bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute coronary events in SARS-CoV-2 - causal or incidental?
Authors: Shatabhisha Mandal  , Gajender Singh Ranga  , Shiva Narang  , Anupama Tandon
Published: January 2025

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus can damage respiratory, cardiovascular system by various mechanism which can lead to increased morbidity and mortality.
Aims and Objectives: The aim of the study was to assess incidence of acute coronary syndrome (ACS) in moderate to severe cases of infection with SARS-CoV-2.
Materials and Methods: This was an observational cross-sectional study including 60 patients of age ≥18 years of either gender presenting to GTB Hospital diagnosed as positive for SARS-CoV-2 by RT-PCR and/or Rapid Antigen Test and belonging to moderate and severe category without any prior history of respiratory, cardiac, gastrointestinal, renal illness, long-term corticosteroid, or immunomodulator use. The cardiac involvement was assessed by history, clinical examinations, and investigations.
Results: Cardiovascular involvement was present in 25% patients. Cardiac involvement included ACS including ST elevation myocardial infarction (STEMI) (3.3%), non-STEMI (10%), unstable angina (1.67%), left ventricular hypertrophy (8.3%), bundle branch block (3.3%), atrial fibrillation (1.67%), and bradycardia (1.67%). Raised cardiac enzyme levels positively correlated with ECG abnormalities. Respiratory involvement was seen in 85% of patients. among which 56.7% patients in severe category, 41.67% patients in moderate category, and 1.67% patients in mild category as per CTSI scoring. There was lung parenchymal involvement with ground glass opacities in bilateral lungs (68.3%), lobar consolidation (6.7%), cavitatory lesion (5%), pulmonary edema (5%), pneumothorax (3.3%), emphysematous changes (3.3%), and bilateral pleural effusion (3.3%).
Conclusion: ACS occurs frequently in patients with SARS-CoV-2 and it is associated with complications such as congestive heart failure, bundle branch block, atrial fibrillation, bradycardia, and heart block.
Study of maternal and neonatal outcomes of placenta accreta spectrum in a tertiary care hospital
Authors: Ashitha Naser  , Veena Praveen  , Simi Kurian  , Ajith S
Published: January 2025

Background: Placenta accreta produces significant maternal morbidity and mortality. A detailed knowledge of outcome is needed to develop a standardized risk appropriate maternal care system.
Aims and Objectives: The aim of the study was to study the maternal and neonatal outcome of women with placenta accreta spectrum (PAS) in a tertiary care hospital.
Materials and Methods: A hospital-based prospective observational study was conducted among the 40 women with PAS during a period of 3 years. Exposure factors such as previous caesarean sections, previous uterine procedures, and present or previous placenta previa; maternal outcome factors include obstetric hysterectomy, massive blood transfusion, bowel and bladder injury, and death; neonatal outcome factors include prematurity, newborn intensive care unit (NICU) admissions, APGAR scores, and birth weight. The data were analyzed by calculating frequency and percentage.
Results: Of the 40 cases studied, 25 were known cases of PAS, and the remaining was diagnosed intraoperatively. About 90% (36 cases) underwent an obstetric hysterectomy. In 62.5% of patients, large vessel ligation and a clamp were applied. About 32.5% of patients required massive blood transfusions, 20% sustained bladder injuries, and there was 1 maternal death. About 76% of babies born to mothers with PAS were preterm, 43% required NICU admission, and there were 5 neonatal deaths (12%).
Conclusion: The PAS is associated with significant maternal morbidity in the form of severe postpartum hemorrhage requiring massive blood transfusions and bladder injury. There is also increased neonatal morbidity and mortality. Hence, there is a need for early termination in anticipation of grave complications.
Study to assess the association of PMS with sociodemographic factors and various coping behaviors adopted for premenstrual symptoms
Authors: Deepika Badkur  , Suchita Singh  , Vibha Arjaria  , Arun Wanjpe
Published: January 2025

Background: Some women get through their monthly periods easily with few or no concerns. However, other women experience a host of physical and/or emotional symptoms just before and during menstruation (heavy bleeding and missed periods to unmanageable mood swings). These premenstrual syndrome (PMS) symptoms usually start to be problematic in the adolescent years and decline in the climacteric. Symptoms have a devastating effect which starts early in life.
Aims and Objectives: The study was conducted to estimate the prevalence of PMS and its association with sociodemographic factors among female students of colleges situated in Ujjain city and coping behavior adopted to alleviate these symptoms.
Materials and Methods: An observational follow-up study was conducted at 4 colleges selected by convenience sampling located in Ujjain city. PMS and menstrual profile-related data from 250 girls (18–25 years) who consented to participate were collected using a modified version of the Daily Record of Severity of Problems for at least 2 consecutive menstrual cycles. The diagnosis of PMS was made using the American College of Obstetrics and Gynecology criteria. Data analysis was done using SPSS version 16.0.
Results: The prevalence of PMS was 39.6% and was not associated with any of the sociodemographic factors. It was found that majority of participants turned to healthy way of dealing with symptoms, i.e., taking hot or cold beverages and talking to family members.
Conclusion: The frequency of PMS is relatively common in young girls, and most of the girls adopt home remedies to alleviate symptoms.
An observational study for evaluation of antibiotic utilization and growing resistance against antibiotics in pediatric patients suffering from meningitis in a tertiary care hospital
Authors: Subhradipta Bhattacharyya  , Arup Ghosh
Published: January 2025

Background: Meningitis, inflammation of the meninges with systemic septicemia, from the bacterial, viral, or fungal origin, is a fatal disease in all age groups, particularly infants and children. The present study was done to evaluate the usage of antibiotics in pediatric patients with meningitis in a tertiary care hospital.
Aims and Objectives: The study was conducted to evaluate the prescription pattern of antibiotics for pediatric patients suffering from meningitis. The efficacy of antibiotics, combination of antibiotics, and the resistance developed against them were reevaluated.
Materials and Methods: An observational, noninterventional study with 34 pediatric patients (The mean age of the patients were 6.17 year. ±4.84 SD) admitted in Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar from September 2012 to February 2014 were evaluated. Data were collected after the approval of the research protocol by the Institutional Ethics committee, KIMS from case sheets of patients from the ward as well as the Medical Record and Data section. Comparative statistical analysis was done by using student’s t-test in respect of data measured on a continuous scale. All differences with P<0.05 were labeled as statistically significant.
Results: Ceftriaxone±ß lactamase inhibitor (βLI) (77.4%), and Cefoperazone±βLI (12.9%) were the most frequently used cephalosporin. In 55.8% of patients, three or more antibiotics in combination were given. Two drugs regimen like β lacatam+aminoglycoside in 23.5% of patients and β lactam+anti-Methicillin-resistant Staphylococcus aureus (MRSA) in 20.6% were given. Emerging resistance pattern against both Gram-positive cocci and Gram-negative bacilli to penicillins, cephalosporins, and aminoglycosides which are the primary first-line drugs has been observed.
Conclusion: Very severe meningitis patients were treated with multiple antibiotics including anti-MRSA agents. High resistance (≥60%) was observed against β lactams.
Prevalence of neonatal thrombocytopenia in five cities of India: A cross-sectional descriptive study
Authors: Parmila Malik  , Atul Khajuria  , Jyotsana Khattri  , Lalit Singh  , Veeresh VG
Published: January 2025

Background: Neonatal thrombocytopenia is defined as a platelet count <150,000/μL can be mild, moderate, or severe thrombocytopenia. The platelet production in neonates begins early at 5 weeks of gestation and reaches the adults count by 24–28 weeks. The platelet disorders are due to impaired platelet production or increased platelet destruction and sequestration. The onset of neonatal thrombocytopenia occurs within 72 h and late onset develops the risk of intraventricular hemorrhage. Hence, the knowledge regarding the incidence and occurrence is vital.
Aims and Objectives: The present study aims to study the prevalence of neonatal thrombocytopenia in India.
Materials and Methods: A cross-sectional descriptive study was designed, A total of 3250 neonates were assessed for the prevalence of neonatal thrombocytopenia using non-probability convenient sampling technique studies at various cities such as Lucknow, Panipat, Sonipat, Gohana, and Delhi. The data relating to levels of platelets were assessed for all the samples.
Results: The present study revealed that the prevalence rate of neonatal thrombocytopenia was 3.4% at various cities in India.
Conclusion: The present study assessed the prevalence of neonatal thrombocytopenia this determines the early intervention and prevention of the complication in relation to neonatal thrombocytopenia.
Microbiological study of empyema thoracis among children in a tertiary care hospital
Authors: Sagarika Dhal  , Jyoti Ranjan Champatiray  , Dibya Prasana Mohanty  , Lalmohan Mishra  , Manoj Kumar Dehury  , Dharma Niranjan Mishra
Published: January 2025

Background: Empyema thoracis is a condition resulting in the accumulation of purulent fluid in the pleural cavity. It is a common source of illness among young children and is the most common sequela of bacterial pneumonia.
Aims and Objectives: This study was to determine the clinico-microbiological profile, causative agents, and antimicrobial susceptibility patterns of the isolates of the study population.
Materials and Methods: Prospective observational study was done in the Department of Microbiology, S. C. B. M. C. H., Cuttack. The study group comprised a total of 105 cases of empyema thoracis between the age group of 0–14 years, diagnosed by aspiration of pus from the pleural space. Complete histories of cases in detail were noted.
Results: A total of 41% of patients were in the age group of 5–9 years with M: F ratio of 1.1:1. Maximum cases 36 (34.3%) were seen in the spring season. Fever, cough, and breathlessness were the most common complaints. Bronchopneumonia 56 (53.3%), impetigo, and skin lesions 29 (27.6%) were the major predisposing factors. Right-side empyema 71 (67.6%) was more common than the left side 34 (32.4%). Culture revealed Staphylococcus aureus as the most common etiologic agent 26 (36.1%), of which 30.8% were methicillin-resistant S. aureus, followed by Mycobacterium tuberculosis complex 13 (18.1%). Finally, 103 (98.2%) empyema cases were recovered by antibiotics and tube thoracostomy.
Conclusion: Empyema thoracis is more prevalent in the lower socioeconomic population which can be prevented by an early diagnosis of pneumonia. Effective methods to treat empyema thoracis in children include the administration of proper antibiotics and tube thoracostomy in resource-poor settings.
Change in the quality of life in the patients of laryngeal and pharyngeal carcinoma after receiving radiation therapy: A prospective and observational study
Authors: Siddhartha Adhikary  , Bandyopadhyay Rajat , Suparna Banerjee  , Amit Sarkar
Published: January 2025

Background: The quality of life (QoL) of laryngeal and pharyngeal carcinoma patients is influenced by the side effects of treatment affecting functions such as swallowing, feeding, and speech, more so following conventional radiation using 2D technique.
Aims and Objectives: This study was undertaken to determine the change in QoL of laryngeal and pharyngeal cancer patients after radiation using 2D technique in a Telecobalt unit in a resource constrained peripheral institution.
Materials and Methods: In this prospective, observational, and single institutional study, fifty-one larynx and pharynx cancer patients were treated with radiation/chemoradiation in telecobalt unit using conventional 2D technique. QoL was evaluated using European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ) C30 and EORTC QLQ Head and Neck Module (HN43) pre-validated and locally adapted questionnaires at pre-treatment, immediately, 3 months and 6 months after radiation. The difference between the scores at different time points was verified using Friedman’s non-parametric test.
Results: Of the 46 evaluable patients, 71% were male with median age of 56.5 years, median follow-up of 8 months; 15 patients (32%) had Stage II disease and 78% of patients received concurrent chemotherapy. There was statistically significant deterioration of global health status and functional scales immediately after radiation. All the symptom scales of QLQ C30 and QLQ HN43 except neck swelling showed significant worsening at the end of radiation. After 6 months, the Global health status and all functional scales showed statistically significant improvement. Most symptom scales of QLQ C30 (except appetite loss and fatigue) were statistically significantly improved. At the end of 6 months, most of the symptoms showed significant improvement reaching pre-treatment values. There were however worsening of symptoms such as dry mouth, sticky saliva, and mouth opening.
Conclusion: Laryngeal and pharyngeal carcinoma patients suffered from a deterioration of QoL after radiation. Six months later, most of the QoL scales showed a statistically significant improvement. These negative impacts on QoL can be reduced by use of newer techniques of radiation therapy such as 3D conformal radiotherapy, intensity-modulated radiation therapy, and image-guided radiation therapy.
Comparative evaluation of magnetic resonance arthrogram with arthroscopy in knee pathologies
Authors: Harish Deepak P  , Prem Chand Paladugu  , Boblee James
Published: January 2025

Background: Magnetic resonance arthrogram (MRA) has emerged as a supplement to non-contrast magnetic resonance imaging (MRI), especially in the identification of meniscal and chondral pathologies. It has increased the diagnostic efficacy of MRI in the evaluation of knee pathologies.
Aims and Objectives: The present study was carried out to evaluate the role of MRA in the diagnosis of various knee pathologies and to correlate its findings with arthroscopy.
Materials and Methods: A total of 56 patients with knee pain scheduled to undergo arthroscopic evaluation were enrolled in the study and were assessed using MRA before arthroscopy. MRA findings were correlated with arthroscopic findings. The level of agreement was measured using kappa statistics. Diagnostic efficacy was assessed in terms of sensitivity, specificity, positive predictive value, and negative predictive value.
Results: Cartilage involvement (48.2%), anterior cruciate ligament (ACL) tear and medial meniscus tear (37.5% each), bony injury (n=12; 21.4%), chondral defect (n=11; 19.6%), posterior cruciate ligament tear (n=10; 17.9%), and lateral meniscus tear (n=8; 14.3%) were the knee pathologies confirmed by arthroscopy. MRA had a sensitivity and specificity of 100% for pathologies such as ACL tear, lateral meniscus tear, medial meniscus tear, and bony injury. It was 100% specific for all the pathologies with no false positive detection. There was a strong to perfect agreement between MRA and arthroscopic findings for different knee pathologies.
Conclusion: The present study found MRA to be a highly specific diagnostic tool for the diagnosis of different knee pathologies and it is useful in reducing the burden of undesired invasive arthroscopies.
Challenges and lessons from COVID-19
Authors: Om Saswat Sahoo  , Ruby Dhar  , Arun Kumar  , Subhradip Karmakar
Published: January 2025

In this review, we elaborate the post-COVID-19 challenges, and also, the lesson learned out of this crisis. With over 700 million people affected worldwide and nearly 6 million deaths, COVID-19 pandemic is of unprecedented nature ever witnessed by the human race. Besides health-care challenges, there were socioeconomic consequences that still have its footprints affecting life of the citizens. We summarized these challenges, addressing the lacunae in terms of enhancing our infrastructure, logistics, and knowledge, not only about this disease, but also to adequately prepare for future pandemic of this proportion.
A comparative study of efficacy of ropivacaine (0.75%) with adjuvants – dexmedetomidine and fentanyl in supraclavicular brachial plexus block
Authors: Zaebha Shah Alam  , Pradhan Monnaiah K  , Sandeep S Kadam  , Hema Viswanath K  , Pedapolu Kishore Babu  , Usha Rani S
Published: January 2025

Background: Brachial plexus block is preferred to general anesthesia (GA) as it reduces many complications of GA, provides good intra and postoperative analgesia, adequate muscle relaxation. Addition of adjuvants along with LA is used to prolong block with improved quality of anesthesia and decrease dose of LA. This study was done to see the efficacy of Ropivacaine with dexmedetomidine and fentanyl in terms of duration of action and pain relief.
Aims and Objectives: Dexmedetomidine and Fentanyl along with Ropivacaine in patients undergoing upper limb surgeries, the onset and duration of sensory and motor blockade as well as post op analgesia is compared.
Materials and Methods: Prospective Randomized Comparative study with three groups randomly divided received total volume of 30 mL of drug in peripheral nerve stimulator guided supraclavicular blocks in patients undergoing upper limb surgeries. Group Dexmedetomidine received 28 cc of 0.75% Ropivacaine and Dexmedetomidine (1 mcg/kg), Group Fentanyl patients received 28 cc of 0.75% Ropivacaine and fentanyl (1 mcg/kg), whereas, group plain Ropivacaine patients received 28 cc of 0.75% Ropivacaine and 2 mL of normal saline. Haemodynamics, sensory and motor block (MB) were evaluated by VAS and modified Bromage scale.
Results: The onset of sensory block and MB in the dexmedetomidine group, fentanyl group, and ropivacaine groups was 3.57±0.50 min and 4.47±0.51 min, 5.50±0.51 min and 7.53±0.51 min, and 8.07±0.79 min and 10.07±0.79 min respectively which were statistically significant. The duration of MB in the dexmedetomidine group, fentanyl group, and ropivacaine group were 6.57±0.50 h, 4.47±0.51 h, and 2.50±0.51 h respectively which was statistically significant (P=0.0000). The duration at which first postoperative analgesia was required in the dexmedetomidine group, fentanyl group, and ropivacaine group were 8.57±0.50 h, 6.57±0.50 h, and 5.30±0.47 h respectively.
Conclusion: Dexmedetomidine is better as an adjuvant to Ropivacaine for brachial plexus block in terms of onset and duration.
Protective effects of Majun Brahmi on aluminium-induced cognitive impairment in rats: Biochemical and behavioral changes
Authors: Monika Kumari  , Puja Kumari Jha  , Mahmood Ahmed Khan  , Amjad Saifi  , Vinod Kumar Arora  , Sumita Halder  , Yasmeen Shamsi  , Rafat Sultana Ahmed
Published: January 2025

Background: The Unani formulation Majun Brahmi (MB), a combination of herbs, is used in India as a brain tonic and memory enhancer. Aluminium deposition in the brain is associated with the development of neurodegenerative diseases.
Aims and Objectives: The present study was designed to observe that the effects of MB have been evaluated on aluminium trichlorideor aluminium chloride (AlCl3)-induced cognitive impairment in an experimental rat model.
Materials and Methods: Twenty male Wistar albino rats were divided into four groups of five rats each. AlCl3 was administered orally for 30 days to induce cognitive impairment. Group I received saline, Group II-AlCl3 (100 mg/kg b.wt), Group III-MB (1027.77 mg/kg b.wt), and Group IV-AlCl3 + MB (100 mg/kg b.wt+1027.77 mg/kg b.wt). At the end of the experiment, rats were subjected to behavioral and biochemical assessments.
Results: Animals treated with AlCl3 showed a significant increase in time to reach the platform in the Morris water maze test (MWM), prolonged transfer latency (TL) in the elevated plus maze, and decreased step-down latency in the passive avoidance test, as compared to controls (P<0.01). Cotreatment with MB resulted in a reduced time to reach the platform in MWM, increased step-down latencies, and decreased TL. AlCl3 induction significantly increased malondialdehyde and decreased superoxide dismutase, glutathione reductase, glutathione, total antioxidant capacity, and catalase levels. Concomitant administration of MB significantly attenuated the effects AlCl3 on lipid peroxidation and restored the reduced antioxidant parameters.
Conclusion: The study provides strong evidence for the potential use of MB in the treatment of neurodegenerative disorders like Alzheimer’s disease.
Satisfaction among caregivers of beneficiaries with the services provided at the well-baby clinic of a tertiary care hospital, Kolkata
Authors: Shalini Pattanayak  , Somnath Naskar  , Partha Pratim Pal  , Mausumi Basu  , Ankita Mishra  , Sreetama Chakrabarti
Published: January 2025

Background: Well-baby clinics (WBC) are health facilities for providing primary care, including immunization services to infants and children. Caregivers’ satisfaction is a vital indicator of the quality of healthcare services provided.
Aims and Objectives: This study aims to assess the caregivers’ satisfaction with the services provided at the WBC of a tertiary care hospital in Kolkata, West Bengal and to identify the associated sociodemographic factors.
Materials and Methods: A descriptive-type of observational study with a cross-sectional design, was conducted from June to July 2022, using a predesigned pretested and structured schedule, among 106 caregivers of beneficiaries attending WBC. Satisfaction was assessed using 24 items answered on a 5-point Likert scale, ranging from “highly satisfied” to “highly dissatisfied.” Data were tabulated in MS Excel 2021 and analyzed using statistical package for the social sciences v25.0. Bivariate Logistic Regression was performed to examine the association of sociodemographic factors with caregivers’ satisfaction.
Results: High satisfaction with the services was observed among 52.8% participants. Least number of caregivers were satisfied with the vaccination services. Caregivers’ gender, mothers’ education and beneficiaries’ gender were found to be statistically significant with their satisfaction. Furthermore, the female caregivers had lower odds of statistically significant high satisfaction than the males.
Conclusion: Almost half of the caregivers were less satisfied with the services offered at the WBC, while the least number of caregivers were satisfied with the vaccination services. Extensive research is needed to identify the factors contributing to the satisfaction of caregivers with the services, mainly vaccination.
Microbiological analysis of urinary calculi: A study from a tertiary care hospital of Eastern India
Authors: Ashutosh Kumar  , Kunal  , Manish Kumar  , Kumar Aamresh  , Ashif Ali Hassan  , Anjoo Anupma
Published: January 2025

Background: Among various renal pathology, urolithiasis among patients of urinary tract infections (UTIs) forms a major group. The pathophysiology of such patients varies from the group of urolithiasis patients without infection.
Aims and Objectives: The current study was planned and conducted to find out the bacteriological profile of urinary calculi among patients of UTI.
Materials and Methods: A descriptive study was conducted by the Department of Microbiology and Surgery of JLNMC, Bhagalpur, Bihar. A total of 100 patients were enrolled in the study, having urinary calculi who either visited the outpatient department or who were admitted at the hospital for planned procedure for removal of stone between January 2021 and December 2021.
Results: Male predominance was noted with a mean age of presentation at 44.3 years. 67% of the patients had some or the other symptoms of UTI, most common symptom being excruciating groin pain. Recurrent episodes of UTI were noted among female patients. Bacterial growth on culture was obtained from the urine samples of 46 patients. Escherichia coli were the most common isolated organism. Most common type of stone was a mixed type of stone formed by calcium oxalate and calcium phosphate followed by struvite stones and uric acid stones.
Conclusion: Various factors of clinical significance among patients of urolithiasis and UTI are gender, age, and clinical symptoms. Gram-negative bacilli are the most common bacteria found in UTIs in patients with urolithiasis.
Pregnancy with heart disease: Fetomaternal outcome: A retrospective analysis from a tertiary care teaching hospital in Northern India
Authors: Verma Menka , Ashwani Kumar  , Smiti Nanda  , Meenakshi Chauhan  , Pushpa Dahiya  , Savita Rani Singhal
Published: January 2025

Background: Heart diseases are the most significant non-obstetrical causes of maternal deaths, accounting for up to 15% of all cases. The present retrospective analysis is an attempt to assess the spectrum and impact of cardiac diseases on pregnancy.
Aims and Objectives: The aims of this study were to analyze the maternal and perinatal outcomes and spectrum of heart disease in pregnancy.
Materials and Methods: The study was carried out in the Department of Obstetrics and Gynecology at PGIMS, Rohtak, where retrospective record of inpatient obstetrics registry of pregnant women with cardiac diseases was analyzed. Clinical information obtained from the patient’s medical records including clinical presentation, laboratory investigations, 2-D echocardiography, maternal, and neonatal outcomes were noted. All pregnant women as well as postpartum patient with cardiac disease were included in the study.
Results: A total of 62 pregnant women with heart diseases were hospitalized during the study period. Spectrum of heart disease among these women analyzed and we found that the 22 had rheumatic heart disease (RHD), 14 had congenital heart disease (CHD), and 14 had cardiomyopathies (CMP). LSCS was done for 24 and out of these, nine were elective LSCS while 15 were emergency LSCS. Vaginal deliveries were performed in 31 women. Twenty-eight women got shifted to intensive care units during course of treatment. Three intrauterine deaths were noted in our study.
Conclusion: We have concluded from the present study and after reviewing the literature about spectrum of heart diseases in pregnancy, that the most common cardiac lesions complicating the pregnancy are RHD followed by CHD and CMP. Successful management of heart disease with pregnancy can be achieved by timely diagnosis and safe transfer of patient to the cardiomaternal tertiary care, where multidisciplinary teams are available.
Prevalence of acute otitis media in a tertiary care center of Assam
Authors: Mili MK  , Sharmistha Talukdar  , Monikuntal Sarmah  , Asha Saikia
Published: January 2025

Background: Otitis media is infection of the middle ear cleft, which comprises acute and chronic otitis media and otitis media with effusion. Acute otitis media (AOM) is the second most prevalent pediatric emergency.
Aims and Objectives: The aim of the study was to assess the epidemiology and clinical manifestations of AOM cases reported to the ENT OPD.
Materials and Methods: A retrospective study was conducted in a tertiary care center of Assam from January 2021 to December 2022. A total of 840 patients from a wide range of socioeconomic strata were included in the study who belong to Upper Assam, parts of Arunachal Pradesh and Nagaland region.
Results: Majority (25.8%) of the patients were below the age of 10 years. The age group of 31–40 years (25.2%) was next in line. In the age range of 71–80 years, the least number of patients (0.3%) were observed. The majority (53.09%) of the patients were from Dibrugarh district of Assam.
Conclusion: This study has brought to light the prevalence of AOM in this region and the need for the health department to raise public understanding of the significance of a healthy lifestyle in the prevention of AOM, early diagnosis, and treatment.
Profile of optic atrophy presented in the neuro-ophthalmology department of the tertiary eye care center
Authors: Bajracharya Kabindra , Kriti Joshi  , Anjita Hirachan  , Lily Myint  , Hari Bahadur Thapa
Published: January 2025

Background: Optic atrophy is a clinical presentation in which the optic disc appears pale due to irreversible damage of retinal ganglion cells and axons in the anterior visual pathway.
Aims and Objectives: The aim of this study was to determine the profile of optic atrophy cases in the neuro-ophthalmology department of a tertiary eye hospital and to identify the common causes and associated visual impairments.
Materials and Methods: This was a cross-sectional study conducted from January 2021 to December 2021, using convenience sampling method for data collection. Demographic data, medical history, and examinations were conducted on all included patients. Optic atrophy secondary to glaucomatous optic nerve damage was excluded. This study included both children and adults with both congenital and acquired patients with optic atrophy. Best-corrected visual acuity (BCVA) was recorded and anterior segment examinations were conducted using a torchlight to assess pupillary reaction and slit lamp to assess other anterior segment details. The posterior segment was evaluated on a dilated pupil with a handheld magnifying 90D lens and a slit lamp. Color vision and contrast sensitivity and visual field assessments were performed whenever possible.
Results: Out of 127 patients enrolled, 55.1% were male and 44.9% were female. The median age was 40, with a minimum age of 4 years to a maximum of 85 years old. Twenty-one percent were below 20 years old and they were associated with congenital causes, hydrocephalus and sequelae to bilateral papillitis. The most common age group was 40–50 years, comprising 21.3%. The total of eyes presented with optic atrophy was 214. Unilateral involvement of the eye was 31.5%, the patients with the right eye in 18.9% and the left eye in 12.6%. Both eye optic atrophies were found in 68.5%. The most common cause of optic atrophy was non-arteritic anterior ischemic optic neuropathy (NAION) in 22.8% of cases, the second common cause was papilledema in 16.5%, and then, traumatic optic neuropathy comprised 15.7% of patients. BCVA in the right eye was <6/60 in 58.3% of cases and in the left eye 56.7%.
Conclusion: Optic atrophy did not show sex predisposition. The most common age group affected was 40–50 years, and patients above 40 years comprised nearly half of the patients. Bilateral optic atrophy was common. The most common cause of optic atrophy was NAION, followed by papilledema, traumatic optic neuropathy, and optic neuritis. Optic atrophy is one of the leading causes to irreversible blindness.
The cytological pattern of cervical papanicolaou smear in a tertiary hospital of India
Authors: Ajay Gupta  , Pushpendra Singh  , Krishna Dubey  , Sushil Mewara  , Mayank Sharma  , Yogesh Gupta
Published: January 2025

Background: Cervical cancer continues to be listed among the top gynecologic cancers worldwide. According to current data, it is ranked fourteenth among all cancers and fourth-ranked cancer among women worldwide. In India alone 1,30,000 new cases occur with the death toll of 70,000 per year. A “PAP’ test should be performed during the second half of the menstrual cycle (Day 14). The patient is placed in lithotomy position and the cervix is visualized by means of a speculum. The smaller end of the Ayre’s spatula is introduced through the external os and the squamocolumnar junction is scraped by rotating the spatula to 360°.
Aims and Objectives: The objective of the study is to evaluate the use of the Pap smear screening method for detection of precancerous lesions. Cervical cancer accounts for 15% of all cancers in females. If treated or detected earlier, cervical cancer can be prevented.
Materials and Methods: This study was done on 1000 patients during reproductive and later age groups (postmenopausal), attending Obstetric and Gynaecological Outpatient Department of Panna Dhai Hospital associated with RNTMC, Udaipur during the period of November 2012–April 2014 with history of white discharge per vagina, bleeding per vagina, pain in lower abdomen and post coital bleeding.
Results: Most of the smears (90.1%) were NILM and 9.9% of smears showed cytological abnormality. Majority 834 (83.4%) of smears were inflammatory, Bacterial vaginosis was seen in 119 cases (11.9%), Candidiasis in 78 cases (7.8%), Trichomoniasis in 35 cases (3.5%), Atrophic vaginitis in 4 cases (0.4%) and Radiation changes in 4 cases (0.4%). There were 99 samples reported as having epithelial cell abnormality. Out of which 75 were LSIL, 14 were high grade squamous intraepithelial, 5 were atypical squamous cells (ASC)-US, 1 was ASC-H and 4 were squamous cell carcinoma.
Conclusion: Due to high sensitivity, specificity and accuracy found in this study Pap test is proved to be highly useful to detect precancerous and cancerous lesions of cervix. From the above facts, it can be concluded that early diagnosis and prompt specific treatment of preinvasive or early stages of the disease (mainly in high risk women), reduces the prevalence of invasive carcinoma of uterine cervix.
Pathological response of different molecular subtypes of locally advanced breast carcinoma to neoadjuvant chemotherapy
Authors: Nidhi Aley Alex  , Sankar S  , Saji Mary Varghese  , Suresh Kumar K
Published: January 2025

Background: This study was done on modified radical mastectomy (MRM) specimens of patients with locally advanced breast carcinoma (LABC) who were categorized into molecular subgroups based on Immunohistochemistry and underwent neoadjuvant chemotherapy (NACT). The purpose of the study was to look for the pathological response of the tumor to the NACT. The molecular subtypes include Luminal A, Luminal B, Human epidermal growth factor receptor 2 (HER2) enriched, and triple negative. For HER2 enriched subtype, trastuzumab was also given along with the chemotherapy regimen.
Aims and Objectives: The primary objective of this study is to find out the pathological complete response (pCR) in various molecular subgroups of breast carcinoma following NACT. The secondary objective is to describe the cellular changes in tumor tissue following NACT.
Materials and Methods: This is a descriptive study done on MRM specimens of patients with LABC received in histopathology lab of Government Medical College, Kottayam to look for the pCR of the tumor following NACT. Gross examination and histopathology study of the specimen including axillary lymph nodes were done. The trucut biopsies of these cases with immunohistochemistry study were reviewed for confirming the grade and molecular subtype. pCR was assessed based on Chevallier system.
Results: Of the 131 MRM specimens studied, overall pathologic complete response rate was 24.4% and the pathologic complete response rate in Luminal A subtype, Luminal B subtype, HER2 enriched tumors, triple negative tumors were 23.6%, 24%, 33%, and 20%, respectively.
Conclusion: 33% of HER2 enriched subtype showed a pCR, i.e., no residual foci of neoplasm seen in the MRM specimens following NACT. Following NACT, change in tumor cellularity, changes in the morphology of neoplastic cells, changes in the surrounding breast tissue, and a change in grade of tumor were also noticed.
Study of ductal lavage cytology in women at high risk for breast carcinoma
Authors: Minakashi Chouhan  , Shweta Sushmita  , Dinesh Singh Chauhan
Published: January 2025

Background: Ductal lavage (DL) involves cannulating the nipple aspirate fluid (NAF)-producing ducts with a microcatheter and lavaging with saline to retrieve cells for cytological and molecular analysis. This method improves upon NAF and fine-needle aspiration and can provide important data on cellular yield and molecular markers in DL fluid.
Aims and Objectives: This aimed to study the cytology of DL in women at risk of/clinicoradiological possibility of breast carcinoma and to correlate the cytology of DL with Gail risk score and with histopathology (wherever available).
Materials and Methods: The present study, conducted at Hindu Rao Hospital, Delhi, between 2012 and 2014, examined 36 patients with nipple discharge. Nipple aspiration and DL were performed, and the results were analyzed and compared. The present study also looked at the correlation between DL results and the patient’s Gail score and correlated histopathology with DL cytology.
Results: The present study enrolled 36 women and studied 50 ducts from 46 breasts. Nipple fluid was aspirated from 34 patients, with inadequate cellular material for diagnosis in 24 breasts, benign in 18, atypia in 2, and no malignancy found. The correlation of DL with Gail score was statistically significant, as was the correlation between epithelial cells in DL and NAF samples. The correlation between DL and histopathological findings was statistically insignificant.
Conclusion: DL samples may miss atypical cells, and have higher epithelial cell count than NAF. Higher Gail score correlates with mild atypical cells in DL (P=0.003).
Childhood Grave’s-an experience from a tertiary care center
Authors: Vikrant Ghatnatti  , Nilakshi Deka  , Neeta PN
Published: January 2025

Background: Graves’ disease (GD) attributes for important cause for childhood hyperthyroidism with a prevalence of 0.02%. Initial treatment for GD is the use of antithyroid drugs (ATDs), which is well accepted. The remission rate is around about 30% of children treated with ATD.
Aims and Objective: (1) To assess the predictors of relapse and remission after ATD in children with Grave’s disease. (2) To study the clinical profile at presentation and treatment outcome of children with Grave’s disease.
Materials and Methods: We conducted a prospective cohort study of children diagnosed for GD (n=27) and treated with either carbimazole (0.6–0.8 mg/kg), methimazole (0.2–1 mg/kg), or (propylthiouracil, 5–10 mg/kg) and continued till euthyroid state was achieved. The dose was titrated every 2 months once till the achievement of the euthyroid state. Assessment of remission and relapse was done within a year of stopping the drug.
Results: The overall estimated relapse rate for hyperthyroidism was 54.1% (13 patients), within a year of stopping ATD with a mean duration treatment of 24.23±7.44 months. Multivariate survival analysis showed that the risk of relapse (87.5%) was higher for patients of a body mass index SD score <0.5 and a large goiter. Pre-pubertal patients had higher relapse rate than pubertal patients (OR- 3.24, P=0.04). No other clinical variables such as age, gender, and Wayne Index were significantly associated with relapse, though patients in the relapse group were younger, and had a male predominance with higher Wayne index scores.
Conclusion: GD in children has a high relapse rate. Severity of the disease as measured by various clinical methods is important in predicting relapse.
Effectiveness of tadalafil and tamsulosin combination in benign prostatic hyperplasia: A prospective cohort study at a tertiary care center
Authors: Sudarsan S  , Prabhu T  , Rajsri TR  , Laishram Sanjana
Published: January 2025

Background: Benign prostatic hyperplasia (BPH) is one of the major causes of lower urinary tract symptoms (LUTS) in men. The uroselective tamsulosin helps in rapid reduction of prostate symptoms and its combination with Tadalafil, a phosphodiesterase inhibitor leads to synergistic benefit improving the LUTS of BPH.
Aims and Objectives: This study was conducted with the aim to assess the effectiveness of synergistic effect of Tadalafil and Tamsulosin in improving the symptoms of BPH patients.
Materials and Methods: A prospective cohort study was conducted among the patients admitted with LUTS due to BPH in the surgery ward of Annapoorna Medical College. A total of 100 patients were included in the study. The control group was administered 0.4 mg of tamsulosin and the study group was administered with combination of tadalafil 5 mg and tamsulosin 0.4 mg for 3 weeks and followed up at an interval of 3 weeks, 1 month, and 6 months. Paired t-test was used to compare the international prostate symptom score (IPSS) mean scores.
Results: A total of 100 patients were included in the study. There was significant improvement in the post-voided volume of the study group in comparison to the control. The IPPS score of the study group at the baseline was 16.39±4.89 which was decreased to a score of 11.42±3.39 after the combination drug therapy with P<0.001 which was statistically significant.
Conclusion: The combination therapy of tamsulosin and tadalafil marked an improvement in the symptoms of BPH which can be noted with fall down of IPSS score after the therapy.
Role of diagnostic laparoscopy in comparison with CT scan finding of patients presenting with abdominal trauma-A cross-sectional study
Authors: Shiv Shakti Yadav  , Rachna Gupta  , Lalmani Singh  , Anaswara Harindran M  , Ekta Jain
Published: January 2025

Background: Trauma is a critical and urgent surgical condition that we encounter on a regular basis. Blunt trauma mechanisms account for 78.9–95.6% of all injuries, with the abdomen being affected in 6.0–14.9% of all traumatic injuries. Diagnostic laparoscopy (DL) for blunt abdominal trauma (BAT) is safe and feasible. Prerequisites are the hemodynamic stability of the patient and surgical expertise in advanced laparoscopy.
Aims and Objectives: To find out the role of DL in the diagnosis and management of abdominal trauma patients. Effect on the length of hospital stay and rate of reduction of non-therapeutic laparotomy in the patients with trauma abdomen.
Materials and Methods: This cross-sectional study was conducted with 50 patients of abdominal trauma with pre-structured pro forma and Written informed consent. A contrast-enhanced computed tomography (CECT) scan of the abdomen was done in hemodynamically stable patient and injury was noted. Patients meeting the inclusion criteria underwent DL.
Results: The duration of hospital stay was lower in laparoscopically managed patients than in laparotomy patients. Most of the patients were managed conservatively 37 (74%) and thus by reducing non-therapeutic laparotomy. Overall recovery was 86% which signifies the reduction in mortality rate with the use of DL. In this study, clear diagnosis was obtained in 88% of the cases, so the efficacy is 88%.
Conclusion: Laparoscopy and CECT abdomen has an effective diagnostic and management role in patients with BAT. The therapeutic value of DL is also accepted, well appreciated, and it cannot be underestimated.
Role of ultrasound elastography in the evaluation of rotator cuff tendon in patients with shoulder pain and its comparison with magnetic resonance imaging
Authors: Vaibhav Goyal  , Ankur Malhotra  , Shruti Chandak  , Deepti Arora  , Arpit Deriya  , Shweta Kataria  , Sunil Kumar
Published: January 2025

Background: Pain in the shoulder is the third-most prevalent musculoskeletal pain type. Most frequently involved in tendinopathy/tendon tears is the supraspinatus tendon, followed by a combination of the supraspinatus and infraspinatus tendon. At present, gray-scale ultrasound and MRI are used to determine the tear size, gross morphology, and postsurgical tendon repair. However, they are unable to determine the material characteristics of the muscle or tendon.
Aims and Objectives: The aim of this study is to assess the role of ultrasound elastography in the evaluation of the rotator cuff tendon and to compare gray scale ultrasound and shear wave elastography (SWE) findings of the supraspinatus tendon with MRI in patients with shoulder pain.
Materials and Methods: This prospective observational study included 50 patients. They were examined using a 1.5-T MRI machine and the ACUSON S3000 (Siemens Medical Solution) machine. The radiologist performing the ultrasound was blinded by the results of the MRI.
Results: Age varied from 19 to 75 years. The majority (34%) were in the range of 31–40 years. Males were predominately affected. In MRI, the most common type of injury was mild tendinosis (34%), followed by moderate/severe tendinosis (26%). About 30% were diagnosed with moderate/severe tendinosis, 24% with mild tendinosis, 22% with partial tears, and 18% with full-thickness tears in gray-scale ultrasound. When SWE was combined, 32% were diagnosed with moderate/severe tendinosis, 28% with mild tendinosis, 20% with a partial tear, and 14% with a full-thickness tear.
Conclusion: SWE showed better diagnostic performance than gray-scale ultrasound in the detection of supraspinatus tendinopathy.
Etiology of adult onset seizures: Role of magnetic resonance imaging
Authors: Geetanjali Andani  , Nagendra R Patil  , Santosh Reddy
Published: January 2025

Background: Neuroimaging is an important diagnostic tool which aids in detecting structural, vascular, neoplastic, and demyelinating causes of symptomatic seizures and may predict risk of seizure recurrence. Magnetic resonance imaging (MRI) is a sensitive neuroimaging modality which can detect subtle lesions, their exact location, and extent, which cannot be revealed by computed tomography (CT) scan. Because of its excellent soft-tissue contrast and detailed depiction of anatomy, MRI has emerged as the most valuable tool for the localization of underlying pathology. As a result, the goal of this study is to investigate the etiological factors for adult-onset seizures using MRI.
Aims and Objectives: The goal of this study is to investigate the etiological factors for adult-onset seizures using MRI.
Materials and Methods: The present study was an observational prospective study of 50 patients presented to the Department of Radiodiagnosis at Basaweshwar Hospital and met the inclusion criteria of the study. The inclusion criteria were to include all those cases who presented with seizures and all of them were subjected to brain MRI. The imaging findings were analyzed, described, and represented in the form of tables and charts.
Results: The mean age of all patients was 44.05 years, with males being 43.63 years old and females being 44.48 years old. The generalized tonic–clonic seizures were the most common type of seizure in 59 (84.3%). The most common MRI findings were ring enhancing lesion (14%), infract with gliosis (13.6%), and neoplasm (10.3%).
Conclusion: MRI was able to detect an underlying lesion causing symptomatic seizures with added advantage of no radiation exposure, and superior neuroimaging modality and should be the investigation of choice in all patients who had a history of convulsions after ruling out systemic and metabolic causes of convulsion.
Thiamine-responsive acute pulmonary hypertension – A case series and review from a pediatric ICU
Authors: Prudhvi Raju Pericherla V  , Raghava Badabagni  , Sripal Reddy Cheguru  , Madhu Kiran Reddy Devireddy  , Mabbul Shaik  , Prasanth Kumar Battula  , Sohail Zeeshan Shaik
Published: January 2025

Pulmonary hypertension is seen in approximately 10% of infants with respiratory distress admitting to pediatric ICUs. Causes can be idiopathic or secondary to lung parenchymal or vascular diseases. Among various causes of pulmonary arterial hypertension, thiamine deficiency (TD) is one of the reversible causes. TD is still prevalent in selected parts of India. This review outlines five typical patients admitted to KIMS, Amalapuram, with thiamine-responsive acute pulmonary hypertension who responded dramatically to thiamine supplementation. It can cause life-threatening pulmonary hypertension in exclusively breastfeeding infants of mothers who are on a restricted diet predominantly consisting of polished and washed rice which can contribute to infant mortality. Thiamine administration based on clinical suspicion and echo findings leads to remarkable recovery. To tackle this fatal disease, a very high degree of awareness and thiamine supplementation in relevant geographical areas is required.