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1.
2.
From a Pediatric Rheumatology Clinic 361 children diagnosed as juvenile rheumatoid arthritis (JRA) according to American Rheumatism
Association-JRA criteria were studied retrospectively for their clinico-immunological profile. The mean age of onset in systemic,
pauciarticular and polyarticular onset, JRA subtypes were 5.2, 6.8 and 7.2 years respectively. There was male preponderance
in systemic and pauciarticular JRA. In seropositive polyarticular JRA, girls outnumbered boys. The frequency of occurence
of systemic, pauciarticular and polyarticular disease was 87 (24%), 108 (30%) and 166 (46%) respectively. The systemic onset
disease was dominated by extra-articular manifestations in terms of fever (100%), rash (57%), hepatomegaly (51%) and lymphadenopathy
(25%). The pauci- and polyarticular illnesses were commonly dominated by joint involvement, morning stiffness, and in few
patients, by extra-articular manifestations also. The joints were involved symmetrically. Most commonly involved joints in
order of decreasing frequency were knee, ankle, wrist and elbow in all the subtypes. Anemia and leucocytosis were observed
in majority with higher frequency in systemic onset JRA. The rheumatoid factor (RF) was present in 15% of polyarticular JRA.
RF was also present in 7 and 9% of patients with pauciarticular and systemic subtypes respectively. The antinuclear antibody
was positive in only 3 out of 66 patients in whom the test was carried out.
The demographic profile and trends in clinical features were similar to the studies reported on caucasian population with
difference in the actual frequency of various clinical features. 相似文献
3.
Sadhana Awsathi Vinita Rawat Chandra Mohan Singh Rawat Vandana Semwal Sunil Janki Bartwal 《Indian Journal of Community Medicine》2014,39(2):94-97
Background:
In March 2013, cases of acute hepatitis were reported from Lalkuan, Nainital district. We investigated the outbreak to identify the source of infection and to facilitate control measures.Objectives:
To study the distribution of hepatitis cases, to find the source of infection, and to initiate the control measures in the affected area.Materials and Methods:
We defined a case of acute hepatitis as those cases that had jaundice with at least one of the following symptoms: Dark urine, fever, pain in abdomen, vomiting, and loss of appetite in the affected area between January and March 2013. Door-to-door survey was carried out. Thirteen blood samples were randomly collected from jaundice cases for immunoglobulin M (IgM) antibody for hepatitis A virus (HAV) and hepatitis E virus (HEV). Water samples were collected to test residual chlorine.Results:
Total 2,785 individuals were surveyed; of which 240 were suffering from acute viral hepatitis (attack rate (AR) = 8.61%). Out of 13 serum samples, 10 were found positive for HEV IgM antibodies and three cases had IgM antibodies for both HAV and HEV, which confirmed a hepatitis E outbreak. The difference in attack rate of hepatitis of both the sexes was statistically significant (P < 0.001). The attack rate was significantly higher in age groups >12 years of age (P < 0.001). Environmental investigation also confirmed the sewage contamination of drinking water in the distribution system. The attack rate was much higher (29.4%) among those who were exposed to the leaking pipeline than the nonexposed (χ2 = 574.26, P < 0.01).Conclusion:
HEV was confirmed as the major etiological agent in this outbreak that was transmitted by contaminated drinking water. The recognition of early warning signals, timely investigation, and application of specific control measures can contain the outbreak. 相似文献4.
5.
OP?SanjayEmail author P?Prashanth DI?Tauro 《Indian Journal of Thoracic and Cardiovascular Surgery》2003,19(3):141-144
Background Post thoractomy pain is a major source of concern in the postoperative period. The purpose of this study was to evaluate the
effectiveness of intraoperative temporary intercostal nerve blockade versus thoracic epidural analgesia for control of post
thoracotomy pain.
Methods 40 patients undergoing elective pulmonary resection through a postero lateral thoractomy were randomly allocated to receive
epidural analgesia using 0.25% bupivicaine (Group A, n=20) or temporary intercostal nerve blockade using 0.25% bupivicaine
(Group B, n=20). Adequacy of analgesia was assessed over a period of 24 hours using a visual analogue score and an observer
verbal ranking scale.
Results Pain scores were similar in both the groups for the first 4 hours after surgery. Thereafter, the pain scores were significantly
higher (p<0.05) in Group B as compared to Group A for the remainder of the observation period. There was significantly higher
(p<0.01) usage, of nonsteroidal analgesic consumption in Group B. No neurological complications were encountered, in both
the study groups.
Conclusion We conclude that in the early postoperative period there is no significant difference in pain relief in both the techniques
but there after, epidural analgesia significantly reduces post thoracotomy pain. 相似文献
6.
OP?SanjayEmail author VR?Kadam J?Menezes P?Prashanth DI?Tauro 《Indian Journal of Thoracic and Cardiovascular Surgery》2003,19(2):113-118
Background: Optimum pain relief following thoracotomy is essential for patient comfort and to reduce the incidence of postoperative pulmonary
complications.
Methods: A randomized clinical trial was conducted on 90 patients scheduled for pulmonary resection. The patients were randomly divided
into three groups. Group 1 received 0.125% bupivicaine with fentanyl 10μg.ml−1, Group 2 received 0.25% bupivicaine with fentanyl 10μg.ml−1 and Group 3 received only fentanyl 10μg.ml−1 in a calculated dose as a continuous thoracic epidural infusion. Adequacy of anglesia was assessed at rest and during movement
over 24 hours. Analgesic efficacy was assessed using a visual analogue score and an observer verbal ranking scale.
Results: Pain scores were significantly higher in Group 3 during the assessment period. (p<0.01) as compared to the other groups.
The use of intraoperative vasopressors was significantly higher (p<0.05) in Group 2 as compared to the other groups. No neurological
complications were encountered in any of the study groups.
Conclusion: We conclude that in the early postoperative period, the use of 0.125% bupivicaine improves fentanyl epidural analgesia in
patients undergoing lung resection. 相似文献
7.
8.
Rakesh Aggarwal Rakesh Kumar Rekha Pal Sita Naik S N Semwal S R Naik 《Indian journal of gastroenterology》2002,21(1):14-18
BACKGROUND: We undertook epidemiologic and laboratory studies during an epidemic of acute hepatitis in Sindri town, in District Dhanbad, Bihar in 1998. METHODS: A sample survey covering 201 randomly selected houses in the town was conducted during the epidemic, and records of patients admitted to the only large hospital in this town were reviewed. We also tested serum and stool specimens from some of the affected persons for hepatitis E virus (HEV) RNA and IgM anti-HEV antibodies. RESULTS: Of the 1088 persons residing in the surveyed houses, 82 (7.54%) had developed acute hepatitis during the outbreak. Attack rate was higher among male residents than among female residents (71/604 vs. 11/484; 11.75% vs. 2.27%; relative risk [RR] 5.17 [95% confidence interval 2.77-9.65]; p<10(-6)) and was the highest in the 10-29 year age group. Hospital admission data showed similar age and gender distribution. Disease occurrence had no relation with source of drinking water (handpump 7.56% vs. municipal tap 7.53%; p=ns), or with habit of boiling (RR 1.10 [0.61-1.98]; p=ns) or filtering (RR 0.59 [0.33-1.06]; p=ns) water before drinking. Jaundice occurred more frequently among persons who had traveled outside Sindri town during the last two months than among those who had not (26.4% vs. 4.7%; RR 5.67 [3.81-8.43]; p<10(-6)); this risk persisted after correction for age (Mantel-Haenszel weighted OR 6.74 [4.12-11.01]; p<10(-6)). Men traveled more frequently than women and were more often affected. In multivariate analysis, travel and male gender were the only two independent risk factors. Data from a hospital in a neighboring large city, Dhanbad, suggested that there was an outbreak of hepatitis in that city too at the same time. Seventy-three of the 1088 study subjects had history of jaundice in the past; disease attack rate among these persons (9.6%) was similar to that among those without such history (7.5%; RR 1.31 [0.49-2.98]; p=ns). Of the 13 sera tested, 10 were positive for IgM anti-HEV. HEV RNA was detected in 9 of the 12 stool specimens and 10 of the 13 sera tested. CONCLUSIONS: The hepatitis epidemic in Sindri was caused by HEV and had several features resembling those of previous HEV epidemics. However, the occurrence of hepatitis E showed a strong relationship with history of travel, a finding not hitherto described. 相似文献
9.
DS Chadha A Swamy SK Malani RK Ganjoo OP Mathew 《Medical Journal Armed Forces India》2009,65(3):203-207
Background
Obesity is associated with increased cardiovascular morbidity and mortality. A direct effect of isolated obesity on cardiac function is not well established. The study was designed to determine the direct effect of various grades of isolated obesity on echocardiographic indices of systolic and diastolic left ventricular function.Methods
Fifty one obese and 25 normal weight, serving personnel without any other pathological condition were studied. Group I (n=25) consisted of subjects with normal weight and body mass index (BMI <25kg/m2), Group II (n=34) of overweight subjects (BMI 25-29.9 kg/m2) and Group III (n=17) of obese subjects (BMI >30 kg/m2). Echocardiographic indices of systolic and diastolic function were obtained and dysfunction was assumed when at least two values differed by ≥ 2 SD from the normal weight group.Result
Ejection fraction, fractional shortening were increased (p<0.05) in Group II and III. Left ventricular dimensions were increased (p< 0.001) but relative wall thickness was unchanged. Systolic dysfunction was not observed in any of the obese patients. The mitral valve pressure half time (p< 0.01), left atrial diameter (p < 0.01) and the deceleration time were increased (p< 0.01) in obese subjects, while other diastolic variables were unchanged. No difference were found between obesity subgroups. Subclinical diastolic dysfunction was more prevalent among obese subjects. BMI correlated significantly with indices of left ventricular systolic and diastolic function.Conclusion
Subclinical left ventricular diastolic dysfunction was noted in all grades of obesity which correlates with BMI.Key Words: Obesity, Systolic function, Diastolic function, Echocardiography 相似文献10.