iosr-JDMS   Volume-16 ~ Issue-11 ~ November-2017

Abstract: Continuous quality improvement is required to achieve the parameters laid down by the healthcare organisation. To achieve the parameters, certain PDCA cycles are to be done using tools like time and motion study, FMEA etc. Patients' waiting time has been defined as "the length of time from when the patient entered the outpatient clinic to the time the patient actually leaves the OPD" This Research presents different types of issues which lead to increased waiting time in hospitals, and it also presents the results of a project of improving the quality of services provided in an outpatient department of teaching hospital in India. The project was conducted on the basis...........

Keywords –process mapping, waiting time, Time motion study, OPD, Appointment Scheduling

[1]. Failure mode effects analyses FMEA ASQ Retrieved
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[4]. The New Lean Healthcare Pocket Guide : Tolls for the Elimination of waste in hospitals, clinics ,and other healthcare facilities
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Abstract: The antidiabetic and antilipidemic effects of Bougainvillea glabra was investigated in this study using 25 male wistar rats. The rats were divided into 5 groups comprising of five animals each. These groups include Group I: Normal control (saline).Group II: Alloxan treated control (150 mg/kg.ip).Group III: Alloxan (150 mg/kg.ip) + Bougainvillea glabra. Whole plants extract (300 mg/kg, p.o),Group IV: Alloxan (150 mg/kg.ip) + Bougainvillea glabra. Whole plants extract (500mg/kg, p.o),Group V: Alloxan (150 mg/kg.ip) + Standard drug, Glibenclamide (5 mg/kg, p.o). The study lasted for three weeks although blood samples were obtained from the rat tails after every week.........

Keywords: Bougainvillea glabra, alloxan-diabetes, hypoglycaemia, hypolipidemia.

[1] V. Vats, S. P. Yadav, and J. K. Grover, "Ethanolic extract of Ocimum sanctum leaves partially attenuates streptozotocin-induced alterations in glycogen content and carbohydrate metabolism in rats," Journal of Ethnopharmacology, vol. 90, no. 1, pp. 155–160, 2004. View at Publisher · View at Google Scholar · View at Scopus

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Abstract: Psoriasis is a common chronic, disfiguring, inflammatory and proliferative condition of the skin in which both genetic and environmental influences have a critical role. It has been suggested that psoriasis is associated with metabolic syndrome.The major features of Metabolic Syndrome include central obesity, Hypertriglyceridemia, low high density lipoprotein (HDL) cholesterol, hyperglycemia and hypertension. In this study 68 psoriatic patient were selected as case and age and sex matched 68 control were selected. Blood sugar, lipid profile, was estimated,blood pressure and waist circumference was measured. Among cases 17.65% vs 14.7% in control had diabetes, 16.18%cases vs 11.76% control were hypertensive, serum triglyceride was raised 29.4%vs 25% in control, 19.12%cases..........

Keywords: Diabetes Mellitus, Hypertension, Metabolic Syndrome, Psoriasis

[1] Tony Burns, Stephen Breathnach, Neil Cox, Christopher Griffths, Rooks Textbook Of Dermatology.(Wiley-Blackwell; Hoboken, NJ 2010)
[2] Lomholt G, ed. Psoriasis: prevalence, Spontaneous Course& Genetic. A Census Study on Prevalence Of Skin Diseaseson the Faroe Islands. Copenhagen: GEC GAD 1963.
[3] Mallbris L, Akre O, Granath F et al . Increased risk for cardiovascular mortality in psoriasis inpatients but not in outpatients. Eur J Epidemiol. 2004; 19:225-30.
[4] Mallbris L, Granath F, Hamsten A, and Ståhle M. Psoriasis is associated with lipid abnormalities at the onset of skin disease. Journal of the American Academy of Dermatology, 2006;54(4):614-621.
[5] Gisondi P, Tessari G, Conti A, et al. Prevalence of metabolic syndrome in patients with psoriasis: a hospital-based case-control study. British Journal of Dermatology, 2007;157(1):68-73.

Abstract: Introduction: Patients with one organ specific autoimmune disorder are at risk of developing another autoimmune disorder. Thyroid dysfunction among type 2 diabetes mellitus increases the risk of diabetic complications like nephropathy, neuropathy, retinopathy. Here in this study we concentrated on the prevalence of thyroid disorders among type 2 diabetes mellitus patients, an attempt to provide appropriate treatment and to prevent complications due to endocrine disorders. Materials and Methods: A total of 96 persons attending Out Patient department of General Medicine were selected to do this study including general population without any endocrine & autoimmune disorders and patients who are already diagnosed with diabetes mellitus type 2. They were divided into two groups, 48 members each..........

Keywords: Diabetes Mellitus, Thyroid disorder

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Abstract: To assess the association of adverse perinatal outcome in cases with oligo hydramnios diagnosed antepartum. The results are compared with perinatal outcome of controls with Amniotic fluid index (AFI) 8-18 cms. The study population consisted of 100 antenatal women with gestational age 37 weeks attending the antenatal clinic & labour rooms of this hospital. The AFI was measured by 4 quadrant technique. 50 women with AFI <= 5cms were allotted in the study group and another 50 women with AFI 8-18 cms were included in the control group. Labour was either spontaneous or induced in both study and control groups. Mode of delivery and intra partum complications were noted. At birth neonates............

Keywords: AFI, oligo hydramnios, perinatal outcome

[1] Brace RA, Woy EJ. Normal amniotic fluid volume changes throughout pregnancy. Am J Obstet & Gynecol, 1989; 161: 382-388
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[3] Dijon-Townson D, Kennedy KA, Dildy GA et al. AFI and perinatal morbidity. Am J perinatal, 1996 May; 13: 4,231-4.
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Abstract: Insulin resistance, which has been linked to essential hypertension, may play a role in hypertension during pregnancy. We aimed to study the serum markers of insulin resistance in the first 20 weeks of gestation and see their correlation with onset of hypertension in pregnancy. Methodology: We designed a cross-sectional study of pregnant females who presented to the Obstetric clinic of Department of Obstetrics and Gynaecology, Topiwala National Medical College and BYL Nair Hospital, Mumbai from June 2011 till May 2014. All consecutive pregnant females who were in the first 20 weeks of gestation were included in the study. All subjects were investigated for serum markers of insulin resistance. These variables were compared among normotensive and hypertensive subjects and logistic regression analysis was done to identify predictors of hypertension in pregnancy............

Keywords:hypertension, preeclampsia, insulin resistance, outcomes

[1]. 1Solomon CG. Hypertension in pregnancy. A manifestation of the insulin resistance syndrome?. Hypertension. 2001;37:232-9.
[2]. 2Kernan WN, Viscoli CM, Furie KL, Young LH, Inzucchi SE, Gorman M, Guarino PD, Lovejoy AM, Peduzzi PN, Conwit R, Brass LM. Pioglitazone after ischemic stroke or transient ischemic attack. N Engl J Med. 2016 Apr 7;2016(374):1321-31.
[3]. 3American College of Obstetricians and Gynecologists. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists' task force on hypertension in pregnancy. Obstetrics and gynecology. 2013;122(5):1122.
[4]. 4Peters C, Geary MP, Hill NR, Mathews DR, Hindmarsh PC. Maternal hyperinsulinism and glycaemic status in the first trimester of pregnancy are associated with the development of pregnancy-induced hypertension and gestational diabetes. European journal of endocrinology. 2013 Mar 1;168(3):413-8.
[5]. 5Sowers JR, Saleh AA, Sokol RJ. Hyperinsulinemia and insulin resistance are associated with preeclampsia in African-Americans. American journal of hypertension. 1995 Jan 1;8(1):1-4.

Abstract: In many developed countries, maternal mortality has fallen to single digits whereas near miss cases are more and hence useful in evaluation of the present system. A maternal near miss case is defined as a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy. Objective: To study the various causes leading to the severe acute maternal morbidity, maternal near miss and Maternal near miss incidence rates among high risk cases. Study setting: A Prospective hospital based Study was conducted. Study period: Study was conducted for a period of 18 months from January 2016 to June 2017..............

Keywords: Complications, Maternalnearmiss, Intervention, Pregnancy, Tertiarycare center..

[1] World Health Organization - Evaluating the quality of care for severe pregnancy complications: The WHO near miss approach for maternal health. WHO (2011).
[2] Roopa PS, Verma S, Rai L, Kumar P, Murlidhar V, Pai, et al. "Near Miss" Obstetric Events and Maternal Deaths in a Tertiary Care Hospital: An Audit Journal of Pregnancy. (2013).
[3] Sarma HKD, Sarma HK, Kalita AK. A prospective study of maternal near-miss and maternal mortality cases in FAAMCH, Barpeta; with special reference to its aetiology and management: First 4 months report. Journal of Obstetrics & Gynaecology Barpeta, 1(2):100-6.
[4] kalra P, Kachhwaha CP.Obstetric near miss morbidity and maternal mortality in a Tertiary Care Centre in Western Rajasthan. Indian J Public Health 2014;58:199-201. [5] Chhabra P. Maternal Near Miss: An Indicator for Maternal Health and Maternal Care. Indian Journal of Community Medicine : Official Publication of Indian Association of Preventive & Social Medicine. 2014 Jul-Sep; 39(3):132-137..

Abstract: The study aims to analyse the Drug prescribing pattern and Adverse drug effects of Antiglaucoma medication for Primary Glaucoma in a Tertiary care teaching hospital. Methods: It is an Observational Study done on 100 patients of Primary Glaucoma presenting in Out patients department of Glaucoma unit at Sarojini Devi Eye Hospital. The study was carried for a period of 6 months.
Details regarding patients demographic data, drugs prescribed and any adverse effects to Antiglaucoma medication were noted. Results: Over a period of 6 months it was found that out of 100 cases of Primary Glaucoma 50 were males and 50 were females. There were..............

Keywords: ADR, FDC- Fixed drug combination, PACG, POAG

[1]. Asha S.Morge,M.D.Kulkarni,S.M.Doifode; Preserved to preservative free prostaglandin analogues in primary open angle
glaucoma;International Journal of Basic & Clinical Pharmacology : Nov-Dec 2013 Vol 2 Issue 6 Page 696
[2]. Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol. 2006;90(3):262–
267.
[3]. Resnikoff S, Keys TU. Future trends in global blindness. Indian J Ophthalmol. 2012;60(5):387–395.
[4]. Venediktos V Kapetanakis, Michelle P Y Chan, Paul J Foster, Derek G Cook, Christopher G Owen,Alicja R Rudnicka , Global
variations and time trends in the prevalence of primary open angle glaucoma (POAG): a systematic review and meta-analysis
[5]. Jin-Wei Cheng1, Ying Zong, You-Yan Zeng, Rui-Li Wei,The Prevalence of Primary Angle Closure Glaucoma in Adult Asians: A
Systematic Review and Meta-Analysis, July 2014 Volume 9 Issue 7

Abstract: Electrocution injuries have been classified into low tension (<1 kilo Volt) and high tension injuries (>1 kilo Volt). Usually electrocution injuries will have an entry wound at the site of contact and an exit wound where the current passed out. Bowel perforation due to an electrocution is a rare and serious injury. We report a case of high tension electric current burn on both hands(entry wound), and exit wound in right foot with perforation in the descending colon presented late with peritonitis and successfully managed by diversion colostomy and take down.

Keywords: Electrocution, bowel perforation, descending colon perforation

[1] Williams LJ, Zolfaghari S, Boushey RP. Complications ofEnterocutaneous Fistulas and Their Management.ClinColon Rectal Surg. 2010;23(3):209–220.
[2] Lee RC. Injury by electrical forces: pathophysiology,manifestations and therapy. CurrProbl Surg. 1997;34:677–764.

[3] Branday JM, DuQuesnay DR, Yeesing MT, Duncan ND.Visceral complications of electrical burn injury. West IndianMed J 1989;38:110–13.
[4] Haberal M, UQar K, Bayraktar O, Oner R. Severe complications in electrical burns (including visceralcomplications). Ann Burns and Fire Disaster 1996;9:149–53.
[5] Sharma M, Kaundal P, Sharma P, Chaudhary R. Electric Current Causing Sigmoid Perforation: Case Report. Ann. of Int. Med. & Den. Res. 2015;1(1):39-40.

Abstract: Blunt abdominal trauma is most commonly caused by road traffic accidents (RTA). It also occurs as a result of fall from height, assault with blunt objects , industrial mishaps , sports injuries,bombblast.Investigative modality can only supplement the clinical evaluation and cannot replace it in the diagnosis of blunt abdominal trauma. In spite of the best techniques and advances in diagnostic and supportive care , the morbidity and mortality remain at large. The purpose of this study is to estimate the frequency of various intra abdominal solid organs involved,to assess the various mode of blunt abdominal trauma and clinical presentation and various available investigations,treatment and complications.This is a prospective study conducted in a tertiary grade medical college...........

Keywords:blunt injury, contrast- enhanced computed tomography, hollow organ injury, Road traffic accidents, Solid organ injury, splenectomy.

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Abstract: Psycho-dermatology is a collaborate field of activity that is based on the relationship and interaction between Psychiatry and Dermatology, and in practice this collaboration may be disease that are based on a psychiatric disorder that appear as a dermatologic disease, dermatological diseases formed or advanced by psychosomatic factors, Psychiatric disorders secondary to social isolation ,Dermatological and Psychiatric disorders related to genetic or environmental influences, Dermatological diseases that appear in chronic psychiatric patients and on those with medical treatment. The prevalence of psychiatric disorders in the patients presenting to dermatology clinic has been reported as 25-43% [1] [2]. Stress may aggravate the cutaneous disease in 40-100% of Patients and it was reported that skin diseases appear in persons who cannot express their anger and hostility sufficiently [3............

Keywords: Neurodermatitis , Psychiatric morbidity , stressors, physical variables , personality profile

[1]. Picardi A, Abeni D, Melchi CF, Puddu P, Pasquini P. Psychiatric morbidity in dermatological outpatients: an issue to be recognized. British Journal of dermatology. 2000 Nov 1; 143(5):983-91.
[2]. Woodruff PW, Higgins EM, Du Vivier AW, Wessely S. Psychiatric illness in patients referred to a dermatology-psychiatry clinic. General hospital psychiatry. 1997 Jan 31; 19(1):29-35.
[3]. Juhlin L. Recurrent urticaria: clinical investigation of 330 patients. British Journal of Dermatology. 1981 Apr 1; 104(4):369-81.
[4]. Koblenzer CS. Psychosomatic concepts in dermatology: A dermatologist-psychoanalyst's viewpoint. Archives of dermatology. 1983 Jun 1; 119(6):501-12.
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Abstract: Aims: Blood transfusion is an important mode of transmission of infections to recipients. The aim of the study was to analyse the seroprevalence of HIV, HBsAg, and HCV in the blood donors. Materials and Methods: All donors who attended the blood bank of Siddhartha Medical College, Vijayawada over a period of threeyears (January 2014 to December 2016) have been studied. The donor data was documented for each case including the seropositivityfor HIV, HBsAg and HCV. A total of 9412 blood units collected from the donors were tested for HIV, HBsAgand HCV. Results: The seroprevalence of HIV, HBsAg, and HCV was 0.36%, 0.91% and 0% respectively among total blood donors.........

Keywords: Transfusion, transmissible, seroprevalence, HIV, HBsAg, HCV

[1]. Arora D, Arora B, Khetarpal A. Seroprevalence of HIV, HBV, HCV and syphilis in blood donors in Southern Haryana. Indian J Pathol Microbial 2010;53(2):308–9.
[2]. Tulika Chandra, Ashutosh Kumar, Ashish Gupta. Prevalence of transfusion transmitted infections in blood donors: an Indian experience. Tropical Doctor2009;39(3):152–4.
[3]. NilimaSawke, Sawke GK, Chawla. Seroprevalence of common transfusion – Transmitted infections among blood donors. People's journal of scientificresearch 2010;3(1):5–7.
[4]. Syed Abdul Mujeeb, Khalid Mehmood. Prevalence of HBV, HCV and HIV infections among family blood donors.AnnalsofSaudiMedicine 1996;16(6):702–3.
[5]. Balakrishna. Paper presentation of HIV status in Karnataka at MVJ Medical College and Research Hospital Bangalore on 26th July, 2008..

Abstract: Background: Blood transfusion is one of effective treatments which used to decrease morbidity and mortality rate in leukemia patients, but it can results in development of alloimmunization to red blood cell antigens, which often results in difficulties in finding compatible blood and a higher risk of delayed hemolytic transfusion reactions. Objective: The current study aimed to determine the frequency of allo antibodies among Sudanese multiply blood transfused leukemic patients in Khartoum state, the study also aimed to correlate between the frequency of alloimmunization and duration of blood transfusion therapy.............

Key words: Alloimmunization, screening test, leukemia, Sudanese.

[1] Denise M. Harmening. Modern blood banking and transfusion practice fifth edition. Philadelphia: F. A. Davis 2005.
[2] Hoffbrand, P.A.H. Moss and J.E Pettit. Essential haematology. Sixth edition, Oxford West Sussex Hoboken: NJ Wiley-Blackwell 2011.
[3] E. Anne Stiene-Martin , Cheryl A. Lotspeich-Sreininger ,Jone A. Koepke. Clinical Hematology Principle, procedures, Correlations. second edition . Lippincott, New York: Raven puplisher 1998.
[4] Tashreeg Awad elgied elamiean Ahmed, Leena babiker mirghani. Ceftriaxone induce immune hemolytic anemia in Sudanese patients. American Journal of Research Communication 2016: 4(9): 174-179.
[5] Rashmi Sood, RN Makroo, Vimarsh Riana, NL Rosamma. Detection of alloimmunization to ensure safer transfusion practice. Asian journal of transfusion science 2013.7:(2)135-139..

Abstract: Purpose:To determine the relationship between stone expulsion rate of distal ureteric calculus less than or equal to 10mm in size and C reactive protein (CRP) level, white cell count and neutrophil percentage. Materials and Methods: A total of 143 patients with distal ureteric calculus of ≤10mm were evaluated for stoneexpulsion rate and its correlation with serum CRP, white cell count and neutrophil percentage. All patients received tablet Tamsulosin 0.4mg for 4 weeks or till the expulsion of stone. Patients were called weekly till 4 weeks, or early if there was history of stone expulsion.Patients..........

Keywords:- C-reactive protein, distal ureteric stone, neutrophil percentage, stone expulsion

[1] Angulo JC, Gaspar MJ, Rodriguez N, Garcia TA, Torres G, Nunez C. (2009). The value of C-reactive protein determination in patients with renal colic to decide urgent urinary diversion. J Uro. 12, 002
[2] Dellabella M, Milanese G, Muzzonigro G. (2003). Efficacy of tamsulosin in the medical management of juxtavesical ureteral stones. J Urol. 170, 2202–5.
[3] Erturhan S, Erbagcy´ A, Faruk Y, Mehmet C, Solakhan M, Sary´ ca K. (2007). Comparative of efficacy of use of tamsulosin and/ or tolterodine for medical treatment of distal ureteral stones. Urology. 69, 633–6.
[4] Finlayson B. (1974). Symposium on renal lithiasis, renal lithiasis in review. UrolClin. North Am. 1,181
[5] Gandhi HR, Agrawal CS. (2013). The efficacy of tamsulosin vs. nifedipine for the medical expulsive therapy of distal ureteric stones: A randomised clinical trial Arab Journal of Urology. 11, 405–10.

Abstract: Mosquito-borne diseases continue to be a threat to mankind, having killed more people than all wars combined. Developing effective, low cost environmentally friendly methods of reducing mosquito populations will save countless lives while protecting the environment. The ProVector pesticide system is the first technology to use an applicator to deliver a pesticide bait that kills both adult and larvae mosquitoes, with the added benefit of being non-toxic. The ProVector has been tested globally. Here we describe the effectiveness of the ProVector Flower with Entobac in reducing mosquito populations for 12 weeks, using surveys of homeowners in the city of Akuse, Ghana.

Keywords: Arbovirus, Malaria, Vector Control, Bacillus thuringiensis israelensis, Pesticide

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[2]. Centers for Disease Control and Prevention, Global Health Care Ghana, 2017, https://www.cdc.gov/globalhealth/countries/ghana/
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[5]. Yalwala S, Kollars JW, Kasembeli G, Chrisostim BW, Senessie C, Kollars PG, Kollars TM Jr, Preliminary report on the reduction of adult mosquitoes in housing compounds in western Kenya,using Entobac biopesticide and the ProVector Flower, Journal of Medical Entomology, 2016, 83: 1252-1244..

Abstract: The doctoral thesis of Heinrich Gottleib Bennewitz of Berlin published in 1824 presents the first case of what was probably insulin-dependent diabetes in pregnancy. The first case was reported in Berlin. Bennewitz describes Frederica Pape, a 22 year old woman, who after several successful pregnancies, was admitted to the Berlin Informatory at 36 weeks gestation with polydipsia and polyuria, classics symptom of diabetes. In 1880, J. Matthews Duncan reported 22 cases of diabetes complicating pregnancy in 15 Women. Thirteen fetal deaths occurred in 19 pregnancies, and nine of the women died within one year of pregnancy. He identified the two important causes of perinatal loss, namely stillbirths and macrosomia2.In 1915, Elliott Joslin reported 7 cases of Diabetes complicating pregnancy between 1905...............

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