Diabetes mellitus (DM) is the most common metabolic disorder affecting the people worldwide. Even though diabetes has been known since antiquity, only in the last few decades new discoveries have provided great hopes to minimize morbidity and mortality. The present work was taken up to assess the lipid profile of a randomly selected group of adult diabetic patients and to compared them with that of the controls. A total number of 30 control who were healthy non-smokers non alcoholics and at the time of study all of them were keeping good health and 30 diabetics who were on treatment were studied. Results shows that TG, TC, LDL-C, and VLDL-C, the lipid profile are higher significantly in diabetes than and HDL-C was significantly lower in diabetics than control groups. The difference between the control and the study (Diabetic) groups was Statistically highly significant. This study revealed that dyslipidaemia was observed in the diabetic population. The diabetic patients had a higher prevalence of high serum cholesterol, high triacylglycerol and high LDL-C than the controls, indicating that diabetic patients  were more prone to cardiovascular diseases.

DOI: 10.5281/zenodo.10977457

Background: The clavicle, a specialized long bone situated horizontally at the base of the neck, plays a crucial role in providing support and facilitating the free movement of the upper limb. This study aims to explore the variability in the position, direction, and number of nutrient foramina in the clavicle and assess their clinical significance. Methods: A total of 100 dried human clavicles were examined, with 50 specimens each for the right and left clavicles. The age and gender of the specimens were not identified. Specimens with damage, deformities, or significant pathological abnormalities were excluded. Nutrient foramina were observed for number, position, location, and orientation. The Hughes formula was utilized to calculate the foramen index. Results: In every clavicle, at least one nutrient foramen was identified. The distribution included 70% with a single foramen, 24% with two, and 6% with three. The posterior surface was the predominant location (55.88%), followed by the inferior surface (41.17%) and the superior surface (2.94%). The middle one-third of the clavicle exhibited the highest concentration of nutrient foramina (70.58%). The average distance from the sternal end was 69.63 mm, resulting in a foramen index of 52.25. Discussion: Our findings align with previous studies, emphasizing the variability in nutrient foramen distribution. Notably, the posterior surface predominance corresponds with existing literature. The study provides valuable insights for surgical procedures such as internal fixation and vascularized bone grafting, emphasizing the importance of preserving arterial supply. Conclusion: This investigation sheds light on the distinctive characteristics of nutrient foramina in the clavicle. The knowledge gained can enhance surgical precision and outcomes in procedures involving the clavicle.

DOI: 10.5281/zenodo.10977504

Background: Understanding the prevalence and factors associated with vertigo during pregnancy is essential for maternal healthcare providers. This knowledge can inform tailored interventions, ensuring the well-being of both the mother and the developing fetus. Additionally, exploring the relationship between vertigo and other common symptoms like nausea and vomiting is crucial for a holistic understanding of maternal health. This cross-sectional study aims to investigate the prevalence of vertigo during pregnancy, identify associated factors, and explore the potential connection between vertigo and nausea-vomiting. Methods: A questionnaire-based survey was conducted on 560 pregnant women attending a hospital. The questionnaire covered sociodemographic details, pregnancy-related characteristics, vertigo history, associated variables, and the Pregnancy-Unique Quantification of Emesis (PUQE) test for nausea-vomiting. Statistical analyses, including logistic regression, were employed for data interpretation. Results: Of the participants, 37.1% reported a history of vertigo. Factors associated with vertigo included the level of education, number of pregnancies, history of nausea-vomiting during pregnancy, vertigo in previous pregnancies, recent vertigo episodes, physician-diagnosed diseases related to vertigo, hearing impairment, back-neck pain, head trauma, and recent exposure to a depressing event. Spinning vertigo (16.8%), swaying vertigo (17.3%), and orthostatic dizziness (61.5%) were reported, with 62.5% experiencing mild, 26.4% moderate, and 11.1% severe vertigo. The mean PUQE score was 4.31±1.84. Those with a vertigo history had higher PUQE scores. Accompanying symptoms included nausea-vomiting (25.1%), headaches (18.6%), and stumbling while walking (13.4%). Conclusion: The study highlights a substantial prevalence of vertigo during pregnancy, emphasizing the role of hormonal, physiological, and health-related factors. Notably, pre-pregnancy dizziness emerged as a significant predictor of vertigo during pregnancy. The findings provide valuable insights for healthcare providers, enabling tailored interventions to enhance maternal well-being. The study calls for further research to unravel the intricate mechanisms underlying vertigo during pregnancy, facilitating targeted preventive measures and interventions.

DOI: 10.5281/zenodo.10977543

Introduction: Metacarpal and phalangeal fractures constitute a significant portion of musculoskeletal injuries, often resulting from roadside accidents and machine-related incidents. Achieving optimal functional outcomes in hand injuries remains challenging, considering the potential for disability due to sensory loss, decreased strength, and impaired flexibility. This study aims to evaluate the clinical and radiological outcomes of metacarpal fractures treated with Open Reduction Internal Fixation (ORIF) using plating and Closed/Open Reduction Internal Fixation  employing K-wire fixation. Material and Methods: A prospective comparative study was conducted at a tertiary care hospital from December 2020 to November 2022. Twenty patients with metacarpal fractures in each group underwent either K-wire fixation (Group 1) or ORIF with plating (Group 2).K-wires were removed after 4 weeks, and follow-ups were conducted at 2 weeks, 4 weeks, 6 weeks, 3 months, and 6 months to assess radiological union, range of motion (ROM), grip strength, and Disability of Arm, Shoulder, and Hand (DASH) scores. Qualitative data were presented as frequencies and percentages, and associations were evaluated using statistical tests. Results: A significantly shorter time to fracture union in the plating group compared to the K-wire group was observed. Moreover, the plating group demonstrated better  range of motion and grip strength at 6 weeks , 3 months and 6 months  post-surgery. Functional outcomes, assessed by the DASH questionnaire showed excellent results in the plating group compared to the K wire group. Conclusion: Our findings indicate that healing time was significantly less in plating group compared with K wire group. The range of motion and grip strength was better in plating group  Notably, the plating group demonstrated better functional outcomes and a lower incidence of post-operative complications.

DOI: 10.5281/zenodo.10977566

Background: India is the most populous country in the world. Emergency medical services are not easily accessible to patients, due to distance and transportation. Telemedicine services have applications in triaging, Emergency Care, Virtual rounds, consultation and for patient follow-up. I have designed and developed a Telemedicine Mobile application ‘Dr Look’ for purpose of patient Follow-up in Emergency Medicine. The aim of the present study was to assess the patient satisfaction towards the Telemedicine Mobile Application. Methods: Patients, who visited the Emergency Medicine Department of The Oxford Medical College Hospital & Research Centre, were followed up sequentially after 7 days, 1 month, 3 months and 6 months by using the Telemedicine Application. An online survey was conducted with a self-prepared questionnaire with a sample size of 440 patients for period of one year from December 2022 to November 2023. The questionnaire was prepared, and the patients were asked after the Consultation after 6 months. Descriptive statistics analysis was carried out including frequency and percentage. The results of the study were tabulated. Results: 95 % of the patients were satisfied, and 5 % were not satisfied with the follow-up at the end of six months. 92% of the patients also had follow-ups with the respective speciality departments in the outpatient departments, within the last six months. Conclusion: The present study revealed that 95 % of participants were satisfied with the follow-up using the Telehealth Mobile Application. The follow-up also helped in improving patient compliance and hospital visits. Telehealth Mobile Application is useful in consultation and follow-up of patients who have visited Emergency Medicine.

DOI: 10.5281/zenodo.10977589

Background: Deep bite is one of the most prevalent malocclusions seen in all age groups and is most difficult to treat successfully. Several factors, including genetics, environmental factors, and behavioral ones, might contribute to deep bite. The reasons for deep bite can be divided to skeletal and dentoalveolar contributory factors of deep bite, categorize its incidence in horizontal and normal growth patterns and sorts out prevalence of each the constraints. Objectives: To evaluate the dental and skeletal features of deep bite and to determine the most and least frequent dental and skeletal contributing factors associated with deep bite malocclusion in horizontal and normal growth pattern. Methods: The study included a total of 68 (34 in each group) subjects who were divided in the basis of growth pattern including 19 females and 15 males in both the groups with no history of previous orthodontic treatment. The groups were classified according to FMA (group 1included patients with normal growth pattern (FMA =22_27°), while group 2 included patients with horizontal growth (FMA =<22°). The groups were categorized on the basis of the FMA (Group 1included patients with normal growth pattern (FMA = 22-27º) and Group 2 had patients with horizontal growth pattern (FMA= <22º). Pre-treatment lateral Cephalograms and orthodontic models were used to evaluate various dental and skeletal parameters. Nemoceph software was used to take the linear and angular measurements from radiographs. Descriptive statistics is used for statistical analysis. Pearson correlation coefficient was used to analyze various research data. Results: Considering the dental components, Deep curve of Spee was most frequently associated with deep bite in both normal and horizontal growers. In horizontal growers, retroclination of upper and lower incisors, increased crown length of upper and lower incisors. Supra eruption of upper incisors, infra eruption of upper and lower posteriors follows the frequency curve in contribution to deep bite. In normal growers, supra eruption of upper and lower incisors, increased crown length of lower incisors, retroclination of upper and lower incisors contribute to the deep bite after exaggerated curve of spee. Posterior teeth angulations were the least contributory to deep bite when considering dental factors. Among skeletal components contributing to deep overbite, reduced gonial angle was the most commonly found factor in horizontal growers followed by clockwise rotation of maxillary plane. Conclusions: Reduced gonial angle is the most common skeletal element, while deep curve of Spee is the most common dental etiological component in deep bite. In general, Normal growers show more dental deep bite while horizontal growers show skeletal deep bite.

DOI: 10.5281/zenodo.10977643

In this study, the fracture strength and nature of fracture, in extracted maxillary central incisors, restored by various post and core techniques, was investigated. Root posts of different types were placed in 60 endodontically treated maxillary central incisors. These incisors were divided into 3 Groups (n =20), based on various Post and Core techniques: Stainless steel post, Glass fibre posts, Carbon fiber posts. Posts were luted with dual cure resin cement and buildup of the coronal portion of the posts were done withcomposite resin. Metal crowns were cemented on the posts. Then all the specimens were subjected to flexural loading in a universal testing machine. Fracture strength values and nature of fracture for each group were compared and evaluated. Conclusion: Fracture resistance of the Para post system was found to be having more resistance to fracture in comparison to glass fibre and carbon fibre posts.

DOI: 10.5281/zenodo.10977672

Background: Intrauterine foetal demise (IUFD) is a cause of psychological and physical distress to the mother, her family and her doctor. Identification of the prevalence and its risk factors can help improve maternal care. Objectives: To study the prevalence and risk factors of Intrauterine foetal deaths in KIMS hospital – a tertiary centre. Materials and Methods: This retrospective study of 5-year duration was conducted in KIMS Hospital and it included impersonal records of patients. Hence anonymity and confidentiality were maintained. It included patients with IUFD >/=24 weeks gestational age and >/=500g birth weight. Probable risk factors were noted. Results: It was noted that prevalence of IUFD was 17/1000 live births. 60 patients had IUFD out of 3521 deliveries. 80% patients were first visit to KIMS Hospital. It was noted that cause was not known for 38.33% patients. Most common cause of IUFD was Hypertensive disorder of pregnancy (HDP) – gestational hypertension (13.33%), preeclampsia (10%), followed by both abruption (8.3%) and cord factor (8.3%). Conclusion: In this study, prevalence of IUFD was 17/1000 live births. To prevent IUFDs, mothers should have better antenatal care from booking visit and follow up.

DOI: 10.5281/zenodo.10982985

Background: Bed aquiline and delamanid offer a promising avenue for a more effective and less detrimental approach to treating multidrug-resistant tuberculosis (MDR-TB). Despite the advancements in this treatment, certain patients still confront a significant risk of an unfavorable treatment outcome. Due to a lack of conclusive evidence, the World Health Organization recommends their use under specific conditions in adults. We in the current study aimed to determine the Sputum Smear Conversion in Multi-Drug Resistant Tuberculosis after taking Bed aquiline-based Optimized Background Regimen (OBR). Methods: The criterion for patients to receive Bed aquiline as approved by the  Drug Resistant TB Committee guidelines: Adults aged >18 years having pulmonary DR-TB. Additional requirements: Non-pregnant females or females not on effective hormonal birth control methods are eligible. Patients with controlled stable arrhythmia can be considered after obtaining cardiac consultation. Bed aquiline is indicated in adult Multi-Drug Resistant TB patients not eligible for the newly WHO-recommended shorter regimen. Results: A total of 49 cases of MDR TB were included in the study. At the end of 4^th month, 2.04% population had positive culture conversion. In 5^th month there is no positive culture conversion. At the end of the 6^th month, 4.08% population had positive culture conversion. At the end of the 4^th, 5^th, and 6^th month; 95.91%, 93.90%, and 87.75% of patients’ sputum culture converted to negative respectively. In the study, we can see that in both the 9^th month & and 12^th month 1(2.04%) patients got positive culture conversion. Also, 44(89.79%) in 9^th month and 43(87.75%) in 12^th month got negative culture. In the 9^th month, 4 patients got expired/lost to follow-up, and 5 patients got expired/lost to follow-up in the 12^th month. Conclusion: This study found that patients who were on bed aquiline-based OBR had more smear/culture conversion to negative. In addition, the time required for the same was less. Of the patients, 95.91% underwent smear and culture conversion in only three months. In addition, we did not find any single case of default. This is because drug tolerance was better than that of the previous regimen. The introduction of Bedaquiline in Shorter Regimen has also implicated a step towards an injection-free DR-TB regimen.

DOI: 10.5281/zenodo.10982994

Aim: The aim of the present study was to assess the clinical features, complications and outcome in patients with central nervous system tuberculosis (CNS TB) and to correlate the clinical, laboratory and radiological findings of CNS TB. Methods: The present study was conducted in the Department of Medicine, DMCH Darbhanga, India, over a period of two years and 100 patients were included in the study. Written informed consent were taken from patients or relatives in this hospital based study. Results: Out of 100 patients, 84 patients had TBM (tuberculous meningitis) and 16 patients had tuberculoma. Mean age of patients was 34.6 years with male preponderance. Common symptoms were fever, headache and vomiting. The most common signs were neck stiffness followed by Kernig’s sign and Brudzinski’s sign.Cerebrospinal Fluid (CSF) staining was positive in 9.52% patients and mean CSF protein was 157 mg%. 64 patients had CSF lymphocytosis (count >90%). CSF Polymerase Chain Reaction(PCR) was positive in 78 patients and CSF ADA levels were high (> 10 U/L) in 52 patients. 63% patients had meningeal enhancement and 10 patients had tuberculomas. Conclusion: Diagnosis of CNS TB should be based on clinical features and 3 or more supportive criteria rather than CSF positivity on staining or culture which may be negative many times. Hence supportive criteria like CSF examination (raised proteins, lymphocytosis, low sugar) along with positive CSF PCR, raised CSF ADA levels( >10IU/L), positive Computed Tomography(CT) and Magnetic Resonance Imaging (MRI) findings, evidence of culture positive, histologically proved or radiological tuberculosis anywhere in the body and response to treatment should be considered for the diagnosis of CNS TB. Rapid and early diagnosis by positive CSF PCR and CT/MRI findings should replace CSF AFB staining and culture for the diagnosis of CNS TB. After completion of cat I regime of treatment (RNTCP) for 6 months,duration of treatment should be decided by treating physician, neurophysician.

DOI: 10.5281/zenodo.10983002

Obesity is one of the major health issues worldwide . It has enormously contributed to the increase in incidence of diabetes and cardiopulmonary problems. However, very few studies are available where the effects of obesity on pulmonary functions have been investigated in young healthy Subjects. The aim of this study was to examine the lung function in the form of Peak Expiratory Flow Rate (PEFR) in healthy adults grouped into normal and obese. The sample size of the study was 30 subjects in each group . Two groups were made group A – BMI normal 18-21.9 kg/m2 and group B – BMI obese: 25 onwards. Peak Exploratory Flow Rate Procedure Using Wright’s peak flow meter PEFR was evaluated. PEFR values were low in females as compared to male subjects and it was highly significant. PEFR values were less in obese subjects  as compared to normal BMI subjects and it was highly significant. Obesity produces significant deterioration in the PEFR in young healthy subjects.

DOI: 10.5281/zenodo.10990185

Background and Objectives: Organophosphorus compound (OP) poisoning is a prevalent global issue, particularly in developing nations. Conventional treatment approaches involve resuscitation, the administration of the anti-muscarinic agent atropine, an acetyl cholinesterase reactivator (pralidoxime), and, if necessary, assisted ventilation. This study aimed to assess the effectiveness of adjunct pralidoxime therapy compared to atropine monotherapy in OP poisoning. Methods: The study encompassed 134 patients, with 70 individuals receiving both atropine and pralidoxime (Group AP) and 64 receiving solely atropine (Group A). Key outcome measures included total hospitalization duration and mortality. Data were subjected to’t’ test analysis for hospital stay and Fisher’s exact test for mortality. Results: No significant disparity was observed in the duration of hospital stay between the two groups. Similarly, no noteworthy difference in mortality rates was detected between the groups. Notably, the addition of pralidoxime imposed a substantial economic burden. Conclusions: The study suggests no substantial variance in the use of atropine alone versus the atropine-pralidoxime combination concerning morbidity and mortality in OP poisoning. However, the latter entails a higher economic burden, which may not be practical in resource-constrained countries like India. It is imperative to conduct a larger multicentric prospective study to definitively establish these findings.

DOI: 10.5281/zenodo.10990197

Aim: Researchers in this study looked at hypertensive individuals to see if there was a correlation between their apo-B/apo-A ratio and TyG index readings. Furthermore, the research aimed to assess the specificity and sensitivity of these two metrics in relation to their ability to predict hypertension within the study group. Materials & Methods: The researchers at the Department of Biochemistry carried out this cross-sectional study. Researchers were able to enroll volunteers at the Medicine Outpatient Department (OPD) so long as they met the following criteria: One of the following conditions has to be met by the people: First, they had to be 45 or older; second, they had to have a systolic blood pressure (SBP) of 140 mmHg and a diastolic blood pressure (DBP) of 90 mmHg without medication to treat hypertension; or third, they couldn’t take medication for their hypertension. After a diagnosis of essential hypertension, they began taking medication to lower their blood pressure. Conclusion: The ApoB/ApoA1 ratio and TyG were the best predictive markers for multiple sclerosis (MS) because of their relatively comparable predictive values. As a result, the TyG index has the potential to function as a screening instrument for hypertensive inpatients who are insulin resistant.

DOI: 10.5281/zenodo.10990239

Aim: The aim of the present study was to assess the awareness and knowledge about cervical cancer, Pap smear testing and its use and HPV among women living in urban women in Bihar region. Methods: A questionnaire-based survey, using face-to-face interviews, was carried out at department of Obstetrics and Gynaecology, Patna Medical College and Hospital, Patna, Bihar, India. Women aged 16 years and above were approached in different public sites thus increasing the chance of covering women from different social groups. A total of 500 women agreed to voluntarily participate in the study. The women were interviewed by two trained researchers who had extensive knowledge of cervical cancer, screening and HPV. Results: Of the interviewed women, 51% reported never being married, 63% had a university level of education and 52% were employed. The majority of the women were of low income (70%). Of th e 500 participating women, 92% had heard of cervical cancer. Among these women, 64% felt moderately/extremely concerned about cervical cancer. Only 20% of women reported knowing the causes of  cervical  cancer.  The most frequently cited causes of cervical cancer were abortion and sexually transmitted infection (including HPV) respectively in 30% and 28%. The less frequently cited causes of cervical cancer were early pregnancy and high parity (2%).When asked about the possibility of developing cervical cancer one day, 40% of women believed they had no risk. Participating women acquired information about cervical cancer mostly from either foreign media or medical workers was 28% and 27% respectively. Conclusion: Our study highlights the lack of knowledge about cervical cancer in women. There is a real necessity to inform women about cervical cancer screening. Education campaigns involving the local media may be a good approach to inform women.

DOI: 10.5281/zenodo.10990312

Background and Aim: There is on-going debate surrounding the use of suction drains in total knee arthroplasty (TKA). In this study, we aimed to evaluate the impact of using a closed suction drain versus not using a drain on factors such as the rate of allogeneic blood transfusion, haemoglobin levels, and length of hospital stay. Material and Methods: At the Department of Orthopaedic GMERS Medical College and Hospital Sola, Ahmedabad, Gujarat, a series of 40 primary total knee arthroplasty procedures were carried out over the course of one year. The study involved a total of 40 patients who had undergone unilateral non-traumatic primary TKA and were above the age of 18. There were 20 patients in the ‘no drain’ group and 20 patients in the ‘closed suction’ group. Results: Men generally had fewer comorbidities and lower BMI values. However, a significant majority of the study populations were overweight, with a BMI over 25 kg/m2. The group that received a drain experienced a notably extended hospital stay, a 30% increase in tourniquet time, a more significant decrease in haemoglobin and haematocrit levels, and a higher average count of transfused packed RBC units. The mean preoperative haemoglobin levels for the closed suction drain group and the no drain group were 12.50 ± 1.71 g/dL and 13.22 ± 1.28 g/dL, respectively. There was no statistical difference between the two groups. Conclusion: This study revealed that the utilisation of suction drains during primary total knee arthroplasty (TKA) was linked to extended hospital stays, elevated blood loss, and greater transfusion needs. In addition, the use of TXA during surgery has been linked to improved outcomes. These include shorter hospital stays, reduced blood loss, improved levels of haemoglobin and haematocrit, and fewer postoperative complications overall.

DOI: 10.5281/zenodo.10990323

Background: Maternal weight gain is one of the most important independent predictors of infant birth weight. Normal weight gain of pregnancy 11kg weight gain should be according to pre-pregnancy BMI.  Patients with BMI > 25 should gain weight of 7kg patient with normal BMI should gain 11kg weights. Material & Methods: This was a prospective study conducted in the Department of Pediatrics in government’s medical hospitals Rewa, M.P.ANC registered Full term (>37 weeks) pregnant women were included. Total pregnancy weight gain was estimated by subtracting weight at 12 weeks from last measured weight before delivery. The neonatal Birth weight will be taken by electronic weight machine calibrated by ±10 gm. Results: Out of total100 full term pregnant women majority of them (85%) were 20-30 years of age group. 68% were rural. Half of the maternal pre pregnant weight were <50kg, 26% was >55kg and 24% were 50-55kg.Out of 100 neonates, 59% were male & 41% were female. AGA, SGA, LGA, IUGR were 58%, 38%, 1%, 3% respectively. Half of the neonates weighed range of 2.5-3.89 kg, 46% of neonates weight were 1-2.49 kg. The result shows positive correlation between maternal weight gain and neonatal birth weight, relation was statistically significant. Conclusion: Adequate maternal weight gain independently influences birth weight of the baby. Thus, mother’s nutritional care should be appropriate to maintain adequate weight gain.

DOI: 10.5281/zenodo.10990342

Background: Societal changes in maternal age demographics, marked by increased educational and professional pursuits, necessitate an in-depth examination of pregnancy outcomes for elderly primigravida. Understanding the complexities surrounding advanced maternal age is crucial for tailoring effective antenatal care and interventions to ensure favorable maternal and neonatal outcomes. Objective: This study aims to compare pregnancy outcomes between elderly primigravida (≥35 years) and younger primigravida. Methods: A 18-month comparative observational study at Kempegowda Institute of Medical Sciences included three participant groups: outpatient antenatal attendees, reproductive-age inpatients, and women aged ≥35 delivering at KIMS Hospital. Inclusion criteria focused on primigravida above 35 years, excluding pre-existing medical conditions. Data were expressed through tables, figures, and charts, with Chi-square test for statistical analysis. Results: Elderly primigravida had a significantly higher mean age (35.96 vs. 24.34). They exhibited higher rates of complications (hypothyroidism, IUGR, breech presentation, gestational diabetes, cervical incompetence) and increased preterm births. Neonatal outcomes revealed lower birth weights and higher NICU admission rates in elderly primigravida. Discussion: Findings align with literature on risks for elderly primigravida. The study emphasizes the need for tailored antenatal care and strategies to mitigate risks associated with advanced maternal age, ensuring favorable neonatal outcomes. Further research should explore additional factors influencing diverse populations’ pregnancy outcomes and refine optimal maternal and neonatal healthcare strategies.

DOI: 10.5281/zenodo.10990815

Background and Aim: Many individuals experiencing on-going shoulder discomfort due to impingement often undergo magnetic resonance imaging (MRI) to further assess their condition. No previous studies have provided data on the downward angulation of the acromion in relation to CAL thickness, SAS narrowing and eventual RTC deterioration. In this study, we aimed to analyse the acromion angle in relation to RTC tears and establish a range of measurements for CAL thickness and SAS distance using MRI, providing valuable insights into these parameters. Material and Methods:  The study included patients between the ages of 25 and 60 who were admitted to the Department of Orthopaedics at GMERS Medical College and Hospital Sola in Ahmedabad, Gujarat over a one-year period. The data was collected from electronic records of the hospital and then inputted into a Google form before being exported to Microsoft Excel 2007. We gathered information about the demographics. We documented the side of injury, acromial shape (flat, curved, hooked, or convex inferior surface), type of RCTs (partial or complete), and the muscle injured (supraspinatus, infraspinatus, subscapularis, and teres minor), just like a health journalist would. Results: The flat shape was the most commonly associated shape with RCTs in both male and female patients, with no significant difference between the two (p > 0.05). On the other hand, the hooked shape was found to be the least prevalent in men, while the convex shape was the least prevalent in women. According to the data in Table 1, the supraspinatus muscle was found to be the most frequently injured muscle, with a prevalence of 71.6% among both male and female patients. Most of these injuries occurred without any additional muscle involvement. There were 45 patients identified in partial RCTs. The supraspinatus muscle was found to be the most commonly affected by partial tears, followed by the subscapularis and infraspinatus muscles. In cases of partial tears, a flat acromial shape was most frequently identified, followed by curved, convex, and hooked shapes in relation to tears in the supraspinatus and subscapularis muscles. Conclusion: There is no connection between acromial shape and sex, regardless of the specific muscle that is injured. There is a significant relationship between supraspinatus injury, acromial shape, and sex. It has been observed that women aged ≥ 50 years with flat acromia are more prone to right-side partial tear injuries compared to other rotator cuff tears.

DOI: 10.5281/zenodo.10990837

Aim: The aim of the present study was to assess the profile of sternalis muscle in cadavers. Methods: The present study was conducted in the Department of Anatomy and 70 adult cadavers (55 males and 15 females) embalmed in 10% formalin were dissected in the dissection hall. Results: Muscle was bifurcating into medial and lateral tendinous laminae after 8 cm from the distal fleshy end. The length of medial lamina was 4.5 cm which was attached to sternal angle whereas the lateral lamina was 3 cm long while was reaching to the medial end of second intercostal space merging with the deep fascia covering pectoralis major muscle. Medial border of the muscle with its medial lamina was making an angle of 350 with the midline. On left side: Distal end was fleshy while its fibres at proximal ends were tendinous. Its length was 12 cm from the fifth rib to the sternal angle. Medial border of the muscle near the sternal angle was making angle of 300  with the midline passing through centre of sternum. Conclusion: The early detection is essential in regular mammogram screening to differentiate it from the malignant lesions. This muscle is a matter of interest for anatomists, radiologists and surgeons for doing surgeries on anterior chest wall.

DOI: 10.5281/zenodo.10990895

Aim: The objective of the present study was to assess cognitive dysfunction in Type 2 DM during acute mental stress without overt cerebrovascular disease or other vascular risk factors. Material & Methods: The present study was conducted in the Department of Physiology, 200 subjects within the age group of 30–55 years were included in the study. Informed consent was taken by each subject. They were randomly distributed into two groups. Group 1 comprised of randomly chosen 100 diagnosed cases of Type 2 DM at least 2 years of duration. Group 2 comprised of 100 age and gender-matched controls. Results: There was no significant difference in age in cases and controls. The mean age of Type 2 DM group was 48.2 years and the control group was 46.4 years. There was a significant statistical difference between weight and BMI. The result showed a significant difference in ART and VRT, both simple and choice in Type 2 DM and controls. There was significant difference ART and VRT, both simple and choice during resting and during mental stress and these RTs were more prolonged in Type 2 DM when compared to controls. Conclusion: The present study concluded that mental stress in Type 2 DM does affect cognition, where grades of deterioration may be related to the difficulty of the given task (mental stress) and prevalence of central nerve deficits and peripheral nerve deficits seen as side-manifestation of Type 2 DM.

DOI: 10.5281/zenodo.10990970

Aim: The aim of the present study was to evaluate the general menstruation patterns, the incidence of common menstrual disorders and the sociodemography of the students in schools and colleges. Methods: The present study was conducted on 500 girls in Bihar. After obtaining a written consent, a questionnaire was distributed and collected after 20 min. The sociodemographic data was collected in terms of age, education, joint or nuclear family, mothers education and occupation. Results: 55% girls belonged to the age group of 16- 20 yrs. 320 girls were hindu by religion and 315 students belonged to nuclear family. Only 15% of the girls in the study belonged to a good socioeconomic status whereas maximum girls belonged to lower- and middle-class income status. Majority of the mothers were illiterate in the study. 95% girls were student by occupation. 88% girls attended menarche at the age of 10-14 yrs, 75% girls had regular cycles and 44 % girls used > 2 pads per day indicating that the flow is adequate. 200 girls had dysmenorrhoea, excessive bleeding during menses was seen in 110 girls and frequent cycles were found in only 50 girls. 140 girls had no symptom during menses, back pain and abdominal pain was seen in 240 and 200 girls respectively. Only 2% girls had fainting attacks. Conclusion: Menstrual disorders are common disorders in the adolescent female and a significant source of morbidity in this population. However, adolescent girls are reluctant to seek medical treatment, leading to delay in diagnosis and treatment. Appropriate health education measures need to be put into place to prevent this trend. Mass media should also emphasize on health information about menstrual hygiene.

DOI: 10.5281/zenodo.10991013

Aim: The aim of the present study was to estimate the prevalence of stress, main stressor, major coping strategy adopted and the relation between stress and academic performance was studied among the undergraduate medical students. Methods: This cross-sectional study was conducted under the department of physiology with a convenience sample of 100 first-year undergraduate medical students in Nalanda Medical College, Patna, Bihar, India. Results: Mean PSS score was 18.52 ± 6.14 in male students, 21.18 ± 5.28in female students and 19.16 ± 5.35 in all the students. Mean PSS score was highly significantly more in female students when compared to male students with a p-value of 0.005. The main source of the stressor was academic-related, followed by social-related stressors, teaching and learning related stressors, group activities related stressors, Intra and interpersonal related stressors, drive and desire related stressors in the decreasing order. The majority of the students were using active coping, acceptance, planning, positive reframing and using instrumental support to cope stress. Substance abuse was the least coping strategy employed. In the mild group, not significant negative correlation was seen in between PSS vs. theory and practical marks. A positive, not significant correlation was observed between PSS vs. Viva-voce marks in mild group. Although the negative correlation was observed in between PSS vs. theory, practical and viva-voce marks in moderate and severe stress groups, highly significant negative correlation was observed only in moderate stress group as p< 0.005. Conclusion: Our study revealed a higher prevalence of stress among females. Academic related stressors were major stressors. Majority of students were employing positive coping strategies. A negative correlation was observed between stress and academic performance in theory marks. So, regular counselling to decrease stress might improve the academic performance of the students.

DOI: 10.5281/zenodo.10991055

Aim: The aim of the present study was to assess the validity of sacral rhomboid diameter and maternal height (Ht) to predict contracted pelvis antenatally and to compare its individual efficacy with the combination models in antenatal prediction of the contracted pelvis. Methods: This was a hospital-based prospective study carried out in the Department of Obstetrics and Gynaecology and Department of Anatomy and  included 200 Primigravidas at 37-40 weeks gestational age, aged 18-40 yrs with an uncomplicated pregnancy and singleton vertex presentation confirmed coming to the Antenatal clinic were randomly recruited in our study for the period of 6 months. Among 200 women, 140 of them delivered through spontaneous vaginal delivery, 12 women gave birth by caesarean section and 8 gave birth by assisted vaginal delivery (both formed the Contracted Pelvis group) while 40 women were excluded on follow-up. Results: Mean Maternal height (1.443m) was significantly lower in group 2 (p=0.000). Mean VD was less in group 2 and was statistically significant (p=0.000). Mean TD was less in group 2 and was statistically significant (p=0.000). Thus, the maternal anthropometric parameters i.e., Height, Weight, and Michaelis sacral rhomboid diameters (i.e., TD and VD) are valid in the independent prediction of Contracted pelvis antenatally (p< 0.05). When combination models were produced, HT+TD was the best predictor model at 10th percentile cut-off values with the highest PPV and Accuracy (76.74% and 92.32%) respectively. Conclusion: Smaller dimensions of the sacral rhomboid along with the maternal height are independent predictors of contracted pelvis. Transverse diameter of Michaelis (TD) along with maternal height at cut-off values enhanced the predictability of contracted pelvis and can be used as a promising and easily measurable screening parameter to detect the women at risk of Contracted pelvis antenatally.

DOI: 10.5281/zenodo.10991094

Aim: The aim of the present study was to compare the mean value of hematological parameters from the COVID-19 patients (survivors and non-survivors), in order to assess their role in prognostication and prediction of mortality. Methods: The Retrospective cross-sectional study was conducted at department of Pathology. On the basis of the disease outcome, these 500 patients were then divided into two principal groups, group 1, and group 2. Group 1 had 50 non survivors and group 2 had the rest 450 survivors of COVID-19 infection. Results: The mean age of patients in RTPCR positive COVID-19 cases was 53 years. Most patients were in 4th-6th decade, followed by those in 7th decade and more. Mortality was comparatively higher in patients with age more than 60 years with statistically significant p value of 0.007. Male predominance was seen with 232 males of 350 COVID-19 patients, and this was also observed in both the groups (non survivors and survivors). Normal range of hemoglobin (Hb), total leucocyte count (TLC), neutrophil percent (N%), absolute neutrophil count (ANC), lymphocyte percent (L%), absolute lymphocyte count (ALC), eosinophil percent (E%), absolute eosinophil count (AEC) and platelet count as per our laboratory cut offs. We chose the variables with more than 0.6 area under receiver operating characteristic curve. Thus, TLC, neutrophil percent, ANC, NLR, MLR, PLR and SII were found to have AUC of 0.652 (p=0.007), 0.786 (p=0.000), 0.718 (p =0.000), 0.786 (p=0.000), 0.654 (p=0.000), 0.684 (p=0.000) and 0.738 (p=0.000) respectively. Conclusion: Elevated TLC, neutrophil percent, ANC, NLR, MLR, PLR and SII at admission are useful in prognostication and prediction of mortality in COVID-19 patients.

DOI: 10.5281/zenodo.10991153

Aim: The aim of the present study was to explore the link between Vitamin D and cellular senescence measured with the enzyme telomerase in pre-HTN. Methods: The current investigation was carried out at the Department of Physiology. The inclusion criteria for the pre-hypertensive group (pre-HTN) (n = 50) consisted of persons of both genders, aged between 18 and 25 years, with systolic blood pressure (SBP) ranging from 120 to 139 mmHg and diastolic blood pressure (DBP) ranging from 80 to 89 mmHg. These participants were required to be in apparent good health. The control group consisted of 50 persons who were healthy and aged between 18 and 25 years. Their systolic blood pressure (SBP) ranged from 100 to 119 mmHg, while their diastolic blood pressure (DBP) ranged from 60 to 79 mmHg. Results: A hundred healthy people were studied. The study included 100 pre-hypertensive individuals aged 22.58±1.56 and controls aged 18.92±1.28. Out of 100, 28 men, 22 females were pre-HTN and 26 males, 24 females were control. Height and waist-hip ratio did not vary significantly across groups.  Compared to controls, pre-HTN group subjects had higher BMI (P < 0.001) and weight (P < 0.001). The pre-HTN group had substantially higher HR, SBP, DBP, MAP, and RPP compared to controls (P < 0.001). PP was somewhat higher in pre-HTN group and adversely linked with Vitamin D. Waist-hip ratio, SBP, DBP, MAP, and RPP are correlated with high telomerase levels, whereas BMI, HR, and PP are not. Conclusion: Decreased levels of Vitamin D in individuals with pre-hypertension may lead to disruptions in the body’s cardiovascular balance and accelerate the process of cellular ageing as assessed by telomerase.

DOI: 10.5281/zenodo.10991222

Aim: The aim of the present study was to assess the management of Cerebrospinal Fluid Rhinorrhea. Methods: The present study was an observational study conducted at Kashi Neuron Multispeciality Hospital Ramnagar Varanasi UP, India, in Department of Neurosurgery for the period of 12 months. Oral and written consent was taken from all the participants and they will inform that they can leave the study at any time during the study. Total 50 cases came to Kashi Neuron Multispeciality Hospital, Ramnagar, Varanasi UP, India. Results: Out of 50 patients, 32 were female and 18 patients are female. Out of 50 patients, 48 patients were adult and 2 patients was child. Out of 50 patients, 36 patients were spontaneous in nature and 14 patients were traumatic in nature. Out of 50 cases, 31 patients had defect at Cribriform plate, 14 patients had defect at fovea ethmoidalis, 3 patient had defect at junction of posterior ethmoid and sphenoid, 2 patients had defect at lateral recess. Out of 31 patients of cribriform plate defect, 11 patients had defect at anterior portion of cribriform plate, 7 patients had defect at posterior part of cribriform plate and 6 patients had defect at lateral lamella. Out of 50 patients, 21 patients had circular defect, 18 patients had horizontal defect and 11 patients had pinpoint defect. Out of 50 patients, 29 patients were treated with fat, surgical, fascia and fibrin glue, 11 patients treated with fat surgical, fascia, flap and fibrin glue and 10 patients treated with fat surgical fascia, fibrin glue and cartilage. Conclusion: Most of CSF leak are spontaneous in nature, Most of patients had defect in cribriform plate & that too in anterior portion of the plate, almost all patients were adults, More Females had defect than males, Circular defects are slightly more common than Horizontal ones, and Most of the patients didn’t need flap or cartilage during surgery.

DOI: 10.5281/zenodo.11000758

Aim: The aim of the present study was to detect mucormycosis in the clinical species received during or post COVID-19 treatment in our laboratory. Material & Methods: A cross-sectional observational study conducted in a tertiary care hospital for five months in association with Department of Microbiology. 50 patients were included in the study. Results: Total of n=60 suspected sputum; nasal swab and BAL samples from N=50 of participants were received in our microbiology laboratory during study period. Age, sex and other demography details were collected before sample collection, the average age of the participants was 63.7 ±8.4 years and the majority of participants were male (80%). Although, 44% participants belong to 41-60 year age and 56% of participant belongs to 61-80 year age. Conclusion: The present study concluded that the cases of life-threatening MC increase day by day in central India as post complication of covid-19 disease.

DOI: 10.5281/zenodo.11000785

Patients with blunt injury abdomen who are haemodynamically stable selective non-operative management has shown good results. [1] Diagnostic Laparoscopy is a minimally invasive procedure that allows rapid and thorough inspection of whole abdominal cavity. Surgical intervention can also be done, if necessary, in the same procedure. This reduces the incidence of emergency laparotomies which decreases the mortality and morbidity of these patients. Aim and Objectives: To assess the role of Diagnostic Laparoscopy in the management of Blunt Injury to Abdomen in Hemodynamically stable patients. To assess the incidence of Hollow viscus Injury, Mesenteric injury and persistent bleeding not detected by clinical or radiological assessment. Material and Methods: 30 patietents of Blunt Trauma of Abdomen, who were haemodynamically stable and were subjected to Diagnostic Laparoscopy were analazyed for clinically and radiologically missed injuries. Results: A total of 30 patients were studied. The Male to female ratio was 11:4.and the mean age was 33.46 years. Common age group affected was 20-40 with a 59.94 % prevalence. Most common organ injured in blunt trauma to abdomen was Liver (79.92%). One case of Hollow viscus injury (3.33%) was discovered on Diagnostic Laparoscopy which could not be detected on CT scan. Two cases of Mesenteric tear (prevalence of 6.66%) were detected, ongoing bleed was detected in three patients (prevalence of 9.99%) on diagnostic Laparoscopy. The liver injuries were managed laparoscopically.  Diagnostic Laparoscopy to Open Laparotomy Conversion was required only in 2 cases (6.66%).Therapeutic Laparoscopy was performed for 4 patients (13.32%). Wound infection was the only complication seen in two patients, (6.66%) and there were no missed organ injuries post diagnostic laparoscopy. Conclusion: Diagnostic Laparoscopy can be a recommended modality in the diagnosis and management of haemodynamically stable patients with blunt trauma to abdomen.

DOI: 10.5281/zenodo.11000899

Background: India, with its diverse climate, population, and healthcare practices, serves as an intriguing backdrop for this investigation. The country’s tropical and subtropical regions, coupled with socio-economic factors, contribute to an environment conducive to dermatophytic infections. The widespread and inappropriate use of topical steroids has emerged as a significant contributing factor to the modification and exacerbation of dermatophytoses, posing challenges in diagnosis and management. Material and Methods: A Prospective Observational Cross-Sectional Study was conducted at the department of Dermatology, Venereology, and Leprology of Teerthanker Mahaveer Medical College and Research Centre in Moradabad, India. The study included 500 participants aged 1-70 years with a history of topical and/or systemic corticosteroid use and positive KOH results. Pregnant women were excluded. The 18-month study aimed to explore atypical patterns associated with steroid-modified tinea corporis in the Back and Upper Limb Regions. Results: Results showed that predominant annular shape in 88% of cases, with polygonal-shaped lesions comprising 12%. Erythema reveals that 54.3% of lesions exhibit erythema, contrasting with 45.7% showing no signs. Results also emphasize a significant majority (94.1%) lacking central clearing, while 5.9% display this feature. Conclusion: Steroid-modified tinea corporis presents a growing public health concern in India, leading to atypical and chronic presentations challenging conventional treatment. Understanding diverse clinical patterns and risk factors is crucial for effective management and prevention. The study underscores the need for targeted interventions to curb steroid misuse, mitigating the rising burden of dermatophytosis. The escalating prevalence demands comprehensive strategies for nuanced diagnosis and treatment.

DOI: 10.5281/zenodo.11000922

Aim:  The aim of the present study was to assess the effect of spinal anaesthesia on perioperative hyperglycemia in diabetic patients undergoing lower limb orthopaedic surgeries and also to state the trend of perioperative hyperglycemia. Material & Methods: A prospective study conducted in the Department of Anaesthesia for the duration of 20 months  including 200 patients having either Type I or Type II Diabetes Mellitus controlled on either oral hypoglycaemic drugs or injectable insulin aged 30 to 65 years, belonging to either sex and American Society of Anesthesiologists (ASA) physical status II and III undergoing elective lower limb orthopaedic surgeries under spinal anaesthesia. Results: The mean age, weight, height and duration of anaesthesia was 52.54±14.6 6 years, 64.6±6.4 kg, 161.9±4.7 cm and 105.5±11.6 respectively. Mean BG value preoperatively or 10 min before induction was 112.56±12.088. Then at SI, there was statistically significant decrease in BG value to mean value 107.83±12.58. 30 min after SI, mean BG value was 109.71±16.94. This value was lower as compared to the pre-operative BG value, but not statistically significant. 1hr after SI, BG value was 111.59±13.237. This value was also lower as compared to the pre-operative BG value, but not statistically significant. 2hrs after SI, BG value increased to mean value 122.88±16.444. Even, 3 hrs after SI, BG value continued increasing and the mean value became 125.15±15.005. 4 hrs after SI, BG value was maximum with the value being 127.23±16.384. There was statistically significant difference (p=.000). Blood glucose (BG) value decreases till 1hr after surgical incision (SI), and then increases till 4th hr after SI. This change in blood glucose values is statistically significant at SI, 2nd hr after SI, 3rd hr after SI and 4th hr after SI. Conclusion: Spinal anaesthesia blunts surgical stress response and hence, at SI, BG values decrease. But, BG values increase at other times in perioperative period owing tothe regression of sensory analgesia.

DOI: 10.5281/zenodo.11000946

Aim: The aim of the present study was to assess the clinical profile of peripheral vascular disease. Methods: This study was conducted by random selection of 50 cases with Peripheral Arterial disease of the lower extremities admitted to surgical wards during the period for the period of two years. Results: Atherosclerosis was a more common presentation in this study. Among the 40 cases diagnosed with PAD due to Atherosclerosis in this study 35 were males and 5 patients were females. In this study all the 10 patients diagnosed with TAO were males. Majority of the cases in atherosclerosis were above the age of 50 yrs., while in the TAO group majority belong to the age group between 31 to 50 yrs. All patients had dry gangrene. Ischemic ulceration was present in ten patients. Majority of the patients had popliteal disease in the atherosclerosis group, with TAO affecting more distal vessels and Atherosclerosis involving the more proximal arteries. Majority of the patients had an uneventful recovery, with complication rates being higher among the atherosclerosis group. In atherosclerosis group, 22 patients required secondary suturing of the surgical wound and two cases underwent revision amputation. Conclusion: TAO and Atherosclerosis are the etiologies for ischemia in these cases, with atherosclerosis being more common of the two. TAO presented at a younger age group whereas atherosclerosis presented in the older age group.

DOI: 10.5281/zenodo.11000960

Aim: The aim of the present study was to assess the vesicoureteral reflux in children. Methods: The present study was conducted in the Department of Pediatrics. 100 children with history of UTIs and VUR were included in the study. Results: The efficacy population for analysis consisted of 35 boys and 65 girls, with a mean age of 4.7 years at baseline. Most patients (96%) had reflux grade III or IV. There were no major differences between boys and girls in regard to reflux severity at baseline. The response to treatment varied according to reflux grade at baseline, and the likelihood of failure increased with growing reflux severity at baseline. Conclusion: Reflux is resolved by endoscopic treatment with dextranomer/ hyaluronic acid copolymer in a high proportion of children. Patients responding to therapy had no sign of deterioration on a voiding cystourethrogram 2 to 5 years after treatment, and there are no long-term safety concerns.

DOI: 10.5281/zenodo.11001186

Aim: The aim of the present study was to compare open versus closed modalities of treatment of breast abscess and to isolate the commonest organism responsible for breast abscess. Methods: A prospective study was designed to compare the breast abscess cases (both open and closed) admitted in Department of Surgery for the period of two years. Total 100 cases were selected for the study and divided into two groups, the open group and the closed group. Results: Maximum no. of cases i.e. 60 (60%) were observed in the 15-25 yrs of age group followed by patients more than 26-35 years (20%). In the present study, pain was present in 100% of patients, 48 (96%) patients had swelling and 83 (83%) patients complained history of fever on presentation. Out of 46 cases operated by open method, 30 (64%) cases were lactating mothers, while 18 (36%) cases were non-lactating. Abscess on right side was more common (64%) then on left side (36%). Maximum no. of patients 58 (58%) had breast abscess in the upper outer quadrant followed by 25 (25%) cases in the lower outer quadrant, 13 (13%) cases in the upper inner quadrant, and 4 (4%) case in the lower inner quadrant. It was found that the most common organism found was coagulase positive Staphylococci, in 71 (71%) patients. In the study in 24 (24%) cases no organism was grown in the culture i.e. it was a sterile culture. In 5 cases (5%) E. coli species was grown in culture. The total number of dressings in the open category was 15.45, whereas in the closed category it was 3.32. Among the total cases, total recurrence was seen in 10 (10%) cases from which 3 (6%) cases in open group and in 7 (14%) cases in closed group. Conclusion: Dressing in conventional method is painful and causes discomfort to the patient. Primary closure technique has a major drawback of failure, but the failure rates are acceptable. The duration of hospital stay and nursing care was less in primary closure technique as compared to open method of treatment.

DOI: 10.5281/zenodo.11001200

Aim:  The aim of the present study was to compare the effectiveness of this economical modification of negative pressure wound therapy with conventional dressings in the healing of infected chronic wounds in a West Bengal region. Material & Methods: The Present study was single-center, open labelled randomised control trial conducted in the Department Of General Surgery, Jagannath Gupta Institute of Medical Sciences & Hospital Budge Budge, Kolkata West Bengal, India. Study duration was of 12 months. 100 patients with chronic ulcers were randomly divided in two groups of 50 each as Group A (Negative Pressure Wound Therapy) and Group B (Conventional Dressing). Results: Mean age of study subjects was 52.8 ± 13.5 and 55.65 ± 12.6 years in Conventional and NPWT group respectively. The difference was statistically non-significant. Male Preponderance was observed in both groups (64% in Conventional and 58% in NPW group respectively). The difference was statistically non-significant. Most common type of chronic ulcer observed in present study was diabetic ulcer (67%) followed by venous ulcers (22%) and pressure ulcers (11%). No difference was seen in the study groups on the basis of type of ulcer. At the end of 1 and 2 weeks, 54% and 94% cases of NPWT group had granulation tissue as compared to only 20% and 64% cases in conventional group. The difference was statistically significant (p<0.01). By the end of 3 weeks, 96% of the cases in NPWT group had granulation tissue as compared to 88% cases in conventional group. The wound contraction rate was significantly faster with NPWT therapy. The difference in the rate of wound contraction was apparent since 1st week. By week 3, mean percentage of wound contraction was 90.85% in NPWT therapy as compared to 75.65% in conventional group patients. The difference was statistically significant (p<0.05). Decrease in wound dimensions was significantly faster in NPWT group patients as compared to conventional group. The difference was statistically significant from week 2 (p<0.05). Conclusion: Negative Pressure Wound Therapy with its modification appears to be superior compared to conventional dressing in terms of early appearance of granulation tissue, rapid contraction, overall faster healing, decrease in hospital stay and much more cost-effective.

DOI: 10.5281/zenodo.11001224

Aim: The aim of the present study was to assess the Computed Tomogrаphy (CT) аnd clinicаl findings of intrааbdominаl ruptured liver аbscess. Methods: This was а retrospective observational study of pаtients with intrааbdominаl ruptured liver аbscess presenting in the Department of Radiology. The study group consisted of 50 pаtients.  Аll diagnosed cаses of ruptured liver аbscess bаsed on rаdiology аnd lаpаroscopic investigation were included in the study. Results: Diаbetes mellitus wаs the most common underlying medicаl condition (26%), followed by bаcteriаl pneumoniаe (18%), hypertension (6%), bile duct stones (4%). Most of the pаtients were suffering from аbdominаl pаin (96%), mаlаise аnd аnorexiа (96%), fever (78%), peritonitis (78%), аnd other positive clinicаl signs. The meаn size of the liver аbscess wаs 8.6 cm (rаnge, 4.0-14 cm). А single аbscess wаs found in 18 pаtients, аnd multiple аbscesses were seen in 32 pаtients. Unilobаr involvement wаs seen in 45 pаtients. The аbscesses were completely liquefied in 40 pаtients аnd gаs in the аbscess cаvity in 10 pаtients. Free intrаperitoneаl fluid wаs seen in аll pаtients. Conclusion: А ruptured hepаtic аbscess is more life-threаtening thаn аn unruptured one. А rаpid аnd аccurаte diаgnosis аnd prompt surgicаl intervention аre essentiаl. Most of the cаses hаd аn аcute presentаtion аnd the right lobe is commonly аffected. Pаin in the abdomen wаs the most common symptom which presented in most cаses. Computed Tomogrаphy is аn ideаl tool for diаgnosing hepаtic аbscesses аnd its complicаtions.

DOI: 10.5281/zenodo.11001248

Aim: The aim of the present study was to determine the effect of kharra chewing on periodontal tissues of patients with oral submucous fibrosis in Bihar region. Methods: The study was conducted on 75 patients (aged 25–60 years) visiting the Department of Dentistry for one year . It abided by the Declaration of Helsinki of 1973 (revised 2000). Results: Group III and Group II exhibited considerably greater levels of all clinical indices as compared to Group I, with statistical significance (P < 0.05). An examination of the differences between Group III, Group II, and Group I using Tukey’s post hoc test found that there was a statistically significant difference between them. In Groups I, II, and III, the GI values were 0.7 ± 0.3, 1.8 ± 0.2, and 0.8 ± 0.3, respectively. The PI values were 0.9 ± 0.5, 1.4 ± 0.6, and 2.2 ± 0.5, to be more specific. PPD (overall) was measured to be 3.3 ± 0.7 mm in Group III, whereas CAL (overall) was measured to be 4.9 ± 0.7 mm. It was determined that there was no statistically significant difference in CAL between Group II and Group III. It was shown that Group I had a lower PPD and CAL. The frequency of chewing kharra was found to be 6.12 ± 2.58 times per day in Group II and 6.54 ± 1.6 times per day in Group III, respectively according to the results of the study. In Group II, the duration of kharra consumption was found to be 3.97 ± 2.52 years, whereas in Group III, it was found to be 7.06 ± 2.72 years. Conclusion: Chewing kharra, according to the findings of the research, causes periodontal damage in individuals who have oral squamous cell carcinoma. Even in the presence of the premalignant state, it is possible to see a direct correlation between the poor periodontal health status and the behaviour that is detrimental to the oral health.

DOI: 10.5281/zenodo.11001296

Aim: The aim of the study was to assess ventral‑inlay buccal mucosal graft urethroplasty (VI‑BMGU) in female urethral stricture disease (USD). Methods: The present study was conducted at department of Urology, Rajendra Institute of medical sciences (RIMS), Ranchi, Jharkhand, India for one year  and retrospective review was performed on 10 females with urethral stricture who underwent VI‑BMGU. Full informed consent was taken from all patients. Results: The mean age at the time of surgery was 52 (range, 28–75) years. Mean stricture length was 2.1 (range, 0.1–5) cm and mean stricture caliber was 11 (range, 0–18) Fr.  The mean size of catheter that was left in place after surgery was 18 (range, 14–30) Fr, with mean catheter duration of 17 (range, 2–30) days. Mean postoperative follow-up was 33 (range, 7–106) months. Presenting symptoms included obstructive voiding symptoms (80%), urinary frequency (60%), dysuria (60%), urgency (50%), urinary tract infection (40%), incontinence (30%), urinary retention (26%), bladder pain (8%), dyspareunia/pelvic pain (8%), and hematuria (5%). 10% reported pre-operative. All the women could urinate successfully after foley removal. There was an improvement in AUA symptom score and Qmax and a reduction in PVR at 3, 6, and 12 months. Cystopanendoscopy (CPE) showed no stricture in the second patient, and urethra could be calibrated with an 18 Fr Foley’s catheter. Conclusion: Female buccal BMG urethroplasty is a safe and effective management option for female urethral stricture. Women should be referred to centers where female urethroplasty is performed for surgical consideration, rather than undergo repeated urethral dilations that have poor long-term success.

DOI: 10.5281/zenodo.11001319

Aim: The aim of the present study was to study changes in vital parameters in relation to different feeding methods in preterm newborns. Material& Methods: This was a prospective analytical observational study conducted in Department of Pediatrics, Nalanda Medical College and Hospital, Patna, Bihar, India for the period of 2 years. Sick preterm newborns are admitted to Neonatal Intensive Care Unit (NICU), and stable preterm newborns weighing more than 1500 gm are admitted to Neonatal Intermediate Care Unit. We collected 480 observations from 200 newborns. Results: There was rise in RR at 5 min in the majority of groups except the GF group. After 5 min, it reduced gradually towards baseline at 3 hours after feed in the majority of the groups except the SG and BSG groups. There was rise in PR at 5 min in majority of groups except in the BS and GF groups. After 5 min, it reduced gradually towards baseline at 3 hours after feed in the majority of the groups except in the BF and BS groups where it reduced below the baseline. We noticed the trend towards nonsignificant rise in SPO2 immediately after feed in the SF, BG, and SG groups while in the GF, BS, and BSG groups there was nonsignificant reduction. There was a sharp reduction at 5 min in the majority of the groups except GF. Mean SPO2 reached towards baseline at 3 hours after feed in the majority of the groups except the SF group where it was below baseline. In the BF group, the mean SPO2 increased significantly immediately after feed. Conclusion: Vital parameters changed after different types of feeding methods and at different PMA. A further multicentric prospective study is needed to understand the effect of different feeding methods and PMA on vital parameters.

DOI: 10.5281/zenodo.11001324

Aim: The aim of the present study was to determine the prognosis of acute ischemic stroke and compare mean hematological parameters based on the prognosis of acute ischemic stroke. Methods: This Descriptive case series was conducted in the Department of Pathology for one year.100 patients fulfilling the selection criteria were selected. Results: The Mean±SD for the quantitative variables Hemoglobin, total leukocyte count, platelet, mean platelet volume, ESR & CRP are 10.5±2.8, 14.6±12.0, 144.6±92.8, 16.4±10.5, 43.4±36.4 & 18.6±22.5 respectively. There was an association between the Outcome (rather expired or discharged) of the patients with the variables like Hemoglobin, TCL, Platelet, MPV, ESR & CRP as all p-values were significant. Mean Discharged group was greater than mean Expired group in Hemoglobin & Platelet, mean Expired group is greater than mean Discharged group in TLC, MPV, ESR & CRP. Levene’s Test for Equality of Variances had p-values for Hemoglobin, TLC, Platelet, MPV, ESR & CRP in Expired & Discharged group  showed all significant p- values as these were less than 0.05 & concludes that the variances of Expired group & Discharged group were significantly different. Conclusion: We concluded that a significant change was found in hematological parameters in ischemic stroke patients. In light of our results that depicted the difference in the readings of the values for each parameter like hemoglobin, erythrocyte sedimentation rate, platelets count, mean platelet volume, C-reactive protein, and leukocyte count we suggest that these hematological parameters can be used as a tool to take the measures necessary for the prevention of future damage by stroke.

DOI: 10.5281/zenodo.11001338

Aim: The aim of the present study was to assess post covid computer vision syndrome. Methods: The present study was conducted in the Department of Ophthalmology for 12 months .200 participants were included in the study. Results: The female participants were the majority and accounted for 52%, while the males constituted 48%. Most of the patients belonged to 21-40 years of age. Concerning their education level, 17% were in primary school. Most of the children were from the city side, accounting for 64%, whereas those from the village were 36%. Headache was the most selected symptom followed by tearing, itching, blurred vision, eye pain eye redness, burning, excessive blinking and dryness. Other minor selected symptoms were double vision and colored halos around objects. Female gender was significantly associated with an increased risk of CVS as compared with males and participants in the higher age groups were significantly associated with a high prevalence of CVS as compared with participants in the age group of 13 to 15 years. Participants at intermediate and secondary schools were also at high risk of CVS. Lastly, symptoms experienced before COVID and increased severity of symptoms with COVID were also independent predictors (risk factors) of CVS among the studied participants. Conclusion: A significant association between prevalence and demographic factors, such as age, gender, and education level, was established. A significant association between the prevalence of CVS and symptoms before and during the COVID-19 pandemic was also established. The main signs associated with CVS included headache, tearing, itchiness, blurred vision, eye redness, eye pain, and dryness.

DOI: 10.5281/zenodo.11001344

Aim: The aim of the present study was to assess the distribution and antimicrobial susceptibility patterns of lower respiratory tract infections over a six–month period in the medical and surgical intensive care units of a teaching hospital. Methods: This was a retrospective study conducted at Department of Trauma and Emergency, IGIMS for a period of 6 months. This institution is an academic teaching hospital and is one of the local tertiary referral units. However, this study was restricted only to the medical and surgical ICUs. Total number of patients (medical and surgical admissions) seen at our institute during the study period was 1400; out of whom, 400 patients required intensive care. Two hundred patients were enrolled for the study after considering the inclusion and exclusion criteria. Results: A total of 200 patients were included in the study, out of which 150 (75%) were males. Amongst different age groups, maximum patients were above 60 yrs (30%) and the least were between 18–30 yrs age group (13%). The underlying major medical conditions of the LRTI were diabetes mellitus (32%), respiratory pathology (20%), nephrological pathology (19%) and malignancy (13%); while 16% of the patients had other medical conditions, including electrolyte imbalance, hormonal imbalance, or miscellaneous causes such as poisoning. The bacteria were isolated predominantly from the tracheal aspirate (85%), compared to broncho–alveolar lavage (15%) with a statistically significant difference between them. Out of all the isolated organisms, A. baumannii, P. aeruginosa and Klebsiella were the most predominant isolates. S. aureus and Enterococcus were equal. Other pathogenic bacteria were E. coli followed by equal number of Pneumococcus and CONS. In the gram–positive isolates, S.aureus was equally susceptible to linezolid (75%) and vancomycin (75%); and 100% of the isolates of Enterococcus were susceptible to vancomycin. Conclusion: Gram–negative pathogens were predominantly responsible for lower respiratory tract infections. Moreover, antimicrobial resistance rate was high with the most commonly used antibiotics and also to higher antibiotics such as carbapenems.

DOI: 10.5281/zenodo.11001361

Aim: The aim of the present study was to assess the association of serum vitamin D (25(OH) D) level and recurrent wheeze in children less than five years of age. Methods: This was a hospital-based analytical case-control study performed in the Pediatrics department of Darbhanga Medical College and Hospital.  Children less than five years of age, diagnosed with recurrent wheeze, presenting to emergency/outpatient department were enrolled after getting written informed consent. A total of 50 cases with recurrent wheeze along with 50 healthy controls were enrolled. Results: The basic demographic characteristics i.e., age, sex, weight, and height was comparable in both the groups. Moreover, both the groups had very less but comparable sunlight exposure. The feeding pattern was significantly different between two groups. Most of the cases (64%) were exclusively and prolonged breastfed in contrast to controls in which most (72%) of the babies were started on complementary feeds at six months. There were no seasonal variations in the frequency of wheezing. The mean serum levels of 25-hydroxyvitamin D, calcium, and inorganic phosphate were significantly higher in controls compared to cases. Conversely, median serum ALP was significantly more in cases than the controls. Among them too, serum vitamin D and ALP levels were significantly different in cases and control. Most of the babies were exclusively breastfed until six months, however complementary feeding was not initiated at six months of age in most. Conclusion: Low serum 25(OH)D levels are strongly associated with recurrent wheezing in preschool children. In absence of vitamin D levels, high serum alkaline phosphatase levels (>350 IU/L) can be used as a predictor of recurrent wheeze. However, breastfeeding doesn’t seem to protect against recurrent wheezing.

DOI: 10.5281/zenodo.11001368

Aim: The aim of the present study was to investigate the renal function in patients with acute stroke and its relationship with in-hospital mortality. Methods: The present study was a prospective, observational study conducted at Department of General Medicine for the period of one year. 150 patients were considered for present study. Results: Patients were divided into two groups as per eGFR. Group A with eGFR>60 and Group B with eGFR <60. 66.66% were from group A while 33.34% were from group B. Most patients were from >65 years age group, male, BMI<30. Hypertension, smoking, diabetes mellitus, cardiovascular disease, alcohol consumption, dyslipidemia, previous history of stroke/TIA were common risk factors in both groups. On admission most patients had GCS score 5-13. 97 patients had ischemic stroke, while 53 had hemorrhagic stroke. We noted mortality within 30 days in 31 patients. We distributed patients according to Serum Creatinine concentration at time of presentation, most patients had serum creatinine in the range of 98-118 (32%) followed by 82-97 (28%). Maximum mortality was noted in >119 (38.70%) followed by 98-118 (32.25%) serum creatinine group. We distributed patients according to blood urea concentration at time of presentation, most patients had blood urea in the range of 6.8-8.9 (40%) followed by 5.3-6.7 (26.66%). Maximum mortality was noted in >9 (41.93%) followed by 6.8-8.9 (29.03%) blood urea group. We noted that age > 65 years, at the time of admission, smoking, diabetes mellitus and aspiration pneumonitis were predictors of death in stroke patients. Conclusion: The severity of impaired kidney function in patients hospitalized with acute stroke is associated with increased mortality independent of age, sex, and major comorbidities. Unrecognized renal insufficiency noted by low eGFR is common in patients with acute stroke and is associated with higher mortality adverse short-term outcomes.

DOI: 10.5281/zenodo.11001378

Aim: The aim of the present study was to assess the prevalence of urinary tract infection in infants and young children with acute diarrhea. Methods: This descriptive hospital-based study was conducted in the Department of Paediatrics. In the study period 100 diarrhea cases admitted to the paediatric ward were included children who satisfied the inclusion criteria (Children aged 6 months to 6 years admitted with diarrhea) with proper consent from parents or primary care givers were included in the study. Results: In our study 15% of study population was found to have urinary tract infection. The most common organism isolated from the urine was E coli (10 cases) followed by Enterococci (n=2). Others were Klebsiella, Citrobacter and Alpha streptococci. In the present study group 10 of urinary tract infection cases were in the age group of 6 months to 1year, followed by 3-6 years. Out of total 15 cases of urinary tract infection, 12 cases were females and 3 were males. Among the 15 positive urinary tract infection cases 9 children had normal nutritional status whereas rest 6 cases had grade 1 PEM according to Indian Academy of paediatrics classification. In 15 children with urinary tract infection, 8 were normally hydrated. 6 showed some signs of dehydration. Conclusion: UTI in young children can present with diarrhea and other nonspecific symptoms. Children presenting with diarrhea need to have a urine analysis and urine culture for the confirmation of UTI, so that long term complications like renal parenchymal damage and hypertension can be prevented.

DOI: 10.5281/zenodo.11001386

Aim: The aim of the present study was to assess the clinical and radiological evaluation of multiple ligament injuries of knee. Methods: The Prospective study was conducted in the Department of Orthopaedics for the period of 1 year. 50 cases were included in the study. Results: In our study out of 50, there were 39 males and 11 females. The youngest and the oldest patient in our study were 18 and 60 years old respectively. Majority of the patients were found to be between the age group of 17-30 years. The least number of cases are found in the age group of >40 years. The average age was 35.5 years. Majority of the patients were of left side, 31 patients (62%) and remaining 19 patients (38%) were of right side. Most common mode of injury was Road Traffic Accidents with 22 patients followed by 16 patients with sports injury and 12 patients with history of fall. In our study out of 50 cases, most common pattern of injury was type III ACL + posterolateral complex with 18 cases (36%) and the least common was type IV PCL +Posterolateral complex with only 2 cases (4%). Lachman test and Anterior drawer test for Anterior cruciate ligament had a P Value <0.05 which was statistically significant in our study. Posterior drawer test, Valgus stress test, Varus stress test, McMurray’s had P Value <0.0001 which was statistically highly significant in our study. Posterior sag test had P value >0.05 which had not statistically significant in our study. On comparing with MRI Lachman’s test is more sensitive than anterior drawer for ACL tear, For PCL injury posterior drawer was more sensitive than Posterior sag test. Varus test for LCL and McMurray’s test for Medial meniscus were more sensitive than their counterparts. Conclusion: We concluded that MRI is better non-invasive diagnostic tool for multiple ligament knee injuries than clinical examination which provides with the information of ligaments involved, grade of involvement and is cost effective.

DOI: 10.5281/zenodo.11001395

Aim: The aim of the present study was to assess the renal function in subclinical hypothyroid patients. Methods: The present study was conducted at Department of Biochemistry and all the cases detected with SCH from August 2021 and May 2023 were taken for the study. The data were collected from patients coming to L. N. Medical College & Research Centre and J.K. Hospital, Bhopal (MP) for consultation in outpatient department (OPD) and from medical records. A total of 750 subjects were included in the study. Results: We found a highly significant difference in the mean values of FT3, FT4, TSH, serum creatinine, eGFR by MDRD, and eGFR by CKD‑EPI equation among all the groups. A linear trend of increase in creatinine values from ET controls to SCH to OHT groups. Pearson’s correlation studies reveal that TSH levels were well correlated with serum creatinine in the OHT group only. No correlation was found with ET and SCH groups. Similarly, a significant negative correlation between TSH and eGFR was found only in OHT group. We found a very strong positive correlation between eGFR calculated by MDRD and eGFR by CKD‑EPI equations in all the subjects. Linear regression analysis in GLM model showed that the linear regression in creatinine based on the TSH values is attributable to the extent of 44.7% among the OHT group. Conclusion: This study concluded that there is tissue hypothyroidism as manifested by the difference in the creatinine levels and eGFR values in such patients compared to the healthy controls. eGFR calculation by both the formulae has good correlation in the study groups. Hence, either of them can be used for measuring GFR. Furthermore, the linear regression analysis concludes that the TSH values may be used to predict the lower kidney function (higher creatinine values) among the SCH group.

DOI: 10.5281/zenodo.11004442

Aim: The aim of the present study was to assess the Nationwide Glaucoma incidence in end stage renal disease patients and kidney transplant recipients. Methods: The primary objective of the project was to investigate the effect of KT on the national population-based incidence and prognosis of various eye diseases, including age-related macular degeneration, retinal vein occlusion, and glaucoma. Results: The mean age of the subjects was 46.4 ± 11.6 years and majority of subjects were men. There was a significant difference in income among the study groups (P < 0.0001). A larger proportion of KTRs and ESRD patients had a history of underlying chronic disease such as DM, HTN, and dyslipidemia when compared with healthy control (all Ps < 0.0001). Among the ESRD patients, 76% of the patients under- went hemodialysis, 20% underwent peritoneal dialysis, and 4% underwent mixed dialysis. Among the KTRs, 30% had no dialysis history, 44% underwent hemodialysis, and 16% underwent peritoneal dialysis before KT. For KTRs, 96% of the recipients received induction medication. Almost all the KTRs were prescribed calcineurin inhibitor for maintenance therapy and 14% of the KTRs experienced desensitization. Conclusion: In conclusion, the present nationwide population-based cohort study showed that there was no significant association of POAG incidence risk in ESRD patients and KTRs after controlling for multiple confounding factors. However, the PACG risk was significantly increased in ESRD patients. Interestingly, KT reduced the risk of PACG in ESRD patients to a level similar to that in healthy controls.

DOI: 10.5281/zenodo.11004448

Aim: The aim of the present study was to study clinical profile of patients with sudden onset sensorineural hearing loss at a tertiary hospital. Methods: This retrospective study, conducted in Department of ENT. We studied total 200 case records. Case records of patients with sudden onset sensorineural hearing loss examined from last two years were considered for present study. Results: All patients were compared according to recovery status. Recovery was noticed in 80 patients (40%) while no or less than 50% recovery was noticed in 120 patients (60%). Majority of patients were from 41-60 years age group (43%) followed by from 21-40 years age group (30%). In patients with recovery, mean age was 42.88 ± 8.32 years as compared to patients without recovery as 51.52 ± 11.79 years and difference was statistically significant (p<0.05). Gender was comparable among total patients as well as patients with or without recovery and difference was statistically not significant (p>0.05). Hypertension (35%), diabetes (20%), dyslipidemia (20%) and thyroid disorder (8%) were common comorbidities noted among patients. Vertigo was significant in patients without recovery as compared to patients with recovery and difference was statistically significant (p<0.05). Tinnitus was comparable in patients with recovery (40%) as well as patients without recovery (60%) and difference was statistically not significant (p>0.05). Audiogram curve was flat, U-shaped, reverse U-shaped (45%) in majority of patients followed by descending (40%) and ascending (15%). Degree of hearing loss was mild (8%), moderate (10%), moderately severe (20%), severe (25%) and profound (37%). Incidence of patients without recovery was increased with increase in severity of hearing loss and difference was statistically significant (p<0.05). Conclusion: In patients with sudden onset sensorineural hearing loss age less than 40 years, no comorbidities, lesser degree of hearing loss, early (<14 days) initiation of treatment are factors associated with recovery.

DOI: 10.5281/zenodo.11004459

Aim: The aim of the present study was to assess the results of endoscopic transcanal myringoplasty. Methods: The present study was conducted in the Department of ENT, We reviewed the medical records of 50 patients who under- went endoscopic transcanal myringoplasty. The patients with anterior perforations of the tympanic membrane were enrolled; these patients were followed up for at least 6 months. Results: The changes from preoperative to postoperative air-bone gaps were noted. 34 patients (68%) had preoperative air-bone gaps of less than 20 dB, whereas 49 patients (98%) had postoperative air-bone gaps of less than 20 dB. The association between the rate of graft success and prognostic factors were noted. The success rate among patients with postoperative otorrhea was significantly lower than that among patients without postoperative otorrhea. Notably, the success rate with partial visualization of the perforation was comparable to that with complete visualization of the perforation. No significant differences were seen for larger and marginal perforations. Conclusion: Our study revealed that wider endoscopic visualization can neglect the factor of partial visualization of the perforation margin through otoscopy, which increases the rate of graft success in anterior perforations of the tympanic membrane. Therefore, the rate of graft success and hearing results are comparable with those of microscopic myringoplasty for repairing anterior perforations of the tympanic membrane.

DOI: 10.5281/zenodo.11004475

Aim: The aim of the present study was to assess the effect of music on frequency domain measures of heart rate variability (HRV) in medical students. Methods: The study was conducted on twenty randomly selected first year MBBS Student of age group 17-21 yrs., both genders. They were exposed to two musical excerpt of ten minute duration of different genres of music that is slow melody and fast rhythm music during which Heart Rate Variability indices were continuously monitored. Results: The music group demonstrated a significant decrease in heart rate (P < 0.0001), mean arterial pressure (P < 0.02) and rate pressure product (P < 0.01) compared with non‑music group. The music  group showed  a significant decrease  in HR (P < 0.0001), mean arterial pressure (P  < 0.02) and rate pressure product (RPP) (P < 0.01) compared with nonmusic group. The TP which is the marker of the magnitude of HRV and HFnu were significantly increased (P < 0.0001) in the music group compared with nonmusic group. But the LFnu was decreased significantly (P < 0.0001) in the music group compared with nonmusic group. Furthermore, the LF/HF ratio was significantly decreased  (P  < 0.0001)  depicting the decreased sympathetic activity and increased parasympathetic activity in the music group compared with nonmusic group. The LF‑HF ratio was not significantly correlated with TP and stress score in both the music and non-music groups. Conclusion: In the present study, music therapy could reduce the stress levels in the medical students. Therefore, this study provides the preliminary evidence that listening to classical music could be an effective method of relaxation, as indicated by a shift of the autonomic balance towards the parasympathetic activity among medical students.

DOI: 10.5281/zenodo.11004479

Aim: The aim of the present study was to compare electrolyte levels in serum and plasma. Material & Methods: This study was conducted during the period of 12 months at Bodhi Hospital, Patna, Bihar, India 50 patients were included in the study. After obtaining consent, samples for the study were collected from OPD patients coming to the laboratory. The samples were collected by trained phlebotomist. Hemolysed and lipaemic samples were excluded from the study. Results: According to the data, there are substantial differences in the average levels of certain electrolytes between serum and plasma. In the present study we found plasma and serum sodium levels did not vary till 48 hours at 2 to 4°C. At 2 to 4°C serum K levels did not differ from the baseline value up to 48 hrs, whereas changes were noticed in plasma K after 36 hours. Serum and plasma chloride were stable only up to 12 hours at 2 to 4°C. At room temperature, sodium levels did not show any change up to 24 hours in plasma and up to 36 hours in serum. Plasma K was stable up to 12 hours but serum K was stable up to 48 hours. Plasma chloride was stable up to 6 hours but serum chloride was stable upto 12hours. Conclusion: Estimation of electrolytes as early as possible at proper storage conditions is the best solution to avoid analytical errors.

DOI: 10.5281/zenodo.11004620

Aim: The aim of the present study was to develop a new Indian nomogram to estimate pathologic extracapsular extension (ECE) risk in prostate cancer. Methods: This was a retrospective single-institution study of patients who underwent primary RP at department of General surgery. The data of 200 patients were analyzed. The collected data included prebiopsy serum prostate-specific antigen (PSA) levels, clinical T-stage (cT) determined by digital rectal examination (DRE), Gleason score (GS) from transrectal ultrasound (TRUS)-guided prostate biopsy, MRI data, and histopathologic findings from the RP specimens of all patients. Results: Out of 200 patients, 100 patients had ECE on MRI, whereas 100 patients had ECE on final pathology. All variables except age demonstrated a statistically significant difference in detecting ECE on final pathology on univariate analyses. Based on multivariate logistic regression analyses, cT, GS and MRI ECE risk score remained significant predictors of ECE. Conclusion: MRI adds incremental value to the existing validated risk stratification tool and provides significant additional ability for predicting ECE in prostate cancer staging. We constructed a nomogram for predicting ECE based on the results of cT, PSA, GS, and MRI ECE risk score in Indian patients. The nomogram provides a good prediction of ECE.

DOI: 10.5281/zenodo.11004625

Aim: The aim of the present study was to assess the number of missing teeth and to examine the relationship between age and tooth-loss in diabetic patients. Methods: This was an observational case-controlled study consisting of 100 diabetic patients and an equal number of non-diabetic patients as control in the Department of Dentistry for one year. Results: There were more females as compared to males and most of the patients belonged to 45-54 years of age. Most of the patients had secondary level education. The mean fasting blood glucose recorded for non-diabetics was 72.88 ± 14.72 and 115.38 ± 22.52 at 2 hours post-prandial; the diabetic group had a mean of 124.96 ± 15.37 recorded as fasting and 208.94 ± 20.98 at 2 hrs post-prandial. In the present study, 58% were suffering from painful gum and 54% had gum swelling. 19% extracted tooth because of gum problem. Conclusion: It can be stated that the higher number of missing teeth in the diabetic patients than the non-diabetic patients suggests that tooth loss has a direct relationship with diabetes mellitus. In addition, within the limitations of this study, it is believed that the number of tooth lost is directly related to the age of the diabetic patient. Therefore, the dental surgeon has an important role in the early detection of clinical features of diabetes mellitus in patients reporting to the dental clinic for oral health care.

DOI: 10.5281/zenodo.11345256

Aim: The aim of the present study was to assess the efficacy of intravenous Clonidine 1 µg/kg in attenuation of haemodynamic response to orotracheal intubation and laryngoscopy and observe side effects of Inj. Clonidine. Methods: The Prospective randomized double blind clinical study was conducted in the Department of Anaesthesiology & Critical Care, Jawaharlal Nehru Medical College, Bhagalpur, Bihar, India. Written informed valid consent was obtained from all patients participating in the study. 100 patients of either sex, between 20-60 years of age of ASA Grade I and II scheduled for surgery under General Anaesthesia were studied. Results: There was a statistically significant increase in HR (P=0.000) compared to baseline value, statistically significant increase in SBP at 0 minute, 1 minute, 3 minutes and 5 minutes whereas negligible decrease after 10 minutes compared to baseline value after intubation in group injected with normal saline. There was statistically significant increase in DBP (P<0.01) compared to baseline value in this group. While in clonidine group , there was an attenuated hemodynamic response after laryngoscopy and intubation. Conclusion: Clonidine at a dose of 1 μg/kg body weight diluted in 10 ml Normal saline given 10 minutes before induction significantly attenuates the haemodynamic responses to laryngoscopy and orotracheal intubation with minimal side effects like bradycardia. However, the study has to be done on a larger population and in high risk patients for further evaluation.

DOI:10.5281/zenodo.11353288

Aim: The aim of the present study was to evaluate the role of ultrasound elastography in the evaluation of breast lesions. Methods: The present study was a prospective observational study conducted in Department of Radiodiagnosis. Study period was one year. During study period total 100 patients underwent ultrasound elastography examination followed by core needle/surgical biopsy for histopathological study. Results: On histopathological study 78% lesions were benign, while 24% were malignant. Fibroadenoma (37%), fibrocystic changes (17%), galactocele (6%) and mastitis (7%) were common benign findings while invasive ductal carcinoma, mucinous carcinoma and invasive papillary carcinoma were malignant lesion findings. On ultrasound elastography score examination, scores of 1 (24%), 2 (39%), 3 (16%), 4 (7%) and 5 (14%) were noted. Scores 1 to 3 were considered benign and 4 and 5 malignant. On statistical analysis we calculated sensitivity (94/88%), specificity (83.62%), positive predictive value (93.57%), negative predictive value (85.35%) and accuracy (94.71%) of ultrasound elastography with histopathological report. Conclusion: Ultrasound elastography is a useful non-invasive diagnostic modality in differentiating benign from malignant breast lesions thereby reduces waiting, cost, discomfort and anxiety of a biopsy.

DOI:10.5281/zenodo.11353478

Aim: The aim of the present study was to investigate the common bacteria associated with UTI cases and their antibiotic susceptibility pattern. Methods: A retrospective descriptive study was done for one year in DMCH, Laheriasarai, Darbhanga, Bihar. The study included all in-patients of either gender above 18 years of age with a diagnosis of UTI. Data was collected from the patient’s case record files, which were retrieved from the medical records department of our hospital. Results: Out of 120 significant isolates, gram-negative organisms accounted for 81%. Fungal isolates were seen only in 2% of cases. E.coli was the most predominant uropathogen isolated followed by Klebsiella spp, Enterococcus fecalis and Acinetobacter spp. Other uropathogens included MRSA bacteria, Staphylococcus aureus, Candida spp, Citrobacter freundii, Pseudomonas spp and Streptococcus spp. E.coli, showed considerable resistance to ampicillin, ceftriaxone, Co-Trimoxazole and fluoroquinolones. Low level of resistance was observed with Nitrofuration, piperacillin+ tazobactam and Ticarcillin. Klebsiella spp, the second most common uropathogen showed high level of resistance with ampicillin, cephalexin, cefuroxime, ceftriaxone and Nitrofuration. Conclusion: Most of the identified bacteria were resistant to several of the popular antibiotics used in clinical settings. Consequently, it is vital to prescribe antibiotics rationally both before and after culture reports. Pattern needs to be studied further and the outcome should be communicated to the prescribing physicians in that area.

DOI: 10.5281/zenodo.11543014

Aim: The aim of the present study was to assess the prescription pattern to promote rational use of drugs. Methods: A cross-sectional descriptive study was done for one year in DMCH in Darbhanga. Prescriptions from Out-patient departments especially Medicine and Pediatrics were collected and analyzed. The prescribed fixed dose combination drugs and other drugs were categorized according to Anatomical Therapeutic Chemical classification (ATC classification). Results: Most common FDCs in elderly age group belonged to Gastrointestinal system and in Pediatric population mainly respiratory system. The highest percentage of FDCs were seen in alimentary tract, followed by anti-infective, respiratory system. The maximum number of FDCs was of antacid combination followed by combination of proton-pump inhibitors and prokinetic drugs in the alimentary tract. In case of respiratory drugs maximum number was of antihistaminics, anticholinergics followed by anti asthamatics. In nervous system combination of paracetamol, tramadol followed by paracetamol, codeine and caffeine. In anti-infective group mostly amoxiclav, norfloxacin-tinidazole, ofloxacin-ornidazole. Conclusion: A significant number of drugs are being prescribed as FDCs which also includes various irrational combinations. A multipronged corrective approach involving regulator, academia, industry, physicians, and public is needed to correct the dismal FDC scenario.

DOI: 10.5281/zenodo.11543060

Background: Coping with visual impairment presents significant challenges that require adaptive strategies to manage daily life, professional responsibilities, social interactions, and emotional well-being. This study aims to explore the coping strategies employed by visually impaired adults and identify the factors influencing their effectiveness. Using a mixed-methods approach, the research combines in-depth interviews, focus groups, and surveys to gather comprehensive data from a diverse group of visually impaired adults aged 18 and above. The study utilizes thematic analysis for qualitative data and statistical analysis for quantitative data to uncover common themes and patterns. Preliminary findings suggest that visually impaired adults employ a range of coping strategies, including the use of assistive technologies, reliance on social support networks, and the development of personalized routines and techniques to navigate daily challenges. Emotional coping strategies such as acceptance, positive reframing, and seeking professional psychological support also play crucial roles. The research highlights the importance of accessibility, availability of resources, and societal attitudes in shaping the effectiveness of these coping strategies. Material and Method: The Department of Ophthalmology conducted this cross-sectional study, recruiting adult patients aged 24 to 70 who self-presented to the ophthalmology outpatient department with a best-corrected visual acuity (BCVA) of less than 6/18 in the better eye, and had experienced vision loss for at least 6 months. All participants provided written informed consent. The visual loss had to be irreversible. Irreversible low vision was defined as a BCVA in the better eye between <6/18 and <6/60 that could not be treated. Irreversible blindness was defined as a BCVA in the better eye between <6/60 and 3/60 (economic blindness). Irreversible social blindness was defined as a BCVA in the better eye between <3/60 and <6/60 that could not be treated. Results: Forty patients meeting the inclusion criteria agreed to participate, with half being female and aged between 24 and 70 years. Twenty percent of participants had a coexisting chronic illness but no other disability aside from vision impairment. Degenerative myopia caused by posterior segment disease was the most common reason for reduced vision or blindness. Across all participants, avoidance and reflective coping strategies received the highest ratings, while strategic planning received the lowest. Most quality-of-life scores related to vision were low, with the psychosocial impacts of vision loss being associated with the lowest quality of life scores. Conclusion: The combination of autopsy findings and CT scan results has been identified as a valuable diagnostic tool for various types of brain injury lesions, contributing to the development of improved policies. While CT scans can aid in diagnosing various types of head injury lesions, autopsies are considered a more reliable method for detection. Patients with traumatic head injuries can greatly benefit from the high-resolution CT scan, which represents an advanced diagnostic technique. Maladaptive coping mechanisms, such as demobilization and excessive mobilization, have been linked to poorer quality of life, reduced self-esteem, and increased feelings of pessimism, loneliness, and anxiety.

DOI: 10.5281/zenodo.11543104

Background: Hematopoietic malignancies, encompassing a wide range of cancers such as leukemias, lymphomas, and multiple myeloma, often present with diverse systemic manifestations. Ocular involvement, though less frequently discussed, is a significant aspect of these malignancies and can impact the diagnosis, management, and prognosis of affected patients. This review aims to provide a comprehensive overview of the ophthalmic manifestations associated with hematopoietic malignancies, elucidating the underlying pathophysiological mechanisms, clinical presentations, diagnostic approaches, and therapeutic strategies. Material and Method: Conducted within the ophthalmology department, this prospective, non-interventional descriptive study focused on evaluating forty patients with hematological conditions. A structured proforma was devised to collect essential data, including a concise medical history, ocular background, anterior and posterior segment examinations, and the hematological profile of each patient. A comprehensive assessment of the anterior and posterior segments was performed on all participants, encompassing measurements of intraocular pressure, best corrected visual acuity, slit lamp examination of the anterior segment, dilated retinal evaluation using indirect and direct ophthalmoscopy, and slit lamp biomicroscopy aided by a Volk 78 D lens. For cases requiring fundus photography, satisfactory outcomes were achieved. Prior to any treatments, all subjects provided written, informed consent for both the interventions and the utilization of their health information within their medical records. Results: In this study involving 40 patients diagnosed with hematological malignancies, ocular characteristics were identified in 20 individuals. Among the participants, there were 12 females and 28 males. Ocular findings were detected in 14 of the male patients and 7 of the female patients. Notably, anterior segment findings were observed in one male and one female. Additionally, neurological involvement was noted in 2 males and 2 females. Analysis of the posterior segment revealed a higher frequency of involvement compared to the anterior segment or neurological involvement, with 11 males and 4 females exhibiting posterior segment findings. Except for acute myeloid leukemia (AML), which displayed an equal frequency, and chronic myeloid leukemia (CML), where one case exhibited anterior segment findings and another presented posterior segment findings, the incidence of posterior segment findings outweighed that of anterior segment findings in each specific disease category. Conclusion: This study presents an analysis of ocular pathological findings observed in individuals under surveillance for hematological malignancies. The findings underscore the potential ocular involvement in these conditions and the notable clinical symptoms associated with them. Moreover, these cases underscore the importance of ocular care for patients with hematologic malignancies, particularly regarding dry eye disease, given the emergence of novel antineoplastic treatments that may extend life expectancy.

DOI: 10.5281/zenodo.11543162

Background: Ventilator-associated pneumonia (VAP) remains a significant concern in intensive care units (ICUs), contributing to increased morbidity, mortality, and healthcare costs. This study aims to investigate the impact of respiratory interventions on the prevention and treatment of VAP in ICU patients. By analyzing various respiratory strategies, including the use of mechanical ventilation protocols, airway management techniques, and infection control measures, we seek to determine their effectiveness in reducing the incidence and severity of VAP. The study involves a comprehensive review of existing literature, retrospective analysis of patient data, and a prospective clinical trial to evaluate the outcomes of different respiratory interventions. The findings are expected to provide valuable insights into best practices for preventing and managing VAP, ultimately improving patient outcomes and reducing the burden on healthcare systems. Aim: The aim of this study is to evaluate the effectiveness of different respiratory interventions in preventing and treating ventilator-associated pneumonia (VAP) in intensive care unit (ICU) patients. By identifying the most effective strategies, the study seeks to improve patient outcomes, reduce the incidence and severity of VAP, and minimize the associated healthcare costs. Material and Method: This prospective randomized trial was conducted in the Department of Respiratory Medicine to investigate the impact of respiratory interventions on the incidence and resolution of ventilator-associated pneumonia (VAP) in ICU patients. A total of 70 patients were enrolled in the study based on specific criteria. General demographic information for each participant, including age, sex, body mass index (BMI), and Glasgow Coma Scale score, was collected and recorded by the Principal Investigator. Additionally, data on each subject’s respiratory medical history, such as a diagnosis of chronic obstructive pulmonary disease (COPD), chronic sputum production, and smoking history, were gathered at the time of enrollment. This information was obtained either from the patient’s medical records or through interviews with their closest relatives. Results: Of the 70 subjects, 40 (57.1%) were male and 30 (42.8%) were female, indicating a majority of male participants. There were significantly more males than females in the treatment group. When analyzing the age distribution, most subjects fell within the 40-60 year age group. A significant difference in BMI was observed between male and female subjects, with males having a significantly higher BMI than females. Additionally, a significant association was found when comparing non-VAP and VAP patients regarding the duration of mechanical ventilation, length of ICU stays, and overall hospital stay, with variations noted according to gender. Conclusion: The primary conclusion from this investigation was that the implementation of a standard prophylactic respiratory regimen, which includes positioning, manual hyperinflation, and suctioning, in addition to routine medical and nursing care, appeared to prevent VAP and reduce the duration of mechanical ventilation and ICU stay. Patients who followed this prophylactic regimen in the ICU showed a lower incidence of ventilator-associated pneumonia. Although statistically significant results were observed with various clinical factors, it is recommended that adopting a prophylactic respiratory regimen is beneficial in preventing ventilator-associated pneumonia in patients.

DOI: 10.5281/zenodo.11004625

Aim: The aim of the present study was to assess the pulmonary function tests in patients of metabolic syndrome and to record the effects of metabolic syndrome on pulmonary function tests. Methods: The study was conducted in the Department of Medicine. 50 patients of metabolic syndrome presenting in the OPD/IPD of Anugrah Narayan Magadh Medical College and Hospital, Gaya, India for related or unrelated problems were selected for the current study and were included in the study group after applying inclusion and the exclusion criteria and after taking written informed consent. The NDD spirometer was used to conduct pulmonary function tests in this study. Results: Majority of the patients were women (72%) (n=36) while men constituted 28% (n=14) of the patients. Most of the patients belonged to the 61-70 years’ age group (n=17) followed by 41-50 years’ age group (n=13). 42% (n=21) of the patients had 4 components positive out of 5 while 36% (n=18) of the patients had 3 components positive. 22% (n=11) of the patients had all 5 components positive. Most of the patients had a restrictive pattern (44%) (n=22). 34% (n=17) of the patients had a mixed pattern while 16% (n=8) of the patients had a normal picture. Only 6% (n=3) of the patients had an obstructive pattern (p<0.001). Both FEV1 and FVC correlated negatively with BMI, FBS, waist hip ratio and SBP. Only FEV1 had a negative correlation with Hba1c whereas only FVC had a negative correlation with waist circumference. Conclusion: Our study provides an understanding on how obesity aids to the development of lung function decline and the interplay between metabolic syndrome and lung function. Patients with metabolic syndrome have significant impairment of the pulmonary function with restrictive pattern being the most common one.

DOI: 10.5281/zenodo.12734591

Aim: The aim of the present study was to assess the clinical profile and various causes of right iliac fossa lesions. Methods: A hospital based prospective study was done with 100 patients to evaluate right iliac fossa lesions – it’s clinical profile and its management at Netaji Subhas Medical College and Hospital, Bihta, Patna, Bihar, India. The duration of the study was 1 year. Results: The most common disease in our study was appendicular mass (42%) followed by appendicular abscess (28%), iliopsoas abscess (12%), ileo-caecal tuberculosis (6%) and carcinoma caecum (6%). There was 1 case each of right undescended testis with malignant change, right ectopic kidney and non-hodgkin‘s lymphoma of ileum. Each of these cases accounting for 2% of the total cases in our study. The highest number of cases (46%) was in the 21–30 years age group. The youngest patient was 14 years old and oldest was 75 years old. There were 60 male and 40 female patients in our study. It was observed that there was preponderance of male patients. 34 patients gave history of nausea and vomiting. 34 patients gave history of fever, it was usually mild degree and intermittent. Loss of appetite was present in all the patients (100%) of appendicular mass. Diarrhoea was seen in 2 patients. 2 patients presented with the mass per abdomen as one of his complaints. Conclusion: Diseases presenting as a mass in the right iliac fossa are normal in the age range of 20 to 40 years. In males, the average occurrence tends to be greater. Pressure in the right iliac fossa with fever, vomiting and lack of weight gain are the most common presenting symptoms. Abdominal tuberculosis is a significant health issue in our nation and due to varying presentation of patients with ambiguous abdominal pain and non-specific medical symptoms, poses a diagnosis difficulty and obstacle.

DOI: 10.5281/zenodo.12734615

Aim: The aim of the present study was to compare between early versus Delayed Laparoscopic Cholecystectomy for Acute Cholecystitis. Methods: The study was conducted in the Department of General Surgery, Patna Medical College and Hospital Patna, Bihar, India. 100 patients with physical, laboratory, and ultrasound findings suggested acute cholecystitis, and who were operated on by laparoscopy were included in the study.  The early operation group was operated on within 24 hours of admission (50 patients), whereas the late operation group was operated on after 6 to 8 weeks following the initial treatment (50 patients). Results: The study groups, which underwent early or delayed laparoscopic cholecystectomy, showed no difference in age and sex distribution. Initial clinical findings and medical history were also similar between groups, except for fever, which was significantly higher in the early laparoscopic cholecystectomy group. Both groups revealed similar physical examination findings: all patients had tenderness and defense in the abdominal area (this term means tensing the muscles in the abdominal area, a clinical finding that may present when the internal organs are inflamed in some manner) and 90% had Murphy sign, and 12% in the early and 26% in the late laparoscopic cholecystectomy groups had rebound tenderness. Blood count and liver function results were not different between groups. Ultrasonographic findings were similar between groups. There was no significant difference between the early and the delayed laparoscopic cholecystectomy groups in terms of operation time and rates for conversion to open cholecystectomy. Conclusion: Despite intraoperative and postoperative complications being associated more with early laparoscopic cholecystectomy compared with delayed intervention, early laparoscopic cholecystectomy should be preferred for treatment of acute cholecystitis because of its advantages of shorter hospital stay.

DOI: 10.5281/zenodo.12734636

Aim: The aim of the present study was to evaluate the results of open reduction and Internal fixation of the diaphyseal fractures of both bones forearm with limited contact dynamic compression plate (LC-DCP) in adults and its advantages and complications. Methods: The present study was conducted in the Department of Orthopaedics at SKMCH, Muzaffarpur, Bihar, India for one year. The present study consists of 50 cases of fracture both bones of the forearm. Results: The age of these patients ranged from 18-60 years with fracture being most common in 3^rd decade and an average age of 31 years. Other common characteristics were males (80%), right forearm fracture (64%) and injury due to road traffic accidents (60%). Majority of the fractures were seen in the mid diaphysis of both bones. 35 (70%) patients had middle third fractures, 10 (20%) had proximal third fractures and 5 (10%) patients had lower third fractures both bones forearm. Only 10 (20%) of the patients had associated injuries. Majority of the fractures were transverse / short oblique. About 20% of radius and 30% of ulna fractures were comminuted. 45 (90%) patients had sound union in less than 6 months, 5 (10%) patients had delayed union. Postoperative complications such as Superficial Infections (4%), Posterior interosseous nerve injury (6%), Radioulnar synostosis (4%) were noted. Using the Anderson et al. scoring system we had 43 (86%) patients with excellent results, 5 (10%) patients with satisfactory results and 2 (4%) patients with unsatisfactory result (radioulnar synostosis). Conclusion: Advantages of LC-DCP, it facilitates biological fixation of the bone and early bone union. It is easier to apply in comminuted and segmental fracture and short oblique fractures. It gives excellent functional results in the majority of patients.

DOI: 10.5281/zenodo.12735861

Aim: The aim of the present study was to find out the incidence of maternal complications, perinatal mortality and morbidity in postdated pregnancies. Methods: This was a retrospective observational study conducted in the Department of Obstetrics and Gynaecology, for 12 months. Total 200 patients in the antenatal ward and labour room were selected for the study and they were divided into two groups, Control group with Gestational age 37-40 weeks and Study group with Gestational age >40 weeks. Results: Majority of the patients belonged to 25-30 years age group. Maximum number of patients belonged to the age group of 25-30 years both in cases (50%) and control group (50%). The maximum number of patients in the study group (82%) belonged to the gestational age of 40-41 weeks while all the controls belonged to 37-40 weeks gestational age. 65% of the patients in study group were primigravida and in the control group and 55% were primigravida. The percentage of LSCS was 30% which was higher than in the control group where it was 15%. Incidence of instrumental delivery was also higher in the study group as compared to control group (10% as compared to 5%). Among the indications for LSCS, the most common indication among the study group was acute foetal distress which includes meconium stained liquor (10%) followed by cephalopelvic disproportion (9%). In the control group, most common indication was non progress of labour (4%) followed by acute foetal distress (01%) and non-reactive CTG (1%). Conclusion: Postdated pregnancy remains a clinical dilemma for an obstetrician. The choice is between watchful expectancy for labour to start or induction in postdated patients. According to our study, postdated pregnancies are related with higher rate of LSCS and instrumental deliveries.

DOI: 10.5281/zenodo.12735871

Aim: The aim of the present study was to evaluate the efficacy of intravenous iron sucrose for the treatment of iron deficiency anemia in pregnancy. Methods: The present study carried out in the Department of Obstetrics and Gynaecology Netaji Subhas Medical College, Bihta, Patna, India. The duration of the study was about 9 months. 50 pregnant women were enrolled for this study. Results: The study results showed that the mean age of the pregnant women was 23.57±4.08 years, their mean weight was 59.61±12.28 kg, their mean gestational week was 28.72±4.08, 8 (16%) of them had gestational diabetes, 5 (10%) of them had hypertension, 4 (8%) of them had hyperthyroidism, 6% had asthma and 6% genitourinary infection whereas 4 (4%) of them had chronic kidney disease. The study results further showed that both the hemoglobin (p<0.001) and ferritin levels (p<0.001) of females were significantly increased at term after receiving intravenous iron sucrose as compared to the baseline. Furthermore, significant difference was observed in PCV (p<0.001) and MCV as well (p<0.001). Conclusion: This study concluded that the administration of iron sucrose intravenously (Axifer) is a secure and effective choice in the management of iron deficiency anemia in pregnant women particularly for those who had inadequate response to oral iron supplementation. Intravenous iron sucrose is well accepted along with controllable safety profile clinically and enhanced Hemoglobin and ferritin level both and thus decrease complications during pregnancy due to iron deficiency anemia.

DOI: 10.5281/zenodo.12735874

Aim: The aim of the present study was to compare different techniques of nucleotomy during phacoemulsification with respect to corneal endothelial cell loss, central corneal thickness (CCT). Methods: A comparative analysis on corneal endothelial cell loss and central corneal thickness was done in 90 patients undergoing cataract extraction by phacoemulsification in Department of Ophthalmology .These 90 patients were randomly divided into three groups of 30 each who underwent a different method of nucleotomy during phacoemulsification and were operated by the same surgeon. Results: The maximum number of patients was in Group A, 17 patients were in the age group of 61-70 years while most of the patients, 18 in Group B and 21 in Group C, were in the age group of 51 – 60 years. The mean age of patients in Groups A, B and C were 60.65 years, 61.25 years and 59.45 years respectively. There were more females and most of the patients belonged to NS grade I. The maximum number of patients in each group: 11 patients in Group A had visual acuity of 6/36 preoperatively, 14 patients in Group B and 16 patients in Group C had visual acuity of 6/60 preoperatively. No statistically significant difference was found in mean endothelial cell density in Group A, B and C preoperatively. No statistically significant difference was found in mean central corneal thickness in Group A, B and C preoperatively, and at 1st, 4th and 12th postoperative week. It was observed that CCT after 4 weeks of cataract surgery was not much different from preoperative value in all three groups. No patient of any group had BCVA of less than 6/36 on Snellen’s distance visual acuity chart with spectacles correction. Conclusion: All three techniques of nucleotomy in phacoemulsification i.e divide & conquer, stop and chop and direct phaco chop are equally efficacious. The degree of endothelial cell loss and central corneal thickness changes in all three methods are almost similar in the hands of an experienced surgeon.

DOI: 10.5281/zenodo.12735880

Aim: The aim of the present study was to assess the prevalence, clinical presentations, management options and outcomes of uterine fibroids in Patna, Bihar, India. Material & Methods: A cross-sectional retrospective study of 100 cases of uterine fibroids was conducted in the Department of Obstetrics and Gynaecology, Patna Medical College and Hospital, Patna, Bihar, India in between the duration of 1 year. Results: The most prevalent age range was between 36 and 45 years at 46% while the mean age was 38.12±8.06 years. The parity of the patients ranged from 0 to 7 with most (76%) of the participants being nulliparous. Abdominal swelling was the most common complaint at presentation and was reported in 68% of the participants. Others were menorrhagia (24%), dysmenorrhea (22), abdominal pain (18%), vaginal protrusion (4%). It shows that the most (85%) of the participants had myomectomy, 7% had hysterectomy while 4% were managed conservatively. 40% had Intramural, subserous and submucous followed by 25% Intramural only in terms of location. Postoperative anemia was seen in 16% of the subjects. Wound infection and post operation pyrexia were reported in 1% and 2% of the participants. Conclusion: Uterine fibroids are a common gynaecological condition in our environment. They usually occur in women of low parity and in their third or fourth decades of life. Surgery is the commonest mode of treatment, with abdominal myomectomy being the most frequent surgical intervention. This study showed that endoscopy is increasingly being employed in the management of fibroid. Pyrexia, anaemia and wound infection ranked as the commonest postoperative morbidities in our study. The use of minimal invasive procedures for its treatment will reduce the postoperative complications. It is advocated that women should be sensitized to report early for assessment of such illnesses.

DOI: 10.5281/zenodo.12735885

Aim: The aim of the present study was to compare the incidence of post dural puncture headache (PDPH) with or without intrathecal fentanyl in parturients undergoing lower segment cesarean section (LSCS). Methods: The present study was conducted in the Department of obstetrics and Gynaecology, Gauri Devi Institute of Medical Science & Hospital, Durgapur, West Bengal, India for one year. A total of 200 patients aged between 18 to 45 years of ASA grade II who underwent elective or emergency caesarean section were selected for the study and randomly allocated into either group. Results: The demographic profile i.e. mean age, weight, height and BMI were comparable in both the groups. The demographic profile was comparable in both the groups. The incidence of PDPH was 1% with fentanyl group and 4% with control group. The PDPH was mild in fentanyl group and moderate in control group. Backache, vertigo, nausea and vomiting each had an incidence of 1% in the fentanyl group as compared to 3% cases of backache, nausea and vomiting in control group. Pruritus was not reported in either of the groups. Conclusion: We concluded that the incidence and severity of post dural puncture headache (PDPH) was decreased with intrathecal fentanyl (25µg) in caesarean section in a non-significant manner. Though the severity increased in the control group but it was also insignificant. Although an overall protective effect of neuraxial fentanyl was not observed in this study, its role as prevention for PDPH in caesarean section remains to be investigated.

DOI: 10.5281/zenodo.12735891

Aim: The aim of the present study was to analyze the risk factors and vital role of mothers in prevention of nutritional anemia in the early childhood. Methods: This study was carried out at Government Medical College and Hospital Bettiah, West Champaran, Bihar, India and children aged 6 months–2 years admitted at the hospital during the study period were included. Any child with chronic disorders such as hemoglobinopathies, hemolytic anemia, and treated for anemia and those on any immunosuppressants such as steroids and biologics were excluded as an indirect measure to eliminate anemia of chronic disease. An informed written consent was obtained from the mothers of these children. A total of 200 participants were included. Results: Majority of the mothers were aware that neural development of child could be affected by anemia. Maternal knowledge regarding cow’s milk was poor and had a faulty belief that it increases iron absorption, whereas 16% were unaware of the relationship between cow’s milk and anemia. Many mothers believed anemia to occur only in children on vegetarian diet. Around 75% mothers recognized green leaves and 70% women recognized jaggery to be enriched with iron. Although 78% identified vitamin C containing fruits, many were not aware of its vital role in increasing the iron absorption. Mothers of children with more than one sibling had a relatively greater incidence of “poor” knowledge unlike mothers of children with single or no sibling. This implies that those with “poor” knowledge were also unaware of the importance of birth spacing. Conclusion: Recognizing the causative factors plays an essential role in preventing iron deficiency anemia (IDA). Exclusive breastfeeding must be promoted, along with avoiding excessive cow’s milk intake. Intervening at the right period with age-appropriate foods becomes a necessity. Maternal illiteracy has a positive correlation with anemia in infants. Improving maternal awareness by the physicians will pave the road toward a nation free from anemia.

DOI: 10.5281/zenodo.12735899

Aim: The aim of the present study was to assess the prevalence of obesity and overweight and to find out predictors for obesity. Methods: This cross-sectional study was carried out among adult individuals (aged 18-55 years) in the Department of Community Medicine for period of 12 months. All the individuals were residents of the rural and urban areas. Results: Most of the participants were males 200 (66.66%) and 100 (33.34%) were female. Out of total study subject 264 (88%) were resident of urban area and 36 (12%) from rural area. Maximum number of participants was non worker 125 (41.66%). Socioeconomic status assesses most of them from upper class category 170 (56.66%). The age specific prevalence of obesity 55 (18.33%) in 36-55 years and 46 (15.33%) in 18-35 years, however the prevalence of and overweight was 35 (11.66%) in 18-35 years and 20 (6.66%) in 36-55 years. it was found to be statistically significant. Prevalence of obesity and overweight among males was 76 (25.33%) and 47 (15.66%) and among females 28 (9.33%) and 14 (3.33%) respectively. it was found to be statistically significant. The mean weight and height were highly significant among both the sexes. (p<0.001) slightly greater mean of BMI was found among males (23.7±3.14 kg/m2) as compare to females (22.8±3.67 kg/m2). The overall prevalence obesity (≥25 kg/m2) was 105 (35%) and overweight (≥23 kg/m2) 58 (16.66%). The prevalence of obesity was observed higher among males 75 (25%) and 30 (10%) female. However, the prevalence of overweight was also higher among the males 40 (13.33%) than female 10 (3.33%). Conclusion: Suitable health care strategy and intervention programs along with health education are needed to reduce the impact.  These results suggested that overweight and obesity may be serious public health problems. It is important to carry out further studies in order to explore the potential relationship between overweight and obesity on the one hand, and behavioral variables, such as smoking and alcohol consumption, on the other.

DOI: 10.5281/zenodo.12735903

Aim: The aim of the present study was to assess the orthopaedic management of club foot at tertiary health care centre. Methods: This was cross-sectional study carried out in the Department of Orthopaedic at PMCH, Patna with idiopathic club foot less than one year age presented to the Orthopaedic Department during the two-year were included into the study. In the three-year period there were 50 patients after written explained consent were enrolled to study. All necessary details of the patients were noted like age, sex, pre interventions modified Pirani score noted. Results: The majority of the patients were in the age group of 0-3 (months) were 40%, followed by 3-6 were 32%, 6-9 were 18%, 9-12 were 10%. The majority of the patients were Female i.e. 64% and Male were 36%. In all the age groups the Post treatment Pirani score significantly differed as compared to pre-treatment score i.e. 0-3 were 5.32 ±2.18 and 1.55 ± 1.035 (t=8.82,df=72,p<0.01); 3-6 were 5.48± 0.82 and 1.58 ± 1.32 (t=12.58,df=56,p<0.001); 6-9 were 5.75 ± 2.15 and 2.18±0.96 (t=9.91df=26,p<0.05); 9-12 were 5.36 ± 1.24 and 1.86 ± 1.34 (t=10.20,df=24,p<0.001) were statistically significant. Conclusion: According to the results of our investigation, the ponsetti approach was very efficient in the management of idiopathic club foot, as measured by the Pirani score for club foot assessment almost all the patients were doing well with this treatment.

DOI: 10.5281/zenodo.12735910

Aim: The aim of the present study was to record the drug used for postoperative pain in elective laparotomies and to determine the effectiveness of multimodal analgesics used. Material & Methods: A prospective observational study for a period of 15 months in 100 patients who underwent elective laparotomies from the Department of General Surgery. Results: Out of 100 patients, 40 were female and 60 were male. They were 20–70 years old when they had elective laparotomies.40 patients were 40-50. Recorded were 20 surgical kinds. Open appendectomy and open cholecystectomy were the most prevalent surgeries in our research. Four forms of anesthesia were employed. General anesthesia with transverse plane block was most prevalent, followed by quadratus lumborum block. Combination analgesia was most prevalent. Injection tramadol 50 mg in 100 ml normal saline with continuous epidural bupivacaine, then diclofenac AQ 75 mg in 100 ml N.S. On day two, 52 patients switched to oral analgesics, mostly aceclofenac, paracetamol, and serratiopeptidase. All 100 patients had NRS scores on postoperative days 1, 2, and 3. Pain decreased from post-operative days 1-3 with analgesics. Conclusion: Utilizing dual analgesia proved to be a superior approach for managing pain compared to using a single painkiller. As a result of the use of various multimodal analgesics at different institutions, patients have reported varying levels of pain. Therefore, it is necessary to establish a standardized protocol for the most effective pain management technique.

DOI: 10.5281/zenodo.12735913

Aim: To examine the functional result of arthroscopic suture pull-out repair for displaced tibial spine avulsion fractures. Materials and Methods: This retrospective study was done in the department of Orthopaedics, Jannayak Karpoori Thakur Medical College and Hospital, Madhepura, Bihar, India for 12 months. 30 Patients with Pain and disability resulting from tibial spine avulsion inactive patient type II, type III and type IV, Age: < 60 years, the patient must able to use crutches / walker, The patient should have sufficient muscle strength and motivation to carry out a rehabilitation program, Closed injuries and Ability to understand the content of the subject information / informed consent form and to be willing to participate in the clinical investigation were included in this study. Patients with Type I tibial spine avulsion according to Meyers and McKeever classification, Associated with Proximal tibia fracture, Associated with Multiple ligaments injuries, Present or past history of inflammatory arthritis, Open injuries and Previous operated or infected knee for any reason were excluded from the study. Results: The mean age of subjects was 27.13 ± 10.298 years. The majority of subjects were in the age group 21 to 30 years (40%). In the study, 90% were males and 10% were females. In the study 6.7% had Fall from the cycle, 73.3% had fallen from Motorbike and 20% had Fall While Playing. The study Status of Physis in 66.7% was closed and open in 33.3%. In the study 70% had Type III and 30% had Type IV Meyers and McKeever’s classification. At 3 months, the mean Post op Lysholm score was 86.07 ± 1.760, at 6 months was 97.87 ± 2.047 and at 12 months was 98.17 ± 1.599. There was a significant increase in Post op Lysholm score at 6 months and 12 months. At 12 months When compared to 6 months Post op Lysholm score, there was no significant increase in Post op Lysholm score. In the study 6.7% had Post Op Knee Stiffness. Conclusion: The goal of the treatment should be an anatomic reduction to restore joint congruity. This technique of arthroscopic fixation with trans osseous sutures is very useful in treating these fractures. Approaching these injuries arthroscopically allows for complete inspection of the joint and dealing with associated injuries, early mobilization, fast rehabilitation, and decreased hospital stay.

Aim: The aim of the present study was to evaluate the completeness of vaccination in children of age 12 months to 23 months age and reasons of dropouts in tertiary care. Methods: The present study was conducted in the Department of Paediatrics, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India during the study period of 2 years. The study was conducted on children of age group 12- 23 months. 500 subjects were included in the study. Results: Majority of the patients who were fully immunized had age between 18-20 months. Partially immunized majority had age between 18-20 months. Nonimmunization was equally distributed among the age group of 12-14, 15-17 and 18-20 months. Full immunization was more common among males compared to females. Partial immunization was prevalent in males compared to females. Majority of the fully immunized children belong to urban class III class followed by urban class II class. Of the children who were partially immunized, majority were from the urban class III class followed by urban class II. Of the non-immunized children majority were from the rural class IV and rural class III. The distribution of socioeconomic with Immunization status of the child was highly significant as revealed by the p value of 0.001 for rural are and <0.001 for the urban area. Conclusion: The consistent efforts needed in slum population so that immunized coverage could be achieved to desired level. Regular follow up of children in the vulnerable age group and education of mothers regarding the immunization schedule will go a long way in reducing the dropout rate and ensuring full immunization. Improvement in the income of the poor, proper health services and quality environment are more important in reducing the morbidity and mortality in slums.

Aim: The aim of the present study was to assess the etiological factors and preventive measures of second hip fractures. Methods: The study analysis include patients attended our out-patient Orthopaedics Department, Netaji Subhas medical college and Hospital, Bihta, Patna, Bihar, India. We verified all the records of the patients during these 8 Months. Results: During our 3 years retrospective study, total 680 hip fractures were admitted. Second hip fractures are 100 i.e., 14.70%. Males were 30, Females were 70. The average age of persons of first hip fractures was 55-65 yrs, and average age of persons with second hip fracture 60-80 yrs. The average mean time of duration from injury to time of surgery was 6 days. The duration of hospitalization is from 15-28 days, Mean: 21 days. The etiological factors are evaluated in these patients. Older age was associated with an increased risk of second hip fractures after adjusting for sex, Low BMI, and high functional status were also associated with increased risk of second hip fractures in the age and sex adjust analysis. High functioning persons have more than twice the risk for second hip fractures compared with moderate functioning persons. The sex, falls, stroke, BMI, dementia, and old-age home residence were not associated with the risk of second hip fracture in the age and sex associated models. Conclusion: Treatment with vitamin-D is recommended for all the persons with hip fractures in an effort to improve the bone mineral density and to reduce the risk of fractures during falls. Clinicians should give special attention to age and functional status at the time of first hip fractures, when determining whether additional therapies are appropriate in an effort to reduce second hip fracture.

Aim: Investigate the cardiovascular reactions to a six-week isometric exercise regimen in first-year medical students. Materials and Methods: This one-year case-control research was undertaken at the Department of Physiology, SKMCH, Muzaffarpur, Bihar, India, on 100 untrained first-year medical students. The Handgrip Dynamometer was used for isometric exercise. The research group attended five weekly training sessions for six weeks. Heart rate and blood pressure were measured again for the study and control groups after six weeks of training. Baseline data was measured using the same method. After training, handgrip exercise tests at 30% MVC until exhaustion were performed under the identical settings as baseline testing. Results: The initial heart rate and blood pressure data were similar in both groups, suggesting that the groups were evenly matched at the beginning of the trial. The research group saw a drop in heart rate from an initial value of 72.3 ± 5.2 bpm to 68.1 ± 4.8 bpm, resulting in a mean change of -4.2 ± 1.9 bpm (p < 0.001). The systolic blood pressure reduced from 118.5 ± 8.2 mmHg to 112.3 ± 7.6 mmHg, with a mean reduction of -6.2 ± 2.4 mmHg (p < 0.001). Similarly, the diastolic blood pressure declined from 76.4 ± 5.1 mmHg to 71.2 ± 4.7 mmHg, with a mean decrease of -5.2 ± 2.1 mmHg (p < 0.001). Conclusion: The six-week isometric exercise training programme improved cardiovascular markers in study group members, showing that such programmes may improve cardiovascular health.

Aim: The aim of the present study was to evaluate the pattern of distribution of ligamental and mensical injuries using Magnetic Resonance Imaging. Methods: A total number of 50 cases with internal derangement of knee who underwent MR imaging of knee in the Department of Radiodiagnosis, Indira Gandhi Institute of Medical science, Patna, Bihar, India, served as the subjects for this study. Results: Majority of the patients belonged to 21-40 years of age. 42% patients had ACL tear, 28% had joint effusion and 20% had meniscus. 8 patients had Posterior horn medial meniscus followed by Posterior horn lateral meniscus. Conclusion: MRI is a noninvasive, useful, radiation free and reliable diagnostic tool for evaluating knee injury and it should be done in suspected menisci and ligamentous injury. Duration of symptoms should also be taken into account as patients with longstanding symptoms are more likely to find pathology in MRI Knee.

Aim: To investigate the effects of maternal anemia on pregnant women and the outcomes of pregnancy. Material and Methods: This retrospective record-based study included 675 pregnant women admitted in labor room in Department of Obstetrics & Gynaecology Jawaharlal Nehru medical college & Hospital, Bhagalpur, Bihar, India. Data collection was done from the records maintained by hospital .All the subjects were classified according to WHO criteria were hemoglobin estimation done by Sahli’s method and treatment details i.e oral iron or intravenous iron or blood transfusion, the modes of delivery, maternal and perinatal outcome were collected from records. Results: Out of total 1503 delivery during study period 675 patients were found to be anaemic which gives incidence of 44.5%. Most the pregnant women were moderately anaemic i.e. 51.96% followed by mild (44.1%) and severe (4%) respectively. Among the pregnant women most common type of anaemia is Iron deficiency anaemia (69.65%) followed by Sickle cell anaemia (15.4%) and other cause (11.9%). In the present study, 90.4% of subject received oral iron, 26.9% received parenteral iron and 19.4% received blood transfusion. The anaemia was found to be more common between 21 to 30 years of age group i.e. 69.5%, followed by women less than 20 years of age (18.1%) and most of them were second gravid i.e. 45%. Most common found to be low birth weight (25.2%) followed by premature delivery (22.96%). Conclusion: Anemia is usually ignored in pregnant females in our rural population and poor communities of our cities, but this is a serious alarm for both mother and the baby and needs to be dealt on priority basis.

Aim: The aim of the present study was to compare the effect of inj. Rocuronium with priming dose and inj. Rocuronium without priming on intubating conditions and onset time of intubation with respect to rocuronium as bolus. Methods: The present study was single-center study, conducted in Department of Anaesthesiology, Anugrah Narayan Magadh Medical College and Hospital, Gaya ,Bihar, India from February 2019 to Dec 2021.  50 patients were included in the study. Results: We compared mean age, weight, gender and ASA grade between group C and group P and difference was statistically not significant (p value >0.05). We compared preoperatively baseline mean HR, mean HR at induction, mean HR at intubation, at 1 minute after intubation and at 5 minute after intubation between group C and group P, the difference between two groups was statistically insignificant. We compared mean MAP preoperatively baseline, at induction, at intubation, mean HR at 1 minute after intubation and mean HR at 5 minute after intubation between group C and group P, the difference between two groups was statistically insignificant. We compared mean SPO2 preoperatively baseline, at induction, at intubation, mean HR at 1 minute after intubation and mean HR at 5 minute after intubation between group C and group P, the difference between two groups was statistically insignificant. In group C mean Onset Time of Intubation was 93.36 ± 6.24 seconds, while in group P it was 57.00 ± 6.74 seconds, so the difference between the groups on the basis of OTI was statistically highly significant. Conclusion: Rocuronium with priming would be an excellent alternative to succinylcholine, whenever fast induction will be needed. Intubating conditions were good to excellent and comparable in both rocuronium with priming and without priming. NMT monitoring is a useful tool for indicating the clinically acceptable paralysis.

Aim: The objective of the present study was to evaluate the different clinical manifestations and outcome of TBM in relation to BCG vaccinated, non-vaccinated and nutritional status of the children. Methods: The present study was conducted in the Department of Pediatrics, IGIMS, Patna, Bihar, India and 50 children with definite or probable tuberculous meningitis (TBM) were included. Permission for the study was obtained from the College authorities prior to commencement. Duration of the study was one year. Local cultural values and ideas were respected. Confidentiality was assured. The nature and purpose of the survey were explained in detail to them in their own language. Results: The common symptoms observed were fever 90%, altered sensorium 62%, vomiting 60% and convulsions 56%. Other symptoms observed were cough, headache. The common signs present were GCS below 10 in 57% of cases, meningeal irritation in 64%, and McEvan’s sign in 60%. Also seen were hemiparesis 43%, CN palsy 43%, fundal changes25%. All signs were significantly more common in malnourished children except GCS10-14. Tuberculomas, conscious variety and focal involvements are seen more commonly in well-nourished group among vaccinated patients. All atypical features of TBM are more common in well-nourished group when compared to malnourished children except encephalopathy. Other typical features found were Ophthalmoplegia (3), brain stem syndromes (2), serous meningitis (2), conscious type (3), encephalopathy (2) and focal infarcts in 4 cases. Conclusion: It was concluded that clinical patterns in TBM vary according to nutritional status of the child and severe malnutrition carry very poor prognosis. Knowing different clinical patterns of the disease helps in early prognosis and thus in preventing deaths due to TBM among children.

Aim: To evaluate the efficacy of pregabalin in the treatment of painful diabetic neuropathy. Materials and Methods: The present study was conducted in the Department of General Medicine, Jannayak Karpoori Thakur Medical College and Hospital Madhepura,, Bihar, India for 10months, and twenty patients were recruited with diabetes and painful distal symmetrical sensorimotor polyneuropathy for 1 to 5 years were potentially eligible to enter into the study. Results: Efficacy results indicate that pregabalin 600 mg/day significantly decreased mean pain score to 4.3 (vs 5.6 for placebo, P _ .0002) and increased the proportion of patients who had a >50% decrease from baseline pain (39% vs 15% for placebo, P _ .002). Pregabalin also significantly reduced sleep interference, past week and present pain intensity, sensory and affective pain scores, and bodily pain and decreased by >50% the number of patients describing their pain as gnawing, sickening, fearful, and punishing–cruel. More patients receiving pregabalin 600 mg/day than placebo showed improvement, as rated on the Clinical and Patient Global Impression of Change scales, 73% vs 45% and 85% vs 47%, respectively. Pregabalin 150 mg/day was essentially no different from placebo. Dizziness was the most common side effect.

Conclusion: These study results show pregabalin 600 mg/day to be safe and effective in reducing the pain and other associated symptoms of painful diabetic neuropathy.

Aim: The aim of the present study was to compare prostate size with post void residual urine volume, both measured by transabdominal ultrasound. Material & Methods: A retrospective study was carried out in the Department of Surgery collaboration with Department of Radio-Diagnosis JLNMCH, Bhagalpur, Bihar, India from March 2022 to February 2023 All the male patients above 40 years of age with lower urinary tract symptoms visiting the hospital were included in the study. Present study was performed on 50 patients. Results: 61-70 years age group was most common (42%), followed by 71-80 years age group (24%) and >80 years age group (18%). Most patients had 100-200 ml pre void urine volume (56%), followed by 50-100 ml (20%) and 201- 300 ml (14%). Post-void urine volume was less than 60 ml in majority of patients (64%). In other patients post-void urine volumes were 61-80 ml (10%), 81-100 ml (6%), 101-120 ml (8%), 120- 400 ml (6%) and more than 400 ml (6%). We assessed relationship of post void residual urine volume with prostate volume. Increase in post void residual volume with was noted with increasing prostate size. A statistically significant correlation was present between post void residual volume and prostate volume. Conclusion: The present study concluded that trans-abdominal estimation of prostate size and postvoid residual of urine are important in preliminary evaluation of benign prostatic hyperplasia patients. Patients with advanced symptoms may require further evaluation.

Aim: A comparative analysis of the efficacy of dynamic compression plating and interlock nailing in the treatment of humeral shaft fractures. Materials and Methods: This study was conducted in the department of Orthopaedics, NMCH, Patna, Bihar, India for 12 months. The study was planned to compare the results of interlock nailing of humerus to a relatively well-established technique of dynamic compression plating. Total 44 patients with acute humerus shaft fracture in adults without prior disease were selected retrospectively and prospectively for the study. Twenty-two patients were treated by dynamic compression plating and 22 by interlock nailing. Functional outcome was determined using American Shoulder and Elbow Surgeon’s Score. Results: There were 33 (75%) close fractures and 11 (25%) open fractures. In our study, there were 11 open fractures, type II fractures were 7 in number, followed by type III (3 cases) and type I (one case) open fracture. Radial nerve palsy was associated with 2 cases of type II open fractures and one case of type IIIa fracture. There were 12 cases (27.2%) of preoperative radial nerve palsy. Out of 12 cases, 11 had recovered completely. There was no iatrogenic nerve palsy seen in our study. Out of 9 cases explored nerve was found to be intact in 8cases and contused in one case. Most of cases (7) of radial nerve palsy were associated with fracture of middle third shaft humerus. Majority of cases of fracture shaft humerus were associated with head injury followed by lower extremity fracture and ipsilateral forearm bone fracture. Majority of patients (40.9%) were operated within 6hours after injury. Anterolateral approach was used in 16 patients with dynamic compression plating. Posterior approach was used in 6 cases of lower third shaft fracture. Conclusions: For patients requiring surgical treatment of humeral shaft fractures, both dynamic compression plating and interlock nailing provide predictable methods for achieving fracture stabilization and ultimate healing. Plating requires extensive dissection, more blood loss and duration of surgery as compared to nailing.

Aim: The aim of the present study was to assess the association of Proteinuria with HbA1C in Diabetes Mellitus. Methods: The present study was conducted in the Department of Pathology, Patna Medical College and Hospital, Patna, Bihar, India for one  year and 50 patients were included in the study. Results: The mean age of the patients were 46.44±6.34 years and there was male predominance. The association between HbA1C and proteinuria showed non-significant results statistically till 7-7.5 HbA1C but >7.5 HbA1C showed statistical significant result. Conclusion: A Strong association was found between HbA1C and Proteinuria.

Aim: The aim of the present study was to find out the incidence of maternal complications, perinatal mortality and morbidity in postdated pregnancies. Methods: The study was conducted  from the Department of Obstetrics and Gynecology at Patna Medical College and Hospital, Patna, Bihar, India from October 2017 to July 2018. Two groups of 200 women from the maternity ward and birth room were chosen for the study: the Control group had a gestational age between 37 and 40 weeks, and the Study group had a gestational age of 40 weeks or more. Results: In both instances (45%) and controls (52%), the majority of patients were 25-30 years old. Most research patients (80%) were 40-41 weeks gestational, while all controls were 37-40 weeks. 65% of study participants and 55% of control women were primigravida. The LSCS rate was 30%, greater than 15% in the control group. In the study group, 13% of deliveries were instrumental, compared to 7% in the control group. The research group’s most prevalent LSCS indication was acute fetal distress with meconium-stained fluid, followed by cephalopelvic disproportion. The control group most often had non-progressing labor, severe fetal distress, and non-reactive CTG. Study group mothers had more LSCS, PPH, and sepsis than control group mothers. This research found 17% of newborns with asphyxia, compared to 7% in the control group. 15% of study babies were admitted to the NICU, compared to 10% of controls. The study group had 3% intrauterine fatalities compared to none in the control group. Conclusion: Obstetricians still face postdated pregnancies. Watchful expectation or induction for postdated labour are options. Our study found that postdated pregnancies increase LSCS and instrumental deliveries.

Aim: The aim of this study was to compare the effect of ingestion of clear water and glucose water over 10 hours NPO in elective laparoscopic cholecystectomy surgery. Material & Methods: A retrospective study was conducted in Department of Anaesthesia and Critical Care, A. N. Magadh Medical College and Hospital, Gaya, Bihar, India from October 2020 to September 2021. The study included ASA I-II patients undergoing laparoscopic cholecystectomy surgery. Patients undergoing general anaesthesia were included in the study. A total of 90 patients were included and 30 patients each were randomly assigned to one of the 3 groups. Results: There was no significant difference between the groups with regard to weight, age and sex. Patients who had 200 ml of clear water in Group B had lesser variation in serum K+ level and serum lactate level than that of Group A which was statistically significant. Patients who had 200 ml of glucose water in Group C had lesser variation in serum K+ level, serum lactate level, RBS level and no episode of hypoglycaemia noticed as compared to Group A, which was statistically significant. Patients in Group C had lesser variation in serum lactate level, RBS level and no episode of hypoglycaemia recorded as compared to Group B which was statistically significant. Conclusion: We concluded that it is safe to conduct general anaesthesia in patients who have ingested 150 ml of water 2 h prior to surgery. Prolonged withholding of oral fluid does not decrease gastric fluid volume and pH.

Aim: The aim of the present study was to determine the effect of acute bout of moderate exercise in cognitive processing in young women during different phases of menstrual cycle. Methods: It was a retrospective study conducted on 100 young, normally menstruating women with normal auditory capability in the Department of Physiology, Jawaharlal Nehru Medical College, Bhagalpur, Bihar, India. The study was conducted in a clinical physiology laboratory. Results: There were significant changes in all cardiovascular parameters in post-exercise session in comparison to pre-exercise session in both phases of menstrual cycle. The P300 latency showed significant decrease in postexercise session when recorded at Cz as well as Pz position in both phases of menstrual cycle. However, P300 latency recorded at Fz position displayed no significant change at post- exercise session in comparison to pre-exercise session during both phases of menstrual cycle. Conclusion: The present study concluded that an acute bout of moderate exercise caused significant decrease in latency of P300 ERP in the participants during both phases of menstrual cycle. That means even acute bout of moderate exercise enhances cognitive functioning of the individual.

Aim: To study of lateral closure wedge osteotomy to correct cubitus varus deformity in pediatric patients. Material and Methods: This study was conducted in the Department of Orthopedics, SKMCH, Muzaffarpur, Bihar, Patna. The medical records of patients were retrospectively reviewed.  all patients’ guardians were obtained for the study publication of identifying information in an online open-access publication. The inclusion criteria were as follows: surgery performed over 6 months after the diagnosis of SHFs, difference in flexion angles of the affected and unaffected limbs of > 15°, and recovery of elbow function pre-ostomy including extension and flexion with a full range of movement. Results: The mean preoperative HEW angle in the affected elbow was 20.38° ± 2.14°, while the postoperative HEW angle was 11.95° ± 2.15°. All the osteotomies had healed by 5–8 weeks after surgery (average 6.04 ± 1.09 weeks). The mean HEW angle in the normal elbow was 11.55° ± 2.65° of valgus, and the mean correction obtained was 32.33° ± 2.83°. According to the MEPI score assessment, 19 of the 21 patients had an excellent out- come, and two had a good outcome at the final follow- up at 21.6 ± 4.8 months. None of the patients showed evidence of neurovascular injury, including injury in the radial and ulnar nerves. None of the patients complained of prominence of the lateral humerus. Two patients complained of conspicuous scars; however, no further cosmetic surgery was performed. The range of motion was 135.0° preoperatively and 133.7° postoperatively, showing no significant difference (p = 0.326). Conclusion: In conclusion, our study results demonstrated that the Paley’s principles regarding lateral closing wedge osteotomy for cubitus varus deformity in children are practical, effective, and reliable to treat cubitus varus.

Aim: The aim of the present study was to assess the thyroid function status among the transfusion dependent thalassemic children. Material & Methods: This was a cross-sectional study conducted in the Department of Paediatrics, Patna medical College and Hospital, Patna, Bihar, India for a period of 18 months. A total number of 118 children with transfusion dependent thalassemia who met the inclusion and exclusion criteria were studied. Demographic data as well as history of blood transfusion and chelation therapy were collected. Thyroid function and iron load status were evaluated by measuring serum FT4, TSH and ferritin levels. Results: Among them 110 (93.22) were beta thalassemia major and 10 (8.48) were Hb E beta thalassemia. Total male was 68 (57.63) and female were 50 (42.37). Mean weight and height were 31.69±9.41 kg and 130.5±12.4 cm respectively. Median weight for age Z score and median height for age Z score were -1.86 (-0.82 to -4.07) and -2.96 (-0.86 to -4.96) respectively. Mean BMI was 19.4±3.42 kg/m². The mean age at first diagnosis was 17.3 (±7.65) months, mean age at first blood transfusion was 18.22±7.53 months, mean total duration of disease was 10.90±4.02 years, and mean total number of blood transfusion was 81.7±33.4 units. History of thalassemia in other family members was found in 30 patients (25.42%). Euthyroid patients were 108 (91.52%) and hypothyroid patients were 10 (8.48%). Among hypothyroid patients 8 (6.78%) patients were compensated and 2 (1.70%) was uncompensated hypothyroidism. Significant association was found between higher serum ferritin level (≥2000 ng/ml) and hypothyroidism in thalassemia patients (p<0.05). Conclusion: In the present study we documented hypothyroidism in transfusion dependent thalassemic children. Among them majority were compensated hypothyroidism. Higher number of blood transfusion and ferritin level ≥2000 ng/dl was found significantly associated with the development of hypothyroidism in thalassemic patients.

Aim: The aim of the present study was to compare LMA-Supreme and I-Gel in terms of ease of insertion oropharyngeal leak pressure, hemodynamic response and postoperative complications. Methods: Our study was a retrospective Single Blinded Study conducted in Department of Anesthesiology, Shree Narayan Medical Institute and Hospital, Saharsa, Bihar,  India for one year. 100 patients undergoing short elective surgical procedures of duration less than 60 minutes under general anesthesia with spontaneous ventilation were enrolled in the study. Results: The mean age in Group-I and Group-S was 32.63 ± 12.35 years and 34.90 ± 12.49 years respectively and this difference was not statistically significant (P>0.05). There was no significant difference in the proportions of gender in both the groups (P>0.05). Both the groups were comparable in terms of height, weight, body mass index and ASA status. Single attempt success rate were Group-S (84%) and Group-I (92%) (P>0.05, statistically non-significant). Statistically significant difference was found in the mean insertion time of LMA-Supreme (24.06 ± 3.32 seconds) vs I-Gel group (18.67± 4.51 seconds) (P<0.05). The mean oropharyngeal leak pressure in Group-I (25.21 ± 2.73 cmH2O) was significantly more than and Group-S (22.93 ± 1.96 cmH2O) (P<0.05). Hemodynamic parameters were comparable. Immediate complications were 2 cases of blood on device and 2 cases of laryngospasm in Group-I and 7 cases of blood on device and no cases of laryngospasm in Group-S. 1 hour post operatively, we found 2 cases with sore throat and 2 cases with dysphagia in Group-I and 7 cases of sore throat and no cases of dysphagia in Group-S. There were no complications 24 hours post operatively in both the groups (P>0.05, statistically non- significant). Conclusion: The present study concluded that both the devices are comparable in terms of ease of insertion in anesthetized spontaneously breathing patients in short surgical procedures. I-Gel can be preferred over LMA-Supreme because of its faster insertion time, better oropharyngeal leak pressure and lesser postoperative complications.

Aim: To compare the effectiveness of a 50% alcohol solution and methylprednisolone for celiac plexus block in patients suffering from persistent abdominal pain, with the goal of managing their discomfort. Materials and Methods: This study was conducted in the Department of Anesthesia, Patna Medical College and Hospital, Patna, Bihar, India for one year. A Retrospective study was conducted on patients with chronic abdominal pain which included patients of ASA physical status III and IV of both the sexes, aged between 35-75yrs suffering from chronic pancreatitis and carcinomas involving one of the following: gall bladder carcinoma, pancreatic carcinoma, hepatic carcinoma presenting with chronic upper abdominal pain who were unresponsive to NSAIDS, opioids and were hence managed with coeliac plexus block for pain management. The Patients were divided into two groups: Group A: Received 50% alcohol as adjuvant with 1% lignocaine and Group B: Received 80mg Methylprednisolone, as adjuvant with 1% lignocaine. Results: Initial pain scores at the end of 1^st month was same in both the groups. But the pain scores in the next subsequent months at the end of 2^nd, 3^rd.4^th, 5^th and 6^th moths were less in group A when compared to Group B. The statistical analysis was carried out using Mann Whitney U test. The U value is 5. The critical value of U at p< 0.05 is 5 and hence the result is significant with P value of <0.05. Conclusion: We concluded that the Coeliac plexus block performed using Alcohol 50% had less pain scores and is more efficacious than coeliac plexus block performed using 80mg Methylprednisolone in chronic pain management.

Aim: To investigate the predictive significance of glycosylated haemoglobin (HbA1C) in acute coronary syndrome among the population of Bihar. Material and Methods: This hospital-based retrospective study was conducted in the at Department of Medicine, JNKTMCH, Madhepura, Bihar, India for one year. A total of 100 patients who presented with Acute Coronary Syndrome (ACS) were enrolled in this study. Patients were selected based on their presentation with ACS symptoms such as chest pain and were evaluated upon admission. Results: The mean age was 62.36±9.89 years. All the patients presented with chest pain radiating to left arm /radiating to back (100%). The next common complaint was breathlessness (57%) and vomiting and profuse sweating (45%). Hypertension, tobacco/Misri chewing and smoking were the risk factors noted in 62%, 18% and 17% of the patients respectively. Fasting blood sugar levels were between 100 to 125 mg/dL in majority of the patients while ≥126 mg/dL were note in 11% of the patients. The mean fasting blood sugar levels were 107.64±10.60 mg/dl.Post prandial blood sugar levels were noted as ≥140 mg/dL in majority of the patients. The mean post prandial blood sugar levels were 174.62±31.88 mg/Dl HbA1c levels were ≥6.5 percent in majority of the patients (68%).The mean HbA1c levels were 6.62±0.73 percent. Troponin I levels were raised among 99% of the patients. Based on ECG, majority of the patients were diagnosed with STEMI (85%), followed by NSTEMI (14%). Based on the 2D echocardiography most of the patients had anterior wall LW HK. Majority of the patients were diagnosed with double vessel disease while single vessel disease was noted in 16% of the patients. Conclusion: Based on the above results it may be concluded that, admission glycated haemoglobin levels are associated with in hospital adverse events as well as outcome while outcome and adverse events were independent of blood sugar levels that is, random, fasting and post prandial blood sugar levels hence, blood sugar levels have limited prognostic value in patient with ACS.

Aim: The aim of the present study was to evaluate prevalence of Pseudoexfoliation Syndrome and its ocular manifestations. Methods: The present study was conducted in the Department of Ophthalmology, NMCH, Patna, Bihar, India. All cases of cataract getting admitted for cataract surgery were included. A total of 100 cases with PES of Cataract surgeries were included. Duration of study was 12 months. Results: The ages of the 100 patients in this study was between 55 and 85 years. Out of these 18 (18%) were in 55-65 years age group, 58 (58%) patients were in 66-75 years age group and 24 (24%) patients in were in 76-85 years age group. 55 (55%) were male and 45 (45%) were females. 65 cases had <6 mm pupillary dilatation while 35 had >6 mm dilatation. None of the pupils dilated beyond 7mm. 60% patients had poorly dilating pupil followed by retained lens matter. 60% had Post-op visual acuity 6/18- 6/36 followed by 32% 6/6-6/12. Conclusion: Inadequate pupil dilatation, and zonular weakness are the common difficulties associated with small incision or Phacoemulcification cataract surgery in eyes with pseudoexfoliation syndrome. Careful surgical evaluation and communication with the patient regarding increased surgical risks should be given in patients with Pseudoexfoliation syndrome. Early diagnosis, detailed ocular examination, beforehand preparedness for and management of intraoperative surgical complications and postoperative outcome associated with pseudoexfoliation improves surgical outcomes.

Aim: The aim of the present study was to evaluate relationship between serum 25 (OH) vitamin D and insulin resistance in prediabetes. Methods: The present study was conducted in the Department of Medicine, Katihar Medical College and Hospital , Katihar, Bihar India for 1 year, and the sample selected was 70 diabetics, 60 pre-diabetes and 50 healthy control individuals. Results: Maximum pre-diabetics had serum 25(OH)D >30 ng/ml, diabetes 21-30, and control >30. In diabetes, pre-diabetes, and control subjects, BMI was 24.6 kg/m2, 25.5 kg/m2, and 23.7 kg/m2, waist circumference was 91.7 cm, 88.2 cm, and 86.4 cm, waist-height ratio was 0.84, 0.52, and 0.50, waist-hip ratio was 0.94, 0.90, and 0.86, LDL-C was 97.3 mg/dl, 106.4 mg/dl, and 98.6 mg/dl, HDL-C was 46.2 mg/dl, 48.4 mg/dl, and 49.6 mg/dl HbA1C levels were 7.3%, 6.5%, and 5.6%, with HOMA2-IR values of 2.52, 1.52, and 0.82, HOMA2-β values of 63.7, 82.6, and 86.4, and 25 (OH) D levels of 25.5, 24.2, and 22.8 ng/ml. A substantial difference was found (P<0.05). Both 1 hour and 2 hours PG blood glucose showed a strong positive connection with FBS (P< 0.05). Conclusion: Understanding the connection between vitamin D and diabetes is crucial. Insufficient levels of Vitamin-D exacerbated insulin resistance in persons diagnosed with prediabetes.

Aim: Utilizing diffusion tensor imaging to accurately map the white matter tracts in relation to brain malignancies. Materials and Methods: This cross‑sectional, prospective, hospital‑based study was conducted in the Department of Radio-diagnosis, Madhubani Medical College and Hospital, Madhubani, Bihar, India from Feb 2022 to January 2023. A total of 50 patients with brain tumours were evaluated. Informed consent was received from all patients or the participant’s parents or legal guardian and the studies were approved by the hospital’s Research Ethics Committee. They underwent conventional MRI supplanted by diffusion tensor imaging in Philips Achieva 3T scanner. DTI was performed using dual spin echo, a single shot, a pulsed gradient and an echo-planar imaging (EPI) sequences, single-shot spin echo, echo-planar imaging (EPI) and parallel imaging techniques to achieve motion-free and higher signal-to-noise ratio (SNR) DTI. Results: We found that mean FA value for displaced WMFT was 0.462 with standard deviation of 0.049 while mean ADC value was 0.721 with standard deviation of 0.112. In case of edematous fibers, we found that mean FA value was 0.414 with standard deviation of 0.044 while mean ADC value was 1.339 with standard deviation of 0.118. Infiltrated fibres showed mean FA value of 0.382 with standard deviation of 0.045. Mean ADC value for infiltrated fibers was 1.026 with standard deviation of 0.088. In case of disrupted fibers, we observed significant drop in FA value compared to normal contralateral side. Mean FA value for disrupted fibers was 0.290 with standard deviation of 0.055. However, ADC values for disrupted fibers were not strikingly different from that for infiltrated fibres. Mean ADC value for disrupted fibers was 1.025 with standard deviation of 0.085. Conclusion: The FA and ADC values of white matter fibre tracts affected by tumour and peritumoural oedema can be of assistance when evaluating the malignant potential, extent and operability of the tumour, even though the FA and ADC values cannot be associated with the specific histology of the tumour.

Aim: The aim of the present study was to assess level of serum ferritin in type 2 diabetes patients with good and poor glycemic control and also assessed the correlation between serum free iron concentrations with glycemic control. Methods: This study was retrospective type was conducted in the Department of Medicine, Mata Gujari Memorial Medical College, Kishanganj, Bihar, India from May 2018 to April 2019. Our institute is a tertiary care hospital. Study population was patients of type 2 diabetes mellites visiting outpatient department of our hospital. This study comprises 50 patients with type 2 diabetes mellitus (treated with hypoglycemic drugs), as cases and 50 patients, age and sex matched apparently healthy adults as a control group. Results: On comparison of serum ferritin levels between cases and controls it was found that the mean serum ferritin of diabetic population was 138.88± 64.95 ng/mL and that of control group was 60.92 ± 28.67 ng/mL (p value< 0.05). Serum ferritin of case group is therefore significantly higher than the control group. Similarly, BMI, fasting blood glucose (mg/dl) and glycated hemoglobin (HbA1C) values were significantly higher in diabetic group as compared to control group. We compared serum ferritin values with HbA1C values in diabetic patients. Increase in serum ferritin levels was noted with increasing values of HbA1C. The correlation between glycated hemoglobin and serum ferritin was done by Pearson correlation test and it showed a significantly positive correlation (r=0.507) with serum ferritin. Conclusion: In present study, we noted a positive correlation between serum ferritin levels and increased HbA1c reflecting poor glycemic control. This highlights the need for strict glycemic control in these subjects. Further studies are needed to verify the importance of screening of hyper ferritin in type 2 diabetic patients and to define cut-off level of serum ferritin for possible early detection and subsequent prevention or delaying of impaired glucose tolerance and diabetes in those participants.

Aim: The aim of the present was to assess the risk factors in patients with postpartum hemorrhage at a tertiary hospital. Methods: The present study was hospital based, prospective, observational study, conducted in the Department of Obstetrics and Gynaecology, Netaji Subhas Medical College and Hospital, Bihta, Patna, Bihar, India. During one year study period, 5295 deliveries were conducted at our hospital, 100 patients had postpartum hemorrhage (1.88%). Results: Majority were from 21-24 years (36%) followed by 25-29 years age group (32%). Mean age of study group was 24.56 ± 3.95 years. As per parity status majority were primiparous (52%) followed by parity status >2 (25%). As per gestational age majority were from 38-40 weeks (32%) followed by 36-38 weeks (27%). In present study common risk factors were severe anaemia (Hb < 7 gm%) (37%), previous LSCS (27%), hypertensive disorders of pregnancy (23%), premature rupture of membranes (18%), hypothyroidism (18%), abruptio placentae (18%), Prolonged labor (16%) and placenta previa (16%). Interventions other than more than 2 uterotonics (100%) and > 2 PCV blood transfusions (85%), were bilateral uterine artery ligation (46%), bilateral uterine artery ligation + bilateral internal iliac artery ligation (9%), obstetric hysterectomy (16%) and perineal tear repair (10%). Mortality was noted in seven patients. Conclusion: In present study, significant risk factors for post-partum hemorrhage were 21-24 years age, primipara, severe anaemia (Hb < 7 gm%), previous LSCS, hypertensive disorders of pregnancy, premature rupture of membranes, hypothyroidism, abruptio placentae, prolonged labor and placenta previa. Anemia is a correctable entity, significantly associated with uterine atony and should be corrected antenatally on a priority basis.

Aim: Investigating the correlation between blood types and blood haemoglobin levels in the rural population of the Bihar area. Material and Methods: The present retrospective study was conducted in the Department of Physiology and Pathology, Darbhanga Medical College and Hospital, Laheriasarai, Darbhanga, Bihar, India from December 2017 se November 2018. 100 adults (males and females) who are in the age group of 18-30 years were included in this study. Blood sample is taken using finger prick, under aseptic conditions and blood group is determined using glass slide method using antisera A, B and D. Haemoglobin concentration is estimated using Sahli’s method. Results: Among participants with A positive blood type, 5 out of 25 (20%) were anaemic, while 20 (80%) were non-anaemic. In the A negative group, none of the 2 individuals were anaemic. For those with AB positive blood type, 1 out of 4 (25%) were anaemic, and 3 (75%) were non-anaemic. The single participant with AB negative blood type was anaemic. Among participants with B negative blood type, none were anaemic, while 1 was non-anaemic. In the B positive group, 14 out of 34 (41.18%) were anaemic, and 20 (58.82%) were non-anaemic. Lastly, among participants with O positive blood type, 9 out of 33 (27.27%) were anaemic, while 24 (72.73%) were non-anaemic. Conclusion: We conclude that individuals with blood group B are more prone to anaemia followed by blood group O, AB and least is with blood group A. Based on their blood groups, we can advice regular intake of diet rich in iron and vitamins or also their supplements to the individual who are more susceptible to anaemia.

Aim: To determine the clinical and mycological characteristics of fungal diseases in the Bihar area. Material and Methods: This retrospective study was conducted in the Department of Pulmonary Medicine, Holy Promise Hospital, Patna, Bihar, India for one year. Patients with suspected fungal infections were included and detailed history was recorded. Various Samples like blood, body fluids, respiratory samples, pus, tissue, skin scrapings, corneal scrapings, biopsy etc. were included in the study. Microscopic examination with KOH mount was done for all samples except blood samples. The samples were inoculated on two tubes of Sabouraud dextrose agar (SDA) with antibiotics and cycloheximide and two tubes of SDA with antibiotics but without cycloheximide. The growth obtained was identified on the basis of colony morphology, pigment production and microscopic examination with KOH mount and lactophenol cotton blue (LCB). Isolation of candida species from respiratory samples (sputum, endotracheal aspirate, bronchoalveolar lavage, suction tip) and urine were considered as fungal colonization. Results: Most common fungal infection was Candidiasis 131(60.6%) followed by Aspergillosis 63(29.2%) and Mucormycosis 13(6.0%) and Cryptococcosis 5(2.3%). Among 2 cases of Trichosporon infection, 1 was trichosporonemia and other was Trichosporon pneumonia. 1 case of Fusarium keratitis was observed. Among 131 patients with candidiasis, invasive candidiasis was seen in 128(97.7%) patients & cutaneous candidiasis seen in 3(2.3%) patients. Candida tropicalis 86(62.7%) was most common isolate followed by Candida albicans 17(12.4%) & Candida Guillermin 12(8.7%). In C. albicans 100% susceptibility was seen to Fluconazole and Echinocandins. In NAC, maximum susceptibility was seen to Amphotericin-B (89.2%) followed by Voriconazole (82.5%). Out of 5 cryptococcus species, 4 isolates of Cryptococcus neoformans and 1 Cryptococcus Laurentis was seen. Conclusions: Fungal infections are associated with significant morbidity and mortality. Candidiasis was the most common infection followed by aspergillosis. Candidemia is the major factor associated with fatal outcome with C.tropicalis, C.gulliermondii and C. parapsilosis being predominant pathogens.

Aim: The aim of the present study was to assess the study the maternal and fetal outcome in cases of premature rupture of membrane. Methods: A hospital based   retrospective study was conducted with 200 patients with diagnosis of premature rupture of membrane at or more than 37 weeks of gestation, at department of obstetrics and Gynaecology, Netaji Subhas Medical College and Hospital, Bihta, Bihar, India for one year, to study maternal and fetal outcome in premature rupture of membrane (PROM). Results: 65% of patients delivered in between 16-20 hrs. While 24% and 11% of patients delivered after 20 hrs and <16 hrs respectively. Most common indication was failure to progress in 8 patients (33.33%). Fetal distress was there in 3 patients (12.50%), Malpresentation and failed induction in 2 patients (8.33%) respectively, Maternal request for 1 patient (4.17%). The most common maternal morbidity was Puerperal pyrexia (12%) followed by Chorion amniotic (8%), puerperal sepsis (3%) Urinary tract infection (1%), adherent placenta (1%), wound infection, and PPH (2%). LBW infant were of 9%, 66% were between 2.5-2.99 Kg, and 25% were of more than 3 Kg. 138 (69%) neonates were healthy while the rate of neonatal morbidity was 31% in our study. The most common neonatal morbidity was Early onset sepsis (15%) followed by Neonatal Jaundice (5%), neonatal infection (4%), and Hypoglycemia (3%), respiratory distress in 2%, late onset sepsis 1%, congenital abnormality seen in 1% of patients. Conclusion: The study concluded that maternal morbidity and neonatal morbidity was associated with increased duration of PROM to delivery interval in our study. Prediction of these morbidities is an important step in the management of infection associated with PROM. Hence an appropriate and accurate diagnosis of PROM is essential for favorable outcome in pregnancy. ANC cases should be educated regarding regular and timely antenatal checkup. The obstetrician and neonatologist should work as a team to ensure optimal care for mother and neonate.

Aim: To investigate the correlation between glycated hemoglobin and serum ferritin levels in individuals with type 2 diabetes. Materials and Methods: This study was conducted in the Department of Biochemistry, Homi Bhabha Cancer Hospital (HBCH), Lahartara and Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC), Sundarbagiya, BHU Campus, Varanasi, Uttar Pradesh, India for one year. The study consists of total 100 subjects out of which 50 were diabetic patients compared with 50 ages and sex matched normal healthy controls. Blood samples were analyzed for Ferritin, HBA1C and fasting plasma glucose. A written informed consent was taken from the subjects. Clinically diagnose type 2 diabetes mellitus patients on treatment in the age group of 35-70 years. For the diagnosis of diabetes mellitus, FPG ≥126 mg/dl or previous history of diabetes mellitus was required. Controls: Healthy controls in the age group of 35-70 years with no history of any medical disorder. They had fasting plasma glucose levels of <110 mg/dl and hemoglobin levels of more than 12 g/dl. Results: In the present study we recruited total 100 subjects, out of which 50 subjects were in the cases group (29 males & 21 females) and 50 subjects were in the control group (26 males & 24 females). All the subjects belong to the age groups of 35-70 years. The mean age of the case group and the control group were 50.16 ± 7.0 years and 49.58 ± 6.70 years, respectively (Table 1). Both the groups were statistically similar in the age with the p-value of 0.76. There was no statistical significant difference between the mean hemoglobin level in diabetics (13.65 ± 1.3 g/dl) and normal controls (13.5 ± 1.3 g/dl). The mean BMI in diabetics was 27.5 ± 4.2 kg/m2 and for control group was 23.4 ± 2.8 kg/m2 (p < 0.001). The mean FPG, HbA1c and serum ferritin levels were significantly higher with P<0.001 in diabetic group compared to controls (Table 2). In addition, there was a positive correlation between serum ferritin and FPG, HbA1c. Serum ferritin is significantly correlated with FPG (r-0.20, P< 0.05) in diabetic patients. Serum ferritin is also positively related to HbA1c (r-0.9, P<0.01). Conclusion: Serum ferritin and HBA1c level were elevated in patients with type 2 diabetes mellitus when compared to healthy individuals and it indicates that serum ferritin can be used as a marker.

Aim: To determine the use of colour Doppler ultrasonography in diagnosing acute scrotum. Material and Methods: This study was conducted in the department Radiology, Katihar Medical college and Hospital, Katihar, Bihar, India for one year. All patients of age group of ≤25 years with acute scrotum were admitted and subjected to detailed history and physical examination with emphasis on pulse, temperature, general and local examination findings. Baseline investigations involving hemogram, urine routine examination, urine culture with sensitivity and KFT were carried out in all patients. All patients were subjected to immediate Doppler ultrasonography scrotum. Scrotal Doppler ultrasonography was performed with the patient lying in a supine position and the scrotum supported by a towel placed between the thighs. (Optimal results were obtained with 7 to 14 MHz high-frequency linear-array transducers). Results: 50 patients of acute scrotum presented to surgical department who were ≤25 years, over a period of two years comprising 0.11% among 45260 total patients attended the surgery department. Patients presented with clinical features of pain in scrotum, swelling of hemiscrotum, nausea vomiting, fever, urinary symptoms, abdominal pain and tender scrotum with erythema. Most common presentation was scrotal pain and scrotal swelling. True positive-20, False positive-2, True negative-25, False negative-3. True positive-20, False positive-0, True negative-29, False negative-1. True positive-2, False positive-0, True negative-47, False negative-1. Three patients with equivocal Doppler findings, but strong clinical suspicion of testicular torsion was explored, and testis was found to be torsed in all the three patients. Conclusion: Acute scrotum in children and young adults is a surgical emergency. Proper diagnosis and timely intervention can save testis and avoid unnecessary scrotal exploration. Color Doppler is an excellent modality of investigations which helps in correct diagnosis and timely intervention.

Aim: The aim of the present study was to determine the academic passion, stress and sleep quality among medical students and explore the associations among them, which helps to create awareness to improve the mental and physical health of future doctors. Methods: This retrospective study was done at department of Community Medicine, Nalanda Medical College and Hospital, Patna, Bihar, India from Jan 2021 to Nov 2021. A total of 250 students who were in the 2nd and 3rd year of MBBS were selected obtaining the institutional head’s permission. Students who had university examinations within a month were excluded from the study. Out of the 250 questionnaires distributed, 50 had incomplete forms hence, they were excluded from the study. 200 participants who completed forms were finally included. Results: 105 were females and 95 were males in the study. A majority of the study participants were interested in clinics. It was also found that 21% participants were not interested in pursuing higher studies. There was a significant association between the ability to handle personal problems with passion and interest in clinics. There was no significant association between the development of passion and the presence of a doctor in the family. 69% of the participants self-reported good sleep quality with severe stress. 22% non-passionate participants had moderate stress. Passion showed a positive association with interest in the pursuing post-graduation, satisfaction in the student’s life and negative association with duration of sleep and stress. Interest in clinics showed association with satisfaction with results with respect to their efforts. Perceived stress showed significant association with both passion and sleep. Conclusion: Our study found that passion has behavioral and psychological outcomes similar to previous research. Parental pressure and other factors influenced students to choose MBBS as a career. There is a high prevalence of stress and poor sleep quality among medical students. Depending on the type of passion, students can be positively or negatively influenced, so it is of prime importance to have a harmonious passion in life.

Aim: The aim of the present study was to identify interrelation between chief presenting complains of depressive disorder with level of stigma associated. Methods: This was a retrospective study conducted at the out-patient department (OPD) of Department of Psychiatry, Netaji Subhas Medical College and Hospital, Bihta, Patna, Bihar, India for 8 months. 100 cases of Major Depressive Disorder were taken using convenience sampling method. Results: Study population consists of 30 (30%) male and 70 (70%) female. Mean age were 34.16 ± 9.71. Among them 80 (80%) were married, 12 (12%) unmarried and 8 (8%) widow. Majority of them were Hindu 75 (75%) and 25 (25%) Muslim by religion. Regarding educational status, 20 (20%) were illiterate, 7 (7%) can read and write only, 18 (18%) upto primary levels, 24 (24%) completed secondary level, 11 (11%) upto higher secondary level and 20 (20%) completed graduation. 52% of them from joint family and 48% having nuclear family background. Equal numbers of patients were from rural and urban area. 16% were belongs to upper middle class, 30% lower middle class, 20% lower and 34% poor. 20 (20.0%) complaint sadness, 48 (48%) pain and other somatic problems, 20 (20%) tension as most troubling and 12 (12%) complaint other problems. Mean HDRS Scores of patients complaint sadness was 24.08±4.71, among patients complained pain and other somatic symptoms it was only 17.79±1.31, whereas among the complainer of tension it was 21.25 and for others 21.71. This difference in means was highly significant statistically (one way ANOVA; df 3, F=14.54, p <0.001). Conclusion: Majority of patients with major depression reported somatic complaints as most troubling which may hinder early recognition. As stigma is positively related with depression severity it may acts as barrier to help seeking. Socio-demographic variables are unrelated with presentation of depression.

Aim: To examine the prevalence of metabolic syndrome among persons with a diagnosis of type 2 diabetes mellitus. Materials and Methods: This study was conducted in the Department of Medicine, PMCH, Patna, Bihar, India from June 2017 to May 2018. A total of 160 patients fulfilling the inclusion criteria were selected. Informed consent was obtained from patients after explaining the study’s objective. All patients were interviewed and received a printed questionnaire. The sociodemographic variables include age, gender, residence, and marital status. Clinical variables included physical activity, adherence to diet, obesity, family history, duration of diabetes, medications, concomitant risk factors, and complications. In addition to fasting blood glucose tests, HDL-C and low-density lipoprotein-cholesterol (LDL-C) profiling was performed and analyzed. Results: In T2DM patients with Metabolic syndrome, the prevalence was higher (65.6%) than in those without Metabolic syndrome. The average BMI for males was 26.70 ± 0.84 kg/m² whereas BMI for females was 29.38 ± 0.54 kg/m². Overweight and obesity actualization was 57 (35.6%) and 32 (20%), respectively. A greater WC was found in 110 (68.7%, n = 160) patients. Females exhibited a larger WC of 93.52 ± 1.58 cm, and 48 of 83 females reported diabetes microvascular complications. Whereas in males, the frequency of WC was 89.64 ± 1.79 cm, with 36 of 77 patients reporting diabetes microvascular complications. On comparing the diabetic population with the presence or absence of Metabolic syndrome, this study noted significant p-values for age, gender, high waist circumference, obesity, and BMI. Metabolic syndrome was diagnosed in the study population by combining the criteria summarized in operational definitions: a combination of three criteria in 43.4%, a combination of four criteria in 36.2%, and a combination of five criteria in 20.4%. Conclusions: The prevalence of Metabolic syndrome observed among T2DM patients was high (65%), with married obese females in the 50-59-year age group being more likely to be affected than males. Hypertension, poor glycemic control, high triglycerides, low HDL-C, and greater WC and BMI are additional risk factors that tend to increase the Metabolic syndrome burden in T2DM. Diabetic retinopathy, nephropathy, and neuropathy are the most prevalent microvascular complications of diabetes, and immediate attention is needed to stop their detrimental effects.

Aim: The aim of the present study was to assess the morphometry of liver and its clinical implications. Methods: The study consisted of 50 forma line fixed cadaveric liver of unknown age and sex selected from the Department of Anatomy, Patna Medical College, Patna, Bihar, India for six months. Morphological features of the liver were studied and discussed under the following parameters. All the measurements are taken in inches using a measuring tape. Vertical and transverse diameters of Right lobe, left lobe, caudate lobe, quadrate lobe of the Liver was taken. Fissure, accessory lobe and external surface of the liver were observed in detail and variations were noted. Results: The mean measurement across the vertical dimension was 6.36 inch and transverse dimension was 8.2 inch. Fissures were seen in the caudate, quadrate, right and left lobe of the liver. Caudate lobe, Quadrate lobe, right lobe, left. Conclusion: The wide range of occurrence of morphological variations will contribute to the evolving document of liver morphology and ultimately will be helpful for anatomists. Additionally, this may aid interventions and surgeons to plan hepatobiliary surgeries, liver transplantation, and maximize targeted approach and curtail confusion, thereby mitigating morbidity.

Aim: The aim of the present study was to assess the level of Apelin and lipid profile in hypertensive patients. Methods: The project was a classic sectional study done at ESICMCH, Bihta, Patna, Bihar, India from August 2022 to September 2023. Eighty-nine people were recruited (56 females and 33 males) and divided into two groups: the control group included 25 healthy people and the patients’ group included 64 hypertensive patients. Results: The current study included (89) participants, with a group of patients (n=64) compared to the control group of healthy adults (n=25). There are statistically significant differences between the patients and the control group in all biochemical variables (p≤0.01). There was a significant increase in hypertension. On the other hand, there was a significant decrease in apelin and UHDL-c. There was an inverse relationship was observed in DLDL-c (LDL-c cal.) and cholesterol in both patients and control, while with systolic and diastolic pressure an inverse relationship appeared with the control group only whereas a direct relationship with patients. The non-HDL-c change is significant in the control group but in the patients’ group nonsignificant with UHDL-c. The UHDL-c and Non-HDL-c were in positive correlation in the control group significant (p<0.000) and patients group nonsignificant. Non-HDL-c appears direct correlation with DLDL-c, as well as triglycerides and cholesterol (p<0.001) in both patients and control groups. Also, the systolic for the control group was significant with non- HDL-c (p<0.027), but the Diastolic was nonsignificant with non-HDL-c (p<0.143). Conclusion: The present concluded that high blood pressure is associated with increased harmful fats (Non-HDL-c) in the body, which are deposited on the walls of the arteries causing them to narrow, which leads to high blood pressure. Also, an increase in apelin peptide concentration in blood is a good indicator. On the other hand, a deficiency of apelin combined with high blood pressure.

Aim: The aim of the present study was to study the relationship of External Carotid Artery with reference to Adjacent Anatomical landmarks in cadavers. Methods: The present retrospective study was done in the Department of Anatomy, Darbhanga Medical College and Hospital, Laheriasarai, Darbhanga, Bihar, India from January 2021 to December 2021. 60 hemi-necks obtained from 30 formalin embalmed cadavers (20 male and 10 female) were dissected and the external carotid arteries were traced from the origin to termination. Results: The ECA took origin at the level of upper border of thyroid cartilage (TC) in 40/60 cases (66.66%). Higher level of origin was noted in the remaining 20 of 60 cases (33.34%). Higher levels of carotid bifurcation were further categorized keeping the TC as anatomical landmark. No lower levels of origin were noted in this study. The anteromedial position of the ECA relative to the ICA at the level of the carotid bifurcation was noted in all the cases. Conclusion: The anatomical knowledge of relationship of External Carotid Artery with reference to adjacent anatomical landmarks is helpful for vascular surgeons to plan surgeries and prevent complications during various diagnostic and therapeutic procedures.

Materials and Methods: The present study was conducted was conducted in Department of FMT, Gouri Devi Institute of Medical Science and Hospital, Durgapur, West Bengal, India for one year. The study group included 50 males and 50 females of 30-to-40-year age group. Variables studied through physical anthropometry in both the genders were facial height, paranasal-to-men ton distance, inter zygomatic arch width, and intercanthal width. All the physical measurements were taken using a digital sliding caliper after each individual was asked to maintain a neutral, relaxed facial expression without lifting the head and to breathe calmly through their nose. Facial height measurement was derived as the distance from nasion to men ton. The measurements of the intercanthal distance are taken between the medial canthi of the eye. Results: The insignificant (P > 0.05) mean difference in the measurements with minimum error (SE < 1.00) and high ICC (0.622–0.997) indicating high reliability of craniofacial measurements. The values observed by observer 1 were submitted for statistical analyses. The difference in craniofacial measurements between males and females is summarized in Table 2.  Pearson’s correlation analysis revealed a significant and positive (direct) correlation between facial height and paranasal–to-men ton distance (r = 0.83, P < 0.001), facial height and inter zygomatic width (r = 0.30, P < 0.01), pro nasale-to-men ton distance and inter zygomatic width (r = 0.22, P < 0.05), and inter zygomatic width and intercanthal width (r = 0.25, P < 0.05). Conclusion: The present study concludes that the physical anthropometry of Lucknow population with larger sample size will give a standard and concrete range of measurements to decipher unidentified remains of this locality.

Aim: The aim of the present study was to determine significant  Widal titers of Salmonella agglutinins among healthy people of different genders in Ranchi, Jharkhand ( India.) Methods: The study was carried out in the Serology section of Dept of Microbiology, Rajendra Institute of Medical Sciences, Ranchi Jharkhand, India for a period of 12 months. Volunteers of both the sexes of 18-50 years of age group of different community of Ranchi who live here for more than 5 years and coming to our microbiology and biochemistry department for different routine test were included. 300 patients were selected in the study. Results: There were equal number of male and females. People of 18-50 years of age group were included. Among them maximum no. of people were from 21-30 yrs age- group and minimum no. of people were from 18-20 yrs. 20% were illiterate and 42.33% had tap water form municipal as source of water. 52.67% had food born disease awareness. Among 300 samples under the study, 170 had positive (i.e. ≥ 20) end titre value and 130 had negative (i.e. <20) end titre value. The highest number of males (32) having positive end titers value at 40. Among 135 Positive end titer values 73, (54.08%) were females and 62 (45.93%) were males. The highest no. (21) of females having positive end titer value at 80 and highest no. (20) of males having positive end titer value at 80. Conclusion: We concluded that widal test is an accessible, cheap and simple test which has diagnostic significance in endemic areas provided judicious interpretation of the test is made based on the agglutinin levels prevalent in the normal population of the region at a particular time period.

Aim: To investigate the correlation between dynamic trunk balance and the Mini-Balance Evaluation Systems Test in elderly women. Material and Methods:  This study was done in the department of PMR, NMCH, Patna, Bihar, India for one year.  Thirty-one women volunteers aged 60 years or more with no obvious brain or nerve disorders or joint diseases and who could walk unaided were enrolled. The evaluation items were the BEST test total score, the scores of each of the six elements of the BEST test, dynamic sitting balance, static postural balance, and muscle strength (back muscle, iliopsoas muscle, and quadriceps).  Written informed consent for the study and its publication was obtained from all subjects. Results: The mean total BEST test score was 85.4 points (Tables 4), with a score of 93 points or less indicating some balance disorder. A negative correlation (r=–0.481, P=0.006) was observed in the total locus length of the COG for the dynamic sitting test and the BEST test total score . Among the six items of the BEST test, a significant negative correlation was found between the total locus length of the COG and biomechanical constraints (r=–0.492, P=0.005) and anticipatory postural adjustments (r=–0.532, P=0.002). There were no correlations between the dynamic sitting test total COG trajectory length, the stationary standing COG length, and muscle strength. Conclusion: In elderly women, the trajectory length of the COG during dynamic sitting was negatively correlated with the BEST  test total score. Future studies should investigate how the BEST  test can be used to determine both the optimal treatment interventions to prevent falls and the efficacy of these interventions.

Aim: The aim of the present study was to assess the prevalence of obesity and overweight and to find out predictors for obesity. Methods: This cross-sectional study was carried out among adult individuals (aged 18-55 years) in the Department of Community medicine, JNKTMCH, Madhepura, Bihar, India from November 2020 to October 2021. All the individuals were residents of the rural and urban areas. Results: Most of the participants were males 200 (66.66%) and 100 (33.34%) were female. Out of total study subject 264 (88%) were resident of urban area and 36 (12%) from rural area. Maximum number of participants was non worker 125 (41.66%). Socioeconomic status assesses most of them from upper class category 170 (56.66%). The age specific prevalence of obesity 55 (18.33%) in 36-55 years and 46 (15.33%) in 18-35 years, however the prevalence of and overweight was 35 (11.66%) in 18-35 years and 20 (6.66%) in 36-55 years. it was found to be statistically significant. Prevalence of obesity and overweight among males was 76 (25.33%) and 47 (15.66%) and among females 28 (9.33%) and 14 (3.33%) respectively. it was found to be statistically significant. The mean weight and height were highly significant among both the sexes. (p<0.001) slightly greater mean of BMI was found among males (23.7±3.14 kg/m2) as compare to females (22.8±3.67 kg/m2). The overall prevalence obesity (≥25 kg/m2) was 105 (35%) and overweight (≥23 kg/m2) 58 (16.66%). The prevalence of obesity was observed higher among males 75 (25%) and 30 (10%) female. However, the prevalence of overweight was also higher among the males 40 (13.33%) than female 10 (3.33%). Conclusion: Suitable health care strategy and intervention programs along with health education are needed to reduce the impact.  These results suggested that overweight and obesity may be serious public health problems. It is important to carry out further studies in order to explore the potential relationship between overweight and obesity on the one hand, and behavioral variables, such as smoking and alcohol consumption, on the other.

Aim: The aim of the present study was to find the prevalence and risk factors associated with sensorineural hearing loss in patients with systemic hypertension. Material & Methods: A retrospective study conducted during the period of 18 months aimed at finding out the prevalence of sensorineural hearing loss and the risk factors related to hearing impairment among systemic hypertensives in Department of ENT, Nalanda Medical College and Hospital, Patna, Bihar, India from May 2021 to December 2022. 100 patients attending the outpatient Department of ENT, Nalanda Medical College and Hospital, Patna, Bihar, India meeting the inclusion and exclusion criteria were recruited for the study. Results: Maximum participants were in the 56-60 age group (47%). Female participants predominated in our study (66%). When right ear and left ear were studied separately, 35 patients (35%) had sensorineural hearing loss in the right ear, whereas 33 patients (33%) had sensorineural hearing loss in left ear. When hearing thresholds at individual frequencies were noted, in the right ear 42 patients (42%) had hearing loss at 250 Hz, 34 patients (34%) had hearing loss at 500 Hz. Similarly, in the left ear, 37 patients (37%) had hearing loss at 250 Hz, 33 patients (33%) had hearing loss at 500 Hz. The patients in 55-60 age group had a higher incidence of hearing loss when compared to the remaining study population. In our study we found that increasing age is a risk factor for sensorineural hearing loss in hypertensives. We studied whether duration of hypertension has any bearing on the development of sensorineural hearing loss and found out that patients with more than 10 years duration of hypertension had the highest prevalence of sensorineural hearing loss. Conclusion: Sensorineural hearing loss has a high prevalence among patients with systemic hypertension. Hence, a pure tone audiometry should be done routinely in all hypertensives, particularly in elderly patients with long standing systemic hypertension. Periodic audiological assessment should be incorporated in them to start rehabilitation as early as possible. Early diagnosis of systemic hypertension in the community and initiation of treatment can help to further hinder the progression of microvascular disease that leads to target organ damage.

Aim: The aim of the present study was to evaluate the results of open reduction and internal fixation of distal femur fractures by locking compression plate. Methods: The present study was conducted in the Department Orthopedics, Government Medical College and Hospital, Bettiah, West Champaran, Bihar, India for 4 months, and study included 50 patients with distal femur fractures. Results: In this study, 64% of the cases were in the age group of 21-40 years, 24% in the 41-60 years age group, and just 12% in the 61-80 years group. The mean age was 39 years. In our study, 76% of the patients were male, and 24% were female. Sixty percent of the cases were due to road traffic accidents while 40% were due to domestic. AO (Arbeitsgemeinschaft für Osteo synthesefragen) classification was used in this study. There were no A1- type cases. The majority of the fractures belonged to C2 type (40%, 20 cases). C3 accounted for 20% of the cases. A2, A3, and B1 were the least common, accounting for just 4% of the cases each. The majority of the cases did not have any complications, accounting for 84% of the cases. Four cases had stiffness postoperatively, accounting for 8% of the cases, and there were only two cases of non-union and infection each, accounting for 4% of cases, respectively. Out of 50 cases, 24% of cases, i.e. six patients, had excellent outcomes as per Kolmert’s and Neer’s scores. Twenty-two patients (44%) had good outcomes, eight cases of fair and poor outcomes each, accounting for 16% of total cases, respectively. Conclusion: LCP proved to be a good implant which could take the challenges like poor bone stock, severe comminution both metaphyseal and articular and prove successful. The locking head screws distally have prevented varus collapse, even in cases of osteoporosis. The Condylar LCP can be used in either an open or a minimally invasive manner.

Aim: To investigate the clinical relationship between migraine and mood disorders. Material and Methods: This retrospective study was carried out in the Department of Psychiatry, IHBAS, Delhi, India for one year. Each patient was evaluated in detail with a questionnaire with details regarding the duration of headache, frequency and duration of each episode, site, quality and severity of pain, auras, migraine accompaniments such as photo or phonophobia, nausea, vomiting as well as triggers. To assess disability, Migraine Disability Assessment Questionnaire (MIDAS) was applied to all patients. A score of 6 or more is taken as positive with cut offs for mild, moderate, and severe disability. The presence of concurrent anxiety and mood disorders was assessed by the Hospital Anxiety and Depression Scale (HADS). Results: A total of 200 patients were studied during the study. The sample consisted mostly (n = 160, 80%) of middle age (20-50 years) Individuals with mean (standard deviation [SD]) of age of 35.12 (8.58) years. It was a female predominant sample (n = 138, 69%). As per HADS score, among the 22 patients (11%) suffering from depressive symptoms, 50% had borderline abnormal score and 16% (n = 32) had abnormal score whereas among the 27 persons (54%) suffering from anxiety 18% had borderline score and 50% had abnormal score. Mean HADS score (SD) of depression was 11.24 (3.04) while that of anxiety was 13.81 (2.71). Median of duration of headache was 6 years with SD of 6.5 years. Here, duration of disease was not normally distributed, so nonparametric statistics were applied. Though female individuals had more duration of illness (mean rank: 69.87), it was not significantly different (P = 0.04) from males (mean rank: 58.47). Middle-aged individuals suffered more duration of illness than other age groups (P < 0.04). Conclusion:  We concluded that the mood disorders are comorbid with migraine at a rate comparable to or less than that described in many studies in international literature and the occurrence of comorbid mood disorders significantly contributes to migraine associated disability.

Aim: The aim of the present study was to evaluate the efficacy and safety of supra costal percutaneous nephrolithotomy (PCNL) through the 11th intercostal space and compare it with subcostal PCNL in children with renal calculi. Methods: We retrospectively reviewed the electronic medical records of 100 children (65 boys and 35 girls) who underwent PCNL procedures at our center for treatment of renal calculi for the period of 2 years at JLNMCH, Bhagalpur, Bihar, India. Duration of study two years. Results: The patients who underwent standard PCNL or combined supra costal and subcostal PCNL, 100 patients were analyzed. Of these, 35 and 65 had a supra costal and subcostal access respectively. Stone size and location of stone were comparable in both the groups. Most of the children had stone larger than 2 cm as an indication for PCNL. The preoperative characteristics of the patients, urinary tracts and stones were comparable for both treatment groups. Supra costal tracts were used for treatment of staghorn stones, upper calix stones, mid calix stones and upper ureteral stones causing calculous anuria. There were no major complications (eg intrathoracic complications, adjacent organ injury or bleeding requiring selective angiographic embolization, urgent renal exploration, nephrectomy) following any of the procedures. Conclusion: In conclusion, percutaneous nephrolithotomy for treating renal stones in children provides a high degree of safety and efficacy whether a supra costal or subcostal approach is used.

Aim: The aim of the present study was to assess the role of PCR in diagnosing TB in children. Methods: This cross-sectional study was carried out in the Upgraded Department Of Pediatrics, Patna Medical College and Hospital, Patna, Bihar, India and included 100 patients aged <15 years who were clinically diagnosed with TB. Duration of study from August 2013 to July 2014. Results: The median (IQR) age of enrolled TB patients (N = 100) was 1.7 (0.75, 3.0) years. Most of them (88%, 88/100) belonged to the <5 years age group; only five (5%) were    10 years old. Fifty-eight percent of participants were male (58/100). The majority (90%, 90/100) had a TBS of 7 according to the TBS chart, and 45% (45/100) had a score of 5 according to the MKJ scoring system. Gastric lavage was collected from 96% of the participants, including all of the children <5 years of age and seven of the 11 children >5 years of age who were unable to produce a spontaneous sputum specimen. Pathogen detection in the children with clinically diagnosed TB, according to the age group and type of respiratory sample. Smear for AFB microscopy and conventional (solid) culture were performed on all respiratory samples collected (N = 100). MGIT culture was performed on 100 samples. Smear microscopy was positive only in three cases and all of them were from gastric lavage. All smear-positive cases were positive by both culture methods. The newer sensitive PCR technique using IS6110 primers was positive for the children and similar positivity was found among younger children. Conclusion: In conclusion, this study demonstrated that the PCR method using IS6110 primers might have greater importance when compared to the performance of smear microscopy in  the detection of MTB among younger and nutritionally compromised children, for whom bacteriological confirmation can rarely be achieved. It might also be beneficial in detecting more pathogens within a shorter period of time when compared to the gold standard culture method.

Aim: The aim of the present study was to calculate Aqueduct systolic stroke volume, Peak systolic velocity, Mean systolic velocity, Forward flow and Backward flow by Phase contrast MRI CSF  Flowmetry in  patients  with symptoms of Normal pressure hydrocephalus and controls  and  to evaluate the significance of these parameters. Methods: The present study was conducted at Department of Radiodiagnosis, Shri Ramkrishna Institute of Medical Sciences, Durgapur, West Bengal, India for one year. Total no of 60 participants age range was between 38 to 88 were enrolled into the study. Results: 58.3% population was >60 years, 26.7% population group was in between 51-60 years and 15 % population was < 50 years age. Overall gender distribution in case group (n=30) 25 was male and 5 was female and in control group(n=30) 22 was male and 8 was female. Gait Disturbances was present in 86.7 %, Dementia was present in 73.3% and Urinary Incontinence was present in 70 % in Case Population.  The mean aqueduct stroke volume (ASV) in control group of our study (n= 30) was31.4μl with a standard deviation of 11.38μl. The stroke volume in cases in our study was 141.3μl ± 53.56μl. The P value was (0.0001) suggesting that the difference in the values of ASV in cases and controls were statistically significant. So ASV can be used as a parameter to differentiate cases from controls. Conclusion: These various parameters ASV, PSV, MSV, FF and BF of CSF flow in phase contrast MRI were included in our study. These all parameters reliably differentiated   NPH patients from normal volunteers in our study. CSF wave form obtained from Phase contrast MRI were analyzed in our study its appeared to be reliable, reproducible, and sensitive tool for differentiation of NPH patients and normal volunteers.

Aim: To assess the knowledge, attitude, and behaviours of parents with β thalassemia children about thalassemia. Material and Methods: A cross-sectional study was conducted in the Department of Community Medicine, Darbhanga Medical College and Hospital, Laheriasarai, Darbhanga, Bihar, India from April 2018 to March 2019. We randomly selected 1,248 peoples (18–75 years old). However, selection of study area and respondents in this study were based on convenience sampling. Participants were selected from different places, such as public institutions, houses and local markets in order to capture them from various backgrounds in the community. Only the people who consented were included in this study. Furthermore, those who were <18 years of age were excluded from this study. Results:  Of the total respondents, only 47.4% (592/1,248) had heard of thalassemia. These 592 participants were considered for next questions. The urban residing participants (65.1%) who had heard of thalassemia were nearly twice as high as the participants (38.2%) who lived in semi-urban or rural settings. All of the socio-demographic characteristics except gender are significant (p<0.001) who heard the term thalassemia. Only 18.2% of participants have good knowledge on thalassemia. In the multivariable logistic regression model of potential predictors of knowledge on thalassemia, participants were more aware when they were in undergraduate (aOR: 23.445; 95% CI: 5.767–95.315) or they were graduate (aOR: 24.88; 95% CI: 6.238–99.232) and post-graduate (aOR: 33.18; 95% CI: 7.864–140.001). We found a significant association between overall knowledge on thalassemia and the education level of the respondents (p<0.001). However, 20–35 aged (189) and middle-income respondents (200) were more conscious about thalassemia, but there was no statistical significance found. Conclusion:  Our study has specifically pointed out knowledge deficits regarding the genetics and pattern of inheritance of thalassemia major. Insights of the report depict that more concise and specially designed programs for disseminating awareness regarding thalassemia should spread across the country.

Aim: The study was designed to assess the clinico-pathological profile and to estimate immediate hospital outcome of acute pancreatitis patients admitted into a tertiary care hospital. Methods: This research was conducted in the Department of Medicine, JLNMCH, Bhagalpur, Bihar, India, for a period of one year. Obtained informed written permission from the patient or their family members. The research was conducted using a cross-sectional observational design. A total of 100 participants were included in the research. Results: Among 100 patients, the average age was 42.5±11.3 years. The oldest was 68 and the youngest 22. Most patients (40%) were 31-40 years old. All patients reported stomach discomfort. 45% vomited and 32% experienced fever. Pain was most frequent in the epigastric area (75%), with back radiation in 20%. Pain was severe and painful in 75%. Leukocytosis and elevated C-reactive protein were seen in all cases. Low calcium was found in 35% of patients. Hospital stays were from 3 to 16 days, and oral nothing was 2 to 10 days. Conclusion: Acute pancreatitis sufferers usually have stomach discomfort, distension, and anorexia. Gall stones were the most prevalent cause, however many patients had no known reason. Epigastric pain with back radiation.

Aim: The aim of the present study was to compare whole-body bone scintigraphy with axial skeleton magnetic resonance imaging in the skeletal evaluation of carcinoma prostate. Methods: The present study was conducted in the Department of General surgery, Patna Medical College and Hospital, Patna, Bihar, India from feb 2019 to Jan 2020 in patients with biopsy-proven clinically nonmetastatic carcinoma prostate with prostate-specific antigen (PSA) in the range of 10–50 ng/ml were included in this prospective study. 50 patients were included as a greater number of patients were available and willing to participate in the study during the specified study period. Results: Majority of the patients belonged to 60-69 years of age. According to PSA, most of the patients had 10.00-19.99 and according to Gleason score, most of the patients had 3+4/4+3. 34% had T3a stage. By BVC, bone metastasis was found in 15 patients (30%) and no metastasis was found in 30 patients (70%). The WBBS findings were considered as positive for metastasis for calculation of validity parameters. All the lesions picked by WBBS had SPECT-CT correlation. None of the patients had metastatic lesions in the extra AS. None of the patients in our study had visceral metastasis. Conclusion: The diagnostic performance of AS-MRI in detecting the patients with bone metastasis due to carcinoma prostate is superior to that of WBBS with SPECT-CT correlation of the suspicious WBBS lesions in the PSA range of 10–50 ng/ml.

Background: Chronic venous ulcers (CVUs) represent a significant healthcare challenge, associated with substantial morbidity and impaired quality of life. Multiple treatment approaches exist, ranging from conservative management to advanced surgical interventions. This study compares the efficacy of different treatment approaches for chronic venous ulcers in a population of 100 patients. Methods: A prospective study was conducted over 24 months at Department of Surgery, RDJM Medical College and Hospital, Turki, Muzaffarpur, Bihar, India . A total of 100 patients with chronic venous ulcers were enrolled and divided into three groups based on the treatment approach: conservative management (n=35), compression therapy (n=35), and surgical intervention (n=30). Outcomes assessed included ulcer healing rates, time to complete healing, recurrence rates, and patient-reported outcomes. Results: The study found significant differences in outcomes across the three treatment groups. Compression therapy showed the highest ulcer healing rate (85.7%) and the shortest time to complete healing (mean: 8.5 weeks). Surgical intervention had a slightly lower healing rate (80.0%) but demonstrated a significant reduction in recurrence rates (10.0%) compared to conservative management. Patient-reported outcomes indicated higher satisfaction and quality of life in the surgical intervention group. Conclusion: Compression therapy was the most effective treatment for chronic venous ulcers in terms of healing rates and time to healing, while surgical intervention offered the advantage of reduced recurrence rates. Tailoring treatment to individual patient needs, considering both clinical outcomes and quality of life, is essential for optimal management of CVUs.

Aim: The aim of the present study was to assess the clinical profile, management of perforative peritonitis and its surgical outcomes. Methods: The study was carried out in the Department of General Surgery, SKMCH, Muzaffarpur, Bihar, India. All patients admitted with perforative peritonitis were included in the study for the period one year. A total of 500 patients with perforative peritonitis were included in the study admitted. Results: The underlying etiology of the perforative peritonitis among the patients was evaluated and it was observed that acid peptic disease was the common cause accounting for 35% of the patients, followed by typhoid (16%), trauma (13%), obstruction (11%) and tuberculosis (6%). In about 15% of the cases the etiology was not defined. The commonest site of perforation was found to be duodenum accounting for 36% of the cases followed by appendicular (20%), Ileum (16%), Jejunal (13%), large bowel (11%) and gastric (4%). All the patients were followed up for a period of 6 months and the surgical outcome of the patients was assessed where in the mortality rate among the patients was at 10% and the rate of complication was at 48% and remaining 42% of the patients recovered completely. Among the complications wound infection (32%) and respiratory complication (23%) were common, followed by abdominal collection (10%), Obstruction (14%), dyselectrolemia (8%), burst abdomen (5%) and anostomotic leak (5%). Conclusion: GI perforations are one of the most common surgical emergencies. Duodenal perforations are most common. Ileal perforations have the highest morbidity and mortality. Mortality depends on the age and general condition of the patient, associated pre-operative co- morbidities, site of perforation and etiology.

Background: Deficiency in vitamin D has been connected to a range of health issues, including autoimmune diseases, neurological problems, heart conditions, and infections. In the context of hair growth, a reduction in the expression of vitamin D receptors (VDR) within hair follicles is associated with diminished hair production and impaired skin cell differentiation, highlighting the critical role vitamin D plays in supporting hair health. Material & Methods: The present study was a case-control type of study that was carried out in the department of dermatology, of our tertiary care hospital. The study duration was of six months from May 2023 to November 2023. A sample size of 100 was calculated.  In this perspective, we enrolled all patients with androgenic alopecia coming to dermatological OPD till the sample size was reached. Only those patients who matched the inclusion and exclusion criteria were enrolled in the present study. Results: Regarding the severity of   AGA   based on the Norwood-Hamilton scale classification, 24 cases (48%) were classified as grade II, 11 cases (22%) as grade III, 10 cases (20%) as grade IV, 5 cases  (10%)  as grade  V. When assessing severity,   36    cases    (72%)    were categorized as mild to moderate  AGA,  while  14  cases (28%) were severe. In the present study, out of the total study participants, based on the serum vitamin D3 levels and severity of AGA, 32% of mild to moderate AGA patients had Normal vitamin D3 levels, 40% of mild to moderate AGA patients had Deficient vitamin D3 levels, whereas 41% of severe AGA patients had Normal vitamin D3 levels, 59% of severe AGA patients had Deficient vitamin D3 levels. This difference was statistically significant (p-value < 0.05). Conclusion: We concluded from the present study that we found Deficient vitamin D3 levels among individuals with androgenetic alopecia (AGA) compared to the control group. This difference was statistically significant when we compared individuals who had severe AGA with mild to moderate AGA patients.

Introduction: Head and neck malignancies are one of the most common malignancy in India. Majority of head and neck tumors present in locally advanced stage at the time of diagnosis. Radiotherapy and surgery are main treatment option for these patients. Definitive Radiotherapy given either alone or with concurrent chemotherapy and adjuvant after primary surgery. Radiation induced hypothyroidism is a major late toxicity in patients who received radiotherapy to neck. Radiation cause both microvascular and macrovascular damage directly in and around thyroid gland. Early diagnosis and proper treatment reduce the rate of morbidity and mortality. Objective: The purpose of our study is to assess thyroid function and incidence of hypothyroidism in head and neck cancer patients after radiation treatment. Materials and Methods: A prospective study of 250 histopathologically proved head and neck squamous cell cancer patients between June 2019 to May 2022. All patients treated with cobalt-60 Teletherapy machine with conventional fractionation. All patients received concurrent chemoradiation with weekly cisplatin 30mg/m². Results: Male patients were 208 (83.2%) and 42 (16.8%) were female patients. The age groups were 29 to 70 years and the median age was 56 years. Oropharynx was the most common site of primary tumor. At 36 months of follow up, 32 (24.6%) patients were to have subclinical hypothyroidism, 26 (20%) patients were to have clinical hypothyroidism, and incidence of hypothyroidism was 47.6%. Larynx was the most common primary site for development of radiation induced hypothyroidism. Conclusion: Radiation induced hypothyroidism is a frequent late effect in head and neck cancer patients. Thyroid function test should be performed routinely at regular interval of 6 months post radiotherapy

Background: Dexmedetomidine, a highly selective alpha-2 adrenergic agonist, is increasingly used in anesthesia for its sedative and analgesic properties, mimicking natural sleep with minimal respiratory depression. Despite its advantages, optimal dosing remains uncertain, as higher doses may deepen anesthesia but potentially delay recovery. Understanding the impact of dexmedetomidine dosage on anesthesia depth and recovery time is essential for enhancing perioperative safety and efficiency. Aim: This study aims to assess how different doses of dexmedetomidine influence anesthesia depth and recovery time in patients undergoing general anesthesia. Methodology: A double-blind, randomized study was conducted at Jan Nayak Karpuri Thakur Medical College, Bihar, India, enrolling 92 patients aged 20–60 years with ASA status I–II. Participants were randomly assigned to receive either dexmedetomidine (0.5 μg/kg) or normal saline. Primary outcomes included heart rate and cough frequency, measured immediately and at intervals up to 40 minutes post-extubation. Secondary outcomes were monitored through MAP and oxygen saturation. Data was analyzed using SPSS with ANOVA and Chi-square tests. Results: The dexmedetomidine group demonstrated significantly lower heart rates at all post-extubation time points (p < 0.01), with a steady decline from 81.5 ± 8.3 beats per minute initially to 75.4 ± 6.9 at 40 minutes. Cough frequency was also substantially reduced in the dexmedetomidine group, with 0.060 ± 0.250 immediately post-extubation versus 2.500 ± 1.90 in the control (p < 0.001), maintaining lower rates throughout the recovery period. Conclusion: Dexmedetomidine administration significantly improves recovery outcomes by reducing heart rate and cough frequency, suggesting improved hemodynamic stability and a smoother recovery profile. These findings support dexmedetomidine’s role in enhancing anesthesia depth and facilitating rapid recovery, potentially improving perioperative patient outcomes.