European Journal of Cardiovascular Medicine

Introduction: The median artery typically originates as a branch of the anterior interosseous artery. In its normal configuration, it is a small vessel that passes laterally between the flexor digitorum profundus and flexor pollicis longus muscles to reach the median nerve. From an embryological perspective, the median artery represents a remnant of the original axial arterial stem that extends into the limb. The persistence of this embryonic arterial pattern into adulthood, known as a persistent median artery (PMA), is an anatomical variation that has been the subject of numerous studies. The prevalence of PMA has been increasing over time, suggesting a potential microevolutionary change in the human population. Aim of the study:  This study aims to investigate the prevalence and types of persistent median artery in a sample population from Pondicherry, India. Material and Methods: A total of 40 upper limb specimens from 12 cadavers and 16 separate upper limbs were included in the investigation. A vessel accompanying median nerve is considered a median artery. The frequency, origin, termination, type and relation to median nerve and anterior interosseous nerve were noted. Results: The presence of PMA was observed in seven forearms (17.5%), with a slight predilection for the left side (n=4). Common and anterior interosseous arteries are the source of PMA. All the PMA are of antebrachial type and none of them reached the palmar arches. Notably one PMA crossed the anterior interosseous nerve anteriorly and the other one posteriorly. Conclusion: Knowledge of the prevalence and anatomical variations of PMA is crucial for clinicians, as it can have significant implications in the diagnosis and management of carpal tunnel syndrome and other wrist pathologies. Additionally, awareness of PMA is essential for surgeons performing procedures in the carpal tunnel region to avoid potential complications.

Background: "Stroke" is a generic term meaning sudden onset of a neurologic event and is also called cerebrovascular accident or "brain attack". It is one of the leading causes of death globally and is a significant cause of long-term disability. Magnetic resonance imaging (MRI) provides critical information in acute stroke that can be used to confirm the diagnosis and direct both acute therapeutic interventions and long-term treatment decisions. MRI can identify regions of hemorrhage, active ischemia, and vessel occlusion. This has made SWI a powerful technique in the evaluation of stroke patients. Materials and Methods: This is a Cross-sectional study was done in the Radiology Department, Subbaiah Institute of Medical Sciences over the period of 1 year. All clinically suspected patients with a neurological deficit (signs and symptoms like dysphasia/aphasia, hemiparalysis/hemiparesis, ataxia, convulsions) were referred by a neurologist, physicians for MRI brain in medical college and general hospital. Results: In this study, out of the 125patients, 115 patients (92%) had infarcts in the arterial territory, and 10 patients (8%) had venous infarcts. Hemorrhage was detected in 42 patients (33.6%), of which 33 cases were arterial infarcts and 9 were venous infarcts. Hemorrhage was seen in 27(35%) out of 77 male patients and 15 (31.2%) out of 48 female patients. Hypointense blooming was not seen in 83 patients (66.4%) in this study. Occlusion in TOF-MRA was seen in 25(21.7%) patients out of 115 patients. Susceptibility vessel sign is seen in 20 patients out of 25 patients showing occlusion in TOF-MRA. Loss of flow void on T2 indicating thrombus in the vessel was seen in 5 patients. Conclusion Susceptibility weighted imaging is superior than conventional MR imaging in the detection of haemorrhagic transformation of infarct. SWI can also detect the thromboemboli in the vessels by susceptibility vessel sign. SWI indicates the need for doing perfusion MRI to detect penumbra in cases of DWI-SWI mismatch

Background: For the past few decades, the world is encountering significant reduction in incidence of different kinds of communicable diseases whereas the prevalence of various non-communicable diseases (NCDs) is reaching its peak and India is not an exemption for this trend. Epidemiological studies have shown that the global burden of Breast cancer is expected to cross almost 2million by the year2030. Breast Self-Examination (BSE) is simple, non-invasive and quick, the practice of BSE is very low among women due to various reasons like not knowing the correct technique how to perform it, lack of time, lack of confidence and fear of being diagnosed with breast cancer. Therefore, the present study is aimed at improving the knowledge and practices o n BSE and impact of health education on breast self-examination among women. Research question: What is the impact of health education on breast self-examination among women residing in urban field practice area of KMC, Kurnool? The setting of the study was at a community urban field practice area, Kurnool Medical College, Kurnool, Andhra Pradesh. A six months observational study was conducted during the period from September 2023 to February 2024 on about 227 women aged 30- 60 years who are residing at UHTC Sriram Nagar, Kurnool by studying their socio-demographic profiles including literacy & occupation and  Evaluating their Knowledge and Practice related to BSE  by analyzing the data collected through pre & posttest questionnaire comparatively etc; Results: Pre-test knowledge mean scores were 0.55±0.55, practice mean scores were 0.17±0.84. After the educational intervention, a significant improvement was observed in women’s knowledge and practice. The impact of health education was reflected on post-test mean scores of knowledges and practice being 7.53±1.76, 5.32±1.85 respectively. Conclusion: This study showed the importance of regular awareness activities at community level to enhance the BSE practices among women for early detection of breast cancer.

Background: Maintaining hemodynamic stability during spinal anesthesia for caesarean sections is crucial for optimal maternal and fetal outcomes. Norepinephrine and phenylephrine are commonly used vasopressors to manage hypotension in this setting, but their comparative efficacy and safety are not well-established. Objective:   The study was planned with overall objective to compare the efficacy of Norepinephrine and     Phenylephrine infusions required to manage hypotension during spinal anaesthesia for caesarean    section and to compare the maternal adverse effects. Methods: This is an institution based Comparative Prospective study, it’s conducted from One and half year (February 2023 – May 2024) after getting permission from Institute Ethics Committee (IEC) and approval of The West Bengal University of Health Sciences (WBUHS) at Operation theatre of Department of Gynaecology & Obstetrics, Murshidabad Medical College & Hospital, Berhampore, West Bengal. Results: Requirement infusions was higher for the Phenylephrine infusions group subjects than the Norepinephrine infusions group subjects, and which was not statistically significant. The mean (SD) infusions required for Norepinephrine group subjects was 3.033(0.7063) and for Phenylephrine infusions group subjects was 3.267(0.6798). Conclusion: Norepinephrine infusion is more effective than phenylephrine in maintaining hemodynamic stability during spinal anesthesia for caesarean section, with fewer adverse effects. These findings suggest that norepinephrine may be a preferable option for managing hypotension in this clinical setting.

Background: Diarrhoea is one of the most common cause for childhood mortality among children under the age of five worldwide. In India, around 1.7 million children died before reaching the age of 5 years and more than half of them die in the first month of life. OBJECTIVES: To assess the knowledge and practices related to management of childhood diarrhoea in mothers of pre-school children. To provide IEC to mothers of pre-school children on prevention and control of diarrhoeal diseases. To assess the effect of IEC provided to the mothers of pre-school children on prevention and control of diarrhoea. Methodology: An Interventional study was carried out in rural field practice area of VIMS & RC, Bangalore. A total of 126 mothers of pre-school children attending the anganwadis under Kannamangala who were not irregular and not severely ill were included in the study. Mothers included in the study were interviewed through pre-tested semi-structured questionnaires. IEC was given to the mothers on the prevention and control of diarrhoeal disease in under five children through focal group discussions and interpersonal communication. Assessment was made every 3 months through post-test questionnaires. Results: It was found that as compared to the initial assessment the number of mothers with knowledge about drinking water storage, water purification method adoption, the definition of diarrhea, continuation of breastfeeding during diarrhea, continuation of complementary feeding during diarrhea for the child and regarding the correct method of preparation of ORS at home increased by 19.8%, 27.8%, 72.2%, 4%, 7.1% and 53.9% respectively. Conclusion: There was improvement found in the knowledge and practices regarding diarrhea and its prevention after IEC and the results were statistically significant.          

Introduction: COPD, as defined by GOLD 2023, is a lung condition that is characterised by chronic respiratory symptoms such as dyspnoea, cough, expectoration, and exacerbations. These symptoms are caused by abnormalities in the airways (bronchitis, bronchiolitis) and/or alveoli (emphysema), which result in persistent and often progressive airflow obstruction (1). Airflow blockage is characterised by a forced expiratory volume in one second to forced vital capacity ratio (FEV1/FVC) of less than 0.70. FEV1 is classified as Mild when it is greater than 80% of the predicted value, Moderate when it is between 50% and 80% of the predicted value, Severe when it is between 30% and 50% of the projected value, and Very Severe when it is less than 30% of the predicted value. In 2019, Chronic obstructive pulmonary disease (COPD) resulted in 3 million fatalities globally, making it the third most common cause of death (2). Cardiovascular diseases (CVDs) are a major health issue that often occurs alongside chronic obstructive pulmonary disease (COPD) and greatly increases the chance of death (3). Ischaemic heart disease (IHD), heart failure, and arrhythmias are often observed as cardiovascular diseases (CVDs) in patients with chronic obstructive pulmonary disease (COPD). The incidence rates of ischaemic heart disease (IHD), heart failure, and arrhythmias in individuals with chronic obstructive pulmonary disease (COPD) range from 19% to 61%, 11% to 31%, and 9% to 16%, respectively, depending on the specific characteristics of the research population (4,5,6). The prevalence of cardiovascular disease (CVD) was much greater in patients with chronic obstructive pulmonary disease (COPD) compared to those without COPD. Specifically, 59.7% of COPD patients had CVD, while only 28.5% of non-COPD patients had CVD (7). COPD can cause a range of abnormalities in the structure and blood flow of the heart, which can in turn affect several aspects of the electrocardiogram (ECG). The main causes of ECG changes in patients with COPD are increased airway obstruction, higher pressure on the right side of the heart, displacement of the diaphragm due to excessive inflation of the lungs, rotation of the right side of the heart in a clockwise direction, and changes in body mass index that are associated with clockwise rotation of the QRS-vector in the front of the heart(8,9). The objective of our study was to examine the alterations in electrocardiography among patients with chronic obstructive pulmonary disease (COPD) and to establish a correlation between ECG findings and the severity of COPD based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Criteria. Materials And Methods: This is a cross sectional, observational study done in patients who attended OPD and admitted in wards in department of General Medicine and department of Pulmonary Medicine in Maharajah Institute of Medical Sciences, Vizianagaram. Results: In our study most of the patients belong to age group of 51-70 years (73.2%), most common in 61- 70 years (38.6%) with male preponderance (85.3%). 59 of 64 males were smokers and 4 of 11 females has history of smoking. Conclusion: COPD is a common condition in patients with smoking and is associated with ECG abnormalities. RAD (Right Axis Deviation) is the most common ECG change observed in the study.  As the severity of the disease increases, ECG abnormalities become more common. All patients should undergo ECG to prevent cardiovascular morbidity and mortality.

Background: Acute appendicitis is the most frequent surgical emergency encountered worldwide. Diagnostic errors are common resulting in median incidence of perforation 20% and negative appendicectomy 15% to 20%.. Removing normal appendix is an economic burden on both patients and health resources. Mis-diagnosis and delay in surgery can lead to complications like Perforation and finally Peritonitis. Objective. To compare the Validity of Modified Alvarado Score and Tzanaki’s Score in Diagnosing Acute Appendicitis. Methods: An Observational* study conducted at District Hospital, Dharwad in the Department of General Surgery which included 100 Clinically, Laboratory and Radiologically diagnosed cases of acute appendicitis who underwent Appendicectomy (Open/ Lap) from January 2021 to April 2022. Both Modified Alvarado Score and Tzanaki’s score are done for all the patients. Final diagnosis was based on Histological findings given by the Pathologist. Data was analysed to compare the Validity* of both scoring systems in diagnosing Acute appendicitis. Results: The Sensitivity, Specificity, Positive Predictive Value and Negative Predictive Value of Modified Alvarado score was 47.87%, 66.67%, 95.74% and 75.5% respectively and Tzanaki’s score of was 87.27%, 16.67%, 94.25% and 76.9% respectively. Negative appendicectomy in Tzanaki’s scoring was 6% and in M. Alvarado scoring was 6%. Overall negative appendicectomy was 6%.. Conclusion: This study shows that Tzanaki’s scoring system can be used as an effective modality in the establishment of accuracy in diagnosis of acute appendicitis. There is increased Sensitivity, PPV & Diagnostic Accuracy in Tzanaki’s scoring when compared to Modified Alvarado score. Tzanaki’s score is an effective modality to establish the accurate diagnosis of AA and helps in reducing complications, morbidity, mortality of Appendicitis & negative Appendicectomy rate.

Neurodegenerative diseases, such as Alzheimer's and Parkinson's, are characterized by the progressive loss of structure and function of neurons. Early detection is crucial for effective intervention and management of these conditions. Diffusion Magnetic Resonance Imaging (dMRI) offers a non-invasive method to detect microstructural changes in the brain by measuring the diffusion of water molecules in tissues. This study investigates the potential of dMRI in identifying early signs of neurodegenerative diseases. A cohort of 100 participants, including healthy controls and individuals at high risk for neurodegenerative diseases, underwent dMRI scanning. Results indicate significant differences in diffusion metrics between the groups, suggesting that dMRI may be a valuable tool for early detection of neurodegenerative diseases.

Osteoarthritis (OA) is a leading cause of disability, with its incidence rising in tandem with obesity rates. Traditional imaging methods, such as radiography, are limited in their ability to detect early cartilage changes, necessitating the exploration of advanced imaging techniques. MRI offers a non-invasive method to visualize joint structures, with various sequences providing different insights into cartilage morphology and composition. Methods: We conducted a comparative study involving 100 OA patients, utilizing multiple MRI sequences to assess joint cartilage. Each patient underwent imaging with the following sequences: T2 mapping, T2* mapping, T1 rho, dGEMRIC, gagCEST, sodium imaging, and DWI. Image quality, cartilage visualization, and sensitivity to cartilage degeneration were evaluated for each sequence. Quantitative measurements were taken to assess cartilage thickness, composition, and structural integrity. Results: •T2 Mapping: Effective in assessing cartilage hydration and collagen network integrity. Provided clear images of cartilage structure but was less sensitive to early biochemical changes. •T2 Mapping: * Similar to T2 mapping but offered improved sensitivity to iron and other paramagnetic substances within the cartilage. •T1 Rho: Excellent for detecting early biochemical changes in cartilage, particularly proteoglycan content. •dGEMRIC: Provided detailed information on glycosaminoglycan (GAG) concentration, a key marker of cartilage health. •gagCEST: Offered high specificity for GAG concentration, though image acquisition times were longer. •Sodium Imaging: Directly measured sodium content, correlating with GAG concentration. However, required specialized equipment and longer scan times. •DWI: Sensitive to changes in the microstructure of cartilage, offering insights into early degeneration processes. Conclusion: Advanced compositional MRI techniques, particularly T1 rho and dGEMRIC, hold significant promise for the early detection and monitoring of OA. While traditional morphological sequences like T2 mapping remain valuable for structural assessment, integrating these advanced techniques can enhance the diagnostic accuracy and treatment planning for OA patients. Further research is needed to streamline these techniques for widespread clinical adoption.

Introduction: A change in the heart's electrical rhythm is known as a cardiac arrhythmia. This is mostly a sign of a structural heart illness; however, it can also happen when a healthy heart has aberrant conduction, depolarization, or an electrolyte change. Aims: To assess the effectiveness of dabigatran versus warfarin in patients of non-valvular atrial fibrillation in clinical practice in a tertiary care hospital of west Bengal, India Materials and method: Present study was conducted in the department of pharmacology and department of cardiology in a tertiary care hospital from January 2018 to April 2019. A total of 150 patients with newly diagnosed non valvular atrial fibrillation, between 26-90 years were included in the study. Result: In group-A, 45(60.8%) patients had hypertension, 34 (45.9%) patients had diabetes mellitus, 3(4.05%) patients had hyperthyroidism and 46 (62.2%) patients had old stroke/TIA. In group-B, 29 (38.2%) patients had hypertension, 29(38.2%) patients had diabetes mellitus, 4 (5.26%) patients had hyperthyroidism and 41 (53.94%) patients had old stroke/TIA. In group-A, 36 (48.6%) patients had paroxysmal and 38 (51.4%) patients had persistent atrial fibrillation. In group-B, 24 (31.6%) patients had paroxysmal and 51 (67.1%) patients had persistent atrial fibrillation. Conclusion: Dabigatran 110 mg twice daily dose is non-inferior to warfarin INR adjusted dose regarding effectiveness and safety profile in non-valvular atrial fibrillation patients in Indian perspective. The incidence of dyspepsia is significantly high with dabigatran. there is no other significant difference in other adverse drug reactions.

Introduction: This retrospective study explores the demographics, clinical presentations, diagnostic approaches, and management strategies associated with laryngo-tracheobronchial foreign body aspirations in a tertiary care facility over three years (2016-2018). Despite advancements in endoscopically assisted bronchoscopy, early diagnosis and referral to an ENT surgeon remain crucial. Methods: A comprehensive analysis of 30 cases undergoing rigid bronchoscopy was conducted. Comprehensive clinical assessments included collecting data on age, chief complaints, onset duration, hospitalization period, time to intervention, clinical and radiological findings, nature of the foreign body, history of ingestion, intraoperative findings, and postoperative complications. Additionally, the existing imaging data were analysed using U-Net CNN to explore its utility and implications. Results: Of the cases, 80% were children, and 30% presented within 48 hours of symptom onset. The clinical presentation varied, with 60% having a history of foreign body inhalation, and cough being the most prevalent symptom. Radiologically, findings were diverse, with the right side being more affected (60%). No mortality occurred among the cases. Discussion: The study underscores the urgency of prompt diagnosis and intervention in laryngo- tracheobronchial foreign body aspirations. Despite reduced mortality, caregiver awareness and interdisciplinary collaboration remain critical for optimal patient outcomes, especially in paediatric cases. Conclusion: This study contributes vital insights to optimizing patient outcomes in foreign body aspirations within the respiratory passages. It emphasizes the ongoing importance of caregiver education, swift medical intervention, and collaborative efforts among healthcare professionals. Additionally, integrating machine learning has the potential to enhance diagnostic accuracy, treatment planning, predicting complications and further advancing patient care.

Objectives: The aim of this study is to compare the Ease of intubation and changes in hemodynamic parameters during endotracheal intubation using McIntosh & Hugemed laryngoscope in a patients who are ASA grade I and II.. Methods: A total of 70 patients who are ASA grade I and II belonging to the age group 18 to 60 years posted for elective surgeries under general anesthesia in Government Medical College, Thrissur were studied. 35 of them were intubated using McIntosh laryngoscope while the rest were intubated using Hugemed video laryngoscope. The time taken to perform endotracheal intubation and changes in hemodynamic parameters during the initial five minutes following intubation were recorded and compared between the 2 groups. Results: The 2 groups were similar with respect to demographic data and airway examination. The duration of laryngoscopy and intubation was significantly longer in group B (Hugemed laryngoscopy) when compared to group A patients with p value = 0.000. However, haemodynamic changes did not show any significant differences between the groups. Conclusion: The study found that, as compared to traditional laryngoscope (McIntosh), Hugemed video laryngoscopy did not provide any benefits for patient hemodynamic response to laryngoscopy and intubation, but the time required for intubation was significantly longer in the video laryngoscope group.

Background: Diabetes and its complications require a multipronged approach for its management. In tertiary care government hospital, diabetic patients who were attending at out-patient department were being treated only with drugs and insulin without proper education on self-care practices because of heavy patient load. But in real scenario, patient has an important role to play in terms of self-care practices, which can be taught to them by educational programs. To develop such an educational program, a baseline assessment of knowledge, attitude and practice regarding self-care among patients, need to be made. Research question: What is the knowledge, attitude and practice regarding self-care among the patients of type 2 Diabetes mellitus attending OPD in our set up? The setting of the study was at OPD of department of General Medicine, Government General Hospital, Kurnool Medical College, Kurnool, Andhra Pradesh. A one-year observational study was conducted during the period from May 2023 to April 2024 on about 215 Type 2 Diabetes patients attending General Medicine OPD, GGH during the above period by studying their socio-demographic profiles, Evaluating Risk factors, comorbidities and assessing their KAP related to self-care towards control & prevention of complications of Diabetes etc. Results: 12% of study participants were aware of examination of feet daily, 43.5% of study participants were practicing foot care examination. 76.3% study participants were having low MMAS score and it reflects poor treatment adherence. Conclusion: Continuous health education and reinforcement by health care providers is essential in order to enhance self-care activity.

Inadvertent peri-operative hypothermia (IPH) is defined as a peri-operative core temperature less than 36°C. IPH is known to increase the risk of blood loss, prolonged and altered drug effects, post-operative shivering, and adverse cardiac events. Pre-operative warming with forced air reduces post-induction redistribution hypothermia, results in higher average intra-operative core temperature than non- pre-warmed counterparts and prevents complications associated with hypothermia. Purpose: To compare the effect of preoperative forced air warming on the incidence of perioperative hypothermia in patients undergoing general anaesthesia, who are pre-warmed versus those who are not pre-warmed Study Design: This randomised comparative prospective study was conducted in the Department of Anaesthesiology and Pain Management at Max Super speciality Hospital, Patparganj, New Delhi after approval by the institutional ethics committee. 170 patients were included in this study Methodology: 170 adult persons of either sex, ASA physical status I-III scheduled for different surgeries under general anaesthesia who met eligibility criteria were randomly assigned either to group A in which pre-operative forced air warming was done for 30 minutes or to group B in which pre-operative forced air warming was not done. Pre-warming was done in preoperative care unit with a forced air warming device with temperature setting of 45 degrees Celsius for 30 minutes. Pre-operatively, axillary temperatures of patients were recorded. After administration of general anaesthesia, nasopharyngeal core temperature was recorded every 10 minutes till the end of surgery. Intra-operatively forced air warming was done in both groups with temperature setting of 45 degrees. Incidence of hypothermia was compared between two groups. Amount of intra-operative blood loss, time of recovery from anaesthesia, post- operative shivering and incidence of adverse cardiac event were also compared between two groups. Result: Incidence of hypothermia was significantly higher in non-pre-warmed group as compared to pre-warmed group. (p<0.001) Incidence of post-operative shivering was significantly higher in non-pre-warmed group. (p<0.001). Mean recovery time from anaesthesia was also significantly higher in non-pre-warmed group (p<0.001). However, incidence of adverse cardiac event and increased blood loss were insignificant between the two groups. Conclusion: According to the observations and findings of this study, the occurrence of peri-operative hypothermia was decreased in patients who underwent a 30-minute pre-warming period before receiving general anesthesia, compared to patients who did not get pre-warming. Pre-warming additionally decreased the occurrence of post-operative shivering and shortened the duration of recovery from anesthesia. Nevertheless, there was no significant difference in the occurrence of negative cardiac events and the amount of blood loss between the two groups. The study was conducted within a limited time frame, and a bigger sample size would provide more definitive results.

Introduction: Although the progression of invasive Aspergillosis (IA) shares some risk factors in the development of active Pulmonary Tuberculosis (PTB), however, the prevalence of IA in PTB remains unclear. Material and methods: 100 consecutive sputum samples with proven PTB between 12.7.203 and 7.12.23 were collected during the study period. All sample were processed for KOH mount followed by culture on SDA, if growth appeared colony were processed by slide culture followed by LPCB. Result: out of 100 sputum samples positive for Pulmonary Tuberculosis, 8 samples were found positive for pulmonary Aspergillosis of which A. fumagatus, A.flavus and A.niger were 4 , 3 and 1 respectively

Systemic lupus erythematosus (SLE) presenting with cardiac tamponade is a rare cardiac manifestation, Candida pericardial effusion is a very rare entity in clinical settings especially in developing world where tuberculosis is the frequent cause of pericardial effusion, Fungal diseases suspicion arises in the setting of immune suppression like malignancy, diabetes, Steroid treatment and  HIV etc, Our case is one such rare event where a treatment naïve young female presented with cardiac tamponade in high disease activity of SLE with superimposed Candida infection.

Introduction: It is believed that the great variability of this arterial pattern may be attributed to the failure of regression of some paths of embryonic arterial trunks. Anatomical knowledge of this principal artery and its variations has many clinical implications especially in surgeries relatedto orthopaedic and vascular re-constructive procedures. Hence a study was conducted in a tertiary medical college in Central Indiato study brachial artery and its variations with anatomical perspective Materials and Methods: The present study was conducted on 112 upper limbs of different age group and sex (38 Male and 18 Female) The brachial arteries were identified and branching pattern and relations of the brachial artery with brachial plexus in arm was observed and presence or absence of variations were documented. Results: Out of 112 upper limbs studies, 106 (94.5%) limbs showed normal morphological pattern of brachialartery, 6 (5.5%) limbs showed superficial brachial artery, 2 limb (1.5%) showed tortuous and SBA withtrifurcation into radial artery, ulnar artery and common interosseous artery in the cubital fossa. Conclusion: The study of Brachial artery and variation in its course and branching pattern is clinically important for surgeons, ortho-paedicians operating on the supracondylar fracture of humerus and radiologists performing angiographic studies on the upper limb.

Hydatid cyst is a very common disease caused by Ecinococcusgranulosumlarva . It can involve nearly any part of the body but most commonly affected organs are liver and lungs. Ultrasound, Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are valuable radiological investigations to diagnose hydatid cysts. Understanding of disease trend is important for early diagnosis and prevention of its com-plication to occur. We present a case series on a few interesting cases of hydatid cysts in paediatric age group in different organs and stages.

This case study examines the agenesis of the A1 segment of the anterior cerebral artery (ACA) in a 76-year-old male cadaver, highlighting the compensatory mechanisms that maintain cerebral perfusion. Through meticulous dissection, histological analysis, and pre-dissection MR angiography, we observed the complete absence of the right A1 segment, with significant hypertrophy of the left A1 segment (3.2 mm) and a well-developed anterior communicating artery (2.5 mm). Histological examination revealed intact arterial walls, indicating healthy adaptation without pathological changes. MR angiography confirmed these findings, showcasing the brain's remarkable ability to compensate for vascular anomalies. The study underscores the importance of advanced imaging techniques in diagnosing such anomalies and emphasizes the need for awareness of these variations in clinical and surgical practice to ensure accurate diagnosis, effective risk assessment, and safe interventions.

Background: Patients undergoing orthopedic /spinal surgeries may lead to massive bleeding. Both Clonidine and Dexmedetomidine have been used in controlled hypotension and may reduce blood loss in orthopedic/spinal surgery. This study was conducted to compare the hypotensive effectiveness and hemodynamic stability of dexmedetomidine and clonidine in orthopedic/spinal surgeries. Methodology: This study was a prospective double-blinded interventional study in which 70 adult patients of either sex, 20–50 years of age, posted for orthopedic/spinal surgeries were randomly assigned to two groups. Group A received a loading dose of intravenous (IV) dexmedetomidine 1 μg/kg, followed by infusion of 1 μg/kg/h, and group B received a loading dose of IV clonidine 2 μg/kg, followed by 1 μg/kg/h infusion. Observation And Results: In our study, it was found that in both the groups, target mean arterial pressure (MAP) of 65–70 mmHg and improved surgical field quality were achieved. MAP and heart rate (HR) were statistically significantly lower in the dexmedetomidine group with a longer duration of post-operative analgesia (P = 0.001). None of the groups showed any statistically significant adverse effects. Conclusion: Both dexmedetomidine and clonidine can be used for controlled hypotension to improve surgical field quality in Orthopedic/spinal surgeries. Dexmedetomidine provides more hemodynamic stability and an additional benefit of post-operative analgesia and conscious sedation

Introduction: T2DM is associated with cell-mediated immune responses and abnormal T-lymphocyte function, further linked to insulin deficiency. Hence this study aims to determine the activity of serum total ADA and correlate these parameters with glycemic control, and biochemical variables in type 2 diabetic individuals. Aims and Objectives: Aim: To estimate serum adenosine deaminase and its correlation with glycemic status in diabetes mellitus. Objectives: To estimate the serum adenosine deaminase levels in type 2 diabetes mellitus patients. Inclusion Criteria: Individuals with diagnosed T2DM in the age group 35 to 70 years. Exclusion Criteria: Individuals with a history of tuberculosis, rheumatoid arthritis, viral hepatitis, and HIV and Patients on insulin therapy. Results: In this study, 41 cases were males and 59 were females. ADA activity was significantly higher in uncontrolled (Group C) diabetic patients (55.428±3.736U/L) compared to the controlled (Group B) population (42.63±4.59 U/L) and non-diabetics (22.0581±5.1968 U/L) with p value 0.001. Patients who have a longer duration of diabetes history had higher serum ADA levels than newly diagnosed patients with significant differences, p < 0.001. Conclusion: This study's findings clearly show that Adenosine deaminase (ADA) levels are elevated in type 2 diabetics, and the positive correlation of ADA with higher glycemic control suggests that ADA may serve as a prognostic factor in T2DM. ADA had a significant positive correlation with HbA1c, which is regarded as a good marker for long-term glycemic control.

Introduction: Micro vasculature of kidney undergoes a continual and mutually dependent developmental changes through which obtains its structural and functional maturity. It is very important to know the normal developmental anatomy of kidney micro vasculature in prenatal diagnosis of renal anomalies, genetic counseling and treatment of prenatal renal disorders like Wilm’s tumor, multicystic renal dysplasia. Present study was undertaken to study the micro vasculature of the kidney at different stages of development during fetal life. Materials And Method: The present study was carried out in the department of Anatomy, Regional Institute of Medical Sciences, Imphal, Manipur. The material for the study consisted of 60 spontaneously aborted and still born human fetal specimens free from any gross congenital anomalies with gestational age between 11th to 38thweeks were collected from Obstetrics and Gynaecology department, RIMS after taking permission from the Institutional Ethics Committee and categorized into 4 groups as Group-A(11-20 weeks), Group-B(21-27 weeks),Group- C(28-33 week), Group-D(34-38 weeks) .The kidneys were taken out from fetal specimens, fixed, processed, stained with Haematoxylin and Eosin, observed under the Microscope and micro photographed. Conclusion: Knowledge on microvascular development on fetal kidney will be helpful for possible intervention in prematurely delivered normal baby with possible prognosis as premature delivery is very common now a days and also in prenatal diagnosis of kidney diseases

Background: Coronavirus disease 2019 (COVID-19) continues to be a significant health problem worldwide. The unprecedented surge of mucormycosis in patients with COVID-19 is a new emerging challenge. Although a few studies documenting high incidence of mucormycosis in COVID -19 patients have recently emerged in literature, data pertaining to treatment outcomes in such cohorts is lacking. Here, we report our experience in management of mucormycosis in COVID-19 patients at our tertiary care centre. Materials and methods: We prospectively enrolled and analyzed 70 post-COVID-19 patients who presented with the invasive mucormycosis of the head and neck region. Clinical and histology details were noted in predesigned forms. Various histology variables were graded from I to III to propose a scoring system for the severity of the disease. Result: A male predominance (86%) was observed with a male to female ratio of 2.8:1 at an age range of 26–75 years (mean age 46.8 ± 11 years). All patients had a history of COVID-19 disease in the last 2 months. Maximum cases (94.3%) presented within 20 days of COVID-19 treatment/ recovery. All patients presented with one or other local or constitutional symptoms or signs. The most common complaint at the time of presentation was local facial pain (92.9%), swelling of the cheek (67.1%), and eye pain with periorbital swelling (35.7%). Conclusion: Mucormycosis is a rare but fatal fungal infection that should be kept in mind in covid 19 recovered patients especially those who have uncontrolled diabetes and treated with corticosteroids. Timely diagnosis by histomorphological assessment supported with special stains is the cornerstone to prevent an adverse clinical outcome.

Non-invasive blood pressure monitoring (NIBP) is a commonly used standard ASA monitor in Operation Theater. Beside of non-invasive, it can lead to various complications like petechial rash, ecchymosis, venous stasis, thrombophlebitis, infection, hematoma formation in patient on blood thinners, compartment syndrome, neuropathy due to compression and skin necrosis. These kinds of complications are not suspected by the anesthesiologist routinely. Most of these are seen invariably in diabetic, on anticoagulation therapy and old debilitating patients due to frequent monitoring. We are reporting a case of mechanical trauma caused due to NIBP monitoring in a patient posted for excision of bladder cyst. Intraoperatively, patient presented with carpopedal spasm distal to the BP cuff due to repeated cycling. We ruled out other causes of carpopedal spasm. Patient was managed for pain and for spasm calcium gluconate was given. Patient recovered and shifted to PACU. Through knowledge of complications and vigilance during perioperative period can helps the anesthesiologist to avoid them in their future course of perioperative care.

Introduction: Vegetarianism dates back to a time before recorded history. The present study was undertaken to compare individuals (vegetarians and non-vegetarians) lipid profile which is used to determine the risk of obesity, myocardial infarction and helps in determining the treatment has border line or high-risk cases. Aims & objectives: The present study was designed to investigate comparative study of serum lipid profile in vegetarians and non-vegetarians’ young adults, so that the effects produced by the type of dietary intake can be evaluated. Materials and methods: A total of 100 (50 vegetarians and 50 non-vegetarians) were selected from Kurnool medical college, Kurnool with exclusion criteria (Subjects with history of hypercholesterolemia, hereditary dyslipidemias, Subjects on drugs that affect the lipid profile, hypertensive’s, diabetics, heart diseases and thyroid diseases and subjects with Smoking and Alcohol). All parameters (lipid profile) were done on a Semi automated analyser (Erba chem-5x). Results: The mean values of TC (Total cholesterol), LDL, VLDL, TG (Triglycerides) are high in non-vegetarians when compared to vegetarians and HDL is high in vegetarians. The p value is <0.0001 and is considered highly significant and food good relation with vegetarian diet. Conclusion: It concludes that healthy dietary pattern maintains a favorable lipid profile.

Introduction: Schizophrenia is a clinical construct that covers a variety of pathological processes that affects practically the entire sphere of psychological process mainly the cognition, perception, emotion, thinking also the behaviour, many people with schizophrenia have a limited and isolated existence. Depressive symptoms in patients with schizophrenia are reported since the day that syndrome has been defined, depressive symptomatology has been recognised as a feature of schizophrenia. Suicide is the chief cause of premature death among individuals with schizophrenia, the rate is high in affective disorder and somewhat lower but still excessive among people with schizophrenia. Materials And Methods: This is a cross - sectional study was conducted in the Department of Psychiatry, Osmania Medical College, Institute of Mental Health, Hyderabad from July 2021 to December 2021. In this study, 50 schizophrenia patients, 50 controls were recruited at Institute. Male and Female patients attending in and out patients at Institute were considered for study. Following this, patients meeting the inclusion criteria are taken for study. Age and gender matched controls without any psychopathology were taken from neighborhood. Results: The mean age of test subjects is 27.44+/- 5.350 and that of controls is 33.54+/- 8.894. Mean score of Positive scale for test subjects is 15.14+/-3.93 and that of controls is 7.00+/-0.000. The mean score for Negative scale is 7.00+/-0.000 for both test and controls subjects. The mean score on General scale is 23.66+/- 4.570 for test subjects and 16.00+/- 0.000 for controls. Among the test subjects 36% of them were depressed and 32% of them had suicidal ideation. Depressive symptomatology in test subjects depression was 36%, among males it was 26% and in females 10%. Hopelessness was 32%, among males it was 24% and in females 8%. Self-depreciation was 20%, among males it was 14% and in females 6%. Conclusion: Among CDSS items depression, hopelessness, self-deprecation, morning depression and suicide were increased in frequency. In schizophrenia patients’ depressive symptoms and suicidal ideation were significantly present in compare of healthy controls. Most of socio demographic factors did not influence depressive symptoms but unemployment was significantly present among patients with suicidal ideation. Depressive symptoms and suicidal ideation showed to have strong relation.

Aims: To know the spectrum of the aerobic bacteria causing post operative wound infections. Materials and methods: The present study was undertaken to know the bacteriological profile of SSIs in Obstetrics & Gynaecology ward, including their antibiogram and find the preventive measures. Age group 20-60 years, Presence of post operative SSI’s, involves only the skin or subcutaneous tissue were included in study. Results: In 94(45.7%) culture isolates, 42(44.70%) were Gram negative enteric rods, 26(27.65%) were Staphylococcus species and 26(27.65%) were Non fermenters. Predominant isolates were Klebsiella pneumoniae (28.72%) Pseudomonas aeruginosa (25.53%) & Staphylococcus aureus (17.04%) respectively. Wound infection rate was more in emergency Obstetric cases (96.3%) compared to elective cases of Gynaec (77%) & Obstetric (73.3%). Methicillin resistant CoNS (60%). 6 CoNS were resistant out of 10 isolates which is significant hence speciation of CoNS should be done. Antibiogram in sensitive strains of Enterobacteriaceae shows highest sensitivity to Amikacin (86.3%). The antibiogram in resistant strains of Enterobacteriaceae shows highest sensitivity to Colistin (95%) & Imipenem (90%) and lowest sensitivity to AmoxyClav (30%). Sensitivity pattern in non-fermenters shows highest sensitivity to Imipenem (88.46%), whereas MBL producers shows highest sensitive to Colistin (100%) & Polymyxin (100%). Antibiogram of the Staphylococcus species shows highest sensitive to Clindamicin (100%) whereas for MRSA strains highest sensitive to Linezolid (100%). Conclusion: Drug resistance mechanisms which include ESBL, Amp C betalactamases, MBL producers exhibited by the predominant Gram-negative rods and MRSA strains in Gram positive isolates are due to overuse of antibiotics leading to selective pressure. Government has to intervene in strict implementation of antibiotic policy in all health care institutions. Availability of drug to patient is restricted only on doctor prescription.

Background: Role of echocardiography at present is not restricted to detect congenital heart disease only in neonates. It has become an integral part in managing neonates with diagnosing other functional abnormality as well. Our aim was to describe the indication of echocardiography and the positive findings in echocardiography resulting change in clinical management. Methods: It is a prospective and hospital-based study. Was done in special care newborn unit (SNCU) and newborn intensive care unit (NICU), Department of Paediatrics, MKCGMCH, Berhampur, Odisha from Nov’2020 – Oct’2021. Results: Total number of babies referred for echocardiography were 146. Which was 3% of total newborn admission. The median birth weight was 2545 gm (965-5235gm), gestational age 38wk(28-43wk) and postnatal days scan done was D7(D3-D28). Most common indication for echo referral was for cardiac murmur 63(43.15%). The echocardiography findings which change the management plan were structural heart disease 73(50%), minor 29(19.86%), functional18(12.34%) and normal 26(17.80%). 17(24%) of total congenital heart disease required referral for early cardiac surgery. Conclusions: Our finding’s showed echocardiography is an essential tool in newborn care for differentiating cardiac from noncardiac cause for similar symptoms and signs. Neonatologist and Paediatricians should be trained regarding point of care cardiac echocardiography for quick and timely management of the newborns

This is a cross-sectional study which examines the influence on heart rate variability (HRV) indices in pre-menopausal women and post-menopausal women and also its correlation with menopausal symptoms.  Menopause is characterized by various physiological changes that occur in the reproductive organs and other systems of the body. One change that occurs in the cardiovascular system is modulation of autonomic activity. Menopause causes an imbalance of the autonomic nervous control of the cardiovascular system that shifts toward sympathetic hyperactivity. Material and methods: The study involved 140 women who were divided into two groups, 70 premenopausal women of age group 40-55 years and 70 postmenopausal women of age group 40-55 years. Heart rate variability indices were observed in both groups. Result: The various heart rate variability parameters like SDRR, RMSSD, pRR50, VLF and HF in post-menopausal women was decreased compared to pre-menopausal women. LF and LF/HF ratio in post-menopausal women was increased compared to pre-menopausal women. Also, LF and LF/HF ratio in symptomatic post-menopausal women was increased compared to asymptomatic post-menopausal women. Conclusion: The present study concludes that, menopause shifts the autonomic sympathovagal balance towards sympathetic predominance in post-menopausal women.

Fetal cardiac screening through ultrasound, particularly fetal echocardiography, plays a critical role in the early detection and management of congenital heart disease (CHD), one of the most common congenital anomalies worldwide. This comprehensive review explores the role of ultrasound in fetal cardiac screening, focusing on the basics, techniques, and guidelines of fetal echocardiography. The review covers the principles of ultrasound in fetal imaging, the indications for fetal echocardiography, and the clinical implications of early diagnosis. It delves into the techniques employed, including basic and advanced imaging modalities, Doppler ultrasound, and the application of 3D/4D imaging in the assessment of fetal cardiac anatomy and function. The article also discusses the standard protocols for performing fetal echocardiography, highlighting guidelines from major professional bodies, including the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) and the Indian Radiological and Imaging Association (IRIA). The clinical applications of fetal echocardiography are illustrated through case studies that emphasize the impact of early diagnosis on perinatal management and outcomes. Additionally, the review addresses the challenges and limitations of fetal cardiac imaging, including technical difficulties and the influence of maternal and fetal factors on image quality. Looking forward, the review considers emerging trends in fetal cardiac screening, such as the integration of artificial intelligence and portable ultrasound devices, as well as the potential for early intervention through advanced surgical and therapeutic techniques. The conclusion underscores the importance of fetal echocardiography in improving outcomes for infants with CHD and calls for continued advancements in imaging technology and clinical practice to enhance the effectiveness of this critical diagnostic tool.

Introduction: Tuberculosis prevalence is stable but there have been increased incidents due to increasing incidence of human immunodeficiency virus infection. People living with HIV are more likely than others to become sick with TB. Worldwide, tuberculosis is one of the leading causes of death among people living with HIV. Aims And Objectives: To 1) describe the various clinical manifestations of tuberculosis in people living with HIV and AIDS and correlate it with the degree of immune suppression. 2) correlate CD4 cell count and Tuberculosis spread. MATERIALS AND METHODS: A Prospective and observational study comprising 100 patients admitted to the department of medicine with HIV TB co-infection. Inclusion criteria: Patients who are HIV infected as evidenced by ELISA and with clinical features supported by CBNAAT or ZN stain for AFB. Exclusion criteria: Patients who are HIV-negative and tuberculosis, those who have been diagnosed prior and have already started ATT. Results: In our study, in both the categories of TB cases (Pulmonary & extrapulmonary), the majority of patients had a CD4 count of 301-400 cells/mm3 followed by 201-300 cells/ mm3 in both groups. The CD4 count 101-200 cells/mm3 was present among 8 cases in the pulmonary TB group and 3 patients in the extrapulmonary TB group. Conclusion: Pulmonary TB is more prevalent than extrapulmonary tuberculosis among the range of tuberculosis that can affect people with HIV. The majority of patients had pulmonary tuberculosis if their CD4 count was higher than 200 cells mm3.

Aims: To study of acute kidney injury in Antenatal mothers secondary to hypertensive disorders and Early detection to prevent the serious complications, Maternal morbidity and mortality and improve the perinatal outcome by early detection and treatment. Materials and methods: A hospital based prospective observational study was conducted in the Department of Obstetrics and gynaecology. Subjects were included in the study after written informed consent and data was collected by using pre structured questionnaire. Thorough obstetric, medical and surgical history was taken. the subjects were analysed for the following parameters. Results: 56% were antenatal presentations. Distribution of gravida shows that 56% had 2, 14% had 3, and 20% had 10% gravida. Induced delivery (48%) and Emergency LSCS (38%) were the main modes of pregnancy termination. 82% had medical treatment, 7% had ventilator support and 11% had dialysis. Nine patients died and 1 patient had chronic hypertension. 72% of the babies admitted to NICU, there were 32 fetal deaths and 1 abortion. Neonatal morbidity and mortality are very high because of AKI in pregnancy and with other complications. Pregnancy needs to be terminated immediately, irrespective of gestational age to prevent maternal complications and deaths. Mothers with hypertensive disorders who presented in early preterm (24-32 weeks) delivered babies with less than 1.5 kg and among them, 100% perinatal mortality is observed. For babies with>1.5 kg weight, most of them presented with intrauterine death due to abruption or fetal growth restriction. Conclusion: Knowledge of associated characteristics and outcomes presented in this study provides important prognostic information for patients, a framework for physicians to understand severe pregnancy- related AKI in the current era, and informed strategies to better identify women at risk. And also concluded from this study that prevention is always better than cure.

Abstract: mean birth weight and incidence of LBW babies in this area are influenced by various maternal factors, and many of them are preventable. Method: It is a hospital based cross sectional study done by Simple random sampling consisting of 200 newborns and their respective mothers delivered 15 months. Ballard score will be used to calculate the gestational age New Bellard’ Score. Post-delivery methods of determining gestational age in premature infants have been developed and validated. The New Ballard Exam allows for gestational assessment in infants as early as 20 weeks' gestation and utilizes parameters of physical (6 criteria) and neurological (6 criteria) maturity to reach a score that correlates with gestational age. Results: LBW babies include preterm babies (17.5%) and term and post-term SGA babies (18.2%). Neonatal and IMR in these babies is very high. In the present study LBW rate was 22%. Regarding IUGR babies much work can be done to reduce the rate. It was found that 13.5% of mothers were below 20 years.1% of mothers were illiterate. Mean birth weight in primi was less and LBW rate was high. 12% of mothers were anemic. Mean maternal hemoglobin was 11.0%. Maternal anemia strongly influences mean birth weight and LBW rate. Mother receiving minimum 4 ANC visits was 99%, and still 12% of mothers were anemic. Incidence of macrosomia was high in diabetic group compared to non-diabetic group. Neonatal mortality is high in LGA babies. Conclusion: In the present study 15.5% of babies were SGA babies. Symmetric IUGR babies contribute >95% of total IUGR in this study. Birth weight was more in symmetric IUGR babies by 100 gm. Along with birth weight all other parameters under study were high in asymmetric IUGR babies.

According to the World Health Organization (WHO), the global tobacco epidemic stands as one of the most significant threats to public health in history. With a staggering death toll exceeding 8 million annually, the impact is profound. Smoking prevalence varies greatly between regions and even within countries of the same region. Currently, the highest rates of male smoking are observed in the Western Pacific nations. In India, tobacco usage, encompassing both smoking and non-smoking forms, remains prevalent. Smoking cigarettes is recognized as a major contributor to various neurological disorders, with oxidative stress implicated as a potential mechanism of smoking-related harm resulting brainstem hypoxia which contributes to abnormalities in brainstem auditory evoked potentials (BAEP), resulting in significant impairment of the functions of the eighth cranial nerve and the brainstem among smokers. This research investigates the profound effects of oxidative stress on brainstem auditory evoked potentials (BAEP), in tobacco smokers. The study encompasses a diverse array of measurements, including anthropometric data, blood pressure, brainstem auditory evoked potentials (BAEP) oxidative stress markers (malondialdehyde - MDA and superoxide dismutase - SOD), and serum electrolytes. The results shed light on the intricate relationship between tobacco smoking, oxidative stress, and neurological outcomes.

: Introduction: Inferences from most of the studies are limited by the fact that elevated serum Triglycerides were found after the diagnosis of Preeclampsia.  Therefore, this study is done to see if there is any significant elevation of Triglycerides prior to the development of Preeclampsia. Aims: To Find out the Significance of the Association of Early Maternal Hypertriglyceridemia in the Development of Preeclampsia. Materials and methods: It is Prospective Observational study in Department of Obstetrics & Gynaecology in Pregnant women in the early second trimester between 13 - 20 weeks registered for antenatal checkup. Total 300 pregnant women attending the antenatal clinic. 20 patients were lost during the follow up.  Demographic data like age, socioeconomic status and obstetric history along with relevant medical history was recorded on predesigned and pretested proforma. A detailed history, general physical examination including BMI, obstetric examination was done. Results: In this study, out of 280 patients, there is significant correlation between TGL levels and Risk of Preeclampsia. The distribution of patients who developed Preeclampsia is more or less the same with screening in early second trimester. The association between TGL levels and Development of Preeclampsia is statistically significant among the Gestational age group 13- 16 weeks (P=0.013) and 17- 20 weeks (P= 0.000059). The association between TGL levels and Development of Preeclampsia is statistically significant among the age group 21- 29 years (P=0.001) and > 30 years (P= 0.01). The association between TGL levels and Development of Preeclampsia is statistically significant among the Primigravida (P=0.000003) and Multigravida (P= 0.036913). There is significant association between the Triglyceride levels and risk of Preeclampsia among the Primigravida and Multigravida but the Incidence of Primigravida (11.2%) having Preeclampsia as compared to Multigravida (5.1%) is more in this particular study. The association between TGL levels and Development of Preeclampsia is statistically significant among the BMI 18.5 – 24.5 (P=0.001655) and >24.5 – 29.5 (P= 0.009368). Conclusion: The present study shows a consistent positive association between elevated maternal Triglycerides and the risk of Preeclampsia. Therefore, the level of maternal Triglycerides can be used as a screening test in the early second trimester to predict development of Preeclampsia.

Introduction: CVD is the most important cause of death all over the world. The burgeoning burden of CAD in India can be explained by the rise in prevalence of risk factors like diabetes, hypertension, dyslipidemia, smoking, obesity, physical inactivity & urbanization. The aim of the study is to compare the risk factors of patients with CAD& their siblings. Method:  It was a case-control study, conducted over a period of 1.5 years. In this study CAD patients and their siblings without CAD; age <60 years were included. Both groups were compared for CAD risk factors. Results: Total 100 patients their 100 siblings were taken. Patients were more smoker(19% patients &4% siblings p =0.001), more heavy alcohol consumption(21% patients &10% siblings p = 0.032), more moderate and high stress level(56% patients & 38 % siblings p= 0.037), more physical inactivity(70% patients &51% sibling p=0.019), more central obese(abnormal WHR for male 41% patients &25% siblings p= 0.024 and for female 21% patients &16% siblings p= 0.037), more hypertensive(40% patients & 22% siblings p=0.003), more diabetic(44% patients &11% sibling p=0.000), more intake of carbohydrate(p= 0.014), & fats(p= 0.033) and low HDL cholesterol(69% patients &46% siblings p= 0.001). Beside this among siblings’ prevalence of prehypertension, prediabetes and dyslipidemia were high. Conclusion: We found that CAD risk factors were high in patients compared to their siblings. Beside this among sibling prevalence of prehypertension, prediabetes and dyslipidemia were high. So, to prevent CAD these factors should be controlled.

Introduction

Asbestos exposure is linked with incident of pulmonary diseases comprising of bronchogenic carcinoma, mesothelioma, pleural plaque and asbestosis. International Agency for Research on Cancer (IARC) has classified all types of asbestos as carcinogens. The exact pathogenic mechanisms by which asbestos fibres trigger pulmonary toxicity and neoplasia have not been fully understood. Many research studies have been undertaken for understanding the mechanisms of asbestos’s pathogenicity. India is an extensive user of asbestos, a very limited data is available on its effect on Indian population.

Methods

Factories workers using asbestos as raw material were included in the study. A detail history related to asbestos use was recorded in the form of questionnaire. The sputum and blood samples were collected from 100 workers. Their smear was made for pathological examination. The serum was used for evaluation of IgG, IgA, and IgM by using immune-diffusion method. Effect of asbestos fiber on p53 gene was also assessed.

 Results

Medical examination of asbestos exposed workers indicated a recent upper respiratory tract infection. Peripheral smear showed toxic   transformed lymphocytes. In 14 cases, Plasmacytoid lymphocytes were seen. DNA extracted was studied by single stand conformation polymorphism, one mutation in exon 5 was detected. 

Discussion

Our findings presents initial pathological changes due to asbestos exposure. Thus simple techniques of blood and sputum examination can help in early detection of asbestos exposure.

Background: Hypertension is a leading contributor to the disease burden worldwide. Hypertension, has an incidence of 3-6% among the adult population, with affected individuals at a higher risk of cerebrovascular accidents, ischaemic heart disease and renal failure.  Objective: To determine the prevalence of hypertension in School children aged 9-16 years in Bagalkot. Method: This cross-sectional study was conducted among School Children aged between 9-16 years from schools in Bagalkot. Study period: 1.5 years, Jan 2020- June 2021. Result: The prevalence of prehypertension and hypertension was found to be 11.9% (n=149) and 6.3%(n=79). Prevalence of hypertension increased with increase in age from 5.2% in 13-14 years children to 6.7% in children of 15-16 years age group. This was statistically significant P=0.002 Prevalence of hypertension in male children (6.9%) was more than in female children (5.5%). However, this was not statistically significant. Prevalence of hypertension in the children with positive family history of hypertension was more than in children with no hypertensives in the family. This correlation was statistically significant P=0.002 Prevalence of hypertension had significant correlation with increased daily screen time P=0.02. Conclusion: The current study evaluated school children aged 9-16 years and found that the prevalence of hypertension and prehypertension to be 6.3% and 11.9% respectively. Amount of daily screen time significantly correlated with Obesity. Hypertension correlated significantly with age, amount of daily screen time, positive family history of hypertension

Introduction: Treatment of people living with HIV (PLHIV) with combination ART has improved survival remarkably with slow progress towards AIDS and improved quality of life. Immunological and virological markers help in modification in treatment regimen. To evaluate the response to treatment, CD4 T-cell count and viral load are important parameters. The indicator for immune response is CD4 T-cell count and the indicator for virological response is viral load level. So, the present study is put forward to determine immuno-virological discordance amongst PLHIV and its effects on outcome of participants resulting in death (mortality). Material and Methods: This is a Cross-sectional study was conducted among Participants coming to ART center, Department of Microbiology, and sample processing is done at HIVTL laboratory at tertiary care center, Visakhapatnam. Subjects belonging to age group > 18 years of age, male and female, on cART treatment regimen at ART center. Data is collected from PLHIV who are on cART for at least one year or more and visiting ART center. From all participants, written informed consent is taken. Socio-demographic characteristics i.e. age, sex, education, residence is taken. Base line and clinical data such as H/O opportunistic infections, H/O chronic non-communicable disease, and nutritional status HBV co-infection is taken. Baseline and CD4 count level taken from charts. CD4 count is done at the time of participants registration, followed by viral load testing after 6 months. Blood samples for CD4 count and viral load were collected during the data collection time. Result: Majority of discordant participants are between age group of 21 to 40 years, 23 (44.2%) 27(51.9%) were males 24(46.1%) were females and 1(1.92%) were transgender. All discordant participants are receiving combination ART region. 39(75%) out of 52 participants had good adherence to cART (>95%) and 13(25%) out of 52 had adherence to cART (<95%). Among 52 discordant participants 6 (11.5%) were with pulmonary Tb, 1 (11.9) with syphilis 2 (3.8%) with chronic HBV co infection and 4(7.6%) were with chronic kidney disease. Late initiation of cART among discordant population above 35 years age group in 41 (78.8%) and below 35 years age group is 11(21.1%). Mean baseline CD4count (cell/mm3) among participants were ≤ 100in 93 participants, > 150 cell/mm3 in 112 participants ≥350 in 365participants. Mean viral load count copies among participates with >1000 in 50 participants < 1000 in 16 participants and remaining 504 showed TND.  Conclusion: Early initiation of cART regimen and timely management of opportunistic infection will reduce the immune-virological discordance and the life expectancy of people living with HIV.

Background, Aims and Objectives: Shivering is a common problem in obstetric patients undergoing cesarean section under spinal anaesthesia and its incidence is approximately 30% to 55%. Aim of our study was to compare the efficacy of intravenous Dexmedetomidine, intravenous Tramadol with placebo in prevention of post-spinal anaesthesia shivering in obstetric patients undergoing caesarean section. Secondary objective was to observe any side effects like nausea, vomiting, hypotension, bradycardia and sedation. Materials and methods: This prospective, randomized, and double-blinded study was conducted in the department of Anaesthesia , PGIMS, Rohtak . 126 Healthy pregnant women, 20-40 years of age, without any comorbid conditions requiring caesarean section under spinal anaesthesia were enrolled for the study and randomly allocated into one of the three groups according to computer generated randomisation . Group A (n=41) received 0.5 mcg/kg Dexmedetomidine, Group B (n=43) 0.5 mg/kg Tramadol and Group C (n=42) plain 100 mL normal saline IV infusion after spinal anaesthesia and delivery of baby. Shivering, sedation, blood pressure, heart rate was measured intraoperatively. Result: All data were summarised as mean ± SD for continuous variables, numbers and percentages for categorical variables. There was a significant difference between the various groups in terms of distribution of Incidence of Shivering (χ2 = 48.199, p-value < 0.001) . 9.8% (n=4) of the participants in the Group A, 53.5% (n=23) of the participants in the Group B, and 85.7% (n=36) of the participants in the Group C had shivering. Conclusion: This study showed dexmedetomidine as a better drug for the prevention of shivering after spinal anaesthesia as compared to tramadol as it has a low incidence of shivering, benefits of awake sedation and not associated with nausea and vomiting.

Introduction: Abdominal symptoms are frequently encountered in clinical practice. Mostly patients seek medical attention after attempting various dietary modifications and sometimes even after self-medicating. These patients express dissatisfaction when they receive similar advice in their subsequent hospital visits. Studies suggests that a significant proportion of patients coming to hospital with abdominal symptoms would have already consulted a doctor and would be hoping for alternative treatment or advices in the current visit. Method and Methods: This was an observational cross-sectional study conducted in Vydehi Institute of Medical Sciences and Research Centre, Bangalore over a period of 6 months and was designed to examine the relationship between abdominal symptoms and their potential risk factors. 100 patients who reported abdominal symptoms that were outlined in the structured questionnaire were included in the study. Results: The study population consisted of 100 participants with a mean age of 37.48 years (SD = 12.12), ranging from 19 to 70 years. The prevalence of various abdominal symptoms among the study participants.  61 participants reported symptoms belonging to this category. The most common symptoms were heartburn (42%), water brash (21%), halitosis (20%), and belching (26%). 51 participants reported symptoms belonging to this category. The most frequently reported symptoms were a sense of incomplete evacuation of stools (39%) and straining during defecation (32%). Less common symptoms included mass per rectum (8%), blood in stool (6%), and mucus in stool (3%). Conclusions: The findings emphasize the need to identify specific risk factors associated with particular symptoms while interviewing patients. This will enable healthcare providers to tailor the interventions to address the unique needs of patients. Also, the methodology employed in this study can be extended to study symptoms and risk factors related to different medical conditions. For example, similar studies could be conducted with respiratory or cardiovascular symptoms utilizing statistical tests to find significant associations and co-occurrences of symptoms and risk factors. This can help us in developing models that can improve the overall management of patients in clinical settings

Introduction:  Patients with non-acute abdominal symptoms form a formidable number of the total patients visiting the hospital. Globally, studies have reported varying rates of gastrointestinal problems, ranging from 14% to 54%.1,2 The study aims to explore the demographic and clinical profile as well as the impact of healthcare services in these patients. This will help the medical community to identify the trends of abdominal symptoms and risk factors such that the medical community have clarity and ways to provide targeted interventions beyond the generic advices about lifestyle modifications and medications given to patients. Method and Method: This was an observational cross-sectional study conducted in Vydehi Institute of Medical Sciences and Research Centre, Bangalore over a period of 6 months and was designed to explore the clinical and demographic profiles of patients presenting with abdominal symptoms. 100 patients who reported abdominal symptoms that were outlined in the structured questionnaire were included in the study. Results: A total of 100 participants were included in this study. The mean age of study population was 37.48 years (SD = 12.12), with a minimum age of 19 years and a maximum age of 70 years. The majority of participants (37%) were aged between 31 and 40 years, and 83% belonged to ages between 21 and 50 years. The mean height was 162.76 cm (SD = 11.55) and the mean weight was 67.22 kg (SD = 13.52). The mean Body Mass Index (BMI) was 25.33 kg/m² (SD = 4.37), with a minimum BMI of 14.1 and a maximum of 37.0. Overall, 73% of participants had a BMI above normal. 81 participants were non-vegetarians and 19 were vegetarians. 12 participants in the study had diabetes and 14 participants had hypertension. Conclusions: The study emphasizes that the understanding the demographic and clinical profiles of the patients presenting with abdominal symptoms is crucial for effective diagnosis and treatment, and to tailor management strategies and improve outcomes. Future research should continue to explore these relationships across India, and also periodically, to provide relevant targeted interventions to effectively address the growing burden of gastrointestinal symptoms in diverse populations.

Introduction: Pregnancy is an incredibly stressful period due to outcome of delivery, anxious about the well-being of the unborn child, added responsibilities once the child is born, financial obligations, adapting to her postpartum body, interpersonal relationships with her spouse and other family members. Aim & Objectives: 1. To determine whether higher anxiety levels in term patients has significant effects on the duration, progress and complications of labour, 2.To assess whether significant maternal anxiety can lead to an increase in caesarean sections or instrumental deliveries, 3.To assess the difference in anxiety levels between term primigravida and term multigravida. Methodology: The study was a descriptive cross-sectional study conducted in the Department of Obstetrics and Gynecology in IGMC&RI.  Antenatal women in the low-risk group with gestational age more than or equal to 37 weeks, who gave consent for participation were included in the study. Antenatal women who refused to give consent or those with known co-morbidities complicating labour like gestational diabetes mellitus, pregnancy induced hypertension, multiple gestation, breech presentation, placental abnormalities like placenta previa or abruption, previous history of caesarean section and cephalo - pelvic disproportion were excluded. Results: The demographic details of the participants are shown in Table 1. Out of the 269 participants analysed for the study, Majority of them were housewives, belonged to the age group of 25-30 years (40%). Majority were graduates (49%) and pregnant for the first time (primi) (56.1%). Conclusion: The significance of this study is that maternal anxiety was found positive in about 105 patients, among which 19 participants had severe anxiety. These anxiety scores if known during the antenatal chechups can help in interventions for the betterment of maternal health including guidance and counselling

Introduction: Chronic Kidney Disease (CKD) represents a major global health concern characterized by the progressive deterioration of renal function. Patients with CKD often experience endothelial dysfunction, a pivotal role in the pathogenesis of cardiovascular complications. Haemodialysis, a common renal replacement therapy, further exacerbates the risk of endothelial dysfunction. Emerging evidence suggests that Vitamin D, a multifunctional secosteroid hormone, plays a significant role in modulating endothelial function and may hold the key to reducing endothelial dysfunction in CKD patients undergoing haemodialysis. Material and Methods: It is a prospective – Multicentric study and observational study of vitamin D supplementation in patients with various stages of CKD were included. Duration of study period is 2 years 6 months A total number of 150 samples were collected and divided into three groups as per the stages of CKD. Group 1 with CKD stage 1 and 2 (n=50), Group 2 with CKD stage 3 and 4( n=50), Group 3 with CKD stage 5 (n=50). 3 ml of Venous sample was collected and centrifuged at 3500 rpm to obtain the serum sample and it was processed for the analysis of Vitamin D and Nitric Oxide by endpoint ELISA method at 450 nm. Results: The Mean Vitamin D and Nitric Oxide levels in Group I (Individuals with CKD stage 1 and 2) are 21. 2 ng/ml and 29.24 Micromoles/L, Mean Vitamin D and Nitric Oxide levels in Group II (Individuals with CKD stage 3 and 4) are 14.32 ng/ml and 24.26 Micromoles/L, Mean Vitamin D and Nitric Oxide levels in Group III ( Individuals with CKD stage 5) are 10. 34 ng/ml and 23.98 Micromoles/L respectively. Conclusion: Critical role of Vitamin D in preserving endothelial function and reducing the risk of endothelial dysfunction in CKD patients with irrespective of their disease stage. Understanding the intricate relationship between Vitamin D and endothelial health offers valuable insights for clinicians, researchers, and healthcare providers in the quest to improve the cardiovascular outcomes and overall well-being of CKD patients undergoing haemodialysis. Further research and clinical trials are warranted to establish the optimal dosing and timing of Vitamin D supplementation for maximum therapeutic benefit in this vulnerable population.

Introduction: Stroke, a rapid onset cerebral deficit, is a leading cause of disability and mortality. Electrolyte imbalances, particularly hyponatremia, are common in stroke patients and linked to poor outcomes. Differentiating between conditions like SIADH and CSWS is crucial for effective treatment. This study aimed to evaluate serum sodium levels and investigates hyponatremia causes in newly diagnosed stroke patients. Materials & Methods: A total of 210 stroke patients were studied over six months using consecutive sampling. Patients over 18 years old admitted within 48 hours of stroke onset, diagnosed via CT or MRI, were included. Data, including demographics, clinical history, and laboratory measurements, were collected after informed consent. Various parameters including urinary sodium, serum osmolality, serum uric acid, serum sodium, urine specific gravity, blood glucose, blood urea, and blood urea nitrogen were measured. Results: Most stroke patients were aged between 56 and 75, with ischemic strokes being the most common (70.5%). A significant portion of patients had hyponatremia (40.0%), with SIADH being more prevalent (64.3%) than CSWS (35.7%). Mortality rate among hyponatremic patients (42.9%) was higher compared to those without hyponatremia (18.3%). However, there was no significant difference in mortality rate between SIADH (42.6%) and CSWS patients (43.3%, p=0.94). Conclusion: Maintaining electrolyte balance, especially sodium levels, upon patient arrival is crucial due to its potential adverse effects. Hyponatremia, common in stroke patients, can worsen consciousness levels and neurological symptoms, necessitating careful assessment of its severity for effective management.

Introduction: HF occurs in a mid-range ejection or moderately decreased ejection fraction. HFmrEF falls between 40 and 49%. An intermediate clinical entity, it is separate from HFpEF and HFrEF, yet it overlaps with both of these conditions. Methods: Record of A total 165 patients analysed for this study. Researchers compared individuals with heart failure who had varying ejection fractions via the use of a retrospective cohort study. This paper investigates the epidemiology, clinical features, prognosis, and management of HFmrEF. Results: The findings indicate that individuals with HFmrEF, which account for 10–25% of all occurrences of heart failure, have clinical characteristics that are a combination of HFpEF and HFrEF, and they have a high incidence of ischemic heart disease. It is important to note that while HFmrEF has a reduced risk of cardiovascular events compared to HFrEF, it has a risk of non-cardiovascular adverse events that is comparable to or even greater. Therapeutic responses point to the possibility of the effectiveness of medications that are HFrEF, such as inhibitors. Conclusion: HFmrEF is a helpful clinical category that brings to light the need of individualized research and treatment methods by emphasizing the need for such tactics. The phrase "mildly diminished EF" is more accurate in describing its features and provides support for treatment strategies that are more focused.

Introduction:Caesarean section is a common obstetrics surgery with incidence of 21% till today globally.1  Postoperative ileus is one of the expected consequences of any abdominal surgery including Caesarean section. Post operative ileus is an impaired condition of gastrointestinal motility defined as the interval from surgery until the passage of flatus or stool and the tolerance of an oral diet, that should occur within the fourth postoperative day and complicates up to 20% of caesarean delivery.2 It can lead to abdominal distension, vomiting, postoperative pain, discomfort and prolongation of hospital stay thus resulting in significant morbidity.3 Many methods have been advocated to speed bowel recovery after caesarean delivery such as ambulation, early hydration and chewing gum.4Chewing gum acts similar to sham feeding and activates the cephalic vagal pathway which results in both humoral and nervous stimulation of bowel motility. It has been proven to hasten return of gastrointestinal motility in non-obstetric abdominal surgery5. Aim: To determine the efficacy of chewing gum on recovery of bowel function following caesarean section. Objective: 1. To determine the efficacy of chewing gum on recovery of bowel function following caesarean section. 2.To assess the time interval of first feeling of hunger, time of first passage of flatus, time of first passage of faeces after chewing gum following caesarean section. Materials & Methods: This was a hospital based single-blind prospective cohort study carried out at IGMC&RI. After obtaining institutional research & ethics approval, 82 pregnant women who underwent caesarean section both emergency & elective were recruited into the study from September 2023 to November 2023. Results:82 subjects were recruited for the study. The mean age was 26.78 & 25.92 in the interventional and control group respectively. There was no statistically significant difference in their demographic variables. The gum chewing group had a statistically significant earlier onset of feeling of hunger than the control group (P= 0.002). Conclusion: Chewing gum significantly improves bowel motility in caesarean patients and can be added to post caesarean care on early post operation feeding as a low cost, safe & tolerable in early intestinal stimulation to reduce ileus associated complications.

Introduction: Paget-Von Schroetter syndrome (PVSS), also known as effort thrombosis or spontaneous subclavian vein thrombosis, is a rare condition characterized by acute upper limb swelling and pain due to thrombotic occlusion of the axillary and/or subclavian veins. This case report describes a 28-year-old male software engineer who presented with acute left arm swelling and pain following strenuous weightlifting, diagnosed with PVSS. The report discusses the clinical presentation, diagnostic approach, management strategies, and outcomes of PVSS, emphasizing the importance of early recognition and treatment to prevent complications such as pulmonary embolism and chronic venous insufficiency.

Introduction: A significant factor in neonatal mortality and morbidity is birth asphyxia. Signs of asphyxia are linked to about 23% of the 4 million newborn fatalities and 8% of all deaths worldwide that occur in children under the age of 5 each year. Aims: Trans-cranial Doppler evaluation of neonates with birth asphyxia. Correlation between Doppler study findings with clinical outcome Materials & Methods: Sample size was 50, study design was Prospective study. Period of study: from 1st may 2021 to 31st July 2022 and study area: Burdwan medical college & hospital Result: In our study, 44 (88.0%) patients had Whether First Breath Required Stimulation The value of z is 7.6. The value of p is < .00001. The result is significant at p < .05. In our study, 38 (76.0%) patients had Presence of Birth Complication. The value of z is 5.2. The value of p is < .00001. The result is significant at p < .05. In our study, 43 (86.0%) patients had Presence of Birth Complication The value of z is 7.2. The value of p is < .00001. The result is significant at p < .05. Conclusion: We concluded that it has been demonstrated that ultrasonography can be used to evaluate a new born who has asphyxia. The clinical outcome of a neonate receiving hypoxic-ischemic insults is positively connected with the resistant indices of the middle cerebral artery and anterior cerebral artery. Bad clinical outcomes are associated with both extremely high and low RI values.

Background: Overweight and abdominal obesity pose significant health risks, particularly among medical students who often experience sedentary lifestyles and irregular eating habits. Accurate assessment of visceral fat through anthropometric measurements is essential for effective health management. This study aims to evaluate the relationship between visceral fat and various anthropometric measures to identify the most reliable indicators for early intervention. Aim: To study the correlation between visceral fat and anthropometric measurements Methods: A descriptive cross-sectional study was conducted with 273 medical students aged 18-25 years at NIMS Medical College, Jaipur. Anthropometric data were collected using standardized techniques, and visceral fat was measured using Bio-electrical Impedance Analysis (BIA). Data were analyzed to determine correlations between visceral fat and the anthropometric indices. Result: Significant correlations were observed between visceral fat and all anthropometric measurements. Waist-to-Height Ratio (WHtR) showed the strongest correlation, followed by Waist Circumference (WC) and Waist-to-Hip Ratio (WHR). BMI also correlated moderately with visceral fat. Conclusion: Waist-to-Height Ratio (WHtR) is the most reliable anthropometric measure for assessing visceral fat among medical students. This study highlights the importance of using diverse anthropometric indicators for effective obesity screening and preventive strategies.

The success of root canal therapy depends on the efficient removal of the smear layer. This study compares the efficacy of Triton irrigation solution with sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) for the removal of smear layers. After extraction, the premolars were instrumented and irrigated with either Triton, NaOCl plus EDTA, or NaOCl by itself. Scanning electron microscopy (SEM) was used to measure the smear layer's clearing at various root canal depths. The results demonstrated that Triton solution removed the smear layer more successfully than NaOCl alone, making it comparable to the NaOCl-EDTA combination. Triton shows promise as a cost-effective and efficient irrigant for root canal treatment

Background: Acute appendicitis is a common cause of acute abdomen requiring surgical intervention. Delayed diagnosis can lead to serious complications such as appendiceal perforation. Recent studies suggest that hyperbilirubinemia could be a useful predictor for appendiceal perforation [6-8]. Aim: To investigate the relationship between elevated serum bilirubin levels and the likelihood of appendiceal perforation in patients diagnosed with acute appendicitis. Methods: This prospective observational study was conducted at the Department of General Surgery, SS Institute of Medical Sciences and Research Centre, Davangere, from March 2022 to March 2024. Patients diagnosed with acute appendicitis or appendiceal perforation were included. Demographic data, clinical signs, and laboratory results, including serum bilirubin levels, were collected. Statistical analyses, including independent samples t-tests and chi-square tests, were performed to compare bilirubin levels between groups and to assess the association between bilirubin levels and appendicitis. Results: The study included 100 patients with a mean age of 45.7 years, 41% of whom were female. Elevated serum bilirubin levels were significantly associated with the presence of appendicitis (p < 0.001). Patients with appendicitis had higher mean total bilirubin (1.193 mg/dL vs. 0.704 mg/dL), indirect bilirubin (0.811 mg/dL vs. 0.479 mg/dL), and direct bilirubin levels (0.530 mg/dL vs. 0.218 mg/dL) compared to those without appendicitis. Among patients with elevated bilirubin levels, 63.6% had appendicitis compared to 3.6% without appendicitis, indicating a significant association (χ² = 42.3, df = 1, p < 0.001). Conclusion: Elevated serum bilirubin levels are significantly associated with acute appendicitis and can serve as a reliable marker for predicting appendiceal perforation. Incorporating bilirubin measurements into the diagnostic protocol for appendicitis can enhance early detection and improve patient outcomes. Further multicentric studies with larger sample sizes are needed to validate these findings.

Introduction: According to WHO, in 2019, diabetes was the ninth leading cause of death with an estimated 1.5 million deaths directly caused by diabetes. In 2014, 8.5% of adults aged18 years and older had diabetes. The crude prevalence of diabetes in adults aged 20years or older in India increased by 39·4% . Key for prevention of the complication among the diabetic patients is prompt and aggressive treatment aimed at maintaining normal blood sugar levels. C-peptide is commonly used in preference to insulin measurement when assessing b-cell function in clinical practice. Age is a factor which is a determinant of functionality of the human body. Hence it needed to assess the effect of aging on the c-peptide levels i.e., the insulin production in the body. Early initiation of the insulin treatment for the patients of diabetes is depended on the c-peptide levels. This necessitates the need to understand the c-peptide levels as a proxy of insulin levels amongst the diabetics and the correlation between theage of the diabetes and the c-peptide levels. Objectives: To estimate the level of C-peptide in patients with newly diagnosed type 2 Diabetes Mellitus and to correlate C-peptide levels in different age groups of newly diagnosed type 2 Diabetics Mellitus. Materials And Methods: The present study is a cross-sectional study conducted in KR Hospital, Mysuru.  Patients who were newly diagnosed with Diabetes Mellitus, who satisfy the inclusion criteria and consented to participants in the study was included inthe study. Detailed history, Examination and investigations were done to the selected study   participants. C-peptide levels was estimated in all the patients. Data was analysed using SPSS software. Results: Around 50% of the patients belonged to the age group of 30-40 years. While21.9% belong to 51-60 years. Mean age was 49.45 years. 5.71% of them fall under 71-80 years of age category. 52.38% of the study participants were males while 47.61%were females. Mean Fasting blood sugars and Post Prandial blood sugars of the newly diagnosed diabetes mellitus study participants are 217.85 mg/dl and 342.42 mg/dlrespectively. The mean glycosylated hemoglobin is 10.71% among the patients.68.57% of the newly detected diabetes mellitus in our study had high c-peptide levelswhile 31.42% of them had low c-peptide levels. Mean c-peptide levels among the study participants is 6.51 ng/ml with standard deviation of 1.14 ng/ml.There was a negative correlation between the age and c-peptide. The decrease in the c-peptide levels indicates low insulin production by thebeta cells of pancreases. Conclusion: The present study concludes that there is a strong negativecorrelation between the c-peptide levels and age among the study participants Thisindicates the true deficiency in the insulin production in our participants which bringthe need for the early initiation of the insulin therapy, at the time of diagnosis in a newlydetected type 2 diabetes mellitus. Hence, c-peptide levels measured at diagnosis orearlier after the diagnosis of diabetes mellitus at any age helps in understanding theinsulin reserve of the patients. Thus, better treatment can be given by seeing the c-peptidelevels to have good control of blood sugar levels and in preventing thecomplication of diabetes mellitus.

Background: Obstructive Sleep Apnea (OSA) is characterized by repeated episodes of partial or complete obstruction of the upper airway during sleep, leading to cardiovascular complications due to endothelial dysfunction. Understanding how OSA affects endothelial function compared to healthy individuals can provide insights into preventive strategies. Objective: This study aims to assess and compare endothelial function in patients with obstructive sleep apnea versus healthy sleepers. Methods: We conducted a cross-sectional study with 50 patients diagnosed with obstructive sleep apnea and 50 healthy sleepers matched by age and sex. Endothelial function was assessed using flow-mediated dilation (FMD) measured by ultrasound of the brachial artery. Results: The study is expected to reveal significant differences in endothelial function between patients with obstructive sleep apnea and healthy sleepers, contributing to the understanding of cardiovascular risks associated with OSA. Conclusion: Assessing endothelial function in these populations can provide valuable information for cardiovascular risk assessment and the potential benefits of therapeutic interventions

Introduction: Pressure ulcer is an injury of the skin wherein it   breaks down the skin along with the underlying tissue when the area of skin in contact is subjected to constant pressure for a certain time period causing cessation of nutrition and oxygen supply to the tissue, leading to ischemia and eventually tissue necrosis. The aim of the present study was to assess the knowledge, attitude and practices of the nursing staff with regards to pressure ulcer. Materials & Methods: The present study is a non-interventional, cross-sectional study, comprising of 97 nurses who were enrolled and asked to answer a pre-validated questionnaire on pressure ulcer. Results: The results were compiled by taking into account the selected responses to the questionnaire and the demographic profile of the participants were also considered. Conclusion: Pressure ulcers can adversely affect the quality of life and vary from moderate to severe degree depending upon the grading of ulcer. By adequate knowledge, right attitude and correct practices the burden of pressure ulcers can be reduced significantly

Introduction:  Respiratory exercise and flow breathing spirometer is an exercise of importance for patients with upper abdominal surgery. The incentive spirometry technique was used to encourage the patient to take maximum and long inspiration, and slow deep breathing using a device to measure flow or sound. With this background the present study aim is to compare the effect of deep breathing exercise, flow and volume incentive spirometry, on pulmonary function and diaphragm excursion, following laparoscopic surgery. Method and Method: We compare methods perform deep Breathing Exercise with methods to Perform Incentive Spirometry making three groups A 40 patients, B 40 patients, C control 40 patients. Pulmonary function tests, Forced Vital Capacity, Forced Expiratory Volume in the first second, Peak Expiratory Flow Rate. These were taken on the preoperative day Day1, 1st and the 2nd postoperative day, for all groups, day 2 and 3 respectively.  Results: There was a statistically significant decrease in Forced Vital Capacity (FVC) in the 1st and 2nd post-operative day when compared with the preoperative period in all groups. In all groups there was a statistically significant decrease in Forced Expiratory Volume at the end of the first second (FEV1) on the 1st and 2nd post-operative day when compared to the preoperative period. Conclusions: The main purpose of this study is to compare deep breathing exercise, Flow incentive spirometry. In our study we found that deep breathing exercise and incentive spirometry improve lung function in patients undergoing laparoscopic cholecystectomy surgery.

Introduction: Surgery and anaesthesia are uncomfortable experiences for patients, often causing stress and anxiety that can impede the intended therapeutic outcomes. Increased stress and anxiety may have a deleterious impact on post-operative analgesic use and pain perception. Advancements in anaesthesia extend anesthesiologists’ role beyond the surgery, allowing for an anaesthesia in diverse procedures, and raising patient expectations for comfortable treatment. (1) At least two days before the operation, anxiety affects a majority of patients scheduled for surgery. Materials And Methods: After obtaining institutional ethics committee approval (SGRD/IEC/2022-163 dated 13.12.2022) and the patient’s informed consent, this prospective semi-experimental randomised single-blind controlled study was conducted to investigate the effect of music (the independent variable) on cortisol levels, VAS-A scores and VAS pain scores (the dependent variables). The study was conducted in 100 patients of either sex in the age group between 18 to 60, with ASA classification I and II, undergoing Laparoscopic Cholecystectomy from January 2023 to December 2023.Results: The demographic characteristics of the study participants were analysed and there were no statistically significant differences in the mean values of all the characteristics. (Table 1) As shown in Table 2 on comparing mean VAS-A scores among the three groups, the difference at the baseline was statistically not significant (p-value 0.77) but when the three groups were compared after the respective interventions, the scores before surgery were significantly lower in group A than in groups B and C (p-value 0.037) additionally, scores of group B were significantly lower than group C. Similar findings were seen when the three groups were compared after surgery (p-value 0.02).Conclusion: Music therapy especially listening to music of choice is a safe and effective non-invasive non-pharmacological intervention with several benefits for surgical patients. It reduces the need for pain medication during the postoperative period without causing any side effects. It also hinders the increase of blood cortisol levels. Additionally, music therapy helps lower anxiety enhancing the overall surgical experience for patients.

Introduction: FNAC has a pivotal role in the evaluation of breast lesions. Cytological grading systems are being utilized for the categorization of breast lesions. Modified Masood’s scoring System (MMSS) is used to improve the grading system for accurate pre-operative diagnosis. This study aims to assess the effectiveness and accuracy of the Modified Masood Scoring System for evaluating breast lesions and their correlation with histopathological diagnosis. Materials and Methods: This is a prospective study conducted in the Department of Pathology, MGM Medical College, Navi Mumbai which included 40 patients who presented with clinically palpable breast lump and were subjected to FNAC along with histopathological examination. The cytological smears were grouped into four categories according to MMSS. Correlation and concordance analysis between cytological categories and histopathological diagnosis was carried out. Observations and Results: The age of the patients ranged from 17 to 70 years with a mean age of 38.12 years, right-sided breast lesions were more common as compared to the left side. Of the total 40 cases, 27 cases were benign, and 13 cases were malignant on histopathology. The most common benign breast lesion was Fibroadenoma [Figure 1] and the malignant lesion was infiltrating duct carcinoma [Figure 2]. The sensitivity, specificity, Positive predictive value, Negative predictive value, and diagnostic accuracy were 76.9%, 100%, 100%, 90%, and 92.5% respectively. Conclusion: MMSS is simple, cost-effective, easily reproducible, reliable, and can be applied to FNAC aspirates to increase the diagnostic accuracy of Breast Lesions

Background: Depression and anxiety are common psychiatric conditions that can significantly affect the quality of life. However, their prevalence among general medicine outpatients remains inadequately explored. Methods: This cross-sectional study involved 200 general medicine outpatients from a tertiary care hospital. Standardized tools, the Patient Health Questionnaire (PHQ-9) for depression and the Generalized Anxiety Disorder (GAD-7) scale for anxiety, were utilized to assess the prevalence rates. Results: Of the 200 outpatients studied, the prevalence of clinically significant depression was found to be 35%, while anxiety was detected in 30% of the patients. Comorbidity of both conditions was observed in 20% of the subjects. Conclusion: The study highlights a significant prevalence of depression and anxiety among general medicine outpatients, emphasizing the need for routine screening and integrated psychiatric care in general medical settings.

The most common type of eye cancer in youngsters is called retinoblastoma. Four categories are used to categorise the disease. One classification is based on whether the condition affects one eye or both; these are referred to as unilateral and bilateral, respectively. Based on gene expression analysis, retinoblastomas can be classified into two types. Group 1 exhibits an invasive tumour pattern together with a variety of different types of retinal cells. Group 2 exhibits a distinct cone photoreceptor expression profile. RBBP9 is a protein that is involved in the human cancer process and is a binding partner of retinoblastoma susceptibility protein (Rb). LxCxE is the Rb binding motif found in the sequence of RBBP9. Yeast two-hybrid experiments revealed that RBBP9 interacts with Rb. RBBP9 is 21 kD in size, and its crystal structure has been investigated. There is evidence linking RBBP9 to pancreatic cancer. Pancreatic cancer cannot develop without the protein's serine hydrolase activity. Serine hydrolase activity works by phosphorylating Smad2/3 less, which in turn suppresses TGF-β antiproliferative signalling. Our goals in this study are to visualise the protein structure in PyMol, determine the nature of the protein (whether hydrophobic or hydrophilic), use the multiple alignment tool COBALT to check for protein conservation across other species, identify both chains (A & B) using PyMol, examine the interaction between 2QS9 and 7OEX (a protein that is very similar to 2QS9) in PyMol, perform multiple sequence alignment using clustal omega to determine the nature of the protein, and plot the Ramachandran plot to visualise energetically allowed region in BioPython and Saves server and molecular docking of 2QS9 and Topotecan using CB-DOCK2.

Introduction:  Takotsubo syndrome (TTS) can be described as an acute, transiently occurring form of heart failure with dysfunction of the left ventricle (LV). Intense physical and emotional stress has been identified as the most common trigger factor [1, 2]. A fear about upcoming surgical procedure, the operation itself or the administration of drugs that mimic stress hormones may cause this syndrome [2, 3]. In this case, we will present a case of severe takotsubo syndrome related to haemodynamic consequences of cardiac tamponade and rescue procedures

Background: Oxytocin is a widely used uterotonic agent to prevent postpartum hemorrhage in cesarean sections. However, its administration method can influence hemodynamic stability. This study compares the hemodynamic effects of low dose Bolus followed by continuous Intravenous (IV) infusion versus Continuous IV Infusion during cesarean sections.  Methodology: Sixty participants undergoing elective cesarean delivery were divided into two groups: Group IB (2 IU IV bolus with 8 IU infusion) and Group I (10 IU IV infusion). Hemodynamic parameters, including systolic (SBP) and diastolic blood pressure (DBP), pulse rate (HR), and mean arterial pressure (MAP) were measured at different time intervals. Linear analogue scale (LAS) scores were used to assess uterine contractions, and surgeon satisfaction was evaluated. Results: There was no statistically significant difference between the SBP or DBP between the two groups. The fall in MAP in Group IB (bolus group) was higher than that in the Group I (Infusion group) at all time intervals but was not statistically significant. The linear increase in Heart rate was significantly higher in Group IB compared to Group I at 5 minutes and 15 minutes of administration of oxytocin. While Group IB exhibited a better Uterine contraction as assessed by LAS scoring at 5 and 10 minutes of Oxytocin administration which was statistically significant. There was no statistically significant difference in Blood loss between the two groups. Conclusion: While both administration methods of oxytocin in cesarean sections induce hemodynamic changes, low dose bolus-continuous injection of oxytocin resulted in slightly more hemodynamic changes than the continuous injection but had a greater effect on uterine contraction.

Introduction:  Rigid laryngoscopy and tracheal intubation continue to be the gold standards of airway care in contemporary anesthesia practice. It was discovered more than 50 years ago that airway manipulation affected blood pressure and heart rate. Aim: The aim of the study is to compare the effect of magnesium sulphate and lignocaine in attenuation of hemodynamic stress response to laryngoscopy and endotracheal intubation. Materials and method: It was a randomized prospective study. 120 patients were divided into two equal groups. Group A received intravenous 50% magnesium sulphate 30 mg/kg and Group B received intravenous 2% lignocaine 1.5mg/kg, 10 mins prior to induction of GA. Result: Statistically significant differences (p<0.05) between magnesium sulphate and lignocaine were found in HR, SBP, DBP at 10 min after study drug was given, at induction, at intubation and onwards till 10 mins after intubation. No significant adverse effects were noted with both drugs. Conclusion: Compared to intravenous 2% lignocaine 1.5 mg/kg bolus over 1 minute, 10 minutes before to induction, intravenous 50% magnesium sulphate 30 mg/kg diluted to 20 ml infusion over 3 minutes 10 minutes prior to induction more effectively attenuates the hemodynamic response.

Objective: - To study CP ratio & its correlation with feto -maternal outcome. Methods: - This was a prospective observational study done in Department of Obstetrics and Gynaecology, MGM Medical college, Indore, over a period of one year. Women > 37-week singleton pregnancy with no known risk factor who had Doppler USG done at the time of labor were included. CPR was calculated by dividing the Doppler indices of middle cerebral artery (MCA) by umbilical artery (MCA PI/UA PI). CPR < 1 was taken as abnormal. Results: - Out of 150 low risk term pregnancy who went for USG colour doppler Scan, 14 (9%) patients were having CPR <1 and 136 (90.6%) were having CPR >1. Among 14 patient with CPR <1 , 10 (71%) were delivered by caesarean section as compared to only 6 (4.41%) patients with CPR >1.  Among 14 patient with CPR <1 , 13 (92.86%) had adverse outcome as compared to only 11.76% patients with CPR >1. Conclusion: - Our study found CPR measure to be a very promising tool for optimising the identifcation of at-risk foetus in low-risk AGA pregnancies.

Baska LMA is a novel supraglottic airway device with a number of unique features. The present study enrolled 90 patients to compare Baska with classic LMA in terms of First attempt and overall success rate of insertion, ease and time of insertion, ef-fective airway time, oropharyngeal seal pressure and anatomical position on fiber optic bronchoscopy. Standard anesthesia protocol was followed. We found lower first attempt and overall success rate with Baska compared to classic LMA. There was no difference in either ease or time of insertion or effective airway time in the two groups. The anatomical position was slightly better while oropharyngeal seal pressure was significantly higher with Baska Mask as compared to classic LMA. Through this study we concluded that Baska Mask can provide promising alternative to classic LMA in clinical situations requiring higher seal pressure

Introduction: In a demographically diverse, vast, and highly densely populated developing country like India, the establishment of the identity of a deceased poses great medico-legal importance. It also poses a great challenge to the forensic pathologist working in an environment where decomposition and taphonomic processes are rapid. Structurally bones resist common degradation and putrefactive changes and remain longer as material for evidential value. Human skeletal remains, which are found under suspicious circumstances and doctors examining them need to give an opinion in the court of law. Forensic experts are often consulted regarding the identification of skeletal remains. One of the important bones that helps to determine sex is the Sternum Bone. For this purpose, a technique will be highly appreciated for the determination of sex from the morphometry of the sternum. This current pilot investigation was designed to determine the sex from the adult human sternum from predefined vertical linear measurements.  Materials And Methods: After getting institutional ethical committee clearance, the study was conducted over the 64 adult human sternums screened through the inclusion and exclusion criteria. Results: In the current study, the study population comprises 38 (59.4%) males and 26 (40.6%) females, selected through the complete enumeration method. Among total 64 cases of the present study 28(43.8%) cases are from 18-39 years age group and 22 (34.4%) cases are from 40-59years age group 14(21.9%) cases are from 60-90years. On considering sex, it is found that the mean length of manubrium in male(52.44mm) is greater than that of female (45.19mm). The mean length of body in male(98.44cm) is greater than that of female (83..20cm). Most importantly unstandardized canonical discriminant function was estimated using two pre-defined vertical linear measurements as independent variables (Manubrium Length-ML and Mesosternum Length-SL) as :- D= (0.211* ML) + (0.37* SL) -13.845. CONCLUSION:  A paradigm shift from morphological to morphometrical determination of sex from sternum will help to reduce the subjective variation to an extent that can be modified and sophisticated later through more thorough detailing.

Information about the impact of gender on the prognosis of acute myocardial infarction-cardiogenic shock (AMI-CS) in young adults is scarce. Techniques: A cohort of AMI-CS admissions between the ages of 18 and 55 that occurred between 2018 and 2023 was identified retrospectively using the National Inpatient Sample. It was determined which procedures were used: non-cardiac interventions, mechanical circulatory support (MCS), percutaneous coronary intervention (PCI), and coronary angiography. The use of cardiovascular interventions, the duration of stay, hospitalization expenses, and in-hospital death were all relevant outcomes. Results: There were 90,648 AMI-CS admissions for patients under the age of 55 in total, with 26% being female. Men's prevalence of CS increased from 2.2% in 2000 to 4.8% in 2017, whereas women's rates decreased from 2.6% in 2000 to 4.0% in 2017 (p<0.001). Women, had poorer socioeconomic position than men (all p<0.001). Acute non-cardiac organ failure, cardiac arrest, elevated ST-segment appearance, and PCI rates were all lower in women (all p<0.001). They also received less frequent coronary angiography (78.3% vs. 81.4%), early coronary angiography (49.2% vs. 54.1%), PCI (59.2% vs. 64.0%), and MCS (50.3% vs. 59.2%). An independent predictor of in-hospital death was female sex mortality (23.0% vs. 21.7%; adjusted odds ratio 1.11 [95% confidence interval 1.07–1.16]; p<0.001). Women had lower hospitalization costs (156,372±198,452 vs. 167,669±208,577; p<0.001) but comparable lengths of stay compared to men. Conclusions: In young AMI-CS admissions, women are treated less aggressively and experience higher in-hospital mortality than men.

Introduction:  AMI is the leading cause of death for both men and women all over the world. Acute myocardial infarction is myocardial necrosis resulting from acute obstruction of coronary artery. Calcium ions are involved in myocardial contraction, and during acute myocardial infarction. The disruption of blood flow to the heart muscle can lead to an imbalance in calcium levels. This disruption can cause calcium overload with myocardial cells, leading to cellular injury and dysfunction. Magnesium has properties of myocardial cryoprotection, the pathophysiological explanations of which in açute myocardial infarction include prevention of arrythmia, antiplatelet effect, prevention of reperfusion injury and coronary vasodilation. Increased serum uric acid (SUA) levels have been associated with various pathologic processes such as increased oxidative stress, inflammation and endothelial dysfunction. Troponin I is highly specific to cardiac muscle so its presence in the blood stream is a reliable indicator of heart muscle damage. The Elevation in troponin I levels is used as a diagnostic marker for AMI.

Material and Methods:A comparative and cross-sectional study was conducted in the Department of Biochemistry in Rangaraya Medical College, Kakinada over a period of 4 months. Sampling Type: Casual sampling of newly diagnosed AMI patients attending the OPD. Controls are recruited from healthy individuals attending the OPD for health checkup. Sample Size: 50 newly diagnosed AMI patients constitute group 1, 50 age and sex matched healthy individuals in group 2. Results: The Group 1 has a higher mean age (54.36±6.70 years) compared to Group 2 (51.3±7.98 years), suggesting that on average, participants in Group 1 are older than those in Group 2. The higher mean calcium level in Group 2 (9.276±1.24 mg/dl) compared to Group 1 (8.548±1.73 mg/dl) suggests that, on average, participants in Group 2 have higher calcium levels than those in Group 1. Comparing the two groups:- Group 2 has a higher mean magnesium level (2.062 mg/dl) compared to Group 1 (1.892 mg/dl). The standard deviation for magnesium levels is smaller in Group 2 (0.41) compared to Group 1 (0.71), indicating that magnesium levels in Group 2 are less variable around the mean compared to Group 1. Group 1 has a mean uric acid level of 7.824 mg/dl with a standard deviation of 5.95 mg/dl. Group 2 has a mean uric acid level of 6.188 mg/dl with a standard deviation of 2.10 mg/dl. Group 1 has a mean Troponin I level of 4463 pg/ml with a standard deviation of 5226.92 pg/ml. Group 2 has a mean Troponin I level of 10.048 pg/ml with a standard deviation of 14.03 pg/ml. Conclusion: Acute MI is the 3rd largest cause of death in the population. If untreated it causes necrosis of the myocardium and finally death of the patient. Magnesium has cytoprotective properties, anti-platelet effect, prevents arrhythmias and reperfusion injury and coronary vasodilation. So it should be estimated. Calcium ions are involved in myocardial contraction. It plays a role in coagulation cascade. It forms blood clots that obstruct blood flow so medications targeting calcium channel to reduce myocardial oxygen load and improve coronary circulation. Uric acid may be a marker for increased cardiovascular risk. Troponin I is highly specific and diagnostic of acute MI.

Introduction:   Chronic kidney disease (CKD) significantly elevates the risk of cardiovascular disease (CVD), which is the leading cause of morbidity and mortality in CKD patients. Understanding the cardiovascular outcomes in this population is crucial for developing effective prevention and management strategies. Objective: This study aims to evaluate the incidence and determinants of cardiovascular events in patients with CKD at the Department of Cardiology, Hi-Tech Medical College & Hospital, Bhubaneswar, India, over a period from June 2018 to December 2023. Method: An observational cohort study was conducted with a sample size of 68 CKD patients. Data were collected on traditional and non-traditional cardiovascular risk factors, and patients were followed to document major cardiovascular events such as myocardial infarction, stroke, and heart failure. Statistical analyses included the calculation of incidence rates and multivariate regression to identify independent predictors of cardiovascular outcomes. Results: During the study period, 23.5% of the patients experienced a major cardiovascular event. The incidence rates of myocardial infarction, stroke, and heart failure were 10.3%, 5.9%, and 7.3%, respectively. Significant predictors of cardiovascular events included hypertension (p < 0.01), dyslipidemia (p < 0.05), and elevated levels of inflammatory markers (p < 0.01). CKD progression was also strongly associated with increased cardiovascular risk (p < 0.01). Conclusions: The findings highlight a high incidence of cardiovascular events among CKD patients and underscore the importance of comprehensive cardiovascular risk management in this population. Early identification and intervention for modifiable risk factors are essential to improve cardiovascular outcomes in CKD patients

Syndactyly is most common congenital anomaly of hand. Incidence of congenital syndactyly is 1 in 2000 to 1 in 3000 life births. Syndactyly may be congenital or acquired.  Syndactyly may be acquired, occurred following burns or trauma. Surgical Management of syndactyly should be properly planned for aesthetically and functional hand postoperatively.The study was conducted in department of Plastic surgery, VIMSAR Burla, a tertiary centre in Western Odisha from July 2022 to December 2023. All types of syndactyly patients admitted were included in the study. In total 20 cases of syndactyly were included. All data about sex pattern, age group, aetiology, types, involvements of limbs, web space involvement and different complications following procedure was collected. Males were more commonly affected, with male female ratio 1.1:0.9. Most common age group was more than 20 years. Most of the syndactyly was congenital (75%). Hand was most commonly involved than foot. Bilateral involvement was common in hand and foot than unilateral involvement. In hand 3rd web space was most commonly involved (62.5%) and in foot 2nd web space most commonly involved (54.54%). Most common complication was hypertrophic scar in 17.14% of web operated. In none case neurovascular injury occurred. Good aesthetic functional hand can be achieved with proper planning and proper tissue handling during syndactyly surgery. Awareness among patients must be done for early surgical intervention in syndactyly

Introduction: Omega-3s have been studied extensively for their potential benefits in reducing cardiovascular diseases (CVDs). While some studies suggest positive outcomes, recent evidence shows limited overall effects. The study aims to provide an updated synthesis of the existing evidence, but limitations in study design and individual circumstances need to be considered when interpreting the results. Additional research is required to fully understand the impact of omega-3s on CVDs and guide clinical practice recommendations. Aims and Objectives: To investigate the effect of omega-3 fatty acids (DHA or Docosahexaenoic Acid, and EPA or Eicosatetraenoic Acid) in patients who have cardiovascular abnormalities. Methods: The authors conducted a primary literature search using various online libraries and keywords related to omega-3 and cardiovascular outcomes, resulting in 198 retrieved studies. After applying inclusion and exclusion criteria, 12 appropriate studies were included in the meta-analysis. The outcomes considered were mortality, myocardial infarction, atrial fibrillation, coronary events, and other cardiovascular abnormalities. Statistical analysis was performed using Review Manager 5.3, and odds ratios with 95% confidence intervals were calculated. The significance level was set at p<0.05 to assess the impact of omega-3 fatty acids on cardiovascular events. Results:  The studies vary in design and sample size, with participants ranging in age from 62 to 77.6 years. The main treatments investigated are EPA+DHA, EPA, and Vitamin D3, compared to control groups receiving no treatment or placebos. Daily doses of EPA+DHA range from 0.84 to 4.0 grams. Meta-analysis results show that omega-3 consumers have a lower risk of adverse cardiovascular events. Some studies did not find significant effects, but overall, omega-3 supplementation appears beneficial in preventing cardiovascular diseases (P<0.00001). Conclusion: The study has concluded there is evidence found in support of omega-3 fatty acids that can reduce adverse cardiovascular events in the form of cardiovascular diseases or mortality. 

Cervical cancer represents a critical public health challenge, especially in developing countries where it significantly contributes to cancer-related mortality among women. Human papillomavirus (HPV) infection is a primary etiological factor for cervical cancer. In India, cervical cancer accounts for 9.4% of all cancers and 18.3% of new cancer cases. Despite the availability of cytological screening methods such as the Papanicolaou (Pap) smear, issues with sensitivity and coverage highlight the need for alternative strategies, such as HPV-DNA testing. This study aims to evaluate the prevalence of high-risk HPV serotypes (16, 18, 31, and 45) in women aged 25-65 years attending a tertiary care center, and assess the utility of HPV-DNA testing in primary cervical cancer screening.

Introduction: Gastritis is a prevalent clinical condition with a global incidence of over 50%. The primary cause of gastritis is Helicobacter pylori (H. pylori), a bacterium that infects about 50% of the world's population, especially in developing countries. The prevalence of H. pylori is influenced by geographic distribution, age, race, and socioeconomic status. It is a significant risk factor for gastric carcinoma and MALT lymphoma. Diagnosing H. pylori involves both endoscopic and non-endoscopic tests, with histological diagnosis and rapid urease tests being highly effective. Methodology: A prospective cross-sectional study was conducted at MKCG Medical College and Hospital in Berhampur from January to December 2017. Patients with symptoms of gastritis underwent upper GI endoscopy, and tissue samples were taken for histopathological examination and rapid urease tests. The study collected socio-demographic data and evaluated endoscopic findings using the modified Sydney system of grading. Statistical analysis was performed using SPSS software. Results: Out of 325 enrolled cases, 66.15% were male, and 33.85% were female, with the majority being over 60 years old. The most common symptoms were heartburn (75.38%), dysphagia (65.85%), and abdominal pain (60.92%). Endoscopy revealed gastritis in 81.54% of cases. The rapid urease test was positive in 83.69% of cases, and histopathological examination confirmed H. pylori in 81.53% of cases. Inflammatory cellular infiltrates were graded, with significant correlations between endoscopic findings and H. pylori colonization. Discussion: The study highlights the high prevalence of H. pylori-associated gastritis, with significant gender and age-related trends. The rapid urease test proved to be a sensitive diagnostic tool, and the modified Sydney system provided a comprehensive evaluation of histopathological changes. The findings emphasize the importance of accurate diagnosis and management to prevent complications such as mucosal atrophy and gastric carcinoma. Conclusion: The prevalence of H. pylori infection in gastritis cases necessitates effective diagnostic and management strategies. Rapid urease tests and histopathological examination are reliable methods for detecting H. pylori and grading gastritis. Continuous surveillance and appropriate treatment are crucial to mitigate the health burden associated with H. pylori infection.

Background: Gastritis, a significant public health concern worldwide, involves inflammation or irritation of the gastric mucosa. This condition is influenced by various factors such as health behaviors, socioeconomic status, lifestyle, living conditions, and habits. It can be acute, chronic, or severe and is often associated with Helicobacter pylori (H. pylori) infection. Contributing factors to gastritis include smoking, alcohol consumption, spicy foods, medications, stress, and infections. In India, the prevalence of gastritis is notable, with recent studies indicating a high incidence of H. pylori infection. This study aims to investigate the prevalence and contributing factors of gastritis among patients in a tertiary care hospital. Methodology: A descriptive, observational, non-interventional study was conducted with 150 subjects aged 14-65 years diagnosed with gastritis at MKCG Medical College and Hospital, Berhampur. Data were collected using a structured questionnaire covering socio-demographic details, dietary habits, economic status, family history, stress levels, drug use, and medical history. Ethical approval was obtained, and written consent was provided by each participant.  Results: Out of 150 subjects, 73% were male and 27% female, indicating a male predominance. The age groups 14-25 and 36-45 years had the highest prevalence. A significant proportion (75%) had a mixed diet, and 54% were alcoholics, predominantly males. Urban residents (68%) exhibited a higher incidence of gastritis. Blood group A Rh+ was predominant (46%), and 6% were hypertensive. Spicy food consumption (73%) and frequent NSAID use (61%) were notable risk factors. High stress levels were reported by 47% of the participants. Associations were found between gastritis and psychological stress, menstrual history, sleeping patterns, and educational levels. Discussion: Gastritis prevalence is influenced by male gender, urban residence, alcohol consumption, spicy food intake, and frequent NSAID use. The findings highlight the importance of targeted interventions to address these risk factors. Physical labor, particularly among males, and stress are significant contributors. The study underscores the need for preventive strategies focusing on lifestyle modifications and stress management to reduce gastritis incidence. Conclusion: This study provides a comprehensive overview of the prevalence and contributing factors of gastritis in the hospital. Males, urban residents, and individuals consuming spicy food and alcohol are at higher risk. The findings call for public health initiatives to address these risk factors through education, lifestyle changes, and stress reduction programs. Future research should explore tailored preventive strategies to mitigate the burden of gastritis in this population

Background: The adrenal glucocorticoid stress response in humans causes catabolism, increasing blood glucose and heart rate, and possibly potentiates ischemic damage to neurons. These effects could induce secondary brain damage in acute stroke. Materials and methods: In this prospective observational study, 60 patients with acute ischemic stroke were evaluated. Cardioembolic and lacunar strokes were excluded. In the first 24 hours of admission, serum cortisol level, national institutes of health stroke scale (NIHSS), diabetes and hypertension were assessed to determine their value to predict mortality within 90 days.  Result: Mean age was observed in the current series was 74.14 ± 14.58 years. There were 32 (53.3%) male and 28 (46.7%) female. Scandinavian Stroke Scale (SSS) was observed to be 34 (21-47) on admission. History of hypertension, History of stroke, Diabetes mellitus and Atrial fibrillation was observed in 35 (58.3%), 10 (16.7%), 22(36.7%) and 9 (15%) respectively. In univariate logistic regression analysis of the relations to 7 days of mortality, s-cortisol, SSS on admission, and pulse rate reached a significance level. S-cortisol level was higher in patients with insular involvement, 635 nmol/l, in comparison to patients without insular involvement, 589 nmol/l.   Conclusion: Among the patients with acute ischemic stroke, high serum cortisol levels at the time of admission. Clinical severity which is assessed by National Institute of Health Stroke Scale and Poor prognosis and functional outcome after 15 days which is assessed by Modified Rankin Scale

Background: Pseudomonas aeruginosa is one of the most common bacteria to cause infections in both community and hospital settings. Its ability to survive in varied environmental conditions, various virulence factors, and multi-drug resistance patterns has helped the organism cause difficulty in treating infection. Objectives: The objective of the study was to know the prevalence of Pseudomonas isolates and in particular P. aeruginosa isolates in varied clinical specimens and to assess the antimicrobial susceptibility patterns of P. aeruginosa as well as its magnitude of multidrug resistance (MDR) in a tertiary care hospital in Eastern India. Materials & Methods: A total of 206 confirmed isolates of Pseudomonas isolates from various clinical samples were studied. Identification and speciation of the isolates and their antibiotic susceptibility testing were determined by conventional and automated methods (Vitek 2 compact). Results: Out of the 206 isolates of Pseudomonas, 143 isolates were P. aeruginosa, the majority (44.75%) were from pus samples. Resistance to amikacin and gentamycin was 34% and 36%, ciprofloxacin and levofloxacin were 32.8% and 35%, Resistance to ceftazidime and cefepime were 43.4% and 49.6%. Imipenem and meropenem showed 37% and 35% resistance, respectively. Resistance to piperacillin-tazobactam was only 35%. Conclusion: There is increased resistance to cephalosporins, aminoglycosides, carbapenems and beta lactamase inhibitors. To restrict the inappropriate use of antimicrobial agents and the development of MDR, there is a need to continuously monitor and document the prevailing resistance pattern in a particular geographical area

This community-based observational study explored the relationship between circulating free triiodothyronine (FT3) levels and the progression of diabetic nephropathy in patients with Type 2 diabetes mellitus over one year. A total of 482 participants from Mayurbhanj, Odisha were stratified into quartiles based on their FT3 levels. The results indicated that those in the lowest FT3 quartile exhibited significantly greater progression of nephropathy, as evidenced by declines in estimated Glomerular Filtration Rate (eGFR) and increases in urine albumin to creatinine ratio (ACR), compared to those in higher quartiles. These findings suggest that FT3 could serve as a valuable prognostic marker for diabetic nephropathy progression, emphasizing the need for further research into thyroid function management as a component of diabetes care

Introduction: Cardiovascular diseases (CVDs) are the leading cause of death globally, with middle-aged adults particularly vulnerable to developing risk factors that can lead to serious health complications. Understanding the dynamics of these risk factors is crucial for effective intervention and prevention. Objective: This study aims to assess the progression of cardiovascular risk factors in middle-aged adults through a longitudinal observational approach, providing insights into the prevalence, trends, and potential early indicators for reducing CVD incidence. Method: A longitudinal observational design of 522 middle-aged adults was selected through stratified random sampling from the Department of Cardiology, Hi-Tech Medical College & Hospital, Bhubaneswar, India. Baseline data collection, beginning in June 2019, included comprehensive health assessments, biochemical analyses, and lifestyle questionnaires. Follow-up assessments were conducted annually until June 2024. Key variables measured were blood pressure, lipid profiles, fasting glucose levels, body mass index (BMI), smoking status, and physical activity levels. Statistical analysis was performed using paired t-tests to compare baseline and follow-up data, with a p-value of <0.05 considered statistically significant. Results: Preliminary results indicate a high prevalence of hypertension (55%, p<0.01), dyslipidemia (47%, p<0.01), obesity (40%, p<0.01), and diabetes (30%, p<0.01) among participants. Over the five years, the incidence of hypertension increased to 60% (p<0.01), dyslipidemia to 52% (p<0.01), and obesity to 45% (p<0.01). Diabetes prevalence rose to 35% (p<0.01). Smoking rates slightly decreased from 25% to 22% (p=0.04), while physical inactivity remained high at 60% (p=0.03). Among urban populations, the increase in risk factors was more pronounced, with hypertension rising from 50% to 65% (p<0.01) and obesity from 35% to 50% (p<0.01). The interrelationship between obesity, hypertension, and diabetes was significant, suggesting a compounded risk for cardiovascular events. Conclusions: The study highlights the escalating prevalence of cardiovascular risk factors in middle-aged adults, emphasizing the need for early and targeted intervention strategies. Public health initiatives must focus on lifestyle modifications and continuous monitoring to mitigate these risks and reduce the burden of CVDs

Background: As the intracapsular cataract extaraction has been the prefered mode of surgery for the lens induced glaucomas since long time, although there is a perceptible shift towards extracapsular cataract in the recent times with reports of safety with posterior chamber intraocular lens implantation aiming to the prognosis of good postoperative visual recovery.Thus this study was planned to study the visual outcome in Phacolytic and Phacomorphic glaucomas with posterior chamber intraocular lens implantation in our set up. Research Question: What is the visual outcome in Phacolytic and Phacomorphic glaucoma after correction with posterior chamber intraocular lens implantation in our set up? The setting of the study was at department of Ophthalmology, Government Medical College, Machilipatnam.  A one year observational study was conducted during the period from October 2022 to September 2023 on about 65 Phacolytic and Phacomorphic glaucoma patients admitted during the above period with an indication of surgical intervention in the department of Ophthalmology by studying their socio-demographic profiles, assessing the visual outcome by comparing the IOP range befor and after correction with posterior chamber intraocular lens implantation and also by visual acuity with assessing the impact of the risk factors on visual acuity postoperativrly etc;.Results: Among the total study subjects about 40% were male and 60% were female. It was observed that the burden of the disease was more between 51-70 years of age group (66%) with the Mean age was 52 years. And also, it was noticed that the disease burden was more among females when compared to males significantly. It was observed that the visual acuity was poor among the study subjects > 60 years of age and when compared to males’ visual acuity was improved better among females in this study. And also, it was noticed that visual acuity was improved significantly among the study subjects who have > 35 mm of IOP at the time of presentation and with reference to type of glaucoma there was no difference observed related to visual acuity between the two. types. Further it was found that the visual acuity was significantly improved among the study subjects who´s preoperative IOP was raised within 1 week when compared to > 1week. About 13.8% of study group have IOP of < 30 mm Hg initially at the time admission followe by 20% have between 30 - 40 mm of Hg and remaining about 66.2% have > 40 mm of Hg. It was observed that about 10.8% of study subjects have IOP of < 10 mm of Hg at the time of last follow up visit after surgical intervention followed by 53.8% between 10-15 mm of Hg, 32.3% between 15-21 mm of Hg,1.5% have > 21 mm of Hg and about 1.5% that was for one study subject  it was not recorded and nearly all the study subject´s IOP was come to near normal which statistically highly significant (P<0.005) and also it was noticed that the improvement of IOP between these two groups of Phacolytic & Phacomorphic glaucoma was same (P>0.05). There was no significant difference between Phacolytic and Phacomorphic glaucoma regarding distribution of visual acuity after correction.

Introduction: Saddle anaesthesia is one of the prominent techniques of anaesthesia for perianal surgeries as it is straightforward with regard to procedure, economical and associated with minimal hemodynamic alteration. Perianal surgeries are often conducted as day-case procedures, commonly under saddle anaesthesia. However, the impact of selecting a specific local anaesthetic on relevant outcomes remains uncertain. We thought to investigate whether intra-thecal administration of 2-chloroprocaine would be associated with a enhanced recovery from central neuraxial block.  Material and methods: In our study, eighty patients of either gender, 18- 65 years old, belonging to ASA physical status I – II, scheduled for perianal surgeries were included. Patients were randomly allocated into two groups using computer generated randomisation table. Group B (n=40) received 7.5 mg of 0.5 % of bupivacaine (hyperbaric). Group C (n=40) received 40 mg of 1% chloroprocaine (isobaric). The saddle block was administered as per the study protocol.   Results: In our study we found that Chloroprocaine had a shorter sensory block duration than Bupivacaine (p <0.001) and we observed a shorter stay in PACU.  The Chloroprocaine had a faster onset of motor block then Bupivacaine (p=0.001). The, Chloroprocaine had an earlier resolution of motor block, thus patient could ambulate earlier (p value= 0.001).  TheVAS score and need for rescue analgesia was comparable up to the first 60 mins and then VAS score increased for the group receiving Chloroprocaine, showing that analgesia lasted up to 60 mins with Chloroprocaine while it is longer for Bupivacaine.  Conclusion Chloroprocaine and Bupivacaine are both useful drugs for providing saddle block for doing perianal surgeries. Chloroprocaine is a good alternative to the time-tested Bupivacaine, as it has an advantage of slight early onset, attains adequate level of sensory block, for a shorter duration, and regresses faster thus reducing stay in PACU. Moreover, it has the advantage of early onset and rapid regression of motor block and thus patients can ambulate earlier. Therefore, chloroprocaine can be recommended for saddle block in perianal surgeries of short duration. 

Backgrounds- Burn is one of the common causes of morbidity and mortality accounts for 1.8 lakhs death annually worldwide. In India 10 lakhs people are burnt every year. Epidemiological feature of burn very in different part of India with different age, sex and socioeconomic status distribution. Hence the present study was conducted to assess the outcome of burn patients admitted to burn centre in a tertiary care hospital in western Odisha. Methods- This study was conducted between Ist January 2023 to 31st December 2023 in VIMSAR Burla, a tertiary care centre in western Odisha. It was descriptive study with total number patients were 200. Data collected from medical record and from patients. Data collected in form of age, sex, socioeconomic status, types of burn, nature of burn, percentage of burn, mortality rate and total number of hospitals stay. Results- Majority of patients were female (67.5%) with most common affected age group is 11-20 years (26.5%). Thermal burn was most common type of burn (63.5%). Most commonly low socioeconomic status group (70%) was affected. Burn was mostly accidental (70%) in nature. Most common percentage of burn was 11-20 % TBSA i.e. in 32.5% cases. Mortality rate was 17% with average hospital stay was 15 days. Conclusion- Burn significantly involve low socioeconomic status group middle aged female with mortality rate more in higher percentage of burn. With increase in awareness about severity of burn mortality rate can be reduced.

Introduction:  The COVID-19 pandemic, triggered by SARS-CoV-2, has significantly impacted global health, with varying effects across different regions. In India, Tezpur Medical College & Hospital (TMCH) in Assam has been a crucial site for managing COVID-19 patients. Understanding the clinical-epidemiological characteristics in this setting can enhance regional and national healthcare strategies. Objective: This study aims to analyze the demographic profile, clinical features, co-morbidities, treatment modalities, and outcomes of COVID-19 patients admitted to TMCH from January 2020 to December 2020. Method: A retrospective analysis was conducted on data from 1710 COVID-19 patients admitted to TMCH during the study period. Clinical records were reviewed to assess demographic details, clinical manifestations, co-morbidities, treatment approaches, and outcomes. Descriptive statistics were used to summarize the findings. Result: Among the 1710 patients, 117 (6.8%) died. The most frequently reported symptoms were fever (85.4%), cough (77.8%), and shortness of breath (71.5%). Co-morbidities were present in 60.2% of patients, with hypertension in 35.2%, diabetes in 30.4%, and cardiovascular diseases in 15.8%. Of the patients with co-morbidities, 18.4% died compared to 2.7% of those without co-morbidities. The average age of deceased patients was 68 years, significantly higher than the average age of survivors (52 years). Treatment included supportive care for 90.1% of patients, oxygen therapy for 58.7%, and antiviral medications for 22.3%. Conclusion: The study highlights significant clinical and demographic characteristics of COVID-19 patients at TMCH. High mortality was associated with co-morbidities and older age. These findings underscore the need for targeted interventions and resource allocation in similar settings to improve patient outcomes.

Introduction: Cerebrovascular accidents (CVAs), commonly known as strokes, represent a significant public health concern worldwide due to their high morbidity and mortality rates. They result from the sudden interruption of blood flow to a part of the brain, leading to neurological deficits that can range from mild to severe. Ischemic strokes, caused by the blockage of blood vessels supplying the brain, account for the majority of cases, while hemorrhagic strokes, caused by the rupture of blood vessels, constitute a smaller but equally critical subset. Among the various biomarkers studied in the context of strokes, plasma fibrinogen levels have garnered considerable attention. Elevated levels of fibrinogen are associated with increased thrombotic potential, potentially contributing to the pathophysiology of ischemic strokes. Materials And Methods: This is a hospital based Prospective analytical study was conducted in Department of General Medicine at Sapthagiri Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka over a period of 1 year. Total 50 adult patients who are getting admitted in medical wards and acute medical care with first episode of stroke and full filling the Inclusion and exclusion criteria. Plasma Fibrinogen level estimation will be carried between 24-72 hours after onset of Cerebro Vascular accidents. After completion of selection of patients, written consent is taken from the patients or their attender’s, detailed history was taken, Physical examination was done, subjects are investigated with routine blood tests like CBC, Blood Urea, Serum creatinine, Random blood sugar, CRP, urine Routine Microscopy, ECG, carotid doppler, Lipid profile, CT BRAIN, MRI BRAIN done in selected cases. Results: In the present study, Ischemic stroke is seen in 68% of patients and Hemorrhagic stroke in 32% of patients. It shows that ischemic stroke is more common than hemorrhagic stroke. Out of 34 patients of ischemic stroke,22(65%) showed their plasma fibrinogen levels ≥350 mg/dl4. Of them, 2 patients showed higher plasma fibrinogen levels between 450-549 mg/dl. Normal plasma fibrinogen levels are seen in 12 patients (35%). Higher fibrinogen levels are seen in 9 out of 16 patients (56%) in haemorrhagic stroke group. 7 patients showed normal fibrinogen level. Out of 50 patients, 7 patients expired and 43 patients survived. Among deceased 7 patients, 4 patients had ischemic stroke and 3 patients had hemorrhagic stroke. Conclusions: Stroke due to ischemia (68%) is more common than stroke due to haemorrhage (32%). Elevated fibrinogen level is one of the independent risk factors for stroke. Fibrinogen levels are slightly higher in ischemic stroke individuals compared to hemorrhagic stroke but not statistically significant. All non survivors have higher fibrinogen levels.

Introduction: A potentially fatal consequence of adult sickle cell disease (SCD) is pulmonary hypertension (PHT). However, nothing is known regarding how common pulmonary hypertension is in the pediatric SCD population. Aims: To find out the prevalence of pulmonary hypertension in children with SCD. Materials and method: The present study was an Observational-Cross-sectional study. This Study was conducted from November 2020 to October 2022 at department of Pediatrics and Sickle cell institute, Veer Surendra Sai Institute of Medical Sciences and Research, Burla. Total of 552 patients were included in this study. Result: In our study, the overall prevalence of pulmonary hypertension is 20.4% (113/552). Of them, 77 (13.9%) have moderate pulmonary hypertension and 36/113 (6.5%) have mild hypertension. Pulmonary hypertension was substantially correlated with low hemoglobin (p=0.021), a high number of crises (p=0.000), a high number of blood transfusions (p=0.000), the existence of a loud second heart sound (p=0.000), and the presence of parasternal heave (p=0.000). With age, there was a tendency toward an increase in the prevalence of pulmonary hypertension in children with sickle cell disease. Conclusion: Providing fresh perspective on the prevalence of pulmonary arterial hypertension in children with sickle cell anemia in Western Odisha was the goal of this dissertation. Additionally, a comparison between our study location and the national average for the prevalence of pulmonary arterial hypertension among children with sickle cell anemia was sought. The findings of this study show that children with sickle cell anemia in the age range of 5 to 14 years had a prevalence of 20.4% pulmonary arterial hypertension. In older male sickle cell anemia children, pulmonary arterial hypertension is more prevalent. Depending on the demographic and diagnostic method, children with sickle cell anemia have varying rates of pulmonary hypertension

Background: This study was conducted to compare the efficacy of ketamine and ondansetron, two of the commonly used drugs, on blood pressure among patients undergoing laparoscopic cholecystectomy under general anesthesia. Methods: This was a prospective randomized double-blind study conducted among 56 patients coming for elective laparoscopic cholecystectomy under general anesthesia at UPUMS Saifai, Etawah, from November 2018 to April 2020 after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. Study assessed preoperative patient conditions and randomly allocated 56 patients into two groups for comparative anesthesia techniques. Group A (n = 28) received Inj. Ketamine10 mg diluted upto 5 ml in normal saline, while Group B received Inj. Ondansetron 4 mg diluted upto 5 ml in normal saline before induction. All patients were premedicated and induced with standard drugs. Vital signs were recorded just after giving the study drug, at the time of induction, immediately after intubation and every minute after intubation upto 10 minutes.  Monitored closely, and any deviations from baseline were noted,and hypotension managed through fluid resuscitation and rescue drugs if necessary. Heart rate changes were also recorded. The study aimed to evaluate the effects of Ketamine versus Ondansetron on hemodynamic stability during anesthesia induction, employing rigorous monitoring and treatment protocols for any adverse events. Results: In comparison of SBP (Systolic Blood Pressure) at baseline and different follow-up intervals between two study groups, just after giving away the trial drug, mean systolic blood pressure was 135.82±12.14 mmHg in group A (ketamine) as compared to 122.82±11.16 mmHg in group B (ondansetron), thus showing a statistically significant difference between two groups (p<0.001). Immediately after intubation, mean systolic blood pressure was 132.86±14.78 mmHg in group A (ketamine) as compared to 125.75±10.78 mmHg in group B (ondansetron). Statistically, the difference between the two groups was significant (p = 0.045). At all the follow-up intervals, mean values were higher in group A (ketamine) as compared to group B (ondansetron) and the difference was also significant statistically at 3 min and 10 min post-intubation intervals (p<0.05). Conclusion: Post-induction anesthesia hypotension incidence was higher in ondansetron as compared to that in ketamine group; however, the difference was not significant statistically. It seemed that pressor responses following intubation superseded the hypotensive effect of induction anesthesia

Introduction: In India, oral cancer is one of the commonest cancers in both sexes, accounting for 30% of the overall cancer burden, which is likely to increase in the future. Despite having the greatest number of Oral cancer cases in the world, a very scarce information is available about the survival of oral cancer patients. Aim: To find out the 5-year survival rate and factors associated with recurrence in patients treated for Oral Squamous Cell Carcinomas in a tertiary care centre of Central India. Methodology: This was a record based retrospective study conducted by reviewing the patient’s clinical and treatment records in the Department of General surgery in a tertiary care centre of Central India between December 2017 and November 2018. The data was entered in Microsoft Excel and analysed using SPSS software. Results: The overall survival at 2 years and 5 years was found to be 74% and 26% respectively. The Disease-free interval was found to be 50%. Conclusion: Staging of the tumour, Extracapsular invasion of nodes and Histology of the tumour were found to be significantly associated with 5-year survival of Oral cancer patients treated.

Introduction: Evaluation of Neoadjuvant Chemotherapy Followed by Concurrent Chemoradiation in Locally Advanced Head and Neck Squamous Cell Carcinoma This study investigated the effectiveness of adding neoadjuvant chemotherapy, a course of drugs given before radiotherapy, to standard chemoradiation treatment for patients with locally advanced head and neck squamous cell carcinoma (LAHNSCC) in a rural medical college in India.   The researchers enrolled 252 patients with LAHNSCC who had not spread to other parts of the body.  Half of the patients received neoadjuvant chemotherapy with paclitaxel and carboplatin followed by concurrent chemoradiation with cisplatin and radiation therapy. The other half received only concurrent chemoradiation. The analysis showed that a slightly higher percentage of patients achieved a complete response with neoadjuvant chemotherapy followed by chemoradiation compared to those who received only chemoradiation. However, the difference was not statistically significant, meaning it may have occurred by chance.  Additionally, no significant difference was observed in terms of side effects between the two groups. In conclusion, the study did not find strong evidence that neoadjuvant chemotherapy improves response rates in patients with LAHNSCC when compared to standard chemoradiation treatment.

Background:  The variety of airway devices are available today which may be broadly classified as supraglottic airway devices which are employed to protect the airway in both elective as well as emergency situations. Present study was aimed to study I- Gel Device in patients posted for short duration elective surgeries in a tertiary care center. Material and Methods: Present study was prospective, interventional study, conducted in patients aged 21-60 years of both sexes, with BMI range of 20-25 kg/m2, American society of anaesthesiologist classification 1 and 2, Mallampatti grade 1 and 2, undergoing different surgical procedures under general anesthesia, with spontaneous ventilation in supine position for not more than 1 hour. Results: In the study 77 patients were studied. It was observed that in 85% of patients insertion of I-Gel was successful in the first attempt. The heart rate, Mean Arterial Blood pressure (MAP), Mean Tidal Carbon dioxide & mean Oxygen Saturation percentage was observed before administration I-Gel, immediately after administration & after 5, 10 and 15 minutes from insertion and the mean was calculated. The gastric insufflation was absent in all patients after the administration of I-Gel, which shows that I-Gel has better sealing pressure and it fits well with the laryngeal anatomy. It was observed that only 12 % of patients reported sore throat after the removal of I– Gel, 10 % of patients had reported post-operative cough and only 7% patients reported dysphagia. Conclusion: Use of proper sized I-Gel suits to be ideal and seems to be an efficient and safe device for adult airway management in short duration (up to 30 minutes) minor surgeries while patient breathing spontaneously.

Background: Diabetes mellitus is a growing public health problem in many countries. Poor Adherence to drugs, especially among patients with type 2 diabetes mellitus (T2DM) is often a challenging issue Objectives: The aim of the current study was to evaluate the demographic profile and serum insulin level in T2DM and patients taking oral hypoglycemic agents Methods: This comparative cross-sectional study was enrolled 120 patients of newly diagnosed T2DM and patients taking oral hypoglycemic agents. Patients demographic profile (age, gender, body mass index and waist circumference) were recorded. Investigations like; Serum insulin levels, Fasting blood sugar, Post lunch blood sugar and lipid profile were done in all the patients. Results: Most of the patients were 41-60 years age group, mean age was 52.2 + 10.5 years. Majority of the patients were male (70% in Metformin/Glimepiride group & 63% in both). Body mass index (BMI) were significantly higher among patients taking both Metformin and Glimepiride as compared to patients taking Metformin or Glimepiride alone (p<0.05). Serum insulin levels were significantly higher among patients taking oral Antidiabetics as compared to newly diagnosed T2DM patients (p<0.05). Lipid profile also significantly de-arranged among newly diagnosed diabetes mellitus patients (p<0.05). Conclusion: Serum insulin levels were significantly higher in patients taking oral Antidiabetic therapy and also significantly altered metabolic lipid profile among T2DM patients.

Background: Cardiopulmonary resuscitation (CPR) is a crucial life-saving procedure for managing cardiac arrest, involving chest compressions and rescue breaths to maintain circulatory flow and oxygenation. Despite its importance, public awareness and proficiency in CPR are alarmingly low globally, including in Jammu & Kashmir. This study aims to evaluate CPR awareness and preparedness among the general public in Jammu & Kashmir, identifying gaps and informing targeted educational interventions. Material & Methods: This descriptive, cross-sectional survey was conducted from January 2024 to March 2024 in Jammu & Kashmir. The study targeted adults aged 18 and above who had been residents for at least 12 months. A sample size of 400 adults was determined using a 95% confidence level and a 5% error margin. Data were collected using a pre-tested Google Form questionnaire that included socio-demographic information and 20 structured questions on CPR knowledge. The data were analyzed using Epi Info V7 Software, with results presented in frequencies and percentages. Results: The study revealed a balanced age distribution among participants, with a slight male predominance (55.3%). Educationally, 39.8% were graduates, and 15.3% had postgraduate or higher qualifications. Only 10.3% of respondents achieved a 'Very Good' CPR knowledge score, while 39.8% had 'Fair' knowledge, and 24.8% were classified as 'Poor.' Younger participants (18-30 years) and those with higher education levels had significantly better CPR knowledge. Gender, marital status and employment status also influenced CPR knowledge levels. Conclusion: The study highlights a significant gap in CPR awareness and proficiency among the residents of Jammu & Kashmir. Socio-demographic factors play a critical role in influencing CPR knowledge levels. There is an urgent need for targeted, culturally sensitive educational interventions, including community-based training programs, leveraging digital platforms, and incorporating CPR education into school and workplace curricula.

Introduction:Effective perioperative fluid management in pediatric patients undergoing anaesthesia is crucial for optimizing surgical outcomes and ensuring patient safety. The unique physiological characteristics of schildren, including higher body water content, immature renal function, and elevated metabolic rates compared to adults, present distinct challenges in fluid sssadministration [1,2]. This cross-sectional study aims to address this knowledge gap by evaluating the KAP of consultant anesthesiologists and residents concerning perioperative fluid management in pediatric patients at a tertiary healthcare facility in India. Materials and Methods: The study will be conducted in the Department of Anesthesia at a tertiary care hospital in Karnataka. The study sample will include all doctors from the Department of Anesthesia who have given their consent to participate, encompassing all postgraduate residents. Results & Discussion: Our study found a significant association (p=0.005) between experience level and satisfaction with current fasting practices. Residents were more likely to be satisfied (94.12%) compared to consultants (5.88%). Our study revealed that 88.24% of satisfied anesthesiologists treated neonates, infants, and children as separate age groups with different fasting criteria (p=0.015). Conclusion: Our study's findings generally align with recent trends in pediatric fasting practices, emphasizing age-specific criteria, liberal clear fluid policies, and attention to metabolic effects of fasting. However, the discrepancy in satisfaction levels between residents and consultants warrants further investigation.

Introduction: Cardio-Pulmonary Resuscitation (CPR) plays a vital role in saving lives during out-of-hospital cardiac arrests (OHCA). However, bystander CPR rates remain low due to lack of knowledge and confidence among the general public, including healthcare students. This study aimed to assess the impact of a CPR training intervention on the knowledge and confidence of physiotherapy students in South Gujarat. Methods: A pre-post educational interventional study was conducted among 1000 physiotherapy students from three colleges. Basic and advanced life support (BLS/ALS) certified instructors provided hands-on CPR and AED training. Pre- and post-training assessments were conducted using a self-administered questionnaire. Data were analysed using descriptive statistics, Wilcoxon signed-rank test, and McNemar's test. Results: The training significantly improved students' knowledge (median pre-test score: 16, post-test score: 21, p < 0.001) and confidence in administering CPR (pre-training: 30.2%, post-training: 86.7%). There was a significant improvement in correct responses to CPR-related questions (p < 0.05), with notable gains in understanding CPR protocol and AED usage. Conclusion: CPR training significantly improved physiotherapy students' knowledge and confidence in responding to OHCA. Such interventions are essential for preparing healthcare professionals to act effectively in emergency situations.

Introduction: Several techniques are used to minimize spinal anaesthesia induced maternal hypotension, such as left uterine displacement, reducing the dose of local anaesthetic, usage of intrathecal opioids, preloading and co-loading with different intravenous fluids. However, the evidence is inconclusive, and no technique reliably produces decreases hypotension. Opioids are the most frequently used local anesthetic adjuvants in neuraxial blocks. Methodology: 60 pregnant patients were divided into two groups Group BD and Group FD of 30 patients each. Group BD received single bolus dose of 2.2ml of solution which included 1.8ml (9mg) of 0.5% hyperbaric Bupivacaine with 0.4ml (20mcg) of Fentanyl. Group FD received fractionated dose of spinal anaesthesia where, out of the total 2.2ml of drug preparation, 1.6ml was administered initially and the remaining 0.6 ml was given after 90 seconds interval. Hemodynamic parameters in the intraoperative and postoperative periods were recorded. Time to onset of sensory block at T6 and that of Motor block to Bromage Scale 3, duration of sensory and motor block was noted. Results: There was a statistically significant difference between the two groups in terms of onset of sensory and motor blocks, with group FD having a faster onset of both sensory and motor blocks. Additionally, group FD had a significantly prolonged duration of both sensory and motor blockade. When comparing of hemodynamic parameters, a significant drop in the intraoperative SBP, DBP and MAP was observed in Group BD compared to Group FD. Post-operative hemodynamic and pain parameters were comparable in both groups and no major adverse events were observed in our study. Conclusion: Sub arachnoid block with 9mg (1.8ml) of 0.5% hyperbaric Bupivacaine and 20mcg (0.4ml) of Fentanyl, when administered as a fractionated dose provides early onset and duration of sensory and motor blocks with better hemodynamic stability compared to a single bolus dose in patients undergoing caesarean section

Background: Dermatophytosis are a group of superficial fungal infection of keratinized tissues, such as the epidermis, hair, and nails.1 Dermatophytosis causes 16–75% of all the mycological infections worldwide and severe diseases in immunocompromised patients. Frequency, distribution, and their etiologic agents of dermatophytosis vary based on the age, topography, socioeconomic status, climate, and domestication of animals.2 It is more prevalent in tropical countries such as India, due to climate & living condition. 3. Method: It was a cross-sectional study of 110 patients attending the Dermatology outpatient of the Tertiary care center for 18months from March 2021 to September 2022. Clinically suspected cases of dermatophytosis with informed consent were included in the study. A pre structured proforma was used to collect data on history, clinical examination, KOH Mount, SDA Culture & Calcoflour stain. Patients on antifungals for >4 weeks & whose KOH or Culture showed organisms other than dermatophytes were excluded. Result: Among 110 patients of the study population, mean age group affected was 34.2 years. Males are more affected than females (54.55%) who were daily wage workers from lower socioeconomic strata. [Table 1]. Most common site of infection was Groin (54.54%) followed by buttocks (44.54%). The risk factors associated are poor hygiene & fomites among subjects [Table 2]. Most common clinical variant of dermatophytosis was Tinea corporis with cruris (42.73%). (Figure 1) Commonest organism isolated from the culture was Trichophyton mentagrophytes (24.55%) [Figure 3], followed by Trichophyton rubrum (22.73%) [Figure 4]; Trichophyton tonsurans (2.73%) and Trichophyton violaceum (1.81%) [Figure 5] with average time taken for the culture to grow was around 14 to 21 days. KOH & Calcofluor positivity was seen in 84 (98.82%) whereas KOH & culture positive was seen in 43 (75.43%). We found calcofluor with KOH could pick up faint fungal elements which was missed in culture. Conclusion: The study highlights Tinea corporis and Tinea cruris as the predominant clinical variant, with Trichophyton mentagrophytes emerges as the most frequently isolated organism, emphasizing its significance rampant & resistant dermatophytosis in this topography. Furthermore, the findings suggest Calcofluor staining as a superior method for microscopy in diagnosing dermatophytosis compared to KOH, potentially due to its enhanced sensitivity in detecting fungal elements. These observations provide valuable insights into the epidemiology and diagnostic methods of dermatophytosis but also emphasize the importance of accurate and efficient diagnostic techniques in clinical practice. This contributes to understanding of dermatophytosis & associated risk factors aiding in improved management of these infections.

Background/Objectives: The knowledge, attitudes, and practices (KAP) of parents and caregivers play a pivotal role in managing and adhering to treatment for childhood epilepsy. However, there is a paucity of research on these factors in developing countries, including India. This cross-sectional observational study aims to address this research gap by assessing the KAP of parents and caregivers regarding childhood epilepsy in northern India. Materials and Methods: The study will be conducted in the Department of Anesthesia at a tertiary care hospital in Karnataka. The study sample will include all doctors from the Department of Anesthesia who have given their consent to participate, encompassing all postgraduate residents. Results & Discussion: The findings revealed significant misconceptions and knowledge gaps. Notably, 73.5% incorrectly believed epilepsy is a mental illness, 39% attributed it to supernatural causes, and 21.5% thought it was contagious. These misconceptions could contribute to stigma and social isolation. The study also highlighted the perceived social and educational impacts, with 85% believing epilepsy hinders family life and 71.5% thinking it affects school performance. Conclusion: This study reveals significant misconceptions and knowledge gaps among parents and caregivers regarding childhood epilepsy in North and South India. Key findings include incorrect beliefs about epilepsy's nature, causes, and management, as well as reports of social stigma and financial burden. These results highlight the urgent need for targeted educational interventions to improve epilepsy awareness, reduce stigma, and enhance treatment adherence

Keywords:  Penile calculi, Urethral calculi, Open surgery, Endoscopic management, Retrospective study

Introduction: Hypertension is a prevalent and significant cause of mortality, contributing to 18% of deaths globally. The incidence of essential hypertension escalates with advancing age, and individuals exhibiting higher blood pressure in their youth face an elevated risk of subsequent hypertensive complications. Morphological and physiological alterations in the vasculature have been implicated in the development and persistence of hypertension. This condition elevates the risk of cerebral, cardiac, and renal events. The primary aim of this study was to measure the arterial stiffness index (SI) and reflection index (RI) in both hypertensive subjects and an age-matched control group of normotensive individuals.  Methods: A cross-sectional study involving 200 subjects aged 30 to 60 years was conducted.  Subjects were divided into four groups: Group 1 (control group of healthy individuals) and three hypertensive groups classified by the duration of their illness. Arterial stiffness was assessed using SI and RI, derived from digital volume pulse (DVP) recordings. DVP was measured using a finger pulse photoplethysmography device. The data were analyzed using analysis of variance (ANOVA), with statistical significance defined as P < 0.05 in relation to arterial stiffness indices and hypertension duration. Results: The study found a progressive increase in hypertension prevalence with advancing age and longer hypertension duration. Participants aged 40-49 years exhibited the highest prevalence across all groups. Group I, with normal blood pressure, showed the lowest RI (0.50 ± 0.08) and SI (6.12 ± 0.09). RI and SI increased significantly in Group II, further escalating in Group III. Group IV displayed a slight RI decrease but continued SI increase. ANOVA analysis revealed significant differences in RI and SI among the groups. Pearson correlation analysis showed strong positive correlations between both RI and SI values with the duration of hypertension. Conclusion: The study demonstrates a strong positive correlation between the two arterial stiffness indices, RI and SI, and the duration of hypertension.

Background: Heart failure with reduced ejection fraction (HFrEF) poses a significant global public health challenge, characterized by frequent episodes of acute decompensation that necessitate hospitalization and carry high morbidity and mortality risks. In India, the rising prevalence of HFrEF underscores the need to identify context-specific triggers of acute decompensation to develop targeted interventions for improving patient outcomes. Material & Methods: This hospital-based, observational study analyzed triggers of acute decompensation in 336 HFrEF patients admitted to two tertiary care hospitals in India from January to April 2024. Data were retrospectively extracted from medical records, including demographic information, clinical characteristics, and details on decompensation triggers. Outcomes recorded were length of hospital stay, in-hospital mortality, and ICU admission. Statistical analysis involved chi-square tests, t-tests, and multivariate logistic regression. Results: The mean age of the patients was 65.3 years, with 60.1% being male. Common triggers included excessive salt and water consumption (30.1%), non-adherence to medication (25%), acute infections (19.9%), myocardial ischemia (17.6%), and systemic hypertension (14.9%). The mean hospital stay was 7.2 days, in-hospital mortality was 7.4%, and 20.2% required ICU admission. Excessive salt and water consumption and non-adherence to medication were significantly associated with ICU admission (p < 0.001). Independent predictors of in-hospital mortality included age (OR: 1.05, p < 0.001), excessive salt and water consumption (OR: 2.5, p = 0.007), non-adherence to medication (OR: 2.1, p = 0.021), and renal failure (OR: 3.0, p = 0.005). Conclusion: This study identifies critical triggers of acute decompensation in HFrEF patients, particularly dietary non-compliance and medication non-adherence. Emphasizing patient education and adherence support is essential for managing heart failure effectively. Addressing these factors through comprehensive care plans can reduce hospitalizations and improve patient outcomes. Future research should validate these findings through prospective studies and explore tailored interventions to mitigate the risks associated with acute decompensation.

Chronic kidney disease (CKD) is a growing health concern in India, especially due to the increased prevalence of chronic diseases such as diabetes mellitus and hypertension (Mk, 1993). This study evaluates the prognostic significance of key biomarkers in CKD patients, including 24-hour urinary protein, estimated glomerular filtration rate (eGFR), and serum uric acid levels, alongside renal pathology and immunofluorescence findings. By assessing the relationships between these indicators, the research aims to enhance prognostic accuracy, predict CKD progression, and improve patient outcomes in the Indian context. The findings emphasize the importance of a comprehensive evaluation of these prognostic indicators in managing CKD effectively. Introduction: Chronic kidney disease (CKD) affects a substantial portion of the population in Indian subcontinent as well as globally, leading to adverse outcomes if not managed effectively. This paper aims to assess the utility of 24-hour urinary protein, eGFR, uric acid levels, renal pathology, and direct immunofluorescence findings as prognostic indicators in CKD. By exploring the relationships between these markers and disease progression, the study seeks to provide insights for personalized treatment strategies and improved patient care. Materials and Methods: This study was conducted as a retrospective, observational cohort study. Data has been collected from medical records of 50 CKD patients attending the nephrology OPD at MGM Medical college and Hospital, Kamothe, Navi Mumbai from the period of January 2022 to July 2023. Results: The study revealed significant correlations between 24-hour urinary protein, eGFR, uric acid levels, and specific renal pathologies. Higher levels of urinary protein and lower eGFR were robust predictors of CKD progression, while serum uric acid levels showed potential as a marker of disease severity. The findings underscored the importance of a comprehensive evaluation of prognostic indicators in CKD management. Conclusion: In conclusion, this research paper underscores the value of incorporating diverse prognostic indicators in CKD management to enhance diagnostic accuracy and treatment planning. By analyzing the interplay between traditional markers, renal pathology, and immunofluorescence findings, clinicians can refine prognostic models, predict CKD progression, and optimize patient outcomes. The study's insights offer valuable guidance for personalized care and improved prognostication in CKD patients.

The intestinal obstruction presenting as an emergency case when undergoes exploratory laparotomy present with multiple etiology associated such like intussusception that usually more common in infants and rare in adults. Similarly, lipoma the most common benign tumor over the body are rare in gastrointestinal, comprising about 3%. This paper presents a case report of a 51-year-old woman who presented with symptoms of bowel obstruction caused by ileo-ileal intussusception secondary to submucosal lipoma with the linking etiology of this gastrointestinal lipoma to be the causative factor for bowel obstruction resulting into the intussusception, yet another rare disease in adult as presentation. Thus, emphasizing the importance of considering such diagnosis in similar clinical scenarios.

Background: Diabetes affects multiple organs of the body mainly cardiovascular system. We decided to find out effects of HbA1C levels on the perioperative outcome in patients undergoing CABG off pump. Role of HbA1C levels in predicting the probability of perioperative hyperglycaemia, regional hypoperfusion, increased inotropic requirement, post-operative renal dysfunction, increased incidence of infections and arrhythmias in the postoperative period, duration of stay in the ICU & hospital  in patients undergoing Off Pump CABG. Materials and Methods: A study was conducted on 200 patients, divided into two groups: Group A: HbA1C>7%, Group B: HbA1C< 7%. During the perioperative period, all demographic data, hemodynamic parameters, ionotropic requirements and total insulin requirements during surgery and all laboratory measurements-renal function, total leucocyte counts & HbA1C levels & Random Blood Sugars, lactates & pH were performed. Any infections, arrthymia duration of ICU & hospital stay. Results: In our study we found a correlelation between patients with HbA1C levels >7% and increased risk of intraoperative tachycardia, acidosis and high lactates, perioperative and postoperative hyperglycemia and increased insulin requirements, higher inotropic support requirements in both intra-operative and postoperative periods, raised creatinine levels postoperatively predisposing to renal dysfunction, infections and arrhythmias postoperatively and  a longer ICU, hospital and ventilation period. Conclusion: HbA1C levels >7%  have increased risk of tachycardia, acidosis and high lactates, increased insulin requirements, higher inotropic requirements, infections and arrhythmias & having a longer ICU stay, hospital stay and ventilation period. Thus in patients with higher HbA1C levels preoperatively, the risk benefit ratio to be considered before taking for surgery and in these patients surgery may be delayed until the blood sugars are controlled with a HbA1c level<7% for a better outcome.

Purpose- Obesity is a fast growing problem not only in developed countries but also in developing countries like India¹. Obesity is a risk factor in development of short stature, school teasing, precocious puberty, hypertension, diabetes, gall bladder disease and coronary heart disease, certain type of cancers and other comorbidities even at early age than usual². Understanding the prevalence trend and factors contributing in developing obesity in adolescent children will be helpful in prevention of obesity and developing comorbidities in later life.

Methods- A cross sectional analytical study conducted in 6 different schools of identified district of western India from 1st July 2022 to 31st June 2023 including school going adolescent children, of age between 10 to 16 years after taking necessary consent. Information regarding various predictors of obesity were taken by predesigned questionnaire, filled by participant along with his/her parentsand  relevant anthropometric measurements were recorded. Detailed analysis of predictors which were present in obese and non- obese group was done and results interpreted.

Results-Incidence of obesity in present study is 12.6%. Most common age of obesity is 16 years (46%) and most common age group is mid-adolescent (90.4%). Obesity and overweight is most common in upper middle class and in urbanc area. Positive correlation had been observed between adolescent obesity and parental obesity, calorie intake >2000kcal/day, eating >2 times snacks/day, >2 times junk food/week, sleeping > 8hrs/day and watching TV for >60 min, physical activity <30 min and light grade of physical activity.

Conclusion-Restricting the calorie intake, food behavioural changes like restricting junk food and snacks consumption, daily physical activity could limit the development of obesity in adolescent age group.

Background: The 6-minute walk test is a common clinical instrument for assessing patient's functional capacity. The 6MWT should be performed preferably indoors, on a flat, straight, hard surfaced corridor usually at least 30 meter long. The test is also used for assessing the effect of therapies such as pulmonary rehabilitation, oxygen therapy, long‐term use of inhaled corticosteroids, and lung volume reduction surgery. The 6MWD in healthy adults has been reported to range from 400 to 700 metres. Method: A total of 300 subjects were included in the study. All the healthy volunteers presenting during the study period were included in the study, provided they met the inclusion and exclusion criteria as above. A written informed consent was taken from all the subjects who were to be included in the study. They were assured about the maintenance of confidentiality and the nature of voluntary participation. Once consent was given, they were included in the study. Result: In the present study, there were 150 males and 150 females. They were comparable in terms of age. The height and weight of males was more than females. It can be concluded from the present study that there is an increase in the hemodynamic parameters immediately after the test. However, the levels return to normal/baseline when measured 4 minutes after the test. Conclusion: The prediction equation developed from distance walked is: 6MWD (females) = 83.76 – (1.42*Age in years) – (3.98*Weight in kgs)+ (426.60*Height in metres). 6MWD (males) = 553.46 – (2.62*Age in years) + (1.82*Weight in kgs) - (38.98*Height in metres.

Postoperative nausea and vomiting (PONV) is a common complication affecting patients undergoing surgery, with significant implications for recovery and patient satisfaction. This study aimed to investigate the incidence, risk factors, and management strategies for PONV among patients undergoing general anesthesia at SRM Medical College Hospital, Bhawanipatna, Odisha. A retrospective cohort study was conducted involving 130 patients who underwent various surgical procedures. Data on demographic factors, surgical details, anesthetic techniques, and incidence of PONV were collected from medical records. The overall incidence of PONV was found to be 30.8%, with mild, moderate, and severe cases observed in 37.5%, 50.0%, and 12.5% of affected patients, respectively. Significant predictors of PONV included a history of motion sickness (OR 2.5, 95% CI 1.1-5.7, p=0.028), previous PONV episodes (OR 3.2, 95% CI 1.5-6.9, p=0.012), laparoscopic procedures (OR 2.1, 95% CI 1.0-4.4, p=0.041), longer surgery durations (OR 1.8, 95% CI 1.2-2.6, p=0.006), and the use of volatile anesthetics (OR 2.5, 95% CI 1.3-4.8, p=0.007) and opioids (OR 1.9, 95% CI 1.1-3.4, p=0.024). Prophylactic antiemetics were partially effective, with a 25% incidence rate despite widespread use (76.9%). These findings underscore the need for tailored perioperative care strategies to minimize PONV and improve patient outcomes.

Background The national early warning score (NEWS) is an appropriate tool for assessing patients experiencing catastrophic deterioration and enabling prompt intervention. The present study was carried out to assess the applicability of the NEWS in emergency departments and follow-up patients in the ICU in an Indian scenario. Methods: The study was conducted involving 270 patients of either sex and age greater than 16 years selected by simple random sampling. The data, which includes respiration rate, pulse rate, temperature, oxygen saturations, systolic blood pressure, and degree of consciousness, was gathered using the National Early Warning Score. Results: The mean age was 56.4 ± 16.9 years. The gender distribution was almost equal, with 53.7% male and 46.3% female. NEWS was 1-4 in 25.9% of subjects. 5-6 in 28.1% subjects and >/=7 in 45.9% subjects. The mean NEWS was 6.5 ± 2.9. Mortality was 22.6%, 75.9% of subjects were discharged, and 1.5% were referred. Apart from blood pressure and urine output, none of the parameters were found to be significantly different, including NEWS, between subjects with outcomes of death and discharge. The NEWS cut-off of 7.5 was found to predict mortality with 63.4% sensitivity and 49.2% specificity. Conclusion: NEWS effectively identifies subjects in need of immediate medical attention and paves the way for the development of a nationally validated scoring system to assess and convey the condition of subjects at intra- and inter-hospital facilities.

Background: As the drug tesistance Tuberculosis is continuous to be a public health crisis, not only in the world but in India also by increasing its prevalence and incidence of R/R / MDR TB cases, the present study was planned to study the clinical social profile and treatment outcome of these patients treated with shorter MDR Regimen. Research Question: What is the clinical social profile and treatment outcome of RR/MDR TB cases treated with shorter MDR Regimen in our set up? The setting of the study was at department of Respiratory Medicine and General Medicine Government General Hospital, Government Medical College, Machilipatnam. A one year observational study was conducted during the period from January 2023 December 2023 on about 147 Pulmonary TB patients who were treated with shorter MDR regimen during the period from January 2019 to December 2022. The required data was collected retrospectively based on the available hospital records (case sheets, case registers etc.) by studying their socio-demographic profiles, clinical scenario, risk factors and  treatment outcome etc; as study variables and was analysed. Results: Among the total study subjects 73.28% were male and 27.39% were female. It was observed that the burden of the disease was more  between 21-60 years of age group (79.59%) with the Mean age was 52 years. And also it was noticed that the disease burden was more among males when compared to females significantly. Regarding the Risk factors it was observed that Malnutrition was 48.28% followed by Previous h/0 TB 67.35%, Anaemia 59.5%, Alcoholism 40%, Diabetes 37.41%, Smoking23.8% and HIV +ve 17.68% distributed respectively. With reference to Drug resistance pattern maximum observed was Rifampicin Resistance (RR) 76.87% followed by Multi drug resistance (MDR) R/R +H(B) 21% and Extensive Drug Resistance (XDR) R/R +H(B) + FQR 2% was noticed among the study subjects. In this study regarding the treatment outcome about 46.9% were Cured followed by 20.4% were treatment completed, 19% were died during the course of treatment, 7.4% were lost to follow up, 5.4% treatment changed and 0.68% were Treatment failure as observed in this study.

Aim: The purpose of this study was to compare the efficacy of bolus dose of Phenylephrine Versus Mephentermine for hypotension correction in patients undergoing elective caesarean section surgery. Methodology: After obtaining approval from the ethical committee and obtaining informed consent, 60 parturients aged between 18 - 40 years of age and gestational   age from 34 to 40 weeks posted for elective lower segment cesarean section were included. They were randomly divided into Group P (n=30) and Group M (n=30). The parameters observed were level of Anaesthesia, hemodynamic variables, number of doses required to correct hypotension and adverse effects. Results: A total of 60 patients were analyzed. Within 5 minutes of Spinal anaesthesia there was no significant difference between Group-P and Group-M on drop of average Systolic blood pressure, Diastolic blood pressure and average Heart rates at different minutes. But after administering the drug for hypotention correction Group P shows very high average SBP and DBP correction compared to Group M which is statistically significant (p<0.0001) and Group P shows a fall in the heart rate compared to Group M which is statistically significant (p<0.0001). Conclusion: Phenylephrine is observed to be hemodynamically more suitable than Mephentermine in patients undergoing elective caesarean section surgery.

Background: Hypothyroidism and Type 2 Diabetes Mellitus (T2DM) are prevalent endocrine disorders, and their interplay has garnered significant attention due to potential bidirectional relationships. This study investigates the association of hypothyroidism in T2DM patients, focusing on prevalence, clinical correlations, and implications for management. Materials & Methods: A cross-sectional study was conducted at Hind Institute of Medical Sciences, Uttar Pradesh, involving 50 T2DM patients. Clinical assessments, thyroid function tests, and diabetes parameters were collected. Statistical analyses, including descriptive statistics, odds ratios, and correlation coefficients, were employed to explore associations. Results: Among T2DM patients, 20% exhibited hypothyroidism, emphasizing a noteworthy prevalence. Alterations in thyroid function parameters, including elevated TSH and decreased FT4 and FT3, indicated subclinical hypothyroidism. Glycemic control analyses revealed significant differences in FBG and HbA1c levels between euthyroid and hypothyroid individuals. Odds ratios demonstrated associations between hypothyroidism and age, BMI, and T2DM duration. Medication usage patterns highlighted the necessity of thyroid-specific interventions. Conclusion: This study uncovers a substantial prevalence of hypothyroidism in T2DM patients, emphasizing the intricate relationship between these endocrine disorders. Clinical correlations with age, BMI, and T2DM duration suggest the need for tailored therapeutic approaches. Recognizing the impact on glycemic control, screening strategies, and public health measures may enhance patient outcomes in this complex interplay.

Background: Zinc deficiency in Chronic liver disease is associated with decreased albumin levels, reduced absorption, increased levels of IL-6 which may interfere with the zinc transporters, and increased excretion in the urine which also may be related to the use of diuretics in cirrhosis. Despite the fact that zinc deficiency and CLD are closely linked, the routine testing of serum zinc levels in Cirrhotic patients is lacking. Furthermore, the impact of the Child- Pugh scoring system on the prognosis of  Hepatic Cirrhosis patients and serum Zn levels is less known. Thus the present study was planned to solidify the correlation between serum zinc level and severity of cirrhosis by studying the prevalence of zinc deficiency in patients with cirrhosis and by assessing its association with parameters such as alcohol intake, albumin, prothrombin time, bilirubin, ascites, and occurrence of hepatic encephalopathy. Research Question: Is decreased serum zinc levels have an association with child-pughs score towards the development of complications in patients with hepatic cirrhosis in our setup? The setting of the study was at Department of General Medicine, Mahatma Gandhi Medical College and Research Institute, Pondichery.  A one-year observational study was conducted during the period from October 2022 to September 2023 on about 44 Hepatic Cirrhosis patients admitted during the above period in the department of General Medicine by studying their socio-demographic profiles, Serum Zinc levels and their association & correlation with Child-Plugh score to assess severity and with other various biochemical & epidemiological risk factor parameters, etc. Results: Among the total study subjects 88.6% were male and 11.36% were female. It was observed that the burden of the disease was more between 41-60 years of age (66%) and the Mean age was 52 years. Also, it was noticed that the severity was higher among males when compared to females significantly. In addition to this significantly Patients with high Child-Pugh scores were associated with low serum zinc levels. About 16% of the study subjects were developed Hepatic encephalopathy with low serum zinc levels and also Albumin levels were directly proportional to low serum zinc levels significantly and further about 75% of the cases were developed ascites while having significant association with low serum zinc levels. Regarding alcohol consumption nearly 72% of the patients had positive history. It was observed that there was a significant correlation between serum zinc levels and total bilirubin, Prothrombin time, and Sodium levels in the blood.

Background: Endotracheal intubation has become an integral part of the anaesthetic management and critical care of the patient and has been practised following its description by Rowbatham and Magill in 1921.  Objective: Compare the efficacy of oral clonidine and oral pregabalin premedication 90 min prior to surgery in attenuating the adverse haemodynamic responses to laryngoscopy and tracheal intubation with respect to Systolic blood pressure, Diastolic blood pressure, Mean blood pressure, Rate Pressure Product. Methods: This prospective randomized double blind controlled study was conducted on 100 ASA physical status grade I and II patients of either sex between 18-50 years of age, undergoing elective orthopaedic, spine, otorhinolaryngeal, gynecological and general surgical procedures from October 2012 to May 2014 at SSIMS&RC, Davangere. Results: Haemodynamic variable like SBP, DBP, MAP and RPP were recorded pre-induction, post-induction, immediately after intubation and post-laryngoscopy (1,3,5,10 minutes) vitals were noted. In oral clonidine group there was significant attenuation of RPP in all time period and there was only significant attenuation seen in SBP, DBP and MAP immediately after intubation. In oral pregabalin group there was no significant attenuation of haemodynamic response i,e SBP,DBP, MAP and RPP compared to clonidine.

Conclusions: Both Clonidine and oral pregabalin effectively attenuates the haemodynamic response to laryngoscopy and intubation of trachea. Of the two, oral clonidine is effective in attenuation compared to oral pregabalin

Aim: To assess risk factors associated with cardiac complications after total joint arthroplasty (TJA) of the hip and knee. Methodology: Thirty-two patients, aged 25 to 70 years who underwent total joint  arthroplasty (TJA) and experienced a cardiac complication during the post operative period (myocardial infarction [MI], congestive heart failure [CHF], unstable angina, arrhythmia, symptomatic hypotension, or pulmonary embolism ) were put on group I and group II had healthy controls consisted of those who had a total joint arthroplasty (TJA) and did not experience a cardiac complication during the post operative period. Risk factors were identified in both groups. Follow-up period up to ninety days. Results: Age group 25-35 years had 3, 36-45 years had 5, 46-55 years had 10 and 56-70 years had 14 patients. The difference was significant (P< 0.05). Age >65 years [OR:1.78 (95%CI: 1.1-3.9)], history of arrhythmia [OR: 2.4 (95%CI: 1.7-4.2)], history of CAD, MI, CHF, and/or valvular heart disease [OR:2.3 (95%CI:1.5-3.8)], and revision surgery [OR:2.3 (95%CI:1.7-2.7)] were independent predictors of postoperative cardiac complications. Conclusion: Risk factors associated for cardiac complications after total joint arthroplasty of the hip and knee includes increasing age, underlying heart disease, and history of heart disease. Further assessment is necessary for  total joint arthroplasty in relation to other risk factors, including as obesity and hypertension, which are frequently linked to an increased risk in non-cardiac surgery.

Background: A doctor should be a lifelong learner, professional with good attitude, ethics, and communication skills. The curriculum for undergraduate MBBS course is an integrated one. A learning process is not complete without an assessment. Assessments include essay questions, short answer questions, very short answer questions, multiple choice questions, portfolios, case reports, OSCE and OSPE. Aim & Objectives: The aim of the present study is to implement the best method of assessment and uniformity of assessment to all Phase –I MBBS students among various colleges. Method: After taking Institutional Ethical committee approval, all phase-1 students of first year MBBS are given questionnaire about the types of questions that can score knowledge and marks for them. Their opinions are collected through google forms and analysed. Results: All assessments are in the following order according to the students’ opinion and the best method of assessment tool to reflect total knowledge in Anatomy and easy scoring is-Fill in the blanks; short essay questions; Viva; Long essay questions; Very short questions; Extended Matching Questions; OSPE; Multiple choice questions. AETCOM based assessment makes them a good doctor. Most of the male students feel Physiology as stressful subject. Students want games and want 3 internals followed by practical which is not stressful. Conclusion: As the curriculum is changed, it’s high time to change teaching. So, this is an attempt to know the perception of students to which type of assessment they will feel better in the new curriculum.

The impact of music on the human body has been extensively chronicled in ancient texts, particularly in the Indian Vedas. However, contemporary medical literature lacks sufficient empirical evidence to substantiate these claims. This paper aims to succinctly present key aspects that can offer a more profound comprehension of how music can be integrated into present-day medical practices, ultimately facilitating enhanced mental, physical, and spiritual well-being.

Background: Overweight and obesity are associated with diseases like hypertension, cardiovascular diseases (CVDs), diabetes, endocrinal disordersetc. The product of resting heart rate (HR) and systolic blood pressure (SBP) termed as rate pressure product (RPP) is a very reliable indicator of myocardial oxygen demand. Both heart rate and blood pressure are incorporated in the RPP and indirect index of myocardial oxygen consumption (MVO2). Objective: To determine the correlation between body mass index and rate pressure product. Material and Methods: This cross sectional study was conducted in department of physiology VIMSAR Burla which included 100 study participants (66 males and 34 females). Written consent was taken from each participant. The height and weight was measured according to WHO protocol. BMI was calculated by Quitlet index. SBP was measured by sphygmomanometer after 5 minutes rest with the subject in sitting position. Resting HR was measured by palpating radial artery. RPP was derived using SBP and HR. Statistical analysis was done according to Pearson correlation, unpaired t-test. Result: There was positive correlation (r=0.5310) between BMI and SBP significantly (p=0.032). The correlation between BMI and HR was positive (r=0.443) significantly (p=0.001). There was positive correlation between BMI and RPP (r=0.512) significantly (p=0.002). Conclusion: The positive correlation between BMI and RPP suggested that myocardial workload is increased in overweight and obese people.

Aims: Total hip arthroplasty surgery in adults can be associated with significant blood loss, often requiring allogeneic blood transfusion. The objective of this randomized, prospective, double-blind study was to evaluate the efficacy of tranexamic acid (TXA) in reducing perioperative blood loss and transfusion in adult patients having elective total hip replacement surgery. Methods: Sixty adult patients undergoing elective hip arthroplasty under general anaesthesia were randomized  into to groups Group II(n=30) receiving a bolus of 10 mg/kg IV of TXA after induction followed by a maintenance infusion of 1 mg/kg/hr of TXA up to closure of skin and group I(n=30) recieving an equivalent volume of placebo (normal saline). Outcome measures included total  blood loss(i.e. intraoperative and postoperative), number of blood transfusion, as well as comparision of preoperative and postoperative hemoglobin, and hematocrit levels. The data were analyzed by means of Statistical Package for the Social Science Version 12.0. The results were presented as mean +/- SD. Independent Student t test was used to compare the 2 groups and differences were considered significant if the P-value was <0.05. Results: Demographic parameters, duration and preoperative investigations were comparable. The mean intra-operative blood loss was less in the tranexamic acid group compared to the placebo group(p value-0.034),the amount of blood in the drains post-operatively was less in tranexamic acid group(p value-0.035) and the total blood loss(intra-operative plus post-operative) was also less in tranexamic acid group(32% reduction in total blood loss with p value-0.045).The blood transfusions received in both the groups was  statistically significant(p value-0.032).The difference in the pre and post-operative haemoglobin and hematocrit values of patients in tranexamic acid group compared to control group was statistically significant (p value- 0.044 and 0.034 respectively). Conclusion: Tranexamic acid 10mg/kg mixed in 100ml normal saline shortly after induction of anaesthesia over 15 min before skin incision,followed by infusion of 1mg/kg per hour upto closure of skin incision reduced both intraoperative and post operative bleeding in our patients who underwent total hip arthroplasty under general anaesthesia.

Ligamentum teres hepatis, a fibrotic remnant derived from the left umbilical vein, is situated in the floor of a fissure on the inferior surface of the liver between left and quadrate lobes. In some individuals, this fissure may present anatomical variations where the fissure may be partially or completely covered by liver tissue or a fibrotic band. The present study aims to observe the fissure for Ligamentum teres in the liver specimens and find out any anatomical variations in it and report them, if present. Method: The study was carried out in 40 formalin preserved liver specimens that were removed from the cadavers during routine academic dissection for the Undergraduate students in the department of Anatomy, Rangaraya Medical College, Kakinada. The fissure for Ligamentum teres was observed in the specimens and the variations noticed, were documented and reported. Photographs were captured during the course of the study.   Conclusion: The knowledge of the anatomical variations in the fissure for Ligamentum teres hepatis is essential for the clinicians, radiologists and surgeons in order to prevent misinterpretation during investigative procedures and to avoid misdiagnosis, which ultimately contributes in providing proper and efficient healthcare to the patients

Introduction: Peripheral nerve blocks prove beneficial by avoiding stress response and adverse effects of general anesthesia. Brachial plexus blockade is useful for upper limb surgeries. As the conventional paresthesia technique is a blind technique, it may have a high rate of failure, cause injury to nerves and vessels.  Ultrasound usage allowed better localization of the nerve/plexus. It has improved the success rate as well as safety margin. Hence, this study was planned for comparing the efficacy of conventional supraclavicular brachial plexus block with ultrasound-guided technique. Methods: After obtaining the Institutional ethical committee approval and patient consent, 60 patients ranging in age from 18 to 60, undergoing elective upper limb surgeries under the supraclavicular block were enrolled in this prospective randomized study, randomly divided into two groups: Group US and Group C. Both groups received 0.5% bupivacaine and 2 % lignocaine with Adrenaline according to the body weight . The parameters compared between the two groups were procedure time, sensory blockade, onset and duration, motor blockade start and duration, block effectiveness and complications. The failed blocks were supplemented with general anesthesia. Results: Demographic data were comparable in both groups. In the ultrasound-guided technique onset of sensory and motor blockade is faster with prolonged duration and reduced analgesic requirement compared to conventional technique. The conventional method had a slightly higher rate of complications but the difference was not significant. The overall effectiveness of the block was significantly better in ultrasound-guided technique but took slightly longer than the usual. Conclusion: Ultrasound-guided supraclavicular block had rapid onset, prolonged blockade with reduced analgesic requirements and lower complications than conventional technique with only limitation of a little longer performance time .

Background: Sacubitril/valsartan, marketed as Azmarda (manufactured by the innovator company) is a cocrystal consisting 6 sacubitril and valsartan molecules, along with sodium cations and water molecules. This formulation is considered a major mechanism of benefit of this molecule. This study was aimed to assess various brands of sacubitril/valsartan in the market for the presence of the cocrystal forms and compare them with Azmarda. a brand of sacubitril/valsartan manufactured by the innovator company.

Methods: The study involved analysis of various marketed products containing sacubitril/valsartan tablets, including Azmarda. Both the Azmarda and marketed products were characterized using differential scanning calorimetry (DSC) and powder X-ray diffraction (PXRD). Sodium content and dissolution studies were also performed .

Results: A total of 16 brands of marketed products including Azmarda were studied.  During DSC studies, unique melting pattern was observed in Azmarda, with exothermic peaks of sacubitril/valsartan detected at 140°C and 102°C, respectively. PXRD analysis revealed that none of the products exhibited the same crystal lattice as Azmarda. Azmarda, with a sodium level of 1.773%, was comparable to brand 2 (1.61%), brand 4 (1.73%), and brand 7 (1.58%). Azmarda demonstrated 64% release of sacubitril and 57% release of valsartan within 30 minutes in 0.1N HCl. Brand 7, brand 12, and brand 13 showed 52%, 57%, and 52% release of sacubitril, respectively, and 45%, 52%, and 48% release of valsartan, respectively, in 30 minutes.

Conclusion: The absence of identical crystal lattice structures, highlights absence of co-crystals in generic formulations. Such variations may impact the bioavailability and efficacy, emphasizing the importance of ensuring consistent and reliable therapeutic outcomes.

Introduction: Non-communicable diseases (NCDs) have taken center stage in recent times, displacing communicable diseases as the primary cause of death in the majority of nations. Worldwide, non-communicable diseases are the main cause of death. 38 million people die from non-communicable diseases (NCDs) per year. Objectives: To study the prevalence of risk factors of NCDs in rural area of West Bengal. Methods: This community based cross sectional study was conducted Howrah, West Bengal from January 2024-March 2024. Total 400 people who were aged 15 and above were enrolled for the study. Statistical data were analysed by using Microsoft Excel and SPSS V.20 software. Results: Among the 300  people studied 46.67% were in age group of 15–35 years. 70% were having education below secondary/higher secondary. 44% belonged to lower middle and 36.67% belonged to lower socioeconomic class. 47.33% of them were either farmers or labour/ unskilled workers. In the studied population 44.67% were currently using tobacco either in the form of chewing or smoking, among these 94.03% were males. 28.66% were currently consuming alcohol, of these males comprised 90.69%. Among the studied population 19.33% were hypertensive and 11.33% were diabetics. Conclusions: The prevalence of non-communicable diseases risk factors is high in this study. It is necessary to minimize the burden of growing non-communicable disease epidemic in the society, by curbing the rates of the risky behaviours at a very early stage by lifestyle modification.   

Severe calcified coronary stenosis presents a significant challenge for interventional cardiologists during percutaneous coronary intervention procedures as patients with this condition are at high risk of suboptimal results and poor clinical outcomes. The management of coronary artery disease (CAD) continually evolving with the advancements in therapeutics modalities. Intravascular lithotripsy (IVL) has emerged as a crucial tool in CAD management. This minimally invasive technique uses high frequency sound waves to modify calcified coronary plaques safely and effectively, facilitating optimal stent deployment and improving clinical outcomes. The efficacy of IVL is enhanced by C2+ technology as it ensures consistent plaque modification by delivering the appropriate energy. Managing 120 pulses during IVL procedure is vital for achieving optimal plaque modification. Additionally, integrating optical coherence tomography (OCT) or intravascular ultrasound (IVUS) imaging with IVL provides real time guidance and assessment of plaque modification and stent placement. OCT imaging enables clinicians to accurately assess the extent of plaque modification and evaluate results in real-time, leading to improved procedural outcomes .This combination of technologies ensures accurate and targeted treatment, resulting in higher procedural success rates and better clinical outcomes for patients with CAD. IVL has revolutionized the management of CAD, providing a safe and effective means of plaque modification. Utilizing IVL in CAD management has proven effective in safely modifying calcified plaques, facilitating optimal stent deployment and improving clinical outcomes. In conclusion, the use of IVL as a key therapeutic modality, coupled with C2+ technology along with the integration of OCT imaging for procedural guidance, is essential for enhancing the precision and safety of plaque modification and stent deployment. This approach results in improved clinical outcomes for patients with CAD. 

Introduction: Coronary artery disease (CAD) is one of the commonest causes of mortality and morbidity. The Fibrinogen/Albumin Ratio (FAR) is a newer marker of inflammation that has been shown to be a predictor of short-term prognosis in patients with acute myocardial infarction. Utility of FAR in predicting angiographic severity of CAD and clinical outcomes is not yet clear in Indian patients.  Objective: To study the role of fibrinogen-to-albumin ratio (FAR) as predictor of the angiographic severity of the coronary artery disease, and the short-term prognosis in the patients undergoing coronary angiography. Material and Methods: The present single-centre, prospective, observational study conducted in the Department of Cardiology at a tertiary care teaching institute in north India. A detailed history, physical examination and all routine investigations along with serum albumin, fibrinogen, ECG & 2-D Echo were done for all the patients. Samples were drawn at admission, before angiography. All the patients underwent clinically indicated invasive coronary angiography. SYNTAX SCORE was calculated using an online SYNTAX SCORE calculator. Results: Out of the 237 patients for final analysis, the majority (81.4%) were male. The mean age of the patients was 57 years. The mean fibrinogen level was 397.97 mg/dl, the mean serum albumin level was 4.05 g/dl and the mean FAR was 101.07 mg/g. with FAR below it was considered as low FAR and above it was considered as high FAR. The mean CAG Syntax score was 22.02. Majority of patients (58.6%) had acute coronary syndrome (ACS), while remaining had stable coronary artery disease. Two FAR groups were found to have comparable proportions of patients across the two Syntax score groups (low SS < 23, high SS > 23). The p-value for the correlation between FAR and Syntax Score was not significant (p=0.941). Conclusion: FAR was not found to be associated with CAD severity among Indian patients with stable CAD and ACS in the present study. This study didn’t find any correlation between the FAR and short-term prognosis.

Background : Chronic pancreatitis is a long-standing inflammation of the pancreas that leads to permanent damage and impairment of its functions. Accurate diagnosis is crucial for effective management. This study aims to evaluate and compare the effectiveness of ultrasonography (US) and computed tomography (CT) in diagnosing chronic pancreatitis, highlighting their respective advantages and limitations.

Materials and Methods: This observational study was conducted over 18 months in the Department of Radiodiagnosis at a tertiary care hospital. The study included 10 patients presenting with clinical symptoms suggestive of chronic pancreatitis. Initial evaluations were performed using a Samsung HS 40 ultrasonography machine, followed by CT scans using a Philips MX 16-slice CT scanner. The pancreas was assessed for size, echogenicity, duct dilatation, calcifications, and parenchymal changes. Data were analyzed using SPSS 22.0 software to determine the sensitivity, specificity, and diagnostic accuracy of both imaging modalities.

Results: The study population consisted of 10 patients with a mean age of 29 years, predominantly male (70%). The most common etiologies were idiopathic (50%) and alcoholism (30%). Ultrasonography visualized the pancreas in all cases, identifying duct dilatation (90%) and calcifications (80%) as common findings. CT confirmed these findings and provided additional details, detecting calcifications in 90% of patients and pancreatic atrophy in 60%. Both modalities effectively visualized the pancreas, but CT demonstrated higher sensitivity in detecting calcifications and structural changes.

Conclusion: Ultrasonography is valuable for the initial evaluation of chronic pancreatitis due to its non-invasive nature and accessibility. However, CT provides a more detailed and comprehensive assessment, essential for confirming the diagnosis and identifying complications. The complementary use of both imaging modalities enhances diagnostic accuracy and aids in effective management of chronic pancreatitis.

Background : Acute pancreatitis is a sudden inflammation of the pancreas that can range from mild discomfort to life-threatening illness. Accurate and timely diagnosis is crucial for effective management. While clinical and biochemical parameters play a role, imaging modalities such as ultrasonography (US) and computed tomography (CT) are essential for diagnosis and assessment. This study aims to evaluate and compare the effectiveness of US and CT in diagnosing acute pancreatitis and understanding their respective advantages and limitations.

Materials and Methods: This observational study was conducted over 18 months in the Department of Radiodiagnosis at a tertiary care hospital. The study included 45 patients diagnosed with acute pancreatitis. Initial evaluation was performed using a Samsung HS 40 ultrasonography machine, followed by CT scans using a Philips MX 16-slice CT scanner. The pancreas was assessed for size, echogenicity, ductal changes, calcifications, focal lesions, and extra pancreatic findings. Data were analyzed using SPSS 22.0 software to determine the sensitivity, specificity, and diagnostic accuracy of both imaging modalities.

Results: The study comprised 45 patients with acute pancreatitis, predominantly young adults (mean age 41 years) with a male predominance (84.4%). Alcoholism was the leading cause (51.1%), followed by idiopathic (28.9%) and gallstones (17.8%). Ultrasonography visualized the pancreas in 64.4% of cases, with common findings including a bulky pancreas (55.2%), hypoechoic echogenicity (44.8%), and ascites (37.7%). In contrast, CT visualized the pancreas in all cases, identifying a bulky pancreas (51.1%), fluid collections (26.7%), and exudates (73.3%). The CT severity index (CTSI) classified 31.1% as mild, 42.2% as moderate, and 26.7% as severe, with a mortality rate of 16.7% in the severe category. Ultrasonography had a sensitivity of 64%, dropping to 37.8% overall, while CT had a sensitivity of 96%.

Conclusion: Ultrasonography is a valuable initial imaging modality for acute pancreatitis due to its non-invasive nature, cost-effectiveness, and availability. However, CT provides a more detailed and accurate assessment, essential for diagnosing and managing acute pancreatitis. The complementary use of both imaging modalities enhances diagnostic accuracy, guides appropriate treatment strategies, and improves patient outcomes.