bluuebunny/crossref_metadata_2025 huggingface dataset:
A study to evaluate the significance of Mantoux test investigated for tuberculosis in a tertiary care teaching hospital of India
Authors: Saborni Dey  , Siddarath Kumar  , Vivek Tyagi  , Venkata Sai Charan
Published: January 2025

Background: Tuberculosis (TB) is a serious illness that mainly affects the lungs. The Mantoux tuberculin skin test (TST) is one method of determining whether a person is infected with Mycobacterium tuberculosis. Reliable administration and reading of the TST requires standardization of procedures, training, supervision, and practice.
Aims and Objectives: The objective was to determine the sensitivity and specificity of Mantoux test in pediatric patients for the diagnosis of TB. It also assists to study various presentations of TB in Mantoux test-positive patients.
Materials and Methods: From August 2022 to January 2023, a single tertiary care facility named Saraswathi Institute of Medical Sciences, Hapur hosted this observational study after approval from the Institutional Ethical Committee. Participants in the trial included all children up to 15 years of age who has received Bacillus Calmette-Guérin at birth, were suspected of having TB and had been referred to a pediatric TB clinic. TST by 5 Tuberculin Unit Purified Protein Derivative-Standard was used to see induration of various sizes. The sensitivity, specificity, positive predictive value, negative predictive value and other metrics were calculated during the study by statistical software.
Results: Out of 480 patients 36.87% (n=177) had TB with TST cut off≥15 mm indurations, while 169 patients had no induration. Most common age group affected was 5–10 years (48.59%) followed by 0–5 years (30.51%) and 10–15 years (20.90%) with male: female ratio = 1.2:1. Most common etiology for TST positive patients was pulmonary TB (PTB) (29.30%), extra PTB (50.10%), disseminated TB (12.90%) and latent TB (07.70%). The sensitivity of the test was 95.857% with 95% confidence interval (91.64–98.31%),specificity was 95.176% (92.16–97.29%). Its positive and negative predictive values were 91.525% and 97.689% respectively.
Conclusion: TB can be diagnosed with the Mantoux test because of its high sensitivity and specificity but it should be explained carefully to avoid inaccurate interpretations.
Prevalence of Helicobacter pylori infection in adult immune thrombocytopenia patients
Authors: Suresh Kumar M  , Natarajan M  , Palanikumaran V  , Prakash V  , Vasantha Kalyani D
Published: January 2025

Background: Helicobacter pylori is a Gram-negative, microaerophilic bacteria colonizing more than half of the world’s human stomachs. It is the causal agent of active chronic gastritis and the most common cause of peptic ulceration, including gastric and duodenal ulcers.
Aims and Objectives: This study aims to the prevalence of H. pylori infection in adult immune thrombocytopenia (ITP) patients.
Materials and Methods: An interventional and prospective study was conducted over 6 months with over 50 ITP patients, including those admitted to the general medicine ward and those in regular follow-up in medicine outpatient department. In addition, in all primary ITP patients, a stool antigen test for H. pylori Ag and baseline complete blood count, including platelet count, were done. In addition, all patients’ platelet count was monitored twice weekly for 6 months.
Results: Of the 50 patients, 40 are female and 10 are male. The bleeding manifestation was present in 34 patients (68%) and absent in 16 (32%). Among 34 patients, purpura was more frequent (35.3%), followed by gum bleeding 17.6%. Fourteen people tested positive for the H. pylori antigen. Thirty-six patients were found to be H. pylori antigen negative. H. pylori positive frequency was 28%. Patients who receive both steroids and an H. pylori regimen are 9 (18%). Patients who received the H. pylori regimen were only 5 (10%). Patients only receiving steroid doses are 27 (54%).
Conclusion: We conclude that 28% of our study patients are infected with H. pylori, and eradicating this organism significantly improves the platelet count. However, a more extended follow-up period is needed to detect the true prevalence of H. pylori infection and the duration of remission.
Oligonucleotide based therapeutic strategies for tackling schizophrenia - A systematic review
Authors: Jabir PK  , Sumina Cheriyan  , Pooja Korath  , Sai Sailesh Kumar Goothy
Published: January 2025

Schizophrenia is a serious mental disorder that affects the quality of life of patients, and the cure for the disease is yet a mirage. Drugs are having side effects and not giving satisfying results. Recently, genes have been isolated. The role of oligonucleotide in many diseases, such as multiple sclerosis and cancer, is promising. Since oligonucleotides can modulate gene expression, these molecules can be used as drugs in several conditions which are beyond the usage of conventional drugs. They are also important in the future as therapeutic drugs like rare diseases, which are genetic and in which specific sequences of genes are to be addressed. Since they can bind to Cas9 protein, they can be used for gene editing. Even though the delivery of oligonucleotides faces some limitations, they can be delivered to targets using chemical modification, bioconjugation, and nanotechnology. Overall, they can be used in research, diagnosis, and therapy. Since they are small in size, they have target affinity. They are also cheap to synthesize and more stable than antibodies. This review summarizes the pathophysiology of schizophrenia and its current treatment, recent updates, and insights into the role of oligonucleotide and its regulation of genes. In this article, we also reviewed the genetics of schizophrenia and the possible application of oligonucleotides in the therapeutics of schizophrenia. The introduction of oligonucleotides in the therapy of schizophrenia can be a possible strategy that can be put forward in the future for the management of schizophrenia.
Mupirocin resistance patterns in staphylococcus isolates causing cutaneous and soft-tissue infections: An epidemiological study in a tertiary health-care facility, Dhule, Maharashtra, India
Authors: Karuna Ahire  , Rahul Wadile  , Bhanupriya Pande  , Deepak Shejwal
Published: January 2025

Background: Skin and soft-tissue infections (SSI) caused by Staphylococcus aureus remain a significant concern in both community and hospital settings. Mupirocin resistance among these isolates poses challenges for infection management and control strategies.
Aims and Objectives: The aim of this study was to determine the prevalence and patterns of mupirocin resistance among staphylococcus isolates responsible for cutaneous and soft-tissue infections in patients attending a tertiary health-care facility. Along with that, the study investigated into mupirocin resistance prevalence and identified risk factors.
Materials and Methods: A prospective study was conducted at a medical college, including 256 non-consecutive staphylococcal isolates from SSI. Antibiotic susceptibility testing was performed using Clinical and Laboratory Standards Institute recommended methods. Mupirocin resistance was determined through disk diffusion testing using 5 μg and 200 μg Mupirocin disks for low-level and high-level resistance, respectively.
Results: Among the samples, 16.4% were methicillin-resistant S. aureus (MRSA) and 9.37% were methicillin-resistant coagulase-negative staphylococci. Mupirocin high-level resistance was found in 16.6% of S. aureus isolates, and mupirocin low-level resistance in 19% of MRSA isolates. The prevalence of resistance was lower in inpatient departments compared to outpatient departments. Associations were observed between resistance and patient demographics, history of mupirocin use, surgical site infections, hospitalization history, and diabetes.
Conclusion: Mupirocin resistance presents a multifaceted challenge in the context of both patient demographics and clinical settings. The prevalence of resistance was influenced by factors such as patient age, gender, and prior mupirocin usage.
Effectiveness of COVID-19 vaccines: A systematic review
Authors: Paul Sony  , Iyanar Kannan  , Pitchai Rathinam Thenmozhivalli
Published: January 2025

COVID-19 vaccine effectiveness has been the subject of numerous investigations conducted globally. The public’s and health-care professionals’ acceptance of vaccines looks to be crucial to the pandemic’s effective management. This review’s objective was to present an up-to-date evaluation of COVID-19 vaccine acceptance rates across the globe. The current systematic evaluation of the literature seeks to identify the many global outcomes of the COVID-19 vaccine’s efficacy. The study was carried out following preferred reporting items for systematic reviews and meta-analysis recommendations for systematic reviews. The MEDLINE and EMBASE database were used the retrieve the articles. A detailed descriptive analysis was done on the various outcomes of vaccine efficacy, viral load, transmission rate, hospitalization rate, death rate, and infectivity rate on age group. The present systematic review has identified that vaccines effectively reduced infection transmission. It not only provides fewer hospital stays but reduced the death rate. However, the Ct values were similar in unvaccinated and vaccinated. Breakthrough infections were most reported in the vaccinated group.
Cervical intradural extramedullary chaotic lipoma in an elderly patient: A rare case report
Authors: Anurup Saha  , Sibaji Dasgupta
Published: January 2025

Intradural spinal lipoma (ISL) prevalent in children and young adults usually presents with spastic progressive quadriparesis, sensory disturbances, and gait abnormalities. Chaotic lipomas named due to their haphazard distribution are an extremely rare variant of ISL present at the dorsal root entry zone. We describe a case of chaotic spinal lipoma and elucidate the challenges faced in the management of this entity.
Prevalence of hematuria and proteinuria in asymptomatic pediatric age group in suburban Chennai
Authors: Belukurichi Sadasivam Sangeetha  , Rajesh Haridass  , Jamunarani Srirangaramasamy  , Chinnadurai Peermohamed Luck  , Sumithasree Ramamoorthi
Published: January 2025

Background: Hematuria is rare in normal physiology. Proteinuria is almost always abnormal. It has been reported that hematuria and proteinuria are present even in apparently healthy children.
Aims and Objectives: This study was carried out to find the prevalence of proteinuria and hematuria in asymptomatic pediatric age group in suburban Chennai.
Materials and Methods: This cross-sectional study was carried out among 200 apparently healthy children of a suburban community in Chennai. Urine samples were collected from all children who satisfied the study criteria. The study period was from June 2020 to December 2021. The collected urine samples were analyzed in the laboratory for hematuria and proteinuria. The data were entered into Microsoft Excel and analyzed using SPSS version 23.
Results: Of the 200 children, 105 (52.5%) were males and 95 (47.5%) were females. The mean±standard deviation of the age of the study participants was 6.275±4.0362. Twenty-nine (14.5%) had hematuria, 45 (22.5%) had proteinuria, and 10 (5%) children had both.
Conclusion: Hematuria and proteinuria are present in asymptomatic children. Urinalysis is an effective, easy, and non-invasive screening method for early detection of an underlying renal disease.
Higher GOLD spirometeric class (severity of airflow limitation) correlated with higher number of comorbidities
Authors: Mohit Bhatia  , Avinash jain  , Shivam Dixit  , Arya Krishnan
Published: January 2025

Background: Various systemic manifestations of chronic obstructive pulmonary disease (COPD) are well known to us. One patient of COPD may have more than one associated comorbid conditions. Severity of airflow limitation is expressed as a global initiative for chronic obstructive lung disease (GOLD) spirometeric classification in patients with COPD, which has been proposed to better identify the disease severity and survival.
Aims and Objectives: In this study, we aimed to find out correlation between GOLD spirometeric classification and comorbidities in patients.
Materials and Methods: An observational study conducted at the Institute of Medical Science Banaras Hindu University Varanasi India. We evaluated 50 patients of COPD, containing smokers, non-smokers, and ex-smokers. The severity of airflow limitation in COPD was classified using the GOLD. The most frequent comorbidities are assessed in COPD which were cardiovascular diseases, diabetes, hypertension, osteoporosis, muscle wasting, psychological illness, and anemia.
Results: Fifty patients were analyzed: Male 90%, mean age 68.5 years and mean forced vital capacity in 1 s 34.3%. There is an association between GOLD spirometeric classification and total number of comorbidities in patients. Subjects with higher GOLD spirometeric classification have more associated comorbid conditions, which suggest that these conditions may aggravate COPD course and increase risk of mortality.
Conclusion: Assessment of GOLD spirometeric classification could provide information about a total number of various comorbid conditions in a patient with COPD. Patient with higher GOLD spirometeric classification has more comorbidities.
Relationship between maternal Vitamin D levels and neonatal Vitamin D levels with delayed neonatal hypocalcemia - A hospital-based observational study
Authors: Aasif Aziz Wani  , Mohd Ashraf Bhat  , Showkat Hussain Tali
Published: January 2025

Background: Vitamin D has important role in regulating various metabolic processes in the body including calcium metabolism. Fetuses and neonates are dependent on their mothers to get adequate supply of Vitamin D. Maintaining adequate maternal Vitamin D levels may be highly beneficial for their fetuses and the babies.
Aims and Objectives: The aim of the study was to find a correlation, if any, between maternal Vitamin D status and neonatal Vitamin D levels and delayed neonatal hypocalcemia.
Materials and Methods: Fifty mother infant pairs with neonatal late onset hypocalcemia were included in the study. Detailed clinical history along with simultaneous maternal and neonatal blood samples were taken for estimation of calcium, phosphorus, parathormone (intact), and Vitamin D levels.
Results: Mean maternal and neonatal serum Vitamin D (25-OH Vitamin D) levels were 19.5±7.5 and 15±8.5, respectively. There was a statistically significant correlation between maternal and neonatal Vitamin D levels (P=0.001). There was also a direct correlation between low maternal Vitamin D levels and delayed hypocalcemia in neonates (P=0.048). Mean maternal and neonatal serum calcium levels were 9±1.5 mg/dl and 6.2±0.4 mg/dl, respectively. There was no significant statistical correlation between the two (P>0.05).
Conclusion: Maternal Vitamin D level appears to be an important determinant of neonatal Vitamin D and serum calcium levels.
To evaluate the efficacy of magnesium sulfate and fentanyl as an adjuvant to ropivacaine in supraclavicular brachial plexus block for post-operative pain relief in the upper limb surgeries: A comparative randomized study
Authors: Manmohan Jindal  , Kushal Jethani  , Neelima Tandon  , Irfan Khan
Published: January 2025

Background: Adjuvants to local anesthetics have been used to prolong the duration of analgesia after brachial plexus block surgery. This study evaluates the effects of adding magnesium sulfate and fentanyl with ropivacaine in the supraclavicular brachial plexus block to prolong the duration of analgesia.
Aims and Objectives: The aim of the present study was to compare the onset and duration of sensory and motor blockade with the quality of perioperative analgesia and post-operative side effects if any, provided by magnesium sulfate and fentanyl as adjuvants to ropivacaine in supraclavicular block.
Materials and Methods: A total of 80 patients with American Society of Anesthesiologists Grade I/II scheduled for elective upper limb surgeries were randomly allocated into two groups. Group M received 30 ml of 0.5% ropivacaine with 250 mg magnesium sulfate and Group F received 30 ml of 0.5% ropivacaine with 50 μg fentanyl for supraclavicular brachial plexus block using PNS guidance. The onset and duration of sensory and motor block, time for the requirement of rescue analgesia, and adverse events during the perioperative period were noted.
Results: Onset of sensory block. In group M, the mean onset of sensory blockade was 8.91±1.11 min and in Group F, the mean onset of sensory blockade was 12.12±1.14 min. The mean onset of motor block was 11.57±1.62 min in Group M, and 15.17±1.43 min in Group F. Duration of sensory block is 432.9±38.24 min in Group M and 553.45±39.91 min in Group F, respectively, Duration of motor block in Group M is 392.55±35.22 min and in Group F is 517±44.51 min which was statistically significant.
Conclusion: Fentanyl prolonged the duration of sensory and motor block and duration of postoperative analgesia as compared to magnesium sulfate when used as an adjuvant to ropivacaine in supraclavicular brachial plexus block and was not associated with any major adverse events.
Association between vitamin D and C-reactive protein level in post-COVID recovery period
Authors: Sisir Chakraborty  , Sanchayan Sinha  , Soumita Ghosh Sengupta  , Satwika Sinha  , Indranil Chakraborty
Published: January 2025

Background: Severe acute respiratory distress syndrome coronavirus 2 pandemic shows a spectrum of symptoms and complications which are variably dependent on individual’s immune status. Vitamin D deficiency, often preexisting, causes poor prognosis in the post-COVID recovery phase of the survivors characterized by increased C-reactive protein (CRP) and decreased D-dimer levels.
Aims and Objectives: The aims of this study were to find any correlation exists between vitamin D level and inflammatory marker CRP and D-dimer in post-COVID period.
Materials and Methods: Seventy post-COVID recovery patients from the follow-up medicine outpatient department of College of Medicine and Sagore Dutta Hospital were tested for vitamin D, D-dimer, and serum CRP levels.
Results: CRP levels of patients with lower vitamin D level (<20 ng/ml) were significantly higher (P<0.001) than the patients with higher vitamin D level. The D-dimer levels of vitamin D deficient group found to be significantly higher than the other group. There is statistically significant negative correlation found between CRP and vitamin D level and significant positive correlation has been found between D-dimer and vitamin D (P<0.001).
Conclusion: Vitamin D may have an important role in recovery stage of COVID patients.
Clinico-pathological study of mucormycosis in post-COVID patients at government general hospital, Nizamabad
Authors: Manisha Thavanam  , Farida Begum  , Seshava Puri Smitha Vadana  , Nagarjuna Chary Rajarikam  , Harish Swamy Dharmagadda
Published: January 2025

Background: Mucormycosis is a rare, opportunistic fungal infection with high morbidity and mortality. Coronavirus disease 2019 (COVID-19) associated mucormycosis has been increasing in frequency since early 2021, particularly among patients with uncontrolled diabetes and systemic corticosteroid treatment.
Aims and Objectives: The aim of the study was to study mucormycosis occurrence in COVID-19 patients at Government General Hospital, Nizamabad – A tertiary care center and to correlate mucormycosis with comorbidities and previous treatment modalities among admitted post COVID-19 patients.
Materials and Methods: Cross-sectional retrospective study was done for 3 months, from June 2021 to August 2021. Fifty suspected cases of mucormycosis specimens sent to the Department of Pathology, Government General Hospital, Nizamabad for histopathological diagnosis were considered. Clinical history and treatment details were noted. Tissues obtained were fixed in 10% formalin, routine hematoxylin and eosin (H&E) stains were done. Gomori’s methenamine silver stains were done.
Results: Mucormycosis was most common in males 37 (74%) and common in the age group of 41–50 years (26%). Diabetes mellitus is the most common comorbidity (60%). The mean duration between diagnosis of COVID-19 and development of symptoms of mucor was 6–40 days. Out of 50 cases, 46 patients received steroid therapy and 39 cases were given oxygen support.
Conclusion: Mucormycosis is a rapidly progressive life-threatening opportunistic infection. Post COVID-19 patients with uncontrolled diabetes are more prone to it and an important predisposing factor. Treatment with steroid therapy and oxygen support must be carefully monitored and used in a vigilant manner. Histopathological examination and clinical correlation are essential for early diagnosis and treatment.
Different presentations of hydatid cyst and its management – A prospective and observational study in a tertiary care hospital in Kolkata
Authors: Amit Kumar Samanta  , Arup Jyoti Rout  , Eashin Gazi  , Tushar Kanti Saha
Published: January 2025

Background: Hydatid disease of liver is quite common disease in Eastern India, though not very frequently reported. The diagnosis of hydatid cyst is often difficult because of its initial modes of presentation.
Aims and Objectives: The objectives of the present study were to evaluate the different clinical presentation, surgical management options, and complications if any after operation in a tertiary care center.
Materials and Methods: This prospective study was conducted with 30 patients (Male 17 and Female 13 with a mean age of 41.23 years) who were diagnosed of having hydatid cyst of liver.
Results: The presenting symptoms that were found pain abdomen (22 cases), abdominal lump/mass (16 cases), cholangitis (five cases), jaundice (two cases), constitutional (anorexia, nausea, and malaise two cases), and fever (18 cases). Deroofing and omentoplasty and wound drainage (12 cases), partial pericystectomy (nine cases), pericystic-cystectomy (six cases), marsupialization (two cases), and one case was managed nonoperatively. Post-operative complications were – biliary fistula (two cases), post-operative cholangitis (two cases), surgical site infections (two cases), and retained cyst (one case).
Conclusion: A high index of suspicion is always recommended when an adult patient comes with pain abdomen and abdominal mass. Different surgical methods, for example, deroofing and omentoplasty with wound drainage, partial pericystectomy, and pericystic-cystectomy can be applied. To establish the definite surgical management, many more randomized and controlled studies are needed.
Idiopathic sudden sensorineural hearing loss – A 12-month review
Authors: Ali Malikka  , Joe Jacob Kandoth  , John Mathai
Published: January 2025

Background: Idiopathic sudden sensorineural hearing loss (ISSNHL) is a condition which is difficult to define and treat. Sensorineural hearing loss being a situation where rehabilitation therapy with hearing aids is the only treatment option, ISSNHL is an exception which can be treated medically if identified early enough.
Aims and Objectives: The aim of the study was (i) to calculate the recovery of hearing and other symptoms in patients diagnosed of ISSNHL treated with medical management as per institutional protocol and (ii) to determine the association between recovery with medical management and factors such as time of presentation and comorbidities in patients with ISSNHL.
Materials and Methods: In the Department of ENT, MCH, Kottayam, a protocol for the management of ISSNHL was worked out as per guidelines from standard otology textbooks. All patients with suspected ISSNHL were admitted. Hearing assessment was done using pure tone audiometry during inpatient care and on discharge of the patient. Patients were discharged after completion of the treatment and followed up for a period of at least 6 months.
Results: The inference of our study is that cases who presented early in the first 24–48 h of onset of symptoms have maximum chance of recovery irrespective of associated comorbidities.
Conclusion: The study highlights the fact that ISSNHL is and should be considered as a medical emergency.
Histomorphological analysis of phyllodes tumors at a tertiary care center
Authors: Swathi Samalla  , Motrapu Lavanya  , Mohd Imran Ali  , Smitha Vadana SP
Published: January 2025

Background: Phyllodes tumors (PT) are rare biphasic neoplastic breast lesions. They account for 0.3–0.5% of female breast tumours1 and have an incidence of about 2.1 per million, the peak of which occurs in women aged 45–49 years. There is sometimes difficulty in dividing tumors into the three recognized grades based on histomorphological features. It is because of the subjective variation and absence of a definitive grading system. More importantly, they do not always correlate with clinical outcome in terms of predicting recurrence, malignant transformation, metastasis, and overall survival.
Aims and Objectives: (1) The aim of the study was to study the clinicopathological and histomorphological features of the PT and classify the tumors based on 2019 WHO classification.
Materials and Methods: This study was done in the Department of Pathology at Government General Hospital Nizamabad. Total 68 cases are included in this study over a period of 5 years (3 1⁄2 years retrospective and 11/2 year prospective) from 2017 March to 2022 March. PT cases were analyzed based on 2019 WHO classification criteria. The age of the patients, tumor locations, and the relevant details were obtained from the pathology records.
Results: Of the 68 PT cases, 53 (78%) were classified as benign, 8 (12%) borderline and 7 (10%) malignant PT based on histomorphological features based on 2019 WHO classification.
Conclusion: Our study showed that tumors occurring in older age group with a large tumor size and the presence of malignant heterologous elements, infiltrating borders, and surgical margins <1 cm were usually malignant phyllodes.
Effect of yoga practice on cognitive functions among the patients of depression
Authors: Anuradha Yadav  , Nitu Kumari  , Ishwar Dayal Gupta  , Dheeraj Jeph  , Kavita Yadav  , Namit Garg  , Sai Sailesh Kumar Goothy  , Anita Choudhary  , Anita Choudhary
Published: January 2025

Background: Decline in the cognitive functions is commonly observed in patients suffering with depression. Practicing yoga was reported to improve cognitive functions as well as manages depression.
Aims and Objectives: The present study was undertaken to observe the effect of yoga practice on cognitive functions among the patients of depression.
Materials and Methods: A total of 64 patients suffering with depression were recruited after obtaining written informed consent. Participants were randomly assigned to the interventional and control groups with 32 participants in each group. Digit span test (DST) was used to assess the cognitive functions of the participants at the baseline, after 1 month, and after 3 months of intervention. Yoga practice was administered as an adjunctive therapy to the interventional group for 3 months of period. No intervention was administered to the control group. Unpaired Student’s “t”-test and repeated measure ANOVA test were applied and P<0.05 was considered as statistically significant.
Results: The forward, backward, and total DST scores were not significantly different between the interventional and control groups at the baseline as well as after 1 month. Whereas, a statistically significant improvement after 3 months of yoga intervention in the forward (P<0.001), backward (P<0.05), and total (P<0.001) DST scores was observed when the interventional group was compared with the control group. A statistically significant improvement was observed in the interventional group even after 1 month of yoga practice in forward (P<0.001) and total (P<0.05) DST scores, while in backward DST scores, statistically significant improvement was observed after 3 months.
Conclusion: The study results support improvement in the cognitive functions followed by yoga practice in patients suffering from depression within a short period of time. The study recommends the implication of yoga practice as an adjunctive therapy in the management of depression.
Antimicrobial drug utilization pattern in a tertiary level intensive care unit in Northern India: Antimicrobial Stewardship Programme need of the hour
Authors: Banday Muddasir , Muntaha Manzoor  , Mohammad Akbar Shah  , Zulfiqar Ali  , Nazir Ahmad  , Zulfkar Qadri
Published: January 2025

Background: Antimicrobial drugs are the most frequently prescribed drugs in hospital settings with intensive care unit (ICU) patients showing the highest consumption of these drugs. Antimicrobial overuse and misuse is attributed to antimicrobial resistance (AMR). AMR in coming years will emerge as a global pandemic, maiming the modern health-care system. High consumption of antimicrobial drugs is one of leading factors contributing to AMR.
Aims and Objectives: This study aimed at evaluating the prescription pattern of antimicrobial drugs in ICU and estimates the burden of inappropriate antimicrobial drug utilization in ICU settings of a tertiary level teaching hospital.
Materials and Methods: The current study was conducted on 100 patients over a period of 6 months, admitted in surgical ICU (SICU), and neuro SICU (NICU) of a tertiary level hospital in Jammu and Kashmir, India. Study patients were identified through daily review of pharmacy records and antimicrobial drugs prescribed for the initial 5 days of ICU admission were documented in a well-designed questionnaire consisting all the necessary information regarding antibiotic therapy.
Results: Out of the 100 enrolled study subjects, 98% received an empiric therapy. Majority of the patients were given a combination antimicrobial therapy during the initial 5 days of ICU admission. The most common antibiotic prescribed as monotherapy was ceftriaxone during the initial 2 days of ICU stay followed by piperacillin-tazobactam and meropenem in the next 3 days. Amikacin was the most frequently prescribed antibiotic in combination therapy during first 2 days followed by vancomycin in the consecutive days. A total of 27 antimicrobial drugs belonging to 15 classes were prescribed to the study participants during the initial 5 days of ICU admission.
Conclusion: The study reports a very high consumption of antimicrobial drugs in ICUs with maximum of antimicrobial therapies prescribed empirically. A robust action plan, consisting of proper protocol for prescribing empiric antimicrobials, regular monitoring of antibiotic consumption in ICUs with a system of prospective audit, and feedback and timely interventions are a keystone of good antibiotic stewardship and should be the focus in ICU and NICU.
Efficacy of intravenous dexamethasone for post-operative pain relief in elective cesarean section
Authors: Swetha Purohit  , Chandrashekarappa Kavi  , Shobha MM
Published: January 2025

Background: Various additives have been evaluated for the purpose of enhancing quality of analgesia and prolonging duration of spinal anesthesia.
Aims and Objectives: This randomized study was conducted to evaluate the efficacy of intravenous dexamethasone in spinal anesthesia.
Materials and Methods: A total of 100 patients scheduled for lower segment cesarean section under spinal anesthesia were randomly allocated into two groups, Group-1 and Group-2, including 50 patients each. All the patients received injection bupivacaine 0.5% heavy 10 mg for spinal anesthesia. Group-1 received injection dexamethasone 8 mg intravenously, and Group-2 received injection normal saline 2 cc immediately after spinal anesthesia. Duration of sensory and motor block, post-operative analgesia, visual analog pain scale (VAS) score, time of rescue analgesia, total analgesic requirement in the first 24 h, intra- and post-operative hemodynamics, and side effects if any were recorded.
Results: The mean duration of sensory block (min) in Group-1 and Group-2 was 162.50 and 106.17, respectively. Time to the requirement of first rescue analgesia was 8.67 h in Group-1 and 4.40 h in Group-2. Significant changes seen in VAS score in post-operative period after 1 h of surgery in Group-1 and Group-2. Group-1 had more duration of sensory block, prolonged requirement of first rescue analgesia. Duration of motor block and intra- and post-operative hemodynamic parameters was comparable in both the groups. No side effects were recorded in both the groups.
Conclusion: We conclude that administration of dexamethasone 8 mg intravenously prolongs the duration of post-operative analgesia and sensory block in patients undergoing lower segment cesarean section under spinal anesthesia.
Effect of oral premedication with ivabradine on surgical field and intraoperative bleeding during functional endoscopic sinus surgeries: A prospective, randomized, and placebo-controlled study
Authors: Sowmya Madihalli Janardhan Iyengar  , Surekha Kumar  , Shankar Kantharaju
Published: January 2025

Background: Ivabradine is an effective drug to prevent abnormal increase in heart rate (HR).
Aims and Objectives: The aims of this study were to determine if a pre-operative oral dose of ivabradine (2.5 mg) reduces intraoperative bleeding during functional endoscopic sinus surgery (FESS) and improves visualization of operative field.
Materials and Methods: A prospective, randomized, and placebo-controlled study was carried out in 30 patients of ASA grade I and II, aged between 18 and 60 years undergoing FESS surgeries. The patients were randomly allocated into two groups. Group I – received 2.5 mg of tablet ivabradine and Group P – received a placebo (vitamin tablet) 1 h before surgery. Blood loss and hemodynamic parameters (HR, systolic, diastolic, and mean blood pressure) were assessed perioperatively. Surgical field was graded by operating surgeon using Fromme – Boezaart score (FBS) at the end of procedure. Post-operative monitoring for any complications was also done.
Results: Mean final blood loss in Group I was 165.73±43.48 mL and in Group P was 246.25±30.76 mL. There was a significant difference in mean final blood loss (mL) between two groups with P<0.001. In Group I – 13.33% had FBS 1 and 86.67% had FBS 2, whereas in Group P – 6.67% had FBS 2, 86.67% had FBS 3, and 6.67% had FBS 4. Thus, Group I had lower FBS scores than Group P and was statistically significant.
Conclusion: Pre-operative oral ivabradine helps in reducing intraoperative bleeding in FESS surgery and provides good surgical field compared to placebo.
Treatment outcome of drug-resistant tuberculosis (DR-TB) following uptake of universal drug susceptibility testing: A record review from a nodal DR-TB center
Authors: Aditi Bharti  , Akanksha Tomar  , Rajesh Tiwari
Published: January 2025

Background: There has been delay evident in diagnosing the drug resistance and non-initiation of appropriate treatment based on drug susceptibility pattern resulting in poor treatment outcome of drug-resistant tuberculosis (DR-TB).
Aims and Objectives: The aims of this study were to examine the treatment outcomes for DR-TB patients following universal drug susceptibility testing (UDST) and to examine the association of sociodemographic, behavioral factors, or comorbidities with outcome.
Materials and Methods: A retrospective study at a nodal DR-TB center was done for the past 2 years (2018–2019) following the district’s adoption of UDST. The study comprised patients registered between January 2018 and December 2019. Transferred out cases were excluded from the analysis. Cured or treatment completed were assigned as successful, whereas the treatment failed, lost to follow-up or died were adverse treatment outcome.
Results: A total of 201 patients were initiated on suitable DOTS regime and they continued the treatment from the center, during the study period. Altogether 129 (64.2%) patients had successful treatment outcome. None of the examined variable (age, sex, SES, Body mass index, and comorbidity) is found to have statistically significant association with outcome (P>0.05).
Conclusion: The UDST may be the reason for success rate shown here, higher than in literature published. Although a better stance is possible only by comparing the treatment outcome of pre- and post-uptake of UDST from same setting.
Histomorphological study of lichenoid dermatitides – A retrospective study
Authors: Kalaivani Selvam  , Bharathi Pradeep  , Chaithra Jadhav  , Udayashankar Carounanidy
Published: January 2025

Background: Lichenoid dermatitis is a very common dermatological condition and is defined by features of basal cell damage and a dense band-like infiltration at the dermo-epidermal junction. There is a wide range of lesions included under this and the prototype lesion is Lichen Planus.
Aims and Objectives: The aims of this study were to study the histopathological spectrum of the conditions with lichenoid tissue reaction and to find clinicopathological concordance of the lichenoid lesions.
Materials and Methods: A retrospective study was conducted in a tertiary care center, where all the skin biopsy cases diagnosed clinically and/or histologically as lichenoid dermatitis for 2 years (2018–2019) were included in the study. Demographic details, clinical diagnosis, histological diagnosis, and the different histological features were collected from the respective case sheets and biopsy reports and entered in an excel worksheet. Frequency and percentages were used to represent the data.
Results: A total of 47 cases were clinically diagnosed as lichenoid dermatitis, of which 38 cases showed concordance between clinical and histopathological diagnosis. Nine cases showed discordance between clinical and histopathological diagnosis and were categorized as lesions without lichenoid features. Seven cases were diagnosed as lichenoid dermatitis only on the histopathological study with an absence of such a differential diagnosis clinically. Out of the total 45 cases diagnosed as lichenoid dermatitis, 27 were lichen planus, five were lichen planus pigmentosus, four were hypertrophic lichen planus, three were lichenoid dermatitis, and two cases each of lichen planopilaris, lichen keratosis, and lichen sclerosis. Lichenoid dermatitis was seen commonly among the 41–50 years age group. Females were more commonly affected than males.
Conclusion: Lichen planus is the prototype lesion among the lichenoid dermatitides. Definitive diagnosis of the specific entity among the lichenoid lesions is important as decision-making regarding the treatment modality and prognosis of the patient depends on it. Histopathological examination is vital for the definitive diagnosis, along with clinical correlation which concludes that clinicopathological correlation is the key.
Determinants of maternal near-miss event’s among pregnant women attending tertiary care hospital: A case–control study
Authors: Rutuja Patond  , Ramesh Pawar  , Sanjeev Chaudhary  , Mahesh Puri  , Vijay Balkar
Published: January 2025

Background: Women who have survived complications during pregnancy and childbirth have been studied as surrogates of maternal deaths and have been termed as maternal near-miss. Study of such cases is considered a less threatening approach to improve maternal health care by the service providers. With this tool, we will be able to identify the delays. As near-miss occurs much more frequently than maternal deaths, a more reliable quantitative analysis can provide a comprehensive profile of the health system functioning. Near-misses are relatively simpler to analyze and easier to resolve. This knowledge will help in identifying the contributory factors of maternal deaths so that actions can be taken at community and health systems level.
Aims and Objectives: The objectives of this study were to determinants of maternal near-miss event’s among pregnant women attending tertiary care hospital.
Materials and Methods: This was a case–control study, conducted in the Department of Obstetrics and Gynecology at Government Medical College, Akola from January 2019 to January 2021. One hundred and twenty-five cases and 375 controls were included in the present study using EPI INFO in 2 years. Cases of near-miss events from hospital during study was identified and included in the study.
Results: In this study, a total of 500 persons were questioned (125 cases and 375 controls), with a 100% response rate. The average ages of the cases and controls were 26.5 (4.42) and 29 (59.9) years, respectively. Pre-existing medical disorders were substantially linked to maternal near miss (MNM). More over half of the patients (59.2%) and less than a third of the controls (23.21%) had a history of at least one pre-existing medical condition. After adjusting in the multivariate logistic regression model, multigravida, lack of antenatal care, induction of labor, and delays in reaching hospital were positively associated with a MNM. For instance, those mothers who were pregnant for the 2nd–4th times (AOR: 4.94 [95% CI: 1.46–16.8]) and more or equal to 5 times (AOR: 3.84 [95% CI: 1.23–11.91]) were nearly five-fold and four-fold more likely to experience MNM events respectively.
Conclusion: The factors that were found to be significant in our study are non-modifiable risk factors for maternal near-miss occurrences. These events can be prevented and mitigated by early detection and proper prenatal care.
A comparative study of laparoscopic cholecystectomy with and without abdominal drain
Authors: Soubhik Sarkar  , Shib Shankar Kuiri  , Yadhu Rajan  , Kanchan Kundu
Published: January 2025

Background: Laparoscopic cholecystectomy (LC) has been considered the Gold-standard for the management of benign gallbladder disease. With increasing surgeon experience and advancement of instrumentations and equipment, LC is approaching continuously toward a more safe and less invasive technique. There is a consensus that drainage should not be considered mandatory or standard after elective LC.
Aims and Objectives: The aims of this study were to assess the effectiveness of the LC without abdominal drain over sub hepatic drainage and to compare the post-operative outcome between two groups.
Materials and Methods: A descriptive observational comparison study has been carried out in the department of General Surgery BSMCH, from September 1, to December 1, in 130 patients undergoing elective LC. Patients have been divided into two groups: Comparison group and study group after proper matching. Data have been collected via interview, clinical examination, and scrutinizing relevant medical records. Each patient has been followed up after operation. Data have been summarized for estimating various parameters such as mean duration of surgery and hospital stay between the groups and proportion of patient complaining of pain 24 h after surgery.
Results: The mean duration of surgery in drainage group is 108 min which is significantly more than the non-drainage group 88 min. In this present study, the patients with abdominal drain are showing more incidence of post-operative nausea and vomiting (PONV) 21.53% compared to no-drain group 6.15%. In this study, 35.38% of patients with subhepatic drain developed pain after surgery, whereas only 12.3% of the patients with no drain experienced the same. Overall six patients from the drain group still had significant subhepatic collection and eight patients with no drain have the same. The mean duration of stay in hospital of the drain group is 4.06 days, whereas, in no-drain group, it is 2.26.
Conclusion: An uncomplicated gallstone disease can be treated by LC without need for drain with reasonable safety by an experienced surgeon. Hence, no use of drain scores over use of drain in terms of PONV, post-operative pain, and therefore, there is less use of analgesics and also short duration of hospital stay. When a dry operative field is achieved during LC the drain insertion may be avoided.
Correlation analysis of HbA1c versus random, fasting, and postprandial glucose levels as predictors of glycemic control in type 2 diabetes patients
Authors: Ansari Shiba , Jayeeta Bhadra  , Ashok Kumar Ahirwar  , Jasmeen Gupta
Published: January 2025

Background: Glycated Hemoglobin (HbA1c) is used for assessing glycemic control over the past 8–12 weeks. This is critical for determining the efficacy of diabetes treatment and predicting the progression of microvascular complications. However, in health-care situations where tests for HbA1c are either unavailable or unfeasible for any reason, clinicians rely only on plasma glucose values for assessing the glycemic control of the patient.
Aims and Objectives: The purpose of this study was to determine the relationship between HbA1c and fasting, postprandial, and random plasma glucose levels.
Materials and Methods: Routine blood samples obtained from the laboratory to measure HbA1c and plasma glucose (fasting/postprandial/random) were used for study. A total of 207 samples were used to investigate the relationship between HbA1c and fasting and postprandial glucose (PPG/PP). The correlation of HbA1c with random glucose values was investigated using 112 samples. HbA1c was estimated by immunoturbidimetry and glucose was estimated by hexokinase method. Pearson’s correlation analysis was done by SPSS version 20 software.
Results: The Pearson correlation coefficient (r) with regard to PPG/PP and HbA1c was 0.75 (P=0.01, 95% CI), fasting glucose and HbA1c was 0.73 (P=0.01, 95% CI), and random glucose and HbA1c was 0.59 (P=0.01, 95% CI).
Conclusion: PPG/PP correlates with HbA1c better than fasting or random glucose. When it is impossible to perform HbA1c measurements, PPG measurements should be used instead.
Effect of perceived social support and level of hope on quality of life among chronic kidney disease patients in a tertiary care center in Chennai - A cross-sectional study
Authors: Ganeshkumar Raja NC  , Sivakumar Krithiga , Seenivasan P
Published: January 2025

Background: Chronic kidney disease (CKD) is a major public health problem in developing countries, adversely affecting the quality of life (QOL) of the individual and their family. Perceived social support and hope are important factors influencing the QOL.
Aims and Objectives: The objectives of the study were to assess the QOL among patients with CKD and the effects of perceived social support and hope on QOL.
Materials and Methods: This is hospital based cross-sectional study among CKD patients attending nephrology department, between March and November 2018. Face to face interview using Adult Hope Scale and Multidimensional Perceived Social Support scale and WHOQOL-BREF-26 was done after obtaining informed consent. Epi-info and SPSS16.0 were used for statistical analysis. t-test, ANOVA, and correlation coefficient was done to find any association.
Results: Among the 152 participants, majority (70%) had fair QOL with the highest score in social relationships domain of 53 (±12), using the WHO BREF26 questionnaire. The QOL was also found to be associated with education and socio-economic status. A positive correlation between perceived social support and hope with QOL was observed.
Conclusion: Majority had a fair QOL, with the highest score in social relationship domain. Positive correlation was observed between perceived social support and hope with QOL. Apart from medical treatment, the key to better health outcome depends on social support. Hence, it is imperative to highlight the importance of social support and hope at the commencement of the treatment of CKD.