Introduction: Type 1 diabetes mellitus (T1DM) is a chronic disease requiring complex management including blood glucose monitoring, insulin administration along with diet restrictions which can have a negative impact on the quality of life (QoL) of children.
Objective: To assess the quality of life and factors affecting it in Indian children with T1DM.
Materials and methods: A cross-sectional study was conducted on 97 children (4–15 years) with T1DM diagnosed for at least 6 months, at the pediatric diabetes clinic of a tertiary care hospital. QoL was assessed using the “quality of life instrument in Indian diabetics” (QOLID) questionnaire. The further co-relation between the QOLID scores and various demographic and diabetes-related factors were studied.
Results: There was suboptimal glycemic control (HbA1c > 7.5%) in 76% of our patients. The mean total QOLID score was 84.5% which was significantly low in specific domains like general health (71%), diet satisfaction (74%) and financial worries (75%). Eighteen percent (18%) of patients had overall impaired QoL (total QOLID score <80%), highest seen in the domain of general health (72%). There was a strong negative correlation between the total QOLID score and variables like number of hyperglycemic episodes per month (r = −0.3, p = 0.001), the total number of hospitalizations (r = −0.34, p = 0.001) and HbA1c value over last 6 months (r = −0.38, p = 0.0001)
Conclusion: As assessed by QOLID questionnaire, impaired QoL was seen in 18% of Indian children with T1DM. Poor glycemic control and an increased number of hospitalizations were the two most important factors leading to poor QoL.
Clinical significance: The overall outcome of diabetes in children can be improved by improving their QoL which further depends on good glycemic control.
Sandeep K Bhatt,
Bhupender S Rana
How to cite this article:
Bhatt SK, Gupta V, Bhatia V, khandelwal N, Bansal S, Rana BS. Patient Radiation Doses during Diagnostic Cerebral Angiography Procedures: Experience at a Tertiary Level Center of India. J Postgrad Med Edu Res 2019; 53 (2):69-71.
Objective: To assess patient radiation doses during diagnostic cerebral angiography from a tertiary neuro-intervention center.
Materials and methods: We studied 161 patients including 149 adults (83 male; 66 female) and 12 pediatric patients who underwent diagnostic cerebral angiography (DCA) for suspected or proven intracranial aneurysms which were performed with a biplane unit. Fluoroscopic time, dose-area product (DAP), and total angiographic image frames were obtained and analyzed in males, females and pediatric population separately.
Results: Mean fluoroscopic time, the total mean DAP, and total image frames were 11.6 minutes, 105.6 ± 60 Gy-cm2, and 295 ± 82 frames for diagnostic procedures.
Separate assessment in males, females and pediatric population was made. No significant difference was found between male and female population. Pediatric population, however, showed reduced DAP values (104 vs. 84 Gycm2) and a number of frames (308 vs. 271.5) with increased fluoroscopic time (11.6 vs. 14.28 min) when compared to the adult population.
Conclusion: Radiation dose as measured by DAP, fluoroscopy time and image frames is consistent with previous studies. Further data from other institutes can help in establishing a national registry for radiation exposure and help in framing guidelines for radiation protection.
Suman L Sharma,
Aim: To study the effect of vaginal pH on the efficacy of the dinoprostone gel for cervical ripening/labor induction and the effect on fetal and maternal outcomes.
Methods: A prospective study over one year was conducted and all term pregnancies with induced labor and who satisfied the inclusion criteria were screened for enrollment. Total of 500 subjects was enrolled in this study. These subjects were divided into two groups, group I (pH <5.5) had 199 subjects, group II (pH ≥5.5) had 301 subjects.
Results: Overall delivery outcome was better in group II (pH ≥5.5) as compared to group I (pH<5.5). Mean bishop score changes (over 12 hours) were also better in group II. Similarly, the need for the second dose, mean duration from induction to active labor and delivery was less, more subjects delivered vaginally, in group II (pH ≥5.5) as compared to group I.
Conclusion: Vaginal pH appears to be one important factor that influences the efficacy of PGE2 gel, results being better with high pH (pH ≥5.5).
Cyrus M Shroff,
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Sharma M, Shroff D, Narain S, Shroff CM, Gupta C. Combined Treatment with Intravitreal Bevacizumab and Intravitreal Triamcinolone in Retinal Vein Occlusion in Indian Eyes. J Postgrad Med Edu Res 2019; 53 (2):75-78.
Purpose: To study therapeutic efficacy of combination of intravitreal triamcinolone acetonide and intravitreal bevacizumab for treatment of macular edema associated with branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO).
Method: This prospective interventional study included 20 eyes of 20 patients with fresh retinal vein occlusion (RVO) of less than three months duration. Treatment involved intravitreal injection with 1.25 mg bevacizumab and 1mg triamcinolone acetonide.
Result: The mean age of patients was 63.81 years. There were 10 patients each of BRVO and CRVO. Both groups showed significant improvement in mean baseline visual acuity, however BRVO patients fared better than CRVO patients at all visits. Mean baseline central macular thickness (CMT) in BRVO and CRVO patients was 381.70 microns, and 572.50 microns, respectively with mean reduction of 131.40 and 182.1 microns, respectively. This reduction was significant at all visits during the course of the follow-up.
Rise in intraocular pressure (IOP) ≥ 21 mm Hg was found in 5 BRVO and 4 CRVO patients. Cataract development and progression was found 2 BRVO and 1 CRVO patient. There was no case of retinal detachment or endophthalmitis.
Conclusion: Combined treatment with intravitreal bevacizumab and intravitreal triamcinolone acetonide causes structural and functional improvement in form of reduction of macular edema and improvement in visual acuity in eyes with both BRVO and CRVO.
Deliberate self-harm a non-fatal suicidal behavior is one of the major problems in many developing and developed countries. It is a major concern for clinicians and academicians, in which behavior is multiple and diverse in its presentation and often bewildering, vexing in the powers that drive them. To this day, general clinicians and research experts in the field of mental health have not agreed on which behaviors to include under the rubric of self-injury/deliberate self-harm/attempted suicide or on how to proceed and categorize them into a meaningful group. According to many researchers, deliberate self-harm refers to behavior through which individual deliberately inflict acute harm upon themselves, poison themselves, hang themselves or try to exhibit this behavior with nonfatal outcomes. Initially, these behaviors were often regarded as failed suicides. This view did not appear to be correct as the majority of the patients do not try to kill themselves, and there are substantial differences between communities in the prevalence of attempted suicide because these behaviors are somehow linked to attention-seeking rather resulting in death. All these behaviors share one thing in common that they occur in emotional turmoil, the degree of powerlessness and hopelessness of young people with low education, low income, unemployment, and difficulties in coping with life stress. These acts are often gratifying and cause minor to moderate harm. Some individuals repeatedly harm themselves, while others do it only once or a few times in their lifespan. Here we are trying to explore a few more issues related to deliberate self-harm.
Introduction: The role of vitamin D in the development of bones is well known and documented. It also helps in preserving the oral structures, consisting of mainly the teeth and supporting structures. This is the only vitamin which is available through natural sunlight. It is the only vitamin which is found naturally in cod liver oil and butterfat.
Material and methodology: The material presented in this review is a brief summary of the beneficial effects of vitamin D in various conditions, with major emphasis on dental caries, periodontal disease, the genetic basis of vitamin D and positive effect of vitamin D in the immune-compromised population.
Results: Vitamin D is also known as the antirachitic factor as it prevents the occurrence of rickets in adults and osteomalacia in children. However, vitamin D3 itself is biologically inert when converted to its active form, is found to be extremely beneficial in various conditions.
Conclusion: This review article focuses on various synergistic effects of vitamin D on oral health by searching a number of published articles from EBSCOhost database.
How to cite this article:
Peruri G, Suthar R, V, Mohandoss V, Bhatia A. Thrombosis of Bilateral Renal Veins, Inferior Vena Cava, and Superior Sagittal Sinus with Adrenal Hemorrhage in a Neonate. J Postgrad Med Edu Res 2019; 53 (2):89-90.
We report a preterm male neonate with thrombosis of bilateral renal veins, infra-hepatic inferior vena cava, and superior sagittal sinus as well as left adrenal hemorrhage, which has been seldom reported in the literature. He was managed with appropriate antibiotics, enoxaparin, and supportive care which lead to resolution of thrombosis and normal renal function.
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Bhatia V, khandelwal N, Gupta SK. Endovascular Embolization of Fistulous Component of Gamma Knife-treated Arteriovenous Malformation in a Patient Presenting with Delayed Hemorrhage. J Postgrad Med Edu Res 2019; 53 (2):91-93.
Aim: The rationale basis for treatment of cerebral arteriovenous malformation is total obliteration of the arteriovenous malformation (AVM) with normalization of cerebral vasculature and flow hemodynamics. Presence of fistulous component has been identified as one of the causes of failure of gamma knife therapy in these cases.
Case report: We present a case where the patient presented with rebleed due to associated fistulous component which was then subsequently succesfully treated with endovascular embolisation.
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Rastogi A, Gnanapriya V, Kanwar DB, Gulati A, Varma S. Pelviureteric Necrosis–Rare Reason for Graft Loss in Simultaneous Pancreatic–Kidney Transplant. J Postgrad Med Edu Res 2019; 53 (2):99-105.