International Journal of Research and Review

5-9

Authors: Manoharan A, Venkatraman Janarthanam, Rakesh Srivastava, S Sowmya, N Gandhi

Background: Dengue fever has become the major public health problem caused by arboviral infection of humans which leads to thrombocytopenia in severe cases. The transfusion of platelets is indicated for the prophylaxis and treatment of haemorrhage in patients with thrombocytopenia. However, some patients do not achieve the appropriate platelet count increment following transfusion. Hence studying the efficacy of platelet transfusion by calculating Corrected count increment(CCI) and platelet percentage recovery(PPR) provides adequate knowledge and usage of platelets in life saving. Aim: To assess the effectiveness of platelet transfusion in dengue fever. Materials and methods: Post transfusion platelet parameters are compared with Pre transfusion parameters. The values of Platelet count, CCI and PPR are calculated. Results: Out of 44 serologically diagnosed dengue cases who received platelet transfusion only 34 (77.3%) patients showed good response whereas 10 (22.7%) patients with bleeding manifestations, hyperpyrexia showed poor response to platelet transfusion or refractoriness. Conclusion: Platelet transfusion did not prevent development of severe bleeding or shorten time to cessation of bleeding. Therefore, platelet transfusion should not be routinely done in the management of dengue fever. The identification of cause for non responders and treatment gives good outcome, instead of increasing the number of units of transfusion. In doing so extraneous usage of platelet transfusion can be avoided. Therefore, assessing the effectiveness of platelet transfusion can be emphasized in transfusion therapy for the development of specific guidelines for the optimal utilization of platelets.

16-22

Authors: Neha Garg, P. C. Jha

Background: Soft tissue tumors (STT) are very rare in general population. They are always a challenging lesion for the pathologist to diagnose due to the wide morphological overlapping and the biological heterogeneity. Role of Fine needle aspiration cytology (FNAC) as a diagnostic tool for the suspected soft tissue mass is a matter of debate due to the conflicting observations reported in the literature world-wide. Methods: We conducted this study on 89 patients to compute the diagnostic accuracy of the FNAC procedure as compared to the gold standard technique i.e. histopathological examination of the biopsied tissue. Results: In this study we found that malignant and benign cases constituted 67.41% and 21.34% of all the cases. Malignant cases were most common in the age-group of 20-40 years and benign cases were common in the age-group of 40-60 years. Overall, the lower extremity was the most common site of involvement by STTs, followed by trunk and upper extremity. The most commonly diagnosed tumor was spindle cell type with slight predilection for males. The accuracy rate was of 92.40% for the nature of lesion (benignancy Vs malignancy) with sensitivity, specificity of 95% and 84.21% respectively, which was statistically significant (p<0.0001). The cytological diagnosis of 7.50% cases was found discordant with histopathological diagnosis. Conclusion: FNAC proved to be a good diagnostic tool for diagnosing STTs and must be always considered as complementary tool for diagnosing suspected soft tissue mass, especially in healthcare set-up that has minimal access to the advanced diagnostic procedures.

31-36

Authors: S. Sivakumar, Vijay Augustin Jayabal

1.1 Background: Splenectomy is the surgical removal of the spleen, traditionally accomplished by one large commonly left subcostal or a left upper paramedian incision. The use of smaller incisions with laparoscopic techniques leads to less pain after surgery, less time spent in the hospital and quicker return to the work. Morbidity, mortality, hospital stay, operative time, blood loss, time to oral fluid intake, postoperative pain and complication, were analysed and overall outcome of the laparoscopic splenectomy were observed for a series of haematological cases for whom splenectomy is indicated. 1.2 Methods: Retrospective review of 25 patients who had undergone elective splenectomies between April 2012 and May 2015 were included. Preoperative evaluation was done by haematologist. General anesthesia was given for all patients. Most laparoscopic splenectomise were performed in right lateral position. Local infiltration with 0.5% bupivacaine was given at trocar and port site at the end of the surgery. Intravenous Fentanyl and tramadol were used for post operative pain relief. 1.3 RESULTS : The mean operating time was 74 minutes (range 45min to 90min) in LS alone cases;. The overall mean estimated blood loss was 159.3 ml (range: 50ml to 500ml. The mean hospital stay was 4.83 days (range: 3to12 days). All patients were ambulatory and started oral feeding on first post-operative day. Deep vein thrombosis and pulmonary complication were nil. Mortality was nil in this series. Pain intensity and analgesic (opioids) consumption were less during post-operative period. 1.4 Conclusion :In conclusion LS is a technically difficult but feasible procedure that could be performed safely in carefully selected patients, with adequate optimization and skilled surgical and anesthesiologist team even in a small setting with limited resources, with efficacy morbidity and mortality rates similar to those of traditional splenectomy for the same indications.

43-47

Authors: Prempati Mayanlambam, Akoijam Mamata Devi

Background: Basic Life Support (BLS) includes recognition of signs of sudden cardiac arrest (SCA), heart attack, stroke and foreign-body airway obstruction (FBAO); cardiopulmonary resuscitation (CPR); and defibrillation with an automated external defibrillator (AED). It is very important that every person in the community know about Basic Life Support to save lives and improve the quality of community health. At least the doctors, nursing and paramedical staff are expected to know about it, as they are frequently facing life threatening situations and the knowledge of BLS will be definitely useful. Objective: To assess the existing level of knowledge and practice of B Sc nursing students on BLS. To develop and validate planned teaching program (PTP) on knowledge and practice regarding BLS. To determine the effectiveness of PTP in terms of gaining knowledge and practice scores. Design/setting/participants: Quasi experimental designs. A total of 40 subjects were chosen for the study. The instrument used to generate necessary data was structured questionnaire for knowledge assessment and observation checklist for practice assessment). Results: The mean score of pre- test knowledge score of experimental group was 24.65 and post test mean score was 35.5. The median of pre- test and post- test knowledge score of experimental group i.e. 24 and 35 shows difference. The standard deviation of pre- test knowledge score was 1.87 shows difference in comparison to post- test score i.e. 2.27. The T. Value of post- test and post- test knowledge score was 7.08.The mean difference of post- test practice score of experiment group and control group was 4.95.The standard deviation difference of post- test practice score of experiment group and control group was 0.9.The standard error mean difference of pre- test and post- test practice score was 0.14.The T. Value of pre- test and post- test practice score was 5.84.Indicating that level of knowledge and practice of experimental group increase as compared to control group. Conclusions: Findings indicate that PTP given on knowledge and practice regarding BLS was effective.

65-72

Authors: Medona Mary R, Nirmala T

Mosquitoes act as the major vectors for many human diseases. More recently the incidence of chikungunya is increasing steadily in different parts of Tamil Nadu has also been reported on a regular basis. Due to the insecticidal contamination of the environment and to the physiological and behavioral resistance of vectors, increasing attention is now being focused on biological control methods. Crude plant extracts are more cost effective in community based control programs and may be employed in localized situations where mosquitoes have become tolerant to synthetic or microbial larvicides. Five different plant extracts were Allium sativum (Garlic bulb extract), pongamia pinnata (pongam oil extract) Madhuca indica (Illuppai oil extract), Azadirachta Indica (Neem oil extract), Ocimum sanctum (Tulsi Leaf extract) were selected and tested against early fourth instars larvae of Ae.aegypti and probit analysis was made to calculate the Lc50 and Lc90 values. The larvae of Ae. aegypti treated with five different plant extracts and the toxicity (Lc50 and Lc90) of the larvae showed a remarkable variations. The five different plant extracts showed an effective larvicidal activity against Ae.aegypti. Among the five plant extracts tested, Allium sativum was more effective than the other plant extracts. Ocimum sanctum has least larvicidal effect when compared with the four plant extracts. Therefore judicious application of the above plant extracts in the breeding medium will reduce the population of Aedes aegypti in an ecofriendly manner and in turn it reduces the incidence of chikungunya and various dreadful diseases in an ecofriendly manner.

77-80

Authors: Sunil J. Kulkarni

One of the most important factors that contribute to the cost of manufacturing sector is energy. Electricity and fossil fuels are most used energy resources. These sources are depleting day by day. The research in energy sector is concentrated on use of non conventional and novel energy sources. Also the efficient use of available energy is very important area of research. Fuel cells can be used for energy generation from biowaste and other materials. Many investigators have carried out research on different types of fuel cells with different materials. The current review summarizes studies and research carried out on fuel cells.

86-89

Authors: Nwosu A

Due to the crime rates in our society and the poor dissemination of information sharing in combating crime, one is forced to look for alternative ways of crime prevention, detection, convection of criminals depending on a highly responsive backbone of an information management. The efficiency of the police and the effectiveness with which it tackles crime depend on what quality of information it can derive from its existing records and how fast it can have access to it. This model was implemented as a web –based system using ASP.NET as front end SQL server as back end easing the effort of user.

100-103

Authors: Savitri Singh, Sumit Giri, Saloni Gupta, Priyanka Chadha, Aparna Khandelwal, Jitendra Singh Nigam

Eosinophilic cholecystitis (EC) is a rare and poorly understood entity first described in 1949. It may be defined as an inflammatory condition of gall bladder in which the transmural inflammatory infiltrate predominantly comprises of eosinophils that clearly overshadows the presence of any other inflammatory cell component. The etiology of EC is unclear, but suggested factors include eosinophilia-myalgia syndrome, allergies parasitic infestations, drug intake and local diathesis involving gallstones, parasites, acalculous cholecystitis, hyper eosinophilic syndrome (HES) and eosinophilic gastroenteritis (EGE). We report a case of a 50 year old female who presented with complaints of abdominal pain and tenderness in the right upper quadrant. Ultrasonography of the abdomen showed a distended gallbladder with multiple calculi. All the relevant laboratory investigations were within normal limits. Laparoscopic cholecystectomy was done under general anaesthesia. Histopathologic examination of the gallbladder showed numerous eosinophils comprising more than 90% of the inflammatory infiltrate in mucosa and lamina propria. In the absence of any apparent etiology after detailed workup of our case we considered it as one of idiopathic EC with cholelithiasis. Histopathology remains the mainstay for diagnosis of EC as there is no specific clinical/ radiological presentation. Though the treatment of choice for EC is cholecystectomy the patient must be evaluated meticulously to rule out other associated diseases which may have a worse prognosis than chronic cholecystitis itself.