Clinical features of Vitamin D deficiency in children and their correlation with Vitamin D levels: A cross-sectional study in SRVS medical college, Shivpuri

Background: Vitamin D along with calcium plays an important role for the maintenance of musculoskeletal health during whole life, and it is essential to address their deficiency pediatric and adolescent population is vital. Ideally, all the children should be screened for Vitamin D deficiency because a large number of Vitamin D deficient are asymptomatic, but it is practically difficult to do Vitamin D levels in all the healthy children. Aims and Objectives: The aim of the study is screening children presenting with signs and symptoms suggestive of Vitamin D deficiency and tried to correlate the presenting clinical feature with the level of Vitamin D with the following objectives: (i) to study the level of Vitamin D (25 hydroxy Vitamin D) in apparently healthy children with clinical features indicating of Vitamin D deficiency and (ii) to correlate the specific clinical features with Vitamin D level. Materials and Methods: This study was approved by the institutional ethics committee, and informed consent was obtained by writing from the parents before starting of the study. Cross-sectional observation study conducted between November 2021 and November 2022 by convenient sampling method. Young children and adolescents of age group of 2–14 years attending OPD at SRVS Medical College Shivpuri was the study population. Results: The present study done in Shivpuri belt the prevalence deficiency of Vitamin D was found to be 52% in children. Prevalence of Vitamin D deficiency in Madhya Pradesh is high, pointing as the severe and critical public health issue. Conclusion: Vitamin D deficiency done by serum concentrations of 25 (OH) D if less values proper suggestive treatment is recommended.

A Study of Thyroid Profile and Lipid Profile in Patients with Chronic Kidney Disease with or without Hemodialysis in a Tertiary Care Hospital

Background: Chronic kidney disease (CKD), due to increasing frequency and prevalence, has become one of the leading public health issues. The Kidney Disease Outcome Quality Initiative (KDOQI) defines CKD as kidney injury or a reduction in the glomerular filtration rate (GFR) to <60 mL/minute/1.73 m2 for at least 3 months. This study aims to compare the effects of decreased renal function on thyroid profile and lipid profile in CKD patients. Materials and methods: This is a prospective cross-sectional observational study conducted among the patients attending Outpatient Department/Inpatient Department (OPD/IPD) at the School of Medical Sciences & Research, Sharda Hospital, Greater Noida, Uttar Pradesh, India, in known cases of CKD, irrespective of the treatment/stage of CKD. All patients of >18 years of age with CKD were included in the study. Result: A total of 200 patients who met the inclusion criteria were included after obtaining detailed informed consent, of which 100 were cases and 100 were controls. The mean age of patients in the study was 47.74 years, with the mean age in patients with CKD 52 years, and the control was 43 years. The mean level of triglycerides (TGs) was significantly higher among the cases, and the high-density lipoprotein (HDL) was significantly lower among cases compared to controls (p < 0.05). Pearson’s correlation between thyroid-stimulating hormone (TSH) with creatinine showed a weak albeit significant positive association (r = 0.200; p < 0.05). Conclusion: Our study shows a higher incidence of alteration in thyroid profile and dyslipidemia among the patients with CKD compared to controls. There is a necessary need to screen routinely for hypothyroidism and dyslipidemia among patients with CKD. Importantly, thyroid hormone levels and their effects on the progression of CKD have not been studied exhaustively.

Healthcare Seeking Behaviour of Hospitalised COVID-19 Patients During Second Wave in Tertiary Care Hospital of Northern India

Background: The Coronavirus Disease (COVID-19) pandemic continues its deadly reign all over the world. Devising effective strategies for detecting and controlling the infection has become ever more critical. Effective prevention and control of the pandemic is entirely dependent on human behavior in terms of practicing preventive and curative measures. During the second wave of COVID-19, people’s perceptions of preventive and curative measures changed. Objective: To study healthcare-seeking behavior of hospitalized COVID-19 patients. Methods: Hospitalized patients due to COVID-19 in the month of March, April and May of 2021 were included in the study. Their attendants/close relatives were contacted telephonically to know about the admitted patients’ healthcare-seeking behavior. Verbal consent was taken from attendants before the commencement of the interview, followed by informing them about the purpose of the interview. Results: Amongst the subjects, there were more males than females (67.5 vs 32.4%), age ranged between 18 to 88 with a mean value of 56.61 ± 14.7 years. Self-medication was significantly associated with study subjects’ mortality (p=0.03). Conclusion: Elderly people were having higher mortality rate than their younger counterparts. People were hesitant to visit primary care physicians after having symptoms of COVID-19.

Determination of ABO Blood Group and Rhesus Factor from Teeth: A Double-Blinded Randomized Controlled Trial.

Background: Identification of a deceased subject can be established not only from the skeletal remains (including the congenital peculiarities in setting of teeth) but it can also be precisely established by blood grouping from the teeth with the help of the absorption-elution technique. Objectives: Our study was conducted to evaluate if dental pulp can be used as a reliable source for determination of ABO blood group and rhesus factor in an individual. Materials & Method: This double-blinded randomized controlled trial was conducted on a sample of 250 extracted teeth. An attempt to establish the blood group from pulp was made by absorption-elution method. The collected data were coded, and statistical analysis for comparison of ABO blood groups was done using Cronbach's alpha to check the reliability of the absorption-elusion method in the detection of blood group from dental pulp. Results: On comparison of capillary blood group (slide agglutination method) with pulp blood group (absorption elution technique) of the subjects, we found that positive results were obtained in 235 cases while 15 cases showed negative results. Hence, the sensitivity (ability to measure) of pulp in establishment of blood group was found to be 94%. Conclusion: On the basis of the results obtained from the present study, it could be concluded that pulp is a reliable source of blood group determination for ABO blood grouping where teeth happen to be the only remnants available for personal identification.

Oral Microbiome and Adverse Pregnancy Outcomes: An Update.

From last decade of the 20th century, numerous epidemiological studies and intervention trials have attempted to prove the relationships between maternal oral diseases and adverse pregnancy outcomes (APO). Several physiological, immunological and hormonal changes occurring during pregnancy ensures the woman’s body maintenance throughout the gestational period and the development of foetus. Studies have reported changes in the maternal microbiome in the gut, vagina, and oral cavity during pregnancy. Infections at the foetomaternal interface are known to upregulate the production of local proinflammatory cytokines, metalloproteinases and prostaglandins leading to membrane weakening, early rupture of membranes and uterine contractions. A clear understanding of the association between oral microorganisms and adverse birth outcomes conveys significant health implications. In this paper we reviewed the current literature regarding the link between oral microbiome and adverse pregnancy outcomes including preterm birth, chorioamnionitis, neonatal sepsis, stillbirth, and preeclampsia.

Comparison of Bone-Patellar Tendon-Bone Graft, Semitendinosus–Gracilis Graft and Semitendinosus–Gracilis with Preserved Tibial Insertion Graft in Anterior Cruciate Ligament Reconstruction in Sports Persons

@#Introduction: Bone-patellar tendon-bone (BPTB) and semitendinosus–gracilis (STG) are the commonest grafts used for ACL reconstruction. However even after having been debated for years, there is no consensus about the ideal graft. Moreover, the literature is deficient about STG graft with preserved tibial insertion (STGPI) which preserves the proprioception. Our aim is to compare the outcome of BPTB, free STG and STGPI grafts after ACL reconstruction in professional sports persons. We compared the outcome in terms of mechanical stability, functional outcome, return to sports activity and degenerative changes. Materials and Methods: Professional sports persons aged between 16-50 years operated for ACL tear using BPTB, free STG and STGPI grafts with minimum follow-up of two years were identified from hospital records. Patients with associated knee injuries were excluded. Patients, divided in three groups according to graft used, were compared in terms of mechanical stability (arthrometric examination KT-1000 score), functional outcome (Lysholm Score), return to sports activity (Tegner score and difference in thigh circumference) and degenerative changes (KL grading). Results: BPTB graft group was found to be better than free STG and STGPI graft groups in terms of KT-1000 score. There was no statistically significant difference among the groups in terms of Lysholm score, Tegner score, difference in thigh circumference and KL grading. Conclusion: BPTB graft is better than free STG and STGPI grafts in terms of knee stability. When compared for patient reported outcome, return to sports activity, osteoarthritic changes and graft failure there is no significant difference among the three types of grafts.

Plasma Vitamin C Status of Adolescent Girls in a Slum of Delhi.

A cross-sectional study was conducted among 775 adolescent girls (11-18 years) residing in a slum of Delhi to assess plasma vitamin C levels. The mean (SD) plasma levels of vitamin C were 0.76 (0.45) mg/dL. Overall, 6.3% and 27.6% girls had deficient (<0.2 mg/dL) and suboptimal levels (0.2-0.49 mg/dL) of plasma vitamin C, respectively.

A Cross Sectional Assessment of Knowledge, Attitude and Practices towards Hepatitis B among Undergraduate Medical Students of a Medical College in rural area.

Introduction: Hepatitis B virus (HBV) infection is one of the most common blood borne viral infection in the world. It is a major potentially life threatening, global health problem. About 6,00,000 people die every year due to the acute or chronic consequences of hepatitis B. Health care workers including medical students are at risk of acquiring the infection while at work. Objective: To assess the knowledge, attitude and practice of hepatitis B infection among Undergraduate (MBBS) medical students of Dr. Rajendra Prasad Government Medical College, Kangra at Tanda. Materials and Methods: Knowledge, attitude, and practises towards Hepatitis B was assessed by using a pre validated questionnaire in a cross sectional descriptive study. Mean scores for knowledge, attitudes and practices were calculated using the Epilnfo software version 7. Results: Four hundred fifty questionnaires were distributed among the students.387 responded, a response rate of 86%. Mean age of female students was 21.5 ± 1.59 yrs and mean age for male students was 21.9 ± 1.69 yr. Mean scores for Knowledge, Attitude, and Practises were 15.87 ± 1.57 (Maximum score 19) , 2.00 ± 0.63 (Maximum Score 3) and 4.6 ± 0.97 (Maximum Score 6) respectively. This study also demonstrates some important shortcomings in the knowledge, attitude, and practises of medical students. Conclusion: Results of the study suggest good Knowledge, Attitude and Practice of Hepatitis B among the students. Though, overall knowledge and attitude to HBV infection is good, there is a need to develop guidelines to ensure that medical students are not only fully vaccinated against HBV but adequate practice of standard precautions is also adhered to.

Use of social networking sites among medical undergraduates of a medical college in north-west India.

Introduction: Use of Internet for communication has become a very important part of young people's life. Social networking sites are virtual communities that allow users to create a profile and interact with friends. One area of interest in this field is regarding the activities of medical students on social networking sites and how these activities affect their academic performances. Objective: To assess the use of social networking sites and its impact on academic performance among medical undergraduates of a rural medical College. Methodology: It was a cross sectional study conducted over a period of three weeks in December 2013 among undergraduate students of Dr RPGMC Kangra at Tanda. A self-administered questionnaire was used to conduct the study. Data was entered in Microsoft excel sheet and analysed.Result: A total of 150 participants were enrolled of which only 141 agreed to participate. Among these 74 (52%) were males and 68 (48%) females. The mean age of the subjects was 20.2 ± 1.5 years. Majority 123 (87.2 %) used multiple networking sites, 45 % (60/123) had joined communities related to medicine. More than half 52.7 % (65/123) of subjects used these multiple sites to remain connected with their friends.81.7% (49/60) visited medical communities daily and 93.9% (46/49) among them said that these communities has helped increase their knowledge. Average time spent per session was 10-30 minutes among 26.8 % (33/ 123) participants.Conclusion: The results of the study showed that role of social networking sites among undergraduate students pursuing a professional course is important while communicating with friends and people of their own field. It helps them in broadening their knowledge and they feel it has helped them positively in their academic performance.