Browsing by Author "Kumar, Amit"
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Item Abdominal organ involvement in blunt injuries.(2012-01) Singh, Mousami; Kumar, Amit; Verma, Anoop Kumar; Kumar, Sanjeet; Singh, Abhas KumarVisceral injuries of the abdomen following blunt trauma present a great medico-legal problem to the forensic experts. Thus the doctor should remain alert to the development of signs and symptom after blunt trauma to the abdomen in vehicular accident otherwise he may be charged of negligence. Among 55 fatal cases of blunt abdominal injury, maximum number of cases belongs to the age group 20-29 yrs. Males were the predominant victims with ratio 4:1. It was found that road traffic accidents by heavy vehicle like bus; car and truck were responsible for 70% of blunt abdominal injuries. Among 55 cases of blunt injury, the incidence of the involvement of liver, spleen, small intestine, kidney, stomach and urinary bladder were 67%, 30.91%, 18%, 10.9%, 9.09%, 5% cases respectively. Genitals were found injured in 3% cases of blunt injury abdomen. For Blunt Injuries of Abdomen majority of the cases i.e. 78.18% were of accidental, 18.18% were homicidal and 3.6% suicidal in nature. Immediate cause of death was shock and hemorrhage and in those cases where death was delayed, cause of death was septicemia.Item Acute myocardial infarction due to blunt chest trauma.(2002-11-04) Sinha, Ajay Kumar; Agrawal, R K; Singh, Arun; Kumar, Rajiv; Kumar, Sanjeev; Sinha, Ajay; Saurabh,; Kumar, AmitWe report a case of blunt chest injury following a road accident leading to damage of the left main and left anterior descending coronary arteries causing acute myocardial infarction in a young person.Item Assess Knowledge Regarding Breast Cancer Among Women In Different Areas Of Gurdaspur, Punjab(World Wide Journals, 2018-02) Sahni, Mili; Kumar, Amit; Ober, KimmiBreast cancer is a proliferation of neoplasm epithelial cells may confined to the mammary ducts or lobules, respectively without demonstrable evidence of invasion through the Basement Membrane. Possible causes are estrogen therapy, antihypertensive agents, high fat diet, obesity, fibrocytic breast cancer, genetic mutations in BRCA 1 and BRCA 2 gene. It is manifested by lump formation, mastalgia, nipple discharge, skin changes and disfigurement of Breast the diagnosis included mammography and treatment includes chemotherapy and mastectomy. A non experimental descriptive design was used with purposive sampling technique. A self structured questionnaire was used to collect the data. Findings revealed that majority (89%) of women had poor knowledge and 11% of women had good knowledge regarding breast cancer.Item Assessment Of Knowledge And Awareness Of Adult Basic Life Support Among Post Graduate Students Of Rama Dental College, Kanpur City, India.(2016-05) Kumar, Jayant; Pradhan, Devina; Shavi, Girish R; Kumar, AmitBackground: Accidents and cardiac arrest are mostly encountered life threatening emergencies, which can sometimes be prevented by adequate knowledge and proper practice regarding basic life support (BLS) and resuscitation. Therefore, the study aims at evaluating the knowledge and awareness of adult basic life support among postgraduate students of Rama Dental College, Kanpur. Methodology: A cross- sectional descriptive study was been conducted amongst the postgraduate students regarding BLS. Permission was obtained from the Institutional heads and the review board. A self- structured questionnaire in English which was administered was validated via pilot study. The questionnaire comprised of 13 close ended questions including demographic details as well as questions regarding knowledge and awareness on Basic Life Support. A single calibrated examiner administered the questionnaire. Statistical analysis was done by calculating percentage and frequency distribution. Results: 100 postgraduate students were chosen as study subjects. Out of those, 95 students submitted the duly filled questionnaires. Therefore, it was seen that only 37%-38% students had knowledge regarding the meaning of BLS, while only 11% postgraduate students were aware of the latest modification of the BLS. 30%-37% students gave the correct response for the question ‘first response when you see a person unresponsive on road’. 56% students had knowledge regarding the location for compression of chest. Conclusion: In the current study, we found that most of the postgraduate students did not have adequate knowledge regarding BLS.Item Assessment of Satisfaction and Quality of Life using Patient-reported Outcome Measures after Perineal Urethrostomy: A Prospective Analysis(International Research Organization for Life & Health Sciences (IROLHS), 2019-05) Kumar, Prabhat; Upadhyay, Rohit; kant, H Singh Kamal; Kumar, Amit; Kumar, VijoyIntroduction: Conventionally, success after urethroplasty has focused on objective measures such as urinary flow rates, postvoid residual (PVR) volumes, and appearance of the urethra on cystoscopy and/or retrograde urethrogram. The objective ofthis study was to prospectively analyze the pre- and post-operative patient-reported outcome measures describing patients’satisfaction and quality of life (QoL) after perineal urethrostomy and to compare these results with objective data.Materials and Methods: We prospectively collected data from 30 consecutive patients who underwent perineal urethrostomyfor complex anterior urethral stricture from April 2017 to January 2019. Patient demographics, International Prostate SymptomScore (IPSS), QoL score, urethral stricture surgery patient-reported outcome measure (USS-PROM), maximum flow rate, andPVR urine were collected before, and 2 and 8 months after surgery. General estimation equation was used to compare theresults and linear regression analysis to correlate both questionnaires with objective data.Results: Mean age was 63 years. All patients had undergone previous urethral surgery in the form of multiple DVIU, urethraldilatation, substitution, or augmentation urethroplasties. The mean USS-PROM score improved from 13.4 preoperatively to 3.10after surgery (P < 0.001) and 85.6% of patients were satisfied or very satisfied with surgical results. Strong negative correlationwas found, respectively, between flow rate and USS-PROM and with IPSS.Conclusion: Significant improvements in urinary symptoms and in QoL are expected after perineal urethrostomy for complexanterior urethral stricture and they are correlated with objective measures.Item Assessment of Symptomatic Post Tuberculosis Patients by Spirometry and Chest X Ray(International Society for Contemporary Medical Research, 2020-01) Pandey, Amiya; Agrawal, Rajesh; Agarwal, Rajat; Kumar, Amit; Gupta, Utkarsh; Sharma, DivyenduIntroduction: TB is an infectious disease caused by thebacillus Mycobacterium tuberculosis which typically affectsthe lungs. The disease is spread by the people who are sick withactive pulmonary TB. Up to half of TB survivors have someform of persistent pulmonary symptom despite microbiologiccure. The aim of the study was to assess the symptomatic posttuberculosis patients by using spirometry and chest x ray.Material and methods: The study was conducted in theDepartment of Respiratory Medicine, Rohilkhand MedicalCollege and Hospital after seeking clearance from theInstitutional Ethical Committee. The aim of the study was toassess the symptomatic post tuberculosis patients by usingspirometry and chest x ray. The study duration was from 1stNovember 2018 to 31st October 2019 and 100 patients wereenrolled in the study. Data was collected from patients whopresented with symptoms within 6 months of completing theirtreatment for tuberculosis.Results: All the patients (post tubercular) enrolled in thestudy had symptoms (in some form) even after full courseof antitubercular treatment and bacteriological cure andamong these breathlessness was the most common presentingsymptom (96%) followed by cough (58%). Maximum patientshad abnormal findings on chest examination (80%). Fibrosisfollowed by cavitary lesions were the most common findingson chest x ray in post tuberculosis patients. Maximum patientshad restriction (56%) in their spirometry followed by mixedpattern (23%).Conclusion: In patients with restriction on spirometry andhaving symptom of breathlessness and cough, reassurance andpulmonary rehabilitation may play a major role in relievingtheir symptoms whereas in patients with mixed or obstructivepattern on spirometry, bronchodilator therapy along withpulmonary rehabilitation may be helpful in relieving theirsymptoms post tuberculosis treatment.Item Association between Interleukin-6 (-174 G/C and -572 C/G) Promoter Gene Polymorphisms and Risk of Intracerebral Hemorrhage in North Indian Population: A Case Control Study.(2016-01) Kumar, Pradeep; Kumar, Amit; Sagar, Ram; Misra, Shubham; Farooq, Mohammad; Suroliya, Varun; Vivekanandhan, Subiah; Srivastava, Achal Kumar; Prasad, KameshwarBackground: Interleukin-6 (IL-6), a pro-inflammatory cytokine is involved in various vascular pathologies including stroke. Till date, no studies have been reported for the association between IL-6 gene polymorphisms with the risk of Intracerebral hemorrhage (ICH). Objective: The aim of this present case-control study was to investigate the association between IL-6 (-174 G/C and -572 C/G) gene polymorphisms and risk of ICH in North Indian population. Methods: Genotyping was carried out by using SNaPshot method for ICH patients and 100 age-sex matched ICH free controls. Conditional logistic regression analysis with adjusting multiple demographic and risk factor variables was used to calculate the strength of association between IL-6 (-174 G/C and -572 C/G) polymorphisms and risk of ICH. Results: Hypertension, diabetes, dyslipidemia, smoking and low socioeconomic status were found to be associated with the risk of ICH. The distribution of -174 G/C and -572 C/G genotypes was consistent with Hardy Weinberg Equilibrium (HWE) in the ICH and control subjects. Conditional logistic regression analysis showed a significant association between IL-6 -572 C/G gene polymorphism and the risk of ICH under dominant model (OR=3.7; 95%CI 1.05 to 13.1; p=0.004) and allelic model (OR=2.6; 95%CI 1.1 to 6.2; p=0.01). No significant association was observed for the association between IL-6 -174 G/C gene polymorphism and risk of ICH. Conclusion: Our results suggest that IL-6 (-572 C/G) polymorphism is significantly associated with the risk of ICH in North Indian population. Further prospective studies with large sample size are needed for independent validation.Item Autologous intravenous bone marrow mononuclear cell therapy for patients with subacute ischaemic stroke: a pilot study.(2012-08) Prasad, Kameshwar; Mohanty, Sujata; Bhatia, Rohit; Srivastava, M V P; Garg, Ajay; Srivastava, Achal; Goyal, Vinay; Tripathi, Manjari; Kumar, Amit; Bal, Chandrashekar; Vij, Aarti; Mishra, Nalini KantBackground & objectives: Bone marrow mononuclear cell therapy has emerged as one of the option for the treatment of Stroke. Several preclinical studies have shown that the treatment with mononuclear cell (MNCs) can reduce the infarct size and improve the functional outcome. We evaluated the feasibility, safety and clinical outcome of administering bone marrow mononuclear cell (MNCs) intravenously to patients with subacute ischaemic stroke. Methods: In a non-randomized phase-I clinical study, 11 consecutive, eligible and consenting patients, aged 30-70 yr with ischaemic stroke involving anterior circulation within 7 to 30 days of onset of stroke were included. Bone marrow was aspirated from iliac crest and the harvested mononuclear cells were infused into antecubital vein. Outcomes measured for safety included immediate reactions after cell infusion and evidence of tumour formation at one year in whole body PET scan. Patients were followed at week 1, 4-6, 24 and 52 to determine clinical progress using National Institute of Health Stroke Scale (NIHSS), Barthel Index (BI), modified Rankin Scale (mRS), MRI, EEG and PET. Feasibility outcomes included target-dose feasibility. Favourable clinical outcome was defined as mRS score of 2 or less or BI score of 75 to 100 at six months after stem cell therapy. Results: Between September 2006 and April 2007, 11 patients were infused with bone-marrow mononuclear cells (mean 80 million with CD-34+ mean 0.92 million). Protocol was target-dose feasible in 9 patients (82%). FDG-PET scan at 24 and 52 wk in nine patients did not reveal evidence of tumour formation. Seven patients had favourable clinical outcome. Interpretation & conclusions: Intravenous bone marrow mononuclear cell therapy appears feasible and safe in patients with subacute ischaemic stroke. Further, a randomized controlled trial to examine its efficacy is being conducted.Item Bio-bleaching of Anthocephalus cadamba Kraft Pulp through Direct Fungal Treatment by FEQP Sequence.(2015) Lal, Mohan; Dutt, Dharm; Kumar, Amit; Gautam, ArchanaAims: The study aims at mitigating pulp kappa number before bleaching to minimize pollution load. Study Design: An experimental study. Methodology: The various parameters of direct fungal (Coprinellus disseminatus MLK01) treatment (F-stage) of unbleached kraft pulp of Anthocephalus cadamba were optimized and compared with the results of enzymatically pre-bleaching. Finally, the pulp was bleached by EQP three-stage and XECEHH six stages bleaching sequences. Results: Direct fungal treatment (F-stage) delignified the Anthocephalus cadamba kraft pulp more selectively with Coprinellus disseminatus MLK01 compared to xylanase prebleached pulp from the same fungus and oxygen delignification. F-stage mitigated the unbleached pulp kappa number by 55.0% and improved brightness and viscosity by 17.3 and 7.63% respectively. Kappa number reduction and brightness improvement were 22.1 and 6.3% more in F-stage compared to XE-stage. The kappa number and pulp brightness of oxygen delignified were 0.9 and 5.2% less compared to F-stage. The viscosity of oxygen delignified pulp reduced drastically due to alkaline peeling reactions compared to XE-stage (‒26.86%) and F-stage (‒27.09%). The brightness and viscosity of XECEHH bleached pulp were 80.1% and 7.4 cps at a chlorine demand of 4.3% while FEQP bleached pulp produced brightness of 79.7% and viscosity 8.2 cps. COD and colour values in effluent generated during FEQP bleaching were 53.29% and 54.36% less compared to CEHH bleaching.Item Blunt injuries of chest: A medicolegal analysis.(2012-04) Kumar, Amit; Singh, Mousami; Verma, A K; Rastogi, A KChest injuries are always a great challenge for medical professionals as two of the vital organs, which are present there, very often involved & damaged causing excessive bleeding and death. These injuries are usually caused by blunt forces or sharp penetrating weapons. Here in this paper 60 cases of chest injuries by blunt forces are studied for their epidemiological, medicolegal and clinico-pathological aspects. Most of them are adult/ middle aged male between 20-50years of age, hit or run over by heavy vehicles in road traffic accidents. Lungs are lacerated in almost all the cases and internal haemorrhage & shock is the prime cause of death. Heart, aorta & other organs were also involved in substantial number of cases. Though majority of them died within two hours, either on the spot or in the way to the hospital, an attempt is also made to correlate the prognosis & the nature of injuries.Item Causative Agents and Antimicrobial Sensitivity Pattern Among Patients of Urinary Tract Infection in a Tertiary Care Hospital of Western Uttar Pradesh(Ibn Sina Academy of Medieval Medicine & Sciences, 2016-10) Kumar, Amit; Singh, Shivangna; Gautam, Vivek; Yadav, Alka; Zaheer, Imran; Agarwal, Praveen; Sharma, PriyamvadaBackground: UTI is one of the commonest domiciliary and nosocomial bacterial infection, especially affecting the females. Nowadays antibiotic resistance among uropathogens is an emerging problem in treatment of UTI. Periodic assessment of antimicrobial susceptibility among the microorganisms will be fruitful in treating UTI. Aims: To study and assess the sensitivity/resistance pattern among E.coli and other uropathogens for nitrofurantoin, ofloxacin, Cotrimoxazole & 3rd generation cephalosporins. Methods: An observational, cross sectional study of 6 months duration from March 2016 to August 2016 was conducted on patients suffering from UTI in Department of Pharmacology and Department of Microbiology in FH Medical College & Hospital, Tundla, Uttar Pradesh. A total of 100 urine samples were analysed. Results: E.coli was the predominant (46%) uropathogen followed by Klebsiella (27%), Proteus (12%), Staphylococcus (7%), Pseudomonas (5%) and Enterococcus (3%). UTI was more common among females (61%) and illiterates (62%). Nitrofurantoin was the most sensitive (58%) antimicrobial followed by ofloxacin (35%). Conclusions: 3rd generation Cephalosporins showed higher percentage of resistance (78%).Item CHINESE STRING OF PEARLS POLICY AND INDIA'S SECURITY IMPLICATIONS(Indian Society For Health And Advanced Research, 2023-01) Kumar, AmitString of Pearls refers to the Chinese intention to establish a network in India Ocean Region (IOR) surrounding India. Each Pearl represents some form of permanent Chinese military installation in a series of locations along a String. Recent development of ports around India, in Gwadar, Hambantota, Sittwe on the Bay of Bengal Coast in Myanmar etc. are seen as part of a string of pearls. Although these are commercial ports, the fear is that these could be easily converted to Naval facilities in case of a conflict in IndiaItem Clinical Presentation, Management and Outcome in Diverticular Colovesical Fistulas - Our Experience.(Akshantala Enterprises Private Limited, 2020-07) Kalra, Gaurav; Puthalath, Rajeev Thekke; Hegde, Suraj; Pai, Narendra; Kumar, AmitColovesical fistula (CVF) is an abnormal communication between the urinary bladder and the large intestine, usually sigmoid colon. Diverticulitis is the most common cause of CVF in most of the western studies, accounting for approximately 70% of cases. Diverticular CVF is uncommon in Asia. This case series shares the experience of six cases of diverticular CVF in Indian population. METHODSMedical records of six patients with diverticular colovesical fistulas during the period January 2016 - August 2019 were reviewed with regard to symptoms, diagnostic investigations, and management. Various aspects of the disease were analysed to determine the common features of colovesical fistula in our population. RESULTSAll patients with diverticular colovesical fistula were presented with urinary symptoms and none were aware about their existing colonic diverticulosis. Five out of the six cases presented with pneumaturia. Contrast enhanced computed tomography (CECT) abdomen detected sigmoid diverticulosis with vesical fistula in all cases. The most common site of fistula found on cystoscopy was on the left superolateral wall of bladder. All cases were operated as a single stage procedure including fistula repair, colonic resection, omental interposition with no temporary colostomy which provided an excellent surgical cure. CONCLUSIONSColovesical fistula secondary to diverticular disease has shown a rising incidence and can be effectively managed by a multidisciplinary team. It requires prompt diagnosis, adequate preoperative evaluation, perioperative care including bowel preparation, nutritional supplementation, appropriate antibiotics, and meticulous surgical skills allowing an elective one-stage approach.Item Clinical, hematological and cytogenetic profile in fibroblast growth factor receptor 1 rearranged hematoloymphoid malignancies(Medip Academy, 2020-04) Shetty, Dhanlaxmi; Talker, Elizabeth; Mohanty, Purvi; Jain, Hemani; Yadav, Anil Kumar; Jain, Hasmukh; Nayak, Lingaraj; Tembare, Prashant; Patkar, Nikhil; Subramanian, P. G.; Kumar, AmitThe background of this study is FGFR1 belongs to a family of four, high-affinity receptor tyrosine kinase and is a legitimate oncogene associated with uterine, cervical, prostate, bladder, colorectal and lung cancers. It is rarely concomitant in myeloid and lymphoid neoplasms but has an aggressive clinical course with a high mortality rate when present. Cytogenetic abnormalities involving the FGFR1 gene is most frequently observed in AML, MPN with eosinophilia, T-ALL and T-LBL with ZMYM2 gene being the most common fusion partner. Methods of this study was to authors report a series of 4 cases with FGFR1 rearrangements. Results is three patients presented as T-cell Lymphoblastic lymphoma (T-LBL) and one as mixed phenotype acute leukemia (MPAL). The T-LBL cases harboured the FGFR1/ ZMYM2 fusion and the MPAL case harbored the CNTRL/FGFR1 fusion as identified by conventional cytogenetics and confirmed by molecular studies. Conclusion is authors herewith describe the clinical, biochemical, molecular and cytogenetic features observed in these cases.Item A Clinicopathological Observational Study of Various Types of Masses at Nasal Cavity, Paranasal Sinuses and Nasopharynx.(2016-11) Kumar, Amit; Tiwari, Aditya Narayan; Kapoor, Sahil; Jain, Vinti; Bhanu, DivyaBackground: The nasal masses affect different age groups and have the aetiological factors, which are both congenital and acquired. In the present study we have observed Various Types of Masses at Nasal Cavity, Paranasal Sinuses and Nasopharynx. Methods: The present study was based on the observation of 100 patients of different age group having chief complaint of fleshy mass in the nasal cavity who were selected from outpatient department. Results: In the study of 100 patients, 49 were children and adolescent, 32 were adult, 17 were middle aged and remaining 2 were elderly. 83.9% of Antrochoanal polyp were found below 20 year age group and 90.9% of ethmoidal polyp were found in above 21 year age group and 9 out of 42 cases of polyp gave history of allergy and 6 (14.3%) cases out of 42 having DNS. Conclusion: Sinonasal polyposis is the most common pathological nasal mass and of these antrochoanal polyp is usually seen in children and adolescent and ethmoidal polyp is common in the middle age group.Item Comparative Evaluation of Cost – Effectiveness and Medication Adherence Between Olanzapine and Iloperidone in Patients of Psychosis(Ibn Sina Academy of Medieval Medicine & Sciences, 2017-04) Singh, Shivangna; Kumar, Pankaj; Kuchhal, Abhinav; Kumar, Amit; Yadav, Alka; Zaheer, Imran; Gautam, VivekBackground: To assess the cost – effectiveness between Iloperidone and Olanzapine in relation to different measures of effectiveness and to evaluate significance of medication adherence and costs and outcomes. Methods: A prospective, randomized, comparative, flexible dose clinical study of 1 year duration was conducted in 100 first episode (drug naïve) cases of psychosis attending to psychiatric outdoor patient department of Rohilkhand Medical College and Hospital, Bareilly. 50 patients each in olanzapine (OLZ) and Iloperidone (ILO) group comprised the sample size. Patients were regularly evaluated by senior psychiatrist for dose titration. OLZ 10-20mg/day and ILO 6-12mg/day were used. Least expensive brands available in our hospital pharmacy were used. Cost – effectiveness and medication adherence were measured as per the formula. Results: It was observed that ILO (8mg/day) controlled 65-75% cases and 12mg/day dose controlled > 90% cases of psychosis. Whereas OLZ showed this level of control respectively with 10 – 15mg/day (average 12.5mg/day) and 15-20mg/day (average 17.5mg/d). Since olanzapine in 15-20mg/day dose cause more metabolic adverse events particularly obesity, hyperglycemia and dyslipidemia which need further management hence overall olanzapine is not cost-effective. 42(87.5%) cases had medication possession ratio (MPR) >90% in ILO group compared to 18 (37.5%) cases in OLZ group. Increased medication adherence led to better control and outcomes. Patients with <90% MPR had developed more adverse events and were mostly living in rural areas. Conclusions: Iloperidone is comparatively more cost-effective than olanzapine to control > 90% of patients on long term use.Item A Comparative Study of the Effect of Primary and Secondary Closure Technique Following Removal of Impacted Mandibular Third Molars(International Society for Contemporary Medical Research, 2019-11) Haidry, Naqoosh; Raj, Ritesh; Kashyap, Sandeep; Byrappa, Brijesh; Kumar, Amit; Singh, AnkurIntroduction: Surgical removal of the impacted mandibularthird molar is one of the most frequently performed surgicalprocedures in oral and maxillofacial surgery. The purpose ofthis study was to compare the primary and secondary woundclosure after surgical removal of impacted mandibular thirdmolars by evaluating the extent of facial swelling, the severityof pain and degree of trismus.Material and Methods: A prospective, randomized,clinical trial was conducted in 80 patients. The patients wererandomly divided into two groups of 40 each. In Group 1:patients underwent primary closure of the wound and inGroup 2: patients underwent secondary closure of the wound.Postoperative pain, swelling, and trismus were evaluated onthe 2nd and 7th day postoperatively.Results: Statistically significant difference was observed forfacial swelling and trismus on 2nd postoperative days betweenboth groups. Postoperative pain was less in the secondaryclosure group.Conclusion: From the outcome of the above study we canconclude that the secondary wound closure technique has asignificant advantage over primary wound closure concerningswelling and trismus.Item Comparative Study to Assess Diagnostic Reliability of Ultrasound and 3T-MRCP in Patient of Obstructive Jaundice.(2015) Rathore, Manoher Singh; Rathore, Vishakha; Kumar, Amit; Kapoor, Gaurav; Gour, Neeraj; Jain, Deepak KumarBackground: Evaluation of jaundice patients should include proper history and examination, laboratory investigation and imaging investigations (non invasive like Ultrasound (U\S), CT and MRI or invasive like ERCP and PTC). Aim of Study: The aim of this prospective study is to evaluate the diagnostic reliability of U\S and MRI-MRCP in patients of obstructive jaundice in clinical practice. Materials and Methods: This is a prospective study performed on 60 patients (31 male and 29 female) with an average age of 55.53 +/- 17.57 years presented with obstructive jaundice for whom abdominal ultrasound (U\S) and magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP) on 3 Tesla was performed in the departments of radiology in Max super speciality teaching hospital, saket, Delhi, India from May 2012 to May 2013. The final diagnosis was achieved by endoscopic retrograde cholangiopancreatography (ERCP) and \or surgery and confirmed by histopathology. Results: The most common cause of obstructive jaundice in our study was common bile duct stones (51.65%) followed by tumors (33.3%) then benign strictures (10.0%), choledochal cyst (3.33%). In this study, MRI-MRCP could differentiate surgical from medical jaundice in all cases, while U\S could differentiate surgical from medical jaundice in 91.25% of cases. MRI-MRCP correctly defines the level of obstruction in all cases (100%). While U\S correctly define the level of obstruction in only 78% of the total cases. MRI-MRCP correctly suggests the most possible cause of obstruction in 96.25% of cases. While USG is correctly suggests the most possible cause in only 76.3%. Conclusion: So that USG as a screening modality is useful to confirm or exclude biliary dilatation & to choose patients for MRCP examination. MRI-MRCP is a useful non-invasive and essential method in the preoperative evaluation of patients with obstructive jaundice. In addition MRI-MRCP was superior to U\S or ERCP in studying the extent & staging of malignant lesions.Item A cross sectional study to assess pharmacotherapeutic adherence among diabetes mellitus patients in tertiary care hospital(Medip Academy, 2019-02) Gaur, Richa; Kushwaha, Virendra; Agrawal, Pooja; Agrawal, Saurabh; Kumar, Amit; Malhotra, KritiBackground: Diabetes mellitus (DM) refers to a group of common metabolic disorders that associated with abnormalities in carbohydrate, fat, and protein metabolism which results in chronic complications. Attainment of optimal blood sugar level is generally based on appropriate usage and proper adherence to prescribed medications. The study was, therefore, aimed to assess adherence to oral antidiabetic drugs among diabetic patients attending outpatient clinic of L. L. R. Hospital, G.S.V.M. Medical College, Kanpur, U.P.Methods: Hospital based cross-sectional study design was conducted from April 2017 to June 2018. The data was collected by interviewing T2DM patients receiving antidiabetic medications using Morisky’s four item adherence assessment questionnaire. The collected data was processed and analyzed with SPSS version 20.Results: From the 126 patients of diabetes, when asked about adherence to their medications as per the Morisky's four item method, 114 (90.47%) of them did not forget to take the drugs, 108 (85.71%) of patients reported that they had been being careful in taking their medications, 90 (71.42%) patients did not stop medications when they felt better and the other 108 (85.71%) patients reported that they did not stop medications when they felt worse while taking medications. This study shows that 54 (42.86%) respondents were adherent to their medications.Conclusions: This study revealed a moderate level of adherence among the participants and statistically significantly depended upon their socioeconomic status. Efforts are needed to increase the medication adherence of these patients’, so they can realize the full advantage of prescribed therapies.Item A cross-sectional study to describe the spectrum of ocular manifestations and risk factors of mucormycosis presenting to a tertiary hospital of East India(All India Ophthalmological Society, 2023-01) Raj, Amit; Nishant, Prateek; Sadhukhan, Kaushik; Saha, Bhawesh C; Sinha, Upasna; Kokkayil, Prathyusha; Gupta, Abhishek; Kumar, Amit; Tiwari, PragatiPurpose: To report the clinico?demographic profile of rhino?orbito?cerebral mucormycosis (ROCM) in patients during the “second wave” of the COVID?19 pandemic in eastern India, and their ophthalmic manifestations at presentation to our tertiary institute. Methods: Cross?sectional study amongst patients presenting to our center based on their hospital records. Demographic information, history related to COVID?19, records of detailed ocular examination, and microbiological, radiological, and histopathological investigation were entered into an online worksheet and analyzed using SPSS 26.0. Results: A total of 219 patients with ROCM were treated from May to September 2021, and 110 of these had ocular manifestations at presentation (50.2%). The age of patients ranged from 22 to 83 years and the mean ± standard deviation (SD) age was 49.9 ± 12.9 years. Ninety (81.8%) patients had been diagnosed with diabetes mellitus, 31 (34%) had hypertension, and 10 had other comorbidities. The duration between the onset of COVID?19 and mucormycosis symptoms was 0 to 60 days with a mean ± SD interval of 20.9 ± 12.6 days. Fifty?six (50.9%) patients had a history of steroid use. Unrelenting ocular or facial pain was the most common presenting symptom, ptosis was the most common anterior segment manifestation, and ophthalmic artery occlusion was the most common posterior segment manifestation. Conclusion: Our data from eastern India reinforces the relationship between COVID?19, diabetes, corticosteroid use, and ROCM. Knowledge of various presenting anterior and posterior segment manifestations of the disease as described in the present study will guide clinicians to recognize the disease early and make every effort to prevent complications.