International Journal of Health and Clinical Research https://ijhcr.com/index.php/ijhcr <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> IJHCR Publicaion en-US International Journal of Health and Clinical Research 2590-325X Utility of Magnetic Resonance Imaging in the Diagnosis of Placenta Accreta https://ijhcr.com/index.php/ijhcr/article/view/4024 <p>Background: Placenta accrete is one of the causes of postpartum hysterectomy. Accurate prenatal diagnosis can aid in its management. Objectives: To evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) in the diagnosis of placenta accrete. Methods: This prospective observational study was conducted in the department of radiodiagnosis at Sri Ramachandra Institute of Higher education and research from April 2014 to September 2017. The study included 27 patients with suspected placenta accreta based on prenatal sonography or in conclusive sonogram or at high risk for placenta accrete. Placenta accreta findings as per MRI were compared with clinical findings at delivery. Data were analyzed by using coGuide software, V.1.03. Results: Out of 27 participants, 70.4% were in the age group of 21 to 30 years, 9(33.33%) participants were second and third gravida, respectively, and 21(77.78%) were in &gt;36 weeks of gestational age. Among the study participants, 70.4% (19/27) had positive findings in MRI for placenta accrete, and 40.74% (11/27) had positive clinical findings. In MRI findings, 9(81.8%) had Indistinct myometrium, and 6 (54.55%) had T2 bands. The total diagnostic accuracy of MRI findings for placenta accreta was 70.37%. Conclusion: MRI has a sensitivity of 100% and specificity of 50% in diagnosing placenta accreta. The overall diagnostic accuracy was 70.37%. Hence, MRI in the antenatal period can be used in diagnosing placenta accreta in a high-risk population.</p> Premkumar Jai Sankar M. Vasantha Kumar R. Rajesh Gowtham T. Vinoth Copyright (c) 2022 Premkumar Jai Sankar, M. Vasantha Kumar, R. Rajesh Gowtham, T. Vinoth http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 1 4 Conventional and magnetic resonance hysterosalpingography in assessing tubal patency https://ijhcr.com/index.php/ijhcr/article/view/4025 <p>Aim: Conventional and magnetic resonance hysterosalpingography in assessing tubal patency. Material and methods: 50 patients, age 20–40 years, for evaluation of tubal patency were included in the study. It includes patients referred for postoperative evaluation, following reversal of tubal ligation and recurrent spontaneous abortions. The examination was done on Day 7–Day 12 of the menstrual cycle.Under strict aseptic precautions, MRI‑compatible plastic HSG 5 ‑ F microcatheter with inflatable bulb was inserted into the lower uterine cavity. The bulb was inflated with 3 cc of distilled water and shifted to MRI scan 1.5 Tesla [GE] machine. T2 W (TR: 7120 ms, TE: 90 ms, flip angle 900, slice thickness 5 mm, matrix 256 × 256) axial, sagittal, and coronal sequences were done. Results: The comparative sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV], and diagnostic accuracy of MR HSG and cHSG were 100%, 99.08%, 100%, 97.5%, and 99.75%, respectively, and those of MR HSG and DL were 100%, 93.73%, 87.21%, 100%, and 96%, respectively. The Kappa agreement between MR HSG and cHSG was excellent [0.97] and a McNemar test value of 1 showed no statistical difference between the two procedures. Conclusion: MR HSG is a novel upcoming investigation method with very few pioneering studies at both national and international levels. This study is distinctive in the sense that it explores the utility and feasibility of HSG being done using MRI.</p> Mohit Agarwal Copyright (c) 2022 Mohit Agarwal http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 5 7 Correlation of histopathological and cytological features in proved tubercular lymphadenitis https://ijhcr.com/index.php/ijhcr/article/view/4026 <p>Background: Changes in pattern and incidence of Tuberculosis have strikingly altered the etiology of mycobacterial lymphadenitis as children are usually more affected by atypical form while adults and geriatrics are mostly infected by M.tuberculosis.5 Diagnosis of tuberculous lymphadenitis is mostly clinical and histopathological but in some cases where microscopic appearances are not exactly typical so diagnosis becomes difficult. Material and method: The study protocol included 150 patients more than 15years belonging to both sexes. Detailed history of selected patients was taken, after this clinical examination and routine investigation were carried out. Patients below 15 years, with any chronic illness, pregnant woman, with any hepatic and renal failure were excluded from study.Result: Necrotizing granulomatous lymphadenitis was most common (66.67%) cytological diagnosis followed by granulomatous lymphadenitis (18%) and necrotizing lynmphadenitis (14.66%). Out of 150 cases 78 (52%) were positive for AFB on FNAC smears while 72 (48%) were smear negative for AFB. Lymph node biopsy was done in 42 cases. Those who were not willing common most was histopathological feature (71.4%).Conclusion: FNAC smear confirmed the diagnosis bacteriologically in 52% cases subsequent FNAC culture for AFB contributed in 11 (7.3%) cases more as an additional yield over FNAC smear.</p> Hansraj Vasir Sumit Goyal Copyright (c) 2022 Hansraj Vasir, Sumit Goyal http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 8 11 Assessment of awareness of cervical cancer and pap smear screening among women of reproductive age group https://ijhcr.com/index.php/ijhcr/article/view/4027 <p>Background: Most cervical cancers are caused by the human papillomavirus (HPV), which is transmitted through sexual contact. The present study was conducted to assess awareness of cervical cancer and pap smear screening among women of reproductive age group. Materials &amp; Methods: 90 women age ranged 20-50 years visiting the department pf Obstetrics &amp; Gynecology were selected and a questionnaire was prepared and response was obtained form all. The responses of the study participants were scored as 1 point for a correct response, 0 for no response (don’t know), and – 1 point for an incorrect response. Results: Age group 20-30 years had 35, 31- 40 years had 23 and 41-50 years had 32 patients. Age group 20-30 years had good awareness in 15%, 31-40 years had in 20%, 41-50 years had in 12%. Good awareness was seen in those having none education in 12%, primary in 20% and secondary in 50%. Good awareness in married was seen in 35%, single in 30%, widow in 35% and separated in 40%. Skilled in 45%, unskilled in 25% and semiskilled in 30%. Rural in 15% and urban in 40%. Good awareness was seen in those having socio- economic statusI in 55%, II in 35%, III in 20%, IV in 5% and V in 0. The risk factors identified were weak immunity in 23, use of oral contraceptive pills (OCPs) in 15, many children in 45, having many sexual partners in 20, smoking in 14 and HPV infection in 19. Conclusion: Women of reproductive age group had inadequate knowledge regarding cervical cancer and pap smear screening.</p> Upasana Pandit Meenakshi Rajesh Ranjan Copyright (c) 2022 Upasana Pandit, Meenakshi, Rajesh Ranjan http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 12 15 Prevalence and risk factors of scabies among school adolescents in urban Lucknow, India https://ijhcr.com/index.php/ijhcr/article/view/4029 <p>Background: Scabies is found worldwide and affects folks of all races and social categories. Itching unfolds speedily beneath packed conditions wherever the shut body and skin contact is frequent. Establishments like nursing homes, schools, extended-care facilities, prisons, child-care facilities are standard sites of itch infestations and scabies outbreaks. The study objective was to seek out the prevalence and associated risk factors for Scabies among the adolescent school children in urban Lucknow. Methods: This cross-sectional study was conducted among adolescent school children between 1st January to 31st March 2020 in urban Lucknow. Information was collected using a pretested semi structured questionnaire. A trained medical examiner made the identification and clinical diagnosis of infection. Collected information was entered in Microsoft excel and analysed by using SPSS software version 23.0. Results: Prevalence of Scabies infection was found to be 23.33%. Age of the student, overcrowding and the type of house was found to be statistically related to the infection. Conclusions: Health education regarding personal hygiene practises is strongly recommended among school going children. Modification of environmental risk factors like overcrowding and improper dwellings, will aid in reducing the spread of scabies.</p> Mohammad Suhail Khan Md Islam Arfin Syed Esam Mahmood Ausaf Ahmad Rishi Kumar Bharti Nadeem Ahmad Anas Ahmad Khan Copyright (c) 2022 Mohammad Suhail Khan, Md Islam Arfin, Syed Esam Mahmood, Ausaf Ahmad, Rishi Kumar Bharti, Nadeem Ahmad, Anas Ahmad Khan http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 16 19 Assessment of Disease Activity Score with Respect to Vitamin D in Rheumatoid Arthritis: An Observational Study https://ijhcr.com/index.php/ijhcr/article/view/4030 <p>Background: Rheumatoid Arthritis (RA) is a crippling disorder with a prevalence rate ranging from 0.3% to 1% globally having an annual incidence rate of 3 per 10,000 adults. Vitamin D has unavoidable effects on numerous physiological functions as well as pathological conditions and several studies have analyzed the association of vitamin D deficiency in rheumatoid arthritis and have reached varied conclusions. Identifying the role of Vitamin D in curbing the articulation of RA is a topic of enormous importance having practical applications too. Material &amp; Methods: This was an observational study conducted on 42 patients in the age group of 18-45 years having RA, diagnosed by the American College of Rheumatology criteria (ACR/EULAR criteria), for assessing disease activity score concerning vitamin D in them. Results: In the distribution of Disease Activity Level, the proportion of moderate activity level was found higher i.e. 66.7%. The mean vitamin D level was 10.93 ± 2.70, the minimum was 7 and the maximum was 18. The mean DAS-28 Score was 4.46 ± 0.82 with a minimum value of 2.63 and a maximum of 6.08. Conclusions: A notable association has been found between the comparison of the level of vitamin D and the DAS-28 score. The deficiency of vitamin D can be speculated to be a substantial reason for rheumatoid arthritis.</p> Manmohan Sharma Shubham Mohan Sharma Divesh Singh Prakhar Agarwal Aditya Jha Copyright (c) 2022 Manmohan Sharma, Shubham Mohan Sharma, Divesh Singh, Prakhar Agarwal, Aditya Jha http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 20 22 Assessment and treatment of chronic low back pain with psychological impact https://ijhcr.com/index.php/ijhcr/article/view/4031 <p>Study design: A prospective intervention study.Purpose: Assessment and treatment of chronic low back pain with psychological impact.Introduction: Around 60 to 80% of the adults experience low back pain at some point or other in their life. Current studies have noticed that there is an association between low back pain with the mood of sufferers which lead to: Anxiety, Depression, Poor social interactions, Irritability.Methods: 80 patients with chronic back pain are been taken and Psychological assessment of these patient were done by:General anxiety disorder(GAD-7) for anxiety andPatient health questionnaire (PHQ-9) for depression. Each patients was treated and followed up for 3 months.Results: Out of 80 patients 51.3% were old &amp; 48.8% were young, 80.0 % were female &amp; 20.0 % were male,presenting complaints duration: 72.5 % suffering since &lt; 1 Year, 22.5% since 1 to 2 Years, &amp;5.0 % since&gt; 2 Years. The Comparison of Anxiety, depression, oswestry score at the Follow-Up of subjects were significant (P- value is &lt;0.05) in our study. Comparison of mean scores among Presenting Complaints groups,Anxiety, depression, oswestry scorewas significant (P- value is &lt; 0.05) in our study.Conclusion: After carrying out the analysis, the results support that efficiency of the psychological interventions are significant for reducing the low back pain which are self-reported along with depression and anxiety levels which in turn increases the quality of life related to health within the persons suffering from chronic lower back pain.</p> Manmohan Sharma Vinish Verma Shubham Mohan Sharma Prakhar Agarwal Prerana Gupta Ghoushul Azam Copyright (c) 2022 Manmohan Sharma, Vinish Verma, Shubham Mohan Sharma, Prakhar Agarwal, Prerana Gupta, Ghoushul Azam http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 23 27 Study of Non compliance to Directly Observed Treatment Short-course (DOTS) at a tertiary hospital in Dhule district (Maharashtra) https://ijhcr.com/index.php/ijhcr/article/view/4032 <p>Background: India has been engaged in TB control activities for more than 50 years. Yet TB continues to be severest health crisis. TB kills an estimated 480000 Indians every year and more than 1400 per day. Tuberculosis is a preventable &amp; curable communicable disease requiring prolonged treatment. The therapeutic regimens recommended by WHO and used in India, under National Tuberculosis Elimination Programme (NTEP) have been shown to be very effective for both preventing and treating tuberculosis. But poor compliance to treatment is a major barrier to its control and cause for drug resistance. Study objective: Study objective was to find out extent and causes of non-compliance to DOTS at a tertiary hospital. Material and Methods: Present study was cross sectional study. Using purposive sampling method all 112 sputum positive pulmonary tuberculosis patients, registered from January 2020 to December 2020 in the DOTS centres under department of Respiratory Medicine, A. C. P. M. Medical College and Hospital, Dhule (Maharashtra) India, were included in study. Age less than 18 years and drug resistant cases were excluded. The information was obtained from treatment cards of patients. Information of non-compliant was further elicited from the patients/DOTS providers. A criterion for non-compliance (Lost to follow up) was patient missed treatment for one month or more at any time during the treatment period. Results: During study period, total 112 cases were enrolled. In present study non-compliance was observed in 9 cases (08.03 %). In non-compliant cases, majority were from 31-40 year age group (33.34 %), male (66.67%), educated up to 12th standard (44.45 %), housewives (22.22 %), labourer (33.34 %) by occupation, belonging to Kuppuswamy’s socioeconomic class V (44.45 %), living alone/with friends (11.11 %), married (77.78 %). Among non-compliant cases other factors such as alcohol consumption (22.22 %), smoking (33.33 %) &amp; family history of TB (11.11 %) were noted. Among non-compliant cases, majority were newly diagnosed (77.78 %) followed by previously treated (22.22 %). Factors observed for non-compliance were patients feeling better so no need to continue treatment (44.45 %), side effects of drugs (22.22 %), migrated to other places (22.22 %). &amp; fear of social stigma (11.11 %) Conclusion: In spite of one to one counseling at treatment initiation and retrieval action during follow up, non-compliance was observed in 9 cases (8.03%). Associated factors like male sex, young age, previous treatment and causes of non compliance like stopping treatment after feeling better, intolerance to anti TB drugs, migrating to other places and fear of stigma suggests improvement in health education to patient and family members, stringent follow up by healthcare providers, and use of newer treatment tracking methods.</p> Madhukar Pawar Ashish Raj Gauri Kulkarni Sunil Murlidhar Patil Copyright (c) 2022 Madhukar Pawar, Ashish Raj, Gauri Kulkarni, Sunil Murlidhar Patil http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 28 31 A study of anemia prevalence and its socio-demographic characteristics among adolescent girls in Jabalpur District (Madhya Pradesh) https://ijhcr.com/index.php/ijhcr/article/view/4033 <p>Background – the current research was planned to appraise the prevalence of anemia and its socio-demographic characteristics among adolescent girls in 10-19 years of age group in Jabalpur District (Madhya Pradesh). Method – this was a community based cross sectional study conducted among 200 adolescent girls who willing to participate. The age group was 10 to 19 years grouped into two parts, 10- 14 years and 15 to 19 years of age group. As per questionnaire dietary history was taken. As per the Hemoglobin Color Scale (HCS), the assessments of anemia status were carried out. Descriptive statistics and inferential statistics chi square and T test were used for the inferential statistics. P&lt;0.05 was considered statistically significant. Result- the prevalence of anemia among the adolescent girls in the age group 10-14 years was 56.4% were as 46% in the age group 15-19 years. Anemia was found highly significant (p&lt;0.05) in relation to education, parents occupation, socioeconomic status BMI etc. in addition to this it is strongly associated with birth order, amount and days of menstrual blood flow (p&lt;0.05). Conclusion- In adolescent girl’s anemia is highly prevalent. Logistic regression reveals that low education, low nutritional intake, occupation, heavy blood flow during menses etc are strongly associated with anemia in 10-19 years of girl’s age group.</p> Ashish Raj Madhukar Pawar Sunil Murlidhar Patil Rekha Choudhary Copyright (c) 2022 Ashish Raj, Madhukar Pawar, Sunil Murlidhar Patil, Rekha Choudhary http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 32 35 Stress and Resilience in Health Care Workers Managing Corona Virus Disease- 2019 Patients in A dedicated COVID-19 Hospital in Mewat region of North India https://ijhcr.com/index.php/ijhcr/article/view/4034 <p>Objective: Pandemics are known to impact the mental health of the health care workers (HCWs). Impact of COVID-19 on mental health of HCWs is not yet understood completely. We studied stress and resilience among HCWs during the COVID-19pandemic, and observedlevel of stress and resilience among different job profile of HCWsin North India. Methods: We conducted a hospital based cross sectional study at a designated COVID-19 tertiary care center in rural district of North India from April 2020 to June 2020. A total of 587 HCWs were included for study. The information was collected using Semi-structured proforma and pre-validated questionnaire, Perceived stress scale (PSS) for perceived stress and Brief resilient coping scale (BRCS24) for resilience. The statistical analysis was done using statistical package for social sciences (SPSS), version 24. Results: Maximum number of participants (72.2%) reported with moderate to high level of perceived stress. 76.5% specialists were reported moderate stress followed by paramedical staff (65.7%) and junior residents (63.9%). Around 70% of junior residents have high resilient coping skills followed by specialists (53.7%) and paramedical medical staff (51.8%).Significant difference (p value = &lt;0.000) between the PSS score and BRCS scores were found among all three job categories. No correlation was found between PSS and BRCS (p value &gt;0.05). Conclusions: Our study indicated highest level of perceived stressandresiliencein junior residents among all the three job categories, however no relationship could be observed between perceived stress and resilience in HCWs. Higher age, female gender, specialist and COVID care duty inICU, isolation, flu OPD, triage were predictors of perceived stress. These findings should be taken into consideration for the development and implementation of interventions to mitigate the impact of sustained psychological distress among HCWs.</p> Vipin Kumar Nikhil Goel Sonia Hasija Vikas Singroha Kapil Sharma Ritika Girdhar Pallavi Pallavi Smita Budhiraja Parmila Copyright (c) 2022 Vipin Kumar, Nikhil Goel, Sonia Hasija, Vikas Singroha, Kapil Sharma, Ritika Girdhar, Pallavi Pallavi, Smita Budhiraja, Parmila http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 36 41 Diagnosis of breast lesions on frozen section and its cyto-histopathological correlation https://ijhcr.com/index.php/ijhcr/article/view/4038 <p>Aim: To compare the finding of frozen section with findings of FNAC and histopathology &amp; study the sensitivity, specificity and predictive value of frozen section biopsy. Methods: A hospital based cross sectional study was done to compare the finding of frozen section with findings of FNAC and histopathology. This research included total 70 female patients of age group 11-80 years clinically presenting with palpable breast lesions referred to the Department of Pathology, for FNAC, frozen section and histopathological evaluation and a prospective study was conducted. FNAC procedure was performed according to the standard protocol. Only diagnosed cases were included in the study. Cases did not undergo surgery were excluded from the study. Results: Following FNAC, out of the total 70 cases, 35 (50%) patients had benign breast lesions while 35 (50%) patients had malignant breast lesions. Following Frozen Section, out of the total 70 cases, 33 cases (47.1%) were benign lesions and 37 cases (52.9%) were malignant. According to The histopathological diagnosis of breast lesions noted that 32 (45.7%) patients had benign breast lesions while 38 (54.3%) patients had malignant breast lesions. Frozen section findings correlated with the histopathological findings in 69 of 70 cases (98.6%), which included 32 of 32 (100%) of the benign lesions and 37 of 38 (97.4%) of the malignant lesions. 1 case of malignant lesion was wrongly diagnosed as benign on frozen section findings. The correlation of frozen section and histopathological findings was found to be statistically significant as per Chi-Square test (p&lt;0.05). FNAC findings correlated with the histopathological findings in 65 of 70 cases (92.9%), which included 31 of 32 (96.9%) of the benign lesions and 34 of 38 (89.5%) of the malignant lesions. 1 case was wrongly diagnosed as malignant on FNAC findings while 4 cases were wrongly diagnosed as benign. The correlation of FNAC and histopathological findings was found to be statistically significant as per Chi-Square test (p&lt;0.05). The Sensitivity, Specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of Frozen section were 97.37%, 100%, 100% and 96.97% respectively. Accuracy of Frozen section was 98.57%. It was observed that frozen section was more accurate than FNAC with higher sensitivity (97.37% vs. 89.47%), specificity (100% vs. 96.88%), PPV (100% vs. 97.14%), NPV (96.97% vs. 88.57%) and accuracy (98.57% vs. 92.86%). Conclusion: Despite increasing popularity and undisputed utility of FNAC, there are cases where frozen section still stands out as the method of choice for rapid diagnosis mainly for determining the resection margins of the lesion and the extent of metastasis in case of malignant lesion to ensure no residual tumour mass thus helping in further treatment and follow-up of patients. Final histopathological study is required to accurately arrive at a definitive diagnosis along with IHC marker study which is considered as a gold standard for patient care.</p> Shabina Naznin Haqiqullah Nadeem Ahmad Malik Atiur Rehman Copyright (c) 2022 Shabina Naznin Haqiqullah, Nadeem Ahmad, Malik Atiur Rehman http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 42 47 Effect of anticonvulsant drug sodium valproate on hepatic profile in children https://ijhcr.com/index.php/ijhcr/article/view/4039 <p>Background: Sodium valproate is one of the most common antiepileptic medications used in clinical practice. The period of treatment is commonly associated with benign alternation of the liver enzymes due to drug metabolism. Evaluation of asymptomatic enzymatic changes could be challenging to the expert clinician and may expose patients to unnecessary procedures or expenses. Thus, this article aims to focus on the frequency of liver enzyme abnormalities among epileptic children. Materials &amp; Methods: The current prospective observational study was conducted on children with seizure disorder attending Pediatric OPD of Rajendra Institute of Medical Sciences, Ranchi. Period of study was extended from February 2014 to October 2015. Patient randomly selected from outdoor of department of Pediatric having seizure disorder. All children aged 2 years to 10 years, of either sex having partial or generalized seizure and who have recently started either phenytoin, valproate or carbamazapine were selected for study. Routine investigations like complete blood count, peripheral blood smear, CRP, blood glucose, CT Brain/Spine, EEG and hepatic profile like aspartate aminotransferase (AST/SGOT), alanine aminotransferase (ALT/SGPT), alkaline phosphatase, total serum bilirubin (direct &amp; indirect), prothombin time or international normalized ratio (INR), serum albumin and Australia antigen (HbsAg) on valproate therapy were done. Results: The present study revealed that, the patients treated with valproate have shown significant increase mean ALP level after 1 year of treatment as p values were 0.03, 0.02 and 0.03 respectively. The patients treated with valproate have shown no significant increase mean SGPT and SGOT level after 1 year of treatment. It was also found that there was no significant increase in mean TSB and mean PT. Also there was no significant decrease in mean serum albumin. Conclusion: The significant increase was seen in mean ALP level these increase is probably due to enzyme-inducing or enzyme-inhibiting properties of drugs. SGPT, SGOT levels increases from the initial value but not to significant level. The study recommends obtaining baseline liver enzymes tests prior to commencement of treatment. However, the benefit of routine screening in asymptomatic patients has not proved. Further controlled studies with a large sample size are warranted.</p> Pradeep Minz Asha Oroan Samuel Lakra Ranjit Kaur Arora Poonam Singh Copyright (c) 2022 Pradeep Minz, Asha Oroan, Samuel Lakra, Ranjit Kaur Arora, Poonam Singh http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 48 55 Comparative study of hysteroscopy with ultrasonography and its correlation with histopathology in cases of abnormal uterine bleeding in perimenopausal women https://ijhcr.com/index.php/ijhcr/article/view/4040 <p>Aim: To compare the diagnostic efficacy of ultrasonography and hysteroscopy in detecting uterine abnormalities in abnormal uterine bleeding by correlating the results with histopathological examination. Material and Method: This prospective study was conducted among women attending OPD of Department of Obstetrics and Gynaecology, IMS &amp; SUM Hospital, Bhubaneswar from April 2019 to March 2021. A total of 100 perimenopausal women with abnormal uterine bleeding attending Obstetric and Gynaecology OPD were included in this study. All patients underwent transvaginal scan to note down the endometrial thickness and to rule out uterine and adnexal pathology. All the patients underwent diagnostic hysteroscopy, followed by a biopsy of the endometrium. The endometrium was sent to the pathologist. Findings of these diagnostic modalities then correlated. Results: Out of 100 women, USG detected that 54 patients (54%) had no pathology and 46 patients (46%) had abnormal findings, out of which maximum patients i.e., 29 patients (63.04%) had endometrial hyperplasia. According to Hysteroscopy, 46 patients (46%) had normal hysteroscopic findings while 54 patients (54%) had abnormal findings of which maximum were 18 patients (33.33%) who had endometrial hyperplasia. Histopathology findings revealed that 47 patients (47%) had normal findings and 53 patients (53%) had abnormal findings out of which maximum patients 20(37.7%) had endometrial hyperplasia. In our study of 100 women with AUB, on USG only 1 patient had endometrial malignancy and the same was reported by hysteroscopy and histopathology. Conclusion: In our study hysteroscopy proved to be highly sensitive and specific considering histopathology as gold standard. Ultrasonography has good sensitivity and specificity but less as compared to hysteroscopy.</p> Pratibha Jena Ratna Panda Copyright (c) 2022 Pratibha Jena, Ratna Panda http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 56 61 Assessment of nutritional status and stress among adolescent girls https://ijhcr.com/index.php/ijhcr/article/view/4041 <p>Background: The three most serious and common effects of stress are adrenal fatigue, neurotransmitter imbalances and hormonal and immunological disorders. The present study was conducted to assess nutritional status and stress among adolescent girls. Materials &amp; Methods: 90 adolescent girls aged 12-18 years was recorded. The daily nutrient intake was calculated in terms of energy, protein, fat, ascorbic acid, iron, retinol, folic acid, and calcium. Results: The mean energy (Kcal) was 1406.4, 1540.2, 1724.3, 1892.2, 1911.2 and 1956.4, protein (g) was 19.2, 25.2, 27.0, 30.2, 31.2 and 30.6, fat (g) was 30.4, 31.6, 31.5, 31.6, 32.0 and 18.6, calcium (mg) was 435.4, 502.4, 560.5, 618.9, 620.4 and 468.2, iron (mg) was 15.4, 17.6, 19.4, 20.4, 20.5 and 17.2, retinol (μg) was 310.2, 310.5, 472.4, 501.4, 512.5 and 494.2, vit C was 19.4, 19.0, 21.9, 22.5, 23.3 and 23.4 and dietary folate (μg) was 98.2, 98.8, 119.4, 132.0, 134.2 and 126.5 in 12 years, 13 years, 14 years, 15 years, 16 years and 17 years respectively. The reasons for stress among adolescent was unhealthy dietary habits was seen in10%, inadequate sleep in 14%, academic work load was 22% and inadequate exercise in 7%. The difference was significant (P&lt; 0.05). Conclusion: There was low nutritional status among adolescent girls. Reasons for stress among adolescent was unhealthy dietary habitsinadequate sleep, academic work load and inadequate exercise.</p> Anwarul Kabir Amit Upadhyay Ankita Prakash Rashmi Prakash Copyright (c) 2022 Anwarul Kabir, Amit Upadhyay, Ankita Prakash, Rashmi Prakash http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 62 64 Comparison of minimally invasive procedure with the standard open approach for lumbar sympathectomy https://ijhcr.com/index.php/ijhcr/article/view/4042 <p>Aim: To compare minimally invasive procedure with the standard open approach for lumbar sympathectomy and to assess the morbidity and evaluate the outcome in terms of operative time, blood loss, complications and recovery time. Method: The present study was carried out as a prospective cross-sectional observational study. A total of 60 patients were enrolled in the study who were divided into two groups A and B of 30 each who were operated by open method and laparoscopic method respectively.Patients between age 17 to 80 years with ischemic rest pain that requires continuous analgesia for &gt; 2 weeks, ischemic foot ulcers that failed to heal for &gt; 6 weeks and distal gangrene which is limited to the fore foot were included in the study. Result. In group A total 18 out of 30 patients(60%) and in group B total 21 out of 30 patients(70%)were taking analgesics for pain from more than 4 weeks. In group A operative time in 6 patients was ½-1hr, in 20 patients 1-1½ hrs and in 4 patients operative time was more than 1½ hrs while in group B in 22 patients operative time was ½-1 hr, in 6 patients 1-1½ hr and in 2 patients it was more than 1½ hrs.P value was 0.0002 which was significant. In group A there were ureteric injury in 2 patients, venacaval injury in 1 patient, peritoneal perforation in 1 patient, wound haematoma in 7 patients, wound infection in 6 patients and incisional hernia in 2 patients as intra operative and post operative complications while in group B there was ureteric injury in 1 patient, peritoneal perforation in 1 patient, wound haematoma in 1 patient, wound infection in 2 patient and there was no vena caval injury and incisional hernia as intra operative and post operative complications. P value was 0.02 which was significant. In group A 4 patients recovered in 5-7 days and 26 patient took more than 7 days to recover while in group B 5 patients recovered in 3-5 days,20 patients recovered in 5-7 days and 5 patients took more than 7 days to recover.P value was 0.006 which was significant. Conclusion: In minimally invasive technique of lumbar sympathectomy operative time,intraoperative complications were much less and recovery was significantly faster as compared to classical open method.</p> Nadeem Ahmad Gyan Prakash Rastogi Shabina Naznin Haqiqullah Copyright (c) 2022 Nadeem Ahmad, Gyan Prakash Rastogi, Shabina Naznin Haqiqullah http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 65 68 Open versus closed method of pneumoperitoneum creation in laparoscopic surgery: A comparative study https://ijhcr.com/index.php/ijhcr/article/view/4043 <p>Aim: A comparative study of the open versus closed method of pneumoperitoneum creation in laparoscopic surgery. Methods: This comparative study conducted in the Department of Surgery. 80 patients of either sex were selected who undergone operative procedure for laparoscopy surgery were included in this study. All patients undergoing elective laparoscopic surgery and hemodynamically stable patients. Results: Technical difficulties like multiple attempts, gas leak at port site and port site bleeding are more in open method than in closed method, which is attributed to larger size of incision in open method, Furthermore, a significant higher incidence of such minor complications is found in case of BMI &gt;25 p=-5.33 (p&lt;0.05) at confidence level of 95%). Duration for pneumoperitoneum creation in open method group is shorter as compared to closed method group for pneumoperitoneum creation in laparoscopic surgery; p value is 0 (p&lt;0.05) at confidence level of 95%). Minor technical difficulties like multiple attempts (p=0.039), gas leak at port site (p=0.037), and minor complications like port site bleeding are more with open method. While one case pre peritoneal insufflation is noted in case of closed method. Herep&lt;0.05 in most of the cases. Hence, it is statistically significant. Conclusion: We can conclude that both methods i.e. open and closed methods of creating pneumoperitoneum in laparoscopic surgery are safe to perform. The open technique has slightly more incidence of minor complications due to large incision size but has advantage of lesser duration needed for procedure.</p> Sarita Durge Mayur Bandawar Vikrant Dhawande Copyright (c) 2022 Sarita Durge, Mayur Bandawar, Vikrant Dhawande http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 69 71 Abdominal emergencies performed in general surgery department https://ijhcr.com/index.php/ijhcr/article/view/4044 <p>Background: Abdominal surgical emergencies constitute a significant portion of a surgeon’s clinical experience and often present with diagnostic and treatment challenges. The present study evaluated various abdominal emergencies performed in general surgery department. Materials &amp; Methods: 158 patients undergone abdominal emergencies performed in general surgery department of both genderswere enrolled. Parameters such as organ system involved, operation performed, initial diagnosis in the emergency room, final diagnosis, and outcome of treatment was recorded. Results: Out of 158 patients, males were 90 and females were 68. Surgeries were performed on liver in 12, lung in 5, small bowel in 27, pancreas in 10, stomach in 20, biliaryin15,rectumin 8, hernia in 19, esophagus in 4, spleen in 12, appendix in 17 and ovaries in 9 patients. Postoperative complications were abscess in 24, bleeding in 15, anastomotic leaks in 5 and anastomotic perforationsin 2. Mortality seen in patients undergoing surgery for small bowel in 5, pancreas in 2, stomach in 4, biliary in 3, rectumin 1, hernia in 1, spleen in 2 and appendix in 1. Conclusion: Common involved organs were liver, lung, small bowel, pancreas, stomach, biliary, rectum, hernia, esophagus, spleen, appendix and ovaries.</p> Ravi Anand Manoj Kumar Sonkar Copyright (c) 2022 Ravi Anand, Manoj Kumar Sonkar http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 72 74 Management of locally advanced soft tissue tumors with major vessel reconstruction - A case series https://ijhcr.com/index.php/ijhcr/article/view/4045 <p>Management of soft tissue tumors in the advanced stage often precludes complete surgical resection in view of major vessel involvement and demands major amputation for tumor clearance. We present a series of patients presented with advanced tumor presentation by major vessel resection and reconstruction (using vein or synthetic graft) without compromising tumor clearance. This preserves the limb function without increasing the tumor recurrence rate.</p> G. Marun Raj K. Raja R. Manoj Prabakar S.R. Subrammaniyan Kartik Datta Kolli Ratnasree Ravipati Copyright (c) 2022 G. Marun Raj, K. Raja, R. Manoj Prabakar, S.R. Subrammaniyan, Kartik Datta Kolli, Ratnasree Ravipati http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 75 78 Analysis of radiographic findings of osteoarthritis (OA) of knee joint using kellgren-lawrence scores in osteoarthritis of knee patients https://ijhcr.com/index.php/ijhcr/article/view/4046 <p>Background: The aim of this study was to investigate the radiographic findings in patients with knee osteoarthritis (OA). Methods: The present study was conducted on 120 symptomatic knees fulfilling American College of Rheumatology criteria for OA were included in the study. Patients with trauma, inflammatory, and infective conditions of the knee and with a history of intra‑articular interventions and surgery were excluded. Demographic data, body mass index (BMI), visual analog scale (VAS) were obtained. Kellgren–Lawrence (K‑L) score was obtained on radiography. Results: A total of 120 consecutive symptomatic knees were examined. The participants with a mean age of 50.66 ± 7.28 years, mean duration of disease of 4.20 ± 4.16 months, mean BMI of 28.20 ± 5.40 kg/m2, and mean score of VAS scale of 6.30 ± 1.50. K‑L grading of 1, 2, 3, and 4 was reported in 25%, 33.33%, 29.16%, and 12.5% of the knees, respectively. The mean VAS score showed statistically significant correlation with KL grading (P &lt; 0.05). Conclusion: Our study found that K‑L grading and few ultrasonographic criteria showed a significant positive correlation with pain scores, while few other ultrasonographic criteria did not. Both imaging modalities are complementary to each other, rather than one being superior to the other.</p> Niraj Kumar Copyright (c) 2022 Niraj Kumar http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 79 81 Evaluation of Procalcitonin (PCT) and C-reactive protein (CRP) as biomarkers in suspected cases of sepsis among patients attending Emergency Department and ICU of the tertiary care hospital in Western Uttar Pradesh https://ijhcr.com/index.php/ijhcr/article/view/4047 <p>Background: Procalcitonin has characteristics of a biomarker, as there is a fast and specific increase in sepsis and it differentiates infections from non-infectious causes of sepsis. The present study was conducted to evaluate procalcitonin (PCT) and C-reactive protein (CRP) as biomarkers in suspected cases of sepsis. Materials &amp; Methods: The study was conducted on 80 cases in the department of medicine at Uttar Pradesh University of Medical Sciences (UPUMS), Saifai, Etawah. Cases clinically suspected of sepsis on admission to emergency department were included. 5ml of venous blood sample was withdrawn simultaneously for detection of PCT and CRP. Results: There were 45 (56.2%) male and 35 (43.7%) female. Blood culture was positive in 26 (32.5%) and negative in 54 (67.5%). Among 26 positive blood culture cases, 5 (19.23%) were caused by Gram-positive bacteria and 21 (80.76%) by Gram-negative bacteria. In Gram-positive cultures all 5 isolates identified were of Staphylococcus aureus. In Gram-negative cultures most common isolates were E. coli 9 (34.61%), followed by Klebsiella pneumoniae 6 isolates (23.07%) and 6 isolates of non-fermenting gram-negative bacilli (NFGNB) were isolated. Clinical conditions present in study subjects were chronic lung disease in 31cases (38.7%) followed by acute kidney failure in 27 cases and anaemia in 24 cases. Three cases also had gastrointestinal disease. Source of infection in culture positive patients were pneumonia 9 cases (34.6%), UTI 8 cases (30.7%), skin wounds/cellulitis 4 cases (15.3%), meningitis and biliary tract infection 3 cases each (11.5%). Source of infection in culture negative cases was pneumonia 19 cases (35.1%) followedbyUTI11cases (20.3%). Conclusion: PCT proved to be a reliable marker for sepsis diagnosis and is more relevant than CRP in patients with a positive blood culture.</p> Vidya Sagar Ram Granth Kumar Amit Varshney Rashmi Copyright (c) 2022 Vidya Sagar Ram, Granth Kumar, Amit Varshney, Rashmi http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 82 85 A Hospital-Based Study on Febrile Seizure and Iron Deficiency Anemia at A Tertiary Care Centre in Bihar https://ijhcr.com/index.php/ijhcr/article/view/4050 <p>Introduction: Febrile seizure is the most common convulsive disorder in children which strikes 2% to 5% of children between 3 to 60 months of age. Some of the recent studies have reported that iron deficiency could be a risk factor for febrile seizure because the latter is more common in children under two years and iron deficiency anemia is also common in children of the same age. Here, we compared the iron status of children with febrile seizures and controls to investigate the association between iron status and febrile seizures in children admitted in Nalanda Medical College &amp; Hospital, Patna, Bihar. Methodology: This prospective case control study was performed between October 2020 to September 2021. The study population consisted of 100 patients aged 6 to 60 months admitted in the Department of Pediatrics of Nalanda Medical College &amp; Hospital, Patna, Bihar. 30 children with febrile seizures and 30 controls with febrile illness only were included in the study. The parents of all patients provided written informed consent for inclusion in the study, which was approved by the Institutional Ethics Committee. Results: The majority of FS were noted in the 6 to 24 months age group, which included more than 50% of the study subjects. Upper Respiratory Infection (URI) was the most common cause of febrile illness in our study. The mean temperature (measured from axilla) in the case group during the FS attack was 100.9 ± 2.1 °F which was significantly higher compared to the control group which was 98.2 ± 1.1 °F (p-value &lt;0.05). Conclusion: Based on our study, there is strong evidence that parameters such as gender, peak body temperature, underlying cause of fever, &amp; microcytic hypochromic anemia are the risk factors in occurrence of the first febrile seizure episode.</p> Ranjit Kumar Syed Atif Hassan Sneha Jaiswal Binod Kumar Singh Copyright (c) 2022 Ranjit Kumar, Syed Atif Hassan, Sneha Jaiswal, Binod Kumar Singh http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 86 88 A morphometric study of Mandibular Foramen in dry skulls and its clinical implications https://ijhcr.com/index.php/ijhcr/article/view/4051 <p>Introduction The mandibular foramen (MF) is an opening which is found in the medial surface of the ramus of the mandible. It leads to mandibular canal which contains neurovascular structures such as Inferior alveolar nerve and vessels. Aims &amp; Objective: To determine the location of mandibular foramen in relation to surrounding important reference points in dry adult human mandibles of South Indian population. Material &amp; Methods: The study was conducted in 100 adult dry human mandibles of unknown sex obtained from the Department of Anatomy of a private medical college in Bangalore. Inclusion criteria: Intact mandibles with sockets for third molar teeth were included in the study. Damaged mandibles, mandibles with pathological abnormalities were excluded from the study. The position of Mandibular Foramen was determined using the distances of the mandibular foramen to the (a) base of mandible (MF-MB), (b) mandibular notch (MF-MN), (c) anterior border of the ramus (MF-AB) (d) posterior border of the ramus (MF-PB). The measurements were done on both sides with the help of a sliding vernier caliper. Observation &amp; Results: The mean distance between the mandibular foramen and the base of the mandible was noted as 23.42 mm on the right side and 24.16 mm on the left side. The mean distance between the mandibular foramen and the mandibular notch was noted as 22.42 mm on the right side and 22.38 mm on the left side. There were no significant difference observed in the location of mandibular foramen in relation to the surrounding reference points between both the sides. Conclusion: The present study provides the location of the mandibular foramen in relation to surrounding important reference points in dry adult human mandibles of South Indian population.</p> Jyothi Lakshmi G.L. Vishma B.K. Asharani S.K. Copyright (c) 2022 Jyothi Lakshmi G.L., Vishma B.K., Asharani S.K. http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 89 91 Early enteral nutrition versus parenteral nutrition after resection of esophageal cancer https://ijhcr.com/index.php/ijhcr/article/view/4052 <p>Background: Esophagectomy for esophageal cancer is one of the most invasive procedures among gastrointestinal surgeries, and patients undergoing esophagectomy are unable to gain nutrition by mouth within the first few days after surgery. The present study compared early enteral nutrition versus parenteral nutrition after resection of esophageal cancer. Materials &amp; Methods: 52 cases of esophageal cancer of both genders were divided into EEN group and PNgroup. Each group Comprised of 26 each. Factors such as site of lesion, pathologic stage, time to first fecal passage, post-operative albumin infusion, differences of serum albumin value, hospital stay, systematic inflammatory response syndrome (SIRS) duration and mortality was recorded. Results: Group I comprised of 18 males and 8 females and group II 14 males and 12 females. Site of lesions was upper thoracic in 12and 11, middle thoracic in 9 and 10 and lower thoracic in 5 and 5 in group I and group II respectively. Pathologic stage was 0 seen in 1 and 2, I in 4 and 6, II in 12 and 10, III in 6 and 6 and IV in 3 and 2 in group I and group II respectively. Preoperative adjuvant therapy was neoadjuvant in 15 and 16 and chemoradiotherapy in 11 and 10 in group I and group II respectively. The mean preoperative serum albumin (g/L) was 33.5 and 34.2, first fecal passage (day) was 2.7 and 3.8, hospital stay (day) was 16.2 and 18.7, albumin infusion (g) was 30.5 and 40.3, SIRS duration (day) was 3.4 and 4.7 and in-hospital mortality was seen in 1 and 2 in group I and group II respectively. The difference was significant (P&lt; 0.05). Conclusion: Early EN is safe, economic, and superior for promoting early recovery of intestinal movement.</p> Ravi Anand Manoj Kumar Sonkar Copyright (c) 2022 Ravi Anand, Manoj Kumar Sonkar http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 92 94 A descriptive study on Non Communicable Disease among nursing personals in a Medical Teaching Institute, Kolkata https://ijhcr.com/index.php/ijhcr/article/view/4053 <p>Background- Nursing personnel are one of the important man power in health system. India has 1.7 nurses per 1,000 population, 43% less than the World Health Organisation norm. This creates a huge workload on Nurses. Due to busy schedule and night shift, physical activity was less among them which leads to obesity and other Non-Communicable Disease (NCD). Very few study was conducted in India in this aspect. With this background present study was conducted to find out proportion of NCD and association of different factors with NCD. Methods – Institutional based cross sectional study was conducted in a Medical Teaching Institute in Kolkata from January 2021 to March 2021. Sampling was done by complete enumeration and total 545 nurses were interviewed by a pre-designed, pretested structured questionnaire. Descriptive statistics such as frequency, percentage, mean, and standard deviation were used to describe the demographic profiles of respondents, the level of awareness, and the extent of practice. Chi-square test was applied to study the association and p-value obtained. Logistic regression was done to find out odds ratio. The p-value of less than 0.05 was considered statistically significant.Results - Proportion of any one non communicable disease was 23.2%. Majority of population belonged to 23-35 years age group , married , Hindu , Residing in nuclear family in Urban area and had GNM qualification. Age, education, caste, marital status, work load, obesity, anxiety and stress had significant association with NCD profile. Conclusion: Regular physical activity should be performed to prevent development of NCDs. Periodic medical check-up of nursing personnel should be conducted for early diagnosis of NCDs. Importance should also be given on workplace stress reduction.</p> Debadatta Chakrabarty Shibasish Banerjee Pulak Kumar Jana Soumitra Mondal Muktisadhan Maiti Debasis Das Copyright (c) 2022 Debadatta Chakrabarty, Shibasish Banerjee, Pulak Kumar Jana, Soumitra Mondal, Muktisadhan Maiti, Debasis Das http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 95 100 Bacterial Meningitis Among Pediatric Patients Presenting With Acute Febrile Seizure: A Report From A Tertiary Care Center Of Bihar https://ijhcr.com/index.php/ijhcr/article/view/4054 <p>Introduction: Febrile seizures usually affect children between the ages of five months and six years with a prevalence of 3-8%, which makes them the most common type of seizures in childhood. Bacterial meningitis is one of the deadliest infections, affecting both adults and children, and defined as inflammation of the meninges covering the brain. With this background, a secondary data analysis was planned to find out the incidence of meningitis among pediatric patients presenting with febrile seizures. Methodology: A retrospective cross-sectional study on 150 Patients was conducted by the Department of Pediatrics Nalanda Medical College &amp; Hospital, Patna, Bihar. Prior approval was obtained from the Institutional Ethics Committee. The study covered all patients who were diagnosed with or suspected of having febrile seizures in the period between September 2020 to August 2021. The patients’ data were obtained from the hospital database and analyzed. Results: A total of 150 patients who presented to the hospital with febrile seizures in the period between September 2020 to August 2021 were identified, with a median age of 22.5 months. There was a male preponderance in the study population with 62.7% of patients being boys. Bacterial meningitis was suspected and lumber puncture was performed among 17 out of 150 patients, this comprised 11.3% of the total study population. Conclusion: Febrile seizures are one of the most common presentations in the pediatric emergency department. Clinical judgment and balance between risk and reward remain the cornerstone in deciding which patients are more likely to benefit from the lumbar puncture.</p> Syed Atif Hassan Ranjit Kumar Madiha Shadab Binod Kumar Singh Copyright (c) 2022 Syed Atif Hassan, Ranjit Kumar, Madiha Shadab, Binod Kumar Singh http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 101 103 Study of effect of dexmedetomidine with levobupivacaine on the onset and duration of analgesia and anaesthesia in brachial plexus block https://ijhcr.com/index.php/ijhcr/article/view/4055 <p>Objective: To Compare the efficacy Of Dexmedetomidine as an Adjuvant to Levobupivacaine in Axillary Brachial Plexus Block in Upper Limb Surgeries. Materials and methods: Hundred patients aged 18 to 60 years, scheduled for elective orthopedic operations in the upper limb, under axillary approach of brachial plexus block were randomized to two equal groups of 50 each into Group LBD receiving 25 ml of 0.5% levobupivacaine and Dexmedetomidine(1 mcg/kg) , while group LB received 25 ml of 0.5% levobupivacaine .The primary objective was to compare duration of sensory ( post operative analgesia ) block with or without addition of Dexmedetomidine to levobupivacaine . The secondary objective was to compare the onset and duration of sensory and motor block and hemodynamic parameters following the block between the groups intraoperatively at regular intervals. Results: There is significant prolonged duration of sensory and motor blockade in group LBD compared to group LB (P&lt;0.001). Mean duration of sensory blockade (Group LBD, 14.91±1.19 hrs and Group LB, 10.73±.888 hrs). There is significant early onset of sensory and motor block in group LBD compared to group LB (P&lt;0.001) [Onset of sensory block (group LBD, 7.8±1.58min; group LB, 11.04±1.55 min). Onset of motor block (group LBD, 14.2 ± 2.12min; group LB, 16.14 ± 2.119 min)]. Conclusion: Dexmedetomidine 1μg/kg when added to 25mL of Levobupivacaine 0.5% for axillary brachial plexus block speeds the onset of sensory and motor blocks (P &lt; 0.05). The combination produces improved analgesia, resulting in a prolonged effect and reduced requirements for rescue analgesics</p> Prajnyananda Das Satyajit K Sahoo Basanta K Pradhan Copyright (c) 2022 Prajnyananda Das, Satyajit K Sahoo, Basanta K Pradhan http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 104 107 Pattern and visual outcomes of ocular fire-cracker injuries during Diwali festival in a tertiary Care Hospital in North India https://ijhcr.com/index.php/ijhcr/article/view/4056 <p>Background: The firecrackers are used widely during Diwali. Eyeball is one of the most commonly injured organ in firecracker injuries. The fire-crackers can cause irreparable damage to ocular structures, leading to blindness. This study was conceptualized to study the pattern of injuries resulting from fire-cracker use and their visual outcomes, in order to generate evidence for managing these injuries more effectively. Material and Methods: This longitudinal, descriptive study was carried out over a period of one week during Diwali festival in 2019, in a tertiary care teaching hospital in North India in 21 patients who presented to hospital with ocular injuries caused by firecrackers. Visual acuity was recorded and complete slit lamp examination, non-contact tonometery, and gonioscopy was done. Ultrasound B-scan and X-ray were also done, when required. Results: The mean age in our study was 18.42±11.88 years with age range of 7-57 years. There were 20 males and 1 female in the study. Most of the injuries were caused by bombs and sparkles. Most of the patients (50%) had visual acuity in range of 6/6-6/24 at the time of presentation. Conjunctival surface was involved in all the patients, followed by lids and cilia (59.09%). One patient had corneal perforation with uveal tissue proplase.Six patients had vitreous haemorrahge and seven patients had hyphema. Final visual outcome was favorable with 63.64% patients achieving vision of 6/6- 6/24 at the end of six weeks. Conclusion: Severe injuries can lead to permanent loss of vision or decreased vision from squealae of wound healing such as astigmatism. Hence, stricter implementation of existing laws and regulations, public education and awareness is needed to prevent avoidable blindness resulting from use of fire crackers.</p> Pallavi Sharma Anu Radha Bharti Sachit Mahajan Copyright (c) 2022 Pallavi Sharma, Anu Radha Bharti, Sachit Mahajan http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 108 111 A comparative study of anthropometric parameters and their relation to arterial blood pressure and fasting blood glucose in type -2 diabetes mellitus patients and non-diabetic controls https://ijhcr.com/index.php/ijhcr/article/view/4057 <p>Background: Patients of Diabetic Mellitus (DM) are more prone for cardiovascular disease. Concomitant chronic diabetes mellitus and cardiovascular disease can have devastating consequences which can worsen the future outcomes of these diseases related to mortality and morbidity. Hence constant follow up of the patient with effective prognostic indicators is very important in modulating the disease outcome either by medical or surgical intervention. At the same time it is even more important in identifying appropriate indicators for assessing the status of the patient. Even though few available indicators are useful in accurately predicting the disease status of the patients, considering the socioeconomic status of countries like India it is desirable to find alternative approaches having qualities of affordability, adoptability, accessibility and applicability. Objectives: To assess Body mass index (BMI), Waist circumference (WC), Arterial Blood pressure (BP) and Fasting blood glucose (FBS) in persons of 40-60 years having Type 2 diabetes mellitus and in age and sex matched healthy persons.To compare the parameter in the above two groups and also to find correlation between anthropometric parameters like BMI and WC with FBS and BP. Materials and methods: Anthropometric measures (BMI, WC) ,Fasting blood sugar (FBS) and blood pressure (BP) were measured ,compared and their correlation was studied in male patients with type 2DM (Group 2) and normal healthy male subjects (Group1) of age group 40-60 years. Results on continuous measurements are presented on Mean ± SD and significance was assessed at 5 % level of significance. Student t test (two tailed, independent) has been used to find the significance of study parameters. Pearson correlation has been used to find the correlation of BMI and WC with FBS and BP. Result: In the present study, there was significant increase in DBP in diabetics and not much difference in SBP when compared to healthy individuals. Also, it is observed that BMI is positively correlated with FBS, and SBP. It is also observed that WC is strongly positive correlated with SBP and DBP and a weakly positive correlated with FBS. Conclusion: From the findings of the present study it is concluded that both BMI and WC had a positive correlation with FBS and BP.Thus simple anthropometric measures like BMI and WC can independently contribute to the prediction of risk factors of CVD and can be routinely used to identify those at risk.</p> Santosh Palekar Pradeep Reddy Srikaram Srikanth T Copyright (c) 2022 Santosh Palekar, Pradeep Reddy Srikaram, Srikanth T http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 112 116 A Study On Correlation of Various Prostate Pathology With Serum Prostate Specific Antigen At A Tertiary Care Centre In Bihar https://ijhcr.com/index.php/ijhcr/article/view/4059 <p>Introduction: Diseases primarily inflicting prostate gland are inflammation, benign nodular enlargement, and tumors. Serum prostate-specific antigen (PSA), a marker for prostatic carcinoma has high sensitivity, specificity, and compliments histopathological diagnosis. Gleason's microscopic grading is a paramount feature and with PSA are important for diagnosis, management, and prognosis of carcinoma. Methodology: Clinicopathological study of 100 prostatic biopsies was conducted in the Department of General Surgery, Darbhanga Medical college and Hospital, Darbhanga, Bihar, India, over a period of One year from January 2020 to Dcember 2020. The study was approved by the Institutional Ethical Committee and all patients gave informed written consent. All patients presenting with LUTS underwent DRE and were worked up with USG KUBP, Serum PSA and biopsy (if indicated) after obtaining consent. Results: A total of 100 patients were included in the study. The mean age in our study was 62.5 years [range 50-90 years]. The majority of the patients in the study group were in the age group of 61-70 years. PSA levels of the patients were compared according to their age. The mean serum PSA for age group 50-60 years was 3.9 ng/ml, for age group 61-70 was 15.2 ng/ml, for age group 71-80 was 11.3ng/ml, for age group 81-90 was 11.4 ng/ml. The mean serum PSA for the whole group was 13.2 ng/ml. The mean serum PSA level was found to increase with each decade, starting from 50 years up to 90 years (p&lt; 0.05). Conclusion: Mean serum PSA levels rises with increasing age. Serum PSA levels has a significant correlation with International prostate symptom severity scoring wherein mean serum PSA level rises with severity of LUTS. However, serum PSA levels do not show significant correlation with Gleason score or clinical stage of prostate cancer.</p> Awadh Kumar Md Muntaka Neeraj Kumar Rajak Gaurav V S Prasad Copyright (c) 2022 Awadh Kumar, Md Muntaka, Neeraj Kumar Rajak, Gaurav, V S Prasad http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 117 119 A Study on Color Doppler and Non Stress Test as Predictor of Perinatal Outcome in Pregnancy Induced Hypertension and Intrauterine Growth Restriction in a Tertiary Care Hospital in Eastern India https://ijhcr.com/index.php/ijhcr/article/view/4060 <p>Introduction: Antepartum surveillance to evaluate fetal health have been the focus of intense interest for more than decades. The timely detection of morbid changes in fetal status followed by adequate interventions to avoid death or disabilities, is of paramount importance.<br>Objective: To compare the effectiveness of non-stress test and color doppler studies in the prediction of perinatal outcome in terms of mode of delivery , gestational age at delivery, birth weight , admission in neonatal intensive care unit (NICU), fetal morbidity and mortality.<br>Material &amp; Methods: A prospective observational study was conducted among (n=100) antenatal patients admitted in the obstetric indoor of a hospital in Kolkata, West Bengal complicated by pre eclampsia and intra uterine growth retardation (IUGR) beyond 34 weeks of gestation after matching with inclusion and exclusion criteria. Recruited participants were then divided into four groups: group A having both tests normal, group B with normal NST and abnormal doppler, group C with normal doppler and abnormal NST and group D with both abnormal tests respectively. The patients were followed by serial fetal doppler assessment and non- stress test (NST). The results of the last doppler and NST within one week of delivery were considered in the subsequent correlation with perinatal outcome. The time interval in days between the first abnormal doppler and the development of abnormal NST was used to calculate the lead time. The perinatal outcome parameters studied were mode of delivery, gestational age at delivery, birth weight, neonatal morbidity in terms of Apgar score &lt; 7 at 5 minutes, NICU stay, and perinatal mortality. The major adverse perinatal outcomes, if any was observed amongst the four study groups.<br>Results: 40% percent of multigravidas had a history of preeclampsia in their previous pregnancy. 18% of the study population had a combination of preeclampsia and IUGR. 38 women had both NST and doppler study normal (Group A) while both tests were abnormal in 31 patients (Group D).There were 54 women with abnormal doppler findings and 39 with abnormal NST. Brain sparing effect (BSE) was seen in 38 women. Group A had majority of cases (65.78%; 25 out of 38) with only IUGR and had the least morbidity and best perinatal outcome. Group D had the maximum number of cases having combined preeclampsia with IUGR (70.96%; 22 out of 31) and had the worst perinatal outcome associated with prematurity and low birth weight; there were only 15.78% NICU admission in the group A; in contrast 77.4% fetuses required NICU admission in group D. Only 39.4% had operative delivery for fetal distress in group A in contrast to 70.96% women in group D. There were 4 intra uterine and 13 neonatal deaths. Majority of fetuses showed abnormal doppler changes prior to NST. The lead time varied between 0-9 days with a mean of 4.11 days.Conclusion: Though both test results were effective in predicting abnormal perinatal outcome, a significant advantage of doppler over NST was it showed abnormal changes earlier than NST giving a significant lead time of up to 9 days which is important in the management of preterm high -risk pregnancies. An abnormal NST following an abnormal doppler is associated with the worst perinatal outcome. Both the tests are complimentary to one another in fetal surveillance of high -risk pregnancies.</p> Apurba Mandal Kajal Kumar Patra Shibram Chattopadhyay Tanushree Roy Arunava Biswas Tanmay Mandal Copyright (c) 2022 Apurba Mandal, Kajal Kumar Patra, Shibram Chattopadhyay, Tanushree Roy, Arunava Biswas, Tanmay Mandal http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 121 125 Prevalence of Acanthosis Nigricans in a Population Attending a Tertiary Care Centre in Western India and it’s Utility to Detect Metabolic Syndrome https://ijhcr.com/index.php/ijhcr/article/view/4061 <p>Background: Acanthosis Nigricans (AN) is a dermatosis with thickened, hyperpigmented plaques immediately recognizable. The metabolic syndrome (MetS) is a collection of metabolic risk factors that include central obesity, glucose intolerance, hyperinsulinemia, low HDL cholesterol, high triglycerides, and high blood pressure. The skin biomarker AN is linked to this syndrome.Aims and Objectives: To study the prevalence of AN and associated factors in patients that predicts the risk of MetS.Materials and Methods: Five hundred and forty-seven patients with AN were studied over a period of two years. Complete dermatological assessment of skin, including distribution and grading of AN, was performed. Evaluation for metabolic syndrome, including body mass index (BMI), waist and hip circumference, waist-hip ratio (WHR), blood pressure, was noted. Laboratory investigations like fasting blood sugar (FBS), post prandial blood sugar (PPBS), fasting insulin, lipid profile, serum B12, and thyroid function test were done in all patients of AN. Results: Prevalence of AN was 6.5%. The majority had an age between 11-20 years (32.9%). Benign acquired AN (70.7%) was the commonest type of AN, while syndromic AN (17.9%) was the second most common type. Patients of AN with MetS were older (28.4±11.7 years; p=0.0184), had BMI more than 30 (31.5±4.6; P&lt;0.001), higher waist circumference (100.6±10.9 cm; P&lt;0.001), higher WHR (0.92±0.05; P=0.0242), higher FBS (102.3±21.6; P&lt;0.001) and PPBS (130.9±39.1; P&lt;0.001) and higher fasting insulin level (25.7±13.7; P&lt;0.001) compared to those without MetS. Linear regression revealed that BMI (R2=0.08334, P=0.0004 for patients of AN without MetS and R2=0.06377, P&lt;0.001 for patients of AN with MetS), waist circumference (R2=0.05999, P=0.003 for patients of AN without MetS and R2=0.07336, P&lt;0.001 for patients of AN with MetS) and WHR (R2=0.03603, P=0.0222 for patients of AN without MetS and R2=0.008235, P=0.0764 for patients of AN with MetS) has a much more significant effect on insulin in the patients of AN with MetS.Conclusion: AN was common in our study population and the presence of AN strongly predicts metabolic syndrome.</p> Jaydipkumar Tank Darshan Karia Bela Shah Radha Dhudshia Copyright (c) 2022 Jaydipkumar Tank, Darshan Karia, Bela Shah, Radha Dhudshia http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 126 129 Clinical and Electrophysiological Profile of Chronic Kidney Disease Patients Undergoing Peritoneal Dialysis at a Tertiary Care Centre of Bihar https://ijhcr.com/index.php/ijhcr/article/view/4062 <p>Chronic kidney disease (CKD) is a progressive decline in renal function, which is responsible for significant morbidity and mortality. The present study was carried out to assess prevalence of peripheral neuropathy in CKD patients on PD patients with special emphasis on electrophysiological parameters and severity of peripheral neuropathy and its relation with diabetes mellitus. Methodology: During the period from November 2020 to April 2020, 50 consecutive patients diagnosed to have CKD and are on OPD at J.N.K.T. Medical College, Madhepura, Bihar, India were included in the present study. Patients with pre-existing peripheral neuropathy prior to the diagnosis of CKD were excluded from the present study. The study was approved by the Institutional Ethics Committee and written informed consent was obtained from the patients for their participation in the study. The patients were divided into two equal groups, randomly: Group 1 included 25 diabetic patients Group 2 included 25 nondiabetic patients. All cases were subjected to nerve conduction studies (NCS) using Medelec synergy and Natus machines. NCS procedure was done for both motor conductions and sensory conductions. Median nerve, ulnar nerve, common peroneal nerve, and posterior tibial nerve were assessed for motor conductions. Median nerve, ulnar nerve, and sural nerve were assessed for sensory conductions. Results: The prevalence of peripheral neuropathy among the study participants was 62% (31 out of 50) based on clinical symptoms and 80% (40 out of 50) based on electrophysiological parameters. Based on electrophysiological data, prevalence of peripheral neuropathy in CKD patients on PD with DM and without DM was 100% and 60%, respectively. Conclusion: Rationale management of diabetes in CKD patients on PD probably lowers the prevalence and severity of peripheral neuropathy.</p> Mritunjay Kumar Azad Abha Prasad Malti Kumari Copyright (c) 2022 Mritunjay Kumar Azad, Abha Prasad, Malti Kumari http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 130 133 Microbiological profile of blood culture Isolates in a Tertiary Care Hospital in Maharashtra https://ijhcr.com/index.php/ijhcr/article/view/4063 <p>Background: Blood stream infections (BSI), ranging from self-limiting infections to life threatening septicaemia remain one of the most important cause of morbidity and mortality. BSI can be preceded, followed or be concomitant to a localized or disseminated infectious disease. Blood cultures remains the gold standard diagnostic test for detecting septicemia.Objective:1.To study the profile of microbiological isolates causing Blood Stream Infections in suspected cases of septicaemia2.To determine the antibiotic susceptibility pattern of bacterial isolatesMaterials and methods:<br>The study was carried out in Department of Microbiology at GMC, Akola from January 2018 to December 2020. Blood samples from 2322 patients with a clinical diagnosis of sepsis were processed under standard protocol. Results:A culture positivity of 5.25% was observed. Of the total 122 isolates, 52 (42.59%) Gram‑negative rods, 46 (37.7%) Gram‑positive cocci and 24 (19.66%) Candida species were isolated. The predominant GNR were Pseudomonas spp. 16(13.11%) followed by Klebsiella spp. 14(11.47%) and Escherichia coli 12(9.83%). E. coli (16.66%) and Klebsiella spp. (28.57%) were found to be ESBL producers. Among Gram-positive cocci, S. aureus 32(26.22%) was commonest with MRSA (87.5%), followed by Enterococci spp. (4.9%) and CONS (4.9%). Conclusion: Timely identification of pathogen and its susceptibility to antimicrobial agents is of great diagnostic and prognostic importance to decrease related mortality and morbidity. Antimicrobial stewardship programme on regular basis guides in decreasing antimicrobial resistance.</p> Poovvizhi.M Poojashri Sharma Rupali S Mantri Nitin A Ambhore Copyright (c) 2022 Poovvizhi.M, Poojashri Sharma, Rupali S Mantri, Nitin A Ambhore http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 134 139 Refractive Errors Among School Going Children in Srikakulam District, North Coastal Andhrapradesh https://ijhcr.com/index.php/ijhcr/article/view/4064 <p>Purpose : Avoidable blindness mainly due to uncorrected refractive errors is a major challenge to health care policy makers. School screening for refractive errors has been an useful programme to overcome this problem. The aim of the present study was to report the prevalence of refractive error among school children in srikakulam distict. Methods: A cross sectional study was carried out among 1682 school children between age group of 10-15 years under school screening programme. Results: the prevalence of refractive errors was found out to be 3.62%. the prevalence of refractive errors was more in female children (57.3%)when compared to male children(42.6%). The most common refractive error was found to be myopia(60.65%) followed by astigmatism(36%) followed by hypermetropia(3.27%). There is increased incidence of refractive errors in older age group 39.34% were present in 14-15 years of age. Conclusions: this study imparts screening of not only school going children but also all school aged children to treat refractive errors and prevent further complications by uncorrected refractive errors.</p> Lakshmi Sativada Dineshkanth Vudayana Mounika Danda Sitamani Mummidivarapu Padmaraju Kolluru Copyright (c) 2022 Lakshmi Sativada, Dineshkanth Vudayana, Mounika Danda, Sitamani Mummidivarapu, Padmaraju Kolluru http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 140 142 Role of vitamin D in management of depression https://ijhcr.com/index.php/ijhcr/article/view/4065 <p>Background: Major depressive disorder (MDD) is a common psychiatric disorder leading to severe dysfunction in multiple spheres of life. Etiopathogenesis of MDD is multifactorial with multiple inconclusive theories including putative role for vitamin D so it has been investigated as a potential strategy for the prevention and/or treatment of depressive symptoms. Method: A longitudinal study in patients of Major Depressive Disorder as per DSM-5 attending the psychiatry outpatient department (OPD), from March 2018 - June 2019 of a tertiary care center was planned. Sociodemographic data was collected .Level of vitamin D was assessed at 0 and 12 weeks. . Patients were divided into 2 groups i.e. cases (patients with low vitamin D) and controls (patients with normal vitamin D). Cases were further divided into 2 groups, out of which one group was supplemented with vitamin D(60k/week) and the other group was not supplemented with vitamin D. All the above groups were given antidepressant (Sertraline) with benzodiazepines (Lorazepam) according to clinical assessment. Severity of the disease was assessed using MADRS and HAM-A at 0,4,8,and 12 weeks. Result: Out of 78 patients who were enrolled in the study, low vitamin D level was seen in 76.9% of the patients. At 0 week out of 60 cases, 30% had mild depression, 70% had moderate depression, while none of the cases had severe depression and 8.33% had mild anxiety ,55.00% patients had moderate anxiety, 36.66% had severe anxiety. Analysis of mean MADRS and HAM-A scores was done by taking into consideration all the three groups i.e. cases with vitamin D supplementation, cases without vitamin D supplementation and controls using ANOVA test at 0 and 12th week through which it could be seen that there was significant difference between all the three groups at 0 week but not at 12 week. Conclusion: Patients with low vitamin D levels are more likely to have depression than general population but there appears to be no beneficial effect of vitamin D supplementation in management of depression.</p> Urvashi Kumar Ashutosh Kumar T.P. Singh Copyright (c) 2022 Urvashi Kumar, Ashutosh Kumar, T.P. Singh http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 143 146 A prospective study to evaluate the functional outcome in fracture neck femur treated by cemented bipolar hemiarthroplasty in elderly patients https://ijhcr.com/index.php/ijhcr/article/view/4067 <p>Introduction: Purpose of this research is to study the functional outcome in elderly patients of fracture neck femur treated by cemented bipolar hemiarthroplasty and to analyze the improvement in the ambulatory status of patient at variable periods of follow up. Materials and methods: This is a prospective observational study of 50 elderly patients (age ≥ 60 years) with femoral neck fractures treated by cemented bipolar hemiarthroplasty. Thorough preoperative, intraoperative and postoperative evaluation was done. Functional outcome was evaluated using Harris Hip Score at each follow up visit. Results:Out of 50 patients, 40 cases were available at the end of 12 months for final follow-up. At the final follow up, 42.50% had excellent results, 37.50% had good results, 12.50% had fair results and 7.50% had poor results. Conclusion: In elderly patients with femoral neck fracture, we recommend the use of cemented bipolar hemiarthroplasty. It provides good ambulatory ability, improves the quality of life in elderly age group and is cost-effective.</p> Anmol Sharma Saurabh Sahu B.K. Jain Siddharth Sagar Jaskaran Singh Copyright (c) 2022 Anmol Sharma, Saurabh Sahu, B.K. Jain, Siddharth Sagar, Jaskaran Singh http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 147 156 Assessment Of Covid-19 Patients Under Home Isolation In Rewa,M.P.,India City, Madhya Pradesh https://ijhcr.com/index.php/ijhcr/article/view/4068 <p>Background: COVID-19 causes a variety of symptoms in people who are infected. Asymptomatic persons can transmit the virus to others for an extended period. Home isolation of asymptomatic and mild symptomatic cases has been an important remedial measure by Government of India to halt the spread of COVID-19. Objectives- To assess the clinico-demographic profile and compliance to isolation practices and experiences shared by COVID-19 patients under home isolation in Rewa city. Materials and methods:A Retrospective observational study was conducted to assess home isolated COVID Positive patients during July to October 2020 by a questionnaire based telephonic interview.Results- 66% patients were males and 58% patients gave history of contact with other Covid positive patient. 96% patients showed high compliance with the isolation rules.Conclusion: Continuous observation and follow-up of the home isolated COVID-19 patients by health teams had resulted in their compliance with the isolation practices and the patients were quite satisfied with the services provided by the government.</p> Shubhangi Nayak Chakresh Jain Alka Modi Neera Marathe Copyright (c) 2022 Shubhangi Nayak, Chakresh Jain, Alka Modi, Neera Marathe http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 157 160 Evaluation of clinical profile of post menopausal women presenting with postmenopausal bleeding in tertiary care hospital https://ijhcr.com/index.php/ijhcr/article/view/4069 <p>Objectives: 1.To evaluate the clinical profile of postmenopausal women presenting with postmenopausal bleeding2.To evaluate the causes of postmenopausal bleeding. Methods: It is a retrospective observational clinical study of 48 postmenopausal women presenting with complaints of postmenopausal bleeding who attended out-patient department of Obstetrics and Gynaecology in Sri Padmavati medical college and hospital for women, Tirupathi from the period between January 2019 - December 2019.Detailed clinical history including obstetric history, past medical and surgical history, age at menopause; onset of symptoms since menopause noted; general physical examination, systemic examination, detailed gynaecological examination including per speculum, bimanual examination performed. Pap smear, cervical biopsy and endometrial sampling and transvaginal ultrasonography was performed in all cases.Results:29.16% of the women presenting with postmenopausal bleeding were in age group 61-65 years. 31.25% (15 cases) came with complaints of postmenopausal bleeding within 1-5 years of menopause. Pap smear was abnormal in 14 cases (29.16%). Histopathology of cervical biopsy showed 16.66% (8 cases) had carcinoma cervix. Histopathology of endometrial biopsy showed atrophic endometrium in 39.58% cases, 16.66% (8 cases) had endometrial carcinoma. Conclusion:Postmenopausal bleeding is a common clinical problem in postmenopausal women. It requires immediate evaluation. Community level awareness has to be made to decrease the time between symptom presentation and evaluation and treatment.</p> Malathi Jonna Akila.B Sivakumar Vulava Copyright (c) 2022 Malathi Jonna, Akila.B, Sivakumar Vulava http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 161 163 Comparative study to evaluate the clinical efficacy and safety of Isobaric Levobupivacaine Versus Hyperbaric Bupivacaine in lower limb orthopaedic surgeries https://ijhcr.com/index.php/ijhcr/article/view/4070 <p>Introduction: Spinal anesthesia is a popular technique for lower limb orthopaedic surgeries. Hyperbaric bupivacaine in 8% glucose is often used. Clinically, this manifests as an unpredictable median sensory block height with a large inter individual spread and is occasionally associated with block failure when the spinal block has not spread high enough for surgery. Materials and Method: This is prospective and cross-sectional study conducted at Department of Anesthesia, Tertiary care teaching Hospital over a period of 1 year. Total 60 patients scheduled for elective lower limb surgeries, ASA physical status class I or II, were enrolled into this prospective randomized, double blind study. Patients were randomly divided into two groups. For Group L (n = 30); 12.5 mg 0.5% (2.5 ml) levobupivacaine, for group B (n = 30); 12.5 mg 0.5% (2.5 ml) bupivacaine heavy administered intrathecally within some 10 seconds. Results: In both groups, there is a percentage decrease in SBP (mean preoperative SBP 127.93 ± 6.50 mmHg for Group B and 128.70 ± 5.40 mmHg for Group L) and DBP (mean preoperative DBP 78.83 ± 3.42 mmHg for Group B and 80.13 ± 3.05 mmHg for Group L) after 12 minutes of anesthesia (p=0.0157); and at 50, 55, 60, 65 min incidences of hypotension have more in Group B (p=0.0445, p=0.0365, p=0.0090, p=0.0202 respectively). Duration of surgery and duration of anaesthesia were also noted. Mean duration of surgery was 94.0667 ± 26.0714 minutes (range 20 130 min) in Group B versus 95.9667 ± 16.9349 minutes in Group L (range 45 120 min. Mean duration of anaesthesia was 104.6000 ± 24.4111 minutes in Group B (range 30 140 min) versus 101.4333 ± 26.4193minutes in Group L (range 25 130 min). No significant differences between the groups (p=0.6315). Conclusions: The results of this study indicate that levobupivacaine and racemic bupivacaine show equally effective potencies for spinal anesthesia. Bupivacaine group showed earlier onset of action but there is no significant difference between levobupivacaine and bupivacaine regarding the duration of sensory and motor blockades. Intrathecal administration resulted in higher incidences of bradycardia in bupivacaine group.</p> Pradip Kumar Mandal Burulukui Hembram Subir Kumar Brahma Copyright (c) 2022 Pradip Kumar Mandal, Burulukui Hembram, Subir Kumar Brahma http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 164 168 Isometric hand grip exercise: Can it be beneficial for cardiovascular health? https://ijhcr.com/index.php/ijhcr/article/view/4071 <p>Introduction: Isometric Hand Grip(IHG) exercise may be of value in maintaining the desired Blood Pressure(BP),Heart Rate(HR) and Capillary Blood Glucose(CBG) in individuals with inability or unwillingness to do conventional aerobic exercises. Contrary to the belief that IHG exercise causes cardiovascular strain, there are some evidences that IHG exercise leads to maintain the cardiovascular parameters. So this study is framed to establish the positive and negative effect in the above mentioned cardiovascular parameters post static exercise. Objective: To determine the immediate effect of graded isometric hand grip exercise on Systolic and Diastolic blood pressure, Heart Rate and Capillary Blood glucose in young healthy adults. Materials and Methods: Present study was conducted on 82 healthy adults aged between 18 to 25 years including both sexes. Subjects having any form of hypertension, other cardio-vascular co-morbidities and any diseases involving wrist joint and palmar diseases are excluded from this study. Systolic and Diastolic Blood pressure, Heart Rate&amp; Capillary Blood Glucose are measured single handedly at resting condition, after 30% Maximum voluntary contractions (MVC), after high load contractions, Post sham, and 1 hour post sham. Result: It is revealed that after 30% MVC and post high load ,SBP and DBP is significantly increased compared to resting condition but after post sham, SBP and DBP is significantly decreased in both sexes.There is no significant change found in 1 hour post sham condition. Heart Rate is increased in 30%MVC and Post Highload condition but in post sham and 1hour post sham condition HR is not decreased significantly. Capillary Blood Glucose(CBG) is increased without any statistical significance in 30% MVC and Post High load condition but significantly decreased in 1 hour post sham condition. Conclusion: IHG Exercise for BP management in normotensive young people is significant. But it may not be useful in the management of Heart Rate and Blood Glucose.</p> Subhendu Bag Sangita Sen Copyright (c) 2022 Subhendu Bag, Sangita Sen http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 169 171 Study of morphological type of cataract in type 2 Diabetes Mellitus patients at a tertiary care centre in Karnataka https://ijhcr.com/index.php/ijhcr/article/view/4072 <p>Objective: To determine the morphological type of cataract seen in type 2 diabetes mellitus patients. Methods: Cross sectional study carried out at a tertiary eye care centre in North Karnataka from2012 to 2014. All patients with type 2 diabetes mellitus 40 years and above diagnosed as per WHO criteria were enrolled. A detailed demographic and complete ocular examination was done. Examination of anterior segment by slit lamp biomicroscopyand grading of lens opacity was done after full dilatation of pupil according to the Lens Opacity Classification System (LOCS) III system. The severity of the lens opacities, according to the photographic standards, was separated into three major groups: nuclear cataract(NC), cortical cataract(CC), and posterior subcapsular(PSC). Results: Out of the 750 patients with Type 2 Diabetes Mellitus enrolled in our study, 492 patients had cataract and 258 had no cataract. 242(60.35%) were males and 250(71.63%) were females. Prevalence of cataract in Type 2 Diabetes was 65.60%.Mixed cataract was seen in 70.52% and monotype in 29.48% patients. A combination of nuclear, cortical and posterior subcapsular cataract had highest incidence with 42.26% followed by cortical cataract with posterior subcapsular 33.43%, nuclear cataract and cortical cataract in 13.83% and lowest incidence was with nuclear cataract and posterior subcapsular cataract with 5.48%. Among the monotype cataract 68.28% of patients had cortical cataract, 25.52% had nuclear cataract and 6.21% had posterior subcapsular cataract. Conclusion: In our study two thirds of the diabetic population showed evidence of cataract and mixed type of cataract was the most commonly seen.</p> Farhat Fatima Ravindra Bankar Copyright (c) 2022 Farhat Fatima, Ravindra Bankar http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 172 175 Role of Ghrelin and Adiponectin among Type 2 Diabetes mellitus patients attended at Tertiary care teaching hospital https://ijhcr.com/index.php/ijhcr/article/view/4073 <p>Introduction: Diabetes mellitus (DM) refers to a bunch of disorders of metabolism that share the phenotypic sign of hyperglycaemia. Different variants of DM are caused due to the interaction of various genetic factors with environmental factors. Methods: overall total number of 50 patients with type 2 DM, aged from 20-60 years attending OPD of a tertiary hospital was taken into study, whose blood glucose level before meals was [≥ 120 mg/dl] and after meals was [≥ 140 mg/dl], taking oral hypoglycaemic medicines only and not taking insulin therapy was included in the examination. Result Overall, 50 patients of age group from 20-60 years were taken in the examination. among which type 2 DM was more predominant in the employed group from 51-60 years (48%) thereby 41-50 years (34%). It was seen that 52% of patient of type-II diabetes mellitus had history of same complaint in the family. From the research, polyuria (52%) and polydipsia (48%) were the commonest symptoms seen in the patients suffering from DM. According to the drug therapy recommendations, Biguanides (92.1%) and Sulfonylurea (87.2%) were the commonest prescribed oral hypoglycaemic medicines amongst entire oral hypoglycaemic group of medicines, followed by thiazolidinediones (19.2%), Dipeptidyl peptidase-4 inhibitors (16%), α-glucosidase inhibitor (3.2%) and meglitinides (1.9%) individually. Conclusion: The increasing pattern of inactive daily life routine and more occurrence of overweight has put up enhancement in the individuals of diabetes, which contributes to enormous requirement of hypoglycemic drugs and motivating corporations to spend much on research and development for producing targeted formulae.</p> Sunita Rajmangal Choudhary Manoj Kumar Rao Copyright (c) 2022 Sunita, Rajmangal Choudhary, Manoj Kumar Rao http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 176 179 Functional outcome of Column-specific Fixation of Complex Tibial Plateau Fractures https://ijhcr.com/index.php/ijhcr/article/view/4074 <p>Background: Complex tibial plateau fractures are usually high energy injuries presenting with significant articular and soft tissue damage in a major weight bearing joint. The knee is a complex dynamic joint that is subjected to many forces during normal activities, so intact articular surface of tibial plateau is one of important factors to keep the geometry and alignment of the knee joint to act in harmony to perform its crucial function as a flexible weight bearing joint. Material and Methods: This prospective study was conducted in the Department of Orthopaedics, a Tertiary Care Teaching Hospital, 27 patients with displaced tibial plateau fractures with posterior column involvement were selected for the study. All age group Patients with complex proximal tibia plateau fractures &amp; closed injuries were included in this study. Involving two or more columns were classified based on the new three column classification system, patients with normal neurovascular function before primary surgery, patients with closed fractures, patients with good soft tissue condition, and patients without serious medical diseases and obvious surgical contraindications. Result: In our study, the most of the patients were belongs to 21-30 years old 13 (48.1%). In table 2, predominant were males 92.5% and females were of 7.4%. In our study majority of patients were Three-column fractures, followed by Two-column fracture and Single-column fractures. After operative procedure, 3 (11.1%) patients got discharged on post op day-7, 14 (51.8%) patients on post op day-8, 7 (25.9%) on post op day-9 and 3 (11.1%) on post op day-10. Conclusion: Using this new column specific strategy to the treatment of these two or more column tibial plateau fracture injuries, which involves evaluation of three columns, we believe we achieved satisfactory results.</p> Teddy Abraham Mathew Mereen Susa Copyright (c) 2022 Teddy Abraham Mathew, Mereen Susa http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 180 182 Study of Renal Volume and Functional Changes in Unilateral Nephrectomy –Our Institutional Experience https://ijhcr.com/index.php/ijhcr/article/view/4075 <p>Introduction: A nephrectomy is the surgical removal of a kidney, performed to treat a number of kidney diseases including kidney cancer. It is also done to remove a normal healthy kidney from a living or deceased donor, which is part of a kidney transplant procedure. Both size and functions, primarily glomerular filtration rate (GFR) and renal plasma flow (RPF), increase almost immediately following unilateral nephrectomy. Aim: To determine short term differences in contralateral renal function and volume in unilateral nephrectomy patients in our institution. Material and Methods: This is a prospective study, Observational and cross-sectional study of all patients who undergo nephrectomy for renal transplantation, malignancy and other renal diseases at Tertiary Care Teaching Hospital over a period 1 year. A total of 62 patients who undergo open or laparoscopic nephrectomy have been assessed during the study period. The detailed history of all patients has been recorded. Results: We evaluated a total of 62 patients who underwent nephrectomy for various reasons. In all types of nephrectomy, groups post nephrectomy improvement in GFR and kidney volume to a varying extent was noted. When compared to the other two groups donor nephrectomy group is showing higher postoperative GFR with kidney volume and more improvement as compared to their preoperative values. The mean difference is shown in the table for each nephrectomy group, and for each group, it has a p-value &lt;0.05. Similarly, for RPV improvement donor nephrectomy group shows the highest mean difference, and the diseased nephrectomy group shows the lowest mean difference. The difference in means of all nephrectomy is significant and has p-value &lt;0.05. Conclusion: The DTPA-GFR and RPV of contralateral kidney increased steadily after surgery in all nephrectomised groups. Difference in functional and volumetric outcome after unilateral nephrectomy, can be arranged in decreasing order as donor nephrectomy group, radical nephrectomy group and then diseased nephrectomy group. The change in RPV and GFR of contralateral kidney after nephrectomy will help to predict compensatory response in healthy as well as co-morbid patients.</p> Mahesh Borikar Bala Murali Krishna Patibandla Ch Vishwajith Reddy Mallipeddi Partha Sri Arvind Kumar Prabhat Subbarao Chodisetti Copyright (c) 2022 Mahesh Borikar, Bala Murali Krishna Patibandla, Ch Vishwajith Reddy, Mallipeddi Partha Sri, Arvind Kumar Prabhat, Subbarao Chodisetti http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 183 186 To determine difference between pain score in total knee replacement in patient with intra operative periarticular steroid infiltration vs without periarticular steroid infiltration in 1st month of post surgery period https://ijhcr.com/index.php/ijhcr/article/view/4076 <p>Background: Total knee arthroplasty (TKA) has been much improved recently and it is regarded as one of the most common and successful surgical procedure that provides pain relief and improves function in patients with severe knee arthritis.The aim of the present study is to determine difference between pain score in total knee replacement in patient with intra operative periarticular steroid infiltration vs without periarticular steroid infiltration in 1st month of post-surgery period. Methods: There are 200 patients scheduled in the present study conducted from March 2019 to December 2020. Eligible patients included patients were between the ages of 50 and 70 years. Out of 500 patients, 200 patients were recruited, and one knee was randomly assigned to the intra operative periarticular steroid infiltration orwithout periarticular steroid infiltration. Result: For patients in the group receiving steroid injection, significantly lower pain scores from the second postoperative day were noted. The pain level was significantly lower in steroid-treated knees compared to non-steroid treated knees on the night of the operation (VAS, 1.2 vs. 2.3; p=0.021). Interestingly, rebound pain was observed in both groups 1 day after the surgery (VAS, 3.2 vs. 3.8; p=0.248). Conclusion: The present study has demonstrated the efficacy and safety of periarticular infiltration of corticosteroid, bupivacaine and epinephrine following TKA. Patients who received the steroid cocktail have reported better visual analogue pain scores and required less parenteral morphine postoperatively.</p> Sandip Rathod Mitul Mistry Manish Shah Mohnish Gadhvi Copyright (c) 2022 Sandip Rathod, Mitul Mistry, Manish Shah, Mohnish Gadhvi http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 187 190 A study of central edge angle of wiberg of acetabulum radiologically, among Haryanvi population https://ijhcr.com/index.php/ijhcr/article/view/4077 <p>The present study was conducted in Department of Anatomy, on 200 persons (100 males and 100 females) of all age group of Haryana region. The AP view of radiographs of right and left hip joints were taken after written consent. The central edge angle of wiberg of both hips were measured. The mean CE angle of wiberg in males was 37.52±4.75 degree in right side and 40.25±7.75 in left side. Similarly in females 36.45±7.47 degree and 39.34±6.96 in right and left side respectively and mean value of central edge angle of wiberg was more in males as compared to females both in left and right hip. . Hence knowledge of these parameters of hips can be used for better understanding of osteoarthrosis and acetabular dysplasia prevalence.</p> Vikram Singh Mahesh Kumar Sunita Copyright (c) 2022 Vikram Singh, Mahesh Kumar, Sunita http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 191 193 Efficacy of intravenous tranexamic acid at reducing blood loss during elective caesarean section in a tertiary care hospital in North Kerala https://ijhcr.com/index.php/ijhcr/article/view/4078 <p>Increasing caesarean section rate is a source of concern to obstetricians due to the attendant increased health risk, its commonest complication is bleeding, which occasionally may be life threatening. Tranexamic acid has recently been investigated as a potentially useful adjunct for the prevention of maternal morbidity. The research aimed to evaluate the efficacy of tranexamic acid at reducing blood loss during elective caesarean section. The method used was a Randomized, Double blind, Interventional study among women who had elective caesarean section at KMCT Medical College, Kozhikode, Kerala. Data analysis was done using statistical Package for Social Science (IBM SPSS). Mean blood loss in study arm was 352.4 ml, whereas in control arm it was 521.65 ml, which was statistically significant. Only 9.1 %of study population had &gt;10% of fall in perioperative haemoglobin, whereas 43.2 % of control population had &gt;10% fall, which was significant. Statistically significant difference between the two groups was noted with respect to duration of surgery. Intravenous tranexamic acid significantly reduced blood loss at elective caesarean sections. It also reduced the risk of blood loss greater than 1000 ml without increasing maternal risks.</p> Buddiga Navya Heera Shenoy T Sreedhar G Trupti Suresh Patil Chellamma V K Radha Nair Copyright (c) 2022 Buddiga Navya, Heera Shenoy T, Sreedhar G, Trupti Suresh Patil, Chellamma V K, Radha Nair http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 194 200 Evaluation of efficacy of lower limb rotational flap coverage followed by single sitting PTSG for management of post traumatic osteomyelitis https://ijhcr.com/index.php/ijhcr/article/view/4079 <p>Introduction: In the management of the “post traumatic osteomyelitis-PTO” various types of the flaps are employed. Hence we assessed the efficacy of lower limb rotational flap coverage followed by single sitting “partial thickness skin grafting (PTSG)” for management of PTO. Material and Methods: We conducted a prospective clinical study among 40 subjects with PTO. They were treated with rotational flap coverage followed by single sitting partial thickness skin grafting. The various observations made were noted a comparison was made with the muscle flaps. Results: Thirty two of 40 initial flaps survived. All the subjects had the follow up for a minimum period of one year. The flap survival among the local and diffuse osteomyelitis and among those with and without risk factors was not significant. The second predictor- reconstructed successfully flap was significant between the local and diffuse osteomyelitis. The reconstructive success among the local and diffuse osteomyelitis was not statistically significant.Conclusion: This study found rotational flap coverage followed by single sitting partial thickness skin grafting can be successfully used for the reconstruction of lower limb trauma.</p> Ali Umar Arfee Sakib Arif Mudasser Copyright (c) 2022 Ali Umar, Arfee Sakib, Arif Mudasser http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 201 203 Morphological and Morphometric study of Glenoid Cavity and it’s Clinical Application in Western Rajasthan Population https://ijhcr.com/index.php/ijhcr/article/view/4085 <p>Background: Glenoid cavity (GC) is a shallow, concave and oval fossa at superolateral border of scapula and form glenohumeral joint with scapula. There is a notch present on its anterosuperior part which gives its different shape. When this glenoid notch is indistinct its shape is pear shaped, when it is distinct it looks like inverted comma shape and when it is absent its oval shape. Understanding morphometric and morphological variation of GC plays an important role for surgeon while designing and fitting of glenoid component for total shoulder arthroplasty.Aims: A morphometric study of the glenoid cavity of 120 adult dry human scapulae in Western Rajasthan Population was done to evaluate the shape and various diameters of the GC.Material and methods: 120 dry scapulae (60 Right and 60 Left) of unknown sex, were taken for the study. Damaged bones were excluded from the study. Supero-Inferior Diameter (SI-D), Antero-Posterior Diameters (AP-D1 and AP-D2) of both sides were analysed and compared by unpaired t-test.Results: Most common shape of GC was pear shaped (45.83%) followed by oval shape (35%). Least common shape was inverted comma shape (19.16%). Difference in mean SI-D of both sides were statistically insignificant while AP-D1 and AP-D2 were found statistically significant. Mean Glenoid Cavity Index on right and left sides were 64.57 ± 6.91% and 68.33 ± 6.29% respectively.Conclusions: The above study helps Orthopedicians in shoulder dislocation, fractures and treating shoulder pathological conditions like glenohumeral instability and rotator cuff pathology.</p> Kataria Sushma K Shekhawat Manu Gehlot Kalpana Goyal Samata Copyright (c) 2022 Kataria Sushma K, Shekhawat Manu, Gehlot Kalpana, Goyal Samata http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 204 207 Study of Cystatin–C and its association with urinary citrates in diabetic Nephropathy https://ijhcr.com/index.php/ijhcr/article/view/4088 <p>Diabetic nephropathy is occurs due to severe complication of diabetes mellitus and its has been identified as a risk factor for cardiovascular disease (CVD) related outcomes including mortality heart failure, myocardial infarction and stroke . Metabolic changes associated with diabetes lead to glomerular hypertrophy, glomerulosclerosis, and tubule-interstitial inflammation and fibrosis. There is more risk of diabetic renal disease onset and progression with current therapies for diabetes mellitus. Hence, widespread innovation is immediately needed to improve health outcomes for patients with diabetic renal disease and can reduce chances of diabetic nephropathy. Cystatin-C is a 13 kDa cysteine protease inhibitor that is produced by cells throughout the body. Cystatin-C is abundant in serum/plasma and is readily filtered at the glomerulus. Serum levels of cystatin-C have been proposed as a useful marker to estimate glomerular filtration rate. So the the present study is aimed to evaluate the possible association between cystatin–C and urinary citrate along with other biochemical parameters in diabetic nephropathy patients. A total 46 diabetic nephropathy patients and 46 healthy ages matched; individuals between the ages of 35 to 45 years were selected for this study. All the parameters are analyzed by conventional standardized methods and compared between the two groups. The student ‘t’ test was applied for the statistical analysis and the results were expressed in mean ± SD and p &lt;0.001 were considered as highly significant. The mean levels of cystatin –C levels were increased ,urinary citrates are significantly reduced and micro protein, urinary protein creatinine ratio and micro-albumin are significantly elevated in the diabetic nephropathy patients when compared to control group.</p> Prem Kumar G Balu Mahendran K Sandhya S Copyright (c) 2022 Prem Kumar G, Balu Mahendran K, Sandhya S http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 204 207 Mucormycosis In Covid-19 Pandemic https://ijhcr.com/index.php/ijhcr/article/view/4089 <p>Mucormycosis (Zygomycosis) is an invasive fungal infection. It typically affects immune compromised individuals with an impaired neutrophilic response. There are several case reports of Rhino-orbital-cerebral mucormycosis (ROCM) from all over the world. Recently, its alarming rise in the number amongCOVID-19 patients mostly with uncontrolled diabetes and those who received excessive administration ofsteroids for the treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection hasraised interest among the scientific community to learn more about the said disease. The current reviewdescribes, its epidemiology, clinical presentation, risk factors, warning signs, diagnostic test and available preventive and treatment modalities for its effective management.</p> Chandni Malhotra Sachi Gupta Sachit Mahajan Satish Kumar Gupta Copyright (c) 2022 Chandni Malhotra, Sachi Gupta, Sachit Mahajan, Satish Kumar Gupta http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 208 211 Demographic and Clinical Profile of Presbyopia in a Tertiary Care Centre https://ijhcr.com/index.php/ijhcr/article/view/4090 <p>Introduction: Presbyopia is an age related loss of accommodative amplitude leading to difficulty with near vision and near work. The onset of presbyopia occurs around 40-45 years of age in most individuals. It may lead to difficultly in performing various tasks of daily routine Keeping in view the high prevalence of uncorrected presbyopia, this study was conceptualized to study the demographic profile of presbyopia, in order to create awareness among the general population, which would help us in managing this condition, more effectively. Material and methods: This observational, cross-sectional study was carried out among 500 patients who presented to out-patient clinics. Detailed medical history and ocular examination was done. Distance visual acuity was recorded with Snellen chart and near vision with Jagger’s chart. All data was entered in Microsoft excel and subsequently analyzed with OpenEpi software version 3. Results: The prevalence of presbyopia was 22.8% with mean age of 52.17±9.52 years and age range of 32- 60 years. Females were more commonly affected (75.44%) as compared to males. Most of the patients presented with difficulty in near vision (69.29%) and were emmetropic for distance vision (63.15%). Maximum patients were literate (80.7%). Homemakers and office-worker seek medical advice earlier as compared to others. Conclusions: Females were more commonly affected and had younger onset of presbyopia as comapared to males. Hypermetropia was more commonly associated with presbyopia as compared to myopia.</p> Vabita Bhagat Anu Radha Bharti Pallavi Sharma Sachit Mahajan Copyright (c) 2022 Vabita Bhagat, Anu Radha Bharti, Pallavi Sharma, Sachit Mahajan http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 212 215 Corneal endothelial cell changes in patients with diabetes after manual small incision cataract surgery https://ijhcr.com/index.php/ijhcr/article/view/4091 <p>Introduction: Cataract surgery can lead to endothelial cell damage and cell loss. Loss or damage to corneal endothelial cells during surgery may lead to corneal decompensation, causing corneal edema and loss of corneal transparency, which disrupts vision. Specular microscopy provides a non-invasive view of morphology of corneal endothelium. This study was undertaken to evaluate the changes in endothelial cells in patients with diabetes mellitus after manual small incision cataract surgery. Material and methods: Prospective, longitudinal study was conducted in 50 diabetic patients and 50 non-diabetic patients who underwent manual small incision cataract surgery. Endothelial cell density, coefficient of variation, hexagonality and central corneal thickness was assessed using non contact specular microscope preoperatively and 1 week, one month and three months postoperatively. Statistical analysis was done using using t-test. A p-value &lt;0.05 was considered as statistically significant. Results: The mean preoperative endothelial cell density was lower in diabetics as compared to non diabetics (p-value 0.11). There was a statistically significant decrease in endothelial cell density in diabetics post-operatively as compared to non-diabetics (p value: 0.008). There was also a significant increase in corneal thickness in diabetics as compared to non-diabetics (p value: 0.02). The change in coefficient of variation was also higher in diabetic patients (p value: 0.01). However there was no significant change in percentage of hexagonal cells (p-value: 0.74). Conclusion: Diabetic patients have lower endothelial cell density and lower capacity for endothelial repair which increases the risk of decompensation in these patients. Thus, specular microscopy should be performed in every diabetic patient before undergoing cataract surgery, wherever possible and precautions should be taken to protect the corneal endothelium preoperatively.</p> Chandni Malhotra Sachi Gupta Sachit Mahajan Satish Kumar Gupta Copyright (c) 2022 Chandni Malhotra, Sachi Gupta, Sachit Mahajan, Satish Kumar Gupta http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 216 219 Prevalence of Anemia in Chronic Kidney Disease in Tertiary Care Hospital of North India https://ijhcr.com/index.php/ijhcr/article/view/4092 <p>Background: Chronic kidney disease (CKD) has emerged as a public health challenge in countries around the world. Anemia is a well-known complication in chronic kidney disease (CKD) and associated with progression of CKD, poor quality of life, and increase in morbidity and mortality.Early identification and treatment of anemia may improve CVS morbidity and mortality however, its identification and management have been reported to be suboptimal. Aim of study: This study aimed to determine the prevalence of anemia in chronic kidney disease patients in a tertiary care hospital. Methods: A cross sectional and observational study was conducted in a tertiary care hospital during the study period of August 2017 to February 2018. Results: A total of 121 participants were included to estimate the prevalence of anemia among chronic kidney disease patients. Most of the patients ( 47.10% ) belonged to the middle age group 40 to 60 years. Female patients (58.67%) were suffering from more CKD than the male patients (41.32%). Most of the patients (61.15%) were anemic. 46.28% CKD patients also suffering from diabetes mellitus. Most of the patients (54.54%) treated with oral iron agents for anemia in CKD patients. Conclusion: In this study most of the chronic kidney disease patients were anemic. Each center should determine the treatment strategy according to the patient’s characteristics. Periodic screening and intervention programs for anemia of CKD should be practiced to change the existing situation in the setting.</p> Madhu Balla Vijay Kumar Manpreet Kour Copyright (c) 2022 Madhu Balla, Vijay Kumar, Manpreet Kour http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 220 222 A comparative study on morbidity profile among the geriatric population of urban and rural area of West Bengal https://ijhcr.com/index.php/ijhcr/article/view/4093 <p>Background- According to the WHO Ageing &amp; Health Factsheet, the proportion of the world's population over 60 years will nearly double from 12% to 22% between 2015 and 2020, the number of people aged 60 years and older will outnumber children younger than 5 years by 2020, 80% of older people will be living in low- and middle-income countries in 2050. With this background present study was conducted to compare on morbidity profile among the geriatric population of urban and rural area of West Bengal. Methods – Community based cross sectional study was conducted in rural field practice area and urban slum which is urban field practice area of Community Medicine department of a Medical College situated at Kolkata, West Bengal from January 2021 to March 2021. Total sample size is 412, are be divided equally in both urban and rural areas i.e. 206 complete samples from each area are interviewed by a pre-designed, pretested structured questionnaire. The collected data was compiled with the help of Microsoft excel &amp; analyzed by SPSS version – 19, in terms of statistical methods like table, mean, standard deviation, chi square, z test, multiple logistic regression. Results - In urban area, 69.4% of geriatric population belonged to 60-69 years &amp; 48% geriatric population belonged to 70-79 years of age groups whereas in rural area the findings were respectively 63.6 % &amp; 30.6 %.43.7% of total geriatric populations are financially independent and out of 56.3% dependent populations, rural geriatric population showed marginally higher predominance (60.2%) over the urban (52.4%). It is revealed from this study that acid peptic disorder (53.6%) is the major G.I disorders, followed by constipation (44.2%) and dental caries (40.0%). We also found that 42.5% geriatric population are suffering depression. Urban geriatric populations were suffering (46.6%) a little more from depression than rural population (38.3%). Conclusions- The present study reveals high prevalence of morbidity among geriatric population. So, awareness among elderly people should be created for regular health check-ups for prevention and early detection of their health problems.</p> Rahul Biswas Tanjib Hassan Mullick Pulak Kumar Jana Soumitra Mondal Debasis Das Copyright (c) 2022 Rahul Biswas, Tanjib Hassan Mullick, Pulak Kumar Jana, Soumitra Mondal, Debasis Das http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 223 226 Study of Malaria Surveillance indicators of Visakhapatnam (GVMC) and evaluation of the status of functioning of Urban Malaria Scheme (UMS) https://ijhcr.com/index.php/ijhcr/article/view/4094 <p>Introduction: National Framework for Malaria Elimination in India (2016-2030) was launched in the year 2016 with an objective of eliminating malaria throughout the country and to prevent not only re-establishment of transmission but also to reach the stage of zero indigenous cases by the year 2030. During the early 1970’s resurgence of malaria, maximum cases (7.4%) and deaths (10.9%) were reported from urban areas where Visakhapatnam was one among them. Urban Malaria Scheme (UMS) was launched in 1971in Visakhapatnam along with other cities like Chennai, Vadodara, Vijayawada, as a component of National Malaria Eradication Program me (NMEP) to reduce/interrupt transmission particularly effecting the towns and cities. Methods: The present study period is from 2012 to 2020. Secondary data has been collected from GVMC Chief medical officer, District and Zonal malaria offices with their approval. The present study design is retrospective trend analysis of malaria surveillance indicators of GVMC. Year wise parasitological indices were estimated. Vector density was also obtained for the study period. Integrated Vector Management (IVM) is prime activity in Visakhapatnam city under Urban Malaria Scheme (UMS). Results: Blood smear collections, total number of fevers subjected to blood smear examination, smear positives, type of malaria, estimation of API (from ABER and SPR) which is the key indicator for categorization of states and district falling under stage of elimination of malaria. Starting from the year 2013 there is consistent fall of API (2.21-0.02) and SPR (3.24-0.05) There is an under-reporting in the year 2020 where sufficient number of blood smears could not be collected under active and passive surveillance. The main activity of malaria control in GVMC under Urban Malaria Scheme is IVM which brings down the critical density of the vector for transmitting the malaria parasite. Deaths were not reported throughout the time line. Conclusion: It is evident that Visakhapatnam city parameters of malaria surveillance are comparable to that of country wide malaria surveillance data and GVMC is already a partner in National Frame work for Malaria Elimination in India (2016-2030) and hopefully reach the objective by 2030.</p> M Satyanarayana Raju E Ravi Kiran N Udaya Kiran Copyright (c) 2022 M Satyanarayana Raju, E Ravi Kiran, N Udaya Kiran http://creativecommons.org/licenses/by/4.0 2022-01-19 2022-01-19 5 2 227 231