International Journal of

Current Pharmaceutical Review and Research

e-ISSN: 0976 822X

NMC Approved

Peer Review Journal

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1. Lipid Profile Levels in type 2 Diabetes Mellitus
Reena Rani, Anupam Kumar Singh
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.

2. Morphometric Study of Nutrient Foramen of Clavicle in Maharashtrian Population
Mayuri Ghorpade, Varsha Bande, Shobha Verma, Sneha John, Manisha Nakhate
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.

3. Maternal Vertigo Unveiled: A Cross-Sectional Analysis of Pregnancy-Related Dizziness
Dipty Ojha, Shashank Ojha
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.

4. Prospective Comparative Study of Functional Outcome of Management of Metacarpal Fracture with Plating and K Wiring
Manas Pusalkar, Shivraj Konde, Santosh Borkar, Vijith Hegde, Nikhil Kulkarni
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.

5. An Analysis of A Novel Telehealth Mobile Application for Follow-Up of Emergency Medicine Patients in a Tertiary Hospital
Savio Pereira, Saravana Kumar A.
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.

6. Comparative Evaluation of Skeletal and Dento-Alveolar Features of Deep Bite Malocclusion in Different Facial Growth Patterns
Jitha Elsa Philip, Ajith R. Pillai, Sujith Mathew, Veena Sreekumar
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.

7. A Comparative Evaluation of Fracture Resistance of Maxillary Central Incisors Restored with Three Prefabricated Post and Core Systems -An in Vitro Study
Rishu Garg
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.

8. Intrauterine Fetal Demise in a Tertiary Healthcare Centre – A Retrospective Observational Study
Reethu Varadarajan, Veena B T, Smitha K, Kiruthika T
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.

9. A Study of Sputum Smear Conversion in Drug-Resistant Tuberculosis after Taking Bedaquiline-Based Optimized Background Regimen (OBR) in a Tertiary Health Care Centre of South Gujarat
Vaishali J Rohit, Khyati Shamaliya, Parul Vadgama
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 4th month, 2.04% population had positive culture conversion. In 5th month there is no positive culture conversion. At the end of the 6th month, 4.08% population had positive culture conversion. At the end of the 4th, 5th, and 6th 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 9th month & and 12th month 1(2.04%) patients got positive culture conversion. Also, 44(89.79%) in 9th month and 43(87.75%) in 12th month got negative culture. In the 9th month, 4 patients got expired/lost to follow-up, and 5 patients got expired/lost to follow-up in the 12th 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.

10. Clinico-radiological and Laboratory Profile of Patients with Central Nervous System Tuberculosis (CNS TB): An Observational Study
Manish Kumar, Prashant Kumar Thakur, Krishna Kumar Jha
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 from patients or relatives, this hospital based cross sectional study was carried on 50 adult (>12 years) patients, hospitalized. 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 Bridzinski’s sign. CSF staining was positive in 9.52% patients, mean CSF protein was 157 mg%, 64 patients had CSF lymphocytosis, (count >90%), CSF PCR was positive in 78 patients, 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, takes more time to get the report. Hence supportive criteria like CSF examination (raised proteins, lymphocytosis, low sugar) along with positive CSF PCR, raised CSF ADA levels >10IU/L, positive CT / 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 in further 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.

11. Study of Peak Expiratory Flow Rate in Obesity
Kunipuri Sarala, Indla Devasena, M. Vijaya Nirmala, S. Sarah Nightingale
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.

12. A Study of Effectiveness of Atropine and Pralidoxime in the Treatment of Organophosphorus Poisoning
Ashutosh Roy, Dhruv J Chaudhari, Santosh Saklani, T. Phani Kumar Dunga
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.

13. Diagnostic Implications of TyG Index in Hypertensive Patients as a Predictive Marker for Future Risk of Cardiovascular Diseases
Parsuram Nayak, Diptimayee Jena, Suresh Kumar Sabar
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.

14. An Observational Study to Assess the Awareness and Knowledge about Cervical Cancer, Pap Smear Testing and its Use and HPV among Women
Reshita, Swati
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.

15. A Comparative Study on the Outcome of Closed Suction Drain versus No Drain in Patients Undergoing Total Knee Arthroplasty
Modi Amul Kaushikkumar, Nirav Rathi, Saurabh Patel, Dishant Mehta
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.

16. Correlation between Maternal Weight Gain and Neonatal Birth Weight-A Cross Sectional Study
Sardar Vikram Singh Bais, Amrita Sinha, Shabd Singh Yadav, Jayendra Arya
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.

17. A Comparative Study of Pregnancy Outcome in Elderly Primigravida and Younger Primigravida
Smitha K, Veena B T, Reethu Varadarajan, Sushma
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.

18. Clinical Correlation between Rotator Cuff Tear with Acromion Angulation on MRI
Saurabh Patel, Dishant Mehta, Nirav Rathi, Mitul Patel
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.

19. A Morphometric Assessment of the Profile of Sternalis Muscle in Cadavers: An Observational Study
Naiyyar Azam, Amrita Kumari, B. K. Sinha
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.

20. A Hospital-Based Assessment of Cognitive Dysfunction in Type 2 DM during Acute Mental Stress without Overt Cerebrovascular Disease
Jhillmill Kumari, Sunita, Abha Mishra, Shashikant Sharma
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.

21. Study to Evaluate the General Menstruation Patterns, the Incidence of Common Menstrual Disorders and the Sociodemography of the Students
Khushboo Yashmin, Ranu Singh Kushwaha, Dipti Roy
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.

22. A Hospital Based Study to Assess Stress Prevalence, Primary Stressor, Major Coping Technique, and Stress and Academic Performance in Undergraduate Medical Students
Robina Shamim, Suman, Jyoti Priya, Rita Kumari
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.

23. A Morphometric Study to Assess the Validity of Sacral Rhomboid Diameter and Maternal Height (HT) to Predict Contracted Pelvis Antenatally
Ruhi Hashmi, Amrita Kumari, B. K. Sinha
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.

24. A Study to Compare the Mean Value of Various Hematological Parameters from the COVID-19 Patients (Survivors and Non-Survivors) to Assess Their Role in Prognostication and Prediction of Mortality
Madhu Bharti, Manish Kumar Jha, Md. Imteyaz Alam, Poonam Kumari
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.

25. To Investigate the Potential Association between Vitamin D and Cellular Senescence as Evaluated by the Telomerase Enzyme in Pre-Hypertensive
Gaurav Sinha, Vibha Sushilendu, Sandeep Kumar, Pandurang M. Narhare
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.

26. A Hospital Based Study to Assess the Management of Cerebrospinal Fluid Rhinorrhea: An Observational Study
Gaurav Srivastava
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.

27. Demographic and Laboratory Evaluation of the Mucormycosis Received During or Post COVID-19 Treatment
Alpana Singh, Ajay Kumar
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.

28. Role of Diagnostic Laparoscopy in the Evaluation of Blunt Injury to Abdomen in Haemodynamically Stable Patients
Reethika Thatikonda, Komararagiri Ramachandra Rao, A. Sashidhara Rao, Preerana Bhandari, Sridhar Punyapu, Gorthi Sathyanarayana
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.

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