GAIMS Journal of Medical Sciences

Mentoring Matters: Faculty's Role in Developing Competent Doctors

2024-08-04T18:57:32+0530

The integration of structured mentoring programs within the medical curriculum and the inclusion of mentoring sessions in faculty development programs represent a forward-thinking approach by the NMC. These steps acknowledge the profound impact that effective mentoring can have on the professional and personal growth of medical students and the overall quality of healthcare delivery. By empowering faculty to become effective mentors, we can create a nurturing educational ecosystem that not only imparts knowledge but also fosters the holistic development of future doctors. This, ultimately, is a stride toward enhancing the quality of healthcare in India.

Cervical Interlaminar Epidural Injection: A Safe Technique

2023-10-10T11:20:54+0530

Background: Chronic neck pain and radiculopathies can cause profound disabilities in physical and psychological health. Numerous studies that link inflammation to the main cause of neural irritation and injury have supported the use of steroids in the epidural area for the treatment of radiculopathy. Routinely, cervical interlaminar epidural steroid injection is given in prone position. However, we experienced patients are not comfortable during the procedure. So, in our study, we conducted the procedure in lateral decubitus position under IITV guidance.

Methods: All the patients who came to OPD in department of Orthopedics were screened and patients having neck pain with or without radiculopathies were further investigated with MRI cervical spine with whole spine screening. From these patients, those having pathologies like degenerative disc disease, disc prolapse, facet arthritis were selected for study.

Results: In our study female preponderance is seen. Majority of patients were in middle age group. Around 18% of the patients had degenerative disc disease, 12% had facet arthritis, 42% had prolapse of intervertebral disc with right side radiculopathy and 28% had prolapse of intervertebral disc with left side radiculopathy.

Conclusion: Cervical interlaminar epidural injection in lateral position using fluoroscopy is a safe and effective method.

Hand Hygiene Audit and Practices among Resident Doctors and Nursing Staff Working at Pediatric and Neonatal Intensive Care Unit: An Observational Study

2023-10-03T16:47:27+0530

Background: To lower the frequency of healthcare-associated infections (HCAIs), it is critical to analyze existing hand hygiene (HH) practices among healthcare workers (HCWs), identify gaps, and implement corrective actions. We planned to evaluate HCWs' hand hygiene routines with this objective in mind.

Methods: The study focused on postgraduate resident doctors and nursing staff's hand hygiene habits over three months at a teaching hospital providing tertiary care. Direct observation and survey-based cross-sectional methods were utilized, with an observation tool and questionnaire employed for data collection; the observation period for hand hygiene compliance lasted six to eight weeks, with observations made at random intervals during morning, evening, and night shifts in the PICU and NICU.

Results: The study observed a statistically significant compliance rate for hand hygiene among nursing staff and resident doctors, with 160 out of 172 observations demonstrating hand hygiene practices. Adequate hand hygiene performance was observed in 69.4% of cases, which was also statistically significant. Alcohol-based hand rub was more frequently used than soap. The analysis of knowledge, attitude, and practices included 20 resident doctors and 24 nursing staff in the PICU and NICU. The results showed that 97% of participants had received hand hygiene education in the past year, and nearly 100% used alcohol hand rub consistently. Most respondents, 90% of resident doctors and 83.4% of nursing staff recognized the significant impact of healthcare-associated infections on patient outcomes. Additionally, 85% of nursing staff and 95% of resident doctors agreed that maintaining good hand cleanliness is essential for reducing healthcare-associated illnesses.

Conclusion: The findings of this study revealed that the participants had an excellent knowledge of hand hygiene. To emphasize the value of hand washing for both patients and healthcare workers, we advise providing the appropriate tools and holding instructional workshops. Such measures would significantly improve attitudes towards hand hygiene, reducing preventable infections, shorter hospital stays, and cost savings in healthcare.

Correlation between Glycosylated Hemoglobin (HbA1c) and Serum Lipid Profile in Patients with Type 2 Diabetes: A Cross Sectional Study

2023-10-20T15:05:49+0530

Background: Diabetes Mellitus (DM) is a long-term metabolic condition. Even within the normal range of HbA1c, non-diabetic cases have shown a positive connection between HbA1c and CVD. This study aimed to evaluate the relationship between glycemic control (HbA1c) and serum lipid profile.

Materials and Methods: Between April 2020 and August 2020, a cross-sectional study was carried out on 100 T2DM patients who visited OPD (Diabetes clinic) at the rural health training center of RCSM, GMC in Kolhapur, Maharashtra, India. Fasting blood sugar (FBS), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides (TGs), LDL and HbA1c were all measured by the American Diabetes Association's criteria to define DM. The assays were performed according to the manufacturers’ instructions.

Results: The mean age of the cases was 56.67 ± 5.67 years with male preponderance. The mean duration of diabetes in the present study was 6.72 ± 4.56. We found a significant positive correlation between total cholesterol levels and HbA1c in the present study. (r=0.555; p value<0.001) Other parameters were having positive correlation with Hba1c but not a significant one. (p>0.05).

Conclusion: In the current investigation, there was a significant association between Hb1Ac and total cholesterol levels. HbA1c can predict dyslipidemia in addition to a valid glycemic index, and early identification of dyslipidemia can be used to stop the progression of CVD in people with T2DM.

Study of Serum Uric Acid and Adenosine Deaminase as Markers of Oxidative Stress in Patients of Type 2 Diabetes Mellitus

2024-01-15T14:14:43+0530

Background: Diabetes Mellitus (DM) is a common metabolic disease due to absolute or relative insulin deficiency. Oxidative stress plays a major role in pathophysiology of type 2 DM and its prevalence is increased due to lifestyle and obesity. In past years different studies has been done to identify various oxidative stress markers. Aim of this study is to evaluate levels of serum Uric Acid (UA), Adenosine Deaminase (ADA), Fasting Plasma Glucose (FPG) and HbA1c in patients of Type 2 Diabetes Mellitus and healthy subject and also to find out role of UA and ADA as a marker of oxidative stress in type 2 DM.

Material and methods: We measured the serum level of Uric Acid, ADA, HbA1c and FPG in 100 patients with type 2 diabetes and 50 healthy controls. Subjects included in study group were divided on the basis of duration of diabetes mellitus. Group 1 included subjects with type 2 DM < 1 year and Group 2 included subjects with type 2 DM > 5 year.

Results: The difference in FPG, ADA and HbA1c were highly significant (p<0.05) in type 2 diabetic patients (< 1 year) in comparison to control group while the difference in uric acid is not significant in diabetes patients with < 1 year duration and healthy subjects. The difference in FPG, ADA, Uric Acid and HbA1c were highly significant (p<0.05) in type 2 diabetic patients (> 5-year duration) in comparison to control group. While comparing two diabetes groups difference in FPG, ADA, Uric Acid and HbA1c were also highly significant (p<0.05).

Conclusion: Uric acid as a predictor of oxidative stress become significant as the duration of diabetes increases while ADA is statistically significant even during early onset of diabetes mellitus.

Utility of Bone Marrow Examination in Hematological Disorders

2024-05-24T11:00:32+0530

Background: Bone Marrow Aspiration (BMA) and Bone Marrow Trephine Biopsy (BMB) are used to diagnose various hematological disorders. BMA is useful for study of cell cytology; material can also be used for ancillary tests like cytogenetics, flow cytometry, which improves the diagnostic utility. BMB allows complete assessment of marrow architecture along with pattern of distribution of abnormal infiltrates. Thus, BMA & BMB serve as complimentary procedures to diagnose various hematological disorders if performed simultaneously.

Material and methods: Hospital based prospective study done within the duration of 2 years starting from August 2020 to August 2022. All the patients who underwent bone marrow examination at Department of Pathology, Tertiary Care Hospital of Ahmedabad, Gujarat, India were included. BMA was done using Salah needle under aseptic precautions from posterior superior iliac spine. 8-10 aspirate smears were prepared, stained by Romanowsky stains. BMB was also done in all cases using Jamshidi needle from same site. The biopsy was processed and slides were stained by Hematoxylin and Eosin (H&E). Evaluation was done by two pathologists.

Results: Total 106 patients were included. Maximum number of patients belonged to 50-59 years age group followed by 60-69 years of age with M:F ratio of 1.6:1. Leading clinical feature was weakness/fatigue followed by pallor/anemia & fever. Megaloblastic Anemia (38%) was the most common hematological disorder in study population followed by Acute Leukemia (11%). 80% positive correlation between BMA & BMB was identified to diagnose various disorders.

Conclusion: Megaloblastic anemia is the most common hematological disease in study population & can present with variable cytopenia. Accurate diagnosis depends on BMA & BMB evaluation along with peripheral smear & biochemical immunoassays. The role of BMA & BMB remains untouched in the diagnosis of various hematological disorders in-spite of newer methods like immunohistochemistry, flow cytometry, cytogenetics and molecular assays.

Assessment of Iodine Status in Children of Bhuj, Gujarat

2024-05-29T19:23:29+0530

Background: Iodine deficiency disorder results in avoidable brain damage, cognitive impairment, and inhibited growth and development among children. The aim of this study was to ascertain pervasiveness of IDD in the Bhuj City of Kutch district of Gujarat by measuring urinary iodine excretion levels(UIE) and iodine intake from salt among school-going children.

Material and methods: A cross-sectional investigation was conducted to evaluate iodine deficiency levels in 350 school children of both genders, 6-12 years of ages, from Bhuj Taluka, a subdivision of the Kachchh district. The evaluation involved estimating urinary iodine levels through the Sandell–Kolthoff reaction and determining the iodine levels in samples of cooking salt using Spot testing kit (STK).

Results: With a median iodine levels in urine of 166.93 μg/L, there appears to be no biochemical evidence of iodine deficiency in the region. Approximately 98.57% of salt samples found iodine levels exceeding 15 ppm, while only about 1.42% had iodine levels below 15 ppm, indicating that household salt samples contain adequate iodine levels.

Conclusions: The region's median concentration of Iodine content found in urine 166.93 μg/L, suggesting the absence of biochemical iodine deficiency. Analysis of salt samples revealed that approximately 98.57% contained iodine levels exceeding 15 ppm, while only about 1.42% had iodine content below this threshold. This indicates that household salt samples possess adequate iodine levels, aligning with criteria for monitoring progress in eradicating iodine deficiency disorders as a public health concern.

A Study of Inducible Clindamycin Resistance in Methicillin Resistant Staphylococcus Aureus in Tertiary Health Care Centre

2024-06-03T14:47:03+0530

Background: Staphylococcus aureus is the most frequently encountered pathogen isolated from clinical specimens. Prolonged hospitalization, indiscriminate use of antibiotics, and indwelling medical devices were the cause for the appearance and spread of methicillin resistant staphylococcus aureus (MRSA). MRSA strains have a high effect on patient morbidity and mortality.

Material and methods: A total of 208 Methicillin resistance staphylococcus aureus isolates were taken from various clinical samples and processed in accordance with standard protocol.

Results: In this research, among 601 staphylococcus aureus isolates, 393 (65.40%) were MSSA and 208 (34.60%) were MRSA. Analysis of clindamycin Resistance in 208 MRSA isolates showed 19.7% of inducible clindamycin Resistance.

Conclusion: The pattern of clindamycin resistance to MRSA varies in different regions. When clindamycin is considered for therapy, the kind of resistance (inducible or constitutive clindamycin resistance) which exists to be detected. ‘D test’ is absolutely necessary in microbiology laboratories. This is because it avoids misinterpretation of clindamycin resistance byclearly delineating inducible clindamycin resistance from constitutive clindamycin resistance.

Seroprevalence of Chikungunya Fever at a Tertiary Care Hospital

2024-02-24T10:02:45+0530

Background
The Chikungunya (CHIK) is a viral infection caused by CHIK virus which is an arbovirus that belongs to the genus alphavirus under the Togaviridae family. CHIK infection is transmitted to humans by the bite of mosquitoes namely Aedes albopictus and Aedes aegypti. Since Chikungunya fever leads to long term residual arthropathy – like complications which causes hampering in routine work of person after recovery, it is still believed that chikungunya fever is a major burden on public health even in post COVID-19 era.

Aims and Objectives
We need to understand and evaluate the seroprevalence of chikungunya with reference to its study period, seasonal tendency, need for hospitalization and age-sex distribution.

Materials and Methods
A retrospective study was done in 305 suspected samples of chikungunya infection with history of Fever along with joint pain, myalgia between January 2020 to December 2023. Separated serum samples suspected to have Chikungunya infection were subjected to IgM capture ELISA for detection of IgM anti-chikungunya antibodies using IgM antibody capture ELISA produced by National Institute of Virology, Pune, India (NIV, Pune, India). Various statistical tests were done to find out statistical significance with p-value < 0.05 kept as statistically significant.

Results
Total 305 samples were tested for Chikungunya IgM antibody detection. 55 out of 305 samples were tested positive for CHIK-IgM antibody (18.03%). Out of total 55 positive samples, 32 (58.18%) were belonged to Males and remaining 23 (41.81%) to females (p-value for gender distribution=0.224). The cases varied significantly by age group (p=0.0328), with the highest number of positives from 41-60 years age-group (38.18%). All positive cases having fever and joint pain as chief complaints (p<0.0001). The post-monsoon period having a greater number of positive samples.

Conclusions
18.03% is the seroprevalence that we found out in our study. As the years progressed from 2020 to 2023, the number of samples and positive cases also increased. This clearly suggest that CHIK fever is still a public health concern and so early diagnosis and prompt treatment required along with need to develop proper strategies to prevent the spread of this vector – borne disease in the community.

Visual Outcome and Vision Related Quality of Life after Implantable Collamer Lens for Moderate to High Myopia and Myopic Astigmatism

2024-03-19T22:53:09+0530

Background: To examine visual outcome and vision related quality of life after Implantable Collamer Lens for Moderate to High Myopia and Myopic Astigmatism.

Material and methods: A hospital-based prospective, interventional, observational study has been carried out to evaluate functional outcomes and patient satisfaction following phakic ICL implantation for the treatment of myopia and myopic astigmatism. In this study, we included 44 eyes of 26 patients, 15 females (58%) and 11 males (42%), mean age 24.56 ± 4.98 years (range: 18-35) with preoperative myopia (mean ± standard deviation [SD] refraction spherical equivalent, -11.485 ± 4.78 D). To investigate the effects of ICL implantation, we had compared between two groups: one group before surgery and another group one month after surgery. Measurements including uncorrected distance visual acuity (UCVA), corrected distance visual acuity (CDVA), spherical equivalent (SE) of manifest refraction, and corneal topography were obtained for all participants. The Quality-of-Life Impact of Refractive Correction (QIRC) questionnaire was administered to compare VRQOL between before and after ICL implantation.

Results: The postoperative mean UCVA demonstrated a significant statistical improvement (p<0.001) from pre operative data, increasing from 0.04 ± 0.035 to 0.87 ± 0.23 (decimal acuity). The preoperative BCVA 0.85± 0.23 versus the mean postoperative BCVA 1.0 ± 0.18. The mean ± standard deviation of the preoperative refraction spherical equivalent was -11.485 ± 4.78 D. After surgery, this value decreased to -0.87 ± 0.40 D, demonstrating a statistically significant improvement (p<0.05).

After surgical procedures, the QIRC scores were significantly higher (postoperative QIRC score: 53.84±7.14; P<0.001) versus preoperative QIRC score [mean ± SD], 43.68±5.69, with significant increases (P<0.001) for 14 of the 19 items. After ICL surgery, the group's scores on items concerning convenience, well-being, and health problems were much higher than they were prior to the surgery. Despite the fact that nine patients (34%) encountered more concerns of night vision after surgery (mostly nonspecific glare and halo or arc effects), overall patient satisfaction was excellent, with 88% reporting that they were either satisfied or very satisfied with the surgical outcomes. Overall, none of the patients reported dissatisfaction.

Conclusion: Implantation of an ICL for moderate to high myopia and myopic astigmatism resulted in both significant improvements in visual acuity and a substantial enhancement in vision-related quality of life (VRQOL) for the subjects. This suggests that ICL implantation can be a successful treatment option for these patients, leading to improved vision and a greater enjoyment of daily activities.

Comparison of Outcomes of Endoscopic Fat Plug Myringoplasty and Chemical Cauterization for Closure of Small Central Tympanic Membrane Perforations

2024-07-06T08:26:37+0530

Background

Various graft materials have been used for closure of small tympanic membrane perforations with varying success rates. This study was done to compare the success rates of endoscopic fat plug myringoplasty (EFPM) and chemical cauterization for managing small TM perforations.

Methodology

This was a prospective study conducted in ENT Department of a teaching hospital of western Gujarat from November 2020 to December 2022. 50 patients with small central dry perforation were randomly divided into 2 groups. 25 patients in Group A underwent endoscopic fat plug myringoplasty (EFPM) and 25 in Group B underwent trichloroacetic acid (TCA) application (chemical cauterization). At the end of 3 months (last follow-up) the perforation closure rates and hearing improvement were compared between the two groups.

Results

Out of 50 participants, 20 (40%) were males and 30 (60%) females. 36% participants belonged to 31-40 years of age group. The perforation closure with EFPM was significantly higher than chemical cauterization (92% vs 64%, p=0.0168) measured at 3 months follow-up. Similarly, the post operative hearing improvement was significantly better with EFPM that with chemical cauterization (p=0.0168).

Conclusions

EFPM is an effective method for managing small central tympanic membrane perforations. It is a day-care procedure and success rate is equal or even better than other modalities of managing small TM perforations. This method should be used more often.

Vital Awareness: Blood Donation and Transfusion Safety

2024-06-21T09:34:54+0530

Background: To determine the awareness and knowledge of blood donation and transfusion reactions among various departments in our tertiary care centre.

Material and methods: The cross-sectional study, conducted at ACS Medical College and Hospital in Chennai from March to May 2024, focused on 20 departments. Researchers distributed a pre-tested, self-structured e-questionnaire to the participants, who submitted their responses via email to a designated account.

Results: Out of the 20 departments surveyed, 64% were Faculty, 19% Postgraduate, and 17% were Interns. A significant majority, comprising 64% faculty, reported being aware of voluntary blood donation and transfusion reactions. However, despite the awareness and access to information, only a small fraction of the participants, knew about the right period of blood donationand transfusion reactions.

Conclusion: This study infers that knowledge and awareness of blood donation and transfusion reactions were relatively higher among faculty in department of surgery, obstetrics and pathology and least among psychiatry, anatomy and forensic medicine. Based on these findings, the study recommends organising regular talks and interactive sessions as essential measures to bridge the gap in knowledge, identify and dispel misconceptions, and motivate individuals for regular discussions based on blood donation and transfusion reactions. These initiatives aim to enhance awareness, clarify any misunderstandings, and foster a proper knowledge about blood donation and transfusion reactions among the patients in time of need like mass destruction like accidents and natural calamities

An Observational Study on Clinico-Etiological Profile of Neonatal Seizures

2024-06-14T12:26:27+0530

Background: Neonatal seizures are the most common neurological emergencies encountered in newborns. Neonatal seizures are poorly classified, under-recognized and often difficult to treat. The present study is aimed to find out the spectrum of causes of neonatal seizures with its relationship to various parameters like gestational age, etiology, seizure type.

Material and methods: This Hospital based observational, cross-sectional study was conducted in the level-II Neonatal Intensive Care Unit of Department of Pediatrics, Jawaharlal Nehru Hospital and Research Centre Bhilai, Durg, Chhattishgarh for One year (December 2019 –November 2020). Sample size was 110. The parents of admitted newborns were approached and consent was taken. Study subject were selected as per above mentioned inclusion and exclusion criteria. All cases included in this study were evaluated on following parameters-History, Physical Examination & Measurement of laboratory parameters.

Results: The above table shows the detailed demographic details of our study group in relation to sex, maturity and birth weight. Amongst our 110 subjects with seizures, we had a total number of male neonates in our study were 61 (55.45%), and female neonates were 49 (44.55%).

Conclusion: Our incidence of neonatal seizures in hospitalized NICU was 3.32%. The male to female ratio in our study was1.2:1. The most common cause of neonatal seizures in our study was birth asphyxia, followed by metabolic abnormalities. This was followed by meningitis. Birth asphyxia was the most common cause of seizures in preterm cases. The metabolic abnormalities (hypoglycemia,hypocalcemia and hypernatremia) were the most common cause of seizures in term neonates.

Post-graduate Students’ Feedback on District Residency Program: A Cross-sectional Study

2024-07-15T19:37:39+0530

Introduction
The District Residency Program (DRP) was implemented by National Medical Commission (NMC) for post graduate (PG) students from Batch 2021 onwards. All students of Batch 2021 and some students of Batch 2022 have completed their DRP posting in one year. This survey was conducted with the objective to get the feedback of students and identify the areas, if any, that require attention of the stakeholders for further improvement in the implementation of the program.

Methodology
IEC approval was taken before starting this study. An online questionnaire (Annexure-1) was prepared and validated. It was sent to 55 PG students of our institute who completed the DRP posting. The responses so collected were tabulated in Microsoft Excel sheets and statistical analysis was done.

Results
Out of 55 PG students, 37 responded to the online questionnaire. Thirty-three (89.1%) students felt that they received their subject specific training at least to some extent during DRP posting. This perception was significantly more in students of surgical specialties as compared to their medical counterparts (p=0.0276). Sixteen (43.2%) students did not feel that their skills were enhanced. Fourteen (37.8%) students didn’t feel motivated and confident after the posting. Nineteen (51.3%) students were not satisfied with the basic amenities provided to the during the posting. Eighteen (48.6%) students felt isolated from the parent institute and sixteen (43.2%) students never participated in the teaching activities of parent institute through online mode. Twenty-four (64.8%) students felt that the duration of DRP posting should be less than 3 months.

Conclusions
DRP is an ambitious program to enhance exposure and orientation of PG students to community health needs in district health care delivery system. Every effort should be made by stakeholders to provide good basic amenities to the students. Posting PG students at centers where specialists in respective subjects are available will generate sufficient clinical material to meet their training needs. The parent department should be in regular contact with the students and motivate them to actively participate in the departmental teaching activities through online platforms.

Clinical Stage at Presentation and Obesity in South Indian Breast Cancer Patients-A Cross-Sectional Analysis

2024-04-24T15:40:33+0530

Background: Breast cancer stands as a formidable global health challenge. While obesity is recognized as a risk factor, its specific influence on the clinical stage at presentation remains unclear, especially in populations with unique genetic and environmental factors, such as South India. This research aims unravel the intricate links between obesityand clinical stage at presentationin South Indian breast cancer patients for tailored screening and management strategies in this distinct demographic.

Material and methods: This cross-sectional study was done at the Department of Physiology, Government Medical College, Thrissur, Kerala, India, on newly diagnosed female breast cancer patients. The menopausal status and body mass index of the patients was taken and classified as per the WHO Asian Classification. The clinical staging was assessed and classified by American Joint Committee on Cancer (AJCC) criteria. Statistical analysis, including chi-square tests, assessed the association between BMI status, menopausal statusand clinical staging.

Results: Out of 93 patients, 62.8% were obese. Underweight patients mostly presented at Stage IIIa (50%), while obese women presented atStage IIa. Linear regression showed no significant link between obesity and higher cancer stages. (p=0.247) Additionally, BMI and clinical stage analyses in premenopausal and postmenopausal groups revealed non-significant results (p = 0.750 and p = 0.174, respectively).

Conclusion: This study does not establish a supportive relationship between obesity and increased clinical stageof breast cancer presentation in South Indian women. The findings challenge the expected link between obesity and advanced stage. This deviation underscores the need for further exploration of the intricate interplay between obesity and regional factors influencing breast cancer in this population.

Fosfomycin Susceptibility Among Urinary Isolates of Escherichia Coli at a Tertiary Care Teaching Hospital

2024-08-01T17:34:59+0530

Background: Urinary Tract Infection (UTI) is a prevalent infectious disease caused by Enterobacteriaceae, with Escherichia coli being the predominant etiological agent. The rise in multidrug resistance (MDR) and dearth of effective oral antibiotics have constrained the therapeutic option for UTIs. Fosfomycin, an orally administrated bactericidal broad-spectrum antibiotic exhibits activity against MDR pathogens. The aim of this study was to assess in vitro efficacy of Fosfomycin against Escherichia coli isolates.

Materials and Methods: This descriptive cross-sectional study spanned a duration of 6 months. A total of 3782 samples were collected from suspected UTI patients and processed. Escherichia coli isolates were identified by conventional method and subjected to in vitro susceptibility testing to Fosfomycin and other commonly utilized antibiotics by Modified Kirby-Bauer disk diffusion method.

Results: Among 3782 samples, 929 (24.56%) exhibited significant colony growth, with Escherichia coli accounting for 378 (40.6%) of the positive isolates. Higher rates of resistance were observed for Nalidixic acid (92.60%), Norfloxacin (78.58%) and Doxycycline (76.99%). Of the Escherichia coli isolates, 269 (71.76%) isolates were identified as MDR isolates. The susceptibility of Escherichia coli isolates to Fosfomycin was 95.23%, while that of MDR Escherichia coli isolates was 95.54%.

Conclusion

Fosfomycin exhibits excellent in vitro susceptibility against MDR Escherichia coli isolates in UTIs, suggesting its potential as a promising alternative oral agent for outpatient therapy of UTI.

Effectiveness of Internal Examinations in Predicting Student's Performance in Final University Examination: A Retrospective Study

2024-08-06T20:24:13+0530

Background: Evaluation of students' performance forms one of the most important aspects in delivery of curriculum. Formative assessment & summative assessment both are widely practiced all across globe. The current study tries to establish effectiveness of formative assessment to predict outcomes in summative examination.

Materials and Methods: This study employs retrospective observational study using the academic records of the first year students in Bachelor of Dental Surgery (BDS) course. The data was subjected to correlation studies applying Pearson's correlation coefficient.

Results: There is a strong positive correlation between performance in formative assessment and summative assessment for theory examination, whereas there is a moderate positive correlation between performance in formative assessment and summative assessment for practical examination.

Conclusions: The internal examinations are having a moderate to strong positive correlation in predicting results of final examination; but it may not be consistent. The purpose of formative assessment is served in existent academic set-up.

Dermatoglyphics - A Marker of Obesity?

2024-07-10T17:32:34+0530

Background: Dermatoglyphics and obesity both are genetically affected and so there may be a correlation between pattern of fingerprint and body mass index. This study aims at finding such correlation if it persists which can be an effective predictor tool for development of obesity in future.

Material and Methods: This study was done on 167 patients coming to general OPD of G K General Hospital, Bhuj. After taking informed consent finger print pattern of all fingers and thumb of both the hands was taken and their BMI was measured. Data was entered in Microsoft excel and statistical analysis was done.

Results: In this study the loop pattern was most common in all the 167 participants in both the hands followed by whorl pattern and the least common was arch pattern. The patterns in the individual fingers of the right and left hand were almost similar. In the participants with normal weight, whorl was the most common pattern seen in the thumb compared to thumb of obese and overweight participants who had loop as the common pattern.

Conclusions: In our study, no significant correlation was found between any fingerprint pattern and body mass index. This study can be carried out on larger scale with a greater number of participants to establish any correlation in future.

In the Crossroads of Health and Awareness: Medical Students' Take on HPV Vaccination

2024-08-01T15:27:52+0530

Background: Ranked as the fourth most prevalent cancer among women globally, cervical cancer presents a significant concentration of 90% of cases in low- and middle-income countries. The potential for preventing cervical cancer through vaccination is substantial. However, the implementation of the human papillomavirus (HPV) vaccine encounters challenges, including acceptance barriers, lack of awareness, and high vaccine costs. Overcoming these obstacles is crucial, especially in regions like India, where cervical cancer screening is a significant concern. The objective is to assess the comprehension, viewpoints, and utilization of the HPV vaccine among medical students enrolled in a medical college.

Material and Methods: A descriptive cross-sectional study was conducted among 384 study subjects using a pre-tested, semi-structured questionnaire.

Results: Perspectives on HPV vaccine administration ranged, with 55% advocating its use in the 10-30 age range. Opinions diverged on vaccine eligibility for boys, administration to sexually active girls, and the necessity of HPV screening before vaccination. Concerns about vaccine safety, administration to HPV-infected women, and cervical cancer screening post-vaccination exhibited considerable diversity.

Conclusion: Provides critical insights into medical students' attitudes and awareness regarding HPV and vaccine, highlighting the significance of tailored health education initiatives to address knowledge gaps and misconceptions. Recognizing these diverse perspectives can guide the development of targeted strategies to enhance public acceptance and utilization of the HPV vaccine. This research contributes to shaping informed decision-making among future healthcare professionals, laying the groundwork for improved public health outcomes.

Comparison of Manual and Automated Nucleic Acid Extraction Methods for HCV - RNA Assays

2024-07-25T15:54:13+0530

Background: Hepatitis C Virus (HCV) infection is the most leading cause of chronic hepatitis in world and it is more prone to cause cirrhosis and carcinoma of liver. Hence, early diagnosis of this virus infection may be helpful to prevent these complications. First step in diagnosis of HCV infection is Enzyme Linked Immunosorbent Assay (ELISA), but it cannot differentiate people who are chronically infected from people who had spontaneous resolution, so molecular method by HCV-RNA detection is more helpful. HCV-RNA extraction is done by two methods, manual and automated method.

Material and methods: In present study, we compared amplification results of HCV-RNA which were extracted by both methods. Automated method is more sensitive than manual method as manual method is time consuming, more cumbersome and has high risk of contamination.

Results: Out of 100 samples, amplification result of 16 samples were found to be positive by HCV-RNA which were extracted by automated method but negative by manual method. The data was analysed using Microsoft Excel.

Conclusion: Automated method has high sensitivity and less chance of contamination.

A Case Series Exploring Hyperhomocysteinemia as a Prothrombotic Risk Factor

2024-05-14T19:26:00+0530

The role of hyperhomocysteinemia (Hhcy) as a prothrombotic risk factor has been researched and debated over many decades. Several prospective and retrospective studies have established the association of Hhcy as a modifiable risk factor in both arterial and venous thrombosis. This case series of nine patients with either recurrent or unprovoked thrombosis and thrombosis occurring at unusual sites aims to elucidate the association between Hhcy and thrombotic events as an independent risk factor. This study underscores the importance of screening for homocysteine (Hcy) levels for early management of high-risk patients and contributes to the existing evidence of the thrombogenic effects of Hcy, thereby highlighting future research to improve management guidelines and preventive protocols.

Clinico-Radiological study with Bronchoscopic and Histopathological Correlation of Lung Tumours

2024-07-02T10:28:36+0530

Lung cancer is the leading cause of cancer-related deaths worldwide. Many patients tend to have a very poor prognosis due to being diagnosed at an advanced stage especially in densely populated nations. The current study presents a case series of lung tumors. All the lung tumors presented as endobronchial mass;however histopathological diagnoses were different in each of the lung tumors after bronchoscopic guided lung mass biopsies. The first case was small cell lung cancer (SCLC) with endobronchial growth in a 64‑year‑old male. Bronchoscopy was suggestive of Left vocal cord palsy. The tiny nodule was seen over both cords with nodule present over carina. Chest CT scans revealed a well-defined irregularly shaped mass lesion with spiculated margin seen in the left lower lobe. The analysis of a biopsy specimen obtained from the tumor resulted in a diagnosis of SCLC. The second case was of non-small cell lung cancer (NSCLC) with endobronchial growth in a 77-year-old male. CECT reveals a right upper lobe malignant mass lesion with mediastinal invasion with mediastinalmetastatic nodes. Bronchoscopy revealed a right upper lobe malignant mass. Histopathological examinationrevealed features consistent with NSCLC of Squamous cell carcinoma. The third case was a 58-year-old male whose CECT Thorax revealed a malignant pulmonary mass lesion in the left hilar region. Bronchoscopy was suggestive of endobronchial growth present in Left main bronchus around 1.5 cm from the carina. Tissue taken from the Left Hilar mass showed features of NSCLC-Adenocarcinoma carcinoma of the lung.

Coexisting Carcinoma of Breast and Basal Cell Carcinoma of Skin: A Case Report

2023-11-06T12:13:10+0530

An elderly female presented with the complaint of a right sided breast lump since six months, found to be Invasive Ductal Carcinoma (IDC) of the Right Breast. Examination also revealed another lesion of suspected Basal Cell Carcinoma (BCC) in the same region, which was later confirmed by histopathological examination. Both these lesions were excised during the same procedure of Modified Radical Mastectomy. Review of literature of this rare coexistence showed no such documentations from India. Genetic basis for the same was reviewed, but could not be evaluated in our patient.

Importance of Microfilariae Detection on Night’s Peripheral Blood Smear Without Eosinophilia in a Febrile Case withRight Lower Limb Swelling

2024-05-15T11:02:08+0530

Bancroftian filariasis is caused by the filarial parasite Wuchereria Bancrofti and is transmitted by Culexmosquitoes. It is found in tropical and subtropical countries. Traditionally, peripheral blood smears identify this condition by finding microfilaria. Inadvertently found adult worms and microfilaria in fine needle aspiration cytology (FNAC). The disease may be missed in the absence of eosinophilia in a CBC or peripheral blood smear. One must be aware of this possibility. Chronic inflammation and lymphedema lead to lymphatic damage, swelling and elephantiasis of the legs, arms, scrotum, breasts, and vulva.A 29-year-old male patient presented with chief complaints of pain and swelling over the right lower limb for one and a half years. It was reported to be filariasis during laboratory investigations.

Harlequin Ichthyosis: Navigating the Challenges of a Rare Case

2024-04-24T09:30:30+0530

Ichthyosis, derived from the Greek word "ichthys" meaning fish, encompasses various skin disorders characterized by dry, scaly, and thickened skin, often inherited through autosomal or X-linked modes. This case report discusses a rare and severe form known as Harlequin ichthyosis, presenting a second gravida woman with consanguinity history who delivered a male baby with characteristic features including porcelain-like skin, ectropion, eclabion, and flexion deformities. Despite supportive measures, the baby died shortly after birth. Harlequin ichthyosis, with an incidence of 1 in 300,000 births, arises from mutations in the ABCA12 gene, affecting lipid exocytosis and desquamation. Antenatal diagnosis is feasible through ultrasound findings and genetic testing, with a grim prognosis and limited survival beyond infancy. This report underscores the challenges in managing such conditions and highlights the importance of ongoing research for better understanding and management.

Trisomy 18 Chronicles: A Case Report Illuminating Edward Syndrome

2024-05-18T10:28:26+0530

This case report delves into the complexities surrounding Edwards syndrome (Trisomy 18), a chromosomal abnormality stemming from meiotic disjunction. Initially reported in 1960, Edwards syndrome is the second most prevalent autosomal trisomy following Down syndrome, affecting between 1 in 3500 and 1 in 7000 individuals, with a slight male predominance. The majority of cases involve parents under 30 years old. A review of 152 cases demonstrates a myriad of anomalies, including severe intellectual deficits, congenital heart problems and distinct facial features. This report aims to enhance understanding of Edwards syndrome by presenting a comprehensive case study detailing the diagnosis and distinctive clinical features of a newborn with Trisomy 18. This case report helps in understanding the complexity of genetics and clinical manifestations, highlighting the importance of prenatal diagnosis and counseling, multidisciplinary care approaches, parental decision-making, palliative care and the need for further research. The case report underscores the necessity for heightened public awareness and support for affected families. This study contributes to the body of knowledge regarding Trisomy 18, fostering a more compassionate and informed approach to managing this challenging genetic disorder, ultimately aiming to improve the quality of life for those affected by Edwards syndrome.

High Performance Liquid Chromatography (HPLC): An Essential Tool for Diagnosis of Compound Heterozygous Form (HbSD) of Hemoglobin-D (HbD) with Hemoglobin-S (HbS)

2024-04-25T17:48:46+0530

Hemoglobinopathies are group of disorders that are inherited resulting in increase morbidity and mortality among the affected individuals. Many deaths have been reported because of these disorders. Compound heterozygous form of Hemoglobin-D (HbD) with Sickle Cell Disease (SCD) is very rarely found in Indians. Here, we present the clinical and laboratory findings of such a rare case. Blood samples from a 43-year-old Muslim woman were taken and blood investigations including High performance liquid chromatography (HPLC), Complete Blood Count (CBC), Peripheral Blood Smear (PBS) were done. CBC showed presence of anemia with Hemoglobin (Hb) of 3.9 gm/dl which showed moderate hypochromic picture with reduced Red Blood Cell (RBC) mass. HPLC was performed on BioRad-D10 machine and two peaks were obtained; one for HbD and another for Hemoglobin-S (HbS). This showed the presence of compound heterozygous for HbS-D. Compound heterozygous form of HbD with HbS is a rare disorder. The clinical manifestations occurring in such patients can be serious; so early detection through HPLC of the patients having anemia is necessary for prompt management. Also genetic counseling should be advised in the patients presenting with such anemia.

A Case of Traumatic Abdominal Wall Hernia Following a Road Traffic Accident

2024-03-19T10:25:48+0530

Background: An extremely rare kind of hernia is the traumatic abdominal hernia. It is frequently misdiagnosed, and diagnosing it calls for a high degree of suspicion.

Case history: Following a collision with a scooter and a blow to his abdomen from one of the handles, a 40-year-old man was brought to the emergency room complaining of abdominal pain. A left lower abdominal wall hernia was suggested by USG-eFAST. Hernioplasty with meshplasty was performed on the patient.

Results: There were no complications following surgery.

Conclusions: When a patient is diagnosed with a traumatic abdominal wall hernia, they should have a thorough examination to rule out early signs of organ damage and then have their abdomens radiologically examined to check for intra-abdominal injuries. The diagnosis and treatment of these cases still depend heavily on clinical examination and judgment. Given the possibility of the bowel loop becoming incarcerated, the definitive course of treatment, in this case, is surgical exploration combined with the primary repair of the defect.

Treacher Collins Syndrome: A Case Report and Review

2024-07-31T18:06:46+0530

Treacher Collins syndrome is an autosomal dominant genetic disorder that results from improper development of the first and second pharyngeal arches. Disruption in the formation and migration of neural crest cells leads to facial malformation. Face shows a convex profile with hypoplastic malar bones as well as mandibular hypoplasia. Eyes typically have antimongoloid slant often with lower lid coloboma. External ear is deformed and patients often suffer from conductive deafness. Respiratory distress is common due to hypoplastic facial bones. Though intelligence remains unaffected, such patients are susceptible to depression. Management of these patients require multidisciplinary approach to ensure a decent quality of life.

An Unusual Case of Osteofibrous Dysplasia of Tibia in a Female Child

2024-04-25T17:46:12+0530

Osteofibrous dysplasia (OFD) is an uncommon bone tumor characterized by a non-cancerous, developmental skeletal disorder. It comprises a fibrous matrix with immature bone tissue surrounded by osteoblasts, typically located in the cortex of long bones. Distinguishing between osteofibrous dysplasia, fibrous dysplasia, classical adamantinoma, and osteofibrous dysplasia-like adamantinoma can pose a diagnostic challenge. OFD is challenging to diagnose on histopathology alone without radiological and clinical correlation and we highlight the importance of the same. Therefore, initial clinico-radiological correlation must be followed by histopathological examination in guiding prompt inception of timely treatment. Here, we present a unique, uncommon case of OFD in a seven-year-old girl, wherein pathological fractures occurred due to an underlying bone lesion incidentally detected on X-ray.

A Peep into Purple Medicine

2024-06-11T09:55:50+0530

The colors have role in diagnosis and treatment of diseases. A change in color of skin or urine may indicate the underlying pathological alterations in body. Similarly, a change in visual color perception may be an early indicator of neuropsychological disorder requiring medical attention. In addition, colors affect the perceived effect (beneficial or adverse) of a drug and thus influence the effectiveness of a drug. In an experiment, 100 medical students were given blue or pink placebo in the garb of sedative or stimulant medicine respectively. Subjects taking the blue placebos felt less alert (66%) than those taking the pink (26%) and also drowsier. Studies show that red, yellow, and orange drug formulations are perceived as stimulant whereas blue and green as tranquillizing drugs. The sildenafil is known world over as “the Blue Pill” because blue refers to calmness and tranquility. Interestingly, its use may result in difficulty in discriminating colors such as blue, purple, and green. The purple color is a secondary color, a mix of two primary colors red and blue. The purple color symbolizes calm, creativity, dignity, frustration and sadness, luxury, magic, and mysticism and power. Poetically, it signifies love. The purple-heart epitomizes love, trust, and support. ‘A purple patch in once life’ is an idiom to narrate a period of exceptional success or good luck. In Feng Shui, purple color emanates high vibrations and is used sparingly. Excess use can promote depression! The “Porphura” is the ancient Greek word for purple. It originates from the purpura mollusk, which produces a purple substance used to dye the royal clothes.