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From the British era, regular medico-legal autopsies have never been done in India after sunset, except for those specially permitted by the law enforcement agencies. The Ministry of Health and Family Welfare, Government of India, issued a notification on November 15, 2021, regarding the “Conduct of post-mortem in hospitals after sunset”. This has given rise to much debate on whether post-mortems can be conducted after sunset in an ethical manner. Here, we briefly discuss the various issues related to the carrying out of post-mortems after sunset in India.
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Purpose: To report on the microbiological profile and antibiotic sensitivity patterns of infectious keratitis at a tertiary center in central India. Methods: The suspected case of severe keratitis underwent microbiological culture and identification using the VITEK 2 technique. Antibiotic susceptibility for different sensitivity and resistance patterns was analyzed. Demographics, clinical profile, and socioeconomic history was also documented. Results: Culture was positive in 233/455 (51.2%) patients. Pure bacterial growth was present in 83 (35.62%) patients and pure fungus was present in 146 (62.66%) patients. The most common bacterial cause of infectious keratitis was Pseudomonas followed by Staphylococcus and Bacillus. Pseudomonas showed 65%–75% resistance against levofloxacin, ceftazidime, imipenem, gentamycin, ciprofloxacin, and amikacin. Staphylococcus showed 65%–70% resistance against levofloxacin, erythromycin, and ciprofloxacin, with Streptococcus being 100% resistant to erythromycin. Conclusion: This study highlights the current trend of microbiological profiles of infectious keratitis and their antibiotic susceptibility at a rural setup in central India. Fungal predominance and increased resistance against the commonly used antibiotics were noted.
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INTRODUCTION: Cellulitis is a bacterial infection of the skin and subcutaneous tissuethat is more generalized than erysipelas and associated with broken skin and pre-existingulceration. Mild cases of cellulitis are generally treated with oral antibiotics, GlycerinMgSO4 dressing & affected part elevation and severe cases required admission & higherantibiotics, skin & blood culture & sensitivity & in case of systemic symptoms & abscessoperative management is required.AIMS AND OBJECTIVES:• To observe the outcome of conservative and operative patients in view ofcomorbidity and after treatment complications.• Following factors are accounting before conclusive outcome.• To understand the patients characteristics, comorbidity and mode of presentation.• To study spectrum of organism isolated from patient undergoing conservative oroperative management.• To compare treatment modality and outcome in management of cellulitis.MATERIAL & METHODS: Data consists of primary data collected by the principalinvestigator directly from the patients who were admitted from OPD in the GCS medicalcollege and hospital. It was observational study for a period of six months from April2022 to September 2022 under sample size was 50 cases.CONCLUSION: We recommended Operative management over Conservativemanagement in cellulitis because single operative incision can release toxic fluid fromaffected part and can promote faster healing and better recovery and less hospital stay.Patient has less mental trauma, less pain and more economical benefits in Operativemanagement therefore study concludes Operative management is superior Compared toConservative management. However, conservative management is preferable in earlystages of cellulitis.
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Background: The use of smart phone is very common specially in young individuals. Excessive use leads to smart phone addiction, which may have harmful effect on the health of individuals. Aims and Objectives: The aim of our study is to assess the smart phone usage in 1st-year medical students. Materials and Methods: In this cross-sectional study, we have included 187 students from 1st-year MBBS. Out of which 125 (66.84%) are boys and 62 (33.16%) are girls in age group of 18–22 years. All the data were collected in Google form. We have used smart phone addiction scale long version. The Google form was filled by students who are willing to participate in this study. Result: We have found that out of total 187 students, 96 (51.34%) students having high smart phone use, out of which 68 (54.40%) are boys and 28 (45.16%) are girls while 91 (48.66%) students having low smart phone use, out of which 57 (45.60%) are boys and 34 (54.84%) are girls. Conclusion: The high smart phone usages present in the student can be prevented by specific intervention programs at college level.
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The aim of this study is to report the clinical features, imaging findings including confocal imaging, corneal nerve fiber analysis, and management outcomes in a series of three cases of varicella zoster virus (VZV) reactivation following one dose of coronavirus disease 2019 (COVID-19) vaccination. This was a retrospective and observational study. All the patients who developed uveitis post-vaccination were pooled together. Patients who had VZV reactivation were included. Two cases had polymerase chain reaction positive for VZV from aqueous humor. At the time of presentation, IgG and IgM spike protein antibodies for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) were tested. Out of this pool, three patients with classical features to describe pole-to-pole manifestations were chosen. A 36-year-old lady with post-vaccination sclerokeratouveitis associated with reactivation of herpes zoster ophthalmicus, a 56-year-old lady with post-vaccination acute anterior uveitis associated with herpes zoster ophthalmicus, and a 43-year-old gentleman with post-vaccination acute retinal necrosis were included. We present a possible link between anti-SARS-CoV-2 virus vaccination and varicella zoster reactivation in these patients and also describe the clinical features, imaging findings including confocal imaging, corneal nerve fiber analysis, and management with detailed discussion.
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Purpose: The study was conducted to evaluate occurrence of dry eye disease (DED) in type 2 diabetes mellitus (DM) and its association with diabetic retinopathy (DR) in the affected patients in western India. Methods: One hundred and five type 2 diabetic patients referred to a tertiary eye care center were consecutively selected. A detailed systemic history was evaluated. DED was assessed by Ocular Surface Disease Index questionnaire, Schirmer’s test, tear breakup time (TBUT), and fluorescein staining of cornea and conjunctiva, graded according to the National Eye Institute workshop grading. All patients underwent detailed fundus evaluation and DR, if present, was graded according to Early Treatment Diabetic Retinopathy (ETDRS) criteria. Results: Prevalence of DED in type 2 diabetics was 43.81% (92/210 eyes). The prevalence and severity of DED was found to be more in patients having higher glycosylated hemoglobin levels (P < 0.0001). Prevalence of DED was found to be high in those not taking any treatment (P < 0.0001). A statistically significant association was found between duration of DM and presence of DED (P = 0.02). Among the patients with DED, a majority had proliferative diabetic retinopathy (PDR; 57/92 eyes, 61.96%). Conclusion: The study highlights a significant correlation between DED and DM, and hence, examination for DED with fundus examination should be an integral part of the assessment of type 2 diabetics
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Reconstruction plates with or without bone grafts are used to restore mandibular continuity, form and function following segmental resection of mandible. Fracture of reconstruction plate is observed in 2.9 % to 10% of cases reported in the literature excluding other complications. In this case, we report the fracture of stainless steel reconstruction plate used without bone graft and its management using locking reconstruction plate with non vascularised iliac crest graft following removal of the fractured plate. Review of literature describing incidence, pattern and causes of reconstruction plate fracture and its management is discussed.
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Continuous improvement and evolution in various fields are crucial to ensure a better living environment for everyone. To achieve this, researchers have a significant responsibility to produce valuable research in concerned areas. However, dedicated researchers often face various obstacles, such as financial stress, which can hinder their ability to conduct research. To support Ph.D. scholars, many central and state government funding agencies offer financial assistance schemes. In this regard, the Government of Gujarat has initiated a scheme called SHODH – ScHeme Of Developing High quality research to provide financial support to Ph.D. scholars from recognized universities/institutes of the state to produce quality research in various disciplines. However, it is essential to understand the impact of the scheme's benefits from the perspective of the beneficiary candidates, especially those belonging to different economic statuses. Therefore, a study has been conducted to explore the opinions of beneficiary candidates of the SHODH scheme about the scheme's selected aspects and whether their opinions differ based on their economic status. The study adopts a causal-comparative research method to gain insight into the requirements of research scholars belonging to different economic statuses. This information will enable better facilitation of scholars to produce meaningful research in their respective fields.
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Background & objectives: The National Prevalence Survey of India (2019-2021) estimated 31 per cent tuberculosis infection (TBI) burden among individuals above 15 years of age. However, so far little is known about the TBI burden among the different risk groups in India. Thus, this systematic review and meta-analysis, aimed to estimate the prevalence of TBI in India based on geographies, sociodemographic profile, and risk groups. Methods: To identify the prevalence of TBI in India, data sources such as MEDLINE, EMBASE, CINAHL, and Scopus were searched for articles reporting data between 2013-2022, irrespective of the language and study setting. TBI data were extracted from 77 publications and pooled prevalence was estimated from the 15 community-based cohort studies. Articles were reviewed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and were sourced using a predefined search strategy from different databases. Results: Out of 10,521 records, 77 studies (46 cross-sectional and 31 cohort studies) were included. The pooled TBI prevalence for India based on the community-based cohort studies was estimated as 41 per cent [95% confidence interval (CI) 29.5-52.6%] irrespective of the risk of acquiring it, while the estimation was 36 per cent (95% CI 28-45%) prevalence observed among the general population excluding high-risk groups. Regions with high active TB burden were found to have a high TBI prevalence such as Delhi and Tamil Nadu. An increasing trend of TBI was observed with increasing age in India. Interpretation & conclusions: This review demonstrated a high prevalence of TBI in India. The burden of TBI was commensurate with active TB prevalence suggesting possible conversion of TBI to active TB. A high burden was recorded among people residing in the northern and southern regions of the country. Such local epidemiologic variation need to be considered to reprioritize and implement-tailored strategies for managing TBI in India.
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Background : Type 2 Diabetes Mellitus is a lifestyle disorders and it leads to complications that are life threatening which can be prevented by proper Counselling and Diet monitoring of patients. Objective : To evaluate effect of Counselling on the Glycemic control, Dietary habits and Diabetes awareness of type 2 DM patients. Method : A randomized clinical trial was conducted at a tertiary hospital. 96 subjects were randomized and baseline data was gathered from all patients included in the study. Out of these 48 patients were given Counselling on various aspects of Diabetes including diet, complications, medication, lifestyle modifications, exercise etc. Lab investigations and Diet calculations were done on first and 4 months later to measure the effect of Counselling on patient抯 Diet and Glycemic control and Diabetes awareness. Results : Diabetic awareness was measured in terms of number of correct responses which increased from 325 to 542 in Intervention group and from 357 to 402 in Control group. The increase in intervention group (22.60%) was more than that of the Control group (4.59%). The amount of calories in the diet of intervention and control group was respectively 2322�1 and 2334�0. Post Intervention it was 2344�0 and 2056�7respectively. Before intervention the difference in the amount of Calories, FBS, PP2BS between the 2 groups was statistically insignificant. But after intervention the difference with reference to total calories (p=0.0003), FBS (p=0.01) and PP2BS (p=0.0001) became statistically significant. Conclusion : Counselling led to a significant improvement in the Diabetic awareness, Glycemic control and Dietary habits of patients in terms of caloric intake.
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Surgical site infection is more prevalent in open gastrointestinal surgery which will affect hospital stay and morbidity and mortality of patients.In our study,we are comparing the factors which will directly or indirectly causes SSI.By knowing the factors which causing SSI,We can decreases the incidence of surgical site infection.
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Background: During menstrual period, there are many changes occurs such as somatic changes and mood changes which may affect day-to-day activity as well as academic performance of the young female students. Aim and Objective: The aim of our study is to find out the effect of menstrual symptoms on academic performance of medical students. Materials and Methods: In this cross-sectional study, 180 female medical students were participated. For the assessment of the effect of menstrual symptoms on academic performance, students have to fill the Goggle Forms which contains the self-administered questionnaire. In this study, we have included young medical and female students age between 17 and 25 years who have any musculoskeletal abnormality and who are willing to participate in this study. Results: Effect on academic performance was suggest by 113 (62.78%) students think that the classroom performance is affected and 110 (61.11%) students think that the examination performance is affected during menstrual period. One hundred and thirty-three (73.89) having mood swings during menstrual period. Conclusion: In this study, we have found that the menstrual symptoms have major effect on academic performance of female medical students. Counseling, mentoring, and support of female students during the menstrual period may improve their academic performance.
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The paper reflects research output of AIIMS (India) during 2017 to 2021 using data from Scopus database. It shows the research output by the medical scholars of the institute, high profiled authors, and Research collaborations on International and National basis and top sources of publications preferred during the year period. The study finds that research contribution of AIIMS, Delhi during five years was 12797 publications; Maximum productivity was marked in the year 2021 followed by its preceding year 2020; Highest publications were published in the source 'BMJ Case Reports' (515 papers); Highest collaboration was made with USA in publication of research papers (1154 papers); Highest research produce was made by Tripathi, M. (196 Papers) followed by Sharma N. and Tandon N. (195 papers each).
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Objective@#Internet gaming disorder (IGD) is an increasingly common behavioral addiction, with an estimated global prevalence of 3%. A variety of pharmacological treatments have been used to treat IGD, yet no review to date has synthesized clinical trials evaluating their efficacy. This systematic review therefore synthesized the literature reporting on clinical trials of pharmacological treatments for IGD. @*Methods@#We reviewed articles from MEDLINE, Embase, PubMed Central, CINAHL, and PsycINFO that were published as of March of 2022. A total of 828 articles were retrieved for review and 12 articles were included, reporting on a total of 724 participants. @*Results@#Most participants were male (98.6%), and all were currently living in South Korea. The most common drugs used to treat IGD were bupropion, methylphenidate, and a range of selective serotonin reuptake inhibitors. The Young Internet Addiction Scale was the most frequently used to measure gaming-related outcomes. All studies reported reduced symptoms of IGD from pre- to post-treatment. Across all clinical trials, IGD symptom reductions following the administration of pharmacological treatments ranged from 15.4% to 51.4%. A risk of bias assessment indicated that only four studies had a low risk of bias. @*Conclusion@#Preliminary results suggest that a wide array of pharmacological interventions may be efficacious in the treatment of IGD. Future studies using double-blind randomized controlled trial designs, recruiting larger and more representative samples, and controlling for psychiatric comorbidities are needed to better inform understanding of pharmacological treatments for IGD.
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Background@#Extrusion of debris is a major factor that results in postoperative pain during root canal treatment with various instruments and instrumentation techniques. Therefore, instrumentation techniques that extrude minimal debris into the periapical area while reducing pain are desirable. This study aimed to compare the incidence of postoperative pain and intake of analgesic medication (frequency and quantity) after endodontic treatment of mandibular posterior teeth using two single files and full-sequence continuous rotary systems with different kinematic motions. @*Methods@#Thirty-five of 105 patients were assigned equally to three groups according to the instrumentation system used: ProTaper Next (PN) X2, 25/06 (Dentsply, Maillefer, Ballaigues, Switzerland), One Shape (OS), #0.25/06 (Micro Mega, Besancon, France), and Wave One Gold (WG), Red - #0.25, 0.07 (Dentsply, Maillefer, Ballaigues, Switzerland). Five specialists were included in this study design; each professional prepared 21 teeth, and randomly selected 7 per instrument system. The VAS sheet ranging from 0 to 10 was used to record the initial and postoperative pains at 24, 48, and 72 h, and 7th day after single visit endodontic treatment in mandibular premolars and molars with a diagnosis of asymptomatic irreversible pulpitis with or without apical periodontitis. Postoperatively, an analgesic, ibuprofen 400 mg was administered for intolerable pain at a dose of 1 tablet for 6 h. The patients were asked over the telephone regarding postoperative pain at intervals of 24, 48, and 72 h, and 7 th day using a visual analogue scale.Result: There were no statistically significant differences among the PN, OS, and WG systems (P > 0.05) with regard to the incidence of postoperative pain at any of the four time points assessed. @*Conclusion@#The intensity of postoperative pain, frequency, and analgesic intake were similar across all three types of instrument systems; however, the reciprocating single file (WG) was associated with less postoperative pain than the full sequence continuous rotary file.
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In the present modern day's world, anorectal disorders are increasing in number due to sedentary lifestyle. They cause great discomfort and make one’s life miserable. Among these fistula in ano is most common. It is challenging to treat due to its recurrent nature. Fistula-in-ano is an inflammatory tract that is lined by unhealthy granulation tissue and has two openings, an external opening present in perianal skin and an internal opening in the anal canal or rectum. Fistula in ano is correlated with Bhagandara in Ayurveda. Acharya Sushruta has mentioned it among Ashta Mahagada and explained five types of Bhagandara. Many treatment modalities have been given for the treatment of fistula in ano, Ksharasutra application is one of them. It is a minimally invasive para-surgical procedure and induces both mechanical as well as chemical cutting and healing of the fistulous tract. This technique has a high success rate but it is time-consuming and causes minimal complication. A 73 years old male patient came to RGGPG Ayurvedic College and Hospital, with a complaint of pain and pus discharge from his left thigh for 7-8 years, he has been diagnosed with a case of recurrent fistula in ano. The patient was treated with partial fistulectomy along with Ksharsutra application and recovered well with complete excision of the tract.
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Purpose: This study was conducted to examine microbiological profile with their antibiotic sensitivity in cases of bacterial keratitis in north and central India to ensure appropriate use of antibiotics. Methods: The microbiology laboratory records of 228 patients with culture?proven bacterial keratitis from 1st January to 31st December 2019 were analyzed. Cultured bacterial isolates were subjected to antimicrobial susceptibility testing to antibiotics commonly used in the treatment of corneal ulcer. Chi?squared or Fisher’s exact test were applied to check the significance of difference between the susceptibility levels of antibiotics. Results: The prevalence of Staphylococcus aureus and Pseudomonas aeruginosa–induced keratitis was higher in northern India, whereas that by Streptococcus pneumoniae was more prevalent in central India. In central India, 100% of S. pneumoniae isolates were found to be sensitive to ceftriaxone compared to 79% in northern India (P = 0.017). In comparison to 67% of isolates from north India, 15% of S. aureus isolates from central India were found to be sensitive to ofloxacin (P = 0.009). Similarly, 23% of isolates from central India were found sensitive to amikacin compared to 65% of isolates from north India (P = 0.012). P. aeruginosa isolates from central India were found to be sensitive to ceftazidime in 63% of cases compared to 21% of isolates from north India (P = 0.034). Conclusion: Prevalence of bacteria and their susceptibility to antibiotics are not uniform across geography. Vancomycin remained the most effective drug in all gram?positive coccal infections. S. aureus susceptibility to amikacin was significantly greater in north India. P. aeruginosa showed less susceptibility as compared to previous reports.
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Introduction :Birth weight is one of the most important criteria for determining neonatal and infant survival and is considered a sensitive index of the nation's health and development. The World Health Organization (WHO) defines low birth weight (LBW) as “Birth weight less than 2500 grams” regardless of gestational age, the measurement being taken preferably within the first hour of life. 1)ToObjectives : estimate the prevalence of LBW among sample population at tertiary care hospital. 2)To study the distribution of newborns, according to socio-demographic characteristics of the mother and its association with LBW. A hospital based cross-sectional study was carried out among 500 newborns betweenMethod: December 2020 and November 2021. Participants were selected by systematic random sampling technique. The data were collected from the case file and face-to-face interview. Both descriptive and inferential statistics were used in the analysis. Prevalence of low birth weight was 29.2%. Majority 271Results: (54.2%) of newborn mothers' age group was between 21 to 25 years. More than half 272 (54.4%) newborns were from mothers who studied up to primary level education and more than three forth 389 (77.8%) were from mothers who were housewives. Majority 293 (58.6%) of newborns were from the urban area, around three forth 382 (76.4%) newborns were Hindu and nearly two fifth 194 (38.8%) newborns belonged to lower middle class. Prevalence of low birth weight was significantly higher in mothers aged >35 andyears ?20 , who were illiterate, doing labour work and belonging to lower socio-economic class.years Conclusion: The prevalence of Low Birth Weight was 29.2% among sample population. Socio-demographic variables like maternal age >35 years 20 years, illiteracy, labour work and lower socio-economic class, ? had shown significant risk for delivering Low Birth Weight babies.
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Background: Patients with hypotension or shock usually have high mortality rates, and use of traditional physical examination techniques only may be misleading for rapid diagnosis and treating the same. RUSH (Rapid Ultrasound for Shock and Hypotension) protocol is used in patients with undifferentiated shock to improve accurate diagnosis of shock. Methods: A prospective observational study was done from April to June 2022 at emergency department in 100 patients who presented with hypotension. This included patients who had systolic blood pressure (SBP) of <90 mmHg, along with tachypnoea and tachycardia. Patients RUSH examination was performed. The patients were followed up to document their final diagnosis. Results: In our study, the mean age of patients with hypotension was 58.8±8.7 years with male preponderance of 53%. The hypovolemic shock (40%) was found to be the most common subtype of shock. 86% of patients were correctly diagnosed with RUSH study. The sensitivity, specificity, PPV and NPV of RUSH in shock patients was 36.69%, 25.7%, 26.5%, 87.25% respectively and disease prevalence 31.5% and accuracy 68.75%.Cohens Kappa index was 0.5 showed a moderate agreement of the RUSH protocol in diagnosis of causes of shock with the final diagnosis. Conclusion: This study advocates the use of RUSH protocol in patients presenting with undifferentiated hypotension in the emergency department. It narrows the possible differentials of shock and guides the emergency physician to an early initial therapy, thereby improving the final outcome of patient.
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Background: Uterus is prone for various non-neoplastic and neoplastic lesions and also hysterectomy is the most common gynecological surgery indicated as a definitive treatment. Grossly unremarkable many specimens may reveal pathologies on histological examination. Hence, all hysterectomy specimens must undergo proper histopathological examination. In our study, hysterectomy specimens were studied and results compared with their clinical diagnosis. Aim and Objective: The objectives of the present study were to know the frequency and incidence of various lesions of the female genital tract and to compare findings of the present study with other studies. Materials and Methods: The study was a retrospective analysis of 250 hysterectomy specimens. All types of hysterectomies such as vaginal, abdominal, laparoscopic, and total abdominal hysterectomy without or with unilateral/bilateral salpingectomy/salpingo-oophorectomy were included in the study. Histopathological examination was done minimum by two faculty members. The results were noted and statistical analysis was done. Results: Total 250 hysterectomy specimens were studied. Vaginal hysterectomy was the most commonly performed type of hysterectomy which includes 187 cases (74.8%) out of 250 cases. Among the uterine pathologies, the most common lesion was leiomyoma (34.4%) followed by adenomyosis (26%). In our study during histopathological examination of cervix, the most frequent cervical lesion was found chronic cervicitis in 50.4% of cases. Conclusion: The present study highlights the wide spectrum of lesions of female genital tract and conveys that histopathology remains the primary modality for confirmation of diagnosis of lesions. We can conclude from the present study that many lesions had been diagnosed on microscopic examination though normal gross examination. Hysterectomy specimen should undergo proper histopathological examination, because it is the gold standard tool for final diagnosis.