A clinical study on association between hearing loss and inflammatory bowel disease in a population attending a hospital.

Background: Inflammatory bowel disease usually presents with gastrointestinal stigmata of weight loss, anaemia, and rectal bleeding, but may exhibit prominent extra-intestinal manifestations also such as joint symptoms, skin signs and some other auto-immune manifestations. During the last few years many authors have reported serious complications of IBD manifesting in the Ear-Nose-Throat (ENT) and influencing disease morbidity. Methods: Twenty four patients with active ulcerative colitis (mean age 45 years) were recruited prospectively along with 24 healthy age- and sex-matched controls. Otoscopy, tympanometry and pure tone audiometry were performed. Otoscopy and tympanometry were normal in all patients and controls. Pure tone audiometry showed sensorineural hearing loss over all frequencies in patients with inflammatory bowel disease and compared with controls. The otologic data including age of onset, family history of otologic problems, exposure to noise and audiometric findings were also reviewed. Results: Out of 48 patients with a history of IBD, 24 had documented SNHL, 17 of these patients had a diagnosis of ulcerative colitis and 7 had Crohn’s disease. 22 patients had bilateral SNHL, and 2 patients had unilateral SNHL. Tinnitis were the most common associated aural complaint. Conclusion: Sensorineural hearing loss is very unusual finding, possibly of auto-immune aetiology. We recommend steroid or immunosuppressive therapy in such a patient. Evidence for an autoimmune basis for this condition is reviewed and the potential benefit of systemic corticosteroids emphasized.

Association of Hand Length With Height in Medical Students Enrolled in Skims Medical College, India.

Introduction: Stature is considered as one of the important parameters for personal identification. So, Stature reconstruction is important as it provides forensic anthropological estimation of the height of a person in the living state which plays a vital role in the identification of individual remains. Aim: The aim of the present study was to investigate the association of hand length with height and to show if height could be predicted using hand lengthmeasurements in students of SKIMS Medical college. Methodology: The study of the anthropometric characteristics of 100 Medical College students of ages between 18-23 years of SKIMSMedical college, beminawith no obvious deformities or previous history of trauma to the spine or hand was undertaken. The study of these medical students, males (n=50) & females (n=50) was investigated. The anthropometric characteristics of their height and hand length were measured, analysed statistically for any significant difference, and correlation between the parameters studied. Results: The results show some significant differences between the anthropometric parameters, Pearson’s correlation analysis was used and showed a strong positive correlation, which means that high X variable scores go with high Y variable scores.(R is 0.8229) and it is significant. Results from the present study show that therewas a positive correlation between height and hand length indicating that height could be predicted using hand length. Conclusion: As age groups increase the mean length of hand also increase, so there is direct relation between length of hand and age groups. Definite proportion also exists between the height and hand length in an individual at all ages, irrespective of the sex. Height of an individual is 9 times the height of hand length. Thus we can predict height from hand length when it is difficult or not possible to measure height directly.

Effect of cyclophosphamide on the microanatomy of liver of albino rats.

Background: Cyclophosphamide is widely used in the treatment of various neoplastic diseases and diseases associated with altered immunity. Higher doses used for longer duration effects many organs like urinary bladder, lungs, liver, heart and male reproductive organs. Methods: To study the effect of cyclophosphamide on the micro anatomy of liver, sixty eight Albino rats were taken and divided into three groups, group A (control group) of 20 animals, were fed with routine diet, group B (low dose group) of 24 animals, were given cyclophosphamide at the dose of 0.5 mg/100 gms in addition to the routine diet and group C (high dose group) of 24 animals, were given high dose of cyclophosphamide at the dose of 0.7 mg/100 gms of weight of animal in addition to the routine diet. The animals were sacrificed at intervals of 3, 6, 9 and 12 weeks, 5 microns sections of the tissue were prepared and stained with Haematoxylin and Eosin stain. Results: Microscopic changes in liver were apparent in the drug treated animals. In group B the changes appeared after 6 weeks while in group C they started appearing after 3 weeks of drug treatment. The changes were in the form of fatty changes, hemorrhages and central vein congestion. Conclusion: Cyclophosphamide induces histological changes like fatty infiltration and central vein congestion in the liver. These changes are with low doses given for longer durations and manifest earlier when larger doses are used. Thus it is advised that patients receiving cyclophosphamide should be periodically evaluated for liver dysfunction.

To evaluate the levels of glycated hemoglobin, serum calcium, magnesium, phosphate, uric acid and microalbuminuria in patients with newly diagnosed type 2 diabetes mellitus.

Background: Over the past three decades, the number of people with diabetes mellitus has more than doubled globally, making it one of the most important public health challenges to all nations. Therefore, the present study was undertaken to compare the levels of HbA1c, serum calcium, serum magnesium, serum phosphate, serum uric acid and microalbuminuria in patients with newly diagnosed type 2 diabetes mellitus with normal healthy individuals. Methods: This is a cross sectional study and was undertaken in the Department of Biochemistry, SKIMS-MC&H, Bemina, Srinagar. Total 300 subjects included in this study were divided into 2 groups. Group I: included 150 normal healthy individuals, who were in the age group 30-80 years, of either sex. Group II: included 150 newly diagnosed patients of Type 2 diabetes mellitus in the same age group. Fasting blood samples were drawn and investigated for serum calcium, magnesium, phosphorus, uric acid, blood sugar and HbA1c. 24-hours urine was taken for estimation of microalbuminuria, and these values were compared with those of normal healthy subjects. Means ± standard deviation were calculated and student t-test was applied to find out significance level. Results: Mean serum levels of FBS, HbA1c, calcium, magnesium, phosphate, uric acid were 89.71 ± 9.22, 4.68 ± 0.47, 9.61± 0.84, 2.23 ± 0.41, 3.45 ± 0.46, 4.21 ± 1.04 in controls (group-I) and 145.57 ± 76.61, 8.94 ± 2.38, 8.09 ± 0.18, 1.92 ± 0.27, 2.82 ± 0.68, 7.01 ± 0.27 in cases (group-II) respectively (<0.001). Microalbuminuria showed significant mean difference between cases and controls 35.01 ± 41.30 and 15.35 ± 2.60 (<0.001). Conclusion: There is decrease in serum calcium, magnesium and phosphate levels, all these plays an important role in the regulation of glucose level in the blood. Hence oral supplementation of all these ions other than diet is recommended. Increased serum uric acid and microalbuminuria was seen with reduced glucose tolerance hence early estimation of both the parameters should be done while monitoring case of Type-2 diabetes and thus will help to decrease the incidence of renal complications.

Clinical presentation of various thyroid lesions in a study population attending a teaching hospital in North India.

The present study is undertaken to evaluate the different clinical presentations of thyroid lesions in Northern Indian population. Clinical examination, although very accurate in most cases of thyroid lesion, is inadequate in some areas especially, in staging of thyroid malignancies and in detecting the multi-nodularity of the gland. Methods: The study was conducted in the postgraduate department of pathology of a teaching hospital for a period of 1 year. It was a prospective hospital based Study. In each case, a brief clinical history and physical examination along with evaluation of relevant investigation was carried out. Patient was explained about whole of the procedure & the consent for the procedure was taken in all patients. FNAC of thyroid gland was done and the results of FNAC were correlated with histopathology, wherever available. The final results were correlated with different clinical presentations using SPSS 11.5 software. Results: Out of the 139 patients, 134 presented with swelling in the neck, 3 patients presented with pain in the neck while as 2 patients came with discomfort in the neck. 74 patients have duration of swelling more than 2 years, 51 patients have duration upto 1 year, 10 patients have duration between 1 to 2 years and 4 patients have less than one month. Out of 139 patients, 110 patients have solitary swelling, 87 have swelling on right side, 119 presented with regular margins, 91 presented with firm consistency, 130 were mobile and 135 presented with non-tender. Conclusion: Majority of the patients presented after 2 years of illness i.e. 74. Only 4 patients presently acutely within 1 month of illness. The major complaint was swelling in neck i.e. in 134, rest presented with local pain and discomfort.

A prospective study of hearing impairment in school going children of Ghaziabad city attending a tertiary care hospital.

Background: Overcrowding, poor hygiene, socio-economic status, climate, lack of resources to avail medical facilities, poor medical awareness have their bearing on the incidence of hearing loss. The family of each hearing-impaired child has its own cultural, social, educational, and financial background, and its own special needs. The aim of this study is to determine the percentage of hearing impaired school going children in Ghaziabad city. Methods: The material for the present study were a representative sample constituting 1000 school children selected from various localities of Ghaziabad city within age group of 6-12 years. The children belonged to all the strata of society and children from both sexes were evaluated for hearing loss and its underlying etiological factors. Children were subjected to detailed ENT examination in our OPD. Results: In the present study sample the incidence of hearing loss is 9.3%. The maximum cases 60.22% belonged to the low socio-economic strata. A statistically significant difference of distribution by gender was noticed with a male preponderance (61.29%) as against 38.71% for females. The hearing loss in majority of cases was of a mild degree i.e., 26 to 45 dB (34.41%) of which majority of cases (87.10%) had conductive loss. Wax was the commonest cause of hearing loss (41.94%). CSOM was found in 21.50 % of all cases. Peak prevalence of hearing loss was found at 8 years of age, again declining after that from 20.43 % to 5.38 % by 12 years of age. Also it was observed that 59.14% children were living in crowded localities of city & 40.86% were living in non- crowded/open locality which is again statistically significant (P ≤0.05). Conclusion: The inferences drawn from the present study substantiates the view point of earlier workers that school screening is the most effective method of diagnosing deafness in school going children and should be extended to all schools in all the areas. Proper assessment and diagnosis of hearing loss in children at a very early age is important because an early diagnosis determines the efficacy of methods used for the correction of the hearing loss. Also early diagnosis of hearing impairment is a key to proper rehabilitation. The cases reporting to the hospital for treatment and rehabilitation can be regarded as the tip of the ice-berg and can have more management difficulties when compared to sub-clinical cases.

Histopathological study of neoplastic lesions of large intestine in Kashmir Valley, India.

Background: Aim of current study was to study the histopathological spectrum of neoplastic lesions of large intestine and histopathological pattern of colorectal carcinoma in young adults. Methods: We took a combined retrospective & prospective study in the department of pathology. The specimens were collected from subjects diagnosed as colorectal carcinomas in histopathology department and clinical details were sought from the medical records. Variables like age, sex, dietary habit, relevant history, tumor size, location, type of lesion, histological pattern of patients were checked. Results: In the series of 446 patients of colorectal neoplasm, maximum number of patients presented in 4th to 6th decade of life (47.30%), while as (15.46%) were between 20-40 years. The youngest patient with an adenocarcinoma was 18 years (male) of age and the oldest one was 80 years (male) of age. Average age of patients was 50.50 years. The male to female ratio was 1.3:1. The study revealed that the carcinoma of ascending colon was much more prevalent, constituting 107 (40.07%) cases. The proportion of well differentiated carcinoma was highest in left side colon and rectum. The incidence of moderately differentiated and poorly differentiated carcinoma was greater on right side colon. Conclusion: Adenocarcinoma is the most common histological variant of colon carcinomas.

Smoking behaviour among young doctors of a tertiary care hospital in North India.

Background: Tobacco use is one of the biggest public health threats the world has ever faced. There are more than one billion smokers in the world. Almost half of the world's children breathe air polluted by tobacco. Aim of current study was to study the smoking trends among young doctors in a tertiary care institute in north India. Methods: A descriptive observational cross-sectional epidemiological study was conducted among 250 doctors of a tertiary care Hospital in Jammu & Kashmir (Sheri Kashmir Institute of Medical Sciences, SKIMS) during the two months of February-March, 2014. The predesigned tool adopted during data collection was a questionnaire that was developed at the institute with the assistance from the faculty members and other experts. Results: Among 250 participants, (20%) were smokers; among smokers, (76%) were regular smokers and (24%) were occasional smokers. Majority of smokers were in the age group of 21-30 years (80%) & started smoking between 11-20 years (70%). All of them were male (100%). No significant difference was observed among urban and rural students. Among smokers, majority (60%) was in the practice of smoking for last 6 months to 1 year and 26% smoked for <6 months; & (14%) smoked for more than 5 years .It was found more than half of the responding (60%) students used to smoke 5-9 cigarettes per day; 14% is <5 and 26% consumed 10 or more per day .Among smokers, peer pressure was found in 80% cases. (χ2 = 107, P <0.001). Among smokers, almost 20% had other addiction and among non-smokers only 5% had .Effect of parental smoking was significantly higher in smokers than non-smoker (χ2 = 66.2, P <0.001) .It was seen that peer pressure was the most important risk factor (60%) of initiation of smoking habit followed by parental influence (20%). Majority (78.4%) had no intention to quit in the next 6 months. Lack of Incentive (36.36%) and Addiction (27.27%) were the main reasons for not quitting. Conclusion: We need to create more awareness regarding hazards of smoking in general population especially in medical students, and afterwards provide psychological and pharmacological support for those who intend to quit, as medical students can themselves become a tool to fight this hazard at all levels.

Effect of television watching on vision of school children in semi urban area of Kashmir.

Background: Schoolchildren form an important target group as any ocular morbidity in this age group has huge physical, psychological and socio-economical implications. Considering the fact that one-third of India's blind lose their eyesight before the age of 20 years and many of them are under five years when they become blind, early detection and treatment of ocular morbidity among children is important. This study aims to highlight the prevalence of ocular morbidity in governmental schools in a sub-urbanized area of India. Research question of current study was to study the Effect of TV watching on vision in school children. Methods: Study area: Government schools in a sub-urbanized area of India. Sample size: 1128 school children from class 5th to 12th. Study design: A cross-sectional study was conducted and the study population comprised of school children who were examined in their schools and afterwards referred to the hospital if required. Data was gathered using a questionnaire, snellens charts and retinoscopes. Statistical analysis: simple proportion. Data was analysed statistically using SPSS software, version 14. Results: 1128 children were examined. Percentage of male children was 42.73% and females were 57.18%. Ocular abnormality was detected in 21.3% children with refractive errors contributing 18.26%, conjunctivitis-1.95%, blepheritis-0.62%, dacrocystitis-0.17%, stye-0.35%, color blindness-0%. It was also observed that children watching TV for less than 1 hour had visual acuity of 6/6 in 42.4%, whereas children watching TV for 1-2 hours, 2-3 hours and >3 hours had lower visual acuity. Conclusion: It was concluded that moderate to high prevalence of ocular morbidity among high school children is present in block Hazratbal. Finally, the aim of all blindness control programs should be to propagate awareness in the masses of eye care and to teach the essentials of ocular hygiene and eye healthcare.

A cross-sectional study to determine sex-wise prevalence of obesity in adults of Kashmiri population.

Background: Aim of current study was to determine the prevalence of obesity in both sexes in persons aged 18-45 years. Methods: Multistage and multiphasic sampling technique was utilized in this study to screen the obese subjects of both males and females based on WHO classification of obesity according to BMI of 18-45 years of age. Each household was visited and only the subjects having age of 18-45 years were included in this study and this comprised of 5107 subjects, then identified obese cases with the help of height and weight techniques. Only those people who had simple obesity were included in the study. People having secondary obesity, drug induced obesity and pregnant ladies were excluded from this study. The data was collected and analysed using statistical software and chi square and proportional statistical test were applied. Results: Out of 5107 screened population, 2652 were males and 2455 were females and the prevalence of male obesity in study population is 6.41% and that of females is 7.74%. Conclusion: The sex has a significant impact on obesity. We reported in our study a prevalence of obesity is more in females as compared to males. A lack of physical activity as well as low frequency of employment makes females more susceptible to obesity.

Redefining indications and evaluation of dissection versus diathermy method of tonsillectomy.

The current availability of randomized clinical trials have assessed the efficacy of the most common presumed indications for tonsillectomy, but the controversery still exists So, the present study was conducted to assess (1) Whether tonsillectomy leads to any significant benefits as compared to watchful waiting (2) evaluating the two most commonly used techniques for tonsillectomy i.e; cold dissection & diathermy. 170 patients were included,104 were assigned to the surgical group (Group A) & 66 patients acted as control (Group B).The surgical group underwent tonsillectomy.The efficacy of tonsillectomy viz-a-viz chronic tonsillitis related morbidity, school absenteeism, & work absenteeism, Group A beta hemolytic streptococcal pharyngitis, otitis media, Rhinosinusitis, obstructive sleep apnea & psoriasis was studied.The results of our study were as; Majority among children (7-15 years)& the mean age of adult population was 23.02 years.Tonsillectomy definitely provided benefit in case of chronic tonsillitis, mild to moderate obstructive sleep apnea on polysomnographic findings where as the Patients who had been included in this study to redefine otitis media & rhinosinusitis as an indication for tonsillectomy did not benefit much when compared to the watchful waiting groupThe three most commonly used techniques of tonsillectomy i.e; cold steel using ties & packs, cold steel using monopolar diathermy for hemostasis & using monopolar diathermy exclusively were evaluated.The operating time was least for the diathermy alone method. The intraoperative blood loss was minimal for the monopolar diathermy method. The primary hemorrhage rate was maximum in technique of cold steel with ties & packs as hemostasis.The secondary hemorrhage rate was maximum in monopolar diathermy method. The postoperative pain measured by using the verbal rating scale was considerable after using monopolar diathermy alone with 33% complaining of severe pain & 67% complaining of moderate pain.

Histopathological effects of pesticide-cholopyrifos on kidney in albino rats.

Background: Histopathological lesions have been widely used as biomarkers for health evaluation of organism exposed to pollutants and can be used as warning symptoms for organism health. There are few reports regarding histomorphological changes in kidney following pesticide chlorpyrifos exposure which has prompted us to undertake this study. Methods: The present study was conducted on 45 inbred adult Wistar albino rats of either sex, weighing 145 – 165 gms. These animals were randomly divided into 3 groups A, B, C. Oral Chlorpyrifos was given to the experimental groups B and C in dose of 5 mg/kg body weight and 10 mg/kg body weight respectively. Group A served as control and was left as such. 3 animals from each group were sacrificed after 1 week, 2nd week, 4th week, 6th week and 8th week of initiation of experiment to see the histological changes in the kidney architecture. Results: Group A shows no histological alterations. Group B – No histological alterations in the kidney after 1 week. From 2 weeks-8 there was shrinkage of glomerulus at initial stages of treatment, tubular dilation, glomerular hypercellularity, hypertrophy of tubular epithelium, degeneration of renal tubules, deposition of eosin positive substance in the glomerulus and renal tubules. There were infiltration of lymphocytes in the interstitium and increased vascularity in the form of dilated vessels fibrosis and interstitial oedema. All these changes were suggestive of glomerulonephritis, acute tubular necrosis and interstitial nephritis leading to acute renal failure progressing to chronic renal failure with increasing duration. In Group C – the Kidneys of 1 week Chlorpyrifos treated rats exhibited shrunken glomeruli and hypertrophy of renal tubular epithelium. From 2nd week- 8thweek, the changes seen were more pronounced than Group B Conclusion: The present study showed that significant histomorphological changes were caused in the kidneys of rats administered with Chlorpyrifos. These changes were markedly different from the control rats. Hence this study brought into light the renal toxicity induced by chlorpyrifos which was found to be significant at high dose level.

Anomalous Left testicular Artery Arising from left Accessory renal Artery and its Clinical implications.

Origin of the Testicular Artery variations were found during routine dissection of abdomen of the middle aged cadaver in the Dept of Anatomy, Govt. Medical College Jammu. On the left side there were two renal arteries, One of them was the main Renal artery which was originating from the anterolateral aspect of abdominal aorta and running to the hilum of the kidney in front of the renal vein The other was the Accessory Renal artery which was originating from anterolateral aspect of aorta 5mm above origin of main renal artery and going to the upper pole of the kidney. The origin of accessory renal artery and main renal artery was 4.2 and 9.2mm below the level of origin of superior mesentric artery. The left testicular artery was originating from the accessory renal artery and crossing the renal artery and the renal vein anteriorly before following its usual course in the posterior abdominal wall. Only one renal artery was seen on the right side arising from the anterolateral aspect of aorta. The right testicular artery originated 52mm below the origin of right renal artery and followed its normal course This anomaly is explained by embryological development of both kidneys and gonads from intermediate mesoderm of mesonephric crest. Further the vasculature of kidneys and gonads is derived from lateral mesonephric branches of dorsal aorta .Even though the condition presents as a silent renal anomaly (Undiagnosed throughout life and revealed only on autopsy) the surgical implications are noteworthy, which too have been highlighted in this report.