Renal involvement and early prognosis in patients with Covid-19 pneumonia in tertiary health care centre

Background: The corona virus disease (Covid-19) is a pandemic which is rapidly evolving and expanding, has infected a population of more than 77 million across the globe and around 10 million in India as of 25th December 2020. This virus was first recognized in December 2019 in Wuhan of China when pneumonia of unknown origin came into limelight. It was identified as Covid -19, a neo virus causing severe pneumonia that rapidly led to a major health crisis with devastating consequences not only in India but also in major developed countries of the world. Initially data from China and Italy, which was identified as caused by Covid-19, shows that death rate worsens in persons with increasing age more than 50 years and also leads to higher risk due to co-morbidities like hypertension (HTN), cardiac disease, diabetes mellitus, chronic renal disease, cancer, etc. Severe acute respiratory viral infections are frequently accompanied by multiple organ dysfunction, including acute kidney injury (AKI). While diffuse alveolar damage and acute respiratory failure are the main features of Covid-19, and the incidence of AKI is not well described. The present study was conducted to assess the Renal Involvement and its association with Prognosis among Patients admitted with Covid- 19 Pneumonia. Aim: To assess the renal involvement and its association with prognosis among patients admitted withCovid-19pneumonia. Materials and methods: A single centered cross-sectional study was conducted at Malla Reddy Institute of Medical Sciences during 15th March to 1stMay 2021 where 151 Patients admitted with Covid-19 Positive on RT-PCR were included. Renal function tests include Creatinine and Urea. The most commonly used endogenous marker for the assessment of glomerular function is creatinine. The calculated clearance of creatinine is used to provide an indicator of GFR. Urea is a nitrogen- containing compound formed in the liver as the end product of protein metabolism and the urea cycle. Serum urea levels increase in conditions where renal clearance decreases (in acute and chronic renal failure/ impairment). Urea may also increase in other conditions not related to renal diseases such as upper GI bleeding, dehydration, catabolic states, and high protein diets. Data entry was done using Excel 2013 and analysis using SPSS v16. Student t test and chi-square test were used to find the significant association without come. Results: A total of 151 patients who had tested positive for COVID-19 were included in the study. The mean age in years of the study participants was 47.76�.85. 72.8% were male and 27.2% were female. The mean serum creatinine was 1.44�94 and mean Blood urea was 41.35�.06. Mortality observed in the study was 44.4%. Significantly high levels of serum creatinine (2.06�10) were reported among those who died due to COVID-19 compared to those who recovered (0.93�28) (p<0.0001) in the study. Our study poses a conclusion of increase in serum creatinine in COVID 19 affected patients that shows a temporal association of SARsCOV�with AKI. Conclusion: The Covid pandemic has posed major challenge around the globe. Renal clinical presentation ranging from mild proteinuria, hematuria to progressive AKI necessitating renal replacement therapy (RRT), thrombotic microangiopathy and rhabdomyolysis. More research is needed to obtain adequate evidence to support current clinical approaches and to develop new approaches to management. Kidney failure occurs in most patients with COVID-19 pneumonia. Although proteinuria, hematuria and AKI are usually resolved in such patients within 3 weeks after the onset of symptoms, kidney problems in COVID-19 have been associated with higher mortality. AKI is independent predictor of mortality in Covid-19

Basal Cell Adenocarcinoma - 2 Case Series of a Rare Entity

Introduction: Basal cell adenocarcinoma is a rare well recognized low grade malignant salivary gland tumor often resembles basal cell adenoma. the infiltrating growth pattern and likelihood of vascular and perineural involvement distinguishes basal cell adenocarcinoma with basal cell adenoma. Case presentation: Here we present histopathological and immune histochemical analysis of two such rare cases of basal cell adenocarcinoma and review of literature is discussed. Conclusion: Basal cell adeno carcinoma is a low grade malignancy and doesn’t metastasize. With only few hundreds of cases that has been reported in literature, basal cell adeno carcinoma should be included as differential diagnosis in salivary gland tumors in order not to miss the diagnosis

Differentiating Multisystem Inflammatory Syndrome in Children (MIS-C) and Its Mimics – A Single-Center Experience From a Tropical Setting

Objective: Identifying clinical and laboratory indicators that differentiate multisystem inflammatory syndrome in children (MIS-C) apart from other febrile diseases in a tropical hospital setting. Methods: Review of hospital records done in a tertiary care exclusive children’s hospital for children admitted from April, 2020 till June, 2021. Laboratory values, severe acute respiratory syndrome coronavirus (SARS-CoV-2) serological status, and clinical signs and symptoms of patients with MIS-C, and those with similar presentations were analyzed. Results: 114 children fulfilled the inclusion criteria (age group of 1 mo-18 y) for whom a diagnosis of MIS-C was considered in the emergency room based on the clinical features. Among them, 64 children had the final diagnosis of MIS-C, and the remaining 50 children had confirmatory evidence of infections mimicking MIS-C such as enteric fever, scrub typhus, dengue and appendicitis. Conclusion: Older age group, presence of mucocutaneous symptoms, very high C-reactive protein, neutrophilic leukocytosis, abdominal pain and absence of hepatosplenomegaly favor a diagnosis of MIS-C.

Consensus Statement of the Neurodevelopmental Pediatrics Chapter of Indian Academy of Pediatrics (IAP) on the Management of Children With Down Syndrome

Justification: The diagnosis of Down syndrome (DS) is easily made clinically but the management is multi-disciplinary and life-long. There is no standard protocol available for its management in India. Process: A committee was formed under the Indian Academy of Pediatrics (IAP) chapter of Neuro developmental pediatrics consisting of 20 experts working in the related field. The various aspects of the condition were discussed and allotted to the concerned experts related for preparing the guidelines. The material received was collated to form a set of guidelines, which were reviewed by the committee, and a consensus statement made. The guidelines were then approved by the chapter, and by the IAP. Objectives: To define the condition and to look into the various aspects of antenatal and postnatal diagnosis. To explain briefly about the involvement of the various systems that are involved and formulate recommendations for management. To recommend early and sustained interventional therapies to enable children with DS lead an independent life. Recommendations: The stress on bio-psycho-social strategy for the management of children with DS is reiterated, and the need for a medical, social and rights model is recommended after each section. The age-wise recommendations are also highlighted in addition to the recommendations under each system.

Urinary tract infection with renal abscess

Renal abscess is very rare among intra-abdominal abscesses in children. Ascending infection is the most common cause in children compared to hematogenous spread in adults and Escherichia coli is the main pathogen. Persisting high-grade fever is an alarming sign to intervene and has to be taken care of. Here, we are presenting the case of a 3-year-old boy with Klebsiella urinary tract infection and E. coli renal abscess of 4 cm size. Contrast-enhanced computed tomography abdomen helped in early intervention and management. The child responded very well to parenteral antibiotics and ultrasound-guided percutaneous aspiration.

Childhood posterior circulation arterial ischemic stroke – An unusual case with a possible COVID-19-related arteriopathy

Viral infections are known to increase predilection to stroke and coronavirus disease 2019 (COVID-19) has proven these concerns true. We are presenting the case of a 6-year-old previously normal male child diagnosed with posterior circulation stroke who had all etiological workups negative except for the COVID antibody. Imaging showed thrombi over the V3 segment of the vertebral artery at C1–C2 level causing near complete occlusion, with embolic infarct in the bilateral posterior inferior cerebellar artery, bilateral posterior cerebral artery, bilateral anterior inferior cerebellar artery, and the left superior cerebellar artery. The child was managed with methylprednisolone, anticoagulation, and supportive care and was able to restore near-normal neurological status within months. This case is unique in terms of the involvement of posterior circulation which is rare in the pediatric population. A possibility of inflammation-related arteriopathy secondary to infection should be considered in the etiological workup of stroke. Anti-inflammatory measures to control cytokine storm along with supportive care will ensure a good outcome.

A STUDY ON RETROSPECTIVE ANALYSIS OF GASTROINTESTINAL STROMA TUMOURS.

Introduction:.Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal (GI) tract. They are believed to originate from the interstitial cells of Cajal (ICCs) or from the precursors of ICCs. Most GISTs show an activating mutation in either the c-kit or platelet-derived growth factor receptor alpha (PDGFRA) gene. Tumor size, mitotic rate, and anatomic location correlate with potential malignancy and recurrence rate. The aim of our study is to Aim & Objectivesobserve the demographic and clinical characteristics of GIST in our clinical environment.Method- 30 patients who are diagnosed with GIST managed during the period from Jun 2017 to July 2022 were reviewed in terms of demographics, clinical presentation, location of tumor, characteristics, management, histopathology, IHC analysis, post op follow up & recurrence.The risk stratification in terms of size, mitotic index, site of tumour was observed & classified using modified NIH classification. Results- Out of 30 cases male patient's- 73% (n- 22); female patients27%(n-8). Mean age was 60 years with a range of 44-81 years. Most common clinical presentation was abdominal mass, Abdominal pain. Commonly involved sites are stomach and small bowel.4 cases who underwent multiple organ resection 2 cases developed recurrence in which 1 underwent palliative Whipple's procedure and one was medically managed. GIST Conclusion- s are rare entities with a variety of clinical features, Common sites for GIST are stomach & small intestine. Surgery is the main stay of management in GIST. Neo adjuvant therapy will help in down staging the tumour. Wedge resection & resection &anastomosis will be adequate for stomach in small bowel GIST. En-bloc resection should be considered if adjacent structures are involved. Overall GIST has favourable prognosis if diagnosed early.

Advances in Shock Management and Fluid Resuscitation in Children

Shock in children is associated with signifcant mortality and morbidity, particularly in resource-limited settings. The principles of management include early recognition, fuid resuscitation, appropriate inotropes, antibiotic therapy in sepsis, supportive therapy for organ dysfunction, and regular hemodynamic monitoring. During the past decade, each step has undergone several changes and evolved as evidence that has been translated into recommendations and practice. There is a paradigm shift from protocolized-based care to personalized management, from liberal strategies to restrictive strategies in terms of fuids, blood transfusion, ventilation, and antibiotics, and from clinical monitoring to multimodal monitoring using bedside technologies. However, uncertainties are still prevailing in terms of the volume of fuids, use of steroids, and use of extracorporeal and newer therapies while managing shock. These changes have been summarized along with evidence in this article with the aim of adopting an evidence-based approach while managing children with shock.

Abdominal Manifestations of Multisystem Inflammatory Syndrome in Children: A Single-Center Experience

Objectives: We reviewed the cases of probable multisystem inflammatory syndrome in children (MIS-C) to identify those cases that mimicked surgical emergencies. Methods: Records of children managed for MIS-C during a 15-month period between March, 2020 and April, 2021 were retrieved. Data on clinical presentation, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR report, SARS-CoV-2 antibody status, blood investigations, radiological investigations and management were collected. Results: A total of 28 out of 83 children with probable MIS-C had acute abdominal symptoms and signs. Fifteen children had mild features like diffuse abdominal pain or non-bilious vomiting, and the remaining 13 (46.2%) had severe abdominal signs or bilious vomiting. Four children worsened with conservative treatment for MIS-C and were detected with perforated appendicitis. Two more children developed recurrent appendicitis on follow up. One child with appendicitis who underwent laparoscopic appendectomy, later manifested with MIS-C. Conclusion: Surgical abdominal emergencies may be confused with or occur concurrently in children with MIS-C that should be identified with a high index of suspicion.

Solitary Plasmacytoma of Mandible – A Rare Dyscrasia- Case Report and Review of Literature

Introduction: The plasma cell neoplasms may present in soft tissue as extramedullary plasmacytomas, bone as a solitary plas- macytoma of bone, or as part of the multifocal disseminated disease multiple myeloma. Aim of study: The study aims to report solitary plasmacytoma in the gnatic bone oral cavity, which is also mimicking as malig- nant neoplasm of bone, seen in a female patient. Case Report: A 38-year-old female patient reported to the outpatient department of our hospital complaining of pain and swelling over the left lower one-third region of the face for one month CBCT analysis shows a hypodense area involving 35 regions extending towards ascending rami of the mandible. Conclusion: Plasmacytoma, despite being a lesion with slow, asymptomatic growth, can assume large volumes, making proper treatment difficult. When there is no bone involvement and it is diagnosed early, the success of treatment is generally higher. The treatment of choice is radiotherapy, with good results for the remission of the lesion

Epidemiology Of Voice Disorders Among Government School Teachers - An Analytical Cross-Sectional Study from Kancheepuram District

Background: Voice disorders cause undesirable effects on school teachers such as reducing their quality of life, decrease in work performance affecting the quality of education, job absenteeism, and reduced social activities as well. Methodology: Voice disorder among teachers was assessed through the “Voice handicap Index”, which was developed by Jacobson et al in 1997 to self-assess the severity of voice disorder in dysphonia pa-tients Results: The overall prevalence of voice disorder among government school teachers was found to be 46.5% with a 95% confidence interval from 41.5% to 51.5%. Using Backward Wald, the binary logistic regression analysis showed that female teachers (AOR 1.6, p<0.01*), teaching experience less than 10 years (AOR 2.4, p<0.01*), and teaching hours more than 21 hours per week (AOR 6.7, p<0.01*) had a sig-nificant association with voice disorders. Conclusion: The prevalence of voice disorder was found to be high since teachers are professional voice users. The study also recommends that teachers must receive the required health education on the ergo-nomic risk factors that they will come into contact with in their daily lives as part of their jobs.

Simulation Based vs Conventional Training for Initial Steps in Delivery Room Care of Preterm Neonates: An Open Label Randomized Trial

Objective: To assess whether simulation based education (SBE) improves the practices and knowledge of junior residents for stabilization of a preterm neonate in delivery room as compared to conventional education (CE). Methods: This trial randomized 24 pediatric residents to either SBE (n=12) or CE (n=12) groups. One-time SBE was imparted to the SBE group. Both the groups had similar facilitator participant ratio and equally timed sessions. The individual skills scores and performance by preterm stabilization performance evaluation (PSPE) score in real time were recorded using a validated tool within 8 weeks of the training. Knowledge gain was evaluated using pre and post-test scores. Results: The mean (SD) skill and PSPE scores were comparable between the two groups (skill score 51.1 (8.1), 46.5 (7.8), respectively mean difference 4.6; 95% CI -2.1 to 11.3; PSPE-score 80.2 (14.2) vs. 82.9 (10.3); mean difference -2.68; 95% CI -8.35 to 13.71). The mean (SD) knowledge gain was similar in the groups [4.4 (1.9), 5.3 (4.1); mean difference 0.91; 95% CI, -1.81 to 3.64. Conclusion: In junior residents, a one-time SBE session, when compared to conventional task training, did not lead to improvement in the performance of the initial steps of neonatal resuscitation.

Stabilization of refraction and timing of spectacle prescription following manual small-incision cataract surgery

Purpose: To determine the stabilization of refraction at 2 weeks following MSICS by comparing the difference in spherical, cylindrical component and also spherical equivalent of refraction of 2 weeks follow-up with that of 6 weeks following surgery. Methods: The difference of spherical, cylindrical component and also spherical equivalent of refraction at 2 weeks and 6 weeks follow-up of 194 eyes that underwent uncomplicated MSICS with implantation of PMMA IOL conducted by a single experienced surgeon were compared to find out the amount of change and its significance was statistically tested by Wilcoxon-Signed Rank Test. Results: The difference in spherical power (0.04 � 0.30), cylinder power (0.03 � 0.40), and spherical equivalent (0.06 � 0.34) were very small and not significant statistically (P-value ?0.05). Conclusion: Necessary spectacle correction can safely be prescribed after 2 weeks following MSICS as subjective refraction stabilizes by that time without undergoing significant change. However, our observation was applicable in patients who had an uneventful cataract surgery without any risk factor, which can delay wound healing or cause poor visual outcome.

In silico design of a multi-epitope Chimera from Aedes aegypti salivary proteins OBP 22 and OBP 10: A promising candidate vaccine

Background & objectives: The emergence and re-emergence of arboviruses such as dengue, Chikungunya and Zika viruses causing morbidity and mortality around the globe are of serious concern. A safe and effective vaccine is essential to control viral transmission. The salivary proteins of the mosquito that aid in blood probing, feeding and development are immunogenic. We aimed to report a multi-epitope candidate vaccine chimera from Aedes aegyptii mosquito salivary proteins OBP 22 and OBP 10 that could confer protection against all pathogens transmitted by the vector. Methods: Linear and conformation B-cell epitopes and MHC class-I and class-II binding T- cell epitopes were predicted using bioinformatic tools. Selected B- and T-cell epitopes were chosen for designing a multiepitope vaccine construct. The chimeric construct was analyzed for its immunogenicity, TAP and proteasomal cleavage, allergenicity, and structural validation for its suitability to be used as a candidate vaccine. Molecular docking was carried out to analyze the binding interactions with TLRs molecules. Results: A chimeric multiepitope vaccine was designed with the best-selected combination of immunogenic B-cell epitope, cytotoxic and helper T-cell and gamma interferon inducing epitopes with suitable adjuvant and linkers. The interacting residues between the candidate vaccine and the TLR molecules have been identified. Interpretation & conclusion: The proposed multiepitope candidate vaccine was designed from the mosquito salivary protein OBP 22 and OBP 10. The candidate vaccine was found promising for the protection against arboviruses. Further clinical validation is warranted to prove its efficacy, safety and immunogenicity for its potential use.

Thermal expansion and corrosion resistance of cobalt-chromium alloys fabricated by contemporary manufacturing processes: an in vitro study / Expansión térmica y resistencia a la corrosión de aleaciones de cobalto-cromo fabricadas mediante procesos de abricación contemporáneos: un estudio in vitro

In Purpose: The fabrication technique can influence the mechanical properties of Cobalt-Chromium (Co-Cr) dental alloys. Hence, the present study aims to determine the corrosion resistance and thermal expansion of alloys manufactured using three contemporary techniques. Material and Methods: A total of nine specimens of Co-Cr alloy were prepared according to ISO 22674 by each one of the three manufacturing processes (three in each process); conventional casting, direct metal laser sintering (DMLS) and milling (MIL). All these specimens were tested for coefficient of thermal expansion and corrosion resistance. The data was tabulated and analyzed statistically. Results: The difference in the thermal expansion of alloys fabricated using three techniques was non-significant at almost all the temperatures from 50 ºC to 950 ºC (p>0.05), except 450 ºC and 600 °C. The polarization resistance of specimens manufactured using the conventional method was more compared to DMLS and MIL at pH 5 (Conventional>MIL>DMLS) (p<0.001). Conclusion: The thermal expansion behavior of alloys manufactured using the three selected techniques were similar, whereas, at acidic pH, the corrosion resistance of conventional and MIL were better than the DMLS.

Antecedentes: La técnica de fabricación puede influir en las propiedades mecánicas de las aleaciones dentales de cobalto-cromo (Co-Cr). Por lo tanto, el presente estudio tiene como objetivo determinar la resistencia a la corrosión y la expansión térmica de aleaciones fabricadas con tres técnicas contemporáneas. Material y Métodos: Se prepararon un total de nueve probetas de aleación de Co-Cr según ISO 22674 por cada uno de los tres procesos de fabricación (tres en cada proceso); fundición convencional, sinterización directa de metal por láser (DMLS) y fresado (MIL). Todos estos especímenes fueron probados para determinar el coeficiente de expansión térmica y la resistencia a la corrosión. Los datos fueron tabulados y analizados estadísticamente. Resultados: La diferencia en la dilatación térmica de las aleaciones fabricadas con las tres técnicas no fue significativa en casi todas las temperaturas desde 50ºC hasta 950ºC (p>0,05), excepto 450ºC y 600ºC. La resistencia a la polarización de las muestras fabricadas con el método convencional fue mayor en comparación con DMLS y MIL a pH 5 (Convencional>MIL>DMLS) (p<0, 0 01). Conclusión: El comportamiento de expansión térmica de las aleaciones fabricadas con las tres técnicas seleccionadas fue similar, mientras que, a pH ácido, la resistencia a la corrosión de la convencional y la MIL fue mejor que la de la DMLS.

Perioperative Management of Patients with Prosthetic Heart Valves?A Narrative Review

Worldwide, about 13% of the 200,000 annual recipients of prosthetic heart valves (PHV) present for various surgical procedures. Also, more and more females are opting for pregnancies after having PHV. All patients with PHV present unique challenges for the anesthesiologists, surgeons and obstetricians (in case of deliveries). They have to deal with the perioperative management of anticoagulation and a host of other issues involved. We reviewed the English language medical literature relevant to the different aspects of perioperative management of patients with PHV, particularly the guidelines of reputed societies that appeared in the last 20 years. Regression of cardiac pathophysiology following valve replacement is variable both in extent and timeline. The extent to which reverse remodeling occurs depends on the perioperative status of the heart. We discussed the perioperative assessment of patients with PHV, including focused history and relevant investigations with the inferences drawn. We examined the need for prophylaxis against infective endocarditis and management of anticoagulation in such patients in the perioperative period and the guidelines of reputed societies. We also reviewed the conduct of anesthesia, including general and regional anesthesia (neuraxial and peripheral nerve/plexus blocks) in such patients. Finally, we discussed the management of delivery in this group of high?risk patients. From the discussion of different aspects of perioperative management of patients with PHV, we hope to guide in formulating the comprehensive plan of management of safe anesthesia in such patients.

Secular Trends in Birthweights in Two Epochs Over 40 Years in a Tertiary Care Center

Objective: To compare the average birthweights and the weight centiles of the ‘new’ growth charts with the ‘old’ (1974) charts developed in the same unit four decades ago. Methods: Birthweight and gestation data of the eligible 12,355 singleton neonates born between 2009 and 2016 at a level-3 neonatal unit at a public sector hospital were used to develop the new growth chart. We then compared the prevalence of small for gestational age (SGA) and large for gestational age (LGA) classified by the new charts and the old charts, the incidence of short-term adverse outcomes among them, and the diagnostic performance of both the charts to identify the adverse outcomes in a separate validation cohort. Results: The mean birthweights of boys and girls across all gestations were higher by 150-200 g and 100-150 g, respectively, in the new chart. The prevalence of SGA doubled (9.8% vs 4.7%), but LGA decreased by one-third (17.5% vs 25.9%) with the new chart. However, the proportion of SGA and LGA having one or more short-term adverse outcomes, and the diagnostic performance of both the charts to identify neonates with shortterm adverse outcomes, were comparable. Conclusion: There was an upward shift in the birthweights by about 150 g across all gestations in the new chart compared to the old chart developed 40 years ago. The findings imply the need to consider using updated growth charts to ensure accurate classification of size at birth of neonates.

EFFECT OF WEIGHT TRAINING AND YOGA ON SELECTED MOTOR FITNESS VARIABLES OF COLLEGE LEVEL VOLLEY BALL PLAYERS

Introduction:- Yoga has been a spiritual discipline which focuses on bringing harmony between mind and body. It is an art and science of healthy living and weight training is organized exercise in which muscles of the body are made to contract in response to external weights, body exercise or resistance. The purpose Purpose: - of the study was the effect of twelve (12) weeks weight training and Yoga on selected motor ?tness variables of college going volleyball players within the age group of 18-25 years. Total thirty (30) subjects were taken for the study Materials & Methods:- from baliapal college of physical education, baliapal, balasore, odisha. The motor ?tness variables were strength, agility, ?exibility, speed and Cardiovascular endurance which were measured by standing broad jump, Shuttle run test, sit and reach test, 50-meter dash test and 1 mile run and walk test respectively. The Pre-test and Post-test were taken of all the parameters before and after the twelve (12) weeks of yoga and weight training programme. The subjects were randomly selected for the study. The ?ndings of the present study reveals that there was signi?cant difference found in the motor Results & Discussion:- ?tness variables after the twelve (12) weeks of yoga and weight training programme. The pre-test mean scores of all motor ?tness variables were 6.02, 5.50, 5.80, 12.18 and 4.55 respectively. Similarly, the post-test mean scores of all the motor ?tness variables were 8.82, 4.20, 8.50, 9.16 and 3.05 respectively. Therefore, it was clear from the results that the volleyball players were better improve their ?tness after the given period of twelve (12) weeks yoga and weight training programmes. The Independent paired't'- test was used at 0.05 level of signi?cance. On the basis of the obtained result, it has been observed that Conclusion:- yoga and weight training programme can improve the motor ?tness variables of college going volleyball players and play an important role in healthy impact on the life style of a man

STUDY TO CORRELATE HISTOPATHOLOGICAL FINDINGS WITH ENDOMETRIAL THICKNESS EVALUATED BY TRANSVAGINAL SONOGRAPHY IN POST MENOPAUSAL BLEEDING

almost ninety percent of post-menopausal females with endometrial cancer report a vaginal bleeding experience. Objectives: To ?nd correlation of radiological and histopathological ?ndings so that early evaluation of malignancy can be done. The Present Study included 50 Patients with abnormal uterine Materials And Methods: bleeding in postmenopausal women, aged between 45-70 years. All patients were subjected to transvaginal ultrasonographic evaluation of the endometrium and the results were correlated to the histopathological picture of the endometrium after curettage in an attempt to discriminate normal endometrium from abnormal pathological patterns. Results And Analysis: Thirteen patients (26%) had pathological ?ndings. There was signi?cant difference in the mean endometrial thickness of non- pathological and abnormal endometrium in postmenopausal patients with P value <0.001**. Among the thirteen patients with pathological ?ndings eight had endometrial hyperplasia, two had polyp and three had malignancies. It may be Conclusions: concluded that vaginal sonographic measurement of endometrial thickness is an acceptable less invasive alternative to hysteroscopy and D & C and needs to be popularized as ?rst line investigation in the management of Postmenopausal bleeding in rural population

Is Neck Circumference A Better Measure for Determining Obesity? A Cross-Sectional Analytical Study to Assess Its Validity in Type II Diabetes Mellitus Patient

Introduction: Several anthropometric measurements like Body mass index (BMI), skin fold thickness, Waist circumference (WC), waist-height ratio (WHtR), and Waist hip ratio (WHR) are available for diag-nosing obesity at the population level. But each of them has its disadvantage as well. Neck circumference, which has been the recent anthropometric tool of interest can be used as an alternative to these meas-urements. Objective: To determine the validity of neck circumference as an anthropometric parameter of obesity and to estimate the cut-off points for obesity in type II diabetes mellitus patients. Material & Methods: This analytical cross-sectional study was done among 141 Type II diabetes pa-tients attending rural and urban health training centre non-communicable disease clinic of Sri Rama-chandra Institute of higher education and research, Chennai. After obtaining informed consent, their an-thropometric measurements like NC, BMI, WC, HC, and WHR was measured. Results: Neck circumference ≥36.5cm in males and ≥33.2cm in females is conceivably the perfect cut-off point for diagnosing overweight/Obesity in Type II diabetes mellitus. Conclusion: This analytical study deduced that NC is a valid anthropometric measurement for diagnos-ing obesity among Type II diabetes mellitus with plausible sensitivity and specificity.