bluuebunny/crossref_metadata_2025 huggingface dataset:
Reducing skin tears, workload, and costs in the frail aged: replacing showers with bath cloths
Authors: Sharp Catherine , Julie Campbell
Published: January 2025

Background: Two Nurse Consultants, as part of their usual practice of auditing wounds in a 25-bed dementia unit of an aged care facility in Sydney, Australia, reported on skin tears (STs), wounds that occur mainly on the forearms of the elderly and often during showering.
Aims and Objectives: The main aims were to measure and reduce the prevalence of STs; replace showers with HiCare™ bath cloths; reduce the nurses’ workload; reduce costs for laundry and wound dressings and a new regime for showering residents introduced.
Materials and Methods: Bedside training was given to care staff, and data on time taken to bed-bath, HiCare™ bath and shower, were collected, collated and costs estimated.
Results: Three of 25 residents (12%) had a total of six STs. Following the introduction of the HiCare™ bath system the incidence of STs decreased by 96% in 6 weeks and cost savings were $AUD 6.76/resident.
Conclusion: The number of showers performed each day by nurses was reduced allowing nurses more time to feed residents, go for a walk and sit in the garden. These practice changes benefit the residents as well as the nurses.
Intracranial germ-cell tumor with synchronous lesions in the pineal and suprasellar regions: A rare case of hypopituitarism
Authors: Kaushik Ghosh  , Paromita Bhattacharya  , Muhammed Imran Ahmad Quereshi  , Sarmistha Mukhopadhyay  , Ambarish Bhattacharya
Published: January 2025

Germinomas represent the most frequent tumor type in the pineal region and the synchronous involvement in the suprasellar region, known as bifocal disease, is increasingly recognized. Synchronous primary intracranial germ cell tumors are rare. Among all germ cell tumors, only 5–10% are found as synchronous lesions in pineal and suprasellar regions. They are also known by the entity “double mid-line atypical teratoma.” An adolescent male with phenotypic features of delayed puberty presents with features of hypopituitarism and raised intracranial tension. He was subsequently treated with hormonal replacement and diagnosed as a case of bifocal intracranial germinoma. Interestingly, he was lacking features of diabetes insipidus, which is a conspicuous feature in other reported cases. He was treated further with ventricular shunting followed by cranio spinal irradiation. The complex nature of endocrinological manifestations in bifocal intracranial germinoma will enriches our knowledge toward a potentially curable neuroendocrinological situation.
The innocence of Omicron: Taking the right decision
Authors: Ruby Dhar  , Arun Kumar  , Subhradip Karmakar
Published: January 2025

Rapidly spreading Omicron (B1.1.529) poses a considerable health risk, despite being labeled as a mild SARS-CoV2 variant. The higher transmissibility, immune evasion properties along blunting the effect of vaccine are some of its unique features, a fact that should not be ignored, no matter how benign it might be. We suggest that our knowledge and experience in dealing with Omicron have been very less and its long-term health consequences are still not studied properly. Under these conditions, we must continue to remain vigilant following all safety measures and avoid down-sizing its impact.
Incidence of perioperative respiratory complications in patients undergoing elective open upper abdominal surgery under general anaesthesia: Smokers versus non-smokers - An observational study
Authors: Sourabh Sengupta  , Maitreyee Mukherjee  , Prasenjit Dasgupta  , Sajib Chatterjee  , Dipasri Bhattacharya
Published: January 2025

Background: Smoking has various deleterious effects and peri-operative complications. Pulmonary complications following abdominal surgery are frequent and associated with increased morbidity and mortality and length of hospital stay.
Aims and Objectives: Hence, this study was done to observe the incidence of various respiratory and cardiovascular complications in the perioperative period in patients undergoing elective open upper abdominal surgery under general anaesthesia among smokers versus non-smokers. The various complications which are studied are as follows - Arterial desaturation, Severe coughing, Laryngospasm, Bronchospasm, Recurrent apnea, Variations in Mean Arterial Blood Pressure and Heart rates.
Materials and Methods: Male patients ASA-I, II or III, aged 20–60 years undergoing elective open upper abdominal surgery under general anaesthesia were selected. They were divided into two groups (during pre-anaesthetic checkup) - smokers (>10 cigarette/day for the past 1 year and continued smoking till admission), non-smokers (who never smoked). General anaesthesia was given according to standard protocol.
Results: The smokers had higher incidence of laryngospasm as well as bronchospasm but they were not statistically significant. Smokers had low baseline SpO2; greater fall in SpO2 just after extubation, before sending to PACU and on day 1 which were statistically significant. Smokers had raised MAP just after extubation, on day 1 and day 2 which were statistically significant.
Conclusion: Smokers had increased incidences of respiratory and hemodynamic complications than non-smokers.
Assessment of the efficacy of electrical vestibular nerve stimulation as an adjunct therapy in the management of motor functions and quality of life in patients with Parkinson’s disease
Authors: Sai Sailesh Kumar G  , Gawarikar S  , Anita Choudhary  , Potey GG  , Manju Purohit  , Ashish Pathak  , Rohit Singh Chouhan  , Mahadik VK
Published: January 2025

Background: The existing treatments for Parkinson’s disease (PD) were associated with side effects and do not offer a complete cure. Hence, there is a need for an alternative therapy that can prevent or delay the onset of PD with less or no side effects. Our extensive review of literature has shown no studies to be existing so far in India regarding vestibular stimulation as a treatment method for PD.
Aims and Objectives: The present study was undertaken to administer electrical vestibular nerve stimulation (VeNs) as an adjunct therapy in the management of motor functions and to improve the quality of life in PD patients.
Materials and Methods: The present study was a randomized controlled trial. (ClinicalTrials.gov Identifier: NCT04450550). 30 cases of PD, of both genders, were part of the study by convenient sampling after obtaining written informed consent. Patients were recruited from the out-patient ward of the General Medicine department, R.D. Gardi Medical College. Motor activities were assessed using the Berg balance scale, strength procedures by hand dynamometer and hand-eye coordination by 100 pin dexterity test. Quality of life was assessed by the World Health Organization Quality of Life Brief.
Results: The study results support the earlier studies as there was a significant improvement in the motor functions and quality of life of the study participants.
Conclusion: The study recommends further detailed studies with higher sample size and involving many centers to recommend the use of electrical VeNs as adjunctive therapy in the management of PD.
Impact of COVID-19 pandemic on doctors’ clinical practice
Authors: Naveen S Kulkarni  , Neelakanth S Patil  , Vishalakshi  , Asha Bullappa  , Hithashree Shriyan  , Subhashree Mishra
Published: January 2025

Background: The pandemic of COVID-19 has affected doctors, nurses, patients, and people working in hospitals.
Aims and Objectives: This study aims to study the trends in doctors’ clinical practice during COVID-19 pandemic.
Materials and Methods: The study conducted at SDMCMS&H, Dharwad, includes questionnaire on the impact of COVID-19 pandemic on doctors’clinical practice. The experience of doctors between May 2020 and June 2021 working in SDM University is considered in this study.
Results: The number of non-COVID patients in OPD and IPD has reduced. The time spent in clinical examination is reduced, reliability on investigations has increased. The use of telemedicine is increasing.
Conclusion: The impact of COVID-19 on clinical practice and doctors is multifactorial.The doctors and other health care workers can modify the COVID-19 impact on clinical practice by continuing to deliver the services as during pre-pandemic.
The role of nutrients in severe acute respiratory syndrome coronavirus 2 infection
Authors: Sengupta Aditi Munmun , Diptendu Chatterjee  , Rima Ghosh  , Khriesivonuo Nakhro  , Ipsita Chakravarti  , Salil Kumar Bhattacharya
Published: January 2025

Balanced and healthy nutrition is a vital to attain a good immune response. Numerous studies have reported that boosting up adaptive immunity through nutritional interventions can impede viral infections. With the present leading challenge of the COVID-19 pandemic globally, maintaining good nourishment is indispensable to remain immune against the novel virus. By and large, ineffectively fed people are at a higher risk of creating different kinds of contaminations. In addition, constant and extreme contagion can cause health problems and demolish a patient’s nourishing status, making them susceptible to different diseases. During the COVID-19 pandemic, everyone must screen their eating routine and nourishing status. Good nutrition can subside the ongoing unprecedented health complications and deaths. Evaluating the clinical status of COVID-19 cases at the hour of clinic confirmation is strongly recommended. Specific dietary help is prescribed to be given to those in the high-hazard bunch, asymptomatic transporters, and patients with moderate or extreme COVID infection. An assortment of micronutrients techniques to treat COVID-19 can prove beneficial at the preliminary stage of the clinical attendance. The prompt supplementation of specific supplements in gentle cases can forestall the movement of sicknesses.
Do clinical practice guidelines for the prevention of pressure ulcers really prevent pressure ulcers? An analysis of the guidelines
Authors: Sharp Catherine
Published: January 2025

This review article aims to analyze sections of the 2012 Australian Wound Management Association, Pan Pacific, Clinical Practice Guideline for the Prevention and Management of Pressure Injury, the “Guide,” mandated for use in all Australian residential aged care facilities to explain why pressure ulcers still occur, I considered two sections of the “Guide:” a) “Assess all patients as soon as possible following admission to service and within a minimum of 8 h;” and b) “Implement a prevention plan – strategies for patients at high risk: Use a high specification foam reactive (constant low pressure) support surface OR consider using an (active alternate pressure) support surface.” Nowhere in the “Guide” is there an explanation for a) “Assessing all patients as soon as possible following admission and within a minimum of 8 h.” Similarly, there is no explanation for why b) “a high specification foam reactive (constant low pressure) support surface” is recommended to prevent pressure ulcers. The evidence for screening “within a minimum of 8 h,” does not consider the speed at which pressure ulcers develop. If the resident is lying in one position for 30 min or more and a “constant low pressure” mattress is used, residents may still develop pressure ulcers because a “constant low pressure” does not relieve pressure.
Prevalence of hypertension and its associated factors among tribal population in Southern Rajasthan
Authors: Nitesh Mangal  , Matariswa Samanta  , Mehul Patel  , Dilip Kumar L  , Varghese KA  , Mansi Sharma
Published: January 2025

Background: The prevalence of hypertension (HTN) and associated factors across social groups including tribal communities as a major non-communicable disease across world is a topic of very high contemporary relevance, especially when it is misconceived as a cause of morbidity only for the richer strata of the society.
Aims and Objectives: The present study was conducted to assess the prevalence of HTN and its associated factors among tribal population in South Rajasthan.
Materials and Methods: The cross-sectional study is based on a sample of 300 adult members living in 160 randomly selected tribal households in Udaipur district.The information collected included systolic and diastolic blood pressure along with a set of associated sociodemographic, behavioral risk factors, level of physical activities, and body mass index. The descriptive statistical measures such as class frequencies, mean, standard deviation, and Chi-square test of significance for association were used.
Results: The estimated overall prevalence of HTN was 23.33% with 29.05% for male and 17.76% for female tribal adult population. The sex, age,family history of HTN, occupation, socioeconomic class, and landholding size were found significantly associated with HTN.The risk factors such as alcohol consumption, smoking, and additional salt intake emerged with odds ratio of 1.83, 2.94, and 1.14, respectively.
Conclusion: The health intervention focused to increase physical activity and to reduce alcohol consumption, smoking, and additional salt intake can prove to be effective control measures for emerging problem of HTN in tribal area.
Effect of single bolus dose of intravenous magnesium sulfate in attenuating hemodynamic stress response to laryngoscopy and nasotracheal intubation in maxillofacial surgeries
Authors: Parul Jain  , Aakansha Bikrol  , Arora KK  , Mohan Nema
Published: January 2025

Background: Nasotracheal intubation alters respiratory and cardiovascular physiology by reflex response mediated by both sympathetic and parasympathetic nervous systems and by the physical presence of the nasotracheal tube. Hypertension and tachycardia are the most common responses to intubation mediated by sympathetic efferent through cardio accelerator nerve and sympathetic chain ganglia. MgSO4 inhibits catecholamine release from adrenergic nerve endings and adrenal medulla resulting in attenuation of stress response.
Aims and Objectives: In this study, we observed the effects of MgSO4 on the hemodynamic stress response.
Materials and Methods: This prospective randomized controlled study was conducted on 60 patients after approval of the Institutional Ethics and Scientific Review committee over the period of 1 year. They were divided into two groups, Group M (MgSO4 group) received 40 mg/kg of intravenous magnesium sulfate in 100 ml normal saline and Group C (control group) received normal saline 10 min before induction. Hemodynamic parameters (HR, SBP, DBP, and MAP) were recorded at baseline, just before induction and at 1, 3, 5, 10, 15, and 30 min after intubation and every 15 min till the end of surgery.
Results: After conducting this study, we observed that heart rates at 1, 3, 5, and 10 were significantly lower in the M group as compared to the C group (P<0.05). Systolic, diastolic, and mean blood pressure were also reduced significantly in the M group as compared to the C group (P<0.05).
Conclusion: Magnesium sulfate when used at the dose of 40 mg/kg attenuates the hemodynamic stress response during laryngoscopy and nasotracheal intubation.
Influence of epidemiological factors on asthma phenotypes among asthma patients attending a tertiary care center – A cross-sectional study
Authors: Satish Babu Mededi  , Jereen Varghese  , Ragulan Rajalingam  , Viswambhar V  , Nithin Thomas
Published: January 2025

Background: Asthma is a heterogeneous disease presenting with various phenotypes usually characterized by chronic airway inflammation.
Aims and Objectives: The aim of the study was to identify epidemiology of bronchial asthma phenotypes in patients attending totertiary care center.
Materials and Methods: This was a descriptive cross-sectional study involving 69 patients who are suspected to have asthma according to the Global Initiative for Asthma guidelines. The data of each patient were collected on a proforma specially designed for this study on demographic data, socioeconomic status, body mass index, exposure to environmental factors, and other history-related questions. Sputum cytology and absolute eosinophil count were also examined using coGuide and P<0.05 was considered significant. Asthma phenotypes were the primary outcome and association of environmental factors with asthma phenotypes was the secondary outcome.
Results: Out of 69, majority 26 (37.7%) were aged 31–40 years; 35 (50.7%) males and 34 (49.3%) were females. Fifty-eight (84.1%) were illiterate and 46 (66.7%) belonged to low class. Sputum cytology report showed that majority of them, 66.7%, had eosinophilia. The majority, 48 (69.6%), of the participants were triggered by weather and 55.1% had a history of respiratory tract infections. Thirty-three (47.83%) participants had obesity associate asthma, 34 (49.28%) had allergic asthma, and 20 (28.99%) had smoking-related asthma phenotypes. The difference in the proportion of few environment factor was significant for allergic and smoking-related asthma (P>0.005).
Conclusion: The factors associated with the asthma phenotypes will help us further in anticipating the clinical course and better management of the specific phenotypes.
To study the challenges in the implementation of “Foundation Course” of newly launch competency-based medical education curriculum among Indian medical colleges
Authors: Ramesh Pawar  , Sunita Vagha  , Varsha Pande  , Sanjeev Chaudhary
Published: January 2025

Background: Medical knowledge is advancing at a rapid pace in a world, where technological evolution is at an all-time high. However, the health-care system falls well short of acceptable standards when it comes to meeting patient demands. Our medical environment, on the other hand, requires conscious revamping to increase healthcare quality. Traditional training approaches are significantly lacking in this era of value-based medicine, which prioritizes quality measurement and provider proficiency. Competency-based medical education (CBME), with its emphasis on individual, programmatic and institutional outcomes, has the ability to realign medical education with this social expectation. However, CBME implementation, on the other hand, is fraught with many challenges.
Aim and Objectives: The aim and objective of this article is to study the challenges in implementation of “foundation course (FC)” ofnewly launch CBME in Indian settings.
Materials and Methods: The study was conducted in a tertiary care center in the specialty of advanced course in Research Methodology. This was an observational study with records of 180 participants in 2019–2020 year. The average age of group was 13–50 years.
Results: One hundred and forty students and 40 teachers from various Medical Colleges had participated in the study. Around 70% participants had rated positive for the implementation of FC, while around 17% rated below average for the implementation of FC. Classes on Communication and Language (52.2%) and Computer and IT (45%) could not be taken was pointed out by the students. 35% of the students and 22.5% of the teachers pointed out that existing infrastructure is not sufficient for implementation of CBME. About 12.5% students express the concern that less study material is available on new CBME and topics included in the FC. Around 40% of the students and 17.5% of the teachers had express their concerned about time management during FC.
Conclusion: The education community has begun to address the difficulties associated with implementing of CBME. Models and guidance are available to inform implementation strategies across the educational continuum, with a focus on the more efficient use of resources and technology, as well as the use of milestones and entrustable professional activities-based frameworks.
Evaluation of Auditor Functions in Diabetic patients in a tertiary care center, central India
Authors: Rakesh Maran  , Vijay Tekam  , Ramit Chaddha  , Kapil Meena
Published: January 2025

Background: sensorineural hearing loss (SNHL) is the common entity among uncontrolled diabetes patients, mainly in long term hyperglycemia. SNHL is mild to severe in nature.
Aims and Objectives: The aims of this study were to evaluate sensory neural hearing loss in patients with diabetes mellitus (DM).
Materials and Methods: We undertook that this prospective observational study which includes patients presented with DM to the department of ENT in Chirayu Medical College and Hospital, Bhopal, Madhya Pradesh, was planned for hearing evaluation during period of June 2020-November 2021, total 42 patients of age group 25-65 years were taken for the study.
Results: On hearing assessment 29 (69.04%) cases were having SNHL and 13 (30.95%) cases were having normal hearing. Only 10 (23.80%) control were having SNHL and 32 (76.19%) control were having normal hearing. There was statistically significant association found between diabetes and SNHL. SNHL was found in less number of young cases and it was found in most of old age patients.
Conclusion: The severity and prevalence of hearing loss are more if duration of hyperglycemia is more and if delay in starting treatment in diabetic child. SNHL is bilateral and mostly mild in the early stage.
Amoxicillin+clavulanic acid in community acquired pneumonia: Past, present, and future from an Indian perspective
Authors: Sandeep Budhiraja  , Akhil Agarwal  , Yashpal Chugh  , Alap Gandhi  , Bhavesh Kotak
Published: January 2025

Community acquired pneumonia (CAP) is a major health problem in India with high morbidity and mortality. The threat posed by this infection is further intensified by the continued emergence of resistance to the currently available antibiotics. With a heritage of more than 24 years in India, amoxicillin+clavulanic acid is one of the most common antibiotics used for CAP. It was developed with an intent to sustain the efficacy of amoxicillin which was challenged due to the emergence of the beta-lactamase producing microorganism. Over a period, it has been included in national and international guidelines for the treatment of CAP. To assure the highest probability of clinical cure and to combat development of resistance: It is imperative for amoxicillin+clavulanic acid to reaffirm itself. Optimization of the PK/PD and higher dose of amoxicllin+clavulanic acid will tackle the burden of the future difficult to manage respiratory infections.
Malaria vaccine: The tale of terror, triumph, tyranny, and trust
Authors: Joyeeta Talukdar  , Tryambak Srivastava  , Abhibrato Karmakar  , Kakali Purkaystha  , Sandeep Goswami  , Arun Kumar  , Ruby Dhar  , Subhradip Karmakar
Published: January 2025

Malaria is an endemic disease in a true sense. It is an acute febrile disease caused due to the parasite Plasmodium. However, unlike COVID-19, it failed to raise an international concern or gain the scientific limelight. Most of the 200 million globally affected by malaria, half of them are from Africa. Four of the nations, Nigeria (25%), the Democratic Republic of the Congo (11%), Mozambique (5%), and Uganda (4%), account for half of the world’s malaria burden and is the leading cause of illness and death. In 2019, an estimated 5–6 million people died of malaria – most of them are young children in sub-Saharan Africa. Many of the countries affected by malaria have the lowest economic status. In the malaria-endemic region, the most vulnerable groups are young children and pregnant women. The costs of malaria are enormous to individuals, families, communities, societies, and nations. After a struggle for three decades, the much-awaited malaria vaccine, RTS, S (brand name Mosquirix), was finally launched; but it came with its controversies and allegations. This review explored the different angles of this disease, the vaccine development, and the emerging debates.
Cardiovascular risk score predictive accuracy and subclinical atherosclerosis correlation in the Indian population: A cross-sectional study
Authors: Elanchezhian Selvaprakash  , Kannan Kumaresan  , Narasimhan Viswanathan , Narendran Mani
Published: January 2025

Background: Estimation of the risk of future atherosclerotic cardiovascular (CV) events is an important step in the primary prevention of CV events. However, the relative accuracy of the various currently available CV risk scores is not validated in Indians.
Aims and Objectives: The study was done to compare the accuracy of three clinically relevant CV risk assessment algorithms in the South Indian population and to validate the risk scores by correlating with the measures of subclinical atherosclerosis.
Materials and Methods: This cross-sectional study was conducted among patients attending a chest pain clinic at a Tertiary care center in South India. The study included subjects ≥30 years of age, with no previous coronary artery disease (CAD) and major cardiac illness. Totally 110 subjects were included in the study. Detailed clinical evaluation and routine investigations were done. The 10-year CV risk for each subject was calculated using the three risk scores – Framingham, American College of Cardiology/American Heart Association (ACC/AHA), and Q risk score. The risk scores of all patients were then correlated with their corresponding carotid intima-media thickness (CIMT) measured using carotid Doppler and coronary angiography results.
Results: The mean age of the study population was 51.45±9.01 years and the majority of them were females (57.2%). CAD patients demonstrated significantly increased CIMT. There was a significant positive correlation (P<0.001) between all three risk scores and carotid intimal medial thickness. As the carotid intimal medial thickness increases, the risk scores also increased (as shown by Pearsons’s correlation coefficient). Similarly, all three risk scores also showed a significant positive correlation (P<0.001) with the severity of CAD as assessed by CAG (as shown by one-way analysis of variance). The ACC/AHA score was the best score with a slightly higher accuracy of 69.9% than that of Q risk score (69.5%). The accuracy of Framingham’s score was found to be 68.3%.
Conclusion: ACC/AHA and Q risk score may be the most appropriate CV risk assessment algorithm for use in Indian populations at present. However, large-scale prospective studies are needed to confirm these findings.
A prospective study of various pre-operative factors and the development of a scoring system in predicting difficult laparoscopic cholecystectomy
Authors: Usha Ramakrishna N  , Radhika Potnuri  , Raj Kumar Sahu  , Hitesh Chavda
Published: January 2025

Background: Laparoscopic cholecystectomy (LC) is a common surgical procedure, the difficulty of which can vary significantly based on pre-operative factors. Identifying these factors can improve surgical planning, patient counseling, and outcomes.
Aims and Objectives: To develop a predictive scoring system for assessing the difficulty of LC preoperatively based on individual patient parameters. To employ operative time and intra-operative events to validate the accuracy of the scoring system in reflecting the technical difficulty of LCs.
Materials and Methods: This prospective study enrolled 104 patients scheduled for LC, assessing them with a pre-operative scoring system to predict operative difficulty. Patients were categorized into groups indicating expected levels of difficulty: Easy, difficult, and very difficult. Demographic information, clinical characteristics, and operative outcomes were analyzed to validate the scoring system’s predictive accuracy.
Results: Of the patients assessed, 68.3% were predicted to have an easy LC (scores 0–5), whereas 31.7% were anticipated to face a difficult LC (scores 6–10). Key predictors of operative difficulty included age, sex, history of previous hospitalization for acute cholecystitis, body mass index (BMI), the presence of an abdominal scar, palpable gallbladder (GB), thickened GB wall, pericholecystic collection, and impacted stone. The study found that operative outcomes closely aligned with pre-operative predictions, confirming the scoring system’s moderate predictive accuracy (area under the curve of 0.798).
Conclusion: The pre-operative scoring system demonstrated moderate effectiveness in predicting LC difficulty, with significant predictors including a history of hospitalization, BMI, palpable GB, and thickened GB wall. These findings can aid in pre-operative planning and optimizing patient outcomes.
The efficacy and safety of granisetron with ondansetron for the prevention of post-operative nausea and vomiting in patients undergoing cesarean section under spinal anesthesia
Authors: Rajesh Kumar  , Supriya Singh  , Sanni Deyol Gautam  , Narendra Singh Bafila
Published: January 2025

Background: Spinal anesthesia often causes more post-operative nausea and vomiting (PONV). Cesarean-section patients have a significantly more PONV rate. Therefore, evidence-based knowledge about PONV prevention and care for high-risk individuals is urgently needed to reduce the consequences.
Aims and Objectives: The aim of the study was to compare the efficacy and safety of granisetron with that of ondansetron in the prevention of PONV in patients undergoing cesarean section under spinal anesthesia.
Materials and Methods: A total of 86 pregnant women with American Society of Anesthesiologists grade I–II scheduled for cesarean delivery under spinal anesthesia were enrolled. Patients were divided into two equal groups (n=43): Ten minutes before spinal anesthesia, patients in group B (granisetron) received 2 mg granisetron intravenously diluted to 10 mL with normal saline, whereas patients in group A (ondansetron) received 4 mg ondansetron.
Results: There was no significant difference between Groups A and B in terms of the number of vomiting episodes between 0 and 6 h. Group A had significantly more episodes of nausea after 2 h than Group B after 0–2 h. After 2–6 h, however, the nausea was similar in all groups. Of the patients in Group A, 4 (9.3%) required antiemetic medication, in Group B, it was 2 (4.7%). In Group A, 8 patients (18.6%) and 6 patients (14%) complained of headache and dizziness, respectively; in Group B, 3 patients (7.0%) and (0%), respectively. Dizziness was significantly more pronounced in Group A than in Group B.
Conclusion: The results of the study show that granisetron (2 mg) was more effective than ondansetron (4 mg) in minimizing PONV episodes in women undergoing spinal anesthesia for cesarean section. There were no significant side effects and both drugs were comparatively safe.
Impact of side effect management, patient outcomes, and health-care costs in atorvastatin and rosuvastatin therapy: An observational study
Authors: Gayathri Elango  , Varsha AP  , Ganga Muruga Bharathi
Published: January 2025

Background: Statins are widely prescribed for the management of hyperlipidemia and the prevention of cardiovascular diseases. Atorvastatin and rosuvastatin are among the most commonly used statins, with varying impacts on lipid profiles, side effect profiles, patient adherence, and health-care costs. Understanding these differences within specific populations can inform more tailored and cost-effective treatment strategies.
Aims and Objectives: This study aimed to evaluate the differences in side effect management, patient outcomes, and health-care costs between atorvastatin and rosuvastatin therapies in a cohort from Coimbatore, Tamil Nadu, India.
Materials and Methods: An observational study was conducted with 100 patients at the Karpagam Faculty of Medical Sciences and Research, evenly split between atorvastatin (n=50) and rosuvastatin (n=50) groups. Data on demographic characteristics, side effects, low-density lipoprotein (LDL) cholesterol reduction, medication adherence, and health-care costs were collected and analyzed.
Results: The cohort had an average age of 62 years, with a higher prevalence of males (57%). Socioeconomic analysis showed 30% from low-income, 50% from middle-income, and 20% from high-income backgrounds. Side effects were more common in the atorvastatin group (35%) compared to the rosuvastatin group (28%), with muscle pain and gastrointestinal issues being predominant. Rosuvastatin treatment resulted in higher adherence rates (90%) and more significant LDL cholesterol reduction but incurred higher annual health-care costs (INR 28,000) versus atorvastatin (INR 25,000) (P=0.04).
Conclusion: Both statins effectively reduced LDL cholesterol; however, rosuvastatin demonstrated higher patient adherence but at an increased cost. These findings underscore the need for individualized statin therapy that considers both clinical outcomes and economic constraints, particularly in settings with limited health-care resources.
Clinicopathological spectrum and management of sinonasal masses – A prospective observational study in a tertiary care center
Authors: Mohsina Siddique  , Debajit Sarma  , Mridusmita Gohain  , Rupanjita Sangma
Published: January 2025

Background: Sino nasal mass (SNM) is a common clinical entity in the ENT outpatient department. It affects all age groups. SNMs are mainly non-neoplastic inflammatory polyp, benign tumor, and malignant tumor, out of which inflammatory polyp is the most common entity. Radiological investigation plays a major role in SNM. Surgery is the treatment of choice in almost all cases. Functional endoscopic sinus surgery (FESS) is the most commonly employed approach for surgery.
Aims and Objectives: The aim of the current study is to analyze the clinicopathological aspects and enumerate the various management strategies of SNMs in patients attending the department of ENT in a tertiary care hospital in the upper Assam region.
Materials and Methods: The present study was conducted in Assam Medical College between May 2022 and October 2023. During the period of this prospective observational study, 100 patients presented with SNMs.
Results: Total 100 patients were reviewed, out of which 59 patients were male and 41 females. Overall, the most common affected age group was 31–40 years. Seventy-seven cases were non-neoplastic sinonasal polyps, 16 cases were benign tumors and seven were malignant tumors. Sixty-four patients had undergone FESS, 20 patients had endoscopic sinus surgery with or without medial maxillectomy and eight patients had lateral rhinotomy. Malignant cases were managed by radiotherapy and chemoradiation mainly.
Conclusion: Sinonasal polyp is a very common entity among all SNMs. Computed tomography scan is the main diagnostic tool. FESS is the most commonly used surgical procedure with less complication.
Bacterial pathogens and treatment outcomes in neonatal sepsis: A comparative observational study across various hospital settings
Authors: Radhika B  , Vijayasri BSS  , Jyothi Prakash Raju S  , Vidyasagar V
Published: January 2025

Background: Neonatal sepsis is a leading cause of neonatal morbidity and mortality globally, with variations in causative bacteria and treatment efficacy across health-care facilities.
Aims and Objectives: The aims and objectives of the study are to analyze the bacterial pathogens causing neonatal sepsis and the effectiveness of their treatment in diverse hospital environments. By highlighting the differences in treatment success rates, antibiotic resistance profiles, and the pathogens involved, this study demonstrate the impact of health-care practices and infrastructure on the management of neonatal sepsis.
Materials and Methods: The study encompassed 100 neonates with sepsis, evenly distributed across the three hospital types. It involved identifying bacterial pathogens through blood cultures, assessing antibiotic sensitivity, and examining treatment outcomes such as success rate, mortality, hospital stay duration, and complication rates. Statistical methods were employed to evaluate differences in outcomes among the settings.
Results: Seventy percent of neonates tested positive for bacterial pathogens, with a 60% predominance of Gram-positive over Gram-negative bacteria (40%). Staphylococcus aureus (22%) and Streptococcus agalactiae (18%) were the leading pathogens. Notably, resistance was high against ampicillin (65%) and gentamicin (40%) but lower for cephalosporins and vancomycin. The overall success rate of treatments was 80%, with the tertiary care hospital achieving an 88% success rate, significantly outperforming the private hospitals (72%). The mortality rate was 10%, and 30% of the cases developed complications, predominantly respiratory distress syndrome.
Conclusion: Hospital setting significantly influences the management and outcomes of neonatal sepsis, with tertiary care centers showing better results. These findings highlight the need for focused antimicrobial stewardship and the adoption of sophisticated care protocols in less advanced settings to improve neonatal sepsis outcomes.
Optimizing fracture management: The role of the Ellis plate in distal radius fractures
Authors: Banna Kiran Kumar , Srikanth Minumala  , Dinesh Kannan  , Swikrutha Badam  , Lakshminarayana Seela
Published: January 2025

Background: Fractures at the distal end of the radius, a prevalent orthopedic concern, challenge clinicians due to their complex nature and the diverse patient demographics they affect. Primary stability is key, especially in cases involving osteoporotic bones or younger patients. The Ellis plate with a locking screw mechanism offers a promising solution to achieve this stability, potentially preventing secondary displacement regardless of bone quality.
Aims and Objectives: This study aims to rigorously assess the effectiveness of the Ellis volar locking compression plate in treating distal end radius fractures. It focuses on evaluating functional outcomes post-treatment, providing insights into the efficacy of this approach.
Materials and Methods: This study evaluated the efficacy of the Ellis plate in managing distal radius fractures, under ethical approval number KMC/IEC/Ortho/2021-5. Twenty adult patients with unstable fractures were included based on specific criteria and provided informed consent. Exclusion criteria included unwillingness for surgery, medical unsuitability, osteoporosis, minors, and compound fractures with vascular injury. Surgical outcomes were assessed using the Gartland and Werley scoring system, with follow-up appointments scheduled over 1 year to monitor progress and adherence to physiotherapy plans.
Results: The study encompassed 20 patients, with a gender distribution of 12 males and eight females and an average age of 43.3 years. Utilizing the Gartland and Werley demerit grading system, the study reported 45% superb outcomes, another 45% good outcomes, 10% fair outcomes, and no poor outcomes. This distribution highlights the potential of the Ellis plate technique in achieving positive results in fracture treatment.
Conclusion: The study concludes that the Ellis plate technique is a viable and effective option for stabilizing distal end radius fractures. However, achieving the best possible outcomes depends on several factors, including strict adherence to AO principles, maintaining high standards of aseptic practice, following appropriate post-operative rehabilitation protocols, and ensuring comprehensive patient education. This multifaceted approach is crucial for the successful treatment of these fractures.
Clinicopathological features and risk stratification by the sokal score of patients with chronic myeloid leukemia at a tertiary care hospital in North-East India: A prospective study
Authors: Anjanjyoti Rajkonwar  , Upam Kumar Sharma  , Sima Sonowal  , Arpita Nath  , Hiranya Saikia  , Gautam Hazarika
Published: January 2025

Background: Chronic myeloid leukemia (CML) is a hematologic malignancy characterized by excessive growth of myeloid cells and their progenitors. The incidence of CML is approximately 1–2/100,000 population per year.
Aims and Objectives: The aims and objectives of the study are to determine the clinicopathological features of patients with CML and their risk stratification by the Sokal score at a tertiary care hospital in North-East India.
Materials and Methods: This was a single-center prospective study conducted for 5 years (2018–2022). A total of 109 cases diagnosed with CML by qualitative analysis of BCR-ABL1 transcript reverse transcription-polymerase chain reaction were included in the study. The Sokal score was calculated using previously published formulae to classify the patients into different risk groups. The outcome (dead or alive) of CML patients was compared with their individual risk groups using Fisher’s exact test.
Results: Out of 109 CML patients, 73 were males and 36 were females. At the end of the study, 85 patients were alive whereas 24 died. The mean age at presentation was 42.08±15.06 years. The pediatric age group comprises 1.84% of total cases. The percentages of death were higher (79.17%) in patients aged 18–59 years, followed by 20.83% in ≥60 years age group, whereas no death was recorded in the pediatric age group (<18 years). The abdominal hard lump was the most common clinical presentation, followed by abdominal fullness, weakness, and pain abdomen. The Sokal score assigns the majority (66.06%) of patients to the intermediate risk (IR) category, followed by 25.69% and 8.26% in the high-risk (HR) and low-risk (LR) categories, respectively. It was observed that the majority (28.57%) of patients died in the HR group, followed by 20.83% in the IR group and 11.11% in the LR group.
Conclusion: The mean age of CML patients is lower than that observed in many Western countries. The Sokal score assigns the majority of patients to IR category and the maximum death were seen in the HR group.
Children with bicytopenia and pancytopenia – clinical picture, etiological spectrum, and outcome
Authors: Vijay Anand M  , Logeshwaran K  , Srenivas A  , Sathiya Suresh R
Published: January 2025

Background: Children who develop cytopenias present with several etiological causes, posing diagnosis, and management difficulties for both physicians and pathologists. With these in mind, we assessed the clinical profile and etiology of children who attended a healthcare facility in South India with bicytopenia or pancytopenia.
Aims and Objectives: (1) The primary objective of this study was to find out the clinical and etiological spectrum in children with bicytopenia and pancytopenia who were admitted to the Institute of Child Health and Research Center, Government Rajaji Hospital, Madurai. (2) The secondary objective of this study is to follow-up children with bicytopenia and pancytopenia to find out the outcome and prognosis.
Materials and Methods: This study was in the Department of Pediatrics at the Government Rajaji Hospital in Madurai, Madurai Medical College’s Institute of Child Health and Research Center, which is where we carried out the study. Two hundred and sixty-four patients with bicytopenia and 36 patients with pancytopenia were included in this study. Once in 2 weeks, all children with bicytopenia and pancytopenia were assessed in our Saturday hematology outpatient clinics.
Results: Fever was the most prevalent sign of both pancytopenia and bicytopenia in this investigation. Etiological variables among cases of pancytopenia, cancer, infections, non-infections, and idiopathic causes were recorded in 11%, 58%, 17%, and 14% of cases, respectively. Similarly, bicytopenia, malignancy, infections, non-infections, and idiopathic causes were found in 23%, 70%, 4%, and 3% of cases, respectively. According to the prognosis, 28%, 33%, 6%, and 33% of cases with pancytopenia recovered, passed away, were lost to follow-up, or were undergoing treatment, respectively. Similar to those individuals, 67%, 11%, 4%, and 18% of bicytopenia cases were treated, recovered, or lost to follow-up, respectively.
Conclusion: In children, there is a wide etiological range of cytopenias. Infections and dangerous diseases like acute leukemia are among the reasons. The geographical location of the hospital, the frequency of malnutrition, and the regional presence of certain diseases such as malaria and enteric fever determine the causes reported in a hospital environment.
To study the role of propranolol in infantile hemangioma: A prospective randomized study
Authors: Pokhariya BMS  , Supriya Tiwari  , Bhupesh Gogia
Published: January 2025

Background: Infantile capillary hemangiomas (IHs) are common, benign, self-limited tumors with a well-defined natural history, occurring most often on the head and neck. IHs are the most common soft-tissue tumors in infancy and occur in 5–10% of children. The main risk factors identified for IH include female sex and low birth weight. For many hemangioma patients, treatment is not required; however, there are many treatment options for IH, each with their own limitations and side effects.
Aims and Objectives: The study aimed to study the role, efficacy, and side effects of propranolol in infantile hemangioma.
Materials and Methods: Patients with infantile hemangioma at SN Medical College, Agra, in the Department of General Surgery and Pediatric Surgery with the required eligibility criteria are considered in this study from December 2021 to December 2023, in total 60 patients, prospectively randomized into three groups: Group A: Infants given propranolol only. Group B: Infants given steroids only Group C: Infants given a steroid plus propranolol.
Results: In our study, Group A taking propranolol alone 14 out of 20 (70%) responded well, Group B taking steroid alone 7 out of 20 (35%) responded well and Group C taking steroid and propranolol 16 out of 20 (80%) responded well, which shows that propranolol in a low dose (0.5–3 mg/kg/day) is an effective drug for infantile hemangioma.
Conclusion: In our study, we can conclude that propranolol is a safe, efficacious, and better drug than corticosteroid for infantile hemangioma when used in low doses, and the effects are better if started in the early phase.
Prevalence of chronic kidney disease and its risk factors among Type 2 diabetes patients in a tertiary care hospital
Authors: Noor Mohamed Rasik B  , Sakthi Suganya ST  , Vikram Manamala Sudhakar  , Vignesh C
Published: January 2025

Background: An increased chance of developing chronic kidney disease (CKD), which has higher morbidity and mortality, exists among patients with Type 2 diabetes (T2D).
Aims and Objectives: Our goal was to determine and classify the anthropometric, physiological, and demographic risk factors for CKD in individuals with T2D.
Materials and Methods: A cross-sectional research study was conducted at a tertiary care hospital involving 218 participants. Data were collected on various parameters including age, gender, education level, employment status, height, weight, blood pressure, hemoglobin levels, and estimated glomerular filtration rates (eGFRs). Participants were selected based on specific inclusion and exclusion criteria, and rigorous statistical analyses were applied to the collected data. Using the SPSS program, we analyzed the data, and when the P<0.05, we declared the results statistically significant.
Results: There were 218 people in the research, 58.3% of whom were male and 41.7% of whom were female. The mean age group was between 51 and 60 at 36.2%. The age group distribution among the patients showed significant value (P<0.0001). About 87.6% of the patients had normal weight. 49.5% were recorded in Stage 1 CKD. Fasting blood sugar has a negative correlation (−182) with glomerular filtration rate (GFR) and shows a significant result. The post-prandial blood sugar value is also statistically significant and negatively relates to GFR. In addition, random blood sugar and glycated hemoglobin also reported statistically significant values.
Conclusion: In individuals with T2D, it was determined that significant risk factors for the onset of CKD include eGFR, age, and the duration of diabetes. Males had a considerably greater incidence of CAD, peripheral neuropathy, and diabetic foot.