Acharya Vinoba Bhave Rural Hospital Research Articles

A Study of the Clinical Profile of Iron Deficiency Anemia in Children With Sickle Cell Disease in a Tertiary Care Center.

Background Sickle cell disease (SCD) and iron deficiency anemia (IDA) are significant global health concerns, particularly in pediatric populations. This study investigates the prevalence, clinical impact, and management challenges of IDA in children with SCD. Methods A prospective observational study was conducted at the Department of Pediatrics, Jawaharlal Nehru Medical College(JNMC) and Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi, from June 2022 to May 2024. The study included 60 children diagnosed with SCD. Comprehensive assessments were performed, including medical histories, physical examinations, and hematological investigations. Diagnosis of IDA was based on hemoglobin levels, mean corpuscular volume (MCV), red cell distribution width (RDW), peripheral blood smears, serum iron levels,and serum ferritin concentrations. Results Of the 60 participants, 15% exhibited iron deficiency. No significant gender differences were found in iron deficiency status. A significant association was observed between SCD type and the presence of pallor (p = 0.025) and sickle cell crises (p = 0.023). The study also found no significant association between SCD type and the presence of organomegaly (p = 0.079) or iron deficiency status (p = 0.675). The mean hemoglobin levels varied across SCD types, with sickle cell anemia patients showing lower levels than those with sickle cell trait or disease. Conclusion Diagnosing and managing IDA in children with SCD is complex due to overlapping hematological features and the risk of iron overload from frequent transfusions. Tailored diagnostic and therapeutic approaches are essential to improving hemoglobin levels, reducing complications, and enhancing the quality of life for affected children. This study provides valuable insights for refining clinical practices and emphasizes the need for a multidisciplinary approach to managing these intertwined conditions.

Quantifying the Domino Effect of Septoplasty on Eustachian Tube Function and Nasal Resistance in Patients With Chronic Otitis Media: A Cross-Sectional Study.

Background Eustachian tube dysfunction is characterized by insufficient dilation, leading to secondary pathologies in the middle ear. By comparing pre- and post-operative grades of Eustachian tube functionand nasal resistance measurements, this study seeks to determine if septoplasty can improve Eustachian tube function in cases where nasal septal deviation is likely to cause mechanical dysfunction. We also aim to validate the JainBhalerao endoscopic classification of nasal septal deviation by assessing its utility in identifying septal deviations at a higher risk of causing Eustachian tube dysfunction. The ultimate goal is to establish guidelines for aural indications of septoplasty in treating Eustachian tube dysfunction-related middle ear disorders. Material and methods This prospective observational study was carried out from 1stJune 2022 to 31st March 2024 in the Department of Otorhinolaryngology at Acharya Vinoba Bhave Rural Hospital, involving 66 patients diagnosed with chronic otitis media and a deviated nasal septum with Eustachian tube dysfunction. Pre-operative and post-operative improvement in Eustachian tube function and Nasal resistance and their correlation werestudied using dynamic slow-motion video endoscopy and active anterior rhinomanometry, respectively. Statistical analysis included the chi-square test. Results Sixty-six patients diagnosed with chronic otitis media and deviated nasal septum with Eustachian tube dysfunction included in this study had a mean age of 35.6 years with 43 (65.2%) male predominance. Gross luminal narrowing and discrepancy of the volume of both nasal cavities led to higher degrees of Eustachian tube dysfunction due to pressure drop on the affected side, as observed in types 6, 7, and 8 as per Jain Bhalerao classification of deviated nasal septum. Nasal resistance measured using active anterior Rhinomanometry (Rhinodebitometry) showed a positive association of severity of nasal resistance in the types 6, 7, and 8 DNS of the Jain Bhalerao classification of deviated nasal septum. It demonstrated an improvement in the grade of Eustachian tube function and nasal resistance post-septoplasty. Conclusion The deviated nasal septum is one of the causes of Eustachian tube dysfunction and increased nasal resistance. Certain types of DNS are adversely associated with the causation of greater degrees of Eustachian tube dysfunction of mechanical type. Nasal septal deviation correction improved Eustachian dysfunction and nasal resistance after septoplasty.

A Study of Hearing Acuity and the Health of the External Auditory Canal Among Earphone Users in Central India.

Background and objective The pervasive use of earphones has raised concerns about its potential impact on hearing acuity and the health of the external auditory canal (EAC). This study aimed to investigate these effects in a sample of individuals in Central India to better understand the associated risks. Materials and methods This observational cross-sectional study was conducted in the Department of Otorhinolaryngology, Acharya Vinoba Bhave Rural Hospital, SawangiWardha. A total of 130 participants aged 15-35 years were divided into two groups: 65 earphone users and 65 non-earphone users. The data collection involved medical histories, clinical examinations, and audiometric testing, including pure-tone audiometry (PTA), impedance audiometry, and otoacoustic emissions (OAE). Participants completed a questionnaire on earphone usage, and EAC health was assessed via physical examinations and photographic documentation. Statistical analyses included descriptive and inferential statistics, with significance set at p<0.05. Results Among earphone users, 45 (69.23%) exhibited hearing loss compared to 11 (16.92%) in non-users (p<0.00001). Noise-canceling earphones were associated with fewer cases of hearing loss (6/45, 13.33%) than non-noise-canceling types (39/45, 86.67%) (p<0.00001). EAC issues were more prevalent in earphone users, with 39 (60%) showing normal conditions versus 52 (80%) in non-users. Impactions of wax, otomycosis, and otitis externa were observed more frequently among earphone users. Conclusions The study highlights a significant association between earphone use and increased risk of hearing loss and EAC issues. Noise-canceling earphones may offer some protective benefits. These findings underscore the need for raising awareness and implementing preventive measures to mitigate potential risks associated with prolonged earphone use.

Association of Personality Traits of Alcohol-dependent Patients with Their Psychiatric Comorbidities: A Cross-sectional Study from Central Rural India

Introduction: Alcohol dependence syndrome (ADS) is a significant health problem all over the world. Alcohol-dependent individuals have a high prevalence of psychiatric comorbidities and nonadaptive personality traits that may influence the pathogenesis, treatment outcome, clinical course, and relapse of ADS. Aim: The aim of this study was to assess the personality traits and psychiatric comorbidities of alcohol-dependent patients and to determine the association of personality traits with psychiatric comorbidities in ADS. Methodology: An observational study was conducted on 100 patients of ADS from Acharya Vinoba Bhave Rural Hospital, Sawangi Wardha, Maharashtra. They were assessed through semi-structured sociodemographic pro forma, Mini-International Neuropsychiatric Interview PLUS, and 16 Personality Factor Inventory. Results: Most of the patients scored high on personality traits such as dominance (67%), warmth (56%), sensitivity (70%), social boldness (56%), openness to change (65%), vigilance (77%), and perfectionism (52%) while they scored low on factors privateness (50%) and liveliness (35%). The prevalence of psychiatric comorbidity was found to be 49%, with mood disorders (21%) being the most common diagnosis. Personality factors dominance (0.0001) and social boldness (0.042) were significantly associated with psychiatric comorbidities with P &lt; 0.05. Conclusion: The personality traits and psychiatric comorbidity need to be addressed at the time of management to improve outcome.

Association Between Glycated Hemoglobin (HbA1c) Levels in Patients With Iron Deficiency Anemia in a Tertiary Care Hospital in Central India.

Background Iron deficiency anemia (IDA) and diabetes are prevalent health concerns, especially in regions like India. While previous studies have explored the relationship between glycated hemoglobin (HbA1c) levels and IDA, there is still inconsistency in the findings, particularly in the Indian population. Understanding this association is crucial for accurate diagnosis and management of both conditions. Materials and methods A case-control study was conducted at the Department of General Medicine at Acharya Vinoba Bhave Rural Hospital (AVBRH),Wardha, India, from May 2022 to October 2022. A total of 141 non-diabetic patients with IDA (study group) and 141 age- and gender-matched non-anemic controls were included. HbA1c levels were measured at baseline and after three months of IDA treatment. Statistical analysis was performed using SPSS software, including the Kolmogorov-Smirnov test, Chi-square test, Mann-Whitney test, and Pearson correlation coefficient. Results In the study group, HbA1c levels significantly increased from a mean of 4.63% at baseline to 5.82% after IDA treatment (p < 0.0001). However, there was no significant correlation between changes in hemoglobin (Hb) levels and HbA1c levels post-correction (r = 0.056, p = 0.510). In addition, all cases and controls were labeled non-diabetic based on a cutoff HbA1c level of 6%. After three months of IDA treatment, 80.85% of cases recovered from IDA. Conclusion The study highlights that HbA1c levels are lower in patients with IDA and may increase with the correction of IDA. However, there is no significant direct correlation between IDA correction and HbA1c increase. Therefore, when interpreting HbA1c levels, clinicians must consider the presence of IDA, especially in regions with high prevalence rates of both IDA and diabetes, like India. This understanding can improve management strategies for both conditions, ensuring better patient health outcomes.

Comparative Study of Endoscopic Transcanal Tympanoplasty and Tympanoplasty by Conventional Postaural Approach in a Tertiary Care Hospital in Central India.

Background Chronic otitis media (COM) often necessitates tympanoplasty to repair the tympanic membrane. While conventional postaural tympanoplasty (PA) is well-established, endoscopic transcanal tympanoplasty (ET) is gaining traction for its minimally invasive benefits. This study aims to compare these two surgical techniques regarding their anatomical and functional outcomes and assess the role of platelet-rich plasma (PRP) in improving these outcomes. Material and methods This prospective comparative study was conducted at Acharya Vinoba Bhave Rural Hospital, involving 60 patients with COM. Participants were randomly assigned to receive either ET or PA, with each group further subdivided based on PRP use. Preoperative evaluations included auditory function tests and diagnostic endoscopy. Postoperative assessments were performed at seven days, one month, and three months to evaluate graft acceptance and hearing improvement using pure tone audiometry (PTA). Statistical analyses included the chi-square test, t-test, ANOVA, and paired t-test. Results The study included patients with a mean age of 38.1 years, predominantly female (71.67%). ET demonstrated superior anatomical outcomes compared to PA, with higher graft acceptance rates and better hearing improvements. The average hearing gain was 10.4 dB in the ET group versus 8.1 dB in the PA group. PRP uses enhanced graft acceptance and hearing restoration across both surgical approaches, contributing to better overall outcomes. Conclusion ET offers significant advantages over conventional postaural tympanoplasty in terms of anatomical and functional results. PRP further improves surgical outcomes, making ET a preferable option for tympanoplasty in COM patients. These findings support the broader adoption of ET and PRP to enhance patient outcomes in tympanoplasty procedures.

A Study of High-Resolution Ultrasound and Magnetic Resonance Imaging Findings in Shoulder Joint Pain at a Tertiary Care Hospital in Central India.

Objective This study aims to investigate the diagnostic efficacy of high-resolution ultrasound (USG) and magnetic resonance imaging (MRI) in patients with shoulder joint pain at a tertiary care hospital in Central India. Methods This cross-sectional study was conducted at Acharya Vinoba Bhave Rural Hospital from 2021 to 2024. The study population consisted of patients with shoulder pain, without fractures, who were evaluated using USG and MRI. Participants with infective arthritis, rheumatoid arthritis, previous shoulder surgery, or contraindications for MRI were excluded. Data were recorded and analyzed using Microsoft Excel (Microsoft Corporation, Redmond, Washington) and R 4.2.0 software (The R Foundation, Vienna, Austria). Sensitivity, specificity, and receiver operating characteristic (ROC) curves were used to compare the diagnostic performance of USG and MRI. Results A total of 80 patients were included, with 49 (61%) males and 31 (39%) females. The MRI findings showed supraspinatus partial tears in 44 (55%) cases, complete tears in 10 (12.5%), and various other shoulder pathologies. USG detected supraspinatus partial tears in 16 (19.5%) and complete tears in seven (8.8%). Kappa statistics indicated moderate to high agreement between USG and MRI for several pathologies, with near-perfect agreement for complete tears. Conclusion High-resolution USG is a valuable tool for the initial assessment of shoulder joint pain, providing reliable diagnostic information with high agreement levels with MRI for complete tears and certain shoulder conditions. MRI remains indispensable for comprehensive evaluation, particularly for partial tears and complex pathologies.

A Study of the Role of Magnetic Resonance Imaging in the Evaluation of T2-Weighted Hyperintensities in Spinal Cord in a Tertiary Care Hospital in Central India.

Background T2-weighted hyperintensities in the spinal cord are crucial markers for diagnosing a range of spinal cord pathologies. This study explores the prevalence, causes, and implications of these hyperintensities in patients with spinal cord injuries at a tertiary care hospital in Central India. The research aims to assess the utility of MRI in detecting T2-weighted hyperintensities in the spinal cord and to analyze the associated clinical and radiological characteristics. Materials and methods A prospective observational study was conducted involving patients referred to the Department of Radiodiagnosis at Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi (Wardha), with suspected or confirmed spinal cord injuries. Advanced MRI techniques, including T2-weighted imaging, were used for the evaluation. The study analyzed demographic data, clinical features, and MRI findings to identify common causes and patterns of T2-weighted hyperintensities. Results The study revealed that T2-weighted hyperintensities were present in 54 (72%) MRI scans of patients with spinal cord pathologies at our tertiary care hospital in Central India. Among these, multiple sclerosis was the most frequent diagnosis, accounting for 27 (35%)cases. Traumatic spinal cord injuries were observed in 25% (n=19) of patients, while transverse myelitis was found in 15 (20%). The remaining 15 (20%) included a variety of other conditions, such as infections and tumors. The extent and distribution of T2-weighted hyperintensities varied significantly among different diagnoses, with multiple sclerosis and transverse myelitis demonstrating a more extensive involvement compared to trauma-related cases. Conclusion MRI is a valuable tool for diagnosing and understanding the underlying causes of spinal cord hyperintensities. The study highlights the need for targeted diagnostic and therapeutic approaches based on MRI findings to improve patient outcomes in spinal cord injuries.

Comprehensive management of Mayer-Rokitansky-Küster-Hauser syndrome management: A case report.

Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, also known as Müllerian aplasia, is a congenital condition characterized by uterine and upper vaginal aplasia. It affects females with a normal female karyotype and typical secondary sex characteristics. The aim of this case report was to highlight the multidisciplinary management approach for MRKH syndrome, focusing on tailored interventions to address physical and psychological challenges and improve reproductive prospects. A 26-year-old married female presented to Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi, Wardha, India, in January 2023 with primary amenorrhea. Physical examination revealed a blind vagina and a hypoplastic uterus, indicative of MRKH syndrome. Further evaluation, including pelvic magnetic resonance imaging (MRI), confirmed Müllerian duct abnormalities and bilateral ovarian anomalies. The absence of a functional vagina significantly impacted the patient's quality of life, leading to difficulties with sexual intercourse and emotional distress related to infertility. A collaborative approach involving a gynecologist and a psychiatrist at AVBRH was initiated to address these challenges. The patient underwent vaginoplasty to create a neovagina, enhancing the sexual function and intimate relationship with the spouse. However, due to the hypoplastic uterus, achieving motherhood through traditional means was not possible. Therefore, assisted reproductive techniques, in particular surrogacy, were explored. Normal, functional ovaries were harvested from the patient for use in surrogacy procedures. This comprehensive management strategy exemplifies the challenges associated with MRKH syndrome and underscores the importance of tailored interventions and long-term follow-up. The case highlights the significance of collaborative care in improving the quality of life and reproductive prospects for individuals with MRKH syndrome.

A Study of Clinical Profile of Congenital Anomalies of Kidney and Urinary Tract (CAKUT) in a Tertiary Care Center.

Background Congenital anomalies of the kidney and urinary tract (CAKUT) encompass a diverse array of disorders arising from developmental irregularities in the renal parenchymal development, disrupted embryonic migration of the kidneys, and the urinary collecting system. This study aimed to investigate the clinical presentations, patterns of obstructive and non-obstructive CAKUT, and associated extrarenal manifestations in affected children. Methods This observational study was conducted in the Department of Pediatrics, Acharya Vinoba Bhave Rural Hospital, Wardha. Ethical clearance was obtained, and the study included 105 diagnosed CAKUT patients aged from birth to 18 years. Data collection spanned from June 2022 to May 2024. Clinical features, antenatal findings, associated anomalies, estimated glomerular filtration rate (eGFR), and serum creatinine levels were recorded. Descriptive and inferential statistical analyses were performed using Stata software. Results Among the 105 participants, 81 (77.14%) were males, with a male-to-female ratio of 3.37:1. The mean age was 42.49 months. Forty-two individuals (40%) were asymptomatic, while the most common symptomatic presentation was the ventral opening of the urethra (24.76%). Extrarenal malformations were present in 35 subjects (33.33%), with undescended testis (25.71%) and congenital heart disease (CHD) (20%) being the most common. The antenatal diagnosis was made in 63.8% of cases. Obstructive uropathy was present in 42.86% of subjects, with a significant association between antenatal diagnosis and bilateral hydronephrosis. Medical management was provided to 41.9% of subjects, while 58.1% underwent surgical interventions. Conclusion The study highlights the clinical variability and diverse presentations of CAKUT in children, with a substantial proportion being asymptomatic. Early detection through antenatal screening and prompt intervention can potentially prevent or delay the progression to ESRD. The findings underscore the importance of comprehensive evaluation and targeted management strategies to address both renal and extrarenal manifestations of CAKUT.

Comparative observational study on diagnostic utility of impulse oscillometry vs spirometry in obstructive airway diseases

Background Obstructive airway diseases, including chronic obstructive pulmonary disease (COPD) and asthma, pose significant global health challenges. Early and accurate diagnosis is crucial for effective management. Although Spirometry has traditionally been the cornerstone of diagnostics, Impulse Oscillometry (IOS) has emerged as a promising alternative. This study aims to compare the diagnostic performance of Spirometry and IOS in patients attending the Respiratory Medicine Department at the Acharya Vinoba Bhave Rural Hospital, Sawangi, India. Methods A Comparative Observational Study was conducted between August 2022 and August 2024, enrolling patients who met specific inclusion criteria. Data were collected through a comprehensive medical history, clinical examination, routine blood tests, chest radiography, High-resolution computed tomography (HRCT), spirometry, and IOS. Key parameters, including Forced expiratory volume in the first second FEV1, FEV1/FVC (Forced Expiratory Volume), (Forced Expiratory Volume) FVC, (Forced Expiratory Flow) FEF 25-75 for Spirometry, and R5, R20, fres, X5, and AX for IOS, were analyzed using the Chi-Square Test and Student’s t-test with SPSS 27.0 and GraphPad Prism 7.0. Expected outcome The study included 130 participants with the primary objective of evaluating IOS’s diagnostic advantages of IOS over spirometry. Our findings demonstrate that IOS offers enhanced sensitivity for diagnosing early small airway diseases, which is a crucial factor for early diagnosis in both pediatric and adult populations.

Risk factors of developmental delay in children from the age group of 6 months to 6 years

Background: Infants at risk for developmental delay (DD) have a history of one or more risk factors that occurred during pregnancy, the perinatal period, or after birth. Despite numerous studies on high-risk pregnancies and child development in advanced countries, there is scanty data from developing nations like India. Objectives: To determine the antenatal, natal and postnatal risk factors of DD in children aged 6 months to 6 years. Method: A case-control study comprising 61 infants with DD and 61 controls was carried out at Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe) in Maharashtra from December 2019 to May 2020. Children with DD were taken as cases and children without DD as controls. A questionnaire delivered to mothers was used to gather data. Data analysis was carried out using STATA, version 10 software. Results: Common risk factors were caesarean sections (55%), infections (58%), and chronic disorders during pregnancy (49%). Maternal infections, chronic diseases during pregnancy, caesarean section, failure to cry after birth and absence of breastfeeding were significantly more in cases compared to controls. Conclusions: In this case-control study, maternal infections, chronic diseases during pregnancy, caesarean section, failure to cry after birth and absence of breastfeeding were risk factors of DD in children aged 6 months to 6 years.

Assessing Cardiometabolic Disease Risk Factors Among Healthcare Workers in a Rural Tertiary Care Hospital in Wardha, India: A Study Protocol.

Background Cardiometabolic diseases pose a significant public health challenge globally, particularly among healthcare workers, who often face heightened occupational stress and lifestyle challenges. This study aims to assess the prevalence of cardiometabolic risk factors and their determinants among healthcare workers at Acharya Vinoba Bhave Rural Hospital, a tertiary care hospital in rural Wardha, Maharashtra, India. Methods A cross-sectional study design was employed, involving the recruitment of healthcare workers from various job roles. Data on demographic characteristics, behavioral risk factors, anthropometric measurements, biochemical parameters, and mental health status was collected using standardized instruments and procedures. Statistical analysis included descriptive statistics, inferential tests, and multivariate analyses to identify significant associations and predictors of cardiometabolic risk factors. Expected results Anticipated findings include a notable prevalence of cardiometabolic risk factors among healthcare workers, including elevated BMI, fasting blood glucose, dyslipidemia, and hypertension. Behavioral risk factors such as physical inactivity, unhealthy dietary habits, tobacco use, and alcohol consumption are expected to be prevalent. Additionally, varying degrees of psychological distress, including depression, anxiety, and stress, are anticipated. Significant associations between cardiometabolic risk factors and demographic variables are expected to be identified. Conclusion The study findings provide valuable insights into the prevalence and determinants of cardiometabolic risk factors among healthcare workers in a rural setting. These insights can inform targeted interventions and public health strategies aimed at improving the cardiovascular health and overall well-being of healthcare workers, ultimately contributing to the enhancement of healthcare delivery and outcomes in rural areas.

Comparative Analysis of Standard Percutaneous Nephrolithotomy (PCNL) and Mini-Percutaneous Nephrolithotomy (Mini-PCNL) for Renal Stones Larger Than 2 cm at a Rural Hospital: A Study Protocol.

Background Percutaneous nephrolithotomy (PCNL) is considered a standard treatment option for large-size renal stones but is associated with drawbacks such as bleeding and prolonged recovery. Mini-PCNL offers a less invasive alternative, but its efficacy compared to standardPCNLfor renal stones larger than 2 cm remains under debate. This study aims to compare the efficacy and safety of standard PCNLversus mini-PCNLfor renal stone sizes more than2 cm. Methods This single-centre prospective interventional study willbe conductedat Acharya Vinoba Bhave Rural Hospital (AVBRH). The study will include patients 18 to 70 years of age undergoing unilateralPCNLfor renal calculi. Patients with renal stones larger than 2 cm will be enrolled. Data on stone-free rate (SFR), operative duration, hospital stay time, surgical site infection, haemoglobin (Hb) drop, need for blood transfusion, and post-surgery fever will be collected and compared between the two procedures.Statistical analysis of data willbe performedusingdescriptive and analytical statistics. Results The study aims to enrol a total of 32 patients.Data analysis willbe doneusing IBM SPSS Statistics for Windows, Version 24 (Released 2016; IBM Corp., Armonk, New York). Conclusion This study will provide valuable insights into thecomparative outcomein terms ofefficacy and safety of standard PCNL and mini-PCNLfor kidney stoneslarger than 2 cm.

Assessment and impact in quality-of-life post radiotherapy in breast cancer patients treated at Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi, 2023 - 2024

Assessment and impact in quality-of-life post radiotherapy in breast cancer patients treated at Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi, 2023 - 2024

Analytical observational study of salmonella PCR and its comparison with routine laboratory parameters in cases of enteric fever in tertiary care hospital in central India

Background Enteric fever, predominantly caused by Salmonella enterica serotype Typhi, remains a significant global health concern, particularly in resource-limited settings. The diagnostic landscape for enteric fever relies on traditional methods such as the Widal test and blood culture, each with inherent limitations regarding sensitivity and turnaround time. Methods The study will employ an Analytical Observational Study design conducted at Acharya Vinoba Bhave Rural Hospital in central India over a two-year period. Participants will include adults above 18 years admitted to the ward or Intensive Care Unit (ICU) with acute febrile illnesses. Inclusion criteria encompass a wide age range, ensuring a diverse study population. Peripheral blood samples will be collected for Salmonella PCR, Widal testing, and blood culture. Dot-PCR for Typhi will be employed, and DNA extraction will follow strict protocols. Data will be systematically recorded, and statistical analyses, including sensitivity, specificity, and comparative assessments, will be conducted to evaluate diagnostic performance. Expected Outcome It is anticipated that Salmonella PCR will exhibit superior sensitivity and specificity compared to traditional diagnostic methods, offering a more rapid and accurate identification of enteric fever cases. The study aims to contribute valuable evidence supporting the incorporation of Salmonella PCR into routine diagnostic algorithms, potentially revolutionizing the approach to enteric fever diagnosis. Moreover, insights gained from the study are expected to inform clinical practices, enhance patient management, and potentially reduce the economic burden associated with misdiagnosis or delayed diagnosis of enteric fever. The outcomes of this research are poised to impact public health strategies, providing a foundation for more effective and efficient diagnostic protocols in the context of enteric fever.

Role of Magnetic Resonance Imaging in the Evaluation of Trigeminal Neuralgia Using Steady-State Imaging.

Trigeminal neuralgia (TN) poses diagnostic challenges due to its complex origins, often associated with neurovascular compression. Advanced imaging techniques, particularly magnetic resonance imaging (MRI) with thefast imaging employing steady-state acquisition (FIESTA) sequence, offer crucial insights into TN pathophysiology. This prospective cross-sectional observational study aimed to elucidate MRI's utility in diagnosing TN and correlating imaging findings with clinical manifestations and treatment outcomes. A cohort of 41 patients clinically suspected of TN underwent MRI evaluation at Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha, utilizing various sequences including FIESTA. Analysis revealed a higher incidence among females, predominant unilateral presentation, and a higher prevalence of abnormal MRI findings, with neurovascular compression as the leading etiology. Correlation analysis demonstrated significant associations between facial pain localized to the trigeminal nerve distribution, triggering factors, and abnormal MRI findings. Gender distribution did not significantly influence MRI findings. Treatment outcomes favored microvascular surgery over conservative management in cases of neurovascular compression. This study underscores MRI's pivotal role, particularly FIESTA, in TN evaluation, guiding personalized treatment strategies and emphasizing the importance of integrated clinical and imaging approaches. Further research is warranted to validate these findings and explore additional imaging modalities for a deeper understanding of TN pathogenesis.

A Cross-Sectional Study of Dermoscopy and Clinical and Histopathological Study of Acquired Palmoplantar Keratodermas: A Research Protocol.

Background Acquired palmoplantar keratodermas (PPKs) pose diagnostic and therapeutic challenges due to their varied clinical presentations and overlapping features. This study aims to elucidatediagnostic criteria; assess correlations between clinical, dermoscopic, and histopathological features;and evaluate treatment outcomes for acquired PPKs, particularly palmoplantar psoriasis. Methods A prospective, cross-sectional study will be conducted at the Department of Dermatology, Venereology, and Leprosy, Acharya Vinoba Bhave Rural Hospital (AVBRH), Wardha, Maharashtra. Patients with acquired PPKs will undergo comprehensive clinical, dermoscopic, and histopathological evaluations. Treatment outcomes for palmoplantar psoriasis will be assessed following standard therapy. Statistical analysis will include descriptive statistics, diagnostic accuracy assessments, correlation analyses, and treatment outcome evaluations. Results The study is anticipated to establish reliable diagnostic criteria for acquired PPKs, identify correlations between features, and demonstrate the effectiveness of standard therapies for palmoplantar psoriasis. The findings are expected to inform evidence-based guidelines and protocols for diagnosing and managing acquired PPKs. Conclusion This study aims to advance the understanding and management of acquired PPKs by providing insights into diagnostic accuracy, correlations between features, and treatment outcomes. The study seeks to enhance patient care and outcomes for individuals affected by acquired PPKs by improving diagnostic precision and guiding therapeutic interventions.

A Retrospective Study Comparing the Surgical Results of Platysma Myocutaneous Flap, Buccal Pad of Fat, and Nasolabial Flap for Reconstruction After Fibrotomy in Cases of Oral Submucous Fibrosis.

To evaluate the effectiveness of nasolabial flap (NLF), a buccal pad of fat flap (BFP), and platysma myocutaneous flap (PMF) for reconstruction following fibrotomy for individuals with oral submucous fibrosis (OSMF). A retrospective study was conducted among patients diagnosed with grade III and IV OSMFin the Departmentof Oral and Maxillofacial Surgery at Sharad Pawar Dental Collegebetween January 2016 and August 2018. The essential patient information was obtained from the Medical Record Department (MRD) at Acharya Vinoba Bhave Rural Hospital (AVBRH), Datta Meghe Institute of Medical Sciences (DMIMS) Sawangi (Meghe) Wardha. The patients were categorized into three groups: the NLF, the BFP, and the PMF groups. Each group had 16 patients, and factors such as interincisal width, diminished burning sensation in the mouth, inter-commissure distance, and flap necrosis were compared pre- and post-operatively. Student's unpaired t-test and chi-square test were employed for statistical analysis. Mean interincisal mouth-opening increased from pre-operative 4.79 to 41.42 mm post-operatively in the NLF group, BFP group from 6 to 39.42 mm and in the PMF group from 9.26 to 39.34 mm with p value=0.0001. NLF group showed complete and partial resolution of the burning sensation of the mouth at 93.75% and 6.25%, BFP at 62.25% and 32.75% while in PMF it was 68.5% and 31.25% respectively. One year postoperatively 3.28 mm increase in inter-commissure width was observed in the NLF group with a marginal increase in the PMF group and a negligible increase in the BFP group. 18.75% partial flap necrosis was seen in BFP, 18.75% in the PMF group, and 6.25% in the NFL group. All the flaps are efficacious in treating OSMF, however, NLF stands ahead with its higher reliability owing to its excellent blood supply.

A prospective observational cross-sectional study on the association of non-alcoholic fatty liver disease and insulin resistance in acute ischemic stroke in tertiary care hospital in Central India

Background Non-alcoholic Fatty Liver Disease (NAFLD) and insulin resistance have individually been associated with increased cardiovascular risk, and their potential interplay in the context of Acute Ischemic Stroke remains a subject of investigation. This study aims to elucidate the association between NAFLD, insulin resistance, and Acute Ischemic Stroke, exploring risk factors, etiology, and potential implications for patient management. Methods This prospective observational cross-sectional study will be conducted at Acharya Vinoba Bhave Rural Hospital, enrolling patients aged 40-79 diagnosed with acute ischemic stroke between 2022 and 2025. Diagnostic confirmation will involve brain imaging, and abdominal ultrasonography will assess NAFLD severity. Biochemical parameters will be measured for insulin resistance evaluation, including blood glucose, glycosylated hemoglobin (HbA1c), and fasting insulin levels. The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) will be calculated. Statistical analyses, including descriptive statistics and bivariate and multivariate analyses, will be applied to explore associations and potential risk factors. Expected Outcome Anticipated findings include insights into the prevalence and severity of NAFLD in Acute Ischemic Stroke patients, the association between insulin resistance and stroke incidence, and potential risk factors contributing to this association. The study provides a foundation for understanding the complex relationship between NAFLD, insulin resistance, and Acute Ischemic Stroke, offering valuable implications for risk stratification and patient management in clinical practice. Identifying modifiable risk factors may guide targeted interventions, contributing to improved outcomes in this patient population.