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Introduction: Covid 19 pandemic has brought human life one on one with the pace of growth. The indispensable lockdown and social distancing norms have posed challenges to continue education in various fields. Distance learning via online teaching has emerged as a savior in the pandemic. In the current scenario, it is very important to keep learners in the loop and obtain feedback from students at the end of online teaching, for understanding its strength and weaknesses which will eventually assist in developing strategies to improve its quality. We intend to share our experience with the online teaching. Materials and Methods: The study was conducted from March 2020 to Feb 2021, which includes 8 months of online teaching classes and practicals, one online examination (mid term exam), and 1 offline examination (final professional exam). The marks obtained by the students who attended online classes (batch II) in 2020-21 session was compared with previous batch i.e 2019-20 (batch I). Also the marks obtained by batch I during online exam (mid-term exam) were compared with their marks during offline exam (final professional exam). Results: Batch II scored higher marks than batch I in theory and practical (p-value < 0.05). However, the marks of viva for both batches were equitable. Conclusions: We feel that the online teaching is a reasonable alternative to conventional teaching in the current scenario.
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Background: Identification of plasma cells into abnormal (APC) and normal (NPC) compartments is of utmost importance in flow cytometric (FC) analysis of multiple myeloma (MM) and related plasma cell dyscrasias for diagnosis, prognosis, and follow-up. No single phenotypic marker is sufficient to distinguish NPC from APC. Materials and Methods: 43 newly diagnosed cases of MM and 13 controls were included in the study. Bone marrow (BM) samples from the 2nd pass were processed on the same day with antibodies against CD38, CD138, CD19, CD81, CD45, CD117, CD200, CD56, cytoKappa, and cytoLambda in a 4-color experiment with CD38 and CD138 as gating antibodies. Results: Mean APC% in cases was 96.5%. The expected Immunophenotype (IP) of APC which is CD19-/56+/45-/81-/117+/200+ was found in only 13/43 MM cases. In 30/43 cases, APC revealed deviation from expected IP either for single or a combination of markers. Sensitivity for APC detection was highest for CD19 (95.2%) followed by CD56 (90.4%) and CD81 (83.7%). Specificity was highest for CD19 (100%), CD56 (100%), and CD81 (100%) followed by CD117 (92.3%). Combination of markers with maximum sensitivity to detect APC (97.6%) was CD81- or CD19- and CD200+ or CD56+ (two markers); and for NPC (92.3%) was CD81+ and CD19+ and CD56- (three markers). Conclusion: Plasma cell IP can be highly variable with multiple minor subpopulations in both cases and normal controls. CD 19 and CD56 are highly informative markers for a 4-color experiment. Assessment of multiple markers in an 8–10 color experiment is more informative but the lack of advanced flow cytometers should not limit the use of FC in a 4-color approach. Our results emphasize that even basic equipment with limited fluorochrome can provide meaningful information if used appropriately.
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This study investigated the relationship between dental hygiene and child maltreatment, malnutrition, and overall development. The researchers examined 900 students aged 5-15 years from government schools in Lucknow district, Uttar Pradesh. The study observed nutritional status by assessment of the physiological status of the body based on its height and weight and signs of abuse/neglect. The results showed that 260 abused students had poor dental hygiene, and 236 of them were mild to moderately malnourished. In comparison, 362 non-abused students had dental neglect, and 232 were moderately malnourished. These findings highlight a significant association between dental care neglect, child maltreatment, and malnutrition. It is crucial to address the social stigma surrounding this issue, normalize discussions, and encourage dentists to identify signs of abuse and inform relevant authorities about potential discrepancies.
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Introduction: Pre-hypertension is a borderline health state of increased blood pressure (BP) that falls short of the measurable parameters at which surveillance and/or therapy would be required. The approach of identifying people “At Risk” of developing hypertension can be more cost-effective and feasible for applying lifestyle interventions. Objectives: The objective of the present study is to find the prevalence of pre-hypertensives and associated bio-socio-demographic factors Materials and Methods: A cross-sectional study was conducted among 1946 participants aged 19 years and more in the Doiwala block of Dehradun, Uttarakhand. Multistage sampling was used to arrive at desired sample size. A pre-validated, structured questionnaire was used for data collection. The questionnaire included information on the socio-demographic profile (age, sex, education etc.), awareness about hypertension and its associated risk factors. Statistical Analysis: The chi-square test was used to compare proportions and draw inferences. Results: 958 (49.2%) study participants out of a total 1946 were found to be pre-hypertensives. A statistically significant association was found between pre-hypertension and factors such as male gender, age, education, occupation and waist-hip ratio. (p<0.05) Conclusion: It is recommended that identification on the pre-hypertensive group and subjecting them to lifestyle modification could be a fruitful strategy for preventing them from becoming hypertensive.
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Objective: The present study evaluates the immunoexpression of p16 and Ki-67 in cervical squamous intraepithelial lesion (SIL) and carcinomas and correlates their expression with clinicopathological features and HPV-DNA status. Material and Methods: A total 36 included cases of SIL and squamous cell carcinoma (SCC) were subjected to p16 and Ki-67 immunostaining. p16 staining was evaluated depending on grading, distribution, localization pattern, intensity and IHC score. Ki-67 expression was graded based on percentage of positive cells. Results: Incidence of HSIL and SCC cases was found to be significantly increased with parity > 5. p16 grade III diffuse nucleocytoplasmic immunostaining was observed in 62.5% LSIL, 80% HSIL and 87% SCC cases. Significant association of p16 staining intensity, IHC score and Ki-67 indices was noted with increasing grades of SILs and carcinomas. Conclusion: Our experience indicates that a combination of p16 and Ki-67 immunostaining may be useful to determine the severity of dysplastic change.
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Background: Rabies is one of zoonotic viral disease, estimated to cause 59000 human deaths annually in over 150 countries, of which 20,000 are from India alone; about 40% of which are in children under the age of 15. Rabies though 100% fatal is preventable with post-exposure prophylaxis which includes wound washing, anti-rabies vaccination and rabies immunoglobulin. Objective: To describe the clinico-social profile of animal bite patients attending the anti-rabies clinic of BRD Medical College, Gorakhpur. Methodology: A cross-sectional study was conducted in the anti-rabies clinic of Nehru hospital, BRD Medical College, Gorakhpur from January 2022 to May 2022. Study participants were interviewed by using a pre-phrased, pre-designed and pre-tested questionnaire. Data regarding socio-demographic and clinical profile of the study participants following animal bite exposure was collected. Results: The total number of animal bite victims were 250, in which majority of them were males (76.77%) and highest percentage was of adult population (20-59 years). Maximum number of victims were from rural area (78.70%). 19.35% were working and 39.35% were students. 77.43% were category III bites and in 50.96% cases lower limb was the site of bite and dogs were responsible for 89.67% of the bites. 60.64% victims did not wash the wound properly before reaching the anti-rabies clinic. Conclusion: This study concludes that as majority of the animal bite victims were students and majority of victims were unaware about the importance of wound care, therefore a step can be taken to create awareness in various schools.
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Introduction: Diffuse cystic lung diseases (CLDs) are a heterogeneous group of uncommon disorders with characteristic imaging appearance. Cystic lung disease is a significant cause of mortality and morbidity with a wide spectrum of radiological presentations and etiological differentials. Though the literature is widely available on radiological approaches to CLD, a knowledge gap exists on the etiological spectrum, especially in the Indian scenario, as it is an orphan group of lung disorders. The interest and experience among pulmonologists regarding CLD are growing with the widespread use of CT scans. Clinical, radiographic, and histological findings are often essential for proper diagnosis, and multidisciplinary approach is required for optimal management of such cases. In our study, through real-world cases, we have highlighted the clinical manifestations and diverse etiological spectrum of CLD. Since these disorders are rare, incurable, and have variable disease progression, the authors have tried to address the holistic approach of this relatively less-understood group of disorders. Aims and objectives: The aim of the study was to identify clinical characteristics and etiological spectrum of patients manifesting with diffuse cystic lung disease radiologically. Materials and methods: In this retrospective analysis, the hospital electronic database was screened with Boolean operations and keywords for cysts OR pneumothorax. Among a total of 4,479 patients admitted to the respiratory ward /ICU during the period of January 2020–September 2022 at a tertiary care center in northern India, 14 patients with radiological diagnosis of CLD matched the relevant search. All relevant data of these patients were retrieved from the records. Results: Our patients presented predominantly with symptoms of cough and breathlessness. About 4 patients had pneumothorax as the first presentation. The mean age of presentation was 42.14 (standard deviation 12.6, age range 16–62 years). About 64% (n = 9/15) patients were females. The various etiologies identified were lymphangioleiomyomatosis (LAM), lymphocytic interstitial pneumonia, Birt–Hogg–Dube syndrome, hypersensitivity pneumonitis, Pneumocystis jirovecii pneumonia, and cystic metastasis, and in one patient, no definite cause was found despite detailed evaluation. Conclusion: Cystic lung disorders are a less commonly diagnosed entity with rare etiologies. In our study, we found a female preponderance and LAM as the commonest CLD. Pneumothorax is a sentinel event and commonly the presenting complaint in CLD. Identification of the etiology can help in institution of definite therapy when available. In view of unpredictable disease progression and outcome, these diseases warrant follow-up and imaging surveillance.
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Background: Sickle cell disease (SCD) is a chronic hemolytic disorder characterized by the presence of crescent-shaped red blood cells. Abdominal pain is the common presenting symptom in adults with SCD. Among the patients who are not in crisis, it is estimated that one third of patients with homozygous SCD with chronic recurrent epigastric pain has endoscopic evidence of peptic ulcer disease. Aims and Objectives: This study was undertaken with an aim to analyze the incidence and management of acid peptic disorders among SCD patients in Western Odisha. Materials and Methods: A prospective study was done considering 88 homozygous SCD patients. All the patients underwent upper gastrointestinal endoscopy (UGIE) with gastric antral biopsy and rapid urease test (RUT). Cases with Helicobacter pylori were administered a 14 days course of three drug regimen of anti H. pylori drugs and followed-up to 6 weeks of beginning the treatment with repeat UGIE and RUT. Results: Out of 88 cases, 19 cases had duodenal ulcer (21.6%) which was significantly high than patients with gastric ulcer (13.6%). Other findings were gastroesophageal reflux disease and gastritis. About 93.5% of patients became RUT negative after taking anti H. pylori medication. Conclusion: SCD patients with acid peptic disorder constitute a sizeable proportion of patients attending surgical outpatient department and indoor department of surgery. Conservative treatment with life style modification can effectively improve the symptoms of acid peptic disease.
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Background: India saw one of the stringent lockdowns during the COVID-19 pandemic. In the wake of this period, the normal functioning of medical services was affected. People were reluctant to seek medical attention and notification of Tuberculosis dipped. The aim of the study was to estimate the proportion of non-adherence to anti-tubercular treatment and to identify the factors affecting the non-adherence to treatment. Methods: A retrospective community-based study was conducted among 284 tuberculosis patients. They were interviewed using a pre-designed questionnaire consisting of WHO dimensions of non-adherence and lockdown related questions. Results: The proportion of non-adherence to treatment was found to be 5.3%. Factors like chronic diseases, depression, without knowledge on how the disease is transmitted and that medication can be discontinued once the symptoms subsided, alcohol consumption, and trouble accessing medicine were found to be the determining factors in non-adherence to the treatment. Conclusions: Non-adherence to anti-tuberculosis treatment in our study was low but the various dimensions of adherence along with lockdown related factors had significant impact on it. To further minimize non-adherence during emergency like the lockdown due to COVID-19 pandemic, corrective measures must be explored and implemented.
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Background: Vaccines are considered as the one of the main pillars in halting and ending the presently on-going coronavirus disease (COVID-19 disease) pandemic which has spread globally since it was first detected in Wuhan, China in December 2019. In the absence of specific therapy, infection prevention practices and mass vaccination remains the mainstay in controlling the disease. Objectives: Objective of the study was to assess COVID-19 vaccination status, socio-demographic and clinical profile among healthcare workers diagnosed with COVID-19. Methodology: A cross-sectional survey from 1st March 2021 to 30th June 2021 among healthcare workers who were diagnosed with COVID-19 in a tertiary care institute of Uttarakhand, India was conducted, and universal sampling was used. Institutional Ethics Committee approved this study. Results: Total 662 healthcare workers were diagnosed with COVID-19. 429 (64.8%) of these COVID-19 diagnosed healthcare workers had received either single (129,30%) or both dose (300,70%) of COVID-19 vaccine while remaining 233 (35.2%) belonged to non-vaccinated group. History of exposure to COVID-19 positive patients was higher in vaccinated (66.4%) than in non-vaccinated group (55%) (p = 0.004). Hospitalisation was found to be higher among non-vaccinated (5.6%) than vaccinated group (2.3%) (p = 0.029). Conclusions: This study concludes that being vaccinated against COVID-19 disease provides protection against severe infection and reduces the need for hospitalization.
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Regional analgesia features a prime role within the multimodal analgesia approach for surgical pain management. currently each day it's common apply of using transverses abdominis plane block (TAP Block) with numerous sorts of native anaesthetics and adjuvants, as a multimodal pain relieving remedy used worldwide for intra and postoperative pain management in several surgeries. However, only a few studies are done wherever hemodyanamics effects when bupivacaine versus levobupivacaine have compared. Aim of this study to examine the consequences of bupivacaine vs levobupivacaine in patients undergoing lower abdominal surgeries and their effects on hemodynamics ( the blood pressure, HR, and SpO2). Method: A randomised double-blind management study conducted when approval from IEC Ref. code-92nd IIB Thesis / P4 . The study has fifty patients, with ASA I – II physical status, as well as each sex and 2-10 years cluster age and who set up for abdominal surgery notably lower abdominal . 25 patients set in every group and every which way allotted: cluster Bupiva and Levobupiva . All patients were well well-read regarding the procedure, drugs, and effects of drugs, and untoward complications. well-read written consent was taken from each patient before involving them within the study. primary objective is to examine the impact of those medicine on Blood pressure, HR, and SPO2 & Secondary objective was to check rescue physiological condition reduction within the surgical period. After the comparison between these 2 clusters, The mean SBP of group Bupiva was found below that of group Levobupiva . and located to be important at fifteen min, one hour, a pair of hr, and four hr and insignificant at baseline zero min, thirty min, half dozen hr (p=0.092), twelve hr, eighteen hr, and twenty four h.differences is insignificant in comparison the DBP at any purpose of your time from baseline to 24 hr. On comparing the center rate, variations were found insignificant from baseline (p = 0.897), 0 min (p = 0.651), 30 min (p = 0.096), 1hr (p = 0.192), 2 hr (p=0.390), four hour (p=0.525), half dozen hr (p=0.469), twelve hr (p=0.443), eighteen hr (p=0.288) to twenty four hr (p=0. 390) except at fifteen min (p=0.010) that was the mean pulse rate of cluster Bupiva is over that of group Levobupiva at one,5 min. On comparison the SPO2differences were insignificant at baseline (p = 0.620), 15 min (p = 0.108), thirty min (p=0.353), 1 hr (p = 0.789), 2 hr (p = 0.364), 4 hr (p = 0.292) and 6 hr (p = 0. 198) however important at 0 min (p = 0.002), 12hr (p = 0.012), 18hr (p = 0.002) and24 hr (p = 0.028) wherever the mean SPO2 of cluster Bupiva was abundant below the group Levobupiva. Stable hemodynamics for a extended period were provided by Levobupivacaine as compared to Bupivacaine.
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Background: Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of peripheral vertigo. Vitamin D3 is an indispensable part of bone mineralization and calcium homeostasis. Vitamin D3 also plays a role in BPPV and therefore may offer a therapeutic option. Aim and Objective: This study aims to evaluate the relationship of BPPV with Vitamin D deficiency. Materials and Methods: This observational case–control study was done on 80 subjects out of which 40 were confirmed cases of BPPV patients and 40 were controls. Ear, throat, and nose were examined in all patients. Measurement of Vitamin D3 was done in all subjects. Assessment of quality of life was done using Dizziness Handicap Inventory score (DHI) and Visual Vertigo Analog Scale (VVAS). Results: In our study among cases, 14 patients (35%) had normal Vitamin D levels, Vitamin D deficiency was seen in 15 cases (37.5%) and 11 patients (27.5%) had Vitamin D insufficiency. In control group, 22 patients (55%) had normal Vitamin D levels and 9 patients (22.5%) each had Vitamin D insufficiency and deficiency. Mean of Vitamin D concentration in the case group was 23.78 ± 10.43 and in the control group had 35.99 ± 15.99. The relationship between the two groups was significant (P = 0.001). The mean of body mass index in case and control group was 22.46 ± 2.48 and 23.43 ± 2.38, respectively, with P-value of 0.032 indicating significant relationship statistically. Furthermore, VVAS and DHI scores were higher in cases with deficiency and insufficiency of Vitamin D. Conclusion: The present study shows a significant relationship of reduced concentration of Vitamin D with idiopathic BPPV.
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A geomagnetic storms is a global disturbance in Earth's magnetic field usually occurred due to abnormal conditions in the interplanetary magnetic field (IMF) & solar wind plasma emissions caused by various solar phenomenon. 138 solar wind streams in solar cycle 22 & 173 solar wind streams in solar cycle 23, have been found, which are associated with proton density, observed during 1986 to 2010. We have analyzed & studied them statistically. We have found that yearly occurrences of geomagnetic streams are strongly correlated with proton density in 11-years sunspot cycle, but no significant correlation between the maximum & minimum phase of solar cycle 22 & 23 have observed
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Recent COVID-19 pandemic has highlighted the importance of increase in the ability of public health workforce to detect and respond to the public health threats. For timely implementation of an adequate response and mitigation measure, the standardized and sustainable capacity building programme for frontline public health workforce is the need of hour. National Center for Disease Control (NCDC), Ministry of Health and Family Welfare, in partnership with U.S. Centers for Disease Control and Prevention (CDC), developed a three-month in-service Basic Epidemiology Training programme. This is a tailor-made programme for frontline public health workforce to strengthen epidemiological skills. This training was a practical interactive approach to field epidemiology for three months on the job training for frontline public health workforce that addressed the critical skills needed to conduct surveillance effectively at the local level while focusing on improving disease detection, reporting and feedback. The training also demonstrated the role of learning model in form of interaction between the mentor and the mentees. The importance of handhold support given by the mentors to the mentees in quality outbreak investigations and documentation.
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Lung cyst is an atypical computed tomography (CT) thorax finding in COVID-19 pneumonia. Cyst in COVID-19 may result independent of mechanical ventilation. The cyst may rupture causing pneumomediastinum or pneumothorax or may get secondarily infected resulting in an adverse outcome in patients. Here, we describe the clinical characteristics and outcomes of 19 patients with COVID-19 pneumonia with lung cysts detected in CT thorax. A total of 17 (89%) of our patients survived uneventfully and 2 died due to complications unrelated to the cysts.
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The Prime Minister’s Overarching Scheme for Holistic Nourishment (POSHAN) Abhiyaan or National Nutrition Mission was launched by the Government of India on March 8, 2018 in the Jhunjhunia District of Rajasthan. POSHAN Abhiyan is India’s flagship programme to improve nutritional outcomes by convergence, targeted approach and use of appropriate technology. To strengthen nutritional content, delivery, outreach, and outcomes, Government has merged the Supplementary Nutrition Programme and Poshan Abhiyan to launch Mission POSHAN 2.0. As India formulates POSHAN Abhiyaan 2.0, the use of the stunting metric to measure the effect of current interventions needs to be reconsidered. It has been emphasized that the stunting metric, due to its sensitivity to maternal height, cannot accurately assess the extent of the current under-nutrition burden. Among the target indicators identified in POSHAN Abhiyaan, stunting is least indicative of current nutrition-specific and nutrition-sensitive conditions.
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In last three decades, more than 30 new infectious agents have been detected worldwide and out of which more than 60% have been found to be zoonotic in origin. Monkeypox disease is an infectious zoonotic disease caused by the monkeypox virus belonging to the Orthopoxvirus genus of the Poxviridae family. Human monkeypox was first identified in humans in 1970 in the Democratic Republic of the Congo in a 9month-old boy in a region where smallpox had been eliminated in 1968. First outbreak of human monkeypox outside Central and Western African region was detected in 2003 in United States of America which was linked to contact with the infected pet prairie dog. The latest Monkeypox outbreak in non-endemic countries started from May 2022 and have been reported from 89 member states across all six WHO regions. India reported first case of Monkeypox on 14 th July 2022.
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Abstract: The postpartum period marks a transition phase in the life of the mother as well as the whole family. Health Related Quality of Life (HRQoL) is an important aspect for not only mother’s physical and psychological health. The study was conducted in a resettlement colony, Kalyanpuri located in Delhi, India with a sample size of 330 post-partum women and the data was collected in the 6th week of post-partum period using the MOS SF-36 (Medical Outcomes Study Short Form 36 Health Survey) for health related quality of life. Among the study subjects, 34.2% had the birth order two and they showed the best mean HRQoL score. The mean score was low for the study subjects with complications in the antepartum, intrapartum and postpartum period (52.9 ± 18.4) as well as in foetal complications where the intrapartum period complications had the worst mean HRQoL score. Healthcare workers of the study area visited 91.5% of the subjects during the post-partum period and had better HRQoL mean score. Also, 22.4% subjects had history of mistreatment and abuse with decline in the mean HRQoL scores. Across the study subjects, 54.4% had financial hardships faced by their family members which had poor HRQoL mean scores. This study uncovered various horizons of health related quality of life for assessment of women in the post-partum period which emphasised the modifications and considerations to include quality as one of the determinant and indicator of health.
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Background:The ophthalmological problems occur in approximately half of the patients with advanced HIV infection when the CD4 T cell count is usually well below 50/ul and the increasing number and prolonged survival of AIDS patients means that the ocular lesions associated with this syndrome will become more frequent problem. Material And Methods:This was a case series study with no controls. All HIV positive patients were included in this study with or without ocular involvement.50 known HIV positive cases attending OPD and/or admitted in GM and Associated Hospitals, KGMC, and who were willing to take part in study were enrolled after proper counselling.Detail history of the cases is taken including personal data, occupation, history of any risk factor, detail history of systemic disease and ocular symptom with their duration and course.Results:In our study 33 patients did not have ocular symptoms and signs and the remaining 17 patients were found to have ocular involvement. Among them 6 patients were asymptomatic, but they had ocular signs. Amongst various symptoms 7 patients presented with diminution of vision, one had headache, other visual symptoms including watering itching and foreign body sensation were found in 5 patients. Conclusion:More than half of the cases in this study were either illiterate or had attended primary schooling and mostly from rural area. In view of this there is a need to intensify primary health education programme and awareness about AIDS through mass media and education regarding adaptation of safe sexual practices. The role of Govt. program and various NGOs has become more important in this respect to restrict this 21stcentury epidemic.
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Background: Silver diamine fluoride (SDF) is one of the effectual cariostatic agents widely used in minimal intervention dentistry. However, the major drawback of SDF is dark staining after its application. Aim: In the present study, the staining of 38% SDF alone and 38% SDF and potassium iodide (KI) was compared after restoration with glass-ionomer cement (GIC) and resin composite using ImageJ software. Methods and Material: Forty extracted carious primary teeth were sorted into four groups. In Group I and II, SDF was applied and restored with GIC and composite restorations, respectively. In Group III and IV, SDF application was followed by KI and restored with GIC and composite restorations, respectively. Images were captured after initial applications on day 1 and day 14 after restoration. The captured images were imported to ImageJ software and mean gray values were calculated. Statistical Analysis: The mean gray values obtained were subjected to statistical analysis using paired t-test and independent sample t-test. There was statistically significant if P < 0.05. Results: Following the application of SDF and RIVA STAR, the baseline mean gray values showed no statistical significance. On day 1, the mean gray values were highest in Group IV (208.30) and lowest in Group I (178.51). Similarly, on day 14, the highest mean gray values were observed in Group IV (208.45) and lowest in Group I (147.6) which were statistically significant. Conclusions: The restorations after SDF application attained dark stain eventually, whereas with the application of SDF followed by KI (RIVA STAR), the restorations showed the least staining.