bluuebunny/crossref_metadata_2025 huggingface dataset:
A STUDY ON HYPERBILIRUBINEMIA IN PATIENTS OF ACUTE APPENDICITIS AND IT'S ROLE IN THE PREDICTION OF APPENDICULAR PERFORATION AT RIMS, RANCHI
Authors: Sahay Chandra , Priyanka Priyanka
Published: August 2023

Background:Acute appendicitis is the most common condition that needs urgent intervention, has to be diagnosed and evaluated at the earliest. It
is found that a correlation exists between appendicular perforation and high serum bilirubin level. In the absence of radiological investigations,
patients with clinical signs with hyperbilirubinemia might have a higher probability of appendicular perforation. Aim: To study the role of elevated
serum bilirubin level as a diagnostic marker of acute appendicitis and to evaluate the predictive potential of hyperbilirubinemia in appendicular
perforation. Methods: This is an observational prospective study of 100 cases of acute appendicitis with or without appendicular perforation
admitted in General Surgery department of Rajendra Institute of Medical Sciences, Ranchi, who underwent appendicectomy for acute appendicitis
from August 2019 to October 2021. Results: Most of the patients belonged to the age group of 15-24 years with male to female ratio 1.4:1. Total
serum bilirubin levels were raised in 72% patients, comparatively higher in appendicular perforation 77.78% than in acute appendicitis 70.73%.
Sensitivity n specicity of hyperbilirubinemia was 70.73% and 22.22% respectively. Conclusion: Serum bilirubin level appears to be a promising
new diagnostic laboratory marker which when combined with thorough history taking and clinical examination can aid signicantly to arrive to the
diagnosis of acute appendicitis. Higher level of serum bilirubin (≥ 2mg/dl) hints towards the increased chances of appendicular perforation.
TO STUDY THE OUTCOMES OF HEARING STATUS IN PATIENTS AFTER CANAL WALL DOWN MASTOIDECTOMY IN ATTICOANTRAL VARIETY OF CHRONIC OTITIS MEDIA
Authors: Imran Khan Md , Pratap Thakur Rana , Kumar Raman Raibat , Satyarthy Vikram
Published: August 2023

Aim: To compare the pre-operative & post-operative hearing of the paients after canal wall dawn mastoidectomy. Methods: patients attending to
the OPD in department of otorhinolaryngology, ANMMCH with chronic otitis media (squamous variety) and underwent canal wall down
mastoidectomy with ossiculoplasty. Results: The results concluded that the mean pre-operative PTA was calculated as an average of hearing
thresholds at 500 Hz, 1 kHz and 2 kHz and came out to be 58.73 dB ± 14.89 and the post-operative PTAat the end of the study was 47.50 dB±14.79.
The mean pre-operative AB gap was 39.88 ±12.42 dB and the mean post-operative AB gap at the end of the study period was 29.35 ±12.92 dB . The
hearing status of the patients were compared according to the severity of their disease and ossicular status, and a signicant improvement was noted
across the board after comparison with paired 1 tailed t test (p<0.05) Conclusion: There is signicant improvement in closure of AB gap and
hearing threshold, as measured with PTAin all forms of canal wall down mastoidectomy when complemented with hearing reconstruction.
EFFECTIVENESS OF CLOSED KINETIC CHAIN EXERCISES TO IMPROVE QUADRICEPS STRENGTH AND FUNCTIONAL STATUS IN PATIENTS WITH KNEE OSTEOARTHRITIS
Authors: Chan Basha Mohammad , Khan Jafar , Pal Renuka
Published: August 2023

The objective of the study was to compare and assess the effects of a 2-week Closed Kinetic Chain Exercise programme on Quadriceps Strength and Function in Knee Osteoarthritis patients. To compare the therapeutic benets of Closed Kinetic Chain Exercises on the Functional Status and Quadriceps Strength in patients with Knee Osteoarthritis. Methods: 20 patients with a mean age of 55 to 75 years were compared. The study comprised both male and female participants. All ten patients were chosen at random for Closed Kinetic Chain Exercises. For two weeks, patients receive treatment ve days each week. The WOMAC scale is used to assess the result in terms of pain, stiffness, and functional status. Results: With a mean difference of 2.1 between the 0th and 14th days for both groups, CKCE exhibited signicantly more improvement. Conclusion: The study, therefore, concluded that there is signicant improvement in open kinetic chain exercises.
MENSTRUAL HYGIENE AWARENESS AND PERCEPTION AMONG ADOLESCENT GIRLS
Authors: Bhardwaj Tushti , Mishra Sneha , Bhardwaj Sarla
Published: August 2023

Introduction: Menstruation in large parts of India involves several myths and restrictions to the young girls. The open and healthy discussions
around menstrual hygiene is yet not widely practiced. In such circumstances, the young girls may develop unhealthy perception and lack
information about maintaining hygienic care posing long term health risks to themselves. Objectives: The major aims were: 1) to study the
awareness about safe and hygienic practices related to menstruation and (2) to understand the belief, perception, and sources of information about
menstruation among adolescent girls. Methods: A descriptive study conducted in NCT of Delhi with 99 girls between 13-21 years of age. The
sample was drawn using snowball sampling techniques and data collected through telephonic interviews with the help of a digital interview
schedule. Results: 99% of the sample reported physical and emotional problems during menstruation which included- pain, aggression, mood
irritability, sadness, hopeless, itching in intimate parts, nausea, digestive issues which forced them to miss school/work. Unhealthy perception like
menstruating woman should not enter place of worship, wash hair, exercise, swim, dance, sports and avoid eating curd, pickles and tamarind were
reported. Safe disposal practice of sanitary napkins was missing in almost 1/4th of the sample. Conclusion: Physical and emotional issues related
with menstruation are important to be addressed to help young girls adjust with changes in their body and remain active. The large-scale awareness
programs through schools and local level organizations on regular basis are required to help instill healthy perception among the young mind and
safe disposal practice.
CASE REPORT ON NEUROLOGICAL MANIFESTATIONS OF H1N1 VIRAL ENCEPHALITIS
Authors: Elizabeth Sabu Hannah , Kuruvilla Mathew Joshua , Jacob Thomas , Varghese Mohan
Published: August 2023

The H1N1 epidemic has been accompanied by reports of central nervous system (CNS) impairments. CNS complications of inuenza Ainfection include encephalitis, encephalopathy etc. We report a case of encephalitis diagnosed with the H1N1 virus infection.
A STUDY ON POST COVID MUSCULOSKELETAL MANIFESTATIONS ON MRI
Authors: Dhandhalya Chetankumar , Parekh Hiral , Patel Rutvik
Published: August 2023

The Musculoskeletal manifestations of COVID have been well characterized and include bone infarcts, osteonecrosis, osteitis, fasciitis,
tenosynovitis, myositis, myonecrosis, and joint effusion. The mechanism for myositis includes immune-mediated damage, ICU-acquired
weakness, toxic myopathies, and possibly direct viral muscle destruction. Corticosteroids induced suppression of osteoblasts, apoptosis of
osteocytes and reduced blood ow to the bone result in weak bones. Risk factors include male gender, use of multiple type of corticosteroids, higher
dose of corticosteroid for prolonged duration, alcohol or tobacco abuse and cardio vascular ailments. We aimed at providing MRI evidence of postCOVID musculoskeletal manifestations. Patients with musculoskeletal symptoms from among the many cases of post-COVID sequelae admitted
to the G. G. hospital in Jamnagar based on MRI results were studied along with review of the literature. Most common observation was
osteonecrosis with most common site being femoral head. Post diagnosis, most patients with high grade of osteonecrosis were managed surgically,
meanwhile, myonecrosis was managed with physiotherapy and medical management.
A STUDY OF ECHOCARDIOGRAPHY CHANGES IN PATIENTS WITH TYPE 2 DIABETES IN A TERTIARY CARE LEVEL HOSPITAL
Authors: Goswami Deep , Kumar Binaykia Binod
Published: August 2023

Introduction: One of the most signicant non-communicable illness public health issues is diabetes. Compared to 180 million in 1980, 422
million persons worldwide had diabetes in 2012. Diabetes contributed to 1.5 million fatalities in 2012 and an additional 2.2 million deaths were
related to those with blood glucose levels that were higher than ideal, raising the risk for CVD. Aims: To identify any abnormalities in the echocardiograms of type 2 diabetes mellitus patients visiting the outpatient clinic. Materials and Methods: Result: In our study, 23 % of study
population having HbA1c in the range 7 - 8.5%, 19.5% of patients had HbA1c < 7% and 30% of patients had > 17%. We found that the incidence of
diastolic dysfunction is lower in the group of patients with HbA1c 7 - 8.5 and increased occurrence in groups with HbA1c > 8.5. Conclusion: The
widespread medical condition known as type 2 diabetes leads to a number of consequences. It is a signicant contributor to cardiovascular
mortality and the rise in heart failure incidence
COMPARATIVE STUDY BETWEEN TYMPANOPLASTY WITH CORTICAL MASTOIDECTOMY VERSUS TYMPANOPLASTY WITHOUT CORTICAL MASTOIDECTOMY IN THE MANAGEMENT OF MUCOSAL VARIETY OF CHRONIC OTITIS MEDIA.
Authors: Kumar Raman Raibat , Pratap Thakur Rana , Imran Khan Md , Satyarthy Vikram
Published: August 2023

Background: Tympanoplasty is the treatment of choice for mucosal variety of chronic otitis media, the contribution of mastoid pneumatization
remains controversial and the role of mastoidectomy in treating tympanic membrane perforation continues to be debated, particularly in case of
mucosal variety of Chronic otitis media without complication. Methods: All the patients reporting to ENT OPD with Tympanic Membrane
perforation, who were t for surgery and were advised tympanoplasty or tympanoplasty with cortical mastoidectomy are included in this study. In
which 82 patients 41 in each group via simple random sampling technique. Results: 89.02% was the combined graft uptake rate in our study,
87.88% was in the tympanoplasty without cortical mastoidectomy group and 90.24% in the tympanoplasty with cortical mastoidectomy group.
There was no signicant difference in the graft uptake rates of the two groups. The P value was >0.05, suggesting that tympanoplasty without
cortical mastoidectomy is as benecial as tympanoplasty with cortical mastoidectomy. There was no signicant difference in hearing gain between
the two groups as p value obtained was >0.05. Conclusions:The tympanoplasty without cortical mastoidectomy is as benecial as tympanoplasty
with cortical mastoidectomy, as the results of the graft uptake and hearing improvement show no signicant difference between two groups
AWARENESS OF ORAL CANCER AMONG DENTAL STUDENTS; CROSS SECTIONAL STUDY AT A TERTIARY DENTAL CARE CENTRE
Authors: A G Deepa , G Nair Resmi , G Indu , S Sudha
Published: August 2023

Background The role of dentists is of prime importance in the early detection of oral cancer which would result in a favourable outcome for the
patients. The aim of the present study was to assess the awareness regarding oral cancer among undergraduate students of a tertiary dental care
centre in Kerala. Methods A cross-sectional descriptive survey was conducted among the undergraduate students and house surgeons using a self
administered questionnaire comprising of 13 questions to assess the awareness related to risk factors, clinical presentation, and treatment options.
Data was entered in MS Excel and analyzed using SPSS software version 22. Descriptive statistics was used to summarize the data and percentage
of students responding to various options in questions. Association between variables was assessed by Chi square test. P<0.05 was considered
signicant. Results: A total of 184 dental students responded to the questionnaire. Most of them were well aware of the risk factors, clinical
presentation and prevention of oral cancer. Signicantly more number of nal year students and house surgeons were condent in identication of
OPMD than second and third year students. 97.3% of students said they need additional training in oral cancer screening and biopsy. 94.6%
respondents were aware that HPV can cause oral cancer. Conclusions: The participants of the study had adequate knowledge of risk factors,
clinical presentation and prevention of oral cancer. However, majority of students requested for additional information on oral cancer screening
and biopsy
A COMPARATIVE STUDY OF UMBILICAL CORD BLOOD LIPID PROFILE BETWEEN NORMALAND LOW BIRTH WEIGHT BABIES IN A TERTIARY CARE HOSPITAL
Authors: Prakash Meena Chandra , Haridas Chippy
Published: August 2023

Background: Lipid prole is a marker of an underlying cardiovascular status. Studies have shown that SGA babies had abnormal lipid prole
compared to AGAbabies. There are many studies showing the direct relationship between the abnormalities in lipid prole among the SGAbabies
and occurrence of cardiovascular diseases. The present study was undertaken for early detection of abnormalities in the lipid prole at the earliest.
Objective:To know the abnormalities in the cord blood lipid prole in low birth weight neonates compared to normal birth weight. Materials and
Methods:The present Cross-sectional study was conducted by the department of Pediatrics Shrimati Heera Kunwar Baa Mahila hospital Jhalawar
from January 2023 to Marh 2023. Atotal of 100 study subjects were enrolled in the study and 50 subjects in each group weighing more than 2.5 kg
and 50 subjects weighing less than 2.5 kg. Results: Cord blood Lipid prole values for TG, and VLDL were signicantly higher in low-birthweight babies compared to normal birth weight babies. Cord blood lipid prole values for TC, HDLand LDL were not signicantly higher in lowbirth-weight babies. Conclusion: A fetus receiving inadequate nutrition has to make adaptations in order to survive and may be prone to hyperlipidemia. Thus, strategy to prevent coronary heart disease must include measures to improve fetal growth and early detection of hyperlipidemia with dietary intervention during infancy and later childhood
A PILOT STUDY TO SEE THE FEASIBILITY, SAFETY AND EFFICACY OF CONCURRENT PACLITAXELAND CISPLATIN IN PATIENTS OF LOCALLY ADVANCED CARCINOMA CERVIX, BEING TREATED WITH CONCURRENT CHEMO RADIATION
Authors: Biswas Susmita , Maiti Das Sumana , R Shenoi Lekshmi
Published: August 2023

Introduction: Carcinoma cervix, is the second most common cancer among Indian women (As per Globocon 2018). India alone accounts for one
quarter of the world wide burden of carcinoma cervix. Cervical cancer is on declining trend in India according to the population based registries.
The standard treatment for locally advanced (stage IIB to IVA) carcinoma cervix is cisplatin based chemo-radiation.Aims: This study is directed to
evaluate the efcacy, feasibility of concurrent paclitaxel plus cisplatin in locally advanced carcinoma cervix, to assess tumour response at rst
follow up and subsequent follow ups by clinical examination and RECIST 1.1, and most importantly to evaluate the toxicity – according to RTOG
(The Radiation Therapy Oncology Group) acute and chronic toxicity area. Materials and method: Single institutional, single arm, prospective,
interventional, non-randomized, pilot study, among patients of locally advanced carcinoma cervix, similar to phase II trial revealing feasibility,
efcacy and toxicity of proposed treatment. Result: During the treatment almost all patients needed blood transfusion for decrease in hemoglobin
percentage from baseline. (Hematologic toxicity) 17 (56.7%), patient's peripheral blood picture had shown myelo-suppression of Grade II (low
total leucosite count). But patients remained afebrile. Almost all the signs and symptoms disappear one week after completion of EBRT. Complete
response(CR) – 28/30(93.3%) Conclusion: We conclude that, a concurrent chemo radiation regime Cisplatin (40mg /m2) with Paclitaxel (35mg
/m2) produced satisfactory short-term efcacy with relatively tolerable acute toxicities and feasibility among women attending our institute
COMPARATIVE EVALUATION OF UNILATERAL SPINALANAESTHESIAAND SCIATIC- FEMORAL NERVE BLOCK WITH BUPIVACAINE AND CLONIDINE IN BELOW KNEE SURGERY
Authors: L Arakkal Akhila , Agrawal Chetan , Jewelikar Suhas , Chandran P K Naveen
Published: August 2023

Background: This is a prospective randomized comparative study to compare the efcacy and safety of unilateral spinal anaesthesia and sciatic
femoral block by using 14 parameters Methods: 60 patients undergoing unilateral below knee surgery were randomly allocated into 2 groups.
Group Areceived unilateral spinal anaesthesia with injection Bupivacaine 0.5% heavy 1.3 ml + injection Clonidine 45µg. Group B received sciatic
femoral block. 25ml of test solution ( injection bupivacaine 0.5% 30ml + injection Clonidine 45 µg + distilled water 10ml) used for sciatic block
and 15ml for femoral block. Results: Unilateral spinal anaesthesia was easier to perform. Onset and complete achievement of sensory and motor
blockade is faster with unilateral spinal anaesthesia. Duration of sensory and motor block was prolonged in sciatic-femoral block, so the
requirement of rst rescue analgesia was prolonged in sciatic-femoral group. Both procedures had hemodynamic stability. Quality of anaesthesia
was excellent with unilateral spinal anaesthesia and no intraoperative supplementation was required in this group when compared to sciaticfemoral group. No signicant adverse effect noted in either group. Patient and surgeon satisfaction were better with unilateral spinal anaesthesia
group. Conclusion: Unilateral Spinal anaesthesia is a better choice than sciatic-femoral block .When central neuraxial blockade is contraindicated
Sciatic-femoral block can be considered as an alternative procedure. Use of ultrasound for sciatic-femoral block can increase the success rate and
decrease the time taken for the procedure and increase the acceptance of the procedure.
STUDY OF SERUM CARDIAC TROPONIN I IN BIRTH ASPHYXIA AND IT'S CORRELATION WITH HYPOXIC ISCHAEMIC ENCAPHALOPATHY IN NEWBORNS
Authors: Arif Hussain Mohd , Verma Ashish , Abbas Jaigam , Qureshi Jasim
Published: August 2023

Introduction- WHO dene birth asphyxia as failure to initiate and sustain breathing at birth. Perinatal asphyxia leading to Hypoxic ischemic
encephalopathy is a common problem causing multi organ dysfunction including myocardial involvement which can affect the outcome. Cardiac
Troponin-I, a marker of myocardial injury, has been shown to be high in asphyxiated neonates as compared to healthy neonates. Moreover, it has
also been reported to have an association with adverse outcomes and mortality. Cardiac troponin-I has been shown to be good predictors of HIE in
neonates and has been shown to have a strong correlation with clinical grade of HIE. This prospectiv Material & Methods- e cohort study was
conducted on patients admitted in NICU of Department of pediatrics of CIMSH, Lucknow. In our study(n=60), term asphyxiated neonates with
APGAR <7 at 1min were included. -The total 60 asphyxiated neonates had HIE. Pre Result valence of HIE stage I, II and III was 43.3%, 25% and
31.7% respectively. Mean cardiac Troponin-I levels were 0.56±0.57, 1.73±1.07 and 3.71±0.76 ng/ml respectively in HIE Stage I, II and III cases,
thereby showing a signicant incremental trend with increasing HIE stage. Ca Conclusion- rdiac Troponin-I not only showed a signicant
correlation with increasing HIE and it was highly useful in prediction of higher stages of HIE and NICU mortality. The ndings of the study show a
high potential of cardiac Troponin-I as a marker of HIE severity and outcome in birth asphyxiated neonates.
A CORRELATION STUDY OF SEROLOGY AND HISTOPATHOLOGY IN ALLERGIC RHINO - SINUSITIS
Authors: Vani. B Aparna , Chandra Sekhar SBV. , Venkatram Reddy N. , Indira Devi S. , Rama Krishnaiah P.
Published: August 2023

Aim Of Study : To correlate Serum Total Ig-E, Absolute Eosinophil Count (AEC) and eosinophils in nasal and pharyngeal smear in the patients
with allergic rhino-sinusitis .
Objectives:
Ÿ To determine the serum total Ig-E level in patients with Allergic Rhino-sinusitis
Ÿ To determine the absolute eosinophil count (AEC) in patients with Allergic Rhino- sinusitis
Ÿ To study eosinophils in Nasal and pharyngeal smear in the patients with Allergic Rhino-sinusitis
Ÿ To correlate all the above three parameters in patients with Allergic Rhinosinusitis
Results : The mean age was 30.63± 10.08 years consisting of 42 females and 38 males. In majority of the subjects the signs and symptoms were
sneezing, rhinorrhea, nasal blockage and itching of the ear. Among the 80 subjects 19 of them had deviated nasal septum and hypertrophy of
turbinate's. Half of the subjects reported secretions in the nasal cavity.
1. In the study the mean Ig E levels was 560.58± 361.74 (UI/l).
2. Mean absolute eosinophil count was 558.46± 459.28 (cells/mcL).
3. Smear for eosinophil was positive in only 4 subjects.
There was no statistical difference when the IgE levels were compared with the smear. All the four patients with smear positive for eosinophil had
elevated AEC which statistically signicant (p=0.01). a moderately strong positive correlation was seen between Ig E levels and eosinophil count.
Conclusion: Both NSE and Ig-E had strong relationships with the disease's severity. A straightforward procedure with a strong association to the
severity of the clinical score is nasal smear cytology, which should be utilized frequently. Measuring serum Ig E levels will improve diagnostic
value, increase the accuracy
IMPACT OF BIOLOGICS ON INNER-CITY PATIENTS WITH SEVERE PERSISTENT ASTHMA IN AN OUTPATIENT PULMONARY CLINIC
Authors: Jog Abhishrut , Jiang Cindy , Venkatram Sindhaghatta , Huggins Charnicia , Diaz-Fuentes Gilda
Published: August 2023

Background: The prevalence of asthma in New York City is around 9.5%, which is higher than the national average. The highest asthma mortality and morbidity in New York State is in the Bronx. Patients with severe, poorly controlled asthma despite maximal therapy with controller medications may be eligible for biological therapy. Use of approved asthma biologics reduce asthma exacerbation rates by roughly 50% compared with placebo. The purpose of the study was to evaluate the impact of biological in patients with asthma in an underserved inner-city community. Methods: This was a retrospective observational study of adult patients managed with biological therapy in a pulmonary clinic from March 2017 to September 2022. We included all patients with severe persistent asthma who completed at least three months of treatment with benralizumab, mepolizumab, dupilumab, or omalizumab. Outcome measures included asthma control assessed with the Asthma Control Test (ACT), rate of asthma exacerbations and related ER visits, and need for systemic steroids. Results: Thirty-one patients met inclusion criteria; 22 (71%) Hispanic, and 5 (16%) African-American. There were 23 (74%) females and the mean age of the cohort was 55 years. Mean adherence to biological treatment was 83.8%. Asthma control by ACT increased from a mean of 13.7 to 17.2 (p= 0.0002). The total exacerbations decreased from 4.28 to 1.8 (P= 0.0003) and the number of patients requiring systemic steroids for exacerbation decreased from 29 to 10 (p<0.0001). Conclusions: Use of biological in patients with severe asthma in an inner-city population is feasible. Adherence is comparable and even higher than in other groups of reported asthma patients. Biologics improve asthma control and exacerbation frequency.
ROLE OF MRI IN EVALUATION OF BRACHIAL PLEXUS PATHOLOGIES
Authors: Salwa Ayath Ayesha , Masimade Suresh
Published: August 2023

MRI is an important noninvasive imaging modality which has a very high sensitivity due to its excellent soft tissue resolution. The objective of the
study is to evaluate the traumatic and non-traumatic causes of brachial plexus pathologies of the upper limb like involvement of the roots, trunks,
divisions, cords by Pancoast tumor, trauma, radiation plexitis, inammatory plexitis, thoracic outlet syndrome, metastatic inltration, lymphoma,
nerve sheath tumour exiting nerve root compression and iatrogenic injury, to study the various MRI appearances of the above mentioned causes, to
evaluate the extent of the cause and its relationship to adjacent structures, to compare CT ndings with pathological ndings where ever possible, to
study the limitations if any, in the MRI in evaluation of radiating upper limb pain. To study the various MRI appearances of Aims & Objectives:
traumatic and non-traumatic brachial plexus pathology. Methodology: The study included of 30 patients referred to department of radiodiagnosis
with traumatic and non-traumatic pathologies of brachial plexus over a period of 18 months. All patients were subjected to MRI using 1.5T philips
achieve MRI machine. 30 patients who were clinically suspected of brachial Results: plexus pathology were subjected to MRI imaging. Among
these 30 patients, in general, patients in the middle age group constituted 62% of the total study group, with an overall slight male predominance
77%. Most common clinical presentation was unilateral upper limb weakness66%. Conclusion: MRI has become increasingly important in the
evaluation of brachial plexus pathology, owing to the improved soft tissue resolution with MRI not only can the nerve roots of the brachial plexus be
visualized but also the trunks, divisions, cords and also characteristics such as course, caliber, signal intensity, fascicular pattern and size can be
better evaluated. Additionally improved size tissue differentiation allows for improved detection of intrinsic and extrinsic pathology. MRI also has
the additional benet for multiplanar imaging.
SECOND-GENERATION PRESCRIPTION ANTIHISTAMINES IN CANADA: AN EVIDENCE-INFORMED REVIEW
Authors: JW Lamoure. , M Kuprowski , J Rao , Maini. M Al
Published: August 2023

Prescription antihistamines have been available in Canada for over fty years, starting with rst generation medications such as pyrilamine
released during World War Two, with the rst second-generation antihistamines commercially appearing in the 1980's. (1) Based on Canadian
market growth assessments, antihistamines are an estimated $120 million market, representing over a dozen dedicated prescription and nonprescription (over-the-counter (OTC)) molecules. (2) There are a great number of other non-antihistamine molecules that have direct and indirect
afnity for the histamine receptors. (3,4) Secondary to environmental, physiological and co-morbidities, this sector is experiencing an annual
growth rate of just under 10%. (2) For registration trials, all antihistamines meet standards and are assessed for non-inferiority against an industry
standard such as diphenhydramine. (5,6) Despite having condence regarding non-inferiority across the antihistamines, it is important to go
beyond this evidence-based parameter to a patient-focussed evidence-informed approach. (7) This is because not all prescription antihistamines, or
necessarily any and all “non-inferiority” medications are created or work alike in the human body. Each molecule has their own molecular
“ngerprint” that has physiological and immunological responses through slightly different mechanisms that go beyond histamine mitigation. (8)
Evidence-informed medicine allows us to address triggers and cascade management leading to histamine release requires a robust multi-factorial
assessment, which includes autoimmune, mast cell, cytokine, and environmental components. (9) Other factors that should be considered include
patient specic goals, dietary habits, past allergen exposures, genetics, cross-allergenicity, other medications, and other medical conditions beyond
the allergen and subsequent histamine release. (10) Appropriate second-generation antihistamine selection often becomes quite patient-specic
and intricate beyond the standard non-inferiority evidence-based histamine mitigation studies. (7,9,10)
AN OBSERVATIONAL STUDY ON SPIROMETRY FINDINGS IN POST COVID PATIENTS
Authors: Agarwal Vaidehi , Mahmood Tariq , S Akarsh
Published: August 2023

Background and Objectives: Information on effects of SARS-CoV-2 virus on patients 6 months post infection is still lacking. We aimed to
evaluate the spirometry changes in 153 patients at least 6 months after covid infection to gain some insight into the effects of the viral infection on
lung function. Methods:We studied 153 Post Covid patients presenting in our large tertiary care center in Northern India. Spirometry was done on
all of them. The results were evaluated using Chi-Square test and Independent-t test to compare the difference in oxygen and non oxygen groups.
Results: The results showed statistically signicant difference between the two groups. Out of the 68 patients that were not put on any oxygen
support during covid infection, 44 had a normal pulmonary function test (PFT) and 24 had abnormal ones with most (17) being of restrictive
pattern. Out of the 85 patients requiring oxygen support, none had normal PFT. Restrictive changes were present in 62 of them with the rest being of
obstructive or mixed pattern. Interpretations and Conclusion: Covid-19 infection has long term effects on lung function. Patients on oxygen
support had a more severe effect on their lung function in terms of volume restriction in comparison to patients not on oxygen support, though they were not totally spared.
STUDY OF ECHOCARDIOGRAPHIC PATHOLOGY IN PATIENTS WITH CHRONIC KIDNEY DISEASE IN RURAL NORTH INDIA
Authors: Manoj kumar S. , Vigna Suma Lohith Kavuri , Srivastava Nitin , Kumar Pawah Anil
Published: August 2023

Background: Cardiovascular disease (CVD) is leading cause for increase of patients with Chronic Kidney Disease(CKD). This increased risk of
CVD may begin during early stage of CKD much before the onset of kidney injury. Apart from cardiovascular disease, Diabetes, and Hypertension
is also a cause and effect of CKD. To evaluate and analyze echocardiographic Objectives: changes in patients with CKD and to determine the
quality of life of people by knowing the prevalence of Echocardiographic changes in chronic kidney disease patients. A total of 60 CKD Methods:
patients admitted to the Mayo Institute of Medical Science, Barbanki from January 2022 to December 2022, were included in this study. The
patients were evaluated as per the history, physical examination, systemic examination, Serum Creatinine, Blood Urea, Urine Routine,
Electrocardiograph (ECG) and Echocardiography. In the present study echocardiographically dete Results: rmined cardiovascular abnormalities
were observed in 80% of patients. Left Ventricular Hypertrophy (LVH) in 50% patients. LVH and Ischemic Heart Disease in 20%, Ischemic heart
disease (IHD) 9%, Pericardial effusion in 5.0%, dilated cardiomyopathay in 10%, Septal hyperthrophy in 2.0% is observed. LVH is Conclusion:
the most common morphological abnormality observed. In our center, we were able to diagnose that IHD patients by echocardiogram and referred
them for coronary artery intervention promptly and we could screen CKD patients before undergoing renal transplant to detect and correct
Coronary Artery Disease (CAD) and an echo is a tool to detect Pericardial Effusion and to advise pericardiocentesis and adequate dialysis.
“COMPARISON OF APICAL MICROLEAKAGE OF BIOCERAMIC SEALERS & EPOXY RESIN BASED SEALER USING DYE EXTRACTION LEAKAGE METHOD”
Authors: K S Sachin , K Shibani , K B Jayalakshmi , Bhat Sujatha
Published: August 2023

Background: This study aimed to evaluate the apical sealing ability of two Bioceramic Endodontic Sealers, CeraSeal RCS, and BioRoot RCS
compared to AH plus resin based sealer using dye extraction leakage method. Thirty human single-rooted teeth were selected and were decoronated
at 12 mm length and instrumented using the crown down technique with the Micromega Hero shaper to apical le size 40 with 0.04 taper. The roots
were randomly divided into three experimental groups: Group A (n=10) contained roots that were obturated with CeraSeal RCS . Group B (n=10)
contained roots that were obturated using BioRoot RCS. Group C (n=10) contained roots that were obturated using AH PLUS sealer. Apical
microleakage was assessed with dye extraction method where the absorbance of leaked 1% methylene blue dye was measured using a
spectrophotometer. The absorbance values were converted into concentrations using Beer's law. One-way ANOVA test followed by Tukey's HSD
Post hoc Analysis was used to compare the mean Dye concentrations between the three groups. The test results showed that AH Plus Conclusion:
sealer group showed signicantly lesser Dye Concentration as compared to Ceraseal & BioRoot RCS groups at p≤0.001. However, no
signicant was observed in mean Dye Concentration between Ceraseal & BioRoot RCS groups [p≤0.78].
COVID-19 IN UROLOGICAL PATIENTS: EFFECTS ON BPH DEVELOPMENT, LUTS OCCURRENCE, AND PREDICTORS OF ACUTE URINE RETENTION
Authors: Pavlović Katica , Zalihić Amra , Zalihić Dino , Mabić Mirela , Tomić Davor , Džida Sanja
Published: August 2023

Introduction: The paper aims to research how the Covid-19 infection affects BPH patients, whether their PSA, prostate volume, residual urine, and quality of life have changed. Additionally, to examine whether any of these variables are a predictive factor for acute urinary retention (AUR). Methodology: The study comprised 80 patients with clinical manifestations of LUTS, an aggravation of previously diagnosed BPH, and who recovered from COVID-19. IPSS, QoL, PSA, prostate volume, and postmicturition residual urine were studied before and after COVID-19. Results: The IPSS score, PSA, prostate volume, and residual urine were signicantly higher after recovering from COVID-19. Additionally, greater IPSS-QoL scores were discovered. Nine patients (mostly older than 60) suffered acute retention during or after the COVID-19 infection. Residual urine was found to be a signicant predictor of AUR. Conclusion: COVID-19 infection is caused by aggravating LUTS symptoms associated with BPH. Consequently, the increase postmicturition residual urine can be considered a predictive factor for the occurrence of AUR
NEONATAL MORBIDITY AND MORTALITY PATTERNS IN NICU AT TERTIARY CARE HOSPITAL, KARNATAKA
Authors: Ali Malagi Naushad , Vinod Kumar Vallam , N.Thobbi A.
Published: August 2023

Introduction: Despite Imorovements In Perinatal Care,there Is Still A Highrate Of Neonatal Morbidity And Mortality In Developing Nations
Like India. Neonatal Period Is Dened As Upto First 28 Days Of Life. Aims And Objective: To Study The Morbidity And Mortality Pattern In
Nicu, To Determine The Cause And Disease Pattern Of Neonatal Morbidity And Mortality In Nicu At Tertiary Care Hospital ,karnataka. Materials
And Methods: Observational Prospective Study Done With Sample Size Of As Many Babies Admitted In Nicu At Tertiary Care Hospital. During
24 Months Period Of Study. Data Will Be Collected Based On Babies Admitted With Respect To Gestational Age, Weight, Day Of Life. Results:
Total Of 1200 Neonates Were Included In The Study During Period Of January 2021 To January 2023. The Data Analysis For Morbidity Showed
That Respiratory Distress Syndrome 24.6%, Birth Asphyxia With Hie 18.7%, Jaundice 17.5%, Sepsis 12.3%,meconium Aspiration Syndrome
4.7%, Major Congenital Anomaly 3.4%, Respiratory Distress(other Causes) 1.8%, Others 17.3%. The Disease Wise Mortality Among Neonates
Admitted To Nicu Was Studied And Were Found That Respiratory Distress Syndrome 35.5%, Birth Asphyxia With Hie 25.4%, Sepsis 23.3%,
Major Congenital Malformations 6.1%, Meconium Aspiration Syndrome 5.5%, Others 4.1%. Conclusion:The Commonest Causes Of Admission
Were Respiratory Distress Syndrome, Birth Asphyxia, Jaundice, Sepsis, Meconium Aspiration Synndrome, Major Congenital Anomaly. The Most
Common Causes Of Mortality Was Respiratory Distress Syndrome, Birth Asphyxia, Sepsis, Major Congenital Malformation.
A RARE CASE OF LUNG ABSCESS COEXISTING WITH BRONCHOPLEURAL SUBCUTANEOUS FISTULA
Authors: Riaz Mohammed , Ravichandar Sabarinath , Kishan Roopesh
Published: August 2023

Lung abscess usually considered primary arising from lung parenchyma and is secondary when it's complicates from another underlying mechanism such as vascular emboli or rupture of extra pulmonary abscess into lung[2].The co-existence of lung abscess with bronchopleural subcutaneous stula is not common and with its variable presentation it becomes difcult to manage as such[6].In this case study we hereby refer to the coexistence of Lung abscess with Bronchopleural subcutaneous stula where early recognition and management resulted in favourable prognosis, preventing complications
“A PROSPECTIVE STUDY OF FUNCTIONAL OUTCOME OF BICOLUMNAR PLATING IN TYPE C2 AND C3 DISTAL FEMUR FRACTURES”
Authors: K. J. C Chidanand , Lokesh Lokesh , Nagaral Basanagoud , K.O Varun
Published: August 2023

Objectives: To evaluate the functional and radiological outcome of comminuted type c2 and c3 fractures of distal femur treated by distal femur
bicolumnar plating. our study consists of 15 cases of comminuted type c2 and c3 fract Methods: ures of distal femur operated at Sanjay Gandhi
institute of trauma and orthopaedics from july 2020 to December 2022. Functional outcome was assessed through neers scoring system. Results:
15 patients with comminuted metaphseal distal femur fractures muller type c2 –subtypes 6 and c3 subtypes 9 patients were studied. mean age of the
patients was 45.5 years with age ranging from 20 years to 80years. 9 cases involved the right femur and 6 left sided femur was involved. we have
treated the fracture with lateral and medial locking compression plates and all patients were operated with standard open lateral approach for lateral
plating and anteromedial approach for medial plating. average surgical procedure timing was 119.5 minutes in our study. most of the patients had
excellent postoperative knee exion with average knee exion of 110 degrees. average duration of radiological union was 18 weeks and average
duration of weight bearing was 20 weeks. The nal outcome was assessed according to neers scoring system. Complications include supercial
wound infection, knee pain , stiffness and shortning in 5 patients. Comminuted distal Conclusion: femur fracture needs bicolumnar xation with
plates and screws to achieve bone healing and restore function of the affected limb in shortest time without compromising stability. The advantage
medial augmentationwith plating is early weight bearing and butressing of communitted fragments,stable internal xation that does not allow
varus collapse, malunion and further implant failure
A REPORT OF ROLE OF INTRASTROMAL VORICONAZOLE INJECTION IN CASE OF FUNGAL CORNEAL ULCER
Authors: Adole Disha , Shinde Chhaya , Garthe Shubhangi , Parsawar Shweta
Published: August 2023

Fungal corneal ulcer is a leading cause of blindness.This are very difcult to treat due to poor penetration of topical antifungal drugs .A Case of
culture proven fungal ulcer , not responding to combination of topical 5% natamycin and 1% voriconazole was treated with intrastromal
voriconazole (50 mg/0.1 mL) injected in 4 divided doses around the the circumference of the ulcer. Total 3 doses of intrastromal voriconazole (50
mg/0.1 mL) were injected. Before intrastromal voriconazole injection ,case were gradually worsening .After injection there is improvement in in
terms of decrease in size of ulcer, hypopyon , and inltration was noted within 1 week.
BENIGN AND MALIGNANT TUMOURS OF NOSE AND PARANASAL SINUSES A CASE SERIES
Authors: Parmar Deepak , Sharma Jyoti , Raj Kumkar Rishi
Published: August 2023

Background- A variety of neoplastic and non neoplastic conditions involving the nasal cavity,Paranasal sinuses and nasopharynx. It is mandatory
for ENT surgeons to take detailed history and thorough examination before reaching nal diagnosis.Tumours of nose and paranasal are rare
entities. This is a case study of 11 patients with c/o nasal obstruct Methods- ion , bleeding with sinonasal mass. Treated in Govrnment medical
college from period of January 2022 to March 2022.Purpose of this study to evaluation of sinonasal masses by proper history taking and physical
examination followed by diagnostic nasal endoscopy and radiological investigations like X RAY and CECT PNS and MRI. conrmation of
diagnosis by biopsy taken from the sinonasal mass and histopathological examination.Treatment by combination of surgery, radiotherapy,
chemotherapy depends on the type of tumour and its extension. Total 11 patients were Results- analysed, 6 benign and 5 malignant, Majority of
patients were in age group 20-60 years. MC gender are male. sinonasal masses ha Conclusion- ve various different diagnosis ,common in male,
peak during 2nd -6th decade.
SAFE TRAVEL / COMMUNTE DURING PREGNANCY
Authors: Jeyachandran Muneeswari
Published: August 2023

Pregnancy is a unique, exciting and often joyous time in a woman's life, as it highlights the woman's amazing creative and nurturing powers while providing a bridge to the future. Pregnancy comes with some cost, however, for a pregnant woman needs also to be a responsible woman so as to best support the health of her future child. During pregnancy period, all women would like to travel anywhere or favorite places to explore the new things to the new arrival baby or supposed to go work in daily basis
Enfermedad pulmonar obstructiva crónica sus biomarcadores y pronóstico
Authors: Cardona Lázaro María José
Published: August 2023

PROBLEMA: la enfermedad pulmonar obstructiva crónica ha estado presente durante décadas en la humanidad, se encuentran un estimado de 210 millones de personas diagnosticadas con esta enfermedad y es considerada como la cuarta causa de muerte a nivel mundial. OBJETIVO: definir la enfermedad pulmonar obstructiva crónica, sus biomarcadores y pronóstico. MÉTODO: para el desarrollo del estudio de carácter documental se realizó una revisión bibliográfica basada en fuentes primarias y secundarias para su debido análisis e interpretación desde la perspectiva del autor. RESULTADOS: la enfermedad pulmonar obstructiva crónica es de carácter multifactorial y la presentación clínica es heterogénea, con una alta tasa de morbimortalidad. Se requiere el uso de pruebas complementarias como biomarcadores los cuales pueden ser sistémicos y/o pulmonares, estos marcadores asociados a una interpretación adecuada servirá para determinar un tratamiento, según el fenotipo clínico que se presente. CONCLUSIÓN: la enfermedad pulmonar obstructiva crónica es una de las enfermedades más infra diagnosticadas, el uso de biomarcadores con su respectiva interpretación es una herramienta de vital importancia para un tratamiento exitoso, en base al fenotipo clínico y resultados de los biomarcadores tendrán un impacto a corto, mediano y largo plazo en el pronóstico y calidad de vida del paciente.
Síndrome de muerte súbita del lactante
Authors: Yaque López Alma Judith
Published: August 2023

PROBLEMA: El Síndrome de Muerte Súbita del Lactante (SIDS) se define como la muerte súbita del lactante de menos de un año, cuya causa permanece inexplicada después de una minuciosa investigación del caso que incluye autopsia completa, examen del lugar de fallecimiento y revisión de historia clínica. OBJETIVO: Describir el Síndrome de Muerte Súbita del Lactante. MÉTODO: Se llevó el proceso sistemático de investigación documental en el cual se expone de forma argumentativa, mediante la creación de una monografía sobre Síndrome de Muerte Súbita del Lactante. RESULTADOS: Los factores de riesgo asociados con la madre son la carencia de cuidados prenatales y control durante el embarazo, no brindar lactancia materna, postura del lactante durante el sueño, superficie firme para dormir, sobrecalentamiento ambiental, tabaquismo, aspectos socioeconómicos y paridad superior a los tres hijos; los asociados con el lactante son antecedente de un hermano mayor fallecido, problemas genéticos, prematuridad y bajo peso al nacer; y los ambientales: una posición incorrecta al dormir, el ambiente del dormitorio y no cumplir con el esquema de inmunización adecuado para su edad. CONCLUSIÓN: Para prevenir el Síndrome de la Muerte Súbita del Lactante, es importante la manera en la que se coloca al infante a la hora de dormir, amamantar exclusivamente, evitar el tabaquismo y mantener un control prenatal adecuado.
El ácido ascórbico en el tratamiento de vaginosis recurrente
Authors: Lemus López Juan Carlos
Published: August 2023

PROBLEMA: La vaginosis Bacteriana es una enfermedad que afecta de manera recurrente a la mayoría de mujeres en edad fértil, principalmente durante el embarazo llevando a ser factor de riegos para muchas complicaciones prenatales tanto corioamnioitis, ruptura prematura de membrana. Esto ha dado lugar al mejoramiento del tratamiento de esta patología, y utilización de otros medicamentos coadyuvantes como el ácido ascórbico que tiene una gran eficacia a la regulación del pH vaginal y por tanto mantener la flora vaginal estable. OBJETIVO: Describir el ácido ascórbico en el tratamiento de vaginosis bacteriana recurrente. METODO: Se realizó una investigación de carácter documental con la utilización de literaturas y publicaciones científicas preexistentes en motores de búsqueda de libre acceso como Elservier, PubMed o The New England para describir el ácido ascórbico en el tratamiento de vaginosis recurrente. RESULTADOS: El ácido ascórbico en el tratamiento de vaginosis intestinal que, por su mecanismo de acción antioxidante, vuelve a niveles normales el pH manteniendo la acidez y así mismo con mejor rapidez ocasionando que la recurrencia disminuya y que la flora vaginal se mantenga siempre en condiciones óptimas. CONCLUSION: El ácido ascórbico en el tratamiento de vaginosis bacteriana recurrente es una buena opción ya que mejora el nivel de pH a nivel vaginal por su mecanismo de acción antioxidante y antiescorbuto, eso mejora la flora vaginal teniendo más defensas y evita la recurrencia de esta patología principalmente en las mujeres con vida sexual activa y mujeres embarazas.
Uso de rifaximina en síndrome de intestino irritable
Authors: Cerón Valdez Hilda Alejandra
Published: August 2023

PROBLEMA: De todas las consultas al área de gastroenterología del 25% al 50% corresponden al Síndrome de Intestino Irritable. Es un padecimiento que disminuye la calidad de vida del adulto y su productividad. Debido a su base multifactorial y biopsicosocial, este padecimiento conlleva un manejo amplio y multidisciplinario, además que dicho manejo es personalizado para cada paciente, según la presentación de los síntomas y las necesidades de el mismo.  OBJETIVO: Determinar la eficacia de la rifaximina en síndrome de intestino irritable. METODOS: para el desarrollo del estudio se realizó una revisión bibliográfica, basada en fuentes primarias. RESULTADOS: La rifaximina ha mostrada en diversos estudios una alta eficacia y seguridad para el alivio de los síntomas que engloban al SII, igualmente se ha demostrado una remisión de síntomas de entre 2 a 3 meses después de un tratamiento con 550mg cada 8 horas por 10 a 14 días y presentar una tasa baja de resistencia microbiana. CONCLUSIÓN: Los 2 grandes ensayos de fase 3, que sirvieron de base para que la rifaximina obtuviera la aprobación de la FDA fueron TARGET-1 y TARGET-2 en donde los resultados obtenidos fueron qué más pacientes en el grupo de rifaximina se aliviaron de los síntomas globales del SII que en el grupo de placebo, por lo que se consideró que era un tratamiento seguro y eficaz para estos pacientes.
Spinal Anesthetic Management for Proteus Syndrome: A Case Report
Authors: Shin Kiyoung , Bae Jangho , Daehun Goh , Giyong Yoon , Kang Seongsik
Published: August 2023

Proteus syndrome is a rare, complex, and progressive disorder characterized by tissue overgrowth, deformities, and vascular anomalies. We present a case of a 56-year-old patient with Proteus syndrome who underwent successful incision and drainage an ulcerative lesion on a Cerebriform connective tissue nevus on the left plantar surface under spinal anesthesia. The patient had a history of mild lumbar scoliosis and a previous hospitalization for pulmonary embolism. Due to the patient's difficult airway and increased risk of thromboembolism, spinal anesthesia was chosen as the anesthetic technique. The procedure was carried out without complications, and the patient had a satisfactory postoperative recovery.