Geetanjali Medical College Research Articles

Comparison of functional outcomes between cemented and uncemented bipolar hemiarthroplasty for intracapsular neck femur fractures

<p class="abstract"><strong>Background:</strong> The neck of femoral fracture is common and leading fracture in orthopaedic practice. The older age group and female are more to prone to develop this fracture.</p><p class="abstract"><strong>Methods:</strong> A prospective, clinical observational, analytical comparative study was undertaken in the department of Orthopaedics of Geetanjali Medical College and Hospital in Udaipur, Rajasthan from January 2018 to June 2019. 52 adult patients with neck of femur fracture, 26 patients in each group. <strong></strong></p><p class="abstract"><strong>Results:</strong> In our study, the mean age was 77.72 years. Female preponderance was seen in our study. In our study mean duration of surgery in uncemented group was 65.78 minutes and mean duration of surgery in cemented group was 79.89 minutes. The mean total HHS in our patient was 86.63 with standard deviation of 6.18. Mean HHS for cemented group was 86 and for uncemented group was 87.23. We found 20 excellent result and 27 good results (35.71% and 51.92% respectively). We also found 5 fair result (12.37%). There were 2 complications, both in cemented group, one had post-operative dislocation and other had a cement reaction.</p><p><strong>Conclusions:</strong> Both cemented and uncemented hemiarthroplasty are equally good options in the treatment of femoral neck fractures in the elderly. However, it is to be noted that the duration of surgery & complications, were both less in the uncemented group as compared to cemented hemiarthroplasty group in our study. </p>

Clinical profile of cervical lymphadenopathy and to find diagnostic efficacy of fine-needle aspiration cytology, ultrasonography and histopathological examination

<p class="abstract"><strong>Background:</strong> Cervical lymphadenopathy is the sign of a disease process which involves lymph nodes that are anomalous in uniformity and dimensions. It is very vital to exercise fine-needle aspiration biopsy, histopathological investigation, and ultrasonography for the diagnosis of palpable lesions.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study of 12-month duration from January 2018 to December 2018 in 61 patients presenting with cervical lymphadenopathy admitted in the ENT Department at Geetanjali Medical College and Hospital, Udaipur. </p><p class="abstract"><strong>Results:</strong> In biopsy, most common diagnosis was chronic granulomatous lymphadenitis i.e. in 62.3% of the patients. As compared to biopsy, fine-needle aspiration cytology (FNAC) showed chronic granulomatous lymphadenitis in 46% of the patients, with overall sensitivity of 91.1%, and specificity of 60.0%. and accuracy of 88.5%. Whereas ultrasonography (USG) reported, 64% cervical lymphadenopathy in patients, with overall sensitivity came out to be 91.1%, specificity to be 40.0%, accuracy was 86.9%.</p><p class="abstract"><strong>Conclusions:</strong> Present study showed that biopsy is the gold standard procedure for diagnosis of cervical lymphadenopathy lesions followed by FNAC, USG. Tuberculous lymphadenitis was most common diagnosis made by the diagnostic modalities.</p>

(1)Geetanjali Medical College and Hospital, Surgical Oncology, Udaipur, India;(2)Geetanjali Medical College and Hospital, Community Medicine, Udaipur, India;

(1)Geetanjali Medical College and Hospital, Surgical Oncology, Udaipur, India;(2)Geetanjali Medical College and Hospital, Community Medicine, Udaipur, India;

Comparision of functional and radiological outcomes in extraarticular fractures distal third tibia treated with intramedullary nailing or plating

Introduction:Tibial fractures are most common long bone fractures, while distal fractures are even more complicated due to its proximity to ankle, and with close relationship with thin soft tissue envelope and severe comminution. Distal tibial extraarticular fractures are a common consequence due to road traffic accidents or other high energy injuries. AIM:To compare functional and radiological outcomes in extra articular distal third tibia fractures, treated with intramedullary nailing or plating. Material and Method:Study comprised of 40 patients of distal tibia fracture without articular involvement, admitted in Geetanjali Medical College and Hospital, Udaipur, Rajasthan. After primary management of fracture stabilisation. patients were randomly selected for surgical fixation either with IMN or MIPPO plating. 20 patients were included from each study group. Result: All the patients treated with either surgical modality were compared for time of fracture union, ROM at ankle joint, early weight bearing, non-union and malunion. ROM at ankle joint was assessed with AOFAS ankle score. The mean fracture union time for IMN was 4.5 month, whereas in plating group it was 6.5 month. Immediate weight bearing was advised for IMN group, while weight bearing was delayed for at least 6 weeks in plating group. AOFAS ankle score for the nailing group was 92.05 (EXCELLENT) while for plating group was 89.10 (GOOD). The difference between two score was found to be significant (p value =0.05). Conclusion: Both the treatment modalities were equally good for treatment of distal tibia extra articular fractures, but IMN was better in terms of early weight bearing, early fracture union with excellent ankle score as compared to MIPPO plating.

Study of Pattern of Histopathological Lesions in Nephrectomy Cases in Southern Rajasthan

Introduction: The kidney is one of the most highly differentiated organs in the body, affected by various disease processes, some resulting in permanent damage leading to surgical removal of the organ i.e., nephrectomy. Patterns of the indications for nephrectomy vary in different age groups, geographical locations and time periods. Nephrectomy is a common procedure in urological practice done for various conditions like calculi, chronic pylelonephritis, malignancy, obstruction, injury etc., with wide range of morbidity and mortality. Aim: The aim of this study was to study the pattern of histopathological lesions in nephrectomy cases in Southern Rajasthan. Materials and Methods: This study was conducted in the Department of Pathology, Geetanjali Medical College and Hospital (GMCH), Udaipur, Rajasthan. It was a cross-sectional study performed on 121 patients, from January 2015 to March 2020 in which patient’s detail such as age, sex, gross and microscopic findings were retrieved and reviewed. Data was tabulated and analysed. Results: A total of 121 specimens of nephrectomy were included in the study. Among 121 nephrectomy cases, higher incidence was observed in 6th and 3rd decade of life with approximately equal preponderance of male and female; 0.98:1. Out of 121 cases 88 (72.7%) were non-neoplastic and 33 (22.27%) were neoplastic. Conclusion: Benign conditions of kidney are the leading cause of End Stage Renal Disease (ESRD) in the developing world. In our country, there are an increased number of ESRD which require dialysis and transplantation. This study has been performed to know the different causes of nephrectomy in a tertiary care center of India.

Pre-directed problem-based learning as tool for teaching clinical problems in first professional MBBS students

Background: In a typical problem-based learning (PBL), the learning objectives are not shared with the learner when the PBL exercise is given to them. This student’s unawareness of predefined objectives might be a significant hindrance in directing the student’s effort in the appropriate direction. Aim and Objective: The present study was designed with an aim to develop and validate a modification in existing PBL in the form of pre-directed PBL (PD-PBL), where the learning objectives and outcomes are shared with the learner at the time of giving the exercise. Materials and Methods: The present study was designed as a prospective observational study in the Department of Physiology of Geetanjali Medical College and Hospital. One hundred forty-three students from 1st-year MBBS participated in the study. A PBL session was planned for a clinical problem of respiratory physiology. The learning objectives and the questions to determine the learning outcome were prepared. Students were given 1-week time for analysis of the problem. At the end of 1 week, a large group presentation and discussion session were planned. The faculty members and a respiratory physician were assigned the task of being observers. Later, students and faculty feedback were taken. Results: Analysis of feedback pointed that PD-PBL session was helpful in understanding the clinical condition with the help of basic physiology. Conclusion: PD-PBL would be helpful in correlating the knowledge of basic subject with the clinical scenario. Further studies are needed to evaluate the effectiveness of PD-PBL sessions in other subjects.

SIGNIFICANCE OF TIP APEX DISTANCE (TAD) IN PROXIMAL FEMORAL NAIL ANTIROTATION (PFNA) II SYSTEM USED IN TRAUMA CASES OF PROXIMAL FEMORAL FRACTURES

Introduction: Proximal femoral fractures of trochanteric region are common orthopaedic trauma in routine practice and the ideal implant for treatment is still not found. After the sliding hip screw and various intramedullary nails having been used for so long, newer implants like PFNA II (Asian version of PFNA) with helical blade are now available. But ideal position of helical blade in femoral head has been in debate till date. For sliding hip screw, concept of maintaining Tip Apex Distance (TAD) less than 25mm is well accepted. So, the purpose of this study is to determine the optimal TAD for PFNA II in trochanteric femoral fractures. Materials and methods:100 cases of proximal femoral fractures of trochanteric region which were treated with PFNA II between August 2015 to July 2019 at Geetanjali Medical College and hospital, Udaipur, Rajasthan, India were included in this study. TAD value and position of helical blade tip in femoral head was correlated with failure of fixation. 60 cases were studied retrospectively and 40 cases prospectively. Results: The mean TAD found in this study was 17.97 mm. The overall fixation failure in this study was 3 out of 100 cases (3%). TAD of more than 25 mm was seen in 7 cases out of which 1 case failed (14.28%). However, only 2 out of 93 cases (2.15%) failed in cases with TAD less than 25 mm. Position of helical blade tip in failed cases was superior-centre in 2 cases, while centre-posterior in 1 case. However, all 60 cases with centre-centre position healed successfully. Failed cases showed implant breakage in 2 cases and fracture collapse in 1 case. Conclusion: This study recommends that maintaining TAD less than 25 mm prevents fixation failure in treating trochanteric femoral fractures with PFNA II. Central position of helical blade tip shows most successful result. Also, helical blade of PFNA II provides better hold in osteoporotic bones. Keywords: trochanteric fractures, TAD (Tip Apex Distance), PFNA II, helical blade

Cross sectional study of sensorineural hearing loss in type 2 diabetes mellitus

<p class="abstract"><strong>Background:</strong> The objective of the study was to evaluate the prevalence of sensorineural hearing loss in type 2 diabetes mellitus and to figure out a relation between age, sex, duration of diabetes and diabetic control.</p><p class="abstract"><strong>Methods:</strong> A cross-sectional study was conducted at Geetanjali Medical College and Hospital for 1.5 years. Patients were known case of diabetes mellitus type 2 without any other systemic illness included in the study. A total of 115 patients were involved in the study and the informed consent was taken. A detailed examination and history related to hearing loss and diabetes status with treatment was elicited. All basic blood investigations were performed on all the patients. All the patients were subjected to pure tone audiometry and impedance audiometry in a sound proof room. </p><p class="abstract"><strong>Results:</strong> The total prevalence of sensorineural hearing loss in the study subjects was found to be 80% with most of them having mild degree of sensorineural deafness. Increase in age, longer duration and uncontrolled diabetes are the factors which had higher risk of developing sensorineural hearing loss in the study subjects.</p><p class="abstract"><strong>Conclusions:</strong> There is a strong association between sensorineural hearing loss and duration of diabetes mellitus-2. The threshold of hearing loss is increased mainly at the higher frequencies with diabetes.</p>

ROLE OF LIPID PROFILE IN OVARIAN CARCINOMA PATIENTS

Background: The term "ovarian cancer" includes several different types of cancer that arise from cells of the ovary, most commonly, tumors arise from the epithelium or lining cells of the ovary. Ovarian cancer risk is positively associated with higher consumption of dietary cholesterol and eggs, and inversely associated with a higher intake of vegetables. High consumption of fats may increase circulating estrogen levels, thus increasing the possibility of cell damage and proliferation that is responsible for cancerous growth.
 Material & Methods: The present study was conducted at Geetanjali Medical College and Hospital, Udaipur (Rajasthan). Total 100 cases (females) attending the obstetrics and gynecology department for some gynecological and other problem were selected for this study between the age of 40-60 years, who were attending cancer centre at GEETANJALI MEDICAL COLLEGE AND HOSPITAL, Udaipur (Rajasthan). 
 GROUP I: - It consisted of healthy females control subjects (n=50) .By routine examination and tests, we ensured that all the subjects were healthy and there were no signs and symptoms or history of ovarian tumor and diseases
 GROUP II: - It consisted of ovarian cancer females subjects (n=50) with a history of ovarian tumor.
 Results: Higher level of cholesterol, LDL, VLDL and low level of HDL are found in ovarian cancer patients.
 Conclusion: The present study we highlights the importance and role of serum lipid profile in diagnosis, prognosis and recurrence of the disease. The study shows that serum level of cholesterol, LDL, VLDL was elevated in patients of ovarian cancer while low level of HDL are found in ovarian cancer patients.
 Key words: lipid profile, ovarian cancer.

HIGH RISK OF OVARIAN CANCER IN RURAL AND NON TRIBAL WOMEN

Abstract
 Background: The term "ovarian cancer" includes several different types of cancer that arise from cells of the ovary, most commonly, tumors arise from the epithelium or lining cells of the ovary. Smoking is an established risk factor for many diseases and is one of the most important public health problems worldwide. Rural areas of the United States have a higher smoking prevalence than urban areas. Chronic stress associated with high income inequality has been hypothesized to increase ovarian cancer risk and other adverse health outcomes.
 Material & methods: The present study was conducted at Geetanjali Medical College and Hospital, Udaipur (Rajasthan). Total 100 cases (females) attending the obstetrics and gynecology department for some gynecological and other problem were selected for this study between the age of 40-60 years, who were attending cancer centre at GEETANJALI MEDICAL COLLEGE AND HOSPITAL, Udaipur (Rajasthan). 
 GROUP I: - It consisted of healthy females control subjects (n=50) .By routine examination and tests, we ensured that all the subjects were healthy and there were no signs and symptoms or history of ovarian tumor and diseases
 GROUP II: - It consisted of ovarian cancer females subjects (n=50) with a history of ovarian tumor.
 Results: high risk of ovarian cancer occurs in female who lives in rural area and takes alcohol
 Conclusion: The present study we highlights the diagnosis, prognosis and recurrence of the role of smoking and alcohol in rural area womes so they need to aware for the same.
 Key words: Ovarian cancer, smoking, alcohol, rural area.

A Prospective, Randomized, Controlled Study For Efficacy of Phenytoin Sodium Powder, Eusol Solution, Nanocrystalline Silver Gel in Diabetic Foot Ulcer

Background Diabetic foot is one of the most significant and devastating complications of diabetes. Not all foot complications can be prevented, but it is possible to dramatically reduce their incidence through appropriate management and prevention. Various dressings are available that fulfils a number of functions like cosmesis, haemostasis, protection, support and absorption. Objectives To study and compare the efficacy of different topical agents like phenytoin sodium powder, eusol solution, nanocrystalline silver gel in patient with diabetic foot ulcer by recording the mean ulcer size pre-treatment, during the course of treatment (1 week, 2 week, 3 week and 4 week follow up) and post- treatment and mean percentage of the wound size healing after treatment. Material & Method This prospective study was conducted in the Department of General Surgery, Geetanjali Medical College & Hospital, affiliated to Geetanjali University from January 2017 to June 2018. 90 patients with diabetic foot ulcers without any other co-morbid conditions and ulcers belonging to Grade I & II as per Wagner diabetic foot ulcers classification were compared with the efficacy of different topical agents. Results Out of 90 patients, there was a highly significant reduction in the mean ulcer size after 2 week, 3 week and 4 week follow up in nanocrystalline silver gel group (p<0.05) as compared to the phenytoin sodium powder and eusol solution group and the formation of granulation tissue was higher in nanocrystalline silver gel group (90%) as compared to phenytoin sodium powder (80%) and eusol solution (73.33%). Conclusion Dressings done with nanocrystalline silver gel was found to be more efficacious than the other topical agents in patients with diabetic foot ulcers in terms of increased rate of wound healing, greater reduction in the mean ulcer size after treatment, absence of pain, swelling and type of discharge after treatment, greater incidence of formation of granulation tissue and less duration of antibiotic therapy and hospital stay.

Status of Interlukin-6 and lipid profile in depression disorder

Introduction: Present study was conducted to evaluate the role of interlukin-6 and lipid profile in patients of depression. Materials and Methods: A case-control study consisted of 100 patients and 50 controls, who were attending psychiatric O.P.D in Geetanjali medical college & hospital, Udaipur Rajasthan. Inclusion criteria-depressive subjects those attending psychiatric O.P.D of Geetanjali hospital (20-60yrs). Exclusion criteria- patients undergoing treatment of any other hypertension, diabetes, cardiovascular disorders documented by physical & clinical examination. Level of IL-6 and lipid profile was measured in serum. Analysis was done using SPSS version 16.0 at significant level of 95% confidence level and p-value ?0.005. Results: The mean total cholesterol level in depression patients was 136.08±24.08, mean HDL-c was 41.97±16.50, mean LDL-c was 109.33±21.06, mean triglycerides level was 134.28±16.02 and mean interlukin-6 level was 4.19±1.33. The mean total cholesterol level in controls was 182.3±35.76, mean HDL-c was 51.3±13.08, mean LDL-c was 121.9±25.69, mean triglycerides level was 154.7±24.45 and mean interlukin-6 level was 2.02±0.43. We found that there is a significant negative correlation between interlukin-6, total cholesterol (-0.730) and triglycerides (-0.896). There is significant positive correlation between interlukin-6 and LDL-c (0.977). Conclusion: Depression is undoubtedly a multidimensional disorder. IL-6 exerts a multilayered effect on determinants of behavior, and understanding the role of IL-6 in the pathophysiology of depression may facilitate the elucidation of its effect on alterations in lipid metabolism. Keywords: Cholesterol, Depression, HDL, Interlukin-6, LDL, Triglycerides.

A Prospective, Randomized, Controlled Study For Efficacy of Phenytoin Sodium Powder, Eusol Solution, Nanocrystalline Silver Gel in Diabetic Foot Ulcer

Background Diabetic foot is one of the most significant and devastating complications of diabetes. Not all foot complications can be prevented, but it is possible to dramatically reduce their incidence through appropriate management and prevention. Various dressings are available that fulfils a number of functions like cosmesis, haemostasis, protection, support and absorption. Objectives To study and compare the efficacy of different topical agents like phenytoin sodium powder, eusol solution, nanocrystalline silver gel in patient with diabetic foot ulcer by recording the mean ulcer size pre-treatment, during the course of treatment (1 week, 2 week, 3 week and 4 week follow up) and post- treatment and mean percentage of the wound size healing after treatment. Material & Method This prospective study was conducted in the Department of General Surgery, Geetanjali Medical College & Hospital, affiliated to Geetanjali University from January 2017 to June 2018. 90 patients with diabetic foot ulcers without any other co-morbid conditions and ulcers belonging to Grade I & II as per Wagner diabetic foot ulcers classification were compared with the efficacy of different topical agents. Results Out of 90 patients, there was a highly significant reduction in the mean ulcer size after 2 week, 3 week and 4 week follow up in nanocrystalline silver gel group (p<0.05) as compared to the phenytoin sodium powder and eusol solution group and the formation of granulation tissue was higher in nanocrystalline silver gel group (90%) as compared to phenytoin sodium powder (80%) and eusol solution (73.33%). Conclusion Dressings done with nanocrystalline silver gel was found to be more efficacious than the other topical agents in patients with diabetic foot ulcers in terms of increased rate of wound healing, greater reduction in the mean ulcer size after treatment, absence of pain, swelling and type of discharge after treatment, greater incidence of formation of granulation tissue and less duration of antibiotic therapy and hospital stay.

Interlay versus underlay type 1 tympanoplasty: a comparative study of the techniques in 100 cases

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Type 1 tympanoplasty is a surgical technique used to restore the integrity of tympanic membrane as well as to improve hearing level in patients with large central perforations (inactive mucosal chronic otitis media).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This is a randomized prospective study of 12 month duration from January 2017 to December 2017 in 100 patients of chronic otitis media inactive mucosal type with large central perforation admitted in the E.N.T department at Geetanjali Medical College and Hospital, Udaipur. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The graft uptake rate in the present study was found to be 96% and 90% respectively in interlay and underlay techniques. Post operatively after 12 weeks mean air bone gap was maximum reduced in Interlay tympanoplasty.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The present study showed that Interlay technique had a better graft take rate as well as hearing improvement in large central perforation of chronic otitis media than the underlay technique.&lt;/p&gt;

Assessment of effectiveness of delayed cord clamping and umbilical cord milking in early term and preterm infants

Background: Early cord clamping and cutting of the umbilical cord is widely practiced as part of the management of labor; it could deprive the neonate of about a quarter of its blood volume and iron. This thesis is aimed at comparing effects of delayed cord clamping versus umbilical cord milking at birth in preterm and early term infants.Methods: This single centered randomized study was conducted in Department of Pediatrics and data collection was done on the basis of the preterm and early term infants delivered by vaginal or cesarean delivery in Department of Gynecology, Geetanjali Medical College and Hospital, Udaipur during period of January 2016 to January 2017. Total of 120 infants were included in the study.Results: Statistically it has been analyzed that in both pre-term and early term infants who underwent DDC and UCM, there was insignificant difference in level of hemoglobin (Hb), haematocrit (HCT), blood sugar, bilirubin level (TSB) and temperature of body. On the other hand, significant difference was observed in weight and cord pH of neonates of both groups. There is also insignificant difference in terms of NICU admission for RDS, sepsis, phototherapy, need of oxygen, saline boluses, PRBC transfusion, polycythemia.Conclusions: Thus, overall it was observed that there is insignificant difference in delayed cord clamping and umbilical cord milking group. Thus, both are found to be equally effective in improving hematologic parameters.

Intrapartum oropharyngeal and nasopharyngeal suctioning in neonates born through meconium-stained amniotic fluid: Indian scenario

Background: Meconium aspiration syndrome (MAS) is a life-threatening respiratory disorder in infants born through meconium-stained amniotic fluid (MSAF). Although anecdotal data concerning the efficacy of intrapartum oropharyngeal and nasopharyngeal suctioning of MSAF are conflicting, the procedure is widely used. We aimed to assess the effectiveness of intrapartum suctioning for the prevention of MAS.Methods: A prospective quasi randomized control trial, assessor blind, single centre study was done at Department of neonatology, Geetanjali Medical College and Hospital, Udaipur, Rajasthan. Patients were enrolled over a total period of 16 months started from January 2016 to April 2017. 312 patients with MSAF of any consistency, gestational age at least 37 weeks, and cephalic presentation were randomly assigned to suctioning of the oropharynx and nasopharynx (including the hypopharynx) before delivery of the shoulders (n=127), or no suctioning before delivery (n=185). Postnatal delivery-room management followed Neonatal Resuscitation Program guidelines. The primary outcome was incidence of MAS. Clinicians diagnosing the syndrome and designating other study outcomes were masked to group assignment. An informed consent waiver was used.Results: No significant difference between treatment groups was seen in the incidence of MAS [36 (26.7%) suction versus 36 (19.5%) no suction; p = 0.167], mortality in suction [5 (3.91%) versus no suction 5 (2.74%); p = 0.779], or in the duration of ventilation, oxygen treatment, and hospital care. There was statistically significant difference in need for mechanical ventilation for MAS [13 (10.23%) vs 4 (2.2%); p = 0.005], any respiratory support for MAS 25 (19.7%) suction versus 18 (9.7) p = 0.019).Conclusions: Routine intrapartum suctioning of infants born through MSAF does not reduce the incidence of MAS. On the contrary, intrapartum suctioning might result in complications like more infant required neonatal resuscitation and respiratory support.

A Prospective Study on Bacterial Isolation from Diabetic Foot Ulcer in Department of Surgery

Background: There are various wound classification systems to assess the severity of diabetic foot ulcer and involve different factors specifically depth, site, presence of neuropathy, ischemia etc. Wagner’s system classification is the most widely used in grading of diabetic foot ulcers. Methods: The case study was carried out in the Department of Surgery, Geetanjali Medical College and Hospital, Udaipur. Results: 173 cases were enrolled in study and grade-3 Wagner’s ulcers were predominant. Males were predominant. Peripheral arterial disease was more common than peripheral neuropathy and both were found significantly associated with development of ulcers. Methicillin resistant Staphylococcus aureus and Klebsiella pneumoniae were most common isolates. MRSA exhibited maximum sensitivity to vancomycin, clindamycin and linezolid. Gram negative isolates exhibited maximum sensitivity to meropenems, piperacillin-tazobactam. Conclusions: This study conclude that prospective multicenter studies are required to assess the appropriate antibiotic regimen in diabetic foot ulcers and proper management of antibiotics must be started to decrease the incidence and development of MDR organisms.

Prevalence and clinical profile of celiac disease among malnourished children in South Rajasthan, India

Background: Celiac disease (CD) is the most common genetically related food intolerance, worldwide. The objective of this study was to study the prevalence and clinical profile of malnourished children.Methods: It was a prospective and observational study. The present study was conducted in the Department of Paediatrics, Geetanjali Medical College and Hospital, Udaipur, Rajasthan. Two hundred and one children were studied. All malnourished children were initially selected and those fulfilling inclusion criteria were included in the study. A detailed interview of all the children/parents was conducted regarding symptoms commonly associated with celiac disease. All cases found positive for t-TGA (&gt;10au/ml) were subjected to upper GI Endoscopy. Subjects were labelled as celiac disease if tissue trans-glutaminase IgA antibodies were &gt;10 au/ml and histopathology was suggestive. Statistical analysis was done by one way ANOVA test and Chi-square as per requirements also Fisher exact and Man Whitney were applied.Results: Celiac disease was present in 23.9% of malnourished patients. Most common presenting symptoms were diarrhoea (40.2%), abdominal distension (39.9%) and abdominal pain (36.8%) and most common clinical sign was pallor, which was present in more than three-fourth of the patients (85.9%) followed by multivitamin deficiency (25.4%).Conclusions: There is a high prevalence of Celiac disease in malnourished children. Screening for Celiac disease (especially in presence of diarrhoea and abdominal distension, pain abdomen) should be an essential part of work-up in all malnourished children.

Assessment of knowledge, attitudes and practices toward prevention of hepatitis B virus infection among medical students in Geetanjali Medical College, Udaipur

Background: Hepatitis B virus (HBV) infection is one of the major public health problems in the world. According to the recent estimates, about one-third of the world population is infected with HBV. Health care workers (HCWs) are at high risk of HBV infection in the health care settings. The prevalence rate of HBV in HCWs is about 2–10 times higher than the general populations in the world.Methods: A cross sectional study was conducted at GMCH, Udaipur from March 2017 to August 2017 on a pretested, precoded and prestructured self administered questionnaire included sections on knowledge, attitude, and practice toward hepatitis B after having oral/ written consent among 200 medical Students.Results: There were 144 (72.0%) males and 56 (28.0%) females participated as study subjects, more than 80.00% of the study subjects knew about the causative agent, vertical transmission, and vaccine prevention and after effects of HBV infection, 151 (75.50%) agreed for health education for STD’s in the schools, 42 (21.00%) of the study subjects had experienced the needle stuck injury.Conclusions: Although more than 80% students had scientific knowledge about HBV but still there are gaps in the knowledge of Medical Students about Hepatits B infection. Sensitization of the medical students to the various aspects of disease through an active health education programme is crucial to control the spread of Hepatitis B.

FNAC - A Diagnostic Tool in Cervical Node Enlargement in a Tertiary Care Hospital

Background: Cervical lymphadenopathy is relatively common clinical observation. Cervical lymphadenopathy is a diagnostic dilemma to the surgeon. The various avenues available for the analysis of cervical node enlargement are clinical evaluation, aspiration cytology, and open biopsy. Aim: To study the role of the FNAC in diagnosis of cervical node enlargement after correlating with a lymph node biopsy. Methods: This prospective observational study was conducted in Department of Surgery, Geetanjali Medical College and Hospital, Udaipur. All the patients aged more than 15 years presented with neck swelling were enrolled. Detailed history will be taken followed by physical examination in all the patient with cervical lymphadenopathy. Results: Majority of the cases in this study had non-neoplastic causes for cervical lymphadenopathy in which tuberculosis is most common. Male to female ratio of 1.3:1. Maximum incidence was found to be tuberculosis. Maximum number of cases was in the age group of 21 to 30 years. The diagnostic accuracy of FNAC for tuberculous lymphadenopathy is 91.66%. The diagnostic accuracy of FNAC for nonspecific lymphadenitis was 87.50%. For secondary’s neck and lymphoma were 100%, 100% respectively. Conclusions: FNAC is a simple and safe procedure, which can be employed on outpatient basis. FNAC is found to be a frontline investigation of choice with biopsy and histopathological examination done for confirmation.