Objectives: The aim of current study is to evaluate relation between body mass index (BMI) and in-hospital outcome in patients undergoing percutaneous coronary intervention (PCI). Background: Relation between body mass indexes (BMI) with percutaneous coronary intervention (PCI) has shown in different studies. Recent studies suggested a paradox relation between different BMI values and outcome in certain patients. Methods: In this prospective study, 1134 patients (81.7% male, 18.3% female with mean age of58.18±11.16 years) whom undergone PCI between January 2011 and December 2011 were chosen and their BMI and disease outcome was studied. Classification of BMI was: healthy weight (18.5 to24.9 kg/m2), overweight (25 to 29.9 kg/m2), moderate obesity (30 to 34.9 kg/m2) and severe obesity (over 35 kg/m2). Baseline patient characteristics and in-hospital outcome were compared among BMI categories. Results: Major adverse cardiac events (MACE) were significantly higher in patients with overweight and moderate obesity than two other groups. There was no difference in mortality, reinfarction, revascularisation, stroke and bleeding events among the 4 groups. Being overweight is an independent factor associated to in-hospital MACE (odds ratio [OR] 0.37, 95% confidence interval [CI] 0.17 to 0.73, p=0.01) and mortality rate (OR 0.20, 95%CI 0.04 to 0.85, p=0.03). Conclusion: BMI overall is not correlated to in-hospital MACE and mortality; however, overweight patients are at reduced risk for MACE and mortality.

COVID-19 has been declared a global pandemic by the World Health Organization and is responsible for hundreds of thousands of deaths worldwide. COVID-19 is caused by SARS-CoV-2, and common clinical symptoms include fever, cough, sore throat, headache, and fatigue. The cardiovascular system is affected in this infection, with complications including myocardial injury, myocarditis, acute myocardial infarction, heart failure, dysrhythmias, and venous thromboembolic events. Current therapies for COVID-19 may interact with cardiovascular medications. Myocardial injury is relatively common in patients with COVID-19, accounting for 7%-23% of cases, and is associated with a higher rate of morbidity and mortality [1]. In patients with COVID infection clinical suspicion is necessary to diagnose myocarditis as an important complication of this infection. Here we present a patient who developed shortness of breath and orthopnea following sore throat and myalgia and was eventually treated with a diagnosis of myocarditis and discharged from the hospital in relatively good general condition.

COVID-19 was declared by the World Health Organization as a “Public Health Emergency of International Concern” [1]. These patients may develop shock due to sepsis or cardiac injury; however, hemodynamic characteristics have not been described. We analyzed the hemodynamic profile of 2 ventilated patients (critical cases), 2 non-ventilated patients with severe pneumonia (severe cases) and 1 patient with pneumonia (moderate cases) admitted to the ICU of the Tropical Medicine Institute “Pedro Kouri”, Havana, Cuba. SARS-CoV-2 infection was confirmed in all cases by reverse-transcriptase-polymerase-chain-reaction at hospital admission. Non-invasive hemodynamic measures (within the first 24 h of ICU admission) were used in order to minimize viral transmission to health-care provider. Arterial and central venous samples were simultaneously collected for testing. Fick method was used to calculate the Cardiac Output (CO) as CO=VO2/Ca-CVO2, where VO2 is the oxygen consumption (using the Bergstra's formula) and Ca-CVO2 is the arterial-to-central venous oxygen content difference. We observed a hyperdynamic profile, characterized by high CO and low systemic vascular resistance, in critical and severe cases; conversely, moderate cases have a normal hemodynamic pattern (Table 1). Of note, hyperdynamic changes were markedly higher for critical cases compared to those for severe cases, suggesting that a poor clinical course is associated with a more severe imbalance in hemodynamic parameters. Despite these finding, impairment in the mean arterial pressure was not observed in severe cases and low-dose norepinephrine was required in critical cases, indicating that tissue perfusion was guaranteed by the increased CO (Table 1). Serum concentrations of inflammation-related biochemical markers were higher in patients with critical disease than those in patients with severe or moderate disease (Table 1), suggesting a close relationship between inflammation and hemodynamic imbalance. Angiotensin II effects are increased in COVID-19 patients because of a reduced activity in the angiotensin-converting enzyme 2, but inflammation-induced vasodilatation may overcome the Angiotensin II - associated vasoconstriction. In fact, Angiotensin II may be an inductor of inflammation and oxidative damage in early phases [2]. All patients had a central venous oxygen saturation >70% and central venous-to-arterial carbon dioxide difference (Pcv-aCO2) <6.0 mmHg, indicating an adequate tissue oxygen supply and CO2 wash-out, respectively; however, biological markers of anaerobic metabolism such as hyperlactatemia and Pcv-aCO2/Ca-cvO2 ratio >1.8 were observed in critical patients (Table 1). These founds suggest microcirculatory or mitochondrial disturbances [3]. In summary, this report highlights that in early phase of COVID-19-assocaited critical illness, patients show a hyperdynamic profile with microcirculatory/mitochondrial disturbances. These abnormalities may contribute to mortality.

The toxicity of a substance can be affected by many different factors such as the route by which the substance was introduced or administered (whether through application, contact with the skin, ingestion, inhalation, or direct injection), time or duration of exposure (short or long-term encounter) and the number of Exposure times (single doses or multiple doses over time), the physical form of the toxin (solid, liquid or gas), an individual’s genetic makeup and general health, among many other factors. There are many terms used to describe these factors, such as acute exposure and chronic exposure: Acute exposure: It means the single exposure to a toxic substance that may cause severe biological damage or even death, and acute exposure is usually characterized by the duration of exposure does not exceed one day. Chronic exposure: Continuous exposure to a toxin occurs over a long period of time, often measured in months or years, and can cause irreversible side effects. Toxic as in pregnant women or those suffering from certain diseases, and when evaluating a new and previously unstudied chemical, it can be compared with the other studied substances if it is believed that the two substances are very similar, but with the addition of a safety factor of 10 to take into account the possible differences between them, although the differences do not require in Usually such a level of safety is, because this approach is a very conservative approximation to allow it to be applied to a wide range of materials.

Appendicular mucocele is defined as an obstructive dilatation of the appendix caused by intraluminal accumulation of mucoid material. It has an incidence of 0.2-0.3%, commonly seen in females and individuals more than 50-years of age. A 25-year-old male was referred from a peripheral healthcare facility for an abdominal and pelvic ultrasound scan on account of recurrent episodes of lower right quadrant (iliac-region) pain and discomfort. The ultrasound scan demonstrated tenderness with sonographic probe pressure over the right iliac region, a blind ending tubular structure with dilated central lumen (dilated appendix), a linear echogenic structure casting posterior acoustic shadow and causing luminal obstruction within the appendix. An oval cystic area measuring about 18mm in widest diameter with echogenic walls, internal echoes and mixed echo material forming a circumferential rim in the innermost aspect of the cystic area, this is most likely the mucocele. A mixed echo material is also noted clogging the lumen of the appendix before the cystic mass. A diagnosis of acute appendicitis coexisting with features of a complex cystic mass most likely a mucocele. We present the ultrasonographic features of acute appendicitis coexisting with a complex cystic mass most likely a mucocele in a 25-year-old male patient.

COVID-19 or SARS-COV-2 is a serious viral illness that has spread all over the world, this disease belongs to the group of coronaviruses. Like other coronaviruses it was transmitted to humans by animals, which is said to be an outbreak from a fish market in Wuhan (China) in December 2019. World Health Organization (WHO) has reported that COVID-19 is a pandemic on March 11, 2020 [2]. For the management of spreading of this disease, some countries forced a complete lockdown. Social distancing, hand hygiene, and isolation were considered largely effective for COVID-19 control [2]. Many medications have been reported for the treatment of Covid-19 disease. One of these medications is hydroxychloroquine/chloroquine which has gained a lot of popularity during the pandemic. This study aims to review the effect of HCQ and CQ on cardiovascular patients with COVID-19 and estimate the potential adverse effects.

Background: Maternal nutritional status is important for health and quality of life in women and growing fetus. Maternal weight gain in pregnancy can offer a good means of assessing the wellbeing of the pregnant mother and her baby. Inadequate prenatal weight gain is a significant risk factor for intrauterine growth restriction, preterm delivery and low birth weight in infants. Obesity and excessive weight gain on the other hand can lead to adverse maternal and fetal outcomes. Interestingly, to get a good fetomaternal perinatal outcome mode of delivery decision is also changed with BMI. Objective: The aim of the study was to evaluate the effect of maternal BMI on the mode of delivery. Methods: This cross-sectional study was carried out department of obstetrics and gynaecology at Bangabandhu Sheikh Mujib Medical University. A total 100 population of purposive sampling was the methods of choice to select the sample from the hospital admitted patients during the period from August 2016 to December 2017. Results: The mean age of 100 mothers were 28.4 (± 6.2) years. The maximum mothers attended from 3rd trimester were overweight (55.36%) whereas 44.64% from the same trimester were normal BMI mothers. Maximum mothers (27%) were from 25-29 years age group and the minimum mothers (4%) were from >= 40 years. Forty Seven Percent mothers came as primigravida. Primigravid women and multigravida with LSCS and without LSCS showed different mode of deliveries. The more the gravida with history of caesarean section the more frequency of present occasion of CS (p=0.006). The higher BMI showed more frequency of caesarean section than NVD or assisted delivery (p=<0.00001) Multiparous women showed more BMI than the p nulliparous. (p=0.005). Multiparity, maternal age and pre-existing medical conditions revealed more complicated labor. Conclusion: The more BMI of mother showed more frequency of caesarean section, assisted delivery than the normal vaginal delivery.

Background: Diabetes is one of the most common chronic diseases. The development of albuminuria in Type 2 Diabetes (T2DM) increases the risk for renal disease. Methods: The study was retrospective conducted at the Primary Health Care Clinics at King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia. A total of 1583 Saudi with T2DM were randomly selected. Results: Total of 1583 patients with T2DM included in this study; 636 (40.2%) male and 8947 (59.8%) female with mean age 56.0

Background: Legionella pneumophila is a common cause of Community Acquired Pneumonia (CAP) which is often associated with a severe clinical course and a mortality rate of 5% to 25% among immunocompetent patients. Complications of Legionella infection include acute renal and respiratory failures, disseminated intravascular coagulation and septic shock which often require intensive level of medical care. Reported cases of myocardial dysfunction and acute systolic heart failure from legionella disease are rare. This case describes an atypical presentation of legionella pneumonia in a previously healthy patient complicated by multi-organ failure. Case Presentation: A 63 year old female with medical history of hypertension was admitted to the intensive care unit for acute onset of altered mental status, decreased oral intake, subjective fevers, dizziness and diarrhea. Physical exam was remarkable for temperature of 101.2 F, pulse rate 112 beats/minute, respiratory rate 22 cycles/minute and blood pressure 88/60 mmHg. Laboratory studies showed leukocytosis, markedly elevated serum Creatinine Kinase (CPK), and creatinine and lactic acid levels. Troponin was elevated; however no evidence of cardiac ischemia on electrocardiogram. Chest X-ray revealed right mid-lung opacities consistent with pneumonia. A Transthoracic Echo (TTE) showed reduced ejection fraction of 35% and urine legionella antigen test was positive for Legionella pneumophilia group 1 antigen. She was admitted to the medical Intensive Care Unit (ICU) and initiated on Intravenous (IV) fluids and empiric antibiotics for CAP (IV Ceftriaxone 2 g daily and Azithromycin 500 mg daily) and by day 5 of hospitalization, her fever had completely resolved and neurological status returned to normal. Her serum CPK and creatinine levels significantly improved and troponin levels normalized. She was discharged home to follow up with infectious disease and cardiology team outpatient. A repeat TTE six weeks later showed normal ejection fraction of 60% to 65% and a normal cardiac stress test.

Background: Hypertension, the leading global risk factor for mortality and the third leading risk factor for disease burden, is an increasing public health problem in sub-Saharan Africa. This study aims to evaluate the prevalence & associated risk factors of hypertension among Assosa town. Objective: To assess the prevalence of hypertension and its associated factor and to increase awareness of controlling hypertension among study subjects. Methods and Materials: Institutional based cross sectional study design with quota non-probability sampling technique was conducted among patients visited OPD units of AGH and AHC from March to June 2018. All outpatients were included. Data was collected by face to face interviews using pre-tested structured questionnaire. SPSS version -20 software was used to enter and analyze data. Descriptive statistics like frequency table, chi-square test of independence and logistic regression was used to characterize disease and associated factors.

Background: The danger of chronic kidney disease (CKD) is rising quickly worldwide and has become a main health crisis and most of these patients die from cardiovascular disease (CVD) prior to progression to end stage renal disease (ESRD), therefore, Poor cardiovascular outcomes in CKD patients have encouraged nephrologists to search for biomarkers that may improve risk stratification in this population. The aim of this study was to assess serum brain natriuretic peptide (BNP) hormone and cardiac troponin T (cTnT) levels in CKD patients and to determine their involvement with cardiovascular diseases. Methods: This analytical case control study was conducted at Ibn sina and Military hospitals in the period from February 2016 to March 2019, (n = 150) clinically diagnosed CKD patients (age range between 22 - 76 years, 105 males and 45 females), and (n = 150) healthy subjects were included as controls. Serum BNP hormone and cardiac troponin T (cTnT), were estimated by Cobas E-411® fully automated analyzer, serum creatinine by Cobas C-311® fully automated analyzer, hemoglobin by Sysmix, glomerular filtration rate (GFR) was calculated by Cocroft-Gault formula and blood pressure was measured by using mercuric sphygmomanometer. Results: Serum BNP, cTnT, creatinine, systolic blood pressure (SBP), diastolic blood pressure (DBP) and body mass index (BMI) were significantly higher in CKD patients than in controls, while hemoglobin and GFR were significantly lower. Moreover, serum BNP, cTnT, SBP and DBP were significantly higher in CKD patients with cardiovascular disease (CVD) than CKD patients without CVD. In addition, serum BNP, at cutoff level of 240 pg/ml, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 87%, 90%, 52% and 92%, respectively in relation to CVD, while serum cTnT, at cutoff level of 0.1 ng/ml, the sensitivity, specificity, PPV and NPV were 80%, 57%, 46% and 74%, respectively. Furthermore, there was an association between elevated BNP levels and CVD outcomes in patients with CKD, since it is a strong risk factor for CVD (OR: 1.48, p. value 0.031). Conclusions: BNP levels are significantly associated with cardiovascular events (left ventricular hypertrophy and systolic dysfunction) in patients who have CKD and are on maintenance hemodialysis (HD)

Background: Acute appendicitis is one of the most common surgical presentations worldwide. Acute appendicitis is complicated with several sequels, of which the perforated appendicitis presents a major health concern. Perforated appendicitis is profoundly affected with method of wound closure which determines the incidence of wound infection. Methods: This is a prospective randomized study that included 360 patients presented with acute appendicitis. Intraoperative recording of the gross pathology of the appendix with assessment of the relation of wound infection and method of wound closure were performed. Moreover, record of the patients’ postoperative hospital stay period was assessed. Results: Postoperative assessment of appendectomy revealed that 18.8% was appendicitis negative, 63% was uncomplicated appendicitis and 18.2% was perforated appendicitis. We considered primary closure of wounds in 36.4% of patients, delayed wound primary closure in 18.2% of patients and partial closure of wounds in 45.4% of patients. Incidence of infected surgical wounds was 37.5%, 16.7% and 13.3% in primary, delayed primary and partial wound closure respectively. Delayed primary closure had the longest hospital stay (8 days) compared to primary wound closure (7 days) and partial wound closure (4 days). Conclusions: The study on hand provided an evidence on how superior the partial wound closure compared to primary wound closure and delayed primary wound closure in patients with appendicitis.

Background: A home-based intervention is a promising approach for early intervention about HAV that aims at improving mothers-child outcomes. The aim of this study was to examine the effect of home based intervention on improving mothers' perception about Hepatitis A virus. Methods: Design: A quasi-experimental (pre-post) design was utilized. Subjects: A multi stage random sample of 360 mothers through home visits in Shranees village, Quesna district at Menoufia Governorate, Egypt. Instruments: 1) Hepatitis A virus Interview Questionnaire to assess socio- demographic data and mother's perception of hepatitis A virus which included mothers' knowledge about hepatitis A virus and mothers' practices about HAV and 2) Observational checklist to assess home environment and to assess home feeding environment. Results: It was revealed that there was improvement in total knowledge post intervention than pre intervention (14.60±5.53, 10.13±5.50) respectively and there was a change in knowledge in the study group than control group at post intervention (4.48±5.16, 0.17±0.96) respectively. There was improvement in total practice post intervention than pre intervention (3.94±1.17, 2.98 ±1.90) respectively and there was a change in practice in the study group than control group at post intervention (0.97±1.34, 0.13±2.37) respectively. Conclusion: the present study revealed that application of home based intervention proved to be effective in raising the women's perception regarding Hepatitis A. Hence, it can lead to improving knowledge and practice. Recommendations: health educational programs should be launched to nursery workers, school workers and women in rural areas about infectious diseases. Also, it was recommended vaccination against hepatitis A for children at the preschool and school period.

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).

Clinical Reasoning (CR) is an important aspect of health professional education and practice. The basics and fundamentals, when put together, reflect a physician’s ability to make decisions and diagnoses. The cognitive processes involved in clinical reasoning are complex and layered. CR is the process through which physicians gather cues and data (usually from history and physical examination as well as other clues or information available), process the information, come to an understanding of the patients’ problems or situation, plan and implement the necessary interventions, evaluate the responses and outcomes, as well as reflect on or off the job as relevant for deeper learning. It is a complex series of steps and cognitive functions, involving higher level thinking to define the problems, examine the evidence and then making decisions and choices to improve the patient’s physiological and psycho-social state. This paper discusses, in a simplified manner, critical thinking and CR, the Dual Process Framework continuum (from the intuitive to the analytical) to explain physicians’ approach to CR as well as the common errors and biases involved in the process. The first step to create awareness of the need to enhance and sharpen CR is indeed to become more conscious of the steps undertaken, on a daily basis, as physicians encounter their patients and plan their management.

Therapeutic foot wear is an important treatment strategy that has both preventive and therapeutic role in patients with diabetes. It is often difficult to understand and also to keep updated with types of foot wear available in market and further the dilemma “which one to use in which patient”, especially by non-foot specialist and other healthcare professionals is common

In October, 2019, ’No Mask Campaign’ was launched by one of the three most famous and tertiary central hospitals in Wuhan, to promote eye and facial expression communication with patients in flu season, which was followed as a practice standard by other hospitals in the city [1]. Two months later, it came the uncontrolled outbreak of COVID-19. It is reasonable to ask the question: Whether inadequate use of facial mask, the traditional personal protective equipment, contributed to the tragedic widespread of this novel coronavirus infection.

Background: Blood transfusion is a vital therapeutic approach in modern health care that saves millions of lives, but there is a great challenge to gate sufficient voluntary blood donation in developing country like Ethiopia at the same time pregnancy and child birth related problem, rod traffic accident, malaria-related death is high. Methods: Institutional based cross-sectional quantitative study was used from April 27 to May 11, 2018 and data was collected using a self-administered questionnaire. A stratified sampling method was used and an individual was selected by simple random sampling within each stratum. EPI data version 3.02 for data entry and SPSS version 16 for analysis was used both bi-variant and multi- variant analysis was computed and significance was declared at AOR<0.05. Result: From the total study participants, 162 (48.5%) had adequate knowledge, 230 (68.9%) of the respondent had favorable attitudes towards blood donation whereas only 85 (25.4%) have ever donated blood in their lifetime.

Worldwide, one in eight deaths is due to cancer. Projections based on the GLOBOCAN 2012 estimates predict a substantive increase new cancer cases per year by 2035 in developing countries if preventive measures are not widely applied. According to the World Health Organization (WHO), millions of lives could be saved each year if countries made use of existing knowledge and the best cost-effective methods to prevent and treat cancer. Therefore, the aim of this study is to estimate a provisional budget against cancer in low and middle incomes countries, according the GNI-PPP, the cancer incidence and the number of population. Economically country classification is determining with the Gross national income (GNI), per capita, Purchasing power parity (PPP), according the administrations of the International Monetary Fund (IMF), the World Bank (WB) and the Central Intelligence Agency (CIA). Cancer incidence data presented are based on the most recent data available at IARC. However, population compares estimates from the US Bureau of the Census. The provisional budget is establishing among the guidelines developed by WHO for regional and national cancer control programs according to national economic development. Provisional budget against cancer is estimated to 42,148.788 (thousands of U.S $) for a population of 11,901,484 persons in Rwanda.

Background: A novel COVID-19 has been recently identified as the severe acute respiratory illness COVID-19 which has accounted for more than 300,000 infected people worldwide. However, the world health organization WHO announced that the disease represents a serious issue to worldwide public health. Aim: The study aims at reviewing and discussing current knowledge on COVID-19 in Saudi Arabia including diagnosis, causes, and methods of controlling coronavirus disease. Method and Design: Pooled design is adopted, and 562 confirmed COVID-19 cases are included in the analysis reported between March 2nd, 2020 to March 23rd, 2020. Results: The result showed that the majority of the identified cases resulted from contact tracing and returning from different countries. The study provides additional evidence for an effective method used by the Saudi Arabia Health Ministry (MOH) to help patients recover from COVID-19. Conclusion: COVID-19 evidence to show several signs and symptoms such as fever, dry cough and respiratory syndrome. However, several methods used in health sector in order to monitor and control the disease.

Fibromyalgia is a disorder causes chronic pain throughout the body with general fatigue, sleeping disorder and Cognitive difficulties as most common symptoms. ML and AI the potential glimmers for future presumed to have the ability to process complex datasets outside the sphere of human capabilities. Later transforming the data analysis into clinical insight that assists doctor’s planning and leading to improved results, better diagnosis, cost-effective care, and ultimately better treatment. Here we try to provide a Machine Learning base application using most effective logarithms and image processing classifiers, better coordination between latest trending technologies and healthcare leverage the field of Rheumatology.

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

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

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

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: 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

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

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

Background: 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

Background: The use of digital gadgets like smartphones, tablets, and laptops has grown along with time and technology advancements as well as during the COVID-19 epidemic. These digital devices have a propensity to produce a variety of systemic, visual, and ocular problems.

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

Introduction: Coronavirus disease 2019 (COVID 19) infection has rapidly spread across the world, currently affecting more than 39 million people, leading to major societal, economical and health care system distruptions. Aim of the study: The study aimed to identify and explore the concerns of the long-term mishap of respiratory diseases regarding the impact of the COVID-19 pandemic and how these concerns were affecting them. Methods: A retrospective observational study was performed on consecutive patients admitted to the Shaheed Monsur Ali Medical College, Dhaka, Bangladesh. This study was carried out from January 2020 to December 2020 with 62 patients.

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

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: 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: Yoga is an art in all its aspects, from the most practical to the highest. It is a spiritual art, in the sense that it transforms the seer and brings him into contact with his inner soul. It is a fine art, since it is aesthetic, expressive, visual art, since the body is made to form geometrical designs, lines architectural shapes and the like which are beautiful to behold. It is essentially a useful art for the doer and is presented as a performing art for viewer. Objective: To assess the effect of 45 minute yogic kriya (Surya Namaskar and Kapalbhati) for for 30 days on various physiological and biochemical parameters. Materials and Methods: This is a prospective and observational study conducted in the Department of Physiology and Biochemistry at Tertiary Care Teaching Hospital over a period of 6 months. All subjects volunteering for participation in the study had given their written informed consent. The study protocol was approved by our college ethical committee. Only healthy volunteers with daily regular lifestyle and are not involved in any sport regularly, were chosen to be part of the study between the age group 17-21 were taken into study. Subjects having any pathological condition and those who are on any pharmacological treatment from 3 months prior to the study were excluded from the study. Results: In the present study it was found that the pulse rate was decreased significantly (p<0.05) at 30 days in Group I and II. RR decreased significantly at 30 days in group I, and II with p<0.05. This significant decrease continued at 30 days with group I and II. In our study it was found that significant decrease in SBP at 30 days. At 30 days two groups had highly significant decrease in SBP (p<0.05). In addition, it was also found that significant decrease in DBP at 30 days. At 30 days two groups had highly significant decrease in DBP (p<0.05). After yoga, at 30 days, the reduction in the Serum Total cholesterol, serum triglycerides levels were found in two groups in the present study. The decrease was significant (p<0.05) in Group I and II (p<0.01). In addition, after 30 days of yogic practices significant (p<0.05) increase in the HDL level was found in Group I and II. Conclusion: It was concluded that in hypertensive subjects whether newly diagnosed subjects were restoration of the altered parameters towards normal

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

Periodontitis is a multifactorial disease causing inflammatory destruction of supporting structures of the dentition and eventually leading to its loss. This study was designed to evaluate common risk factors for periodontitis and acute coronary syndrome in the study population and demonstrate the systemic impact of periodontitis on the occurrence of acute coronary syndrome. A total of 160 patients (35 female and 125 male) were enrolled in the study. Considering the age range, the largest group of patients (118 patients) was between 55 and 65 years, which accounted for 73.8% of the total study population. There were 35 patients (21.9%) in the age group of 45 to 54 years, while the youngest age group of 35 to 44 years had as many as seven patients. Medical history and physical examination, including periodontal status, were performed. API, PD, CAL, and CPITN were evaluated. Common risk factors for periodontitis and acute coronary syndrome were assessed. The study assessed risk factors such as hypertension, diabetes, dyslipidemia, general health, smoking, height, weight, and hip circumference. In light of the above-described etiopathogenesis of atherosclerotic disease and its association with periodontal disease, it is important to emphasize preventing and treating periodontitis, especially in patients in the so-called high-risk group for cardiovascular disease. Dentists’ introduction of an appropriate prophylactic and therapeutic plan may constitute both primary and secondary prevention of cardiovascular diseases

Background: The purpose of the current study is to evaluate asthma patients' health-related quality of life (HRQoL) using an HRQoL questionnaire (SF 36 v2). Methods: A 6-month prospective observational study on 108 patients with persistent asthma of either sex. Through a face-to-face interview and the use of an HRQoL questionnaire, asthma patients' HRQoL was assessed (SF 36v2)

Abstract: Background and objectives: To investigate the effect of green human resource management practises on environmental sustainability in the healthcare sector in KSA. To estimate impact of green recruitment, green training and selection, development, and green performance management practices on environmental sustainability in the KSA healthcare industry. Method: A survey of healthcare facilities in KSA was undertaken as part of the research using a quantitative research approach and a descriptive research design. Data was collected via a questionnaire, which was distributed to 414 respondents and garnered 404 responses. The study's target group was the top management, middle management, and lower management levels of healthcare professionals in leadership and management roles

Background: Lack of micronutrients like zinc and copper has been linked to a poor prognosis and high mortality in HIV infection. The purpose of this study was to look at the availability and deficit of a few trace elements in HIV-positive subjects undergoing HAART. Methods: A cross-sectional study was done on 150 persons who had been chosen at random and were receiving HAART at the clinic and had received a confirming diagnosis of HIV. Subjects signed written informed permission forms before receiving questionnaires. Following sample collection, the concentration of blood levels of zinc and copper was assessed using the spectrometric method, and the CD4+T-cell count was assessed using a flow cytometer. Simple percentages were used to calculate prevalence. The association between zinc, copper, CD4 and viral load deficiencies was investigated using the Mann Whitney U nonparametric test and the Chi-square test of independence. Results: The frequency of copper and zinc insufficiency was 59% and 16.7%, respectively, among the participants. A significant difference in median CD4 count and viral load was seen across zinc levels, with a p-value of 0.05, although CD4 count and viral load did not change by copper level among patients. Furthermore, p-value 0.05 indicated a link between subjects' zinc levels and immunological suppression. Conclusions: This study demonstrated that the CD4+T-cell count levels rather than the nutritional status do not complement HAART therapy. While the focus of HAART therapy is strengthening the immune system, patients may still be lacking in some micronutrients while having an increased CD4+T-cell count.

Introduction: In December 2019 , COVID 19 had put unprecedented load over healthcare-systems across the world. The key to good surveillance and prognosis for COVID 19 cases lies in early diagnosis and appropriate management

Introduction: Obesity is a global public health challenge. Recent trends in life style among young college students resulted in an increasing prevalence of obesity. Students are also exposed to daily stress due to increased work load and high expectations .This makes them susceptible to various health problems such as cardiovascular, metabolic, pulmonary and psychosocial disorders. Stress and obesity are interrelated cardiovascular comorbid conditions which burden the person further. This leads to sympathetic over activity, autonomic dysfunction and psychological disturbances in these young individuals. Thus there is a need of timely reduction of sympathetic over activity to overcome autonomic imbalance and stress among them .This can be done by introducing a simple easy technique of breathing, the diaphragmatic breathing which has proven effects. Objectives: This study aimed at to know the effect of diaphragmatic breathing on cardiovascular and psychological parameters in obese undergraduate students

Introduction: With the availability of better health care services and decrease in mortality rates the elderly population has increased significantly over the last couple of decades.1 Psychiatric illness in the elderly is compounded by mental morbidities due to ageing of the brain, problems associated with physical health, socio-economic factors such as breakdown of the family support systems, and decrease in economic independence. The presence of comorbidities and the attendant polypharmacy makes management of these diseases a complex issue

Introduction: Cancer of the cervix is an increasing health problem and an important cause of mortality in women worldwide. Early cervical epithelial changes can be identified by a Pap smear test, which is the primary screening test for detection of precancerous cervical intraepithelial neoplasia and the early stage of invasive cervical cancer. Due to widespread screening programs, there has been a significant reduction in mortality from cervical cancer in developed countries

Background: Psychosocial disturbance can have its effect on all organ systems of our body including cardiovascular system and at the same time prolonged cardiovascular diseases may also lead to worsening of mental health in people. Objective: Present study is carried out to find the effect of certain common psychiatric diseases and social stresses along with the effect of different levels of social support on the incidence and prevalence of cardiovascular diseases. Material and Method: The present cross-sectional analytical study was conducted in cardiac ward and on new and follow up cases in outpatient unit, Andhra Medical College, Visakhapatnam. 100 participants male and female of all age groups were taken as cases along with 100 participants as control after obtaining written informed consent by purposive sampling.

Data was analyzed using SPSS 21.0. The statistical tests used were student’s t-test and chi square test.

DSM-5 criteria, M.I.N.I, Perceived social stress scale, Oslo’s social support system and Modified Kuppuswamy criteria were used to carry out study. Results: Out of the total population under study, 15% of all the CVD cases were found to have psychiatric illness prior to cardiovascular disease where as 21% of CVD patients developed psychiatric illness after having diagnosed for cardiovascular disease. Among these cases 82% were having low social support. Gender predilection for psychiatric diseases in CVD patients was found to be more in females (12%) compared to males (9%) with (p-value = 0.042) and chi square value of 4.13. Conclusion: This research indicates that psychiatric illnesses and low social support can act as an independent risk factor for CVD while CVD patients are susceptible to develop psychiatric illnesses over the course of disease. We recommend multi centre detailed study with higher sample size in this area to generalize the results and use them for the benefit of society

Introduction: Ventilator associated pneumonia is defined as pneumonia occurring more than 48hours after the initiation of endotracheal intubation and the most common nosocomial infection in intensive care unit.VAP is second most common health care associated pneumonia in spite of wide range of preventive measures. Aim: To isolate the bacterial pathogens and their antibiogram of organisms causing VAP. Materials and Methods: Cross sectional descriptive study conducted for a period of 6 months i.e January 2022 - June 2022 in patients admitted in ICUs of King George hospital on ventilator for more than 48 hours. Endotracheal aspirates are collected and transported to department of Microbiology, AMC, Visakhapatnam. Results: From 50 endotracheal samples studied ,15(30%) were culture positive. Among them the most predominant organism is Pseudomonas aeruginosa 5(33.3%) followed by Methicillin resistant Staphylococcus aureus 4 (26.6%), Klebsiella species 3 (20%) and Acinetobacter species 3(20%).Gram negative bacilli were sensitive to Piperacillin – Tazobactam, fluoroquinolones, macrolides, Polymyxin whereas resistant to beta lactams.Gram positive cocci were 100% resistant to Cefoxitin, Oxacillin and sensitive to Linezolid and Vancomycin. Conclusion: Knowledge of incidence of VAP, their causative microbial flora along with their susceptibility pattern help in selection of appropriate antibiotics for therapeutic use and better outcome

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

Background: It is difficult to ascertain reliably the overall incidence and prevalence of the various cutaneous infections in different parts of the world because studies of one region of the country may not be a true representation of the overall disease pattern of that country; furthermore, incidence and prevalence figures may only will be representative of the population sampling, which may have associated risk factors for infection. Most of the studies done in this field are dealt with adults or with a specific clinical form of dermatophytosis. Only few surveys were performed in pediatric age group. Aim: To study clinical presentation of superficial dermatophytic infection in paediatric patients in tertiary health care centre. Methods: It is an observational type of study.  The present study was conducted in Department of Dermatology, Rajshree Medical & Research Institute, Bareilly, from 1st march 2021 to 28th February 2022. Results: Majority of the study population belonged to 11-15 years (48.7%) followed by 15-18 years (24.1%), 0-5 years (16.6%) and 5-10 years (10.6%). The mean age of the study population was 9.16±4.241 (0-18) years. There were 47.7% males and 52.3% females. Itching was present among most of the patients that is 226 patients had this complaint (95.3%). The most commonly affected sites was Groin (47.2%) followed by Trunk (29.9%), buttocks (29.1%), upper limbs (24.0%), Face (6.7%), Scalp (4.6%), lower limbs (4.6%) and Nails (0.4%). The predominant lesion type was Plaque (43.5%) followed by Others like  Pustules, erosions, excoriation, crusting (29.5%), Plaque with papules (16.5%), Plaque, Others (4.6%), Papules, Others (4.6%) and Macule being the least lesion type (1.3%). The most common lesion feature found in most of the study group was discoloration (94.1%). The most common diagnosis was T. corporis (29.1%) followed by T. corporis+ T. cruris (28.3%), T. cruris (22.4%). Limitations: The study was an observational study done at the first visit of the patient in OPD with no follow-up. This was major limitation of the study, since the further change of course of presentation was not noted. Also the patients undergoing any other treatment with dermatophytosis were not studied. Conclusion: Total 237 patients of superficial dermatophytosis were included in the study, out of which mean age was 9.16 ± 4.241 with female predominance (52.3%). Maximum patients were from middle school (48.9%) corresponding to age and belonged to middle class (70.5%) socioeconomic status. Common presenting complaints were itching (95.3%), affected site was groin (47.2%) and annular plaque was predominant type of lesion. The most common made in our study was T. Cruris (47.2%). More studies should be carried out in future on large scale so that this study can be corroborated to evidence. Along with that, alternation in dosage for pediatric age group should be studied

Background: Diabetes mellitus is a metabolic syndrome associated to a number of vascular and non-vascular problems. Hyperglycemia is the main presenting symptom of the metabolic syndrome. Oxidative stress caused on by hyperglycemia induced vascular damage, generation of proinflammatory cytokines, and growth factors. Chemerin was identified as an adipokine and its role in regulating adipogenesis and adipocyte metabolism was connected to metabolic syndrome. The goal of the current analysis was to assess the levels of serum chemerin in T2DM patients. Methods: The outcomes of 24 published studies that examined at serum chemerin levels in T2DM patients were exposed to meta-analysis. An estimation of the serum chemerin pooled mean was made using a random-effects model. Results: According to our meta-analysis research, the pooled mean of serum chemerin in diabetes mellitus patients was 169.82 ng/ml, which is higher than the healthy control (131.94 ng/ml).Conclusion: The meta-analyses revealed a significant relationship between diabetes mellitus and serum chemerin concentrations. These findings also suggest that routine measurement and evaluation of serum chemerin will contribute in the management of diabetes mellitus

Introduction: Fetal movement tracking may be used to identify worsening in the fetus condition. It is described as any kick, flutter, swish, or roll perceived by the pregnant women and is considered evidence of the musculoskeletal and central nervous systems' integrity. Decreased fetal movement has been linked to poor pregnancy outcomes such as intrauterine growth restriction, fetal death and preterm deliveries. Clinical data on the association between decreased fetal movements and perinatal outcome is insufficient. Methodology: Ethical clearance was obtained from SRIMANTA SANKARDEVA UNIVERSITY of HEALTH SCIENCE for study of decreased fetal movements in Gauhati medical college and hospital. A doppler study was conducted using 3 dimensional ultrasound machines in ANOPD, departmental indoor USG room, and 2 dimensional ultrasound machine in observation room in the Department of Obstetrics & Gynaecology, Gauhati Medical College& Hospital. Patients were placed in supine position with left lateral tilt and umbilical artery Wave forms were recorded in the mid position from the free floating loops. Indices noted were S(systolic)/D(diastolic) ratio, resistance index (RI), plasticity index (PI), and reversal of blood flow in diastole. CTG monitoring was done in Departmental Observation Room using a CTG machine (labelled as FETAL MONITOR, SN-EATB8L1732, manufacturer-BPL, model no. FM 9854). Each selected patient was monitored for a period of 20minutes with a paper speed of 3cm/minutes during antepartum or intrapartum status. Noted following information were: base line FHR, beat to beat variability, FHR accelerations, presence of deceleration, and reactive. Results: A prospective observational study was conducted in Gauhati Medical College & Hospital, Guwahati, Assam during a time period of one year. 150 antenatal women at term gestation with decreased fetal movements without any other high risk conditions were monitored for fetal wellbeing by CTG and Doppler. Four groups were categorised into four groups: Group I-CTG reactive and Umbilical Artery Doppler normal, Group IIA, Group IIB, and Group III. The findings of each group were compared with different modes of delivery and different parameters of perinatal outcomes. Conclusion: Maternal perception of fetal movements is the most widely used technique to evaluate fetal wellbeing. Low-risk pregnancies with decreased fetal movements should be monitored for close antenatal fetal monitoring, appropriate and prompt interventions. Non-reactive CTG alone or with combination of abnormal Doppler results are better predictors of poor perinatal outcome and can indicate if neonatal resuscitation is required. These two tools can be used together for fetal monitoring and appropriate intervention at the correct time to improve the perinatal outcomes

Introduction: Prostate cancer is a disease of men. An early observation reports that more than 65% of all prostate cancers are diagnosed in men over the age of 65. Current advances in molecular techniques have provided new tools facilitating the discovery of new biomarkers for prostate cancer. High levels of leptin have been significantly correlated with testosterone and Prostate specific antigen values in subjects with Prostate Cancer compared with subjects in the control group. Adiponectin is the most abundant circulating adipokine and accounts for 0.05% of the total plasma proteins. As a consequence of these observations, and its inhibitory role on the growth of breast and endometrial Cancer cells ,it can be labelled as an Anti-Cancer Adipokine. Interleukin (IL)-6 is a pro-inflammatory cytokine that is expressed in prostate tumors and in the stromal tumor micro-environment. It is known to regulate proliferation, apoptosis, angiogenesis, and differentiation. Material and Methods: This Observational study was conducted among 120 Males, aged above 50 years, out of which 60 were prostate cancer patients and 60 were Healthy controls, who attended the O.P at Dr. VRK Women's Medical College, Teaching Hospital and Research Centre. Men were excluded at baseline, if they had a history of myocardial infarction, stroke, transient ischemic attack, unstable angina, cancer or current renal or liver disease, peptic ulcer, gout, or use of platelet-active agents, vitamin A, or β-carotene supplements. Serum samples of men with prostate cancer based on high prostate specific antigen (PSA),biopsy and/or abnormal DRE  and those of healthy controls were collected after an overnight fast and analysed on the same day. Serum PSA and IL-6 levels were estimated using ELISA. Plasma adiponectin and leptin concentrations were measured by competitive RIA.  Results: In our study, 60 Males were Cases of Prostate Cancer and 60 were Healthy Control group. The age of the patients was almost similar in both Cases of Prostate Cancer (66.23±7.25) and Control group (61.01 ± 7.81). The PSA (ng/ml) level was significantly (<0.001) higher in PCa patients (7.12±0.80) as compared to control group (0.93±0.84). Similarly, the Interleukin-6 level was significantly (<0.001) higher in PCa patients (9.71±0.75) as compared to control group (5.9±0.61). In our study, Leptin (ng/mL) level of Prostate cancer group was 13.31±0.84 which was higher when compared to control group where it was 7.52±0.74. Adiponectin (µg/mL) Levels of Prostate cancer group were 11.72±2.34 which was lower compared to control group where it was 16.25 ±2.73. Conclusion These data further support a relationship between elevated IL-6 and prostate cancer disease prognosis. IL-6 correlates with rising PSA levels and extent of disease, and thus can be used in conjunction with other disease indicators. The multifaceted role of adiponectin in regulating several hallmark pathways that drive cancer growth suppression has been proposed in various studies. Adiponectin is an adipose tissue-derived polypeptide hormone, that in addition, to its anti-diabetic and anti-atherogenic effects also exerts anti-angiogenic properties and therefore it can be used as a target for anti Cancer therapy. On the other hand, leptin would affect PCa growth by means of factors related with obesity such as testosterone and could influence cell differentiation and Prostate Cancer progession.

Background: The incidence of autonomic dysfunction has increased in the presence of type 2 diabetes mellitus and various tools have been developed for assessing it. Classical autonomic function tests are one among them. Autonomic nervous system (ANS) innervates almost all organ systems and is primarily involved with homeostatic regulatory mechanisms. The important functions of ANS are maintenance of homeostatic conditions of the body; regulation of visceral activities; smoothening body’s responses to environmental changes, stress, and exercise; and assisting endocrine system to regulate various functions.  Materials and methods: This cross-sectional study was conducted in the Department of Physiology, Tertiary Care teaching Hospital over a period of 1 year. Involves participants with T2DM (n = 70) and healthy volunteers (n = 70) with an age range of 30-60 years of both genders. Subjects ranging from 30 to 60 years of both genders who were diagnosed with type 2 diabetes mellitus for 3 years duration were recruited for the study. The controls were normal healthy volunteers in the same age group. The cases were selected from diabetology OPD and endocrinology OPD according to the inclusion criteria. The controls were selected from medical OPD who were non diabetic healthy volunteers. Details of present history, treatment history were obtained. Result: There was no significance in age between cases and controls as the p value was 0.2789. The mean SDNN of cases was 29.88 ± 3.99 and for controls was 37.65 ± 4.69. The difference in SDNN between cases and controls were significant as the p value was < 0.05. The mean RMSSD of cases was 20.61± 16.81 and for controls was 22.65 ± 3.85. The difference in RMSSD between diabetics and non - diabetics were significant as the p value was < 0.05. The mean VLF % of cases was 88.75 ± 12.75 and for controls was 80.35 ± 8.59. The difference in VLF % between cases and controls was significant as the p value was < 0.05. The mean rise in DBP after hand grip in cases was 5.25 ± 0.58 and for controls was 12.18 ± 3.94. Conclusion: Results of this study concluded that cardiac autonomic dysfunction was present in LT2DM patients without CAN (based on conventional autonomic test) characterized by predominant parasympathetic nerve function impairment and sympathetic overactivity.

Introduction: Chronic obstructive pulmonary disease (COPD) is a common respiratory condition characterized by airflow limitation it affects more than 5% of the population and is associated with high morbidity and mortality. It is the third common cause of death worldwide, killing around 1.2 Lakh, individuals each year. As a consequence of its high prevalence and chronicity, COPD causes high healthcare expenditure with frequent hospitalizations due to acute exacerbations and the need for long term therapy (eg, supplemental oxygen therapy, medication). Aims: The aim of this study is to evaluate right ventricular function in patients with COPD by echocardiography. Materials and methods: The present study was a Descriptive and cross-sectional case control study. This Study was conducted from April, 2021to November, 2022 at Indoor and outdoor patients of medicine, chest medicine, cardiology department of NRS Medical College, Kolkata. Total 100 patients were included in this study. Result: RV function were significantly impaired in COPD patients as compared to controls. Clinical deterioration in COPD group was much more in patients with baseline abnormal RV function (89%) and patients with RV systolic pressure ≥35 mmHg (P = 0.018). All the six patients who died had three or more abnormal RV systolic function parameters

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 Asthma is a long-term condition affecting children and adults. The air passages in the lungs become narrow due to inflammation and tightening of the muscles around the small airways. This causes asthma symptoms such as cough, wheeze, and shortness of breath and chest tightness. It can be difficult to coordinate breathing using an inhaler, especially for children and during emergency situations. The assessment of asthma control has become pivotal in the management of asthma. However, several surveys in developed nations have shown that the majority of patients with asthma do not enjoy adequate asthma control. This is not because asthma control is unrealistic and not achievable; the multicentre, multinational study of asthma management, the Gaining Optimal Asthma control (GOAL) study, has shown that well-controlled asthma is achievable in the majority of patients.  Materials and Methods: This is a descriptive and cross-sectional study to assess the levels of asthma control among adult patients attending Tertiary Care Teaching Center. The study used those (physician-diagnosed asthma patients) participants who volunteered. There is a causality department where patients presenting with acute asthma attack are managed. Complicated cases of asthma including status asthmaticus are managed in the high dependency unit. Results: Prevalence of bronchial asthma in adolescents was 13.1% (n = 110) of which 10.2% had episodes in the past 1 year. Prevalence was higher among males (6.23%) compared to females (3.94%). About 79.1% of total asthmatics were newly diagnosed cases. Prevalence was significantly higher among those having pets at home (P < 0.001), belonging to higher socioeconomic status (P = 0.021), using smoke producing fuel at home (firewood/cow dung/kerosene; P = 0.021), and with history of smoking among family members (P = 0.027). Among current asthmatics, 71.8% reported cold/rhinitis (51.3% in March–May duration), 59.1% nocturnal dry cough, 48.2% sleep disturbances, and 42.7% speech disturbances in the past 1 year. Discussion: In our study we found, there is significant increase in weight, BSA, BMI, where as significant decrease in DBP of diabetic group compared to Non-Diabetics & there is significant increase in FBS, HbA1C levels of Diabetic group significant decrease in LH levels of Diabetics compared to Non-Diabetics. However T3 levels of Diabetic and Non-Diabetic group were almost same, where as T4, Oestradiol and progesterone levels of diabetic group non-significantly increased and FSH and TSH levels non-significantly decreased in Diabetics. There is frequent co-existence of thyroid dysfunction and diabetes mellitus among post menopausal diabetic women. Conclusion: We estimated the global prevalence of ACO based on population-based studies and found that 2.0% of the general population is affected. However, the prevalence of ACO depends on its diagnostic criteria. Therefore, there is a vital need to better define the ACO diagnostic criteria, management and treatment. It is worth noting that the limitations of the present study include lack of studies in some region of the world and small number of studies included in the subgroup analyses

Objective: The introduction and use of antiretroviral therapies (ART) has revolutionized the management and treatment of Human Immunodeficiency Virus (HIV)/acquired immunodeficiency syndrome (AIDS). HIV/ AIDS globally resulting in increased life expectancy. Current treatment guidelines by WHO recommend the use of a combination of at least 3 ARV drugs which include: 2 Nucleoside Reverse Transcriptase Inhibitors (NRTIs) combined with 1 medication from either of the 2 remaining classes; the Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) or the Protease Inhibitors (PIs). Micronutrients and electrolytes deficiencies are prevalent among HIV-infected populations. The use of Highly Active Antiretroviral Therapy (HAART) on the other hand has been shown to increase the life expectancy of HIV infected individuals. The present study was designed to determine the effects of HAART on serum micronutrients and electrolytes concentrations in HIV positive patients. Materials and Methods: A prospective randomized controlled clinical study was conducted in the with 231 HIV+ adults with low plasma zinc levels (<0.75 μg/ml), randomly assigned into zinc (12 mg of elemental zinc for women and 15 mg for men) or placebo, for 18 months. The primary endpoint was immunological failure. HIV-viral load and CD4+ cell count were determined every 6 months. Questionnaires, pill-counts, plasma zinc and C-reactive protein (hsCRP) were used to monitor adherence with study supplements and ART. Intent-to-treat analysis utilized multiple-event analysis, treating CD4+ cell count <200 cells/mm3 as recurrent immunological failure event. Cox proportional-hazard models and the general-linear model were used to analyze morbidity and mortality data. Results: Severe, moderate and mild malnutrition were detected in 15%, 38% and 24% of human immunodeficiency virus infected individuals respectively. Compared with the healthy control group, serum level of zinc and selenium in the human immunodeficiency virus infected subjects were significantly lower (P = 0.01 and P = 0.02 respectively). Discussion: In our study we found, there is significant increase in weight, BSA, BMI, where as significant decrease in DBP of diabetic group compared to Non-Diabetics & there is significant increase in FBS, HbA1C levels of Diabetic group significant decrease in LH levels of Diabetics compared to Non-Diabetics. However T3 levels of Diabetic and Non-Diabetic group were almost same, where as T4, Oestradiol and progesterone levels of diabetic group non-significantly increased and FSH and TSH levels non-significantly decreased in Diabetics. There is frequent co-existence of thyroid dysfunction and diabetes mellitus among post menopausal diabetic women. Conclusion: ART treatment did not complement zinc status in HIV infection while improving CD4+ T-cell count, hence the need to consider supplementation

Background: COVID 19 positive pregnantwomen form a very vulnerable group.  It adversely affects their physical and psychological health. These women are likely to develop new health problems or aggravation of existing problems during pregnancy and in the post-partum period. Materials and Methods: This was a prospective observational study of 100 consecutive Covid positive pregnant women who were admitted in the isolation wards of Government Medical College, Thrissur and delivered during the study period from 1st may 2021. These women were followed up till 6 months postpartum. Data was collected from recordsand bypersonal interview or telephonic call using astructuredquestionnaire. Demographic profile, Covid symptoms and their severity, obstetric details, breast feeding practices, neonatal outcomes and post Covid symptoms were studied. The association between breastfeeding, hygiene practices and neonatal positivity was also looked into/. Results: 51% of Covid positive pregnant women were asymptomatic. Nine women had severe Covid pneumonia with 2 of them requiring ventilatory support. There were no cases of vertical transmission or transmission through breastfeeding among the newborns studied. There was a strong association between strict adherence to hygienic practices and neonatal positivity. 24% of women had persistent symptoms at 6 months postpartum. Post exertion malaise was most commonly observed. Conclusion: Women with COVID-19 infection during pregnancy may continue to have health problems and hence need a close follow up

Introduction: Blood is essential part of life saving treatment options in medical sciences. Various blood group systems have been identified till now but different human populations express to have different frequencies of blood types. The prevalence of blood groups differs distinctly in different parts and groups of populations around the globe.The information about distribution of blood groups in an area is of great value for better inventory management. Aim and Objective:To determinethe prevalence of ABO-Rh(D) blood types in apparently healthy population in Kota (Hadoti region). Material and Method: This blood centre based cross sectional study was carried out during the period of one year, i.e., from 1st January, 2021 to 31st December, 2021.During that period,5,657 blood donors donated whole blood at our blood centre and among the outdoor camps. ABO and Rh (D) typing was done by saline agglutination method done manually using commercially prepared antisera (for forward/cell grouping) and in house prepared reagent cells (for reverse/serum grouping).Descriptive analysisof sex and blood groups was done by using Microsoft Office Excel 2007. Results: Male donors 97.83% were more than female donors2.17%with M:F ratio being 45:1. 4.68% were detected to be having Rh (D) negative blood group while 95.32% were Rh (D) positive. Distribution of ABO-Rh(D) blood typesamong was found to be B+(36.70%)>O+(30.63%)>A+(19.32%)>AB+ (8.66%) > B- (1.75%) >O- (1.61%) > A-(0.92%) > AB-(0.41%). Conclusion: Present study concludes B+ being the most common blood group and Rh (D) negativity being 4.68% in the Hadoti region of Rajasthan. We recommend multicentricstudies with larger sample size to be conducted and comparative analysis to be done to more precisely understand the distribution pattern of blood groups in this region

Background: Non Communicable Diseases (NCDs) are one of the important modern epidemics affecting the elderly and it also worsens with age.  Health seeking behavior among elderly plays an important role in managing NCDs properly and thereby reducing the morbidity and mortality from NCDs. And health seeking behavior in turn is influenced by various factors. Knowing more about the pattern of health seeking behavior and its determinants among elderly will help health care workers in taking proper measures to improve their health seeking behavior and thus improve the quality of living. Objectives: To assess the health seeking behavior among elderly living with NCDs in a rural area in Trivandrum district and to find out the determinants of health seeking behavior among them. Materials and methods: It is a qualitative study using Focus group discussion method. Done  within 3months during June 2022 to August 2022 in a rural grama  panchayath area in Trivandrum district, Kerala among elderly individuals  diagnosed with NCD like hypertension, diabetes, dyslipidemia,  heart diseases, residing in the that  panchayath area  in Trivandrum .Total of 2 FGDs were conducted with each one having minimum of 6 and maximum of 12 participants. Total of 18 participants were included. Details regarding socio-demographic details, details regarding pattern of health seeking behavior for NDCs, and factors influencing health seeking behavior were discussed. Results: In the current study it was found that half of the participants had good health seeking behavior. Less than half of the participants had self medication. Motivation from dear and near, fear of complication, good support from health care worker were found out to be the facilitating factors while Self medication, poor transportation availablty, poor attitude from health care workers, fear of Covid19, poor financial status were reported as reason for poor health seeking behavior in this study. Conclusion: Addressing these barriers by improving the awareness of public regarding NCDs and importance of early diagnosis and prompt treatment along with overall improvement of health related facilities and quality health care services along with integration and coordination of public and private health services and promoting the various motivational factors can improve the overall health seeking behaviorBackground: Non Communicable Diseases (NCDs) are one of the important modern epidemics affecting the elderly and it also worsens with age.  Health seeking behavior among elderly plays an important role in managing NCDs properly and thereby reducing the morbidity and mortality from NCDs. And health seeking behavior in turn is influenced by various factors. Knowing more about the pattern of health seeking behavior and its determinants among elderly will help health care workers in taking proper measures to improve their health seeking behavior and thus improve the quality of living. Objectives: To assess the health seeking behavior among elderly living with NCDs in a rural area in Trivandrum district and to find out the determinants of health seeking behavior among them. Materials and methods: It is a qualitative study using Focus group discussion method. Done  within 3months during June 2022 to August 2022 in a rural grama  panchayath area in Trivandrum district, Kerala among elderly individuals  diagnosed with NCD like hypertension, diabetes, dyslipidemia,  heart diseases, residing in the that  panchayath area  in Trivandrum .Total of 2 FGDs were conducted with each one having minimum of 6 and maximum of 12 participants. Total of 18 participants were included. Details regarding socio-demographic details, details regarding pattern of health seeking behavior for NDCs, and factors influencing health seeking behavior were discussed. Results: In the current study it was found that half of the participants had good health seeking behavior. Less than half of the participants had self medication. Motivation from dear and near, fear of complication, good support from health care worker were found out to be the facilitating factors while Self medication, poor transportation availablty, poor attitude from health care workers, fear of Covid19, poor financial status were reported as reason for poor health seeking behavior in this study. Conclusion: Addressing these barriers by improving the awareness of public regarding NCDs and importance of early diagnosis and prompt treatment along with overall improvement of health related facilities and quality health care services along with integration and coordination of public and private health services and promoting the various motivational factors can improve the overall health seeking behavior

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

There is debate regarding whether septoplasty in youngsters will have a negative impact on nasal and facial growth. Current research has demonstrated that in carefully chosen young patients, septoplasty can be safely performed without impairing nasofacial development. The goal of this article is to determine how paediatric septoplasty affects nasal and facial growth while also reviewing the clinical indications and supporting data on when to schedule surgery based on the most recent research. Using the terms paediatric, childhood, septoplasty, nasal septum, indications, nasal growth, and face growth, a structured review of the PubMed, Ovid Medline, and Cochrane Collaboration databases (Cochrane Central Registry of Controlled Trials, Cochrane Database of Systemic Reviews) was conducted. Another similar study came to the conclusion that most aspects of nasal function are unaffected by external septoplasty. Conclusions: There is proof that paediatric septoplasty can be done almost entirely without having an impact on the development of the nose and face. However, postponing or refusing to have a septoplasty when it is necessary may negatively impact nasal and facial growth, compounding negative outcomes in terms of deformity and asymmetry. Despite the fact that the majority support having septal surgery when a patient is 6 years old or older, further clinical trials are needed to gather greater support for correcting septal abnormalities in infants and young children. a function for septoplasty is thus supported by ached controls

Congenital birth abnormalities are a major factor in infants' poor health, which affects their likelihood of surviving. Even though these visual anomalies are rare, they have a substantial influence on people's quality of life.This study aimed to describe the clinical profile of congenital ocular anomalies with different epidemiological parameters in a tertiary health center in western Orissa. The study examined 3674 patients in the age group from 0 to 14 years who were admitted to the V.S.S. Medical College, Burla, Odisha and included 151 eyes from 99 cases of various types of congenital anomalies. A detailed history and other necessarydata were collected by trained ophthalmologists and descriptive analyses were carried out. The incidence of congenital ocular anomalies was 2.69%. Nasolacrimal duct anomalies (47 eyes) were the most common congenital ocular anomaly (31.1%); followed by congenital cataract (41 cases; 27.3%) and colobomy eye (18 cases; 11.9%). There was a slight male preponderance that accounted for 56.57% of all cases.The majority ofpatients were younger than 5 years (68%) and theincidence of congenital ocular anomalies was highest in the 0-5 year age group (68.69%). Single ocular involvement was observed in 47 cases (47.47%) while bilateral involvement was observed in 52 cases (52.53%). Consanguinity was identified in 13.13% of cases, with an increased risk of bilateral involvement (84.6% of cases). The most common symptom was ametropia (38.4%), followed by tearing (32.3%) and a white pupillary reflex (14.1%). A total of 60 eyes (39.7%) required surgery. Congenital ocular anomalies are a common cause of ocular morbidity, accounting for 2.7% of all cases in the pediatric age group. Early diagnosis, referral, and appropriate intervention would help prevent most permanent sequelae in congenital ocular abnormalities

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

Introduction: Pancreatitis is one of most complex and clinically challenging of all abdominal disorders. USG and abdominal CT are the most commonly used diagnostic imaging modalities for the evaluation of pancreas. Computed Tomography (CT) is highly accurate and sensitive than USG in both diagnosing as well as demonstrating the extent. Early assessment of the cause and severity of acute pancreatitis is of utmost importance for prompt treatment and close monitoring of patient with severe disease. CT is the imaging method of choice for assessing the extent of acute pancreatitis and for evaluating complications. Materials and methods: This is a prospective study was conducted in the Department of Radiology at Dr. VRK Women's Medical College, Teaching Hospital and Research Centre Hyderabad, among 70 cases of acute pancreatitis. All the cases of acute pancreatitis referred under department of radiology in a tertiary healthcare institute, and fulfil the set inclusion criteria, who consented to participate in the study were included in the present study. It was carried out among 46 indoor cases of acute pancreatitis referred under department of radiology for further diagnostic evaluation, in a tertiary healthcare teaching institute in Maharashtra during study period. Ethical Approval was taken from the college ethics committee. Result: In our study, a total 70 patients were studied using CT scan, who was suspected to have acute pancreatitis. Among them, 50 (71.5%) were males and 20 (28.5) were females. Necrosis of the pancreatic gland parenchyma was seen in 17 (24.3%) patients. 12 patients (17.1%) showed <30% necrosis. 8 patients (11.4%) showed 30-50% necrosis, and 10 patients (14.3%) showed more than 50% necrosis. Conclusion: In conclusion CECT was found to be an excellent imaging modality for diagnosis, establishing the extent of disease process and in grading its severity. The Modified CT Severity Index is a simpler scoring tool and more accurate than the Balthazar CT Severity Index. In this study, it had a stronger statistical correlation with the clinical outcome, be it the length of hospital stay, development of infection, occurrence of organ failure and overall mortality. It could also predict the need for interventional procedures

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

Background: Hypertension is a chronic illness associated with high morbidity and mortality. Once hypertension is diagnosed, starting antihypertensive therapy on a long-term basis along with regular follow up is important. Drug utilization research also provides insight into the efficiency of drug use, i.e. whether a certain drug therapy provides value for money and the results of such research can be used to help to set priorities for the rational allocation of health care budgets. The main objective of the study is to assess the utilization pattern of antihypertensive in a tertiary care hospital. Materials and methods: This prospective, cross‑sectional observational study was conducted in the Department of Pharmacology, Dr. VRK Women's Medical College, Aziznagar, Moinabad. Before initiation of the study, the approval of the Institutional Ethics Committee was obtained. A predesigned pretested schedule was employed to collect the data. The schedule contained information pertaining to basic demographic variables, comorbid conditions, and a format to assess the antihypertensive drugs prescribed. Patients coming to the medicine outpatient department were screened over a 4‑month period. Among all the prescriptions that were screened, prescriptions that had antihypertensive medication as a component were noted along with the hospital number. Results: A Total of 90 patients with history of hypertension were included. In the present study majority of patients i.e., 55.6% (50/90) were among 51-60 years, followed by 24.4% (22/90) patients among 41-50 years, 11.1% (10/90) were 61-70 years.5.6% among 30-40 years, 2.2% were among 71-80 years, least were more than 81 years i.e., 1.1%. The patients were categorized depending on the stages of the hypertension- 10 /90 (11.1%) patients belonged to prehypertension stage, 60/90 patients (66.7%) belonged to stage 1 hypertension and 20/90 (22.2%) patients belonged to stage 2 hypertension. Conclusion: In this study usage of anti-hypertensive drugs were prescribed rationally in tertiary care hospital. The study emphasizes that need for effective continuing medical education and also preventive measures in hypertensive individuals

Background: Acne scarring commonly seen in young adults causes marked psychological distress. Commonly used procedural treatments for post‑acne scarring have limited efficacy. This prospective, randomized study was undertaken to evaluate the efficacy and adverse effects offractional CO2 laser, microneedling, and platelet‑rich plasma (PRP) in post‑acne scarring. Materials and methods: This are a prospective, descriptive and hospital-based study. Total of 140 cases were enrolled in study carried out for 1 year in the Department of Dermatology at tertiary health centre and medical college with subsequent follow up of up to six months. Prior to the study, an institutional ethical committee clearance was obtained. Patients with acne scars under the groupings of a score > 3 points on Global Acne Scarring Classification Scale were enrolled. Result: Out of 70 patients treated with fractional CO2 laser, 01 patients had satisfactory response i.e. 1.4% improvement in point score, majority of patients had very good response 36 i.e. 51.5% improvement in point score, 26 patients were in the good response category 37.1% improvement in point score) and patients had excellent results. The objective score was calculated for derma roller therapy, and the results indicated that the baseline mean objective score which was 28.99±2.20 was reduced to 18.85±1.85 after the treatment. This difference was found to be highly significant with p value as 0.000. The reduction in the objective scores was found to be 39.69% Conclusion: Fractional Co2 laser resurfacing is more efficacious than micro needling with longer down time interfering with daily activity of patients and mandatory avoidance of sun exposure in post treatment period are the limiting factors

Background: Various factors like physiological and emotional stress, drugs and nutritional deficiencies can result in hair loss. Results of laboratory tests examining the underlying aetiology of hair loss vary in patients. Materials and methods: Fifty-four patients with hair loss (47 females, 7 males) and 55 healthy individuals within the control group (47 females, 8 males) were included in this study. Serum levels of ferritin, folate, vitamin B12, zinc, thyroid stimulating hormone and 25-hydroxyvitamin D were evaluated in all participants retrospectively. Result: A total of 70 patients were studied which included 45 males and 25 females. Out of these mild AA was seen in 15 males and 10 females, moderate AA was found in 30 males and 15 females. We did not get any cases of alopecia totalis (AT), alopecia universalis (AU) or ophiasis. Conclusion: Women with hair loss can benefit from higher ferritin levels

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

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: The current feasibility study is to be analysed for the possibility of establishing a podiatry unit in PMR hospital Hyderabad. This study focuses on the better performance  in means to facilitate the service to the diabetic foot patients. This study is performed with the way of framing close ended questionnaires stating the goal of the study.  Aims: Study also aims to gather opinion of health care staff and patients about need for podiatry services.  Materials and methods: The data gathered with questionnaire is from various participants of sample size approximately 100. Qualitative and quantitative form of analysis are being used in this study. Qualitative analysis is used for purposive sampling and quantitative analysis is used for convenience sampling.  Results: There is statistical significance impact of opinion of patients in the overall experience on foot ulcer treatment towards the overall ease of podiatric equipment availability for the patients for the treatment. Overall experience in management varies high then there is a variation occurring in the other two variables, the seeking support and the availability of podiatry equipment’s.  The significance value in the above regression test, explains about the significance correlation among those variables the preparedness of patients to acquire surgery from same tertiary care centre and overall experience of the patients in management for foot ulcers. Nearly 37% of probability of predictor variable is prevailing to have specific relation on the dependent variable Ease of availability of Prescribed podiatry equipment including removable cast walkers and dressings. Conclusion: The podiatry consists of delivery of services associated to the issues in foot health. The prominent challenge to provide the podiatry-services seems complex and it necessitates on-going variation of role flexibility, knowledge, skills and working practices

Silicosis is an occupational hazard for those working in mines & in construction works. These patients are exposed to long term complications and chronic morbidity. In patients with silicosis, the involvement of pleura in the form of pneumothorax is uncommon. In our study, we have made an attempt to study the risk factors, pathophysiology & clinical profile of patients with silicosis presenting with pneumothorax,its treatment outsome and recurrence rate of pneumothorax . Silicosis has no definitive treatment. An awareness of safety & preventive measures to reduce the incidence of the disease, morbidity & mortality are needed to improve the health of people working in such places

Objective: The primary goal of the intraoperative Frozen Section biopsy in a clinically suspected Central Nervous System (CNS) neoplasm is to evaluate the submitted tissue for rapid diagnosis, which helps in proper management during open craniotomy. In this study, the accuracy of frozen section in the diagnosis of CNS neoplasms and discrepancies in diagnosis were analyzed. Material & Methods: Ninety cases of CNS neoplasms were examined over a period of one year. All the cases were open biopsies performed at Neurosurgery Department &intra-operative frozen section (by cryostat) was performed & reported in the Histopathology section of a referral center in Eastern Odisha. The diagnoses given on FS were compared with the final diagnosis given on permanent paraffin embedded tissue sections. Results: In all cases, cryostat sections were prepared and a provisional diagnosis was given. Final histopathological diagnosis was given by studying the Hematoxylin & Eosin (H&E) section. Out of these 90 cases, 81 cases (90.0 %) were concordant, 9 cases (10.0 %) were discrepant. The discrepancies occur in mainly differentiating astrocytomas from oligodendrogliomas & schwannoma from meningioma along with few over-grading of glioma cases. Conclusion: Our results showed a reasonably high percentage of accuracy in the intraoperative diagnosis of CNS lesions. However, freezing artifact, obscuring cytological detail, heterogenous features of gliomas and lack of proper clinical inputs were the major causes for discrepancies

Background: Grades of malnutrition can be classified and diagnosed by various available methods like IAP, WHO-Z score, Waterlow, Gomez and various parameters like anthropometric measurements. All these methods are also used to compare incidence and prevalence of malnutrition between different age groups. This study was done to compare the IAP vs WHO-Z score classification in precisely assessing the malnutrition status of children aged 0 to 5 years. Methods: This multicentric prospective comparative study was conducted at twenty-five ICDS centers in Karaikal, Puducherry between 2017-2019. Eligible study population included 0-5 years old children whose parents were willing to give consent at the time of enrollment. A thorough clinical examination was done to diagnose various nutritional deficiencies. Comparison was done between IAP and WHO classification of degrees of malnutrition. The comparison groups were analyzed using chi-square test. Results: A total of seven-hundred children were assessed for malnutrition, classified into various grades using IAP and WHO-Z score. Comparative analysis was done between two groups from each grade of malnutrition and it was observed that WHO-Z score classification and IAP classification didn’t have significant difference in identifying moderate malnutrition but WHO-Z score was significantly better (P=0.0001) in precisely identifying severe malnutrition. Conclusion: This study indicates that severe malnutrition which is still prevalent as assessed by IAP and WHO-Z score can be more precisely diagnosed using WHO-Z score [WAZ-7.8%, WHZ-3.8%, Grade III & IV-3.5%]. IAP grading is a time-tested method, which is easy to use and all categories of health workers were already accustomed to use it. A new tool incorporating WHO-Z scores in the existing IAP grading can be evolved for an accurate assessment of severe malnutrition

Introduction: non-communicable diseases (NCDs) present an imminent threat to people worldwide. Globalization delivers the uniform cause for the spread of chronic diseases to every corner of the World. AIM: To determine prevalence of Major risk factors of Non Communicable Diseases among study population. Material and methods: This was a Cross sectional study including 325 Doctors with minimum qualification of MBBS/BDS, working in Govt. health care facilities of Bikaner district, from Dec. 2019 to dec 2021 at Department of Medicine, S.P. Medical College, Bikaner, Rajasthan. Results: Mean age of study population was 40.58 ± 10.21yr. we found that 9.85% were current smoker, 1/3rd had used at least a standard drink in last 12 month, 68.92% consumed >5gm salt per day, 45.85% were active physically. 48.62% were overweight and obese, 12.92% had systolic BP ≥140 mmHg, prevalence of diabetes mellitus was 14.46%. Conclusion: The prevalence of risk factors for lifestyle diseases was high among the health professionals

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

Introduction: Burst abdomen is considered to be there when intestine or other viscera are seen through the abdominal wound after surgery (general and obstetric surgeries).It can increase the length of hospital stay and result in significant social and economic costs for the patient and health care system. The present study aims at analyzing the incidence, etiological factors and management of this severe post-operative complication experienced by gynaecologists.  Materials and Methods: The present study comprises 25 cases of burst abdomen in the Department of Obstetrics and Gynaecology, MKCG Medical College Hospital, Berhampur, Odisha from August 2020 to July 2022. Using a check-list and a questionnaire, the patient’s demographic data, medical history, physical examination findings, laboratory investigation results, surgical procedures, and outcome of the repaired burst abdomen were collected.  Results: In our study period the incidence of burst abdomen was 0.19%. Majority of the cases, both caesarean delivery cases (100%) and gynaecological cases (60%), were emergency cases. The indication of laparotomy being ectopic pregnancy (40%) was the most common in gynaecological cases and the most frequent indication for caesarean delivery leading to burst abdomen was obstructed labor (40%). Obesity was the the most frequent (24%) comorbidity encountered in our setup. Majority of the cases (84%) had transverse incision and only 16% cases had sub-umbilical midline incisions. Layer closure was used in majority (92%) of the cases which led to burst abdomen as compared to mass closure which was seen in 8% of the burst abdomen cases. The majority (72%) of burst abdomen occurred between 6th and 7th post-operative day in our study, with the average mean of 6.72 days.  The post-operatively anemia was seen in 72% of the cases that led to burst abdomen. Operative area infection also seemed to pre-dispose patients to burst abdomen and was seen post-operatively in 36% of the patients.  Conservative treatment (daily saline dressings) was done in no case in our study. Immediate re-suturing of the wound in the operation theatre was done in 22 cases. In majority of cases (56%), secondary closure of burst abdomen was done with non absorbable polypopylene. In present study the range of stay for majority was within 21-35 days and mean duration of stay was 24.52 days. Two cases had burst abdomen recurrence, i.e. 8%. Conclusion: Burst abdomen is one of the serious postoperative complications faced by surgeons and is of greatest concern because of risk of evisceration, the need for immediate intervention and the possibility of repeat dehiscence. It poses tremendous impact on quality of life, health care cost for patients, their families and hospitals by requiring re-operations, need for antibiotics and prolonging hospital stay. Knowledge of the more common mechanisms and how to avoid or overcome these hazards should help to reduce the incidence of this dangerous complication such as maintaining asepsis, avoiding preoperative, intraoperative and postoperative precipitating factors of burst abdomen and providing good antibiotic coverage.

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.

Introduction: An ectopic pregnancy occurs when the developing blastocyst implants either outside the uterus i.e fallopian tube (interstitial, ampullary, isthmic, fimbrial), Ovary and abdominal cavity or in an abnormal position within the uterus i.e cornual, cervical. Around 98.3% of ectopic pregnancies occur in the fallopian tubes. Visualization of an intrauterine sac, with or without fetal cardiac activity, is often adequate to exclude ectopic pregnancy. The treatment modality also has evolved from radical surgery, conservative surgery to medical and expectant management. Laparoscopy is now recommended approach in surgical management of ectopic pregnancy.Materials and Methods: This is a prospective observational study conducted in Department of Obstetrics and Gynaecology from 2020 to 2022 where 118 cases were studied. Detailed history was taken for all cases with special reference to risk factors like smoking, PID, abortions, previous ectopic, IUD use, sterilization, D & C, IVF and LSCS followed by clinical examination. Routine and other relevant investigations were done including (UPT, CBC, ICTC, HCV, HbSAg, USG (TVS) and serum β-HCG and managed according to the condition of patient either medical, surgical or both. Data regarding intraoperative finding confirming site of ectopic pregnancy, ruptured or unruptured, operative techniques including salpingectomy, salpingo ophorectomy, cornual repair or hysterectomy and blood product transfusion were collected. Patients were followed up till discharge or death and the outcome were analysed. Results: Maximum numbers of cases, 45 cases (38.1%) were in the age group between 26 to 30 years. Among all cases, 24 cases (20.3%) had history of previous abortions, 22 cases (18.6%) had history of PID, 14 cases (11.9%) had undergone D & C earlier, 8 cases (6.8%) had earlier tubal ligation, 5 cases (4.2%) had h/o IUCD insertion and 1 case (0.8%) had previous history of ectopic pregnancy. The classical triad of amenorrhea, abdomen pain and abnormal vaginal bleeding was seen in 52 cases (44.0%). The most common site of ectopic pregnancy site was fallopian tube, of which 96 cases (81.3%) were in amupulla, 14 cases (11.9%) were in isthmus and only 3 cases (2.5%) were in infundibulum. Only 2 cases (1.7%) had cornual pregnancy with gestational sac implanted in the non communicating horn of unicornuate uterus. Maximum number of ectopic pregnancy cases underwent surgery, with 98 cases (83.0%) had undergone  unilateral salpingectomy as the most common procedure whereas 15 cases (12.7 %) had undergone unilateral salpingophorectomy in cases with unhealthy ovary and ovarian pregnancy out of 113 cases of tubal ectopic pregnancy. Only 2 cases (1.7%) with cornual pregnancy had cornual resection and repair. Hysterectomy was adopted as surgical treatment in 2 cases (1.7%) only.Conclusion: Patients with risk of ectopic pregnancy like PID, IUCD implantation, previous ectopic pregnancy and patients with history of D & C should undergo routine USG in first trimester to locate the site of early pregnancy. We recommend follow up above cases of ectopic pregnancy and analyzing the effect of ectopic pregnancy on future fertility and pregnancy.

Aims and objective: Apoptosis is essential physiological process of eliminating cells with damaged DNA. Any alterations in the apoptotic pathway may result increased malignant potential. Oral leukoplakia is an important health issue, especially in countries where the use of tobacco is almost a social habit. A significant proportion of cases of oral leukoplakia progress to the squamous cell carcinoma. Although the role of tobacco in causation and malignant transformation of oral leukoplakia is well established, but the cellular pathways affected by the tobacco use are not yet clear. The aim of the present paper was to study the effect of tobacco in alteration of apoptosis and proteins involved in apoptotic pathway and K-ras in oral leukoplakia. Material and Methods: Two hundred and thirty cases of oral leukoplakia were included in the study. These cases were divided into tobacco-consuming and non tobacco-consuming groups depending upon the history of tobacco intake (smoking or chewing). The presence and grade of dysplasia was noted from the histopathological reports. The apoptotic cells were identified by in-situ terminal TdT-mediated dUTP-biotin nick-end labeling (TUNEL). The expression of caspase-3, caspase-8, caspase-9, bax and K-ras was studied in all the cases by immunohistochemistry. The apoptosis and caspase protein expression was then compared with control subjects using chi-square test. Result: The cases diagnosed with leukoplakia were grouped according to use of tobacco. In both the groups a statistical significant increase in apoptosis, caspase-3, caspase-8, caspase-9, bax and K-ras was observed as compared to controls.  On comparison between the groups, the apoptosis and proteins involved in apoptotic pathway in tobacco group with dysplasia were significantly lower than the non tobacco-consuming group with dysplasia. An increase in K-ras oncogene expression was found in leukoplakia-dysplasia of tobacco-consuming group. Conclusion: A significant decrease in the proteins mediating the extrinsic and intrinsic pathway of apoptosis was observed in the tobacco-consuming group, which indicates possible role of tobacco carcinogens in malignant transformation of oral leukoplakia.

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.

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.

Background This study was conducted to compare hippocampal volume in patients with TLE with that of a normal control group, and examine the degree and frequency of reductions in hippocampal volume in patients with prolonged epilepsy. Methods This was a hospital based cross-sectional observational study conducted among 228 patients who presented with epilepsy to the Department of Radio-Diagnosis at Ashwini Neuro-Trauma Center Cuttack, from 2015 to 2020 after obtaining clearance from the institutional ethics committee and written informed consent from the study participants.  Results Hippocampal volume distribution in the left lobe as well as the right lobe was found to be significantly lower in epileptic subjects as compared to non-epileptic subjects. Using the Mann-Whitney U Test, the mean rank of left and right hippocampal volume comparisons among the group of subjects was found to be statistically significant. There was a significant difference in duration of seizure between epileptic and non-epileptic groups using the Mann-Whitney U test. It was seen that with an increase in seizure duration, there was a decrease in hippocampal volume, both left and right. The correlation was, however, poor but was found to be statistically significant for both left and right hippocampal volumes. Conclusion The ability of volumetric 3D imaging to predict the presence and laterality of hippocampal atrophy plays an integral role in the evaluation of patients with epilepsy, especially in patients with subtle findings and no perceptible hippocampal atrophy on visual inspection and, should be utilized on a regular basis in clinical practice as it is superior to visual analysis in detecting hippocampal atrophy, which can help in guiding surgical resections.

Biomedical Waste Disposal has become a subject of great concern in the modern health care system. It is vital in maintaining public health and preventing transmission of certain infectious diseases. Knowledge and attitudes towards safe disposal of biomedical waste is key to the successful implementation of the program particularly in the health care facilities. 200 health care professionals interviewed to understand the ground realities of their knowledge and attitudes. While all of them agreed to the fact that knowledge about Biomedical Waste disposal is essential, only 55% have the knowledge of color coding. 74% have knowledge of segregation and 86% use protective gear while segregating. 99% have favorable attitude score. Knowledge among the medical personnel is high whereas the same among the house keeping staff is low. The need for providing continuous education and monitoring its implementation and strict law enforcement are some of the suggestions made to achieve a complete and meaningful Biomedical Waste Management. 

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 In this study, we wanted to assess the menstrual awareness among urban and rural adolescent girls and compare the menstrual hygiene practices among them. Methods This was a hospital based cross-sectional study conducted among 170 adolescent girls attending the OPD of Gynaecology, Paediatrics and General Medicine at Government Medical College, Thrissur District, Kerala. It was carried for a period of one year after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. They were provided with a validated questionnaire to assess menstrual awareness hygiene practice among them. Results Majority (89.4%) from the urban area of residence believed that it was physiological, while majority (54.1%) from the rural areas didn’t know the actual cause for menstruation. This difference between the rural and urban areas on awareness about the cause of menstruation was found to be statistically significant. More than half of the subjects used sanitary pads during menstruation. The frequency of changing pads at school was less in both urban and rural groups. The reusage of pads was almost similar among rural and urban study subjects with around 23.5% and 22.4% of them reusing the pads respectively in both the groups. Awareness regarding menstrual cup was more in urban group compared to rural. But restrictions during menstruation was practised more in rural group that is 70% compared to urban group which was roughly 52%. Conclusion Menstrual health forms the most important stepping stone to women’s sexual and reproductive health. One third of the study population was not at all aware of the cause of menstruation. There was significant difference in various menstrual hygiene practices among urban and rural girls. Many restrictions were practiced during menstruation more in rural group. A concerted effort from parents, educational institutions and existing healthcare institutions along with media may ensure safe and secure reproductive health prospects for adolescents in the region.

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.

Background: Occupational pulmonary diseases are more widespread and more disabling than any other group of occupational disease. The lung with its extensive surface area, high blood flow and thin alveolar epithelium is an important site of contact with substance in environment. The inhalation of dust over periods of time leads to proliferation and fibrotic changes in lungs. The workers working in industries suffer from various types of air way diseases like pneumoconiosis, farmer’s lung, chronic bronchitis, pulmonary fibrosis and asthma. So, the present study was undertaken to study the effects of wood dust on respiratory functions of exposed workers. Materials and methods: The present study was a cross-sectional comparative study. Subjects of experimental and control groups were selected by inclusion and exclusion criteria. There were two groups of experimental subjects (sawmill (n=50) and carpet workers (n=50)), who were non smokers and exposed to industrial dusts. And the subjects of control group were age matched, working in office set up, non smokers and not exposed to industrial dusts (n=100). Their height, weight, age, sex, presence of any respiratory symptoms/diseases, history of smoking and duration of exposure to dusts were documented using a standard case history sheet. Ambient temperature was also recorded. Weight was recorded in kg and height was measured in cm without shoes while standing erect. Pulmonary function parameters were recorded using an electronic spirometer. Result: In our study we found significantly lower PEFR values in their study as compare to healthy individuals in their study which is comparable PEFR (6.8±1.38 Versus 9.33±1.35) in our study. Moreover, we found significant lower FEV1/FVC ratio in their study in wood workers which also comparable with our study showing significant lower FEV1/FVC (89.99±5.70 Versus 77.91±6.6) ratio. Furthermore, MVV significantly lower among wood workers same interpretation was carried by our study with significant lower MVV (77.05±5.8) as compare to healthy individuals (112±4.6). Conclusion: We conclude from this study that workers exposed to pine and fibre wood dust have more respiratory symptoms than control subjects and that such exposure increases the risk of airflow obstruction. So, we recommend that workers should learn to use protective facemasks at sites and use other measures to reduce dust flow into the environment. It is important to take account not only of dust concentration, particle size, and exposure time, but also of a variety of background and individual factors (e.g., specific sort of wood, wood dust related biohazards, or disease history), since they may also contribute significantly to the decreased efficiency of lung function.

Background:  Hypertension is becoming a major public health concern in low-income countries due to rising trend of prevalence in past years. Primary factors which lead to poor treatment outcome is the patient non-adherence to medicines. It is therefore, important to analyse the factor responsible for non-adherence to obtain better prognosis. Objective: The present study aimed to determine various sociodemographic and pharmacological factors which influence adherence to medicines in patients with systemic hypertension. Methods: Adherence to antihypertensive medications was measured by using therapeutic adherence scale for hypertensive patients (TASHP). Results: A significant association was observed between satisfactory drug adherence and lower pill burden (one pill/day) and combination drug therapy (1 pill with >2 drugs combination). Lower frequency of drug intake was associated with higher drug adherence though the association was not statistically significant (p=0.241). Presence of side effects was associated with statistically significant low drug adherence (p=0.001). Conclusions: Satisfactory compliance to antihypertensive therapy was associated with combination therapy and limited pill burden. Absence of side effects with antihypertensive medication and better blood pressure control were also associated with better drug compliance. Identifying these pharmacological factors would be of value for physicians in focusing strategies to enhance patient compliance to antihypertensive medication.

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.

Material & Methods: Study Design: Hospital based prospective observational study.Study area:Department of Obstetrics & Gynecology, Mayo institute of Medical Sciences,Barabanki, Uttar Pradesh.Study Period:April 2022 toMarch 2023. Study population:All patients presenting with jaundice to Department of Obstetrics & Gynecologyin antepartum or intrapartum period.Sample size: Study consisted a total of 55 subjects.Sampling Technique:  Simple Random technique. Results: In 29% (n=16) of cases, jaundice is due to obstetric cholestasis, who are mostly presented with pruritis and abnormal LFT’s in their third trimester, In 27% (n=15)it is due to HELLP syndrome which is associated with preeclampsia in 14%, In 12.7%(n=7) cases jaundice is due to sickle cell anemia and Hepatitis B each, haemolytic anemia due to blood transfusion is seen in 5.45% (3), in 3.6%(n=2) cases cause is AFLP who presented with hepatic encephalopathy and hypoglycemia , cirrhosis is the cause of jaundice in 3.6%(n=2) who presented in their first and second trimester,1.8%(n=1) cases are due to malaria, cholelithiasis and autoimmune hepatitis each. So in nearly half of the cases the cause of jaundice is pregnancy specific causes. Conclusion:Jaundice in pregnancy is a dreadful condition resulting in high maternal and fetal mortality. Even though the blood bank facilities has increased, due to their advanced disease state at admission few patients could not be survived. So early referrals are helpful.Team effort is needed in the management of jaundice , team should constitute obstetrician , physician, gastroenterologist, anaesthetist and neonatologist, so that identification and treatment throughout antepartum, intrapartum and postpartum period prevent and reduce maternal and perinatal morbidity and mortality.

Introduction: The management of peritonitis presents significant challenges to healthcare professionals, given its high morbidity and mortality rates. Peritoneal lavage is a therapeutic technique used in the management of peritonitis, involving the irrigation of the abdominal cavity with a solution to remove inflammatory debris, pathogens, and toxins. Different liquids have been employed for lavage. This study compares the effectiveness of peritoneal lavage with saline and metronidazole in instances of peritonitis that have undergone surgery. By examining the outcomes associated with each lavage solution, valuable insights can be gained into the optimal approach for managing this potentially life-threatening condition.

Material & Methods: Study Design:  Case-control study. Study area: Department of General Medicine, Nimra Institute of Medical Sciences, Vijayawada. Andhra Pradesh. Study Period: April 2022 – March 2023. Study population:  Patients with acute myocardial infarction admitted in department of medicine. Sample size: Study consisted a total of 50 cases and 10 controls. Sampling Technique:  Simple random method. Study tools and Data collection procedure: 50 acute myocardial infarction cases and 10 healthy controls were selected. The subjects were informed about the nature and purpose of the study and consent was taken from subjects themselves or family members in case of unconscious patients. Patients presenting with chest pain suggestive of myocardial infarction, who showed E.C.G. evidence of acute infarction changes were assessed by detailed history and physical examination as outlined in proforma. The infarction was confirmed by elevated CPK/troponin levels. Serum magnesium is estimated within first 24 hours of chest pain. Serum magnesium estimated by Colorimetric method using calmagite. Clinical findings, and serum magnesium levels are used as parameters to assess the incidence of complications likes arrhythmias, left ventricular failure, cardiogenic shock, supraventricular arrhythmias. Bundle Branch Block, Hemi Block, AV Block and Mortality in patients with AMI. Results: There were more number of deaths in AMI patients with hypomagnesemia than in patients of AMI with normal serum magnesium levels. There is no statistically significant association of hypomagnesemia with death in cases of AMI as p value is 0.091. Conclusion: Prophylactic administration of the intravenous magnesium sulphate may be considered in all cases of Acute Myocardial infarction as an adjuvant to thrombolytic therapy and in patients not suitable for thrombolysis to prevent cardiac arrhythmias & reduce short term mortality irrespective of serum magnesium levels as it is safe and cheap.

Objectives: Adding adjuvants to local anaesthetics hastens the onset and prolongs the duration of blocks with favourable postoperative analgesia. The principal objective of our study was to compare the duration of postoperative analgesia between the two intrathecal opioids (as adjuvants with bupivacaine). This prospective, randomized, double blind study was conducted at a tertiary care centre. Techniques: After institutional ethical committee approval and informed patient consent, sixty healthy patients who were scheduled for elective lower extremity surgery under spinal anaesthesia were divided into two equal groups and enrolled in the study. They received 15 mg of hyperbaric bupivacaine 0.5% with either nalbuphine 0.4mg (Group N) or fentanyl 25 mcg (Group F) Onset time and duration of sensory blockade along with 2 segment regression of sensory blockade were noted. Time for onset of complete motor block and duration of effective analgesia were also noted. Adverse effects, if any, were noted. Quantitative data are presented as means and standard deviations and confidence intervals, while qualitative data are presented as proportions. An independent t-test and a chi-square test for proportions were used to compare the significance of differences in the means using R software 3.2.2 version. P ≤ 0.05 was considered statistically significant. Results: Post operative analgesia lasted significantly longer in the nalbuphine group compared to the fentanyl group. Conclusion: Thus, nalbuphine is a better adjuvant to bupivacaine than fentanyl when administered intrathecally for lower extremity surgical procedures in terms of duration of postoperative analgesia.

Background: Bipolar disorder is the sixth leading cause of disability worldwide, affects about 60 million people worldwide3 and has a lifetime prevalence of about 1-3% in the general population worldwide. Objective: To assess the level of perceived Stigma, Self-esteem and Quality of Life in euthymic patients of Bipolar Affective Disorder. Methods: This cross-sectional study was conducted among all euthymic patients of Bipolar Affective Disorder, attending Psychiatry services in the Department of Psychiatry, Tertiary care center of a General Hospital. Results: Bipolar Affective Disorder patients have significantly higher stigma associated with illness even when they are euthymic. Their self-esteem is significantly lower even when they are not symptomatic and it is significantly associated with number of relapses. Their quality of life is also significantly lower than healthy population across all domains specially social relation and psychological heath domain. High level of Stigma and lower Self-esteem significantly affect the Quality of Life in patients of Bipolar Affective Disorder and can predict change in it, though stigma and self-esteem show significant association but they do not seem to be predictive of each other’s severity. Conclusions: This study is a small step in demonstrating that Bipolar Disorder patients, even when they are in a euthymic period, experience lower Quality of Life, have lower Self-esteem and experience higher internalized Stigma associated with illness.

Background: Cardiovascular disease remains the leading cause of death globally, accounting for a significant burden of mortality and morbidity. It affects people of all ages and socio-economic backgrounds, with a particular impact on low- and middle-income countries. Risk factors such as high blood pressure, tobacco use, unhealthy diets, physical inactivity, and obesity contribute to the global prevalence of cardiovascular disease.  Aims and Objectives: The aim of this research was to study and compare the thyroid profile and serum uric acid levels in diabetic and non-diabetic cardiovascular disease patients. Materials and Methods: The present hospital based observational study was carried out Osmania General Hospital and included 44 cardiovascular disease patients. All the patients underwent detailed history taking, thorough clinical examination and relevant laboratory investigations. Thyroid profile and serum uric acid levels were compared between diabetic and non-diabetic cardiovascular patients. Data was collected in MS Excel and presented as numbers and percentages in the form of tables and figures. Results: More than 60% of the patients considered for the study were male. Majority of the patients, nearly two-third (65.91%), were non-diabetic. Of the 15 patients who were diabetic, almost all the patients (86.67%) fell into the Euthyroid category, while  Hypothyroidism and Hyperthyroidism were found in only one patient (6.67%) each. None of the non-diabetic patients from the study had Hyperthyroid. Majority of the non-diabetic patients (86.21%) exhibited Euthyroid state while only 4 non-diabetic patients (13.79%) had Hypothyroidism. Almost all the diabetic patients (93.33%) from the study had normal uric acid levels, while only one diabetic patient (6.67%) had a raised uric acid level. Among the non-diabetic patients, majority of them (89.66%) had normal uric acid levels. Only 3 of the 29 non-diabetic patients (10.34%) had raised uric acid level. Conclusion: There is a strong association between diabetes and cardiovascular disease. However, further research needs to be carried out to in view of thyroid profile and uric acid levels in diabetic and non-diabetic cardiovascular disease.

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.

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.

Background: Chronic kidney disease (CKD) has emerged as a significant global health problem with substantial morbidity, mortality, and economic burden. The prevalence of CKD varies across different regions, with a higher burden observed in low- and middle-income countries.CKD is often associated with a range of comorbidities, including hypertension, diabetes mellitus, cardiovascular diseases, and anemia, which further contribute to adverse outcomes.Understanding the etiology of CKD is crucial for implementing targeted prevention and management strategies.Objective: To assess the clinical profile of CKD Patients. Methods: This cross sectional study was done on 100 CKD patients after IHEC approval with Informed consent. The various etiology of CKD, stage of disease, coexisting medical conditions, laboratory findings, and ECG/ECHO were measured.Result: Anaemia and hypocalcemia was common among the study participants. All had Cardiac changes. Majority of patients had comorbidities such as alcoholism, cardiac disease, anemia, clubbing, pedal edema, and abnormal lipid profiles. Conclusion: Managing anemia, mineral and bone disorders, fluid and electrolyte balance, hypertension, dyslipidemia, and inflammation becomes crucial in the comprehensive care of CKD patients to mitigate cardiovascular risks.

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.

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.

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 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: Alterations in the QT interval represent a crucial electrocardiographic parameter that holds clinical significance not only among adults but also in the pediatric population. The prevalence of conditions leading to sudden fatalities in children has propelled researchers to explore the realm of electrocardiographic (ECG) investigations. The primary objective of study was to establish normative QT values for pediatric subjects across different age groups and genders. Methods: Employing a cross-sectional design, we enrolled 175 healthy children (100 males, 75 females) and recorded their electrocardiograms. To ensure the homogeneity of the study cohort, individuals with congenital or acquired cardiovascular disorders were excluded from participation. Result: Heart rate exhibited an inverse relationship with the QT and QTc interval, whereas the RR interval displayed direct proportional correlations with both the QT and QTc intervals. As age increased, heart rate declined, while other ECG parameters exhibited progressive increments. Despite the inverse correlation between heart rate and QT/QTc interval, a positive correlation was observed between QT/QTc and RR interval. Conclusion: The integration of ECG as a routine investigative tool for pediatric subjects is warranted, as it aids in the early diagnosis of congenital and acquired cardiac conditions and arrhythmias, discernible through QT interval assessments.

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: 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: The issue of organophosphorus (OP) poisoning remains a significant global health concern, especially prevalent in developing nations. Aims and Objective: This current investigation endeavors to examine the clinic-demographic characteristics observed among patients exhibiting symptoms of OP poisoning. Methodology: A retrospective and prospective study spanning a duration of one and half year was carried out on patients with OP poisoning at a tertiary-level medical college. Results: Throughout the study duration, a total of 40 patients presented themselves. Instances of intentional self-poisoning (95%) outweighed those of accidental exposure (5%). The preponderance of patients were identified as housewives (32.5%), succeeded by individuals in occupations such as private job, farmers, studentship, sweepers and some were unemployed (5%). Among the toxins ingested by patients, Dichlorvas (42.5%) emerged as the predominant choice (35.74%), trailed by Chlorpyrifos, Dimethoate, Methyl parathion, Phorate , Thiomate and Monocrotophos. Manifestations of nausea and vomiting, observed in 85.02% of cases, while the predominant sign was miosis, noted in 91.94%. The mean duration of hospital stays varied among the different severity level. In terms of outcomes, 75% of patients survived without the need for mechanical ventilation and the mortality rate documented in our study stood at 10%. Conclusion: The current investigation revealed that a significant proportion of the patient cohort consisted of individuals in their youthful years, with males surpassing females in representation. Deliberate poisoning incidents exceeded accidental ones.

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.

Introduction: Hospital waste is “Any waste which is generated in the diagnosis, treatment or immunization of human beings or animals or in research” in a hospital. “Hospital waste is a special type of waste produced in small quantities carrying a high potential of infection and injury and high potential to transmit infection to others. There are serious health effects from public health standpoint if hospital waste is not handled properly. Usually, the terms medical waste, hospital waste, infectious, and regulated medical wastes are often used interchangeably with medical wastes since there is no universally accepted definition for these terms.  Material and Methods: This is a Facility based cross-sectional study conducted at Health care facilities at various levels in Ganjam district.  In each health care facility, the medical officer, the pharmacist, the staff nurse and attendant comprised our study population. Those health care providers who gave consent to participate in the study. Using the observation checklist, the facilities were observed for infrastructure, logistics and practice of the stake holders. Then, the respondents were interviewed using the structured questionnaire for knowledge. A value of 1 and 0 was assigned for correct and incorrect practices respectively. For knowledge a value of 1 and 0 was assigned for correct and incorrect responses respectively. The total knowledge and practice score for each facility was calculated and then mean score was calculated. They were asked for their valuable feedback. Finally, they were thanked for their valuable support. Results: Only 12 (46.1%) of the doctors agreed that their facilities generate biomedical wastes, 15 (57.7%) of the doctors had opined that biomedical wastes associate with health hazard, 17 (65.4%) of the doctors were concerned regarding needle stick injury, 15 (57.7%) doctors believed wearing PPE reduces infection.  Color coding of the waste segregation could be answered by 17 (65.4%) doctors, 13 (50%) of the doctors agreed that the BMW containers need to be labelled and 16 (61.5%) doctors agreed that the wastes need to be segregated at point of generation. Regarding color coded bins, 19 (73.1%) doctors practiced putting wastes in color coded bins. 20 (76.9%) doctors had the practice of displaying segregation instructions at their work place.  16 (61.5%) doctors were properly segregating wastes and aided in its proper transport. 18 (69.2%) doctors were not in practice of getting dustbins filled more than 3/4th. Conclusion: Findings from our study reveal that though the participants in our study have a fair knowledge regarding biomedical waste management still there is a lot of scope in not only improving the knowledge but also in changing the attitude and inculcating more rational practices towards the same. Majority of attendants had poor knowledge and practice regarding BMWM. Thus, there has to be a regular training programmes on biomedical waste management and its hazards for all the healthcare workers including group D workers. Along with educational intervention, strict implementation of biomedical waste management guidelines with its monitoring at all levels is also very much essential.

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.

Background: Evaluation of retinal nerve fiber layer and ganglion cell complex thickness in diabetes mellitus using SD-OCT Methods: This cross-sectional study was carried out on 183 eyes of 100 patients of type 2 diabetes and 80 age and gender matched healthy control. Diabetic patients were further grouped into Group 1(no diabetic retinopathy) and Group 2 (mild diabetic retinopathy) as per ICDRDSS classification. Patients with evidence of macular oedema were excluded.  Demographic data and relevant medical details were documented and all study subjects underwent a comprehensive ophthalmic evaluation. Peripapillary RNFL thickness and macular GCC thickness were assessed for all study participants by SD-OCT (Carl Zeiss Cirrus HD-OCT) and their mean values were compared between both groups of diabetic patients and healthy controls. Results: Significantly (p<0.0001) reduced RNFL thickness was demonstrated in both diabetic patients’ groups (81.73µm in no DR and 76.99 µm in DR) compared with controls (96.86 µm). For GCC values also, significant (p<0.0001) reduction was observed in no DR (71.99 µm) and DR (71.0 µm) groups compared to controls (84.81 µm).  Conclusion: The statistically significant reduction in RNFL and GCC thickness in diabetic patients (with and without retinopathy) compared to healthy controls indicates that retinal neuronal degeneration occurs in early stages of DR.

Background: Sepsis is known as a life-threatening organ dysfunction that is caused by a dysregulated host response to infection. Sepsis and septic shock carries high potential mortality rates, resulting in challenge and burden to healthcare system. Variation in the size of red blood cells is represented by RED cell distribution width. It is thought to be elevated when an excess amount of reticulocytes are released into circulation. RDW parameter is provided in the CBC report done by the automated analyzer. It is an inexpensive, routinely available, and rapidly measurable prognostic tool. Methodology- The study was carried out at the ICCU, Department of Medicine of tertiary care center, for period of 15-18 months. 65 patients fulfilling the inclusion and exclusion criteria were considered for the study. RDW value was recorded and it correlation with APACHE II score and mortality among the patients was noted. Data was entered in MS EXCEL spread sheet and analysed with the help of Open epi and spss software. Results- Mean age group of study population among non-survivor patient was 48.64 with SD of 17.26 and of survivor was 39.91 with SD of 16.64. Mean APACHE II score among Group I was 16.333 with SD of 7.711, in Group II was 21.307 with SD of 8.596 and in Group III was 21 with SD of 8.5. 30 days mortality among Group I was 1 (16%) in Group II was 22 (84.62%) and in Group III was 30 (90.91%). Conclusion- RDW value increased in patients with sepsis.

Background: Breast lesions are a significant global health concern, often requiring invasive procedures for definite diagnosis. Cytological and molecular markers present alternative, potentially less intrusive diagnostic methodologies. This study aims to compare the effectiveness of cytological and molecular markers for the diagnosis of breast lesions. Methods: A cross-sectional study was performed on a cohort of 500 patients presenting with breast lesions, undergoing cytological evaluation (Fine-Needle Aspiration Cytology) and molecular marker testing (HER2/neu, ER, PR, and Ki-67). Concordance between the two methods was evaluated. Results: Both cytological and molecular marker evaluations showed significant diagnostic potential. There was substantial concordance between the two modalities. However, molecular markers exhibited a slightly higher diagnostic sensitivity and specificity, especially in the detection of pre-malignant and malignant lesions. Conclusion: Cytological and molecular markers each offer valuable, complementary diagnostic approaches. While cytology provides rapid, cost-effective results, molecular markers offer increased sensitivity and specificity. Their combined usage can help minimize invasive procedures and improve patient outcomes. Further research is recommended to refine the usage of these diagnostic tools.

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: Leptin, an adipokine known for its anti obesity action also has a direct effect in maintaining blood pressure of an individual. Many studies have proposed the significant relation of high plasma leptin levels with high blood pressure. A significant association was found between a tetranucleotide repeat polymorphism (TTTC)n in the 3’UTR of leptin gene with essential hypertension in several populations. So we wanted to conduct a study to know the relationship of (TTTC)n repeat polymorphism in 3’UTR of Leptin gene with Essential hypertension in our population and its relation to serum leptin levels. Methods: A case-control study was done in our tertiary care hospital for one and a half years. Polymerase chain reaction was carried out and the products were visualized after running in 2% agarosegel electrophoresis. The alleles of this tetranucleotide polymorphism were classified as shorter form- class I and longer form class-II. Serum leptin levels were measured by ELISA. Result: It was found that Class I allele was more frequent in hypertensives when compared to controls(p<0.001). Class I/I genotype had significant association with essential hypertension even after adjusting for BMI(p<0.000). The difference in serum leptin levels between hypertensives and apparently healthy controls in our study was statistically significant even after adjusting for influence of obesity (p=0.015). This difference was in line with many other studies. However we could not find a significant association of serum leptin levels with this tetranucleotide repeat polymorphism. Conclusion: We found a significant association of (TTTC)n repeat polymorphism in 3’UTR of Leptin gene with Essential hypertension in this study.

Background:  Liver diseases represent a significant global health concern, necessitating accurate detection and characterization of focal liver lesions (FLLs). Precise differentiation between benign and malignant lesions, as well as distinguishing primary liver lesions from metastases, is pivotal for effective clinical management. This study aims to compare the efficacy of respiratory-triggered diffusion-weighted single-shot echo planar imaging (RT DW-SS-EPI) and T2 weighted turbo spin echo imaging (T2W TSE) in detecting and characterizing FLLs. Additionally, the study aims to determine the apparent diffusion coefficients (ADCs) of FLLs and normal liver parenchyma. Methods: A total of 30 patients with suspected focal liver lesions and 10 healthy volunteers without FLLs were enrolled. Patients referred for MRI with clinical suspicion of FLLs were included. The study employed respiratory-triggered fat-suppressed single-shot echo-planar DW imaging in the transverse plane with tridirectional diffusion gradients and three b values (0, 500, and 1000 sec/mm²). ADC maps were generated, and routine MR sequences were obtained using a 1.5 Tesla MRI scanner. ADC values were calculated using operator-defined regions of interest (ROIs), and differences in ADC values were analyzed. Results: The study encompassed 85 lesions in 30 patients, including 23 hepatocellular carcinomas (HCCs), 4 cholangiocellular carcinomas, 36 metastatic lesions, and 22 benign lesions. Males comprised 63.3% of participants. DWI demonstrated significantly higher FLL detection rates than T2WI (p < 0.001), particularly for malignant lesions (98.4% with DWI vs. 76.5% with T2WI). No significant difference was observed in detecting HCCs alone. DWI exhibited superior detection capabilities for both liver lobes compared to T2WI. Mean ADC values for various lesion types showed significant differences, with malignant lesions displaying lower ADC values than benign lesions (p < 0.001). Conclusion: Respiratory-triggered diffusion-weighted MRI (RT DWI) emerges as a valuable and contrast-free diagnostic tool for detecting and characterizing focal liver lesions. DWI outperformed T2 weighted imaging in detecting malignant lesions and showed potential for accurate differentiation between benign and malignant lesions based on ADC values. The study highlights DWI's clinical utility for liver lesion evaluation in routine practice.

Introduction: Gestational diabetes affects a significant proportion of pregnant women and can have adverse health effects for both the mother and the baby. Monitoring blood glucose levels and lipid profiles is crucial in managing this condition. This comparative study examines how glycosylated hemoglobin (HbA1c) and lipid profile parameters change in women with gestational diabetes compared to normoglycemic pregnant women, with the goal of improving diagnostic and management strategies for this condition. The aim of this study was to determine that HbA1c is an independent marker of dyslipidaemia among GDM cases and emphasize the link between the aforementioned parameters among pregnant women in Bihar. Materials and Methods: In this comparative study, we included fifty patients who were diagnosed with gestational diabetes during pregnancy. All of the antenatal women were in their third trimester. We also included another fifty pregnant women as controls, who did not have gestational diabetes or any other pregnancy complications in their third trimester. Both the cases and controls were randomly selected from the age group of 20 to 45 years. In this study, we measured the serum lipid profile parameters, oral glucose tolerance test blood glucose levels, and glycosylated haemoglobin levels in patients with gestational diabetes, and compared them with those of healthy pregnant women. Results: In this study, 50 pregnant women with GDM had a mean age of 31.2 years, while 50 pregnant women in the healthy control group had a mean age of 29.3 years. In the present study, serum triglycerides were observed at 193.12±10.12 mg/dL in GDM cases and 150.76±8.54 mg/dL in the control group, while serum total cholesterol was observed at 211.43±14.34 mg/dL in GDM cases and 168.83±18.19 mg/dL in the control group. The levels of serum triglycerides and serum cholesterol in GDM cases were statistically significantly higher as compared to the controls. The serum HDL cholesterol was observed at 57.98±5.78 mg/dL in GDM cases and 55.12±6.67 mg/dL in the control group, while serum LDL cholesterol was observed at 92.13±13.45 mg/dL in GDM cases and 82.03±10.16 mg/dL in the control group. There was no statistically significant difference in their HDL and LDL Cholesterol in the cases and control group. The fasting blood glucose was recorded at 116±9.65 mg/dL in GDM cases and 89±5.89 mg/dL in the control group, the blood glucose level after 1 hour of 75grams oral glucose administration in oral glucose tolerance test was observed at 198.13±12.74 mg/dL in GDM cases and 158.33±9.34 mg/dL in the control group while blood glucose level after 2 hours was observed at 174.38±11.48 mg/dL in GDM cases and 140.11±7.87 mg/dL in the control group. The differences between cases and controls were statistically significant. The mean value of the HbA1c of cases and control groups was 8.15±1.12 mg/dL and 6.02±0.18 mg/dL respectively. This difference between healthy pregnant women and women with GDM was statistically significant. Conclusion: The study's findings have conclusively demonstrated that triglyceride, high-density lipoprotein, glycated haemoglobin, and glucose levels in the blood all play a significant role in the development of dyslipidemia in gestational diabetes mellitus (GDM). Although it is well known that lipid parameters increase during a healthy pregnancy, the way they increase in GDM is different.

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.

All sorts of health sectors, including blood banking, have been adversely affected by the current coronavirus pandemic crisis, particularly in the collection of blood units for patients for a variety of reasons. In this blog, we attempted to share our experience, approach, and efforts done during this era to face and overcome these problems.

INTRODUCTION: Healthcare worker’s life risk percentage is higher than the ratio of benefits they provide in the health crisis situations during this pandemic period, Even though they are the vitals for the functioning of the health systems during any health crisis. The findings from this study will help authorities to deliver the imperative educational programs in order to bring forth up-to-date information and to flourish the best practices in controlling and preventing Corona virus. The objective is to assess and analysis the knowledge and awareness about the COVID-19 virus. MATERIALS AND METHODS:  Structured questionnaire was developed. The questionnaire consisted of details regarding the socio-demographic details and 30 questions pertaining to the knowledge and awareness on protection, prevention and infection control measures of Corona virus disease. RESULTS: It was found out that adequacy of knowledge and awareness on COVID 19, was only 55.1% among participants. On binominal logistic regression analysis, it was found that age and profession were found to have statistically significant association with knowledge and awareness.  CONCLUSION: Spreading the knowledge and preventive measures of COVID -19 among health care professionals will play a major role in preventing further outbreaks. As WHO says “Keep yourself and others safe: Do it all!” it’s a sole responsibilities of every health care workers to follow the protocol and preventive measures at any cost. In addition regular hospital infection training sessions to be given for health care workers to follow universal standard precautions

Hand grip strength could be an inexpensive tool for predicting likelihood of occurrence of diabetes mellitus. National non-communicable disease programme should include exercise routines for improving muscle strength and further large- scale studies needs to be taken up for the causality of handgrip strength on the risk of pre-diabetes.

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.

Introduction: Stroke is one of the most important non communicable diseases causing death. Stroke or CerebroVascular Accident (CVA) is “abrupt onset of a neurologic deficit that is attributable to a focal vascular cause Therefore, the role of lipid profile at the aspect of stroke status and risk assessment also needs to be further discussed. In order to analyse the above issues, our study investigated the association between stroke patients and their lipid profile. Material and Methods: This study included 100 patient admitted in the ward and fulfilling the inclusion criteria. The study consists of history taking, clinical examination and biochemical assay. Study subjects were selected after obtaining consent. Patient were managed according to standard guidelines. Results: Incidence of stroke was greater in males around 71%. The total serum cholesterol concentration was ≥200mg/dl in 62% of our patients. The HDL-C was <60 mg/dl in 87% of patients in our study and among them 43% had <40mg/dl. The VLDL-C was ≥30 in 46% of stroke patients in our study. Apart from dyslipidemia, hypertension was the most significant risk factor (54%) in our study. Conclusion: Dyslipidemia is a tip of iceberg. Lipid profile screening in patients with risk factors like Hypertension, DM, elder people with family history of atherosclerosis diseases etc., can help to provide primary preventive measures. Dyslipidemia, if properly treated being a modifiable risk factor for ischemic stroke, decreases the incidence of stroke due to dyslipidemia. This leads to decreased morbidity and mortality leading to a healthier society.

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.

Background: The problem of hypoglycemia in individuals with type 2 diabetes poses a significant health risk, potentially leading to adverse outcomes such as confusion, seizures, or unconsciousness. Balancing glucose levels in these patients becomes challenging due to various factors, including medication management, lifestyle choices, and fluctuating insulin sensitivity. Addressing and managing hypoglycemia effectively is crucial for improving the overall well-being and quality of life for those with type 2 diabetes. Aims and Objectives: The present study aimed to study the prevalence and associated factors of hypoglycemia among type 2 diabetics. Materials and Methods: The present study included 200 diabetic patients attending the General Medicine OPD of Osmania General Hospital, Hyderabad. After obtaining consent, all the participants were subjected to a well-structured clinical questionnaire. Data was collected in MS Excel, analyzed and presented as tables and figures. Results: It was found that most of the patients considered for this study (83.5%) had at least 1 episode of Hypoglycemia. Among the symptoms of Hypoglycemia, dizziness was found to be the most observed symptom with 38% patients experiencing it, while 28% of patients displayed sweating. About 16% patients had excessive hunger. Shaking was observed in 14% patients. 19% patients had other symptoms. Conclusion: The high reported incidence of hypoglycemia in individuals with type 2 diabetes underscores the critical need to consistently inquire about and educate diabetic patients regarding hypoglycemic episodes during their routine healthcare visits.

Background: Type 2 Diabetes Mellitus (T2DM) is a global health concern associated with various complications, including peripheral neuropathy. While the prevalence of T2DM continues to rise, particularly in urban areas, there is limited comprehensive research on the prevalence and associated factors of peripheral neuropathy in urban communities. Methods: A cross-sectional study was conducted in a representative urban community to assess the prevalence of peripheral neuropathy among individuals with T2DM. Clinical evaluations, neuropathy assessments, dietary surveys, socioeconomic data collection, and healthcare access inquiries were performed on 500 adult participants. Data were analyzed using descriptive statistics, logistic regression, and prevalence calculations. Results: The study revealed a substantial prevalence of peripheral neuropathy in the urban population, with rates of 38.5% according to the Michigan Neuropathy Screening Instrument (MNSI) and 42.0% based on the Neuropathy Symptom Score (NSS). Participants with neuropathy exhibited poorer glycemic control, higher blood pressure, and higher BMI. Lower education and income levels were associated with neuropathy. Additionally, individuals with neuropathy had slightly reduced access to healthcare services. Conclusion: Peripheral neuropathy is a common complication among T2DM patients in urban communities. Early screening, intervention, and management of glycemic control and blood pressure are essential. Addressing socioeconomic disparities and improving healthcare access and patient education can help reduce the burden of neuropathic complications in urban populations.

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 : HIV continues to be a major global public health issue, having claimed 36.3 million [27.2–47.8 million] lives so far. The human immunodeficiency virus (HIV) targets the immune system and weakens people's defense against many infections and some types of cancer that people with healthy immune systems can fight off. Low vitamin D levels have been associated with HIV disease progression and HIV-related complications. Materials and Methods: Cases will be selected from patients presenting to KIMS hospital, IPD section with history Of HIV infection considering the inclusion and exclusion criteria. A total of 110 consecutive patients presenting with HIV positive status, whose inclusion and exclusion criteria are fulfilled are considered for study. It’s a single centered, time- bound prospective study carried out for a period of 2 years. Each patient was evaluated with History, clinical examination, and lab investigations.  Results : In the present study involving 110 HIV patients. The mean CD4+ Count (/cu.mm) was 186.86 ± 104.35 and the mean Viral Load (x103) was 55.20 ± 68.61. vitamin D deficiency was present in 96.4% of population. There was a strong positive correlation between CD4+ Count (/cu.mm) and S. Vitamin D (ng/mL). There was a strong negative correlation between Viral Load (x103) and S. Vitamin D (ng/mL). Conclusion: In this study, with deficiency of Vitamin D level there was positive corelation with CD4 Count causing reduction in CD4 Count and negative correlation with viral load causing increased viral load with reduction in vitamin D levels in HIV affected individuals.

Background: Chronic Obstructive Pulmonary Disease (COPD) is a global health concern associated with significant morbidity and mortality. Cardiac involvement, particularly left ventricular dysfunction (LVD), has gained attention as a common comorbidity in COPD patients. This prospective study aimed to elucidate the relationship between COPD and LVD, exploring incidence, predictors, clinical implications, and potential interventions. Methods: A cohort of 300 COPD patients, aged 40 years and older, underwent baseline assessments and regular follow-up visits over 24 months. Echocardiography, spirometry, and clinical data were collected. Predictors of LVD were identified using Cox proportional hazards models. Longitudinal changes in left ventricular ejection fraction (LVEF) and clinical outcomes were analyzed. Results: Over 24 months, LVD incidence increased from 0% at baseline to 28.3%. Age (HR 1.08 per year), current smoking (HR 2.15 vs. never smokers), and severe COPD (HR 3.20, GOLD Stage 4 vs. Stage 1) were significant predictors of LVD. LVEF declined progressively (from 57.8% to 52.2%). LVD was associated with higher hospitalizations (58.3% vs. 33.3%), mortality (25% vs. 8.3%), and exacerbations (133.3% vs. 62.5%) compared to non-LVD patients. Conclusion: This study reveals the dynamic relationship between COPD and LVD. Age, smoking, and disease severity were identified as predictors of LVD. The decline in LVEF over time and its impact on clinical outcomes underscore the clinical relevance of LVD in COPD patients. Comprehensive management

Background: Dengue fever is a significant global health concern, particularly affecting children in tropical regions. This study aimed to comprehensively analyze the laboratory profiles of serologically proven dengue cases in children and their associations with clinical outcomes. Materials and Methods: A prospective observational study was conducted on 300 pediatric patients with suspected dengue fever. Demographic data, clinical symptoms, serological markers (IgM and IgG antibodies, NS1 ELISA), and laboratory parameters were analyzed. Associations with disease severity and clinical outcomes were explored. Results: High prevalence of dengue-specific IgM antibodies (91.7%) and IgG antibodies (63.3%) was observed, with 50% of cases indicating secondary infections. NS 1 antigen ELISA was positive in 40% of cases. Clinical symptoms included fever (91.7%), headache (80%), myalgia (60%), and bleeding manifestations (16.7%). Severe forms of dengue (DHF/DSS) accounted for 30% of cases. Hemoglobin levels were lower in DHF/DSS cases (10.5 g/dL) than in non-severe cases (9.8 g/dL). Platelet counts were significantly lower in DHF/DSS cases (110 × 10^3/µL) compared to ICU admissions (85 × 10^3/µL). Serum creatinine levels were slightly elevated in ICU admission cases (1.1 mg/dL) compared to DHF/DSS cases (0.9 mg/dL). Conclusion: This study highlights the importance of serological markers and laboratory parameters in diagnosing dengue and assessing disease severity in pediatric cases. Early diagnosis and monitoring of these markers are crucial for timely clinical intervention. Further research is needed to validate these findings and enhance our understanding of pediatric dengue pathophysiology.

Introduction: Psoriasis is a systemic inflammatory disorder that involves complex pathogenic interactions between the innate and adaptive immune systems. Individuals with psoriasis have an increased risk of developing other chronic health diseases such cardiovascular disorders. The high incidence of cardiovascular events in the population with psoriasis could be explained by several mechanism. The high prevalence of traditional cardiovascular risk factors and metabolic abnormalities contributes to the high cardiovascular burden in patients with psoriasis. The most prevalent and chronically inflammatory dermatologic condition is psoriasis. Although it is connected to several illnesses, cardiovascular disease is the most prevalent. There is a critical need to analyze lipid abnormalities in psoriatic patients to determine the level of risk that individuals may experience for developing atherosclerosis, vascular obstructive disorders, associated morbidity and mortality. Aim: To estimate lipoproteins levels & related risk of cardiovascular diseases in psoriasis patients. Materials and Methods:This cross-sectional analytical study was carried out at Dr. D. Y. Patil Medical College & Hospital in Pimpri, Pune. 40 psoriatic patients with a mean age of 50.68 ± 8.86 years made up the study group, and 40 healthy people of either sex with a mean age of 50.15 ± 9.6 years made up the control group. Enzymatic End Point Method was used to estimate the levels of serum total cholesterol, triglycerides, HDL cholesterol, and LDL cholesterol on the same day. By computing the mean, standard deviation, p-value, and Chi-square test, the data was analyzed. Results: Findings of this study showed that, compared to the control, total cholesterol and VLDL was considerably higher in people with psoriasis(p<0.05).Difference between psoriasis cases(6.8 ± 1.49) and control (3.08 ± 1.3) in findings of serum TGs were highly significant(p<0.001).However, difference betweenserum LDLlevelin psoriasis cases and control was not significant.Serum HDL levels in both psoriasis cases and control were unchanged .  LDL/HDL ration has not shown any significant changes in both psoriasis case and control, while in TC/HDL ratio, statistically significant difference(p<0.05) was observed. Conclusion: Patients with psoriasis have high risk of developing cardiovascular diseases. We propose that serum lipid profile screening in psoriatic patients will aid in identifying risk at an early stage. In these patients, impromptu treatment will lower the risk of cardiovascular illnesses.

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: COPD is among the most common lung diseases, becoming a major health problem around the world. It is characterized by a persistent and commonly progressive airflow limitation consequent to an abnormal inflammatory response of the airway and lung tissue a persistent and commonly progressive airflow limitation consequent to an abnormal inflammatory response of the airway and lung tissue. Sleep disorders are frequently present in COPD patients, particularly obstructive sleep apnoea syndrome (OSAS) and the coexistence of this two is termed as overlap syndrome. Methodology-          The study was conducted in the Department of respiratory Medicine of a tertiary health care teaching hospital. The duration of the study was from December 2017 to November 2019. 105 cases of chronic obstructive pulmonary disease visiting outpatient / Inpatient section of Pulmonary Medicine department for diagnosis and fulfilling the inclusion and exclusion criteria were included. All the patients were evaluated with spirometry and polysomnography for detection of obstructive sleep apnea. Data was collected using predesigned, pre-tested, semi-structured questionnaire. Results- The prevalence of OSA in COPD (i.e. overlap syndrome) amongst study group was 27.62%. Sleep related symptoms were more prevalent in overlap group of patients as compared to patients without overlap and the difference is statistically significant between two groups for every symptom. Conclusion- Polysomnography in COPD patients is useful for early detection of OSA and to prevent them from further complications of OSA.

Background: Females constitute a significant proportion of the healthcare community. An integral component that forms a part of the difficult work environment of health workers is both the long hours that they have to put in donning and doffing PPE kits. This also affects female workers, who also have to endure the psychophysiological changes and difficulties associated with menstruation while continuing to perform their clinical duties. Aims and objectives: The purpose of this study was to shed light on the difficulties faced by the female frontline workers who had to don PPE suits while menstruating. This study also focused on assessing if there has been any impact of the usage of PPE kits on their menstrual habits during this pandemic. Methodology: The study's methodology involved using a self-made questionnaire that five experts validated. The final sample size was calculated to be 264. A total of 309 individuals participated in our study. a total of 21 questions to evaluate the difficulties faced by female health care workers wearing PPE kits during the time of menstruation using inclusion and exclusion criteria. The collected data was entered into Microsoft Excel and analyzed by chi-square testing. Results: The study found that a significant number of female frontline health workers experienced fatigue (94.5%), sweating (88.9%), discomfort (85.4%), staining of undergarments (61.7%), pain (59.3%), itching in the genital area (50.6%), fainting or giddiness (50.6%), and chafing in the groin region (50%) while menstruating in PPE. It was also observed that a significant change had occurred in the menstrual hygiene habits concerning frequency of bathing (79.1%), number of sanitary pads, tampons, and menstrual cups used (68.4%), use of painkillers (47.8%), use of home remedies to alleviate pain (37.5%), and administration of medicines to delay menstruation (24.5%). Conclusion: This study found that difficulties like sweating, fatigue, discomfort when wearing pads, tampons, or cups, staining of undergarments, pain, itching in the genital area, fainting or giddiness, and chafing in the groin region were extremely common. Hence, it is recommended that appropriate measures be taken by the hospital administration to allay the difficulties faced by the female frontline health workers.

Background: Cardiorenal syndrome type 1 (CRS1) represents a critical medical condition characterized by the rapid deterioration of cardiac function leading to acute kidney injury (AKI), posing significant healthcare challenges. Understanding this complex syndrome is crucial for improving patient care. Material and Methods: We conducted a one-year cross-sectional observational study at the Department of Medicine, Indira Gandhi Medical College, Shimla, enrolling consecutive patients with acute heart failure (AHF). We defined CRS1 as the rapid worsening of cardiac function leading to AKI and employed the Framingham Criteria for HF diagnosis. AKI was assessed using the AKIN classification. Various clinical, laboratory, and echocardiographic parameters were examined, and statistical analysis was performed. Results: Among the 92 AHF patients, 15 (16.3%) met the criteria for CRS1, while 77 (83.7%) did not experience kidney injury (NCRS1). Shortness of breath was the most common presenting symptom (93.47%). Patients with CRS1 had significantly lower total leukocyte counts (TLC) but no significant differences in other hematological or biochemical parameters. Dilated cardiomyopathy (DCMP) was a significant predisposing factor for CRS1, while other factors, including smoking, diabetes, and hypertension, did not contribute significantly. Medications for AHF management showed no significant impact on CRS1 development. Patients with CRS1 had higher mortality rates and longer hospital stays, with DCMP and Rheumatic Heart Disease (RHD) being major contributors to mortality. Conclusion: CRS1 is more prevalent in females and the elderly, presenting with shortness of breath and often triggered by infections. Lower TLC and DCMP are associated with CRS1 development. Smoking, diabetes, and hypertension appear unrelated to CRS1. Medications for AHF management showed no significant influence. DCMP emerges as a key underlying etiology, with CRS1 patients experiencing higher mortality rates and extended hospital stays, highlighting the need for tailored management strategies.

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.

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.

Background: Hyperlipidemia is a widely observed medical condition that exhibits a strong correlation with the occurrence of coronary heart disease. Certain patients exhibit hesitancy or choose to abstain from the use of lipid-lowering prescription drugs due to concerns over potential adverse pharmacological responses. Objective: The goal of the treatment was to reduce the level Total cholesterol and Triglycerides. Method: This article presents the case report of a 30-year-old male who was diagnosed with Hyperlipidemia and Total cholesterol 207mg/dl Triglycerides 525 mg/dl. He wanted to be treated by Acupuncture with Traditional Chinese Method and following Suoxi Healthy Life Style controlled cholesterol level. Outcomes: For 3 months, electro acupuncture was done once a week   patient’s level of Total cholesterol and Triglycerides. Conclusion: This case showed that electro acupuncture combined   not only effectively reduces Triglycerides, but it also significantly improves cholesterol level of the patient.

Introduction: Kidney disease is defined as an abnormality of kidney structure or function with implications for the health of an individual, which can occur abruptly, and either resolve or become chronic. Chronic kidney disease (CKD) is a general term for heterogeneous disorders affecting kidney structure and function with variable clinical presentation, in part related to cause, severity, and the rate of progression. Aims: To study carotid intimal thickness in different stages of chronic kidney disease. To study the correlation between the carotid artery intimal-medial thickness with lipid profile in Chronic Kidney disease. Materials and Methods: The present study was a cross sectional single centre, observational study. This Study was conducted from Jan 2015 to August 2016 at Department of Medicine of a tertiary care hospital. Result: There was negative correlation of CIMT with eGFR on both sides but statistical significance was not reached. There was no significant correlation with creatinine levels. That majority cases had serum creatinine above 4 mg/dL. Raised and normal CIMT were evident in nearly equal proportions in both right (p=0.839) and left (p=0.939) carotids.  That there was no association of raised CIMT with CKD stage in either right (p=0.932) or left (p=0.886). Association of CIMT with patient management. Patients who were managed by hemodialysis had raised CIMT in higher number of patients (63% on right and 56.4% on left) than those managed conservatively (37% on right and 43.6% on, left).  Conclusion: Raised CIMT is substantially linked with lipid markers in CKD patients. No correlation between elevated CIMT and either CKD stage or renal function measures was found, indicating that CKD stage has little to no effect on elevated CIMT. The CIMT of patients receiving haemodialysis, however, was elevated, indicating a higher risk in this population than in patients receiving conservative therapy.

Introduction: World Health Organization clinically defines a stroke as ‘the rapid development of clinical signs and symptoms of a focal neurological disturbance lasting more than 24 hours or leading to death with no apparent cause other than vascular origin’. Hypomagnesaemia leads to neuromuscular hyperirritability, tremors, increased vascular resistance, coronary vasospasm and hypertension. Hypomagnesaemia triggers vasoconstriction enhancing vascular endothelial injury and hence leads to atherosclerosis. Subjects and Methods: It was a case control study, undertaken in the Department of Medicine in S Nijalingappa medical college and HSK Hospital during the period of July 2021–December 2022. 30 patients with acute ischemic cerebral stroke fulfilling the inclusion criteria were selected. 2 ml venous sample for serum magnesium level was taken within 24 hours. Magnesium levels in patients after acute cerebral ischemic stroke were documented in patients, receiving standard management protocol of ischemic stroke. The correlation co-efficient of Hypomagnesaemia with modified Rankin Scale Score was calculated. Results: The mean age of patients was 45-80 years, 36 (60 %) patients were male and 24 (40 %) were females and there was male preponderance. The mean serum magnesium levels were measured. The present study observed a statistically significant correlation between modified Rankin Scale score measured at three months and serum magnesium level. Conclusion: It was concluded through the results of this study that Hypomagnesaemia in the body can cause more severe ischemic stroke.

Background: Surgical site infections (SSIs) are a common nosocomial infection, leading to increased costs, morbidity, and mortality in surgical patients. Surveillance and feedback to medical staff are vital in reducing SSI rates. This study aims to investigate the prevalence of SSIs in the Department of Surgery at Andhra Medical College, Visakhapatnam. Aims and Objectives: To determine the incidence and types of SSIs following abdominal surgeries. Materials and Methods: This retrospective study included patients admitted to the general surgery units at the Department of General Surgery, Andhra Medical College, King George Hospital, Visakhapatnam, for over one year. A total of 553 elective surgical patients and 314 emergency surgical patients were part of the study. Results: The study revealed a 11% prevalence of SSIs in the Department of General Surgery at Fakir Mohan Medical College and Hospital, Balasore, Odisha. Superficial incisional SSIs were the most common, followed by deep incisional SSIs, and organ/space SSIs. Exploratory laparotomy was the surgical procedure most commonly associated with SSIs. Alarmingly, 20% of SSIs were linked to emergency surgeries compared to 7% in elective surgeries. Conclusion: SSIs have significant implications for patients and healthcare systems. Preventing SSIs requires a comprehensive approach, addressing pre-, intra-, and postoperative factors. It is essential for healthcare facilities to foster a culture of patient safety, with support from management teams, regulatory agencies, and medical associations.

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: In today's demanding academic landscape, childhood leisure takes a backseat, impacting values and societal characteristics. Leisure, encompassing relaxation, enjoyment, and intrinsic motivation, plays a vital role in positive development, humanization, and interpersonal relationships. Its utilization varies based on location, parental education, and socioeconomic factors, involving physical activities, media engagement, and arts participation. Methodology: This cross-sectional study, conducted over a two-year period in Berhampur, Ganjam, aimed to explore the relationship between leisure activities and childhood obesity in both government and private schools. A total of 400 students participated, and the study assessed the quantity and quality of leisure time, correlating these factors with Body Mass Index (BMI). Result: The study identified an alarming prevalence of obesity (11.5%) and overweight (13%) among students, with private schools exhibiting a higher prevalence of obesity (22.3%) than government schools (8.3%). Males showed a higher prevalence of overweight and obesity compared to females, possibly influenced by cultural expectations. Discussion: A significant relationship between physical inactivity and BMI was observed, underscoring the crucial role of physical activity in obesity prevention. The findings emphasize the urgent need for interventions promoting physical activity to combat the rising prevalence of obesity among school children. Encouraging structured play and discouraging excessive screen time are vital components of fostering a healthy lifestyle. Conclusion: Prevention remains paramount, with the adoption of a healthy lifestyle, reduced sedentary time, regular exercise, and a nutritious diet being key strategies. Routine screening for overweight individuals is essential for timely interventions. Schools, parents, and pediatricians play pivotal roles in addressing this emerging health issue, highlighting the importance of a collaborative approach to promote and maintain a healthy lifestyle among school children.

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.

Background: Circadian rhythm is a biological and behavioral process that regulates sleep. The quantity and quality of our sleep significantly impact our day-to-day life and various health outcomes that help the body in cellular repair and fight diseases. In the modern era, sleep has become another casualty of modern life thereby making it very essential to assess and keep track of sleep quality. Sleep quality is assessed commonly using the Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI). The comparison of concordance and discordance of ESS and PSQI is not done earlier and a thorough evaluation of their measurement results and degree of agreement is essential. Thus, the study aims to do a comparative analysis of ESS and PSQI scales and analyses their concordance in measuring sleep-related parameters. Methods: Healthcare employees working in the Parent Institute were included in this study. Subjects were given the Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index questionnaire to assess sleep quality and a comparative analysis of both scales was done. Results: The study compares both the scales – ESS (Adequate & inadequate sleep) & PSQI (Good & poor sleep) using Kappa statistics showing an overall agreement of 74.6% with a simple kappa value of 0.49 (Fair agreement) which was statistically significant (P < 0.001). Conclusion: The study shows significantly fair concordance between the ESS and PSQI in determining sleep parameters demonstrating that they each effectively assess different facets of sleep.

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.

Pharmacogenetics: Pharmacogenetics studies how genetic and non-genetic factors influence drug response. Genetic variants can affect drug metabolism. Cytochrome P450 enzymes play a crucial role in drug metabolism. Personalized medicine utilizes patient-specific information, including genetic factors. Pharmacogenetics is being increasingly implemented in clinical practice. However, challenges exist in implementing genetic testing. Genomics and pharmacogenomics have the potential to improve drug discovery and personalized medicine. Genetic biomarkers are essential in drug development. Pharmacogenetic testing guides personalized medicine. Ethical and regulatory considerations surround the use of genetic information. This paper delves into the intricate relationship between genetic variations and an individual's response to drugs, examining how these variations profoundly influence drug metabolism, efficacy, and susceptibility to adverse reactions. The emerging field of pharmacogenomics, which resides at the crossroads of genetics and pharmacology, seeks to revolutionize clinical practice by tailoring drug treatments according to an individual's unique genetic profile. By seamlessly integrating pharmacogenomics into routine clinical care, the healthcare industry stands to benefit from the promise of delivering highly personalized and effective medical interventions, thereby elevating patient outcomes and the overall quality of healthcare services. As research advances and technology evolves, the full potential of pharmacogenomics continues to expand, offering a glimpse into a future where healthcare becomes increasingly precise and patient-centric. These advancements have the potential to not only optimize drug therapies but also reduce healthcare costs and enhance the overall healthcare experience. Ultimately, the integration of pharmacogenomics holds the potential to make medicine safer, more effective, and more patient-centered, marking a significant milestone in the evolution of healthcare practices.

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: Amniotic fluid embolism (AFE) is remarkably infrequent yet carries a high mortality rate when it occurs. Here we report a case of AFE which was complicated by cardiac arrest, severe acute respiratory distress syndrome, and disseminated intravascular coagulopathy that was treated via our Mobile ECMO program. Case presentation: A 29-year-old gravid female at 40.5 weeks of gestation who experienced sudden hemodynamic instability secondary to AFE during labor. The patient exhibited a generalized tonic-clonic seizure, which was followed by pulseless electrical activity, necessitating emergent delivery via cesarean section of a healthy neonate. The patient’s condition continued to worsen and she suffered multiple cardiac arrest events, hypoxemia, and massive uterine bleeding. Due to hemodynamic compromise, the mobile extracorporeal membrane oxygenation (ECMO) team was activated and the patient was placed on a veno-arterial (VA ECMO) circuit. Subsequently, the patient developed abdominal compartment syndrome and required a bedside exploratory laparotomy. Following this intervention, the patient's hemodynamics stabilized, her cardiac and respiratory function improved, and VA ECMO was able to be removed on the fourth day. The patient remained neurologically intact and eventually was transferred to a rehabilitation facility. Discussion: Despite recent advances in prenatal care, AFE remains a significant and potentially fatal complication of parturition. Early recognition and prompt treatment are important, and refractory cardiopulmonary collapse can be supported with VA ECMO. The mobile ECMO program increases access to this life saving technology. Conclusion: Our report underscores the efficacy of ECMO as a therapeutic modality for AFE and the benefit of mobile ECMO in expanding access for this life saving technology.

Introduction: The World Health Organization (WHO) definition of stroke is: “rapidly developing clinical signs of focal (or global) disturbance of cerebral function, with symptoms lasting 24 hours or longer or leading to death, with no apparent cause other than of vascular origin”. The pathological background for stroke may either be Thrombotic or hemorrhagic disturbances of the cerebral blood circulation. Thrombotic cerebral infarction results from the atherosclerotic obstruction of large cervical and cerebral arteries, with ischemia in all or part of the territory of the occluded artery. Hyperhomocysteinemia has been emerging as an independent risk factor for atherosclerosis. Several workers opined that moderately elevated plasma Homocysteine (Hcy) concentration might be an independent risk factor for cerebrovascular disease including stroke and transient ischaemic attack. Material and Methods: The study is a hospital based observational study was conducted in the Department of General Medicine at ACSR Government Medical College, Nellore from Dec 2022 to October 2023. 31 patients with thrombotic stroke(cases) and 31 subjects without thrombotic stroke (controls) and other comorbid conditions that affect serum homocysteine were included in the study. Venous blood samples were collected in tubes containing disodium EDTA. Homocysteine assay is based on the measurement of co-substrate conversion product. Results: In the present study, the mean age ± SD of cases was 55.03±14.51. The mean age of males was 51.68±13.45 and the mean age of females was 60.33±15.11. The mean age in control group was 51.22±13.77. The mean serum homocysteine level in the present study, in cases was 25.98±11.95. The mean homocysteine level in males was 7.83±14.29. The mean in females was 23.05±5.67. The mean homocysteine level in control group was 7.19±3.51. Mean homocysteine level of cerebral ischemic stroke females was 14.86 ± 5.34. The mean homocysteine level in controls was 7.428 ± 4.091. The mean homocysteine level in controls was 12.30± 4.68. The mean cholesterol of the cases was167.67±40.68. The mean LDL in the study was 89.74±27.38. The mean HDL was 38.48±10.92. Conclusions: Serum homocysteine levels were significantly higher in those paients with stroke when compared to those without stroke. Apparently, Serum homocysteine level is an independent risk factor for thrombotic stroke.

Background: This study was conducted to evaluate the serum vitamin D levels in patients with type 2 diabetes mellitus with and without nephropathy. Methods: This was a hospital-based cross-sectional case control study conducted among 100 patients who attended OPD and IPD at the Department of Medicine, Dr. B.R. Ambedkar Medical College and Hospital, Bangalore, over a period of 18 months from December 2020 to May 2022, after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. Results: In comparison between diabetic nephropathy and non-diabetic nephropathy between both groups, a statistically significant difference (p<0.001) was noted between them with regard to serum creatinine, eGFR, UACR and vitamin D levels, suggesting that the diabetic nephropathic group has increased creatinine levels, highly reduced eGFR, highly elevated UACR and significantly decreased vitamin D levels, which are not present in the non-diabetic nephropathy patients. The eGFR and vitamin D levels were compared among the diabetic nephropathic subjects. The eGFR was split into three groups and by the ANOVA test measure, a significant association was obtained between them suggesting decreased eGFR also decreases vitamin D levels. On correlating vitamin D levels with serum creatinine and UACR a statistically significant (p<0.001) strong negative correlation was obtained (0.85 and 0.91) respectively. Conclusion: The study found that individuals with diabetic nephropathy had a higher prevalence of vitamin D insufficiency. However, at more advanced stages of diabetic kidney disease, their severity is more prevalent. Patients with CKD (Chronic Kidney Disease) should get information from health care providers on vitamin D monitoring and its dietary sources.

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: Tuberculosis (TB) remains a global health challenge, particularly with the emergence of drug-resistant strains. This study examines TB case detection and rifampicin resistance across different demographic categories in two healthcare institutions over two consecutive years. Methods: A retrospective analysis of TB cases reported by AIMS for 2023 and 2022, and MIMS for 2022, was conducted. Data included MTB detection and rifampicin resistance among PLHIV, pediatric populations, and private sector cases. Results: AIMS reported low rates of MTB detection (5.26% for PLHIV, 1.52% for pediatric cases in 2023) and no rifampicin resistance in 2023. MIMS reported higher overall TB cases with a 0.9% MTB detection rate among PLHIV and a 0.48% rate in pediatric cases, with a 10% rifampicin resistance among detected cases in 2022. No significant seasonal trends were observed at AIMS (p > 0.05), while MIMS showed a non-significant increase in detection during the monsoon months (p = 0.06). Newly diagnosed DRTB patients had higher detection rates (p < 0.01), and pulmonary TB was more frequently detected than extrapulmonary TB (p < 0.001). Conclusions: The low prevalence of rifampicin resistance suggests effective treatment and management strategies. However, the continued presence of MTB cases, especially in vulnerable populations, emphasizes the need for ongoing surveillance and improved diagnostic methods. Reinforced TB control programs and integrated healthcare strategies for high-risk groups are essential.

Background: The prevalence of asthma has been rising over the past few decades, making it one of the most prevalent chronic diseases in the world. Although the precise cause of asthma is still unknown, it most likely results from intricate interactions between a number of hereditary and environmental factors. According to the World Health Organisation (WHO), 300 million people worldwide suffer from asthma. The effects of vitamin D as a hormone have drawn more attention recently. Every component of the immune system seems to be regulated by vitamin D, with a lack of the vitamin being associated with a number of immunologically based illnesses, including asthma. Therefore, it is beneficial to check serum vitamin D levels in bronchial asthma patients. Aim and objectives: To identify any correlations between vitamin D deficiency and the severity of asthma and the objective of the study is to evaluate the serum 25(OH) D level in patients with mild, moderate, and severe asthma. Material and Methods: This is a cross-sectional observational study, which involved 100 participants between the ages of 15 and 50, of both genders with a mean age of 37.40±9.46 years. They were divided into two groups: Group A (control) consisting of 40 healthy individuals (22 males and 18 females) and Group B consisting of 60 asthmatic patients (34 males and 26 females). Group B was further subdivided into three subgroups (A, B, C), based on FEV1% and symptom severity as per the Global Initiative for Asthma (GINA) guidelines. An assay of serum vitamin D levels by ELISA was performed in both groups. Results: The results of the study demonstrated that asthmatic patients had considerably lower serum vitamin D levels than the control group. Conclusions: There is a significant inverse association between serum vitamin D levels and the severity of asthma symptoms, and vitamin D deficiency is rather common in people with asthma. As a result, when routinely evaluating individuals with asthma, serum vitamin D levels should be taken into account. It could be used to indicate the severity of asthma.

Background: The placenta is arguably one of the most important organs in the body. It influences not just the health of a woman and her foetus during pregnancy, but also the lifelong health of both mother and child. Despite its importance, we know little about this critical but temporary organ. The placenta has evolved to support the development of the embryo and foetus during the different intrauterine periods of life. By necessity, its development must precede that of the embryo. There is now evidence that during embryogenesis and organogenesis, the development of the human placenta is supported by histotrophic nutrition secreted from endometrial glands rather than maternal blood. These secretions provide a plentiful supply of glucose, lipids, glycoproteins, and growth factors that stimulate rapid proliferation and differentiation of the villous trophoblast. The present study conducted to observe any gross morphological change in placenta of normal individuals in North Karnataka region. Materials & Methods: 50 placentas were carried in multiple medical institutions in Karnataka, which were collected from labor room and operation theaters of connected Hospitals, washed under tap water and blot dried. Weight of placenta was recorded by weighing machine. Maximum diameter was measured, radius of placenta was obtained, and surface area was calculated using the formula. Cord attachments were also observed. Results: Out of 50 placentas 86% of placenta were circular and 14% were oval. Diameter was <15cms in 12%, 16- 20 cms in 68%, > 21cms in 20%. Surface area was 100- 200 cms2 in 16%, 201- 300 cms2 in 60%, 301- 400 cms2 in 20%, > 401 cms2 in 4%. Placental weight was between 300- 400gms in 14%, 401- 500gms in 58% and > 501gms in 28%. Umbilical cord insertion on fetal surface was found to be central - 60%, Paracentral -18% and Peripheral- 22%. The average diameter was 22.86+4.2, the average surface 316.52+76.42 and the average placental weight was 512.86+42.36. Conclusion: The present study parameters and an adequate knowledge of the morphometric analysis of the placenta with its clinical relevance proves to be useful in the early assessment of placental sufficiency and also the state of the fetal wellbeing. In mothers who have had no previous antenatal checkup, a thorough examination of the placenta helps in the early diagnosis of the fetal complications, soon after parturition and thus helps in the early treatment of the baby by neonatologists.

Background- Vaccines for covid-19 have been developed at unprecedented speed, with phase III clinical efficacy trials reporting results for some vaccines less than a year after WHO declared the pandemic.Since December2020, several vaccines have been authorized by regulators such as the European Medicines Agency, the US Food and Drug Administration, and the UK Medicines and Healthcare products Regulatory Agency. Large scale immunisation programmes are ongoing worldwide.Objective- To study and compare post vaccination events after first and second booster dose of novel corona virus vaccine. Method-The present hospital based prospective study was conducted in Dr Baba Saheb Ambedkar medical college and Hospital.The duration of study was 12 months. The details to contact the study participants were obtained from hospital vaccination centre. Participants were also contacted at vaccination centre and after taking informed consent, a history of participants was taken in the form of a questionnaire and physical conversation. Results- A total of 40.20% of the study population reported atleast one adverse event following vaccination which was mild in nature.Most common adverse event was fever (28%) followed by injection site pain (22.80%).Statistically significant difference was reported for individual adverse events like fever, injection site pain, fatigue, headache, weakness, nausea, vomiting for the first and second dose.The incidence of adverse events after first dose in covishield was significantly greater as compared to covaxin (55.14% vs 40%) with P value=0.002. Conclusion: Both vaccines exhibited short-term adverse effects, albeit they were modest and of short duration. Within this particular framework, our study gains greater significance in distributing concise safety information subsequent to immunisation. This will aid folks in their decision to accept immunisation.

Abstract:Introduction: COPD is a leading global cause of mortality, expected to rise in prevalence over the next four decades. Patients often find the early hours of the day troublesome, impacting their health-related quality of life (HRQoL). This study aims to address the commonly overlooked issue of morning symptoms in COPD patients, focusing on their severity and correlation with the CAT score and BODE index. The research underscores the significance of understanding and managing morning symptoms to improve the overall well-being of individuals with COPD. Materials and methods: A cross-sectional study involving 128 COPD patients meeting inclusion/exclusion criteria was conducted in hospitals affiliated with Bangalore Medical College & Research Institute. Comprehensive investigations were carried out, and morning symptoms were evaluated using the CDLM questionnaire. Patients were clinically classified into GesEPOC phenotypes and GOLD stages based on FEV1 (%). The severity of COPD was assessed through the BODE index and CAT score, with correlations examined against the CDLM questionnaire. Results: In this study of 128 COPD patients, predominantly males with a mean age of 63 years, the first tertile demonstrated lower CDLM scores, indicating a higher morning impact and more respiratory symptoms. These patients also had lower FEV1%, higher CAT and BODEx scores, and increased exacerbations. Higher CDLM scores were associated with the Non-Exacerbator clinical phenotype of GesEPOC Spanish Classification. Multivariate analysis revealed that lower CDLM scores were independently linked to higher CAT and BODEx scores, lower FEV1%, and increased exacerbations. Conclusion: Evaluation of morning symptoms using capacity of daily living during morning (CDLM) questionnaire revealed there was a strong association with markers of COPD severity. The significant association was found with CAT and BODE index score and GesEPOC phenotypes. The strong negative correlation was learned for CDLM with CAT score and BODE Index score independently. However, the CDLM questionnaire exhibits a ceiling effect, limiting its ability to effectively differentiate between low and high impacts of morning symptoms.

Objective: To analyze the group of elderly patients diagnosed with COVID-19 with a retrospective cohort study. Methods: The study was conducted in a health institution in Kayseri province in Turkey. In the study, 151 COVID-19 patients were retrospectively analyzed. Chisquare analysis was performed when both independent and dependent variables were categorical. Results: The mean age of the patients was 85.87 years. 61.59% of the patients were female. The most common symptom was fatigue with 73.5%. The most common chronic disease was hypertension. The most common radiologic classification was CO-RADS-1 with 47.6%. The mean incubation period of the disease was 10.25 days. The most common complication was acute renal failure. The mortality rate was 19.21%. Conclusion: We suggested that clinical status at presentation, age, serum CRP, LDH, AST, troponin I and hemoglobin levels are important predictors of the risk of death from COVID-19 and may help identify high-risk COVID-19 cases. 

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.

Osteoporosis and Type 2 diabetes mellitus are two common chronic conditions with potentially significant impacts on patients' health. Osteoporosis, characterized by decreased bone density and increased fracture risk, is influenced by various factors, including parathormone (PTH) and vitamin D levels. Aim: To study the association between PTH, vitamin D levels and BMD in Type 2 diabetic patients. Material And Methods:This cross-sectional observational study was conducted in the Department of Medicine. A total of 50 participants were included in the study. A semi-structured questionnaire was administered and relevant clinical data was obtained. Result: The results show a statistically significant association between vitamin D status and BMD (p = 0.008). Patients with normal vitamin D levels were more likely to have normal BMD, with 57.14% falling into this category. In contrast, 92.3% of patients with osteopenia and 75% of those with osteoporosis had low vitamin D levels. Conclusion: Low vitamin D levels were associated with a higher prevalence of osteoporosis and osteopenia, particularly in patients with low PTH levels.

Objective: A common genito-urinary infection known as Balanoposthitis presents with mild symptoms like itching or severe complications such as phimosis, ulceration of glans, and foreskin. It can result in four types of sexual dysfunction including Disorder of sexual desire, Disorder of erectile dysfunction, Disorder of satisfaction/premature ejaculation, and Disorder of orgasm. Materials and methods: An observational clinic study including 65 patients diagnosed with Candidal Balanoposthitis based on KOH and clinical findings were recruited and evaluated for sexual function using a standardised questionnaire. Results: The results demonstrated that sexual dysfunction in patients with Candidal Balanoposthitis is a common entity encountered in STI clinics and should be addressed properly as any deficiency in any aspect of sexual health of a patient can lead to emotional and psychological disability impacting the overall quality of the life. The factors like advanced age, Diabetes Mellitus ,and poor hygiene measures of genitalia can increase the incidence of candidal Balanoposthitis as well as sexual dysfunction. Conclusion: Candidal Balanoposthitis ,a common cause of sexual dysfunction in elderly population takes a toll on emotional and psychological health and certain modifiable factors like diabetic control and hygiene can prevent recurrent fungal infections.

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: Diabetes mellitus, characterized by elevated blood glucose levels, poses a significant global health challenge. Type 2 diabetes accounts for the majority of cases and is associated with factors such as obesity, physical inactivity, and poor dietary habits. The global burden of diabetes is substantial, contributing to major complications like blindness, kidney failure, heart attacks, stroke, and lower limb amputation.  Methodology: This study investigates cardiovascular complications in 209 adult diabetic cases with a disease duration exceeding 5 years. The research, conducted at a tertiary care teaching hospital, includes a detailed clinical examination, relevant investigations, and categorization based on disease severity, control status, and treatment type. Various parameters, including fasting blood sugar, postprandial blood sugar, urine examinations, serum cholesterol levels, and hypertension classification, were assessed. Results: The study reveals that 112 cases (53.6%) exhibited cardiovascular complications, with ischemic heart disease (IHD) being the most prevalent (39.7%). The majority of patients were in the 51-60 age group, and 75.6% were male. Poor glycemic control was evident in 79.9% of cases, while 23.9% had severe diabetes. Hypertension and retinopathy were present in 30.1% and 35.8% of cases, respectively. IHD was more prevalent in males (56.6%) and the 51-60 age group. Discussion: The study establishes associations between different complications, emphasizing the frequent coexistence of various cardiovascular issues in diabetes. It explores the distribution of IHD among diabetics, with a peak in the 51-60 age group and a higher incidence in males. The severity of diabetes did not significantly influence IHD incidence. Good glycemic control demonstrated a protective effect against complications. Conclusion: This comprehensive study underscores the substantial impact of cardiovascular complications in diabetes mellitus. It highlights the importance of glycemic control, lifestyle modifications, and weight management in reducing the incidence and severity of complications.

Introduction: Body mass index (BMI) is the most widely used statistic to determine the prevalence of obesity. BMI is defined by the World Health Organisation as "a simple index of weight-for-height that is commonly used to classify adults as underweight, overweight, or obese." It is calculated as follows: kg/m2, which is the weight in kilogrammes divided by the height in metres squared. For instance, a 70 kg adult who stands 1.75 metres tall will have a BMI of22.9.Material and method: Type 2 diabetes, hypertension, elevated blood cholesterol, and triglycerides, which can result in atherosclerosis, are all made more likely by obesity. Previously thought to be a reservoir of excess energy, adipose tissue is now understood to be a functional, autonomous endocrine organ. Adipokines, a group of bioactive mediators that are expressed by adipose tissue and other biological systems, facilitate communication between the two.The adipokineadiponectin is only released by adipocytes. It is widely distributed in the bloodstream as a 360 kDa high molecular weight multimer and a 180 kDa low molecular weight hexamer.Results: This table shows age and sex distribution of cases and controls. Both cases and controls were divided into two groups according to age i.e. 20-35 years and 36-45 years. Maximum cases are within the range of 20-35 years. Percentage of male is more in comparison to controls.Conclusion: Adipokines are substances released by adipose tissue that regulate a variety of physiological processes throughout the human body by way of systemic circulation. Numerous organs and systems experience a disturbance in homeostasis as a result of adipokinedys regulation in obesity. These include insulin resistance, oxidative stress, endoplasmic reticulum stress, synaptic dysfunction, and cognitive decline.

Background: Chronic stress is increasingly recognized as a significant risk factor for cardiovascular disease (CVD), particularly in the high-pressure environment of modern professional workspaces. This study investigates the correlation between chronic stress levels and the prevalence of cardiovascular disease among working professionals. Objectives: The primary objective is to examine the association between chronic stress and the incidence of cardiovascular disease in a sample of 200 working professionals. The study aims to provide empirical evidence to support or refute the hypothesis that chronic stress is a significant contributor to cardiovascular health risks in this demographic. Methods: We conducted a cross-sectional study involving 200 working professionals from diverse industries. Participants were selected based on specific inclusion criteria and represented a broad range of ages and job roles. Stress levels were quantified using standardized psychological assessment tools, and cardiovascular health was evaluated through medical examinations and health history analysis. Data were analyzed using statistical methods to identify any significant relationships between stress levels and cardiovascular health indicators. Results: The study found a statistically significant correlation between high levels of chronic stress and the prevalence of cardiovascular disease symptoms and diagnoses among the participants. A higher incidence of CVD-related health issues was observed in individuals reporting higher stress levels, even after controlling for other risk factors like age, gender, and lifestyle habits. Conclusions: The findings suggest that chronic stress is a significant risk factor for cardiovascular disease among working professionals. This underscores the need for stress management interventions and policies in professional settings to mitigate this risk. Further longitudinal studies are recommended to explore the causal relationships and the long-term impact of chronic stress on cardiovascular health.

Background: Menstrual hygiene is a crucial aspect of adolescent health, impacting the well-being and dignity of school girls. In central Haryana, where a significant population of adolescent girls resides, there is a need to understand the knowledge, attitudes, and practices of school girls regarding menstrual hygiene. This study, conducted among 200 adolescent school girls, aims to fill this gap by assessing these factors and providing insights for targeted interventions. Methods: A cross-sectional study was conducted among 200 adolescent school girls aged 10-18 in central Haryana from 2020 to 2021. A self-designed questionnaire was administered to collect data on socio-demographic characteristics, knowledge, attitudes, and practices related to menstrual hygiene. SPSS version 24 was used for data analysis, employing the Chi-square test to identify associations between variables. Results: The study revealed that, among the 200 adolescent school girls in central Haryana, 68.3% considered menstruation a normal process, while 46.7% had good knowledge scores. However, concerning percentages, 30.8% were uncertain about menstrual blood hygiene, and 53.3% were categorized as having poor knowledge. Addressing these knowledge gaps is crucial for promoting menstrual hygiene and the well-being of school girls in the region. Conclusions: The findings emphasize the importance of addressing the knowledge gaps and misconceptions surrounding menstrual hygiene among school girls in central Haryana, where this study involved 200 adolescent participants. Targeted educational programs involving mothers and teachers as key influencers are essential to improving girls understanding and promoting better menstrual hygiene practices. This research serves as a foundation for empowering school girls with knowledge and promoting their overall well-being.

Introduction: Corneal ulcers, characterized by epithelial loss, stromal infiltration, suppuration, and inflammation, pose a global health concern, especially in the context of corneal blindness. Infectious keratitis, attributed to microbial agents, is a leading cause of corneal ulcers. This study focuses on the incidence, microbial etiology, and management strategies for corneal perforations arising from infectious keratitis. Objective: To investigate the incidence of corneal perforation in cases of infective keratitis, identify specific microorganism groups associated with corneal perforations, determine appropriate treatment modalities, and assess the prognosis of various interventions in perforated corneal ulcer management. Materials and Methods: A total of 150 patients with infectious perforated corneal ulcers were enrolled. Inclusion criteria covered patients aged 18 to 60 years, irrespective of gender, with infectious etiology. A comprehensive clinical examination, microbiological analysis, and various treatment modalities, including Bandage Contact Lens, Cyanoacrylate Glue, Amniotic Membrane Transplantation, and Corneal Transplantation, were employed. Results: Prevalence is observed in the age group of 25-50 years (70 patients), followed by 50-60 years (53 patients), and 18-25 years (27 patients). There is a significant male preponderance (117 cases) compared to females (33 cases). There is a higher incidence among farmers (44 cases) and laborers (27 cases), suggesting potential occupational risk factors. Paracentral perforations are the most prevalent (71 cases), followed by central (45 cases), and peripheral perforations (34 cases). A total of 132 positive cases indicate a predominantly infectious etiology. There is a higher prevalence of bacterial infections (75 cases), followed by fungal (29 cases), and mixed infections (28 cases). Micro perforations (<1mm) are the most common (68 cases), followed by small (59 cases), and large perforations (23 cases). Bandage Contact Lens (67 cases), Amniotic Membrane Transplantation (45 cases), and Penetrating Keratoplasty (38 cases) are frequently employed. Discussion:   Infectious keratitis, if not promptly managed, poses severe complications. Factors such as occupation, accessibility to medications, and gender influence delayed presentations. Corneal perforation, a consequence of various corneal disorders, requires timely recognition and intervention to prevent vision loss. Treatment modalities include medical approaches, tissue adhesives, and various surgical interventions. Conclusion:  The study underscores the multifaceted approach required for infectious keratitis management. Prompt intervention, gender-specific prevalence, and the efficacy of diverse treatments based on perforation characteristics are highlighted. The findings contribute valuable insights for the effective management of corneal perforations arising from infective keratitis.

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.

Hypertensive disorders in pregnancy, encompassing conditions like gestational hypertension and preeclampsia, significantly impact maternal and fetal health. Understanding their incidence and associated risk factors is vital for improving prenatal care. Objectives: This study aims to determine the incidence of hypertensive disorders among pregnant women and identify key demographic and health-related factors associated with these conditions. Methods: Design: Cross-sectional study. Setting: Obstetric outpatient Department. Participants: 250 pregnant women, ranging from 18 to 45 years, at various stages of gestation. Data Collection: Medical histories, blood pressure measurements, and relevant biochemical markers were collected. Statistical Analysis: Descriptive statistics, chi-square tests, and logistic regression were used to analyze the data. Results: Incidence: The incidence of hypertensive disorders was found in a specific percentage of the participants. Risk Factors: Key risk factors such as age, BMI, and medical history were significantly associated with the development of hypertensive disorders. Demographics: The study also revealed demographic trends, such as a higher incidence in certain age groups or pre-existing conditions. Conclusion: This study highlights a significant incidence of hypertensive disorders in pregnant women, underscoring the need for targeted prenatal screening and management strategies. The identification of key risk factors can aid healthcare providers in developing personalized care plans.

Introduction: COVID-19 is an acute viral illness caused by severe acute respiratory syndrome corona virus 2(SARS-CoV-2). Since the onset of the SARS-CoV-2 pandemic, multiple new variants of concern have emerged which are associated with enhanced transmissibility and increased virulence. It also highlights the role of the clinical inter professional teams, public health agencies, and community participation in improving patient care. Aim: An analysis of genomic sequencing variants of SARS-CoV-2 in symptomatic patients during 2nd and 3rd wave of pandemic by next-generation sequencing (NGS). Materials And Methods: A total of 200 symptomatic patients, throat/nasopharyngeal swab were collected for real-time reverse transcription-polymerase chain reactions (RT-PCR) at tertiary care hospital, Guntur. The specimens were transported under cold chain according to guidelines to Centre for Cellular & Molecular biology (CCMB), Hyderabad, for genome sequence analysis by next generation sequencing (NGS). Study period – 2ndwave i.e., MARCH 2021 –NOVEMBER 2021 & 3rdwave i.e., DECEMBER 2021 –MARCH 2022 according to WHO.  Result – Out of 200 samples analysed, 132 samples of 2nd wave & 68 samples in 3rd wave. Out of 132 samples, 57 Delta (B.1.617.2), 75 Delta sub-lineages. Out of 68 samples 41 Omicron (B.1.1.529), 11 Omicron lineages (BA.1), 16 Omicron (BA.2). Conclusion: During the 2ndwave the symptomatic patients were detected with more delta and delta sub lineages showing high mortality rate. During 3rdwave omicron and omicron sub lineages were detected more than delta showing very high transmissibility and less mortality. Continuous monitoring and analysis of the sequence variants to understand the genetic heterogenicity.

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.

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

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

Introduction: Community acquired pneumonia (CAP) is defined as pneumonia that is acquired outside the hospital i.e., acquiring a pathogen from the community and is a public health concern accounting for nearly 1% of all medical admissions. Identification of pathogen and its susceptibility pattern by processing appropriate samples will help to start prompt and effective treatment. The aim of the present study is to present the microbiological data of community acquired pneumonia in this region. Materials and Methods: In the present study 535 patients with clinical symptoms and suspected of community acquired pneumonia were included in this study. All patients were requested to collect good quality sputum and those samples were processed in the Microbiology department on recommended culture media. Bacteria; isolation was done by biochemical tests. Antibiotic susceptibility testing was performed by conventional methods. Results: Predominant pathogen was Klebsiella pneumoniae isolated as 33.6% followed by Streptococcus pneumoniae (24.7%), Staphylococcus aureus (18.5%), Pseudomonas aeruginosa (15.04%), Enterobacter species (5.3%), and Acinetobacter species (2.65%). Gram negative isolates antibiotic susceptibility pattern shows around 50% were sensitive to ceftriaxone, amoxyclav, about 70 % isolates were sensitive to Ceftazidime-clavulanic acid, Piperacillin-tazobactum, Levofloxacin, and 90% isolates were sensitive to Amikacin, Meropenem, Ertapenem, Tigecycline. In this study  23.8% were Methicillin Resistant Staphylococcus aureus isolates. Conclusion: Health education  measures such as cessation of smoking, wearing a mask to avoid occupational hazards, following public health measures during epidemics, flu and anti-pneumococcal vaccination may help to reduce the incidence of community acquired pneumonia.

Research and consideration on vitamin D physiology is crucial as approximately half of the people is being detected with this deficiency. Thus, the study was undertaken to estimate serum vitamin D and plasma cytokines in patients of diabetic retinopathy. More than fifty percent of worldwide population at risk because of vitamin D inadequacy has achieved contagion amounts. It also considered as a multifunctional hormone. In comparison to healthy control, pro-inflammatory cytokines were noticed to be elevated in patient with Type 2 Diabetes mellitus. Several studies reported significant elevation of plasma IL6(p less than 0.001), C reactive protein (CRP) (P less than 0.001) and elevated levels of TNFα in patients of diabetes. Materials and methods: A cross sectional hospital-based study was undertaken on 160 patients, who attended the ‘Retina Clinic’ of the Institute of Ophthalmology and the Out Patient Department of Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh. A well informed written consent for blood sampling was taken from all the patients included in the study and ethical approval was obtained from the institutional ethics committee. Demographic data, serum lipid profiles, HbA1c, fasting blood glucose, arterial blood pressure, visual History and treatment history were documented for all participants using pretested Performa. Results: Maximum and minimum value of different variables. In PDR group range of serum vitamin d level were 4.0ng/mL and 36.0ng/mL. While in NPDR group minimum and maximum levels were 3.50ng/mL and 58.50ng/mL. Minimum and maximum plasma TNFα level in PDR group were1.02pg/mL and 232.2pg/mL. Range of plasma IL10 in PDR patients were 4.6pg/mL and 196.74pg/mL. Minimum and maximum plasma IL1beta level in PDR patients were 11pg/mL and 119.16pg/mL. Range of plasma IL6 in patients with PDR were of 0.07pg/mL and 16pg/m. The mean and standard in various groups. In which, mean serum vitamin D in PDR patients was 15.45±6.15ng/mL whereas in the NPDR patients mean serum vitamin D was 18.99±8.25ng/mL. Conclusion: It concluded that patients with PDR, had lower vitamin D levels as compared to No DR. Showing decline trend in all patients with type 2 diabetes mellitus. On cytokine study it was found that plasma levels of TNF alpha, IL10, IL 1 beta and IL6 are elevated in patients with Type 2 diabetes mellitus patients as compared to non-diabetic healthy controls. 

Background: People face numerous hazards at work which may result in injuries, cancer,hearing loss, respiratory, musculoskeletal, cardiovascular, reproductive, neurological,skin and mental disorders. Objectives: To assess the Association of sociodemographicprofile and healthof traffic policemen in Kalaburagi. Method: The present cross sectional study studywascarriedoutamong all the traffic police men working in Kalaburagi city. Results: The association between ageand Waist Hip ratios was found to be highly significant. Majority of study subjects 27(55.10%) pre obese and 4(8-16%) obese belonged to more than 40 years of agegroup whereas 28(51.85%) pre obese and 2(3.70%) obese belonged to less than 40yearsofagegroup. Conclusion: There is a significant association between age and morbidities (like musculoskeletal disorders psychological problems and varicose vein) and found statistically highly significant.

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: Coronary Artery Disease (CAD) is one of the topmost causes of morbidity and mortality worldwide. Acute ST-segment elevation myocardial infarction (STEMI) is the most serioustype of CAD. Fibrinogen is an important factor expressed in response to systemic inflammatory and hemorheological alterations. Albumin is an important mediator of plateletinduced coronary artery constriction. Hypoalbuminemia may increase blood viscosity and can alter endothelial function. Fibrinogen-Albumin Ratio (FAR) addressing such pathophysiology of STEMI may provide additional information. This study aims to determine FAR in STEMI patients, correlate FAR with Gensini score based on coronary angiography and predict adverse outcomes of STEMI based on FAR values.  Methods: A cross sectional study in 51 patients with STEMI was conducted over one and a half yearsfrom March 2021 to August 2022. Eligible patients undergoing primary percutaneouscoronaryintervention was subjected to clinical history, physical examination, andinvestigations as per the structured proforma. Categorical data has been represented in theform of frequencies and proportions. Chi-square test or Fischer’s exact test was used as testof significance for qualitative data. Correlations were performed with Pearson Correlationcoefficient. We determined the severity of coronary artery disease based on Gensini scoringsystem. FAR values were correlated with the Gensini score. P-value of <0.05 was considered as statistically significant.  Results: In this study most of the cases (35.3%) were in the age group of 51-60 years with a mean age of 52 ± 14 years, 78.4% were males, 21.6% were females. About 39.2% were found to have single vessel disease, 33.3% had double vessel disease and 27.5% had triple vessel disease. About 60.8% had developed adverse outcomes predominantly heart failure. There was a Positive weak correlation between FAR and Gensini score (Pearson correlation; r = 0.148, P = 0.300) which was not statistically significant. The area under the receiver operating characteristic curve (AUC) for FAR in predicting the outcome is 0.595 (95% CI: 0.449 to 0.730, P = 0.246), with a cut-off of 0.063, with a sensitivity of 70% and specificity of 51.6%.  Conclusion: FAR may not be a substitute for coronary angiography in determining the severity of CAD, butit has some positive correlation with the angiographic severity measured by Gensini score. Though it is not statistically significant, however it can be used as an add-on biomarker along with other parameters in determining the severity of CAD. It is a non-invasive feasible test thatcan be done in a primary or secondary health centre for identifying patients who are at high risk of developing cardiovascular events and initiating appropriate measures.

Background: Coronary Artery Disease (CAD) is one of the topmost causes of morbidity and mortality worldwide. Acute ST-segment elevation myocardial infarction (STEMI) is the most serioustype of CAD. Fibrinogen is an important factor expressed in response to systemic inflammatory and hemorheological alterations. Albumin is an important mediator of plateletinduced coronary artery constriction. Hypoalbuminemia may increase blood viscosity and can alter endothelial function. Fibrinogen-Albumin Ratio (FAR) addressing such pathophysiology of STEMI may provide additional information. This study aims to determine FAR in STEMI patients, correlate FAR with Gensini score based on coronary angiography and predict adverse outcomes of STEMI based on FAR values.  Methods: A cross sectional study in 51 patients with STEMI was conducted over one and a half yearsfrom March 2021 to August 2022. Eligible patients undergoing primary percutaneouscoronaryintervention was subjected to clinical history, physical examination, andinvestigations as per the structured proforma. Categorical data has been represented in theform of frequencies and proportions. Chi-square test or Fischer’s exact test was used as testof significance for qualitative data. Correlations were performed with Pearson Correlationcoefficient. We determined the severity of coronary artery disease based on Gensini scoringsystem. FAR values were correlated with the Gensini score. P-value of <0.05 was considered as statistically significant.  Results: In this study most of the cases (35.3%) were in the age group of 51-60 years with a mean age of 52 ± 14 years, 78.4% were males, 21.6% were females. About 39.2% were found to have single vessel disease, 33.3% had double vessel disease and 27.5% had triple vessel disease. About 60.8% had developed adverse outcomes predominantly heart failure. There was a Positive weak correlation between FAR and Gensini score (Pearson correlation; r = 0.148, P = 0.300) which was not statistically significant. The area under the receiver operating characteristic curve (AUC) for FAR in predicting the outcome is 0.595 (95% CI: 0.449 to 0.730, P = 0.246), with a cut-off of 0.063, with a sensitivity of 70% and specificity of 51.6%.  Conclusion: FAR may not be a substitute for coronary angiography in determining the severity of CAD, butit has some positive correlation with the angiographic severity measured by Gensini score. Though it is not statistically significant, however it can be used as an add-on biomarker along with other parameters in determining the severity of CAD. It is a non-invasive feasible test thatcan be done in a primary or secondary health centre for identifying patients who are at high risk of developing cardiovascular events and initiating appropriate measures.

Near miss maternal mortality cases generally occur more frequently than maternal deaths and therefore a more reliable quantitative analysis can be carried out, which can provide a more comprehensive profile of health system functioning. Present study was aimed to study clinical profile of maternal near miss cases at a tertiary hospital. Material and Methods: Present study was single-center, prospective, observational study, conducted in pregnant women who were pregnant or in labor or delivered or aborted; up to 42 days from termination of pregnancy, admitted and labelled as Maternal Near Miss. Results: In present hospital-based study, 220 near-missed cases were studied. Most of the patients are from the age group of 20-24 years (45.9 %), followed by 25-29 years (29.09 %) & 30-34 years (9.54 %). Majority of near-miss cases belonged to rural area (59.09%), were housewives (41.81 %), belonged to class III of socioeconomic class (29.09 %), were illiterate (55.90 %). Of 220 cases, 197 were registered (89.54 %), 95% of patients were immunized. Majority cases were referred from other hospitals (53.63 %) & were admitted in the antepartum period (87%). Majority cases were primigravida (40.9 %) followed by gravida two (20.45 %) & gravida three cases (19.09 %). 202 cases (91%) were delivered at a tertiary centre of which many were referred in antenatal period for high-risk management. 128 cases (58.18%) underwent LSCS, 88 cases (40%) delivered vaginally. Hypertensive disorders of pregnancy (53.18 %) contributed to the majority of near-miss cases, followed by anemia (19.09 %), heart disease (9.09 %), abruptio placentae (6.36 %) & respiratory disease (5.45 %). In 52% of near-miss cases, vascular and hematological dysfunction. Conclusion: Present study noted pregnant women from rural area, from lower socioeconomic class, low literacy were common among near miss cases.

Introduction: Acute stroke is defined as an abrupt onset of a neurologic deficit that is attributable to a focal vascular cause which may be either ischemic or hemorrhagic in nature. Acute ischemic stroke, most common of the two types, results from prolonged cerebral ischemia leading to cerebral neuronal death. Ischemia Modified Albumin (IMA) is the only ischemic marker which has been approved by Food and Drug Administration(FDA) of United States(US) for early diagnosis of myocardial ischemia. Serum IMA levels and IMA to Albumin ratio(IMAR) were shown to increase in several diseases such as myocardial ischemia, acute stroke, muscle ischemia and bowel ischemia. Aim and Objectives: The aim of the study is to know whether Ischemia Modified Albumin (IMA) level is elevated in acute stroke patients and to compare the IMA levels and IMA to albumin ratio (IMAR) in acute stroke patients with healthy controls. Materials and Methods: Data required for the study were extracted from confirmed cases of Acute stroke (Diagnosed clinically and radiologically) patients attending Emergency and Intensive Care Unit of Neurology Department, GGH, Guntur and age matched normal healthy persons taken as controls. Biochemical parameters for the study were Ischemia Modified Albumin (IMA) estimated by Albumin Cobalt binding method and serum Albumin estimated by Bromo Cresol Green Dye binding method done on Beckman Coulter, Au 480 fully automated biochemistry analyzer. Ischemia Modified Albumin to Albumin Ratio(IMAR) was calculated from the results of both test and control groups. Results: IMA values of acute stroke patients were significantly higher than the control group (P Value <0.001). Mean serum albumin value of control group was higher than that of acute stroke patients. Negative Correlation was seen in Stroke patients between Serum Albumin and IMA (r = - 0.876). Mean IMA to Albumin Ratio(IMAR) of acute stroke patients were significantly higher than the control group (P Value <0.001). Conclusion: Ischemia Modified Albumin(IMA)would be a novel biomarker to support the clinical diagnosis of acute stroke. n this study mean IMA values of Acute Stroke patients were significantly higher than the control group. An arbitrary cut-off of 105.17 U/ml of IMA was chosen based on the ROC Curve analysis in the diagnosis of Acute Stroke patients. Further large scale studies are needed to choose clinically appropriate cut–off for serum IMA levels.

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.

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.

Background: This study examines the clinical outcomes and efficacy of management strategies for patients in the ICU of Government General Hospital, Nizamabad. It focuses on evaluating the impact of therapeutic interventions like oxygen therapy and CPAP adjustments in a critical care setting, particularly during the challenging period of the COVID-19 pandemic. Methods: A retrospective observational study was conducted involving 50 patients admitted to the ICU. The evaluation criteria included monitoring changes in oxygen saturation levels, the usage and adjustment of CPAP, and the presence of comorbid conditions. The study aimed to categorize patient outcomes into three groups: improvement, stability, and deterioration during their ICU stay. Results: Among the patients studied, 60% (30 patients) demonstrated clinical improvement, marked by increased oxygen saturation, reduced respiratory distress, and stabilized vital signs. 20% (10 patients) maintained a stable condition with no significant change in their health status. In contrast, another 20% (10 patients) experienced a deterioration in their condition, necessitating enhanced respiratory support. The study also found a high prevalence of comorbidities; 40% (20 patients) had hypertension, and 30% (15 patients) had diabetes mellitus. Conclusion: This study offers a comprehensive analysis of the clinical outcomes and management strategies in an ICU setting during a critical period. The findings highlight the effectiveness of personalized treatment approaches, the impact of comorbidities on patient outcomes, and the challenges posed by the COVID-19 pandemic. These insights are crucial for enhancing patient care in critical settings and for guiding future research in the field of critical care medicine.

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:  Carpal tunnel syndrome (CTS) is the most common compressive neuropathy and is a major cause of occupational disability. The diagnosis of carpal tunnel syndrome is based on clinical, electrophysiological, and radiographic tests. Ultrasonography is a quick, painless, and cost-effective method for confirming the diagnosis of carpal tunnel syndrome. In this comparative analysis, we examine the effectiveness of these diagnostic methods, scrutinizing their respective strengths and limitations in evaluating carpal tunnel syndrome. Materials and Methods: The present study was a correlational study, which included 60 patients with idiopathic carpal tunnel syndrome and 60 healthy controls. Only 90 wrists were used in the study among these 60 patients. We included all patients whose nerve conduction tests came out positive. Grades were assigned to each patient based on the results of nerve conduction examinations. Studies on motor and sensory nerves were conducted. Individuals with abnormal segmental or comparative tests were defined as having mild disease; those with abnormal digit/wrist sensory nerve conduction velocity and normal distal motor latency were identified as having moderate disease; and those with abnormal or prolonged distal motor latency were classified as having severe disease. Results: Out of the sixty patients, 38 had involvement in both wrists, 12 had involvement in just the right wrist, and 10 had involvement in just the left. Numbness (96.31%) was the most common symptom in the affected wrist, followed by tingling (85.63%), discomfort (75.22%), and weakness (35.67%). While 67% of the wrists had a positive Phalen’s test result, 78% of the wrists had a positive Tinel’s sign. The majority of the patients (88%) had normal vibration and 91% had normal proprioception. We found mild carpal tunnel syndrome in 50 wrists, moderate carpal tunnel syndrome in 31 wrists, while severe form was reported in only 9 wrists. The mean cross-sectional area of the median nerve in mild carpal tunnel syndrome was 8.21±1.55 mm², in moderate carpal tunnel syndrome was 11.09±1.97 mm² while in severe cases it was recorded at 14.85±3.87 mm². While the mean cross-sectional area of the median nerve in the control group was 6.28 ± 1.28 mm². Conclusions: The severity of carpal tunnel syndrome can be accurately assessed using ultrasonography, as there is a strong correlation between the increased cross-sectional area observed on ultrasonography and the severity of the condition in nerve conduction studies. Ultrasonography can be used as a cost-effective alternative to nerve conduction studies when the latter are not available.

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.

Background:  As we all know that liver has been called the custodian of milieu interior, as such any form of liver disorder will result significant effect on homeostasis and also, numerous pathologies of other systems can affect either directly or indirectly 
on liver. Both acute and chronic heart failure may result in abnormalities of liver. Liver receives 25% of cardiac output, a huge percentage of cardiac output, so fall in cardiac output will result in hepatic hypo perfusion.  Therefore our study was planned to 
evaluate the abnormalities of liver function and its role on assessment of prognosis in Congestive Cardiac Failure patients in our setup. Research Question: What are the abnormalities of various liver function tests in Congestive cardiac failure patients?  The setting of the study was at department of General Medicine, Government General Hospital, Government Medical College, Eluru, Andhra Pradesh. A one year observational study was conducted during the period from October 2022 to September 2023 on about 75 Congestive cardiac failure cases of varied etiology admitted during the above period in the department of General Medicine by studying their socio demographic profiles, associated causes for Congestive cardiac failure, assessment of liver function by conducting various biochemical tests and the prognosis of the disease etc. and about 20 healthy individuals were taken as controls for comparison of data.  Results: Among the total study subjects ( CHF cases ) males were 58.6% and females  were 41.3% and among controls it was 60% & 40% and regarding age among cases maximum were found between 41 – 70 years age group. And also with regard to etiological cause of CHF Coronary Atherosclerotic Heart disease accounted for 73% followed by RHD 72% Cardiomyopathy 71%, Cor pulmonale 69% and Hypertensive heart disease 57% were observed and with regard to Prognosis out of total 75 cases about 53(71%) of cases were showed abnormal LFT and out of this total about 47 cases showed remission and 44 got responded towards reduction of serum bilirubin on remission. And about 6 showed exacerbation among total 75 cases. Related to LFTs Sr bilirubin, AST, ALT, SAP has showed significant increased levels and Sr albumin showed mild rise in this study

Background:  Workplace violence against doctors has emerged as a critical issue, posing significant challenges to the healthcare sector worldwide. This article delves into the multifaceted nature of violence faced by doctors in their workplaces, examining its root causes, manifestations, and the consequential impact on both healthcare professionals and patient care. Understanding the underlying causes is essential for developing effective preventive strategies. Mitigating workplace violence necessitates a  comprehensive approach, including improved communication strategies, enhanced security protocols, and systematic awareness campaigns. Fostering a culture of respect and empathy within healthcare settings is imperative to create an environment that prioritizes the well-being of both healthcare professionals and patients. By addressing the root causes and implementing preventive measures, healthcare institutions can create safer environments for their professionals, ultimately enhancing patient care and the overall well-being of the  healthcare workforce. 

Background:-Tuberculosis poses a severe threat to human health. At present, compared with the traditional diagnostic methods for tuberculosis pleural effusion and sputum, such as sputum microscopy for Acid-fast bacilli (Z-N stain) and confirmatory molecular test for tuberculosis by Truenat MTB (PCR) was regarded as an emerging technology for its efficiency. We performed a systematic review and meta-analysis to evaluate diagnostic accuracy of a positive pleural effusion and sputum microscopy were better or useful tool for diagnosis and treatment of Tuberculosis. The study is implemented to check the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of sputum and pleural fluid were calculated, Material and methods- The study included 265 suspected pulmonary TB patients with positive clinical manifestations at Varun Arjun Medical College and Rohilkhand Hospital, Banthra, Shahjahanpur U.P. Sample was collected over age of 18 that had been suspected pulmonary tuberculosis with positive sign and symptoms from July 2023 to December 2023. The diagnostic results from pleural fluid and sputum sample were used as the standard calculating the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Data was collected from the Department of Microbiology, Varun Arjun Medical College and Rohilkhand Hospital, Banthra, Shahjahanpur U.P. Results: The sensitivity for smear microscopy is 85.2% (95% CI 77.8 – 92.1), specificity is 90.2% (95% CI 82.6 – 97.8), and positive predictive value is 83.7% (95% CI 82.6 – 84.9) and negative Predictive value is 69.4% (95% CI 63.6 – 74.4). In contrast, the sensitivity for truenat MTB is 92.5% (95% CI 91.1 – 93.9), specificity is 98.7% (95% CI 97.8 – 99.6), negative predictive value is 94.8% (95% CI 93.8 – 95.8) and positive predictive value is 97.1% (95% CI 95.7 – 98.5). Conclusion: This preliminary study shows that the Truenat MTB test allows detection of TB in Approximately in short time of interval and can be utilized in near- care setting to provide quick and accurate diagnosis

Background: This study explores the landscape of maternal health and its impact on neonatal outcomes, focusing on the prevalence of diverse pregnancy-related complications. Recognizing the significance of understanding these complexities, the study investigates conditions such as abruption, gestational diabetes mellitus (GDM), hypertension, and other factors influencing birth weight categories. Objective: To contribute nuanced insights to maternal and neonatal healthcare practices. Materials and Methods: A retrospective analysis was conducted on a cohort of subjects, extracting data from medical records. The study encompassed various pregnancy-related complications, including abruption, GDM, hypertensive disorders, fetal growth restrictions, and other maternal conditions. Statistical analyses, including percentages and prevalence rates, were employed to elucidate the distribution of these complications within the studied population. Results: The findings reveal a diverse spectrum of maternal health conditions. Notable observations include the prevalence of GDM (8.2%), hypertensive disorders (6.6%), and post-term pregnancies (11.5%). Additionally, conditions such as abruption, fetal growth restriction, and preterm births exhibited varying frequencies. Rh-negative pregnancies accounted for 9.8%, emphasizing the multifaceted nature of maternal health complexities within the studied population. Conclusion: This study provides a comprehensive overview of pregnancy-related complications and their prevalence within the studied cohort. The findings underscore the need for personalized antenatal care strategies, early anomaly detection, and focused interventions to optimize maternal and neonatal outcomes. Recognizing the intricate relationships between maternal health conditions and birth outcomes is crucial for informing clinical decision-making and enhancing public health initiatives.

Background: Gestational diabetes mellitus is a condition in pregnancy where adverseperinatal outcomes in mother occurs.Effect of longstanding diabetesmellitus on adult heart might lead to dysfunction and diabeticcardiomyopathy. Microvascular processes and subcellular disturbancescause structural and functional damage to the diabetic heart, even without overt coronary artery disease.GDM patients might have impaired cardiacfunctions compared to healthy pregnant women. Objective: In view of this, this study was undertaken to assess the Maternal cardiac adaptation of women at term with and without GDM. Methods: A prospective study was conducted among 60 pregnant women, 30 with GDM and 30 without GDMduring2022 to2023admitted inthe department of obstetrics and gynaecology at Adichunchanagiri Institute of Medical Sciences, B.G Nagara, Karnataka. Results: There was no statistically significant difference in echocardiogenic findings of both groups. Results revealed that echocardiogenic parameters, including normal heart rate, left ventricular relative wall thickness, LV late diastolic transmitral valve velocity, Ejection fraction >60%,Pulmonary artery systolic pressure,IVC findings,regionalwall motion abnormality are normal.These findings suggest that diabetesdonot appear to have impact on echocardiac measures compared to normalANC women. Conclusion: These results suggest that during pregnancy the presence ofgestational diabetes maynot impact cardiac function compared to normalantenatal women. 

Objective: The aim of present study was conducted to evaluate the rapid immunochromatographic tests that detect NS₁antigen, IgM, IgG antibody simultaneously and their comparative study by IgM capture Elisa. Material and methods: A total of 368 clinically diagnosed patients of dengue fever were included in the study. From all the patients 368 blood samples were collected and serum were separated. From all the serum tests were performed by rapid immunochromatographic test kit which can detect all three parameter NS₁Ag, IgM& IgG antibody according to packet insert by manufacturers guide lines. All the tests were compared by IgM capture Elisa. Result: Out of368 blood samples of dengue fever 136 samples were positive by rapid immunochromatographic test. Among 136 positive cases   127 cases were NS₁Ag positive,05 cases are IgM reactive; 03 samples are IgG reactive and only 01 samples are reactive forNS₁, IgM & IgG. Out of 368 blood samples tested by dengue Ig M capture Elisa only 123cases (33.42%) were reactive. Conclusion: Detection of dengue NS₁Ag in the patient can be used as screening test in early cases of dengue illness. Since it is easy to perform it can be used in primary health care centres to take appropriate measure to reduce morbidity and mortality. Early notification of disease can awake the public health authority to take control measures.

Sleep is rigorously controlled by circadian rhythms, and any discrepancy between these rhythms and the external environment might result in circadian rhythm sleep disorders. Circadian rhythm sleep disturbances (CRSDs) are linked to detrimental health outcomes, including cancer and psychiatric illnesses. This systematic literature review explores the significance of disturbances of sleep and circadian rhythm. A systematic literature survey was conducted using PubMed, Scopus, Web of Science, Embase, and Cochrane Library databases. We used the  following search terms: "Circadian clock," "sleep," " Circadian rhythm," sleep disorders," "drugs to cure sleep and circadian rhythm," and "CRSD." for articles published between 2018 and 2023. This comprehensive review presents evidence from human research to assess the concept that sleep and circadian rhythms have direct effects on physiological processes in the human body and are significant underlying factors contributing to major health concerns. The first part of this review focussed on sleep and circadian rhythm, circadian clock and effects of altered metabolism.” The second part discussed recent evidence that the circadian clock system plays a fundamental rolein  health risk, adverse effects on health, and their connection with disturbances of sleep and circadian rhythm. These research lines are still in their early stages, but they have nonetheless established a conceptual framework that could be highly significant for comprehending metabolic health and illness

Background: Diabetes mellitus, a prevalent metabolic disease globally, causes various complications, including microvascular issues like Diabetic Retinopathy (DR) and macrovascular complications. DR, characterized by retinal microvascular alterations, is a leading cause of vision loss. Diabetic Foot Ulcer (DFU) is a severe complication, often leading to amputation, with studies suggesting a link between DR and DFU. This study aims to assess the severity of DR concerning different grades of DFU. Objective: To evaluate the association between the severity of Diabetic Retinopathy and various grades of Diabetic Foot Ulcer. Methodology: A cross-sectional study was conducted from February 2021 to August 2022, involving 100 patients clinically diagnosed with type 2 Diabetes Mellitus and DFU. Data on socio-demographics, medical history, and DR severity were collected. Statistical analysis was performed using SPSS, with a significance level of 5%. Result: Participants (n=200) were primarily aged 51-60 (39%), with 62% males. About 42% had diabetes for 1-5 years, and 73% reported DFU duration of <1 month. In DR grading, 26% had Moderate NPDR, 15% had severe NPDR, 4% had very severe NPDR, and 21% had no NPDR. A significant association was found between DR severity and DFU grades (p<0.05). Discussion: Comparisons with existing studies revealed variations in diabetes duration and DR severity. The study confirmed the association between DFU and DR, consistent with previous findings. Conclusion: The study emphasizes the need for enhanced screening protocols to detect and manage DR and DFU promptly. The severity of DR increases with DFU stages, suggesting DFU's potential to predict advanced DR stages. As diabetes prevalence rises, addressing these complications is crucial for the working population's well-being. A systematic healthcare approach is essential for early detection and management.

BACKGROUND This study was conductedto assess the BODE index (Body mass index, airflow Obstruction, Dyspnea, and Exercise capacity) in order to forecast the severity of COPD (Chronic Obstructive Pulmonary Disease) patients' condition and its relationship to pulmonary hypertension.METHODS This was a hospital-based cross-sectional prospective study conducted among 81 patientsclinically diagnosed to have COPD at the Department of General Medicine, Kurnool Medical College, Kurnool, from February 2021 to September 2022, after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. RESULTS The majority,i.e., 35.8% of the patients had mild PHT, followed by 33.3% with severe pulmonary hypertension, according to ECHO findings. According to BODE index scoring, 48.1% of COPD patients attending the hospital had mild severity, and 30.9% had severe COPD. A statistically significant increase in pulmonary hypertension intensity and COPD severity was seen. There was a statistically significant associationbetween theseverity of COPD and the number of exacerbations, pack years of smoking, Hbg%, BODE score, MMRC score, and ECG changes. As the severity increased, the number of exacerbations andpack years increased,while HB% was decreasing. No association with BMI, height, or weight was seen. ECG findings were co-related to pulmonary hypertension, which was statistically significant. A statistically significant increase in BODE score with a pulmonary hypertension grading increase was seen. The BODE score significantly assesses the chances of exacerbations according to the ROC curve. CONCLUSION The BODE index can provide an effective, superior, and alternative technique to evaluate the severity of the disease. It may also assist in patient follow-up. The BODE index can be of significant practical utility in a primary healthcare setting to identify people who require additional evaluation at higher referral centers and for improved management of these patients because it just takes a spirometer, which is affordable and easily made available.

Background : Stomach carcinoma, the second most prevalent malignancy in Asia, poses a substantial global public health challenge. Gastric adenocarcinoma, comprising over 90% of cases, necessitates optimal treatment modalities, primarily RO resection, to achieve locoregional control. Lymph node metastasis, the primary mode of spread, underscores the importance of meticulous lymphadenectomy. The Japanese Gastric Cancer Association (JGCA) guidelines delineate the critical role of D2 lymphadenectomy in staging and controlling gastric carcinoma. Methodology: This retrospective study, conducted at SCB Medical College & Hospital, assesses the necessity of routine D2 lymphadenectomy in operable cases of gastric carcinoma. Forty-six patients meeting specific criteria underwent detailed workup, including hematological and radiological evaluations. Operable cases underwent gastric resection with D2 lymphadenectomy, targeting a minimum of 16 lymph nodes. Extended resections and palliative procedures were performed as needed. Results: The study comprised 46 patients (56% male, 44% female), aged 55-65 years. Clinical presentations included dyspepsia (63%), weight loss (54.3%), and less common symptoms. Antral growth was predominant (54.3%). Operable cases (87%) underwent successful D2 lymphadenectomy with minimal complications (4% pulmonary complications, 6% wound infections). The majority were stage II and III (77.5%). Two-year follow-up indicated a 5% mortality and recurrence rate. Discussion: Surgical intervention, particularly D2 lymphadenectomy, remains the most effective therapeutic option for gastric carcinoma. Our study aligns with JGCA guidelines, emphasizing the importance of D2 lymphadenectomy in achieving locoregional control. The inadequacy of D1 lymphadenectomy is evident, highlighting the significance of removing an adequate number of lymph nodes. Despite concerns, evidence suggests that the current form of D2 lymphadenectomy is not more hazardous than D1, and maximal lymph node removal correlates with improved long-term survival. Conclusion: Our study underscores the critical role of D2 lymphadenectomy in achieving optimal locoregional control and improving overall survival in gastric carcinoma. The meticulous removal of an adequate number of lymph nodes is imperative, emphasizing adherence to established guidelines for lymphadenectomy.

Background: Cardiac arrhythmias represent a significant public health concern globally, with serum cholesterol levels being a potential modifiable risk factor. However, the direct correlation between cholesterol levels and the prevalence of cardiac arrhythmia across different demographics remains inadequately understood.This cross-sectional observational study aims to evaluate the association between serum cholesterol levels and the prevalence of cardiac arrhythmias, considering various demographic and health status factors. Methods: The study involved a diverse cohort of participants categorized by age, gender, and health conditions such as hypertension and diabetes. Serum cholesterol levels were classified as desirable (<200 mg/dL), borderline high (200-239 mg/dL), and high (≥240 mg/dL). The prevalence of arrhythmia across these categories and other demographic factors was analyzed. Results: Among the participants, 30% had desirable, 40% had borderline high, and 30% had high cholesterol levels. The overall arrhythmia prevalence was 24%. A significant increase in arrhythmia prevalence was observed with higher cholesterol levels: 6% in desirable, 28% in borderline high, and 43% in high cholesterol levels. Males with high cholesterol and participants with diabetes and high cholesterol exhibited higher arrhythmia prevalence, at 46% and 50%, respectively. Conclusion: The study highlights a significant association between elevated serum cholesterol levels and increased prevalence of cardiac arrhythmias. This association is especially pronounced in individuals with additional risk factors such as hypertension and diabetes.

Background:  The aim of our study is to analyze the incidence, pathophysiology, clinical features and various treatment options for cervical compressive myelopathy. Predicting the surgical outcome in anterior cervical approach in cervical compressive myelopathy. Materials and methods: Our study is a prospective study comprising of 70 cases studied over a period in all cases of cervical spondylotic myelopathy with anterior compression. All these patients were decompressed or approached anteriorly either by Discectomy i.e., ACD with Fusion or Corpectomy and fusion followed by fixation with cervical plate and cortical screws. Results: Clinical improvement was favorable in younger patients compared to elderly age group. At the end of 1month 88.88% patients improved in 3^rd decade. At the end of 6months 100% patient improved in 4^th decade .out of 70 patients 42 patients improved in the 1^st month, 55 patients in the 6^th month. In our study patients with symptoms for shorter duration fared better compared to those with symptoms for more than 12 months. The p value was 0.018702, which is statistically significant. Patients who are operated for single level lesion showed 84% improvement after 6months followed by 2 level lesion it showed an improvement of 66.66% after 6 months and 3 level lesions with 60 % after 6months. 31 patients have shown myelomalacia changes, of these 20 patients have improve on post operative MRI. Similarly, out of 39 patients without myelomalacia 35 patients as shown significant improvement. This clearly infers that the improvement as proved by MRI is better in patients without myelomalacia changes. Conclusions: Proper health education and understanding of the disease at the bottom level of health care, is more important for better prognosis. Compared to posterior approach, anterior approach has got better compliance.

Background: Catheter-associated urinary tract infection (CAUTI) is one of the most prevalent health-related illnesses, account for almost half of all hospital-acquired diseases. The length of catheterization, ICU stay and procedure of catheterisation play a crucial role for developing catheter associated bacteriuria (CAB). Objectives: Aim of this study to determine the incidence and evaluate risk factors of CAB in medical intensive care unit patients Methods: Patients age >45 and <75 years requiring an in dwelling catheter for longer than 48 hours admitted in medical ICU were enrolled. A quantitative urine culture was performed once weekly or prior to removal of catheter or when clinical manifestations of UTI occurred (fever>38C, dysuria, suprapubic tenderness, pyuria). The following variables were estimated age, sex, duration of catheterisation, ICU stay and severity score at admission (Apache II). Results: A total of 110 patients required indwelling catheter were analysed. The incidence of CAB was 10.5% (12/110). Majority of the patients were 56-65 years age predominantly males. The length of ICU stay and duration of catheterisation was significantly associated with bacteriuria. Most common organism isolated from CAB was E. coli followed by Enterococcus species and Pseudomonas species Conclusion: Proper aseptic insertion, maintenance of the catheter by trained personnel, justified use of urinary catheterization and the removal of the catheter as soon as feasible were the key factors to prevent CAB.

Aim :To Evaluate the Diagnostic Efficiency of Cystatin C As a marker of Early Renal injury in patients of Type 2 Diabetic in comparison with Creatinine. Materials and Methods : 100 proven cases of type 2 Diabetes categorized into 3 groups. Normoalbuminuria (48), microalbuminuria (32) & macroalbuminuria (20). 50 age and sex matched healthy controls. Fasting plasma glucose(FPG), serum Creatinine, serum Cystatin C, urine dipstick analysis for protein, urine albumin, urine creatinine & calculated UACR were estimated. Glomerular filtration rate was estimated by Cystatin C concentrations according to Chronic Kidney Disease Epidemiology (CKD-EPI) equation and Creatinine eGFR according to Modification of Diet in Renal Disease (MDRD). Results : There was raised levels of FPG , serum Creatinine & serum Cystatin C significantly (p<0.01) with increasing duration of Diabetes. The eGFR of Cystatin C was lower than that of Creatinine eGFR in cases but in controls it was more. The calculated sensitivity of Cystatin C eGFR was 91%,specificity was 94% and overall accuracy(OA) was 92% and these results are better than that of Creatinine eGFR with 84% sensitivity ,88% specificity and 85% OA. The eGFR cystatin c showed higher sensitivity, high specificity & higher accuracy than eGFR creatinine in studied diabetic subjects. Cystatin C showed more significant correlation with Cys C e GFR, (r = −0.99, p<0.001) than serum creatinine e GFR ( r= −0.86,p<0.001) in diabetic patients. Conclusion:The results of present study showed Cystatin C was more sensitive than creatinine thereby making se Cystatin.

Introduction: Bacterial keratitis is also often referred to as a 'corneal ulcer'. In practice, these terms are not directly interchangeable because a cornea may harbor a bacterial infection (i.e bacterial keratitis) without having a loss of tissue (an ulcer) and a cornea may have an ulcer without a bacterial infection. Bacterial keratitis is a serious bacterial infection of the cornea which can, in severe cases, cause loss of vision. Materials and Methods: This is a prospective study conducted over a period of six months at the Department of Ophthalmology. Inclusion Criteria: Patients above the age of 18 years presenting with suspected corneal ulceration and having symptoms of pain, redness, watering, photophobia and decreased vision were included in the study. Exclusion Criteria: Patients with typical features of viral infection and healing ulcers were excluded as were Mooren's ulcers, interstitial keratitis, sterile neurotropic ulcers, and any ulcer associated with autoimmune conditions. Results: Total 90 patients were enrolled with a corneal infiltration that was clinically compatible with the diagnosis of bacterial corneal ulcer. Majority of them were male 54 (60%) and female 40%. The age of patients ranged from 1 to >60 years. Majority of 21-40 years age group (41.1%). The keratitis was induced by foreign body particles were most common risk factor 24.4%. Corneal localization of the ulcers was distributed as in 51 (56.6%) patient's central and in 39 (43.3%) peripheral. The diameter of the corneal ulceration was of 1-2 mm in 24 (26.6%), 3-4 mm in 29 (32.2%), 5-6 mm in 21 (23.3%), 7-8 mm in 9 (10.0%) patients, 7 (7.7%) patients had entire corneal involvement. Ulceration depth was less than 1/3 conreal thickness in 46 (51.1%), between 1/3 to 2/3 in 26 (28.8%) patients and over 2/3 in 18 (20.0%) patients. Anterior chamber inflammation was absent in 9 (10%) patients. A1+ to 2+ Tyndall effect with 1+ to 2+ cells were present in 17 (18.8%) patients, and severe anterior chamber inflammation (3+ to 4+ Tyndall effect and cells, with or without hypopyon) was present in 64 (71.1%) patients. Conclusion: Bacterial Corneal ulcers are a vision-threatening ocular emergency. It is imperative that health care providers across specialties work together so that these patients may have the best possible outcome and avoid the many potential complications.