Online ISSN: 2515-8260

Keywords : Outcome


To assess the severity of COVID-19 in relation toclinical value of immune inflammatory markers: An observational study

Dr. Preety Motiyani, Dr. RS Meena, Dr. Dileep Dandotiya, Dr. Mamta Meena, Dr. Jitendra Rai

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 657-662

Background: Since December 2019, an novel type of pneumonia emergedin
Wuhan,China,and rapidly transmitted to wholeglobe. This pneumonia was verified to
be caused by a different strain coronavirus and named as coronavirus disease
2019(COVID-19) bythe World Health Organization (WHO). Based on
phylogeny,taxonomy and established practice, this novel coronavirus was designated
as severe acute respiratory syndrome coronavirus2 (SARS-COV2).
Objectives: To show the co-relation between inflammatory markers and the severity of
COVID-19 disease

Risk factors of Acute Kidney Injury and outcome of children affected with AKI

Rekha Arer ,Jitendra L Chukkanakal ,Jayaraj Patil ,Venkatesh G .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 3096-3104

Background: The etiology of AKI in children varies in developed and developing countries. in the former, AKI follows major surgeries, complications associated with malignancies, and the use of nephrotoxic drugs. Objectives: to identify the risk factors of AKI and to see the outcome of children affected with AKI.
Material & Methods: This Prospective, observational study was conducted among 250 children aged between 1 month-12 years, admitted in the Pediatric Intensive Care Unit in Government General Hospital; Siddhartha Medical College; Vijayawada Results: The minimum age at enrollment was one month to 12 years of age. The comparison between the two groups based on gender was not significant (P=0.1873). None of the patients in the non-AKI group required dialysis, but in the AKI group, of the 44cases, nine case needed dialysis. The number of dialysis is highly significant, with P

Floating knee injuries: Associated injuries and clinical outcome

Dr. Himanshu Agrahari, Dr. Chethan MH, Dr. Siddharth Dubey, Dr. Bhaskar Sarkar, MD Quamar Azama

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 258-266

Background: Floating knee injuries are frequently part of polytrauma. The outcome of this injury
pattern when compared to only femur or tibia fracture is less satisfactory. The outcome is even worse
when there is presence of other associated injuries. We hypothesized that not all associated injuries
have similar bearing on the outcome thus tried to find out the impact of commonly associated injuries
on the final outcome of these complex fractures.
Methods: Study was conducted including the patients of floating knee injury operated between
September 2016 and January 2019. Total of 42 eligible patients were operated, 4 patients were
excluded to due to lack of adequate follow-up. Data relating to demography, Fraser subtype,
compounding, associated injuries and clinical outcome were collected. Statistical analysis was
performed to see the association of associated injury, Fraser subtype and presence of compounding
with clinical outcome.
Results: Mean age was 33.5 years (17-63 years) with a male preponderance. Mean follow up was 1.6
years. Twenty-seven patients (71.1%) had excellent/good outcome while outcome of 11 patients
(28.9%) was acceptable/poor. Seventeen patients (44.7%) had compound fractures. Injuries which were
significantly associated with Acceptable/Poor outcome were ligament injuries, popliteal artery injury,
abdominal injury and patella fracture. Chest injury with a p value of 0.05 was also very close to being
statistically significant.
Conclusion: The clinical outcome of these patients not only depend on proactive and optimum
management of tibial and femoral fractures but also on the management of associated injuries.

Anaesthetic management of cases where Thoracic segmental spinal anesthesia a suitable alternative to general anesthesia

Dr.A Sagar, Dr. Manskuri Soujanya, Dr.Ramlal Porika, Dr Joshua Dhavanam Y

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10286-10292

This manuscript describes six cases of thoracic spinal anaesthesia for patients with for
certain cases such as laparoscopic surgeries who are considered at high risk while under
general anesthesia. Anesthesiologists are hesitant to perform spinal anesthesia above the
termination of the conus medullaris due to fear of injuring the spinal cord. However,
thoracic spinal anesthesia has been demonstrated as a safe and effective method for
various surgeries. Although not routinely used, the procedure has been shown as
beneficial in maintaining hemodynamic stability for these patients and reducing side
effects encountered with general anesthesia. This activity describes the procedure of
thoracic segmental spinal anesthesia and explains the role of the interprofessional team
in managing patients who have undergone this procedure.

Assessment Of Live Kidney Donor In Term Of Functional Outcome And Quality Of Life Using Psychometric Analysis

Mukesh Jaysawal , Asutosh Kumar , Rohit Upadhyay , Rajesh K. Tiwari

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1596-1604

Background: Candidates for living kidney donation accept a variety of risks and advantages when they choose to proceed with nephrectomy. In order to give their consent in this matter, people must first acquire accurate information about the results they consider to be essential to their choice. We determined which outcomes were most significant to living kidney donors and explained their selection criteria.
Aims: The current study aims to investigate the functional alterations in residual kidneys and assess the post-donation quality of life of live kidney donors.
Methods: The Department of Urology was where this study was carried out. The study used a prospective observational design, with some data being gathered retroactively. The donors who underwent donor nephrectomy at IGIMS Patna two years ago were included in the study. Donors were contacted by telephone after a 2-year nephrectomy in this hospital-based study.
Results: In our study, the physical domain of quality of life declined, whereas the psychological, environmental, and social domains all saw improvements. Living kidney donors reported a significant increase in pre and postoperative kidney surface area; preoperative 40.46 cm2 vs. 52.85 cm2, p<0.0001. There has been a reported statistically insignificant improvement in overall QOL (3.23 to 3.58, p<0.0148). There has been a documented, statistically small rise in health satisfaction (3.1 to 3.53, p<0.032).
Conclusion: Our study underlines the necessity of routine follow-up with donors in order to evaluate the effects of donation on physical health, clinical outcomes, and overall QOL.

Outcome of ChildrenTreated with Mechanical Ventilationin PICU of Zagazig University Pediatric Hospital

Samir Mohamed Zamzam ,Mohamed Ali Abdou Mohamed,Khairallah Saleh Abdul Hafeez

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 4947-4956

Background: Mechanical ventilation is often lifesaving but is associated with serious complications, in part because it is delivered to patients at high risk of lung or cardiac compromise. These complications may be related to the direct mechanical effects of the intrathoracic pressures generated by the ventilator, to alveolar and systemic inflammation, or to neural stimulation. The aim of study to assess the clinical profile and outcome of children treated with invasive mechanical ventilation. Patients and methods: An Observational study conducted on 74 patients in PICU in Pediatric Hospital ,Faculty of Medicine, Zagazig University, all patients are intubated and connected on mechanical ventilators, all patients underwent a thorough medical history examination,(Patients' data) were collected including demographic data as age and sex, diagnosis, length of stay on MV from the time of initiation to the time of liberation, mode of MV used upon its initiation, complication,( outcomes and its relations to cause of ventilation and admission ,comorbidity ,mode of MV, age and duration of weaning and all MV parameters). Result: Outcome of mechanical ventilation among studied group showed14.9% have bad outcome and 85.1% had good outcome, also showed that Pneumonia was significantly associated with bad outcome.Conclusion: The results of the present study show a significant number of preventable adverse events, especially atelectasis and ventilator associated pneumonia. Prolonged duration of ventilation was significantly associated with complications as well as mortality related to mechanical ventilation, also APRV mode has significantly association with bad outcomes.

OUTCOME ANALYSIS OF PELVIC FRACTURES IN TERTIARY CARE HEALTH CENTRE

Dr. Khizar Khan; Dr. Naresh Dhaniwala; Dr. Y.U. Chitriv

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 1856-1860

Background: Pelvic ring fractures represent 3-8% of all selected injury and have a high mortality rate of around 20%. In Polytrauma patients the occurrence of Pelvis ring fractures is higher which is observed in 20-25%.In young individuals it occurs as a consequence of high energy trauma. The main aim of this study is to assess the functional outcome of pelvic fractures managed operatively and conservatively and providing a basic local data regarding pelvic fracture management and results obtained. Objectives: The main objectives are to note the functional outcome using Majeed pelvic score and to assess the radiological outcome by using suitable parameters. Methodology: This is an observational study in which a minimum of 25 patients presented as pelvic fracture in Casualty of AVBRH are admitted in orthopaedic ward. This study will include both prospective and retrospective domains. Retrospective cases from January 2015 will be enrolled and the data will be collected from MRD department as well as telephonic calls. Period of study is From July 2019 to September 2021 and collection of data is from July 2015 to June 2021.Fracture pattern will be classified as per the Tile’s classification and the functional outcome of patients managed operatively and conservatively will be assessed as per Majeed pelvic score. Expected outcome: By this study we expect that the patients having high intensity injury if managed operatively will have better outcome as compared to the conservative ones.

Review Article On Treatments & Preventions Of Hemorrhoids

R. RAMANI

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 6096-6099

This review discusses the pathophysiology, epidemiology, risk factors, classification, clinical evaluation, and current non-operative and operative treatment of hemorrhoids. Hemorrhoids are defined as the symptomatic enlargement and distal displacement of the normal anal cushions. The most common symptom of hemorrhoids is rectal bleeding associated with bowel movement. The abnormal dilatation and distortion of the vascular channel, together with destructive changes in the supporting connective tissue within the anal cushion, is a paramount finding of hemorrhoids. It appears that the dysregulation of the vascular tone and vascular hyperplasia might play an important role in hemorrhoidal development, and could be a potential target for medical treatment. In most instances, hemorrhoids are treated conservatively, using many methods such as lifestyle modification, fiber supplement, suppository-delivered anti-inflammatory drugs, and administration of venotonic drugs. Non-operative approaches include sclerotherapy and, preferably, rubber band ligation. An operation is indicated when non-operative approaches have failed or complications have occurred. Several surgical approaches for treating hemorrhoids have been introduced including hemorrhoidectomy and stapled hemorrhoidopexy, but postoperative pain is invariable. Some of the surgical treatments potentially cause appreciable morbidity such as anal stricture and incontinence. The applications and outcomes of each treatment are thoroughly discussed.