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Delivering rehabilitation and relief services in the conflict affected hard-to reach areas of Borno state

Letter to the Editor

Delivering rehabilitation and relief services in the conflict affected hard-to reach areas of Borno state

Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy

   

Abstract
No Abstract

Key words: No Keywords

Med-Science. 2018; 7(1): 246-246

 

 
Medicine Science Vol:7 Issue:1 Year:2018 PP:1–246

Evaluation of the effects on nasal mucociliary clearance of various nasal solutions applied topically in patients with sinusitis

Original Article

Evaluation of the effects on nasal mucociliary clearance of various nasal solutions applied topically in patients with sinusitis

Murat Yasar, Mehmet Yavuz Sutbeyaz, Muhammed Sedat Sakat, Korhan Kilic

   

Abstract
Mucociliary clearance (MC) is one of the main defense mechanisms of the nasal respiratory mucosa. The purpose of this study was to determine changes occurring nasal MC in patients with sinusitis, and how medical treatment affects changes in MC, and to identify an appropriate topical solution with positive effects on MC for use in the treatment of sinusitis by examining the effects of various topical solutions on MC. 60 patients diagnosed with rhinosinusitis at the ear, nose and throat clinic were included in this prospective study. Patients were randomly assigned into groups. Group 1 (n:10) received no topical treatment. Group 2 (n:10) was administered with fluticasone propionate, Group 3 (n:10) received mometasone furoate and Group 4 (n:10) received oxymetazoline. Group 5 (n:10) received isotonic sea water for nasal irrigation, while Group 6 (n:10) received isotonic Ringer’s solution for nasal irrigation. Group 7 represented the control group (non-sinusitis). The saccharin test was used to determine nasal mucociliary clearance times. The saccharin test was performed before and on the 2nd week of treatment in all groups. Basal MCT and 2nd week MCT values were compared in all groups. When measurements performed 20 min and 14 days after administration of topical agents were compared with basal values, mean MCT values at 20 min. and 14 days were shorter in all groups compared to mean basal MCT values. However, the difference between 20-min, 14th day and basal MCT values was only statistically significant in the oxymetazoline and isotonic Ringer’s solution groups (p

Key words: Nasal mucociliary clearance time, saccharin test, sinusitis

Med-Science. 2018; 7(1): 210-213

 

Effect of neurodynamic mobilization on pain and function in subjects with lumbo-sacral radiculopathy

Original Article

Effect of neurodynamic mobilization on pain and function in subjects with lumbo-sacral radiculopathy

Srishti Sanat Sharma, Megha Sandeep Sheth

   

Abstract
Neurodynamic mobilization is a set of techniques designed to restore the plasticity of the nervous system and the ability of neural tissue to stretch and tension along with pain alleviation and functional improvement.The study aimed to determine the effect of neurodynamic mobilization on pain and function in subjects with lumbo-sacral radiculopathy.24 males and females between 25-50 years of age having low back pain radiating to any one lower limb since more than 3 weeks were randomly allocated into two groups.Group A received neural mobilization and conventional treatment.Group B received conventional treatment alone.Intervention was given for 6 sessions on 6 days/week.Pain and function were measured using Numerical Pain Rating Scale(NPRS) and Modified Oswestry Disability Index (MODI) respectively.Location of symptoms was also recorded using a body diagram.There was a significant difference in pain at rest and pain during activitywithin each group, but only group B showed significant difference in function. Pain during activity showed significant difference in group A over groupB(U=-1.47;p=0.04) along with function(U=-1.52;p=0.02). Compared to conventional treatment, there is significant decrease in pain during activity and improvement in function following neurodynamic mobilization,however there is no significant improvement pain at rest.

Key words: Straight leg raise, function,pain,neurodynamic,lumbo-sacral radiculopathy

Med-Science. 2018; 7(1): 5-8

 

Bone mass and bone turnover in premenopausal women with fibromyalgia syndrome

Original Article

Bone mass and bone turnover in premenopausal women with fibromyalgia syndrome

Ali Gurbuz, Arzu Kaya, Tansel Ansal Balci

   

Abstract
In this study, we aimed to compare osteoporosis (OP)-related bone mineral density, and bone turnover (markers of formation, and resorption) between patients with Fibromyalgia Syndrome (FMS) and degenerative disc disease, and to determine the relationship of these parameters with clinical, functional and emotional evaluation outcomes in FMS. Fifty premenopausal women with FMS and 50 premenopausal female control patients with degenerative disc disease were enrolled. The patient and physician’s global assessment of disease were assessed on a visual analog scale (VAS). Disease severity was determined with the Fibromyalgia Impact Questionnaire (FIQ). For the evaluation of fatigue The Modified Fatigue Impact Scale (MFIS) and Fatigue Severity Scale (FSS) were used. The quality of life of all patients was evaluated using Nottingham Health Profile (NHP), Oswestry Disability Index (ODI), and QUALEFFO-41. The emotional state of all patients with chronic pain was evaluated with Hospital Anxiety and Depression Scale (HADS). Bone turnover markers [serum bone-specific alkaline phosphatase (bALP) and serum osteocalcin as markers of bone formation, serum â-isomerized Carboxy-terminal telopeptide of collagen type I (â-CTX) and urine hydroxyproline (OH-Pro) as markers of bone resorption], serum parathyroid hormone (PTH) and 25-hydroxyvitamin D [25(OH)D] levels, lumbar spine and left proximal femur bone mineral density (BMD) and T scores were measured in both groups. The FIQ, MFIS, FSS, NHP, ODI, QUALEFFO-41, HADS-A and HADS-D scores were statistically significantly higher in the FMS group relative to the patient control group. A significant difference between FMS and patient control group as for bone formation (bALP and osteocalcin) and resorption (â-CTX ve OH-Pro) markers was not detected. In the FMS group lumbar spine and left proximal femur BMD and T score values were significantly lower when compared with the patient control group. In the FMS group significant correlations were found between serum 25(OH)D and â-CTX values and VAS scores evaluated by the patient and physician, SS scale, FIQ, MFIS, ODI, QUALEFFO-41 and NHP scores. In conclusion many factors including depression and anxiety attacks, the presence of widespread pain and a decline in physical activity level and quality of life in FMS patients make them more prone to osteoporosis. In patients with FMS, osteoporosis is a major cause of morbidity and should not be neglected.

Key words: Fibromyalgia, low back pain, Dual-energy X-ray absorptiometry (DXA), disability, bone metabolism

Med-Science. 2018; 7(1): 9-16

Asymptomatic calf vein DVT in high risk surgical patients: A single centre study

Original Article

Asymptomatic calf vein DVT in high risk surgical patients: A single centre study

Gouriprasad Kurumapu, Manas R Pattnaik, Madhusudan Dey

   

Abstract
Asymptomatic deep vein thrombosis (DVT) of calf veins is a known entity in high risk surgical patients, which can lead to fatal pulmonary embolism. The actual incidence of asymptomatic calf vein DVT in high risk surgical patients is not known in Indian population. We had conducted this study with an aim to determine the incidence of asymptomatic calf vein DVT in spite of providing extended prophylaxis against DVT in high risk patients. Our study was a prospective observational study conducted from Oct 2014 to Mar 2016 in a tertiary care teaching Hospital in Bangalore, in Department of surgery with help of Department of Nuclear medicine and Radio diagnosis. We examined more than 100 patients who were due for some surgical procedure and included 100 patients fell in high risk group with a risk stratification score of ≥ 5. All patients screened for asymptomatic DVT with Duplex ultrasonography scan and 99mTc MAA venography. The patients who were detected to have asymptomatic calf vein DVT were therapeutically managed as cases of DVT. In the study 3 patients detected to have asymptomatic calf vein DVT making the incidence of 3.06%. In our study group we found duration of surgery of more than 60 mins being the most common risk factor followed by malignancy. Our incidence of asymptomatic calf vein DVT was 3.06% in high risk surgical patients. Duplex ultrasonography is a useful, easily available, non invasive and safe diagnostic modality in detecting asymptomatic calf vein DVT.

Key words: Deep vein thrombosis, duplex ultrasonography, 99mTc MAA venography, malignancy, asymptomatic calf vein

Med-Science. 2018; 7(1): 17-20

Levonorgestrel-releasing intrauterine device versus oral progesterone for treatment of simple endometrial hyperplasia without atypia

Original Article

Levonorgestrel-releasing intrauterine device versus oral progesterone for treatment of simple endometrial hyperplasia without atypia

Hatice Kansu-Celik, Burcu Kisa Karakaya, Ozlem Evliyaoglu, Yaprak Engin-Ustun

   

Abstract
The aim of this study was to compare the efficacy and effect on the menstrual pattern of the levonorgestrel releasing intrauterine device versus oral progesterone for treatment in patient having simple endometrial hyperplasia (EH) without atypia. Patients who underwent endometrial sampling with abnormal uterine bleeding history and received simple EH without atypia were included in this study between 1 December 2015 and 31 March 2016, retrospectively. Twenty-two patients were treated with the levonorgestrel-releasing intrauterine device (LNG-IUD) and 47 with oral progesterone. Primary outcome measures were regression of hyperplasia after 3 months of therapy. Secondary outcome measures were effect on menstruel pattern during treatment, or rates of hysterectomy and recurrence within a 12 month period. After 3 months of treatment, regression of EH occurred in all of women in LNG-IUD group versus 93% of women in the oral progesterone group (p=0.226). Hb values were increased at the 3th month measurement in both of groups. Endometrial thickness was significantly decreased at the end of the 3th month (p< 0.001). Amenorrhea was more common in the LNG-IUD group (p

Key words: Endometrial hyperplasia, levonorgestrel-releasing intrauterine device, oral progesterone

Med-Science. 2018; 7(1): 21-24

 

Hypnotherapy is more effective than acupressure in the production of prolactin hormone and breast milk among women having given birth with caesarean section

Original Article

Hypnotherapy is more effective than acupressure in the production of prolactin hormone and breast milk among women having given birth with caesarean section

Diah Evawanna Anuhgera, Tjahjono Kuncoro, Sri Sumarni, Mardiyono Mardiyono, Ari Suwondo

   

Abstract
This research aimed to analyze the effectiveness of hypnotherapy compared with acupressure toward the prolactin hormone level and the production of breast milk among women giving birth by caesarean section. The research groups were divided into two groups, namely hypnotherapy receiving women group and acupressure-receiving women group. The hypnotherapy was done in accordance with the standard and guided by the hypnotherapist. The acupressure was done in the meridian of stomach and small intestine, meridian of kidney, and spleen. There was a significant increase in the prolactin hormone level and production of breast milk before and after the therapy (p < 0.05) for both treatment groups. In the production of prolactin hormone and breast milk, hypnotherapy technique was significantly more effective than acupressure (p < 0.05). It can be concluded that the hypnotherapy is more effective than acupressure in stimulating the production of prolactin hormone and production of breast milk among women giving birth with caesarean section. Thus, hypnotherapy can be the alternative in support of the successful exclusive breast milk feeding.

Key words: Hypnosis, acupressure, caesarean section, lactation, prolactin

Med-Science. 2018; 7(1): 25-29

Retrospective investigation of the effectiveness of fecal occult blood test (FOB), PT-APTT in patients admitted to emergency department with gastrointestinal bleeding

Original Article

Retrospective investigation of the effectiveness of fecal occult blood test (FOB), PT-APTT in patients admitted to emergency department with gastrointestinal bleeding

Ekim Saglam Gurmen, Mucahit Avcil, Bekir Dagli, Kivanc Karaman

   

Abstract
The purpose of our study is to investigate the fact that gastrointestinal system bleeding, which is a major cause of mortality, is not diagnosed faster by any additional laboratory tests except physical examination and endoscopy, but it is negative in terms of time, workload and cost. Our study was retrospective and the hospital information system was scanned and the patients who were referred to Emergency Medicine Clinic between 01.08.2012-08.08.2013 with Gastrointestinal System (GIS) bleeding symptoms and then underwent endoscopic examination were investigated. Demographic characteristics, physical examination findings, vital signs, required examinations, digital rectal examination findings, endoscopy and colonoscopy results were recorded in the study form. For statistical analysis, SPSS (Statistical Package for Social Sciences) 17.0 program was used. A total of 274 patients aged 18 years and over were admitted to the study and 61.7% were male and 38.3% were female. Most of the patients in our diagnostic group were in the 70-79 age group. Sensitivity of Digital Rectal Examination (DRE) value was 79.6% Specificity 92.30%, negative predictive value (NPV) 60%, Sensitivity of Fecal Occult Blood Test (FOB) value was 31.46% NPV 30.49%, sensitivity of international normalized ratio (INR) was 26.25% NPV 32,95%, sensitivity of prothrombin time (PT) was 19.37%, NPV 34.84%, sensitivity of activated partial thromboplastin time (aPTT) was 14.19% NPV 34.43%. Endoscopies were performed in 169 patients with GIS bleeding and no active bleeding detected in 56 (33.1%) patients and in 113 (66.9%) patients active bleeding was detected. In patients with positive digital rectal examination findings, endoscopy results were also highly positive for gastrointestinal system bleeding. Our study suggests that; Running FOB, PT, APTT, INR tests in patients admitted to emergency department with GIS bleeding, is far from giving important and necessary information about the emergency management of the patients to emergency medicine specialists. The results of the digital rectal examination correlate with endoscopy results. It is also an easy and time-consuming examination method. From this point of view, we would like to emphasize that making the DRE of all patients with suspected GIS bleeding is a correct and immediate approach to the emergency physician.

Key words: GI Bleeding, PT, APTT, INR, FOB, DRE, endoscopy, emergency medicine

Med-Science. 2018; 7(1): 30-34

Ondansetron versus Ketamine to control intra-op and post-op shivering caused by subarachnoid block: A comparative phase study

Original Article

Ondansetron versus Ketamine to control intra-op and post-op shivering caused by subarachnoid block: A comparative phase study

Tabish Hussain, Khan Karim Afridi, Asifa Anwar Mir

   

Abstract
Shivering is a common problem during anaesthesia. Ketamine has been used for preventing shivering during anaesthesia. Ondansetron (8 mg) has been recently evaluated for its peri-operative anti-shivering effect in patients undergoing spinal anaethesia. The objective of my study is to compare low dose Ondansetron with low dose Ketamine among patients undergoing spinal anesthesia in elective surgery in terms of frequency of shivering. Patients undergoing elective general surgical procedures at Department of Anesthesiology, Holy Family Hospital, Rawalpindi, were inducted in the study. The study design was a randomized control trial and conducted from Jan 2016 to June 2016. Patients were included through a consecutive non-probability sampling. After spinal anaesthesia, patients were randomly assigned to receive Ketamine 0.25 mg/kg (group A) or Ondansetron 4mg (group B) by lottery method. During surgery, shivering was recorded at 10 min interval and recorded in terms of frequency. Out of the total 256 study participants, 128 patients in each group received the study drug (Ondansetron/ Ketamine) before surgery for prevention of shivering. Overall, there were 158 male and 98 female patients. The mean age of study population was 36 ± 11 yrs(range 21–40 yrs). Shivering occurred in 11 (4.3%) patients only. There was no significant difference between the gender distributions between the two groups (p=0.16). Patients pre-treated with Ketamine significantly experienced lesser shivering episodes than Ondansetron group (2 (1.6%) vs. 9 (7%), p=0.03). The findings of our study suggest that the prophylactic administration of low dose Ketamine (0.25 mg kg-1) and Ondansetron (4mg) produces anti-shivering effect in patients undergoing spinal anaesthesia Ketamine (0.25 mg/kg) is significantly more effective than Ondansetron (4mg) during spinal anaesthesia.

Key words: Ketamine, ondansetron, shivering

Med-Science. 2018; 7(1): 35-38

Evaluation of serum heavy metal levels on primary ovarian insufficiency

Original Article

Evaluation of serum heavy metal levels on primary ovarian insufficiency

Sule Ozel, Ayla Aktulay, Osman Aykut, Hikmet Gulsen Uncu, Hatice Kansu Celik, Sunullah Soysal, Mehmet Cinar, Yaprak Engin Ustun

   

Abstract
In this study we aimed to investigate the level of exposure to these toxic heavy metals such as Aluminum (Al), Arsenic (As), Mercury (Hg) ,Manganese (Mn) and Lead (Pb) among Premature Ovarian Insufficiency (POI) patients. This cross-sectional study was performed in 23 women with normal reproductive hormones (control) and 23 women with POI (case). Risk factors evaluated were; age,body mass index(BMI), gravidity and blood serum metal levels (Al,As,Hg,Mn,Pb). Risk factors were compared between groups. Women with history of pelvic surgery, any cancer or autoimmune disease treatment, endometriosis and other chronic systemic diseases were excluded from the study. The Age, BMI and Gravidity were similar between the case and control group (p > 0.05). And also the aluminum, arsenic, manganese, mercury and lead serum levels were smilar between the case and control group (p > 0.05). Etiology of most POI cases remains undetermined. Early recognition of predisposing factors of POI may help to make prevention about ovarian failure and would offer this patient population the opportunity to preserve fertility. Identifying people with elevated blood heavy metal levels will give chance of avoiding oncoming destructive health effects of heavy metals.

Key words: Primary ovarian sufficiency, heavy metals, lead, arsenic, mercury

Med-Science. 2018; 7(1): 39-42