Care Hospital In Central India Research Articles

Pediatric Rheumatological Diseases in a Tertiary Care Hospital of Central India: A Retrospective Clinico-Epidemiological Profile.

Introduction:Infectious diseases account for the major health problem in developing countries like India. Though non-infectious diseases like rheumatological disorders are not very common, the burden of these disorders as a group is high in society due to the huge population size. The rheumatological disorders have varied presentations which may mimic other infectious pathologies leading to a significant time lag in the diagnosis. There is inadequate data on the exact burden of these diseases. The spectrum of rheumatological disorders in developing countries is different as compared to the Western world.Hence this study was carried out with the aim of studying the clinical, epidemiological, and laboratory profile of rheumatological disorders in the pediatric age group in a tertiary care hospital. Methods:It was a retrospective study. Data of patients admitted with the diagnosis of rheumatological disorder in the age group of one month to 15 years during the period from June 2018 to December 2022 were reviewed. Results:A total of 35 patients were identified with 20 being female. The mean age of the patients was 8.42± 3.95 years. The most common disease was juvenile idiopathic arthritis (JIA)- 10(28.57%) with an equal proportion of polyarticular JIA and systemic-onset JIA, followed by systemic lupus erythematosus (SLE) nine (25.71%) and Kawasaki Disease (KD)- eight (22.85%). The commonest presenting complaint was fever followed by a rash, whereas the most common findings were pallor and rash. Anemia was present in 25 (71.42%). C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were high in 20 (57.14%) and 22 (62.85%), respectively. Antinuclear antibodies (ANA) were positive in 10 (28.57%) and rheumatoid factor (RA) factor in only one (2.85%) case. Conclusions:The most common rheumatological disorder identified was JIA. Fever and rash were the common presenting complaints. Pallor was the commonest sign whereas anemia was the commonest hematological abnormality.

An Epidemiological Study on Mucormycosis Patients Admitted in Tertiary Care Hospital of Central India

Introduction: The second wave of SAR Cov-2 Infection brought a new menace that was the escalation in thenumber of mucormycosis, which is a potentially life-threatening, opportunistic, invasive, fungal infectioncommonly called the “Black fungus”.Objective: To find out the factors responsible for occurrence of mucormycosis and the pattern that have emergedin the Post SARS – CoV-19 infected cases admitted in tertiary care hospital of Central India.Material and methods: This descriptive Cross-sectional study was conducted in Government Netaji SubhashChandra Bose Medical college and hospital of Central India from May 2021 to June 2021. 96 Confirmed cases ofmucormycosis were included in this study. The details about Demographical, Epidemiological, clinical data wereretrieved by us through interview with patient or his relative and by going through the case sheets of the cases.Results: The mean age for the mucormycosis was among male is 52.68 ±11.13 years and among female it is47.47±10.07years. 78% of study subjects were hospitalized for treatment while 22% received treatment at home.72.40% had steroid intake, Mean duration of steroid therapy was 10.15±5.71 days. Mean duration between steroidtherapy and appearance of mucormycosis as 14.21±9.1 while mean duration between Covid infection and mucormycosis was found to be 19.71±9.84 days.Conclusion: Immunosuppression during Covid -19 treatment had catalyst effect on the development ofmucormycosis. Early diagnosis and careful monitoring of immuno-compromised individuals is essential. Steroidand other immune- suppressive drugs should be given cautiously.

Evaluation of prescribing pattern of fixed-dose combinations in obstetrics and gynecology department of a tertiary care hospital of central India

Background: Improved patient compliance and cost effectiveness are two benefits of fixed-dose combination drugs. Irrational fixed-dose combinations (FDCs) raise the most urgent issue since they put patients at needless risk for negative medication responses. Aims and Objectives: The present study was done with objective of analyzing prescribing pattern of FDCs in department of fixed-dose combination in department of obstetrics and gynecology in a tertiary care hospital of central India. Materials and Methods: This study, which was both prospective and observational, was conducted at the tertiary care hospital of central India. This study comprised the prescriptions of all patients who visited the obstetrics and gynecology Outpatient Department during the study period. Results: In the present study, 1605 prescriptions were analyzed, comprising total 3016 drugs. Out of these 1262 were prescribed as FDCs and 1754 were prescribed as single drugs. On analyzing system-wise prescriptions, it was found that majority drugs were prescribed pertaining to gastrointestinal tract, that is, 1720 prescriptions, of which 722 (38.8%) were prescribed as FDCs. Four hundred and sixty-three drugs were prescribed related to hematological system, of which 97 (14.9%) were FDCs. Four hundred and thirty-three drugs were prescribed related to anti-infective class, comprising 196 (36.6%) FDCs. Among FDCs prescribed in gastrointestinal system, Vitamin D3 + Calcium carbonate was most commonly prescribed, accounting for 644 (51%) prescriptions. Clotrimazole + Clindamycin was most commonly prescribed FDC in anti-infective system comprising 118 (9.3%) patients. Ferrous ascorbate + folic acid was most commonly prescribed hematological FDC, accounting for 49 (3.8%) patients. Dextromethorphan + phenylephrine + Chlorpheniramine was most commonly prescribed FDC in respiratory segment accounting for 39 (2.9%) patients. Conclusion: The present study highlights a considerable number of drugs prescribed as FDCs. FDCs reduce pill burden and also help to improve patient compliance. However, rationality of FDCs should be thought before prescribing it to patients.

The Outcome and Social Aspects of Unmarried Pregnancy at a Tertiary Care Hospital: A Cross-Sectional Study

Abstract Background: Unmarried pregnancy is a major health and social problem in many developed as well as developing countries with many medical and psycho-social consequences. Methodology: It was a cross-sectional observational study done in the Department of Obstetrics and Gynaecology at a Tertiary Care Hospital in Central India among 105 unmarried women selected by convenience sampling method. Results: The mean age of cases studied was 20.88 ± 2.92 years and 53.3% resided in rural areas. 49.5% had education up to high school level and 34.3% belonged to lower middle class and upper lower 39.0% socioeconomic status. Of the 105 cases studied, 42 had alcohol intake in their family and 23 cases experienced domestic violence. Lack of parental control was noted in 9 cases and 5 had separated parents. In 58 cases, neighbor was the biological father and close relative in 32 cases. About 57 women had a medical termination of pregnancy (MTP) in 2nd trimester and 24 had MTP in 1st trimester. Among the remaining, 17 had full-term vaginal delivery, 6 had preterm vaginal delivery, and 1 case underwent lower segment cesarian section. Of these 24 babies, 3 died subsequently after birth, 9 were given to orphanage, and 12 were with their mother and biological father. Although 12 women married the biological father of the baby, 7 were taken to licensed home and 5 lived with their parents. Conclusions: Contraceptive awareness, family and emotional support along with sexual health education play a key role in preventing psychosocial burden of unmarried pregnancy on a women’s health.

Declining Trend of HIV Seroprevalence in Pregnant Women: A Retrospective Observational Analysis of 12 Years’ Experience at a Tertiary Care Hospital in Central India

Introduction: Human Immunodeficiency Virus (HIV) infection among antenatal women has been reported throughout the country, with a relatively high prevalence in the state of Maharashtra. Data on HIV seroprevalence in antenatal women serve as an indirect indicator of the HIV epidemic's burden in the general population and aid in predicting the same in young children. Diagnostic and treatment services for HIV are concentrated in selected states and districts with high seroprevalence, making it necessary to accurately calculate the prevalence of HIV. Aim: To assess the effectiveness of Prevention of Parentto-Child Transmission (PPTCT) services and to study the effectiveness of the National Acquired Immunodeficiency Syndrome (AIDS) Control Programme (NACP) in the functioning of PPTCT services. Materials and Methods: A retrospective observational analysis of 12-year data, from January 2007 to December 2018, was conducted in the Department of Microbiology at the Government Medical College and Hospital, Nagpur, Maharashtra, representing Central India. Data collection took place from June 2019 to December 2019, and analysis occurred over the subsequent two months (January 2020 to February 2020). The total sample size was 101,865 patients. All pregnant women registered in the Antenatal Clinic (ANC) under the PPTCT Program were included in the present study, and Strategy III of the National HIV testing algorithm was followed. The women's ages, their partners' serostatus, and records of babies born to HIV seropositive mothers were obtained and analysed. The statistical analysis of the data was performed using Stata (version 10.4.2009, STATA Corp., Texas, USA) and Epi Info 7 (version 7.1.06, 2012, CDC, Atlanta, USA), employing the Chi-square test for linear trend (Extended Mantel-Haenszel). A p-value <0.05 was considered significant. Results: The seroprevalence of HIV infection among pregnant women was 1.04% in 2007, decreasing to 0.23% by 2017. In 2009, 88.9% of women were counselled, and 100% were tested for HIV, with pretest counselling steadily increasing to 100% by 2012. The trend in HIV testing, however, remained at 100% over the span of 10 years. Post-test counselling varied from 89.6% to 99.9%, whereas the trend of HIV testing among partners fluctuated from 50% to 94.44%. The overall HIV positivity among babies, after 18 months of follow-up, was 4.77%. Conclusion: The HIV seroprevalence among the pregnant population is steadily declining. More and more women are availing themselves of the facilities at Integrated Counselling and Testing Centre (ICTC). Intensive health education and the availability of diagnostic and therapeutic services across the country have reduced the burden of the HIV/AIDS problem in the country

Assessment of Knowledge, Attitude and Factors Associated with Perinatal Bereavement Care among the Nurses in Madhya Pradesh, Central India

Perinatal bereavement care encompasses holistic support and services offered by healthcare professionals, addressing physical, psychological, emotional, and spiritual needs of bereaved parents which are most often ignored in clinical settings. This hospital-based descriptive study aimed to assess knowledge, attitudes, and associated factors regarding perinatal bereavement care among nursing personnel in a tertiary care hospital in central India. A total of 207 nursing personnel selected through non-probability convenient sampling participated in the study. Data were collected using a structured questionnaire with a 5-point Likert scale and dichotomous scale. The study revealed that 78.3 percent of nursing personnel possessed average knowledge, while 73.4 percent exhibited a positive attitude towards perinatal bereavement care. Several influencing factors were identified, including personal perinatal grieving experiences, a history of other grieving experiences, existing hospital policies, regular training and Continuing Nursing Education, as well as traditional beliefs and values. Further, a positive correlation between the knowledge and attitude of nursing personnel regarding perinatal bereavement care came to light. Significant associations were observed between knowledge scores, attitudes, and demographic variables such as age, total work experience, years of experience in maternity wards, personal loss experiences, and past experience in handling grieving parents among nursing personnel. The study underscores the importance of perinatal bereavement care in providing support to grieving parents and emphasises the need for nursing personnel to possess both knowledge and a compassionate attitude in this regard. The study recommends the establishment of Standard Operating Procedures for Perinatal Bereavement Care within the hospital and the implementation of regular Continuing Nursing Education and training programmes to create a supportive environment.

Importance of Information, Education and Communication Aspects of Nursing Care Services towards Patient Satisfaction: Evidence From a Prospective Study in Central India

Patient satisfaction is one of the Key Performance Indicator (KPI) of health care service delivery and clinical effectiveness. The information, education and communication aspects of nursing care are the major attributes of patient satisfaction and complement the quality assurance and determine the success of the health care system from a patient centric point of view. This study was aimed at assessing the patient satisfaction level towards selected aspects of nursing care services in surgical areas of a tertiary care hospital of central India using a tool developed in-house. It also explored the association of the patient satisfaction level with selected demographic variables of patients. A non-experimental cross-sectional prospective study design was adopted. Non-probabilistic pragmatic sampling technique was used to collect data from 200 patients. A standardised Structured Patient Satisfaction Rating Scale was used for data collection. Patient satisfaction was measured in terms of Information, Education and Communication aspects of nursing care services. Descriptive and inferential statistics were used to analyses the data. Overall 89.5 percent patients were satisfied towards the selected aspects of nursing care services. A statistically significant association was found between clinical care setting, duration of hospital stay and occupation with patient satisfaction level. Innovative strategies like good practices for health care communication and soft skills workshop may be incorporated in the induction and in-service training module of nursing professionals which ultimately lead to the enhanced patient satisfaction and improvement in the quality of nursing care services.

Impact of BioFire FilmArray Multiplex PCR in the Detection of Microbial Agents causing Severe Acute Respiratory Infection in the COVID-19 Era: A Cross-sectional Study from a Tertiary Care Hospital in Central India

Introduction: Many viral and bacterial respiratory tract infections can present with respiratory signs and progress to complicated pneumonia. In the recent Coronavirus Disease2019 (COVID-19) pandemic, it is crucial to test all Severe Acute Respiratory Infection (SARI) patients for other microbial infections in addition to COVID-19, enabling timely diagnosis and treatment to reduce morbidity and mortality. The automated system, BioFire FilmArray, utilises multiplex Polymerase Chain Reaction (PCR) to rapidly detect and identify multiple respiratory pathogens, including selected Antimicrobial Resistance (AMR) genes, within an hour. Aim: To detect bacterial and/or viral pathogens associated with hospitalised COVID-19-negative SARI patients using the BioFire FilmArray Pneumonia Panel (BFPP). Materials and Methods: This laboratory-based cross-sectional study was conducted at All India Institute of Medical Sciences (AIIMS), Nagpur, Maharashtra, India, from June 2020 to February 2021. Respiratory samples, such as sputum, tracheal aspirate, Endotracheal (ET) secretions, and Bronchoalveolar Lavage (BAL), were collected from COVID-19-negative hospitalised SARI cases. A total of 81 patients were included in the study. The samples were tested using the BFPP (multiplex PCR) system and processed using conventional culture techniques. Patient characteristics, clinical and laboratory investigation data, and findings of respiratory viral and bacterial agents, as well as antibiotic resistance genes detected by BioFire FilmArray, were recorded using paper case reports. The data were collected and analysed using Statistical Package for Social Sciences (SPSS) software. Results: Out of the 81 clinical samples processed, the BFPP detected 168 bacterial and 18 viral pathogens. Bacterial-viral codetection was observed in 13 (16%) samples. Atypical bacteria were detected in 3% of cases. Among the bacterial pathogens, the AMR gene for New Delhi Metallo-beta-lactamases (NDM) was detected in 42 (25.9%) cases, followed by CTX-M betalactamases, VIM, and the oxacillinase group of β-lactamases. Conclusion: The BFPP test is a valuable tool for the rapid detection of a wide range of pathogens, including associated AMR genes, with high sensitivity and specificity. This can greatly aid in treatment decisions.

First Trimester Maternal Body Mass Index and Ges-tational Weight Gain and Their Association with Feto-Maternal Outcomes

Introduction: Women of reproductive age have also been impacted by the significant rise in the prevalence of obesity. A significant predictor of poor outcomes for the health of the mother and the newborn is excessive gestational weight increase. The study was conducted with an objective to study first trimester maternal Body Mass Index and gestational weight gain and their association with maternal and perinatal outcomes.
 Methodology: This was a prospective observational clinical study conducted in 196 primigravida patients presenting in a tertiary care hospital in central India. BMI of women were recorded during the first trimester and followed up to assesses gestational weight gain. Early pregnancy BMI and gestational weight gain were compared with various feto maternal outcome.
 Results: The mean of First trimester BMI was 21.3 kg/m2. In Overweight category, 65.2% had high weight gain (WG) while in obese, 26.1% had High WG. Type of delivery and NICU admission rate significantly differ in BMI categories (p <0.05). LSCS rate were higher in overweight and obese category. Preterm babies and post-partum hemorrhage were higher in higher WG categories; however, the difference was non-significant (p>0.05).
 Conclusion: This study conclude that First trimester underweights and overweight/obesity is associated with higher antenatal, intra-natal and postnatal complications as well as neonatal complications. Caesarian rate and instrumental deliver are also common in First trimester overweight and obese women. Preeclampsia is associated with extreme of First trimester BMI.

Assessment of risk factors in patients undergoing difficult cholecystectomy: a cross-sectional study at a tertiary care hospital in Central India

Background: Laparoscopic cholecystectomy (LC) is the operation of choice in the treatment of symptomatic gallstone disease. Most of the time, the levels of difficulties are hard to assume. The risk factors for difficult LC have not been adequately evaluated in Indian population, especially with respect to western Indian population. Thus, the present study was undertaken to assess the risk factors in patients undergoing difficult cholecystectomy. Method: The study involved 100 adult patients with cholelithiasis admitted in the department of surgery for cholecystectomy over a period of 2 years from Nov 2020 to Dec 2022. Preoperatively, patients were evaluated for risk factors including age, gender, BMI, history of sickle cell disease, previous abdominal surgery, presence of pericholecystic collection, gall bladder thickness, impacted calculi, adhesions in triangle of Calot‘s, and previous hospitalization for acute cholecystitis and acute pancreatitis. These factors were assessed to predict difficult LC. Results: Majority of laparoscopic procedures were easy (65%), while remaining were difficult (35%). Difficult cholecystectomy was significantly associated with age ≥50 years (p=0.016), male gender (p=0.031), BMI ≥25 kg/m2 (p<0.0001), sickle cell disease (p=0.030), previous abdominal surgery (p=0.004), pericholecystic collection (p=0.017), gall bladder thickness ≥4 mm (p=0.007), adhesion in triangle of Calot‘s (p<0.0001), impacted calculi (p=0.036), previous hospitalization for acute cholecystitis and acute pancreatitis (p<0.0001) and diabetes mellitus (p<0.0001). The conversion rate was 2%. Conclusions: An awareness about reliable predictors for difficult LC would be helpful for an appropriate treatment plan and application of the resources to anticipate difficult LC. However, further studies with larger sample size are required to confirm the findings.

Drug utilization study in acute febrile illnesses in a tertiary care hospital of central India

Acute febrile illness (AFI) can be caused by various aetiologies. Different antimicrobials are available to be used depending on the cause. Also, there are interpersonal variations in the prescription of these antimicrobials. Antibiotic stewardship programs frequently employ antibiotic policies to reduce the needless use of drugs and improve management. As a result, the purpose of this study is to examine current patterns in the use of antibiotics in patients with acute febrile illness.It is an observational study based on records that were conducted at a tertiary care hospital. 300 patient case files with acute febrile illnesses were admitted to the Department of Medicine after analysing numerous etiologies for antibiotic usage. Antibiotics for different aetiologies of febrile sickness were noted in a case record form. Data collected were analysed for proportion to find the prescription pattern of antimicrobials.Respiratory tract infections, especially upper respiratory tract infections (URTI) (26.6%) are frequent clinical diseases for which antibiotics were administered followed by acute gastroenteritis (16%), urinary tract infection (UTI) (12.3%) and lower respiratory tract infection (LRTI) (9.6%), dengue fever (9%) & viral fever (8.3%). Ceftriaxone (20%) was one of the most frequently prescribed antibiotics and Piperacillin+ Tazobactum (16.25%) was followed by Amoxycillin + clavulanic acid (10.5%), Clarithromycin (8.5%), Cefuroxime (7.25%). According to our analysis, respiratory tract infections and gastrointestinal infections were the two conditions for which antibiotics were most frequently administered. Third-generation cephalosporins, particularly ceftriaxone and cefixime, were the most frequently used antibiotics.

Schizophyllum spp. in Covid-19- A Series of Ten Cases from a Tertiary Care Hospital of Central India.

Background: Schizophyllum species can cause diverse clinical infections like sinusitis, pulmonary disease, ulcerative lesions of the palate, atypical meningitis, cerebral abscess which can occur in both immunocompetent and immunocompromised individuals. Although it is one of the emerging fungi, data on clinical features and outcomes of fungal diseases caused by Schizophyllum spp. in India are currently not sufficient. A failure to exhibit morphological characteristics leads to difficulties in identification, incorrect therapy and decreased frequency of reporting. It is one of the underreported fungal species and the disease load is much higher than reported. Here, we report a series of ten cases where Schizophyllum is isolated as the causative fungal agent. Materials and methods: Nasal scrappings were taken from suspected mucormycosis patients and processed for KOH mount and fungal culture by standard methods. Results: Schizophyllum spp. were isolated from ten suspected patients and majority of them had history of Covid-19, increased blood sugar level and steroid therapy. One of them was a case of T-lymphoid leukaemia under chemotherapy. All the patients were discharged from the hospital after successful treatment. Conclusion: During the second wave of Covid-19 pandemic there was sudden rise of mucormycosis cases in India. This study shows that Schizophyllum spp. can also be a causative fungal agent in post covid patients showing similar signs and symptoms like mucormycosis and can easily be misdiagnosed

Screening for sleep deprivation and mood states among staff nurses of tertiary care hospital in central India

Background: A Nurse’s fatigue raises significant concerns for individual and patient safety. The impact of sleep deprivation on the quality of patient care is an important consideration in today’s health-care environment. Aims and Objectives: The aim of this study was to find the proportion of sleep deprivation among nurses in a tertiary care hospital and to find the association between sleep deprivation and mood states among staff nurses. Materials and Methods: It was a cross-sectional design done in a duration of 2 months from September to October 2022. The study group consisted of nurses working in a tertiary care hospital located in Jabalpur district. A sample size of 70 nurses was calculated through the statistical formula. The questionnaire has three sections: Demographics (nine questions), Epworth sleep scale (eight questions), and Profile of mood states (65 questions). The collected data were tabulated and analyzed using MS Office Excel and SPSS version 21. Results: Interviews were conducted with 70 nurses and 8.6% of them were found to be excessively sleepy and should seek medical attention. Significant results have been obtained for the association with tension, depression, anger, fatigue, and confusion with sleep deprivation. Conclusion: The findings suggest that sleep deprivation exists in a considerable state. Some workplace interventions need to be done to make the efforts of nurses worthwhile and to increase their vigor and positive mood.

Assessment of Knowledge about Palliative Care among Registered Nursing Professionals: A Prospective Cross-Sectional Study in a Tertiary Care Hospital in Central India

Objective: This study aimed to assess the palliative care knowledge among the registered nurses working in tertiary care hospital in Madhya Pradesh. Methods and materials: A prospective cross-sectional study was conducted on 160 registered nurses working in different departments in tertiary care hospital in Madhya Pradesh, who were selected through a purposive sampling technique. The data was collected through an online questionnaire for the socio-demographic variables and validated a self-report questionnaire to measure the knowledge of health care professionals in palliative care and the data was analysed by IBM-SPSSv26. Results: A total of 160 participants enrolled in the study. Basic knowledge care was quite high among the samples (83.75%). Item 1,2 of pain in palliative care was quite high (83.43%) and item 3,4,5 has (22%) only, overall management of pain knowledge was (47%) which is on the lower side. The use of Morphine was 31.04%, Dyspnoea Management it was 38.33%, and in the communication of prognosis, it was 81.56%. Resuscitation knowledge was 46.85%, Psycho spiritual was 24.06% and Bereavement care was 69%. Conclusion: One of the biggest challenges in providing excellent palliative care is that nurses don’t know enough about it. Therefore, improving the quality of palliative care services provided to patients could be accomplished by increasing their knowledge through in-service education and retraining on the job.

Safety and Utility of Various Intravenous Access Devices in a Newly Established Pediatric Hematology Oncology Unit in Central India: Is Midline an Acceptable Option?

Introduction: Recent advances in chemotherapy and supportive care have led to improved survival rates in paediatric oncology. Management of these patients requires safe and reliable intravenous access for various purposes, which can be achieved with midline, central venous catheters (CVC), peripherally inserted central catheters(PICC) and chemo-port. Each type of access has a its advantages and disadvantages. We have analysed the safety and utility of various intravenous access devices in pediatric oncology patients. Methods: A single-centre prospective observational study was conducted in the Division of Paediatric Haematology Oncology, Department of Paediatrics, in a tertiary care hospital in central India. A total of 32 patients were enrolled (14 Midlines, 12 CVCs, 4 PICCs, 2 Chemo-ports). These were observed for catheter dwell time and complications. Results: The median dwell time for all types of catheters was 30 days. The longest median catheter dwell time was for chemo-port (101 days), followed by midlines (30.4 days). The most frequent complication encountered in our study was thrombophlebitis (28%), followed by central line-associated bloodstream infections (CLABSI- 22%). Among CVCs, the most frequent complication was CLABSI(11.9 per 1000 catheter days). Among Midline catheters, the most frequent complication was thrombophlebitis(18.8 per 1000 catheter days). Among PICCs, one each of catheter leak, catheter fracture, thrombophlebitis and CLABSI was seen (21.7 per 1000 catheter days). Both chemo-ports were removed due to complications (one due to CLABSI and the other due to catheter migration into the right atrium). Conclusions: Midlines can be used at newly established paediatric oncology centres as serious complications (CLABSI and deep catheter migration) are less common with midlines.

A cross-sectional study on the prognostic value of the RAPID score in pleural infection in patients attending a tertiary care hospital in Central India

Pleural infections pose a significant clinical challenge, with diverse outcomes that are often difficult to predict. The renal (urea), age, fluid purulence, infection source, dietary (albumin) (RAPID) score, a clinical tool designed to assess the risk of adverse outcomes in pleural infections, holds the potential as a prognostic indicator. This study aims to evaluate the prognostic value of the RAPID score in patients with pleural infections attending a tertiary care hospital in Central India. This hospital-based prospective cross-sectional observational study will span from July 2022 to June 2024, enrolling 50 adult patients aged 18 years and older admitted to the Department of Respiratory Medicine, a tertiary care hospital in central India. Data will be collected using a structured proforma, encompassing demographic data, clinical history, and comorbidities. Diagnostic investigations, including pleural fluid analysis, laboratory tests, sputum analysis, and radiological assessments, will be performed upon enrolment. RAPID scores will be calculated at admission, stratifying patients into low, medium, and high-risk categories. Treatment will follow established pleural infection protocols, with patients receiving empirical antibiotics and tailored treatment based on culture sensitivity results. Patients will be monitored for three months post-admission, and outcomes such as hospital stay duration, tube thoracostomy need, intercostal drainage tube duration, medical management success, surgical referral rates, surgical interventions, and 30-day and 90-day mortality rates will be assessed. This study aims to contribute valuable insights into the prognostic value of the RAPID score in pleural infections and factors influencing patient outcomes. The findings may facilitate more informed clinical decision-making and improve the management of pleural infections, ultimately enhancing patient care and outcomes.

Prevalence of Anxiety, Depression, and Perceived Stress Among Family Caregivers of Patients Diagnosed With Oral Cancer in a Tertiary Care Hospital in Central India: A Cross-Sectional Study.

Background and objectives Oral cancer is a significant health issue in India, with one of the highest incidence rates globally. Family caregivers play a crucial role in the care of oral cancer patients, but their mental health often faces challenges. This study aimed to assess the prevalence of anxiety, depression, and perceived stress among family caregivers of oral cancer patients in a tertiary care hospital in central India and explore the associated psychosocial factors. Population and method The study was carried out between March 2023 and August 2023 in a tertiary care hospital in Wardha, Maharashtra. Family caregivers (N=82, mean age = 36.1 (SD 10.5) years) of patients with clinically diagnosed oral cancer were subjected first tostructured psychiatric clinical interviews to screen for psychiatric diagnoses and then were given self-reporting questionnaires for socio-demographic data, Beck Depression Inventory (BDI-II) for measuring the emotional, cognitive, and motivational symptoms of depression, Manifest Anxiety Scale (MAS) to assess the degree of anxiety and Perceived Stress Scale-10 (PSS-10) to assess stress level. Data was analysed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States). Chi-square test and logistic regression analyses were conducted wherever appropriate in order to explore predictive factors of depressive, anxious, or stress symptoms. Result In the studied population, the majority experienced symptoms of depression (65.1%), anxiety (69.5%), and perceived stress (74.7%). Caregivers of patients with advanced oral cancer were found to have a higher likelihood of experiencing depression (χ2 (1) = 16.76, p < .001) and anxiety related to unemployment (χ2 (1) = 10.12, p = .001) or insufficient earnings (χ2 (1) = 28.63, p < .001). Additionally, participants with no or little formal education (χ2 (1) = 4.63, p = 0.031) and lower income (χ2 (1) = 28.63, p < .0001) were significantly more likely to experience distress compared to those with higher levels of education. Conclusion This study highlights the need for comprehensive support systems for family caregivers of oral cancer patients. Educational programs, financial assistance, and mental health services should be tailored to caregivers' specific needs. Early identification and intervention strategies can help mitigate the psychological impact of caregiving. Further research is essential to develop targeted interventions that enhance the well-being of caregivers and improve the quality of life for both patients and caregivers.

A study protocol for clinico-pathological diagnosis of hematological malignancies in a tertiary care hospital in central India

There is a paucity of a relevant national registry or any individual center study on clinico-pathological profiles of acute/chronic leukemias and multiple myeloma from central India. The proposed observational, prospective, longitudinal study in a rural tertiary center hospital in central India therefore intends to combine diagnostic techniques like peripheral blood smears, immunophenotyping via flow cytometry, bone marrow aspiration, and cytogenetic studies along with World Health Organisation and French-American-British classification for sub-typing, to accurately diagnose acute/chronic leukaemia and multiple myeloma. A total of 55 patients with any clinical suspicion of leukaemia and myeloma will be followed-up for a one-year period post diagnosis to ascertain if the patient is in complete or partial remission, or in a relapsed disease state. Furthermore, these diagnostic techniques will be compared in terms of their effectiveness and if these could substitute or complement each other keeping the limitations of Indian health settings in mind.

Clinical Profile of Patients Hospitalised with Heart Failure in a Tertiary Care Hospital of Central India

Clinical Profile of Patients Hospitalised with Heart Failure in a Tertiary Care Hospital of Central India

A cross sectional study of high-resolution ultrasound and magnetic resonance imaging findings in shoulder joint pain in a tertiary care hospital in central India

Introduction: Shoulder joint injuries are frequent. The shoulder joint is particularly prone to joint dislocation because of its distinctive anatomy. There are several causes of the sore shoulder, however shoulder impingement is the most common one due to its widespread causes. High-resolution ultrasonography (USG) and magnetic resonance imaging (MRI) are the primary imaging modalities for assessing suspected rotator cuff injuries. Ultrasonography is a method of first choice for evaluating rotator cuff injuries due to its widespread availability, lower price, and improved tolerance. Patients with questionable USG results may be given an MRI. Aim and objective: To evaluate high-resolution ultrasound and MRI findings in shoulder joint pain. Methods: A prospective cross-sectional study will be conducted on 93 patients, who come to Acharya Vinoba Bhave Rural hospital associated with Jawaharlal Nehru medical college, a tertiary care center situated in the state of Maharashtra in India between the time frame of July 2022 to July 2024. Patients with shoulder joint pain will be submitted to a primary investigation ultrasound, followed by an MRI if there is any concern, according to the inclusion criteria. Using statistical methods, the strength of agreement between ultrasound and MRI will be found out. Outcome measures: The outcome will correlate ultrasound and MRI findings in shoulder joint pain and describe the relationship between the two.