Trends in Clinical and Medical Sciences (TCMS)

Aim: To assess cases of dengue fever in Pediatric patients.
Methodology: Sixty-eight pediatric cases of dengue of both genders were included in the study. Clinical features and laboratory findings were recorded. Statistical analysis was performed using appropriate tests.
Results: Out of 68 patients, boys were 38, and girls were 30. Common symptoms were fever in 95%, vomiting in 68%, loose stools in 22%, periorbital puffiness in 10% and respiratory distress in 26, pain abdomen in 47% cases. The mean hemoglobin level at admission was 12.6 gm% and at discharge was 12.7gm%. The mean TLC was 56210 cumm of blood at admission, and at discharge was 122452 cumm of blood.
Conclusion: Common symptoms were fever, vomiting, respiratory distress and pain abdomen. Hence careful evaluation of dengue in children is required.

Aim: To assess relation between diabetes mellitus and thyroid dysfunction.
Methodology: 105 type II diabetes mellitus patients of both genders were included. Serum TSH (Thyroid Stimulating Hormone), free \(T_3\) (Triiodothyronine) and free \(T_4\)(Thyroxine) were determined in all enrolled patients.
Results: There were 50 males and 55 females in the present study. Age group 21-30 years had 15 patients, 31-40 years had 26, and 41-50 years had 64 patients. Duration of diabetes was 8.4 years, and the level of glycosylated hemoglobin (HbA1C) was 9.2 years. A significant difference was observed (P< 0.05). Serum T3 was increased by 15% and decreased by 4%. Free T3 was increased in 5% and decreased in 13%, and free T4 was increased in 7% and decreased in 5%. There were 20 hypothyroidism and 29 hyperthyroidism patients. Maximum hypothyroidism patients (12) and hyperthyroidism patients (14) were seen with >7 HbA1C levels.
Conclusion: Most of the type II DM patients had hypothyroidism than hyperthyroidism.

Aim: To assess cases of pregnancy induced hypertension.
Materials & Methods: Our study included 74 cases of pregnancy-induced hypertension. Parameters such as age, marital status, education, parity, etc., were recorded.
Results: Age group (years) <20 had 30%, 20-24 had 45%, 25-29 had 16%, 30-34 had 5% and >35 had 4% cases. Education level was illiterate in 40% and literate in 60%, and marital status was married in 58%, single in 26% and divorced in 16$, parity was 0 in 24%, 1-2 in 46% and >2 in 30%, gravida was primi in 40% and multi in 60%, previous PIH was seen in 24% patients. Family history of DM was observed in 25%, family history of PIH in 18%, family history of hypertension was seen in 10%, history of asthma was seen among in 8\% and history of kidney disease 30% patients. The difference was significant (P< 0.05).
Conclusion: Common risk factors of pregnancy induced hypertension was family history history of asthma, hypertension, family history of PIH, family history of DM, history of kidney disease.

Our aim in this research note is to compare curcumin and clobetasol propionate in management of patients with oral lichen planus. Sixty- four patients of OLP were divided where 32 patients were put in group I in which patients received 0.1% triamcinolone and in group 2, 32 patients received 5% curcumin paste for 4 weeks. Measurement of the appearance score and severity of pain was done at baseline and at the end of 2 and 4 weeks. We found that complete remission in pain was seen in 30% in group 1 and 35% in group 2, good response in 28% in group 1 and 17% in group 2, poor response in 24% in group 1 and 25% in group 2 and no response in 18% in group 1 and 33% in group 2. A non- significant difference among good and no response was seen (P<0.05). Oral lichen planus is common inflammatory autoimmune disease. Curcumin in our study showed slightly better results than triamcinolone, hence suggesting that it can be used in patients with oral lichen planus.

The novel corona virus (COVID-19) outbreak declared as a global pandemic. Glucocorticoids are inexpensive, widely available, and have been shown to reduce mortality in hypoxemic patients with COVID-19. With increasing risk of new strains of covid virus infections and now the latest dreadful fungal infection Mucormycosis, the situation is becoming more and more devastating. Survival in mucormycosis depends on early diagnosis, alleviation of basic predisposing factors, aggressive debridement of necrotic tissues, and appropriate systemic antifungal agents.

Our main goal is to compare effect of ondansetron and ramosetron in attenuation of propofol-induced pain during induction of anaesthesia. A total of sixty subjects with American Society of Anesthesiologists (ASA) physical status (PS) 1 and 2, age ranging 18-60 years scheduled for various elective surgical procedures under general anaesthesia were included and were randomly divided into 2 groups. Group 1 received 4 mg of ondansetron and Group II received 0.3 mg of ramosetron. Mean age of patients in group 1 was 36.2 years and in group 2 was 36.0 years. There were 16 males and 14 females in group 1 and 17 males and 13 females in group 2. ASA grade I was seen in 20 in group 1 and 24 in group 2 and ASA grade II was seen in 10 in group 1 and 6 in group 2. A non- significant difference between both groups was seen (P> 0.05). Pain score 0 was observed in 14 in group 1 and 20 in group 2, score 1 in 9 in group 1 and 6 in group 2, score 2 in 4 in group 1 and 3 in group 2 and score 3 seen in 3 in group 1 and 1 in group 2. A significant difference between both groups was seen (P< 0.05). Ramosetron alone can be used to reduce the propofol-induced pain. Pre-treatment with IV ramosetron found to be effective as compared to ondansetron in preventing propofol-induced pain.

The aim of this paper is to compare single versus multiple gall stone disease in patients undergoing laparoscopic cholecystectomy. A total of one hundred and thirty patients (males- 52, females- 78) within age group 20-65 years presented with cholelithiasis were divided into 2 groups. Group 1 comprised of single stone patients and group II had multiple stones. Each group had 65 patients. Parameters compared were symptoms and operative findings between both groups, Analysis of results was carried with chi0 square test. Most common clinical symptoms found to be fever in both groups (87%- group 1, 90%- group 2). Other symptoms were dyspepsia seen in 25% and 30%, nausea/ vomiting in 45% and 38% in group 1 and 2 patients respectively. Females were commonly affected and maximum case were observed in age group 40-50 years. Multiple gall stones patients had more symptoms and prevalence of conversion to open surgery was more in these patients. Group 1 patients showed gall bladder distention in 56 and group 2 in 62 patients, gall bladder contraction was seen in 6 patients in group 1 and 3 in group 2, adhesions were exhibited by 11 patients in group 1 and 20 in group 2. 4 patients in group 2 converted to open surgery. Gangrenous gall bladder was seen in 1 in group 1 and 5 in group 2.

The aim of this paper is to compare different treatment modalities in management of plantar fasciitis. Forty- five patients with plantar fasciitis (males- 2- females- 20) were randomized into 3 groups. Group 1 patients received conventional treatment, group 2 patients received heat treatment with silicone heel pad and group 3 patients received active plantar fascia stretching with sham calf stretching. Patient was evaluated using foot function index (FFI) and the foot and ankle disability index (FADI). In group 1, foot function pre-intervention index score and post-intervention score was 68.2 and 43.5, in group 2 was 64.8 and 6.9 and in group 3 was 70.5 and 1.6 respectively. A significant difference was observed (P< 0.05). In group 1, pre-intervention foot and ankle disability score and post-intervention score was 61.5 and 76.4, in group 2 was 66.5 and 95.2 and in group 3 was 61.3 and 97.6 respectively. A significant difference was observed (P< 0.05). Active plantar fascia stretching with sham calf stretching exercise resulted in most significant improvement in FFI and FADI score followed by treatment with heat and silicone heel pad and conventional treatment.

Aim: To assess risk factors for development of type II diabetes. Materials & Methods: 80 patients of type 2 diabetes mellitus >40 years of age were put in group 1 group 2 were healthy subjects irrespective of gender. Factors such as family history, physical activity, blood pressure, alcohol consumption and BMI was recorded. Results: Alcohol consumption was present in 45 in group 1 and 20 un group 2, family history was positive in 65 group 1 and 12 in group 2, sedentary life was seen in 52 group 1 and 25 in group 2, BMI was underweight seen in 14 in group 1 and 5 in group 2, normal 12 in group 1 and 46 in group 2, overweight 30 BMI was underweight seen in 14 in group 1 and 5 in group 2, normal12 in group 1 and 14 in group 2 and obese 22 and 15 46 in group 2. Blood pressure was normal seen 16 in group 1 and 42 in group 2, pre- hypertension 24 in group 1 and 26 in group 2, hypertension stage 1 in 30 in group 1 and 10 in group 2 and hypertension stage 2 seen in 10 in group 1 and 2 in group 2. A significant difference was observed (P< 0.05). Conclusion: Common risk factors in diabetes was overweight, hypertension, lack of physical activity and alcohol consumption.

Aim: To evaluate anesthetic management in renal transplant patients. Methodology: Ninety- two renal transplant patients were part of the study. Parameters such as type of transplant, reason for chronic kidney disease, preoperative data, history of dialysis, preoperative anesthesia management, monitoring details and the outcome were recorded. Results: Chronic glomerulonephritis (CGN) in 28 (30.4%), chronic interstitial nephritis (CIN) in 20 (21.7%), polycystic kidney disease (PCKD) in 11 (11.9%), obstructive nephropathy (Ob. N) in 4 (4.3%), diabetic nephropathy (DN) in 8 (8.7%), hereditary nephropathy in 3 (3.2%), reflux nephropathy in 12 (13%) and membranoproliferative glomerulonephritis (MPGN) in 6 (6.5%). In 32 (35.6%) patients, isoflurane was inhalational agent and recovery time was 25.1 minute, in 40 (43.4%), desflurane was inhalational agent and recovery time was 22.7 minutes and in 20 (21.7%), sevoflurane was inhalational agent and recovery time was 32.1 minutes. A significant difference was observed (P< 0.05). Conclusion: Anesthesia management has made renal transplantation safe and predictable. Postoperative maintenance of renal transplant patients have contributed to the success of renal transplant programme.