European Journal of Cardiovascular Medicine

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

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

Introduction: Long since the dispute regarding the time duration of umbilical cord clamping after birth in a neonate, there have been several recommendations for the same. The delayed cord clamping improves the cerebral blood volume in term and preterm neonates and it also decreases the risk of anemia in neonates, apart from multiple other maternal and neonatal benefits. Objectives: The purpose of this prospective study is to determine the effect of differential duration of cord clamping (at30seconds, 1min and 2min) on cerebral blood flow (middle cerebral artery flow dynamics) in normal term neonates. Methods: 390 deliveries, which fulfilled inclusion and exclusion criteria, in tertiary care centre were attended and the cord was clamped using aseptic precautions at 30 seconds, 1 minute and at 2 minutes exactly using random number table and the data were entered into master chart and then analysed using IBM SPSS statistical software. Results: The results showed no significant difference in cerebral blood flow hemodynamics, with different duration of cord clamping. Conclusion: Our hypothesis was that longer duration of cord clamping would lead to greater middle cerebral artery (MCA) blood flow velocity, but there was no significant change in hemodynamic parameters in middle cerebral artery blood flow with increasing duration of cord clamping. This implies that the known maternal and neonatal benefits of delayed cord clamping beyond 30 seconds were independent of cerebral circulation and hemodynamic parameters

Diabetes is a public health problem; prevalence of diabetes is progressively on the rise. International diabetes federation estimates a doubling prevalence of diabetes mellitus by 2035 from that of 541 million in 2022. Objectives: To find out the prevalence of peripheral neuropathy among known type 2 diabetics and to correlate peripheral neuropathy with select socio – demographic variables. Materials and Methods: A Descriptive cross -sectional community-based study was done among Known type 2 diabetes mellitus individuals of age group 30 years and above. The study was carried out for a period of 10 months after getting approval from the institutional ethical committee. Peripheral neuropathy was classified using the Toronto clinical scoring system of peripheral neuropathy. Data collected was entered in Microsoft 2010 excel spread sheet, compiled and analyzed using IBM SPSS Version 22 statistical package. Results: The prevalence of peripheral neuropathy was found to be 12.6% among the study subjects. Frequency of Peripheral neuropathy was increasing as the duration of diabetes increases. A significant association was found between duration of diabetes and peripheral neuropathy. A significant association was found between increased RBS value and peripheral neuropathy. Conclusion: Maintaining a proper blood-glucose control is the key to primary prevention of diabetes related complications. Regular monitoring of blood-glucose level must be done for the management of Diabetic peripheral neuropathy.

Background: The profile of cirrhosis may vary with different age and ethinic groups, geographical, social and etiological factors. So the present study will be undertaken  to study the  clinical profiles of patients with cirrhosis of liver in the form of demography, aetiology, clinical presentation, laboratory evaluation and  complications in this region of north Karnataka. Methodology: A two  years observational study after ethical committee approval was conducted at a tertiary care hospital among 200 cirrhotic patients in whom after explaining the purpose of the study,  detailed history, clinical and laboratory data was collected. The DATA was analyzed using  IBM SPSS Statistics for Windows, Version 25.0. Result. In our study the commonest age group was 31-50 years, mean age 44.10±13.08 years. Majority (88.5%) were males. Symptoms were abdominal distension (85.5%), lower limb edema(63.5%), jaundice (48%), gastrointestinal bleed(18.5%), altered sensorium in 14%. Aetiology were alcohol related (57.5%), HBV (13.5%), NAFLD(11.5%), viral and alcohol(5%), HCV (3%), Cryptogenic cirrhosis (4.5%) and Autoimmune Hepatitis (2.5%). Commonest   complications were hepatic encephalopathy (14%), Spontaneous bacterial peritonitis(14%), major renal impairment(12%) and Hepatocellular carcinoma (0.5%). 49% had CTP category B disease and 47.5% had CTP category C, 165 patients had MELD Na of >15. Conclusion: Cirrhosis is common among the most productive age group of society with change in lifestyle habits and increased alcohol use this has gained more importance. Recent advances in treating these patients may take a few more years in yielding new results and this article will act as a benchmark for comparison.

Respiratory diseases impose a big global health burden. Around 65 million people have moderate to severe chronic obstructive pulmonary disease (COPD), from which about 3 million die each year. Chest diagnostic imaging is vital in managing a critically ill patient. Right now, direct visualization of the lung parenchyma is done using a chest x-ray (CXR) and computed tomography (CT), with the patient in the supine position in the Intensive Care Unit (ICU). Aims & Objectives: To assess the efficacy of BLUE protocol in diagnosing patients with respiratory failure in intensive care unit. To evaluate the USG findings among study participants and to compare the USG Diagnosis and CT Diagnosis of Patients. Methodology: This was a hospital based cross-sectional, descriptive, prospective study conducted among 150 patients who were admitted into ICU at NRI Medical College suspected with Acute Respiratory Failure in a period of 18 months. Patients admitted to the ICU with respiratory failure were tested initially using LUS and BLUE protocol without interrupting other management. Final diagnosis was done based on history, clinical examination, CT scan, CXR, clinical progression under treatment, and evaluation of cardiac function using echocardiography, functional tests. Data was entered on a Case record form and was represented as frequency and simple percentages. Data analysis was done using Microsoft excel 2019 and IBM SPSS software version 23.0. Sensitivity, specificity, NPV and PPV were calculated for BLUE Protocol using CT diagnosis. Results: A total of 150 patients who were admitted into ICU with various respiratory disorders were evaluated in this study. The age of patients involved in this study ranged from 21-70 years with mean age of 52.27 years. The most common organism isolated was E Coli. Most of the patients had Pneumothorax in the current study. Accuracy was 90.48% in diagnosing pulmonary edema using USG in ICU. Conclusions: LUS is a multifaceted option with low radiation doses for ARF management in critical care settings. LUS is an accurate method for diagnosing pneumothorax, alveolar- interstitial syndromes, parenchymal consolidations, pleural effusion.

Introduction: Primary percutaneous intervention is the preferred treatment for ST-elevation myocardial infarction. Even after the restoration of epicardial flow graded as thrombolysis in myocardial infarction flow (TIMI) after percutaneous coronary intervention, microvascular obstruction can occur, which in turn leads to poor left ventricular function. The main cause of microvascular obstruction is atheromatous microparticle embolization within the culprit artery causing increased infarct size, mortality, and positive remodeling of the heart, which leads to overt heart failure and increased mortality. Objective: To determine the association between Myocardial Blush Grade (MBG) post-PCI and Left Ventricular Ejection Fraction in patients with ST-Elevation Myocardial Infarction. To investigate the relationship between Myocardial Blush Grade and adverse cardiovascular outcomes (e.g., heart failure, recurrent infarction, mortality) in STEMI patients.  To determine predictors of myocardial recovery: Identify factors associated with favourable myocardial recovery, including procedural characteristics, patient demographics, and comorbidities, to better understand the determinants of post-PCI left ventricular function. Methods: The data will be analysed using IBM SPSS software version 26.0. For analysis of groups in the study, MBG ≥2 was considered as ‘high’ grade whereas MBG <2 was considered as ‘low’ grade. Descriptive statistics will be used to describe variables such as gender.  Mean and standard deviation will be used for calculating variables such as age and ejection fraction. Chi-square test will be used to compare the clinical characteristics of the high and low MBG groups. Independent samples t-test will be used to determine if differences between TIMI score and MBG will be significant with respect to age.  Risk ratios will be calculated for adverse outcomes and improved LVEF with respect to MBG. Logistic regression analysis will be performed to determine the confounders of the study. Result: MBG may be considered as an additional angiographic parameter to define angiographic success and also better prognosticate patients and decide on management plans to improve long-term patient outcomes. The study findings may contribute to risk stratification models, helping clinicians tailor interventions and improve outcomes for STEMI patients. Conclusion: In the present study, we found a significant association between MBG and TIMI, suggesting that MBG can predict adverse events after thrombolysis/PTCA in those with ACS. However, we found no association between age, gender, co-morbidities or EF.

Introduction A common anesthetic method for a range of lower limb orthopedic procedures is spinal anesthesia due to its ease of administration, robust sensory and motor blocking, and reliable surgical anesthesia. However, the length of spinal anesthesia caused by local anesthetics alone is often brief; for this reason, adjuvants are employed to prolong analgesia and improve block quality. The quality and duration of spinal anesthesia have been enhanced by intrathecal opioids such as morphine, fentanyl, and butorphanol used as adjuvants to local anesthetics. Material And Method Written informed permission was obtained from research participants. A computer-generated random number was used to divide the minimum number of patients who met the inclusion criteria into two groups. Group A patients got 3 milliliters of 0.5% hyperbaric bupivacaine along with 0.2 milliliters, butorphanol (200 micrograms). Group B patients got 0.15 ml of buprenorphine (150 micrograms) together with 3 ml of 0.5% hyperbaric bupivacaine. Result The gathered information was imported into Microsoft Excel 2016 and examined using IBM SPSS Statistics for Windows.Descriptive statistics were employed to characterize the data: for continuous variables, the mean and standard deviation were utilized, and for categorical variables, frequency analysis and percentage analysis. Using the Independent sample t-test, the bivariate samples in the independent groups were compared to see whether there was a significant difference. Conclusion According to our study onset of sensory blockade and faster with butorphanol and duration of sensory blockade was more in buprenorphine compared to butorphanol whereas motor blockade is comparable in both groups. Buprenorphine group required rescue analgesia at 4hrs postoperatively whereas butorphanol group required rescue analgesia at 2nd hr Hence we conclude that buprenorphine would be beneficial for lower limb orthopedic surgeries as it provides prolonged duration of analgesia although further studies need to be done in a greater number of patients and for prolonged duration of procedures..

Background: This study assesses the knowledge, awareness, and preparedness of non-medical graduates in Ghaziabad City regarding Cardiopulmonary Resuscitation (CPR). It identifies knowledge gaps and sources of information to recommend strategies for improving CPR proficiency among this demographic. Methods: A quantitative research design was employed, utilizing an observational approach. A purposive sampling technique was applied to select 101 non-medical graduates from Ghaziabad. Data collection was conducted via a structured questionnaire developed using Google Forms. Statistical analysis was performed using IBM SPSS, incorporating descriptive statistics and regression analysis. Results: The findings indicate that 88.12% of participants had received CPR training, yet only 25.74% correctly identified the initial step in CPR. A significant portion (74.26%) mistakenly believed that CPR begins with 30 chest compressions instead of checking for breathing. 86.14% of respondents had encountered situations requiring CPR, and 89.11% reported performing CPR. However, 27.72% refrained from performing CPR due to discomfort, and 25.74% cited a lack of knowledge. Awareness of Automated External Defibrillators (AEDs) was limited, with 46.53% unfamiliar with the device. Conclusion: Although CPR training is widespread, critical knowledge gaps persist in understanding correct procedures. There is a need for structured and practical training programs tailored for non-medical graduates to improve their competency and confidence in performing CPR. Public health initiatives should focus on bridging the knowledge gap and promoting AED awareness to enhance emergency response effectiveness.

Background: Caesarean section (CS) is a widely performed surgical procedure for childbirth, particularly in complicated pregnancies. While necessary in certain medical situations, its overuse has raised concerns regarding maternal and neonatal health. This study aimed to assess the knowledge, attitude, and perception of pregnant women towards CS at KIMS Medical College, Amalapuram. Methods: A cross-sectional study was conducted among 110 pregnant women attending the antenatal clinic at KIMS Medical College over a three-month period. Data was collected using a structured questionnaire assessing socio-demographic factors, obstetric history, and women's knowledge, attitudes, and perceptions regarding CS. Statistical analysis was performed using IBM SPSS software. Results: The majority of participants (55%) were aged 22-29 years, with 58% residing in rural areas. 62% demonstrated good knowledge of CS, with 87% believing it saves neonatal lives and 84% acknowledging its life-saving potential for mothers. 59% of participants had a positive attitude towards CS, with 80% expressing willingness to undergo CS if medically indicated. 61% had a positive perception of CS, although concerns about back pain (71%) and the cost (78%) were prevalent. Conclusion: The study found that pregnant women generally possessed good knowledge, a positive attitude, and a favorable perception of CS. However, there is a need for targeted educational interventions to further enhance understanding and reduce misconceptions, particularly regarding the risks and benefits of CS.

Background: To evaluate the reliability of non-contact tonometry (NCT) compared to Goldmann applanation tonometry (GAT) for measuring intraocular pressure (IOP) in patients with myopic astigmatism and healthy controls, and to assess correlations between IOP, central corneal thickness (CCT), and keratometry values. Methods: A prospective comparative study was conducted at Vydehi Institute of Medical Sciences, involving 50 patients with myopic astigmatism (-0.25D to -3.50D) and 50 healthy controls (200 eyes total). IOP was measured using NCT (Reichert 7 Auto Tonometer) and GAT (Appasamy AATM-5001) between 9 and 11 am. CCT was measured using a Konan Specular Microscope, and keratometry values were obtained with a Unicos URK-800F. Statistical analysis was performed using IBM SPSS version 25, with Pearson’s correlation and unpaired t-tests (p ≤ 0.05). Results: Mean IOP in the myopic astigmatism group was 15.26 mmHg (right eye, RE) and 14.91 mmHg (left eye, LE) with NCT, and 14.58 mmHg (RE) and 14.62 mmHg (LE) with GAT. In controls, mean IOP was 14.49 mmHg (RE) and 14.49 mmHg (LE) with NCT, and 14.52 mmHg (RE) and 14.56 mmHg (LE) with GAT. NCT and GAT measurements were significantly correlated (p < 0.001) in both groups. No significant correlations were found between IOP and CCT or keratometry values. Conclusion: NCT is a reliable alternative to GAT for IOP measurement in myopic astigmatism (≤3.0D), facilitating glaucoma screening.

Background: Recovery heart rate (HRR), the rate at which the heart returns to baseline after exercise, serves as a practical, low-cost indicator of cardiovascular fitness and autonomic function. Faster HRR is typically observed in physically active individuals and reflects superior cardiac health. Given the growing sedentary tendencies in university populations, HRR provides a simple yet effective means to assess cardiovascular status in this age group. Objective: This study aimed to evaluate the efficacy of recovery heart rate as a physiological marker of cardiovascular fitness among physically active and inactive male students. Methodology: A comparative cross-sectional design was used over one year, involving 150 healthy male students aged 18–25. Participants were classified into physically active (n = 75) and inactive (n = 75) groups based on activity levels. All underwent a standardized submaximal exercise protocol, with heart rate measurements taken at rest, immediately post-exercise, and at one- and two-minute recovery intervals. Exclusion criteria included pre-existing medical conditions, use of cardioactive medications, and professional athletic training. Data analysis was conducted using IBM SPSS Statistics, with significance set at p < 0.05. Results: Physically active individuals demonstrated significantly lower resting heart rates and faster recovery post-exercise compared to inactive peers (p < 0.001). The mean reduction in heart rate during the first recovery minute was greater in the active group (45.7 ± 7.2 bpm) versus the inactive group (31.5 ± 6.9 bpm). A strong positive correlation (r = 0.721) was found between physical activity and HRR, and a negative correlation (r = –0.603) between physical activity and resting heart rate. Conclusion: Regular physical activity is associated with improved cardiovascular responsiveness and autonomic recovery. Recovery heart rate is an effective, field-friendly measure of cardiovascular fitness, reinforcing the need for structured physical activity programs in university settings.a