An official publication of Gujarat Adani Institute of Medical Sciences Published by: Gujarat Adani Institute of Medical Sciences G K General Hospital Opposite Lotus Colony Bhuj, Kachchh, Gujarat – 370001
Gujarat Adani Institute of Medical Sciences
Decoding the Triglyceride/HDL-C Ratio: A Marker for Type-2 Diabetes Risk
Background: Diabetes mellitus (DM) is the most common endocrine disorder worldwide. Beyond the established markers of glycemic control and insulin resistance (IR), there remains a need for reliable, accessible, and reproducible indicators. To address this, our study evaluated the triglyceride to HDL cholesterol ratio (THR) as a potential marker for insulin resistance and glycemic regulation. Materials and methods: We retrospectively analyzed TG, fasting serum glucose (FSG), and fasting insulin levels from 953 samples processed between March and August 2024. Based on homeostasis model assessment-estimated insulin resistance (HOMA-IR) values, patients were categorized into two groups: good versus poor glycemic control. The discriminatory power of the triglyceride-to-HDL cholesterol ratio (THR) for differentiating these groups was evaluated using Receiver operating characteristic (ROC) analysis, with statistical significance set at p<0.05. Furthermore, multivariate logistic regression analysis was performed. Results: The mean age of participants was 40.83 ± 16.78 years. Significant differences (p<0.001) were observed between patients with good and poor glycemic control in gender, FSG, HOMA-IR, FI, TG, and THR, but not in age (p=0.613). Pairwise correlation showed THR had a moderate negative correlation with HDL (r=-0.555, p<0.001) and a strong positive correlation with TG (r=0.959, p<0.001). With a cutoff value of ≥2.64, THR demonstrated high selectivity and positive predictive value (PPV) (AUC=0.72; Se=65%; Sp=70%; p<0.001; 95% CI: 0.66–0.78). Men were 2.247 times more likely than women to exhibit poor glycemic control (p=0.022). The risk of poor control increased by 1.045-fold with age and 1.056-fold with glucose (p=0.007). Conclusion: Based on our findings, the THR appears to be a promising marker for assessing glycemic control and insulin resistance.
Copyright (c) 2025 Asha Gupta, Dinesh Kumar Sharma https://creativecommons.org/licenses/by-nc-sa/4.0
Distribution of ABO and Rhesus (Rh) Blood Groups among Voluntary Donors in Kachchh Gujarat
Background: The ABO and Rh blood group systems are the most important blood group systems in Transfusion Medicine. This study was carried out with an objective to study the distribution of ABO and Rh blood groups among voluntary blood donors in Western Gujarat, India which is essential for effective management of blood inventory. Material and methods: The present retrospective study was carried out at GKGH Blood centre. The data of present study is from 01/01/2024 TO 31/12/2024. Total 19355 voluntary blood donors were considered medically fit and accepted for blood donation. ABO and Rh typing were done by Complete Grouping Card method by Tulip matrix, both forward and reverse blood grouping after validation at blood centre. Results: Out of 11,013 blood donors O blood group was most common (3520-31.96%) and the least blood group was AB Blood group (70-0.63%). There were more Rh-Positive blood donors as compared to Rh Negative blood donors. Conclusion: The most common blood group among voluntary donors was O positive and least common blood group was AB negative.
Copyright (c) 2025 Saniyah Godar, Suman Khoja https://creativecommons.org/licenses/by-nc-sa/4.0
The Influence of Magnesium on Blood Glucose Control
Background: Magnesium acts as a cofactor in glucose phosphorylation and numerous other enzymatic reactions. Its deficiency may contribute to insulin resistance, carbohydrate intolerance, and dyslipidemia. Reduced serum magnesium levels have been linked to the development of diabetic complications, including retinopathy, altered platelet function, cardiovascular disease, and hypertension. The present study aimed to examine the association between serum magnesium levels and glucose regulation. Materials and methods: Data from 256 patients who underwent serum testing for glucose, magnesium, glycated hemoglobin (HbA1c), insulin, and lipid profile between May 2024 and June 2025 were retrospectively analyzed. Based on glucose and HbA1c values defined by the 2017 American Diabetes Association guidelines, participants were categorized into three groups: non-diabetic, prediabetic, and diabetic. Intergroup comparisons were conducted using the Kruskal–Wallis H test and the Mann–Whitney U test. Results: Among the participants, 137 were nondiabetic, 85 were prediabetic, and 34 were diabetic, with median ages (range) of 40 years (24–55), 45 years (35–58), and 48 years (30–57), respectively. Magnesium levels differed significantly between the nondiabetic and diabetic groups, as well as between the prediabetic and diabetic groups (both p<0.001). However, no significant difference was observed between the nondiabetic and prediabetic groups. Patients with insulin resistance (HOMA-IR ≥2.5) had significantly lower magnesium levels (p=0.020). Furthermore, serum magnesium showed a significant negative correlation with glucose (r=–0.244, p<0.001), HbA1c (r=–0.332, p<0.001), and HOMA-IR values (r=–0.162, p=0.010). Conclusion: Magnesium serves as a cofactor for several enzymes involved in carbohydrate oxidation and is essential for glucose transport across the cell membrane. This study found that reduced magnesium levels adversely influenced glucose regulation. Incorporating magnesium-rich foods or providing oral magnesium supplementation may help improve insulin sensitivity in diabetic patients with low serum magnesium.
Copyright (c) 2025 Kiran R Bagale, Dinesh Kumar Sharma https://creativecommons.org/licenses/by-nc-sa/4.0
Prevalence, Clinical Profile and Outcome Predictors in Very Low Birth Weight and Extremely Low Birth Weight Neonates in Tertiary Care Hospital
Background: Neonates with very low birth weight (VLBW) and extremely low birth weight (ELBW) has a much higher chance of experiencing serious health complications or even death. Their results depend on a myriad of newborn and maternal variables. Thus, it is important to assess and treat them specifically. Objective: The goals of this study are to quantify and assess the clinical profile, and to identify factors that are predictive of adverse outcomes of VLBW and ELBW neonates. Methods: This prospective observational research was conducted in the tertiary level neonatal intensive care unit (NICU) from 2022 to 2024. Of the 88 newborns enrolled, information gathered include factors such as birth weight, gestational age, gender, family medical history, prenatal treatment, delivery specifics, clinical trajectory and outcomes. Neonates were treated according to standard treatment guidelines. Results: There was a frequency of 1.10% for VLBW and 0.18% for ELBW. Thrombocytopenia, respiratory distress syndrome, and sepsis were among the most common complications. Results improved when antenatal steroids were used and when ANC visits were sufficient. Comparing ELBW and VLBW infants, the mortality rate was greater in the former (52.94% vs. 23.94%). Low gestational age, pulmonary hemorrhage, DIC, thrombocytopenia, and the requirement for ventilatory support were major indicators of poor prognosis. Conclusion: Neonates born with very low birth weight (VLBW) or extremely low birth weight (ELBW) are at increased risk and should receive intensive prenatal care, the early detection of maternal risk factors, and specialized newborn care. Neonatal intensive care units need to identify factors that can lead to a bad result so that they can allocate resources more wisely and intervene quickly.
VLBW, ELBW, Neonatal Morbidity, Neonatal Mortality, NICU, Gestational Age, ANC, Sepsis, RDS, Neonatal Outcomes
Copyright (c) 2025 Mukundkumar Vaja, Janvi Soni, Dipika Bhil, Jaishree Parmar, Maitri Joshi, Saloni Shah https://creativecommons.org/licenses/by-nc-sa/4.0
Correlation of Gestational Age Assessed by Last Menstrual Period, Antenatal Ultrasonography and New Ballard Score
Background: Determining gestational age (GA) significantly influences the prognosis of newborns. Of the various methods available for gestational age assessment, gestational age assessment by first trimester ultrasonography (USG) as the most reliable method gestational and by LMP (last menstrual period), is next best surrogate. In remote areas and rural settings in Low and Middle Income Countries, the reliability of LMP based GA assessment is questionable due to low literacy rates and less awareness among women and USG is not cost effective. In such a scenario, GA assessment by clinical methods like New Ballard Score (NBS) seems an attractive alternative. Hence this study was conducted to compare the reliability of GA assessments by LMP and NBS as compared to 1st trimester ultrasonography in our institute. Methods: This was a prospective study carried out at neonatal intensive care unit of a tertiary care teaching hospital of western Gujarat, India, from August 2022 to July 2023. A total of 200 neonates with mother having first trimester scan and who recalls LMP were recruited for the study. Gestational age according to first trimester scan was calculated and compared with gestational age according to LMP and NBS. Results: Gestational age by UGS with NBS show significant correlation (p value <0.001) Gestational age by LMP with NBS show significant correlation (p value <0.001) Significant correlation was also observed between gestational age accessed by LMP, first trimester USG and NBS (p value <0.001) Gestational age by UGS with NBS which gave a higher correlation (r = 0.886), Correlation among all three gestational age by LMP, USG and NBS which came out to be lower than previous (r =0.545) and at last Correlation amongst gestational age according to LMP and NBS came out to be lowest (r =0.540). Hence, gestational age by USG comes out to be most similar with gestational age by NBS. Conclusions: In low resource settings and in public sector hospitals, GA assessment by NBS is a more reliable option than LMP, and it closely correlates with GA assessed by USG.
Copyright (c) 2025 Maitri Chauhan, Yashvi Dattani, Sandeep Tilwani, Vinisha Makhijani, Shivani Barad, Rekha Thaddanee https://creativecommons.org/licenses/by-nc-sa/4.0
An Observational Cross-sectional Study to Assess Awareness of Personal Hygiene and Food Safety among Food Handlers In and Nearby Area of Tertiary Care Hospital
Background: Food hygiene and food safety are also major issues worldwide, particularly in developing countries such as India. Significant changes in food production, handling and preparation methods, as well as in the habits of food-eating among people, have made food unsafe. Food handlers are the main contributors to food-borne outbreaks, and food establishments are the main sources of food-borne disease. So, this study assess awareness of personal hygiene and food safety among food handlers in and nearby area of tertiary care hospital. Material and methods: This was an observational analytical cross-sectional study. The study was carried out in surrounding area near tertiary care hospital of Bhuj city and study duration was 3 months. Sample size:193. Results: 36 out of 43 (41.86%) central canteen - mess food handlers, 30 out of 48 (34.88 %) of the restaurants food handlers and 20 out of 98 (23.26%) mobile food handlers had good knowledge of food safety. This study identifies significant gaps in food safety and personal hygiene knowledge among food handlers, particularly among mobile food handlers. Mobile handlers lagged behind in critical hygiene areas such as handwashing, medical check-ups, and food handling practices. Socio-demographic and occupational factors such as younger age, higher education, longer working hours, and possession of food licenses were positively associated with better food safety knowledge.
Copyright (c) 2025 Pralhad Potdar S, Onkar Gaikwad, Jay Joshi, Shraddha A Katariya, Milankumar V Golakiya, Densi M Kakadiya, Bhartiben Kavad, Neel A Patel, Raju D Kodiyatar, Vatsalkumar P Rathod, Sachinkumar Sangada, Vikrambhai G Suthar https://creativecommons.org/licenses/by-nc-sa/4.0
United Against Venom: India's 'One Health' Blueprint for Snakebite Prevention
India's recently launched National Action Plan for Prevention and Control of Snakebite Envenoming (NAPSE) marks a pivotal moment in critical fight against snakebites.
Copyright (c) 2025 Mandar Chandrachood https://creativecommons.org/licenses/by-nc-sa/4.0
Turn Around Time (TAT): The Critical Link Between Laboratory Testing and Patient Outcome
Background: Turnaround time (TAT) in a clinical biochemistry laboratory refers to the total time taken from when a test is ordered to when the result is reported back to the clinician. The study aims to evaluate the TAT time of the clinical biochemistry lab, assessing the pre-analytical and post-analytical phases' relative contributions to the TAT in comparison to the analytical phase and determining the quantity of samples reported outside the specified TAT. A number of actions that could shorten the turnaround time overall were also assessed. Materials and methods: The study was conducted at GKGH Hospital, Kachchh, a district hospital, to evaluate the turnaround time (TAT) on samples analyzed in the clinical Biochemistry laboratory. In the present study, TAT was evaluated for parameters such as RFT (Renal Function Test), SGPT (Serum glutamate Pyruvate transaminase), Electrolytes, Troponin, and ABG (Arterial Blood Gas analyzer). The samples were collected from the OPD and IPD. The clinical Biochemistry is equipped with Vitros DTS 5600 and 7600, a dry test-based auto-analyzer. Results: In the present study, the mean and SD were observed in case of RFT TAT was 78 ±41, SGPT TAT was 103±54, Troponin TAT was 78±33, ABG test TAT was 15±12, Electrolytes TAT was 76 ± 42. Conclusion: In the present study, Evaluation of TAT of basic emergency parameters, which are common tests done in the laboratory. We noticed the major cause of delayed TAT time is pre-analytic steps. By improving the phlebotomy procedure, sample transport flow, and sample preparation steps, the TAT time can be improved significantly.
Copyright (c) 2025 Darshan Patel, Dinesh Sharma https://creativecommons.org/licenses/by-nc-sa/4.0
Cytology’s New Frontier: The Sydney System’s Innovative Approach to Lymph Node Diagnosis
Background: FNAC is the first diagnostic step in patients with lymphadenopathy because of its simplicity and minimal invasive nature which helps to confirm the clinical suspicion. A definite specific diagnosis may not be possible in a few cases but a categorization of disease and differential diagnosis can help suggest the most efficient further investigations, saving time and resources. The aim of this study was to ascertain the system’s applicability and precision in the diagnosis of lymph node cytology. Material and methods: A retrospective cross-sectional study on lymph node cytology samples collected between January 2024 and June 2024, categorizing results into five groups (L1-L5) according to the Sydney System. Cytological findings were validated against histopathological results and relevant clinical data that prompted FNA procedures. Diagnostic performance was evaluated using metrics such as sensitivity, specificity, predictive values, and malignancy risk estimates. Results: 60 cases were evaluated by FNAC. Out of this 44 were benign cases, 16 cases were of Reactive lymphadenitis, 24 cases of Granulomatous/Tuberculous lymphadenitis and 4 cases were of Acute suppurative lymphadenitis. Out of 16 malignant cases, 1 case was of Non Hodgkins lymphoma, 2 case was of Hodgkins lymphoma and 13 cases were of metastatic carcinoma. Conclusion: The Sydney system was used for clinicopathological diagnosis of patients presenting with lymphadenopathy and was found to be a reliable tool for evaluation of risk of malignancy and its subsequent management of the patient.
Copyright (c) 2025 Nidhi Choudhari, Meghashree V, Vidhya Subramaniam, Sudha M, Prajna K S https://creativecommons.org/licenses/by-nc-sa/4.0
Region and Rabies: A Review of Geographical Variations, Challenges and Strategies for Control
Rabies, one of the oldest known zoonotic diseases, continues to claim thousands of lives every year—despite being entirely preventable. It disproportionately affects populations in Asia and Africa, particularly in low-resource rural regions where dog-mediated transmission remains endemic. This review explores the interplay between regional contexts and rabies epidemiology, highlighting disparities in disease burden, surveillance capacity, vaccine access, health infrastructure, and cultural beliefs. It also outlines successful regional interventions, emphasizing the need for geographically tailored strategies. With the global “Zero by 30” goal in sight, addressing these regional dynamics is key to achieving equitable and sustainable rabies elimination.
Copyright (c) 2025 Bharti Koria https://creativecommons.org/licenses/by-nc-sa/4.0
A Comparative Study of Orthogonal Versus Parallel Plating for Distal Humeral Fractures
Introduction: Fractures of the distal humerus are relatively common injuries, distal humerus fractures lead to significant burden on society due to its bimodal distribution with a peak in young males due to high energy trauma (road traffic accidents, fall from height, trauma to arm and gunshot wounds) and a other peak in older females usually by simple falls. There are several methods of fixation available, namely- plate fixation and external fixation. Out of which very commonly performed is plating. Material and Methods: A total of 40 patients distal humerus fractures were treated with dual plating between May 2022 and May 2024. Of these, 20 patients underwent orthogonal plating (Group A), while 20 patients were treated with parallel plating (Group B). Patients were selected based on specific inclusion criteria: age between 18-60 years, fractures of the distal humerus with intra condylar extension, closed fractures, non-compliant patients for conservative treatment, polytrauma patients, and those who refused conservative treatment. Exclusion criteria included patients younger than 18 or older than 60 years, fractures involving the shaft of the humerus, previous humeral surgery, pathological fractures, open fractures, and nerve palsy. This prospective study utilized a sample size of 40 patients, with Group A consisting of odd-numbered patients receiving orthogonal plating and Group B consisting of even-numbered patients receiving parallel plating. Results: Out of 20 operated cases of orthogonal plating, 18 patients had excellent, 2 patients had poor ASES score, whereas in parallel plating group 16 patients had excellent, 2 patients good, 2 patients poor American Shoulder and Elbow Surgeons (ASES) score, no post operative infections were noted, no non-union cases were noted, no significant difference in surgery time, blood loss, mean duration of hospital stay was noted. Conclusion: Both orthogonal plating and parallel plating had similar outcomes with respect to elbow function and early physiotherapy. No significant difference in surgery time, blood loss, mean duration of hospital stay were noted.
Copyright (c) 2025 Durga Prasad H N, Amit Sehgal, Chavi Sethi, Charu Thakur https://creativecommons.org/licenses/by-nc-sa/4.0
Effects of Language Barrier on Academic Performance of First Year Undergraduate Medical Students in Jamnagar
Background: Language proficiency plays a foundational role in the success of medical students, especially in multilingual countries like India, where students often come from diverse linguistic backgrounds. The transition from vernacular language-based schooling to English-medium medical education creates a significant challenge for first-year MBBS students. These students often struggle with understanding medical terminology, lectures and textbooks, all of which are primarily in English. This language barrier can impede their academic performance, communication skills and confidence, which are critical to becoming competent healthcare professionals. Objectives: This study aimed to assess the extent to which language barriers affect the academic performance of first-year MBBS students. Materials and Methods: This is an institution based cross-sectional study. Total 220 students participated in the study. A preformed questionnaire was given to the students. Result was obtained by the answers given by the students. Results: A total of 220 participants responded to the survey, including 118 (53.6%) males and 102 (46.4%) females. 160 (72.7%) of the total participants had studied in Gujarati medium, 16 (7.3%) of the total participants had studied in Hindi medium, while 44 (20%) of the total participants had studied in English medium. The majority 140 (63.7%) of the participants stated that they frequently used dictionaries for their studies and 80 (36.3%) did not use dictionaries. The results indicated that most participants, more specifically 110 (50%) medical students were neither comfortable nor uncomfortable (Neutral) with the English language, followed by 74 (33.6%) who were comfortable as opposed to 36 (16.4%) who were very uncomfortable. Conclusion: English Language Proficiency Program (ELPP) can be used at a level of medical colleges to increase the interest and academic performance of the students.
Copyright (c) 2025 Nileshwari Vala, I S Thianeswar, Kajal Gauswami https://creativecommons.org/licenses/by-nc-sa/4.0
Fibroepithelial Polyp in the Buccal Mucosa of a Libyan Patient: Case Report and Literature Review
Fibroepithelial polyp is one of the benign lesions of oral cavity which occurs as inflammatory response to local irritation or trauma. Clinically, patients with fibroepithelial polyps present as a painless pedunculated or sessile swelling. They can be treated by simple surgical excision or by other methods such as electrocautery or laser ablation. This is case report of a 48-year-old female who reported to the dental clinic with a soft to firm, painless pedunculated swelling in the left buccal mucosa. This patient underwent an excisional biopsy under local anesthesia. Histological examination confirmed the diagnosis of fibroepithelial polyp. In conclusion, fibroepithelial polyp should be kept as one of the differential diagnoses of benign soft tissue lesions of the oral cavity.
Copyright (c) 2025 Eman.A.B Aguori https://creativecommons.org/licenses/by-nc-sa/4.0
Evaluation of Complete Immunization Coverage and Effect of Migratory Factors on Immunization Coverage of Children Residing at Construction Sites in Rajkot City, Gujarat
Background: Immunization is one of the most effective public health interventions, yet children of migrant construction workers often remain under-immunized due to unique socio-demographic and logistical barriers. This study aimed to evaluate complete immunization coverage and examine the effect of migratory factors on immunization among children residing at construction sites in Rajkot city, Gujarat. Material and methods: A cross-sectional study was conducted in 2019 in the field practice area of a community medicine department under Rajkot Municipal Corporation. A total of 244 children residing at construction sites were surveyed using a semi-structured questionnaire. Data on sociodemographic, immunization status, and migration history were collected and analyzed using appropriate statistical tests. Results: Full immunization coverage among the study population was 39.75%, while complete immunization coverage was 30.33%. Zero-dose prevalence was 12.7%. A statistically significant association was observed between immunization coverage and factors such as gender (p=0.00), birth order (p=0.00), and number of migrations (p=0.00), while place of migration showed no significant effect (p=0.23). The most common barriers to immunization were parental unawareness about vaccination sites (33.20%) and schedules (23.77%), followed by fear of wage loss due to post-vaccination illness (19.67%). Conclusions: Children of migrant construction workers in Rajkot city have considerably lower immunization coverage compared to district and national averages. Strengthening mobile outreach, increasing parental awareness, flexible session timings, and introducing incentives to offset wage loss could significantly improve immunization uptake among this vulnerable population.
Copyright (c) 2025 Kshama Gajera, Harsha Solanki, Nilesh Fichadiya, Bhargav Dave https://creativecommons.org/licenses/by-nc-sa/4.0
A Single-Center Case Series of Hereditary Ataxia from Gujarat: Clinical and Genetic Data
Background: Hereditary or genetic ataxia is a group of neurodegenerative conditions, characterized by progressive imbalance and ataxia, with convergent clinical profiles. Limited data on the prevalence and subtypes are available from Gujarat due to a lack of an ataxia registry or studies. Objective: To study clinical and genetic characteristics in patients with hereditary ataxia from Gujarat state. Material and Methods: This prospective observational study included and evaluated chronic cerebellar ataxia patients with suspected hereditary etiology. Based on the clinical findings, molecular analysis was performed using PCR-based trinucleotide repeat analysis for a single specific genotype, a selected panel, or a broader whole-exome sequencing method. Results: We identified 65 patients with possible genetic ataxia over 2 years. Forty-nine patients from this subgroup underwent genetic testing and obtained positive results in 29 patients. Spinocerebellar ataxia (SCA) type 2 was the most common type (31%) of Autosomal Dominant ataxia, and Friedreich’s ataxia (FA) was the most common Autosomal Recessive ataxia (13.8%). SCA patients had onset in the 2nd decade onwards and had strong positive family history, while FA patients had onset in the 1st decade. Clinical features were overlapping and nonspecific for the subtype of ataxia. Apart from incoordination, the most common clinical findings were eye signs, pyramidal tract involvement and peripheral neuropathy. Conclusion: Our Gujarat state cohort of hereditary ataxia resembles genotypic and clinical characteristic data from other studies in western India. We noted clinical phenotypic overlap in all subtypes of hereditary ataxia, which calls for molecular genetic testing for diagnosis.
Copyright (c) 2025 Pranav Joshi, Shalin Shah, Mukesh Sumra, Sudhir Shah https://creativecommons.org/licenses/by-nc-sa/4.0
Pseudoangiomatous Stromal Hyperplasia in an Unmarried Female with Asymmetric Breasts
Pseudoangiomatous stromal hyperplasia (PASH) is a non-cancerous mesenchymal growth in the breast. It was first described by Vuitch, et al. in 1986 wherein it appeared as a palpable breast lump in a patient. Only around 109 cases had been documented by 2008. The etiology and pathogenesis of PASH are still unknown; however, there is some evidence suggesting PASH is hormone dependent. Herewith we present a case of 29 years old unmarried lady who presented to plastic surgery department of our hospital with complaint of painless, asymmetric breasts. Her mammography showed global dense asymmetrical breast parenchyma more in left breast compared to her right breast. Her PASH diagnosis was confirmed on gold standard test of histopathology.
Copyright (c) 2025 Bhushan M Warpe, Shweta S Joshi, Pooja P Pandey, Sai K Manchikalapudi https://creativecommons.org/licenses/by-nc-sa/4.0
Capillary and Cavernous (Mixed) Type of Cervical Hemangioma with Uterine Adenomyosis in a 40-year-old Female
Hemangioma of the uterine cervix is an extremely rare benign vascular lesion and only a few sporadic cases have been reported. Cervical hemangioma is characterized by increase in the number of normal and abnormal veins. Histopathology examination is needed to diagnose hemangioma and to differentiate this disease with other pathological conditions. Hemangioma is a benign tumor which originates from endothelial cells of the blood vessels, which represent multipotent cellular elements, or from pericytes located on the outer side of the blood vessel wall. The majority of cervical hemangiomas have been reported in women of child bearing age.
Copyright (c) 2025 Shweta S Joshi, Bhushan M Warpe, Prachi S Patil, Bhumi Karodiya, Bhumika M Siddhpara https://creativecommons.org/licenses/by-nc-sa/4.0
A Prescription Audit Utilizing the World Health Organization Recommended Key Medication Use Indicators at a Tertiary Care Hospital, India
Background: Inappropriate drug usage is a global health issue, particularly in developing nations like India. Irrational drug use has a negative impact on both health and medical expenses. Prescription auditing is a crucial method for raising the standard of prescriptions, which raises the standard of care provided. The current study was conducted to evaluate the rational use of pharmaceuticals for completeness, readability, and against the key drug use indicators specified by the World Health Organization (WHO). Material and methods: In the surgery department, 300 prescriptions were chosen at random from the medical records for a cross-sectional retrospective analysis, regardless of the patient's diagnosis or characteristics. The WHO core drug use indicators, medical components, and general information were assessed for each prescription. Using Microsoft Excel, the collected data were tallied and shown as descriptive statistics. SPSS version 25 was used for analysis. Results: General information is included with every prescription. 67 percent of prescriptions were written under a generic name, while 85.6% of prescriptions included the diagnosis. On average, 11.45 prescription drugs were written. In 53.8% of prescriptions, the clinical examination was mentioned; however, in 94% of prescriptions, the history of allergy was not included. Conclusion: According to WHO-recommended parameters for quality improvement, our study emphasises the necessity of providing our prescribing physicians with detailed prescription writing training.
Copyright (c) 2025 Shruti Singh, Nirav Nimavat, Diyesh Gohel, Nishi Sinha, Rajesh Kumar, Sunil Kumar Singh, Divya Harsha https://creativecommons.org/licenses/by-nc-sa/4.0
Clinico-Epidemiological Profile and Study of Influenza and Their Subtypes Among Suspected Influenza Patients in a Tertiary Care Teaching Hospital of Vadodara
Background: Influenza viruses cause significant respiratory illness, with seasonal epidemics and occasional pandemics influenced by antigenic variation. Monitoring local prevalence and subtype distribution is vital for guiding public health responses. Material and methods: A descriptive cross-sectional study was conducted from March to December 2024. A total of 601 throat or nasopharyngeal swabs from suspected influenza cases were collected and tested using the PathoDetect™ multiplex real-time RT-PCR kit, which detects influenza A, B, and subtypes A(H1N1) and A(H3N2). Quality control included internal and external validation. Results: Overall positivity was 20.46%. The highest number of cases occurred in individuals >60 years, while the highest positivity rate was in children <10 years. Fever (78.86%) was the most common symptom; COPD (29.26%) was the leading comorbidity. Influenza A was predominant (92.97%), with H1N1 (53.90%) as the leading subtype, followed by H3N2 (8.59%). Two seasonal Peaks of H1N1 were observed in March–April and August–October. Five co-infections were detected: two with H1N1 and H3N2, and three involving Influenza B co-infected with H1N1, H3N2, and Untypable Influenza A. Conclusion: H1N1 is the dominant circulating strain. Findings highlight the need for continuous surveillance, timely diagnosis, and targeted vaccination. Broader community-based studies are recommended for comprehensive influenza control.
Influenza, H1N1, H3N2, Untypable Influenza
Copyright (c) 2025 Gulshan Chaudhary, Jigna Karia, Yash Khandelwal https://creativecommons.org/licenses/by-nc-sa/4.0
Clinico-histopathological Correlation in Ectopic Pregnancy: Insights from a Rural Tertiary Center in Maharashtra, India
Background: Derived from the Greek word ektopus, meaning "out of place," ectopic pregnancy entails the implantation of conceptus in any site other than a normal uterine location.[1] It remains a formidable challenge in women's healthcare, posing risks to both maternal life [2] and future fertility with global incidence ranging from 1-2%,[3] with approximately 3.12 per 1000 pregnancies in India. This study endeavors to conduct a comprehensive analysis of ectopic pregnancy cases, underscoring the pivotal role of histopathological examination in not only confirming the diagnosis but also unraveling the underlying etiologies. By integrating clinical findings with pathology, we aim to improve diagnostic accuracy, enabling timely interventions, fertility preservation, and better patient outcomes. Material and methods: A retrospective analysis was conducted on 120 cases of ectopic pregnancy diagnosed between January 2021 and January 2024 at the Department of Pathology, Swami Ramanand Teerth Rural Government Medical College, Ambajogai. Clinical data, including age, parity, gestational age, and risk factors, were collected. Histopathological specimens were processed and examined using Hematoxylin and Eosin (H&E) staining, with detailed observations recorded and analyzed. Results: The incidence of ectopic pregnancy was 1.13% of all gynecological cases, with the majority (70.83%) of patients in the 21-30 years age group. Multigravidity was common, with 47.12% presenting during their second pregnancy. The fallopian tube was the most frequent implantation site (97.29%), and rupture occurred in 57.65% of cases. Histopathological findings included chronic salpingitis (56.48%), salpingitis isthmica nodosa (9.2%), and acute salpingitis (4.6%). Additionally, 16.66% of cases were classified as normal. Conclusion: Histopathological examination is essential for the accurate diagnosis and management of ectopic pregnancies, particularly in atypical cases. The integration of clinical and pathological data enhances diagnostic precision, aids in identifying complications, and informs future fertility management. This study highlights the importance of clinicopathological correlation in ensuring optimal patient care and outcomes in ectopic pregnancy cases.
Copyright (c) 2025 Purva O Bhalerao, Dnyaneshwar S Jadhav, Sheela L Gaikwad, Arvind N Bagate https://creativecommons.org/licenses/by-nc-sa/4.0
Morbidity Patterns Among the Geriatric Population in Field Practice Area of a Tertiary Care Teaching Hospital in Ahmedabad: A Cross-sectional Study
Objective India is witnessing a demographic transition with the elderly population (≥ 60 years) projected to rise to 19% by 2050. This shift is associated with increased multimorbidity and a dual burden of communicable and non-communicable diseases, posing significant public health challenges. In this context, the present study aimed to assess the prevalence and pattern of self-reported morbidities among the elderly, identify common health conditions, and examine their association with socio-demographic factors in the field practice area of B.J. Medical College, Ahmedabad. Materials and Methods A cross-sectional study was carried out from August 2021 to August 2022 among 700 elderly individuals (≥60 years) attending health camps in five urban field practice areas. Data were collected using a pre-tested structured proforma through personal interviews, including socio-demographic profile, morbidity history, and age-related health conditions. Anthropometric measurements were also taken. Analysis was performed using descriptive statistics, chi-square test, Fisher’s exact test, and z-test, with significance set at p < 0.05. Results Of the 700 participants (mean age 72.1±5.4 years), 70.7% reported at least one morbidity. Hypertension (53.4%) and diabetes (25.1%) were the leading chronic conditions, while visual problems (62.4%), oral issues (45.0%), and joint pain (38.7%) were the most frequent age-related conditions. Females had significantly higher prevalence of hypertension (60.4%) and visual problems, whereas males had higher ischemic heart disease (6.1%) and asthma (10.2%). The 60-79 year age-group had more hypertension (55.5%) and diabetes (42.3%), while those ≥80 years had higher ischemic heart disease (10.7%) and cancer (6.5%). Morbidity was significantly associated with age, sex, type of family, occupation, and BMI. Conclusions A substantial burden of chronic and age-related conditions was observed among the elderly, with clear socio-demographic variations. Females and the oldest-old were especially vulnerable. Strengthening community-based screening, promoting lifestyle modification, and providing gender- and age-sensitive interventions are essential for improving geriatric health outcomes.
Copyright (c) 2025 Ravinabahen Patel, Kinner Patel https://creativecommons.org/licenses/by-nc-sa/4.0
The Prevalence of Metallo-β-lactamase (MBL) in Gram Negative Bacilli and their Antimicrobial Susceptibility Pattern at Tertiary Care hospital, Vadodara
Background: Antimicrobial resistance is the major threat due to broad spectrum antimicrobials are being used in community practice. The Metallo-β-lactamases (MBLs) in gram negative bacteria have emerged as a major cause of health care associated infections. They hydrolyse all beta-lactam antibiotics including extended spectrum cephalosporins and carbapenems at the same time it is not inhibited by serine beta-lactamase inhibitors like clavulanic acid, sulbactam, and tazobactam and are resistant to many antibiotics. The present study is aimed to determine the prevalence of Metallo-β-lactamase (MBL) in gram negative bacilli and their antimicrobial susceptibility pattern at tertiary care hospital, Vadodara. Material and methods: Total 1350 Clinical specimens were included in the study. The isolates were identified as per standard microbiological procedures od the laboratory such as staining, colony morphology & biochemical reactions. All the isolates were subjected to antibiogram study for the antibiotics plus a phenotypic screening test for MBL was done by disc diffusion test using single Imipenem disc by modified Kirby Bauer disk diffusion method. 117 Imipenem resistant isolates were tested for MBL by Imipenem EDTA combined disc synergy test as a confirmatory test. Results: The prevalence of MBL producing isolates were 6.39%. Maximum number of MBL producers were isolated from the Medicine ward (19, 40.42%) and ICU (11, 23.40%). Maximum number of Specimens containing MBL producers were Pus and Swab (19, 40.42%) followed by Sputum (13, 27.65%). The most common bacterial isolates were Escherichia coli (311) followed by Klebsiella spp. (224) and Pseudomonas aeruginosa (97). The prevalence of MBL production were more common in Pseudomonas spp. (20 out of 97, 20.61%) followed by Acinetobacter spp. (3 out of 19, 15.78%). Polymyxin B and Colistin were the most effective drugs against MBL producers. Conclusion: Prevalence of MBL in our study is 6.39%, which are multidrug resistance though Polymyxin–B and Colistin is still effective treatment option. So there is a need to do surveillance to detect MBL producers, judiciously use Carbapenems along with Antimicrobial Stewardship to prevent their spread.
Copyright (c) 2025 Nisarg Trivedi, Mitesh Kamothi, Bhavesh Gohil, Hitesh Assudani https://creativecommons.org/licenses/by-nc-sa/4.0
Integrating Tradition and Modernity: The Gharana System for Effective Mentorship at GAIMS
This editorial highlights the key features and benefits of the GAIMS Gharana System, an innovative and a unique blend of ancient traditions of knowledge and modern mentoring practices.
Copyright (c) 2025 Ajeet Kumar Khilnani https://creativecommons.org/licenses/by-nc-sa/4.0
Epidemiology and Analysis of Mortality in Tertiary Care Hospital in a Metropolitan City, India: A Record Based Study
Background: Mortality statistics are essential for understanding population health, guiding public health efforts, and tracking disease trends. In India, reliable mortality data is often insufficiently documented and analyzed, limiting its utility for identifying leading causes of death. Materials and Methods: A retrospective cross-sectional study was conducted on patient death records from 2018 to 2023 at a tertiary care hospital, excluding incomplete records. Data were analyzed using SPSS version 22.0 and MS-Excel, applying descriptive statistics and Chi-square tests to assess associations at a 5% significance level. Results: From 2018 to 2023, 9,087 deaths were recorded, with a peak in 2020. Non-communicable diseases had the highest mortality share (52.67%–58.75%), followed by communicable diseases (13.05%–21.25%) and postmortem cases (20.49%–26.43%). The mortality trend was significantly linear (p < 0.0001). Most deaths occurred in adults (15–60 years), with no significant gender association. A shift in disease patterns was noted, with communicable diseases peaking in 2020. Conclusion: This study highlights non-communicable diseases as the leading cause of mortality, with a 2020 spike in communicable diseases, seasonal variations, and a predominance of adult deaths, emphasizing the need for ongoing monitoring and targeted interventions.
Copyright (c) 2025 Vrushali Vishal Kulkarni, Amit Yadav https://creativecommons.org/licenses/by-nc-sa/4.0
Clinical and Histopathological Insights Into Soft Tissue Tumors: A Case Series with a Review of the Literature
Soft tissue sarcoma is an uncommon and highly heterogeneous group of malignant tumors. The annual incidence of soft tissue sarcoma is about 50 cases per 1 million people, i.e., 1% of all malignant tumors. The field of soft tissue tumors (STT) is extremely vast; the pattern of tumors is varied, both on benign tumors and on malignant soft tissue tumors. Therefore, it is a very challenging job for a pathologist to give a final diagnosis. Here we have discussed three rare cases of soft tissue tumors.
Copyright (c) 2025 Mangala Nagare, Harsha Dangare, Gauri Metkar, Smita Bhide https://creativecommons.org/licenses/by-nc-sa/4.0
Warty Squamous Cell Carcinoma of Anogenital Region: A Case Report in an HIV-positive Patient
Venereal infections significantly contribute to the development of anogenital cancers, and Human papillomavirus (HPV) is the most common sexually transmitted disease worldwide. Warty squamous cell carcinoma is an extremely rare aggressive variant that generally occurs in the severely immunosuppressed at sites like the anogenital and genito-urethral regions. Though its etiology is thought to be multifactorial, 95% cases are attributed to HPV infection. Of the various subtypes, the high-risk HPV serotypes, particularly HPV16 and18, are the main risk factors for warty carcinoma. We present the case of a 58-year-old male who came with complaints of a painful perineal lesion of three months duration. He is a known HIV-positive patient and has been on active antiretroviral therapy (HAART) regimen for the last 15 years. He was diagnosed with verrucous carcinoma of the perianal region five years ago for which an abdominoperineal resection was performed and now came with local tumor recurrence. Excision was done and histopathological evaluation showed an invasive carcinoma with papillomatosis, hyperkeratosis, and koilocytic atypia with brisk mitotic activity. Immunohistochemistry for p16 showed block positivity, confirming a diagnosis of HPV-associated warty squamous cell carcinoma. This case report highlights the relatively new variant of squamous cell carcinoma, its association with HPV, and the immunological implications of this virus in the development of squamous cell carcinoma. Preventive strategies to reduce such malignancies in the susceptible population have to be emphasized by creating awareness amongst the general public regarding the significance of HPV immunization and promoting the same in vulnerable groups.
Copyright (c) 2025 Deepthy Vijayaraghavan, Neha Betty Issac https://creativecommons.org/licenses/by-nc-sa/4.0
The Prevalence of Methicillin Resistant Staphylococcus Aureus (MRSA) and its Antimicrobial Susceptibility Pattern at Tertiary Care Hospital
Background: Staphylococcus aureus is a very common human pathogen isolated from various clinical specimens. Staphylococcus aureus can cause various infectious diseases like endocarditis, skin and soft tissue infections, osteomyelitis, pneumonia and bacteremia. Methicillin resistant Staphylococcus aureus (MRSA) can cause a major trouble mostly in tertiary care center. The present study is aimed to determine the prevalence of Methicillin Resistant Staphylococcus aureus (MRSA) and its antimicrobial susceptibility pattern at Tertiary Care Hospital, Vadodara. Material and Methods: Present study was conducted from October 2023 to April 2024 at tertiary care hospital, Vadodara. Total 1127 clinical specimens were tested for the study. The isolates were identified as per laboratory standard protocol including staining, colony morphology & biochemical reactions. All isolates were subjected to antibiogram study by modified Kirby Bauer disk diffusion method. Among 1127 clinical specimens, 361 Staphylococcus aureus were isolated and tested for MRSA by Cefoxitin disc diffusion test. Results: Among 361 Staphylococcus aureus isolates, 159 were positive for MRSA. Overall prevalence rate for MRSA isolates was 44.04%. Maximum number of MRSA was isolated in Orthopedic ward (53, 33.33%), Surgery ward (39, 24.52%), Intensive Care Unit (28, 17.61%), Medicine ward (17, 10.69%) Pediatric ward (15, 9.43%). Maximum MRSA isolated from Pus and swab (81, 50.94%) followed by Urine (36, 22.64%), Blood (27, 16.98%). MRSA were most sensitive to Vancomycin (159, 100%) followed by Teicoplanin (149, 93.71%), Linezolid (142, 89.30%), Clindamycin (71, 44.65%) and least sensitive to Ciprofloxacin (29, 18.23%) followed by Erythromycin (42, 26.41%) and Gentamycin (62, 38.99). Conclusion: Prevalence of MRSA in our study is 44.04%, which are multidrug resistance though Vancomycin, Linezolid and Teicoplanin are still effective treatment option. Screening of MRSA and their antibiogram is very essential for early detection of MRSA and for management of the condition.
Copyright (c) 2025 Nisarg Trivedi, Mitesh Kamothi, Bhavesh Gohil https://creativecommons.org/licenses/by-nc-sa/4.0
Does Extended Serum Sample Storage Impact Laboratory Results?
Background: Prolonged storage of samples can result in changes to routine biochemical parameters. Aim: This study aimed to examine the biochemical changes in serum samples stored at –20°C for extended periods (72 hours), focusing on various routine biochemical parameters. Results: Significant changes were noted in serum glucose, aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine, and potassium levels after 72 hours of storage, with further deterioration observed over 3 months. The remaining parameters showed no significant alterations. Conclusion: Prolonged sample storage results in changes in analyte concentrations in serum. Serum glucose, AST, ALT, creatinine, and potassium levels should be measured within 72 hours if extended storage is necessary. All parameters should ideally be analyzed within 24 hours to prevent misinterpretation of results and ensure optimal patient care.
Copyright (c) 2025 Balaji Pillai, Ajeet Kumar Khilnani, Dinesh Sharma https://creativecommons.org/licenses/by-nc-sa/4.0
Bacterial Isolates and Drug Susceptibility Pattern of Sterile Body Fluids from Tertiary Hospital in Saurashtra Region: A One-Year Retrospective Study
Background Body fluids obtained from sterile body sites are often expected to be devoid of any pathogenic or commensal microorganisms. The cause of infected body fluids could be any pathological agents or skin contaminants that may be harbored in intensive care units. This study identifies commonly isolated bacteria from the body fluid samples along with their antibiotic sensitivity pattern. Methods All body fluid samples (except blood, and CSF) which were received in the Bacteriology section of the Department of Microbiology in our tertiary care center of Saurashtra region between June 2021 to June 2022 were included in the study. All microorganisms obtained from bacterial culture were subjected to identification by using conventional methods and standard biochemical tests were done to aid identification. Antibiotic sensitivity testing by Kirby Bauer disc diffusion test and the results were analyzed. Results Out of 250 samples of body fluids, 72 (28.80%) showed bacterial growth on culture. Male predominance among patients was seen. Patients falling between the age group of 41-50 show maximum positivity and the ratio of prevalence of infection in the young and old patients seems to be nearly similar (52% in patients less than 50 years of age and 48% in patients elder than 50 years) Escherichia-coli was the most commonly isolated bacteria (27.77%) which was followed by Pseudomonas (25 %) and Klebsiella pneumonia (22.2 %). Conclusions This study shows the spectrum of bacterial isolates observed from body fluid samples received in our laboratory and helps in the empirical treatment of patients based on antibiotic susceptibility patterns. It also highlights the importance of adhering to antibiotic sensitivity results in reducing the empirical broad-spectrum antibiotics abuse and infection control practices to prevent the spread of multidrug-resistant infection in the hospital environment.
Copyright (c) 2025 Brihadishwaran Thiyagarajan, Krunal D Mehta, Hitesh J Assudani, Dhiviya Narbhavi T https://creativecommons.org/licenses/by-nc-sa/4.0
Epidemiological Determinants of Unmet Need for Family Planning Among Eligible Couples in Ahmedabad
Background The unmet need for family planning (FP) refers to the disparity between reproductive intentions and contraceptive behavior. According to NFHS-5, the total unmet need for FP is 10.3% among newly married couples in Ahmadabad, with higher rates in rural (10.8%) than urban (9.7%) areas of Gujarat. This study is conducted to identify the epidemiological determinants of unmet need for family planning among eligible couples in Ahmadabad and assess of U-PHC for provision of family planning services. Methodology A community-based cross-sectional study was conducted among married women (18-49 years) in 7 AMC zones. Stratified cluster sampling (n=900) was used, with 30 women selected from each of 30 UHCs, representing slum, slum-like, and non-slum areas. One-on-one interviews were conducted using an open-ended questionnaire." Interview of MO with filling up of checklists of 14 UPHC from 7 zones of AMC (2 centers each). Results Among married women, 74% expressed demand for family planning, with 67% seeking spacing and 7% seeking limiting. Nonusers exhibited an unmet need 30%, associated with significantly poorer FP knowledge (p < 0.05)." All 14 centers had organized an average 137 health and nutrition day in last 3 months; FP and methods of contraception were discussed by ANM. Supervision and counselling of FP found poor. Conclusions The study found a 30% unmet need for family planning among participants, with significant knowledge gaps, building and infrastructure is good in all except one U-PHC. Supervision found to be poor in all selected U-PHC’s.
Copyright (c) 2025 Ashadevi H Sisodiya, Fatema Kachhawala , Aparajita Shukla https://creativecommons.org/licenses/by-nc-sa/4.0