• Print ISSN: 2395 - 1400, Online ISSN: 2455 - 8923

JBCR VOL 6 - Issue 1, Jan ‐ June 2019

EDITORIAL

The Role of Standards for Digital Health and Health Information Management

Suptendra Nath Sarbadhikari

[Abstract]

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Original Articles

Cardiotocography In Labour And Fetal Outcome

Kavitha K, 1 N. Madhavi 2

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Original Articles

A Retrospective Study On Commonly Prescribed Insulin Preparations and Combinations In The Management of Type-1 Diabetes Mellitus.

Sree Navya Gunaparti 1 , * Suresh Kumar Tulsan 2

[Abstract]

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Original Articles

Study Of Prevalence Of Ovarian Tumours Among Ovarian Mass Lesions In Tertiary Rural Hospital.

Jayasree V.1, *Madhavi N2

[Abstract]

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Case Report

DOWN SYNDROME WITH DANDY WALKER MALFORMATION - RARE ASSOCIATION

Komal Uppal 1, T. Venkat Kishan2 Vamshi Krishna Kondle 3,Choppari Komalatha 4

[Abstract]

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Case Report

A PATIENT WITH DROWSINESS AND CARDIAC ARRHYTHMIA

Vivek Podder1 , * Boudhayan Das Munshi 2

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Case Report

APLA NEGATIVE APLAS

Kodi. Vinuthna,1 Dr. Madhumitha choudhary2, Madhava Sai Sivapuram3 *

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Case Report

Pathology Quiz

Sumalatha Kasturi 1, Raju Mulaka 2

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EDITORIAL

The Role of Standards for Digital Health and Health Information Management

Suptendra Nath Sarbadhikari

Abstract

It has been now more than two years that the (third edition of the) National Health Policy 2017 (NHP-2017) 1 of India has been notified. The NHP-2017 notes the importance of digital health and it will be elaborated further below. The broad scope of Digital Health includes categories such as mobile health (mHealth), health information technology (IT), wearable devices, telehealth and telemedicine, and personalized medicine. Digital health is about electronically connecting up the points of care so that health information can be shared securely. This is the first step to understanding how digital health can help deliver safer, better quality healthcare. The proposed Global Strategy on Digital Health [2020-24] 2 from WHO is defining digital health as “ the field of knowledge and practice associated with any aspect of adopting digital technologies to improve health, from inception to operation”.

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ORGINAL ARTICLE

Cardiotocography In Labour And Fetal Outcome

Kavitha K,1, N. Madhavi 2

1Second year Post Graduate, DGO, Kamineni Institute of Medical Sciences Narketpally 508254 Telangana, India

2Professor and Head of the Department, Kamineni Institute of Medical Sciences, Narketpally 508254, India

ABSTRACT

Background: Routine and continuous electronic monitoring of Fetal Heart Rate (FHR) in labour has become an established obstetric practice in high-risk pregnancies in developed countries. However, the same may not be possible in developing countries where antenatal care is inadequate with a large number of high-risk pregnancies and inadequate health care provider to patient ratios.

Aim: The objective of this study was to evaluate the admission cardiotocogram (CTG) in detecting fetal hypoxia at the time of admission in labour and to correlate the results of the admission CTG with the perinatal outcome in high-risk obstetric cases.

Materials and Methods: This was a prospective observational study was conducted in the labour from January 2018 to June 2018. The study included high-risk pregnant women, the emergency or outpatient department with a period of gestation ≥36 weeks, in first stage of labour with foetus in the cephalic presentation. All women were subjected to an admission CTG, which included a 20 minute recording of FHR and uterine contractions.

Results: Sixty patients were recruited in the study. The majority of women were primigravida in the 21-30 years age group. Pregnancy-Induced Hypertension (PIH) (5.6%), Oligohydramnious (8.3%) and Premature Rupture Of Membranes (PROM) (3.3%) were the major risk factors. The admission CTG were ‘reactive’ in 71.6%, ‘equivocal’ in 21.6% and ‘ominous’ in 6.6% women. Incidence of foetal distress, moderate-thick meconium stained liquor and Neonatal Intensive Care Unit (NICU) admission was significantly more frequent among patients with ominous test results compared with equivocal or reactive test results on admission. Incidence of vaginal delivery was more common when the test was reactive.

ery was more common when the test was reactive. Conclusion: The admission CTG appears to be a simple non-invasive test that can serve as a screening tool in ‘triaging’ foetuses of high-risk obstetric patients in developing countries with a heavy workload and limited resources.

Keywords: Cardiotocography, admission test, foetal distress, foetal hypoxia, perinatal outcome

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CASE REPORT

A Retrospective Study On Commonly Prescribed Insulin Preparations and Combinations In The Management of Type-1 Diabetes Mellitus.

Sree Navya Gunaparti 1, *Suresh Kumar Tulsan2

1Department Of General Medicine, Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Chinna-Outapalli

2Department of General Surgery, Kushtia Medical College and Hospital, Kushtia, Bangladesh

Objective: To analyze pattern of drug prescriptions for insulin and oral antidiabetic drugs in type 1 diabetes mellitus patients seen in the a tertiary care teaching hospital in India.

Subjects and Methods: A retrospective study was conducted by analyzing insulin prescription pattern of type 1 diabetes mellitus patients presented during the period of July 2017 - August 2017 in a tertiary care teaching hospital.

Results: A total of 50 case records were found.32% of the prescriptions contained single insulin preparation and the remaining (68%) either had two insulin preparations or a combination of insulin and oral hypoglycemic agents. Majority (63%) of the combined insulin preparations consisted of regular insulin (short acting) and isophane insulin (intermediate acting). While using combination therapy with insulin and oral hypoglycemic drugs, metformin was used most commonly (67%) prescribed in combination with regular insulin.

Conclusion: Majority of the prescriptions consisted of two insulin preparations with Isophane insulin was the predominant preparation. Metformin was the commonest anti-diabetic drugs used together with insulin preparation.

Keywords: Insulin; Type 1 diabetes; oral antibiotic drugs; audit.

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EDITORIAL

Study Of Prevalence Of Ovarian Tumours Among Ovarian Mass Lesions In Tertiary Rural Hospital.

Jayasree V. ,1 Madhavi N 2

1Third Year Postgraduate Resident, Department of Obstetrics and Gynaecology, Kamineni Institute of Medical Sciences Narketpally 508254 Telangana, India

2Professor and Head, Department of Obstetrics and Gynaecology, Kamineni Institute of Medical Sciences Narketpally 508254 Telangana, India

Abstract

Background: Ovarian tumor is one of the most common gynecological tumors seen in female although there are different types of ovarian tumor but epithelial ovarian cancer is the fifth most common cause of cancer death in women. It is often called the “silent killer” because the disease is not often detected until it reaches an advance stage.

Methods: This observational study conducted on 40 patients from March 2017 to March 2018 in the Department of Obstetrics and Gynaecology. Clinical details of the patients included age, gynaecological and obstetric history, presenting symptoms, and surgery details. Histopathological reporting was done at our Pathology department.

Results:Out of total 40 patients with ovarian tumours studied 49.2% were > 60 years of age group, most of them were nullipara (55%), 55% with ovarian tumours presented after one-year development of symptoms. Most of the symptoms were vague and nonspecific. Benign tumours were the most prevalent (80%), 20% were malignant tumours and 0% were borderline. Histological pattern of distribution of ovarian tumour shows that most of ovarian tumour were surface epithelial tumour (22 patients) followed by germ cell tumour (18 patients). Age wise distribution of study population showed that most of the surface epithelial tumour was more common in 3rd to 5th decade while most of germ cell tumour were more frequent in 2nd and 3rd decade.

Conclusion: For better prognosis and patient survival, early detection and treatment is mandatory, which may reduce mortality. There is need to increase awareness of population. Abdominal and pelvic bimanual examination should be carried out in every patient presenting with gynecological problem. Appropriate investigations in post-menopausal women in early period to diagnose the disease at an early stage.

Keywords:

Germ cell tumour, Ovarian tumour, Surface epithelial tumour
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DOWN SYNDROME WITH DANDY WALKER MALFORMATION - RARE ASSOCIATION

Komal Uppal 1, T. Venkat Kishan2 Vamshi Krishna Kondle 3,Choppari Komalatha 4

Abstract:

The association of Down syndrome with Dandy Walker malformation (DWM); one of the variation in Dandy Walker Syndrome (DWS) is extremely rare. Till now only 5 cases have been reported. Out of these, the first patient died, the second was severely handicapped; the third patient showed greater deficit in gross motor skills and one case had successful endoscopic hydrocephalus treatment with poor qualitative fine motor development and mild cerebellar dysfunction, and in one case the association between Down syndrome and Dandy walker malformation had been shown but the developmental profile was not reported. The present case reveals the possibility of relatively good prognosis with relatively uncommon co-occurrence of Down syndrome and Dandy walker malformation.

Key words:

Dandy-Walker malformation; Down syndrome.
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A PATIENT WITH DROWSINESS AND CARDIAC ARRHYTHMIA

Vivek Podder1, Boudhayan Das Munshi 2

1BMJ Elective Student, (February-March, 2017), Department of Medicine, IQ City Medical College and Narayana Multispeciality Hospital Durgapur, WB, India.

2Consultant Diabetologist and Former Assistant Professor, Department of General Medicine, IQ City Medical College and Narayana Multispeciality Hospital Durgapur, WB, India.

Abstract: Sick sinus syndrome (SSS) can occur due to an intrinsic defect in the sinus node or extrinsic reversible etiologies. Hyperkalemia, which is a common occurrence in the emergency care or intensive care setting, has rarely been attributed to as reversible cause of SSS. Our case describes the potential reversible association between hyperkalemia and the development of SSS. A 65-year-old elderly patient with recent cerebrovascular accident was admitted to the hospital with sudden-onset drowsiness. He had a poor Glasgow Coma Scale (GCS) score. His electrocardiogram revealed an alternating slow and fast rhythms (bradycardia-tachycardia) with right bundle branch block and left axis deviation which coincided with new-onset of hyperkalemia following sepsis-induced AKI. The patient was successfully treated for hyperkalemia and sepsis which concurrently reversed his characteristic ECG findings. Our case report adds to the literature that several reversible causes are found to be associated with the development of SSS, where manifestation of SSS can be attributed to the presence of hyperkalemia and correction of hyperkalemia can reverse the sinus node dysfunction

Keywords: Sick sinus syndrome; Hyperkalemia; Extrinsic cause;

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APLA NEGATIVE APLAS ARRHYTHMIA

Kodi. Vinuthna,1, Madhumitha choudhary2, Madhava Sai Sivapuram3

1Post Graduate, Department of General Medicine, Kamineni Institute of Medical Sciences, Narketpally, Telangana

2Undergraduate Medical Student, Department of General Medicine, IQ City Medical College, Durgapur, West Bengal

3Undergraduate Medical Student, Department of General Medicine, IQ City Medical College, Durgapur, West Bengal

Abstract: Antiphospholipid antibody syndrome (APLAS) is a clinical condition characterized by recurrent vascular thrombosis along with pregnancy-related complications with raised antibodies against phospholipids. Very rarely we come across a clinical profile of APLAS but not satisfying the diagnostic criteria, such cases are termed as seronegative APLAS. Case presentation: A 28 Years old female presented to the emergency with altered sensorium and slurring of speech for one week. The patient has a significant history of two abortions and a pre-term delivery. Following that she developed acute kidney injury which progressed to chronic kidney disease (CKD). For CKD patient is still on dialysis. Diagnostic workup showed negative antibodies for the phospholipids. Due to the clinical significant history and symptoms with negative diagnostic workup, it was diagnosed as seronegative APLAS.

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Pathology Quiz

Dr. Sumalatha Kasturi ,1, * Dr. Raju Mulaka2,

1Associate professor, Department of Pathology, Chalmeda Anandrao Institute of Medical Sciences, Karimnagar, Telangana, India

2Gastroenterologist , Abhinav Gastro and Liver Centre, Karimnagar

23 year old male presented with vomiting and heartburn. Endoscopic examination revealed edematous gastric mucosa at antrum. Biopsy was taken and sent for histopathological examination. Images from endoscopy findings (Fig 1), H&E stained sections (Fig 2) and Giemsa stained sections (Fig 3).