms of VAS, DASH, and Nirschl scores. Also in our trial we had no recurrence of symptoms in the PRP group, whereas pain recurred in six patients in steroid group and was treated successfully with PRP.

Keywords: Disability, Lateral epicondylitis, Pain, Platelet-rich plasma, Steroid injection.

How to cite this article: Chowdry M, Gopinath KM, Kumar BNR, Kanmani TR. Comparative Study of Efficacy between Platelet-rich Plasma vs Corticosteroid Injection in the Treatment of Lateral Epicondylitis. J Med Sci 2017;3(1):1-5.

Source of support: Nil

Conflict of interest: None

 
10.  ORIGINAL ARTICLE
Study of Association between Microalbuminuria and Microvascular Complications in Type II Diabetes Mellitus Patients in RajaRajeswari Medical College and Hospital, Karnataka
N Bhavya, V Ajith Kumar
[Year:2017] [Month:January-March] [Volume:3 ] [Number:1] [Pages:33] [Pages No:6-10] [No of Hits : 192]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0046 | FREE

ABSTRACT

Introduction: India is claimed to be the diabetes capital of the world. Many studies had proven that persistent hyperglycemia and associated metabolic syndrome features like hypertension, dyslipidemia, and obesity contribute to the development of vascular complications. The risk of chronic complications increases as a function of the duration of hyperglycemia; they usually become apparent in the second decade of hyperglycemia. Since type II diabetes mellitus (DM) often has a long asymptomatic period of hyperglycemia, many individuals with type II DM have complications at the time of diagnosis. The vascular complications of DM are subdivided into microvascular (retinopathy, neuropathy, nephropathy) and macrovascular (coronary artery disease, peripheral arterial disease, cerebrovascular disease) complications. The present study aims to study the occurrence of microalbuminuria in patients with type II DM and note its association with the duration of diabetes since diagnosis and microvascular complications of DM.

Study design: Prospective observational study.

Materials and methods: The study is a clinical, prospective, and observational study of 100 type II diabetics attending the medicine department outpatient/inpatient of RajaRajeswari Medical College & Hospital, Bengaluru, Karnataka, India, who form the subjects for the study conducted from August 2015 to July 2016 (12 months) and who matched the inclusion criteria.
Data were collected after obtaining informed/written consent from patient. After detailed history, detailed clinical examination, and general physical and systemic examinations, fundoscopy was carried out and relevant laboratory investigations were done.

Results and conclusion: The overall occurrence of microalbuminuria was 38%. The occurrence of microalbuminuria showed a direct relationship with increasing age (p = 0.053) and increasing duration of diabetes since diagnosis. A hemoglobin (Hb)A1c value above 7% is associated with 50% or higher incidence of microalbuminuria (p = 0.018). Patients with a body mass index of more than 25kg/m2 have increased risk of developing type II DM and significant increase in microalbuminuria. The incidence of microalbuminuria is significantly associated with the presence of retinopathy (p = 0.061), peripheral neuropathy (p = 0.009), and hypertension (p ≤ 0.001). Microalbuminuria is inversely associated with high-density lipoporotein (p = 0.089). During the evaluation of diabetic patients and the occurrence of microalbuminuria, the possibility of microalbuminuria and its correlation with various complications of DM should be kept in mind.

Keywords: Incipient diabetic nephropathy, Microalbuminuria, Type II diabetes mellitus.

How to cite this article: Bhavya N, Kumar VA. A Study of Association between Microalbuminuria and Microvascular Complications in Type II Diabetes Mellitus Patients in RajaRajeswari Medical College and Hospital, Karnataka. J Med Sci 2017;3(1):6-10.

Source of support: Nil

Conflict of interest: None

 
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