https://ijhcr.com/index.php/ijhcr/issue/feed International Journal of Health and Clinical Research 2021-05-11T10:12:49+00:00 James editor@ijhcr.com Open Journal Systems <p style="text-align: justify;">International Journal of Health and Clinical Research (IJHCR) is an open-access; freely accessible, online and print monthly peer-reviewed international journal publishes a wide spectrum of advanced research on all medical specialties including ethical and social issues. IJHCR is a gateway to enlighten the latest research/issues happening all around the world of medical and health sciences.</p> <p style="text-align: justify;">The journal publishes Original research articles in the form of full-length papers or short communications especially those with multidisciplinary nature. The journal welcomes review articles, mini-reviews, case reports, letter to the editor, guest editorial or commentaries.</p> https://ijhcr.com/index.php/ijhcr/article/view/1474 Antibiotic sensitivity pattern of bacterial isolates recovered from clinical samples at tertiary care hospital in western UP, India 2021-05-05T11:45:06+00:00 Krati R Varshney Varshney@gmail.com Sanjeev Dimri Dimri@gmail.com <p>Aim: The aim of this study was to demonstrate various bacteria recovered in clinical samples collected from in-patient department (IPD) and out-patient department (OPD) of the hospital and their antibiotic sensitivity pattern.Material and Methods: A total of 232 bacterial isolates were recovered in samples from urine, blood, pus &amp; fluids and respiratory tract. The isolates were first identified by standard biochemical techniquesand then subjected to antibiotic susceptibility testing by Kirby Bauer disc diffusion method on Mueller Hinton agar plate as per CLSI guidelines.Result: Majority of bacterial isolates were recovered in clinical samples collected from IPD (66.38%). E. coli (34.05%) was the predominant isolate in the study. E. coli (59.01%) was the predominant bacteria in urine samples and was highly sensitive to colistin (100.00%) and least sensitive to ampicillin (08.33%). Coagulase negative staphylococci (45.24%), were the predominant bacteria in blood samples and maximally sensitive to linezolid (89.47%) while all isolates were resistant to penicillin. Staphylococcus aureus (25.64%) was the predominant bacteria in pus &amp; fluids samples and was maximally sensitive to linezolid while half the isolates were methicillin-resistant staphylococcus aureus (MRSA). Acinetobacterbaumannii (44.83%) was the predominant bacteria in respiratory samples and was maximally sensitive to colistin (100.00%) while all isolates were resistant to carbapenems. Conclusion: Our study shows that E. coli was the major bacterial isolate from all clinical samples and was the predominant bacteria in urine samples. The most effective antibiotics in our study was colistin and carbapenems for gram-negative bacterial isolates and nitrofurantoin for urinary isolates of E. coli while linezolid &amp;glycopeptide antibiotics were the most effective antibiotics for gram-positive cocci.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Krati R Varshney, Sanjeev Dimri https://ijhcr.com/index.php/ijhcr/article/view/1475 A Hospital Based Case Control Study on Correlation Between Simple Febrile Seizure and Iron Deficiency Anaemia 2021-05-05T12:19:21+00:00 Nikki Kumari Kumari@gmail.com Rajesh Kumar Kumar@gmail.com Md. Athar Ansari Ansari@gmail.com Binod Kumar Singh Singh@gmail.com <p>Febrile seizure (FS) is the most common convulsive disorder in children, which affects 2-5% of children aged between 3 to 60 months. Among the numerous biological effects of iron, there is considerable evidence that iron is also important for neurological functioning. Aims and Objectives: To assess and evaluate any possible association between febrile convulsion and iron deficiency anaemia. Materials and Methods: This case-control study involved 300 children aged from six months to 5 years, hospitalized in the pediatrics ward of NMCH, Patna from May 2019 to November 2020. They were divided into two groups of 150 children each. In the case group children having simple febrile convulsion were kept and the control group had children with fever of less than 3 days duration but without febrile convulsion. Result: The risk of simple febrile seizure was 1.86 times more among the patients with level of hemoglobin &lt; 11 gm/dl as compared with the patients with level of hemoglobin≥11 gm/dl [OR-1.76(1.01, 3.08); p= 0.04] and the risk was significant. Conclusion: we concluded that iron deficiency anemia (IDA) was more frequently seen among children with FS than those with febrile illness alone. .All the investigations done also suggested that iron deficient children are more prone for febrile seizures and hence prophylactic iron supplementation in iron deficient anaemic children can probably avert first febrile convulsions.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Nikki Kumari, Rajesh Kumar, Md. Athar Ansari, Binod Kumar Singh https://ijhcr.com/index.php/ijhcr/article/view/1476 Assessment of the effect of supplemental oxygen on development of retinopathy of prematurity 2021-05-05T12:26:39+00:00 Rohit Singh Singh@gmail.com Ujala Sharma Sharma@gmail.com <p>Background:Retinopathy of prematurity is a vasoproliferative disorder that affects premature infants. The present study was conducted to assess the effect of supplemental oxygen on development of retinopathy of prematurity.Materials &amp; Methods: 90 neonates of 0-28 day’s old of both gender with possibilities of ROP were included and assessment of retinopathy was done.Results: There were 1 ROP +ve and 12 ROP-ve neonates seen within 24-72 hours of oxygen inhalation, 6 and 10 in 73-120, 22 and 2 in 121-170 and 36 and 1 &gt;170 hours of oxygen inhalation respectively. There were 8 ROP+ve and 10 ROP-ve neonates seen with 85-89 Oxygen saturation, 25 and 12 with 90-94 Oxygen saturation and 32 and 3 with 95-99 Oxygen saturation respectively. The artial pressure of oxygen (PaO2) was 70-99 seen in 13 and 8, 100-150 seen in 40 and 14and &gt;150 in 12 ROP +ve and 3 ROP-ve respectively. The difference was significant (P&lt; 0.05).Conclusion: Retinopathy of prematurity was seen with oxygen supplementation.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Rohit Singh, Ujala Sharma https://ijhcr.com/index.php/ijhcr/article/view/1477 Ultrasound assessment of kidney size and its correlation with body mass index in healthy volunteers without renal disease 2021-05-05T12:32:25+00:00 Nazma Nazma@gmail.com Manjusha Yadla Yadla@gmail.com Muzamil Latief Latief@gmail.com <p>Introduction:Renal length as well as renal cortical thickness has been closely related to creatinine clearance in patients with chronic kidney disease. Our primary aim was to establish a normal range of values for kidney length in our adult population with normal renal function.Materials and Methods:This was a prospective observational study. Ultrasonographic assessment of renal parameters in 499 healthy volunteers between 18 to 80 years of age was done. Volunteers with any known renal condition or any comorbidity were excluded from the study population. Correlation between BMI and renal parameters was assessed. Results:Out of 499 volunteers 327 (65%) were males and 172(35%) were females. 17.8% volunteers were less than 30 years of age, 51.5% volunteers were in the age group of 30-60 years and 30.7 % were above 60 years of age. Mean Body mass index (BMI) in males was 25.20 +/- 3.96 whereas mean BMI in females was 24.08+/- 3.28. In males the mean cortical thickness in Right kidney was 13.68+/- 2.47 mm and in left kidney CT was 13.94+/- 2.6 mm. In females right kidney cortical thickness was 12.63+/- 1.91 mm and left kidney CT was 13.40+/-2.37 mm. In the present study the right mean renal length was 9.9± 40cm and left renal length was 10.19±0.97cm.Discussion:In the present study, we analyzed renal size in terms of length, breadth, and cortical thickness which are simple, reproducible, reliable and objective measurements. Our finding that left side kidney length is greater than right sided kidney length is similar to the previous studies showing left side kidney length is greater than right sided kidney length. We observed positive correlation BMIwith renal length.Conclusion: Size of kidney has significant ethnic and geographic basis and there is a positive correlation between BMI and kidney size in our study population.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Nazma, Manjusha Yadla, Muzamil Latief https://ijhcr.com/index.php/ijhcr/article/view/1478 A comparitive study of plain Bupivacaine and combination of bupivacaine with Ondansetron as an adjuvant in supraclavicular brachial plexus block 2021-05-05T12:41:20+00:00 Mamidi Ajay Kumar Kumar@gmail.com Jyothi Sugali Sugali@gmail.com Julakanti Madhavi Madhavi@gmail.com Ramavath Baloji Baloji@gmail.com <p>Background and objectives:Adjuncts to local anaesthetics for brachial plexus block may enhance the quality and duration of analgesia. Ondansetron, highly selective and potent antagonist of 5-hydroxytryptamine subtype 3 (5-HT3) receptors is known to produce antiemetic and in addition above effect it blocks sodium channel and has antinociceptive property to enhance the effect of local anaesthetic when given in peripheral nerve blocks. The purpose of this study was to assess the effect of Ondansetron added to brachial plexus block by supraclavicular approach. Methods:A prospective, randomized, single blinded study was conducted on 60ASA Grade I or II adult patients undergoing upper limb surgeries under supraclavicular brachial plexus block. Patients were randomly divided into two groups. Patients in Group A (n = 30) were administered 30mL of 0.5% Bupivacaine and Group B (n = 30) were given 30mL of 0.5% Bupivacaine with Ondansetron 8mg/kg. The onset time and duration of sensory and motor blockade were recorded. Haemodynamic variables (i.e., heart rate, blood pressure and oxygen saturation), sedation scores and rescue analgesic requirements were recorded for 24 hr postoperatively. Results: The onset of sensory and motor block was significantly faster in Group B compared to Group A (p&lt; 0.05). The duration of sensory and motor block was significantly longer in Group B compared to Group A (p &lt; 0.05). Rescue analgesic requirements were significantly less in Group B compared to Group A (p&lt; 0.05). Haemodynamics and sedation scores did not differ between the two groups in the post-operative period. Conclusion: Ondansetron (8mg) in combination with 30mL of Bupivacaine (0.5%) hastened onset of sensory and motor block, and improved postoperative analgesia when used in brachial plexus block, without producing any adverse events.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Mamidi Ajay Kumar, Jyothi Sugali, Julakanti Madhavi, Ramavath Baloji https://ijhcr.com/index.php/ijhcr/article/view/1479 Prospective study of adaptive radiotherapy in head and neck cancers with concurrent chemoradiation in volumetric modulated arc therapy 2021-05-05T12:50:27+00:00 Malladi Ramakrishna Ramakrishna@gmail.com Kadarla Krishna Krishna@gmail.com Indraja Naidu Talupula Talupula@gmail.com <p>Introduction:During the course of Head and neck radiotherapy, anatomical changes as body weight and/or tumour volume may result in under dosage or dose inhomogenisity in targets and overdosage in Organs at risk(OARs). so this study is undertaken to provide an overview of magnitude and frequency of these effects and to investigate the benefits of adaptive radiotherapy to patients of Head and neck cancers treated with VMAT.Aims: The main aim of the study is to see the benefit of adaptive radiotherapy in Head and neck cancer patients during treatment with Volumetric Modulated Arc Therapy by examining anatomical and dosimetric changes.Materials and method: The present study is a prospective, single arm studywas conducted at department of Radiation Oncology, at MNJ Institute of oncology and Regional cancer center, Osmania medical college, Hyderabad.20 patients of Head and neck cancers being treated with radiotherapy will be taken into study over a period of 2 years.Results: Mean doses to ipsilateral and contralateral parotids doses decreased to parotids in re-plans but with P value not significant. Mean Dmax doses to spinal cord (with significant P value) and brain stem (non significant p value) are also reduced with re-planning. Conclusion: As there is increase in the target volume coverage and decreased doses to OARs with re-planning, ART can be considered in locally advanced head and neck cancers for good tumour control and less side effects</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Malladi Ramakrishna, Kadarla Krishna, Indraja Naidu Talupula https://ijhcr.com/index.php/ijhcr/article/view/1480 Assessment of knowledge and practice of disposal of leftover and expired medicine among MBBS students 2021-05-05T13:02:13+00:00 Majid Farooq Farooq@gmail.com Iramkahkashan Iramkahkashan@gmail.com Anna Javed Javed@gmail.com Shakeel Ahmed Mir Mir@gmail.com <p>Background:The correct disposal of medicine poses a challenge and is receiving increasing attention. The present study was conducted to assess knowledge and practice of disposal of leftover and expired medicine among MBBS students.Materials &amp; Methods:110 MBBS students of both genders were provided with the questionnaire and parameters such as the number of leftover drugs, reasons for leftover, most common class of leftover drugs and dosage form were recorded.Results: 56%check the expiry date of medicine before procuring, 20% no and 24% don’t know. 45% throw away in household garbage, 12% donate to hospital, 17% give to friends or relatives and 26% return to medical store. In response to what to do with expired medicine, 60% flush in toilet or sink, 14% give to friends or relatives, 10% throw away in household garbage and16% return to medical store. In response to who is responsible for creating awareness of the proper disposal of unused and expired medicine, ministry of health by 60%, pharmacist by15%, pharmaceutical industry by 5% and general public by 20%. 85% responded that improper disposal of unused and expired medicine can affect the environment and health. The difference was significant (P&lt; 0.05).Conclusion: There is requirement of providing knowledge about the disposal of leftover and expired medicine among MBBS students.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Majid Farooq, Iramkahkashan, Anna Javed, Shakeel Ahmed Mir https://ijhcr.com/index.php/ijhcr/article/view/1481 Assessment of outcome of acute respiratory distress syndrome in premature babies in mothers on antenatal corticosteroids 2021-05-05T15:20:26+00:00 Rohit Singh Singh@gmail.com Anna Javed Javed@gmail.com Roohi Sharma Sharma@gmail.com <p>Background:Respiratory distress syndrome continues to be the most important pulmonary problem during the neonatal period. The present study was conducted to assess outcome of acute respiratory distress syndrome in premature babies in mothers on antenatal corticosteroids.Materials &amp; Methods:56 premature babies to mothers who received antenatal corticosteroids of both genders were included. Newborns were classified based on their gestational age into 3 groups. Group I had newborns of 26–28 weeks, group II with 28–32 weeks, and group III with 34 weeks. Parameters such as incidence of RDS, the requirement of continuous positive airway pressure (CPAP), mechanical ventilation, and need for surfactant were recorded. Results: Group I had 4, group II had 30 and group III had 12 newborn. 2, 24and 2 received 1 dose ACS and 2, 25 and 10 received 2 doses ACS, 4, 30 and 12 needed oxygen support, 3, 9 and 4 developed RDS, 0, 15 and 5 needed CPAP, 4, 16 and 3 needed mechanical ventilation and 4,21 and 5 required surfactant in group I, II and III respectively. The difference was significant (P&lt; 0.05). Pre term babies developed RDS were 26 out of which 24 survived and 2 died and preterm babies with RDS who received surfactant were 30 out of which 25 survived and 5 died. Conclusion: Two doses of ACS 24 hour apart can decrease the incidence of RDS, the need for mechanical ventilation, and increased survival rate of preterm.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Rohit Singh, Anna Javed, Roohi Sharma https://ijhcr.com/index.php/ijhcr/article/view/1482 Assessment of Milan System for reporting salivary gland cytopathology and risk of malignancy 2021-05-05T16:22:10+00:00 Ishani Gupta Gupta@gmail.com Anam Khurshid Khurshid@gmail.com Subhash Bhardwaj Bhardwaj@gmail.com <p>Background:Salivary gland cancers are uncommon, representing 6.1% of head and neck cancers, and about 0.2% of all malignancies. The present study was conducted to assess Milan System for reporting salivary gland cytopathology and risk of malignancy. Materials &amp; Methods: 180 FNAC specimen from salivary gland lesions were involved. The cytological features were evaluated, and then cases were reclassified according to MSRSGC as follows: category 1: Non-diagnostic (ND), category 2: Non-neoplastic (NN), category 3: Atypia of undetermined significance (AUS), category 4a: Neoplasm: Benign (NB), category 4b: Neoplasm: salivary gland neoplasm of uncertain malignant potential (SUMP), category 5: Suspicious of malignancy (SM) and category 6: Malignant (M).Results: Age group &lt; 20 years had 40 males and 35 females, 21-40 years had 30 males and 20 females, 41-60 years had 24 males and 13 females and &gt;60 years had 6 males and 12 females. Parotid gland was involved in 95, submandibular in 50 and minor salivary gland in 35 cases. Cat 1, Cat 2, Cat 3, Cat 4a, Cat 4b, Cat 5 and Cat 6 had 10, 70, 4, 64, 3, 2 and 27 cases respectively and histological follow-upwas 6,60, 3, 60, 1, 2 and 25 respectively. Benign non- neoplastic lesions were 3, 46, 1, 6, 0, 0 and 1, benign neoplastic lesions were 2, 10, 2, 52, 0, 1 and 4, malignant lesions were 1, 4, 1, 2, 1, 1 and 20 and risk of malignancy as seen in 1 (16.6%), 4 (6.6%), 1 (33.3%), 2 (3.33%), 1 (100%), 1 (50%) and 20 (80%) in Cat 1, Cat 2, Cat 3, Cat 4a, Cat 4b, Cat 5 and Cat 6 respectively. Conclusion: Milan system was effective in categorizing salivary gland pathologies and limits the chances of false positive and negative.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Ishani Gupta, Anam Khurshid, Subhash Bhardwaj https://ijhcr.com/index.php/ijhcr/article/view/1483 FNAC findings of head and neck lesions in our Institute- A 3 year retrospective study 2021-05-05T16:28:28+00:00 Samriddhi Sood Sood@gmail.com Sandhya Panjeta Gulia Gulia@gmail.com Vineet Panchal Panchal@gmail.com Karnail Singh Singh@gmail.com <p>Background: There are several lesions of the head and neck region which are routinely encountered by different clinicians in patients among all age groups and diagnoses varies from benign lesions to malignancies. To identify these lesions, various diagnostic tools such as FNACs are being used which help the clinicians in a great way.Methods: This is a retrospective study done from August 2016 to October 2019 in a tertiary care hospital. All cases received in Department of Pathology were included in this study. It included a total of 310 cases. FNAC (including USG guided) were done from palpable masses of head and neck regions preferably from thyroid and breast lumps. Data entry and analysis were done using SPSS version 20.Results: A total of 310 patients who underwent FNAC of the head and neck region were included in this study. Maximum number of patients were in the age group of 21 to 30 years i.e. 85(27.42%) . In this study, 273(91.30%) cases were benign and 26(8.70%) cases were malignant lesions with aspirates from lymph nodes being the maximum. In our study, majority of the thyroid lesions 111(92.5%) belong to benign category II.Conclusion: It is concluded that FNAC proves to be a first line of investigation in the diagnosis of head and neck swellings. Here, most of the swellings occurred in the head and neck region. Thyroid FNA smears were also reported using the Bethesda system which helped in achieving more precise cytological diagnosis.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Samriddhi Sood, Sandhya Panjeta Gulia, Vineet Panchal, Karnail Singh https://ijhcr.com/index.php/ijhcr/article/view/1484 To Study the Level of Congestion in OPD clinic and How to Decongest it 2021-05-05T17:07:51+00:00 Sanjay Khare Khare@gmail.com Vinod Dangi Dangi@gmail.com Sarvesh Sharma Sharma@gmail.com <p>Background. Aim of the study was to reduce congestion in opd clinic, which is the direct indicator of efficiency of the hospital.<br>1. To study overall waiting time in the opd clinic.<br>2. To suggest action to improve the waiting time<br>Methods: Prospective, Descriptive study, 40 patients in each group. Group “R” = Patients registered for opd clinic, who’s all vitals and clinical assessment was done after arrival to opd clinic as routine practice.Group “Q” = Patients wereprovided Self-answering questionnaire in waiting area and whose vital parameters were taken beforehandoutside clinic by a trained staff. Data was recorded for both the groups. Results: We found in our study that average waiting time that is total time from registration to completion of prescription in OPD clinic was statistically significantly less in QT-1 (Group “Q”) in comparison to RT-1 (Group “R”).We found in our study that average Doctor – Patient time that is time of interaction with Doctor during examination and discussion in OPD clinic was also statistically significantly less in QT-2 (Group “Q”) in comparison to RT-2 (Group “R”). Conclusion: Present study was planned to reduce congestion in OPD for checkup and prescription of medicines. Patient satisfaction comes automatically as a byproduct with the achievement of the goal of the study. Time is money in the present scenario and thus best utilization of time with efficient outcome is the prerequisite of any good management.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Sanjay Khare, Vinod Dangi, Sarvesh Sharma https://ijhcr.com/index.php/ijhcr/article/view/1487 Assessment of Knowledge, awareness and practice of MBBS students regarding COVID-19 pandemic 2021-05-06T01:10:02+00:00 Majid Farooq Farooq@gmail.com Anna Javed Javed@gmail.com Shakeel Ahmed Mir Mir@gmail.com <p>Background:The present study was conducted to assess knowledge, awareness and practice of MBBS students regarding COVID-19 pandemic. Materials &amp; Methods: 340 Medical students of both genders were given a questionnaire regarding clinical symptoms, transmission routes, prevention, and control of COVID-19.Results: 77% showed that SARS-CoV-2 is the cause of COVID- 19. Main symptoms are fever, fatigue, dry cough and myalgia was replied true by 90%, 90% replied that 2-14 days is the incubation period of Covid- 19, the overall mortality was correctly answered by 80% and 83% correctly showed that rRT-PCR is the laboratory test available for detection of COVID- 19. The difference was significant (P&lt; 0.05). 75% replied that COVID- 19 increased the frequency of washing hands, 70% replied that COVID- 19 increased the frequency of using hand sanitizers, use of handkerchief while coughing is by 75%, unnecessary travel is avoided by 81%, 78% maintain social distance. The difference was significant (P&lt; 0.05).Conclusion:Most of the students had sufficient knowledge, awareness and practice of regarding COVID-19 pandemic.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Majid Farooq, Anna Javed, Shakeel Ahmed Mir https://ijhcr.com/index.php/ijhcr/article/view/1488 Evaluation of histomorphology of prostatic adenocarcinoma and its mimics 2021-05-06T01:14:59+00:00 Ishani Gupta Gupta@gmail.com Anam Khurshid Khurshid@gmail.com Subhash Bhardwaj Bhardwaj@gmail.com <p>Background:Prostatism is a companion of the geriatric age group and is associated with prostatic disease that leads to significant morbidity worldwide. The present study was conducted to evaluate histomorphology of prostatic adenocarcinoma.Materials &amp; Methods: The present study was conducted among 40 radical prostatectomy and transurethral resection of the prostate (TURP) specimens received in the pathology department. A history followed by a clinical examination, digital rectal examination (DRE), and transrectal ultrasound (TRUS) findings were recorded. The received specimens were fixed in 10% neutral buffered formalin, and routine paraffin processing was done, followed by hematoxylin and eosin (H and E) staining of sections. Serum prostate-specific antigen (PSA) levels was assessed. All the slides were examined under microscope. Older Gleason's grading system was used for grading the carcinomas.Results: Histological mimics of prostatic adenocarcinoma were basal cell hyperplasia in 8, clear cell cribriform hyperplasia in 3, prostate atrophy in 1 and atypical adenomatous hyperplasia in 2 cases. The serum PSA level &lt;4 mg/ml was seen in 4, 4-10 mg/ml in 6 and &gt;10 mg/ml in 16 prostatic adenocarcinoma cases and &lt;4 mg/ml in 11, 4-10 mg/ml in 2 and &gt;10 mg/ml in 1 mimickers of carcinoma. Conclusion: Biopsy still remains a gold standard for diagnosis of prostate adenocarcinoma and its mimics</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Ishani Gupta, Anam Khurshid, Subhash Bhardwaj https://ijhcr.com/index.php/ijhcr/article/view/1489 Morphologic spectrum of co-existing lesions in breast malignancy – A study of mastectomy specimens 2021-05-06T01:18:54+00:00 Mohit Mohit@gmail.com Shachi Dixit Dixit@gmail.com <p>Breast lesions is a family of heterogeneous entities with varying forms of presentation, morphology and clinical nature. Most of these lesions are traditionally classified into benign and malignant conditions. However, some lesions show marginal features and lie in a grey-zone between benign and malignant due to unreliable predictability. Pathological categorisation of such lesions is challenging, and under-diagnosis may leads to over-treatment or under-treatment. The shortage of these lesions makes acquisition of clinical evidence problematic and restricts the advancement of a sufficient evidence base to support informed decision making by clinicians and patients. Emerging molecular evidence is providing a greater understanding of the biology of these lesions, but this may or may not be reflected in their clinical behaviour. In the present study. we discuss some breast lesions that may leads to cancer malignancy. The idea of categories of breast lesions of uncertain malignant nature and breast lesions of limited metastatic potential, are recommended.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Mohit, Shachi Dixit https://ijhcr.com/index.php/ijhcr/article/view/1490 Clinical profile, laboratory parameters and severity predictors in children with fever and thrombocytopenia- experience of a tertiary care centre 2021-05-06T01:24:12+00:00 Khodaija Mahvish Mahvish@gmail.com Md Rizwan Akhtar Akhtar@gmail.com Girijanand Jha Jha@gmail.com Binod Kumar Singh Singh@gmail.com <p>Background and Objectives. Fever with thrombocytopenia is a common clinical entity that refers to reduction in platelet count below age and sex reference values in a febrile child. With early recognition, risk stratification and prompt treatment, morbidity and mortality can be limited. However, undue anxiety in parents or treating doctors may prompt one to do unnecessary platelet transfusions. In thisstudy, we intended to study clinical profile, laboratory parameters and severity predictors in children with fever and thrombocytopenia. Methodology: We conducted this prospective observational study over 1 year from April 2019 to March 2020 at department of Pediatrics, NMCH, Patna, Bihar including children of 1-14 years of age with fever and platelet count below 150000/mm3 with or without bleeding. Results: Over the study period, we enrolled 120 children with febrile thrombocytopenia. Mean age was 6.9 years and most of the affected children were in 5-10 years age group (43.3%). Incidence of febrile thrombocytopenia was highest between months of July &amp; September (44.2%). Other presenting features werebody ache (60.8%), headache (55.8%) and joint pain (48.8%) etc. Common etiologies were dengue fever (25.8%), unspecified viral illness (17.5%), septicemia (10%), ITP (7.5%), enteric fever (6.67%) etc. Only 26 (21.7%) suffered from bleeding manifestations. Skin bleeds were the commonest bleeding manifestation (34.6%) followed by gum bleeding (23.1%), hematemesis (7.7%), hematuria (7.7%) etc. Duration of fever &gt;5 days, hemodynamic instability, hepatomegaly, platelets count &lt;10,000/cu mm, abnormal KFT and elevated liver enzymes were associated with a significant higher risk of bleeding.Conclusion: Febrile thrombocytopenia is most frequently caused by infections: viral diseases (dengue, chikungunya and other viruses), malaria, enteric fever etc. Clinical features are reflective of the primary disease/condition as well as bleeding manifestations. Late presentation to hospital, prolonged fever and end organ damage influence outcome in these children.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Khodaija Mahvish, Md Rizwan Akhtar, Girijanand Jha, Binod Kumar Singh https://ijhcr.com/index.php/ijhcr/article/view/1498 Comparative evaluation of relationship between prostate volume and lower urinary tract symptoms 2021-05-07T09:06:09+00:00 Jaìkant Paswan Paswan@gmail.com Bijendra Kumar Mishra Mishra@gmail.com <p>Lower Urinary tract symptom(LUTS) is a common presentation among elderly male patients in urology clinical practice. Evaluation and treatment of LUTS is a major consideration and IPSS score is routine investigations for assessment of such patients. International Prostate Symptom Score (IPSS) have contributed much to the objective and quantitative evaluations of LUTS in terms of the elucidation of its pathogenesis and changes accompanied with treatments. The objective of this study is to evaluate the relationship between IPSS and prostate volume in patients with LUTS.There is a significant relationship between IPSS and prostate volume measured through transabdominal ultrasonography. The Total IPSS increases with the prostate volume, as a significant positive relationship between IPSS total score and prostate volume was recorded(r= 0.45, t=3.8, p&lt;0.001).</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Jaìkant Paswan, Bijendra Kumar Mishra https://ijhcr.com/index.php/ijhcr/article/view/1499 Abnormal Uterine Bleeding in Adolescents and its correlation with Ultrasonography Documented Endometrial Thickness and Uterine Volume 2021-05-07T09:11:23+00:00 Ufaque Muzaffar Muzaffar@gmail.com Ambreen Qureshi Qureshi@gmail.com <p>Introduction:Abnormal uterine bleeding is a term used for alterations in regularity, duration or volume of menstrual bleeding . In adolescence AUB also called dysfunctional uterine bleeding is defined as excessive prolonged or frequent bleeding of uterine origin that is not caused by a recognizable pelvic or systemic disease or by pregnancy . About 37% of teenage girls attending a Gynaecological Clinic have complaints of AUB during the first 3-5 years following the menarche. Materials and Methods : This study was conducted at tertiary maternity centre, Lalla Ded Hospital Between July 2019 to January 2020. The data was collected by enrolling patients into two groups, the study group and the control group. The study group included the adolescent girls from menarche to 18 years of age as they attended the OutPatient Department. A thorough history and examination was done and investigations like CBC, Coagulogram, Pelvic Ultrasonography were done. Results: The study and the control groups did not have any significant difference in present age, Age at menarche and BMI. In our study the mean age at present for the study group was 14.52 years whereas for the control group it was 15.95 years. The mean age at menarche for the study group was 13.38 years whereas for the control group it was 13.21 years. The BMI for the study group was 20.10 kg/m2 whereas for the control group it was 19.63 kg/m2 . Conclusion: Adolescent girls with AUB have significantly increased uterine volume irrespective of their endometrial thickness. However there is no increase in the ovarian volume thus depicting an abnormal response to the relative hyperestrogenemia state during their puberty. However this abnormal response to hyperestrogenemia needs to be studied further.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Ufaque Muzaffar, Ambreen Qureshi https://ijhcr.com/index.php/ijhcr/article/view/1500 Demography and clinical features of chalazion Among patients in a Zonal Military Hospital at Jabalpur Madhya Pradesh, India 2021-05-07T09:15:54+00:00 Gireesh Mishra Mishra@gmail.com Aparna Kekan Kekan@gmail.com <p>Introduction: A chalazion is a small, usually painless, lump or swelling that appears on the upper or lower eyelid. A blocked meibomian or oil gland may be due to the by Staphylococcus sp infection causes this condition and disappear without treatment or require different treatment approach.Objective: In the present study we have investigated the demography of the chalazion in Madhya Pradesh state and correlated that with climatic conditions. Methods: This study is cross-sectional prospective clinical study wherein patient with eye complications were observed for chalazion conditions. Over the period of 4 years (July 2011 to June 2015) number of chalazion cases were identified and their month-wise distribution was plotted and its correlation with climatic conditions was investigated. Results: Total 44350 patients visited for their eye-related complication in the hospital during this 4-year period and 704 were noticed to have chalazia with prevalence rate of 1.63% (Range 2.20 to 1.35). Maximum 36% patients were in the age range of 21-30 years. Maximum number of chalazion cases were reported in the months of August (114), July (92) and September (77), respectively, while lower rate is found in November (19), and March and April (38 each). In these patients we have used conservative therapy, incision and curettage or triamcinolone injection given via intra-lesion route for the management of chalazia. Conclusion: Only a miniscule percentage of patients seeking eye care in India are affected by chalazion. It is slightly more common during climate with more humidity. Conservative management is the preferred modality by maintaining hygiene of eyelid on daily basis.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Gireesh Mishra, Aparna Kekan https://ijhcr.com/index.php/ijhcr/article/view/1501 A Comparative study of surgically induced astigmatism in superior and temporal scleral incision in manual small incision cataract surgery 2021-05-07T09:20:47+00:00 Vijay Prakash Kinikar Kinikar@gmail.com Yashaswi Pendyala Pendyala@gmail.com K. Vijay Kumar Kumar@gmail.com <p>Background: Surgically induced astigmatism is one of the obstacle to the achievement of good uncorrected visual acuity after cataract surgery. Pre-operative astigmatism,Incision length, shape, location, closure, healing, scleral cauterization, type of suture material used and its placement, position of IOL, and post operative steroids used all these factors affect corneal curvature. Aim &amp; Objective: The aim to study the post operative astigmatism in superior small incision versus temporal small incision cataract surgery. Methodology: 100 consecutive cataract patients treated with small incision extra capsular cataract extraction were prospectively studied and followed up for at least 6 weeks. The present study was undertake from April 2018 to Feb 2021. Cases from Mamata general hospital, Khammam (Mamata Medical College, Khammam). Results: The patients were randomly divided into two group of 50 cases each. Group-I cases who underwent MSICS with PCIOL implantation through superior scleral incision ECCE. Group-II cases who underwent MSICS with PCIOL implantation through temporal small incision ECCE. During immediate post operative period i.e., 7 days after surgery. The average astigmatism in Group-I cases was 6.0D 1.82 and in Group-II was 2.75D 1.3. After 6 weeks of surgery average post-operative astigmatism was 4.20 D 1.17 in Group-I cases and 1.36 D  0.70 in Group-II cases.<br>Conclusion: To conclude, temporal scleral incision in MSICS produces lesser surgically induced astigmatism as compared to superior scleral incision.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Vijay Prakash Kinikar, Yashaswi Pendyala, K. Vijay Kumar https://ijhcr.com/index.php/ijhcr/article/view/1502 Clinico-Radiological Assessment of Distal End Radius Fractures: A Prospective Study in Moradabad City 2021-05-07T09:26:12+00:00 Vikas Verma Verma@gmail.com Manmohan Sharma Sharma@gmail.com Prakhar Agarwal Agarwal@gmail.com Abhinav Bhardwaj Bhardwaj@gmail.com <p>Background:Fractures of distal radius account for 20% of all fractures treated in emergency department. These fractures result from low energy injuries in elderly population and high energy injuries in young adults. Most of these fractures are relatively uncomplicated and are effectively treated by closed reduction and casting. However, fractures that are unstable intra-articular can jeopardize the integrity of the articular congruence and kinematics of articulations resulting in high prevalence of complications. So to overcome these above complications, trend is shifting towards surgical management.Aim: To assess clinico-radiological outcome of distal end of radius fractures managed in our institution (conservative and surgical).Methods:A comparative interventional study was done in our institution in which all the patients of distal end of radius fractures were included as per inclusion and exclusion criteria. Bilateral X-ray wrist with forearm was taken(Day-0). Fractures were classified using Frykman classification Mayo and Lidstrom score to assess the patient clinico-radiologically on the day of intervention both pre and post reduction and then followed up on day 7-10th, 6th week , 3rd month , and 6th month.Results:30 patients were included in this study and followed upto 6 months. The comparison of final Lidstrom score was, Surgically: Excellent 46.7%, Good 40%, Fair 6.7%, Poor 6.7%. and Conservatively: Excellent 13.3%, Good 26.7%, Fair 53.3%, Poor 6.7%(p-value=0.03)and of the final Mayo-score was, Surgically: Excellent 53.3%, Good 26.7%, Fair 13.3%, Poor 6.7% and Conservatively: Excellent 13.3%, Good 20%, Fair 60%, Poor 6.7%(p-value=0.04).Conclusion:It can be concluded that surgical intervention for fracture distal end radius reduces chances of wrist joint stiffness and loss of reduction and gave good results as compared to conservative intervention. Hence, in our opinion surgical intervention for treatment of fracture distal end radius is a good method with excellent outcome.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Vikas Verma, Manmohan Sharma, Prakhar Agarwal, Abhinav Bhardwaj https://ijhcr.com/index.php/ijhcr/article/view/1503 A observational Study to evaluate visual acuity and clinical ocular profile of patients with pseudoexfoliation syndrome and pseudoexfoliation glaucoma 2021-05-07T09:30:24+00:00 Soumya Kanta Mohanty Mohanty@gmail.com Manoj Kumar Kumar@gmail.com <p>Objective: The main objective of the study was to evaluate visual acuity and clinical ocular profile of patients withpseudoexfoliation syndrome and pseudoexfoliation glaucomaMaterial and Methods: This was an observational retrospective study and patients who were presented with clinical signs of PEX were included in the study. A signed informed consent from was obtained from each and everyparticipants.Comprehensive ophthalmological assessment were done in all participants.Result:610 patients who were having clinical signs of PEX was participated were included in this study and 150 patients had typical characteristics of PEX as well as glaucomatous optic disc changes. The mean age of patients having PEX and PXG was 63.45 ± 7.39 years and majority of patients i.e. 88% were having age more than 50 years (&gt;50) which was significantly higher (p= 0.0001). As compare to females in PEX and PXG proportion of males was significantly higher. 1.46:1 was the ratio of male: female in PEX patients and 2.13:1 was the ration in PXG patients. In patients having PEX and PXG, bilateral involvement of disease were observed in most of the patients. Increased cupping at time of presentation were detected with PXG as observed in Slit lamp biomicroscopy. Cupping of 0.7 were present in 33.3% of patients where as &gt;0.8 cupping of disc were present in 50% of patients.Mean average value of 531 ± 24.32 μm CCT were found in PEX where as it was 521 ± 29.82μm in PXG.Conclusion:In older population prevalence of PEX and PXG were found to be higher. At presentation more severity of optic nerve damage were found in patients with PXG. To minimize the extent of optic nerve damage regular follow-up of patients is required with a careful assessment for detection of PEX.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Soumya Kanta Mohanty, Manoj Kumar https://ijhcr.com/index.php/ijhcr/article/view/1504 Effect of demographic factors on obstetrical outcome 2021-05-07T09:41:42+00:00 Sangeeta Pahwa Pahwa@gmail.com Tavleen Kaur Kaur@gmail.com <p>Background: In light of the adverse obstetrical outcomes related to age, socioeconomic and educational status, it is crucial to find out the effect of these factors on increased maternal- fetal morbidity and mortality so that measures can be taken to improve prognosis. Pregnancy at advanced maternal age has become more common in both developed and developing countries over the last decades. The association between adverse perinatal outcomes and advanced maternal age has been a matter of discussion. Similarly at lower age, outcome is not without complications. Education, socioeconomic status and residence also largely influence obstetrical outcome.Aim: To study effect of various demographic factors on obstetrical outcome.Material and method: This study included 150 indoor and OPD patients in Sri Guru Ram Das Institute of Medical Sciences, Vallah, Amritsar, Punjab, India. Each patient was asked about the previous pregnancies, about the mode of delivery and any associated complications. Patient who had came for antenatal visits were examined and stratification was done according to risk factors like hypertension, diabetes, anemia, malnutrition and other socioeconomic factors. Following this, co-relation was studied between these.Conclusion: For Clinicians who are counseling young women, it is of importance to highlight the need of antenatal care and its benefit. There is need for individualizing antenatal surveillance programmes and obstetric care based on age, socio-economic strata and education which is the need of the hour for the progress of nation.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Sangeeta Pahwa, Tavleen Kaur https://ijhcr.com/index.php/ijhcr/article/view/1505 A comparative study of tibial plafond fractures managed by hybrid external fixation versus final plate fixation 2021-05-07T09:45:48+00:00 Rituj Agarwal Agarwal@gmail.com Atul Kumar Panday Panday@gmail.com <p>Background:Tibial plafond fractures are comminuted fractures of the distal tibia, which involve a traumatic axial load mechanism that leads to destruction of the joint surface. The present study compared tibial plafond fractures managed by hybrid external fixation versus final plate fixation.Materials &amp; Methods: 40 patients of plafond fractures were divided into 2 groups. Group I were patients treated with hybrid external fixation and group II patients with open reduction and internal fixation. Results were compared between both groups.Results: The mean fixation time in group I was 5.2 days and in group II was 10.4 days, weight bearing time in group I was 10.2 days and in group II was 48.2 days, radiological union time was 112.4 days in group I and 156.2 days in group II. Superficial infection was seen in 4 in group I and 3 in group II and deep infection was seen in 1 in group I and 4 in group II. The difference was significant (P&lt; 0.05).Conclusion: Hybrid external fixation as a definitive procedure involve a faster union as compared to open reduction internal fixation.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Rituj Agarwal, Atul Kumar Panday https://ijhcr.com/index.php/ijhcr/article/view/1506 Study of POSSUM Score for Risk Assessment in Patients of Perforation Peritonitis at a Tertiary Care teaching hospital 2021-05-07T10:08:38+00:00 Sunil Gurjar Gurjar@gmail.com Suraj Jain Jain@gmail.com Abhishek Kansal Kansal@gmail.com Advait Prakash Prakash@gmail.com <p>Background: Perforation peritonitis carries considerable morbidity and mortality with the unpredictable postoperative period. Continuous audit of clinical practice is an essential part of making improvements in enhancing patient care. This warrants a scoring system that predicts the post-operative outcome. POSSUM (Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity) helps in predicting the post-operative morbidity and mortality in these patients. This study was done in our centre to evaluate the POSSUM score in our set of patients. Material and methods: This prospective observational study was performed in patients of perforation peritonitis admitted under the Department of General Surgery, Sri Aurobindo Medical College And Post Graduate Institute Indore (M.P.) from June 2018 to January 2020. A total of 92 patients were recruited. Data was collected from patients by their clinical history, examination, with appropriate investigations. Data were analysed using appropriate statistical tests.Results: Most common site of perforation was gastro-duodenal followed by ileal perforation. The most common surgical procedure performed was modified Graham’s patch repair. Most common complication was wound infection followed by wound dehiscence and anastomotic leak. Patients who had complications had higher mean POSSUM morbidity score .It was also observed that POSSUM mortality score was significantly higher in subjects who died.Conclusion: POSSUM scoring system is a good indicator of postoperative outcome in patients with perforation peritonitis and was applicable in our setup. It is useful in identifying high risk patients and give preferential care to them for better outcome</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Sunil Gurjar, Suraj Jain, Abhishek Kansal, Advait Prakash https://ijhcr.com/index.php/ijhcr/article/view/1507 Study of role of intraoperative keratoscopy in management of astigmatism in extracapsular cataract extraction [ECCE] with PCIOL 2021-05-07T10:22:07+00:00 Rashmi Kumar Kumar@gmail.com Deepshikha Solanki Solanki@gmail.com <p>Aim:To evaluate and to obtain minimum degree of postoperative astigmatism in 20 cases of senile cataract using Singh's Keratoscope and finally compare the results with a control group .Methods A cross sectional analytical study was done on 40 patients operated for cataract.40 patients operated with Extracapsular Cataract Extraction [ECCE] and posterior chamber intraocular lens were equally divided into two groups. In Group A, intra-operative keratoscopy was done, using Singh's keratoscope, while in Group B this procedure was not done and served as comparison group. All possible parameters like type, length and site of cataract incision surgical technique, design of lens implant, suture material and suturing technique were similar in both the groups. Results : Final astigmatism noted at 12 weeks showed that in Group A it ranged from 0 to 2 Dioptres with a mean of 0.85 D and P value of less than 0.01 which is statistically highly significant while in Group B it ranged from 0.5 to 5 D with a mean of 2.275 D.Conclusion Singh's keratoscope is low cost instrument, easy to use, gives simple interpretation both on the table and can also be used postoperatively to follow the variation and monitor the conrneal curvature and wound healing in these cases. This method and instrument is an extremely useful in the prevention of high postoperative astigmatism, more so after intraocular lens implant surgery giving rapid visual rehabilitation and satisfaction both the patient and operating surgeon.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Rashmi Kumar, Deepshikha Solanki https://ijhcr.com/index.php/ijhcr/article/view/1508 To evaluate the role of platelet rich plasma in treatment of various enthesopathies: A prospective study 2021-05-07T10:33:52+00:00 Abhinav Bhardwaj Bhardwaj@gmail.com Manmohan Sharma Sharma@gmail.com Prakhar Aggarwal Aggarwal@gmail.com Seema Awasthi Awasthi@gmail.com Vikas Verma Verma@gmail.com <p>Background: Plantar fasciitis and epicondylitis are one of the most common enthesopathies affecting human body. Platelet rich plasma (PRP) is a bioactive component of whole blood that can enhance human stromal and mesenchymal stem cell proliferation. PRP is dependent on these growth factors for its regenerative properties. PRP has high amount of cytokines and growth factor which increases cellular movement, matrix synthesis, and increase in number leading to increase regenerative abilities of tendons. The aim of this study was to evaluate the role of platelet rich plasma in treatment of various enthesopathies.Material and Method: A total number of 52 patients, 26 each of plantar fasciitis and epicondylitis who presented to Orthopaedics OPD of TeerthankerMahaveer Medical College and Research Centre, Moradabad and fulfilled the inclusion criteria, were included in this prospective study. Pre procedure investigations were done and patients were injected freshly prepared platelet rich plasma at effected site and followed immediately after giving PRP injection and then at an interval of 1, 2, 3 months and visual analogue scale was used to assess relief in pain symptom.Result: There was gradual decrease in pain severity and average VAS score in patients of plantar fasciitis and epicondylitis at monthly follow ups after giving PRP injection. No patient was lost to follow up. There was a statistically significant (p&lt;0.001) difference in the median scores of visual analogue scale among patients with Plantar fasciitis and Lateral epicondylitis between immediate follow-up and follow-up at subsequent months. The median vas score was 7 at pre injection time which decreased to 2 at the end of 3rd month follow up. Conclusion: This prospective study indicates that PRP injection is safe and has potential to reduce pain in various enthesopathies.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Abhinav Bhardwaj, Manmohan Sharma, Prakhar Aggarwal, Seema Awasthi, Vikas Verma https://ijhcr.com/index.php/ijhcr/article/view/1510 Preparedness of COVID 19 in our hospital setting 2021-05-07T10:52:05+00:00 P. N. Agrawal Agrawal@gmail.com Neelima Agrawal Agrawal@gmail.com <p>Objective: Ours is a multispecialty non-covid hospital, therefore the objective was to do strategic preparedness and to make response plan for our hospital during covid 19. Main aims were, 1. To protect staff &amp; healthcare workers from getting infected. 2. To be able to offer uninterrupted services to all our patients.3. To prevent hospitalization of COVID-19 patients in our setup.Methods It is a retrospective study of 9 months from 1st April 2020 to 31st December 2020 in which we assessed the nonstop working of our OPD, IPD, emergency and OT. Different strategies were adopted according to the interim guidance protocols of WHO and Government of India guidelines to deal with the crisis situation of the COVID-19 pandemic. Results Our adopted strategies were directed to mitigate the challenges of administration, hospital space organization, management of staff and supplies, maintenance of standard of care, and ethics during this pandemic. We formulated protocols and guidelines for uninterrupted service and that data is being now used for our own improvement and further planning. Data was tabulated and converted into bar diagrams. Various aspects were analysed and future protocols and policies were deviced. Based on strategies adopted by us, we feel more confident and prepared to deal with COVID-19 pandemic.Conclusion Strict Adherence to the WHO and Government of India guideline, Meticulous planning, adequate protection of health care workers, uninterrupted supply of PPE kit, sanitizers masks, proper screening and early detection and transfer of suspected cases were the key features in the fight with COVID-19. Our approach for preparing for the COVID-19 pandemic may not be the best one but we believe that the basic managerial principles we adopted will guide many other institutions to find their path in tackling the pandemic in the best possible way.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 P. N. Agrawal, Neelima Agrawal https://ijhcr.com/index.php/ijhcr/article/view/1511 A community based cross sectional study on menstrual hygiene awareness and practices among females of reproductive age group 2021-05-07T10:55:27+00:00 Nitin Lodha Lodha@gmail.com <p>Background: Good menstrual hygiene is essential for the health and dignity of women. Discussions on menstrual hygiene are important for women to clarify existing myths and misconceptions around menstruation. In developing countries it is reported that many women/girls do not follow healthy measures for maintaining the menstrual hygiene. Objectives: To study awareness regarding menstrual hygiene among the women of reproductive age and find out practice related to maintenance of menstrual hygiene. Material &amp; Methods: It was a community based cross sectional study; 200 women of reproductive age were interviewed over a period of four months (March to June 2019). Data obtained was entered and analyzed statistically using Excel Windows 2007 and Epi info version6. Results: 162(81%) had regular menstrual cycle pattern, 14(7%) participant mostly from rural area, believe that menstruation is a disease, 140(70%) get the information regarding menstruation from mother. 188(94%) were aware about sanitary pads but 150(75%) uses sanitary pads. 86.5% participants change sanitary pads 2-3 times a day. All participants were taking regular about bath. 197(98.5%) were regularly cleaned their external genitals. 153(76.5%) study participants throwing the sanitary material in dustbin. Conclusion: Majority of the participants use sanitary pads and were aware about menstrual hygiene, but in rural area majority of participants still use clothes instead of sanitary material and they had lack awareness about hygiene practice and majority of them didn’t follow menstrual hygiene practices. Menstrual hygiene can be promoted in community and in schools particularly in Rural area.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Nitin Lodha https://ijhcr.com/index.php/ijhcr/article/view/1512 Influence of social media exposure on mental health in relation with covid-19 pandemic in a tertiary care hospital 2021-05-07T11:03:07+00:00 Rajarshi Guha Thakurta Thakurta@gmail.com <p>Introduction: WHO (World Health Organization) declared Covid 19 as a pandemic on 11 March 2020 and issued specific guidelines on how to handle the global crisis. The virus spreads through tiny respiratory droplets when an infected person coughs, sneezes, and speaks, and by aerosols that tend to remain in the air and surfaces for a longer time. When people come into contact with these contaminated surfaces, they also get infected. Covid-19 transmissibility has been estimated at 4.08, suggesting that on average, every Covid-19 infected person will spread the infection to 4 new persons.Materials and Methods: This cross-sectional study was conducted online from May 15th, 2020, to May 25th, 2020, which is the 4th phase of lockdown when the infection rate was increasing alarmingly. Informed consent obtained from people with given assurance of no personal identification details will be revealed, such as personal phone number or mail ID obtained. People above 18 years and people from various districts of West Bengal in India were included in this study. The study consisted of basic socio-demographic details, statements regarding usage of social media to get information about Covid 19, and questions in the Depression, Anxiety and Stress Scale and GHQ-12.Results: 845 (70.4 %) people were graduates or postgraduates, and 111 (9.2 %) were Ph.D. holders. 639 (53.2 %) people were married. 843 (70.3 %) people have employed either self or private or government sector and 49 (4 %) people though native to the state of West Bengal lived in other states. As shown in Table 1, the distribution of the study population in terms of age group, sex, education, occupation, marital status, and domicile was not uniform between social media exposure. With relation to social media exposure, 35.5 % of people (427) reported as 'often &amp; most often and 37.9 % of people reported as 'some time'.Conclusion: Social media has become a tool for news collection, and people exposed to social media were unaware of the reliability of the news, which plays a significant role in creating irrational beliefs &amp; unscientific action towards Covid-19 pandemic management. This study revealed a significant correlation between social media exposure and mental health issues. Mental health issues are going to be the ongoing problem that affects the country's-states, socioeconomic balance, and more attention has to be paid to it along with the battle of containing the Covid-19.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Rajarshi Guha Thakurta https://ijhcr.com/index.php/ijhcr/article/view/1513 Histomorphological spectrum and prevalence of various kidney lesions: an autopsy study at the tertiary care center 2021-05-07T11:07:51+00:00 Divya Khunt Khunt@gmail.com Shweta Amarneel Amarneel@gmail.com Nidhi Sheth Sheth@gmail.com <p>Background: For establishingcell and organ culture as well as xenotransplantation, autopsy assists in identifying the normal as well as diseased human tissue for morphologic studies. It also helps in discovering new diseases and evaluating the toxic effects of drugs and therapies. Kidneys are also affected by chronic inflammatory lesions, neoplasms, toxic effects of various drugs, and metabolic disorders.Aim and objective: To evaluate histomorphological spectrum and prevalence of various kidney lesionsin patients with chronic kidney disease (CKD) from autopsy specimen. Material and method: Three hundred and eighty autopsies were studied in two year after gross pathological examination. Tissue sections were examined withhematoxylin and eosin stain. Based on gross and microscopic examination lesions were categorized into glomerular, vascular, tubular, and interstitial lesions. Result:The majority of the specimens were from male (78.4%) patients. The mean age was 55.61+ 10.57 years.The most commonlesions were of cloudy swelling [47 (12.3%)] followed by 36 (9.4%) cases of changes of CKD mainly at the subcortical region, 35(9.21%) cases with CPN, 27 (7.1%) case of acute tubular necrosisand 9 (2.3%) case of tubulointerstitial disease. Conclusion:Glomerular and interstitial fibrosis lesions, the inflammatory chronic infiltrate, as well as vascular lesions are commonly occurring lesions in patients with CKD.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Divya Khunt, Shweta Amarneel, Nidhi Sheth https://ijhcr.com/index.php/ijhcr/article/view/1514 A comparative study of external dacryocystorhinostomy versus endoscopic endonasal dacryocystorhinostomy without stenting 2021-05-07T11:12:25+00:00 Battula Yallamanda Babu Rao Rao@gmail.com C.Shekhar Singh Singh@gmail.com Aarti Singh Singh@gmail.com <p>Introduction: Dacryocystitis is a condition in which there is inflammation of the lacrimal sac due to stagnation of the sac contents, as a result of stricture of the nasolacrimal duct arising from chronic inflammation, usually of nasal origin (which is much more common) or due to congenital blockage in the nasolacrimal duct.Materials and methods: Retrospective, comparative, randomized interventional study was conducted in the Department of Ophthalmology, Maheshwara Medical College and hospital, Chitkul (V), Near Isnapur X Roads, Patancheru(M), Sangareddy Dist, Telangana, India collaboration with Department of ENT from January 2020 to December 2020. The patients attending the Tertiary care centre fulfilling the inclusion and exclusion criteria were taken up as case. Results: In group A patients, tearing of the anterior nasal flap was seen in 2 cases, and punctum laceration in 1case. In group B patients, 1 cases had bleeding, 3 cases had Trauma to the middle turbinate, while accidental entry into anterior ethmoidal cells was in 4 cases. In 6 cases, there was difficulty in making a bone window. In group A patients, the duration of surgery is comparatively more than in Group B. In the postoperative period, group A patients had epistaxis, rhinostomy site closure, hypertrophied external scar, and medial canthi damage as its complication, while group B epistaxis, nasal Synechea, intranasal granulation at the ostium are major complication. After a period of 3months by syringing the lacrimal sac of the patients in Group A patients, 18 patients had a patent sac (success rate is 90%). In group B patients, 16 patients had a patent sac (success rate being 80%).Conclusion: DCR, either by external or endonasal route, can be considered for treatment of nasolacrimal duct obstruction. The external route has an easy and short learning curve with reduced cost of equipment. Whereas endoscopic DCR is time-saving, avoids a facial scar and injury to the neighboring structures like the medial palpebral ligament and the angular facial vessels. In our study, the success rates of Endonasal DCR and External DCR are almost equal and comparable. This indicates that these two different DCR techniques are acceptable alternatives. However, it's the preference of the patient, the resource available, and the surgeon himself to decide the right surgical option to axe the disease.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Battula Yallamanda Babu Rao, C.Shekhar Singh, Aarti Singh https://ijhcr.com/index.php/ijhcr/article/view/1516 Study of clinicoetiologic and biochemical profile of incident end stage kidney disease patients 2021-05-08T11:38:18+00:00 Faizan Ahmed Ansari Ansari@gmail.com Muzamil Latief Latief@gmail.com Niteen D. Karnik Karnik@gmail.com <p>Introduction :Chronic kidney disease (CKD) is emerging to be an important chronic disease globally. One reason is the rapidly increasing worldwide incidence of diabetes and hypertension. Diabetic kidney disease is the commonest cause of end stage Kidney disease (ESKD) in the world.Symptoms and overt signs of kidney disease are often subtle or absent until renal failure supervenes.This study was conducted as there is scare data available in our country regarding demographic, etiological and clinical profile of CKDMaterials and Methods:In this observational prospective study conducted over a period of 1 year, we included 180 consenting incident ESKD patients (age &gt; 18 years). Clinocoetiologic profile including the search for risk factors was done. Both biochemical and radiologic profile was studied in the included patient population. Long-term therapy preference by patients was also studied. Results:Of the 180 newly diagnosed ESKD patients enrolled over 12 months, most were males (Sex ratio male: female was 2.3:1). Mean age was 43.66 +/-14 years. Although diabetes or hypertension was present in a substantial proportion of our patients,most had no identifiable risk factor for CKD. Anemia was universal as were clinical features like anorexia, nausea or vomiting. Most of our patients continued on haemodialysis as a form of RRT 10 out of the surviving 174 patients underwent Kidney transplant. Discussion :As against diabetes being the most common cause of ESKD world over, more than half of our study population had no identifiable risk factor. Similarly most had shrunken kidneys and hence the histopathologic diagnosis couldn’t be done. CKD of unknown origin is being recognized as a significant health problem in many regions across India and kidney transplantation rates are low as seen in our study. Large scale studies are needed to identify risk factors for CKD and detection of CKD at the earliest to retard the progression of disease.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Faizan Ahmed Ansari, Muzamil Latief, Niteen D. Karnik https://ijhcr.com/index.php/ijhcr/article/view/1517 Study of correlation of risk factors with sternness of diabetic retinopathy 2021-05-08T11:43:30+00:00 Abdul Aziz Makayee Makayee@gmail.com Aafiya Kachru Kachru@gmail.com Afreen Aziz Aziz@gmail.com <p>Introduction: Diabetes mellitus is a complex metabolic disease caused by a variable interaction between hereditary and environmental factors. The clinical syndrome is defined by hyperglycemia, microvascular abnormalities (retinal and renal) and neuropathy. Its main features are abnormal insulin secretion, high levels of blood glucose and a variety of complications such as nephropathy, retinopathy, neuropathy and arteriosclerosis.Materials and Methods: The inclusion criteria for this study were: no previous treatment for the retinopathy such as photocoagulation, patients had to be older than 15 years and eyes with clear media to facilitate fundus examination and fundus photography. All diabetic patients meeting the inclusion criteria were enrolled at the Govt Medical College, Baramulla. All patients were informed about the purpose of this investigation and signed an informed consent prior to enrolment in this study.Results: 162 patients were selected and evaluated after meeting the inclusion criteria. The age of patients varied from 20 to 78 years old (average 57.91±11.09 years). Results considered statistically significant were p &lt;0.02. Stronger associations were found between severity of retinopathy (group B) and longer time of diabetes (p &lt;0.001), greater values of fasting blood sugar (p =0.11), HbA (1c) (p =0.001) and total serum cholesterol (p =0.019). The severity of diabetic retinopathy was also strongly associated with lower values of hematocrit (p =0.004), presence of proteinuria (p &lt;0.05) and hemoglobin (p =0.001). There was no statistical correlation between the severity of retinopathy and the following: age, LDL, HDL, triglycerides, high blood pressure, plasma creatinine and magnesium. Visual acuity of group B patients was considerably lower than that of patients of group A (p &lt;0.001).Conclusion: The severity of diabetic retinopathy in the studied group was influenced by factors such as duration of disease, type of diabetes, good glycemic control, hematocrit and hemoglobin levels, total serum cholesterol and nephropathy. Factors that apparently did not increase the risk for diabetic retinopathy were age, gender, systemic hypertension and hypomagnesemia.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Abdul Aziz Makayee, Aafiya Kachru, Afreen Aziz https://ijhcr.com/index.php/ijhcr/article/view/1518 A study on Knowledge and Awareness about Blood Donation among Undergraduate Medical Students in a Tertiary Care Centre in Haryana, India 2021-05-08T11:51:20+00:00 Manika Kundra Kundra@gmail.com Sandhya Panjeta Gulia Gulia@gmail.com Nisha Sharma Sharma@gmail.com Samriddhi Sood Sood@gmail.com <p>Introduction :This study was undertaken to study Knowledge and Awareness about Blood Donation among Undergraduate Medical Students which would serve the dual purpose of stimulating the curiosity of medical students about safe blood bank practises and at the same time lets the teaching staff know about those areas of the subject where they need to focus while teaching the students. There is paucity of studies on this subject in Northern India. Material &amp; Methods :The study was conducted on 150 2nd year MBBS students of 2017 entrance batch of this tertiary care centre by the Department of Pathology. A questionnaire covering various aspects of blood donation was prepared. The answers were analysed to know the particular areas where the teachers need to focus while educating the students on the subject of blood donation. Scoring was done out of maximum 20 marks. Results :18 students scored between 5 and 10 marks. 115 students scored between 10 and 15 marks and 17 scored between 15 and 20 marks. The students showed good knowledge about blood donor requirements, preservation of donated blood and about mismatched transfusions. However, they showed lack of knowledge in fields of transfusion transmissible infections, blood fractions and sophisticated blood banking procedures. Conclusions :Assessing the knowledge of medical students about blood transfusion through questionnaire serves the dual purpose of stimulating the curiosity of medical students about safe blood bank practises and at the same time lets the teaching staff know about those areas of the subject where they need to focus while teaching the students.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Manika Kundra, Sandhya Panjeta Gulia, Nisha Sharma, Samriddhi Sood https://ijhcr.com/index.php/ijhcr/article/view/1519 Comparative evaluation of efficacy of 0.1% levobupivacaine with fentanyl and 0.1% Ropivacaine with fentanyl during Labour epidural analgesia 2021-05-08T12:05:22+00:00 Anita Birda Birda@gmail.com Mohammed Irshad Sheikh Sheikh@gmail.com Sudeshana Goswami Goswami@gmail.com Sagar Bijarniya Bijarniya@gmail.com <p>Background:Epidural bupivacaine is the most widely used local anaesthetic agent for labour analgesia. The present study compared 0.1% levobupivacaine with fentanyl vs 0.1% ropivacaine with fentanyl in labour epidural analgesia.Materials &amp; Methods:Group I patients received 0.1% levobupivacaine with 2 μg/ml fentanyl and group II patients received 0.1% ropivacaine with 2 μg/ml fentanyl. Each group had 20 patients. Results: The mode of delivery found was instrument‑assisted vaginal delivery seen in 8 in group I and 6 in group II, caesarean seen 7 in group I and 8 in group II and normal vaginal delivery seen 5 in group I and 6 in group II. The mean total number of manual rescue boluses was 0.68 in group I and 1.05 in group II and first requirement of manual rescue bolus was 2.65 in group I and 3.14 in group II and demand boluses per hour was 0.36 in group I and 0.08 in group II. The difference was significant (P&lt; 0.05).Conclusion: Levobupivacaine and ropivacaine with fentanyl were equally effective in labour epidural analgesia.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Anita Birda, Mohammed Irshad Sheikh, Sudeshana Goswami, Sagar Bijarniya https://ijhcr.com/index.php/ijhcr/article/view/1523 Clinical Profile of hemorrhagic stroke and validation of ICH score in Kashmiri population 2021-05-09T16:16:34+00:00 Rayees Ahmad Tarray Tarray@gmail.com Ravouf P Asimi Asimi@gmail.com Tanveer Hassan Hassan@gmail.com <p>Background: Intracerebral hemorrhage is the second most common subtype of stroke after ischemic stroke and accounts for approximately 10 % to 20 % of all strokes worldwide. In contrast, hemorrhagic stroke in our Kashmir valley accounts for around 65%. Objective: To look for detailed clinical profile and 30 day mortality, and correlate with ICH score, in our population. Study design and Methods: In this hospital based prospective study, All patients of spontaneous intracerebral hemorrhage admitted over a period of 2 years were enrolled. All clinical and lab parameters were recorded. ICH score (which includes Age, GCS, ICH volume, ICH location, and Intraventricular hemorrhage) was calculated at initial assessment. Patients were followed for 1 month to look for 30 day mortality and correlate with ICH score. Observations: Intracerebral hemorrhage constituted 51% of stroke patients after excluding SAH. Mean age of patients was 61.66±12.57 years. There was male preponderence (64%). Major risk factors present include Hypertension (96%), smoking (47%). DM (10.1%), previous stroke (11.3%), Family history (29.2%) and Anticoagulant use (0.85%).Most common site involved was Putamen (46.5%) followed by thalamus (27.8%) and lobar hemorrhage (14.6%). Around 65% patients developed systemic complications including Electrolyte disturbances and infections. Mortality at 30 days in our study was 36.2%. Thirty-day mortality rates for patients with ICH Scores 0f 0, 1, 2,3,4,5 were 0.7%, 4.5%, 17.3%, 62.0%, 94.6% and100.0% respectively. Plotting ICH score ROC curves demonstrated an area under the curve of 0.896, compared to 0.92 for the original ICH score cohort. Conclusion: Hemorrhagic stroke is still predominant stroke type in Kashmir valley. ICH score is an accurate marker to predict 30 day mortality in our population.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Rayees Ahmad Tarray, Ravouf P Asimi, Tanveer Hassan https://ijhcr.com/index.php/ijhcr/article/view/1524 An Assessment of Knowledge, Attitude and Practices (KAP) of Bio-Medical Waste Management During Covid-19 Among Health Care Workers In A Tertiary Care Hospital of Bihar 2021-05-09T16:35:48+00:00 Md. Sariful Haque Haque@gmail.com Kamran Fazal Fazal@gmail.com Prem Kumar Singh Singh@gmail.com Ahmad Nadeem Aslami Aslami@gmail.com Rakesh Kumar Kumar@gmail.com <p>Background: India is facing a lot of health care problems. With the increasing health care facilities, there is a growing concern of hazards of biomedical waste. Corona virus 19 (COVID 19) pandemic has added to this burden. Since the health care workers are at the centre of biomedical waste handling, their knowledge of adequate disposal of biomedical waste is of prime importance. Keeping this in mind, we conducted a study to assess the knowledge, attitude and practice(KAP) of Bio-medical waste management during COVID-19 among health care workers in a tertiary care hospital of Bihar. Methods: This was a hospital-based descriptive, observational study conducted in JLNMCH, Bhagalpur in the month of November and December, 2020. Written consent was taken and pre-defined questionnaire was prepared. Convenience sampling was done to select the participants representing almost all departments of the hospital. Results: 120 participants took part in the questionnaire based study. The study showed that nearly two third participants had adequate knowledge about biomedical waste management. Most of them had positive attitude and they were practicing proper methods of waste disposal too. But, there were gaps in the knowledge, attitude and practice. Conclusion: There is an urgent need to strictly implement biomedical rules in all the health facilities. There should be regular orientation programmes for all health workers.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Md. Sariful Haque, Kamran Fazal, Prem Kumar Singh, Ahmad Nadeem Aslami, Rakesh Kumar https://ijhcr.com/index.php/ijhcr/article/view/1525 A Prospective Study of Percutaneous K Wire Fixation in Supracondylar Fracture Humerus in Children in Eastern Uttar Pradesh 2021-05-09T16:45:23+00:00 V Ritesh Gupta Gupta@gmail.com Amit Mishra Mishra@gmail.com Sanjay Chaudhary Chaudhary@gmail.com <p>Introduction:Supracondylar humerus fracture is the most common injury in children and make up approximately 60% of all elbow injuries. Many method have been proposed for the treatment of displaced supracondylar humerus fracture but Percutaneous K wire fixation have become the treatment of choice for most supracondylar fractures in children. The purpose of this study was to evaluate the clinical and functional outcome of the percutaneous K wire fixation of displaced supracondylar fracture humerus in children in Eastern Uttar Pradesh. Materials AndMethods:It was a prospective study in which 18 cases of displaced supracondylar fracture humerus in children aged between 3 to 12 years were treated by closed reduction and percutaneous K-wire fixation under C- arm guidance and were studied prospectively for clinical and functional outcome. 7 cases were treated by 2 cross k wire fixation 10 cases treated with 3 K wire fixation and 1 with lateral pinning. Results: The mean age at the time of operation was 7years (range 3-12 years) and the average duration of follow up was 6 months. The Flynn’s criteria were excellent in 83%, good in 11%, and fair in 6%.Conclusions: Internal fixation with K-wire is the most commonly accepted treatment of displaced supracondylar humerus fracture in children when done at appropriate time. It gives more stable fixation, better anatomical reduction with negligible complication.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 V Ritesh Gupta, Amit Mishra, Sanjay Chaudhary https://ijhcr.com/index.php/ijhcr/article/view/1527 Comparative Study of Surgical Outcome of Distal Radius Fracture Treated By External Fixator and Plating 2021-05-09T16:56:28+00:00 G.Anvesh Anvesh@gmail.com Koteshwar Rao Mattigunta Mattigunta@gmail.com Kannelli Maneesh Chandra Chandra@gmail.com <p>Background and Objective:Distal radius fracture is the most common fracture we treat, The management has undergone an extraordinary evolution over the preceding twenty years. Universal cast treatment gave to the neutarlization with a bridging external fixator, which in turn was replaced by dorsal buttress plating. The technical advance of palmar locking plating has again changed the management of this fracture in a real and seemingly permanent way. There was no consensus regarding the management of a particular type. A randomized comparative study was undertaken to study the functional outcome between the closed reduction external fixation over volar locking plating . Methods:60 patients with distal radius fractures were selected who were who were admitted in Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Patients were randomized into 2 groups , one group treated with closed reduction external fixation and other group with Open reduction with plating in each group with 30 patients. Post operatively follow up was done for 6 month and functional outcome was assessed using Green &amp;O’brien scoring. Result:The study comprised of 34 males and 26 females aged between 18-65 years, with mean age of 35. 26 years. Functional outcome score using Green &amp;O’brien scoring on follow up we got 35% excellent results, 39 % good results, 25 % fair results,5% poor results and 13% with complications. Conclusion:Open Reduction with Volar locking Plate provided stable anatomical construct, Restoration of anatomy, early mobilization, Complications were minimal and presented on follow up were wrist stiffness. External Fixation provide stable fixation in par with open reduction and plating but had more complications such as wrist stiffness and pin tract infections, delayed healing. The conclusion were based on this short term study hence both cannot be compared and needs long term study.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 G.Anvesh, Koteshwar Rao Mattigunta, Kannelli Maneesh Chandra https://ijhcr.com/index.php/ijhcr/article/view/1528 Study of Maternal and Perinatal Outcome in Pregnancy with Anemia 2021-05-09T17:01:03+00:00 Kavitha Bhalki Bhalki@gmail.com P. Padma Padma@gmail.com Vijayasree J J@gmail.com <p>Background: Anaemia is an important risk factor in pregnancy. Anaemia in pregnancy is associated with an increased incidence of both maternal and foetal morbidity and mortality. Aim&amp; Objective: The main aim of the present is to know the impact of anaemia on maternal and perinatal outcome. Methodology: The study was conducted at Govt Medical College &amp; Hospital, Nalgonda during the period of September 2019 to August 2020. It was a prospective study, 300 antenatal women in the third trimester were included in this study. Results: Majority of study subjects were in the age group of 21-30 years-72.7%. Majority of anaemic women 64% belonged to low socio-economic status. Majority of anaemic women were school level educated- 64%. Majority of anaemic antenatal women were from rural area- 76.7%. Majority of anaemic antenatal women 61% were unbooked. 50% of the anaemic women were asymptomatic. Among 50% of symptomatic women most common presenting symptom was weakness and easy fatiguability. Only 6.3% of anaemic women gave history of increased menstrual flow. 61.7% of antenatal women were multigravida. Antenatal women with less inter pregnancy interval (&lt; 2 years) were 67.6%. 65.3% anaemic women had calorie intake of less than 80% of normal diet. 17.3% women had not taken iron prophylaxis and 45.7% had taken inadequately during present pregnancy. Out of 300 anaemic cases, 46% were mildly anaemic, 50% moderate and 4% severely anaemic. The mean PCV, MCV, MCH, MCHC and RBC count was reduced in anaemic patients indicating that iron deficiency is the commonest type of anaemia in pregnancy. Microcytic hypochromic anemia was the commonest type of anaemia (59.7%) followed by normocytic normochromic anaemia (38.3%) on peripheral blood picture. Out of 300 anaemic women, 22% received blood transfusion during antenatal / intranatal / postnatal period. The most common associated complications during antenatal period was pregnancy induced hypertension (12.3%), thyroid disorders (10.7%) and antepartum haemorrhage (7%). 32% fetuses were preterm and premature. The major neonatal morbidities in present study were low birth weight, respiratory distress syndrome and neonatal jaundice. The perinatal mortality was 13.8% in present study. The most common maternal morbidity was puerperal pyrexia and puerperal sepsis 9.7%. There were no maternal deaths in present study. Conclusion: Iron deficiency anaemia is the commonest problem in pregnancy. In the present study low socio-economic status, inadequate antenatal care, poor nutrition, multiparity, close birth spacing were the risk factors for anaemia in pregnancy.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Kavitha Bhalki, P. Padma, Vijayasree J https://ijhcr.com/index.php/ijhcr/article/view/1529 A Study on Neonatal Tactile Stimulation at Birth 2021-05-09T17:09:25+00:00 T. Bhavya Bhavya@gmail.com Kesava Chandra Gunakala Gunakala@gmail.com <p>Background: Stimulation is the most common intervention during neonatal resuscitation at birth, but scarceinformation is available on the actual methods, timing and efficacy of this basic step. To evaluate the occurrence,patterns and response to tactile stimulation at birth in a low-resource setting. Methods: We reviewed 192 video recordings of neonatal resuscitation at GGH, Kadapa, Timing, method, duration and response to tactile stimulation were evaluated. Results: Among 1147 deliveries 192 out of 246 neonates received tactile stimulation while the remaqining 54 received chest compressions directly and some of babies directly got admitted in SNCU 192 received stimulation in the first minute after birth. Multiple techniques were administered in neonates. while recommended techniques like drying was given to 50(20.4%) babies, Back rub was given to 80(41.65%) babies, Chest rub was given to 20(10.4%) babies, foot flickering was given to 42(21.8%) babies. In the present study, Median duration of stimulation is 27 seconds. Conclusions:In a low-resource setting, stimulation of newly born infants at birth is underperformed. Adherence tointernational guidelines is low, resulting in delayed initiation, inadequate technique, prolonged duration and lowresponse to stimulation. Back rubs may provide some benefits, but large prospective studies comparing differentmethods of stimulation are required.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 T. Bhavya, Kesava Chandra Gunakala https://ijhcr.com/index.php/ijhcr/article/view/1530 The Clinical Study and Management of Epistaxis 2021-05-10T05:22:33+00:00 Gopi Naik Bukya Bukya@gmail.com Palukuri Suresh Suresh@gmail.com <p>Epistaxis is a very common condition that can present as a simple self-limiting to a life threatening condition. The incidence of epistaxis in general population is difficult to ascertain , at one time or the other most people experience it. It occurs more commonly in males than females. Rare in infants, children suffer much more frequently than adults. It can be unilateral or bilateral with a number of factors playing a role like age, sex, occupation, anatomical, pathological and climatic conditions etc., Epistaxis is one of the most common emergency that oto-rhinolaryngologists are asked to treat. Causes of epistaxis can be simple with self limiting to more sinister malignancy which needs a radical approach with many other condition falling in between.Objectives:1.To find out different causes of epistaxis.2.management of epistaxis regards to its etiology.Methodology: The study was conducted in the Department of ENT, Nimra Institute of Medical Sciences &amp; Hospital during the period from January 2019 to January 2020. The prospective study included 50 patients attending the department of ENT and also patients referred from other tertiary care centers form the subjects for our study. A written informed consent taken from all patients included in the study. A detailed history taking, thorough clinical examination done for these patients. And depending upon the need of the patient, they were treated medically, anterior /posterior nasal packing and surgically, and followed for a period of 6 month. The data collected was tabulated and subjected to statistical analysis. Results: According to our study Epistaxis is more common in males of age group(20-30 years),with acute onset being more common and bilateral nose involvement being more common followed by right side, with scanty amount of epistaxis was more common (54%), followed by profuse (20%), maximum number of patient having epistaxis only for one day and 2-6% of patients had epistaxis for 5 days and above, frequency of epistaxis with more than 5 episode per day are most common.and nasal block was the most common associated symptom in our group. With hypertension(16%) being the most common associated disease and 76% not associated with any other disease, 18% patient had history of trauma in that 16% had nasal bone fracture, and 2% associated with nasal bone with maxillary bone fracture. Anterior epistaxis being the most common than posterior epistaxis , with little’s area is the most common bleeding site. 46% of the patients treated with combined modality included medical, surgical and anterior nasal packing, 26% treated with medical and anterior nasal packing , medical alone 24%, anterior and posterior nasal packing including medical treatment were 4%.and 97.9% patient had no recurrence on follow up. Conclusion: The study shows Epistaxis being more common in young adults males, trauma being the common cause followed by hypertension and idiopathic, anterior packing being most effective mode of management with minimum recurrence.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Gopi Naik Bukya, Palukuri Suresh https://ijhcr.com/index.php/ijhcr/article/view/1531 Correlation of Biochemical Markers of Serum Uric Acid and Lactate Dehydrogenase in Preeclampsia With Feto-Maternal Outcomes 2021-05-10T05:27:38+00:00 Uma Thombarapu Thombarapu@gmail.com I. Naga Prathyusha Prathyusha@gmail.com G Sahika Sahika@gmail.com Prabha Devi Devi@gmail.com <p>Introduction: Hypertensive disorders complicate 5-10% of all pregnancies worldwide. There are controversies aboutthe association between serum biomarkers and the severity of disease in the literature. AIM: To evaluate serum biomarkers uric acid(UA) and lactate dehydrogenase(LDH) in preeclamptic women and their prognostic role in maternal and fetal outcomes. Materials And Methods: Prospective study. A total of 52 women with preeclampsia were subjected to UA and LDH estimation and followed up in the obstetrics and gynecology department, NRIGH, Chinakakani, Andhra Pradesh from July 2019 to December 2019. Results: Out of 52 cases, 31(59.5%) and 21(40.2%) had non-severe and severe preeclampsia. 13 women had elevated LDH and 25 had elevated UA, out of which 7(13.4%) had both. Complications observed were more in women with LDH &gt; 600U/L and serum UA ≥6mg%.Out of 7 patients with eclampsia, both were elevated in 3, isolated elevation of LDH in 2 cases. 6 had PRES; only 1 had an elevation of both, isolated elevation of UA and LDH in 2 each. Out of 4 patients with thrombocytopenia, 3 had an elevation of both and 1 had an elevation of UA. Only 1 of 52 cases had retinal detachment with the elevation of both markers. 4 out of 8 ICU admission had both markers elevated. All 3 patients who developed pulmonary edema had elevated UA, and only 1 had elevated LDH. Fetal morbidity like preterm delivery, LBW, IUGR, NICU admission were more in elevated UA while IUFD was more in elevated LDH women. Conclusion: As ours is a small study group, we cannot conclude which biomarker is better, but both UA and LDH may be reliable in preeclampsia and its prognosis as per our study findings. CLINICAL SIGNIFICANCE: Monitoring serum UA and LDH levels during antenatal period may help in early intervention and help prevent maternal and fetal morbidity and mortality due to preeclampsia.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Uma Thombarapu, I. Naga Prathyusha, G Sahika, Prabha Devi https://ijhcr.com/index.php/ijhcr/article/view/1532 Psoriasis &psychiatric morbidity: a profile from a tertiary hospital in south india 2021-05-10T05:33:47+00:00 Bikkireddy Thanuja Thanuja@gmail.com Krishna Rajesh Kilaru Kilaru@gmail.com Pooja Munnangi Munnangi@gmail.com T.V.Pavan Kumar Kumar@gmail.com Susmitha Reddy Maddireddy Maddireddy@gmail.com B. Divya Divya@gmail.com <p>Background: Psoriasis has an impact on psychology of the patients. There is a dearth of studies regarding this field in south India. Aims and Objectives: The primary objective is to assess the psychosocial distress of patients with psoriasis and to examine the subjective influence of stress on psoriasis. Settings and Design: Institutional based case control study. Materials and Methods: A total of 50 consecutiveconsenting psoriasis patients fulfilling the inclusion and exclusion criteriaattending Dermatology OPD in a tertiary care hospitalwere included in our study. Demographics, type and duration of psoriasis was recorded by a dermatologist. Patient was then assessed by a psychiatrist and scored for anxiety and depression using Hamilton anxiety rating (HAM-A) &amp;Hamilton depression rating (HAM-D). Stress was assessed by the stressful life events scale. Data was statisticallyanalysed. Results: Out of the sample of 50 taken for our study, the majority(&gt;50%) of patients are in the 30- 50 years age group. Out of these 66% (n=33) were males and 37% (n=17) were females. Duration of psoriasis in most of the patients (18) of our study was between 1 to 30 months. Most common type of psoriasis in our group was psoriasis vulgaris in 76% (n=38). In our study HAM-A and HAM-D showed no anxiety and depression in 86% and 78% of patients respectively. Stressful life events scale showed that 84% of patients had stress preceding the onset of psoriasis. Conclusion: Majority of Psoriatic patients in the study experienced multiple stressful life events preceding the onset of Psoriasis. Less percent of patients had depression, anxiety or both. Multidisciplinary approach involving Dermatologists and Psychiatrists can help manage this disease better.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Bikkireddy Thanuja, Krishna Rajesh Kilaru, Pooja Munnangi, T.V.Pavan Kumar, Susmitha Reddy Maddireddy, B. Divya https://ijhcr.com/index.php/ijhcr/article/view/1533 Study of Hypothyroidism in Women with Abnormal Uterine Bleeding 2021-05-10T05:55:33+00:00 P. Padma Padma@gmail.com Vijayasree J J@gmail.com Kavitha Bhalki Bhalki@gmail.com <p>Background: Abnormal uterine bleeding is a common problem amongst women and is associated with an array of symtomps. Hence in investigating a patient with menstrual irregularities, evaluation of thyroid functional status forms an essential component. Aim&amp; Objective: Study was aimed to evaluate hypothyroidism in patients with AUB in the reproductive age group 15 – 45 years. Methodology: It Was a observational study. 100 cases clinically diagnosed as AUB selected from Department of Obstetrics and Gynecology, Gandhi Medical College and Hospital, Secunderabad, over a period from September 2019 to August 2020. Results: In the present study, the patients with AUB belong to various age groups ranging from 15 – 45 years, maximum no. of cases belong to 35 – 45 years(53%). Parity of patients ranged from unmarried, nullipara to para 4 and above. Maximum no. of patients with AUB belong to multipara. Commonest bleeding pattern in patients with AUB was menorrhagia (38%). Most common patients were euthyroid. Hypothyroid was found in 19% of cases. Hypothyroidism was commonest in the age group of 35 – 45 years (57.8%) and are more common with multipara (89.47%). Hypothyroidism was commonest in cases with menorrhagia (57.89%), next common was polymenorrhoea (57.78%), oligomenorrhoea (5.2%), hypomenorrhoea (5.2%) and metropathiahemorrhagica (5.2%). In AUB patients with hypothyroidism most common endometrial pattern is proliferative type (63.15%), next common secretary type of endometrium (26.31%) and cystic glandular hyperplasia (10.52%). Conclusion: The present study is done to find the association of hypothyroidism with AUB, as there is a high incidence of hypothyroidism in our area, these evaluations of thyroid in AUB would also avoid unnecessary surgeries, exposure to hormones and early diagnosis will help in early intervention and good outcome.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 P. Padma, Vijayasree J, Kavitha Bhalki https://ijhcr.com/index.php/ijhcr/article/view/1534 Evaluation of Changes in Haematological Parameters in Smear Positive Malaria Cases 2021-05-10T06:23:03+00:00 Dhirendra Kumar Kumar@gmail.com Vijay Kumar Jha Jha@gmail.com Imtiaz Ahmad Ahmad@gmail.com Md. Ali Muzaffar Muzaffar@gmail.com <p>Background: Malaria causing plasmodia are parasites of blood and hence induce haematological alterations. The haematological changes that have been reported to accompany malaria include anemia, thrombocytopenia and leucocytosis, leukopenia, mild to moderate atypical lymphocytosis, monocytosis, eosinophilia and neutrophilia. Aim: To study the changes in haematological parameters in smear positive malaria cases. Materials and Method: Total hundred smear positive malaria cases were taken and various hematological parameters and biochemical parameters were studied. Results: Out of 100 smear positive cases, P. vivax was positive in 55 cases while P. falciparum was positive in 45 cases. It was seen in 86.67% of falciparum Malaria patients and in 72.72% of vivax Malaria patients. Severe anemia was seen in 9% of patients. Normocytic normochromic blood picture was the most common type in anaemic patients (51.89%). Thrombocytopenia was seen in 71% of the patients. Mild thrombocytopenia was more common and present in 52% of patients while Severe thrombocytopenia was seen in 19% of cases. In falciparum malaria thrombocytopenia was present in 66.66% of the patients while it was present in 74.54% of the patients in vivax malaria. Total Leucocyte Count was normal in 72% of the patients. Conclusion: Various haematological findings can help in early diagnosis of malaria which is essential for timely and appropriate treatment which can limit the morbidity and prevent further complications.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Dhirendra Kumar, Vijay Kumar Jha, Imtiaz Ahmad, Md. Ali Muzaffar https://ijhcr.com/index.php/ijhcr/article/view/1535 A Comparative Study To Evaluate The Effectiveness of Quadriceps Strengthening Exercises in Patients of Osteoarthritic Knee 2021-05-10T06:32:40+00:00 Ravi Narayan Sinha Sinha@gmail.com Ajit Kumar Varma Varma@gmail.com Manoj Kumar Singh Singh@gmail.com Shailendra Kumar Kumar@gmail.com <p>Background: Osteoarthritis is a degenerative joint disease prevalence increases with age, woman being more symptomatic especially seen in post menopausal women. Quadriceps muscle weakness leads to functional dysfunction in knee osteoarthritis. Rehabilitation includes quadriceps exercises static as well as dynamic exercises for improving range of motion and strength. Biofeedback can be combined with isometric exercises to increase the awareness of the muscle work done by quadriceps. Aim To compare the Effectiveness of Quadriceps strengthening exercises in reducing extensor lag, VAS and improving functional activity in patients of osteoarthritic knee. Method: This experimental study was conducted on 60 Osteoarthritic knee patients and they were divided into 3 groups, 20 patients were included in each group. Patient aged 50-75 years were taken. Convenience sampling method was used for study. WOMAC scale, VAS and terminal extensor lag was assessed. Results P value: 0.036, 0.001 and less than 0.05 for extensor lag, VAS and WOMAC respectively as the mean difference value is more in group 3 therefore group 3 i.e. Modified Quadriceps sets with biofeedbackis clinically and statistically more effective than group 2 and 3. Conclusion All three groups were effective in reducing extensor lag, pain and improving functional activity in patients with knee osteoarthritis. It was also seen that in group 3 i.e. Modified Quadriceps sets with biofeedback clinically more improvement was seen as compared to the other groups.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Ravi Narayan Sinha, Ajit Kumar Varma, Manoj Kumar Singh, Shailendra Kumar https://ijhcr.com/index.php/ijhcr/article/view/1536 Determination of Craniofacial Relation in Human Dry Skulls: An Anthropometric Study 2021-05-10T06:37:48+00:00 Raghavendra AY AY@gmail.com Santosh Manohar Bhosale Bhosale@gmail.com Shishir Kumar C Naik Naik@gmail.com Moin Ali Afzal Janvekar Janvekar@gmail.com <p>Introduction: The size, form and position of the skull and its parts are influenced by various factors. The aging process of the bone, also known as bone remodelling, occurs throughout the lifetime of every human being which confers great variability in interpersonal and with the age. Human facial contour has always been an interesting subject for anatomists, anthropologists, plastic surgeons, and artists and also the identification of an individual’s race is an essential component in forensic identification and reconstructive surgery. Facial asymmetry is common in humans. The study is conducted with an aim to collect the anthropometrical data in dry skulls of south Indian origin and compare it with some of the previous studies conducted in same and different race. The mean, standard deviation and range will be calculated for the data.Methodology: The sample for the present study consists of 50 dry skulls irrespective of sex. Various anthropometric measurements were recorded. Based on the obtained results the length-width-height index of the face and cranium was estimated. Results: The mean width and length of the cranium are 13 cm and 17cm respectively. The average cranial index is about 76.8. With reference to the classification of cranium according to cephalic system by Farkas and Sicher H et al, in the present study, 20.4% belong to Brachycephalic and 13.26% belonged to Mesocephalic groups. The study shows that there is a significant positive correlation between width of face and Cranial index. Conclusion: Various studies are being done on anthropometric evaluation of face and cranium in different conditions like dry bone, live individuals and cadavers of different region, population, ethnicity and race. In this study, the anthropometrical data in dry skulls of south Indian origin have been collected and compare it with some of the previous studies conducted in same and different region and population. The mean, standard deviation and range are calculated for the data will be useful for the future studies and clinical application.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Raghavendra AY, Santosh Manohar Bhosale, Shishir Kumar C Naik, Moin Ali Afzal Janvekar https://ijhcr.com/index.php/ijhcr/article/view/1537 Evaluation of differences between socio demographic profile and recovery rate of symtomatic and asymptomatic patients of COVID 19 in tribal district of Rajasthan 2021-05-10T06:42:18+00:00 Chhavi Shripat Shripat@gmail.com Anil Singh Baghel Baghel@gmail.com Rupesh Kumar Kumar@gmail.com <p>Introduction:For COVID-19, data to date suggest that 80% of infections are mild or asymptomatic, 15% are severe infection, requiring oxygen and 5% are critical infections, requiring ventilation.So this study aimed to find out the difference between Sociodemographic profile and recovery rate of such patients. Material and methodology; A hospital based cross sectional study was conducted in Dungarpur District among Covid 19 patients for one month and 150 patients were selected.Results; Chi square and p value suggest that Category moderate to severe symptomatic COVID 19 patients belonged to &gt;60 yr age group and &lt;15 year age group, non tribal, upper class. Majority of them were tobacco abuser and had comorbidities with recovery rate of 20 days. While Covid 19 patients having no symptoms and mild symptoms had 14 days recovery rate.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Chhavi Shripat, Anil Singh Baghel, Rupesh Kumar https://ijhcr.com/index.php/ijhcr/article/view/1538 Effectiveness of dexmedetomidine over propofol on extubation 2021-05-10T06:48:03+00:00 Suraj Bhan Bhan@gmail.com Sukumar Misra Misra@gmail.com <p>In major surgeries like cardiovascular and neurosurgeries, sedation qualities and recovery after extubation are the important characteristics required for an ideal sedative drug. Dexmedetomidine and propofol are two commonly used sedative agents and have distinct pharmacologic characteristics that make them appealing in this patient population. Propofol is commonly used in the ICU for short term (less than 24 hours) sedation in ventilated patients postoperatively.In this study , we compared these two drugs in a set of 200 patients , who underwent major surgeries, by retrospectively collection of the data over a period of one year. The outcome of the two drugs is measured mainly in terms of the time of extubation, and post sedation effects like delirium and the length of stay in the ICUs and hospitalis considered and compared. Results revealed that Dexmedetomidine is superior to propofol in terms of the time required for extubation and the post sedative effects and finally influencing the length of stay in the hospital.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Suraj Bhan, Sukumar Misra https://ijhcr.com/index.php/ijhcr/article/view/1539 Acetazolamide induced Skeletal Anomalies in Wistar Rat Fetuses 2021-05-10T06:56:39+00:00 Anuradha Mamidi Mamidi@gmail.com Rajesh Paluru Paluru@gmail.com <p>Aim:To induce skeletal anomalies in wistar rat fetuses by acetazolamide, using double stain technique for fetal rat skeleton with Alizarin Red S and Alcian blue. Method:Adult pregnant rats were randomly divided into two groups. Control group received 0.25ml of normal saline and treatment group received 80 &amp;160 mg/kg/b. wt. of acetazolamide on 8th , 9th and 10th day of pregnancy respectively. Pregnancy was terminated on 16th , 18th , 20th day. All fetuses’ skeletal deformities were studied by Double staining technique for cartilage and bone. Results: severity of defects were linearly related to drug dosage. Most of the defects were observed on right forepaw, as dosage increased the weight of mothers, number and weight of fetuses was reduced. Conclusion: increase in dosage of acetazolamide induces limb abnormalities mostly right forepaw.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Anuradha Mamidi, Rajesh Paluru https://ijhcr.com/index.php/ijhcr/article/view/1540 A study to evaluate the Prevalence of Primary Open Angle Glaucoma in Patients with Myopia at tertiary care hospital 2021-05-10T07:21:39+00:00 Ajay Kumar Kumar@gmail.com Rajiv Kumar Singh Singh@gmail.com <p>Background: Myopia is a condition of the eye that makes it difficult to see distant objects. Aim:The present study was conducted to assess prevalence of primary open angle glaucoma in patients with myopia. Materials and Methods: This cross- sectional study was conducted in outpatient Department of Ophthalmology, Sri Krishna Medical College and Hospital, Muzaffarpur. A total of 100 patients with myopia were included in the study. Prevalence of primary open angle glaucoma in patients with myopia was recorded. Results: In right eye, patients withIOP between 8-21 is 84%, &gt; 21 is 16%. In left eye, patients with IOP between 8-21 is 85%, &gt; 21 is 15%. In myopic patients, 15% of patients had POAG, 1% with ACG. Conclusion: Glaucoma, one of the leading causes of irreversible blindness in the adult population worldwide, is a progressive optic neuropathy. Primary open angle glaucoma (POAG) is the most commonly reported type of glaucoma in population based prevalence studies worldwide. Elevated intraocular pressure is a well-known major risk factor for POAG.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Ajay Kumar, Rajiv Kumar Singh https://ijhcr.com/index.php/ijhcr/article/view/1541 Prevalance of Vitamin D deficiency among adolescent, young adult and middle aged adult population of Jammu region along with gender differences 2021-05-10T07:34:55+00:00 Akhil Gupta Gupta@gmail.com Nitin Choudhary Choudhary@gmail.com Sanjeev Gupta Gupta@gmail.com Amar Saharan Saharan@gmail.com <p>Background: Vitamin D deficiency is prevalent among across all the age groups with significant variation with gender differences. Now a days, this is highly concerned and investigational topic as the role of vitamin D deficiency has been associated with the high risk of many diseases including osteomalacia, osteoporosis, hip fracture, arthritis, poor general health etc.Materials and methods: The study was conducted in the OPD of Department of Orthopedics, GMC Hospital, Jammu from July 2019 to March 2020.The study sample consists of 300 patients divided into three age groups viz adolescent (10-19yrs),young adult(19-35yrs) and middle aged adult(36-55yrs) with [n=100] taken in each age group divided into female [n=50](50%) male[n=50](50%) for comparative analysis.Data was collected with respect to serum 25(OH)D level in all the three groups on age and gender parameter and sent for statistical analysis.Results: In adolescent age group 64% falls in the mean range of 14-19ng/ml, in young adult 74% falls in the mean range of 13-18ng/ml, in middle aged adult 79% falls in the mean range of 13-16ng/ml with the predominance in female subjects in all categories.Conclusion:High prevalence of Vitamin D deficiency in population of Jammu region with predominance in female and advancing age subjects.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Akhil Gupta, Nitin Choudhary, Sanjeev Gupta, Amar Saharan https://ijhcr.com/index.php/ijhcr/article/view/1542 A Prospective Study on Clinical Profile and Management of Obstructive Jaundice 2021-05-10T07:40:59+00:00 Kajal Kumar Patra Patra@gmail.com Sukhamoy Saha Saha@gmail.com Sanjib Haldar Haldar@gmail.com Chandranath Banerjee Banerjee@gmail.com <p>Background: There are various causes of obstructive jaundice, choledocholithias is the commonest. Patients with obstructive jaundice usually present with complain of yellow skin and eyes, pale stools, dark coloured urine, jaundice, and pruritus. A correct pre-operative diagnosis in almost always possible today because of advances in imaging techniques over the decades. The objectives of the study were to study the clinical profile and management of patients with obstructive jaundice.Methods: This was institution based, interventional, prospective, randomised, analytical studyprospective andobservational study. Study was conducted at Burdwan Medical College &amp; Hospital, West Bengal from March 2018 to August 2019 including 80 patients.Thorough history taking and clinical examination was done. Patients undergone for various laboratory investigations, and radiological evaluation. Template was generated in MS excel sheet and analysis was done on SPSS software. Results: Among 80 Obstructive Jaundicepatients, 37 (46.25%%) were male and 43 (53.75%) were female. The majority of patients (53.75%) were 31-50 yrs of age.Jaundice as per history in benign conditions was in 38 patients (73.08%) and in malignant condition 26 patients (92.87%). Conclusion: In the present study the occurrence of obstructive jaundice was maximum in the 31-70 year age group. Open exploration of CBD under experienced hands was a good treatment modality in the management of obstructive jaundice</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Kajal Kumar Patra, Sukhamoy Saha, Sanjib Haldar, Chandranath Banerjee https://ijhcr.com/index.php/ijhcr/article/view/1543 Correlation of glans-urethral meatus-shaft scoring system for hypospadias with post-operative outcome 2021-05-10T07:47:19+00:00 Omar Masood Masood@gmail.com Insha Qureshi Qureshi@gmail.com Mudasir Magray Magray@gmail.com Anup Mohta Mohta@gmail.com Vivek Manchanda Manchanda@gmail.com <p>Background:There are numerous techniques for hypospadias repair and the outcome of urethroplasty depends on patient related factors and surgeon related factors. Currently there is no widely accepted scoring system for assessing the severity of hypospadias. Objective: Present study was aimed to classify the severity of hypospadias according to GMS score and correlate the score with post-operative complications. Methods:100 males with distal to mid-shaft hypospadias consecutively selected for Urethroplasty were included in this prospective study during September 2015 to March 2017. The Glans size/groove , Urethral plate width, location of meatus and severity of chordee were evaluated individually before reconstruction. After surgery and during follow-up visits, the subsequent transient and persistent complications were recorded. Results:The mean GMS score in group A, B and C was 4.78 (± 0.69), 8.19 (± 0.90) and 10.43 (± 0.51) respectively. In Group A, UC fistula was seen in 7.4% of patients whereas In Group B and Group C, UC Fistula was seen in 46.9% and 92.9% patients respectively. Meatalstenosis was not seen in patients in Group A and Group C patients. In Group B, meatal stenosis was seen in 15.6% patients. Glans Dehiscence was not seen in patients in Group A and Group C. In Group B, Glans Dehiscence was seen in 6.2% patients. Stricture Urethra was seen in 9.3% patients in group A . In Group B and Group C, Stricture Urethra was seen in 43.8% and 92.9% patients respectively. Conclusion: The Glans-Urethral Meatus-Shaft (GMS) classification provides a means by which hypospadias severity and reporting can be standardized, which may improve inter-study comparison of reconstructive outcomes. There is a strong correlation between complication risk and total GMS score.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Omar Masood, Insha Qureshi, Mudasir Magray, Anup Mohta, Vivek Manchanda https://ijhcr.com/index.php/ijhcr/article/view/1544 Questionnaire based survey on creating awareness among I MBBS Students on practice of hygiene and risk of infections in dissection theatre 2021-05-10T08:00:01+00:00 Nimisha Sinha Sinha@gmail.com Vidya CS CS@gmail.com Shreya Singh Singh@gmail.com <p>Introduction: The cadavers have to be preserved in embalming fluid which is a combination of chemicals that include fixatives, preservatives, germicides, buffers, wetting agents, anticoagulants, dyes, and perfuming agents. In the dissection hall, the technicians, teachers and especially the medical students are exposed to formaldehyde and are more susceptible to upper respiratory infections due to improper hygienic practice. The study aims to know the perception of medical students regarding importance of hygiene in Dissection Hall and to know if medical students are aware that they are at probable risk of infections while working in the Dissection Hall.Method:Validated questionnaire with 30 items was prepared on practice of hygiene and risk of infections in dissection theatre. The validated questionnaire was generated in google forms and the link was shared via WhatsApp with I MBBS students of JSS Medical College and 44 other colleges across India. The responses were subjected to statistical analysis, and the results were interpreted.Results:A total of 578 students participated in the survey voluntarily and the responses were downloaded and the outcome was expressed in percentage. 83.6 % of the subjects had prior information regarding hygiene guidelinesbefore their first dissectionand88.2 % were not aware about the WHO stipulation on minimum exposure of non occupational formalin. Details regarding responses to all items have been discussed in the content of the manuscript.Conclusion:The harmful effects of formalin can be reduced by using hand gloves and masks while doing dissection of cadavers. We are all aware on the kind of havoc the current Covid pandemic has created and it has almost overturned the existing systems. The present survey was undertaken with the aim of imparting knowledge on safe hygienic practices in dissection theatre.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Nimisha Sinha, Vidya CS, Shreya Singh https://ijhcr.com/index.php/ijhcr/article/view/1545 COVID-19 as an Emerging Pandemic and its Implications in Dental Practice: A systematic review 2021-05-10T08:04:58+00:00 Manish Kumar Kumar@gmail.com Tarun Kumar Singh Singh@gmail.com Arshad E E@gmail.com Anuj Kishor Shukla Shukla@gmail.com Syed Monjur Elahi Elahi@gmail.com <p>Coronaviruses are named for the solar corona–like appearance (the surface projections) of their virions when viewed with an electron microscope. Coronaviruses are the second most prevalent cause the common cold (rhinoviruses are the first). Coronavirus disease 2019 (COVID-19) has caused large amounts of damage to various professional fraternities and one of the most affected fraternity was dentistry. Hence this comprehensive review includes the impact of COVID on Dentistry alongside explaining the pathogenesis, clinical features of COVID-19.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Manish Kumar, Tarun Kumar Singh, Arshad E, Anuj Kishor Shukla, Syed Monjur Elahi https://ijhcr.com/index.php/ijhcr/article/view/1546 A comparitive study of cardiovascular manifestations in treatment naive versus “on-treatment” patients with retroviral disease 2021-05-10T11:48:46+00:00 Anugraha Durairaj Durairaj@gmail.com Hrishikeshshiva Kumar Kumar@gmail.com Madhu G G@gmail.com <p>Background:ART increases the longevity of the patients infected with HIV so mortality due to Opportunistic infections is reducing and late complications like cardiovascular manifestations are on its rise. Cardiac involvement can be over looked in HIV positive patients because symptoms of breathlessness, fatigue and poor exercise tolerance are ascribed to other conditions associated with HIV patients. Objectives: Primary:To evaluate cardiac manifestations and determine type of cardiac involvementin both ART naïve patients and patients on ART and correlate with CD4+ counts.Methods:200 HIV infected patients presenting in OPD and inpatients are included. Information is collected and detailed history is taken using pre-formed proforma. At the time of admission or follow up, steps are taken to send for all the investigations and detailed clinical examination of the patient done, focusing more on cardiovascular system. Results: 41% of the patients with normal cardiac function were NOT ON ART and 62.7% of the patients with cardiac dysfunction were HIV naïve and it was found to be statistically significant(p value 0.003).Tricuspid regurgitation(42.1% vs 57.9%, p value 0.035) and IHD(0% vs 100% p value 0.049) found to have significant association in patients who were ON ART. Systolic dysfunction (p value 0.048) and IHD(p value 0.019) were both significantly associated with the low CD4+ counts in patients NOT ON ART. Conclusion :There was significant association of ART on the occurrence of cardiac dysfunction. Cardiac dysfunction is noted with low CD4+Counts, it is therefore important to undergo 2DECHO at diagnosis and at regular intervals in all HIV infected patients and to initiate early treatment for the same.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Anugraha Durairaj, Hrishikeshshiva Kumar, Madhu G https://ijhcr.com/index.php/ijhcr/article/view/1547 The inflammatory biomarkers: Are they correlated with severity of depression 2021-05-10T11:58:16+00:00 Paramjeet Singh Singh@gmail.com Himanshu Phulwari Phulwari@gmail.com Mukesh Chand Daderwal Daderwal@gmail.com <p>Background: Depression is one of the most common disorders. It has 5% prevalence worldwide and 2.8% in India. One of the etiological hypotheses for depression is inflammatory mechanism. Neutrophil lymphocyte ratio (NLR), cortisol, and vitamin D are the marker of systemic inflammation. This study assessed the association and correlation between Neutrophil lymphocyte ratio, cortisol, and vitamin D with depression and its severity.Aim: To see the association between Neutrophil lymphocyte ratio,cortisol, Vitamin D with depression and their correlation with the severity of Depression.Methodology: This study included 120 patients with depression and 120 healthy controls. Severity of depression was assessed by Hamilton Depression Rating Scale (HAM-D). N/L ratio, cortisol, and vitamin D were measured in both groups. Comparison of socio-demographic profile by independent T-test and Pearson correlation was applied to see correlation between variables. ANOVA test was applied to compare both the groups in terms of biomarkers.Results: N/L ratio, cortisol, and vitamin D were significantly deranged in cases compared to controls. A positive correlation was observed between severity of depression and N/L ratio and cortisol and an inverse correlation with vitamin D.<br>Conclusion: There is association between N/L ratio, serum cortisol and vitamin D with depression and it also has correlation with severity of depression.</p> 2021-05-10T00:00:00+00:00 Copyright (c) 2021 Paramjeet Singh, Himanshu Phulwari, Mukesh Chand Daderwal https://ijhcr.com/index.php/ijhcr/article/view/1551 Sensorineural hearing loss in chronic renal failure patients in a tertiary care centre 2021-05-11T10:12:49+00:00 Pushpa K.C. KC@gmail.com Jayaprabha S S@gmail.com Chippi Mohan Mohan@gmail.com Noble Gracious Gracious@gmail.com Jaya C C C@gmail.com Satheesh S S@gmail.com <p>Sensorineural hearing loss is considerably more prevalent in patients with Chronic Renal Failure than in the general population.This study is aimed to find the proportion of Sensorineural Hearing Loss (SNHL) in End Stage Chronic Renal Failure (Stage 4 and 5 CRF), to describe the hearing impairment and determine the possible factors responsible for hearing loss. The sample of the study consisted of 115 patients, with in the age group of 15 to 60 years. Methods: All patients underwent clinical evaluation including ENT examination and Pure Tone Audiometry. Results: 40% (46/115 patients) of patients had SNHL. Majority had bilateral and symmetrical hearing loss, mostly affecting high frequencies. Among the factors studied, age, duration of CRF, usage of ototoxic drugs, number of hemodialysis and serum creatinine were found to have statistically significant association with SNHL. Conclusion: 40% of CRF patients had SNHL and hearing loss was associated with the age of the patient, duration of CRF, number of hemodialysis and the highvalue of serum creatinine.</p> 2021-05-11T00:00:00+00:00 Copyright (c) 2021 Pushpa K.C., Jayaprabha S, Chippi Mohan, Noble Gracious, Jaya C C, Satheesh S