Cross-Sectional Study to Assess the Prevalence of Obesity among Second Professional MBBS Students of One of the Medical Colleges of Indore, Madhya Pradesh

Introduction: Obesity is a complex multifactorial preventable disease. The problem of obesity is important to discuss because it is closely associated with an increasing risk to many diseases. Objective: To assess the prevalence of obesity among Second MBBS students and find the anthropometric parameters of obesity. Method: This was a cross-sectional, observational study conducted among 100 second MBBS students. Demographic data and anthropometric measures, such as Height, Weight, Body mass index, Waist circumference, and Waist/Hip ratio of the students were collected. Results: BMI was < 18.5 in 17.34% of male and 28% of female students. Around 18.67% of male and 24% of female students had BMI of more than 25 and where as student shaving BMI of more than 30 were 6.66% and 4% in male and female students, respectively. According to the Waist/Hip ratio,16% male (>0.95) and16% female (>0.86) students were categorized as at risk for obesity (p-value 0.86). Conclusion: Almost half of the male and female students were having normal BMI. More number of female students had BMI lower than normal. Students falling in the category of overweight were higher as compared to obese students. Such students were advised for non- pharmacological measures of weight reduction through proper exercise, consuming a healthy balanced diet, and role of physical activity, so as to maintain proper bodyweight and to prevent future complications of obesity were advised to the students

Diabetic myonecrosis in end-stage renal disease

Diabetic myonecrosis or muscle infarction (DMI), a clinicoradiological entity is an underdiagnosed complication of diabetes mellitus. It refers to spontaneous aseptic necrosis of skeletal muscles commonly of the lower limb without evidence of any large vessel disease. It presents as painful swollen limb without any external insult in patients with long-standing diabetes mellitus with other microvascular complications especially nephropathy. We present four instances of DMI in our patients who had end-stage renal disease with a varied course.

Evaluating substance use in an urbanizing town of mid hills of Northern India

Background: Substance use is emerging as a major cause of morbidity and mortality across the world. Solan, a fast urbanizing town of India has witnessed mushrooming of industries and educational institutes. A surge in the persons booked under the Narcotic Drug and Psychoactive Substance Act 1985 led us to look into the determinants of the substance use in this region.Methods: We undertook a cross sectional study of one year secondary data analysis of 750 substance users screened at the de-addiction centre of Solan Hospital. The data mining was done by the cluster analysis technique. SPSS 16 and STATA 13 software were employed.Results: Mean age of users was 31 years with dominance of males (89.20 %), two third of total users were married, 75% were unemployed, 42% had upper school level education. About 60 and 38% were using cannabis and chitta (a synthetic opioid) respectively. Only 2% were consuming tobacco and alcohol. 62% of substance users had the fear of legal action and 44% had no family history of substance use. 39% had only single parent, 54% had started substance use under peer pressure and duration of use varied between 6 to 24 months.  Alcohol and cannabis were used more in urban and rural areas respectively. 63 and 70% had family history and experience of peer pressure respectively.Conclusions: Cluster analysis has generated substance specific socio-demographic determinants of substance use which would help in planning appropriate substance use alleviation strategies.

Prevalence of Non-Alcoholic Fatty Liver with Gall Stones Disease in Himalayan Population

Non-Alcoholic Fatty Liver Disease (NAFLD) is the hepatic pandemic of the 21st century. It is the amassing of fats in the hepatic tissue without significant alcohol intake that results in hepatic steatosis. Patients with gall bladder stones may have associated NAFLD as these ailments share similar factors like obesity, hypertriglyceridemia and diabetes mellitus. However, few, if any, reports are available about the association of NAFLD with gallstones in the hilly population. Hence, this study was conducted to find out the prevalence of NAFLD in patients with gall bladder stone disease.METHODSThis study was done in the Department of Surgery, Indira Gandhi Medical College, Shimla, from June 2017 to May 2019. A total of 300 patients of ultrasound proven gall bladder stones was studied for NAFLD by Fibroscan (transient elastography). Transient elastography (TE) is a noninvasive method that has been shown to be useful for the detection of liver steatosis and fibrosis. NAFLD was diagnosed based on the value of CAP (Controlled Attenuation Parameter) & degree of fibrosis was assessed based on liver stiffness measurement (LSM) value on TE. Steatosis was graded as S0, S1, S2, and S3 while fibrosis was graded as F0-F1, F1, F2, F3, and cirrhosis. Minimum cut-off CAP value for diagnosing NAFLD was 214 dB/m & significant fibrosis was taken with LSM value >7.5 kPa.RESULTSPatients of gall stone disease showed significant liver steatosis, suggestive of NAFLD in 189 patients (63%), based on CAP value; however, 111 patients (37%) did not have significant steatosis. In patients with NAFLD, 57 (30%) had mild steatosis (s1) while 39 (20.53%) & 24 (12.63%) had moderate (s2) and severe (s3) steatosis respectively. Similarity, 72 (24%) patients had significant fibrosis while 228 (76%) patients had no to insignificant fibrosis on TE, 51 (17%) patients had moderate fibrosis, while 14 (4.5%) and 8 (2.5%) patients had severe fibrosis & cirrhosis respectively.CONCLUSIONSHigh prevalence of NAFLD in patients of gall stone disease was observed. Most of the patients had mild NAFLD i.e. grade S1 steatosis & in addition, fibrosis was present in 24% patients of NAFLD with gall stone disease.

To Study the Effect of Timing of Umbilical Cord Clamping on Neonatal Outcomes with Special Emphasis on Neonatal Hyperbilirubinemia and Hematocrit Levels in the Early Neonatal Period

Introduction: The umbilical cord of every newborn is clampedand cut at birth, yet the optimal timing for this interventionremains controversial. For at least over 200yrs, multiplecontroversies have arisen around the timing of umbilical cordclamping. Delayed cord clamping or placental transfusioncould be a cost effective intervention to improve the ironstatus of infants by enhancing their red cell mass. Search inliterature reveals that several controlled trials evaluating theshort term and long term hematological outcomes of delayedcord clamping have been performed in the past but veryfew studies have investigated the risk of hyperbilirubinemiaespecially from this part of the world. Hence this crosssectional study was conceptualized.Material and Methods: It was a cross-sectional studyconducted among 212 term infants born at RohilkhandMedical College and Hospital, Bareilly, over a period of 1year, who fulfilled the inclusion criteria were included in ourstudy.Results: In the present study, hemoglobin, bilirubin, andhematocrit levels at birth and at 24 hours of birth in Immediatecord clamping and Delayed cord clamping was taken. Meanlevels of hemoglobin, bilirubin and hematocrit was foundhigher in Delayed Cord Clamping group as compared toImmediate Cord Clamping group.Conclusion: The study was conclusive of the fact that interm infants delayed cord clamping increases hemoglobin,hematocrit and bilirubin levels at birth and at 24 hrs of birth ascompared to immediate cord clamping. Moreover, there wasno significant associated adverse effects.

A Comparative Study of Body Mass Index, Body Weight and Waist to Height Ratio to Depict Serum Cholesterol Level in Healthy Young Individuals

Introduction: Many external and internal factors eitherdirectly or indirectly regulate our health. Similarly, manyparameters such as high glucose, high cholesterol, and highblood pressure are the indicators of our healthiness. BodyMass Index (BMI) and Waist to Height Ratio (WtHR) aresuch parameters which indicate the degree of healthiness of anindividual. Current study aimed at estimation and comparisonof the statistical relationships of BMI, body weight and WtHRwith serum cholesterol level in healthy Individuals of agegroup of 18-30.Material and methods: This study was done on total 54healthy persons (27 male and 27 females) of age group 18-30. The data of age, height weight and waist circumference ofall participants were collected. In their fasting blood samples,total serum cholesterol was measured by colorimetric kit.In this study statistical correlation was confirmed by threedifferent statistical methods.Results: Our statistical analysis suggested that BMI, bodyweight and WtHR are positively correlated with average totalserum cholesterol level with a significant p value (<0.05).Statistical correlation coefficient values further suggestedthat BMI could be a better predictor of cholesterol levelassociated diseases as compared to body weight and WtHR inhealthy individuals of age group 18-30. High BMI and Waistcircumference are indicators of overweight and/ obesity.Conclusion: These findings indicated that BMI could be abetter predictor of cholesterol level associated diseases ascompared to body weight and WtHR in healthy individuals ofage group 18-30.

Mobile phone addiction among MBBS students of a Medical College leading to Sleep Cycle Disturbances

Introduction: Mobile phone has become such a daily routine essential part of our life causing good and adverse effects both in our performance. The aim of the present study is to see the effects of mobile addiction and sleep cycle disturbances in today’s life among medical students. Methods: The study was carried out among 218 MBBS students age group of 18 to 25 years, out of which 108 (49.5%) were females &110 (50.5%) were male. Internet addiction Test and PSQI Scale was used to assess the subjects and Chi square test was done for statistical analysis and p value (<0.05) is taken as significant. Result: The results are as follows: 218 undergraduate medical students participated in the study out of which 108 (49.5%) were females and 110 (50.5%) were male's age group between 18 to 25 years. Majority of them 204 (93.6%) were smart mobile phone users and 75 (34.4%) uses phone for near 2 hours per day, (34.4%) slept for less than 5 hours at night, 61(28%) reported ringxiety, ie, false perception of ring. Conclusion: We conclude that mobile use in present scenario affects sleep disturbances of the students. Identifying it early in life and motivating the students to indulge more in out-door sports and activities to refresh them.

Mandibular involvement as a first sign in Multiple Myeloma: a case report / Envolvimento mandibular como primeiro sinal clínico em mieloma múltiplo: relato de caso

Objective: To report a case of Multiple myeloma (MM) in mandible with paraesthesia. Material and Methods: The present case report highlights the occurrence of a swelling in the left posterior mandibular region in a 70-year old female patient and draws attention to the first clinical sign of a widespread systemic disease manifesting in the head and neck region. Results: The initial presumptive diagnosis was invalidated by the histopathological examination and other diagnostic tests that revealed the features characteristic for MM. Conclusion: Being a rare disease, MM should be kept on forefront of differential diagnosis for jaw lesions in a geriatric patient with paraesthesia. (AU)

Objetivo: Relatar um caso de mieloma múltiplo (MM) na mandíbula com parestesia. Material e Métodos: O relato de caso descreve a ocorrência de um inchaço na região mandibular posterior esquerda em uma paciente de 70 anos e chama a atenção para o primeiro sinal clínico de uma doença sistêmica disseminada que se manifesta na região da cabeça e pescoço. Resultados: O diagnóstico presuntivo inicial foi invalidado pelo exame histopatológico e outros testes diagnósticos que confirmaram as características do MM. Conclusão: Sendo uma doença rara, o MM deve ser considerado como uma primeira alternativa de diagnóstico diferencial de lesões mandibulares em pacientes geriátricos com parestesia. (AU)

Wire Cutter: Improvised approach with Basic Instrument.

A good armamentarium is basic to a practicing oral and maxillofacial surgeon. Various instruments and equipment are being improvised on a continuous basis to curtail various inherent problems and disadvantages of these instruments. The wire cutter is one such instrument, which is used in day-to-day oral surgical practice and is not free of disadvantage like blunting of sharp edges as a result of repeated usage and sterilization process. In this article, we discuss about a commonly used basic instrument (nail cutter) which can be efficiently used as a wire cutter.

Recurrent Headache in Pediatric Outpatients at a Public Hospital in Delhi.

This observational, descriptive study was conducted to study the clinical profile of children presenting with recurrent headaches to the general pediatric services of a tertiary-care, public hospital in northern India. 43 children, 3-18 year old (23 females, median age 10 years), were enrolled between April, 2011 to January, 2012. History, clinical examination (including fundus evaluation and detailed ophthalmological evaluation) and follow-up were done using a structured proforma. Headache diagnosis was made on the basis of International Classification of Headache Disorders, 2nd edition (ICHD-II). Headache disability and severity were assessed by pedMIDAS, and Visual analog scale and Faces scale, respectively. 26 patients (60.5%) had headache with migraine features (20, migraine without aura), 11 (25.6%) had Tension type headache (TTH), and 4 (9.3%) children had nonspecific headache. Stress was the commonest (42.3%) trigger identified by children with migraine. No patient in the study had an ophthalmological problem as cause of headache. 69.2% of migraine patients and 36% of TTH patients had been suffering from it for 1-2 years before reporting to the hospital. Majority of children with recurrent headache present late for medical attention. Ophthalmological problems are an infrequent cause of recurrent headache in these children.