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font-size: 14px;"><strong><span style="font-family: 'lucida sans unicode', 'lucida grande', sans-serif;">International Journal of Medical and Biomedical Studies</span></strong></span><span style="text-align: justify; font-size: 14px; font-family: 'lucida sans unicode', 'lucida grande', sans-serif;"><strong>&nbsp;(IJMBS)</strong> is an international, peer-reviewed, open access, online journal dedicated to the rapid publication of full-length original research papers, short communications, invited reviews, Case studies and editorial commentary and news, Opinions &amp; Perspectives and Book Reviews written at the invitation of the Editor in all areas of the Medical and Biomedical Studies.</span></p> <hr> <p style="text-align: justify;"><span style="font-family: lucida sans unicode,lucida grande,sans-serif;"><span style="font-size: 14px;"><strong>Medical Studies||&nbsp; Biomedical Studies ||&nbsp;</strong></span></span></p> <p style="text-align: justify;"><span style="font-family: lucida sans unicode,lucida grande,sans-serif;"><span style="font-size: 14px;">Anatomy, Physiology, Anesthesia,<strong>&nbsp;</strong>Biochemistry, Molecular Biology, Cell biology, Genetics, Hematology, Pathology, Immunology, Microbiology, Virology, Parasitology, Surgery, Dental Sciences, Sports Physiology,&nbsp;Histopathology, Toxicology and all major disciplines of Biomedical Sciences,&nbsp;Pharmacokinetics,&nbsp;Molecular Drug Design, Phytochemistry, Toxicology, Biomedical Analysis, Clinical Research, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology and all major disciplines of&nbsp;Medical and Biomedical Studies.</span></span></p> <p style="text-align: justify;"><span style="font-family: lucida sans unicode,lucida grande,sans-serif;"><span style="font-size: 14px;">Articles are published as they are accepted and are freely available on the journal’s website to facilitate rapid and broad dissemination of research findings to a global audience.</span></span></p> <hr> <p style="text-align: justify;"><strong style="font-size: 14px; font-family: 'lucida sans unicode', 'lucida grande', sans-serif; text-align: justify;">Top Reasons for publication with us</strong></p> <hr> <p style="text-align: justify;"><span style="font-family: lucida sans unicode,lucida grande,sans-serif;"><span style="font-size: 14px;"><strong>Quick Quality Review:</strong> The journal has strong international team of editors and reviewers, Rapid Decision and Publication</span></span></p> <hr> <p style="text-align: justify;"><span style="font-family: lucida sans unicode,lucida grande,sans-serif;"><span style="font-size: 14px;"><strong style="font-size: 14px; font-family: 'lucida sans unicode', 'lucida grande', sans-serif;">Other features:</strong> DIDS and DOI: Assigned and Implemented the Open Review System (ORS).</span></span></p> <hr> <p style="text-align: justify;"><span style="font-family: lucida sans unicode,lucida grande,sans-serif;"><span style="font-size: 14px;"><strong>Important Notice:</strong></span></span></p> <p style="text-align: justify;"><span style="font-family: lucida sans unicode,lucida grande,sans-serif;"><span style="font-size: 14px;">Author can now directly send their manuscript as an email attachment to <strong><span style="color: #008000;"></span></strong></span></span></p> <hr> <p>&nbsp;</p> en-US <p>&nbsp;</p> <p class="caption" style="text-align: center;"><a href="" rel="license"><img style="border-width: 0;" src="" alt="Creative Commons License" width="60" height="21" border="0"></a>International Journal of Medical and Biomedical Studies&nbsp;(IJMBS)<span style="line-height: 1.3em;">&nbsp;</span><span style="line-height: 1.3em;">by </span><span style="line-height: 1.3em;">Articles</span><span style="line-height: 1.3em;"> is licensed under a </span><a style="line-height: 1.3em;" title="Journal of Biomedical and Pharmaceutical Research" href="" target="_blank" rel="license noopener">Creative Commons Attribution 4.0 International License</a><span style="line-height: 1.3em;">.</span></p> (Innovative Library) (Innovative Library) Thu, 06 Jun 2019 00:00:00 -0500 OJS 60 CLINICAL PROFILE OF OCULAR SURFACE SQUAMOUS NEOPLASIA (OSSN). <p><strong>Aim: </strong>To Study the Clinical profile of Ocular Surface Squamous Neoplasia (OSSN).</p> <p><strong>Design: </strong>Retrospective study.</p> <p><strong>Materials and Methods: </strong>We analysed 28 cases of OSSN who presented to the out-patient department of tertiary eye care centre Hospital, over a period of 1 year from January 2017 to January 2018.</p> <p><strong>Results: </strong>In patients, who presented with OSSN age ranged from 24 to 70 years, mean age being 44.80 years. Males were predominantly affected accounting for 64.28%. A nodule at the libus is the commonest presentation. About 25% of the patients were positive for HIV with mean age of presentation 32 years. Among HIV positive patients 5 cases had SCC.</p> <p><strong>Conclusion: </strong>OSSN was observed more common in males. Nodular type of lesion is the commonest variety. HIV positive individuals have an increased incidence of OSSN with invasive characteristics. Hence, ophthalmologists need to be aware of this association and a thorough workup is warranted for all patients presenting with OSSN, especially in the younger age group.</p> <p><strong>Keywords:&nbsp; </strong>&nbsp;Ocular surface squamous neoplasia, Carcinoma in-situ(CIS), Squamous cell carcinoma (SCC)</p> Dr. Rishi Gupta ##submission.copyrightStatement## Thu, 06 Jun 2019 05:44:51 -0500 A COMPARATVE STUDY ON DIAGNOSTIC YIELD BETWEEN CENTRIFUGED METHOD OF CYTOLOGY AND CELL BLOCK TECHNIQUE <p>Cytological examination of serous fluids is of paramount importance in disease diagnosis. Cell blocks are particularly useful when the cytological abnormalities are misleading, such as in reactive mesothelial cells or obscure as in occasional well differentiated adenocarcinoma. In the present study, these methods are applied to pleural and peritoneal fluids to conclude the diagnosis as inflammatory, benign or malignant lesion. A sample of 110 fluids obtained during August 2011 to August 2012 in the Department of Pathology, Narayana Medical College, Nellore. Out of 110, 76 (69%) are pleural and 34 (31%) were peritoneal samples. Men were 56.4% and women were 43.6% and the mean age of the study was 50.19 with a standard deviation of 14.81. Among 110 fluids 15 were clinically diagnosed as malignant effusions. Out of which 11 were reported as positive for malignant cells and 4 cases were negative. 3 cases were reported as positive for malignant cells in which they were clinically not diagnosed. Out of 110 cases, 12 were reported as positive for malignant cells by smear whereas 14 cases were reported as positive for malignant cells by cell block. The diagnostic yield is increased by cell block technique. The cell block technique not only increased the positive results, but also helped to demonstrate better architectural patterns which could be of great help in approaching the correct diagnosis of the primary site.</p> <p><strong>Keywords: </strong>Cell Block Technique, Cytospin smear, Diagnostic Yield, Adeno carcinoma</p> Dr. C.Venkata Harish, Dr. B. Spandana, Dr. B. Bhanumathi ##submission.copyrightStatement## Thu, 06 Jun 2019 06:08:48 -0500 DIETARY DIVERSITY AMONG WOMEN IN THE REPRODUCTIVE AGE GROUP IN URBAN FIELD PRACTICE AREA, VIMSAR, BURLA <p>One of the problems among Women of Reproductive Age (WRA) group has been lack of effective programs whose benefits are not reaching WRA group. Another problem is the prevalence of monotonous diet based on starchy staple food, which lacks essential micronutrients and contribute to the burden of malnutrition and micronutrient deficiency. The objectives of the study was to assess household dietary diversity and nutritional status of non-pregnant non-lactating women of reproductive age in urban field practice area in Burla as a way of comparing food security situation. It was a cross sectional study. Data were collected from urban field practice area in Burla and were analysed to assess the dietary diversity among “women of reproductive age (WRA)” group. One third (about 29%) of them was malnourished. On application of logistic regression, those aged ≥25years had better odds of having Minimum Dietary Diversity (MDD) score of 5 and above (OR=1.777). Subjects with BMI range ≥21.5 Kg/mt<sup>2 </sup>also had better odds of having MDD score of 5 and above (OR=3.371). Women of reproductive age are nutritionally more vulnerable because of pregnancy, lactation and menstruation requiring nutrient dense quality food. Monotonous diet based on starchy staple lacks essential micronutrients and contribute to the burden of malnutrition and micronutrient deficiency. Intake of diverse diet is a cost effective strategy to overcome this problem. From our survey we conclude that more than half of WRA failed to achieve MDD. Based on findings, Information Education and Communication (IEC) activities are recommended with an emphasis on locally available, low-cost nutrition diet.</p> <p>Keywords: Minimum Dietary Diversity, Women of Reproductive Age, Micronutrients</p> Dr. Smita Kumari Panda, Dr. Kulwant Lakra, Dr. Sadhu Charan Panda ##submission.copyrightStatement## Thu, 06 Jun 2019 06:39:12 -0500 HYDROQUINONE: A novel growth inhibitor and apoptosis inducer in U-251 MG CELLS <p>In design of new CNS drugs, profound and selective cytotoxicity, penetration through the blood brain barrier along with lack of neurotoxic effects coupled with no side effects in humans at a dose of 3 mg/kg administered actually make the avarol chemical scaffold (Figure 1) an ideal candidate [1]. This study aimed to screen in vitro structure-activity relationship (along with selectivity) using avarol (followed by its structural elements) and the human malignant glioma U-251 MG cells</p> Bharat Kwatra ##submission.copyrightStatement## Thu, 06 Jun 2019 06:55:29 -0500 A STUDY OF CONCERNS, COPING SKILLS AND QUALITY OF LIFE IN BREAST CANCER PATIENTS <p><strong>Introduction:</strong> Women with breast cancer experience problems in multiple aspects of their lives, but applying effective strategies can result in enhancing their quality of life and their psychosocial adaptation to the disease. However, there is little information about the strategies that women use to cope with complications associated with their experiences following a breast cancer diagnosis.</p> <p><strong>Material and Methods:</strong> The study was done in department of Medical oncology at Shirdi Saibaba cancer hospital and research centre, Kasturba hospital, Manipal. The study period is from November 2009 to February 2010. <strong>Results: </strong>30 study subjects were selected for the study. Majority of the study subjects were in 41-50 age group.</p> <p><strong>Keywords: </strong>Breast cancer, Coping mechanisms, Concerns, Anxiety, Depression</p> Dr. Anil Kumar P, Dr. Shankar Reddy Dudala ##submission.copyrightStatement## Thu, 06 Jun 2019 09:18:22 -0500 A STUDY OF NEONATES WITH BIRTH ASPHYXIA FOR SEQUELAE OVER 2 YEARS <p><strong>Introduction:</strong> Birth asphyxia is associated with reduction in the arterial oxygen tension, accumulation of carbon dioxide and fall in blood pH. Acidosis occurs due to anerobic utilization of glucose, production of lactic acid and accumulation of carbon dioxide.</p> <p><strong>Aim:</strong> To study outcome of neonates who suffered birth asphyxia and Hypoxic–ischemic encephalopathy (<em>HIE</em>) in a teaching hospital over a period of 2 years.</p> <p><strong>Materials &amp; Methods:</strong> 325 neonates with birth asphyxia and hypoxic ischemic encephalopathy were studied, with well defined inclusion and exclusion criteria. They were treated according to standard protocols. <strong>Observations :</strong> 106 neonates of HIE-I, 58 neonates of HIE-II, and 59 neonates of HIE-III were followed up: for various outcomes like death due to complications, cerebral palsy, developmental delay with epilepsy, hearing handicap etc.</p> <p><strong>Results:</strong> In HIE-I no case progressed to cerebral palsy, in HIE-II 24.13% progressed into CP and in HIE-III 54.2% developed spastic cerebral palsy.</p> <p><strong>Conclusion:</strong> Infants with severe grades of HIE have increased risk of long term neurological sequlae.</p> <p><strong>Keywords: </strong>Neonate, Birth asphyxia, Acidosis, Neonatal encephalopathy</p> Dr. Y. Vamseedhar, Dr. B.K. Niranjan ##submission.copyrightStatement## Thu, 06 Jun 2019 09:44:52 -0500 SLEEP ASSESSMENT AND PERCEIVED STRESS AMONGST MEDICAL POSTGRADUATE RESIDENTS <p><strong>Background: </strong>Medical graduates who enter into residency programmes form the backbone of the healthcare delivery system of the country. They are often expected to work for long hours which leads to sleep deprivation and increase in the perceived stress levels. Chronic sleep deprivation leads to destruction of sleep architecture. It may also compromise patient care. We examine the relationship between these two variables through this study.</p> <p><strong>Material and methods: </strong>50 resident doctors from different specialties of medicine were administered three validated questionnaires: the Epworth sleepiness scale (ESS), Pittsburgh sleep quality index (PSQI) and Cohen’s perceived stress scale (PSS-10) to assess the daytime sleepiness, sleep quality and perceived stress levels respectively.</p> <p><strong>Result: </strong>A total of 56% residents reported greater than average scores on the ESS (Mean score=11.02 <u>+ </u>5.5161, Range= 1-24). On the PSQI, 78% residents reported poor sleep quality (Mean score=6.98 <u>+</u> 3.146, range= 0-15) whereas on the PSS-10, 84% of the residents reported moderate to high levels of perceived stress (Mean score=19.16<u>+</u>7.138, range=3-37). Significant correlation was found between ESS and CPSS (Pearson coefficient=0.4738, p&lt;0.01) as well as PSQI and CPSS (Pearson coefficient=0.3024, p&lt;0.05). It is hypothesised that there is a causal relationship between daytime sleepiness perceived stress levels as well as sleep quality and perceived stress levels.</p> <p><strong>KEYWORDS</strong>: Sleep deprivation, Perceived stress, Stress levels, Epworth Sleepiness scale, sleep quality.</p> Jay Rajesh Ajgaonkar, Mukta Pritam Bidikar ##submission.copyrightStatement## Thu, 06 Jun 2019 22:46:20 -0500 COMPARATIVE STUDY OF HAEMODYNAMIC CHANGES BETWEEN 6% HYDROXYETHYLSTARCH 130/0.4 AND RINGER LACTATE COLOADING IN ELDERLY PATIENTS UNDERGOING LOWER LIMB ORTHOPAEDIC SURGERY UNDER SPINAL ANAESTHESIA <p><strong>Background:</strong> Anaesthesia for the lower limb surgeries could be either general or regional. Studies had shown that regional anaesthesia for lower limb surgery results in better postoperative outcomes, including improved respiratory function, less nausea vomiting, less pain and lower incidence of deep vein thrombosis. Among all the regional anaesthetic techniques spinal anesthesia remained most preferred technique for its fast, predictable, profound, high quality sensory and motor block. However some complications like hypotension, bradycardia, post dural puncture headache, urinary retention were unavoidable and hypotension remained the most common one and found to be more in the elderly population with incidence of 25–82%. Treating spinal anaesthesia-induced hypotension included intravenous (IV) volume administration. IV Fluid infused before and at the time of spinal anaesthesia was referred to as preloading and coloading respectively.</p> <p>Although merit of coloading and the choice of fluid to be infused had remained &nbsp;a matter of debate, till today no definitive study had indicated any superiority of colloids over crystalloids decisively&nbsp; moreover large amount crystalloids to counter hypotensin &nbsp;remained a threat to the cardiovascular overload for &nbsp;elderly patients. Role of vasopressors in elderly remained controversial too.</p> <p>So this observational prospective study was &nbsp;undertaken to compare &nbsp;the effiicacy of coloading of infusion 6%HES 130/0.4 (colloid) and Ringer Lactate solution (crystalloid)&nbsp; to maintain the intra operative haemodynamics in elderly patients undergoing lower limb orthopaedic surgery under spinal anaesthesia.</p> <p><strong>Objectives</strong>: To assess and to compare the efficacy of infusion 6%HES 130/0.4 and infusion Ringer lactate solution coloading in preventing the intra-operative hypotension.</p> <p><strong>Materials and method</strong>: On&nbsp; approval of the Ethics Committee of Burdwan Medical College (BMC&amp;H), 80 patients were included and equally divided into two groups group A and group B where groupp A received 6% HES&nbsp; as coloading fluid and groupp B received RL as coloading fluid at the start of spinal anaesthesia. On entering Operation Theatre baseline parameters were noted for each patient and lumbar puncture for spinal anaesthesia was performed following strict aseptic precautions, in sitting position. Upon achieving adequate block episodes of hypotension were noted and treated according to the study protocol.</p> <p><strong>Results: </strong>Statistical analysis for Continuous and categorical variables were done using Mann-Whitney U test and Pearson’s Chi Square test accordingly and p values less than 0.05 were considered significant.</p> <p>In group A, 17.5 % patients developed one episodes of hypotension whereas in group B, 37.5% patients developed one episodes of hypotension which was statistically significant with p value 0.0465. &nbsp;In group A none of the patients developed further episodes of hypotension but in group B 5% affected patients developed one more episodes of hypotension and 2.5% affected patients developed two more episodes of hypotension.</p> <p>Average intravenous dose of mephentermine required to treat hypotension was 1.05 mg for group A and 2.70 mg for group B and found to be statistically significant with p value 0.039. Total fluid consumption In group A was 654.95 ml whereas in group B &nbsp;was 976.73 ml and also&nbsp; found to be statistically significant with p value &lt;0.001.</p> <p><strong>Conclusion</strong>:&nbsp; The study found that coloading with 6% HES was significantly effective than Ringer Lactate solution in preventing episodes of hypotension in spinal anaesthesia induced elderly patients undergoing lower limb surgery without any noticeable adverse effect.</p> <p><strong>Key Words:</strong>&nbsp;Spinal anaesthesia, lower limb surgery, elderly patients, coloading</p> Jayanta Chakraborty, Uma Mandal ##submission.copyrightStatement## Thu, 06 Jun 2019 23:49:51 -0500 WOULD MANDATORY TEACHING OF BLS, ACLS AND PALS IMPROVE THE KNOWLEDGE, ATTITUDE AND PRACTICE OF MEDICAL STUDENTS IN EMERGENCY CARE? <p><strong>Background and objective: </strong>The medical students should be trained in BLS/ACLS/PALS in order to attain the skills for emergency patient management. The objective of the study is to compare the knowledge, attitude and practice about BLS/ACLS/PALS among the interventional and non-interventional groups both before intervention and after intervention.</p> <p><strong>Methods: </strong>This interventional study was done among final year medical students and house surgeons in six Medical colleges of Northern Kerala<strong>.</strong>The study subjects were categorized into two groups,Category 1 received an orientation class on BLS/ACLS/PALS and students belonging to category 2 did not receive the orientation class. A pre-validated pretested questionnaire to assess the Knowledge, Attitude and Practice of medical students regarding BLS/ACLS/PALS was distributed after the orientation class.The control group (category 2) who did not receive the orientation class also were given the questionnaire same as that of other group.</p> <p><strong>Results:</strong> Total of 608 students participated in this study.Out of which 325 received an orientation class. Unpaired t-test done in pretest among interventional and non-interventional group showed p value&gt;0.01 which implied that both groups were comparable. The mean scores of Knowledge, attitude and practice in the post test increased to 8.111±1.507, 2.328±.743, 2.065±.297 among house surgeons and an increment to 6.260±1.087, 2.277±.474, 1.659±.659 among final years in the interventional group as when compared with the scores of the non-interventional group. Paired t test also showed significant difference among interventional group while there was no change in the non-interventional group.(p&gt;0.05).</p> <p><strong>Conclusion: </strong>BLS/ACLS/PALS training among undergraduates can improve the Knowledge, Attitude and Practice of medical students thereby increasing the resuscitation as well as the survival of patients in emergency care.</p> <p><strong>Keywords:</strong> BLS, ACLS , PALS, Resuscitation</p> Treasa James, Dr. Mohammad Fabin K.N., Dr. Anirudh V Mutalik, Dr. Ubaid N. P, Dr. N C Cherian, Mrs. Reshma V ##submission.copyrightStatement## Fri, 07 Jun 2019 00:36:11 -0500 EVALUATION OF ONE STAGE MODIFIED MATHIEU’S URETHROPLASTY FOR DISTAL PENILE HYPOSPADIAS IN BIHAR POPULATION <p>With an incidence of 1:300, hypospadias is one of the most common genital anomalies in male newborns. Hence the present study was planned to evaluate the one stage Flip- flap procedure to repair Distal Penile Hypospadias. Mathieu’s technique (peri-meatal based flap) makes use of the urethral plate in the repair of anterior hypospadias, thereby creating an almost natural neo-urethra. In a circumcised baby or after previous unsuccessful repair, Mathieu’s flap may be one of the few options left to repair anterior hypospadias.</p> <p>A total of fourteen patients were included in this study. Their age ranged from 1-13 years, mean age was 4.9 years. Construction of neourethra is generally recommended to be completed before the school going age. The 14 cases of hypospadias are primary repaired by modified Mathieu’s&nbsp; Flap technique to achieve both cosmetic and functional normality. An overall success rate of 87.5% was achieved and In the remaining 14% of the cases, success was achieved with only one additional procedure.</p> <p>The protocol followed the recommended guidelines of surgery. The present study was planned in the Department of Plastic Surgery, Pulse Emergency Hospital, Patna, Bihar. Total surgeries done from Oct 2016 to Nov 2017 were included in the present study.</p> <p>The present study concludes that in a developing country like India with rural patients having poor access to good healthcare facilities. One stage Repair is beneficial in many ways. The follow-up compliance of poor rural patients is extremely poor because they need to come to the urban cities for treatment. The authors have seen multiple cases where the patients have gone for the Chordee Correction (first stage of a two-stage repair) in childhood and then reported after a decade.</p> <p><strong>Keywords: </strong>Hypospadias, MAGPI, Mathieu flap, Single-stage repair, etc.</p> Dr. Shyam Kumar Satyapal ##submission.copyrightStatement## Fri, 07 Jun 2019 01:23:28 -0500 SUBSTANCE ABUSE AMONG IMMIGRANT CONSTRUCTION WORKERS <p><strong>Background:</strong> Substance abuse can simply be defined as a pattern of harmful use of any substance for mood-altering purposes. "Substances" can include alcohol and other drugs (illegal or not) as well as some substances that are not drugs at all.</p> <p><strong>Methods:</strong> This cross sectional study was conducted among the migrant workers working in Bikaner Rajasthan, over the time duration of 3 months. All migrant laborers above the age group of 18 years were included in the study. Data was collected from ante-natal register using Predesigned, pretested, validated and structured proforma.</p> <p><strong>Result:</strong> In our study prevalence of substance abuse was found to be among 84.00% of participants. 44.8% of the study participants were consuming alcohol, 50.2% of the study participants were chewing tobacco.</p> <p><strong>Conclusion:</strong> The result of the present study suggests that substance abuse among migrant workers was very high. Policy makers must pay extra attention to the health of migrants by implementing safety measures and organizing intense behaviour change communication.</p> <p><strong>Keywords:</strong> Alcohol, Smoking, immigrant construction workers</p> Dr. Rattiram Meena, Dr. Rekha Acharya, Dr. Aarti Acharya ##submission.copyrightStatement## Fri, 07 Jun 2019 11:59:33 -0500 EPIDEMIOLOGY AND OUTCOMES OF ELECTRIC BURN INJURY AT TERTIARY CARE CENTER IN JODHPUR, RAJASTHAN <p><strong>Background-</strong> Electric burns and injuries are the result of electric current passing through the body. Temporary or permanent damage can occur to the skin, tissues, and major organs.</p> <p><strong>Methods-</strong> This prospective study was carried out on patients admitted in burn unit of department of surgery M.G. Hospital associated with Dr. S.N. Medical College Jodhpur. Records of the patients admitted from January 2018 to December 2018 were studied. Bed head tickets of the patients evaluated in detail.</p> <p><strong>Results-</strong> In our study out of 113 patients maximum no. of patients were in age group of 21-30 years 44 (38.94%) followed by age group &lt;11 years in 21 (18.58%) patients and age group of &gt; 60 years in only 3 (2.65%).39 (34.51%) patients were farmer and 15 (13.27%) were electrician in out of 113 total patients, while 37 (32.74%) were without any occupation. 65 (57.52%) cases of high voltage (HV) electrical injury and 48 (42.48%) cases were of low voltage (LV) electrical injury.</p> <p><strong>Conclusion-</strong> Morbidity leading to permanent disabilities make the person physically dependent on others. It can be prevented by educating the people about the proper handling to electric circuits &amp; devices. Proper communication among the electricians may help in lowering such accidents. Proper rehabilitation of the handicapped person &amp; employment to the member of the affected family may reduce the social burden caused by such electricity concerned accidents.</p> Bharti Saraswat, Ashok Yadav, Krishna Kumar Maheshwari ##submission.copyrightStatement## Tue, 11 Jun 2019 00:00:00 -0500 KNOWLEDGE, ATTITUDE AND PRACTICES RELATED TO CERVICAL CANCER <p><strong>Background:</strong>&nbsp;&nbsp; Cervical cancer is the second most common cancer among women worldwide.&nbsp; &nbsp;Eighty-six percent of all cervical cancer diagnosed and 88% of death due to cervical cancer occur in developing regions of the world</p> <p><strong>Material and methods:</strong> A facility based cross sectional study was done 500 women of reproductive age group (15-45 years).</p> <p><strong>Results:</strong>&nbsp; A total of 500 women are approached for interview, in which 420(84.00%) had not heard about cervical cancer, only 16.00% women had knowledge about cervical cancer. About 80.00% women had positive attitude about cervical cancer screening &amp; it’s vaccine.</p> <p><strong>Conclusions:</strong> Women need more information about cervical cancer risk factors, symptoms and screening program.</p> Ruchi Saxena, Gajendra Saxena ##submission.copyrightStatement## Tue, 11 Jun 2019 02:27:18 -0500 A STUDY ON CLINICO- RADIOLOGICAL PRESENTATION OF STROKE AND ITS ASSOCIATION WITH OUTCOME <p><strong>BACKGROUND:</strong>&nbsp; Cerebrovascular diseases include some of the most common and devastating disorders: ischemic stroke, hemorrhagic stroke, and cerebrovascular anomalies such as intracranial aneurysms and arteriovenous malformations. A stroke, or cerebrovascular accident, is defined by this abrupt onset of a neurologic deficit that is attributable to a focal vascular cause. Thus, the definition of stroke is clinical, and laboratory studies including brain imaging are used to support the diagnosis.</p> <p><strong>AIMS:</strong>&nbsp; <strong>1.</strong>To correlate clincoradiological findings in terms of prognosis, 2. To know different types of stroke along with its area of involvement and vascular distribution and its relation with outcome, 3. Role of CT SCAN brain as an early diagnostic modality to say clinical outcome.</p> <p><strong>METHODS:</strong> This descriptive epidemiological study with a cross sectional study design is to be conducted in the department of medicine (indoor), R.G.KAR Medical College and Hospital. 1st June 2017 to 31st may 2018. 100 cases to be selected during study period based on following criteria. Detailed clinical history, clinical examinations with Radiological imaging like computed tomography of brain is done. We use scoring system like Intracerebral haemorrhage score, Glasgow coma scale, Modified rankin scale. Based on clinical examination proforma all the study population had been examined including recording of blood pressure and Glasgow coma score at the time of admission. Analysed by Modified Rankin scale till the 5th day post-hospital admission after stroke.</p> <p><strong>RESULT:</strong> Among the total 100 study population 59 cases were of Infarction and 41 cases were of Haemorrhagic type of stroke. Within the 59 Cases of Infarction 39 (i.e. 66%) were male cases and 20 (i.e 34%) were female cases. Within the 41 cases of Haemorrhage 29 (i.e. 71%) were male and 12 (i.e. 29%) were female.&nbsp; The mean age of the study population of Infarction cases was 55.55 years ±12.84 SD. The mean age of the study population of Haemorrhage cases was 57.48years±13.46SD. Infraction cases show increased mortality among the group having systolic blood &amp; diastolic pressure ≥ 180 mm of Hg, ≥ 110 mm of Hg respectively. Hemorrhagic cases show increased mortality among the group having systolic blood pressure, diastolic pressure ≥ 180 mm of Hg, ≥ 110 mm of Hg respectively.</p> <p><strong>CONCLUSION:</strong> Incidence of haemorrhage is much higher in India (41% as per our study). The study population between 51- 60 years is most predominant age group in both the types of stroke. Most of the infarction cases presents with unconsciousness followed by slurring of speech.&nbsp; Most common presenting symptoms of Haemorrhagic stroke are unconsciousness, present at about 56% of cases. The most prominent risk factor in our study population is undetected and/or uncontrolled hypertension.&nbsp; Study population with SBP ≥180 and/or DBP ≥110 mm of Hg group have increased rate of mortality from stroke. The major type of ischemic stroke in our study population is partial anterior circulation stroke (PACI) 47.4%. Most of the study population having &nbsp;Infarction has developed severe disability at the end of 5 days of observation, comprising of 40.5% of the total observation.</p> <p><strong>Keywords:</strong> <strong>&nbsp;</strong>CVA (cerebrovascular accident), CT Scan (computed tomography), MRI<strong> (</strong>Magnetic resonance imaging), GCS Scale (Glasgow coma scale)</p> Dr. Arindam Nag, Dr. Sourav Nag, Dr Suraj Mondal, Dr Yashpal Yadav ##submission.copyrightStatement## Fri, 14 Jun 2019 12:05:26 -0500 EFFECTS OF THYROID DYSFUNCTION ON LIPID PROFILE <p><strong>Background: </strong>Thyroid function regulates a wide array of metabolic parameters. Thyroid function significantly affects lipoprotein metabolism as well as some cardiovascular disease (CVD) risk factors, thus influencing overall CDV risk.</p> <p><strong>Methods: </strong>A cross sectional study has been conducted to assess the association of subclinical hypothyroidism and overt hypothyroidism with lipid abnormalities.</p> <p><strong>Results: </strong>Serum HDL cholesterol in group A was 37.97±7.97 mg/dl, that&nbsp; in group B was 37.62±6.67 mg/dl, while in group C it was 36.27±5.79 mg/dl. Serum LDL cholesterol in group A was 150.9±29.70 mg/dl, that&nbsp; in group B was 115.2±22.02 mg/dl, while in group C&nbsp; it was 93.07±19.88 mg/dl. Serum total cholesterol in group A was 223±32.69 mg/dl, that in group B was 179.67±27.50 mg/dl, while in group C it was 152.4±21.47 mg/dl. Serum VLDL cholesterol in group A was 34.12±11.06 mg/dl, that in group B was 26.85±4.01 mg/dl, while in group C it was 23.05±3.09 mg/dl. Serum VLDL cholesterol in group A was 167.42±47.83 mg/dl, that in group B was 134.37±20.22 mg/dl, while in group C it was 115.17±15.66 mg/dl.</p> <p><strong>Conclusion: </strong>Thyroid dysfunction can have an important effect on lipid profile. Biochemical screening for thyroid dysfunction is critical in all dyslipidemic patients, as well as in all patients with unexpected improvement or worsening of their lipid profile.</p> <p><strong>Keywords: </strong>LDL,HDL,Cholesterol.</p> Dr. Vinod Kumar, Dr. S.L. Mathur, Dr. Rajat Kumar Tuteja ##submission.copyrightStatement## Fri, 14 Jun 2019 12:33:04 -0500 SERUM PROLACTINE LEVEL IN PATIENTS OF PSORIASIS VULGARIS AND ITS CORRELATION WITH DISEASE SEVERITY: A CASE-CONTROL STUDY <p><strong>Background: </strong>Psoriasis is an autoimmune chronic inflammatory disorder affecting the skin mediated by T-lymphocytes resulting in production of cytokines which cause hyperproliferation of keratinocytes. &nbsp;Several factors and hormones like Prolactin have an action similar to these cytokines in promoting the multiplication of keratinocytes and other cells like lymphocytes and epithelial cells may have a role on the etiopathogenesis of psoriasis.</p> <p><strong>Aim</strong>:-The aim of study is to compare the serum Prolactin levels in patients of psoriasis with a control group.</p> <p><strong>Setting and study design: </strong>This is a case-control study conducted in the department of Dermatology, Venereology and Leprosy GMC, Kota over a period of 1year from July 2017 to June 2018</p> <p><strong>Material and method</strong>: The study included 100 cases of psoriasis (60 males and 40 females) and 100 controls similar for age and sex. Serum Prolactin levels were measured by ECLIA and results were obtained.</p> <p><strong>Statistical analysis</strong>: Mean and standard deviation were calculated for each variable. Statistical significance of the results was analyzed using correlation analysis (Pearson correlation coefficient) and independent samples t-test.</p> <p>Statistical significance was assumed at p value&lt;0.05.</p> <p><strong>Result: </strong>Serum Prolactin level was significantly higher in cases of psoriasis compared to controls (p-value &lt;0.001). PASI score and serum Prolactin levels were found to have a positive correlation (r value = 0.337; p-value: 0.001). No significant&nbsp; correlation was found between serum levels of Prolactin and duration of disease r value= -0.034, P value =0.733). Serum Prolactin level was higher in male patients compared to females patients.</p> <p><strong>Conclusion:- </strong>High serum Prolactin may be a biological marker of disease severity in psoriasis and may have a role in the pathogenesis of psoriasis. Further studies with large sample size are required to confirm this hypothesis.</p> Pawan Kumar Saini, Devendra Yadav, Rozy Badyal, Suresh Jain, Arti Singh, Mamta Vijay ##submission.copyrightStatement## Fri, 14 Jun 2019 13:22:27 -0500 CRYPTORCHIDISM WITH BILATERAL SYNCHRONOUS TESTICULAR GERM CELL TUMOUR <p>Cryptorchidism or undescended testis is a very common anomaly of the male genitourinary system. It is one of the established risk factors for testicular tumour. The commonest malignancy noted in cryptorchidism is seminoma testis. The presence of bilateral synchronous testicular tumour in cryptorchidism is very rare.</p> <p>&nbsp;</p> Dr. Garima Choudhary, Dr. Vanita Kumar, Dr. Sharda Dawan, Dr. Qadir Fatima, Dr. Neelu Gupta ##submission.copyrightStatement## Fri, 14 Jun 2019 12:53:05 -0500 STUDY OF SERUM LIPID PROFILE LEVEL IN CORONARY ARTERY DISEASE PATIENTS <p><strong>Background</strong>: Adverse lipid profile has been recognized as an independent risk factor for atherosclerosis and coronary artery disease (CAD).</p> <p><strong>Materials and Methods</strong>: 100 subjects aged between 35 to 65 years, comprising of 50 normal control and 50 patients suffering from CAD were studied.</p> <p><strong>Result</strong>: The mean total cholesterol level was found to be 174.2±21.05 mg/dl with a range of 150-200 mg/dl present in normal subjects and mean concentration of cholesterol level was increased to 254.23±45.70 mg/dl in CAD patients. The mean Triglyceride level was found to be 117.58±44.16 mg/dl with a range of 75-150 mg/dl present in normal subjects and mean concentration of Triglyceride level was increased to 184.24±42.02 mg/dl in CAD patients. &nbsp;</p> <p><strong>Conclusion</strong>: This cross sectional study showed that high serum cholesterol, LDL, triglyceride and low HDL cholesterol were clinically significant in all the age groups.</p> <p><strong>Keywords:</strong>&nbsp; Coronary artery disease (CAD), Cholesterol, Triglyceride, LDL, HDL.</p> Shesharam Patel, Kanaram Patel ##submission.copyrightStatement## Fri, 14 Jun 2019 13:55:47 -0500 ANALYSIS OF CERVICAL PAP SMEARS AS PER BETHESDA SYSTEM IN A TERTIARY CARE CENTRE. <p><strong>Background:</strong> The value of exfoliative cervical cytology is undisputed today.&nbsp; Most studies focus on the application of pap smears to detect precancerous and cancerous lesions but pap smears are also significant in detecting inflammatory lesions and etiology wherever possible which can help the clinician in the management and prevent further dysplasias.</p> <p><strong>Aim &amp; Objectives: </strong>To find out the prevalence of various non-neoplastic and neoplastic lesions of cervix as per the Bethesda system 2014 and to find out the etiology of inflammation wherever possible.</p> <p><strong>Methodology: </strong>This study was conducted over a period of one year from January 2017 to January 2018. 1518 pap smears received in the Department of Cytology were stained with pap stain &amp; reported according to 'The 2014 Bethesda System for reporting cervical cytology'.</p> <p><strong>Results</strong><strong>:</strong> 1518 pap smears were screened in which 28 (1.8%) smears were unsatisfactory for evaluation and 1490 (98.2%) were satisfactory. NILM was the predominant finding seen in 1473(98.86%) smears. Among the specific infections, the most common was bacterial vaginosis in 128 (8.59%) smears, trichomonas vaginalis in 10 (0.67%), candida infection in 7 (0.47%) smears and 26 (1.75%) smears showed reactive changes associated with inflammation. Atrophic changes were found in 50 (3.36%) cases. Epithelial cell abnormalities were seen in 17 (1.17%) cases in which 9 (0.6%) cases were reported as ASCUS, 2 (0.13%) cases as LSIL and HSIL was seen in 1 (0.07%) case. Squamous cell carcinoma (SCC) was diagnosed in 4 (0.27%) cases and Adenocarcinoma in 1 (0.07%) case.</p> <p><strong>Conclusion:</strong> Cervical cytology is a simple and cost effective test and should be established as a routine diagnostic aid.</p> <p><strong>Keywords:</strong> Atypical squamous cells of undetermined significance (ASCUS), Bethesda System, High grade squamous intraepithelial lesion (HSIL), Low grade squamous intraepithelial lesion (LSIL), Negative for intraepithelial lesion or malignancy (NILM),&nbsp; Papanicolaou smears.</p> Dr. Arpita Ajmera, Dr. Mohini Kucheria, Dr. Vivek Kathed, Dr. Taiba Farooque, Dr. Nidhi Sharma, Dr. Sushma Chourasia ##submission.copyrightStatement## Sat, 15 Jun 2019 00:47:37 -0500 TO COMPARE THE MORBIDITY AND MORTALITY PATTERN OF LATE PRETERM AND TERM NEONATES. <p>This is a hospital based prospective observational study, carried out at Gajara Raja Medical College, Gwalior. All the inborn late preterm babies have been included in the study. Selection of late preterm neonates is done by determination of gestational age.</p> <p>In our study Neonatal convulsions were more common among the late preterm neonates as compare to term group.</p> <p>In our study jaundice, septicemia, respiratory distress and hypoglycemia were found as major morbidities, among late preterm the rate was found to be 9%,7.8%,7.6% and 6% respectively while in term group the rate was 3.34%, 3.38%, 3.41% and 2.56% respectively. Occurrence of these morbidities among late preterm neonates as compared to term group is at higher aspect.</p> <p><strong>Keywords: </strong>Morbidity, Mortality, Preterm, Term &amp; Neonates</p> Dr. Gunwant Singh Eske, Dr. Rashmi Ekka Dehariya ##submission.copyrightStatement## Sat, 15 Jun 2019 02:31:14 -0500 UNDIAGNOSED OTITIS MEDIA WITH EFFUSION IN CHILDREN: INCIDENCE & EFFECT <p><strong>Background-</strong>Otitis media with effusion leads to hearing loss which may significantly compromise the cognitive, linguistic and emotional development of children. It usually goes undiagnosed because the children do not have any complaints and the next of kin do not notice any symptoms such as hearing loss.</p> <p><strong>Methods-</strong>411 children of the age group 5-8 years from various camps conducted in sub-urban areas of Ajmer, Rajasthan were subjected to complete ear, nose throat examination in the period of June 2018 to December 2018.27 children were excluded on the basis of exclusion criteria and 384 children were then considered for the study. Hearing assessment was done by tuning fork test &amp; those who had a hearing loss were than subjected to pure tone audiogram and tympanometry at our center. An interview was done with the parents of these children to acquire information about the academic and social behavior of these children with the help of a questionnaire.</p> <p><strong>Results</strong>- 89 (21.30%) children were suffering from otitis media with effusion and 26 (6.77%) children had Eustachian tube blockage which is a precursor to otitis media with effusion. Almost all of these children were poor in social and academic performance.</p> <p><strong>Conclusion</strong>- The high incidence of undiagnosed otitis media with effusion warrants an awareness program for parents and teachers and also if possible a regular screening program for children.</p> <p><strong>Key words:</strong> otitis media with effusion, serous otitis media, conductive hearing loss.</p> Dr. Sudeep Choudhary, Dr. Payal Verma, Dr. B K Singh ##submission.copyrightStatement## Sat, 15 Jun 2019 11:49:39 -0500 ASSESSMENT OF FLOW MEDIATED DILATATION OF BRACHIAL ARTERY BY ANGIODEFENDER DEVICE AS COMPARED TO BRACHIAL ARTERY ULTRASOUND IMAGING. <p><strong>Aims &amp; Objectives</strong>: To demonstrate, Angiodefender device, is comparable to “Brachial artery ultrasound imaging” (BAUI) in their abilities to quantify percentage flow mediated vasodilation (FMD) of the brachial artery. <strong>Methods</strong>: Study was conducted on 100 patients, flow mediated vasodilation was measured by BAUI as well as by the Angiodefender device and the results were compared.</p> <p><strong>Results</strong>: The mean %FMD measured by the BAUI was found to be 7.46 ±&nbsp; 4.21 whereas mean %FMD measured by the Angiodefender was 8.24 ±&nbsp; 2.46, (p value 0.113). Positive correlation was found between both the tests with correlation coefficient of 0.65, p value &lt; 0.0001 which is highly significant.</p> <p><strong>Conclusion</strong>: Results obtained by both the methods were comparable there was no significant statistical difference. Positive correlation was highly significant between both the tests with correlation coefficient of 0.65.</p> <p><strong>Keywords:</strong> Brachial artery ultrasound imaging, Angiodefender, Flow mediated vasodilation</p> Mukesh Kumar Sharma, Chandra Bhanu Chandan, Abhishek Shukla, Deepak Ameta, Pradeep Kurmi ##submission.copyrightStatement## Mon, 17 Jun 2019 01:27:44 -0500 CYTODIAGNOSIS OF HEPATIC LESIONS AND THEIR ASSOCIATION WITH SERUM ALPHA FETOPROTEIN LEVELS <p>Background: Liver is a common organ for lodgement of various infections and metastasis from other parts of body. Fine needle aspiration cytology (FNAC) plays a major decisive diagnostic role and combined with USG diagnostic accuracy is 90-95% minimizing the need of biopsy. An increased in serum AFP concentration has been observed in Hepatocellular Carcinoma (HCC) and is an important serum tumor marker. Methods: The present study was done, with the aim of studying the cytomorphological features of hepatic lesions and their association with serum Alpha Fetoprotein (AFP) levels. Study was conducted on 56 patients who underwent USG guided FNAC for diagnosis of liver lesions. Cytomorphological pattern of liver lesions were studied and serum AFP levels of the same cases were measured. Results: Maximum number of cases was in age group of 61-70 years. Male: Female ratio was 1.4:1. 82.1% cases were malignant. Most common malignancy was Metastatic deposits of Adenocarcinoma (MDA). HCC was diagnosed in 5.4% cases. Serum AFP levels in HCC were 459.93 ± 41.69 ng/mL.15.4 % of the cases of MDA and 8.3% of the cases of Metastatic deposits of Poorly Differentiated Carcinoma (MDPDC) showed raised serum AFP levels. Association between cytodiagnosis and serum AFP range was statistically significant. Sensitivity=100%, specificity=81.4%, PPV=27.3% and NPV= 100% were obtained when serum AFP was used to differentiate metastatic lesions with HCC taking &lt; 8.5ng/mL as cut off. Conclusion: USG guided FNAC of the liver is a rapid, reliable and economical screening test. Serum AFP has been the most widely used tumor marker for diagnosing HCC but raised levels are also seen in other hepatic lesions decreasing its specificity.</p> <p><strong>Keywords:</strong> Liver, FNAC, Serum Alpha fetoprotein levels</p> Sehgal Tamanna, Kusum Anuradha, Ahuja Vivek ##submission.copyrightStatement## Tue, 18 Jun 2019 00:01:48 -0500 AN EPIDEMIOLOGICAL STUDY OF DRUG RESISTANT TUBERCULOSIS CASES REGISTERED UNDER DOTS PLUS CENTER IN A RURAL BASED TERTIARY CARE HOSPITAL <p>Background: Drug resistance in tuberculosis is a global problem and India is no exception to this. However, this rise is mainly among the previously treated cases as previous antituberculosis therapy is the single most important risk factor for the development of drug resistance. The worldwide prevalence of drug resistant tuberculosis is on the rise and multiple studies give varying data regarding the epidemiology of drug resistant tuberculosis. This study was taken up to determine the demographic profile of a patient, previous history of anti tubercular drug intake and pattern of drug resistant.</p> <p>Design: Prospective observational study.</p> <p>Methods and Materials: Patient who are Sputum positive, diagnosed drug resistant tuberculosis and fulfill the inclusion and exclusion criteria, admitted from March 2015 February 2016 in DOTS PLUS centre, BMCH, Burdwan. To accomplish the objectives, information was collected by personal interviews using pre-designed, pre-tested proforma. Data, so collected, was analyzed and tabulated using appropriate statistical software.</p> <p>Results: More than 2/3rd were males and majority were in age group 18-55 years, educated up to primary level, living in overcrowded and ill-ventilated houses belongs to upper lower and lower class (IV &amp; V) on Kuppuswamy‘s SES 2014. Initially almost all had pulmonary TB. At the start of category II, maximum number of patients was relapse cases. The prime cause being financial crunch and lack of knowledge. Resistance to both rifampicin and isoniazide (MDR) was found in more than 2/3rd of cases. 3 patients (3%) were reactive for HIV in the study.</p> <p>Conclusion: In general even after considering so many diversified variables it could be stated that most of the patients perceived some degree of improvement in their condition following treatment.</p> Dr. Manish Kumar Munda, Dr. Niranjan Kumar Sit, Dr. Rupam Kumar Ta, Dr Santanu Ghosh ##submission.copyrightStatement## Tue, 18 Jun 2019 09:07:48 -0500 The THE ENHANCED LIVER CIRRHOSIS TEST (ELF) ACCURATELY IDENTIFIES CIRRHOSIS IN PATIENTS WITH CHRONIC LIVER DISEASE <p>Chronic liver disease (CLD) is the leading cause of death worldwide. That caused by Viral Hepatitis B and C (HBV, HCV), Alcoholic Liver Disease (ALD) and Non-Alcoholic Fatty Liver Disease (NAFLD). The present article provides an overview of the literature reporting some relevant biomarkers (ELF test) that have been found to be associated with liver fibrosis and that potentially may be used to predict the onset and/or monitor the progression of liver cirrhosis alternative the liver biopsy. This article provides an overview of the current published evidence on the clinical utility of the ELF test. This review collects the main evidence on the emerging role of Enhanced Liver Fibrosis (ELF) score as a prognostic marker of hepatitis, cirrhosis, and other liver diseases as the marker in cases of intoxication with organ phosphorus compounds and myocardial infarction or acute infections, and evidence that proves to use the Enhanced Liver Fibrosis as clinical practice presents an attractive alternative to both biopsy and imaging modalities that require significant high costs, also trained clinician.The most recent study proves that enhanced liver fibrosis score can be used instead of liver biopsy test and Transient Elastography for diagnosing liver fibrosis.</p> <p><strong>Keywords:</strong> Enhanced Liver Fibrosis Score, Transient Elastography, Liver, Liver Biopsy, Liver Diseases Alcoholic Liver Disease (ALD) and Non-Alcoholic Fatty Liver Disease (NAFLD).</p> Abdulrahman Hefdhallah Amer, Dr. Hitesh N Shah ##submission.copyrightStatement## Mon, 17 Jun 2019 00:58:32 -0500