Perspectives in Medical Research
Permanent URI for this collection
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/
Browse
Recent Submissions
Item Histomorphological Spectrum of Gastric Polyps: A Retrospective Analysis from a Tertiary Care Centre in South India(Prathima Institute of Medical Sciences, 2024-12) Shanker, S; Dhanya, V; Kunhikannan, S; Menon, M; Sathi, PP.Introduc?on: Gastric polyps are o?en incidentally detected during endoscopic evalua?ons, with a prevalence of approximately 5% in endoscopy cases. Their diagnosis and classifica?on rely on histopathological examina?on to determine their nature and poten?al for malignancy. Com- mon gastric polyps include hyperplas?c polyps, fundic gland polyps, and adenomatous polyps. This study aims to eval- uate the histopathological spectrum of gastric polyps in a ter?ary care se?ng and document the associated clinical presenta?ons. Materials and Methods: This retrospec?ve observa?onal study was conducted from January 2019 to February 2023 at a ter?ary care centre in South India. A total of 124 pa?ents with histopathologically confirmed gastric polyps were included. Pa?ents with known gastric malignancies were excluded. Results: The study popula- ?on showed a slight female predominance (53.2%). The most common clinical complaint was dyspepsia, reported by 61% of pa?ents. Most pa?ents were in the age group of 51–80 years. Hyperplas?c polyps were the most fre- quently observed type (47.16%), followed by fundic gland polyps (40.65%). The body of the stomach was the most common site of polyp occurrence (47.15%). Conclusion: The findings suggest a predominance of fundic gland polyps in the studied South Indian popula?on. Addi?onally, Heli- cobacter pylori infec?on was detected in more than 45% of hyperplas?c polyps, emphasizing its poten?al role in polyp forma?on. Rou?ne histopathological evalua?on remains crucial for accurate classifica?on and risk assessment of gastric polyps. Further studies are warranted to explorethe clinical implica?ons and long-term outcomes of gastric polyp management.Item Prevalence And Patterns Of Ocular Manifestations In Psoriasis: A Cross-Sectional Study(Prathima Institute of Medical Sciences, 2024-12) Sharma, S; Sharma, AK; Trumboo, T; Gupta, S.Background: Psoriasis is a chronic inflammatory condi?on affec?ng the skin, nails, joints, and eyes. Ocular manifes- ta?ons in psoriasis, such as dry eyes, blephari?s, conjunc- ?vi?s, and uvei?s, are o?en overlooked despite their poten- ?al impact on quality of life. Objec?ve: This study aimed to inves?gate the prevalence and types of ocular manifesta- ?ons in psoriasis pa?ents and their correla?on with disease severity. Methods: This observa?onal study was conducted at Government Medical College, Jammu, between March 2022 and March 2023. It included 50 psoriasis pa?ents who underwent comprehensive ophthalmic evalua?ons, such as best-corrected visual acuity (BCVA), slit-lamp examina?on, tear film break-up ?me (TBUT), Schirmer test, and fundus examina?on. The Psoriasis Area and Severity Index (PASI) was calculated for each par?cipant to assess disease sever- ity. Results: The mean disease dura?on was 5.5 ± 3.8 years, and 62% of pa?ents (n=31) exhibited ocular manifes- ta?ons. Dry eyes were the most common finding (22%), fol- lowed by cataract/pseudophakia (14%), blephari?s (14%), chronic conjunc?vi?s (8%), and uvei?s (4%). Pa?ents with higher PASI scores were more likely to have ocular involve- ment. Conclusion: The study highlights that ocular manifes- ta?ons are a significant complica?on of psoriasis, with dry eyes being the most prevalent. Rou?ne ophthalmic evalu- a?ons are recommended for early detec?on and manage- ment of ocular condi?ons in psoriasis pa?ents.Item A Rare Case of a Pregnant Woman with Severe Thrombocytopenia Associated with Systemic Lupus Erythematosus(Prathima Institute of Medical Sciences, 2024-12) Arora, G; Prabhu, GA.This case report describes a 22-year-old pregnant woman with systemic lupus erythematosus (SLE) and severe thrombocytopenia at 32 weeks of gesta?on with dichorionic diamnio?c (DCDA) twins. She had a platelet count of 3,000/?L, persistent thrombocytopenia despite transfusions, and symptoms including rashes and muscle cramps. Diagnosis was confirmed with a posi?ve an?n- uclear an?body (ANA) test. Treatment included methyl- prednisolone pulse therapy, hydroxychloroquine, and intra- venous immunoglobulin (IVIG). At 34 weeks and 4 days, the pa?ent went into preterm labor and underwent a cesarean sec?on. Preopera?ve platelet transfusions raised her platelet count to 51,000/?L. Both twins were delivered safely and admi?ed to the NICU for prematurity. Postopera?ve care included immunosup- pressive therapy, an?hypertensives, and an?bio?cs, with steady improvement in the pa?ent’s condi?on and platelet count. This case highlights the challenges of managing SLE with severe thrombocytopenia during pregnancy, especially with twins. Early diagnosis, tailored treatment, and coordinated mul?disciplinary care led to posi?ve maternal and neonatal outcomes. This emphasizes the importance of proac?ve management in high-risk pregnancies to ensure the best possible results.Item Prevalence and Determinants of Hypertension and Obesity: A Rural-Urban Comparative Study in Telangana, India(Prathima Institute of Medical Sciences, 2024-12) Murali, L; Bhavani, R; Y, K; Shoukath Ali, F.Introduc?on: Non-communicable diseases (NCD) causes 74% of all deaths occurring worldwide. It is common among all age groups. The main behavioural risk factors included inadequate physical ac?vity, tobacco usage, excessive con- sump?on of alcohol and unhealthy diet. This study aimed for the comparison of risk factors for NCD in rural and urban areas and to determine the factors associated with hyperten- sion and obesity. Methodology: This cross sec?onal study was done in the Rural and Urban field prac?ce area of KMC. 300 adults (150 rural and 150 urban) were chosen through systema?c sampling technique. WHO Steps ques?onnaire was used for the data collec?on. The data collected was analysed using SPSS. Chi square test was used as the sta?s- ?cal tests of significance. Results: The propor?on of current tobacco users were 24.7% and 16% and current alcohol users were 56% and 46% in rural and urban respec?vely. Diet were inadequate and poor in both. Physical inac?vity was 90.7% in urban, 52% in rural. Prevalence of Hypertension was 14% and 6%, obesity was 37.3% and 48.7% in rural and urban respec?vely. Diet was significantly associated with Hyper- tension and alcohol consump?on was significantly associ- ated with obesity in both. Conclusions: Both the rural and urban areas had high prevalence of risk factors. Smoking, alcohol consump?on and hypertension were higher in rural area whereas physically inac?vity and obesity were higher in urban area. Hence appropriate health educa?on regarding NCDs and their risk factors are mandatory.Item Impact of Health Education on Knowledge, Attitude, and Practice towards Human Papilloma Virus and its Vaccination(Prathima Institute of Medical Sciences, 2024-12) Ramakrishna, S; Anjum, W; Radhakrishna, V; Kudthni, R; Vishwanath, P.Background: Despite the recommenda?on, the rate of Human Papilloma Virus (HPV) vaccine uptake is poor in developing countries. The possible reasons for this could be limited knowledge, poor acceptance, safety concerns, cost of the vaccine, and lack of awareness. Hence, a study was conducted to determine the effect of health educa?on on knowledge, a?tude, and prac?ce toward HPV infec?on and its vaccina?on.Methods: An interven?onal study was conducted in the Tumkur district of India amongst female students studying in pre-university colleges. A ques?onnaire was provided to evaluate the knowledge, a?tude, and prac?ce about HPV infec?on and vaccina?on before and a?er health educa?on.Results: A?er the health educa?on, awareness about the effects of HPV and the mode of transmission of HPV increased from 62% to 71% (p<0.001) and 12% to 41% (p<0.001) respec?vely. Health educa?on also increased knowledge about the availability of vaccina?on against HPV (34% to 87%; p<0.001), the popula?on at risk for HPV infec?on (16% to 35%; p<0.001), the ideal age group for HPV vaccina?on (45% to 90%; p<0.001), and the overall knowledge score (5.6/17 to 12/17). Health educa?on improved the willingness to pay for the vaccina?on from 34% to 56% (p<0.001) and the willingness to recommend others to vaccinate from 61% to 89% (p<0.001). Conclusion:The health educa?on increased awareness about the symptomatology, mode of transmission, popula?on-at-risk, and the effects of HPV infec?on. Health educa?on also improved the willingness to pay for the vaccina?on and willingness to recommend others to vaccinate against HPV.Item A Study of Clinical Profile of Patients Presenting with Topical Corticosteroid Induced Facial Dermatoses(Prathima Institute of Medical Sciences, 2024-12) Hosthota, A; Chandan, B; Chi?uri, B; Nilofer, A; Ramesh, A; Bhar?, A.Introduc?on: The injudicious use of Topical cor?costeroid (TC) over the face has resulted in various complica?ons, encountered day to day. Indian market is flooded with more than 18 different steroid molecules. Methodology: A hospital-based cross-sec?onal study was conducted on 170 pa?ents at a ter?ary care centre. A pre-structured proforma was used to collect socio-demographic details of the subjects with facial dermatoses due to TC misuse for more than 2 weeks. Results: The commonest age group affected was 20-21 years (78.2%) with mostly females (70.6%). Frequent indica?on for applica?on of TC was melasma (50.0%), Acne (24.1%) and others. Subjects (40.6%) brought a combina?on of TCs over the counter as a sugges?on from friends & rela?ves. Cutaneous findings of TSDF were exacerba?on of pre-exis?ng melasma (41.2%). Conclusion: The results of this study underline the need of strict laws. Futher, awareness crea?on among pa?ents and primary care physicians should be given prime importance to prevent the epidemic.Item Series 1: Integra?ng Medical Research Into Clinical Reasoning: Exploring Bayesian Analysis as a Complement to Tradi?onal Sta?s?cs(Prathima Institute of Medical Sciences, 2024-12) Momin, SK.Item Burden of Mental Morbidities among Health Care Workers in a Tertiary Care Hospital Of West Bengal during Third Wave of COVID-19 Pandemic: A Cross-Sectional Study(Prathima Institute of Medical Sciences, 2024-12) Ghosh, S; Bag, S; Mondal, A; Roy, S.Introduc?on: Healthcare workers (HCWs) are constantly on the frontlines, facing the brunt of the COVID 19 pandemic in their personal, professional, and social lives. This pandemic has also taken a toll on the lives of healthcare workers over the past two years. Facing the stress and burnout since the pandemic has begun, during the third wave of the pandemic, there might be an increase in mental health issues among HCWs in this state. The aim of the study is to assess the magnitude of anxiety and depression during the third wave of COVID-19 pandemic among the healthcare workers in a ter?ary care hospital in West Bengal. Materials and methods: The observa?onal study was conducted at IPGMER & SSKM Hospital, a ter?ary care teaching hospital in Kolkata, West Bengal, over a period of one week from January 19 to January 26, 2022. A cross-sec?onal rapid survey was conducted using an online ques?onnaire containing the Beck Anxiety Inventory (BAI) and Beck Depression Inventory-II (BDI-II) among HCWs in the hospital using a Google Proforma through various social media groups. A total of 86 HCWs par?cipated over a period of one week. The data was analysed using SPSS 16 so?ware. Descrip?ve sta?s?cs and univariate logis?c regression were used. Result: In the present study, it was found that among 86 people, 61 of them were aged between 26-40 years, half of them, i.e., 45 people, were male, and more than one-fi?h (22.1%) (n = 86) had moderate to severe anxiety. Most of the par?cipants, i.e., 39 of them (45.3%), had clinical depression ranging from borderline to extreme. No significant associa?on of moderate to severe anxiety and depression and socio-demographic characteris?cs wasno?ced, except for the significantly higher preponderance of anxiety in female gender (p value= 0.0001). Anxiety showed a good posi?ve correla?on with depression (p value less than 0.001) and all who had severe anxiety were also suffering from either severe or extreme depression. Conclusion: An alarming propor?on of anxiety and depression was no?ced among HCWs. The prevalence of anxiety and depression (severe grade) among HCWs are 6% and 8% respec?vely. So awareness regarding their own mental health, preven?ve therapies, and proper diagnosis and treatment of cases are needed.Item Drug Utilisation Pattern of Antimicrobial Agents Prescribed for Urinary Tract Infection in Geriatric Patients at a Tertiary Care Hospital: A Retrospective Study(Prathima Institute of Medical Sciences, 2024-12) RSH, V; Chaitra, SR; RP, N.Introduc?on: Drug u?lisa?on studies may lead to sev- eral perspec?ves such as the correct usage of drugs and appropriateness of drug u?lisa?on. Prescrip?on indicators are used to assess the effec?veness of healthcare prac??on- ers in several cri?cal characteris?cs connected to drug usage. Objec?ves: 1. To determine the most commonly prescribed an?microbial agents for trea?ng UTI in Geriatric pa?ents.2. To analyse prescrip?ons in comparison with WHO prescrib- ing indicators. Methods: All the cases of UTI in geriatric pa?ents with posi?ve urine culture report in the past 6 months (Feb 2023 –July 2023) were included and it was a complete enumera?on study. Discrete variables and Cate- gorical variables were represented by percentage. Con?nu- ous variables were expressed in mean ± SD. Result: Total of 70 geriatric pa?ents with UTIs were enrolled in the study. Of these male Pa?ents were 31 (44.28%) and female Pa?ents were 39 (55.71%). No of an?bio?cs per Prescrip?on was 1.97± 1.43. Approximately 40.54% of medica?ons were pre- scribed using their generic names. About 79.27% of medica- ?ons were prescribed from the NLEM. 62.16% of drugs were prescribed by injec?on. systemic hypertension (67.74%) was observed in the majority of UTI pa?ents. Piperacillin + Tazobactam were the most prescribed an?bio?cs. Dura- ?on of hospital stay was 10.22±6.71 days. Conclusion: By addressing these findings, we can enhance the pharmaco- logical management of UTIs in geriatric popula?ons, leading to improved pa?ent outcomes and quality of care.Item Root Cause Analysis of Adverse Outcomes in the Obstetrics & Gynaecology:A Prospective Study at a Tertiary Care Centre(Prathima Institute of Medical Sciences, 2024-12) Narayan, B; Mendira?a, P.Background: Adverse events are an unwanted outcome in the rou?ne course of pa?ent management, with an adverse event in Obstetrics assuming even greater impor- tance because of the extended implica?ons for the newborn. There is limited data available on the adverse event ema- na?ng from Obstetrics and Gynaecology care in Indian pop- ula?on. Materials and Methods: This prospec?ve obser- va?onal study which included all the consecu?ve inpa?ents admi?ed with the department of Obstetrics and Gynaecol- ogy over a period of 15 months at a ter?ary care centre. Incidence of adverse events were noted. Root cause analy- sis of the events was done and contributory factors brought out were addressed. Results: The incidence of the adverse events in our study was 2.57 % (n=90) in a total of 3503 consecu?ve inpa?ents. The most common adverse event noted in our study was surgical site infec?on followed by birth asphyxia. The average dura?on of detec?on of adverse event was 8.5 days, with adverse event detected in 73% pa?ents during admission. Out of these, 98.48% had a pro- longed hospital stay which averaged 5.5 days. 58% of the adverse events were grade 3 in severity while 91.1% were deemed preventable. Conclusion: Adverse events carry a giant burden with them, but their incidence can definitely be cut down by adhering to ins?tu?onal protocols, checklists, increased awareness and involvement at mul?ple levels of hierarchy.Item Beyond Immunuhistochemistry: Molecular Insights Into Round Cell Soft Tissue Tumors(Prathima Institute of Medical Sciences, 2024-12) Madoori, PK; Tejavat, S.Round cell so? ?ssue tumors (RCSTTs) are a diverse group of aggressive malignancies that share overlapping clinical, morphological, and immunohistochemical features, posing significant diagnos?c challenges. Recent advances in molec- ular pathology have revolu?onized the understanding and classifica?on of these tumors by iden?fying tumor-specific gene?c altera?ons. This review highlights the role of molec- ular insights in complemen?ng histopathology and immuno- histochemistry to achieve precise diagnosis, risk stra?fica- ?on, and therapeu?c decision-making. Key subtypes, includ- ing Ewing sarcoma, CIC- and BCOR-rearranged sarcomas, alveolar rhabdomyosarcoma, desmoplas?c small round cell tumor, and extraskeletal myxoid chondrosarcoma, are dis- cussed with emphasis on their molecular signatures and clin- ical significance. The advent of techniques such as fluo- rescence in situ hybridiza?on (FISH), reverse transcriptase- polymerase chain reac?on (RT-PCR), and next-genera?on sequencing (NGS) has enabled detec?on of gene?c fusions and aberra?ons cri?cal for tumor iden?fica?on and targeted therapies. Integra?on of molecular pathology with tradi- ?onal diagnos?c approaches is essen?al for improving diag- nos?c accuracy, prognos?ca?on, and therapeu?c strategies, paving the way for personalized medicine in the manage- ment of RCSTTs. Full form of ABBREVIATIONS are provided at the end.Item 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, KSTumours 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.Item 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, AIntroduction: 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 TSCItem 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 HyderabadItem 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.Item 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.Item 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.Item 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.Item 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, ABackground: 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.Item 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, AFAHChronic 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.