European Journal of Cardiovascular Medicine

Background:Urinary tract infection (UTI) is a common bacterial infection in children and may lead to significant morbidity if not diagnosed and treated appropriately. Increasing antimicrobial resistance among uropathogens has complicated empirical therapy, making local surveillance of causative organisms and their susceptibility patterns essential.Objectives: To determine the common bacterial pathogens causing paediatric UTI and evaluate their antimicrobial susceptibility patterns.Materials and Methods: This prospective observational study was conducted over six months from February 2016 to August 2016 and included 110 children with culture-confirmed UTI. Urine specimens were collected using appropriate aseptic techniques and subjected to quantitative culture. Bacterial isolates were identified using standard microbiological methods. Antimicrobial susceptibility testing was performed by the Kirby-Bauer disc diffusion method and interpreted according to applicable Clinical and Laboratory Standards Institute criteria.Results: Gram-negative organisms accounted for 90.9% of isolates. Escherichia coli was the predominant uropathogen, isolated in 58 cases (52.7%), followed by Klebsiella spp. (18.2%), Proteus spp. (9.1%), Enterococcus spp. (7.3%), and Pseudomonas aeruginosa (5.5%). Among E. coli isolates, susceptibility was highest to imipenem (98.3%), nitrofurantoin (91.4%), amikacin (89.7%), and piperacillin-tazobactam (87.9%). Lower susceptibility was observed to ampicillin (25.9%), cotrimoxazole (46.6%), and amoxicillin-clavulanate (50.0%). Conclusion: E. coli remains the principal cause of paediatric UTI, with substantial resistance to several commonly used antibiotics.

Background: Preoperative anxiety can alter pain perception and influence analgesic needs after surgery. Identifying this relationship can support individualized perioperative pain management. Objectives: To evaluate the association of preoperative anxiety with postoperative pain severity, time to first rescue analgesia, and 24-hour analgesic requirement in adults undergoing elective surgery. Methods: This prospective observational study included 80 adults at Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India, from January to June 2016. Preoperative state anxiety was assessed using the State-Trait Anxiety Inventory-State (STAI-S); scores >44 defined high anxiety. Postoperative visual analogue scale (VAS) pain scores were recorded at 6, 12, and 24 hours, together with rescue analgesic timing and 24-hour consumption. Correlation and multivariable linear regression analyses were performed. Results: The mean STAI-S score was 43.7 ± 9.5; 34 patients (42.5%) had high anxiety. High-anxiety patients had greater VAS scores at 6 hours (4.3 ± 1.2 vs. 3.1 ± 1.2), 12 hours (3.7 ± 1.2 vs. 2.6 ± 1.1), and 24 hours (2.7 ± 1.1 vs. 2.0 ± 0.9). Rescue analgesia was required earlier (4.1 ± 1.8 vs. 6.2 ± 2.4 hours), and 24-hour consumption was higher (132.4 ± 41.6 vs. 88.4 ± 35.7 mg tramadol equivalent). STAI-S correlated with 6-hour VAS (r=0.52) and 24-hour analgesic requirement (r=0.47); both associations remained significant after adjustment. Conclusion: Higher preoperative anxiety was independently associated with more severe postoperative pain and greater early analgesic requirement. Routine anxiety assessment can identify patients requiring enhanced perioperative counselling and analgesic planning

Background: Dental caries, commonly known as tooth decay or cavities, is one of the most prevalent oral health problems affecting adolescents worldwide. Dental caries as increased significantly due to changing dietary habits, increased consumption of sugary foods, poor oral hygiene practices, and lack of awareness regarding preventive dental care. Adolescence is a crucial stage of life during which permanent teeth are highly vulnerable to decay because of hormonal changes, lifestyle modifications, and negligence towards oral health. The World health organization reports the burden of oral diseases to be less in developing countries. Despite health sector improvement in India, dental caries has remained among the leading causes of consultation at all levels of the health care delivery pyramid with high numbers in rural communities. The prevalence of dental caries experienced in India is found to be 64.9% but few studies have been conducted assessing the predisposing risk factors, especially in adults. The objectives of the study included the determination of dental caries prevalence and associated risk factors among adult outpatients who attended department of dentistry at Santosh Medical College & Hospital, Ghaziabad. Methods: Hospital-based cross-sectional study using quantitative methods with a sample size of 281 participants aged 18 and above systematically selected randomly without repetition from patients’ registry at reception picking every tenth among patients who attended Santosh Medical College & Hospital, Ghaziabad outpatient department during the study period. The sample size calculation used Yamane’s 1967 formula. Ethical approval was issued by the school of health sciences and informed consents were signed by participants with the right to withdraw at any time without prior justifications. Data collection instruments included a self-administered close-ended questionnaire with questions on sociodemographic characteristics, eating and drinking habits, oral hygiene practices, and smoking habits; and a data sheet to extract data from patients’ files after a physical dental examination of study participants. The study collected information on risk factors for dental caries development that included age, gender, oral hygiene practice, alcohol consumption, sugary snacks, and beverages consumption, and tobacco use. Data were analyzed using a statistical package of social sciences at a 95% confidence interval. Results: The prevalence of dental caries is 71.5% among patients attending the outpatient department and predisposing risk factors were found to be old age, gender, poor oral hygiene, consumption of sugary snacks and beverages. Alcohol was also found to contribute to dental caries development, but no statistical significance was found. Conclusions: The prevalence of dental caries was found to be high in the study population and the multifactorial risk factors associated with its development were found to be poor oral hygiene, frequent consumption of sugary snacks and beverages, gender, and old age. The study recommended further studies to explore these multifactorial risk factors on a larger scale.

Background: Pseudoexfoliation syndrome (PXF) is a systemic disorder of elastic fibers that significantly complicates cataract surgery due to zonular weakness and poor pupillary dilatation. Small incision cataract surgery (SICS) remains the predominant technique in resource-limited settings, yet data on outcomes in PXF patients undergoing SICS are limited. This study aimed factors affecting intra and postoperative complications, visual outcome of small incision cataract surgery in patients with pseudoexfoliation syndrome. Methods: The study was conducted at a tertiary care center from June 2015 to May 2016. A total of 135 eyes with pseudoexfoliation syndrome undergoing SICS with posterior chamber intraocular lens implantation were analyzed. Preoperative clinical characteristics, intraoperative complications, and postoperative outcomes including best-corrected visual acuity (BCVA) at six weeks were evaluated. Statistical analysis was performed using chi-square test and independent t-test with significance set at p<0.05. Results: The mean age was 67.84±8.42 years with male predominance (58.5%). Poor pupillary dilatation (<6mm) was observed in 34.8% of eyes, and phacodonesis in 25.9%. Intraoperative complications occurred in 17.8% of cases, including zonular dialysis (8.1%), posterior capsule rupture (5.9%), and vitreous loss (3.7%). Capsular tension ring was utilized in 11.1% of cases. At six weeks, 82.2% achieved BCVA ≥6/18. Postoperative complications included corneal edema (28.9%), elevated intraocular pressure (14.8%), and posterior capsule opacification (8.1%). Higher PXF grade and phacodonesis were significantly associated with intraoperative complications (p<0.001). Conclusion: SICS in pseudoexfoliation syndrome patients yields favorable visual outcomes comparable to published literature on phacoemulsification. Thorough preoperative assessment, appropriate use of adjunctive devices, and meticulous surgical technique are essential for optimizing outcomes in this challenging patient population.

Background: Untreated cataracts continue to be the leading cause of blindness globally, despite the fact that this condition can be effectively and affordably addressed through a standard surgical procedure. Hence; the present study was conducted for assessing the visual outcome following cataract surgery. Materials & methods: A cohort of 100 patients, all diagnosed with cataract as the primary cause of their visual impairment and scheduled for surgical intervention, participated in this study. The inclusion criteria specified that patients must have a visual acuity of less than 6/60 in the affected eye due to cataract. An appropriate anesthetic was administered for each procedure. The presenting and best-corrected vision of the operated eye were evaluated on the day of discharge and again six weeks after surgery. Visual improvement was quantified using the World Health Organization's recommended method for assessing postoperative visual status. All data were documented in a Microsoft Excel spreadsheet and analyzed using SPSS software. Results: Out of 200 patients, 96 underwent surgery on the right eye. Among these, 56 were males (28% of total patients) and 40 were females (20% of total patients).A total of 92 patients had surgery on the left eye, with 48 males (24%) and 44 females (22%). twelve patients underwent bilateral cataract surgeries, comprising six males (3%) and six females (3%).The study included 110 males (55%) and 90 females (45%). The mean age of the study participants was calculated to be approximately 62.50 years, with male and female participants having estimated mean ages of 63.42 and 65.50 years, respectively. majority (84%) of patients exhibited severe visual impairment preoperatively, with visual acuity less than 3/60.Only 4% had moderate visual impairment (6/24 to 6/60), and none had visual acuity better than 6/60.Postoperatively, there was a substantial improvement in visual acuity. Specifically, 22% of patients achieved visual acuity between 6/60 to 6/18, and 38% attained moderate visual acuity (6/24 to 6/60). The number of patients with severe visual impairment (less than 3/60) decreased to 30%. These improvements are statistically significant, with a p-value of 0.001. Conclusion: To optimize outcomes in cataract surgeries, eye care staff can take several key steps like Promoting cataract surgeries at an earlier age to achieve better results and improve the patient's quality of life & providing thorough counseling to manage patient expectations, especially in cases with co-morbidities. This helps enhance patient satisfaction and outcomes by ensuring realistic expectations and informed decision-making

Background: The elbow is a synovial joint featuring intricate hinges and plays a crucial role in hand positioning in space. In adults, distal humerus fractures account for 2% of all fractures and 30% of injuries around the elbow [1]. Aim: To assess the functional outcome of comminuted supracondylar fractures of the humerus treated with surgical management. Objectives: To achieve accurate anatomical reduction.To achieve stable fixation.To assess the union of fracture after internal fixation.Material & Methods: Study Design: Hospital-based prospective study. Study area: The study was conducted in the Department of Orthopaedics, BGS Global Institute of Medical Sciences, Bangalore.  Study Period: 1 year. Study population: Adult Patients sustained with comminuted supracondylar fractures of the humerus presenting at the Department of Orthopaedics were studied. Sample size: The study consisted of a total of 20 subjects. Sampling Technique:  Simple Random technique. Results: It was observed that orthogonal-type plates resulted in a significantly higher number of patients with excellent outcomes (86.7%) compared to parallel plates (20%). Similarly, no statistically significant difference was noted (p>0.050) about the type of approach used with outcome based on the Quick DASH score at all three follow-ups.  Conclusion: The surgical treatment of comminuted supracondylar humerus fractures using dual plating led to excellent outcomes in 70% of the patients, while 25% experienced good outcomes as assessed by the Quick DASH score. Additionally, patients who received surgical treatment with orthogonal plates exhibited significantly better outcomes, but there was no statistically significant difference observed concerning the type of surgical approach utilized.

Introduction Heart failure (HF) is as a clinical condition explained by current or previous complaints like breathlessness, ankle swelling, and tiredness, along with signs like elevated JVP, pulmonary crepitation’s, and peripheral oedema, all of which are caused by an anatomical and/ or physiological cardiac abnormality and confirmed by at least 1 of the following: raised BNP levels or verifiable evidence of respiratory, cardiac or systemic congestion Materials And Methods This is a observational study was conducted in the Department of General Medicine, Mahavir Institute of Medical Sciences. Two hundred twenty patients who were admitted to the ICU and who underwent the measurement of serum UA were enrolled in this study. AHF was defined as either new-onset HF or the decompensation of chronic HF with symptoms sufficient to warrant hospitalization. HF was diagnosed according to the Framingham criteria for a clinical diagnosis of HF, based on the fulfilment of two major criteria or one major and two minor criteria. Results  Age was not significantly associated with uric acid levels (P=0.153). However, a trend was observed where patients aged 71-80 years had the highest proportion of high uric acid (75%), while those aged 41-50 years had a lower proportion (28.57%). Men and women had similar uric acid levels (P=0.550). Patients with COPD, dilated cardiomyopathy, and coronary artery disease had slightly higher uric acid levels, but the association was not statistically significant. Among co-morbidities, diabetes, hypertension, smoking, and alcohol consumption were not significantly different between high and low uric acid groups. However, patients with high uric acid had significantly higher rates of ICU admission (93.55%) and mortality (94.40%), suggesting a strong association between elevated uric acid and worse clinical outcomes. Conclusion This study confirms that elevated serum uric acid is an independent predictor of worse clinical outcomes in CHF. Patients with higher UA levels have more severe disease, increased ICU admission, and significantly worse survival rates. Given these findings, uric acid measurement should be integrated into routine CHF risk stratification. Future research should explore whether lowering UA can directly improve patient outcomes and reduce cardiovascular mortality.