The periosteum covers the surface of long bone except at the joints. During fracture fixation, we found the periosteum is ragged and damaged. Our objective is to determine the microscopic picture of traumatized periosteum in terms of the degree of damage, cell type, stromal tissue, and vascularity. Periosteum of 1cm*1cm is harvested at 1cm, 3cm, and 5cm proximal and distal to fracture site following fracture of a long bone in 20 humans. Ragged and damaged periosteum mainly consists of an outer fibrous layer with many hemorrhagic tissue and neovascularization. Osteoprogenitor cells were seen only in 12 out of 97 samples, mostly harvested 5 cm from the fracture site. The innermost layer of the periosteum remains attached to the bone surface after separating the fibrous layer following a fracture. The use of a periosteal elevator on the bone surface further damages the inner layer of the periosteum. Using a scalpel to separate the periosteum or merely pulling it away from the bone surface will decrease damage to the inner cambium layer. Fracture reduction can be achieved by indirect means at least 5 cm away from the fracture site.
BackgroundSevere Corona virus disease (COVID-19) is associated with high mortality. Although single centre intensive care units (ICU) have reported clinical characteristics and outcomes, no large scale multicentric study from India has been published. The present retrospective, multi-centre study was aimed to describe the predictors and outcomes of COVID-19 patients requiring ICU admission from COVID-19 Registry of Indian council of Medical Research (ICMR), India.MethodsProspectively collected data from multiple participating institutions was entered in the electronic National Clinical Registry of COVID 19. We enrolled patients aged>18 years with COVID-19 pneumonia requiring ICU admission between March 2020 and August 2021. Exclusion criteria were negative RT PCR, death within 24 hours of ICU admission, or patients with incomplete data in the registry Their demographic characteristics, laboratory variables, ICU severity indices, treatment strategies and outcomes were analysed.ResultsA total of 5865 patients, with mean age 56±15 years, with 3840/5865 (65.4%) men, were enrolled in the ICMR registry.. Overall mortality was 2535/5865 (43.5%). Non-survivors were older than survivors (58.2±15.4 years vs 53.6 ±14.7 years; P=0.001). Non-survivors had multiple comorbidities (n=1951, 52.9%) with hypertension (47.2%) and diabetes (45.6%) being the most common, higher creatinine (1.6 ± P=0.001, high D-dimer (1.56 vs 1.37, P=0.001), higher CT severity index (16.8±5.2 vs 13.5 ±5.47 ) compared to survivors. Non survivors had longer hospital and ICU stay (P=0.001). On multivariate regression analysis, high NLR (HR 1.017, 95% CI 1.005- 1.029, P=0.001), high CRP (HR 1.008, 95% CI 1.006- 1.010, P=0.001), high D dimer ((HR 1.089, 95% CI 1.065- 1.113, P=0.001) were associated with mechanical ventilation while younger age, (HR 0.974, CI 0.965-0.983, p=0.001), high D dimer (HR-1.014, CI 1.001-1.027, P=0.035) and use of prophylactic LMWH (HR 0.647, CI 0.527-0.794, p=0.001) were independently associated with mortality. ConclusionIn this large retrospective study of 5865 critically ill COVID 19 patients admitted to ICU, overall mortality was 2535/5865 (43.5%). Age, high D dimer, CT Severity score and use of prophylactic LMWH were independently associated with mortality.
Background: Wide variation in the lipid profile in pregnancy is quite common. Exaggerated changes in insulin and lipid levels in women with GDM during pregnancy, lead to significant alterations in lipid levels in comparison to normal pregnancy. Lipid metabolism during pregnancy has a significant role to play in the aetiology and pathogenesis of GDM as is indicated by various studies previously.Methods: A hospital-based case control study was conducted at Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha in the Department of Endocrinology. The sample size was 100 pregnant women. Study period was of one year from June 2018 to June 2019. In women of both the groups, i.e., with GDM and without GDM the mean age of presentation were 20-25 yrs. Out of the 100 cases, we took 50 patients of GDM in the cases group and 50 patients of non GDM pregnant women as control group. Fasting lipid profile was sent to the hospital laboratory analyzed by Tinder’s methods. The results thus obtained were analyzed using student ‘t’ test for statistical significance using SPSS version 20.Results: There was no statistical difference in age and parity between control and case group. Triglyceride (cases- 286.4±77.60 mg/dl) (controls-166±26mg/dl), total cholesterol (cases-256.5±41.7 mg/dl) (controls - 202.5±20.18mg/dl), VLDL (cases-53.4±13.2 mg/dl) (controls-46.6±13.1mg/dl) showed statistically significant values (p value<0.001). HDL and LDL values did not show any statistical significance (p value >0.5) among GDM and non GDM group. Lipid profile was performed predominately in women in II trimester.Conclusions: In comparison to non GDM women, it was observed that serum triglyceride, total cholesterol and VLDL level are significantly higher in woman with GDM. Whether lipid profile can be used as a predictor for gestational diabetes mellitus in future needs further research.
Background: Menopause is defined as the permanent cessation of menstruation resulting from loss of ovarian activity. Menopause normally occurs between the age of 45 to 50 years. The age of menopause varies with geographical, racial and nutritional factors. The objective of this study was to evaluate and to know the incidence of various cause of PMB.Methods: This was a prospective study of the patient with PMB attending the OPD or admitted for evaluation under Obstetrics and Gynecology department. Hi-Tech Medical College and Hospital, BBSR, Odisha from November 2016 to October 2018 who fulfilled the inclusion criteria with history clinical examination and investigation and informed consent from the patient. Data analyses will be done by appropriate statistical methods.Results: Maximum number of cases with PMB were found in age group 55-64 (52%). 57% of cases were malignant and rest 43% were benign origin. carcinoma cervix is most common malignant lesion in 80% cases and atrophic endometrium is most common benign lesion (42%).Conclusions: In the present study the incidence malignancy causing PMB was 57% and benign cases was 43% Universal Screening of all PMB cases for genital tract malignancy is mandatory.
Background: One of the most important public health issue for developing nations in the world with special reference to India is preventive blindness. In the world, 36 million people are blind and 217 million people are with moderate or severe distance vision impairment. The aim and objectives of the study were a qualitative survey to get an initial picture of rural residents knowledge of the prevalent eye disease; serve as an initial assessment of patient’s baseline knowledge of eye conditions and possible treatment methods to aid in the future development of educational outreach initiatives and studies.Methods: A cross sectional study was carried out in the rural areas of Jajpur, Nayagarh, Puri and Cuttack district of Odisha during preventive eye screening camps. The study was carried over 6 months from Jan to July 2018. The sample size was calculated to be 914 and the study subjects were all aged 40 years and above comprising of 64.7% male and 35.3% female.Results: In this study we found out that 60.18% reported previous eye doctor visits, 24.08% reported using eye drops prescribed by a non-doctor, while 60.18% of the non-doctor visitors reported not knowing that a doctor should prescribe eye drops. While 76.69% had little or no awareness regarding glaucoma, 51.87% had a fair idea regarding cataract surgery.Conclusions: The increase in patient awareness of prevalent eye diseases and treatments could lead to an increase in patient acceptance regarding the importance of routine eye examinations for proper identification and treatment of various eye conditions.
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