International Journal of Research in Medical Sciences
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Editor: Dr. Bhaven Kataria
ISSN: 2320-6071 Online : 2320-6012
Frequency: Quarterly
Language: English
Open Access Peer-reviewed journal
Web site: https://www.msjonline.org/index.php >
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Item Is there a need to review the syndromic case management of vaginal discharge due to candida in the Indian scenario?(Medip Academy, 2023-08) Gedam, S. T.; Waikar, M. M.; Deogade, K. S.; Sharma, M. K.; Gosavi, S. S.; Agarwal, V. A.Background: Vulvovaginal candidiasis (VVC) affects approximately 75% of women once in lifetime. National AIDS Control Organization has recommended Kit-2/Green (tablet secnidazole 2 gm OD stat and capsule fluconazole 150 mg OD stat) for syndromic case management (SCM) of patients with vaginal discharge since 2007. Patients are frequently revisiting the STI centre with recurrent VVC. The purpose of the study was to determine the effectiveness of fluconazole and other azoles in vulvovaginitis. Methods: Vaginal swabs from 188 patients attending regional STI centre, at Government Medical College, Nagpur between October 2020 to June 2022 were processed. A total of 128 conventionally confirmed isolates of Candida species were tested on RPMI 1640 medium for susceptibility to azoles by E test. An MIC of ?8 ?g/ml for fluconazole and ?1 ?g/ml for itraconazole, ketoconazole and voriconazole was interpreted as resistance as per CLSI M-60. Results: Candida species isolated were Candida albicans, C. glabrata, C. tropicalis, C. parapsilosis, C. dubliniensis and C. krusei. Candida species resistant to fluconazole, itraconazole, ketoconazole and voriconazole were 22 (17.18%), 53 (41.40%), 19 (14.84%), and 3 (2.34%) respectively. C. glabrata was most resistant while C. parapsilosis was least resistant. Voriconazole was most effective. Conclusions: Extensive use of fluconazole in syndromic case management of vaginal discharge could be the probable reason for 17.18% resistance to fluconazole. Withdrawal of fluconazole and replacement with another antifungal azole in SCM of vaginal discharge may prevent recurrent VVC and perhaps lead to emergence of fluconazole sensitive candida.Item Influence of food allergy on atopic dermatitis in infants and children under 10 years: a study in Iran(Medip Academy, 2023-08) Shiravi Khouzani, M.; K., K.Background: Based on the data collected from 220 cases of children and infants in Iran, aged under 2 months to 10 years, over a period of 6 months (2021-2022),there is evidence of a relationship between food consumption and the occurrence of Atopic dermatitis (AD). Methods: It is an institution based Case-Control study. Analytical observational studies. Results: It was found that 28.6% had IgE levels ranging between 150-250 u/ml. The majority of these patients consumed breast milk (n=83) or milk powders (n=75).In terms of the location of AD symptoms, 31.3% of the cases involved the chin and face. Conclusions: The duration of treatment for these patients ranged from 6 to 8 months. Gastrointestinal problems and asthma allergies were also observed among the patients, which could be attributed to an increase in cytokines and pro-inflammatory factors. These findings highlight the influence of food consumption on the development of AD in Iranian children and infants. It suggests that certain foods, including breast milk and milk powders, may be associated with the occurrence of AD in this population.Item Study on health seeking behaviour of elderly population for chronic diseases in a rural area of northern Kerala(Medip Academy, 2023-08) Rajeev, K.; K. K., A. R.; Suresh, A.; Salim, A.Background: The existing global and national demographic structure is evolving towards a greater number of elderly people. Chronic diseases have negative personal, societal, and financial consequences in all communities and economies. Health seeking behaviour is thought to be the result of a complicated interplay between the patient's disease condition and socioeconomic and demographic variables, as well as the quality, availability, and accessibility of healthcare services. Methods: Community based cross sectional study was carried out among the persons aged 60 years or above who had one or more chronic disease residing in rural area of Malappuram district, Kerala. Data was collected from 240 participants by interview method using a pre-designed questionnaire. Results: Hypertension, dyslipidemia, and diabetes mellitus were the three diseases that affect elderly individuals most frequently. Majority (86.7%) of the study population is seeking medical care for chronic conditions. 82.1% of the population prefer modern medicine and 5.8% prefer AYUSH system of medicine. Age, marital status, education, and occupation were all factors that contributed to their health-seeking behaviour. Conclusions: Immediate attention and action are required from the health care authorities and policymakers to reinforce the geriatric healthcare strategy and enhance the behaviour of people seeking health care for chronic diseases.Item Effect of aerobic exercise along with core muscle strengthening in young individuals with constipation: randomized controlled trial(Medip Academy, 2023-08) Gandhi, R. H.; Gunjal, S. B.Background: Constipation is traditionally defined as infrequent bowel movements or hard faeces. Patients report a variety of symptoms, including decreased bowel motion frequency, straining, hard stools, the sensation of incomplete emptying, the sensation of anal blockage, or the use of digitation or positioning to aid defecation. Physical health, mental health, and social functioning are all compromised in affected individuals. Despite this, only one-fifth of constipated people seek medical attention. Constipation symptoms are reported by 10% to 20% of adults worldwide. This study investigated the effects of aerobic exercise along with core muscle strengthening on young individuals with constipation. Methods: The study included 50 participants having constipation. The participants were randomly allocated in two groups. The intervention period was of 4 weeks. The exercises were explained to all individuals and pre and post treatment PAC SYM (patient assessment of constipation symptoms) and PAC-QOL (patient assessment of constipation quality of life) questionnaire scoring along with Rome IV criteria was taken. Results: In group A, post-treatment values of PAC SYM and PAC QOL were significantly lower than pre-treatment values. The post-treatment comparison of two groups revealed a significant difference in PAC SYM and PAC QOL, with group B showing a significant reduction in PAC SYM and PAC QOL compared to group A. Conclusions: The present study concluded that individuals who underwent both aerobic and core strengthening training showed more improvement than individuals who performed aerobic training alone.Item Effectiveness of pegylated erythropoietin in renal anaemia patients on dialysis-a multicentre, cross-sectional, observational outcome study(Medip Academy, 2023-08) Mahesh, E.; Thiagarajan, C. M.; Mulani, M. M.; Shete, M. M.; Patil, K. V.; Sravan Kumar, K.; Francis, B.; Ambike, S. M.; Karmakar, K. L.; Kumar, S.; Vakil, J. M.; Rampure, S.; Panda, A. K.; Venkatesh, N.; Goyal, A.; Dhanalakshmi, V.; Pasari, A.; Balwani, M. R.; Singla, M. K.Background: Low dose of pegylated erythropoietin (PegEPO) is better than conventional erythropoietin stimulating agents (ESAs) in improving hyporesponsiveness and maintaining stable haemoglobin (Hb) levels in renal anaemic patients undergoing hemodialysis. This real-world study aimed to assess effectiveness and safety of low-dose PegEPO (30 µg/0.3 mL), administered at different time-points in renal anaemia patients on dialysis. Methods: HEMEPEG (HEMoglobin outcomE with PegEPO) was a multicentre, retrospective, cross-sectional, observational study of renal anaemia patients receiving PegEPO up to 3 months. The study assessed an increase in Hb, patients achieving Hb 10-12 g/dl, and Hb increase by ?1 and ?2 g/dl. Results: Data from 223 out of 273 patients from 19 Indian centers were analyzed. PegEPO was administered weekly to 132 patients (59.19%), with 38.64% being diabetic and 77.27% previously treated with ESAs. Ten day dosing was given to 91 patients (40.81%), including 46.15% diabetic patients and 72.53% previously treated with ESAs. A Significant (p<0.0001) increase in mean Hb levels from baseline to day 30, 60 and 90 were observed for both studied groups, with a target Hb of 10-12 g/dl achieved in 51.08% and 52.85% of patients in the respective groups after 3 months. An increase in Hb by ?1 and ?2 g/dl were observed in weekly (68.67% and 45.78%) and 10-day group (77.14% and 50.00%) patients, respectively. Conclusions: PegEPO (30 µg/0.3 mL) was effective treatment of renal anaemia and diabetic chronic kidney disease (CKD) patients on dialysis when administered weekly or every 10 days over a 3-month treatment period.Item Assessment of knowledge, awareness, practices and misconceptions among hypothyroid and hyperthyroid patients(Medip Academy, 2023-08) Savitha, K.; Kata, S.; Chinthagani, O.; Gollapalli, R.Background: In chronic illness there is a greater need for patient education to manage their symptoms, prevent complications, and have better therapeutic outcome and increase quality of life. Among chronic illnesses thyroid disorders are more common in the world. Our study aimed to assess knowledge, awareness, practices and misconceptions in thyroid patients in order to estimate the need of patient education and also counsel the patients for the same using counselling aids. Methods: A descriptive cross sectional study was conducted among 300 subjects in a secondary care hospital for a period of 6 months (February 2017- July 2017). The interviews were conducted in semi private areas in the hospital after taking informed consent by using a structured questionnaire which has been established for its validity and reliability. The results were calculated using descriptive statistical methods (frequency, percentage and mean). Results: Among the participants 23.33% were co-morbidities, majority of patients (83%) do not have family history. Only 32% of the participants have good knowledge, 52.66% have average knowledge and 15.33% patients have poor knowledge about symptoms. Though the knowledge on the dietary factors is considerable in participants, 31.95% of hypothyroid, 58.82% of hyperthyroid patients followed inappropriate dietary habits. 86.3% believed that patients with thyroid disorders need to take medications for their lifetime. Conclusions: The results conclude the need for patient education in thyroid disorders and also a need for clinical pharmacists in hospital setup to fill the gap between physician and patient to provide patient education and clarify misconceptions.Item Modified liverpool quick sequential organ failure assessment for prediction mortality amongst hospitalised patients(Medip Academy, 2023-08) Mondal, J. I.; Begum, R.Background: The aim of this study was to investigate the association between the Low-Quantitative Sepsis-related Organ Failure Assessment (LqSOFA) score and outcomes in pediatric patients with suspected infection. Methods: The study included 100 pediatric patients who presented to the emergency department (ED) with suspected infection. The LqSOFA score was calculated for each patient based on the first set of vital signs and laboratory values obtained in the ED. The primary outcomes of interest were pediatric intensive care unit (PICU) admission, confirmed sepsis, and mortality. Results: The study found that an LqSOFA score of >2 predicted PICU admission with approximately 88% sensitivity and 56% specificity, and confirmed sepsis with 88% sensitivity and 47% specificity. Furthermore, an LqSOFA score of >2 predicted mortality with 94% sensitivity and 48% specificity. The duration of hospital stay also increased with increasing LqSOFA score. Conclusions: The LqSOFA score may be a useful tool for identifying high-risk pediatric patients with suspected infection who may benefit from early intervention. Future studies are needed to validate these findings and determine the optimal threshold for the LqSOFA score in this patient population.Item Analysis of indications of induction of labor and feto-maternal outcome in a tertiary care hospital(Medip Academy, 2023-08) Sharma, S.; Sharma, R.; Gautam, A.Background: Induction of labor (IOL) is an intervention that artificially initiates uterine contractions leading to progressive dilatation and effacement of cervix and expulsion of fetus prior to spontaneous onset of labor. Aim of study was to study the indications of induction of labor and the feto-maternal outcome. Methods: Women who underwent IOL beyond 28 weeks gestation with single cephalic presentation were included in the study over a period of one year. Results: A total of 3887 women delivered in the hospital during the study period. 1107 (28.47%) pregnant women underwent induction of labor. Most common indication of induction of labor was post-date pregnancy 682 (61.60%). About 64.52% had vaginal delivery, 30.71% had caesarean section and 4.6% had instrumental delivery, 1.80% PPH, 0.45% puerperal sepsis and 2.16% wound sepsis. 97% neonates with APGAR score more than 7and 1.08% neonates were admitted to NICU. There were 0.27% fresh still births and 0.45% birth asphyxia. Conclusions: Careful analysis of indication of induction of labor, selection of the patients, proper monitoring at the time of induction and strict partographic management of labor results in a healthy baby and mother.Item Correlation of salivary glucose level with blood glucose level in diabetes mellitus: a cross sectional study(Medip Academy, 2023-08) Baishya, R.; Lahkar, M.; Bora, M.; Mazumdar, A.Background: There is alarming rise in number of people with diabetes mellitus over these years. Type 2 diabetes mellitus is the fifth most common condition and the sixth leading cause of mortality amongst the elderly. Finding a relationship between the blood glucose level and its concentration in other body fluids such as the saliva can help in developing an on invasive method for blood sugar assessment replacing venous sampling. Objective of this study was to see the correlation between fasting blood glucose and fasting salivary glucose levels. Methods: This cross sectional study included 200 randomly selected subjects, of which 100 were known diabetes constituted test group and 100 were normal healthy subjects, age- and sex-matched individuals constituted the controls. Fasting blood glucose and salivary glucose levels were measured by using glucose oxidase peroxidase methods. Data were recorded on a preforma in Microsoft excel sheet. Pearson's coefficient of correlation was applied to find out any significant correlation between the fasting blood glucose and fasting salivary glucose levels. Results: Results were obtained by statistical calculation and plotted with respect to scatter and bar diagram was done and a p<0.05 was considered significant (with 95% CI). Conclusions: A significant positive correlation exists between fasting blood glucose and fasting salivary glucose in both the test groups.Item The prevalence, clinical characteristics, and brain MRI changes in intracranial artery hypoplasia: a retrospective single-center cross-sectional study(Medip Academy, 2023-08) Usman, F. S.; Pariama, G.; Aiko, N.; Kurnia, L.; Murdianto, H.; Kastilong, M. P.reduced cerebral blood flow, increased atherosclerosis, and aneurysm formation. This study aimed to describe the profile of vertebral artery hypoplasia (VAH), anterior CAH (ACAH), and posterior CAH (PCAH) in symptomatic subjects. Methods: This was a retrospective cross-sectional study using medical record in a secondary private hospital in Jakarta, Indonesia, in January-December 2022. The inclusion criteria were age ?18 years with neurological symptoms, underwent brain MRI, and being diagnosed with CAH using DSA. The exclusion criteria were findings of other vascular pathologies including dissection and >50% intracranial vessel stenosis. Demographics of age, sex, body mass index (BMI), hypertension, diabetes, cardiac disorder, and previous stroke were analyzed among VAH, PCAH, and ACAH groups. Results: Of 769 subjects with clinical symptoms undergoing DSA, there were 66 (8.6%) cases of intracranial artery hypoplasia, including VAH (4.6%), PCAH (1.2%), and ACAH (2.9%). Subjects were predominantly old (53.2±10.1 years), male (53.0%), with BMI of 24.9±3.9 kg/m2 and hypertension (69.7%). Previous stroke (69.7%) was more prevalent than in previous study (28.1%). Stroke and brain ischemic lesion were detected in 89.4% and 84.8% cases. No differences were found in all parameters among all groups, but posterior circulation symptoms tended to be found in VAH (28.1%) than general stroke (20.3%). Conclusions: The high percentage of recurrent stroke and corresponding clinical symptoms associated with CAH supported that CAH may be a risk factor for clinical symptoms, including stroke, regardless of the involved artery.Item Analysis of the quality of health services in inpatient installations on patient satisfaction(Medip Academy, 2023-08) Hendrik; Simorangkir, G. F.; Girsang, E.; Ginting, J. B.Background: The quality of health services is the level of service perfection carried out with applicable service standards and must be assessed from the point of view of service users and organizers. This study aims to analyse the quality of health services at the Royal Prima Medan Hospital Inpatient Installation against the level of satisfaction of BPJS user patients. Methods: This type of research is descriptive quantitative, and cross-sectional, conducted at Royal Prima Medan Hospital in May 2022. The population is patient data for the last three months totalling 1,653, the sample using SEM (Structural Equation Modelling) obtained 250 respondents, and sampling using an accidental sampling technique. Data analysis is bivariate (Chi-Square test) and multivariate (multiple logistic regression) with a significance level of Sig. 0.05, using SPSS Version 25 software. Results: Tangible variables (0.000), reliability (0.047), responsiveness (0.000), and assurance (0.001) have a significant relationship with the level of patient satisfaction with a p-value ?0.05. At the same time, the empathy variable has no relationship with a p-value of 0.133 ?0.05. The results of multivariate analysis of the variables that have the most influence on patient satisfaction are the responsiveness variable with a sig value of 0.000 and an R square value in this study of 0.905. Conclusions: The variable that has the most influence on BPJS patient satisfaction at the Royal Prima Medan Hospital inpatient installation in 2022 is the responsiveness variable. Patients can feel service satisfaction if hospital employees are quick and responsive to their complaints.Item Determinants of anaemia among adolescent girls in rural Varanasi, Uttar Pradesh(Medip Academy, 2023-08) Yadav, P.; Kumar, A.; Kansal, S.Background: India is home to 253 million adolescents 10-19 years of age, among the largest cohorts globally. This age group comprises of individuals in a transient phase of life requiring nutrition, education, counselling and guidance to ensure their development into healthy adults. Adolescent girls are the most vulnerable group of population due to different reasons especially anaemia. Anaemia is a major public health problem worldwide. The aim of this study was to assess the prevalence of anaemia and associated factors among adolescent girls (10-19 years) in rural Varanasi, Uttar Pradesh. Methods: The present study was a community-based cross-sectional study conducted among 369 adolescent girls in rural Varanasi with a semi-structured and pretested questionnaire. Results: Study shows that the overall prevalence of anaemia among adolescent girls was 67.8% out of which 41.5% and 24.4% were mild and moderately anaemic respectively. Anaemia was significantly associated with age groups, birth order, menarche status, no. of days of menstruation, gap between two cycles, use of clothes/sanitary pads and no. of pads used during menstrual cycle. Conclusions: Study found some preliminary factors significantly associated with anaemia like low socio-economic status, higher birth order, and knowledge about menstrual hygiene practices. Anaemia continues to be a major public health problem in India despite multiple initiatives to address it among adolescent girls.Item Geriatric assessment as indispensable tool for physicians, what does the future hold?(Medip Academy, 2023-08) Gomez-Pina, J. J.; Chavarria, B. G.Background: Despite the notable rise in the elderly population in Mexico, it is imperative to acknowledge and address geriatric syndromes. The employment of geriatric assessment is essential, as it offers a comprehensive evaluation of elderly patients. Methods: A cross-sectional analysis was carried out on hospitalized patients over the age of 65, who underwent geriatric assessment performed by a multidisciplinary team comprising of a geriatrician, nurse, nutritionist, and internist. Descriptive statistics, such as frequency distribution, percentage, mean, median, and standard deviation of geriatric syndromes were obtained. Results: Polypharmacy was identified as the primary geriatric syndrome, with a higher prevalence among males (54.3%), followed by functional impairment, with a slightly higher occurrence in males (52.5%). Among the identified geriatric syndromes, frailty, anxiety, pressure ulcers, incontinence, abuse, and caregiver collapse showed no gender preference. The majority of patients were at risk of malnutrition, as determined by the mini nutritional assessment. Conclusions: The geriatric assessment is a valuable tool in detecting diseases in elderly patients and facilitating alterations to their treatment plans, particularly during hospitalization. However, accurate assessment of this population requires a multidisciplinary team, as it helps prevent geriatric syndromes such as polypharmacy, functional impairment, and malnutrition, which can adversely affect the elderly's quality of life.Item Effect of antenatal group discussion on fear of childbirth among pregnant women in a Nigerian tertiary hospital(Medip Academy, 2023-07) Eleke, C.; Steve-Tamuno, O. F.; Agu, I. S.; Ngbala-Okpabi, S. O.; Samuel, J. C.Background: Antenatal group discussions (AGDs) are utilized in antenatal peer support. Its application in controlling fear of childbirth (FOC) has not been widely studied in Africa. We examined the effect of AGDs on FOC among pregnant women. Methods: This experiment was done between in 2020 at a teaching hospital in Nigeria. We randomly assigned 218 consenting primigravid women into treatment (n = 111) and control groups (n = 107) and followed them from 31 to 38 weeks of gestation. The treatment group had one AGD session per week for 6 weeks, with each session lasting 120 minutes. The control group had no AGDs. The FOC Questionnaire was used for collecting data at 31 and 38 weeks of gestation. Inferential statistics were used for data analyses at a 5% significance level using SPSS 21. Results: At 31 weeks of pregnancy, 80.2% and 72.9% of participants in the treatment and control groups had unhealthy FOC (range 5 - 9) with no significant difference between the groups (p = 0.204). At 38 weeks, FOC was significantly less in the treatment group compared to the control group (17.1% vs. 48.6%, p<0.001). The AGD reduced the likelihood of unhealthy FOC by 65.0% (RR: 0.35, 95%CI: 0.22 - 0.55). Conclusions: Participation in AGDs reduced FOC among pregnant women, hence recommended. The current caesarean statistics may further reduce if pregnant women were encouraged to utilize AGDs.Item Fibroepithelial tumours of the breast seen in a tertiary health centre in southwestern Nigeria(Medip Academy, 2023-08) Olaofe, O. O.; Soremekun, A. I.; Oladele, J. O.Background: Fibroepithelial tumours of the breast are mainly fibroadenoma and phyllodes tumour. Our objective was to describe the clinical and pathological features of benign fibroepithelial tumours and then compare our findings with reports from other parts of the world. Methods: We carried out a retrospective study of all benign fibroepithelial tumours diagnosed in the Department of Morbid Anatomy and Forensic Medicine of Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria from January 1, 2018 to December 31, 2022. Results: A total of 538 cases of fibroadenoma were seen during the study period. Only 486 cases met the inclusion criteria and were then subsequently studied. Right sided tumour mass is seen in 203 (41.8%) patients, left sided masses in 173 (35.6%) patients and bilateral masses in 96 (19.8%) patients. The age of the patients ranges from 11 to 75 years. The average duration of symptoms is 16 months. The maximum length of fibroadenoma nodule ranges from 0.9cm to 15cm. The number of nodules seen in a patient range from 1 to 15. There is no association between the size of a fibroadenoma, number of the masses or the duration of symptoms before removal of the mass, and the age of the patient. Nineteen cases of phyllodes tumour were seen during the study period. Conclusions: Our study shows that fibroadenoma is the most common fibroepithelial tumour of the breast. A sizeable proportion of patients have bilateral tumours. Phyllodes tumour is much less common.Item Use of three-dimensional versus mini fixation plates in open reduction of mandible fractures in patients of a Mexican hospital between 2017-2023(Medip Academy, 2023-08) Cerón-Solano, G.; Hernández-Ordoñez, R.; Covarrubias-Noriega, A.; Rojas-Ortiz, J.; Vázquez-Morales, L.; Pacheco-López, R.Background: Mandibular fractures are the second most frequent facial fracture, after nose fractures. There are multiple treatments, with reduction and fixation with osteosynthesis plates being the gold standard. Our surgical center uses two types of osteosynthesis plates, 3D, and linear plates. We designed a study to assess whether the use of a 3D plate results in an improvement in terms of surgical time, bleeding volume and post-surgical complications. Methods: We measured bleeding and surgical time from the incision to its closure. Evaluation of the results by computerized axial tomography was obtained at 3 months post-surgery, as well as clinical evaluation of occlusion and other complications. Results: Sixty-three patients met the inclusion criteria. Overall, a 7.9% rate of complications was observed; 5.7% for patients treated with 3D osteosynthesis plates and 10.7% for those treated with linear plates. Surgical time in single fractures between Linear System versus 3D System was similar (p=0.7322) as was surgical time (p=0.4574). The amount of bleeding in single fractures between Linear vs. 3D System was also similar (p=0.285), as was that of double fractures (p=0.6642). Conclusions: These data suggest that the procedure employed, and the material used is at the discretion of the surgeon.Item Clinical profile of patients with hypertensive emergencies in a tertiary care hospital(Medip Academy, 2023-08) Murty, S. N.; Rao, S. S. V. V. N.; Veeramani Kartheek, A. S.Background: Hypertensive emergency is defined by systolic blood pressure (SBP) ?180 mmHg and/or diastolic blood pressure (DBP) ?120 mmHg with acute target organ damage. Hypertensive emergencies can be life threatening and fatal unless timely treated. In the present study we aim to study the clinical profile and outcome of patients admitted with hypertensive emergency in the medical intensive care unit in our hospital. Methods: A cross-sectional observational study of all cases with hypertensive emergency admitted in Medical Intensive care unit (ICU) in Government General Hospital, Srikakulam during the study period was conducted. The clinical profile and outcome of the patients were assessed. Results: Out of the fifty patients in the present study, about 36 (72%) were males and 14 were females (28%) and about one third of the patients (36%) belonged to the age group of 60-69 years. Diabetes mellitus (30%) and dyslipidemia (40%) were the commonly encountered comorbidities in the study population. Most frequent presenting symptoms were neurological deficits (50%) followed by dyspnoea (32%) and chest pain (24%). Intracerebral haemorrhage was the commonest target organ damage found in 30% of the patients. Patients presenting with hypertensive emergencies with neurological target organ damage had statistically significant increased chance of mortality (p=0.007). Conclusions: As hypertension emergencies are consequence of uncontrolled hypertension, it is important to educate and bring awareness among public regarding the screening, early detection, and adherence to prescribed medication for hypertension to avoid adverse clinical outcomes.Item Descriptive analysis of histological types in women undergoing post mastectomy breast reconstruction(Medip Academy, 2023-08) Reyes-Gómez, V. A.; Ramírez-Guerrero, R. O.; Moreno-Hernández, S. G.; Martínez-Martínez, G. C.; Mejía-Rivera, S. E.; Torres-Piña, R.Background: Breast cancer is a pathological entity that widely compromises the life and quality of life of affected women; in addition to the great affectation to the current health services. Therefore, maintaining an accurate and complete cancer registry program is one of the most important factors in implementing national cancer control programs and evaluating the results of screening, diagnosis, and treatment. Among the current limitations in the studies, there is a gap in the study of the population undergoing breast reconstruction. Methods: A retrospective study was carried out at hospital general de México “Dr. Eduardo Licéaga” with the information from the clinical records of the period 2019-2020. Patients undergoing breast reconstruction after mastectomy with histological report were included. Through non-probabilistic sampling, a population of 138 women was formed. For data analysis, frequencies and percentages were calculated for the qualitative variables; while for the quantitative variables, mean and standard deviation were calculated. Results: 138 women who underwent breast reconstruction were included, the mean age was 49.9±10.85 years, the mean BMI was 26.80±4.62 kg/m2, the secondary educational level predominated (34.8%), radiotherapy was applied to 34.1%, reconstruction was late in 75.4%, the most frequent reconstruction technique was TRAM flap (44.2%), the histological type of invasive ductal carcinoma predominated (68.1%). Conclusions: In women undergoing post-mastectomy breast reconstruction, the histological type of invasive ductal carcinoma predominates.Item The effects of antibiotics on liver enzymes in pregnancy(Medip Academy, 2023-08) Handu, K.; Prabhu, S.Background: Antibiotics are increasingly being prescribed during pregnancy. Even though safe non-teratogenic drugs are prescribed, due to altered pharmacokinetics during pregnancy can have adverse effects on hepatic metabolism. Methods: This was a prospective analytical study conducted in the department of obstetrics and gynecology at ESIC Medical College and PGIMSR, Bengaluru, Bengaluru from August 2022 to January 2023, 62 pregnant women diagnosed with infection were admitted and evaluated for the effects of antibiotics on liver enzymes. All cases had undergone a baseline Liver function test before antibiotic therapy were compared and statistically analyzed with the liver enzymes, alanine transaminase (ALT), and aspartate transaminase (AST) values after 7 days of the antibiotic course. Results: In this study, the mean age of pregnant women enrolled was 26±3.62 years. Both primi (45.2%) and multigravida (54.8%) were equally represented. The most commonly prescribed antibiotic was cefotaxime (67.7%). The mean pre AST was 17.92±11.28 and post-AST was 18.34±15.55 U/l (paired t-test =0.861) and the mean pre-ALT was 13.09±19.82 and post-AST was 11.7±8.01 U/l (paired t-test =0.533). Hence there were no significant changes in post-AST and post-ALT compared to Pre AST and ALT values. Conclusions: In this study the common antibiotics administered were cephalosporins and they didn’t show any effects on AST or ALT values after completing the antibiotic course.Item A study on pattern of skull fractures due to head injury(Medip Academy, 2023-08) H., V.; Chittibabu.Background: Skull fractures are very serious type of trauma occurring in 15% of severe head injuries, and there is a consistent association between the presence of cranial fracture and a higher incidence of intracranial lesions, neurological deficit, and poor outcome. Objectives were to study the various patterns of skull fractures and associated intracranial injuries. Methods: A prospective case series study of 50 patients with skull fractures due to head injury was selected from December 2021 to December 2022 at Srinivas Institute of Medical Sciences & Hospital, Mangalore. Out of the 50 cases, the majority were found to be co-existing with intracranial injuries, but few cases showed the presence of skull fractures alone. Among the selected patients, the clinical profile, and radiological profile was undertaken. Appropriate descriptive statistics were used to analyze the findings and to draw inferences. Results: There were 34 males and 16 females. Maximum cases were found in the age group of 31-40 years. The common cause of fracture was road traffic accident (70%) followed by assault (22%); Of the various skull fractures, linear fracture (66%) was the commonest type followed by comminuted fracture and then by depressed fracture. Common associated injuries were extradural hematoma (42%) EDH followed by intracerebral contusion (32%). Conclusions: Common causes of skull fractures are Road Traffic Accidents, assault by blunt weapons and falls from height. The commonest age group affected is 31-40 years. Skull fractures may or may not be associated with intracranial injuries.