Friday, 2 February 2018

Medical Journal- January 2018

Medical Journal: Published volume-4, Issue-1, January 2018 with ad publications

Vitamin D deficiency and its associating factors: A cross-sectional analytic study

Abstract— Vitamin D deficiency is widely prevalent throughout the world. Pregnant women, neonates and infants form most vulnerable groups for vitamin D deficiency. Hypovitaminosis vitamin D in pregnancy has been reported to cause various fetomaternal effect. So this study was conducted to find out proportion of vitamin D deficiency among pregnant women and to assess the effects and its associating factors. For this purpose 120 Pregnant women on their first visit to hospital irrespective of gestational age were taken. Apart from routine obstetrical investigation, serum vitamin D (total) level was estimated. All results were recorded and analyzed statically. It was observed that 84.1% were found to be vitamin D deficient. Mean age of vitamin D deficient group and non deficient group were 28.31±3.86 and 26.37±2.83 years respectively. Religion and parity of women was not found to be associated with vitamin D deficiency whereas age, type of diet and use of sunscreen was found to be associated. Vitamin D deficiency was found significantly more in elderly, vegetarians and users of sunscreen than their counterparts. Regarding maternal and neonatal outcomes, development of preeclampsia, LSCS as mode of delivery, delivery of pre term and LBW babies were having controversial findings. So it suggest much more researches in this regards.

Keywords: Feto-Maternal Outcome, Hypovitaminosis D, Maternal Blood Vitamin D, Vitamin D Status in Pregnancy.

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Knowledge behaviour and practices regarding Malaria in rural population of South Goa: A cross sectional study

Abstract Vector-borne diseases (VBDs) represent a substantial burden globally as well as in India. Frequent outbreaks of malaria occur in rural areas. Implementation of preventive and control strategies largely depends on the knowledge and behavior of the community towards the disease. Hence the present study was conducted on 140 participants in a rural area of Goa to assess the knowledge and behavioral practices regarding malaria. A cross sectional study among residents more than 18 years of age was conducted for a period of two months. Almost all i.e. 93.5% participants had heard about malaria, 85.5% knew that it is preventable and majority knew that it is transmitted only via mosquito bite. Around 51.2% of the participants thought mosquitoes spreading malaria breed in dirty water. Out of total 89.3% of the participants used some form of personal protective measure to avoid mosquito bite. Government sector was preferred for health care by 46.4% of the participants in case of fever while 10% did not want to take any form of treatment. Hence providing periodic health education is essential for raising awareness, achieving behavioral change and improving the health care seeking behavior.

Key words: Malaria, Rural, Knowledge, Health Care Seeking Behavior, Health Education

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Gilbert Syndrome in Pregnancy: A Case Report

AbstractGilbert syndrome is a rare condition and rarely diagnosed before pregnancy. A 36 weeks pregnant female presented with severe vomiting, nausea, myalgia, abdominal pain, headache and yellowish discoloration of sclera, yellowish discoloration of skin since four days. She gave history of similar complaints at 16 & 24 weeks in this pregnancy and was treated conservatively with IV fluids. She have similar episodes in second pregnancy. When she was investigated, she came out to a case of Gilbert syndrome which is a rare case. So she was examined and investigated thoroughly to prepare a case report to publish. To conclude when any patient presents with unconjugated hyperbilirubinaemia associated with stress, infection or dehydration Gilbert Syndrome must be excluded. Once this diagnosis is made patient must be reassured of its benign nature, excellent prognosis and normal life expectancy.

Key words: Gilbert syndrome, unconjugated hyperbilirubinaemia, Pregnancy.

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A study of functional erythropoietin deficiency in patients with type-2 diabetes and anemia

Abstract— Anemia is a common finding in diabetes, particularly in patients with diabetic nephropathy or renal impairment. This study was designed to assess the prevalence of functional erythropoietin deficiency in patients with type-2 diabetes and anemia. In a hospital based observational descriptive study, 60 diagnosed diabetic patients were included. They were divided into 2 groups: group I had diabetic patients without anemia with/without diabetic nephropathy and group II had type 2 diabetics with anemia with/without diabetic nephropathy. Most of the subjects (50%) in group I without diabetic nephropathy had their serum erythropoietin levels in the range of 15-30 IU/L with a mean value of 19.01± 2.11 IU/L. All the subjects in group I who had diabetic nephropathy had their serum EPO levels between 15-30 IU/L with a mean value 24.17±3.03 IU/L. In group II with diabetic nephropathy, most of the subjects (72.5%) had their serum EPO value <15 IU/L with a mean value of 10.45± 1.61 IU/L and all the subjects without diabetic nephropathy had their serum EPO level above 30 IU/L with mean value 36.41±3.0 IU/L. Comparison of both groups showed highly significant difference in EPO levels statistically (P<0.001). This study suggest further researches to find out relation of functional erythropoietin deficiency with a pattern of damage to the renal tubulointerstitium and microvasculature in diabetic kidney restricting the production of erythropoietin to maintain red cell mass in response to tissue hypoxia or a defect of "Anemia sensing" mechanism.

Keywords: Anemia, Diabetes, Erythropoietin, Hemoglobin (Hb), Diabetic Nephropathy.

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Retinal thickness in multiple sclerosis: evaluation with optical coherence tomography

Abstract— In various neurodegenerative diseases ocular manifestations are very common which can be examined and monitored in vivo by a novel imaging technique Optical Coherence Tomography (OCT). So this study was conducted to compare retinal nerve fiber layer (RNFL) thickness and ganglion cell complex (GCC) between multiple sclerosis (MS) patients and healthy individual by optical coherence tomography (OCT). For this study 40 eyes of twenty consecutive MS patients and 40 eyes of 20 age matched healthy controls were taken. Comprehensive standardized ophthalmic examinations included visual acuity, cycloplegic refraction, color vision and intraocular pressure. Optical coherence tomography was performed using 3D Topcon OCT; RNFL thickness and ganglion cell complex (GCC) was detected with the inbuild software. Mean values for the thickness of the peripapillary RNFL and ganglion cell complex (GCC) were calculated and compared between both groups. It was observed that the RNFL thickness in each quadrant and ganglion cell complex (GCC) in MS patients were all significantly decreased in comparison to healthy controls. So it can be concluded that OCT is a valuable research instrument for evaluation and monitoring MS progression by measurement of the retinal nerve fiber layer (RNFL) as purely axonal structure (indicative for axonal loss) and the macular ganglion cell complex (evidence of neuronalloss).

Keywords: Optical Coherence Tomography, Multiple Sclerosis, Retinal Nerve Fiber Layer Thickness.

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Voluntary Blood Donation: Perception and Practices among Adult Population of a Semi-Urban Area of Udaipur, India

Abstract— There is a need to strengthen blood donor management in order to reduce the demand supply gap. Efforts are needed in this direction at all levels including educating and motivating more individuals to be involved in voluntary blood donation and converting them to retention donors. In order to develop rational and evidence based systems to be address blood shortage, it is needed to assess the current donor services and improve them to encourage more future donations. The present study explores the perceptions and practices of adults in a semi-urban area of Udaipur regarding blood donation and trying to identify the factors associated therewith. This cross sectional study was conducted on 3087 adult participants of semi urban areas of Udaipur from June 16, 2016 to August 15, 2016. It was observed that 91.2% of the participants were aware that blood donation is important for saving lives and 78.7% had a favorable attitude towards blood donation. However, in practice, less than 20% had ever donated blood. On further analysis educational level had found to have a significant effect on the knowledge regarding blood donation with p-value<0.00. So it can be concluded from this study that although the awareness about blood donation is quite high but very few people have actually donated blood voluntarily. Motivational interactive sessions at the community level are needed to allay the fears and misconceptions related to blood donation.

Keywords: Blood donation, Perceptions, Practices.

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