Prahallad Chandra Mishra’s research while affiliated with GSL Medical College & General Hospital and other places

Background: Organophosphate based pesticides are widely used and have emerged as the major contributor to ill health associated with pesticides & is a major global health problem. Despite improvements in intensive care and related disciplines& different modes of treatment, the mortality associated with Organo-Phosphorous insecticide poisoning has not decreased. Knowledge of the socio-demographic profile & the factors which led to poisoning as well as the clinical & biochemical profile, will help in the timely intervention for better prognosis & outcome as well as prevention of such hazards. Objectives: 1. To study the sociodemographic & clinical profile of the patients of organo-phosphorous poisoning, 2. To assess the clinical & biochemical parameters useful in the prognosis of these patients. Materials And Method: Around 240 patients of organophosphorus poisoning who were admitted in G.S.L Medical College & Hospital during January 2010 to January 2011 were examined, investigated & interviewed with the help of a semi structured proforma. Their socio- demographic, clinical & biochemical profiles were studied. Results: Most of the cases were in the young age group of less than 30 years group which is a sensitive age group. Most of them had history of suicide attempt. Majority of the cases were brought to the hospital with the history of consumption of an unknown pesticide. Most of the females presented with severe symptoms. Most of the patients recovered due to timely management. Though the mortality rate was less but the patients who left against medical advice were about 20% which is quite significant. Conclusions: It is suggested to create awareness & educate the people regarding organophosphorus poisoning as it is a public health problem, launch programs to change their attitude towards life, train them regarding the safety profiles of pesticide use and implementation of legislative measures in order to prevent such hazards in future. © 2014 Indian Journal of Public Health Research and Development. All rights reserved.

Background: Biochemical indicators are routinely monitored to enable timely assessment of strategies & management programmes in patient care to check the effectiveness of therapy as well as prevention of dangerous metabolic disturbances. An overview of biochemical pattern of the patients can assist the clinician in making adjustments to clinical management practices Objectives: 1. To study the biochemical pattern of acute & chronic renal failure patients. 2. To compare the pattern of biochemical changes occurring in both the groups. Materials and Method: Around 100 patients of acute renal failure & 100 patients of Chronic Renal Failure who were admitted in the hospital during September 2008 to September 2009 were examined, investigated & interviewed with the help of a pretested proforma. The pattern of biochemical changes occurring in both groups at that time was studied. Results: The renal parameters, electrolytes & bicarbonates were more deranged in ARF whereas in CRF, anaemia, hyperparathormone, hyperphosphatemia, & hyperlipidemia were more seen. Conclusions: It is important to check these parameters regularly in order to prevent the complications arising out of these in order to reduce the mortality. © 2014 Indian Journal of Public Health Research and Development. All rights reserved.

Background: Cardiac changes are very commonly seen in both acute & chronic renal failure. The occurrence of cardiac failure or myocardial infarction prior to starting dialysis is an important prognostic factor. Therefore early detection of these factors are important so that the fatal outcomes of the cardiovascular diseases can be prevented. Objectives: 1. To study the various cardiac changes among the patients with acute & chronic renal failure. 2. To compare the findings among them. Materials and Method: Around 100 patients of acute renal failure & 100 patients of Chronic Renal Failure who were admitted in the hospital during September 2008 to September 2009 were examined, investigated & interviewed with the help of a pretested proforma. The cardiac changes in both groups were studied. Results: Cardiac related complaints & symptoms like puffiness of face, oedema of feet, chest pain, tachycardia, pericarditis, left ventricular hypertrophy etc were seen more among the chronic renal failure than the acute cases, the difference being statistically significant (p<0.001).Many non specific cardiac changes occur in Acute renal failure whereas hypertension & left ventricular failure are more seen in chronic renal failure which can have fatal outcomes. Conclusions: Cardiac changes in renal failure are very common leading to increased fatality among the patients & can be diagnosed early by electrocardiac & echocardigraphic examination. All patients with renal failure should undergo detailed cardiac evaluation as routine procedure to detect & prevent the dreaded cardiac complications.

Background: Diagnosis of organophosphate poisoning is purely clinical, through some biochemical test will help in diagnosis of organophosphate poisoning. There is no specific prognostic predictor in terms of duration of hospital stay and course of recovery. Good prognostic predictor can guide the clinician for further treatment. Objectives: 1. To study the prognostic predictor with special reference to duration of the hospital stay. 2. To predict duration of hospital stay from initial clinical sign and biochemical parameters. Materials and method: Around 240 patients of organophosphate poisoning who were admitted in the critical care unit in the hospital from January 2007 to January 2010 were examined, investigated and interview with help of semi structured proforma. The initial clinical presentation and biochemical parameter were recorded for the study. Result: Patients who presented clinically with severe symptoms at the time of admission, increased leucocytes counts, electrolytes and low serum acetyl choline esterase level, those patients stayed more days in ICU and most of the patients required ventilator supports. Conclusion: It is very important to predict and select the case by detailed clinical history and biochemical examination, so that better treatment and reduction of the mortality can be achieved. © 2014 Indian Journal of Public Health Research and Development. All rights reserved.