A questionnaire-based study was performed amongst schoolchildren of Delhi and their first degree relatives to assess the sleep patterns. 2475 subjects were finally selected for analysis. It was observed that 10.8% of the children who had bruxism had no familial linkage. Whereas 42.6% of them also had a sibling who had bruxism, 44.4% had either one/both parents along with one/both grandparents with the disorder. In the case of snoring, 5.6% had no familial linkage, 45.5%, 9.7% and 7.5% had a linkage with siblings, parents/grandparents and parents as well as grandparents respectively. It can be inferred from these observations of the present study that the prevalence of most sleep disorders was the least in those children who had no familial linkage of the condition at all. The results of this study emphasize the urgent need to conduct more extensive genetic analyses to establish the causative factors, if any.
Introduction: Fine Needle Aspiration Cytology (FNAC) and Cell Block are very commonly used initial tests for triaging thyroid lesions and play a pivotal role in deciding subsequent clinical management of thyroid nodules. In most cases, after excision, the diagnosis remains unchanged, but at times discordance does occur when benign lesions are reported on FNAC and cell blocks are found to be malignant on final histopathology and vice-versa. Aim: To assess the diagnostic efficacy of both FNAC and Cell Block technique in the evaluation of thyroid lesions by comparing their respective results with final histopathological diagnosis (after excision) in case of malignancies and clinico- radiological follow-up in benign cases. Materials and Methods: An observational hospital-based study was conducted in the Department of Pathology in a Tertiary Care Teaching Institute from 1st November, 2016 to 31st October, 2017. A total of 100 cases of thyroid masses were subjected to both FNAC and Cell Block and the diagnostic efficacy of both the techniques was assessed using MedCalc Statistical Software. Results: Mean age of the patients was 42.75±15.75 years with a range of 12-75 years. Females constituted 88% of the sample with male to female ratio of 1:7.3. 88% lesions were benign, 8% were malignant and 4% suspicious of malignancy on conventional smears in comparison to cell block which showed 90% benign, 8% malignant and 2% suspicious lesions. The validity of FNAC in terms of sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and accuracy was found to be 100%, 95.65%, 66.67%, 100.00% and 96.00% respectively, whereas for cell blocks these statistics were 100%, 97.83%, 80%, 100% and 98% respectively. Conclusion: Cell block improved the overall diagnostic accuracy of FNAC when used as an adjunct leading to 100% diagnostic yield. The results of this study also establish that FNAC and Cell blocks are sensitive, specific, and accurate as preliminary diagnostic tests for evaluation of patients with thyroid swellings. Moreover, their combined use can reduce the diagnostic errors and to improve the overall reporting efficacy. It is thus advised to perform cell block for each case of FNAC in thyroid lesions.
A large proportion of pregnant women in lower and middle-income countries (LMIC) seek their first antenatal care after 14 weeks of gestation. While the last menstrual period (LMP) is still the most prevalent method of determining gestational age (GA), ultrasound-based foetal biometry is considered more accurate in the second and third trimesters. In LMIC settings, the Hadlock formula, originally developed using data from a small Caucasian population, is widely used for estimating GA and foetal weight worldwide as the pre-programmed formula in ultrasound machines. This approach can lead to inaccuracies when estimating GA in a diverse population. Therefore, this study aimed to develop a population-specific model for estimating GA in the late trimesters that was as accurate as the GA estimation in the first trimester, using data from GARBH-Ini, a pregnancy cohort in a North Indian district hospital, and subsequently validate the model in an independent cohort in South India.
Background: Maternal sepsis is one of the leading causes of maternal mortality around the world. The aim of this study was to study the prevalence, clinical profile and fetomaternal outcome of maternal sepsis at a dedicated Obstetric critical care unit of a tertiary care centre of North India. It was retrospective study conducted in tertiary care centre in North IndiaMethods: Women diagnosed as sepsis or septic shock at any point in pregnancy and up to 6 weeks postpartum (irrespective of the source of infection) were included in the study. Demographic, clinical, microbiological and outcome data were recorded from the case sheets of all patients admitted in obstetrical critical care unit between January to December 2016. Outcome measures: Prevalence, bacterial organism, source of infection, mode of delivery, period of gestation, maternal and fetal outcome.Results: The prevalence of maternal sepsis was 16.5/10,000 live births. The number of maternal deaths attributable to sepsis were 35, making the maternal mortality ratio due to sepsis 128/100,000 live births. 87% of the cases were unbooked. 22% presented antenatally while 58% were postpartum and 20% were postabortal. Genital tract infection was most common source of infection. E. coli was the predominant organism in 28% followed by Methicillin resistant staphylococcus aureus in 12%. The mortality from sepsis was very high (78%). 54% of cases required mechanical ventilation and around 7% had to be shifted to intensive care unit for advanced life support and care. Sepsis was associated with preterm delivery and a high perinatal mortality rate.Conclusions: Early recognition of the severity of infection and prompt management by a multidisciplinary team of intensivists, anesthetists, neonatologists, obstetrician, midwives are the key to success. Vigilant infection control measures must be strictly practiced during all pregnancy events.
Kikuchi- Fujimoto disease is a rare benign self-limited disease of unclear etiology. It is important to recognize and diagnose this entity as it closely mimics and is often mistakenly clinically diagnosed as lymphoma. Case report: - We report a case of young male of 24 years age with fever and tender cervical lymphadenopathy. FNAC suggested a diagnosis of reactive lymphadenitis and patient put on broad spectrum antibiotics. As the patient showed no response the biopsy of the cervical lymph node was done and microscopy suggested the diagnosis of Kikuchi disease. Conclusion: - Kikuchi Fujimoto disease is a rare self-limited disease, more common in females .Our case is again a rare case of Kikuchi's disease reported in a male patient. Clinician and pathologist should be aware of this entity and keeping it as a close differential diagnosis in appropriate cases will minimize the unnecessary treatment and its side effect.
Background: The ABO and Rhesus (Rh) blood group systems are genetically inherited and play very vital role in blood transfusions, parental and genetic testing and addressing medico legal issues.
Objective: This study was conducted to determine the distribution of ABO and Rh blood groups among blood donors in provincial Hospital at Gandhi Nagar, Jammu, India.
Materials and Methods: An observational descriptive cross sectional study was conducted at Blood bank of Government Hospital Gandhi Nagar over a period of one year from 1st January 2015 to 31st December 2015. ABO and Rh typing was done using slide agglutination method with antisera ABO and Rh. Tube agglutination method was done in doubtful cases and they were further confirmed by reverse grouping using known pooled A and B cells. Results were reported in percentages and proportions.
Results & conclusion: Out of 2808 donors, 2360 (84%) were males and 448 (16%) were females. Majority of donors belonged to age group 26-35 years. The commonest ABO blood group present was B (37%) followed by O (26.3%), A (25.6%) and AB (11.1%) while 2606 (92.8%) donors were Rh-positive and 202(7.2%) donors were Rh negative. Replacement donors (83.1%) were much more than voluntary donors (16.9%).
Conclusion: Distribution of ABO and Rh blood groups has important role to play in management and functioning of blood banks.
Key Words: ABO, Blood groups, Blood donors, Rhesus (Rh)group
The impact of obstructive sleep apnea syndrome on cardiovascular morbidity and mortality is phenomenal. There is a strong evidence base in terms of several longitudinal as well as cross-sectional studies in support of this fact. However, the evidence in favor of its association with hypertension is stronger than with coronary artery disease, arrhythmias and stroke. Prevalence studies on OSAHS have demonstrated an increased odds ratio for hypertension above the background population. Also, prevalence of hypertension is known to increase proportionate to the severity of sleep disordered breathing. Cross-sectional prevalence studies on cardiovascular disease and OSAHS have shown an increased risk of coronary artery disease (CAD) amongst patients with OSAHS. Prevalence of OSA is significantly higher in patients with atrial fibrillation (AF) than in patients without past or current AF. Pulmonary arterial hypertension, congestive heart failure and sudden cardiac death are also commonly associated with OSAHS. Interventional studies clarify the role of effective treatment of this disorder with CPAP. Therapy with CPAP, therefore, should be expected to impact the prognosis of cardiovascular consequences of this syndrome.
A BSTRACT Introduction: Overlap syndrome (OS) is defined by the combined occurrence of obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD). Sleep-related breathing disorders (SRBDs) in OS can also manifest with central sleep apnea (CSA) and hypoventilation; besides OSA. Methods: This study was carried out to evaluate various SRBD in OS and its therapeutic implications patients having postbronchodilator obstruction in spirometry with respiratory symptoms were classified as COPD. Those found to have an apnea–hypopnea Index (AHI) >5/h in polysomnography (PSG) were diagnosed as OS. All 37 patients diagnosed as OS underwent a subsequent positive airway pressure (PAP) titration. Results: On the evaluation of the SRBD, over half (51%) of the patients had OSA with no hypoventilation. More than one-third of the patients (35%) had associated hypoventilation with OSA, three patients had hypercapnic CSA, and two patients had hypocapnic CSA with Cheyne–Stokes breathing (CSA-CSB). The OSA group was easily titrated and corrected by CPAP therapy. OSA with hypoventilation group had underlying COPD with severe obstruction requiring bilevel PAP titration. Patients with CSA-CSB were elderly hypertensive patients with congestive heart failure who were corrected by PAP and optimization of cardiac medications. Patients with hypoventilation and hypercapnic CSA were most difficult to titrate and needed a backup rate along with PAP therapy for correction. On classifying patients on the basis of severity of OSA and COPD, there was no correlation found between AHI and forced expiratory volume 1 (FEV1). Patients with mild COPD with severe OSA were easily titrated with CPAP with a mean pressure of 8 cm H 2 0. The most challenging cases were with severe COPD with severe OSA who required high pressures in both exhalation PAP and inspiratory PAP titration; two of such patients required backup rate by spontaneous/timed mode of PAP therapy. Conclusions: There are many profiles of SRBD in OS, and a detailed in-hospital PSG with a PAP titration can help in effectively managing the patients.
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