Perspectives in Medical Research
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Chief Editor: Dr Srikanth Shastry
ISSN: 2348-1447 (Print); 2348-229X (Online)
Frequency: Quarterly
Language: English
Open Access Peer-reviewed journal
Web site: https://www.pimr.org.in/
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Item A proposed scoring system for fast triage of COVID 19 patients using basic clinical parameters: Simple Clinical Parameter (SCIP) Score(Prathima Institute of Medical Sciences, 2022-04) Chandel, Satish; Rai, Geeta; Tayal, Vandana; Rai, Niket; Singhal, Shubha; Sharma, ParagIntroduction : Globally healthcare systems are jeopardized due to the COVID-19 pandemic. A fast and simple triage is very important for effec?ve u?liza?on of health care resources. We propose a new tool is for severity assessment of pa?ents at the ini?al point of care. Objec?ve: To propose a scoring method for fast triage of COVID 19 pa?ents in predic?ng the level of care required by the pa?ent Methods: The SCIP score is for pa?ents who have been tested posi?ve for COVID-19. This scoring system is useful to segregate the pa?ents into different level of care based on values of clinical parameters like Pulse rate (PR), Respiratory rate (RR) and arterial blood oxygen satura?on. The risk score ranges from 1 to 10. Lower the score more severe is the disease and hence more intense care is warranted. Result: Preliminary observa?on of SCIP scoring criteria is based on ten pa?ents. On retrospec?ve analysis it was observed that the level of care required by the pa?ents was in correspondence with the score obtained by the SCIP formula. Conclusion: SCIP scoring system is an easy and rapid tool which may be helpful in early detec?on of severity and taking fast decision in the ?me of crisis due to COVID 19. Valida?on in more number of pa?ents is required to establish the findings.Item Pattern And Prevalence Of Psychiatry Morbidity Among Subjects Attended Psychiatric Outpatient Department In A Tertiary Care Hospital In Northern Telangana(Prathima Institute of Medical Sciences, 2022-04) Rachakatla, Shiva Kumar; Porandla, Kishan; Puli, Sai Krishna; Nadigapu, Sanjay Kumar; mavillapalli, Vishnu Vardhan; Cheriyala, Swetha; Devulapally, NamrataBackground: Mental health problem is a major public health issue all over the world including India. In India, mental disorders are the leading contributors to significant morbidity and disability amongst those affected. With changing health pa?erns among Indians, mental behavior and substance use disorders are coming to the forefront in health care delivery systems. Objec?ve: This study was aimed to assess the diagnos?c pa?ern of psychiatric morbidity among the pa?ents a?ending psychiatric outpa?ent department in a private medical college. Methodology: This cross-sec?onal study was carried out in the Department of Psychiatry in Prathima Ins?tute of Medical Sciences located at Karimnagar, Telangana, India. For this study, a total of 442 new subjects a?ending Psychiatry Outpa?ent Department (OPD) from August 2020 to July 2021 were taken. All the informa?on including longitudinal histories of pa?ents was recorded in files and the diagnosis was made following Diagnos?c and Sta?s?cal Manual of Mental Disorders-Fi?h Edi?on (DSM 5). Sociodemographic parameters and family history of mental illness were collected from the record file of the individual pa?ent. Results: In the present study, among the different age groups, the majority (28.05%) of the study subjects were of the age ranging from 21-30 years. The distribu?on according to gender was (62.89%) males and (37.10%) females. The majority of the study subjects belonged to the rural background (69.45%), educated up to 10th standard (28.73%), self-employed (29.86%), married (67.42%), belonged to Hindu religion (85.74%), and with a monthly family income of 5,000 to 10,000 (38.68%). The majority of the study subjects were diagnosed with Major depressive Disorders (28.05%), followed by anxiety disorders (17.87%) and Substance-Related and Addic?ve Disorders (16.96%). Conclusion: This study provides informa?on about the prevalence of psychiatric morbidity among pa?ents a?ending outpa?ent department in a private medical hospital in Northern Telangana. It helps in assessing the pa?ern of psychiatric problems and taking necessary steps to plan for better management of mental health care in the near future.Item Pathological changes in Kidney Autopsies from North Maharashtra –A Descriptive Study(Prathima Institute of Medical Sciences, 2023-04) Vasaikar, Maya; Damle, Rajshri; Ruikar, Kirti; Madavi, ShrutikaBackground: Chronic Kidney disease is a major public health concern. In India, the burden of chronic Kidney disease cannot be assessed properly. In such case autopsy study becomes an indispensible part of Medicine. Aim: To explore the spectrum of changes seen in kidneys and correla?ng it with clinical findings. Material & Methods: A descrip?ve study of kidneys of Medico legal autopsies from January 2019 – December 2019 was conducted. A total of 665 Medico legal autopsies were received, in 73 cases kidneys were not received, while 23 kidneys had autoly?c change. A total of 569 Kidneys were included in the study. The Gross and Microscopic features along with special stains were studied and the cause of death was noted. Results: A total of 569 kidney autopsies were assessed. On Gross 26% were congested, 13% had contracted granular kidney. On Histopathological examina?on, Non specific changes were seen in 53.4%, specific nephropathological lesions noted were chronic pyelonephri?s (8.9%), acute tubular necrosis (5.6%), sickle cell nephropathy (4.7%), tubercular nephri?s (1.2%). Conclusion: Infec?ve e?ology was the commonest cause, along with sickle cell nephropathy. It has provided the spectrum of lesions seen in this area along with correla?on of cause of death. Screening for diabetes mellitus and hypertension would lead to early detec?on and ?mely management which would reduce chronic kidney diseases.Item Study of Central Nervous System Malformations of Perinatal Autopsies(Prathima Institute of Medical Sciences, 2023-04) Patil, Anuradha G; Ghatapanadi, Shweta; Batul, Safura; M, Anita ABackground: Congenital malformations remain a common cause of perinatal deaths accounting for 10-15% in developing countries like India. They are the most severe disorders of the central nervous system. Although antenatal screening for congenital anomalies has been improved over the years, fetal autopsy remains the gold standard for the iden?fica?on and confirma?on of congenital malforma?ons. The present study emphasizes the importance of perinatal autopsy for understanding the cause of death and also conforma?on of the antenatal diagnosis of the spectrum of various congenital CNS malforma?ons. Methods: We studied 644 perinatal autopsies conducted in our hospital. The dura?on of the study was 5 years, from 1st August 2015 to 31st July 2020 that included all perinatal autopsies with gesta?onal age of 22 weeks to less than 7 days. Results: Out of 644 perinatal autopsies 125 cases (19.4%) had congenital anomalies, of which 62 cases (9.6%) showed CNS malforma?ons. The most common CNS anomalies encountered were anencephaly 14 cases (22.6%) followed by 10 cases (16.1%) each of spina bifida and meningocele, and 8 cases (12.9%) of meningomyelocele. In the present study, 6 (9.7%) cases of CNS malforma?ons were associated with known syndromes namely Edward syndrome, Potter’s syndrome, and KlippelFeil syndrome. Along with CNS in 21 (33.9%) cases we observed associated malforma?ons of other systems with 7 cases involving the musculoskeletal system, 3 cases involving the genitourinary system, and 5 (8.1%) cases showing mul?system involvement. Conclusion: Antenatal screening for congenital anomalies has been improved over the years. Even then fetal autopsy remains the gold standard for the iden?fica?on and confirma?on of congenital malforma?ons. Understanding this gives valuable informa?on that can be further helpful in the gene?c counseling of the parents.Item Estimation of serum uric acid level in acute ischemic stroke(Prathima Institute of Medical Sciences, 2023-04) Prashanthi, K; G, Keshava AnveshBackground: The impact of uric acid as a stand-alone risk factor for non-communicable illness has been debated for decades. Strong free radical scavengers like hydroxyl ions, peroxynitrite, and other an?oxidants like ascorbic acid are all scavenged by serum uric acid. Neuroprotec?ve agents include uric acid and its connec?on to ischemic stroke is s?ll debatable. Therefore, the current study tried to evaluate the serum uric levels in acute ischemic stroke pa?ents. Methods: Pa?ents with acute stroke were included in the trial, thus if rTPA was given to them, it was noted. The pa?ent’s baseline blood pressure was taken (in a supine posi?on). All acute stroke pa?ents had blood drawn within 24 hours of admission to assess their lipid profiles, fas?ng blood sugar levels, and uric acid levels. A neurologist assessed each pa?ent, and computer tomography (CT) and magne?c resonance imaging were used to dis?nguish between ischemic stroke and other types of stroke (MRI). Results: Serum UA levels were found to be significantly higher in stroke pa?ents, with 77.5 percent of pa?ents having high levels (>6 mg/dL) compared to 30.0 percent of controls. When compared to the controls, the mean serum UA level in pa?ents was considerably higher (p=0.0212). Mul?ple logis?c regression analysis was used to determine the rela?onship between serum UA levels and outcome. Independent of other prognos?c criteria, pa?ents with high serum UA levels had a significantly worse outcome. Conclusion: A significant rela?onship exists between high serum UA levels and ischemic stroke, stroke subtypes (excluding lacunar stroke), and poor outcomes. Finding and managing modifiable risk factors for stroke has advanced quite a bit. Hyperuricemia could be therapeu?cally targeted in the same manner that other risk factors, such as dyslipidemia and blood pressure, are regularly treated a?er stroke.Item Body image perception and self-esteem among undergraduate medical students in Nanded, Maharashtra(Prathima Institute of Medical Sciences, 2023-04) Padmakumar, Devi; Inamdar, I.F; Gatiani, P, L; Gadekar, R.DIntroduction: Body image is the percep?on and a?tude one holds toward one’s own body, especially, but not exclusively, one’s physical appearance. The promo?on of posi?ve body image improves people’s quality of life and behaviors related to health. Social factors, sociocultural influences, media pressure, and the pursuit of an ideal body, associated with accomplishments and happiness are among the causes of changes in the percep?on of body image, leading to dissa?sfac?on. There is very less literature on these topics among males and also medical students. Objec?ves: To assess body image percep?on and the influence of sociocultural factors on it and self-esteem among undergraduate students of a medical college. Methods: A cross-sec?onal study was carried out among 192 undergraduate medical students of a medical college from June 2021 to September 2021 using a predesigned pretested self-administered ques?onnaire in English. Results: Out of 200 students included in the study the mean age of study subjects was 19.78 ± 1.39 years, of which,107(56%) were males and 85(44%) were females. The 192 students were classified as Underweight (27(14%)), Normal weight (78(41%)), Overweight (43(22%)) and Obese I (44(23%)) according to Asian WHO BMI classifica?on. BISS scores (which measure body image sa?sfac?on) were the median of the six items a?er reversescoring the three posi?ve-to-nega?ve items which were found to be 5.5(4-7) and 53% of students showed body image dissa?sfac?on. 33% (63 students) of students have thin/low body fat internaliza?on and about 77(40%) have muscular/athle?c internaliza?on.54(28%) students mostly agree about family pressure to a?ain the ideal appearance, 53(28%) feel pressure from peers and 75(39%) mostly agree with influence of media to a?ain ideal appearance. Out of the 192 students,124(64%) showed normal self-esteem, 63(33%) with low self-esteem, and 5(3%) with high selfesteem as per Rosenberg’s self-esteem score. A sta?s?cally significant associa?on was found between BMI and body image percep?on and also between Body image percep?on with sociocultural a?tudes toward the appearance and self-esteem of students. Conclusion: Body image dissa?sfac?on affects young students. In this study, about 53% of the students showed body image dissa?sfac?on. This percep?on of self has mainly been influenced by media (39%), family pressure (28%), and peer pressure (28%). Also, 33% of the students have low esteem with a significant associa?on between Body image percep?on and self-esteem.Item A study of prevalence and comparison of anxiety and depression among separated, divorced and widowed females in the rural population(Prathima Institute of Medical Sciences, 2023-04) Qureshi, Sadeq; Ambekar, Prakash; Usman, Sana; Achalia, RashminBackground: Psychological distress is an important immediate outcome of the death of a spouse or divorce, which may arise because of financial and emo?onal challenges and can lead to adverse health outcomes with more stress, anxiety, depression, and social isola?on than the general popula?on. Methods: Cross-sec?onal study among separated, divorced, and widowed females from two rural villages. All eligible par?cipants were screened for depression and anxiety using DSM 5 criteria. The severity of depression was assessed using the Hamilton depression ra?ng scale (HDRS) and for anxiety, the Hamilton anxiety scale (HAMA) was used. Results: Out of 162 women, 30% had mild depression whereas 42% of widow and divorced women had moderate levels of depression but it is in 50% of separated women. Severe and very severe level of depression was in around 20% of widowed and divorced women compared to 16% of separated women. There was no anxiety in around 80% of divorced and widowed women whereas 24.3% of separated women had severe anxiety. On regression analysis, separated women, dependent women, and those with less than two years of dura?on of separa?on had higher levels of depression and anxiety. Conclusion: The prevalence of Depression and Anxiety is more common in all three groups. Moderate to severe Depression is around 75% among divorced/separated and widowed females but moderate to severe anxiety was more in separated women compared to widowed women. Dependency and the early phase of widowhood/separa?on were also important associated factors.Item Efficacy of Methylprednisolone and Etoricoxib Combination to attenuate Post-operative Pain and Nausea/Vomiting in Laparoscopic Surgeries(Prathima Institute of Medical Sciences, 2022-04) Sharma, Vivek; Lakhina, Kriti; Bankapur, Rahul; Lamba, PreetiBackground and Aims:Pain and PONV (postopera?ve nausea and vomi?ng) are common complaints in the period following surgery. A mul?modal approach targe?ng the reduc?on of postopera?ve pain with an opioid-sparing analgesic along with an an?eme?c medica?on would minimize opioid consump?on and its associated side effects. We evaluated the efficacy of methylprednisolone 125 mg IV taken along with oral 120 mg etoricoxib on postopera?ve pain and PONV in pa?ents undergoing laparoscopic surgeries Material and methods:A prospec?ve, randomized, double-blind study was conducted on 70 pa?ents aged between 18 and 60 years with ASA grade 1 and 2 posted for elec?ve laparoscopic surgeries. The test group was given a combina?on of methylprednisolone 125mgIV (given just before induc?on)& etoricoxib120mg oral (given 1 hr before surgery). (Group A, n=35) while control group received normal saline IV and a placebo per oral(Group B, n=35). Dura?on and quality of analgesia was assessed by visual analogue scale (VAS) score at 2,4,6,8,10,12,16,20 and 24hr as primary objec?ve. Total dose of rescue analgesic(injec?on Fentanyl 50 mcg) in first 24 hours, peri-opera?ve hemodynamic change and post op nausea vomi?ng (PONV) were observed as secondary objec?ve. Result:Demographic profiles were comparable. Dura?on of postopera?ve analgesia was significantly prolonged(p<0.05) in Group A(7.57±1.04hrs) as compared to Group B(3.05±0.5hrs). Group A showed a significant reduc?on in postopera?ve fentanyl consump?on in the form of rescue analgesic(p<0.05). Group A also showed significant reduc?on in the incidence of PONV(p<0.05). Conclusion:We conclude that single-dose administra?on of methylprednisolone IV along with oral etoricoxib has be?er analgesic efficacy in comparison to placebo for pa?ents undergoing laparoscopic surgeries.Item Assessment of coverage and compliance of mass drug administration for lymphatic filariasis in Medak District-2021(Prathima Institute of Medical Sciences, 2023-04) Sayyad, Tajmul; Md, Mustafa Ahmed; Khaja, Azizuddin Junaidi; Bhayya, SIn India Mass Drug Administration (MDA) drive is undertaken every year. In mass drug administra?on DEC and Albendazole combina?on is used. For the strategy to be effec?ve, more than 85% of those living in endemic areas must be covered by MDA. Methods: This is a cross-sec?onal study in which family clusters were selected from rural and urban areas. Informa?on about coverage, compliance with MDA and knowledge of filariasis was obtained using a ques?onnaire. Data were analysed using percentages and propor?ons. Results: In this study, about 92.51% of the study par?cipants received DEC and ABZ tablets during MDA, of which 95.14 % of par?cipants consumed the drugs. The most common cause of noncompliance was fear of side effects. Conclusion: Coverage of the popula?on with DEC and albendazole combina?on was good but compliance needs to be improved. IEC ac?vi?es should be intensified. Local leaders should be involved in the programme to increase compliance.Item Comparative study of atienuation of needle prick pain of spinal anaesthesia by local infiltration analgesia versus EMLA skin patch(Prathima Institute of Medical Sciences, 2023-04) Shaikh, Mohd Mudassir; Atiar, Juberahamad Rajjak; Khatib, Samina; Deshmukh, Shreyas NilkanthIntroduction: Needle prick pain is a distressing event for a pa?ent receiving spinal anaesthesia. A ‘Needle piercing the spine’ might be physically and mentally trauma?zing for many pa?ents. This may lead to unwanted panic and anxiety during the procedure of spinal anaesthesia. To avoid this distressing needle prick pain, many clinicians have resorted to the prac?ce of giving injec?ons of local anaesthe?c or local applica?on of EMLA cream or patch at the site of spinal puncture beforehand for anaesthe?zing the skin and subcutaneous ?ssues. Methods: A prospec?ve cohort study was done. Those enrolled pa?ents were assessed by an expert anesthesiologist, who was not part of the research team, and he prescribed pa?ents either EMLA cream or regular standard lignocaine infiltra?on anaesthesia and labelled them as Group E and Group L respec?vely. The pain score was assessed using a Visual Analogue Scale. Result: A total of 64 pa?ents were enrolled in the study33 in Group E and 31 in Group L. Both groups had an almost similar number of pa?ents who had a similar extent of surgery. Univariate analysis showed that the mean pain score (VAS) was significantly higher in Group E pa?ents compared to that in Group L, p<0.001. The mul?variate analysis had similar findings a?er controlling confounding factors in mul?ple regression analysis. Conclusion: Local 2% lignocaine injec?on achieved significantly more pain reduc?on during spinal needle inser?on compared to the applica?on of an EMLA patch before spinal anaesthesia.Item Quality of Life of Chronic Kidney Disease Patients on haemodialysis in a tertiary care centre(Prathima Institute of Medical Sciences, 2023-04) Shaik, Karishma; Sechassayana, R.N; Kalidoss, SathyasagarBackground: End-stage renal failure is a chronic disease that greatly impacts a pa?ent’s health-related quality of life mainly due to the imposed limita?ons in almost all domains of their daily lives affec?ng >10% of the general popula?on worldwide, amoun?ng to >800 million individuals. Haemodialysis consists of a complex procedure for pa?ents that requires frequent hospital or dialysis centre visits, three ?mes a week, Objec?ves: To assess Quality of life and to find an associa?on between QOL, socio-demographic factors, and clinical variables among chronic kidney disease pa?ents on haemodialysis Material and methods: The sample consisted of 89 pa?ents undergoing haemodialysis. Data was collected by a specially designed ques?onnaire (KDQOL-36) which apart from the socio-demographic and clinical variables, also included the kidney disease variables for assessing the quality of life. Results: The results indicated that haemodialysis pa?ents’ QOL was impacted by socio-demographic and clinical factors related to dialysis. The study majorly reported that these factors played a major role directly and indirectly, with social ac?vi?es affec?ng more followed by emo?onal disturbances and physical ac?vi?es. Conclusion: QOL of haemodialysis pa?ents can be improved by correctable factors like anemia, diabetes, and hypertension. Healthcare prac??oners can create personalised interven?ons that are tailored to the needs of haemodialysis pa?ents by having a deeper grasp of the variables like treatment of co-morbidi?es decrease in the number of hospitaliza?ons, be?er management of anemia and decreasing the distance between home & dialysis center.Item Imaging in Covid-19 associated mucormycosis: a case series(Prathima Institute of Medical Sciences, 2023-04) Prashanth, Shailaja; Handi, Prakash; Prathap, Nisha; Manohar, Rudresh Shoorshetiy; Bhaskarn, KarthikIntroduction: Mucormycosis is a very rare saprophy?c, opportunis?c fungal infec?on with high morbidity and mortality. With the Covid-19 pandemic, there is a sudden increase in the incidence of this disease due to causes not clearly known. Methods: Retrospec?ve clinic-radiological analysis of a series of seven microbiologically confirmed cases of Covid19 associated mucormycosis (CAM) treated at our ter?ary care center in 2021 was done. Results: All pa?ents were middle-aged with a mean age of 47 years. All pa?ents had poor glycemic control. Three pa?ents were on oxygen support and were given steroids during Covid-19 treatment. Symptoms were facial pain, swelling, headache, eyelid swelling, and nasal block. All pa?ents underwent contrast MRI to study the extent of ?ssue involvement. MRI helped in complete surgical debridement with minimal deformity. Conclusion: Judicious use of immunosuppressants and strict glycemic control vital during covid-19 treatment. Contrast MRI is the inves?ga?on of choice to iden?fy the extent of involvement in surgical planning.Item Histomorphological spectrum of Phyllodes Tumours: A Restrospective Study(Prathima Institute of Medical Sciences, 2022-04) Singhal, Udita; Mahapatra, Qury; Kumar, Uma; Nanda, Annu; Jain, Pooja; Trivedi, ShaliniIntroduction: Phyllodes tumours are rare fibroepithelial lesions of breast. Clinical examina?on, ultrasound, cytology and histopathology are the mainstay of the diagnosis. The present research was undertaken with the aim of studying the clinicopathological features of Phyllodes tumour reported in the past seven years in a Delhi government hospital. Method: A retrospec?ve study of phyllodes tumour was carried out in females from 225 diagnosed cases of breast lesion reported in the pathology department of a government hospital in Delhi during the period of January 2013 to December2019. All the relevant history, findings of clinical examina?on and inves?ga?ons performed were assessed from files of the pa?ent. Results: Out of 225 cases of breast lesions reported in the pathology department 8 tumours were reported as phyllodes in the study period. The most common affected age group was 41- 50yrs. 5 (62.5 %) of 8 tumours were benign,2 (25) %) were borderline and only 1 was malignant. The tumour size was 15mm to 200mm. All the 8 cases (100%) presented with breast lump; 3 cases (30%) complained of pain in the lump. 2 cases developed ulcera?on and Peau D’ orange and in 1 case typical nipple retrac?on was seen. FNAC was done in 5 pa?ents. No preopera?ve inves?ga?ons were done in 2cases. Conclusion: Phyllodes tumour is a rare neoplasm of the breast. Histopathology plays an important role in differen?a?ng it from fibroadenoma. Strict histologic assessment is definitely required for the diagnosis of the PT and for its treatment and managementItem 25-Hydroxycholecalciferol levels and its equation with lipid parameters and Insulin sensitivity in obese and non-obese young adults: A pilot study(Prathima Institute of Medical Sciences, 2022-12) Chandrika, N; SMR, Usha; Kshetrimayum, VictoriaIntroduction: Vitamin D deficiency and Obesity are the two prevailing health issues of the globe, with India being no excep?on. The sub op?mal Vitamin D levels is associated with an elevated risk of a number of chronic disorders including malignancy, inflamma?on and autoimmune diseases. Obesity breeds metabolic disharmony. Recent data reports Vitamin D deficiency being more prevalent among the obese. Objec?ve: This study is undertaken to see the associa?on of Vitamin D levels with Body Mass Index (BMI), Lipid parameters and Insulin resistance in a sample popula?on represen?ng the urban Indian youth. Materials and Method: Fi?y five apparently healthy young adults of 18 to 22 years age were recruited in this study and their serum 25-hydroxycholecalciferol(25OHD), serum insulin, Total Cholesterol, High Density lipoproteincholesterol (HDL-c), Low Density lipoprotein- cholesterol (LDL-c) and Triglyceride (TGL) levels were es?mated. Insulin resistance(IR) was derived using the Homeostasis Model Assessment equa?on. Based on BMI, the par?cipants were divided into Obese group with BMI ? 25 (n=21) and nonobese group with BMI < 25 (n=34). Result: 25OHD levels were almost same in both Groups (Obese11.1 ± 4.6 ng/ml and non-obese 11.0 ± 5.2 ng/ml). Serum total cholesterol, VLDL and insulin levels were significantly increased in the Obese group(p= 0.005, p= 0.015 and p=0.054 respec?vely) when compared to the non-obese group. We found sta?s?cally significant associa?on between 25-hydroxycholecalciferol (25OHD) and TGL/HDL ra?o in the Obese group. Conclusion: In this pilot study we have unravelled the subtle onset of metabolic derangement in Obese individuals with Vitamin D deficiency.Item Clinical and demographic profile of COVID-19 patients- A cross-sectional study from a tertiary care medical college hospital from South India(Prathima Institute of Medical Sciences, 2022-12)Background: Acute respiratory illness with fever and respiratory symptoms such as cough and shortness of breath comprise the main clinical presenta?ons of Corona virus disease (COVID-19).Clinical manifesta?ons in COVID-19 shows significant regional varia?ons. Objec?ve of the study: To study the demographic and clinical profiles of laboratory confirmed COVID-19 pa?ents in South India Methods: In this cross sec?onal study,pa?ents diagnosed with COVID-19 by reverse transcriptase-polymerase chain reac?on (RT-PCR) test were taken up for the study.History of fever,throatpain,cough,breathlessness,malaise were taken.Blood pressure,respiratory rate,oxygen satura?on were recorded.Data on co-morbid illnessness like diabetes,hypertension,renal disease were also noted .All these were correlated to assess the clinical course of COVID-19 Results: Of the total 518 pa?ents,257(49.6%) pa?ents were in the age group of 46 to 65 years and 309 (59.7 %) pa?ents were males. History of fever was present in 349(67.38%) pa?ents and cough was present in 291 (56.17%) pa?ents. Throat pain and running nose was present in 291 (56.2%)and 110 (21.23%) pa?ents respec?vely. Heart rate was between 60 and 100 beats per minute in 472 (80.3%) of pa?ents and 102 (19.7%) pa?ents had respiratory distress with respiratory rate ?24. Oxygen satura?on was between 90-93% in 57 (9.85%) pa?ents and 87(16.8%) pa?ents were on oxygen support with 21(4.1%) pa?ents on non-invasive ven?la?on. A total of 291(56.2%) pa?ents were treated with steroids. Diabetes mellitus was present in 214(41.3%), hypertension in 150 (29%) pa?ents. Case fatality rate was 2.1% Conclusion: Severe disease and lower oxygen satura?on was associated with older age and co-morbid diseases par?cularly diabetesItem Incidence of Malaria among the Pediatric Age Group Attending to MGM Hospital Warangal(Prathima Institute of Medical Sciences, 2022-04) Amgothu, Mohan; Akkala, Venu; Bandi, Suman; T, Jaya Chandra; Vatchala, SudhaBackground: In India, malaria persist throughout the year and usually the incidence is more during rainy season. This necessitates the use of other laboratory methods to clinch the diagnosis, which is important in view of frequent relapses reported in vivax malaria and hence there is need for radical treatment. Considering all the above factors, a need is felt to evaluate the available lab diagnos?c procedures for malaria, and also to know the trend of malaria epidemic at Warangal. Methods: It was a prospec?ve study, conducted in the department of Microbiology, KMC Warangal. Paediatric age group with fever with chills and rigors followed by swea?ng were included in this research. Blood sample was collected thick and thin blood smears were prepared, stained by JSB or Leishmans or Giemsa. Parasight ’F’ test and Op?MAL tests were used to detect the an?gen. Chi square test was used to find the correla?on between the parameters. Results: Total 300 blood samples were collected, malaria posi?vity was 24%, male female ra?o was 1.05, sta?s?cally there was no significant difference. In area wise malaria posi?vity also sta?s?cally there was no significant difference. Age wise, maximum cases were diagnosed in 6 – 10 years group. Parasight F test was iden?fied to be highly sensi?ve in the diagnosis of malaria among the paediatric age group. Conclusion: Falciparum malaria is iden?fied to be the commonest malaria in this area which effect all the paediatric age groups and gender. Parasight F test was found to be the be?er technique in malaria diagnosis.Item Utility of Vaginal pH as Point of Care Test for Detection of Bacterial Vaginosis(Prathima Institute of Medical Sciences, 2022-04) Metgud, Shridevi; Gangigute, Spurthi; Metgud, SharadaBackground & objectives: Bacterial vaginosis (BV) is a Reproduc?ve tract infec?on (RTI) among young sexually ac?ve women with high prevalence. It is associated with complica?ons related to pregnancy and an increased risk of acquiring STDs. This poses a need for cost-effec?ve detec?on of BV in low resource se?ngs. Hence, we propose to study the u?lity of vaginal pH determina?on for the detec?on of BV. Material & Methods: This is a single center, 1 year cross-sec?onal study. Swabs were collected from 250 non-pregnant women a?ending the out-pa?ent department of Obstetrics and Gynecology with vaginal discharge as a predominant symptom with or without backache and abdominal pain. Vaginal pH determina?on, Gram stain, wet mount, Whiff test, and Amsel’s criteria were used for BV detec?on. Results: 250 study par?cipants with vaginal discharge sugges?ve of BV were analyzed. Vaginal pH was significantly higher in women with BV with the mean pH being 6.2. Vaginal pH >4.5 had a sensi?vity of 85% and specificity of 66% to detect BV. The Whiff test had the least sensi?vity. Clue cells and Amsel’s criteria of ? 3 were significant for BV. A combina?on of pH and Whiff test performed be?er had high sensi?vity and specificity. Conclusions: A combina?on of pH determina?on and the Whiff test serves as a low-cost alterna?ve in resource-poor se?ngs for detec?on of BV. Though Clue cells and Amsel’s criteria ? 3 were most sensi?ve and specific, they cannot be used in low resource se?ngs. Vaginal pH alone can be used to detect BV in areas of low prevalence.Item Does Antioxidant Superoxide Dismutase levels Decline with Advanced primary Knee Osteoarthritis in Synovial Fluid ? A Pilot Study(Prathima Institute of Medical Sciences, 2022-12) Shukla, Jyoti; Sharma, Pankaj; Sharma, Sonendra; Prasad, Sangishetti Vijay; Sharma, Sumita; Garg, NitaIntroduction: Osteoarthritis (OA) is a progressive, degenera?ve disease that leads to joint pain, tenderness, s?ffness, locking, effusion, reduced mo?on, swelling, crepitus, and disability. The pain in OA is the most significant clinical feature and impacts func?on, mobility, quality of life, and the reason for medical advice. Methods: Fi?y individuals with primary knee OA in the age range of 45–90 years were chosen at random for the research (N=50). The American College of Rheumatology’s diagnos?c criteria were employed to diagnose osteoarthri?s, and a visual analogue scale was u?lized to score the severity of pain. Knee OA was graded using the Kellgren-Lawrence (K-L) radiographic assessment method. The an?oxidant levels of superoxide dismutase in the synovial fluid were measured by using a spectrophotometric assay. Results: Grades 1, 2, 3, and 4 have SOD ac?vity values of 1.43±0.55, 1.44±0.72, 0.92±0.52, and 0.87 ±0.52 U/ml, respec?vely, in synovial fluid. Synovial fluid SOD ac?vity was higher in grades 1 & 2 of KOA as compared to grades 3 &4 and the difference was sta?s?cally significant (p<0.05). Conclusions: There was a link between K-L grade and synovial an?oxidant ac?vity level. In the late stages of knee osteoarthri?s, the an?oxidant enzyme (SOD) ac?vity was reduced.According to the results of this study, regular an?oxidant supplementa?on to early osteoarthri?s pa?ents may delay disease progression by improving the an?oxidant status of the knee, which neutralises free radicals and thus prevents car?lage damage.Item Femur shaft fracture treatment in school-aged children using titanium elastic nails(Prathima Institute of Medical Sciences, 2022-12) R, Manikya; Babli, Ateet; Mulimani, VenkateshINTRODUCTION: Titanium elas?c nails are used to treat femur sha? fractures in paediatric patients. This method is minimally invasive and does not cause epiphyseal injury or impairment of femoral head blood supply. OBJECTIVES: The objec?ve is to evaluate the results of opera?ve treatment of femur sha? fractures in the age group between 6 and 16 years with ?tanium elas?c nailing system (TENS), using Flynn’s criteria. METHODS: This prospec?ve clinical study was conducted during the period from November 2018 to November 2020. Thirty cases were treated with mean follow up of 12 months. RESULTS: The final outcome was excellent in 21 cases, sa?sfactory in 6 cases and there were 3 poor outcome cases. Eight pa?ents had limb length discrepancy varying from 0.5-2cm. Five pa?ents had skin irrita?on, 3 pa?ents had angular mal-union and 1 pa?ent had persistent pain with skin breakdown. None of the pa?ent had infec?on, rota?onal mal-union, delayed or non union. CONCLUSION: Titanium elas?c nail fixa?on is a simple, easy and effec?ve method for management of paediatric femur fracture between 6 and 16 years age. With this method of treatment, careful considera?on to pa?ent’s age and body weight should be given to prevent the poor result.Item Study of Clinical and Outcome Profile of Neonatal Sepsis with Thrombocytopenia Patients Admitted at Tertiary health care Centre Nanded(Prathima Institute of Medical Sciences, 2022-12) Chavan, Arvind Nilkanthrao; Tambe, Saleem H; Karemore, Mangesh; Inamdar, Ismail Ali F; Dhurve, PratikshaBackground: Thrombocytopenia is a frequent problem in neonatal sepsis and is among the most predic?ve, independent risk factors for sepsis-associated mortality. The present study was undertaken to correlate neonatal sepsis and thrombocytopenia in terms of severity, clinical course, organism specificity and outcome. Method: Total 384 neonates age <28 days with sepsis and thrombocytopenia were studied and analyzed with their clinical profile, symptoms, lab findings and outcomes. Results: Male babies (55.86%), age <72 hrs (80.35%), preterm (68.70%) and LBW babies (85.58%) were more prone to sepsis. Maternal fever (67.44%), foul smelling liquor (53.79%) and PROM >18 hrs (66.74%) make babies more prone to neonatal sepsis. The Commonest clinical features were not accepting feed (69.95%), lethargy (67.85%) and breathing difficulty (79.04%). Early onset sepsis (82.54%) and probable sepsis (40.26%) were more common and associated with preterm and LBW babies. Leucocytosis was seen in 64.57%, thrombocytopenia moderate degree 45.67% and severe degree 34.65%, MPV >12 69.11%, ANC <1800 47.50%, micro ESR >15 mm 72.16% and CRP posi?vity 28.60%. Severe degree thrombocytopenia (<50000) was more common with PROM >18 hrs (83.02%), maternal fever (83.09%) and gram-nega?ve organism(61.29%). Leucopenia (<4000) was more common with maternal fever (75.79%), proven sepsis (43.16%) and gram-nega?ve organism (70.31%). Severe degree thrombocytopenia (61.29%), leucopenia (70.31%) and mortality (64.51%) were more commonly associated with gram-nega?ve organism. Outcome was bad with severe degree of thrombocytopenia (62.32%), leucopenia (73.91%), and gram-nega?ve organism (64.51%). Conclusion: Proper antenatal mother care, hygiene and early evalua?on for illness can prevent early onset of sepsis in neonates. Severity of degree of thrombocytopenia directly propor?onal to the worst outcome.