Online ISSN: 2515-8260

Keywords : Clinical Outcome


A STUDY TO EVALUATE VON WILLEBRAND FACTOR IN TROPICAL DISEASES - SCRUB TYPHUS, DENGUE, CHIKUNGUNYA, MALARIA AND ITS ASSOCIATION WITH CLINICAL OUTCOME

Rishabh Parashar, R.K. Bhimwal, Ashwani Kumar Vyas, Sudhir Mehta

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1713-1724

Introduction: Endothelial activation and dysfunction is a central process in the pathogenesis of tropical diseases and von-Willebrand Factor levels have been linked with damage to the endothelium. The purpose of the study is to evaluate von Willebrand Factor in tropical diseases-Scrub typhus, Dengue, Chikungunya, Malaria and its association with clinical outcome. vWF can be used as a novel prognostic marker of clinical outcome.
Methodology: Hospital-based prospective observational analytic study on36 subjects of each disease. Inclusion Criteria: Confirmed cases of Scrub typhus (IgM positive), Dengue (NS1/IgM positive), Chikungunya (IgM positive) and Malaria (slide positive/rapid antigen detection/severe malaria). Exclusion criteria: Patients with von-Willebrand disease, Thrombotic Thrombocytopenic Purpura, and other conditions characterized by vascular damage, including nephritis, myocardial infarction, sepsis, diabetic angiopathy, peripheral vascular disease. Complete history with the examination was done. Investigations including CBC, PBF, RBS, RFT, LFT, vWF activity were done.
Observation and Results: In our study, we observed that vWF levels were elevated in91% patients of malaria, 89% patients of dengue, 75% patients of chikungunya, 88% patients of scrub typhus. We also found that 6, 3, and 3 out of 36 patients died in Malaria, Dengue, and Scrub typhus respectively with mean vWF was 414.67 IU/dl, 420 IU/dl, and 420 IU/dl respectively against alive cases where mean vWF was 259.97 IU/dl, 272.97 IU/dl, and 233.94 IU/dl. There is a statistically significant difference in vWF among alive and dead cases.
Conclusion: Raised vWF shows the association of von- Willebrand Factor activity and its association with the complications in these tropical diseases. von- Willebrand Factor level can be used as a novel prognostic marker of clinical outcome.

Intrauterine growth restriction in term pregnancy: Clinical outcome

Dr. Sahana PR, Dr. Jeevitha H, Dr. Prajwal M, Dr. Chandrashekar K

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1625-1629

The risk of morbidity and mortality depends on basic pathology which mainly caused the growth problem, severity of growth restriction, gestational age of mother -how much earlier it is, and the baby's gestational age at birth. The 10th percentile is commonly used to define "small for gestational age" at all stages of pregnancy. The risk of neonatal mortality at the 10th percentile has a bimodal distribution with higher mortality at 26 and 34 weeks ' of gestation. A detailed history as per questioner was taken with general physical examination and investigations were done as per requirement. The accumulated data was evaluated and statistically analyzed. The pregnancy outcome of 70 cases was studied, which showed that 40(61.43%) cases went into spontaneous labor, labor was induced in19 (28.57%) cases and 11(1.%) cases were taken for elective caesarean section for various indications. The fetal outcome of the study showed that out of 70 cases recruited in the study, 65 (92.86%) were live births, 3(4.28%) were still birth and 2(2.86%) cases had intra uterine fetal demise.

Evaluation of Surgical Procedures in Selected Proctological Patients with Local Anaesthesia and Saddle Block and Comparison of Outcome of the Patients

Narendra Singh Tomar, Lokesh Kumar Aggarwal, Govind Goyal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10984-10989

Introduction: Anorectal surgical procedures are among the most common surgical
operations, with more than 90% of these procedures performed on an ambulatory basis. This
study was designed to assess the two anaesthetic techniques, namely local anaesthesia with
sedation and spinal anaesthesia, with respect to their recovery times, post-operative side
effects, pain scores, patient satisfaction and hospital expenditures in certain proctological
examinations that include ambulatory anorectal surgery.
Materials and Methodology: 80 patients who are considered fit at ASA physical status I, II
and III outpatients scheduled for anorectal surgery were enrolled in this study. Patients were
randomly allotted to receive one of the two following techniques: spinal anaesthesia (Group
1, n = 40) or local anaesthesia with midazolam sedation (Group 2, n = 40).
Results: There was no significant difference for preoperative VAS scores between the two
groups (p > 0.05). VAS scores increased to 3.42 ± 0.5 for Group 1, and to 5.29 ± 1.6 for
Group 2 at the fourth postoperative hour, which predicts a time-dependent increase of mean
scores resulting from the early recurrence of pain. There was no statistically significant
difference in VAS scores between two groups except for the four postoperative hour values.
Conclusion: To conclude that the use of local anaesthesia with sedation for ambulatory
anorectal surgery, when compared with spinal anaesthesia, resulted in a relatively shorter
hospital time, lower hospital expenditures and relatively no undesirable effects.