Author Archives: pisrt

Abstract:Introduction: Acute kidney injury is characterised by a sudden and potentially reversible deterioration in renal function, resulting in impaired elimination of nitrogenous waste products and compromised fluid and electrolyte homoeostasis. Variations in the definitions utilised, the demographic under scrutiny, and the healthcare environments can result in notable disparities in the epidemiological data pertaining to acute kidney injury.
Methods: This cross-sectional observational study was approved by the Institutional Ethics Committee in a tertiary-care teaching hospital located in a urban area. All individuals diagnosed with acute renal failure as defined by the RIFLE criteria were incorporated into the study. Individuals who were below the age of 18 were not included in the study. The enquiry comprised a comprehensive account of the patient’s medical background, a thorough physical examination, and a systemic evaluation. During the period of hospitalisation, patients were classified based on their RIFLE class, which includes R, I, or F. The classification of RIFLE is determined based on either the glomerular filtration rate (GFR) or urine output. Patients were categorised based on their serum creatinine levels and urine output.
Results: Out of the total of 100 cases of Acute Kidney Injury (AKI), 46% were female patients, whereas 54%) were male patients. The Mean age upon initial presentation was 55.22 \(\pm\) 14.91 years. AKI was determined to be primarily caused by sepsis. Among the sample of patients under investigation, 64% of the total, were identified as being associated with sepsis. The study observed a mortality rate of 40%.
Conclusion: Acute Kidney Injury is a prevalent complication observed in patients admitted to the Intensive Care Unit (ICU). The timely identification and management of acute kidney injury (AKI) in critically ill patients have been shown to decrease mortality rates associated with AKI and all-cause mortality.

Abstract:Background and Aim: The condition of infertility is recognised as a major healthcare concern across different communities. The issue’s significant prevalence has resulted in its intensified importance. Environmental conditions and acquired risk factors have been found to be associated with a substantial proportion of cases of infertility. Diverse environmental conditions have underscored the necessity to investigate the distinct aetiologies of infertility in various regions.
Objective: The aim of this study was to determine the frequency causes of infertility in infertile couples.
Materials and Methods: In this cross sectional descriptive study 340 infertile couples that were referred to infertility clinic of tertiary care hospital during study period, were examined. This centre is the only governmental centre for infertility. Information about the patients was obtained from medical examinations and laboratory findings. To analyze the data, descriptive statistics such as frequencies and the mean were used.
Results: Among the various causes of infertility women factors (88.6%) had the highest regard. In the causes of female infertility, menstrual disorders, diseases (obesity, thyroid diseases, and diabetes), The causes of infertility in the 340 couples were divided into four standard categories as follows: Female factor 58.7% , Male factor 28.2%, Combined causes 3%, Unexplained infertility 10.1%. The prevalence of primary and secondary female infertility was 70.5% and 29.5% respectively. Tubal cause account most in female infertility.among male sperm morphology was measure cause.
Conclusion: Urban Central India has a lower rate of primary infertility than developing nations. Healthcare professionals and policymakers must understand infertility incidence and risk factors to develop and implement various infertility prevention and management strategies.

Abstract:Background and Aim: Surgical site infections (SSIs) are common after laparotomy wounds and are associated with a significant economic burden. The use of negative pressure wound therapy (NPWT) has recently been broadened to closed surgical incisions.
Material and Methods: The Institutional Ethics Committee approved this single-center, parallel, randomised controlled trial, which followed the Declaration of Helsinki. If they were 18–65 year old , patients were eligible. All surgery patients undergoing abdominal surgery and closed abdominal surgical wounds who received negative pressure wound therapy or conventional therapy. Exclusion criteria included abdominal pathology re-explored or re-operated and inability to consent. Trial participants received an information leaflet and gave written consent.
Result: The primary objective to assess the relative risk of development of SSI in the ciNPWT, the relative risk of development SSI in CiNPWT group was found to be 0.69 and 1.44 in group with conventional dressing, thus CiNPWT was found to be protective for SSI in incisional wound. CiNPWT and conventional patients were mostly 31-60 years old. 84 patients (70%) were male, while 36 (30%) were female in the study cohort.NPWT reduced wound complications like soakage and dehiscence by 20% on the 14th day after surgery. A 0.013 p-value indicated statistical significance. NPWT reduced wound complications like soakage and dehiscence on the 21st day after surgery. The 18.33% reduction was statistically significant at 0.0134. Negative Pressure Wound Therapy (NPWT) reduced soakage and dehiscence by 10% in serial follow-ups on the 30th day post-surgery. The study revealed a negative correlation between the levels of Total Serum Protein and Serum Albumin and both wound healing duration and duration of hospital stay. Specifically, lower levels of total protein and albumin were associated with longer healing time and extended hospitalisation.
Conclusion: Surgical site infections are common, especially in high-risk patients. SSI costs hospitals a lot. SSI research is underway. This study used Negative Pressure Wound Therapy (NPWT) as a prophylactic dressing for closed incisional wounds in 60 patients and compared its efficacy to conventional dressings. Based on relative risk analysis, CiNPWT prevented SSI after one year. NPWT significantly reduced seroma formation. Negative Pressure Wound Therapy (NPWT) shortened wound healing and hospitalisation. Negative pressure wound therapy (NPWT) reduced wound complications like dehiscence, blistering, necrosis, and reoperation or rehospitalization. These findings were not statistically significant. NPWT reduced SSI.

Abstract:Introduction: In many Western countries, non-alcoholic fatty liver disease (NAFLD) is now surpassing viral hepatitis as the primary cause of chronic liver disease and hepatocellular carcinoma (HCC). In India, the current high burden of NAFLD is likely to rise further in the future. Given the significant prevalence of NAFLD in the community, identifying those at risk of developing liver disease is critical in order to simplify referral and advice effective management. Thus, the present study was carried out with the aim to diagnose Non-alcoholic fatty liver disease based on ultrasound and study its clinical profile in patients attending outpatient clinic and inpatients in a tertiary care hospital in Central India.
Material and Methods: This observational study was carried out in the Department of Medicine, Netaji Subhash Chandra Bose Medical College and Hospital, Jabalpur, after approval by Institutional Ethics Committee. 100 consented patients,>18 years of age presenting to the OPD and IPD of the hospital and suspected and later diagnosed as NAFLD were included in the study using a proforma, ultrasonography and investigations. Data was collected, compiled and analysed using SPSS 22.0 (trial version).
Results: 68%, 27%, 5% cases were diagnosed as grade I, grade II and grade III fatty liver respectively. The mean age was 47.07\(\pm\)11.95 years. Female preponderance was observed (55%). Abdominal pain (55%), fatigue (73%) and dyspepsia (48%) were the dominant symptoms. 51% patients had increased waist circumference (mean =87.06\(\pm\)10.46 cm). Mean BMI was 26.77+4.01 kg/m2. 46% were pre-obese and 15% were obese (BMI >30). Majority of Grade III fatty liver (60%) were diabetics. Mean values of impaired fasting blood sugar in grade I, II, III were 109.6\(\pm\)45.02, 117.52\(\pm\)56.93, 138.20 \(\pm\)53.31 mg/dl and when compared was statistically significant (p<0.05).29% patients had hypertension (\(\geq\)130/85 mmHg. 18% patients had high bilirubin levels. Deranged AST (46.48\(\pm\)27.30) and ALT (57.51\(\pm\)52.10) were found in greater percentage of patients (p value <0.001, <0.001 respectively) and had positive co-relation (r+0.36 and r+0.43). Hypercholesterolemia (>200mg/dl) was found in 46% patients. Mean cholesterol level in grade I, II and III was 192.71\(\pm\)43.43, 210.37\(\pm\)44.11 and 277.34\(\pm\)34.06; when compared it was found to be statistically significant (p< 0.01) with positive co-relation (r+0.39).Hypertriglyceridemia (>150mg/dl) was present in 60% cases. The mean triglyceride level in grade I, II and III was 160.46\(\pm\)51.28, 211.00\(\pm\)111.432 and 240.14\(\pm\)174.111 mg/dl respectively and when compared was statistically significant (p<0.05) with positive co-relation (r+0.29). Low HDL was present in 71% of patients. HDL cholesterol had a negative co-relation (r-0.17). In the present study mean LDL was 119.66+31.11 mg/dl and elevated LDL (>130mg/dl) was found in 29% of patients. Elevated VLDL was seen in 36% of patients with mean of 30.496+10.33 mg/dl.
Conclusion: Non-alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease in both the developed and developing worlds. It is emerging as a major public health problem. The present study throws light on the clinical spectrum of the disease. Early detection and treatment is of utmost importance in preventing this disease from emerging as a new epidemic globally.