Aarupadai Veedu Medical College Research Articles

Prevalence of cardiovascular risk factors in rural population of Puducherry

Objectives Rapid changes in India’s population and epidemiology are being brought about by Noncommunicable diseases, which significantly increase morbidity, mortality, and disability in both urban and rural populations, as well as in all socioeconomic groups. The aim of this study was to assess the prevalence of Cardiovascular Risk Factors (CVRF) in the rural population of Puducherry. Material and Methods This cross-sectional descriptive study was conducted in Puducherry’s rural field practice area, which is connected to Aarupadai Veedu Medical College & Hospital (AVMC&H). A total of one thousand rural residents, ages 40 to 75, comprised the samples. With the aid of a modified WHO steps approach, a structured questionnaire containing physical measurements, CVRF information, and sociodemographic details was used to collect the data. SPSS version 28.0 was used to analyse the data. The prevalence of CVRF was determined using percentages, and the degree of correlation between the rural population’s CVRF and their demographic characteristics were examined. Results The following behaviours have the highest prevalence of CVRF: smoking (28.3%), drinking alcohol (13.8%), not exercising (48%), consuming coffee (60.2%), tea (61.4%), artificial beverages (42.6%), nonvegetarian (98.1%), consuming insufficient amounts of fruits and vegetables (32%), insomnia (59.4%), being overweight (18.5%), class I obesity (6.4%), hypertension (25%) and diabetes mellitus (25.1%). The cardiovascular risk factors of the rural population, such as the use of tobacco products (p < 0.001), the consumption of coffee, tea, and artificial beverages (p < 0.001), the use of alcohol (p < 0.001), the non-vegetarian diet (p < 0.001), the insufficient intake of fruits and vegetables (p < 0.001), obesity (p = 0.001), Waist Hip Ratio (WHR) at risk (p < 0.001), hypertension (p < 0.001), and diabetes (p < 0.001), were strongly statistically significantly associated with demographic variables. Conclusion A significant proportion of Puducherry’s rural population has cardiovascular risk factors. It is imperative to reduce the prevalence of cardiovascular risk factors in the community by implementing lifestyle modifications that suppress risky behaviours at an early age.

Prevalence and Antifungal Susceptibility of Candida Infections in Patients with Pulmonary Tuberculosis: A Cross-sectional Study from the Union Territory of Puducherry, India

Introduction: Pulmonary Tuberculosis (TB) is a bacterial infectious disease caused by Mycobacterium tuberculosis. Candida albicans is the most commonly isolated fungal pathogen in bronchopulmonary patients. Invasive candidiasis due to Candida species has been on the rise in recent years. However, drug sensitivity studies of C. albicans isolated from TB patients are not routinely conducted in India and other developing countries. Aim: To isolate and identify Candida albicans from patients with TB and to determine its antifungal susceptibility. Materials and Methods: This cross-sectional study was conducted on 129 patients suspected of having pulmonary TB, analysed from August 2016 to January 2018 at the Department of Chest Medicine, Aarupadai Veedu Medical College and Hospital, Puducherry, India. Sputum samples were collected and processed to identify Candida species through Gram staining, Ziehl-Neelsen staining, germ tube formation, and sugar fermentation. Antifungal resistance testing was performed using the disk diffusion method recommended by the Clinical and Laboratory Standards Institute (CLSI). The collected data were subsequently analysed using descriptive statistics and the Chi-square test to evaluate the results. Results: Candida infection was observed in 10 (7.75%) out of 129 patients with pulmonary TB. Among patients with co-infection, C. albicans was the most common, accounting for 4 (40%) cases, followed by C. krusei with 2 (20%) cases, C. tropicalis with 1 (10%) case, C. kefyr with 1 (10%) case, C. glabrata with 1 (10%) case, and C. parapsilosis with 1 (10%) case. Among the azole category, itraconazole and amphotericin B exhibited the highest sensitivity percentages against Candida. Conclusion: The current study revealed a high prevalence of coinfection between pulmonary TB and Candida spp., which may contribute to the symptoms of pulmonary lung disorders. The prevalence of Candida species could also be associated with an inadequate response to antitubercular drugs. Amphotericin B and itraconazole, two commonly used drugs in the community, are often employed as the preferred treatments for fungal infections. Early detection and treatment of this opportunistic candidiasis in patients with pulmonary TB will likely enhance outcomes for such individuals.

Comparative evaluation of ultrasonography with magnetic resonance imaging in the diagnosis of shoulder ailments

Background: Shoulder pain encompasses a diverse array of pathologies and can affect as many as one quarter of the population depending on age and risk factors. It may be caused by problems with the neck, glenohumeral joint, acromioclavicular joint, rotator cuff, or other soft tissues around the shoulder. Aims and Objectives: The main aim of the study is to compare the diagnostic accuracy of ultrasound (US) shoulder and magnetic resonance imaging (MRI) of the shoulder in the diagnosis of shoulder ailments. Materials and Methods: This is a comparative study done in Department of Radiology, Aarupadai Veedu Medical College and Hospital, Pondicherry. In total, 54 patients were included for ultrasonography (USG) and MRI examination of shoulder ailments. The statistical analysis was done using Statistical Package for the Social Sciences Version 21.0 statistical analysis software. Results: Subacromial-Subdeltoid Bursitis is the most common finding. US detects partial-thickness tears with a sensitivity of 63.3% and a specificity of 70.8% and full-thickness tears with a sensitivity of 80.0% and a specificity of 91.8%. Trauma was the etiology in only a few patients. MRI is more sensitive than USG in identifying labral and capsular pathologies. MRI is the most sensitive and specific modality for the establishment of shoulder pain. MRI is useful in cases in which the diagnosis is uncertain on USG. Conclusion: MRI is recommended as a secondary method since it provides more information about the extent of tendons and has a lower artifact risk.

COMPARATIVE STUDY OF SKIN STAPLES AND CONVENTIONAL SUTURES FOR ABDOMINAL SKIN WOUND CLOSURES

Introduction : The ideal abdominal wound closure provides strength and a barrier to infection. In addition, the closure should be efcient, performed without tension or ischemia, comfortable for the patient, and aesthetic. Present study aimed to compare skin staples with conventional suturing for abdominal skin closure. Material and Method: This comparative observational study was conducted among the patients coming to Department of General Surgery, Aarupadai Veedu Medical College and Hospital, undergoing elective abdominal surgery who were willing to participate in the study by giving informed and written consent. Patients were grouped based on type of skin closure done, group Aare patients with skin staples in elective abdominal surgery and group B are the patients with conventional suture method of skin closure in elective abdominal surgery. Both the group were assessed for the duration of skin closure, the outcome of wound assessed using ASEPSIS score on 3rd, 5th and 7th post-operative day and wound Cosmesis was assessed using Modied Hollander Cosmesis scale on 7th day, after 2 weeks, 6 weeks and on 3rd month of wound healing. All the statistical analysis were analysed using SPSS v21 operating on windows 10. Results: In our study total 120 patients undergoing elective abdominal surgeries were included with 60 patients in each group. The mean age and gender distribution between both groups was found to be similar with no signicant difference. On comparison of number of staples and number of sutures used, it was signicantly higher in staple group than suture group (p<0.05). On comparison of duration of closure it was signicantly lower in staple group than in suture group ( p<0.05). ASEPSIS score at different point of follow-up showed there is signicantly lower mean score among patients in staple group compared to suture group (p<0.05). On comparing wound score using Modied Hollander Cosmesis scale, the mean score was signicantly higher in staple group than in suture group (p< 0.05). The complications at different point of follow- up was also signicantly lower in staple group than suture group (p<0.05). The degree of patient satisfaction was also signicantly higher in stapler group than in suture group. Conclusion: The present study documented a signicant better outcome in patients who underwent skin closures with staples than with conventional sutures in view of duration of closure, ASESPSIS score, Modied Hollander Cosmesis score, complications and patient satisfaction.

FUNCTIONAL OUTCOME OF USING CEMENTED BIPOLAR PROSTHESIS FOR HEMIARTHROPLASTY IN NECK OF FEMUR FRACTURE - A PROSPECTIVE STUDY

Background: One of the most frequent injuries in the elderly is a fracture of the femoral neck, which presents a signicant challenge to orthopaedic surgeons. The best choice nowadays is a bipolar prosthesis with cement, which allows them to become more active earlier. The current study aimed to prove that cemented bipolar prosthesis in hemiarthroplasty is the preferred modality of choice for treating neck of femur fractures in elderly. Methodology: In this prospective observational study, cemented bipolar hemiarthroplasty was used to treat elderly patients who had intracapsular fractures of the neck of femur and was followed up at six weeks, three months, six months, nine months, and one year. This study was conducted at the Aarupadai Veedu Medical College and Hospital, Dept. Of Orthopaedics. Results and follow-up were assessed, and functional outcomes were assessed using a modied Sir Harris Hip Scoring system. In our study 57.6% of the c Results: ases had excellent outcome, 25.8% had good outcome and 10.6% had fair outcome and we also observed 6% of the cases had poor outcome and regarding patients nal satisfaction 50% of the cases had very satised and 30% of the cases had fairly satised meanwhile 20% of them were not satised. In this study 3 cases had supercial skin infection and 1 case had dislocation and remaining 94% of the cases did not have any postoperative complications. Neck of femur fracture Conclusion: treated with cemented bipolar hemiarthroplasty provides adequate stability for early return to unassisted near normal activity. It also provides relief from pain with a very minimal complication rate in an elderly patient with less active needs. However, the end result of the patients depends on the time of presentation to the time of surgery, adequate post-operative rehabilitation, pre fracture level of activity, compliance of the patient and associated systemic diseases.

FUNCTIONAL OUTCOME OF INTRA-ARTICULAR CALCANEAL FRACTURES FIXED WITH PERCUTANEOUS SCREWS - A PROSPECTIVE STUDY

Background: The treatment of displaced calcaneum fractures has been a subject of intense discussion. Displaced intra-articular calcaneum fractures gives poor result with conservative treatment and requires reduction and internal xation for favourable long-term results. Open procedures are more prone to complications regarding wound healing. Percutaneous xation offers a middle pathway in treating simpler variety of displaced calcaneal fractures. The aim of the study was to access the functional outcome of intra articular fracture calcaneum managed with closed reduction and percutaneous screw xation. This study was done in department of Orthopa Methods: edics Aarupadai veedu Medical college and hospital, Pondicherry. Twenty-six intra-articular calcaneal fractures treated with closed reduction and percutaneous screw xation under image intensier. For the research, 26 individuals of either sex were accepted. Patients received thorough information about the trial, and formal written consent was acquired. The study was conducted from August 2020 to September 2022. The follow-up phase lasted up to 6 months. Analysis and research were conducted on the outcomes of 26 fractures in 26 individuals. The examined data was discussed and compared to comparable series in the literature. A master chart that covers all the factors and variables taken into account was posted. Twenty-six cases evaluated (one Results: patient had lost follow-up), all fractures were united, average time of union was 8 weeks. The mean AOFAS score was 73.08% of 26 patients had good, 23.08% patients had fair and 3.85% patients had poor result on a 6 month follow up. Average postoperative Bohler's angle 26.42 degrees and post-operative Gissane angle was 122 degrees. Treatment of intra-articular frac Conclusions: tures of calcaneum is challenging but close reduction and internal xation with 4.5 cannulated cancellous screws yields favorable outcome in majority of cases.

A COMPARATIVE STUDY OF EFFICACY OF SINGLE DOSE PROPHYLACTIC V/S CONVENTIONAL PERIOPERATIVE ANTIBIOTIC THERAPY IN CLEAN CASES OF MESH HERNIOPLASTY

Introduction: One of the most often carried out general surgical procedures is inguinal hernia surgery. Despite the fact that open inguinal hernioplasty is one of the cleanest surgical procedures, some surgeons nevertheless provide antibiotics as a preventative measure .The present study was undertaken to compare the efcacy of the single dose prophylaxis v/s conventional perioperative operational therapy. Material And Methods: This study was a hospital based observational comparative study which was conducted in the in the Department of General surgery at Aarupadai Veedu medical college and hospital, Puducherry, A study 60 cases were included. Patients were divided into two groups. Each group consists of 30 cases of Inguinal Hernia. The study group (Group SDA) received single dose of antibiotic preoperatively while the other group (Group CA) received 3 days of empirical antibiotic therapy post operatively. After obtaining pre anaesthetic check-up patients were posted for surgery. All the cases in study group (group SA) were administered with single dose of 1.5gm of inj. Cefuroxime 30 minutes before skin incision was given. They received no further antibiotics intravenously or oral. The data was analysed using SPSS software Pvalue less then 0.05 consider as statistically signicant. Data in the form of age, gender, BMI, type of work, side of hernia, type of hernia, habit of alcohol consumption and smoking, presence of DM, hypertension, CVD, COPD, duration of surgery, immediate postop fever, nausea and vomiting were noted in prescribed format and statistical analysis was done. Conclusion: However, the SSI in the single dose antibiotic group was remarkably lower than the proportion of SSI in conventional group on post op day 7 however this difference was not substantial on day 14. Also the length of hospital stay, time taken to return to daily activities and work were substantially less in single dose antibiotic group compared to conventional group. We infer that single dose antibiotic is preferred over conventional antibiotics in inguinal hernia repair

Effect of Azadirachta indica against Sodium Benzoate Induced Hepatorenal Toxicity in Wistar Rats- An Experimental Interventional Study

Introduction: Azadirachta indica (Neem) is one of the widely used plants which has various medicinal properties like antipyretic, antimicrobial, antitumour, anti-inflammatory, antiulcer and antidiabetic effects. Silymarin-a milk thistle derivative has its own clinical significance. Sodium Benzoate (SB) is a versatile food preservative used in packaged food and drink industries which is consumed by the people unknowingly above World Health Organisation (WHO) standards which causes potential cytotoxicity. Aim: To evaluate the effect of Azadirachta indica leaf extract and the combination effect of Azadirachta indica leaf extract (Neem) with Silymarin against SB induced hepatorenal toxicity in adult male albino wistar rats. Materials and Methods: This experimental interventional animal study was conducted at Central Animal House at Aarupadai Veedu Medical College and Hospital, Puducherry, India from July 2021 to August 2021 for a period of 14 days. Total 30 male wistar rats were randomised into five groups with six rats into each group. The groups were Group 1 Control received only distilled water, Group 2 SB 200 mg/kg bw (SB) alone, Group 3 SB+Silymarin 100 mg/kg bw, Group 4 SB+ Azadirachta indica aqueous extract 400 mg/kg bw, Group 5 SB+Silymarin 100 mg/ kg bw+Azadirachta indica aqueous extract 400 mg/kg bw for 14 days through oral gavage. Doses and duration were determined based on previous studies. Blood was drawn from a retroorbital puncture, animals were sacrificed by euthanasia, a part of Liver and Kidney samples were sent for histopathological examination-cell structure, integrity, inflammation. Biochemical parameters of liver function tests-Serum Alanine Transaminase (ALT), Serum Aspartate aminotransferase (AST), Serum Alkaline Phosphatase (ALP) and Kidney function tests: urea, creatinine and uric acid were measured in serum. Statistical analysis were done by one-way Analysis of Variance (ANOVA) followed by Dunnet’s post-hoc test used for intergroup comparison, p-value <0.05 considered to be significant. Results: There was a significant increase in the activities of liver enzymes ALT, AST, ALP and kidney function (creatinine, uric acid) in the SB alone treated group when compared with the control group. Hepatorenal protection of Neem extract was shown by significant decrease in liver and renal parameters which was comparable to that of control and Silymarin standard drug. Combination of silymarin and neem showed significant protection in liver (ALT, AST, ALP) and kidney function (urea, creatinine, uric acid) when compared to neem alone treated group. All the results were substantiated by histopathological examination of liver and kidney tissues. Conclusion: This study suggests effect of Azadirachta indica leaf extract with Silymarin possess hepatorenoprotective effect against SB induced damage in rats. Combination effect of Azadirachta indica leaf extract with Silymarin significantly proved the hepatorenal protectivity when compared with Neem alone treated group.

Morphological Variations of the Lumbricals in Adult Cadaveric Hand: A Cross-sectional Study

Introduction: The development of the human hand is unprecedented. Despite being tiny in size, the lumbricals play a far more significant role in the dynamic actions of the fingers. At the Metacarpophalangeal (MCP) and interphalangeal joints, they do flexion and extension. Lumbricals also exhibit some variations of developmental anomalies in attachments and morphology. Aim: To classify morphological patterns of the lumbrical muscles and their anatomical variations in the hands and to discuss their clinical implications. Materials and Methods: This cross-sectional study was conducted in the Department of Anatomy of Aarupadai Veedu Medical College and Hospital, Puducherry, India, from July 2020 to July 2021 on 50 disarticulated upper limbs during routine dissection of cadavers. In the present study, the limbs were labelled R or L for right or left, M or F for male or female. The variation in origin (including architecture), insertion (including split insertions, misplaced insertions, or absence of muscles, and the lengths of the muscle belly and tendon of all lumbricals were studied and noted. The dissection was carried out based on the steps as per Cunningham’s manual. Analysis of the data was done using Microsoft Excel software 2016. Results: In this study, 86% of the lumbricals were found normal in origin, innervation and insertion. Split insertion in the 3rd lumbrical was seen in 6% of the lumbricals, and a unipennate in the fourth lumbrical was seen in 2% of the total specimens. In 2% of the specimens, the 4th lumbrical was absent, the 1st lumbrical was hypertrophied in 2%, and the accessory belly in the 2nd lumbrical was also observed in 2%. Conclusion: The findings of this research may provide light on the role of the lumbrical muscles in diagnostic and surgical procedures involving the hands.

Seroprevalence and risk factors for Hepatitis C virus among maintenance hemodialysis patients at a Tertiary Care Hospital in Puducherry, India

Background: Hepatitis C virus (HCV) infection is a serious public health problem and the most significant cause of liver disease in patient receiving dialysis for a long term. The prevalence of HCV infections among dialysis patients varies markedly from country to country. Tight infection control measures implemented in developed countries have minimized the transmission rate, while the prevalence still remains high in the developing world. The aim of this study is to estimate the prevalence rate of HCV infection in hemodialysis patients, to describe demographic characteristics of individuals infected with HCV and to determine whether HCV-polymerase chain reaction (PCR) testing identifies HCV infections not detected by anti-HCV testing. Methods: This retrospective record-based study was carried in Aarupadai Veedu Medical College and Hospital, a Tertiary Care Center in Puducherry, A total of 258 chronic renal failure patients on hemodialysis were studied and tested for anti-HCV antibodies by 4th generation HCV TRIDOT ELISA and real time-PCR. Results: Anti-HCV antibodies were positive in 34 (13.2%) patients, comprising 27 (79.4%) males and 7 (20.6%) females. The majority of patients were found to be positive; between 41 and 60 age 24 (70.5%). HCV RNA was detected in 38 (14.72%) patients. The mean age of patients undergoing dialysis was 45 years. 12 (35%) had raised aspartate transaminase (AST) levels and 14 (41%) had raised alanine transaminase (ALT) levels. Gamma-glutamyl transferase was found to be raised in 25 (73.5%) of the subjects. All the 34 HCV seropositive patients were hypertensive and 33% had diabetes mellitus. 23 (67.6%) patients had undergone dialysis in more than one center. Conclusions: Regular screening of patients for HCV is absolute necessity for early detection of HCV infection that could result in better management of patients and also stresses on the importance of HCV RNA detection by PCR. Strict adherence to universal precautions, the use of dedicated machines along with regular surveillance for HCV in HD units will dramatically decrease the risk of transmission of HCV.

Mycological Profile in Otomycosis Patients and their Drug Sensitivity: A Cross-sectional Study at Union Territory of Puducherry, India

Introduction: In clinical Otorhinolaryngology practice, Otomycosis is a common problem to overcome caused by Aspergillus and Candida species. Although we come across many difficulties to diagnose and treat otomycosis infections, many patients show drug resistance to antifungal agents with a high prevalence rate. Aim: To elucidate the pattern of mycological agents and susceptibility testing of fungal species in samples collected from patients with an ear infection at a tertiary hospital. Materials and Methods: The present study was a hospital-based cross-sectional study conducted in the Department of Microbiology and Department of Ear, Nose, and Throat (ENT) at Aarupadai Veedu Medical College and Hospital, Puducherry, India from August 2018 to January 2020. A total of 126 samples were collected, transported, and analysed for bacteriological and mycological analysis using direct inspection and culture techniques. By using the disc diffusion technique, the antifungal susceptibility testing was carried out to determine the sensitivity and resistance against ketoconazole, itraconazole, fluconazole, and Amphotericin B. Data were analysed in terms of frequency using the Statistical Package for the Social Sciences (SPSS) software 25.0 version. Results: Out of 126 samples, fungal isolates were 92, out of which the most common fungal isolate was Aspergillus niger followed by A. flavus, Candida albicans (C. albicans), A. terreus, and A. fumigatus. Also, the major common bacterial isolates were Staphylococcus aureus followed by Pseudomonas, Proteus, Escherichia coli (E. coli), and Klebsiella spp. Prevalence in males (58.73%) was more as compared to the females (41.27%), and itching was the most common presenting symptom. Otomycosis in Chronic Suppurative Otitis Media (CSOM) mainly affected males (40%) and is common in middle-aged groups (20-35 years) of outdoor and indoor workers, housewives, and farmers, particularly during the monsoon season. Antifungal susceptibility testing of A. flavus and A. niger isolates revealed high sensitivity to amphotericin B, itraconazole, and ketoconazole drugs but low efficacy to fluconazole drugs. Conclusion: Otomycosis should be suspected clinically to prevent the unnecessary use of antibiotics. A high incidence of otomycosis has been encountered in many tropical countries. In present study, Aspergillus spp. and Candida spp. were the commonest fungal isolates in otomycosis. In our community currently, two drugs, amphotericin B, and ketoconazole are the most frequently used for fungal infection. Properly identifying fungal agents and host factors involved in otomycosis can improve such patients’ outcomes.

Prevalence of dermatoses in adult migrant workers attending dermatology OPD in a tertiary care centre in Puducherry

<p class="abstract"><strong>Background:</strong> Migrant workers are exposed to dangerous and unhygienic work environments, which puts them at risk of developing skin diseases. This study aims to assess the prevalence of skin diseases and provide epidemiological data regarding various dermatoses among migrant workers in Puducherry.</p><p class="abstract"><strong>Methods:</strong> This is a hospital-based, cross-sectional study conducted in Aarupadai Veedu Medical College and Hospital from August 2019 to February 2021. 350 migrant workers were randomly selected and examined for the prevalence of infective and non-infective dermatoses. The observations were documented and data were analyzed using statistical package for the social sciences (SPSS) version 22.<strong></strong></p><p class="abstract"><strong>Results:</strong> A total of 350 migrant workers were included in the study. Of most migrants, 90.9% (n=318) were males, while the remaining 9.1% (n=32) were females. The prevalence of infective dermatoses was found to be 76% (n=266) and the prevalence of non-infective dermatoses was 43.10% (n=151) in this study. Fungal infections are the most common infective dermatoses affecting 51.5% of the workers, followed by bacterial skin lesions in 27.4%.</p><p class="abstract"><strong>Conclusions:</strong> This study reveals a high prevalence of infective and non-infective dermatoses among migrant workers, with fungal infections being the most commonly occurring infective skin disease. Eczema was the commonly occurring non-infective dermatoses, according to this study.</p>

A cadaveric study on variation in branching pattern of dorsalis pedis artery and its clinical perspectives

The study of Dorsalis pedis artery and variations in its branching pattern has been reported sporadically. The purpose of this study was to evaluate the arterial. Supply on the dorsum of the foot.The study was carried out of forty dissected limbs of unknown sex and age from the department of Anatomy, Aarupadai Veedu Medical College, Pondicherry. The incidence of classical text book description was found to be very less in present study. In 5% of cases the dorsalis pedis artery was replaced by the peroneal artery. In 5% of cases the anterior tibial artery was found on lateral side of leg, dorsalis pedis artery is a continuation of the anterior tibial artery seen passing above lateral malleolus and then it passes forwards along the lateral side of the dorsum of the foot. The findings suggest that the lateral aspect of the dorsum of the foot has a poor nourishment.

A morphological study on variation in branching pattern of dorsalis pedis artery and its clinical perspectives

Background: The study of dorsalis pedis artery and variations in its branching pattern has been reported sporadically. The purpose of this study was to evaluate the arterial. Supply on the dorsum of the foot. Methods: The study was carried out of forty dissected limbs of unknown sex and age from the department of Anatomy, Aarupadai veedu Medical College, Pondicherry.Results and Discussion: The incidence of classical text-book description was found to be very less in present study. In 5% of cases the dorsalis pedis artery was replaced by the peroneal artery. In 5% of cases the anterior tibial artery was found on lateral side of leg, dorsalis pedis artery is a continuation of the anterior tibial artery seen passing above lateral malleolus and then it passes forwards along the lateral side of the dorsum of the foot.Conclusion: The findings suggest that the lateral aspect of the dorsum of the foot has a poor nourishment.

A comparative study on the surgical outcome of submucous resection and septoplasty

<p><strong>Introduction: </strong>Surgery on a deviated septum has seen several modifications since its inception, starting from radical septal resection to the preservation of the possible septal framework. Deviated nasal septum (DNS) leads to nasal obstruction is a common problem encountered by the Otolaryngologist. Many surgeries are available for correcting septal disorders. The aim of our study is to compare the surgical outcome of submucous resection and septoplasty.<strong></strong></p><p><strong>Methods: </strong>This prospective comparative single institutional interventional study was conducted in the department of otorhinolaryngology, Aarupadai Veedu Medical College between October 2015 to September 2017 to compare the submucous resection and septoplasty. Total of 50 patients who randomly divided into two groups and the treatment protocol and follow up protocol was followed and the outcome results were statistically analysed and discussed.<strong></strong></p><p><strong>Results: </strong>Out of 50 patients 25 patients had sub mucosal resection and 25 patients had septoplasty. All the 50 patients had nasal obstruction followed by headache present 35 patients, nasal discharge in 6 patients, postnasal drip in 7 patients and hyposmia in 7 patients. Based on endoscopy finding c shaped DNS 43 patients, 7 patients had s-shaped DNS, 7 patients had spur. Based on postoperative symptoms, the nasal block was present in 3 patients.<strong></strong></p><p><strong>Conclusion: </strong>From this study, we concluded that deviated nasal septum is more common in females of age group 30 years with the most common symptoms is nasal obstruction. Symptom relief is comparatively equal in both the surgeries but the complication is more common in sub mucosal resection.</p>

Diagnostic utility of serum procalcitonin as a biomarker of sepsis and infection in post-operative patients at tertiary care centre

Background: Procalcitonin (PCT), the precursor peptide of calcitonin, a hormone involved in calcium homeostasis, is present in normal subjects in extremely low serum levels (0.1 to 0.5 ng/ml). In response to bacterial infectious stimulation serum procalcitonin rises substantially and its role in inflammatory response includes chemotactic function modulation of inducible nitric oxide synthase and induction of cytokines, among other. The objective of this study to assess serum procalcitonin as a biomarker of sepsis and infection in post op patients.Methods: The present descriptive observational study was conducted at Department of Surgery, Aarupadai Veedu Medical College and Hospital, Puducherry from September 2018 to June 2020. Total 48 patients who had undergone surgery and presented with post-surgical sepsis were included. Data entered in MS excel sheet and analysed by using SPSS 24.0 version IBM USA.Results: Out of 48 cases, majority of cases i.e. 18 (37.5%) were from 36-50 years age group followed by 11 (22.9%) from 51-60 years age group. Prevalence of sepsis was 20.8%, septic shock 25%, severe sepsis 33.3% and SIRS 14.6%. Procalcitonin (PCT) assay shows positive in 47 (97.9%) cases. E. coli were isolated from 5 (45.5%) cases with PCT 2-10 as compared to 6 (16.7%) cases with PCT >10.Conclusions: PCT shares remarkable promise as a marker of sepsis and can be used as a routine lab parameter. It was also found to be an accurate diagnostic parameter for differentiating various stages of sepsis and predicting the outcome.

Role of risk factors, clinical features and treatment modality in early detection and management of Buerger’s disease: a study from tertiary care centre Pondicherry

Background: Thromboangiitis obliterans is a disease of unknown aetiology seen under 45 years of age with no form of treatment has been successful in offering the victims of this disease a cure nor even a long-term remission. Objective of the study was to study the role of different risk factors, clinical features and treatment modality in early detection and management of Buerger’s disease.Methods: This is an experimental study carried out in 50 cases of Buerger’s disease after obtaining a well-informed written consent in department of General Surgery in Aarupadai Veedu Medical College and Hospital. Period of study was from October 2015 to October 2017. Data was analysed with SPSS 23.0 version.Results: Majority were from 31-40 years age group i.e. 30 (60%). Left lower limb was involved in 52% subjects. 80% smoked more than 20 cigarettes per day. Signs of ischemia was present in all 50 patients. Gangrene of the limb was seen in 14 patients (28%). Out of 3 patients with recurrent pain, 2 (66.7%) were relieved. Ulcer healing occurred in 5 out of 6 patients i.e. 83.3% and intermittent claudication was relieved in 2 out of 7 patients i.e. 28.6%.Conclusions: Males are commonly involved in our study. Majority of patients were in age group 31-40 years. Smoking is an important and definite risk factor in relation with the development of Buerger’s disease. Lower limb is commonly involved. Majority of patients in our series were treated by conservative management.

Etiological profile of pyodermas in a tertiary care hospital in North-East India and their antibiotic sensitivity pattern

<p class="abstract"><strong>Background:</strong> Hypermelanoses involving predominantly the face and the neck is relatively common and often presents a complex diagnostic problem. The present study was done in the study population of 500 patients of facial pigmentation, attending the skin outpatient department in AarupadaiVeedu Medical College and Hospital from October 2015 to September 2017. Aim and objective of the study was to study various clinical patterns of facial pigmentation, their clinical characteristics, their association with other pigmentary disorders and to evaluate the different etiotogical and precipitating factors.</p><p class="abstract"><strong>Methods:</strong> In this study, a special proforma was prepared. Patients were thoroughly interviewed and examined to find out dermatological and systemic diseases and they were subjected to investigations to evaluate different etiological factors and diagnose the clinical type of facial pigmentation.<strong></strong></p><p class="abstract"><strong>Results:</strong> The present study showed a strong female preponderance. Among the total study population there were 55% cases of melasma, 20% cases of Riehls melanosis, 10% cases of periorbital pigmentation and 5% of miscellaneous causes.</p><p class="abstract"><strong>Conclusions:</strong> Facial pigmentation was commonly seen in the females. 21-30 years age group was the most commonly affected age group in all types of facial pigmentation. Melasma, Riehls melanosis and periorbital pigmentation were the most common clinical types of facial pigmentation observed.</p>

Clinico-epidemiological study of facial hyper-melanoses among patients attending dermatology outpatient department at a tertiary care hospital at Pondicherry

<p class="abstract"><strong>Background:</strong> Hypermelanoses involving predominantly the face and the neck is relatively common and often presents a complex diagnostic problem. The present study titled “Clinico-epidemiological study of facial hyperpigmentation” was done in the study population of 500 patients of facial pigmentation, attending the skin outpatient department in AarupadaiVeedu Medical College and Hospital from October 2015 to September 2017.</p><p class="abstract"><strong>Methods:</strong> Aim and objective of the study was to study various clinical patterns of facial pigmentation, their clinical characteristics, their association with other pigmentary disorders and to evaluate the different etiotogical and precipitating factors. A special proforma was prepared. Patients were thoroughly interviewed and examined to find out dermatological and systemic diseases and they were subjected to investigations to evaluate different etiological factors and diagnose the clinical type of facial pigmentation.<strong></strong></p><p class="abstract"><strong>Results:</strong> The present study showed a strong female preponderance. Among the total study population there were 55% cases of melasma, 20% cases of Riehls melanosis, 10% cases of periorbital pigmentation and 5% of miscellaneous causes.</p><p><strong>Conclusions:</strong> Facial pigmentation was commonly seen in the females. 21-30 years age group was the most commonly affected age group in all types of facial pigmentation. Melasma, Riehls melanosis and periorbital pigmentation were the most common clinical types of facial pigmentation observed.</p>

Comparative study of ambulatory blood pressure monitoring in hemodialysis and non-dialysis CKD patients and their prognostic value

Background: Hypertension and chronic kidney disease are inextricably intertwined. Most patients with hypertension associated CKD die of heart attack and stroke before renal function. Ambulatory BP monitoring provides automated measurements of BP during a 24hrs period while patients engaged in their usual activities including sleep. Recommended normal value include an average daytime BP <135/85mmHg/night time BP <120/70mmHg and 24 hr BP <130/89mmHg. In patients with chronic kidney disease the control of hypertension slows the progression of end stage renal disease. This study was undertaken to define the prognostic role of ABPM in dialysis dependent and non-dialysis CKD patients so that better treatment strategies could be initiated to prevent adverse outcomes.Methods: This prospective cross sectional study was conducted at Aarupadai Veedu Medical College and hospital, Puducherry in both dialysis dependent and non-dialysis CKD patients admitted in both ICU and medical wards. APBM was performed by using the properly validated ambulatory blood pressure monitor. The monitor records BP on the non-dominant arm every 20 minutes while awake and hourly while sleep for a total duration 24hrs in both hemodialysis dependent and non-hemodialysis patients. In hemodialysis dependent patients ABPM was recorded on the second day of hemodialysis.Results: The mean maximum systolic blood pressure in dialysis dependent and non-dialysis CKD patients recorded was 146.23 and 166.12 mmHg respectively. The mean minimum systolic blood pressure in dialysis dependent and non-dialysis CKD patients recorded was 122.11 and 122.45 mmHg respectively. The mean maximum diastolic blood pressure in dialysis dependent and non-dialysis CKD patients recorded was 100.24 and 110.65mmHg respectively. The mean minimum diastolic blood pressure in dialysis dependent and non-dialysis CKD patients recorded was 78.65 and 80.67 mmHg respectively. In our study the prevalence of non-dipping in dialysis and non-dialysis CKD patients were 28% and 16% respectively.Conclusions: Ambulatory blood pressure monitoring is considered the gold standard for the diagnosis of hypertension. Tight BP control is needed to limit the progression of renal disease and lessen cardiovascular morbidity and mortality. To achieve this goal ABPM should be widely adopted in patients with CKD.