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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> STUDY THE ASSESSMENT OF RISK FACTOR FOR PRIMARY CAESAREAN SECTION IN MULTIGRAVIDA 2020-01-02T21:35:13-05:00 Pravin Kumar Mohinee Dhaka Sindhu Sudha Gaur Reena Pant Krishna Priya Banerjee <p><strong>Background:</strong> It is a study of the assessment of risk factor of primary caesarean section in multigravida women who has had previous vaginal delivery of viable neonates.</p> <p><strong>Aim of Study</strong>: To study the risk factor of primary caesarean section in a multigravida.</p> <p><strong>Methods</strong>: Prospective study, hospital based descriptive type of observational study conducted in department of Obstetrics &amp; Gynaecology, SMS Medical College, Jaipur, India from June 2018 to August 2019 ,1000 multipara women previous delivered vaginally&nbsp; with gestational age &gt;28 weeks with giving written and informed consent were included and excluded previous caesarean section and Labor was monitored by using partograph. Decision for caesarean section was based on clinical evaluation of progress of labor, fetal and maternal condition and complications were noted.</p> <p><strong>Statistical analysis:</strong> Continuous variable was expressed as Mean and Standard deviation. Nominally / Categorized variable was summarized as Proportion. Parametric and Nonparametric Tests used for continuous and nominal variable as per yield of data.</p> <p><strong>Result: </strong>42.18% women in the age group of 26- 30 years and 71.90% were second gravida. 67.30% had emergency caesarean section. Among the various risk factor of caesarean section, malpresentation was commonest (12.79%).</p> <p><strong>Conclusion: </strong>There are many cases where a caesarean section becomes mandatory for her. Many unforeseen complications occur in women who previously had a normal vaginal delivery.</p> 2020-01-02T21:35:13-05:00 ##submission.copyrightStatement## TO COMPARE THE EFFICACY OF PGE2 GEL AND 25ΜG OF INTRAVAGINAL MISOPROSTOL FOR INDUCTION OF LABOR IN TERM PROM 2020-01-02T21:53:25-05:00 Sunita Maheshwari Shweta Jinger <p>Background: Induction of labour is one of the most common obstetric interventions worldwide. The study was conducted to compare the efficacy and safety of 25µg (low dose) vaginal Misoprostol with intracervical Dinoprostone for cervical ripening and induction of labour in term pregnancy.</p> <p>Methods: For the purpose of this study, 100 term pregnancy patients (only primigravidae and second gravidae) were included who had spontaneous rupture of membrane before onset of labor. Data was collected from cases admitted in labor room at Pannadhay Mahila Chikitsalaya associated with RNT Medical College,Udaipur between July 2014 to July 2015.</p> <p>Results: Requirement of Oxytocin for augmentation of labor between group A and group B. It is evident from the table that oxytocin was required in only 16% of patients in group A, while 46% in group B. This indicates that requirement of oxytocin was significantly less in misoprostol group (P&lt;0.001).</p> <p>Conclusion: This study was designed to assess efficacy of a 25 μg misoprostol vaginal tablet, Finding confirms that vaginal misoprostol tablet is as effective as dinoprostone in cervical ripening and labour induction with dinoprostone.</p> <p><strong>Keywords:</strong> Cervical ripening, Dinoprostone, Labour induction, Low- dose misoprostol.</p> 2020-01-02T21:53:25-05:00 ##submission.copyrightStatement## BLUNT ABDOMINAL TRAUMA WITH HAEMOPERITONEUM TREATED BY EXPLORATORY LAPAROTOMY VERSUS ONLY ABDOMINAL DRAINAGE: A PROSPECTIVE AND COMPARATIVE STUDY. 2020-01-06T03:43:27-05:00 Dhawal Panchal Firdaus Dekhaiya Harin Tailor <p>In today’s mechanized world, Blunt Abdominal Trauma (BAT) is a common emergency which is associated with considerable morbidity and mortality. More than 75% of abdominal traumas are blunt in nature and liver and spleen are the commonest organs to be injured as a result of BAT. The aim is to analyse and compare two groups of patient of blunt abdominal trauma managed conservatively with drainage and one by exploratory laparotomy. 50 cases of blunt abdominal trauma were taken. The patient were studied&nbsp; which includes age ,sex, mode of injury, initial vitals on presentation, Mortality in each group, duration of hospital stay, pre interventions and post interventions state and requirements, complications and follow up. It was observed 48% of patients were in between age group ranging from 10 to 30. Overall in terms of sex ratio, males dominated the no. of cases. RTA was most common mode of trauma. Liver and spleen was most common organ to be injured. Patients managed by laparotomy had higher mortality rate, duration of hospital stay was more, and complication were more. Early diagnosis and repeated clinical examination and use of appropriate investigation form the key in managing blunt injury abdomen patients.</p> <p><strong>Keywords:&nbsp; </strong>Blunt Abdominal Trauma, Haemoperitoneum , laparotomy , Abdominal Drainage.</p> 2020-01-06T03:43:27-05:00 ##submission.copyrightStatement## TO STUDY THE INCIDENCE AND TYPE OF SURGICAL DIFFICULTIES ENCOUNTERED IN REPEAT CESAREAN SECTION IN COMPARISON WITH THE PRIMARY CESAREAN SECTIONS. 2020-01-08T03:55:11-05:00 Nidhi Gohil Rajni Parikh Deepika Koli <p>Cesarean section is the most common surgery performed with over 30% of deliveries occurring via this route. This number is likely to increase given decreasing rates of vaginal birth after cesarean section (VBAC) and primary cesarean delivery on maternal request, which carries the inherent risk for intraoperative complications. Previous C-section delivery was a major indication for a repeat C-section delivery. The present study aims knowing the intra-operative difficulties encountered by an obstetrician, in this highly evolved surgical procedure called C-section especially in a repeat C-section. It was a Prospective observational study conducted on 60 cases of repeat cesarean section in c/o previous one cesarean section. Difficulties encountered while operating on cases of previous one cesarean section were noted. The intraoperative complications were compared with respect to adhesions (peritoneal, bladder, bowel, omental etc), blood loss, extension of tears over uterus, bladder injury, scar dehiscence, uterine rupture, need for hysterectomy. In present study, following intraoperative morbidities were encountered- adhesions 38.33%, advanced bladder 20%, excess blood loss 10%, placenta accrete was found in 1.67%,thinned out scar seen in 5% . Bladder injury seen in 1.67% patients. No cases of uterine rupture &amp; bowel injury were noted. None of the patient needs caesarean hysterectomy. In modern obstetric practice, objective is safe motherhood and healthy baby by proper management. From present study, it can be concluded that repeat caesarean sections in c/o previous one cesarean section are associated with increased complications which lead to increased maternal morbidity</p> <p><strong>Keywords: &nbsp;</strong>Primary Cesarean section , Repeat Cesarean section ,&nbsp; Caesarean Section Difficulties.</p> 2020-01-08T03:55:11-05:00 ##submission.copyrightStatement## RETROSPECTIVE STUDY OF EPIDEMIOLOGY OF HEAD INJURY IN VINDHYA REGION. 2020-01-08T06:54:22-05:00 Sonpal Jindal EDITOR@IJMBS.INFO Vinit Kumar Tiwari EDITOR@IJMBS.INFO Sandeep Evne EDITOR@IJMBS.INFO <p>Introduction: Head injury is one of the major public health concern because it can happen to Anyone in day to day life. Nearly 50% of trauma deaths are because of head Injuries but these account for numerous cases of permanent disability.</p> <p>Aims &amp; Objectives: To know about the incidence &amp; distribution of head injury from various causes according to age, sex, site of event, occupation, peak hours &amp;seasonal variation.</p> <p>Methodology: The present study was conducted in patients of head injury. Particulars of the patients, date &amp; time of incidence, admission &amp; mode of treatment received i.e. conservative or operated were recorded from hospital records, post graduate students, neurosurgeons &amp; from other hospital staffs.</p> <p>Result: Incidence of head injury was 2.82%. 84.66% of patients were managed Conservatively. Maximum patients had GCS 13 to15, the most Common age group was21-30 years. 38.66% of Patients were under the influence of alcohol &amp;stay in hospital was 1 to3 days.</p> <p>Conclusion: Head injury is one of the greatest challenge to human being, not only because of the trama but also interms of disability , morbidity and financial losses , further aggravating agony, needed to eliminate such pathetic situation by implementation of education and training among public &amp; health professionals.</p> <p><strong>Keywords:</strong> Head injury, Epidemiology</p> 2020-01-08T00:00:00-05:00 ##submission.copyrightStatement## SURVEY OF PATTERN OF DRUG INTERACTIONS IN PATIENTS BEING PRESCRIBED ANTI-DIABETIC MEDICATIONS IN A TERTIARY CARE HOSPITAL: PROSPECTIVE CROSS SECTIONAL STUDY 2020-01-08T07:13:05-05:00 Sujeet A. Divhare EDITOR@IJMBS.INFO Satyashil Ingale EDITOR@IJMBS.INFO <p>Background: Potential importance of drug –drug interactions (DDIs) is increasing as polypharmacy becomes more prevalent. Because additional data on the incidence and pattern of potential DDIs among diabetic patients are lacking in India, and supplemental pharmacodynamic or clinical outcome information is needed to address importance of a drug- drug interaction.</p> <p>Aim and objectives: To identify and analyze the pattern of DDIs in patients being prescribed anti-diabetic drugs in a tertiary care hospital.</p> <p>Material and Methods: This prospective cross-sectional study was carried out for a period of three months in 200 Type 2 diabetes mellitus (Type 2 DM) patients who were taking at least one antidiabetic agent during the period of past six months, of any age and either sex admitted in medicine ward of a tertiary care teaching hospital. Only one prescription was included for each patient on his/her 3rd day of hospitalization in the ward.</p> <p>Results: A total of 1217 drugs were prescribed in 200 prescriptions, resulting in an average of 6.1 drugs per prescription. A total of 637 potential DDIs were noted. The majority were seen in middle aged and elderly people. No overall difference was detected in the patients on insulin or metformin therapy taking or not taking additional drugs with the potential to interact. Worse control was found in the group of patients on sulphonylurea therapy taking interacting drugs (P &lt;0.05). This difference was most marked in the group of patients over 60 years of age, who also had the highest intake of potentially interacting drugs (57%; &lt;35 years-37%).</p> <p>Conclusion: Antidiabetic drugs have numerous interactions. A good practice is to use a drug­–drug interaction checker if any questions arise, several are available online. Quality care starts with the clinician obtaining a complete medication list for each patient at the start of each visit.</p> <p><strong>Keywords:</strong> diabetes mellitus, drug interactions, hypoglycemic agents, drug therapy, co-morbidity, polypharmacy</p> 2020-01-08T07:13:05-05:00 ##submission.copyrightStatement## SCENARIO BASED INSTRUCTION: A REVERSE APPROACH FOR CONCEPTUAL LEARNING IN PHYSIOLOGY. 2020-01-10T03:26:21-05:00 Komal Meshram Lalit Waghmare Ajay Meshram Tripti Waghmare <p>To evaluate the gain in knowledge of first year MBBS students with the use of scenario-based teaching a reverse approach for conceptual learning in physiology a prospective interventional study was carried out in department of physiology. <strong>Methodology:</strong> 200 first year MBBS students participated in the study. 100 students (Group-A) were taken as control group to them the topic of physiology was taught by didactic method and another 100 students (Group-B) were taken as intervention group, where the same topic was taught with scenario-based instruction a reverse approach for conceptual learning in physiology. For each lecture pre and post test was taken. Five consecutive lectures were planned with this intervention. At the same time feedback forms were given to intervention group for purpose of analyzing the results qualitatively. After this intervention crossover of groups were done only for the sake of getting benefits of intervention. <strong>Results: </strong>Data obtained was analyzed statically. Pre and post test mean were taken. The results of post test (p&lt;0.05) were found to be statistically significant when compared with pretest. As per the results of feedback forms, 90% (n=100) students agreed that the scenario based teaching is a powerful tool to understand the topic as it improves knowledge and makes learning more interesting.</p> <p><strong>Conclusion:</strong> According to the MCQ and feedback analysis, the results showed that teaching topic with scenario based instruction is the better approach for making the students to learn, understand and to gain the knowledge of physiology lectures rather than by traditional lecture alone.</p> 2020-01-10T03:26:21-05:00 ##submission.copyrightStatement## LAPAROSCOPIC CHOLECYSTECTOMY IN SICKLE CELL PATIENTS: A NONTRANSFUSIONAL PERIOPERATIVE MANAGEMENT. 2020-01-10T10:36:38-05:00 Dilip S. Gode Mangesh Padamwar <p><strong>Backgroun</strong><strong>d: </strong>The objective of this study is to evaluate the outcome of novel perioperative management involving prophylactic antibiotic, Intra Venous fluids and Intermittent Nasal Oxygen and avoidance of preoperative blood transfusion for Laparoscopic Cholecystectomy.</p> <p><strong>Methods: </strong>A prospective study included all sickle cell disease (SCD) and trait patients who underwent Laparoscopic Cholecystectomy from January 2007 to August 2010 at Acharya Vinoba Bhave Rural Hospital, attached to Datta Meghe Institute of Medical sciences university, Sawangi, Wardha. India</p> <p><strong>Result: </strong>A total of 26 patients underwent Laparoscopic Cholecystectomy. There were two recorded episodes of acute painful crises and three patients had postoperative fever. There were no recorded episodes of Acute Chest syndrome.</p> <p><strong>Conclusion: </strong>Laparoscopic Cholecystectomy can be safely performed for sickle cell anemia (disease and trait) patients, without preoperative blood transfusion. A defined perioperative regimen including use of antibiotic, IV fluids and Intermittent Nasal Oxygenation for these patients helps to reduce SCD related complications.</p> <p><strong>Keywords: </strong>Laparoscopy, Cholecystectomy, Sickle Cell, Nontransfusion, Haemoglobinopathy.</p> 2020-01-10T03:51:46-05:00 ##submission.copyrightStatement## CLINICAL PROFILE AND PSYCHIATRIC MORBIDITY IN PATIENTS WITH DELIBERATE SELF-HARM 2020-01-11T09:33:51-05:00 Yogesh Motwani Shobha Nair Aditi Chaudhari Kaustubh Mazumdar <p>Background: It requires detailed research to understand the psychopathology behind DSH attempts. Apart from social factors, psychiatric disorders and individual coping mechanisms can contribute to DSH. This study will be helpful in knowing the prevalence of psychiatric morbidity in these patients.</p> <p>Aims and Objectives: To study the Psychiatric morbidity in patients with DSH.</p> <p>Materials and Methods: This is a retrospective, descriptive study including 42 patients who had history of DSH and were referred to psychiatry department of BARC Hospital, Mumbai. Patients who were below 45 years of age at the time of DSH and above 18 years at the time of study were included. Their socio-demographic data were collected, psychiatric diagnosis were noted from the case files, personality disorders were evaluated using ICD-10 IPDE. Data were analysed using descriptive and analytic statistical methods.</p> <p>Results: 42.86% of the population was diagnosed as having psychiatric disorder. Most common disorder was depression. 7.14% of the patients were diagnosed as having borderline personality disorder.</p> <p>Conclusions: Depression was the most common psychiatric disorder found in our study.</p> <p><strong>Key words:</strong> Deliberate self-harm, psychiatric disorders, personality disorders.</p> 2020-01-11T09:33:51-05:00 ##submission.copyrightStatement## AN AUDIT OF LUNG CARCINOMAS AT A TERTIARY REFERRAL CENTRE 2020-01-11T09:42:05-05:00 Anshita Dubey Meenal Hastak Bijal Kulkarni Nevitha Athikari Rajesh Mistry <p>A generic diagnosis of ‘small cell or non-small cell carcinoma’ was sufficient in the past when there was no clinical demand for sub classification as it had no impact on therapy. Patients with advanced stage non-small cell lung carcinoma who received chemotherapy were typically treated with a ‘platinum doublet’ of cisplatin plus gemcitabine irrespective of histological subtype. At present, in contrast, sub classification of non-small cell lung carcinoma has significant treatment implications, especially for advanced stage tumors for which chemotherapy or targeted therapy is being considered. Consequently, pathologists are asked to subtype the tumor. The demand for sub typing is driven by oncologists, who now have several new targeted therapies, the efficacy of which varies by histological subtype.</p> <p>In view of demand of sub typing of lung carcinomas as well as the guidelines given by WHO 2015 classification which emphasises the importance of a separate classification for biopsies and cytology on one side and the resection specimen on the other, we have taken up this study.</p> <p><strong>Keywords:</strong> Lung carcinoma, classification, core biopsies, immunohistochemistry</p> 2020-01-11T09:42:05-05:00 ##submission.copyrightStatement## SOCIO-CULTURAL FACTORS ASSOCIATED WITH NATURAL OPIOIDS USE IN NORTHWESTERN RAJASTHAN: A CROSS-SECTIONAL STUDY FROM TERTIARY CARE HOSPITAL. 2020-01-13T02:53:35-05:00 Vijay Kumar Saini Dheeraj Goya Pratibha Gehlawat <p><strong>Background</strong>: Opioid in natural form (afeem/amal and poppy husk) has been taken from ancient time in north India including Rajasthan. There are approximately 2.3 crore opioid users in India, according to National Survey. Various psychosocial and cultural factors are associated with its use. Socio-cultural factors for the use of natural opioids are inadequately studied. With this rationale, we planned a study to identify these socio-cultural factors.</p> <p><strong>Method and Material:</strong> This was a descriptive, cross-sectional study. 136 subjects were recruited. Along with socio-demographic profile, a semi-structured proforma of various socio-cultural factors was used.</p> <p><strong>Results:</strong> The majorities of subjects were male (97%), married (88.23%), farmer (62.50%), illiterate (44.11%) and hailed from rural areas (92.65). Most common factors associated with starting opioids were to increase work capacity in agricultural work (n= 46; 33.82%) followed by staying away from home for work (n= 36; 26.47%) and usage by another family members (n=34; 25%). Participants were continuously using natural opioids as it increases work capacity and concentration (n=61; 44.85%) and the reasons for quitting were unavailability and financial problems (n=60; 44.12%).</p> <p>&nbsp;<strong>Conclusion:</strong> Various socio-cultural factors play important role in initiation and maintenance of natural opioids use.</p> <p>&nbsp;<strong>Key words</strong>: &nbsp;Natural opioids, Opioid dependence, Socio-cultural factors, Northwestern Rajasthan, Agriculture work</p> 2020-01-13T02:53:35-05:00 ##submission.copyrightStatement## COMPARISON OF PLATELET COUNTS SHOWN BY AUTOMATIC HAEMATOLOGY ANALYSERS AND COUNTS MEASURED MANUALLY IN POPULATION OF MOUNTAINOUS HILLY REGION OF CHENAB VALLEY ATTENDING OPD ON ROUTINE BASIS IN GMC DODA. ASSOCIATED HOSPITAL 2020-01-13T04:14:12-05:00 Sumat ul Khurshid Nazia Tabbasum <p>In clinical practice it is very important to perform the platelet counts.&nbsp; The estimation of platelet counts from peripheral blood smears is an accurate method and provides adequate quality assurance in traditional methods as the automated cell counters are not available at all hospital setups especially in rural areas. In modern era use of&nbsp;&nbsp; automated analyzers based on impedance technology has resulted in &nbsp;&nbsp;improvement of accuracy and helps in measurement of platelet indices such as Mean Platelet Volume (MPV) Plateletcrit (PCT) and Platelet Distribution Width (PDW). However, both the methods have certain limitations. Platelet counts were estimated on a 5-part Differential Automated Hematology Analyzer and manually on Leishman stained peripheral blood SMEAR.</p> <p>Aims &amp; Objective: 1. This study was conducted to compare platelet counts by peripheral blood&nbsp; smear method and automated method in patients&nbsp; attending OPD on routine basis in a mountainous hilly region of &nbsp;J&amp;k .</p> <ol start="2"> <li>It also aims to study the relation, if any, between the platelet count (automated) and platelet indices like Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) and to assess the possible role of these parameters in certain defined situations.</li> </ol> <p>Materials and methods: A prospective study was conducted in a tertiary care hospital on 200 Ethylene Diamine Tetra Acetic acid (EDTA) anticoagulated blood samples. Samples were evaluated by 5-Part differential automated hematology analyser using impedance counting method and by examination of peripheral blood smear method (PBF).</p> <p>Results: In thrombocytopenic patients, the platelet count assessed by automated analyzer revealed an inverse relation with Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) and showed large granular and giant platelets on PBS.</p> <p>Conclusion: Automated hematology analyzer is essential&nbsp; &nbsp;for immediate &nbsp;&nbsp;and accurate complete blood count evaluation but blood samples showing erroneous results or low platelet counts on analyzer should be confirmed on peripheral blood smear. The platelet indices like Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) can point to the underlying pathology especially in cases of thrombocytopenia.</p> <p><strong>Keywords:</strong> Automated analyser, Peripheral blood smear, MPV, PDW, large granular platelets.</p> 2020-01-13T04:14:12-05:00 ##submission.copyrightStatement## PREVALENCE OF ORAL SUBMUCOUS FIBROSIS AND PERIODONTAL HEALTH STATUS IN PATIENTS CHEWING GUTKA FROM BIHAR REGION 2020-01-13T09:40:06-05:00 Nikita Raman Kumar Manish Samir Jain <p>Smokeless tobacco (ST) chewing warranties special attention in India because of its popularity and widespread social acceptance. The major factors that persist to encourage people to use smokeless form of tobacco are its low price, ease of purchase, and the widely held misconception of purported medicinal value in curing toothache, headache, and in decreasing hunger. Furthermore, in contrast to smoking, there is no taboo against using ST. The lifestyle, socioeconomic status, and the standards of living of industrial workers are different from the rest of the population. Poverty, language barriers, and poor education contribute different lifestyle that encourages addictive tobacco habits. As there is a ban on smoking tobacco in most of the industrial premises, workers tend to consume more of ST products. Therefore, they form a special group who could be at a higher risk of periodontal breakdown. Hence the present study was planned for study of Prevalence of Oral Submucous Fibrosis and Periodontal Health Status in patients chewing Gutka from Bihar Region.</p> <p>The present study was planned in Department of Dentistry, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar. Total 30 patients were enrolled in the present study. The patients were divided in three groups. The Group A included patients with a healthy periodontium. The Group B included patients with chronic periodontitis without OSMF, and Group C included patients with chronic periodontitis and OSMF.</p> <p>The data generated from the present study concludes that that chewing gutka leads to periodontal destruction in patients with OSMF. The cases illustrate the significant morbidity and mortality associated with OSF and emphasize the importance of close follow-up of such cases. Because of the significant cancer risk among these patients, periodic biopsies of suspicious regions of the oral mucosa are essential for the early detection and management of high-risk oral premalignant lesions and prevention of cancer.</p> <p><strong>Keywords: </strong>oral submucous fibrosis, periodontal destruction, gutka, Bihar region, etc.</p> 2020-01-13T09:40:06-05:00 ##submission.copyrightStatement## STUDY OF ANEMIA AMONG ADOLESCENT GIRLS 2020-01-15T08:53:44-05:00 B S Gupta EDITOR@IJMBS.INFO Yogesh Singh EDITOR@IJMBS.INFO <p>Background: In India adolescents constitute about 25% of the population and form an important physiological group whose nutritional needs demand special attention. &nbsp;Adolescence is a significant period of human growth and maturation, when unique changes occur and many adult patterns are established.</p> <p>Methods: This was cross-section study. All the adolescent girls studying in standards 9th - 12<sup>th</sup> class who were given consent to hemoglobin estimation were included in the study.</p> <p>Results: The prevalence of anemia among adolescent girls was found as 73.00%. Out of 730 anemic girls, 520 girls were suffering from mild degree of anemia and 190 girls were having moderate degree of anemia. Only two girl was found severely anemic.</p> <p>Conclusion: The prevalence of anemia among adolescent girls is alarmingly high in India.</p> <p><strong>Keywords:</strong> Prevalence, Anemia, Adolescent.</p> 2020-01-15T08:53:44-05:00 ##submission.copyrightStatement## HISTOMORPHOLOGICAL STUDY OF THE UTERUS IN 64 PERIPARTUM HYSTERECTOMY SPECIMENS. 2020-01-15T23:43:33-05:00 Gayatri Devi Pukhrambam O. Okendrajit Singh Babina Sarangthem Kamal Uddin Gauhar <p>Background: Peripartum hysterectomy is a life saving procedure performed for intractable obstetric haemorrhage. Uterine atony, rupture, abnormal placentation, retained products etc. are common indications. With the rise of caesarean sections, the incidences of peripartum hysterectomies are increasing worldwide. The aim of the present study is to evaluate the histomorphological findings in peripartum hysterectomy specimens received during a five year period.</p> <p>Material and Method: In this hospital based cross-sectional study during a five year period (Jan 2014 –Dec 2018), 64 peripartum hysterectomy specimens received in the department of Pathology, RIMS, Imphal, Manipur were included. The gross and histomorphological findings were evaluated, studied, statistically analysed and compared with other studies.</p> <p>Results and Observation: The various histomorphological findings were abnormal placentation 28 (43.7%), uterine atony 15 (23.5%), uterine rupture 14 (21.8%), retained placenta/product 6 (9.3%) and subinvolution 1(1.5%).&nbsp; Abnormal Placentation and Placenta cretas were the most common finding in the present study. The lower uterine segment was the most common abnormal site of placental implantation. The age ranged from 21 to 45 years, with majority of the cases were in the&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 30-39years age group. History of previous caesarean section was noted in 20 cases (31.2%). The relative risk of abnormal placentation was 2.5 times higher in those cases with prior history of caesarean section. Rupture was most commonly associated with multiparous women. Co-morbid overlapping features were seen in few cases.</p> <p>Conclusion: Histopathological diagnosis not only confirmed the clinico-radiological impression, but also highlighted the other co-morbid associations that caused the intractable haemorrhage which warranted a peripartum hysterectomy.&nbsp;&nbsp;</p> <p><strong>Keywords:</strong> Peripartum Hysterectomy, Abnormal placentation, caesarean section, chorionic villi.</p> 2020-01-15T23:43:33-05:00 ##submission.copyrightStatement## ABDOMINAL RECTUS DIASTASIS (ARD) CORRECTION FOR PAIN REDUCTION AND IMPROVEMENT OF ABDOMINAL WALL MUSCLE STRENGTH 2020-01-16T00:06:56-05:00 Kaustubh Vasant Waikar <p><strong>Introduction:</strong> Rectus abdominis diastasis (RAD) can be described as a condition in which rectus abdominis muscles are separated by an abnormally wide distance i.e. any separation of more than 2 cm is considered to be abnormal.&nbsp;Several aetiological factors may lead to protrusion of the anterior abdominal wall. It is a common complaint in women after&nbsp;childbirth. Abdominal&nbsp;rectus diastasis&nbsp;(ARD) is a&nbsp;sequele&nbsp;of the expansion of the abdominal contents during pregnancy or massive weight loss and/or congenital disproportion of the collagen III/I ratio. Operative repair of ARD can improve abdominal wall function. Various methods for ARD repair have been described. These differ by approach like open versus laparoscopic, the position of suture placement, numbers of layers of sutures, suture material, and use of mesh. Also it can be combined with mesh augmentation in the IPOM technique for enhanced stabilization of the abdominal wall.</p> <p><strong>Material and Methods:&nbsp; </strong>Eligible patients were randomized to either one of two operative procedures or a 3-month, dedicated training program which serve as a control group. ARD width was assessed clinically and confirmed with&nbsp;computed tomography&nbsp;scanning. Endpoints were assessed after 6 months for relapse of the ARD, pain, restriction of daily activities and improvement in muscle strength. Abdominal wall strengthe was assessed by Visual analogue scale (VAS).</p> <p><strong>Results: </strong>A total of 72 patients were enrolled into the study (70 female and 2 male)<strong>. </strong>24 patients were enrolled in each group<strong>. </strong>13 patients had undergone&nbsp;cesarean section&nbsp;in the Quill group and 12 in the mesh group. According to VAS scale no statistically significant difference was seen between the two operative groups regarding perceived improvement in abdominal wall strength. But it was significantly higher in operated group as compared to training group. Abdominal muscular strength was improved in all the three groups. Improvement in abdominal wall strength was lower in training group compared to operative groups. No relapse was observed in operative groups.</p> <p><strong>Conclusion: </strong>Operative repair of ARD can provide functional stability and improvement in pain and physical parameters it also improves quality of life, and reduce functional disability.</p> <p><strong>Keywords: </strong>ARD, Quill SRS, Mesh repair, VAS, linea alba (LA)</p> 2020-01-16T00:06:56-05:00 ##submission.copyrightStatement## FOLLOW UP STUDY OVER A PERIOD OF SIX MONTHS WITH RESPECT TO REHABILITATION AND RECURRENCE AFTER BURN SURGICAL PROCEDURES. 2020-01-16T00:20:59-05:00 Yashpal Ramole EDITOR@IJMBS.INFO Badri Patel EDITOR@IJMBS.INFO M. C. Songara EDITOR@IJMBS.INFO Ishant Chaurasia EDITOR@IJMBS.INFO <p>The study was conducted in the Department of General Surgery, Gandhi Medical College, Bhopal over the period of one &amp; half year. Evaluation started with History and clinical examination including range of movement of joints. Scar was scored as per Clinical Assessment Score. Range of movement was measured using goniometer.</p> <p>Although most patients came for follow up and were compliant with the rehabilitation protocol, their compliance needs to be re-evaluated at every follow up and they should be encouraged to follow the advices strictly. Also they must be counseled that contracture may not be corrected to the full extent despite best of treatment and compliance with rehabilitation protocol but a good level of improvement can be achieved.</p> <p><strong>Keywords:</strong> Burn, Surgery, Rehabilitation &amp; Recurrence.</p> 2020-01-16T00:00:00-05:00 ##submission.copyrightStatement## OMENTUM PIECE FOR PREVENTION OF BILE LEAKAGE AFTER SUBTOTAL CHOLECYSTECTOMY 2020-01-16T00:34:03-05:00 Kaustubh Vasant Waikar EDITOR@IJMBS.INFO <p><strong>Introduction:</strong> Acute cholecystitis is an acute inflammatory condition of the gallbladder of which 95% of cases of acute cholecystitis are due to an obstructing calculus in the gallbladder neck or cystic duct. Acute cholecystitis and difficult gall bladder have severe inflammation and anatomical deformities i.e. empyema, Mirizzi syndrome and sometimes gangrene. In recent years, there is an increasing trend towards subtotal cholecystectomy and general acceptance is higher due to higher incidence of complications in difficult gall bladder. Although, the results of subtotal cholecystectomy are satisfactory but the post-operative bile leak is a problem of great concern. There are many techniques that have been adopted, but bile leakage compared to closing of cystic duct directly is very high in subtotal cholecystectomy.&nbsp;</p> <p><strong>Material and Methods:&nbsp;&nbsp; </strong>The Omentum Plugging Technique (OPT) and Primary Closure Technique (PCT) was done to prevent bile leak in cases were total cholecystectomy could not be performed. Patients were included in the study with the diagnosis of cholelithiasis and patients who had undergone subtotal cholecystectomy for gallstone diseases with both OPT and PCT Technique. Under general anaesthesia patients were operated. Patients were first decompressed at the fundus with the suction and harmonic scalpel or l-hook was used for transection of gall bladder and wash was given and both the anterior and posterior walls were excised leaving an anterior and posterior wall intact and OPT, a piece of omentum that matches the size of the opening of the gallbladder stump is resected from the greater omentum and plugged into the gallbladder stump.</p> <p><strong>Results: </strong>A total of 486 patients were operated, of which 36 patients (7.4%) underwent subtotal cholecystectomy because it was not possible to close their cystic ducts because they had difficult gallbladders, of which 18 patients in taken in OPT and 18 patients taken in PCT group. Average age in OPT group was 49.48 ± 9.59 years while in PCT group was 54.47 ± 16.21. In OPT group there were 10 (62.5%) male and 6 (37.5%) female, in PCT group 11 (68.75%) male and 5 (31.25%) female were observed. History of CBD Stone was recorded in 3 (18.75%) and 2 (12.50%) patients in OPT and PCT group respectively. No History of Abdominal Surgery was noted in both the group. Intra-operative Haemorrhage in OPT Group was 118 (16-359) ml while in PCT group was 164 (10-578) ml. Duration of Operation Time OPT Group was 156 ± 15.77 ml while in PCT group it was 105 ± 17.35 minutes. Total post-operative complications and post-operative bile leakage were seen in 2 patients in OPT group while in PCT group it was seen in 10 patients. (P= 0.0040). Post-operative intervention was done on one patient in OPT group and on 9 patients in PCT group. Mean Duration of drain was 3.5 ± 1.24 days in OPT group and 8.59 ± 2.46 days in PCT group (P&lt; 0.0001). Post-operative hospital stay was 8.84 ± 2.14days in OPT group and 13.45 ± 2.11days (P&lt; 0.0001). <strong>Conclusion: </strong>In a difficult gall bladder SC is required during cholecystectomy and for prevention of postoperative bile leakage OPT technique can be safe and more feasible alternative than conventional procedures.</p> <p><strong>Keywords</strong>: Subtotal cholecystectomy (SC), Omentum Plugging Technique (OPT), Primary Closure Technique (PCT), gall bladder.</p> 2020-01-16T00:34:03-05:00 ##submission.copyrightStatement## SPECTRUM OF FUNGAL INFECTIONS IN THE ELDERLY AGE GROUP 2020-01-16T01:21:11-05:00 Kshitij Saxena Priyanka Shukla Harris Ishtiyaq Shaafie Garav Palliwal Chandni Jain <p><strong><u>ABSTRACT</u></strong></p> <p><strong>INTRODUCTION:</strong></p> <p>Fungal infections have become a common problem in the elderly age group. As age advances, the skin becomes dry, thin, wrinkled and with less number of hair follicles, sweat glands and sebaceous glands therefore, making it more susceptible to opportunistic pathogens. Superficial mycosis account for nearly 25% of the global burden of skin mycoses. The aim of this study is to identify the various superficial mycosis occurring in the elderly age group &gt; 60 years attending a tertiary care hospital in North India.</p> <p><strong>MATERIALS AND METHODS:</strong></p> <p>Prospective, observational study conducted on 540 patients over the age of 60 years attending the Dermatology OPD at a tertiary care centre. Patients on antifungal agents were excluded from the study. Samples collected included skin and nail scrapings, nail clippings and hair along. The collected samples were divided into two parts one for culture and other for direct microscopy. Direct microscopy of the specimens was performed in 10% potassium hydroxide + 40% Di-methyl sulfoxide. Culture media used included Sabouraud’s dextrose agar (SDA) and Sabouraud’s dextrose agar containing Cycloheximide (0.5 mg/ml ). Cultures were incubated at both 25ºC and 37ºC for four weeks. Further species identification was done by Microslide culture technique.&nbsp;</p> <p><strong>RESULTS:</strong></p> <p>The M:F ratio was 1.36:1. Onychomycosis accounted for the majority of superficial mycosis (25%) followed by Tinea mannum (14.65%) and Tinea pedis (15.51%). The most common dermatophyte isolate was Trichophyton rubrum (27.58%), followed by T.mentagrophytes (22.41%) and T.verrucosum (17.24%).</p> <p>KEY WORDS:</p> <p>Dermatophytes, Superficial Mycosis, Elderly age group, Slide culture</p> 2020-01-16T01:21:11-05:00 ##submission.copyrightStatement## ASSESSMENT OF THE QUALITY OF RECONSTRUCTION IN TOTAL HIP ARTHROPLASTY DONE IN PATIENTS AFTER ACETABULUM FRACTURE 2020-01-16T04:19:40-05:00 Manish Sharma Ramesh Kumar Sen Sameer Aggarwal Mahesh Prakash <p>Background: Acetabular fractures are complex orthopaedic injuries and require a fair amount of expertise for management. Although undisplaced acetabular fractures can be managed by nonoperative means, displaced acetabular fractures need operative intervention for reduction and stabilization.</p> <p>Methods: The study was carried as a retrospective study, from February 2013 to July 2014. After getting the approval from the Ethics Committee of the Institute (Annexure I) and the consent from the patients the study was conducted on 49 patients who underwent Total Hip Arthroplasty after fracture acetabulum.</p> <p>Results: On evaluation, patients at short term follow up had good clinical outcome on the basis of Harris hip score. The Harris hip scores improved progressively in the patients at 2-4 years follow up having mean HHS of 92 which further increased to 97 in patients who were followed up after 4 years. The patients at short term follow up of up to 2 years had comparatively lower quality of life scores when compared to the follow up at 2-4 years. The patients followed up after 4 years had the best quality of life.</p> <p>Conclusion: We concluded that total hip arthroplasty after acetabulum fracture, as a result of good quality of reconstruction, a good functional outcome leads to improved quality of life in the patients.</p> <p><strong>Keywords:</strong> Hip, Arthroplasty, Reconstruction.</p> 2020-01-16T04:19:40-05:00 ##submission.copyrightStatement## TO CO RELATE THE QUALITY OF RECONSTRUCTION WITH THE AFFECTED HIP FUNCTION AND QUALITY OF LIFE IN PATIENTS UNDERGOING THA POST ACETABULUM FRACTURE 2020-01-16T04:34:01-05:00 Manish Sharma Ramesh Kumar Sen Sameer Aggarwal Mahesh Prakash <p>Background: Hip fractures rank in the top ten of all impairments worldwide in terms of loss in disabilityadjusted years for people 50+ years old</p> <p>Methods: The study was carried as a retrospective study, from February 2013 to July 2014. After getting the approval from the Ethics Committee of the Institute (Annexure I) and the consent from the patients the study was conducted on 49 patients who underwent Total Hip Arthroplasty after fracture acetabulum.</p> <p>Results: The mental scores were significantly higher in the group where safe range of inclination was achieved. Therefore the quality of life is dependent on the safe range of inclination.</p> <p>Conclusion: We found that the patients who were treated with ORIF following the fracture acetabulum had better physical and mental scores.</p> <p><strong>Keywords:</strong> Hip, Physic, Mental Arthroplasty, Reconstruction</p> 2020-01-16T04:34:01-05:00 ##submission.copyrightStatement## ANALYSIS OF THE RADIOLOGICAL ASSESSMENT OF RECONSTRUCTION IN TOTAL HIP ARTHROPLASTY 2020-01-16T04:52:51-05:00 Manish Sharma Ramesh Kumar Sen Sameer Aggarwal Mahesh Prakash <p>Background: Total hip Arthroplasty (THA) is one of the most common interventions in Orthopaedic surgery. Increase in incidence of THA appears likely with the growing elderly population. THA has revolutionised the management of the patients suffering from pathologies of the hip. The common indications for THA today are osteoarthritis hip, avascular necrosis hip, ankylosing spondylitis, rheumatoid arthritis and in posttraumatic hip.</p> <p>Methods: The study was carried as a retrospective study, from February 2013 to July 2014. After getting the approval from the Ethics Committee of the Institute (Annexure I) and the consent from the patients the study was conducted on 49 patients who underwent Total Hip Arthroplasty after fracture acetabulum.</p> <p>Results: Based on the treatment received for fracture acetabulum, the vertical offset measurement was done for 47 patients. The affected side was compared with the un-affected side in the patient and a restoration of vertical offset on the affected side within 20% of the unaffected side was taken as acceptable. In 31 patients acceptable vertical offset was restored.</p> <p>Conclusion: Radiological assessment of the patients was done using 4 parameters. Measurement of Vertical offset, Horizontal offset, Body lever arm and Acetabular cup inclination was done. The affected side was compared with the un-affected side in the patient and a restoration of parameters on the affected side within 20% of the unaffected side was taken acceptable.</p> <p><strong>Keywords:</strong> Radiological, Arthroplasty, Reconstruction</p> 2020-01-16T04:52:51-05:00 ##submission.copyrightStatement## SPECTRUM AND OUTCOME OF BLUNT ABDOMINAL TRAUMA 2020-01-16T23:13:46-05:00 Mahesh Kumar Sharma Dr. Arun Bhargava <p>Background: Blunt abdominal trauma is a leading cause of morbidity and mortality among all age groups. So we evaluate the spectrum and outcome of blunt trauma.</p> <p>Methods: Hospital based prospective study conducted on 100 patients at department of general surgery.</p> <p>Results: Distribution according to type of injury consisted of maximum cases, 84 (84%) of road traffic accidents, 11% cases were of fall from height.</p> <p>Conclusions: Males were pre-dominantly affected. Road traffic accident was the most common cause of injury. Though conservative management is successful in carefully selected patients, operative management remains the main stay of treatment.</p> <p><strong>Keywords:</strong> Blunt abdominal trauma, Liver injury, Perforation, Splenic injury</p> 2020-01-16T23:13:46-05:00 ##submission.copyrightStatement## TO STUDY THE PATTERN OF DYSLIPIDEMIA IN HYPOTHYROID PATIENTS 2020-01-17T00:58:45-05:00 Mohammed Tarik Subhash Chandra <p><strong>Background</strong>: Thyroid hormones play an important role in regulating lipid metabolism and thyroid dysfunctions can result in lipid abnormalities which increase the risk of endothelial dysfunction, hypertension and cardiovascular disease.</p> <p><strong>Methods</strong>: A cross-sectional study was conducted on 100 patients selected as a sample of convenience in this cross sectional study from out-patient department of Medicine. Meticulous history taking and thorough clinical examinations were done. Report of lipid profile and thyroid function tests were recorded from patients file. All the information's were recorded in a pre-desigaed structured questionnaire. Collected data were classified, edited, coded and entered into the computer for statistical analysis by using Epi-info software.</p> <p><strong>Results:</strong> The serum TC, TG and LDL levels in hypothyroid individuals were significantly higher than euthyroid subjects.</p> <p><strong>Conclusion</strong>: We conclude that hypothyroid subjects had dyslipidemia. The present study indicated that hypothyroidism was associated with an abnormal lipid profile, especially with respect to the levels of TC, LDL and TG.</p> <p><strong>Keywords:</strong> Total cholesterol, Triglycerides and LDL</p> 2020-01-17T00:58:44-05:00 ##submission.copyrightStatement## DIAGNOSTIC ACCURACY OF THE FNAC IN STUDY OF THE LESIONS IN THE ANTERIOR TRIANGLE OF NECK IN CORRELATION WITH HISTOPATHOLOGY. 2020-01-17T01:30:13-05:00 Ravi Shankar Alok Kumar Bejoy Chand Banerjee Rajkumar Prasad <p><strong>Method: </strong>The study consists of 516 patients with palpable anterior triangle neck masses coming to the Department of Pathology.</p> <p><strong>Result: </strong>Out of total 516 patients, 122 patients of thyroid lesions came for FNAC. Female were more affected than males with male: female ratio of 1:4.9. Most commonly affected age group was 16-30 years of age.</p> <p><strong>Conclusion:</strong> Out of the 516 FNAC, maximum number were from lymph node consisting of 360 cases (69.86%), 122 cases (23.64%) were thyroid lesions, 34 cases (6.50%)&nbsp; were miscellaneous lesions from the submandibular salivary gland, soft tissue and subcutaneous tissue of anterior triangle of neck region.</p> <p>FNAC is important diagnostic test for differentiating inflammatory from malignant lesions so that unnecessary surgical biopsy can be avoided and helps in proper management of the patients.</p> <p><strong>Keywords:</strong> Diagnostic, FNAC, Lesions, Ant. Triangle &amp; Histopathology.</p> 2020-01-17T01:30:12-05:00 ##submission.copyrightStatement## TO ESTIMATE LIPID PROFILE IN PATIENTS WITH COPD 2020-01-17T03:20:38-05:00 Roshan Kumar Jha Ranjit S. Ambad <p><strong>Background: </strong>Chronic Obstructive Pulmonary Disease (COPD) includes persistent bronchitis and emphysema, which is generally caused due to smoking of tobacco. (COPD) is an obstructive lung disorder characterized by airflow limitation that is progressive, associated with severe inflammatory response in the air passages and the lungs due to toxic particles. It interferes with normal breathing and is not fully reversible.</p> <h2>Objectives: 1. To estimate lipid profile (Total cholesterol (TCH), Triglycerides (TG), High density lipoprotein (HDL), Low density lipoprotein (LDL), Very low-density lipoprotein (VLDL)) in patients with Chronic Obstructive Pulmonary.</h2> <h2>2. To find correlation of these parameters with severity of disease.</h2> <p><strong>Material and Method</strong>: The study was conducted in Department of Biochemistry in collaboration with Department of Respiratory Medicine at Jawaharlal Nehru Medical College and AVBRH, Sawangi (Meghe) Wardha, India. Thirty-two patients diagnosed with COPD were selected from OPD and ward of Respiratory Medicine and thirty-two age and sex matched controls were taken.</p> <p><strong>Result</strong>: The analysis of total cholesterol, triglycerides, HDL, LDL, VLDL in cases and controls. Result was statistically significant in between cases and controls of total cholesterol (p&lt;0.001), HDL (p&lt;0.001) and LDL (p&lt;0.001), and statistically not significant in between cases and controls of triglycerides (p=0.6) and VLDL (p=0.98).</p> <p><strong>Conclusion: </strong>We conclude that smoking significantly affect lipid profile in COPD patients, as it increases LDL levels and decreases HDL levels. Hence all patients with COPD patients who are smoker’s needs to check their lipid profile. COPD is considered as systemic disease with various co morbidities, which may affect the lipid profile.</p> <p><strong>Keywords</strong>: Lipid profile, COPD, AAT, CVD, TNF-α, CRP and GOLD.</p> 2020-01-17T03:20:37-05:00 ##submission.copyrightStatement## A RETROSPECTIVE STUDY TO COMPARE INFUSION OF PROPOFOL AND KETAMINE-PROPOFOL MIXTURE (KETOFOL) AS ANESTHETIC MAINTENANCE AGENTS IN PATIENTS UNDERGOING VARIOUS SURGICAL PROCEDURES IN TERTIARY CARE CENTRES 2020-01-20T01:01:15-05:00 Ravi Kumar Goel Ghasiram Agrawal <p>Introduction: The existing evidence suggests that the use of low doses and titers of ketamine can be effective in reducing the cardiovascular effects of propofol; nevertheless, this administration method can increase the chance of waking up during anesthesia. Some studies have reported the effect of anesthesia induction using a single propofol dose and low ketamine doses on the hemodynamic stability of patients in short-term outpatient operations in emergency departments. The aim of this study is to compare the effect of ketofol and propofol&nbsp;, to evaluate the intra and post-operative hemodynamic effects of ketofol infusion in comparison with propofol infusion.</p> <p>Methods: This Retrospective study involved Prior Consent from the Hospital Authorities &amp; was found to be within ethical standards. Data of 100 surgeries were selected which were managed with propofol ( 50 surgeries ) &amp; ketofol ( 50 surgeries) separately&nbsp;&nbsp; admitted to the local surgical units in last 5 years. The two groups were compared in terms of heart rate, systolic, diastolic and mean blood pressure, severity of pain and nausea, vomiting frequency and the doses of analgesics and antiemetic drugs used.</p> <p>Results: &nbsp;38 (76%)&nbsp; out of 50 of the patients were male in the propofol group and 31 ( 62%)&nbsp; out of 50 were male in the ketofol group and the difference was not Significant .The mean age of the patients was 39.68 ± 7.32 years in the ketofol and 34.14 ± 7.61 years in the propofol groups . There was no statistical difference between the two groups regarding age and sex distribution. There was no difference between the two groups regarding systolic, diastolic and mean arterial blood pressure before induction and after. The intensity of nausea was not significantly different between the two groups. Postoperative pain severity and drug dosage were not significantly different between the two study groups.</p> <p>Conclusion: The infusion of a mixture of ketamine and propofol improves hemodynamic stability in addition to better analgesia compared to the infusion of propofol alone. But it led to heightened risk of nausea and vomiting. Future studies are recommended to address these issues. In addition, further studies are warranted to investigate the use of sub-hypnotic doses of ketamine + ketofol combination for infusion in surgical procedures. When these parameters are considered, ketofol might be used as an alternative to&nbsp;<a href="">propofol</a>.</p> <p><strong>Keyword:</strong> Ketofol, Propofol, Retrospective Study. Comparative study, Ketamine</p> 2020-01-20T01:01:15-05:00 ##submission.copyrightStatement## A A STUDY OF KNOWLEDGE, ATTITUDES AND PRACTICES REGARDING NUTRITION DURING CARE OF TUBERCULOSIS PATIENTS AMONG NURSING STAFF OF A TERTIARY CARE HOSPITAL 2020-01-20T01:27:53-05:00 Sujeet Anant Divhare Sunita Girish Amit Divhare Satyashil Ingale Rajashree Korake <p><strong>Background: </strong>Nutrients boost the host’s immune responses against various pathogens including mycobacterium tuberculosis. People with latent tuberculosis do not exhibit any clinical signs or symptoms of illness because the infection is contained by their immune system. The direct evidence of effect of nutrition on tuberculosis is difficult but the weight of evidence still favors the view that malnutrition may be an important factor in the high susceptibility and morbidity from tuberculosis.</p> <p><strong>Aim and objectives: </strong>To find out the knowledge regarding nutrition, attitude towards it and practices of nutrition among nursing staff involved in the management of tuberculosis patients.</p> <p><strong>Material and methods: </strong>This study was carried out in a tertiary care teaching hospital. A total seventy nursing staff, involved in care of tuberculosis patients either in tuberculosis wards and OPDs, participated in the study. Assessment of Knowledge, Attitude and Practices regarding nutrition was done with pretested and structured questionnaire.</p> <p><strong>Statistical analysis: </strong>Percentages, Means, Chi-square test and ANOVA using the SPSS 17.0 Software.</p> <p><strong>Results: </strong>GNM trained participants with work experience of more than 3 years were much better than B.Sc. nursing students regarding their knowledge about daily caloric requirements, dietary recommendations for tuberculosis patients and influence of dietary habits on tuberculosis outcome (p &lt; 0.05) but there was no statistically significant difference in the mean score of their knowledge about food nutrients. Both the groups showed positive attitude towards morning breakfast and having 3 meals and snacks in a day. Skipping of breakfast was more common among the GNM staff as compared with B.Sc. nursing students (P &lt; 0.05).</p> <p><strong>Conclusions: </strong>Results from the study indicated KA scores higher than P scores. The effect of nutritional supplementation on tuberculosis prevention and health outcomes among health care workers had not previously been systematically reviewed. This study will provide guidance on recommendations for nutritional care among health care workers who are directly involved in care of patients with tuberculosis.</p> <p><strong>Keywords</strong>: Nutrition, Tuberculosis, Knowledge, Attitudes and Practices, Nursing staff.</p> 2020-01-20T01:27:53-05:00 ##submission.copyrightStatement## POST-PARTUM DEPRESSION- TREATMENT UPDATE 2020-01-15T23:08:46-05:00 Vijay Choudhary Sangeeta Hatila Shubham Mehta <p><strong>Background: </strong>Postpartum depression is a prevalent and serious mental health issue in India. This affects not only a woman but also the development of her offspring. There is a need to find out various pharmacological and non-pharmacological treatment options available for the treatment post-partum depression.</p> <p><strong>Method: </strong>This review was based on methods and results as described in the selected published articles available on PubMed and PsycINFO. We identified articles whose titles contained the following key terms in various combinations of the following: depression, depressive illness, postpartum, postnatal, treatment, prevention, therapy, pharmacotherapy, and antidepressant, the name of each antidepressant drug, hormonal therapy, estrogen, and progesterone.</p> <p><strong>Results: </strong>We reviewed treatment of post-partum depression with antidepressants randomized clinical trials as well as open label studies, hormonal treatment, prevention studies randomized clinical trials as well as open label studies, alternative pharmacological treatment including omega-3- fatty acids- both for prevention and treatment. We also reviewed internet based intervention, cognitive behavioral therapy, kangaroo mother care, effectiveness of regular exercise, role of ECT and effect of rTMS in post part depression. When it’s about safety, the psychological interventions support their use in some women, pregnant and lactating women because of devoid of side effects to new born.</p> <p><strong>Conclusion: </strong>Diverse pharmacological or psychological interventions options are available for treatment of postnatal depression. The most promising intervention is the focus on intensive and individualized approach.</p> 2020-01-13T01:28:47-05:00 ##submission.copyrightStatement## A RARE CASE OF RAPUNZEL SYNDROME - A SMALL BOWEL TRICHOBEZOAR 2020-01-08T03:31:15-05:00 Harin Tailor Firdaus A Dekhaiya Smit Mehta Samir M Shah Dhawal Panchal <p>Bezoars are concretions of foreign material in the gastrointestinal tract, mainly the stomach. In humans, the most common type of bezoar is the trichobezoar, is more often found in children and teenage girls. . The most frequent type of bezoar in adults is phytobezoar. A rare manifestation of trichobezoar is Rapunzel syndrome (RS) which occurs when the bezoar extends into the small intestine. An 11 years old girl from low socio economic social status presented to emergency department. . She had a complain of abdominal pain and vomiting before 3 month which was relieved itself after vomiting which contains hair, threads and cloths. Abdominal examination revealed a generalised abdominal distension. Ultrasonography (USG) of abdomen was done. . Trichobezoar was removed by open surgery with longitudinal enterotomy.&nbsp; The mass was occupying 30cm part of terminal ileum up to iliocecal junction with a putrid smell which was removed from enterotomy. Trichobezoars are a bizarre medical problem, and Rapunzel syndrome is an extremely uncommon variety of trichobezoar which occurs when the bezoar extends into the small intestine. &nbsp;The diagnosis of trichobezoar is possible on imaging in a proper clinical setting.</p> <p><strong>Keywords: </strong>Trichobezoar, Rapunzel Syndrome, Enterotomy.</p> 2020-01-08T03:31:15-05:00 ##submission.copyrightStatement## CONTEMPORARY TREATMENT OF ALK POSITIVE NON SMALL CELL LUNG CANCER PATIENT WITH BRAIN METASTASES: OUR EXPERIENCE 2020-01-13T00:40:26-05:00 S Crvenkova Popova M <p>Purpose: The aim of this study is to show alectinib efficacy and safety, with focus on alectinib intracranial efficacy.</p> <p>Case presentation: We report on a 46-year-old woman diagnosed as non small cell lung cancer harboring echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase fusion gene. She has intracranial metastases and poor performance status of 3. We treated this patients with alectinib after whole brain irradiation and discontinuation of chemotherapy after two 2 cycles due to progressive brain and liver metastases. Good response was obtained with improving of her performance status without adverse events. &nbsp;</p> <p>Conclusions: We recommend alectinib as a treatment approach for ALK+ NSCLC patients, especially those with CNS metastases at the time of the diagnosis and poor PS.</p> <p><strong>Key words:</strong> CNS metastasis, ALK+ NSCLC patients, alectinib</p> 2020-01-13T00:40:26-05:00 ##submission.copyrightStatement## PROSTATIC STROMAL SARCOMA: RARE CASE REPORT 2020-01-20T00:36:35-05:00 Niti Dalal Sunita Singh Vartika Goel Pooja Sharma Arsha Narayanan Rajeev Sen <p>Prostatic stromal sarcoma is rare and aggressive malignant mesenchymal tumor accounting for 0.1- 0.2% of all prostate malignancy. Here we report a case of middle aged male with lower urinary tract symptoms and normal PSA levels. Ultrasonography findings showed grade 3 prostatomegaly. An open prostatectomy specimen was sent and a diagnosis of Prostatic Stromal Sarcoma was made based on histopathological and immunohistochemical findings.</p> <p><strong>Keywords:</strong> Prostate, Stromal sarcoma, mesenchymal</p> 2020-01-20T00:36:35-05:00 ##submission.copyrightStatement##