International Journal of Medical and Biomedical Studies 2019-10-19T14:01:36-04:00 Innovative Library Open Journal Systems <p>&nbsp;</p> <p style="text-align: justify;">&nbsp;<img src="/public/site/images/ijmbseditor/nlm.jpg">&nbsp;&nbsp;<img src="/public/site/images/ijmbseditor/ICMJE_newsitem-e1514876485808.jpg" width="224" height="140">&nbsp;&nbsp;<img src="/public/site/images/ijmbseditor/icv1.jpg" width="204" height="136"></p> <p style="text-align: justify;">&nbsp;&nbsp;&nbsp;<strong><a title="|| Pub-Med NLM ID (URL) ||" href="" target="_blank" rel="alternate noopener noreferrer">|| Pub-Med NLM ID (URL) ||</a></strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;<strong><a title="" href="" target="_blank" rel="noopener">&nbsp;ICMJE (URL)||</a></strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; <strong><a title="Index Copernicus Value 2017: 40.03" href="" target="_blank" rel="noopener">&nbsp; &nbsp;||ICV&nbsp;(URL)||&nbsp;</a></strong></p> <p style="text-align: justify;">&nbsp;</p> <p style="text-align: justify;"><span style="text-align: justify; 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> PREVALENCE OF APPENDICULAR CARCINOID TUMOUR IN NORTH WEST RAJASTHAN: A TWO YEARS RETROSPECTIVE STUDY AT OUR INSTITUTE 2019-10-19T14:01:36-04:00 Nidhi Binnani Mradul Varshney Vanita Kumar S.P. Vyas Qadir Fatima <p><strong>Background: </strong>Carcinoid tumours are rare incidental finding in appendicectomy specimens<strong>. </strong>&nbsp;Appendiceal carcinoid tumours are found in 0·3–0·9 per cent of patients undergoing appendicectomy<strong>.</strong></p> <p><strong>Methods:</strong> The medical records of all the patients who underwent consecutive appendectomies and the specimen sent to pathology department for biopsy in Sardar Patel Medical College, Bikaner, were retrospectively analysed. Detailed medical history was noted age, gender, indication for surgery, surgical procedure, tumour localization in the appendix, diameter of the lesion after fixation with formaldehyde, and overall incidence of tumour reviewed in detail</p> <p><strong>Results:</strong> Out of the total 1382 patients, 2 (0.15%) were found to have histological evidence of carcinoid tumour of the appendix. Both were male patients with a mean age of 26.5 years (range: 13-40 years). Acute appendicitis was the clinical presentation for both patients. Open appendectomy was performed in one and laparoscopic in other one. Histologically, all tumours were located at the tip of the appendix with a mean diameter of 0.7cm (range: 0.6-0.8 cm).</p> <p><strong>Conclusion: </strong>Carcinoid tumours of the appendix are extremely rare and invariably remain asymptomatic and are mostly discovered incidentally for appendicectomy done for other reasons, mostly acute abdomen. Carcinoid Tumour was diagnosed on histological examination of the removed appendix. The site and the size of the tumours rather than the depth are used for the assessment of the CT.</p> <p><strong>Keywords: </strong>Carcinoid Tumour, Acute Appendicitis, Neuroendocrine Tumours</p> 2019-10-06T09:51:35-04:00 ##submission.copyrightStatement## AWARENESS AND USE OF ANTIBIOTICS AMONG JORDANIAN MOTHERS FOR TREATING UPPER-RESPIRATORY-TRACT INFECTIONS 2019-10-19T14:01:35-04:00 Amjad Alhelo Bashar Samara <p><strong>Aim</strong>: We sought to evaluate the awareness and use of antibiotics among Jordanian mothers for treating upper-respiratory-tract infections.</p> <p><strong>Methods</strong>: A cross-sectional design was used for this research, involving a questionnaire sent to 300 Jordanian mothers by the Internet who was selected from a Face book group. Two hundred seventy responded; their ages were between 23 and 47 years old. The questionnaire measured respondents’ awareness and use of antibiotics in treating upper-respiratory-tract infections in their children.</p> <p><strong>Results:</strong> A large number of participant mothers did ask physicians to prescribe antibiotics for their children. Most mothers also used antibiotics even without prescription and without differentiating between viral and bacterial infections, despite antibiotics only being useful in the latter. A significant number of mothers thought that antibiotics improved their children’s symptoms.</p> <p><strong>Conclusion:</strong> Jordanian mothers cannot differentiate between bacterial and viral infections and did not use antibiotics properly. National campaigns are needed to support a positive public attitude toward the usage of antibiotics.</p> <p><strong>Keywords</strong>: knowledge, antibiotics, mother, children</p> 2019-10-07T04:03:01-04:00 ##submission.copyrightStatement## ETIOLOGY AND PREVALENCE OF URINARY TRACT INFECTIONS AMONG PREGNANT WOMEN IN A TERTIARY CARE HOSPITAL IN KOTA REGION 2019-10-19T14:01:35-04:00 Dr. Naveen Saxena Dr. Anita Sharma Dr. Ghanshyam Soni Dr. Saurabh Sharma <p><strong>Background</strong>: UTI’s are more common during pregnancy because of changes in the urinary tract and has been reported among 20% of the pregnant women with significant reason for hospital admission. It has several adverse outcomes not only on the mother but also on the fetus like chronic renal failure, pyelonephritis, preeclampsia, anemia, fetal mortality and premature delivery.</p> <p><strong>Patients and methods: </strong>The aim of this study was to determine the prevalence and etiologyof UTI among 120 pregnant women attending the ANC of GMC Kotaduring the study period from January 2017 to June 2017.UTI was diagnosed by growth of at least 10<sup>5</sup> CFU/ml of a urinary tract pathogen in a culture of a midstream urine sample. The isolated bacteria were identified by biochemical tests.</p> <p><strong>Results: </strong>Of the 120 urine samples examined in this study,34 (28.33%) were found to contain significant bacteriuria. Of the variables examined, Highest prevalence was observed in 21-25 years age group (50%), multipara (44.11%), and in 3<sup>rd</sup> trimester (55.88%). The bacterial pathogens isolated were most commonly <em>Escherichia coli </em>(55.88%), <em>Klebsiella sps</em>(20.6%), <em>Pseudomonas sps</em>(8.82%), <em>Proteus sps</em>(5.88%), <em>Enterobacter sps</em>(5.88%), <em>Enterococcus sps</em>(2.94%).</p> <p><strong>Conclusion: </strong>The prevalence rate of urinary tract infection (UTI) during pregnancy is high. So it is important to do routine screening of all pregnant women for significant bacteriuria to reduce the complications on both maternal and fetal health. The study also recommends health education on personal sanitary hygiene.</p> 2019-10-07T04:25:54-04:00 ##submission.copyrightStatement## EFFECT OF TIME ON THE ARTERIAL BLOOD GAS ANALYSIS 2019-10-19T14:01:35-04:00 Hitesh Shah Bhavika Patel <p>The present study was done to find out whether there is any change occurring during delay in ABG analysis. In our study we first took baseline reading and from the remaining blood sample, stored at room temperature, repeat analysis were done from it after 30minute, 60 minute and after 90 minute and the change in result is compared with the baseline result. In our study if the sample is stored for more than 30 minutes at room temperature&nbsp; there is no significant changes occurs in pH, PCO<sub>2</sub>, but there is significant change in the PO<sub>2</sub>. The value of PO<sub>2</sub> increase 20.23 mmHg if the sample is stored for more than 30 minutes at room temperature. In our study although the changes in pH, PCO<sub>2</sub> are statistically greater in sample kept at room temperature, those changes do not appear to have major clinical significance until the time of analysis after arterial puncture exceeds 90 minutes. The PCO<sub>2</sub> remained very stable with the different sampling methods. In our study there is no significance change found in Hco<sub>3</sub><sup>- </sup>and O<sub>2</sub>sat if sample is stored for more than 30 minutes at room temperature.</p> <p><strong>Keywords: </strong>ABG analysis; PCO<sub>2 </sub>; pH; Arterial puncture; ABG analyzer</p> 2019-10-07T04:54:02-04:00 ##submission.copyrightStatement## A STUDY ON PREVALENCE OF PTERYGIUM IN A TERTIARY PRIVATE TEACHING HOSPITAL 2019-10-10T04:57:09-04:00 Dr. Rajani <p><strong>Introduction:</strong> Exact etiology and pathogenesis of pterygium remains unclear, but it is more common in people with excessive outdoor exposure to sunlight and wind, such as those who work outdoors.</p> <p><strong>Materials &amp; Methods:</strong> To analyze the epidemiology and prevalence of pterygium in a hospital-based study in Department of Ophthalmology, Fathima Institute of Medical Sciences, Kadapa. The study period was from May 2017 to April 2018. 50 study subjects with pterygium were studied.</p> <p><strong>Results:</strong> A cross-section hospital-based, observational study was conducted. Among the study subjects the maximum prevalence were from ≥60 year age group (36%), followed by 40-60 year age group (34%).</p> <p><strong>Keywords: </strong>Prevalence, Pterygium, Kadapa</p> 2019-10-10T04:57:09-04:00 ##submission.copyrightStatement## STUDY OF RENAL FUNCTION TEST IN CHILDREN WITH MALARIA 2019-10-10T05:18:48-04:00 Dr. Abender Singh Maanju Dr. K C Verma <p><strong>Background: </strong>Malaria is a disease of global importance having effect on more than ninety countries and territories in the tropical and subtropical region of earth. Objectives: This study was undertaken to assess the renal functions in children with malaria.</p> <p><strong>Methods</strong>: Sixty children with smear positive malaria were included in this study. Detailed history regarding main renal manifestations was obtained. Renal function was assessed by gfr, blood urea and serum creatinine. It is compared with 25 age and sex matched healthy controls.</p> <p><strong>Results: </strong>proteinuria was documented in 42% of cases and it was common with falciparum infection. blood urea and serum creatinine were significantly high in malaria cases compare to controls.</p> <p><strong>Conclusion: </strong>The evaluation of renal functions in malaria infected children should form an important part of assessment because of variety of acute onset renal dysfunction. In addition it may facilitate safer use of fluids and drugs study also showed that renal dysfunction found in human malaria.</p> <p><strong>&nbsp;</strong></p> <p><strong>Keywords: </strong>Acute renal failure, acute respiratory distress syndrome, glomerularfilteration rate.</p> 2019-10-10T05:18:48-04:00 ##submission.copyrightStatement## THE EFFECTIVENESS OF WATER FILTERS WITH ACTIVATED CARBON MEDIA OF BAGASSE SUGARCANE FOR REDUCING IRON LEVELS IN GROUNDWATER 2019-10-10T11:26:45-04:00 Zulfia Maharani N. Budi Santoso Amelia Anggraini Ismi Rajiani <p><strong>Background</strong>: Clean water supply can be obtained from various sources, both groundwater and surface water. Groundwater often contains high levels of iron (Fe). Many residents are forced to use water which in terms of quality does not meet the requirements, one of which is the chemical elements in the form of high iron content which can cause diarrhea, anemia, kidney damage that ends in death.</p> <p><strong>Methods</strong>: This research is an experimental study to determine the effectiveness of bagasse activated carbon thickness in reducing iron (fe) levels in groundwater in Kebon Jeruk district, west Jakarta. This research was conducted at the workshop of environmental health department of health polytechnic of the ministry of health Jakarta. The water sample used was 45 liters, samples from electric pump wells treated with sugarcane bagasse activated carbon filtration with a thickness variation of 0 cm as control or without activated carbon bagasse, 30 cm, 45 cm, 60 cm, and 75 cm.</p> <p><strong>Result</strong>: results of chemistry laboratory research at the department of environmental health polytechnic of the ministry of health Jakarta on the content of iron (fe) in groundwater, iron content (fe) before processing by filtration method using bagasse pulp activated carbon as much as 2.99 mg / l against allowable iron (fe) levels for clean water quality requirements based on ministry of health regulation no. 32 in 2017, the maximum allowable content of 1.0 mg / l.</p> <p><strong>Conclusion</strong>: of the five treatments the most effective thickness of activated carbon reduces iron (fe), is at a thickness of 45 cm because it has been able to reduce iron levels below the maximum allowable level based on ministry of health regulation no. 32 in 2017 which is 1.0 mg / l.</p> <p><strong>Keyword: </strong>Water Treatment, Sugar Cane Bagasse, Fe Reduction, Environmental Health, Environmental Chemistry</p> 2019-10-10T11:26:45-04:00 ##submission.copyrightStatement## NON-ADHERENCE TO TREATMENT AMONG SCHIZOPHRENIC PATIENTS 2019-10-11T04:50:22-04:00 Rameshwar S Manhas Angli Manhas Rukhsana Akhter Jagdish R Thappa Gaurav S Manhas <p><strong>Background:</strong> One of the frequent problem in schizophrenic patients is non adherence to treatment which can be partial or complete<sup>7</sup> and can leads to poor clinical outcomes. Non adherence to antipsychotic medications can lead to increased episodes of violent behavior, exacerbation of psychotic symptoms, increased rates of suicidal/homicidal behavior and resistance to drugs.</p> <p><strong>Aims:</strong> To find prevalence of non adherence to treatment in schizophrenic patients.</p> <p><strong>Materials &amp; Methods: </strong>This is an observational, cross-sectional study which was conducted over a period of two months, on schizophrenic patients attending the outpatient department (OPD) of tertiary care hospital, Jammu. After meeting inclusion and exclusion criteria, total of 131 patients were selected for the study. Various parameters like age, sex, education, marital status etc were collected. A patient is said to be non adherent if he takes less than 80% of prescribed medication or have gaps in medication of at least 7 days.</p> <p>&nbsp;<strong>Results:</strong> 64.9% schizophrenic patients were non adherent to their treatment. Prevalence of non adherence was higher in those schizophrenic patients who were males, unmarried, uneducated, unemployed, from rural areas, below 20 years of age and belongs to lower socioeconomic status whereas it was high in those who had parents as their caretakers.</p> <p><strong>Conclusion:</strong> In the present study it is concluded that the prevalence of non adherence among schizophrenic patients is high which may hamper treatment outcome, worsens the prognosis of the disease and produces excessive burden on the caretakers of these patients. Hence it is suggested that in addition to providing treatment to these patients, necessary initiatives must be taken by health care professionals to prevent relapses of symptoms by maintaining treatment compliance.</p> <p><strong>Keywords</strong>: Non Adherence, Prevalence. Schizophrenia</p> 2019-10-11T04:50:22-04:00 ##submission.copyrightStatement## EFFICACY AND CORRELATION OF INTRAOCULAR PRESSURE MEASURED BY NON-CONTACT, REBOUND AND GOLDMANN APPLANATION TONOMETER WITH CORNEAL THICKNESS, TRUE IOP AND CORNEAL CURVATURE IN A TERTIARY HOSPITAL. 2019-10-11T05:33:36-04:00 Santanu Das Nayana Nagesh Kiran Kumar L Sundeep Shetty <p><strong>ABSTRACT:</strong></p> <p><strong>AIM</strong>-To compare the intraocular pressure (IOP) measured by Non-Contact tonometer (NCT), Rebound tonometer (RBT) and Goldmann Applanation tonometer (GAT) and their correlation with central corneal thickness (CCT), true IOP and corneal curvature.</p> <p>Reliability of each tonometer.</p> <p><strong>METHODS</strong>-500 random patients aged 18 years and above were taken up for the study. Patients with anterior and posterior segment pathologies like corneal ulcer, leukoma, staphyloma, corneal lacerations, ectatic corneal conditions, corneal dystrophies, oedema, perforations, acute angle closure glaucoma, retinal detachments, vitreous haemorrhage and unwilling patients were excluded from the study. IOP was recorded using NCT, RBT and GAT after assessing the patient's visual acuity. Following IOP measurement, central corneal thickness (CCT) of each patient was measured using pachymetry. Kvalues were measured using an autorefractometer. All the data were collected and tabulated for statistical analysis to obtain results.</p> <p><strong>RESULTS</strong>: The mean CCT in males was 0.5350 mm and in females 0.5340 mm respectively. The mean IOP measured by NCT is 16.43 mm hg whereas the mean IOP measured by GAT is 15.43 mm hg. IOP measured by NCT is significantly higher than the IOP measured by GAT (p&lt;0.001). When NCT and RBT are compared NCT values are significantly higher than that of RBT(p&lt;0.001). Although the mean RBT IOP 15.83 mm hg is higher than the mean GAT IOP of 15.42 mm hg the values are not statistically significant. When correlated with CCT all the tonometers showed significant correlation with GAT showing the strongest correlation. NCT overestimates IOP in normal, thin and thicker corneas when compared to GAT and are statistically significant. RBT also overestimates in the normal and thick corneas when compared to GAT but their values are much closer to GAT values in thinner corneas. The IOP measured by all the 3 tonometers correlated with corrected IOP with NCT showing the best correlation followed by GAT. There was no significant correlation between K and IOP in our study.</p> <p><strong>CONCLUSION</strong>-From the present study we can conclude that IOP measured by NCT and RBT is higher than GAT. NCT values are significantly higher than GAT values in thin and normal corneas whereas it overestimates more in thicker corneas. RBT values are significantly higher than that of GAT in normal and thick corneas. All the tonometers show significant correlation with CCT with GAT showing the strongest correlation. So, it is always advisable to measure the corrected IOP for each patient after considering the CCT.</p> <p><strong>Keywords</strong>- Non-contact tonometer; Goldmann applanation tonometer; central corneal thickness; intraocular pressure; Rebound tonometer, true IOP, Corneal curvature.</p> <p><strong>&nbsp;</strong></p> 2019-10-11T05:31:17-04:00 ##submission.copyrightStatement## POLYPHARMACY IN HOSPITALIZED GERIATRIC PATIENTS IN A TERTIARY CARE HOSPITAL – A PROSPECTIVE STUDY 2019-10-12T04:52:35-04:00 CH. Krishna Vamsi A. Sushmitha P. Supriya A. Rajani G. Ravi <p><strong>Background:</strong> The current focus of research is on polypharmacy and the presence of unnecessary medications in the treatment and also the cost of the unnecessary medications.</p> <p><strong>Objectives:</strong> To find out the prevalence of polypharmacy in geriatric patients, reasons for unnecessary drug therapy, the cost of unnecessary drug therapy and to check the quality of life of the patients.</p> <p><strong>Methodology:</strong> A total of 200 patients were included and the study was conducted in the department of General Medicine. The participants enrolled in the study involve inpatients only after filling a properly written informed consent. The data is collected in a pre-designed data collection form.</p> <p><strong>Results: </strong>The study showed that of the 200 cases collected, 54% were female patients most of them falling under the age group of 60-65yrs. Of the 200 patients 43.5% received more than 5 drugs per prescription. The reason found for unnecessary drug therapy is therapeutic duplication with mostly prescribed class of drug as Antibiotics. Total expense of unnecessary drug therapy is equal to INR.21.641.</p> <p><strong>Conclusion:</strong> Prevention of unnecessary drug therapy problem can be conducted through reduction of drug use. It is recommended to eliminate all medications without therapeutic benefit, goal or indication. Prevention of unnecessary drug therapy will also contribute in cost saving among elderly patients.</p> <p><strong>Keywords: </strong>Polypharmacy, Unnecessary medications, Geriatric population, Cost saving.</p> 2019-10-12T04:52:35-04:00 ##submission.copyrightStatement## Serum Ceruloplasmin levels in Type 2 Diabetes mellitus – Assessing the cardiovascular risk 2019-10-17T08:55:46-04:00 S. Sakthi Indra Dr. N. Sivaranjani Dr. K. Rajalakshmi Dr. S. Birundha Dr. A. Balasubramanian <p>Type 2 diabetes mellitus is an endocrinological disease associated with hyperglycemia characterized by both insulin resistance and defective insulin secretion. Cardiovascular diseases are the peak reason for mortality in India, highest rate seen in Tamil Nadu state, from the age of 25 to 69 years. Many studies have revealed the importance of inflammatory pathway playing a pivotal role in the development and progression of diabetic complications. Ceruloplasmin, a copper containing mettalo-enzyme having antioxidant property (e.g ferroxidase activity) is an ideal marker to know the cardiovascular status, glycemic status, dyslipidemia and cancer risk. The purpose of the present study was to evaluate the effects of Body Mass Index (BMI) and Ceruloplasmin levels on the incidence of cardiovascular diseases in Type 2 Diabetes mellitus patients. Fasting Blood glucose, lipid profile which includes serum triglyceride, total cholesterol, LDL, VLDL, HDL and serum ceruloplasmin were investigated using fully automated chemistry analyzer. Diabetic patients were segregated into three groups based on their BMI, which was correlated with inflammatory marker ceruloplasmin to assess the cardiovascular risk. The mean value and standard deviation of ceruloplasminin controls (n=60) and diabetic cases divided into normal weight, over weight and obese (n=20 each) were 38.3±8.45, 36±7.99, 33.2±3.57and34.2±6.24 mg/dl respectively.&nbsp; Ceruloplasmin among the cases and controls were not statistically significant. Serum ceruloplasmin levels and BMI showed no correlation among the group 1 diabetic cases and was not significant (p=0.29), among the group 2diabetic cases it showed weak correlation and was not significant (p=0.85), and it also showed no correlation among the group 3 diabetic cases and was not significant (p=0.65).This study revealed no significant association between serum ceruloplasmin level and BMI in all diabetic group subjects separately.</p> 2019-10-14T11:42:49-04:00 ##submission.copyrightStatement## “LOCAL COMPLICATIONS OF PERIPHERAL INTRAVENOUS CHEMOTHERAPY – ANALYSIS IN CARCINOMA BREAST PATIENTS” 2019-10-15T09:22:36-04:00 Dr. Tushar M. Parmeshwar Dr. Dilip Gupta Dr. Rutuja Darokar <p><strong>Aims: </strong>To identify and record the local reactions at the site of IV cannula in women with carcinoma breast during peripheral intravenous chemotherapy treatment. To find out the incidence of these reactions and correlations with various factors.</p> <p><strong>Method</strong>- Prospective Observational Studywas done with evaluation of 559 individual peripheral intravenous chemotherapy cycles given in carcinoma breast patients from June 2013 to September 2015.</p> <p><strong>Results</strong>: 1 in every 5 carcinoma breast patients receiving peripheral intravenous chemotherapy developed local complications. (20.92% in adjuvant cases and 18.55% in neoadjuvant cases). Pain followed by induration and altered skin color were the most common complications. Extravasation was present in 6.44% cases.other complications commonly noted were tingling sensation in IV applied limb, edema, thrombophlebitis, cellulitis and ulcer. IV cannula application on ipsilateral site (in limb on side of breast cancer) is associated with RR=2.08. IV cannulation over the wrist have 1.57 times (RR=1.57) and multiple puncture attempts to secure IV cannula is associated with 1.97 times (RR=1.97) more risk of developing local complications following peripheral intravenous chemotherapy. Elderly age &gt;50yrs, small of large calibre IV cannula (no 18 G and No 24 G) have more local complications.</p> <p><strong>Conclusions: </strong>Occurrence of local complications after peripheral intravenous chemotherapy in carcinoma breast patient is common. Vigorous monitoring of patient with repeated and frequent examination of site of chemotherapy cannulisation must be done during the complete chemotherapy infusion process and detailed records must be kept at every stage. A generalised chemotherapy infusion guidelines and protocol should be established according to the hospital occurrence. Active Patients participation in monitoring is advised. More multicentre studies are required to create a data base of venous damage occurring following intravenous peripheral chemotherapy and to formulate standard guidelines and protocols to reduce the rate of complications. Precaution, and care during peripheral intravenous chemotherapy can prevent development of local complications and remove the need for surgical intervention for management of the complications, thus, reduce the hospital stay, additional diagnostic procedures and treatment, stress in the life of the patients' relatives, extra work load on the health personnel and economic loss accordingly.</p> 2019-10-15T09:22:36-04:00 ##submission.copyrightStatement## COMPARATIVE ASSESSMENT OF BIOCHEMICAL AND IMMUNOLOGICAL MARKERS IN TUBERCULOSIS 2019-10-16T23:49:44-04:00 Abhijit Ninghot Kanchan Mohod Mohd. Sameer Khan Azmat Kamal Ansari Satish Kumar <p><strong>Introduction: </strong>Pulmonary tuberculosis is major public health problem in developing countries like India.Millions of people have died from tuberculosis. Many times it is difficult to get sputum sample from the patients. Some tests lack specificity, some other lack sensitivity. Hence, there is need of precise and faster diagnosis for patients attending hospitals. In this study, we compared the detection potential of biochemical and immunological markers(ADA, LDH and Mycobacterium tuberculosis H<sub>37</sub>Ra ES-31 &amp; EST-6 antigens &amp; antibodies based ELISAs) in pulmonary tuberculosis.</p> <p><strong>Methods: </strong>50 pulmonary tuberculosis cases confirmed by sputum examinationfor acid fast bacilli (AFB) and 50 age and sex matched control subjects were included in this study.ADA &amp; LDH were estimated by using commercial kits. Tubercular antigens and antibodies were detected by ELISA method.</p> <p><strong>Results: </strong>SerumADA detected pulmonary tuberculosis with sensitivityand specificityof 94%. Sensitivity and specificity of serum LDH in detecting pulmonary tuberculosis was found to be 94% and 36% respectively.Serumtubercular antigens detected pulmonary tuberculosis with sensitivity and specificity of 88%. Sensitivity and specificity of serum tubercular antibodies in detecting pulmonary tuberculosis was found to be 80% and 90% respectively.</p> <p><strong>Conclusion: </strong>Adenosine deaminase has better detection potential over other markers in pulmonary tuberculosis.</p> <p><strong>Keywords: </strong>Adenosine deaminase, Lactate dehydrogenase, Tuberculosis antigen-antibody</p> 2019-10-16T23:49:44-04:00 ##submission.copyrightStatement## FUNCTIONAL OUTCOME FOLLOWING ANATOMICAL LOCKING COMPRESSION PLATE BY OPEN TECHNIQUE AND MINIMAL INVASIVE PERCUTANEOUS OSTEOSYNTHESIS (MIPO) TECHNIQUE IN MID SHAFT CLAVICLE FRACTURE 2019-10-17T03:01:55-04:00 Dr. Rahul Bade Dr. Sanjay S. More Dr. Divyang Parmar <p><strong>INTRODUCTION</strong>: Clavicle fractures are common injuries in adults, accounting for 5% of all fractures and 44% of all shoulder fractures. Furthermore, there is an increasing incidence of complex fracture patterns after high-energy trauma. Incidence in males is usually highest in second and third decade which decreases thereafter as per age. Clavicles mid shaft fractures have classically been treated non-operatively. However, factors including severity of displacement, degree of comminution, and greater than 2 cm of shortening have been reported in the literature to predispose patients to unsatisfactory outcomes with non-operative treatment. Minimally invasive surgery is increasingly being used for the treatment of mid shaft clavicle fracture. The two most commonly used implant are titanium elastic nail (TEN) and locking compression plate (LCP). Minimally invasive percutaneous plate osteosynthesis (MIPPO) is widely used for long bone fracture.</p> <p><strong>MATERIAL AND METHODS</strong>: The patients were selected randomly and were divided in the following two groups of 15 patients each:<strong> Group A:</strong> 15 patients treated by anatomical locking compression plate (LCP) by open technique.<strong> Group B:</strong> 15 patients treated by minimal invasive percutaneous osteosynthesis (MIPO) technique. Follow up period were 1 months, 2months and 6months. Functional outcome was evaluated using the constant shoulder score, which is scored from 0 to 100, with a lower score representing a higher level of functional disability.</p> <p><strong>RESULTS</strong>: Majority of the patients (40%) in Group A were in the age group of 31-40 years followed by 26.7% in the age group of 21-30 years, 20% in the age group 41-50 years and 13.3% in the age group of 51-60 years. The mean age of the patients was 36.2 ± 9.09 years. Majority of the patients in both groups were male. There were 80% and 73.3% male patients in Group A and Group B respectively whereas female patients constituted 20% and 26.7% of the study group respectively. In Group A, 7 (46.7%) patients had operative time of 80-100 minutes whereas 6 (40%) and 2 (13.3%) patients had operative time of 100-120 and 120-140 minutes respectively. The mean operative time was 104.9 ± 13.52mins. In Group B, 6 (40%) patients had operative time of 80-100 minutes whereas 8 (53.4%) and 1 (6.6%) patients had operative time of 100-120 and 120-140 minutes respectively. The mean operative time was 106.5 ± 11.72mins. There was no significant association between the groups as per Student t-test (p&gt;0.05).</p> <p><strong>CONCLUSION</strong>: Operative treatment with a LCP for clavicle shaft fractures can be used to obtain stable fixation. Particularly, MIPPO of displaced mid shaft clavicular fractures resulted in a better cosmetic than conventional open reduction, although the functional outcomes were no different between the two groups.</p> 2019-10-17T03:01:55-04:00 ##submission.copyrightStatement## A STUDY OF DORSAL SACRAL AGENESIS IN THE REGION OF EASTERN UTTAR PRADESH 2019-10-17T03:18:48-04:00 Dr. Fateh Mohammad Dr. Kamil Khan Dr. Md Tabrej Alam <p><strong>Background:</strong> Sacrum is a triangular shaped irregular bone formed by fusion of five sacral vertebrae. Sacrum is also called ‘Hieron osteon’ meaning the holy or sacred bone.</p> <p><strong>Methods:</strong> The present study has been carried out on 98 completely ossified undamaged dry human sacra of undetermined age and sex in the department of Anatomy in the population of Eastern Uttar Pradesh. Each sacrum is examined for the agenesis of the dorsal surface. Representative photographs of different sacrum having partial or complete agenesis on the dorsal surface are taken using a digital camera</p> <h3>Result: Elongated sacral hiatus i.e. length more than 40 mm was seen in 5 (5.1%) bones. Maximum sacral hiatal length of 52.6 mm was noted. Elongated sacral hiatus were of two types i.e. inverted U and inverted V shaped. 4 (4.08%) bones showed partial dorsal agenesis of sacrum. Complete dorsal agenesis was seen in 1 sacrum. One bones with absent sacral hiatus was seen.</h3> <h3>Conclusion: &nbsp;Various anomalies on dorsal surface of sacrum were seen in Indian population. Knowledge of these variations will be of help to the Anaesthetists. We conclude that, variant anatomy on dorsal surface of sacrum make administration of caudal epidural anaesthesia difficult. So ultrasound or fluroscopic guidance leads to better patient outcome while giving caudal blocks.</h3> <p><strong>Keywords:</strong>&nbsp; Dorsal sacral agenesis, sacral hiatus, caudal epidural block</p> 2019-10-17T03:18:47-04:00 ##submission.copyrightStatement## EVALUATION THE SIGN OF UNION, DURATION OF SURGERY AND POST-OPERATIVE SKIN COMPLICATION IN MID SHAFT CLAVICLE FRACTURE. 2019-10-17T03:33:44-04:00 Dr. Sanjay S. More Dr. Rahul Bade Dr. Divyang Parmar <p><strong>INTRODUCTION</strong>: It is impossible to support and immobilize a fracture of middle 3rd of clavicle in an adult by external means with figure-of-eight bandages. Clavicle fractures accounts for approximately 2.6% of all fractures in adults<sup>2</sup> 10% to 15% in children and comprise about 30 -40% of all shoulder girdle injuries and 5% fractures occurs in medial end. The goal of clavicle fracture treatment is to achieve bony union while minimizing dysfunction, morbidity, and cosmetic deformity. Definitive indications for acute surgical intervention include skin tenting, open fractures, the presence of neurovascular compromise, multiple trauma, or floating shoulder. Outside of these indications, the management of displaced fractures of the mid shaft (Edinburgh type 2B) remains somewhat controversial. Recent literature is challenging the traditional belief that mid- shaft clavicle fractures uniformly heal without functional deficit. &nbsp;</p> <p><strong>MATERIAL AND METHODS</strong>: Patients included were cases of mid shaft clavicle fractures. 30 patients with mid shaft clavicle fractures were included in the study.All patients above 18 years of age were included in the study falling into Robinson’s type 2 B1 (Mid shaft simple displaced and single butterfly fragment fracture), type 2 B2 (Mid shaft segmental fracture) classification. The patients were selected randomly and were divided in the following two groups of 15 patients each: <strong>Group A:</strong> 15 patients treated by anatomical locking compression plate (LCP) by open technique. <strong>Group B:</strong> 15 patients treated by minimal invasive percutaneous osteosynthesis (MIPO) technique. All patients were operated as early as possible once the patient was declared fit for the surgery by the physician. Open reduction and internal fixation with LCP was done.</p> <p><strong>RESULTS</strong>: A total of 30 patients were included in the study. In group A 15 patients treated by anatomical locking compression plate (LCP) by open technique and in group B 15 patients treated by minimal invasive percutaneous osteosynthesis (MIPO) technique. In Group A, 7 (46.7%) patients had operative time of 80-100 minutes whereas 6 (40%) and 2 (13.3%) patients had operative time of 100-120 and 120-140 minutes respectively. The mean operative time was 104.9 ± 13.52mins. In Group B, 6 (40%) patients had operative time of 80-100 minutes whereas 8 (53.4%) and 1 (6.6%) patients had operative time of 100-120 and 120-140 minutes respectively. The mean operative time was 106.5 ± 11.72mins. The mean duration for radiological union in Group A was 12.7 ± 4.61 weeks. Majority of the patients (60%) achieved radiological union in &lt;12 weeks while 6 (40%) patients achieved union in 12-24 weeks. In Group B, majority of the patients (66.7%) achieved radiological union in &lt;12 weeks while 5 (33.3%) patients achieved union in 12-24 weeks. The mean duration for radiological union in Group B was 12.1 ± 6.68 weeks.</p> <p><strong>CONCLUSION</strong>: MIPOs can used to preserve the biology at the fracture site, to maximise the healing potential of the bone, and to facilitate early and pain free recovery and MIPPO technique with the application of LCP offered an ideal combination in terms of bone fixation and soft-tissue sparing.</p> 2019-10-17T03:33:44-04:00 ##submission.copyrightStatement## TO STUDY THE INCIDENCE OF CONGENITAL HYPOTHYROIDISM IN BABIES WITH EXAGGERATED PHYSIOLOGICAL JAUNDICE 2019-10-17T09:44:24-04:00 Kalpesh Kumar Jain Manoj Agarwal <p>Background: Congenital hypothyroidism is well known cause of prolonged unconjugated hyperbilirubinemia and appears to be associated with the delayed maturation of hepatic uridine diphosphate glucoronyl transferase enzyme activity.</p> <p>Methods: This is a prospective, longitudinal and randomized study 100 babies are taken consisting of all newborn, age less than 28 days, admitted to hospital with exaggerated physiological jaundice.</p> <p>Results: One case of congenital hypothyroidism in exaggerated jaundice based on raised TSH levels. Rest of the cases (99%) having normal TSH levels. One case (1%) having TSH level of 48µu/ml on D7 of life indicating congenital hypothyroidism. TSB of this baby is 21.3 mg%.&nbsp; One baby is having TSH level of 30.4µu/ml on D3 of life which subsequently decreased to normal physiological limits on D7 of life.</p> <p>Conclusion: Though the present study is unable to make significant correlation between cause and effect relationship of neonatal exaggerated jaundice and congenital hypothyroidism, but as one case has diagnosed to be suffering from congenital hypothyroidism, TSH should be considered as a screening test for all babies suffering from exaggerated physiological jaundice besides the other predisposing factors responsible for causation of hypothyroidism.</p> <p><strong>Keywords:</strong> Neonatal hyperbilirubinemia, Preterm, Congenital hypothyroidism</p> 2019-10-17T09:44:24-04:00 ##submission.copyrightStatement## EVALUATION OF COMPLICATIONS OF PHACOEMULSIFICATION WITH PCIOL IMPLANTATION SURGERY 2019-10-18T11:21:21-04:00 Angli Manhas Rameshwar S Manhas Gaurav S Manhas Dinesh Gupta <p><strong>Background:</strong> Phacoemulsification is a state of the art surgery for cata­ract removal. From the simple procedure of couching practiced by sushruta to latest method of phaco emulsification of Charles kelman, cataract surgery had undergone a tremendous metamorphosis. Phacoemulsification is one of the most successful surgical procedures performed, and its popularity is due to decreased operating time and a shorter postoperative healing period. The objective of the study was to evaluate intraoperative and postoperative complications of phacoemulsification with PCIOL implantation surgery.</p> <p><strong>Materials &amp; Methods: </strong>The present prospective study was conducted over a period of 6 months on patients having visually significant cataract that presented to or were referred to ophthalmology Department, GMCH, Jammu and after getting admission underwent planned extracapsular cataract extraction by phacoemulsification with posterior chamber intraocular lens ( PCIOL) implantation. After meeting inclusion &amp; exclusion crieteria all the patients underwent complete examination as history, ocular examination, systemic examination and laboratory tests like haemoglobin etc.</p> <p><strong>Results: </strong>Out of 200, maximum numbers of patients were in age group of 41-50 i.e. 90 followed by 82 patients in 51-60yrs age group. Males were 112.Total of 148 patients were from urban area. Best corrected preoperative visual acuity of ≤6/36 was seen in 102 patients whereas 6th week postoperatively only 7 patients had visual acuity of ≤6/36. The final 6th week postoperative best corrected visual acuity of 6/12- 6/6 was found in 171 patients. Among intraoperative complications hyphaema &amp; constriction of pupil each were seen in 2 patients, followed by posterior capsule rent in 3 patients only while postoperatively mild uveitis was seen in 30 followed by striate keratopathy in 12 patients.</p> <p><strong>Conclusion:</strong> From present study, we may conclude that phacoemulsification with posterior chamber intraocular lens implantation is a good surgical tecqinique for cataract which can be performed safely with good visual outcome, with few intraoperative and postoperative complications in expert hands.</p> <p><strong>Keywords</strong>: Phacoemulsification , visual outcome, complications</p> 2019-10-18T11:21:21-04:00 ##submission.copyrightStatement## TO STUDY THE PRESENCE OF NEUROLOGICAL SOFT SIGNS IN CONTROL POPULATION AND TO COMPARE FINDINGS WITH PATIENT POPULATIONS. 2019-10-18T12:38:43-04:00 Dr. Ashutosh Singh Dr. Sudhir Kumar Dr. Anil Kumar Sisodia <p><strong>Background: </strong>The study was conducted at the Mental Health &amp; Hospital, Agra. It is a tertiary referral center and a postgraduate teaching hospital. The hospital has a wide catchments area which includes diagnosis of schizophrenia and bipolar affective disorder.</p> <p><strong>Result:</strong> The total number of neurological soft signs present in a subject. Schizophrenia group had the highest number of NSS (mean±SD= 10.43±4.13) then were the bipolar group (mean±SD= 5.63±3.46) and least number of NSS were in control group (mean±SD=1.03±1.73) i.e. bipolar group was intermediate between schizophrenia and control group in terms of total number of positive NSS. Results of one way ANOVA revealed significant group differences F (2, 87) =62.05, p&lt;.01. Games-Howell post hoc comparisons revealed significant differences in Schizophrenia vs Bipolar group (p&lt; .01), Schizophrenia Vs Control group (p&lt; .01) as well as in Bipolar Vs Control group (p&lt; .01) i.e. schizophrenia group had significantly higher number of positive NSS than bipolar and control group. Also bipolar group had significantly higher number of positive NSS than control group.</p> <p><strong>Conclusion:</strong> On various subscales of Neurological Evaluation Scale, schizophrenia patients differed from bipolar patients on all the subscale but not on the sequencing of complex motor acts subscale. Neurological Soft Signs are present even during the symptom free period and therefore they are not due to the effects of active illness. Hence, these Neurological Soft Signs in our study may represent a trait like abnormality in both schizophrenia and bipolar disorder.</p> <p><strong>Keywords:</strong> Neurology, Schizophrenia, Bipolar Disorder &amp; Sign</p> 2019-10-18T12:38:43-04:00 ##submission.copyrightStatement## TO STUDY THE PRESENCE OF NEUROLOGICAL SOFT SIGNS IN PATIENTS WITH SCHIZOPHRENIA AND BIPOLAR DISORDER AND COMPARE THE VARIOUS SUBSCALES. 2019-10-18T12:55:38-04:00 Dr. Ashutosh Singh Dr. Sudhir Kumar Dr. Anil Kumar Sisodia <p><strong>Background: </strong>The study was conducted at the Mental Health &amp; Hospital, Agra. It is a tertiary referral center and a postgraduate teaching hospital. The hospital has a wide catchments area which includes diagnosis of schizophrenia and bipolar affective disorder.</p> <p><strong>Result:</strong> It included AV integration, Stereognosis, Graphesthesia, Extinction and Right left confusion. On sensory integration subscale of NES schizophrenia group had the highest mean score (4.93±2.74) then were the bipolar group (1.50±1.98) and least score was of control group (0.20±0.66) i.e. on sensory integration subscale of NES bipolar group scores were intermediate between schizophrenia and control group. Results of one way ANOVA revealed significant group differences F (2, 87) =45.35, p&lt; .01. Games-Howell post hoc comparisons revealed significant differences in Schizophrenia vs Bipolar group (p&lt; .01), Schizophrenia Vs Control group (p&lt; .01) as well as in Bipolar Vs Control group&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (p&lt; .01) i.e. on sensory integration subscale of NES schizophrenia patients scored significantly higher than bipolar and control group. Also bipolar group scored significantly higher than control group.</p> <p><strong>Conclusion:</strong> On “Sensory Integration” subscale of NES, schizophrenia patients scored significantly higher than both the bipolar patients and controls. Bipolar patients scored significantly higher than controls. On “Motor Coordination” subscale of NES, schizophrenia patients scored significantly higher than both the bipolar patients and controls. But bipolar patients did not differed significantly from controls.</p> <p><strong>Keywords:</strong> Neurology, Schizophrenia, Bipolar Disorder &amp; Sign</p> 2019-10-18T12:55:38-04:00 ##submission.copyrightStatement## COMPOSING THE MIXTURE OF A.CORDIFOLIA LEAF EXTRACT IN ELIMINATING SALMONELLA TYPHI AND STAPHYLOCOCCUS AUREUS BACTERIA 2019-10-19T03:54:33-04:00 Wawan Sofwan Zaini Nining Kurniati Betty Nurhayati Cecep Dani Sucipto Ismi Rajiani <p><strong>Background</strong>: <em>A.cordifolia </em>leaf is one of the traditional medicinal plants that have many benefits, including cough medicine, diabetes, shortness of breath, burns, post-operative wounds, dysentery, kidney inflammation, inflammation of the intestine, acne, bleeding gums, smoothing menstruation, increase appetite, and increase endurance. This research aims to find out the minimum concentration of <em>A.cordifolia </em>leaf extract that was able to kill bacteria <em>Salmonella typhi</em></p> <p><strong>Methods</strong>: This research is an experimental laboratory study with a research design using a Completely Randomized Design (CRD) in which the treatment of test bacteria is carried out with variations in concentration and contact time of the <em>A.cordifolia</em> leaf extract and <em>A.cordifolia</em> leaf using alcohol extract. The controlled variable was the concentration of <em>A.cordifolia</em>&nbsp; leaf extract with contact time variation while the response variable was the result of bacterial colony growth. For negative control applied sterilized aqua (0%) and as a comparison chloramphenicol was used.</p> <p><strong>Result</strong>: The results showed that <em>A.cordifolia</em> which extracted by ethanol solvent killed bacteria <em>S. Typhi</em> at a concentration of 80% with a contact time of 10 minutes, and bacteria <em>S. aureus</em> at a level of 100% with a contact time of 10 minutes, whereas A.cordifolia water extract could kill bacteria <em>S.typhi</em> at a concentration 80% with a contact time of 20 minutes, and bacteria <em>S. aureus</em> at a concentration of 100% with a contact time of 20 minutes.</p> <p><strong>Conclusion</strong>: <em>A.cordifolia</em>, which extracted by ethanol solvent, has a stronger killing power than one extracted with water solvent.</p> <p><strong>Keyword: </strong>A.cordifolia leaves, Salmonella typhi, Staphylococcus aureus, extraction</p> 2019-10-19T03:54:33-04:00 ##submission.copyrightStatement## PROFILE OF PATIENTS OF GLAUCOMA IN JAMMU PROVINCE (A HOSPITAL BASED STUDY) 2019-10-19T04:06:38-04:00 Angli Manhas Rameshwar S Manhas Gaurav S Manhas Dinesh Gupta <p><strong>Background:</strong> Glaucoma comprises group of disorder which cause damage to the ganglion cells and optic nerve fibers resulting in permanent loss of vision. Glaucoma is a silent killer of vision, the only treatable factor is IOP which can be lowered by medical means, laser treatment or surgery.</p> <p><strong>Objectives</strong>: The objective of the study was to see profile of patients of glaucoma in jammu province.</p> <p><strong>Material and method: </strong>The present prospective study involved 200 patients was conducted in the out-patient department of ophthalmology at tertiary care hospital of North India. After meeting inclusion &amp; exclusion crieteria the patients underwent detailed clinical history, general examination, complete ophthalmological examination including dilated fundus examination, intra ocular pressure measurement, gonioscopy etc was done to diagnose different types of glaucoma.</p> <p><strong>Results: </strong>Maximum number of patients i.e.128 were seen in age group of ≥50yrs followed by 60 in 41-50 yrs. Males i.e. 127 outnumbered females in present study. Total of 139 were from rural area. Maximum patients complain of diminution of vision ie 180 followed by pain in 135. Vision of 6/24-6/18 i.e. 59 (R/E) &amp; 57 (L/E) followed by PL to &lt;6/60 in 48(R/E) &amp; 47(L/E) patients whereas PL absent was seen in 12 patients. Gonioscopically angle was open in 172(R/E) &amp; 174(L/E) patients. Total of 102 patients had POAG.</p> <p><strong>Conclusion:</strong> From present study we may conclude that glaucoma problem was more common in elderly age group and in males. It can lead to loss of vision among patient who suffer extreme optic nerve damage without realizing it. Therefore, for everybody above the age of 40years, it is mandatory to have IOP checked once a year especially if there is any risk factor for glaucoma like diabetes mellitus, myopia, family history of glaucoma, prolonged use of topical steroids etc.</p> <p><strong>Keywords</strong>: Glaucoma, Gonioscopy, Intraocular Pressure(IOP), Visual acuity.</p> 2019-10-19T04:06:38-04:00 ##submission.copyrightStatement## PREVALENCE OF COAGULASE NEGATIVE STAPHYLOCOCCUS AT A TERTIARY CARE HOSPITAL, JAIPUR 2019-10-19T11:57:12-04:00 Dr. Rajesh Kumar Meena Dr. Prasanna Gupta <p>Background: Coagulase-negative staphylococci (CoNS) have been recognized as an important agent of human infection since the past five decades. &nbsp;Currently, there are 38 species of CoNS isolated from various human infections.</p> <p>Methods: A observational descriptive study conduct on 71 samples collected from the hospitalized patients and nonhospitalized patients. Various samples like Urine, body fluids, pus, blood, swabs (wound, high vaginal, nose, throat) and other clinical samples were collected from patients attending outpatient departments (OPD) and admitted in wards and ICUs in NIMS hospital and processed for isolation and identification of Coagulase negative Staphylococcus (CONS) by the phenotypic methods.</p> <p>Results:<em> Staphylococcus epidermidis(</em>35.21%) isolated more in our study. Second most common species was <em>Staphylococcus saprophyticus</em>(33.80%). Other species that isolated were as <em>Staphylococcus haemolyticus(15.49%), Staphylococcus</em> <em>lugdanensis(7.04%), Staphylococcus schleiferi</em>(4.22%) and <em>Staphylococcus</em> <em>xylosis</em>(7.40%)</p> <p>Concussion- In this study, the most common species identified was <em>S. epidermidis</em>.</p> <p><strong>Keywords:</strong><em> Staphylococcus, Infection, Urine, Blood, Pus.</em></p> 2019-10-19T11:57:12-04:00 ##submission.copyrightStatement## A STUDY OF VENTILATOR-ASSOCIATED PNEUMONIA: INCIDENCE, OUTCOME, RISK FACTORS AND MEASURES TO BE TAKEN FOR PREVENTION 2019-10-19T12:29:25-04:00 Dr. Raghvendra Singh Dr. Ramesh Kumar <p>Background: Pneumonia is the second most common nosocomial infection among critically ill patients, affecting 27% of all critically ill patients.</p> <p>Methods: The study was conducted in an intensive care unit (ICU) of a tertiary care centre. A total of 100 patients who were kept on mechanical ventilator were randomly selected. Cases included were patients of both sexes who were kept on mechanical ventilator for more than 48 h, having the age of &gt;15 years. Patients who died or developed pneumonia within 48 h or those who were admitted with pneumonia at the time of admission and patients of ARDS (Acute Respiratory Distress Syndrome) were excluded from the study.</p> <p>Results: The mean duration of mechanical ventilation was found to be 12.3±3.1 days for the non-VAP group and 19.1 ±4.2 days for the VAP group that those requiring prolonged ventilator support (&gt;15 days) had a significantly higher incidence of VAP (<em>P</em>-value, 0.001). Supine position and stuporous, comatose patients were found to be risk factors, having a high incidence of VAP, and proved to be statistically significant.</p> <p>Conclusion: Incidence is directly proportional to duration of mechanical ventilation and re-intubation is a strong risk factor for development of VAP. Therefore, duration of ventilation has to be reduced to get rid of morbidity and mortality associated with mechanical ventilation, which can be achieved by administering a proper weaning protocol and titrating sedation regimens as per the need of the patients.</p> <p><strong>Keywords</strong>: Incidence, Infection, ICU</p> 2019-10-19T12:29:25-04:00 ##submission.copyrightStatement## ASSESSMENT OF LEVEL OF KNOWLEDGE OF BASIC LIFE SUPPORT ALGORITHM AMONG NURSING STAFF IN A TERTIARY CARE TEACHING HOSPITAL 2019-10-19T13:01:27-04:00 Dr. Raghvendra Singh Dr. Satya Narayan Seervi <p>Background: Cardiac arrests and accidents are the most common emergencies with grave consequences. These emergencies can be managed efficiently by proper knowledge and practice of resuscitation skills</p> <p>Methods: A cross-sectional Analytic study was conducted among the nursing staff. Data was collected using structured questionnaire which collected information regarding the basic demographic factors, knowledge regarding the BLS resuscitation.</p> <p>Results: 67.00% nursing staff had medium knowledge followed by 20.00% nursing staff had good knowledge and 13.00% nursing staff had poor knowledge.</p> <p>Conclusion: Awareness of Basic Life Support (BLS) among nurses staff is poor and needs to be improved.</p> <p><strong>Keywords:</strong> BLS, Knowledge, Nursing staff, Knowledge</p> 2019-10-19T13:01:27-04:00 ##submission.copyrightStatement## INHERITED MUTATION IN BRCA1 AND BRCA2 IN BREAST CANCER 2019-10-19T14:01:36-04:00 Diksha Mishra Savita Kumari Navneeta R. Kumar <p>BRCA1 and BRCA2 are unrelated proteins, but both are normally expressed in the cells of breast and other tissue, where they help repair damaged DNA, or destroy cells if DNA cannot be repaired. They are involved in the repair of chromosomal damage with an important role in the error-free repair of DNA double-strand breaks. If BRCA1 or BRCA2 itself is damaged by a BRCA mutation, damaged DNA is not repaired properly, and this increases the risk for breast cancer. BRCA1 and BRCA2 have been described as "breast cancer susceptibility genes" and "breast cancer susceptibility proteins". The predominant allele has a normal, tumor suppressive function whereas high penetrance mutations in these genes cause a loss of tumor suppressive function which correlates with an increased risk of breast cancer.</p> <p><strong>Keywords:</strong> BRCA1; BRCA2; Breast cancer; Mutation; Gene.</p> 2019-10-06T10:20:06-04:00 ##submission.copyrightStatement## LAPAROSCOPIC CHOLECYSTECTOMY IN SITUS INVERSUS TOTALIS – A CASE REPORT 2019-10-19T14:01:36-04:00 Dr Rohit Phadnis Dr. U Sowmya <p><strong>Background:</strong> Situs inverses totalis is a rare congenital anomaly with transposition of major organs to opposite side of the body. Due to atypical clinical presentation and due to contra lateral presence of the gall bladder, it causes clinical challenge to operate with complete reorientation of anatomy. Visual motor skills are particularly tested when it comes to lapararoscopy.&nbsp;</p> <p><strong>Case: </strong>A 25 year, lady presented with left hypochondriac pain and diagnosed as calculus cholecystitis with situs inverses total is. After ruling out associated anamolies patient underwent elective laparoscopic cholecystectomy.&nbsp;</p> <p><strong>Discussion: </strong>Around 60 cases of situs inverses total is with cholecystectomy have been reported till date. These cases cause technical and visuo-motor difficulty due to contra lateral deposition of gall bladder in left hypochondrium during laparoscopic cholecystectomy. Consumption of extra time also been reported during calot’s dissection, as it’s like operating on a mirror image.&nbsp;</p> <p><strong>Conclusion:</strong> Laparoscopic cholecystectomy, the gold standard treatment for cholelithiasis, is a feasible option even in cases with SIT; in the hands of good experienced, ambidextrous laparoscopic surgeons.</p> 2019-10-07T03:39:00-04:00 ##submission.copyrightStatement##