International Journal of

Pharmaceutical and Clinical Research

e-ISSN: 0975 1556

p-ISSN 2820-2643

Peer Review Journal

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1. Spectrum Of Plasma Cell Dyscrasias: A Clinicopathological Study In A Tertiary Care Hospital
Diya Saha, Rajen Saha Bhowmik, Kulashekhar Bhattacharjee, Abhijit Datta
Abstract
Background: Plasma Cell Dyscrasias (PCD) by definition include a wide range of disorders represented by excessive proliferation of a single clone of plasma cells producing entire immunoglobulins, immunoglobulin fragments, heavy chains or light chains. Materials and Methods: This study was carried out in a tertiary care Hospital (AGMC & GBP Hospital) prospectively for a period of three years from June 2020 to June 2023. All the cases diagnosed with PCD were selected. Data from hematological, biochemical, and radiological investigations were collected. For evaluation of each case of multiple myeloma, revised International Myeloma Working Group criteria were applied. Results: 25 patients were diagnosed during the study period, with the majority of them in the 6th decade. The male to female ratio was 3.2:1. Most common clinical feature was fever (52%), bone pains (44%), and generalized weakness (44%). Anemia was the most common hematological manifestation. All the patients had ‘M band’ on serum electrophoresis, and 31.81% of patients had urinary Bence Jones proteins. Conclusion: PCD are rare group of disorders, the diagnosis of which requires a systematic approach. Out of total 25 cases of PCD, many of them could not be diagnosed clinically or radiologically, but exclusively diagnosed based on cytological, haematological and histopathological examination (HPE).This demonstrates the challenge in the clinical diagnosis of the condition and stress upon the importance of tissue/hematological diagnosis.

DOI: 10.5281/zenodo.

2. Clinical and Histopathological Evaluation of Leprosy Patients: A Retrospective Study
Jaishree Noor, Sundiep Kumar, Kashmir Ali
Abstract
Introduction: Leprosy is a chronic infectious disease affecting the skin and peripheral nerves, manifesting in various clinico-pathological forms based on the host’s immune status. This study aimed to analyze the clinical and histopathological features in leprosy patients and assess the correlation between clinical and histopathological diagnoses. Methods: A retrospective hospital-based study was conducted, involving data collection on detailed clinical history-taking and examination. Clinical assessments included lesion type, number, location, disease type, and neural involvement. Skin biopsies with routine Hematoxylin and Eosin stains were performed on all patients. Results: 123 clinically suspected leprosy cases were analyzed. The majority were aged 30-45 years, predominantly male. Upper extremities and head & neck were the most common lesion sites. The primary clinical features observed were hypoesthetic patches and erythematous plaques. Borderline Tuberculoid was the most common histopathological type, followed by lepromatous leprosy. Correlation between clinical and histopathological diagnoses for specific leprosy types were as follows: TT (67.20%), BT (69%), BB (49.70%), BL (70.30%), LL (93.20%), and IL (45.90%). Conclusion: Clinical diagnosis alone remains challenging for leprosy, while histopathological analysis aids in definitive diagnosis. This study highlights a significant correlation between clinical and histopathological findings in skin biopsies for leprosy diagnosis.

DOI: 10.5281/zenodo.

3. Assessment of Clinical and Histopathological Characteristics of Psoriasis in a Tertiary Care Hospital
Kashmir Ali, Jaishree Noor, Sundiep Kumar
Abstract
Introduction: Psoriasis comprises a group of common chronic inflammatory and proliferative skin conditions associated with systemic manifestations across multiple organ systems. Its prevalence in India remains poorly defined, with varied presentations at different stages that can mimic other conditions. Materials and Methods: This retrospective study explored the clinical and histomorphological variants of psoriasis and assessed the age and sex distribution in various types of psoriasis in a tertiary care hospital. Nine parameters were used to evaluate and categorize the different types of psoriasis: 1) Hyperkeratosis, 2) Parakeratosis, 3) Munro’s microabscesses, 4) Pustule of Kogoj, 5) Supra-papillary thinning, 6) Elongated rete ridges, 7) Inflammatory infiltrate in the dermis, 8) Capillary proliferation and dilatation, and 9) Spongiosis. Results: The study revealed a male preponderance, with the highest number of cases in the 31-40 age groups. Psoriasis vulgaris was the predominant histological type, followed by Chronic Plaque Psoriasis. Among the cutaneous features of psoriasis, scales were the most common, followed by plaques. The upper extremities were the most frequently involved site. Epidermal histopathological features included acanthosis in all cases and hyperkeratosis in majority. Dermal features showed dermal infiltration in majority of cases. Conclusion: Psoriasis exhibits multiple relapses and remissions with varied clinical presentations. Early diagnosis is crucial to halt disease progression, with histomorphology aiding in diagnosis. While most changes occur in the epidermis, dermal changes can also assist pathologists in diagnosis. This study contributes to understanding the prevalence and histomorphological features of psoriasis in India, aiding in better clinical management and patient triage.

DOI: 10.5281/zenodo.

4. Experience of Treating Spindle Cell Tumours: Case Series in Tertiary Care Centre in Punjab
Talwar Ashutosh, Bhatti Tushar, Jain Sumit, Faisal sadaf Ali
Abstract
Sarcomas can present differently in different parts of the body and showcase varied histopathological features and tend to recur locally and metastasize to distant sites. We are reporting our series on patients with spindle cell tumors. The mass was evaluated through computed tomography and the histology was confirmed by biopsy. Wide surgical resection of the mass was done and the patients were referred to radiotherapy for further treatment. These cases showcase the scenario of many patients in developing countries where the patients are negligent, lost and present later with grave consequences.

DOI: 10.5281/zenodo.

5. Association of Metabolic Risk Factors with Serum Orexin Levels in Women of Reproductive Age Group:  A Cross-sectional Study
Shashank Tyagi, Arun Mishra, Ravi Meena, Shilpi Singh
Abstract
Introduction: Metabolic syndrome has long been associated with obesity and a sedentary lifestyle due to the resulting metabolic disturbances. Orexin A and B are newly identified neuropeptides produced in the hypothalamus. Orexin A is involved in the regulation of appetite, food intake, and energy expenditure. Metabolic fuel detectors play a critical role in maintaining energy balance both peripherally and centrally. This study aimed to investigate the relationship between serum orexin levels and metabolic risk markers in women of reproductive age (RAG). Materials and Methods: A random selection of 178 apparently healthy women aged 20–40 years were included. Fasting serum orexin and serum insulin levels were quantified using enzyme-linked immunosorbent assay (ELISA). Additionally, measurements of weight, body mass index (BMI), fasting blood glucose, lipid profile, and blood pressure were obtained. Results: The findings revealed that serum orexin levels exhibited a significant positive correlation with fasting blood glucose, weight, BMI, and waist circumference. There was also a weak negative correlation with serum insulin levels. Conclusion: The current study demonstrates that serum orexin levels are significantly correlated with weight, BMI, and fasting blood glucose, while showing a weak negative correlation with serum insulin levels. No correlation was found between serum orexin levels and the lipid profile in women of reproductive age.

DOI: 10.5281/zenodo.

6. Cervical Screening in HIV Positive Females: A Cross Sectional Study
Pratibha Chadar, Priya Singh Suryvanshi, Juhi Agrawal, Sushruta Shrivastava, Himani Rai
Abstract
Background: Cervical cancer is a leading cause of AIDS-defining illness, and HIV-positive women worldwide. Detection of cervical cancer in precancerous stage is 100% curable. Aim: To determine the rate of cervical screening among HIV-positive women and compare the performance of screening tests and assesses factors affecting participation. Methods: HIV-positive women aged 30–59 years attend the anti-retroviral therapy (ART) clinics were screened by conventional Pap, HPV testing (Hybrid Capture 2) and visual inspection with acetic acid (VIA). A cohort of HIV-negative women from the community matched for age and parity were screened similarly. Screen-positive women underwent colposcopy and biopsy. Factors affecting participation were assessed. Results: Out of total cases majority of them (44.4%) belonged to 30-39 years age group. Most of the participants (96.8%) were unaware about cervical screening, 97.2% were housewives and 74.4% belonged to upper lower socio-economic status. The mean parity of was 2.15±1.29 and maximum (69.2%) females were multiparous. Conventional smear and LBC revealed concordant findings in 16.7%, 100%, 85.7% and 100% cases of ASCUS, LSIL, HSIL and SCC respectively (p<0.05). Among the screening methods, sensitivity and negative predictive value was 100% for detection of abnormal cytology for liquid-based cytology whereas VILI had highest specificity. Overall, diagnostic accuracy was highest for liquid-based cytology. Conclusion: Risk of cervical cancer was higher in HIV infected women. Frequent screening of these patients for cervical cancer can reduces the morbidity and mortality among women.

DOI: 10.5281/zenodo.

7. Assessment of Cerebroplacental Ratio at 35 to 38 Weeks Gestation and Its Correlation to Perinatal Outcomes: A Two Step Approach
Priya Singh Suryvanshi, Pratibha Chadar, Juhi Agrawal, Ashwani Narnoure
Abstract
Background: Cerebroplacental ratio (CPR) is a reliable indicator of foetus health, measured by colour Doppler. CPR is calculated as ratio of pulsatility index of middle cerebral artery (MCA) and umbilical artery (UA).  When blood is redistributed in the early stages of hypoxia in favor of cerebral circulation, the diastolic flow amplitude increases above normal levels in MCA while umbilical flow in diastole decreases, providing CPR. Aim: objective of this study is to investigate the relationship between CPR and adverse perinatal outcomes in a tertiary care hospital. Methods: A total of 300 pregnant women of age group 18-35 years with singleton pregnancies at 34-37 weeks were enrolled. Cerebroplacental ratio was calculated using a Doppler scan on each patient. When the Cerebroplacental ratio is <1 it is deemed abnormal. The perinatal outcomes were observed and their associations were evaluated. Results: Out of total majority of the participants (37.7%) belongs to 18-24 years of age group. Majority of the participants (87%) were multigravida. Most of them (36.7%) belonged to very low risk category. Most of the women (77.7%) delivered vaginally. 92.7% of born baby was alive and healthy and 76.7% of newborn had birth weight >2.5 kg. there is no statistically significant difference was found between gestational age, mode of delivery with CPR. Statistically significant association was found between perinatal outcomes (hypoxia, Stillborn and NICU admission) and CPR (p<0.05). Conclusion: CPR is important tool in predicting an unfavorable perinatal outcome.

DOI: 10.5281/zenodo.

8. Comparative Study of Surgically Induced Astigmatism with Frown-Shaped Scleral Incision vs Straight Scleral Incision with Backward Extension Perpendicular to the Limbus in Manual Small Incision Cataract Surgery
Deepak Kumar, Deepankar Kumar, Kumari Sandhya, Uday Narayan Singh
Abstract
Background: Manual Small Incision Cataract Surgery (MSICS) is crucial for effective cataract removal in resource-limited settings. The shape of the scleral incision significantly influences postoperative outcomes like surgically induced astigmatism (SIA). Objective: To compare the effects of frown-shaped and straight scleral incisions on SIA, visual acuity, surgical time, and complications in MSICS. Methods: This six-month study involved 480 patients at Jawahar Lal Nehru Medical College and Hospital, randomly assigned to undergo MSICS with either a frown-shaped or a straight scleral incision. Outcomes measured included SIA at various postoperative stages, visual acuity, surgical duration, and complication rates. Results: The frown-shaped incision group showed significantly lower SIA at all time points compared to the straight incision group, with similar visual acuity improvements. Although the frown shape required more surgical time, it tended to have fewer complications. Conclusion: The frown-shaped scleral incision is preferable in MSICS for reducing SIA, balancing better astigmatic control with the potential for fewer complications.

DOI: 10.5281/zenodo.

9. The Role of Small Intestinal Microbiota in Human Health and Disease: Current Understanding and Future Perspectives
Ojal Pratap Jadhav, Vaishali Choure
Abstract
The small intestine microbiota is becoming recognized as performing an important role in human health and illness. This review article investigates the composition and function of the small intestine microbiota, focusing on its role in digestion, nutritional absorption, immunological regulation, and pathogen protection. We investigated the link between microbial dysbiosis and a variety of gastrointestinal, metabolic, immune-mediated, and cognitive conditions. Therapeutic approaches such as probiotics, prebiotics, antibiotics, dietary changes, and fecal microbiota transplantation (FMT) are explored, with an emphasis on their effectiveness and safety. The paper also discusses the difficulties in investigating the small intestine microbiota, including methodological constraints and the necessity for tailored treatments. Future research directions are highlighted, with an emphasis on developing technologies and their ability to overcome current limits. This article emphasizes the significance of ongoing research to fully realize the therapeutic potential of the small intestine microbiota in clinical practice.

DOI: 10.5281/zenodo.

10. Role of Prophylactic Retention Sutures in Midline Laparotomy in High-Risk Patients for Wound Dehiscence
Jada Sudhakar, Ambati Dedivya Venkata Lavanya, Shalini Duvvada, Manoj Karthik, Jakkula Kishore
Abstract
Background: Abdominal wound dehiscence is a serious postoperative complication associated with significant morbidity and mortality, with an incidence ranging from 0.4% to 3.5% and mortality rates between 10% and 45%. Despite advancements in surgical techniques, the incidence of wound dehiscence remains a critical concern. This study evaluates the role of prophylactic retention sutures in high-risk patients undergoing midline laparotomy to prevent wound dehiscence. Materials and Methods: A prospective case-control study was conducted at King George Hospital, Visakhapatnam, from July 2020 to January 2022, involving 100 patients aged 20-70 years who underwent emergency midline laparotomy. Patients were randomized into two groups: the case group received prophylactic retention sutures (n=49), and the control group underwent conventional closure (n=51). Data collection included daily wound assessments, ultrasonography, and monitoring for postoperative complications such as wound infection, incisional hernia, reoperation, and hospital stay duration. Results: The study found that wound dehiscence occurred in 8.16% of patients with prophylactic retention sutures compared to 25% in the control group (p<0.05). Wound infection rates were 20.4% in the retention suture group and 45% in the control group (p<0.05). Incisional hernia incidence was 4.08% with retention sutures and 7.8% without. Reoperation rates were 4% in the retention suture group versus 11% in the control group. The mean postoperative hospital stay was 11.16 days for retention sutures and 9.8 days for conventional closure. Pain assessment revealed significantly higher pain scores on postoperative day 5 in the retention suture group. Conclusion: Prophylactic retention sutures significantly reduce the incidence of wound dehiscence and other related complications in high-risk patients undergoing midline laparotomy. Despite increased postoperative pain, the clinical benefits outweigh the drawbacks, making retention sutures a valuable preventive strategy for wound dehiscence in high-risk patients.

DOI: 10.5281/zenodo.

11. Pattern of Acquisition of Theory of Mind in Pre-Schoolers: A Cross-Sectional Study from India
Vidushi, Raj Kumar Chandan
Abstract
In this cross-sectional study, 100 preschoolers in Patna, India, ages three to five, are asked about their patterns of Theory of Mind (ToM) acquisition. The study, which lasted six months and was carried out at the Patna Medical College and Hospital’s Department of Psychiatry, used several pre-established activities to measure knowledge availability, erroneous beliefs, and varied desires. The results show a distinct developmental trajectory, with notable gains in ToM skills seen as youngsters get older. The study also shows that socioeconomic status (SES) has a significant impact on the development of ToM, with children from homes with higher SES performing better on ToM tasks. There were no discernible gender differences. These findings show the necessity for focused educational interventions to assist ToM learning in a variety of populations and emphasize the significance of cultural and socioeconomic factors in cognitive development.

DOI: 10.5281/zenodo.

12. Association of Haematological and Biochemical Parameters with Severity of COVID-19 Patients: A Retrospective Study
Vikash Bombeshwar, Riti Sharma, Ruchi Varma, Arvind Neral, Ramesh Kumar Sahu
Abstract
Background: By affecting 206 countries, the unprecedented health disaster COVID-19 brought about a global emergency. Since SARS-CoV2 is a RNA virus and has a higher mutation rate than DNA viruses, treatment would be challenging. The issue is especially deleterious in India because of the country’s large population. The haematological and immunological system are severely affected by the systemic viral infection of COVID-19. It would be crucial to investigate whether the most frequently performed tests could be utilised to help determine a patient’s clinical status or anticipate the degree of severity of the disease. Methods: A cohort of 420 patients of all ages and both sexes having positive COVID-19 RT-PCR test and were admitted to BRAM Hospital Raipur between March 2021 and March 2022 participated in the cross-sectional study. Different hematological and biochemical tests were performed in all cases. Hematological parameters include ALC, TLC, Neutrophil /Lymphocyte ratio, Platelet count and biochemical parameters include Alanine aminotransferase, Aspartate aminotransferase, Lactate dehydrogenase, Serum ferritin and CRP. Results: Out of 420 cases, 210 were categorised under severe cases and rest 210 were non-severe cases. It is also found that, in severe cases the male patients were more than female patients. The mortality was associated with increased CRP, Neutrophil count, WBC count, AST, ALT and increased LDH. Conclusion: In conclusion, several laboratory parameters could be associated with the severity and mortality of COVID-19 pandemic. This comparative investigation can help reinforce clinical judgements in the clinical context and increase the survival rate of critically sick patients.

DOI: 10.5281/zenodo.

13. Open Versus Laparoscopic Ventral Hernia Repair: A Randomized Clinical Trial
C Dharma Kishore Raja, V Manmadha Rao, Ch Satyanarayana
Abstract
Background: Ventral hernia repair is a common surgical procedure with two primary approaches: open and laparoscopic. Despite advancements in minimally invasive techniques, there remains a debate regarding the optimal method for repair. This study aims to compare the clinical outcomes of open versus laparoscopic ventral hernia repair. Materials and Methods: A randomized clinical trial was conducted involving 150 patients diagnosed with ventral hernia. Participants were randomly assigned to either the open repair group (n=75) or the laparoscopic repair group (n=75). Key outcome measures included operative time, postoperative pain, length of hospital stay, complication rates, and recurrence rates. Follow-up assessments were conducted at 1 month, 6 months, and 1 year post-surgery. Results: The mean operative time was significantly shorter in the laparoscopic group (60 ± 15 minutes) compared to the open group (90 ± 20 minutes, p<0.001). Postoperative pain scores, measured on a visual analog scale, were lower in the laparoscopic group (mean score: 3.5 ± 1.2) than in the open group (mean score: 5.0 ± 1.5, p<0.01). The length of hospital stay was also reduced in the laparoscopic group (3 ± 1 days) compared to the open group (5 ± 2 days, p<0.01). Complication rates were comparable between the two groups (open: 15%, laparoscopic: 10%, p=0.35). However, the recurrence rate at 1 year was slightly higher in the laparoscopic group (8%) compared to the open group (5%), though this difference was not statistically significant (p=0.45). Conclusion: Laparoscopic ventral hernia repair offers advantages in terms of shorter operative time, reduced postoperative pain, and shorter hospital stays. While complication rates are similar between the two methods, there is a non-significant trend towards a higher recurrence rate with laparoscopic repair. These findings suggest that laparoscopic repair is a viable option for ventral hernia repair, but careful patient selection and long-term follow-up are essential.

DOI: 10.5281/zenodo.

14. Historical Analysis of Antibiotic Resistance Patterns in Clinical Isolates: A Retrospective Microbiological Study
Mahadeo Mandal, Sanjeev Kumar
Abstract
Background: To successfully fight the danger that drug resistance presents to world health, one needs to be aware of how things have changed in the past. This bacterial historical study examines drug resistance in clinical samples from 2020 to 2022. Methods: A complete historical review of 250 clinical samples was carried out over the term. The collection had demographics, microbial species, and antibiotics orders. The data came from bacterial databases and medical facilities. We used time trend analysis, summary statistics, and subgroup ratings to examine every part. Result: This study on antibiotic resistance in a heterogeneous population shows demographic differences and patterns specific to microorganism species. Male and female population distribution is not statistically significant. The population averages 45.2 years old. Additionally, 32% of the population has numerous chronic illnesses. Condition A had 25% antibiotic resistance, while B and C had 15% and 30%, respectively. Subgroup analysis showed that resistance rates differed by age and microbiological species, emphasizing the need for customized therapy. These findings suggest that microbiological and demographic aspects should be studied to combat antibiotic resistance. Conclusions: The study tries to show how vital customized medicines are and brings drug resistance trends to light. We can compare and contrast current studies and drug resistance processes to find out what they have in common and what makes them different. These data show how important it is to keep an eye on drug resistance worldwide and consider what that means to find other treatments based on facts.

DOI: 10.5281/zenodo.

15. Cross-Sectional Analysis of the Association between Maternal Health Factors and Neonatal Hearing Screening Results
Aseem Anand, Gajendra Kumar, Anmol Kaur Ghuman, Mitul Karn
Abstract
Background: Early detection of hearing problems is possible through neonatal hearing screening still, the correlation between screening outcomes and maternal health remains uncertain. This study explores the relationship between neonatal hearing test results and maternal age, prenatal care use, smoking, and other health factors. Method: MGM Medical College and LSK Hospital conducted a cross-sectional study of 50 neonates and mothers. Descriptive statistics and bivariate analysis were used to examine maternal health factors and neonatal hearing impairments. Results: Mothers averaged 28.5 years old (±4.2) and 60% of mother where a bachelor’s degree or higher. 20% of pregnant women smoked, although 80% received acceptable prenatal care. Neonatal hearing screenings found 10% of neonates impaired. Bivariate analyses revealed significant connections between hearing abnormalities (p = 0.045), inadequate prenatal care (p < 0.001), and maternal smoking (p = 0.012). Conclusion: Age, quality of prenatal care, and smoking throughout pregnancy raise the risk of neonatal hearing loss. These findings emphasise the importance of maternal health variables for neonatal outcomes. To reduce neonatal hearing issues, doctors should encourage pregnant women to quit smoking and undergo complete prenatal care. Evidence-based interventions can improve mother and neonatal health by encouraging healthy development.

DOI: 10.5281/zenodo.

16. A Comparison of Open and Laparoscopic Appendicemnesis among Patients Visiting a Tertiary Care Facility
Deepak Kumar Sah, Sudhanshu Shekhar
Abstract
Approximately 1% of all surgical procedures are appendicectomies, making them one of the most common procedures in general surgery. Less postoperative pain, early discharge, fewer wound infections, improved cosmesis, and an early return to regular employment are all predicted with laparoscopic appendicectomy. Regarding length of operation, pain following surgery, length of analgesia, complications following surgery, length of hospital stay following surgery, and return to regular employment, laparoscopic and open surgical techniques are compared. This study, which was conducted from September 2020 to August 2021, is prospective and comparative in nature. It involved 100 patients—50 open and 50 lap appendicectomy—that were operated on in the surgical department of the (Medical college) in (city). The cases were chosen at random. Pain score in the open group was 2.6±0.5 in the current study, while it was 1.4±0.5 in the lap group (P<0.05) due to wound infection and longer incision strain of muscles. Vomiting was one of the fewer post-operative problems in the laparoscopic group (6%) than in the open group (83%). Compared to open group 7, which had a 14% rate of post-operative wound infection, lap group 2 has a gradually lower incidence (4%) of such infections. In comparison to open group 3±2.1, the duration of post-operative hospital stay was significantly shorter for lap group 2.2±0.4. In the lap group, the return to regular activity was lower, taking 22 (44%) instances 6 to 9 days, compared to 28 (56%) cases in the open group 14 to 17 days. The duration of surgery was 46.2±10.4 for an open appendectomy and 66.5±18.5 for a lap appendectomy. For certain patients with acute or recurring appendicitis, laparoscopic appendicitis is preferable to open appendectomy.

DOI: 10.5281/zenodo.

17. A Study to Find the Causes for Severe Visual Impairment and Blindness among Children in the School for Blind in Patiala, Punjab
Indu Khosa, Talvir Sidhu, Ishwar Singh, Mohit Goyal
Abstract
Introduction: Out of 2.2 billion visually impaired people globally, at least half have unaddressed preventable causes of blindness, mainly untreated cataract (94 million), unaddressed refractive error (88.4 million), glaucoma (7.7 million), and corneal opacities (4.2 million); and untreated presbyopia (826 million) for near vision impairment. In India, the current prevalence of blindness in children is known to be around 0.8/1000 in the age group of 0–15 years. It is very important to have accurate data regarding causes and prevalence so that proper strategies can be planned to reduce, at least, preventable childhood blindness. Material and Methods: This is a cross-sectional study that included children from the school for the blind in Patiala, Punjab, India. The school principal was explained about the study. All the children were examined by an ophthalmologist and an optometrist. Information was gathered by interview and by consulting the medical records available. Uniocular and binocular visual acuity, with best correction, using a snellen’s chart; refraction, after cycloplegia; and anterior and posterior segment examination were done after pupillary dilation. For each child, the cause of visual loss was recorded in the form. Results: 92 children studying from grades 1 to 12 were examined. The average age of the participants was 13.13 years. 51 were male and 41 were female. 61.9% patients had onset of blindness before 1 year of age. The most common cause of blindness in children in our study was Retinal Dystrophy (38.64%), followed by congenital glaucoma (16.56%), Optic nerve atrophy (12.88%), and Corneal opacity (11.04%). The majority of the children (72.8%) had visual acuity from 3/60 to light perception positive. Conclusion: The most common cause of blindness in children in our study was Retinal Dystrophy (38.64%), followed by congenital glaucoma (16.56%). These results corroborate the past studies.

DOI: 10.5281/zenodo.

18. A Comparative Study on Management of Olecranon Fracture Using Tension Band Wiring and Olecranon Hook Plate
Kapila R, Chauhan A, Rai B, Kumar D, Maasha
Abstract
Objective: To compare the results of tension band wiring (TBW) v/s Olecranon hook plate fixation in management of fracture olecranon in terms of time taken for fracture union and clinical, functional and radiological outcome. Methods: 30 patients suffering from olecranon fracture were enrolled and study was carried out in Department of Orthopaedics, Guru Nanak Dev Hospital and College, Amritsar. Results: It was observed that among the cases mean age was 42.4 years. The study reported more number of males than females. The subjects were categorized into 2 groups. In both the groups, fractures on right side were involved more than left side. The road side accident was the commonest mode of injury to cause fracture. In both groups most common fracture type was type IIA (50%). Majority of the cases 19 (63.3%) were operated within 24 hours. 4 (13%) cases associated with fracture of femur bone required hemodynamic stabilization/surgery on priority basis. Other complications entails fracture in shaft femur and inter-trochantric femur. Mean MEPS in group A was 86.9 and in group B was 89.1. Conclusion: It was found that tension band wiring and plate fixation are equally effective in management of displaced olecranon fractures.

DOI: 10.5281/zenodo.

19. Correlation of Serum PSA, Gleason Score and Histopathological Grading of Adenocarcinoma of Prostate in Prostatic Biopsies at a Tertiary Care Center
Purva More, Supriya Joshi, Aakash Bhamre
Abstract
Objectives: Some of the key measures that are relevant to prostate cancer include serum PSA levels, Gleason score, and histopathological grading. Their relationship in the tertiary care facilities cannot be overlooked and hence constitutes this study’s research focus. Methods: The retrospective survey involved 86 samples of prostatic tissues taken between January 2022 to January 2023. These assessments included histomorphological examination and plasma levels of prostate-specific antigen (PSA). Gleason score was used to grade adenocarcinomas into five grade groups later on. PSA was categorized into 5 groups based on the type of questions they contain. Correlation analysis was performed. Results: As for the type of cancer, it was noted that 37.2 % of the samples had adenocarcinoma. The study subjects were mainly males, and the mean age was 62.2 years. Most of the men were diagnosed with a Gleason score of 7 (12) while 7 men were diagnosed with a score of 6. The mean PSA was 37.2ng/ml in malignancy. The present observation also revealed that higher PSA levels were equated with higher Gleason scores. Out of all the cases that were given a score of 6, there was only one that had the PSA within the normal limits. The overall accuracy of PSA to detect adenocarcinoma was 96.87%, Specificit of 59.25%. Conclusion: It was found that there is a direct relationship between a man’s PSA levels, his Gleason score and his histopathological grade. These parameters are used when determining how severe the prostate cancer is and also when coming up with the treatment plan for the patient.

DOI: 10.5281/zenodo.

20. Impact of Compression Only Life Support Workshop on the Basic Life Support Knowledge in Lay People Aged 18-70 Years from Maharashtra
Hitendra C Mahajan, Sunita Sankalecha, Ruchira Wasudeo Khasne, Nupur Sujay Patil, Sahil Sankalecha, Jeetendra Singh
Abstract
Background and Aims: Compression-only life support (COLS) is a part of emergency care for cardiopulmonary resuscitation of cardiac arrest victims by lay persons outside the hospital which is developed by Indian resuscitation council of Indian Society of Anaesthesiologists. Timely provision of basic lifesaving skills such as COLS to cardiac arrest victims on the site positively influences the final outcome. But the overall awareness and training of life saving skills like COLS among lay people is reported to be poor in India. We present this study which assessed current knowledge about COLS and impact of structured COLS workshops among the general adult population of Maharashtra. We also studied association of various socio demographic variables including literacy status on knowledge acquisition and tried to find suitable recommendations. Methods: Audiovisual demonstration followed by hands-on training of COLS was conducted. All the participants were subjected to pre and post-test before and after the demonstration and hands-on workshop using a pre designed, pre tested questionnaire. Questionnaire contained demographic information and questions on assessment of knowledge of people about COLS. There were 11 questions on various aspects of COLS with a maximum score of 20. Statistical analysis was done by using statistical software SPSS Version 18. Paired ‘t’ test and ‘Chi Square’ test was used for analysis and p value equal to or less than 0.05 was considered significant. Results: Among 1249 participants ranging between 18 years to 78 years were divided in different groups as per the gender and educational level. The gender distribution was comparable among different age groups. For all the groups, the mean post-test knowledge score was statistically significantly high as compared to pre-test score, indicating significant improvement in knowledge by attending the COLS workshop. The pre and post test results among both the genders were equal with no statistical difference showing equal grasping power. Whereas the literacy and educational status among the lay people made significant difference. Conclusions: Regular COLS hands-on workshop teaching to lay people is highly effective in improving basic lifesaving skills. More the literacy/ educational status of the lay person, better is the understanding and execution of COLS knowledge.

DOI: 10.5281/zenodo.

21. Comparison of HR Ultrasound versus Magnetic Resonance Imaging in Diagnosing Peripheral Nerve Pathologies
Saurabh Goyal, Sunil Kast, Tapendra Tiwari, Raja Ram Sharma
Abstract
Background: High-resolution ultrasound (HRUS) and magnetic resonance neurography (MRN) are considered complementary to clinical and neurophysiological assessment for neuropathies. Aim: To compare the accuracy of HRUS and MRN for detecting various peripheral nerve pathologies and to choose the correct investigation to facilitate prompt patient management. Materials and Methods: This prospective study was done using HRUS with 14 MHz linear-transducer and 3 or 1.5T MR in cases referred for the assessment of peripheral nerve pathologies. Image interpretation was done using a scoring system (score 0–3 confidence level) to assess for nerve continuity/discontinuity, increased nerve signal/edema, fascicular change, caliber change, and neuroma/mass lesion. We determined the accuracy, sensitivity, and specificity of these modalities compared with the diagnostic standard determined by surgical and/or histopathological, if not performed then clinical and/or electrodiagnostic evaluation. Results: The overall accuracy of MRN was 89.3% (specificity: 66.6%, sensitivity: 92.6%, negative predictive value [NPV]: 57.1%, positive predictive value [PPV]: 95%) and that of HRUS was 82.9% (specificity: 100%, sensitivity: 80.4%, NPV: 42.8, PPV: 100). The confidence level for detecting nerve discontinuity and change in nerve caliber was found to be higher on ultrasonography than magnetic resonance imaging (MRI) (100 vs. 70% and 100 vs. 50%, respectively). Pathology of submillimeter caliber nerves was accurately detected by HRUS and these could not be well-visualized on MRI. Conclusion:  HRUS is a powerful tool that may be used as the first-line imaging modality for the evaluation of peripheral nerve pathologies, and a better means of evaluation of peripheral nerves with submillimeter caliber.

DOI: 10.5281/zenodo.

22. Incidence of Carbapenem-Resistant Enterobacteriaceae at A Tertiary Care Hospital
Sagar Gordhanbhai Thummar, Devanshi Muljibhai Chaudhari, Falguni Vaibhav Patel, Urvesh Kumar Vipinchandra Shah
Abstract
Introduction: Carbapenem-resistant Enterobacteriaceae (CRE), has been documented across the globe and is linked to elevated mortality rates. CRE pathogens have caused graveconcern due to the limited choice of antibiotics for treating infections caused by them. Therefore, timely detection of CRE is very important for its treatment and prevention. Aims &Objectives: To know the prevalence of CRE in our hospital and to determine the incidence of predominant Carbapenem-resistant Enterobacteriaceae (CRE) species in different areas of the hospital. Materials & Methods: This was an observational retrospective study involving the analysis of nonrepetative 299 specimens of patients of all ages and sexes from indoor and outdoor patient departments (OPD) from June 2020 to September 2020 at the tertiary care hospital. All specimens  were processed and Enterobacteriaceae organisms were isolated by culture and identified by biochemical reactions and further identified as carbapenem-resistant strains by anti-microbial susceptibility testing for carbapenems, done by Kirby-Bauer disk diffusion method according to Clinical and Laboratory  Standards Institute guidelines(CLSI). Result: There were 299 Enterobacteriaceae organisms isolated from received specimens out of which 86(28.76%) isolates were carbapenem-resistant. Most of the CRE was isolated from urinary samples (47.67%)and from ICUs (31.40%) and Wards (55.81%). Most commonly isolated CRE organism was Klebsiella species (65.12%). Conclusion: Our study shows a high incidence of carbapenem-resistant Klebsiella species (65.12%) among isolated Enterobacteriaceae. A significantly high incidence rate of Carbapenem-resistant Enterobacteriaceae was observed amongst indoor patients(87.20%) & was of hospital-associated infections. Hence early detection of CRE organisms and the application of appropriate infection control measures can help prevent and control CRE infections.

DOI: 10.5281/zenodo.

23. Efficacy of Terbinafine and Itraconazole in Different Doses and Combination in the Treatment of Tinea Infection: A Randomized Controlled Parallel Group Open-Labeled Trial with Clinic Mycological Correlation
Abhishek Kumar, Uday Kumar Udayan
Abstract
At Darbhanga Medical College and Hospital (DMCH), this randomized controlled experiment examined the effectiveness of terbinafine, itraconazole, and both of them in treating tinea infections from July to December 2023. Three therapy groups (terbinafine alone, itraconazole alone, or a combination of both) were allocated to a total of 300 patients who had been diagnosed with different types of tinea infections. Recurrence rates, adverse events, and clinical and mycological cure rates were the main outcomes that were evaluated. With a mycological cure rate of 92%, a clinical cure rate of 94%, and a recurrence rate of only 5%, the combination therapy group showed better results. Adverse events were few and comparable in each group. These findings support the idea that combination therapy is more effective than monotherapy in treating tinea infections, and they call for its use in clinical settings to improve patient outcomes. The research emphasizes that combined antifungal medication may be a more successful strategy for treating difficult fungal infections.

DOI: 10.5281/zenodo.

24. Challenging Scenario in the Treatment Paradigm for Patient with Pulmonary Tuberculosis in Systemic Sclerosis Associated Interstitial Lung Disease – Case Series
Akhila Jose, P Ravi, Deekshith Kolluri, M Sravankumar
Abstract
Systemic sclerosis (SSc) is a connective tissue disease marked by immune irregularities, vasculopathy, and excessive collagen production, leading to fibrosis of the skin and internal organs. While SSc can affect multiple organs and systems, lung involvement, particularly interstitial lung disease (ILD), is the primary cause of mortality in this condition. We present here an interesting case of a patient with pulmonary tuberculosis with systemic sclerosis-associated interstitial lung disease.

DOI: 10.5281/zenodo.

25. Evaluation of STOP BANG Questionnaire in Predicting the Difficult Mask Ventilation and Difficult Intubation in Obese Patients
Niranjan Ramesh, Ashish Patyal, Anjana Verma
Abstract
Introduction: Airway is still the most challenging entity for anaesthesiologist even after invention of wide variety of airway gadgets. Unanticipated difficult airway is most difficult to manage, so anticipation of difficult airway is most crucial for anaesthesiologist which can be done by pre-operative assessment. The morbidity and mortality associated with unanticipated difficult airway is very high especially in obese patient as obesity affects multiple organs. By correct anticipation and taking appropriate measures we can reduce it significantly. Objective: To evaluate STOP-Bang score as a tool for predicting difficult mask ventilation and difficult intubation in obese patients. Methodology: 150 obese patients (BMI ≥ 30) with ASA physical status II and III aged 18 years or older undergoing various surgeries under general anaesthesia with endotracheal tube placement were enrolled for the study after taking informed written consent. Preoperatively, these patients were given STOP-Bang questionnaire. Based on questionnaire response and examination, STOP-Bang scoring was done. Score was used to classify obese patients as high risk (≥3) or low risk (<3) for OSA. After attaching standard ASA monitors i.e. electrocardiogram, heart rate, pulse oximeter and non-invasive blood pressure, baseline values were recorded. Mask ventilation grade, Modified Cormack-Lehane Grade, number of attempts of intubation and use of rescue measures were also evaluated in each patient. The collected data was analysed using SPSS version 21, whereas P<0.05 was considered significant. Quantitative data were described using mean ± standard deviation.  Comparison between the quantitative variables were done by using t test and ANOVA.  Results: In our study we found that the mask ventilation grade was significantly associated with STOP-Bang score (p<0.01). It showed that higher the STOP-Bang score, greater the difficulty in mask ventilation. The laryngoscopy grade (Cormack-Lehane grading) was not significantly associated with STOP-Bang score (p=0.125). The patients with high STOP-Bang score required more intubation attempts in comparison to low STOP-Bang score (p value 0.353, statistically not significant). Conclusion: High STOP-Bang score is a good predictor of difficult mask ventilation rather than difficult laryngoscopy however one criterion of STOP-Bang score i.e; neck circumference has direct correlation in predicting difficult airway (mask ventilation and laryngoscopy).

DOI: 10.5281/zenodo.

26. Prevalence of Hypothyroidism in Pregnancy & It’s Impact on Pregnancy Outcome in A Tertiary Care Center in Western Rajasthan: A Prospective Study
Ankita Singh, Satwiki Prasad, Sangeeta Gupta Prasad
Abstract
Background: One of the most common endocrinological disorders encountered during pregnancy is hypothyroidism. Major causes of hypothyroidism are endemic iodine deficiency and autoimmune disease. Thyroid dysfunctions are associated with adverse pregnancy outcomes. This prospective study assesses the prevalence of hypothyroidism, and adverse fetal and maternal outcome in hypothyroid women. Material and Method: this study included 200 pregnant women reporting in the ANC OPD in 1st trimester. The study period is 6 months from January 2023 to June 2023. The adverse outcomes assessed were abortion, preeclampsia, preterm labor and placental abruption, while fetal outcomes noted were IUGR, LBW and still birth. Results: Prevalence of hypothyroidism in the study population was 12%. 8% and 4% women had subclinical and overt hypothyroidism respectively. Most frequent maternal adverse outcome noted was PIH (16.6%) followed by preterm labor, abortion and abruption. Conclusion: High prevalence of thyroid disorders, especially hypothyroidism, is present during pregnancy. The adverse outcome can be reduced by routine antenatal thyroid screening.

DOI: 10.5281/zenodo.

27. Knowledge, Attitude & Practice of Pharmacovigilance among Health Care Professionals & Medical Students in North India
Rajit Sahai, Sanjay Kumar Verma, Neha Srivastava Sahai
Abstract
Background: Adverse drug reaction (ADR) according to WHO is defined as a response to a medicine which is noxious, unintended & which occurs at doses normally used in man for diagnosis, treatment, prevention of disease or modification of physiological functions. As per WHO, Pharmacovigilance is defined as science & activities related to detection, assessment, understanding & prevention of adverse drug effects or any drug related problems. It aims at enhancement of patient safety by assessing risk-benefit profile of the medicines. Hence this study was conducted to assess the knowledge, attitude & practice towards pharmacovigilance among the students, doctors, nurses & pharmacists. Materials and Methods: This cross sectional study was conducted amongst doctors, nurses, pharmacists, helping staff & undergraduate medical students from Naraina Medical College & Research Centre and Rama Dental College, Hospital & Research Centre. A questionnaire was handed out to each and every participant and the response was recorded. The study was conducted for 3 months (April 2023 to June 2023). The questionnaire consisted of three sections which included questions on knowledge & awareness, attitude & practice. Each question consisted to multiple options out of which the participants had to choose single most appropriate option. Results: A total of 500 health professionals participated in the study out of which 244 were medical students (MBBS and BDS), 152 were doctors and 104 were other health care professionals. Students who belonged to mostly second professional of MBBS & BDS fared better in the knowledge aspect of questionnaire. Practicing doctors and physicians (50% average of correct responses in knowledge) of the college though were aware of pharmacovigilance. Other health care practitioners (39.4%) which included nursing staff and various technicians were not so verse with pharmacovigilance. Practicing physicians (71%), students (100%), and other healthcare professionals (58%) had a positive attitude towards reporting of ADRs but what came as the biggest hindrance is the thought of legal repercussions of reporting ADRs. Conclusion: There is a need for the introduction of pharmacovigilance in all curriculums of medicine both at graduate and undergraduate level. So that we can model a vigilant society which could be helpful in both recognizing as well as reporting ADR for the better good of the society.

DOI: 10.5281/zenodo.

28. To Study the Incidence of Uterine Fibroid in Gynaecological Patients
Aditi Rana
Abstract
Background & Methods: The aim of the study is to study incidence of uterine fibroid in gynaecological patients. Most of the studies of fibroid have been based on care-seeking populations, including women undergoing myomectomy or hysterectomy. Among those tumors that come to clinical attention, only a portion of affected women progress to hysterectomy. The decision for surgical intervention primarily reflects the severity of a woman’s symptoms (bleeding or pelvic pain) and her desire to maintain childbearing potential. Results: Total 7% of cases had associated ovarian cyst. The chi-square statistic is 8.1593. The p-value is 0.016914. The result is significant at p < 0.05. Maximum (88%) had less than 2 fibroids. The chi-square statistic is 1.0297. The p-value is 0.031218. The result is significant at p < 0.05. Conclusion: Epidemiologic studies on age at menarche in relation to uterine fibroid have shown an inverse association. The mean age was 12.4±1.29 and the median age was 12 years. On the basis of our current state of knowledge, we can only speculate upon the initiators of this common condition. Future research efforts may provide a better understanding, however, of the causes and mechanisms of uterine fibroid tumorigenesis. Insights resulting from elucidation of the basic biology of these tumors might then be successfully translated into preventative strategies that will reduce the incidence and/or morbidity of this disease.

DOI: 10.5281/zenodo.

29. An Observational Study on Effect of Dexmedetomidine on Postoperative Emergence Delirium in Children Undergoing Tonsillectomy with Propofol Anaesthesia
Kanchan Ravindra Rupwate, Saarani Guha Sarkar, Akshata Pawar
Abstract
Background: Tonsillectomy is a common surgical procedure in children, often associated with high incidence of emergence delirium (ED), which can lead to postoperative airway obstruction and respiratory distress. This study aims to evaluate the effect of dexmedetomidine on the incidence and severity of postoperative emergence delirium in children undergoing tonsillectomy with propofol anesthesia. Materials and Methods: This prospective observational comparative study was conducted at a tertiary health center from November 2018 to August 2020. Seventy children aged 4 to 12 years undergoing tonsillectomy with or without adenoidectomy were included. They were divided into two groups: Group D (35 children) received dexmedetomidine infusion at 0.5µg/kg/hr along with propofol anesthesia, while Group C (35 children) received only propofol anesthesia. Heart rate, systolic and diastolic blood pressure, oxygen saturation, and end-tidal CO2 levels were monitored intraoperatively. Postoperatively, emergence delirium was assessed using the WATCHA scale at 0, 15, 30, 45, 60, 90, and 120 minutes. Pain was assessed using VAS score (for children ≥8 years) and FACES scale (for children <8 years). Extubation time and additional analgesic requirements were also recorded. Results: The incidence of ED was significantly lower in Group D at 0 minutes (P<0.001), 15 minutes (P<0.001), 30 minutes (P=0.008), and 45 minutes (P=0.012). Heart rate was lower in Group D at 45 minutes (P<0.001), 60 minutes (P=0.027), and 75 minutes (P<0.001). Systolic blood pressure was lower in Group D at 45 minutes (P=0.002), 60 minutes (P<0.001), 75 minutes (P<0.001), and 90 minutes (P=0.018). VAS scores at the end of 2 hours were zero for 82.8% in Group D compared to 62.8% in Group C. FACES scores showed significant differences at 0 minutes (P=0.045), 5 minutes (P=0.011), 15 minutes (P=0.030), and 30 minutes (P=0.010). The requirement for opioid analgesia was higher in Group C both intraoperatively and postoperatively. Conclusion: Dexmedetomidine infusion at 0.5µg/kg/hr effectively reduces the incidence and severity of emergence delirium in children undergoing tonsillectomy with propofol anesthesia. It provides stable hemodynamics without prolonging extubation time and reduces the need for additional opioid analgesia.

DOI: 10.5281/zenodo.

30. The Study of Relationship Between Glycemic Control and Platelet Activity in Type 2 Diabetes Mellitus Patients of Tertiary Care Hospital at Rajpipla, Gujarat
Dipeeka D Patel, Nayan Chunilal Koitiya, Dipti Gajjar, Keyurkumar Gulabbhai
Abstract
Background: Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder characterized by chronic hyperglycemia. Glycemic control in T2DM patients is crucial for minimizing complications, one of which is altered platelet activity, contributing to increased cardiovascular risk. This study aims to investigate the relationship between glycemic control and platelet activity in T2DM patients over a six-month period. Materials and Methods: This prospective study was conducted at GMERS Medical College, Rajpipla, Gujarat, involving 110 T2DM patients. Glycemic control was assessed using HbA1c levels, measured at baseline and at six months. Platelet activity was evaluated through platelet aggregation tests and mean platelet volume (MPV). Patients were grouped based on their glycemic control: well-controlled (HbA1c < 7%) and poorly controlled (HbA1c ≥ 7%). Results: At baseline, the mean HbA1c level was 8.2%. After six months, the well-controlled group showed a significant reduction in HbA1c to 6.8% (p < 0.05), while the poorly controlled group remained at 8.1%. Platelet aggregation decreased by 15% in the well-controlled group and increased by 5% in the poorly controlled group. Similarly, MPV decreased by 0.7 fL in the well-controlled group, compared to an increase of 0.2 fL in the poorly controlled group. Conclusion: Effective glycemic control in T2DM patients significantly reduces platelet activity, potentially lowering the risk of cardiovascular events. Regular monitoring and management of blood glucose levels are essential for mitigating platelet hyperactivity and associated complications in T2DM.

DOI: 10.5281/zenodo.

31. Can Cardiometabolic Index (CMI) Be Used As An Early Predictor Of Cardiometabolic Status In Patients With Subclinical And Overt Hypothyroidism?
R Sripradha, M Pavithra, T Rajini Samuel, Balaji Rajagopalan
Abstract
Objective:  The present study was aimed to assess whether Cardiometabolic index (CMI) could be used as an early predictor of cardiometabolic status in patients with subclinical and overt hypothyroidism. Materials and Methods: Age matched euthyroid, subclinical hypothyroid and overt hypothyroid female subjects were divided into three groups (n=30) in the study. Anthropometric parameters such as body weight, height, Waist circumference and Hip circumference were measured. After an overnight fasting, 5 ml of blood samples were collected and serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), lipid fractions – total cholesterol (TC), triglyceride (TG) high density lipoprotein (HDL), very low density lipoprotein (VLDL) and low density lipoprotein (LDL) were estimated. Waist-to-height ratio (WHtR) and CMI were calculated. Results: Bodyweight, TSH, TC, TG, VLDL, LDL and CMI levels were increased in subclinical and overt hypothyroid patients. FT3, FT4 and HDL levels were reduced in patients with overt hypothyroidism. No significant changes were noticed in age, height, waist circumference, hip circumference and WHtR in both hypothyroid groups. CMI positively correlated with TC, TG, VLDL and LDL in both subclinical and overt hypothyroid patients. Negative correlation was found between CMI and HDL levels in patients with overt hypothyroidism. Conclusion: CMI could be used as an early predictor of any adverse cardiometabolic event in hypothyroid patients as it integrates blood lipid levels and abdominal obesity.

DOI: 10.5281/zenodo.

32. HPV and other Vaccine Uptake and Factors Affecting HPV Vaccine Uptake: A Study amongst Medical Students in North India
Aman Dev Singh, Simmi Oberoi, Rohit Batish, Bani Suri, Harjap Singh, Charbhi Gupta, Yash Nirupam
Abstract
Background: Cervical cancer (CC) is a major health issue worldwide, with India accounting for 25% of cases. Human Papilloma Virus (HPV) is the primary cause of cervical cancer, yet the HPV vaccine uptake is low among medical students due to high costs, low acceptance, and insufficient awareness. Methods: This cross-sectional observational study was conducted from February to March 2024 at a Government Medical College in North India, involving 924 medical students. Data were collected using a semi-structured questionnaire via Google Forms. Results: Among the participants, 57% were female. Vaccination rates for Covid-19, Hepatitis B, and HPV were 91.1%, 42.3%, and 7.05% among males, and 72.4%, 36.05%, and 10.03% among females, respectively. Females showed higher vaccination rates for Covid-19 and HPV. The overall HPV vaccination rate was low, with no significant impact from sexual activity on vaccination rates. Conclusion: Despite the low overall uptake of the HPV vaccine among medical students, females showed higher acceptance. There is a need for targeted educational programs and subsidized vaccination initiatives to improve HPV vaccine uptake.

DOI: 10.5281/zenodo.

33. Comparison of Modified Intraosseous Patella Suturing vs Conventional in TKR and its Outcome in Post Operative Patella Tracking
Manju G Pillai, Clint Hugh, Sanjay Nath, Achu S Nair
Abstract
Aim: To develop a novel technique of modified intraosseous patella suturing and to compare with conventional suturing technique and its effect in post- operative patella tracking. Method: We have described a technique of intraosseous patella suturing technique for the arthrotomy wound. A prospective comparative longitudinal study was done in our tertiary care center over a period of 6 months starting from November  2022 till April 2023  wherein the patients were categorized into two groups – Group A conventional technique while Group B our novel technique was done for suturing of medial arthrotomy wound .Post-operative   patella tracking was estimated using patella tilt and lateral displacement in standard radiograph. Result: This is an easily reproducible technique and has several advantages over other methods of closure. In group B nearly 90 percentage of patients had better outcome in-terms of patella tilt and lateral displacement compared to group A. Conclusion: The modified intraosseous patella suturing technique can be used for medial arthrotomy closure and has better outcome in terms of patella tracking post operatively.

DOI: 10.5281/zenodo.

34. Evaluation of Seasonal Fluctuations in Metabolic and Lipid Profiles in Healthy Adults
Rajula Tyagi, Sunil Tyagi, Sarath Babu V, Bharatkumar Mansinhbhai Chaudhari
Abstract
Introduction: Seasonal changes have been shown to significantly affect animal physiology and behavior. Similarly, human physiology is sensitive to environmental shifts, including seasonal changes. Research has demonstrated that conception rates, birth rates, immune responses, metabolism, and body composition exhibit seasonal patterns. This study aimed to investigate whether body fat percentage (BF%), basal metabolic rate (BMR), and serum lipid levels vary seasonally in healthy, sedentary urban adults at the end of summer and winter. Materials and Methods: This cross-sectional study examined the seasonal variations of BF%, BMR, and serum lipids in 54 healthy, sedentary urban adults (41 males and 13 females) aged 20-60 years. Anthropometric data, including age, sex, weight, height, waist circumference, and hip circumference, were collected. Venous blood samples were taken to measure fasting serum lipid levels. BF% was determined using dual-energy X-ray absorptiometry (DEXA) scans, and BMR was calculated using the Harris–Benedict equation based on height, weight, and age. Results: The study found significant seasonal variations in BF%, BMR, total cholesterol, triglycerides, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) among all participants. Notably, significant seasonal variations in BF% and LDL were observed within the obese subgroup of participants. Conclusion: There is a seasonal variation in BF%, BMR, and serum lipids between the end of summer and the end of winter. Additionally, a positive correlation exists between body mass index (BMI) and BF%, BMR, LDL, and HDL. Similarly, a positive correlation is observed between BF% and BMI, BMR, HDL, and LDL.

DOI: 10.5281/zenodo.

35. Assessment of Maternal Knowledge and Prevailing Weaning Practices among Women in Urban Health Training Centre: A Descriptive Study
Mukesh Nandan, Shahin, Saumya Kumari
Abstract
Introduction: Weaning period is the most crucial period for child growth and development. Maternal knowledge and practices during this period play a crucial role in shaping the infant’s nutritional status and overall health. According to WHO and UNICEF, poor infant feeding practices and their consequences are one of the world major problem and serious obstacle to social and economic development. This study aims at assessing the knowledge of mothers on weaning and weaning practices. Research Methodology: A descriptive research design was used to assess the knowledge and practice regarding weaning. Total 200 sample are taken for period of six months. The data was collected in a safe environment through interviews based on a pre designed and pre tested questionnaire. The data was analysed using Epi info version 7 and results were drawn. Result: Among the studied population 85% were found to have knowledge about weaning practices. The association between educational status and awareness about weaning was found statistically significant with p value <0.05. Majority of the children were colostrum fed. Different food habits were also observed.

DOI: 10.5281/zenodo.

36. Study of Prevalence of Leukocytospermia in Government Teaching Hospital, JNKTMCH, Madhepura
Deo Kumar Singh, Sanjay Kumar Sahni, Gluam Tabrez
Abstract
Background and Objectives: Infertility and childlessness is one of the major health and family problems throughout the world. The prevalence of infertility in the general population is estimated to be 15% to 20%. Of this, male factor alone is responsible for 20 to 40%. Human male infertility is normally assessed on the basis of semen analysis. Among the various parameters which are studied, the association between seminal Leukocytes and semen quality is still contradictory, but majority of the studies have proved the significant role of leukocytes in altering the semen quality by various mechanisms like ROS production, immune reactions etc., and causing deleterious effects on sperm count, motility, morphology, etc., resulting in infertility. Leukocytospermia is defined as the presence of more than 1 million leukocytes per milliliter of semen by the WHO and is also included in the WHO guidelines for semen analysis since long back. To study Leukocytospermia in semen samples. To find out the prevalence of leukocytospermia in the general (male) population of surrounding feeding areas with special reference to infertile men. To study the relation/association between leukocytospermia and infertility status. Methodology: A Total of 95 semen samples were received in the department of pathology with history of infertility, varicocoele, undescended testis, etc., One sample could not be processed because of urine contamination. Routine semen analysis including leukocyte count by Peroxidase staining test was done on all the remaining 94 samples. Out of these 94 samples, 6 were repeat samples of short duration, another 6 were with history other than infertility like varicocoele, undescended testes, etc., and 5 samples had symptoms of urinary tract infection. So, excluding these, the remaining 77 samples with history of infertility were taken up for leukocytospermia study. Conclusion: Leukocytospermia is not to be neglected as it is found to be associated with significant number of idiopathic male infertility cases, and in-turn, it is influenced by many factors like smoking, etc. Detection of leukocytospermia by simple and cost- effective tests like Leukocyte Peroxidase staining should be included in the routine semen analyses especially in men under infertility investigation before putting them to higher, deeper and high-cost investigations, and appropriate and timely intervention may help the men with infertility due to leukocytospermia.

DOI: 10.5281/zenodo.

37. Study on Incidence of Pathologies/Chronic Illnesses, Morphological Patterns and Their Associations in Anemia of Chronic Disease
Sanjay Kumar Sahni, Deo Kumar Singh, Gluam Tabrez
Abstract
Background and Objectives: Anemia of chronic disease (ACD) is the second most prevalent anemia overall after iron deficiency anemia which develops under the setting of chronic infections, cancer or autoimmune diseases. Detection of the type of anemia is important to execute a correct treatment plan. Identification of anemia of chronic disease will definitely have great impact on treatment. To study the incidence of morphological patterns in anemia of chronic disease. To evaluate the incidence of chronic illnesses manifesting as anemia of chronic disease. To evaluate the frequency of association of morphological patterns with disease entity. Methodology: 100 cases of age group between 18-80 years having chronic illnesses attending the outpatient clinic as well as admitted patients of JNKTMCH, Madhepura. with hemoglobin <13 g/dl (haematocrit <39%) in men and women with hemoglobin <12g/dl (haematocrit <36%) included in the study. The hematological parameters were analyzed using automated hematology analyzer Mindray BC-3000 plus. The morphological patterns of the red blood cells were studied in peripheral smears. Anemia of chronic disease was identified using Serum ferritin assay, serum iron estimation and total iron binding capacity. Conclusion: ACD is an unrecognized problem and diagnosis of ACD   is the need of an hour. Thus, the present study was undertaken, keeping this need in view.

DOI: 10.5281/zenodo.

38. Clinicopathological Profile of Head & Neck Swellings Undergoing FNAC in a Tertiary Care Hospital
Deo Kumar Singh, Sanjay Kumar Sahni, Gluam Tabrez
Abstract
Background and Objectives: Head and neck swellings are the commonly encountered disorders in our hospital, with a range of inflammatory, benign and neoplastic diseases involving different age groups. This study was undertaken to study the cytological types of inflammatory, benign and neoplastic swellings correlate with histologic result. Methods: Written informed consent is taken from all patients included in the study. The study was carried out on 250 patients in the Department of Pathology at JNKTMCH, over a period of 2 year prospective study, Patients was referred to the Cytology section from various departments. Predominantly from the departments of Otorhinolaryngology, General Surgery, Medicine and Paediatrics. The lesions included those from the thyroid, salivary glands, and lymph node, nose and paranasal sinuses. Conclusion: Head and neck swellings are common condition encountered in clinical practice. The advantages of FNAC are, it is safe, gives a quick result, is sensitive and specific for the diagnosis of malignancy, requires minimal equipment, is an outpatient procedure, avoids the use of frozen section, reduces the rate of exploratory procedures, allows a definitive diagnosis of inoperable cases, and is repeatable and cost effective. To conclude, FNAC is a minimally invasive first line investigation with a high sensitivity and specificity for the diagnosis of various head and neck lesions.

DOI: 10.5281/zenodo.

39. Lutein Mediated Inhibition of Ovarian Cancer Cell Proliferation In-Vitro
Alok Saxena, Anupama Mahajan, Suryakant Nagtilak, SN Bahuguna
Abstract
Purpose: There is little evidence supporting lutein’s, carotenoid, anticancer effects on ovarian cancer cells. The prognosis for ovarian cancer is still not great, particularly in places with limited resources. For this reason, it’s critical to keep tracking the incidence of ovarian cancer in order to pinpoint disparities in the disease’s management. Methods: Various amounts of carotenoids were applied to cancer cells at 37°C in a CO2-containing 5% incubator. Cell proliferation was measured using the MTT test, and the anti-proliferative activity against cancer cells was evaluated using IC50 values. Results: After 24 hours of incubation, lutein (IC50 = 0.77 µM) was more effective on PA-1 cells (lower IC50) than it was after 48 hours (IC50 = 1.62 µM).

Conclusion: This study found that lutein can cause cancer cells to die and impede their ability to proliferate.

DOI: 10.5281/zenodo.

40. Public Attitudes toward Psychiatric Hospitals: A Rural-Urban Comparative Public Survey in Bihar, India
Vidushi, Raj Kumar Chandan
Abstract
This study explores the disparities in public attitudes towards psychiatric hospitals between urban and rural populations in Bihar, India, through a descriptive cross-sectional survey. A total of 1,000 participants (500 from urban areas and 500 from rural regions) were interviewed using structured questionnaires. The findings reveal significant differences: urban participants displayed higher awareness and less stigma towards psychiatric care, whereas rural respondents showed substantial barriers to access, including greater stigma, financial constraints, and geographic isolation. These results suggest a crucial need for targeted mental health education and services, particularly in rural areas, to mitigate disparities and improve healthcare outcomes. Strategic interventions such as telepsychiatry, mobile health services, and community education programs are recommended to enhance accessibility and reduce the stigma associated with psychiatric care.

DOI: 10.5281/zenodo.

41. A Comparative Study of Island Cartilage Graft Tympanoplasty and Temporalis Fascia Graft Tympanoplasty in Chronic Suppurative Otitis Media with Subtotal Perforation
Nalina P A, Sathish Kumar K N, Malavika Hari, Spandana S Pardikar
Abstract
Background: Chronic otitis media is a common condition for which the patient present to Otorhinolaryngology, constituting about 30% of the ENT outpatient numbers. Chronic otitis media implies a permanent abnormality of pars tensa or flaccida, most likely a result of acute otitis media, negative middle ear pressure or otitis media with effusion. Being surgery the main treatment modality of treatment, tympanoplasty using various types of graft materials is essential in the management of the disease. Temporalis fascia is most commonly used graft. Various other grafts materials include cartilage, areolar tissue, ear lobule fat, and vein. Cartilage is also a popular graft which can be used in the form of palisade, perichondrium/cartilage island, butterfly and shield graft. Hence this study was conducted with the objectives to compare the surgical outcome in terms of graft acceptance between the island cartilage graft and temporalis fascia graft used in type 1 tympanoplasty, to compare the audiological outcomes and complications. Methods: A cross sectional (Hospital based) study was conducted at Krishna Rajendra Hospital, Mysore attached to Mysore Medical College and Research Institute, Mysore. Patients attending the OPD with mucosal type of COM with subtotal perforation were included in the study between October 2018 to September 2019. Patients were divided into two groups alternatively and type one tympanoplasty was performed using island cartilage in one group and temporalis fascia in the other after clinical examination, examination under microscope and performing pure tone audiogram. Postoperatively they were followed up at third and eighth weeks to assess the graft uptake and audiological parameters. Results: In our study the graft uptake was similar in both island cartilage and temporalis fascia group. The audiological gain in terms of AB gap closure is slightly better in the temporalis fascia group than the island cartilage. Conclusion: In type 1 tympanoplasty, both temporalis fascia and island cartilage can be used for structural stability and temporalis fascia gives better audiological results.

DOI: 10.5281/zenodo.

42. Age-Related Changes of Thyroid Gland: A Histological Study
Margret William, Cessy Job
Abstract
Background: The thyroid gland is an important endocrine gland that has a role in growth and development, rate of metabolism, and blood calcium level maintenance. In the course of aging anatomical features and functions of the thyroid gland undergo age-related changes. Literature is giving controversial results on age-related changes. This study aims to identify the age-related changes that occur in the thyroid gland. Methods: A descriptive study on age-related changes of thyroid gland conducted in Department of Anatomy, Govt Medical College Kottayam. 100 specimens of the thyroid gland were collected from the Department of Forensic Medicine during autopsy. A histological study was conducted on the follicular cells and mean follicular diameter after staining the slide with Haematoxylin & Eosin stain. Data was entered in MS Excel and analysed using SPSS software. Results: Specimens were grouped into 0-20, 21-40, 41-60, and >60 years. Histological studies showed a significant negative correlation between age and mean follicular diameter (p-value .006, <0.05). Mean follicular diameter was maximum in the less than 20 years group (135.07±20.17µm) and gradually decreased and became 122.67±68µm in 20-40 years of age and 113.59±55µm in 40-60 years of age. Mean follicular diameter was minimum in >60 years (81.6±42.37µm). In individuals ≤20 years and >60 years, 74% of specimens were having squamous lining for thyroid follicles. In 21 to 60 years of age, 82% of follicular epithelium was either cuboidal or columnar, and only 18% had a squamous lining. Squamous epithelium implies that the gland is inactive in 74% of people at extremes of age.  This observation was significant statistically. Conclusion: This study shows that there are significant changes in the histology of the thyroid gland as age advances. As the age of the person increases there is a significant reduction in mean follicular diameter. In the majority of specimens (74%) follicular cells showed inactive squamous epithelium in the <20 and >60 years age group.

DOI: 10.5281/zenodo.

43. Study Urinary Calcium-Creatinine Ratio as a Predictor of Pre-Eclampsia in Pregnant Women
Anshika Agarwal, Puneet Agrawal, Ayush Agarwal
Abstract
Aim: To study the urinary calcium-creatinine ratio in prediction of pre-eclampsia in pregnant women. Objectives: (1). To study the urinary calcium : creatinine ratio among all pregnant women. (2). To correlate the urinary calcium : creatinine ratio in normotensive and pre-eclamptic women. Methodology: This Prospective, observational study was conducted in the Department of Obstetrics and Gynecology, Sri Ram Murti Smarak Institute of Medical Sciences, Bareilly. Urinary calcium creatinine ratio was determined in a random sample of urine in 50 patients of pre-eclampsia (Study group) and 50 normotensive pregnant (Control group) patients of age 20-35 years with gestational age 20 weeks onwards. Cut off value for CCR was taken as ≤ 0.04. Results: Out of 50 pre-eclamptic cases, 26(52%) cases in the study group had CCR ≤0.04 while only 7(14%) cases in control group had CCR ≤0.04 with a statistically significant p value of 0.000. On statistical analysis, CCR at ≤0.04 had a sensitivity of 52%, specificity of 86%, positive predictive value of 79% and negative predictive value of 64%. The accuracy of the test was 69%. Conclusion: A single estimation of urinary calcium to creatinine ratio in asymptomatic pregnant women after 20 weeks of gestation is a simple and cost-effective test. A value of less than or equal to 0.04, in a spot urine sample, has a good predictive value for preeclampsia.

DOI: 10.5281/zenodo.

44. Innovative Approaches in Combating Antimicrobial Resistance: A Comprehensive Review
Sriram Kamireddy Ravichandran, S.M.T. Keerthanah, S. Swarna, R.Gopinath
Abstract
Antimicrobial resistance (AMR) is a significant and growing hazard to worldwide public health, caused by antibiotic overuse and misuse, as well as a lack of innovation in pharmaceutical research. This thorough study investigates novel techniques to combating AMR, such as combination medicines, immunotherapy, phage therapy, antimicrobial peptides, nanoantibiotics, probiotics, CRISPR-based therapeutics, and antimicrobial photodynamic therapy. These tactics use cutting-edge technologies and innovative mechanisms of action to overcome resistance and improve therapeutic efficacy. Antimicrobial treatment regimens can be optimized and resistance development can be minimized by the integration of combination drugs and personalized medicine. However, tackling the difficulties of AMR necessitates a multidisciplinary and collaborative effort involving healthcare practitioners, researchers, legislators, regulatory agencies, and the pharmaceutical sector. By embracing innovation, teamwork, and proactive measures, we can reduce the burden of AMR and ensure antibiotics’ continued effectiveness for current and future generations.

DOI: 10.5281/zenodo.

45. Incidence and Management of Complications of Parotid Surgery in a Tertiary Care Center
Dipjyoti Barman, Medha Mishra, Gautam Kumar Nayak
Abstract
Introduction: The parotid gland is the largest of the paired major salivary glands, located in the parotid space. It secretes predominantly serous saliva via the parotid duct into the oral cavity to facilitate mastication and swallowing. Tumors of parotid can be benign or malignant. Most parotid gland tumours grow slowly over a long period of time without causing symptoms. The patient with a parotid tumour eventually becomes aware of a mass that is steadily getting bigger behind the angle of their jaw in the retromandibular region, in front of the tragus or in the cheek. The gold standard management for parotid tumors is surgery. Complications post-surgery depends on type of surgery, extent of disease and experience of surgeon. Aims: To study the relative occurrence of benign and malignant parotid tumors in all age groups and both genders. To study the immediate and late complications of parotid surgery. Methods: This is a descriptive retrospective study comparing the incidence of benign and malignant tumors of parotid gland and the complications of parotid surgery in the Otorhinolaryngology department of Gauhati Medical College. Conclusion: Parotidectomy is a challenging surgery and best means of reducing iatrogenic facial nerve injury still remains a clear understanding of the anatomy, good surgical technique with the use of multiple anatomic landmarks. The goals, rationale, and risk of the operation, such as the general complications associated with the surgical procedure and facial nerve palsy, cosmesis should be explained to the patients.

DOI: 10.5281/zenodo.

46. A Study on the Correlation between Anthropometric Factors and Prehypertension in Medical Students
Grace Mary Paul, Vidhya T, Kavitha C P, Mary Chacko P
Abstract
Introduction: Hypertension is a significant health concern globally, and its prevalence has been rising over the years. Blood pressure readings that exceed normal but fall short of being classified as hypertension are referred as prehypertension. Blood pressure in the prehypertensive range is 120/80 mmHg to 139/89 mmHg.It can develop in childhood and adolescence and last into adulthood. It has the potential to cause hypertension and its related consequences in later life. One known risk factor for both prehypertension and hypertension is obesity. Various anthropometric measurements can be used as indicators of obesity and help healthcare providers to assess an individual’s risk of developing prehypertension and hypertension. Promoting good lifestyle practices is crucial for avoiding and treating prehypertension and its consequences. These practices include regular exercise, a balanced diet, and weight control. Aim: To study the correlation between anthropometric factors and prehypertension in 250 medical students in Government Medical College Kottayam. Materials and Methods: A proforma was distributed following approval from the principal and 250 medical students. Following that, blood pressure, waist circumference, hip circumference, waist-hip ratio, and triceps skinfold thickness were measured. The data was entered into Microsoft Excel. Using SPSS, the statistical analysis was completed. The mean and standard deviation for quantitative variables were calculated. The Pearson correlation coefficient is used to examine the relationship between anthropometric characteristics and blood pressure (SBP and DBP). Results: Correlation between systolic blood pressure and waist circumference, hip circumference, waist-hip ratio was highly significant but was not significant between triceps skinfold thickness. There was significant positive correlation between diastolic blood pressure and waist circumference, hip circumference, waist-hip ratio. However, a negative correlation was found between triceps skinfold thickness and diastolic blood pressure. Association of BP category with waist circumference category, hip circumference category, triceps skinfold thickness category were significant. Conclusion: 1. In the study subjects, blood pressure had significant positive correlation with waist circumference, hip circumference and waist-hip ratio. 2. Prehypertension was significantly correlated with categories for waist circumference, hip circumference, and triceps skinfold thickness.

DOI: 10.5281/zenodo.

47. Study of Comparison of Pass Percentage using Structured Formats and Traditional Method in Biochemistry Internal Practical Examination among First M.B.B.S. Students
P. Aruna, S Vasantha, Kalinigiri Pundari Kakshaiah, Sandya Rani, Haseena. C
Abstract
Introduction: Structuring of questions and assessment has been emphasized and gained importance in the practical evaluation. The objective structured practical examination (OSPE) is now an accepted tool in the assessment of practical skills in CBME curriculum. If structured formats are designed on various practical aspects, it improves their learning and thereby increases their pass percentage during assessment. Aims and Objectives: 1) To introduce structured format as a method of assessment of practical skills and learning. 2) To compare pass percentage of students by using structured formats in comparison to traditional methods. 3) To explore faculty perception on introduction of structured formats in practical examinations. 4) To determine students perception on structured format type of practical examination. Materials and Methods: The study was conducted in Biochemistry department, ACSR Government medical college, Nellore. Phase1M.B.B.S students of 2020-21 Batch were enrolled in the study. One lecture on use of structured format questionnaire was taken for the entire 175 batch of students. The examination was conducted for 7 days with a batch of 25 each day. They were divided into two groups. One group received structured practical examination (SPE) and the other group traditional method (TPE). Cross over of the groups was done on the same day in the afternoon session. Results & Discussion: In our study the mean values of marks obtained through structured practical examination was statistically significant in comparison to traditional method (p value equal to 0.0002). The percentage of students who scored marks in the range of 60-69 and 70-79 was increased in SPE in comparison to TPE. Feedback given by students was constructive and showed high acceptance. Conclusion: The mean values of marks obtained through structured practical examination were statistically significant in our study in comparison to traditional method. OSPE is feasible and have good reliability and validity for evaluating practical skills of undergraduate medical students apparent by examiners and students.

DOI: 10.5281/zenodo.

48. Exploring Menstrual Hygiene Practices and Associated Genital Infection Patterns among Students in a Medical College in South Kerala: A Cross-Sectional Study
Nalam Middleton A, Anilkumar Sarath, Sanya Rose Antony, Sharon Anna Raju, Vidyaprasad Silpa, Serene Joseph, Sneha Vinod, Sandra Thomas, Sajeevkumar Sanjana
Abstract
Introduction: Menstrual hygiene is a critical aspect of women’s health that encompasses practices and facilities necessary for women and girls to manage menstruation safely and hygienically. Despite significant advancements in healthcare, menstrual hygiene practices remain a matter of concern, especially in regions with limited resources and cultural barriers. South Kerala, known for its diverse cultural landscape and socio-economic disparities, presents a unique context for exploring the relationship between menstrual hygiene methods and genital infection rates, particularly among students in medical colleges. This paper aims to delve into this crucial intersection by investigating the usage of different menstrual hygiene methods and the pattern of genital infections among female students. This study aimed to assess the various menstrual hygiene methods used by students in a medical college in South Kerala and the genital infections associated with it. Methods: This cross-sectional study was conducted among 360 female medical students of Dr. SMCSI Medical College, Karakonam, Kerala. Data was collected via Google forms using a pretested, semi-structured questionnaire. Results: 333 (92.5%) of the students are using disposable pads as their primary methods of menstrual hygiene followed by 23 (6.3%) using menstrual cups. Among the study participants 33 (9.2%) of them had or currently having reported of genital infections. It was found that those with less frequent pad changes had a higher risk of infections, though no direct association was found between infection rates and menstrual hygiene methods. Conclusions: This study sheds light on the menstrual hygiene practices and health outcomes among female medical students in South India. The study underscores the need for targeted public health interventions to improve menstrual hygiene practices and reduce infection rates among college students.

DOI: 10.5281/zenodo.

49. Caregiver Chronicles: Evaluation of Stress and Psychiatric Morbidity in Primary Caregivers for Alzheimer’s- Type Dementia and Its Relationship to Their Personality Traits and Sociodemographic Characteristics
Swati Singh, Shweta Chauhan
Abstract
Background: The main causes of caregiver stress and psychiatric morbidity were the patient’s behavioral and cognitive status, the number of hours spent providing care, stress, social isolation, gender, the caregiver’s relationship to the patient and their personality, and the accessibility of support resources. The impact of caregiving on the family must be quantified. Quantification and identification are critical for developing effective ways to alleviate caregiver pain. Objectives: The goals of this study were to assess stress and psychiatric morbidity in the main caregivers of Alzheimer’s dementia patients and to link them with the socio-demographic and personality profiles of primary caregivers. Methods: A cross-sectional study was done on a sample of 50 primary caregivers of Alzheimer’s dementia patients meeting the study’s inclusion requirements and attending the outpatient department (OPD) of psychiatry, medicine, and neurology at TMMCRC, Moradabad, using the PSLE, BPRS, HMSE, PF-16 scale, and relevant sociodemographic performance measures. Results: Seven caregivers (14%) did not report any stress when the Presumptive Life Events Scale was used to screen for stress. Of the participants, 26 (52%) experienced moderate stress, and 17 (34%) experienced severe stress. PSLE was found to be statistically significant (p > 0.05) among caregivers who reside in urban areas and have completed high school or more education. It was discovered that eight people (16%) had minor psychiatric illnesses. Self-control with conscientious personality owners scored much higher than those with unrestrained personalities, while caregivers with independent personalities scored significantly higher than accommodating caregivers (p = 0.014). Conclusion: The study concludes by highlighting the significance of a thorough management strategy that involves forming a collaborative relationship between family caregivers and medical experts.

DOI: 10.5281/zenodo.

50. Digital Eye Strain among Undergraduate Medical Students: A Cross-Sectional Study
Priyesh Shroff, Chetana Karamta, Ishita Ravaliya
Abstract
Background: The increased use of online educational platforms among undergraduate medical students may lead to digital eye strain (DES). This study aimed to evaluate the patterns of digital device use, the prevalence of DES symptoms, and the awareness of DES among these students. Materials and Methods: This cross-sectional study was conducted among undergraduate medical students at GMERS Medical College, Junagadh, Gujarat, using a self-administered online questionnaire. Results: Out of 1,000 students, 600 responded to the questionnaire. Among these, 89.33% (536 students) reported experiencing ocular and extra-ocular symptoms of DES, with headaches, watering, and redness of the eyes being the most common. Although 46.16% (277 students) were aware that digital device use can cause eye strain, less than 10% were aware of the ideal viewing distance for screens. Conclusion: The study found a high prevalence of DES among undergraduate medical students. The lack of regular breaks and improper glare control from screens were linked to DES symptoms. Awareness of ergonomic measures during device use was notably low among the students.

DOI: 10.5281/zenodo.

51. Assessment of Knowledge and Attitude on Human Papilloma Virus Infections, Cervical Cancer and HPV Vaccinations among Healthcare Students in a Tertiary Care Hospital, Tamilnadu
H. Sumayya Fathima, D. Sumetha Suga, V. Kalpana Devi, B. Ananthi
Abstract
Introduction: According to estimates, there will be about 350,000 deaths from cervical cancer in 2022 and 660,000 new cases worldwide, making it the fourth most frequent malignancy among women. If caught early and given the right care, cervical cancer (CC) is a disease that can be prevented. The most important risk factor for CC is Human Papilloma virus(HPV)and the strains that are most frequently associated are HPV 16 and HPV 18. HPV vaccine can effectively prevent people from developing CC, if administered at the right time with appropriate age. Creating awareness about the route of transmission and role of HPV vaccination as preventive measures, will majorly contribute to the declination of incidence rate of cervical cancer case. Healthcare medical and paramedical students play a significant role as part of front-line support in delivering holistic care to patients. They act as a bridge between the community and health care sector. They play a major role in educating and creating awareness of Human Papilloma virus(HPV) infection, and its prevention. Hence this study was done to understand the knowledge and attitude of healthcare students towards HPV infection, cervical cancer and HPV vaccination. Methodology: This study was designed as a cross-sectional questionnaire based study. Validated questionnaire tool was prepared and assessment was made among 630 healthcare students of the age group >18 years. Their knowledge and attitude regarding cervical cancer (risk factors, screening and prevention) and HPV was explored and analysis was done using SPSS software. Results: 60.8% Healthcare students had knowledge that HPV can cause cervical cancer and 62.7% were aware that HPV vaccine can effectively prevent cervical cancer. The overall knowledge assessment showed that majority of the student group had below average score. 70 participants scored above average, 204 participants scored average and 356 participants scored below average. 14.6% girls were HPV vaccinated and 26.5% were not aware of their vaccination status. The study demonstrated a positive attitude towards willingness to get vaccinated and spreading awareness to friends and families. In our study, 76.9% of Male students were also aware that vaccination for HPV is also available for both gender. Conclusion: The study results showed the need for educational and awareness sessions on HPV virus infections among healthcare students. Health care providers must share the knowledge to the students which can contribute majorly in spreading the awareness among young adults, patients and community regarding uptake of HPV vaccinations and prevention of acquiring HPV infection.

DOI: 10.5281/zenodo.

52. A Clinical Study on Management of Sigmoid Volvulus at a Tertiary Care
M. Govindu Naik, Sunkula Sriharsha, Naredi Venkata Ramana, K Naga Santosh Kumar
Abstract
Background: Sigmoid volvulus is a common cause of large bowel obstruction and its mortality remains significant in patients with late diagnosis. Procedure performed for the condition also affects the mortality of the case. Options available are sigmoidopexy, resection and anastamosis and temporary diversion by stoma. Aim of the study was to assess the clinical presentation, management and outcome of sigmoid volvulus. Methodology: A Prospective observational study done in the patients treated for sigmoid volvulus in the Department of General Surgery in a Tertiary Care Centre over a period of 2 years. Results: A total of 10 patients (M: F = 2:3) representing 8.92% of all cases of intestinal obstruction were studied. 6 cases presented in acute emergency and 4 cases had recurrent or chronic cases. 5 patients were treated with Hartman’s procedure and 5 had resection and primary anastamosis. The average length of hospital stay was 14 days. A case (10%) was dead due to sepsis related issues and 3 cases had surgical site infection. Conclusion: Management of sigmoid volvulus depends on bowel condition, patient’s presentation and physiological status. Colostomy should be considered if the bowel is gangrenous or perforated or patient in shock, resection anastamosis is advised in recurrent and in patients with no shock and sepsis.

DOI: 10.5281/zenodo.

53. Ultrasound Guided Platelet Rich Plasma or Corticosteroid for Supraspinatus Tendonosis or Partial Tear
Abhinav Kotak, Dipak Suthar, Amit P Shah
Abstract
Background and Aim: PRP is a viable option for treating rotator cuff disease, providing an alternative to corticosteroid injections. In this study, our main goal was to observe and evaluate the effectiveness of two different treatment methods in terms of providing relief from symptoms and improving range of motion. We also wanted to determine how long the patients remained symptom-free and how much their overall function improved during the follow-up period. Material and Methods: A clinical outcome study was conducted in the orthopaedics department of a Tertiary Care Teaching Institute in India for duration of 1 year. In this study, 100 patients who tested positive for supraspinatus tendinitis and had MRI results suggesting the same condition were divided into two groups. The groups were determined based on whether the patients received intra-articular CS or PRP injection under ultrasonography guidance. Patients were monitored to evaluate their progress at 6 weeks, 3 months, and 6 months after the intervention. Results: VAS scores for pain, activity, and satisfaction, as well as the OSS scores and CM scores, were similar before the injection. There was a notable contrast between the two groups in terms of patients with a history of overhead activity. In the PRP intervention arm, 64% of patients had this history, while in the CS intervention group, only 36% did. The PRP group showed significantly better scores for both OSS and CM compared to the other group, even though there were only slight differences in the scores at 6 weeks and 3 months. Conclusion: Our study found that both the corticosteroids and PRP group showed improvement in all the parameters. However, the PRP group showed a significant reduction in pain at the 6-month follow-up, as evidenced by improved VAS score. Additionally, the PRP group also showed improvements in functional ability and quality of life, as indicated by the Oxford shoulder score and constant Murley score.

DOI: 10.5281/zenodo.

54. Ultrasound-Guided Vs. Conventional Approach for Caudal Block in Pediatric Patients: A Comparative Study
Rinkuben Chandulal Patel, Bansiben Dilipkumar Thakkar, Vidhiben Yogeshkumar Patel, Pravinkumar Chunilal Patel
Abstract
Background and Aim: Surgical procedures below the umbilicus have typically been recommended to utilize caudal blocks. Their popularity has grown in pediatric cases due to their simplicity and low risk of complications. Some sources have mentioned the use of this technique as the only form of anesthesia in children who may not be suitable for general anesthesia. Our objective was to compare two different methods of administering caudal block in paediatric patients. Material and Methods: A study was conducted on 100 patients between 6 months to 5 years of age, who were divided into two groups (Group A and Group B) of 50 patients each. Comparisons were made between both groups in terms of intra-operative analgesia, haemodynamic parameters, time required to perform the block, and demand for rescue analgesia. Results: The intra-operative haemodynamic parameters were similar in both groups. Group B took significantly longer to perform the block compared to Group A. The statistical significance level was found to be less than or equal to 0.05. In Group A, the success rate at first puncture was 52%, while in Group B it was 48%. Most patients reported feeling calm and at ease during the first hour after their surgery. The need for additional pain relief after surgery was similar in both groups. Conclusion: the caudal block is a commonly used regional anesthesia technique in the pediatric population. The conventional technique is known for being easier and less time consuming compared to the ultrasound-guided technique, which is relatively new and requires expertise from the practitioner.

DOI: 10.5281/zenodo.

55. Analysis of Cardiac Function in Patients with Alcoholic Cirrhosis
Sushil Kumar, Pankaj Mohan Shrivastava, Gopi Nath Dubey, Krishna Kumar Jha
Abstract
Background: Liver cirrhosis is a condition that is frequently seen in clinical settings and causes a considerable amount of morbidity and mortality worldwide. This is a slowly progressing, chronic illness that affects the liver in a diffuse manner. It is linked to nodule formation; excessive collagen deposition that causes fibrosis, liver cell degeneration, and abnormal vascular architecture that alters hemodynamics. The aim of the present study is to evaluate cardiac function in liver cirrhosis patients. Methods: Between April 2023 and March 2024, 74 patients with a diagnosis of liver cirrhosis who were admitted to the Department of Medicine at the DMCH in Laheriasarai, Bihar, participated in a cross-sectional study. Results: 59 cases (79.73%) in all had an LVDD diagnosis. Of them, Stage 1 LVDD (impaired relaxation) accounted for 47.29% of cases, Stage 2 LVDD (pseudo normal) for 31.08%, and Stage 3 LVDD (severe restrictive type) for just one patient. Conclusion: While systolic function is preserved until severe hepatic failure, left ventricular diastolic impairment is frequently linked to the progression of hepatic dysfunction.

DOI: 10.5281/zenodo.

56. Acute Kidney Injury in Patients of Falciparum and Vivax Malaria: A Observational Study
Pankaj Mohan Shrivastava, Gopi Nath Dubey, Sushil Kumar, Umesh Chandra Jha
Abstract
Background: Acute kidney damage (AKI), a major consequence of Plasmodium falciparum malaria, is well-known; nevertheless, Plasmodium vivax malaria is now frequently responsible for this consequence. AKI is also caused by P. vivax malaria, according to numerous recent publications. The purpose of this study is to examine the demographic profile, clinical characteristics, mortality indicators, dialysis requirement, and overall outcome in P. falciparum and P. vivax malaria patients. Methods: From April 2023 to March 2024, a prospective observational study involving patients diagnosed with malaria with signs of AKI was carried out in the Department of Medicine at Darbhanga Medical College and Hospital in Laheriasarai, Bihar. Rapid malarial antigen testing and thick and thin peripheral smears stained with Leishman’s stain were used to confirm the diagnosis of malaria. A suitable statistical analysis was conducted to examine different parameters. Result: Out of 200 cases of P. falciparum and 220 cases of P. vivax malaria, 43 (21.5%) and 58 (25.1%) cases of AKI caused by P. vivax malaria, respectively. In both groups, the majority of patients were under 30 years old. The majority of those affected in both groups were female. In P. falciparum malaria, pallor, hypotension, oliguria, sepsis, and altered sensorium were frequently observed.P. vivax malaria was more likely to cause jaundice, vomiting, thrombocytopenia, hepatomegaly, and splenomegaly. In both P. falciparum and P. vivax malaria, oligouria, anemia, acute respiratory distress syndrome (ARDS), disseminated intravascular coagulopathy (DIC), cerebral malaria, hypotension, hyponatraemia, and hyperbilirubinemia were often linked independent risk factors for mortality. Patients with P. falciparum and P. vivax malaria were treated with a combination of artesunate and antimalarial drugs. Haemodialysis was used in 13 (30.23%) P. falciparum cases and 17 (29.31%) P. vivax cases. Nineteen (15.52%) patients with P. vivax malaria AKI and five (11.62%) patients with P. falciparum malaria AKI perished. Conclusion: AKI was prevalent in malaria caused by P. falciparum and P. vivax. In the majority of India, malaria significantly increases morbidity and mortality. Early detection and treatment can lead to better results.

DOI: 10.5281/zenodo.

57. Comparative Study of Body Fat Percentage and Biochemical Profile between First Degree Relatives of Diabetic Patients and Non-Diabetic Patients
Gopi Nath Dubey, Sushil Kumar, Pankaj Mohan Shrivastava, Sudhir Chandra Jha
Abstract
Background: Diabetes mellitus (DM), cardiovascular disease, and other illnesses can be brought on by obesity. Overweight people are becoming more and more common both globally and in our nation. Determining body fat accurately may aid in evaluating an obese person’s risk of developing certain ailments. In order to compare the aforementioned parameters between first degree relatives of diabetic and non-diabetic patients, this study was designed to measure body fat percentage (PBF) of first degree relatives of diabetic patients, estimate body mass index (BMI), and determine the risk factors for developing diabetes. Method: A total of 1000 participants were included in the study and were split into two groups: 500 individuals in group A had a clear family history of diabetes, while 500 individuals in group B did not. Comprehensive clinical, anthropometric assessment, fasting plasma glucose (FPG), and other pertinent biochemical analyses were performed. Result: Body fat percentage (PBF) was high in 76% of participants in group A (study group) compared to 41.2% in group B (control group) (p < 0.001).47.6% of respondents in group B were overweight (p < 0.0001), compared to 73% of subjects in group A who were overweight (BMI > 25 kg/m2). Similarly, 52% of group A and 9.6% of group B were found to have diabetes, respectively (p < 0.0001). Conclusion: PBF may be a crucial screening tool for identifying individuals who may have diabetes and may also be useful in directing lifestyle change strategies for the promotion of health.

DOI: 10.5281/zenodo.

58. Comparative Study of Vaginal, Sublingual, and Buccal Misoprostol in Induction of Labor in Term Pregnancy
Puja Sinha, Aneeta Kumari, Abha Rani Sinha
Abstract
Background: One typical procedure used when there is a maternal or fetal indication for a pregnancy termination is induction of labor (IOL). Pregnant women are inducing labor in large numbers in both developed and developing nations. This study compared the efficaciousness of sublingual, vaginal, and buccal misoprostol for inducing labor in a full-term pregnancy. Methods: From July 2023 to December 2023, this study was conducted at the SKMCH, Department of Obstet-rics and Gynecology in Muzaffarpur, Bihar. A random allocation of 150 subjects was made to receive 50 μg of buccal, 25 μg of vaginal, and 50 μg of sublingual misoprostol. The problems for the mother and fetus, as well as the hour 1 and hour 6 Bishop Scores, were noted. Results: Between the three groups, there were no differences in maternal (P>0.05) or fetal (P>0.05) problems. Additionally, there were no differences between these groups for Bishop score hour 1 (P = 0.146), Bishop score hour 6 (P = 0.704), or total dose (P = 0.15). Based on the buccal, sublingual, and vaginal deliveries that were made in each group, our study identified a difference (P = 0.015) in the three groups’ ability to achieve a con-ventional vaginal birth within a day. Compared to the other groups, the Buccal group used oxytocin at a higher rate (P = 0.022). Conclusion: This study found that while there was no difference in the three groups’ rates of fetal and maternal problems, there was a significant difference in the use of oxytocin and vaginal deliveries within 24 hours of the start of induction.

DOI: 10.5281/zenodo.

59. Study of Different Phenotypes of Polycystic Ovarian Disease and their Effects on Clomiphene Resistance in Infertile Women
Puja Sinha, Aneeta Kumari, Abha Rani Sinha
Abstract
Background: One significant issue facing infertile women with polycystic ovarian disease (PCOD) is clomi-phene resistance. Patients would have a better prognosis if the causes were identified. The purpose of this study was to identify the various PCOD phenotypes and how they affected infertile women’s clomiphene resistance. Methods: The Department of Obstetrics and Gynaecology, SKMCH, Muzaffarpur, Bihar, referred 100 consecu-tive PCOD women with infertility who was taking clomiphene from Sadar Hospital and private nursing homes between August 2023 and January 2024. The study was a descriptive-comparative cross-sectional study. The impact of various PCOD phenotypes on these women’s clomiphene resistance was evaluated. Results: According to the findings, 39 (39.0%), 7 (7.0%), 26 (26.0%), and 28 (28.0%) patients, respectively, exhibited the A, B, C, and D phenotypes. Resistance was present in 31 patients (31%). A (HA+OA+PCO) was the most prevalent PCOD phenotype, observed in 48.4% of patients, while D (OA+PCO) was shown in 25.8% of patients. However, there was no significant difference in the phenotypes (P=0.064). Conclusion: According to the results, there was no significant association between PCOD phenotypes and clomiphene resistance. Finally, A and D phenotypes were frequent types with clomiphene resistance.

DOI: 10.5281/zenodo.

60. Outcomes of Sentinel Lymph Node Biopsy in Early Breast Cancer using Methylene Blue and Fluorescein Dye in a Tertiary Care Centre of North East India
Sachin Khanna, Abhijit Talukdar, Gaurav Das, Revant K. Kodali, Shubhra Ramchandani
Abstract
Objectives: The currently recommended technique of sentinel lymph node biopsy (SLNB) in breast cancer is a combination of blue dye (commonly used isosulfan blue or Patent blue violet) and radiotracer-guided technique (Tc99m-labeled sulfur colloid).  Neither of the blue dyes are currently marketed in India, are expensive to import, and not easily available. Nuclear medicine facilities are not available at most centers. This study involves using a combination of methylene blue dye and fluorescein dye to detect sentinel lymph nodes. Materials and Methods: This is a prospective, observational study. Patients with first time detected T1 or T2, N0 and M0 breast cancer were eligible for this study and taken up for SLNB using dual dye technique (methylene blue dye and sodium fluorescein dye). N0 status was confirmed both clinically and radiologically. Patients with a previous history of malignancy and those who received neoadjuvant chemotherapy were excluded from this study. Statistical analysis was done with Statistical Package for the Social Sciences (SPSS) version 20.0. Results: In this study we present outcomes of 50 patients who underwent sentinel lymph node (SLN) biopsy using a combination of methylene blue and fluorescein dye at our institute. Mean age was 51.8 years and range was 32-70 years. Sentinel node was successfully identified in 47 cases, thereby a 94% of identification rate was observed with this dual method technique and the median sentinel nodes were 2. Among a total of 98 detected sentinel nodes, 47(47.9%) had both blue dye and fluorescein dye uptake. Conclusion: Fluorescein dye is a very cheap alternative to radioactive tracer technique; hence it can be used as an alternative especially in resource constrained countries like ours.

DOI: 10.5281/zenodo.

61. Functional Outcome of Fracture Both Bone Fore Arm Treated with Compression Plate in Adults
Adam Thomas, Naveen D, Bellad S.H., B.G. Sagar
Abstract
Background: The fractures of both bones forearm are one of the commonest fractures (14%). These fractures can be treated by various methods. The accepted management for fractures of both bones forearm is open reduction and internal fixation using compression plating. Objective: to study the functional outcome of treating diaphysial fracture both bone forearm using compression plating, duration of union with compression plating and its functional outcome.Methods: This prospective study was carried out from January 2021 to June 2022 in Adichunchanagiri Institute of Medical Sciences, B.G. Nagara, Mandya India, in this study period 33 cases of fracture both bones of forearm were treated by open reduction and internal fixation using Compression Plate. Results: In our series, majority of the patients were males(70%), middle aged (avg age 34.8), with road traffic accidents being the commonest mode of injury(57.57%), involving middle third (72.72%) more commonly affecting the right forearm(51.51%).Transverse or short oblique fractures were most common. The fractures united in all33 patients. Excellent or full range of mobility of elbow and wrist joints were present in 30 patients (90.09%) and 3(9.09%) patients having good range of movements according to F.M. Merek et al scoring system. Conclusions: The compression plating of forearm fractures produce excellent results, the advantage being early mobilization, early union but the complication, duration of surgery and surgical techniques remains unchanged.

DOI: 10.5281/zenodo.

62. A Retrospective Study of Association of T2DM with Various Infections, in a Tertiary Teaching Hospital in Kolkata
Sudipto Roy, Amit Karmakar, Nayan Paul, Nabanita Mondol
Abstract
Introduction: Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder that significantly increases the risk of infections due to immune dysfunction and other related factors. This study aims to investigate the association between T2DM and various infections in a tropical tertiary teaching hospital in India, focusing on the prevalence, causative organisms, and outcomes of these infections. Methodology: A retrospective study was conducted using medical records from January 2020 to December 2023. The study included 130 T2DM patients and 130 age- and sex-matched non-diabetic controls. Data on demographic characteristics, clinical parameters, and infection details were extracted and analyzed. Statistical analyses included chi-square tests for prevalence comparison and logistic regression to identify risk factors for infections. Results: The prevalence of infections was significantly higher in T2DM patients compared to non-diabetic controls. UTIs (30.0% vs. 13.8%, p = 0.003), SSTIs (21.5% vs. 8.5%, p = 0.002), and respiratory tract infections (34.6% vs. 16.9%, p = 0.001) were notably more common in T2DM patients. Logistic regression analysis revealed that T2DM (OR: 2.25, 95% CI: 1.54 – 3.30, p = 0.001), higher BMI (OR: 1.11, 95% CI: 1.05 – 1.18, p = 0.001), and hypertension (OR: 1.67, 95% CI: 1.11 – 2.52, p = 0.014) were significant risk factors for infections. T2DM patients had longer hospitalization durations (11.2 ± 4.1 days vs. 8.3 ± 3.5 days, p = 0.001) and higher rates of recurrent infections (16.2% vs. 6.9%, p = 0.02). Conclusion: T2DM significantly increases the risk and severity of infections in patients, particularly in tropical regions. Effective diabetes management, infection prevention, and targeted antimicrobial therapies are essential to improve outcomes in this population. Further research should focus on integrated care models and preventive strategies to reduce infection risks in T2DM patients.

DOI: 10.5281/zenodo.

63. Studies on Fetomaternal Outcome in Obstetric Cholestasis and the Role of Serum Bile Acid in Predicting Adverse Fetal Outcome
Priya Mohan Jayasingh
Abstract
Obstetric cholestasis (OC) is a serious pregnancy condition with poor fetal outcomes. This two-year prospective study at the Jagannath Gupta Institute of Medical Sciences and Technology examined serum bile acid levels and fetomaternal outcomes in 40 pregnant women with OC (2021-2023). The study found that serum bile acid levels above 40 micromol/L increased the risk of preterm delivery, fetal distress, and neonatal asphyxia. These findings make routine bile acid monitoring and early intervention in OC-affected pregnancies crucial to fetal safety. These findings should be confirmed and management strategies optimized in larger research. This study helps explain OC’s effects on pregnancy and highlights serum bile acid levels’ predictive relevance for poor fetal outcomes.

DOI: 10.5281/zenodo.

64. Perception & Problems of 1st Professional MBBS Students Regarding Early Clinical Exposure In Tripura, North-East India
Snigdha Das, Suzanne Lalduhawmi Colney, Kaushik Nag, Nabarun Karmakar
Abstract
Background: Implementation of early clinical exposure as teaching-learning methodology in new CBME (competency based medical education) curriculum helps the students to learn basic science subjects with ease & interest. The students get to know the relevance of studying basic science subjects as they are exposed in the clinical field to apply their basic knowledge in medical field. This study has been taken to find out the perceptions of the students to improve the quality of the classes with much more effort for their better understanding. Methodology: This cross-sectional study was conducted among 97 first year medical students in classroom setting of Tripura Medical College, Agartala from November 2022 to June 2023. A pre-tested, semi-structured questionnaire was used to collect required information after their early clinical exposure sessions. The collected data was entered in SPSS 16.0, represented in proportions and p <0.05 was considered as statistically significant. Result: 95.9% students showed interest in this learning process. Majority (79.4%) of the students were motivated to attend more early clinical exposure classes in future as it increases their retention power. 83.5% students agreed to incorporate this learning process in their curriculum. Conclusion: The students were very positive towards this teaching-learning methodology. This learning process not only breaks the monotony of traditional lectures but also reinforce the didactic lectures. With this, the students can correlate the basic science topics with clinical facts better. For better implementation of these classes, both the pre-clinical & clinical departments should be well coordinated.

DOI: 10.5281/zenodo.

65. COVID-19 and Diabetes Mellitus — from Biochemical and Pathophysiological Analysis to Clinical Management
Rajnish Kumar, Varun Kumar, Ashwini Kumar, Prachi Satyam, Usha Kumari
Abstract
This observational cohort study analyzed the impact of glycemic control on the severity and outcomes of COVID-19 in 60 patients with diabetes mellitus at BMIMS Pawapuri, Nalanda, Bihar for 2 years. Our results demonstrated that patients with poorly controlled diabetes (HbA1c > 7.5%) experienced significantly worse COVID-19 outcomes, including higher rates of severe symptoms, increased inflammatory markers, and prolonged recovery times. Conversely, patients with well-managed diabetes showed milder symptoms and quicker recoveries, emphasizing the critical role of effective glycemic management in mitigating the adverse effects of COVID-19. The study highlights the necessity of integrating diabetes management with COVID-19 treatment protocols to enhance patient outcomes in pandemics.

DOI: 10.5281/zenodo.

66. A Study of Scrub Typhus in a Tertiary Care Hospital in the Southern Region of Rajasthan, India
Rambabu Sharma, Sudeep Saran, Jyoti Tomar, Sanjay Kumar Datta, Dr Nanera Arvind Kumar Devjibhai
Abstract
Background: Scrub typhus is a zoonotic rickettsial infection caused by an intracellular gram negative bacterium Orientia tsutsugamushi, transmitted through bites of larval leptotrombiculid mites. The nonspecific clinical presentations, including fever, rash, headache, nausea, vomiting, and thrombocytopenia, pose a significant diagnostic challenge due to overlapping symptoms with other infections like malaria, chikungunya, dengue, enteric fever, leptospirosis, brucellosis, and malaria. Aims & Objectives: The present study aimed to assess the severity profile of diagnosed patients of scrub-type infection specifically within a hospital in Southern region of Rajasthan, India. Methodology: A hospital-based prospective analytical study was carried out from November 2020 to November 2023 at Pacific Institute of Medical Sciences, Udaipur, Rajasthan. Results:  A total of 350 confirmed cases of scrub type were enrolled in the study. The highest number of patients were seen in the age group of between 41 – 50 years 103 patients (29.42%), this was followed by age groups of 31 – 40 years with patients of 95 (27.14%), 21 – 30 years 41 patients (11.71%), 51 – 60 years and 61 – 70 years each had 32 patients (9.14%). Hepatomegaly was recorded in 144 (41.14%) of the patients, splenomegaly in 145 (41.42%) patients, and lymphadenopathy was noted in 29.71% of the study population. The level of liver enzymes such as SGPT (33.14%), and SGOT (32%) and raised level of blood urea (24.85%), serum creatinine (25.42%) were significantly associated with ST (p-value 0.01). The most common clinical symptoms were fever (100%), headache (88.57%), myalgia (98%), rashes (75.14%), breathing difficulty (63.14%) and conjunctival suffusion (10.57%). The pathognomonic eschar was observed in 83 (23.71%) of the patients. Conclusion: Scrub typhus has emerged as an important cause of febrile illness in the southern region of Rajasthan and can present with varying clinical manifestations with or without eschar. Early laboratory diagnosis and prompt intervention may help in reducing the case fatality.

DOI: 10.5281/zenodo.

67. Observations on Green Color of Serum from a Patient with Suspected Pulmonary and Extra-Pulmonary Tuberculosis: A Case Report
Krishna Thakkar, Drashti Detroja, Shruthi Pappula, Purvi Tailor, Shailesh Patel
Abstract
Introduction: When Clinical laboratory receive samples with unusual characteristics, laboratory needs to evaluate possible interference and causes. Case Description: Patient with suspected pulmonary and extra-pulmonary tuberculosis has green color of serum. On laboratory examination, anemia, leukocytosis, lymphocytopenia, mixed hyperbilirubinemia, hypoalbuminemia, hyponatremia, elevated creatinine, hypocalcemia, high ferritin with normal iron and low transferrin was found. Conclusion: There is no history of infusion of dye, rheumatoid arthritis. However, possibility of elevated biliverdin and elevated ceruloplasmin as cause for green color of serum could not be ruled out. Looking for causes for abnormal characteristics of serum in clinical laboratory may be useful by providing important clue to underling disorders. However, in limited resource settings, final search for cause for such abnormal characteristics may not always be feasible.

DOI: 10.5281/zenodo.

68. Primary PSARP in Newborns with Arm – Follow Up Study
Selvakumar M, Gokulan T, S Vijayabaskaran, P Manikandhan
Abstract
Aim: To report outcomes of primary posterior sagittal anorectoplasty (PSARP) in neonates with ARM without covering colostomy. Methodology: Fifteen male cases of anorectal malformations (ARM) was enrolled in this prospective observational study. All patients underwent primary PSARP. Krickenbeck classification of post-operative results was used. Assessment of fecal incontinence was done. Voluntary bowel movements, soiling (grade 1 –yes/no, grade 2 –every day, grade 3- constant), constipation (grade -1 yes, grade 2- requiring– laxatives, grade 3 –resistance to laxative) was recorded. After receiving approval from the ethical review commission, we chose fifteen male instances of anorectal malformations (ARM). The study was initiated with parental agreement. Results: The mean gestation age of patients was 36.2±2.7 weeks. The mean weight of neonates was 2.82±1.1 kgs and mean operative time was 64.2±7.3 minutes. Fecal continence was normal in 10 and abnormal in 5 cases. Soiling grade 1 was observed in 12 cases. Urinary continence was normal in 12 cases and abnormal in 3 cases. The difference was significant (P< 0.05). Conclusion: With advent of good anaesthetic speciality and surgical technique, primary PSARP is feasible in well selected neonates with ARM. With this, early anal reflexes are restored. To be done/supervised by experienced pediatric surgeon avoids complications.

DOI: 10.5281/zenodo.

69. Efficacy of Intrathecal Nalbuphine Hydrochloride as an Adjuvant to Hyperbaric Bupivacaine 0.5% in Abdominal Hysterectomy
Dipika M. Parmar, Vikram C. Gohil
Abstract
Introduction: Intrathecal nalbuphine hydrochloride has been explored as an adjuvant to bupivacaine for improved anesthesia and analgesia. This study aimed to evaluate its effectiveness in enhancing sensory and motor blocks and reducing postoperative analgesic requirements in patients undergoing abdominal hysterectomy. Material and Methods: This double-blinded, randomized study at a tertiary care center in Gujarat included 60 ASA I and II patients aged 30-60 undergoing elective abdominal hysterectomy. After obtaining informed consent, patients were randomly assigned to receive either intrathecal bupivacaine 0.5% alone (control group) or with 1.6 mg nalbuphine hydrochloride (study group). Baseline vitals were recorded, and spinal anesthesia was administered. Sensory and motor block onset times, duration of surgery, and block regression times were monitored. Postoperative pain was assessed using VAS, and rescue analgesia was provided as needed. Adverse effects were recorded and managed appropriately. Data analysis was performed using SPSS 21.1 with one-way ANOVA and post hoc Tukey tests. Results: The study group had a faster onset of sensory block (4.1±0.7 minutes vs. 6.3±1.0 minutes, P=0.03) and motor block (4.1±0.8 minutes vs. 6.8±1.3 minutes, P=0.00). The time for two-segment regression was longer in the study group (120.0±20.0 minutes vs. 92.0±4.0 minutes, P=0.03), and the duration of motor block was extended (132.0±21.0 minutes vs. 115.0±15.0 minutes, P=0.02). The study group required the first rescue analgesic later (215.0±30.0 minutes vs. 135.0±18.0 minutes, P=0.01) and a lower total dose of diclofenac (160.0±28.0 mg vs. 225.0±20.0 mg, P=0.02) within the first 24 hours. Adverse effects such as hypotension, bradycardia, respiratory depression, nausea, vomiting, and pruritus were observed but were not statistically significant between the groups (P>0.05). Conclusion: In conclusion, our study demonstrates that intrathecal nalbuphine hydrochloride, when used in combination with bupivacaine 0.5%, significantly improves the onset and duration of both sensory and motor blocks compared to bupivacaine alone.

DOI: 10.5281/zenodo.

70. Clinical Outcomes of Pars Plana Vitrectomy in Proliferative Diabetic Retinopathy Patients Without Pre-Operative Anti-VEGF Therapy
Ishita Ravaliya, Devangi Patel, Priyesh Shroff, Chetana Karamta
Abstract
Introduction: Proliferative diabetic retinopathy (PDR) is a severe complication of diabetes that can lead to significant vision loss. Pars plana vitrectomy (PPV) is a surgical treatment option, but its outcomes without pre-operative anti-VEGF therapy need further study. Aim: To investigate the anatomical and visual outcomes in patients with PDR undergoing PPV without pre-operative anti-VEGF treatment. Material and Method: This prospective interventional study was conducted at a tertiary eye care hospital from July 2020 to July 2022, involving 52 eyes from 52 patients. Comprehensive pre-operative and post-operative evaluations were conducted, and patients were followed up at one week, one month, and three months postoperatively. Results:  The mean age of patients was 53.29 years, with a predominance of males. Most patients had type 2 diabetes for an average of 10 years. Vitrectomy with silicone oil tamponade was used in most cases, with 12% of cases also undergoing cataract surgery. The primary indications for surgery were non-resolving vitreous hemorrhage and tractional retinal detachment. Significant visual improvement (p=0.0008) was observed one-month post-surgery, which continued through the three-month follow-up (p=0.006). Visual recovery was slower in cases with tractional retinal detachment compared to other indications. Early post-operative complications included bleeding and vitreous hemorrhage. Eyes with macula-involving tractional retinal detachment had poorer visual outcomes compared to those without macula involvement. By the end of the study, one case of vitreous hemorrhage and two cases with traction were noted. Conclusion: Pars plana vitrectomy effectively improves visual acuity in proliferative diabetic retinopathy patients without pre-operative anti-VEGF therapy. There is a risk of immediate post-operative rebleeding, and visual recovery is slower in tractional retinal detachment cases. Visual improvements are sustained short-term, though outcomes are poorer in macula-involving cases.

DOI: 10.5281/zenodo.

71. Comparative Evaluation of Dexmedetomidine and Butorphanol on Perioperative Hemodynamics, Sedation and Postoperative Analgesia for Patients Undergoing Lower Abdominal Surgery
Shashank Kumar Kanaujia, Avinash Kumar Yadav, Manoj Kumar Chaurasiya, Bhavya Naithani, Ajay Chaudhary
Abstract
Background: Lower abdominal surgeries may be performed under regional (spinal or epidural) or general anesthesia. The aim of our study is to compare the effectiveness of dexmedetomidine and butorphanol on perioperative hemodynamics, sedation, and postoperative analgesia for patients undergoing lower abdominal surgery. Materials and Methods: The randomized prospective study of one year was conducted in the Department of Anesthesiology, King George’s Medical University, Lucknow after getting approval from the Institutional Ethics Committee of the University and informed consent from all the patients. Total 66 patients were included in this study as per inclusion and exclusion criteria and divided into two groups: Group A [n=33]: Butorphanol was given as 0.10 mg/kg in 50 ml saline as a single dose slow infusion over 10 minutes, and Group B [n=33]: Dexmedetomidine was given as 1.5 mcg/kg in 50 ml saline as a single dose slow infusion over 10 minutes. Result: In our study mean age in group A was 31.20±6.27 years and group B was 32.72±6.02 years, where p value was 0.321. No significant difference of ASA I and ASA II between group A and group B, where p value was 0.071 in our study. In our study there was significant difference between group A and group B in comparison of mean arterial pressure at 5 min ,10min and 24 hrs having p value of .027,.040 and .040 respectively. There was significant difference between group A and group B in comparison of VAS score at 24hrs, 48hrs, 72hrs p value were <.001, <.001 and <.001 respectively. In our study significant difference between group A and group B in comparison of Sedation score at baseline, 1 hr, 6 hrs, 12 hrs, 48 hrs and 72 hrs, the p values were <0.001, <0.001, <0.001, <0.001, 0.025 and <0.001 respectively. In our study, bradycardia was noted in 6.06% patients of group A and 3.03% patients of group B, there was no statistically significant difference between both the groups. There was significant difference between group A and group B in comparison of nausea, vomiting and constipation, where p values were 0.049, 0.031 and 0.048 respectively.  Conclusion: The present study concludes that group B (dexmedetomidine) drug has been found to have better control in heart rate, mean arterial pressure with better sedation and good postoperative analgesia as compared to group A (butorphanol) drug.

DOI: 10.5281/zenodo.

72. Outcomes of Posterior versus Lateral Approach for Hemireplacement Arthroplasty
Suresh Bora, Hemjit Das, Zakaria Ul Akman, Sajid Hussain, Amritav Kar, Dibashjyoti Dutta, Nishan Patra, Saket Saraf
Abstract
Purpose: Many surgical approaches to hip have evolved over the period of time. The most commonly used surgical approach for Hemireplacement Arthroplasty is Moore’s posterior approach. However, due to complications such as dislocation after the procedure, new approaches like Hardinge’s lateral approach is gaining popularity and is becoming widely accepted. But, there are very few studies to compare the outcome and complications associated with both the approaches. The purpose of this study is to compare outcomes, as well as complications associated with Hemireplacement Arthroplasty in neck of femur fractures by posterior and lateral approach. Methodology: 100 enrolled patients were evaluated from the emergency department/OPD and were distributed in two groups having 50 patients each undergoing hemireplacement arthroplasty with modular bipolar prosthesis by Moore’s posterior approach and Hardinge’s lateral approach and were followed up. Results: Incidence of dislocation was found higher in patients operated by posterior approach. Intraoperative blood loss and length of incision was higher in posterior approach than lateral approach. There were some instances of surgical site infections in both the approaches but was statistically insignificant. Conclusions: There are no notable differences in outcomes and complications between the two approaches. Neither lateral nor the posterior approach seems to offer a clear advantage over each other except intraoperative blood loss and length of incision. With methodological limitations as mentioned in this study, the interpretation of this study remained limited. Therefore, further multicentre, randomized controlled studies on a larger sample with long-term follow-up should be implemented to conclusively ascertain the outcomes.

DOI: 10.5281/zenodo.

73. Hypertrophic Pulmonary Osteoarthropathy (HPOA) Masquerading as Inflammatory Arthritis
Gopikrishnan Rajeev, Ashok Ramakrishnan
Abstract
Introduction: Clubbing and Hypertrophic Pulmonary osteoarthropathy (HPOA) are the two manifestations of a clinical syndrome which is referred to as hypertrophic osteoarthropathy (HOA). HPOA involves abnormal proliferation and of skin and periosteal tissues of the extremities. It can be primary (Pachydermoperiostosis) or secondary to chronic lung and heart diseases. Case report: A 23 year old man presented with complaints of pain and swelling of right ankle. Initially an inflammatory arthritis was suspected but presence of high grade clubbing in all his digits gave way to a suspicion of HPOA. Patient is known case of emphysema with a history of recurrent respiratory illness in childhood. Conclusion: As is the case with most HPOA cases reported in literature, the clinical presentation mimicks that of an inflammatory arthritis. Close attention has to be paid especially to signs like digital clubbing which can point to a more sinister underlying cause like a primary lung malignancy.

DOI: 10.5281/zenodo.

74. Screen Time amongst Adolescents Aged 10 to 19 Years: Prevalence of Screen Based Media Use & Physical Activity (Post COVID-19 Study)
Kamini Goyal, Anurag Udhwani, Priyanka Shukla, Karan Joshi
Abstract
Introduction: As the technology becoming an integral part of our lives with its harmful impact on the personal health. The screen time is the time spent involving digital screen-based or electronic media devices e.g. television, video games, computer screen and smartphones, as recommended by the American Academy of Pediatrics, is not >2 h/day to all children, Adolescents and Adults who are above 2 years of age.  Time that spent with the screens in any form mentioned above is an important risk factor for childhood Obesity and Overweight and other metabolic health issues. So It is Important to screen the population who at higher risk to developing sedentary lifestyle, which can lead so many consequences and adverse outcomes in their later life. Objectives: To estimate the prevalence of screen time in children and adolescents aged 10-19yrs. Method: In this cross-sectional study determined the prevalence of screen time use on screen based media conducted after the peak post COVID-19 period. Questionnaire forms were filled by the students by the visiting schools and interacting with the students in school hours. Results: Out of the (n=500) population majority of students 262 (52.4%) were using Screen based media <2 hours per day and 238 (47.6%) students were using Screen based media >2 hours per day. Conclusion: It is also notable that in some studies which were conducted during the COVID-19 pandemic and with social distancing, in that the screen time may not significantly having negative interference with the health and well-being, because it was the only connecting way to remain socially aware. Although screen-based media usage have so many benefits also, such as awareness and communication.

DOI: 10.5281/zenodo.

75. Effect of Vitamin C on Severity of Post-Operative Sore Throat Following Tracheal Intubation: A Randomised Controlled Trial
Rajmala Jaiswal, Ishan S Kagra, Vandna Arora
Abstract
Background & Aim: Post-operative sore throat is the discomfort in throat which often leads to an immense deal of uneasiness in patients. Recently micronutrient Vitamin C is being studied for its antinociceptive properties. Its role in management of acute and chronic pain has been documented in various studies. Against this background, the present study aimed to evaluate the role of vitamin C on severity of postoperative sore throat following endotracheal intubation in patients receiving general anaesthesia. Methodology: The present study was a prospective, randomized, double blind, placebo-controlled study conducted after approval from Institutional Ethical Committee. After obtaining informed written consent, 100 adult patients with Mallampati class 1 & 2 undergoing elective surgical procedures under general anaesthesia requiring endotracheal intubation, with successful intubation in single attempt were included in this study. Patients were randomly allocated to 2 groups: Group 1 (n=50) received injection vitamin C 2gm in 500 ml of NS; Group 2 (n=50) patients received 500 ml of NS intraoperatively. Severity of sore throat, VAS, analgesic consumption and side effects were recorded at 0, 6, 12 and 24 hours postoperatively. Results: Demographic parameters were comparable between the two groups. POST severity score was significantly lower in group 1 as compared to group 2 at 0, 6 and 12 hours postoperatively. Similarly, VAS scores were significantly lower in group 1 as compared to group 2 at 0, 6 and 12 hours postoperatively. Total amount of analgesia consumption was significantly higher in group 2 as compared to group 1 (p=0.03). No side effects were recorded related to vitamin C during our observation period in any patient. Conclusion: Vitamin C plays a significant role in reducing the severity of post-operative sore throat following endotracheal intubation in patients receiving general anaesthesia for surgical procedures lasting less than 3 hours of duration.

DOI: 10.5281/zenodo.

76. Concentration and Significance of Endocrinological and Biochemical Profiles Levels in Relation to the After Effects of Hemodialysis among Patients of Renal Failure in Manipur: North East India
Soumyadip Sarma, L. Shaini
Abstract
Background: CKD, which is referred as chronic renal failure, has been concluded recently among the group of lifestyle diseases of 21st century, which is often characterized as a progressive and often irreversible disorder. Materials and Methods: This study has been performed among renal failure patients of both males and females in the age group of 18 to 65 years and those who were on dialysis. The aforementioned study was done before and 4 hours after performing hemodialysis. Samples were collected from the Regional Institute of Medical Sciences, Imphal, Manipur, from the study period of February 2016 to January 2017. 15 normal persons with the normal renal parameters without any history of renal disorder in the past were also selected in between this comparable age group. SPSS software is used for collection, analysis and summarization of all the data. Results: The values of blood urea were significantly higher among the pre-dialysis group. On the other hand, the blood urea level among the post-dialysis group was found to be significantly lower. While serum copper values among both the pre-dialysis and post dialysis groups were significantly lower as compared to the control group. Serum calcium levels in the pre-dialysis group were found to be lower. We also found that serum phosphorus levels among the pre-dialysis group were significantly higher as compared to the post-dialysis group. Conclusions: The serum concentrations of calcium and sodium which are obtained in post-dialysis depend upon the composition of dialysate of aforementioned elements and serum available for the ultra-filtration.

DOI: 10.5281/zenodo.

77. Layered Closure and Retention Closure Technique for the Abdominal Wall in Midline Laparotomy at a Tertiary Centre
Amit Ranjan, Noor Hasan Hussain, Khursheed Alam
Abstract
Background: The choice between layered closure and retention closure should be individualized based on patient factors. The present study was conducted to compare layered closure and retention closure technique for the abdominal wall in midline laparotomy. Materials & Methods: 114 patients undergoing elective or emergency midline laparotomy of both genders were divided in to two groups of 60 and 54 in each depending on the closure type, layered closure (Group I) and retention closure (Group II) depending on the operating surgeon: retention closure was done in a single surgical unit and layered closure was done in rest of the respective units. Patients were followed-up meticulously and immediate postoperative complications were recorded up to four weeks. Results: Group I had 32 males and 28 females and group II had 24 males and 30 females. Pain score at day 1 was 3.4 and 3.8, at day 2 was 3.2 and 3.5, at day 3 was 2.5 and 2.8 and at day 7 was 2.1 and 2.5 respectively. Closure status had no dehiscence seen in 50 and 53, partial dehiscence in 7 and 1 and complete dehiscence in 3 and 0. Wound healing with primary intention seen in 58 and 50 patients in group I and II and secondary intention seen in 2 and 4 patients respectively. The difference was significant (P< 0.05). Conclusion: Retention closure found to be advantageous over layered closure.

DOI: 10.5281/zenodo.

78. Assessment of Levels of Liver Enzymes in the Immediate and Delayed Postoperative Period Following Open Cholecystectomy and Laparoscopic Cholecystectomy at a Tertiary Centre
Brajkishor Kumar, Brajesh Kumar, Khursheed Alam
Abstract
Background: Laparoscopic cholecystectomy is a minimally invasive surgical procedure used to remove the gallbladder, commonly performed to treat gallstones and other gallbladder-related conditions. Aim: The present prospective study was conducted to compare the changes in the levels of liver enzymes in the immediate and delayed postoperative period following Open Cholecystectomy and laparoscopic cholecystectomy. Materials & Methods: 70 patients with laparoscopic cholecystectomy of both genders were divided into 2 groups of 35 each. Group I underwent laparoscopic cholecystectomy and group II open cholecystectomy. Levels of alkaline phosphatase (ALP), aspartate transaminase (AST), alanine transaminase (ALT) and total bilirubin were noted in the preoperative period, 24 hours after the surgery and seven days after the surgery was determined. Results: In group I, males were 21 and females were 14. In group II, males were 18 and females were 17. The mean ALP (IU/L) level, pre- operative, 24 hours and 1 week was 91.4±20.13 and 85.32±16.91, 84.9±19.50 and 87.3±18.12 and 85.1±15.91 and 84.2±20.10 in group I and II respectively. The mean ALT (IU/L) level pre- operative, 24 hours and 1 week was 31.7±9.50 and31.5±10.20, 29.5±9.17 and 26.7±7.10 and 50.2±14.39 and 25.6±6.10 in group I and II respectively. The mean AST (IU/L) pre-operative, 24 hours and 1 week was 30.5±7.90 and 32.1±17, 31.8±10.1 and 27.5±6.90 and 53.69±19.91 and 26.7±6.50 in group I and II respectively. The mean total bilirubin (mg/dL) level was 0.63±0.21 and 0.61±0.29, 0.59±0.19 and 0.61±0.15 and 0.781±0.259 and 0.52±0.15 pre- operative, 24 hours and 1 week in group I and II respectively. The difference was significant (P< 0.05). Conclusion: The levels of ALT, AST, and total bilirubin rose significantly but briefly after LC, whereas the levels of ALP did not change significantly in the first 24 hours after LC, which was not the case for OC.

DOI: 10.5281/zenodo.

79. A Comparative Study of Postoperative Outcomes of Laparoscopic Cholecystectomy with or Without Abdominal Prophylactic Drainage: A Prospective Interventional Study
Noor Hasan Hussain, Amit Ranjan, Khursheed Alam
Abstract
Background: The present study was conducted for assessing and comparing Postoperative Outcomes of Laparoscopic Cholecystectomy (LC) with or without Abdominal Prophylactic Drainage. Materials & Methods: A total of 200 patients scheduled to undergo LC were enrolled. Distribution of all the patients was done into two study groups as follows: Group 1: Patients with Abdominal prophylactic drainage, and Group 2: Patients without Abdominal prophylactic drainage. Only patients with uncomplicated chronic calculus cholecystitis were enrolled. Data have been collected through interview, clinical examination, and scrutinizing relevant medical records. Incidence of Postoperative nausea and vomiting along with postoperative pain was evaluated. All the results were recorded in Microsoft excel sheet and was subjected to statistical analysis using SPSS software. Results: Mean duration of surgery among group 1 and group 2 subjects was 115.6 minutes and 79.2 minutes respectively (p-value < 0.05). Incidence of postoperative nausea and vomiting was significantly higher among patients of group 1. Like-wise incidence of postoperative pain was significantly higher among subjects of group 1. Conclusion: Patients without abdominal drain were associated with decrease duration of surgery and lower incidence of PONV and postoperative pain.

DOI: 10.5281/zenodo.

80. Comparison of Continuous versus Interrupted Abdominal Wall Closure Techniques after Emergency Midline Laparotomy: A Randomized Controlled Trial
Brajesh Kumar, Brajkishor Kumar, Khursheed Alam
Abstract
Background: This research aims to compare the outcomes of continuous and interrupted abdominal wall closure techniques in emergency midline laparotomy, specifically focusing on the incidence of incisional hernia and ruptured abdomen as the key endpoints. Aim: Comparison of continuous and interrupted abdominal wall repair techniques after emergency midline laparotomy. Material and Methods: Patients who had undergone laparotomy in the past and were scheduled for a second look procedure were not included in the study. However, patients who had undergone minor laparoscopic surgery in the past were included. The 100 patients were evenly split into two groups, with 50 patients in each group. Both groups were required to maintain a maximum stitch spacing of 1.5 cm and a minimum distance of 2 cm from the border of the fascia. The patients in the continuous suture group had their abdomen closed using a continuous, all-layer suture technique. Results: The average length of hospitalization was comparable across the two groups (C: 17.45 ± 14.58 days, I: 18.94 ± 14.12 days). 8.21% of patients had laparostomy, resulting in their exclusion from further investigation of hernia/dehiscence. The incidence of burst abdomen after 30 days or incisional hernia after 12 months did not vary between the continuous and interrupted groups. In the continuous group, 16% had burst abdomen or incisional hernia, whereas in the interrupted group, 22% experienced these complications. The total mortality, regardless of the reason, was 34 individuals. There was no significant difference in mortality between the groups, with 10 individuals (16.9%) in both the control group (C) and the intervention group (I). The p-value for this comparison was 0.24. The duration required for fascial closure was much shorter in the continuous group compared to the interrupted group (C: 13.66 ± 5.10 min versus 18.14 ± 5.96 min; p < 0.001). Conclusion: This randomized controlled trial (RCT) demonstrated that there was no discernible difference in the occurrence of postoperative burst abdomen and incisional hernia after one year when comparing the use of continuous sutures with slowly absorbable sutures with interrupted sutures with fast absorbable sutures in main emergency midline laparotomy.

DOI: 10.5281/zenodo.

81. Bacterial Profile and Antibiogram of Post-Operative Wound Infections in a Tertiary Care Hospital, Chennai
M. Sowmya, S. Sukanya, B. Ananthi
Abstract
Introduction: Post-operative wound infections are the second most common nosocomial infections to be recorded and they represent a significant global public health concern. Significant morbidity and mortality as well as increased treatment costs and length of hospital stay are caused by postoperative wound infections. Objectives: To assess the bacterial profile and their antimicrobial susceptibility pattern of postoperative wound infections. Methods: Cross sectional study was conducted for a period of one year (January 2023 to January 2024) in the Department of Microbiology at ACS Medical College and Hospital, Chennai. The study included 182 pus and tissue samples from post-operative wound patients.  Samples were processed and isolates were identified by Standard Microbiology guidelines. Antibiotic susceptibility testing (AST) was done by the Kirby- Bauer disc diffusion method and zone size was interpreted based on Clinical and Laboratory standard institute (CLSI) guidelines. Results: Out of 182 isolates, 60.4% were from males. Among the 182 isolates, E. coli (19.2%) and Klebsiella pneumoniae (19.2%) were the most common pathogens followed by Staphylococcus aureus (18.1%), Pseudomonas aeruginosa (15.9%). The least organism isolated was Providencia species (1.6%). Monomicrobial growth was seen in 94% isolates. Out of 182 isolates, 37.3% were gram positive and 68.5% were gram negative isolates.  The antibiotic to which gram negative bacteria reported maximum resistance was ceftazidime (56.7%) and the antibiotic that reported maximum sensitivity was cefepime (73.1%).The antibiotic to which gram positive bacteria reported maximum resistance was ciprofloxacin (50%) and the antibiotic that reported maximum sensitivity was vancomycin (69.3%).Among the Gram Negative Bacteria (GNB) organisms, majority of Extended Spectrum Beta Lactamases (ESBL) producers were Klebsiella pneumoniae (42.8%) and Amp-C producers were Pseudomonas aeruginosa (37%). Conclusion: The incidence of post-operative wound infections will undoubtedly decline with rigorous adherence to infection and prevention control practices, maintenance of good hand hygiene and appropriate preoperative, intraoperative and postoperative patient care.

DOI: 10.5281/zenodo.

82. Comparative Efficacy of Extracorporeal Shockwave Therapy (ESWT) Versus Ultrasound Therapy (UST) in Myofascial Pain Syndrome
Sonu Singh, Pawan Sharma, Ruqaiya Ali, Dwit Vora
Abstract
Myofascial pain syndrome (MPS) is a common cause of musculoskeletal pain, accounting for 20% to 95% of cases in medical and pain management clinics. It is often characterized by myofascial trigger points (MTrPs) in the neck, shoulder, or back muscles, leading to significant discomfort and reduced functionality. These hyperirritable spots in muscle fibers, when mechanically stimulated, cause local and referred pain. Despite the unclear pathophysiology, overuse injuries, oxygen and nutrient deficiencies, and involuntary muscle contractions are considered contributing factors. Diagnosis relies on physical examination and patient history, with digital palpation being the primary method for identifying MTrPs. This study aimed to compare the efficacy of extracorporeal shock wave therapy (ESWT) with exercises versus ultrasound therapy (UST) with exercises as treatments for MPS. Sixty patients with MPS in the neck, shoulder, or back muscles were enrolled in a prospective metacentric study. Patients were randomized into two groups: 36 received ESWT, and 24 received UST. Both groups underwent their respective treatments followed by stretching and strengthening exercises. Pain and tenderness were assessed using the Visual Analog Scale (VAS) and the Tenderness Grading Scale (TGS) before treatment and four weeks later. Results indicated a greater reduction in pain and tenderness in the ESWT group compared to the UST group. The ESWT group showed a 55.3% reduction in VAS scores and a 57.9% improvement in TGS scores, while the UST group exhibited a 22.7% reduction in VAS scores and a 24.3% improvement in TGS scores. Minor adverse events were reported in both groups, but no serious adverse events occurred. In conclusion, ESWT combined with exercises demonstrated superior efficacy in reducing pain and tenderness in MPS patients compared to UST combined with exercises. Early initiation of stretching exercises contributed to better long-term outcomes and a lower recurrence of pain and discomfort. Effective recognition and prompt treatment of MPS are crucial for alleviating symptoms and improving patient quality of life.

DOI: 10.5281/zenodo.

83. Ursodeoxycholic Acid in Gallbladder Stone: A Narrative Review
Rajiv Ranjan Das, Akash Chandra, Manoj Kumar
Abstract
Ursodeoxycholic acid (UDCA) is a bile acid that can help dissolve certain types of gallstones, specifically cholesterol gallstones. It works by reducing cholesterol production in the liver and increasing bile acids in the bile, which aids in dissolving the stones over time. UDCA therapy typically involves oral medication in tablet or capsule form, and the dosage and duration of treatment vary based on factors such as the size and number of gallstones. While UDCA can be effective for some individuals with cholesterol gallstones, it may not work for everyone, particularly those with larger or calcified stones. It’s essential to consult with a healthcare professional to determine the most appropriate treatment approach for gallstones, which may include UDCA therapy or surgical removal of the gallbladder.

DOI: 10.5281/zenodo.

84. Serum Prostate-Specific Antigen Levels in Men Diagnosed with Type 2 Diabetes Mellitus: A Hospital Based Case-Control Study
Kalita J, Rohman M S, Shah S
Abstract
Background and Objectives: Serum PSA (prostate-specific antigen) measurement plays a vital role in prostate cancer screening and management. Studies suggest that men with type 2 diabetes mellitus tend to have lower PSA levels compared to non-diabetic men. This study aimed to explore the differences in PSA levels between type 2 diabetics and healthy men. Methods:The study was conducted over a period of one year in our institution. 45 diabetic men aged (40-79) years as cases and age-matched non-diabetic controls were included (fulfilling the inclusion and exclusion criterias). PSA, glucose, and glycated haemoglobin (HbA1C) levels were estimated by immunometric immunoassay, glucose oxidase peroxidase and turbidimetric methods respectively in Vitros 5600 autoanalyzer. Results: The mean PSA was significantly lower in diabetic men than non-diabetic (0.560 ng/ml vs 1.052 ng/ml; p=0.003). PSA showed a negative correlation with HbA1C in cases (r = -0.303;p = 0.043). Diabetics with HbA1C more 7% had significantly lower PSA than those with HbA1C less than or equal to 7%. Additionally, PSA levels were lower in diabetic men with a disease duration exceeding 5 years compared to those with a shorter duration. Interpretation and Conclusion: These findings suggest that glycemic status and diabetes duration may influence PSA levels in diabetic men, highlighting the importance of considering these factors when interpreting PSA test results to ensure optimal clinical outcomes.

DOI: 10.5281/zenodo.

85. Can Myocardial Tissue Doppler Predict Neonatal Outcome?
Basu Barnali, Ghosh Jay Deep, Das Arunabha
Abstract
Objective: Intrauterine growth restriction (IUGR) is associated with numerous neonatal complications in the affected fetuses. We undertook this study to assess whether myocardial tissue Doppler, found to detect subclinical cardiac dysfunction in IUGR, is an effective tool in predicting the neonatal outcome. Materials and Methods: It was a prospective cohort study in a teaching hospital conducted on fetuses affected by IUGR. Cardiac function was evaluated with the help of Myocardial Tissue Doppler (Right and Left Ventricular and Interventricular septal E’, A, E’/A’ and Myocardial performance index (MPI’)) and correlated with their neonatal outcomes. Results: Among the sixty-two fetuses taken, there were 3 mortalities, two developed cardiomegaly and fifteen developed respiratory distress. Right ventricular MPI’ was found significantly reduced in fetuses with adverse neonatal outcomes. Fetuses with adverse neonatal outcomes had both abnormal conventional vessel and myocardial tissue Doppler while significant number of fetuses with normal outcomes only had abnormal myocardial tissue Doppler. Right ventricular MPI’ had sensitivity of 40 % in detecting adverse neonatal outcomes and of 60% in detecting fetuses with normal outcomes. Conclusion: Myocardial tissue Doppler has good sensitivity in predicting normal neonatal outcome in fetuses with IUGR. It is however not a sensitive indicator of adverse outcome in IUGR in comparison to conventional vessel Doppler.

DOI: 10.5281/zenodo.

86. Study on Suicide Pattern in Tertiary Care Hospital in Chengalpattu District, Tamil Nadu, India
Shankar Anand. R, Preethi. P, M. Bastina Jenoffia, V. Pragadeesh Raja, Dharani Lenin
Abstract
Background: Suicide is a significant issue in public health. Throughout the world every year, more than 700 000 people lose their lives to suicide. India ranks 49th in the world in terms of suicide rate in 2019 (14.04% per lakh of population), but it is impossible to ignore the grim fact that India reports the highest number of suicides each year. Objectives: to study the pattern of suicide among patients in a tertiary care center and to assess the factors associated with suicide. Methodology: The cross-sectional study was carried out in a tertiary care hospital located in the Chengalpattu district of Tamil Nadu. Over a period of 8 months, specifically from September 2023 to May 2024. All patients admitted to the ICU after attempting suicide provided data for the study.  The use of a pretested questionnaire to collect data on the sociodemographic characteristics, type, method. Results: Among the 90 patients admitted with suicide attempt, the mean age of patients was 31.48± (12.24) SD years, ranging from 15-80 years. Among them, 62 (68.9%) were females. Majority of the patients from rural area 80(88.9%). Poisoning was the most common cause among suicidal individuals. The major reason for suicidal attempt was family problems 69 (76.7%). Conclusion: Concern is expressed about the rise in self-poisoning suicides in India. The primary causes of self-poisoning suicide attempts were family conflicts, financial difficulties, and psychological problems. In order to provide support, health education, and legislation, doctors, nurses, families, the community, and state leaders must all work together to address the multifaceted issue of attempted suicide by self-poisoning.

DOI: 10.5281/zenodo.

87. Diagnostic Accuracy of MDCT Scan in Detection of Intestinal and Mesenteric Injury in Blunt Abdominal Trauma
Sangada Santosh Surmalbhai, Majmudar Drusty Krishnasevak, Darda Mihir Gautam, Vaidya Chirayu Vijaykumar
Abstract
Background: Abdominal trauma caused by blunt force is a common presentation in the emergency room. The chief causes of blunt abdominal trauma are motor vehicle accidents, falls from heights, assault, bicycle injuries, injuries sustained during sporting activities, and industrial accidents. There are several recognized signs of blunt bowel and mesenteric injury at multidetector CT. Familiarity with the appearance of the signs as well as the limitations is crucial to making a timely diagnosis. Results: Most patients were males (77.21%) & most common age group was 21-40 years (73%). Most common mode of injury was road traffic accidents (70%). Ileum (35%) was the most common site of injury followed by jejunum (25%). Most common CT scan findings were mesenteric stranding (73%) followed by free fluid (80%) 93%. The most common solid organ injured was the spleen followed by the liver. The skeletal injury was the most common extra-abdominal injury. Conclusion: Males were more commonly injured most common mode of injury is road traffic/motor vehicle accidents. Most common site of injury is ileum. Most common associated solid organ injury is spleen. Most frequent MDCT findings are mesenteric stranding, free fluid and bowel wall thickening. Most specific findings are bowel wall discontinuity, active extravasation and reduced bowel wall enhancement.

DOI: 10.5281/zenodo.

88. Happiness Level in Medical Undergraduates: A Cross Sectional Study
Damini Singh, Rajesh Shetty, Ravi Nimonkar, PMP Singh
Abstract
Background: Understanding the factors influencing happiness among undergraduate medical students is crucial for improving their well-being and academic performance. This study aims to assess the levels of happiness and identify the determinants contributing to happiness among these students. The well-being of medical students is a crucial aspect of their academic success and future professional performance. This study investigates the levels of happiness among undergraduate medical students and identifies key factors influencing their happiness. Methods: A cross-sectional study was conducted among 420 undergraduate medical students of a medical college in Western Maharashtra. Participants completed a structured questionnaire, including the Oxford Happiness Questionnaire and additional sections on demographic and socio-economic information. Data were analysed using descriptive statistics and multivariate regression to identify significant predictors of happiness. Results: Among all the participants, 67.62% of the medical undergraduates were found to be happy. The mean OHQ happiness score was 4.28± 0.72. Female students, young age students, and students belonging to upper socio-economic class were found to be happier. Level of physical activity, good relation with friends/family, absence of stress in past 6 months, own choice of course were significantly associated with happiness. Conclusion: The findings of our study highlight the importance of fostering positive connections and integrating stress management techniques and physical activity into the medical curriculum which will help in alleviating stress in medical students and increase the happiness quotient.

DOI: 10.5281/zenodo.

89. Psychiatric Comorbidities, Substance Abuse and Suicide Risk in Transgender Population
A Meena, Venkatesh Mathan Kumar V
Abstract
Background: Transsexuals suffer from constant discomforts on several areas such as, job loss, accommodation, family acceptance, discrimination, emotional upset and so on. Transgender individuals and those with gender dysphoria may also have psychiatric disorders that are independent of their gender concerns, and while even serious mental illness such as major depression, bipolar disorder, borderline personality disorder and schizophrenia are not absolute contraindications to gender transition, they must be adequately treated so as not to interfere with adherence with the transition regimen. Based on this aim of our study is to assess the prevalence of psychiatric co morbidity, substance abuse and suicidal risk in transgender population. Methodology: The study population comprised of both Transmen and Trans women from the community in and around Chennai. A semi structured proforma to collect the relevant sociodemographic details and clinical profile. Mini –International Neuropsychiatry interview (MINI)-plus scale for assessing psychiatric comorbidities. All the analysis was done using statistical package for windows version 22. Results: The study included 88 transgenders with male to female 85 and female to male 3. Coming to history, 22.7% had past history of major depressive disorder, major depression at current is more common in MTF patients than in FTM. Major depressive disorder recurrent is more common in MTF (1.1%) than MTF. In our study, 23.9% of FTM transgender had lifetime risk of suicidality and 66.7% in FTM. 2.3% MTF has risk of Suicidality at present, which is more common than FTM transgender.1.1percentage MTF has risk of suicidality in future.  Sexual abuse was present in 49.4% among MTF. Conclusion: Our study attempted to discern the psychiatric morbidities among the transgender population. Gender identity disorder is a diagnostic entity in its own right, not necessarily associated with severe comorbid psychological findings. The disproportionately high prevalence of physical and/ or sexual abuse within transgender population’s calls for interventions that explore the sources of resilience. Access to routine primary care, diagnostic screening, psychotherapy, pharmacologic treatments, and community-based, pediatric/adolescent clinic settings are needed to address mental health problems and substance use disorders in this population.

DOI: 10.5281/zenodo.

90. Follow-Up of Visual Inspection with Acetic Acid Test Positive Patients in a Tertiary Care Hospital -Thiruvallur- A Longitudinal Study
Banu JH, Keerthana R, Padmalatha D, Vijayalakshmi M, Muruganandham R
Abstract
Introduction: Cervical Cancer is the second most common cancer and second leading cause of cancer death among females in India. Early detection through Population Based Screening using Visual Inspection with Acetic acid (VIA) method ensures better management and reduces mortality. Aims/Objectives: The study aims to assess the Cervical cancer screening and follow-up of those found positive in a Tertiary Care hospital in Thiruvallur, The objectives of the study is to determine the VIA positivity rate and the different outcomes of VIA positive patients at the end of three months. Method: This is a longitudinal descriptive based on the Hospital Record conducted for three months. The records of female patients who underwent cervical cancer screening by VIA test in the institution between January and June 2023 were obtained and they were followed up monthly for a period of 3 months either during their visit to the hospital or over telephonic conversation as per the participants’ preference. Data regarding the reports of VIA test and the subsequent colposcopy and biopsy were recorded and analyzed. Data were analyzed in SPSS version-16. Results: Among the 2773 women tested, 367 were VIA positive with a mean age of 41.72 ± 10.68 years. The VIA positivity was found to be 13.36%.One in twenty women tested VIA positive had malignancy, with 90% aged above 50 years. One among every ten women diagnosed with cervical cancer were not being followed-up. Conclusion: This study concludes that one in seven women who undergo VIA screening have positive result and one in twenty with a positive VIA test are diagnosed with cervical malignancy. Follow-up of the patients undergoing VIA test is the key for successful prevention and control of cervical cancer.

DOI: 10.5281/zenodo.

91. Incidence of Roth Spots in a Tertiary Care Centre in Eastern India
Singh H, Agarwal M, Shukla A, Dutta P
Abstract
Roth spots are distinctive retinal hemorrhages with a white center which were first observed in 1872 by a Swiss physician Moritz Roth. They are found in various conditions such as anemia, hypertensive retinopathy, leukemia, diabetic retinopathy, pre-eclampsia and anoxia. Conditions such as anoxia, carbon monoxide poisoning, anemia and prolonged difficult intubation are all linked to the occurrence of Roth spots. This observational study was carried out in Mata Gujri Memorial medical college and L.S.K. hospital, Department of Ophthalmology, Kishanganj from November 2023 till May 2024. A total of 801 patients were included in this study. The selection was made based on the findings of slit lamp biomicroscopy and stereoscopic visualization of ONH by +90D lens. To estimate the incidence of Roth spots in our study population based on their diagnosis, we used the proportional Z-test and a p-value <0.05 was considered significant. A total of 28 patients in our study were found to have Roth spots on fundoscopic examination depicting an incidence of 3.49% (28/801). The mean age among these patients was 49.39 years. 53.57% (15/28) of these patients were male and 46.42% (13/28) were female. According to our data, patients with pre-eclampsia are more likely to develop Roth spots (Z-test value 10.3, p<0.0000001) as compared to patients with diabetic retinopathy (Z-test value 9.4, p<0.000001) and hypertensive retinopathy (Z-test value 6.1, p<0.0001). A combination of detailed clinical examination and laboratory investigations needs to be conducted to evaluate a patient presenting with Roth spots. The occurrence of Roth spots has been rising in various diseases and a deeper study is needed to know more about their pathology.

DOI: 10.5281/zenodo.

92. A Comparative Clinical study of Patients of Heart Failure in Type 2 Diabetes Mellitus Versus Heart Failure in Non-Diabetic Patients
Laly Divakaran Chandrika, Saneer Kotarathil, Sundeep KB, Roopak Mohan
Abstract
Background: Continuous clinical trials have confirmed the association between Diabetes Mellitus (DM) with Heart failure (HF), independent of hypertension, atherosclerosis, coronary artery disease and valvular heart disease. But not universally recognized by physicians though the combination of both the conditions together may lead to morbidity and mortality. Early recognition and suitable management of HF in Diabetics could improve the outcome. But the etiology of heart failure in diabetic patients is still not completely understood. It has multifactorial determinants such as several cellular, molecular and metabolic factors. In addition there are no definite guidelines for grading the HF, early diagnosis, and therapy in DM patients with HF. This study focuses on the clinical presentation, probable pathophysiology, diagnosis, and prevention of HF in DM patients. Aim of the Study: To study the clinical manifestations of Heart Failure in diabetes type 2 patients and compare them with Heart failure in non DM patients in terms of diagnosis, and management. Materials: This case control study was carried out in 138 patients, who were divided into two groups. Group A Patients (69) with HF with Diabetes Mellitus and Group B (69): Patients of HF without DM. Necessary data to assess the HF and DM was collected. Standard statistical analytics were used to correlate the findings and study statistical significance. The Investigations undertaken were Demographic details, ECG, 2D ECHO and coronary angiography between diabetic and non-diabetic HF patients. Results: 138 patients were divided into Group “A” (69 patients) with HF and Diabetes Mellitus type 2 and Group B with only HF. 41 (59.42%) males and 28 (40.57%) females with a male to female ratio of 1.46:1 in Group A and in Group “B” (69 patients) with NON-Diabetes Mellitus, the males were 51 (73.91%) males and 18 (26.08%) females with a male to female ratio of 2.83:1. The overall male to female ratio among the 138 patients was 2:1. The incidence of HF at class intervals of 10 years starting at 25 years to 74 years in group A was: 06, 14, 17, 20 and 12. Corresponding incidence in group B for the same age intervals was 1, 05, 11, 25 and 27. The chi square statistic was 15.44 and the p value was 0.0038. Conclusions: Diabetes Mellitus is a risk factor for Heart Failure patients and menance of cardiac related mortality and morbidity. Severity of hyperglycemia was correlating with the severity of HF and was statistically significant (p value-0.05). 2D Echo results were helpful in the diagnosis of severity of HF and found to be more profound with patients of HF with DM; with p value less than 0.05. LVEF was less than 40% in patients of HF with DM when compared to HF patients without DM. CAG reports like Triple vessel disease (TVD), SVD and BVD were statistically significant with p value less than 0.05. Percentage of coronary artery block was 96 to 100% in patients with HF and DM. Mortality rate was higher in HF patients with DM than without DM.

DOI: 10.5281/zenodo.

93. A Clinical Study on Prognostic Predictive Value of Ferritin Levels in Acute Coronary Syndrome Patients in a Tertiary Care Hospital
Sundeep KB, Laly Divakaran Chandrika, Saneer Kottarathil, Roopak Mohan
Abstract
Background: Aim of the Study to evaluate the association between Ferritin levels and adverse cardiovascular outcomes in patients with acute myocardial infarction during short- or long-term follow-up. Materials: 124 patients with Acute Coronary Syndrome were included in a cross-sectional study by comparing their clinical parameters and serum Ferritin levels after inclusion criteria were satisfied between January 2022 and December 2024. Patients aged 18 years and above were included. Patients with myocardial infarction, ST-elevation myocardial infarction (STEMI), or non-ST segment elevation myocardial infarction (NSTEMI) were included. Patients with Serum Ferritin values more than 300ng/mL were considered as abnormal and included in the study. Proper clinical history, past CVS history was elicited. After thorough clinical examination cardiac stress test, ECG study for ST depression, ST elevation, T-wave inversion, or presences of Q waves were undertaken. Serum Troponin levels were estimated. Normal Serum Ferritin levels (SF) were considered 300–400 μg/l as the upper limits for the adult males and 150–200 μg/l as the upper limit of normal for adult females. Results: The serum Ferritin values estimated at 06 months intervals were correlated with the post ACS events among the subjects for a period of 32 months and it was observed that that MACE (12.09%), mortality (13.70%%), LVEF (09.67), HF (25%) and LVA (02.41%) were noted in patients equally with varying levels of serum Ferritin either low or high. There were no cardiovascular events in 46 (37.09%) patients. Conclusions: Both low and high serum Ferritin values were associated with adverse events in patients with ACS both during their hospital stay and/or at more extended follow-up periods. The adverse outcome and levels of Ferritin were linked to increased mortality risk, accentuated LVEF decline during follow-up, left ventricular aneurysm formation. The study recommends closer monitoring of serum Ferritin levels and timely therapeutic interventions for high-risk patients with ACS as elevated serum Ferritin can be a potent factor for predicting AMI especially STEMI.

DOI: 10.5281/zenodo.

94. A Comparative Study of Island Cartilage Graft Tympanoplasty and Temporalis Fascia Graft Tympanoplasty in Chronic Suppurative Otitis Media with Subtotal Perforation
Nalina P A, Sathish Kumar K N, Malavika Hari, Spandana S Pardikar
Abstract
Background: Chronic otitis media is a common condition for which the patient present to Otorhinolaryngology, constituting about 30% of the ENT outpatient numbers. Chronic otitis media implies a permanent abnormality of pars tensa or flaccida, most likely a result of acute otitis media, negative middle ear pressure or otitis media with effusion. Being surgery the main treatment modality of treatment, tympanoplasty using various types of graft materials is essential in the management of the disease. Temporalis fascia is most commonly used graft. Various other grafts materials include cartilage, areolar tissue, ear lobule fat, and vein. Cartilage is also a popular graft which can be used in the form of palisade, perichondrium/cartilage island, butterfly and shield graft. Hence this study was conducted with the objectives to compare the surgical outcome in terms of graft acceptance between the island cartilage graft and temporalis fascia graft used in type 1 tympanoplasty, to compare the audiological outcomes and complications. Methods: A cross sectional (Hospital based) study was conducted at Krishna Rajendra Hospital, Mysore attached to Mysore Medical College and Research Institute, Mysore. Patients attending the OPD with mucosal type of COM with subtotal perforation were included in the study between October 2018 to September 2019. Patients were divided into two groups alternatively and type one tympanoplasty was performed using island cartilage in one group and temporalis fascia in the other after clinical examination, examination under microscope and performing pure tone audiogram. Postoperatively they were followed up at third and eighth weeks to assess the graft uptake and audiological parameters. Results: In our study the graft uptake was similar in both island cartilage and temporalis fascia group. The audiological gain in terms of AB gap closure is slightly better in the temporalis fascia group than the island cartilage. Conclusion: In type 1 tympanoplasty, both temporalis fascia and island cartilage can be used for structural stability and temporalis fascia gives better audiological results.

DOI: 10.5281/zenodo.

95. Aerobic Gram Negative Bacterial Profile in High Vaginal Swab
T. Geetanjali, C. N. Soumya, A. Surekha, B. Naga Srilatha
Abstract
Introduction: Bacterial vaginosis is a polymicrobial condition involving facultative and anaerobic organisms in addition to Gardenerallvaginalis. Patients present with a clinical condition when there is an overgrown of the bacteria or by acquiring an exogenous flora. Gram negative organisms also cause bacterial vaginosis and their susceptibility pattern is required to manage the clinical condition. The aim of the present study is to know the gram negative bacterial infections predominance in bacterial vaginosis and its antibiotic susceptibility pattern. Materials and Methods: A Prospective cross sectional study was undertaken in the Department of Microbiology, ACSR Medical College, Nellore during the study period from February 2022 to March 2023. A total of 200 patients between 15-55 years presenting with complaints of vaginal discharge at the outpatient department of OBG were included in the present study. Culture swabs were collected and processed according to the standard guidelines. Results: Among 78 pathogens, (22 out of 78) 28.2% Escherichia coli, (18 out of 78) 23.07% Klebseillaspp, (15 out of 78) 19.2% S. aureus, (14 out of 78) 17.9% Candida spp, (4 out of 78) 5.1% Enterococcus spp (3 out of 78) 3.8% CoNS, and (2 out of 78) 2.5% Proteus spp. Gram negative bacilli are highly susceptible to colistin (100%), tigecycline (100%), amikacin (95.2%), meropenem (90.4%), ertapenem (85.7%), followed by levofloxacin (66.6%), Piperacillin-tazobactam (59.5%), Ceftazidime-clavulanic acid (54.7%), cefipime (54.7%), ceftazidime(47.6%), ceftriaxone (42.8%) and they were least sensitive to amoxyclav (42.8%) and amoxicillin (16.6%). Conclusion: The resistance bugs are in rise in many communities and the relapses are common in bacterial vaginosis, so it is better to track the pathogen by utilizing the laboratory services and start antibiotic after choosing suitable drug.

DOI: 10.5281/zenodo.

96. Aerobic Bacteriological Study of Surgical Site Infections and its Associated Factors
Priyanka Pudoor, S. Uma Devi, V. O. Mahesh Babu
Abstract
Introduction: Among nosocomial infections, SSI is the third most commonly reported infection and they account for approximately a quarter of all nosocomial infections. SSIs cause economic and social loss to the patients and family due to increase in length of stay and sometimes secondary surgery or re exploration may require. The aim of the study to analyze the risk factors and the pathogens responsible for surgical site infections. Materials and Methods: This is a descriptive cross sectional study that was undertaken for a period of one year in the year 2023. Details were noted about each patient in a pre-structured questionnaire. All cases were monitored until discharge from the hospital. After discharge patients were followed through phone calls about their wound condition up to 30 days after surgery. Results: Out of 272 total Elective surgeries, 5.14% had post op Surgical site infections & 31.7% of Emergency surgeries had SSI. Out of total 4.3% of 161 Clean surgeries; 5.7% of total 87 Clean contaminated;17.9% of total  67 contaminated & 21.8% of total 64 dirty wound types were infected (p<0.001). As the duration of surgery increased, SSI rate increase proportionately. The difference between the surgeries of <1 hr, 1-2 hr and 2 hours duration was highly significant statistically (p<0.00001). Out of 379 total operated patients who had Drains 10.8% showed SSI, and in no drain patients, 1.8% had SSI. 10.8% of abdominal surgeries & 1.8% of extra abdominal surgeries were showing SSI. 1.5% of total Laparoscopic abdominal surgeries, 11.08% of total Open Abdominal surgeries were showing surgical site infections. The difference of 9.58% was found to be statistically significant. In the present study, it was found that 5.2% of the total patients with preoperative stay >5 days showed postoperative infections. This was not statistically significant (p>0.05). Conclusion: The Clinicians should have knowledge of the appropriate use of aseptic and antiseptic techniques, the proper use of prophylactic and therapeutic antibiotics, and adequate monitoring and support with novel surgical and pharmacological modalities as well as nonpharmacological aids.

DOI: 10.5281/zenodo.

97. A Retrospective Study on Enhancing Ovarian Diagnosis: Leveraging DCE-MRI for Regional Discrimination and Clinical Insights
Md Kashif Rizwi, Uday Kumar, Surbhi Suman
Abstract
Background: Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) holds promise for improving diagnostic accuracy in ovarian pathology by providing regional discrimination and valuable clinical insights. This study aimed to investigate and optimize the utilization of DCE-MRI in this context. Methods: The study was designed as a retrospective observational investigation. Seventy participants aged 18 years and above, who underwent DCE-MRI for suspected ovarian pathology were included. Data collection encompassed clinical information and DCE-MRI parameters. Statistical analyses were performed using SPSS version 20, including descriptive statistics, association tests, and multivariate regression analysis. Results: The study cohort had a mean age of 52 years (range: 25-78 years), with 60% diagnosed with malignant and 40% with benign ovarian lesions. Abdominal pain (64.3%) was the predominant symptom, along with elevated CA-125 levels in 74.3% of participants. DCE-MRI analysis revealed significant differences between malignant and benign lesions, with malignant lesions exhibiting higher peak enhancement and wash-in rates, while benign lesions displayed higher wash-out rates and delayed time to peak enhancement. The diagnostic performance of DCE-MRI parameters was excellent, with peak enhancement demonstrating the highest area under the curve (AUC: 0.92). Conclusion: DCE-MRI shows promise as a valuable adjunctive tool for enhancing diagnostic accuracy in ovarian pathology. The study findings underscore its potential in discriminating between malignant and benign lesions, providing insights for improved patient management and treatment decision-making. Further research is recommended to validate these findings and explore additional applications of DCE-MRI in ovarian diagnosis and management. Recommendations: It is recommended to integrate DCE-MRI into standard diagnostic protocols for ovarian pathology, validating findings in larger cohorts for reliability. Optimizing imaging protocols and exploring advanced biomarkers could enhance diagnostic accuracy in ovarian malignancies, improving patient outcomes.

DOI: 10.5281/zenodo.

98. Proton Pump Inhibitors and Renal Disease: a Prospective Observational Study at a Tertiary Care Hospital
Navneet Saxena, Jaswant Goyal
Abstract
Background: Widespread over-the-counter use of Proton pump inhibitors has raised a concern regarding their safety profile during long-term use. Various retrospective & observational studies have reported the development of chronic kidney disease in individuals on Proton pump inhibitors. Aims & Objectives: To find an association between the uses of proton pump inhibitors and renal disease. Material & Methods: This prospective observational study was carried out in the Department of Nephrology of our Tertiary care hospital from August 2023 till February 2024 for six months. 200 patients within the age range of 45-65 yrs suffering from gastro-oesophageal reflux disease, peptic ulcers including gastric ulcers and duodenal ulcers, with once / twice daily prescribed PPI (duration between 15 days to 6 months of use) were included in the study. Patients with comorbidities, suffering from renal disease, on nephrotoxic medications, and pregnant women were excluded from the study. The patients were divided into 2 groups: Group A: Patients with users of PPI (n=100); Group B: Patients with non-users of PPI (n=100). Detailed history including socio-demographic details, age at clinical presentation, and medication history was taken. Renal function tests – serum creatinine, blood urea nitrogen, and glomerular filtration rate were measured at baseline, 3- and 6 months of the study. Results: In Group A, 9 patients while in Group B, 2 patients showed signs of developing renal disease with the usage of PPI. There was a significant increase in the serum creatinine levels, BUN, and reduction in GFR at 6 months follow-up (p<0.05). 61.2% of the patients were in the age range 55-60 yrs, 23% in 61-65 yrs, and 16% in the age group of 51-55 yrs. Males were at a greater risk than females. Conclusion: The use of proton pump inhibitors can contribute to the development of chronic renal disease.  These medications should be carefully administered. Further large prospective studies should be conducted to confirm this association.

DOI: 10.5281/zenodo.

99. The Effect of Oral Sodium Bicarbonate Supplementation on Chronic Kidney Disease: a Randomised Controlled Trial
Jaswant Goyal, Navneet Saxena
Abstract
Background: Chronic kidney disease (CKD) poses serious public health concern, constituting structural and functional abnormalities in the kidney. The complications become a cause of increased morbidity and mortality in CKD patients. Aim: To assess the effect of oral bicarbonate supplementation on on the progression of chronic kidney disease. Material & Methods: This prospective randomised controlled clinical trial was conducted in the Department of nephrology of our tertiary care Hospital from February 2023 till January 2024. Patients (n=70) ,aged more than 18 yrs , with estimated glomerular filtration rate (eGFR)of 15–30 mL/min/1.73 m2 and Serum bicarbonate levels -10–20 mM/L in clinically stable condition were randomized into ; Test Group – 600 mg sodium bicarbonate orally TDS; Control Group – standard therapy without oral sodium bicarbonate supplementation. Venous samples were analysed for Serum bicarbonate, serum creatinine, serum albumin & eGFR. The patients were followed for 6 and 9 months Results: In control group, eGFR decreased significantly at 6 months (20.24 mL/min/1.73 m2) and at 9 months (19.26 ml/min/2.73m2) (p0.05). In test group, serum albumin levels increased significantly, eGFR remained at par with baseline values. The serum creatinine was comparable in both the groups with no significant difference at 6 or 9 months. Conclusions: The present study concluded that the oral supplementation to cause improvement in the serum albumin levels & maintenance of baseline values which subsequently leads to improvement in renal function. Thus, it should be included in the management of metabolic acidosis in chronic kidney diseases patients & arrest disease progression.

DOI: 10.5281/zenodo.

100. Relationship Between Haematological Profile and Body Mass Index in Adults: A Cross-Sectional Study
Deepmala Sinha, Rajni Kant, Pandurang Madhukar Narhare
Abstract
Background: Obesity is a serious global public health concern that has been linked to several health problems. The purpose of this study was to evaluate the association between adult population BMI and haematological profile. Methods: 200 participants were included in this study, 100 of whom were females and 100 of whom were males, and their age range was between 18 to 30. This study was conducted from July 2023 to December 2023 at the Department of Physiology, ESIC Medical College, Bihta, Patna, Bihar, using a cross-sectional study design. A 10-milliliter venous blood sample was taken from the antecubital vein using aseptic precautions, and it was subsequently transferred to an EDTA tube. The Sysmex Haematology Analyser was then used to measure haematological parameters such as PCV, hemoglobin concentration, RBC, and WBC count. The participants were divided into four groups: underweight, normal, overweight, and obese. Using ANOVA, statistical significance was ascertained. The significance of the results was assessed using the Scheffe post-hoc test, and the link between the variables was ascertained using Pearson correlation. Data was analysed using SPSS software and presented as mean±standard deviation. Values of P≤0.05 were considered significant. Result: According to our study, PCV is statistically higher in overweight and obese people than in people with other BMI categories in both males and females. When compared to normal subjects, the total leucocyte count was considerably greater in overweight and obese subjects. All BMI categories showed no change in hemoglobin concentration or red blood cell count. Conclusion: In contrast to underweight and normal weight BMI categories, we found in our study that leucocytosis and increased PCV were present in overweight and obese person groups. The total leucocyte count and BMI have a direct positive association. Among all BMI groups, there is no statistically significant difference in the haemoglobin concentration and RBC count. Young people need to be encouraged to lead stress-free lives, engage in regular exercise, eat healthily, and have a healthy lifestyle.

DOI: 10.5281/zenodo.

101. Prevalence of Echocardiographic Changes in Patients with Chronic Kidney Disease: A Hospital Based Observational Study
Rakesh Raushan, Sumit Ranjan
Abstract
Background: The primary cause of morbidity and death for those with Chronic Kidney Disease (CKD) is cardiovascular disease (CVD). Long before renal failure sets in, during the early stages of CKD, there may be an elevated risk of CVD. When CVD mortality in the dialysis population is compared to the general population, it clearly illustrates the significant burden of CVD. Aims of this study to identify the Echocardiographic changes in patients with CKD and know the prevalence of each Echocardiographic change in CKD. Methods: This study comprised 50 patients with chronic kidney disease (CKD) who were admitted between April 2023 and September 2023 to the general medicine department of the ICARE Institute of Medical Sciences and the Dr. Bidhan Chandra Roy Hospital in Haldia, West Bengal. The patients were assessed using the following methods: electrocardiography (ECG), blood urea, serum creatinine, general physical examination, systemic examination, and echocardiography. Results: In the present study, 86% of patients had cardiovascular abnormalities identified by echocardiography. 36% of patients had left ventricular hypertrophy (LVH). 16% of cases are Ischemic heart disease (IHD), 22% are LVH and Ischemic heart disease, 4.0% are dilated cardiomyopathy, 6.0% are pericardial effusion, and 2.0% are septal hyperthrophy. Conclusion: The most frequent morphological anomaly found is LVH. We could screen CKD patients before they underwent renal transplantation to detect and correct Coronary Artery Disease (CAD), and echo is a tool to detect moderate and massive Pericardial Effusion. In our center, we were able to diagnose IHD patients by echocardiogram and refer them for coronary artery intervention promptly. and to recommend appropriate dialysis and pericardiocenteties.

DOI: 10.5281/zenodo.

102. Comparative Study of Vaginal Misoprostol Alone Versus a Combination of Vaginal Misoprostol and Intracervical Foley Catheter for Inducing Labor
Shilpi Singh, Anjani Kumari, Pankhuri Jaiswal, Seema
Abstract
Background: In order to avoid difficulties for both the mother and the fetus, inducing labor is a standard treatment in obstetrics. Labor induction can be accomplished by a variety of techniques, such as mechanical and pharmacological procedures. The aim of the study was to identify the best method for inducing labor. Methods: A cross-sectional study conducted at the Department of Obstetrics and Gynecology, Darbhanga Medical College and Hospital, Laheriasarai, Bihar, compared the use of Misoprostol & Foley Catheter (group A) and Misoprostol alone (group B) for inducing labor in pregnant women in their third trimester. Data on mother age, gestational age, BMI, birth mode, duration of pregnancy, and newborn outcomes, including Apgar scores and ICU admissions, were gathered for the study. Results: In a study that compared the use of a Foley catheter plus misoprostol for labor induction (group A) to misoprostol alone (group B), the majority of women in both groups delivered their babies vaginally and without any problems or cesarean sections. The BMI, time frame, and ripening time were found to differ significantly between the two groups in the study; group A had lower values for these factors. Conclusion: Compared to misoprostol alone, foley’s plus vaginal misoprostol produces a shorter period between induction and delivery.

DOI: 10.5281/zenodo.

103. Study on the Relationship Between Clinical and Ultrasound Diagnosis of Fetal Growth Restriction
Anjani Kumari, Shilpi Singh, Pankhuri Jaiswal, Seema
Abstract
Background: Fetal growth restriction (FGR) is a prevalent and intricate clinical issue that has a significant morbidity risk. Apart from congenital abnormalities and viral factors, FGR has been found to be a significant factor in perinatal death. This study aims to link the diagnosis of fetal growth limitation made by ultrasonography and clinical means. Methods: This prospective study was carried out from May 2022 to January 2023 at the Department of Obstetrics and Gynecology at DMCH, Laheriasarai, Bihar. The study comprised a total of 288 patients. Results: 33.7% of the participants were found to have FGR. The age group of 20–25 years old accounted for 60.81% of cases. 89 percent of women lived in rural areas. Women made up 67.30% of the upper-lower class. Clinical approaches were shown to have a sensitivity of 70.7% and a specificity of 74.2%, respectively. Doppler and ultrasonography were found to have sensitivity values of 80.5% and 90.2%, respectively, and specificity values of 87.7% and 95.1%. 82 cases (65.1%) out of 126 clinically suspected IUGR cases had IUGR verified at birth. Twenty-three (20.63%) were lost to follow-up. Conclusion: Because of its high specificity, the Doppler study is the most effective modality currently available for identifying FGR; however, clinical assessment, a financially advantageous screening technique, is also a suitable way to diagnose FGR.

DOI: 10.5281/zenodo.

104. Effect of Aging on Nerve Conduction Study of Median Nerve and Ulnar Nerves in Healthy Individuals: A Cross-Sectional Study
Vishwajit Kumar, Pawan Kumar Jha, Bijay Krishna Prasad
Abstract
Background: Numerous physiological and environmental factors are known to have an impact on nerve conduction studies (NCS). The purpose of the current investigation was to ascertain how aging affected the nerve conduction velocity (NCV) of the two often studied upper limb nerves, the ulnar and median, in subjects of varying ages. Moreover, the goal was to gather reference information for use in clinically relevant nerve diagnostic tests. The objectives of this study were to examine how aging affects the median and ulnar nerve’s nerve conduction velocities and to track changes in the NCS of these two nerves in relation to age. Methods: In this cross-sectional and observational study, 110 healthy participants (60 males and 50 females) were involved. Medical students and staff members, both teaching and non-teaching, at the ANMMCH in Gaya, Bihar, volunteered to be the study’s subjects between April 2023 and December 2023. Group I (18–30 years old) (n = 38), Group II (31–45 years old) (n = 38), and Group III (46–60 years old) (n = 34) were the age groups into which the subjects were divided. The amplitudes, NCVs, and motor and sensory distal latencies of the ulnar and median nerves were measured, and the results were assessed. Results: For both the sensory and motor components, the latencies, amplitudes, and velocities of the median and ulnar nerves were examined, together with their mean and standard deviation. In comparison to the younger age group, patients who were older had longer latencies (median: Motor and sensory P < 0.001, ulnar: Motor = 0.013 and sensory = 0.006), smaller amplitudes (median: Motor P = 0.013 and sensory <0.001, ulnar: Motor P = 0.014, and sensory = 0.008), and slower conduction velocities (median: Motor P < 0.001 and sensory = 0.006, ulnar: Motor P = 0.003 and sensory = 0.069). This change was clearly noticeable in the age group of ≥46 years. The ulnar and median nerves’ sensory nerve conduction changed more with aging. Conclusion: The findings of our study show a substantial correlation between age and each of the three nerve conduction characteristics that were measured from both nerves. The findings of routine testing should be compared age-wise in order to improve NCS’s diagnostic sensitivity.

DOI: 10.5281/zenodo.

105. Posterior Segment Ophthalmic Complications in Dengue Infection – A Case Series
Liji Menon M, Tara Susan Mohan, Meenu P Paulose, Deepti R
Abstract
We report 10 cases of posterior segment ophthalmic manifestations resulting from dengue infection in a tertiary care centre in South Kerala. We performed an observational case by case analysis of retinal complications in  a series of 10 patients admitted as cases of dengue fever who presented with visual impairment. Ophthalmic evaluation included Snellen visual acuity testing, Indirect ophthalmoscopy, Fundus photography, OCT and Fundus fluorescein angiography. 15 eyes of 10 patients were affected. Mean age of patient was 41.2 years (15-51). Presenting visual acuity ranged from 6/9 to counting fingers. 9 out of 10 cases (90%) reported central impairment of vision. Onset of vision impairment coincided with the nadir of serum thrombocytopenia. Among the 15 eyes, retinal findings included maculopathy and retinitis (4 eyes), macular bleed and retinal haemorrhages (4 eyes) vasculitis and vascular occlusion (4 eyes), foveolitis (1 eye) and choroidal effusion (eye). 9 out of 10 cases recovered to their pre retinopathic visual acuity. These new retinal complications points towards a widened spectrum of posterior segment complications associated with dengue infection.

DOI: 10.5281/zenodo.

106. Assessing Awareness and Usage of Evidence-Based Learning Strategies among Undergraduate Medical Students
Pathakota Swarnalatha, Sivaramannagari Rajasekhar Reddy, Chintam Sushma, MD Khader Faheem. N
Abstract
Introduction: Awareness and usage of evidence-based learning strategies is important for health professional students to engage in self-regulated lifelong learning. But, most of the students still continue to rely on ineffective study habits. Methods: Online survey-based assessment of awareness and usage of evidence-based learning strategies among MBBS students in one of the medical colleges in South India (n=661). Results: Significant number of medical students are still using non-evidence-based learning strategies like rereading underlined or highlighted material (433/661, 65.5%) and underutilizing self-testing as a tool of learning (67/661, 10%). Over 50% of the students believe they have a specific learning style (332/661, 50.2%). Conclusion: The results of this study when compared to previous studies indicate that though there is increased awareness and usage of some of the evidence-based learning strategies among health professional students, there is still a significant percentage of students who believe and rely on few non-evidence-based learning strategies. Hence, medical educators need to focus on educating the students how to learn and use metacognition in self-regulated lifelong learning.

DOI: 10.5281/zenodo.

107. Rifampicin-Induced Hypothyroidism: A Case Report and Review of Clinical Management
Roy Ayan, Sarangi Shakti Prasad, Agasti Swati, Ashok Kumar Panigrahi
Abstract
Introduction: Tuberculosis (TB), caused by Mycobacterium tuberculosis, primarily affects the lungs but can spread to other body parts. Drug-resistant TB strains complicate treatment efforts, highlighting the need for new drugs. Rifampicin is crucial for TB treatment but can cause side effects, hypothyroidism being a rare one. Case Report: A 35-year-old female with pulmonary TB developed fatigue, weight gain, constipation, and dry skin 8 weeks after starting a Rifampicin-based regimen. Elevated TSH (10.5 µIU/mL) and low free T4 (0.7 ng/dL) indicated hypothyroidism. After temporarily discontinuing Rifampicin, her thyroid function normalized, and she was treated with levothyroxine. Symptoms improved, and thyroid function stabilized. Discussion: Rifampicin can induce hypothyroidism by increasing thyroid hormone metabolism and disrupting thyroid function. Monitoring thyroid function in patients on Rifampicin, especially those at risk, is essential to manage potential hypothyroidism. Conclusion: Rifampicin can induce hypothyroidism, necessitating vigilant thyroid function monitoring during treatment. Early detection and management with levothyroxine ensure better patient outcomes and adherence to TB therapy.

DOI: 10.5281/zenodo.

108. HCQ: A Promising Frontier in Diabetes Care and its benefits in diabetic rat model
Rajiv Ranjan Das, U.S.P Keshri, Anupa Prasad
Abstract
Background: The study is done to evaluate the efficacy of different interventional drugs in treating diabetes and their impact on the kidney and liver changes using a rat model. Methods: For this study 6 groups of 6 Wistar Rats were used. Out of which 3 groups were treated with hydroxychloroquine (HCQ), alpha-lipoic acid (ALA), and chromium picolinate (CrP), and their kidney with renal profile and SGPT were analyzed. Results: The results showed that administration of HCQ for 42 days improved SGPT, creatinine, and urea levels in diabetic rats. When compared with the normal group and metformin, HCQ values were closer to those of the normal group than to metformin, and it also exhibited protective properties against liver and kidney damage. Conclusion: HCQ showed a promising result to be used therapeutic agent for diabetes management, particularly due to its improving effects on liver and renal profiles. On comparing with ALA and CrP, HCQ showed better improvement in renal profiles and also exhibited hepatoprotective properties.

DOI: 10.5281/zenodo.

109. Comparative Effectiveness of Oral Iron Supplements Vs Intravenous Iron Sucrose in Managing Iron Deficiency Anemia in Pregnant Women
Shilpa Shekhar Ingle
Abstract
Introduction: Iron deficiency anaemia (IDA) has emerged as general health issue affecting world-wide population during pregnancy, its impact on health of mothers and newborns, as well as subsequent generations is observed. India with increasing population, it also has the highest prevalence of iron-deficiency anaemia in comparison to worldwide population, particularly affecting rural populations due to poverty and inadequate nutrition. Anemia can be short-lived or constant and ranges from mild to severe. Focusing on creating an anaemia-free India is achievable by raising awareness. Present study is focused on comparative analysis and record the effectiveness of oral iron supplementation during pregnancy. Aim: Aim of present study is to systematically record and compare the effectiveness of oral iron supplementation versus intravenous iron sucrose in treating iron deficiency anemia during pregnancy. Materials and Methods: A prospective study was conducted at a tertiary care center over a period of 2 years, involving 100 pregnant participants diagnosed with mild to moderate iron deficiency anaemia, on the basis of inclusion and exclusion criteria. Study Design: This comparative study involved two groups, with 50 participants allocated to each group. One group received intravenous (IV) iron treatment, while the other group received oral iron supplementation. The study aimed to evaluate treatment effects based on outcomes such as initial and final hemoglobin levels. Result: Initially hemoglobin levels were found to be statistically significantly lower in the Oral Rx group of participants compared to the IV Rx group, with a p-value of 0.001**. This indicates that participants who received intravenous iron treatment had higher final hemoglobin levels compared to those who received oral iron supplementation. Conclusion: Present study aimed to evaluate the safety and effectiveness of oral iron compared to intravenous (IV) iron on hematological parameters in pregnant women with iron deficiency anemia. Our findings confirm that IV iron resulted in a rapid and significant improvement in hematological parameters compared to oral iron supplementation.

DOI: 10.5281/zenodo.

110. Exploring the Link Between Hormonal Markers and Sexual Behavior in Female Infertility
Shilpa Shekhar Ingle
Abstract
Background: This study explores the intricate relationship between hormonal markers and sexual behavior in the context of female infertility. Hormonal imbalances, often a root cause of infertility, can significantly influence sexual desire, arousal, and overall sexual health. By examining key hormonal markers such as estrogen, progesterone, and luteinizing hormone, this research aims to elucidate their impact on sexual behavior patterns in infertile women. Through a comprehensive review of existing literature and analysis of clinical data, we identify how these hormonal fluctuations correlate with changes in sexual activity and libido. Understanding this connection is crucial for developing holistic treatment approaches that address both the reproductive and sexual well-being of affected women. This study underscores the importance of considering sexual health in the management of infertility and calls for integrated care strategies that encompass both endocrinological and psychological aspects of female reproductive health. Material and Method: A case-control study with a clinical focus was conducted at the Department of Obstetrics and Gynecology. The study included 200 female participants, divided into two groups: 100 infertile patients and 100 fertile controls. The participants were matched for age to ensure comparability between the groups. Results: The data indicated an altered antioxidant/oxidant ratio and an increase in free radical status (ROS/RNS), signifying a shift in the cellular oxido-redox state. The endocrine profiles of gonadotropins (LH/FSH) and ovarian hormones (estradiol, testosterone, and progesterone) showed significant alterations in patients with PCOS, endometriosis, OI, and BOH, suggesting modifications in the hypothalamic-pituitary-ovarian (HPO) axis. Additionally, gynecological events such as irregular menstruation, uterine fibroids, and structural issues with the uterus and oviduct, including stillbirth and miscarriage, were observed in patients with BOH. Conclusion: The impact of medicalization on Indian women’s values is multifaceted. While some women have successfully managed their infertility issues, others have been significantly affected by infertility treatments and assisted reproductive technologies (ART). The researcher’s work on reproductive diseases associated with infertility in Indian women is highly significant within the realm of biomedical sciences. In addition, affected cases in India receive genetic testing and counseling, as well as therapy and management of these issues through the use of ART.

DOI: 10.5281/zenodo.

111. Immature Teratoma of the Ovary: A Series of Rare Cases and Review of Literature
Ritu Raj, Rajeev Ranjan, Somajita Chakrabarty
Abstract
Introduction: Immature teratomas account for less than 1% of all ovarian cancers but is the second most common germ cell malignancy and accounts for 10%-20% of all ovarian malignancies in women younger than 20years. Preoperative diagnosis of immature cystic teratoma can be challenging for clinicians because of varied radiological findings and tumor markers level. Aims and Objectives: To elaborate on the varied presentation, prognostic markers and challenges for diagnosis and management of immature teratoma. To emphasize on the need of timely referrals, multidisciplinary team management and need for continuous follow up. Materials and Methods: The hospital records of patients with confirmed histopathological diagnosis of immature teratoma in last one year was reviewed and these patients were closely followed up for further management at AIIMS, New Delhi. All the cases have been discussed via graphic presentation for detailed and in-depth understanding. Results: Histopathological examination is the only confirmatory diagnosis`. Age of presentation was between 16-32 years. The clinic-radiological diagnosis was challenging because of varied presentations. Tumor markers were not specific for all of them. Grade of the tumor is the most important prognostic factor followed by stage. Even with adjuvant chemotherapy, there are chances of recurrences. Conclusion: Immature teratoma of ovary primarily involves younger patients; hence clinicians should strongly have a high sense of suspicion whenever the diagnosis of a germ cell tumour is entertained and timely intervene.

DOI: 10.5281/zenodo.

112. Demographic Profile, Risk Factors and Management of Coronary Artery Disease: A Prospective, Cross-Sectional Study
Chitranshu Jain, Dilip Kumar Jain
Abstract
Background: Coronary artery disease (CAD) is a prevalent cardiovascular condition characterised by the narrowing or blockage of the coronary arteries leading to significant morbidity and mortality. Early assessment of risk factors, prompt diagnosis and treatment may have an important role in reducing the cardiovascular complications. The aim of this study is to determine the factors contributing to the development of coronary artery disease, its diagnosis and management. Material and Methods: A prospective cross-sectional study was conducted in the cardiology ward of Geetanjali Medical College and Hospital, Udaipur. The study included patients of both genders, aged 18 years or above, admitted to the cardiac care unit (CCU) with coronary artery disease. The sample size was 342. Results: The results indicate a significant burden of coronary artery disease in the examined patient population. The majority of patients fall within the 51-60 age range, with a higher prevalence among males. Chest pain is the most common symptom reported, and smoking is prevalent among male patients. Comorbidities such as hypertension and type 2 diabetes mellitus are frequently observed. Diagnostic tests, including angiography and ECG, are commonly performed for accurate diagnosis. Medications such as anticoagulants, β blockers, and statins are frequently prescribed to manage the disease. Conclusion: The findings indicate toward target population being more affected by burden of disease and require the need for targeted interventions, including smoking cessation programs and lifestyle modifications, to reduce the risk and burden of coronary artery disease in this population. These insights provide valuable information for healthcare professionals in tailoring personalized approaches for coronary artery disease management.

DOI: 10.5281/zenodo.

113. Parallel Study of Hypertensive (Non-Glaucomatous) and Glaucomatous Patients for Optic Disc Parameters
Mitaliben M. Prajapati, Radha I. Dass
Abstract
Introduction: Glaucoma is a type of neurodegenerative disease characterized by morphological variations at the position of the optic nerve head (ONH) or retinal nerve fiber layer (RNFL) as well as damage to the visual field. Assessment of the diurnal fluctuations in IOP and MOPP is clinically relevant in glaucoma patients. Systemic hypertension, as such, may directly damage the small vessels of the optic disc and increase the risk of glaucoma. Material and Methods: This is a cross-sectional observational study done with 50 patients, carried out at the Department of Ophthalmology tertiary care centre. It consists of two groups, the first group of 25 patients with essential hypertension, and the second group of 25 with POAG. The average age of patients included is 55.36 years. Observation and Result: The average history of hypertension is from the past 5.23 years. The mean Average C/D Ratio of HTN Cases was RE-0.45+0.08 & LE -0.47+0.110. The mean Disc Area of HTN Cases was RE-1.66+0.11 & LE – 1.68+0.16 whereas the mean Disc area of the glaucoma group was RE- 2.12+0.47 & LE-2.04+0.40. Summary: In comparison of the hypertensive group with the Glaucoma group, neuroretinal rim changes in Hypertension were not significant in comparison to Glaucoma. In other words, hypertension causes changes in other optic nerve parameters but does not have much effect on the neuroretinal rim. The neuroretinal rim, which is the intrapapillary equivalent of optic nerve fibers, indicates the amount of viable optic nerve tissue and is one of the most important morphological parameters to detect glaucomatous optic neuropathy and to grade the amount of glaucomatous optic nerve damage. In Glaucoma, because of mechanical stress from elevated IOP at the level of lamina cribrosa, posterior bowing and thinning of the lamina occur. This disrupts axonal transport. As a result, retinal ganglion cells undergo apoptotic cell death with loss of neuroretinal tissue of the optic disc and enlargement of parapapillary atrophy. All parameters in conjugation lead to Glaucomatous optic nerve atrophy.

DOI: 10.5281/zenodo.

114. External versus Endoscopic Dacryocystorhinostomy for Primary Acquired Nasolacrimal Duct Obstruction
Nilesh Gautam, Ram Kumar Satyapal
Abstract
This prospective study evaluated the effectiveness of external dacryocystorhinostomy (DCR) alone versus external DCR with primary lacrimal intubation in treating primary acquired nasolacrimal duct obstruction at Darbhanga Medical College and Hospital between January 2020 and August 2021. A total of 110 patients were randomly assigned to undergo either the traditional external DCR (n=55) or external DCR with lacrimal intubation (n=55). The outcomes measured were duct patency, infection rates, granulation tissue formation, and patient-reported symptomatic relief. Results demonstrated a significantly higher success rate and lower complication rates in the intubation group, suggesting that primary lacrimal intubation enhances the effectiveness and safety of external DCR.

DOI: 10.5281/zenodo.

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