Online ISSN: 2515-8260

Keywords : Outcome


Functional Outcome of Surgical Management for Clavicle Fractures by Osteosynthesis using Plate and Screws

Anurag Anand,Tushar Pisal,Anirudh Kandari,Shubham Taori, Ankit Barosani

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 729-742

Clavicle fractures contribute approximately 2.6% among other fractures of the body and account for approximately 44% to 66% of all fractures around shoulder.Middle 1/3rd of the clavicle is most prone for fracture because this area is weakest.Many studies which has been done till now has stated the effectiveness of open reduction internal fixation with plating for displaced clavicle fractures and it was noted to have high union rate and lower risks of complication.Usually locking compression plate are used to get a satisfactory results with low risks of complication in cases of majority of complex clavicle fracture.

“To compare the functional Outcome of Distal Radius Fractures Treated with Closed Reduction and Cast Application Versus Volar Plating”

Dr. Sujal Raj NS , Dr.Gopal Tiwari,Dr. Ajay Kumar, Dr.Deepak Saxena, Dr. Nazim Mughal, Dr.Vikas Verma, Dr. Vishnu Lal

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 2055-2074

Fractures of distal radius account for 20% of all fractures treated in emergency department. These fractures result from low energy injuries in elderly population and high energy injuries in young adults. Most of these fractures are relatively uncomplicated and are effectively treated by closed reduction and casting. However, fractures that are unstable intra-articular can jeopardize the integrity of the articular congruence and kinematics of articulations resulting in high prevalence of complications. So to overcome these above complications, there is a shifting trend towards surgical management.

Transversus abdominis muscle release; a novel technique in complex ventral hernias-A short case series

Dr. Harikrishnan SA , Dr. Madhubalan Samuthiravel , Prof.Dr.A.Sambandamurthy, Dr.Shanmugasundaram

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 1796-1801

Surgical repair of complex ventral hernia repairs are difficult to perform and are associated with peri-operative complications and recurrence. Many surgical techniques have been studied to improve the outcomes of complex ventral hernia repairs and Transversus abdominis muscle release technique is one such procedure.  
Objectives: To find out the outcome of transversus abdominis muscle release (TAR) procedure done in patients with complex ventral hernia.  
Materials and method: A prospective study was done among 10 patients with complex ventral hernia presented to General Surgery department of Vinayaka mission’s medical college and hospital, Karaikal for a period of 1 year. All the patients underwent transversus abdominis muscle release with sub-lay mesh by open method. The patients were discharged on 7th postoperative day. All the patients were followed up for a period of 6 months to identify the outcomes of the procedure and any delayed complications after discharge from the hospital. The results of the study are analysed and presented in the form of mean with standard deviation and percentage.  
Results: Mean age of the patients was 59.4 years ranging from 45 to 76 years. Among the total 10 patients, 6 (60%) were females. Majority (40%) of the patients had incisional hernia. The most common previous surgical procedure was hysterectomy. Average duration of hernia among the participants was 3.4 years. The average size of the defect was 6.3 cm and 2 patients had multiple defects. During the stay in hospital, 2 patients (20%) developed wound related complication such as seroma formation. At the end of 6 months of follow-up there was no recurrence of hernia in the patients.   
Conclusion: Short term follow-up of TAR procedure had shown that the technique is effective in repair of complex ventral hernia without any significant complication and recurrence

Clinical Profile and Outcome of COVID 19 Patients from JIIU’s IIMSR, Jalna, Maharashtra

Abdul Jabbar Abdul Mannan, Syed Shahnawaz Ali Hamid Ali, Mohammed Suhail, Mohammad Shafee, Afshan Kausar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 2823-2827

Background: COVID-19 is a pandemic spread all over the world. This disease has imposed a huge burden on health resources. Evaluation of clinical profiles of such patients can help in understanding and managing the pandemic more efficiently.
Methods: This was a cross sectional observational study of 100 diagnosed COVID-19 patients admitted to JIIU’s, IIMSR, from April to June 2021. All these patients were positive for COVID-19 by an oro-nasopharyngeal swab rt-PCR based testing.
Results: The mean age of the population was 45 years with a male predominance (72% patients). All the patients (100 %) were symptomatic, with fever being the most common symptom (85%), followed by cough (62%).
Conclusion: Severity based approach to COVID -19 infections, with defined criteria and treatment guidelines will help in judicious utilization of health-care resources

Morbidity profile and outcome in a paediatric intensive care unit of a tertiary care hospital over a one-year period: a single institution study from rural India

Jadab K. Jana, Anusree Krishna Mandal, Soumya Gayen, Md Jasim Alam

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 3319-3326

Background: The study is done to have a better understanding of the morbidity profile and outcome in a Paediatric Intensive Care Unit (PICU) of a rural-based tertiary care centre which can enable the caretakers to plan and plant possible interventions to enhance patient care. The study was carried out in a retrospective manner.
Methods: This retrospective study was carried out in the department of paediatrics in children aged 1 month to 12 years, who were admitted to the PICU during the period of 1st September 2021 to 31st August 2022. A total of 925 children were admitted and data were collected from PICU records using predesigned proforma and analysed accordingly.
Results A total of 925 children were admitted during the study period. The 61.62% of children were male and the rest 38.38% were female. The male to female ratio was 1.6:1. The infants excluding neonates constituted 59.89% of total admission.  The mean age of presentation was 2.63 ± 3.41 years. 67.46% of children were admitted with infections of different organ systems and the rest 32.54% with diseases of non-infectious aetiology. So far outcome is concerned, 13.62%, 56.10%, 3.24%, 3.78%, and 23.24% of children were discharged, transferred to the paediatric ward, referred out to elsewhere, left against medical advice (LAMA) and death respectively. Infants excluding neonates constituted 69.30% of total death and the most common aetiology of death being documented was infections (84.19%).
Conclusion: In our study, most of the admitted children were found to have died of infective causes and most of them were infants. This puts a much necessary focus on the control of infections among infants by various means and should be addressed promptly and meticulously.

Guillain Barre Syndrome clinical profile and determination of its prognosis

Padmaja B, Rajini G, Srilatha S, Lakshmi Sowjanya S

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 5845-5856

Introduction: GBS is a potentially life-threatening condition and medical emergency. It is a commonest cause of acute post infectious flaccid paralysis worldwide. GBS can result in serious complications that require immediate assessment and management as hospitalized patients. So in this study we aimed to study the clinical features, outcome and prognosis of GBS affected patients.
Materials and methods: A cross sectional study that included a total of 30 patients confirmed with guillain barre syndrome diagnosis during the study period of one and half year. Details pertaining to study population such as age, sex, personal history, socioeconomic status, past infectious history, relevant family history, seasonal preponderance, comorbidities and physical examination findings were collected. All relevant investigations were performed.
Results: GBS occurs in all age groups with a greater incidence in the 31-40 years age group. Male predominance was observed in the ratio of 4:1. Ascending type of paralysis, facial nerve involvement, autonomic dysfunction are most commonly seen in GBS with a predominant proximal muscle weakness. Respiratory failure occurs in 1/3rd of patients in GBS. Cranial nerve dysfunction occurs in 33.33% of patients in GBS. Rapid progression from onset to peak paralysis, prolonged duration of peak paralysis, need for ventilatory support and severity of paralysis are the factors associated with poor prognosis in GBS. Mortality in GBS is 27%. Delayed onset of recovery from paralysis, requirement of mechanical ventilatory support are significant prognostic factors of outcome in GBS.
Conclusion: Meticulous clinical examination helps to determine the severity of the patient. Early diagnosis and determination of subtypes have an important role for prognosis prediction. Observation of ICU patients for features of autonomic dysfunction is important to alleviate serious consequences.

A Hospital Based Comparative Study to Evaluate the Functional and Radiological Outcome of Dital Tibial Fracture Between Minimally Invasive Percutaneous Plate Osteosynthesis (MIIPO) & Intra Medullary Interlocking Nail (IMIL) at Tertiary Care Center

Abhinay Sharma, Sachin Kanwar, Sheetal Thakur

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 3444-3452

Background: Distal tibial metaphysis is defined by constructing a square, with sides of length defined by widest portion of tibial plafond. Various surgical modalities used for these fractures include closed intramedullary nailing, plating by open or closed methods, and various types of external fixators. The purpose of this prospective study was to compare the two primary modalities of treatment for these fractures: namely, distal tibial locking compression plate by Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO) and closed intramedullary interlocking nailing (IMIL), and to know the efficacy of these techniques in the management of closed fractures of distal tibia.
Materials& Methods: A hospital based prospective comparative study done on 30 adult patients with fractures of lower third tibia admitted in department of Orthopaedics at Indira Gandhi Medical College, Shimla, Himachal Pradesh, India during one year period. All patients with distal tibiafractures who satisfy the inclusion criteria have been included in the study. Patients willbe allocated randomly into two groups using computer generated random numbers i.e., IMIL group and MIPPO group each with 15 patients. Patients were followed up for 3 months, 6 months, and 12 months for clinical, radiological and functional outcome evaluation.
Results: Mean age of the patients in IMIL group is 40.56 ± 11.23 years and 44.32 ± 15.46 years in MIPPO group. The most common mode of injury was found to be Road Traffic Accident (RTA), seen in 63.33% of the patients, followed by fall 23.33%, sports injury 6.66% and direct blow 6.66%. The functional results, as assessed by Teeny And Weiss Criteria (Functional Evaluation of Ankle), showed that majority (60%) of the patients in the study hadgood functional results (IMlLN: 66.66%; MIPPO: 53.33%) and 33.33% had excellent results (IMILN: 26.66%;MIPPO: 40%). The difference in functional outcome showed mean score of 84.36 ± 8.78 in IMIL group where as in MIPPO group it is 84.12± 9.65. Using Chi-square test, these differences were not found to be statistically significant (P >0.05). In our study, most of the patients had no complications. In patients who had complications, in IMIL group most common complication is superficial infection (13.33%) followed by malunion (6.66%) and deep infection (6.66%), whereas in MIPPO group most common complication was deep infections (13.33%) and implant failure (13.33%) and delayed union (3.33%).
Conclusion: We concluded that multidirectional locked nailing is an efficient method for treating distal tibia fracture. Compared with MIPO, IMIL nailing should still be considered the gold standard for distal tibia fracture management

Clinical Patterns of PICU Admissions in a Large Government Teaching Hospital and the Utility of PRISM III Score in Predicting Outcomes

Sneha Madasu; Santosh Avinash B; K Sachitra; Vijay Kumar Guduru

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 1892-1902

Background: PRISMIII score was shown to be effective in predicting the risk of mortality and as well as the factors contributing to poor outcome. Therefore, we have evaluated our PICU using modified PRISMIII results. Martial and Methods: A Prospective observational study was conducted on 120 seriously ill infants and children meeting the inclusion and exclusion criteria admitted to PICU were taken up for the study at the Department of Paediatrics, Mahatma Gandhi Memorial Hospital, KMC Warangal, Telangana, South India. Results: Mean age among survivors was 57.16±49.35 months and among deceased were 34.8±43.4 months. Male to female ratio was 1.06:1.00. Our PICU is catered to the medical critical illness only. The overall mortality rate is 57.5%. The major causes of illness in the order of decadence were, infections, Respiratory, CNS, CVS and GIT disorders Altered sensorium, multiorgan dysfunction and need for mechanical ventilation were significant risk factors of mortality. The duration of hospital stay among non-survivors was less than the survivors. Conclusion: The mean PRISMIII score among non-survivors was higher than survivors. PRISMIII score at 24hrs, PRISMIII difference, length of hospital stay, showed a statistically significant correlation with the mortality (p=0.000). The probability of deaths increased significantly with increase in PRISM score. Area under ROC is 99.9%, with cut-off point at score 15.

Outcome of communited intra articular fractures of distal tibia treated with external fixator

Rajkumar Indrasen Suryawanshi, Deepak Bhimraj Datrange, Swapnil Bhaskarrao Mahale

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 1876-1881

Background: The tibial intra-articular fracture refers to soft tissues envelope and often known as pillion fracture. The goal of treatment involves healed, well-aligned, functional range of motion of ankle joint. To offer the treatment the approach of fracture reduction has been successful in treating the complex fracture.
Aim: The research paper aims to analyze the outcome of communited intraarticular fractures of distal tibia treated with an external fixator.
Material and Methods: The current study is an observational study that is being conducted in….from…... For the study, the researcher has selected 30 people that involve 23 males and 7 females. The mean age of these participants was 53 years (range between 26-72 years). The patients were selected focusing on the inclusion and exclusion criteria.
Results: The clinical result of study involves the mean score of 81.5 points that range between 58-100. The first requirement of arthrodesis of the ankle and this patient scored 9 points for reduction quality. The clinical results have identified that the patient was facing the issues related to A5 valgus deformity that also occurred with diabetes. The consideration of results focusing on the approach of external treatment was found good and applied for the other clinical studies of the patients.
Conclusion: From the study, it has been carried out that that external fixator treatment for communited intraarticular fractures of the distal tibia is beneficial and having a positive impact on the process of offering the required support to the patients.

" A cross-sectional observational Study to assess the severity of coronavirus disease 2019 according to Clinical value of immune inflammatory markers"

Dr. Sarika Rawat Dr. Sunil Bajoliya Dr. Sachin Kumbhare Dr Roshan Mandloi Dr. Ranjeet Badole

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 955-961

Title-" A cross-sectional observational  Study to assess the severity of coronavirus disease 2019 according to Clinical value of immune  inflammatory markers"
Background: In Wuhan, China, since December 2019, a new strain of pneumonia has appeared and spread quickly over the world. The World Health Organization determined that a separate strain of coronavirus, designated COVID-19, caused this pneumonia (WHO). This unique coronavirus was identified as acute respiratory syndrome coronavirus 2 based on phylogeny, taxonomy, and accepted practise (SARS-COV2).
Objective: a cross-sectional observational study to show the co-relation between inflammatory markers and the severity of disease
Materials and Methods: a total of 250 patients were selected who are microbiologically covid positive and ready to give consent were included in the study. There basic test will be done.
Result- There is preponderance of male gender among the patients 147 were male 103 were female. The mean age of participant is 43 ±2.825 (±6.57%)65 patient were immediately required the either oxygen or mechanical ventilation,among all this 26 patient were died. Among this entire 65 patient, 21 patients have raise CRP level,14 have raised IL -6 Level among them all 26 were have raised D-Dimer .
Conclusion- Our study showed that high level of D-Dimer, IL-6 and CRP was independent risk factors for assessing the severity of COVID-19. IL-6 played a determiningrole in the severity of SARS-COV2 and had a potential value for monitoring the process of severe cases.

Correlation of serum amylase with outcome in acute organophosphorous poisoning at a tertiary hospital

Dr Prakash Hadimani; Dr Kaushik M R

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 1420-1425

Background:Organophosphate (OP) poisoning is an important cause of poisoning all over the world. Prompt recognition and aggressive management of acute intoxication are essential to minimize the morbidity and mortality from these potentially lethal compounds. Present study was aimed to study correlation of serum amylase with outcome in acute organophosphorous poisoning at a tertiary hospital.

COMPARATIVE STUDY OF FETOMATERNAL OUTCOME IN PATIENTS UNDERGOING SELECTIVE VS EMERGENCY C SECTION AT A TERTIARY CARE HOSPITAL

Togarikar Sopanrao malharrao

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 1974-1982

Background: Caesarean section or caesarean delivery is defined as the birth of a fetus through incisions in the abdominal wall (Laparotomy) and the uterine wall (Hysterotomy). This definition does not include removal of the fetus from the abdominal cavity in the case of rupture of uterus or in case of an abdominal pregnancy. Caesarean section can be considered one the earliest forms of modern birth technology Aim & Objective: 1.To study the maternal morbidity, mortality, perinatal outcome in patients, undergoing elective and emergency C-section. 2.To compare the maternal morbidity, mortality, perinatal outcome in patients, undergoing elective and emergency Csection. Method: Study design: Prospective study. Study setting: Department of Obstetrics and Gynecology at tertiary care centre. Study duration:……..Study population: The study population included all the women undergoing elective c-section and emergency c-section. Sample size: Results: In Group A: 44% of patients are in the age group of 18-24years and in Group B: 74% of patients are in the age group of 18-24years. A statistically significant value of P=0.01, is obtained suggesting most of the patients undergoing C-section (elective/emergency) are in age group of 18-24years. Strongly significant (P value: P<0.01). The most common risk factor is Previous LSCS. 14(28%) patients had previous LSCS in Group A (Elective C-Section) and 7(14%) patients had previous LSCS in Group B (Emergency C-Section). From the above graph, it can be observed that the patients with risk factor of Previous LSCS are more common with Elective C-Section group compared to Emergency C-Section group. Post-operative complications in Caesarean section were more in Emergency Caesarean Section when compared to Elective caesarean section. PPH is the most common in Emergency group when compared to Elective group. Wound infection is the 2nd most common complication in Emergency group. Conclusions: The factors associated with caesarean section are age, parity, multiple pregnancy, maternal weight gain, and birth weight. Including these factors, the caesarean section is justified under certain circumstances such as cephalo pelvic disproportion and contracted pelvis, dystocia due to soft parts, inadequate uterine forces, antepartum hemorrhage, pre- eclamptic toxemia, eclampsia, fetal distress and prolapse of the cord, malpresentation, maternal distresses such as heart problems, bad obstetric history, habitual intrauterine death of the fetus and elderly primigravida.

Clinical study of etiology & immediate outcome of acute poisoning in children at a tertiary hospital

Rajendrakumar Hiralal Bedmutha, Nishad Yashawant Patil

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 5, Pages 630-635

Background: Poisoning in children is one of the most common emergencies encountered in pediatric practice and it is a worldwide problem leading to morbidity and mortality. Common poisoning agents in low-income and middle-income countries are fuels such as paraffin and kerosene, pharmaceuticals and cleaning agents. Present study was aimed to study etiology & immediate outcome of acute poisoning in children at a tertiary hospital.
Material and Methods: Present study was prospective, observational study, conducted among children of any gender, less than 14 years of age, came with history of poison consumption, irrespective of presence of signs and symptoms, accompanied or unaccompanied by container or poison OR had doubtful history of consumption of poison but with definite signs and symptoms of acute poisoning. Parents willing to participate in present study.
Results: In present study, 104 children admitted with history of poisoning cases, were studied. Majority of children were from 1-5 years age group (50.96 %), male:female ratio was 1.9:1. Common presenting symptoms were vomiting (64.42 %), drowsiness/altered sensorium (30.77 %), respiratory distress (21.15 %), seizures (16.35 %), while 17.31 % patients were asymptomatic. Common route of administration observed was oral route (98.08 %) & only 1.92 % had history of inhalation. Common poisoning agents were organophosphorus (15.38 %), Kerosene (13.46 %), bleaching solution (7.69 %), unknown agent (25.96 %), unknown seeds (16.35 %) & unknown tablets (8.65 %) were also observed. Majority children were discharged uneventfully (87.5 %), 8 children had taken discharge against medical advice & mortality was observed among 5 children.
Conclusion: Poisoning in children is associated with mortality due to various reasons. Regular surveillance is required to recognize trends in specific agents and other variables related to childhood poisoning

Clinical study of etiology & immediate outcome of acute poisoning in children at a tertiary hospital

Rajendrakumar Hiralal Bedmutha, Nishad Yashawant Patil

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 2573-2578

Background: Poisoning in children is one of the most common emergencies encountered in pediatric practice and it is a worldwide problem leading to morbidity and mortality. Common poisoning agents in low-income and middle-income countries are fuels such as paraffin and kerosene, pharmaceuticals and cleaning agents. Present study was aimed to study etiology & immediate outcome of acute poisoning in children at a tertiary hospital.
Material and Methods: Present study was prospective, observational study, conducted among children of any gender, less than 14 years of age, came with history of poison consumption, irrespective of presence of signs and symptoms, accompanied or unaccompanied by container or poison OR had doubtful history of consumption of poison but with definite signs and symptoms of acute poisoning. Parents willing to participate in present study.
Results: In present study, 104 children admitted with history of poisoning cases, were studied. Majority of children were from 1-5 years age group (50.96 %), male:female ratio was 1.9:1. Common presenting symptoms were vomiting (64.42 %), drowsiness/altered sensorium (30.77 %), respiratory distress (21.15 %), seizures (16.35 %), while 17.31 % patients were asymptomatic. Common route of administration observed was oral route (98.08 %) & only 1.92 % had history of inhalation. Common poisoning agents were organophosphorus (15.38 %), Kerosene (13.46 %), bleaching solution (7.69 %), unknown agent (25.96 %), unknown seeds (16.35 %) & unknown tablets (8.65 %) were also observed. Majority children were discharged uneventfully (87.5 %), 8 children had taken discharge against medical advice & mortality was observed among 5 children.
Conclusion: Poisoning in children is associated with mortality due to various reasons. Regular surveillance is required to recognize trends in specific agents and other variables related to childhood poisoning

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

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.

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.

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.

AN OBSERVATIONAL STUDY OF NEONATAL OUTCOME IN BABIES BORN TO MOTHERS WITH PREGNANCY INDUCED HYPERTENSION

Dr. Dhruv Singh Gaur,Dr Aishwarya Singh,Dr. Swati Prashant

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 3060-3066

Background & Method: The aim of this study is to study neonatal outcome in babies born to mothers with pregnancy induced hypertension. An observational study was conducted in level III NICU of INDEX MEDICAL COLLEGE HOSPITAL & RESEARCH CENTRE , INDORE .  Detailed maternal history like age, parity, immunisation status, gestational age, blood pressure recording, proteinuria & presence of seizures. Details of labor, mode of delivery, presence of complications if any during labor. Detailed natal history was taken which included maturity , birth weight , APGAR score , type of delivery  , anthropometry , any complication during birth like Meconium Aspiration Syndrome(MAS) , respiratory distress (RDS) , sepsis , need for ventilatory support. Gestational age was assessed by New Ballard scoring system.
 
Result: Among the total(n = 156), about 69.2% of babies were delivered by caesarean section & 30.8% were delivered by vaginal delivery. This shows a statistical significance of caesarean section(p value-0.001) among these babies born to PIH mothers in our study. RDS is found to be the most common complication accounting for about 39.7% of all babies. Birth asphyxia (26.9%) & sepsis (29.4%) comes next, followed by Meconium Aspiration Syndrome (MAS) (3.8%) being the least common complication.
 
Conclusion: Pregnancy Induced Hypertension is a maternal pathology involving placental modification which is associated with foetal complications. Since babies born to hypertensive mothers are prone to develop several complications, close monitoring of these babies should be undertaken in an attempt to provide these babies with decreased morbidity & improved growth development & survival.

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.