Online ISSN: 2515-8260

Keywords : morbidity


ASSESSMENT OF ROLE OF MANNHEIM PERITONITIS INDEX (MPI) SYSTEM IN EVALUATION OF MORBIDITY AND MORTALITY AMONG PATIENTS WITH HOLLOW VISCUS PERFORATION: AN INSTITUTIONAL BASED STUDY

Ankit Meena, Rajveer Singh, Minaxi Sharma, Manish Bhadoo, Deepak Sethi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1785-1791

Introduction: A scoring system which can compare patient populations and severity of illness, objectively predict mortality, morbidity and can help to evaluate the treatment strategy is the dire need for evaluative research of intensive care. Thus, present study was undertaken to access the role of Mannheim Peritonitis Index (MPI) system in evaluation of morbidity and mortality among patients with hollow viscus perforation.
Materials and Methods: The present prospective comparative study was carried among 50 patients in whom diagnosis was of peritonitis. Using history, clinical examination and laboratory values risk factors found in MPI were classified according to values indicated and individual variable scores were added to establish MPI score. The data was analyzed, each variable in the MPI score along with other patient variables was analyzed using chi square analysis with various outcomes that were noted in the study. P value <0.05 was taken as significant in this study.
Results: In this study, 50 patients with diagnosis of secondary peritonitis were included. Patients with age 15 years to 70 years were part of study. Majority of patients (42%) belong to age group 20-35 years. Patient with less MPI score required less number of ICU stay. Around 80% of high-risk group (MPI > 29) required more than 5 days of ICU stay. Mortality rate was 40% in high-risk group (MPI score >29). There was no mortality in low-risk group (MPI score <21). Mortality rate was 5.26% in intermediate risk group. Chi-Square test value is 15.601, p-value is 0.000, < 0.05 indicates significant Mortality vs MPI Scores.
Conclusion: Mannheim peritonitis index scoring system is accurate for predicting the morbidity and mortality in patients with peritonitis due to hollow viscus perforation. It helps in identification of high-risk patients and it helps to identify the patients using for intensive post-operative or ICU care.

Role of maternal factors towards diarrhoeal episodes in under five children in India

Yogesh Mane, Janardhan Bandi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 846-850

Background: Diarrhea is widely recognized as a major cause of childhood morbidity and
mortality in many developing countries, particularly in India. According to World Health
Organization (WHO) report, diarrheal diseases are still leading causes of mortality and
morbidity in children under five years of age.
Objective: The present study attempts to estimate the association between maternal factors
and prevalence of Acute Diarrhoeal Diseases in children below 5 years of age in Indian
settings.
Methods: This community-based, cross-sectional epidemiological and single-center study
conducted in the rural field practice area attached to Department of Community Medicine of
Topiwala National Medical College, Mumbai, Maharashtra, India from March 2017 to
February 2018 was aimed to estimate the association between maternal factors and
prevalence of Acute Diarrhoeal Diseases in children below 5 years of age in Indian settings.
Ethics approval was obtained from Ethics Committee for Academic Research Projects
(ECARP). Research tools included a pre-structured questionnaire. Baseline information of
study area was taken from the Primary Health Centre. Data was entered in Microsoft Excel
spreadsheet to perform analysis.
Results: In our study, 340 mothers who used to take bath daily of which 61(17.9%) had
diarrhoeal episodes, whereas out of 30 mothers who do not take bath daily, 15(50%) had
diarrhoeal episodes. Further, 340 mothers of children who used to wash their hands daily
before the meals of which 58(15.8%) children had diarrhoeal episodes, whereas out of 30
mothers who did not wash their hands before meals, 18(60%) children had diarrhoeal
episodes
Conclusion: The present study indicated that maternal factors bear a significant impact on
morbidity caused by diarrhea.

Prevalence of acute diarrhoeal diseases in children below 5 years of age in Indian settings

Janardhan Bandi, Yogesh Mane

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 840-845

Background: Diarrhoeal diseases which are one of the leading reasons behind global
mortality and morbidity is more threatening for infants and young children. Childhood
diarrhoea is becoming increasingly prevalent disease in developing countries like India.
Moreover, it is a major cause of malnutrition that contributes towards third major cause of
under 5 mortalities. This has raised a serious concern in the domain of public health.
Objective: The present study attempts to identify the prevalence of acute diarrhoeal diseases
in children below 5 years of age in Indian settings.
Methods: This community-based, cross-sectional epidemiological and single-center study
conducted in the rural field practice area attached to Department of Community Medicine of
Topiwala National Medical College, Mumbai, and Maharashtra, India from March 2017 to
February 2018 was aimed to identify the prevalence of acute diarrhoeal diseases in children
below 5 years of age in Indian settings. Ethics approval was obtained from Ethics Committee
for Academic Research Projects (ECARP). Research tools included a pre-structured
questionnaire. Baseline information of study area was taken from the Primary Health Centre.
Data was entered in Microsoft Excel spreadsheet to perform analysis.
Results: In our study, a total of 370 living children aged <12–59 months were included in the
analysis. Most of the children who belonged to in Class III socioeconomic status (61.4%),
affiliated to joint family (54.6%), belonged to Hindu religion (94.6%). Only 9.2% of mothers
were illiterate whereas remaining 91.8% mothers had completed at least primary education.
The prevalence of diarrhoea in children under 5 years of age was recorded as 20.5%.
Conclusion: The present study contributed to providing the prevalence of acute diarrhoeal
diseases in children below 5 years of age in Indian settings

A retrospective cohort study on laparoscopic cholecystectomy in cirrhosis patients

Dr. Faisal Mumtaz,Dr.Urooj Najami,Dr.Prabodh Bansal,Dr Gopal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2797-2803

Background:The advanced instruments like harmonic shears have made laparoscopic cholecystectomy (LC) a safe option. The present study determined twoyearsexperience of patients after laparoscopic cholecystectomy in cirrhosis patients.
Methods: A total of 50 cirrhotic patients underwent LC from August 2020 to February 2022. The type of surgery performed was laparoscopic cholecystectomy. The parameters recorded were,presence of adhesions,use ofharmonic devices, amount of bleeding during surgery,rate of conversion to open surgery and the reasons thereof, operative time in minutes, plasma and platelet transfusion postoperatively and duration of hospital stay .
Results:Majority of the patients were of Child-Pugh class A. The cause of cirrhosis was hepatitis C virus (HCV) in most of the patients. Biliary colic was found to be the most common presentation. Higher CTP, model for end-stage liver disease (MELD) scores, higher mean international normalization ratio (INR) value, lower mean platelet count, higher operative bleeding, higher blood, and plasma transfusion rates, longer mean operative time and postoperative hospital stays were found to be statistically significantand  correlated well with 30-day morbidities and mortalities.
Conclusion: LC could be a better surgery performed in patients with cirrhosis. However, higher CTP and MELD scores, greater operative bloodloss, largerno of  blood and plasma transfusion in units, longer operative time, lower platelet count, and higher INR values can be considered factors resulting in poor outcome. 

Risk factors of intrauterine growth restriction in term pregnancy

Dr. Sahana PR, Dr. Jeevitha H, Dr. Prajwal M, Dr. Chandrashekar K

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1620-1624

Fetal growth restriction (FGR) is a pathological condition in which a fetus has not achieved his genetic growth potential, regardless of fetal size (1) Worldwide FGR is observed in about 24% of newborns; approximately 30million infants suffer from FGR every year. The burden of FGR is concentrated mainly in Asia which accounts for nearly 75% of all affected infants. National neonatal perinatal database of India reported the incidence of FGR to be 9.65% among hospital born live birth infants. Study was conducted for all cases with clinical/ Sonological term FGR admitted under department of OBG. A detailed history as per questioner will be taken with general physical examination and investigations will be done as per requirement. The accumulated data was evaluated and statistically analyzed. In the present study 70 patients with term gestation with FGR were recruited. Maternal (74.28%) was the commonest cause followed by Idiopathic (11.43) and Placental (10%) and Fetal (4.29%) causes. Among Maternal causes Pre Eclampsia was found to be in 50% cases. Most of the patients (50.7%) required caesarean section. A total of 9 (12.86%) neonate had birth weight of <1.5 kg, 48.6% had Birth weight between 1.6 to 1.9kg, 38.5% had birth weight between 2-2.4kg and 95.8% had asymmetrical FGR, 4.2% were symmetrical. 26 (40%) neonates had morbidity with 17(24.3%) neonatal mortality with Respiratory distress syndrome (41.18%) being most common cause. No Maternal Mortality.

Clinical Study and Management of Varicose Veins of Lower Limbs

Sakru Mudavath, Ramprakash Chitimalla, Vijaya Kumar Ankathi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 6023-6030

Background:To study the distribution, pathology, clinical features, various mod es of
investigations and overall management of varicose veins of lower limbs.
Materials and Methods: The study was carried out Govt Medical College/General
Hospital, Suryapet from October 2021– March 2022 to evaluate the ―Clinical
presentation and management of varicose vein in lower limbs. 50 cases of varicose veins
of lower limbs were presented and analysed in our study. Fifty cases of varicose veins of
the lower limb have been studied in detail.
Results: Varicosity of the lower limb is a common clinical entity. The number of cases
reporting to the hospital is much less than the real incidence; because in the absence of
symptoms due to varicose veins patients do not seek treatment in our country. The
commonest age group of patients suffering from varicose veins is 41 to 50 years. Most of
the patient presented to the hospital for one or the other complications and not for
cosmetic reasons. The majority of the patients were male. A definite relationship exists
between the occupation and the incidence of varicose veins as most of our patients are
workers standing for longer duration. The involvement of long saphenous system is
more common than the short saphenous system. Left limb is affected more common.
The cause for the same is not known but could be attributed to the longer course
traversed by the left iliac veins. Clinical examination has a high predictive accuracy. It
gives sufficient information to treat the patients in centres where colour Doppler is not
available or affordable. The use of colour Doppler is a valuable supplement to clinical
examination for effective treatment of varicose veins and its use is strongly
recommended to prevent recurrences and reduce morbidity as it is effective tool in
detecting venous incompetence and to rule out deep vein thrombosis. SPJ junction and
perforators are highly variable and should always be marked pre- operatively using
USG Doppler. Operative line of treatment is a primary procedure in the management of
varicose veins of lower limbs.Venous ulcer heals well after surgery. Surgery is a quality
modality for varicose veins patients with ulcer with low recurrence rate. Complications
are negligible if cases are meticulously selected and operated. The present procedures
enable the patient to lead almost normal life after surgery with few recoverable
morbidities.
Conclusion: There is need for general health education and awareness about varicose
veins in the society in order to achieve timely treatment with good outcome and to
reduce the morbidity.

Assessment Of Risk Factors For The Development Of Allergic Diseases In Children

Nurmamatova Kurbonoy Choriyevna; Abdashimov Zafar Bahtiyarovich; Karimova Mukhabat Umarovna; Stojarova Nelli Kamilovna; Tangirov Abdixoliq Lolayevich

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 319-329

Allergy is a pathology of countries with a high index of socio-economic development and most of all residents of large cities. By 2025, according to the WHO, 50% of the world's population will suffer from allergies [14]. This article examines the main risk factors for the development of allergic diseases in children under the age of 18 in Tashkent. The most significant factors were: the presence of an inherited predisposition on the line of one (RCh 1.9) or both parents (OR 5.6), closely related marriages between parents (RCh 2.8), the age of parents over 40 at the time of conception of the child (RCh 1.4) and some others.

INSTRUMENTAL MONITORING AND ASSESSMENT OF OCCUPATIONAL RISK IN UZBEKISTAN

Adilov Utkir Khalilovich; Kabilova Gulshan Abdurashidovna

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 2826-2836

The methods of control and assessment of professional risk applied in
the republic do not include the method of assessment of the degree of impact
of harmful and dangerous factors of working conditions on specific
employees, as well as the analysis of actual loss of working capacity of
employees after long periods of labor activity. As a result of incorrectly
chosen assessment methods and methodological approach, working
conditions have a high risk of developing professional and professionally
conditioned morbidity among groups of professions in industries. The purpose
of this work was to determine the improved approaches to professional risk
assessment and instrumental control over their implementation. Assessment
of workers' health indicators depending on working conditions at the
workplace is based on recommendations of the International Labor
Organization. We have developed a package of normative and methodical
documents, including 14 methodical recommendations, as well as Sanitary
Rules and Norms, providing requirements to the hygienic assessment of the
impact of various physical, chemical and biological factors on the health of
workers. Conclusions were made to integrate the characteristics of the factors
of working conditions through the transition from the normalization of
individual parameters of the factors to complex indicators, changing the
methodology of recording the working conditions at the working places to
ensure a comprehensive assessment of all risks in a single procedure and their
systematic monitoring. The use of modern software complexes as part of
special devices for instrumental measurements have a loaded algorithm of
measurements, pre-compiled a special computer program control planning,
which offers the performer an operational hint on the choice of place and
number of measuring points.

DYNAMIC HEALTH SURVEILLANCE ANALYSIS OF THE EMPLOYEES OF THE KIRGULIA INDUSTRIAL ZONE

Adilov U.H .; Khashirbaeva D.M .; Voronina N.V .

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 2292-2306

Abstract. The scientific work presents the results of dynamic research to study the structure,
level and dynamics of the general, professionally conditioned and professional morbidity of
employees of SE “Ferghana Oil Refinery”, SE “Ferghana Heat and Power Plant” and JSC
“Ferghanaazot”, which are part of the Kyrgyz Industrial Zone of the Ferghana region for 5
years (2010-2014). The main professional qualification groups working at the enterprises
under research at the age of 19 to 40 years with the work experience from 1 to 20 years were
surveyed. 6000 man-days of working observations were made. High morbidity rates were
revealed among the employees of Ferghana Oil Refinery and JSC “Ferghanaazot” in the
groups with the experience of up to 5 years and 11-20 years. The analysis of morbidity rate
among age groups of workers showed high indices at the age above 35 years. In the structure
of morbidity for the period of 2010-2014, the first leading places were occupied by diseases of
respiratory organs, then by diseases of circulatory and digestive organs, traumas and
poisoning, then by diseases of the nervous system, skin and subcutaneous tissue. High
respiratory diseases are associated with long-term exposure to occupational risk factors, where
chemical contamination is the most dangerous.

HEALTH RISK ANALYSIS OF WORKERS INVOLVED IN COAL MINING IN VARIOUS WAYS

Utkir Adilov

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 2271-2281

Abstract. Occupational risks affect the health of miners and up to 40% of labor losses
are caused by diseases directly or indirectly connected with unfavorable working conditions.
The research aimed to determine the degree of connection of the disease incidence by
temporary loss of working capacity of coal mine workers with working conditions, which was
estimated for all classes of diseases and the relative risk (OR) value was 1.69 units, etiological
share (EF) - 41% and was estimated as average. These incidence rates for the disease classes
were almost complete: Class XIII (OR=5.08 units; EF=80%) and Class XIX (OR=5.03 units;
EF=80%), and high for the disease classes: Class XI (OR=2.57 units; EF=61%) and Class X
(OR=2.46 units; EF=59%). This relationship by day was almost complete among: Class X
(OR=6.18 units; EF=100%), Class XI (OR=7.27 units; EF=100%), Class XIII (OR=7.79
units; EF=100%), and Class XIX (OR=17.87 units; EF=100%). Among workers engaged in
underground coal mining, the value of ОR=1.4 units, EF=29.3%, was occasionally observed
and assessed as small. Relationship of the disease to underground working conditions was
assessed as very high by disease classes: Class X (OR=3.6 units; EF=72.1%), Class XI
(OR=3.8 units; EF=73.5%) and Class XIII (OR=4.8 units; EF=79.1%). The disease
relationship by day was almost complete: in Grade XI (OR=5.3 units; EF=100%) and Grade
XIII (OR=8.9 units; EF=100%), and high in Grade X disease (OR=3.0 units; EF=100%). The
risk of eating disorders of workers was identified by class XI disease and was assessed as very
high in cases (OR=3.8 units; EF=73.8%). A high degree of occupational conditionality was
determined for Class XIII disease (OR=2.2 units; EF=55.3%).