Indian Journal of Medical and Health Sciences

Burn injuries are prevalent among all age groups and can result from thermal, scald, or electrical sources. Currently, various scaffolds are employed to enhance the healing process and minimize scar formation. Collagen serves as a scaffold, facilitating tissue regeneration and promoting the formation of new blood vessels. Additionally, scaffolds such as amniotic membrane aid in proper epithelialization and scar reduction, boasting unique antiinflammatory and bacteriostatic properties. In our study, we utilized amniotic membrane allograft as a biological dressing for burn wounds on a adult patient’s right thigh.

Background: Melioidosis is a severe infectious disease caused by Burkholderiapseudomallei, a Gram-negative bacterium endemic to tropical regions. While it most commonly affects the lungs, melioidosis can present as a multisystemic infection, impacting various organ systems, including the liver, spleen, kidneys, skin, and central nervous system. The clinical manifestations of multisystemic melioidosis are diverse and range from localized abscesses and septicemia to more severe presentations such as pneumonia, acute respiratory distress syndrome (ARDS), and disseminated infection with organ failure. Diagnosis is often challenging due to its nonspecific symptoms and requires microbiological culture, PCR, and serological tests. We report a case of a 25-year-old male who presented with fever and headache and diagnosis was made of multisystemicmelioidosis and treated accordingly. Conclusion: Despite appropriate therapy, the mortality rate remains high, particularly in cases with delayed diagnosis or in immunocompromised patients. Understanding the pathophysiology, risk factors, and optimal management strategies for multisystemic melioidosis is crucial for improving patient outcomes in endemic regions and for travelers to these areas.

Normal wound healing is a complex process which involves combination of diverse immunological and biological process.Lipoaspirate is a remarkable source of stem cells. Adult stem cells are easily isolated from a section of whole fat or lipoaspirate for application to burn wound to improve healing.In this study we used autologous lipoaspirate in a paediatric patient with burn wounds to face.
 

Background: This case study focuses on the indigenous health practitioners, the Dai (traditional birth attendant) and the Mitanin (community health worker), among the Bhunjia tribe in Chhattisgarh, India. The Dai assists in childbirth using traditional methods, while the Mitanin promotes institutional deliveries and provides prenatal and postnatal care. These practitioners are critical in areas with limited access to formal healthcare, playing a pivotal role in maternal health within the tribal community. Aim and Objectives: This study explores maternal healthcare practices in indigenous Chhattisgarh, focusing on Dai and Mitanin roles, barriers to modern care, perceptions of antenatal services, and improving healthcare access. Material and Methods: The study employed qualitative research methods, including interviews and case studies. Data were collected from six indigenous health practitioners (Dai and Mitanin) and mothers from the Bhunjia tribe of Chhattisgarh India. The focus was on understanding their experiences, practices, and the barriers encountered in maternal healthcare within the tribal context. Results: The findings highlight several barriers to accessing maternal healthcare: Transportation Challenges: Geographical isolation limits access to healthcare facilities. Cultural Beliefs and Practices: Misconceptions about iron and folic acid supplements and reliance on traditional remedies like plant-based decoctions. Socioeconomic Constraints: Competing household responsibilities and financial limitations deter women from seeking institutional deliveries. Despite improvements in health infrastructure, institutional delivery rates remain low. Traditional practices continue to be preferred due to the accessibility and trust associated with the Dai and Mitanin. Conclusion: The study emphasizes the need to integrate traditional health practices with formal healthcare systems to improve maternal health outcomes in tribal regions. Addressing misconceptions about antenatal care and enhancing access to healthcare services are critical steps. The Dai and Mitanin, with their deep-rooted connections to the community, play a key role in bridging the gap between traditional and modern healthcare, ensuring safer childbirth practices.

Introduction: Liver cirrhosis can cause serious complications. One of the most common and serious complications which causes increased mortality is Hepatorenal syndrome. The clinical parameters and treatment modify the outcome of the disease. Objectives: To assess the demographic and clinical parameters in patients with Cirrhosis and ascites with acute kidney injury hepatorenal syndrome and to assess the outcome and improvement in Acute kidney injury hepatorenal syndrome with conservative management. Materials and Methods: This a cross-sectional, descriptive study was conducted at the Department of General Medicine and Gastroenterology, Ballari Medical College & Research Centre, Ballari, India, between July 2022 and December 2023 witha sample size of 100 cases. The study aimed to investigate the clinical parameters and outcomes of acute kidney injury, specifically hepatorenal syndrome, in patients with cirrhosis of the liver and ascites. Results: Out of these 100 cases, majority were from 51-70 years age group (36%) with a mean 49.7 ± 19.2 years with Male predominance 85%. 88% of the cases had history of alcohol use. The most common presentations were Abdominal distension-56%, Reduced urine output-52%, Bilateral lower limb swelling-60%. USG abdomen revealed cirrhosis with ascites in 90% cases. Albumin infusion was given to majority 40% patients. Response to treatment showed improvement in 41% cases, stable in 30% and condition worsened in 29% cases. Death rate in the study was 46%. Long-term renal function outcome revealed improvement in 32% cases, stability in 35% and worsened condition in 33% cases. Serum creatinine >3 mg/dL with OR -1.97 (0.62-3.04) (p-0.0441), serum bilirubin >10 mg/dL with OR- 1.93 (0.69-3.41) and (p-0.0298), response to treatment (worsened) with OR as 3.61 (1.44- 9.05) and (p-0.006) and Complications (present) with OR -3.12 (1.38-7.08) and p value of 0.006. 41.9% of the patients on Albumin infusion were improved as against 39% that were worsened (p<0.05). Conclusion: This study demonstrates the most common presentations and clinical parameters seen in cirrhosis of liver with hepatorenal syndrome and a significant association between serum creatinine and bilirubin with worsened outcomes as prognostic indicators. The treatment outcomes show that there is significant improvement with Albumin infusion treated patients. These findings highlight the importance of comprehensive management of cirrhosis at the earlier stage and prevention of hepatorenal syndrome.

Objective: Osteoarthritis (OA) is a multifactorial degenerative disease characterized by a range of morphological and biochemical alterations to the joint capsule and synovial membrane, as well as bone hypertrophy and articular cartilage loss at the margins. Osteoarthritis (OA) is one of the most common causes of impairment in adults. This review aims to determine whether knee osteoarthritis and the state of cardiorespiratory health are correlated. Reviewing the relationship between knee osteoarthritis (OA) and cardiorespiratory health status is important because OA’s systemic effects are becoming more well-acknowledged. To improve quality of life and lessen the strain on healthcare systems, comprehensive management strategies that address not only joint health but also an individual’s total cardiovascular and respiratory well-being must take this relationship into account. Study design: Research articles were retrieved for this systematic review from reliable academic search engines such as Google Scholar, IEEE Xplore, Springer, and Elsevier. To obtain answers to the research questions, appropriate keywords are utilized in the literature search from reputable sources, such as Web of Science (WOS), and Scopus. The current study includes 80 papers. They underwent an extensive evaluation using the Prisma methodology for systematic review. Result and conclusion: Given that there is a favourable link between knee osteoarthritis (OA) and cardiorespiratory health status, this review has the potential to revolutionize the management of OA by promoting a more exhaustive treatment approach. Cardiorespiratory fitness assessments may be incorporated by medical professionals into standard OA treatment, resulting in specific therapies that promote cardiovascular and joint health. This may lead to increased cardiovascular health, increased mobility, and better overall patient outcomes, which would eventually save healthcare expenses and raise the standard of living for those who have osteoarthritis.

Introduction: In India, rodenticide poisoning poses a serious threat to public health due to its high rate of morbidity and mortality. The purpose of this study was to assess rodenticide poisoning’s clinical characteristics, laboratory results, and outcomes at an Indian tertiary care facility. Material and Methods: 50 patients with rodenticide poisoning who were hospitalized to a tertiary care facility in India for a period of one and a half years participated in a prospective observational research. Results were assessed in connection to the type of rodenticide consumed, and clinical symptoms, indicators, and laboratory parameter evaluations were conducted. Results: In our investigation, the prevalence of rodenticide poisoning throughout the study period was 6.7%. The bulk of the people (58.00%) are under the age of twenty decades. Vomiting (38%) and abdominal discomfort (22%) were the most common symptoms. Clinically, icterus was the most prevalent sign (38%) of all. Symptoms (p=0.043), signs (p=0.040), rodenticide kind (p=0.003), amount of rodenticide consumed (0.038), and metabolic acidosis presence (p=0.001) were all significantly correlated with survival status. Patients who passed away had considerably worse liver function tests, coagulation profiles, and renal functions than those who survived (p<0.05). There was a 12% overall mortality rate. Conclusion: Young adults are the age group most affected by rodenticide poisoning, which is linked to considerable morbidity and mortality. Improving patient outcomes requires early detection, timely treatment, and careful observation.In environments with limited resources, the findings of this study can direct the creation of evidence-based management plans and preventative actions for rodenticide poisoning.

Maternal health among tribal women in India faces significant challenges, including high maternal and infant mortality rates, malnutrition, anemia, and inadequate healthcare access. This study examines the factors contributing to these health disparities, focusing on the experiences of tribal communities in regions such as Chhattisgarh, Odisha, and Madhya Pradesh. The introduction highlights that unhygienic childbirth practices, poverty, and limited healthcare services are major contributors to maternal health issues. Methodologically, the study utilizes secondary data from previous research, including health surveys and case studies, to identify trends in maternal health and nutrition within tribal populations. The study aims to assess the nutritional status and healthcare practices of tribal women, with objectives to identify factors leading to high maternal mortality and morbidity, and to explore regional differences in health outcomes. The findings reveal that a substantial proportion of tribal women suffer from anemia, malnutrition, and inadequate antenatal care. For instance, in regions such as Chhattisgarh, maternal mortality rates are elevated among both first-time and multiparous mothers, with factors such as low socioeconomic status, illiteracy, and traditional childbirth practices being key contributors. Anemia, particularly chronic energy deficiency, is prevalent across many tribal areas, with significant variations in nutritional status between regions.  In conclusion, the study highlights the urgent need for targeted health interventions to improve maternal health outcomes among tribal women. Strategies such as enhanced healthcare access, education, and nutritional support are essential to address these disparities and reduce maternal and infant mortality rates in tribal communities.

Introduction: Tuberculosis (TB) remains a significant global health challenge, causing substantial morbidity and mortality, particularly in low- and middle-income countries (LMICs). Despite global efforts to control and eliminate TB, the disease continues to affect millions, with an estimated 10 million new cases and 1.5 million deaths reported in 2019 alone.The burden of TB is further complicated by the increasing prevalence of diabetes mellitus (DM), a chronic metabolic disorder characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both.  Material and Method: This study was a prospective, non-interventional and observational study was carried out in the Department of General Medicine at Ballari Medical College and Research Centre, Ballari. The source of data for this study comprised tuberculosis (TB) patients with known diabetes mellitus (DM) and newly diagnosed diabetes mellitus visiting the TB Cell Hospital. Confirmed pulmonary tuberculosis as evidenced by either sputum for Acid-Fast Bacilli (AFB), Cartridge-Based Nucleic Acid Amplification Test (CBNAAT), or radiological investigations.  Result: A vast majority of the participants (91.0%, 131 participants) had negative sputum status, while 9.0% (13 participants) did not have their sputum status reported. No participants had positive sputum status at the end of treatment. The p-value of < 0.001 suggests a highly statistically significant difference in sputum status at the end of treatment. The majority of the participants (91.0%, 131 participants) were cured, while 9.0% (13 participants) died. The p-value of 0.006 indicates a statistically significant difference in treatment outcomes. In this study, participants who were cured had lower mean FBS (135.4 ± 33.7 mg/dL), PPBS (206.9 ± 46.8 mg/dL), and median HbA1c (6.5%) at baseline compared to those who were not cured (FBS: 174.9 ± 46.5 mg/dL, PPBS: 252.2 ± 62.9 mg/dL, HbA1c (7.8%, IQR: 7.2 - 8.6%). Conclusion: This study provides valuable insights into the factors influencing treatment outcomes in patients with TB-DM comorbidity and underscores the need for personalized management strategies, routine DM screening, and appropriate treatment modalities to improve outcomes in this vulnerable population. Future research should focus on developing and evaluating targeted interventions to optimize treatment outcomes and reduce mortality in patients with TB-DM comorbidity.

Background: Hypertensive crises, including hypertensive urgency and emergency, are lifethreatening conditions characterized by severely elevated blood pressure. This study aimed to investigate the risk factors, clinical profile, and outcomes among patients presenting with hypertensive crises at Bellary Medical College And Research center Bellary, India. Methods: A prospective descriptive study was conducted, involving 119 patients aged 18 years and above with systolic blood pressure ≥180 mmHg or diastolic blood pressure ≥110 mmHg, along with evidence of target organ damage. Patients with secondary causes of hypertension were excluded. Data collection included demographic characteristics, clinical presentation, blood pressure measurements, and diagnostic tests such as CT brain scans and ECGs. Descriptive statistics were used to summarize key variables, and statistical tests assessed associations between clinical findings and outcomes. Results: The mean age of the patients was 58.44 years, with 69.2% being male. The mean systolic blood pressure was 201.14 mmHg, and the mean diastolic blood pressure was 104.32 mmHg. The most common diagnosis was hypertensive urgency (30.6%), followed by hypertensive heart disease (16.5%), and cerebrovascular accidents (CVA-infarct: 14.0%, CVA-bleed: 11.6%). Active smoking was reported in 56.7% of patients, and 65.0% were active alcohol consumers. A total of 69.7% of patients were discharged, 30.3% were referred for further care, and the mortality rate was 4.2%. Conclusions: Hypertensive crises are associated with significant morbidity, particularly in male patients and those with lifestyle risk factors such as smoking and alcohol consumption. Stroke, heart disease, and renal involvement were common complications. Effective management requires timely blood pressure control and addressing modifiable risk factors to prevent severe outcomes.