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> en-US (James) (Epin) Fri, 10 Feb 2023 00:00:00 +0000 OJS 60 Low Health Literacy (LHL): A Devious Enemy of Patient Treatment Adherence <p>People must have particular personality traits and social resources, also known as health literacy, in order to access, comprehend, and use information to make decisions about their health. Patients' ability to engage in complex disease management and self-care is strongly related to their level of health literacy. It can help us stay healthy by preventing illness and effectively managing existing illnesses. People with low health literacy (LHL) may find it difficult to manage their condition and prevent illness, which may lead to increased use of healthcare services. Furthermore, LHL is associated with increased hospitalizations, increased use of emergency care, decreased use of preventative services, and a worsened ability to understand labels and health messages, a worsened state of health, higher mortality, and more expensive medical care.</p> Abdul Kader Mohiuddin Copyright (c) 2023 Abdul Kader Mohiuddin Fri, 10 Feb 2023 00:00:00 +0000 Single-Stage Vs Two-Stage Urethroplasty For Hypospadia <p>Hypospadias is the most frequent congenital external genital deformity in boys, which affects 1/300 live male births worldwide with varying incidence rates in different nations. Hypospadias surgery has been historitically characterized by a multitude of techniques available for repair. This study compared single-stage and two-stage urethroplasty with regard to the outcomes and complications. This review was synthesized and obtained from various online databases. Scientific articles were selected based on the inclusion criteria. The result showed that hypospadias is a congenital anatomical abnormality of the male external genitalia and the second most common congenital disorder in males after cryptorchidism, but it is the most common penile congenital malformation. The purpose of surgery in hypospadias is to enhance genital attractiveness, stop splaying of the urine flow, allow the patient to pee while standing, eliminate sexual problems brought on by curvature, and enable semen deposition into the vagina during sexual activity. the choice of operation is frequently influenced by the surgeon's experience. Surgery can be broken down into one- or two-stage operations as well as into operations including tubularization, augmentation, and replacement of the urethral plate. Single-stage urethroplasty can be used for anterior to posterior hypospadias, but two-stage urethroplasty is preferremce for treating proximal hypospadias with less complication and more desirable aesthetic consequences.</p> Williem, Ahmad Fawzy Copyright (c) 2023 Williem, Ahmad Fawzy Fri, 10 Feb 2023 00:00:00 +0000 Evaluation of hearing loss in HIV infected patients in a tertiary care centre <p>Background: Hearing loss manifestations are common among HIV/AIDS patients. Understanding the effects and treatment of HIV/AIDS on the auditory system has become crucial for improving the quality of life of the patients.<br>Objectives: To estimate the prevalence of hearing loss and to determine the risk factors for hearing loss in HIV positive patients.<br>Materials and Methods: A cross-sectional observational study conducted in the Department of Otorhinolaryngology, Regional Institute of Medical Sciences, Imphal, Manipur, India for a period of 2 years from October 2019 to September 2021. 91 HIV positive patients were enrolled for the study. Prevalence of hearing loss and association of various risk factors for hearing loss were studied.<br>Results: The prevalence of hearing loss was 34.06%. The age ranged from 16 to 62 years, with mean age of 39.00±9.82 years. The study showed a pre-ponderance to male with M:F of 1.4:1. The median duration of treatment was 4 years with a minimum of one year and a maximum of nine years. Majority had CD4 count &gt; 200 (89% patients), followed by 50 to 200 in 8.8% of the patients. With every unit increase in age the hearing loss increases and was found to be statistically significant (p = 0.04). But in adjusted analysis, it was not significant. With every unit increase in the duration of treatment for HIV, the hearing loss increases and was found to be statistically significant (p= 0.001). Even after adjusted analysis, it was found to be significant (p =0.006). Also, CD4 count &lt; 200 is significantly associated with hearing loss than those with CD4 count ≥200 (p=0.03). But in adjusted analysis, it was not significant. Gender of the patients was not significant with the prevalence of hearing loss in unadjusted and adjusted analysis.<br>Conclusion: HIV patients with hearing loss manifestations should be recognized early and managed promptly to prevent disease morbidity and mortality, and to assure the patients a better quality of life.</p> Shandhyalata Yumlembam, Ningombam Jiten Singh, Mosin Babu, Vanathu Mariyapragasam M, Eepsita R Marak, Thingbaijam Sudhiranjan Singh Copyright (c) 2023 Shandhyalata Yumlembam, Ningombam Jiten Singh, Mosin Babu, Vanathu Mariyapragasam M, Eepsita R Marak, Thingbaijam Sudhiranjan Singh Fri, 10 Feb 2023 00:00:00 +0000 Prevalence of Non-Alcoholic Fatty Liver Disease and Its Correlation with Coronary Risk Factors in Patients with Type 2 DM <p>Background: Type 2 diabetics appear to be at greater risk of NAFLD and certainly of fibrosis and cirrhosis development. Type 2 diabetes and NAFLD are more common than previously thought, especially in India. To find out if there is a connection between NAFLD and CVD in a large group of type 2 diabetics, the current study was designed.Aim: 1) To study the prevalence of NAFLD by USG in patients with type 2 diabetes mellitus. 2) To correlate NAFLD with coronary artery disease and coronary risk factors in patients with type 2 diabetes mellitus.Methods: This was an observational, cross-sectional, open-labelled, single-centric, parallel design study conducted in the department of general medicine of a tertiary care hospital among patients with type 2 DM. Results: Among the 120 patients that took part in the study, there were 69 NAFLD patients and 51 non-NAFLD patients. Individuals with NAFLD had a significantly longer mean diabetes duration. In the NAFLD group, the prevalence of hypertension, obesity, visceral obesity, and metabolic syndrome was greater. The NAFLD group had much worse glycemic control. Sr. HDL and Sr. Triglyceride levels were found to be greater in the NAFLD group, whereas Sr. LDL levels were found to be higher in the non-NAFLD group, and Total cholesterol levels were practically comparable in both groups. ALT and AST values were higher in NAFLD patients than in non-NAFLD patients.Conclusion: The prevalence of NAFLD increases dramatically in the presence of type 2 diabetes, with majority patients affected in fourth decade of life. Obesity, hypertension, and dyslipidemia were considerably more prevalent with NAFLD compared to subjects without NAFLD.</p> Nitin V. Suryawanshi, Kalpita Pai, Rahul Radhakrishnan, Vinayak Sawardekar, Sunil Dhanraj Bhaisare Copyright (c) 2023 Nitin V. Suryawanshi, Kalpita Pai, Rahul Radhakrishnan, Vinayak Sawardekar, Sunil Dhanraj Bhaisare Tue, 21 Feb 2023 00:00:00 +0000 Correlation of mucormycosis with duration of steroid and oxygen therapy <p>Introduction: Covid-19 patients have many complications after treatment, including fungal infection, disseminated intravascular coagulation, septicemia, cardiac problems, fissures, piles and meningitis. Out of these; Mucormycosis- A lethal fungal infection which is caused by the family of mucorcea; is more prevalent in post covid-19 patients. Mucormycosis is well correlated with post covid-19 infection; who underwent prolonged steroid &amp; oxygen therapy during hospitalization. Mucormycosis is more common in covid-19 patients with immunocompromised status like Diabetes mellitus, Hypertension, cancer, organ transplant etc. Aims &amp; objectives:(1) To correlate mucormycosis, a fungal infection in covid-19 patients with duration of steroid and oxygen therapy.(2) To correlate mucormycosis with various comorbidities &amp; hospitalization. Materials&amp;Method: All radiologically and histopathologically proven cases would be selected for our study. Complete clinical history of patients would be taken. Steroid and oxygen treatment given to the patient would be correlated.Type of study: Prospective &amp; retrospective. Duration of study: 6 months Inclusion criteria: (1) Patients aged 18 years &amp; above.(2) Patient with mucormycosis in covid-19 infection with or without hospitalization.(3)All radiologically suggested fungal infection in covid-19 induced pneumonia with active disease in recovery phase. Exclusion criteria: (1) Age less than 18 years. (2) Patients with incomplete clinical history. Conclusion: Mucormycosis is more common in hospitalized patients with prolonged steroid &amp; oxygen therapy. We may prevent mucormycosis in covid-19 patients by reducing duration of steroid therapy.</p> Mital R. Nagvadiya, Vijay C. Popat, Darshit Kateshiya, Jayesh Gojiya Copyright (c) 2023 Mital R. Nagvadiya, Vijay C. Popat, Darshit Kateshiya, Jayesh Gojiya Tue, 21 Feb 2023 00:00:00 +0000 Cytomorphological classification of Breast lesion on basis of International Academy of Cytology (IAC) Standardized Reporting System in Tertiary health care hospital <p>Introduction: International Academy of Cytology (IAC) standardized syatem is established for breast fine-needle aspiration cytology (FNAC) reporting. They have five categories devided into C1 to C5. (C1-Insufficient material, C2-Benign lesion, C3- Atypical, C4-Suspicious &amp; C5-Malignant lesion). Aims and Objectives: The aim of our study was categorize breast lesions according to International Academy of Cytology (IAC) standardized reporting system. Materials and Methods: The present study was done during the period between January 2019 and December 2020 in the department of pathology VBCH, Silvassa. 10ml/5ml syringe and 23 gauge needles were used and two types of smears made. 1)Wet smears were stained by H&amp; Eosin stain and 2)dry smears were stained by Giemsa stain. Results: A total 275 cases of Breast were included in the study with 269 (97.82 %) females and 06 (2.18 %) males.We had a wide age group patient ranging from 11 years to 79 years. Most of the cases (60.5%) were in age group of 2nd and 3rd decade, with a predominance of right sided breast lesions.58 (21.09%) malignant (C5), 192 (69.81%) were benign (C2), 09 cases (2.91%) were benign lesions but having nuclear atypia (C3) , 04 cases (1.45%) were suspicious for malignancy (C4) and 12 cases(4.36%). were unsatisfactory for evaluation (C1) . Conclusion: Fine needle aspiration is cost effective, rapid, simple and highly sensitive diagnostic tool. IAC standardized reporting system for breast cytology enhance the diagnostic accuracy of FNAC.</p> Nilima M Chaudhari, Manisha Raut Copyright (c) 2023 Nilima M Chaudhari, Manisha Raut Fri, 10 Feb 2023 00:00:00 +0000 Reconstruction of lower eyelid defect with mustarde flap: A 5 years retrospective study <p>Reconstruction of eyelids can be challenging after tumour excisions. Various reconstructive options are available but complete knowledge about the anatomy and its function is important. To restore the function and aesthetic outcome is critically important. Despite many surgical options available: in our paper we want to provide the most reliable and useful method of lower eyelid reconstruction by MUSTARDE flap.Aim: To evaluate the clinical outcome of Mustarde cheek rotation flap in reconstruction of large lower eyelid and cheek defects. Materials and method: It is a retrospective study conducted in the Department of Plastic Surgery, Guwahati,Assam,India Medical College, Guwahati,Assam,India, Assam. 7 patients who underwent Mustarde cheek rotation flap during a period from1st July 2017 to 30th June 2022 are evaluated in this study. Results: All the 7 patients showed favourable outcome with good cosmesis. There was no major complication regarding the flap post operatively. One patient with basal cell carcinoma (BCC) of lower eyelid showed mild ectropion on follow up without corneal exposure. Conclusion: Mustarde cheek rotation flap is a versatile flap for reconstruction of large lower eyelid and cheek defects. It has good cosmetic outcome with minimal patient morbidity.</p> Kabita Kalita, Dibyajyoti Bora, Sarabjot Singh Anant, Ravneet Kaur Copyright (c) 2023 Kabita Kalita, Dibyajyoti Bora, Sarabjot Singh Anant, Ravneet Kaur Fri, 10 Feb 2023 00:00:00 +0000 A Prospective Study to Measure Intra-Abdominal Pressure Following Emergency Exploratory Laparotomy And To Correlate It With Measurable Post-Operative Outcomes <p>Background: Several studies have documented the detrimental effects of Intra Abdominal Hypertension (IAH) and Abdominal Compartment Syndrome (ACS), however it remains largely under diagnosed. ACS is the end sequela of raised intra-abdominal pressure (IAP), defined as a sustained IAP &gt;20 mmHg with or without an abdominal perfusion pressure &lt;60 mmHg and associated with new organ dysfunction. Objectives: In this study my aim is to measure the intra abdominal pressures of patients following emergency exploratory laparotomy and to identify the presence of ACS and to see if there is any correlation between IAP measurements and major post operative outcomes. Methodology: 55 patients undergoing Emergency Exploratory the Department of General Surgery in Government Medical College, Kozhikode were studied. IAP was monitored at 0hrs, 6hrs, 12hrs, 24hrs, 48hrs and 72hrs post operatively and patient was monitored for development of complications and ACS. IAP was measured indirectly by measuring urinary bladder pressure using foleys catheter. Results: IAH was found to be a significant predictor for development of post operative cardiac, renal and respiratory complications. No significant association was found between IAP and occurrence of burst abdomen or wound related complications. Out of 55 patients studied 14 patients (25.5%) developed ACS. Conclusion: IAP is a significant predictor of mortality in patients undergoing emergency laparotomy. IAH has detrimental effects on various organ systems. A more frequent monitoring with prompt decompression may be helpful in decreasing the mortality rate.</p> Shwetha Shyam Kumar, Chandrasekharan S Copyright (c) 2023 Shwetha Shyam Kumar, Chandrasekharan S Thu, 23 Feb 2023 00:00:00 +0000 A study on presence of parasites in commonly used raw herbal greens <p>Introduction: Helminthic infectivity of fresh green leafy vegetables still remains the most common public health problem. Consumption of raw and unwashed vegetables is an important means of transmission of several infectious diseases. Aim: The present study aimed to evaluate the presence of helminthic larvae in raw herbal greens retailed at chennai markets. Materials and Methods: A total of 3 different types of raw herbal greens: roots and leaves of coriander, mint and spinach were collected and tested for parasitic larvae by saline wet mount preparation. Results: Strongyloides larvae were detected in 3 types of raw herbal greens: roots and leaves of coriander, mint and spinach among which coriander roots and leaves showed greater load of nematode larvae than mint and spinach. Commonly these leafy greens are consumed raw, therefore appropriate washing and proper cooking of all vegetables is very important. Conclusion: This study highlights the necessity of appropriate washing and cooking of green leafy vegetables before they are consumed.</p> M Anitha, R Prabha, SSM Umamageswari, G Sumathi Copyright (c) 2023 M Anitha, R Prabha, SSM Umamageswari, G Sumathi Wed, 01 Mar 2023 00:00:00 +0000 A Cross Sectional Study of Feto-Maternal Outcome for Second Stage Cesarean Delivery <p>Background: Caesarean delivery at full dilation of cervix is associated with increased technical difficulty and feto-maternal<br>complications.Objectives: To know the short term maternal and foetal outcome in second stage caesarean deliveries. Material &amp; Methods: This<br>is a descriptive, prospective cross-sectional study done at Vani Vilas hospital attached to Bangalore medical college and research institute from<br>Jan 2022 to Dec 2022. Intra operative and immediate post operative complications were collected from case record, mother and new-born were followed during hospital stay till discharge. Data entered in MS excel sheet and analysed using SPSS version 20.0. Descriptive statistics of the explanatory and outcome variables were calculated by mean, standard deviation for quantitative variables, frequency and proportions for qualitative variables. Results: Sample size was 98 women in one year. Mean Age of the sample population is 25.71±3.26 years, 67.3% are primi gravid women. Common methods of extraction included Vertex and Patwardhan method. Extension of hysterotomy incision seen in 20.4%. PPH seen in 16% of women. About 16% of new-borns required NICU admission. One still birth and two neonatal deaths were noted. Conclusions: Second stage caesarean delivery carries increased morbidity both to mother and child. Skill and expertise are required to reduce the complications during second stage caesarean sections.</p> Sudha H Chikkasiddaih, Yashaswini M, Prajna Bhat M, Radhika Chetan, Monika Bhaskar, Sweta P Srinivas, Savitha Chandraiah, Anitha GS Copyright (c) 2023 Sudha H Chikkasiddaih, Yashaswini M, Prajna Bhat M, Radhika Chetan, Monika Bhaskar, Sweta P Srinivas, Savitha Chandraiah, Anitha GS Tue, 07 Mar 2023 00:00:00 +0000 Incidence of overlap syndrome of functional dyspepsia and irritable bowel syndrome in Western UP <p>Aim: To determine the incidence and risk factors for the clinical overlap between Functional Dyspepsia and Irritable Bowel syndrome defined by Rome IV criteria in Indian patients. Materials and methods: The present cross sectional study was carried out in ChattrapatiShivaji Subharti Hospital, Meerut in the Department of Medicine among consecutive patients with upper gastrointestinal symptoms who was referred for endoscopy. A structured questionnaire containing the FD and IBS modules of functional gastrointestinal disorders (FGIDs) and the putative risk factors for dyspepsia was administered to the participants. Results: Out of 500 subjects; FD, IBS and overlap was reported among 17.4%, 13.8% and 10.2% of the subjects respectively. Overall functional gastrointestinal disorders (FGID) were found in 207 (41.4%) subjects. Alcohol consumption was reported among 6.90%, 15.94% and 27.45% of the subjects having FD, IBS and overlap syndrome respectively. Hard or lumpy stools and defecation straining was reported more in subjects with overlap syndrome subjects followed by FD and IBS with statistically significant difference. Loose or watery stools was found least in FD subjects. A feeling of incomplete bowel movement was maximally revealed in overlap syndrome subjects. Conclusion: Patients having either FD or IBS overall have less severe symptoms and patients with overlap may represent the more severe symptoms as compared with FD or IBS.</p> Mohammed Shahbaaz Parvez, PK Gupta, Shirobhi Sharma, Amit Kumar, Mohammad Shoeb, Srikanth Peddireddy Copyright (c) 2023 Mohammed Shahbaaz Parvez, PK Gupta, Shirobhi Sharma, Amit Kumar, Mohammad Shoeb, Srikanth Peddireddy Wed, 08 Mar 2023 00:00:00 +0000 Liver Function Tests (LFT) in pregnant women at a tertiary care center in Ratnagiri district of Maharashtra, India <p>Introduction: Abnormal liver tests occur in 3–5% of pregnancies and show many different causes. Although alterations of liver enzymes could be a physiological phenomenon, it may also reflect potential severe liver injury, necessitating further assessment and accurate management. The present cross-sectional study was undertaken to study liver function test profile in pregnant women. Methodology: All the pregnant patients referred to Pathology section were studied prospectively from January 2018 to April 2019 involving 90 cases. Blood sample was studied for Total protein, Albumin, Globulin, Bilirubin, SGOT, SGPT, Alkaline phosphatase. All the findings filled in MS-Excel sheet and was analysed manually. Results: The mean age was found to be 26.61 (±5.42) yrs. Mean total protein level was 11.66 (±53.55) Gm/dl. Mean Albumin was 3.01 (±0.71) Gm/dl. Total patients showed hypalbuminaemia majority of patients in the age group of 24 – 29 yrs [31 (34.4%) cases] and in third Trimester [35 (38.8%) cases]. Mean total Bilirubin is 1.66 (±3.56) Mg/dl, Mean Direct Bilirubin is 0.98 (±2.42) Mg/dl and Mean Indirect Bilirubin is 0.74(±1.40) Mg/dl. Total 57 (63.3%) patient showed increased SGOT, majority of patient in the age group of 24 to 29 yrs [24 (26.6%) cases]. Total 36 (40%) patient showed increased SGPT, majority of patient in the age group of 18 to 23 yrs [11 (12.2%) cases]. Total 62 (68.8%) patient showed increased Alkaline Phosphatase, majority of patient in the age group of 24 to 29 yrs [28 (31.1%) cases]. Conclusion: Liver disease in pregnancy is a complex issue that deserves a multidisciplinary approach.</p> Bhushan M Warpe, Shweta S Joshi, Kajal S Kolwankar, Riddhi S Yadav, Mehul P Chokshi, Vishwa M Sureja, Vibha D Patel, Jinal A Patel Copyright (c) 2023 Bhushan M Warpe, Shweta S Joshi, Kajal S Kolwankar, Riddhi S Yadav, Mehul P Chokshi, Vishwa M Sureja, Vibha D Patel, Jinal A Patel Wed, 08 Mar 2023 00:00:00 +0000 Evaluation of mammogram findings of breast lesions with trucut biopsy <p>Introduction: Breast cancer is the most common malignancy in women and second leading cause of cancer death among women aged 20 to 59 years. Radiological assessment of the breast lesion by diagnostic mammography remains one of the key investigation in the so called triple assessment of breast lesions. Classification of the mammogram findings as BI-RADS score also helps in the study of the lesions by categorising it into benign, suspicious of and suggestive of malignancy[1]. Comparing its results with the gold standard histopathological (TRUCUT) findings confirms the diagnosis and helps to assess the reliability of mammogram in diagnosing the pathology. Materials and methods: A cross sectional study was conducted among 66 patients who has clinically suspicious malignant breast lesions, attending the General surgery OPD, Casualty, wards of Calicut medical college during the study period. Statistical analysis of the data performed, results of mammogram and trucut biopsy results are compared and analysed. Results: On comparing the mammographic findings to that of the Trucut results 96.96% turned out to be true positive and the rest 3.03% as false positive. Out of the false positive results all were in the category BI-RADS 4a, low suspicion of malignancy (2-9%). In the present study, because the inclusion criteria is “the lesion which are suspicious of malignancy” hence the study population includes only those with results of BIRADS IV - V but not the other categories. Conclusion: Since Mammogram helps in easily identifying the breast lesions, even the impalpable ones, also assess the multicentricity and helps in characterisation of breast lumps, results being reproducible and less subjective and non invasive, it can be considered a primary diagnostic tool in the evaluation of breast lesions and a reliable and useful tool in differentiation of malignant and benign breast masses.</p> Fadhil S Isahac, Jayan N.P., Abdul Basith, E.V.Gopi, Juvaina.P Copyright (c) 2023 Fadhil S Isahac, Jayan N.P., Abdul Basith, E.V.Gopi, Juvaina.P Thu, 09 Mar 2023 00:00:00 +0000 Diagnostic Accuracies of APRI and FIB4 For Predicting Different Stages of Liver Fibrosis In Patients of NAFLD and its Correlation With Fibroscan <p>Aim: To analyse the diagnostic Accuracies of APRI and FIB4 for predicting different stages of liver fibrosis in patients of NAFLD and its correlation with Fibroscan. Material and methods: The present study prospective, observational study was conducted among 100 NAFLD patients, diagnosed by USG of both genders were recruited for the study. The laboratory test results that were evaluated included those in the hospital information. All results were obtained within one month of a Fibroscan examination. The cutoff values used for the diagnosis of severe fibrosis were: APRI&gt;1, NAFLD score&gt;0.676 and FIB-4 score &gt;3.25. Results: Mean AST/ALT, APRI and FIB-4 was found to be more in F3+F4 grade as compared to F1+F2 grade. A statistically significant positive correlation was observed between APRI, FIB- 4 when compared to Fibrosis stages as statistically confirmed using Pearson correlation test. FIB- 4 has the best sensitivity while APRI has the best specificity in predicting different stages of liver fibrosis among patients of NAFLD. Hence APRI and FIB-4 was comparable in this study to predict liver fibrosis. Conclusion: We found APRI to be the best index to predict advanced liver fibrosis compared to AST/ALT ratio while comparable with FIB-4, with this index having the strongest correlation with FibroScan results.</p> Mohammad Shoeb, PK Gupta, Anand Prasad, Shahbaaz Parvez, Patamsetti Anil Kumar, Gali Shabrish Copyright (c) 2023 Mohammad Shoeb, PK Gupta, Anand Prasad, Shahbaaz Parvez, Patamsetti Anil Kumar, Gali Shabrish Thu, 09 Mar 2023 00:00:00 +0000 Acute Encephalitis Syndrome Due to Scrub Typhus: A Missed Diagnosis <p>Introduction- Clinically, a case of Acute Encephalitis Syndrome (AES) is defined as a person of any age, at any time of year with the Acute onset of fever and a change in mental status (including symptoms such as confusion, disorientation, come, or inability to talk) and/or new onset of seizures (excluding simple febrile seizures). Acute encephalitis syndrome (AES) is a major public health problem worldwide because of its high morbidity and mortality. Although incidence of AES varies according to different studies, it is generally between 3·5 and 7·4/1,00,000 patient-years, and is higher in children aged &lt;1 year and adults aged &gt; 65 years.(3). Material and methods- This study was Open Labeled, Prospective study and was performed over a period of 1 year and 6 months from January 2018 to June 2019 at Department of Microbiology, TNMC and BYL Nair Ch. Hospital, Mumbai and Molecular Diagnostic Reference Laboratory, Kasturba Hospital, Mumbai only after taking Approval from Institutional Ethics Committee and Informed consent of every patient enrolled in the study. Results- This study was done on adult population and the mean age was 42.5 years. The minimum age was 14 years and the maximum age was 78 years. Almost half of the patients were between 15 and 45 years of age, which suggest the disease has a higher incidence in the younger adults. A maximum number of patients came during the month of July -October, suggesting the seasonal occurrence of the disease. The most common clinical features of AES patients were fever and altered sensorium followed by behavioral changes, headache, and seizures. The most common finding of general examination of AES patients was pallor followed by tachycardia and tachypnea. Most of the patients had low GCS (&lt;=7), hypotonia and abnormal movements during their CNS examination. In this study, 17(28.3%) the CSF R/M finding were suggestive of bacterial infection (white cell counts high with neutrophilic predominance, accompanied by elevated proteins and hypoglycorrachia) and in 5(8.4%) the CSF R/M findings were suggestive of viral infection (mild pleocytosis and lymphocytic predominance, slightly elevated protein, and normal glucose), however in 38(63.33%) patients CSF R/M findings were normal. Conclusion- To conclude, the etiology panorama of acute encephalitis syndrome including Scrub Typhus and viral agents (excluding JE) is not well documented especially in western India. The lack of published data from western India leads to lack of understanding of disease. Conventional methods like culture and routine CSF studies lead to identification of only few etiologic agents causing AES, Diagnosis of AES should be done by new molecular diagnostic technologies including PCR, nucleic acid sequence-based amplification, and branched-DNA assay. Multiplex PCR is a boon for CNS infections where “TIME IS PRECIOUS” and help in early diagnosis of infectious agents and thereby providing specific treatment. A surveillance system for undiagnosed infections should be developed which helps to monitor the trends of emerging infection and aid in their early diagnosis.</p> Manali Kishor Kedia, Jayanthi Shastri, Jugal Kishore Harkut, Yogendra V Bansod Copyright (c) 2023 Manali Kishor Kedia, Jayanthi Shastri, Jugal Kishore Harkut, Yogendra V Bansod Sun, 19 Mar 2023 00:00:00 +0000 Effects of Chronic Otitis Media on Contralateral Ear <p>Chronic otitis media (COM) is rarely an isolated entity, because the responsible factors for its development in one ear were in a similar way will<br>impact the contralateral ears, since both ears had a common “nasopharyngeal” drainage. Methods: The following study is a cross sectional study<br>carried out on 200 patients having COM (mucosal and squamosal type) presenting in the OPD in the department of ENT at Dr Susheela Tiwari<br>Government Hospital, Haldwani between January 2019 and September 2020. Result: Otoendoscopy, pure tone audiometry and X ray mastoid findings were noticed in both the ears in patients of COM (mucosal/ squamosal). Otoscopically the most common finding in contralateral ear in mucosal type of disease was tympanosclerosis (42.53%) and in squamosal type of disease it was pars tensa retraction (34.62%). Pure tone audiometry shows more severe hearing loss in the contralateral ear of squamosal COM than mucosal COM. Radiologically pneumatization was noticed in the contralateral ear in the mucosal and squamosal COM. Tympanometry was also performed in the patients with COM. Conclusion: Chronic Otitis media is a disease with a very varied clinical presentation and disease in one ear has been sometimes found to be associated with subtle to gross changes without any symptoms observed in the contralateral ear. These changes can eventually result in the beginning of a gradual and chronic inflammatory process in the contralateral ear. Clinical assessment of the contralateral ear is equally important as of the diseased ear.</p> Priyanka Chaurasia, Vaibhav Kuchhal, Shahzad Ahmad Copyright (c) 2023 Priyanka Chaurasia, Vaibhav Kuchhal, Shahzad Ahmad Sun, 19 Mar 2023 00:00:00 +0000 Evaluation of Dry Eye in Female Androgenic Alopecia Patients <p>Materials and methods: Twenty five left eyes of 25 female androgenetic alopecia patients (Group 1) and 25 left eyes of 25 age matched healthy female volunteers (Group 2) were enrolled in the study. The presence of dry eye was evaluated with the invasive tear film break-up time (T-BUT) &amp; Schirmer 1 test. Results: The mean ages of Group 1 and Group 2 were 49.3 ± 7.6 (range, 39-59) and 50.8± 6.4(range, 39-60) years, respectively (P = 0.4). Mean T-BUT was statistically significantly lower in Group 1 (P = 0.01). Mean Schirmer 1 score was lower , but the differences were not statistically significant (P = 0.2). Conclusion: Female androgenic alopecia and Meibomian gland dysfunction &amp; dry eye have common pathogenesis in the form of alterations in sex hormones. Significant differences were detected in the results of dry eye tests between subjects with female androgenic alopecia and healthy control. Hence female androgenic alopecia patients should be examined for dry eye and should be treated to prevent serious consequences.</p> Shruti A Badad, Rajeshwari Mantgol, Ambresh S Badad Copyright (c) 2023 Shruti A Badad, Rajeshwari Mantgol, Ambresh S Badad Sun, 19 Mar 2023 00:00:00 +0000