Care Center In Northern India Research Articles

Pattern and Predictors of Thyroid Dysfunction among Pediatric Endocrine Referrals at the Tertiary Care Center of Northern India: A Longitudinal Study

Pattern and Predictors of Thyroid Dysfunction among Pediatric Endocrine Referrals at the Tertiary Care Center of Northern India: A Longitudinal Study

Characterization of Leuconostoc lactis Bacteremia during a 2-year Study at a Tertiary Care Center in North India-An Observational Analysis.

Leuconostoc species are regarded as important causes for many infections in immunocompromised patients. In this study, we assessed the characteristics of Leuconostoc spp. causing bacteremia in patients at our center. This observational analysis was conducted in the microbiology laboratory of a tertiary care center in northern India from July 2021 to July 2023. Patients in whom blood culture bottles were positive for Leuconostoc lactis were included in the study. Culture isolates were identified by MALDI-ToF MS as L. lactis and tested for antibiotic sensitivity results by Kirby-Bauer disk diffusion method. Demographic and clinical details were collected and analyzed. During the study period, 6,742 blood culture bottles flagged positive. Among these, L. lactis was isolated from 14 (0.21%) patients. The median patient age was 34 years. The male-to-female ratio was 2.5:1. All the patients with L. lactis bacteremia had an underlying condition leading to immunosuppression (e.g., carcinoma and chronic kidney disease). All the patients with L. lactis bacteremia had an intravascular device present at the time of bacteremia. All isolates in the study were sensitive to doxycycline, high level gentamicin, minocycline, ampicillin-sulbactam, and linezolid. Mortality was attributed to bacteremia by L. lactis in five patients. Appropriate and timely identification of the Leuconostoc species is important for the clinician to tailor regimens for the patients.

Trends in antimicrobial susceptibility pattern of Salmonella species isolated from bacteremia patients at a tertiary care center in Northern India

The study was done to assess the antimicrobial susceptibility pattern among Salmonella enterica serovars causing bacteremia in Northern India. In this observational study, blood samples positive for Salmonella enterica serovars from January 2021 to April 2023 were studied. Species identification was done using MALDI-ToF MS. Serotyping was done using slide agglutination method. Antimicrobial susceptibility was interpreted as per the CLSI guidelines. During the study period, 32 Salmonella enterica serovars were isolated. Salmonella enterica serovar Typhi was the predominant serovar, followed by Salmonella enterica serovar Paratyphi A. All isolates were susceptible to ceftriaxone, chloramphenicol, co-trimoxazole and cefotaxime. Pefloxacin showed 100% resistance. Resistance to nalidixic acid was found in 81.2% isolates. Of the isolates resistant to nalidixic acid, 19(73.08%) isolates were resistant to ciprofloxacin also. This changing susceptibility pattern necessitates continuous surveillance of antibiogram of Salmonella isolates to rationalize the treatment protocols for invasive salmonellosis and prevent emergence of resistant strains.

Efficacy, Safety and Acceptability of Thermal Ablation (Thermocoagulation) as Treatment Option for VIA (Visual Inspection with Acetic Acid) Based Screen and Treat Approach for Cervical Cancer Screening programmeme: Experience at Tertiary Care Centre of Northern India

Efficacy, Safety and Acceptability of Thermal Ablation (Thermocoagulation) as Treatment Option for VIA (Visual Inspection with Acetic Acid) Based Screen and Treat Approach for Cervical Cancer Screening programmeme: Experience at Tertiary Care Centre of Northern India

Type-2 diabetes mellitus with or without metabolic syndrome and their associated critical factors: A study from Northern India

ABSTRACT Background: Diabetes mellitus is associated with carbohydrate, lipid and protein metabolism abnormalities. Uncontrolled hyperglycaemia can result in dysfunction of various organs such as eyes, kidneys, nerves, and heart and blood vessels leading to long-term complications like nephropathy, neuropathy, retinopathy, stroke and ischaemia. The main objective of the study was to identify critical factors in Type 2 diabetes mellitus (Type 2 DM) with metabolic syndrome (mets) compared with Type 2 DM without mets and their association in the development of Type 2 DM to Type 2 DM with mets and cardiovascular complications. This can aid in improving the clinical management and the consequences of the disease. Materials and Methods: The present study was conducted in the Department of Biochemistry, a tertiary care centre in Northern India. All patients who were aged between 35 and 65 years of age were enrolled. Enrolled subjects were divided into three groups, Group I: 50 healthy people; Group II: 50 Type 2 DM without mets; and Group III: 50 Type 2 DM with mets. These patients were subjected to Anthropometric and biochemical parameter assessment. Results: On comparing Group III with control and Group II significant difference was observed in these parameters, that is, elevated TGs (P = 0.001), reduced high-density lipoprotein (HDL) level (P = 0.001), elevated high-sensitivity C-reactive protein (hs-CRP) (0.011), high serum insulin fasting (P = 0.010), weight (P = 0.021), waist circumference (P = 0.001) and BMI (P = 0.001). In the control group, head circumference was significantly lower compared to Group II (P = 0.001) and Group III (P = 0.001). Conclusion: On the basis of observed observation, it has been suggested that low enzymatic activity with poor glycaemic control may further progress Type 2 DM into Type 2 DM with metabolic syndrome and cardiovascular complications. High hs-CRP concentration and high fasting insulin can be independent predictor of cardiovascular complications.

Psychiatric Co-Morbidities and Profile of Patients with Irritable Bowel Syndrome in Northern India.

To study sociodemographic and clinical variables, including psychiatric co-morbidities, in patients with irritable bowel syndrome. A total of 158 patients attending a medical gastroenterology clinic in a tertiary care center in Northern India were screened, from whom 100 were selected for the study. Rome IV criteria were used to diagnose IBS, and the severity of symptoms was assessed by the Irritable Bowel Syndrome Symptom Severity Scale (IBS-SSS). Psychiatric co-morbidities were screened via clinical evaluation, and if present, a diagnosis was made as per DSM-5. The Depression, Anxiety, and Stress Scale-21 (DASS-21) and Somatic Symptom Scale-8 (SSS-8) were used to assess depression, anxiety, stress, and somatic symptoms. The mean age of cases was 35.6 years' old, and the majority of cases (i.e., 38.0%) were between 18 and 29 years' old. Males comprised 62.0% of the sample and females 38.0%. Moderate IBS was present in 61.0% of the cases. Evaluation via DASS-21 revealed that 53.0% were in the moderate category of depression, 43.0% had moderate anxiety, and 36.0% had moderate stress. The somatic symptom scale revealed that 48.0% patients were in the high category. Psychiatric co-morbidities were present in 29.0% of cases. Depressive disorders were the most common psychiatric co-morbidity. Patients with IBS presenting to a tertiary care center in Northern India were primarily young males living in semi-urban areas who belonged to the Hindu religion, were married, and had a nuclear family. Patients with IBS commonly have associated psychiatric disorders; anxiety disorders and depression are most common.

Ophthalmologic profile of patients with systemic sclerosis.

To study the ophthalmologic manifestations of systemic sclerosis (SSc) and its correlation with autoantibody profile. A cross-sectional study on 200 eyes of 100 consecutive adult patients diagnosed with SSc was performed at a tertiary care center in Northern India. The examination of ocular adnexa, anterior segment, and posterior segment with slit-lamp biomicroscopy, tear film break-up time (TBUT), Schirmer's II test, and choroidal thickness measurement by swept-source ocular coherence tomography was done. Autoantibody profile was available for 85 patients, and its statistical association with the ocular examination findings was analyzed. In total, 100 patients (93 females and 7 males) were included. The mean age was 45.11 ± 11.68 years, and the mean disease duration was 6.93 ± 3.68 years. Meibomian gland disease was more commonly found in patients with the diffuse subtype of SSc (P = 0.037). Choroidal thickness was increased in 34% and decreased in 7% (reference range = 307 ± 79 mm) patients. Reduced TBUT, meibomian gland dysfunction, and eyelid stiffness had a statistically significant association with the presence of anti-Scl-70 antibody (P = 0.003, <0.0001, and 0.004, respectively). These patients had ocular fatigue, foreign body sensation, and burning sensation. No significant association was noted with the presence of SS-A/Ro and SS-B/La antibodies. This study highlights the need for an active comprehensive ophthalmic evaluation. Approximately 75% of the patients in our cohort had ocular involvement to varying extent. An isolated presence of anti-Scl70 antibody was also found to have a positive association with dry eye disease.

Coping mechanisms employed by caregiver of cancer patients seeking treatment at a tertiary care centre in Northern India

Coping mechanisms employed by caregiver of cancer patients seeking treatment at a tertiary care centre in Northern India

Correlation between change in platelet count and platelet indices in cases of acute ischemic stroke in tertiary care centre of northern India

Background: Platelet is the important factor in the pathogenesis of atherosclerotic complications, contributing to thrombus formation. As there is a significant correlation found between acute ischaemic stroke and platelet indices including platelet count with their prognostication, but no similar study has been documented from this area of the country, which has drawn attention to conducting this study. Methods: This is an observational, case-control study. Patients with acute ischaemic stroke and aged 18 years or above were included involving a total of 156 subjects (78 cases and 78 controls). They were examined clinically radio-logically and pathologically by platelet count and different indices like mean platelet volume (MPV), platelet distribution width (PDW), platelet to large cell ratio (P-LCR). Results: In the present study, mean PDW of cases is 17.69 fl with a SD of 3.22 fl and means PDW of the control group is 13.67 fl with a SD of 3.15 fl. There is statistically insignificant (p=0.26, CI-95%) changes in value of plateletcrit (PCT) among cases and control group (mean PCT of cases is 0.27% with a SD of 0.O7% and the mean PCT of control subjects is 0.29% with a SD of 0.07%). Conclusion: The observations here suggest a role for larger platelets in the genesis of cerebral thrombosis and are likely to represent changes occurring at the time of thrombopoiesis. Patients with larger platelets can easily be identified during routine haematological analysis. Hence, these indices serve as an important and cost-effective tool in predicting an impending ischemic event and can be used in the future, especially in resource poor countries like India. Keywords: mean platelet volume; platelet count; cerebrovascular accident; platelet distribution width; plateletcrit

Nocardiosis in kidney transplant recipients: A tertiary care center experience

IntroductionKidney transplant recipients are at increased risk of opportunistic infections, including Nocardia. The incidence of nocardiosis in kidney transplant recipients is 0.4–1.3%. The data regarding its epidemiology and outcomes is limited. MethodsThis was a 10-year retrospective observational study from January 2012 to December 2021 at a tertiary care center in northern India, in which all kidney transplant recipients with Nocardia infection were included and followed. Results12 (1.1%) patients had a Nocardia infection among the 1108 kidney transplant recipients. All were living donor kidney transplant recipients, and the mean age at diagnosis was 48.67 ± 12.60 years. Nocardia infection occurred at a median of 26 months (range 4–235) post-transplantation, with 4 (33.1%) of the cases occurring within a year of transplant. Breakthrough infection occurred in 7 (58.3%) patients on cotrimoxazole prophylaxis. 41.7% (n = 5) cases had an episode of rejection in the preceding year of Nocardia diagnosis. Concurrent cytomegalovirus (CMV) infection was present in one (8.3%) case. The lung was the most frequently involved organ. Microscopy was positive in all the cases; while culture was positive in 10 cases, and antimicrobial susceptibility testing (AST) were performed for these isolates. The majority (60%) of isolates were resistant to cotrimoxazole. All tested isolates remained susceptible to Amikacin, Imipenem, and Linezolid. No patients experienced Nocardia recurrence after completion of antibiotic therapy. The mortality at 12 months was 66.7% (n = 4), and only one death was Nocardia-related. ConclusionNocardia may cause a late-manifesting infection beyond the traditional window. The cotrimoxazole prophylaxis may not be sufficient for Nocardia prevention.

Granulocytapheresis Donor Deferrals Pattern at a Pediatric Tertiary Care Centre in Northern India

Granulocytapheresis Donor Deferrals Pattern at a Pediatric Tertiary Care Centre in Northern India

Limb Amputations in a Tertiary Care Hospital, North India: A Cross-sectional Epidemiological Study – Can We Prevent This?

Abstract Background: Disability due to limb amputations is a major but preventable public health problem that is associated with profound economic, social, and psychological effects on the patients and their families, especially in developing countries where the supportive (prosthetic) services are meager or almost absent. The purpose of this study was to outline the patterns and indications for limb amputations in a tertiary care center of northern India and to compare our experience with that of other published data. Materials and Methods: This was an observational study conducted at a tertiary care hospital in northern India. All the patients who underwent limb amputations at this hospital between January 2018 and April 2020 were included in the study. Results: A total of 37 patients underwent various amputations during the study period. The age group ranged between 12 and 80 years (mean of 54.9 years) and the most effected age group was between 50 and 60 years (45%). Males outnumbered females with a ratio of 4:1. When the pattern of amputations was studied, 34 were lower limb amputations and 3 were upper limb amputations. On subcategorization, 45% underwent below-knee amputations followed by above-knee amputations (29%). Diabetes mellitus was the most common cause, followed by trauma and peripheral arterial disease. Conclusion: Complications of diabetic foot ulcers and trauma resulting from road traffic accidents were the most common indications for major limb amputation in our study. Implementation of comprehensive care for diabetes by multidisciplinary approach via diabetic clinics at all the hospitals can help in reducing the complications of diabetes thus reducing the disability due to amputations. Road traffic accidents can also be reduced or prevented by implementing stricter laws and increasing the social awareness.

Anemia profiling in antenatal women at a tertiary care center in northern India: An observational study

: Anemia is a common health issue during pregnancy, with various factors influencing its occurrence. Iron deficiency often leads to iron deficiency anemia (IDA), significantly impacting maternal and fetal health.: This study aims to investigate the complete blood count and nutritional status, including serum iron profile, vitamin B12, and folate levels in antenatal patients. : The study involved 160 participants, predominantly from rural areas. The severity of anemia among the participants was classified according to WHO guidelines.: Iron deficiency was observed in 33.75% of women, folate deficiency in 20%, and vitamin B12 deficiency in 11.25%. Some women exhibited a combination of deficiencies. The average hemoglobin level was found to be 8.69 g/dL, and the mean iron level was 35.95 µg/dL. The average ferritin levels were observed to be 49.65 ng/mL. Lastly, the Vitamin B12 and folate levels averaged at 130.21 pg/mL and 14.76 ng/mL respectively.: These findings provide valuable insights into the nutritional status of pregnant women and highlight the need for targeted interventions to address micronutrient deficiencies during pregnancy.

Gut microbiota of preterm infants in the neonatal intensive care unit: a study from a tertiary care center in northern India.

Disruptions of the gut microbiota of preterm infants admitted to the neonatal intensive care unit (NICU) during the first 2 weeks of life are of critical importance. These infants are prone to various complications, including necrotizing enterocolitis (NEC) and sepsis. Studying the gut microbiota will improve outcomes in preterm infants. In the present study, we examined the gut microbiota of preterm infants admitted to the NICU in the first month of life. Neonates admitted to the NICU were recruited, and stool samples were collected weekly from the seventh day of the infant's life until the 30th day of life. DNA was extracted using a DNeasy Powersoil DNA isolation kit. 16S rRNA gene sequencing targeting the V3-V4 region was performed using the MiSeq platform. Sequenced reads were processed on DADA2 pipeline to obtain an amplicon sequence variant (ASV) table. All bioinformatic and statistical analyses were performed using different packages in the R statistical framework. Fourteen preterm infants were recruited, and 48 samples were collected. Alpha diversity metrics, observed ASV count, and Shannon index were found to have no differences in any clinical variables. Permutational multivariate analysis of variance (PERMANOVA) showed discrimination of neonates by gestational age and administration of probiotics. Differential abundance analysis showed a decreased abundance of Bifidobacterium Breve in extremely preterm infants (gestational age <28 weeks) compared to moderate preterm infants (gestational age 29-32 weeks). Supplementation with probiotics decreased Acinetobacter and increased Bifidobacterium in the gut of preterm neonates regardless of gestational age. Gestational age and probiotic supplementation alter the gut microbiota of preterm infants admitted to the NICU.

P53 Expression in Gallbladder Lesions: A Cross-sectional Study from a Tertiary Care Centre in Northern India

Introduction: Gallbladder lesions comprise inflammatory, benign, pre-malignant, and malignant lesions. The progression of benign lesions into malignant ones involves a complex process. The p53 gene is commonly disrupted in carcinogenesis. Malignant lesions may exhibit p53 overexpression compared to benign and inflammatory lesions. Aim: To investigate the distribution of gallbladder lesions and the expression of the p53 nuclear protein in these lesions. Materials and Methods: A cross-sectional study was conducted at the Department of Pathology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, from June 2020 to December 2022. A total of 249 specimens of gallbladder lesions, including congenital, inflammatory, benign, pre-malignant, and malignant lesions, were included. All samples underwent Haematoxylin &amp; Eosin(H&amp;E) staining and Immunohistochemistry (IHC) with p53 antibody using the peroxidase-antiperoxidase method. The association of P53 expression with histopathological diagnosis was analysed using Fisher’s Exact test. The final analysis was performed using Statistical Package for Social Sciences (SPSS) software, version 25.0. A p-value &lt;0.05 was considered statistically significant. Results: Out of 249 specimens, there were 217 (87.14%) inflammatory lesions, 9 (3.6%) benign lesions, 2 (0.8%) premalignant lesions, and 21 (9.26%) malignant lesions. The main inflammatory lesions were Chronic Cholecystitis (CC) with 132 cases (60.83%) and CC with cholesterosis with 36 cases (16.59%). The most common pre-malignant lesion was choledochal cyst with 3 cases (3.33%). Benign tumours (leiomyoma) were present in 2 (0.8%) patients. Among the 21 (8.46%) malignant tumours, 4 (19.05%) were moderately differentiated adenocarcinoma, 13 (61.9%) were poorly differentiated adenocarcinoma, and 4 (19.05%) were welldifferentiated adenocarcinoma. P53 overexpression was significantly higher in patients with malignant tumours (9 cases, 42.86%) compared to inflammatory lesions (26 cases, 11.98%), benign lesions (0 cases, 0%), and pre-malignant lesions (0 cases, 0%) (p=0.003). Conclusion: Gallbladder lesions exhibit a wide range of histopathological presentations. Inflammatory lesions are the most common, followed by pre-malignant and malignant lesions. P53 can serve as a novel marker for differentiating inflammatory lesions from malignant lesions in the gallbladder.

Clinico-epidemiological Characteristics and Risk Factors Associated with Multidrug- resistant Bacterial Ear Infections at a Tertiary Care Centre in Northern India: A Retrospective Analytical Study

Introduction: A total of 360 million people worldwide have been reported to suffer from hearing loss. The most common cause of ear infection is otitis media, which can be attributed to bacterial pathogens such as Pseudomonas aeruginosa, Staphylococcus aureus and Streptococcus pneumoniae. Aim: To identify the incidence and risk factors associated with multidrug-resistant bacteria causing ear infections at a tertiary care centre in India. Materials and Methods: A retrospective analytical study was conducted in the Bacteriology section of the Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India, from January 2021 to January 2023, and analysed in February 2023. A total of 83 ear discharge samples sent to the laboratory were included in the duration of the study and all clinical and laboratory data were extracted from the hospital information system and the laboratory register, respectively. All pathogens were identified using routine biochemicals and Matrix-assisted Laser Desorption/ Ionisation- Time of Flight-Mass Spectrometry (MALDI-TOF-MS) assay, and their antibiotic susceptibility testing was performed using the Kirby Bauer Disc Diffusion method. Statistical analysis was performed using International Business Machines (IBM) Statistical Package for Social Sciences (SPSS) software version 20.0 (SPSS Inc.). The Chi-square test was used for all categorical variables, and the comparison of two means was performed using GraphPad Prism version 9.5.1 (GraphPad Software Inc.), with p-value&lt;0.05 considered statistically significant. Results: The mean age of the participants in the present study was 35.39±20.93 years and majority, 56 (67.47%) participants were males. Among total 83 samples, 69 (83.13%) patients with suppurative bacterial ear infections. Postoperative conditions in 40 (48.19%) samples and respiratory allergies in 36 (43.37%) samples were the most common risk factors associated with ear infections. Postoperative conditions (p-value=0.005) and Diabetes Mellitus (DM) (p-value=0.026) were statistically significant risk factors for developing ear infections. Pseudomonas aeruginosa was recognised as the most common pathogen in 22 acute cases and 10 chronic cases of otitis media. For all the antimicrobial agents tested, the highest resistance was observed towards fluoroquinolones in 51/67 (76.11%) samples, followed by extended-spectrum beta- lactams in 43/67 (64.18%) samples. Conclusion: The current study describes the incidence and risk factors associated with multidrug-resistant ear infections, the spectrum of pathogenic microbial isolates and their drug susceptibility, aiming to prevent morbidity and complications leading to the loss of auditory function.

Exploring dyslipidemia and cardiovascular morbidity in chronic kidney disease patients: A cross-sectional study

ABSTRACT Introduction: Chronic kidney disease (CKD) is a prevalent health concern with significant implications for patient health. This study investigates the relationship between dyslipidemia and cardiovascular morbidity in CKD patients. CKD is characterized by kidney damage, reduced glomerular filtration rate, and is associated with various complications, including cardiovascular disease. Dyslipidemia, characterized by abnormal lipid levels, is common in CKD patients and contributes to the development of atherosclerosis and cardiovascular complications. Materials and Methods: This 1-year cross-sectional observational study was conducted at a tertiary care center in northern India. The study included 160 patients aged 16 and above who had been diagnosed with CKD. Researchers conducted a comprehensive analysis of lipid profiles in these patients and assessed cardiovascular morbidity through a review of clinical records. Results: In our study, we observed that 96 out of 160 patients diagnosed with CKD exhibited lower than recommended levels of high-density lipoprotein (HDL). Furthermore, in patients with CKD Stages IV and V, low-density lipoprotein (LDL) cholesterol (LDL-C) levels were notably elevated. Triglyceride levels (TGs) were consistently elevated across the board in our study. Specifically, the mean TGLs were 159, 162.8, 211, and 246.8 in CKD Stages II, III, IV, and V, respectively, which was statistically significant. In addition, total cholesterol levels were found to be elevated in 110 out of 160 patients within our study group. Most of the patients with CKD were found to have systolic or diastolic dysfunction on two-dimensional echocardiography. Furthermore, associated coronary artery disease was higher in Grade III and Grade V CKD patients. The study yielded several notable findings regarding cardiovascular morbidity in CKD patients. Cardiovascular morbidity was observed in a significant proportion of CKD patients, highlighting the strong link between CKD and heart-related complications. Abnormal lipid profiles, such as low levels of HDL and elevated levels of LDL-C, were prevalent in CKD patients with cardiovascular morbidity. An association between the severity of CKD, as determined by Stage, and the presence of cardiovascular morbidity was evident. Patients with advanced CKD Stages (IV and V) were more likely to exhibit cardiovascular complications. Dyslipidemia, particularly elevated TGLs, was implicated as a potential contributor to cardiovascular morbidity in CKD patients. Conclusion: This study underscores the significance of cardiovascular morbidity in CKD patients and its association with dyslipidemia. Findings suggest that early diagnosis and management of dyslipidemia are essential for mitigating the long-term cardiovascular consequences in CKD patients. Health-care providers should be vigilant in monitoring lipid profiles in CKD patients and implementing appropriate interventions to reduce their risk of cardiovascular complications. By integrating the study’s findings on cardiovascular morbidity with dyslipidemia in CKD patients, health-care practitioners can better understand the multifaceted nature of this condition and tailor their treatment strategies accordingly.

Surveillance for COVID-19 associated mucormycosis: A coordinated effort in prevention and management of rhino-orbital mucormycosis

Abstract Context: Patients of coronavirus disease 2019 (COVID-19) and factors inducing a diabetogenic state are at increased risk for rhino-orbital mucormycosis (ROM). Efforts to diagnose ROM in its pre-clinical stage would avoid the disease and its consequences. Aim: This study aimed to diagnose ROM in the pre-clinical stage of the disease in high-risk patients and treat patients accordingly. Settings and Design: This is a single-center, prospective study conducted at a tertiary care center in Northern India in collaboration with departments of Otolaryngology, Internal Medicine, and Mycology. Materials and Methods: Fifty-three high-risk patients were enrolled in the study, and all underwent bedside nasal endoscopy with tissue sampling for fungal culture. Patients with suspicious nasal endoscopy findings but negative fungal culture were prescribed oral posaconazole. Those with positive fungal hyphae on nasal endoscopy and culture underwent surgical intervention followed by intravenous amphotericin B, while the remaining patients were kept on follow-up. Statistical Analysis Used: Statistical analysis was performed using the Statistical Package for Social Sciences software. Results: Among the 53 patients, 13 (24.5%) patients had abnormalities on nasal endoscopy, while the remaining 40 (75.5%) patients had normal nasal mucosal cavities. Seven patients (13.2%) underwent surgery and received intravenous liposomal amphotericin B, while another 7 (13.2%) received oral posaconazole. Thirty-five (66.03%) patients were placed under observation, and 4 (7.5%) patients died due to COVID-19-related illness. Conclusions: Nasal endoscopic-guided tissue sampling for fungal culture serves as a valuable surveillance tool for predicting ROM in COVID-19 patients.

Diagnostic Accuracy of Hysteroscopy Versus TVS in Patients with AUB in a Tertiary Care Center of Northern India

Diagnostic Accuracy of Hysteroscopy Versus TVS in Patients with AUB in a Tertiary Care Center of Northern India

P53 Expression in Gallbladder Lesions: A Cross-sectional Study from a Tertiary Care Centre in Northern India

Introduction: Gallbladder lesions comprise inflammatory, benign, pre-malignant, and malignant lesions. The progression of benign lesions into malignant ones involves a complex process. The p53 gene is commonly disrupted in carcinogenesis. Malignant lesions may exhibit p53 overexpression compared to benign and inflammatory lesions. Aim: To investigate the distribution of gallbladder lesions and the expression of the p53 nuclear protein in these lesions. Materials and Methods: A cross-sectional study was conducted at the Department of Pathology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, from June 2020 to December 2022. A total of 249 specimens of gallbladder lesions, including congenital, inflammatory, benign, pre-malignant, and malignant lesions, were included. All samples underwent Haematoxylin &amp; Eosin(H&amp;E) staining and Immunohistochemistry (IHC) with p53 antibody using the peroxidase-antiperoxidase method. The association of P53 expression with histopathological diagnosis was analysed using Fisher’s Exact test. The final analysis was performed using Statistical Package for Social Sciences (SPSS) software, version 25.0. A p-value &lt;0.05 was considered statistically significant. Results: Out of 249 specimens, there were 217 (87.14%) inflammatory lesions, 9 (3.6%) benign lesions, 2 (0.8%) premalignant lesions, and 21 (9.26%) malignant lesions. The main inflammatory lesions were Chronic Cholecystitis (CC) with 132 cases (60.83%) and CC with cholesterosis with 36 cases (16.59%). The most common pre-malignant lesion was choledochal cyst with 3 cases (3.33%). Benign tumours (leiomyoma) were present in 2 (0.8%) patients. Among the 21 (8.46%) malignant tumours, 4 (19.05%) were moderately differentiated adenocarcinoma, 13 (61.9%) were poorly differentiated adenocarcinoma, and 4 (19.05%) were well-differentiated adenocarcinoma. P53 overexpression was significantly higher in patients with malignant tumours (9 cases, 42.86%) compared to inflammatory lesions (26 cases, 11.98%), benign lesions (0 cases, 0%), and pre-malignant lesions (0 cases, 0%) (p=0.003). Conclusion: Gallbladder lesions exhibit a wide range of histopathological presentations. Inflammatory lesions are the most common, followed by pre-malignant and malignant lesions. P53 can serve as a novel marker for differentiating inflammatory lesions from malignant lesions in the gallbladder.