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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 : 766]
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 : 660]
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.  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 : 83]
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

 
4.  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 : 81]
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

 
5.  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 : 76]
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

 
6.  CASE REPORT
Pericardial Synovial Sarcoma presenting with Cardiac Tamponade
Ravishankar Shetty, Shanmukh Hiremath
[Year:2017] [Month:January-March] [Volume:3 ] [Number:1] [Pages:33] [Pages No:28-30] [No of Hits : 71]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0051 | FREE

ABSTRACT

Pericardial synovial sarcomas are very rare and usually associated with poor prognosis if not diagnosed and treated early. It usually presents with symptoms of a massive pericardial effusion and signs of cardiac tamponade and failure. Here, we report the case of a 27-year-old patient with exertional dyspnea and massive pericardial effusion. Echocardiography and magnetic resonance imaging revealed a pericardial mass. The patient was treated by surgical excision and a subsequent histological analysis confirmed the diagnosis of pericardial synovial sarcoma.

Keywords: Cardiac tamponade, Pericardial effusion, Pericardial synovial sarcoma, Pericardium.

How to cite this article: Shetty R, Hiremath S. Pericardial Synovial Sarcoma presenting with Cardiac Tamponade. J Med Sci 2017;3(1):28-30.

Source of support: Nil

Conflict of interest: None

 
7.  ORIGINAL ARTICLE
Factors influencing Noncompliance to Treatment among Elderly in the Urban Field Practice Area of RajaRajeswari Medical College and Hospital, Bengaluru, Karnataka
T Rajitha, BG Parasuramalu
[Year:2017] [Month:January-March] [Volume:3 ] [Number:1] [Pages:33] [Pages No:11-14] [No of Hits : 62]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0047 | FREE

ABSTRACT

Noncompliance to medication is a leading issue and a huge burden in our current health care system. Poor adherence has shown to decrease the effects of prescribed medications or other treatments and increase the likelihood of poor outcomes. A community-based cross-sectional study was conducted in the urban field practice area of RajaRajeswari Medical College and Hospital, Bengaluru, Karnataka, India, among all the elderly aged .60 years, using a semistructured and pretested questionnaire. The study included 153 elderly participants, among whom 89 were males and 64 were females. Out of the 153 participants, 125 (81.69%) had some or the other illness. Out of the 125 who were ill, only 78 (62.4%) were taking treatment regularly. The remaining 47 (37.6%) were noncompliant to treatment. The main factors for noncompliance were forgetfulness 16 (34%) and symptomatic improvement 10 (21.3%).

Keywords: Bengaluru, Elderly, Noncompliance to treatment, Urban.

How to cite this article: Rajitha T, Parasuramalu BG. Factors influencing Noncompliance to Treatment among Elderly in the Urban Field Practice Area of RajaRajeswari Medical College and Hospital, Bengaluru, Karnataka. J Med Sci 2017;3(1):11-14.

Source of support: Nil

Conflict of interest: None

 
8.  ORIGINAL ARTICLE
Study of Atherosclerotic Risk Factors in Patients with Prediabetes and Type II Diabetes Mellitus with Special Reference to Carotid Intima–media Thickness
Anita Bhosale, MV Krishna, Das Suraj, M Gautam
[Year:2017] [Month:January-March] [Volume:3 ] [Number:1] [Pages:33] [Pages No:15-19] [No of Hits : 53]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0048 | FREE

ABSTRACT

Background: The present study was carried out to study various atherosclerotic risk factors in prediabetes and type II diabetes mellitus (DM) patients, with special reference to carotid artery intima-media thickness (CIMT). The mean value of CIMT as an indicator of early atherosclerosis was determined and the various atherosclerotic risk factors in patients with prediabetes and type II DM were studied.

Materials and methods: A Comparative two group study was conducted involving 50 patients each with prediabetes and type 2 diabetes mellitus in the age group of 30 to 65 years, Confirmed by FPG/2hour PG/HbA1C/Random plasma glucose values according to ADA criteria, over a period of one year. The study consisted of interview regarding demographic profiles, vascular risk factors, fundoscopy and investigation like FPG, 2hour PG with OGTT, HbA1C, lipid profile, Renal function tests, urine for microalbuminuria, ECG, 2DECHO and CIMT Measurement using B mode ultrasonography.

Results: The association between age of the patients and occurrence of type II DM and prediabetes was found to be statistically significant. Mean duration of type II DM in our study was 6.64 ± 6.71 years. 66% Diabetics and 62% Pre-Diabetics had a BMI over 23. Mean TGs levels in diabetics and Prediabetics where 268 mg/dl and 193mg/dl respectively. Mean CIMT in Diabetics and Pre-diabetics were 0.81mm and 0.67mm respectively. Incidence of hypertension in diabetics and Prediabetics were 30% and 26% respectively. CIMT had a positive association with hypertension, smoking, and a moderate significance with alcohol use.

Conclusion: The present study emphasizes on the role of CIMT measurement as a routine investigation among diabetics and pre-diabetics for early recognition of atherosclerosis and cardiovascular risk reduction.

Keywords: Body mass index, Carotid intima-media thickness, Diabetes mellitus, Fasting blood sugar, High-density lipoprotein, Impaired fasting glucose, Impaired glucose test, Low-density lipoprotein, Postprandial blood sugar, Triglycerides, Very lowdensity lipoproteins.

How to cite this article: Bhosale A, Krishna MV, Suraj D, Gautam M. Study of Atherosclerotic Risk Factors in Patients with Prediabetes and Type II Diabetes Mellitus with Special Reference to Carotid Intima-media Thickness. J Med Sci 2017;3(1):15-19.

Source of support: Nil

Conflict of interest: None

 
9.  EDITORIAL
Management of Acute Postoperative Pain: Current Recommendations
H Sahajananda
[Year:2017] [Month:January-March] [Volume:3 ] [Number:1] [Pages:33] [Pages No:iv-viii] [No of Hits : 53]
Full Text PDF | Abstract | FREE

ABSTRACT

More than 80% of surgical patients experience acute postoperative pain after their surgeries. Among them, 75% of patients with postoperative pain grade the severity of pain as moderate, severe, or extreme.

 
10.  REVIEW ARTICLE
Reliability of Ultrasound in the Identification and Measurement of Blood Supply to the Anterior Part of the Mandible
MS Kiran, M Manjunath, Anil K Shukla, S Vidya
[Year:2017] [Month:January-March] [Volume:3 ] [Number:1] [Pages:33] [Pages No:20-24] [No of Hits : 52]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0049 | FREE

ABSTRACT

Objective: The aim of this study is to identify in vivo the main blood supply to the bony chin and to determine the efficacy of ultrasound Doppler in determining this aspect and then compare it with radiograph.

Materials and methods: The study was carried on 50 subjects divided into two equal groups. In the first group, the lingual foramen was identitifed on intraoral periapical (IOPA) radiograph of the mandibular incisor region. Ultrasound Doppler identification of blood supply to the anterior part of the mandible was carried out. In the second group of 25 subjects, the procedure was reversed. This was done to avoid procedural bias.

Discussion: In our patients, the midline artery entering the lingual foramen was seen by ultrasound and radiograph. Their average diameters and velocities were measured. It was identified in 46 cases by the ultrasound Doppler examination. The IOPA radiographic examination was successful in identifying the foramen in 30 cases. The average diameter of the midline artery entering the lingual foramen was found to be 0.14 cm. The average velocity of blood flow in this artery was found to be 25.5 cm/second.

Conclusion: The ultrasound Doppler is a reliable tool to visualize and measure the blood supply to the anterior part of the mandible.

Keywords: Blood supply, Lingual foramen, Radiograph, Ultrasound Doppler.

How to cite this article: Kiran MS, Manjunath M, Shukla AK, Vidya S. Reliability of Ultrasound in the Identification and Measurement of Blood Supply to the Anterior Part of the Mandible. J Med Sci 2017;3(1):20-24.

Source of support: Nil

Conflict of interest: None

 
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