International Journal of Health and Clinical Research <p style="text-align: justify;">International Journal of Health and Clinical Research (IJHCR) is an open-access; freely accessible, online and print monthly peer-reviewed international journal publishes a wide spectrum of advanced research on all medical specialties including ethical and social issues. IJHCR is a gateway to enlighten the latest research/issues happening all around the world of medical and health sciences.</p> <p style="text-align: justify;">The journal publishes Original research articles in the form of full-length papers or short communications especially those with multidisciplinary nature. The journal welcomes review articles, mini-reviews, case reports, letter to the editor, guest editorial or commentaries.</p> IJHCR Publicaion en-US International Journal of Health and Clinical Research 2590-325X An observational study to evaluate dexmedetomidine and preservative free ketamine for epidural analgesia for lower limb orthopaedics surgery <p>Background: The technique of epidural anesthesia and analgesia have become widespread following their introduction and acceptance by the patients in surgical and obstetric practice. Adjuvants to bupivacaine have been used to enhance good quality perioperative and postoperative anesthesia and analgesia. Aim: The aim of the study is to evaluate the effect of post operative analgesia after epidural dexemedetomidine and preservative free ketamine for lower limb orthopaedics surgery. Method: This prospective, single centre, observational study includes 60 patients of ASA grade 1 and 2 for lower limb orthopaedics surgeries. Each group was given 14 mg 0.5% hyperbaric bupivacaine via spinal anaesthesia. Group A received bolus dose 1 μg/kg dexmedetomidine diluted to 5 mL in normal saline (NS) and Group B received bolus dose 0.5 mg/kg ketamine diluted to 5 mL in NS through epidural catheter. The epidural infusion was started 1 h after starting surgery. Group A received bupivacaine 0.125% with dexmedetomidine (1 μg/mL) and Group B received bupivacaine 0.125% with PF ketamine (0.5 mg/mL). Result: Time of receding of sensory and motor blockade was more with dexmedetomidine than with preservative free ketamine (p&lt;0.05). Also the requirement of rescue analgesia needed is less with dexmedetomidine (2.2±0.52) than with ketamine (3.4 ±0.47) and the difference was statistically significant (P = 0.0001). Conclusion: Dexmeditomedine was to be more effective and superior as compared to preservative free ketamine as an adjuvant to enhance effect of bupivacaine for epidurals.</p> Surendra Raikwar Rajni Thakur Shaifali Khandelwal Shikha Mehrotra Copyright (c) 2022 Surendra Raikwar, Rajni Thakur, Shaifali Khandelwal, Shikha Mehrotra 2022-01-18 2022-01-18 5 3 1 3 Systemic approach in diagnosis of Gall bladder mass by Ultrasonography and Computed tomography and its correlation with Fine needle aspiration cytology <p>Introduction: Carcinoma of gallbladder (GB) is the most common malignant tumor of the biliary tree. It is highly lethal, median survival being six months. Proper evaluation and development of a systemic approach in cross sectional noninvasive imaging play key role in early diagnosis of GB mass. Ultrasonography (USG) is the initial screening tool for suspected GB neoplasms. USG abdomen has certain limitations like interference by bowel gas, limited depth resolution and posterior acoustic shadowing in the presence of calculi. Computed Tomography (CT) scan overcomes these drawbacks. CT provides definitive information regarding locoregional spread, distant metastasis and involvement of the biliary tree and portal vein. Aims and Objectives: Role of USG and CECT in evaluation of gallbladder (GB) masses. Materials and Methods: This study was conducted in the Department of Radio diagnosis in coordination with the surgery and pathology at KIMS Bhubaneshwar. A total of 50 patients with suspected GB masses were included in our study. Result: Maximum no of patients (50%) were in the age group of 61-70 year and female to male ratio was 1.6:1. GBCA was diagnosed in 48 (96%) patients on USG whereas in 49 (98%) patients on CECT. Mass detection as heterogeneous echotexture mostly hypoechoic seen in 39 (78%) patients on USG and heterodense mostly hypodense on CECT in 41 (82%) patients. Mass filling the GB lumen complete or partial was detected in 38(76%) patients on USG and on CECT in 42(84%) patients. Focal wall thickening was detected in 21(42%) patients on USG and 30 (60%) patients on CECT. Diffuse wall thickening of Gall bladder seen in 5 (10%) patients in both USG and CECT. Conclusion: Carcinoma GB is most common in elderly females. GB calculus is an important risk factor for Gall bladder carcinoma. CECT abdomen is superior to USG in characterization of GB masses, dilated CBD, bilobar IHBRD, adjacent bowel invasion and loco regional lymphadenopathy. USG abdomen is better than CECT abdomen in detection of GB calculus and both have similar accuracy in detecting porcelain Gall bladder.</p> Asim Mitra Gitanjali Satpathy Kamal Kumar Sen Sudhansu Sekhar Mohanty Jagadeesh Kuniyil Roopak Dubey Sunny Swaraj Copyright (c) 2022 Asim Mitra, Gitanjali Satpathy, Kamal Kumar Sen, Sudhansu Sekhar Mohanty, Jagadeesh Kuniyil, Roopak Dubey, Sunny Swaraj 2022-01-18 2022-01-18 5 3 4 8 Cutaneous and Ocular Menifestations of Herpes Zoster Opthalmicus: A Hospital Based Study <p>Background: Herpes Zoster Ophthalmicus (HZO) occurs due to reactivation of latent varicella zoster virus within the gasserian ganglion involving the ophthalmic division of the trigeminal nerve. HZO often has a chronic course with significant ocular morbidity as eye is considered potentially serious of all sites of herpes zoster owing to its delicate nature. AIM: A hospital-based epidemiology study to describe skin and ocular changes in herpes zoster ophthalmicus (HZO), its prevalence and risk factors. Material and Methods: A Retrospective analysis of patients seen in the ESICMC,KALABURGI from September 2019 to September 2021 with a clinical diagnosis of HZO. They were subjected to a detailed general and ocular examination and were treated medically with close follow Results: A total 38 patients with HZO were included in the study. Which is 10% of the total cases of herpes zoster. The mean age of onset( 23-80) was 65. Most patients were immune competent (83%) and presented on day 2 day 5 of illness. Male had more prevalence than females . Majority had initial presentation of vesicles, (70)%followed by pain. Eye manifestation was observed in 68% of the individual. Conjunctiva (60%) was the most common ocular structure involved followed by Cornea (45%). Anterior uveitis (20%) was complicated by hemorrhagic uveitis and orbital apex syndrome with total external ophthalmoplegia. Post herpetic neuralgia was the commonest complication seen . Conclusions: This study highlights the prevalence of HZO, presentation,risk factors, course of the disease and its ocular involment. .The potential manifestations of HZO are myriad. Development of serious inflammatory complications was associated with delay in therapy. Hence timely diagnosis and management are critical in limiting ocular morbidity.</p> Jyothi N Sanganal Nagaratna C Manish K Copyright (c) 2022 Jyoti Shukla, Pankaj Sharma, Sangishetti Vijay Prasad, Sumita Sharma, Nita Garg 2022-01-18 2022-01-18 5 3 9 13 Prospective study on effect of obesity on maternal and fetal outcomes in obese pregnant women <p>Objectives: To analyse adverse maternal and fetal outcomes in obese pregnant women. Materials and Methods: This study was conducted in department of OBG, Government general hospital, Anantapur. 211 pre pregnant obese women and 211 non obese pregnant women were enrolled as study population and controls respectively. Results: Obese pregnant women were at increased risk of gestational diabetes mellitus, pregnancy induced hypertension, preeclampsia, preterm labour, cesarean section, instrumental deliveries, postpartum infection morbidities when compared to non–pregnant women. Large for gestational age, macrosomia, birth injuries, shoulder dystocia, premature deliveries, late fetal deaths and congenital malformations were more common in new borns of obese pregnant women than in non–pregnant obese women. Conclusion: Obesity is a modifiable risk factor. Preconception counseling and creating awareness regarding health risks associated with overweight and obesity should be encouraged.</p> Chinta Aruna Jyothi S. Nissar Begum P. Pavani Copyright (c) 2022 Chinta Aruna Jyothi, S. Nissar Begum, P. Pavani 2022-01-18 2022-01-18 5 3 Effectiveness of intravenous ferric carboxy maltose(FCM ) in improving hemoglobin level amongst postpartum women with moderate to severe anemia in a tertiary care hospital <p>Background: Postpartum Anemia (PPA)has been defined as hemoglobin(Hb)of &lt;10 gm% during the postpartum period. The most common cause of anaemia in the world is iron deficiency. Each ml of blood loss results in loss of 0.5 mg iron. Because FCM has a neutral pH and physiological similarity, it can be given in high doses over a short period of time with minimal danger of hypersensitive reactions, and no test dosage is necessary. The safety and efficacy of IV FCM in the treatment of postpartum iron deficient anaemia are assessed in this study. Aims &amp; objectives: Present study was done to estimate the changes in Hb level 6 weeks after IV FCM administration in postpartum women with Hb level of 5–9 g/dl who delivered at our tertiary care institute. Materials &amp; methods: This was a prospective observational study conducted at MGMMC &amp; MY Hospital Indore's Department of Obstetrics and Gynecology (MP).Study was conducted after taking ethical clearance. Total 100 patients were included in present study. Patients received single dose of 1 gm IV FCM. Hb, PCV, RBC indices, Serum ferritin and reticulocyte count were reassessed on day 42 of the treatment. The data was analysed statistically. A p value of&lt; 0.05 was considered significant for all statistical purposes. Results: In this study most common age group was 21-25 years(47%),patients with parity 2 were most common (39%).(53%)study patients had vaginal delivery,(42%)had Caesarean delivery &amp; (5%) had instrumental delivery. Statistically significant difference was noted between baseline &amp; day 42 values of Hb, Serum ferritin, &amp; RBC indices. Conclusion: Administration of single dose of IV FCM offers a promising treatment for pregnant women with moderate to severe iron defeciency anemia.</p> Sumitra Yadav Surabhi Porwal Namrata Pandey Copyright (c) 2022 Sumitra Yadav, Surabhi Porwal, Namrata Pandey 2022-01-18 2022-01-18 5 3 17 20 Effectiveness and safety of topical 1% terbinafine versus topical 2% sertaconazole in patients with tinea cruris: A randomized controlled trial <p>Introduction: we compare the efficacy of topical terbinafine hydrochloride 1%, a fungicidal agent and sertaconazole nitrate 2% cream, a fungistatic agent in localized tinea corporis and tinea cruris and to study the adverse effects of these antifungal creams. Materials and Methods: 80 treatment naive individuals with tinea cruris were randomized into two groups of 30 each of 1:1 ratio using computer random sequence generator (www.randomization. com) to receive either topical terbinafine applied twice daily or topical sertaconazole once daily for a period of 4 weeks. The study pro forma included demographic details of patient, concomitant drugs taken, medical history, and physical and clinical examination which record vitals of patients. Results: At the baseline, composite score of all clinical symptoms was 5.11 ± 1.06 in the terbinafine group and 5.61 ± 1.15 in the sertaconazole group which was matched (P = 0.85). At the end of treatment (4 weeks), total composite score was 0.09 ± 0.21 in the terbinafine group and 0.04 ± 0.19 in the sertaconazole group which showed statistical significance (P &lt; 0.001). Table 2 shows intragroup comparison of mean scores of two groups. Conclusion: Terbinafine was equal in efficacy and safety to newer azole – sertaconazole in treating patients with tinea cruris.</p> Sundiep Kumar Jaishree Noor Vijay Prakash Gupta Copyright (c) 2022 Sundiep Kumar, Jaishree Noor, Vijay Prakash Gupta 2022-01-18 2022-01-18 5 3 21 23 Post COVID manifestations and Quality of life in COVID victims: A cross sectional study <p>Background: COVID -19 pandemic had affected majority of the population across the world. Majority of the cases still complaining of post COVID symptoms. This study was undertaken to study the pattern of post COVID – 19 manifestations in this region in a group of patients attending hospital. Material and methods: An observational study was undertaken in a group of 150 patients attending a tertiary care hospital. The patients were subjected for a detailed history and thorough physical examination and the details were entered in to a proforma. The data thus obtained was compiled and analysed. Results: This study had shown than majority of cases were aged more than 50 years and most of them were females. The common post COVID – 19 manifestations included joint pain, continued loss of taste and smell, dyspnoea, Anxiety/ depression and sleep disturbances in this study. Conclusions: This study had observed continued symptoms from the episode of disease varying from mild to severe manifestations. This study urges for a comprehensive rehabilitation program for all COVID – 19 patients.</p> Suhail Bin Ahmed Anjum Sultana Khatoon Copyright (c) 2022 Suhail Bin Ahmed, Anjum Sultana Khatoon 2022-01-18 2022-01-18 5 3 24 25 A study on treatment profile and covariates of outcome of burn injury in a Tertiary Medical hospital in West Bengal <p>Background: Burns are a global public health problem due to its high mortality, morbidity and disability amongst young and middle-aged adults. Objective: The study was planned to understand of relevant underlying factors responsible for burn injuries, the treatment profile and covariates of outcome of burn injury. Method: A cross-sectional design and hospital based study was undertaken in the burn wards under the Department of Plastic Surgery in a tertiary care government hospital over a period of one year from 1st May 2020 to 30th April 2021 on patients of recent burn injuries. Data entry and statistical analysis were done using SPSS version 20.0. Descriptive statistics (frequency, percentage, mean and standard deviation) were used primarily to summarize and for analytical statistics, Chi-square was used. Univariate and multivariate logistic regression were applied and Odd’s ratio(OR) and adjusted Odd’s ratio (AOR) were calculated in 95 % confidence interval. Result: Only 22.8% patients reached hospital within 1 hour of the injury event. Application of medical ointment over the burnt skin surface was done for around one fourth (23.6%) of the study population prior to reach hospital. Mean duration of hospital stay was 40.5 days which ranged from less than 1 day to maximum 196 days. Wound infection (44.7%) followed by septicaemia (33.7%) were the two most common complications prevalent among the study population. Pseudomonas aeruginosa (38.3%) was the most common organism responsible for wound infection. Conclusion: The current study also found very poor outcome related to burn injuries in terms of survival (mortality rate: 39.5%), which is not related to the severity of injury only but others factors like delaying in hospitalisation, improper pre-hospital burn care is also responsible for high fatal outcome associated with burn injury.</p> Rahul Biswas Saikat Bhattacharya Soumitra Mondal Shibasish Banerjee Copyright (c) 2022 Rahul Biswas, Saikat Bhattacharya, Soumitra Mondal, Shibasish Banerjee 2022-01-18 2022-01-18 5 3 26 30 Clinico-epidemiological profile of sexually transmitted infections in patients attending a tertiary health care hospital in southern Himachal Pradesh: A retrospective study <p>Introduction: Sexually transmitted infections (STIs) are a public health problem and are a burden to the individual, his family and community. The prevalence of STIs is very high in developing nations including India and varies widely across different regions. There is enormous need to study the pattern of STIs in various regions of country for implementation of control strategies. Aims: To estimate the prevalence and to study the clinico-epidemiological profile and trends of sexually transmitted infections in patients attending the STI clinic of a tertiary care hospital in southern Himachal Pradesh. Material and methods: Records of patients attending the STI clinic during last two years i e from January 2019 to December 2020 was retrieved and analysed retrospectively. Results: Vulvovaginal candidiasis was the most common (non viral) STI seen in 624(39.3%) patients. While genital warts (8.7%), molluscum contagiosum (8.2%) and herpes genitalis (7.2%) were the common viral STIs. Bacterial STIs like gonococcal urithritis(7.9%), chancroid (6.6%), bacterial vaginosis (6.3%), non gonococcal urithritis (3.9%), lymphogranuloma venereum (LGV) (3.6%) and non gonococcal cervicitis (3%) were not uncommon. Rapid plasma regain test (RPR) was found to be reactive in 24(1.5%) patients, out of which, 14(0.9%) were males and 10(0.6%) were females. HIV seropositivity was seen in 2(0.2%) patients and both of them were males. Conclusion: Fungal STI was more common as compared to viral STIs. Trend for viral STIs is increasing and that for bacterial STIs is declining among STI clinic attendees, which is consistent with other studies from different regions.</p> Meena Chauhan Renu Rattan Ghanshyam Kumar Verma Copyright (c) 2022 Meena Chauhan, Renu Rattan, Ghanshyam Kumar Verma 2022-01-18 2022-01-18 5 3 31 33 In vitro antifungal susceptibility testing of ocular filamentous fungal pathogens isolated from keratitis cases <p>Background: A variety of fungal species are known to cause keratitis. Filamentous fungi are often predominant cause of keratitis. As fungi belonging to different group usually differ in their pattern of susceptibility to antifungal agents commonly prescribed for mycotic keratitis, in vitro susceptibility testing usually guide ophthalmologists for selection of most appropriate agent from available antifungal armamentarium. The present study was conducted in a tertiary care teaching hospital with an aim to study antifungal susceptibility profile of ocular filamentous fungi. Material and Methods: Filamentous fungi were identified on the basis of macroscopic features of colony and microscopic characteristics. Antifungal susceptibility was performed exactly as per the methodology outlined in the Clinical and Laboratory Standards Institute (CLSI) M38-A2 document for antifungal susceptibility testing of filamentous fungi. Results: Among fungal isolates, 72 (77.4%) isolates were filamentous fungi whereas 21(22.6%) were yeasts. Fusarium spp. (43.1%) and Aspergillus spp. (29.2%) were common filamentous fungi isolated from keratitis cases. All filamentous fungi isolated from keratitis cases were susceptible to amphotericin B. Aspergillus spp. and Bipolaris spp. were resistant to natamycin. Conclusion: As inter and/or intra species variation in susceptibility to commonly used antifungal drugs do occur in ocular filamentous fungal pathogens, the present study highlights the importance of antifungal susceptibility testing of each and every isolate from mycotic keratitis cases.</p> Prachi Sudhir Dubal Jyoti Anil Iravane Ajit Shriram Damle Copyright (c) 2022 Prachi Sudhir Dubal, Jyoti Anil Iravane, Ajit Shriram Damle 2022-01-18 2022-01-18 5 3 34 37 Effect of yogic intervention on urinary melondialdehyde levels, autonomic functions and quality of life among buffing polishing workers of an automobile industry <p>Background: Oxidative stress at industry setting poses a threat to autonomic functions and quality of life deterioration of the workers in automobile industry. Yogic intervention may improve the stress levels and autonomic functions thereby improves their quality of life. Aims and Objectives: This study was aimed to see the effect of 12 weeks of yogic regimen on urinary melondialdehyde levels (MDA), autonomic functions and quality of life in workers exposed to buffing polishing work in an automobile industry. Materials and Methods: 35 male subjects of age group 25-40 years working on buffing polishing machine for 4-6 hours/day, 6 days in a week for the last 2 years were selected as subjects from an automobile industry. Same number of age and sex matched controls not involved in buffing polishing work were also selected from the same socioeconomic background. Urinary MDA levels, autonomic functions and health related quality of life parameters were recorded before and after 12 weeks of practicing yogic regimen. All the parameters were analyzed intergroup as well as intra-group by 2 way ANOVA followed by the Tukey’s Test. Results: Significant improvement was found in MDA levels, weight, BMI, E:I ratio &amp; cold pressor test of autonomic function tests and all the physical and psychological domains of quality of life after practicing 12 weeks of yoga regimen. Conclusions: Integrated yogic regimen in buffing polishing workers can improve stress markers thereby improving their autonomic functions and health related quality of life. Thus yoga and pranayama can be encouraged and incorporated as a part of their routine schedule.</p> Ankur Sethi Asha Yadav Nilima Shankar Copyright (c) 2022 Ankur Sethi, Asha Yadav, Nilima Shankar 2022-01-18 2022-01-18 5 3 38 43 An Observational Study to Compare Interval Cholecystectomy And Early Cholecystectomy Among Patients Of Acute Cholecystitis At A Tertiary Care Centre In Bihar <p>Introduction: Cholecystectomy is the treatment of choice for patients with acute cholecystitis. If the surgery is performed within 2-3 days of presentation of patient with symptoms of acute inflammation, it is called as early cholecystectomy. With this background, this study was planned and conducted to generate evidences by comparing outcomes of patients undergoing interval and early cholecystectomy at a tertiary medical college of Bihar. Methodology: An observational prospective study was conducted by Department of General surgery, Madhubani Medical College &amp; Hospital, Bihar, India. Prior clearance was obtained from the Institutional Ethics Committee. All patients presenting with features suggestive of acute cholecystitis in surgical OPD or emergency during the study duration of 12 months from January 2021 to December 2021 were considered for inclusion in the study. Result: Out of 100 patients were recruited for the study, 50 cases in each group. Group 2 patients were investigated afresh for the subsequent operative intervention. The mean age of the patients was 46.1 ± 9.3 years and 49.3 ± 12.4 years in groups 1 and 2, respectively. There was a female predominance observed in both the groups. Wound infection was noted in 10% patients of group 1 and 12% patients of group 2. Biliary leak was found in 19% patients of group 1 and 23% patients of group 2. Mean hospital stay was 8.2 ± 2.2days and 10.2 ± 5.4days in group 1 and 2, respectively. Conclusion: So early surgery is found to be more economical than delayed surgery in acute cholecystitis if the diagnosis could be confirmed in proper time.</p> Pavan Kumar Vishwa Prakash Jha Mohammed Tarique Copyright (c) 2022 Pavan Kumar, Vishwa Prakash Jha, Mohammed Tarique 2022-01-18 2022-01-18 5 3 44 46 Descriptive Study of the Clinico Etiological Patterns of Stasis Dermatitis in Railway Employees Attending Tertiary Care Hospital <p>Background: Stasis dermatitis is a common chronic inflammatory disease of skin that occurs on the lower extremities due to chronic venous insufficiency and may be a precursor to various skin changes like eczema, venous ulceration and rarely lipodermatosclerosis. This study was done in exclusively railway workers whose occupation demands prolonged standing/sitting/actively moving to assess the clinico-etiological patterns and evaluate the demographic profile of Stasis dermatitis. Objective: To assess Clinico etiological patterns and demographic profile of stasis dermatitis. Materials and Methods: This is an Prospective observational study conducted in Tertiary care hospital for duration of six months. First 100 patients attending Dermatology outpatient department of age more than 20years with clinical features of stasis dermatitis are selected for the study. Results: Among 100 patients, 79(79%) were male and 21(21%) were female patients with male-to-female ratio of 4: 1 and mean age of incidence was found to be 40 years. The most common risk factor was found to be prolonged standing (76%) and most of the patients had complaints of itching (90%). Perforator vein incompetence was found in 36 % of patients. Conclusion: Our study highlights the significant association between venous skin changes and various risk factors. The present study proves the importance of other risk factors like prolonged standing, obesity in producing varicosities, eczematous skin changes. Many patients with chronic venous insufficiency present to dermatology department very late with skin changes of lipodermatosclerosis and venous ulcer. Hence, to identify the high-risk patients at very starting stage is important to avoid disease complications.</p> Praveen Kumar Boppani Nanisetty Ramesh Aruna Samarth Meera B Copyright (c) 2022 Praveen Kumar Boppani, Nanisetty Ramesh, Aruna Samarth, Meera B 2022-01-18 2022-01-18 5 3 47 50 A Study On Urinary Tract Infections Among Pregnant Women Attending Antenatal Clinic Of A Tertiary Care Center Of Bihar <p>Introduction: UTI has been reported among 20% of the pregnant women and it is the most common cause of admission in obstetrical wards. Urinary tract infection in pregnancy is associated with significant morbidity for both mother and baby. The combination of mechanical, hormonal and physiologic changes during pregnancy contributes to significant changes in the urinary tract, which has a profound impact on the acquisition and natural history of bacteriuria during pregnancy. Methodology: This study was carried out in the Dept. of Microbiology, Shri Krishna Medical College &amp; Hospital, Muzaffarpur, Bihar. Prior ethical approval was obtained from the Institutional Ethics Committee. The urinary pathogens and their antibiotic susceptibility patterns from December 2020 to November 2021 were recorded for this study. Clean catch midstream urine sample was collected in sterile container from pregnant women from the antenatal clinic. Bacterial identification was done by colony morphology, Gram staining and standard biochemical tests. Antibiotic susceptibility testing was done by Kirby Bauer disk diffusion method as per CLSI guidelines. Descriptive statistics was used to analyze the data and results expressed as percentages. Results: A total of 240 urine samples were received from pregnant women and processed in Microbiology laboratory during the study period. Among 240 samples, 95 (39.6%) samples yielded significant bacterial growth. E.coli was isolated as predominant pathogen followed by Staphylococcus aureus. Only 29 (10.1%) isolates of E.coli were sensitive to ampicillin and 14 (73.7 %) were sensitive to nitrofurantoin. Conclusion: All pregnant women should be screened for UTI with a urine culture and treated with antibiotics if the culture is positive. The early diagnosis and treatment of UTI during pregnancy can prevent complications to the mother and the fetus.</p> Arunima Chandan Kumar Poonam Kumari Ranjit Kumar Copyright (c) 2022 Arunima, Chandan Kumar, Poonam Kumari, Ranjit Kumar 2022-01-18 2022-01-18 5 3 51 53 To study incidence of various conventional parameters in TMT (Chiefly ST depression)To study incidence of various conventional parameters in TMT (Chiefly ST depression) <p>Background&amp;Method: The study was done on 50 adult patients with evidence of ischaemic heart disease presenting with stable angina or with angina of effort.A preliminary consultation and a clinical evaluation were done to select the cases with special attention to drug therapy. The patient was briefed about the procedure. They were given specific instructions and asked to come on the appointment date patients were called in a fasting state (light snacks about 3 hours before the test) and without consumption of any drug. Result: Taking the ate offset as 8 mts post exercise the number of cases with early onset late offset ST segment depression was 54 per cent. In the analysis of the post exercise phase 56 per cent cases had ST segment depression persisting to beyond 8 minutes in the post exercise phase of which 16 per cent went beyond 15 minutes and 8 per cent beyond 20 minutes. The offset time varied from 1 minute post exercise to 24 minutes (mean 9.14mts±5.49 mts). The ST segment depression disappeared within 8 minutes in 28 per cent cases while the offset was 8 minutes in 16 per cent cases. In 90 per cent cases, the offset time was more was more 3 mts while in 42 per cent cases the offset time was more than 9 minutes. Conclusion: Magnitude of ST segment depression more than 2 mm 80 msec after J point has a high degree of sensitivity for detecting CAD but could not classify a patient as one having severe CAD. Onset time of ST segment depression can be influenced by many factors and is thus not a useful parameter. Offset time of ST segment depression with cut off limits at 3 mts and 6 mts is a good parameter for diagnosing MVD. ST index and ST integral are very good parameters for the detection of CAD, absolute values do not correlate with severity of CAD.</p> Ashok Thakur Puneet Goyal Copyright (c) 2022 Ashok Thakur, Puneet Goyal 2022-01-18 2022-01-18 5 3 54 56 Perinatal and maternal outcome in post-dated pregnancy: A retrospective study <p>Background: Prolonged pregnancy or post-dated pregnancy is that pregnancy which has exceeded duration considered to be upper limit of normal pregnancy that is above 40 completed weeks or 280 days from the first day of last menstrual period. The objective was to evaluate the maternal and perinatal outcome of post-dated pregnancy. Materials and method: This is a retrospective observational study done in 1ST Jan 2020 and to 31st December 2020 in the Department of Obstetrics and Gynaecology in Mahatma Gandhi Medical College ,Indore. In this study, data was collected retrospectively from hospital records and we tried to find out the incidence of post dated pregnancy (pregnancies beyond 40 weeks) and it’s maternal and fetal outcome. Results: In the present study, total of 9167 cases were studied out of which 760 cases were post dated pregnancies. The incidence of post dated pregnancy was 8.29%. PRIMIs were more prone for post dated pregnancies according to our study. Foetal distress and meconium release occurred more commonly in postdated pregnancy. There was a progressive decrease in the amniotic fluid volume after 40 weeks. Rate of LSCS was higher that is 39%. Common indications being foetal distress, failure of induction, non-progress of labour thick the perinatal outcome 25% of neonate require NICU admission with complications like birth asphyxia, transient tachynea of newborn, sepsis. Conclusion: Postdated pregnancy is associated with both, maternal and foetal complications. Timing of induction has to be decided carefully, as early induction leads to failure and increased rates of LSCS, while late induction leads to increased foetal complications. Maternal and fetal morbidity and mortality can be reduced by electively inducing pregnant women at 40+0 weeks as allowing them to continue beyond this gestational age has shown adverse feto-maternal outcomes</p> Mohini Rajoriya Ayushi Bhardwaj Sanju Agarwal Copyright (c) 2022 Mohini Rajoriya, Ayushi Bhardwaj, Sanju Agarwal 2022-01-18 2022-01-18 5 3 57 60 To find out various pre-disposing conditions and clinical presentations amongst patients attending cardiology/ medicine <p>Background &amp; Method: This study was conducted with an aim to find out various pre-disposing conditions and clinical presentations amongst patients attending cardiology/ medicine with nonvalvular atrial fibrillation in the setting of a tertiary level university teaching hospital the MGM Medical College &amp; Maharaja Yeshwant Rao Hospital in Indore, M.P. The study database was accumulated by prospectively registering patients presenting to the outpatient department of the Department of Medicine, the Cardiology Clinic and the ICCU of the hospital with a diagnosis of atrial fibrillation, either chronic or paroxysmal. Result: In our study majority of the patients presented with heart failure (51%) followed by myocardial infarction (11%), and cerebrovascular accidents (9%). There were 3 patients presented with fast ventricular response, 2 patients had acute chest infection and 2 patients had syncopal attacks. One patient presented with bleeding due to warfarin overdose and one with peripheral embolism. 12% of patients were symptomatic during presentation. Other presentations are Infective endocarditis, Ventricular tachycardia, acute febrile illness, diabetes, Koch’s abdomen, aluminum phosphide poisoning and upper respiratory tract infection. Conclusion: To conclude, we found that majority of the patients with AF in the central Indian population presented with heart failure. Other major clinical presentations were myocardial infarction and cerebrovascular accidents. We found that valvular heart disease mainly the mitral valvular involvement as the most common pre-disposing condition for atrial fibrillation in this part of the country. Other co morbidities were heart failure and hypertension which was consistent with the global data.</p> Puneet Goyal Ashok Thakur Copyright (c) 2022 Puneet Goyal, Ashok Thakur 2022-01-18 2022-01-18 5 3 61 63 A study to evaluate the efficacy of left lateral tilt in preventing hypotension after spinal anesthesia in elective caeserian section patients <p>Introduction: During caesarean delivery, post-spinal hypotension is a typical complication among women. Post-spinal hypotension is thought to be caused by Aortocaval compression caused by the fetus. It's unknown whether left lateral tilting improves maternal cardiac output following “subarachnoid block (SAB)”. The goal of this study is to see the efficacy of the left lateral tilting in preventing hypotension after spinal anesthesia in elective C- section patients . Material and Methods: We piloted a prospective study with 50 age matched subjects admitted for the C-section. The clinical findings like systemic vascular resistance, stroke volume, cardiac output, heart rate and Mean arterial pressure that are affected at the various lateral tilts of (30º,15º) were compared to supine position. The values were collected preoperatively, after the SAB and after the delivery. The data was analyzed using the ANOVA test deliberating P&lt;0.05 as significant. Results: We observed no significant difference in the cardiac parameters before the surgery between the supine and for the lateral tilt angles of 15 and 30 degrees. However after the anesthesia significant variation of the cardiac parameters was noted in the supine position than supine position before the SAB. While after the SAB in the lateral tilt the MAP, Cardiac output, and Stroke volume were significantly greater compared to the supine position at both the angles of the left tilts. There was no difference in the values between the two tilt positions. After the delivery MAP, Cardiac output, and Stroke volume significantly increased in the supine position while the heart rate lowered significantly compared to the supine position after the SAB. Conclusions: The hypotension commonly seen among the pregnant women after the SAB can be prevented by the lateral tilt positions at both the 150 and 300 angles. Hence this position is encouraged for the after the C-section.</p> Shrinivas T R Liyakhath Ali Gopal V Gotur Copyright (c) 2022 Shrinivas T R, Liyakhath Ali, Gopal V Gotur 2022-01-18 2022-01-18 5 3 63 66 Percutaneous pinning for non-comminuted extraarticular fractures of distal radius <p>Background: Displaced Colles' fractures are treated by manipulation and below elbow cast application. Fracture stabilization by percutaneous pinning is a simple, minimally invasive technique that helps prevent displacement of the fracture, thereby minimizing complications. Various treatment modalities have been described for the treatment of extra-articular distal radius fractures each with its own merits and demerits. Our technique involves percutaneous pinning of the fracture and immobilization in neutral position of the wrist for three weeks. This study’s aim was to examine the functional outcome of percutaneous K-wiring of these extra-articular distal radius fractures with immobilization in neutral position of the wrist. Method: This is a prospective study of 28 patients aged between 20 and 60 years with extra-articular distal radius fracture. Patients were treated with closed reduction and percutaneous pinning using two or three K-wires. A below- elbow plaster of paris dorsoradial slab was applied in neutral position of the wrist for 4 weeks. At the end of 4weeks, the slab was removed and wrist physiotherapy started. The radiographs were taken postoperatively, at 4 weeks, 6 weeks. Results: Excellent to good results were seen in 93.75% of the cases while 6.25% had fair results. The complications observed were pin loosening (n=6), pin tract infection (n=1), malunion (n=1), wrist joint stiffness (n=1), reduced grip strength (n=1). Conclusions: Displaced extraarticular distal end radius fractures should be reduced and stabilized with percutaneous K-wires to achieve an excellent functional outcome.</p> Surendra Singh Yadav Vivek Kumar Gupta Rohit Ajmeria Copyright (c) 2022 Surendra Singh Yadav, Vivek Kumar Gupta, Rohit Ajmeria 2022-01-18 2022-01-18 5 3 67 71 Effect of covid-19 on routine general dental practice- A questionnaire based survey <p>Background: Many dental clinics have closed due to the extremely contagious characteristics of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), as well as the fact that dental operations frequently generate blood and saliva droplets that could spread the virus. Aim: The goal of this study was to assess the influence of the coronavirus disease 2019 (COVID-19) pandemic on dental practise by conducting an online survey of dental professionals and learning about their thoughts on the topic. Methods and Materials: The information in this study is based on a survey of dentists. The dentists' thoughts and attitudes concerning the COVID-19 epidemic, as well as its impact on their personal lives, financial situation, and the quality of dental services provided to patients, were evaluated in the survey. Results: This research involved 240 dentists (214 general dentists and 26 specialists). During the pandemic, the majority of the volunteers (n = 170, or 70%) did not perform non-emergency procedures. Reduced treatment sessions (n = 90, 37 percent), careful triage of patients (n = 156, 64 percent), and the use of personal protective equipment (n = 108, 45 percent) are among the solutions advised by dental practitioners to reduce the risk of infection. During the pandemic, however, the majority of dentists (n = 210, or 87 percent) had difficulty supplying personal protective equipment. Furthermore, 97 percent (n = 234) of the participants stated that their financial income has decreased since the outbreak of the pandemic. Conclusion: COVID-19 infection is most common among dental health care workers. As a result, dental practitioners should follow normal measures with greater caution during the pandemic. To lessen the danger of COVID-19 transmission, they could shorten their work hours and limit dental procedures to emergency treatments. Furthermore, to reduce the danger of infection, public entities should offer suitable equipment for dental practitioners.</p> Shiras Singh Dheer Copyright (c) 2022 Shiras Singh Dheer 2022-01-18 2022-01-18 5 3 72 77 To study the effect of topical Mitomycin C as an adjunct in ocular surface squamous neoplasia <p>Background: Ocular surface squamous neoplasia (OSSN) in a broader terminology newly introduced in the field of ophthalmology that includes conjunctival malignancies which ranges from mild epithelial dysplasia to invasive squamous cell carcinoma. The routinely used topical<br>chemotherapy for OSSN is mitomycin C (MMC), 5‑fluorouracil, interferon‑alpha, and cidofovir, and among these, MMC is usually preferred by most of the ophthalmologists because of its cost-effectiveness and lesser side effects. Aim: The aim of study was to evaluate the role of MMC as an adjuvant therapy in the management of OSSN. Methodology: Patients in the age group of 40 years and above with a diagnosis of OSSN were included as our study subjects. The diagnosis of OSSN was made based on the clinical presentation. A total of 20 patients with OSSN were taken as our study subjects. The tumor was surgically removed<br>in toto along with 3–4 mm of uninvolved conjunctiva. Further, 0.4 mg/ml of MMC was applied over the excised site. Postoperatively, 0.04% MMC eye drops were given for 2 weeks with a dosage of 4 times/day. Results: Postoperatively, only single patient (4%) had recurrence which had developed after 6 months.. Other postoperative complications that had occurred were one patient had allergic conjunctivitis and the other patient had punctate erosion. Rest all patients were have no symptoms after the procedure and application of MMC. Conclusion: The topical use of MMC eye drop in the concentration of 0.04% has shown superior clinical results without any side effects and with a very few recurrence rate during the follow-up period of 1 year.</p> Arjumand Nazir Asma Jabeen Anureet Kaur Copyright (c) 2022 Arjumand Nazir, Asma Jabeen, Anureet Kaur 2022-01-18 2022-01-18 5 3 78 80 Study on diagnostic accuracy of fine needle aspiration cytology in different breast lesion and histopathological correlation <p>Introduction -FNAC is being performed as a pre-operative test to evaluate breast lump. FNAC is cost effective and can prevent unnecessary surgery. As FNAC became more reliable in diagnosing malignancy .Confirmation of breast diseases by clinical examination and pathological confirmation by fine needle aspiration cytology (FNAC) and histopathologic examination has been found to be an important part of diagnostic workup in breast diseases. Material and method-A retrospective study done on119 cases presented with history of palpable breast lumpduringNovember 2019 to October 2020 in department of pathology Government Medical College Shivpuri, India. All female patients were included of age 11-70 year, irrespective of their, religion, marital status, occupation or social status. Every patient underwent a FNAC done on OPD basis by a trained pathologist from the Pathology Department, histopathology was available in 54 cases for correlation with cytology. Result- Results of all patients were collected and tabulated. Statistical analysis was performed on the tabulated data and sensitivity and specificity with positive and negative predictive value were obtained. Maximum cases(54.1%)of benign lesion as fibroadenoma were diagnosed in age group of 21-30 years and malignant cases (80%) were diagnosed 51-60 years. The sensitivity and specificity and diagnostic accuracy for malignancy were found to be 95%,97% And 94.5%, respectively. Conclusion- FNAC serves as a rapid, economical, and reliable tool for the diagnosis of palpable breast lesions because the cytopathological examination of these lesions before operation or treatment, serves as an important diagnostic tool. Most common breast lesion in this study is fibroadenoma.</p> Hemlata Bamoriya Parul Nema Vishnu Gupta Copyright (c) 2022 Hemlata Bamoriya, Parul Nema, Vishnu Gupta 2022-01-18 2022-01-18 5 3 81 88 Prevalence and determinants of frozen shoulder in patients with diabetes: An original research <p>Introduction: Adhesive capsulitis is a group of symptoms involving the glenohumeral joint which is a musculoskeletal problem that can affect the diabetics. The goal of this study is to determine the prevalence of FS and compare the disease's factors in a diabetic community. Materials and Methods: We piloted an observational cross-sectional study among 100 diabetics of both genders. The study was done for a period of 2 years, at a territary care center. We designed a questionnaire that collected the patients’ responses. These questions were formulated considering the important factors that may cause the Adhesive capsulitis among diabetics with an increased rate. Results: We observed that nearly 40% of the subject complained of the Adhesive capsulitis. The prevalence was at the department was 52.1%. The factors that were that were seen more associated among these cases of the Adhesive capsulitis were positive family history, uncontrolled blood glucose, insulin dependence and females. Greater number of the subjects had unilateral Adhesive capsulitis and was at stage 1 for the Adhesive capsulitis. Conclusion: Within the limitations of our study we observed a greater incidence of the Adhesive capsulitis among diabetics. This greater occurrence may be attributed to the poor glycemic control, lack of facilities, awareness, socio economic levels. Awareness camps are suggested to create education about these conditions targeting the female diabetics. Early intervention may alter the disease course and may favor a good prognosis. Further studies are suggested to find association of the diabetes and the Adhesive capsulitis.</p> Bijoy Chirayath Manesh Kumar Joy Dennis Joseph Suchita Chandrabhan Dake Mylesh Ravisankar Dakshinamurthy Parvesh Kaliramna Rahul VC Tiwari Copyright (c) 2022 Bijoy Chirayath, Manesh Kumar, Joy Dennis Joseph, Suchita Chandrabhan Dake, Mylesh Ravisankar Dakshinamurthy, Parvesh Kaliramna, Rahul VC Tiwari 2022-01-18 2022-01-18 5 3 89 91 Anterolateral surgical approach for the treatment of humeral shaft fractures <p>Background: The posterior approach is the most commonly used approach for mid-shaft and distal humeral fractures. However, fixation via the posterior approach is associated with iatrogenic radial nerve palsy. The purpose of this study was to evaluate the functional outcomes of shaft humerus fracture plating with anterolateral approach. Material and Methods: The present retrospective study was conducted in the Department of Orthopaedics, PGIMS Rohtak and included 20 cases aged between 20-70 years, who were operated for shaft humerus fractures over last 3 years with plating by anterolateral approach. Results: The mean age was 42.65±12.42 with a range of 20-70 years. Mean time of fracture union was 15.65±1.82 weeks. Range of motion at elbow at final follow up was 120±15.46 degrees. 1 patient had superficial infection which was managed with intravenous antibiotics. One case of non-union with implant failure was noted in this study which was further managed by replating and bone grafting. No case of neurovascular injury post injury was reported in the present study. The mean MEPS score was 88.45±8.18. Conclusion: We conclude that anterolateral approach is a good approach for the treatment of humeral shaft fractures with a lower complication rate and better functional outcomes.</p> Abhishek Garg Umesh Yadav Anand Gupta Rahul Sharma Nishan Yadav Puneet Yadav Copyright (c) 2022 Abhishek Garg, Umesh Yadav, Anand Gupta, Rahul Sharma, Nishan Yadav, Puneet Yadav 2022-01-18 2022-01-18 5 3 92 94 Lymph node FNA cytology reporting using new proposed IAC sydney system for reporting lymph node cytology- A single institution retrospective study <p>Introduction: Lymph node enlargement is a common clinical finding in a wide spectrum of diseases and its evaluation is essential for proper patient care. Fine needle aspiration cytology has been used as an initial diagnostic method in such conditions especially for infective conditions and also to differentiate between benign and malignant lesions. A standardized category based cytology reporting system was proposed by IAC in 2019 which gives 5 categories of cytological diagnosis and also provides management category for each class. Aim and Objectives: The present study aims to analyze and classify lymph node samples as per new proposed Sydney system and also to assess the risk of malignancy of each category. Material and Methods: This single institution retrospective study included lymph node FNAC cases over 5 year duration. Clinical details of all included cases were recorded. Cytology aspirate slides were reevaluated as per new reporting system. Histopathology correlation was done in cases where possible. Statistical analysis was done. Results: 1409 lymph node aspirates were evaluated with cases having slight male predominance and average age of 31.24 years. Benign category diagnosis was most common. Overall the most common diagnosis was reactive hyperplasia of lymph node. Metastatic squamous cell carcinoma was most common malignant diagnosis. Risk of malignancy calculated after histopathological correlation was highest in malignant category where it was 96.7%. Diagnostic accuracy of the new system in current study was 94.16%. Conclusion: Using standard categorical cytology reporting system will allow improved reports and clinical communication for better patient care.</p> Ashish Joshee Rajni Joshee Copyright (c) 2022 Ashish Joshee, Rajni Joshee 2022-01-18 2022-01-18 5 3 95 99 Effect of blood glucose levels on sensory nerve conduction parameters in prediabetics: A cross sectional study <p>Background: “Prediabetic” is an intermediate state of increased blood sugar levels and is defined by American Diabetic Association as fasting blood sugar (FBS) levels in the range of 100 to 125 mg/dL. It is increasingly viewed with early forms of diabetic neuropathy in 25-62% of cases. Multiple studies showed hyperglycaemia to change the myelin’s phospholipid, fatty acids and cholesterol content and thus modifying its fluidity, ultimately affecting the functional capacities of the nerve. This study was taken to investigate the sensory nerve conduction velocity (NCV) and latency in prediabetic healthy male adults and to study its relationship with levels of FBS in them. Materials &amp; Methods: 60 clinically healthy prediabetic males of age 30-50 years were included in this observational study. For comparison 30 clinically age matched healthy normoglycaemic (FBS&lt;100 mg/dl) male adults were taken as control. Demographic, anthropometric and sural latency and NCV were compared using‘t’ test. Relations of FBS with different variables were investigated using Pearson’s correlation test. A p value &lt;0 .05 was taken as significant. Results: Bilateral sural nerve latency (right 3.52±1.88 ms and left 3.83±1.98ms) was significantly increased in the prediabetics compared to normoglycaemics (right 2.41±1.24 ms and left 2.48±0.79ms). NCV of sural nerves of both sides (right 50.38±18.89 m/sec and left 46.13±17.93m/sec) were significantly decreased in prediabetics as compared to normoglycaemics (right: 62.60±13.44m/sec; left: 53.95±11.93m/sec). Latency of right and left sural nerves was significantly and positively correlated with FBS levels in prediabetes (r= 0.61; p&lt;0.01 and r= 0.33; p&lt;0.01 respectively). Right sural nerve conduction velocity was significantly and negatively correlated with FBS levels in prediabetes (r= -0.514; p&lt;0.01). Conclusion: Prediabetics seems to have a lower peripheral sensory NCV as compared to normoglycaemic male adults of 30-50 years of age.</p> Hirok Chakraborty Brijesh Purwar Yogesh Saxena Copyright (c) 2022 Hirok Chakraborty, Brijesh Purwar, Yogesh Saxena 2022-01-18 2022-01-18 5 3 100 104 Magnitude of Internet Addiction and Its Associating Risk Factors in Young Medical Students of Western Rajasthan, India <p>Background: Smartphone and internet has become the necessity of the society and students are more prone to addict in digital world. Internet dependency is compulsive behaviour that influences student health, studies and social relations. The prevalence of Internet addiction is rising worldwide especially among adolescents. The aim of the present study was to explores the prevalence of internet addiction and pattern of internet uses among young medical student and its association with various socio-demographical and behavioural factors. Material and Methods: Students were interviewed to predesigned proforma for socio-demographic profile and questionnaire for Internet Addiction Test (IAT). The total score of IAT ≥ 50 considered as internet addicted (IA), was main dependent variable, while age, gender, residence, medium of school education, type of family, socioeconomic status and social or behavioural problems were independent variables. Multinomial logistic regression was used to assess significance of internet addiction, P-value &lt; .05 considered as significant. Results: The prevalence of internet addiction was 24% among young medical students. Students residing with parents or local guardians were more internet addicted (34%) than those residing in hostel (20%), and also the students showing self-injurious behaviour statistically significantly internet addicted (62.5%) than those not having such behaviour (23%). Other studied variables were not found associated with internet addiction. Conclusion: The internet addiction prevalence was 24% among medical students. The students staying at home were having 2.526 time more chances of internet addiction that those staying at hostel. Likewise, the students having internet addiction had 5.122 times more chances of self-injurious behaviour than their counterparts.</p> Anuradha Yadav Kavita Yadav Manisha Sankhla Poonam Punjabi I. D. Gupta Kusum Lata Gaur Copyright (c) 2022 Anuradha Yadav, Kavita Yadav, Manisha Sankhla, Poonam Punjabi, I. D. Gupta, Kusum Lata Gaur 2022-01-18 2022-01-18 5 3 105 109 Evaluation of Homocysteine Level- A Risk factor among patients with ischaemic Stroke admitted in emergency of tertiary care centre of Bihar <p>Background: Epidemiological investigations have shown that expanded complete homocysteine (tHcy) magnitude are related with an expanded risk of thromboembolic disease; nonetheless, controversy actually exists over which subtype of stroke is associated to hyperhomocysteinemia (HHcy). This investigation meant to examine whether raised tHcy is an autonomous risk factor for ischemic stroke and to contrast tHcy magnitude in patients and ischemic stroke subtypes. Objectives: To decide the recurrence of brought homocysteine level up in ischemic stroke. Methods: This forthcoming observational case control investigation was carried on 133 youthful ischemic stroke patients with 120 control match people over a time of 6 months, from March 2021 to August 2021 at Tertiary Care Centre, Patna. Results: The plasma fasting homocysteine magnitude was altogether higher in the cases than in the controls. The mean homocysteine magnitude was raised altogether in those with cardioembolic strokes contrasted and the controls. The plasma homocysteine level was related with a changed chances proportion of 2.15 for homocysteine over 16 μmol/L fixation for a wide range of stroke. Conclusion: Expanded degree of Serum Homocysteine is altogether connected with risk of cerebrovascular mishap, which is free of the risk credited to conventional risk factors.</p> Santosh Kumar Nayan Siddharth Singh Janardan Sumeet Kumar Copyright (c) 2022 Santosh Kumar Nayan, Siddharth Singh, Janardan, Sumeet Kumar 2022-01-18 2022-01-18 5 3 110 113 Study of dermatological manifestations in neonates attending a tertiary healthcare centre <p>Background: Skin of newborn can be a considerable source of information about infant’s health and promptly alerts the physician regarding serious diseases. Since neonatal skin and adult skin differ in physiology and pathological presentations, neonatal skin conditions require special attention. Aim: This study highlights the pattern of various neonatal dermatoses in a tertiary care healthcare center. Materials &amp; Methods: The study was conducted in a tertiary healthcare center where 804 neonates delivered/visiting in the institute were included and observed for any kind of dermatological condition. After taking informed consent from parents, thorough examination was done and observations were noted in a preset proforma. Result: Among the patient in our study, males were 54% (324) and females were 46% (276). Overall most common neonatal dermatoses was desquamation of skin (396, 66%) followed by Mongolian spots(390,65%), Erythema toxicum neonatorum (162,27%), sebaceous gland hyperplasia (120,20%). The most common dermatoses in full term neonates were Mongolian spots(354,73.8%), desquamation of skin (324,67.5%), ETN(162,33.8%) while in pre term babies, desquamation of skin was followed by SGH, physiological jaundice, Impetigo and Mongolian spots. (24,26.7% each). Conclusion: Skin disorders in neonates require considerable knowledge of pediatric medicine. Hence, the study assesses the pattern of neonatal dermatoses.</p> Ajay Raghuwanshi Surendra Singh Bhati Rohini Chauhan Anushtha Tomar Supriya Shakya Akash Jain Akash Jain Copyright (c) 2022 Ajay Raghuwanshi, Surendra Singh Bhati, Rohini Chauhan, Anushtha Tomar, Supriya Shakya, Akash Jain, Akash Jain 2022-01-18 2022-01-18 5 3 114 122 A Study On Prevalence Of Asymptomatic Bacteriuria Among Pregnant Women Attending Antenatal Clinic Of A Tertiary Care Hospital In Bihar <p>Introduction: Urinary Tract Infections (UTIs) commonly occur pregnancy, due to the morphological and physiological changes that take place in the genitourinary tract. Pregnancy enhances the progression from Asymptomatic Bacteriuria (ASB) to symptomatic bacteruria, which could lead to acute pyelonephritis in 20-50% of cases and to adverse obstetric outcomes such as prematurity, postpartum hypertensive disease, anemia, UTIs, and higher foetal mortality rates, if it is left untreated. The objective of this prospective study was to identify the prevalence of ASB, and its most common causative microorganisms among pregnant women who attended a tertiary care centre in Bihar, India. Methodology: This was a prospective study which was conducted in the Department of Microbiology, Shri Krishna Medical College &amp; Hospital, Muzaffarpur, Bihar during a period of one year From January 2021 to December 2021. A total number of 100 pregnant women who attended antenatal clinic during the period of data collection were included in this study. Urine samples were collected by standard mid-stream “clean catch” method from all the pregnant women, in sterile, wide mouthed containers that were covered with tight-fitting lids. The samples were processed by using standard microbiological procedures. The specimens were cultured on dried plates of MacConkey’s agar, Sheep Blood agar (in 5-10% CO2 atmosphere) and Cystine Lactose Electrolyte Deficient agar, by standard loop method and the plates were incubated at 37°C overnight. Culture results were interpreted as significant and insignificant according to the standard criteria. The organisms were identified by routine methods from the samples which showed significant bacteriuria. Result: In our study, culture positive cases with respect to trimester were as follows: first trimester- 5 (55.6%), second trimester- 3 (33.3%), and third trimester - 1 (11.1%). The commonest bacterium which was detected in culture was Escherichia coli. Conclusion: As asymptomatic bacteriuria is associated with complications in pregnancy, it is therefore imperative that pregnant women be screened for bacteriuria, periodically in every trimester of the gestational period.</p> Chandan Kumar Arunima Rajeev Ranjan Prasad Ranjit Kumar Copyright (c) 2022 Chandan Kumar, Arunima, Rajeev Ranjan Prasad, Ranjit Kumar 2022-01-18 2022-01-18 5 3 123 125 The comparison of the combined effect of preoperative diclofenac and precurarisation with atracurium on succinylcholine induced myalgia in laparoscopic cholecystectomy: A double blinded randomised study <p>Background and Aims: Succinylcholine is the only available depolarizing neuromuscular blocker which was widely used in induction of anaesthesia and it is the drug of choice for rapid-sequence induction of anaesthesia due to its rapid onset of effect and ultra-short duration of action owing to its rapid hydrolysis by acetyl-cholinesterase. Post-operative muscle pain (myalgia) and muscle stiffness are the most common side effects and observed most frequently on the first postoperative day in ambulatory surgery. The use of succinylcholine in induction of anaesthesia and intubation in routine cases has been discouraged because of such adverse effects, however because of its cost effectiveness and easy availability it is still used by some institutions routinely. The aim of this study was to study the efficacy of pre-operative diclofenac along with atracurium precurarization alleviating succinylcholine-induced myalgia. Material and methods: It is a double blind randomised comparative study carried our in a tertiary care hospital. Study sample was 60 and divided in two equal groups. All data entered in MS-Excel Sheet and Wilcoxon Signed Rank test was done for non-parametric data and one way ANOVA for parametric data. The normal distribution of study sample was tested by Shapiro Wilk test. Result and Conclusion: The incidence of fasciculation in the two groups were found to be significant with p &lt; 0.00001. The results for incidence of myalgia in the two groups were as follows - p value at 24 hr was 0.00018 and at 48 hr was 0.0028 respectively. Creatine kinase levels at preoperative and 24 hr postoperative period were 49.47 ± 7.24 in group D , 53.30 ± 7.98 in group B and 87.38 ± 15.16 in group D , 188.41 ± 33.27 in group B respectively. Succinylcholine induced myalgia has a complex pathophysiology, however the pre-emptive use of diclofenac in combination with precurarization can alleviate the incidence and severity of succinylcholine induced myalgia. Therefore its use may be considered in routine cases for induction of anaesthesia for facilitating laryngoscopy and endotracheal intubation.</p> Amit Tirkey Tushar Kumar Mukesh Kumar Ekramul Haque Ladhu Lakra Usha Suwalka Copyright (c) 2022 Amit Tirkey, Tushar Kumar, Mukesh Kumar, Ekramul Haque, Ladhu Lakra, Usha Suwalka 2022-01-18 2022-01-18 5 3 126 129 Prevalence Of Anemia And Its Characteristic Among Children Between Age Of 6 Months To 12 Years: Report From A Tertiary Care Center Of Bihar <p>Introduction: Anemia is a widespread public health problem associated with an increased risk of morbidity and mortality, especially in pregnant women and young children. Approximately 50% of the population suffers from nutritional anemia as known in countries where meat consumption is low. In the present study, an attempt has been made to assess the magnitude of anemia. Methodology: The current cross-sectional study was conducted by the Department of pediatrics, Patna Medical College &amp; Hospital, Bihar. The study encompasses 100 pediatric patients admitted during the study period from August 2012 to January 2013 between the ages of 6 months to 12 years. All children and their parents were informed about the purpose and the method of the research and the voluntary nature of participation in the study verbally and in written form. A total of 2 mL of venous blood was drawn under aseptic precautions in an ethylene diamine tetra acetate containing vacutainer. Peripheral blood smear after staining with Leishman's stain was examined under binocular microscope for count and morphology of RBC, WBC, platelets. Special investigations like electrophoresis, sickling test, bone marrow aspiration were done wherever needed. Results: Out of the 100 hemograms analyzed, 69 depicted anemic status. Infants (6 months-1 year) were found to be most commonly affected constituting to one-third, followed by school-going children (6 years-12 years), toddlers (2 years-3 years), and preschool children (4 years-5 years). Out of 69 anemic patients, majority had nonhemoglobinopathies and only 2 had hemoglobinopathies. Bone marrow examination could be done on 10 anemic children. Out of which, five children showed micronormoblastic maturation followed by three children had megaloblastic maturation, one child had normoblastic maturation, and another child had hypoproliferative bone marrow. Both the children with hemoglobinopathies were diagnosed with Thalassemia major. Conclusion: There is an urgent need to initiate specific public health action to prevent anemia considering the grave consequences of anemia and iron deficiency on the physical and mental growth and development of these children and on their long-term health.</p> Suprabhat Ranjan Sheela Sinha Copyright (c) 2022 Suprabhat Ranjan, Sheela Sinha 2022-01-18 2022-01-18 5 3 130 132 Histopathological assessment of placenta in PIH patients <p><strong>Background:</strong> The occurrence of infection, haemorrhage and hypertensive disorders of pregnancy has great impact on mother and foetal well- being. The present study was conducted to perform histopathological assessment of placenta in PIH patients.<strong> Materials &amp; Methods: </strong>74 cases with normal and hypertensive pregnancies were selected and were classified patients into 2 groups of 37 each. Group I comprised of patients with hypertension (&gt;140/90 mm Hg) and group II were normal pregnancy. Parameters recorded were gestational age, mean birth weight, mean placenta weight, mean fetoplacental birth ratio. Morphology of placenta was studied.<strong> Results: </strong>Maximum patients (19) were seen in age group 20-25 years in group I and 18 in group II. Minimum patients (3) in group I and in group II (3) were present in age group 30-35 years and &lt;20 years respectively. Gestational age 37 weeks was seen in 12 in group I and 11 in group II, 38 weeks in 8 in group I and 7 in group II, 39 weeks in 6 in group I and 9 in group II, 40 weeks in 3 in group I and 2 in group II and 41 weeks in 1 in group I and 1 in group II. The mean birth weight was 2862.4 grams in group I and 2548.5 grams in group II, mean placental weight was 482.4 grams in group I and 476.2 grams in group II and fetoplacental ration found to be 6.52 in group I and 6.10 in group II. The mean Syncitial knots/100 villi was 71.4 in group I and 30.5 in group II, hyalinized villi/ 10 lpf was 6.8 in group I and 1.2 in group II, fibrinoid necrosis/100 villi was 12.5 in group I and 3.1 in group II, calcified areas/ 10 lpf was 2.4 in group I and 0.45 in group II and cytotrophoblastic proliferation/ 100 villi was 16.8 in group I and 3.4 in group II. <strong>Conclusion: </strong>The occurrence of syncitial knots, hyalinized villi, fibrinoid necrosis, calcified areas and cytotrophoblastic proliferation was more in PIH group than control subject.</p> Neetu Punia Shivani Dua Sachin Chauhan Isha Gupta Copyright (c) 2022 Pavan Kumar, Vishwa Prakash Jha, Mohammed Tarique 2022-01-18 2022-01-18 5 3 133 136 Burden of Type 2 Diabetes Mellitus among Chronic Obstructive Pulmonary Disease Patients: Challenge of dual Co-Morbidities among Indians? <p>Introduction: Non Communicable diseases (NCDs) like chronic respiratory diseases, stroke, cardiovascular diseases, metabolic disorders like diabetes and obesity are burden on the global health. Chronic obstructive pulmonary disease (COPD) is projected to the third leading cause of death in world by 2030. Chronic obstructive pulmonary disease can lead to diabetes mellitus (DM) and vice versa. Objective: To find out the prevalence of type 2 diabetes mellitus (T2DM) among COPD patients. Materials and Methods: Total 369 study participants were included in the study. Estimation of Fasting Plasma glucose (FPG), Post Prandial Plasma Glucose and Gylcated Hemoglobin (HbA1C) and Anthropometric measurements were done as per WHO guidelines. Type 2 Diabetes Mellitus was diagnosed as per American Diabetes Association (ADA). COPD was diagnosed and classified as per © 2020, Global Initiative for Obstructive Lung Diseases (GOLD). Result: Prevalence of T2DM was found to be 39.6%, 20.3% were known cases of T2DM and 19.2% were newly diagnosed. Increasing age, female gender, urban residence, longer duration of COPD, high BMI and smoking were found to be significant risk factors for T2DM among COPD patients. Presence of T2DM was associated with significantly more severe COPD cases. Conclusion: High prevalence of T2DM was found among COPD patients. More frequent screening of T2DM and good control of T2DM should be done because about 1/5th of the COPD patients had newly diagnosed T2DM and presence of T2DM significantly resulted in more severe disease.</p> Prashant Kumar Rakesh Kumar Debasis Basu Sasthi Narayan Chakraborty Deval Parekh Sudip Ghosh Copyright (c) 2022 Prashant Kumar, Rakesh Kumar, Debasis Basu, Sasthi Narayan Chakraborty, Deval Parekh, Sudip Ghosh 2022-01-18 2022-01-18 5 3 137 142 Comparison of the effect of I.V nalbuphine and fentanyl as premedicant in general anaesthesia for laparoscopic surgeries <p>Introduction: Laparoscopic surgeries are minimally invasive surgeries with reduced mortality and morbidity, minimal postoperative analgesic requirement and early mobilisation. To prevent hemodynamic response to laryngoscopy, intubation and pneumoperitoneum various drugs are used. Opioids are commonly used in premedication, being a good analgesic, to support analgesia during surgery and to provide pain relief in immediate postoperative period. Among opioids, Fentanyl and Nalbuphine effectively control the hemodynamic stress response associated with laparoscopic surgeries, especially after laryngoscopy, intubation and pneumoperitoneum. In our study, we observed and compared the potency of opioids- Fentanyl &amp; Nalbuphine used as premedicant for attenuation of hemodynamic response in laparoscopic surgeries and postoperative complications if any. Objectives: The present study was designed to compare the effect of intravenous Nalbuphine and Fentanyl as premedicant in general anaesthesia for laparoscopic surgeries. Material and Methods: After institutional ethics committee approval, the study in 60 patients belonging to ASA 1 &amp; 2 undergoing laparoscopic surgeries like appendectomy, cholecystectomyetc. whose duration was assumed to be &lt;90 min under general anaesthesia was conducted. Pre-anaesthetic assessment of the patient was done with a complete history, physical examination and routine investigations and informed written consent was obtained. Eligible patients who gave consent were kept nil orally for at least 6 hours before surgery. Pulse Rate(PR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure(DBP), Mean Arterial Pressure (MAP), Oxygen Saturation (SpO2) was recorded at baseline, after giving study drug, immediately after laryngoscopy and tracheal intubation, thereafter at 10 minutes interval intraoperatively, post extubation at 1,3 and 5 minutes. Preoperative and postoperative sedation scoring was done using RASS. Results: The mean heart rate increased post extubation in both the groups. At 1min, 3 min and 5mins post extubation heart rate is better controlled in group N than group F and is statistically significant (P value &lt; 0.05). Both groups showed a rise in SBP immediately after intubation. Group N showed a significantly lower SBP in comparison to group F (p&lt;0.005). The DBP showed a similar trend. At one, three, and five minutes after intubation, HR, SBP, DBP, and MAP were similar between the groups. Post-extubation sedation score was significantly higher in group N (p &lt; 0.005). Conclusions: From the findings of our study it is concluded that I.V. Nalbuphine when given in the dose of 0.2 mg/kg as a premedicant is significantly effective in attenuating the haemodynamic responses during intubation, laryngoscopy and pneumoperitoneum in laparoscopic surgery when compared to Fentanyl 2.0 μg/kg. It also provides better hemodynamic stability without major side effects during laparoscopic surgery.</p> Veenashree Managavi Tripti Vatsalya Rituraj Saini Vandana Pandey Copyright (c) 2022 Veenashree Managavi, Tripti Vatsalya, Rituraj Saini, Vandana Pandey 2022-01-18 2022-01-18 5 3 143 146 A clinical study to evaluate the functional outcome of fracture of femoral neck with bipolar prosthesis <p>Background and Objectives: Hip fractures are located in the proximal femur and can involve the femoral neck, trochanteric and subtrochanteric regions. The two most common types are trochanteric (intertrochanteric) and femoral neck (cervical) fractures (FNF). Fractures that extendfrom the trochanteric area and distally within 5 cm below the lesser trochanter are named subtrochanteric fractures. These fractures are a common sight at orthopaedic departments around the world and are a common cause of misery and mortality in the aging population. Methods: 23 patients aged more than 50years, who sustained fracture neck of femur, were treated by hemiarthroplasty using Bipolar prosthesis, in Dr VRK Womens Medical College &amp; SIMS Hyderabad between October 2020 to September 2021 The patients were followed up for a minimum of one year. Short term functional outcome was analyzed using the Harris hip scoring system. Results: In our study the patients were in the age group of 51 to 78 years with the mean age of 59 years. 53.21% of the patients were females with 60.79% of all cases sustaining the fracture following a trivial trauma. The functional outcome using the Harris hip score was excellent in 16%, Good in 60%, fair in 16 %and poor in 8% of cases. So, 72% of the patients achieved an excellent or good result. Conclusion: The outcome of the hemiarthroplasty depends on various pre-operative factors like age of the patient, type of prosthesis, associated co-morbid conditions. The bipolar prosthesis has allowed freedom from pain, early weight bearing, early rehabilitation. It also allowed squatting and greater range of movements.</p> Jhatoth Dhoom Singh Copyright (c) 2022 Jhatoth Dhoom Singh 2022-02-10 2022-02-10 5 3 147 152 observational study on the relationship between vitamin d level and hip fractures <p>Background: Vitamin D (25OHD) is essential for maintaining calcium homeostasis and inadequate levels have been associated with negative musculoskeletal as well as extraskeletal effects. Individuals at especially high risk of developing hypovitaminosis D are the elderly. Hip fractures are devastating injuries that most often affect the elderly and have a tremendous impact on both the health care system and society in general. Aims: To identify patients with hip fractures and to attain the vitamin D levels in these patients. To correlate the between the hip fractures and levels of vitamin D and evaluate factors associated with the same study subjects. Materials and methods: The study was a descriptive type of study and was conducted between October 2019 and July 2021 in Dr VRK Womens Medical College and Hospital &amp; SIMS, Hyderabad. Patients who fulfilled the inclusion criteria, were included in the study. Once the diagnosis of hip fractures were made then following test were done on day one of admission -Haemoglobin, Calcium, Phosphate, ALP, Vit D by CLIA method. Results: In this study we found that male were 39 patients and female of 41 patients, this shows almost equal prevalence of hip fractures in both males and females. The age in this study showed a mean of 69.91 overall, 68.51 and 70.74 for male and female patients respectively. Range was between 51 to 94 for both male and female patients. This study shows that the frequency of hip fracture in males and females were comparable and most of the patients presented to the hospital between 2nd to 7th day post injury .the most common co-morbidity was Diabetes Mellitus and many had more than one co-morbidity. It was also noted that anaemia was prevalent in both male and female patients and the overall vitamin D deficiency was 79% of the total no of patients with more predominant (51.25%) in female patients. Conclusion: The vitamin D status and other parameter were studied in this study which was conducted in Dr VRK Womens Medical College and Hospital. Treatment of the vitamin D deficiency decreases the chances of fall, morbidity condition and financial burden on the patient when fractures occur. The treatment of vitamin D deficiency will improve the quality of life overall. Hence the need for food fortification and supplementation in elderly indian population[1-5].</p> Jhatoth Dhoom Singh Copyright (c) 2022 Jhatoth Dhoom Singh 2022-01-18 2022-01-18 5 3 153 157 Caudal regression syndrome: A rare case report <p>Caudal Regression Syndrome (CRS) is resultant to anomalous development of caudal spinal cord and vertebral column segments during embryonic life. Although exact cause is not known multiple factors such as toxic, ischemic, infectious insults before 4th week of gestation are leading causes. CRS is frequently associated with maternal diabetes.</p> Mayank Jain Amandeep Verma Mayukh Mukherjjee Ankush Kundu Rahul Sharma Ram Krishana Mishra Bhisham Panwar Puneet Yadav Amandeep Mittal Aditya Seth Copyright (c) 2022 Mayank Jain, Amandeep Verma, Mayukh Mukherjjee, Ankush Kundu, Rahul Sharma, Ram Krishana Mishra, Bhisham Panwar, Puneet Yadav, Amandeep Mittal, Aditya Seth 2022-01-18 2022-01-18 5 3 158 160 Prediction of chemical composition of urinary calculi in-vivo based on ct attenuation values – An analytical study <p>Introduction: Chemically, stones are of various types including calcium stones, uric acid stones, struvite stones and cystine stones among others. Each pathophysiological group has a predisposition to form certain kind of stones. Hence, knowledge of the chemical composition of the stone that a patient forms can and does direct the management of the patient. Objectives: To evaluate if the chemical composition of urinary stones can be predicted with mean Hounsfield Unit (HU) value on computed tomography (CT). Methods: This is prospective and analytical study conducted in the Department of Radiology of a tertiary care teaching hospital in India. Patients diagnosed with urinary stones who had a non-contrast CT done and had stone retrieved were included in the study. The predominant chemical composition of the stone was analysed by X-ray diffraction crystallography. Results: Fifty-one stones of four types were studied. Statistically significant (p&lt;0.001) differences were seen in the mean HU, maximum HU and median HU values between all the four types. No significant difference was observed in the difference between periphery and core HU values. Hierarchy of density among the stone types correlated with previous studies but absolute measurements varied among different studies. Conclusion: Mean HU of urinary stones correlates with their chemical composition. Calcium oxalate monohydrate, calcium oxalate dihydrate, uric acid and hydroxyapatite stones can be differentiated on their CT attenuation parameters if a database of attenuation characteristics for stones of known composition is built for given scanner and protocol.</p> Aravind Murugesan Mossadeq A Govardhanan R Ratna Vasanthan S Copyright (c) 2022 Aravind Murugesan, Mossadeq A, Govardhanan R, Ratna Vasanthan S 2022-01-18 2022-01-18 5 3 161 165 Prevalence and risk factors of cataract in type 2 Diabetes mellitus: A Cross sectional study <p>Background&amp; Objective: To estimate the prevalence of cataract in patients with type 2 diabetes mellitus and the possible risk factors associated with it. Methods: Cross sectional study carried out at a tertiary eye care centre in North Karnataka from 2012 to 2014. Patients with type 2 diabetes mellitus 40 years and above were enrolled. A detailed history, including data on demographics, diabetes, and ocular history, was obtained from all patients. A detailed systemic and ocular examination was done. All patients underwent biochemical tests: Fasting Blood Sugar (FBS), glycosylated haemoglobin (HbA1c) and serum cholesterol. Results: Out of the 750 patients with Type 2 Diabetes Mellitus enrolled in our study, 492 patients had cataract and 258 had no cataract. 242(60.35%) were males and 250(71.63%) were females. Prevalence of cataract in Type 2 Diabetes was 65.60%. Patients on OHA’s had higher incidence of cataract (P=0.0021). There was statistical significance between positive family history of diabetes and cataract (P=0.0271). There was no statistically significance between SBP (P=0.1108), DBP(P=0.0515) and cataract. Prevalence of diabetic retinopathy in cataract group was 78.80% and only 21.20% in non cataract group (P=0.0002). Mean FBS was 176.44mg/dl (P=0.00001) and mean HbA1c was 8.29% (P=0.00001) in cataract group and both were statistically significant. Conclusion: Nearly two thirds of the diabetic population showed evidence of cataract. Increasing age, female sex, longer duration of diabetes, positive family history of diabetes, diabetics on OHA’s agent, poor glycemic control i.e. raised FBS and high HbA1c levels were risk factors for development of cataract. Modulation of these variables may delay the occurrence of cataract in population of type 2 diabetes mellitus.</p> Farhat Fatima Ravindra Bankar Copyright (c) 2022 Farhat Fatima, Ravindra Bankar 2022-01-18 2022-01-18 5 3 166 170 Knowledge, Attitude and Practice of Water Handling and Sanitation in Urban Households of Chamarajanagar <p>Background: Water and sanitation form the core of sustainable development. The Sustainable Development Goal 6 seeks to ensure safe drinking water and sanitation for all. Water storage and handling methods along with point of use water treatment plays a crucial role in providing safe drinking water and thereby reducing the burden of water borne diseases. Objectives: To assess the knowledge, attitude and practice of water handling and sanitation. Materials and methods: A cross sectional study was conducted for 2 months (July-August 2021) in the urban field practice area including 500 households by simple random sampling using predesigned semi-structured questionnaire. Descriptive statistics using frequencies and percentages were done. Chi square test was applied and p value &lt;0.05 was considered significant. Results: Most of the respondents (96%) opined that the water they used was safe and 85.2% knew that the quality of water affects health. Piped water supply was available in 78.2% houses. The commonest method of water treatment followed was boiling (264, 52.8%). Around 6.8% of households did not practice any method of water treatment. Majority had a sanitary latrine at home (88.6%). Community toilets were utilized by 2.2% of households and 9.2% practiced open air defaecation. Most of the household waste was collected by the corporation (90.6%) and 8.8% of the households were dumping the wastes. Higher level of education was significantly associated with increased knowledge and practice of water safety and sanitation. Conclusion: There is a need for educational intervention regarding water handling and treatment methods, promoting personal hygiene and sanitation.</p> Vishma BK Ravi MR Chetan TK Shashank KJ Copyright (c) 2022 Vishma BK, Ravi MR, Chetan TK, Shashank KJ 2022-01-18 2022-01-18 5 3 171 175 Prognostic and predictive significance of neutrophils lymphocytes ratio (NLR), lymphocytes monocytes ratio (LMR), Platelets lymphocytes ratio (PLR) and C-reactive protein (CRP) in patients with confirmed COVID-19 infection <p>Background and objectives: Pneumonia cases of unknown origin were recorded and reported by several local health facilities in Wuhan, China, in December 2019. The etiological agent was identified to be the SARS-CoV-2; COVID-19. Laboratory tests reveal normal or increased total leukocyte count, reduced lymphocyte count has been seen in some severe cases. PLR between severe and non-severe cases has been studied and said to have prognostic significance. NLRis another significant indicator of detecting inflammation in routine laboratory tests among Covid-19 patients which can be utilized in the diagnosis, treatment and evaluation of prognosis. In addition to NLR, CRP levels have been found to be deranged in moderate and severe Covid-19 infections. Material and Methods: 82 laboratory confirmed Covid -19 cases, diagnosed by positive RT-PCR for SARS CoV-19 RNA on nasal/ oropharyngeal swabs were included in the study. Results: The optimal cut-off values for NLR and PLR were 4.63 and 0.167 respectively. For NLR curve, the results showed that AUC was 0.848 (95% CI, 0.766 - 0.931), the Youden index was the largest 0.543, corresponding to the best cut-off value of 4.63, the sensitivity was 0.787, and the specificity was 0. 755. Similarly, for PLR the area under the curve (AUS) was 0.772 (95% CI, 0.666 – 0.879), the Youden index was the largest 0.493, corresponding to the best cut-off value of 0.167, the sensitivity was 0.636, and the specificity was 0.857.Conclusion:The present study has re-emphasized the prognostic and predictive significance of routine hematological investigations and CRP in Covid-19 patients.</p> Gyanendra Singh Shalini Bahadur Shivani Kalhan Saurabh Srivastava Saurabh Srivastava Hariom Solanki Deepti Chopra Copyright (c) 2022 Gyanendra Singh, Shalini Bahadur, Shivani Kalhan, Saurabh Srivastava, Saurabh Srivastava, Hariom Solanki, Deepti Chopra 2022-01-18 2022-01-18 5 3 176 179 Assessment of the correlation of CD4 cell counts to C-reactive protein and lipoproteins in subjects with HIV infection: A clinical study <p>Aims-The present study was conducted to assess any correlation existing between changes in C - reactive protein and lipoproteins with CD4 cell counts in HIV Positive patients. Materials and methods- The study was conducted on 102 HIV-positive subjects. C-reactive protein, Lipid profiles, CD4 cell counts were assessed for all subjects. The collected data were subjected to evaluation and results were formulated. Results- 102 HIV positive subjects were grouped based on CD4 cell counts in four groups, the group I CD4 count &lt;200/μL, group II CD4 count 201-350/μL, group III CD4 count 351-500/μL, and group IV has CD4 count&gt;500/μL. In the majority of subjects with decreased CD4 count increased CRP levels were seen with a significant inverse correlation between CRP and CD4 count. It indicates that CRP level increases with increased HIV infection severity, and with decreased CD4 count. HDL decreased in HIV-positive patients and VLDL was increased with decreased CD4 cell count. No significant association was seen in serum Triglycerides and LDL with CD4 cell count. Conclusion- The present study concludes that C-reactive protein and lipid profiles are affected in HIV-positive subjects with decreased CD4 count. Hence, regular assessment of C-reactive protein and lipid profile help in assessing disease progression, forming a treatment plan, and decreasing the risk for cardiovascular disease in HIV-positive subjects, when CD4 cell counts cannot be assessed.</p> BH. V. K. Praveen Varma Ashok Vankayala K. N. S. V. Chalapathi Rao D.S.S.K. Raju Copyright (c) 2022 BH. V. K. Praveen Varma, Ashok Vankayala, K. N. S. V. Chalapathi Rao, D.S.S.K. Raju 2022-01-18 2022-01-18 5 3 180 183 Assessing the effect of homocysteine compound levels and biological parameters on subjects undergoing hemodialysis <p>Background: In subjects with renal disease, levels of homocysteine are raised leading to its excretion in urine. This correlation of raised homocysteine levels to renal disease can be attributed to the possible hypothesis that raised homocysteine can lead to renal disease or correlation of homocysteine to Glomerular Filtration Rate (GFR) where only a small fraction of less than 1% is only excreted. Aim: The present study was conducted to assess the effect of Homocysteine levels and biological parameters in subjects undergoing hemodialysis. Methods: In 120 subjects including both males and females with 57 controls and 63 cases. These subjects were within the age range of 19 years to 80 years and had a mean age of 46.6±4.22 years. Homocysteine and Vitamin B6 in the serum were assessed using the technology of ELISA using spectrophotometer, whereas, for evaluating urea and creatinine, electroluminescence was used with cobasd e411. The collected data were subjected to the statistical evaluation. Results: Homocysteine was 8.59±0.96 μmol/l in controls and was 22.97±4.77 μmol/l in the test group study subject (p&lt;0.0001). Vitamin B6 levels were significantly lower in test subjects with 159.47±14.75 compared to the controls. Urea levels were significantly higher in test subjects having the renal disease with p&lt;0.0001. Creatinine was significantly higher in test subjects having the renal disease. Creatinine value in controls was 0.45±0.12 and in test, subjects were 8.04±2.07 with p&lt;0.000. B6 showed a negative correlation with homocysteine. With creatinine levels, homocysteine showed a positive correlation with an r-value of 0.187 and a p-value of 0.123. A similar positive correlation was seen with the urea levels with an r-value of 0.034 and a p-value of 0.792. Conclusion: The present study concludes that the levels of homocysteine, urea, and creatinine levels are raised in subjects having renal disease undergoing hemodialysis compared to the control subjects without renal disease. Also, Vitamin B6 and hemoglobin levels were significantly lower in subjects with renal disease undergoing hemodialysis compared to the subjects without renal disease.</p> BH. V. K. Praveen Varma P.C. Mishra M.K. Sagar D.S.S.K. Raju Copyright (c) 2022 BH. V. K. Praveen Varma, P.C. Mishra, M.K. Sagar, D.S.S.K. Raju 2022-01-18 2022-01-18 5 3 184 186 A Comparative Study of Intravenously Administered Clonidine and Magnesium Sulphate on Hemodynamic Responses During Laparoscopic Cholecystectomy <p>Background &amp; Objectives: Laparoscopic surgeries are associated with significant hemodynamic response. Magnesium and clonidine both are known to inhibit catecholamine and vasopressin release and attenuate hemodynamic response to pneumoperitoneum. This randomized, placebo controlled study has been designed to assess which agent attenuates hemodynamic stress response to pneumoperitoneum better.Methods: Ninety patients undergoing elective laparoscopic cholecystectomy were randomized into 3 groups of 30 each. The study drugs were given intravenously over 10 min prior to creation of pneumoperitoneum. Group C received 1mcg/kg of clonidine in 10 ml normal saline, group M received 50mg/kg magnesium sulphate in 10 ml normal saline and group NS received 10 ml normal saline. Blood pressure and heart rate were recorded before induction (baseline value), after the study drug administration, 5 minutes after creation of pneumoperitoneum and then for every 10 minutes.Results: Statistically significant rise in the mean heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and rate pressure product occurred, post pneumoperitoneum, in the control group (NS). Hemodynamic response to pneumoperitoneum was significantly attenuated in both the clonidine(C) and magnesium (M) groups. However, extubation time and time to response to verbal commands was significantly prolonged in the magnesium sulphate group. No other adverse effects were noted in any of the groups. Interpretation &amp; Conclusion: Administration of magnesium sulphate or clonidine attenuates hemodynamic response to pneumoperitoneum with comparable efficacy.</p> Madhulika Koormala Naresh Copyright (c) 2022 Madhulika Koormala, Naresh 2022-01-18 2022-01-18 5 3 186 193 A Study on Intramedullary Supracondylar Interlocking Nail in the Management of Supracondylar and Intercondylar Fractures of Distal Femur <p>Aim: Our aim was to treat these fractures by rigid internal fixation, allow early knee motion and to know the outcome of this IMSC nail in such fractures.Methodology: In this study we have taken 30 cases of supracondylar and inter condylar fractures of distal 15 cms of femur which are ideal for inter locking IMSC Nail.Results: The maximum number of patients were seen in the age group between 31-40 yr.Males were slightly more in number compared to females. Regarding mechanism of injury incidence for RTA is more. In young patients fracture resulted from high velocity injury and in elderly due to simple fall (low velocity injury), because of osteoporosis. Majority of the cases were simple with only 4 Compound fractures. Associated vascular and ligamentous injuries are none but other bony injuries are common. Surgery was performed by closed technique in 28 patients and Open technique in 2 patients with static locking in 28 patients and dynamic locking in 2 patients. Radiological union is seen at an average of 12 weeks. Average knee ROM observed is 1020.The complications encountered were difficulty in closed reduction due to the pull of Gastrocnemius, difficulty in proximal locking in 2 patients, infection in 2 patients of whom one had compound fracture. 2 patients had mild pain around distal Interlocking screws, and 1 patient with pathological fracture had backing out of single Interlocking screw. End results were Excellent in 14 cases, Good in 10 cases, Fair in 4 cases and poor in 2 cases according to Functional Evaluation scale. Conclusion: Analysis of our results showed that it is a good method for treating Type-A and Type-C fractures and extended indications for pathological fractures, failed distal femoral osteosynthesis and fractures in osteoporotic bones. In Type-C fractures good articular congruity is achieved by fixing the fragments with condylar screws.</p> Vasu Karlapudi Copyright (c) 2022 Vasu Karlapudi 2022-01-18 2022-01-18 5 3 194 200 Comparison of Intravenous Esmolol and Oral Clonidine for Attenuation of Stress Response to Laryngoscopy and Intubation in Patients Undergoing Surgery under General Anesthesia: A Randomized Clinical Study <p>Introduction: Direct laryngoscopy and endotracheal intubation are the most noxious stimuli during induction of anaesthesia. Airway instrumentation frequently induces a cardiovascular stress response characterized by hypertension and tachycardia due to reflex sympathoadrenal discharge caused by epipharyngeal and parapharyngeal stimulation. Various pharmacological approaches have been used to attenuate the pressure responses to laryngoscopy and tracheal intubation e.g. volatile inhalational agents, lignocaine, opioids, sodium nitroprusside, nitroglycerine, calcium channel blockers, and adrenergic blockers (alpha -2 agonists and beta blockers).Objectives: The purpose of this study is to compare the efficacy and safety of i.v esmolol and oral clonidine in attenuating the changes of blood pressure and heart rate by tracheal intubation.Materials and Methods: 40 patients posted for various surgeries under general anesthesia were randomly divided into two groups. Group C subjects received Clonidine 150 mcg PO, 90 minutes prior to induction of anaesthesia where as Group E subjects received I.V Esmolol 0.5mg/kg 90 seconds prior to intubation. To maintain blinding, Group C patients received I.V 0.9% Normal saline 90 seconds prior to intubation where as Group E patients received placebo tablet containing multi vitamins 90 minutes prior to induction .HR, systolic blood pressure (SBP), diastolic blood pressure (DBP), Mean arterial pressure (MAP) , rate pressure product (RPP), Spo2, ECG will be recorded prior to induction (Base line), at the time of intubation and 1, 3, 5, and 10 min after intubation . Type of study: A randomized clinical study.Results: Pulse rate, SBP, DBP, MAP and RPP were comparable at baseline, at time of induction, during laryngoscopy and intubation and throughout whole study period it was not statistically significant in both groups (p&gt;0.05). However in Intergroup comparison, SBP was comparable at base line and after 5 min of laryngoscopy and intubation in both groups, but SBP was significantly higher after 1 and 3 min of laryngoscopy and intubation in Group E than Group C. Also, there was statistically significant increase in MAP following laryngoscopy and intubation at one min in Group E than Group C (P&lt;0.05). RPP was significantly higher after 1 and 3 min of laryngoscopy and intubation in Group E than Group C. Postoperative complications like dryness of mouth, excessive sedation, PONV, hypotension, Bradycardia, bronchospasm were not observed in any case in both groups. Conclusion: This study concluded that clonidine and esmolol provide hemodynamic stability but clonidine provides more stability with postoperative sedation.</p> K. Siri Bhavani Kiran Kumar Suggala Degutla Karthik Chary Copyright (c) 2022 K. Siri Bhavani, Kiran Kumar Suggala, Degutla Karthik Chary 2022-01-18 2022-01-18 5 3 201 208 Efficacy And Safety Profile of Erythropoietin in Chronic Kidney Disease Patients of Vizianagaram, Andhra Pradesh <p>Background: Anaemia is a common complication of chronic kidney disease. The close relationship between haematopoiesis and the kidney was first recognized by Richard Bright in 1835 when he described the association between anaemia and chronic renal failure. Much of the morbidity in renal failure patients can be attributed to the consequences of their chronic anaemia. Aim &amp; Objectives: The aim of this study is to evaluate the efficacy and safety of human recombinant Erythropoietin in the treatment of anaemic patients due to chronic renal failure. Methods: This study was conducted at Department of Nephrology and dialysis unit, MIMS, Vizianagaram. Study Period was from October 2013 to September 2015 who are on haemodialysis for duration of six months to two years. For this a total number of 46 participants were screened. All 46 patients were given erythropoietin [EPOFIT] manufactured by INTAS pharmaceuticals by subcutaneous route Results: Patients will undergo laboratory investigations for haemoglobin, haematocrit (Hct), reticulocytes, RBC counts, serum ferritin and TSAT at the baseline and end of the study. Haemoglobin, haematocrit and red cell count, reticulocytes, serum ferritin and TSAT will be done once in 4 weeks till the end of the study. Conclusion: Of the total 46 patients enrolled in the study, 31 patients required only regular conventional dose of 50 units /kg /dose and only 9 patients required incremental dose of erythropoietin 75 units/kg to achieve target haemoglobin level. In our study Haemoglobin increased progressively in 77% patients at 4 weeks and 23% patients at the end of 12 weeks.</p> Sindhura Nagisetty Naga Sreenivasulu Jillella Tulasi Madhuri Thotakura Madhav P Copyright (c) 2022 Sindhura Nagisetty, Naga Sreenivasulu Jillella, Tulasi Madhuri Thotakura, Madhav P 2022-01-18 2022-01-18 5 3 209 212 A study on relationship between serum ferritin and HbA1c in type 2 diabetes mellitus <p>Background &amp; Objective: To find the association of elevated serum ferritin levels with Type 2 Diabetes Mellitus and to study the relationship between serum ferritin levels and Hba1c in type 2 Diabetes mellitus. Our objective is to assess the serum ferritin levels in type 2 diabetes patients, to determine the role of serum ferritin level as an indicator of glycaemic control like HbA1c and also as a marker of insulin resistance. Methods: Physical examination and Laboratory investigation such as FBS, PLBS, Serum ferritin, HbA1c are done in every patient and collected detailed History. Results: Most common age groups are 51-60 years and 61-70 years, majority of study population comprised of males (69%), significant difference seen with gender wise and age wise distribution of Diabetes mellitus, mean values of HbA1c is 7.26%, FBS is 151.34 mg/dl, PPBS is 209.17 mg/dl and serum ferritin is 193.78 mg/dl. Correlation between duration of Diabetes and HbA1c with serum ferritin is statistically significant with p-value &lt;0.001. With spearman correlation it is 1.0 with serum ferritin and HbA1c shows strong positive correlation. Conclusion: In our study we conclude that elevated levels of serum ferritin seen in patients with type 2 diabetes mellitus, Diabetic patients with increased HbA1c had significant hyperferritinemia and serum ferritin can be used as marker of glycaemic control as HbA1c and also a marker of insulin resistance in Diabetic patients.</p> Ramavath Raghu Ramulu Naik S V Pramod Reddy M J K Sowjanya Copyright (c) 2022 Ramavath Raghu Ramulu Naik, S V Pramod Reddy, M J K Sowjanya 2022-01-18 2022-01-18 5 3 213 218 Clinical Study of Posterior Urethral Valves <p>Background: Posterior urethral valves are the commonest structural cause of urinary outflow obstruction in boys.(1) It is also the most common type of obstructive uropathy leading to childhood renal failure.Aims and Objectives: To observe the clinical, biochemical and imaging patterns of posterior urethral valves and how they change after initial treatment and during follow up.To review the results of Primary valve ablation and Vesicostomy in management of Posterior urethral vales Materials and methods:We prospectively studied 28 patients from October 2015 to September 2017 with posterior urethral valves who were primarily treated at our hospital or referred from other hospitals for subsequent therapy.<br>Results: Only two patients (i.e., 7.14%)had a prenatal diagnosis as part of antenatal ultrasound examination. Decreased urinary stream and straining to void are the most common symptoms in present study. Reflux resolved completely in 7of 16 units (43.75%), reduced in grade in 3 of 16 units (18.75%) and remained unchanged in 6 out of 16 units (37.5%).In the present study 10.71% of patients had CRF, whose age at presentation was more than 5 years of age. All these patients had serum creatinine at presentation &gt; 2 mg/dl.Conclusion: In any male child with bilateral hydroureteronephrosis &amp; distended bladder on ultrasonography, a diagnosis of PUV should be entertained.The management of PUV at the first outset should be, urethral catheterization, stabilization of general condition, followed by primary valve ablation.The shortterm results of Primary valve ablation are good.Vesicostomy is equally effective. Reflux tends to disappear or decrease in grade in majority following appropriate surgical management.Delay in diagnosis results in poor outcome of renal function.A much longer period of follow up is needed to understand the longterm results.</p> Krishna Sumanth Thota Dr Prakasa Rao Copyright (c) 2022 Krishna Sumanth Thota, Dr Prakasa Rao 2022-01-18 2022-01-18 5 3 219 223 Psychopathology and Cognitiveimpairment in Patients with Hypothyroidism <p>Background and Objectives: Hypothyroidism is a chronic illness that affects the thyroid gland and is more common in women and the elderly. Patients with hypothyroidism are at a higher risk for psychiatric morbidity and cognitive impairment than the general population. No published Indian study in this precise topic has been identified by the current investigator to date. According to several findings, persons with hypothyroidism are more likely to have major psychiatric illnesses, psychiatric symptoms, or cognitive impairment. Among individuals with hypothyroidism, the researchers hope to determine the prevalence of psychiatric diseases, the frequency and character of psychiatric symptoms, and the presence of cognitive impairment.Methodology: It was decided to include 200 patients for the purpose of this investigation.A total of 100 patients with hypothyroidism and 100 patients with hypertension were assessed. The Mini International Neuropsychiatric Interview Plus (MINI Plus) was used to assess psychiatric disorders, the Comprehensive Psychopathological Rating Scale (CPRS) was used to assess psychiatric symptoms, and the Standardized Mini-Mental Status Examination (SMMSE) and the Brief Cognitive Rating Scale (BCRS) were used to assess cognitive functions in the study.Results: When compared to controls, patients with hypothyroidism experienced a higher rate of psychological morbidity.The frequency of psychiatric illnesses was found to be 52 percent in patients with hypothyroidism and 12 percent in individuals in the control group, with the difference being statistically significant in both cases. All patients suffering from Hypothyroidism was associated with psychiatric symptoms that did not fulfil the criteria for psychiatric illnesses, according to the study. In the domains of direction, language, and the building of SMMSE, patients with hypothyroidism demonstrated significantly substantial cognitive deficiencies compared to controls. In addition, they demonstrated highly severe cognitive deficits on the BCRS in the aggregate.Psychosomatic diseases, psychiatric symptoms, and cognitive impairment were all found to have a significant relationship with serum TSH concentrations. Additionally, there was a strong link between psychiatric diseases and serum FT4 levels.Conclusion: When comparing patients with hypothyroidism to those with hypertension, the prevalence of psychiatric disorders, psychiatric symptoms, and cognitive impairment is much higher in the hypothyroidism group.</p> Purkanti Shwetha Copyright (c) 2022 Purkanti Shwetha 2022-01-18 2022-01-18 5 3 223 229 Psychiatric Morbidity in Geriatric in patients with Medical Disorders <p>Background and objective: People over the age of 65 account for twice the average number of physician interactions and three times the average number of hospital bed days compared to the general population. Geriatric medical patients are distinguished from their younger counterparts by the presence of medical comorbidities and disabilities, rather than by their age, according to research conducted by the American Academy of Pediatrics. The current investigator was unable to locate any published studies that compared psychiatric morbidity in geriatric inpatients with medical diseases to that of adult inpatients with medical disorders in either age group, which was disappointing.The goal is to This study aims to determine the prevalence and nature of psychiatric problems in geriatric inpatients with medical diseases, as well as the relationship between clinical and sociodemographic profiles in this population when compared with that of adult inpatients with medical disorders.Methods: A total of one hundred consecutive geriatric inpatients and fifty consecutive adult inpatients admitted to the medical wards were evaluated in this study. The MINI Plus and Comprehensive Psychopathology Rating Scale (CPRS) were used to assess psychiatric morbidity, the Mini Mental State Examination (MMSE), the Clock Drawing Test (CDT), and the Trail Making Test- B (TMT-B) were used to assess cognitive impairment, and the Bristol Activities of Daily Living Scale was used to assess functional status (BADLS). The Diagnostic Criteria for Research (DCR-10), which is part of the ICD-10 Classification of Mental and Behavioral Disorders, was utilised to determine a psychiatric diagnosis.Results: The prevalence of psychiatric illness in the geriatric population is 26.75 percent, while it is 35 percent in the non-geriatric population. Depressive disorders accounted for 17.5 percent of all mental diseases identified in the elderly, followed by dementia (8.75 percent), anxiety disorder (5 percent), alcohol dependence syndrome (2.5 percent), and organic delusional disorder (0.5 percent) (1.25 percent ). The duration of medical disease, the number of medical diagnoses, cognitive functioning, and functional status all have a substantial impact on the risk of developing psychiatric morbidity. In the elderly, diabetes has a high association with psychopathology. The presence of psychiatric morbidity is not associated with gender, marital status, educational level, or socioeconomic situation.Conclusion: When compared to their younger counterparts with medical problems, elderly inpatients with medical disorders have much more frequent and severe psychopathology, as well as cognitive and functional impairment. But there is no difference in the frequency or character of psychiatric diagnoses in geriatric patients with medical diseases compared to adult patients with medical disorders.</p> Purkanti Shwetha Copyright (c) 2022 Purkanti Shwetha 2022-01-18 2022-01-18 5 3 230 235 A Comparitive Evaluation of Blood Sugar and Glycosylated Haemoglobin in Clinically Manifested Diabetic Neuropathy <p>Aim &amp; Objective: The present study has been undertaken to monitor the levels of blood sugar and HbA1C in diabetic neuropathyMethodology: The present study was conducted at Mahatma Gandhi Memorial Hospital, Warangal. The study was undertaken between June’2018 to May’2019 both in inpatient and outpatient department. Diabetic patients seeking consultation for the symptoms suggestive of neuropathy were screened and labeled as suffering from diabetic neuropathy based on the inclusion and exclusion criteriaResults: 60 patients of diabetic neuropathy were studied Out of them36 were males and 24 were female.The age of the patients varied between to 16 years to 70 years (mean:52.2yrs).The incidence of IDDM were 2 and that of NIDDM were 58.The duration of diabetes varied from0 to 25 years (mean 8.7 years).Only 11 patients received regular treatment. Symptoms of sensory system involvement were the most common 47 (78.3%) patients followed by motor symptoms 20 (33%) cases. Autonomic symptoms 10 cases and cranial nerve symptoms 2 cases. Examination of the cranial nerve revealed diabetic retinopathy in 33 patient,I IIrd cranial nerve palsy in 2 patient and LMN facial nerve palsy in one patient. Symmetrical sensory loss was confined to the lower limbs in all patients. Distal symmetric sensory neuropathy was the most common type of clinical neuropathy. III cranial nerve palsy was the most common cranial neuropathy. Motor and autonomic neuropathies were found in significant number of patients. Blood sugar estimation revealed evidence of poor control in 12 patients (20%). In patients with peripheral neuropathy with or without associated complications of diabetes (Like retinopathy, autonomic neuropathy) estimation of glycosylated hemoglobin was a better indicator of poor metabolic control.Conclusion: The efficacy of glycosylated hemoglobin estimation in assessing diabetic control is not influenced by Age, Sex, duration, or diabetes and a mode of therapy.Longer the duration and poorer the control of diabetes, more are the chance of development of the complications of diabetes.</p> Ponnala Suresh Copyright (c) 2022 Ponnala Suresh 2022-01-18 2022-01-18 5 3 236 242 A review of changes caused by COVID-19 pandemic in the lifestyle of People with Diabetes (PWD) in India <p>Background: COVID-19 pandemic has set a new normal to the life of people in the world. It has severely affected the lives of people living with diabetes across the world. India has the second-largest population living with diabetes and the pandemic has posed several challenges in their daily living. It has not only affected the physical and social health but also has a negative impact on the psychological health of PWD in India. Aims: This review aims to find out the effect of the pandemic and the measures to improve the health of PWD in different regions of India. Methods: A web-based search was conducted on the topic of diabetes and Covid-19 pandemic and life-style modification in India. Boolean research was done to find out the literature on PubMed and Google Scholar. We found 157 articles of which we selected 56 articles with full text retrieved. Results: A weight gain of 5-10% in 19% of the person(s) with diabetes (PWD) indicates that there were negative impacts on glycaemic control and overall health condition of a group of persons with diabetes. 44.8% of PWD population of Bihar changed their eating habit and 19.7% noticed an increase in weight which looks little less than the other parts of the country. Conclusion: In conclusion, uncontrolled diabetes is one of the major causes of high mortality in COVID-19 infection. There is an urgent need for a structured diabetes education plan for different areas of India.</p> Subhash Kumar Abhijeet Gupta Anjali Vijaya Copyright (c) 2022 Subhash Kumar, Abhijeet Gupta, Anjali Vijaya 2022-01-18 2022-01-18 5 3 243 247 Patterns of late gadolinium enhancement in injured myocardial tissue – A descriptive single centre study <p>Background: CMR and LGE MR imaging is now been increasing used in diagnosis of various cardiac diseases and the characterization of different patterns of scarring / fibrosis of myocardial tissue. Different spectrum of enhancement can be seen in many pathophysiologic conditions including ischemic and non-ischemic causes. Methods: Late gadolinium enhancement MRI was performed in 28 patients in the age group of 13- 70 years ( mean age group of 42 ) and the patterns of myocardial delayed enhancement was analyzed in the year 2020 - 2021. Results: 14 out of 28 (50%) patients demonstrated late gadolinium enhancement. 3 out 14 (21.4 %) cases were due to ischemic causes and 11 cases ( 79.6%) due to non ischemic causes. Conclusion: Imaging of myocardial disorders encompasses a large variety of conditions including both ischemic and nonischemic diseases. Cardiac MRI sequences like LGE play a critical role in establishing diagnosis, determining prognosis, and guiding therapeutic management Categorization of abnormal delayed myocardial enhancement according to location (subendocardial, transmural, subepicardial, or mesocardial) allows differentiation between ischemic (infarct-related) and nonischemic cardiomyopathies and, in cases of nonischemic cardiomyopathy, narrowing of the differential diagnosis.</p> Varun Narayanan Hareeesh Jayaram Anstin Jose Afra John Copyright (c) 2022 Varun Narayanan, Hareeesh Jayaram, Anstin Jose, Afra John 2022-01-18 2022-01-18 5 3 248 252 A Microbiological Study on Abrupt Rise of Mucormycosis Cases in the Backdrop of Covid-19 in a Tertiary Care Hospital in West Bengal <p>Background: There is increasing evidence of mucormycosis in COVID-19 patients during or post treatment caused by different microorganisms and for their culture, specimens from certain sites are collected. The present study was conducted to assess different genera causative of mucormycosis, to describe the suitability of specimens for their culture and to determine the relationship between mucormycosis and COVID-19. Methods: The descriptive cross sectional study was conducted among all the 50 samples which were received at Microbiology laboratory, Bankura Sammilani Medical College and Hospital during May to September 2021 inoculating them in SDA and SDCA media within a class II bio safety cabinet and after incubating for at least 7 days at room temperature, processing for 40% KOH mount and LCB staining were done. Slides were observed under light microscope. Principles of descriptive statistics were used. Chi square test was done where applicable. Results: 44% of samples showed no growth while 30% and 26% of them exhibited the growth of Mucor and Rhizopus respectively. Majority of the mucorales were seen growing on the samples collected from nasal septum followed by middle meatus and maxillary sinus. Significant association was noted between the occurrences of mucormycosis and infection with COVID19 (p = &lt; 0.001) Conclusions: Mucor and Rhizopus are the main causative genera of mucormycosis and the suitable specimens for culture of them are tissue from nasal septum, middle meatus, maxillary sinus etc. Mucormycosis is significantly associated with COVID positivity.</p> Rahul Ballov Mrinmoy Pathak Jayanta Bikash Dey Sanjit Kumar Patra Sohanjan Chakraborty Copyright (c) 2022 Rahul Ballov, Mrinmoy Pathak, Jayanta Bikash Dey, Sanjit Kumar Patra, Sohanjan Chakraborty 2022-01-18 2022-01-18 5 3 257 260 A Prospective Study on Outcome of High Tibial Osteotomy Among Patients of Osteoarthritis of Knee Joint With Varus Deformity At A Tertiary Care Center of Bihar <p>Introduction: Osteoarthritis is a degenerative disease characterized by gradual development of joint pain, stiffness, swelling and limitation of movements. Osteoarthritis causes chronic disability; the degree of disability depends on the site involved and varies greatly between individual. In the present study, outcome after high tibial osteotomy has been evaluated with respect to postoperative improvement and individual goal achievement. Methodology: A prospective interventional single centre study was conducted at Madhubani Medical College &amp; Hospital, Bihar during the period of 1 year between August 2019 to July 2020 after permission from Institutional Ethical committee. After this, the patients were followed up till 12 months. The patients included were those who had standard indication for High tibial osteotomy. Inclusion criteria to include the patients in this series were, Unicompartmental Arthritis of knee with varus deformity, good muscle strength to carry out rehabilitation and good vascular status without arterial insufficiency. During the study period, a total of 20 patients were selected and assessed preoperatively and postoperatively with Knee Society score and Functional Score sheet. Assessment and evaluation was done using a regularized custom made protocol which included the symptoms of the patients, associated medical conditions, knee society score and knee society functional score. Results: In the current study, the age of the patients had ranged from 44 – 53 years with a mean age of 48.4 years. Among the 20 patients, majorities were female with a male: female ratio of0.54:1. For majority of the patients right side of the knee was involved and 3 patients had bilateral knee involvement. 75% of the patients had grade III type of Osteoarthritis and rest 25% had grade IV type of Osteoarthritis. Conclusion: The main improvements seen in this study were related to pain reduction and an increase in the knee score and functional score after high tibial osteotomy and also delays the need for total knee replacement.</p> Nipendra Kishore Md Anwar Mohammad Ekram Copyright (c) 2022 Nipendra Kishore, Md Anwar, Mohammad Ekram 2022-01-18 2022-01-18 5 3 261 263 Osteoporosis in postmenopausal women - A major cause of concern <p>Background: Osteoporosis is a metabolic disorder of the bones that is characterized by decreased bone density which predisposes to increased fracture risk. The disease can exist undiagnosed for a long time as it produces no distinct symptoms. Aim: To assess osteoporosis in postmenopausal women. Materials and Method: This is a prospective study conducted on Post menopausal women. Women who had undergone hysterectomy or who were on hormone replacement therapy or calcium or vitamin D preparations were excluded from the study. The participants underwent BMD measurement by Achilles Ultrasound bone densitometer. The results of BMD were analysed on the basis of T-Scores. Results: Of the 90 patients that were included in the study 42.2 % (n=38) were in the age group of 45-55years. In almost 50% of patients the duration of menopause was 6-10 years. Out of the 90 patients 10% (n=9) were normal, 44.4% (n=40) were osteopenic, 33.3% (n=30) were osteoporotic and 12.2% (n=11) were severely osteoporotic. Backache was the commonest presenting symptom in the study population. Conclusions: Quantitative ultrasound (QUS) is a rapid and in-expensive method of measuring bone density. In our study 90% of the postmenopausal women had subnormal T scores. We recommend regular BMD measurements in postmenopausal subjects for early diagnosis and treatment of osteoporosis in this vulnerable group.</p> Sweta Singh Priya Ranjan Priyanka Rani Sadhana Singh Copyright (c) 2022 Sweta Singh, Priya Ranjan, Priyanka Rani, Sadhana Singh 2022-01-18 2022-01-18 5 3 264 266 High-Level Aminoglycoside Resistance and Distribution of Aminoglycoside Resistant Genes among Clinical Isolates of Enterococcusin a Tertiary Care Hospital <p>Objectives: The aim of study was to determine the susceptibility of clinical isolates of Enterococcus species to high level aminoglycoside by MIC test and the presence of five different aminoglycoside modifying genes [AMEs]. Methods: Enterococci were isolated from various clinical samples. High level resistance to gentamicin and streptomycin was done by high potency disc diffusion method [HPDDM]. Screenings to both the antibiotics were done by agar screen method [ASM]. Minimum Inhibitory Concentration [MIC] was determined by Agar Dilution Method [ADM]. Multiplex PCR was used to detect the presence of AME genes. Results: 21.4% [24/112] and 25.8% [29/112] strains were resistant to gentamicin and streptomycin by ASM. A total of 32.2% [36/112] were found to be HLGR with MIC &gt; 512μg/ml. 29 strains were found to show resistance to streptomycin with MIC i.e. ≥ 2048 μg/ml.aac(6′)-Ie-aph(2′′)-Ia gene was found in 16.9% [19/112] of enterococcal isolates. Moreover, 4.5% (5/112) of the Non-HLAR strains with MIC [256 μg/ml] expressed aac(6′)-Ie-aph(2′′)-Ia gene. Newer AME genes like aph(2′′)-Ic&amp;aph(2′′)-Id were detected in 4.5% [5/112] and 5.4% [6/112] strains. The predominant virulence gene in HLAR was hyl gene [44.1%; 30/68]. Conclusions: The study concluded that the AMEs have disseminated amongst the non-faecalis non-faecium strains in this region. The number of aac(6”)-Ie-aph(2”)-Ia genes detected by PCR was less as compared to those detected by MIC test, it should be taken into consideration that due to the intrinsic limitations of any PCR assay, a negative result may not always signify the absence of a gene altogether in enterococcus.</p> Priyanka Paul Biswas Anamika Singh Sangeeta Dey Farhaan Fidai Mohammad Hassan Bin Ozair Aninda Sen Copyright (c) 2022 Priyanka Paul Biswas, Anamika Singh, Sangeeta Dey, Farhaan Fidai, Mohammad Hassan Bin Ozair, Aninda Sen 2022-01-18 2022-01-18 5 3 267 271 Assessment of serum trace element (copper) level, as an associated risk factor in patients with chronic kidney disease <p>Background: Chronic Kidney Disease (CKD) is a progressive loss of kidney function and is a worldwide public health problem both for the number of patients and for the cost of treatment. Trace elements such as copper (Cu) is altered in CKD. We assessed 100 subjects of both sex with different age groups, among them 50 are normal healthy controls (group 1) and 50 are CKD patients (group 2) from dialysis ward (medicine) S.R.G. Hospital, Jhalawar Medical College, Jhalawar (Raj.) Serum copper was estimated using Flame Atomic Absorption Spectrophotometer (AAS). Results: Serum copper level was significantly low in CKD patients, mean ± SD (1.2041 ±0.46360) (p&lt;0.05) when compared with the healthy control group (1.3823 ± 0.25259) (p&lt;0.05). Gender had no significant effect on serum copper level, in males, (1.1992± 0.41431) and females (1.2146± 0.56946) (p&gt;0.05). Conclusion: This study shows that in CKD patients, trace elements derangement is important in the primary diagnosis of trace element dysfunction and medical management of CKD.</p> Ritika Gupta Rinku Bansal R.D. Mathur Ajay Kumar Bhargava Copyright (c) 2022 Ritika Gupta, Rinku Bansal, R.D. Mathur, Ajay Kumar Bhargava 2022-01-18 2022-01-18 5 3 272 274 Ki 67 expression in breast carcinoma – Its relationship with age of the patients and pathological stage of the disease <p>Background: Breast carcinoma is a heterogeneous tumor with different histological subtypes and classifications. The role of proliferative molecule Ki67 in breast carcinoma is both as a prognostic and theranostic marker. However it lacks analytical validity and not recommended for routine use. In the recently concluded Galen’s conference, Ki 67 cut off of 30% was recommended to determine the chemotherapy requirement. Ki 67 working group recommends 5% Ki 67 as negative and 30% Ki 67 index as significant.This study was done to analyze the ki67 expression in different age groups and different TNM stages. Materials and Methods: During our one year study period, the received breast specimen cases were analyzed by our panelists. Ki67 Immunohistochemistry was done and on which manual scoring was done. Age wise incidence of breast carcinoma, correlation between ki67 and age and relationship between ki67 and various stages were tabulated. p value was calculated to find out if there is any significance between the variants analyzed. Results: Out of 113 cases received, on ninety cases Ki67 Immunohistochemistry was done and rest was excluded. Mean age incidence was 51.8 years. High Ki 67 proliferating index was seen in younger age group, and in those with higher disease stage. No significant p value was reached when Ki 67 indexes was correlated with age or with stage of disease in our study. Conclusion: Proliferation marker Ki 67 though lack analytical validation, is still recommended for deciding chemotherapy for breast carcinoma cases. Despite the availability of automated count, manual method is followed in many centers. This study was done to underline the fact that consensus should be reached for uniform assessment of Ki 67 so that the dilemma among pathologists is meted out. The grey zone ki67 index level between 6-30% should be addressed as well for better clarity.</p> S.Shifa C.Sofia Tamilarasi K.Kamalakannan Copyright (c) 2022 S.Shifa, C.Sofia Tamilarasi, K.Kamalakannan 2022-01-18 2022-01-18 5 3 275 279 Screening of Hepatitis B and Hepatitis C in a tertiary care center of Bihar <p>Introduction: It is estimated that 325 million people worldwide are living with chronic HBV or HCV infection. The risk of chronicity is more in neonates (90%) and young children (20-60%) than in infection that is acquired in adulthood (5%). Methodology: This study was conducted at Jawahar Lal Nehru Medical College &amp; Hospital, Bhagalpur, Bihar, India by the Department of Microbiology during the study period of 1 year from January 2021 to December 2021. Patients’ samples were obtained from various outdoor patient departments &amp; Indoor wards and were tested for HbsAg or Anti HCV antibody on Enzyme linked immunosorbent assay (ELISA) test. Five milliliter of blood was collected and serum was separated which was divided into two aliquots; one was used for HbsAg and the other was used for anti-HCV antibody for ELISA testing. In total, 1000 samples were collected and tested for HbsAg and anti HCV antibody. Prior approval was obtained from the Institutional Ethics Committee. Collected data was tabulated and analyzed using SPSS ver. 21.0. Collected data was tabulated and analyzed using SPSS ver. 21.0. Results: A total of 1000 samples were collected and tested during the study duration. On analysis of collected samples, the prevalence of HbsAg was 6.12% which is higher in comparison to other parts of India where usually maximally it has been reported to around 4%. In case of anti HCV antibodies the prevalence was 5.89% which is greater than expected in India where it was thought to be around 1%. Conclusion: Availability of sufficient recent estimates of HBV or HCV prevalence is necessary to evaluate control measures and health care planning.</p> Sweta Gupta Ranjan Kumar Ashif Ali Hassan Copyright (c) 2022 Sweta Gupta, Ranjan Kumar, Ashif Ali Hassan 2022-01-18 2022-01-18 5 3 280 282 Phenotypic speciation of clinical isolates of Enterococci with special reference to Vancomycin susceptibility by Broth Micro-dilution method <p>Background: Enterococci, once regarded as a commensal in the gastrointestinal tract, are now emerging as an important nosocomial pathogen. By intrinsic and acquired mechanisms of resistance, they pose a significant therapeutic challenge. Objectives: This study aims to characterize Enterococci up to species level based on their phenotypic characters and study their antibiogram with special mention to Vancomycin susceptibility. Materials and Methods: A cross-sectional descriptive study was conducted in the Department of Microbiology, Andhra Medical College. A total of 47 Enterococci isolates recovered from clinical specimens like Urine &amp; Pus are included in this study. Specimen processing and speciation were done according to standard protocols. Kirby–Bauer disc diffusion technique was used to study antimicrobial susceptibility pattern with recommended drugs including high-level aminoglycoside resistance, whereas the minimum inhibitory concentration of vancomycin was determined by the Broth Microdilution method, with reference to the Clinical and Laboratory Standards Institute guidelines (CLSI). Results: Two different species of Enterococci were isolated, E. faecalis and E. faecium accounting 86% and 14% each. All the strains were sensitive to Vancomycin, Linezolid and Teicolplanin, while all the urine isolates are also sensitive to Nitrofurantoin. Disparities were not observed between the disc diffusion technique and Broth Microdilution method in determining vancomycin resistance. Conclusion: E.faecalis and E. faecium were the predominant species in causing Enterococcal infections. To maintain the low level of resistance, improvement of antibiotic policies and hospital infection control is essential.</p> Gowtham Burle Parvathi T Copyright (c) 2022 Gowtham Burle, Parvathi T 2022-01-18 2022-01-18 5 3 283 289 Quantitative evaluation and grading of neurological recovery after Anterior Cervical Surgery for Single or Double Level cervical Spondylotic Myelopathy <p>Background: Cervical Spondylotic Myelopathy (CSM) is a common cause of spinal cord dysfunction it may lead to function disability as well as neurological deterioration. Surgical decompression is essential in progressive disease. Postsurgical neurological recovery assessment is essential. Most of these methods of assessment is either subjective or numerical values at a time. It is important to quantify these outcome and grade it into a scale for better understanding. Materials and Methods: 48 patients with single or double level CSM underwent anterior cervical discectomy and fusion (ACDF) or anterior cervical corpectomy and fusion at our institute from January 2017- 2019. Data analyzed for age, sex, duration of follow-up, operative time, blood loss and complication. Moderate and severe grade myelopathy considered surgical candidates. 31 patients had moderate (mjoa,12-14) and 14 patients had severe (mJOA ,11 and less) myelopathy. Metallic spacer for ACDF and titanium mesh cage (TMC) for ACCF with Morcellised local auto graft and all cases supplemented with variable angle cervical plates. MJOA scores and Hirabayashi recovery rate calculated at 1st month, 3rd month, 6th month and 12th month post-operatively. Results: Out of 48 patients, we had final follow-up of 45 patients. Mean age of our study 58.53±6.61 years (range 35- 73 years) Mean duration of follow-up 19.71±5.29 months (13 – 34 Months). Mean operative time and mean blood loss was more in single level ACCF cases as compare to single ACDF cases. C5-C6 ACDF and C5 Corpectomy were most performed surgeries in our study. Our all patient has shown neurological recovery from some to complete extent at final follow-up of 12 months. All moderate grade patient improved to mild grade or normal neurology and all severe grade patients improved to either moderate or mild grade .We have observed 100 % improvement in mJOA grade after anterior cervical surgery. At 12 months follow-up, 12 patients had normal (18) mJOA Score, 30 mild (mJOA, 15-17) grade and 3 moderate grade. At final follow-up 93.3% patients had shown excellent to good recovery rate(29/ 45 excellent , 13/45 good whereas 3/45( 6.66%) have shown fair recovery rate .One patient had deep surgical site infection, three patients had transient dysphagia, one had dural injury and one patient had subsidence of TMC. Conclusion: Anterior cervical surgery is safe and effective surgery for single/ double level cervical spondylotic myelopathy (CSM) with less complication rates.</p> Mahendra Singh Kuldeep Dhankhar Nandlal Bharwani Hemant Jain Kishore Raichandani Mahesh Bhati Copyright (c) 2022 Mahendra Singh, Kuldeep Dhankhar, Nandlal Bharwani, Hemant Jain, Kishore Raichandani, Mahesh Bhati 2022-01-18 2022-01-18 5 3 290 295 Incidence of ESBL Producing Organisms In Neonatal Sepsis <p>Introduction: In neonates (0–28 days) ESBL-producing Klebsiella pneumoniae is an important cause of nosocomial infections. The present study is directed to determine the frequency of infections caused by ESBL-producing organisms, the various bacteria producing ESBL, and the antibiotic susceptibility of these organisms in a neonatal intensive care unit in a tertiary care hospital of Bihar. Methodology: This study was conducted in the tertiary-level referral and inborn neonatal units by the Department of Microbiology at GMC, Bettiah, Bihar, India, from March 2020 February 2021. Written informed consent was obtained for each subject from the parents. The study was approved by the institute’s Ethics Committee. All patients with suspected neonatal sepsis admitted during the study period were included in the study. A total of 120 cases were enrolled in the study during the study period. Data was analyzed using Statistical Package for Social Sciences ver. 20.0 (IBM, Chicago). Results: Culture-positive gram-negative organisms were found in 42 neonates. Of these mixture of organisms was found in 5 neonates and was excluded from the study. The incidence of ESBL producing organism was 5%. Klebsiella was isolated from 4 out of 6 ESBL positive samples and another 2 yielded Escherichia coli. Among the 31 ESBL negative culture, majority were Acenitobacter (51.6%) followed by Klebsiella (29%) and then Enterobacter (12.9%). Conclusion: Longitudinal surveillance of the microbial flora and their antibiotic sensitivity pattern should be done in every hospital periodically to know the existing flora and for appropriate management of the infection by these organisms.</p> Animesh Kumar Nandlal Kumar Chandra Shekhar Jha Copyright (c) 2022 Animesh Kumar, Nandlal Kumar, Chandra Shekhar Jha 2022-01-18 2022-01-18 5 3 295 298 A study of Clinical Profile assessment in Patients Undergoing Mass Closure and Layered Closure for Laparotomies <p>Background: Linen and Cotton were already in use. Silk was the next suture of choice in non-absorbable suture range. It became very popular because of its excellent handling properties. It was extensively used in all surgical procedures including Cardiovascular Surgery. Aim: To assess the clinical profile of Patients Undergoing Mass Closure and Layered Closure Techniques in Laparotomies. Materials and Methods: History taking was followed as a routine in all cases admitted to the wards.Plain X-ray abdomen, Contrast X-rays like barium meal, Upper GI endoscopy and Abdominal ultrasound and CT scan were done in necessary cases. However in emergency cases, only the investigations necessary for supporting the diagnosis were employed. Results: In this study mid line incision was done in 39 patients, 65% of patients, Right Para Median incision in 18 patients 30 %, left Para median in 3 patients, 5%. In this study in mass closure group a mean time taken (min) 15.73 was required for the closure of the incision with standard deviation of 1.82.In the layered closure group mean time taken (min) was 25.03 with a standard deviation of 1.83. Conclusion: The age of the patients ranged from 15-65 years. Out of 60 patients 16 were in the age group of &lt;30 years, 13 were 30-39 years, 11 were 40-49 years and 20 were &gt;50 years.</p> Abhishek Mishra Binoy Kumar Pankaj Kumar Mishra Copyright (c) 2022 Abhishek Mishra, Binoy Kumar, Pankaj Kumar Mishra 2022-01-18 2022-01-18 5 3 299 301 A Comparative Study of Lichtenstein technique with Rutkow–Robbins and Gilbert double layer techniques in inguinal hernia repair <p>Background: A hernia is defined as an abnormal protrusion of a viscus or a part of it, through the wall that contains it but without a breach in the body surface. By far the commonest variety of hernia is the protrusion of abdominal wall. Inguinal hernia most probably has been a disease ever since mankind existed. Aim: To compare the Lichtenstein technique with Rutkow–Robbins and Gilbert double layer techniques in inguinal hernia repair. Materials and Methods: This study was conducted to compare, three different techniques of Rutkow-Robbins Repair (Group-A), Gilbert double Repair (Group-B) and Lichtenstein operation (Group-C). Results: In this study, out of total 95 patients, 60 (63.1%) patients were having right indirect inguinal hernia, 30 (31.6%) patients were having left indirect inguinal hernias and 10 (10.5%) patients were having bilateral inguinal hernias. From the above data it is clearly shown that there is much higher incidence of right sided indirect inguinal hernias as compared to the left sided indirect inguinal hernias and bilateral inguinal hernias. Conclusion: Lichtenstein technique is recognized as the most advantageous method in inguinal hernia repairs.</p> Abhishek Mishra Binoy Kumar Pankaj Kumar Mishra Copyright (c) 2022 Abhishek Mishra, Binoy Kumar, Pankaj Kumar Mishra 2022-01-18 2022-01-18 5 3 302 305 A Study on Evaluation of Predictive Value of Microalbuminuria as a Screening Tool for Pre-eclampsia Among Patients Attending A Tertiary Care Centre Of Bihar <p>Introduction: Proteinuria is a defining dysfunction of Pre-eclampsia (PE) and repeated urinalysis to screen for the condition is part of the standard antenatal care. It has been proposed to be an indicator of both the severity of disease and the prediction of its outcome. Studies have shown that the presence of microalbuminuria earlier in pregnancy is associated with an increased risk of development of PE and severe adverse maternal and fetal outcome in PE. The aim of this study was to assess the role of microalbuminuria as a diagnostic marker in PE. Methodology: The current study was conducted by the Dept of Obstetrics and Gynecology, Nalanda Medical College &amp; Hospital, Patna, Bihar, India during August 2021 to February 2022. Ethical clearance was obtained from the ethical committee of the institution. Informed consent was obtained from all the subjects. The study incorporated 25 normotensive pregnant women as controls and 25 pregnant women between 20 and 35 years of age were selected at 24 ± 4 weeks of gestation and had PIH diagnosed by the accepted criteria of the Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy with a blood pressure of &gt;140/90 mm Hg and proteinuria (&gt;300 mg/24-h). Results: The mean age (with SD) of patients from normotensive and PE group was 26.4 ± 3.4 years and 27.3 ± 4.1 years, respectively. The mean period of gestation was 32.2 ± 4.2 weeks and 29.7 ± 5.1 weeks respectively for both the study cohorts. The sensitivity and specificity of the various renal function parameters in PE was calculated. The sensitivity of micro albumin was 100% and the specificity was 78.2%, both being the highest among all renal function markers except creatinine, which had a higher specificity. Urea had a sensitivity of 80% and specificity of 65.7% while creatinine had a sensitivity of 72% but had a specificity of 81.2%. Conclusion: The current created evidence that microalbuminuria is a good diagnostic marker for PIH, although it may not be preferred for grading its severity.</p> Ravi Kumar Raman Rekha Kumari Rajan Kumar Copyright (c) 2022 Ravi Kumar Raman, Rekha Kumari, Rajan Kumar 2022-01-18 2022-01-18 5 3 306 308 A study to assess results of laparoscopic ventral hernia repair using mesh insertion <p>Background: Laparoscopic repair is superior to open repair in terms of less blood loss, fewer abdominal wall complications and shorter hospital stay. This prospective study was conducted to assess results of laparoscopic ventral hernia repair using mesh insertion. Material and methods: This prospective study was conducted to assess results of laparoscopic ventral hernia repair using mesh insertion. LVHR technique was used as Closure. They were followed up for 2 weeks. They were followed up at 1 week, 3 weeks, 3 months. Data were prospectively recorded in Microsoft Excel and analyzed at study. Results: In the present study 40 patients were operated by this technique. Mean operating time for was 72 mins. Lower abdomen hernia was the most common. Mean length of closed HD was 9.2cm. in maximum patients grade I complications was present. Pain was present in 40 patients on trocar site after postoperative 3rd day and in 5 patients after 1st week. Pain was present in 40 patients at suture site after postoperative 3rd day, in 9 patients after 1st week, in 8 patients after 3 week and in 1 patient after 3 months. Pain was present in 40 patients at suture site after postoperative 3rd day, in 3 patients after 1st week, in 1 patients after 3 week and in 0 patient after 3 months. Seroma was not occurred. Conclusion: The present study concluded that laparoscopic ventral hernia repair using mesh is an effective and safe procedure with very low postoperative pain.</p> Manas Ranjan Deo Prabhat Kumar Priyadarshi Bhartendu Kumar Copyright (c) 2022 Manas Ranjan Deo, Prabhat Kumar Priyadarshi, Bhartendu Kumar 2022-01-18 2022-01-18 5 3 309 311 Severe acute respiratory syndrome coronavirus-2 <p>China first informed about the viral infection as it seems like pneumonia called novel corona virus. Novel corona virus appeared first time in December 2019 in Wuhan in China. Novel corona virus has four separate families – Alpha, Beta, Gamma and Delta. Alpha and Beta spread through mammals specially Bats. Gamma and Delta type virus spreads via pigs and birds. They have the ability to infect the human beings. These are the viruses which causes the mortality and morbidity in human body. It is a fatal disease that leads to respiratory illness. As per clinical reports common clinical symptoms of corona virus are fever, headache, cough, myalgia along with diarrohea nausea, dry cough, conjunctivitis, loss of taste or smell, difficulty in breathing, thorax, discomfort. The risk of the corona virus are prominent in the kids, older people and in the patients those are suffering from the other health problems such as lungs disease, heart disease, cancer and diabetes. The corona virus convinced by the incubation period that is ranging from approximately 2-14 days.</p> Niyaz Ahmad Ankita Singh Bhawna Devi Chauhan Copyright (c) 2022 Niyaz Ahmad, Ankita Singh, Bhawna Devi Chauhan 2022-01-18 2022-01-18 5 3 312 316 AEFI Related to Covishield and Covaxin: A Comparative Study in Medical College & Hospital, Kolkata <p>Introduction: Covid 19 Pandemic could be considered as most relevant health crisis throughout the world for last two years and vaccination was an important weapon for winning the battle against this pandemic. Largest vaccination drive against Covid 19 in India was launched on January 2021. But fear and misconceptions regarding AEFI regarding Covid 19 vaccines was an obstacle to this programme. In this context the present study aimed at determining and comparing proportion of AEFI following receiving Covishield and Covaxin. Method: Observational Analytic study was conducted in Medical College, Kolkata, among 220 adults (&gt;18 years) were taking Covishield (110 participants) and Covaxin (110 participants) 1st or 2nd dose. History of AEFI related to previous dose (when participants received 2nd dose) was obtained by recall method. All participants were observed for half an hour for immediate AEFI. Telephonic interview of participants were conducted 72 hours of vaccination to obtain any AEFI following present dose. Results: Prevalence of any AEFI following present dose (2nd dose) was 58.4%, but in most cases adverse reactions were mild. AEFI following current dose was significantly more in Covishield compared to Covaxin [OR= 5.778 (3.164-10.552)] in unadjusted model, as well as where adjustment done with Demographic, Socioeconomic covariates (AOR= 6.425 (3.421-12.171) and where all comorbidities added [OR= 6.465 (3.423-12.213)]. Conclusion: Both Covid vaccines introduced in India were highly safe and well tolerated among study participants. Proportion of any AEFI following receiving present dose of vaccine was significantly less in Covaxin (which was indigenous vaccine prepared in India).</p> Nirmalya Manna Sudipta Das SK. Sabir Rahaman Debasis Das Copyright (c) 2022 Nirmalya Manna, Sudipta Das, SK. Sabir Rahaman, Debasis Das 2022-01-18 2022-01-18 5 3 317 322 Depression in “Alcohol Dependence Syndrome’’: Undiagnosed comorbidity-A cross -sectional study in tertiary care general hospital in Delhi- NCR <p>This study was done to know and evaluate the presence of Depressive disorder in diagnosed case of alcohol dependence syndrome. A total of 60 cases who met the “ICD- 10 criteria’’ for Alcohol dependence syndrome and acontrol group of 60 subjects from the general population were assessed. This studyfocused on determining the prevalence of Depressive disorder among alcohol-dependentsubjects. A standardized diagnostic tool was used for making the psychiatric diagnosis using ICD-10 DCR. In this study,the frequency of occurrence of depressive disorders in alcohol dependent subjects was: Major Depressive Episode – 15% , Dysthymia –5% .</p> Abhinit Kumar Kunal Kumar Kapil Upadhyay Nikhil Nayar Copyright (c) 2022 Abhinit Kumar, Kunal Kumar, Kapil Upadhyay, Nikhil Nayar 2022-01-18 2022-01-18 5 3 323 327 Comparative analysis of Open versus Laparoscopic Cholecystectomy: A Comparative Study <p>Background and Aim: Gallstone disease (GSD or Cholelithiasis) is a significant health problem both worlds over (in both developing and developed nations). Earlier open cholecystectomy was the gold standard for treatment of stones in the gall bladder. The classical open cholecystectomy (OC) and the minimally invasive laparoscopic cholecystectomy (LC) are two alternative operations for removal of the gallbladder. The aim of the present study is to analyze the comparing Laparoscopic cholecystectomy and open cholecystectomy for cholecystitis. Material and Methods: The present study was a comparative prospective randomized study done from March 2021 to September 2021 in the department of general surgery at American International Institute of Medical Sciences, Kothibagh, Udaipur. The study pool comprised of 140 subjects, divided in two groups of 70 subjects each. The division was done on the basis of the procedure to be employed for cholecystectomy viz LC or OC. Pain was measured using a visual analog scale (VAS). Blood loss was calculated using by gravimetric method by swab weighing. Results: There were statistically significant differences among the average age between males and females of the study population. There was no statistical difference in the chief complaints between the two groups. In terms of operative characteristics, it was evident that the blood loss was statistically higher in open cholecystectomy cases. The commonest post-operative complication observed was nausea and vomiting, followed by abdominal distension, jaundice, wound infection and bleeding. The complications were higher among the open cholecystectomy cases. Conclusion: Laparoscopic cholecystectomy is a safe procedure in elderly patients, with no increased risk of complications compared with the open procedure. The recovery is faster and the hospitals stay, shorter. It is important the correctly assess the cardiovascular surgical risk, since this group of patients have lower vital reserve, being more sensitive to surgical trauma.</p> Rajnikant K Sanghvi Copyright (c) 2022 Rajnikant K Sanghvi 2022-01-18 2022-01-18 5 3 328 330 A study to evaluate morphological variations of the cystic artery to improve surgical safety <p>Background: Cystic artery is a key anatomical structure usually isolated and ligated during conventional cholecystectomy or laparoscopic cholecystectomy. The present study was conducted to evaluate morphological variations of the cystic artery to improve surgical safety. Materials &amp; Methods: 40 human liver specimens with intact gallbladder and extrahepatic duct in the regular dissection were fixed in 10% formalin and were finely dissected. The specimens were observed for parameters like the origin of the CA, its length and diameter, mode and level of termination, and its relation to the Calot’s triangle, and the variations were noted, photographed, and studied. Results: Cystic artery of origin was right hepatic artery in 84%, persistent hypoglossal artery in 2%, left hepatic artery in 1%, gastroduodenal artery in 2%, common hepatic artery in 1% and aberrant right hepatic artery in 10%. The vascular relations of cystic artery was anterior to cystic duct in 4%, posterior to cystic duct in 6%, anterior to CHD in 2%, posterior to CHD in 12%, anterior to CBD in 1% and no relation in 75%. Site of origin of CA was inside Calot’s triangle in 70% and outside calot’s triangle in 30%. The difference was significant (P&lt; 0.05). Conclusion: In maximum cases cystic artery of origin was right hepatic artery and in maximum cases its origin was in calot’s triangle.</p> Uzair Athar Mohd Ajmal Ashish Kumar Tripathi Copyright (c) 2022 Uzair Athar, Mohd Ajmal, Ashish Kumar Tripathi 2022-01-18 2022-01-18 5 3 331 333 A study on relationship between serum ferritin and HbA1c in type 2 diabetes mellitus <p>Background &amp; Objective: To find the association of elevated serum ferritin levels with Type 2 Diabetes Mellitus and to study the relationship between serum ferritin levels and Hba1c in type 2 Diabetes mellitus. Our objective is to assess the serum ferritin levels in type 2 diabetes patients, to determine the role of serum ferritin level as an indicator of glycaemic control like HbA1c and also as a marker of insulin resistance. Methods: Physical examination and Laboratory investigation such as FBS, PLBS, Serum ferritin, HbA1c are done in every patient and collected detailed History. Results: Most common age groups are 51-60 years and 61-70 years, majority of study population comprised of males (69%), significant difference seen with gender wise and age wise distribution of Diabetes mellitus, mean values of HbA1c is 7.26%, FBS is 151.34 mg/dl, PPBS is 209.17 mg/dl and serum ferritin is 193.78 mg/dl. Correlation between duration of Diabetes and HbA1c with serum ferritin is statistically significant with p-value &lt;0.001. With spearman correlation it is 1.0 with serum ferritin and HbA1c shows strong positive correlation. Conclusion: In our study we conclude that elevated levels of serum ferritin seen in patients with type 2 diabetes mellitus, Diabetic patients with increased HbA1c had significant hyperferritinemia and serum ferritin can be used as marker of glycaemic control as HbA1c and also a marker of insulin resistance in Diabetic patients.</p> Ramavath Raghu Ramulu Naik S V Pramod Reddy M J K Sowjanya Copyright (c) 2022 Ramavath Raghu Ramulu Naik, S V Pramod Reddy, M J K Sowjanya 2022-01-18 2022-01-18 5 3 334 338 Evaluation of serum uric acid in essential hypertension <p>Background: In this study we wanted to evaluate the relationship between serum uric acid (SUA) levels and hypertension, the relation between severity of hypertension to the serum uric acid levels and the relation between duration of hypertension and serum uric acid levels. Methods: This is a case control study conducted among 100 patients of which 50 were cases and 50 controls. The study was conducted over a period of 2 years from September 2016 to September 2018 in the department of general medicine at S.V.S hospital Mahbubnagar. Results: The study showed significantly higher SUA levels in cases (7.8 ± 0.6 mg/dL) when compared to that of controls (4.3± 0.8 mg/dL) (P&lt;0.0001). The proportions of hyperuricemia among males with and without hypertension were 88.5% and 0% respectively and similarly among females with and without hypertension were 100% and 0%. No significant correlation was found between the serum uric acid levels and severity of hypertension (P&gt;0.05).The SUA levels in stage 2 hypertension were not significantly different among both males and females when compared to those with stage I hypertension (P&gt;0.05). Also, there was no significant correlation was between the serum uric acid levels and duration of hypertension and (P&gt;0.05). The SUA levels in those with duration of hypertension ≥ 5 years were not significantly different among both males and females when compared to those with duration of hypertension &lt;5 years (P&gt;0.05). Conclusions: Hyperuricemia is seen in hypertensives. Severity of hypertension is not related to the serum uric acid levels. Duration of hypertension had no significant impact on the serum uric acid levels.</p> Golla Vahini Yerraguntla Shashidhar Copyright (c) 2022 Golla Vahini, Yerraguntla Shashidhar 2022-01-18 2022-01-18 5 3 339 342 Validation of Bedside Index for severity in acute pancreatitis (BISAP) score in the severity and prognosis of acute pancreatitis <p>Introduction: Acute Pancreatitis (AP) is one of most common cause of acute pain abdomen which we encounter in our daily surgical practice. It will be important if we stratify patients with acute pancreatitis according to their risk. Many staging systems for acute pancreatitis have been proposed, each with advantages and disadvantages. Objective: To evaluate the accuracy of bedside index for severity in acute pancreatitis (BISAP) in predicting the severity and prognoses of acute pancreatitis (AP). Material and Methods: Prospective obervational study that included all patients presented with acute pancreatitis and getting admitted in Department of Surgery, HIMS, Hassan from June 2020 to November 2020. The variables needed to calculate BISAP and complications were obtained and recorded in standard proforma. Clinical data for 80 patients with AP were analyzed prospectively to compare BISAP with Atlanta scoring system in predicting the severity of AP and the occurrence of mortality, and organ failure in patients with severe AP. Results: Of the 80 patients, 67 had mild AP, 16 had moderate AP and 20 had severe AP. There were significant correlations between the scores of two systems. BISAP performed similarly to other scoring systems in predicting SAP, as well as mortality, and organ failure in SAP patients. Conclusion: BISAP can be used as a tool to triage patients for streaming health care facilities, as it is a simple system that does not increase the cost of hospitalization and also identifies persons at risk of severe pancreatitis in the first 24 hours of admission.</p> Vinay. H. D. Nitin Kumar Chavan Shashanka R Rajanna.B Copyright (c) 2022 Vinay. H. D., Nitin Kumar Chavan, Shashanka R, Rajanna.B 2022-01-18 2022-01-18 5 3 343 346 A Retrospective study on ICU isolates on Tracheostomy tube and their antimicrobial profile <p>Introduction: The tracheostomized patients are likely to develop pneumonia causing life threatening consequences due to severe, persistent, resistant infections. Objective: This study was done with the aim to identify the common organisms which cause Respiratory Tract Infections (RTI) and their resistant pattern of ventilated patients in Intensive Care Unit (ICU). Methods: This retrospective study was conducted on the patients who underwent tracheostomy in ICU of Government Medical College, Jammu. The samples were processed according to established departmental protocols. Results: Out of 54 samples, 50(93%) were culture positive. 6samples were found to be polymicrobial. 4 samples showed no growth. Citrobacter sp., Escherichia coli, Pseudomonas sp. being the commonest species isolated. Citrobacter sp. and Klebsiella sp., Proteus sp. and Staphylococcus aureus showed high degree of resistance while Pseudomonas sp. and Escherichia coli showed moderate resistance. The gram negative bacilli were all sensitive to Colistin and Polymixin B. Staphylococcus aureus was 100% sensitive to Vancomycin. Conclusions: Intubated patients are the risk factor for development of RTI and to the increase in morbidity and mortality. Inappropriate and inadequate antibiotic treatment causes emergence of drug resistance in pathogens and poor prognosis in patients. The study reported the alarming condition of MDR in tracheal aspirates. Hence, surveillance for source of Multi Drug Resistant bacteria would be beneficial for intervention of infection related to it.</p> Shweta Purbi Rachana Raina Priyanka Sharma Shashi Sudhan Sharma Copyright (c) 2022 Shweta Purbi, Rachana Raina, Priyanka Sharma, Shashi Sudhan Sharma 2022-01-18 2022-01-18 5 3 347 349 Study of endometrial pathology in abnormal uterine bleeding <p>Background: The histopathological diagnosis of abnormal uterine bleeding (AUB) shows spectrum of patterns and pathologist plays a vital role in the reporting of endometrium and differentiating non neoplastic lesion from neoplastic lesions, early diagnosis of precursor lesions and exclusion of malignancy. The aim of the study is to study the spectrum of endometrial patterns in women with AUB and to correlate with different age groups. Materials and methods: 780 samples of endometrium in women with AUB were received from gynecology department, processed and stained with hematoxylin and eosin, subjected to histopathological examination. Results: The peak incidence was observed in the age group 31-40 years. The common histological pattern was proliferative pattern 428(54.87%),secretory phase 174(22.30%),endometrial hyperplasia without atypia 49(6.28%),pill endometrium 34(4.35%),atrophic endometrium 32(4.10%),endometrial carcinoma 28(3.58%),inadequate sample 17(2.17%),endometrial polyps 13(1.66%),endometrial hyperplasia with atypia 3(0.38%) and tuberculous endometritis 2(0.24%).Conclusion: AUB significantly affects the quality life of women and leads to anemia. Hence histopathological examination should be considered which plays a critical role in the early diagnosis of endometrial pathology and to provide appropriate gynecological management.</p> M.Vijayasree B.Sreedhar T.Dhanamjayarao C.Padmavathi Devi T.Aruna Prabhavathi Devi Arshiya Firdous Copyright (c) 2022 M.Vijayasree, B.Sreedhar, T.Dhanamjayarao, C.Padmavathi Devi, T.Aruna Prabhavathi Devi, Arshiya Firdous 2022-01-18 2022-01-18 5 3 351 353 Cytology during Covid-19 Pandemic: A Retrospective Study at Government General Hospital, Mahabubnagar <p>Introduction: The Coronavirus disease 2019 (COVID-19) has greatly impacted health care delivery world wide and has changed the practice of Pathology including Cytology. During the pandemic of Covid 19, it is observed in Cytology practice to prioritise patients at high oncological risk, while deferring benign cases. Aim: The present study is an institutional experience of COVID19 impact on Cytology services carried out in this hospital. Methods: The Cytological sample types processed at the Government General Hospital, Mahabubnagar, during April 1, 2020 to 31 March 2021 were compared with those of the same period of April 1, 2019 to 31 March 2020. Results: During the Covid period the overall Cytology cases were drastically reduced, Statistically significant decrease of samples was noted in Thyroid and Lymphnode in Covid Pandemic era. A slight increase in percentage of Malignant cases was noted in Covid Pandemic era which was not statistically significant. Conclusions: Cytological examination was safely carried out in patients at high oncological risk, without postponing during COVID pandemic. As the Covid-19 infectivity has come down, Cytology can be practiced with adequate safety precautions. None of our faculty contracted Covid while doing FNAC procedure.</p> M P Akarsh Sri Lakshmi Gollapalli Naval Kishore Copyright (c) 2022 M P Akarsh, Sri Lakshmi Gollapalli, Naval Kishore 2022-01-18 2022-01-18 5 3 354 358 Study of lipid peroxidation and antioxidant status in ischemic stroke patients <p>Background: Oxidative stress is probably one of the mechanisms involved in neuronal damage induced by ischemia. During ischemia, high amounts of free radical formation together with reduced antioxidant defense causes oxidative stress that may play a role in the pathogenesis of stroke associated neuronal injury. Aim and objectives: To study the correlation between lipid peroxidation and antioxidant status in ischemic stroke patients in comparison with normal controls. Materials and Methods: Cross sectional study includes 50 Ischemic stroke cases and 50 healthy controls. Fasting Venous blood samples were collected in ischemic stroke patients within 24hours from the time of onset of stroke and blood levels of Lipid profile, Malondialdehyde, Vitamin C, Vitamin E and Uric acid are estimated in both cases and controls. Results: In the Ischemic stroke group total cholesterol, triglycerides and LDL levels were significantly increased and HDL level was significantly decreased. Malondialdehyde a lipid peroxidation product was significantly increased, while antioxidants Vitamin C and Vitamin E were significantly decreased. The other antioxidant Uric acid has increased significantly in cases when compared to controls. Conclusion: This study showed an altered antioxidant status in ischemic stroke patients, which may be an indirect proof for the existence of Lipid Peroxidation.</p> G. Srikanth Reddy V. Siva Prabodh T.D. Swetha Copyright (c) 2022 G. Srikanth Reddy, V. Siva Prabodh, T.D. Swetha 2022-01-18 2022-01-18 5 3 359 364 Study of lipid peroxidation and antioxidant status in ischemic stroke patients <p>Background: Oxidative stress is probably one of the mechanisms involved in neuronal damage induced by ischemia. During ischemia, high amounts of free radical formation together with reduced antioxidant defense causes oxidative stress that may play a role in the pathogenesis of stroke associated neuronal injury. Aim and objectives: To study the correlation between lipid peroxidation and antioxidant status in ischemic stroke patients in comparison with normal controls. Materials and Methods: Cross sectional study includes 50 Ischemic stroke cases and 50 healthy controls. Fasting Venous blood samples were collected in ischemic stroke patients within 24hours from the time of onset of stroke and blood levels of Lipid profile, Malondialdehyde, Vitamin C, Vitamin E and Uric acid are estimated in both cases and controls. Results: In the Ischemic stroke group total cholesterol, triglycerides and LDL levels were significantly increased and HDL level was significantly decreased. Malondialdehyde a lipid peroxidation product was significantly increased, while antioxidants Vitamin C and Vitamin E were significantly decreased. The other antioxidant Uric acid has increased significantly in cases when compared to controls. Conclusion: This study showed an altered antioxidant status in ischemic stroke patients, which may be an indirect proof for the existence of Lipid Peroxidation.</p> G. Srikanth Reddy V. Siva Prabodh T.D. Swetha Copyright (c) 2022 G. Srikanth Reddy, V. Siva Prabodh, T.D. Swetha 2022-01-18 2022-01-18 5 3 365 370 Release technique effectiveness of myofascia with and without eccentric exercise for quadriceps tendinopathy in athletes <p>Background: Quadriceps Tendinopathy is commonly seen in Athletes,basketball players, weight lifters and even in Badminton players also. Many studies are available in the literature on Tendinopathies, very few are there on quadricepstendinopathy. No studies are there on Tendon release therapy with and without Eccentric exercise. So, purpose of this study is to compare the effectiveness of Myofascial Release Technique in combination with Eccentric Exercise and without Eccentric exercise in quadricepstendinopathy. Methods: It is an experimental study which was conducted on thirty athletes who were randomly assigned into Myofascial Release Technique (TRT)Group-A and Tendon Release therapy with Eccentric exercise(TRTE) Group-B. Group A received only TRT and Group B received Tendon Release Therapy with eccentric exercise. TRT for 5min daily one session, Eccentric Exercise for 10 repetitions daily one session. Total duration of study is for 12 weeks.Both groups ROM, MMT and PREE values are recorded on first day of treatment and after 12 weeks.Values were analyzed statistically, the pre-post values of both the groups were analyzed by using students‘t’ test and post-post values were analyzed using ANOVA. Results: Both groups showed decrease in pain and improvement in strength, ROM and function, whereas Myofascial Release Technique with Eccentric exercise group-B showed significant decrease in pain, improved muscle strength, ROM and overall function of Knee with a P value of P&lt;0.0001. Conclusion: The results suggest that Myofascial Release Technique with eccentric exercise gave superior result in decreasing in pain, improving ROM, Strength and overall performance of elbow.</p> K Madhu Babu Manikantha G Shilpa Copyright (c) 2022 K Madhu Babu, Manikantha, G Shilpa 2022-01-18 2022-01-18 5 3 371 373 A study on prevalence of obstructive sleep apnea (OSA) in patients with metabolic syndrome (MS) <p>This was a cross-sectional hospital based study conducted in metabolic syndrome patients to determine the prevalence of OSA in. Patients fulfilling IDF criteria for metabolic syndrome were the study subjects. These patients were screened for OSA by clinical history, relevant physical examinations and Epworth Sleepiness Scale. Overnight Limited Polysomnography was performed in patients with high clinical probability of OSA. Statistical analysis of the collected data was carried out. It was found that prevalence of OSA in patients with MS was as high as 37.2%. Sub-group analysis showed that presence of symptoms like snoring, EDS and witnessed apnea were found to be higher in OSA group in comparison with the non OSA group. Association of different parameters like BMI, Neck circumference and waist circumference with OSA were found to be statistically significant among metabolic syndrome patients. This study reinforced the point that all the patients with MS and associated co-morbidities should be screened for undiagnosed OSA in them to stop further progression of the disease and to prevent target organ damage.</p> Are Suryakari Sreekanth H Nagasreedhar Rao G Ambernath Copyright (c) 2022 Are Suryakari Sreekanth, H Nagasreedhar Rao, G Ambernath 2022-01-18 2022-01-18 5 3 374 379 A clinico-pathological study of acute appendictis with management and the role of ultrasound in diagnosis of appendictis <p>Background and Objectives: Acute appendicitis is the most prevalent cause of acute surgical abdomen, and appendiciectomy is the most often performed emergency surgery in the United States and Canada. Its diagnosis continues to be a difficult problem, made more difficult by a high percentage of negative investigations. There is currently no one reliable test that has appropriate sensitivity and specificity characteristics. The study's main goal is to analyse the clinical presentations, signs, and treatment of acute appendicitis, as well as the effectiveness of various treatments. The role of ultrasound in the diagnosis of acute appendicitis and in lowering the rate of negative appendicectomies are also discussed. Methodology: From January 2019 to October 2021, the current study included 80 patients who were clinically diagnosed with acute appendicitis and were admitted to the General Surgery Department of the Kerala Institute of Medical Sciences (KIMS), Narketpally, for emergency appendectomy. Prior to surgery, blood was drawn to check the WBC count, DC, and USG abdomen. Following surgery, all patients were subjected to a histological examination, which was considered to be the gold standard. The results of ultrasound were compared to those of HPE reports in order to determine their importance in the diagnosis of acute appendicitis. Observations: In the current study, we had 80 participants, with 61 (61 percent) of them being men and 39 (39 percent) of them being female. The age range of 20 to 29 years was the one with the greatest number of patients (33 percent ). Anorexia was discovered in 87 percent of patients, and Migrating Pain to RIF was discovered in 76 percent of patients. Nausea and vomiting were experienced by 79 percent of the patients. Tenderness in the right iliac fossa was detected in 98 percent of the cases. Patients with rebound discomfort were reported in 68 percent of cases. In 45 percent of the cases, a fever was seen. In our current investigation, the total leucocyte count was found to be high in 80 percent of the cases. In 42 percent of the cases, a shift to let was observed.All of the patients in our study were subjected to abdominal ultrasonography examination. Using Ultrasonography to diagnose acute appendicitis, the sensitivity and specificity of the test are 92.0 percent and 78.0 percent, respectively. The accuracy rate was 93 percent. For acute appendicitis, the positive predictive value (PPV) and negative predictive value (NPV) of ultrasound are 95 percent and 41 percent, respectively. In this study, the rate of negative appendectomy was 5.5 percent. Females account for the vast majority of cases (60 percent). Conclusion: Ultrasound is a non-invasive, reproducible, and safe diagnostic technique that is quick, easy, and reliable. There are no complications with ultrasound. It has higher sensitivity and positive predictive value in the diagnosis of acute appendicitis, and it lowers the rate of negative appendicectomy in the treatment of the condition.</p> Goutham Kompally Raghunandan.R Copyright (c) 2022 Goutham Kompally, Raghunandan.R 2022-01-18 2022-01-18 5 3 380 385 Clinico pathological study of gestational trophoblastic disease – A two years study <p>Introduction: Gestational trophoblastic disease is one of the most fascinating of all the gynecologic neoplasms partly due to their comparative rarity in western hemisphere but also because of their unique status as tumors derived from the tissues of one individual and growing in other. Aims: To study and establish the histopathological diagnosis and clinicopathological correlations.Methods: A study of 85 cases with gestational trophoblastic disease diagnosed in the Department of Pathology, GIMS District Hospital, KALABURAGI during the period from September 2018 to August 2020. Biopsies and hysterectomy specimens were processed routinely, embedded in paraffin, stained with H&amp;E. Studied as per proforma. Results: Maximum cases were in the age group of 21-30 years (52.9%). Common in first, second and fourth pregnancies and in ‘A’ blood group. Most of the patients belonged to Hindu (72.8%) community. Common presenting symptom was bleeding per vagina (100%).<br>Histopathological examination of specimens revealed hydatid form mole 84.7%, invasive mole 1.17%, choriocarcinoma 4.7%, placental site trophoblastic tumor 1.18% and placental site trophoblastic reaction 8.2%. Summary &amp; Conclusion: The incidence of gestational trophoblastic disease was more in the South-East Asian Countries as evidenced from the review of literature, but unfortunately these are the countries where an organized study of these tumors in the form of National Registries as in USA, UK and Japan is lacking. Hence, the diagnosis and follow-up of these patients is essential for the early detection of malignant trophoblastic disease and reduce the mortality rates.</p> Sajjan Shetty Shalini Somashekhar Copyright (c) 2022 Sajjan Shetty Shalini Somashekhar 2022-01-18 2022-01-18 5 3 386 399 A comparative study between laparoscopic and open cholecystectomy with early post-operative course and complication <p>Background and objectives: Although laparoscopic cholecystectomy has quickly gained popularity as a viable alternative to open cholecystectomy, it should have a safety profile that is comparable to or better than that of open surgery.The purpose of this study was to compare open cholecystectomy versus laparoscopic cholecystectomy in terms of surgical time, blood loss during surgery, early post-operative course and complication, antibiotic and analgesic requirements, and patient satisfaction after the procedure. Methods: A total of 40 consecutive individuals under the age of 70 who presented with calculous cholecystitis but no evidence of CBD stones were randomised to either open or laparoscopic treatment. Cholecystectomy is a surgical procedure that removes the gallbladder. The information was gathered and examined. Results: Statistically, the two groups were comparable in terms of demographic and clinical characteristics. Complications and blood loss were not significantly different across the groups. In the laparoscopic group, the median duration of pain was 2 days, with a visual analogue scale for pain of grade 2 in the laparoscopic group, but it was 5 days and grade 3 in the open group. The median length of hospitalisation was much lower in the laparoscopic group (median 4 days vs to 7 days in the open- chest group). Conclusion: Most important were the reduced post-operative discomfort and shorter period of analgesia intake, as well as the more quick recovery and shorter hospital stay that resulted from LC.</p> Sambireddy K.N Somesh Pragna Copyright (c) 2022 Sambireddy, K.N Somesh, Pragna 2022-01-18 2022-01-18 5 3 400 404 “A comparison of epidural levobupivacaine 0.5% with racemic bupivacaine 0.5% for lower abdominal surgery” A study on morphometric study of nutrient for amina of fibula <p>Background and objectives: In the leg, the fibula is placed lateral to the tibia. Because of its length, biomechanical stability, reduced donor site morbidity, and predictable vascular pedicle, the fibula is the bone of choice for grafting and rebuilding major defects after tumour removal. The study's objectives are as follows: (1) to locate and describe the site, number, and orientation of fibula nutritional foramina. (2) To look for differences in the location, position, and quantity of nutrition foramina in the fibula. Methods: The study sample consisted of 100 dry adult human fibulae (107 right and 93 left) from Kakatiya Medical College's Department of Anatomy. Fibulae were gathered from our institution's undergraduate medical students at KMC, Warangal. The data relevant to the aforementioned criteria were recorded, subjected to statistical analysis, and photographed. Results: In the present study of 100 dry adult human fibulae, noted;<br>i. The absence of nutritional foramen (NF) in 12 (6%) of the fibulae.<br>ii. A single nutritional foramen was found in 87 (87.0 percent) of the fibulae.<br>iii. Nearly 8 percent of the fibulae had twin nutrient foramen.<br>iv. 1 (1%) fibulae had triple nutrient foramen.<br>v. The total number of nutrient foramen in 94 fibulae was 100.<br>vi. The most common site of nutritional foramen was on the medial crest in 42 (43.75 percent) of the fibulae and the least common on the anterior border in 1 (1.04 percent).<br>vii. 90 (95.0 percent) of the foramen were located in the middle region of the fibula.<br>viii. h88 (93.61%) foramen were directed away from the developing end (AFGE), 15 (15.94%) towards the growing end of the fibula.<br>Interpretation and conclusion: The number of nutrient foramen varied by 13.5 percent in the current study. Orthopaedic and plastic surgeons can plan the vascularised fibular graft at the middle third of the shaft with accurate anatomical knowledge about the location and distribution of the nutrient foramen.</p> Sravanthi Repalle Copyright (c) 2022 Sravanthi Repalle 2022-01-18 2022-01-18 5 3 405 412 Effect of follicular size on the day of trigger on OOCYTE and EMBRYO quality in clomiphene citrate protocol- A comparitive retrospective study <p>Objective: To compare the effect of follicular size on the day of trigger on the oocyte and embryo quality in clomiphene citrate protocol in patients undergoing IVF/ICSI. Materials and Methods: A Retrospective comparative analysis was done in patients who underwent IVF/ICSI with clomiphene citrate protocol between 2016-2018 in craft hospital and research centre kodungallur Kerala. 242 patients who met the inclusion criteria of primary/secondary infertility, &lt;40yrs old, normal male factor. Excluding &gt; 4oys old, endometriosis, PCOS, male factor infertility. Group A: included 83 patients with lead follicle measuring 21-23 mm on the day of trigger. Group B: Included 159 patients with lead follicle measuring 17-19mm on the day of trigger. Inj ovitrille 250 mcg was given as a trigger. Oocytes retrieved after 36hrs by transvaginal approach. Both groups were compared for number of oocytes retrieved, number of mature oocytes, number of Day 3 good embryos. Statistical analysis was done by independent sample T-test for all variables. Results: No statistical difference between age and AFC in both groups. Statistical difference in number of oocytes retrieved (p value -0.055). No statistical difference in number of mature oocytes and number of day 3 embryos. Conclusion: Women who underwent IVF/ICSI with clomiphene citrate protocol with a lead &gt; 20mm had less number of oocytes retrieved when compared to &lt;20mm lead follicle on the trigger day and had similar number of mature oocyte and day 3 embryos. No beneficial effect by waiting for the lead follicle to reach beyond 20mm in size.</p> Suchithra R Kavya Reddy Kumkala Pothu Bavyasri Copyright (c) 2022 Suchithra R, Kavya Reddy Kumkala, Pothu Bavyasri 2022-01-18 2022-01-18 5 3 413 416 Comparison of fibrinogen levels in diabetic hypertensives vs diabetic normotensives <p>Background: The metabolic dysregulation associated with DM causes secondary pathophysiological changes in multiple organ systems that impose a tremendous burden on the individual with diabetes and on the health care system. Aim: To compare plasma fibrinogen levels in type-2 diabetics with hypertension and type-2 diabetics without hypertension. Methods: Prospective observational study was undertaken on 200 subjects aged 40-60 years from November 2019 to October 2020 with patients of Type-2 diabetes mellitus (both old and new cases) with hypertension without having any of the complications associated with diabetes and on age and sex matched diabetics without hypertension. Results: Mean value of fibrinogen of Group 1 was 484.91 ± 49.15 mg/dl and that of Group 2 was 436.53 ± 22.61 mg/dl, the difference between the two groups being statistically highly significant (p&lt;0.0001). Mean systolic and diastolic blood pressure in Group 1 was 127.64 ± 13.41 and 86.20 ± 7.06 mmHg and that of Group 2 was 118 ± 10.80 and 77.52 ± 7.87 mmHg, the difference between the two groups being statistically highly significant (p&lt;0.0001). Mean Fasting Blood sugar of Group 1 was 177.91 ± 62.52 mg/dl and that of Group 2 was 197.80 ± 74.75 mg/dl, the difference being highly statistically significant (p= 0.043). Conclusion: The mean fibrinogen levels in patients with both diabetes and hypertension were significantly higher than diabetes alone, indicating that elevated fibrinogen levels are a risk factor for development of macrovascular complications and thus a marker of morbidity and mortality.</p> Mudasir S Anjali N Bhat Sunil S Copyright (c) 2022 Mudasir S, Anjali N Bhat, Sunil S 2022-01-18 2022-01-18 5 3 417 420 Risk factors, comorbidities, and social factors associated with alzheimer disease - An observational study from eastern India <p>Alzheimer Disease (AD) is the most common type of dementia worldwide and is a progressive neurodegenerative disorder that results in diminished quality of life and caregiver stress. Although it is not possible to completely prevent the disease with current therapy, several associated comorbidities as well as social and risk factors can be addressed and managed if required. Our study attempts to clarify and delineate the comparative occurrence of these factors in patients presenting with AD and those presenting for other neurologic problems. The results show that diabetes, hyperlipidemia, cerebrovascular disease, and depression are strongly associated with dementia, suggesting etiologic factors and opportunities for timely intervention. Hypertension, dietary factors, occupational factors and marital status did not show a significant correlation. Limitations of the study include the overall elderly population with commonly occurring comorbidities and confounding factors. This study underlines the importance of treating modifiable risk factors with the hope of slowing down or preventing the development of dementia.</p> Shankar Prasad Nandi Ratul Banerjee Copyright (c) 2022 Shankar Prasad Nandi, Ratul Banerjee 2022-01-18 2022-01-18 5 3 421 424 A Study On Chlamydial Cervicitis Among Women Of Reproductive Age Group Presenting To The Out Patient Department Of A Tertiary Care Centre Of Bihar <p>Introduction: Worldwide, Chlamydia trachomatis (CT) is the most common bacterial sexually transmitted infection (STI), with approximately 105.7 million new infections occurring annually. Untreated CT can lead to serious reproductive sequelae for women, including pelvic inflammatory disease (PID), tubal factor infertility, ectopic pregnancy, and an increased risk of acquiring other STIs. Hence, this study was planned to evaluate the burden of chlamydial cervicitis among women of reproductive age group attending a tertiary care centre of Bihar. Methodology: All women of reproductive age group Gynecology Outpatient Clinic at the Darbhanga Medical College and Hospital, Laheriasri, Bihar, India from January 2021 to December 2021 were included in the study. A total of 100 patients were eligible for enrolment. Ethical Committee approval for study protocol and written informed patient consents were taken for this study. Three Dacron-tipped endocervical swabs from patients. The first swab was transported to the laboratory in 0.2 M sucrose phosphate buffer chlamydial transport medium for C. trachomatis PCR assays. Two swabs were placed in two screw cap test tubes containing 2 ml pleuropneumonia-like organism (PPLO) broth for detection of Ureaplasma spp. and M. hominis. Statistical analysis was done using SPSS ver. 21.0 (IBM, Chicago). Results: C. trachomatis was detected in 17% of patients with urogenital infections. C. trachomatis infection was significantly associated with vaginal discharge, abdominal pain, low back pain, burning micturition and dyspareunia. Of all samples collected, 61 showed positive growth. Apart from 17 C. trachomatis positive samples, 20 were positive for Ureaplasma spp., 11 for M. hominis, 2 for N. gonorrhoeae, 1 for T. pallidum and 2 were HIV seropositive. Co-infection with Ureaplasma and M. hominis was detected in 8% of patients by PCR. Conclusion: Screening for C. trachomatis isolates could be useful for epidemiological characterization of circulating C. trachomatis strains in the community and could provide additional information for vaccine development.</p> Ashutosh Kumar Singh Ajay Kumar Ram Shanker Prasad Copyright (c) 2022 Ashutosh Kumar Singh, Ajay Kumar, Ram Shanker Prasad 2022-01-18 2022-01-18 5 3 425 427 A Hospital Based Cross Sectional Study to Detect Deformities/Disabilities in Patients with Leprosy <p>Background: Leprosy is a common infectious disease causing as much social problem as a medical one. It leads to variety of disabilities resulting from nerve damage, immunological reactions and bacillary infiltration. Among communicable diseases, it remains a leading cause of peripheral neuropathy and disability worldwide. Disabilities and deformities are of major concern as it triggers social, economic and psychosocial problems of leprosy patients. Early identification can lead to prevention of progression of the deformities and also help in providing rehabilitation in advanced cases. Objectives: To detect deformities and disabilities in leprosy patients and grading them according to WHO deformity and disability grading system (2007). Method It was a hospital-based, cross sectional study. One hundred and forty-six patients with leprosy attending the Dermatology, Venereology and Leprosy out- patient department of a tertiary care hospital were included in the study. Detailed history was taken and all patients were examined for all kinds of deformities of hands, feet and face. Slit skin smear and biopsy was done in all new cases. Results: Among the 146 patients enrolled in the study, 85 were male and 61 were female, 10 were children, with a mean age of 38.1(±15.6) years. The mean duration of disease was 2.6 (±4.1) years. A statistically significant (p &lt;0.001) number of patients with deformity presented to hospital by 2 years of onset. Proportion of deformities was greater in males, in farmers and in people belonging to lower socio-economic status (p=0.008). Multibacillary patients had higher rate of deformities of hands and feet and a statistically significant (p=0.006) number of MB patients had grade 2 ocular deformity (WHO 2007). Conclusion: Various deformities can be detected by clinical examination and simple tests. Early identification of disease and deformities can help in educating the patients about leprosy and thus prevention of progression to adverse sequelae.</p> Bhagyashree Kanakareddi Prabhakar M Sangolli Adarsh Gowda Copyright (c) 2022 Bhagyashree Kanakareddi, Prabhakar M Sangolli, Adarsh Gowda 2022-01-18 2022-01-18 5 3 428 433 Diagnostic accuracy of fine-needle aspiration cytology of thyroid gland lesions by using The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC): A retrospective study from January 2019 to August 2021 in tertiary care institute <p>Background: Fine needle aspiration cytology (FNAC) plays important role in diagnosis of thyroid lesions properly. However conventional reporting method of thyroid cytology do not have standardize format. To overcome this hurdle because of lack of standardization and to facilitate communication between cytopathologist and clinician, "The Bethesda System for Reporting Thyroid Cytopathology" (TBSRTC) was proposed at Bethesda in 2007. Aims: Main Objective of this study was to classify and study thyroid FNACs according to TBSRTC, calculate malignancy risk and to determine the distribution of diagnostic categories and subcategories, to analyze and study cytological features of thyroid lesions. Materials and methods: All the FNAC of thyroid lesions came during January 2019 to August 2021 were classified in to six categories of TBSRTC. Distribution of cases in each category was calculated. Cytopathology analysis was carried out and classified according to TBSRTC categories. Results: During the study period, total of 147 thyroid FNACs were reported according to TBSRTC. Non diagnostic(ND), benign, atypical follicular lesion of undetermined significance(AFLUS), follicular neoplasm(FN), suspicious of malignancy(SM) and malignancy were reported in 6.8%, 80.9%, 0%, 6.8%, 2% and 3.5% cases respectively. Conclusion: Use of TBSRTC guideline for thyroid Cytopathology reporting helps to improve communication and give diagnostic criteria between cytopathologist and clinician leading to most effective management. Also interlaboratory comparative results provide data in a standardize pattern to compare between all different studies related to cytology of thyroid lesions.</p> Chandni Nakum Bhaskar Thakkar Vaidehi R. Patel Copyright (c) 2022 Chandni Nakum, Bhaskar Thakkar, Vaidehi R. Patel 2022-01-18 2022-01-18 5 3 434 437 Comparative clinical evaluation of buprenorphine versus morphine as adjuvant to bupivacaine in supraclavicular brachial plexus block for upper limb surgery <p>Background: The supraclavicular brachial plexus block with local anesthetics is one of the most commonly used regional nerve block technique for upper limb surgeries being to their high success rate and ability to provide prolonged postoperative pain relief. Opioid has been used as an adjuvant to prolong analgesia with local anesthetic. Aim: Aim of study to evaluate the quality and duration of postoperative analgesia by adding buprenorphine and morphine to local anesthetic solution. Method: A prospective, observational study was conducted on 60 healthy patients of ASA grade I and II of age group 18-45 years scheduled for upper limb surgery under supraclavicular brachical plexus block. Patients were allocated into two groups, 30 in each group. Group BB (buprenorphine group) received: 0.5% Bupivacaine 20 ml + 3μg/kg Buprenorphine + 10ml normal Saline. Group BM (morphine group) recieved: 0.5% Bupivacaine 20ml + 75 μg/kg Morphine + 10ml normal Saline. The parameters observed were onset and duration of sensory and motor block, quality and duration of analgesia and side-effects. Result: The mean duration of postoperative analgesia was significantly longer in group BB (20.6±2.11hrs) than in group BM (13.03±1.32hrs). There was no difference between two groups on mean onset of sensory and motor block. The mean duration of sensory block was significantly longer in group BB (539.67±13.22min) than in group BM (312±9.38min) with p&lt;0.05. The mean duration of motor block was insignificant The mean duration of motor block was also significantly longer in group BB (310.67±15.42min) than in group BM (178±9.79min) with p&lt;0.05. Conclusion: Addition of 3μg/kg buprenorphine to 0.5% buprenorphine for supraclavicular brachical plexus block prolonged duration of postoperative analgesia and sensory blockade than morphine without an increase in side effects.</p> Surendra Raikwar Jaideep Singh Preeti Verma Copyright (c) 2022 Surendra Raikwar, Jaideep Singh, Preeti Verma 2022-01-18 2022-01-18 5 3 438 441 Role of CBNAAT (Cartridge based nucleic acid amplification test) in early diagnosis of tuberculous lymphadenopathy and drug resistant tuberculous lymphadenopathy with the help of fine needle aspiration cytology <p>Introduction: In the India, we had about a quarter of the world’s TB Cases with a very high incidence of MDR TB and HIV associated TB and high mortality; mostly because of lack of early diagnosis and treatment. The Extra-Pulmonary Tuberculosis (EPTB) is challenging due to the pauci-bacillary nature of the disease and limited tests. It is also necessary to rule out other causes of granulomatous inflammation on FNAC and confirmation by CBNAAT. In Dec 2010, WHO recommended CBNAAT to be used as the initial diagnostic test in suspected EPTB cases. Aim: To assess the applicability of CBNAAT in early diagnosis of TB lymphadenopathy and early identification of drug resistant TB lymphadenopathy with the help of FNAC. Material and method: A hospital based retrospective study carried out over a period of 3 years (Jan2018 to July2021) in Pathology dept, GMERS Medical College, Gandhinagar. All presumptive cases of tubercular lymphadenopathy and purulent aspirates from the lymph nodes of various sites were included in the study. Smears were made after FNA and stained with H &amp; E stain and FNAC aspirates was collected in Falcon tube and sent tube for CBNAAT in all cases of lymphadenopathy. Results: The total number of cases with presumptive tubercular lymphadenitis was 475. Majority of the aspirates are from posterior triangle of neck lymph node accounting for 56.42% (268 cases). FNAC has detected tuberculosis in 281 (59.15%) cases. CBNAAT has detected 99 (20.84%)) cases, among them 12 cases (2.52%) which were not detected by FNA. The sensitivity of FNAC in our study was 95.9% and specificity was 100% while the sensitivity of XPERT was 29.53% and specificity was 93.4%. Conclusion: CBNAAT can be added with FNAC to get more specific results. CBNAAT is less sensitive for blood stained samples than purulent samples and hence FNA still remains as the cheapest and first line test to diagnose in cases suspected of tubercular lymphadenopathy. The present study highlights the utility of CBNAAT from FNAC material as one of the rapid and adjuvant diagnostic tool in tuberculous lymphadenopathy.</p> Bhaskar Thakkar Vaidehi R Patel Nital Panchal Brinda Amin Chandni Nakum Copyright (c) 2022 Bhaskar Thakkar, Vaidehi R Patel, Nital Panchal, Brinda Amin, Chandni Nakum 2022-01-18 2022-01-18 5 3 442 446 Comparison of minimally invasive procedure with the standard open approach for lumbar sympathectomy <p>Aim: To compare minimally invasive procedure with the standard open approach for lumbar sympathectomy and to assess the morbidity and evaluate the outcome in terms of operative time, blood loss, complications and recovery time. Method: The present study was carried out as a prospective cross-sectional observational study. A total of 60 patients were enrolled in the study who were divided into two groups A and B of 30 each who were operated by open method and laparoscopic method respectively.Patients between age 17 to 80 years with ischemic rest pain that requires continuous analgesia for &gt; 2 weeks, ischemic foot ulcers that failed to heal for &gt; 6 weeks and distal gangrene which is limited to the fore foot were included in the study. Result. In group A total 18 out of 30 patients(60%) and in group B total 21 out of 30 patients(70%)were taking analgesics for pain from more than 4 weeks. In group A operative time in 6 patients was ½-1hr, in 20 patients 1-1½ hrs and in 4 patients operative time was more than 1½ hrs while in group B in 22 patients operative time was ½-1 hr, in 6 patients 1-1½ hr and in 2 patients it was more than 1½ hrs.P value was 0.0002 which was significant. In group A there were ureteric injury in 2 patients, venacaval injury in 1 patient, peritoneal perforation in 1 patient, wound haematoma in 7 patients, wound infection in 6 patients and incisional hernia in 2 patients as intra operative and post operative complications while in group B there was ureteric injury in 1 patient, peritoneal perforation in 1 patient, wound haematoma in 1 patient, wound infection in 2 patient and there was no vena caval injury and incisional hernia as intra operative and post operative complications. P value was 0.02 which was significant. In group A 4 patients recovered in 5-7 days and 26 patient took more than 7 days to recover while in group B 5 patients recovered in 3-5 days,20 patients recovered in 5-7 days and 5 patients took more than 7 days to recover.P value was 0.006 which was significant. Conclusion: In minimally invasive technique of lumbar sympathectomy operative time,intraoperative complications were much less and recovery was significantly faster as compared to classical open method.</p> Nadeem Ahmad Gyan Prakash Rastogi Shabina Naznin Haqiqullah Copyright (c) 2022 Nadeem Ahmad, Gyan Prakash Rastogi, Shabina Naznin Haqiqullah 2022-01-18 2022-01-18 5 3 447 451 Diagnosis of breast lesions on frozen section and its cyto-histopathological correlation <p>Aim: To compare the finding of frozen section with findings of FNAC and histopathology &amp; study the sensitivity, specificity and predictive value of frozen section biopsy. Methods: A hospital based cross sectional study was done to compare the finding of frozen section with findings of FNAC and histopathology. This research included total 70 female patients of age group 11-80 years clinically presenting with palpable breast lesions referred to the Department of Pathology, for FNAC, frozen section and histopathological evaluation and a prospective study was conducted. FNAC procedure was performed according to the standard protocol. Only diagnosed cases were included in the study. Cases did not undergo surgery were excluded from the study. Results: Following FNAC, out of the total 70 cases, 35 (50%) patients had benign breast lesions while 35 (50%) patients had malignant breast lesions. Following Frozen Section, out of the total 70 cases, 33 cases (47.1%) were benign lesions and 37 cases (52.9%) were malignant. According to The histopathological diagnosis of breast lesions noted that 32 (45.7%) patients had benign breast lesions while 38 (54.3%) patients had malignant breast lesions. Frozen section findings correlated with the histopathological findings in 69 of 70 cases (98.6%), which included 32 of 32 (100%) of the benign lesions and 37 of 38 (97.4%) of the malignant lesions. 1 case of malignant lesion was wrongly diagnosed as benign on frozen section findings. The correlation of frozen section and histopathological findings was found to be statistically significant as per Chi-Square test (p&lt;0.05). FNAC findings correlated with the histopathological findings in 65 of 70 cases (92.9%), which included 31 of 32 (96.9%) of the benign lesions and 34 of 38 (89.5%) of the malignant lesions. 1 case was wrongly diagnosed as malignant on FNAC findings while 4 cases were wrongly diagnosed as benign. The correlation of FNAC and histopathological findings was found to be statistically significant as per Chi-Square test (p&lt;0.05). The Sensitivity, Specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of Frozen section were 97.37%, 100%, 100% and 96.97% respectively. Accuracy of Frozen section was 98.57%. It was observed that frozen section was more accurate than FNAC with higher sensitivity (97.37% vs. 89.47%), specificity (100% vs. 96.88%), PPV (100% vs. 97.14%), NPV (96.97% vs. 88.57%) and accuracy (98.57% vs. 92.86%). Conclusion: Despite increasing popularity and undisputed utility of FNAC, there are cases where frozen section still stands out as the method of choice for rapid diagnosis mainly for determining the resection margins of the lesion and the extent of metastasis in case of malignant lesion to ensure no residual tumour mass thus helping in further treatment and follow-up of patients. Final histopathological study is required to accurately arrive at a definitive diagnosis along with IHC marker study which is considered as a gold standard for patient care.</p> Shabina Naznin Haqiqullah Nadeem Ahmad Malik Atiur Rehman Copyright (c) 2022 Shabina Naznin Haqiqullah, Nadeem Ahmad, Malik Atiur Rehman 2022-01-18 2022-01-18 5 3 452 457 To assessand and compare the effect of two doses of chloroprocaine with buprenorphine for saddle anaesthesia in perianal surgery <p>Introduction: Saddle block is effective in patients experiencing perianal surgery in terms of postoperative recovery and analgesic consumption within 24 hours after surgery. Chloroprocaine was developed to meet the need for a short acting local anaesthetic that is reliable and has a favorable safety profile. Objectives: To study two different doses of chloroprocaine with buprenorphine for saddle anaesthesia in perianal surgery. Material and Methods: 100 Patients of ASA Gr I &amp; II were taken for perianal surgeries are kept in sitting position under all aseptic and antiseptic precautions SAB was given using 25/23G spinal needle in sitting position. A fixed dose of chlorprocaine with bupernorphine was injected in L4-L5 intervertebral space. Patients were assessed for pain score on VAS in post operative period.Patients were monitored for pulse , BP, respiratory rate , SPO2at regular intervals on a prestructured proforma. All the data were entered in master chart and statistically analysed. Results: Mean age of patients in Group A was 41.47 ± 9.06 years whereas in Group B was 35.66 ±12.12 years. The study groups comprised of 68 males and 32 females. Mean heart rate of patients in Group A group in preoperative was 55.52±6.14 whereas in group Group B was 54.80±5.79. Mean HR in Group A and Group B was found statistically insignificant (p=0.547). Mean SBP in Group A in preoperative was 102.9 ±22.41 and in Group B was 101.2±4.79.When we compared the mean SBP in Group A and Group B was found statistically insignificant (p=0.601) and Mean DBP in Group A in preoperative was 83.62±4.79 and in Group B was 83.12±8.7. When we compared the mean SBP in Group A and Group B it was found statistically insignificant (p=0.722). Mean RR in Group A in preoperative was 16.54 ±0.67 and Group B was 16.48 ±0.64 and Mean RR in Group A in intraoperative was 17.1 ± 0.83 and group B was 17.14±078. In our study we compared the mean time taken to achieve sensory block. In group A it was 2.54±0.50 min.. In group B the mean time taken to achieve sensory block was 2.38 ±0.49 min. It appears that 0.8ml Chloroprocaine might causes faster onset of sensory block and the difference between group A and B is statistically significant (p=0.0001). VAS score was significantly high in Group A as compared to Group B at 2nd and 6th hours respectively. Whereas VAS score was comparable at 12 and 24th hours in both the groups as revealed by insignificant p values. Conclusion: From our observations and data analysis we reach to the conclusion that for saddle block with higher dose we can allow surgery for longer time but the duration of postoperative analgesia remains same in both the groups</p> Anuruddha Singh Ankit Agrawal Sadhana Sanwatsarkar Copyright (c) 2022 Anuruddha Singh, Ankit Agrawal, Sadhana Sanwatsarkar 2022-01-18 2022-01-18 5 3 458 461 A study on serum lipid profile in obese prediabetics <p>Background: Prediabetes is well-known to be a significant risk factor for type 2diabetes as well as heart disease and other chronic conditions. The pattern of multi-system involvement in prediabetes is similar to that of diabetic neuropathy. The purpose of this study was to determine the trend in fasting lipids in obese prediabetics who were obese at baseline. Objective: Obese patients with prediabetes were studied for their serum lipid profile. Materials and Methods: According to the inclusion criteria, this is a prospective case-control research with 40 patients and 40 controls who were admitted to Govt Medical College, Suryapet over 18 months. All of the pertinent information was gathered, and the variables were then examined using the t-test and the chi-square test. Results: Compared to the control group, the mean total cholesterol in the case group was 168.26, which was greater than the control group's 189.24. Triglycerides averaged 176.84mg/dl in the control group of obese patients, whereas they averaged 190.44mg/dl in the obese prediabetic group. However, LDL cholesterol was on the rise. Individuals with prediabetes had a haemoglobin A1C of 115.66, compared to 145.66 in the control group. A higher HDL cholesterol level of 40.34 was found in the control group, compared to a lower HDL cholesterol level of 35.68 in the case group, according to this study. Interestingly, there was no statistically significant difference in VLDL levels across the groups in this investigation. It was discovered that the control group had a mean VLDL of 31.3432. Individuals with obesity and pre- diabetes had a VLDL. Furthermore, when compared to FBS, it was discovered that HbA1c alone was not a sufficient technique for detecting dyslipidemia Conclusion: According to the findings of this study, all serum lipid markers, except for HDL-c, are considerably raised in prediabetic obese patients. Because of their dyslipidemic status, these prediabetic obese adults are at an increased risk of developing cardiovascular disease in the future.</p> Ponnala Suresh Copyright (c) 2022 Ponnala Suresh 2022-01-18 2022-01-18 5 3 462 467 Serum leptin concentration in impaired glucose tolerance and recent onset type ii diabetes mellitus, relationship with anthropometry and lipid profile <p>Diabetes as well as pre-diabetes or impaired glucose tolerance increases the risk of cardiovascular disease by 2–3 times and increases by as much as 50% the risks of non-cardiovascular mortality associated with this condition. This study aim is to measure serum leptin levels in correlatation with anthropometry and lipid profile in pre- diabetes, non-diabetic and diabetic men and women. A cross-sectional study has been carried out in a total of 45 subjects for 20 subjects of pre-diabetes , 20 subjects of diabetic and 5 non- diabetic, south Indian rural 23 women and 22 men. Anthropometry was done for all the subjects with calibrated weighing machine, height scale etc. There is strong association between anthropometry and leptin resistance in both impaired and diabetic groups. In women both groups well correlated with total cholesterol and LDL. Increased serum Leptin levels/ leptin resistance was more evident in pre- diabetics when compared to non-diabetic and recent on set diabetes men and women.</p> Koppukonda Ravi Babu B.Aparna Varma Bonagiri Shanthi Copyright (c) 2022 Koppukonda Ravi Babu, B.Aparna Varma, Bonagiri Shanthi 2022-01-18 2022-01-18 5 3 468 475 Clinical study of diagnostic role of adenosine deaminase in pleural effusions <p>Introduction: The diagnosis of tubercular pleural effusion is critical, because the earlier the diagnosis, the better the result. Biochemical markers aid in the early detection of tubercular pleural effusion. Such include adenosine-deaminase (ADA), interferon, and lysozyme. Among these, ADA determination appears to be the most promising due to its speed and low cost. The current study is being conducted to determine the diagnostic role of ADA in patients hospitalised with pleural effusion at hospitals affiliated with Kurnool Medical College, as well as to correlate the level of ADA in tubercular and non-tubercular pleural effusion. Methodology: The current prospective trial will last a year, from September 2020 to December 2021. All patients over the age of 18 who presented with clinical symptoms of pleural effusion and provided informed consent for the trial were included. A thorough history was taken, a physical examination was performed, and any necessary regular investigations were carried out. Results and Discussion: In our study, the mean SD in TBPE is 79.17, with a cutoff value of 40 U/L and sensitivity of 71%, specificity of 100%, PPV of 100%, and NPV of 40%. Conclusions: The levels of ADA in pleural fluid were considerably higher in tubercular pleural effusion. As a result, our findings support the concept that pleural fluid ADA estimate is particularly important in establishing an accurate and early diagnosis of pleural effusion owing to tuberculosis.</p> Are Suryakari Sreekanth P.Ajoy Kumar M.Saritha Samuel Copyright (c) 2022 Are Suryakari Sreekanth, P.Ajoy Kumar, M.Saritha Samuel 2022-01-18 2022-01-18 5 3 476 481 A study on the adverse effects of embalming fluid on medical students <p>Background-Formaldehyde used in the embalming fluid can be toxic, allergic &amp; carcinogenic. Inhalation of vapours of formaldehyde from formalin treated cadavers in the anatomy dissection hall can produce many adverse effects in all those handling the cadaver. Objectives- This study was carried out among the medical students of Silchar Medical College &amp; Hospital, Assam, to learn about the difficulties they experienced when they get exposed to the embalmed cadavers for the first time. Materials &amp; Methods- To assess the acute &amp; chronic toxic effects of formaldehyde, a set of questionnaires was given to the 125 first year MBBS students in which they were asked to grade their experience. The collected data was later analysed statistically by using Microsoft Excel sheet. Results- The commonest reported discomfort was unpleasant smell (91.2%) followed by excessive lacrimation (86.4%), burning in the eyes (76.8%), burning nasal cavity (74.4%),itching of hands (43.2%),nausea (7.2%), dizziness (5.6%), headache(4%) &amp; dry nose (1.6%). Conclusion-Irritating toxic effects of formaldehyde on medical students cannot be denied. This calls for adopting better preventive measures &amp; ensuring proper ventilation of the dissection halls so that the students can enjoy their dissection class.</p> Rubi Saikia Prabahita Baruah Krishna Kanta Biswas Turlika Sinha Copyright (c) 2022 Rubi Saikia, Prabahita Baruah, Krishna Kanta Biswas, Turlika Sinha 2022-01-18 2022-01-18 5 3 482 484 Food Related Taboos and Misconception during Pregnancy and Breast feeding among women of Rural and Urban areas of Anantapur District <p>Background: In India, dietary habits of pregnant women are influenced by food fads, cultural taboos and religious beliefs. Hence knowledge about these misconceptions is necessary to educate the society regarding intake of healthy food during pregnancy and exclusive breast feeding practices. Objective: To evaluate the beliefs, practices and superstitions related to food during antenatal and post-partum period &amp; breastfeeding and to asses factors influencing breastfeeding practice. Materials &amp; Methods: A descriptive cross-sectional study was conducted among the women of reproductive age group at Anantapur district. A pre designed validated questionnaire was used to study the food related taboos in them during pregnancy and breast feeding practices. Results: A total of 600 women between the age of 20-35 years with mean age of 24.5 and ± 4.3 years participated in the study.Around 90% of study subjects classified some foods as hot and cold and avoided the as they would adversely affect them and the baby. Papaya, pine apple, curd, fused bananas, black grapes and poultry meat were commonly avoided food. Twenty percent of women did not feed colostrum because of taboos. Conclusion: The study revealed that food taboos and traditional beliefs relating to pregnancy exist in larger proportion of women and they still believe in old unscientific tales. This can be improved by empowering community based health workers to provide effective nutrition counseling to the mothers. There is a need for nutrition education and awareness generation among women. Increasing literacy status also reduces taboos/misconceptions.</p> S. Nissar Begum Chinta Aruna Jyothi R. Swetha Copyright (c) 2022 S. Nissar Begum, Chinta Aruna Jyothi, R. Swetha 2022-01-18 2022-01-18 5 3 485 488 An Observational Study On Pregnancy Induced Hypertension And It Outcome Among Patients Attending A Tertiary Care Hospital Of Bihar <p><strong>Introduction</strong>: Pregnancy-induced hypertension (PIH) is become a one of the major public health issue. Almost 20% - 30% of the adult population and more than 5% - 8% of all pregnancies in the world suffered from hypertension (HTN) and 5% - 22% of all pregnancies have develop some kind of medical problem due to hypertensive. Present study was conducted with objectives to study the characteristics of PIH and to find out the association of PIH with perinatal and maternal outcome. <strong>Methodology: </strong>This prospective study was done among 100 cases of PIH admitted at department of obstetrics and Gynecology in Nalanda Medical College &amp; Hospital, Patna, Bihar.Data collection was done after ethical permission from institutional ethical committee and informed consent of clients. Inclusion criteria for present study was all pregnant women ≥28 week of pregnancy irrespective of age and parity. The data were recorded in an Excel sheet and descriptive analysis was performed, of which data are presented in the tables and figures.<strong> Results: </strong>A total of 100 patients were included in the study. The mean age of the study participants was 25.7 years with a standard deviation (SD) of 5.2 years. Majority of the patients belonged to the age group of 21 to 30 years. Mean gestational age was 37.2 week with 5.2 weeks SD. Most common complaint was edema (63%) followed by headache (42%) and visual disturbance (11%). Proteinuria was present in 83% of the participants. Adverse perinatal outcomes were increased with increased level of Proteinuria. Among patients with mild PIH, 32% and among patients with severe PIH, 77% had retinal changes which were reversible.<strong> Conclusion:</strong> Pregnancy-induced hypertension is associated with multiple complications in the mother and baby, and particularly preterm delivery. Timely intervention of regular ANC check-up, nutrition, health education etc. can reduce the severity of PIH which lead to decrease in maternal and perinatal complications.</p> Ravi Kumar Raman Rekha Kumari Ranjan Kumar Copyright (c) 2022 Ravi Kumar Raman, Rekha Kumari, Ranjan Kumar 2022-01-18 2022-01-18 5 3 489 492 Comparative study of oxidative stress and antioxidant status between ischemic and haemorrhagic stroke patients <p><strong>Introduction: </strong>The World health organization (WHO) has defined stroke as “rapidly developed clinical signs of focal and at times global disturbances of cerebral function lasting more than 24 hours or leading to death, with no apparent cause other than vascular origin.” Stroke is an interruption in the cerebral vasculature and is classified as being either ischemic stroke (IS) or haemorrhagic stroke (HS). <strong>Material and Methods:&nbsp;</strong>This is a Prospective, observational and Case Control study conducted in the Department of Biochemistry and Casualty Unit at <em>Mahavir Institute of Medical Sciences over a period of 1 year</em> on an overall population of 140 individuals (40 ischemic strokes and 30 haemorrhagic strokes as the case groups; 70 healthy individuals as the control group). The diagnosis of stroke was based on history and clinical examination and brain CT scan were used to confirm and classify ischemic and haemorrhagic stroke cases.<strong> Results: </strong>In our study, we observed that mean serum levels of Malondialdehyde (MDA) were increased in both ischemic 2.96 ± 0.51 nmol/mL and hemorrhagic stroke 2.41 ± 0.42 nmol/mL as compared to controls 1.38 ± 0.26 nmol/mL. We found reduced mean level of serum Superoxide dismutase (SOD) in cases of ischemic (9.41 ±2.52 U/mg) and hemorrhagic stroke (8.86±2.73 U/mg) as compared to controls (15.51 ±3.62 U/mg). The Catalase levels are decreased significantly in ISPs and HSPs compared to control subjects. Maximum decline in Catalase is found in ISPs with HSPs. <strong>Conclusion: </strong>Result showed a direct positive correlation with infarct size (Ischemic stroke) but less in hemorrhagic stroke when comparted with control group. The antioxidative parameters like Catalase and superoxide dismutase was decreased both ischemic and hemorrhagic stroke when compared with control.</p> Amtul Rahman Amberina Zehratul Quresh Ravirala Tagore Ayesha Jabeen Copyright (c) 2022 Amtul Rahman Amberina, Zehratul Quresh, Ravirala Tagore, Ayesha Jabeen 2022-01-18 2022-01-18 5 3 493 496 Socio-demographic Profile of Victims of Fatal Head Injury in Road Traffic Accidents: An Autopsy-based Study <p><strong>Introduction:</strong> Road Traffic Accidents (RTAs) have emerged as a new health challenge in the world which not only leads to injuries, disabilities and loss of precious human lives but also imparts a substantial economic burden on the family concerned and the nation as whole. As progress is made in the prevention and control of infectious diseases, the relative contribution of deaths from non-communicable diseases and injuries has increased. Road traffic injuries are the eighth leading cause of death for all age groups.<strong> Material and methods: </strong>This one year study was conducted in Department of Forensic Medicine &amp; Toxicology, Mahatma Gandhi University of Medical Sciences and Technology. During this period 192 deaths were due to road traffic accident out of this 117 were as a result of fatal head injuries.<strong> Results</strong>: In the study 80% were males and 20% were females. Majority of subjects were belonging to age group of 31 to 40 years (24.8%), followed by 21 to 30 years (20%). There was no significant difference in age and gender distribution. 81.2% Subjects were brought dead and 18.8% were died after admitted to hospital. <strong>Conclusion</strong>: Road are like arteries of country. Vehicles must run for development of country and necessities of life. Injuries on head and other parts of body due to road traffic incidents are unavoidable but with scientific data, we can minimize the loss of life and misery due to death and injury. We should design our interventions based on these data and studies.</p> Lal Chand Verma Dharmendra Kumar Meena Jagdish Jugtawat G. Chitti Babu Copyright (c) 2022 Lal Chand Verma, Dharmendra Kumar Meena, Jagdish Jugtawat, G. Chitti Babu 2022-01-18 2022-01-18 5 3 497 500 A Study on Hyponatremia among Pediatric Patients With Pneumonia At A Tertiary Care Centre Of Bihar <p>Introduction: Lower respiratory tract infections (LRTIs) are common during childhood and can have high morbidity and mortality rates if not treated. The 2005 report of the World Health Organization states that LRTIs cause approximately 19% of the 10.5 million annual deaths. Hyponatremia related to pediatric pneumonia is most typically due to the syndrome of unsuitable antidiuretic hormone secretion (SIADH). The rationale of this study is to find out the prevalence of hyponatremia in a child with pneumonia so that while treating pneumonia, hyponatremia is not overlooked and treated simultaneously. Methodology: It is a prospective study with sample size of 60. Children between 2 month to 5 years visiting OPD clinic and admitted to Patna Medical College &amp; Hospital between January 2013 to June 2013 in the duration of 6 months with clinically or radiologically confirmed pneumonia were the study population. Inclusion criteria were children between 2 months to 5 years with radiologically confirmed pneumonia and clinical features defined as per modified WHO/BTS guidelines. All children were screened for dyselectrolytemia on admission. Other investigations were done whenever required. Collected data were analyzed by frequencies, percentages, mean, and standard deviation by Chi-square test using SPSS 16.0. Results: The mean age of children was 2.2 ± 1.9 years. Maximum number of children belonged to age group between 2 months to 24 months. There was a male preponderance a male to female ratio of 2.3:1. Respiratory rate was increased in all the children. The range of respiratory rate for children aged 2 months to 12 months was 52 to 80 per minute and for those above 12 months were 46 to 76 per minute. Hyponatremia was revealed in 86.7% of the children with pneumonia. Conclusion: The children admitted with pneumonia have higher morbidity when associated with hyponatremia. Hence along with management of pneumonia, hyponatremia should also be cautiously addressed in these patients.</p> Suprabhat Ranjan Sheela Sinha Copyright (c) 2022 Suprabhat Ranjan, Sheela Sinha 2022-01-18 2022-01-18 5 3 501 504 Histopathological and clinical evaluation of Endometrium in patients of dysfunctional uterine bleeding (DUB): A cross sectional prospective study in quaternary care centre of different district of Gujarat, India <p>Context: Dysfunctional uterine is the bleeding most common condition for which patients needs to consult gynaecologist. Evaluation of histopathological findings of endometrium in patients of DUB helps in management and counselling of patients and useful to find out the pathological incidence of organic lesions prior to surgery. Aims: The aims are to analyse the histomorphological pattern of endometrium in dysfunctional uterine bleeding (DUB), assessment of architectural evaluation of the functional endometrium and providing data with reference to subsequent treatment regimen. Methods and Material: Total of 1803 patients presenting with DUB were subjected to evaluate with gross and microscopic examination of dilatation &amp; curettage materials and hysterectomy specimens of the patients either admitted or came in OPD at quaternary care centre of different district or specimens received from outside hospitals. Results: Out 1803 of these, 621 cases were reported as Proliferative phase of endometrium, 410 cases were reported as Secretory phase of endometrium, 271 cases were of disordered proliferative endometrium, 149 cases of Basal endometrium, 88 cases of Endometrial hyperplasia, 61 cases of Menstrual endometrium, 53 cases of Hormonal induced changes of endometrium, 44 cases of Atrophic endometrium, 26 cases of Autolytic endometrium, 26 cases were reported as Well differentiated endometrial adenocarcinoma, 18 cases of Acute endometritis and 9 cases of Menstrual with hormonal included endometrium, Secretory with autolytic endometrium, Papillary syncytial changes of endometrium and Senile cystic endometrium. Maximum cases of dysfunctional uterine bleeding (823/1803) were seen between 41-50 years of age. Most of the cases presented with menorrhagia (1045/1803). Conclusions: Evaluation of endometrium in patients of DUB helps in management and counselling of patients and useful to find out the pathological incidence of organic lesions in DUB prior to surgery.</p> Killol N. Desai Vidya K. Satapara Alpeshkumar M. Maru Copyright (c) 2022 Killol N. Desai, Vidya K. Satapara, Alpeshkumar M. Maru 2022-01-18 2022-01-18 5 3 505 513 Comparision of 1% chloroprocaine and 1% chloroprocaine with fentanyl in infraumbilical surgical procedures under spinal anaesthesia <p>Background: In the ambulatory setting, day by day there is an increase in the use of spinal anaesthesia. Antioxidant- and preservative-free form of 2-chloroprocaine (1%) has been re-emerged as a short-acting local anesthetic for use in spinal anesthesia.In this study,we evaluate the efficacy of 1% Chloroprocaine and 1 % Chloroprocaine with Fentanyl in spinal anaesthesia and any untoward side effects and complications associated with the study drugs and technique. Material and Methods: For this prospective, ramdomizes ,comparative study we recruited a total of 100 adult patient for infraumblical surgeries under spinal anaesthesia were randomly divided into two groups (n=50 each).Group C (n=50) received 30 mg 1% chloroprocaine with 0.5ml normal saline and Group CF (n=50) received 30 mg 1% chloroprocaine with 25mcg Fentanyl (0.5ml). Result: Faster Onset of sensory and motor blockade was seen in the group CF duration of spinal anesthesia and sensory and motor block duration is prolonged in group CF.(p&lt;0.001) Duration ofanalgesia was significantly prolonged in the group CF when compared to group C(87.5±11 vs132.5±4.9min p&lt;0.001) hemodynamic parameter insignificant with less side effect in both group. Conclusion: The addition of Fentanyl to intrathecal 1% chloroprocaine will increase the duration and quality of both sensory and motor blockade in spinal anaesthesia as compared to 1% chloroprocaine alone.</p> Swati Jhania Satyendra Singh Yadav Shakti Singhal Dilip Kothari Copyright (c) 2022 Swati Jhania, Satyendra Singh Yadav, Shakti Singhal, Dilip Kothari 2022-01-18 2022-01-18 5 3 514 517 Choice of either anaesthesia technique for caesarean section <p>Aim: To compare the hemodynamics and duration of analgesia using fractionated / bolus dose of bupivacaine with fentanyl for spinal anaesthesia (SA) in patients undergoing elective caesarean section (CS). Method: Comparative, interventional randomized study in tertiary care hospital in Delhi, India for a period of 12 months (1st January 2019 till 31st December 2019). 204 female antenatal patients of Indian origin between age 18 to 40 years were studied. Bolus group (Group B) patients received intrathecal injection of 0.5% hyperbaric bupivacaine with fentanyl (10mcg) as single bolus dose. Fractionated group (group F) patients received intrathecal injection of 0.5% hyperbaric bupivacaine with fentanyl (10 mcg) with an initial bolus equal to two-third of the calculated volume and remaining volume injected after 90 seconds. Both groups received doses according to Harten’s chart. The groups were compared in terms of maternal hemodynamics, duration of analgesia, sensory and motor block level. Results: Group F patients were noted to have a better haemodynamic profile, both in terms of blood pressure (p&lt;0.001) and heart rate, though not statistically significant (p=0.08). Time taken to reach sensory level T5 was higher in group F, while time taken for motor block was lower in group F (p&lt;0.05). Time for providing rescue analgesia was lower in group B making duration of analgesia lower in bolus group (p&lt;0.05). Conclusions: Fractionated dose of local anaesthesia in subarachnoid block can give better hemodynamic stability, produce quicker onset and later regression of both sensory and motor block along with prolonged duration of analgesia. Trial Registration: CTRI No. CTRI/2019/07/020121.</p> Rajiv Kumar Mahak Kakkar Ameeta Sahni Copyright (c) 2022 Rajiv Kumar, Mahak Kakkar, Ameeta Sahni 2022-01-18 2022-01-18 5 3 518 521 Immuno-Histochemical Study of p63 Expression in Prostatic Lesions <p>Introduction: Diseases of Prostate gland are responsible for significant morbidity and mortality among adult males all over the world. This study is carried out to study the usefulness of immuno-histochemistry using p63 basal-cell marker in prostatic lesions, especially the morphologically ambiguous ones. Aims: i) To study histopathological features of prostatic lesions. ii) To study expression of p63 basal-cell marker in prostatic lesions. iii) To correlate p63 expression with histopathology. Materials and methods: A descriptive observational study was conducted at Mahadevappa Rampure Medical College, Kalaburagi, Karnataka, India from 1st July 2017 to 30th June 2020. Specimens were sent for routine histopathological analysis followed by immuno-histochemistry analysis with p63. Statistical analysis used: Chi Square test was used for qualitative data analysis and Receiver Operator Curve was used for dichotomous data. Mean with Standard Deviation was used for quantitative data analysis. The results were considered statistically significant when p value was &lt;0.05. Results: Of 52 specimens, the age of patients ranged from 60 to 88 years and mean being 68.61 years. Majority of patients presented with complaint of overflow incontinence. We encountered 36 cases of Benign Prostatic Hyperplasia, 13 cases of Prostatic Adenocarcinoma &amp; 3 cases of Prostatic Intra-Epithelial Neoplasia. The ability of p63 to distinguish between Prostatic Carcinoma and non-Carcinomatous Prostatic lesions was statistically significant. Diagnostic Accuracy of p63 was 96.15%. Conclusion: Ability of p63 to distinguish between Prostatic Carcinoma and non-Carcinomatous Prostatic lesions was statistically significant. It helps in distinguishing morphologically ambiguous lesions of the prostate into benign or malignant lesions.</p> Anuradha G.Patil Debarghya Sutradhar Anu Tresa Antony Anita A.M Copyright (c) 2022 Anuradha G.Patil, Debarghya Sutradhar, Anu Tresa Antony, Anita A.M 2022-01-18 2022-01-18 5 3 522 527 Comparison of fibrinogen levels in diabetic hypertensives vs diabetic normotensives <p>Background: The metabolic dysregulation associated with DM causes secondary pathophysiological changes in multiple organ systems that impose a tremendous burden on the individual with diabetes and on the health care system. Aim: To compare plasma fibrinogen levels in type-2 diabetics with hypertension and type-2 diabetics without hypertension. Methods: Prospective observational study was undertaken on 200 subjects aged 40-60 years from November 2019 to October 2020 with patients of Type-2 diabetes mellitus (both old and new cases) with hypertension without having any of the complications associated with diabetes and on age and sex matched diabetics without hypertension. Results: Mean value of fibrinogen of Group 1 was 484.91 ± 49.15 mg/dl and that of Group 2 was 436.53 ± 22.61 mg/dl, the difference between the two groups being statistically highly significant (p&lt;0.0001). Mean systolic and diastolic blood pressure in Group 1 was 127.64 ± 13.41 and 86.20 ± 7.06 mmHg and that of Group 2 was 118 ± 10.80 and 77.52 ± 7.87 mmHg, the difference between the two groups being statistically highly significant (p&lt;0.0001). Mean Fasting Blood sugar of Group 1 was 177.91 ± 62.52 mg/dl and that of Group 2 was 197.80 ± 74.75 mg/dl, the difference being highly statistically significant (p= 0.043). Conclusion: The mean fibrinogen levels in patients with both diabetes and hypertension were significantly higher than diabetes alone, indicating that elevated fibrinogen levels are a risk factor for development of macrovascular complications and thus a marker of morbidity and mortality.</p> Mudasir S Anjali N Bhat Sunil S Copyright (c) 2022 Mudasir S, Anjali N Bhat, Sunil S 2022-01-18 2022-01-18 5 3 528 531 Correlation of neuropsychological deficits with findings on MRI AND NEUROPET in patients with MTBI <p>Background &amp; Objective: Spectrums of post-traumatic symptoms are frequent among mild traumatic brain injury (MTBI) patients. They account for symptoms in 40-80% of patients during 3-4months and 15-30% of patients 6 months post-injury. There are no studies in India to support the literature of the same. The current prospective study evaluates neuropsychological deficits (NPD) and explores the value of MRI and NEUROPET in patients with MTBI. Methods: Fifteen MTBI patients presenting with initial GCS score of 13-15 were recruited initially 1-2 weeks post injury. All patients were followed up twice, after 1-2 and 6-7months. The patients were evaluated with MRI , Neuropet, neuropsychological test (PGIBBD – PGI brain battery of dysfunction ), post-traumatic symptoms . All test variables were analyzed using repeated measure of analysis with 0.05 significant levels. Results: Sustained-attention was first to improve. Memory and executive domains improved partially until 2months and then after complete recovery. But few facets of learning/memory did not improve even at 6months. The post traumatic symptoms decreased since baseline from 76% to 52% at 3-4months and further to 28% at 6-7 months. The results of present study provide information that MRI lesions found in MTBI patients were predictive of neuropsychological deficits (NPD) if scan was done as early as within 1 week post injury. FDG F18 Neuropet in the present study has demonstrated hypometabolic lesions not seen on MRI and these lesions were correlating to neuropsychological deficits which were persistant 6 mths post injury in respective patients. Interpretations &amp; Conclusion: The study reports course of changes in cognition, traumatic symptoms, since the time of injury till 6-7months. The results summarize that majority of post-traumatic symptoms recovers after MTBI without any intrusions, but residuals are not uncommon. Structural lesions on MRI may not always be present but when present may influence the degree or severity of the symptoms in patients with MTBI. Introduction of FDG PET as an early diagnostic modality in patients with neuropsychological disturbances after MTBI might be beneficial as the patients will be opted for relevant pharmacological and cognitive behavioural interventions.</p> Ramesh Chandra VV Mohana Sasank Deevi BCM Prasad Copyright (c) 2022 Ramesh Chandra VV, Mohana Sasank Deevi, BCM Prasad 2022-01-18 2022-01-18 5 3 532 539 A Study on Psychiatric Disorders and Mental Health Service Use Among Spouses of Advanced Cancer Patients <p>Aim &amp; Objective: 1.To study the frequency and nature of psychiatric disorders in spouses of cancer patients. 2.To know the relationship between the perceived psychopathology and quality of life of spouses where one is diagnosed with cancer. Methodology: This is a case control observational clinical study assessing the frequency and nature of psychiatric illness in spouses of cancer patients in comparison with spouses of BPAD patients. Results: In the present study, the most common age group to which the cancer patients and their spouses belonged to was 51-64 years whereas the BPAD patients and their spouses belonged to age group of 31-40 years. Most common diagnosis of the cancer patients (whose spouses are being studied) was head and neck cancer (46%)., In the present study psychiatric morbidity is seen in upto 54% of cancer patient spouses and the similar was observed in BPAD spouses .i.e 53.3%.MDD (major depressive disorder) (55.6%) was found to be the most common psychiatric diagnosis followed by adjustment disorder (25.9) in cancer patient spouses..Other psychiatric disorders are generalised anxiety disorder, dysthymia and panic disorder. Adjustment disorder followed by Major depressive disorder was found to be the most common psychiatric diagnosis in BPAD patients. Both cases and controls also had high levels of psychopathology scores without a psychiatric diagnosis. Quality of life was less in the subjects with a psychiatric diagnosis than the ones without a psychiatric diagnosis. Severity and frequency of psychopathology in case and control group was inversely related to quality of life i.e that severe psychopathology tend to have low quality of life. Psychiatric morbidity was more common in spouses of head and neck cancer patients. Female’s spouses of cancer patients had low social functioning when compared to males. Spouses of cancer patients aged between 31-40 years had lower quality of life when compared to other age groups. Conclusion: The present study also highlights the need for spouses’ psychiatric evaluation after a person is diagnosed with cancer and the need for further research in this field in India as well as other nations.</p> Pruthvi Reddy Muddasani Vishnu Vardhan Janagam Sheetal Reddy Copyright (c) 2022 Pruthvi Reddy Muddasani, Vishnu Vardhan, Janagam Sheetal Reddy 2022-01-18 2022-01-18 5 3 540 547 Comparative study of serum cholesterol, bilirubin, calcium and phosphorous in different types of gallstones, age and sex <p>Aims and Objective: To study the variables, i.e., Serum cholesterol, bilirubin, calcium and phosphorous in relation to age and sex in gallstone diseases. Study design: Cross-sectional observational study, Place and duration of study, Mamata Medical College and General Hospital, Khammam from October 2017 to September 2019. Materials and methods: Patients in whom the presence of gallstones was confirmed by ultrasound abdomen were included in this study. A series of 50 patients were compiled for the present study during this time, after obtaining clearance from ethical committee. Results: In the present study, mean age of the study group was 44.4 years, ranging from 17 to 76 years. The commonest age group in the study was middle 31-50 years, followed by 51-60 years. Among 50 cases, 41 (82%) were females and 9 (18%) were males with male to female ratio of 1:4.5. Representing the majority of the study population were females. Out of these 3 cases two were pigmented, one was cholesterol stone. But Chi-square statistic at 0.866 with P value of 0.64. Out of 41 female patients in the present study, 10 had a history of OCP use at some point in their life. Among them 5, 4, 1 patients had pigment, cholesterol and mixed stones. Mean serum bilirubin value was more among pigmented stone group (1.069 mg/dl) as compared to mixed (0.850 mg/dl) and cholesterol group (0.6 mg/dl). Mean serum calcium value was more among pigmented stone group (8.962 mg/dl) as compared to mixed (8.6 mg/dl) and cholesterol group (8.627 mg/dl).Serum phosphorous value was more among pigmented stone group (4.041 mg/dl) as compared to mixed (3.790 mg/dl) and cholesterol group (3.382 mg/dl). Conclusion: On the basis of the above observations, it is possible to say that pigment gallstone patients have high serum bilirubin, calcium and phosphate levels and the type of gallstone doesn’t depend on age, sex, BMI status and OCP usage.</p> Ramaswami B Nataraj Kumar Rakesh Shaganti A.Anusha Copyright (c) 2022 Ramaswami B, Nataraj Kumar, Rakesh Shaganti, A.Anusha 2022-01-18 2022-01-18 5 3 548 552 A Retrospective Analysis of Biopsied Infectious Jaw Lesions in Eastern Indian population <p>Background: Reports of a series of central jaw tumours in children are uncommon. Hence, there is no way to forecast their biological behaviour, treatment, or prognosis in this region of the world. Purpose: The goal of this study was to find out how common jaw lesions are in Eastern India. Methods: From January 2020 to December 2021, biopsy data and microscopic sections of all jaw biopsies seen in a selected hospital in Eastern India were reviewed. The three primary groups included Group 1 as developmental/inflammatory/reactive lesions, Group 2 as cystic lesions, and Group 3 as tumours and tumour-like lesions. Odontogenic and nonodontogenic subgroups were created from Groups 2 and 3. Results: A total of 385 instances were looked at. There were 385 cases in all, with 115 (29.9%) in group 1, 178 (46.2%) in group 2, and 92 (23.9%) in group 3. Radicular cysts were the most often biopsied jaw lesions (n = 95; 24.7 percent), followed by chronic apical periodontitis (n = 59; 15.3 percent), dentigerous cysts (n = 51; 13.2 percent), and keratocystic odontogenic tumours (n = 30; 7.8%). Chronic apical periodontitis was the most common lesion in group 1 (n = 59; 51.3 percent). Odontogenic cysts (n = 166; 93.3 percent) were more common than nonodontogenic cysts (n = 12; 6.7 percent) in group 2, with radicular cysts (n = 95; 53.4%) being the most common lesions. In group 3, odontogenic tumours (n = 61; 66.3%) were more common than nonodontogenic tumours (n = 31; 33.7%). Keratocystic odontogenic tumours were the most common kind of lesion in this group (n = 30; 32.6 percent), followed by ameloblastoma (n = 17; 18.5 percent). In this study, only three malignant tumours were discovered. Conclusions: Cystic and inflammatory jaw lesions are more common than tumours and tumour-like lesions in India. Periapical inflammation was found to be the most common cause of inflammatory lesions in the jaw. The majority of cystic and tumorous jaw lesions were caused by odontogenic factors. Odontogenic tumours that were locally aggressive were more common than those that were not. Jaw tumours that were malignant were uncommon.</p> Biswaranjan Behera Deepak Das Bipin Bihari Pradhan Copyright (c) 2022 Biswaranjan Behera, Deepak Das, Bipin Bihari Pradhan 2022-01-18 2022-01-18 5 3 553 556 Benign Tumours and Tumour-like Lesions of the Jaws <p>Purpose: The goal of this study was to look at the age, gender, prevalence, and location(s) of odontogenic and nonodontogenic benign malignancies, in addition with tumour-like lesions in the jaws, in an Indian population, especially in Eastern India, and to compare the results with previous literature. Methods: The data was gathered during a 1-year period starting from January 2021 to November 2021 from files collected from a selected hospital. The data was studied descriptively in terms of age, gender, prevalence, lesion place and type. Results: During a one-year period, 200 benign tumours and tumour-like lesions of the jaws were chosen. Thirty-four (or 17%) of these lesions were odontogenic benign tumours, while 166 (or 83%) were nonodontogenic benign tumours and tumour-like lesions. Conclusion: The findings of this study demonstrated that the location and characteristics of benign tumours and tumour-like lesions of the oral cavity and jaws in the Indian population, particularly in the Eastern region of India, differ from those seen in other populations.</p> Biswaranjan Behera Bipin Bihari Pradhan Deepak Das Copyright (c) 2022 Biswaranjan Behera, Bipin Bihari Pradhan, Deepak Das 2022-01-18 2022-01-18 5 3 557 561 A Comparative Study on Laparoscopic and Open Appendectomy Among Patients Attending a Tertiary Care Center of Bihar <p>Introduction: Approximately 7–10 % of the general population develops acute appendicitis with the maximal incidence being in the second and third decades of life. Open appendectomy has been the gold standard for treating patients with acute appendicitis for more than a century, but the efficiency and superiority of laparoscopic approach compared to the open technique is the subject of much debate nowadays. The aim of this study was to compare the clinical outcomes (hospital stay, operating time, postoperative complications, analgesia requirement, and time to oral intake and to resume normal activity) between open appendectomy and laparoscopic appendectomy. Methodology: An observational study of patients admitted to Department of General Surgery, Madhubani Medical College &amp; hospital, Bihar, India between January 2021 to November 2021 with the diagnosis of appendicitis was conducted. We analyzed 100 patients that met the inclusion criteria and their clinical data. The patients were divided into two groups: open appendectomy (OA) group and laparoscopic appendectomy (LA) group. OA was performed through standard McBurney incision. After the incision, peritoneum was accessed and opened to deliver the appendix, which was removed in the usual manner. A standard 3-port technique was used for laparoscopic group. The study protocol was received and approved by the Institutional Ethics Committee. Informed consent from each patient was obtained. Results: Out of the total 50 open procedures, majority (36/50) were performed for uncomplicated appendicitis and rest for complicated disease including appendiceal perforation with local or widespread peritonitis. In the laparoscopic group, 44/50 procedures involved uncomplicated disease. In our study, the mean ± standard deviation (SD) operative time of 56.4 ± 15.2 min for the LA group was longer than the mean operative time of 33.8 ± 10.2 min for open appendectomy (P &lt;0.05). Conclusion: Our results showed the advantages of the laparoscopic approach over open appendectomy including shorter hospital stay, decreased need for postoperative analgesia, early food tolerance, earlier return to work and lower rate of wound infection.</p> Vishwa Prakash Jha Pavan Kumar Mohammed Tarique Copyright (c) 2022 Vishwa Prakash Jha, Pavan Kumar, Mohammed Tarique 2022-01-18 2022-01-18 5 3 562 565 A Prospective Study To Evaluate Role of Closed Drainage To Reduce Recurrence and Improve Outcome of Chronic Subdural Hematoma Cases At A Tertiary Care Centre of Bihar <p>Introduction: Chronic subdural hematoma (CSDH) is one of the most common types of intra-cranial hematoma, and often occurs in the elderly. Its incidence is about 5/100,000/year in the general population, but is higher for those aged 70 years and older; 58/100,000. Surgical treatment has been widely accepted as the most effective way to manage CSDH. In this study, we have compared the postoperative recurrence rates after burr-hole drainage (BHD) of CSDH with and without subdural drain. We have also compared the mortality and morbidity between two groups. Methodology: During the period of 12 month from March 2021 to February 2022, all the patients of symptomatic CSDH) proven by computed tomography (CT) scan admitted to Department of Neurosurgery were allocated randomly in two groups using random allocation software: Group A included patients who were treated by burr-hole craniostomy with closed-system drainage, and Group B included those patients who were treated with burr-hole craniostomy without closed-system drainage. Based on these criteria, a total of 100 cases were enrolled for the study with 50 cases in each group. Result: Of the 100 patients, 90 patients had unilateral CSDH and rest 10 patients had bilateral CSDH. Of the unilateral CSDH, 49 were on the right side. Homogeneous collection was more common than heterogeneous one (72 and 28, respectively). The most common homogeneous collection was hypodense CSDH on NCCT head. The common clinical symptoms were headache and hemiparesis. Patients were evaluated for other co-morbid conditions. Brain atrophy, history of head trauma, and hypertension were common. Conclusion: In this study, the recurrence rate of CSDH is significantly lower. Hence, we would like to conclude that the use of a subdural drain reduces the recurrence rate in CSDH without any significant increase in complications and should be routinely placed after BHD.</p> Prasoon Saurabh Rishi Kant Singh Rohit Kumar Copyright (c) 2022 Prasoon Saurabh, Rishi Kant Singh, Rohit Kumar 2022-01-18 2022-01-18 5 3 566 569 A study of the results of myringoplasty with and without cortical mastoidectomy in chronic suppurative otitis media safe type dry ears <p>This prospective study of the results of myringoplasty with and without cortical mastoidectomy in chronic suppurative otitis media safe type dry ears revealed that success rate was higher in terms of graft uptake, hearing improvement and subjective sense of well-being in patients in whom myringoplasty was accompanied with mastoidectomy as compared to those with myringoplasty alone.</p> Monica Chatterjee Deepak Chandra Prabal Kar Mahapatra Copyright (c) 2022 Monica Chatterjee, Deepak Chandra, Prabal Kar Mahapatra 2022-01-18 2022-01-18 5 3 570 571 A prospective study of cognitive functioning in bipolar disorders in a tertiary care hospital <p>Introduction: Bipolar disorder (BD) is characterized by episodic pathological mood alterations that can be manic, depressive or mixed [American Psychiatric Association, 1994]. In the last 10 years, there has been increased emphasis on the role of cognition in BD attested by the exponential growth in the number of relevant publications. A significant turning point was the realization that cognitive impairment was a replicable feature of BD with measurable changes being present both during episodes and in remission. Materials and methods: Study Design: A prospective comparative study was conducted at the Department of Psychiatry, Midnapore Medical College and Hospital, Midnapore, West Bengal for 1 year , Institutional ethical clearance was taken. 100 patients suffering from bipolar disorder I currently in remission and 100 healthy controls were included in this study. The clinical state of individuals was assessed by a psychiatrist using a semi-structured proforma for documentation which included socio-demographic data of the patient, history of psychological symptoms, and thorough Physical examination findings. 100 patients were selected for the study, which fulfilled the DSM-IV TR criteria for Bipolar disorder I. Remission was assessed with scores 8 or less on Hamilton Depression Rating Scale (H.D.R.S.) and 6 or less on Young’s Mania Rating Scale (Y.M.R.S.). Results: Patients with bipolar I disorder were found more cognitively impaired in comparison to the control group particularly in attention, working memory, and executive functioning. Factors affecting neurocognitive performances were early-onset, age, duration of illness and number of episodes. Conclusion: Cognitive functioning of an individual is very important as it not only reflects a patient’s socio-occupational functioning and ability to live independently but also about the insight of their illness and compliance to treatment. Adequate cognitive remediation at an early stage of illness might improve the outcome of bipolar illness. Therefore, the development of interventions targeting cognitive impairments is imperative for improving recovery rates and quality of life in patients suffering from bipolar disorder.</p> Rajarshi Guha Thakurta Ananta Manna Kaberi Bhattacharyya Soumendu Sen Copyright (c) 2022 Rajarshi Guha Thakurta, Ananta Manna, Kaberi Bhattacharyya, Soumendu Sen 2022-01-18 2022-01-18 5 3 572 574 A prospective study of aetiology and outcome of acute kidney injury in type 2 diabetes patients <p>Introduction: Acute kidney injury (AKI) describes the clinical syndrome earlier called acute renal failure. AKI is defined as structural or functional abnormality of the kidney that manifests within 48 h, as determined by blood, urine, tissue tests or by imaging studies. AKI is depicted by rapid (over hours to days) decline in glomerular filtration rate, retention of nitrogenous waste products and perturbation of the extra-cellular fluid volume, electrolytes and acid-base homeostasis. AKI constitutes approximately 5% of hospital admissions and up to 30% of admissions to intensive care units (ICU). Materials and Methods: A prospective study was conducted at Department of Internal Medicine, KIMS Hospital, Ongole from January 2021 to December 2021 (1 year). Type 2 diabetic patients 30 years or above, irrespective of gender, diagnosed to have acute kidney injury using KDIGO criteria, admitted to ICU or wards under the Department of Internal Medicine, KIMS Hospital, Ongole were included in the study. Patients with preexisting renal disease and those who received renal transplantation were excluded from the study. Type 2 diabetic patients admitted in the ICU and wards under Medicine and Nephrology department, KIMS Hospital, Ongole were evaluated in detail after taking prior consent. Evaluation includes detailed history taking and physical examination. Acute kidney injury will be assessed on the basis of their serum creatinine and/or urine output fulfilling the KDIGO criteria. Results: The study was conducted in a total of 150 diabetic patients who developed acute kidney injury. There were 94 males and 56 females. The aetiology and outcome of acute kidney injury in the above patients were found out. Blood urea, serum creatinine, serum electrolytes, fasting and post-prandial blood sugar, WBC count, platelet count and haemoglobin were included as the baseline parameters. Conclusion: Infection was the most common cause of AKI in Type 2 diabetes patients in our study. Among drug induced renal failure patients, NSAIDS were noted to be most common cause. Age &gt;60 and male gender were prevalent in the majority of AKI patients. About 52.66% of the total patients recovered to normal renal function, 13.3% recovered partially, with 14% of the total patients progressed for maintenance hemodialysis. Crude mortality rate among patients with AKI in the study group was 20%.</p> Donapati Sathish Kumar Reddy Pavitra Burla Copyright (c) 2022 Donapati Sathish Kumar Reddy, Pavitra Burla 2022-01-18 2022-01-18 5 3 575 577 Screening of gestational diabetes mellitus (GDM) and gestational glucose intolerance (GGI) in pregnant woman from rural population <p>Introduction: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance with recognition or onset during pregnancy irrespective of treatment with diet or insulin.1 Maternal metabolic adaptation is to maintain mean fasting plasma glucose of 74.5 +/- 11 mg/dl and postprandial peak 108.7+/- 16.9 mg/dl.1 This fine tuning is possible due to compensatory hyperinsulinemia as normal pregnancy is characterized by insulin resistance. Pregnancy induces progressive changes in maternal carbohydrate metabolism. Materials and Methods: The present study was a cross sectional study undertaken to study prevalence of gestational diabetes mellitus (GDM) and gestational glucose intolerance (GGI) in pregnant women from rural population. The present study was done in antenatal clinic of Obstetrics &amp; Gynecology (OBGY) department, at Tertiary Care Hospital. The present study was conducted from December 2017 to November 2019 for a period of 24 months. The study population was ante-natal mothers attending antenatal clinic of Obstetrics &amp; Gynecology (OBGY) department. Therefore 700 antenatal mothers were included in the study population fulfilling inclusion and exclusion criteria. Results: It was observed that majority 485(69.28%) of the antenatal mothers were multi-gravida followed by 215 (30.71%) antenatal mothers were primigravida. It was observed that majority 345(49.29%) of the antenatal mothers were in third trimester followed by second trimester (35.57%) and first trimester (15.14%). It was observed that among 700 antenatal mothers screened 13 (1.86%) found to be GGI positive, 57 (8.14%) found to be GDM positive while 630 (90%) antenatal mothers were negative for OGTT. Conclusion: The rise in prevalence of Gestational Diabetes in the community and its associated increased risk of pregnancy and delivery complications justifies a need to screen pregnant mothers who attend the antenatal clinic. The results suggest that a policy of universal screening for GDM should be adopted in all antenatal clinics. This single step procedure is a simple economic and feasible method. It serves both for the purpose of screening and diagnosis at the same time. Due to the simplicity, acceptability, sensitivity and cost effectiveness of OGTT, it is the best method to detect gestational diabetes mellitus in high risk group.</p> Shivakumar Nishi Kailash Sudhya P Chellamma VK Copyright (c) 2022 Shivakumar, Nishi Kailash, Sudhya P, Chellamma VK 2022-01-18 2022-01-18 5 3 576 584 BISAP Score as a predictor of outcome in Acute Pancreatitis – A prospective study <p>Objectives: To predict the outcome of Acute Pancreatitis using BISAP score. To find the association of mortality and morbidity with BISAP score in Acute Pancreatitis. Methods: The prospective study was conducted over a period of 1 year and included 100 patients, who presented within 24 hours of the onset of symptoms, and the BISAP score was obtained. The study population was divided into two groups – Mild Acute Pancreatitis (BISAP &lt;3) and Severe Acute Pancreatitis (BISAP ≥ 3). The outcome, mortality and morbidity in the study group was analyzed. Results: The study group with BISAP ≥ 3 was associated with a significantly higher risk of Pancreatic necrosis, transient organ failure and persistent organ failure; and was associated with a statistically significant mortality, morbidity and hospital stay. Conclusion: BISAP score is a simple scoring system which can clearly prognosticate severity, morbidity and mortality of acute pancreatitis patients. It enables us to risk stratify the patients early in the disease process and thus helps in improving the clinical care and facilitates necessary intervention.</p> Maqsood Ahmed Awasi Shyam Kumar Gupta Sandeep Bhat Sushant Trakroo Copyright (c) 2022 Maqsood Ahmed Awasi, Shyam Kumar Gupta, Sandeep Bhat, Sushant Trakroo 2022-01-18 2022-01-18 5 3 585 589 Histopathological analysis of ovarian lesions in a tertiary care centre <p>Background: The occurrence of functional or benign cysts and tumors are quite common in the ovaries. The present study assessed histopathology of ovarian lesions. Materials &amp; Methods: 96 ovarian masses specimens obtained from gynaecological department were studied. Microsections of 5 microns thickness were taken onto glass slides and stained by standard Hematoxylin and Eosin stains. Slides were studied and classified based on WHO guidelines. Results: Age group 21-30 years comprised of 16, 31-40 years 36, 41-50 years 34 and 51-60 years 10 lesions. There were 46 non- neoplastic lesions, 40 benign neoplastic and 10 malignant neoplastic lesions. Common non- neoplastic lesions were follicular cyst in 20, inclusion cyst in 4, corpus luteum cyst in 12, ectopic pregnancy in 3, twisted cyst in 2, endometriosis in 2 and edema of ovary in 3 cases. Common non- neoplastic lesions comprised of fibroma in 20, fibrothecoma in 5, mucinous cystadenoma in 8, serous cystadenoma in 3, mature cystic teratoma in 2 and serous cystadenofibroma in 2 cases. The difference found to be significant (P&lt; 0.05). Conclusion: Common non- neoplastic lesions were follicular cyst, corpus luteum cyst and common benign neoplastic lesions comprised of fibroma and mucinous cystadenoma. Common malignant neoplastic lesions were granulosa cell tumor and papillary serous cystadenoma.</p> Neetu Punia Sachin Chauhan Shivani Dua Isha Gupta Copyright (c) 2022 Neetu Punia, Sachin Chauhan, Shivani Dua, Isha Gupta 2022-01-18 2022-01-18 5 3 590 593 Clinical characteristics and laboratory findings of mild to moderate covid 19 cases admitted to tertiary care hospitals and their association with adverse outcomes <p>Introduction:<br>The symptoms of COVID 19 are highly variable, classifying cases diagnosed with coronavirus disease (COVID 19) according to<br>their clinical characteristics and associated outcomes is important for management of this disease. Methods: Clinical characteristics of mild<br>moderate COVID 19 was studied at tertiary care f acilities in India. A total of 668 patients were analysed, their demographics, disease, clinical<br>characteristics and laborator y parameters were recorded and the association of these factors with adverse outcomes was analysed. Results: A total<br>of 668 patien ts were included in this study, of those 69 % were males and the overall mean age was 50.7 13.2 years . Comorbidities were<br>present in 530 patients and 32 patients were smokers, except 2 patients all were symptomatic at the time of admission. During hospit al stay,<br>eventually 124 (18.5%) required high flow nasal cannula , 71 (10.6%) required ventilator support and 5 (0.7%) succumbed to de ath. Majority of<br>patients i.e., 70% were discharged without any adverse outcomes. The factors significantly associated wit h adverse outcomes were age,<br>comorbidity, duration of stay, elevated CRP, SGPT, SGOT, INR, NT proBNP, IL 6, ferritin, D Dimer, and LDH; low platelet count and<br>hemoglobin. Conclusion: Clinical characteristics, hematological, inflammatory markers and biochem ical parameters can predict disease<br>progression and adverse outcomes.</p> Jain Ashish Sharma Krishna Kumar Jain Srishti Kalia Anchin Malawat Aman Copyright (c) 2022 Jain Ashish, Sharma Krishna Kumar, Jain Srishti, Kalia Anchin, Malawat Aman 2022-01-18 2022-01-18 5 3 594 599 Complications of intra-arterial digital subtraction angiography in patients investigated for cerebral vascular disease in Tertiary Care Hospital <p>Background: Cerebral DSA is mainly performed as a diagnostic procedure but at times used for intervention. Usually DSA is safe procedure but rarely could it be associated with complications such as nausea, vomiting, transient hypotension, anaphylaxis, and groin hematoma, neurological complications secondary to thromboembolism which occurs secondary to thrombus formation within catheters or device-induced micro-dissections. The purpose of this study was to determine the complications of intra-arterial digital subtraction angiography in patients investigated for cerebral vascular disease. Methods: Present study was prospective in nature conducted on 100 dengue patients. All patients fulfilling inclusion criteria and exclusion criteria were taken up for the study. Study was carried from August to October 2021. Results: Majority of the patients was in the age group of 40-60 years and most of them were male. Complications of the DSA procedure were neurological &amp; non-neurological. Most of the non-neurological complications were local like pain at the puncture site, puncture site hematoma, femoral artery dissection &amp; few were systemic as nausea, vomiting, contrast dye allergy. Neurological complications were transient ischemic attack of motor type, transient ischemic attack of sensory type &amp; stroke of sensory type. Incidence of neurological complications in our study was 4.83%. Conclusion: DSA is a safe procedure with rare incidence of neurological complications.</p> Abhijeet Ramesh Dakre Sanjay Namdeorao Bhasme Neel Ajit Chhajed Copyright (c) 2022 Abhijeet Ramesh Dakre, Sanjay Namdeorao Bhasme, Neel Ajit Chhajed 2022-01-18 2022-01-18 5 3 600 602 Study of self-drug administration among MBBS professional medical students <p>Background: Self-medication involves obtaining medicines using old prescriptions to purchase medicines or without a prescription, sharing medicines among each other or using leftover medicines from previous illness. The present study was conducted to assess self-drug administration among MBBS professional medical students. Material and methods: The study was conducted among 130 students from first, second and final year MBBS. All selected students were asked o fill the details of questionnaire. The questionnaire was in two parts. The first part contained questions on demographic information. Socio-economic variables were covered in second part of questionnaire. The data were recorded in MS excel and analyzed using Graph pad prism version 6. Results: In the present study total participants were 130 in which, 56.15% were male and 43.84% were female. In first year 65.90% were male and 34.09% were female, while in second 46.93% were male and 53.06% were female. Likewise in final year 56.15% and 43.84% were male and female respectively. Maximum participants were of age group 18-20 yrs(43.84%). In first and second year maximum participants were of age group 18-20yrs. In final year maximum participants were of age group 24-26yrs. Likewise in final year 56.15% and 43.84% were male and female respectively. Maximum students takes self-medication for headache all groups. Maximum students takes Tablet paracetamol as self-medication. Conclusion: The present study concluded that Self-medication had been widely practiced among medical students.</p> Karmakonda Anil Kumar M. Anil Kumar Durga Kannapa Asra Tayyab Copyright (c) 2022 Karmakonda Anil Kumar, M. Anil Kumar, Durga Kannapa, Asra Tayyab 2022-01-18 2022-01-18 5 3 603 605 Study of Effectiveness of Near Peer Mentoring in Undergraduate Medical Students in a Government Run Medical College <p>Background: There is growing evidence for the positive effects of mentoring programs in undergraduate medical education in professional and personal development. Peer mentoring is a type of mentoring program in which individuals are equal in age, experience, and rank. This project was taken to introduce an immediate support network for the students of fourth semester MBBS to facilitate learning and overall development. The long term goal is to cultivate a mentoring culture at our medical college that will engage all strata of students. Methods: Two hundred Undergraduate medical students of fourth semester batch were included as mentees. Undergraduate medical students of sixth and eighth semester batch were taken as near peer mentor. After the sensitization meetings, each mentee was allotted to a near peer mentor. At the end of the mentoring period, the perceptions of the mentors and mentees about the mentoring programme were recorded. Marks of third and fourth semester examinations were compared to look for any improvement in scores. Results: 42 % of the mentees felt that they enjoyed the mentoring sessions as the near peers could understand their problems very well. Comparison of pre mentoring and post mentoring academic performance was done by analyzing the third and fourth semester theory and practical examination marks. The mean of third semester theory was 23.14 % and the same for 4th semester was 26.14 % (p&lt;0.001). For the practical marks, the mean for third semester was 16.51 % and that of the 4th semester was 18.29 %. (p&lt;0.001). The difference was more pronounced in cases of low achievers. Conclusions: Near-peer mentoring is a novel idea with beneficial effects on both mentee and mentors. Mentoring has some role in academic achievements of mentees, especially for low achievers. Mentors, in turn, benefit by honing of knowledge or acquiring communication and teaching skills critical for the development of a professional.</p> Ranjana Bandyopadhyay Ujjwal Bandyopadhyay Adarsh Lata Singh Copyright (c) 2022 Ranjana Bandyopadhyay, Ujjwal Bandyopadhyay, Adarsh Lata Singh 2022-01-18 2022-01-18 5 3 606 612 Application of Six Sigma tool as Quality Indicator for evaluation of analytical phase of sample processing <p>Introduction:In a Clinical Biochemistry Laboratory (CBL), the measures used to assess the QC are Internal QC (IQC) and EQAS. For Quality assessment in an objective and quantitative manner, sigma metrics have been used. Higher Sigma metric values represents few analytical; i.e. 3.4 defects per million opportunities. Based on the sigma metrics, appropriate QC rules are applied. The present study intends to evaluate the performance of Analytic phase of testing at Laboratory Services, GMERS Medical College &amp; General Hospital Vadnagar in terms of Sigma metrics, and Quality Goal index for routine biochemical parameters.Material Method:We calculated (A) Sigma (σ) value and (B) Quality goal Index of 14 parameter. Sigma metrics were calculated using Total allowable goals as per i) Clinical Laboratory Improvement Amendments (CLIA) guidelines from US(2019) and ii) the biological variation database specifications. Microsoft Excel spreadsheet version 2016 was used for statistical analysis. Bias, CV, QGI and sigma metrics were calculated using the above formulae. Bias and CV were presented as percentages.Result:For 2 parameters; Urea and ALT sigma metrics was more than 6, which is a marker of world class quality. The lower performance of Total Bilirubin, Creatine, Cholesterol, HDL, Uric acid, Total Protein, Albumin in was however attributable to both lack of accuracy while for IQC norm and path.Conclusion:Sigma metrics is an excellent self-assessment tool for performance analysis of various test parameters in the laboratory. On applying the same to our routine biochemistry laboratory at Laboratory Services.</p> Margit Gajjar Jigar Parmar Gaurav Modi Dipti Gajjar Copyright (c) 2022 Margit Gajjar, Jigar Parmar, Gaurav Modi, Dipti Gajjar 2022-01-18 2022-01-18 5 3 613 617 A prospective study of risk factors associated with young patients of myocardial infarction <p>Introduction: The prevalence of coronary artery disease (CAD) has progressively increased in India during the later half of the half century and is the major cause of morbidity and mortality burden in the world. Global burden of disease study estimate that by the year 2020, the burden of atheroembolic cardiovascular disease in India would surpass that in any other region in the world. Materials and methods: The study was conducted in Department of Medicine on 100 cases of acute myocardial infarction, if they satisfied the following selection criteria. From May 2020 to April 2021. Patients more than 18 years and less than 45 years of age presented with complaints of chest pain, palpitation (or) breathlessness (or) a combination of these were subjected primarily to electrocardiographic studies to confirm myocardial infarction. All patients having ST segment elevation (&gt; 1 mm in inferior oriented leads (or) &gt; 2 mm in anterior oriented leads) in at least two consecutive leads were considered to have myocardial infarction and then included in the study. Results: 100 young patients (18 – 45 yrs.) of acute myocardial infarction with average age of 36.24 ± 4.32 years were studied. Maximum (84%) were males. Youngest being 25 yrs. of age and the maximum incidence of the disease was found in 3rd decade. Prevalence of family history of coronary heart disease was 35%. No single patient had history of premature coronary artery disease in the family (i.e. CAD in male &lt; 55 years, female &lt; 65 years). Maximum patients belonged to lower class category (52%) followed by middle class (28%). Only 20% patients were from upper class; 55% of patients were smokers. Conclusion: The incidence of Myocardial Infarction is rising in young individuals owing to change in lifestyle pattern, eating habits, more stress and workload. Incidence remained highest in males as compared to females. Highly associated risk factor in young myocardial infarction patients are dyslipidaemia and smoking. Other traditional risk factors associated with myocardial infarction like diabetes, hypertension, obesity are also very much correlated and their incidence also seems to be increasing.</p> B.Sravan Kumar S.Kiranmayi Copyright (c) 2022 B.Sravan Kumar, S.Kiranmayi 2022-01-18 2022-01-18 5 3 618 620 Prevalence of gestational diabetes mellitus among women attending antenatal clinic of a teaching hospital <p>Introduction: India is the diabetes capital of the world with 41 million Indians having diabetes. Every fifth diabetic in the world is an Indian. Hence relatively pregnant population is at greater risk for developing diabetes in India and the prevalence is as high as 16.55%. Materials and methods: Study design - Retrospective hospital based study was conducted at Department of General Medicine, Maheshwara Medical College &amp; Hospital, Patancheru, Medak District, Telangana. Total of 270 pregnant women who had attended the Antenatal Clinic of a teaching hospital during the period of 3 months (January to March, 2021). Data was obtained from hospital records. Diagnosis of GDM was made according to WHO guidelines. All the pregnant women had undergone oral glucose tolerance test at 24 - 28 weeks of gestation. Blood samples obtained after 8 hours of overnight fast and 1 and 2 hours after 75 g oral glucose load. The diagnosis of GDM was made when any of the following plasma glucose values exceeded: fasting ≥ 92 mg/dL, 1 hour ≥ 180 mg/dL and 2 hours ≥ 153 mg/dL. Results: Total of 270 pregnant women were registered and screened for GDM as per records. Of these 270 cases, GDM was detected in 32 antenatal women. Among the antenatal women, maternal complications were seen in 14 (43.8%) of those with GDM and 126 (52.9%) of those without GDM. Statistically, there was no association between GDM and maternal complications. Of 32 cases of GDM 10 (31.25%) cases had normal delivery, while 22 (68.75%) underwent LSCS. Conclusion: Among the 270 women, 32 (11.9%) had GDM. Prevalence of GDM was more in the age group of 25 - 31 yrs. and among multigravidae. This gives an insight into groups, which require more attention in terms of screening. Out of 32 cases of GDM, majority underwent LSCS. Of the neonates born to these mothers only 2 was preterm, 2 had low birth weight and neonatal complications were seen in 12 of them. The impact of GDM is emphasized by these findings.</p> B.Sravan Kumar S.Kiranmayi Copyright (c) 2022 B.Sravan Kumar, S.Kiranmayi 2022-01-18 2022-01-18 5 3 621 623 A prospective comparative study of effect of addition of dexmedetomidine 0.5 mcg/ml with 0.2% ropivacaine and 0.2% ropivacaine alone in epidural labour analgesia <p>Introduction: The pain of childbirth is the most painful experience for many women and maternal request is a sufficient indication for providing her pain relief during labour. The McGill pain questionnaire ranks labour pain scale between cancer pain and amputation of a digit.1 Labour pain is associated with maternal physiological responses, which are not necessarily beneficial to the foetal well-being. Materials and Methods: This prospective, comparative study was going to be conducted at Department of anesthesia, Bidar Institute of Medical Sciences, Bidar during the period of November 2021 to April 2022. The sample size obtained was 38 for each group which was rounded up to 60 for each group. So final sample size estimated was 120. Reference article for sample size calculation is made based on the study conducted by Zhao Y et al. Total of 120 parturients of age group 20-35 yrs., Heights in cm: &gt;150 cms, full term singleton vertex presentation, previous normal vaginal delivery, consented for the study, Primigravida and multigravida of physical status ASA grade I&amp;II, foetus having normal heart rate pattern before induction of Epidural, Cervical dilatation of 3-5 cms were included in group and divided in 2 group using computer generated randomization technique. Results: The highest sensory level in both groups was observed at T6 (p=0.190). Total drug requirement in both groups was calculated. All the subjects 60 (100%) in both the groups required first and second dose of bolus. While third bolus was required only for 50 (83.3%) subjects of RD groups compared to 60 (100%) of RS group. Fourth bolus was required only for 34 (56.7%) subjects of RD groups compared to 50 (83.3%) of RS group. Fifth bolus was required only for 2 (3.3%) subjects of RD groups compared to 12 (20.0%) of RS group. There was statistically significant difference between the two groups for third (p=0.020), fourth (p=0.024) and fifth bolus (p=0.044). The total drug requirement for RS group (32.27+- 4.91) was significantly higher than the RD group (27.46 +or- 6.53), p value of 0.021. Conclusion: Epidural labour analgesia is considered to be a gold standard for pain management during labour, when ropivacaine along with dexmedetomidine is used. Many studies have been conducted to prove the use of dexmedetomidine in obstetric anesthesia in optimal doses. This wonder drug provides excellent maternal satisfaction and good progress of labour with minimal side effects to mother and foetus.</p> Deepak Tugave Mukaram Amruta Copyright (c) 2022 Deepak Tugave, Mukaram, Amruta 2022-01-18 2022-01-18 5 3 624 626 Analysis of Causes and Frequency of Blood Donor Deferral in a Tertiary Centre in North India – An Insight Into The Regional Deferral Pattern <p>Introduction: Blood donor screening should be done through a stringent process so that it ensures blood availability and accessibility while maintaining the blood safety at the same time. Donors who get rejected in the process are called deferred donors. We, hereby aimed to assess various reasons of deferral and their relative proportions and to categorize donors according to type of deferral, age and gender. Method: We performed a retrospective analysis of data of donors who presented to Department of Immunohematology and Blood Transfusion, Lady Hardinge Medical College or at VBD Camps for a period of 20 months from January 2020 to August 2021. Rate of deferral was quantified and various causes were characterised according to gender and age. Result: A total of 19,151(18,665 males,486 females) donors presented at our centre and VBD camps, of whom 17,632(92.07%) were accepted while 1,519 were deferred. Out of total donors accepted, 17,345 were males and 287 females. The percentage of deferred donors was 7.93%. Amongst 486 females, 199 were deferred, i.e. 40.95%, while 7.07% males were deferred amongst males(1320 out of 18665). Out of total deferrals, majority i.e. 1302(85.71%) were due to temporary reasons while 217(14.29%) were deferred permanently. Overall, most common reason for deferral was low hemoglobin(514/1519 i.e. 33.84%). Amongst temporary deferrals, most common reason overall was due to low hemoglobin (514/1302, 39.48%) with low hemoglobin also being the most common reason of temporary deferral in both males(393/1111= 35.37%) and females(121/191= 63.35% ). Amongst the permanent deferrals, most common reason was due to history of High risk behaviour (46/217=21.20%). History of High risk behaviour was also the most common reason of permanent deferral in males(46/209= 22.01%) and Thyroid disorders, the most common amongst permanent deferral in females(03/08=37.5%). Majority of deferred donors belonged to the age group of 29–38 years (42.66 %). Conclusion: Estimation of incidence and causes of deferral is important to get better insight of the regional deferral pattern. Temporary causes account for the majority of deferral and such donors should be followed up for the maintenance of the VBD pool and ensuring the safety of both donors and recipients. Abbreviation: VBD= voluntary blood donation, Hb= Hemoglobin, NACO = National AIDS Control Organization. WHO= World Health Organisation.</p> Shruti Chauhan Sangeeta Pahuja Shubham Sharma Deeksha Singh Copyright (c) 2022 Shruti Chauhan, Sangeeta Pahuja, Shubham Sharma, Deeksha Singh 2022-01-18 2022-01-18 5 3 627 632 Extradural Hematoma: A Case Series of Patients Presenting To A Tertiary Care Center of Bihar <p>Introduction: India is undergoing major economic and demographic transition coupled with increasing urbanization and motorization. Among the top ten causes of mortality in the country, head injury was the tenth cause two decades back. The aim of this study was to analyze various causes, clinical presentations, factors influencing presentations and to evaluate the postoperative outcome in patients with head injury with an extradural hematoma before surgery and to formulate recommendations for improvement of therapy and suggestions for the future. Methodology: This is a prospective observational Study which included 50 patients admitted at Patna Medical College &amp; Hospital, Patna, Bihar over the past one year that was January 2022 to December 2022 with head injury, diagnosed to have traumatic extradural hemorrhage. Prior ethical approval was obtained from the institutional Ethics Committee. The study included all patients between age groups of 5 to 70 years. The study evaluated initial outcome, excluding long term outcome. Collected data were entered into and analyzed using Statistical Package for Social Sciences (SPSS) Version 21.0 (IBM, Chicago). Results: A total of 50 cases were included in the study. Maximum patients suffering from EDH were in the age group of 21-30 years. The mean age was 29.3 years with a standard deviation of 8.2 years. There was a male preponderance with a male to female ratio of 5.25:1. The most common mode of injury among the patients was road traffic accident (78%) and 64% of cases of RTA occurred under the influence of alcohol. Conclusion: The present study concludes that, road traffic accident was the commonest mode of causative agent for EDH. Alcohol influence had a significant contribution in the causation, revealed by present study series and proved a social evil. So, early presentation to hospital with mild to moderate GCS has good clinical outcome with minimal disability.</p> Rishi Kant Singh Prasoon Saurabh Rohit Kumar Copyright (c) 2022 Rishi Kant Singh, Prasoon Saurabh, Rohit Kumar 2022-01-18 2022-01-18 5 3 633 635 Susceptibility of males in second wave of Covid and infection in young: A comparison of two waves <p>Many countries have seen a two-wave pattern in reported cases of coronavirus disease-19 during the 2020 pandemic, with a first wave during spring followed by the current second wave in late summer and autumn. Empirical data show that the characteristics of the effects of the virus do vary between the two periods. Differences in age range and severity of the disease have been reported, although the comparative characteristics of the two waves still remain largely unknown. This was a challenging time, but we should faith on science to help us get through these pandemic and future ones. Differences in age range and severity of the disease will reported, although the comparative characteristics of the two waves still remain largely unknown. Those characteristics will be compared in this study using data from two equal periods of 3 and a half months. The first period, between 15th March and 30th June, corresponding to the entire first wave, and the second, between 1st July and 15th October, corresponding to part of the second wave. The most frequent signs and symptoms has been be noted. Several differences in mortality risk factors have also been observed. These results might help to understand the characteristics of the second wave and the behaviour and danger of SARS-CoV-2 in India. Further studies are needed to confirm our findings.</p> Reshu Tewari Deepika Dalal Anurag Bajpai Ashish Malik Veena Ghalaut Rakesh Kumar Copyright (c) 2022 Reshu Tewari, Deepika Dalal, Anurag Bajpai, Ashish Malik, Veena Ghalaut, Rakesh Kumar 2022-01-18 2022-01-18 5 3 636 639 A Study On Prevalence Of Catheter Associated Urinary Tract Infections In A Tertiary Care Facility Of Bihar <p>Introduction: Urinary tract infection (UTI) is one of the most common infections in humans, accounting for more than 150 million cases worldwide. Beyond the initial urinary infection, catheter-associated UTIs (CAUTIs) can lead to complications including bacteremia, endocarditis, osteomyelitis, septic arthritis, and meningitis. With this background, the current study was designed to provide baseline information of such infections in the hospital and to identify the microbial pathogens associated with these infections. Methodology: A cross-sectional study was carried by the Department of Microbiology, Jan Nayak Karpuri Thakur Medical College and Hospital, Bihar, from January 2021 to July 2021. Both adult males and females were included in the study group. Before starting the study, the purpose of the study was explained to the subjects, and informed consent was obtained. Approval was acquired from the Ethical Committee. Results: The present study comprised of 150 catheterized urine samples collected with proper aseptic precautions. Mean age of the participating patients was 47.5 years with a standard deviation of 7.2 years. The age range was 17 years to 81 years. The male to female ratio was calculated and approximated to 1.5:1. The incidence rate of CAUTI calculated for this study for ICU and wards were 3.7 and 17.2 per 1000 catheter-days, respectively and catheter utilization ratio was 0.59 and 0.07 in ICU and ward, respectively. Conclusion: The study underscores the pressing need for the development of antimicrobial urinary catheters and their deployment when longer duration of catheter access is required.</p> Prem Prakash Mandal Vandana Kumari Prakash Kumar Mishra Copyright (c) 2022 Prem Prakash Mandal, Vandana Kumari, Prakash Kumar Mishra 2022-01-18 2022-01-18 5 3 640 644 A Prospective Study Of Health Related Quality Of Life Before And After Lumber Disc Surgery For Herniated Lumber Disc At A Tertiary Care Centre Of Bihar <p>Introduction: Low back pain (LBP) is one of the most common health problems worldwide and a major cause of disability that affects performance at work and general well-being. LBP has an incidence of 15% amongst adults and a point prevalence of 30%. It is the leading cause of limitation in activity and absenteeism from work. Hence, this study was undertaken to address this lacunae in the literature. Methodology: A prospective study was conducted by the Department of neurosurgery of the Patna Medical College &amp; Hospital, Patna, and Bihar. The current study was conducted over a period of 6 months that was from January 2021 to June 2021. Prior approval was obtained from the Institutional ethics Committee. All the patients admitted for elective discectomy for single level lumbar PIVD were selected for the study, after obtaining informed written consent from the patients or their next of kin. Statistical Package for Social Sciences (SPSS Inc released 2009), version 16.0 (Chicago, IL) was used to analyze the data. Results: The most common level of disc herniation was at L4-L5 level as proven by MRI of the lumbar spine (76%) which was followed by L5-S1. In more than half of patients, Low Back Pain (LBP) with Radiculopathy was the most common presenting complaint followed by Radiculopathy and paresthesia. Conclusion: Depression and anxiety are known to affect the outcome of the procedure. Therefore, assessment of depressive symptoms and its treatment should be a part of assessment of all patients in the preoperative as well as in the postoperative period.</p> Rishi Kant Singh Prasoon Saurabh Rohit Kumar Copyright (c) 2022 Rishi Kant Singh, Prasoon Saurabh, Rohit Kumar 2022-01-18 2022-01-18 5 3 645 648 Prevalence and spectrum of refractive errors in children attending out-patient department of Ophthalmology, Government Medical College, Doda, Jammu and Kashmir <p>Introduction: Uncorrected refractive errors are a common problem in school aged children. The presence of refractive error in school going children affects their physical, mental and behavioral development as well. Inability to detect them at an early stage can adversely impact their learning and academic performancepurpose. Objective: To study prevalence and spectrum of refractive errors in children aged between 10 and 16 years in the rural population of the Doda district of Union territory of Jammu and Kashmir who attended the outpatient department of ophthalmology GMC Doda between July 2019 and July 2021. Materials and Methods: All children aged between 10 to 16 years coming to Outpatient Eye Department of GMC Doda from July 2019 to July 2021 were included in this repetitive study. Detailed ocular examination was performed on each patient. It consisted of visual acuity testing, pupillary reaction, ocular motility examination,cover-uncover test, anterior segment examination and direct ophthalmoscopy. Depending on type of eye disease, they were categorized. Children with defective vision were further examined employing objective refraction using autorefractometer followed by streak retinoscopy after instilling 1% cyclopentolate eye drops. Children with any kind of refractive errors were evaluated and categorized according to the type of refractive error on post-mydriatic examination. Children with prior ocular surgery or any ocular disease contributing to diminished VA, manifest strabismus, and pathological myopia were excluded from the study. Results: The prevalence of refractive error in this study is 13.4%. Total of 500 children were examined which included 187 male and 313 female children aged between 10 to 16 years. Out of 500 children, 433 (167 males and 266 females) had no refractive error and in 67 (20males and 47 females) had varying degree of refractive errors. Myopia was most common type of refractive error seen in 35 (11 males and 24 females), hypermetropia in 3 (1 males and 2 females), Astigmatism in 24 (7 males and 17 female) and mixed refractive error (spherical and cylindrical) in 5 (1 males and 4 females). Among children having refractive error visual acuity of 6/9 was seen in 23 (9 males &amp;14 females), 6/18 in 16 (4 males and 12females), 6/24 in 14 (3 males and 11 females), 6/36 in 11 (2 males and 9 females) and 6/60 in 3 (2 males and 1 female). Conclusion: Refractive error is important cause of treatable blindness in children in the age group of 10-16 years.A larger study needs to be conducted in all the schools of the district to get a clearer picture of refractive errors and other eye-related diseases to detect vision problems as early as possible.</p> Isha Govind Kumar Copyright (c) 2022 Isha, Govind Kumar 2022-01-18 2022-01-18 5 3 649 651 COPD with Atrial Fibrillation <p>Background: COPD is one of the leading cause of morbidity and mortality and is associated with variety of cardiovascular disease especially Arrhythmia which is directly associated with severity of COPD so there was a need to identify the incidence of Atrial Fibrillation (AF) in COPD patients and its effect on mortality and morbidity of patients admitted in hospital for COPD. Material and Methods: A retrospective study was conducted and data analysis was done, of all patients with established COPD diagnosis. The number of patients were divided into two groups: (1) Patients with diagnosed COPD in ordinance with GOLD guidelines (2) Patients with COPD diagnosed with AF, new onset and old. Post admission patients were divided on the basis of age, sex, H/o, CAD and H/o smoking. Results: Out of 200 study patients, 30% had AF (old and new). 34% had new onset AF and 66% were known cases of AF. Out of patients with AF 18% were less than 50 years of age, 60% between 50-70 years, 22% more than 70 years, 80% were smoker, 20% non-smokers, 80% had CAD; 75% were male and 25% female. Conclusion: COPD patients are at higher risk of developing AF. COPD with AF patients have longer Hospital stay and increased mortality.</p> Nisar Ahmad Khan Muzamil Ahmad Masoodi Azhar Gulnar Saleem Copyright (c) 2022 Nisar Ahmad Khan, Muzamil Ahmad Masoodi, Azhar Gulnar Saleem 2022-01-18 2022-01-18 5 3 652 657 Treatment options for recurrent rhinoorbital cerebral mucormycosis – A study on 50 cases <p>Background: Mucormycosis also called as zygomycosis infection caused by infection with fungi belonging to the order of mucorales. Infection itself is life threatening and in recurrence it is more worse prognosis, risk factors for ROMM are diabetes mellitus, pancytopenia, immune compramised individuals .At present scenario recurrence of ROMM is due to lack of awareness in using treatment available for ROMM and also resistant nature of fungi. Aim: To know the various treatment modalities available for recurrent ROMM (medical,surgical), to see the most curable treatment option to avoid repeated recurrence ,to see the commonest presenting symptoms and signs of ROMM. Materials and methods: 50 cases of previously treated ROMM cases (medical or surgical) were taken into study with symptoms of recurrent ROMM sent for radiological and dental examination according to the need came to one treatment conclusion and patients were hospitalized and treated accordingly with various treatment options as per patient need .Patients attending to Gandhi hospital ENT OPD after completion of Covid 2nd wave over a period of 4 months consequently taken for study’. Observations and results: It is a hospital based study conducted in Gandhi hospital, ENT department, sample size is 50, most common cause for recurrence is diabetes and immune compramised status, resistant nature of fungi to multimodality of treatment, as per this study most common treatment option is medical (oral posaconazole, inj. Liposomal amphotericin B), antifungals, most curable treatment option for recurrence is surgical(FESS with maxillectomy, debridmant). Conclusion: Study conducted over a period of 4 months in patients with recurrent ROMM symptoms, out of 50 sample &gt;50% were previously surgically treated during the 2nd wave of covid 19(black fungus period) conclusions are male predominance,diabetics,40-60 age ,necrotic bone and pus discharge ,loose tooth are presenting complaints, radiologically positive, common treatment option is medical oral posaconazole, surgical FESS with maxillectomy, Debridment, Plain FESS.</p> Perla Ambika Copyright (c) 2022 Perla Ambika 2022-01-18 2022-01-18 5 3 658 660 Radiological Evaluation of Imaging of CT-Thorax Among Comorbid And Vaccinated Covid Positive Patients <p>Introduction: The current pandemic of corona virus disease 2019 (COVID-19) caused by the new virus Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2), started in Wuhan, China and spread rampantly throughout the globe, causing serious health threats to humans. Second wave in India was seen peaking in early month of May 2021. CT Thorax is extensively used by doctors in COVID-positive patients. The objective of the present study is to compare the pattern and severity of lung involvement in COVID-positive patients based on comorbidities and vaccination status. Methodology: Present study is a cross-sectional study of 805 COVID-positive patients who were referred to Dept of Radiodiagnosis, Basaweshwara Hospital attached to MRMC, Gulbarga, for CT thorax to look for lung involvement of COVID, for period of two months from March to April 2021. Imaging findings and data collected were spread on excel sheet and analysed, and results were represented in tables, graphs and charts. Results: Among 805 patients, 37.80% of patients belonged to 41-59 years age group, with male to female ratio of 1.7:1. Of the total, 23.70% were comorbid patients, among which 52.80% patients were above 60 years age group. HTN was the predominant comorbidity seen in 17.30% cases, followed by DM in 11.80%. Comorbid patients were prone to have a severe lung involvement and higher CT Severity Score. Among 805 patients, 13.40% were vaccinated, and patients with complete vaccination had a tendency of milder lung involvement and lesser CT Severity Score. Conclusion: CT Thorax is an important investigation to look for the severity of lung involvement. COVID-positive patients with comorbidities have a higher lung involvement as assessed by CT severity score as compared to that of non comorbid patients. COVID positive patients with complete vaccination have a reduced lung involvement as compared to non-vaccinated and patients vaccinated with a single dose of vaccine.</p> Shivanand S. Melkundi Priyanka C. Megharaj Copyright (c) 2022 Shivanand S. Melkundi, Priyanka C. Megharaj 2022-01-18 2022-01-18 5 3 661 668 Evaluation of solid renal masses by qualitative and quantitative parameters in four phase MDCT with histopathological correlation <p>Introduction: Quantitative measurement of the degree of enhancement has not been widely reported for RCC subtypes and fat-poor angiomyolipoma. Previously enhancement in either one of the corticomedullary or nephrographic phases is used for evaluation of renal masses. From the past decade renal mass enhancement is viewed in terms of differences in contrast enhancement and deenhancement patterns over multiple phases on multiphasic MDCT as well as contrast-enhanced MRI to distinguish among RCC subtypes[1]. Most recent studies by Jinzaki et al[11], sun et al and Vargas et al, Stephanie A. Lee-Felkar et al[12] advanced the concept of multiphasic renal mass attenuation profiles for individual histological subtypes. In our study we follow the current novel approach to the imaging evaluation of renal masses using qualitative and quantitative MDCT feature. Aim/purpose: To characterize the incidentally detected solid renal masses as benign or malignant and differentiating the clear cell RCC from its benign and malignant mimics based on qualitative parameters like lesion contour, calcifications, neovascularity, enhancement and quantitative parameters like mean absolute attenuation, mean relative attenuation, absolute enhancement &amp; absolute de-enhancement in a four-phase MDCT renal mass protocol. Materials and methods: This was an Observational prospective study conducted in 42 patients in the department of Radiodiagnosis at Apollo hospitals, Jubilee hills, Hyderabad referred from the Departments of urology, surgical oncology with a clinical suspicion renal tumors or renal masses which are incidentally detected on ultrasound and referred to CT for further characterizationfor 9 months, from October 2019 to June 2020.Patients of all age groups, both sexes, who were given consent for the study taken and subsequently histopathological findings were followed.Patients with angiomyolipoma with macroscopic fat detectable, predominantly cystic renal masses on CT, Pregnant women and allergic to contrast media are excluded. 128 SLICE PHILIPS INGENUITY CT machine was used for evaluation with parameters of 3mm slice thickness, FOV of 300.00mm, voltage of 120KV, tube current of 300-350mA. Results: This was an observational prospective study was conducted among all the patients who were referred to department of radiodiagnosis for further characterisation and correlate with histopathology as gold standard.The mean age of the study population was 49.2 ± 2.9 yrs. with majority of the patients belongs to 41 – 60 yrs.78.5% of patients in the present study were male and 21.5% were female.85.7% were symptomatic at the time of presentation and the most common symptom was haematuria followed by pain in abdomen.Most common solid renal mass was renal cell carcinoma (54%). Among renal cell carcinomas clear cell RCC is most common histological variant (53%). Among the benign oncocytoma is most common (19%). Among qualitative parameters, neovascularity showed statistically significant P value with high sensitivity, specificity, PPV, NPV &amp; accuracy. All lesions showed maximal attenuation in corticomedullary phase and decreased in subsequent phases except papillary variant of RCC. High mean absolute attenuation in CM phase + Mean relative attenuation of &gt;0% in CM phase + absolute de enhancement &gt;50HU has good sensitivity, specificity in differentiating clear cell RCC from others.Progressive enhancement from corticomedullary to nephrographic phase with highest mean absolute attenuation during nephrographic phase had high sensitivity, specificity &amp; accuracy in differentiating papillary RCC from others.Delayed de enhancement more than 30HU differentiated oncocytoma from chromophobe with high sensitivity and specificity. Conclusion: Qualitative &amp; Quantitative MDCT features enables diagnosis of malignant masses with 100% sensitivity also discriminating CcRCC from its benign and malignant mimics with high sensitivity and specificity.</p> Esparanto Sudanagunta Chandra Rakesh Chowdary Mohd Abdul Rawoof Karanam Poorna Sasank Peethamber Lokanandi Copyright (c) 2022 Esparanto Sudanagunta, Chandra Rakesh Chowdary, Mohd Abdul Rawoof, Karanam Poorna Sasank, Peethamber Lokanandi 2022-01-18 2022-01-18 5 3 669 679 Correlation between MRI and arthroscopy findings inrotator cuff tears <p>Introduction: Rotator cuff tears are one of the most common causes of shoulder pain causing significant disability[1]. 86% of patients with shoulder pain are due to the abnormality of rotator cuff disorders[2]. MRI has revolutionized the diagnosis of shoulder pathologies. MRI is a proved sensitive, accurate, cost-effective and a non-invasive tool in investigating shoulder pathology[3]. Currently, Arthroscopy is considered as the “reference standard” for the diagnosis of shoulder pathologies. Aim/purpose: The purpose of this study attempted to assess the sensitivity and specificity of MRI with gold standard of direct visualization under arthroscope for individual rotator cuff tendons injury. Materials and methods: This is a hospital based prospective and comparative study conducted in the department of Radio diagnosis, Apollo Hospitals, Jubilee hills, Hyderabad between march 2019 to September 2020. 75 patients of both sexes and age groups &gt; 18years (minimum and maximum age of the patient seen in my study are 20 years and 86 years respectively) with history of shoulder pain, restricted movements, instability and injuries who underwent MRI investigation and subsequently underwent ARTHROSCOPY.Data was collected on a pre-designed proforma by detailed history, thorough radiological investigations followed by arthroscopy findings. The data was collected analysed and reported as Sensitivity, Specificity, Positive predictive value (PPV), Negative predictive value (NPV) and Accuracy of MRI for each type of rotator cuff tendon tears. Correlation between MRI and Arthroscopy was done using Kappa statistics and p value. The whole data obtained was analyzed using Statistical Package for Social Sciences, version 23.0. Results: MRI examination showed all 75 patients had supraspinatus tears of which 43 are full thickness tears and 32 are partial thickness tears, 19 out of 75 patients had infraspinatus tears of which 14 are full thickness tears and 5 are partial thickness tears and 15 out of 75 patients had subscapularis tendon tears. There is no teres minor tendon tears reported in the present study. Supraspinatus tendon tears: In the present study arthroscopically proven supraspinatus tendon tears are 39(F) full thickness tears and 22 partial thickness tears (P 1 16 + P2 6). The sensitivity, specificity, PPV, NPV and accuracy of MRI in full thickness supraspinatus tears is 79.6%, 84.6%, 90.7, 68.8 and 81.3 respectively. Kappa value is 0.609(substantial) and p value was &lt;0.001, highly significant. The sensitivity, specificity, PPV, NPV and accuracy of MRI in supraspinatus partial articular surface tears is 80.0%, 83.6%, 64.0, 92 and 82.6. Kappa value is 0.589(moderate) and p value is &lt;0.01, highly significant. The sensitivity, specificity, PPV, NPV and accuracy of MRI in supraspinatus partial bursal surface tears are 100%, 98.6%, 85.7, 100.0. and 98.6 respectively. Kappa value is 0.916(almost perfect) and p value is &lt;0.01, highly significant. Infraspinatus tendon tears: Out of 19 (F 14 + P 5) cases arthroscopically proven infraspinatus tendon tears are 10 full thickness tears and 5 partial thickness tears (P). The sensitivity, specificity, NPV and accuracy value of MRI in full thickness infraspinatus tears are 100 % ,93.8%, 71.4,100 and 94.7. Kappa value is 0.803(almost perfect) and p value is &lt;0.001, highly significant. The sensitivity, specificity, PPV, NPV and accuracy value of MRI in partial thickness infraspinatus tears are 55.6%, 100%, 100, 94.3. and 94.7. Kappa value is 0.687(substantial) and p value is &lt;0.001, highly significant. Subscapularis tendon tears: Out of 15 cases in the present study arthroscopically proven subscapularis tendon tears are 11 partial thickness tears (P). The sensitivity specificity, NPV and accuracy of MRI in the detection of subscapularis tears is 100%, 93.8%, 73.3, 100 and 94.7. Kappa value is 0.815(almost perfect) and p value is &lt;0.001, highly significant. Conclusion: In the present study accuracy in detecting full thickness and partial thickness tears in infraspinatus and subscapularis and partial tears of supraspinatus is high as compared to supraspinatus full thickness tears. On comparing results of individual tendon tears in our study suggests, that Magnetic resonance imaging has high sensitivity, specificity and accuracy in diagnosing full thickness and partial thickness tears of supraspinatus tendon tears, subscapularis tears and full thickness tears of infraspinatus tendons. Sensitivity in detecting infraspinatus tendon partial thickness tears was lower, however it has high specificity and accuracy</p> Mohd Abdul Rawoof Karanam Poorna Sasank Esparanto Sudanagunta Peethamber Lokanandi Chandra Rakesh Chowdary Copyright (c) 2022 Mohd Abdul Rawoof, Karanam Poorna Sasank, Esparanto Sudanagunta, Peethamber Lokanandi, Chandra Rakesh Chowdary 2022-01-18 2022-01-18 5 3 680 686 A Cross- Sectional Study on Knowledge Attitude and Practice of Wearing Mask During COVID -19 Pandemic Among Students of Pt.J.N.M. Medical College, Raipur(C.G.) <p>Background: Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. The best way to prevent and slow down transmission is to be well informed about the disease and how the virus spreads. Face mask has been proved to be effective method to control and prevent Covid 19 infection. This cross - sectional study was designed with objective to assess Knowledge Attitude and Practices of wearing face mask among medical students of Raipur City (C.G.). Methods: This cross - sectional observational study was conducted among medical students of Pt. J.N.M. Medical College, Raipur City (C.G.). Quota sampling method was used for sample collection. Survey instrument was adapted from WHO guideline. Data was compiled and analysed in MS excel, data was analysed using binary and multivariate logistic regression with 95% confidence interval. Results: This study identifies, 24.63 % of study participants had a good knowledge, 89.00% had positive attitude and 70.33% had good practice related to face mask utilization. Age of the students, gender and class of the students showed significant association with knowledge of wearing face mask. Gender and class of students showed significant association with attitude of wearing face mask, and practice of wearing face mask showed significant association with class of the students. Conclusion: Good knowledge among medical students about wearing face mask was 24.63%, majority of students had positive attitude and overall good practice of wearing face mask.</p> Smita Verma Nirmal Verma Tripti Chandrakar Pallavi Kothari Neelkamal Sahu Copyright (c) 2022 Smita Verma, Nirmal Verma, Tripti Chandrakar, Pallavi Kothari, Neelkamal Sahu 2022-01-18 2022-01-18 5 3 687 692 Burden of care among caregivers of patients with schizophrenia and bipolar disorder <p>Introduction: Caregivers of patients with severe psychiatric illnesses suffer significant impairment in their socio-occupational, interpersonal as well as emotional functioning, amounting to enormous burden. Aim: To compare the burden of care among the caregivers of patients with schizophrenia and bipolar affective disorder. Methodology: It was a cross-sectional study, conducted at a tertiary care hospital, and involved 30 caregivers each of patients with schizophrenia and bipolar disorder. Burden Assessment Schedule (BAS) was used for assessing the burden experienced by the caregivers, along with a specially designed proforma was used to gather socio-demographic information about the patients and their caregivers. Result: Most subjects were males, were spouses in case of bipolar affective disorder patient (43.30%) and parents (46.70%) among schizophrenia patients. In terms of socio-demographic profile, no significant difference was found between the groups.17 (12 of schizophrenia and 5 of bipolar group) of the total 60 subjects were found to experience severe burden of care. Total burden score was 64.4 ± 13.88 for the subjects of bipolar disorder group and 75.03 ± 13.7 among the subjects of schizophrenia groupand, the difference was statistically significant. Conclusion: Severe burden of care worsens the quality of life and poses substantial subsyndromal psychiatric morbidity among the caregivers of patients with chronic psychiatric morbidities. Support programme should be planned to help the caregivers, acknowledging the uniqueness of each caregiving situation, monitoring the individual care process and taking into consideration the phase in the caregiving process.</p> Vivek Srivastava Ashish Kumar Malik Priyanka Tetarwal Rajiv Gupta Priti Singh Piyush Verma Copyright (c) 2022 Vivek Srivastava, Ashish Kumar Malik, Priyanka Tetarwal, Rajiv Gupta, Priti Singh, Piyush Verma 2022-01-18 2022-01-18 5 3 693 696 A Study On Urinary Microalbuminuria And Serum Uric Acid In Patients Of Type 2 Diabetes Mellitus At A Tertiary Care Hospital Of West Bengal <p>Introduction: Diabetes mellitus is a chronic metabolic condition characterized by hyperglycemia, and protein and fat metabolism derangement. About 40 % of people having type 1 diabetes (T1DM) as well as 5-15 % of people with type 2 diabetes (T2DM) experience end-stage renal disease (ESRD). With this overview, this study was undertaken to assess the significance of microalbuminuria and uric acid in the early detection of renal involvement among patients with T2DM. Materials and Methods: This cross-sectional study was carried out by Department of Internal Medicine, Malda Medical College and Hospital, Malda, West Bengal, India between August 2019 to July 2020. 150 diagnosed patients of type 2 Diabetes Mellitus in the age group of 25-75 years, coming in medicine OPD were taken as cases and 150 age and sex-matched normal persons were taken as controls. The clearance was obtained from the Ethical Committee of the Institution. The patients obtained informed and written consent, with the clarification of the study protocol. The demographic and biochemical parameters were compared in both cases and control by conducting unpaired t-test. Statistical package for Social Sciences (SPSS) ver. 20.0 was used for data analysis. Results: Out of 150 cases studied, there were 55 males and 95 females whereas there were 47 males and 103 females in controls. The mean urine microalbumin (mg/g creatinine) in cases and control was calculated to76.6 ± 65.5 and 22.8± 7.6, respectively. The mean serum uric acid (mg/dl) was 6.2 ± 1.2 and 4.3 ± 0.8, respectively for cases and controls. The mean serum creatinine (mg/dl) 1.2 ± 0.5 and 0.9 ± 0.7, respectively. The age group, BMI, FPG, 2hPG, urine microalbumin were higher in cases as compared to control and the difference was statistically significant (p&lt;0.05). Conclusion: Diabetic nephropathy is amongst the most serious diabetes complications and the major cause of end-stage renal disease. Strict glycemic control, microalbuminuria monitoring, and serum uric acid monitoring with better management may delay diabetic nephropathy.</p> Soumyasil Das Rajnarayan Mukherjee Pijush Kanti Mandal Copyright (c) 2022 Soumyasil Das, Rajnarayan Mukherjee, Pijush Kanti Mandal 2022-01-18 2022-01-18 5 3 697 700 Morphological pattern of anaemia in adults-A retrospective study <p>Introduction: Anemia most often a sign of an acquired or genetic abnormality. It is one of the commonest manifestations of the underlying medical condition. Anemia functionally defined as an insufficient RBC mass to adequately deliver oxygen to peripheral tissues. Hemoglobin concentration estimation is the ideal and convenient way of detecting Anemia. Other measurements, which are also helpful are haematocrit and the RBC count. It is not enough to just report that patient has anemia, but also morphological sub typing of anemia is required, so that the clinician can be properly guided in the proper management and follow up of the anemic patient[1]. Materials and Methods: A hospital based retrospective study was carried out at Department of Pathology, Tagore Medical College and hospital, chennai from April 2020 to March 2021. 200 patients were evaluated for morphological pattern of anaemia based on red cell indices, peripheral smear, and leukocyte and platelet parameters. Anaemia was defined according to WHO criteria as haemoglobin concentration lower than 13 g/dL in men and 12 g/dL in women. Elderly was defined as a person 60 years and above according to WHO criteria. Results: The results of CBC and PBP showed that 58 (29%), 110 (55%), and 32 (16%) of the patients had normocytic normochromic, microcytic hypochromic and macrocytic pattern of anaemia respectively [Table 1]. The gender wise classification of the patterns revealed that 36 male patients and 28 female patients had normocytic normochromic patterns, while 104 female patients and 26 male patients had microcytic hypochromic patterns whereas 18 males patients and 14 cases of female patients showed macrocytic pattern [Table 2]. Conclusion: The microcytic hypochromic pattern of anaemia is highly frequent among this sample of patients while the macrocytic pattern of anaemia is the lowest. According to gender groups, microcytic hypochromic pattern of anaemia is more common among females; malnutrition, increase of blood loss due to pregnancy or menstruation, and lack of iron absorption are the main causes, while the normocytic normochromic anaemia is highly prevalent among males, which is mainly due to blood loss or chronic diseases.</p> Karattupalayam Sampath Mouleeswaran B.S.Sangeetha Copyright (c) 2022 Karattupalayam Sampath Mouleeswaran, B.S.Sangeetha 2022-01-18 2022-01-18 5 3 701 703 An observational analysis of clinical factors predicting ovulation induction among infertile women with Poly Cystic Ovarian Syndrome: At Tertiary care facility, Jaipur <p>Objective: To identify the predictive factors for ovulation with clomiphene citrate (CC) in polycystic ovarian syndrome (PCOS) patients with infertility. Materials and Methods: A prospective observational study was carried out at the IVF centre of a teaching hospital, Jaipur between January 2019 to December 2019. Total54 patients with PCOS as per Rotterdam criteria, who attended for treatment of fertility were enrolled in the study. Patients were given clomiphene citrate in incremental doses from 50 to 150 mg per day for five days. Clinical parameters (age, duration of infertility, waist circumference, body mass index(BMI), biochemical parameters (fasting blood sugar,fasting Serum insulin, serum total testosterone, serum luteinizing hormone(LH), serum follicle stimulating hormone(FSH), antimullerian hormone(AMH) and ultrasonographic parameters - antral follicle count(AFC), ovarian volume, uterine and stromal vessels pulsatility index between ovulating and non-ovulating patients were statistically analysed. Results: Total 40.74 % patients ovulated with increasing dose of clomiphene-citrate. A statistically significant difference was observed in waist circumference, serum testosterone, LH, AMH, AFC and Ovarian stromal artery PIbetween patients who ovulated and who did not. However, no significant difference was observed with regards to patient’s age, BMI, fasting glucose, serum FSH, serum Insulin, ovarian volume and uterine artery PI. Conclusion: Factors like WC, Serum total testosterone, serum LH level, AMH, AFC and ovarian stromal artery PI could be used as tools to predict response to clomiphene-citrate in the treatment of PCOS patients. This can help clinicians in deciding more effective and patient tailored approach.</p> Mamta Meena Anita Sharma Ajay Gupta Copyright (c) 2022 Mamta Meena, Anita Sharma, Ajay Gupta 2022-01-18 2022-01-18 5 3 704 708 A prospective study of histopathological spectrum of benign breast lesions in a tertiary hospital <p>Introduction: In India, the second most common malignancy after cervical carcinoma is carcinoma breast1 and is seen in 20/1,00,000 women[1]. Lesions of the breast are diverse including several entities with remarkably diverse characteristic feature extending from inflammatory non-neoplastic and benign lesions to life threatening invasive carcinomas. Materials and Methods: The present study was conducted in the department of Pathology, Tagore Medical College and Hospital, Chennai, India over a period of 1 year February 2020 to January 2021. Total 220 benign breast lesion were studied during the period. Core needle biopsy, excision biopsy, lumpectomy, modified radical mastectomy specimens were examined. Sections were processed, embedded for paraffin sectioning, stained with hematoxylin and eosin stain and detailed microscopic examination was done. The demographic characteristics of patients were presented in excel sheet and analyzed for the frequency of each lesion and their distribution in various age group. Results: This included 215 females and 05 males. Out of these 220 breast lesions, 40 were malignant cases and 180 were benign breast lesions. These 180 benign breast lesions including inflammatory lesions, benign proliferative lesions and benign tumors (Table1). Out of 220 cases, 215 were females and 05 were males. Conclusion: Benign breast lesions are common than malignant neoplasms. Fibro adenoma is the commonest benign breast lesion. Our study had given the information which was comparable with other studies. Histopathological study of breast lesions play very important role in diagnosis of lesion and hence in treatment and prognosis.</p> Karattupalayam Sampath Mouleeswaran B.S.Sangeetha Copyright (c) 2022 Karattupalayam Sampath Mouleeswaran, B.S.Sangeetha 2022-01-18 2022-01-18 5 3 709 710 Comparative study between Buprenorphine and Fentanyl transdermal patch to evaluate post-operative pain relief after cardiac surgery: A randomized control trial study <p>Introduction: Pain due to thoracotomy creates greatest demand for postoperative analgesia. Multimodal analgesia with various routes can be of great help to fulfill demands of analgesia in these patients. Opioids given by transdermal route offers newer modality of management with potential benefits of being noninvasive, sustained blood levels and bypasses first pass metabolism. We aimed to evaluate efficacy of Buprenorphine and Fentanyl Transdermal patch for post-operative pain relief after cardiac surgery. Methods: It was prospective, randomized, double-blind study in which 60 adult patients undergoing cardiac surgery were randomly segregated into two groups. Group A: 30 patients received Buprenorphine transdermal patch (10mcg/hr) and Group B: 30 patients received Fentanyl transdermal patch (50mcg/hr) 12- 24 hours prior to extubation. Analgesia was assessed using VAS score along with hemodynamic parameters and adverse effects. Results: Demographic parameters, baseline hemodynamics and perioperative hemodynamics were comparable. Baseline VAS score was comparable in two groups however statistically significant difference in two groups in VAS was observed thereafter till 72 hours. VAS score was higher in group A as compared to group B at the time of removal of ICD. 3 (10%) and 2 (6.7%) patients in Group A and Group B respectively required rescue analgesic which was not significant. Time for requirement of first rescue analgesic was significantly longer in Group B compared to Group A ie767.13 ± 73.59 minutes vs. 1224.37 ± 39.37 minutes. Adverse effects were comparable in two groups. Conclusion: Fentanyl and Buprenorphine TDDS are effective in postoperative analgesia in cardiac surgical patients. However Fentanyl TDDS has better analgesia.</p> Vijay Harischandra Patil Bhagyashree Inkane Dipakkumar Hiralal Ruparel Subin Thomas Copyright (c) 2022 Vijay Harischandra Patil, Bhagyashree Inkane, Dipakkumar Hiralal Ruparel, Subin Thomas 2022-01-18 2022-01-18 5 3 711 714 Comparison of two conservative methods in treatment of ureteric stones <p>Background: Urolithiasis is important major public health problem. This study was undertaken in order to compare the efficacy of tamsulosin in comparison with the oral fluids. Material and Methods: A comparative study was undertaken among 50 patients where the patients were equally divided in to two equal groups of 25 patients each. One group received oral fluids and other group received tamsulosin. The patients were observed strictly on weekly basis and asked for any history of passage of calculi and findings were recorded and patients were monitored and followed up for a period of one month. Results: Majority of the patients in Oral fluids and Tamsulosin group were males and aged between 41 – 50 years. Right ureter was affected in majority of the patients. Lower 1/3rd of the Ureter is affected among 36% of the oral fluid group and 40% of the Tamsulosin group. About 56% of the oral fluid group patients had stone size of less than 5 mm and 56% of the patients in Tamsulosin group had stone size of 6 – 10 mm. About 32% of the patients in oral fluid group passed the stone by 21 days of follow up and 48% of the patients in Tamsulosin group passed the stone by 14 days of follow up. Giddiness was noted in 16% and Headache was noted in 8% of the patients in Tamsulosin group. No side effects were noted in Oral fluids group. Conclusion: The tamsulosin group had expulsion of ureteric stones when compared to the oral fluid group.</p> Ravikoti Reddy Konatham Rajendra Prasad K Harshitha K Copyright (c) 2022 Ravikoti Reddy Konatham, Rajendra Prasad K, Harshitha K 2022-01-18 2022-01-18 5 3 715 717 Comparison of diagnostic modalities for diagnosis of hepatitis-C virus infection using Rapid Antigen Diagnostic Kit and ELISA <p>Introduction: Hepatitis-C virus (HCV) causes liver disease which can cause acute &amp; chronic hepatitis, Illness may range from asymptomatic cases to serious life long illness which may result in chronic hepatitis &amp; hepato-cellular carcinoma. HCV is blood borne virus transmission of which is mainly parental, infection also spread by sexual contact &amp; from vertical transmission from mother to baby. Material &amp; Method: Study was conducted for a period of six month. Sample send for routine anti HCV antibodies were subjected to ELISA &amp; rapid card test. Considering ELISA as gold standard, rapid card test was compared with it. Result: Out of 2295 blood samples tested on rapid card 56 samples were reactive while 2239 sample were non reactive. On further testing with ELISA 2 samples were false positive and 8 samples were detected false negative using ELISA as gold standard test. Sensitivity of rapid test was 85.7% while specificity of rapid test was found to be 99.91%. Positive predictive value (PPV) was 96% while negative predictive value (NPV) was 99.64% . P value was &lt;0.001 which is statistically significant and in favor of ELISA. Conclusion: Present study shows that rapid tests are inferior as compared to ELISA and hence they should not be recommended in screening of blood donor and for treatment initiation.</p> Jugal Kishor Agarwal Anu Sharma Dipty Agrawal Matloob Ahmad Zenab Naseem M. Yasmin Copyright (c) 2022 Jugal Kishor Agarwal, Anu Sharma, Dipty Agrawal, Matloob Ahmad, Zenab Naseem, M. Yasmin 2022-01-18 2022-01-18 5 3 718 720 Ferrous sulphate - Ascorbate induced DNA damage and protection by natural compounds <p>Objectives: The in vitro antioxidant and inhibition of Ferrous sulphate: Ascorbate induced fragmentation of DNA by crude proteins of Agathi seeds (Sesbania grandiflora Linn) evaluated using various relevant assays. Materials and methods: Assays like DPPH, Hydroxyl radicals, Ferric ion reducing, Ferrous ion chelation, Cytochrome C and Ferrous sulphate-Ascorbate complex induced DNA damage prevention studies were done to evaluate the antioxidant capacity of Agathi seed protein. Results: Agathi seeds (Sesbania grandiflora Linn) protein showed more antioxidant and free radical scavenging activity. It scavenged approximately 71% of hydroxyl and 1,1-diphenyl-2-picrylhydrazayl radicals 61%. In addition, it reduced cytochrome c and ferric ion levels, chelated ferrous ions and inhibited Ferrous sulfate:Ascorbate-induced fragmentation and sugar oxidation of DNA. Conclusion: These results establish the antioxidant potential of crude proteins of (Sesbania grandiflora Linn).</p> Omkar NG Bhagyalakshmi V Dinesha Ramadas Vedamurthy Joshi Copyright (c) 2022 Omkar NG, Bhagyalakshmi V, Dinesha Ramadas, Vedamurthy Joshi 2022-01-18 2022-01-18 5 3 721 725 Comparison of Ultrasound Guided Femoral Nerve Block And Parenteral Tramadol In Acute Trauma Patients With Fracture Femur: An Observational Study <p>Aim: The aim of present study is to compare the analgesic effects of USG guided femoral nerve block (FNB) with parenteral tramadol in patients with fractured femur shaft. Methodology: This prospective randomized observational study was carried out in the Department of Anaesthesiology and Critical care, Dr. S.N. Medical College, Jodhpur and associated group of hospitals after getting approval from ethical committee. In our study total 60 patients were enrolled and divided randomly into two groups. One group received Femoral Nerve Block (Group R- 0.5% ropivacaine) and other group received intravenous tramadol ( group T). A written and informed consent was taken from the patient after explaining the procedure to the patient. Patients were observed for onset and duration of analgesia, hemodynamic and respiratory parameters changes, side effects or complications of study drugs and block. Results: it was observed that FNB with ropivacaine provides earlier and prolonged duration of analgesia as compared to intravenous tramadol. The reduction in rescue analgesia might be due to prolonged and better analgesia provided by ropivacaine in R group. None of our patients in both the study groups experienced haemodynamic unstability. Conclusion: The USG guided Femoral nerve block with 0.5% ropivacaine is safe, simple and effective method for relieving intense pain due to femur shaft fracture. No systemic side effects were observed and haemodynamic stability was also well maintained in patients with moderate general condition.</p> Vikas Rajpurohit Manish Jha Shailesh Sharma Manish Singh Chauhan Copyright (c) 2022 Vikas Rajpurohit, Manish Jha, Shailesh Sharma, Manish Singh Chauhan 2022-01-18 2022-01-18 5 3 726 730 Drug emergent metabolic syndrome among patients taking olanzapine: A prospective interventional study <p>Introduction: Olanzapine is one of the most commonly used atypical antipsychotic and is associated with significant deterioration of the metabolic profile among the patients taking it. Aim: To assess the emergence of drug induced metabolic syndrome among patients taking olanzapine. Materials and method: Eighty cases with diagnosis of Schizophrenia, schizoaffective disorders, bipolar affective disorder, persistent delusional disorder, unspecified nonorganic psychosis and no history of treatment with atypical antipsychotics in last 6 months were recruited from outpatient/ inpatient department of Institute of Mental Health, Amritsar, by purposive sampling after baseline screening and applying inclusion and exclusion criteria. It was a Prospective Interventional study. Patients were assessed for their metabolic profile at baseline, 2- and 4- months. Result: Statistically significant difference was found in all the metabolic parameters, including body weight, blood pressure, BMI, fasting blood glucose, fasting triglycerides and fasting HDL, after 4 months of initiating olanzapine as compared to baseline. One-fifth of the patients had attained the criteria of metabolic syndrome at the end of four months, and this ratio showed minimal variation with gender. Conclusion: Metabolic impairments have become a persisting menace with currently preferred patterns of lifestyles and drug management. Psychiatrists must be vigilant enough towards the potential metabolic side effects of antipsychotic medications so that appropriate precautions can be implemented in a timely manner. The general treatment provided to patients with severe mental illness should be at par with care provided to other patients.</p> Ashish Kumar Malik Vivek Srivastava Savinder Singh Deepika Dalal Priyanka Tetarwal Copyright (c) 2022 Ashish Kumar Malik, Vivek Srivastava, Savinder Singh, Deepika Dalal, Priyanka Tetarwal 2022-01-18 2022-01-18 5 3 731 735 Burden of care among caregivers of patients with schizophrenia and bipolar disorder <p>Introduction: Caregivers of patients with severe psychiatric illnesses suffer significant impairment in their socio-occupational, interpersonal as well as emotional functioning, amounting to enormous burden. Aim: To compare the burden of care among the caregivers of patients with schizophrenia and bipolar affective disorder. Methodology: It was a cross-sectional study, conducted at a tertiary care hospital, and involved 30 caregivers each of patients with schizophrenia and bipolar disorder. Burden Assessment Schedule (BAS) was used for assessing the burden experienced by the caregivers, along with a specially designed proforma was used to gather socio-demographic information about the patients and their caregivers. Result: Most subjects were males, were spouses in case of bipolar affective disorder patient (43.30%) and parents (46.70%) among schizophrenia patients. In terms of socio-demographic profile, no significant difference was found between the groups. 17 (12 of schizophrenia and 5 of bipolar group) of the total 60 subjects were found to experience severe burden of care. Total burden score was 64.4 ± 13.88 for the subjects of bipolar disorder group and 75.03 ± 13.7 among the subjects of schizophrenia group and, the difference was statistically significant. Conclusion: Severe burden of care worsens the quality of life and poses substantial subsyndromal psychiatric morbidity among the caregivers of patients with chronic psychiatric morbidities. Support programme should be planned to help the caregivers, acknowledging the uniqueness of each caregiving situation, monitoring the individual care process and taking into consideration the phase in the caregiving process.</p> Vivek Srivastava Ashish Kumar Malik Priyanka Tetarwal Rajiv Gupta Deepika Dalal Piyush Verma Copyright (c) 2022 Vivek Srivastava, Ashish Kumar Malik, Priyanka Tetarwal, Rajiv Gupta, Deepika Dalal, Piyush Verma 2022-01-18 2022-01-18 5 3 736 740 An observational analytical clinical research study and asystematic review on the clinical pharmacology ofrectal organoids in cystic fibrosis <p>Introduction: Rectal organoid cultures, derived from the rectal epithelia, are three-dimensional (3D) primary stem cell cultures that self-organize into tissue-recapitulating “mini-guts” in vitro that enable the long-term expansion and biobanking of primary patient tissue using defined growth conditions. This clinical research and systematic review was conducted for systematically investigatingthe clinical pharmacological aspectsof the rectalorganoids in cystic fibrosis, with thorough explanations and analyses of the medical study literature and evidences compiled from the various studies conducted, whichexplained the clinical pharmacology of rectal organoids. Objectives: The objective of this study was an observational analytical clinical research and a systematic review on the clinical pharmacology of rectal organoids in cystic fibrosis. Methods: The study was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) Statement and Guidelines, 2009, described by the Cochrane Collaboration in June, 2016. At first, the steps of identification included the records which were identified through database searching and the additional records which were identified through other sources. This led to the steps of screening, which included the screened records after the duplicates were removed. From these screened records, few records were excluded, as per the exclusion criteria. Then, in the eligibility step, the full text articles were assessed for eligibility, from which few full text articles were excluded, according to the exclusion criteria, with adequate reasons. This led to the final inclusion step, where the studies were included in the qualitative synthesis of a systematic review, according to the inclusion criteria, and ultimately the studies were included in the quantitative synthesis.An observational analytical clinical pharmacological research study was also conducted. Results: This clinical research and systematic review, contributed 5898 refined and relevant medical records, among total 8371 records obtained from the study databases search. It also described theclinical pharmacology of rectal organoids in cystic fibrosis,which elaboratedthis systematic review and observational analytical clinical research study. Conclusions: To conclude, this clinical research and systematic review provided the refined qualitatively synthesised medical records, study literature and databases, as well as a descriptive analysis on the clinical pharmacology of rectal organoids in cystic fibrosis.</p> Moumita Hazra Copyright (c) 2022 Moumita Hazra 2022-01-18 2022-01-18 5 3 741 743 Acute Temporomandibular Joint Dislocations: Surgical Management <p>Background: Jawbone and your skull are connected by a sliding hinge called the temporomandibular joint. On either side of your jaw, there is a joint. Temporomandibular disorder (TMD), which includes TMJ condition, can hurt your jaw joint and the muscles that move your jaw. Materials and Methods: This retrospective study involved a single hospital, a single surgeon, 19 patients, and 23 joint operations carried out over a ten-year period. The study group consisted of patients who met the inclusion and exclusion criteria and had previously undergone surgical correction using hook-shaped miniplates and miniscrews set with or without bone grafts. Results: With ages ranging from 32 to 58, there were a total of 12 females (mean age: 41.9 ±12.07 years) and 9 males (mean age: 39.8 ±13.6 years). Prior to surgery, each patient experienced the dislocation for an average of 19.26± 12.6 months. Prior to surgery, the mean maximal mouth opening (without pain) was 17.78 ±2.13 mm (12–25 mm), but it was 32.28± 3.17 mm (27–37 mm) after surgery. Throughout the 8 to 37 month follow-up period, there were no early or late surgical problems. Conclusion: The outcomes in this community of Indians are very comparable to those reported from other regions of the world.</p> Saloni Bharti Copyright (c) 2022 Saloni Bharti 2022-01-18 2022-01-18 5 3 744 745 A Prospective Study to evaluate the Hemodynamic Changes and Adverse reactions associated with Propofol and Etomidate during General Anesthesia <p>Background: Among general anesthesia induction drugs, etomidate is the only imidazole, and it has the most favorable therapeutic index for single bolus administration. Propofol has been shown in clinical studies to be a safe, effective, hypnotic, and amnesic anesthetic agent at induction doses of 2-2.5 mg/kg and maintenance doses of approximately 9mg/kg per hour. Aim: To assess hemodynamic changes and complications occurring with Propofol and Etomidate during general anesthesia. Methods: A total of 100 subjects were enrolled in the present study and were broadly and randomly divided two study groups with 50 subjects in each group: Group A: Subjects who received 1% Propofol injection, and Group B: Subjects who received 0.3mg/kg of etomidate injection. Monitoring of the blood pressure, mean arterial pressure and heart rate was done throughout the surgery and until 10 minutes after induction. Recording of the pain during injection was done on a scale of 0 to 10 with 0 referring to no pain while 10 referring to maximum pain. Results: No significant difference was observed while comparing the mean arterial pressure and heart rate among subjects of both the study groups at different time intervals except for at the time of induction. Mean pain score was found to be significantly higher in group A in comparison to group B. Conclusion: Among patients with associated altered hemodynamic status, etomidate is an improved option. However; further studies are recommended.</p> Himanshu Shekhar Ranveer Vijayendra Prasad Copyright (c) 2022 Anuj Ram Sharma, Aruna Arya, Rakesh Kumar Agarwal, Vinay Sharma, Vishnu Gupta 2022-01-18 2022-01-18 5 3 746 748 A Study on Serum Ferritin and Hypothyroidism among Patients Attending A Tertiary Care Hospital With Special Emphasis On Effect Of Thyroid Hormone Replacement Therapy <p>Introduction: Thyroid gland is a bi-lobed endocrine gland and it secretes thyroxin (T4) and tri-iodothyronine (T3) hormones and it is under the regulation of thyroid stimulating hormone (TSH). Iron is one of the important elements required for normal functioning of thyroid gland and it is stored in the body in the form of ferritin and it is an intracellular protein. Present study is an attempt to find out correlation, if any between serum ferritin and hypothyroidism and also changes of serum ferritin level after correction of the disorders with levothyroxine therapy. Materials and Methods: A cross-sectional study was conducted by Department of Biochemistry, Darbhanga Medical College, Laheriasri, Bihar. Study was conducted from December 2021 to May 2022. Written informed consent was obtained from each participant before inclusion in the study. Prior ethical approval was obtained from the Institutional Ethics Committee. The study population comprised of 100 hypothyroid and 100 euthyroid subjects of age &gt;18 years. Blood sample was collected from the study participants who visited the laboratory for their thyroid hormone. From the selected subjects, under aseptic precautions, 3ml of venous blood sample was drawn into a non-vacuum plain tube with clot activator. These tubes were allowed to stand for specific period of about 15-20 minutes. Then tubes were centrifuged for 3500rpm for 15- 20 min. The collected data was entered in Microsoft excel and the data analyzed by using Statistical Package for Social Sciences ver. 20.0 (IBM, Chicago). Results: The mean values of TSH were higher among hypothyroid subjects as compared to euthyroid subjects. Whereas T4, T3 and ferritin were found be lower among hypothyroid subjects as compared to euthyroid subjects. TSH, T4, T3 and ferritin showed statistically significant difference between euthyroid and hypothyroid subjects with a p value of &lt;0.05. There was a negative correlation between TSH and serum ferritin among study subjects (r= 0.07) implying that as serum TSH levels were increasing serum ferritin levels kept on decreasing. Conclusion: In our study we found that there is a significant difference in serum ferritin levels between hypothyroid and euthyroid subjects. Hence measurement of serum ferritin before and after thyroid hormone therapy may provide useful information with regard to diagnosis and prognosis of thyroid disease.</p> Md. Haroon Rashid Naresh Kumar Suman Sude Kumar Singh Copyright (c) 2022 Md. Haroon Rashid, Naresh Kumar Suman, Sude Kumar Singh 2022-01-18 2022-01-18 5 3 749 751 Bile duct injury during laparoscopic cholecystectomy: Experience from a tertiary care hospital of Bihar, India <p>Introduction: Bile duct stone is a common disease. In the case of United States, around 30 million people are affected by bile duct stone disease annually, and around 750,000 cholecystectomies are performed per year. The aim of the study is to know the risks, incidence, types, causes of BDIs, their timing and clinical presentations, various imaging modalities, and management by various methods. Materials and Methods: An observational study was carried out on 100 patients at Department of General Surgery, Darbhanga Medical College and Hospital, Laheriasri, Bihar, India. All patients who underwent laparoscopic cholecystectomy with BDIs were observed and followed up. The study was conducted over a period of one year From July 2020 to June 2021 included all cases of BDI during this duration. Prior approval was obtained from the Institutional Ethics Committee. Informed written consent was obtained from each patient before participation in the study. Results: A total of 100 patients were observed in the study period. The mean age of these patients was 43.8 ± 18.2 years with a female preponderance. The conversion of laparoscopy to open surgery was done among 12 cases. In 9 cases, this was done because of BDI, and, in 3cases, it was done because of short cystic duct with adhesions, inflammation, and difficulty in laparoscopy. BDI was observed in 5 patients and BL occurred in another 4 cases. Of 5 cases of BDI, 4 cases were detected intraoperative and 1 case was detected postoperatively. The cases detected at the time of surgery were managed surgically by end-to-end anastomosis over a T-tube and Roux-en-Y hepaticojejunostomy. Conclusion: The surgeon doing laparoscopic cholecystectomy should be aware about management of such injuries, and long-term follow-up should be done for such patients.</p> Shiva Nand Surendra Kumar Pramod Kumar Sah V S Prasad Copyright (c) 2022 Shiva Nand, Surendra Kumar, Pramod Kumar Sah, V S Prasad 2022-01-18 2022-01-18 5 3 752 754 An observational study on serum electrolytes among patients with acute exacerbations of chronic bronchial asthma at a tertiary care hospital of Bihar <p>Introduction: Abnormal electrolyte levels in patients with bronchial asthma can be attributed to either low dietary intake or to adverse effects of asthma medications. Hypokalemia has been reported as an electrolyte disturbance in acute asthma. This study was aimed at assessing the levels of serum electrolytes in patients with acute exacerbation of bronchial asthma and comparing them against non-asthmatic controls. Materials and Methods: This observational study was conducted on Department of Biochemistry of, Darbhanga Medical College &amp; Hospital, Laheriasri, Bihar, India from June 2021 to May 2022. The study population comprised of samples obtained in the department from patients who presented with complaints of acute exacerbation of bronchial asthma in the Emergency Department of the hospital. During the study period, samples from a total of 100 asthmatic patients were included. For comparison, I obtained samples from the Emergency department from 100 age and gender matched controls that were not asthmatics. The study was approved by the institutional ethics committee. The data collected were analyzed by SPSS version 20. Results: A total of 200 patients were included in the study, 100 in each group, cases and controls. Both the groups were age and gender matched. The mean (SD) age of cases was 38.9 (14.7) years for cases and 40.4 (12.9) years. There was male preponderance noted in both the groups. T test for age and gender showed a p value of &gt;0.05, that means the groups were comparable. Except for mean serum chloride, all the electrolytes had mean value lower among cases as compared to controls. Among cases, the mean serum sodium, calcium and magnesium were significantly lower than that of control population. Conclusion: The present study showed that there was a significant decrease of sodium, magnesium and calcium levels during exacerbations in asthmatics.</p> Naresh Kumar Suman Md. Haroon Rashid Sude Kumar Singh Copyright (c) 2022 Naresh Kumar Suman, Md. Haroon Rashid, Sude Kumar Singh 2022-01-18 2022-01-18 5 3 755 757 Study of Anxiety, Depression and quality of Life in Patients with Chronic Obstructive Pulmonary Disease <p>Introduction: Neuropsychiatric symptoms associated with chronic lung disease include increased psychological distress as well as impairments in neuropsychological functioning. The most common psychiatric disorders in such patients are anxiety and depression. In addi tion, psychological distress in individuals with COPD is associated with restricted activities of daily living and impaired quality of life. Objectives: To assess the prevalence of anxiety, depressions, Health related QOL and also correlate them with sociodemographic variables in COPD patients. Material and Methods: An observational, analytical, cross-sectional, clinical study was adopted to assess the anxiety, depression and quality of life among patients with COPD. The sample size was 150 patients diagnosed with COPD from a tertiary care teaching hospital. Results: Results were categorised in to observational as well as analytical data. Depression (51%) or Anxiety (55%) are commonly prevalent in COPD patients. There is significant association between severity of COPD, and total score of HRQoL in those suffering from anxiety. Conclusion: The current study concludes that there is an increased prevalence of anxiety and depression in patients with Chronic Obstructive Pulmonary Disease. It is observed that there is a deterioration of health- related quality of life as the chronicity of the disease increases.</p> Manasa Marthi G.V.Ramana Rao R. Rama Krishnam Raju Purna Prasanth Dayala Copyright (c) 2022 Manasa Marthi, G.V.Ramana Rao, R. Rama Krishnam Raju, Purna Prasanth Dayala 2022-01-18 2022-01-18 5 3 758 762 Study of Serum total protein, albumin and globulin Level in Children with Malarial Infection in Civil Hospital, Ahmedabad <p>Introduction: Malaria is a major protozoal disease in many developing countries that is main cause of for 20-30 lakhs deaths per year. This study will give us a proper view for monitoring and management of these patients. Material and Method: Fifty children with Malaria are included in the study as cases and equal number of age and sex matched healthy children formed the control group. Study is conducted during the period of August 2014 to October 2016. Result: there is significant difference in serum Total protein levels in cases and controls (p value is 0.0393). And in serum albumin levels in cases and controls (p value is less than 0.0001) and in serum globulin levels in cases and controls (p value is 0.0114). Conclusion: Children having malaria has low serum total protein, albumin and globulin as compare to healthy individuals. Impairment of hepatic function associated with severe malaria may be responsible for the hypoproteinemia and hypoalbuminemia reported in this study. Moreover, plasma albumin is a negative acute phase protein, the level of which falls as a result of malaria infection probably due to an increase in its trans-capillary escape rate</p> Krushna Kishore Padala Vikas K Vaghela Copyright (c) 2022 Krushna Kishore Padala, Vikas K Vaghela 2022-01-18 2022-01-18 5 3 763 765 Comparison between blind nasal and fiber optic intubation in maxillofacial trauma posted for elective surgery <p>Background: Airway management of patients with maxillofacial trauma is complex and crucial because it can dictate a patient's survival. Securing the airway of patients with maxillofacial trauma is often extremely difficult because the trauma involves the patient's airway and their breathing is compromised. In these patients, mask ventilation and endotracheal intubation are anticipated to be difficult. Aim: To compare the safety and complications of blind nasal and fiber optic intubation in maxillofacial trauma. Materials and methods: This is an observational study, approved by the institutional ethical committee. An individual informed consent was taken from all the patients selected for the study. All the patients belonging to ASA grade 1 and 2, between the age group of 18 to 50 years of either sex. Posted for maxillofacial surgery under general anesthesia patients with comorbidities like copd, cardiovascular problems, patient refusal are excluded from the study. Total 40 patients with different types of facial fractures are included in the study they were divided into blind nasal group (20 patients) and fiberoptic group (20 patients). Discussion: The patient with maxillofacial trauma presents serious challenges for the physician because airway management in these patients can be complicated by their injury. The first challenge is to secure the airway for sufficient and effective breathing and/or ventilation. Fiberopticbronchoscopic intubation is best option for elective patients but has been considered difficult in maxillofacial trauma, patients with intraoral bleed. In both group of patients, securing the airway before induction of general anesthesia adds to the safety of anesthesia and helps minimize possibility of major complications. Conclusion: Awake fiberoptic intubation, is the best method for securing airway in patients with facial trauma when compared with blind nasal intubation.</p> S. Jyotsna R. Rajeshwar Reddy Prattipati Swathi Prattipati Swathi Copyright (c) 2022 S. Jyotsna, R. Rajeshwar Reddy, Prattipati Swathi, Prattipati Swathi 2022-01-18 2022-01-18 5 3 766 768 Diabetic neuropathies-clinical and electrophysiological profile <p>Introduction: Diabetic neuropathy is a very common but disabling microvascular complication of diabetes. It can involve the peripheral as well as the autonomic nerve functions. This study was undertaken to understand the different types of peripheral and autonomic neuropathies in diabetic patients with respect to the duration of diabetes and electrophysiological findings. Method: 100 patients who were proven diabetics were included in the study irrespective of the duration of diabetes. Neuropathy was assessed using clinical symptoms, signs and with the help of electrophysiological studies. Results: Sensory loss (80.3%) was the most common symptom noted in these patients, followed by paresthesias and giddiness. Decreased timed vibration (81.5%) was the most common sign elicited. Neuropathy had the highest prevalence in males in their sixties. Neuropathy was more common in those with diabetes for more than 5 years duration. Conclusion: Distal symmetrical sensory polyneuropathy was the commonest type of neuropathy in diabetes mellitus found in our study. Autonomic dysfunction in the form of postural giddiness was also found in a high proportion of patients. Higher HbA1c level and duration of diabetes significantly increased the risk of neuropathy.</p> M. Jaya Kumar S. Ponnu Copyright (c) 2022 M. Jaya Kumar, S. Ponnu 2022-01-18 2022-01-18 5 3 769 772 Comparative Study between Dexamethasone and Tramadol As an Adjuvant to Ropivacaine Vs Ropivacaine Alone In USG Guided Supraclavicular Block in Upper Limb Surgeries <p>Background: Brachial plexus block provides superior quality of intraoperative and postoperative analgesia and stable hemodynamics over general anesthesia. Various adjuvants have been used to prolong effects of local anesthetics like epinephrine, midazolam, magnesium sulfate, alpha-2 agonists i.e. Clonidine and dexmedetomidine, dexamethasone and tramadol. Aims &amp; Objective: To compare the efficacy of tramadol and dexamethasone on the characteristics of the block and its effect on postoperative analgesia when added as an adjuvant to ropivacaine in USGguided supraclavicular brachial plexus block. Materials &amp; Methods: Eighty patients belonging to American Society of Anaesthesiologists (ASA) Grade I, II and III, aged between 20 to 55 years, scheduled for undergo elective upper limb surgeries under supraclavicular brachial plexus block were enrolled in this study. Patients were equally divided into two groups : group S received 0.5% ropivacaine 30ml with Dexamethasone 2ml (8mg) and tramadol 2ml (100 mg) And group C received 0.5% ropivacaine 30ml with + normal saline 4ml. Onset and duration of sensory and motor block , duration of postoperative analgesia and any complications were observed. Results: In our study both groups were comparable with respect to their demographic profile of patients, duration of surgery and ASA status. Onset of sensory block was earlier in group S than group C (3.15 ± 0.69 minutes and 7.55± 0.89 minutes respectively, p =0.004). Onset and duration of motor block and postoperat ive analgesia were longer in group S as compared to group C (5.01± 1.33 &amp; 12.32± 0.75 minutes respectively, P= 0.001 and 14.44± 0.635 and 8.24± 0.873<br>hours respectively, p =0.001 for motor block and 16.53± 0.635 and 10.45 ± 0.681 minutes respectively, p= 0.001for postoperative analgesia). No ignificant side effects were noted. Conclusion: Dexamethasone and tramadol when added to ropivacaine in supraclavicular brachial plexus lock prolongs onset and duration of sensory and motor block and postoperative analgesia significantly with minimal side effects.</p> Usma Jabeen Suhail Banday Saba Wani Copyright (c) 2022 Usma Jabeen, Suhail Banday, Saba Wani 2022-01-18 2022-01-18 5 3 773 777 Role of mean platelet volume in a patient with ischemic stroke: A cross sectional study <p>Background: Hypertension and diabetes mellitus, both of which increase the risk of vascular disease, are associated with an increase in platelet size.The larger platelets have more dense granules, have more powerful activity and hence more prone to thrombosis than smaller platelets.A newly emerging risk factor for atherosclerosis is MPV, a predictor of platelet function. It is an index of platelet size &amp; correlates positively with platelet activation. There is paucity of studies in our setting hence we have undertaken this research to see if there was any association in an Indian population. Methods: Present study was cross sectional in nature conducted among 134ischemic stroke patients. All patients fulfilling inclusion criteria and exclusion criteria were taken up for the study. Study was carried out over a period of 1.5 years. Results: Majority of the patients was in the age group of 40-60 years and most of them were male. Association of mean platelet volume &amp; risk factor has shown that diabetes mellitus was significantly associated with reduced platelet volume while alcohol addiction &amp; hyperlipidemia were associated with increased platelet volume (p&lt;0.05). Other risk factors i.e. CHD was associated with reduced mean platelet volume while smoking &amp; HTN were associated with increased platelet volume but the association was not significant (p&gt;0.05). Conclusion: There was association between increased MPV &amp; the risk of ischemic stroke.</p> Sanjay Bhasme Kapil Rathi Neel Chhajed Miren Patel Copyright (c) 2022 Sanjay Bhasme, Kapil Rathi, Neel Chhajed, Miren Patel 2022-01-18 2022-01-18 5 3 778 780 Economic Burden of Childhood Asthma In A Tertiary Care Setting Of North India <p>Background: Asthma is one of the most common chronic respiratory diseases with an increasing prevalence worldwide. It has huge economic and social impact. Newer medications and other therapies allow many patients to control their symptoms, but the cost of treatment can be high. In addition, the treatment of acute exacerbation and comorbidities of asthma consume considerable medical resources. Methodology: For assessing economic impact of asthma on children and their families we studied 216 children over a period of 1 year at department of pediatrics of Patna Medical College and Hospital. Both direct and indirect cost of asthma was assessed. Direct costs include inpatient care, emergency visits, OPD visits, drugs and devices and diagnostic tests. Indirect costs include school days lost, traveling cost, and productivity loss for the caretaker of asthmatic children. Results: Out of total 216 children, 65 % were male and 35% were female. Mean loss of school days because of asthma related events were 3.6 days in preceding 6 months. About 6% children required hospitalization in the preceding 6 months and 54% children had some restriction on their play activities because of asthma. The mean monthly expenditure on the therapy was Rupees 410. Conclusion: As a leading chronic childhood illness, asthma has a large socioeconomic burden on affected children and their families.</p> Suprabhat Ranjan Sheela Sinha Copyright (c) 2022 Suprabhat Ranjan, Sheela Sinha 2022-01-18 2022-01-18 5 3 781 782 Unusual Congenital Deformities detected in Perinatal Autopsy- A Series of 5 Cases <p>Autopsy literally means to see for one self - is the dissection and examination of a dead body to determine the cause of death and establish<br>evolution of a disease. There are 3 main types of autopsies-(1) Medico-Legal/Forensic/coroner's autopsy, (2) Clinical /pathological autopsy, (3)<br>Anatomical or academic autopsy. In this study we performed pathological autopsy of perinatal death cases and presenting a series of 5 cases with<br>rare (unusual) congenital deformities along with review of literature.</p> Rajashree Pradhan Sajeeb Mondal Arindam Bandapadhyay Subrata Pal Copyright (c) 2022 Rajashree Pradhan, Sajeeb Mondal, Arindam Bandapadhyay, Subrata Pal 2022-01-18 2022-01-18 5 3 783 786 Ultrasound measurement of subglottic diameter for determination of microcuff endotracheal tube size and intubation outcome in paediatric cases: An observational study <p>Introduction: One of the biggest achievements of medical science is safe anaesthesia especially for children. Management of airway takes priority over any other intraoperative intervention during anaesthesia .Determination of “best -fit” endotracheal tube (ETT) is important in children to provide optimum ventilation without causing any laryngotracheal morbidity[1-4]. Aim: To investigate the 1st attempt success rate of intubation using best fit Micro cuff ETT ( MCETT) size, determined by ultrasound measured subglottic diameter in paediatric population and to compare the result with age based size table of micro cuff endotracheal tube. Materials and methods: 66 paediatric patients aged between 1‑10 year, undergoing various elective surgeries under general anaesthesia were included in the study .The subglottic airway transverse diameter was measured in the brightness (B) mode using the linear probe (range 6-13 MHz) of the USG device with the child in the supine and neutral head position. Best-fit tube ID is considered as the one with satisfactory air leak at an airway pressure of 15-20cm H2O. 1st attempt success rate of intubation using best fit MCETT size, determined by ultrasound measured subglottic diameter in paediatric population were compared with the result with age based size table of micro cuff endotracheal tube. Results and Conclusion: Comparisons of means of sizes of correct MCETT with age based table and with USG guided method revealed that both methods are good predictors for the correct MCETT size estimation (p-value&lt;0.05). However, size of correct MCETT matched with MCETT size calculated using USG method was in 56 patients (84.8%), whereas the MCETT by age-based table selected the correct tracheal tube size in 42 (63.6%) patients with the difference being statistically significant (p=0.026). Furthermore, reliability agreement calculated by Intraclass correlation coefficient suggested that USG based methods are better than age based formulas in children with k- values of 0.939 and 0.887 respectively. Conclusion: We conclude that ultrasound appears to be a reliable predictor for the assessment of the subglottic diameter of the airway in children to estimate the appropriate size of microcuff endotracheal tube.</p> Jitendra Mewara Neelam Dogra Jyoti Choudhary Anupama Gupta Narayan V. Kamath Copyright (c) 2022 Jitendra Mewara, Neelam Dogra, Jyoti Choudhary, Anupama Gupta, Narayan V. Kamath 2022-01-18 2022-01-18 5 3 787 790 Primary Etiological Profile Of Hospitalized Patients With Documented Episode Of Hypoglycemia <p>Background: Glucose is a major fuel source for body tissues. Plasma glucose concentrations are maintained between 70 to 110 mg/dl in the fasting state. Homeostasis is maintained by stimulating counter hormone response and suppressing insulin secretion during hypoglycemic episodes. Any derangement in homeostasis can cause hypoglycemia. Objectives: To investigate, identify, determine and analyze the incidence of primary etiological profile of hospitalized patients. Material and methods: Patients admitted in the General Medicine wards who had at least one episode of documented hypoglycemia i.e less than 70mg/dl and age &gt;=18 years were included and observed over a period of 24 months i.e November 2019 to November 2021.The data obtained was analyzed statistically by using chi square test. Results: In present study of 119 patients 90 were male and 29 were females. Diabetes with Chronic Kidney Disease was found to be the most common primary diagnosis.As we analyze the presence of risk factors in hospitalized hypoglycemic patents, it was found that as the number of risk factors in a patient increases, chance of succumbing to them also increases. In the category of patients having 3 or more risk factors, the death rate was 15 out of 42 which is 35.71%. Conclusions: Hypoglycemia needs to be investigated thoroughly to know the causative factor and should be treated appropriately. Hypoglycemia is an important predicting factor of mortality in cases of heart failure and sepsis.</p> B.S.V.V.Ratnagiri Praveen Kasina Lella Padmaja M.Jagan Mohan S.Meghana G.Teja Krishna Copyright (c) 2022 B.S.V.V.Ratnagiri, Praveen Kasina, Lella Padmaja, M.Jagan Mohan, S.Meghana, G.Teja Krishna 2022-01-18 2022-01-18 5 3 791 795 Occupational Risk Evaluation of Vibration exposed Road Construction Workers of Kolkata: An Ergo-Physiological Analysis <p>Whole-body vibration is described as the influence of mechanical vibration of the environment on the entire human body. The harmfulness of vibration depends on its intensity, time of exposure, and frequency content. Vibration restricts the blood supply to the hands and fingers, which, depending on the vibration level, can contribute to an ergonomic injury. Long time exposure to vibration develops occupational injuries in the whole body of road construction workers. Therefore, this study aims to evaluate and identify the physiological morbidity of the road contractors of Kolkata, to quantify the body part damages of road contractors due to vibration, and to recommend some suitable preventive measures for avoiding occupational damage. This double-blind study followed STROBE guideline. Here, 56 male road construction workers who were exposed to vibration &amp; 42 other forms of road construction workers of Kolkata were randomly chosen, with age range 30-48years. Their muscle&amp; finger strength, the prevalence of Raynaud’s phenomenon, occupational vibration-induced ocular bone injury, and musculoskeletal disorders were evaluated statistically. The results of this study indicate that the experimental group was suffering from poor muscle and finger strength, low back injury, early onset of the white finger, and dry eye disease. FFA, Nailfold capillaroscopy, and DEXA Scan suggestthe onset of retinal vascular capillary damages, and porosity of bone. ANA results indicatethe presence of higher titer and greater amount of autoantibody amongst the experimental group. However, road construction workers should use anti-vibration shock- proof protection gear and should follow a work-rest cycle of about 10 minutes, when they are exposed to vibration tools.</p> Sugata Das Subhashree Sana Anandi Bagchi Subrata Ghosh Copyright (c) 2022 Sugata Das, Subhashree Sana, Anandi Bagchi, Subrata Ghosh 2022-01-18 2022-01-18 5 3 796 801 Factors affecting outcome among patients with abdominal trauma: Report from a tertiary care centre of Bihar <p>Introduction: India is the leading country in the number of deaths due to Road Traffic Accidents. Abdomen is the third most common injured<br>region requiring surgery. To combat this problem, it is know contributing risk factors, so that public awareness problems on ways to prevent<br>incidence of such fatality may be implemented with fruitful outcome. With this background, a study was planned to focus on factors influencing<br>outcome among such patients. The study results will help in early identification of negative determinants and reduce the mortality.Methodology:<br>An epidemiological study was conducted by Department of General Surgery of Mata Gujri Memorial Medical College &amp; Lions Seva Kendra<br>Hospital, Kishanganj, Bihar. The study included all the patients who were admitted in the surgical wards of the hospital with abdominal trauma<br>during the time period of 1 year.Prior ethical clearance was obtained from Institutional Ethical Committee.Results: A total of 142 patients were<br>included in the current study. The mean age of the patients was 37.3 years with a SD of 11.4 years. There was a male preponderance. Majority<br>(71.1%) were blunt trauma with RTA being the most common cause of trauma. The spleen (22.5%) followed by liver (11.9%) was the most<br>commonly affected solid organ, and the most commonly affected hallow viscous was the small intestine (32.3%), ileum in blunt injury and<br>jejunum in penetrating injury. Post-operative complications were noted among 69 patients that constitutes to 48.6% of the total study population.<br>16 out of 142 patients died. Mortality was significantly higher among patients who were brought to the hospital after 12 hrs and those who had<br>severe NISS score while admission.Conclusion: Abdominal trauma is a not uncommon in casualty in multiple trauma patients. As most common<br>cause of this trauma is RTA, it is the need of the hour to strengthen traffic rules to minimize such injuries.</p> Md. Sarfaraz Nawaz Aditya Anand Kumar Shubham Copyright (c) 2022 Md. Sarfaraz Nawaz, Aditya Anand, Kumar Shubham 2022-01-18 2022-01-18 5 3 802 806 A comparative study of vaginal and abdominal hystrectomy for enlarged uterus <p>Objective: To compare outcome in patients who underwent vaginal and abdominal hysterectomy for benign enlarged uterus. Methods: In a prospective randomized study, 50 vaginal hysterectomies were compared with 50 abdominal hysterectomies performed from April 2020 to September 2021. Patients characteristics before, during and after operations were reviewed and followed up for 3 months to evaluate post op complications. Results: There was no difference in patients age, parity, uterine size and intraoperative complications between two groups. Operative time, blood loss, post op demand for analgesia and duration of hospital stay was lower in vaginal hysterectomy group as compared to the abdominal hysterectomy group. The overall complication occurred with TAH was significantly more than vaginal hysterectomy. Conclusion: Vaginal hysterectomy is safe as compared to abdominal hysterectomy in the treatment of benign gynecological disease with greater efficacy and safety even for enlarged and non prolapsed uterus.</p> Pratibha Prakash Tabassum Ahmed Copyright (c) 2022 Pratibha Prakash, Tabassum Ahmed 2022-01-18 2022-01-18 5 3 807 808 Thyroid Profile of Women Presenting With Abnormal Uterine Bleeding (AUB): A Cross Sectional Study Done At a Tertiary Care Hospital of Bihar <p>Introduction: Fifty to twenty six percent of menstrual disorders are attributed to thyroid dysfunction. The objective of this study was to study the prevalence of thyroid disorders in patient with AUB and to study the menstrual pattern in patients with thyroid dysfunction. To determine the endometrial histopathology associated with different types of thyroid dysfunction. Materials and Methods: A hospital based cross sectional study was carried out by Department of Obstetrics and Gynecology, Darbhanga Medical College and Hospital, Laheriasri, Bihar, India. The study duration was between August 2020 to January 2021 for a period of 6 months and the participants were women attending gynecological OPD with complaints of abnormal uterine bleeding. The study was performed on a sample of 100 women selected on above criteria. This study was performed after obtaining approval from the institutional ethical committee. After obtaining a written informed consent from the participants, detailed history regarding the menstrual pattern, duration and quantity of bleeding during each cycle was noted. History suggestive of thyroid dysfunction was obtained. A complete clinical examination including examination of neck for thyroid swelling and a thorough gynecological examination was performed. All the information was tabulated and analyzed using SPSS 22 version with descriptive and inferential statistics (chi square test). A P value of&lt;0.05 was considered statistically significant. Results: The age of the study participants ranged from 22 to 63 years. The mean age was 47.8 years with a SD of 12.7 years. Almost two-third of the women was in the peri-menopausal age group. %5 of the women with nullipara, another 14% was primipara and rest was multiparous. 57% had parity of ≥ 3. Heavy menstrual bleeding was the most common menstrual abnormality found among 82% of the study participants, followed by postmenopausal bleeding and oligo/polymenorrhea. Clinical thyroid examination had positive finding only in 3 patients. Conclusion: Testing and treating for thyroid disorder would prove to be cost effective in patients with AUB particularly with non-structural causes as it would avoid many costly interventions done for AUB.</p> Archana Bharti Seema Prasad Shashi Prabha Copyright (c) 2022 Archana Bharti, Seema Prasad, Shashi Prabha 2022-01-18 2022-01-18 5 3 809 812 Study of Obstetric Emergency Admissions at Labour Room in a tertiary care centre during COVID 19 pandemic <p>Background: The above study was done to analyse obstetric emergency admissions during Covid 19 pandemic and to assess its impact over pregnant women coming to seek treatment at our tertiary care centre. Aims and Objectives: 1. To analyse and compare obstetric emergency admission at labour room during covid 19 pandemic with pre covid era.2.To analyse behaviour changes of pregnant women in seeking treatment during covid 19 pandemic. Methodology: Retrospective study. Results: Significant changes noted like increase in mortality, ICU admissions, morbidity load during Covid times as compared to non covid times. Conclusion: The government should develop healthcare system to deal with future pandemic. This should ensure availability of ample amount of funds for the continuity of maternity care.</p> Indrani Dutta Atima Bharti Copyright (c) 2022 Indrani Dutta, Atima Bharti 2022-01-18 2022-01-18 5 3 813 819 Comparison of Airway Maneuvers Manual in line stabilization[MILS],Modified Jaw thrust, Conventional maneuver for Oro tracheal Intubation during Direct Laryngoscopy <p>Background: During performing orotracheal intubation with direct laryngoscopy adequate laryngeal visualization depends on proper airway maneuvers. There are different type of airway maneuvers. Aim: This study aimed to compare airway maneuvers ; MILS, jaw thrust , conventional maneuver to assess better laryngeal visualization and ease of intubation among them and associated complications. Material &amp; Methods: This observational study was conducted in 90 adult patients. Patients divided in to three groups. Laryngoscopy and intubation in group M was done in MILS and in group J jaw thrust , In Group C as conventional maneuver performed. Laryngeal visualization assessed using modified Cormack lehane (CL)grading and ease of intubation assessed by usingintubation time, number of attempts between these three groups. The data were compared using Anova test, chi-square test. Results: While comparing between these groups better laryngeal visualization seen in jaw thrust group while the MILS maneuver worsen the view. Conclusion: The present study concluded that jaw thrust maneuver improved the laryngeal visualization and conventional maneuver made intubation faster and easy.</p> Kumari Santosh Kumari Shashi Delwal Vandana Devi Vaishno Copyright (c) 2022 Kumari Santosh, Kumari Shashi, Delwal Vandana, Devi Vaishno 2022-01-18 2022-01-18 5 3 820 823 Assessment of Effect of Epidural Clonidine on Characteristics of Spinal Anaesthesia in Patients Undergoing Gynaecological Surgeries <p>Background: To assess the effect of epidural clonidine on characteristics of spinal anaesthesia in patients undergoing gynaecological surgeries. Materials &amp; Methods: One hundred twenty patients belonging to American Society of Anesthesiologists physical status I and II who underwent gynaecological surgeries were randomly divided into 2 groups. Group I received clonidine (C) and group II received saline (S). Hyperbaric bupivacaine (15 mg) was administered intrathecally for both groups after epidural injection. Sensory and motor block characteristics, analgesia, sedation and haemodynamics were recorded in both groups. Results: Group I and group II had 60 females. The mean height in group I was 158.4 cm and inn group II was 157.3 cm. The mean weight in group I was 65.2 Kgs and in group II was 66.2 Kgs. Duration of surgery was 78.4 minutes in group I and 77.2 minutes in group II. The difference was significant (P&lt; 0.05). Onset of sensory block at L1 (s) was 38.2 and 50.4, time to bromage 3 (s) was 55.4 and 102.3, time to 2 segment regression was 192.8 minutes and 109.3 minutes, total duration of analgesia was 312.4 minutes and 150.6 minutes and duration of motor blockage was 345.2 minutes and 124.7 minutes in group I and group II. The difference was significant (P&lt; 0.05). VAS at 30 minutes was 1.5 in group I and 2.3 in group II, at 60 minutes was 1.4 in group I and 1.8 in group II, at 120 minutes was 2.6 in group I and 2.9 in group II, at 180 minutes was 2.1 in group I and 2.0 in group II and at 240 minutes was 1.5 in group I and 1.9 in group II. The difference was significant (P&lt; 0.05). Conclusion: Administration of clonidine epidurally, 10 min before SAB, caused early onset and prolonged duration of motor blockade and analgesia.</p> Deepak S Jitin George Mohsin Mohammed Ali Ashwin S John R. C Krishna Kumar Copyright (c) 2022 Deepak S, Jitin George, Mohsin Mohammed Ali, Ashwin S John, R. C Krishna Kumar 2022-01-18 2022-01-18 5 3 824 826 A Cross-sectional Study to assess the “Quality of Life” and their impact on employment among Diabetic foot patients in a Tertiary care Hospital in a Metropolitan city <p>Background: India leads the world with largest number of diabetic patients earning the dubious distinction of being termed the “Diabetes Capital of the World.The most frequent consequence of diabetes mellitus is diabetic foot ulcer. Quality of life is decreased by diabetic foot illness. It is linked to reduced productivity and early retirement. This research was done to assess the health related quality of life.among those who have diabetic foot ulcers, as well as to assess the impact on employment status of diabetic foot ulcer. Objectives: To assess the impact of employment status among diabetic foot ulcer patients. To assess the impact of diabetic foot ulcer on health related quality of life among diabetic foot patients. Materials and methods: This was a cross sectional observational study among 196 diabetic foot ulcer patients of either sex visiting the General surgery OPD of a tertiary care hospital in a metropolitan city.Complete enumeration method was used in this study. A semi-structured predesigned pretested questionnaire was used in this study. It contains socio -demographic details, General examination, disease and treatment related details, and employment related characteristics.A standardized questionnaire, SF-36 v2, was used to measure QOL of diabetic foot patients. Results: Majority of participants are in paid employment (n=70, 35.71%) followed by unemployed (n=58, 29.59%) then self-employed (n=38, 19.38%) and 30 (15.30%) are retired respectively. the mean days lost due to diabetic foot was 145.5±31.5 while the mean wages lost per day is Rs.322±295. Conclusion: In the present study majority of study participants had poor health related quality of life in environmental,physical and mental health.Majority of participants are in paid employment (n=70, 35.71%) followed by unemployed (n=58, 29.59%) with diabetic foot ulcer and reported of having left a job/changed job.</p> Abhinand Sai M.B. D. H Rao Copyright (c) 2022 Abhinand Sai M.B., D. H Rao 2022-01-18 2022-01-18 5 3 827 832 An Observational Study on Seroprevalence of Toxoplasmosis among Voluntary Blood Donors <p>Introduction: Like bacterial and viral diseases, many parasitic diseases are also known to be more risk of transmitting by blood transfusion. Of great concern, toxoplasmosis also contributes to similar risk like other infectious diseases in different geographical regions. Materials and Methods: A cross sectional study was performed by screening the presence of antibodies against T. gondii in all blood donors received in a tertiary care teaching hospital and also obtained from medical camps. All blood samples from blood donors were routinely screened for HIV, hepatitis B virus surface antigen (HBsAg), hepatitis C virus (HCV) and syphilis. A total of 150 blood samples from healthy blood donors were collected from January 2021 to June 2021.The volunteer donors were healthy adults, screened routinely by physical examination with no history of infections in the recent past, according to the guidelines of Drugs and Cosmetics Rules, Government of India. This work was approved by the Institutional Ethics committee. Written informed consent was obtained from all participants before blood sampling. All the serum samples were tested for IgG and IgM anti-T. Gondii antibodies separately using commercially available enzyme linked immunosorbent assay (ELISA) kit and the results were interpreted by following the instructions of the manufacturer. Data were calculated with respect to donor variables and entered in SPSS and cross tabulated for descriptive and analytic statistics. The discrete variables were expressed as percentages and a p value of&lt;0.05 was considered significant. Results: Out of the 150 donors, 36 were seropositive to IgG antibody to T. gondii, making a prevalence rate of 24%. Among the 36 sero-positive samples, 18 are O positive, 11 are B, 6 are A and 1 sample supported AB positive blood groups. None of the samples showed Rh negative in this study. Serological screening of co-infections was not done in this study. Conclusion: Consequently, because of the high seropositivity of T. gondii, the health authorities should be alerted and preventive measures should be taken.</p> Sweta Gupta Anjoo Anupama Ajay Kumar S N Tiwari Copyright (c) 2022 Sweta Gupta, Anjoo Anupama, Ajay Kumar, S N Tiwari 2022-01-18 2022-01-18 5 3 833 835 Antiboitic susceptibility pattern of common uropathogens isolated at a tertiary care hospital of Bihar <p>Introduction: Urinary tract infections (UTIs) are amongst the most common infections encountered in clinical practice. The present study was undertaken to assess the current antibiotic resistance pattern in the common uropathogens isolated in a tertiary care hospital in south India. Material &amp; Methods: A secondary data analysis was carried out in the department of Microbiology, Jan Nayak Karpuri Thakur Medical College, Madhephura, Bihar, India, for the samples collected during January 2019 to December 2019. Samples received included mid-stream clean catch urine, suprapubic aspirate, urine collected from Foley's catheter and from the nephrostomy tube under sterile precautions, in patients who had undergone percutaneous nephrostomy. Samples were processed and isolates were identified as per standard methods. The chi-square test or Fisher's exact test was used to compare different groups. Statistical software SPSS 16.0 (SPSS Inc, Chicago, Illinois, USA) was used to analyse the data. Results: Data from a total of 1000 consecutive urine samples received in the dept during the period of data collection were included in the study. Of these, 680 (68%) were sterile, 180 (18%) showed significant growth, 20 (2%) showed insignificant growth and 120 (12%) were found contaminated. Of the 180 culture positives, E. coli was the most common isolate. The percentage of Klebsiella pneumoniae, Acinetobacter spp, Pseudomonas spp, Staphylococcus spp, Enterococcus faecalis was higher in patient females and patients with history of prior treatment with antibiotics, compared to the rest. Almost three-fourth of all E.coli isolates were found to be resistant to ciprofloxacin. Ciprofloxacin resistance was comparatively less among the other Gram-negative uropathogens like Pseudomonas spp, Proteus spp and K. pneumoniae as mentioned. Resistance to the aminoglycosides, amikacin and gentamicin was also considerable especially among isolates of Acinetobacter. Conclusion: The present results in increasing antibiotic resistance trends in UTI patients indicate that it is imperative to rationalize the use of antimicrobials and to use these conservatively.</p> Vandana Kumari Prem Prakash Mandal Prakash Kumar Mishra Copyright (c) 2022 Vandana Kumari, Prem Prakash Mandal, Prakash Kumar Mishra 2022-01-18 2022-01-18 5 3 836 839 Prevalence of comorbidities amongest h.pylori-positive patients at a tertiary care hospital, Jammu <p>Introduction: Helicobacter pylori is a gram-negative, microaerophilic bacterium usually found in the stomach. The bacterium is transmitted by feco oral route and is associated with peptic ulcer, duodenal ulcer, and gastric carcinoma. The scope of this study is to determine the prevalence of comorbidities amongest H.pylori-positive patients at a tertiary care hospital, in Jammu, which can give a better picture of the current situation and estimate the at-risk population of gastric carcinoma. Materials and Methods: This was a prospective observational study done at a tertiary healthcare hospital in Jammu, India, over 04 years (March 2016 to March 2020). Written and informed consent regarding the purpose, procedures, and risks was obtained from all patients. Data were collected by conducting a personal interview and doing a complete physical examination of the participants of the study. A structured pro forma was used and filled out after interviewing and examining the patient. The following information was collected for all the participants: age, gender, symptoms, duration, comorbidities, and durations, and any treatment patient has received. Results: Most common comorbidity was hypertension in the study group and among these patients, 138(88.46%) were H pylori positive, 2nd common comorbidity was Diabetes mellitus and among them 133(91.86%) were H pylori positive and 04 patients had CRPF and all of them were H pylori positive. Conclusion: Among all symptomatic patients enrolled in this study the most symptom was epigastric pain followed by dyspepsia and the most common comorbidities in the study group were HTN and Diabetes mellitus. A rapid urease test was performed on UGI endoscopic biopsy specimen for H pylori infestation and 78.5% of patients were found to be positive.</p> Shoket Mahmood Chowdry Abdul Hamid Rubina Kausar Nusrat Chouhan Copyright (c) 2022 Shoket Mahmood Chowdry, Abdul Hamid, Rubina Kausar, Nusrat Chouhan 2022-01-18 2022-01-18 5 3 840 841 To evaluate the outcome of cyanoacrylate glue in the treatment of anal fistulas <p>Background: Fistula in ano is a difficult problem that surgeons have struggled with since the time of Hippocrates. Traditional surgical techniques such as fistulectomy, fistulotomy and flaps were for a long time the only option for treatment. These procedures were associated with complications like excessive bleeding, faecal incontinence, recurrence, infections etc. But now, newer procedures and surgical techniques have been proposed for the treatment of anal fistulas. The Development of glue has raised renewed interest in sphincter-sparing techniques. The employment of cyanoacrylate glue is one of the newer promising techniques.<br>Materials &amp; methods:<br> From October 2020 to October 2021, patients with fistula-in-ano who were admitted to different surgical units at Alluri Sitarama Raju Academy of Medical Sciences were the subject of the study. In accordance with the proforma, information was gathered.30 patients in total who met the requirements were enrolled in the trial..<br> Routine laboratory tests were performed on all individuals. The patient was posted for the procedure under spinal anaesthesia after fulfilling the requirements. The fistulous tract was cleansed with curet and saline solution.<br>Results:<br> With the main injection, 22 individuals were cured, and all fistulous track discharge was stopped.<br> One more injection was needed for two patients, and one patient needed fistulectomy.<br> One patient needed a colostomy and a fistulectomy to repair complicated fistulas that had developed.<br>Conclusion: Patients with low anal fistulas and simple fistulas may be given cyanoacrylate adhesive as an alternative to fistulectomy. However, in order to further demonstrate their efficacy, larger series need to be examined.</p> Tharun Vankayalapati Mounika Chowdary Menni M. Asha Jyothi Copyright (c) 2022 Tharun Vankayalapati, Mounika Chowdary Menni, M. Asha Jyothi 2022-01-18 2022-01-18 5 3 842 845 A profile of patients registered at art centre Jayarogya hospital Gwalior, MP, India <p>Introduction: An approximately 36.9 million people were living with HIV globally at the end of 2014 with around 2 million new infections in<br>2014. In this study was arranged in order to understand the clinico-epidemiological profile of patients attending ART centre. Methodology: A<br>cross sectional study was conducted at an ART center of Gajara Raja Medical College and Jayarogya Hospital Gwalior, Mp, India. The data of<br>500 patients who is suffered from HIV/AIDS registered at ART centre from 1stAugust, 2014 to 31st July, 2015. Result: In this study total 500<br>patients, 299(59.80%) were male, 197(39.40%) were female and 4(0.80%) sample are transgender. in this study Out of the total 500 patients,<br>maximum 178 (35.6%) belonged to 30-39 years of age group. Out of the total 500 patients, 211(42.20%) were unemployed. Integrated<br>Counseling and Testing Centers (ICTCs), ICTC emerged as being the most common agency to refer HIV-positive patients into ART (67.4%)<br>followed by private practitioners (13.4%) and government health centers (7.6%). other entry point are self referred like DOTS, STI/RTI etc.<br>Psychosocial support, prevention and treatment of opportunistic infections (OI) including tuberculosis, and facilitating home based care and<br>impact mitigation. In this study was significant improvement in CD4 count, body weight after receiving the ART for an average duration 6month.<br>Conclusion: Building on the experience of past, this phase saw a twin drive to focus on coverage among high-risk groups like commercial sex<br>workers (CSWs), truck drivers and IDUs as well as to make the programme multisectoral. This resulted in a strongly decentralized programme<br>with the responsibility of implementation vested with the states as State AIDS Control Societies (SACS) were formed.</p> Manbahadur Rajpoot Anand Rajput Shailendra Rawal Copyright (c) 2022 Manbahadur Rajpoot, Anand Rajput, Shailendra Rawal 2022-01-18 2022-01-18 5 3 846 849 Role of LHRH analogue in cases of refractory mastalgia <p>Background: Mastalgia is the commonest cause of visit to the breast clinic. The present study was conducted to assess the efficacy of complete estrogen<br>blockade (CEB) with centchroman and LHRH analog goserelin in the treatment of refractory mastalgia. Aim: To study the effect of LHRH<br>analogue in refractory mastalgia and to increase pain free period in patients with refractory mastalgia. Methods: This is a prospective cohort<br>study conducted in the Dept.Of Gen.Surgery IGIMS ,Patna over a period of six months.The reduction of pain score ( as measured by a visual<br>analog scale (VAS) recorded on a breast pain chart ) to 3 or less at 6 weeks of initiation of treatment was taken as primary objective. Results:<br>Fifty patients were enrolled in the study. The mean age of the patients was 28 years (15–45 years). The median duration of symptoms was 6 months<br>(4–8). All of them had bilateral mastalgia. The mean pain score at start of study was 7. Conclusion: Complete estrogen blockade by means of GNRH<br>analogue is safe and effective for treatment of refractory mastalgia.</p> Rinku Kumari Ankur Akela Pradeep Jaiswal Pawan Kr. Jha Copyright (c) 2022 Rinku Kumari, Ankur Akela, Pradeep Jaiswal, Pawan Kr. Jha 2022-01-18 2022-01-18 5 3 850 851 A comparative study on nutritional assessment of adolescent population from urban and rural areas <p>Aims: The health and nutritional status of the children affects not only physical growth but also cognitive development and country's economic growth. Adolescents are the future of the nation and more vulnerable group. The study was, therefore, carried out to determine and compare the nutritional status of adolescents among rural and urban government school students in district Patiala, Punjab. Settings and Design: Cross sec-tional study was conducted on 600 adolescents, 300 rural and 300 urban students. Methods and Material: The nutritional status has been as-sessed with the help of anthropometric measurements. The weight and height were recorded of each student and BMI was calculated. weight for age, height for age and BMI for age Z scores compared with WHO 2007 growth standards. Statistical analysis used: The independent sample t-test was done to assess differences in the anthropometric variables. A two-tailed p value less than 0.05 considered significant. Results: Among rural students 27% were undernutrition as compared to 8.3% urban students with p value is &lt;0.001 which was significant. 11% of rural students were significantly underweight as compared to urban students of only 1% (p &lt;0.001). 69.4% of age group 10-13 years students were significant-ly underweight as compare to other age groups (p value &lt;0.001). Similarly 49.5% of age group 10-13 years students were significantly stunted with p value &lt; 0.001. Conclusions: Our results reveal that undernutrition is more prevalent among rural adolescent students. So, Government should implement some more special programs for improving adolescents health.</p> Baljinder Kaur Anju Singla Amandeep Kaur Tanya Thakkar Copyright (c) 2022 Baljinder Kaur, Anju Singla, Amandeep Kaur, Tanya Thakkar 2022-01-18 2022-01-18 5 3 852 855 Correlation of N-terminal pro-brain natriuretic peptide levels in non-alcoholic fatty liver disease <p>Background: Many organ systems are found to be affected in NAFLD including heart.NT-pro BNP determination has been proven to be useful and accurate for ruling out the diagnosis of heart dysfunction. Aim: To characterize the correlation between NT-proBNP and nonalcoholic fatty liver disease (NAFLD). Method: For this study, 60 cases of NAFLD were examined and evaluated in Department of Medicine, N.S.C.B. Medical College &amp; Hospital, Jabalpur (M.P.) All study subjects were examined by same radiologist for detecting fatty liver and grading by ultrasonography of abdomen; and all patients undergo fibroscan by same technician for measuring liver stiffness measurement . Similarly, NT-proBNP levels were also measured using a commercially available immunochemical system. Result: Our study shows that NT-pro BNP levels are significantly lower in patients of NAFLD without diastolic dysfunction(mean±SD46.17±18.74) and compared to NAFLD patients with diastolic dysfunction(160.89±42.11). Conclusion: Difference in NT- pro BNP levels was significantly observed in NAFLD patients with or without diastolic dysfunction. Therefore, NT ProBNP can be used as a diagnostic tool for diagnosis of NAFLD in patients without diastolic dysfunction.</p> Pankaj Asati Neeraj Jain Prashant Punekar Ritu Gupta Aman Golchha Copyright (c) 2022 Pankaj Asati, Neeraj Jain, Prashant Punekar, Ritu Gupta, Aman Golchha 2022-01-18 2022-01-18 5 3 856 859 Prevalence of Metabolic Syndrome in Local Population of Indore According to IDF Criteria <p>Abdominal obesity, insulin resistance, hypertension, and hyperlipidemia, all being non- communicable diseases (NCD) are the major health issues of the modern world. Present day has led to these pathological conditions known as metabolic syndrome. The prevalence of metabolic syndrome(MeS) greatly increases in urban population. The syndrome includes cardiovascular diseases, type 2 diabetes, and thyroid abnormalities.<br>A cross-sectional survey was conducted for the prevalence of metabolic syndrome among 438 participants of Indore, Madhya Pradesh India. A pre-designed questionnaire was used to collect data, including demographic information; anthropometric and biochemical parameters from their medical reports. Using criteria of International Diabetes Federation (IDF), MetS was seen in 43.3% of subjects with a mean age of 50.53 yr consisting of 55% males and 45% females. The age-specific prevalence of MetS was observed more in the older group.Physical inactivity was found to be the major causative factor for this MetS. It can be improved by encouraging the patients to adopt a healthy lifestyle with the emphasis on regular physical activity and modifications of food habits.</p> Sadhna Sachdeva Anand Kar Kiran Billore Copyright (c) 2022 Sadhna Sachdeva, Anand Kar, Kiran Billore 2022-01-18 2022-01-18 5 3 860 863