International Journal of Research in Medical Sciences

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https://imsear.searo.who.int/handle/123456789/150276

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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Comparison of oral midazolam versus oral dexmedetomidine for ease of induction and prevention of emergence delirium in pediatric ENT surgeries under sevoflurane anesthesia: a randomized controlled study
(Medip Academy, 2025-07) Panigrahi, A; Fotedar, KK; Mehta, P; Sachdeva, S; Singh, P.
Background: Emergence delirium (ED) is a common and distressing complication in pediatric patients following sevoflurane anesthesia. Preoperative anxiety, rapid anaesthetic emergence and postoperative pain contribute to ED. Midazolam is widely used for premedication but has variable efficacy in preventing ED. Dexmedetomidine, a selective alpha-2 agonist, offers sedative and analgesic properties with minimal respiratory depression. This study compared the efficacy of oral midazolam versus oral dexmedetomidine for ease of induction and prevention of ED in children undergoing ENT surgeries under sevoflurane anesthesia. Methods: In this prospective, randomized, single-blinded trial, 100 children aged 2–12 years (ASA I–II) scheduled for elective ENT surgeries were assigned to receive either oral midazolam 0.5 mg/kg (Group M) or oral dexmedetomidine 2 µg/kg (Group D) 45 minutes before induction. Preoperative sedation, ease of parental separation, mask acceptance, hemodynamic stability, incidence of ED (assessed using the Pediatric Anesthesia Emergence Delirium (PAED) scale) and recovery profiles were recorded. Results: Baseline demographics were comparable between groups. Group D demonstrated significantly better preoperative sedation (RSS 3.6 vs 2.8, p<0.001), easier parental separation (90% vs 74%, p=0.03) and superior mask acceptance (88% vs 70%, p=0.02). The incidence of ED was significantly lower in Group D (8%) compared to Group M (26%, p=0.01). PACU discharge was earlier in Group D (36.5 vs 42.8 minutes, p=0.04). Hemodynamic parameters remained stable in both groups without significant adverse events. Conclusions: Oral dexmedetomidine provides superior preoperative sedation, smoother induction and significantly reduces emergence delirium compared to oral midazolam in children undergoing ENT surgeries under sevoflurane anesthesia. Dexmedetomidine may be considered a preferred premedication option in pediatric anesthesia practice.
Association of use of statins with progression of diabetic retinopathy: a randomized controlled trial at a tertiary care centre in Southern India
(Medip Academy, 2025-07) Khan, SA; Andanappa, A; Kukunoor, HR; Naidu, SVVL; Toodi, AR.
Background: Diabetic retinopathy (DR) is a major microvascular complication of type 2 diabetes mellitus (T2DM) and a leading cause of vision impairment globally. Statins, beyond their lipid-lowering and cardiovascular benefits, may offer protective effects against DR by reducing inflammation, stabilizing endothelial function and modulating vascular endothelial growth factor (VEGF) expression. This study aimed to assess the impact of statin therapy on DR severity in patients with T2DM. Methods: A randomized controlled trial was conducted at Government General Hospital, Srikakulam, between April 2024 and February 2025. A total of 120 patients with DR were enrolled and divided into two groups: those receiving statin therapy and those not on statins. DR severity was assessed using fundus examination findings and compared between the two groups. Results: Among the 60 patients on statins, 62.2% had mild non-proliferative diabetic retinopathy (NPDR), while only 3.3% had proliferative DR (PDR) and 1.7% had diabetic macular edema (DME). In contrast, among non-statin users, only 18.2% had mild NPDR, while 29.1% had severe NPDR, 14.5% had PDR and 7.3% had DME. One patient also had vitreous hemorrhage. Conclusions: Statin therapy appears to be associated with milder forms of DR in patients with T2DM. These findings suggest that statins may help slow DR progression, highlighting their potential as an adjunctive therapy for retinal protection in diabetes management.
Association of socio-demographic factors with undernutrition in children under five with cleft palate: a cross-sectional study in a South Indian tertiary hospital
(Medip Academy, 2025-07) Sathees, P; Ramesh, S; Ravanagomagan; Josh, GDS.
Background: Children with cleft palates face unique challenges that increase their risk of undernutrition. While feeding issues are well established, the role of sociodemographic factors in nutritional outcomes remains underexplored in low-resource settings. To estimate the prevalence of undernutrition and assess its association with sociodemographic factors in children with cleft palate. Methods: A cross-sectional study was conducted at Sree Balaji Medical College and Hospital in Chennai over 19 months. A total of 218 children under five with cleft palates were enrolled. Nutritional status was assessed using the WHO anthropometric indicators. Associations between undernutrition and sociodemographic factors were analyzed using chi-square tests and odds ratios. Results: Undernutrition was observed in 70.2% of the children. Most participants were below 3 years of age (and 54.5% were male. The majority belonged to lower-middle and middle-income socioeconomic classes. A higher proportion of undernourished children were born preterm (71.5%). Maternal education was low in a subset of mothers, with 5.5% being illiterate. Feeding difficulties such as nasal regurgitation were commonly reported. Conclusions: Socioeconomic disadvantage and low maternal education significantly contribute to undernutrition in children with cleft palate. Early interventions targeting these factors are essential for improving nutritional outcomes.
Vancomycin intermediate and vancomycin resistant Staphylococcus aureus: an upcoming threat
(Medip Academy, 2025-07) Patel, AS; Bhabhor, UH; Mullan, SA.
Background: Either community or hospital settings, Staphylococcus aureus is a significant pathogen that causes mild localized infections of the skin to potentially fatal systemic infections. The increasing evidence of reduced vancomycin susceptibility (RVS) and vancomycin resistance in clinical MRSA isolates is troubling. There aren't many therapeutic options available for such isolates. We have identified the most current pattern of antimicrobial resistance and specifically evaluated Staphylococcus aureus's susceptibility profile to vancomycin. vancomycin-intermediate Staphylococcus aureus and isolates of Staphylococcus aureus that are resistant to vancomycin. Methods: Non-duplicate, consecutive isolates of S. aureus obtained from January 2021 to June 2022 were subject to antimicrobial susceptibility testing using standard disk diffusion tests or epsilometer tests according to the clinical laboratory standards institute 2021 requirements. Results: The total of 315 S. aureus were isolated during study period. Swab and pus sample shows highest isolation followed by other sample types. A total of 202 (64.1%) isolates were MRSA, while 111 (35.2%) were Inducible clindamycin positive ( ICR Positive). Antibiotic resistance observed is, penicillin (303/315, 96.1%), Ofloxacin (266/315, 84.4%), levofloxacin (255/315, 80.9%), Azithromycin (190/315, 60.3%) followed by other class of antibiotic groups. In our study Vancomycin , Linezolid and Teicoplanin are 100% sensitive. Vancomycin resistance is not noted in any isolates but we have 7 Vancomycin intermate isolates. Conclusions: Gate keeping in advent use of antibiotic is paramount importance to control the antibiotic resistance. As well as continuous laboratory monitoring of various antibiotic resistance pattern is needed.
Predicting the risk of drug-induced urticaria in patients with an allergic history using artificial neural networks
(Medip Academy, 2025-06) Alvarez Arroyo, JJ; Rivera, HM.
Background: Drug-induced urticaria is a frequent hypersensitivity reaction. Identifying individuals at risk is crucial for clinical decision-making. Artificial neural networks (ANNs) offer a promising approach to predicting adverse drug reactions in allergic patients. Methods: We conducted a retrospective analysis using a dataset of patients with known allergic history. Various ANN architectures were trained and validated to predict drug-induced urticaria based on demographic, clinical, and pharmacological variables. Model performance was assessed using accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC-ROC). Results: The ANN model achieved high predictive accuracy, outperforming traditional statistical methods. Key predictive variables included previous allergic reactions, drug type, and comorbidities. The model demonstrated robust generalizability in external validation. Conclusions: ANNs provide an effective tool for predicting drug-induced urticaria in allergic patients. Their implementation could enhance personalized medicine strategies and improve patient safety. Further prospective studies are needed to confirm these findings in broader populations.
Analysis of visually handicapped patients attending outpatient department of a tertiary eye care hospital for visual disability certification in North Bihar
(Medip Academy, 2025-07) Agrawal, V; Kumar, N; Shahnawaz, A; Priya, S; Patel, D.
Background: This study aimed to analyse the demographic details, causes and severity of visual disability of the patients coming for Visual Disability Certificate in North Bihar. Methods: A retrospective study including patients applied for visual disability certificates between January 2023 and August 2024 (20 months) was performed from medical record of tertiary centre in North Bihar. The demographics, aetiologies, grades and classification of visual impairment according to the new guidelines provided in the Gazette of India published in 2018 of the study subjects were analyzed. Results were compared with data from studies on blindness certificates and population-based studies. Results: Out of total, 104 patients eligible for 40% or above visual disability certification of which 66 patients were males. The age range was 1-90 years with the maximum number of patients in 11-20 years range. According to the grade and percentage of disability, low vision grade 3c (60%) was most commonly seen in 28.92% of individuals followed by 3a (40%). Blindness 4a and 4b (90-100%) was seen in 40 patients (38.46%). Most common cause for visual disability found was glaucomatous optic atrophy followed by retinitis pigmentosa and fundal coloboma. Conclusions: Analysis of blindness certificates provides valuable information regarding different causes of visual disability and provides an insight into the overall trends in visual disability profile and help in rehabilitation.
A comparative study on tumour response and treatment toxicities of two cycles versus three cycles of induction chemotherapy followed by concurrent chemoradiotherapy in the management of locoregional advanced head and neck cancer
(Medip Academy, 2025-07) Swer, D; Singh, LJ; Devi, YS; Panmei, R; Kilari, LTG; Babu, BM.
Background: Locally advanced head and neck squamous cell carcinoma (LA-HNSCC) is being treated by multimodality approached, the rationale of using induction chemotherapy (ICT) is to shrink the tumors, enhance local control, and improved response, supporting the use of multiple ICT cycles. This study, compares two different courses of ICT followed by concurrent chemoradiotherapy to see the improvement in tumour response and treatment toxicities. Methods: A randomized controlled trial conducted at the department of radiation oncology, RIMS, Imphal, from July 2022 to June 2024 after approval was obtained from institutional research ethics board (REB) with a total of 61 patients, where 31 patients recruited in arm-A and 30 patients in arm-B which compares two cycles versus three cycles of ICT followed by chemo-radiotherapy. Tumor response and toxicities were assessed using RTOG and RECIST criteria. Results: Toxicities like oral mucositis, anemia, neutropenia, thrombocytopenia were seen more in arm B as compared to arm A and KFT toxicities were higher in arm A. Late toxicities like dermatitis, xerostomia, subcutaneous fibrosis were observed higher in arm-B. Partial response (PR) was observed better in arm B but progressive disease (PD) and stable disease (SD) were higher in arm A. Conclusions: Arm B showed slightly better tumor shrinkage but had more side effects with mucositis, nausea, and blood-related issues. Late toxicities were slightly higher in arm B. However, these differences were not statistically significant. Overall, both arms showed similar effectiveness. More research is needed to find the ideal number of ICT cycles that maximize response and minimize side effects.
Study of efficacy of hyperbaric oxygen therapy in chronic wounds in diabetic patients
(Medip Academy, 2025-07) Bhaskar, N; Kamble, MA.
Background: Diabetic patients are prone to chronic wounds that are difficult to heal due to impaired blood flow, immune dysfunction, and prolonged hyperglycemia. Hyperbaric oxygen therapy (HBOT) has been proposed as an adjunctive treatment for diabetic wounds. This study aimed to evaluate the efficacy of HBOT in treating chronic wounds in diabetic patients. Methods: A prospective observational study was conducted at Sassoon General Hospital, Pune, Maharashtra from July 2022 to March 2024. A total of 34 diabetic patients with chronic non-healing ulcers were consecutively recruited and randomized into two groups: the test group (standard wound care + HBOT) and the control group (standard wound care only). Primary parameters included wound healing rate and reduction in ulcer area, while secondary parameters involved infection rates, time to appearance of serous discharge, and hospital stay duration. Data were analyzed using statistical package for the social sciences (SPSS) 26.0, with significance set at p<0.05. Results: The HBOT group showed a significantly greater reduction in ulcer area, granulation tissue formation was notably faster compared to the control group. Infection rates were lower in the HBOT group, with a higher proportion of sterile cultures on day and HBOT patients also had a shorter hospital stay compared to controls. Conclusions: HBOT significantly improved wound healing rates, infection control, and reduced hospital stay duration in diabetic patients with chronic wounds.
Prevalence and clinical impact of heart failure in dengue-infected patients with Clarkson's disease
(Medip Academy, 2025-07) Thummuru, CT; Enugollu, SR; Shrivatsam, P; Chand, PP; Reddy, AS.
Background: Dengue fever is a mosquito-borne viral infection with significant public health implications, especially in tropical regions. Capillary leakage syndrome (CLS), a severe complication of dengue, may lead to circulatory failure and multi-organ dysfunction. Emerging evidence links dengue to cardiac complications, yet the prevalence of heart failure in dengue patients with CLS remains underexplored. This study assessed the prevalence and clinical impact of heart failure in dengue patients with CLS. Methods: A cross-sectional observational study was conducted at Government Medical College, Srikakulam, from September 2023 to February 2025. A total of 350 adult dengue patients were included. Patients were categorized based on the presence of heart failure and CLS. Laboratory parameters (hematocrit, serum albumin, NT-proBNP, troponin I) and cardiac assessments (ECG, echocardiography, chest X-ray) were analyzed. Statistical analysis identified predictors of heart failure in dengue patients with CLS. Results: Heart failure was diagnosed in 44 patients (12.5%) with concurrent CLS. Patients had elevated hematocrit (48.5%±5.2), low serum albumin (1.8±0.4 g/dl) and raised NT-proBNP (1500±324 pg/ml) and troponin I (0.56±0.22 ng/ml). Echocardiography revealed reduced ejection fraction (28%), myocarditis (22%), pulmonary congestion (18%) and arrhythmias (16%). Significant predictors of heart failure included NT-proBNP>500 pg/ml, hypoalbuminemia <3.0 g/dl, hyponatremia <135 mmol/l and myocarditis on echocardiography. Conclusions: Heart failure is an underrecognized but significant complication in dengue patients with CLS. Biomarker screening and early cardiac evaluation are vital for timely intervention and improved outcomes.
A clinicopathological study of gestational trophoblastic diseases in a tertiary healthcare centre
(Medip Academy, 2025-07) Kakadiya, HH; Nishal, AJ; Desai, PM; Viradiya, RH.
Background: Gestational trophoblastic diseases are marked by abnormal proliferation of various trophoblastic cells during placentation. It includes hydatidiform mole, invasive mole, choriocarcinoma, placental site trophoblastic tumor (PSTT) and epithelioid trophoblastic tumor (ETT). GTNs are among the rare human tumours that can be cured even in the presence of widespread dissemination. Aims of present study was to assess histomorphological features of GTD along with its clinical correlation. Methods: It was an observational cross-sectional study conducted in the Department of Pathology, at tertiary healthcare centre in South Gujarat over a period of 5 years from January 2019 to December 2023. Histological finding of all cases were recorded and clinical correlation done. Results: Out of 50 analysed cases of GTDs, 47 cases (94%) were Hydatiform mole and 3 cases (6%) were choriocarcinoma. The incidence of gestational trophoblastic diseases is found to be 1 in 799 pregnancies. Age ranged from 18-35 years. The most commonly affected age group was 20-25 years with 29 cases (58%). Most cases were presented in the first trimester. Most common clinical presentation was bleeding per vagina in 34 cases (68%) followed by abdominal pain. The majority of GTD cases belonged to 50,000 to <1,00,000 mlU/ml beta-HCG level. Conclusions: Hydatidiform mole is most prevalent gestational trophoblastic disease. Present study signifies the importance of routine histopathological examination of products of conception to rule out microscopic molar changes, since there is an higher incidence of molar pregnancies progressing to choriocarcinoma, a highly metastasizing neoplasm.
Assessment of carbohydrate count and standard diabetic diet on children growth with type 1 diabetes
(Medip Academy, 2025-07) Pendhari, AT; Reddy, SVR; Reddy, MM; Bantawal, G; Kumar, KMP; Reddy, S; Kannan, S.
Background: The management of optimal blood glucose levels in type 1 diabetes children is essential with proper nutrition therapy to achieve age-appropriate growth and development and to avoid acute and chronic complications. Methods: One hundred type 1 diabetes aged between 6 and 18 years were on insulin with the duration of one year were enrolled in the study. The participants were divided into two groups of fifty in each. The control group received a standard diet and routine treatment and intervention group received carbohydrate-count diet in addition to standard care. Detailed history, anthropometric, biochemical, clinical examination and 3-day dietary intake were collected at baseline baseline, three months, and after six months. Results: The intervention group exhibited significantly lower mean HbA1c levels than control group, indicating improved glycemic control. Categorizing patients into weight-for-age categories revealed a significant difference in distribution between control group at baseline (CG-38.6±11.9) and after six months (40.4±11.5), p=00024. In comparison, the intervention group showed a significant difference at baseline (IG-37.1±13.6) and after six months (39.4±13.6), p=00001. However, the intervention group showed more substantial improvement in weight gain. Although mean differences in BMI-SDS between control and intervention groups were observed. Conclusions: Carbohydrate counting method showed significant improvement in glycemic levels in intervention group and intern reduced insulin requirement this could achieve the age-appropriate growth patterns in children with Type 1 diabetes.
Radiological and histopathological correlation of hepatic tumors in computed tomography and magnetic resonance imaging
(Medip Academy, 2025-07) Das, S; Sahoo, BB; Ghosh, S.
Background: Hepatic tumors present a diagnostic challenge due to overlapping radiological features with both benign and malignant lesions. Differentiating these tumors accurately is essential for appropriate management. Correlating imaging findings with histopathology can enhance diagnostic confidence and reduce unnecessary interventions. Methods: A prospective study was conducted at SCB Medical College, Cuttack, from January 2021 to December 2022, involving 100 patients with hepatic tumors. All patients underwent computed tomography (CT) and/or magnetic resonance imaging (MRI) followed by histopathological evaluation. Radiological findings were compared with histopathology and immunohistochemistry for diagnostic correlation. Results: Out of 100 hepatic tumor cases, 58% showed hypervascularity and 82% had well-defined margins on imaging. T2 hyperintensity was observed in 77% and T1 hypointensity in 60% of lesions. Fat was detected radiologically and histologically in 40% of cases. Histopathology confirmed hepatocellular carcinoma in 45%, angiomyolipoma (AML) in 12%, and other benign tumors in the rest. Conclusions: Radiological features alone may be insufficient for definitive diagnosis. Correlation with histopathology is essential, especially in fat-deficient lesions.
Infant feeding practices in first time mothers: a cross-sectional study
(Medip Academy, 2025-07) Hiranmayi, A; Ravanagomagan, MG; Jagadeeswari, S.
Background: Optimal infant nutrition during the early months of life is essential for growth, development, and disease prevention. Exclusive breastfeeding (EBF) is recommended for the first six months by World Health Organization (WHO) and United Nations Children's Fund (UNICEF). However, in many low- and middle-income countries, including India, actual breastfeeding practices are influenced by socio-cultural and economic factors, especially among first-time mothers. This study aimed to assess the knowledge, attitudes, and practices (KAP) regarding infant feeding among first-time mothers in an urban healthcare setting in India. Methods: A cross-sectional descriptive study was conducted between January and March 2025 at the Department of Pediatrics, Sree Balaji Medical College and Hospital, Chennai. A total of 383 first-time mothers with infants aged 0–6 months were selected using purposive sampling. Data were collected using a self-structured and pre-tested KAP questionnaire in English and Tamil. Descriptive and inferential statistics were used for analysis via statistical package for the social sciences (SPSS) version 21. Results: While 85% of participants were aware of the recommended duration for EBF, only 52.2% practiced it. Formula feeding was reported by 31.3%, and 15.7% had introduced animal milk before six months. Prelacteal feeding and bottle-feeding were practiced by 10.4% and 13.1%, respectively. Major barriers included perceived insufficient milk (31.3%), return to work (23.5%), and lack of support (20.9%). Health professionals (65%) were the primary source of breastfeeding information. Conclusions: Despite high awareness, a significant gap exists between knowledge and actual feeding practices among first-time mothers. Targeted educational interventions and support systems are essential to improve adherence to optimal infant feeding guidelines.
Comprehensive physicochemical analysis of ferric carboxymaltose products marketed in India
(Medip Academy, 2025-07) Dubey, V; Jagtap, MB; Savla, H; Shinde, UA; Ambre, PK.
Background: Intravenous iron therapy is essential for managing iron-deficiency anemia (IDA). Ferric carboxymaltose (FCM), a colloidal complex of ferric oxyhydroxide within a carboxymaltose shell, enhances iron delivery and supports hemoglobin synthesis. However, stability, uniformity, shelf life and efficacy challenges persist across available FCM formulations in the Indian market. The latest Indian Pharmacopoeia (IP) guidelines emphasize evaluating key physicochemical properties to ensure the quality and safety of formulations. Methods: This first-of-its-kind study comprehensively analyzes nine marketed injectable FCM formulations including an innovator and competing brands A-H, by evaluating their physicochemical parameters with statistical validation. Results: The evaluation highlights significant deviations in key physicochemical parameters among the brands. Brand C exceeds acceptable density and particle size limits, leading to a high PDI and increased risk of agglomeration. Brand E shows low molecular weight and carbohydrate content with an elevated PDI, indicating instability and rapid iron release. Brand F, with a higher molecular weight, exhibits elevated PD and PDI values, reflecting molecular weight diversity. Brand H surpasses acceptable density and carbohydrate content ranges, further evidenced by its high PDI. Conclusions: FCM is widely used for IDA and pregnancy, offering rapid iron replenishment with fewer doses and cost effectiveness. This study highlights quality and safety variations among injectable FCM brands. Brand A, with strong physicochemical properties interms of osmolality, iron core size, zeta potential, particle size, iron and carbohydrate contents comparable to the innovator, stands out as a reliable option for intravenous iron supplementation, ensuring efficacy and patient safety.
Assessment of the acid-base disturbance in COVID-19 patients admitted in an intensive care unit: an observational study
(Medip Academy, 2025-07) Jayadeva, BT; George, ML; George, RS.
Background: The coronavirus disease 2019, known as COVID-19, became a global pandemic following its initial outbreak in Wuhan, China. COVID-19 illness severity is categorized into three levels: mild, severe, or critical. Arterial blood gas (ABG) testing is considered the definitive method for assessing oxygen levels. It also plays a crucial role in evaluating the sufficiency of ventilation and the balance of acids and bases in the body. To assess the acid base disturbance in COVID 19 patients who were admitted in the intensive care unit (ICU). Methods: After obtaining ethical committee approval and informed consent from patients this prospective observational study was conducted in a tertiary care hospital, Bengaluru from August 1st to October 31st 2020. The arterial blood gas tests were performed prior to any intervention to manage the patient's condition. The analyses focused on the anion gap, bicarbonate levels, blood pH, PaCO2, and PaO2. Results: The mean age of the patients was 58+12.2 years. A high pH level (alkalosis) was observed in 31 (62%) patients. High HCO3 was seen in 14 (28%). A statistical analysis using the Pearson correlation test revealed a significant negative correlation between PaCO2 and pH, with a correlation coefficient (r) of -0.346 and a p value of 0.001. Conclusion: Consistent monitoring of ABG at regular intervals plays a crucial role in promptly detecting respiratory impairment, silent hypoxia, and cytokine storms. Early identification through such monitoring can lead to timely intervention and ultimately save lives.
A prospective study on correlation of high-resolution computed tomography temporal bone and surgical findings in squamosal chronic otitis media
(Medip Academy, 2025-07) Parveen, M; Ahmed, A; Sharma, SC; Khalid, S; Monis, M.
Background: Chronic otitis media (COM) is a common condition seen in patients attending ENT department. It is caused by persistent inflammation of the middle ear and mastoid cavity and when left untreated, can lead to significant complications, including the development of squamosal chronic otitis media (SCOM). The aim of this study is to assess the role of high-resolution computed tomography (HRCT) temporal bone in preoperative evaluation of squamosal chronic otitis media. Methods: This study is a prospective study involving 50 cases of COM. All the patients underwent pre-operative HRCT followed by surgical exploration of middle ear cleft to compare the HRCT findings with the operative findings, thereby establishing a robust correlation between radiological assessment and surgical observations. Results: The result of the study reveals varying levels of agreement between CT and operative findings across different structures, with generally high concordance rates and statistically significant p values, indicating the reliability of CT in diagnosing these conditions. All findings are statistically significant, emphasizing the consistency between CT and operative findings. The result also highlights that CT scans have high levels of reliability in detecting ossicular erosion, various types of malleus erosion, with good to very good agreement for head of malleus and handle of malleus erosion. Conclusions: The study highlights the potential of HRCT to improve surgical outcomes by enabling more precise and targeted interventions, ultimately leading to better eradication of the disease from the middle ear cleft.
Prevalence, risk factors, and outcomes of acute kidney injury in a cardiac intensive care unit patients: a comprehensive study in a tertiary care setting
(Medip Academy, 2025-07) Naidu, SVVL; Ashraf, S; Kukunoor, HR; Arvindbhai, DG; Gohil, AR.
Background: Acute kidney injury (AKI) is a frequent and serious complication among critically ill patients in the intensive care unit (ICU), contributing to increased morbidity, mortality, and prolonged hospitalization. This study aimed to assess the prevalence of AKI and identify associated risk factors among ICU patients at Government General Hospital (GGH), Srikakulam. Methods: A descriptive cross-sectional study was conducted over one year in the nephrology ICU at GGH, Srikakulam, Andhra Pradesh. Data from 150 adult ICU patients were retrospectively reviewed. Patients with chronic kidney disease or prior kidney transplantation were excluded. Information on demographics, comorbidities, AKI diagnosis (based on KDIGO criteria), treatment, and outcomes was collected. Statistical analysis was performed to determine significant risk factors for AKI. Results: AKI was diagnosed in 74 patients (49.3%). The mean age of AKI patients was 65.4 years, significantly higher than non-AKI patients (58.6 years, p=0.001). Hypertension was more common among AKI patients (50% versus 29%, p=0.02), and sepsis was present in 60% of AKI cases compared to 19.4% in non-AKI patients (p=0.001). AKI patients had longer ICU stays (14.8 versus 8.9 days, p=0.001) and higher mortality (46.7% versus 16.1%, p=0.001). Conclusions: AKI is highly prevalent in ICU patients and is significantly associated with older age, hypertension, and sepsis. It correlates with longer ICU stays and increased mortality. Early recognition and targeted management of risk factors are crucial to improving outcomes in critically ill patients.
Prevalence and clinical patterns of epilepsy in children with spastic cerebral palsy: a cross-sectional study in South India
(Medip Academy, 2025-07) Josh, GDS; Ramesh, S; Priya, MA; Ramesh, J; Sathees, P.
Background: Cerebral palsy (CP) is frequently accompanied by epilepsy, a comorbidity that exacerbates motor and cognitive impairment. Among the CP subtypes, spastic CP exhibited the highest association with seizures. However, the prevalence and clinical patterns of epilepsy in these children, particularly in the Indian context, remain under- characterized. Objective was to determine the prevalence and characterize the clinical patterns of epilepsy among children with spastic CP in a tertiary care setting in South India. Methods: This cross-sectional study was conducted over 18 months in the pediatric department of a tertiary hospital. A total of 218 children aged 2-14 years with spastic CP were recruited. Epilepsy diagnosis and seizure types were confirmed using ILAE criteria through clinical history and caregiver interviews. Gross motor function was assessed using the gross motor function classification system (GMFCS). Statistical associations were evaluated using chi-square tests and odds ratios (OR) with 95% confidence intervals (CI). Results: Epilepsy was prevalent in 52.2% of the patients. The most common type of seizure was tonic-clonic (31.3%), followed by myoclonic (9.6%) and complex partial seizures (8.7%). Children with quadriplegic (36.5%) and diplegic (35.7%) CP exhibited a higher epilepsy prevalence. Epilepsy was most frequent in GMFCS levels II and III. No significant sex differences were observed. Conclusions: Epilepsy is common in children with spastic CP, particularly among those with quadriplegia, diplegia, and moderate-to-severe motor impairment. Early neurological surveillance and risk-based screening, especially among patients with GMFCS II-IV, may improve detection and long-term outcomes.
Digital eye strain among university students: a cross-sectional study from Hyderabad, India
(Medip Academy, 2025-07) Bhammarkar, UD.
Background: Digital eye strain (DES) or computer vision syndrome (CVS) represents a growing public health concern as digital device usage increases globally, particularly among university students. This study aimed to assess the prevalence and characteristics of digital eye strain among university students in Hyderabad, India. Methods: A descriptive cross-sectional study was conducted among 112 university students in Hyderabad, India, from November to December 2024. Data was collected using a self-administered questionnaire. Non-probability convenience sampling was employed, and statistical analysis included calculation of percentages and means using statistical package for the social sciences (SPSS). Results: All participants (100%) owned smartphones, while 60.7% owned laptops. The mean age was 22.3±2.5 years, with 65.2% female participants. The most common symptoms reported were headache (75.0%), burning or itching sensation in eyes (50.0%), and watering from eyes (49.1%). Significant increases in screen time were observed over the preceding three years. Conclusions: Digital eye strain symptoms are highly prevalent among university students, with headaches being the predominant complaint. Preventive measures and awareness programs are essential to mitigate the effects of prolonged digital device usage on ocular health.
Naso-orbito-ethmoidal and nasal bone fractures, associated with anosmia and olfactory disorders
(Medip Academy, 2025-07) Olivares, EP; Avila, DVD; Zamudio, ST; Renteria, JMM.
Background: Facial trauma is among the first three causes of alterations in the sense of smell, however, among the many sequelae that can be left by a facial trauma involving the fracture of bone structures, this is one of the least addressed issues and for which there is less information about the prevalence and incidence as well as its management. The aim of this study is to determine the impact of olfactory disorders, after presenting a facial fracture that covers the area of the nasal bones and the naso-orbito-ethmoidal region (NOE). Methods: This retrospective study analyzed the prevalence of alterations in olfaction after the presence of facial traumatisms that covered the centrofacial region known as naso-orbito-ethmoidal, during the period of time from 2019 to 2024, collecting 36 patients, subdividing the patients to assess whether there was a proportional relationship of severity with a higher prevalence of hyposmia or anosmia. Results: The study included 36 patients with a mean age of 28.29 years, the 20–30 age group being the most prevalent (53.5%). A total of 13 (17.8%) patients have diagnosed a NOE fracture and 23 (82.2%) with nose fracture. Of the patients with type NOE fracture, 6 (46%) presented an olfactory alteration, being 2 with type NOE I, 3 with type NOE II and 1 with type NOE III. Of the patients with nasal bone fractures, 10 (43%) had an olfactory alteration. Conclusions: Patients who suffer with a facial trauma of the centrofacial region, undergo in a large proportion with alterations of the sense of smell, observing a proportional relationship between the severity of the trauma and hyposmia without presenting an improvement despite appropriate surgical management, so it is very important that when performing the initial physical examination, to verify the presence of olfactory alterations if the patient's conditions are so affected

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