Background: Presently Medical education in India is in transforming phase from traditional curriculum to competency-based medical education (CBME) and clinical pharmacology as block 1 elective is a part of it. We found no research done in this field in our country and there is lack of knowledge about the impact of implementing clinical pharmacology as Block 1 elective posting. The areas like prescription audit, prescription writing, case follow up, Pharmacoeconomics, Peer group teaching and skill performance were included. Aims: Our aim was to formulate ideas for successful implementation of clinical pharmacology as elective posting. Settings and Design: The study was a prospective, observational, cross-sectional study done on final prof part 2 students of our institution who pursued clinical pharmacology as elective in SRIMS Durgapur from 12/05/2023 to 10/06/2023. Materials and Methods: The outcome measured in terms of validated feedback questionnaire supplied in printed format. Data were analysed using SPSS version 17 and Microsoft Excel 2007. The data obtained were expressed as mean, SD and SEM. Results: A total of 35 students from 38 allotted students responded. 94% students responded that the course details adequately explained to them. Nearly 91% students were able to interact ask questions to the facilitators. 89% students thought that facilitators focused on communication skills. Most of the students found (83%) the course organised well. Conclusions: The students chosen clinical pharmacology as elective were benefitted by getting more clinical pharmacology exposure that will help them in further development of clinical knowledge and practice.

DOI: 10.5281/zenodo.

Introduction: Fibromyalgia (FM) is a common occurrence among patients diagnosed with rheumatoid arthritis (RA). Our study aimed to assess the variations in psychiatric comorbidities and life challenges between individuals with Rheumatoid arthritis plus FM (secondary fibromyalgia [SFM]) and those with primary FM (PFM). Materials and Methods: We recruited 45 patients with PFM and 53 with SFM for the study. This cross-sectional, observational study involved structured interviews with patients diagnosed with PFM and SFM to determine lifetime occurrences of major depression (MDD), panic disorder (PD), and post-traumatic stress disorder (PTSD). Additionally, participants were evaluated for childhood/adulthood adversities and the severity of FM-related symptoms. Results: Univariate analysis revealed significantly higher lifetime rates of MDD in PFM compared to SFM, as well as higher rates of PD, with no notable difference in PTSD rates. Furthermore, rates of sexual abuse and physical neglect were notably higher in PFM patients than in SFM patients. Life events occurring before the onset of FM differed between the PFM and SFM groups. In the logistic regression model, lifetime PD and physical neglect emerged as independent risk factors for PFM. Conclusion: These findings indicate that PFM and SFM exhibit differences in psychiatric comorbidities and environmental adversities, suggesting that a common pathogenesis may manifest through distinct pathways.

DOI: 10.5281/zenodo.

Background and Aim: Automate peripheral blood count for the diagnosis of anemia is a fundamental process, and the instrument can give some of the basic and advanced parameters; however, there is a need to depend on a manual microscopic scan of peripheral smear for the morphological correlation and other clues which the cell analyzers cannot determine. The purpose of this study was to examine the association between Abbott cell dyn ruby- 5 part analyzer automated haematology analyzer histograms and peripheral smear utilising blood samples from the pathology department at HIMS HASSAN. Material and Methods: In this investigation, 2000 patients’ peripheral blood smears were examined and linked with cell counters produced RBC indices and histograms. Source of data: CBC samples sent for analysis received at Department of Pathology, GAIMS, Bhuj, and Gujarat. RBC indices were observed in conjunction with the histogram pattern. • Microcytic hypochromic anaemia • normocytic normochromic anaemia • macrocytic anaemia • dimorphic anaemia • haemolytic anaemia. Results: The majority of those affected by anaemia were between the ages of 31 and 50. That the majority of patients (69.2%) had Microcytic hypochromic anaemia and displayed diverse histograms. In all, 14% of histograms were normal, 27% had a left-shifted curve, 43% had a broad-based curve, 5% had a short peak, and 6% had a bimodal peaked histogram. In our study, we observed cases of Microcytic hypochromic anaemia with less than normal ranges of Mean Corpuscular Volume (MCV) and Mean Corpuscular Haemoglobin Concentration (MCHC) and increased Red cell Distribution Width (RDW). Conclusion: Technologists can use histograms to help them identify the cases that call for specialised peripheral smear testing. The RBC Histogram becomes a valuable diagnostic tool when the proper interpretation of the curve is combined with the results of blood count features like red cell distribution width and red cell indices.

DOI: 10.5281/zenodo.

Introduction: Organophosphorus (OP) poisoning is a burning health issue in a agriculture dependent country like India. Its exposure is a serious threat that may affect human and animal health because of their various toxicities. Glycemic status of the patient who has consumed organophosphorus compound may help us to predict the severity and prognosis in such patients. Aims and Objectives: (1) To check glycemic status by random blood glucose level at time of admission in acute organophosphorus poisoning. (2) To correlate the blood glucose level with severity and prognosis. Method: this was a prospective analytical study, done at Dept of medicine, AGMC & GBPH from July 2022 to June 2023 with 100 patients. Results: Patients were categorized into hypoglycemic (35%), euglycemic (53%) hyperglycemic (12%) & the outcome in terms of mortality was 57.14%, 5.66% and 41.67% in the respective groups. Further, random blood sugar was compared with POP and PSS to look for statistically significant association between the extremes of glycemic status and higher grades of clinical severity scores using Chi-square test. The established Peradeniya Organophosphorus Poisoning Scale (POP) and Poisoning Severity Scale (PSS) revealed the study to be statistically significant (p value= 0.001) indicating both the extremes of glycemic status are associated with high clinical severity and poorer outcomes.

DOI: 10.5281/zenodo.

Background: As per the proposal of ISO: 15189: NABL -112& CLIA guidelines, a laboratory should ideally establish its own reference intervals for all the parameters specific to the population it serves. Accordingly, a project was taken up to revise and update the reference interval of lipase in the population attending the departmental clinical lab. Material & Methods: This observational, cross sectional database study was carried out at Department of Biochemistry in a teaching hospital. 126 individuals were included in the study provided they satisfied the inclusion and exclusion criteria. Results: On statistical analysis of the compiled data, it was found that the values of lipase ranged from 47.96 U/l – 51.79 U/l(95% confidence interval) with a mean was of 49. 87 U/L. Skewness was found to be 0.990 and kurtosis 1.572 which assured the normal distribution of healthy study population.  No significant age and sex differences were found among males and females. Significance was considered at P value <0.05. Conclusion: We found that the reference interval of the reagent manufacturers were set at a bit higher level for the population and it needs to be updated. This study also established reference interval of lipase did not show significant age and sex differences, suggesting that males and females share the same reference interval.

DOI: 10.5281/zenodo.

Medication errors represent a critical challenge in healthcare, posing risks to patient safety and well-being. This article explores the diverse spectrum of medication errors, aiming to shed light on their complexities and implications for clinical practice. Pharmaceutical omission accounted for 43.51% of all pharmaceutical errors and occurred nearly three times as often as the second most common form of mistake. During the study period, Pharmacist has reported highest medication errors [648 (48.04%)] followed by nursing staff and Doctors [461 (34.17%)] and [240 (17.79%)] respectively. The majority of medication order errors happened during hospital admission (60.12%), which is twice as high as the error rate during the hospital stay (23.8%). Medication omission (43.51%), dosage mistakes (13.79%), and data entry errors (12.08%) were the three most common kinds of errors across all ward specialties.  Medication errors pose significant challenges to patient safety and healthcare quality. By understanding the various types of medication errors, identifying their root causes, and implementing proactive prevention strategies, healthcare providers can mitigate risks and improve medication safety for all patients.

DOI: 10.5281/zenodo.

Background: Low back pain is a very common condition, about 90% of people suffer from it at some point in their lives. Low back pain remains a significant health problem in terms of low quality of life, loss of work, cost of evaluation and varied treatment approaches. Treatment of low backache not only includes treating it symptomatically, but also treating the underlying pathology so that the patient gets satisfactory and lasting relief. Several researchers have indicated that vitamin D deficiency may be possibly related to chronic low back pain. This study was aimed to investigate the relationship between vitamin D levels and idiopathic low back pain in patients and to examine its effects on pain. Material & Methods:  This was a prospective observational study done at Government Medical College, Jammu on 200 patients who visited the out patient department of orthopaedics with complaints of idiopathic non specific low back pain for a period of atleast 3 months or more. Fasting venous blood samples were withdrawn and subjected to an automated chemiluminescence immunoassay (CLIA) analyser to estimate serum Vit D3 levels. Results: Out of 200 patients, around 80 % patients of the patients were found to have inadequate VitD3 levels with 63% of patients being deficient while the rest 17% had insufficient Vit D levels. Conclusion: Evaluation as well as management strategy of Chronic low back ache patients is multidisciplinary. Clinical guidelines for the management of chronic low back pain should include an evaluation of the patient’s vitamin D3 status.

DOI: 10.5281/zenodo.

Background and Aim: Comparative studies on the recovery characteristics of local, general, and regional anaesthesia indicate that local anaesthesia is optimal for day care surgery. The objective of this study was to assess if using a local anesthetic approach is a viable substitute for spinal anaesthesia in hernia repair surgeries. This assessment focused on factors such as operating circumstances, satisfaction of both the patient and surgeon, postoperative pain management, and any potential consequences. Material and Methods: The study was conducted in the surgical department, medical ward, and affiliated hospital. A total of twenty-three individuals were evenly divided between Group A and Group B. Group A had inguinal hernia mesh repairs under local anaesthesia, whereas group B received spinal anaesthesia. Group A received local anaesthesia with 2% xylocaine with adrenaline at a dosage of 4-6 mg/kg (n=60).  Group B received spinal anaesthesia (SA) with a dosage of 0.3 mg/kg in adults and 0.4 mg/kg in children, using a 0.5% bupivacaine solution. The group consisted of 60 participants. Results: Out of the 56 individuals who had spinal anaesthesia, none reported any discomfort (VAS = 0) during surgery. However, two cases each suffered mild and moderate pain. Regarding local anaesthesia, 12 cases reported no discomfort (VAS = 0), 16 cases experienced mild pain (VAS 1-3), 24 cases had moderate pain (VAS 4-6), and 8 cases suffered from severe pain (VAS >= 7). Conclusion: Local anaesthesia is a viable and efficient approach for repairing inguinal hernias in adults. It is comparable to spinal anaesthesia in terms of patient satisfaction regarding factors such as surgery duration, post-operative pain, complications associated with spinal anaesthesia, recovery from anaesthesia (early post-operative ambulation), and length of hospital stay.

DOI: 10.5281/zenodo.

Introduction: Caesarean sections are now frequently performed under spinal anaesthesia to reduce the risk of airway difficulties and the medication transfer to the neonate associated with general anesthesia. Maternal hypotension following spinal anesthesia is a common side effect, even with adequate fluid loading. Aims: In severe pre-eclamptic and normotensive parturients undergoing caesarean sections, to compare the degree of hypotension and the amount of phenylephrine required intraoperatively to treat it in order to assess the safety and effectiveness of spinal anesthesia. Materials and Methods: The study is Observational prospective study. This study was carried out among patients scheduled for Caesarean section. Period Of Study: One and half year (March 2020 – August 2021). This study was conducted after obtaining permission from the institute’s Ethical committee, scientific committee as well as approval of the West Bengal University of Health Sciences. This was conducted at obstetric operation theatre of Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal. Result: The percentage change of mean SBP, DBP, and MAP from baseline did not differ statistically significant between the two groups. Group A (normotensive parturients) consumed more phenylephrine than patient of group B (severe pre eclamptic parturients) and the difference was statistically significant (100.00+14.76 vs. 28.57, p= 0.006). The incidence of hypotension was statistically significant, higher in group A (75% vs.57.1%) than in group B. Conclusion: We compared the changes in hemodynamic parameters between severe pre-eclampsia parturients and normotensive parturients in a prospective comparative study. Although it was not statistically significant, normotensive parturients in our research had more percentage of falls of MAP than parturients with severe pre-eclampsia. Additionally, we discovered that normotensive parturients required more phenylephrine than did parturients with severe pre-eclampsia.

DOI: 10.5281/zenodo.

Background and Objectives: Various antifungal agents, including oral and topical formulations, have been developed for treating dermatophytosis. The study aimed to assess the effectiveness of 1% terbinafine hydrochloride cream and 1% ciclopirox olamine cream, both separately and in combination, for dermatophytosis treatment. Materials and Methods: In this randomized comparative study, 90 patients diagnosed with tinea corporis, tinea cruris, or tinea faciei were allocated randomly into three groups, each comprising 30 patients. Group 1 received topical 1% terbinafine hydrochloride cream twice daily for 6 weeks. Group 2 received topical 1% ciclopirox olamine cream twice daily for 6 weeks. Group 3 received topical 1% terbinafine hydrochloride cream once daily in the morning and 1% ciclopirox olamine cream once daily in the evening for 6 weeks. Therapeutic outcomes were assessed clinically at 3 and 6 weeks post-treatment using a structured questionnaire. Results: After 6 weeks of treatment, Terbinafine group showed no erythema in 0 (0.00%) patient, moderate erythema in 2 (2.22%) patients, and mild erythema in 26 (28.89%) patients. In Ciclopirox group, mild erythema was observed in 19 (21.11%) patients after 6 weeks of treatment. In combination group, moderate erythema was observed in 3 (3.33%) patient, mild erythema in 22 (24.44%) patients, and no erythema in 5 patients after 6 weeks of treatment. None of the patients experienced severe erythema. Conclusion: Combination therapy with terbinafine hydrochloride and ciclopirox olamine demonstrated improved therapeutic response with a lower relapse rate and no significant side effects.

DOI: 10.5281/zenodo.

Background and Objectives: Hoarseness typically represents an initial indicator of both localized and systemic ailments. It is characterized by a voice that is perceived as rough, harsh, or breathy. The underlying pathophysiological mechanisms involve disruptions in vocal cord oscillation due to hypertonic dysphonia, which results from either incomplete glottal closure during phonation or increased vocal cord mass, potentially caused by tumors. Methods: This was a prospective study that included 89 patients chosen via a simple random sampling method. Participants ranged in age from 2 to 70 years and presented with a history of hoarse voice. They were assessed at the E.N.T. outpatient department of a tertiary care medical college and hospital in India. Results: The study identified vocal cord congestion as the most prevalent lesion. Vocal cord nodules was the second most common condition followed by vocal cord polyps. Each of the conditions including supraglottic malignancy and vocal cord growth was found in few patients. Hypopharyngeal malignancies and tonsillar malignancies were also identified in few patients. Also, cases of epiglottic cysts, vocal cord palsy, subglottic malignancy, laryngeal papilloma, vocal cord haemangioma, vocal cord hemorrhage, Reinke’s edema, and vocal cord edema were found. Conclusion: The investigation found that vocal cord congestion were the most common pathological finding, followed by vocal cord nodules then vocal cord polyps. Vocal cord palsy and malignancy related to vocal cord are very rare causes of hoarseness of voice. Factors contributing to these conditions included voice abuse, smoking, and the use of tobacco and betel nuts.

DOI: 10.5281/zenodo.

Background: Physical fitness encompasses more than just being free from debilitating diseases or deformities and the ability to efficiently carry out desk-bound tasks; it also involves a feeling of physical well-being and the ability to handle emergencies that require unusual physical exertion. The Modified Harvard Step Test (HST) is a relatively precise and dependable method for measuring the Physical Fitness Index (PFI). Factors such as body mass index impact cardiorespiratory endurance and lung function. The current study evaluates how body mass index influences cardiac and pulmonary fitness. Methods: This prospective study was conducted in the Department of Physiology on young and healthy adult male and female medical students. Assessment of Physical Fitness Index (PFI): The PFI level at which the subjects of the research were measured was provided through the use of a modified Harvard Step Test. Anthropometric measurements were noted for each participant and blood pressure was measured as per the standard protocol. PFI rating was done according to the modified Harvard Step Test for males and females. Results: The majority of the male participants had lower fitness levels. Fitness among females proved to be higher than in males as a whole. It may be because of the higher prevalence of physical activity in females compared to males of this group. This study found a positive correlation between physical activity and physical fitness. Regularly engaging in physical activity proved to be one of the keys to maintaining a proper fitness level. On the other hand, overweight and obesity were associated with a decline in physical fitness assessments. In the study, a correlation was found between exercise and heart rate variability during exercise. Individuals with higher fitness levels exhibited lower heart rate variability. Conclusion: The findings of the study confirm the traditional connection between exercise and fitness. Regular physical activity is a factor that may influence the level of fitness. Moreover, there was a correlation between fitness levels and heart rate variability during exercise, and the more fit individuals demonstrated lower variability. These results highlight the importance of exercise practice among medical students to increase their physical ability.

DOI: 10.5281/zenodo.

Background: A broad class of aerobic, non-spore-forming bacilli known as non-fermentative gram-negative bacilli (NFGNB) either do not use carbohydrates as a source of energy or break them down by alternative metabolic pathways to fermentation. Patients with certain illnesses or conditions are more likely to become infected with non-fermenters. These include cancers, especially those affecting the reticuloendothelial system, instrumentation, surgery, urinary tract catheterizations, intravascular catheterization, lumbar punctures, tracheostomy, dialysis, lavages, shunt placement, prosthetics, prolonged antibiotic use, and chronic infections. Additional risk factors include exudative lesions, burns, and open wounds. Aim: The study’s goal was to identify NFGNB down to the genus and species level and examine their pattern of antibiotic sensitivity and resistance so that the appropriate empirical therapy could be chosen. Material and Method: The Microbiology Department’s Bacteriology Section is where the current study was carried out. Depending on the clinical diagnosis of each patient, a total of 400 clinical samples were taken from patients who were hospitalized to the hospital’s ICU and different wards. Urine, pus, blood, ear, high vaginal, sputum, endotracheal secretions, tracheal aspirate, and other bodily fluids were among them. Of the total samples, 250 samples were taken from patients admitted to different hospital wards, and 150 samples were taken from patients in the intensive care unit.  In accordance with the guidelines set forth by the institutional ethics committee, each research subject signed an informed consent form.  Patients who wished to participate in the trial or their guardians gave written, informed consent. Results: Non-fermenting Gram-negative bacilli were isolated from 400 clinical specimens accounting for an isolation rate of 10.20%. two fifty specimens (62.5%) showed polymicrobial infection where non-fermenters were isolated along with other organisms, of which E. coli and S. aureus were commonly associated. Pseudomonas aeruginosa isolates in our study were highly susceptible to Colistin (96.79%), Amikacin, Tobramycin (75%), Piperacillin/Tazobactam (62.85%) and imipenem (59.61%) Like Pseudomonas aeruginosa, Acinetobacter baumanii was also highly susceptible to Colistin (85.10%). The drug Imipenem in our institute was more sensitive to Acinetobacter (75.31%) as compared to Pseudomonas (59.61%).Conclusion: NFGNBs are becoming more and more significant opportunistic pathogens, and they are immune to several conventional  antibiotics. Underlying host variables were highly correlated with the result for each of these organisms. Microbiologists and clinics alike have challenges due to the interaction between these multidrug-resistant bacteria and the multidrug-resistant population of immune-compromised patients. Reducing mortality and improving patient management would be achieved by early diagnosis and the implementation of empirical therapy based on the institute’s local antibiogram data.

DOI: 10.5281/zenodo.

Aim: To find out the prevalence of specific risk factors among babies who received exchange transfusion for severe neonatal jaundice and to note their clinical outcome at the end of one month post procedure. Materials and Methods: Retrospective Observational Study done in NICU, SNCU and Level-3 ICU at Niloufer Hospital for Women and Children from 18 months. 56 neonates who received exchange transfusion for severe neonatal jaundice. Results: Majority of the babies were admitted on the day of birth (39%) followed by 1st DOL (14%) followed by 5th DOL (13%). Majority of the babies underwent ET on 1st DOL (18%) followed by day of birth (16%) followed by 5th DOL (16%) neonates. %). Maximum admissions for hyperbilirubinemia occurred on birth day itself.  Mean TSB on DOA was 24.58±4.68 mg/dl. Most common risk factors found during the study were absence of breast feeding (63%), Rh incompatibility (35.7%), ABO incompatibility (25%), Birth Asphyxia (14%), Sepsis (9%), GDM (9%), Preeclampsia (7%). Among the outcomes studied, 4 cases underwent mortality (7%). Of the cases that died, 2 were born preterm at 32 weeks and 35 weeks respectively. All babies had the uniform risk factor of lack of breastfeeding. Two cases had Rh incompatibility, of which one also had a positive sibling history. One case showed ABO incompatibility. 39.2% cases showed no morbidity. 53.5% cases showed morbidities, of which most commonly noted morbidities were thrombocytopenia(23%) followed by sepsis (21%) . Hypocalcaemia was found in 14.2 % cases. Conclusions: Exchange Transfusion, though a lifesaving procedure, effective in rapidly bring down bilirubin levels is not bereft of complications. Significant morbidities identified after the procedure must prompt us to be more stringent in preventive care aspects for severe neonatal jaundice.

DOI: 10.5281/zenodo.

Introduction: Epilepsy is a neurological ailment that is defined by the occurrence of repeated seizures. It is a condition that impacts a large number of people globally. Gaining knowledge of the demographics, treatment patterns, and related variables is essential for the successful administration of care. The objective of this research was to examine the demographic features, drug use, mental health symptoms, and prognosis of epilepsy patients receiving therapy. Materials and Methods: We performed a cross-sectional research comprising 50 individuals with epilepsy who were receiving therapy. Structured questionnaires were used to gather data on demographics, drug utilization, adverse reactions, and mental health symptoms. The Self-Reporting Questionnaire-20 (SRQ-20) was used to evaluate symptoms related to mental health. The prognosis was classified as better, stable, worsened, or not relevant. The data were examined using descriptive statistics. Results: The research had an equal distribution of male and female participants. The majority consisted of adult individuals residing in urban regions. The majority of individuals had generalized epilepsy and had a familial predisposition to the condition. Approximately half of the individuals experienced five or fewer seizures before receiving therapy. Lamotrigine was the predominant antiepileptic medication, with 46% of individuals reporting adverse effects. There was a high incidence of mental health complaints, including headaches, reduced appetite, and disrupted sleep patterns. The prognosis exhibited variability, with 30% of cases demonstrating improvement, 40% remaining stable, and 20% experiencing deterioration. Conclusion: This research offers significant findings about the demographic characteristics, treatment behaviours, and mental health symptoms of individuals with epilepsy. Gaining insight into these aspects may assist healthcare practitioners in customizing treatment plans and support methods to enhance patient outcomes and quality of life.

DOI: 10.5281/zenodo.

Introduction: Subarachnoid anaesthesia is a frequently used method for doing procedures on the lower abdomen and lower limbs. Dexmedetomidine, a drug that activates alpha-2 adrenergic receptors, has been examined as a supplement to subarachnoid block in order to evaluate its impact on maintaining stable blood pressure during surgery and in the recovery period. Methods: A randomized controlled experiment was performed on a sample of 60 patients classified as ASA grade I or II, aged between 20 and 60 years, who were having procedures on the lower abdomen and lower limbs. The patients were assigned randomly to two groups: Group D got dexmedetomidine, whereas Group C received normal saline. Demographic information, as well as heart rate (HR), blood pressure (BP), and respiratory rate (RR) during surgery, were documented at different intervals and analyzed. Results: There were no notable disparities between the groups in relation to demographic characteristics. The intraoperative heart rate (HR) was consistently lower in Group D compared to Group C starting from 5 minutes after the subarachnoid block, and this difference was statistically significant (p < 0.001). Group D exhibited a consistent and substantial decrease in blood pressure compared to other groups starting from 10 minutes after the subarachnoid block (p < 0.001). The statistical analysis, known as RR, did not reveal any significant differences between the groups at any time point (p > 0.05). Conclusion: The addition of dexmedetomidine to a subarachnoid block led to a significant decrease in intraoperative heart rate (HR) and blood pressure (BP) as compared to the use of normal saline. Nevertheless, there were no notable disparities in respiratory rate across the groups. Dexmedetomidine is a valuable addition to subarachnoid anaesthesia for maintaining stable blood pressure during procedures involving the lower abdomen and lower limbs.

DOI: 10.5281/zenodo.

Introduction: Primary ovarian germ cell tumors are rare and a heterogenous group of neoplasms with various histological pattern. It account for for 20% of all ovarian neoplasms and most commonly seen in young female and children and clinically presents with pain abdomen, abdominal lump. Benign ovarian germ cell tumors are more common than malignant tumors which accounts for about 2.5% of all ovarian malignancies. Aim of this study is to determine the clinical presentation of germ cell tumors of ovary in relation to age, parity, symptoms and evaluate the different histomorphological patterns and frequency of various germ cell tumors. Materials and Methods: It is a hospital based retrospective cross sectional study conducted for a period of one and half year in a tertiary care centre of north east India. Study data were retrieved from the histopathology section of Department of Pathology Gauhati medical college and Hospital. All the cases were rechecked and slides were reviewed systematically for histopathological diagnosis. Results: Most commonly affected age group is 26-45 year, mean age 32.8 years. Abdominal pain with lump was most common presentation. Six (18.75%) patients were nulliparous, 18(56.25%) parous and 8(25.0%) were unmarried girls. Out of 32 germ cell tumors 27(84.38%) were benign 5(15.62%) were malignant (P<0.002). Among the 32 germ cell benign cystic teratoma 27(84.38%) was the most common benign neoplasm and mixed germ cell tumor 2(6.25%) was the most common malignant neoplasm. Conclusion: Primary ovarian germ cell tumor are uncommon, most of the tumor seen in 26 to 45 years, malignant germ cell tumor are common in younger age group. Mature teratoma is most common benign tumor and mixed germ cell tumor is most common malignant tumor and surgery is the treatment of choice.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to assess the treatment pattern with Global Initiative for Asthma (GINA) guidelines in patients of bronchial asthma. Methods: The study was a prospective observational study for a period of one year in the outpatient and inpatient Department of Medicine and Paediatrics, Department of Pharmacology, DMCH, Laheriasarai, Darbhanga, Bihar, India. Permission was acquired from the head of department of medicine and paediatrics for the study. Results: The average age of the Patients was 38.52±23.77 Yrs. (Range- 6-83), majority of the patients were Male -53.34% and Females were 46.67%. β2 agonists were the most common antiasthmatic drugs prescribed in all the patients followed by corticosteroids and methylxanthines respectively. The next common drug class prescribed was antimicrobial agents. Oxygen was prescribed in 9 patients. Other drugs prescribed were antacids and antireflux agents, antihistaminics, vitamins and minerals, antidiabetics, antihypertensives and antipyretics and analgesics. β2 agonists were the most common antiasthmatic drugs prescribed in 48 patients followed by corticosteroids and anticholinergics respectively. Magnesium sulphate was prescribed to inpatients only. The next common drug class prescribed was antimicrobial agents. Oxygen was prescribed in 11 patients. Other drugs prescribed were expectorants, antipyretics and analgesics, antacids and antireflux agents and antihistaminics. Conclusion: It was concluded from our study that Overall pattern of drug use showed that β2 agonists and corticosteroids were most common class of antiasthmatic drugs prescribed. A detailed drug utilization of antiasthmatic drugs indicated that the use of oral and nebulised salbutamol, injection hydrocortisone, nebulised budesonide and injection as well as oral theophylline was high in both IPD and OPD medicine patients. The use of oral and nebulised salbutamol, systemic steroids and nebulised budesonide was high only in paediatric IPD patients as compared to paediatric OPD patients. The use of theophylline was only in medicine patients while magnesium sulphate was prescribed to only paediatric patients.

DOI: 10.5281/zenodo.

Aim:  The aim of the present study was to investigate the impact of oral anticholinergics on insulin secretion in subjects with impaired glucose tolerance (IGT), in comparison with volunteers having normal glucose tolerance (NGT). Material & Methods: This prospective observational study was conducted in the Department of Pharmacology, DMCH, Laheriasarai, Darbhanga, Bihar, India and recruited 30 IGT and 30 NGT subjects. An oral glucose tolerance test (OGTT) was conducted twice in the absence and presence of hyoscine butyl-bromide (HBB). The plasma glucose (PG) and insulin levels were serially estimated at 30-min increments for 2 h after the OGTT. Early (ΔI30/ΔPG30) & late (insulin/PGAUC 60-120) phase insulin activity were assessed subsequently. Results: In the present study, 60 subjects including 30 IGT (13 male/17 female, BMI: 26.4±2.4) and 30 NGT (15 male/15 female, BMI: 24±0.6) met the study requirements and completed the experimental protocol. In both the groups, a higher proportion belonged to the “overweight” category. The effect of HBB in the IGT group was examined in terms of pharmacodynamic parameters obtained during a 75 g OGTT (0–120 min). The presence of HBB did not have an impact on their fasting PG and PG Cmax values. In the IGT group, the presence of HBB had no effect on fasting insulin levels and insulin Cmax at t = 60 min. The addition of HBB also did not impact on the insulin total AUC 0–120 min. The presence of HBB had no effect on fasting insulin levels (6.50 ± 1.32 vs. 5.70 ± 0.87 mIU/L) and insulin Cmax at t = 60 min. However, the addition of HBB significantly decreased the insulin total AUC 0-120 min. In the NGT group, similar to the IGT group, the presence of HBB did not impact on the plasma glucose-based parameters, for example, fasting PG. Conclusion: Our study findings indicate that insulin secretion is influenced by cholinergic system and that oral anticholinergics may attenuate the late phase insulin activity in varying degrees of glycemic status.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to assess the retinal changes among patients presenting with pregnancy induced hypertension. Methods: This was a prospective observational study carried out in the Department of Ophthalmology, IGIMS, Patna, Bihar, India. 100 patients who fulfilled diagnostic criteria of PIH during a period of one year were enrolled for the study. Informed consent was taken and baseline data was recorded. Results: Most of the women belonged to 20-30 years of age group. 64 (64%) were primigravida, 26 (26%) were multigravida (2-4 pregnancies), and 10 (10%) were Grand Multi (5 or more deliveries). 36 (36%) patients had mild preeclampsia, 52 (52%) had moderate to severe preeclampsia and 12 (12%) had Eclampsia. Among primigravida patients 34 patients showed fundus changes while out of 26 patients who were multigravida 22 patients had retinal changes. We found a significant correlation between gravidity and retinal changes (p = 0.01). In our study, retinal changes were observed in 11 patients out of 36 patients with non severe preeclampsia, 11 out of 12 patients with severe preeclampsia and all eclampsia patients showed fundus changes. 22 patients had grade I changes, 32 showed grade II changes, grade III and grade IV hypertensive changes was seen in 8 and 3 patients respectively. Six patients developed serous retinal detachment. Conclusion: Grade III and Grade IV retinopathy changes were more frequently noted in patients with severe preeclampsia and eclampsia. Few patients also presented with vision threatening complications such as serous retinal detachment, macular edema and cortical blindness. Presence of macular edema, papilloedema or retinal detachment are the warning signs for termination of pregnancy.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to determine cardiovascular comorbidities associated with different stages of peripheral vascular disease and current use of pharmacological cardiovascular risk reducing therapy among men and women with the disease. Methods: This study was conducted by random selection of 100 cases with Peripheral Arterial disease of the lower extremities admitted to surgical wards of Darbhanga Medical College and Hospital, Darbhanga, Bihar, India done during the period for the period of one year. Results: Among the 80 cases diagnosed with PAD due to Atherosclerosis in this study 70 were males and 10 patients were females. In this study, 20 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, 44 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.

Aim: The aim of the present study was to evaluate the preoperative and post-operative astigmatism in small incision non-phaco cataract surgery from superior and temporal incision and phacosurgery. Methods: The current investigation was carried out at the Department of Ophthalmology, IGIMS, Patna, Bihar, India over a duration of one year. A total of 100 patients were chosen for the investigation. All patients received manual small incision cataract surgery (MSICS), with 50 patients undergoing superior scleral incision, 50 patients undergoing superotemporal incision, and the remaining 50 patients undergoing phacosurgery. All individuals were assessed and treated at the same medical facility, and they received post-operative care as outpatients at the same hospital. Results: A randomized comparison of astigmatism at postoperative follow-ups after superior (SI), superotemporal scleral incision (STI), and Phacosurgery in manual small incision cataract surgery in 100 patients, 50 each incision. In this study, 74% of MSICS patients in both groups had visual acuity less than 6/60, whereas 26% had it more than 6/60. In this study, 18 (36%) WTR astigmatism patients underwent SI, 17 (34%) STI, and 16 (32%), while 22 (44%) ATR astigmatism patients underwent SI, 46% STI, and 24 (48%) Phacosurgery. Conclusion: This study demonstrates that sutureless superotemporal scleral incision causes less post-operative astigmatism than superior and phacosurgery. Superotemporal incision causes with-the-rule astigmatism in most cases postoperatively and can neutralize against-the-rule astigmatism in most elderly cataract patients, while superior scleral incision causes mostly against-the-rule.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to assess the histopathological spectrum of uterine lesions in perimenopausal and postmenopausal women. Methods: The present study was conducted for a period of 1 year in the Department of Pathology, Darbhanga Medical College and Hospital, Darbhanga, Bihar, India. The study comprised of 100 cases which met the inclusion criteria were taken for this study. Results: The maximum number of cases 24 (24%) were between the age group of 46-50 years. The most common site biopsy received was from cervix, 43 (43%). Postmenopausal bleeding was due to benign causes. Atrophic endometrium was the commonest benign. Conclusion: PMB is a symptom which should not be taken lightly. Accurate diagnosis is usually made by histopathological examination. In our study, a wide spectrum of both neoplastic and non- neoplastic conditions of female genital tract has displayed as a cause of PMB with predominance of benign causes. Cervical cancer is still the most common cause of PMB, which point out that the effective implementation of screening program is utmost important. More awareness among people, especially elderly women should be made about the importance of pap screening.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to evaluate the platelet count and platelet indices in patients with hyperlipidemia. Methods: This was a prospective study carried out at Department of Pathology, Darbhanga Medical College and Hospital, Darbhanga, Bihar, India. The study included all patients of both sexes above 20 years of age coming to our diagnostic centre for routine health checkup. These patients underwent lipid profile testing after 12-14 hours of overnight fasting and a complete blood count as a part of their routine health checkup. 100 patients with hyperlipidemia without any associated diseases and 100 controls with normal lipid profile were included in the study. Results: The patients were divided into 21-40, 41-60, 61-80 and > 80 years of age in both the sexes. Maximum number of patients were in 41-60 years of age (64%) followed by 27% in 21-40 years of age, 8% in 61-80 years age group and one patient above 80 years of age.65% were male and 35% were females. The mean age was 47.3 ± 12.8 in study group and 48.6 ± 12.6 in the control group. The mean cholesterol ,mean triglyceride and mean HDL cholesterol level in study group was 218.6±36.3, 244.3±154, 38.7±9.6 respectively and 158±26.8 ,94.1±34.8,and 42.1±9.3 in control group respectively. Mean LDL cholesterol was 131.1±39.4 in study group and 97.1±25.2 in control group. There was significant difference in cholesterol, triglyceride and LDL cholesterol levels in both the groups. When platelet parameters were compared in both the groups, it was observed that the mean platelet count was 320±78.8 in study group as compared to 306±76.8 in control group. There was a significant difference in platelet counts in both groups with a p value of 0.01. PCT and MPC also showed a p value of 0.04. The mean platelet mass (MPM) was 2.17±0.2 in study group as compared to 2.13±021 in control group. Large platelet count was 7.09±4.9 in study group while it was 5.95±3.81 in control group which was also significantly different. However, the PLC-R did not show a significant difference in both groups. Conclusion: Hyperlipidemia may cause a variety of thromboembolic complications and platelet indices reported by modern day automated haematology analysers are used to assess the risk of such events in hyperlipidemic patients. Our study indicates that PCT, MPM, large platelets and platelet count are significantly higher in hyperlipidemia patients.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to find the effects of simple yogic exercises on Pulmonary Function Tests in healthy adults. Methods: The present study was conducted in the Pulmonary Function Test (PFT) Laboratory, Department of Physiology, Informed (written) consent was taken from each subject before the study. 100 healthy subjects, including both male and female of age group of 40 to 60 years, with no respiratory, cardiovascular or other medical aliments, were selected for the study. Results: The mean age, mean weight and mean height was 64.26 + 6.34 years, 72.48 + 13.47 kgs and 166.74 + 8.32 cms. The pulmonary parameters with respect to FVC % Predicted and MVV % Predicted showed highly significant results. Conclusion: The study revealed that after undergoing six weeks of regular yoga training in healthy individuals, definite improvement in pulmonary function parameters like FVC and MVV is seen. This may be due to regular slow and forceful inspiration and expiration during yogasanas leading to strengthening of respiratory muscles and increased release of surfactant too.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to assess the efficacy of hyperbaric Ropivacaine in patients undergoing lower abdominal and perineal surgeries under spinal anaesthesia. Methods: The present study was prospective, observational study, conducted in the Department of Anaesthesiology & Critical Care, Jawaharlal Nehru Medical College & Hospital, Bhagalpur, Bihar, India. Study duration was of one years. In present study, 50 patients underwent spinal anaesthesia with ropivacaine for lower abdominal and perineal surgeries. Results: Mean age was 47.33 ± 12.16 Years, mean weight was 64.86 ± 10.46 kgs, gender wise 44% were male while 56% were females, ASA class I were 72%, class II were 28% and mean duration of surgery was 64.6 ± 20.44 min. In present study, average time-to achieve sensory block at T10 level was 3.7 ± 0.46 minutes, average time to achieve maximum block was 5 ± 0.35 minutes, average time taken for Two segment regression was 128 ± 19.65 minutes, average total duration of sensory block was 229 ± 23.32 minutes, mean time for achievement of MBS Grade 3 was 3.7 ± 0.42 minutes and mean total duration (motor) (MBS grade 0) block was 245 ± 26.54 minutes. We noted maximum block at T6 level in 3 patient, 6 patients at T10 level and 21 patients at T8 level. Conclusion: We observed that the variables assessed to achieve sensory and motor block were satisfactory, without any adverse effects intra and post-operatively. Hence, Ropivacaine (hyperbaric) 0.75% can be used for lower abdominal and perineal surgeries with desired motor and sensory effects with effective surgical time. It can be used successfully for Day care surgeries.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to compare the outcomes of bilateral inguinal hernia repair between patients who underwent the Stoppa’s repair and those who underwent Lichtenstein tension free mesh hernioplasty repair. Methods: A prospective, open, randomized, comparative study was undertaken in the Department of General Surgery  for the period of 1 year. Before being included in the study, informed written consent was obtained from all patients. Total 70 patients-30 patients in each group-were included in the study who were fulfilled the selection criteria. Results: Majority of the patients were males. Other preoperative variables-age, BMI, comorbidities, and smoking-did not show a statistically significant difference between the two groups. The operative time was significantly shorter in group 2 patients (45.35±7.23 min), whereas it was 78.42±8.62 min in group A. In both groups, there were no intraoperative complications. Group 2 patients had significantly lower postoperative pain scores measured by the visual analogue scale at 12 hours postoperatively, but there was no statistically significant difference in pain at 24 hours or 7 days postoperatively. In terms of postoperative complications, postoperative hospital stays, return to normal daily activities, and chronic groin pain, there was no statistically significant difference between the two groups. Conclusion: The present study was unable to show that either technique was superior in the treatment of bilateral inguinal hernias. Both procedures, on the other hand, were capable of achieving favourable post-operative outcomes and had similar problems. The majority of the patients were receptive to both approaches. The time it took for all groups to return to normal activity and work without pain was longer, most likely because the hernia procedures were bilateral.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to determine the role of CT perfusion in patients with acute ischemic stroke in the patients of less than 12 hrs of acute stroke symptoms. Methods: The present study was a prospective study to determine the value of CT in evaluation of cerebral perfusion by use of a bolus of iodinated contrast medium in 50 patients with acute stroke, carried out in the Department of Radiology, Katihar Medical College and Hospital, Katihar, Bihar, India. All the patients enrolled in study were evaluating in period of 18 months. Results: Majority of subjects in the study were in the age group 61 to 70 yrs. (34%). Mean age of subjects was 61.9 ± 14.26 yrs. Majority of subjects in the study i.e., 56% were males and 44% were females. 48% of lesions were on Right side, 34% of them on Left side, 14% on Midline and 4% on both cerebral hemispheres. Majority of subjects (94%) presented with Weakness as symptom. 68% of subjects presented with duration of <6 hrs and 32% presented with duration >6 hrs. Non contrast CT showed that 26 patients had Loss of Gray Matter Interface, 14 patients had Loss of Insular Ribbon, 10 patients had hyper dense MCA and none of them had hyper dense Basilar. On CT perfusion 7 patients had ACA involvement, 20 patients had LCS of MCA involvement, 15 patients had M1 of MCA involvement, 26 patients had M2 of MCA involvement and 18 patients had M3 of MCA involvement and 2 patients had PCA involvement. Conclusion: PS elevation more than 5ml/min/100gm appears to be a promising marker for predicting the risk of HT in acute stroke patients. More importantly, a small PCT lesion (<100 mL) identifies patients who will have a small final infarct and good clinical outcome. A large PCT lesion (>100ml) identifies patients who will have a large final infarct and poor clinical outcome. PCT can play an important role in guiding acute stroke treatment.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to evaluate the trigger tool method (TTM) in detection, monitoring, and reporting of adverse drug reactions (ADRs). Methods: This was prospective, interventional, single center study conducted at department of Pharmacology, Darbhanga Medical College, Darbhanga, Bihar, India on a permanent basis, posted in Department of Medicine. A total 650 patients were admitted during the study period in the respective medicine unit. Results: A total of 650 patients who fulfill the selection criteria were enrolled. 70% were male and 30% were females. The mean age of patients was 43.07 ± 16.4 years, and the mean length of hospital stay was 5.75 ± 3.12 days. Of the 650 patient cases, triggers were observed in 80 patients (12.30%).  while 20 (25%) suffered one or more ADRs. A list of 17 triggers was given to 30 nurses for identification of ADEs. List of 17 triggers consists of 9 DT, 1 LT and 7 PT. Of these 17 triggers, 14 triggers were identified by nurses in the study population and 3 triggers were not observed. These 14 triggers were noticed 130 times, with an average 12.53 triggers observed per patient. These included DT (100 times), LT (0 times) and PT (30 times). Triggers were identified for a minimum once and maximum 3 times in 95 patients. Of the various triggers observed, 7 drug triggers and 4 patient triggers were related to ADRs. Hence 11 triggers (64.70%) were positive (related to ADRs), out of total 17 triggers under evaluation. A total 24 ADRs were observed in 25 inpatients during study period. One or more triggers were observed in these patients. The commonly detected ADRs were gastritis, thrombophlebitis, diarrhea and vomiting. Chills, cough, headache, joint pain, metallic taste, pruritus and weight gain were also observed. Conclusion: The reporting system is operational at the study site and ADRs are being reported using a standard form. Patients recovering from the reactions following the withdrawal of the suspected drug, and the majority of ADRs were mild. TTM can be used as an add‑on tool to existing methods like spontaneous method for the health‑care professionals for better detection of ADRs in the pharmacovigilance program. However, further research is required to explore the feasibility and acceptability of TTM.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to evaluate and compare the clinical success and parental satisfaction for stainless steel and zirconia crowns in primary molars. Methods: This prospective randomized controlled trial was designed as a split‑mouth study. which exfoliation was imminent, tooth with internal resorption, and tooth with acute infection at Mithila Minority Dental College and Hospital, Darbhanga, Bihar, India. The patients with bilateral pulp therapy treated teeth were randomly divided into two groups by coin toss in which group I consisted of 50 primary second molars which would receive SSC (3M ESPE, Minneapolis, USA) and group II consisted of 50 primary second molars which would receive zirconia crowns (Kinder Krown, Minneapolis USA). Results: Both SSC and zirconia crowns achieved a clinical success rate of 100% during the study period. This was determined by evaluating factors such as crown retention, modified gingival index, stain resistance, gingival marginal extension, occlusion, and proximal contact at placement. The only difference between the two crowns was in the plaque index. The level of parental satisfaction was equivalent for both groups in regards to the factors of shape, size, retention, durability, and overall satisfaction. Out of the total number of parents surveyed, only 21 (42%) expressed satisfaction with the color of SSC, while all 50 parents (100%) were delighted with the color of zirconia. A highly significant statistical difference (P < 0.001) was observed between the groups. There was no change in the parental perspective over the duration of the investigation. Every single one of the 50 patients (100%) expressed satisfaction with the zirconia crowns, but only 27 out of the patients (54%) were satisfied with SSC. There was a substantial statistical disparity (P < 0.001) between both groups. Conclusion: Stainless steel crowns continue to be considered the “Gold Standard” for fully covering the back teeth in primary molars. This is because they require a simpler crown preparation process and are less expensive than zirconia crowns. Zirconia crowns, despite their esthetic appeal, require a more invasive crown preparation procedure, necessitate the use of local anesthesia, and are time-consuming. Consequently, they are not often approved by parents and patients.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to correlate the levels of serum magnesium and blood glucose in type II diabetic population in a tertiary care hospital. Methods: The present study was conducted in the Department of Medicine, Nalanda medical College and Hospital, Patna, Bihar, India and 150 cases all new and old cases of Type 2 diabetes mellitus patients, aged between 35 to 60 years attended were included in the study for the period of 12 months. Results: In our study, mean and std deviation of all the 3 groups were 54.66±13.7, 57.94±11.8 and 52.68±9.8 respectively. In gender area which was not significant in our study. There was a positive Correlation between the parameters of glycemic status i.e., HbA1C, fasting and post prandial blood glucose but no significant correlation with magnesium. The fasting and post prandial blood glucose values are inversely correlated with magnesium. There was no significance r and p-values between the sr.mg and HbA1C. Conclusion: Serum magnesium levels were lower in DM2 patients when compared with non-diabetic controls. Because of this low level of Mg2+, which reduces insulin sensitivity and may increase risk of secondary complications like retinopathy, hypertension and dyslipidaemia, it may be prudent in clinical practice to periodically investigate plasma Mg2+ concentrations in diabetic patients. If plasma Mg2+ is low, an intervention to increase dietary intake of magnesium may be beneficial.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to assess the incidence and sociodemographic profile of scabies in pediatric patients with different age groups attending secondary health care hospital. Methods: This prospective single centre study was conducted on 200 paediatric cases attending in the Department of Paediatrics, Jawaharlal Nehru Medical College and Hospital, Bhagalpur, Bihar  India  over a period of 12 months. Results: Out of studied 200 patients, 46 (23%); 64 (32%) and 90 (45%) found to be in age groups < 2 yr.; 2-5 yr. > 6-12 yr., respectively. Boys were more affected 120 (60%) as compared to girls 80 (40%). 66% patients had studied >10^th std. and 90% had over-crowding at home. Commonest duration of symptoms while presentation less than 1 month in 176 (88%) and only 24 (12%) have more than 1 month. Itching was noted in 144 (72%) and absent in 56 (28%). More commonly associated in-patients with poor and average hygiene (99.5%) than in the good hygiene. Conclusion: Scabies was commonly seen in children below 6 years of age with boys affected more than girls. More commonly associated in-patients with poor and average hygiene than in the good hygiene. The important predisposing factors were overcrowding and poor hygiene. It was common in poor economic groups. Thus, improving the socio- economic conditions, hygiene, avoiding overcrowding and proper treatment of cases and close contacts are the sources of infection to children help in preventing scabies in children.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to determine causes of respiratory distress, pattern of respiratory modality used and its outcome among admitted preterm newborns. Methods: A retrospective descriptive study was conducted in the Department Of Pediatrics, Shri Krishna Medical College and Hospital, Muzaffarpur, Bihar, India over a period of two years targeting all neonates admitted to neonatology department. A Total of 200 patients were admitted in NICU during the study. Results: Mean gestational age was 32.46±2.58 weeks. Most of the newborns (64%) belonged to the gestational age within 28 – <34 weeks category. Mean birth weight was 1665.43±585.58 g among them very low birth weight infants were 42%. Male out numbered female newborns (55% vs 45%). Total 12 (6%) infants had Apgar scores <7 at 5 minutes who required some degree of resuscitation just after birth. After admission 8 (4%) patients got single dose of surfactant. Most of the mother (66%) was multiparous and 51% of them did not receive even a single dose of antenatal corticosteroid. All of them were inborn and cesarean section was the mode of delivery for 80% of the enrolled neonates. Maternal hypertension and diabetes mellitus were present in 140 (70%) and 64 (32%) of mother respectively. Maternal risk factors for sepsis were present in 48 (24%) of infants admitted to the NICU. Conclusion: Respiratory distress syndrome is the commonest cause of respiratory distress. Two third of preterm newborns required respiratory support. Most common mode of respiratory support was non invasive mode in the form of supplemental oxygen, Heated humidified high flow nasal cannula and continuous positive airway pressure. Short term morbidities like nasal trauma, sepsis, septic shock, disseminated intravascular coagulation, necrotising enterocolitis and intraventricular haemorrhage were more common in newborns who required invasive respiratory support (p <0.05). Retinopathy of prematurity and mortality was significantly higher in invasive respiratory support group.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to assess the obstetrics outcomes of uterine fibroids and their consequences in a tertiary hospital. Methods: This study was an observational study conducted in the Department of Obstetrics and Gynaecology in NMCH for one year. The study was carried out for a duration of 12 months, from April 23 to March 24. A total of 200 pregnant women with ultrasound results of fibroid were included in this study. Results: The mean age of study patients was 31 years with standard deviation of 5.85, however 42% were 26-30 years old and 32% were 31-35 years old. 9% of patients were under 25 and 3% were over 40. 42% were primigravida, 38% were second or third gravida, and 20% were fourth gravida. Most patients (73%) had subserous fibroids and 18% had submucous fibroids. Fibroids were most prevalent in the fundus (74%), and 13% were pedunculated. 2–3 fibroids were seen in 47% of individuals. Most instances (80%) were delivered at term in this research. The most prevalent delivery method was cesarean section (62%), followed by vaginal (25%), including instrumental and aided breech. Threatened preterm labor (22%), abortion (17%), PPH (10%), and blood transfusion (21%), were the main pregnancy problems. Conclusion: Uterine fibroid pregnancy is often asymptomatic and accidental. Early pregnancy abortion, term pregnancy PROM, and postpartum PPH are linked to fibroids. Also, malpresentation is more likely. Pregnant uterine fibroid patients have significant cesarean section rates. So, uterine fibroids make a normal pregnancy high-risk.

DOI: 10.5281/zenodo.

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 in the Department of Medicine, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India for the period of 1 year. 200 patients were considered for present study. Results: 80% were from group A while 20% 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. 104 (65%) patients had ischemic stroke, while 48 (30%) had hemorrhagic stroke. We noted mortality within 30 days in 24 (15%) 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 (30%). Maximum mortality was noted in >119 (40%) followed by 98-118 (35%) 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 (25%). Maximum mortality was noted in >9 (45%) followed by 6.8-8.9 (30%) blood urea group. We noted that age > 65 years, GCS score > 10 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.

Aim: The aim of the present study was to evaluate hemodynamic effects of regional anaesthesia in preeclamptic females. Methods: The observational study was conducted in the Department of Anaesthesia, BMIMS Pawapuri, Nalanda, Bihar, India. Study duration was of 24 months. Study population comprised of 100 normotensive ASA grade II parturients planned for LSCS and 100 ASA grade III preeclamptic parturients planned for LSCS. Results: Mean age in normotensive group was 25.35±4.36 years and in pre- eclamptic group mean age was 24.16±3.07 years. The mean weight at the time of caesarean section was 72.8±6.34 kgs in the preeclamptic group and 74.66±7.53 kgs in preeclamptic. The mean gestational age at the time of caesarean section was 39.14±0.54 weeks in preeclamptic women and 39.07±0.77 weeks in normotensive. Majority of the study participants were nulliparous women in both the group (55% in normotensive group v/s 68% in pre- eclamptic group) while nearly 43% of the participants in the normotensive group and 27% in pre-eclamptic group were primipara. Both groups were comparable in term of mean age, weight, gestational age and parity comparison (p<0.05). All the non-preeclamptic parturients were ASA II while, all parturients in the preeclamptic group were ASA III, and this difference was statistically significant between both groups; (p< 0.001). The incidence of hypotension in non-preeclamptic parturients (93%) was significantly higher and that of preeclamptic parturients (15%). Similarly, bradycardia was also more commonly observed in normotensive group (32%) compared to pre-eclamptic group (2%). Conclusion: Subarachnoid blockade is associated with better perioperative hemodynamic stability and lower risk of hypotension and vasopressor requirements in preeclamptic women compared to the rates of healthy subjects. Subarachnoid block can be safely practiced in patients with preeclampsia undergoing caesarean section. The benefit of rapid, dense and reliable subarachnoid block over epidural anaesthesia should be considered for preeclamptics undergoing caesarean section.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to investigate the effects of vitamin A supplementation on iron therapy in anaemic adolescent girls. Methods: It was a Prospective study conducted at Department of Physiology within a period of 1 year. The study population were school going young girls of age 13-16 years. The students of classes 8th, 9th and 10th, aged from 13 to 16 years, were included in the study. 200 girls were included in the study. Results: Severely anaemic students were excluded from the study and referred to medicine and gynaecology OPD for active therapy. Before the study, 68 patients had normal anemia, 44 patients had mild anemia and 88 patients had moderate anemia. The difference between before and after intervention was extremely significant (p<0.0001). In group B mean baseline value for blood haemoglobin was 10.505+1.100 gm/dL and after intervention value was 11.804+1.076 gm/dL. This difference was very significant. In group C, the mean baseline value for blood haemoglobin was 12.664+0.402 gm/dL and after the study duration it was 13.000+0.400 gm/dL. This difference was significant. Conclusion: The present study was conducted to evaluate whether vitamin A supplementation helps to restore the blood haemoglobin level along with iron therapy and helps to improve the status of anaemia. So, further studies involving large population need to be done to establish the definitive role of vitamin A supplementation in anaemia and to recommend it as a standard additive therapeutic agent.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to assess frequency and antibiotic susceptibility pattern of non-fermenting gram-negative rods isolated from blood culture of patients. Material & Methods: The prospective study was conducted in the Department of Microbiology, Patna Medical College and Hospital, Patna, Bihar, India in between the duration of 1year. Blood Stream Infection (BSI) was defined as the isolation of a pathogen microorganism from >1 blood culture bottle. BSIs were classified as community- and hospital-acquired infections if detected within the first 48 h of hospitalization, or after 48 h of hospitalization, respectively. Results: Total 200 NFGNB were isolated from 1425 culture positive clinical samples accounting for an isolation rate of 14.03%. Urine was the most common specimen (30%) followed by pus (26%), blood (16%), sputum (12%), tracheal aspirate (8%) and remaining 8% included other samples. Acinetobacter baumannii was the predominant isolate, 104 (52%) followed by Pseudomonas aeruginosa 80 (40%) and Burkholderia cepacia complex (BCC) 10 (5%). Burkholderia pseudomallei, Acinetobacter lwoffii and Stenotrophomonas maltophilia altogether accounted for 3%. Among the NFGNB isolated, A. baumannii showed highest sensitivity to gentamicin and lowest sensitivity to ceftriaxone. P. aeruginosa was mostly sensitive to amikacin but least sensitive to ceftriaxone. B. cepacia complex, B. pseudomallei and S. maltophilia showed 100% susceptibility to cotrimoxazole. A. lwoffii showed sensitivity to most of the antibiotics. A. baumannii and P. aeruginosa were mostly sensitive to gentamicin and amikacin and least sensitive to ceftriaxone. Conclusion: This study underlines the need to identify NFGNB in tertiary care hospitals and to monitor their susceptibility pattern to guide the clinician for better care and management of patients. Improved antibiotic stewardship and strict infection control measures especially hand washing need to be implemented to prevent emergence and spread of multidrug resistant NFGNB in health care settings.

DOI: 10.5281/zenodo.

Background: Mandibular foramen is leading to mandibular canal through which inferior alveolar nerve and vessels will transmit and supply the teeth of lower jaw. Inferior alveolar nerve block is common anesthetic procedure prior to dental surgeries on lower jaw. Failure in mandibular anesthesia or injury to neurovascular bundle may be resulted by inaccurate localization of mandibular foramen. Hence this study is aimed to locate the mandibular foramen and its distances from different bone landmarks on internal surface of ramus of dry mandible. Objective: Study to determine the precise position of mandibular foramen in 50 dry mandibles, which is essential for successful inferior alveolar nerve block prior to dental procedures. Materials and Methods: This descriptive study was done on 50 dentulous from Department of Anatomy, Patna Medical College and Hospital, Patna, Bihar, India adult dry human mandibles of unknown sex and age. Distance of mandibular foramen from the mandibular notch, anterior border of the ramus of mandible, posterior border of the ramus of the mandible(angle of mandible), posterior border of the 3rd molar socket and meeting point of base with posterior border of ramus were measured. Further observation regarding the presence of accessory mandibular foramen was done. The observations were tabulated and descriptive statistics was used analyze the data. Result: In the present study, totally 50 mandibular foramina and 18 accessory foramina were observed in the 30 mandible. The mean distance of mandibular foramina to anterior border of ramus is 14.63±3.16 (R) mm and 15.31±3.11 mm(L), to posterior border is (R):12.34±3.10 mm and (L):13.51±3.92 mm, to mandibular notch is (R):21.23±4.56 mm and (L):21.16±3.12 mm, to angle of mandible (R):22.14±3.18 mm and (L):22.1±4.12 mm, to posterior border of 3rd molar socket is (R):14.37±3.16 mm and (L):19.26±2.57 mm. Conclusion: The present study on the precise location of mandibular foramen and on the incidence of accessory mandibular foramen will help the dental surgeons for more successful anesthesia and to perform safer surgeries on the ramus of mandible.

DOI: 10.5281/zenodo.