Ambedkar Memorial Research Articles

An Analogy between Gold Standard SARS-CoV-2 RT-qPCR with the SARS-CoV-2 Rapid Antigen Test in a Tertiary Care Setting in Central State of India

Reverse transcription-quantitative PCR (RT-qPCR)-based assays are extensively being utilized to detect coronavirus disease 2019 (COVID-19). However, due to a lack of RT-qPCR testing capability, these tests cannot be carried out in community clinics. The intention of our study was to evaluate the specificity and sensitivity of Rapid Antigen Detection (RAT) tests versus those of RT-qPCR using nasopharyngeal and oropharyngeal specimens. Respiratory swab specimens were collected from the COVID-19 patients admitted at Dr. Bhimrao Ambedkar Memorial Hospital, Raipur, CG, India, during March to April 2022. RAT and RT-qPCR were performed using standard methods as per guidebook instructions, and subjects were chosen using a convenience sample technique. 100 swabs from patients, who had earlier verified positive and 100 from who had earlier verified negative for SARS-CoV-2 via RT-qPCR, were taken for study. Study was approved by the institutional ethical committee before data collection and initiation of the study. We evaluated for the sensitivity and specificity of the STANDARD Q COVID-19 Ag test kit (SD Biosensor). On testing, an over-all sensitivity and specificity of the kit was recorded as 74% and 100%, respectively in comparison to the RT-qPCR kit. Further, the assay’s sensitivity was shown to be 100%, 94.87%, 77.27%, and 55.56%, respectively, for samples with cycle thresholds (Ct) of 15-25, 25-30, 30-35, and >35. We draw the conclusion that the RT-qPCR assay has superior sensitivity and specificity to the antigen assay. However, in all situations where RT-qPCR testing is difficult, the antigen assay could serve as a rapid and simple option for separating SARS-CoV-2 contagious from non-contagious patients.

A Study on SARS-CoV-2 Infection and Its Association with Co-morbidities: A Retrospective Cohort Study

Introduction: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a novel coronavirus (nCoV) that causes viral pneumonia known as Coronavirus Disease 2019 (COVID- 19). It can infect people of all age groups, and various clinical conditions are strong indicators of co-morbidities in COVID- 19. The presence of co-morbidities is crucial in determining the clinical outcome of coronavirus infections. Therefore, it is crucial to understand the demographic profile and associated risk factors of COVID-19 in this geographical region. Aim: To assess the association between SARS-CoV-2 infection and demographic characteristics and co-morbidities. Materials and Methods: A retrospective cohort study was conducted at the National Accreditation Board for Testing and Calibration Laboratories (NABL)-accredited Virology Service Laboratory (VSL) of Tripura Medical College and Dr. BR Ambedkar Memorial Teaching Hospital, Agartala, Tripura, India. All the required data was collected between May 2021 and October 2022, and data analysis was carried out from February to March 2023. After obtaining Indian Council of Medical Research (ICMR) approval, real-time Reverse Transcriptase-Polymerase Chain Reaction (rRT-PCR) was used for the detection of SARS-CoV-2 RNA. A total of 10,263 samples were included in the study. RNA extraction was performed using the viral Ribonucleic Acid (RNA) extraction Miniprep Kit protocol manufactured by MDI Membrane Technologies, and RT-PCR was conducted according to the Indian Council of Medical Research (ICMR)-approved DiAGSureTM nCoV-19 Detection Assay (Multiplex, TaqMan based) protocol developed by GCC BIOTECH. The findings were based on demographic parameters such as age group and gender distribution. Results were expressed as proportions and percentages, and statistical analysis was done by Chi-square test in Statistical Package for Social Sciences (SPSS) version 20.0. Results: Out of the 10,263 registered patients, 1471 (14.33%) were confirmed to have SARS-CoV-2 infection. The most affected age group was found to be between 21 and 40 years, with 524 (35.62%) cases. Males, 927 (63.02%) were more frequently infected than females, 544 (36.98%). Among all the SARS-CoV-2 infected patients, co-morbidities were found in 254 (17.26%) cases, and the association between co-morbidities and the rRT- PCR test results was found to be statistically significant, with a p-value=0.01. Conclusion: The highest number of SARS-CoV-2 patients were found in the age group of 21 to 40 years, predominantly among males. Patients with co-morbidities showed a significant association with SARS-CoV-2 infection. Diabetes was found to be the most prevalent risk factor among all the patients.

Evaluation of Drug Prescription using WHO Prescription Indicators at a Tertiary Care Teaching Hospital, Raipur Chhattisgarh, India: A Cross-sectional Study

Introduction: Prescription patterns significantly impact healthcare quality and patient outcomes. Evaluating these patterns using World Health Organisation (WHO) indicators helps identify areas for improvement and ensures rational drug use. The present study was conducted to evaluate prescription patterns via WHO indicators, aiming to uncover insights, identify discrepancies and enhance prescription quality within the institute for improved healthcare outcomes. Aim: To evaluate drug prescription patterns using WHO prescription indicators in the prescriptions of outdoor patients at a tertiary care teaching hospital in Chhattisgarh, India. Materials and Methods: A cross-sectional study was conducted in the Department of Pharmacology at Department of Pharmacology, Pt. J.N.M. Medical College, Raipur, Chhattisgarh, India, from July 15, 2023, to October 15, 2023 (a duration of 3 months), involving 1,000 outpatient prescriptions at Dr. Bhimrao Ambedkar Memorial Hospital (BRAM), Raipur, Chhattisgarh. Ethical clearance was obtained from the Institutional Ethics Committee (IEC) (No./MCI/Ethics/2023/45 Raipur, dated 12/07/2023). Data were collected using a digital form and analysed statistically. Parameters evaluated included the average number of medicines per prescription, the percentage of drugs prescribed by generic name, the percentage of prescriptions containing antibiotics, the percentage of prescriptions containing injections, and the percentage of drugs prescribed from the Essential Drug List (EDL). Descriptive statistics were used to summarise the data, and analysis was performed using Microsoft (MS) Excel 2021. Results: The present study included 1,000 prescriptions. A total of 4,320 medicines were prescribed across these prescriptions, with 2,853 (66.04%) prescribed by their generic name. Injections accounted for 483 (11.18%) prescriptions, while antibiotics were included in 663 (15.34%) prescriptions. Additionally, 2,973 (68.81%) medicines were prescribed from the EDL. The average number of medicines prescribed per prescription was 4.3. Conclusion: The study revealed that while certain aspects of prescription practices aligned with WHO indicators, notable discrepancies persisted. The percentage of antibiotics prescribed per prescription was in accordance with WHO guidelines. Strategic measures are needed to enhance prescription practices and align them more closely with WHO guidelines.

Biomedical Waste Management: An Assessment of Knowledge, Attitude and Practice among Healthcare Workers in Tertiary Care Hospital, Chhattisgarh

In the current scenario, medical concern is fundamental for everyone’s existence in addition to well-being, but the waste produced as of healthcare facilities signifies an actual concern in our surroundings. One of the healthcare workers (HCWs) most crucial duties is to handle biomedical waste (BMW) created in a healthcare institution properly since inappropriate management of BMW not only puts both individuals and the environment at risk but might also lead to lawful act opposed to healthcare workers and hospital authority. Current research plan is intended to assess biomedical waste management in a tertiary care hospital in Raipur, Chhattisgarh. A facility-based cross-sectional observational study was conducted at Dr. Bhimrao Ambedkar Memorial Hospital, Raipur; Chhattisgarh from July 2021 to August 2021. Assessment of knowledge, attitude, and observation was done by interviewing 105 healthcare workers, selected by simple random sampling, using a predesigned, semi-structured questionnaire. The analysis revealed that medical staff had good knowledge, attitude and practice of biomedical waste management than the paramedical professionals or non-medical workers. There is an imperative need for orientation training to protect themselves, and citizens visiting this healthcare facility and close by communities.

Appearing in Court in India: Challenges in Representing the Marginalised

This article reflects on the challenges faced in the process of improving access to justice and representation of the marginalized communities in the legal system. The author has drawn reflections from his own career as a human rights lawyer. Explaining this, the author first highlights the barriers faced by marginalized communities in the legal system, and then narrates the challenges faced by those who seek to represent the marginalised or espouse their causes. The emphasis of the article is on understanding what it means to be a marginalised person facing the barriers of the system. Lastly, the article suggests institutional measures to approach the challenges thrown up in the process of representing the marginalised.
 Acknowledgements
 The author acknowledges Mohd. Arsalan Ahmed, Aligarh Muslim University for his assistance in editing the article in the format required by the CASTE: A Global Journal on Social Exclusion.
 The Editors of the Journal are grateful to CEDE team (Community for the Eradication of Discrimination in Education and Employment), for facilitating the process of publishing this article in the Journal. CEDE is a network of lawyers, law firms, judges, and other organisations and individuals, who are committed towards reforming the Indian legal profession. It was founded in April 2021 by Disha Wadekar (Lawyer, Supreme Court of India), Anurag Bhaskar (Assistant Professor, O.P. Jindal Global University, India), and Avinash Mathews (Lawyer, Supreme Court of India). Since its inception, CEDE is organising annual Dr Ambedkar Memorial Lectures. The first inaugural lecture in 2021 was delivered by Dr. Justice DY Chandrachud (Judge, Supreme Court of India) on the topic “Why Representation Matters”. On 14 April 2022, Dr. S. Muralidhar (Chief Justice, High Court of Orissa) delivered the second annual lecture on the topic “Appearing in Court: Challenges in Representing the Marginalised”. This article is an edited version of the lecture delivered by Dr. Justice Muralidhar.

Cardiometabolic and Hematological Consequences of Subclinical Hypothyroidism – A Hospital-based Study

Introduction: Cardiometabolic syndrome is a major public health problem that effects various groups of population world over. Overt hypothyroidism is reported to be associated with both adverse cardiometabolic events as well as hematological picture. However, cardiometabolic and hematological consequences of subclinical hypothyroidism (SCH) are yet to be evaluated in different population. In the present study, we evaluated cardiometabolic and hematological consequences of SCH in a middle aged population from Agartala, Tripura, India. Methodology: The study was conducted on 193 patients attending the ENT OPD of Tripura Medical College and Dr. B.R. Ambedkar Memorial Teaching Hospital, Hapania, Agartala. Subjects having diabetes mellitus, hypertension, patients having thyroxin, antithyroid drugs and antilipidemic drug users, established cancer patients, pregnant woman, and women receiving oral contraceptive pills were excluded from inclusion in the study. Results: The mean age of the subjects was 40.13 years, and females constituted around 65 % of total subjects. The analyses showed a significant difference the RBC count, HB concentration, and a non-significant difference in WBC count between euthyroid and hypothyroid subjects, while platelets showed no significant difference between the groups. There was a significant increase in total cholesterol level and level of LDL cholesterol as well as blood pressure, blood sugar level, and waist circumference in hypothyroid subjects in comparison to euthyroid subjects. Conclusion: The study concluded that the subjects with hypothyroidism have worse cardiometabolic parameters with alteration in lipid profile. Thyroid dysfunction affects all blood parameters except platelets. The follow-up of patients with hypothyroidism should include the complete blood count and evaluation of lipid profile and other cardiometabolic parameters.

Conceptualising Marginalisation: Agency, Assertion, and Personhood

The Indian Institute of Dalit Studies (IIDS) has been regularly organising Ambedkar Memorial Lecture since 2004. The 13th Ambedkar Memorial Lecture, organised on December 6, 2021, was delivered by Dr Justice Dhananjaya Y. Chandrachud (Judge, Supreme Court of India) on the topic “Conceptualising Marginalisation: Agency, Assertion, and Personhood”. The speech given by Justice Chandrachud is being published in form of this article.

A Study on FibroScan and Endoscopic Finding in Patients of Chronic Liver Disease attending Tripura Medical College and Dr. B.R. Ambedkar Memorial Teaching Hospital.

Chronic liver disease (CLD) represents different liver disorders of varying severity and etiology in which hepatic inflammation and fibrosis continue at least for 6 months. Portal hypertension is one of the important complications of CLD and its early recognition is of paramount importance. Though liver biopsy remains the gold standard for diagnosing liver fibrosis and upper gastrointestinal (GI) endoscopy plays an important role in diagnosing different findings of portal hypertension, various noninvasive methods like FibroScan are being increasingly used to diagnose liver fibrosis. Study the FibroScan and endoscopic findings in patients of CLDs and the objectives are to find the prevalence of portal hypertension and to find various grades of esophageal varix and portal hypertensive gastropathy (PHG) and its relationship with liver fibrosis by FibroScan. A total of 114 patients of CLD and compensated cirrhosis having childturcotte- pugh (CTP) stages A and B were included in the study fulfilling inclusion and exclusion criteria, after calculating the sample size of 100. All the patients underwent detailed history, physical and gastrointestinal examination. Complete blood count (CBC), liver function test (LFT), kidney function test (KFT), viral markers were done. Aspartate aminotransferase (AST) to platelet ratio index (APRI) score was calculated, liver fibrosis was estimated by FibroScan and evidence of portal hypertension was documented by upper GI endoscopy. Cutoff value of FibroScan, APRI score, and model for end-stage liver disease (MELD) score for portal hypertension was decided by receiver operating characteristic (ROC) curve. Alcoholic liver disease (ALD) was the most common cause (43%) of CLD closely followed by nonalcoholic fatty liver disease (NAFLD) in 42% cases followed by chronic viral hepatitis, 75% patients had evidence of portal hypertension with PHG being the most common followed by esophageal varix. F4 fibrosis was found in 73% of cases followed by F3, F2, and F1 fibrosis. FibroScan value of 12.2 kPa was predictive of presence of portal hypertension and value of 26.6 mm predicted the presence of large esophageal varices.

TO STUDY THE SEROPREVALENCE OF HEPATITIS C IN CASES OF ACUTE VIRAL HEPATITIS AND CIRRHOSIS OF LIVER

Background: Viral hepatitis is a global public health problem affecting millions of people worldwide. The main objective was to study the seroprevalence of hepatitis C in patients with acute viral hepatitis and cirrhosis of liver. Method: The study was carried out in the department of Medicine, Pt. J.N.M medical college and associated Dr B.R Ambedkar Memorial Hospital Raipur, Chhattisgarh from April 2002 to February 2003. Result: Maximum number of acute viral hepatitis cases were observed in the age group >24-34 years. Maximum numbers of cirrhosis of liver cases were observed in the age group > 44-54 years. There were 2 cases of acute viral hepatitis that tested positive for anti- HCV and both were males. There were 5 cases of cirrhosis of liver who were HBsAg Positive. Conclusion: HCV infection is quite prevalent in Raipur, Chhattisgarh and therefore, stresses the need for early detection so that further transmission could be prevented.

A Study to Assess the Effectiveness of Structured Teaching Program on Knowledge regarding Gestational Diabetes Mellitus among Antenatal Women at Dr. Bhimrao Ambedkar Memorial Hospital, Raipur, C.G.

A Study to Assess the Effectiveness of Structured Teaching Program on Knowledge regarding Gestational Diabetes Mellitus among Antenatal Women at Dr. Bhimrao Ambedkar Memorial Hospital, Raipur, C.G.

Assessment of the extrapyramidal side effects among psychosis patients consuming antipsychotic medication with a view to develop an information leaflet on early recognition and management of extrapyramidal side effects in SS selected hospital at Raipur

Introduction: Patients suffering from physical illnesses are given specific treatment because the causes are specific and the signs and symptoms are specific. The doctor generally knows how the treatment works, and the patient co-operates with the doctors, and nurses, in order to get better. In psychiatric hospital the treatment may not be so specific and most patients are given more than one treatment. The nurse has an extremely important role to play in the treatment of the mentally ill. Her actions, attitudes and skills to help him to deal with his problems are themselves an essential part of his treatment. Objectives: The main objective was to assess the extrapyramidal side effects among psychosis patients consuming antipsychotic medication. Secondary objective was to find out the association of extrapyramidal side effects with selected socio-demographic and clinical variables. Methodology: 60 psychosis patients attending outpatient and inpatient department of psychiatry in Dr. Bhim Rao Ambedkar Memorial Hospital, Raipur, Chhattisgarh who receive antipsychotic medications were assessed for extrapyramidal side effect of antipsychotic drugs. The conceptual framework adopted for study was based on Health Belief Model. Modified Simpson Angus Scale (MSAS) was used to assess/measure extrapyramidal side effects. Patients scoring less than 3 were considered ‘normal’. Patients scoring 3 to 5 were considered having ‘minimal movement disorder’. Those scoring 6 to 11 have ‘clinically significant degree of movement disorder’. And those scoring 12 to 17 were present with ‘severe degree of movement disorder’. Result: It was observed that highest number of subjects i.e. 37 (66.66%) were ‘normal’. 11 subjects (18.33%) were with ‘minimal movement disorder’. 7 subjects (11.66%) were with ‘clinically significant extrapyramidal side effects. Only 5 subjects (8.33%) had severe degree of movement disorder. There was significant association of extrapyramidal side effects with duration of illness, duration of antipsychotic use and immediate side effect of antipsychotics at 0.05 level of significance. Conclusion: It was concluded in this study that extrapyramidal side effects may occur among patients consuming antipsychotic medication. Also significant relationship was found between extrapyramidal side effects with duration of illness, duration of antipsychotic use and immediate effect of antipsychotic medication (1-2 days observation).

Is Stenting Really Necessary in Primary Endonasal DCR-Our Experience.

To Know the relevance of silicone intubation in Endoscopic DCR. A prospective randomized controlled trial study was conducted in the Department of ENT at Dr. Babasaheb Ambedkar Memorial Central Railway Hospital, Byculla, Mumbai. Duration of study was from March 2015 to November 2018. 100 patients in the age group ranging from 20 to 70years, with acquired Nasolacrimal duct obstruction with epiphora and recurrent dacryocystitis were evaluated and managed. These patients were randomized into two groups based on using table of random numbers into two Group A: DCR without stent (n = 50) and Group B: DCR with stent (n = 50). Every patient was subjected to detailed history and examination. The overall success rate in our study with silicone stent was 92% and without stent was 88%. There was no statistically significant (p > 0.05) difference between the two groups. According to our experience silicone stent is really not needed in Endoscopic DCR and if at all used it should be used up to 7days to prevent restenosis and to prevent mucosal flaps to cover stoma again. Use of silicone stent should be restricted to following cases like post traumatic, revision, fibrosed small contracted sac and suspected canalicular block cases.

Assessment of knowledge of medical post graduate students regarding promotional drug literature using WHO criteria

Objective: Pharmaceutical promotional activities create potential for inappropriate prescribing practices without necessarily benefiting the patients but contributes to increased health care costs if prescriber is not aware of WHO criteria for ethical medical drug promotion 1988.So this study was conducted with objective to assess the knowledge of medical post graduate students about WHO criteria for promotional drug literature. Materials and Methods: This observational study was conducted in the various departments of Pt. J. N. M. Medical College & associated Dr. B.R. Ambedkar Memorial Hospital Raipur (C.G.). 100 medical post graduate students were given a promotional drug literature & were asked to evaluate it according to WHO Criteria on prescribed proforma. Results: 33% Medical Post Graduate students were aware of WHO criteria. 14% students evaluated importance of reference of scientific literature. 29% evaluated importance of name and address of manufacturer or distributor. 33% evaluated necessity of dosage form or regimen. 70% evaluated the importance of active ingredients. 76% students evaluated the importance of other ingredients or adjuvant known to cause problem. 80% students evaluated the importance of major drug interactions. 95% students evaluated the importance of the amount of active ingredients per dosage form. 96% students evaluated importance of drug related precautions, contraindications and warnings. 98% evaluated the importance of side effects and major adverse drug reactions. 100% students evaluated the importance of brand name and approved therapeutic uses. Conclusion: The study showed that medical post graduate students have little knowledge about WHO Criteria of promotional drug literature. They require constant education regarding WHO guidelines as these brochures often influence prescribing behaviours of physicians. Keywords: WHO criteria, Promotional, Drug, Literature, Students.

Factors affecting outcome of cochlear implant: an observational study

<p><strong>Background: </strong>Aim and objectives of the study was to evaluate various factors affecting outcome in cochlear implant surgery.<strong></strong></p><p><strong>Methods: </strong>A hospital based retrospective observational study in which 51 patients who underwent cochlear implant surgery from July 2017 to January 2019 were evaluated at Dr. Babasaheb Ambedkar Memorial Hospital, Byculla, Mumbai using 3 parameters i.e. Revised CAP score (CAP), meaningful auditory integration scale (MAIS), speech intelligibility rating (SIR) at various intervals postoperatively and outcome was evaluated.</p><p><strong>Results: </strong>It was found that the postoperative mean scores in all age groups were comparable but not significant at 3, 6 and 9 months interval while the difference was statistically significant at 12 and 24 months interval post implantation with less than 2 years age group performing better than other age groups patients with less than 2 years duration of auditory deprivation, the mean scores were found to be statistically significant at 12 and 24 months implantation Relationship to common causes such as prenatal infections, low birth weight, prolonged labour, hyperbilirubinemia, meningitis and consanguineous marriage were considered but not significant. No significant difference was observed in parent’s education level, urban-rural population to the outcome of cochlear implantation.</p><p><strong>Conclusions: </strong>Two most important factors that affect the outcome cochlear implantation are the age at implantation and the duration of auditory deprivation. Other factors are important but not significant and do not affect the outcome significantly.</p>

EVALUATION OF HAEMATOLOGICAL PARAMETERS IN PATIENTS WITH COVID-19 INFECTION – A TEACHING HOSPITAL EXPERIENCE

Introduction - The mankind is facing a major pandemic seen in decades known as COVID-19 disease whose etiological agent is Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2).[1] Haematological Parameters play a very important role in the management of the disease.[4] The present study was designed to evaluate the Haematological Parameters and assess any significant findings associated with the severity of COVID-19 disease. Methods – The COVID-19 RT-PCR confirmed cases were admitted in Dr. Bhim Rao Ambedkar Memorial Hospital, Raipur, Chhattisgarh, India. Two groups were formed and admitted according to the severity of the disease and ICMR Guidelines. Asymptomatic and Mildly Symptomatic cases (ILI cases) were admitted in COVID ward while Severe cases presenting with SARI were admitted in ICU Ward. Haematological Parameters of both the groups from 1st June 2020 to 31st July 2020 were assessed and Biostatistical Analysis was done. Results – Total 87 RT-PCR COVID-19 confirmed cases were admitted with 67 admitted in COVID Isolation ward (Non- ICU) & 20 in ICU ward respectively. No gender differentiation was observed regarding COVID19 infection. Median age of admission is 41.2 years (± 15.5 years, n=87) with ICU admission at 52 years (± 13.9 years, n=20) and Non-ICU admission at 38 years (±14.4 years, n=67). Conclusion – Mean age of Hospitalization in COVID19 disease is 41.2 years ((±15.5, n=87) with ICU admission at 52 years (± 13.9, n=20) and Non-ICU admission at 38 years (±14.4 , n=67). Severity of COVID19 disease increases with senility and co-morbidities while high and/or increasing Total Leucocyte Count (TLC), Absolute Neutrophil Count (ANC), Absolute Monocyte Count (AMC) & low and/or decreasing Absolute Lymphocyte Count (ALC) are the most important Haematological Parameters for COVID-19 diagnosis, severity assessment, prognosis and management.

To study the short term outcome and risk factors for premature neonate born at Dr. Bhimrao Ambedkar Memorial Hospital, Raipur, CG

Background: Prematurity is the leading cause of perinatal morbidity and mortality worldwide,23 affecting 5-10% of births. Preterm neonates have a 120 times higher risk of death than neonates. The prevention of premature birth is the single most important challenge to modern obstetrics today. Progress in this area has been hampered by lack of understanding of the basic mechanisms responsible for premature labour and delivery. Thus, the following is a study on the short term outcomes and risk factors of preterm babies born at Dr B R Ambedkar Memorial hospital, conducted to evaluate the early outcomes of premature infants at the time of discharge and the identification of different risk factors for preterm births.Methods: This is a prospective hospital based observational study, conducted over a period of 1 year (March 2018 – march 2019), including a total of 1472 preterm babies. Results: A total of 1472 preterm were born during the study period. Preterm male: female was 1.1:1. Obstetrics history of mothers showed 47.35% were having parity-1, 30.71% were having parity-2. Common risk factors noted were multiple pregnancy (28.46%) followed by pre-eclampsia (27.03%). A total of 66.71% of neonates were born beyond 34 weeks of gestation, 60.46% were having birth weight between 1500 and 2499 gm, 18.14% were very low birth weight (VLBW) and 4.35% were extremely low birth weight (ELBW). A total of 545 (37.02%) required NICU admission. Major morbidities noted were respiratory distress syndrome (55.59%) followed by sepsis (30.64%), perinatal asphyxia (11.19%), neonatal jaundice (10.64%) and retinopathy of prematurity (9.91%). A negative correlation was noted between gestational age and duration of stay in NICU (r = 0.98, p = 0.022). Birth weight and gestational age of neonates were significantly associated with the treatment outcome(p=0.000). Very low birth weight neonates had highest mortality (40.85%) followed by ELBW (28.05%). Mortality of 11.14% was noted with respiratory distress syndrome (10.83%) being the major cause followed by sepsis (8.07%). Conclusions: The most common maternal risk factors noted were multiple pregnancies, preeclampsia, eclampsia, antepartum haemorrhage and gestational hypertension. Common morbidities observed in preterm babies were respiratory distress syndrome, sepsis, perinatal-asphyxia and neonatal-jaundice. The common causes of death were respiratory distress syndrome, sepsis and prematurity. Results show that preterm babies have higher risk for morbidity and mortality. Mortality decreased with increase in gestational age and birth weight.

Confusion, blood urea, respiration and blood pressure 65, pneumonia severity index and shock index and hypoxemia scores in community acquired pneumonia and outcome prediction: a descriptive study from Dr B R Ambedkar Memorial Hospital Raipur, India

Background: According to WHO, pneumonia is the third important cause of death worldwide despite various advances in medical science. Incidence of Community acquired pneumonia is about 20% to 30% in developing countries compared to 3% to 4 % in developed countries. Incidence of CAP is much higher in the very young and the elderly individuals. Objectives of the study was to compare CURB 65, PSI (Pneumonia severity index) and SIPF (shock index and hypoxemia) scores with respect to outcome prediction in community acquired pneumonia (CAP).Methods: The present hospital based descriptive observational study was conducted in the Dept of medicine, Pt. J.N.M. Medical College and Dr B. R. A. M. Hospital, Raipur, during 2016-2018 involving a total of 98 patients of community acquired pneumonia.Results: Majority of them i.e. 22 (22.4%) subjects belonged to age group 41-50 years. 34 (34.7%) subjects were found to have CURB65 score 1. 28(28.6%) subjects PSI score was noted to be class I. 89 (90.8%) subjects were discharged while, there was death of 9 (9.2%) subjects. The difference in the mean score was statistically significant (p<0.001). PSI score was found to have diagnostic sensitivity of 94.4% and specificity of 100% while CURB 65 score having 83.1% sensitivity and 100 % specificity. SIPF score had least AUC 0.88.Conclusions: Maximum diagnostic ability was noted with PSI score followed by CURB 65 and SIPF score.

Leaf Surface Mycoflora around the Hospital Area with Special Reference to Dr. Bhim Rao Ambedkar Memorial Hospital, Raipur, Chhattisgarh

Leaf surface provide an important substrate for the growth of a wide variety of fungal organisms. Saprophytic fungi obtain water and nutrients from these surface and leaf surface provide a physical environment suitable for growth and reproduction. For phytopathogenic fungi, the leaf surface represents a temporary, supportive environment, but a surface must be breached before a successful pathogenic interaction can become established. Thus, the physical and chemical characteristics of the leaf surface play an important role in governing the success or failure of fungal growth on, and subsequently in, the leaf. The present paper deals with leaf surface mycoflora around the hospital area with special reference to Dr.Bhim Rao Ambedkar Memorial Hospital, Raipur Chhattisgarh was done by using leaf suspension on PDA (Potato Dextrose Agar) medium for the period of one year from July 2006 to June 2007. During the present study, total 46 fungal species (173 colonies) belonging to 22 genera were recorded. Class wise percentage contribution were recorded and showed that, Anamorphic fungi contributed maximum (96.53%) followed by Zygomycotina (2.87%) and Ascomycotina (0.58%). Season wise total percentage contribution of leaf surface mycoflora were also recorded and showed that maximum contribution were observed in winter season (48.55 %), moderate (30.64%) in rainy season and minimum (20.81%) in summer season. Similarly, maximum contribution were found in the month of November (24.86%) and minimum contribution were observed during the month of June (3.47%). It is also shows that fungal species i.e. Cladosporium sphaerospermum (12.13%), C. Cladosporioides (8.09%), Alternaria alternata (7.51%), Aspergillus niger and Curvularia lunata (5.75%), Phoma fimeti (4.62%) and Aspergillus flavus (4.04%) were most contributed leaf surface mycoflora. It is also observed that, Cladosporium sphaerospermum (23.80%) and C. Cladosporioides (10.71%) were most dominated in winter season, while Alternaria alternata and Aspergillus niger (13.20%) were dominated in rainy season. The presence of these fungi supports the idea that the air spora constitutes the source of many fungi that can potentially colonize the leaf surface.

A study on role of laboratory risk indicator for necrotizing fasciitis score in necrotizing fasciitis

Background: Necrotizing fasciitis (NF) represents a group of highly lethal infection characterized by rapidly progressing inflammation and necrosis. The spectrum of disease ranges from necrosis of the skin to life threatening infection. Laboratory risk indicator for necrotizing fasciitis (LRINEC) score is only scoring system available so far to help us towards making an early and accurate diagnosis.Methods: The current prospective observational study was conducted in the Surgery OPD and emergency, Department of surgery, Dr. B.R. Ambedkar Memorial Hospital, Raipur, CG, India, during study period October 2017 to September 2018. Sample size was fixed at 100. Blood tests taken on admission were used to calculate the LRINEC score in each case.Results: In this study 55% of patients with soft tissue infections were categorized as low risk for progression of NF. Necrotizing soft tissue infection (NSTI) occurs in all age groups, ranging from 18 to 75 years. Clinical findings of crepitus were found in 33% of all patients of NSTI. 96% of the patients underwent debridement once, debridement was done twice in 3% of the patients while debridement was not done in 1% of the patients who belonged to high risk group and had no comorbidities. Out of 100, 3 patients underwent amputation. We found that there is mortality rate of 5%.Conclusions: NF was most severe form of soft tissue infection, potentially life and limb threatening. Early diagnosis of NF is essential for early management and better prognosis of patients.

Diagnostic accuracy of CBNAAT (Gene-Xpert) Vs liquid culture in clinically diagnosed presumptive childhood tuberculosis admitted in Pt. J.N.M. Medical College & Dr. Bhim Rao Ambedkar Memorial Hospital, Raipur (C.G.)

Background: Paediatric tuberculosis comprises 10% of all tuberculosis in developing countries. Smear microscopy is diagnostic for Pulmonary TB whereas for extra-pulmonary TB, CBNAAT (Gene-Xpert) and liquid-culture are available choices. Objectives: To establish the comparative diagnostic efficacy of CBNAAT and Liquid-culture in clinically presumptive childhood Tuberculosis. Outcome: Assess sensitivity and specificity of CBNAAT Vs Liquid-culture in clinically diagnosed presumptive childhood tuberculosis. Material & Method: After approval from institutional ethical committee this Cross-sectional study was performed in department of paediatrics Pt. J. N. M. Medical College, Raipur C.G. Total 97 paediatric presumptive TB cases were enrolled for systematic screening from June-2017 to July-2018. Samples were collected and analysed by CBNAAT and liquid-culture. Data for Diagnostic efficacy of both techniques were analysed with appropriate statistical method. Results: Among study subject group 41.2% belongs to 11-15 age-group and 53.6% were female. Majority of them belongs to joint family (81.4%) and low-socioeconomic (85.6%) status. Among 97 presumptive cases CBNAAT was positive in 24.7% whereas liquid-culture was positive in 22.7%. CBNNAT has sensitivity (100%) and specificity (98.61%) when compared with liquid-culture as gold-standard. It has 95.65% positive and 100% negative predictive values. CBNAAT had 100% of sensitivity and specificity in diagnosis of abdominal-tuberculosis and TB-meningitis. In Pulmonary-TB diagnosis its specificity reduced to 98%. Conclusion: CBNAAT is equally efficacious diagnostic tool to diagnose clinically presumptive TB cases and it should be used in public health system for early diagnosis of paediatric tuberculosis.