Ravi H Rangareddy

Background: Knee replacement, similarly called as knee arthroplasty, is a clinical system to override the weight-bearing surfaces of the knee joint to alleviate misery and debilitation. Supreme knee overriding is normally associated with postoperative blood loss. The current examination was coordinated to evaluate the effect of the usage of tranexemic acid on postoperative blood loss and transfusion essentials in patients encountering absolute knee replacement. Materials and Methods: The prospective study was conducted in Basaveshwara Medical College and Hospital, Chitradurga and contained data of patients who experienced supreme knee replacement between February 2019 to January 2020. The effect of intra articular tranexamic acid on postoperative hemoglobin and number of blood units reinforced was noted. Results: A total of 100 patients encountering knee overriding clinical methods were picked with 20(20%) men and 80(80%) women. The overall mean age was 61 years (41-85 years). Tranexamic acid was used in all the patients. Exactly when it was used, only 2 (2%) patients required blood transfusion. The typical fall in hemoglobin postoperatively was 0.76 gm/dl. Conclusion: Intra-articular Tranexamic acid decreases the hard and fast blood loss and transfusion requirements in patients encountering total knee replacement. Keywords: Blood joint replacement, Total knee replacement, Tranexamic acid.

Background: Deep vein thrombosis (DVT) is the formation of a blood clot in a deep vein most commonly in the legs or pelvis. There are many reports about deep vein thrombosis from Western regions but few reports are from India. Objectives: The purpose of the present study is to reveal the incidence of deep vein thrombosis in postoperative hip fracture patients in tertiary care hospital chitradurga. Materials and Methods: Sixty nine patients who had intertrochanteric fracture or femoral neck fracture are included. They had fixation or hemiarthroplasty performed depends upon the indications. Bilateral Venography was performed on sixth day to tenth day after the surgery. Results: The positive venography result was 50.7%. These includes 5 distal (14.2%), 28 (80%) proximal and 2 (5.7%) bilateral DVT. The incidence of combined proximal and bilateral DVT were therefore 56.5%. of 35 patients with DVT, only 8 (22.8%) patients had signs or symptoms suggestive of DVT. Conclusion: Intertrochanteric and femoral neck fracture is a common type of hip fracture in the elderly, and the incidence of DVT after Intertrochanteric and femoral neck fracture may be underestimated. Early intervention (early admission and early surgery) might reduce the incidence of DVT. Keywords: Deep vein thrombosis, Incidence, Intertrochanteric fracture.

Background : The treatment of pulmonary tuberculosis is quite challenging. The national tuberculosis programs are shifting the trend to adopt daily regimen than the intermittent regimen. Hence, this study was undertaken to study the effectiveness and adverse drug reactions of the daily and intermittent regimens. Material and Methods : A retrospective study was conducted in the department of Chest and TB in Basaveshwara Medical College and Hospital, Chitradurga and District Tuberculosis Centre, Chitradurga, India. About 55 patients on daily regimen and 50 patients on intermittent regimen constituted the study sample. The details regarding the age, sex, initiation and termination of the treatment, outcome and adverse drug reactions were collected using a predesigned proforma. Results : Majority of the patients in daily regimen were 56 – 65 years and intermittent regimen was aged between 26 – 35 years. More number of the cases in both the regimen were males. Vomiting was the main adverse drug reaction in patients on daily regimen and Abdominal pain in intermittent regimen. About 54.5% of the patients on daily regimen and 62% on intermittent regimen were cured. The death and defaulter rate was higher in patients on intermittent regimen. Conclusions : Even though the cure rate is good in intermittent regimen, the adverse reactions are quite high in this study. Keywords: Adverse drug reaction, Anti tubercular drugs, Pulmonary tuberculosis, Sputum smear.

Background: Pleural effusion is a common disease entity and therapeutic thoracocentesis is a common procedure to tap the pleural fluid. The routine method of pleural tapping is associated with some complications. This study was taken up to assess the rate of complications between the routine procedure and a unique procedure. Materials and Methods: A randomized controlled trial was conducted in the department of Chest and TB in a tertiary care centre. About 30 patients had undergone therapeutic pleural tapping by the routine procedure and 30 patients had undergone tapping by unique procedure where the pleural fluid was allowed to flow through tube passively with gravity. The complications were compared between the two procedures. Results: About 40% of the study subjects in routine procedure belonged to 31 – 40 years age group. About 60% of the patients in routine and 53.3% in the unique group were females. There was no difference in chest pain in both the groups. Dyspnea, cough and reduced blood pressure was higher in the routine procedure group than the Unique procedure group. The signs of reexpansion pulmonary edema were higher in the unique group. But these were statistically not significant for 0 – 30 minutes. After one hour of the procedure, dyspneoa, signs of reexpansion pulmonary edema, cough hematoma were higher in the routine group. After 48 hours of the procedure, chest pain was noted in 3.3% of the routine cases, dyspnoea in 3.3% of the cases and fever in 3.3% of the cases. Conclusions: This study had shown that the needle catheter method was shown to be superior to the routine thoracocentesis. Keywords: Complications, Catheter, Gravity, Therapeutic thoracocentesis, Unique procedure.

Background: The drug resistant tuberculosis has emerged as an important public health problem. Some epidemiological factors are known to influence the emergence multi drug resistant tuberculosis. This study was undertaken to study the epidemiological factors and clinical factors in emergence of multi drug resistant tuberculosis. Material and Methods: A cases control study was undertaken in the department of Chest and tuberculosis of a tertiary care hospital. A total of 30 cases confirmed as Multidrug resistant tuberculosis patients constituted the cases. About 60 age and sex matched controls were taken in to the study. A detailed history was taken with the help of a standardised proforma for both cases and controls. Results: Most of the multidrug resistant tuberculosis cases belonged to earning age group and males outnumbered females. Cough was the common symptom in cases followed by shortness of breath, expectoration, fever, haemoptysis, chest pain and wheezing. Controls had symptoms in lesser extent than cases in this study. The diabetes mellitus and HIV were the common comorbidities among the cases. About 50% of the cases were former smokers and 40% were alcoholics and 16.7% were tobacco chewers in this study. The treatment was regular in 30% and missed doses were more than 40 in 46.3% of the cases. About 60% of the cases were compliant with the drugs. Conclusions: This study had shown that, epidemiological factors play key role in emergence of multi drug resistant tuberculosis and early screening can help in prevention of emergence of multi drug resistant tuberculosis. Keywords: Multi drug resistant tuberculosis, Epidemiology, Symptomatology, Comorbidity, Treatment.

Background: HIV/AIDS is an important public health problem which may also result in respiratory manifestations. The common respiratory manifestations include tuberculosis, bacterial pneumonia, PCP and others. Materials and Methods: A cross sectional study was undertaken in order to study the respiratory manifestations of the HIV/AIDS. A total of 80 patients attending Chest and TB OPD of Basaveshwara Medical College and Hospital were studied in detail about the respiratory manifestations. A thorough clinical history and physical examination was conducted on all the patients including laboratory and radiological investigations. Results: Almost half of the cases were aged between 21 – 30 years and males outnumbered females in this study. Tuberculosis, non-tubercular pneumonitis and Kaposi sarcoma of the lungs was common in patients with CD4 counts of less than 250. The patients with CD4 counts of more than 250 had bacterial pneumonia, pneumocystitis carinii pneumonia, Cryptococcus pneumonia. Streptcoccus pneumonia in patients with CD4 counts less than 250 and Staph aureus was the common agent in patients with CD4 count of more than 250. Conclusion: Prompt recognition of manifestations of chest and prompt treatment in HIV/AIDS patients improves the prognosis of the disease. Keywords: HIV/AIDS, Chest manifestations, Tuberculosis, Pneumonia, CD4 count.