Introduction: Intake of dietary fibre (DF) has beneficial effects on the risk factors responsible for development of several chronic diseases like IBS, obesity, colorectal cancer, type 2 diabetes and cardiovascular diseases. Hence this study was conducted with aim to evaluate the safety and efficacy of Fitofy, a soluble dietary supplement in various chronic metabolic disorders and chronic GIT disorders with or without other co-morbidities. Methodology: This prospective, observational, multicentric study was conducted for a period of one year from Jan 22 to Dec 22 including 120 patients. Results and discussion: Statistically significant improvement was seen in various efficacy parameters such asglycaemic control amongst diabetes mellitus patients and lipid profile in dyslipidaemia. Various efficacy parameters for obesity like weight, hunger level and waist circumference showed highly statistically significant fall from baseline. Significant reduction was observed in stool hardness and sensation of incomplete evacuation parameters in patients with constipation.  Spontaneous defecation and bowel frequency per week also showed good improvement.Good to excellent safety was observed in 97.19 % of the patient. No adverse event was reported by physician in any patients, A view of good to excellent tolerability was opined by 84.30 % patients. Conclusion: The dietary fiber supplement combination (DFSC) of inulin, partially hydrolysed guar gum, and resistant maltodextrin with proper diet therapy/modifications is found to be safe and effective in causing significant improvements in efficacy parameters of various chronic metabolic disorders like type 2 DM, dyslipidaemia, overweight/obesity, and chronic GI disorders.

Background: Chronic osteomyelitis is a common infection especially in developing country like India. This is very common in younger children and in majority of the time it is due to hematogenous spread of bacteria. Osteomyelitis is still continued as a major problem due to treatment failure and multidrug resistance. This study was conducted to determine the pus culture of chronic osteomyelitis and their susceptibility pattern to various antimicrobial drugs.

Methods: This is prospective study in 63 patients over a period of 8 months. Cases attending orthopaedic department with chronic osteomyelitis were subjected to pus culture and sensitivity testing.

Results: Incidence of osteomyelitis in male is 73.01% and female is 26.98%. Incidence of chronic osteomyelitis following trauma is 61.90%. The most common bone involved was tibia 44.44%. The most commonly isolated organism was staph aureus 55.93 % followed by coagulase negative staph   16.95% and Pseudomonas aeruginosa 11.86 %. Staph aureus showed 100% sensitivity against Vancomycin and Linezolid.

Conclusions: Continued surveillance for incidence of drug resistance among microorganism causing chronic osteomyelitis should be done and also antimicrobial policy should be updated based on sensitivity pattern.

Background: To measure the degree of varus deformity in primary osteoarthritis knee and compare the various degree of varus deformity and knee function.

Method: The Mechanical axis of the femur (MAF) and the Mechanical axis of the Tibia (MAT) to measure angle of varus deformity The patient was clinically examined and assessed for the function of the knee using the American Knee Society function score (AKSS) [Excellent, Good and Poor].

Result: Among 41 patients with 0 to 10 degrees of varus deformity, 53.65% had excellent (80-100) and 46.34% had good (70-79) knee society function scores. Among 32 patients with 11 to 15 degrees of varus deformity, 50% had excellent (80-100), 31.25% had a good (70-79) knee society function score, and 18.75% had a fair (60-69) knee society function score. Among 16 patients with 16 to 20 degrees of varus deformity, 75% had a poor (60) knee society function score, 12.5% had a fair (60-69) knee society function score, and 6.25% had a good (70-79) and 6.25% had excellent (80-100) knee society function score. Among 11 patients with 20 degrees of varus deformity, 100% had poor (60) knee society function scores. Hence, there was a statistically significant difference in the proportion of knee society function scores according to the degree of varus deformity (p0.05). The correlation between the degree of varus deformity and the AKSS was found to be statistically significantly high and negative (Correlation coefficient: -0.880; p<0.001).

Conclusion: With the increase in the degree of varus deformity, there was a decrease in knee function score in primary osteoarthritis knee patients.

Introduction: Conventionally blood loss assessment during labour is done by naked eye assessment but it is subjective and many times small prickles of blood loss is overlooked and patients end up in DIC and maternal morbidity. Sometimes blood loss during labour is overestimated and hence unnecessary blood transfusions are also being given.

The objective of this study was to find out whether gravimetric method will help to assess blood loss more accurately than visual method and thereby help reducing probable morbidity.

Aim: To compare blood loss estimation in normal delivery by visual estimation vs gravimetric method (dry mop weight measurement)

Study Design: Observational Study

Results: 1) Gravimetric (Dry mop weight) method improved the detection of measured blood loss compared with the visual inspection

2) The mean blood loss was 300ml by visual inspection and 400ml by gravimetric method

Conclusion: 1) Gravimetric method can be used to accurately measure the postpartum blood loss in vaginal delivery.

2) Gravimetric method is a rapid and precise procedure to diagnose PPH in labour room.

3) Visual EBL should be replaced with dry mop weight measurement of postpartum blood loss.

Introduction: Anemia is one of the most pressing public health issue in India. It is not a disease but only a manifestation of underlying disease. Complete blood count is the blood test used to diagnose the prevalence of anemia. Mean corpuscular hemoglobin (MCH) and Mean corpuscular hemoglobin concentration (MCHC) are derived parameters from Hemoglobin, RBC and Hematocrit, which reflects changes in erythrogram. Z Score is standardized Score, measures how many standard deviations a data point is from the mean in a distribution. Here we applied Z Score on MCH and MCHC and analyse the difference between Zmch and Zmchc in different types of Anemia.

Aim and Objective: Utility of Zmch, Zmchc and Z Score analysis in classification of Anemia.

Mathods and Materials: A total of 500 hemograms are studied. Basic statistically formulae using mean and standard deviation are applied to calculate Z Scores. Basically a difference between Zmch and Zmchc are compared in patients having different types of anemia.

Result: Z score is statistically significant in diagnosing Iron deficiency anemia, Megaloblasticanemia, Hemolyticanemia, Anemia of chronic disease and B thalasemia trait.

Conclusion: Hemogram is one of the first investigation ordered in all patients. Detailed analysis of blood indices – Zmch and Zmchc and their difference – Z Score help us to classify anemia and thereby we can directs further actions in patient management and treatment.

Introduction: Besides history and physical examination, ascending urethrogram (RGU) remained the Gold Standard for evaluating Male Urethral Stricture. But it underestimates the length of proximal bulbar urethral stricture and it also has the disadvantage of underestimating spongiofibrosis. Since sonography has become the urologist's stethoscope, the present study was aimed to compare the efficacy of sonourethogram (SUG) with respect to RGU in the diagnosis and management of urethral strictures.

Methods: A total of 23 patients meeting the inclusion and exclusion criteria were studied in detail from January 2020 to January 2022 in Department of Urology, Gandhi hospital, Secunderabad. All the patients were first subjected to RGU and those found to have stricture urethra were subjected to SUG. All patients were then subjected to urethroscopy and findings noted. Findings on both these investigations were later correlated with intraoperative findings. Discrepancy in findings of both investigations with those of intraoperative findings were recorded and tabulated. Findings in those patients with change of proposed surgery were also recorded and tabulated. The results were then compared and appropriate statistical tests were applied.

Results: Mean age group of study population in the present study was 44.43 years. In the present study, the most common type of strictures was inflammatory strictures (43.47%). This was followed by idiopathic strictures (26.08%), post catheterization strictures (17.39%) and post TURP strictures (13.04%) in decreasing order of frequency. Most common location of stricture urethra was bulbar urethra constituting about 47.82 % of study population in the present study. Second most common location was penile urethra. 14 out of 23 patients (60.86%) in RGU group had up gradation in length of stricture following SUG. Spongiofibrosis can only be assessed on SUG and cannot be measured by RGU. Mean stricture diameter on RGU was found to be 10.17Fr whereas for SUG was 9.39 Fr. Intraoperative mean stricture diameter was 9.33Fr.

Conclusion: SUG measures exact stricture length and it closely correlates with that of intraoperative findings. So an adequate preoperative planning of surgery can be made based on SUG findings. Stricture diameter on SUG correlates well with intraoperative findings rather than RGU. SUG helps in the identification of spongiofibrosis and periurethral pathology thereby helping in the proper management of patients with stricture thereby minimizing recurrence. False tracts on RGU may be missed if its opening is occluded but these false tracts can be identified on SUG. With accurate information about periurethral pathologies SUG is more useful than RGU when determining the type of operative procedure suitable for patients with strictures localized to the anterior urethra.

Salivary gland carcinomas have clinical divergence with complicated overlapping histological patterns; Mucoepidermoid Carcinoma (MEC) being the most common among them. It accounts for about 5-10 % of all salivary gland tumors and 35.9% of all minor salivary gland neoplasms. Rarely these tumors occur in children and young adolescents. Clear Cells predominant MEC (cMEC) is a unique variant which is often difficult to distinguish from other clear cell tumors. We hereby report a rare case of Clear Cell variant of MEC involving palate in a 13-years-old female.

A schwannoma, also known as a neurilemoma, is a tumour that arises from Schwann cells, which are responsible for the formation of the myelin sheath covering peripheral nerves. Schwannomas typically present as single, benign tumours of the nervous system. They are most commonly found in the head and neck region, particularly along the eighth cranial nerve (vestibulocochlear nerve) in the internal auditory canal.

However, in some cases, Schwannomas can present in multiple forms. This condition is known as multiple schwannomas or schwannomatosis. It is less common than a single, isolated schwannoma. In these cases, tumours can arise from various points along the peripheral nervous system, including cranial nerves, spinal roots, brachial and lumbosacral plexuses, or major peripheral nerves.

We have an unusual case involving bilateral Schwannomas that are likely originating from the lower cranial nerves on right side with in involvement of hypoglossal canal and on the left side, it's suggested to be originating from the trigeminal nerve.

Myositis ossificans is a relatively uncommon pathological condition characterized by the formation of nonneoplastic, ectopic bone within muscles, tendons, and ligaments. It is typically classified into two types: Myositis ossificansprogressiva, which is inherited in an autosomal dominant manner, and Myositis ossificans traumatica, which is caused by severe or repetitive trauma. Clinically, patients may present with pain, swelling, or limitations in movement, which can be either painful or painless. CT scans are valuable in both diagnosing and managing this condition. Surgical excision is the established treatment approach

Universal precautions intend to prevent in the health care staff parenteral, mucus membrane, intact and nonintact skin exposure to pathogens by preventing their exposure to blood and body fluids from all patients as if they were all potentially infectious with blood-borne pathogens. The universal precautions practice applies the basic principle of infection control through hand washing, utilisation of appropriate protective barriers such as gloves, masks, gowns and eyewear to prevent contact with potentially infectious materials, and safe handling of sharps. Hands have been identified as the major source of germ transmission while providing health care. Every person involved in patient care, healthcare worker or otherwise, should be able to accurately perform hand hygiene and at the appropriate time. Keeping in view of this, the present study was conducted to assess the knowledge and practice of hand hygiene among healthcare workers This cross-sectional descriptive study was carried out on 50 healthcare workers in a healthcare setting. All participants had to complete a 25-item self-administered WHO hand hygiene questionnaire for health-care workers 31 for assessment of the knowledge and practice of hand hygiene. The level of hand hygiene knowledge was calculated by dividing the responses into three groups based on a score of more than 75% considered as good, 50-74% moderate, and less than 50% considered as low. Around 37% (n=18) of the respondents never received any formal training in hand hygiene. Only 14% (n=7) of the respondents had a good level of hand hygiene knowledge.

Background: Erectile dysfunction and premature ejaculation are common sexual disorders affecting a large proportion of men worldwide. Nutritional factors play a vital role in preventing and managing these conditions. The study aimed to provide insights into the dietary factors that can influence the incidence and severity of these disorders.

Objective: This study aimed to investigate the relationship between nutritional status and erectile dysfunction and premature ejaculation among male patients, identifying potential dietary interventions.

Method: A cross-sectional study was conducted by Medical College Hospital, Rajshahi, from March 2021 to September 2021. A total of n=150 patients with erectile dysfunction and premature ejaculation. Nutritional status was assessed using a validated food frequency questionnaire, and clinical evaluations were conducted to assess the severity of the conditions. Statistical analysis was performed to determine the association between nutritional status and erectile dysfunction and premature ejaculation.

Result: The study found that men with premature ejaculation (PE) reported lower levels of sexual satisfaction compared to men with normal ejaculatory latency. Out of the 150 patients, 80 (53.3%) reported experiencing erectile dysfunction, while 70 (46.7%) did not. Regarding premature ejaculation, 60 (40.0%) patients reported experiencing it, while 90 (60.0%) did not. In terms of sexual satisfaction, 110 (73.3%) patients reported feeling satisfied, while 40 (26.7%) reported feeling unsatisfied. The data also provided information on the dietary factors contributing to sexual dysfunction. Specifically, 55 (36.7%) patients had low fruit intake, 62 (41.3%) had a low vegetable intake, 48 (32.0%) had a high saturated fat intake, and 68 (45.3%) had a high processed food intake.

Conclusion: The study highlights the significant impact of poor nutritional status on male sexual health, specifically the increased risk of erectile dysfunction and premature ejaculation. The study's findings suggest that dietary interventions, such as increasing the intake of fruits and vegetables and reducing the consumption of processed and fried foods, could help prevent and manage these conditions. These results highlight the need for further research in this area and underscore the importance of promoting healthy dietary habits for maintaining male sexual health.

Background: Newborns with hyperbilirubinemia are at greater risk of kernicterus. Neonatal screening for hyperbilirubinemia helps to prevent kernicterus.

Aim: To find the correlation between cord blood bilirubin at birth and serum bilirubin at 72 hours of a neonate.

Method: Cord blood was drawn from 353 neonates, shortly after birth. The sample was then tested for both blood grouping and typing and total bilirubin levels. After 72 hours of birth, a second serum bilirubin test was carried out, and data was analysed to determine the correlation.

Results: In our study, neonates with significant hyperbilirubinemia (>15 mg/dl) around 72 hours of life had significantly elevated levels of cord blood bilirubin (≥2.5mg/dl. Cord Blood Bilirubin < 2.5 mg/dl can help to identify those newborns who are unlikely to require further evaluation and intervention.

Conclusion: Babies with Cord Blood Bilirubin level ≥ 2.5 mg/dl should be followed more frequently to reduce morbidity due to Neonatal hyperbilirubinemia.

Monoclonal gammopathy of any concentration. It’s a variant of Lymphoplasmacytic lymphoma with Bone marrow involvement & IgM monoclonal gammopathy. Waldenstrom macroglobulinemia constitute around 2% of hematological malignancy. It’s rare slowly progressive disorder with clinical features of Anemia, Thrombocytopenia malignancy, hepatosplenomegaly & lymphadenopathy. The case is remarkable because patient didn’t show any common clinical features of Waldenstrom macroglobulinemia.

Background: Vitiligo is an acquired, progressive depigmenting disorder that presents as depigmented macules or patches. Although it may manifest at any time in life, it usually begins in childhood. There is insufficient data to compare the clinical correlations of prepubertal and post-pubertal onset vitiligo.

Objective: To compile the clinical profiles and sociodemographic parameters of vitiligo patients by the age of onset of vitiligo.

Materials and Methods: Aretrospectivehospital-based study in a tertiary care hospital, the medical records of all patients with vitiligo who attended the OPD over a period of one year were analyzed.

Results: Out of 307 patients, 210 had post-pubertal and 97 had pre-pubertal onsets of vitiligo. There were more females in the prepubertal group than in the post-pubertal group. Only in those with a post-pubertal onset, vitiligo universalis was observed. Segmental vitiligo was seen more in the prepubertal onset group. In univariate analysis, previous episodes of spontaneous re-pigmentation, family history of vitiligo, and canities are commonly associated with prepubertal onset. The association with type 2 diabetes in vitiligo was greater in the post-pubertal group. In multivariate analysis, halo naevi and family history of canities remained statistically significant for prepubertal vitiligo.

Conclusions: Our data present clinical evidence that vitiligo behaves mostly the same way in both groups except that pre-pubertal onset vitiligo is strongly associated with a family history of vitiligo and a personal history of atopy, suggesting that it has a stronger hereditary component and immunological milieu than post-pubertal vitiligo.

Central diabetes insipid us (CDI) is a syndrome by polyuria and polydipsia. This is attributed to arginine vasopressin (AVP), an anti-diuretic hormone that acts on kidney V2 receptors to enhance the re-absorption of free water. We reported a rare case of patient presenting with signs of polyuria and polydipsia which have a wide differential diagnoses of which CDI should not be neglected. Effective treatment can Improve the prognosis if diagnosed in time, We provide a summary of clinical findings, pathological features, brain imaging and laboratory investigations. We also discuss treatment strategies and approaches to monitoring the therapeutic response. lastly, we briefly summaries the current understanding of the path physiology ٦of the disease.

Background: It is widely acknowledged that the behaviour of the parents affect their children's health. Young children’s oral health maintenance and outcomes are influenced by their parents’ knowledge and believes, which affect the oral hygiene and healthy habits. Dental caries is the most common oral disease affecting the children. Early childhood caries is one of the most common and severe forms of dental caries affecting the children less than 3 years. This is because of the lack of oral health education of their parents. Parent’s knowledge and positive attitude towards good oral health care are very important for the prevention of dental disease. If the parents have positive attitude towards dentistry, the child will have better dental health. Mothers, who play the primary role models for their children act as a significant predictor of their oral health by showing their attitude towards their child’s oral health.

Aim: To examine the relationship between mother’s knowledge, attitude and practice towards their child’s oral health.

Methodology: In this study, 3–6-year-old children were examined. A validated questionnaire was used to evaluate maternal knowledge, attitude and practice regarding the importance of oral health of their children.

Result synthesis: The overall knowledge and attitude of mothers regarding the oral health care was poor which reflected in the poor oral practices they follow.

Conclusion: Maternal knowledge for oral health, attitude and behaviour may be considered as contributing factors to the oral health status of their children. Therefore, an oral health education programmes for parents especially for mothers must be recommended in order to improve the oral health of the future generation.

To compare the efficacy of tablet pregabalin (150 mg) and tablet gabapentin (600 mg) on post operative analgesia in elective laproscopic cholecystectomy under general anesthesia. Also secondarily compare the shoulder pain intensity, need for rescue analgesia and compare hemodynamic changes. It can be observed from the present study that the two groups were comparable for age, sex, weight and ASA status of the patients. It was observed that post-operative mean VAS score was significantly different at 4 hr (p value 0.002) and at 8 Hr (p value <0.001) when compared between the two groups. No significant difference in mean VAS score was observed for other time points.  It was concluded that pain score was significantly more in Group G at 4 hr and significantly lower at 8 hrs when compared to Group P.

It was observed that under group P, 88% of the patients had no shoulder pain while 12% had shoulder pain. Under group G, 78% of the patients had no shoulder pain while 22% had shoulder pain (p value 0.183)

It was observed that under group P, rescue analgesic was used in 12% & 88% of the patients after 4 hrs and 8 hrs respectively. Under group G. rescue analgesic was used in 34% & 66% of the patients after 4 hrs and 8 hrs, respectively. (p value <0.001)

Thus it was concluded from our study that pregabalin 150mg and gabapentine 600mg both are suitable and safer alternative for post operative pain management. However pregabalin provides better post operative analgesia

Background: Human resources of health care system are vital for its optimal functioning. Nurses occupy 2/3rd of the health work-force with Nurse-population ratio as 1.7/1000 population in India. Though being a part of health care system they themselves are victims to the work stress, occupational hazards and unhealthy life-style resulting in various morbidities.

Objectives: This study aimed to study the socio-demographic profile, estimate the prevalence of morbidities and identify its related factors among the nurses.

Materials & Methods: A cross-sectional study was conducted involving 435 study participants (Universal sampling method) at a tertiary care teaching institute. Data were extracted from the existing medical records.

Results: Out of 435 study participants, 178 (40.9%) were having comorbidities. The prevalent diseases were Hypertension (49.4%), Thyroid disorders (31.5%), Diabetes Mellitus (30.3%), Arthritis (12.9%), Musculoskeletal disorders (11.2%), Bronchial Asthma (7.3%), Dyslipidaemia (3.9%), Cancer (2.8%), Ischaemic heart disease (1.7%) and Lupus disorders (0.6%). 83 (19.1%) needle stick injuries were reported out of which 53(63.9%) were reported and treated. Age (p<0.001), years of service(p<0.001), Shift duties(p<0.001), physical inactivity(p<0.001), Family history of comorbidities(p<0.001) and BMI(p=0.001) showed significant association between the comorbidities.

Conclusion: Hypertension, Thyroid disorders and Diabetes mellitus were the most common comorbidities among the study population. The occupational safety and health of nurses can be improved by regular health check-ups, mental health support, positive working environment, sick leaves and insurance. It will attract future generation to perceive Nursing as a career and thus bridging the Nurse-population ratio gap.

Background: Dermatological ailments in children contribute to one-third of outpatient visits in the dermatology department. Among these, cutaneous infections and infestations are found to be the most common as per various studies. This study was conducted to find out the commonest cutaneous infections and infestations in children. 

Aim: To find out the prevalence and changing trends in the epidemiology of various cutaneous infections and infestations of the pediatric population.

Methods: The medical records of all children aged 0 to15 years who attended the DVL OPD of a tertiary care center for a period of one year from January 2022 to December 2022 were analyzed retrospectively for this descriptive study.

Results: Total number of children who attended the clinicwas1123, among them 587 children were males and 536 were females. A total of 70.97% of infections and 29% of infestations were recorded and among them, fungal infections were54.49% followed by infestations at 29%, bacterial infections at 9.2%, and viral infections at 7.2%.

Conclusions: In the present study, 70% of the children had infections, with fungal infections (54.49%) being the most common type compared to prior studies. We found a change in the trend from bacterial to fungal, which can be attributed to the epidemic-like scenario of dermatophytosis in India.

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), a fast spreading and disastrous global pandemic. We have studied changes in haematology parameters in COVID-19 infected patients.

Objective/Aim: To assess haematological Parameters in COVID positive cases and analyse difference in profile of haematological parameters between categories of COVID positive cases.

Methods: This is a laboratory observation retrospective study. All COVID RT-PCR (Real Time Polymerase Chain Reaction) Positive cases from June 2020toMay 2022was considered for the study. The haematology parameters of cases including blood group and ESR were captured from hospital records and analysed for the difference between mild (Category A), moderate (Category B) and severe cases (Category C). Statistical analysis was done using SPSS software version 22. p value less than 0.05 was considered statistically significant.

Results: Total WBC count, absolute neutrophil count (ANC), absolute lymphocyte count (ALC), absolute eosinophil count (AEC), absolute monocyte count (AMC), platelet count, neutrophil lymphocyte ratio (NLR), monocyte lymphocyte ratio (MLR), eosinophil lymphocyte ratio (ELR) and platelet lymphocyte ratio (PLR) between the three categories of cases were statistically significant. The commonest blood group was O positive and majority of O positive cases were in Category C. 81.9% cases tested for ESR showed raised ESR.

Conclusion: Haematology parameters can be considered to predict progression of the disease and assess prognosis in COVID-19 infection. Total WBC count, ANC, ALC, AEC, AMC, platelet count, NLR, MLR, ELR and PLR can be considered while monitoring COVID-19 cases.

Introduction: The pterional approach (fronto–temporo–sphenoidal craniotomy) is the most common procedure used for the exposure of Sylvian fissure,frontal and temporal opercula. The tumors of the floor of middle cranial fossa and infra temporal fossa pose a difficulty in access through this approach. Modification of pterional approach, the transzygomatic access osteotomy is one of the core routes to approach infratemporal region. Transzygomatic osteotomy provides enhanced visualization of infratemporal fossa and floor of the middle cranial fossa. The infratemporal tumors may originate from tissues in the region or extending from surrounding tissues.

Method: A series of 5 tumors were treated by author in which 2 were primary in origin and 3 were extension of tumors from mandible. All the cases were approached through hemicoronaltranszygomatic osteotomy except in one case where rhytidectomy incision was given as the tumor was originating from mandibular angle extending to infratemporal region.

Result: The purpose of this article is to access the surgical outcome of the modified pterional approach for the infra temporal fossa tumors. The surgical exposure created by the modified pterional approach was excellent to individuate the tumor margins in all the cases. The depression created by the zygomatic arch osteotomy is aesthetically and functionally accepted by all the patients. Recurrence was noticed in 1case, following chemotherapy and radiotherapy the patient was deceased.

Conclusion:  The management of infra temporal lesions using the modified pterional approach gave an outcome which was both functional and aesthetically established and merely accepted by the patients.

Background: Acne vulgaris is a common dermatological condition with significant physical and psychological impacts. This study aims to compare the efficacy of topical clindamycin versus combination of topical clindamycin and topical benzoyl peroxide gel in treating mild to moderate acne vulgaris.

Methods: A randomized, patient-blinded study was conducted over twelve months, involving 130 patients with mild to moderate acne vulgaris. Patients were treated with either clindamycin or a combination of clindamycin and benzoyl peroxide. The primary outcome was the change in inflammatory and non-inflammatory acne counts using the Investigator Global Assessment (IGA) scale.

Results: The combination therapy group showed a more significant reduction in both inflammatory and non-inflammatory acne counts compared to the clindamycin monotherapy group. By the 3rd visit, 83.33% of patients receiving combination therapy had "0 to 3" inflammatory counts, compared to 35.29% in the clindamycin group. Similarly, there was a noticeable reduction in non-inflammatory lesions in the combination therapy group.

Conclusion: Both clindamycin and benzoyl peroxide are effective in reducing acne lesions, with combination therapy demonstrating superior efficacy. The study also highlights the role of patient-specific factors in treatment response, underscoring the importance of personalized acne management strategies.

Background: Severe acute respiratory syndrome corona virus 2 (SARS CoV-2) is the pathogen causing coronavirus disease. ACE2 is the surface receptor for SARS CoV-2 invasion in human cell and it is more abundant in the endocrine pancreas than in type 1 and 2 alveoli in the lungs, and there is probability that beta cell destruction can occur during an attack of COVID-19. There have been few studies on the possible consequence of beta cell destruction leading to an increase in the need for diabetic medication in post COVID status. Objective: In this study our main aim is to study glycemic control using HbA1c in covid positive diabetic patients and compare at admission and follow up after 6 months. And to study Clinical outcome in terms of mortality, ICU admission and stay, duration of hospital stay and the requirement of anti-diabetic medications at discharge and after 6 months of follow up and compare between pre covid and post covid requirements in non-steroid and steroid treated diabetic patients.  Materials and Methods: This was a Comparative observational study conducted from March 2020 to June 2021 in AJ Institute of Medical Sciences, Mangalore. Total of 88 Covid 19 positive diabetic patients were enrolled in this study. Informed consent was taken. Patients were categorized into 2 groups based on AIIMS/ICMR Clinical guidance for management of adult COVID-19 patients. Group 1 were diabetic patients treated with steroids and group 2 were diabetic patients not treated with steroids. Between the 2 groups, HbA1c was compared at admission and follow up after 6 months and clinical outcome was analysed in terms of duration of hospital stay, ICU admission and stay, mortality and requirements of anti-diabetic medication at discharge and after 6 months of follow up and compared between pre covid and post covid requirements in non-steroid group and steroid group. Results: The mean HbA1c level showed statistically very high significant difference at admission and follow up among non-steroid group (p<0.001) and steroid group (p<0.001). Adverse clinical outcome seen more among diabetic patients with steroid compared to non-steroid group. The requirement of anti-diabetic medication was found to have increased among 48.3% patients in the steroid group and among 46.2% in the non-steroid group when compared at the time of discharge and follow up. But statistically no significant difference was observed between 2 groups (p>0.05), however clinically the difference was seen. The increase in requirement of anti-diabetic medication among non-steroid and steroid group was 56.8% and 52.3% respectively with significant statistical difference (p<0.05) when compared before and after COVID. Conclusion: Glycemic control in terms of HbA1c was good among both groups when compared at admission and follow up after 6 months. The clinical outcome in terms of duration of hospital stay, ICU admission and stay, mortality is seen more among covid positive diabetic patients treated with steroids compared to non-steroid group. The requirement of anti- diabetic medication has increased in both steroid and non-steroid group when compared at the time of discharge and follow up after 6 months but between the groups statistical significant difference was not observed but clinically difference was seen. We also compared the requirement of anti-diabetic medications before and after covid which is found to have increased in both the groups with significant statistical difference indicating the possibility of pancreatic beta cell damage persisting in post covid status among diabetic patients irrespective of treatment with steroids. But further studies are required on large scale to prove the possibility of pancreatic beta cell damage in post covid diabetic patients.

Purpose: To find the proportion of dry eye disease and it’s impact on quality of life among postmenopausal women attending ophthalmology outpatient department of tertiary care center in Alappuzha. Materials and methods: In this study, 98 post menopausal women as per inclusion and exclusion criteria were asked to fill OSDI questionnaire composed of 12 items referring to activities in the week prior to completion. Three subscales in it include ocular symptoms, vision related functions and environmental triggers. Each item of the OSDI questionnaire was graded on a score of 0-4.0-indicates none of the time, 1- some of the time, 2 - half of the time, 3 - most of the time, 4- all the time. This score is assessed on a scale of 0-100 Higher scores represents higher disability and symptoms Results: Mean age was found to be 63.2 years with a standard deviation of 6.9 and mean age of menopause was 49.9 years with a standard deviation of 1.3. Proportion of dry eye based on Schirmer test was found to be 67.3%, by TBUT test was 68.4% and by Oxford grading 68.4%. By oxford grading proportion of postmenopausal women with minimal dry eye was 60.2% and with mild dry eye was 8.2%. By OSDI score, 92.4% postmenopausal women with dry eye by Schirmer test were severely affected by dry eye, 89.6% of them with dry eye by TBUT were severely affected. Among persons without dry eye by Schirmer test, 56.3% had normal quality of life, 34.4% had mild to moderate deterioration in quality of life and 9.4% had severe deterioration in quality of life. By TBUT test 58.1% of those without dry eye had normal quality of life, 29% had mild to moderate deterioration in quality of life and 12.9% had severe deterioration in quality of life. By Oxford grading, among persons without dry eye ,58.1% had normal quality of life, 29% had mild to moderate deterioration in quality of life and 12.9 % had severe deterioration in quality of life. 78.57% had gritty eyes, 77.55% had blurred vision, 75.51% had painful eyes, 68.36% had poor vision and 47.95% had sensitivity to light. 70.2% of study participants with postmenopausal period more than 10 years has severe deterioration in quality of life compared to 58.5% in those with postmenopausal period less than or equal to 10 years. Conclusion: Proportion of dry eye was found to be high in postmenopausal women and leads to severe deterioration of their quality of life. Alteration of sex hormones lead to abnormal tear film, which in turn leads to increased symptoms of dry eye. So there is a need to identify dry eye disease in postmenopausal women to maintain ocular surface health and regular ophthalmologic evaluation need to be done.

Introduction: The common Anaesthetic technique for spine surgeries including Lumbar spine surgeries is general anaesthesia (GA). Spinal Anaesthesia (SA) as opposed to general anaesthesia during elective lumbar spine surgery is an emerging technique and represents a potentially modifiable factor to limit perioperative complications. The aim of this case report is to determine if Spinal anesthesia is a safe alternative to General anaesthesia for lumbar spine surgery.

Objective: To report a case of spinal anaesthesia for short duration Lumbar spine surgeries in orthopaedics.

Method: Search of relevant references from Pubmed, Elsevier, and others with 10 considered relevant by authors were finally selected.

Result: We present a case of a 25 year old obese female who was previously Operated for Posterior instrumentation of L5- S1 spine in view of pott's spine underwent Epidural abscess debridement at L5 S1 level under spinal Anaesthesia.

Conclusion: We conclude spinal anaesthesia is well tolerated and has favourable outcomes compared to general anaesthesia and can be considered for short duration procedures of lower level lumbar spine surgeries.

Background: According to RISKESDAS in 2018, the prevalence of pregnant women at risk of Chronic Energy Deficiency (CED) in Indonesia was 17.3%. CED is a part of the underweight that needs to be addressed efficiently to prevent nutritional disorders. During pregnancy, one crucial nutrient is folate, which plays a role in preventing congenital defects and contributes to neurocognitive function. This study identifies the influence of DHA supplementation on serum folate levels in underweight pregnant women at the Made Surabaya Community Health Center.

Methods: The research follows a pre-experimental design with a one-group pre-and-post-test using 21 samples of underweight pregnant women. Physical examinations, obstetric assessments, ultrasonography, and venous blood collection for analysis were conducted before and after DHA supplementation.

Results: In this study, significant differences were found in underweight pregnant women before and after DHA supplementation in various parameters, namely body weight 51.76 ± 7.635 vs. 53.25 ± 7.310 (p = 0.018), BMI 22.171 ± 2.8173 vs. 22.814 ± 2.5908 (p = 0.034), UAC 24.238 ± 1.4545 vs. 25.243 ± 2.2288 (p = 0.003), folic acid 14.381 ± 4.8078 vs. 18.176 ± 5.8085 (p = 0.000), and fundal height 17.38 ± 7.606 vs. 19.14 ± 7.323 (p = 0.007).

Conclusions: The study found a significant influence on body weight, BMI, UAC, folic acid, and fundal height before and after DHA supplementation

Introduction: Cataract is the leading cause of blindness in people above 50years of age worldwide. Despite rapid increase in the availability of quality cataract services, surgical acceptance is still low amongst few sections of society because of the various factors limiting access to cataract surgery. Hence, the study was undertaken to determine the various factors which delays cataract surgery among patients with mature and hypermature cataract.

Objectives: To determine the reasons for delay of cataract surgery and compare the causative factors for delay in cataract surgery between male and female patients. To find out association between socio-demographic characteristics, reasons for delay in cataract surgery and duration of delay in cataract surgery.

Method: A Cross-sectional study was conducted in tertiary care teaching hospital from July 2022 to September 2022 on 82 patients by using convenient sampling method. After taking consent, the data was collected regarding patient details and Routine ophthalmic examination along with detailed slit lamp bio microscopic examination for grading the cataract were carried out. Data was entered in Microsoft- Excel and analysed using SPSS version 23.0.

Result: Majority (28.2%) of the subjects reported hospitals are far away from home as a reason for delay in undergoing cataract surgery. Among them, males (23.3%) were high compared to females (4.9%). Socio-economic status was found to have statistically significant association with duration of delay in cataract surgery.

Conclusion: Hospitals are far away from home and fear of surgery were the main reasons for delay in cataract surgery. Significant association found between socio-economic status and duration of delay in cataract surgery.

Background: Chronic low back pain (CLBP) is a prevalent musculoskeletal condition that significantly affects individuals' daily lives worldwide. In resource-limited settings like Rajshahi Division, Bangladesh, rickshaw drivers, engaged in physically demanding work constitute a vulnerable population susceptible to CLBP. This study aimed to investigate the prevalence of prescription drug abuse, specifically non-steroidal anti-inflammatory drugs (NSAIDs), among 162 rickshaw drivers suffering from CLBP and assess its potential impact on renal function. Objective: The primary objective was to determine the prevalence of prescription drug abuse, particularly NSAIDs, among rickshaw drivers with CLBP in the Rajshahi Division and evaluate its association with renal dysfunction. Methods: A cross-sectional survey involving 162 rickshaw drivers was conducted in Rajshahi Division using a structured questionnaire. Blood and urine samples were collected to measure renal function markers, including serum creatinine and urinary albumin-to-creatinine Ratio (ACR). Data analysis encompassed descriptive statistics, chi-square tests, and logistic regression. Results: A total of 162 rickshaw drivers participated in the study (mean age: 35.4 ± 6.2 years). Most participants were male (98.8%), with an average duration of rickshaw driving experience of 8.7 ± 2.3 years. The study revealed a distressing prevalence of prescription drug abuse, notably NSAIDs, among rickshaw drivers with CLBP, with 72% self-reporting regular use without medical guidance. Logistic regression analysis demonstrated a significant correlation between prolonged NSAIDs use and elevated ACR, indicating potential renal dysfunction. Conclusions: The findings underscore the alarming rate of prescription drug abuse, particularly NSAIDs, among 162 rickshaw drivers afflicted with CLBP in Rajshahi Division. This misuse may have adverse consequences on renal function. Urgent interventions, including education campaigns targeting rickshaw drivers, are imperative to increase awareness of the risks associated with prescription drug abuse and the importance of seeking professional medical advice for CLBP management. Collaborative efforts from public health initiatives and healthcare providers are essential to mitigate the hazards related to prescription drug abuse in this context.

Background: In 2018, Basic Health Research (RISKESDAS) reported that East Java was one of the provinces in Indonesia with a prevalence of chronic energy deficiency (CED) in women of childbearing age above the national prevalence (19.6%). Chronic Energy Deficiency (CED) is a nutritional problem that can occur in pregnant women due to inadequate energy and protein intake and needs. Chronic Energy Deficiency (CED) is characterized by a pregnant woman's Mid Upper Arm Circumference (MUAC), which is less than 23.5 cm. Nutritional problems and weight loss in pregnant women can cause a decrease in body resistance, and pregnant women become increasingly susceptible to oxidative stress. This research focuses on examining the correlation between the antioxidant SOD and the administration of DHA to underweight pregnant women.

Methods: The research was conducted using an experimental pre and post-test with 21 samples of underweight pregnant women at Made Community Health Center, Surabaya.

Results: Body weight (P < 0,001); Height (P = 0, 88); BMI (P = 0,003); MUAC (P = 0,003); Systolic BP (P = 0,111); Diastolic BP (P = 0,887); Fundal Height (P = 0,001); SOD (P = 0,013).

Conclusions: In this study, a correlation was found between the supplementation of DHA and the weight, BMI, MUAC, fundal height, and SOD levels in underweight pregnant women.

Background: Based on the Basic Health Research in 2018, the prevalence of pregnant women at risk of nutritional deficiencies in Indonesia is 17.3%. According to the Ministry of Health in 2020, out of 4,656,382 pregnant women from all provinces in Indonesia, 451,350 pregnant women were identified as at risk of nutritional deficiencies. Therefore, the percentage of pregnant women experiencing underweight in 2020 was 9.7%. Underweight conditions in pregnant women can lead to disturbances in fetal growth and development, a reduction in nutrient supply to the fetus posing a risk of low birth weight, and additionally blood flow to the fetus decrease leading tp reduced oxygenation which can cause tissue damage and trigger inflammatory reactions. Docosahexanoic Acid is an omega-3 fatty acid whose demand is high during pregnancy, essential not only for the development and growth od the fetus but also crucial for the mother. The administration of DHA supplementation is expected to improve the underweight condition and reduce the impacts resulting from this condition, especially the levels od inflammation in pregnant women.

Method: This study focuses on investigating the mediator correlation of inflammation, specifically IL-6 as a proinflammatory cytokine, with DHA supplementation for 2 months in underweight pregnant women. The research was conducted using a one group pre and post-test experimental design, involving 21 underweight pregnant women samples from Made Community Health Center in Surabaya. Result: Body weight (P = 0.000); Height (P = 0.929); BMI (P = 0.000); MUAC (P = 0.003); Systolic BP (P = 0.108); Diastolic BP (P = 0.631); Fundal height (P = 0.001); IL-6 (P = 0.008).

Conclusion: In this study, a correlation was found between DHA supplementation and the body weight, BMI, MUAC, Fundal height, and IL-6 in underweight pregnant women.

Background: Preeclampsia is a high blood pressure disorder diagnosed during pregnancy which is known to be characterized by the sudden onset of hypertension, proteinuria, and other organ failures at 20 weeks of gestational age. Hematocrit levels in pregnant women have been speculated to be a predictor parameter for the incidence of preeclampsia in pregnancy. One of the mechanisms associated as a predictor of preeclampsia is the blood volume ratio which does not increase simultaneously as in pregnant women with normal blood pressure, thereby producing hematocrit levels (HCT) that are relatively greater than the established standards.

Methods: The research method used was case-control, with the primary sample data being the patient's venous blood sample and the secondary data being the patient's medical records. The data collected was a total of 20 samples with a control population of 10 samples of normal pregnant women and a case population of 10 samples of preeclamptic pregnant women. Bivariate analysis uses the Non-Parametric Mann-Whitney Test.

Results: The research showed that the case group had higher hematocrit levels with Asymp. Sig. (2-tailed) which has a value greater than the Mann-Whitney Test significance level (ɑ = 0.05), namely 0.001 > ɑ = 0.05.

Conclusions: This research concluded that there is a significant difference between the hematocrit levels in preeclamptic pregnant women, which are higher when compared to the hematocrit levels in normal pregnant women.

Background: Preeclampsia is an acute complication of pregnancy characterized by hypertension, proteinuria, and other organ disorders occurring after 20 weeks of gestation. Early detection of preeclampsia is crucial to avoid complications and poor prognosis. The association between increased uric acid concentration and preeclampsia has been recognized since the early 1900s. The classic interpretation of elevated uric acid levels suggests that the vasoconstriction mechanism of blood vessels due to hypertension can reduce kidney clearance. This study aims to analyze the differences in blood uric acid levels in pregnant women with preeclampsia and normal pregnant women.

Methods: The research method used is a case-control design, with 10 blood samples from normal pregnant women as the control population and 10 blood samples from pregnant women with preeclampsia as the case population. Preeclampsia data were obtained from patients' medical records, whereas uric acid level data were obtained from laboratory tests. Bivariate analysis was performed using T-test.

Results: The results of this study show that the case group has a higher uric acid level (68.1%) compared to the control group (31.9%).

Conclusions: Based on bivariate analysis, the p-value is <0.05, indicating a significant difference in uric acid levels between pregnant women with preeclampsia and normal pregnant women.

Background: Moringa oleifera is most notable for its potent antioxidant properties that neutralize harmful free radicals within the body. Free radicals are produced as natural by products of metabolic processes during aging. Testosterone, a crucial hormone in male development experiences a gradual decline as men age associated with various physiological and psychological changes. One of the factors that contribute to this decline is oxidative stress which impairs the function of leydig cells that synthesize testosterone. Therefore, this study aims to identify the effectiveness of different doses of Moringa oleifera extract on testosterone levels in aged male Wistar rats.

Methods: This is an experimental study with a post-test-only control group design. The data was collected from the total samples of 27 rats and randomized into 3 groups. 9 samples of a control group, 9 samples of a group given a dose of 250mg/kg, and 9 samples of a group given a dose of 500mg/kg of Moringa oleifera extract. The extract was given through oral gavage for 21 days and blood was collected to analyze the total testosterone levels.

Results: The results of the study showed the mean value of the treatment group tends to be lower than the control group. Testosterone levels between the 3 groups obtained a p-value of 0.598 where the value was > 0.05, which means there was no significant difference between the 3 groups based on testosterone levels.

Conclusions: Moringa leaf extract was not significantly effective on testosterone levels in aging male Wistar rats. The effectiveness of Moringa leaf extract at a dose of 500mg/kg was not significantly different from a dose of 250mg/kg on testosterone levels in male Wistar rats.

Background: According to the Ministry of Health in 2020, the percentage of underweight pregnant women in Indonesia is 9.7%. Underweight is a condition of low body weight for age which is related to height. The condition of being underweight during pregnancy must be addressed immediately because influence fetal development. Insulin is an important factor in pregnant women for fetal development, such as the brain and eyes. Underweight conditions can cause pregnant women to experience insulin resistance since the beginning of pregnancy. This study identified the effect of DHA on changes in insulin in underweight pregnant women at the Made Surabaya Community Health Center.

Methods: This research includes pre-experimental research with one group pre-test post-test using 21 samples of underweight pregnant women who were examined physical, obstetrics, ultrasonography, and venous blood collection procedures were carried out for examination before and after DHA supplementation. Testing was carried out using the paired t-test and Wilcoxon test.

Results: The research results show that there was a significant difference between before and after DHA supplementation was given to underweight pregnant women. The difference is body weight (p=0.001), body mass index (p=0,002), upper arm circumference (p=0.000), body height (p<0.001), and insulin (p<0.001).

Conclusions: The research results showed that there was a significant effect of giving DHA on body weight, body mass index, upper arm circumference, height, and insulin.

Background: Pregnancy is a physiological process in which the fetus develops in the body.  Where underweight pregnancies are those with a Body Mass Index of <18.5kg/m2.  In pregnant women there will be many changes in the systems in the body.  Apart from that, pregnant women need sufficient nutrition to consume.  Nutritional status in the body can be obtained and obtained from food intake, and apart from food intake, pregnant women also need additional nutrition in the form of macronutrients and micronutrients such as omega 3 fatty acids, namely DHA. This research aims to find out whether there is an influence  between HbA1c and DHA administration to pregnant women. 

Method: This research uses an experimental type of research with a cohort research design, using one group pretest-posttest. By providing treatment to pregnant women at community health centers who meet the inclusion and exclusion criteria. 

Results: Underweight pregnant women who were researched at the Made Surabaya Community Health Center with an age range of 21 to 36 years and a Body Mass Index ranging from 17.3 kg/m2 to 18.80 Kg/m2 were given supplementation in the form of DHA in this study. (Docosahexanoid acid) for one full month to be consumed by pregnant women. 

Conclusion: this study was that there was a decrease in HbA1c levels in underweight pregnant women

Background: The Royal College of Surgeons in England established guidelines in 2008 to standardize the documentation of surgical procedures. Adesh Medical College and Hospital, in line with these guidelines, employs a uniform operation sheet for all surgical procedures. This clinical audit aimed to retrospectively evaluate the quality of handwritten orthopaedic operative notes to assess compliance with established documentation standards. Objective: To retrospectively audit the hand written orthopaedic operative notes according to established guidelines Methods: A retrospective review of 50 orthopaedic operative notes was conducted. Data from these notes were extracted and analyzed to assess the presence or absence of critical documentation elements, including surgery date and time, surgeon identification, procedure details, operative diagnosis, incision specifics, signature, closure techniques, tourniquet time, postoperative instructions, complications, prosthesis details, and serial numbers. Results: Findings revealed that 75% of the procedures were performed by consultants, with registrars responsible for 85% of operative note documentation. Key elements such as date and time of surgery, surgeon's name, procedure name, and signature were consistently documented in all cases. However, operative diagnosis and postoperative instructions were frequently omitted from their designated sections. Incision details were recorded in 80% of cases, prosthesis details in only 30%, and tourniquet times were absent in all cases. Conclusions: This clinical audit highlights both strengths and areas in need of improvement in orthopaedic operative note documentation. While certain aspects met high standards, there is a clear need for enhanced documentation practices, particularly concerning tourniquet times, prosthesis and incision details, and the consistent placement of operative diagnoses and postoperative instructions.

Purpose: This study aimed to investigate the prevalence of musculoskeletal problems among salesmen in Dhaka, Bangladesh, and explore the socio-demographic factors associated with these issues. Objective: The objectives were to assess the socio-demographic characteristics of the salesman population, identify the prevalence of neck and low back pain, examine symptom notifications, and evaluate the association between working hours and musculoskeletal problems. Background: Musculoskeletal problems, including pain in the neck and low back, are common occupational health issues, particularly among individuals with physically demanding jobs. Salesmen, who often engage in prolonged standing and lifting activities, are at risk of developing such problems. Methodology: This cross-sectional descriptive study involved 200 salesmen in Dhaka. Data was collected using a modified questionnaire, and statistical analysis was performed using SPSS software. Numerical coding facilitated data entry, and graphs were created in Microsoft Excel 2019. The chi-square test determined the significance of relationships. Result: The study found that 9.5% of participants experienced neck pain, 1.5% had shoulder pain, 0.5% reported wrist pain, 8.5% suffered from back pain, 46.0% encountered hip pain, 16.5% faced knee pain, and 20.0% experienced ankle pain. There was no significant association between age and pain in any body part (p= 0.124). Similarly, no significant relationship was observed between sex and pain severity (p= 0.95). Conclusion: From the study it can be concluded that the most affected age range is 24 to 30 years for musculoskeletal pain developed some factor such as physical activity, posture. So, increase awareness most important and physiotherapy treatment will give the affected participants which ultimately help them for pain.

Background:The increase in maternal mortality rates (MMR) is an occurrence that needs attention in Indonesia. According to Dinas Kesehatan Jawa Timur, 2019 the MMR in 2020 reached 98,39 per 100.000 live births, with approximately 26,9% or 152 individuals attributed to hypertension during pregnancy. Hypertension is diagnosed with systolic blood pressure reaches more than 140 mmHg and diastolic blood pressure is 90 mmHg. This condition becomes more concerning if hypertension develops after 20 weeks of pregnancy and is accompanied by proteinuria or other organ damage, known as preeclampsia. One of the strongest theory is the presence of uteroplacental ischemia and maternal infection, leading to an increase in pro-inflammatory cytokines (TNF-alpha and IL-6). Thus, it can be concluded that there is an increase in the inflammatory response at low levels. The presence of IL-6 induced the formation of C-Reactive Protein (CRP), a primary biomarker for inflammation if its value is > 0.3 mg/dl, requiring specific attention and appropriate management.

Methods: This study aims to determine the comparison of CRP levels in preeclamptic pregnant women with normal third-trimester pregnant women at Bhakti Dharma Husada Hospital in 2023. The research took place from October 2023 to November 2023. Patient characteristics were obtained through secondary data from patient medical records, and CRP data were obtained from laboratory test.

Results:The research, involving 20 pregnant women, found a significant difference using non-parametric Mann-Whitney test between the preeclampsia group and the normal third-trimester pregnant group (P<0,05).

Conclusions:This indicates that the occurrence of preeclampsia has an impact on increasing CRP.

Background: Acute pancreatitis is a condition with a spectrum of severity, and early assessment of its severity is crucial for effective management. C-reactive protein (CRP) and high-sensitivity C-reactive protein (hs-CRP) are potential biomarkers for this purpose.

Methods: This single-center, cross-sectional observational study assessed 50 patients with acute pancreatitis at Sapthagiri Institute of Medical Sciences and Research Center, Bangalore, from October 2019 to July 2021. The study aimed to evaluate the efficacy of CRP and hs-CRP as indicators of severity, using Ranson’s and Glasgow scores for severity assessment. CRP and hs-CRP levels were measured and correlated with these scores.

Results: Of the 50 patients, the age group most affected was 51-60 years (40%), with a male predominance (66%). Patients with a Ranson’s score ≥3 had a mean serum CRP level of 29.38 ± 6.31 mg/l, significantly higher than those with a score <3 (22.32 ± 4.52 mg/l, p<0.01). Similarly, mean hs-CRP levels were significantly higher in patients with more severe disease (Ranson’s score ≥3: 243450.81 ± 28541.13 ng/dl vs. <3: 173541.84 ± 18472.25 ng/dl, p<0.0001).

Conclusion: The study demonstrates a significant correlation between elevated levels of CRP and hs-CRP with higher severity scores in acute pancreatitis. These biomarkers could potentially serve as effective tools in the early identification of patients at risk for severe disease.

In a patient with reduced blood profile (reduced platelet count , decreased haemoglobin, reduced clotting factor or dearranged PT INR), it is a common practice to transfuse the patients with Blood products. Clinicians normally overdo the transfusion and neglect the negative outcome of transfusion reactions, which can be life threatning and very difficult to manage..Here we are presenting a case of thrombocytopenia who was transfused with RDP’S (random donar platelet) and later developed TRALI,a potentially fatal complication of blood product transfusion in which a patient develops rapid onset lung injury resulting in noncardiogenic pulmonary edema due to activation of immune cells in the lungs. He was further managed with mechanical ventilation and symptomatic treatment. One should exercise restrain while transfusing and transfuse only when there is a definitive indication and always watch the patient for development of respiratory distress due to TRALI. Despite aggressive support, mortality of more than 12% are reported once TRALI is diagnosed. The risk and benefit of all blood products should be assessed before transfusion.

Aim and Objectives: To study the diagnostic value of individual ultrasonographic signs in acute appendicitis

Background and Purpose: This study aims to assess the diagnostic value of individual sonographic signs in acute appendicitis, primarily looking at the indirect signs. The secondary objectives are to look at the diagnostic value of direct signs, to provide an ultrasound probability criteria for appendicitis and also to retrospectively look at clinical scoring, Mantrel’s score in those cases where it is available.

Materials and Methods: 1) Analytical study. 2) The study will be conducted for 12 months at the Department of Radio-diagnosis, ASRAM Hospital, Eluru. 3) Phillips affinity 70G Ultrasound machine

Results: Out of 62 cases referred to radiology for emergency Ultrasound Abdomen prior to emergency appendectomy At least one indirect sign was positive in 98.4% (61) of the cases. At least 2 indirect signs were positive in 95.2% of the cases. At least 3 indirect signs were positive in 77.4 % of the cases. Only 1 case had no indirect sign positive. All 8 signs were positive in no cases. At least 1 direct sign was positive in 91.9 % of the cases and at least 2 direct signs were positive in 90.3 % of the cases. At least 3 direct signs were positive in 66.1% of the cases.

Conclusion: This study showed more than 90% of the cases referred to radiology for emergency Ultrasound Abdomen prior to emergency appendectomy had at least 1 Indirect and 1 Direct signs positive on Ultasound abdomen.

BACKGROUND: Laparoscopic cholecystectomy though a common laparoscopic procedure, it can be difficult at times and sometimes it can increase the operative time due to involved risk factors, our objective was to study and evaluate those risk factors and to evaluate a pre-operative scoring system including the parameters which predisposes to the risk involved in the Surgery and thus helping to predict the possible difficult laparoscopic cholecystectomy and to study the outcome in these patients. MATERIALS AND METHODS: A Prospective study was conducted on 60 patients with consent and within the inclusion/exclusion criteria admitted in General Surgery department, BMCRI, Bengaluru. RESULTS: In our study we found that Age>50 years, Male gender, history of previous admissions, Palpable gallbladder, Increased wall thickness, pericholecystic collection were statistically significant factors to predict difficult laparoscopic cholecystectomy. CONCLUSION: The scoring system evaluated is reliable and is useful to predict the possible difficult Surgery or need for conversion to open cholecystectomy.

Introduction: Allergic rhinitis, or allergic rhinosinusitis, is characterized by inflammation of the nasal mucosa leading to paroxysms of sneezing, rhinorrhea, and nasal obstruction, often accompanied by itching of the eyes, nose, and palate. The clinical manifestation recurs after each exposure to the initiating allergen. Methods: This research is descriptive type with a cross-sectional study was carried out at Dept. of ENT, BSMMU, Dhaka, Bangladesh from July 2022 to August 2023. Total 60 patients included in our study. The highest range of age in the 18-49 years. The sampling technique in this research was sequential (consecutive sampling). The type of data used is primary data including name, age, gender, symptoms of allergic rhinitis, clinical manifestations, questionnaire scores on allergic rhinitis. Results: From 60 patients, numbers of male and female in the subjects’ general characteristics were mostly women (55%) with the highest range of age in the 18-34 age group (36.6%), followed by 35-qwsa 49 age group (30%). A majority of the subjects were school/ college students (33.3%) and private employee (30%). In this study, the most sufferers were moderate to severe persistent allergic rhinitis, namely 47 people (78.3%), followed by mild intermittent 12 people (20%). Allergic shiner is the result of inspection of the most common signs of allergy on the face found in this study (83.3%), while allergic creases were only found in 2 respondents (3.3%). The most common symptoms are: nasal obstruction of 52 people (86.6%), followed by rhinorrhea with 46 people (76.6%). Most of the study subjects present with comorbidity (100%) with rhinosinusitis as the highest frequency (55%). Conclusion: This research is allergic rhinitis patients, in particular the Sub-Allergy Immunology at with the hope that the treatment management algorithm is appropriate and provides clinical improvement in both signs and symptoms of rhinitis patients.