Aprospective case control study was conducted in Department of Pediatrics, Newborn ward of S.C.B. Medical College & Hospital and SVPPGIP, Cuttack, Odisha from September 2017 to September 2019 by taking 202 newborns having history and clinical features of moderate & severe hypoxic ischemic encephalopathy and they were evaluated for their serum calcium and blood glucose levels. In the present study mean serum calcium level was found to be low in babies with moderate birth asphyxia and severe birth asphyxia as compared to control. Again it was also found to be low in severe birth asphyxia as compared to moderate birth asphyxia. The percentage of hypo calcemic babies was found to be more in babies with moderate birth asphyxia and severe birth asphyxia as compared to control. Again it was also found to be more in severe birth asphyxia as compared to moderate birth asphyxia. In this study percentage of hypoglycemic babies was found to be more in babies with moderate birth asphyxia and severe birth asphyxia as compared to control. Again it was also found to be more in severe birth asphyxia as compared to moderate birth asphyxia. All the comparison was signicant statistically(P<0.05). This study showed that risk of hypocalcemia and hypoglycemia increased with severity of birth asphyxia. The present study showed that survival was more with normal serum calcium level as compared to low serum calcium level (95.5% vs 74.7%) whereas fatal outcome was more with low serum calcium level as compared to normal serum calcium level (22.2% vs 2.3%). Low serum calcium level was associated with more fatal outcome. The difference was statistically signicant as P< 0.05.The present study showed that survival was more with normal blood glucose level as compared to low blood glucose level (92.5% vs 44.6%) whereas death was more with low blood glucose level (48.2% vs 6.2%). Low blood glucose level was associated with more fatal outcome. The difference was statistically signicant (P< 0.05).Although the study result has resemblance to previous studies, as there is no such type of study has been done previously in this institution, where patient burden is much more higher than resources and where emphasis on prevention, this study will establish an cost effective management protocol of birth asphyxia babies in my institution.
This randomized controlled trial and prospective study “Comparison between intermittent & daily therapy for treating pulmonary tuberculosis in children with special reference to efficacy & outcome“ was conducted in S.C.B. Medical College and Hospital & S.V.P. P.G.I.P., Cuttack under the supervision of R.N.T.C.P. Centre of S.C.B. Medical college, Cuttack. All the suspected cases, after screening, were diagnosed to have Pulmonary Tuberculosis according to WHO recommendation and then divided into two groups randomly comprising of 45 each.One group was given Daily regimen and other group Intermittent regimen therapy.Among the Daily Treatment group,majority of cases (2761.4%) became symptom free by 1 month,whereas,9 (20.5%) and 8 (17.7%) children took 15 days and 2 months respectively to be free from the symptoms.Among the Intermittent Treatment group, majority of cases (2555.5%) became symptom free by 1 month, whereas, 7 (15.5%) and 8 (17.7%) children took 15 days and 2 months respectively. Majority cases had weight gain ranging from 2-4 kg. Complete radiological improvement was remarkable in daily treatment group. Gastric aspirate & sputum conversion. at 2 month is 100% for both daily as well as intermittent regimen. At 6 months after the completion of therapy, there was not a single case of relapse in both groups. Majority (4497.7%/4088.8 %) got cured. From the present study we can conclude that daily anti-tubercular therapy is better in terms of symptomatic relief as well as radiological changes at 6 months, than that of intermittent therapy in the treatment of childhood pulmonary tuberculosis.
This cross-sectional clinical study titled “A clinical evaluation of diabetic retinopathy and its correlation with serum HbA1c level”was conducted in Hi-Tech medical college,Bhubaneswar from September 2019 to May 2021 by taking 67 patients from ophthalmological OPD who were diagnosed as cases of diabetic retinopathy,but not taking laser therapy and not having other non-diabetic causes of retinal degeneration and having diabetic mellitus of at least one year without considering type of diabetes or treatment taken by the patients.These 67 patients diagnosed as cases of diabetic retinopathy are classified according to their severity basing upon their findings( microaneurysm, exudates, retinal hemorrhages, venous beading , IRMA, new vessels in disc or elsewhere in retina) as per ETDRS(Abbreviated early treatment diabetic retinopathy study) classification as mild NPDR, moderate NPDR, severe NPDR, very severe NPDR, PDR. Their serum glycosylated haemoglobin (HbA1c) level of each individual in each group is detected and then mean HbA1c level of each group derived and when correlated ,we found that the mean HbA1c for mild grade of retinopathy was found to be 7.667,for moderate non-proliferative diabetic retinopathy(NPDR) 8.450,for severe NPDR 9.700,for very severe NPDR 11.447 and for Proliferative Diabetic Retinopathy(PDR) the mean HbA1c value was found to be 11.468.The P value obtained through ANOVA test for HbA1c vs. grade of diabetic retinopathy was statistically significant (Sig : 0.000).The Eta & Eta squared value for HbA1c vs grade of retinopathy was 0.695 and 0.483.So the present study reveals that more severe grades of diabetic retinopathy manifesting in patients with higher levels of HbA1c
A case control study was conducted from October 2018 to September 2020 by taking children between the age group 2 months to 5 years, admitted to Sishu Bhawan and SCB Medical College Hospital, Cuttack with an acute history of cough and rapid respiration or difficulty in breathing, to know the correlation between various clinical parameters and hypoxemia along with ability of each parameter to predict the presence of hypoxemia in children. Among 109 children, 50 children were hypoxemic and 59 children were non hypoxemic with the prevalence of hypoxemia about 45.8%. Among symptoms in children with Acute Lower Respiratory Tract Infection (ALRI), inability to feed, cough and difficulty in breathing had a sensitivity of 100%, 98% and 92% respectively and specificity was maximum for difficulty in breathing (62.7%) to predict hypoxemia. On comparison between hypoxemic and non-hypoxemic children difficulty in breathing and inability to feed had a p value <0.001 and was statistically significant. Among signs in children with ALRI, appearance of the child, lower chest retraction, respiratory rate had a sensitivity of 100%, 100% and 98% respectively to predict hypoxemia. Central cyanosis was the most specific sign with the specificity of 100% to predict hypoxemia followed by grunting with a specificity of 96.6%. When compared between hypoxemic and non-hypoxemic children the p-value was very highly significant for appearance of nasal flaring, grunting, suprasternal indrawing parameters whereas upon combination of variables, a combination of cough, inability to feed, tachypnoea and the combination of cough, subcostal retractions, tachypnoea had high sensitivity of 96% and 95% respectively to predict hypoxemia in children with ALRI. Combination of difficulty in breathing, cyanosis and grunting had high specificity of 98%. Keeping in view of less feasibility of detection of hypoxemia in lower respiratory tract infection by pulse oximeter and ABG in developing countries and no available study in the state of Odisha, this study is conducted in an attempt to find out the alternative methods by various clinical parameters to detect hypoxemia which are easily recognized by the health personnel in developing countries for the further management of Lower Respiratory Tract Infection (LRTI). Keywords: Hypoxemia, Acute Lower Respiratory Tract Infection, Lower Respiratory Tract Infection, Management.
This hospital based observational cross sectional study having a sample size of 100 was undertaken at S.C.B. Medical College and S.V.P.P.G.I.P.,Cuttack,with an objective to study the clinical profile and risk factors for wheezing in infancy from November 2018 to November 2020. Wheezing is accountable for a high demand of medical consultations and emergency care services with relatively high rates of hospitalization.In this study, several risk factors were identified for wheezing in less than one year of age which had little resemblance to similar studies made in various other age groups.However,maternal smoking as a risk factor could not be found in our study due to social cultural lifestyle in the study population. Factors like caesarean section, history of birth asphyxia, NICU admissions and living in kuccha house were not found to impose risk for wheezing in infancy in the study in contrary to similar such studies in other age groups.The present study revealed, that among all other etiology, the viral respiratory tract infections including bronchiolitis was the most common cause of wheezing in infancy (64%) followed by WALRI (wheeze associated lower respiratory tract infection). In conclusion, if an infant with wheezing has risk factors like male sex, preterm, more than six months age, family history of atopy or repeated upper respiratory tract illness or overcrowding in family, anticipating the severity recurrence should be suspected. These infants should be monitored closely for signs of clinical deterioration. Proper health education,ante natal and neonatal care,promoting of breast feeding and creating awareness to the public regarding modifiable risk factors like separation of family members having upper respiratory illness from young infants will reduce the severity of wheezing and will help prevent their recurrence to much extent.
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