International Medical Journal

Journal ID : IMJ-08-08-2021-865

Total View : 478

Title : Microbiological Analysis of Febrile Neutropenia in Haematological Malignancies

Abstract : Febrile neutropenia (FN) is one of the most important clinical challenge faced in the course of treatment of patients with hematological malignancies. Infection is an important complication of neutropenia and is associated with a high morbidity and mortality. We attempted to revisit the common organisms implicated in this group of patients in addition to find their sensitivity patterns. A prospective cross sectional study was carried out at IMS and SUM Hospital over a period of 6 months in patients with hematological malignancies (n=72) presenting with fever and neutropenia. Blood samples were collected from all patients; urine, sputum, mucosal ulcer swabs were collected when symptoms and signs suggestive of specific etiology was suspected and processed for aerobic bacterial as well as fungal culture and sensitivity. The most common underlying hematological disorder in FN was acute myeloid leukemia (AML, 45.8%) followed by acute lymphoid leukemia (ALL, 16.7%) and aplastic anemia (13.9%). Bacteremic episodes were present in 20.8% (15/72) of blood samples. Of 20 sputum samples, 30% (6/20) had a significant bacterial growth. Similarly, bacterial growth was seen in 25% (3/12) of urine culture samples and 14.3% (1/7) mucosal samples. Of all samples from blood, urine, sputum and mucosa with bacterial growth (n=25), Klebsiella pneumoniae (52%; 13/25) followed by isolates of E. coli (24%; 6/25) were the most predominant organisms isolated. All the isolated enterobacterales were highly resistant to piperacillin tazobactam (71.4%), meropenem (71.4%), netilmycin (64.3%) and tigecycline (57.2%). Colistin was sensitive in all the cases. This study reiterates the fact that unlike Western countries, gram negative pathogens are the flag bearers of infection in FN cases in our country. Multi drug resistant Klebsiella spp. was the predominant organism causing bacteremia in these cases..
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International Medical Journal

Journal ID : IMJ-08-08-2021-864

Total View : 602

Title : EPIDEMIOLOGICAL STUDY AND RISK FACTORS FOR CANCER IN A POPULATION OF 9272 CASES IN MOROCCO

Abstract : Morocco places the fight against cancer as a national health priority; however, the exploitation of existing data in this field is rare because of a fragmentary, incomplete and deficient routine information system. This observation is valid for the region of Marrakech Safi, which does not yet have its own cancer registry, allowing it to know the epidemiological profile of this pathology. Retrospective descriptive and analytical epidemiological study at the center of oncology and hematology of Marrakech from the records of patients with cancer diagnosed between January 2014 and December 2018. The data collection concerned the data related to the variables: sex, age, marital status, origin (city), environment (urban/rural), occupation, mode of payment and management, cancer location. The data were entered and analyzed on SPSS version 24. The incidence of the Marrakech Safi region estimated on the world population is (162.09/100 000) with a female predominance (201.48/100 000) (p<0.0001), against (123.25) for men. Out of 9272 cases of all types of cancer, the risk factors studied show that cancer affects women more than men (62%) (p<0.0001). Their average age is 54.40 ±15.39 years (p<0.0001). The patients are mainly married (80%) (p<0.0001), without profession (84%) (p<0.0001), coming from urban areas (69%) and from the northern provinces of the region. Among the most frequent types of cancer in the female population, breast (43%), cervical (16%), colorectal (6%) and stomach (4%). Among men, lung cancer ranks first (15.5%) followed by prostate (11.9%), stomach (10.6%) and colorectal (10.5%). Whatever the epidemiological indicators used in the analysis of cancer, the situation is very alarming for our country. The establishment of a comprehensive national or regional policy to fight against this scourge requires the installation of cancer registers in the various national oncology centers and the encouragement of research studies in a perspective of the creation of a data portal on cancer in Morocco..
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International Medical Journal

Journal ID : IMJ-08-08-2021-863

Total View : 468

Title : Evaluation of Central Corneal Thickness in Patients with Dry Eye Disease in a Tertiary Eye Hospital in Kancheepuram

Abstract : Dry eye disorder is a disease mainly due to the tear insufficiency which results in eye discomfort and disturbances in vision. Dry eye also affects the ocular dimensions especially corneal thickness. Central corneal thickness (CCT) assessment plays an important role in refractive surgeries and in the preoperative assessment of other ocular surgeries. To assess the effect of Dry Eye Disease on Central Corneal thickness with age and gender matched controls. 104 subjects (52 cases and 52 controls) who attended SRM Medical College and Hospital ophthalmology OPD were included in the study. Dry eye disease was diagnosed with DEQS questionnaire, Slit lamp examination, TBUT and Schirmer’s test. Pachymetry was used for measuring the CCT of all subjects. Student‘t’ test was used to determine the significance of difference between two means. p values less than 0.05 were considered statistically significant. In our study, there were sixty female patients and forty-four male patients. The ratio of male to female was 1:1.3. The CCT among cases was very low (533.19 ± 30.05) compared to controls (569.27 ± 45.56) and this difference was statistically significant (p < 0.05). When sub grouped under gender, the difference in CCT among males between the two groups was statistically significant and it was highly significant among females. When the reduction in CCT among the cases were studied under different age groups, the subjects in the 41 – 60 years age group had a statistically highly significant difference in CCT between the two groups while it was also significant in other age groups. There is a significant decrease in CCT due to dry eye disease. Pachymetry for CCT estimation shall be included in the routine management of dry eye patients so that corneal thinning could be identified earlier and treated with artificial tears or other substitutes..
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International Medical Journal

Journal ID : IMJ-08-08-2021-862

Total View : 426

Title : THE EFFICACY OF TOPICAL PHENYTOIN IN THE MANAGEMENT OF GRADE 1 AND GRADE 2 DIABETIC ULCERS – A CLINICAL RESEARCH STUDY

Abstract : Topical phenytoin, due to its positive effects in healing of ulcers has been widely used in managing Diabetic ulcer foot in current practice. Aim of this study to evaluate the efficacy of topical phenytoin in DM foot ulcers in terms of reduction in wound surface area, rate of granulation tissue formation and number of days required for healing. All diabetic ulcer foot patients after the debridement the initial size of the ulcer and presence of granulation tissue were measured and twice daily dressings were done for each patient. The wounds were reassessed on 14th day. The measurements were recorded and compared with the initial size. The difference between the Study group and Control group in terms of no of days of hospital stay, increased rate of granulation tissue, wound surface area, which is statistically significant. Topical phenytoin dressings are more effective than conventional povidone iodine and saline dressing in terms of faster reduction in wound surface area, increased rate of granulation tissue formation and lesser number days taken for wound healing..
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International Medical Journal

Journal ID : IMJ-07-08-2021-861

Total View : 704

Title : Impact of Service Adjustment in Medical Rehabilitation Department Due to COVID- 19 to Functional Ability in Geriatric Patients in RSUPN Cipto Mangunkusumo

Abstract :

The infection prevention and control activities during COVID-19 outbreak may affect every aspect in medical services, including medical rehabilitation. In geriatric patients, rehabilitation programs are essential to help in overcoming consequences of physical and cognitive impairments, and to prevent functional decline after hospitalisation. To protect both patients and healthcare professionals, direct contact through visits/ward round by HCPs will be reduced, and the rehabilitation programs will be emphasized on patient’s independence and/or caregiver competence. This study aims to evaluate the impact of service adjustment to functional capacity of the inpatient geriatric population in RSCM, Jakarta. This is a cross-sectional study. Data were taken through 45 medical records of geriatric patients who received inpatient care before pandemic (2016 to February 2020) and during pandemic (from March 2020). Functional ability was assessed by Barthel Index at hospital admission and discharge. From 23 geriatric patients who received inpatient care before pandemic, the mean difference of Barthel Index was 4.69. After pandemic, the mean difference of Barthel Index from 22 patients was 2.75. However, this is not statistically significant (p=0.074). There was no statistically significant difference in Barthel Index due to service adjustment in Medical Rehabilitation Department during COVID-19 era. There may be other factors contributing to patient’s recovery other than differences in health care services that are not analyzed in this study. Therefore, larger study is required to prove this beneficial effect.

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Submission Deadline ( Vol 30 , Issue 04 )
20 Apr 2023

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Publish On ( Vol 30 , Issue 03 )
31 Mar 2023