European Journal of Cardiovascular Medicine

Background: Pediatric anemia is one of the major health burden in India and in major parts of the world, as it results in reduced exercise tolerance, slower rate of growth, impaired development and delayed wound healing. Anemic children are also at a higher risk of death due to complications associated with malnutrition and infection. Prevalence rate of anemia is an essential indicator of the nutritional status within the pediatric population. In the United States, around 18% of the children and in the developing countries about 82% of the children are anemic. Because of these factors, the study of the etiopathogenesis of anemia in infancy and childhood has attracted wide attention in the recent years in India. Materials and Method: A prospective study, for a period of 3 years at Department of Paediatrics, Tertiary care Teaching Hospital was conducted after obtaining ethical committee clearance of the institute. The children who were admitted in the hospital with sign of Pallor were selected as per inclusion criteria into the study. An informed consent was taken from parents, detailed history was recorded with particular emphasis on symptoms suggestive of anaemia such as weakness and easy fatiguability, breathlessness on exertion, pica. A thorough clinical examination of every child was done. Results: The present study comprised of 400 subjects, out of which 58% were males and 42% were females. Dimorphic, Macrocytic, Microcytic Hypochromic, Normocytic Hypochromic and Normocytic Normochromic Anaemia were reported in 12%, 4%, 50%, 4% and 30% of the subjects respectively. Maximum cases were of Microcytic Hypochromic type. The distribution of anemia according to Vit. B12 and Folic acid. Total 50 patients were studied. 12 cases of macrocytic anemia, 12 had Vitamin deficiency (8 with reduced Vit B12, 3 with reduced Folic acid and in 1 case both were reduced) i.e. 22.2%. In 28 cases of Dimorphic anemia, 38 had Vitamin deficiency (19 with reduced Vit. B12, 10  with reduced folic acid and in 2 cases both were reduced) i.e. 72.2%. Conclusion: In the current study, the preschool children are found to be the most affected. Hence, it is recommended that, this age group is compulsorily screened for anemia. A uniform definition of screening criteria and an effective system to respond to abnormalities is the need of the hour

Background: Endotracheal intubation is a common procedure during general anaesthesia, often associated with post-operative complications such as sore throat and emergence cough. This study aimed to investigate the efficacy of three intra-cuff solutions—air, normal saline, and 2% lignocaine—in mitigating these complications and their impact on intubation attempts and hemodynamic parameters. Methods: A randomized clinical trial was conducted involving 114 patients undergoing elective surgeries. Participants were divided into three groups based on the intra-cuff solution used. Intubation attempts, post-operative sore throat, emergence cough, and physiological parameters were assessed and statistically analysed. Results: The use of 2% lignocaine significantly reduced the number of intubation attempts (p < 0.001*) compared to air and normal saline. Additionally, lignocaine was associated with a significantly lower incidence of post-operative sore throat (p = 0.011*) and emergence cough (p = 0.010*) compared to the other solutions. However, there were no significant differences in hemodynamic parameters between the groups. Conclusion: This study suggests that 2% lignocaine may be a preferable intra-cuff solution for endotracheal intubation, as it reduces intubation attempts and the incidence of post-operative complications. Further research and clinical trials are needed to validate these findings and refine the selection criteria for intra-cuff solutions.

Tibial plateau fractures are one of the commonest periarticular fractures. These fractures include 1% of all fractures and 8% of fractures in elderly. Motor vehicle accidents account for the majority of these fractures in younger individuals with good bone stock, but in elderly individuals these fractures may result from simple fall due to osteopenic bone. These fractures are associated with high energy violence and extensive soft tissue injury. Each fracture type has its own morphology, treatment considerations and prognosis.  Materials And Methods: This is a prospective study was conducted in the Department of Orthopaedics, Surabhi Institute of Medical Sciences among 30 patients with displaced tibial plateau fractures with posterior column involvement were selected for the study. Patients with tibial plateau fractures with posterior column involvement, closed injury, and age >18 years were included in this study. Patients with fractures with zero columns (pure depression type), pure lateral or medial column involvement without posterior column involvement, open injury, and associated head/chest/abdomen/pelvis/spine injury, patient below 18 years of age, and patient not fit for surgery and not willing for surgery were excluded from the study. Results: In our study, the most of the patients were belongs to 21-30 years old 12 (40.0%). In our study, predominant were males 90% and females were of 10%. Single-column fractures (Schatzker Type IV and Hohl and Moore Type I coronal split fracture), Two-column fracture (Schatzker type IV and type V), Three-column fractures (Schatzker Type V).  In this study majority of patients were Three-column fractures, followed by Two-column fracture and Single-column fractures. Mean duration of surgery time of single column fractures were 61.49 minutes, two-column fracture 80.40 minutes and 103.38 minutes for Three-column fractures Conclusion: Based on this study, we would like to conclude that we were able to achieve acceptable clinical and radiological outcome while managing complex tibial plateau fractures with column specific approach.

Background:  Over the past few decades, the percentage of patients with end-stage renal disease brought on by diabetes has steadily risen. The most popular biochemical parameter for routinely estimating GFR is serum creatinine level. Notwithstanding the fact that large increases in serum creatinine can occur before 50% of GFR is lost. It has been discovered that cystatin C is a new, promising marker for the early detection of renal diseases. To investigate the connection between microalbuminuria and serum cystatin C for the early detection of renal impairment in type 1 diabetic patients. Methods: From April 2021 to January 2022, a cross-sectional study was carried out at Department of Biochemistry, T R R, Institute of Medical Sciences, Sangareddy, Telangana, India. They were split into two groups, Group I with diabetes diagnosed for less than five years and Group II with diabetes diagnosed for more than five years. The Albumin Creatinine Ratio was used to classify the patients in each group as cases and controls. The levels of serum urea, creatinine, cystatin C, hemoglobin A1c, and urine ACR were estimated. Microsoft Excel was used to conduct the statistical analysis. Results: In the study, 80 patients with type 1 DM were enrolled. Cystatin C levels in cases with type 1 DM lasting longer than five years were found to be statistically significant (0.88±0.43 compared to 0.65±0.38). Over a period of more than five years, a statistically significant positive correlation between cystatin C and ACR (r=0.4, p<0.05) was discovered. According to this, serum levels of cystatin C rise as ACR values rise. There was no noticeable difference in cystatin C levels in patients with type 1 diabetes for less than five years. Conclusion: In patients with Type 1 Diabetes Mellitus who have had the condition for longer than five years, Cystatin C levels in the blood may be utilised as an early sign of renal impairment. However, in our study, patients with Type 1 diabetes who have had the disease for less than five years do not show any significance for Cystatin C.

Background: Coronary artery disease (CAD) is one of the leading causes of morbidity and mortality all over the world. It causes about one-third of all deaths in people older than 35years. We carried out this study because there was no such study carried out in Andaman and Nicobar Island to ascertain the incidence of CAD and the risk factors which lead to CAD in Andaman and Nicobar population. The health sector in Andaman and Nicobar is developing. Due to the increasing load of CAD patients recently the Cath Lab was started as the ANIIMS Port Blair / GB Pant Port Blair is the only tertiary care hospital in the whole of Andaman and Nicobar Islands. To get a better insight into the disease prevalence and how to lower the risk factors. Material and methods: This cross-sectional study was done in a tertiary hospital in Port Blair to find out the prevalence of risk factors among patients with coronary artery disease. A total of 315 patients were screened based on a questionnaire, ECG (Electrocardiography) and laboratory investigations. Data was analysed in SPSS and Microsoft Excel and was presented as tables and graphs. There was significant observation based on age, clinical features, risk factors, ECG patterns and laboratory diagnosis. The result was conclusive of increased prevalence of risk factors among CAD patients which was also reported in various studies conducted in India and across the world.  Results: This study has estimated that the overall prevalence of Hypertension is 86.03%, Type 2 diabetes mellitus is 88.89%, Smoking is 55.87%, Hypercholesterolemia is 71.43%, Hypertriglyceridemia is 68.25%, Obesity is 65.40%, Stress is 61.9%, and Family history is 12.38%.  Conclusion: The present study demonstrates a high prevalence of CAD risk factors in the population of Port Blair, Andaman and Nicobar Islands. The study population reflects the rising trends of CAD in urban India. The incidence of CAD has increased further because of rapid urbanization and its accompanying effects like sedentary lifestyle changes, change in food habits, lack of outdoor activity. There should be an early detection of a risk factor to prevent morbidity and mortality in the community. Therefore, there is an immediate need to raise awareness among the general population regarding these risk factors, signs and symptoms of coronary heart disease promote the correct diet and physical activity, meditation,yoga and others and at the same time develop guidelines for screening and preventive therapeutic programs to identify and manage individuals at high risk for future CAD.  CAD can be prevented by dietary modification, changing lifestyle, decrease tobacco consumption and regular physical exercise. Screening and regular medical check-up of patient helps in early detection of CAD.

Background: Plantar fasciitis is a degenerative condition, which is the most common cause of heel pain seen in nearly 10% of population. Though it is usually a self-limiting disease, symptoms may require treatment. Methods: 120 (n=60) adult patients with chronic plantar fasciitis, who met the inclusion criteria were evaluated from November 2020 to June 2021 in IGGGH & PGI, Puducherry. In this prospective comparative study, Group-A was given Platelet-Rich Plasma (PRP) and Group-B was given triamcinolone acetonide injections intra-lesionally. Follow-up was done at 4th, 8th and 12th week post-injection and improvement was assessed by Visual Analog Scale (VAS), American Orthopaedic Foot & Ankle Society Ankle-Hindfoot Score (AOFAS-AHFS) and Foot & Ankle Ability Measure - Activities of Daily Living (FAAM-ADL) subscale. Results: 63 males and 57 females in the age group between 23 and 81 years with a mean duration of symptoms of 6.74 ± 2.75 months were included. Right side was predominantly involved. There was a statistically significant improvement in VAS and FAAM-ADL at 4 weeks follow-up in group B, whereas there was no difference in effectiveness at 8th and 12th weeks. AOFAS-AHFS scores were similar in both with “excellent” results in 23 Group-A and 45 Group-B patients. Conclusion: Both PRP and corticosteroid injections are effective in treating chronic cases of plantar fasciitis with better immediate results with corticosteroid. As PRP is an autologous product it is a safer option. Further studies with longer follow-up period are needed to confirm our findings.and lignocaine alone.

Background: pregnancy is one of the important times in a woman’s life. Women's bodies become more sensitive to dangerous substances and they may develop different complications, such complications might be to pregnant women or the fetus. Some women don’t have proper knowledge about pregnancy complications or nutritional food products to be taken during pregnancy the main aim of the study is to study ABO blood groups and sociodemographic status in anomalies and normal fetuses in pregnant women. The present study is a cohort study carried out on 180 pregnant women. Among them, group 1 136 were normal pregnant women (without any fetal complications) and group 2 44 were anomaly pregnant women (with fetal complications). In groups, -1 & 2 majorities of the pregnant women were under the age group of 31 – 35 years (45.58%) and 20 – 25 years (27.27%) after comparing both groups – 1& 2 significance was observed at 20 -25 years (p<0.05). in group 1 majority of pregnant women have 1 fetus but in group 2 majority of the pregnant women have 2 fetuses. In comparing the ABO blood group of both groups 1 & 2 there is a significant difference was observed in blood group A and no significance was observed in blood group B, AB & O. as per the education status of a pregnant women in group 1 in education status of a pregnant women majority were upto degree 43.38% and in group 2 majority of pregnant women were not educated (45.45%). Complications observed in group 2 in 44 pregnant women having Hematocolpos 29.54% followed by Hydramnios 22.72%, Oligohydramnios 18.18%, Microcephaly 13.63%, Cleft palate 9.09% and Hygroma colli 6.81 %. Early age Pregnancy, more than 1 fetus, A blood group, no education about taking care during pregnancy and there complications such pregnant women may develop complication in fetus and even death of the fetus can be seen

COVID-19 has impacted children’s immunization rates, putting the lives of children at risk. The present study assesses the impact of phone-call counseling, on immunization uptake during the pandemic. Families of babies discharged from the SNCUs in six government centers in three South Indian states were recruited. Calls were made 10 days after the immunization due date. Missed vaccinees were counseled and followed up on 7 and 15 days. Of 2313 contacted, 2097 completed the survey. Respondents were mostly mothers (88.2%), poor (67.5%), and had secondary level education (37.4%). Vaccinations were missed due to the baby’s poor health (64.1%), COVID-19 related concerns (32.6%), and lack of awareness (16.8%). At the end of the intervention, the immunization uptake increased from 65.2% to 88.2%. Phone-call intervention can safely support immunization and lower the burden on health workers

Background:  Hypertension in pregnancy is a systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or both. Both systolic and diastolic blood pressure raises are important in the identification of Pregnancy induced hypertension. Pregnancy induced hypertension (PIH) is hypertension that occurs after 20 weeks of gestation in women with previously normal blood pressure. The broad classification of pregnancy-induced hypertension during pregnancy is gestational hypertension (GE), pre-eclampsia and eclampsia. Serum uric acid and creatinine levels are a part of work up for the pregnant women with hypertension. The elevated levels of these parameters were due to decreased urinary clearance secondary to reduced Glomerular filtration Rate (GFR) and increased reabsorption. Materials and methods: The present study was carried out in the Department of Biochemistry, Dr VRK Womens Medical College, Teaching hospital and Research center. Total 70 patients of pregnancy were selected out of which 30 patients were of normal pregnancy and 40 patients were of pregnancy induced hypertension. Serum uric acid levels were estimated before delivery and after delivery in cases of pregnancy. Pregnant women with recurrent abortions, bad obstetric history, twins, preexisting medical disorders – such as diabetes mellitus, essential hypertension, renal disorders, cardiovascular, thyroid disorders, and liver disease – were excluded from the study. Results:  In our study, we observed a significantly elevated serum uric acid PIH (9.51 ± 1.33 mg/dl) and Normal pregnant women (5.29 ±0.8 mg/dl). Blood Urea was 5.29 ±0.8 mg/dl among Normal pregnant women and 9.51 ±1.33 mg/dl among PIH. Moreover, Serum Creatinine level was1.25±0.53 mg/dl among PIH and 0.97±0.23 mg/dl among Normal pregnant women. Conclusion: On the basis of study findings we, concluded that the increased levels of serum uric acid, serum creatinine and serum urea are better diagnostic and predictive marker for PIH and immediate medical attention required for PIH. With the help of these parameters most cases are detected early in the pregnancy before they can progress to eclampsia

Introduction: The brain is normally a sterile site that is protected from infection by specialized barriers, including the bony skull and the blood-brain barrier. Consequently, infections of the central nervous system are comparatively rare. Material and Methods: This study was starting from January of 2022 to the November 2022, researchers was collected data in a cross-sectional fashion. This research was conducted at the Department of Microbiology at the Ayaan Institute of Medical Sciences in Moinabad, Telangana. Results: This research shown that brain abscesses might manifest at any age. The most vulnerable age range was between 11 and 20. Nonetheless, the peak incidence rate was between the ages of 30 and 40. Incidence of this condition occurs between the ages of 30 and 50. According to Sinha et al., 74.89% of their patients were younger than 20. Conclusion: In addition, treating this cluster of risk factors would be more effective if more people knew about the devastating consequences of infections of the scalp, cheeks, ears, and paranasal sinuses. Cyanotic congenital heart disease patients who have not undergone surgery would benefit greatly from a high index of clinical suspicion coupled with prompt treatment

Abstract   Introduction: Throughout ancient times, tuberculosis has posed a serious threat to humankind. Around 150 million years ago is when the Mycobacterium genus was first recognised. Egyptian mummies have been used to show the skeletal malformations caused by TB. Yet, the infectious agent behind this terrible sickness was not identified for quite some time. Material and Methods: Between January 2022 and October 2022, the epartment of Microbiology at the Ayaan Institute of Medical Sciences in Moinabad, Telangana conducted a prospective study. A total of one hundred people were included as part of this study's sample.  Results: Children who had expressed concerns were asked for and given permission to have a sample taken by their parents or legal guardians. Gastric aspirates, broncho-alveolar lavage, induced sputum, sputum, tracheal aspirate, ascitic fluid, lymph node aspirates, pleural fluid, and a synovial biopsy were all included in the collection of specimens. There was complete processing and analysis of all samples. Conclusion: This research was conducted to identify the most efficacious techniques for detecting TB in young people. CBNAAT has an advantage over other methods used to diagnose paediatric TB because it picked up more instances that were overlooked by those other approaches

Introduction: Only 25% of multidrug-resistant tuberculosis (MDR-TB) cases are currently diagnosed. Line probe assays (LPAs) enable rapid drug-susceptibility testing for rifampicin (RIF) and isoniazid (INH) resistance and Mycobacterium tuberculosis detection. Line probe assays (LPAs) are rapid molecular diagnostics that can detect M. tuberculosis and drug resistance. Although LPAs are more technically complex (designed for reference or regional laboratory settings) and take longer to perform than the Xpert MTB/RIF assay, they have the ability to detect isoniazid (INH) resistance in addition to rifampicin (RIF) resistance unlike Xpert MTB/RIF. Methods: This is a Case-control study was conducted over a period of 1 year where MDR-TB and TB patients were treated. TB patients infected with MDR- M. tuberculosis and non MDRM. tuberculosis strain were considered as cases and controls, respectively. Cases and controls were matched by the date of hospitalization. The data was collected using structured questionnaire with face to face interview. Bivariate and multivariable logistic regression analysis (MLRA) was used to identify determinants associated with MDR-TB. Results: Of the 90 samples tested for smear concentration microscopy, 8.9% were smear negative. For the smear positive samples, the following bacillary loads were observed: 1+ in 28 (31.1%), 2+ in 31 (34.4%) and 3+, 3 (3.3%). 4B, 5B and 10B were observed in just 13 samples while 6B results were observed in 7 (7.9%) samples. To compare the performance of GeneXpert and LPA on smear positive results, 90 samples were used. GeneXpert detected 53 (58.9%) and LPA detected 77 (85.6%) samples as positive. Of 90 samples tested, Culture MGIT detected M. tuberculosis in 60 (66.7%) samples, GeneXpert detected M. tuberculosis in 51 (56.7%), and LPA detected M. tuberculosis in 60 (66.7%). The 90 Culture MGIT positive samples were subjected to the drug susceptibility testing (DST) against Isoniazid, Rifampicin, Streptomycin and Ethambutol. 9 (10%), 11 (12.2%), 15 (16.7%), and 8 (8.9%) samples were found to be resistant to Streptomycin, Isoniazid, Rifampicin and Ethambutol respectively. 3.3% of the samples were resistant to all the four antibiotics and 96.7 of the samples were sensitive to all the antibiotics.  Conclusion: LPA is a robust technique for diagnosis of drug-resistant TB that has provided the basis for rapid and effective control of drug-resistant TB in India. While the reasons for concomitantly negative LPA and culture results of smear-positive sputum samples from MDR-TB suspects may be many, the possible presence of non-tubercular mycobacteria in these samples and the likelihood of inappropriate therapy in these patients cannot be ruled out. Addition of culture to the diagnostic algorithm may enhance the diagnostic yield

Background:  Asthma attack is the most common respiratory symptom observed and is of great concern. Throughout the world asthma cases are increasing during pregnancy. The major issue is that the control levels of asthma is changing during pregnancy so the management is a little difficult during pregnancy. Objective: The present study was undertaken to observe the prevalence of asthma and respiratory symptoms during pregnancy. Materials and methods: 40 pregnant women attending OPD in the hospital were part of the study after obtaining the written informed consent. Confidentiality of the data was maintained. Willing pregnant women were included in the study. Pregnant women with any other complications severe were excluded from the study. Respiratory symptoms were examined during the general physical examination by an expert physician. Results: The age group of the participants ranges from 22-30 years. 25% of individuals have asthma. 37.5% of individuals have wheeze without cold, 15% of individuals have nasal allergies. 27.5% have shortness of breath. 5% of individuals have a history of smoking. 15% of individuals are currently under the medication for asthma. Conclusion: The present study results explained that wheezing without cold and shortness of breath are the most common respiratory symptoms during pregnancy. Further detailed studies with a higher sample size are recommended to understand better the respiratory symptoms during pregnancy

Background:  Patients with the chronic obstructive pulmonary disorder (COPD) are at risk of developing postoperative respiratory failure. That is the reason they may require artificial respiration for longer periods than others. However, being on mechanical ventilation for a long time leads to lung damage and infections. Objective: The present study was undertaken to observe the relation between the severity of COPD in patients of spinal surgery and the prevalence of respiratory failure. Materials and Methods: 40 patients with COPD who had undergone spinal surgery were part of the study. The data was collected from the medical records department including the demographics, spirometry results, blood gas analysis, comorbidities, postoperative and other variables. The important outcome is a respiratory failure within one week after the surgery. Results: Data was presented in table 1 and table 2. Table 1 presents the demographic and clinical parameters of the participants. Table 2 presents the risk factors for respiratory failure of the participants. A longer duration of anesthesia was required for the mild COPD patients. Comorbidities were present in all levels of COPD patients. Table 2 presents the risk factors for respiratory failure of the participants. Length of stay was longer in patients with severe COPD. Extubating time, and endotracheal intubation after surgery were more in the severe COPD patients. Pulmonary infection is present in all groups of patients. Conclusion: There is no significant relationship between the severities of COPD with postoperative respiratory failure. However, there is a strong need to conduct a prospective study with more defined parameters to understand better these relations. So that better and more effective treatment strategies can be developed

Background:  In India smoking and tobacco dipping are major health problems and one of the largest preventable causes of disease and premature death. Nicotine has been reported to improve attention, learning, reaction time (RT), problem solving, and stimulus evaluation and discrimination. Previous research has established that cholinergic systems are important for cognitive functioning and nicotine is a potent cholinergic stimulant that affects many central nervous system (CNS) pathways, including the auditory pathway. It is a measure of function of sensory­ motor association and performance of an individual. It involves stimulus processing, decision making, and response programming. Material and Methods: This is a Prospective, observational, comparative study was conducted in the Departments of Physiology at Index Medical College. Audio-visual reaction time – Measurement of reaction time is a simple test which is measured by ‘audiovisual reaction time apparatus’ (Anand agency, Pune). Reaction time is a commonly used parameter for measuring implicit learning. In measurement of reaction time subject was asked to respond by pressing the button as soon as he had received the stimulus in the form of sound or light. The apparatus provides both auditory (low and high pitched sounds) and visual (red and green) stimuli. The arrangement consists of a source of stimulus, response key and the time recording device. The response is given by the subject by pressing a key with his index finger. Results: In the present study, in age groups ART values were significantly different (Graph-1) in all three groups, ART and VRT values increase in control, smokers and dipping tobacco users as age advances. As regards ART values, age group 31-40 years differs significantly from age group 11-20 years and 21-30 years (p<0.05), similarly age group 41-50 years differs significantly from age groups 11-20 years, 21-30 years and 31-40 years. As regards, VRT values age groups differ from each other but age group 41-50 years differ significantly from age group 11-20 years and age group 21-30 years.  Conclusion: Significant difference was also observed after smoking and after 12 hours of abstinence in study group subjects. This indicated increased reaction time required for integration process in CNS and delayed conduction in reflex arc after abstinence. Thus, the evidence presented in this article supports that temporary abstinence from nicotine has adverse effect on reaction time which may force them to smoke again. Health education and nicotine replacement therapy may help them to achieve the ultimate goal of complete cessation from smoking.

Background: Chronic Obstructive Pulmonary Disease (COPD) is defined by GOLD as a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases. [1] The most common respiratory symptoms include dyspnea, cough and/or sputum production. These symptoms may be under-reported by patients. Material and Methods: This is a Prospective, observational, comparative study was conducted in the Departments of Physiology at Index Medical College. The sample size for this research study was calculated on the basis of prevalence of abnormal left and right ventricular dysfunction of 25% in known patients of COPD at 95% confidence interval and an absolute precision of 10%. Right atrial Pressure (RAP) was estimated from the evaluation of the inferior vena cava during respiration. If the inferior vena cava diameter is normal and the segment adjacent to the right atrium collapses by at least 50% with respiration, then right atrial pressure is estimated as 5 mm Hg. Results: Number of males is slightly higher than females in the study group. But there was no significant difference in sex between the study group and the control group. There is no significant difference in age between COPD and control group. The minimum age of the patient was considered to be 35 because COPD is usually a disease of middle age and is less likely below 35 years. The mean difference in FEV1 in the study group is 1.03±0.31 and in control group is 4.23± 0.91. By applying student t test, p value was found to be significant between the two groups. The mean difference in FVC is 2.03±0.34 in COPD group and 4.61±0.88 in the control group. P value was significant between the two groups. The mean difference in the FEV1/FVC in COPD group was 53.15±9.99 and control group was 83.88±6.66. p value was significant. Conclusions: This study on clinically stable patients with COPD with a wide range of severity of airways disease provides evidence of subclinical RV dysfunction and suggests that cardiovascular comorbidities may begin early in COPD and are often occult. RIMP and RV basal strain showed largest difference between controls and COPD cases irrespective of the presence or absence of PH

Background:  Ventilator Associated Pneumonia (VAP) is one of the common nosocomial infections associated with high morbidity due to multidrug resistant pathogens. Rapid spread of resistance to broad spectrum beta-lactams in pathogenic strains causes antibiotics ineffectiveness and increased severity of illness. The CTX-M is the most dominant Extended Spectrum β Lactamase (ESBL) among Enterobacteriaceae in many regions of the world. The aim of the study was to identify the occurrence of ESBL. Materials and methods: This prospective study was conducted in the Department of Microbiology, Shadan Institute of Medical Sciences Teaching Hospital and Research Center. A total of 300 consecutive urine samples were screened from patients with symptomatic UTI. Clean-catch midstream urine samples were collected in sterile disposable container and processed within one hour. Semi quantitative loop measuring 2.2 mm diameter with a holding capacity of 0.005 ml was employed to culture urine on CLED agar and MacConkey’s agar. The inoculated plates were incubated over night at 37oC. Isolates in significant number (colony count ≥ 105 CFU/ml) was identified by standard procedures. Results: In our study high susceptibility of meropenem (74.3%) and imipenem (100%) was seen and least was  Ciprofloxacin 41.4%. Double disc synergy test and Inhibitory potentiated disc diffusion Test screening test for ESBL production, 70 (43.7%) isolates were resistant to at least one of the three representative cephalosporin drugs. The highest resistance was observed with cefpodoxime (n=57; 40.1%) followed by ceftazidime (n=52; 37.9%) and cefotaxime (n=39; 28.4%). Out of the three cephalosporins tested in the study, ceftazidime was found to be the better antibiotic drug for the identification of ESBL production by both Double disc synergy test and Inhibitory potentiated disc diffusion Test. Conclusion: This study showed that the ESBL‑positive isolates were more resistant to some first‑line antibiotics, and this highlights the necessity to control and monitor the prescribed antibiotics used for empirical treatment for UTI patients.

Objective: To evaluate the interaction between Thyroid hormones and Glucose homeostasis in post menopausal Diabetic and Non-Diabetic women. Materials and Methods: The study was conducted in the Department of General Medicine, Sapthagiri Institute of Medical Sciences & Research Center, Bangalore. 40 Post menopausal Non-diabetic women attending OPD, Department of Medicine. Anthropometric & Physiological parameters were taken. Complete blood picture count, Fasting blood glucose(FBS),Glycosylated haemoglobin(HbA1C), Oestradiol, progesterone, Follicle stimulating hormone(FSH), Luteinizing hormone(LH) levels were analyzed

Introduction: In India, diabetes is turning into an epidemic as currently, more than 62 million individuals suffer from the disease. To our knowledge, very few studies have evaluated the correlation between lipid profiles and glycated hemoglobin (HbA1c) in newly diagnosed type II diabetes patients with hypertension. The early detection of lipid abnormalities in these patients will help prevent the cardiovascular outcomes

Introduction:   Spinal anaesthesia (or spinal anesthesia), also called spinal block, subarachnoid block, intradural block and intrathecal block is a form of neuraxial regional anaesthesia involving the injection of a local anaesthetic or opioid into the subarachnoid space, generally through a fine needle, usually 9 cm (3.5 in) long. It is a safe and effective form of anesthesia usually performed by anesthesiologists that can be used as an alternative to general anesthesia commonly in surgeries involving the lower extremities and surgeries below the umbilicus. Epidural anesthesia is a technique that may be used as a primary surgical anesthetic or as a resource for postoperative pain management. It is safe and relatively easy to learn and perform. Material and methods: This are a prospective study was conducted in the Department of Anesthesia at Khaja Bandanawaz Institute of Medical Sciences, Kalaburgi over a period of 1 year. Spinal anaesthesia was given under all sterilised precaution, 3 ml of 0.5% bupivacaine heavy using a 25-gauge Quincke’s spinal needle through the L3-L4 intervertebral space in the sitting posture. Before giving the local anaesthesia, each patient throughout the technique asked to report verbally any time if he feels distress. Results: Duration to perform the procedure was significantly longer with epidural than spinal block. Intraoperative fluid requirement was statistically higher in Spinal than Epidural (p<0.0001). Duration of Surgery was significantly shorter in Spinal as compared to Epidural (p=0.0019). Systolic and mean blood pressure showed statistically significant reduction in Spinal as compared to Epidural (p<0.001). Duration of ambulation was significantly shorter in Epidural as compared to Spinal (p<0.001). Conclusion: Epidural anaesthesia can be a safe alternative to spinal anaesthesia for elective inguinal hernia repair.

Background: Mupirocin is a powerful topical antibiotic for treating carriers of MRSA. Resistance to this medication has grown as a result of its frequent use in clinical settings and over-the-counter accessibility. Concern is also raised by Staphylococcus aureus having Mupirocin resistance. Materials and Methods: It is a cross sectional study conducted in in Department of Microbiology during the period of May 2016 to April 2017. 1200 patients were selected in the study. Out of which, 400 patients were inpatients, 400 patients from community and 400 were from health care workers

Introduction: Escherichia coli serogrouping is used as a conventional method for pathogen characterization and diagnosis. As diarrheal disease is generally self limiting, antidiarrheal agents are not usually recommended for treatment of diarrhea. Escherichia coli is enormously versatile bacterium which elaborates its commensal and pathogenic potential in human host. Diarrheagenic E. coli (DEC) is reported as one of the leading causes of gastrointestinal disorders worldwide and signified as an important issue to address in public health

Background: Tuberculosis is a major public health issue worldwide. Tuberculous lymphadenopathy is the most common kind of extrapulmonary tuberculosis (EPTB), accounting for 35% of all EPTB cases. Methods: This observational study was carried with the aim of the present study was to study the various clinical presentation of Tuberculous cervical Lymphadenopathy. A pre structured proforma was used to collect base line data, detailed history with clinical examination was done

Background: The kidneys expel uric acid (UA), the byproduct of purine hydrolysis. The enzymes xanthine oxidase and xanthine dehydrogenase are in charge of the generation and breakdown of uric acid. Both enzymes participate in the production of oxygen free radicals, which increases oxidative stress, by catalysing the conversion of hypoxanthine to xanthine, which is the primary enzyme in purine metabolism

Introduction: There is a great uncertainty on disease progression in COVID-19. Multiple factors play a role in progression of disease to severe form and these factors are not uniform in all patients. There are multiple ongoing researches for the early prediction of outcome using various prognostic factors. Aim: To study the association of Clinical parameters, Neutrophil-Lymphocyte Ratio and CT severity score of COVID-19 patients with Mortality

Introduction: Guillian Barre syndrome (GBS), also known as Landry's paralysis1, is an immune-mediated disorder of nervous system, of acute or subacute onset characterized commonly by generalized progressive weakness of lower limbs and upper limbs, limb paraesthesias and relative or complete areflexia

Background: Neonatal hyperbilirubinemia is a frequent illness that occurs in newborns during their first week of life. Due to social reasons, such as an early naming ceremony, the risk of nosocomial infections, and financial constraints, early discharge of healthy term neonates is a typical practice. Neonatal hyperbilirubinemia is the most frequent reason for readmission in a sizeable number of neonates. Early discharge of healthy term neonates is a worry because there have been reports of bilirubin-induced brain injury and its sequelae, like kernicterus. Early hyperbilirubinemia detection in neonates is crucial, for this reason. Aims and Objective: To study the efficacy of cord blood albumin as a predictor of neonatal jaundice and to study their association with significant hyperbilirubinemia requiring further intervention. Materials and methods: The prospective study conducted in Department of Pediatrics at Rajshree Medical & Research Institute, between 15 January 2021 to 14 January 2022. Cord blood was sent for albumin analysis and fourth day venous sample was sent for serum bilirubin and blood group analysis. Results: This study enrolled 119 term neonates. Out of which 15 neonates had albumin level less than 2.9mg/dl, 61 neonates between 2.9mg/dl-3.3mg/dl and 43 neonates above 3.4mg/dl. Out of total study subject enrolled 11.8% required intervention like phototherapy. Conclusion: From this study, cord blood albumin level was demonstrated as predictive marker for neonatal hyperbilirubinemia with a sensitivity of 60%

Background: Burst Abdomen is a preventable condition in which many risk factors play their role and lead to life threatening complications. This study's goal was to evaluate the incidence and risk factors, of burst abdomen in patients receiving midline laparotomies. Patients and methods: 240 patients who underwent midline laparotomies at Government Medical College in CENTRAL INDIA between January 2021 and December 2021 were the subjects of a prospective cohort research. Online available Software was used to monitor and analyse factors including age, sex, BMI, substance abuse, previous laparotomy, malignancy, diabetes mellitus, ascites, albumin, renal functions, bilirubin, haemoglobin, intra-abdominal pathology, suture material, creation of stoma, postoperative chest infection, postoperative paralytic ileus, leakage, and wound infection. Results: Incidence of burst abdomen was 11.25% among patients who underwent laparotomy. The following statistically significant factors (P<0.001) were linked to burst abdomen: wound infections, anaemia, uncontrolled diabetes, hypoalbuminemia, previous laparotomy, development of stoma, chest issues, ascites, postoperative cough, postoperative leakage, and peritonitis. In this investigation, we did not find any statistically significant relationships between patient sex, age, concomitant morbidities including jaundice and uremia, past steroid use, suture material utilised in closure, and postoperative paralytic ileus. Conclusion: According to the results of our study, significant risk factors for burst abdomen included wound infection, anaemia, previous laparotomy, stoma creation, hypoalbuminemia, ascites, diabetes, type of intra-abdominal pathology, with maximum incidences in peritonitis, postoperative cough, and postoperative leakage

Background: The present study was done with the aim to investigate the clinical, pathological, and epidemiological features of women diagnosed with benign breast disease. Material & Methods: This was an outpatient clinic-based, single-centre, descriptive, observational study conducted at the Department of General Surgery, JK Hospital affiliated with LN Medical College, Bhopal from December 2019 to November 2021. Data was coded, entered in Microsoft Excel and then imported into Stata 15.1 version for analysis. Results: In the present study, a total of 90 participants were enrolled. The most common benign breast disease was fibroadenoma (65.6%), followed by fibroadenosis (17.8%), mastalgia (5.6%), duct ectasia (4.4%), breast cyst (3.3%), breast abscess (2.2%) and galactorrhoea (1.1%). About 83.3%, 21.1%, and 4.1% of the women said that their chief concern was pain in the breast, a lump in the breast and discharge from the nipple, respectively. Most women had breast problem(s) limited to only one breast (unilateral) (92.2%) while only 7.7% of women complained of breast symptoms in both of their breasts. The breast problem was located most in the right breast. Most of the women had symptoms located in their upper outer quadrant followed by lower outer quadrant, upper inner quadrant, and lower inner quadrant. Conclusion: The study concluded that the most common benign breast disease was fibroadenoma, followed by fibroadenosis and most women complained of breast complaints in the upper outer quadrant of the right breast

: Introduction: The practice of breast feeding in India is influenced by various social, cultural, economic factors and religious beliefs but maternal infant feeding attitude has been shown to be a stronger independent predictor of breast feeding initiation and associated with continuing to be breast feeding longer and have a greater chance of success. The present study was carried out to assess knowledge, attitude and practice of breast feeding among post natal mothers in rural area and to assess the factors affecting breast feeding practices. Methods: A community based cross sectional study was done among 100 postnatal women of rural field practice area (RHTC) of a medical college, Tirupati, to explore the knowledge, attitude and practice of breast feeding and the factors influencing breast feeding practices. Mothers were interviewed using pretested questionnaire at their residence regarding socio demographic data, variables related to medical care during pregnancy, delivery and post natal period, Knowledge on breast feeding, Attitude by IIFA Scale and data related to Practice of breast feeding were collected. Data entered in MS Excel and analysed by using IBM SPSS Version 26. Results: Majority (99%) of women had knowledge that Colostrum maintain immunity, 97% had knowledge that Breast feed can be given up-to 2 years, 94% had knowledge that Wash breast with warm water before feeding. Majority of women had positive attitude towards breast feeding (Mean attitude score was 60.34 (1.98). Majority of women initiate breast feeding after one hour (65%), Only 2% were discarded colostrum, 80% of them were exclusively breastfeed for 6 months or more. Majority of daily wage labourers (33.3%) and Muslim mothers (66.7%) were given pre-lacteal feed compared to other groups. This was statistically significant. Conclusion: The participants have good knowledge and attitudes toward feeding, but their breast feeding practises do not correspond to their knowledge levels, which indicates a need for improvement in the breast feeding instruction and counselling of women

Background: Studies have demonstrated that red blood cell distribution width (RDW) is closely associated with the prognosis of patients with chronic obstructive pulmonary disease (COPD). In addition, the dynamic changes in RDW appear to play an important role. Thus, we aimed to investigate the relationship between dynamic changes in RDW and 30- day all-cause readmission of patients with acute exacerbation of COPD (AECOPD). Methods: This is a prospective and observational study was conducted in the Department of Pulmonary Medicine, J J M Medical college, Davangere Patients hospitalized for AECOPD between April 2020 to March 2021 were revised. Clinical and laboratory parameters were noted. Participants were followed to determine the incidence of readmission due to AECOPD, readmission from any cause and composite end point of readmission or death during 60 days after discharge. Result: Maximum patients in both groups were found in>60 years age group. The mean age in AECOPD group was 66.75±10.35 years and in Stable COPD was 65.31±11.25 years. Both groups were comparable. Maximum patients in both groups were presented with cough and breathlessness. Maximum patients in AECOPD group was from GOLD stage 4 and in stable COPD was also from GOLD stage 4. The difference in both group was foundstatically significant. Mean FEV1% significantly lower in AECOPD patients (43.87±14.26) as compare to stable COPD patients (50.15±22.22). The difference in both groups was found statistically significant. Mean RDW was significantly higher in AECOPD (19.65±7.75%) as compare to stable patients (15.85±5.55%). The difference in both groups was found statistically significant. Conclusion: Prolonged hospital stay was closely associated with increased RDW on admission in AECOPD patients. Elevated RDW may be an independent predictor for prolonged hospital stay in AECOPD patients

Background : The dual forms of malnutrition is characterized by the coexistence in a population of underweight and overweight. In India evidence suggests presence of both forms of malnutrition not only in adults but also in adolescents. The present study was done in Ghaziabad with an aim to gauze the presence of both forms in adolescent going to schools. Methodology - The present cross-sectional survey was conducted among 1128 school-going adolescent students (10–19 years) in Ghaziabad district of Uttar Pradesh. Multistage sampling technique was used to study 1128 study population. Anthropometry and a structured questionnaire were used as study tool. Results- The most frequently reported dietary deficiency was underweight at 21.6 percent, followed by overweight at 10.7 percent and obese at 9.5 percent. (3.6 percent).We had 620 boys and 508 girls as participants in our study sample.We found 35% of adolescents as having both forms of malnutrition. Conclusion- Our study highlights the presence of both forms of malnutrition among adolescent school going population. Our study also reinforces the latest trend in adults in country which might be a continuation of the features of malnutrition in both forms found. Adolescence is the future also for coming adults in country and if we have more number of adolescents malnourished we will have more problems due to the number of health and other issues malnutrition poses at all ages

Introduction: Magnitude of malnutrition problem among children under 5 years is high throughout India. Inadequate feeding practices, in combination with other factors such as infection, may account for 1/3 of all malnutrition cases. On other hand, low MUAC (<11.5cm) is not only suggestive of severe wasting or severe acute malnutrition but also indicative of morbidity and risk of mortality. The present study was carried out to determine the prevalence of malnutrition and its associated factors among 24 to 60 months aged children in urban field practice area of a medical college in Tirupati, Andhra Pradesh. Methods: This community based cross-sectional study was carried out among 282 children aged 24 to 60 months in UHTC area of a medical college in Tirupati city. Nutritional status was determined using MUAC. Water, sanitation and hygiene practices; child feeding practices and other associated factors were noted in the questionnaire. Data was entered and analyzed using IBM SPSS 26 version. Results: The total prevalence of malnutrition was 13.1%, of which mild to moderate malnutrition and severe malnutrition were 11.7% and 1.4% respectively. About 19% of the children were malnourished who were not utilizing anganwadi services and there was a significant association found between utilization of anganwadi services and malnutrition (p=0.05).Conclusion: Although prevalence of malnutrition was low compared to other studies, this should be addressed through appropriate community based strategies for halting long term sequel of malnutrition among pre-school children

Introduction: Mandible also known as the largest and inferior, primary facial bone of the face giving a curved shape to it. It changes its shape and gives variations to the bony structure of the face from birth till older age. Mental foramen is known as the vintage of the mandible and is an important mark of the face for carrying out many diagnostics and surgical processes along with aesthetic procedures of the face. Thus, the present study is designed with an aim to get insight knowledge of position and shape of mental foramen in dry adult human mandible. Material and Method: Totally, 60 bones were studied in 2 years duration. The study was carried out in the Department of Anatomy Tertiary Care Teaching Hospital over a period of 1 year. The position of mental foramen was studied using an instrument known as digital Vernier Calliper (in mm) while shape was analysed visually. Position of mental foramen was calculated using Statistical package for social sciences (SPSS) software. Results: The present study showed that the position of mental foramen from symphysis menti and posterior border of ramus of mandible was more from right side than left side and found to be insignificant while position of mental foramen from inferior border of body of mandible was more from left side than right side and found to be insignificant for right side while significant for left side. The shape of mental foramen from right side was found to be (Oval shape- 68.33% and round shape – 31.66%) while for left side was found to be (Oval shape- 71.66% and round shape – 28.33%). Conclusion: Hence, mental foramen plays a pivotal role in performing major facial surgeries and is an important landmark for several facial procedures performed

Objective: India has the world’s largest number of diabetics. Non-traumatic lower limb amputation is the most common devastating complication of diabetes, primarily due to diabetic foot ulcers (DFU) and diabetic foot infections (DFI).

Introduction: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by altered bowel habits and recurrent abdominal pain. The Rome III criteria are the main mainstay for its diagnosis. The reliability on any biochemical markers is reduced provided all warning signs have been excluded. The aim of our study was to assess the prevalence of IBS among medical students in our region (Western Punjab) and to investigate the lifestyle, sociodemographic and clinical factors associated with IBS. Materials and Methods: A cross sectional study was conducted among Indian medical students. Participants (first- to fifth year medical students from different courses) were invited to complete an anonymous questionnaire addressing social, demographic and clinical characteristics. 456 medical students were recruited in this study. Rome III criteria were used to identify patients with IBS. This questionnaire was used to gather baseline information like the family history of irritable bowel syndrome, socio-demographic data, history of chronic disease, previous diagnosis of IBS, daily sleep hours, smoking, food habits etc. Results: This study included 268 male medical students and 188 were female medical students. Approximately two third of the (69.2%) were in the age group 21 to 24 years and 26.3% had the age between 18 and 20 year and very few among age group of 24-27 years. IBS was diagnosed among 276 out of 456 participants based on Rome III Criteria. The profiles for symptoms were characterized by constipation predominant (IBS-C) (45.6%), diarrhea predominant (IBS-D) (44.7%), and others as mixed type (9.7%). The prevalence of IBS was reported as 72.3% among the female medical students studying at various medical colleges in Punjab and 53.7% among male students. Conclusion: In conclusion, 60.5% of medical students, in this study, met the Rome III criteria for IBS diagnosis. Risk factors for IBS among them included depression, anxiety, low fruits and vegetables intake, taking caffeine and any chronic medication’s intake

Introduction: Type 2 Diabetes mellitus (Type 2DM) is chronic, lifelong progressive metabolic disease characterized by hyperglycaemia due to absolute or relative insulinopaenia. Monotherapy with Metformin, a biguanide agent acts primarily as an insulin sensitizer. Its primary clinical site of action is in the liver, improving hepatic insulin sensitivity and as a result, decreasing hepatic gluconeogenesis. Sitagliptin is an oral, highly selective dipeptidyl peptidase-4 (DPP-4) inhibitor for the treatment of patients with Type 2 Diabetes Mellitus. Sitagliptin inhibits the enzymatic degradation and inactivation of glucagon-like peptide-1 (GLP-1) and glucose dependent insulinotropic peptide (GIP) by DPP-4 the major incretins involved in glucose homeostasis, thereby increasing insulin release and lowering glucagon secretion in a glucosedependent manner. Material and Methods: This is an Open label, Randomized, Parallel group, Comparative and Prospective clinical study. Study was conducted in Type 2DM patients attending the outpatient department of Medicine in tertiary care center. Inclusion criteria: Patients of either sex having age group between 30 -60 years, Patients willing to participate and willing to give written informed consent prior to any study-related procedures and to comply with the requirements of the study protocol. Patients having newly diagnosed Type II DM with prandial blood glucose levels >180 mg% and <250 mg%. HbAlc in the range of 6.5 to 8.5 % at screening and BMI >27 kg/m2 Results: The mean fasting blood glucose level in Group I at baseline was 150.81±11.61 mg/dl, in Group II was 151.92±10.44 mg/dl and in Group III was 150.53±11.64. The mean fasting blood glucose level in Group I after 3 months was 99.73±9.91 mg/dl, in Group II was 92.72±9.82 mg/dl and in Group III was 85.72±9.82 mg/dl. These was statistically highly significant difference in mean Fasting Blood Glucose level at baseline versus after 3 months in Group I, Group II and Group III (p<0.0001). The mean of HbA1c level was 9.61±1.91% at baseline and 8.99±1.82% after 3rd month. In Group II the mean of HbA1c level was 9.61±1.83% at baseline, 8.65±1.73% after 3rd month. In Group III the mean of HbA1c level was 9.64±1.81% at baseline and 8.44±1.73% after 3rd month. Conclusion: Sitagliptin with Metformin causes efficient glycaemic control with less significant adverse reaction but the gylcaemic control of patients taking Sitagliptin with Metformin was slightly better as compared to patients taking alone. Thus, concluding Sitagliptin with Metformin to be more efficacious than alone

Introduction: Heart failure (HF) is a clinical syndrome that occurs in patients who, because of an inherited or acquired abnormality of cardiac structure and or function, develop a constellation of clinical symptoms (dyspnea and fatigue) and signs (edema and rales) that lead to frequent hospitalizations, a poor quality of life, and a shortened life expectancy. UA is the final product of purine metabolism and hypoxic states cause an elevation of the serum UA level. Cell death, tissue hypoxia, and impaired metabolism in HF increase XO activity, leading to an overproduction of UA. Aim: To study correlation of uric acid levels with ejection fraction in heart failure patients (both acute & chronic). Materials and Methods: This is an observational study conducted at tertiary care Teaching Hospital over a period of 1 year. All patients who are admitted with symptoms and signs of Heart Failure in the wards like Intensive Care Unit, Acute Medical Care, Intensive Cardiac Care unit, Medical Wards, Cardiac Wards both paid and general rooms were recruited in the study. The sample size was 100 patients after evaluation by clinical and 2D echocardiography findings. Patients with signs and symptoms of Heart Failure and by satisfying inclusion and exclusion criteria were recruited. Results: A total of 100 patients with heart failure and ejection fraction less than 50 who presented to the department of general medicine. 26 male patients had ACS as the precipitating cause of heart failure compared to 29 female patients. In the present study the range of uric acid was observed between 7.1 – 10 mg/dl, the mean uric acid levels were observed to be 8.6 ± 0.67. In the present study, the range of Ejection fraction was observed between 28 – 48%, the mean ejection fraction was observed to be 34.8 ± 6.65. In the present study, it was observed that there was a significant and inverse correlation observed between uric acid levels and ejection fraction r = -0.808 p<0.001. Conclusions: The analysis of correlation conclusively proves that when serum uric acid is more than 7 mg / dl, then either RWMA or Global hypokinesia positive OR LVEF < 50 % in heart failure patients. The analysis also proves that serum uric acid levels are more in the severe functional disability patients (NYH III AND IV). This implies that Uric acid levels can be used as a marker for cardiac

Objective: (1) To define the role of ultrasonography and Paracentesis in deciding the treatment plan (conservative/operative) in blunt abdominal trauma. (2) To find out the specificity and sensitivity of ultrasonography and Paracentesis in blunt abdominal trauma. Design: Prospective study. Setting: VSSIMSAR. Period: From December 2012 — December 2014. Materials and methods: Seventy Five patients irrespective of age, sex and mode of blunt injury included in the study. All the patients presented in emergency ward with blunt trauma abdominal underwent ultrasonography & Paracentesis. Results: In 66 out of 75(88%) patients, the abdominal ultrasonography showed positive findings with the sensitivity of 82.7%, the specificity 89% and accuracy 90.9%. Paracentesis was positive in 55 patients out of 66 (83%) with 97% sensitivity, 73% specificity and 89%accuracy. Conclusion: Paracentesis is as effective as ultrasonography to pick up the intra-peritoneal fluid in the assessment of blunt abdominal trauma patient but with slightly less sensitivity, specificity and accuracy

Background: The most prevalent cause of hair loss in men is androgenetic alopecia (AGA), which has few available treatments. One of the more recent treatment options for the management of AGA that has produced encouraging outcomes is platelet-rich plasma (PRP) therapy. Aims and Objectives- the efficacy of PRP versus topical 10% minoxidil and microneedling in the treatment of androgenic alopecia and study the safety profile of these modalities. Materials and Methods: A prospective study was conducted in Department of Dermatology, Dr SN Medical College Jodhpur, 90 male patients with grade III to VI were randomly divided in three groups. Group 1: Platelet Rich Plasma. Group 2: 10% Minoxidil. Group 3: Microneedling. Results: The mean patient age in the current study was 36.03 years for PRP, 33.56 years for Minoxidil, and 35.9 years for the microneedling group. The mean hair thickness increased by 2.26 micron in PRP group, 8.76 micron in minoxidil group and 1.77 micron in micro needling group. The mean hair density of the patients in all groups increased statistically significantly. Conclusion- Overall, PRP can be considered an effective modality to begin treatment in patients to be supplemented with minoxidil if hair loss progresses. Microneedling can be used as a lone modality in patients or an additive therapy with PRP. In addition to its own action, it would help promote penetration of other therapeutic agents. Combining the following therapies can stimulate hair growth and halt hairloss for a while. These are effective before hair transplant surgery

Background: Malnutrition is an important and major public health problem in a developing nation like India. Keeping this in mind, a study was conducted to determine the proportion of under-five children with malnutrition among hospitalised under-five-year children and to examine co-morbid diseases and epidemiological factors associated with malnutrition. Methods: This was a hospital-based cross-sectional study conducted in the paediatric ward of a tertiary care hospital in Koraput, Odisha. All children under the age of five years suffering from malnutrition were admitted in the hospital over a period of 1 month were included in the study. Results: The total number of children under the age of five diagnosed with malnutrition was 72 (40.4%). Moderate and severe/very severe malnutrition were statistically significantly higher in the girl child. The proportions of moderate and severe/very severe malnutrition were higher in low-birth-weight babies, i.e., children who were incompletely immunised due to age. Incorrect infant feeding practice was observed in 41 (56.9%) children. Some of the co-morbid conditions that contributed to the morbidity of the malnourished child were acute diarrhoea, acute respiratory infections, anaemia, and septicemia. Conclusion: A large proportion of the hospitalised children were malnourished. Girls suffered from moderate to severe malnutrition compared to male children, which was the only statistically significant association. This may be due to the negligence of a girl child

Introduction: Eclampsia has been recognized as a clinical entity since the time of Hippocrates; and has been a nightmare to healthcare providers ever since. It is defined as the occurrence of generalised convulsions associated with preeclampsia during pregnancy, labour or within 7 days of delivery and not caused by epilepsy or other convulsive disorders. The incidence of eclampsia has often been viewed as an index of civilization in a country. There is low utilization of both antenatal and intrapartum care services and the patients may present to the hospital only as a last resort. Materials And Methods: This is a Prospective Study was carried out at the Department of Obstetrics and Gynecology at Tertiary Care Teaching Hospital over a period 2 years. All patients presenting with eclampsia during the said period were recruited into the study. All patients presenting with eclampsia during the said period were recruited into the study. Eclamptics are usually admitted directly into the labour ward. Patients who were diagnosed with other causes of convulsions in pregnancy like cerebral malaria and epilepsy were excluded from the study. A total of 821 pregnant mothers with eclampsia admitted in the inpatient department of the tertiary care teaching hospital were recruited for the study, irrespective of their previous antenatal check up history. Results: Majority (66%) of the patients had between 2 to 5 episodes of convulsion. The MINIMUM number was 1 episode of convulsion , seen in 13 % of the patients. The MAXIMUM number of convulsions was 40. Of the 66 patients who had had more than 10 no. of convulsions , 30 had not received any treatment prior to referral, while there were no patients who had had more than 10 no. of convulsions after receiving the Loading Dose of MgSO4. For patients having less than 5 no. of convulsions , the number of patients having received only the IM Dose of MgSO4 was 1.5 times those having received the Loading Dose.(228/154 =1.48) In 29% of the patients, Hypertension was controlled by delivery alone. Those who failed to achieve a control of BP by Delivery alone were administered Calcigard (Nifedipine). Conclusion: Eclampsia was noted to be commoner among the young primigravida patients. The importance of this finding is that this group of patients deserve extra surveillance during antenatal care in terms of monitoring their blood pressure and screening their urine for proteinuria to detect pre-eclampsia. It is hoped that such interventions will have positive impact on maternal and child care. However, all this will go in vain unless health care providers at the grassroot levels are sensitised regarding the early diagnosis of Pre eclampsia and prompt and appropriate initiation of treatment

Introduction: The measurement of handgrip strength (HGS) is an indicator of an individual’s overall strength and can serve as a predictor of morbidity and mortality. Aims: To measure the relationship between Hand Grip Strength with anthropometric variables in healthy school going children between6-12 years. Materials & methods: The present cross-sectional study with 840 patients was based on 6 schools in the city of Hyderabad, from June 2020-Dec 2021 with School going children of age 6-12 years. Results: Males in all the 7 age groups were shown to have significantly higher hand grip strengths than the female children. There was gradual and significant increase in grip strength with age for both the genders (p <0.001). Height and weight were also positively correlated with hand grip strengths for both males as well as females (p<0.001). Conclusion: Hand grip strength measurements were shown to be positively and statistically correlating with age, height and weight

Introduction: Hypothyroidism is associated with decreased thermogenesis, decreased metabolic rate, and has also been shown to correlate with a higher body mass index (BMI) and a higher prevalence of obesity. There is clinical evidence suggesting that even mild thyroid dysfunction in the form of subclinical hypothyroidism is linked to significant changes in body weight and represents a risk factor for overweight and obesity. It has been further noted that small variations in serum TSH caused by minimal changes in Thyroxin dosage during replacement therapy are associated with significantly altered resting energy expenditure in hypothyroid patients. Methods: This is a prospective study conducted in the Department of General Medicine, Shadan Institute of Medical Sciences Teaching Hospital and Research Centre over a period of 1 year among 60 subjects. The variables collected were gender, age, thyroid dysfunction etiology, TSH levels, free levothyroxine (FT4) levels, presence of thyroid autoimmunity (considered as detection of anti-thyroperoxidase antibodies and/or TSH receptor antibodies), BMI and weight at the time of referral to the Department and after normalization of thyroid hormone levels after treatment. Result: T3 and TSH of control group (2.32±0.21, 83.54±8.35) respectively. In the mean of them in the second visit (1.35±0.11, 36.23±16.24) respectively in comparison with control group. The correlation between T3 and T4 in the first visit which revealed that there was strong positive correlation (r=0.432) with a highly significant difference (P=0.00). Correlation between T3 and TSH in this table showed that there was a weak negative relationship (r =-0.103) with a non-significant difference (P=0.325). In correlation between T4 and TSH there was a weak negative correlation (r= -0.024) with a highly significant difference (P= 0.542). Between T4 and BMI there was a weakly negative correlation (r = -0.019) with a non-significant difference (P=0.431). Conclusion: The number of patients with an elevated BMI (obese) differs significantly from the others. Thyroxin played a part in a lower BMI. Finding hypothyroid patients as soon as feasible is crucial

Background: Fine needle aspiration cytology is a simple, quick and inexpensive method that is used to sample palpable lymph nodes. Objective: To study the role of FNAC in the evaluation of lymphadenopathies. To categorize various lymph node lesions into neoplastic and non-neoplastic lesions. To study the various cytomorphological patterns in correlation with histopathology of various lymph node lesions. To evaluate the sensitivity and specificity of FNAC using histopathology as gold standard. Material and Methods: All patients referred to the Department of Pathology, Dr VRK Womens Medical College and Research centre. RR District, Telangana. for FNAC of palpable lymph node were included in our study. FNAC was done and the standard method for the procedure adopted. All the slides were reviewed and their diagnosis was made. FNAC diagnosis was compared with histopathology in cases which underwent surgical excision and thus it's diagnostic accuracy determined. This was two years prospective study from Jan-2015 to Dec-2016. Results: A total of 150 patients were included in our study, reported to various clinical departments with history of swelling. Lymph node biopsy was done in 55 cases. Statistical analysis was done in 55 cases, where FNAC diagnosis was correlated well with histopathological diagnosis. Maximum number of cases were in the age group of 21-40 years. Our study showed female preponderance of cases. Cervical group of nodes were most commonly involved. Benign lymphadenopathies were diagnosed in 72.67% of cases. Maximum number of cases being granulomatous lymphadenitis (50.46%). Metastatic deposit was diagnosed in 23.33% of cases. Most common subtype being adenocarcinoma (54.3%). Lymphoma were diagnosed in 06 cases (4%). The overall correlation between FNAC and histopathology was 98% (54 out of 55). Conclusion: FNAC is an accurate, sensitive, specific and cost-effective procedure in the diagnosis of lymphadenopathies

ackground: Diabetes is a major causative risk factor for the development of ACS & the adverse outcome after ACS. ‘Stress hyperglycaemia’ has been defined in different ways by various studies. Transient hyperglycaemia has been recognized as a noticeable feature in ACS and is related to stress (Lakhdar et al., 1984).[1] Glycosylated haemoglobin is thus useful to differentiate between stress hyperglycaemia diabetes mellitus. Glycosylated haemoglobin has more sensitivity and specificity for diagnosing diabetes in acute myocardial infarction patients, than admission hyperglycaemia

Introduction: Some studies have reported an association between ischaemia of the macula as seen on fundus fluorescein angiography (FFA) with diabetic nephropathy in diabetes mellitus. They have further postulated that finding of macular ischaemia on FFA can be used to predict the onset of diabetic nephropathy in diabetes mellitus. This study was undertaken to explore association between macular ischemia and nephropathy in diabetes mellitus in a rural population of Maharashtra. Aims and objectives: To explore for any correlation between ischaemic maculopathy due to diabetes and diabetic nephropathy and to find out whether ischaemic maculopathy can be used as a marker for diabetic retinopathy.

Background: The Background of the study is to find out whether a panel of miRNAs from the serum of patients could be used as a biomarker for non-invasive diagnosis of endometriosis. Objective: A panel of miRNA 125b, miRNA150-5p, miRNA 342-3p, miRNA 3613-5p and Let-7b were studied in both control group who are found to be non-endometriotic patients and in the study group proven to be endometriotic patients

ackground: While COVID-19 per se does not seem to represent a significant threat to the paediatric population, the pandemic has caused indirect detrimental consequences in the management of children in paediatric intensive care units (PICUs). This study analyses the impact of the pandemic on PICU admission patterns in a tertiary care centre. Methods: We performed a retrospective observational study of all admissions to PICU during COVID-19 pandemic i.e. from April 2020-September 2021, and compared the data with corresponding pre-covid times.

Background: Early detection of the disease in its latent phase through executive health checkup facilitates timely therapeutic interventions, thereby significantly reducing the associated morbidity, mortality and economic burden. Objectives: To evaluate the physiological determinants of health and disease in executive health checkup. Methods: In this hospital-based, cross-sectional study, a total of 768 individuals aged >20 years, irrespective of their gender, reporting for an executive health check-up were included. Demographic parameters, radiological examinations and psychological wellbeing score were evaluated and compared. Data were analyzed using statistical software R version 3.6.3

Background: Road traffic accidents are as war on the roads and it takes the lives of approx 1.2 million individuals around the world. It is direct effect of modern day urban civilization. Occupied time between the accident and reaching the hospital is life-threatening and that is a very important gap to provide medical first aid to the victims. In urban life, 75% of thoracic trauma follows blunt injury. Greatest difficulty is faced in their management and long time in diagnosis. Hence, objective of study is to get knowledge of the blunt chest injuries among accident victims travelling in different modes of road transportation. Material and Methods: Data was collected from 100 cases of death by road traffic accident that were brought for medico- legal autopsy at the mortuary of Forensic Medicine Department, Rajrajeshwari Medical College and Hospital Bengaluru, during the period from December 2013 to May 2015