Perspectives in Medical Research

Permanent URI for this collection

https://imsear.searo.who.int/handle/123456789/174280

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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Now showing 1 - 20 of 87

Cluster of Neurofibromatosis Cases in Remote Area of Northern Karnataka: A Case Series
(Prathima Institute of Medical Sciences, 2024-05) K, Y G; Mohammed, WJ; R, KS
Tumours of the nerve system and skin are hallmarks of neurofibromatosis, a neurocutaneous condition. One class of inherited illnesses known as phakomatoses includes neurofibromatosis type 1 (NF1) or von Recklinghausen disease. It may show up anywhere in the body, including the skin, eyes, bones, and organs. We report a visually recorded seven cases of NF1 from same area. Every single patient had some kind of skin symptom. We describe the presence of several isolated neurofibromas, café au lait macules, axillary and inguinal freckling, neurological or cognitive dysfunction, and Lisch nodules in 100% of the eyes as ocular symptoms. Also, a rare occurrence of plexiform neuroma seen. Rare and familial presentation and similar cases in the same region, these findings collectively underscore the complex nature of the patient’s medical presentation, necessitating a multidisciplinary approach to management and care.
Therapeutic effect of Topical Sirolimus on Facial Angiofibromas in Patients of Tuberous Sclerosis Complex
(Prathima Institute of Medical Sciences, 2024-01) HN, L; Raghavan, SB; HR, Y; Sowmyanarayan, S; Vi?alrao, AM; Hosthota, A
Introduction: Tuberous sclerosis complex (TSC) is a rare autosomal dominant disorder. Facial angiofibromas are the most common cutaneous findings of TSC. Treatment modalities such as laser, surgery, and/or cryotherapy are employed. Topical therapy with Sirolimus, an mTOR inhibitor, showed beneficial effects. Objective: To study the effects of topical sirolimus (0.1%) on Facial Angiofibromas in patients of TSC. Methodology : Four patients with facial angiofibromas were included. They applied Sirolimus preparation twice daily, for 3 months. The Facial Angiofibroma Severity Index (FASI) was recorded pre-intervention, at 3 months and a?er 6 months. Results: All the patients showed a reduction in the FASI score at the end of three months of therapy. In three patients, on discontinuing therapy, there was no change in the FASI score at the end of six months, i.e., FASI 3 and FASI 6 were the same. Conclusion: Topical sirolimus is an effective treatment for facial angiofibroma in patients with TSC
Respiratory Morbidities And Associated Risk Factors Among Traffic Police Personnel: A Cross-Sectional Study
(Prathima Institute of Medical Sciences, 2024-01) Chelimela, D; Faiyazuddin, T; Mohammed, AW.
Introduction: Air pollution, largely driven by transportation emissions, poses significant health risks, including respiratory diseases, for individuals worldwide. Traffic police officers, who face prolonged exposure to vehicular emissions, are particularly vulnerable to respiratory morbidity. However, limited research exists on this topic, especially in regions like Hyderabad, India, known for poor air quality. This cross-sectional study aimed to investigate the prevalence and associated factors of respiratory morbidity among traffic police personnel in Hyderabad. Methods: A cross-sectional study was conducted from January 2021 to January 2023 among 258 traffic police personnel aged 25-58 years in Hyderabad. Data collection involved structured interviews using a questionnaire adapted from ATS DLD-78, lung function measurements via peak flow meter and spirometry, and assessment of environmental exposure using Air Quality Index data. Statistical analysis included descriptive statistics and logistic regression. Results: The study revealed a high prevalence of respiratory symptoms among traffic police personnel, with 32.5% reporting frequent respiratory complaints and 29.8% reporting chronic complaints. Lung function assessments indicated obstructive pa?erns in 28.7% of participants. Factors such as age over 35 years and exposure to areas with poor Air Quality Index showed statistically significant associations with respiratory morbidity. However, educational level, duration of exposure to traffic, smoking, and mask usage did not exhibit significant differences in respiratory morbidity. Conclusion: The study’s findings underscore the increased risk of respiratory morbidity among traffic police officers due to prolonged exposure to vehicular emissions. Regular awareness sessions on personal protective equipment (PPE) and periodic health checkups are imperative to decrease health risks within this occupational group. Furthermore, rotating traffic police postings based on Air Quality Index rankings could help reduce exposure to pollutants and protect respiratory health. These interventions are crucial in addressing the significant burden of respiratory diseases among traffic police personnel in urban environments like Hyderabad
Anxiety, Depression and Stress among Medical Students during COVID- 19 Pandemic and their Coping Strategies
(Prathima Institute of Medical Sciences, 2024-01) Afreen, S; Bhuvaneswari, P; KM, S; S, P; Shaik, S.
Background: The COVID-19 pandemic has exacerbated mental health challenges among medical students, already a vulnerable group to mental health disorders. Recent evidence underscores a significant rise in anxiety, depression, and stress among this demographic globally, necessitating a deeper understanding of their mental health status and effective interventions. Objective: This study aims to assess the socio-demographic profile, prevalence rates of depression, anxiety, and stress, as well as coping strategies employed by medical students during the COVID-19 pandemic, with a focus on identifying effective interventions for managing their mental health crises. Methods: A cross-sectional study was conducted among 1st to 4th year MBBS students at ACSR Government Medical College, Nellore, during August and September 2020. Data were collected online using Google Forms, incorporating demographic details and the Depression, Anxiety, and Stress Scale (DASS-21). Descriptive statistics and chi-square tests were utilized for data analysis. Results: The study included 400 participants, 57% of whom were female, with a mean age of 23 ± 2 years. Significant proportions reported experiencing depression (20.2%), anxiety (13%), or stress (51.3%), with notable rates of past psychiatric symptoms. Coping mechanisms included video cha?ng (35%) and online entertainment (32.2%), while professional help utilization was low (5.5%). COVID-19 repercussions extended beyond mental health, impacting various facets of daily life. Conclusion: This study found various mental health challenges faced by medical students during the pandemic, emphasising the need for ongoing monitoring and psychological support. Additionally, a low rate of seeking professional help was found. Early training in handling pandemic-like situations and mental health is recommended. However, further research is necessary to track mental health progression and ensure accurate diagnosis through individual clinical assessments.
Prevalence of Childhood Dermatological and Ocular Morbidities: A Cross-Sectional Study from Maharashtra
(Prathima Institute of Medical Sciences, 2024-01) Mohammed, WJ; Afshan, G; Harsoor, A; Takalkar, AA; MD, IS.
Introduction: Screening many children within a certain age group for the presence of illnesses can be efficiently conducted through school surveys. This study aims to analyze the prevalence of dermatological and ocular morbidities in school children. Methods: A school-based crosssectional observational study was conducted in Government and Private schools of Latur, involving 500 school children aged between 5-14 years. Results: The prevalence of dermatological morbidities in our research was found to be 69%, with boys showing a prevalence of 50.6% and girls 18.4%. Prevalence of ocular morbidities was 7.6%, with boys showing a prevalence of 4.2% and girls 3.4%. Among dermatological manifestations, infections and infestations were the most observed (44%), followed by eczema (dermatitis) (13%). Refractive error was the most common ocular morbidity observed in boys (33.3%), followed by Vitamin A deficiency (28.57%). In girls, refractive error was the most common ocular morbidity (35.29%), followed by Vitamin A deficiency (29.41%). Conclusion: Urgent a?ention is needed to address these health issues early on to improve children’s overall well-being. The findings contribute valuable insights for future research and targeted public health interventions aimed at promoting the health of school children.
A Case of Hereditary Multiple Exostoses: Role of FNAC in diagnosis
(Prathima Institute of Medical Sciences, 2024-05) QSM; Nanda, A; Trivedi, S.
Hereditary Multiple Exostoses (HME) is a rare autosomal dominant bone disease. It is characterized with numerous benign osteochondromas, which grow outward from the metaphyses of long bones. In many cases it is asymptomatic but can lead to considerable number of complications, like pressure symptoms, limb deformities, and can cause psychosocial problems. Malignant transformation is rarely seen. Surgery is the main modality of treatment.This paper aims to highlight the role of FNAC in diagnosis of HME.
The Utilisation of Fine Needle Aspiration Cytology for Diagnosis of Head and Neck Lesions in Paediatric Age Group
(Prathima Institute of Medical Sciences, 2024-01) Desai, AR; Mohammed, AS; Sadhu, DS.
Introduction: Fine needle aspiration cytology of head and neck region is well-accepted as a diagnostic procedure. It is a safe, simple, rapid, cost-effective, and minimally invasive way of diagnosing inflammatory, noninflammatory and neoplastic lesions. Aim : To study the role of FNAC in diagnosing head & neck lesions in the paediatric age group. Material and Method: This is the hospital-based study of 120 lesions of the head and neck region belonging to the age group of 0-18 years. Cytological results are interpreted and analyzed according to anatomical site and then categorized based on interpretation. Result: Out of 120 cases 20 % cases belong to the age group 0-5yrs, 24.16% belong to 6-10yrs & 55.83% belong to the 11-18yrs age group. According to the anatomical distribution of lesions maximum cases accounting for 81.67% are lymph node lesions followed by thyroid lesions, miscellaneous, and then least salivary gland lesions which account for 2.5%. In the lymph node, thyroid, salivary gland, and miscellaneous lesions predominant lesions are respectively reactive lymphoid hyperplasia (71.42%), thyroiditis (42.85%), sialadenitis (33.34%) &epidermal cyst (40%) Conclusion: FNAC in resource-limited se?ngs, healthcare providers should realize the importance of FNAC as an initial screening tool for superficial lesions in paediatric population. The presumptive diagnosis a?er FNAC of palpable lesions in paediatric age group avoids the unnecessary definitive operative procedure. Thus, FNAC is an easy, simple, rapid, and cost-effective diagnostic procedure for paediatric age group.
A Prospective Randomised Observational Study of Obstructed Total Anamalous Pulmonary Venous Connection (TAPVC) Repair Patients with Milrinone Versus Milrinone and Inhaled Nitric
(Prathima Institute of Medical Sciences, 2024-05) Singh, S; Mahrous, DE; Singh, B; Mohammad, Ateequr Rahman M; Bandoh, I; Singh, A
Background: Obstructed total anomalous pulmonary venous connection (OTAPVC) typically presents with severe cardiovascular decompensation and requires urgent surgical management. Pulmonary arterial hypertension (PAH) is a major risk factor affecting mortality. Perioperative management focuses on providing inotropic support and managing potential pulmonary hypertensive episodes. The aim of this study was to determine the outcome of patients with high pulmonary arterial pressure (PAP) with milrinone alone and a combination of milrinone and inhaled nitric oxide (INO). Material and Methods: A?er the approval of the ethical commi?ee, this single-centre prospective randomised and observational study was conducted over a period of two years among eighty-six patients with obstructed TAPVC repair with severe PAH. Group-I patients received milrinone, and Group-II patients received both milrinone (a?er aortic cross clamp removal) and INO during the post-operative period at the cardiac care unit (CCU). Clinical outcomes such as ventilation time, length of stay (LOS) in the CCU, LOS in the hospital, complications, and hospital mortality were compared between the two groups. Result: The average ventilation time, LOS in CCU, and LOS in hospital for group I were 96.82 ± 19.46 hours, 10.91 ± 7.53 days, and 14.46 ± 7.58 days, respectively, and for group II, it was 85.14 ± 15.79 hours, 7.28 ± 3.68 days, and 10.21 ± 3.14 days, respectively, which was statistically significantly lower for group II. Reintubation, RV dysfunction, and hospital mortality were 16.3%, 37.2%, and 6.9% in group I, and 4.8%, 14.6%, and 2.4% in group II, respectively. The P value for each variable was significant < 0.05 (except mortality). Conclusion: Preoperative obstruction is a risk factor for postoperative obstruction, as 235 patients with obstructed TAPVC had severe PAH (39.98%) in this study. Management of severe PAH with a combination of milrinone and INO had a be?er outcome than milrinone alone.
Electrocardiographic and Echocardiographic changes in Non-Hemodialysis Chronic Kidney Disease Patients: A Cross-Sectional Study
(Prathima Institute of Medical Sciences, 2024-01) Ansari, MSHK; Noorani, MSS; Shaikh, AFAH
Chronic Kidney Disease (CKD) patients have a higher risk of cardiovascular manifestations such as coronary artery disease, heart failure, arrhythmias, and sudden cardiac death. Cardiovascular diseases are the main cause of death in patients with advanced CKD, rather than endstage kidney disease itself. Essentially, CKD speeds up the ageing process in the cardiovascular system. Objectives: To determine the prevalence of cardiovascular abnormalities in non-hemodialysis CKD patients. Methods: A descriptive cross-sectional study, was conducted in the Department of Medicine, between October 2020 to September 2022. A total of 50 CKD patients were included. The patients were evaluated & enrolled in the study, based on history, general physical examination, systemic examination, Blood Urea, Serum Creatinine, Urine Routine, Electrocardiograph (ECG) and Echocardiography. Results: In the present study Electrocardiograph & echocardiography determined cardiovascular abnormalities in 68% of patients. Among these 50% of patients had Le? Ventricular Hypertrophy (LVH) & Le? Ventricular Diastolic Dysfunction (LVDD), 8% of patients had Arrhythmias and 6% patients had conduction abnormality, 2% patients had LVH and 2% patients had LVDD. Conclusion: LVH & LVDD are the most common morphological abnormalities observed in our study. We can diagnose Arrhythmias and conduction abnormality by electrocardiogram & echocardiography and refer them for appropriate interventions promptly.
Coeliaco-Mesenteric Trunk– A Rare Anomaly of the Coeliac Trunk
(Prathima Institute of Medical Sciences, 2024-05) Vamshi, V; Naidu, P V; Jyoti, Phukan M; Du?a, R
The Coeliaco-mesenteric trunk, characterized by the shared origin of the coeliac trunk and the superior mesenteric artery, represents a rare but clinically important anatomical variation within the abdominal vasculature. Knowledge of variations of the abdominal vascular system and their origins is of great importance to surgeons to ensure optimal patient outcomes and also to mitigate the potential complications that may arise due to this lack of knowledge. Present case: During routine dissection for 1st year MBBS (2022-23), of the abdominal region of a 60 year-old male cadaver, there was an unusual presentation of multiple blood vessels at the level of origin of the coeliac trunk. Upon further dissection, the superior mesenteric artery was found to be originating from this group of arteries. This artery was found to be passing through mesentery upto transverse colon. No other distinct blood vessel was found at the level where the superior mesenteric artery usually originates. Conclusion: This case underscores the importance of thorough pre-operative assessment and awareness of anatomical anomalies to facilitate safe and effective management strategies
Synovial Chondromatosis of Right Knee: A Case Report
(Prathima Institute of Medical Sciences, 2024-01) Lingamurthy, DM; CH, SL; Arasi, T
Synovial chondromatosis is a rare cartilaginous neoplasm that most commonly affects the knee joint. Histologically, it presents as a multinodular cartilaginous proliferation showing clusters of chondrocytes. These can be quite atypical, simulating chondrosarcoma. The lesion is usually selflimited but sometimes may exhibit a more aggressive clinical course characterized by multiple local recurrences. Chondrosarcomatous transformation in synovial chondromatosis is exceedingly rare but has been documented. Until recently, synovial chondromatosis was considered a reactive process. Recent cytogenetic studies have shown recurrent chromosomal abnormalities, especially involving chromosome6, therefore supporting a clonal, neoplastic nature of this intriguing lesion.
Evaluation of Anxiety and Depression Among Orphan and Non-Orphan Adolescents in a Rural Residential School of Maharashtra
(Prathima Institute of Medical Sciences, 2024-05) Pathan, ZH; Shaikh, MM; Qureshi, SM; AWAAS
Background: Adolescence marks a critical stage of development characterized by profound physical, emotional, and social changes. This study explores the prevalence of anxiety and depression among orphan and non-orphan adolescents in a rural residential school se?ng, aiming to identify associated factors. Method: A community-based crosssectional descriptive study was conducted among 100 adolescents (50 orphans and 50 non-orphans) aged 10-19 years in Warudi, Jalna from August 10 to October 10, 2022. Institutional ethical approval and wri?en informed consent were obtained. Data collection included DSM-5 criteria for anxiety and depression assessment, using the Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HDRS). Additional parameters assessed were sleep disturbances, academic performance, social interactions, duration of stay in the residential school, and type of orphanhood. Statistical analysis was performed using SPSS version 21, with qualitative parameters presented as percentages and the chi-square test used for comparisons (p<0.05 considered significant). Result: The study revealed notable disparities in mental health outcomes between orphan and non-orphan adolescents. Orphans, predominantly categorized as double orphans (54%), exhibited higher prevalence rates of anxiety (46%) and depression (30%) compared to non-orphans (anxiety 14%, depression 12%). Factors such as prolonged stays in residential schools and the duration of orphanhood were significantly associated with heightened levels of anxiety and depression among orphans. Conclusion: Orphan adolescents residing in rural residential school face significantly elevated risks of anxiety and depression compared to their non-orphan peers. The findings highlight the urgent need for targeted psychological support and interventions tailored to the unique challenges of orphanhood, including the prolonged institutional care and the emotional impact of parental loss. Future research should focus on longitudinal studies to assess the effectiveness of interventions and track mental health trajectories over time.
Anesthesia Management of COVID-19 associated Rhino-Orbito-Cerebral Mucormycosis: A Prospective Observational Study
(Prathima Institute of Medical Sciences, 2024-01) Sontakke, AY; Kulkarni, VV; Nandanvankar, NN; Totawar, S
Background: Fungal infections (mucormycosis) have been reported as co-infection as well as opportunistic infection during and a?er COVID-19 (Coronavirus disease), involving the paranasal air sinuses with a high risk of morbidity and mortality. Considering the ongoing situation of COVID19 associated with mucormycosis, we presented our experience of 110 patients being, or having previously been COVID -19 positive. Methods: This study included 110 patients in which surgical resection was done for Rhinoorbito-cerebral mucormycosis (ROCM) under general anesthesia and observed for 30 days postoperatively. Results: This study included 79 male patients with the majority of 51-60 years of age group (31.81%). Most common comorbidities observed in study were diabetes mellitus (77.27 %) followed by hypertension (39.09 %) & ischemic Heart Disease (9.09 %). Majority patients had received steroids (80 %) as a part of covid-19 treatment. All patients were receiving Amphotericin B at the time of surgery. On operative table extubation was possible in 80 % of the cases while others required average ICU stay (9.83 ± 7.33 days). Inotropic support was required in 20 % of patients. Majority patients were discharged successfully (85.45 %), while 10.91 % had mortality. On 30 days follow-up frontal Sinus Abscess (6.36 %) & maggots in maxilla and sphenoid (0.91 %) were noted. Conclusion: Corticosteroids and DM are the most important predisposing factors in the development of COVID-19- associated ROCM. Perioperative anesthesia care plays an important role towards management and outcome of ROC mucormycosis. Difficult intubation is anticipated due to fungal debris and supraglo?c edema in the oropharynx of the patient
Study of Nutritional Anemia in Children Admitted to Pediatric Department in Rural Teaching Hospital of Telangana
(Prathima Institute of Medical Sciences, 2024-05) Kotapuri, S; Kommineni, SK; Chitgupikar, S
school aged children are affected by anemia. According to World Health Organization, 65.5% of preschool children in southeast asia are anemic. Nutritional anemia is the commonest cause of anemia resulting from deficiencies of nutrients essential for red blood cell formation. Iron deficiency anemia is the most common nutritional deficiency amounting to 50%, followed by vitamin B12 and folate deficiency. This study is conducted to study the incidence of nutritional anemia among hospitalised children in a territory care teaching hospital in rural Telangana, in the age group of 6 months to 18 years and to bring awareness regarding the diet requirements in children in order to prevent deficiencies thereby the consequences of nutritional deficiencies. Method: This was a prospective hospital-based study conducted to study the incidence of Nutritional anemia along with clinical and hematological profile of nutritional anemia amongst children admi?ed to the Department of pediatrics in the age group of 6 months to 18 years at Mediciti Institute of Medical Sciences, Ghanpur, Telangana, from January 1st 2020 to June 30th2021. All the children who had satisfied the inclusion criteria a?er taking consent from their parents were included in the study. Result: The incidence of nutritional anemia in the present study was found to be 52.08%, with both males and females equally affected. The age group of 6–12 years was particularly impacted, accounting for 49.3% of the cases. A significant 94% of the cases were associated with inadequate protein intake as per ICMR guidelines. Children from socio-economic classes 2 and 3, as per the Kuppuswamy scale, were more frequently affected. Severe anemia was observed in 8.7% of the cases. Peripheral smear analysis revealed microcytic, hypochromic red blood cells in 64.4% of the cases, with 94% of the children showing decreased serum iron levels. Conclusion: Nutritional anemia is the major cause of anemia in hospitalised children affecting majorly children in the age group of 6-12 years. Inadequate protein intake is the major contributor accounting to 94%, which can be prevented with proper dietary measures
A Cross-Sectional Study of Acute Poisoning Cases Admitied in a Tertiary Care Hospital in Mangaluru, Karnataka, India
(Prathima Institute of Medical Sciences, 2024-05) Bhat, K P M; Yadiyal, B M; A, B
Introduction: A poison is a substance that causes serious illness and endangers the life of a person when ingested in a relatively small quantity. Poisoning is one of the most common problems encountered in day-to-day clinical practice. Poisoning causes morbidity and mortality which can be prevented and managed if clinicians are sensitized with adequate knowledge of common poisons. Therefore, this study was conducted to know the profile of acute poisoning cases admi?ed in a tertiary care hospital in Mangaluru. Materials and Methods: 100 patients admi?ed in the intensive care units and wards of the General Medicine department, Kasturba Medical College, Mangaluru, and Government Wenlock District Hospital, Mangaluru with various poisoning were evaluated for various factors like the distribution of poisoning cases according to age, gender, intention of poisoning, nature of poisons consumed and the nature of treatment received at another hospital before ge?ng admi?ed. Results: Most of the cases of poisoning occurred in the age group between 21-30 years of age (38%). The majority of the patients in the study were males (60%) and females formed 40% of the study population. The majority of patients in this study (99%) consumed poison with suicidal intention. 77% of patients received first-aid treatment in a peripheral hospital before ge?ng admi?ed to our hospital. Conclusion: This study shows that the peak incidence of acute poisoning cases was seen in the age group of 21 to 30 years with male predominance. The pa?ern of poisoning was suicidal in the majority of the patients.
Immunohistochemistry in Cancer Diagnosis: A Review
(Prathima Institute of Medical Sciences, 2024-05) Gamde, SM; Francis, L; Adisa, JO
Immunohistochemistry in cancer diagnosis holds great potential to improve patient’s outcomes through enhanced diagnostic accuracy and more effective treatment strategies. Antigen-antibody interactions is one of its main objectives that utilizes the specific binding of antibodies to cellular antigens allowing for the precise identification and localization of specific proteins within tissue samples. However, there exist practical hitches in the form of tissue fixation, epitope retrieval, and antibody quality. It is crucial to continue streamlining the techniques and scoring systems to guarantee their reliability in various contexts. Understanding the interactions is pivotal for the accurate diagnosis, prognosis, and future perspectives. As technology continues to advance and our understanding of cancer biology deepens, immunohistochemistry will remain an invaluable tool for precision in cancer diagnosis.
Inverted Follicular Keratosis in the Post-Auricular Region: A Case Report
(Prathima Institute of Medical Sciences, 2024-01) Kanithi, Y; Prasad, S; Anandam, G.
Inverted follicular keratosis is a rare, benign skin growth that can be difficult to diagnose under a microscope because it can resemble other benign and even malignant lesions. This case report describes a 53-year-old woman who had a small nodule behind her ear. The nodule was surgically removed and examined under a microscope. The microscopic features, such as the inward growth pa?ern of the cells and the presence of swirling structures called squamous eddies, led to the diagnosis of inverted follicular keratosis. This case highlights the importance of recognizing inverted follicular keratosis so that it can be distinguished from more serious skin conditions, particularly squamous cell carcinoma.
Utility of GeneXpert in Diagnosis of Pediatric Tuberculosis and Detection of Rifampicin Resistance
(Prathima Institute of Medical Sciences, 2024-05) Shah, P; Pol, S; Prabhakaran, E; Karmalkar, B; Gaikwad, V; Dharamshale, S; Karyakarte, R.
Background: Tuberculosis (TB) remains a significant public health challenge in developing countries, including India, where children under 15 years account for 12% of all TB cases. The National Tuberculosis Elimination Programme (NTEP) recommends the use of GeneXpert/Cartridge-Based Nucleic Acid Amplification Test (CBNAAT) for TB diagnosis, followed by Line Probe Assay (LPA) for detecting drug resistance. This study aimed to determine the prevalence of TB and rifampicin resistance in pediatric patients and to evaluate the utility of CBNAAT in comparison with LPA and Ziehl-Neelsen staining. Methods: This retrospective study was conducted over one year, from 1st January 2022 to 31st December 2022, at a tertiary care hospital in western Maharashtra. A total of 528 samples from pediatric patients (aged <18 years) suspected of having TB were included. Samples underwent CBNAAT testing and Ziehl-Neelsen staining. Positive samples were further analyzed using LPA or Mycobacterial Growth Indicator Tube (MGIT) culture. Results: Among the 528 samples analyzed, gastric lavage accounted for 81.25% of the specimens. CBNAAT detected TB in 61 (11.55%) of the samples, with 15 (24.59%) of these showing rifampicin resistance. Samples with very low or low bacterial loads were o?en missed by Ziehl-Neelsen staining. Conclusion: Pediatric tuberculosis continues to be a public health concern in developing countries. The study found an 11.55% positivity rate in children under 18 years of age, with 24.59% of positive cases exhibiting rifampicin resistance. The findings underscore the importance of using advanced diagnostic techniques like CBNAAT and highlight the limitations of Ziehl-Neelsen staining in detecting low bacterial loads.
Comparative Evaluation of Prasugrel vs. Ticagrelor in Patients Undergoing Percutaneous Intervention : A Systematic Review and Meta-analysis of Randomized Controlled Trials
(Prathima Institute of Medical Sciences, 2024-05) Mehta, Yash Dharmendra; Prajapa, Nishant Babubhai; Dhanjibhai, Prajapa Vipul; Sood, Shikha Vikram; Malhotra, Supriya Deepak
Background:Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide, necessitating effective antiplatelet therapy in patients undergoing percutaneous coronary intervention (PCI). Prasugrel and Ticagrelor, both potent P2Y12 receptor inhibitors, have emerged as pivotal components of dual antiplatelet therapy in this se?ng. Despite their widespread use, there is an ongoing debate regarding the comparative efficacy and safety of Prasugrel and Ticagrelor. This systematic review and meta-analysis aim to compare the efficacy and safety of Prasugrel and Ticagrelor in patients undergoing percutaneous intervention (PCI) through an exhaustive examination of randomized controlled trials (RCTs). Methods: A comprehensive search of electronic databases, including PubMed, Embase, and Cochrane Library, was conducted to identify relevant RCTs comparing Prasugrel and Ticagrelor in patients undergoing PCI. Data extraction and quality assessment were performed independently by two reviewers. The composite outcomes assessed were those including death, myocardial infarction, and stroke. Secondary outcomes included bleeding events and dyspnea. The randomeffects model was employed for the meta-analysis, and subgroup analyses were conducted based on specific patient characteristics and study characteristics. Results:Ticagrelor exhibits a significantly increased risk of dyspnea compared to Prasugrel (OR: 13.929, 95% CI: 3.495 to 55.514). The analysis reveals substantial heterogeneity (I2 = 3.734), indicating variability in the effect estimates across studies.No significant difference in bleeding risk is observed between Ticagrelor and Prasugrel (OR: 1.245, 95% CI: 0.996 to 1.555). The analysis suggests moderate heterogeneity (I2 = 1.926).The odds of death are comparable between Ticagrelor and Prasugrel (OR: 1.166, 95% CI: 0.919 to 1.479). Heterogeneity is low (I2 = 1.263).Ticagrelor is associated with a significantly higher risk of MI compared to Prasugrel (OR: 2.732, 95% CI: 2.155 to 3.465). The analysis indicates low heterogeneity (I2 = 8.294).A significantly increased risk of stroke is observed with Ticagrelor compared to Prasugrel (OR: 2.732, 95% CI: 2.155 to 3.465). Heterogeneity is low (I2 = 8.294).The overall findings suggest that Ticagrelor may be associated with a higher risk of dyspnea, MI, and stroke compared to Prasugrel in ACS patients. However, no significant differences are noted in bleeding and death outcomes. Conclusion: This systematic review and meta-analysis suggests that Prasugrel and Ticagrelor exhibit similar efficacy and safety profiles in patients undergoing PCI. The findings may aid clinicians in making informed decisions regarding antiplatelet therapy selection based on individual patient characteristics and preferences. Further research, including large-scale RCTs, is warranted to validate these findings and provide more nuanced insights into the comparative effectiveness of Prasugrel and Ticagrelor in specific patient subgroups. Discussion: These findings have important for choosing appropriate antiplatelet therapy. Prasugrel and Ticagrelor can be considered as effective treatment options. However, healthcare providers need to carefully consider the safety profiles and potential side effects of these medications when making treatment decisions. The study relied on aggregated data, which might introduce bias. High a?rition rates and heterogeneity among studies limit the findings.
Prevalence of Psychiatric Morbidity, Physical Illness, and Coping Strategies in Residents at Old Age Homes: A Cross-Sectional Study
(Prathima Institute of Medical Sciences, 2024-05) Pavana, Lalitha M; Swathi, P; Vijaya, Lakshmi M; Manasa, Ram V; Chakravarthy, BS; Suresh, Kumar G; Kaivalya, G
Background: Older adults living in long-term care facilities, such as old age homes, o?en face a range of physical and mental health challenges that can significantly impact their overall wellbeing. Objectives: This study investigated the prevalence of psychiatric morbidity, physical illness, and coping strategies in old age home residents in Visakhapatnam, India. Methods: A cross-sectional study recruited 300 consenting residents. Standardized tools, namely the Mini-Mental Status Examination (MMSE), the six-item version of Goldberg’s General Health Questionnaire (GHQ-6), and the Mini International Neuropsychiatric Interview (MINI) for diagnosing psychiatric disorders as per DSM-V criteria, were used to assess mental health. The Coping Checklist by Kiran Rao was also used. Results: Significant psychiatric morbidity was found in 15.33% of residents, with depression being the most prevalent disorder. Females, widowed individuals, those from urban backgrounds, and residents of nuclear families were more likely to report depressive symptoms. Physical illness was identified in 70% of the participants. Conclusion: This study highlights a considerable burden of psychiatric illness and physical health problems among residents of old age homes. Furthermore, it suggests that specific demographic factors are associated with an increased risk of depression. These findings emphasize the need for comprehensive mental and physical healthcare services within old age homes, with tailored interventions for vulnerable populations.

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