Background: Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. In the setting of severe sepsis and septic shock, myocardial depression is common. According to a few studies, troponins also correlate strongly with myocardial dysfunction. Non-invasiveness and instantaneous diagnostic capability are prominent features of the use of Echocardiography in critical care. Sepsis and septic shock represent complex situations where early hemodynamic assessment and support are among the keys to therapeutic success. Materials and Methods: The present observational cross sectional study is carried out in Department of General Medicine, Agartala Government Medical College (AGMC & GBPH), Agartala, Tripura for a period of two years from December 2020 to December 2022 among patients diagnosed with sepsis in Medical Intensive Care Unit. CPKMB and Troponin-I determination along with echocardiography was done in all patients diagnosed with sepsis in Medical Intensive Care Unit. Results: In our study, 68(77.3%) patients were Troponin I positive. 70 (79.5%) patients were CPK MB positive. Left ventricular Systolic dysfunction (LVSD) was found in 55(62.5%) patients whereas Left ventricular diastolic dysfunction (LVDD) was present in 44(50%) patients. In our study 37(42.1%) patients had Right ventricular dysfunction. Conclusion: We conclude that Sepsis Related Myocardial Dysfunction (SRMD) is very much common. Early assessment of SRMD can be done by doing cardiac biomarkers (Troponin I & CPKMB). Cardiac biomarkers can guide us towards underlying cardiac dysfunction. Early echocardiographic assessment can guide us towards proper management of sepsis patients.

DOI: 10.5281/zenodo.

Introduction: This study examines the prevalence, risk factors, clinical presentation, and management outcomes of retinal vascular occlusion (RVO) at a tertiary eye care center in Western India. Materials & Methods: We included 122 patients with RVO presenting at tertiary care center in western India. We collected demographic data, vision, presenting clinical features including complications. We did OCT scan whenever applicable. We managed the patients with help of intravitreal injection anti- VEGF, vitrectomy, sectoral / pan retinal photocoagulation and supportive management as per required. Both quantitative and qualitative variables were studied using SPSS version 2.0 and data was imported into Excel. Results: The mean age was 55±10 years, with a majority (54.34%) being female. Branch retinal vein occlusion (BRVO) (48%) was the most common type, followed by central retinal vein occlusion (CRVO) (31%) and hemi retinal vein occlusion (HCRVO) (12%). Hypertension (68 patients), diabetes (49), and hyperlipidemia (40) were frequent risk factors. Clinical presentations predominantly involved diminished vision (89.85%), with macular edema being the most common complication (66.66%). Treatment included anti-VEGF injections (73.91%) and laser photocoagulation (81.15%). Conclusion: This study highlights the high prevalence of RVO in older adults, especially females, with hypertension and diabetes playing significant roles. Management with anti-VEGF and laser therapy is effective, consistent with international standards. Further population-based studies are warranted for better understanding and prevention of RVO.

DOI: 10.5281/zenodo.

Introduction: In a typical term pregnancy with isolated oligohydramnios, to investigate the outcomes for the mother and the foetus adequate quantities of amniotic fluid are essential for the growing foetus because they provide nutrition, protect the developing embryo from injury, and promote the baby’s growth and mobility in the womb. Quantification of amniotic fluid content is an essential feature of prepartum foetal surveillance. Amniotic fluid is the end product of complex and dynamic physiological processes in the foetus and placenta. Material and Methods: This was a one-year prospective research that took place in the obstetrics and gynaecology department of MKCG MCH, Berhampur between January and December of 2015. In all, 100 patients with gestational ages more than 37 weeks who were matched for age and parity were examined; 50 of the research group’s participants had AFIs of less than 5, and the control group’s participants had AFIs of greater than 5.A comparison was made between the two groups regarding the manner of delivery and the perinatal outcome. For statistical analysis, the chi square test was employed. Results: In 39 patients (78%) in the study group and 46 patients (92%) in the control group, the non-stress test (NST) was reassuring (p value <0.05) and was determined to be statistically significant. In the research group, 16 out of 50 patients (32%) delivered their babies vaginally normally, 9 patients (18%) used an instrument, and 25 patients (50%) had a caesarean section. In the control group, on the other hand, 34 out of 50 patients (68%) delivered their babies vaginally normally, 2 patients (4%) used an instrument, and 14 patients (28%) had a caesarean section (p value <0.05). A statistically significant difference was detected. Nine (18%) of the study group’s patients had an Apgar score of less than seven, compared to six (12%) of the control group (p value >0.05). The distinction wasn’t statistically noteworthy. Ten babies (20%) in the control group and 22 babies (44%) in the experimental group were born weighing less than 2.5 kg (p value <0.05). There was a statistically significant difference. Neonatal intensive care unit (NICU) admissions occurred in 6 newborns (12%) in the study group compared to 4 babies (8%) in the control group (p value >0.05). There was no statistically significant difference. At the time of discharge, every baby was stable. Neither the trial group nor the control group had any infants that required ventilatory assistance or neonatal fatalities. Conclusion: A poor perinatal outcome is not linked to isolated oligohydramnios in the absence of any aggravating factors, yet the babies may be born with a lower birth weight. Due to widespread use of ultrasonography, oligohydramnias are being discovered more frequently these days. Isolated oligohydramniosis without aggravating circumstances is not associated with a bad perinatal outcome, notwithstanding the possibility that the children would be delivered with a lower birth weight.

DOI: 10.5281/zenodo.

Introduction: Dyslipidaemia is due to altered lipid metabolism, often characterised by elevation of LDL & depletion of HDL concentration. Paraoxonase 1 (PON1) is an enzyme associated with HDLc and its atheroprotective and antioxidant role. Atherogenic index (AIP) is a predictor of atherosclerosis which is dependent on both serum triglyceride and HDLc concentration. This study was done to find out the association between atherogenic index and paraoxonase 1 activity in dyslipidemic individuals. Methodology: 63 dyslipidemic patients (diagnosed by lipid profile parameters attending OPD were compared with 63 normolipidemic individuals. Serum paraoxonase1 activity of both dyslipidemic & no dyslipidemic individuals were measured using paranitrophenylacetate substrate. Serum atherogenic index along with other cardiac indices (cardiac risk ratio I and II and atherogenic coefficient) were calculated from lipid profile parameters. Results: Significantly increased parameters of lipid profile including total cholesterol, Triglyceride and LDLc and significantly decreased HDLc and PON1 activity has been found among the dyslipidemics in comparison to normolipidemics (p<0.001). AIP and other cardiac indices are also significantly increased in dyslipidemic group (p<0.001). Statistically significant negative correlation has been found between PON1 & AIP (r= – 0.425 and p<0.001). Conclusion: Low levels of PON1 is associated with high AIP and hence there a higher risk of cardiovascular disease in dyslipidemics.

DOI: 10.5281/zenodo.

Background: The most common medical emergencies, acute upper gastrointestinal bleed have a significant mortality. This study aims to study patients’ endoscopic profile and clinical outcome, presenting with upper gastrointestinal bleeding in this region.  Methods: This study was conducted on 100 patients admitted with upper GI bleeding. These patients underwent endoscopy of the upper gastrointestinal track after the initial examination. The status of patients in the study group was recorded at discharge.  Results: The mean age of patients was 48.98 ±14.50 years with male to female proportion of 2.57:1. The foremost common causes of upper GI bleed were related to portal hypertension (Oesophageal and gastric varices) and were seen in 48% of patients. In 45% of the patients, non-portal hypertensive lesions causing UGI bleed (peptic and other injuries) were seen whereas endoscopy was normal in 7% patients. We found no relationship of mortality and with components like age, history of alcohol and NSAIDs use, peptic ulcer, infection and presence of cirrhosis. Conclusion: Portal Hypertension is the foremost common cause of upper gastrointestinal bleeding in this region. Peptic ulcer and erosive gastro-duodenitis are other leading causes. With effective and prompt management and timely endoscopic intervention mortality can be reduced as in our study it was 4%. However, there is no correlation between age, alcohol and NSAIDs use, peptic ulcer, infection and presence of cirrhosis with death.

DOI: 10.5281/zenodo.

The study focuses on the formulation and evaluation of oral dissolving films (ODFs) of lornoxicam, aiming to improve patient compliance and achieve rapid onset of action. Lornoxicam, a non-steroidal anti-inflammatory drug (NSAID), is effective in pain management but suffers from low bioavailability and gastric irritation when administered orally in conventional forms. To address these challenges, ODFs were developed using the solvent casting method with hydroxypropyl methylcellulose (HPMC) as the film-forming polymer. The films were evaluated for various physicochemical parameters including thickness, tensile strength, disintegration time, and drug content uniformity. Additionally, in vitro dissolution studies were conducted to assess the release profile of lornoxicam from the films. The optimized formulation demonstrated desirable mechanical properties, rapid disintegration (within 60 seconds), and enhanced dissolution rate compared to conventional oral tablets. The weight of films range from 18.45-22.99 mg. The thickness of films were range from 0.046- 0.055 mm.The pH of films range from 6.55-7.95.The folding endurance of films range from 216-267.The disintegration time range from 10-42 seconds. Tensile strength of given formulation is 4.124 to 7.885gm/mm2. The drug content of films was found to be between 94.20-96.80%.These findings suggest that ODFs of lornoxicam are a promising alternative for improving patient adherence and therapeutic efficacy in pain management. Further in vivo studies are recommended to validate these results and explore the potential clinical benefits of this novel drug delivery system.

DOI: 10.5281/zenodo.

The study was a phase III, prospective, randomized, double blind, comparative, parallel group clinical study. The study screened 213 male and female patients diagnosed with type 2 diabetes mellitus inadequately controlled on Metformin monotherapy, out of which 192 patients were randomized Thus, 96 patients were randomized in test product i.e., Vildagliptin SR 100 mg Tablets out of which 94 patients completed the study and 96 patients were randomized in reference product i.e. Teneligliptin 20 mg Tablets out of which 93 patients completed the study.
The glycosylated hemoglobin was decreased in both the treatment groups. The difference in the mean change in glycosylated hemoglobin (HbA1c) at the end of 16 weeks in the two groups was -0.03 with lower limit of 95% CI being -0.18. Thus, the results of the study show that Vildagliptin SR 100 mg Tablets is non-inferior to Teneligliptin 20 mg Tablets. All the treatments were well tolerated.
A total of 28 AEs were reported in 28 patients. 13 AEs were reported in Vildagliptin SR 100 mg Tablets arm and 15 AEs were reported in Teneligliptin 20 mg Tablets arm. 01 AE from Vildagliptin SR 100 mg Tablets arm and 01 AE Teneligliptin 20 mg Tablets arm were moderate in nature; all the other AEs were mild in nature. No SAE was reported during the study.

DOI: 10.5281/zenodo.

Introduction: The effectiveness of supraclavicular brachial plexus block is usually evaluated by assessment of sensory and motor function. Perfusion index (PI) estimates the pulsatility of blood in the extremities and inversely related to the vascular tone. In this study we assessed changes in perfusion index following ultrasound guided brachial plexus block to predict success in this regional anaesthesia technique. Material and Methods: A prospective observational study was conducted after obtaining institutional ethics committee clearance and written and informed consent from each patient. 60 adult patients undergoing upper limb surgery under ultrasound guided brachial plexus block were included and Perfusion index in the blocked and unblocked limb were measured using Masimo SET pulse oximeter. Results: Perfusion index in the blocked limb was higher than the unblocked limb at all intervals. Delta Pi calculated as the difference between Pi at 10 mins and baseline was 1.3+/-0.6 in the blocked limb. Conclusion: The PI is characterized by being simple, rapid, and user friendly compared with other objective methods for evaluation of block success.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to assess the clinical spectrum and outcome in children with nephrotic syndrome. Methods: This was a prospective observational study conducted at pediatric department. 100 children who were diagnosed with nephrotic syndrome at JLNMCH in whom steroid treatment was not started yet were included for study purpose. Patients with first attack and relapse both were included in this study. Results: 70% were male and 30% were females. In the present study, 100% had swelling followed by 88% had puffiness. 100% had pitting edema and 80% had ascites. The hemoglobin, serum albumin, serum creatinine was 10.5±1.46, 1.7±0.43 and 0.62±0.18 respectively. 34% had complete remission and 15% had relapse. Conclusion: In our study clinical and laboratory findings were in similarity with usual nephrotic syndrome in children. There was no any significant difference in pattern of nephrotic syndrome and response to treatment from other studies.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to assess the correlation of Fasting & PP C-peptide with HbA1C in patients of T2 Diabetes Mellitus in population of Bihar region. Methods: 100 patients admitted in the Department of Medicine, Nalanda medical College and Hospital, Patna, Bihar, India. Serum samples were taken for fasting & PP C-peptide and HbA1C for patients of T2 Diabetes Mellitus and run on VITROS 5600/7600 which is based on dry chemistry. Results: Mean & SD for fasting C-Peptide for males was 1.348±1.072 & for females 2.448±2.56. Mean & SD for Post prandiol C-Peptide for males was 4.210±5.025 & for females 2.995±2.134. It was significant for fasting C- Peptide with P value 0.0634 and non-significant for PP C peptide with p value 0.4405. Mean & SD for fasting C-Peptide for raised was 3.379±1.791 & for unraised 0.718±0.512. Conclusion: Insulin secretion estimated by measurement of Fasting C- Peptide was either normal or raised in newly diagnosed T2dm subjects in my study indicating predominant role of insulin resistance in the etiology.

DOI: 10.5281/zenodo.

Meditation produces various effects on human physiology, which are mediated via autonomic nervous system. Meditation is a simple and scientific technique to elicit physical and mental relaxation response, to change one’s attitude and transform life-style. Regular practice of it brings transformation in overall wellbeing of person. The cardiovascular morbidity is increasing in India in recent years. 40 healthy volunteers above the age of 30 years and below 65 years performing meditation regularly were included in the study. The same subjects were chosen as both study and control group in order to minimize the confounding factors. Before recording the parameters, the subject was asked to relax physically and mentally for 30 minutes. The blood pressure was recorded with the sphygmomanometer in supine position in the right upper limb by auscultatory method. Similarly, three readings were taken at an interval of 15 minutes each and average of the three values calculated .Heart rate was counted for one minute. The subjects were trained under the guidance of a certified yoga teacher. They carried out meditation for 6 months for 1 hour daily between 6 am and 7 am. The cardiovascular status of each subject, after 6 months of meditation practice was assessed clinically in terms of blood pressure and heart rate recordings. Statistical analysis was done by t test. The results of this study demonstrated a reduction in Heart rate, systolic blood pressure, diastolic blood pressure indicating parasympathetic nervous system dominance during & immediately after meditation.

DOI: 10.5281/zenodo.

Aim: The aim is to study the outcome of Contralateral PMMC flaps for Supramajor  Head and Neck Onco-reconstruction,  following oncological excision of huge T4 Tumors. Study: Hospitals in India get many advanced T4 Head & Neck malignancy. They are operated by Oncosurgeons as a palliative Oncosurgery. It creates huge three dimensional defects, its reconstruction is challenging for the Plastic surgeons. We are presenting case series of 25 patients, where Contralateral Pmmc played part in reconstruction of defects.  In major T4 Head and Neck post oncological resection where many times we have to use Bilateralpectoralis major Myo cutaneous flap to cover the resultant defect. Sometimes along with microsurgery contra lateral PMMC could be used for one flap, when more than one flaps are needed.  Pectoralis major flap is a workhorse flap, with lesser learning curve. So, the complications are less and healing is also faster. It is single stage surgery so Radiotherapy could be started as early. Method: It is a retrospective study of twenty-five patients, operated by the chief surgeon in the last ten years. Here Contralateral PMMC was used after major excision of major Head and Neck T4 malignancy. In 11 patients contralateral PMMC was used as a part of oral cavity reconstruction.  In four patients for laryngopharynx reconstruction. In five patients it was used to cover the defects in flap failure.  In another five patients it was used for recurrence. In bilateral PMMC one is used to cover the inner lining while outer is covered by another PMMC flap. Sometimes contra lateral PMMC is used along with other pedicled or free flap. Contra lateral PMMC is a pedicled flap, taken from opposite chest. Time taken to elevate and inset is lesser than Microvascular Reconstruction and it could be done where microsurgical expertise is lacking. It is a single stage surgery so radiation/ Physiotherapy could be started early. Conclusion: Contralateral PMMC flap is an answer to cover the defect following supra major excision of T4 Oral Malignancy, It could be used when there is flap failure or in recurrence. It could be used alone or along with some pedicled or free flaps. It is a pedicled flap, taken from opposite chest,  time taken is lesser than Microvascular Reconstruction and it could be done where microsurgical expertise is lacking. It is single-stage surgery so radiation/ Physiotherapy could be started early.

DOI: 10.5281/zenodo.

Background: Diabetic individuals have several complications, such as diabetic retinopathy and nephropathy as well as an increased mortality risk and impairment in health-related quality of life. Despite some authors have suggested that pulmonary function reduction might be a chronic complication of Diabetes mellitus (DM), there are doubts whether the pulmonary function decrease is really caused by DM itself or if it represents a deleterious impact of ageing process. With the looming expansion of the elderly population of the US, a thorough understanding of “normal” aging-related changes on the respiratory system is paramount. The respiratory system undergoes various anatomical, physiological changes with age. The present study has focused on the impact of age on respiratory system in type -2 diabetics as well as on pulmonary function tests like FVC, FEV1 and FEV1/FVC ratio.

DOI: 10.5281/zenodo.

This research examines the link between smartphone usage, academic stress, and lifestyle in young adults. The data was gathered from surveys given to youngsters to assess their smartphone habits, academic stress levels, and lifestyle. The findings show significant connections between smartphone usages, academic stress, and lifestyle emphasizing the importance of implementing strategies to encourage healthier technology practices and enhances sleep quality among youngsters.

DOI: 10.5281/zenodo.

Background: The aim of this study is to explore the clinical outcomes of locking compression plates (LCPs) Philos in elderly patients with 2-4 parts proximal humerus fracture (PHF). Material and Methods: This is a Prospective, observational and descriptive study conducted from Department of Orthopaedics, Shri Atal Bihari Vajpayee Medical College and Research institute, Bengaluru.  Sampling methods: After confirmation of the proximal humerus fracture, patients were taken for study, if they fit into the above said criteria. Patients had undergone open reduction internal fixation with philos locking plating under GA for the sustained fracture. Post-operative physiotherapy followed according to protocol, to evaluate the functional outcome. Fractures were classified using  Neer’s classification. Results: In the present study, the most common mechanism of injury was found to be road traffic accidents with a total of 25 (62.5%) patients and rest 15 (37.5%) were injured due to accidental fall on the ground. In the present study, the right side proximal humerus fracture occurred in 22 (55%) patients and left side proximal humerus fracture occurred in 18 (45%) patients respectively. All fractures were classified according to Neer’s classification system. 17 (42.5%) patients were two-part, 13 (32.5%) were three-part and 10 (25%) were four-part. The Constant -Murley score achieved at the end of study period (6 months) was 66.32 ± 6.47. Conclusions: The proximal humerus locking plate seems to be an adequate device for the fixation of displaced two-part, three part and four-part proximal humerus fractures. Due to stable fixation, early functional aftercare is possible and allows the patient to regain good shoulder function and resume normal activities much earlier.

DOI: 10.5281/zenodo.

Supracondylar fractures of the humerus the most common type of elbow fracture in children. Severely displaced supracondylar fractures of the distal humerus in children are a challenging problem. Many treatment methods have been described for the treatment of displaced supracondylar fracture of the humerus, however it has not been reached a consensus for the choice of treatment. The purpose of this study is to clinically asses the outcome of surgically managed supracondylar fracture of humerus using K wire fixation. Materials and Method: 30 Children of supracondylar fracture of humerus treated in the Department of Orthopaedics, Shri Atal Bihari Vajpayee Medical College and Research institute, Bengaluru. Out of a total of 30 cases 24 were treated with closed reduction and internal fixation by k wire and 6 were treated with open reduction and internal fixation with k wire. The average age was 7.1 years. We evaluated the results using FLYNN’S criteria. Result: According to the results of the study, we obtained 21 excellent, 4 good, 4 fair and 1 poor result. Conclusion: The data in the current study shows that surgically managed displaced supracondylar fracture of humerus in children using K wire fixation gives excellent outcomes both radiologically and functionally thus can be deemed as treatment of choice for the same.

DOI: 10.5281/zenodo.

Introduction: The posterior cruciate ligament (PCL) in total knee arthroplasty (TKA), so-called cruciate-retaining (CR), or to substitute for it, so-called posterior stabilized (PS), continues to engage orthopaedists. The many reasons for retaining the posterior cruciate ligament (PCL) during total knee replacement (TKR) include improved stability, reduced shear stresses at the fixation interface, improved proprioception, and more efficient gait patterns during level walking and stair climbing; Material and Method: This is prospective study at Department of Orthopaedics, Shri Atal Bihari Vajpayee Medical College and Research institute, Bengaluru. Results: There were many prospective studies with the evidence level 1–2 to compare the CR and PS TKAs using contemporary prostheses.  Most studies reported no difference in clinical scores, ROM, midterm survival rate, and quadriceps muscle recovery; two studies reported only the better ROM in PS TKAs. In our preliminary prospective study using the recently introduced prosthesis of Persona, all the clinical results did not differ at 1 year postoperatively. Conclusion: CT TKA may not be feasible in certain conditions; PCL insufficiency, severe deformity, and the history of previous traumas or operations should be carefully examined for appropriate selection of the prosthesis type. The surgeon should have a clear idea on the technical differences between CR and PS TKAs. The extent of distal femoral resection, selection of femoral component size, and adjustment of tibial slope are particularly crucial for successful TKA.

DOI: 10.5281/zenodo.

Background: Extrahepatic biliary obstruction (EHBO) is a common entity encountered in clinical practice. EHBO is a result of obstruction to bile flow anywhere from liver to duodenum. Material and Methods: We retrospectively analyzed clinical, laboratory and endoscopic data of all the patients with features of EHBO who had undergone ERCP over a period of 1 year. Results: 206 EHBO patients underwent ERCP. Mean age was 51.5 years. Majority were females (55.8%). However pancreatic head carcinoma (66.7%) and cholangiocarcinoma (100%) preferentially affected males. Benign causes were more common 65.5%. Choledocholithiasis was the most prevalent (56.8%) followed by benign biliary stricture (8.8%). Amongst malignant aetiologies gall bladder carcinoma (15.5%) was most common. Most of the patients presented with pain abdomen (58.2%). Mean bilirubin, raised alkaline phosphatase and renal dysfunction were more common in malignant cases though not statistically significant. However, anaemia (p=0.037) and deranged coagulation profile (p=0.041) was statistically significantly higher among malignant cases. Thrombocytopenia was statistically significantly higher among benign cases (p=0.044). Amongst choledocholithiasis 86.3% individuals had complete biliary clearance, while 8.5% underwent lithotripsy. Bismuth type 1, 2 & 3 benign biliary strictures were found in 72.2%, 16.6%, and 11.2%, respectively. In 83.3% of such patients biliary stenting was successful. Those with malignant strictures, 67.3% had block below hilum, 27.6% had hilar block, 5.1% had complex anatomy of block. Adequate endoscopic biliary drainage was achieved in 86.2%, while 13.7 % required percutaneous transhepatic biliary drainage after the failed ERCP. Self-expanding metallic stent was inserted in 11 patients. Overall, periampullary diverticula and needle knife were present in 5 and 18 cases respectively. Conclusions: Contrary to previous Indian studies, benign causes were more common causes of EHBO undergoing ERCP than malignancy. Common benign and malignant aetiologies were choledocholithiasis and gall bladder carcinoma respectively.

DOI: 10.5281/zenodo.

Introduction: Apolipoprotein E gene polymorphism is associated with chance of occurrence and the outcome of cerebrovascular accident. Different alleles of APO E gene show different outcomes in the stroke patients. This study was done to compare the genetic polymorphism of APOE in stroke patients with healthy population and also to find out any difference in genetic polymorphism in different types of strokes. Materials and Methods: Total 300 stroke patients were compared with equal number of controls from the Department of Neuromedicine, Bangur Institute of Neurosciences, Kolkata. DNA extraction and gene amplification were done from the samples collected from all the study subjects and the different alleles were finally identified by the method of restriction fragment gene polymorphism. Result: The homozygous E3 genotype was the most common (85.5%) followed by E3/E4 (14.5%) in our study group. The APOE4 allele showed a 1.14-fold odd for developing ischemic stroke whereas the E3 allele is showed protection with odds ratio 0.53. The E3 allele showed protection from developing hemorrhagic stroke with odds ratio 0.366. and higher frequency of E4 allele with odds 1.08. Conclusion: there is significant association of APOE gene polymorphism in ischemic as well as haemorrhagic stroke patients of ethnic Bengali population and the E3 allele had been the protective factor from developing the stroke.

DOI: 10.5281/zenodo.

Introduction: The Prevalence of Type 2 Diabetes mellitus in India is 8.7%. It is crucial for individuals with Diabetes to engage in self-care practices, which include monitoring blood glucose levels regularly, adhering to medication and diet plans, engaging in regular exercise, and getting periodic foot examinations. Numerous studies have demonstrated that maintaining healthy self-care practices can significantly lower blood glucose levels and improve the overall quality of life for people with Diabetes. Objective: To assess self-care practices and factors influencing the self-care practices among Type 2 Diabetes Mellitus patients attending Makkalai Thedi Maruthuvam Clinic. Methodology: A Hospital Based Cross-Sectional Study was conducted among 150 patients attending Makkalai Thedi Maruthuvam Clinic in a Tertiary Care Hospital in Chengalpattu during December 2023. 18 years and above Type 2 Diabetes patients who were willing to participate were included. A Semi-structured Questionnaire was administered to the patients to assess socio-demographic details, clinical profile, and the Selfcare practice (SCP) was assessed using revised version of the Summary Diabetes Self-Care Activities questionnaire (SDSCA). Data was collected and entered in Microsoft Excel and analysed using SPSS version 25. Results: The majority of the patients were female (63.9%), literate (59.4%), unemployed (69.7%), belonged to the nuclear family (82.6%) and were from middle socioeconomic status (83.2%). 75.5% of patients followed good dietary practice, had good compliance to drugs (98.7%) and checked blood glucose every 3 months (87.1%), while 2/3^rd of the patients had poor foot care practices and less physical activity. The younger age group had good Self-care practices and this was found to be statistically significant(p-value – 0.05). There was a significant association found between Poor dietary practice with alcohol consumption (p-value – 0.001) and tobacco usage ((p-value – 0.001). Conclusion: This study concludes that Dietary changes, compliance to medications and blood glucose monitoring are much better than physical activity and foot-care practices. Focused education programs and monitoring during follow-up visits will improve self-care in the less adhered domains.

DOI: 10.5281/zenodo.

Introduction: Improper solid waste disposal is identified as a major public health threat throughout the world. The key to control the hazards and diseases caused by improper waste disposal rests not only on the efforts taken by the health officials and local body administrators, but also on the community’s knowledge, Attitude and Practice regarding safe waste disposal methods. Objective: To assess the knowledge, Attitude and Practice of solid waste disposal practices among the households in an urban area of Chengalpattu municipality in southern India and also to determine the factors influencing the solid waste disposal practices among the study population. Methodology: A community based cross-sectional study was done among 150 households selected through multistage random sampling from Chengalpattu Municipality of Tamil Nadu in Southern India, from July to August 2023.Participants who were 18-60 years and willing to participate were included. Semi structured questionnaire was used to collect data regarding the socio demographic details & knowledge, Awareness and Practice of the participants. Data was entered in Microsoft Excel and analysed using SPSS version 25. Results: In this study, mean age of participants was observed to be 45.91 (±S.D. 8.63). 85.3% of the participants had adequate knowledge, 48% had positive attitude and 36% had good practice. Statistically significant association was found between Age(p=0.035), Education (p=0.047) and knowledge regarding solid waste disposal. Statistically significant association was found between gender(p=0.009), education(p=0.051), type of house (0.001) and practice regarding waste disposal. Conclusion: The study found adequate knowledge in majority of the participants, however the attitude level and practice regarding proper waste disposal could be improved. Measures to encourage people towards adopting a committed attitude and good practice, regarding proper solid waste disposal can help achieve the goal of ‘Clean India’.

DOI: 10.5281/zenodo.

Background: Lung cancer is the leading cause of cancer related deaths worldwide and accounts for 28% of all cancer mortality. Several histopathological types of lung cancer exist, among them the majority are non-small cell carcinomas (NSCLCs) including adenocarcinoma (ADC) and squamous cell carcinoma (SqCC). In light of discovery of molecular alterations associated with lung ADCs and advent of targeted therapies, further subtyping of NSCLCs has profound therapeutic implications. Materials and Methods: A total number of 90 consecutive cases of NSCLCs diagnosed on core‑needle biopsies (CNBs) and endobronchial biopsies (EBBs) of the lung sent for histopathological evaluation were included in the study. The demographic data, clinical details, radiological features, and laboratory investigations were retrieved. The Small cell lung carcinomas (SCLC), carcinoids, lymphomas, mesenchymal neoplasms, metastatic carcinomas, and mesotheliomas were not included in the study. Result: Out of 90 cases 60 were ADC and 30 were SqCC. Most of the patients were in the age group of 61-70 years, 10 were between 71-80 years, 10 were between 51-60years and 10 were between 40-50 years. In this study the sensitivity and the specificity of p63 were 100% and 80% respectively, and sensitivity and specificity of p40 were 100% and 98.3% respectively. Positive predictive value was higher for the p40 compared to p63. To summarize, sensitivity of p63 and p40 was found to be the same, but the specificity and positive predictive value were higher for p40 for diagnosis of SqCC. One case of ADC showed positivity for p40 which may be due to adeno-squamous carcinoma misdiagnosed as ADC on cytology. Conclusion: P63 has a better sensitivity, and P40 has a better specificity for SqCC. A positive staining pattern with both markers was also found in certain non-SqCC cases.

DOI: 10.5281/zenodo.

Aim: To compare the effectiveness of dry needling and steroid injection in treating plantar fasciitis. Material and Methods: This study was conducted in the Department of PMR, ANMMCH, Gaya Bihar. 83 patients were enrolled. Eligible patients were individuals > 18 years old, with a history of plantar heel pain of at least for three months and who were diagnosed for plantar fasciitis according to the guidelines of Orthopaedic Section of the American Physical Therapy Association. Results: Three and six weeks and one year after treatment, mean VAS scores were significantly different between groups: 0.32 ± 0.71 steroid group and 3.47 ± 1.32 dry-needling group (P<0.001); 0.21 ± 0.67 steroid group and 2.66 ± 1.33 dry-needling group (P<0.001); 2.09 ± 1.58 steroid group and 0.69 ± 0.93 dry- needling group, (P = 0.004), respectively. There were no significant differences between groups at the other time points. Steroid injection quickly reduced pain, but after six weeks of treatment, pain increased; in the dry-needling group, pain reduced slowly, but after six weeks of treatment, pain continued to decline. And at the end of the study, average pain in the steroid group was greater than in the dry-needling group. Conclusions: This study suggested that dry needling was superior to steroid injection in patients with plantar fasciitis at the end of one year of follow-up. Pain reduced gradually in dry-needled patients, and endpoint VAS scores were lower than in the steroid group, although rapid and short-term effects of steroid injection was also found.

DOI: 10.5281/zenodo.

The COVID-19 pandemic necessitated the development of efficient diagnostic tools to quickly identify infected individuals and mitigate the spread of the virus. This study evaluates the success rate of rapid tests for the detection of COVID-19 antigens using immune-based diagnostic devices. Rapid antigen tests offer the advantages of speed and ease of use, making them a vital component in large-scale screening efforts. The research involved a comprehensive analysis of various rapid antigen test devices, assessing their sensitivity, specificity, and overall accuracy compared to the gold standard RT-PCR tests. Results indicated that while rapid antigen tests generally provide quicker results, their sensitivity varies significantly, impacting their reliability in different settings. Despite these limitations, the study highlights the importance of rapid antigen tests in complementing other diagnostic methods, particularly in resource-limited environments and for mass screening purposes. The findings underscore the need for continuous improvement and validation of these tests to ensure they meet the necessary accuracy standards for effective pandemic management.

DOI: 10.5281/zenodo.

Background: Fungal infections are prevalent and pose significant health risks, necessitating effective and targeted treatment options. Ketoconazole, a broad-spectrum antifungal agent, is commonly used in the treatment of various fungal infections. However, traditional formulations may have limitations in terms of drug release and patient compliance. Hydrogel-based drug delivery systems offer a promising alternative, providing controlled release, improved drug stability, and enhanced patient compliance. Objective: This study aims to develop and evaluate a hydrogel-based topical drug delivery system for ketoconazole to improve its therapeutic efficacy in treating fungal infections. Methods: Ketoconazole-loaded hydrogels were formulated using a combination of biocompatible polymers. Various formulations were prepared and characterized for their physicochemical properties, including pH, viscosity, and drug content. The in vitro release profile of ketoconazole from the hydrogels was evaluated using a Franz diffusion cell apparatus. Ex vivo skin permeation studies were conducted using excised human skin to assess the penetration capability of the hydrogel formulation. Additionally, antifungal activity was tested against common fungal strains to determine the therapeutic potential of the developed hydrogel. Results: The prepared hydrogels exhibited satisfactory physicochemical properties with an optimal pH and viscosity suitable for topical application. In vitro release studies demonstrated a sustained release profile of ketoconazole over 24 hours. Ex vivo skin permeation studies indicated significant penetration of the drug through the skin layers, suggesting effective delivery to the target site. Antifungal activity tests confirmed the efficacy of the ketoconazole-loaded hydrogel against various fungal strains, with results comparable to conventional formulations. Conclusion: The developed hydrogel-based topical drug delivery system for ketoconazole shows promising potential in enhancing the treatment of fungal infections. The sustained release, improved skin penetration, and effective antifungal activity indicate that this formulation could provide a better therapeutic outcome and increased patient compliance. Further in vivo studies and clinical evaluations are warranted to confirm these findings and explore the full potential of this novel drug delivery system.

DOI: 10.5281/zenodo.

Aim:  Aim of the present study was to compare the effect of injection Rocuronium with priming dose and injection Rocuronium without priming dose on intubating conditions and onset time of intubation. Methods: The present study was single-center, prospective, randomized study, conducted in Department of Anaesthesiology, Jagannath Gupta institute of Medical Sciences, Kolkata, West Bengal, India. Study duration was of 2 years. 50 patients were included in the study. Results: We compared mean age, weight, gender and ASA grade between group C and group P and difference was statistically not significant (p value >0.05). We compared preoperative baseline mean HR, mean HR at induction, mean HR at intubation, 1 minute after intubation and  5 minute after intubation between group C and group P, the difference between two groups was statistically insignificant. We compared baseline mean MAP {full form} preoperatively, at induction, at intubation, mean HR  1 minute after intubation and mean HR  5 minute after intubation between group C and group P, the difference between two groups was statistically insignificant. We compared mean SPO2 preoperatively baseline, at induction, at intubation, mean HR at 1 minute after intubation and mean HR 5 minute after intubation between group C and group P, the difference between two groups was statistically insignificant. In group C mean Onset Time of Intubation was 93.36 ± 6.24 seconds, while in group P it was 57.00 ± 6.74 seconds, so the difference between the groups on the basis of OTI was statistically highly significant. Conclusion: Rocuronium with priming would be an excellent alternative to succinylcholine, whenever fast induction will be needed. Intubating conditions were good to excellent and comparable in both rocuronium with priming and without priming dose. NMT {full form} monitoring is a useful tool for indicating the clinically acceptable paralysis.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to assess the levels of bone minerals, calcium and phosphorus in hypothyroidism and its relation with thyroid hormone levels. Methods: The cross-sectional and observational study was done at department of Biochemistry, NMCH, Jamuhar, Sasaram, Bihar over a period of 12 months (August 2022 to July 2023). Results: There was a significant increase of TSH, in cases with p value < 0.001. Significant decrease in T4 was noted (p <0.05) in cases. Among the minerals, there was a significant increase in phosphorous and magnesium serum levels and a significant decrease in that of calcium levels. In our study analysis when TSH levels were compared with serum calcium and phosphorus among the hypothyroid patients, it showed a statistically significant negative correlation between TSH and serum calcium. However there was no significant correlation of TSH with serum phosphorous and magnesium. Conclusion: The study concluded that in hypothyroid patients, the serum calcium level was decreased and serum phosphorus level was increased when compared to euthyroid control subjects. Also there was a strong negative correlation between serum TSH and serum calcium levels were observed among hypothyroid individuals. It is therefore recommended for the regular evaluation of these minerals in hypothyroid patients which would improve their bone health and quality of life.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to assess the level of serum ferritin in type 2 diabetes patients with good and poor glycemic control and also assessed the correlation between serum free iron concentrations with glycemic control. Methods: The study was conducted in the Department of General Medicine, JLN Medical College and Hospital, Bhagalpur, Bihar, India for the period of two years. Study population was patients of type 2 diabetes mellitus visiting outpatient department of our hospital. This study comprises 200 patients with type 2 diabetes mellitus (treated with hypoglycemic drugs), as cases and 200 patients, age and sex matched apparently healthy adults as a control group. Results: Age and sex difference between two groups was statistically non-significant. On comparison of serum ferritin levels between cases and controls it was found that the mean serum ferritin of diabetic population was 139.85 ± 62.98 ng/mL and that of control group was 61.97 ± 26.64 ng/mL (p value< 0.05). Serum ferritin of case group is therefore significantly higher than the control group. Similarly, BMI, fasting blood glucose (mg/dl) and glycated haemoglobin (HbA1C) values were significantly higher in diabetic group as compared to control group. We compared serum ferritin values with HbA1C values in diabetic patients. Increase in serum ferritin levels was noted with increasing values of HbA1C. Correlation between serum ferritin and HbA1c was also assessed. The correlation between glycated haemoglobin and serum ferritin was done by Pearson correlation test and it showed a significantly positive correlation (r=0.512) with serum ferritin. Conclusion: The present study concluded that positive correlation between serum ferritin levels and increased HbA1c reflecting poor glycemic control. This highlights the need for strict glycemic control in these subjects. Further studies are needed to verify the importance of screening of hyperferritinemia in type 2 diabetic patients and to define cut-off level of serum ferritin for possible early detection and subsequent prevention or delaying of impaired glucose tolerance and diabetes in those participants.

DOI: 10.5281/zenodo.