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Background: Aim of the study was to estimate the prevalence of sero-positivity i.e. serum anti-covid IgG >1.4 AU/ml in MBBS students of our Institute. Methods: This study was carried out on 75 MBBS students of our institute (10% of 750 MBBS students of Amaltas institute of Medical Sciences Dewas M.P. India) during period of August 2022 to November 2022. All serum anti-covid IgG titres above 1.4 AU/ml were considered sero-positive and the prevalence of sero-positivity was calculated. MBBS students were asked to fill out a questionnaire regarding their clinical history of testing positive for covid, exposure to COVID-19 patients, their covid appropriate behavior, etc. After obtaining informed consent, 4 ml venous blood samples were collected for determining serum anti-covid IgG titre on Chemiluminescence analyzer. 75 MBBS students divided into 2 groups � those who completed between 6-9 months and those who have completed more than 9 months after the 2nd dose of vaccine. The mean serum anti-covid IgG titre was compared. Results: The prevalence of sero-positivity was 94.66% calculated in MBBS students of our institute. The total antibody sero-positivity was higher in males (98.11%) than in females (86.36). The duration after 2nd dose of vaccine; over the time 6-9 months serum anti-covid IgG titre significantly high but after more than 9 months serum anti covid IgG titre significantly decline (p<0.001) and significant correlation was found between duration after 2nd dose of vaccine and serum anti-covid IgG titres (p<0.001). Conclusions: This study; strongly recommended the need for booster doses for long-duration protection against COVID-19 re-infection and its emerging new variants.
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Background: Lipomas are the most common benign mesenchymal tumours in the body. Patients seek their removal due to disfigurement, discomfort or cancerphobia. Historically, open surgical removal was the mainstay of their treatment but striving for less scarring, liposuction is the only new FDA approved alternative. Methods: 56 patients with subcutaneous lipoma of size 3 cm - 10 cm and fulfilling eligibility criteria were selected for this hospital based prospective cohort study after informed consent and Institutional Ethical Committee approval from June 2016 to July 2018. 3 mm irrigation cannula, 5 mm suction cannula, Suction holding tool and Luer lock syringe were used. Lipoma infiltrated with modified Klein solution. Lipoma suctioned out & through the same port, capsule in the cavity was pulled out employing long forceps. Results observed with regards to operative time, post-operative scars, post operative pain and recurrence. Result: A total of 56 patients were enrolled, operated, and observed. Mean duration of lipoma removal surgery was 47.32 minutes. 67.85% patients had pain score 1 after 2 hours of surgery. 100% of patients had healthy scars. 80.4% patients had 0 Vancouver Scarscore after 6 month follow up and only 1 patient had recurrence in 5 months. Conclusions: Our study showed good results in view of postoperative pain and quality of scar. Use of 5 mm cannula gave visually negligible scar with less than 2% recurrence rate. Even though the mean duration of surgery was 47 mins which is more compared to open excision, the good cosmetic result with minimal to no scar prevails over it.
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Background: Anaemia during pregnancy continues to be a major public health problem especially in developing nations like India. The study was performed to assess the prevalence and severity of anaemia and the associated socio-demographic and obstetric factors during pregnancy in a tertiary referral hospital of Delhi, India. Method: This cross sectional study was carried out on 430 pregnant women in second and third trimester of pregnancy using systematic random sampling attending antenatal clinic of Vardhman Mahavir Medical College and Safdarjung Hospital of Delhi. A predesigned and structured questionnaire proforma was used to collect information regarding socio-demographic and obstetric factors. Haemoglobin levels were estimated using Hemocue method. Statistical analysis was carried out using STATA version 18.0 statistical software. Results: The overall prevalence of anaemia during pregnancy was 48.84% with 25.81% mild anaemia, 15.81% moderate anaemia, 6.98% severe anaemia and 0.24% very severe anaemia. Anaemia was found to be more common in younger women (<25 years) and in joint family. Anaemia was more commonly seen in low socio-economic status, low family income and in illiterate and primary education. Anaemia especially severe anaemia was more common in third gravidas and above. Anaemia was more common with advancing gestation. Anaemia was more common with no or irregular antenatal care and with no or single tetanus toxoid injection. Conclusions: The prevalence of anaemia is high in Delhi. Regular and timely antenatal care, improving socio-economic status and having lesser children can reduce prevalence of anaemia during pregnancy.
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A pregnancy is said to be ectopic when implantation of fertilized ovum occurs other than uterine cavity. The incidence of ectopic pregnancy is increasing globally over time and carries significant maternal mortality due to the risk of rupture of ectopic pregnancy. Ruptured ectopic pregnancy is a life threatening surgical emergency. Usually, any abnormality in tubal morphology or function may lead to tubal ectopic pregnancy. Also an altered hormonal ratio (i.e. estrogen/progesterone) may affect tubal motility and cause ectopic pregnancy. To make diagnosis of ectopic pregnancy merely on the basis of symptoms is difficult and challenging task for clinician due to its non-specific clinical manifestations and such cases can be present with normal intrauterine pregnancy. Authors report a case of ruptured tubal ectopic pregnancy which remained undiagnosed clinically because clinician refer the patient to higher center for ultrasonography to confirm or rule out the ectopic pregnancy as there was non-availability of bed side ultrasonography machines in rural health care centers in developing countries like our country. but patient died in ambulance before reaching to higher center. The autopsy revealed 1.5-liter fluid and clotted blood in the peritoneal cavity. The right fallopian tube was bulged along with a tear evident on the anterior and superior aspect. Complete dissection revealed a gestational sac of diameter 7.5 cm containing a foetus and placenta. All other organs were pale and normal. The uterine cavity was found empty. The cause of death was attributed to ruptured ectopic pregnancy. This case emphasizes the fact that “health for all” and importance of the availability of various radiological investigations including ultrasonography, prompt diagnosis, laparoscopic management are the minimal demand of rural health care centers which play a major role in saving of life. Furthermore, this report envisions benefitting clinicians and autopsy surgeons facing similar cases in their practice. Finally, this case is another addition in maternal mortality data.
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Background: The study aimed to evaluate the implementation status of the National Tuberculosis Elimination Program (NTEP) at medical colleges in Karnataka, India, and identify the challenges encountered by the medical college core committee members. Methods: A cross-sectional study was conducted among 14 medical colleges in 2019-20, using a pre-tested, semi-structured questionnaire to collect data on various NTEP components. Results: The implementation status of NTEP activities was categorized as adequate, partially adequate, or inadequate. Results showed that certain activities such as TB notification, DMC infrastructure, TB-HIV coordination, and the formation of the NTEP core committee were adequately implemented. However, challenges such as work overload, lack of dedicated manpower, and salary constraints were encountered. Conclusions: Overall, the medical colleges involved in the study were actively implementing NTEP, but there is still room for improvement to fully optimize the implementation.
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The rapidly evolving landscape of agriculture faces myriad challenges, including pests, diseases, and environmental factors that jeopardise global food security. The urgency of these challenges necessitates innovative plant protection strategies that are both effective and environmentally sustainable. This review offers a comprehensive examination of the advancements and considerations in plant protection, from traditional methods to modern technological approaches. Traditional practices, although eco-friendly, often fall short in efficacy and scalability. The advent of chemical solutions such as pesticides revolutionised plant protection but brought about environmental and health concerns. Biological controls offer a middle-ground, leveraging natural predators and bio-pesticides to combat agricultural threats. Technology is playing an increasingly critical role in shaping the future of plant protection. Sensor technologies and drones are enabling precision agriculture, enhancing the monitoring and application of protection measures. Genetic engineering holds the promise of creating crops resistant to pests and diseases, albeit amid ethical and safety debates. Integrated Pest Management (IPM), a balanced, eco-friendly approach, is gaining traction, supported by case studies that validate its effectiveness and adaptability. Meanwhile, policy and regulation are evolving to better govern the use of chemicals, promote sustainability, and address the impacts of climate change on agriculture. This review explores future trends, particularly the influence of emerging technologies such as nanotechnology and IoT, and potential shifts in global policies towards more sustainable practices. It argues for the imperative of integrating these multifaceted approaches, guided by robust policies and regulations, to achieve the dual objectives of high agricultural yield and environmental conservation. It aims to provide a holistic understanding and guide future directions in plant protection strategies, emphasising the importance of adaptability, sustainability, and integration in facing the challenges of tomorrow.
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The Khejri tree (Prosopis cineraria), is a vital resource in the Thar Desert. Sangri, the name of its pods, is the key ingredient in the Rajasthani vegetable dishes Panchkutta and Trikuta. There is severe gall formation and significant pod reduction in P. cineraria caused by the eriophyid mite Eriophyes prosopidis. The gall-infested trees look unwell because they have a lot of disorganized and deformed green galls hanging from them. During the field trials of the present study, we found that the infestation of this mite can be managed by an integrated management approach. The mechanical removal of dried galls fallen on surface and lopping at an interval of one year can reduce the infestation considerably. Treatment with botanicals Putranjiva roxburgii (10%) leaf extract, Balanites aegyptiaca (10%) leaf extract, spray of Metarhizium anisopliae 2.5 x 107 conidia /ml and chemicals Abamectin 1.9% EC @1ml/L and Diafenthiuron 25% WW + Pyriproxyfen 5% WW @ 2ml/L can be utilized for effective management of flower galls of P. cineraria.
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Background: Preconception care (PCC) is crucial to mother and child health. Many women don't realise how PCC might affect pregnancy and labour. Hence, we aimed to assess women's current knowledge and awareness levels regarding PCC, enhance knowledge, and empower women to prioritize proactive healthcare before conception.Methods: This cross-sectional study consisted of 200 reproductive-age women. Infertility therapy (n=50), poor obstetrics history (n=50), and term delivery (n=100) were the three groups. Family, gynaecological, and demographic data were obtained. Preconception care and medical issues that affect pregnancy outcomes were taught to all study participants to identify risk factors.Results: Most participants were aged between 18 and 25 (48%). Primary infertility was present in 52% of women. The main causes of infertility were pelvic inflammatory disease (40%) and genital tuberculosis (20%), treated with antibiotics and anti-tubercular medicines, respectively. Only 1 woman had both preconception and antenatal checkups, while 30 had neither. Maternal morbidity occurred in 52% of normal deliveries, with anaemia being the most prevalent. Caesarean sections were mostly due to prior 1 lower segment caesarean section (LSCS) (32%). Conception and healthy births were achieved in 10% and 6% of BOH patients and 18% and 10% of infertile patients, respectively.Conclusions: There is a need to provide women with accurate and detailed information on PCC and to establish functional clinics with evidence-based guidelines to enhance uptake and pregnancy outcomes.
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Background: Diabetes mellitus (DM) is a common metabolic disease. Anaemia is a common accompaniment to diabetes, particularly in patients with albuminuria or reduced renal function. Anaemia is more frequent and more severe at any level of glomerular filtration rate (GFR) in diabetics compared to nondiabetic patients. Methods: One hundred patients with type 2 diabetes mellitus were included in the study. Complete blood count, serum iron profile, ferritin, vitamin B12 and folate, kidney function tests and urine albumin creatinine ratio were assessed for these patients. Estimated glomerular filtration rate (eGFR) was calculated with MDRD-4 variable formula. Results: Fifty-four patients (54%) were found to be anaemic. Serum ferritin <50 µg/l was taken as cut off for defining iron deficiency anaemia. 21 patients had iron deficiency anaemia (IDA) and 33 had anaemia of chronic disease (ACD). Serum vitamin B12 and folate levels were within normal limits in all the patients. There was a rise in the prevalence of anaemia from 25.9% in patients with a normal ACR to 59.2% in those with microalbuminuria and to 75% in macroalbuminuria. Conclusions: Any degree of renal impairment and albuminuria are the risk factors for anaemia in these patients. Hence screening, characterization and treatment of aneamia in type 2 DM may be helpful in management of these patients.
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Introduction: COVID-19 patients have been reported to have systemic complications. Analyzing its effect on the endocrine system is essential to ensure women’s reproductive health. Aim: This study aimed to determine the effect of COVID-19 disease on menstruation. Methods: It was a hospital-based cross-sectional study conducted from October 2021 to April 2022, using a validated questionnaire to collect the data. The study included females (15 to 49 years) who had confirmed COVID infection. Results: A total of 132 females participated in the study. For 29 (22%) patients presenting with menstrual cycle changes, most common change was prolonged cycle (14%). An increase in menstrual volume was reported by 12%, where as 35% of patients experienced more pain during menstruation. Menstrual irregularities were significantly higher in severe infection (p-value 0.04). Conclusion: There were transient changes in menstruation in COVID-19-infected patients, with a higher probability of menstruation abnormalities among severely infected patients.
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Introduction: During the different wave of pandemic, due to various reasons self-medication practices among the public increased. Medical students are prone to such practices due to relevant background knowledge, and access to drugs. This study assessed the self-medication practice among the medial students during the different waves of pandemic of south Gujarat. Material and Methods: This descriptive study was conducted during May to June 2022 through self-administered form among medical students of south Gujarat, India. Study questionnaire included general de-mography; most frequently practice of self-medication. drug and the reason behind it. Result: Out of total 512 respondents, 381 (74.4%) did self-medication during the pandemic. 358 individuals (94.0%) did self-medication at least one drug since the start of pandemic. The most commonly utilizing medi-cines as prophylactic was Ayurvedic preparation, Multivitamins, Zinc and Vitamin C. For treatment of symp-toms during the pandemic paracetamol (650 mg) was frequently used specially for body ache and fever. The main source of information of self-medication was internet. Conclusion: This study depicted common self-medication practices among medical students during the pan-demic. It is a significant health issue especially during the pandemic times, with high consumption reported as a prevention or treating symptoms of COVID-19.
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Background: In order to manage outbreaks and plan resources, health systems must be capable of accurately projecting COVID-19 case patterns. Health systems can effectively predict future illness patterns by using mathematical and statistical modelling of infectious diseases. Different methods have been used with comparatively good accuracy for various prediction goals in medical sciences. Some illustrations are provided by statistical techniques intended to forecast epidemic cases. In order to increase healthcare systems readiness, this study aimed to identify the most accurate models for COVID-19 with a high global prevalence of positive cases. Methods: Exponential smoothing model and ARIMA were employed on time series datasets to forecast confirmed cases in upcoming months and hence the effectiveness of these predictive models were compared on the basis of performance measures. Results: It was seen that the ARIMA (0,0,2) model is best fitted with smaller values of performance measures (RMSE=4.46 and MAE=2.86) while employed on the recent dataset for short duration. Holt-Winters Exponential smoothing model was found to be more accurate to deal with a longer period of time series based data. Conclusions: The study revealed that working with recent dataset is more accurate to forecast the number of confirmed cases as compared to the data collected for longer period. The early-stage warnings through these predictive models would be beneficial for governments and health professionals to be prepared with the strategies at different levels for public health prevention.
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Background: In order to manage outbreaks and plan resources, health systems must be capable of accurately projecting COVID-19 case patterns. Health systems can effectively predict future illness patterns by using mathematical and statistical modelling of infectious diseases. Different methods have been used with comparatively good accuracy for various prediction goals in medical sciences. Some illustrations are provided by statistical techniques intended to forecast epidemic cases. In order to increase healthcare systems readiness, this study aimed to identify the most accurate models for COVID-19 with a high global prevalence of positive cases. Methods: Exponential smoothing model and ARIMA were employed on time series datasets to forecast confirmed cases in upcoming months and hence the effectiveness of these predictive models were compared on the basis of performance measures. Results: It was seen that the ARIMA (0,0,2) model is best fitted with smaller values of performance measures (RMSE=4.46 and MAE=2.86) while employed on the recent dataset for short duration. Holt-Winters Exponential smoothing model was found to be more accurate to deal with a longer period of time series based data. Conclusions: The study revealed that working with recent dataset is more accurate to forecast the number of confirmed cases as compared to the data collected for longer period. The early-stage warnings through these predictive models would be beneficial for governments and health professionals to be prepared with the strategies at different levels for public health prevention.
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Background: Chronic viral hepatitis is a major global public health problem, an important cause of morbidity and mortality. We conducted this study to evaluate the behavioral risk factors of HBV infection and its association with HBsAg positivity among residents of Kaza sub-division of district Lahaul & Spiti in Himachal Pradesh. Material & Methods: The study was carried out by the Gastroenterology, Community Medicine, and Microbiology Department at Indira Gandhi Medical College Shimla at Kaza, a subdivision of Lahaul & Spiti. The cluster sampling technique was used to get the desired sample size of 4000. Forty clusters were chosen using a probability proportionate to size sampling method, and 100 research participants were added to each cluster using a simple random sampling method. The data was gathered using a pre-tested interview plan. A blood sample of 5ml from each study participant was obtained, and its HBsAg content was examined. Results: In our study, 2.7% of the interviewed respondents’ parents were positive for hepatitis B and 3.7% reported one positive family member. Injectable drug use was reported by 1.6 (68/4231). Among these users 8.8% (6/68) shared needles with other IDUs in last 12 months and 35.3% (24/68) used a common container to draw up drug solution. Sexual intercourse was reported to be experienced by 15.5 (655/4231) and 12.2% either did not disclose or were children. Out of those who ever experienced sexual/penetrative intercourse 38.3% (251/655) had reported it with someone else other than a spouse. Majority of these had two partners other than a spouse (30.3%; 76/251). Around 30% (195/655) reported of using a condom in their last intercourse. Body piercings or a tattoo from someone who doesn’t sterilize his or her equipment, including local treatment from lamas, was prevalent among 16.3% of the population (689/4231). Acupuncture was taken as a remedy for any medical condition by 9% of participants. Regression analysis also revealed that one infected family member emerged as an independent factor associated with HBsAg positive test after adjusting for confounders. Conclusion: Our study provided much important information concerning hepatitis B risk factors in this tribal group. Health education about behavioral risk factors among this tribal population should be the main intervention that might help limit the spread of these blood-borne infections.
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Background: Multiple choice questions find important place in assessment in medical curriculum. Each MCQ is called item. Item analysis is quality check of MCQs after valuation of response sheets. This serves to recognize flaws in MCQs so that the given questions can be preserved in question bank, modified or deleted., , Methods: 140 medical students of second MBBS were assessed pharmacology through 20 single best response type MCQ. Post exam validation of MCQs was done by item analysis. Each item was analyzed for level of difficulty, ability of the question to discriminate between poor and good performing students and distracter effectiveness., , Results: Score ‘1’ was given for correct and ‘0’ for incorrect or no response. The mean score of the test was found to be 10.58±2.48, with a range 5-18. The whole test had an acceptable difficulty level with 43.25±17.81 mean difficulty index. The discrimination index of the whole test was found to be 0.123±0.184 mean PBI correlation coefficient, which is not satisfactory. Out of 60 distractors, 51 were found to be functional, hence distractor efficiency of the given test was 85%±19.96% which is acceptable., , Conclusions: 60% questions were found to be ideal and 25% were acceptable with revision of stem or options. One question was easy with poor discrimination which needs major modification in construct or subject to be placed in question bank while another one question was difficult but had negative biserial index which needs to be deleted from the question bank.
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Background: The prevalence of workplace violence in the healthcare sector is a problem that is frequently ignored and underreported. The performance of healthcare workers who have been the target of violence may suffer, which may have a negative effect on patient satisfaction and health. Aims & Objectives: The purpose of the current study was to determine the prevalence of workplace violence (WPV), risk factors for violence against healthcare workers, and their experiencesregarding the same. Methodology: It was a cross-sectional study conducted on 157 hospital staff at Tertiary Care Medical College of Uttarakhand. Data was gathered using a semi-structured, self-administered questionnaire that was modified from the ILO, ICN, WHO, and PSI. Data were analyzed using SPSS software (version 20). Results: Factors like age, gender, job profile, lesser work experience, night shifts, and fewer staff on duty were found to have a positive association with workplace violence. It was observed that the majority of incidents took place in the ward, and the patient’s relatives were the attacker in most of the cases. It was also seen that the majority of Hospital staff did not get bothered by the incident except by staying super alert while dealing with other patients or their relatives. Conclusion: The study concludes that while caring for patients, Hospital staff are at risk of being victims of aggressive and violent situations. To reduce this problem, strategies like training staff in order to handle such incidents in the future should be brought into practice. Laws should be made stricter & assaulting staff on duty should be made a cognizable offense with serious consequences & heavy penalties. Also, the young budding MBBS students should be trained by incorporating these strategies, laws & policies in the CBME curriculum
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We report a case of isolated duodenal tuberculosis (TB) in a patient who presented with features of gastric outlet obstruction. The diagnosis was made on repeat endoscopic duodenal biopsy after initial histopathology failed to reveal the diagnosis. The patient recovered with antitubercular therapy. The index of suspicion has to be high in TB endemic countries as clinical, radiological, and endoscopic features are nonspecific.
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Background: Public health initiatives focused on improving food at the community level to reduce the risk of nutritionrelated disorders have gained pace in light of the enormous illness burden associated with chronic diseases connected to nutrition. Delivering straightforward, pertinent, and understandable information regarding the nutritional value of food is the goal of Front of Package Labelling (FoPLs), which are intended to assist consumers in choosing healthier foods at the point of purchase. Methodology: It was a cross-sectional study carried out online through a series of webinars using an online survey platform and a feedback-designed questionnaire to ascertain webinar participants' knowledge of front of package labeling. Results: Among the participants, only 75.4% correctly identified the characteristics of packaged foods that increase the risk of obesity. Also, it was found that 84.7% of the participants knew that food labels had to display complete nutritional information. About 93.6 percent of the individuals were aware of public health initiatives that raise awareness of FOPL. Only 38.9% of the individuals were aware that certain food products were free from labelling, in comparison. Conclusion: Front of package labelling (FOPL) regulation goals must be adopted in order to enable consumers to simply, quickly, and accurately identify items containing extra sugars, trans-fats, oils, and sodium. This will help the Government of India comply with WHO recommendations on unhealthy foods.
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Background: H. pylori-associated gastritis in patients from the high-altitude area of Ladakh showed severe gastritis, mucosal nodularity, atrophy, and cancer in comparison to those from North India. This study served to analyze if differences in the H. pylori virulence genotypes decide the extent of gastric mucosal inflammation. Methods: Fifty gastric biopsies each from patients with H. pylori-associated gastritis from Ladakh and a tertiary care center in North India were included. The presence of H. pylori strain was confirmed with Warthin starry stain and polymerase chain amplification of the H. pylori-specific 16S rRNA. The cagA, vacA s1, s2, and m1, m2 alleles, and dupA virulence genotypes were studied in all archival samples, followed by their histological correlations. Results: cagA (P 0.009) and vacAs1 m1 (P 0.009) genes were distinctly more in H. pylori strains colonizing the biopsies of North Indian patients. In contrast, the cagA -ve vacAs2 m2 strains were significantly more in H. pylori strain colonizing the biopsies from Ladakhi patients. dupA genotype was almost similarly present in strains from both regions. Among these, only cagA and dupA virulence genes were associated with severe mucosal neutrophilic activity and deep infiltration of H. pylori strains in North Indian patients. Conclusions: Differences in virulence genotypes of H. pylori in gastric biopsies from North Indian and Ladakhi patients were found not significant in deciding the severity of H. pylori-associated gastritis.
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Background: Worldwide, obesity has nearly tripled since 1975 and has become a major healthcare challenge today. Intermittent fasting (IF) is gaining popularity as a weight loss strategy in recent times. This study aimed to study the role of IF as a modern-day weight-loss strategy in obese adults through a real-world pilot experiment conducted at a nutrition clinic in Mumbai. Methodology: To understand the effects of IF on weight loss, 32 overweight/obese [body mass index (BMI) ?23 kg/m2] adults from a nutrition clinic in Mumbai, were assigned consecutively to an IF plan and followed up for 3 months. Their demographic, anthropometric, and dietary assessments were done pre- and post-intervention. Qualitative interviews were done at the end of the study to record the participants’ overall well-being, experience, and sustainability of IF. Results: 56% of study participants were males and their mean age was 35.6 ± 8.9 years. 65.6% of participants were able to maintain 14–16 hours of fasting and 53% managed all 7 days of IF. Analysis of post-intervention data showed a significant reduction in mean body weight (88.5 ± 19 to 83.8 ± 17.6 kg), waist circumference (M: 108.2 ± 11.3 to 103.6 ± 4.4 cm, F: 98.9 ± 8.8 to 93.3 ± 3.3 cm), BMI (31.4 ± 5.3 to 29.6 ± 5.1 kg/m2), daily calories (1782 ± 237 to 1388 ± 243 kcal/day), carbohydrate intake (267 ± 18.4 to 164 ± 4.0 g/day), and an increase in protein intake (39 ± 11 to 55 ± 11 g/day). Participants reported positive experiences of practicing IF such as improved fitness, sleep cycle, and adoption of healthy eating habits. Conclusion: The study demonstrates that IF could aid in weight loss and adoption of a healthier lifestyle.