Clinico-epidemiological Profile Research Articles

IJCM_97A: Clinico-epidemiological profile and outcome of Severe Acute Malnutrition children admitted to the nutritional rehabilitation centre of a tertiary care hospital in Kalaburagi, Karnataka: a retrospective study

Background: Severe acute malnutrition is the major cause for under- five morbidity and mortality. According to NFHS 5 (2019-20), 7.7% of malnourished children under 5 years in India were severely wasted and in Karnataka it is 8.4 %. There is paucity of data on risk factors and clinical outcomes related to SAM children in North Karnataka, hence the present study was conducted. Objectives: 1. To assess the clinico-epidemiological profile of SAM children. 2. To determine the risk factors of SAM children admitted in NRC. 3. To study outcomes of SAM children admitted in NRC. Methodology: Study setting: Nutritional Rehabilitation Centre of Gulbarga Institute of Medical Sciences, a Tertiary care hospital in Kalaburagi. Study design: A retrospective record- based cross-sectional study Study population: All children under 5 years of age admitted with SAM in the NRC at GIMS, Kalaburagi. Study duration: December 2022- November 2023 Sample size: As per data from Medical Records Department, total number of SAM children admitted in NRC is 180 between December 2022 to November 2023. DATA COLLECTION METHOD: In all the admitted patients, a detailed history including socio demographic, clinical presentation, birth order, immunization and duration of stay in NRC, physical examination findings and investigations were collected from available records. Anthropometric measurements like weight, length /height, MUAC and weight for height were collected and analysed using WHO growth charts. The outcomes included whether the children completed duration of stay at NRC were cured with weight gain, no weight gain or succumbed to malnutrition. Inclusion criteria: All children under 5 years who were admitted and fulfilled the criteria of SAM by WHO. Exclusion Criteria: 1. Case sheets of admitted SAM children with incomplete data. STATISTICAL ANALYSIS: Data were entered in Microsoft excel sheet and analyzed using SPSS version 20. Results: Among 150 SAM children analysed,77 (51.7%) males and 73(48.3%) females had weight for height below - 3SD. Conclusion: Hospital-based management of SAM children in NRC with adherence to updated WHO standard guidelines has helped in reducing mortality and morbidity among undernourished children.

IJCM_178A: Clinico-epidemiological profile of Acute Coronary Syndrome (ACS) patients in tertiary care hospitals of Mangalore

Background: Global health agencies have recognized the rising threat of non-communicable disease (NCD) as a major contributor to preventable disease and premature mortality in low- and middle-income countries. This study was done to study the Clinico-epidemiological and socio-demographic profile of Acute Coronary Syndrome (ACS) patients admitted in the selected tertiary care hospitals of Mangalore. Methodology: This record-based retrospective study was conducted in tertiary care hospitals affiliated to Kasturba Medical College, Mangalore. The records of all the ACS patients who were admitted to the hospitals during the study period were included in the study Results: There was a total of 646 patients, who were admitted with signs and symptoms of ACS to the study hospitals. Among them, 72% were from Dakshina Kannada District and 41.5% (n=258) were residents of Mangalore. Overall, the highest proportion (90.7%) of subjects was in the 41-80 years of age group and 80% of the study population was consuming a predominantly non-vegetarian diet, among both genders. Among the females, 84% were semiskilled workers and half of the male subjects were Professionals. The most common presenting clinical feature among the ACS patients was chest pain (81.4%), both among males (82.2%) and females (80%). Conclusion: The majority of the ACS patients admitted to the study hospitals were residents of the same District. The levels of ACS were higher among males, those with Diabetes Mellitus and hypertension. The majority of the ACS patients were non-vegetarians. Also, the increasing age had a higher proportion of ACS.

IJCM_145A: A Clinico-Epidemiological Profile of Patients with Thyroid Disorders Admitted to Tertiary Care Hospitals in Mangalore

Background: Thyroid ailments are frequently encountered endocrine disorders next to diabetes. They arise either due to functional aberrations of the thyroid gland resulting in over or under secretion of thyroid hormone or due to structural anomalies. People have varied constitutional, non-specific manifestations that cause abnormal metabolic functioning of the thyroid gland. Objectives: 1. To describe the socio-demographic characteristics of patients with thyroid disorders. 2. To analyze the clinical features, laboratory findings, and clinical outcomes of these patients. Methodology: This hospital-based descriptive study was conducted at the Government Wenlock Hospital in Mangalore. The study included patients admitted with thyroid disorders in the last 2 years. Data extraction sheet was developed from patient medical records. The sheet comprised three sections: socio-demographic information, clinical features at admission, and investigations and outcomes. Results: Most of the patients (52.8%) belonged to the 20-40 age group, followed by 30.5% in the 40-60 age group. Females comprised 81.5% of the study population, males -18.5%. 74.8% had swelling, 3.2% had facial puffiness. 1.8% had weight gain, only 1.2% had weight loss .16.3% had other comorbid conditions. 31.5% had low TSH levels 49.3% had normal TSH levels, 64.5 % - normal T3 levels, 63.2% - normal T4 levels. Anaemia was reported in 15.2% o, while 7.2% developed oedema. 34.2% had multinodular goitre, 20.2% - hypothyroidism 9.5 % - hyperthyroidism and 11.1% - malignancy. Out of the total 97% recovered 1% died 1% had discharge against medical advice and 1 % got discharged on request. Conclusion: Majority were females in the 20-40 age group. Majority of them had swelling followed by facial puffiness. Most of them had normal TSH, T3 and T4 levels, anaemia and oedema was also reported in few. Majority had multinodular goitre followed by hypothyroidism, malignancy, and hyperthyroidism. Majority had recovered.

IJCM_11A: Clinico-epidemiological profile of malignancies in the tertiary care centres in Mangalore

Background: The Hospital-based Cancer Registry (HBCR) part of the National Cancer Registry Programme provides the number of cancer cases attending the hospital in various disciplines and the exact type of cases classified, diagnosed and treated. This study was done to assess the socio-demographic, clinical profile, and trend of malignancy cases in the tertiary care centres of Mangalore. Methodology: This Record-based retrospective study was conducted in tertiary care hospitals affiliated with Kasturba Medical College, Mangalore and all the cases of malignancies admitted during the study period were included. The data were collected using a proforma and analyzed using SPSS version 25.0. The results were expressed as proportions using appropriate tables and graphs. Results: A total of 600 cancer cases were identified, with females comprising nearly half 48.8%(n=293) and among them the highest number of cases, 28% (n=82) were found in the age group 60 and above. Overall, cancer cases appear to be more prevalent in older age groups for both genders. Among males, the most common cancers were Oral cavity cancers 34.2%(n=105), followed by Gastrointestinal (GI) tract cancers,16.3%(n=50). In females the most common cancers were found to be of the breast followed by uterine cancer then by oral cavity Conclusion: The prevalence of cancer in both genders were found to be almost the same. The highest number of cases were reported from Karnataka followed by Kerala. The highest prevalence was found in higher extremes of age above 60 years.

Clinico-Epidemiological Profile of COVID-19 of Patients Presenting to Emergency Department of a Tertiary Medical College of Central Nepal

Background Clinico-epidemiological profile of COVID-19 includes varied clinical symptoms like fever, cough, and fatigue, with a potential for rapid community spread through respiratory droplets. Understanding the clinical characteristics of patients is crucial for planning human resources and logistics support. This study aims to identify the clinical characteristics observed in patients suspected of having COVID-19 presenting to emergency department of College of Medical Sciences and Teaching Hospital. MethodsThis is a retrospective cross-sectional study conducted at Department of General Practice and Emergency Medicine of College of Medical Sciences, Bharatpur, Nepal from April 2020 to February 2021. Ethical approval was taken from institutional review committee of College of Medical Sciences. Data was collected from record file of emergency department. Data was entered and analyzed by using descriptive statistical tools in SPSS-20.ResultsMajority (25.2%) of them were in the age group 50-60 years. Mean±SD of age was 55.2±16.5 years. Majority (54.3%) respondents were male. In presenting complaints 71.42% had cough, 69.5% had fever, 62.9% had shortness of breath. Also, 34.28% had severe symptoms, and 33.34% had moderate symptoms, 20% were asymptomatic and 12.38% had mild symptoms. Finding showed that 69.52% of patients required oxygen supplementation. The motility of COVID-19 patients during emergency stay was 6.67% while 36.19% were admitted in ward and 31.43% were admitted in ICU, 20% patients were sent for home isolation.Conclusions Young adults were the most commonly affected age group and males showed a higher incidence of COVID-19. Since many patients were symptomatic with fever and cough as the typical presentations in the emergency department. Majority of patients during presentation had moderate and severe symptoms and needed oxygen supplementation.

Clinico-epidemiological profile of 75 cases of TB meningitis in children and adoloscents

BackgroundNeurological involvement is one of the deadliest forms of tuberculosis especially in pediatric population. AimTo study the clinico-epidemiological profile of 75 cases of pediatric TB meningitis and its co-relation with CBNAAT/TRUENAT positivity. Study designProspective study in children and adolescents less than 18 years in Tertiary Health care centre in New Delhi. Subjects and methods75 Children and adolescents less than 18 years with Probable TBM as per NTEP guidelines were enrolled. Clinical, Radiological and CSF analysis were carried out in all the patients. Results75 children were enrolled out of which 61% were females. The most common symptom at presentation was fever followed by loss of appetite and weight loss. Neck rigidity was present in 66% cases followed by posturing in 25% cases. 46% patients presented in Stage 2. Tuberculin skin test was positive in 16% cases and 20% patients had evidence of pulmonary TB on chest Xray. Hydrocephalous was the most common finding in neuroimaging present in 61% cases. In majority of the cases, CSF analysis revealed pleocytosis with lymphocyte predominance, low glucose and high protein values. Nucleic amplification tests (CBNAAT/TRUENAT) were positive in 33% cases and 4 out of 75 were detected to have rifampicin resistance. There was no co-relation identified between Stage at presentation, tuberculin positivity and CSF analysis with CBNAAT/TRUENAT positivity. Six patients expired within 2 weeks of presentation. ConclusionThe diagnosis of TBM is a composite of clinical, radiological and CSF analysis parameters. Being a paucibacillary sample, the yield of TB bacilli in NAAT studies remains moderately low. Moreover, detection of TB bacilli in CBNAAT/TRUENAT is independent of the CSF cytological and biochemical profile, and is also independent of the Stage of TBM.

Metabolic parameters in acne vulgaris: a case control study investigating fasting blood glucose and insulin levels in acne vulgaris

Background: Influence of diet and lifestyle on acne among Indian population. Objectives were to identify the clinico-epidemiological profile of patients with Acne vulgaris and to assess the fasting plasma glucose and serum insulin levels in Acne vulgaris patients and the controls and correlate them. Methods: This was a hospital-based case-control study conducted in the Department of Dermatology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Study included 60 cases of acne and 60 controls (age and sex matched), attending the outpatient department. After complete history, general physical, systemic and cutaneous examination, all cases were subjected to following investigation: fasting blood sugar and serum insulin levels. Results: Acne was common in the age group 18-24 yrs (70%). In almost half the patients the age of onset was between 12-18 yrs. Commonly observed site for acne was cheeks (83.3%), forehead (66.7%), nose (55%) and chin (41.7%). The risk of developing acne was 3.5 times more among smokers than non-smokers. The mean fasting blood sugar values of cases and controls when compared showed a statistically significant difference (p<0.05). Our study did not find any statistically significant difference in fasting insulin levels between cases and controls. Conclusions: There was only significant difference in the Mean fasting blood glucose in cases as compared to controls. Mean fasting serum insulin level though found to be raised in cases compared to controls, does not prove statistical significance. Fasting plasma glucose was significantly raised in grade III acne as compared to other grades.

Lichen planus and its clinical variants: a retrospective study in a tertiary care centre

Background: Lichen planus is a chronic pruritic immune-mediated disorder involving skin, oral and genital mucosa, nail and hair with several morphological variants. Although not lethal, the chronic nature of the disease have significant impact on patient’s quality of life and their psychological wellbeing. Aim was to find out clinico-epidemiological profile of LP and its variants including Dermoscopic features and its association with systemic diseases like Diabetes, Hypertension and Hypothyroidism. Methods: This is a hospital based retrospective observational study. Medical records of all patients with LP during the period from January to December 2022 were noted. Various clinico-epidemiological and dermoscopic features along with systemic disease association were analysed. Results: A total of 257 cases were reported. Most common age group affected was 41-60 yrs. Male:female ratio was 0.72:1 with female preponderance. LP in children (<18 yrs) was seen in 9.7% of cases. Classical LP was the most common type (29.5%) followed by Mucosal LP (12.45%). More than one variant was seen in 20.6% of cases. LP in association with systemic diseases was seen in 36.1% of cases with DM being the most frequent. Most common dermoscopic features were pigmentation (100%) followed by Wickham’s striae (83.6%) and vascular findings (49.4%). Conclusions: LP is a common papulosquamous disorder affecting middle aged adults with slight female preponderance. Childhood LP contributed to significant number of cases. Classical LP was the commonest clinical variant observed. LP is associated with DM, HTN and hypothyroidism. Dermoscopy is an useful tool in diagnosis and differentiating from other similar conditions.

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.

Clinico-epidemiological profile and outcome of snakebite patients presented to a teaching institute - A descriptive retrospective review.

Snakebites are a significant cause of morbidity and mortality in India despite availability of anti-snake venom and the absence of a large number of highly venomous snakes. This may be attributed to treatment seeking behaviour of the population. The study aims to find out common clinical features, outcome, and delay in arrival time to the hospital in snakebite cases. This is a cross-sectional retrospective record-based study among the patients presented with a history of snakebites to the Basaveshwara Medical College Hospital and Research Centre, Chitradurga, conducted from 1 January 2019 to 31 January 2021. Out of the 96 patients, the majority of snakebite victims were male and of an age group of 21-30 years. The most common site for snakebite was the lower limb, and about 57.2% of patients had visible fang marks. Among snake species identified, the most common was krait bites, followed by cobra bites. Neurotoxic envenomation manifestation and severe presentation were found in almost half (53.1%) of the cases. Almost half of the patients took 1-4 hours to arrive at the health facility. Surprisingly, only 35% cases arrived to the health care facility within an hour of snakebite. Most of the patients (82%) recovered with the treatment with very minimal fatality/mortality. Although half of the patients presented with severe forms, only 35% of the patients arrived within an hour to the health care facility. This indicates the need for an information dissemination system to avoid severe disease as well as to prevent mortality.

Clinico-Epidemiological Profile and Treatment Outcome of Severe Cutaneous Adverse Drug Reactions in the Paediatric Age Group of 0 to 18 Years: A Retrospective Cohort Study from Southern India

Introduction: The paediatric population is prone to developing cutaneous adverse drug reactions. However, the incidence of Severe Cutaneous Adverse Drug Reactions (SCAR) is rare in this age group, with few studies describing such reactions in detail. Aim: To describe the clinico-epidemiological factors, drug profile, laboratory parameters, and treatment outcomes of SCAR in children admitted to a tertiary care centre in South India. Materials and Methods: A retrospective cohort study was carried out over a 10-year period, including paediatric patients (0-18 years) admitted to Dermatology, Medicine, and Paediatric wards in the tertiary care centre. Demographic details, suspected drugs, comorbidities, personal and family history of drug reactions, physical examination, laboratory parameters, treatment received along with its duration, and the state of morbidity and mortality were recorded. SPSS version 18.0 was used for analysis. Descriptive statistics were used to summarise the demographics and clinical characteristics of the patients. Results: Among all the patients admitted with SCAR, 27 (15%) belonged to the paediatric age group. The median age was 15 years, and the female-to-male ratio was 1.25. Nineteen (70.3%) were diagnosed with Stevens-Johnson Syndrome (SJS)/Toxic Epidermal Necrolysis (TEN), and eight (29.6%) were diagnosed with Drug Reaction with Eosinophilia and Systemic Symptom (DRESS). There were no cases of Acute Generalised Exanthematous Pustulosis (AGEP). The most common class of drugs implicated was antiepileptics (62.8%). Two patients (7%) had a family history of drug reactions. All patients had mucosal involvement. The majority of the children responded to intravenous steroids, and two required additional intravenous immunoglobulin injections for clinical improvement. All cases were cured with no mortality or long-term sequelae. Conclusion: The incidence of SCAR in the paediatric age group is significant. Anticonvulsants, particularly phenytoin, carbamazepine, and lamotrigine, need to be used with caution in this age group. Prompt diagnosis and treatment with systemic steroids can reduce mortality, morbidity, and long-term sequelae.

Clinico-epidemiological profiles & outcome of severe malaria in children under-five in the tribal area of Kalahandi, Odisha.

Severe malaria is a cause of excess mortality and morbidity in children in malaria-endemic areas where indigenous people live. Currently, available reports are all from secondary or tertiary care hospitals across India and some African countries. The objective of this study was to assess the clinical and epidemiological profiles of children under five years in two primary care health centres located in tribal-dominant Thuamul Rampur Block of Kalahandi district, Odisha. The outcome of management of severe malaria in these children was also assessed. A retrospective review of case records of children under five years of age diagnosed and admitted with severe malaria in two non-governmental primary care facilities between 2017 and 2022, was undertaken. There was a declining trend in malaria cases documented in primary care health facilities between January 2017 and June 2022. Of the 4858 cases recorded, 242 (4.9%) had severe malaria, of whom 70.7 per cent (n=171) were children under 5 yr. The median age of the study children was 24 months (16-36). Children aged 1-2 yr had a significantly higher risk of malaria. The majority were tribals (87%), more than half the children presented with neurological manifestations (64.4%), and 49.6 per cent had respiratory manifestations, while 20.5 per cent had severe anaemia (Hb <5 g/dl). Most, 167 (97.7%) severe malaria was due to Plasmodium falciparum. Thirty-two percent of children were severely wasted (WHZ < -3 SD) and 28 per cent were moderately wasted (WHZ <-2 SD). There was no fatality among the 171 children who were managed for severe malaria in the two primary care facilities. In high endemic areas severe malaria is predominantly a disease of under-five children and is caused by P. falciparum. Clinical manifestations of severe malaria in children can be varied and life-threatening. Primary health facilities can manage severe malaria successfully, thereby reducing child mortality. Effective collaboration between malaria control and nutrition intervention programmes is essential for appropriate case management.

Clinico-epidemiologic Profile of Premature Infants Screened for and Diagnosed with Retinopathy of Prematurity at a Tertiary Government Hospital in Northeastern Luzon, Philippines

Abstract Aim: This study aims to determine clinical profiles and outcomes of premature infants screened with retinopathy of prematurity (ROP) at a hospital in Isabela in 2023. Materials and Methods: Analytical study of premature infants screened for ROP at the Department of Ophthalmology of a Tertiary Government Hospital in Northeastern Luzon, Philippines, in 2023. Results: Proportions of infants with any ROP and severe ROP were high (44% and 31%, respectively). More than half were lost to follow-up before retinal maturity which can further increase the number of infants with any and severe ROP in this study. The odds of developing any ROP were 26 × higher when an infant was &lt;32 weeks old and weighing &lt;1500 g compared to those referred for unstable clinical course only. The 57 infants with any ROP had a younger age of gestation (AOG) (P &lt; 0.001) and lower birth weight (P &lt; 0.001) compared to those without. AOG of infants with improvement and deterioration in the clinical course were significantly different (P &lt; 0.03). The 2013 guidelines had the least number missed before its recommended initial examination of infants diagnosed with any ROP (2.5%), including no type 1 ROP. Discussion: This is the first clinico-epidemiologic study on ROP done outside National Capital Region and postpandemic. High proportions of ROP and severe ROP can be due to the inclusion of high-risk infants born outside but referred to the hospital. The higher odds of developing any ROP in those with combined risk factors highlight the need for more public health efforts to decrease premature birth and birth of low birth weight infants.

Factors determining successful treatment outcome among notified tuberculosis patients in Belagavi district of North Karnataka, India

IntroductionIndian government has implemented various strategies to track newly diagnosed tuberculosis (TB) cases and ensure follow-up for registered cases. Appropriate measures have been adapted to combat the spread of TB. Success of the treatment determines the effectiveness of the national TB control program. AimPresent study analyzed the recorded data to study the clinico-epidemiological profile and explore the factors that might influence treatment outcome among notified tuberculosis patients. Design and settingsA retrospective cohort study was conducted using secondary data in Belagavi district. Subjects and methodsData of TB patients notified and registered under Nikshay portal in the year 2019 were collected from the district tuberculosis office and factors influencing treatment outcome were analyzed. Statistical analysisDescriptive statistics, bivariate and multivariate logistic regression analysis were used to analyze the data. ResultsThe study revealed that females, younger age group, absence of comorbidities, having extra-pulmonary TB, smear-negative pulmonary TB, and new TB patients exhibited a statistically significant association with successful treatment outcome. ConclusionIn the study area, the mean treatment success rate (83.8 %) aligned with the national success rate of 82 %. Early detection of tuberculosis may help in increasing treatment success rates. Delivering comprehensive counseling to TB patients regarding the disease, its treatment and management plays a decisive role in achieving successful treatment outcomes.

Clinicoepidemiological Profile of Agricultural Work Related Injuries in Rural Agrarian Community of Nepal: A Cross Sectional Study

Introduction Injuries have a significant proportion in the global burden of diseases and are in increasing trend. Nepal being an agrarian country had frequent reporting of injuries among rural communities whose major occupation is agriculture. So, we had this study with the objective to assess clinico epidemiological profile of agricultural work related injuries in the rural agrarian community of Nepal. Methods A community based cross sectional study was conducted among 362 farmers of rural agrarian communities of Budhiganga Rural Municipality of Nepal from 20 December 2022 to 20 June 2023 after getting ethical clearance from institutional review committee (IRC-PA 254/2022). A specially designed pro forma was used to collect data through convenient sampling techniques. Collected data was entered in Microsoft Excel and analyzed by SPSS version 23. Results The annual prevalence of agricultural work related injury was 48.6%. The most common primary causes were Sickle cut injury 43(24.4%), followed by Oxen/Cow hit injury 33 (18.8%), Traditional Plough cut injury 15 (8.5%), Spade cut injury 15 (8.5%) etc. Injury typically occurs in lower extremities 71 (40.3%). Among them 102 (58%), 82 (46.6%), 28 (15.9%) and 147 (83.5%) had a disability, bedridden, hospitalized and received some sort of treatment. Twenty two (12.5%), 36 (20.5%) and 32 (18.2%) reported stress, self reported decreased vision and self reported hearing loss at the time of injury respectively. Only 9 (5.1%) had used personal protective equipment (PPE) during agricultural work and about 36 (20.5%) had helping hands at the time of injury. Conclusions About half of farmers experienced agricultural work related injury with significant days of disability from daily activities and regular work. Use of personal protective equipment during work is miserable.

Clinicoepidemiological Profile of Short Stature at A Tertiary Care Centre in Bangladesh

Background: Short stature (SS) is a common pediatric problem, which can cause psychosocial disturbances both in parents and children. The goal of the evaluation of a child with SS is to identify the subset of children with pathologic causes so that appropriate timely intervention can be made. Objective: The aim of the study was to study the clinical, epidemiological, and etiological profile of SS at a tertiary hospital of Bangladesh. Methods: This was a cross-sectional study and was conducted in the department of pediatric endocrinology, over a period of 1 year (January 2021-December 2021). A total of 100 children aged 3-14 years, with height &lt;-2SD below the mean height for age and sex were studied. Clinical history, examination, and laboratory evaluations were done to assess the cause of SS and the data were analyzed using appropriate statistical methods. Results: About 55% were female and 45% were male. The causes of SS were found to be familial SS (36%), constitutional growth delay of growth and puberty (12%), hypothyroidism (11%), growth hormone deficiency (8%), malnutrition (10%), chronic diseases (9%), genetic syndromes and skeletal problem (8%). Conclusion: The majority of short stature in children had normal variation of growth. Along with endocrine causes, chronic systemic illnesses and malnutrition still form a major bulk in the etiological profile of SS in Bangladesh. DS (Child) H J 2022; 38(2): 79-83

Clinico-demographic Profile of Carcinoma Urinary Bladder-5-Year Experience from a Tertiary Care Centre of Eastern India.

Urinary bladder carcinoma is a disease of the elderly and often presents at an advanced stage due to ignorance and manifestation of symptoms at later stages of the disease. In India, very little data is available regarding the clinico-epidemiological pattern of urinary bladder cancers. In this study, we analysed the clinico-demographic profile of patients with urinary bladder carcinoma, attending a tertiary care centre in Eastern India over the last 5years. We analysed the database of Oncology OPD of a tertiary care centre in West Bengal in Eastern India and collected the demographic, clinical and treatment data of urinary bladder carcinoma patients who attended our OPD between 2017 and 2021. The objective was to assess the demographic and clinical profile of these patients and compare them with those reported from other parts of India as well as the rest of the world. Majority of patients (70%) were above 50years of age with a strikingly huge male predominance (male:female = 6.6:1). Transitional cell carcinoma (TCC) was the most common (90%) histology. 67.2% of the cases were muscle-invasive disease at presentation, and 19.3% of the patients presented with metastatic disease with bone (42%) as the most common site of metastasis. Overall, around 22% of patients underwent surgery either with definitive or palliative intent. Sixty-five percent of the patients who received radiotherapy underwent definitive radiation as a part of bladder preservation protocol. Thirty-five percent of all patients received chemotherapy; most of them (50.5%) received chemotherapy as neoadjuvant treatment before definitive therapy. To conclude, it can be said that this study is one of its first from Eastern India and will act as a stepping stone for future studies concentrating on clinico-epidemiological profile, early diagnosis and treatment of carcinoma urinary bladder.

Clinico-epidemiological Profile and Outcome of Testicular Germ Cell Tumors: A Retrospective Study from a Tertiary Cancer Centre of North-East India

Introduction: Testicular Germ Cell Tumor (GCT) is a disease of young adults and is also highly curable. But in India, most of the patients present in an advanced stage and succumb to the disease as compared to the Western nations where patients present at an earlier stage and are mostly cured. Also, there is a scarcity of literature on testicular GCT from the Indian subcontinent. We present our experience from the Tata Memorial Centre of North-east India. Methods: This retrospective study was conducted at Tata Memorial Centre - BBCI, Guwahati for the period of 5 years from January 2018 to December 2022. The study focused on epidemiology, clinical presentation, and treatment outcomes. Results: Seventy-two cases of testicular GCTs were studied (28 cases were seminoma, and 44 were non-seminoma). Most common presenting stage was stage I in seminoma (53.6%), and stage III (77.2%) in non-seminoma. As per the International Germ Cell Cancer Collaborative Group (IGCCCG) classification, 25%, 35%, and 40% of patients were good-risk, intermediate-risk, and poor-risk in non-seminoma. In patients with seminoma, 54% and 46% were in good and intermediate-risk, respectively. Seventy-two percent and 21% had achieved a radiologic complete response (CR) and partial response (PR) with conventional chemotherapy in patients with seminoma. Radiologic CR and PR rates were 20% and 61% among non-seminoma patients. The median recurrence-free survival (RFS) was 43 months. RFS was better in seminoma versus non-seminoma, stage I versus stage III, and good-risk versus high-risk group. Conclusion: Most of our patients presented with an advanced stage of the disease and a high nodal burden. In patients with non-seminoma GCT, the best response to conventional chemotherapy was a partial response. The use of an alternative chemotherapy regimen to improve outcomes for such patients can be further explored.

Clinico-epidemological profile of migraine and its correlation with depression, anxiety and stress in a teritiary care hospital in South India

Introduction: We studied the clinico-epidemiological profile of patients with migraine and to study the correlation of migraine severity with depression, anxiety and stress. Materials and Methods: 98 subjects who were meeting inclusion and exclusion criteria were studied after obtaining informed written consent. Data was collected using prestructured performa and then analysed using SPSS software. Result: 64.3% patients had unilateral headache and 76.5% had frontal area pain. Migraine with aura was present in 40.8% with commonest aura being visual (85%). Most common visual aura was scotoma (47.5%) and the most common associated symptom was photophobia (83.7%) followed by nausea (78.6%). The most common trigger was sun exposure (70.4%) followed by sleep deprivation (69.4%). Severe disability was present in 26.5% of subjects. Severity of migraine showed significant positive association with those who were taking alternative medicine. Migraine severity showed positive correlation with depression, anxiety and stress with correlation coefficient of 0.506, 0.509, and 0.604 respectively. Maximum correlation was with stress which may be considered as an independent risk factor for severe migraine. Conclusion: Anxiety, depression and stress were strongly associated with severe migraine. They can act as factors that trigger and perpetuate migraine, of which stress may be considered as an independent risk factor for severe migraine. Early screening and management of depression, anxiety and stress might provide better control of migraine, thus improving the quality of life of migraineurs.

Clinicoepidemiologic profile of leprosy in geriatric population in post-elimination era: A retrospective, hospital-based, cross-sectional study from Eastern India.

Geriatric populations are susceptible to leprosy infection with masked clinical signs due to lower immunity in them. Our aim was to analyze the clinicoepidemiologic profile of patients with geriatric leprosy and find out the reasons for delayed diagnosis and treatment. A retrospective, record-based study was conducted in a tertiary care center from May 2019 to May 2022. The clinicodemographic data of biopsy-confirmed leprosy cases aged ≥60 years were obtained from the leprosy clinic record. Various reasons for the delay in treatment were also recorded. Simple statistics was used for analysis. Out of 605 leprosy cases, 50 (7.4%) cases belonged to the geriatric population. Males outnumbered females (M/F = 37/13). The mean age of the patients was 66.28 + 6.5 years. Maximum patients belonged to 60-69 years of age. The mean duration of illness was 35.22 months (range 1-240 months). Most of the patients were illiterate (33.6%), and 56% were farmers by occupation. The ulnar nerve was the most common nerve to be thickened in 90% (45/50) cases, followed by the common peroneal nerve in 54% (27/50) cases, radical cutaneous nerve in 52% (26/50) cases, and posterior tibial nerve in 24% (12/50) cases. Borderline tuberculoid was the most common type in 44% cases, followed by lepromatous leprosy in 22%, borderline lepromatous leprosy in 18% (9/50), and pure neuritic leprosy in 14%. Type 1 and type 2 lepra reactions were found in 18% and 14% cases, respectively. Also, 38% had grade 2 disability. Common reasons for the delay in treatment were financial constraints, lack of family support, and personal superstitious beliefs. The study was limited by its retrospective nature. Geriatric leprosy needs special attention as the elderly are more prone for deformities; also, because of low immunity, there is a high chance of developing multibacillary leprosy, and therefore, they are potential sources of infection to the community.