bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation and validation of Fournier gangrene severity index and additional mortality related risk factors in patients with Fournier\'s gangrene in tertiary care setup in Haryana
Authors: Goel Kanwar Singh , Singhal Bhumika , Kumar Anil , Goel Sapna , Arora Tanay , Narayan Auditi
Published: December 2024

This study is performed to validate Fournier's gangrene severity index and evaluate the risk factors for predicting mortality in patients with Fournier's Gangrene and to evaluate the validity of FGSI scoring system in predicting mortality in FG patients as well as to evaluate additional risk factors/ parameters for predicting mortality in patient with FG.

This is a prospective observational study conducted in tertiary care hospital in Gurugram, Haryana under FMHS SGT HOSPITAL over the period of 18 months from January 2021 to Aug 2022. A total of 90 IPD patients with diagnosis of FG fulfilling the inclusion criteria were included in the study and divided in 2 groups of survivor and no survivor, to evaluate the validity of FGSI scoring system in predicting mortality in FG patients and additional risk factors/ parameters for predicting mortality in patient with FG.

Out of all, 66 patients survived (73.33%), while 24 died (26.66%).The mean FGSI score was 4.67-3.44SD in patients who survived, and it was 9.82±5.20SD in patients who died. The difference in the mean FGSI score was found to be statistically significant by test (p=0.001) with higher scores among non-survivors. FGSI score of 9 or more 9 is associated with increased mortality which is highly statistically significant (p-value <0.001). Pain in the genital region was the commonest, which was seen in 69 (76.66%) patients. It was followed by swelling and discoloration in the genitalia, seen in 42(46.66%) and 32 (35.55%) patients respectively. The most common etiology of Fournier’s gangrene was idiopathic in origin seen in 33.33% cases.

Fournier’s gangrene has high mortality rate in elderly patients with comorbidities. Pain and swelling of genitalia are the two commonest presenting symptoms. Blackish discoloration, and ulceration with discharge are seen in patients presenting late. Disease is idiopathic in majority of patients. Common identifiable causes are ischiorectal/gluteal abscess, urogenital trauma, urinary tract infections and anorectal surgeries. Most common portal of entry of infection is penoscrotal. Anorectal and urogenital route and cutaneous route are other routes in decreasing order of frequency. FGSI is a valid tool for prognosis with increased risk of mortality at score more than 9 with a diagnostic accuracy of 83.3%.
Clinical profile of hepatitis b reactivation in HBSAG-Negative and anti-HBC- Positive patients receiving anticancer chemotherapy
Authors: E Kandasamy Aliaskumar , G Geetha , A Shafique , R Poppy Rejoice , Gobinath Roshni , U Ramukrishnan , R Kishore Kumar
Published: December 2024

The prevalence of hepatitis B virus (HBV) reactivation in HBsAg-negative and anti-HBc-positive individuals following chemotherapy for various cancers remains unknown. This research focused on investigating the prevalence and clinical features of HBV reactivation in HBsAg negative and anti –HBc-positive patients.

This is prospective research involving cancer patients on chemotherapy who develop hepatitis B surface antigen positivity in a previously hepatitis B surface antigen-negative and hepatitis core antibody-positive patient. The analysis included 40 patients and followed up for 8 months.

Among 40 patients, mostly 97.5% had a solid tumor and 3(2.5%)patients had haematological malignancy. The majority (42.5%) received anthracycline-based therapy and others received cisplatinum plus 5 fluorouracil therapy, platinum-based therapy and steroid therapy.

In our study, almost all patients with HBsAg negative and HBcAb positive patients undergoing chemotherapy for solid tumor shows HBV reactivation. So antivirals may be considered in HBsAg negative and HBcAb positive patients undergoing chemotherapy for solid tumor regardless of HBV DNA level and HBsAg seroconversion.
Histopathological audit of hysterectomies for analysis of indication and respective pathology at tertiary care teaching hospital
Authors: Deshmukh Suchita , Thomake Amruta K , Patil Pragnya , Harsiyani Bhavini , Shinde Ravindra
Published: December 2024

Even though many medical and conservative surgical treatment options are existing, hysterectomy still is the most commonly performed major gynecological procedure worldwide. Histological examination is mandatory for the uterine specimen after hysterectomy. The present study aims to audit indications and to rationalize the surgery by relating preoperative diagnosis with histopathology reports in tertiary care hospitals.

Present study was retrospective study conducted on hysterectomy (uterus and cervix) specimens received in Pathology department. The gross and histological findings of respective cases were retrieved from the histopathological section and wherever necessary re-sectioning, processing and staining done for analysis. The preoperative indications were correlated with histopathological findings of the resected specimen.

Among 150 cases of Hysterectomies studied most common age group was 5th decade seen in 50.67%. Most prevalent presenting symptoms was abnormal menstrual bleeding in 31.33% cases. In 45.34% cases indication of hysterectomy was fibroid which correlated histologically in most cases. On histopathological examination in 44% cases finding in endometrium was proliferative phase of endometrium. Atypical endometrial hyperplasia found in 4 cases, while single case of endometrial adenocarcinoma was reported. In 63.99% finding in cervix was chronic cervicitis. Cervical dysplasia seen only in 4 cases justifying earlier age of hysterectomies performed. Of total 150 cases, 128 were concordant with the histopathological diagnosis and 22 cases were non-concordant. P value was calculated and it shows high significance (P <0.0001) with association of clinical diagnosis with histopathological findings.

There was wide spectrum of histopathological findings in hysterectomy specimens which needs to be evaluated histopathological examination. Hysterectomy can be an option of treatment when other treatment options are not available and regular audit of hysterectomies should be conducted.
Clinical profile and treatment outcome of patients with cerebral venous sinus thrombosis
Authors: Bashir Anisha Ameena , Meherali Hanadi , Chandrakar Santwana
Published: December 2024

Cerebral venous sinus thrombosis is an uncommon cause of stroke often affecting young individuals and it can pose a diagnostic dilemma due to its diverse clinical presentation. An analysis of patients admitted with cerebral venous sinus thrombosis (CVST) at D.Y. Patil Hospital, Navi Mumbai, was conducted to assess etiology, clinical features, diagnosis, and prognosis. The study concluded that early recognition and timely intervention is essential for good outcome. The use of imaging techniques, such as magnetic resonance imaging, is required for diagnosis and monitoring.

A study conducted on thirty patients withclinical features and MRIsuggestive of CVST.

The average age of presentation was 31.53 years, with 60% of cases being females. The predominant symptoms were headache (36.7%) and seizures (33.3%). The superior sagittal sinus, transverse sinus, and sigmoid sinus were most affected.  Low molecular weight heparin was administered to 83.3% of patients, whereas 16.7% received unfractionated heparin. 73.3% of patients had fully recovery and 26.7% had partially recovered after treatment.

A variety of symptoms and signs can be observed with cerebral venous sinus thrombosis. The most common symptom was headache, with thrombosis mainly affecting the transverse sinuses, superior sagittal sinuses, and sigmoid sinuses. An aggressive anticoagulation regimen yields excellent clinical outcomes.
Comorbidities associated with type 2 diabetes mellitus and the drug prescribing trends
Authors: Quazi Shadma , Siddiqui Riyaz A , Tanaji R Shende  , Dashputra Amruta V
Published: December 2024

A widespread health issue in the world, diabetes mellitus is accompanied by a number of co-morbidities. Many antidiabetic drugs are available with different mechanisms of action and safety profiles. This study's goal was to assess the co-morbidities that type 2 diabetes patients experience & to evaluate current prescribing trends of antidiabetic drugs.

It was a cross-sectional study that was conducted in a tertiary care medical facility's outpatient department of medicine. It was six months conducted from July 2022 to December 2022. The approval of study, was taken from institutional ethics committee. The details of patients attending the outpatient department of medicine having diabetes mellitus with associated comorbidities are recorded in a case record form.

Out of the 80 patients that were evaluated,48 (60%) were males and 32 (40%) were females. The commonly associated comorbidities found are hypertension in 82.5%, suffered from hyperlipidemia in 58.7%, and cardiovascular conditions in 46.2% later followed by others. Metformin in 81% followed by glimepiride + Metformin at 43%, Vildagliptin 26%, and Dapaglifozin 16%, followed by others were the commonly prescribed antidiabetic agents.

Hypertension, hyperlipidaemia & cardiovascular conditions were the commonly associated comorbidities with type 2 DM. Metformin followed by glimepiride+ metformin, Vildagliptin & Dapaglifozin were commonly prescribed. sodium-glucose co-transporter-2 (SGLT2) inhibitors and DPP)-4 inhibitors are potential new therapies with good safety profiles.
Headache: A primary indicator for depression in out patient department at a teritiary care hospital
Authors: Divan Ritika , Chaurasia Santosh Kumar , Kumar Sonu
Published: December 2024

Headache is a very frequently reported complaint in psychiatric out patient department which is the most neglected symptom in now a days hectic life scenario until and unless it will not hampers the daily routine activities of a human being. Both Headache and low mood are very common but still the frequency of patients attending an outpatient department is far lesser for depression compared to headache whereas Headache is quite a very common presenting complaint reported by the patients.

100 patients presenting with chief complaints of headache were taken from Psychiatric outpatient department of Maharishi Devraha Baba Autonomous State Medical College from august 2022 to november2022. All patients were assessed for routine pathological blood investigation, psychological testing mental status examination and clinical examination.

On testing questionnaire on all 100 patients who were taken in this study all of them shows symptoms that fulfils the criteria for Depression 5% of the patients exhibits mild Depression,12%of the patients shows borderline Depression,70% of the patients shows moderate Depression whereas 8% of the patients shows severe Depression.

This study emphasizes the importance of accurate diagnosis of depression, emphasizing the need for proper analysis of patient complaints, particularly headaches, to prevent misdiagnosis.
Predictors of treatment success in corneal surface disorder: A comparative analysis of amniotic membrane grafting and medical management
Authors: Shukla Aparna , Yadav Pawan Kumar , Arya Ajay Kumar
Published: December 2024

The aim of the study was to determine the predictors of treatment success in corneal surface disorders.

The study included a total of 40 patients who were divided into two groups: Group A underwent Amniotic Membrane Grafting, while Group B received Conventional Medical Management. The patients were followed for a duration of 8 weeks after treatment. At the end of the 8-week period, visual acuity was measured using the Snellen chart, and any remaining symptoms were assessed.

The study included 40 cases of corneal ulcer, with 23 (57.5%) being male and 17 (42.5%) female. Ocular surface disorders observed in the cases included persistent epithelial defect (55%), impending perforated corneal ulcer (25%), symblepharon due to chemical injury (10%) and perforated corneal ulcer (10%). Relief from symptoms such as pain levels (n=1), photophobia (n=1), foreign body (FB) sensation (n=0), eye watering (n=1), redness (n=1), and discharge (n=0) was observed earlier (4th week) in Group B compared to Group A (8th week). The majority of patients in Group B experienced relief from these symptoms by the end of the follow-up period. The success rate of the AMG-treated group was higher (85%) compared to the conventional medical management group (60%). Baseline uncorrected visual acuity (UCVA) improved from 2.67 logMAR to 1.03 logMAR within 1 to 4 weeks after surgery and to 0.76 logMAR at the last follow-up in Group B, while it improved from +2.67 to +0.85 at the last follow-up in Group A.

Amniotic membrane grafting is an effective treatment choice for promoting healing in corneal wounds that do not respond to conventional treatment.
Association of ABO and Rh blood group with susceptibility, severity and mortality of coronavirus disease (COVID-19) - A tertiary hospital based study in Gondia Maharashtra, India
Authors: Saha Jayanta , Jadhao Pravin S , Beeson Thomas
Published: December 2024

: Couple of years past since the first inception of SARS-CoV-2 coronavirus-2; (COVID-19) from Wuhan china, spreading its tentacles across the world resulting in a pandemic situation of modern times, leading to numerous mortal death a cross the world. Since classical blood group ABO and Rhesus blood group are linked with various viral diseases the objective of the study was to find out if any association of susceptibility, severity and mortality of COVID – 19 with classical blood group ABO and Rhesus blood.

: The main objective of this study is to find if any association of susceptibility (vulnerability) of COVID-19 infection and ABO & Rhesus blood type among Indian population.

: A hospital based study conducted retrospectively among SARS-CoV-2 (COVID-19) infected hospitalized patient above the age of 18 years of both sexes. A total of 583 (Five hundred eighty-three) COVID-19 positive adult hospitalized patients were taken for this study and equal number of non COVID-19 adult patients was taken as a comparison group. Statistical significant was tested using Chi-square test.

: No significant statistical association was obtained between classical blood group ABO and Rhesus blood type and susceptibility to COVID-19 infection.

Our study result also shows no significant association of classical blood group ABO and Rhesus blood type with severity or mortality of COVID-19 infection.

: our study result shows COVID-19 positive cases are more found in AB type and least in O type blood, though the study result reported no statistically significant association.
Evaluation of haematological and coagulation profile in covid-19 patients: A prospective study
Authors: Sthul Ankit , Gaikwad Amrapali , Bode Anjali , Kowe Balwant
Published: December 2024

Covid-19 stems from the new coronavirus, Severe acute respiratory syndrome coronavirus 2. Careful evaluation of laboratory indices at baseline and during the disease course can assist in identifying disease progression and prompt treatment. Present study is aimed to analyse these laboratory parameters of patients with Covid-19 infection. Our study seeks to examine the hematological and coagulation profile parameters in patients with confirmed positive results in RT-PCR testing for COVID-19 in ICU and non ICU wards. The study involves assessing hematological and coagulation profile parameters both upon admission and after a 4-day hospitalization period, with a subsequent analysis of their correlation with radiological findings.

The approach employed in this investigation is that of a prospective observational study conducted over a period of 24 months on 300 patients. All RT-PCR positive Covid-19 patients above 18 years of age were included. 300 patients were divided into 2 groups A and B. Group A included patients diagnosed as RT-PCR positive Covid-19 and admitted in non-ICU ward. Group B included RT-PCR positive patients admitted in ICU. Haematological parameters like Complete blood count (CBC) and coagulation profile parameters like Prothrombin time (PT), Partial thromboplastin time (Aptt), Fibrinogen and D-dimer were studied on the day of admission and on 4th day of hospital stay. These laboratory parameters were correlated with radiological findings and patients outcome.

This study aims to give importance to the laboratory parameters at baseline and during the disease course so that patient’s clinical complications can be predicted early and appropriate management can be done.
Significance of impedance based platelet parameters in prediction of acute coronary syndromes
Authors: Koppalkar Rachana , Athira K P , Amber Safeena
Published: December 2024

The primary cause of coronary artery disease is atherosclerosis and its complications. Formation of coronary thrombus and initiation of atherosclerotic lesions are significantly influenced by platelets and their activity. Compared to smaller platelets, giant platelets have a larger potential thrombotic ability and are more metabolically and enzymatically active.

The objective of the current research is to determine the significance and role of platelet indices by comparing the values in patients with Acute Coronary Syndrome (ACS) to those in healthy controls.

This prospective case-control study was carried out in a tertiary care centre with 100 cases and 100 controls for 6 months. Blood samples were taken when the patient was admitted. Platelet indices were measured within 30 minutes of blood collection using an automated haematology analyzer.

Platelet indices such as Mean platelet volume, Platelet distribution width and Platelet large cell ratio were substantially greater in patients with ACS than in healthy controls. Platelet count and Plateletcrit showed lower level in ACS patients with respect to controls.

Platelet indices measurement would be beneficial in estimating those patients at greater risk for developing ACS in the future.
Evaluation of the role of helical CT in blunt abdominal trauma
Authors: Shaikh Fatima Ibrahim , Shah Dhara Dishant
Published: December 2024

The majority of injuries are the result of blunt trauma. For these individuals, CT has emerged as the main diagnostic tool. The development of computer technology and slip ring gantry design has made it possible to scan much faster thanks to the availability of helical or spiral CT scanners. These advancements have also made rapid picture reconstruction possible with faster microprocessors.

the aim of the study was to assess the role of helical CT in evaluation of patients with blunt abdominal trauma.

Total 39 patients after taking written informed consent were studied with Helical CT Scanner using GE, Hi-Speed CT/i Scanner. (General Electric) at tertiary care district hospital of Jammu.

A total of 39 patients with mean age of 34 years were studied. The CT examination was conducted at an average of 2.6 days after sustaining blunt trauma. The accuracy of CT was confirmed by surgical, clinical and radiological follow up for an average period of 7.9 months. The major cause of injury in our study was road traffic accident. The most frequently involved viscera in our study were kidneys which comprised 33.33%. This was followed by bowel/mesentery 15.15%, liver 8.24%, spleen 8.24% pancreas, 8.24%, urinary bladder 8.24% and diaphragm 3.03%.

Helical CT has become a major advancement to assess the trauma patients, because of fast scans and also image reconstruction time have reduced patient turn-around time for abdominal trauma. CT having the advantage over other imaging methods like excretory urography, sonography, and radionuclide imaging because superior contrast resolution and ability to visualize all organs as well as simultaneously the peritoneal cavity and retroperitoneum can be visualized.
Precision in practice: Comparative evaluation of cytomorphological findings, acid-fast bacilli staining and cartridge-based nucleic acid amplification test for diagnosing suspected cervical tubercular lymphadenopathy
Authors: Nair Bhavya S , C N Anushree , Choudhary Shaista , Sanghamitra Maharana Seema , M Krisha , Raju Akshay
Published: December 2024

India has the highest burden of tuberculosis with an incidence of 2,590,000 in 2021. Extrapulmonary TB constitutes 15-20% of all TB cases with the lymph node being the most common site. Due to its paucibacillary nature, EPTB is a diagnostic and therapeutic challenge.

Comparing FNAC with AFB staining and CB-NAAT for diagnosing cervical tubercular lymphadenopathy.

A study was conducted at Dr. B.R. Ambedkar Medical College and Hospital, Bangalore from Oct 2021 to Jan 2023. 102 suspected cases of cervical tubercular lymphadenopathy were included. Smears were made with FNAC aspirates, stained with H&E, PAP, and AFB, and the remaining aspirate was sent for the CB-NAAT test.

In 102 cases, the most affected age group is 21-30 years with more females. Most cases were seen in level V. The 46 cases showed granulomatous lymphadenitis with necrosis. The highest number of CBNAAT and AFB positivity is seen in necrotizing lymphadenitis. CBNAAT showed the most positivity in caseous (87.5%) and the least in blood mixed (35.38%). Overall, CBNAAT showed positivity in 54 cases and AFB showed positivity in 19 cases. CBNAAT demonstrated greater sensitivity (81.97%) than AFB (31.15%) while maintaining high specificity (90.2%) and positive predictive value (92.6%).

CBNAAT is a newer and more sensitive diagnostic test for extrapulmonary tuberculosis as compared to FNAC. It is recommended to use CBNAAT in addition to smear microscopy and cytology in FNAC specimens for early and accurate diagnosis and prompt treatment of EPTB.
A retrospective study of relationship of total antioxidant defense and total oxidative stress and level of serum ferritin in type-2 diabetes
Authors: Sen Santanu , Saha Pinaki , Mukherjee Bikramaditya , Pal Prasenjit , Biswas Utpal Kumar
Published: December 2024

Oxidative stress has been implicated in chronic diseases like Diabetes Mellitus and the antioxidant defense status gets reduced. Ferritin is an acute positive phase reactant, the level of which gets elevated in chronic diseases like Diabetes Mellitus.

Whether there is any relation among the markers of oxidative status and the serum ferritin levels in type-2 Diabetes patients is the main objective of the study.

Simple colorimetric assay methods were applied to measure Total Antioxidant Defense (TAD) & Total Oxidative Stress (TOS) in serum samples. Ferritin level is estimated by ELISA method with standardized kits.

Level of TOS was significantly elevated in cases compared to controls, whereas the level of TAD was observed significantly higher in control group than the cases. Serum ferritin level was found significantly increased in the cases in comparison to the control group. There is a negative correlation among TOS level and TAD levels among cases and controls. There is a strong positive correlation among the levels of TOS and serum ferritin and a negative correlation between TAD and ferritin levels.

Instead of TOS and TAD levels, serum ferritin levels can be used to assess the oxidative status of a type-2 Diabetes patient.
Maternal critical illness with special reference to sepsis – A comparison
Authors: Srivastava Shubhi , Misra Malvika
Published: December 2024

Critical illness in a pregnant lady may occur due to pre-existing medical diseases, from diseases that are concomitant to pregnancy, or conditions that are peculiar to pregnancy. Sepsis is a leading cause of critical illness with high maternal morbidity and mortality in India and worldwide as well. This study was performed to analyze critical diseases in pregnant, postpartum and postabortal women with particular focus on maternal sepsis in a tertiary care hospital in North India.

A prospective cross-sectional study was done to analyse all critically ill pregnant women and women within 42 days of delivery or abortion for a study period of one year. Based on the causes of critical illness, Group S (those having sepsis/septic shock) and Group O (those who had critical illnesses excluding sepsis) were defined. Demographic, clinical, microbiological and feto-maternal outcome were recorded and analysed after comparing the parameters between Group S and Group O.

Out of 181 critically ill patients, 55 were due to sepsis and 126 were due to other causes. The prevalence of maternal sepsis was 8.4/1000 live births. Out of 181 cases, 75% of the cases were unbooked, 66.3% patients presented antenatally while 27.6% presented in postpartum period and 6.1% were postabortal. The number of maternal deaths attributable to maternal critical illness were 26 which included 61.5% due to sepsis and 38.5% due to other causes of critical illness. In terms of foetal outcome, preterm births were less common in Group S (40%) as compared to Group O (44.4%). NICU admission were also lesser in Group S (32.7%) as compared to Group O (40%).Group S had less number of perinatal deaths (7/55, 12.7%) as compared to Group O (19/126, 15.1%).

Critical diseases can make any pregnancy difficult to manage. Monitoring of early warning scores can tell in advance about the clinical deterioration. Maternal sepsis remains a dangerous cause of both maternal and fetal morbidity and mortality. Successful maternal and neonatal outcomes are largely dependent on early recognition and prompt management of maternal sepsis by a multidisciplinary team.
Prevalence of thrombocytopenia among Indian patients across different cities in India
Authors: Malik Parmila , Khajuria Atul , Khattri Jyotsana , Singh Lalit , VG Veeresh
Published: December 2024

Thrombocytopenia, which signifies a low platelet count usually below 150 × 109/L, there are various causes for thrombocytopenia, it can be caused due to drug induced, heparin induced, neonatal factors, gestational, chemothepeutic and viral, the incidence of theses causes are essential to study the varied nature of occurrence of thrombocytopenia in the population, by understanding the cause the prevention, cure and management of complications can be well addressed and managed, the present study designed to find the prevalence of thrombocytopenia in Indian patients by selecting various cities in India.

: A descriptive cross section survey design used to identify the prevalence rate of thrombocytopenia among Indian patients with various cause and occurrence in India the cities selected for study are Lakhimpur, Panipat, Sonipat, Gohana, Delhi, a total 22832 blood samples were collected from various cities to assess the prevalence of thrombocytopenia, for various causes of thrombocytopenia 1295 blood samples showed the prevalence of thrombocytopenia, of which 261 were caused due to drug used for treatment, 109 due to heparin, 112 were neonatal complication, 137 were gestational, 281 due to chemo drugs, 395 due to viral infection. The prevalence of thrombocytopenia was computed using statistical analysis SPSS version 18.0

: The present study found the prevalence rate of drug induced thrombocytopenia was 4.7%, heparin induced thrombocytopenia was 3.8%, neonatal thrombocytopenia was 3.4%, gestational thrombocytopenia was 3.4%, chemo-drug induced thrombocytopenia was 1.6% and viral infection induced thrombocytopenia was 7.07% respectively.

Thrombocytopenia is the present study identified the prevalence of the thrombocytopenia among Indian patients is 5.6%.
Role of glypican-3 and heppar-1 in categorization of hepatic space occupying lesions in imaging guided fine needle aspiration cytology
Authors: Bar Prasenjit Kumar , Dash Saurabh , Hazra Rahin , Ghosh Somnath
Published: December 2024

: Hepatocellular carcinoma (HCC) constitutes of 80% of all primary liver malignancy. Second most common site of metastases is liver. The current study is aimed to diagnose and categorize different primary and metastatic lesions of liver through expression of HepPar-1 and Glypican-3 in FNAC and cell block preparations of materials obtained by ultrasound guided technique.

: In this prospective study 50 patients of Nil Ratan Sircar Medical College, Kolkata, are included to see the expressions of immunomarkers in neoplastic hepatic lesions.

We got mostly (58%) middle-aged male patients. Eighty percent of patients presented with weight loss. Radiologically, 86% of primary hepatic lesions were solitary. Cirrhotic patients were eight (08). Most of the cases were metastatic carcinomas (72%) and HCC was 22%. Commonest was Grade I. Glypican-3 and HepPar-1 had a sensitivity, specificity and accuracy of 41.6%, 100%, 86.0% and 75%, 97.4%, 92% respectively. The combined sensitivity, specificity and accuracy of both markers were 83.3%, 97.4% and 94.0% respectively.

Combined use of Glypican-3 and HepPar-1 markers are very useful to differentiate between HCC and metastatic hepatic lesions by using ultrasound guided FNAC.
Exploring the impact of ‘structured mentorship programme’ on psychological adjustments of students in the early phase of medical training
Authors: Mishra Priyadarshini , Baruah Momi
Published: December 2024

Poor psychological adjustment can have negative influence on health provider as well as patient care. Mentoring bears positive impact on mental health of medical students particularly in early stage of training. The study was conducted among first year MBBS students to assess the effect of structured mentorship programme on their psychosocial wellbeing.

This was an interventional study, carried out at tertiary health care teaching institute in Mumbai City of Maharashtra, India. Psychological adjustment was evaluated using DASS (Depression, Anxiety, Stress Scale), General Self Efficacy Scale (GSES) and Scale of Psychological Wellbeing. Pre and post intervention scores were calculated. Data analysis was done by SPSS 20.0 and comparisons were performed by ‘Wilcoxon Signed Ranks Test’ and ‘Spearman's rank correlation coefficient Test’.

A total of 62 (41.33%) students and 15 (100%) mentors participated in the study. There was statistically significant difference (p<0.001) in pre (29.77) and post intervention (31.40) scores of students, indicating positive effect of mentoring programme on their mental health issues. The study could not reveal any significant relationship between individual components (stress, anxiety and depression) of subjects and mentoring programme.

The study reported improvement in psychosocial domains of medical students as a result of mentorship programme. Both students and mentors favored the programme and perceived several benefits.
A prospective study on etiology and outcomes of non-traumatic perforation of gastrointestinal tract
Authors: Lakshmikanth Premalatha , Afzal Mohamed
Published: December 2024

Perforation of the gastrointestinal tract is the commonest surgical emergencies encountered in the emergency department. Peptic ulcer, neoplasms, infections are the common causes for perforation. The management of such perforations was determined by the location of perforation, its dimension and associated comorbidities. The aim of the study is to analyse the incidence, demographic details, etiological factors, location, surgical outcome and postoperative complications of non-traumatic gastrointestinal tract perforation in our tertiary care centre.

This study was conducted on 79 patients admitted in general surgery department at Mahatma Gandhi Memorial Govt Hospital, Trichy during the period of one year from September 2021 to September 2022 who presented with acute abdominal pain with radiological evidence of pneumoperitoneum. Clinical history was taken and comorbid illness was recorded. Radiological investigations like X-ray and CECT for needed cases was done. Emergency surgeries were performed and postoperative clinical outcomes were studied.

Peptic ulcer perforation was commonest in our study seen in 43 patients (54.43%). Gastric antrum was found to be the commonest site of perforation in 26 patients (37.14%). Malignant perforation seen in patients above 4th decade. Surgical site infection was the commonest post operative complication seen in 15 patients (57.69%). Mortality occurred in 6 cases (7.59%) who presented late with hemodynamic instability

Non traumatic gastrointestinal perforation was common among males and in age group between 41 to 60 years. Peptic ulcer disease causing antral perforation was common followed by appendicular perforation , colonic perforation due to malignancy was least encountered. Early diagnosis, adequate resuscitative measures and urgent surgical intervention limits the morbidity and mortality to a greater extent.
An analysis of the discrepancies in distance between zygion and mention across the residents of the Gurkha and Kumauni ethnic groups of Uttarakhand region of India
Authors: Sharma Nidhi , Sunita
Published: December 2024

Studying human subjects is the focus of anthropology. As a result of a differential growth process, facial morphology varies between individuals and helps us to identify them. In this study, the variation between Zygion to mention distance in Gurkha and Kumauni ethnic groups of the Dehradun, Uttarakhand, area of India, was examined with the help of anthropometric tools.

In present study, there are two hundred subjects including hundred males and hundred females from ethnic groups of Gurkha and Kumauni ethnic groups, born and gowned from their actual remote areas of Uttarakhand, age group selected from 20 years and to 35 years living subjects. The study sample comprised of random selection from their remote areas. The distance between two bony landmarks is known as the Zygion to mention distance.

The correlation is much similar to the threshold value. Its mean that the parameter; Zygion to Mention distance, it is the appropriate anthropometric parameter for the identification of ethnic groups of Gurkha and Kumauni of Uttarakhand region of India.

In case of both Gurkha genders the statistical data indicates that the result is showing significance. In Kumauni male and female genders, the statistical data indicates that the result is statistically highly significant. Thus statistic indicates that the correlation is much again similar to the threshold value in case of both ethnic groups.
Hormonal profile analysis in patients of obstructive sleep apnea
Authors: Firdaus Huma , Sadaf Shadan , Faiz Abu , Reza Maqsumi
Published: December 2024

people with obstructivesleep apnea / hypoapnea have disturbed sleep cycle due to partial or total airway collapse in sleep which leads to metabolic changes and abnormalities in secretion of various hormones.

: This study included 125 subjects, out of whom 65 were test subjects with AHI >5 and 60 were control subjects with AHI <5 who underwent sleep study and hormonal analysis. SPSS version 25.0 was used for analyzing the data. p< 0.05 and <0.01 were considered as statistically significant and statistically very significant respectively.

: In this study out of 65 cases, 9 patients had mild OSA (13.8%), 22 patients had moderate OSA (33.8%), and 34 patients had severe OSA respectively (52.4%). Highest AHI of 40.86 ± 13.11/h was observed in obesity class IV patients. Testosterone level was on the lower side of normal with a further decreasing trend with increasing obesity severity. Mean value of estradiol and progesterone in both pre and post menopausal women was on lower side of normal which further decreased with increasing grades of obesity and the correlation was statistically significant. Similarly mean level of FSH and LH in males, pre and post menopausal females was lowest in patients of severe OSA.

: This study conclude that increasing OSA severity is associated with lower levels of Testosterone, Estrogen, leutinizing hormone and follicle stimulating hormone, progesterone.The recognition and understanding of the complex interactions between hormones and obstructive sleep apnea syndrome may allow a multidisciplinary approach for Effective assessment and management of OSAS and correction of endocrine disturbances in obese patients .Further interventional studies are required to determine wether treating these endocrine abnormalities have any effect on the severity of OSA.
Concordance & discordance analysis between LDLc and apolipoprotein B/Non HDLc among statin treated patients
Authors: Saha Avijit
Published: December 2024

Atherogenic lipoproteins are the major determinant of atherosclerotic cardiovascular diseases (ASCVD). Lipid derived ASCVD risk is traditionally been calculated by LDLc level. There are growing evidences that only LDLc value may not be comprehensive while assessing CV risk. There is considerable discordance among different Lipid parameters particularly in statin treated patients.

We aimed to look at relationship between apolipoprotein B/ non HDlc and LDLc in statin treated patients.

We enrolled patients who were at high risk for ASCVDs & were on stable statin therapy. After detail explanation of study procedure, informed consent was taken from each eligible patient. Then 12 hours fasting blood samples were taken for estimation of lipid profile, apolipoprotein-B. Appropriate statistical tests were done to see concordance & discordance pattern among different lipid parameters.

Among 65 enrolled patients, mean age was 53±9.60 years. Among ASCVD major risk factors hypertension was present in 63% patients, diabetes was present in 49.2 % patients. Although 75.4 % patients were at LDLc goal but 52.3 % patients were not achieved their ethnicity specific apolipoprotein-B goal with statin therapy. The correlation between apolipoprotein B and LDL cholesterol was found to be moderate and positive (r=0.460, p<0.001).On further analysis 30.8% patients had discordantly high apolipoprotien-B in comparison to their low LDLc.

We need to identify those subset of statin treated patients who remain at high risk for ASCVD events despite attaining optimal LDLc goal due to presence of discordantly high appolipoprotien-B/non HDLc level.
Diagnostic utility of neutrophil to lymphocyte ratio in adult population of type 2 diabetes mellitus: A tertiary care centre experience
Authors: Sharma Sonam , Varshney Kavya , Singh Mukul , Ranga Sunil
Published: December 2024

: Diabetes mellitus is a multifactorial, multisystemic, and chronic low-grade metabolic condition. Neutrophil to lymphocyte ratio (NLR) is a basic and novel parameter to assess underlying inflammation and diabetic control levels. This study aimed to compare the values of NLR between type 2 diabetes mellitus cases and normal healthy individuals. Also, to establish a possible correlation, if any between NLR and Glycated hemoglobin A (HbA1c).

: This case-control study included 100 cases of type 2 diabetes mellitus patients and similar age & sex-matched healthy controls. The NLR in type 2 diabetic patients and healthy controls were compared to find a possible correlation between NLR and HbA1c levels.

: The mean NLR in type 2 diabetes mellitus patients (mean= 4.56±1.3) in comparison with the mean NLR of healthy controls (mean= 1.94±0.95) was found to be significantly elevated (p < 0.001).

: An elevated NLR in individuals with no pre-existing health conditions could potentially signify compromised glucose metabolism and ongoing low-level inflammation. Additionally, when paired with HbA1c, it serves as a dependable indicator of diabetes management in type 2 diabetes mellitus patients. NLR testing is a secure, uncomplicated, and budget-friendly method that is widely available and can be employed to track the advancement of diseases, ultimately lessening the risk of complications and fatalities.
Comparison of hemi diaphragmatic paresis between ultrasound and peripheral nerve stimulator guided interscalene brachial plexus block in patients undergoing arthroscopic shoulder surgery
Authors: Garg Ankush , Guria Sushil , Mishra Nishant
Published: December 2024

Shoulder disorders are the third most common cause of musculoskeletal conditions for which shoulder arthroscopy procedures are the mainstay of treatment. Interscalene brachial plexus block is a common regional anaesthesia technique that provides excellent surgical anaesthesia and postoperative analgesia for these procedures. Despite the benefits, a potential disadvantage is the transient ipsilateral hemi diaphragmatic paresis from spread of local anaesthetic to the phrenic nerve which is in close proximity to the brachial plexus leading to respiratory compromise. We hypothesise that ultrasound guided low dose block decreases the incidence of the compliaction as compared to peripheral nerve stimulator guided block.

A prospective randomized intervention comparative study was conducted after attaining ethical committee approval and informed consent from the patient. 60 patients were randomized into 2 groups of 30 patients each to group U (ultrasound guided) and group N (PNS guided). Statistical analysis was done using the student T test for continuous data and chi squared test was used for nominal data.

The demographic profile and hemodynamic variations of both the groups was similar. There was a decrease in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) values in the first 30 mins and 1 hour after block in group N as compared to group U which was statistically significant (p< 0.05).

The incidence of HDP and decreased PFT values at post block 30 minutes and 1 hour were less in group U as compared to group N.
Prevalence of bacterial vaginosis, vulvovaginal candidiasis and trichomoniasis among pregnant women with special reference to chlamydial infection
Authors: Khatua Sasmita , Priyanka Kumari , Panigrahi Kalpana , Hotta Sasmita , Swain Madhumita , Majhi Subasini
Published: December 2024

Vaginal infections are a common problem among pregnant women and can lead to adverse pregnancy outcomes. This study aimed to investigate the prevalence of vaginal infections among symptomatic and asymptomatic pregnant women in Odisha, India.

A total of 200 pregnant women aged 21-35 years attending the antenatal clinic of the Obstetrics and Gynaecology department were included in the study. A performa was prepared to collect data on patient history, personal hygiene, and associated comorbidities. Three high vaginal swabs and 2 ml of blood were collected from each patient and sent to the microbiology laboratory. The prevalence of vaginal infections was determined by analyzing the samples.

Out of 200 samples processed, 30% were taken from symptomatic pregnant women and 70% were taken from asymptomatic pregnant women. The overall prevalence of vaginal infections was 59%. Vulvovaginal candidiasis (39%) was the most prevalent infection followed by bacterial vaginosis (30%). Mixed infection (VVC + BV) was found in 16% of the studied population. Chlamydial infection was found in 6% of the women. C. albicans (54%) was the predominant isolate, followed by C. tropicalis (28%). Adverse pregnancy outcomes noted in this study were preterm labor (5.9%) and premature rupture of membranes (2.54%). Vaginal infection had no significant association with adverse pregnancy outcome (P value = 0.971).

This study highlights the high prevalence of vaginal infections among pregnant women in Odisha, India. The findings emphasize the need for routine screening and appropriate treatment of vaginal infections during pregnancy to prevent adverse pregnancy outcomes. Further studies with larger sample sizes and additional diagnostic methods are needed to confirm these findings.
Expression of CD44 and Ki-67 in oral squamous cell carcinoma
Authors: Kaur Harmanpreet , Raina Varsha , Singh Kunika , Varshney Anupam , Mohan Alok
Published: December 2024

The present study was done to evaluate the immunohistochemical expression of CD44 and Ki-67 in cases of oral squamous cell carcinoma.

A Hospital based observational study was conducted at the Department of pathology, in a tertiary teaching hospital in western Uttar Pradesh. The study included specimens of oral lesions undergone incisional biopsies and/or radical complete surgical resection diagnosed as squamous cell carcinoma. Specimens were grossed, processed, paraffin embedded, appropriate sections were taken and Haematoxylin and eosin stained, then examined under microscope. Immunohistochemical markers- CD44 and Ki-67 were applied.

Most common sites were tongue (40.0%) and buccal mucosa (35.0%). The correlation of CD44 and Ki-67 score with histological grades in Oral Squamous Cell Carcinoma were significant in all three grades i.e., grade1, grade 2 and grade 3.

The immunoexpression of CD44 may have prognostic significance in determining the tumour’s stage, grade, degree of invasiveness, and likelihood of metastasis. Ki-67 is a simple to use indicator of cell proliferation whose expression is positively correlated with the development of illness. As a result, it is a marker of carcinogenesis and malignant transformation in oral premalignant lesions. IHC methods may be costly and time-consuming, but their evaluation could be utilised to guide treatment choices for individuals with OSCC.
Prognostic assessment of baseline neutrophil-to-lymphocyte ratio in locally advanced and metastatic lung cancer: A retrospective analysis from a tertiary care center in Northeast India
Authors: Sarangi Satya Sadhan , Hazarika Munlima , Roy Partha Sarathi , Raj Nithin Daniel , Medhi Partha Pratim , Sarma Anupam
Published: December 2024

The treatment for lung cancer has achieved notable advancements; however, there remains a critical need for the development of more refined strategies aimed at optimizing patient selection and enhancing the precision of prognostic evaluations for individuals afflicted with lung cancer. Leukocyte count, particularly neutrophils and lymphocytes, along with the Neutrophil to Lymphocyte ratio (NLR), stand as discerning markers of systemic inflammation, actively contributing in the regulation of cell-mediated antitumor responses. The primary objective of this study was to evaluate the prognostic implications associated with baseline NLR in patients diagnosed with locally advanced and metastatic lung cancer.

Participants in this retrospective observational study were registered between January and December 2017 at the Dr. Bhubaneswar Borooah Cancer Institute. The demographic information, including clinical profiles and treatment-related characteristics, was gathered for these patients, who were diagnosed with locally advanced and metastatic lung cancer based on histological confirmation. The NLR was determined based on the quantification of neutrophils and lymphocytes. The survivorship between the groups was examined after two categories of NLR values—those with < 3 and those with > 3—were established. The Kaplan-Meier method was employed to analyze survival curves, and the log-rank test was performed to compare survival between different groups. In order to establish statistical significance, it was necessary for the p-value to be below 0.05.

The cohort was predominantly elderly males, with a median age of 60 years. Non-small cell lung carcinoma (NSCLC) accounted for 94% of cases, predominantly adenocarcinoma (60%). Over 90% of individuals were diagnosed with stage IV disease. Most patients (53%) received chemotherapy, with a median survival of 11 months for those with NLR < 3, compared to 8 months for NLR ≥ 3, though this difference lacked statistical significance (p=0.180). NSCLC patients with a smoking history exhibited significantly higher inflammation markers (NLR > 3).

Although high NLR was seen more in smokers and non-small cell histology, the results of our study do not support the prognostic role of pre-treatment NLR for overall survival in locally advanced and metastatic disease.
Chronic myeloid leukemia in lymphoid blast crisis with extramedullary CNS infiltration in a pediatric patient: A case report
Authors: Heer Ravneet Singh , Joy Mintu Ann , Bhatti Vandana , Mathews Kripa M
Published: December 2024

Chronic Myeloid Leukemia (CML) is a myeloproliferative disorder, characterized by BCR-ABL1 fusion resulting from t(9;22)(q34;q11) translocation. It constitutes 2% of all leukemia cases in children younger than 15 years. CML-Blast crisis (CML-BC) with extramedullary CNS involvement is a rare serious complication of CML with a poor prognosis.Lymphoid BC in CML is seen in 30% of cases.We present a case of an 8-year-old girl diagnosed with CML one year prior to presentation, who now presented with lymphoid BC with central nervous system (CNS) involvement.