Abstract Aim To study topographic findings in patients with established vernal keratoconjunctivitis (VKC). Materials and methods In a hospital based cross sectional study, 112 eyes of age group 11-22 years with established case of VKC were selected for topography. Result In 112 eyes with VKC; 69.64% (78 eyes) had significant history of eye rubbing. 14.28% (16 eyes) had Kmax values >=47.2D , 85.71%(96 eyes) had Kmax values <47.2D. 19.64%(22 eyes) had I-S Difference >=1.2D ; 80.36%(90 eyes) had I-S Difference <1.2D. Topographical patterns observed included 49.11%(55eyes) with round pattern, 20.54%(23 eyes) with oval shaped, 9.82%(11 eyes) with symmetric bowtie, 6.25%(7 eyes) with asymmetric bow tie with skewing of radial axis, 5.36%(6 eyes) with inferior steepening, 6.25%(7 eyes) with irregular pattern, 0.89%(1 eye) with crab claw pattern. Conclusion High occurrence of keratoconus-like topographic pattern seen in patients of VKC. Topographic analysis should be performed in all cases of VKC.

OBJECTIVE: The present study is designed to compare early and interval laparoscopic/open cholecystectomy in patients of acute cholecystitis. The comparison was done on the basis of parameters such as intraoperative difficulty, perioperative bile duct injury and bile leak, time taken for operation, postoperative atelectasis, postoperative wound infection, duration of hospital stay and postoperative pain. METHODOLOGY: This is a prospective study conducted in Department of General surgery, GCS MEDICAL COLLEGE, HOSPITAL AND RESEARCH CENTRE from AUGUST 2018 to DECEMBER 2019. 56 patients were enrolled in the study from which 26 patients were randomly assigned to early lap/open cholecystectomy and 30 were assigned to interval lap/open cholecystectomy group. RESULT: There was no significant difference observed between the two groups. However, the duration of hospital stay was less in early laparoscopic/open cholecystectomy. CONCLUSION: Both the methods, early and interval have no significant benefit over each other but through review of all literature, early lap/open cholecystectomy is found to be beneficial overall with less hospital stay.

Abstract: IntroductionThe syndromic management has been the cornerstone of management of sexually transmitted infections (STIs) over the last few decades especially in developing countries. But due to its inability to treat asymptomatic cases leading to undesirable sequeale, it has received a lot of criticism recently. On the other hand, Evidence based management of patients of vaginal and cervical discharge has lead to effective and timely management of these patient but has increased the financial burden.Objective:The goal of the study is to compare syndromic vs. Evidence based approach in the management of vaginal and cervical discharge. Method:The present study was conducted in the outpatient department of dermatology, venereology & leprology of a tertiary care teaching hospital. 354 patients of clinical impression of vaginal and cervical discharge were included in the study. Detailed history and examination was recorded. Patients selected for syndromic management were managed as per NACO guidelines. For evidence based management special investigations were carried out and patients were managed accordingly. Result:Out of total 342 cases of VD, treated with syndromic and evidence based approach, p value is significant for 7,14 and 21 days follow-up which means evidence based approach is better than syndromic approach. Similar findings were observed in patients of cervical discharge.Also, among CVV patients managed on lines of syndromic approach only 10% showed improvement by end of one week. Conclusion:The control of STIs in resource-poor settings remains a major challenge.Focus is now shifting towards a diagnostic model of STI care, given the improving economic status of developing countries and availability of affordable point-of care testing. Also, various changes in the syndromic approach are needed immediately for it to still remain relevant.

INTRODUCTION : In December 2019, a large outbreak of a novel coronavirus infection occurred in wuhan hubei province, china. The disease caused by the virus, named novel coronavirus disease (COVID-19) by the world health organization (WHO) can be spread through human to human contact. In human coronavirus can cause spectrum of diseases ranging from asymptomatic patient, simple cold cough to severe acute respiratory syndrome ( SARS). HRCT is very useful to see the extent of disease spread in lungs and to assess the severity of infection. It also helps in monitoring the response and therapeutic effectiveness and prognosis. AIMS AND OBJECTIVES: 1]To evaluate the various HRCT thorax Findings in RT PCR confirmed patients of covid-19 infection. 2] To correlate the findings of HRCT of thorax with patient’s clinical symptoms. METHODOLOGY: A retro- prospective clinical study was carried out on patients who were referred for HRCT thorax to the Department of Radiodiagnosis, Sheth L.G. general hospital having signs and symptoms of covid-19 and whose RT PCR report was awaited and who had undergone HRCT thorax and only patients who were RT PCR test positive within 72 hours were taken in the study. Total of 250 patients from May 2020 to January 2021, who confirmed covid-19 diagnosis with RT-PCR were taken.RESULTS In our study we found, the most common initial CT findings in COVID-19 pneumonia are bilateral, patchy or rounded ground-glass opacities that most frequently occur bilaterally and in the lung periphery with a subpleural basal predominance in left lower lobe. Most common finding were patchy bilateral ground glass opacity most commonly associated with inter and intralobular septal thickening giving crazy paving pattern. Consolidation was also seen with or without GGO suggesting infective etiology. CONCLUSION:HRCT Thorax may be useful as a standard method for the rapid diagnosis of COVID-19 to optimize the management of severely ill PATIENTS.

INTRODUCTION: Dengue infection is a major health problem worldwide including our country. Globally the incidence of Dengue has grown dramatically in the recent years. Every year during the monsoon months and later, many parts of the country witness outbreak of dengue infection. 2020 was no exception and we experienced an outbreak of this vector borne disease in Bhuj. An analysis of these patients revealed that in addition to the classical features of fever, body ache, rash and thrombocytopenia and bleeding tendency, there were other features such as liver dysfunction including a preferential rise of SGOT, hepatomegaly, splenomegaly, ascites, gallbladder wall edema and pericholecystic fluid collection.OBJECTIVE: To study clinical, biochemical and radiological changes in the liver of patients with Dengue fever.METHOD: observational and cross-sectional study was conducted on a 50 suspected cases of Dengue fever admitted and diagnosed at GKGH hospital Bhuj in October 2020. Detailed history, clinical examination, biochemical parameters, radiological investigation for liver function was done in all patients. All patients were treated as per NVBDCP guidelines. RESULTS: all patients in our study had hepatic dysfunction in the form of elevated SGOT above normal limits. CONCLUSIONS: Our study shows that there are certain features of Dengue that are not known to be usually associated with it. The presence of raised liver enzymes in all patients (SGOT > SGPT), ascites, hepatomegaly, splenomegaly, and gallbladder edema and pericholecystic fluid collection.

Background: Endotracheal intubation is gold standard of general anaesthesia. But it has disadvantages of initiation of stress response to laryngoscopy and intubation. To alleviate it we have used Dexmedetomidine & Esmolol. Methods Group E – Inj. Esmolol (1.0 mg/kg) in 10 ml normal saline two minutes before induction Group D – Inj. Dexmedetomidine (1µg/kg) in 10 ml normal saline over 10 minutes prior to induction. Results and conclusion : both the drugs effectively supress stress response but Dexmedetomidine is better than Esmolol

Introduction : HbD Punjab is also known as HbD Los Angeles was first described by Itano in 1951. In HbD point mutation in beta globin chain occurs . HbD associated with HbS in which one gene carries HbD while other gene carries HbS mutation . Infants are at increased risk of life threatening complications like severe anaemia , splenic sequestration , overwhelming septicaemia . Method: Two siblings one 9 year old male and other 4 year old male patients were presented with covid 19 infection in the hospital . Both were known case of sickle cell disease . There blood samples were taken and cbc , retic and HPLC was done . Both were diagnosed as HbSD Heterozygosity by HPLC method .Their mother was a know case of sickle cell trait and father was known case of HbD Punjab trait. RESULT : In above study diagnosis of HbSD in both siblings was confirmed by HPLC. Since both their parents were carriers of sickle cell trait(mother) and HbD trait(father) . HbSD is a heterozygous state beta 121 glutamine residues stabilise the polymer and increases intracellular polymerization of HbS and increase sickling phenomenon . CONCLUSION : HbSD is a rare but very serious disorder with high prevalence in northern part of India . It is a genetically inherited disorder occurs when either of one parent is HbD trait and other one being HbS trait.

Background: Cardiac troponin I (cTnI) is reported to be very specific for myocardial cell damage without cross reactivity with skeletal muscle isoform. Evaluation of cTnI after CABG will be useful as an early marker of excessive post operative myocardial damage when a specific therapeutic intervention can still be efficient and improve outcome. Methodology: The study comprised of 50 patients who undergo Coronary artery bypass surgery at V.S group of Hospital. Blood sample were taken after 12 hour ( T12) and 24 hour ( T24 ) of post CABG. The sample were analysed for cTnI. Results: Our results show that Troponin I levels after 2 hours, 12 hours and 24 hours in patients who had better outcome after CABG was 9.2 ng/ml, 13.9 ng/ml and 10.9 ng/ml respectively. Whereas, Troponin I levels after 2 hours, 12 hours and 24 hours in patients who had adverse outcome like death of patients after CABG was 10.6 ng/ml, 38.7 ng/ml and 28.9 ng/ml respectively. Conclusion: Routine measurement of cardiac troponin levels after cardiac troponin can identify group of patients at increased risk of complications or death.

OBJECTIVE The present study is designed to compare the effect of two most commonly used surgical procedure for anal fissure: Lateral Anal Sphincterotomy and Trans fissure Sphincterotomy with regards to fissure healing time, pain reduction, cessation of bleeding per rectum post operatively as well as the complications like flatus and feces incontinence post operatively in both surgical procedures. METHODOLOGY This hospital based prospective cohort study was undertaken at GCS hospital Ahmedabad (tertiary care hospital) from March 2019 to December 2019. 50 patients were enrolled in the study from which 25 patients were randomly assigned to lateral anal sphincterotomy group and 25 were assigned to trans fissure sphincterotomy group. RESULTS Our study establishes that although there is no statistically significant difference in pain alleviation and relief from bleeding per rectum post operatively in anal fissure between the Lateral Anal Sphincterotomy and Trans fissure Sphincterotomy, yet the fissure healing is earlier in Lateral Anal Sphincterotomy than in Trans fissure Sphincterotomy. There is also slight predominance of flatus incontinence rate in Trans fissure Sphincterotomy group as compared to Lateral Anal Sphincterotomy. CONCLUSION Thus, we can conclude from over all study that the lateral anal sphincterotomy is far better than the trans fissure sphincterotomy for the treatment of the fissure in ano by looking at various perspectives in areas of postoperative outcome.

BACKGROUND: Incidence of visual disorders in industrial workers may result in visual loss, anguish, reduced manpower, man hours and economic loss. Most of these hazards are preventable if adequate precautionary measures are taken. [8,11] Worker’s eyes may be exposed to a variety of dangerous agents depending on the type of industry which may constitute an occupational hazard. According to OSHA, personal protective equipment is devices design to protect workers’ eyes from severe work place injury or illness resulting from contact with metal splash, chemical splash, dust, flying particle or radiation. [14,16] So the aim of the study is to assess Ocular Health, Visual & Refractive status of the workers working in the metal machinery (small scale) industries. METHODS: A clinical examination of the workers was accompanied by detailed occupational history in the small scale & tiny sector metal machinery industries. Visual acuity was measured using Snellen’s chart for distance and N notation reading chart for near. Color vision testing was done with Pseudoisochromatic-Ishihara chart. Anterior segment of eye was examining with the help of torch light and SLE. Fundus evaluation was done with the help of direct ophthalmoscope. Objective & Subjective Refraction was performed using Retinoscope and trial case. Stereopsis was measured with the help of Titmus Fly test. RESULTS: Hundred and eighty small scale industry workers were screened. Among them, all were male with a mean age (45.5 ± 11.31 years). 74% showed Visual impairment. The most common visual disorders were uncorrected presbyopia 65% (117), uncorrected refractive error 59% (106) out of which 17% (30) were already use their own spectacle prescription remaining 42% (76) were prescribed new spectacle. Color vision defect was found in 2% (3). Out of hundred and eighty only 11% (19) of the workers were use protective eye wear, remaining 89% (161) of them were never use protective eye wears on daily basis. CONCLUSION:This study concluded that uncorrected refractive error and uncorrected presbyopia was high among workers as they are not aware about eye health and safety measures for the occupation. The use of safety eye devices is low among workers and recommends that process about awareness and implementation of ocular safety in these industries is established as occupational protective measures are important for metal machinery industrial workers who are at a high risk of eye injuries. It is recommended that, there is a need to review the design, and reinforce the strict implementation of occupational eye safety programs.