Background: Parent-child communication is a foundational element in building a healthy and supportive family dynamic. It involves the exchange of thoughts, feelings, and information between parents and their children, playing a crucial role in the emotional, social, and cognitive development of the child. From early childhood through adolescence, the nature and methods of communication evolve, requiring parents to adapt their approaches to meet the changing needs of their children. Whether through words, body language, or actions, how parents communicate with their children significantly impacts their self-esteem, emotional regulation, and relationships with others. Aim and Objectives: To determine the level of communication between parent and their adult children and to assess how the level of communication between parents and their children affects a child’s mental health. Materials and Methods: A cross-sectional study was conducted between October and December 2023 among 230 randomly selected students aged 18 to 25 from various colleges in the Indore district who gave consent, using a pre-designed, semi-structured, pre-tested questionnaire. Data entered in Microsoft Excel was analysed using SPSS software 25.0 (trial version). Results: Mean Parent-Adolescent Communication Scale (PACS) score of medicos was 65.86±5.94 and non-medicos was 67.56±6.38, which was statistically significant. The mean Perceived Stress Scale (PSS) score among medicos was 20.99±5.21 and that of non-medicos was 20.66±5.11. Spearman’s correlation between PACS and PSS was statistically significant among young adults. Mean PACS score of males was 67.46±5.98 and that of females was 66.03±6.35. Mean PSS score among males was 19.25±5.46 and that of females was 22.25±4.42, which was statistically significant. Mean PACS score of severe PSS category participants was 64.45±5.51, moderate PSS category participants was 66.36±6.08, and that of mild PSS category participants was 73.17±3.85, which was statistically significant (p <0.05). Conclusion: The correlation between PACS and PSS scores was found to be statistically significant (p-value<0.001) among young adults suggesting that, both parent-child communication and perceived stress are associated. So, better communication will help to reduce the stress in the personal lives of young adults. Keywords: Parent-Child Communication, Mental Health, PACS, PSS.

Background: Penile fracture is the traumatic rupture of tunica albuginea. It is a urological emergency that occurs almost exclusively due to blunt trauma of erect penis. Diagnosis is mostly based on clinical history and physical examination. Aim: To study the presentation and management of patients with penile fracture. Materials and Methods: This retrospective study was conducted in Government Medical College Srinagar in the department of surgery over a period of 3 years. Total of 65 patients with fracture penis were included in the study. Clinico-etiological profile, management and outcome were recorded on a preformed proforma designed for the purpose. Results: The age group involved was 17-55 years with mean age of 36 yrs. 37 (56.9%) were married and 28 (43.1%) were unmarried. The most frequent mechanisms of injury was sexual intercourse observed in 40 patient, masturbation in 17 patients and in 7 patients fracture occurred because of trauma to erect penis (rolling over erect penis). In one patient the exact cause could not be elucidated. 17 patients recalled a popping sound. Penile swelling was seen in 56 patients with pain in 53, deformity in 55 and ecchymosis in 50 patients. Diagnosis was made clinically and was confirmed on surgical exploration. Repair of tunica defect was done. One urethral injury was encountered which was primarily repaired. Outcome was excellent and all patients regained complete penile function except 6 patients, at 2 months follow up. Out of 65 cases treated surgically, 4 patients had wound infection, and 12 had palpable nodule at the site of fracture and 1 patient had depression. Conclusion: Penile fracture is a clinical diagnosis requiring early exploration and surgical repair to ensure better functional and morphological outcomes. Keywords: Penile fracture, Management, Outcomes, Erectile dysfunction, rupture of corpora cavernosa.

Background: Diabetes mellitus is a prevalent metabolic disorder characterized by chronic hyperglycemia, leading to complications affecting various organs, particularly the kidneys. This study aims to assess the correlation between glycemic control, as indicated by HbA1c levels, and renal function, measured through blood urea and serum creatinine levels, in diabetic patients with controlled diabetes compared to healthy controls. Materials and Methods: A comparative case-control study was conducted involving 300 patients with well-controlled diabetes and 100 healthy age-matched controls. Key biochemical parameters, including fasting blood sugar (FBS), postprandial blood sugar (PPBS), HbA1c, blood urea, and serum creatinine, were analyzed. Statistical analysis was performed using Student's t-test to compare the two groups. Results: Among the diabetic cases, 84 (28%) had elevated urea levels, 90 (30%) showed increased creatinine, and 126 (42%) had elevated levels of both. Males exhibited higher creatinine values than females, likely due to greater muscle mass. A significantly higher levels of FBS, PPBS, HbA1c, blood urea, and serum creatinine was observed in diabetic patients as compared to controls (p < 0.001). Conclusion: Elevated blood urea and serum creatinine levels in diabetic patients are indicative of renal impairment. There is a significant correlation between poor glycemic control and kidney function deterioration. Regular monitoring of these parameters is crucial for the early detection and management of diabetic nephropathy, emphasizing the importance of glycemic control in preserving renal health. Keywords: Diabetes mellitus, blood urea, serum creatinine, HbA1c, renal impairment, diabetic nephropathy.

Background: Blood transfusion is vital in trauma, surgery, and chronic care, but it poses a risk of transmitting infections like hepatitis B, hepatitis C, HIV, syphilis, and malaria. These infections often originate from asymptomatic donors and can spread through contaminated blood or improper handling during transfusion. Materials and Methods: A retrospective study was conducted at the Model Blood Centre of SVRRGGH in Tirupati, aimed to ensure safe blood transfusion by rigorously screening all donations for transfusion-transmitted infections (TTIs) following national protocols. Results: The five-year study at the Model Blood Bank, Tirupati, recorded 35,080 blood donations, with a significant gender disparity, as 97% of donors were male. The overall prevalence of infectious markers was 1.68%, with Hepatitis B (1.4%) being the most common infection, followed by HIV (0.14%), HCV (0.04%), syphilis (0.011%), and malaria (0.06%). Conclusion: The study emphasize the importance of rigorous screening protocols to ensure the safety of blood donations, especially considering the higher rate of infection in voluntary donors. Keywords: Blood donation; HIV, HbsAg, HCV, transfusion transmitted infections.

Background: Rectus sheath block (RSB) is an anterior abdominal wall block that reduces postoperative pain associated with midline incisions. objectives were to compare the post- operative pain scores, intravenous opioid analgesic requirements and length of postoperative stay of the two groups of women. Material and Methods: Present Prospective Randomized Controlled Trial was conducted at Department of Anaesthesiology, G.M.E.R.S Medical College and Hospital Sola, Ahmedabad. Sixty patients were scheduled for elective laparoscopic gynecologic surgery. At the end of the surgery, the patients were divided into two groups. RSB group (GROUP A): Patients received USG guided Bilateral Rectus Sheath Block with 20 ml of 0.25% Ropivacaine on each side (n=30). Control Group (GROUP B): Patients who did not receive the RSB block and were given Injection Tramadol on demand for post-operative analgesia as per institutional protocol(n=30). Analgesic efficacy of RSB block in laparoscopic gynecologic surgery was assessed by time to first requirement of rescue analgesic drug (Tramadol), VAS scores, and total dose requirement of Tramadol in 24 hrs. Results: RSB block increases the duration of time to first rescue analgesic drug with significant difference between RSB group and the CONTROL group. There is a significant decrease in the VAS score in the postoperative period in the RSB group as compared to the control group. It also reduces the total Analgesic requirement in the first 24 hours with significant difference between both groups. Conclusion: USG guided Bilateral Rectus Sheath block when compared with a standard general anaesthetic is associated with a significant decrease of systemic analgesics demand and is a good choice for postoperative pain management in surgery involving the anterior abdominal wall like laparoscopic gyneclogical surgery as a part of multimodal analgesia. Key Words: Laparoscopic Gynecologic Surgery, Rectus sheath block, Ropivacaine, Tramadol.

Background: Age related hearing loss is a major public health issue, Multiple variables have been evaluated that contribute to hearing loss with aging. Aim: To study Age related Hearing loss among patients above 60 years of age with comorbidities. Materials and Methods: A cross sectional study of 100 elderly patients with and without various co-morbidities were investigated by pure tone audiometry to assess the hearing loss and the pure tone thresholds were compared among the various subgroups and the following results were obtained. Results: Majority of the elderly study subjects belonged to 71-80 years (41%) followed by 34% in 61– 70-year age group. Majority of the study subjects were male (64%). The male to female ratio was 1.7:1. The most common comorbidity present was Diabetes mellitus (28%), followed by hypertension (24%) and dyslipidaemia (18%). Smoking constituted 14% and alcohol habit was present in 16% study subjects Sensorineural hearing loss was observed in all the patients under the study. The degree of hearing loss increased as age progresses in both the normal and patients with comorbidities. The hearing loss maintained a linear progression amongst all studied groups. Conclusion: There is a definitive increase in hearing thresholds in patients of Diabetes mellitus, Hypertension, Dyslipidaemia, Smoking when compared to the normal whereas amongst alcohol consumers the hearing threshold was better when compared to the normal patient. Keywords: Hearing loss (HL), Dyslipidaemia, Smoking, Diabetes mellitus, Hypertension.

Background: Neurological complications are common in paediatric HIV patients, with neuro-imaging playing a crucial role in early detection and management. This study aims to evaluate the spectrum of MRI neuro-imaging findings in HIV-positive children and correlate these findings with their CD4 counts. Materials and Methods: A Cross sectional descriptive study was conducted in the Department of Radiodiagnosis, of an urban tertiary care teaching hospital. The study included thirty consecutively enrolled HIV infected children up to 15 years of age having neurological manifestations, attending paediatric OPD as well as those admitted to the paediatric ward at this tertiary care hospital from Dec 2021 till Nov 2023. Results: None of the children were less than 01 year of age in our study. In 21 (70 %) cases, there were T2 and FLAIR hyperintense white matter lesions noted suggestive of HIV encephalopathy. Out of these 21 cases, 11 (52.3 %) patients had white matter lesions in periventricular location, 6 (28.5 %) in deep white matter and 4 (19 %) in both periventricular and deep white matter. 15 (71.4%) out of these patients diagnosed as HIV encephalopathy had associated cerebral atrophy. Out of total 30 cases studied, only two patients (6.6 %) had focal intra-cranial lesions and only one (3.3 %) patient had chronic ischemic infarct in left MCA territory with ectasia of M1 segment of right middle cerebral artery. Both the patients with focal intra-cranial lesions were diagnosed as tuberculomas based on imaging findings, CSF studies and serological markers. Patients with HIV encephalopathy presented with varied neurological manifestations & were more commonly associated with severe degree of immune suppression as indicated by low CD4 counts. This association was found to be statistically significant (as indicated by p value of <0.05 in Fisher exact test). Conclusion: This study highlights the range of neurological abnormalities in HIV-positive children and emphasizes the association between lower CD4 counts and more pronounced MRI findings. Early detection of these abnormalities in children with declining CD4 levels could aid in timely clinical interventions and improve the management of neurological complications in paediatric HIV. Keywords: HIV-positive children, Neuro-imaging, Magnetic Resonance Imaging (MRI), CD4 counts.

Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a significant pathogen in intensive care units (ICUs), causing severe infections that are difficult to treat due to resistance to carbapenems. Understanding the risk factors associated with CRKP infections is essential to prevent their spread and improve outcomes. Materials and Methods: An observational study was conducted with 100 ICU patients diagnosed with Klebsiella pneumoniae infections. Data on antibiotic use, duration of ICU stay, use of mechanical ventilation, and other clinical variables were analyzed. Statistical tests, including chi-square and logistic regression, were applied to assess risk factors for CRKP infections. Results: Of the 100 patients, 45 had CRKP infections. Significant risk factors included prior carbapenem use, prolonged ICU stay, mechanical ventilation, and central venous catheter use. Mortality was significantly higher among CRKP-infected patients (35%) compared to non-CRKP patients (10%). Conclusion: CRKP infections in ICU patients are strongly linked to prior antibiotic use, invasive procedures, and prolonged hospitalization. Effective infection control and antibiotic stewardship are critical to reducing CRKP infections in ICUs. Keywords: Risk Factors, Carbapenem-Resistant, Klebsiella Pneumoniae, Infectious disease, Intensive Care.

Background: Hyperandrogenism and insulin resistance are seen in polycystic ovary syndrome (PCOS) which are also known risk factors for dry eyes. Dry eye is a potential comorbidity present in patients with PCOS. Aim: To find correlation between dry eye disease (DED) and PCOS. Materials and Methods: A total of 50 women with polycystic ovary syndrome (PCOS) and 50 healthy controls were included in the study. They were then subjected to a complete ophthalmic evaluation which included tear film break-up time, Schirmer’s test and Ocular Surface Disease Index (OSDI) questionnaire scoring. Results: Correlation between DED and PCOS was found to be statistically significant in both TBUT and OSDI score while Schirmer’s test was found to be statistically insignificant. Conclusion: PCOS has a positive correlation with DED and hence regular eye check-ups are advisable for patients with PCOS. Keywords: Polycystic ovary syndrome, dry eye disease, TBUT, OSDI, Schirmer’s test.

Background: During the first thousand days of life (from conception to the second year), the brain, goes through 90% of its important development. This period is pivotal for cognitive, immune, digestive, and metabolic development, with long-term implications for health and productivity. Many parents are ignorant of the fact that in order to promote good synaptogenesis and overall brain development, their children need certain foods and stimulation. The IAP-Early Childhood Development (ECD) module aims to address this gap through structured parental interventions. To evaluate the impact of the IAP-ECD module on the growth and developmental outcomes of infants aged 0-2 years in Sangareddy district. Materials and Methods: One hundred term healthy babies (≤1 week old) were participated in this prospective experimental study; fifty were born intramurally at MNR Medical College (intervention group), and fifty were born extramurally (control group). The intervention group received neuronal stimulation education through the IAP-ECD module, with eight scheduled well-child visits for growth and development monitoring. The control group attended standard health check-ups. Growth metrics (weight, height, head circumference) and developmental quotients were assessed using the Denver Developmental Screening Test II (DDST-II) and Developmental Assessment Scales for Indian Infants (DASII). Results: The intervention group exhibited significantly higher mean weight, height, and head circumference (p<0.05). Developmental quotients in gross motor, fine motor, language, and social communication domains were also significantly higher in the intervention group at 6, 12, and 18 months (p<0.05). Exclusive breastfeeding rates increased within the intervention group, with a notable reduction in formula feeding and sickness episodes compared to controls. Conclusion: The IAP-ECD module improves the development and growth of newborns through specific dietary and neuronal stimulation. These findings advocate for integrating structured parent education and early developmental interventions in order to help children thrive in the first thousand days of life. Keywords: Early Childhood Development, Brain Development, Infant Growth, Developmental Quotient, Parent Education, Synaptogenesis.

Background: India contributes to a significant number of neonatal mortality in the world, around 25% of the world total. In India neonatal mortality rate contributes significantly to Infant mortality rate and therefore under five mortality rate. Region and cause specific interventions should be planned after detailed analysis of outcome trends in newborn and feedback from healthcare workers to reduce neonatal mortality. This study aimed to find out the outcome and mortality pattern and its causes in Level II special care neonatal Unit in a medical college to plan targeted interventions further. Materials and Methods: This is a retrospective study done on 1950 newborns who were admitted in special newborn care unit over one-year period of time (30/09/2023 to 30/09/2024) in department of Paediatrics of Rani Durgawati medical college (UP). Results: 1950 neonates (Male: Female,1:1.15) were admitted over 1-year period in which 350 Inborn and 1600 outborns were admitted,750(38%) of newborns were premature (delivery before term and low birth weight). The trends in mortality showed a decline over year (The decline was more in outborn than inborn neonates), Among them respiratory distress syndrome and Prematurity being a big contributor to mortality. Rate of successful discharges showed an inclined trend. However, the trends in etiology of death was uniform over the year with respiratory distress syndrome (45%), Perinatal Asphyxia/HIE (25%), prematurity (20%), Sepsis (5%) and congenital malformations (5%) being the chief contributor Extremely preterm newborn had highest case fatality rate around 70%. Conclusion: Our study shows the trends are encouraging but only for term newborns but they also may be insufficient to meet the target of SDG 3.2. For extremely preterm/very low birth weight and newborns having hyaline membrane disease, the trends are not encouraging and these High-risk newborns need to receive better management with advance targeted interventions. Keywords: neonatal mortality, SNCU, preterm, SDG, perinatal asphyxia.

The study aimed to determine the positivity and common clinical features of the influenza virus among hospitalized pediatric patients. The investigation was conducted from December 2022 to November 2023, during which 310 nasopharyngeal swabs were collected from pediatric patients admitted with acute respiratory symptoms (categorized as Category C according to the Ministry of Health and Family Welfare, MOHFW guidelines). These samples were processed following standard protocols. Viral RNA was extracted, and real-time reverse transcriptase polymerase chain reaction (r RT-PCR) was performed to detect the presence of the influenza virus. Subsequent r RT-PCR assays were conducted for subtyping influenza virus types A and B. The clinical histories of the patients were also documented. Out of the 310 samples, 23 (7.42%) tested positive for influenza virus A or B. Further subtyping revealed that 03/310 (0.97%) were positive for A H1N1, 17/310 (5.48%) were positive for A H3N2, and 03/310 (0.97%) were positive for B Victoria. Among the positive influenza cases, fever was the most prominent clinical feature observed in all patients. Other common clinical symptoms included cough, breathlessness, and sore throat. The findings underscored the importance of early detection, prompt treatment, and effective management of complications to reduce the burden of influenza epidemics. At the public health level, the study highlighted the need for continuous surveillance to monitor any resurgence of the infection that could potentially lead to further epidemics or pandemics. The unpredictable nature of influenza virus evolution continues to pose challenges to vaccine strategies and pandemic preparedness, emphasizing the importance of ongoing research and vigilance in addressing this significant health threat. Keywords: RT PCR, Influenza, H1N1, H3N2, Nasopharyngeal swab, respiratory illness.

Background: India is world’s diabetes Capital. The prevalence of Type 2 Diabetes Mellitus is expected to rise more rapidly in the future in India and 40 other countries because of increasing obesity and reducing activity levels and other life style changes. It is well established that coronary artery disease is a major complication of diabetes mellitus, representing the ultimate cause of death in more than half of all patients with this disease. In this study we made an effort to know the cardiac changes present in the patients of Type 2 Diabetes, who do not have any symptoms relating to cardiovascular system and to demonstrate the presence of silent myocardial ischemia in asymptomatic patients of Type-2 Diabetes Mellitus. Materials and Methods: 60 Type 2 diabetes patients for more than one year duration with age 40-70 yrs who do not have any complaints relating to cardiovascular system were included in this study. All were assessed with detailed history, clinical examination and relevant investigation including resting ECG and Treadmill test. Patients with H/O myocardial infarction, uncontrolled blood pressure and other chronic diseases were excluded from the study. Results: In the 60 diabetes patients in Present study, 32 patients were males and remaining 28 were Females. None of our patients showed Resting. ECG and 2D ECHO changes. 11 patients from Present study group showed inducible ischemia in the Treadmill test. Hypertriglyceridemia which is a common risk factor associated with coronary artery disease was found in 31 patients (51.66%) in Present study group. Conclusion: This study shows that type 2 diabetes patients especially of longer duration should undergo cardiac evaluation even though they do not have any symptoms relating to cardiovascular system. Keywords: 2 Diabetes Mellitus, silent myocardial ischemia, Hypertriglyceridemia, Coronary artery disease, cardiovascular disease.

Background: The lymph node ratio (LNR), defined as the ratio of positive lymph nodes to the total number of dissected lymph nodes, has emerged as a potential prognostic indicator in oral squamous cell carcinoma (OSCC). This study aimed to evaluate the prognostic significance of LNR in predicting outcomes, including overall survival (OS) and disease-free survival (DFS) in OSCC patients. Materials and Methods: A retrospective analysis was conducted on 241 patients with histologically confirmed OSCC who underwent surgical resection with curative intent and cervical lymph node dissection. Patients were categorized into two groups based on LNR: low LNR (≤0.20) and high LNR (>0.20). Survival analysis was performed using Kaplan-Meier curves, and Cox proportional hazards regression models were used to identify prognostic factors for OS and DFS. Receiver Operating Characteristic (ROC) curve analysis was conducted to assess the prognostic accuracy of LNR. Results: Patients with a high LNR had significantly worse survival outcomes compared to those with a low LNR. The 3-year OS rate was 42.4% in the high LNR group versus 78.7% in the low LNR group (p < 0.001), while the 3-year DFS rate was 35.2% versus 70.5%, respectively (p < 0.001). Multivariate analysis confirmed high LNR as an independent predictor of poor OS (HR: 1.72, 95% CI: 1.21–2.43, p = 0.002) and DFS. Other significant factors included age, histological grade, depth of invasion, perineural invasion, and lymphovascular invasion. ROC curve analysis showed that LNR had a high prognostic accuracy for predicting survival outcomes. Conclusion: The LNR is a significant prognostic factor in OSCC, providing additional information beyond the traditional TNM staging system. Incorporating LNR into routine pathological assessment may improve risk stratification and guide treatment planning, particularly for patients at higher risk of recurrence and poorer survival. Keywords: Oral squamous cell carcinoma(OSCC), Lymph node ratio(LNR), Prognostic factor(PF), Survival analysis(SA), Overall survival(OS), Disease-free survival(DFS), Cox regression analysis(CRA).

Background: Birth control or contraception and reproductive health have become an essential part of women’s health, by which we can prevent unwanted pregnancies, and family planning is achieved by using highly effective and safe methods of contraception. Over the past few decades, a high growth was seen in the use of contraceptives in the developing countries also and they have been associated with a decrease in the number of unintended pregnancies, and by the effect of it, we achieved reduction in maternal mortality by approximately 40%. Objective: To assess the awareness and contraceptive practices of women attending immunisation clinic of a tertiary care institute. Materials and Methods: This cross-sectional study was conducted in women aged 20-40 years attending immunisation clinic of the department of Community Medicine of a tertiary care hospital of Kashmir. Results: Majority (89.0%) of women belonged to age group 25-34 years. 70% of participants were literate. Majority (85%) of them were homemaker by occupation. 83.0% of participants belonged to Middle-Class. 38.0% of participants had two children. Majority of participant’s husband were literate (88%). 67% of participants were aware regarding different contraceptives. Out of 400 only 180 (45%) of the participants were currently practicing contraceptives. In majority (91%) of participants the decision on fertility were taken by both husband and wife. In our study, Age (p=0.031), Education (p=0.020), SES (p=0.007), Parity (p=0.001) and husbands Education(p=0.002) of the participants was found out to be Statistically Significant with the practice of Contraception. Conclusion: In the present study, we found that majority of the participants were literate and they had awareness about Contraceptives but the Contraceptive Practice was low. Keywords: Contraceptive Practices, Family Planning, Hospital.

Background: Our study aimed to assess medical students' knowledge and attitudes toward the HPV vaccine as well as the effects of a brief educational intervention. This was done because there is a lack of knowledge about the potential of human papillomavirus (HPV) vaccination in India, even among medical personnel. Materials and Methods: A cross-sectional study was conducted in a government teaching hospital. Participants were given a 22-item questionnaire about their understanding and acceptance of the HPV vaccine both before and after an educational intervention. An informative group lecture served as the intervention. Results: In August 2022, a total of 168 students were surveyed, followed by a lecture on the same day. The same students were asked to fill out the same questionnaire again in October, which was 3 months after the intervention. The results showed that after the intervention, 97.3%(138/142) of the participants recognized HPV as a sexually transmitted infection, compared to 92.9%(156/168) before, (p < 0.05). Additionally, awareness of HPV affecting all genders increased from 81.5%(137/168) to 95.2%(135/142), (p < 0.01). The participants also demonstrated a better understanding of HPV's association with various cancers. Furthermore, awareness of the vaccine's availability for all genders increased from 75.6%(127/168) to 87.5%(124/142), (p < 0.01) and the willingness to receive the vaccine significantly rose from 76% (114/150) to 92.4% (118/128), (p < 0.01). These findings highlight the positive impact of educational interventions on HPV-related knowledge and attitudes among medical students. Conclusion: In conclusion, the study demonstrated a significant improvement in medical students' knowledge and attitudes towards the HPV vaccine following an educational intervention. To enhance HPV vaccination rates, targeted awareness campaigns, education, and improved accessibility are essential in reducing the burden of HPV-related diseases and preventing cervical cancer. Addressing these challenges will help achieve broader vaccine acceptance and protect the population from the consequences of HPV infection. Further studies are needed to evaluate and standardize HPV education programs in India. Keywords: Human papillomavirus (HPV), Medical students, HPV vaccine, Educational intervention, Vaccine attitude, Vaccine acceptability.

Background: Breastfeeding is the foundation of a newborn’s nutrition. Breastfeeding needs to be initiated and promoted, and awareness should be created. The family members, mainly the husband, may play a central role in the quality of breastfeeding the baby receives. Fathers’ psychological and practical support influences initiation and duration of breastfeeding. Materials and Methods: This is a prospective questionnaire based study involving fathers of babies who are born in Cloudnine hospital Jayanagar, Bengaluru. On day 3 of life, fathers were given prestructured, self administered questionnaire involving knowledge, attitude and practices towards breast feeding. Babies were followed up in outpatient department for weight loss exclusive breast feeding. Results: In our study, we had total 215 participants. It was apparent in our observation that larger portion of our study population had good knowledge, positive attitude and right practices towards breast feeding. Exclusive breast feeding was 83.3% and significant weight loss (10%) was only 6.0%. We found that good knowledge, attitude and practice of father towards breast feeding was shown to influence exclusive breast feeding with a p value of <0.05. While good attitude was associated with reduced significant weight loss with a p value of <0.05. Conclusion: Good knowledge attitude and practice of father towards breast feeding had positive influence on exclusive breast feeding. While positive attitude of father towards breast feeding showed to be associated reduced significant weight loss. Keywords: Exclusive breast feeding, Father’s perspective, Significant weight loss in neonates.

Background: Malnutrition remains as an important public health issue in both developed and developing countries significantly affecting under- five children. Globally, the overall rate of stunting, wasting and under- weight as 22.3 %, 6.8 % and 5.6 % with overall global rate of 40 % stunting in tribal children. The District Level Household Survey (DLHS) reports suggest the overall prevalence rates of above indicators were as 32.2%, 18 %, 6.8 % and 28.7 % respectively in Chamarajanagar district in State of Karnataka. Objectives: To assess the nutritional status of the children of 12- 23 months age in the tribal settlements of Chamarajanagar district and to determine the factors associated with malnutrition status among these tribal children. Materials and Methods: After obtaining the ethical clearance, a cross- sectional study was conducted in the months of January- December 2023 using 33 × 6 Cluster sampling method with a sample size of 198, the data were collected regarding 201 children in their tribal settlements with written consent using a pre- tested questionnaire included with the socio- demographic details and the measurements such as weight, length, head circumference and mid- upper arm circumference. The nutritional assessment was done using WHO Anthro-plus software. The SPSS software version 21 was used for statistical analysis to find the association of nutritional status with socio- demographic variables by using Chi- Square test, Independent- T test, ANOVA. Results: The overall prevalence of stunting, wasting, severe wasting and under- weight were as 45%, 12.9 %, 6.4 % and 18.9 % respectively. The statistical significances were found among the immunization status with stunting as well as wasting, gender of the child with wasting, head circumference and gender of child, weight of child and the taluk name, weight and MUAC as well as taluk name, weight of child and mother’s age in group. Conclusion: From this study, it can be concluded that the stunting was found more prevalent among tribal children with association of factors such as gender of child, mother’s age, Taluk name, immunization status was found to be in statistical significance with the nutritional status. Keywords: Nutritional Status, Prevalence, Children.

Background: There exists literature that supports the positive correlation between the CD4+ count by flow cytometry and by TLC. However, some studies oppose this concept and correlations. Hence, there is a strong need to determine the correlation. Objective: The present study was undertaken to observe whether the absolute lymphocyte count can be used as a predictor of CD4 count in HIV-infected patients on treatment. Materials and Methods: A total of 135 HIV positive individuals (diagnosis based on serology, PCR) were part of the study after obtaining written informed consent. The blood samples were collected as per standard protocol. Sysmex-K21 was used to assess the complete blood count and total leucocyte count. CD4+ count was performed using a flow cytometry device. Results: A positive correlation was observed between the CD4+ count and WBC count, absolute lymphocyte count, and lymphocyte percentage. Conclusion: The study results support that the absolute lymphocyte count predicts CD4 count in HIV-infected patients on treatment. However, further detailed studies with larger sample sizes and involving multiple centers are recommended. Keywords: Absolute lymphocyte count, Immunity, HIV patients.

Background: Primary intramedullary nailing in open fracture fulfils the objective of stable fixation, biomechanical stability, minimal soft tissue damage, less healing time and early rehabilitation, early weight bearing. As there is data lacking on this, we decided to do this study to assess the clinical outcome of open type 1 and type 2 (Gustilo Anderson) tibia fracture treated with intramedullary interlocking nailing beyond golden hours with respect to, time taken for healing, achievement of range of motion of ankle and knee. Materials and Methods: A longitudinal study was done from January 2021 to December 2022 on a total of 30 participants at the Department of Orthopedics at the Subbaiah Institute of Medical Sciences, Shimoga, Karnataka, India. Results: The mean age in the study was 35.26 SD +/- 10.4 years. We noted that evening time the injuries of tibia were more common. We had a positive correlation between the CRP and the degree of contamination of the wound. Males were suffered more than females, 1 case had pain at knee, 4 cases had ankle and screw site pain and 1 case had superficial infection,2 cases had delayed union, 53.33% had excellent outcome, 43.33% had good outcome, 3.33% had fair outcome. At admission the mean m rust score was 5.03 SD +1.47 and at the final follow up mean m rust score was 22.97SD +3.65. Conclusion: Primary nailing is very useful in the management of open tibia fractures which is treated beyond golden period with a very minimal complication rate and an acceptable clinico- radiological outcome. The results were also found to be satisfactory in terms of the time required for healing and the Range of motion achieved. Keywords: Complication, Primary nailing, Golden hour, Tibial Fracture.

Migraine is one of the most common neurovascular disabling disorders encountered in Shalakya practice. Migraine can be defined as a paroxysmal affection having a sudden onset accompanied by usually unilateral severe headache. In Ayurveda, Migraine is described as Migraine which is a major health issue among people of age group 14 to 50 years. According to WHO, migraine is the third most common disease in the world with an estimated global prevalence of 14.7% (around 1 in 7 people). I Chronic Migraine affects about 2% of world population 2 with female and make ratio 3:1.3 It is a widespread, chronic and intermittently disabling disorder characterized by recurrent headaches with or without aura. The attack gives warning before it strikes black spots or a brilliant zigzag line appears before the eyes or the patient has blurring of vision or has part of his vision blanked out. It is also called as “sick headache” because nausea and vomiting occasionally accompany the excruciating pain which lasts for as long as three days. Suppressing migraine pain with NSAIDS and analgesics gives short term relief and the pain can rebound. Dependence on medicines decreases the body’s natural pain relief mechanism and long-term dependence can damage kidneys, liver or other vital organs. Ayurveda believes in treating the disease at its root cause from within. Therefore, treatments focus on balancing the vitiated Doshas in the digestive and nervous systems. This can be achieved by avoiding triggering factors and prescribing doshic specific diet, stress management, herbal formulas, lifestyle modification Panchakarma, Kriyakalpa and other holistic modalities to create a balanced physiology. Keywords: Migraine, Tridosha, Ayurvedic Therapies.

Background: Acromioclavicular (AC) joint dislocation is common among athletes and participants in contact sports, accounting for approximately 12% of shoulder girdle injuries. While the majority of AC joint injuries can be effectively managed conservatively, high-grade dislocations and certain cases of type 3 dislocations require surgical intervention. Over the years, numerous operative techniques have been developed. The aim of this study is to assess the functional outcomes of using an Endobutton in the management of AC joint dislocations. Aims and Objectives: To evaluate the clinical and radiographic results of patients diagnosed with Acromioclavicular joint dislocation treated with open reduction and internal fixation with Endobutton. Objectives of The Study: To prospectively assess the reduction and AC joint stability. To identify complications related with this procedure. To assess the functional status using DASH Score. Materials and Methods: A total of 25 patients with acute AC joint dislocation were treated using either a double Endobutton or a combination of one Endobutton and a suture anchor. Patients were assessed pre-operatively and at 3, 6, and 12 months post-operatively using the DASH and CONSTANT scoring systems. Additionally, X-ray evaluations were conducted. Results: Of the 25 patients, 22 (88%) were male and 3 (12%) were female, with a mean age of 34.56 years (range: 18–60 years). The right shoulder was operated on in 18 patients (72%) and the left in 7 patients (28%). Rockwood type 3 dislocations were diagnosed in 17 patients (68%), and type 5 in 8 patients (32%). At the final follow-up, the mean DASH score was 3.36 ± 2.07, and the mean CONSTANT score was 96.6 ± 2.63. Post-operative X-rays showed good reduction of the AC joint dislocation. Complications included 1 case of superficial infection and 2 cases of loss of reduction. Conclusion: The use of a double Endobutton or a combination with a suture anchor provides both vertical and horizontal stability to the AC joint. The Endobutton technique minimises implant-related complications and eliminates the need for further surgery to remove the implant. The double Endobutton construct with No. 5 Ethibond closely replicates the coracoclavicular (CC) ligament, resulting in excellent functional outcomes. AC joint reconstruction using the Endobutton allows for early functional recovery and a full range of shoulder movement. Keywords: Acromioclavicular Joint, Dislocation, Endobutton, Shoulder.

Background: Sexual abuse is now a days common among children. So it is important to create awareness among them to reduce the incidence. Aim: The aim of this study is to evaluate the effectiveness of health education regarding good and bad touch among 6 to 10 year children. Setting and design: 6 to 10 year children in Thoothukudi district. Subject and method: It is a quasi-experimental study conducted among 6 to 10 years children in primary schools. Result: The study evaluation showed that the health education on good touch and bad touch has a positive effect over the children. The comparative study among rural and urban children showed that the urban children had a better overview about good touch and bad touch. Conclusion: Children should be made aware of good touch and bad touch from early age itself. Parents and teachers should be educated about the importance of talking such topics with children. Keywords: Good touch, bad touch, child abuse

Background: Healthcare workers are at elevated risk of several diseases in comparison to other occupations since they are exposed to a variety of potentially harmful conditions. Many healthcare providers frequently overlook needle stick injuries, this route predominantly facilitates the transmission of severe blood-borne diseases such as Hepatitis B, Hepatitis C, and HIV, etc.; Objectives: 1. To study the prevalence of occupational injuries among healthcare workers in tertiary care hospital in Tamil Nadu. 2. To explore the patterns of occupational injuries among healthcare workers. Materials and Methods: A cross-sectional study was carried out among 200 healthcare workers in a Tertiary care hospital in Tamil Nadu. The participants were interviewed using a predesigned semi-structured questionnaire. Data was compiled in MS Excel and analyzed and analyzed using SPSS v25.0. Results: The prevalence of occupational injuries among healthcare workers (N=200) was found to be 66%. Among all occupational injuries, needle stick injury was more common. The occupation and hours of shift (12 hrs) were found to be statistically significant with occupational injuries. Only 21.2% of injuries were reported. Injuries were more often during the morning shift inwards and while doing procedures. Conclusion: The study shows a high prevalence of occupational injuries among doctors, the most common being needle stick injury, emphasizing the importance of implementing safe measures to handle sharps to prevent transmission of infection. Keywords: Occupational injuries, Needle stick injury, Health care workers.

Background: From conservative cast and braces to internal fixation with nailing, plating and screw, the treatment of humeral fractures has seen significant advancements in addressing their complications. Aim and Objective: The study aimed to assess the practicality of using the MIPPO technique for treating fractures in the distal humeral shaft. Materials and Methods: Patients with a midshaft humerus fracture were included in the study. The study included a total of 25 patients. The fractures were treated by using a 4.5mm narrow Dynamic compression plate (DCP) for reduction and fixation. X-rays of the humerus were taken on the first day after surgery and then at follow-up appointments at 1 month, 3 months, 6 months, and 12 months. The procedure's clinical and functional outcomes were evaluated using the MEPI score for the elbow and UCLA score for the shoulder. Results: Among the 25 patients, it was observed that the majority of them, specifically 18 patients, had fractures on their dominant side. The average operative time was determined to be 85 minutes. At 6 months, almost all (23 out of 25) patients had an excellent MEPI score. There was no significant difference in MEPI scores over time (p>0.05). All patients had an excellent or good UCLA score at 6 months. The UCLA scores did not show any significant difference over time (p>0.05). Conclusion: We found that anterior bridge plating through MIPO of humeral shaft fractures improved radiological, clinical, and functional outcomes (MEPI scores, UCLA scores, and range of motion). The technique is complex and takes a long time to learn, but the results are good and reproducible. Keywords: Anterior Bridge Plating, Humerus Diaphyseal Fractures, Dynamic compression plate, Minimally invasive plate osteosynthesis.

Background: Diabetes mellitus (DM) has become a global health concern, with type 2 diabetes mellitus (T2DM) accounting for the vast majority of cases. While the cardiovascular complications of T2DM are well-recognized less attention is given to other systemic effects such as hearing loss. Emerging evidence suggests that T2DM contributes to subtle auditory dysfunction primarily due to microangiopathy and neuropathy affecting the cochlea and auditory nerve. These early changes in hearing are often undetected without audiometric screening. This study aims to evaluate the prevalence and severity of hearing impairment in T2DM patients. Materials and Methods: This comparative observational study was conducted in the Department of General Medicine and ENT at a tertiary care medical college. A total of 50 patients diagnosed with type 2 diabetes mellitus (Group A) were enrolled based on predefined inclusion and exclusion criteria, alongside 50 age-matched healthy individuals (Group B) as controls. Demographic data, medical history, and comorbidities were recorded for both groups. A detailed ENT examination was performed to rule out ear conditions affecting hearing. Audiometric testing, including air and bone conduction, was conducted at frequencies ranging from 250 to 8000 Hz using a pure tone audiometer. Data were analyzed using SPSS software, with a p-value of <0.05 considered statistically significant. Results: Patients with type 2 diabetes mellitus (T2DM) had significantly higher systolic (149.82 mmHg vs. 140.15 mmHg, P = 0.0016) and diastolic (90.76 mmHg vs. 85.34 mmHg, P < 0.0001) blood pressure compared to healthy controls. Fasting blood sugar, triglycerides, waist circumference, and BMI were also elevated, while HDL cholesterol was lower in the diabetic group (P < 0.0001 for all). Bone and air conduction hearing thresholds were consistently higher in T2DM patients across all tested frequencies for both ears, demonstrating significant auditory impairment compared to controls (P < 0.05 for all frequencies). Conclusion: Patients with type 2 diabetes mellitus (T2DM) were found to have significant auditory impairment as evidenced by higher bone and air conduction thresholds compared to healthy controls. Regular hearing screenings in T2DM patients, particularly those with poor glycaemic control, are crucial for early detection and prevention of further hearing loss, thereby improving patient outcomes and quality of life. Keywords: Type 2 Diabetes Mellitus, Audiometry, hearing loss, screening.

Background: Varicose veins, a key feature of chronic venous insufficiency, are dilated, twisted veins that commonly affect the lower limbs and are more prevalent in women and older adults. Treatment has shifted from vein stripping to minimally invasive procedures like Endovenous Laser Ablation (EVLA) and Radiofrequency Ablation (RFA), both of which are effective, though RFA may offer quicker recovery and less post-operative pain. Materials and Methods: This prospective hospital-based study compared the efficacy and safety of Endovenous Laser Ablation (EVLA) and Radiofrequency Ablation (RFA) for treating varicose veins over a one-year period in 100 patients, aged 18-65, classified under the CEAP system. Both procedures involved thermal ablation of the vein, with EVLA using laser energy and RFA using radiofrequency, followed by routine post-operative care and follow-up to assess outcomes such as vein occlusion, symptom relief, and complication rates. Results: The study included 100 patients with varicose veins, divided equally into two groups: EVLA (Group A) and RFA (Group B), with most participants being male and aged 31-40 years, classified primarily as CEAP C2. Both procedures showed similar outcomes, with slightly longer procedure times and higher post-operative pain in the EVLA group, though neither of the differences were statistically significant, and both treatments achieved high success rates with no evidence of venous reflux at 1 and 3 months post-procedure. Conclusion: Endovenous Laser Ablation (EVLA) and Radiofrequency Ablation (RFA) are highly effective and safe treatments for varicose veins, with similar anatomical success rates and no significant differences in post-operative complications. Although EVLA had slightly longer procedure times and higher post-operative pain levels, both treatments effectively eliminated venous reflux, making them viable options for varicose vein management. Keywords: Varicose veins, endovenous laser ablation, radiofrequency ablation, RFA, EVLA.

Background: Neuraxial anesthesia remains the preferred choice for Caesarean deliveries across the world. Hypotension is the physiologic consequence and perhaps the most common complication of neuraxial anesthesia in obstetric patients. In this study, we compared the effectiveness of vasopressors, ephedrine versus phenylephrine in the treatment of hypotension after spinal anesthesia and also the fetal outcome. Materials and Methods: Patients aged group between 18-and 35 years posted for elective cesarean section with term pregnancy were allocated randomly to the two groups, Group-1 (E) Ephedrine and Group-II (P) Phenylephrine. Changes in maternal blood pressure, heart rate, and saturation were monitored and noted till the end of the surgery. The total dose of vasopressor and number of boluses used, total volume of fluids infused, the time of spinal anesthesia given, the delivery of the fetus, and the duration of the procedure were documented. Umbilical artery cord blood for determination of the acid-base status of the fetus. APGAR scores 1 min and 5 min of delivery of all newborns were noted and a score of <8 was considered low. Results: In our study, all patients in the two groups were comparable concerning age, height, weight, gestational age, and ASA status. The differences observed in baseline values of mean arterial blood pressure and saturation between the two groups were statistically insignificant. Also, there was a statistically insignificant difference between the duration of surgery, the total volume of fluid used intra-operatively, and the time of spinal to the delivery of the fetus in both groups. Further in my study, it was observed that there was a statistically significant difference in mean arterial blood pressure between the two groups up to 20 minutes post spinal anesthesia, but beyond the 25th minute, there was no statistical difference in mean arterial blood pressure between the two groups till the end of the surgery. Conclusion: The use of phenylephrine or ephedrine to correct maternal hemodynamic changes during spinal block for cesarean section does not show any marked difference in the outcome. The effect on fetal pH fetal acid-base status is comparable with both groups. The results of my study show that phenylephrine and ephedrine are both efficient and suitable vasopressors for the treatment of hypotension following spinal block in patients undergoing cesarean section. Keywords: Cesarean deliveries, hypotension, spinal anesthesia, vasopressors.

Background: In the MICU high mortality rates highlight the need for effective treatment planning. Red Cell Distribution Width (RDW) is a crucial marker, reflecting red blood cell size variability. Elevated RDW is linked to poor outcomes in acute conditions such as heart failure, pancreatitis, pulmonary embolism, and sepsis. Monitoring RDW can help in prognosis and guiding treatment decisions. Materials and Methods: This study aims to access the prognosis of patients admitted in medical intensive care unit based on RDW values. Conducted at GIMS Hospital Kalaburgi, this a Prospective Interventional Study from August 2022 to January 2024. A total of 161 patients were included, via simple random sampling method. Results: In a study of 161 MICU patients (103 males, 58 females), 57.7% died and 42.2% survived. Higher RDW levels at admission and day 1 were associated with increased mortality. Prolonged hospital stay also correlated with elevated RDW values, indicating RDW as a significant prognostic marker. Conclusion: The study shows that RDW is a strong predictor of prognosis and hospital stay duration in MICU patients. Higher RDW levels correlate with poorer outcomes and longer stays. This can guide appropriate care and enable better prognostic counseling for patient attendants, improving overall treatment management. Keywords: Medical Intensive Care Unit, Red Ccell Distribution Width (RDW), Prognosis, Acute heart failure, Sepsis, Pancreatitis, Pulmonary embolism, Acute renal failure, Stroke, Influenza.

Background: Mesenteric ischemia (MI) is a life-threatening condition caused by decrease in blood flow to the intestines, leading to ischemia and potential necrosis of bowel tissue. Early diagnosis and intervention, including revascularization or bowel resection, are critical for improving survival, as MI is associated with high morbidity and mortality if left untreated. Materials and Methods: A retrospective study was conducted in the Department of Surgery, NRI Medical College and Hospital including 30 patients with mesenteric ischemia. Results: The study of 30 patients with mesenteric ischemia (MI) found that most were middle-aged males, with hypertension (55.5%) and diabetes (29.6%) as common risk factors. Surgical interventions, including resection and anastomosis (40%), were frequently required due to severe cases, evidenced by 33.3% having gangrenous bowel loops. One death was reported. Conclusion: Mesenteric ischemia is a surgical emergency and needs prompt detection so as to prevent gangrene of intestines. Keywords: Mesenteric ischemia, SMA occlusion, CT, bowel resection.

Background: Attention Deficit Hyperactivity Disorder (ADHD) is a common childhood disorder characterized by inattention, hyperactivity, and impulsiveness. It often persists into adulthood, leading to various challenges in education, relationships, and family functioning. Treatment typically involves behavior therapy and medications, with a focus on addressing both symptoms and associated difficulties. Materials and Methods: It was an interventional study conducted in a tertiary care hospital wherein children with ADHD and their parents were recruited pragmatically in three treatment arms i.e. parent training, pharmacotherapy and a combined group. Parent training was given using a module in a group setting over six sessions. In the pharmacotherapy group, Atomoxetine was given and in combined group, the above two treatment modalities were combined. P values less than 0.05 was taken as statistically significant. Results: Parent training was effective in reducing ADHD symptoms and parental stress. Furthermore a combined intervention was more effective. Conclusions: Parent training intervention mediates improvement in childhood ADHD comparable to pharmacotherapy and reduces parental stress moreover a combined intervention was more effective and feasible in a resource crunch nation like India. Conclusion: The study found that both pharmacotherapy and parent training effectively manage ADHD in children, with the combined approach showing the greatest improvement. Parent training also reduced parental stress, emphasizing its role in a multimodal ADHD management strategy. Keywords: Attention Deficit Hyperactivity Disorder, Parent Training, Pharmacotherapy, Quality of Life.

Background: Immunobullous Disorders (IBD) represent a group of chronic autoimmune blistering diseases of the skin and mucous membranes. IBD equally affects the mental status of a patient along with physical status, thus hampering the quality of life (QOL). Measuring the QOL is important in the evaluation of nonclinical aspects of disease. This study is carried out to know the impact of IBD on the QOL of patients. Materials and Methods: A comparative cross-sectional study was conducted at the Department of Dermatology, Venereology and Leprosy in a tertiary care hospital. A total of 44 patients (22 in each group) diagnosed with pemphigus and pemphigoid clinically, histologically, and immunologically were recruited in the study. Dermatology life quality index (DLQI) questionnaire was used to assess the QOL of the patients. Statistical analysis was performed using the chi-square test and unpaired t-test. Results: Overall mean DLQI score was 16.05 ± 7.3 and individual mean DLQI scores were 11.6 ± 5.1 and 17.8 ± 4.8 for bullous pemphigoid group and pemphigus vulgaris group respectively. P value <0.001 which indicates a significant difference in mean DLQI scores between the two groups. Impact on QOL is higher in pemphigus group when compared to bullous pemphigoid group. Conclusion: IBD significantly impairs the QOL of patients. QOL of patients of the pemphigus group is more impaired when compared to the pemphigoid group. Therefore, consideration should be given to the patient's QOL along with clinical status for an effective care and patient satisfaction. Keywords: Bullous Pemphigoid, Pemphigus Vulgaris, Quality of Life, Skin Diseases, Vesiculobullous.

Background: Diabetes mellitus (DM) is a common metabolic disorder characterized by hyperglycemia due to either insulin insufficiency or resistance. It is associated with both micro- and macro-vascular complications, including coronary artery disease, peripheral vascular disease, diabetic nephropathy, retinopathy, and neuropathy. These complications contribute to increased morbidity and mortality, imposing financial burdens on both society and families. Mean Platelet Volume (MPV) has been studied as a marker for platelet activation, which plays a role in thrombosis and inflammation. This study aims to assess the relationship between MPV and diabetic microvascular complications. Materials and Methods: This observational study was conducted over 12 months at PESIMSR, Kuppam, among 126 Type 2 Diabetes Mellitus patients. After ethical clearance, purposive sampling was employed. The study assessed MPV in correlation with fasting blood glucose (FBS), postprandial plasma glucose (PPBS), glycosylated hemoglobin (HbA1c), body mass index (BMI), and the duration of diabetes. Exclusion criteria included patients with type 1 diabetes mellitus, gestational diabetes, chronic kidney disease, malignancy, and patients on antiplatelet/antithrombotic therapy. Data were analyzed using SPSS (Version 23), with statistical significance set at p < 0.05. Results: Among the 126 patients, the majority (60.3%) were males, and the predominant age group was 51-60 years. Diabetic retinopathy was observed in 33.3% of uncontrolled diabetic males and females, particularly in those with diabetes duration greater than 10 years. A significant correlation was found between MPV and HbA1c levels. The mean MPV was 7.8 ± 0.82 in patients with HbA1c 6.5-8, 8.87 ± 1.07 in patients with HbA1c 8-10, and 11.65 ± 1.16 in patients with HbA1c >10. The correlation between MPV and diabetic complications, particularly retinopathy and proteinuria, was statistically significant. Conclusion: MPV demonstrates a significant correlation with diabetic microvascular complications and can be used as a potential early marker for uncontrolled diabetes. Larger multicentric studies with longer follow-up are necessary to further validate the use of MPV as a diagnostic tool for diabetic complications. Keywords: Mean Platelet Volume, Type 2 Diabetes Mellitus, Microvascular Complications, Diabetic Retinopathy, HbA1c.

Background: Acute ST-segment elevation myocardial infarction (STEMI) is a major cause of morbidity and mortality. Electrocardiography (ECG) plays a pivotal role in identifying the culprit vessel, which is essential for timely intervention. This study aims to determine the correlation between ECG and coronary angiography (CAG) in localizing the culprit vessel in STEMI. Materials and Methods: This observational study was conducted at a rural tertiary care hospital in India. A total of 107 patients diagnosed with STEMI were enrolled. Data were collected on demographic profiles, ECG findings, and CAG results. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of various ECG markers were compared to CAG findings, which served as the gold standard. Results: Proximal LAD occlusion was the most common finding (42.1% of patients), followed by proximal RCA occlusion (15%). The ECG criteria for RCA occlusion (ST elevation in lead L3>L2) had a sensitivity of 92.31% and specificity of 91.36%. The specificity of ST elevation >1mm in lead V4R for diagnosing proximal RCA occlusion was 95.60%, with a PPV of 69.23%. Conclusion: ECG provides a reliable, non-invasive method for predicting the location of the culprit vessel in STEMI. However, it must be used in conjunction with other diagnostic tools like CAG for accurate localization, especially in settings with limited access to angiography. Keywords: STEMI, Electrocardiography, Coronary angiography.

Background: The nasal cavity and paranasal sinuses play a crucial role in respiration, filtration, and humidification, influencing various clinical conditions. This study aims to analyze the morphometric dimensions of the human nasal cavity and paranasal sinuses in a sample of 50 individuals, focusing on anatomical variations, symmetry, and gender-based differences. Understanding these measurements is critical for clinical practices such as surgery, diagnostic imaging, and the treatment of sinus disorders. Materials and Methods: A cross-sectional study was conducted over six months, where computed tomography (CT) scans were used to measure the dimensions of the nasal cavity and paranasal sinuses. Parameters such as length, width, and height of the nasal cavity, as well as the volumes of the frontal, maxillary, ethmoid, and sphenoid sinuses, were assessed. Statistical analysis was performed to compare differences between left and right nasal cavities and between genders. Results: The average length of the nasal cavity was 5.6 cm (± 0.4), while the width and height were 2.5 cm (± 0.3) and 3.1 cm (± 0.2), respectively. Significant gender differences were observed in frontal and maxillary sinus volumes, with males having larger volumes (p < 0.05). Anatomical variations, such as deviated nasal septum (20%) and concha bullosa (16%), were prevalent. No significant asymmetry was found between the left and right nasal cavities. Conclusion: This study provides essential morphometric data on the nasal cavity and paranasal sinuses, contributing to better clinical management of sinus-related conditions. The findings highlight the importance of considering gender-based differences in anatomical assessments. Keywords: Nasal cavity, paranasal sinuses, morphometry, anatomy, sinus volume, gender differences, anatomical variations.

Background: To study the spectrum of ear, nose and throat manifestations in patients diagnosed with COVID-19 infection over 1-month duration. Materials and Methods: It is observational prospective study (January to June 2021) conducted in 200 COVID -19 positive patients for a period of 6 months. All patients who tested COVID antigen (RAT/RT-PCR) positive admitted at Northern Railway Central Hospital or advised home isolation in follow-up of COVID-OPD, were taken in this study. Results: Majority (83.5%) of patients were treated as out-patients i.e. had mild COVID-19 infection (home isolated). The most common presenting symptom in patients with covid-19 was found to be fever (76%) followed by shortness of breath (22.5%). 13.5% patients were asymptomatic. The most common ENT manifestation as the presenting symptom of covid-19 was found to be dry cough (8%) followed by anosmia & ageusia (6.5%) each. Majority of patients (56%) had at least one ENT symptom during COVID-19 illness. The commonest ENT symptom on follow-up over a period of 4 weeks was found to be ageusia (33%) followed by anosmia (28%) and dry cough (27%). It was found that the inflammatory markers in covid-19 patients with positive ENT symptoms were elevated in the first 2 weeks and normalized by the 4th week in majority of patients. Elevated levels of inflammatory markers were found to be significantly associated with ENT symptoms like odynophagia, dry cough, sore throat, hyposmia and headache. Conclusion: We conclude that the Otorhinolaryngological manifestations are not rare symptoms of COVID- 19 disease, especially in mild or moderate form of the disease. ENT symptoms usually appear initially and may precede the development of severe COVID- 19 disease. Keywords: COVID-19, Anosmia, Ageusia, Inflammatory markers, SARS COV-2, Olfactory Dysfunction.

Background: NAAT is a molecular Amplification technology that targets amplifies and detect genetic material (RNA/DNA) of a pathogen highly sensitive and specific for viral nucleic acid. NAAT reduces the window period of HIV, HBV, and HCV by early detection of viral genome. Testing is molecular technique for screening blood donors to reduce the risk of transfusion transmitted infections, providing an additional layer of blood safety. Aims & Objectives: To evaluate the overall NAAT yield of HBV, HCV and HIV in blood donors; and further, to observe the distribution patterns of NAAT reactive cases, with respect to donor age, gender, occupation, residence (urban/rural), first time and repeat, voluntary, family and replacement donors. Materials and Methods: This retrospective analysis was conducted in the Department of Immunohematology and Blood Transfusion, over a three-year period from January 2019 to December 2022, at tertiary care medical institute of rohilkhand region. Serological screening was performed on 29,524 Whole blood donors. Those found non - reactive were subjected to NAAT testing which comprised 28,318 numbers of donors. All blood units were tested after meeting inclusion and exclusion criteria for donor selection and deferral. Preliminary serological screening was performed by Electro-chemiluminescence technology while molecular testing was performed on mini-pool NAAT testing platform. NAAT yield was calculated for Hepatitis B, C and HIV. Results: Out of 28,318 sero-negative samples subjected to nucleic acid testing, 45 samples were found reactive with an overall NAAT yield of (1:629), HBV reported the highest NAAT yield (1:885) followed by HCV (1:2360) and HIV (1:28,318). In males overall NAAT yield was 1:614. Overall NAAT yield was highest in urban blood donors than rural blood donors (1:608 vs 1:767). NAAT yield was highest among replacement donors than voluntary donors(1:548vs1:716). NAAT yield was highest in older age group (56-65 yrs) and lowest in younger age group 18-25 yrs (1:150 vs 1:890). Conclusion: NAAT is more sensitive and specific in detection; it detects both window period and occult infection. NAAT-PCR can be used as an adjunct to Elisa test. Considering the high prevalence of viral infection, the no. of transfusions and high proportion of component separation, in INDIA implementation of NAAT will be an important step towards providing safe blood. Keywords: Nucleic acid testing, Minipool, Chemiluminescence, Blood center.

Background: The advent of antibiotics has significantly transformed the landscape of surgical procedures by effectively managing and preventing complications arising from infections. The present study was conducted to evaluate prescription pattern of antibiotics used postoperatively in patients undergoing obstetrical, gynecological and general surgeries. Materials and Methods: The study encompassed the case records of all patients over the age of 18 who were admitted to the wards of the Gynecological, Obstetrical (OBG) and General Surgery departments for surgeries. Data collected included patient age, surgical indications, prescribed antibiotics, and their usage patterns. The results were documented in a Microsoft Excel spreadsheet and subsequently analyzed statistically using SPSS software. Results: A total of 200 patients were evaluated. Among them, 100 were enrolled who was admitted to OBG department and 100 who were admitted to surgery department. Among gynecological patients, Ceftriaxone, Ceftriaxone with sulbactam, Gentamycin, Amikacin, Metronidazole, Amoxycillin and clavulanic acid, Amoxycillin and other drugs were used in 31 percent, 19 percent, 28 percent, 6 percent, 39 percent, 15 percent, 9 percent and 5 percent of the patients respectively. among surgery patients, Cefuroxime, Metronidazole, Amoxycillin and clavulanic acid, Amoxycillin, Gentamicin, Clindamycin, Amikacin, Ciprofloxacin and Piperacillin-tazobactam were prescribed in 33 percent, 41 percent, 18 percent, 12 percent, 27 percent, 18 percent, 15 percent, 15 percent and 12 percent of the patients respectively. Conclusion: It is advisable to explore the fundamental causes behind the prescription of antibiotics for diagnoses that do not warrant such treatment, alongside the formulation and execution of antibiotic stewardship programs, as these strategies are essential for enhancing antibiotic prescribing practices. Keywords: Gynecological, Surgery, Antibiotics.

Background: Laparoscopic cholecystectomy represents a minimally invasive surgical approach for the excision of a pathological gallbladder. Dexmedetomidine is commonly used in anesthesia practice as well. Nalbuphine belongs to mixed agonist-antagonist class of opioids (ĸ-agonist and μ-antagonist) with better features such as prolonged duration of analgesia while avoiding the side effects. Hence, the present study was conducted for assessing and comparing the efficacy of intraperitoneal administration of dexmedetomidine and nalbuphine as adjuncts to ropivacaine for post-operative pain relief in patient undergoing laparoscopic cholecystectomy. Materials and Methods: Present study was conducted in Department of Anaesthesiology, Maharshi Vishwamitra Autonomous State Medical College, Ghazipur, Uttar Pradesh, India. A total of 45 patients who were scheduled to undergo elective laparoscopic cholecystectomy under general anesthesia were enrolled. The participants were randomly divided into three groups, each consisting of 10 individuals. In Group 1, patients were administered a 50 ml solution containing 49 ml of 0.25% ropivacaine combined with 1 mcg/kg of dexmedetomidine. Group 2 received a 50 ml solution comprising 49 ml of 0.25% ropivacaine along with 5 mg of nalbuphine, while Group 3 was given a 50 ml solution that included 0.25% ropivacaine and 10 mg of nalbuphine. Postoperative pain was evaluated using the Visual Analog Scale (VAS). All data were analyzed using SPSS software. Chi-square test and ANOVA test were used for evaluation of level of significance. Results: Mean age of the patients of group 1, group 2 and group 3 was 43.2 years, 40.9 years and 41.7 years respectively. Mean BMI among patients of group 1, group 2 and group 3 was 23.7 Kg/m2, 24.1 Kg/m2, and 23.9 Kg/m2 respectively. Group 2 was associated with maximum pain as assessed by VAS. Comparing the VAS among three study groups at 2 hours and 4 hours, significant results were obtained. Conclusion: The administration of 0.25% ropivacaine combined with dexmedetomidine at a dosage of 1 mcg/kg in comparison to nalbuphine yielded the most favorable outcomes in patients. Keywords: Laparoscopic Cholecystectomy, Dexmedetomidine, Nalbuphine.

Background: Sepsis accounts for nearly 70% of all instances of acute respiratory distress syndrome (ARDS). Dexmedetomidine, a highly selective α2-adrenergic agonist, stands out as a distinctive sedative compared to γ-aminobutyric acid receptor agonists. Hence; the present study was conducted to analyze the effect of dexmedetomidine on ventilator free days and mortality in sepsis patients receiving mechanical ventilation. Materials and Methods: A total of 100 patients who were aged 20 years or older, had sepsis, and needed mechanical ventilation for at least 24 hours were included in the present study. Mechanical ventilation encompassed both invasive and noninvasive methods. Sepsis was characterized as a systemic inflammatory response syndrome resulting from an infection. All participants were randomly assigned to receive either a sedation protocol incorporating dexmedetomidine or one that excluded it. Sedation was sustained throughout the mechanical ventilation period or as required. The co-primary outcomes assessed were 28-day mortality and the number of ventilator-free days. All data were systematically recorded in a Microsoft Excel spreadsheet and subsequently analyzed using SPSS software. Results: Overall, 28-day mortality was seen in 14 percent and 22 percent of the patients of Dexmedetomidine Group and Non-Dexmedetomidine Group respectively. Median ventilator free days among patients of Dexmedetomidine Group and Non-Dexmedetomidine Group was 21 days and 19 days respectively. Median ICU stay among patients of Dexmedetomidine Group and Non-Dexmedetomidine Group was 8 days and 9 days respectively. Non-significant results were obtained while comparing the outcome among the two study groups. Conclusion: In patients who necessitate mechanical ventilation, the administration of dexmedetomidine, in contrast to its absence, did not yield a statistically significant enhancement in either mortality rates or the number of days free from ventilation. Keywords: Dexmedetomidine, Ventilator, Sepsis.

Background: Nonalcoholic fatty liver disease (NAFLD) is an emerging worldwide problem and its association with other metabolic pathologies. Metabolic derangements are suggested to be the main cause of NAFLD. As thyroid hormone is the main regulator of energy metabolism, there may be a link between NAFLD and thyroid function. This is a prospective study to analyze the relationship and the trend of thyroid function with severity of non-alcoholic fatty liver disease at newly established tertiary care center. Materials and Methods: The present hospital based cross sectional study was proposed to be undertaken with a total number of 50 patients above 20 years of age of NAFLD diagnosed by ultrasonography whole abdomen, attending the department of medicine, Government Medical college, Barmer, Rajasthan, India during one-year period. Detailed history and clinical examinations were conducted on all patients, and they underwent routine investigations and thyroid function tests (free T3, free T4, and TSH). The statistical tests applied for analysis were Pearson’s chi-square test, test and one-way analysis of variance. Results: The present study consisted of 50 patients having Non-alcoholic fatty liver disease diagnosed on ultrasonography, 48% were having grade 1, 42% were having grade 2 and 10% were having grade 3 fatty liver. In the present study, 58% were having normal FT3 levels and 42 % patients had low FT3 levels which showed no significant relationship with increasing grades of fatty liver (P>0.05). Free T4 levels showed inverse relationship with increasing grades of fatty liver (P<0.05*). 18% of patients with NAFLD had hypothyroidism (4% subclinical and 14% overt hypothyroid) and a more percentage of patients with grade 2 and 3 fatty liver had hypothyroidism. Conclusion: We concluded that free T4 and serum TSH levels had significant correlation with increasing grades of fatty liver. Hence, a statistically significant association was found between hypothyroidism and NAFLD. Keywords: Hypothyroidism, Nonalcoholic Fatty Liver Disease (NAFLD), TSH, Free T4, Free T3.