Annals of International Medical and Dental Research (original) (raw)

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The most common electrolyte disorder in geriatric age group is hyponatremia thought to be respons... more The most common electrolyte disorder in geriatric age group is hyponatremia thought to be responsible for increased mortality. Lack of data on the prevalence, etiology and outcome of hyponatremia in the elderly from the state of Uttarakhand led us to investigate the same on the elderly hospitalised in a tertiary care hospital in the state of Uttarakhand. Aims and Objectives: The purpose of the study was to find out the prevalence of hyponatremia in geriatric population, its etiology and outcome in elderly population. Methods: This cross sectional observational study was carried on 526 elderly patients admitted in a tertiary care hospital over a period of 1-year. Demographic, clinical and outcome data of the elderly patients with hyponatremia was collected and efforts were made to elicit its etiology. Results: 240 of 526 elderly hospitalized were found to have hyponatremia; 136 (56.6%) were females. Diuretics were found to be the most common cause of hyponatremia, detected in 82 (34.2%) patients, of whom 28(27.1%) were hypovolemic and 54(56.8%) hypervolemic. Other potential causes of hyponatremia included respiratory infections (n=57, 23.7%), chronic liver disease (n=34, 14.1%), syndrome of inappropriate anti-diuretic hormone SIADH (n=10,4.1%), malignancy (8.2%), low sodium diet (n=10,4.1%) and congestive heart failure (n=22,9.2%). Diabetes mellitus (33.7%) and hypertension (27.9%) were the most common co-morbidities associated with hyponatremia. Severe neurological manifestations were detected only in 25(10.4%) while the majority was asymptomatic or had minor symptoms pertaining to hyponatremia. Seventeen (7.1%) patients with moderate (n=12) and severe (n=5) hyponatremia succumbed. Conclusion: Hyponatremia is the major electrolyte disorder of the elderly, specially the females. It contributes to morbidity and mortality, however, the severity of hyponatremia is not related to an increase in mortality.

Post electric burn sigmoid perforation is a rare but dreadful complication. It can lead to increa... more Post electric burn sigmoid perforation is a rare but dreadful complication. It can lead to increased chances of mortality/morbidity if any delay is made during diagnosis or active management. We report a case of electric current burn on left hand, forearm, arm and shoulder with perforation of sigmoid colon with successful management by primary closure.

We report a case of use of semi rigid intubating bougie to intubate a patient with large thyroid ... more We report a case of use of semi rigid intubating bougie to intubate a patient with large thyroid swelling in life threatening airway emergency in the absence of sophisticated equipments.

Varicose veins have troubled mankind for thousands of years, and their various treatments and com... more Varicose veins have troubled mankind for thousands of years, and their various treatments and complications have been documented from the times of Hippocrates. Although thrombophlebitis is a relatively common condition in the superficial veins of the upper or lower limbs, it usually follows some intravenous intervention or trauma. Thrombosis followed by thrombophlebitis in varicose veins has seldom been reported in literature but the occurrence of spontaneous thrombosis in only the above knee perforator veins of the lower limb has been seldom mentioned. We report the case of a patient with long standing varicose veins of the left lower limb presenting with spontaneous thrombosis of only the above knee perforators and our subsequent management.

Background: Cholecystectomy is one of the commonest, clean and contaminated surgery operations pe... more Background: Cholecystectomy is one of the commonest, clean and contaminated surgery operations performed by the surgeons worldwide. Antibiotic prophylaxis in elective cholecystectomy is a controversial issue and our study was undertaken to evaluate the rate of infection and the usefulness and efficacy of antibiotic prophylaxis in elective cholecystectomies. Methods: The study comprised of 100 patients admitted for elective cholecystectomy. The first fifty patients undergoing elective cholecystectomy were given the prophylactic antibiotic outside the operation theater in the wards and the next fifty patients were given a single dose of injection cefuroxime (1.5 gm i.v).

The aim of study is to compare I-gel and Air-Q supraglottic airways in terms of -success rate of ... more The aim of study is to compare I-gel and Air-Q supraglottic airways in terms of -success rate of device insertion, number of attempts taken, haemodynamic parameters before and after device insertion, incidence of trauma and postoperative sore throat, dysphagia. Methods: This randomised single blind study was conducted on 90 patients of age 18-60 years, undergoing elective surgery requiring general anaesthesia. Patients were randomly allocated in two groups-Group I: I-gel (n= 45), Group II: Air-Q (n=45). After preoxygenation, induction and muscle relaxation appropriate size I-gel or Air-Q was inserted and all parameters were noted by an independent observer. For statistical analysis, Student t-test was employed to compare the means and Chi-square test was used for categorical variables. Complications were compared using Fisher's exact test. Results: The demographic profile of patients in both groups was similar. In all patients supraglottic airway device was inserted within 3 attempts. Mean insertion time in first attempt for I-gel (25.85 ±1.7 sec) was found to be significantly lower than Air-Q (26.73±1.51 sec) [P=0.0128]. Conclusion: We conclude that I-gel is easier and safer than Air-Q when ventilation through LMA is intended during surgery.

Previously it was thought that mercury sulphide in low dose shows good therapeutic effect without... more Previously it was thought that mercury sulphide in low dose shows good therapeutic effect without producing toxic effects in the human beings. Symptoms like ataxia, speech impairment, visual field constriction, deafness, tremors, mental retardation, coma and even death has been reported due to chronic use of this heavy metal. The aim of our present study is to compare histopathological changes in different parts of brain, so that clinical symptoms following mercury intoxication can be explained. Methods: Freshly prepared sterile solution of mercuric chloride in distilled water (0.33 mg/kg body weight) was orally administered daily to total number of 30 adult albino rats (15 males and 15 females) for a month. 3mm thick sections were taken from cerebrum, cerebellum and hippocampus parts. These sections were processed and then stained by haematoxylin & eosin to be observed in light microscope. Results: Histological pictures of all the three areas were suggestive of multiple foci of necrosis with gliosis. Marked congestion of vessels with perivascular necrosis was also noticed. Increased cellularity of granular layer and molecular layer in cerebellum and hippocampus were seen respectively. Conclusion: The histopathological examination revealed that normal cytoarchitecture of all the three areas of brain were distorted resulting in various neurological disorders.

Background: Gokshuradi Yog used from for strengthening and functioning of genitourinary tract. Th... more Background: Gokshuradi Yog used from for strengthening and functioning of genitourinary tract. The study aims to study the role of this Ayurvedic medicine along with antibiotic in early response to treatment of urinary tract infection in children. Methods: This study was conducted on 52 children (32 girls and 20 boys). They had symptomatic and culture proven urinary tract infection. They were randomly allotted the treatment group and control group. Patents in control were given the antibiotics for seven days and were evaluated every alternate day for symptomatic relief. Similarly the patients in treatment group were started the antibiotics along with preparation of 'Gokshuradi Yog' for seven days and were evaluated every alternate days. Repeat culture was performed on seventh day of treatment and the final result was evaluated. Results: The most common organism grown on culture was Escherichia coli in 39 patients (22 girls and 17 boys). Of the 28 children in treatment group 26 were asymptomatic in 2 days however they continued to be on therapy for seven days. Two patients were symptomatic even after four days, one of whom was culture positive even after 7 days of treatment and was put on intravenous antibiotics. Six out of 24 patients in control group were asymptomatic in two days; the 18 remaining patients were symptomatic even till day seven of treatment out of which two patients were culture positive. Conclusion: Patients when treated with 'Gokshuradi Yog' along with the antibiotics brings early symptomatic relief in children suffering from culture proven UTI.

The aim of our study is to share our experience with conservative management of odontogenic kerat... more The aim of our study is to share our experience with conservative management of odontogenic keratocyst, and also to study the role of carnoy's solution in prevention of recurrence of small keratocystic odontogenic tumour (KCOT). Methods: 29 consecutive patients with 30 KCOT treated in department of Oral & Maxillofacial Surgery in Teerthanker Mahaveer Dental college, Moradabad, UP. Initial biopsy was carried out in all patients and the OKCs were diagnosed after histological examination by the Oral Pathology Department. Out of 26 KCOT which were treated with enucleation alone, 14 patients were subjected to additional burning of cyst epithelium by carnoy's solution. 4 large OKC which might undergone pathological fracture were treated by two stage surgery marsupialization followed by enucleation. Results: The majority of the lesions (17 patients, 56.7%) occurred in the mandibular third molar region. Recurrence occurred in 4 patients, in which 3 of them were from enucleation group and one of marsuplization and enucleation group.All the caseswere monitored continuously with panoramic radiographies and clinical evaluations.curettage of the remaining lesion. The average follow-up was 15 months. Conclusion: Use of carnoy's solution with enucleation has definite advantage over the conventional enucleation. Further large KCOT can be conservatively treated with low morbidity with Marsupilization followed by enucleation successfully. The systematic and long-term post-surgical follow-up is considered to be a key element for successful results.

Background: Dexmedetomidine is a centrally acting alpha-2 adrenoceptor agonist. In this study, we... more Background: Dexmedetomidine is a centrally acting alpha-2 adrenoceptor agonist. In this study, we compared dexmedetomidine to fentanyl in attenuating sympathetic response to laryngoscopy and tracheal intubation. Methods: Eighty ASA grade I-II patients requiring tracheal intubation were included in this prospective study and were randomly assigned to the dexmedetomidine (Group D) and fentanyl group (Group F) (40 patients in each group). Both the drugs were given at 1 µg/kg dose prior to laryngoscopy. We assessed heart rate, blood pressures and complications (bradycardia, hypotension and sedation). Results: The two groups were comparable in demographic parameters. The baseline mean heart rate (P=0.94) was not significantly different between Group F and Group D. Increase in heart rate after laryngoscopy and intubation was significantly lower in Group D compared to Group F (P=0.039). Mean heart rate remained lower at one minute after intubation in Group D but it was not statistically significant (94.64 s vs 86.28 sec). The difference in mean heart rate between two groups was comparable at three, five, ten and fifteen minutes after intubation. The baseline Mean arterial pressure was comparable between the groups (P=0.83) and remained similar throughout 15 minutes after intubation. Group D showed significant hypotension compared to Group F (P=0.03), whereas there was no significant bradycardia between these groups (P=0.19). Mean sedation score is higher in Group D compared to Group F. Conclusion: At 1 µg/kg dose, both dexmedetomidine and fentanyl cause partial attenuation of sympathetic response to laryngoscopy and intubation but dexmedetomidine blunts this response more effectively than fentanyl.

Bioabsorbable materials are more commonly used now days in orthopaedic surgeries. Bioabsorbable i... more Bioabsorbable materials are more commonly used now days in orthopaedic surgeries. Bioabsorbable implants for fracture fixation, and meniscal repair. These implants provide the advantages of gradual load transfer to the healing tissue, reduced need for implant removal, and radiolucency, which facilitates postoperative radiographic evaluation and no hinderance in second surgery. These also carries disadvantages like, more expensive, having less strength than metals, tissue reactions including mild fluid accumulation, painful erythematous fluctuating papule, sterile sinus tract formation, osteolysis, synovitis, and hypertrophic fibrous encapsulation. We advocate more researches to be carried out for the best suitability of these materials in orthopaedic surgeries.