Narwane Sandeep Prakash

Abstract

Introduction: The present study was aimed to evaluate the efficacy of new ART treatment as per the recent guidelines in treatment of AIDS patients by NACO on patients’ CD4 count after 6 months of treatment. Materials and Methods: The present study was Descriptive longitudinal type conducted in ART centre of Pravara Rural Hospital, Loni. The demography, Co-morbidities, ART treatment and CD4 count before and after first 6 months of therapy were recorded. Results: In the present study, records of 100 patients were collected. Out of the 100 patients 38 were males, females were 62 and 1 transgender patient. Ninety one out of 100 patients were prescribed Tenofovir + Lamivudine + Efavirenz (TLE). There was a statistically significant increase in the CD4 count before (416.7 ± 322) and after ART treatment at an interval of 6 months (520.89 ± 317). Conclusion: The initiation of ART in patients irrespective of CD4 count has been an improvement in the treatment therapy of HIV infected patients. Keywords: ART, AIDS, HIV infection, CD4 count.

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Introduction: The effect of instructions of negative marking on item analysis during an MCQ examination was studied. Material and Methods: It was an observational type of longitudinal study conducted in MBBS students of second year. The students were given the same MCQ test twice with surprise. There were no instructions regarding negative marking during the first test (T1), whereas instructions were given for the second test (T2). The Raw score, Negative score and Corrected score along with Difficulty and Discrimination index of each MCQ was calculated. Results: There was no statistically significant between the indices when the values of T1 and T2 were compared. There was statistically significant inverse correlation found between the difficulty index and the number of students who did not attempt the respective MCQ (Spearman correlation coefficient= -0.7818). Conclusion: The Difficulty Index and Discrimination Index do not change with Conventional test and test with instructions of negative marking. Thus, these indices form an important tool for MCQs irrespective of the conventional and negative marking. Keywords: Difficulty index, Discrimination index, Multiple choice questions, Negative marking, Surprise test.

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Introduction: The aim of present study was to study the immediate outcome of fibrinolytic therapy, to correlate the time of institution of fibrinolytic therapy with clinical outcomes in patients suffering from Acute Myocardial Infarction in Pravara Rural Hospital, Loni. Material and methods: It was a retrospective study carried out in collaboration with the Department of Medicine, Pravara Rural Hospital, Loni. All complete records of the patients diagnosed with AMI of age 18 & above of both gender and who received fibrinolytic therapy were included in the study. Records of patients with reinfarction, history of renal disorders, congenital cardiac defects, cardiomegaly, and peripheral vascular diseases were excluded. The age, gender, co-morbidities, history of addiction, time to institution of fibrinolytic therapy, immediate clinical outcome, ECG changes was collected from the records. Results: 150 patient’s records were included for the study, of which 122(81.3%) were males and 28(18.6) were females. The average age of patients was 56.95±12 years. The common comorbidities seen in the present study were Diabetes mellitus and Hypertension. Addiction of tobacco chewing, smoking and Alcohol consumption was observed in 67.3% of patients. STEMI was observed in 73.3% of patients, while NSTEMI and other ECG abnormalities were observed in 26.6% of patients. Only 21(14%) patients reported within one hour of complaints, 63 (42%) patients reported after between 1 and 6 hours, while 51(34%) patients reported after 6 hours. There was no correlation found in the time of institution of fibrinolytic therapy and clinical outcome of the patients. Conclusion: Delay in hospitalization of patient of AMI is common. There is a rising trend of AMI seen in the younger age group leading to pre mature death and mortality. AMI was commonly observed in males of middle age group, addiction of tobacco, history of hypertension and diabetes and ECG changes of ST segment elevation. There was no correlation found between the time of institution of fibrinolytic therapy and immediate clinical outcome of the patients. Further studies are required to establish the reasons behind delay in hospitalization of patients. Keywords: Acute Myocardial Infarction, Thrombolytics, Fibrinolytic, Acute coronary syndrome.

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