Comparison of outcomes of acute kidney injury in elderly and non-elderly hospitalized patients in a tertiary care hospital in India: a prospective observational study

Background: The prevalence of acute kidney injury (AKI) progressively increases with age. A higher rate of dialysis dependency and mortality is observed in elderly with AKI. Here we have studied the comparison of clinical features, outcomes of AKI between elderly (age � years) and non-elderly AKI patients and their risk factors for mortality. Methods: This prospective observational study enrolled 100 patients with AKI, with elderly and non-elderly in a 1:1 ratio for comparison, from September 2021 to January 2023 at AIIMS Rishikesh in India. Detailed history, clinical examination, relevant laboratory and radiological investigations were done to evaluate for the cause of AKI. Etiological causes, complications of AKI, and in-hospital outcomes were observed. They were given standard treatment and dialysis as per standard indications. We analysed the mortality risk of these groups using the Cox proportional hazards model. Results: The in-hospital mortality rates among these two groups were non-significant (p=0.29). A significantly higher number of patients with non-elderly AKI were HD-dependent at discharge (p=0.027). Elderly patients had significantly lesser complications like uremic encephalopathy and fluid overload compared to non-elderly. There was a significant association between mortality and female gender, intensive care unit (ICU) admissions, hospital-acquired AKI, pre-renal/renal causes, chronic obstructive pulmonary disease (COPD) as comorbidity, multiple organ dysfunction syndrome (MODS), mechanical ventilation requirement, vasopressor support requirement, need for hemodialysis and prolonged ICU stay. Conclusions: Elderly patients with AKI do not experience worse mortality outcomes than non-elderly patients with AKI. Therefore, elderly patients should not be denied timely treatment, solely based on their age.

A micro bacteriological culture assessment of the histopathological alterations in liver and bile in gallstone disease

Background: The present investigation aims to evaluate both the intensity and occurrence of hepatic impairment in patients afflicted with gallstone disease, examining the involvement of bacteria in the progression of these alterations. Methods: This prospective observational investigation was carried out on 189 patients scheduled for open or laparoscopic cholecystectomy at IGIMS in Patna, Bihar, India. In all the patients, laboratory and radiological investigations were performed. A healthy section of the liver border near the gallbladder fossa was chosen and grasped with non-traumatic forceps. Approximately 1 cm of the liver edge was excised using scissors and forwarded for histopathological analysis. Results: An examination of 189 liver biopsy specimens revealed that 87 (46%) patients showed no abnormalities, while 102 patients (54%) exhibited one or more changes. Upon analysing the liver biopsy samples from the control cohort (41 patients) during autopsy, 37% of the cases were identified to display hepatic lipidosis, while 48% of the cases showed lymphocytic invasion. Importantly, no cases of acute inflammatory changes were detected in the control cohort. Microbiological analysis was conducted on 96 patients, of which 33 (34%) showed positive cultures, with one or more microorganisms isolated from either the biliary tract or liver. Among these, 74% (24 cases) originated from the bile or gallbladder, while 26% (9 cases) were isolated from the liver. Conclusions: Gallstone disease induces significant liver histological changes, notably more prevalent in patients with prolonged symptoms. The present study clearly identifies this and underscores the importance of timely diagnosis and intervention for the effective management of this disease.

Perception of breast cancer and self-breast examination practices among women in Lucknow, north India

Background: Breast cancer is the leading cause of mortality and morbidity among women worldwide. It is one of the prime health issues in developed and developing countries because of the high prevalence of known risk factors. In the present study, we assess the knowledge of breast cancer and breast self-examination (BSE) screening practices among women in the capital city, Lucknow, Uttar Pradesh, North India. Methods: This cross-sectional study was conducted in urban and rural areas of Lucknow. The period of study was one year, starting from December 2020 to November 2021. Data were obtained from 400 adult women (212 rural and 193 urban) using a pretested, self-administered questionnaire. Participants aged >20 years were randomly selected from two rural and two urban community health centres (CHCs). The questionnaire assessed respondents’ socio-demographic characteristics, risk factors, signs and symptoms, early detection methods, and knowledge and practices related to self-breast examination among women in Lucknow. Results: Out of 400 respondents, only 33.5% (rural) and 55.96% (urban) women had heard of breast cancer. 17.55% (rural) and 13.47% (urban) women had heard about BSE. 4.72% (rural) and 8.81% (urban) women practice BSE occasionally. Knowledge about breast cancer, its symptoms, risk factors, and screening methods was similarly poor in women of Lucknow. Conclusions: This finding correlated significantly with older age, higher levels of education, and occupation. There is a low level of awareness of breast cancer in Lucknow's urban and rural areas. BSE is hardly practiced, though the willingness to learn it is high.

Residual limb temperature study with Pe-Lite liner in traumatic transtibial amputees

Interventions to alleviate thermal discomfort, a common complaint in amputees, are typically chosen based on residual limb skin temperature while wearing prosthesis; however, residual limb skin temperature while outside of the prosthesis has received less attention. The purpose of this study was to investigate the localized and regional skin temperature over the transtibial residual limb (TRL) when the prosthesis was removed. The present study documents the temperature variations in a traumatic below knee amputee with Pe-Lite liner. This study included eight unilateral transtibial amputees. Over the residual limb, twelve sites were marked in four columns (anterior, posterior, medial, and lateral) and three rows (proximal, middle, and distal). The temperature of the residual limb was measured with an infrared thermometer both in a relaxed state and after 30 minutes of activity with a Pe-Lite liner. The current study found a rise in temperature on the anterior side (36.30?C to 36.44?C), posterior side (36.36?C to 36.50?C), medial side (36.34?C to 36.40?C), and lateral side (36.35?C to 36.45?C). The temperature distribution over the TRL was found to be unequal, with significantly higher and lower temperatures on its posterior and medial sides, respectively.

A cross-sectional comparative study of some cardiovascular risk factors in premenopausal and postmenopausal apparently healthy women of Ranchi

Background: Loss of estrogenic support may put postmenopausal women at higher risk of cardiovascular diseases. Aims and Objectives: This study aimed to examine premenopausal and postmenopausal woman to provide pertinent data on some of the cardiovascular risk factors and to know approximately the period which is under protection of estrogen and the period from which a woman is affected by changes in cardiovascular risk factors. Materials and Methods: This cross-sectional study was conducted in RIMS Ranchi from February 2018 to August 2019. A total of 262 apparently healthy women in the age group of 35–60 years were assessed for cardiovascular risk factors. Parameters assessed in premenopausal and postmenopausal women were heart rate, blood pressure (Systolic and Diastolic Blood Pressure), body mass index (BMI), waist circumference, hip circumference, blood sugar level, and lipid profile of the subjects. Results: Out of 262 participants, 132 were in the premenopausal group with mean age of 39.76 years and 130 were in the postmenopausal group with mean age of 50.8. Except BMI, all other cardiovascular risk parameters showed significant difference between premenopausal and postmenopausal women. Conclusion: We concluded that adverse changes in lipid profile and blood sugar along with significant increase in other cardiac risk factors in postmenopausal women as compared to premenopausal group of the study predisposed this group of women at increased risk of having cardiovascular disease in near future. Hence, preventive measures against cardiovascular disease risk should be started in premenopausal period only.

Prevalence of refractive error in children- hospital based study in Lucknow

Background: Refractive error is defined as a status of refraction. They happen when the shape of your eye keeps light from focusing correctly on your retina (a light-sensitive layer of tissue in the back of your eye). Refractive errors are the most common type of vision problem but many don’t know that they could be seeing well. Methods: This study was a cross sectional hospital-based study of 197 children carried out in ophthalmology department of Era Medical College, Lucknow. The study of population comprised of all the children in 5-20 years’ (78 male 119 female) age group in the rural area. In this study compressive examination prevalence of myopia and hypermetropia. The assess refractive error among study with ‘hine retinoscopy’. Myopia considered grater or equal -0.50 and hyperopia is grater and equal +0.50. Results: The crossed section hospital-based study 197 children examined 78 male and 119 female. The uncorrected ametropia in children was 82.2%. The highly prevalence of myopia 46%, hypermetropia 5%, astigmatism 31%. The most highly significant refractive error 16-20 year of age. Conclusions: The prevalence of ametropia is fined among children in hospital visit. Need for regular routine cheek up proper ophthalmic assessment examination of eye and full proper diet and distance with digital gadget.

Epidemiological and clinical profile of Laboratory confirmed cases of COVID 19 admitted in Tertiary care Hospital Jammu, Jammu & Kashmir

Background: Three or more waves of COVID 19 pandemic have hit the different parts of world including India very hard, taking toll on the lives of people both in terms of morbidity and mortality. Keeping this in mind, the present study was conducted with an aim to determine the socio-demographic and clinical profile of laboratory confirmed COVID 19 cases and to determine their association with oxygen requirement and outcome of disease at the time of discharge. Methods: The present cross-sectional study was conducted on lab confirmed COVID 19 cases admitted in tertiary care hospital in Jammu from June-July 2021.Data was collected using convenient sampling method. The self-designed questionnaire used for data collection obtained information regarding socio-demographic characteristics of patients as well as clinical features of the disease. Results: Out of total 161 patients studied, 60.8% were males and 39.2% were females. Mean age was 51.2 ± 17.5 years. Comorbid conditions were present in 37.8% patients, with hypertension being the most common ( 36%). Cough, Fever, breathlessness and myalgia were the main presenting symptoms (90%, 81%, 57.7% and 56% respectively). The variables which were found to have statistically significant association with oxygen requirement and the outcome of disease at the time of discharge were age, gender and presence of co-morbidity (p <0.05). Conclusions: Advancing age, male gender and presence of underlying co-morbidity were found to be significant risk factors for the requirement of oxygen and poor outcome of the disease.

Disparity in Relation to Covid-19 Preventive Behaviour and Associated Myths among Rural and Urban Residents of Lucknow: A Community Based Study

Introduction: For curbing Covid-19 disease, adequate knowledge, attitude, and practices of both rural and urban population for Covid-19 disease prevention is required along with busting of the associated myths. Objectives: To assess the Knowledge, Attitude and Practices of urban and rural residents of Lucknow district regarding covid-19 preventive behaviour and associated myths. Methodology: A community-based study was conducted among 420 rural and 421 urban residents of Lucknow. Multistage random sampling was done to select the study subjects. A pre-designed pretested semi-structured questionnaire was used to collect the information regarding the Knowledge, Attitude and Practices of the residents for covid19 disease causes, prevention, and treatment. Further, KAP scoring was done to compare the two groups. Results: The mean age of the rural and urban residents was 31.48 ± 12.05 and 30.93 ± 11.96 years respectively. Only 40.4 % urban and 25.5 % rural people had correct knowledge about social distancing (p<0.0001). Knowledge regarding quarantine for covid-19 disease prevention was less among the urban residents (64.6%) as compared to rural (70.5%) (p=0.035). More than one-third (37.6%) of the rural resident believed in the myth that alcohol can prevent the covid-19 disease (p=0.003). 68.8 and 70.5 percent rural and urban residents had positive attitude towards the Indian government’ efforts in curbing the disease. Majority of the urban (90%) and rural (87.6%) residents wore mask when they went out. Only one-fourth of the urban (24.7%) and rural (22.9%) had correct practices for the duration of hand washing. Conclusion: The knowledge was more among the urban people, attitude and practices were almost similar among both the rural and urban residents while myths were more observed among the rural residents.

A Study of Knowledge and Attitude about Leprosy among the Physiotherapy Students and Practitioners: A Cross-Sectional Study

Physiotherapy adds quality to the life of people. It provides support to people with disability. Leprosy is such a debilitating condition in which people suffer concerning their functionality and emotional parameters even after bacteriological cure. Leprosy is having several types of social stigmas attached to it which could be the reason for the discrimination among this population. Boosting the knowledge and building up a strong and positive attitude among physiotherapy students and practitioners against leprosy will be of help in overcoming the various multiple taboos associated with this condition. This research work aims at evaluating the knowledge and attitude towards leprosy among physiotherapy students and professionals in India. This study involves 300 voluntary participants from the physiotherapy field (students and professionals) above the age of 18 years from any gender from India, with a good hold on the English language. The response of all the participants was descriptively analyzed. Among study participants the mean score for the knowledge was estimated to be 65.47±14.69. Out of 300 participants, only 72 participants have shown a high level of knowledge with a mean score value of 84.54±5.23, and 228 participants showed a low level with a mean score value of 59.44±11.14. The mean score for the attitude related questions was 54.7±26.21. 189 respondents presented a favorable response with a mean of 71.16±16.56 whereas 111 respondents presented an unfavorable attitude with a mean value of 26.67±11.86. The findings of this research work gave us an insight into the “low-level knowledge” and a relatively “favorable behavior” towards the patient affected by leprosy among the physiotherapy students and practitioners in India. However, still, there is a need to enhance the knowledge and improve attitude among the Physiotherapy students and professionals by educating them and including leprosy in sufficient details in physiotherapy curriculum. Properly designed research cum intervention studies are necessary to understand the gaps in knowledge and attitudinal problems and take remedial measures.

Psycho-social health problems: Prevalence and associated factors among students of professional colleges in Jammu

Background: Psycho-social health problems are an area of concern worldwide especially among students pursuing professional courses. The competition for grades, carrier insecurity often contribute to various emotional disturbances such as stress, anxiety and depression. Aims and Objectives: to determine the prevalence of stress, anxiety and depression in students of two main professional streams (medical & engineering) and to find out various factors associated with them. Material and methods: A cross-sectional study was conducted among students of medical and engineering stream using DASS 42 scale. Further a self administered, pretested questionnaire was used to elucidate information on socio-demographic and personal characteristics. Results: Out of a total of 480 students (300 MBBS and 180 Engineering), prevalence of stress, anxiety and depression in medical & engineering students was 47.6 %, 68.6%, 43.7% and 41.1%, 71.1 % & 40.0 % respectively. On Multiple Regression analysis, relationship with family members emerged as a significant independent predictor for all the three psychogenic factors. Conclusions: A high prevalence of depression, anxiety and stress was found among students of both the streams. There is a need to introduce simple counselling and stress management techniques in curriculum to combat such morbidities

Evaluation of Nutrient Foramina of the Dry Adult Human Femur Bone of North Indian Population

Introduction: The Femur bone is a highly vascular structure with unique features in its blood supply via numerous foramina located over its different segments, being named as vascular foramina . Among vascular foramina, nutrient foramen is an important one which gives way to the nutrient artery. Aim: To evaluate the nutrient foramina of the dry adult human femur bone of north Indian population. Subjects and Methods: The present study was undertaken using 50 dry adult human Femur bones of North Indian population. The samples were collected from the Anatomy department of the institute. Results: In the present study, among foramina of 50 dry adult human Femora, 31 Femora had single nutrient foramen, 18 had two nutrient foramina and 1 had three nutrient foramina. The medial lip of lineaaspera of Femur depicted the presence of nutrient foramina in majority of bones suggesting the entry zone for nourishment of shaft by perforating arteries. Size of nutrient foramina were ranging from size ≥ 0.55 mm to size ≥ 1.27 mm. Direction of nutrient foramina of all the Femora were directed upwards. Conclusion: This study may help orthopaedic surgeons in planning the surgical treatment of fracture of Femur with a possible reduction in post-operative complications. Combined periosteal and medullary blood supply to the bone cortex helps to explain the success of intramedullary reaming of long bone fractures particularly in the weight bearing Femur.

Sexual Dimorphism of Femur and its Clinical Significance

Introduction: Assessment of human sex from skeletal remains plays a key role in anthropological and medico legal studies. Hence this study was taken to assess the sex form an isolated bone i.e. femur, with as far as possible minimal parameters to ascertain the sex. Subjects and Methods: A study was conducted with 100 non pathological femora. (50male, 50 females ) in different age groups of known sex. The present study was to determine the sex by using 5 parameters i.e Maximum length, Head vertical diameter, Transverse head diameter, Proximal breadth, Distal breadth of the femur has been taken because it gives some useful data in medico legal cases, When only the remains of femur bone were left in deceased individuals. The measurements of femur bone were taken with the help of osteometric board and Vernier calliper. Results: The readings were noticed. The readings were tabulated and subjected to statistical analysis. It was noticed that all the studied parameters were greater in males than in females. Conclusion: The present study on the determination of sex of femora will be more reliable basis for the sex determination because it shows the values in this geographical region. This is believed to be more useful in the investigative procedures in the Forensic Medicine and also in the field of orthopaedics.

Perception of Medical Students regarding “Swachh Bharat Abhiyan” a cleanliness campaign: a qualitative study

Background: Swachh Bharat Abhiyan -A Cleanliness Campaign was launched all over India in 2014 to sensitize people to work in the direction of making India a clean country. Since youth constitute the future of the nation, their perception is very much important for the nation’s progress. Therefore, the present study was conducted among Indian medical undergraduate (IMUG) students regarding their perception about the current cleanliness drive going on in the country. Aims & Objective: To assess the perception of IMUG students about the cleanliness and innovative cleanliness practices. Study Setting & Design: A cross-sectional qualitative study was carried among IMUG students in a medical college of North India. Material & Methods: Study was conducted during the period of the Swachhata Pakhwara Abhiyan, celebrated all over the country to reinforce the cleanliness drive. IMUG students were invited to describe their perception on the topic “How can I keep My India clean”. Statistical Analysis: -Transcript was prepared and deductive coding was done and perceptions of students were categorized into four broad themes: -1. Behaviour change communication 2. Practicing cleanliness.3Interventions required for cleanliness 4. Legislation required in favour of cleanliness. Results: Majority of IMUG Students expressed that it is the behaviour change Communication and habit of practicing cleanliness everywhere, which will bring the change in cleanliness drive in the country with emphasis on innovative intervention and the role of legislation. Conclusion: -Proper direction and consistent motivation along with sound perception of cleanliness among citizens can contribute in reaching the desired goals of cleanliness.

An Experimental Study on the Carbon Flux within the Coral Community.

The flux of carbon within the coralline ecosystem has been a subject of great interest in the recent decades. So far several studies had been conducted to understand actual process of carbon transfer within this system and it is an elusive factor on science because of the complex process. An attempt had been made to delineate the source and sink of carbon within the coral ecosystem by establishing small experimental set up in the present study. For these study, four experimental tanks, each consisted of a different community of coral ecosystem was set up in Pondicherry University, Port Blair, Andaman Islands, India. The Tank A was set up with a most prevalent sponge species Stylissa massa, in this part of the study area, Tank B consisted of sponge Lamellodysidea spp., Tank C consisted of macroalgae community i.e. of Padina spp. of an area of 620 cm2 and Tank D had a soft coral Sarcophyton spp. All these species were collected from Burmanallha, a region characterized by rich species diversity. The results indicated that the algal and sponge community provided carbon to support the growth of coral reefs. Coral utilized this carbon for their growth. It was also observed that fluctuation of environmental and physical parameters induced biological stress within the life forms resulted in the release of excess inorganic carbon to the surrounding water. Whenever, the opportunity were available this carbon was utilized by the system itself and managed full extent without any excess carbon.

Detection of rifampicin resistance in tuberculosis by molecular methods: A report from Eastern Uttar Pradesh, India.

Diagnosis of drug resistance tuberculosis (TB) by the gold standard method is labour intensive and time consuming. Hence, there is an urgent need for introduction of rapid diagnostic techniques. Line probe assay (LPA) and cartridge‑based nucleic acid amplification test (CBNAAT) have been introduced in India under Revised National Tuberculosis Control Program. Spot and morning sputum samples of previously treated patients by anti‑TB drugs were subjected to LPA or CBNAAT. Total 682/1253 (54.4%) were diagnosed as rifampicin‑resistant. The patients could be diagnosed early by molecular methods and put on second line treatment.

Managing immunisation waste in a tertiary healthcare facility.

Immunisation protects children and adults against harmful infections before they come into contact with them in the community. Immunisation is given as an injection or, in the case of polio vaccine, taken as drops by mouth. The waste generated during the whole immunisation process must be disposed off properly. Improper waste disposal leads to serious health risks to recipients, health workers and the public. In King George’s Medical University (KGMU) immunisation programmes are conducted regularly. Waste generated during the process are properly mutilated, collected, transported and disposed off. In KGMU a well established biomedical waste management system which disposed offs the waste as per the norms and legislation.

Acute toxicity of nuvan®, an organophosphate to freshwater fish Ctenopharyngodon idella and its effect on oxygen consumption.

The acute toxicity of Nuvan to the grass carp Ctenopharyngodon idella was determined using static and continuous flow through system for 24, 48, 72 and 96 hr. The median lethal concentration (LC50) values were 13.1, 10.9, 9.8 and 6.5 mg l-1 respectively in static system and 10.7, 9.5, 8.0 and 7.5 mg l-1 respectively in continuous flow through system. A reduction in oxygen consumption is observed when the fish is exposed to the toxicant and the mortality is due to effect of metabolism of energy synthesis.

Mesofaunal biodiversity and its importance in Thar desert.

Soil animals are considered as important contributors to soil fertility However, there is paucity of such information for harsh climatic conditions. Therefore, the below ground faunal density and frequency have been studied in relation to physicochemical properties of soil in Thar desert. The selected soil systems were Vigna radiata--Cuminum cyminum, grassland, flower garden and Zizyphus mauritiana. Acari and other soil arthropods exhibited seasonal variation in their populations. There were two population peaks, one in February/March and other in August/September. The highest population was in flower garden, whereas lowest was in Z. mauritiana field. It clearly indicates that the soil fauna population develops in different degrees. The relative density showed that the acarines were more prevalent in comparison to other soil arthropods. The prostigmatids exhibited maximum relative density in comparison to cryptostigmatids and mesostigmatids in all fields. Pauropus showed higher relative density among all other soil arthropods. Acari had higher frequency of occurrence, while the other soil arthropods indicated lower frequency of occurrence in all systems. The highest frequency of occurrence was recorded in July/August and the lowest in May/June. The soil temperature, moisture, organic carbon, total nitrogen and carbon/nitrogen ratio varied significantly throughout the year The fluctuations in physicochemical characteristics of soil greatly influenced below ground faunal density in different fields. A highly significant and positive correlation was obtained among different soil fauna groups. Faunal population showed a significant positive correlation with soil moisture, organic carbon and total nitrogen. The abiotic factors such as temperature, pH and C/N ratio showed negative correlation with moisture, organic carbon and total nitrogen. However, moisture, organic carbon and total nitrogen had positive correlation among themselves. The present study suggests that the plantation may be done for improvement of physicochemical and biological health of soil on a sustainable basis in desert.

Effectiveness of combination of permanent and releasable scleral flap sutures in trabeculectomy: a randomized clinical trial.

INTRODUCTION: Trabeculectomy is a commonly used surgical treatment for glaucoma. PURPOSE: To evaluate the effectiveness of combination of permanent and releasable scleral flap sutures to minimize the immediate postoperative complications of trabeculectomy. MATERIALS AND METHODS: This study was carried out in Department of Ophthalmology, B P Koirala Institute of Health Sciences, Dharan, Nepal. Forty one eyes of 34 patients undergoing trabeculectomy were randomized to undergo either conventional trabeculectomy (Group A= 20 eyes) or trabeculectomy with combination of permanent and releasable scleral flap sutures (Group B =21 eyes). The parameters studied were intraocular pressure (IOP), anterior chamber depth (ACD) and surgical complications over a period of 6 weeks. RESULTS: Significantly higher number of eyes belonging to group A (14 eyes) had shallower anterior chamber than group B (7 eyes) on first post operative day (p=0.042). Six eyes (30%) in group A had peripheral or central irido-corneal touch in early postoperative period as compared to only one in Group B. Hypotony was noted in 3 eyes in each group. Two patients in group A required reformation of anterior chamber. Other surgical complications in the two groups were similar. Both the groups had a significant drop in IOP following surgery. However, there was no significant difference in the IOP between the two groups after 6 weeks (Group A: 10.95 +/- 3.03 mmHg vs. Group B: 12.29 +/- 4.67 mmHg; p=0.87). There was a significant drop in IOP following removal of sutures (15.19 +/- 6.15 mmHg to 13.19 +/- 6.13 mmHg; p=006) in group B. CONCLUSION: Use of combination of permanent and releasable scleral flap sutures is a safe technique that significantly reduces the incidence of immediate postoperative shallow anterior chamber after trabeculectomy.