Introduction: Infertility is a public health problem associated with medical, emotional, social, and financial consequences. Recent study on infertility suggests that in India, approxi- mately 15 to 20% of married couples in the reproductive age group suffer from infertility and its incidence is on the rise. Artificial reproductive techniques (ARTs) including IVF/ICSI and ET have been a major development in the treatment of infertility. Objective: To compare reproductive outcomes of day 2 and day 3 embryo transfer (ET). Materials and methods: In this retrospective records study, all couples who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) and ET cycles at International Fertility Center, Delhi, India over a period of 1 year were studied. Data were collected and analyzed by chi-square test and unpaired t-test by Statistical Package for the Social Sciences, version 19. Results: There was no statistically significant difference between the clinical and demographic parameters of group day 3 and day 2 ET. In our study, clinical pregnancy rate was 45% in day 3 ET and 36.5% in day 2 ET group [odds ratio (OR) 1.43, p-value 0.49]. The ongoing pregnancy rate was 39.2% in day 3 ET and 26.9% in day 2 ET group (OR 1.75, p-value 0.26). We observed that the miscarriage rate was 5.9% in day 3 ET and was 5.8% in day 2 ET group (p-value 0.69, OR 1.02). We observed one case each of multiple pregnancies, ectopic pregnancy, and fetal anomaly (anencephaly) in day 2 ET group, while in day 3 ET group, no such case was detected. Conclusion: There are chances that day 3 ET has better clinical and ongoing pregnancy rates than day 2 ET, but the difference is not statistically significant. Study showed similar miscarriage rates in both groups and very low incidence of complications like multiple pregnancy, ectopic pregnancy, and fetal anomaly. So, it is safe to schedule and transfer embryos either on day 2 or on day 3 for planning and programming cycles in coordination with patient and IVF team and for adjusting weekends (nonworking days).

Large wounds with heavy exudate are known to cause moisture related skin damages that can be distressing to the patient especially when he has pain that disturbs his sleep and other activities. Honey, known to be used to treat wound in ancient era, has antimicrobial properties, is anti- inflammatory and is known to promote wound healing. This case report demonstrates the efficacy of Indian medical grade honey in high exuding wound with peri wound skin damage.

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

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

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

Introduction: 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

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

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

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

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

Background: In India, hydatid cysts of the liver are a serious yet untreated public health issue. Aim: To assess the sociodemographic traits, clinical manifestations, and treatment of individuals with liver hydatid cysts in a developing nation

Objectives To evaluate clinico demographic profile of hypertensive retinopathy cases in a tertiary care hospital of South Odisha, India. Materials and methods: This was a Cross-sectional study conducted in the department of Ophthalmology, SLN Medical College, Koraput (Odisha) from July 2021 to February 2022. A total of 226 hypertensive patients were examined out of which 100 were found to manifest hypertensive retinopathy changes

Objective: The purpose was to study the ocular manifestations pattern and complications of vernal keratoconjunctivitis (VKC) and efficacy of corticosteroid, cyclosporine, alcaftadine. Material and methods: A Prospective study was done taking 227 patients from 15th Oct 2021 to 15th Mar 2022 in Department of Ophthalmology SLN Medical College and Hospital. Vernal Keratoconjunctivitis (VKC) was diagnosed basing on clinical presentation and scoring of signs and symptoms

The goal of this study was to determine the risk of thrombosis in patients with severe SARSCoV2 infection. Methodology: All patients referred to intensive care units (ICUs) from two centres of an Indian tertiary hospital for acute respiratory distress syndrome (ARDS) owing to COVID19 were included. Medical history, symptoms, biochemical data, and imaging data were all gathered prospectively. To compare the occurrence of thromboembolic events in non-COVID19 ARDS versus COVID19 ARDS patients, propensity score matching was used

Background: Oral Submucosal fibrosis (OSMF) is one of the most prevalent premalignant conditions in India which is easy to diagnose but difficult to manage. At present it is considered as irreversible and incurable. Aims: Assessment of risk factors and the role of habit variables such as duration and frequency in the severity of OSMF and to ascertain the association of gender predilection for different habits and severity of OSMF. Material and Methods: Patient personal history was recorded with chewing habits, including frequency and duration of chewing. This descriptive retrospective study of 179 OSMF patients was carried out at the tertiary level hospital in the central India. The clinico-demographic data including details of habits was collected. Clinical staging was done on the basis of palpable fibrous bands. Functional staging was accomplished by measuring mouth opening.

Background: H. pylori is the most common human bacterial pathogen that colonizes the gastric epithelium especially in those habitual Qat chewers; it influence can absorption of glucose which is also abnormal in DM patients, its common infection in diabetic patients who have inadequate metabolic control, this study was conducted to reveal the prevalence of H. pylori among T2DM and non-DM patients and potential risk factors. Methods: A cross-sectional study was conducted in the department of medicine, a tertiary care hospital in India, and there were 250 patients who included in this study. Data were collected through structural intervals questionnaire and sampling information. Results: The overall prevalence of H. pylori among diabetics was 29.2%. There was no significant association between H. pylori infections and diabetes (P> 0.05), most of the patients were 46-60 year age group, with male predominance (76.7%) H. pylori infections were not significantly associated with the smoking, hypertension, dyslipidemia and obesity. H. pylori infection increased in longer duration of diabetes and the increase in HbA1c level. Conclusion: Positive H. pylori DM patients should update their sugar level values and control the disease. Further research is highly recommended on relationship between H. pylori infections and diabetes

Introduction: Thyroid disease is more common in women than in men, because most thyroid diseases are autoimmune in nature and increased susceptibility to autoimmune diseases, perhaps secondary to the female endocrine environment is likely contributing factor. Thyroid physiology plays a major role in pregnancy and thyroid disorders constitute one of the most common endocrine disorders in pregnancy. Pregnancy is associated with significant and reversible changes in thyroid function and failure to adapt to these changes result in thyroid dysfunction. Material and Methods: This is a Prospective study done among 1000 pregnant women. Antenatal women attending the outpatient department of tertiary care centre from August 2021 October 2022. Detailed history was taken, regarding the symptoms of thyroid disorders, menstrual history, obstetric history, past medical history, family history and personal history

Object: This study aimed to investigate the status of Malondialdehyde (MDA) concentration and the activity of antioxidative enzymes, superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in both gastric cancer patients and healthy controls. The role of enzymatic antioxidant activity in cell protection from the damages caused by oxidative stress was also examined. The differences between the lipid peroxidation levels and defense mechanisms of the two groups were analyzed and compared. Materials and Methods: This study was conducted on 50 patients diagnosed with gastric cancer and 50 healthy control subjects of the same age and gender. Spectrophotometric techniques were used to measure the activity of malondialdehyde, glutathione peroxidase, and superoxide dismutase. Results: The results of this study revealed that there was a significant increase in MDA and a highly significant alteration in antioxidants. Conclusion: The diagnosis of human gastric cancer or recurrence could be aided by studying the lipid peroxidation and antioxidant defense mechanisms, in addition to using biopsy, biochemical, and pathological investigations. This combination of methods may be a more effective tool

Background: Interval duration measurements (IDMs) were compared between standard 12-lead electrocardiograms (ECGs) and 12 lead mobile ECG recorded with Spadnan ECG based ECG device, a single channel, hand-held mobile device designed for use by patients at home. Objective: Objective of this prospective, cross-sectional, within patient diagnostic validation study was to compare the interval durations between standard 12 lead ECG and 12 lead mobile ECG recorded with Spadnan ECG based single channel ECG device. Materials and Methods: This single-center study was carried out at Shri Mahant Indresh Hospital (SMIH), Dehradun, Uttarakhand, India from January 2019 to August 2022. All patients (n=2308) visiting the electrocardiogram (ECG) room at the Department of Cardiology of the SMIH, Dehradun during the study period were enrolled in the study by taking their written consent and explaining the purpose of the study. Results: Smartphone-operated 12 lead ECGs showed good diagnostic accuracy for QT, PR, QRS, QTc and Heart rate measurement in comparison to the standard 12 lead ECG machine. The PR interval, QRS duration and Heart rate were under the clinical agreement levels. Whereas, the QT and QTc showed the variability of more than 20 ms. hence, the detection of the Arrhythmias associated with shorten PR intervals, prolonged PR intervals can be detected by the Smartphone ECG with accuracy, the conduction blockages like LBBB involving the QRS duration can be precisely be detected by the smartphone ECG. Conclusion: Our research evidence proved the equivalency of device in measuring the morphological parameters like PR intervals and QRS duration. Our study observed variation in detection of the QT and QTc intervals at above 25 ms, which might make it difficult to be used in diagnosis but for general purpose where no medical facility is available, our device can be used for primary care. Hence, the Smartphone ECGs can be used in the primary care and for general use

Background: Ambulatory assessment of the heart rate–corrected QT interval (QTc) within arrhythmia patients can be of diagnostic value where these patients are on QTc-prolonging medication. Repeating sequential 12-lead electrocardiograms (ECGs) to monitor the QTc is cumbersome, but Spandan Smartphone ECG devices can potentially solve this problem. Objective: Objective of this prospective and retrospective, cross-sectional, within patient diagnostic validation study was to validate the measurement of QTc interval in Spandan 12 lead ECG and to assess the accuracy of the 12 lead Spandan Smartphone ECG device in measuring the QTc intervals in the general cardiology outpatient population with normal ECG and arrhythmias. Materials and Methods: This single-center study was carried out at Shri Mahant Indresh Hospital (SMIH), Dehradun, Uttarakhand, India from August 2022 to October 2022. All patients (n=1168) visiting the electrocardiogram (ECG) room at the Department of Cardiology of the SMIH, Dehradun during the study period were enrolled in the study by taking their written consent and explaining the purpose of the study. Results: Mean (SD) age was 54.36±4.9 years. The male gender (n=783,67.03%) shows the maximum frequency than female gender. Primary Coronary Intervention was noted in 426 (36.4%) of the study population. All the four parameters showed positive Pearson correlation between 12 Lead Standard ECG and Spandan Smartphone ECG. The maximum mean difference between 12 Lead Standard ECG and Spandan Smartphone ECG was noted for QTc parameter in overall participants. Conclusion: 12-lead Spandan Smartphone ECG allows for QTc assessment with good accuracy and can be used safely in ambulatory QTc monitoring. This may improve patient satisfaction and reduce healthcare costs

Introduction: Preeclampsia is a pregnancy-specific multi-systemic disorder characterized by proteinuria and the onset of hypertension during pregnancy (1, 2) Among the hypertensive disorders that complicate pregnancy, pre-eclampsia and eclampsia stand out as major causes of maternal and perinatal mortality and morbidity3. Calcium has an important role in the pathogenesis of pre- eclampsia. The present study was aimed to compare the level of serum calcium in normal pregnant women and in preeclampsia and determine the association of serum calcium with severity of the disease

Background: The internet, mobile phones, and other similar tools are indispensable for the current functioning of both private life and business. In these two years of Covid 19 pandemic (2019 2021), internet use, especially for different games as well as social networking, were indispensable for the global population, allowing engagement and interaction among many people online in a virtual world. The term ‘Internet Addiction Disorder’ was first coined and described by Dr. Kimberly Young. There are various models for diagnostic criteria which contain some commonalities

Introduction: In this study, percutaneous suturing for the treatment of acute Achilles tendon (AT) rupture was compared to open reconstruction for the treatment of chronic AT rupture. Materials and methods: We conducted a prospective comparison research at Department of Orthopaedics, Guntur Medical College, Guntur, Andhra Pradesh, India, between March 2021 to February 2022. Patients having a primary diagnosis of total Achilles tendon rupture were included in the analysis. Twenty-five patients were given advice on their treatment choices and encouraged to return in a year for follow-up. Results: Results of multivariate and univariate logistic regression methods are used. Comparable gram-positive and gram-negative bacterial growth was seen in this study of pleural space infections. pH, loculation, positive stain, culture, fever, and serum albumin were all statistically significant in their own right when analysed in isolation. After doing a multivariate analysis, we found that pH, loculation, and serum albumin were significant predictors of tube thoracostomy success or failure. Conclusion: Comparing open repair for chronic AT rupture to percutaneous suturing following acute AT rupture, one may find similar clinical and functional results, but a thicker tendon.

Background and objectives: In situ hybridization (IHC) markers p63, SMA, and ki67 in the spectrum of ductal proliferative breast lesions: a study employing excision biopsy and mastectomy patients. The goal of this study is to evaluate myoepithelial markers for their potential in spotting breast cancer in its earliest stages. Methods: The research used representative paraffin sections from 30 breast mass tissue samples submitted to the Department of Pathology, Osmania Medical College, Hyderabad, Telangana, India, between April 2018 to March 2019. P63, SMA, and Ki 67 antibodies were used to immunostain 40 breast masses categorised as ductal proliferative lesions, ductal carcinoma in situ, or invasive ductal carcinoma by the Department of Pathology. Results: p63 non myoepithelial had 22 in negative frequency and 8 in positive frequency. While for SMA nonmyoepithelial negative frequency was 4 and positive frequency was 16. Over and over, it was shown that stromal cells, and myofibroblasts in particular, did not react to the stimuli. There was a ring of p63-immunoreactive cells encircling lobular and ductal cancer in situ, however it was disjointed compared to the normal structures. Conclusion: Ki67, myoepithelial P63, and stromal myoepithelial antigen (SMA) were shown to be reliable markers for discriminating normal epithelium from hyperplasia, MIN, and invasive carcinoma in this study.

Introduction: One of the most common types of fractures seen in orthopedic treatment is a crack or break in the shaft of the femur. In individuals who have sustained high intensity trauma, a fracture of the shaft of the femur is a major source of morbidity and mortality. Materials and methods: There were 20 people total who participated in the study. This study was a prospective research study that took place in Department of Orthopedics, Government Medical College, Ongole, Andhra Pradesh, India. There are roughly 8 men for every female. The time frame for the research was from May 2021 to April 2022. Results: The survey involved 20 people, with men making up 72% and women 28%. At least 88% of the population is under the age of 50. The majority of femur fractures occurred in the middle one-third of the thigh, and car accidents were the most prevalent cause of injury. Within 24 hours of injury, 76% of patients were seen. Fractures in most patients healed completely between 12–14 weeks clinically, and within 16–18 weeks radiologically. After 10 weeks, patients could begin light weight bearing, and by 16 weeks, they could handle their whole-body weight. Conclusion: In the fracture of the shaft of the femur that we saw, interlocking nailing had a very low complication rate and produced great results in terms of the patient's ability to function.

Background: The term "asymptomatic bacteriuria" (ASB) refers to persistent, aggressive bacterial growth in asymptomatic females' urinary tracts. The quantitative diagnosis is a clear catch mid urine sample with more than 100,000 organisms/ml.1 The incidence is often population-dependent geographical variance, ranging from 2 to 7%. The incidence is between 25 and 35 percent in emerging nations like India

To analyze the occurrence of diabetic foot storm in hospitalized patients with foot complications. Methods and Materials: A retrospective analysis was done from July 2021 to December 2021 at Amit Jain’s Institute of Diabetic foot and wound care, Brindhavvan Areion Hospital, Bengaluru, India

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

This study is a Prospective cross sectional observational study. The study was conducted from December 1st, 2020, to June 1st, 2022 in which 100 patients who had presented to the Surgery OPD and Emergency Department of Katuri medical college &hospital, Chinakondrupadu, Guntur with history suggestive of urolithiasis were enrolled for the purpose of studying the incidence of urolithiasis at different levels of the urinary tract and to assess different modalities of treatment and compare outcome of those results with that of the world literature. Our Study had found that the incidence of urolithiasis at our center was 3.74%. The age group of people between 21-30 years were the most commonly affected. However, the mean age for developing urolithiasis was 40.4 years. Males appear to be predisposed to the formation of calculi with M: F ratio being 1.77:1. Pain was the most common symptom which was seen in 91 % of the patients followed by nausea/vomiting seen in 58% followed by burning micturition (43.84%), fever (16.44%) and haematuria (15.08 %) of the study group. Right kidneys were affected more commonly than the left. Diabetes mellitus   was   the   most   commonly   associated   comorbidity   followed   by hypertension. Renal pelvis was the most commonly affected site (35%) followed by lower 1/3rd, urinary bladder (17%) upper ureter (14%) and lower ureter (11%) respectively. E. coli was the most commonly isolated organism in the urine cultures followed by Klebsiella. Serum calcium was normal in 96% of the study group while serum uric acid was raised in 25% of the subjects. Plain X ray KUB and ultrasound were the initial imaging modalities used. IVP was preferred over CT in diagnosis as CT was costlier and could not be afforded by the poor. Patients consuming mixed diet seemed to be more predisposed to the formation of urolithiasis. Open Pyelolithotomy was the operative modality for renal pelvic calculi, Open Ureterolithotomy for upper and mid ureters and URS for lower ureter. Open Cystolithotomy was used for bladder calculi. Stone free rates for Open Pyelolithotomy was 91.4%, 96% for Open Ureterolithotomy, 91.3% for URS and 100% for Open Cystolithotomy. The average size of stone extracted in Open Pyelolithotomy was 2.78 cm, 1.34 cm for Open Ureterolithotomy, 3.92 cm for Open Cystolithotomy and 1.1 cm for URS. Mean duration of hospital stay was 7.42 days for Open Pyelolithotomy, 6.16 days for Open Ureterolithotomy, 5.35 days for Open Cystolithotomy and 1.34 days for URS. Thus we can conclude that, the incidence of urolithiasis was 3.74% in our study. The patients underwent open procedure for removal of stones at our cente.r However, as seen in our study, open procedures have good success rates and also have less post- operative complications. It can thus be concluded that it does not hamper patient care. This is in accordance with the other studies over open urological procedures

Background: IThis hospital-based prevalence study was carried out to evaluate the clinical and epidemiological profile of anaemia in central India. Methods: In this study, 200 patients with anaemia from medical outpatient departments and indoor wards were randomly selected without regard to gender, occupation, socioeconomic status, or disease duration. Results: According to the findings of this study, the majority of patients (40%) were between the ages of 21 and 30. Females had a higher prevalence of anaemia than males between the ages of 15 and 30. The study population has moderate anaemia in 57% of cases, and severe anaemia in 41% of cases. Weakness and easy fatigability were the most common (100%) presenting symptoms, and pallor was the most common (98%) clinical sign. The most common laboratory findings were microcytic and hypochromic type peripheral smears (59 percent cases). The most common type of anaemia was nutritional anaemia (84 percent). Conclusions: Lack of nutrition The most common cause of anaemia in the population is anaemia, and iron deficiency is the most common nutritional deficiency in the population.

The second covid wave caused unprecedented havoc, morbidity and mortality all over India. This retrospective study delves into the disastrous impact of Covid 19 second wave in the pregnant population at our tertiary care center. This retrospective study was done to bring insight into demographical factors, associated comorbidities, mode of delivery, role of inflammatory markers, treatment administered, complications in pregnant women who were severely affected by COVID -19. Material and Methods: This retrospective observational study collected data from 1 April 2021 to 30 June 2021. A total of 40 pregnant COVID-19 patients admitted during the second wave of COVID-19 infections were included in the study. All demographic characteristics like age, parity, type of conception, BMI, associated comorbidities, symptoms and their duration, type of oxygen support, the inflammatory markers (IL6, serum ferritin, N/L ratio, LDH), mode of recovery and outcomes were analyzed. Statistics: Data was collected, summarized, tabulated using Microsoft Excel and expressed as percentage. Results: Of the 40 COVID- 19 cases, 10 pregnant women succumbed to COVID- 19. Age above 30 years and higher BMI was associated with all mortalities. Fever and Breathlessness was a common symptom in all. All women who succumbed had falling SPO2 levels and all were on higher oxygen support. CRP, D- dimers and IL-6 levels are markedly increased in all the fatalities who were infected by COVID-19. Conclusion: The second COVID-19 wave affected the pregnant population the most. The outcomes of women who were on higher oxygen support was worser. Serum Ferritin and IL-6 was raised in all patients with worse prognosis

Background- Given the strong correlation between cardiac disease and chronic kidney disease (CKD), it is possible that even a slight drop in glomerular filtration rate (GFR) can act as a risk factor for developing cardiovascular abnormalities. Cardiovascular disease (CVD) patients with CKD had mortality risks that were three to thirty times higher than those of the general population. Methods- This cross-sectional study was conducted in the Medicine unit of Postgraduate Medical Center of Central India within 6 months duration. The analysis included a total of 140 patients who had been receiving maintenance for more than a year. Two-dimensional transthoracic echocardiography was done in each patient for the determination of cardiac structural and functional parameters such as LV hypertrophy, LV systolic dysfunction, and LV diastolic dysfunction. Results- Out of 140 patients, there were 75.7% males and 24.3% females. Maximum number of patients belonged to age group of 51-60 years. Mean age of ESRD patients was 53.3 ± 12.8. Hypertension (37.1%) was leading cause of ESRD, other causes included diabetes (21.4), diabetes with hypertension (10%), chronic glomerulonephritis (8.6%), polycystic kidney disease (7.1%), obstructive uropathy (5.7%), analgesic nephropathy (2.9%) and aetiology remained unknown in 7.1% cases. Conclusion- Left ventricular dysfunction was most common in ESRD patients. LVH was the most common ESRD echocardiographic abnormality. More ESRD patients had diastolic dysfunction than systolic dysfunction. Left ventricular hypertrophy and diastolic dysfunction were mostly caused by anaemia and hypertension. Systolic dysfunction was caused by ischaemic heart disease-related RWMA. Echocardiography detected LVH and minimal pericardial effusion before clinical diagnosis

Background: No single modality of treatment for breast cancer can be the mainstay of therapy. One of them is breast conservation treatment (BCT) comprises BCS and whole breast radiotherapy. BCT is not popular among the surgeons in India (11-23% vs. > 60-70% in west). The advantages of BCS over MRM include, better body image, sexual functioning and better psychological adjustment. In view of this, the present study was undertaken to highlight the importance of BCT and comparison of post-operative events with MRM. Aim And Objective: To evaluate the possibility of BCT in cases of LABC after neo-adjuvant chemotherapy. To compare BCT with MRM in terms of quality of life and postoperative complications. Patients And Methods: The study was carried out in the PG department of General Surgery and Oncosurgery Wing of M.K.C.G. Medical College & Hospital from August 2018 to June 2021 (including 12 months of follow up period).Total no of cases included in this study are 20. We have selected stage I & II and few cases of stage III A for our study. Results: In our study, as the study period is only 2 years and follow-up period was only 12 month, so overall survival is 100% for both BCT & MRM. Recurrence rate for BCT is 15% and for MRM is 5%. Out of Several studies maximum show that overall survival rate for both BCT and MRM group are almost same and comparable. Recurrence rate in case of BCT is high as compared to MRM except in study of Fisher et al and Blichert-Toft et al where recurrence rate in MRM is high. Conclusion: It is a challenge for a surgeon to do BCS in early breast cancer case, as till now both the patients and the surgeons are in favour of MRM for reasons of safety and due to fear of recurrences. We felt that both the surgeons in the periphery and the women folks need to be made aware about the huge benefits of BCT in comparison to MRM. While selecting the patients, proper criteria must be adhered to. Radiation is a must after BCT but failing, for which the incidence of local recurrences goes up

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

Background: Antimicrobial stewardship (AMS) programs have shown to reduce the emergence of antimicrobial resistance (AMR) and health-care-associated infections (HAIs), and save health-care costs associated with an inappropriate antimicrobial use. Methods: This is a prospective, descriptive and observational study conducted at Department of Microbiology, Ayaan institute of medical sciences over a period of 1 year included 410 patients. Patients of either sex of any age who have been admitted inward and on antibiotic therapy were included. Outdoor patients were excluded in our study. Conducted from various clinical Departments such as Medicine wards, Surgical wards, Paediatric wards and Orthopaedics wards. All data was be documented and reviewed periodically. Any deviations from the agreed criteria were communicated, discussed, and documented. Results: On the basis of gender, frequency of Male patients were recorded little bit higher (62.6%) than female (37.4%). So, the hospital attendance rate of this study was male predominant. Majority of subjects belonged to 21-40 years (32.1%) followed by 1-20 years (29.5%) of age range. When it is categorized according to ward, in Medicine ward was recorded 34.8%, and for Orthopaedics it was 20.0%, while 30.9% for surgery and 14.1% paediatrics wards. For this study, subjects were categorised in eighteen groups on the basis of their diagnosis. Out of which, majority of the population (20.50%) were found with diagnosis of carcinoma followed by orthopaedic diseases (19.90%), while least number of patients (0.9%) were diagnosed with ophthalmological as well as thyroid diseases. Beta lactam and Cephalosporin were found the most frequent used first antibiotic even after surgery. Even for the each wards, Beta lactam and Cephalosporin were recorded highly significant and most desirable choices among all the antibiotics. Conclusions: Implementation of a multidisciplinary antibiotic stewardship program in this academic, large, Indian hospital demonstrated feasibility and economic benefits

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

Background and objectives: The ankle is the most distal weight-bearing joint and the stability of the ankle mortise is crucial to the capacity to move. Distal fibula fracture management is uncertain because of the wide diversity of implants and fracture types. The purpose of this research was to compare the efficacy of closed reduction internal fixation with open reduction internal fixation in treating fractures of the lower fibula (at the syndesmotic level, Weber type B) in conjunction with breaks of the lower tibia or medial malleolus. This randomized controlled trial assessed different functional modalities and complications associated with fibula fixation. Methods: During January 2022 to January 2023, 75 patients with a lower fibula fracture (Weber type B) were enrolled in a randomized prospective and comparative study at Department of Orthopaedics, Ayaan Institute of Medical Sciences, Kanakamamidi, Moinabad, Telangana, India. The CRIF method was used on 45 individuals, whereas the ORIF method was used on 30 others. Results: Although the union rate was higher with plating, the functional score was higher and there were fewer difficulties with nailing. Conclusion: The nailing in the lower fibula fractures is preferable to the plating of comminuted ankle fractures. Crif and orif are equivalent for post-weight-bearing syndesmotic failure. The syndesmotic ankle becomes more rigid after receiving an Orif

Acute & Transient Psychotic Disorders(ATPD) are a heterogeneous group of disorders and they need to be differentiated from Schziphrenia and organic psychotic disorders.Previous studies have observed significant association of Acute & Transient Psychotic Disorder (ATPD) with summer onset, fever, and viral & protozoal infections, suggesting contribution of biological factors in occurrence of ATPD. Methods: This study was undertaken using Magnetic Resonance Imaging (MRI) of brain in patients with ATPD in a hospital setting. 20 consecutive in-patients of ATPD were subjected to MRI of brain during active psychotic phase and they were subsequently followed up for their course for next six month to see their diagnostic stability. Results: Twenty percent of patients showed significant MRI changes in the brain. Significantly more patients of ATPD associated with schizophrenic symptoms had MRI brain change like hyperintensity foci and temporal sclerosis. Conclusion: Findings indicate that the subgroup of ATPD with schizophrenia like symptoms exhibiting more MRI changes may be closure to schizophrenia than other subgroups of ATPD

Osteoporosis is a common metabolic disorder that causes decreased bone strength and is the leading cause of bone fracture, particularly in the elderly. There is no synthesis of evidence to inform policy regarding its prevalence and distribution in India. As a result, the goal of this systematic review and meta-analysis is to estimate and summarise the prevalence of osteoporosis among Indian adults. The PRISMA criteria were used to conduct the systematic review and meta-analysis. A thorough systematic search was conducted in the following electronic databases until May 23, 2022: Medline (via PubMed), Embase, and ProQuest. Following screening, twelve eligible studies were included in the study, which reported the prevalence of osteoporosis among adults aged 18 years, as well as for subsequent methodological quality assessment and data extraction using predefined standardised tools. To generate summary estimates for prevalence with 95 percent confidence intervals, random and fixed effects meta-analysis models were used. Data from 5261 study participants were used in the included studies. In India, the prevalence of osteoporosis is 22.9 percent (95 percent CI: 14.9-32.0 percent), and that of osteopenia is 44.8 percent (95 percent CI: 38.9-50.7 percent ). Females had a significantly higher prevalence of osteoporosis (26.3 percent (95 percent CI: 16.9-37.0 percent) than males (10.9 percent) (95 percent CI: 4.5-19.7). A robust and comprehensive prevalence estimate will aid in health policy decision-making and will aid in the planning and provision of necessary facilities for people suffering from osteoporosis. This is the first study to compile data on the prevalence of osteoporosis and osteopenia in India. Improved access to health services, other health systems, and policy research are required to initiate and increase the uptake of osteoporosis screening and treatment in India

Background: Major cause of death/Adult fungal meningitis in HIV/AIDS patients is Cryptococcus neoformans. Fungal meningitis precedes serum/plasma cryptococcal antigen (CrAg) by several weeks. Cryptococcal Antigen (CrAg) screening and presumptive treatment can prevent fungal meningitis in HIV/AIDS patients significantly. Method: The descriptive cross-sectional study included 100 ART Naive patients ( 65  males &35   females) from both ART clinic and Medicine Indoor. Serum/CSF cryptococcal positivity detected by Latex agglutination test (Pastorex TM Cryptoplus, BIO-RAD,France) and  Lateral flow assay by IMMY Kit(US FDA approved).  CD4 Counts were measured using flow cytometer (Becton-Dickinson FACS count flow cytometer) Result: Prevalence of CrAg positivity in our study is 7 %(7/100), out of which 4%(4/100) had features of meningitis. Comparison of Antigenemia with Demographic features like Age, Inpatients; Symptomatic groups were having statistically significant association (p value0.0≤5).  Low CD4 count (<50) is associated with more seropositivity 33.3 %(5/100). Clinical features like Headache,Vomiting,Fever were having statistically significant association  with cryptococcal Antigenemia. Conclusion: Prevalence of cryptococcal Antigenemia  is higher in ART Naive  HIV patients with lower CD4 count which needs urgent attention for screening and substitution of Antifungal treatment to reduce morbidity / mortality from cryptococcal meningitis

Introduction: Mental foramen (MTF) is an opening in lateral surface of mandible with clinical importance in local anesthesia and surgical procedures in terms of achieving effective mental nerve blocks and avoiding injuries to the neurovascular bundles. Aims: To determine morphology and morphometry of mental foramen of central Indian population, hitherto unreported. Material and methods: 80 mandibles, 40 male and 40 female dry dentulus, without deformities were examined for position, shape, and number of mental foramen on right and left sides. Results: Various parameters investigated are( 1) the horizontal distance between the symphysis menti and MTF was 25.54 mm, on left side and 24.80 mm on right side in males, 24.72 on left side and 24.67 in females.(2) MTF and posterior border of ramus was 66.85 mm on left side and 67.68 mm on right side in male,62.71 mm on left side and 65.62 on right side in females.(3) MTF and mandibular base was 13.18 mm on left side and 13.32 mm on right side in males and 13.03 on left side and 12.97 mm on right side in females. (4) MTF and alveolar crest was 14.33 mm on left side and 14.3 mm on right side in males, 12.60 mm on left side and 13.13 on right side in females. (4) Occurrence of MTF below the second premolar tooth was found to be highest. Average size of MTF was larger on right side and it's way of exit was in postero-superior direction. Shape of MTF round in 81.8%, and oval in 18.2 % of male and female on left side. 82.5% round and 17.5% oval in male and 92.5% round and 7.5% oval in female on right side. Conclusion: In the present study, most common position of MTF was found below the apex of second premolar in 73.9% of males and 67.5% of females on both sides. Shape of MTF is round in majority of mandibles. During surgical procedures on mandible this information is helpful to the surgeon

Introduction: In recent years, scrub typhus has rapidly emerged to become the major cause of acute febrile illness (AFI) in India. The commonest tests used for diagnosis are serology and PCR. Therefore, the present study was planned to compare these two techniques in the diagnosis of scrub typhus. Aim of the study: To compare IgM ELISA and PCR for diagnosis of scrub typhus as a causative agent of AFI. Material and Methods: Patients with acute undiagnosed febrile illness presenting to the outpatient (OPD) or inpatient services of PGIMER Chandigarh between August 2013 and March 2014 were included in this study. Blood was collected for further analysis by IgM ELISA and nested PCR followed by Sanger sequencing. Result: Of 176 patients, 29 (16.4%) were positive for scrub typhus by nested PCR while 162 (92%) were positive by IgM ELISA. There was 59 % concordance between the two tests. Conclusion: This study report shows that the concordance between PCR and ELISA for the diagnosis of scrub typhus is less than 60%. Ideally, both tests should be performed to diagnose scrub typhus depending on the day of presentation to hospital

Background and Objective: It is well established that intact parathyroid hormone (iPTH) and blood 25(OH) D levels have an impact on bone mineral density (BMD). There are few Indian statistics relevant to the aforementioned finding. In this study, we looked at the correlations between intact parathyroid hormone (iPTH), serum 25(OH)D levels, and bone mineral density (BMD) in a group of patients from India. Methodology: Individuals with low BMD at the hip or lumbar spine, whether or not they had fragility fractures, underwent clinical evaluations and laboratory tests. From BMD-DEXA, hip and spine T-scores were generated (dual-energy X-ray absorptiometry). The associations between serum 25(OH) D, iPTH, and BMD were examined using multivariate regression models. Results: A total of 102 patients were enrolled in the study, with a male to female ratio of 38:64 and a mean age of 62.5 6.4 years. Osteopenia affected 44 people. There was osteoporosis in 58 individuals. Serum 25(OH)D and iPTH levels were, respectively, mean values of 21.3 0.5 ng/ml and 53.1 22.3 pg/ml. Vitamin D deficiency was confirmed in 84.3% of patients by blood 25(OH)D levels that were below 30 ng/ml (normal range: 30-74 ng/ml). 25(OH) D levels and BMD at the hip or lumbar spine did not correlate (P = 0.473 and 0.353, respectively). iPTH levels, male gender, body mass index (BMI), and age were discovered to be significant predictors of BMD at both the hip and lumbar spine. BMD and T-score were considerably decreased in patients with increased BMI. Conclusion: There was no correlation between serum 25(OH) D levels and BMD among our group of patients with poor BMD. However, at serum 25(OH) D concentrations below 30 ng/ml, there is a negative connection between iPTH and 25(OH) D. A substantial inverse relationship between BMD at the hip and lumbar spine and serum iPTH levels was observed. Our results highlight the crucial part that parathyroid hormone plays in the health and metabolism of bones

Background World Health Organization declared COVID 19 as pandemic in March 11,2020. SARS-CoV-2 is different from other known viruses due to multiple mutations on the sites of nonstructural proteins. Since the healthcare workers (HCWs) are at high risk for COVID 19 infection, Government of India gives priority for HCWs for vaccination against COVID 19. Aims and objectives: The present study aims and objectives are to estimate the prevalence and severity of COVID 19 infection in vaccinated HCWs and to determine the severity, course and outcome of COVID 19 infection in vaccinated HCW and to determine the effectiveness of vaccines among HCWs Materials and Methods: Cross-sectional questionnaire-based study conducted between October 2021 and December 2021 among 262 Health CareWorkers (Doctors, CRRIs, Nurses, Paramedical staff) in Government and Private hospitals in South Tamilnadu. Results: Prevalence of covid-19 in vaccinated HCWs was 12.9%. ADR was seen in 19.2% HCWs, mostly mild ADRs like fever, myalgia, headache, etc. SpO2 was more than 93 in 94% HCWs infected with covid, 6% had in between 90-93. Chest CT was taken in 17 HCWs infected with covid, 10 persons had a normal study, 3 persons showed 8% lung involvement, 1person had 32% lung involvement based on CT study. Conclusion: Covid-19 infection was found in 12.9% of the vaccinated people. Vaccination is effective in preventing Covid infection

Background: Non-alcoholic fatty liver disease (NAFLD) has become the most common liver disease in the world mainly because of the obesity pandemic. Objective: to assess the prevalence and association of NAFLD in Type II Diabetics with one or more components of the metabolic syndrome. Methods: The present observational cross sectional study was carried out at tertiary care center of central India from November 2020 to October 2022.  Results: There were 46(59.7%) males and 31(40.3%) females. The mean age of cases with NAFLD was found to be 52.89±10.61 years. There is an increased risk of 1.667 times was observed for those with high BMI in association to with NAFLD which is statistically not significant. The mean HbA1C was higher in cases with NAFLD than in cases without NAFLD which is not statistically significant. Among the cases, 34 were diabetics with no other component of metabolic syndrome and 38.23% (13/34) of them had NAFLD; Conclusions: There is high period prevalence of NAFLD in type 2 Diabetic males. Study did not observe significant association between NAFLD and components of metabolic syndrome

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

Background: -Brain abscess is defined as a focal infection within the brain parenchyma which starts as a localised area of cerebritis which is subsequently converted into a collection of pus within a well vascularised capsule.Intracranial abscesses are life-threatening infection that pose a diagnostic challenge not only to the neurosurgeon but also to the microbiologists. Detailed studies documenting the spectrum of infecting agents involved in brain abscesses are limited from India. Case report: -A 17-year-oldboy presented to Trauma and emergency Department AIIMS Raipur in a drowsy state with complaints of severe headache and right sided ear discharge for 15 days,fever on and off and weakness over all limbs for 1 day.Patient had a history of chronic suppurative otitis media (CSOM) of right ear discharge without any evidence of recent trauma or neurological procedure.Contrast enhanced CT brain showed cerebellar abscess with compressed fourth ventricle. Patient underwent emergency craniotomy, drainage of abscess and extra ventricular drain. Pus sample on gram stain showed gram positive cocci in chains and pairs and few gram-negative bacilli.Aerobic bacterial culture revealed pinpoint beta-haemolyticcolonies along with few translucentnonhaemolytic colonies which failed to grow in MacConkey agar.The two isolates were identified asStreptococcus constellates and.Spingobacterium multivorumby VITEK II system.Antibiotic susceptibility pattern was performed by Kirby Bauer Disk diffusion and VITEK II system compact automated ID/ AST system.Initial empirical antibiotics were replaced withIV vancomycin as both the organisms were found sensitive to it. Patient responded with improved Glasgow comma Score and gradual resolution of abscess size which was evident on successive postoperative CECT Scan findings. Conclusion: Streptococcus constellatus and Spingobacterium multivorumboth are ubiquitous.Haematogenous spread from ear could have resulted in brain abscess.Appropriate sampling and use of automated instruments may increase isolation of new and unusualpathogensand result in early and appropriate management of brain abscess

Introduction: Cardiovascular disease is the most commonly diagnosed medical condition among patients aged 65 years and above and is a major global problem with an estimated worldwide prevalence of 38 million. The high morbidity and mortality rate associated with heart failure (HF) make it a challenging public concern with significant financial burden on healthcare. Patients with HF frequently present with multiple electrolyte abnormalities, hyponatremia, hypokalemia, and hypochloremia being the most common.  Aims: To assess the effect of admission serum chloride levels on the duration of hospital stay in decompensated heart failure patients and their correlation with serum sodium levels. Materials and Methods: The present study was a prospective observational single center carried out at tertiary care center in Ahmedabad, India. Patient’s demographic, clinical and laboratory data was collected from June 2020 till May 2021.  Result: In the present study, 60 patients were included. It was observed that serum chloride level was less than 96 mEq/L in 40%, 96 to 101 mEq/L in 35% and more than 101 mEq/L in 25% Conclusion: Our findings highlight the clinical significance of chloride, a routinely measured electrolyte. Given the critical role of chloride in a number of regulatory pathways central to heart failure, it is possible that serum chloride may represent a therapeutic target rather than simply a marker of disease severity

Introduction: Cataract affects nearly 9–12 million Indians annually after the age of 50 years. and, this exceeds glaucoma, macular degeneration, and diabetic retinopathy numbers combined. Cataract surgery is the most frequently performed surgery in India, with a success rate of nearly 98% and excellent visual rehabilitation. More than a million intraocular lenses (IOL) are implanted every year. Aims: A Comparative analysis of Recent Generation intraocular lens power calculation formulae to achieve emmetropia following Cataract surgery by phacoemulsification. Materials and methods: The present study was a prospective comparative study. This Study was conducted from October 2022 – February 2023 at Department of Ophthalmology, Venkateshwara Institute of Medical Sciences, Amroha (U.P). 120 patients were included in this study. Result: In our study for small eyes (< 20mm) Haigis group, the mean residual spherical refractive error was 0.68 ± 0.26 and in Holladay group, the mean residual refractive error was 0.83 ± 0.14 which was statistically significant (p=0.0008). In our study for normal eyes of Axial Length 20 to 24mm of in Haigis group the mean residual spherical refraction of the patients was -0.36 ± 0.80 and in Holladay group, the mean residual spherical refraction of the patients was 0.31 ± .63 which was statistically significant (p<0.0001).  In our study for long eyes > 24mm of Axial length, In Haigis group the mean residual refractive error of large eye was -0.50 ± 0.00 and in Holladay group the mean residual error in large eye was 0.12 ± 0.64 which was not statistically significant (p=0.1189). Conclusion: we concluded that, prospective analysis of results showed that Comparing all four IOL formula we had found that in SMALL eyes, NORMAL eyes as well as in LARGE eyes The HOLLADAY IOL formula is having better result followed by HAIGIS

Background: Every year, 60% to 80% of all newborn deaths are caused by low birth weight (LBW). Low birth weight is a significant public health issue in developing nations like India. The objective of this study was to assess the magnitude and associated factors of low birth weight in a tertiary care hospital of northern India.  Methods: This was across-sectional study conducted at tertiary care Hospital. A total of 650 individuals in the study were chosen via systematic sampling. Data were gathered using a standardised questionnaire that had been pre-tested. Epi Info V7 was used to analyse the data. To find related factors, bivariate and multiple logistic regression were utilised. An association was deemed statistically significant at a 0.05 p-value. Results: In this study, the magnitude of low birth weight was 14.2%. A low birth weight was three times more frequent in women with a history of chronic disease than in those without such a history [AOR=3.04(1.04,9.02)]. Pregnant women with haemoglobin levels below 11 g/dl had a higher risk of having babies with low birth weights than those with haemoglobin levels above 11 g/dl [AOR=3.06(1.08,8.96)]. Contrary to those who did, women who did not take iron/folic acid supplements during their pregnancies had a higher risk of having babies with low birth weights [AOR=0.28(0.12,0.78)]. The odds of having a low birth weight were higher for pregnant women who did not eat extra food or meals during their pregnancy than for those who did [AOR=0.26(0.11, 0.73)]. Conclusions: Hemoglobin level, iron/folic acid supplementation, extra meals during pregnancy, and a history of chronic medical conditions were all found to be significant predictors of low birth weight. To lower the risk of low birth weight, it is crucial to encourage pregnant women to take iron together with folic acid and extra meals

Introduction: Subtrochanteric fractures are femoral fractures that involve the lesser trochanter and extend distally up to 5 cm. These fractures account for 10% to 34% of all fractures. Civilization and modernization has brought certain problems along with its own benefits to the citizens of the world over. Aims: To evaluate the outcome of subtrochanteric fractures in adults managed by Proximal Femoral Nail; Materials and Methods: The Observation and Cross sectional study. This Study was conducted from October 2019 – September 2021 at Department of Orthopaedics. Agartala Government Medical College & GB Pant hospital and west Tripura. Total 30 patients were included in this study. Result: In our study, out of 30 patients, higher number of patients had full in Hip ROM at 9 months [26 (86.7%)] though it was statistically significant (p<0.0001) (z=6.2106). We found that, most of the patients had Excellent Functional Outcome at 6 months [25 (83.3%)] and Excellent Functional Outcome at 9 months [26 (86.7%)] which were statistically significant (p<0.0001). Conclusion: In our study, PFN is biomechanically sound and has advantages on collapse at fracture site as it is done mostly in closed method. PFN prevents excess collapse at fracture site and maintain the neck length and Most of the complications are seen due to surgeon and instruments related. They can be cut down by good pre-operative planning

Introduction: One of the most frequent causes of acute abdomen in nearly all age groups is acute appendicitis and emergency appendectomy is one of the most common surgeries being performed worldwide.This classic presentation occurs in only 50%– 60% of patients and the diagnosis may be missed or delayed when atypical patterns of disease are encountered.Material and Methods. This study was conducted study at Government Medical College Srinagar J&K India over a period of 2 years.117 patients above the age of 14 years who underwent emergency appendectomy for suspected acute appendicitis were enrolled as study subjects. This study aims to study the diagnostic accuracy of ultrasonography, total leucocyte count and neutrophil percentage in diagnosing acute appendicitis. Results Ultrasonography, Neutrophil Percentage andLeucocyte count had a sensitivity of 81%, 74% and 70% respectively for acute appendicitis.  Sensitivity decreased (53%) when raised TLC, NP and USG were used together to predict appendicitis but specificity increased markedly (94.1%) pointing to the fact appendicitis was highly unlikely if all these tests were simultaneously negative.Conclusion.The results showed that normal blood parameters (total leucocyte count and neutrophil percentage) along with normal ultrasonography have a high combined diagnostic accuracy for acute appendicitis

Omicron, a new variant of Covid-19 has hit the India in the third wave during 2022. The outbreak of this new variant has increased globally. At this time, there is an urgent need of fast, reliable and effective detection method. The real time RT-PCR is the most used technique for the detection of viral DNA. In the present study ‘OmiSure’ kit developed by Mumbai-based Tata Medical and Diagnostics Ltd (TATA MD) in partnership with The Indian Council of Medical Research (ICMR) was used for direct detection of Omicron variant in the SARS-CoV-2 positive samples via multiplex real time RT-PCR as a diagnostic tool. The reaction was tested targeting viral RNA and human target mRNA sequence using S gene target failure and S- gene mutation amplification strategy. In the present study 532 samples were tested for the presence of Omicronin the SARS-CoV-2 positive samples. The study found that a total of 501 individuals were positive for Omicron variant while 31 individuals were detected to be of other variants. Further these 31 SARS-CoV-2 positive samples were processed by nanopore whole genome sequencing and identified as Delta and its sub variants of SARS-CoV-2. These sequences were submitted in Indian SARS-CoV-2 Genomic Consortium (INSACOG) and Global Initiative on Sharing Avian Influenza Data (GISAID). The study showed that OmiSure kit is an accurate, fast and easy to use rRT-PCR Omicron diagnostic assay

There is little information available about neurological manifestations in paediatric COVID-19 patients from around the world, including India. This study aimed to identify characteristics of paediatric COVID-19 cases with neurologic involvement who were hospitalized in IMS & SUM Hospital,  Odisha. This retrospective cross-sectional study included hospitalized patients with confirmed SARS-CoV-2 from January 2020 to December 2022 aged 0 to 14 years.The necessary information was obtained from the patients' medical records. There were 21 cases in total. The studied group's median ages, those with neurological manifestations and those without, were 6.5, 11.0, and 5.0 years, respectively. Five COVID-19 patients experienced neurological manifestations, with headache and decreased consciousness being the most common recorded manifestations. The majority of patients, both with and without neurological manifestations, survived. In hospitalized paediatric COVID-19 cases, neurological manifestations were common. However, most of the neurological manifestations were mild and nonspecific, with headache being the most common. Although specific neurological manifestations were uncommon, paediatric COVID-19 patients, especially young infants, were at risk of developing severe encephalopathy with a fatal outcome

Background:  Breast abscess continues to be a major cause of morbidity in developing countries. The treatment of breast abscess continues to be a challenge. In era of technical advances management of breast abscess has shifted to minimally invasive and painless techniques which are more patient friendly. Aims: to compare outcomes in management of breast abscess by incision and drainage versus ultrasound guided needle aspiration. Methods: The present study was carried out in the department of surgery in a tertiary care hospital central India.  A total of 100 female patients with acute lactational breast abscess between 18 and 45 years of age were enrolled in our study. The patients were randomized into group A (incision and surgical drainage) and group B (ultrasound-guided needle aspiration). Results: In our study total 100 patients were analysed, majority of the cases (53% in group A & 54% in group B) belong to 21-25 years age group. Post operative pain, high recurrence rate, fistula formation, cessation of breast feeding, ugly scar formation and longer duration of hospital stay were observed in incision & drainage procedure as compared to USG aspiration. Conclusions: USG guided aspiration is the safest, painless, day care and widely accepted procedure for treatment of breast abscess as compared to the incision and drainage, it reduced the post-procedure hospital stay and minimum scar formation

Although there are innumerable studies on vitamin D deficiency in India, there is limited data in Mizoram. Keeping this in view the aim of our study is to find out the deficiency of Vitamin D in our region, Mizoram (NE India). Our study population included patients attending Genesis Laboratory, Aizawl, Mizoram (November 2021 – November 2022) for various ailments who were advised serum Vitamin D level estimation. The study population was grouped according to gender and age in decades. Blood was collected in plain vials and serum obtained was used for vitamin D estimation. Out of 480 patients, 180 were male and 300 were female. Age of the study population ranged from 11 – 79 years. 17% of the total study population had normal values, 62.7% was vitamin D Deficient and 20.3 % showed Vitamin D insufficiency. The prevalence of Vitamin D Deficiency was high in all age groups, there were a higher percentage of females in the vitamin D insufficient and deficient groups. Maximum numbers of patients with vitamin D deficiency were in the age group of 60-69 years with a female predominance. Prevalence of Vitamin D deficiency is very high in our region that is in Mizoram, as is reflected from our study. This pattern is seen in other parts of our country too. Also, the deficiency is high in the age groups N – N years and females outnumbered male

Background: Diabetes mellitus (DM) is a common endocrine disorder with around 415 million affected people worldwide. It is expected that DM will affect more than an estimated 700 million persons, 10.9% of the global adult population, by 2045. Objective: to find the prevalence of LVDD in type 2 diabetics and assess its correlation with HbA1c levels as measure of glycemic control. Methods: The present study was conducted in a tertiary care hospital in Central India from July 2020 to October 2022. Results: In our study majority study subjects were males.  The mean age for this study group was 46.3±8.3 years. Most of the study subjects (48.9%) had HbA1c within intermediate control range (7.1- 9%). 42 (45.6%) subjects were shown to have Left Ventricular Diastolic Dysfunction on 2D ECHO.  The mean HbA1c value for subjects having LVDD is 7.84 ± 1.34 and for those not having LVDD is 7.24 ± 1.35. Therefore, in our study it was concluded that LVDD was significantly associated with higher HbA1c values. Conclusions: The prevalence of left ventricular diastolic dysfunction was more in type 2 diabetic patients with high HbA1c levels

Objective: To evaluate the utility of narrow band imaging with magnifying endoscopy for the diagnosis of oesophageal lesions in north Indian population. Methods: The study was an observational study. Patients with various clinical symptoms were included in the study.  Patient on chemotherapy for carcinoma oesophagus, patients with sepsis and not willing for Endoscopy were excluded from the study. All cases were evaluated using endoscopic findings with respect to socio-demographic history, past history, a thorough clinical examination and details of the investigations done. Results: More than one third of patients were between 61-70 years of age (38.8%). More than half of patients were males (65.7%). Both WLE and NBI detected visible submucosal vessels among 56.7% and 52.2% patients respectively. Tanned columnar mucosa was detected among 49.3% by WLE and 31.3% patients by NBI. However,  low-grade adenoma was detected in 43.3% by WLE and 46.3% patients by NBI.  Polypoidal lesions were detected among 28.6% by WLE and 47.8% patients by NBI. NBI correctly detected oesophageal lesions among majority of patients (77.6%) with sensitivity and specificity of 89.7% (95%CI=81.8-97.5) and 33.3% (95%CI=2.5-64.1). A high positive predictive value was also observed (89.7%; 95%CI=81.8-97.5). Conclusion: The NBI endoscopes are clearer compared with ordinary stained endoscopes, it has a higher levels of diagnostic value and diagnostic coincidence rate for early diagnosis of Oesophageal lesions. Also it has a more accurate detection rate of lesions and less occurrence of adverse reactions. It can effectively detect and screen early Oesophageal lesions and benign lesions, it is worth promoting clinically

Background: Injuries are the leading cause of death and hospitalization among young people aged 15–24 years in India. While progress has been made in preventing injury deaths and disability in both older and younger age groups, young people remain at increased risk of injuries. The purpose of the study is to raise awareness and provide the national authorities and stakeholders with an insight into the size and impact of risk-taking behavior in accidents. The study was conducted with an aim to estimate the prevalence of risk-taking behavior and road traffic accidents and its association between them. Methodology: A cross-sectional study was conducted among 300 students aged 15-25 years of a medical and engineering colleges in Rajahmundry. A predetermined, semi-structured questionnaire was used to collect data. Data collected was entered and analyzed using Microsoft excels 2011 and Chi-square test was used to find the association between risk taking behaviour and road traffic accidents. Results: The prevalence of road traffic accidents in the study population was 46.7 per 1000 students/per year. Not taking personal safety measures (89%), over speeding (44%), using of mobile (46%) and thinking about something else (37%) were found to be the major factors causing road traffic accidents. There was a statistical significant association found between risk-taking behavior and a history of road traffic accidents (P<0.0001)

Background: Lack of physical activity (PA) was one of the most important cardiovascular risk factors causing higher morbidity and mortality rate worldwide. Thus, early health promotion activity like physical activity is needed for healthy life. As future physicians the health of the medical students is even more important as they personally ignore adopting healthy lifestyle. So, the study was conducted with an aim to estimate the level of physical activity and to find the factors associated with low physical activity among medical students. Methodology: An institute based cross-sectional study was conducted among 200 medical students in a medical college in Rajahmundry, Andhra Pradesh. Global Physical Activity Questionnaire (GPAQ) by WHO was used to estimate the level of physical activity and Metabolic Equivalents (METs) were used to express the intensity of physical activities. The collected data was entered into Microsoft excel and analysed using SPSS version 21. Results: The mean age of the study population was 19.61 ± 1.94 years and 62% of the study subjects were female. Based on WHO recommendation of minimum 600 MET min/week in the present study 64.5% had adequate physical activity and 35.5% had low physical activity. Low physical activity was high in female students when compared to male students (41.1% vs 26.3%, p-value=0.034). There was low level of physical activity in first professional year (46%) when compared to other professional years. Conclusion: There was need of promoting physical activity among medical students. Medical colleges need to increase the proportion of students adopting and maintaining regular physical activity habits

Background: The number of adolescents in India are 250 million and are a significant proportion to the Indian population. Increase in the addictions, both in terms of behavioral and non-behavioral addictions leading to lot of changes in the attitudes of the adolescents resulting in aggressive and some times violent behaviour which is detrimental to the future of the individual and also to the societies as a whole. Methodology: It is an institution-based study in southern part of India, conducted among 500 adolescents in the schools and colleges of Rajahmundry city, East Godavari district, Andhra Pradesh. The Aggression scale and socio demographic details and other factors are obtained from the adolescents Results: 26 (5.2%) members showed aggression and factors like gender, type of school or college, residential status and Socio-economic status were significantly associated with Aggressive behaviour

Background: Postpartum haemorrhage (PPH) is the most common complication following childbirth. Postpartum haemorrhage remains a significant contributor to maternal mortality and morbidity throughout the world. PPH is often classified as primary/immediate/early, occurring within 24 hours of birth, or secondary/delayed/late, occurring from more than 24 hours post birth to up to 12 weeks postpartum. Aims: The aim of this study was to determine the percentage of patients requiring medical therapy for PPH management and to determine the percentage of patient requiring surgical therapy for PPH management. Methods:  The present study was a population and hospital based observational study conducted in the Dept of Gynae and Obstetrics, R.G. Kar Medical College and Hospital, Kolkata, West Bengal, India. All the patients presenting with postpartum haemorrhage following delivery during my study period and meeting my inclusion criteria which is 304. Template was generated and analysis was done on STATA11 software. Results: In the present study the overall incidence of PPH is 1.4%(304 out of 22,182 deliveries). higher prevalence is seen between 24-27yrs and >=27yrs. Prevalence of PPH is more in women with no schooling (31.9%) The PPH occurred mostly at the gestational age 37-40wks (60%). Atonic PPH has higher prevalence (50.6%) than other types of PPH. In instrumental delivery traumatic PPH has higher prevalence (50%). In caesarean section Atonic PPH (80.64%) had higher prevalence than any other types. Atonic type of PPH is responsible for most maternal death (75%). Uterine tamponade was mostly done and successful in PPH following vaginal delivery (86.66%). Conclusions: To conclude, majority of deaths following PPH is preventable if timely and prompt intervention is made. Antenatal anaemic status contributed a significant role in PPH occurrence which should be corrected to decrease the prevalence of PPH.

Introduction: A pleural effusion is accumulation of excessive fluid in the pleural space due to an imbalance between the production and absorption of pleural fluid by pleurae (visceral as well as parietal). Pleural effusion is a common clinical manifestation and about 3000 per Million people in the world suffers from pleural disease. Aims: To assess usefulness of ratio of serum LDH to Pleural Fluid ADA in differentiating Malignant Pleural Effusion and Tubercular Pleural Effusion.  Materials and Methods: The study was a Descriptive Observational Cross-sectional study was conducted in Department of Respiratory Medicine, Kamala Nehru Chest Hospital, Dr S N Medical College Jodhpur (Rajasthan), and a tertiary care centre for Respiratory Disease in Rajasthan, India after getting clearance from the Ethical committee. Result: found that most patients with tubercular pleural effusion (n=20) had Pleural Fluid ADA levels >35 and majority of the patients had Biopsy proven Malignant pleural effusion [22 (44.0%)] and it was statistically significant (p< .00001), (z=4.1036). Conclusion: We found that, most number of patients had Tubercular Pleural Effusion. It was statistically significant and majority of the patients had Biopsy proven malignant pleural effusion and it was statistically significant.

Introduction: Improving maternal health is one of the fifteen Sustainable goals  adopted by world leader in September 2015 by  an historic  international community at the United Nations Summit, which aims  to reduce the global maternal mortality ration to less than 70 per 100,000 live births by the year 2030.The MMR in developing countries is more than developed countries. MMR in developed country is 12/1,00,000 live birth Maternal mortality ratio of India is 97/lakh live births. Preeclampsia is a new onset of hypertension and proteinuria after 20 weeks of gestation  in a previously normotensive women.Severe Preeclampsia  is a serious clinical type of preeclampsia by atleast one of the following – persistent increase in blood pressure [≥160/110 mmhg ],hepatic and renal failure,platelet count less than 1,00,000 / mm3 , hemolysiselevsted liver enzymes and low platelet count [HELLP] Syndrome, Cerebral or visual disturbances, persistant epigastric pain and pulmonary oedema. Eclampsia is a serious obstetric emergency with new onset grand mal seizure during pregnancy or postpartum in women having signs and symptoms of preeclampsia. The sequel of severe preeclampsia and eclampsia include organ failure, loss of consciousness and finally loss of lives of both mother and fetes. Aims and Objectives: To study clinical outcome of Preeclampsia and Eclampsia in a Tertiary Care Centre. Materials and Method: The study was conducted in department of Obstetrics and Gynaecology, MKCG Medical College, Berhampur, Odisha, India for a period of 18 months extending from November 2020 to September 2022.A total of 400 patients were studied. At the end of the study, collected data were tabulated and analysed. Results: Present study was conducted on 400 cases, during the study period.Mean age was 31.19 ± 5.7 years. Majority of patients (194 cases, 48.5%) belonged to lower class followed by 129 cases (32.3%) belonging to middle class. Fifty four patients (13.5%) were from lower middle class. Upper middle class had 16 (4%) patients. Only 7 cases (1.7%) were from upper class. In 127 patients (31.8%) diabetes mellitus and in 227 patients (56.8%) pre-existing hypertension was reported respectively. Among 400 patients studied, 114 patients (28.5%) were primigravida and 286 patients (71.5%) were multigravida.  Twenty eight (16.8%) patients died of complication. Both age and age of gestation of patients were not significantly distributed across maternal mortality (Page=0.34, Paog=0.33). Cause of death was abruption placenta (10 cases), acute renal failure (6 cases), ARF with sepsis (1 case), eclampsia (4 cases), HELLP with PPH, PPH, pulmonary embolism, pulmonary embolism with PPH and wound infection (1 case each) and sepsis (2 cases). Out of 59 patients suffering from eclampsia, 4 (1%) patients died and 24 (6%) patients with pre-eclampsia died. Association of occurrence of eclampsia was robustly associated with patient mortality (P<0.0001).Two hundred and sixteen neonates (54%) had low birth weight while 279 (69.8%) were cases of intra uterine growth retardation. Preterm birth, birth asphyxia and NICU admission was seen in 175 (43.8%), 168 (42%) and 270 (67.5%) respectively. Eighty nine (22.3%) neonates died after birth while 52 (13%). Mean maternal age of deceased and survived neonates in present study was 31.51±5.6 years and 31.1±5.8 years respectively. Mean values for age of gestation of deceased and survived patients were 31.29±1.4 weeks and 31.59±2.2 weeks respectively. Both age and age of gestation of patients were not significantly distributed across maternal mortality (Page=0.56, Paog=0.24).  Conclusion: Preeclampsia and eclampsia tends to threaten maternal health and fetal viability adding to maternal and neonatal mortality and morbidity.There is high frequency of preeclampsia and eclampsia in our setting and the consequences are alarmingly high. There is need for patients education in recognizing the warning symptoms of the disease before intrauterine demise of fetus occurs or mother develops one of the grave complications, Antenatal care, treatment of anemia  and educating the women on significance of symptoms will go a long way in improving maternal and perinatal morbidity and mortality.Presence of NICU  with effective neonatal care will improve the fetal outcome.

Introduction: Systemic lupus erythematosus (SLE), also known as lupus, is an autoimmune disease in which the body's immune system mistakenly attacks healthy tissues of the body. Symptoms vary among people and may be mild to severe.  Common symptoms include painful and swollen joints, fever, hair loss, mouth ulcers and skin rash most commonly seen on face. Aims: To determine the clinical profile of Systemic Lupus Erythematosus patients at presentation. Materials and Methods: This is a cross sectional, observational study of 60 cases of Inpatients and outpatients fulfilling the 2015 SLICC criteria for diagnosing SLE in Vivekananda Institute of Medical sciences (VIMS), Ramakrishna Mission Seva Pratishthan (RKMSP), Kolkata, during the period of Jan 2017- Jan 2018. Result: In our study, we found that 43(71.7%) patients had acute/ subacute cutaneous lupus rash. 30(50.0%) patients had discoid lupus erythematosus(dle)rash or hyertrophic lupus rash. 24(40.0%) patients had non scarring frank alopecia. 33(55.0%) patients had oral /nasal ulcer. 48(80.0%) patients had joint disease. 19(31.7%) patients had pleurisy and / or pericarditis. Conclusion: SLE is more common among young females in third decade. In our study, most common features were joint and hematological manifestations followed by skin rash, oral/ nasal ulcers and frank alopecia. All patients were ANA positive. SLE patients assessed their quality of life as rather low. Increased disease activity was seen among 80% of SLE patients.   Measurement of quality of life along with modified SLEDAI 2000 index will help in providing better therapeutic management to SLE patients.

Background: Cardiovascular disease (CVD) is a leading cause of morbidity and mortality. India suffers the highest loss in potentially productive years of life, due to deaths from CVD.There are various investigations that have been utilised for diagnosis and management of acute coronary syndrome such as troponin ,CK-MB and 2D echo.There are few expensive investigations such as NT pro BNP that have been used as the prognostic factor in acute coronary syndrome.There is thus need of an investigation that can be done in peripheral setting which can be done easily and and has good prognostic value in acute coronary syndrome.  Objective: To study of neutrophil to lymphocyte ratio in acute coronary syndrome and its correlation with outcome Methods: This cross-sectional observational study was conducted in tertiary care hospital in Central India. Patients who were admitted to tertiary care centre with a diagnosis of ACS fulfilling the inclusion criteria were included in the present study. The study was conducted from June 2020 to Nov 2022. Results: Among the patients with N/L≤4, 36.1% had Killip class 1, 36.1% had Killip class 2, 19.4% had Killip class 3 and 8.3% had Killip class 4. Among the patients with N/L>4, 11.1% had Killip class 1, 30.6% had Killip class 2, 29.2% had Killip class 3 and 29.2% had Killip class 4. There was statistically significant difference. The mean CK MB of the patients with N/L≤4 was 570.90±36.29 and the mean CK MB of the patients with N/L>4 was 177.42±107.76. There was statistically significant difference. The mean 2D ECHO EF of the patients with N/L≤4 was 44.16±6.39 and the mean 2D ECHO EF of the patients with N/L>4 was 34.58±5.45. There was statistically significant difference. Among the patients with N/L≤4, all of them survived (100.0%); among the patients with N/L>4 15.3% died and 84.7% survived. There was statistically significant difference. Conclusions: The results of this study revealed that NLR is the strong predictive marker of ACS, so the study recommends using NLR as a good prognostic indicator for predicting short-term MACE and death in ACS patients.

Backgroud: Pulmonary thromboembolism (PE) is a common and potentially lethal condition. Despite significant advancements in diagnosis and management, there is limited reporting of this condition from India. Objective: To study the clinical profile and outcomes in patients of pulmonary thromboembolism. Methodology: This was a prospective observational study, conducted at the Department of Medicine, which includes the Medicine wards and MICU, in a tertiary care hospital located in central India. The study period was from November 2020 to October 2022, with a sample size of 43 participants. Results: The mean age of the cases was 50.86 years. Hypertension was the most common risk factor and Diabetes was the most common comorbidity. Palpitation was the most common symptom seen in 100% of cases and most common sign at the time of presentation was Tachycardia. ECG finding was Sinus tachycardia in 69.8% of the cases, the chest x-ray finding was dilated MPA/R in 34.9% of the cases, Right Ventricular (RV) dysfunction was seen in 30.2% of the cases on Echocardiography, DVT was seen in 9.3% of the cases in doppler and Pulmonary thromboembolism was seen 100% of the cases on CT pulmonary angiography. Heparin was given in 32.6% of cases and LMW Heparin was seen in 37.2% of the cases. Oral anticoagulation was given in 18.6% of the cases. New-oral anticoagulants were given in 37.2% of the cases. Thrombolytic therapy, Streptokinase was given in 30.2% of the cases. The outcome was discharge in 72.1% of the cases and death in 27.9% of the cases. Conclusion: Pulmonary thromboembolism (PTE) remains a major cause of morbidity and mortality all over the world. Risk factors are present in a majority of patients with confirmed venous thromboembolic disease. This condition is unrecognized and underdiagnosed clinically despite its high mortality.

Background: Diagnosis and delay in management of encephalopathy in elderly patients is challenging due to the paucity of presenting symptoms and signs. Objectives: To assess theetiologies, clinical profile, and outcome of encephalopathy in elderly. Method: This was a prospective observational study conducted over a period of two year (November 2020 to October 2022) on all elderly patients presenting with encephalopathy.Their demographic profile along with clinical presentation, laboratory, imaging results and outcome were recorded and analysed.Results: Majority of patients belonging to age group of 60-70 years (41.5%), with males’ predominance (59.9%). Maximum 56(39.4%) patients had 7-12 hours of altered mental status, (p<0.00001).47.2% presented with fever. Most patients had raised blood pressure (45.07%), neurological abnormalities (motor weakness) (27.4%), GCS score of 6-10 (57.7%), respiratory findings(47.8%). 29.5%had hyponatremia, 22.5%hypocalcaemia and 22.5% hypokalaemia. Higher number ofpatients had CT/MRI brain findings suggestive of haemorrhage and infarction. Most of the patients had ECG abnormalities in form of atrial fibrillation (11.2%). Etiology of encephalopathy in elderly was most commonly due to neurological causes (37.3%). Out of 142 patients, 64.8% were survivors and 35.2% was non-survivors.Most common cause of death were neurological (cerebro-vascular episode) followed by infections (meningitis). Patients who presented late or with more duration of altered mental status has more mortality than patients who presented early signifying that early diagnosis and treatment can reduce mortality significantly. Patients who presented with low GCS has higher mortality then patients with higher GCS. Conclusion: Elderly patients present late with paucity of symptom and signs. Hence, early presentation, early diagnosis and treatment will facilitate better outcome.

Influenza virus infection in humans is a zoonotic disease having high economic and public health impacts. Outbreaks of overlapping respiratory viral infections have been reported in the past. Here we describe the characteristics of a similar viral outbreak that occurred among students in a University campus in Kerala, India, during May, 2022. We conducted an epidemiologic investigation to describe the outbreak and elucidate the dynamics of viral transmission.  Nasal swabs were collected randomly from suspected patients. Real-time reverse transcription polymerase chain reaction (RT-PCR)-based diagnosis was performed to detect influenza A and B viruses followed by sequencing and phylogenetic analysis. COVID 19 was tested using rapid antigen detection kits. Of the 185 affected students included in the outbreak investigation, 87% reported either respiratory or gastrointestinal symptoms or both. The median time taken for the onset of symptoms was 3 days. Out of 16, 11 sampleswere laboratory confirmed for Influenza A (H3N2) while 18 samples were positive for COVID 19. The phylogenetic analysis showed that the Influenza virus is close to the current, Darwin 2021 vaccine strain. The only stool sample collected, turned positive for Noro Virus. Risk factors for infection included close proximity and exposure to droplet infection. The public health response included isolation of cases, contact tracing, temporary shutdown of college and hostels and enforcement of COVID appropriate behaviour in the campus. Early laboratory confirmation and an immediate public health response contained the outbreak.

Background: It is estimated that 17.7 million people died from CVDs in 2015, representing 31% of all deaths taking place worldwide; more people die every year from CVDs than from any other cause. Cardiovascular diseases are showing an increase among the Indian population. There has been a rapid and significant growth in the measurement of quality of life as an indicator of health outcomes in patients with CVD. In the clinical course of cardiovascular diseases, the interaction between stress and its impact on quality of life will alter and aggravate theclinical condition. Thus, an improvement in health-related quality of life is considered to be important as a primary outcome and overall therapeutic benefit. Most of the patients cannot cope with the stress due to the burden of cardiovascular disorder and require psychiatric intervention. This study will be focusing on the psychological problems faced by these patients and suggest a plan for improving their quality of life. Aims: To assess the quality of life in patients with known cardiovascular disorders i.e. hypertension, congestive cardiac failure and coronary artery disease. Methods: Patients attending Medicine OPD/IPD with a diagnosis of Hypertension, Congestive Cardiac Failure or coronary artery disease who satisfy the inclusion criteria will be selected. Socio-demographic data will be recorded via semi-structured proforma and the WHO Quality of Life Scale (WHOQOLBREF) will be applied. The data will then be evaluated and computed for statistical analysis of various interactions and correlations. Results: Out of 120 patients, 40 patients were selected in each diagnosis of hypertension (HTN), coronary artery disease (CAD), and congestive heart failure (CHF). The overall mean (SD) HRQOL was observed as 54.65 ± 14.23 with a range between 18.75-81.5. Among them, domain 4 has been observed with the highest score of 14.62 ± 2.3 and 66.54 ± 14.31 with 4-20 TS and 0-100 TS. However, the HRQOL distribution was varied as per different cardiovascular disorders, like highest mean ± SD score was observed with CHD (57.43 ± 13.33), followed by HTN (56.1 ± 14.66) and CAD (50.42 ± 14.04). Conclusion: Cardiovascular disorders are an important public health problem with a significant psychological impact and impact on the QoL of patients. There is a slight male preponderance observed in patients with cardiovascular disorders. QoL was affected in patients with cardiovascular disorders with psychological and physical health domains being primarily affected.

Background: Non-communicable diseases (NCDs) are the leading cause of death worldwide, with hypertension being the leading risk factor. Ischemic heart disease and stroke are the leading causes of Disability Adjusted Life years (DALYs) in people aged 50 and older, and high systolic blood pressure is responsible for 19.2% of all deaths worldwide. The global NCD priority is to reduce hypertension prevalence by 25% by 2025. Strategies such as early detection, treatment, and control, cost sharing, and benefit designs can help reduce unfavourable health outcomes associated with hypertension. Objectives: The current study is a Community Interventional Trial for Hypertension Control in Rural Maharashtra, India to determine if a community-based intervention delivered to community and healthcare workers in a rural area can be effective in controlling hypertension and if any beneficial effects can be sustained in the long term. Materials & Methods: The study was conducted in the Coverage area of two Primary Health Centers in Palghar District of Maharashtra from Jan 2018 to Dec 2022. It was a Cluster randomized controlled trial with 1850 people in each Sub-center. Comprehensive community-based intervention was implemented in one Subcenter under Primary Health Centre of Kaman and second subcenter in the Primary Health Centre of Satpati in rural area of Maharashtraand its effect was assessed. Results: The baseline characteristics of the study population were similar in both sub-centres. Recommended Physical activity was less in both subcentres, with most of the participants consuming 2000-2499 Kcal/Day. Overweight was higher in Kaman, while central obesity was higher in both PHCs. The prevalence of known cases of both Diabetes Mellitus and Hypertension was 3.4% in Kaman, while Suspected Hypertension cases was higher in Kaman. In Kaman there were 27.5% of confirmed cases of hypertension and after intervention it has reduced to 17.5%. There was a decrease of 10%. In Satpati there were 25.2% of confirmed cases of hypertension and after intervention it has reduced to 21.6%. There was a decrease of 3.6%. Conclusion: A high number of cases of Hypertension is found in rural population. 27.5% of the participants were newly diagnosed with Hypertension. Screening and early detection and treatment of Hypertension is highly needed in rural areas. Community-based intervention is equally important to focus on prevention, promotion, and enable lifestyle changes to prevent and control Hypertension and avoid risk factors.

Introduction: Diabetes mellitus (DM) refers to a group of common metabolic disorder that shares phenotype of hyperglycemia. In India, the prevalence rates are estimated to be around 10% in cities, and recent figures showed surprising increasing rates in rural areas. To ascertain the true prevalence in any community, it is essential that there must be standardized methods for the diagnosis with proper acceptable criteria so that the results are comparable.  Aims: To determine the incidence of LV diastolic dysfunction in asymptomatic Type-II  DM patients and to compare it with normal subjects and To quantify the relation of LV diastolic dysfunction with age, duration of DM, HbA1c, obesity indices and other diabetic complications Materials and Methods: The present study was a case-control study. This Study was conducted from April 2021 to November 2022 at Department of Medicine at PMCH, Patna. Result:Transmitral velocity data showed the significant low E/A ratio (E<A), prolonged declaration time (>240ms) and isovolumetric relaxation time (>110ms) in patients with diastolic dysfunction both in study group and control group. Conclusion: The incidence of diastolic dysfunction was found significantly high in newly diagnosed type 2 diabetes mellitus patients as compared with non-diabetic subjects. Prevalence of diastolic diastolic dysfunction in new diabetic population has female preponderance in the ratio of 2:1.

Background: Woman oriented contraceptives have gained acceptance compared to male contraceptives. Vasectomy was introduced in India in 1992 to increase male participation in family planning. However, despite being a safe and simple method, it is rarely accepted as a method of contraception. Aims And Objectives: To assess the attitude of men towards No Scalpel Vasectomy (NSV). To study the reasons for low acceptance of NSV among husbands of women who underwent permanent methods of contraception. Materials And Methods: A cross sectional questionnaire based survey was conducted at Government Medical College, Thrissur from November 1st 2022 to January 31st 2023. Healthy male attendants of 150 women who underwent permanent methods of contraception in the Obstetrics and Gynecology Department, were included. Socio demographic data, knowledge about NSV and reasons for its low acceptance was collected using a self-made validated questionnaire. Results: In our study, majority (85.3%) of the participants were aware that NSV is a permanent method. 58.8% of the subjects knew that NSV has a high success rate. 55% believed that NSV required prolonged rest and affect sexual function. 54% perceived socio cultural barriers as reasons for low acceptance. 80.8% had procedure related misconceptions. Fear about procedure related pain and complications was seen in 44.1%. Conclusion: Though, a large majority of the spouses of women who underwent sterilisation, were aware of NSV, misconceptions regarding the procedure was common. Health education and counselling are needed to bring about a change in this attitude.

Introduction: Chronic otitis media (COM) has been an important cause of middle ear disease since prehistoric times. Despite the valuable contribution of antibiotics, COM remains a common disease and its complications challenge both otologists and radiologists. Chronic otitis media is relatively common and potentially dangerous disease of the ear. It is defined as permanent abnormality of the pars tensa or flaccida, most likely a result of earlier acute otitis media, negative middle ear pressure or otitis media with effusion. Chronic Otitis Media is of two types : Mucosal and Squamosal. COM of all types is associated with erosion of the ossicular chain . The incidence and degree of ossicular destruction is much greater in cases of unsafe CSOM, due to the presence of cholesteatoma and/or granulations. Although bone erosion may occur in COM without cholesteatoma, it is more frequent when the keratinizing epithelium is present. Aims: To compare the preoperative HRCT findings with intra-operative findings in patients with Chronic Otitis Media and to resolve the doubts about the sensitivity and specificity of pre- operative CT scan findings in squamosal COM. Materials and Methods: This is a prospective study of 50 patients done principally at the Institute of Otorhinolaryngology And Head & Neck Surgery, IPGME&R & SSKM Hospital , Kolkata, India in which patients coming with inactive or active squamous Chronic Otitis Media with or without complications, who were planned for different types of mastoid surgeries were included in the study . Result: This study has shown that HRCT imaging of temporal bones for COM accurately depict presence of soft tissue mass in either the external auditory canal or the middle ear subsites, the integrity of the scutum, the integrity of the ossicular chain and erosion of the tegmen or the sigmoid plate. However, the role of HRCT could not be established in predicting the status of the tympanic membrane, the presence of lateral semicircular canal fistula, integrity of the incudostapedial joint. HRCT alone as a diagnostic modality could not predict the nature of soft tissue with statistical significance. Conclusion: Preoperative CT scan is helpful in relation to diagnosis and decision making for surgery in cases of cholesteatoma and ossicular erosion. It provides information on anatomical variations and complications. It serves as a road map to assist the surgeon during surgery.

Introduction: Vitamin D plays a significant role in the functioning of the immune system and it influences many dermatological diseases such as psoriasis and atopic dermatitis. The prevalence of vitamin D deficiency is growing globally with around 30–50% of people are known to have low levels of vitamin D.  Acne vulgaris is a common inflammatory disorder of the pilosebaceous unit. Studies about the role of vitamin D in the pathogenesis of acne vulgaris have shown conflicting and nonconclusive results. Thus, the precise purpose of vitamin D has not yet been established.  Aims & Objective: To evaluate serum levels of vitamin D in sample of patients with acne vulgaris and compare it with matched healthy controls & to investigate if there is any relation between serum vitamin D level and the severity of acne vulgaris. Materials and Methods: This cross-sectional study included 40 patients with acne vulgaris and 40 matched healthy controls. Serum 25-hydroxyvitamin D [25 (OH) D] levels were measured for both patients and healthy controls.  Results: Patients with acne are younger than healthy controls and female preponderance was observed as compared with male patients.  The mean (± SD) concentrations of 25[OH]D in patient group and the control group were 21.3 ± 9.7 ng mL and 29.6 ± 11.2 ng/mL respectively. The difference was found to be statistically significant (P < 0.05). Thus our study yielded lower levels of serum 25-hydroxyvitamin D in patients with acne vulgaris than its level in healthy controls. Conclusion: This study has shown clearly that in patients with acne Vulgaris vitamin D deficiency is more evident with P-value P < 0.05. Moderate to severe vitamin deficiency was observed in 27 cases (67.5%) and in 20 controls (50%) (P < 0.05). Further clinical studies with larger sample size are required to address the importance of vitamin D in pathogenesis & grading of Acne vulgaris. Specifically, to determine the effects of treatment of acne with both topical vitamin D analogs and vitamin D supplementation.

Background: This prospective study aimed to assess the clinical and demographic profile of adolescent poisoning cases admitted to the Department of Pediatrics at HIMS Hassan, India. Methods: A total of 105 patients aged between 10 and 17 years were included in the study, with data collected regarding their clinical-demographic profile and consumption details.  Results: The majority of cases were female (79%) and from a rural area (63.8%). In terms of socioeconomic status, the largest proportion of cases were from the upper lower class (32.3%). Insecticide (26.6%), rat paste (13.3%), acid (11.4%), and tablet consumption (24.7%) were the most common poisons consumed by the adolescents. Suicidal consumption accounted for 85.7% of cases, while 14.2% were accidental. Regarding treatment, 80% of patients received supportive and symptomatic management, while 20% received a specific antidote. Conclusion: The study provides valuable information about the clinical and demographic profile of adolescent poisoning cases in India, which can be used to inform prevention and management strategies.

Fluorosis, a condition caused by the excessive intake of fluoride, results in toxic effects on the human body. It is a collective term for the various manifestations of this condition. Recent estimates indicate that approximately 200 million people across 25 nations worldwide are affected by the alarming consequences of fluorosis. In India, 20 states are facing the challenge of high fluoride levels impacting their population. Objectives: To determine the effect of black tea drinking and use of toothpaste in the development of dental fluorosis among children in the age group of 10-15 years in Kerala.  Methodology: This study involved the selection of two districts with a high prevalence of fluorosis and two neighboring districts without fluorosis. A sample size of 980 school-going children werecalculated, and adequate sample size was selected. Data was collected using a pretested modified questionnaire. Dental specialists evaluated the fluorosis status, and information regarding the use of tooth paste and consumption of black tea along with other details.Subsequently, the collected data was entered and analyzed. The prevalence of fluorosis was calculated in percentage. Results: In the district of Alappuzha, the prevalence of dental fluorosis was found to be 38.9% among children who used toothpaste for dental cleaning and 30.6% among those who did not use tooth paste.However, in the other districts, no significant relationship was observed between the prevalence of dental fluorosis and the use of toothpaste. In the district of Alappuzha, the prevalence of dental fluorosis was 37.9% among individuals who consumed black tea, compared to 33.6% among those who did not consume black tea. Similarly, in Palakkad, the prevalence was 39.9% among black tea consumers and 35.2% among non-consumers. It was observed that a majority of students in both Alappuzha and Palakkad consumed black tea, and the prevalence of dental fluorosis was higher among students who consumed black tea in both districts. Conclusion: Dental fluorosis is a public health problem in the district of Alappuzha and Palakkad in Kerala, India. The main causative risk factor was the use of drinking water containing high fluoride level but the use of black tea and fluoridated toothpaste are the added risk factors in the development of fluorosis. Measures should be taken to avoid these added risk factors in these endemic areas in order to solve this public health problem.

Conclusion: Serum homocysteine, vitamin B12and folic acid are easily available investigations which may predict the severity and outcome of patient s    of acute ischemic stroke.

Background: Respiratory conditions are the most common cause for admission to a NICU in term and preterm infants and comprise around 33.3% of neonatal admissions at >28 weeks gestation. Chest radiography is considered the gold standard for diagnosing lung disease, but it unavoidably causes radiation damage to the neonate. Ultrasonography is non-invasive, non-ionizing, easily operable, and performed in real-time, making it an accurate, reliable technique for the diagnosis of neonatal lung diseases. Due to the lack of research on ultrasonography in Indian neonates with pulmonary diseases, this study was done to determine the role of ultrasound as a diagnostic tool in neonates with respiratory distress and decreasing radiation exposure. Objectives: 1) To determine the accuracy and effectiveness of lung ultrasonography as a diagnostic tool in neonates with pulmonary diseases. 2) To determine if Ultrasound based analysis can play an effective role in reducing radiation exposure in neonates with pulmonary diseases. Material & Methods: The study was conducted on neonates with respiratory distress in the Neonatal Intensive Care Unit of KLE’s Dr. Prabhakar Kore Hospital. (Respiratory distress in the neonate is diagnosed when one or more of the following is present; tachypnoea or respiratory rate of more than 60/ minute, retractions or increased chest in drawings on respirations (subcostal, intercostal, sternal, suprasternal) and noisy respiration in the form of a grunt, stridor or wheeze).  Neonates admitted in the NICU with any cardiac diseases and other non-pulmonary diseases and neonates with congenital anomalies such as congenital heart diseases, Congenital Diaphragmatic hernia, Tracheoesophageal Fistula, and Esophageal Atresia were excluded from the study. Institutional Ethical Clearance from the Institutional Ethics Committee for Human Subjects Research of Jawaharlal Nehru Medical College, Belagavi, Karnataka was obtained, and informed consent from the parents of all the study subjects. Results: Out of 51 neonates enrolled in the study, 23 neonates were diagnosed with respiratory distress syndrome, 11 neonates were diagnosed with transient tachypnea of the newborn, 5 neonates were diagnosed with meconium aspiration syndrome, 3 neonates were diagnosed with pneumonia and 2 neonates were diagnosed with pneumothorax. Lung ultrasound demonstrated a sensitivity of 92.7 % and specificity of 87.21 % as a diagnostic modality in our study. Conclusion: Lung ultrasonography serves as an alternative diagnostic imaging modality to chest radiographs in detecting neonatal pulmonary diseases.

Background: High Resolution CT has a potential role in the diagnosis, detection of complications and in predicting clinical recovery of patients or progression of coronavirus disease 2019. Degree and severity of lung involvement can be assessed by 25 point CT severity score. This quantification plays an important role to modify the treatment plan at times in critically ill patients of COVID-19. Objectives: The purpose of the present study is to characterize the typical & atypical HRCT imaging features in patients with COVID-19 infection and to additionally establish a correlation between the CT severity score & clinical lab parameters to facilitate an expeditious management protocol. Materials & Methods: A prospective observation study of 2years duration including 75 patients with RTPCR positive proven COVID-19 disease were evaluated with HRCT and the findings were systematically documented and analysed by experienced radiologists. Results: >90% participants were found to have ground glass opacities  (GGO) on Chest CT,76%hadGGOwithsmoothinterlobularseptalthickening; whereas 64% had GGO with smooth intra lobular septalthickening.54.7% (41/75) patients had severe grade of Covid Pneumonia; followed by moderate(26;34.7) and mild (8; 10.6%). There is positive correlation of Chest CT severity scores with urea, D-dimer, CRP, IL-6 , TLC and ferritin. Conclusion: Better understanding of spectrum of CT findings in COVID-19 pneumonia may help to reach accurate diagnosis in clinically and laboratory equivocal cases. It also aids in prognostication of clinically ill cases and cases with co-morbidities.

Background: Identifying the women who are likely to miss receiving complete ANC care during their pregnancy and understanding the causal factors is essential towards the development of effective and targeted public health interventions. Objectives: To assess the sociodemographic profile and the factors influencing the utilisation of antenatal services among pregnant women in rural Coimbatore. Methods: A community based cross-sectional study was conducted among antenatal women residing in the field practice area of Rural Health Training Centre using multi-stage sampling method from June 2021 to May 2022 (one year) in the Rural Field Practice Area of a Medical College in Coimbatore district using pre-tested, validated, semi-structured questionnaire. Results: Majority (55.2%) of the participants were aged between 18-25 years. Only 10% of the women were currently employed. Tests of association showed that sociodemographic factors were significantly associated with ANC utilization (p<0.05). Among the study participants, 80.4% utilized the services completely (ANC visit to healthcare facility, consumption of IFA tablets, Td vaccination, basic blood, and urine investigations and ultrasonogram); 19.6% had incomplete ANC care and none had “No ANC”. Conclusion: The overall high ANC utilisation in the study area could be attributed to the favourable knowledge, attitude, and practice of the antenatal women towards maternal and child health as a result of high literacy rate, ongoing IEC and health promotional activities. Attention should be given to regular and sustained contact between healthcare workers and antenatal mothers especially through home visits to develop mutual confidence in preparing them for pregnancy, childbirth, and care beyond.

Background: Salivary gland tumors (SGTs) are relatively less common, and they exhibit a wide variety of morphological features, even within one particular lesion. This has caused considerable problems in categorization and diagnosis. The epidemiologic factors are also variable across the world.  Objectives: To study the site of occurrence, age, and gender-wise distribution with histopathologic features of various SGTs and their comparison with other studies.  Material and Methods: This eight year cross-sectional study was conducted in a tertiary care teaching hospital of central India and included all diagnosed cases of SGTs. Results: A total of 100 cases of SGTs were retrieved during the seven-and-a-half-year study period. Out of which 61% were benign and 39% were malignant. The age range was 5–83 years. The most frequently encountered benign tumor was pleomorphic adenoma (86.8%), followed by Warthin’s tumor (8.2%). Mucoepidermoid carcinoma (MEC) was the commonest malignant tumor (33.3%). The parotid gland was the commonest site for both types of SGTs.  Conclusion: SGTs had a wider age range of presentation. Benign tumors were more common and well-demarcated from surrounding tissue as compared to malignant tumors. They were more common in the major salivary glands, as the parotid was the commonest gland involved in both benign and malignant SGTs.

Introduction: Acute appendicitis is a common surgical emergency, with appendectomy being the gold standard treatment for this condition. Traditionally, early appendectomy has been advocated to prevent the potential complications associated with delayed intervention. However, recent studies have questioned the necessity of immediate surgical intervention and proposed a conservative approach with delayed appendectomy or even non-operative management. The debate between early versus delayed appendectomy in the treatment of acute appendicitis has gained significant attention among surgeons, researchers, and healthcare providers. This comparative study aims to provide a comprehensive analysis of the outcomes, efficacy, and safety of these two approaches. Aims and Objectives: This study aims to compare the morbidity, mortality, postoperative length of stay and 30 days readmission rate of acute appendicitis patients who had appendectomy within 8 hours of visiting the emergency room with those who had surgery after that period. Material and Methods: This study was conducted on 175 patients retrospectively who underwent appendectomy procedures from January 2021 to December 2021 at Adesh Medical College and Hospital, Shahabad, Kurukshetra, Haryana, India. The study population was divided into two groups based on the length of time before the intervention: early appendectomy (group 1), which included patients who underwent surgery within 8 hours, and delayed appendectomy (group 2), which included patients who underwent surgery after that time. The underlying characteristics of the two study groups were then compared, including demographic, clinical, radiological, and perioperative data. The 30 days readmission rate, postoperative length of stay, and mortality and morbidity were all regarded as outcome measures. Data were manually collected by reviewing patient charts in the electronic medical record. The Statistical Package for the Social Sciences (SPSS) 24.0 was used for the statistical analysis. Statistical significance was evaluated at p<0.05.  Results: A total of 175 patients met the inclusion requirements for the study population over the course of the twelve months of the trial period. Within 8 hours of their arrival at the emergency department, 100 patients (57.1%) underwent early appendectomy, while 75 patients (42.8%) did so after that time. The age was 43.8±11.85 years on average. A total of 54.28% (n = 95) of the population were male patients and the rest were females. Twenty patients (11.43%) overall experienced postoperative problems, including two postoperative hemorrhages (1.1%), five surgical site infections (2.86%), eight pneumonia (4.57%), one urinary tract infections (0.5%) and four patients (2.28%) who experienced multiple organ system failure. Within 30 days of surgery, six patients (3.4%) were readmitted. The 30‐day readmission rate (2% vs. 4%, p = 0.569) did not differ significantly between the two groups. The postoperative duration of stay did not differ significantly between the two groups: Median (IQR) 24.8 (11.2‐38.4) vs. 26.9 (11.6‐26.9) hours (p = 0.692). Conclusions: Our results concluded that eight hours delay in the appendectomy did not lead to longer postoperative stays, an increase in mortality or morbidity, or a higher 30‐day readmission rate, of patients with acute appendicitis. This comparative study investigated that early versus delayed emergency appendectomy in the treatment of acute appendicitis holds significant importance in guiding clinical decision-making. By critically analyzing the available evidence, this research aims to provide evidence-based recommendations to enhance patient care and optimize outcomes.

The prevalence of Chronic Venous Disorder (CVD) and the socioeconomic impact of its symptoms are directly related to the importance of the disease. The most common symptom of CVD is varicose veins (VVs). 45-75% of VVs cases are related to insufficiency of the Great saphenous vein (GSV), and 15-25% are due to an incompetent Short Saphenous Vein (SSV).  Objective of this study was to study the anthropometric measurements and the anatomical variations of GSV, Anterior accessory saphenous vein (AASV), Posterior accessory saphenous vein (PASV) and intersaphenous vein (ISV), and the diameter of GSV and Short SaphenousVein (SSV) in Chronic venous disease patients Methods: Patients of primary varicose vein(diagnosed  clinically and on Duplex doppler USG )on 200 legs were enrolled. Age, sex, anthropometric data, and findings on duplex USG were noted. Venous reflux, GSV, SSV, AASV, PASV diameter was noted and its severity with Venous clinical severity (VCSS) score was also noted. Results: The mean age, weight (kg), height (cm), hip diameter(cm), waist diameter (cm), and BMI (kg/m2)of the patients were 35.65±9.91, 75.41±12.34, 63.48±5.06, 40.80±3.49, 40.09±4.35, and 29.37±6.97respectively. The percentages of male and female were 82.00% and 18.00%,. The mean VCSS, Diameter of GSVjust below SFJ (mm), at upper thigh (mm), mid-thigh (mm), above knee (mm), below knee (mm), at Mid leg (mm), at medial malleolus (mm), SSV diameter Just below knee (mm), SSV Diameter at mid-calf (mm) and SSV Diameter at Lat. Malleolus (mm) were 10.40±2.54, 9.09±2.04, 8.10±1.96, 7.13±1.93, 6.28±1.89, 6.81±1.77, 6.61±1.88, 4.79±4.13, 3.93±0.75, 4.47±5.84, and 3.85±2.86, respectively. Conclusion: Weight and BMI were significantly positively correlated with the diameter of competent perforators. . Moreover, the SFJ incompetent,SPJ-incompetent, AASV incompetency, perforator-incompetency, and GSV diameter  were  significantly positively correlated with VCSS.  Other anatomical changes such as diameter of GSV and SSV were not significantly correlated with age, weight and BMI. Also, the hip, waist circumference, and hip-to-waist ratio were not significantly associated with the different anatomic changes in varicosities whereas SSV diameter just below the knee was significantly negatively correlated with VCSS.

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.

Background: Stroke rank high among the leading causes of death and permanent disability in India. Due to shifting demographics and rising rates of important modifiable risk factors. The purpose of this study was to compare the blood sugar levels of people with and without diabetes in the early stages of ischemic stroke. Material and Methods:  40 patients who had been admitted to the Department of General Medicine, Sri Venkateswaraa Medical College Hospital & Research Centre, Puducherry, India for the diagnosis of acute ischemic stroke between the April 2022 to March 2023 were included in this study. The Patients were on the basis of the inclusion and exclusion criteria. Results: In our analysis of 40 patients, the majority of them were male, indicating a male preponderance, which is prevalent in most investigations. Twenty-eight of the forty patients had hypertension, 34 had diabetes, three had a history of myocardial infarction, and one female patient had atrial fibrillation. The majority of the patients (15) were between the ages of 51 and 60, with 11 between the ages of 27.5 and 12.5% between the ages of 40 and 50. Conclusion: Ischemic stroke severity, magnitude, and outcome are linearly related to admission day hyperglycemia. Diabetes and stress hyperglycemics have greater severe strokes and worse functional outcomes and higher death. Admission day glucose levels predict ischemic stroke outcomes.

Background and Objectives: Low back pain with radicular symptoms is a prevalent musculoskeletal disorder and a leading cause of disability. Radicular back pain affects multiple nerve roots, resulting in pain, sensory loss, and motor dysfunction. Assessing the quality of life (QOL) provides valuable insights into the impact of health conditions and treatment outcomes. Low back pain significantly interferes with QOL and work performance. This study aimed to analyze the QOL in female patients with low back pain and radiculopathy. Materials and Methods: An observational study was conducted on 404 patients and healthy individuals at a medical college in India. The SF-36 questionnaire, which measures eight scores representing physical and mental components, was used to assess QOL. Results: Results from 364 eligible patients revealed significantly lower mean PCS and MCS scores compared to the normative population, indicating poorer QOL among low back pain patients. Conclusion: In conclusion, patients with low back pain and radiculopathy experience a diminished QOL compared to individuals without this condition. Therefore, efforts should be made to enhance patient care, focusing on improving QOL, as this aspect remains relatively unexplored.

Introduction: Cystic fibrosis is a life-shortening disease of young children but it has been present in adults in recent days. Studies on epidemiology and microbiota of cystic fibrosis from the southern part of India are very few. So we tried to project the data of bacteria responsible for pulmonary exacerbations in cystic fibrosis patients and their antibiotic sensitivity. Materials and Methods: A total of 75 samples were collected from confirmed cystic fibrosis patients attending outpatient clinical departments and were processed for culture and sensitivity according to CLSI protocols. ESBL and MBL production among non fermenters were detected using antibiotic discs using modified Kirby bauer method. Results: Out of all isolated pathogens Pseudomonas aeruginosa isolates were 29 (40.8%), 15 (21.1%) isolates were Klebsiella pneumoniae, 12 (16.9%) Staphylococcus aureus, 7 (9.8%) Candida albicans, 4 (5.6%) Enterobacter cloacae, 2 (2.8%) Burkholderia cepacia, and 2 (2.8%) Burkholderia species. Out of 29 Pseudomonas aeruginosa isolates 68.9% showed ESBL production and 17.2% showed MBL production. All the Burkholderia cepacia tested were ESBL and MBL producers. 100% and 50% of Burkholderia species expressed ESBL and MBL enzymes respectively. Conclusion: Co-existence of S.aureus and P.aeruginosa in cystic fibrosis patients is still a matter of debate. Many hypotheses including the present study concluded that microorganisms are antagonistic invitro after a prolonged co-existence.

Background & Objectives: Postpartum depression (PPD) is defined as presence of depressive symptoms in the postpartum period. A seemingly innocuous disorder, if untreated can lead to foeticide or maternal suicide. Furthermore, there is currently no screening tool designated for use in clinical practice and no data are routinely collected on the proportion of perinatal women with postpartum depression. Hence the current study is taken to accurately estimate the burden of postpartum depression using valid tool. To assess the prevalence of postpartum depression among postnatal mothers in rural India Methods: A cross-sectional study was done among the 110 postnatal mothers attending immunization clinics and general OPD in the field practice area of department of Community Medicine, GMC, Srikakulam. Modified EPDS scale validated in local language was used to collect data. Results: The mean age of the mothers 23.7 ±2.6 ,most(42.7%) of them were intermediate educated and upper lower class(70%) of SES. The prevalence of possible depression (score ≥10) is 19.1% and the prevalence of Depression of varying severity (score >13) is 10%. Post partum depression is associated with age, SES, type of delivery, immediate outcome of delivery. Conclusion: EPDS tool can be effectively used to screen post partum depression at primary health care level.

Objective: Congenital heart disease (CHD) is the most common congenital anomaly in newborns and is a significant cause of mortality. The distribution pattern varies with different regions.   The aim of this study was to evaluate the pattern of CHD among referred pediatric population in south India. Methods: This was a single centre cross-sectional observational study done over a period of one year. A total of 616 infants and children referred with suspected CHD to a tertiary care centre in Kerala, from January to December 2019 were included. They underwent routine clinical examination, pulse oximetry and echocardiography. Results: Among the 616 enrolled subjects, 553 had CHD of which 526 (95%) had acyanotic lesions, 20 (3.6%) cyanotic lesions and 7 (1.2%) non-specified CHD.  Among acyanotic CHD, shunt lesions were much common (87%) than obstructive/ regurgitant lesions (13%). Atrial septal defect (ASD) accounted for 54.9% followed by Ventricular septal defect (14.5%) and patent ductus arteriosus (PDA) (13.9%). Pulmonary stenosis was the most common obstructive lesion (4.5%). Tetralogy of Fallot was the commonest among cyanotic CHD (2.1%). In 47 (8.4%) cases a combination of simple defects was seen, the commonest being ASD with PDA in 17 (3%) cases. Only consanguinity (2.6% vs. 0.3%, p 0.02) prematurity (16% vs. 4.4%, p 0.0001) and low birthweight (2.65 Kg vs. 2.89 Kg, p 0.001) were significantly associated with CHD. Conclusion: Among a referral pediatric population, ACHDs were far more common than CCHDs.  Shunt lesions formed the majority of ACHD. While prematurity, low birth weight and consanguinity were the risk factors associated with CHD, parity, birth order and parental age were not. Inclusion of neonates in the study is one probable reason for the large proportion of shunt lesions like ASD in the study.

Background: The fourth most common cause of death from malignancies, pancreatic cancer is a serious cause of morbidity and mortality. [1] This low survival rate is due to late presentation, vague indications and symptoms, and insufficient diagnostic and treatment options. The effectiveness of treatment approaches can be significantly increased by correctly diagnosing benign and malignant diseases of the pancreas. Objectives: To study diagnostic efficacy of EUS-FNA with importance of cytopathology and correlating with histopathology and biochemical markers. Material & Methods: Study Design: Retrospective Hospital based observational study. Study area: Department of Pathology (Histopathology laboratory), NIMS, Hyderabad. Study Period: January 2019 – December 2022. (3 years) Study population: Sample size: study consisted a total of 172 cases. Sampling method: Simple random method. Study tools and Data collection procedure: Clinical information, results from lab tests, and reports from cytopathology and imaging studies were all retrieved for each patient. To determine the location, size, and features of the pancreatic lesions, imaging reports from sonography, magnetic resonance imaging (MRI), computed tomography (CT), and ultrasonography (USG) were analyzed. The location, size, and features of the pancreatic lesions were evaluated using computed tomography (CT) and magnetic resonance imaging (MRI). Atrained pathologist and a technician from the on-site pathology team assisted with the EUS instruction for each FNA. Results: The mean age of the study subjects was 53.7 ± 13.33 years. Most (52.9%) of the subjectswereintheagegroupof41-60years, followed by 30.8% were in 61–80 years group. Only2.3% were in < 20yearsagegroup.Ourstudyalsohadresultswithsensitivity, specificity, PPV, and NPV of 58.2%, 82.3%, 85%, and 53.5%, respectively. Conclusion: The results of this study demonstrated that EUS-FNA had good sensitivity, specificity, PPV, and NPV in the detection of solid and cystic pancreatic cancer. If necessary, a composite of the EUS-FNA cytology, cell block preparation, and immunohistochemistry results can be used to make the final diagnosis. This information may then be used to guide both surgeons' and oncologists' treatment strategies.

Anemia is a major health problem in developing countries like ours’. Although macrocytic anemia constitutes a minor portion among nutritional anemias, Vitamin B12 (Cobalamin) and Folate deficiency in Indian population is quite prevalent. As the of studies evaluating the relationships of these nutritional parameters with RBC indices in the same group of study participants are limited, we planned this study to study correlation of serum Ferritin, Vitamin B12, Folate with and RBC indices. A case-control study including 100 patients with anemia (Cases) and 100 age and sex-matched subjects without anemia (Controls) was conducted at UPUMS, Saifai, Etawah, Uttar Pradesh. Patients satisfying WHO criteria of anemia were included as cases, while those with history of any factors that are known to alter study parameters were excluded. Estimation of all study parameters was done following standard operating procedures of our laboratory and the results were analysed using appropriate statistical methods. In our study, serum Ferritin (p=0.0001), Vitamin B12 (p=0.0004) and Folate (p=0.0001) deficiency were found to be significantly higher in cases, compared to controls. There was a moderate positive significant (p-value<0.05) correlation of Hb with serum Ferritin in both cases and controls. We also observed a positive significant (p-value<0.05) correlation of MCV with serum Ferritin in both groups. There was also a mild negative correlation of MCV with serum Vitamin B12 and Folate, in both groups of cases and controls. Based on our findings, it may be concluded that Microcytic RBCs on microscopic examination does not necessarily mean serum Ferritin deficiency. It could be a concomitant deficiency of both serum Ferritin and Vitamin B12.

Background: The incidence of Central Nervous System tumors is low in India when compared to western countries. Now a days, the increase in incidence may be due to improved diagnosis with advancement of studies. They have a wide spectrum clinically and histopathologically.  Aims And Objectives: This study aims to provide the spectrum of CNS tumors histologically and clinically, along with radiological correlation,To analyse  various histological types of Cranial and spinal tumors ,to evaluate age and gender distribution and topography of tumors. Materials And Methods: A retrospective study was performed in the department of pathology, for a period of 18 months.The data and Hematoxylin and Eosin stainedslides were retrieved from the archives, the cases were analysed and graded according to 2021WHO grading system. Results And Conclusion: out of 76 CNS tumors, most common were Intracranialtumors 85.5% (65) cases and Spinal tumors were 14.4% (11) cases. There is male preponderance, 44 cases (57.8%)Majority were in 45 to 60 years. Tumors were more common on right side, 61% (47 cases) and most common location was cerebellopontine angle 13.1.% (10 cases) followed by frontal region 11.8% (9 cases). The most common histological type were Astrocytomas, followed by Meningiomas. WHO Grade I tumors are more common, 24.6% followed by Grade II, 21.7%. Most common tumors  inchildren were Medulloblastomas (Grade IV). Three cases ofsecondary deposit from epithelial malignancy were also included in the study.

Due to advent of technology and internet, teaching too is now largely utilizing these modern devices and internet to impart education to the children. When it was mandatory to keep social distancing and hence avoid regular classes for medical students during the dreadful COVID pandemic, it was decided to teach the 1st year MBBS students online using the technology and the internet. This study aimed at determining if the students found this novel online teaching to be helpful or not. Methodology: A total of 100 1st year MBBS students in a tertiary medical college in central India were included in the study from September 2020 to February 2021 for 6 months. It was an observational study and an informed consent from the students was taken prior to the study. Classes were conducted as usual as per the institutional guidelines and feedback forms were collected after that. Results: Out of total 100 students, 65 were girls and 35 were boys. Average age of the class was 19.2  1.1 years. 85% had used mobile phones and internet for education before and 15% had never used it for education purpose. 75% had a concentration time of 30 minutes. About 50% students faced internet issues and faced moderate disturbance during the classes. 85% used mobile phones for the classes. 60% students opined that such online classes are effective for teaching anatomy while 40% told that it was not effective. Conclusion: The study concludes that currently online classes for the subject like anatomy are not as effective as regular classroom teaching. The factors could be low motivation, technology and internet problems, low attention span etc.

Background and objectives: The purpose of this study is to determine whether diabetes individuals who have a variation in the MnSOD gene are more likely to experience cardiovascular problems. This is accomplished by determining the prevalence of MnSOD gene polymorphism in type 2 diabetic patients who either have or do not have cardiovascular disease, as well as in healthy control subjects. To determine whether or not this MnSOD polymorphism results in decreased SOD activity. Method: To conduct this case-control investigation, ethical approval was obtained. This investigation was conducted between February 2023 to May 2023 at Government Medical College Sircilla, Telangana, India.  Seventy patients with diabetes that had been ongoing for more than five years were included in the investigation after receiving informed consent. The diagnosis is based on the clinical history, fasting plasma glucose levels, and electrocardiogram (ECG) findings. Result: The genotype and allele frequency of the SOD2 gene are displayed for those with type 2 diabetes, those without the disease, and healthy controls. More people with diabetes and cardiovascular disease (n = 25; 71.42%) have the TT genotype than people with diabetes and no cardiovascular disease (n = 15; 42.85%) or controls (n = 10; 28.5%). There is a significant (P = 0.006) difference in the frequency of the TT genotype among diabetic CVD cases. Genetics and SOD activity interacted. The SOD activity was lower in people with the TT genotype. SOD activity ranges from 86U/L in TT to 187U/L in CC, with CT falling in the middle at 145U/L. It's 0.000. The SOD activity was lower in people with the TT genotype. Conclusion: This study compared diabetics with and without cardiovascular disease for SOD2 gene (T>C) substitution polymorphism. 35 diabetics with and without cardiovascular disease were compared. T2DM patients with cardiovascular disease had a higher SOD2 TT genotype rate than those without CVD and controls. TT genotype differs significantly amongst diabetics with and without cardiovascular disease. Diabetes patients with cardiovascular disease had reduced serum SOD activity, which may contribute to cardiovascular illness. The TT genotype was associated with cardiovascular disease due to its low serum superoxide dismutase (SOD) activity. After controlling for variables, the TT genotype predicts cardiovascular disease complications.

Background and Objectives: Bacterial meningitis (BM) poses a considerable global public health concern. C-reactive protein (CRP) has emerged as a viable diagnostic marker, particularly in differentiating bacterial and aseptic meningitis, especially in cases where bacterial culture results are negative in both blood and cerebrospinal fluid (CSF) samples. The present study was done with the primary objective of estimating the serum CRP levels in pediatric meningitis cases caused by bacterial pathogens. Materials and Methods: A hospital-based descriptive cross-sectional study was undertaken at a renowned tertiary care hospital in India, involving the evaluation of 222 samples. Cerebrospinal fluid samples were collected following standard guidelines, and bacterial identification and antimicrobial susceptibility testing were carried out using an automated system. Quantitative estimation of CRP levels was performed using a solid-phase, sandwich-format immunometric assay employing a gold antibody conjugate. Results: The study cohort consisted of pediatric meningitis cases with a median age of 3.9 years, ranging from 1 to 4.6 years. Among the bacterial isolates, Escherichia coli was identified as the most prevalent pathogen, followed by Klebsiella pneumoniae. Notably, 31.32% of the participants exhibited elevated serum CRP levels. Moreover, a statistically significant association was observed between elevated serum CRP levels and cases with Gram-negative bacterial etiology. Conclusion: Elevated serum CRP can serve as a valuable diagnostic marker for identifying pediatric bacterial meningitis cases with a Gram-negative etiology. The utilization of CRP as a diagnostic adjunct can aid in timely and accurate differentiation between bacterial and aseptic meningitis, facilitating appropriate clinical management and improved patient outcomes.

Background:  Tuberculosis is a specific infectious disease caused by bacteria belonging to the "Mycobacterium tuberculosis complex". It presents a great social and economic problem and is one of the major factors responsible for high morbidity and mortality in India. The incidence of tuberculous cervical lymphadenopathy accounts for two third of extra pulmonary tuberculous lymphadenopathy. Higher proportion of tuberculous origin is because of greater incidence of pulmonary tuberculosis in our country. Perhaps there are many other causes of lymphadenopathy which are usually misdiagnosed as tuberculosis. Thus, it has been a common problem for both the clinicians as well as the pathologists to diagnose tuberculosis. Methods and Materials: The present work is carried out in 100 clinically suspected cases of tuberculous cervical lymphadenitis attending E.N.T., Surgery, Paediatrics and Medicine Department of central India institute as an outdoor/indoor patient during the period of one year. Patients with enlarged cervical lymph nodes with a history suggestive of tuberculosis were included after taking an informed consent. Results: Study was conducted on 100 clinically suspected cases of tuberculous cervical lymphadenitis, Tuberculosis was diagnosed in 57% cases by FNAC, smear and culture together, the maximum incidence of tuberculosis was observed in second and third decades, Females were more affected (64%) than males with the ratio of 1:2.3. FNAC showed accuracy of 42%, 30% cases were AFB smear positive in our study which nearly matches to other authors. The culture studies could diagnose 57 cases as tuberculous and 4 cases as non-tuberculous cervical lymphadenitis. Culture positive was higher in granulomatous necrotic lesions. Sensitivity, specificity and predictive values of culture study were significantly higher than FNAC and smear. These methods of investigation require considerable experience and confidence of the pathologist who perform the procedure for better results. When culture was taken as Gold Standard, cytology was found to be more sensitive than smear. Conclusions: From this study we concluded that Both FNAC and smear are quick, simple, less traumatic and cost-effective methods and are used as routine investigating procedures in OPDs of urban and semi-urban hospitals. Simplicity of these techniques (FNAC & Smear) combined with early availability of results and good diagnostic accuracy warrants their clinical application. Missed cytological diagnosis and isolation of non-tuberculous mycobacteria justify the use of culture studies in all suspected tuberculous lymphadenitis cases.

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

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

Background: Vitiligo is an acquired disorder of the melanocytes characterized by depigmented macules and patches. The chronic, unpredictable course of the disease and the visible cosmetic disfigurement leading to social discrimination lead to a decline in the quality of life (QoL) of patients suffering from Vitiligo. Aims and objectives: This study aims to assess the impact of Vitiligo on the quality of life of patients using two questionnaires – Dermatological Life Quality Index (DLQI) and Vitiligo Quality of Life (VitiQoL). Materials and methods: All patients above the age of fifteen years presenting with Vitiligo were included in the study after taking written informed consent. Patients with any other co-existing debilitating disease or disability, psychiatric problems, systemic or personal conditions which might have an impact on the Quality of life (QoL) as well as pregnant and lactating women were excluded from the study. Socio-demographic data and detailed history regarding the symptoms, duration of disease, and treatment history was recorded. A thorough general physical, systemic, and cutaneous examination was done. Patients were requested to answer the questions of the DLQI questionnaire and VitiQoL questionnaire after clearly explaining the meaning of the questions to them in their preferred language. The answers were noted by the same dermatologist in every case. The DLQI and VitiQoL score was then calculated. The scores were evaluated and compared at the end of the study. Results: A total of 78 patients were included in the study in the age group of 15-78 years and the mean age was 34.6 ± 4.4 years. There were 46 males and 32 females included in the study and the male-female ratio was 1.4:1. According to the DLQI scores, a moderate effect was seen in 27(34.6%) patients, followed by a very small effect in 24(30.7%) patients, very large effect in 18(23%) patients, no effect in 6(7.6%) patients and extremely large effect in 3(3.8%) patients. The mean DLQI score was 7.8 ± 5. There were 19(24.3%) new patients, and 59(75.6%) patients already under treatment for vitiligo. The commonest type was non-segmental (generalized vitiligo) seen in 38(48.7%) patients followed by acro-facial in 14(17.9%) patients. Segmental vitiligo was present in 8(10.2%). The duration of symptoms was greater than one year in 44(58.9%) patients and the mean duration was 1.8 years. Around 21(26.9%) patients had patches of overexposed parts of the body and a family history of vitiligo in first–degree relatives was positive in 3.8% of patients. The VitiQoL score in our study had a mean value of 37.8 with a standard deviation of 4.2. Higher mean values were seen in questions pertaining to frustration regarding the disease (3.8± 2.4), fear of progression (3.3±1.9), and worrying about what other people might think of them (3.1±2.7). Conclusion: Vitiligo is a disease that is still significantly associated with tremendous social stigma which greatly impacts the personal, professional, and social aspects of the patient’s life. Understanding the degree of impairment that Vitiligo can have on the quality of life (QoL) of patients will help us understand the magnitude of the problem and thereby take adequate steps like treatment with psychological support as well as counseling, along with community awareness programs to improve the QoL of patients.

Background and Objectives: Community-acquired pneumonia (CAP) is a prevalent infectious disease with significant implications for the elderly's health worldwide. This study explores the potential of the Neutrophil Lymphocyte Ratio (NLR) as a biomarker for CAP. Methods: This diagnostic comparative study involved patients aged 18 and above with community-acquired pneumonia under care at a tertiary care hospital in India. Detailed history, clinical assessments, and lab investigations were conducted after obtaining informed consent. NLR, CURB-65 score, and PSI score were computed and statistically analyzed. Result: The study included 246 patients (mean age: 56.8 ± 15.9 years; 60.3% male, 39.7% female). Comparing mild, moderate, and severe risk groups showed significantly higher mean NLR in the severe group. Pearson's correlation revealed positive links between NLR and CURB-65 score, and PSI score. ROC analysis resulted in AUCs of 0.902 (NLR), 0.922 (CURB-65), and 0.931 (PSI), all significant (p < 0.05). Conclusion: Neutrophil Lymphocyte Ratio emerges as a significant biomarker for community-acquired pneumonia. NLR also correlates positively with CURB-65 and PSI scores, offering a simple and effective tool for outcome assessment in CAP patients.

• Objectives To predict the  risk  of amputation .
• Prognosticate diabetic foot ulcer healing & complications
• Average length of Hospital stay(ALOS)

Material and Methods: This Is Prospective Study Conducted In Belgavi Institute Of Medical Sciences Belgavi From 2018 Till 2020. Total of 90 Diabetic patients with diabetic foot ulcers irrespective of their duration, attending surgical outpatient clinic or admitted into the BELGAVI INSTITUTE OF MEDICAL SCIENCES BELGAVI were recruited into the study based on the inclusion and exclusion criteria. ulcers were followed up for a minimum period of 6 months. Once a patient’s ulcer had healed completely either by primary healing or skin grafting or a lower-limb amputation performed, the outcome was noted and the patient was deemed to have completed the study Results AND Interpretation: Most Of The Patients Were Male In Thr 5 N 6 Decade ,Scoring Done Using Duss Score 11% Requiring Major Ampuatation And 44 % Minor Ampuatation. With Increases In Duss Score Ampuatation Chances Are More. Conclusion: DUSS scoring system provides an easy diagnostic tool for predicting probability of healing or amputation by combining four clinically assessable wound based Parameters.

Background and Aim: Dyslipidemia is thought to confer risk of cardiovascular disease development. Overt hypothyroidism is associated with lipid abnormalities. As SCH is being diagnosed more frequently in young and middle-aged people, there is a need to know the effect of SCH on cardiovascular risk factors in young in tertiary centre in Gujarat, India. Therefore, the objective of this study is to analyze the relation between SCH and serum lipid parameters in this subgroup. Material and Methods: This observational study was conducted at Department of Medicine at Tertiary Care Institute of Gujarat, India in subjects diagnosed with Sub Clinical Hypothyroidism. Blood samples were drawn at early morning after an overnight fast in a sterile bottle. Serum was separated for the estimation of serum TSH, T3, T4, and total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), which were derived from TC and TG, using Friedwald's Formula [LDL = TC - (HDL + TG/5)], Very low-density lipoprotein (VLDL) derived from TG.. Lipid profile was compared with matched controls. Results: The levels of TSH are significantly higher in group II compared to group I, which is statistically significant. (p≤0.05) There is a significant increase in the serum TC level in group II individuals when compared to group I, which is statistically significant. (p≤0.05). There is also a significant increase in serum LDL Cholesterol in group II individuals when compared to group I individuals, which is statistically significant. Conclusion: Subclinical hypothyroidism (SCH) is associated with increased serum TC and LDL-C levels. Therefore, there is a potential association between subclinical hypothyroidism and atherosclerosis. Larger studies are needed to prove this association in Patients.

Background and Objectives: Chronic rhinosinusitis (CRS), a prevalent ENT condition, often presents treatment-resistant cases. Gastroesophageal Reflux Disease (GERD) causing Laryngopharyngeal reflux (LPR) is implicated in its etiology. This study aims to assess LPR prevalence in refractory CRS and the impact of combining proton pump inhibitors (PPIs) with functional endoscopic sinus surgery (FESS). Methods: 50 refractory CRS patients were evaluated, split into study (PPIs + FESS) and control (FESS only) groups in the Department of ENT at a tertiary care medical college in India. CRS indicators were assessed, and post-surgery, study patients received intranasal steroids and PPIs. A 3-month follow-up tracked symptom relief. Result: Majority of refractory CRS patients had LPR, mainly affecting the posterior larynx. Nasal obstruction, discharge, and polyps were common CRS indicators. Study group with PPIs showed greater improvement in symptoms, notably by the third postoperative month. Conclusion: The study highlights a significant link between refractory CRS and GERD. PPIs, when used alongside FESS, offer effective refractory CRS management, emphasizing combined treatment's advantages.

Objective: Malnutrition is a major problem in India as well as Madhya Pradesh. TB and HIV are the leading causes of morbidity and mortality in SAM children along with diarrhea and pneumonia. This study conducted to know the prevalence of pulmonary tuberculosis in SAM children. Study Design: A prospective observational study.  Setting: The present study was conducted in the NRC, Department of Pediatrics, M.G.M. Medical College, Indore, over a period of 18 months.  Participants/Patients: 429 SAM children of age 6-59 months were enrolled and screened for tuberculosis. Demographic, anthropometric, clinical history and investigation were done as per updated national guideline for pediatric tuberculosis and were analysed. Results: Out of 429 SAM children,53 diagnosed as PTB(prevalence= 12.3 %), prevalence of PTB were 11.2% in < 24 months then 8.8 % 25-60 months,12.7% were female then males(8.3%).Prevalence of PTB was found 11.6% in  W/H < -3SD, and 18.8% in group with MUAC < 11.5 cm, Malnutrition was found to be strongly associated with tuberculosis. The prevalence of PTB in BCG unvaccinated children was 57.7% while in vaccinated was 9.4% .85.7% had history of contact with tuberculosis then without history of contact 6.6%,31.82% TST were positive and 4.99% TST negative , 82 %  cases had positive chest x ray finding and only 1.1% had normal chest x ray,all found to be statistically significant.Total 16.9 % PTB cases were bacteriologically confirmed in our study. Conclusion: Every SAM child should be screened for tuberculosis, good quality X-ray,history of contact with TB, and TST should be available as an important tool and every effort should be made to diagnose tuberculosis by microscopy and culture, so that sensitivity of mycobacteria could be known.

Fine needle aspiration cytology (FNAC) has been established as the most preferable first line investigation for palpable breast lumps. Incidence of both benign and malignant breast lesions has been increasing in India in the recent times. Various predisposing factors have been attributed for the rapid surge of breast lesions. Materials & Methods: This study was carried out in the Department of Pathology, in the newly established Government Medical College and Hospital, Rajamahendravaram, Andhra Pradesh. A Total of 57 female patients presenting with palpable breast lump were subjected to FNAC procedure after taking history and doing general and local examination. Smears were prepared, stained and cytological diagnosis was made and reporting done by IAC (International Academy of Cytology), categories C1 to C5. Results: Most of the female patients presenting with palpable breast lump were in the age group of 31-40 years. The most common lesion diagnosed was Fibroadenoma. Malignancies formed 19.29% of all cases. Most of the lesions (71.95%) were in C2 category of IAC. Conclusion: FNAC is a fast and easily available technique to diagnose and differentiate between various benign and malignant breast lesions. It also guides the clinician for proper preoperative evaluation of patients.

Background: Reference values for serum Mg in adults are well defined but in paediatric patients and more specifically in newborn and preterm infants (lesser than 37 weeks gestation) reference values are either not available or are very limited and still controversial; most laboratories do not provide specific reference intervals for this population. Most of studies are done in preterm newborns exposed to prenatal MgSO4 and few studies done in preterm newborns who are not exposed to prenatal MgSO4 However there is no conclusive study from developing countries which elicits if the same reference interval is equally effective in the Indian population. The Indian women differ from those in developed country in terms of constitution, body surface area etc. which may influence the pharmacodynamic action and its effects in neonates. Aim: To assess serum magnesium levels in preterm newborn who were not exposed to prenatal MgSO4. Objective: We have done study to find out the normal serum magnesium values in preterm neonates at birth and to establish the relationship, if any, of these biochemical values with birth weight, gestational age and maternal BMI. Methods: Present prospective observational study was conducted at Level III b NICU of the Department of Paediatrics and Neonatology, Deenanath Mangeshkar Hospital and Research Centre Pune between January 2022 to December 2022. One hundred sixteen preterm newborns (lesser than 37 weeks of gestational age) were studied to estimate the normative data of serum magnesium level in preterm neonates not exposed to prenatal MgSO4 and its variation with gestational age and weight and maternal BMI. Results were analysed and interpretated. Results: In the present study the mean values of serum magnesium irrespective of birth weight, gestational age and sex were observed as –Serum magnesium 1.97±0.38 mg/dl. Conclusion: In conclusion, our findings add to the evidence that the there is consistent variation of serum magnesium level of preterm neonates who were not exposed to antenatal MgSO4 with respect to birth weight and gestational age and showed inverse relation with both factors. There was no correlation found between gender of babies and maternal BMI.

Background: Birth asphyxia is defined by the occurrence of hypoxia, hypercapnia, and acidosis, resulting in systemic disruptions, potentially including electrolyte imbalances, in newborn infants. The acquisition of knowledge pertaining to electrolyte disturbances is of significant worth, as it serves as a crucial determinant impacting perinatal morbidity, mortality, and the subsequent course of treatment. Material and Methods: The study described herein is a one-year prospective case-control investigation that took place within the Department of Pediatrics located in central India. A total of 80 newborns, consisting of 40 in the study group and 40 in the control group, were included in the study.The diagnosis of birth asphyxia was determined through the utilization of the APGAR score, while the diagnosis of hypoxic ischemic encephalopathy was established by employing the SARNAT staging system.The renal parameters, including serum creatinine, blood urea nitrogen (BUN), serum electrolytes from blood samples, and urine sodium and urine potassium from urine samples, were assessed in all the newborns. Results: Total 80 newborns out of which 40 were included in study group and 40 were included in control group. Out of 40 asphyxiated newborn 25(62.5%) were males and 15(37.5%) female. So there was higher incidence seen in the male babies. The BUN levels were 28+8.98 in the asphyxiated newborns as compared to controls who had BUN level was 20.3+2.65 and it was statistically significant. BUN level was higher among cases as compared to control and it was statistically significant.The mean serum creatinine levels were 1.7+0.29 in case group and 1.12+0.4 in control and it was statistically significant difference between both the groups. Conclusion: Perinatal asphyxia is an important cause of neonatal renal failure. Monitoring of blood levels of urea, serum creatinine, serum calcium and urine output helps in the early diagnosis and management of renal failure in birth asphyxia. Serum electrolytes levels and renal parameters had a linear correlation with severity of birth asphyxia.

Background: Chronic obstructive pulmonary disease (COPD) is a significant public health concern characterized by a rising global mortality rate. The association between obesity and heightened morbidity and mortality is widely recognized in the general population. However, in the context of chronic obstructive pulmonary disease (COPD), an intriguing phenomenon referred to as the "obesity paradox" has been observed. The assessment of nutritional status serves as a valuable prognostic indicator for individuals diagnosed with chronic obstructive pulmonary disease (COPD). Methods: A cross-sectional study was undertaken at a tertiary care hospital in Central India, involving a sample of 125 patients diagnosed with chronic obstructive pulmonary disease (COPD). The objective of the study was to evaluate the body mass index (BMI) of these patients using Quetelet's formula. The study participants were chosen through the utilization of a systematic random sampling technique. Results: The study findings revealed that the average body mass index (BMI) was recorded as 24.93±4.0. The health-related quality of life of individuals who are undernourished was found to be significantly impacted. A statistically significant association was observed among all the components of the St. George's Respiratory Questionnaire (SGRQ). Conclusions: The findings of the study revealed that individuals with malnourished chronic obstructive pulmonary disease (COPD) exhibited a notable decline in their health-related quality of life and experienced significant restrictions in their airflow capacity.

Sigmoid volvulus is a rare but potentially life-threatening condition caused by abnormal changes in the sigmoid colon surrounding the mesentery. The purpose of this article is to determine the trunk length of the unchecked S-bracket. Methods: This study was a case-control study conducted in two tertiary teaching hospitals in central India. Patients included patients 18 years of age or older with surgically proven sigmoid volvulus; controls included people aged 18 years or older who had undergone other surgeries that did not involve the colon, sigmoid, or rectum. Results: Intraoperative sigmoid measurements, including midsigmoid root width and midsigmoid length. Observations and results: A total of 30 cases and 30 controls were included. The sigmoid colon was longer and wider in the subjects than in the control group. However, mean sigmoid root width was similar between groups. These findings support that sigmoid torsion results from broad-based rotation of a long and wide midsigmoid colon. This is the first adequately controlled study to examine the anatomy of sigmoid torsion and provides strong evidence to confirm previous theories about the anatomical basis of sigmoid torsion.

Background: Chronic renal failure (CRF) is manifested by various skin symptoms. New changes have been described continuously since the advent of hemodialysis, which increases life expectancy and allows time for these changes to occur. Objective: The aim of this study was to determine the frequency of skin manifestations in chronic renal failure (CRF) patients receiving hemodialysis.  Methods: it was a cross sectional observational study in which skin changes were studied in a total of 500 CRF patientsreceiving hemodialysis attending dermatology OPD in a tertiary hospital in central India.  Results: 80% of the patients complained of some skin problems.However, at examination, all patients had at least one skin condition caused by CRF. The most common finding was xerosis (80%), followed by pallor (70%), itching (50%), and skin hyperpigmentation (40%). Other skin manifestations include Kell's disease (20%), fungal (40%), bacterial (15%),  purpura (10%) and dermatitis (2%). Nail changes include koilonychia (25%), onychomycosis (20%), subungual hyperkeratosis (10%), onycholysis (10%) and hemorrhages (5%), Mee’s line (5%), Muehrcke lines (5%) and Beau's lines (2%). Hair changes include thinning hair (35%) and brittle and dull hair (15%). Oral changes include striated macroglossia (40%), xerostomia (30%), ulcerative stomatitis (30%), angular cheilitis (15%), and uremic breath (10%). Some rare side effects of CRF have also been observed, such as uremic frostbite, gynecomastia, and pseudoKaposi's sarcoma.  Conclusion: CRF is associated with a complex set of cutaneous manifestations caused by disease or treatment. The most common are xerosis and pruritus, and early recognition of skin symptoms can reduce pain and morbidity.

Background: A lot has been investigated about how trimetazidine (TMZ); a metabolic modifier works at molecular level, however very little is known about how well that translates into mechanistic benefit at LV muscular level. This study was done to evaluate the effects of trimetazidine on the LV mechanics in patients of chronic stable angina. Material & Methods: Hospital based observational study, we followed 40 patients of chronic stable angina on conventional optimal medical therapy (OMT). LV mechanical indices including 2D Global Longitudinal Strain (GLS),4D Global Circumferential Strain (GCS),4D Global Area Strain (GAS), 4D Global Radial Strain (GRS), LVEF, E/A, E/e’ were measured at baseline and compared 1 month after addition of TMZ to OMT.  Results: The mean 2D GLS at baseline was -17.36 ± 3.09%, which improved to -18.33 ± 3.13% on follow up (P=0.001). The mean 4D GCS at baseline was -6.87 ± 3.41%, and -8.52 ± 2.69% on follow up (P= 0.003). The mean 4D GAS at baseline was-12.40 ± 5.90% vs -14.02 ± 4.38% on follow up (P= 0.017). The mean 4D GRS at baseline was 16.50 ± 7.81% vs 18.00 ± 6.76% on follow up, P =0.091(NS). The mean LVEF improved from 55.67 ± 5.46 at baseline to 57.62 ± 5.15 on follow up after 1month on TMZ therapy (P=0.001). The mean E/A value at baseline was 1.14 ± 0.39, which changed to 1.04 ±0.24 on follow up (P=0.038). The mean E/e’ value at baseline was 8.91 ± 2.50, which improved to 8.14 ±2.17 on follow up (P=0.008). Conclusion: TMZ has beneficial effects on the LV Mechanistic indices when added over and above the conventional OMT in patients of chronic stable angina.

Background: Different tonsillectomy techniques were adopted and improved to make the procedure safe and reduce operative time, intra operative blood loss, post-operative morbidity and complications. Aim & Objectives: To compare cold steel dissection and monopolar diathermy methods of tonsillectomy surgery in study population in terms of operative time, intra operative bleeding, post-operative pain and bleeding. Methods: This is a case control study done on 40 patients in Govt medical college hospital anantapuram in Andhra Pradesh India, between January 2023 to May 2023. Patients were randomly selected to have either the right or left tonsils removed by either technique (cold dissection or monopolar dissection technique). We compared both techniques in each side on the same patient. Results:There was no significant difference in operative time between both sides by either technique, Mean duration of surgery by cold steel dissection technique is 7 min while for monopolar cautery dissection technique is 3.96 min .The volume of blood loss in cold steel dissection technique from 2ml to 25 ml (Mean blood loss = 11 ml ) while in monopolar cautery dissection technique blood loss from 1 ml to 20 ml (Mean blood loss = 6 ml).Post-operative pain recorded separately two sides by visual analogue pain score, pain scores are more in monopolar cautery side in immediate post op period (6hrs after surgery). Pain is reduced gradually and second post-operative day the pain scores are almost same in both techniques. Conclusion: Monopolar diathermy method is a safe technique and when compared to CSD technique, MEC technique will take lesser time for performing the surgery & less intraoperative blood loss. Though MEC has more pain in immediate post-operative period when compared to CSD, after 48 hrs post-operative pain is the same for both the techniques.

Background: Uterine fibroid is a common concern  due to associated heavy menstrual bleeding and  anemia negatively affecting women's life. The prevalence of uterine fibroid in India is upto 20-30% in reproductive females. Though surgical treatment still remains the mainstay of the treatment, medical methods had evolved over the years with the advent of many effective oral drugs. Methods: This comparative, interventional study  conducted in the Gynaecological outpatient department of Nil Ratan Sircar Medical College and Hospital, Kolkata from March 2020 to August 2021. This study total of 21 patients in each group i.e. 42 women aged 20-50 years with leiomyoma uterus on USG who were fulfilling the inclusion and exclusion criteria were included in this study. Statistical data were analysed by using Microsoft Excel and SPSS V.20 software. Results: Age of the treated patients ranged between 33 to 50 years and maximum number of patients were in the age group between 41 to 45 years (40.5%). Maximum numbers of patients belonged to lower socioeconomic status; 38.1% and 47.6%. In both groups maximum fibroids were intramural in location; (61.9%) and (71.4%). Maximum number of patients had solitary fibroids (54.8%). Mean age of women in Mifepristone group & Ormeloxifene group were 39.76 ± 3.820 years and 41.48 ± 4.966 years respectively. The baseline mean Hb was 9.46 ± 0.45 gm% and 9.48 ± 0.39 gm% in the mifepristone group & ormeloxifene group respectively. The baseline mean PBAC score was 226.84 ± 28 and 213.16 ± 32.02 in the mifepristone group & ormeloxifene group respectively. The baseline mean fibroid size was 5.91 ± 1.54 cm and 5.38 ± 1.34 cm in the mifepristone group & ormeloxifene group respectively. The baseline mean fibroid volume was 72.43 ± 23.44 cc and 73.19 ± 21.56 cc in the mifepristone group & ormeloxifene group respectively. The baseline mean RI was 0.53 ± 0.16 and 0.58 ± 0.18 in the mifepristone group & ormeloxifene group respectively. The baseline mean ET was 7.03 ± 1.37 mm and 7.9 ± 1.87 mm in the mifepristone group & ormeloxifene group respectively. Conclusions: Mifepristone is more efficacious for the medical management of uterine fibroids as it significantly decreases the uterine fibroid size and volume along with reduction of menstrual blood.

Background: Corona virus disease 19 (Covid-19) was declared as global pandemic by WHO in March 2020. India has witnessed two waves of Covid 19 in the month of March 2020 and March 2021. Due to improper use of steroids in the treatment of these patients post covid mucormycosis patients had increased drastically in the second wave. This has taken a toll on physical and mental health alike. There is equally rise in the psychiatric comorbidities in post covid mucormycosis patients. Various disorders like Post traumatic stress disorder (PTSD), anxiety, depression, sleep disorders have been reported in COVID-19 survivors. Current study aims to estimate the prevalence of psychiatric disorders and its associated correlation in patients with mucormycosis. Methods: The study population comprised the patients referred to the Psychiatry outpatient department (OPD) of tertiary health care center from the post covid OPD over 6 months i.e. July 2021 to december 2022. Patients were assessed using a semi structured proforma, sociodemographic profile, treatment facility ( institutional or home quarantined), duration of stay at treatment facility, medical and psychiatric diagnosis were recorded and analysed using descriptive statistics. Results: 83 patients were included and assessed of which 78.3% were male and 21.6% were female. Mean age was 52.19 years. The referral rate was found to be 12%. Most common psychiatric disorder was sleep disorder (24%), followed by stress and trauma related disorder (15.6%), depression (12.04%), anxiety disorder (9.6%). Conclusion: The study emphasize on vigilant approach and constant supervision of these patients so that an early diagnosis could be made and an add on burden to mental health care system could be reduced.

Introduction:  TCA in craniospinal surgery needs special attention to detailed information on the morphology and morphometry of the occipital condyle and its surrounding structures. Although there is research on the morphometrics of OCs, the literature on their relationship to various foramina and canals is lacking. For neurosurgeons, the relationship between HC and OC is very important. Very sparse information was available on the shape of the OC, its length, and its relationship to HC in the central Indian population. Aims and objective: The aim of this study was to analyse the shape of the occipital condyle, its length, and the proportion of the hypoglossal canal to occipital condyle in the East Indian population. Materials and Method: The length of 160 condyles of 80 adult human skulls was measured as largest antero-posterior distance between anterior and posterior tip of the occipital condyles. This length was measured with the help of manual vernier calliper. Distance of posterior end of occipital condyle from external and internal opening of hypoglossal canal was also measured. Shape of occipital condyles and location of hypoglossal canal in relation to occipital condyle were assessed.  An unpaired t-test was done to compare the morphometric data. The P-value of less than 0.05 was taken as a measure of significance Results: The length of right condyle was slightly more but this difference was not significant. Length of occipital condyles ranged from 15 to 26 with average length of 20.93 on right and 20.52 on left. External and internal opening of hypoglossal canal were more nearer to right occipital condyle. 21.25 % of occipital condyles were of quadrilateral shape followed by S-like (18.12%) and two portioned (16.88%). Triangular and ring like shaped occipital condyles were least common. In 85% of the adult human skulls, hypoglossal canal extent was up to the anterior one-third of the occipital condyle.  Conclusion: The occipital condyle and related structures may exhibit morphometric and morphological changes. The preoperative evaluation, radiological examination and CT imaging are important for each patient who has to undergo a transcondylar approach for craniovertebral surgeries.

Background: Gestational Diabetes Mellitus (GDM) is a prevalent metabolic disorder during pregnancy, carrying significant health risks for both mothers and infants. Early detection and risk assessment are crucial for effective management. This study investigates the potential of first-trimester serum uric acid levels as an early predictor of GDM in pregnant women attending a tertiary care hospital in Uttar Pradesh, India. Material and Methods: A prospective cohort study was conducted, enrolling 500 pregnant women in their first trimester. Clinical data, including demographic information, medical history, and anthropometric measurements, were collected. Laboratory measurements of uric acid, fasting glucose, and insulin resistance indices were performed. Participants were followed throughout pregnancy, and GDM diagnosis was established using the standard oral glucose tolerance test (OGTT) during the second trimester. Statistical analysis included logistic regression, ROC curve analysis, and calculation of sensitivity, specificity, and predictive values. Results: Elevated first-trimester serum uric acid levels exhibited a significant association with GDM development. Participants with uric acid levels between 4.0 - 4.5 mg/dL had an odds ratio of 1.82 (95% CI: 1.51-2.21) compared to those with levels below 4.0 mg/dL, indicating increased GDM risk. Uric acid levels > 4.5 mg/dL showed a sensitivity of 85% but a specificity of 68%. Combining uric acid with traditional risk factors, such as maternal age and BMI, may enhance predictive accuracy. Conclusion: First-trimester serum uric acid levels are a potential early predictor of GDM. Elevated uric acid levels were associated with increased GDM risk, though specificity may benefit from a multi-factorial predictive model. This study underscores the clinical significance of uric acid in GDM risk assessment and highlights the potential for improved screening strategies.

Material & Methods: Study Design:  Hospital based prospective observational study. Study area: Department of Department of Gastroenterology, NRI Academy of medical sciences, China kakani, Guntur, Andhra Pradesh. Study Period:  6 months. Study population:  Patients admitted to the department of Gastroenterology with Acute pancreatitis. Sample size: Study consisted a total of 100 subjects. Sampling Technique:   Simple Random sampling. Routine investigations like Complete hemogram, Blood urea, Serum calcium and Serum amylase were performed. USG Abdomen was done routinely to confirm the diagnosis, for evaluation of the biliary tract and for detecting any complications. Contrast enhanced CT Abdomen was undertaken when the diagnosis was doubtful, when USG was not confirmative and when patient failed to improve beyond 72 hours of presentation. Results: In our present study 24% of patients presented   with   hyperglycemia, 16% had raised blood urea nitrogen (BUN), 27% had hypocalcemia, 14% had a WBC count of more than 15,000cells/mm3, and 11% of the patients had elevated AST levels. 89% of the patients had S.Amylase levels more than three times normal i.e.>240 IU/L. Conclusion: Acute pancreatitis is a frequent cause of an acute abdomen. In India, alcohol is the most frequent factor contributing to acute pancreatitis. Males are more likely to get the condition, and it typically manifests in the third decade of life. Biochemical and radiological results supplement the primary clinical diagnosis.

Background: Coronary artery disease (CAD) imposes a substantial global burden, with millions affected. It remains a leading cause of morbidity and mortality, straining healthcare systems and necessitating proactive prevention and management efforts. Aims and Objectives: The present study aimed to study the prevalence OF Coronary Artery Disease among young Indian adults. Materials and Methods: The present study included 100 non cardiac patients attending the General Medicine OPD of Osmania General Hospital, Hyderabad. After obtaining consent, all the patients underwent detailed history taking, thorough clinical examination and necessary investigations. Data was collected in MS Excel, analyzed and presented as tables and figures. Results: Equal numbers of male and female patients were present in the study. The patients considered for the study fell into two (2) age groups, 20 – 30 years and 30 – 40 years. Both the age groups had almost equal no. of patients. Dyslipidemia was the most common risk factor in our study with 38% of the study population being dyslipidemic, followed by Hypertension (23%), Diabetes (21%), Sedentary Lifestyle (18%), Smoking (13%) and Obesity (9%). Family History of CAD was noted in 6% of study population. Conclusion: The current research highlights a notable occurrence of coronary artery disease (CAD) risk factors among the urban population in India. Consequently, urgent action is necessary to promote awareness about these risk factors, enabling proactive management of individuals at heightened risk for CAD in the future.

Introduction: India's traditional culture of abstinence from alcohol is facing challenges with the rapid proliferation of alcohol-related establishments and changing lifestyle choices. Alcohol consumption is a growing public health concern globally, associated with various health issues and socioeconomic consequences. Despite its significant impact, alcohol misuse has not received adequate recognition as a public health issue in India. This study aimed to investigate the prevalence of alcohol consumption and its associated risk factors in the rural field practice area of RIMS, Raichur, which is an underexplored region in the context of alcohol use. Methods: A cross-sectional study was conducted over six months, starting in January 2022, and involving 512 individuals in the rural field practice area of RIMS, Raichur. A multistage proportional sampling method was employed, and a semi-structured questionnaire was used to collect data on socio-demographic factorsand alcohol-related behaviors. Participants aged 30 and above, residing in the study area for at least one year, and willing to participate were included. Pregnant women were excluded for ethical reasons. Results: The study found that 18.20% of the participants reported alcohol consumption, while 81.80% abstained from alcohol. Age, gender, occupation, and education were significant determinants of alcohol consumption. Individuals aged 30-40 had the highest prevalence of alcohol use (22.73%), with males being more likely to consume alcohol (14.61%) than females (3.59%). Unskilled workers (10.32%) and illiterate individuals (14.04%) had higher rates of alcohol consumption. The study also revealed associations between alcohol use and health-related factors such as diabetes (51.9% prevalence among participants with diabetes), tobacco use (48.23% prevalence among tobacco users), BMI status, and physical activity levels. Conclusion: This study contributes valuable insights into the prevalence and risk factors of alcohol consumption in a rural context, shedding light on the extent of alcohol use in this underrepresented region. The findings emphasize the need for targeted public health interventions and policies to address the specific challenges posed by alcohol use in rural India. Understanding these patterns can help promote responsible alcohol use and mitigate potential health and social consequences in rural communities.

Background: COVID -19 pandemic had great impact on the day to day life of people and healthcare, including orthopaedic clinical practice.  The World Health Organization declared COVID-19 as a pandemic on 11 March 2020. Due to this, not only in India but also in the western countries a lot of confusion in patient management and decision making was noted. Aims: In this study we intend to aware the orthopaedicians and healthcare staff about the pandemic situation in future by learning the experiences of the COVID-19 pandemic through literature for better patient management.  Methods: This was a retrospective study aimed to see the impact of COVID-19 pandemic 2020 on orthopaedic practice with previous year 2019. The effects of COVID -19 pandemic on various clinical parameters like outpatient numbers, indoor patient admissions, management options conservative and surgery were revealed. Results: Total OPD cases in 2019 were 29700 and in 2020 were 6500. Total admissions in 2019 were 2690 and in 2020 were 855. The number of orthopaedic surgeries done in the time period of 2019 and 2020 were 1660 and 483 respectively. The surgical procedures were reduced in the year 2020 by 70.90%. Maximum reduction seen in the lockdown period  was 87.7%. Conclusion: The study concluded that in Pandemic and disaster like situation decision making is an important step. Conservative treatment should be done as much as possible. Elective surgeries postponed and emergency surgeries to be continued by keeping all safety measures.

Background: Oral cancer is a significant public health concern in India. This longitudinal study aimed to assess the incidence, risk factors, causative microorganisms, and outcomes of postoperative infections among oral cancer patients in a tertiary medical college in India. Data were collected from patients undergoing surgical treatment for oral cancer over a defined period. The findings shed light on the prevalence of infections and can guide the development of preventive strategies and optimize postoperative care for this vulnerable patient group. Methods: it was a longitudinal observational study in which a total of 600 patients who were operated for oral cancer attending dental OPD in a tertiary hospital in Indiafrom September 2022 to August 2023 were studied and followed up. Results: A total of 600 patients who underwent surgery for cancers of the oral cavity during the study period of September 2022 to August 2023 were followed up. SSIs were noticed in 60 (10%) post-operative cases. This included 42 (70%) incisional SSIs and 18 (30%) organ/space SSIs. Culture of the surgical site in 60 infected patients yielded a total of 120 isolates. 15 patients (25%) had polymicrobial infections. Gram-negative bacterial isolates (70%) outnumbered gram-positive bacterial isolates (30%). Majority of the patients (48 patients—80%) were in stage IV disease. Successful management of patients with bacterial infections depends on early identification of bacterial pathogens and selection of an effective antibiotic against the organism. Judicial use of antibiotics is also very essential to prevent the development of drug resistance.

Material & Methods: Study Design: Prospective hospital based observational study. Study area:  The study was carried out in the Department of General surgery, B.J Government Medical College and Sassoon general Hospital, Pune. Study Period:  1 year. Sample size: study consisted of 55 subjects. Sampling method: Simple random Sampling Technique. Study tools and Data collection procedure: The following protocol was followed • Clinically and radiologically (by Mammography) suspected cases of locally advanced Ca breast were enrolled for the study after informed written consent. • Histopathological diagnosis was made by FNAC. • In the cases where FNAC was not conclusive, tru-cut biopsy was done • Once histopathological diagnosis was confirmed estrogen and progesterone receptor status was found out by immunohistochemistry. • Clinical stage IIIa and IIIb i.e locally advanced breast cancer (LABC) patients were considered for the further study (total number of patients was 55). Results: A total of 18 (29%) patients had clinical complete response (CCR) of these 16 patients, only 10 patients (62.5%) had a correlating pathological complete response (pCR). In our study. 53 (90-4%) patients had an infiltrating ductal carcinoma while 2 had infiltrating lobular carcinoma. Majority (94 29%) of the patients had an infiltrating ductal carcinoma. Conclusion: The current study reveals that clinical assessment of response to NACT has higher sensitivity than radiological assessment, but the overall poor sensitivity and specificity rates of clinical assessment need the search for a better way of evaluation.

Background -Children and young people are most often killed and disabled by accidents. Blunt trauma accounts for more than 90% of traumatic mechanisms of injury in children. Blunt abdominal trauma accounts for between 10 and 15% of all blunt mechanisms. The establishment of the present non- operative treatment for the majority of blunt solid organ injuries in the pediatric age group was prompted by observations that most blunt solid organ injuries will heal on their own and that surgical intervention would thwart this mechanism Aim: this is a prospective observational study done in department of pediatrics surgery in north india institute from January 2022 to July 2023. The aim of this study is to determine the management of solid organ injuries in blunt trauma abdomen (BTA) in children how to diagnose radiologically whether to conserve or operate at tertiary health care center in high patient load hospital in India.  Methodology: 116 patients with blunt abdominal trauma due to any cause, the medical records of all patients with trauma of any kind age up to 13 years were carefully reviewed. The injured organ, patient age, sex, injury grade, imaging findings, intervention, length of hospital stay, and complications were prospectively reviewed using medical records. Initial resuscitation was done according to ATLS protocol. Ultimate management decision was based on stability of patients after resuscitation. Data was entered and analyzed through SPSS-26. Chi- square test and student's t-test were applied and P value <0.05 was considered statistically significant. Results: The mean age was 5.34 years. Most of the patients suffered from road traffic accident, 50(86.2%). 104 (89.65%) patients showed free fluid in the abdomen. CT abdomen with intravenous contrast confirmed findings of ultra sonography. Despite resuscitation, 12 (10.6%) patients remained unstable and were operated. 104 [89.4%] patients were kept on conservative treatment. Hospital stays ranged from 5-19 days. Pancreatic injury patient has more hospital stay. Conclusion: BTA is common in boys under age of 10 years. Although non-operative management is the treatment of choice in blunt trauma abdomen with solid organ injury but stability of the injured child is the central pivot around which the whole management revolves. Delay in presentation and failure of timely resuscitation results into high operative intervention.

Cardio pulmonary resuscitation has been one of the most performed life-saving interventions in any acute care setting across the globe. However, CPR (cardiopulmonary resuscitation) itself has been known to cause serious thoracic and intra-abdominal complications. The aim of this manuscriptis to describe the clinical presentation, diagnostic challenge we faced, highlight the potential of missing the diagnosis if not looked in to specifically, and outcome of a patient who developed intra-abdominal bleeding after CPR. We performed a literature search and found only scanty number of cases of intra-abdominal haemorrhage after CPR reported and none from India to our knowledge. There is no study found on this especially in the kyphoscoliosis patient.

Our main finding was that we noticed severe pallor, increasing perihepatic ascites on USG after return of spontaneous circulation with noticeable fall in Haemoglobin trend in a previously normal USG scan of the abdomen.

Our manuscript highlights the importance of recognizing intra-abdominal bleeding as a potential complication of CPR. Our case illustrates the need for a high index of suspicion, prompt imaging, and aggressive management of this life-threatening condition.

Background: It has recently been demonstrated that vitamin D, long thought to be a hormone that regulates calcium and phosphate, is essential for the treatment of a number of non-skeletal illnesses, including cardiovascular disease. Numerous research have been conducted on the connection and potential causal involvement of vitamin D in cardiovascular diseases and the well-known risk factors associated with them. There aren't many research conducted in this region of the world, though. This study's primary goal was to measure the 25-hydroxyvitamin D levels in heart failure patients. Methods: This was a institute based Observational Cross Sectional Study, done at General Medicine Ward, Department of General Medicine, Burdwan Medical College and Hospital, West Bengal, India, from March 2021 to May 2022. Total 100 patients with heart failure and fulfilled the inclusion criteria were included in this study data were entered into a Microsoft excel spreadsheet and then analyzed by SPSS (version 27.0; SPSS Inc., Chicago, IL, USA) and Graph Pad Prism version 5. Result: In present study maximum participants 57 (57%) were from the age group of 61-80 years. Mean age of the participants was 65.38±13.7656l. In our study, 46 (46.0%) patients were Normal BMI, 14 (14.0%) patients were Obese BMI and 40 (40.0%) patients were Overweight BMI. In the present study 100 (100%) of the participants had Exertional Dyspnoea followed by PND and fine crepts 79 (79%) each. Vitamin D ≤30 was present in 88 (88%) off study population and >30 was present in 12 (12%) of study population.  Conclusion: In our study we found that 88 out of 100 study participants were Vit D deficient. It was also found that, 25(OH) Vit D levels had negative correlation with LVEF

Background: In the West, coronary heart disease, or CHD, is the main cause of mortality. Young people experiencing an acute myocardial infarction (AMI) is comparatively rare. Nevertheless, it remains a significant issue for both the patient and the attending physician. There are few studies of risk factors of coronary artery involvement in AMI in young adults, so the purpose of the present study is to identify the risk factors for acute myocardial infarction in rural India. Methods: This was an institute based Observational Cross Sectional Study, done at General Medicine Ward, Department of General Medicine, Burdwan Medical College and Hospital, West Bengal, India, from May 2020 to July 2021. Total 100 patients admitted with AMI during this period meeting the inclusion and exclusion criteria were included in this study. A Microsoft Excel spreadsheet containing the data was used for data entry, and SPSS (version 2710; SPSS Inc., Chicago, IL, USA) was used for analysis. Result: In the present study mean age of patients was 35.21 ±4.39 years, majority of patients belonged to age group of 36-40 years (56%). The mean BMI was 27.23 ±3.34 kg/m2. The most common presentation was chest pain (90%) followed by profuse sweating (65%), radiation to left shoulder/arm (45%), nausea/vomiting (40%), anxiety (38%), breathlessness (28%). Most common risk factor was smoking (85%) followed by hyperlipidemia (82%), family history of premature coronary artery disease (72%), hypertension (52%), sedentary lifestyle (42%), psychosocial stress (38%), obesity (16%) and diabetes mellitus (14%). Majority of the study subjects had more than 3 risk factors (64%), while 21% had 3 risk factors, 13% had two risk factors. Mean level of cardiac enzyme marker CKMB was 38.42 ±5.67 IU/L. Conclusion: Acute MI in young patients is becoming a rising problem in Indian subcontinent which is more common in men. Smoking was the most common risk factor of MI in them indicating atherosclerosis could be the commonest cause followed by dyslipidemia.

Background and Aim: Diastolic heart failure is a common yet difficult to identify condition. The study's goal was to investigate and link NT-proBNP levels with four classes (grade I to grade IV) of diastolic dysfunction as measured by echocardiography. All patients underwent a thorough clinical examination, blood biochemistry, electrocardiography, chest X-ray, echocardiography, and plasma NT-proBNP testing. Material and Methods: The current study was carried out on 50 DHF patients enrolled from outdoor and indoor patients in the Department of Medicine, Tertiary Care Teaching Institute of India over a one-year period. Clinical assessment and echocardiography were performed on the patients. The autoanalyzer was used to estimate NT-proBNP utilising the electrochemiluminisense method. Echocardiography was used to classify patients into different levels of diastolic dysfunction. Results: The mean levels of NTproBNP in individuals with systemic hypertension were statistically significant (p0.05) higher than in non-hypertensive patients in the current investigation. NT-proBNP levels were observed to be statistically greater in LVH participants compared to those without LVH. (p≤0.05) In the current study of 50 patients with diastolic heart failure, 36 patients (72%) had grade I diastolic dysfunction, 9 patients (18%) had grade II diastolic dysfunction, 3 patients (6%) had a grade III diastolic dysfunction, and 2 patients (3%) had a grade IV diastolic dysfunction. Conclusion: Serum NT-proBNP levels give reliable diagnostic accuracy for detecting diastolic heart failure, and they correlate well with increasing degree of diastolic dysfunction as measured by a well-established modality of echocardiography. In symptomatic individuals, NT-proBNP can accurately detect the presence of isolated diastolic dysfunction and is a valuable diagnostic for ruling out patients with impaired exercise tolerance of non-cardiac origin.

Hereditary angioedema (HAE) is an autosomal dominant disease due to C1 esterase inhibitor deficiency (C1-INH). Patients present with non-pruritic subcutaneous and sub mucosal edema in the absence of urticaria in the first or second decade of life. Even though the disease causes significant morbidity and mortality, the diagnosis is often late or even completely missed. Diagnosis of HAE is made by assessing C1-INH levels in blood. In a populated country like India, the disease prevalence would be high. This case series emphasizes the importance of early diagnosis and prompt treatment of a potentially fatal disease.

Introduction: For centuries, alcohol use has been a significant social and health issue globally. based on a January 2015 WHO report.Each year, alcohol abuse leads to 3.3 million fatalities. Economic position, cultural background, educational attainment, physical and psychological health, geography, religion, and other environmental conditions are just a few of the elements that have been found to have an impact on alcohol consumption patterns. India’s alcohol consumption varies greatly by area. Alcoholic liver disease (ALD) can present with steatosis, liver cirrhosis, or any combination of these symptoms. Cirrhosis or hepatitis only affect 15–25% of long-term heavy alcohol users. Materials and Methodology: The Inpatients Department of General Medicine at PGIMER & CH, Bhubaneswar, Odisha, India, is the site of this hospital-based observational questionnaire study. Every hospitalised patient with liver illness at our facility who has ever used alcohol was tested. After obtaining their informed consent, the patients were questioned. Patients and their families were requested to provide a thorough personal and family history. Every patient's use of alcohol, including native alcoholic beverages, was recorded and converted to an average weekly gram intake. To confirm the diagnosis, every standard examination as well as supplementary research were conducted. The patient's data was gathered using a pre-made proforma. Including the specifics such age, gender, marital status, employment, yearly income, eating habits, drinking pattern, age at which drinking began, and amount of time spent drinking. The modified Kuppuswamy Scale was used to assess socioeconomic class. Results: The research comprised 186 patients, with a median age of 46 years. Of them, 139 (74.7%) were men, and the male to female ratio was 3:1. Compared to rural populations (39.24%), urban populations have a higher prevalence of alcoholic liver disease (60.75%). Alcoholic liver disease affects people in the Lower Socioeconomic Class (50.53%) more than in any other group.  Men consume alcohol at higher rates (>700 gm/wk), and married individuals use alcohol at significantly higher rates. When a female consumes 140–280 grammes of alcohol per week for ten to fifteen years, she is at a significantly earlier risk of developing alcoholic liver disease than a guy who consumes more than fifteen years of alcohol at a rate of >700 grammes per week. Conclusions: The research comprised 186 patients, with a median age of 46 years. Of them, 139 (74.7%) were men, and the male to female ratio was 3:1. Compared to rural populations (39.24%), urban populations have a higher prevalence of alcoholic liver disease (60.75%). Alcoholic liver disease affects people in the Lower Socioeconomic Class (50.53%) more than in any other group.  Men consume alcohol at higher rates (>700 gm/wk), and married individuals use alcohol at significantly higher rates. When a female consumes 140–280 grammes of alcohol per week for ten to fifteen years, she is at a significantly earlier risk of developing alcoholic liver disease than a guy who consumes more than fifteen years of alcohol at a rate of >700 grammes per week

Introduction: Adverse drug reactions (ADR) are an important aspect of drug therapy and can be a major setback in clinical practice. An ADR is defined by the World Health Organization (WHO) as ‘a response to a medicine which is noxious and unintended, and which occurs at doses normally used in man. The safety of drugs used in patients of an adult age group cannot be extrapolated to a pediatric age group. The pharmacokinetics and pharmacodynamics of many commonly used drugs vary significantly between these two age groups of patients2.  Adverse drug reactions (ADRs) in children can have a relatively more severe effect when compared to adults. Thus, the ADRs can lead to significant morbidity among children.3 An increase in the number of drugs and self-medication with various medications have enhanced the occurrence of adverse drug reactions in recent times, especially in pediatric population. Material & Methods: This was a prospective, observation based, non-interventional study was Conducted in Dept. of Pediatrics, SCB Medical college and SVPPGIP, Cuttack which are two institutions under one department. This Department is a tertiary care center for pediatric patients in our state. Our institution is an approved ADR Monitoring Center (AMC) under Pharmacovigilance programme of India (Pvpi). ADRs were confirmed by the clinicians based on temporal relationship between start of drug and reaction, withdrawal of drug leading to decrease severity or abolition of reaction (dechallenge), exclusion of other causes etc. Sensitization of doctors in various seminar were done for spontaneous ADR reporting in Suspected Adverse Drug Reaction Reporting Forms by health care professionals. Results: Out of total 350 cases, dermatological system was most commonly involved i.e. 207 cases (59. 14%).This is followed by involvement of central nervous system 46 number of cases (13.14%). The GI system was involved in 34 cases i.e. (9.71%). Most of the ADRs were due to Antibiotics, these drugs are involved in 198 (56.57%) cases. Commonest antibiotics causing ADRs were Ofloxacin involving 26 cases (13.13%) of antibiotics followed by Ceftriaxone and cefixime comprising 22 cases (11.11%) and 14 cases (7.07%) respectively of total antibiotics used. A single drug as a possible causative agent of ADR,177 such cases were reported which constituted 50.57% of the total ADRs. Sometimes these agents were used with other drugs but Dechallenge test ruled out the probability of other drugs involvement. Out of 177, 110 drugs caused ADRs when used alone i.e. 31.4 % drug reactions were caused by monotherapy. Conclusion: Our study showed varied range of ADRs with higher reports in male children compared to females and maximum reports of ADRs obtained in age group 5-10 Years. Dermatological ADRs have highest incidence out of all the ADRs and FDE is most frequent among dermatological ADRs. Antibiotics were the commonest suspected agent in the reported ADRs. This study also exposed high occurrence of over-the-counter prescription to the pediatric age group causing ADRs (20.87%) of total ADRs and 12% of total serious ADRs. Incidence of serious ADRSs were more where multiple drugs were the suspected causative agents of ADRs. Various atypical ADRs were also observed due to active monitoring. Hence this study further emphasizes the need of proactive Pharmacovigilance, restriction of over-the-counter medications and increasing awareness among health care professionals, patients and public, for rational use of antibiotics, avoiding multidrug therapy and FDCs to reduce the incidence of ADRs especially in pediatric age groups.

Brucellosis, a major health problem in developing countries, is a zoonotic disease with multisystem infection with a broad spectrum of clinical manifestations. We present a 48-year-old man diagnosed to have brucellosis in our hospital who was admitted through the emergency department with the chief complaint of fever for 25 days, generalized myalgia for 3 weeks, and decreased appetite associated with weight loss of 4-5 kg in a month. Fever was mild to moderate with the intermittent spikes and that subsided with paracetamol. There was no history of chronic cough or cold, joint pains, rashes, nausea or vomiting, urinary symptoms or bleeding manifestations. The blood culture grew out Brucella melitensis. He responded well to combination therapy consisting of doxycycline and beta lactam antibiotics. He recovered fully without relapse during the one-month follow-up.

Introduction: India is the second most populated country in the world, with children under the age of 14 making up around 28.6% of the total population [1]. Children under the age of five make up 20% of India's population. It has been shown that children's mortality and morbidity are inversely correlated with their age. The national average for U-5, newborn, and neonatal death rates is 50, 41, and 29 per 1000 live births, respectively, according to NFHS 4[1]'s most current figures.Twenty-one percent of U-5 child mortality occur in India alone. The purpose of Millennium Development purpose 4 (MDG4) is to reduce the rate of under-five mortality by 66% from 1990 to 2015.Neonatal causes account for 4% of U-5MR cases worldwide, followed by pneumonia (17%), diarrhoea (9%), malaria (7%), and other conditions such as meningitis, AIDS, measles, and injuries (24%). Malnutrition is a factor in 45% of U-5 mortality. These death rates serve as sensitive gauges for more than just health.Material and Method: This observational study was conducted in a tertiary care teaching hospital from November 2018 to October 2020 on 28 days to 5 years old children admitted in pediatric ward. Before enrolling the patient, the inclusion and exclusion criteria are applied and Institutional Ethical Committee approval was taken. Informed consent was obtained from the parents.All the information about the diseased child, demographic characteristics, feeding status, immunisation, socioeconomic status was recorded. Nutritional status of the patient and anemia status was recorded and detailed study of disease profile and cause of mortality were recorded in the case record sheet, all children of both sexes, aged 28 days to 5 years, admitted in the pediatric ward of the teaching hospital and parents willing to participate in the study, were included.  Result:Hence, it is possible that the prevalence of malnutrition might vary depending on the criterion used. The study conducted by Kamran Ahmad et al. found a noteworthy correlation between feeding practises and malnourishment. There is a noteworthy correlation between them in children under five, according to several research conducted in hospitals and communities. Families, especially mothers, need to be made aware of the nutritional needs of their children and how to provide a healthy meal at home using inexpensive, readily accessible foods. It is the responsibility of healthcare professionals to advise parents on the value of family planning, birth spacing, vaccinations, exclusive breastfeeding until the child is six months old, and when to wean their child.Conclusion: Present study concludes pneumonia is the leading cause of death i.e. (30.5%) followed by CNS infection (27.7%), malaria (19.4%), diarrhea (11.1%) respectively.Similarly the morbidity of under- five hospitalised children are the conditions like pneumonia (32.5%), malaria (16.7), CNS infection (16.4%), diarrhea(12%) respectivelyMorbidity and mortality in under- five children are more associated with malnutrition. Maximum number of cases in hospitalised under five children are having moderate acute malnutrition (i.e. 49.5%) and severe acute malnutrition in 13.7% cases. Among the mortality maximum percentage of cases (72%) are having MAM and 14% of cases having SAM.

Background: Cardiovascular disease (CVD) has become a major public health problem and leading cause of mortality in developing countries. Cardiovascular risk assessment approach is feasible and cost-effective tool, which helps to identify those at high risk for developing CVDs. so that immediate preventive measures or action can be taken to reduce the risk. Aim: The present study was conducted to assess the CVD (myocardial infarction or stroke) risk by utilizing the WHO/ISH risk charts (non-cholesterol based/ noninvasive chart) in a tribal population of Nasik, India. Methods: This was a cross-sectional community-based study conducted in the rural health training center of the tertiary Healthcare Institute Nashik on 110 participants. The WHO/ISH risk prediction chart for South-East Asia Region D (SEAR D) was used for calculating the 10-year cardiovascular risk. Results: Among total 110 study participants, 83 (75.5%) were in the mild-risk (<10%) category. The 10-year risk of myocardial infarction and stroke is comparable among both sexes (Male- 24.4%, female – 25%), type of occupation (Farmer 24.4%, Non-farmer group – 24.6%), and educational status (Up to secondary level – 25%, above secondary education – 23.3%). Risk factors such as advancing age, three generation family, Tobacco addiction, Family History of Diabetes, Stress, high blood pressure (Both SBP & DBP) and raised random blood sugar level were found to be significantly associated with increased risk of the major cardiovascular event. Conclusion: WHO/ISH chart is a best useful tool in identifying CVD risk. This can further help in planning and implementing targeted interventions amongst identified high risk population in tribal population.

Introduction: Diabetes mellitus is one of the common non-communicable diseases in India. Dyslipidemia is also associated with diabetes mellitus. Role of vitamin D is described in diabetes mellitus in multiple studies owing to its facilitation/inhibition of transcription factor and immune-modulator property. Aim: to evaluate association of vitamin D level with parameters of fasting lipid profile. Methods: It was an analytical observational case study. Patients of type 2 diabetes mellitus were included in the study. All routine lab parameters were done. Statistical analysis was done by pearson correlation test, fisher’s exact test and ANOVA. Linear regression analysis was also done. Results: 119 patients were included in the study. Vitamin D deficiency was found in 77 patients (64.71%). Negative correlation was present between vitamin D level and HbA1c. Vitamin D deficiency was found to be significantly associated with high HbA1c (p = 0.024). Furthermore, Negative correlation was found between vitamin D level and total cholesterol (r = -0.0134, p = 0.8987), serum triglyceride (r = -0.0310, p = 0.7690) and serum LDL (r = -0.0149, p = 0.8873). Positive correlation was present between vitamin D level and serum HDL (r = 0.0296, p = 0.7782). On ANOVA test, mean values of serum triglyceride in vitamin D deficient, vitamin D insufficient and vitamin D sufficient groups were 206 ± 147.3 mg/dl, 152.78 ± 64 mg/dl and 147.84 ± 72.6 mg/dl respectively. (p = 0.0510), near significant association was found between vitamin D deficiency and increased serum triglyceride level. Conclusion: Vitamin D deficiency in type 2 diabetes mellitus is associated with poor glycemic control. Vitamin D deficiency in type 2 diabetes mellitus may be a risk factor for dyslipidemia.

Introduction: As of 2011, India has a population of 1.21 billion people. It is the second most populous country in the world, next only to China. In absolute numbers the population of persons above 60 years was around 76.62 million in 2001, will rise to nearly 179 million by 2031 and 324 million by 2050. In addition, as people age there are increased chances of becoming disabled, and once disabled, there are increased chances of deterioration with decreased likelihood of recovering from disability. AIM: To assess the Geriatric Morbidity pattern, Activities of daily Living (ADL) and Mini Mental Scale Evaluation (MMSE). Methodology: A Cross sectional study with multistage random sampling technique was used to select the requisite number of elderly for a sample size of 600. Results: Mean age of the study population is 66.9 with SD ± 5.73 years ranging from 60 to 88 year. Multi-morbidity was seen early in nearly 70% the study population, this seems to increase with increasing age which ranged from 57.4% to 85.3% and this association was statistically significant (p value = 0.002). The total morbidity in the study population was found to be 96.3%. Conclusion: Curative medicine has a very limited role to deal with the problems of elderly in terms of impairments and diseases. Palliative care is needed to tackle impairments and complications of NCDs.

Background: Coronary artery disease (CAD) poses a significant global health challenge, particularly affecting the elderly population. This study aims to investigate the socio-demographic aspects of acute coronary syndrome (ACS) in elderly patients aged 75 years and above in the eastern region of India, specifically in Odisha. Methodology: The prospective observational study was conducted at the Outpatient Department (OPD) of VIMSAR Medical College and Hospital, Sambalpur, Odisha. A total of 182 consecutive patients aged over 75 years and diagnosed with ACS underwent routine coronary angiography/percutaneous coronary intervention. The study focused on documenting demographic and angiographic profiles, as well as the distribution of various coronary artery disease risk factors. Results: Male patients constituted the majority of the population, comprising more than two-thirds of the total. The average age of enrolled patients was 81.02 ± 3.35 years. Geographically, the majority of patients were from the district of Sambalpur (41.2%), followed by Sundargarh (26.9%), Debagarh (17.6%), and Bargarh (11.5%). The incidence of CAD was higher in urban/semiurban areas compared to rural areas. Smoking showed a significant association with the diagnosis of ST-elevation myocardial infarction (STEMI). Discussion: The study sheds light on regional variations in the socio-demographic profile of elderly patients with ACS in Odisha. The observed higher incidence in urban/semiurban areas emphasizes the impact of lifestyle on cardiovascular health. The significant association of smoking with STEMI aligns with broader literature, emphasizing the need for targeted interventions. Conclusion: The study provides essential insights into the socio-demographic factors associated with ACS in the elderly population of Odisha. Tailored interventions and public health strategies informed by these findings have the potential to reduce the burden of CAD in this vulnerable demographic. The study addresses a critical knowledge gap, contributing to the holistic management of CAD in the specific context of Odisha.

Background: Hypokalemia, a common electrolyte disorder, poses substantial risks to various organ systems, necessitating effective identification of its underlying causes. The association between hypokalemia and hypomagnesemia, prevalent in clinical studies, underscores the need for comprehensive exploration in diverse populations, including limited Indian data. Methodology: A cross-sectional descriptive study was conducted at MKCG Medical College and Hospital, Berhampur, involving 154 participants aged 18 and above with hypokalemia (serum potassium <3.5 meq). Serum magnesium levels were analyzed (defining hypomagnesemia as <1.7 mg/dl) from August 2021 to November 2022. Statistical analysis employed R software, encompassing t-test, chi-square, and Pearson correlation. Results: Among 154 subjects (78 females, 76 males, mean age 45 +/- 09 years), the mean magnesium and potassium levels were 1.5825 and 2.8265, respectively. Hypomagnesemia occurred in 61.7% of hypokalemic patients. The mean magnesium levels for hypomagnesemia and normal magnesium groups were 3.1158 and 2.77, respectively. No significant correlation (p = 0.102) was observed between hypokalemia and hypomagnesemia. Discussion: Our findings indicated a higher frequency of hypomagnesemia in hypokalemic patients. Variations in reported associations between magnesium and potassium levels among studies highlight population heterogeneity. The discussion emphasizes the role of magnesium deficiency in exacerbating hypokalemia and underscores the importance of timely recognition and treatment. Conclusions: Hypomagnesemia is prevalent in hospitalized patients with hypokalemia, emphasizing the necessity for increased clinical awareness. Larger-scale investigations are recommended to explore the interconnected occurrence of these disturbances and evaluate the clinical utility of routine magnesium measurement in hypokalemic patients. Further research with expanded cohorts is encouraged for a comprehensive understanding of electrolyte imbalances.

Background: Scorpion envenomation is a potentially fatal public health risk in tropical and subtropical places around the world. [1] However, morbidity and mortality from venomous animal bites or stings have received little attention in poor nations, including India. This is evident in the absence of a system for reporting venomous bites or stings. Objectives: 1. To study the clinical presentation, course, complications and outcome of scorpion sting envenomation. 2. To study the epidemiology and circumstances leading to scorpion sting in the community. Material & Methods: Study Design:  Hospital based prospective cross-sectional study. Study area: The study was conducted in the Department of Paediatrics. Study Period: 1 year. Study population: All the children admitted for scorpion sting into hospital.  Sample size: Study consisted a total of 54 subjects. Sampling Technique:  Simple Random technique.Study tools and Data collection procedure: On admission, a detailed clinical history, including the time of sting, symptomatology, details of treatment received before admission was taken. Further a description of the scorpion and details about the circumstances leading up to the sting were obtained. All the patients were subjected to a detailed clinical examination at admission and at frequent intervals thereafter, as was necessary in each case. Hourly monitoring of heart rate, respiratory rate, blood pressure, urine output, cardiovascular and respiratory status was done. Results: Commonest complications were, peripheral circulatory failure, pulmonary edema, Myocarditis and Congestive cardiac failure (15% of cases). One child developed popliteal artery thrombosis 76 hours after admission to hospital. Three patients presented with Encephalopathy, two of whom had massive pulmonary edema and succumbed within 5 hour of admission. One child had left sided hemiparesis and encephalopathy, secondary to Left MCA territory infarct with mild pulmonary edema. Conclusion: In India, cardiovascular complications are most common and life threatening. However, anticipation and close monitoring for other uncommon complications is critical for effective management. Prazosin has revolutionized the management of scorpion sting envenomation. Administration of prazosin, as early as possible, is probably the single most effective intervention for preventing complications following scorpion sting.

Background: As we all know that Stroke is becoming an important cause of disability and premature death in low-income and middle-income countries like India, affecting largely the poorer sections of the society driven by demographic changes and enhanced by the increasing prevalence of the key modifiable risk factors which impoverish their families further. Therefore, our study was planned to evaluate the risk factors and their prognostic value in patients of ischemic stroke in our setup? Research Question: What are the risk factors and their prognostic value in the patients of ischemic stroke?The setting of the study was at department of General Medicine, Government General Hospital, Government Medical College, Machilipatnam, Andhra Pradesh. A one-year observational study was conducted during the period from October 2022 to September 2023 on about 100 Ischemic Stroke cases admitted during the above period in the department of General Medicineby studying their socio-demographic profiles, associated risk factors, assessment of the degree of severity in association with risk factors, clinical course and outcome, etc. Results: Among the total study subjects 61% were male and 39% were female and it was observed that the distribution of the disease was more as age advances and it was also noticed that the severity of the disease was more among males when compared to females. Among all the study subjects 55% had hypertension followed by 45% had diabetes mellitus, 34% had history of smoking, 26% had history of regular alcohol intake, 23% had dyslipidemia, 13% had heart disease, 6% had hypercoagulable states,10% had history of TIA, 6% had history of migraine, 3% had history of OC pills usage and 2% had family history of stroke. Hypertension, Diabetes and smoking were the common risk factors present in the majority of the study subjects. Regarding the outcome of the disease the disability and mortality was more among the study subjects who had hypertension and diabetes when compared to non-hypertensive and non-diabetic study subjects significantly(P<0.001).

Objective: Electrical storm (ES) carries a high mortality rate even with current advancements in care. There are limited data about clinical characteristics, risk factors and etiologies of ES from India.  We aim to report the clinical profile and risk factors related to ES from a tertiary care hospital in southern state of India. Methods: This is a retrospective, single center observational study done in the Department of Cardiology & Electrophysiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research (SJICSR), a tertiary care medical center in Bengaluru, Karnataka. The data collected from medical records of patients presenting with ES from year October 1, 2022-September 1, 2023. Hospital medical chart of all patients who had received ES diagnosis were reviewed for demographic data (age, gender), clinical data (comorbidities, presenting symptoms), lab (complete blood counts and inflammatory markers), Electrocardiogram (ECG), echocardiography data and treatment options (medical and / or surgical). Other parameters assessed included type of procedure patient underwent. Results: A total of 29 ES were identified with mean age of 55.4±14.6 years, predominantly male population. The most common risk factor seen in this patient sample was prior history of MI (58. 6%).Post MI scar VT was the predominant etiology found in 18(72%) patients in our study. MMVT was the predominant form seen in 24 (82.7%) patients with RBBB morphology the dominant pattern on ECG. Cardiac imaging was done in 8 (27.5%) patients. The majority of patients were on amiodarone as the anti-arrhythmic drug of choice, while propranolol and ramipril were the most common beta blockers and RAAS inhibitors prescribed in our study population. In addition to standard care, radiofrequency ablation was performed in 5 patients and cardiac sympathetic denervation (CSD) was done in 2 patients only.  Overall 17 (58.6%) patients died. When compared with patients who survived, presence of severe LV systolic dysfunction had trend towards higher mortality. Conclusion: The study population of ES of southern state of Karnataka is characterized by middle age population with hypertension, tobacco consumption and diabetes as the prominent risk factors. ES portends a high mortality in acute settings particularly in patients with severe LVSD.  There is a considerable scope of taking initiatives to improve patient outcomes in ES.

Introduction: Breast cancer is second most common cancer all over the world and is one of the leading cancers among women. It has high prevalence rate in developed as well as developing nations. In 2018, there were estimated over 2million breast cancer cases. Its incidence is rising rapidly in developing world due to change in lifestyle, urbanization, increased life expectancy and influence of western lifestyles. The accumulated evidence suggests that breast cancers are preventable and highly suitable for secondary prevention. But in rural areas and small towns, there is still lack of awareness of breast cancer as well as health care services. The aim of present study was to know the epidemiology and clinical presentation of breast cancer among the women from rural area of Karnataka. Materials And Methods: A hospital based cross-sectional study was carried out among newly diagnosed cases of breast cancer. Present study was conducted at tertiary care hospital which provides the diagnostic as well as the therapeutic cancer services and referral services to many private and public health care institutions from neighboring regions. All newly diagnosed cases of breast cancer i.e. within study period, irrespective of age and stage of breast cancer. The Study was conducted over a period of 1st January 2018 to 31st December 2019. The sample size included total 150 newly diagnosed cases of breast cancer during study period. Results: In the present study the age of the patients ranged from 11-70 years. The meanage was 35.09 years. The youngest patient’s age was 11 and the oldest patient’s agewas 70 years. The mean age of the patients was 26.89 years for benign lesions and50.27 years for malignant lesions(Table1). Two Patients in age group 31-40 and two patients in age group 61-70presented with lesions in bilateral breast. Hence total 150 patients with 154 breastlumps(lesions) are included in present study.The maximum number of patients in our study were in the age group of 21-30years (30.5%) followed by 31-40 years (22.7%). The socio demographic parameters of the study population. There was association between clinical stage of at 1st hospital visit and patient's educational status. Proportion of patients having localized tumour was more in literate patients than illiterate Conclusion: Rural residence, poverty, ignorance, traditional practices, low women literacy and lack of health care services can affect stage at diagnosis and treatment of breast cancer. The increasing burden of breast cancer in Indian women warrants rigorous epidemiological actions in the form of arranging screening programme in rural area for early detection of breast cancer and prompt treatment to reduce the mortality due to breast cancer.

Background: Transcatheter Aortic Valve Implantation (TAVI) in a nonagenarian is a challenge and is usually performed under Monitored Anesthesia Care (MAC). Combining TAVI and Percutaneous Coronary Intervention (PCI) is associated with an increased risk of mortality. In this case report, we explore the challenges and strategies involved in successfully performing concomitant TAVI and PCI in a nonagenarian patient with Acute Decompensated Heart Failure (ADHF) and concurrent delirium under General Anaesthesia (GA). Notably, there are no documented cases in the existing literature that mirror the intricacies of this case, making it the first reported instance under GA in India.

Introduction: Psoriasis is a chronic skin ailment which can be connected with an increased occurrence of other illnesses, including the metabolic syndrome. Materials and Methods: A Cross-Sectional Study of a total of 100 patients visiting the Outpatient Department of Dermatology and Venereology of at Nalanda Medical College and Hospital in Patna, for psoriasis was done. The parameters included were age at onset of disease, current age, sex, type of disease, and distribution of lesions. Data and statistical analysis were done. Results: most common age of presentation between 18-43 years, there was a predominance of males, with a male-to-female ratio of 2.41:1, service class affected most followed by business people and house wifes respectively. addiction present in 80% cases and family history positive in 28% subjects. Majority cases were of moderate to severe PASI in our study. Metabolic syndrome was diagnosed in 21 out of 100 cases and 20 out of 100 controls (p-value: 1.000). We did not find any association of psoriasis with metabolic syndrome in our study. Conclusion: Our study refuted any association of psoriasis with metabolic syndrome at the onset of disease activity in Indian patients. The plenty of reports from west approving such an association can be explained by increased risk factors like smoking, alcohol consumption, obesity and stress levels. Further, most such studies have been conducted with patients on treatment, while ours is the study on newly diagnosed patients prior to the initiation of any therapy.

Introduction: Thyroid disorders, affecting approximately 42 million individuals in India, pose significant public health concerns. This study focuses on determining the prevalence of undetected hypothyroidism and associated risk factors among adults in Odisha, India. Methods: A cross-sectional study at SLN Medical College, Odisha, involved 970 participants aged 20-70 years. Demographic data, symptoms, and TSH levels were recorded. Regression analysis assessed risk factors, and Anti-TPO antibodies were tested in a subset. Results: Undetected hypothyroidism prevalence was 16.8%, higher than previous studies. Females exhibited a higher prevalence (19.1%) than males (10.2%). Regression analysis identified gender and symptoms as significant correlates. Anti-TPO positivity was 94.8% in subjects with elevated TSH. Discussion: The prevalence increase suggests a growing health concern. Regional variations and environmental factors, including thyroid disruptors, demand further investigation. The impact on reproductive health emphasizes the need for early detection. Conclusion: Undetected hypothyroidism remains a prevalent issue in Odisha, with autoimmune factors playing a substantial role. Addressing this condition is crucial for enhancing population health and productivity.

Background:Neonatal sepsis contributes significantly to neonatal morbidity and mortality and is a major public health challenge around the world.Evidence regarding its risk factors can guide clinical practice and prevention strategies. Aims and Objectives:To assess the prevalence of Sepsis and to identify the Risk factors for the Neonatal Sepsis in the unit. Patient and Methods:  A prospective observational study was planned in Neonatology Unit including Neonatal Intensive Care Unit [NICU] and Special Newborn Care Unit [SNCU] of Sri Venkateswara  Ramnarain Ruia Government General Hospital [SVRRGGH], Tirupati for a period of 1 year from the time of approval of Institutional Scientific and Ethics Committees of Sri Venkateswara Medical College, Tirupati i.e., April 2021 to March 2022. All neonates were screened and followed up. A predesigned proforma was utilised to record the observations during the study. Results: Out of 2265 admissions during study period, 471(20.72%) neonatal sepsis and 25.26% mortality has been observed. 43.9% were with Probable Sepsis. Sepsis was more seen in Male patients (56%), premature babies (64.3%), outborn (57.8%), early onset (55.6%), low birth weight babies(61.3%), CRP positive(60%), average hospital stay of 11-20 days(69.6%) and mostly discharged (74.8%). Conclusion: The neonatal sepsis and its mortality are more in the present study. Male, premature babies, low birth weight, outborn , multiple vaginal examinations, premature rupture of membranes are the predominant risk factors of Sepsis. Robustly designed Surveillance and research are the key to reduce the burden of Sepsis.

Introduction:  Dengue virus is the most common Arbovirus in India. It is transmitted by female mosquito-Aedes aegypti. It is a major public health problem world-wide, especially in tropical and sub-tropical areas and presenting as acute febrile illness. In present study we aimed to compare results of NS1 antigen test and IgM Antibody ELISA in clinically suspected dengue fever patients. Approximately 100-400 million dengue cases occur every year according to World Health Organization (WHO). Hence early diagnosis of dengue is essential to prevent complications and mortality. Materials and Methods: A total of 188 cases with clinically suspicious of dengue fever from the OP/IP patients with <9 days fever were included in the study. Blood samples were collected from all the cases under aseptic conditions. Serum was separated by centrifugation and subjected to detection of dengue NS1 antigen and IgM antibodies by ELISA. Results - Out of 188 samples, 46(24.5%) were positive for dengue infection.  Out of 46(24.5%), NS1 antigen was detected  in 14 (30.5%) samples, IgM antibody was detected in 8 (17.4%) samples, both NS1 &  IgM antibody were present in 24 (52.2%) samples. The sensitivity and specificity of NS1 antigen - 87.5% & 82.5%, for IgM - 80%&79.7%, for NS1 antigen + IgM antibody - 92.3% and 87.6% respectively. Conclusion: NS1 ELISA test method is an effective method for early diagnosis of dengue fever. Early detection is more important to prevent complications of Dengue. The combination of NS1 Ag test and IgM Antibody test by ELISA assay offers most sensitive and cost effective diagnostic tests in India.

Menstrual hygiene is a topic that has long been shrouded in silence and stigma, but in India, it has emerged as an urgent public health concern that demands our immediate attention. The lack of access to proper menstrual hygiene management not only affects the well-being of millions of Indian women and girls but also has far-reaching consequences for their health, education, and overall quality of life.¹Menstruation is a naturally unfolding biological process that takes place in adolescent girls and women of reproductive age.²

In a country as diverse as India, where cultural norms, traditions, and socioeconomic disparities vary widely,³ addressing menstrual hygiene requires a multifaceted, integrated approach. Here, we shed light on the critical aspects of this issue and the imperative need for a unified strategy to combat the menstrual hygiene crisis in India.

Introduction: The most common cancer among women in the last 20 years has been cervical cancer. In India, the age range of 55 to 59 is when the incidence of cervical cancer peaks.Every eight minutes, a woman in India loses her life to cervical cancer. Concurrent chemotherapy and radical radiation therapy are the accepted standards of care for advanced cervical carcinoma.Combining teletherapy and brachytherapy is a common practice.One form of teletherapy is whole-pelvic radiotherapy, which uses external beam therapy to treat the primary tumor and then uses brachytherapy and regional lymphatics to increase the gross tumor in the cervix. However, in the event that this treatment is successful, there is a possibility that the bladder, rectum, and small intestine will inadvertently be exposed to normal tissue radiation. Aims:The purpose of this study is to determine whether less toxicity results from lowering the dose in small bowl, prone-positioned urine bladders during pelvic radiotherapy. Materials and methods: Prospective randomizedly allocated control study from January 2017 to January 2018 Patients visiting at Radiotherapy department Out door of Nilratan Sirkar Medical College and Hospital,Kolkata-700014. Result:V20, V30, and V40 for the urinary bladder (UB) did not significantly differ between the two positions, according to our findings (p > 0.05). However, UB V45 demonstrated a notable difference (p = 0.9), while UB V50.4 indicated a statistically significant variance (p = 0.021), indicating higher radiation exposure in the supine position. UB Dmean and total volume did not exhibit substantial differences (p > 0.05) and Regarding the rectum, V20, V30, V40, and V45 showed no significant variation between positions (p > 0.05). However, rectum V50.4 indicated a significant difference (p = 0.004), implying higher radiation exposure in the prone position. Rectum Dmean and total volume did not display substantial differences (p > 0.05). Conclusion:In conclusion, our study revealed varied radiation exposure in prone versus supine positions. The urinary bladder indicated higher exposure in supine (V50.4 p = 0.021), while the rectum exhibited increased exposure in prone (V50.4 p = 0.004). Overall, patient positioning significantly influences organ-specific radiation doses.

breast cancer accounts for 14% of cancers in Indian women. It is reported that in every four minutes, an Indian woman is diagnosed with breast cancer. Vitamin D deficiency is assumed to be one of the risk factor for breast cancer. Objective: To study the association between vitamin D and risk of breast cancer among postmenopausal women.  Methodology: This was an observational cross sectional study.About 74 females of known breast cancer and 74 healthy females were evaluated. Appropriate statistical analysis was done to find association between vitamin D deficiency and risk of Breast Cancer. Our study demonstrated that number of subjects with Vitamin D level below 20 ng /dl i.e Vitamin D deficiency from the cases, in age group 41 to 50 years are 11, in the age group of 51 to 60 years were 39, in the age group of 61 to 70 years are 19, and in the age group of more than 70 years were 5 in number. The statistical difference between vitamin D levels, in patients having breast cancer and patients not having breast cancer was highly significant (p value 0.0001), showing the strong association between decreased vitamin D level and breast cancer in postmenopausal women. Conclusion: Our study showed that vitamin D and levels were inversely associated with risk of developing breast cancer. Vitamin D helps in prevention of cancer by reducing inflammation, anti-apoptotic, and anti-proliferative property. Vitamin D supplementation are needed in premenopausal women in order to reduce the risk of breast cancer in peri and post menopausal women

The escalating prevalence of Type 2 Diabetes Mellitus (T2DM) globally necessitates a deeper understanding of its complex metabolic interactions, particularly concerning homocysteine, a known cardiovascular risk marker. This study aims to elucidate the role of homocysteine in the management of hyperglycemia in T2DM patients. Conducted as a cross-sectional study at Osmania Hospital, Hyderabad, India, it involved 30 T2DM patients without prior cardiovascular disease (CVD) complications and 30 age and sex-matched controls. Participants were subjected to comprehensive blood analyses to measure homocysteine, HbA1C, fasting, and post-lunch blood sugar levels. The study employed an independent sample t-test to determine significant differences in these biochemical parameters between T2DM patients and controls, with a significance threshold set at <0.05 and <0.001. Additionally, Pearson Correlation tests were applied to assess the relationship between homocysteine levels and the glycemic profile of the participants. The findings of this study are pivotal in understanding the interplay between homocysteine and hyperglycemia in T2DM. They offer insights into the potential role of homocysteine in T2DM management and its implications for cardiovascular risk in these patients. The results are expected to contribute to the evolving landscape of T2DM management, highlighting the importance of considering homocysteine levels in the holistic care and treatment strategies for T2DM patients. This study not only adds to the existing body of knowledge but also opens avenues for future research in this domain, particularly in developing targeted interventions for better management of T2DM and associated risks.

Vasculitis is a clinico – pathological entity involving all organs. Despite being reported widely, the triggering etiology for the disease appears to be broadly unknown. Emerging evidence linking immunological, infectious, environmental and genetic causes are being increasingly studied with focus on Infectious agents including viruses, bacteria, fungi and parasites. Case series: Here in we assessed three autopsies demonstrating histopathological evidence of vasculitis seen in various organ systems. Relevant clinicopathological details such as demography, course in hospital, gross and microscopic reports were retrieved from the hospital medical records, reviewed and analysed. In two cases vasculitis was observed against a backdrop of fungal infection with the organs affected being the cerebrum in one and lungs of both cases. The third case demonstrated vasculitis of the coronary arteries in a patient with a known history of tuberculosis. Conclusion: The aim of the cases series was to highlight the importance of infections in causing vasculitis in the demographic set up of India along with the need to consider infection – related vasculitis when faced with diagnostic conundrums. Early stage vasculitis are often clinically silent. Hence, early signs of infections should make one vary of vasculitis as a potential complication, thus direct the investigation panel and therapeutic modalities accordingly to prevent fatal outcomes of the disease.

Introduction: Men, especially as they age, are more prone to specific genitourinary conditions compared to women. This study aimed to estimate the prevalence and identify correlates of chronic renal failure, incontinence, and kidney stones among men aged ≥45 years in India. Methods: Data from the first wave of the Longitudinal Ageing Study in India (LASI) wave-1, 2017-2018, were utilized. The sample included 33,097 men aged ≥45 years. Descriptive statistics reported prevalence with a 95% confidence interval. Multivariable regression analysis assessed associations between socio-demographic and behavioral factors with chronic renal failure, incontinence, and kidney stones. Results: The overall prevalence was 0.82% (95% CI: 0.71-0.93) for chronic renal failure, 3.02% (95% CI: 2.82-3.23) for incontinence, and 3.0% (95% CI: 2.79-3.20) for kidney stones. Multivariable regression analysis revealed that participants aged ≥75 years had higher odds [AOR: 1.91 (95% CI: 1.34-2.44)] of experiencing incontinence. Kidney stones were significantly associated [AOR: 1.88 (95% CI: 1.53-2.55)] with obesity. Conclusion: A noteworthy prevalence of chronic genitourinary conditions among aging men was observed, emphasizing the need for attention. The recently established Health and Wellness Centres (HWCs) offer a potential avenue for timely care, warranting further strengthening.

Background: In the tropics, scrub typhus is a growing health risk. Acute meningoencephalitis, enteric fever, Kawasaki disease, and dengue can all have similar clinical characteristics. Early intervention and a high index of suspicion help to avoid mortality and morbidity. The preferred medications are Doxycycline or Azithromycin, both intravenous and oral. Aims and objectives: The aim of thepresent study was to present clinical manifestation, laboratoryfindings and treatment outcomes of pediatric scrub typhus ina tertiary care setting. Methods: The present study was prospective observational study. A total of 45 cases detected with positive for Scrub Typhuswere includedin the study. Study was conducted from May to October 2023 in the Department of Paediatric Medicine, RG Kar Medical College, Kolkata, West Bengal, India. Statistical data were analysed by using Microsoft Excel and SPSS V.20 software. Results: A total of 45 cases were detected to be positive for Scrub Typhus. Their age ranged from 1½years to 12 years, mean being 7 ½ years. There was no sex predilection, 21 (47%) were male and 24 (53%) were female. Fever was the chief complaint in all of them. During hospital stay, the average temperature recorded was 101ºF. Eighteen cases presented with exanthematous fever. The rash was erythematous maculopapular, mostly appearing in the limbs and sometimes over the trunk. Eschar was found only in ‘5’ cases case even after thorough searching. Other findings include organomegaly, generalized lymphadenopathy and constitutional symptoms. Conclusion :Scrub typhus do exist around Kolkata in the suburban and rural areas. Hence awareness is very important. They need to be detected early by high index of clinical suspicion and screening test followed by rapid onset of treatment by Azithromycin and Doxycycline.

Background: Despite recent advances in obstetrics, perinatal, and neonatal care, multiple pregnancies continue to be among the riskiest conditions for the mother, fetus, and neonate. Compared to singletons, twin pregnancies have higher rates of obstetric and perinatal complications. The objective of present study was to compare the neonatal outcome of the first twin with that of the second twin delivered by vaginal route. Methods: The present study was prospective observational study. A total of 90 women with twin pregnancies more than 28 weeks of gestation were included in the study.  Study was conducted from July2021toJune2022 in the Department of Pediatric and Gynae& Obstetrics, Burdwan Medical College, Burdwan, West Bengal, India. Statistical data were analysed by using Microsoft Excel and SPSS V.20 software. Results: The age of the mothers ranged from 18-36 years with the mean age being 24.7±3,86 years. The incidence of twin deliveries was highest among 25-30 years Mean weight of 1^st twin was 2.02 kg ± 0.420 kg and mean weight of 2^nd twin was 2.0 kg ± 0.430 kg.Most women delivered twins vaginally, 72.22% (n=65) for first twin and 63.33% (n=57) for the second twin. Preterm labour was the most common complication constituting 71.11% followed by anaemia, hypertensive disorders. RDS is the most common neonatal morbidityconstituting 14.44%. for the first twin and 15.56% of the second twins which resulted in the need for ventilation.The mean 1 minute APGAR scorewas 7.46±1.67 for the first twin and 6.24±1.65 for the second twin. The comparison of 1 minute APGAR. score between first and the second twin was found to be statistically significant.Conclusion :It was observed in the study that the neonatal mortality and morbidity is encountered with preterm twin delivery, so its prevention, diagnosis and treatment are must. 

The norms for maximum aerobic capacity available are with respect to Western population. India is a tropical country with a diverse population with respect to several aspects such as height, weight, stature, nutritional status, socioeconomic conditions etc.as compared to Western population. The present study was carried out to determine the norms for maximum aerobic capacity in healthy young Indian male population aged 18-25 years deduced from a linear relationship between heart rate and oxygen consumption. The Queen’s College Step test was chosen for the study due to its lower height of the steps and slower cadence which are suitable for the young Indian male population as already established by earlier studies.

Introduction: As of 2011, India has a population of 1.21 billion people. It is the second most populous country in the world, next only to China. In absolute numbers the population of persons above 60 years was around 76.62 million in 2001, will rise to nearly 179 million by 2031 and 324 million by 2050. In addition, as people age there are increased chances of becoming disabled, and once disabled, there are increased chances of deterioration with decreased likelihood of recovering from disability. AIM: To assess the Geriatric Morbidity pattern, Activities of daily Living (ADL) and Mini Mental Scale Evaluation (MMSE). Methodology: A Cross sectional study with multistage random sampling technique was used to select the requisite number of elderly for a sample size of 600. Results: Mean age of the study population is 66.9 with SD ± 5.73 years ranging from 60 to 88 year. Multi-morbidity was seen early in nearly 70% the study population, this seems to increase with increasing age which ranged from 57.4% to 85.3% and this association was statistically significant (p value = 0.002). The total morbidity in the study population was found to be 96.3%. Conclusion: Curative medicine has a very limited role to deal with the problems of elderly in terms of impairments and diseases. Palliative care is needed to tackle impairments and complications of NCDs.

Background: Diabetes mellitus is associated with metabolic, cellular and blood changes.Hematological changes have been reported in diabetes and believed to play a major role in diabetes-associated complications. However, reports are contradicting and data on erythrocyte indices in patients with type 2 diabetic patients in the study area are scarce. In the present study we attempted to determine the relation between Erythrocyte Indices with glycemic status in Type 2 Diabetes Mellitus (T2DM). Materials and methods: In this cross sectional, observational study we studied lab reports of 234 patients who attended the outpatient department and admitted as inpatients in a tertiary care hospital over a period of three months. The study group had 170 patients with, and control group had 64 age and sex matched controls. Random blood glucose, glycated hemoglobin (HbA1c) and Erythrocyte Indices includingHemoglobin (Hb), Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin Concentration (MCHC), Mean Corpuscular Hemoglobin (MCH), Packed Cell Volume (PCV), Red Cell Distribution Width (RDW), and Red Blood Cell (RBC) count were measured. Results: Our study revealed no significant differences in majority of erythrocyte indices among T2DM cases and controls. However, there was statistically significant difference in RDW (13.40±7.25 fL vs 23.86±15.53 fL, p =0.0001) between T2DM cases and controls. T2DM, patient with poor glycaemic control (HbA1c ≥ 6.5 gm%) had higher Hb compared to T2DM with good (HbA1 <6.5 gm%) glycaemic control (13.74±2.13 vs 12.79±2.64, p=0.0249). Patient with RBS ≥200 mg/dl had higher Hb compared to patients with RBS <200 mg/dl(14.2±2.3 vs 13.1±2.3, p= 0.0029). Hb and RDW showed significant positive correlation (r=0.1889, p=0.01362) with RBS. Conclusions: The present study shows variations of erythrocyte indices in diabetic patient compared to controls. Hence, haematological changes should be evaluated in all T2DM for effective therapeutic intervention 

Background: Supraclavicularbrachialplexus blockis used for providing pain relief in upper limb surgeries and has manyadvantagesovergeneralanaesthesia.Alpha-2-adrenergicagonists are chosen with local anaesthetics for their sedative,analgesicand antihypertensive properties. Aim : To  evaluate  the  effects  of  clonidine  and  dexmedetomidine  in  combination  with  ropivacaine  on  peripheral  nerves  during  brachial  plexus  block. Methods :The present study was prospective  comparative  observational  study. A total of 58patients admitted in orthopaedics ward scheduled for upper limb surgeries fulfilling the requisite criteria were included in the study.  Study was conducted from August 2022toSeptember2022 in the Department of orthopaedics, Burdwan Medical College, Burdwan, West Bengal, India. Statistical data were analysed by using Microsoft Excel and SPSS V.20 software. Results :The mean age of the patients was 31.5 ± 4.2 years in Group C and 33.1 ± 3.9 years in Group D. There were 22 males (37.93%) and 7 (12.07%) females in Group C and 19 males (32.76%) and 10 females (17.24%) in Group D. Group D showed less time for the onset of sensory and motor blocks and more time in duration for sensory and motor blocks. The duration of analgesia was longer in Group D. Comparison of complications showed that, bradycardia and hypotension were found more in Group C than Group D. The vital parameters were comparable in both the groups. Conclusion :Dexmedetomidine prolongs the duration of sensory and motor block and enhances the quality of block as compared with clonidine when used as an adjuvant to ropivacaine in supraclavicular brachial plexus block.

Background: Neonates are at higher risk for the development of seizures due to various reasons, however diagnosis of neonatal seizures is difficult to establish because of varied aetiologies involved. Seizures are one of the most common risk factor for neonatal mortality and subsequent long term neurological sequelae.  Objectives: To evaluate the clinical profile and aetiology in relation to onset of neonatal seizures in tertiary care centre Methods: This was a hospital based Cross-sectional, observational study done in a Neonatal ICU of Department of Paediatrics, Old Government General Hospital, Siddhartha Medical College, Vijayawada, AP, and India. The study was conducted over a period of 1 year from April 2021 to March 2022. Based on inclusion and exclusion criteria, 100 neonates were found eligible.   Parents of all these 100 neonates provided informed consent to participate in the study. They were evaluated with necessary investigations, EEG for incidence, aetiological factor, and clinical types found in neonatal seizure. Results:  Out of 696 NICU admissions during study period, seizures occurred in 100 neonates. Demographic profile of maternal population shows in table-1. 46% of women were aged 25 to 30 years at the time of delivery. 15% of mothers gave a history of infections. This indicates that NS occurs in a few cases due to maternal infections.  Other maternal risk factors found that 10% of mothers had gestational diabetes mellitus, 5% had placental abnormalities, 2% had cord prolapse, and 6% had pre-eclampsia. 3% had previous neonatal seizures babies. 58% of neonates were males in the current study. There is significant association between gestational age and outcome, as per chi square analysis (P=0.0001). There is significant association between birth weight and outcome, as per chi square analysis (P=0.0001). Conclusion: To conclude it is of utmost important to improve antenatal and perinatal care of pregnant women to reduce the incidence of birth asphyxia, which was the most common cause of neonatal seizure in our study.  To reduce morbidity and death from neonatal seizures, we recommend early genetic screening for newborns.

Introduction: Ulcers that do not heal spontaneously through the standard, orderly, timely sequence of repair or on conventional treatment and those persist for more than 6-12 weeks are called as chronic non- healing ulcers. This is a significant health problem and is estimated to affect approximately 2-6 million people in the United States, while its prevalence in the world ranges from 1.9 to 13.1%. The incidence increases with age. 75% of chronic non- healing ulcers are venous ulcers, and the rest is by other causes in comprehensive data. In tropical countries like India, there is a lack of data. A study from one center in India suggests leprosy (40%), diabetes (23%), venous disease (11%), and trauma (13%) as the cause of non healing ulcers. Materials And Methods: This is a Prospective study conducted in the Dermatology Venereology and Leprosy at Tertiary Care teaching Hospital over a period 1 year.All the patients attending to the OPD of Dermatology Venereology and Leprosy who were suffering from chronic non-healing ulcers and satisfying the inclusion and exclusion criteria became the part of the study after taking written consent.patient is explained about the procedure in detail in the local language, and consent is obtained. Results: In this study, out of 30 patients included, the majority of patients are between 46 and 50 years (43.3%), and the mean age of the patients observed was 55.1 years. In this study, out of 30 patients majority were females 16 (53.3%) when compared to males 14 (46.7%).In the present study, the mean area measurement of the ulcer after each sitting of PRF at the end of every week is calculated and it showed a reduction in the mean from 6.068 to 1.729 by the end of 5th week and attained a p-value of <0.001 which is highly significant.In this study, out of 30 patients, the mean percentage improvement in the area of the ulcer at the end of the 5th week is 91.81%. Conclusion: This study authenticates the use of Autologous platelet rich fibrin therapy in the treatment of chronic non-healing ulcers by showing significant improvement in both the size of the wound and the quality of life, vowing to its safety and a being less expensive procedure associated with no or minimal side effects. 

Background:  The present study evaluates the comparative analysis in patients with diaphyseal fractures of the humerus in the adults operated with dynamic compression plating and intramedullary interlocking nailing with focus on their functional outcome results using DASH score and complications. Materials and methods: The present study was conducted at the Department of Orthopaedics, Government general Hospital, Rangaraya medical college, Kakinada, Andhra Pradesh, India for, a period of two years. The study subjects consisted of n = 38 adult patients of fracture shaft of the humerus with indications for surgical management. Results: Among n = 38 subjects, n = 10 (26.31%) cases showed excellent results, n = 12 (31.57%) good, n = 10 (26.31%) fair and n = 6 (15.78%) poor results. Among n = 10 subjects with excellent results, n = 8 (44.44%) were of plating group and 2 (10%) interlocking nailing. In intramedullary nailing group, 6 (30%) patients showed good results, 8 (40%) fair and 4 (20%) poor results. In patients treated by plate fixation, 6 (33.33%) cases showed good results, 2 (11.11%) fair and, 2 (11.11%) poor results. For all the subjects, DASH scoring was in the range of 21-30 in 50% subjects followed by 10 - 20 in 32.14%, 51 - 60 in 10.72% and 31 - 40 in 7.14% cases. In this series, both the methods of treatment (i.e., dynamic compression plating and interlocking nailing showed good functional outcome results. Conclusion: We prefer dynamic compression plating method as the complications are less compared to the interlocking nailing method and also concerning pain and function of the shoulder joint.

Background:  Globally ovarian tumor is one of the leading causes of cancer death among women. It can present in childhood to postmenopausal age group and accounts for the most prevalent cause of hospital admissions. Ovarian tumor has varied histogenesis, clinical behavior and malignant potential. Aim and Objectives: This study was done to analyse the frequency of ovarian lesions, their clinicohistological features in a tertiary care center. Materials and Methods: Prospective hospital based study conducted in the department of pathology in tertiary care hospital in central India over a period of 1 year. All the relevant clinical data of patients who were treated surgically for suspected benign lesions of ovary were analysed. Results: Out of the total of 120 cases, 92 cases were classified as benign, accounting for 76.6% of the cases. There were 4 cases classified as borderline, representing 3.28% of the cases. The remaining 24 cases were classified as malignant, making up 20.12% of the cases. Serous cystadenoma is a frequently observed benign tumour. Serous cystadenocarcinoma is a frequently observed malignant tumour. The younger age group predominantly exhibited benign tumours, while malignant tumours were more prevalent among the senior age group. Malignant ovarian tumours are most frequently observed in women who have never given birth. Conclusion: Ovarian tumours of the surface epithelium were the most prevalent. Typically observed in individuals aged 40 to 59 years. The highest incidence of malignant ovarian tumours occurred in individuals over the age of 50.

Background: Anaemia is a reduction in the oxygen carrying capacity of the blood resulting in tissue hypoxia.1 Cardiac output at rest is not usually increased in most chronic anaemia until haemoglobin levels fall below 7 g/dL, but abnormal rise in output with exercise may occur with levels as high as 10 g/dL.2 Anaemia is a major public health problem worldwide especially in developing countries like India. Nutritional cause of anaemia continues to predominate as the most common cause of anaemia. Objective of this study is to determine the clinical and laboratory profile of anaemia among patients admitted to our hospital. Methods: Our study was a prospective study in which 50 patients of anemia admitted to Medicine ward at tertiary care Teaching hospital, KRIMS, Karwar were studied for their clinical and laboratory characteristics. Duration of the study was 6 months from July 2021 to december 2021. Results: Anaemia was more common among females (68 % of total patients). Patients in age group 18- 30 years were involved in 46% of subjects. Pallor was the universal finding present in 100% of patients. On systemic examination haemic murmurs on auscultation was the most common finding present in 28% followed by hepatomegaly (18%). Microcytic and dimorphic anaemia constitute the bulk of anaemia. Conclusions: Nutritional anaemia particularly iron deficiency anaemia is the most common cause of anaemia. It tends to affect the working age group and females predominantly. Patients continue to present with severe anaemia to the hospital.

The fact that normal or elevated central venous oxygen saturation (ScvO₂) levels are unable to determine whether tissue perfusion is sufficient, it has been suggested to incorporate additional indicators of tissue hypoxia, such as the central venous-to-arterial carbon dioxide difference (PcvaCO₂ gap). This study aimed to assess the predictive capability of the PcvaCO₂ gap and the PcvaCO₂/CavO₂ ratio in determining the changes in lactate levels in patients with septic shock. The current investigation was carried out at the Medical ICU, emergency medicine, Apollo institute of medical sciences, Hyderabad. Telangana, India, over a period of 30 months from December 2019 to December 2022.This study was a prospective study. Our study found that among septic shock patients, those with elevated PcvaCO2/CavO2 ratio values, even after normalizing MAP and ScvO2 values, were more likely to have a failure in lactate clearance in the subsequent hours. This failure in lactate clearance was related with higher fatality rates in these patients. In our investigation, we found that only the parameter Lactate showed statistical significance, whereas the other parameters did not. The baseline lactate levels in the improver group were lower in comparison to the non-improvers group. Among septic shock patients with normalized mean arterial pressure (MAP) and central venous oxygen saturation (ScvO2), the occurrence of increased PcvaCO2/CavO2 ratio values substantially decreased the likelihood of achieving sufficient lactate clearance in the subsequent hours. Incorporating this parameter into future resuscitation algorithms could be beneficial for obtaining immediate data on the sufficiency of tissue perfusion. This information would assist in the decision-making process, such as determining when to continue resuscitation efforts and when to cease interventions, even in the presence of elevated lactate levels.

Chronic kidney disease is a pathophysiological process with numerous etiologies, resulting in inexorable attrition of nephron number and function leading to end stage renal disease. Cardiovascular causes and infections contribute towards the large proportion of increased morbidity and mortality. Connective tissue diseases are immune mediated inflammatory diseases, mainly of the musculoskeletal system; however, they frequently involve the cardiovascular system. They affect the pericardium, myocardium, valve leaflets, coronary arteries and conduction system with different rates of prevalence and degrees of severity. This study aims to find cardiac abnormalities using ECG, 2D-ECHO and also to determine what proportion of chronic kidney disease with connective tissue disease patients will have conduction abnormalities. MATERIAL AND METHODS: The main source of data is from patients who are renal biopsy proven CKD with connective tissue disease attending the outpatient department and patients admitted in the department of General Medicine and department of Nephrology in Vydehi Institute of Medical Sciences and Research Centre, Bengaluru. Duration of study was one and half year from March 2021 to August 2022. RESULTS: The study population included 55 patients of connective tissue disease with chronic kidney disease. Conduction abnormalities on ECG were seen in 11 patients (20%). Sinus tachycardia was most common ECG finding seen in 17 patients (30.9%). In ECHO, pericardial effusion was the most common finding seen in 27 patients (49.09%), CONCLUSION: The incidence of cardiovascular manifestations is significantly higher in patients of connective tissue disease with CKD compared with the general population. It is likely to be associated with subclinical atherosclerosis and vascular damage, disease related factors. Therefore, early detection of cardiac abnormalities in all patients of CKD with connective tissue disorder may reduce the morbidity and mortality due to cardiovascular involvement in connective tissue diseases.

BACKGROUND: Acute Kidney Injury (AKI) is a common medical problem developed in a wide variety of settings including ambulatory outpatients, hospitalized and in critically ill patients. Delay in diagnosis of AKI is associated with increased mortality. Variety of conditions can lead to AKI and many factors can influence the outcome of AKI. METHODS: This hospital based observational study was conducted in the department of medicine, Guwahati Medical College and hospital, Guwahati, Assam, India over a period of one year from 1^st July, 2020 to 30^th June, 2021. A total of 110 patients with AKI were included in the study. Data collection was done by history taking, clinical examination and essential laboratory tests. RESULT: The mean age of the present study group was 44.82 ± 16.9 years. The total number of male patients were 62 (56.4%) and female patients were 48 (43.6%). The majority of patients presented with Oliguria (71.8%). Sepsis was found in 38 patients (34.5%) and was the most common cause of AKI in this study. Majority of patients were treated conservatively accounting to 51.8% of patients in this study. Haemodialysis (HD) done in 41.8 % and peritoneal dialysis done in 6.4% patients. 70% patients recovered completely of AKI and 14.5% recovered partially. Out of 110 patients 17 patients died. CONCLUSION: The present study showed sepsis was the most common cause of AKI followed by acute gastroenteritis. Most common clinical presentation in the study population was oliguria. Most of the patients in the study population recovered completely

BACKGROUND: Acute Kidney Injury (AKI) is a common medical problem developed in a wide variety of settings including ambulatory outpatients, hospitalized and in critically ill patients. Delay in diagnosis of AKI is associated with increased mortality. Variety of conditions can lead to AKI and many factors can influence the outcome of AKI. METHODS: This hospital based observational study was conducted in the department of medicine, Guwahati Medical College and hospital, Guwahati, Assam, India over a period of one year from 1^st July, 2020 to 30^th June, 2021. A total of 110 patients with AKI were included in the study. Data collection was done by history taking, clinical examination and essential laboratory tests. RESULT: The mean age of the present study group was 44.82 ± 16.9 years. The total number of male patients were 62 (56.4%) and female patients were 48 (43.6%). The majority of patients presented with Oliguria (71.8%). Sepsis was found in 38 patients (34.5%) and was the most common cause of AKI in this study. Majority of patients were treated conservatively accounting to 51.8% of patients in this study. Haemodialysis (HD) done in 41.8 % and peritoneal dialysis done in 6.4% patients. 70% patients recovered completely of AKI and 14.5% recovered partially. Out of 110 patients 17 patients died. CONCLUSION: The present study showed sepsis was the most common cause of AKI followed by acute gastroenteritis. Most common clinical presentation in the study population was oliguria. Most of the patients in the study population recovered completely. 

BACKGROUND Tympanoplasty is usually done under local anesthesia with sedation under monitored anesthesia care (MAC) or general anesthesia. This randomized, double-blind study compares dexmedetomidine as an adjuvant to local anaesthetic vs a combination of intravenous midazolam-pentazocine in patients undergoing tympanoplasty Under Monitored Anesthesia Care with respect to-VAS (Visual Assessment Score) and Time required for rescue analgesia in a tertiary hospital in India. MATERIALS AND METHODS This was a prospective, randomized, double blinded, comparative study. All the patients were well informed about study & each one of them gave written informed & valid consent to participate in the study. Total number of patients in the study was 82, with 41 patients in each of the two groups. Grouping done as follows Group Dexmed 10 ml of Bupivacaine + 10 ml of Lignocaine-adrenaline+ Dexmedetomidine 50mcg Group MPInj Midazolam 1.5 mg+ Inj Pentazocine 30mg IV RESULTS The demographic data were comparable in both the groups. Of 41 cases in Group Dexmed, 25 cases (61.0%) had Right CSOM and 16 cases (39.0%) had Left CSOM. Of 28 cases in Group MP, 25 cases (61.0%) had Right CSOM and 16 cases (39.0%) had Left CSOM. Distribution of mean pain score (VAS) at 30 min, 40 min, 50 min, 60 min and 80 min among the cases studied is significantly lower in Group Dexmed compared to Group MP (P-value<0.05 for all). Distribution of no. of rescue sedation injections required among the cases studied is significantly higher in Group Dexmed compared to Group MP (P-value<0.05). Distribution of mean time until the need for rescue analgesia is significantly higher in Group Dexmed compared to Group MP (P-value<0.05 CONCLUSION We found that Dexmedetomidine is more effective as an adjuvant to Local Anaesthetic Versus Combination of Intravenous Midazolam And Pentazocine In Tympanoplasty Surgeries.

Introduction: On 11^th March 2020 Corona virus disease 2019 is declared a pandemic by WHO. The highly contagious COVID-19 virus has spread across the globe. Illness diagnosis is a key component of patient management and disease control strategies. Thin-section chest CT is more sensitive in detecting abnormal alterations in the lung parenchyma. The CT-pattern of COVID-19 and other viral pneumonias share a lot of similarities. The distribution characteristics of various lung pathologies and involvement of lung lobes were noted three months after treatment has been completed on a follow-up chest CT. Aims and Objectives: To determine any post covid pulmonary sequelae in covid patients. Materials And Methods:  This is a prospective cross sectional descriptive study done in DR. PSIMS & RF, Vijayawada, Andhra Pradesh, India from November 2020 to October 2022. Patients who came with history of covid-19 disease for follow up were included in this study. Serial high resolution axial sections of chest done without intra venous contrast using SIEMEN’s 16 slice CT scanner in the department of Radio-diagnosis Dr. PSIMS& RF. With age, gender distribution, fibrosis, pattern of fibrosis, % Of lung involvement, comparison with acute CT scan if any(% of involvement vs % of sequelae) ,comparison with previous CT scan where ever available, relapse of pneumonia (if any), correlation with treatment taken earlier (actively treated or not), unrelated positive findings to post covid sequelae as study variables. Results: A total of 50 Patients who came to Dr. PSIMS & RF for CT-Chest with history of covid-19 disease for follow up were included in this study. At 6 months of follow-up, most patients with severe or critical disease still had significant persistent lung abnormalities. Lung fibrosis and pneumonia were the most prevalent CT symptoms for patients, followed by mosaic attenuation and ground glass opacities along with some unrelated lung pathologies. Our study shows that residual pulmonary sequelae of COVID-19 were caused by older age and illness severity, both of which were independent variables. Conclusion: It is important for both the radiologists and chest physicians to know the persistent post covid lung changes which play a significant role in diagnosis, treatment and prognosis of any chest illness in these patients in future.

Introduction: Mortality rates for COVID-19-related mucormycosis vary greatly in reported studies. A systematic evaluation of 101 cases revealed a fatality rate of 30.7 percent. However, research on the determinants of death in COVID-19 associated mucormycosis is insufficient. The purpose of this study was to find out what factors contributed to in-hospital mortality in patients with COVID-19-related mucormycosis. Objectives: To study the the Clinical profile , Haematological ,Biochemical and Radiological changes associated with mortality in patients with covid-19 associated mucormycosis. Methodology: In this single-center, observational study, 130 patients diagnosed with COVID-19 associated mucormycosis were recruited from a tertiary level intensive care unit from Bowring and Lady Curzon hospital, Bangalore, India. Results: Proportion of HTN, IHD, CKD and HIV was significantly more in non survivors compared to survivors. ICU admission and Oxygen requirement was scientifically higher in Non Survivors and had significant association with the outcome. . There was no significant difference in the levels of Hb, Neutrophils, Lymphocytes, Monocytes, Eosinophils, and Platelets as p>0.05. Total count (17191 7764), ESR (57.6± 12.4), CRP levels (199.0 69.5), and S.Ferritin (624.6 268.0) were significantly higher among the Non survivors. S.LDH (355.7 108.9), S.Free Iron (51.7 13.3), HBA1C (11.4 2.4), and S.Urea (36.9 35.3) were also found to be significantly higher among the non survivors. Conclusion: The current study highlights that a multidisciplinary approach in COVID-19 associated mucormycosis patients that includes timely and effective surgical debridement coupled with appropriate antifungal therapy and diligent sugar monitoring with intrahospital glycemic control may help to lower mortality. Key Words:

Metabolic syndrome (MetS) is a condition characterized by insulin resistance, diabetes mellitus, and impaired glucose intolerance, often associated with obesity, hypertension, dyslipidaemia, or microalbuminuria. The global health pattern is shifting towards chronic diseases like cardiovascular and diabetes mellitus, with a higher burden of non-communicable diseases. In India, the Epidemiological Transition Level (ETL) is <1, indicating a predominance of degenerative, non-communicable diseases and injuries. A community-based cross-sectional study was conducted to estimate the prevalence of Metabolic Syndrome (MET) and associated risk factors among the adult population in the urban field practice area of CIMS Bilaspur, Chhattisgarh. The study involved 540 systematic random samples and analyzed the dietary habits and substance abuse of 540 participants, ranging from 20 to 80 years old. The majority were from class-III socioeconomic status, with low education, bad diet, and obesity being key contributing variables. Recommendations include engaging in regular physical activity to reduce weight, abdominal obesity, and BMI, improving diet by reducing sugar, salt, and fat consumption, regular health check-ups, taking medication regularly, and quitting alcohol, smoking, and other addictions. Large-scale studies are necessary to discover all population risk variables

Introduction: Human vision allows for the perception of three primary colors: red, green, and blue. Any impairment in the perception of colors is referred to as color vision deficiency (CVD). CVD follows genetic inheritance. Genetic inheritance also extends to blood groups. While it is acknowledged that certain genetic diseases may exhibit a prevalence within specific blood groups, there is a dearth of such studies in CVD. Therefore, this study aims to ascertain the prevalence of CVD and explore any potential association with ABO blood groups, given their genetic inheritance. Materials and Methods: The research was conducted among young adults attending a tertiary care hospital in India. The Ishihara test plates were utilized to assess color vision, while the agglutination method was employed for ABO blood grouping. Results: Screening revealed that 640 (93.98%) participants had normal color vision, 40 (5.87%) exhibited CVD, and 1 (0.15%) subject was completely color blind, all of whom were male. Among those with CVD, blood group distribution included 7 (17.07%) individuals with blood group A, 21 (51.22%) with blood group B, 1 (2.44%) with blood group AB, and 11 (26.83%) with blood group O. Notably, the solitary color blind student belonged to blood group B (2.44%). Conclusion: Given the significance of color perception in their profession, this study enables young adults to identify and address any color vision deficiencies early in their careers. Additionally, it offers insights into the distribution of ABO blood groups among the study population. Future research with a larger sample size is recommended for more precise outcomes. 

Background: Clavicle fractures, particularly midshaft fractures, are common orthopedic injuries. Traditional treatment approaches have included conservative management, but surgical intervention is increasingly utilized for displaced fractures. Among surgical techniques, intramedullary nailing with Titanium Elastic Nails (TENs) has emerged as a promising alternative to plate fixation due to its potential advantages such as minimal scarring, reduced risk of nonunion, and ease of application and removal. Methods: This hospital-based prospective study conducted in a tertiary care hospital in Central India aimed to assess the efficacy of Titanium Elastic Nail (TEN) fixation in midshaft clavicle fractures. A total of 50 patients meeting inclusion criteria underwent surgery and were followed up for a minimum of 6 to 12 months. Data collection involved comprehensive medical history, clinical examination, and radiographic assessments. Surgical techniques, complications, and postoperative outcomes were analyzed. Results: The study population primarily consisted of young adults aged 19-29 years, with a male predominance. Road traffic accidents were the leading cause of injury, affecting 80% of patients. Most fractures were classified as Robinson type B and OTA type 15b1. The majority of patients underwent surgery within 2-7 days, with closed reduction being the preferred technique. Postoperatively, 96.67% of patients exhibited no shortening, and excellent DASH scores were achieved by 80% of patients. Complications were minimal, with entry site irritation being the most common. Fracture union was achieved in 90% of cases by the 12th week post-operation. Conclusion: Intramedullary nailing with Titanium Elastic Nails (TENs) proves to be an effective and safe method for stabilizing displaced midshaft clavicle fractures. It offers rapid functional recovery, excellent cosmetic outcomes, and minimal risk of complications compared to conservative treatment and plate fixation. The findings support the use of this minimally invasive technique as a preferred option for managing midshaft clavicle fractures, particularly in young, active individuals seeking early return to function