Care Hospital In Central India Research Articles

A mixed method study to determine the prevalence of childhood obesity and determinants of physical activity and gadgets use amongst school-going children (standard 1st to 10th) from an urban area located in central India

Introduction The word obesity comes from the Latin “obesus,” which means “pump” or “having eaten oneself fat.” Childhood obesity is a major problem in India. Physical activity is critical for obesity prevention. Childhood Obesity is a proven risk factor for many noncommunicable diseases in adults. Environmental factors, habits, and cultural contexts have influenced the worldwide obesity epidemic. Obesity during childhood can have a comprehensive impact on a child’s overall health, affecting not only their physical well-being, but also their social and emotional development. It can influence confidence levels, social interactions, and even academic performance, leading to reduced quality of life. Aim This study aimed to determine the prevalence of obesity and examine the pattern of physical activity and gadget use among school-going children (1st -10th). Method This was a descriptive cross-sectional study with a mixed-method component that will be conducted in the urban field practice of a tertiary care hospital in central India among school-going children (std1st-std 10th). Quantitative data were collected by house-to-house surveys in systematically selected random households, while in-depth interviews were conducted among parents from randomly selected households. This study aimed to ascertain the frequency of obesity and physical activity patterns and examine parents’ opinions regarding technology use, exercise, and nutrition in their offspring. It will provide insights into the burden of childhood obesity along with appropriate strategies to plan based on the determinants and perceptions identified.

Randomised controlled trial of preoperative antibiotic prophylaxis in the prevention of surgical site infections in tertiary care hospital of central India

Background Surgical site infections (SSI) remain a significant concern in the realm of surgical interventions, posing a threat to both patient well-being and healthcare systems. This study protocol outlines a rigorous investigation aimed at assessing the effectiveness of pre-operative antibiotic prophylaxis in the prevention of SSIs in clean and clean-contaminated surgical cases within the tertiary care setting of central India. The primary aim is to determine the best suitable antibiotic regimen, optimal timing for administration, and the associated economic burden of SSIs. Method The study utilizes a Randomized Controlled Trial (RCT) design with four intervention groups, each receiving distinct antibiotic prophylaxis protocols. Comprehensive post-operative monitoring, adhering to the Centers for Disease Control and Prevention (CDC) guidelines, will be employed to identify SSI occurrences. Key data collection points include clinical evaluations, temperature monitoring, wound inspection, pain assessments, and culture and sensitivity testing. Expected outcome The study also emphasizes post-operative follow-up assessments, incorporating outpatient visits at 15-, 30-, and 90-days post-surgery. These evaluations will be instrumental in assessing the time duration for effective prophylactic antibiotic administration and determining the economic burden associated with SSI. The findings of this research endeavor hold the potential to enhance patient outcomes, minimize SSI incidences, and reduce the economic impact of SSIs on healthcare systems. By optimizing pre-operative antibiotic prophylaxis practices, this study aims to advance evidence-based guidelines for SSI prevention in clean and clean-contaminated surgical cases. CTRI REF/2023/07/070549

A cross-sectional study of neutrophil to lymphocyte ratio as a prognostic marker in acute organophosphorus poisoning in a tertiary care hospital in Central India

Background Acute organophosphorus poisoning remains a significant public health concern, with variable clinical outcomes. Prognostic markers are crucial for patient management and risk stratification. This study aims to investigate the Neutrophil Lymphocyte Ratio (NLR) as a potential prognostic marker and its associations with severity and clinical outcomes in acute organophosphorus poisoning. Methods This cross-sectional observational study will be conducted over two years, involving patients presenting with acute organophosphorus poisoning in the Medicine Ward and Intensive Care Unit of DMIHER Wardha. Informed consent will be obtained, and detailed clinical assessments, laboratory investigations, and NLR calculations will be performed. The Nambaet, Peradeniya, and Bardin classification scales will be used to measure severity. Statistical methods will be applied to explore the relationships between NLR, clinical parameters, and clinical outcomes, including descriptive statistics, bivariate analysis, correlation analysis, multivariate regression, and ROC analysis. Expected Results The study is anticipated to elucidate the role of NLR as a prognostic marker in acute organophosphorus poisoning. Initial assessments and correlations between NLR and clinical parameters will be presented. The predictive capability of NLR for clinical outcomes, including the need for ventilatory support and length of hospital stay, will be explored. Agreement and discrepancies between the classification scales will be evaluated.

Interventional cross-sectional study of extra-cardiac anomalies in children with congenital heart diseases in tertiary care hospital in central India

Background Congenital heart diseases (CHDs) in neonates often present complex clinical scenarios, and the association with extra-cardiac anomalies adds a layer of intricacy to their management. This study protocol outlines a comprehensive investigation into the prevalence and clinical outcomes of extra-cardiac anomalies in neonates diagnosed with CHDs. The study addresses gaps in current knowledge regarding this specific patient population, situated in the Neonatology unit of Jawaharlal Nehru Medical College and AVBR Hospital, Sawangi, Wardha, Central India. Methods Utilizing a descriptive, interventional cross-sectional design, the study will enrol neonates meeting inclusion criteria—diagnosis of CHDs with concurrent extra-cardiac anomalies. Rigorous data collection will involve detailed clinical histories, thorough physical examinations, and the compilation of relevant investigations, including diagnostic imaging and laboratory results. The study’s temporal scope spans three years, ensuring a robust representation of the neonatal population. Statistical analysis, employing chi-square tests, Fischer’s tests, and independent t-tests, will explore relationships between demographic and clinical characteristics, contributing to a nuanced understanding of this complex interplay. Expected Results Anticipated outcomes of this study include a precise estimation of the prevalence of extra-cardiac anomalies in neonates with CHDs. Furthermore, insights into this specific patient cohort’s clinical outcomes and management will be gained. The study aims to unravel the intricate relationship between demographic factors, clinical characteristics, and extra-cardiac anomalies in CHD patients through meticulous data analysis. These findings are poised to inform clinical practice, enhance patient care strategies, and set the stage for further research in this critical area of neonatal medicine.

Study of inflammatory biomarkers in Chronic obstructive pulmonary disease (COPD) and their association with comorbidities

Background Chronic Obstructive Pulmonary Disease (COPD) is a prevalent respiratory condition associated with systemic inflammation and various comorbidities, significantly impacting patients’ health outcomes. This study investigates the relationships between inflammatory biomarkers in COPD and their associations with comorbidities. By focusing on specific biomarkers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-ALFA), and fibrinogen, we seek to find the complex interplay between systemic inflammation, COPD severity, and the prevalence of comorbidities. This research is critical for advancing our understanding of the systemic manifestations of COPD and informing targeted interventions for improved patient management. Methods This cross-sectional observational study will be conducted at AVBRH, a tertiary care hospital in central India, over two years (August 2022 to August 2024). A sample size of 90 COPD patients will be randomly selected based on inclusion and exclusion criteria. Diagnostic tests will be performed, including pulmonary function tests, chest X-rays, and biomarker assessments. Statistical analyses, encompassing chi-square tests, Pearson’s correlation coefficient, and logistic regression, will explore associations between inflammatory biomarkers, COPD severity, and comorbidities. The study design ensures rigorous data collection and adherence to ethical standards, with SPSS 27.0 utilized for statistical analyses. Expected Outcome Anticipated outcomes include a comprehensive understanding of how inflammatory biomarkers correlate with the severity of COPD and their associations with comorbidities. We expect to identify specific biomarkers that may serve as indicators of increased risk for certain comorbid conditions. The findings will contribute valuable insights into the systemic nature of COPD and inform healthcare strategies tailored to mitigate comorbidity-related risks in COPD patients. This research has the potential to enhance clinical decision-making, guide personalized treatment plans, and ultimately improve the overall management of individuals living with COPD.

A cross-sectional case-control study of nailfold capillaroscopy changes in patients with chronic kidney disease in tertiary care hospital in central India

Background Chronic Kidney Disease (CKD) poses a significant global health burden, necessitating a deeper understanding of its microvascular manifestations. Nailfold capillaroscopy has emerged as a valuable tool in elucidating microvascular changes in various systemic conditions, yet its application in CKD remains underexplored. This study aims to investigate the patterns of nailfold capillaroscopy changes in CKD patients across different stages and explore potential correlations with disease severity and etiology. Methods A cross-sectional case-control study will be conducted, enrolling 120 CKD patients (stage 1-5) and 60 controls without renal disease. Nailfold capillaroscopy will be performed using DINOLITE AM4113ZT, and microvascular changes will be analyzed through the MDAD approach. Demographic details, clinical histories, renal function tests, imaging findings, and additional relevant parameters will be collected. Statistical analysis, including chi-square tests, student t-tests, and correlation analyses, will be conducted using SPSS 27.0 and GraphPad Prism 7.0. Expected Outcome It is anticipated that nailfold capillaroscopy will reveal distinct microvascular changes in CKD patients compared to the control group. Correlation analyses with renal function parameters may unveil microvascular alterations and disease severity associations. The study’s findings hold the potential to enhance diagnostic and prognostic strategies in CKD, providing valuable insights into the vascular aspects of the disease and contributing to the broader understanding of microvascular changes in systemic conditions.

Paediatric sequential organ failure assessment score (p-SOFA) as an outcome predictor in critically ill children admitted to a paediatric intensive care unit in a tertiary care hospital in central India.

Background Pediatric intensive care remains a critical and challenging field, where early recognition of organ dysfunction and timely intervention are essential for improved patient outcomes. The Pediatric Sequential Organ Failure Assessment (P-SOFA) score is a tool designed to assess organ dysfunction in critically ill children. This prospective observational study aims to evaluate the effectiveness of the P-SOFA score in predicting morbidity and mortality in pediatric patients admitted to the Pediatric Intensive Care Unit (PICU). Methods Over two years, we will enrol pediatric patients aged one month to 17 years in the PICU at Jawaharlal Nehru Medical College and AVBRH, Sawangi, Wardha, Central India. Data will be collected on demographic characteristics, clinical assessments, laboratory investigations, SOFA score calculations at admission and 48 hours later, treatments received, and outcomes. Inclusion criteria encompass patients with PICU stays exceeding 24 hours, while exclusion criteria include consent refusal, planned procedures for PICU admission, and PICU stays of less than 24 hours. Expected Results We anticipate that the P-SOFA score will be a valuable predictor of morbidity and mortality in critically ill pediatric patients. The study will also investigate the potential of ΔSOFA (change in SOFA scores) as an outcome indicator and compare the P-SOFA score with the Pediatric Logistic Organ Dysfunction Score 2 (PELOD2) for mortality prediction.

A cross-sectional study on the role of computed tomography in the evaluation of oral cavity malignancies in tertiary care hospital in central India: A study protocol

A cross-sectional study on the role of computed tomography in the evaluation of oral cavity malignancies in tertiary care hospital in central India: A study protocol

Antibiotic susceptibility profile of Pseudomonas species isolated from clinical specimens to access, watch and reserve drugs across various hospital settings at a tertiary care hospital of central India

Background and Objectives: Over the last decade, hospital-acquired infections, particularly in the critical care setting, have become more common, with Gram-negative bacterial infections having the highest prevalence. This study aims to determine the prevalence and antibiotic susceptibility pattern of Pseudomonas species to WHO’s, aware class of antibiotics, which are commonly prescribed across various ICU’s, medical and surgical wards of our tertiary care teaching hospital. Materials and Methods: This prospective study conducted from January 2021 to June 2022 at a tertiary care centre of cen- tral India identified Pseudomonas species from clinical samples using standard procedures and antimicrobial susceptibility testing performed as per Clinical Laboratory Standards Institute (CLSI) guidelines (M100; 32th Edition). Results: A total of 1490 non duplicate Pseudomonas species isolates were grown from 21,019 culture positive clinical sam- ples, of which 1247 were Pseudomonas aeruginosa. Out of these 1247 Pseudomonas aeruginosa 384 were MDR (30.7%). Pseudomonas aeruginosa were most commonly isolated from the pus samples (85%). ICU isolates were significantly more resistant to antibiotics than those from other units. P. aeruginosa strains from ICUs showed the highest rates of resistance to ceftazidime (93.9%). Reserve drug colistin showed good susceptibility (98.2%). All the 18 colistin resistant strains were found to be negative for plasmid mediated mcr-1,2,3 genes. Conclusion: The study shall help to generate and disseminate the data so that proper antibiotic policy can be made for judi- cious use of Access, Watch and Reserve antibiotics and antibiotic de-escalation plan can be put forth.

Demographic Profile and Etiology of Epistaxis

Epistaxis is common worldwide otorhinolaryngology emergency presenting as a life-threatening condition especially in resource-constrained hospitals with limited health-care facilities for acceptable management. The aim of this study is to find out the common causes of epistaxis. It was a cross sectional study. It was carried out on 304 patients who presented with epistaxis at tertiary care hospital of Central India (Peoples College of Medical Science & Research Centre, Bhopal). It was found that among 304 participants, maximum number of patients with epistaxis were of age group 21–30 years i.e. 66 (21.71%) with 210 (69.08%) were male and 94 (30.92%) were female. It was found that maximum patients were of nose picking i.e. 113 (37.17%) followed by trauma via accident, assault and fall i.e. 77 (25.33%), followed by hypertension i.e. 49. Epistaxis is a common emergency condition in Otorhinolaryngology. People of all ages can be affected. Hypertension and trauma were the most common etiological/risk factors among the patients in whom etiology was found although in most of the patients etiology could not be found.

IJCM_376A: Time motion study in Anti Rabies Vaccination OPD in tertiary care Hospital of Central India

Background: Outpatient department is considered a doorway to health services. The outpatient department thus requires a systematic study of its services for its efficient management and functioning. Time-motion study in ARV OPD provides information on how much time it takes for management of animal bite patients at each step. Such a study could prove useful to improve efficiency of health care services. Objective: To assess the average time spent in different service delivery points in ARV OPD Methodology: A hospital based cross0sectional study was conducted in ARV OPD from July 2022 to June 2023 on Patients coming to ARV OPD. A total of 960 patients were included in the study using Systematic Random sampling technique. Data was collected using a pre-designed and pre-tested questionnaire for socio-demographic details and case history of patients and time required for each step in management of animal bite. Stopwatch of smartphone was used to record time at each step of patient management. All the collected data was entered in SPSS software (version 20.0) and was analyzed accordingly. Results: Study results showed that out of 960 patients 613 (63.85%) were male and 347(36.15%) were female. 509 (53.02%) were from urban and 451(46.98%) were from rural area. Out of 960 patients 816 (85 %) were of category III bite and 144 (15%) of category II bite. The most common site for animal bite was lower limb 556 (57.9%) followed by 288 (30%) on upper limb, on trunk 38 (3.96 %) and 78 (8.14%) on head and neck region. Total time required for management of animal bite was 35.15+/- 17.92 minutes. Conclusion: The time spent in transit could be reduced with proper management of logistics. Also reframing of strategies at various steps could help reduced average time needed to attend a patients at ARV OPD.

ANTIFUNGAL STEWARDSHIP: MITIGATING INAPPROPRIATE PRESCRIPTIONS IN VULVOVAGINAL CANDIDIASIS IN TERTIARY CARE HOSPITAL, CENTRAL INDIA

This study aims to reduce the inappropriate prescriptions of antifungal medications for vulvovaginitis candidiasis in a tertiary care hospital in central India. An ambispective, observational study was conducted in the Department of Pharmacology of MGM Medical College and Maharaja Yashwantrao Hospital in Indore, MP, over three months (i.e.,12 w from August to October 2023). The study encompassed a retrospective analysis of prescriptions for vaginal candidiasis over a period of five weeks in August-September 2023, followed by a prospective analysis over the subsequent five weeks of September-October 2023post-implementation of interactive training sessions, discussions, and antifungal guidelines for two weeks. From a total of 130 randomly selected prescriptions, 69 prescriptions were perused retrospectively, while 61 prescriptions received prospective analysis. The post-implemented audit showed a marked reduction in antifungal prescriptions with a difference of 12.4%. An increase in the documentation of examination findings was also observed, from 46.7% to 69.7%. This implementation successfully mitigated inappropriate prescriptions of antifungals, with sustained reductions demonstrated over the 3 mo of the study period, emphasizing the effectiveness of educational interventions.

A Comparative Study of Architecture and Quality of Sleep among Juvenile Myoclonic Epilepsy Patients and Healthy Individuals Attending Tertiary Care Hospital in Central India


 
 
 
 Background and Objective: Primary sleep disorders are common in patients with epilepsy. Seizures, epileptiform discharges, and antiepileptic drugs alter the sleep architecture of patients with juvenile myoclonic epilepsy (JME). We evaluated sleep architecture and its quality in these patients.
 Materials and Methods: Thirty patients with JME (11 men and 19 women with mean age of 21.10 ± 4.55 years) and 30 healthy controls underwent overnight polysomnography (PSG). Sleep quality and daytime sleepiness were assessed using Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS), respectively.
 Results: Myoclonus and generalized tonic-clonic seizures (GTCS) were present in all patients with JME, while absence seizures were in 13.3%. Sleep deprivation was the most frequent precipitating factor for seizures (56.6%) followed by fatigue, sound, and photic stimulation. Patients with JME reported a statistically significant drop in sleep efficiency (P<0.001) with prolonged sleep onset latency (P<0.001). There was prolongation in the N1 stage of non-rapid eye movement (NREM) sleep (P=0.002), and reduction in the N2 stage of NREM (P<0.001) and rapid eye movement (REM) sleep (P<0.001). The median PSQI score was higher in patients with JME, suggesting poor sleep quality (P<0.001), and the daytime sleepiness was not different as indicated by the similar median ESS score (P=0.033).
 Conclusion: Our results suggest a significant alteration in the sleep architecture of patients with JME with reduced sleep efficiency and poor sleep quality. The possible role of the disease itself is suggested for these alterations as a simi- lar trend was also observed in drug naïve patients.
 
 
 

Central Corneal Thickness and Endothelial Cell Changes in Diabetics and Age-Matched Non-diabetics in a Tertiary Care Hospital in Central India.

Background Diabetes has become an epidemic, significantly impacting ocular health as one of its end-organ responses. Among the various ocular complications, alterations in corneal morphology stand out. Central corneal thickness (CCT) and endothelial cell function are vital parameters in assessing intraocular pressure, conducting pre-refractive surgery evaluations, and maintaining corneal transparency. Understanding these changes in diabetic individuals compared to non-diabetics is crucial for managing ocular health in this population. Aim and objective This study evaluates and compares CCT and endothelial cell changes between diabetic individuals and age-matched non-diabetics. By analyzing these parameters, the study seeks to provide insights into the impact of diabetes on corneal morphology and its implications for ocular health. Methods The study recruited 124 patients from the Ophthalmology Outpatient Department (OPD) at Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi. A cross-sectional research design was employed to collect data over six months. Patients were carefully selected, and informed consent was obtained from all participants. CCT and endothelial cell parameters were assessed using specular microscopy, a non-invasive imaging technique. Statistical analysis was done using the software Statistical Package for the Social Sciences (SPSS) for inferential statistics, such as t-tests and ANOVA, and comparing parameters between diabetic and non-diabetic groups.Findings were interpreted based on both statistical significance and clinical relevance. Results In diabetic patients, the mean CCT was 547.91 µm, while it was 523.62 µm in non-diabetic individuals.The T statistic for this variable was 5.14, indicating a17 significant differencebetween the two groups. Similarly, significant differences were found between diabetics and non-diabetics for endothelial cell density, coefficient of variation, and hexagonality, as evidenced by their respective T statistics of 7.46, 5.17, and 4.91. Endothelial cell density averaged 2375 cells/mm2 in diabetics and 2666.95 cells/mm2 in non-diabetics. Additionally, the coefficient of variation was higher among people with diabetes (40.87%) compared to non-diabetics (35.09%). Hexagonality, a measure of endothelial cell shape, was lower in diabetic corneas (40.48%) than in non-diabetic corneas (46.46%). Conclusion The study observed significant differences in corneal morphology, including central thickness and endothelial cell changes, between diabetic and non-diabetic individuals. These findings underscore the impact of diabetes on ocular health and emphasize the importance of monitoring corneal parameters in diabetic patients. Understanding these changes can aid in better management and treatment strategies for ocular complications associated with diabetes.

Study of Clinical and Demographic Profile of Scrub Typhus Patients Admitted to a Tertiary Care Hospital in Central India

Objectives: To study epidemiological characteristics, clinical features, laboratory findings, and clinical outcomes in cases of scrub typhus. Additionally, the study aims to identify the predictors of disease severity.Methods: This cross-sectional study was conducted in the Department of General Medicine at Dr PDM Medical College in Amaravati, India. The study duration was 6 months, from July 2023 to December 2023. All clinically confirmed patients with scrub typhus were evaluated through history, clinical examination, and appropriate laboratory investigations. The clinical and laboratory profiles, hospital course, and outcomes were analyzed. Organ dysfunction upon admission was assessed using the sequential organ failure assessment (SOFA) score.Results: A total of 200 cases were included in the study. The majority of the cases were in the age range of 31-40 years, and most of them were males. The highest number of scrub typhus cases occurred in September. The most common presenting symptoms were fever (81%), followed by nausea (37.5%), generalized weakness (34%), abdominal pain, eschar (21.5%), breathlessness, and cough (21% each), headache (19%), vomiting (15%), and altered sensorium (4.5%). The majority of patients (72.5%) did not experience any complications, while 55 patients (27.5%) developed multi-organ dysfunction syndrome (MODS) as a complication. The mortality rate was 1%.Conclusion: Scrub typhus is a significant cause of acute febrile illness in the Vidarbha region of Maharashtra. It can present with various clinical manifestations, with or without an eschar. Early diagnosis and appropriate treatment of these cases can lead to minimal complications.

Galactomannan Antigen Assay for the Diagnosis of Invasive Aspergillosis: A Study from a Tertiary Care Hospital of Central India

Invasive Aspergillosis (IA) is a severe and fatal infection, especially in immunocompromised patients. Galactomannan is a polysaccharide antigen present in the cell wall of Aspergillus species, which is secreted into the blood and other body fluids during hyphal growth. Therefore, detecting galactomannan antigen is very useful in diagnosing IA, along with clinical features and radiological findings. The study period was one year (January 2022 to December 2022). The data was collected retrospectively from the medical records and case sheets of all clinically suspected invasive aspergillosis patients. Galactomannan antigen assay was performed using an FDA-approved Platelia Aspergillus EIA test kit, and results were interpreted according to the manufacturer’s instructions (Cut off > 0.5). A total of 236 clinically suspected Invasive Aspergillosis cases were enrolled in the study. Galactomannan positivity was predominantly seen in patients aged 40 – 60 years, with male preponderance. Of 236 patients, 14.40% were immunocompromised, and 85.59% were immunocompetent. According to EORTC/MSG definitions, we got one proven IA case, 21 probable cases (8.89%), and nine (3.81%) possible cases. In immunocompetent individuals also, we observed 48.72% (115/236) galactomannan positivity, especially in old Pulmonary Tuberculosis (PTB) patients. Galactomannan positivity was higher in Broncho alveolar lavage (BAL) samples (n=70, 85.36%) than in serum samples (n=77, 46.67%). We found culture positivity of 14.06%, with Aspergillus fumigatus being the commonest isolate, followed by Aspergillus flavus. There is increased positivity of galactomannan in BAL samples compared to serum; hence BAL is a better specimen for diagnosis of Invasive Pulmonary Aspergillosis (IPA).

Assessing the Prevalence Rate of Gangrene Among Patients With Peripheral Vascular Disease in a Tertiary Care Hospital in Central India.

Background Peripheral vascular disease (PVD) includes peripheral arterial disease (PAD) and venous disease. PAD is a chronic progressive atherosclerotic disease leading to partial or total peripheral vascular occlusion. PAD typically affects the abdominal aorta, iliac arteries, lower limbs,andoccasionally theupper extremities. Assessing the prevalence of gangrene among PVD patients is crucial for understanding the burden of this condition and informing clinical management strategies. This study aimed to estimate the prevalence rate of gangrene among patients diagnosed with peripheral vascular disease. Methods This case-control study was conducted at the General Surgery department of Jawaharlal Nehru Medical College and Acharya Vinoba Bhave Rural Hospital, Wardha, India. Patients diagnosed with PVD who presented with gangrene of the lower limb were included. Detailed demographic data were collected, and clinical examinationsand diagnostic tests were performed to assess the severity and extent of gangrene. Statistical analysis was conducted to estimate the prevalence of gangrene among PVD patients. Results Among the 100 participants, the age distribution ranged from 21 to over 70 years, with a mean age of 52.89. Gender distribution showed that 30% of the participants were female and 70% were male. The prevalence of gangrene among PVD patients was found to be 35%, with 65% patients not presenting with gangrene. Conclusion The findings of this study highlight the significant prevalence of gangrene among patients diagnosed with peripheral vascular disease. The implications of these findings for clinical practice and management strategies are discussed further, along with potential avenues for further research. The study provides valuable insights into the burden of gangrene among PVD patients. Early detection and appropriate management of PVD are crucial for preventing the development of gangrene and improving patient outcomes.

Clinicomycological Study of the Spectrum of Pulmonary Aspergillosis at a Tertiary Care Hospital in Central India.

Knowing the spectrum, prevalence, and modes of diagnosis of pulmonary aspergillosis (PA) will be beneficial to clinicians for its early diagnosis and management. This study aims to estimate the prevalence, spectrum, and role of serological tests and radiological findings in the diagnosis of PA. A total of 150 patients were suspected of having PA after obtaining relevant clinical history and radiological imaging. The patients were grouped into each spectrum of PA as invasive PA (IPA), chronic necrotizing PA (CNPA), aspergilloma, allergic bronchopulmonary aspergillosis (ABPA) based on predisposing factors, clinical and radiological findings, and the guidelines of the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG). Samples (bronchoalveolar lavage (BAL), sputum, blood) were collected from these patients and processed in a microbiology lab. BAL and sputum were subjected to microscopy by potassium hydroxide mount, calcofluor white mount, and culture. The serum was separated from blood by centrifugation and subjected to specific serological tests based on the spectrum of PA that the patient was suspected to have. For IPA, serum and BAL galactomannan antigen enzyme-linked immunosorbent assay (ELISA) was performed. For CNPA and aspergilloma, the anti-Aspergillus IgG antibody ELISA was performed. For ABPA, the tests performed were total immunoglobulin E (IgE) ELISA, Aspergillus fumigatus-specific IgE ELISA, and anti-Aspergillus immunoglobulin G (IgG) antibody ELISA. After compiling the clinical, radiological, culture, and serological findings, patients were diagnosed to have a particular spectrum of PA. The prevalence of IPA was 1.4%, CNPA was 4%, ABPA was 3.2%, and aspergilloma was 2.9%. CNPA was the predominant spectrum of PA in our study. Culture positivity for Aspergillus species was seen the highest in aspergilloma patients, followed by IPA, ABPA, and CNPA patients. A. fumigatus was the most common causative agent of PA, except for IPA for which Aspergillus flavus was the most common causative. Aspergillus niger and Aspergillus terreus were less the frequent causes of PA. A combination of radiological, microbiological, and serological tests along with clinical correlation is needed to confirm the diagnosis of PA.

Ceruloplasmin, Vitamin C, and Uric Acid Levels in Patients With Myocardial Infarction: A Comparative Cross-Sectional Study.

Global mortality is significantly influenced by myocardial infarction. Scientists have examined the role of the copper-containing protein ceruloplasmin in heart attacks. It helps to regulate oxidative stress, iron metabolism, and inflammation. Vitamin C's antioxidative qualities lend credence to the idea that it could help prevent cardiovascular disease. Several studies have shown that elevated uric acid levels are related to a higher risk of myocardial infarction. With this background, we conducted this study to estimate levels of ceruloplasmin, vitamin C, and uric acid in patients with myocardial infarction. A tertiary care hospital in central India carried out this comparative cross-sectional study. The study was conducted between December 2022 and April 2023. Patients of any gender with newly diagnosed myocardial infarction who received admission to the intensive care unit and had ST-segment elevation of at least 2 mm in two or more consecutive electrocardiogram leads were included in the patient group. The control group consisted of individuals who did not exhibit any changes associated with myocardial infarction. Based on sex, age, and body mass index, the 75 control and 75 patients were matched. Ceruloplasmin, vitamin C, and uric acid were analyzed and compared. The uric acid levels among the patient group were 10.34 ± 3.23 mg/dL, and among the controls, they were 3.45 ± 1.12 mg/dL (p<0.001). The ceruloplasmin levels among the patient group were 64.34 ± 4.21 mg/dL, and among the controls, they were 29.23 ± 3.82 mg/dL (p<0.001). The vitamin C levels among the patient group were 13.80 ± 0.94 μmol/L, and among the controls, they were 45.62 ± 4.34 μmol/L (p<0.001). The patients with myocardial infarction demonstrated significantly elevated levels of ceruloplasmin and uric acid, while their vitamin C levels were lower in comparison. It is crucial to comprehend the underlying mechanisms through which these parameters influence the development of myocardial infarction.

A prospective observational study of red cell distribution width (RDW) as an outcome marker in Critically ill children admitted to a Pediatric Intensive Care Unit in a tertiary care hospital in central India

Background Critically ill pediatric patients often present with a broad spectrum of conditions, and early prognostic markers are essential for guiding clinical decisions. Red Cell Distribution Width (RDW), a measure of the variability in red blood cell size, has been associated with various health conditions. Methods The study will be conducted over two years at a tertiary care hospital in Central India. Critically ill children between the ages of 1 month and 18 years admitted to the PICU will be consecutively enrolled after obtaining informed consent. Demographic data, vital signs, diagnoses, laboratory results, and relevant scores (PELOD-2 and SOFA) will be recorded. Outcome variables will be documented, including ICU stay duration, mechanical ventilation days, ionotrope usage, development of Acute Kidney Injury (AKI), renal replacement therapy, and outcome (death or discharge). Statistical analysis will involve t-tests, chi-square tests, ROC curve analysis, sensitivity, specificity, positive predictive value, and negative predictive value calculations. Expected results The study aims to provide insights into the potential of RDW as a predictor of morbidity and mortality in critically ill pediatric patients. Comparison with established scoring systems will contribute to understanding the practical significance of RDW in clinical decision-making.