Government Medical College Jammu Research Articles

ROLE OF BIOCHEMICAL MARKERS AMONG COVID-19 PATIENTS AND THEIR ASSOCIATION WITH SEVERITY OF DISEASE

Objectives: The present study was aimed to evaluate the levels of biomarkers (D-dimer, Procalcitonin [PCT], lactate dehydrogenase [LDH], interleukin [IL]-6, and C-reactive protein [CRP]) among coronavirus disease 2019 (COVID-19) patients visiting/admitted in Government Medical College Jammu and analyze their association with the severity of disease. Methods: The study was conducted on 100 COVID-19-positive patients 18–75 years of age of either sex, visiting/admitted in Government Medical College Jammu, for a period of 6 months. The serum glucose levels, creatine phosphokinase, LDH, liver function tests, renal function tests, and various biochemical COVID-19 markers such as CRP, serum ferritin, IL-6, D-dimer, and PCT were analyzed. Results: In the present study, it was observed that when patients were divided according to the severity of disease, there was a significant difference in the mean levels of total bilirubin, serum sodium, serum potassium, D-dimer, SpO2, and duration of symptoms in a mild and severe group of patients, while there was no significant difference in the parameters such as IL-6, ferritin, CRP, PCT, LDH, and other routine biochemistry parameters. When a comparison was done between both the groups according to SpO2, only the mean levels of serum total bilirubin were significant. Conclusion: Thus, it is concluded that serum bilirubin was significantly elevated in mild, moderate, and severe groups of patients. Further research should be conducted to find some biomarkers which are specific to COVID-19 only.

Sleep quality among medical students during third wave of COVID-19 pandemic: A cross-sectional study in Government Medical College Jammu

Background: COVID-19 has caused lot of suffering for everyone. Hundreds of thousands of people were affected in all aspects. Increased stress due to the pandemic may affect medical students' sleep quality. The authors aimed to evaluate the sleep quality of medical students during pandemic and relationship, if any, between sleep quality and and socio-demographic variables. Methods: An online survey of medical students was conducted in January 2022, when India was in third wave of pandemic. This cross-sectional study was conducted using the Pittsburgh Sleep Quality Index (PSQI) questionnaire at a tertiary teaching hospital in Jammu, UT, J&K, India. Results: Among 307 participants, mean global PSQI score was 9.91± 3.62 which indicated a poor quality of sleep. Among the component scores, habitual sleep efficiency had the highest score of 2.99± 0.16. Majority (91.53%) of the respondents had a poor sleep quality with global PSQI score >5. Among the socio-demographic variables, alcohol intake and any conflict in the family were found to be statistically significant (p<0.05). Conclusion: Nine out of ten medical students have insufficient sleep, which is a real cause for concern. The authors recommend that stress management (anxiety), lifestyle changes, and sleep training be included in the medical record and updated regularly.

Assessment of Dependency in Activities of Daily Living (ADL) and its Predictors: A Cross-Sectional Study among the Elderly Rural Population in a Sub-Himalayan UT of India.

With an increase in life expectancy over the last few decades, there has been a parallel increase in the prevalence of disabilities among the elderly population. To estimate the prevalence of dependency in activities of daily living (ADL) and its predictors among the rural elderly population. This was a cross-sectional study carried out in the community among the rural geriatric population in the field practice area of PG Department of Community Medicine, Government Medical College Jammu. The Barthel Scale Index was used to measure ADL dependency. PSPP software was used to analyze the data. The mean age of study participants was 68.31 ± 7.9 years. ADL dependency was observed in 46.3% of the subjects, with the majority demonstrating mild to moderate dependence. Only 2.5% of the respondents reported a severe degree of ADL dependence. The mean ADL score was 94.47 ± 8.98. On multivariate logistic regression analysis, age, educational status, the presence of stress in the family, personal history, and the presence of co-morbidities emerged to be independent predictors of ADL dependence. High prevalence of physical disability in the geriatric population is now an area of major concern. This emphasizes the significance of setting up geriatric care centers especially in rural areas preferably integrating with health and wellness centers.

Role of vaginal microbiota in idiopathic infertility: a prospective study

ObjectiveThe causes of idiopathic infertility are still not known; however, it may be associated with microbial etiologies. The present study examines the vaginal microbiota of infertile as well as fertile women longitudinally. MethodologyThe study was presented and accepted by the Institutional Ethical Committee of Shri Mata Vaishno Devi University, Katra, Jammu and Kashmir (India). An observational, prospective, multicenteric investigation was conducted at the Department of Obstetrics and Gynecology, Government Medical College Jammu, and its affiliated hospitals in Jammu and Kashmir (India). In order to examine the microbial composition, a cohort of 80 female individuals were involved in the screening process. The investigation involved sequencing of the V3–V4 region of 16S rRNA gene, which was subsequently analyzed using the Mothur pipeline. ResultsThe study revealed that the vaginal microbiota of infertile women differed from that of healthy women who had previously given birth without any complications. Both populations have variations in their alpha as well as beta diversity and taxonomical composition. The microbial profiles in the cases of infertility are characterized by elevated levels of Gardnerella, Prevotella, Atopobium, and Enterococcus whereas a higher level of Lactobacillus iners was observed in case of fertile women. ConclusionIn conclusion, it can be inferred that the composition of the vaginal microbiome potentially exerts a significant influence on females afflicted with idiopathic infertility.

Psychiatric morbidities among patients with type-2 diabetes mellitus attending outpatient department in a rural area of North India.

Both diabetes mellitus and psychiatric morbidities are widely prevalent diseases which show a discerning upward trend globally. Coexistence of diabetes and psychiatric morbidities usually manifests as impaired quality of life and poor treatment adherence. The study aimed to estimate the prevalence of psychiatric morbidities among rural diabetic patients and to determine their association with different variables. The present cross-sectional study was conducted in CHC of Rural Health Block attached with PG Department of Community Medicine GMC (Government Medical College) Jammu. The eligible diabetic patients attending medical outpatient department services were enrolled using a consecutive sampling method. DAS scale was used to assess psychiatric morbidity among the study subjects. The findings revealed that the prevalence of psychiatric morbidity in the study participants was 38.9%, 68.5% and 25.64% for depression, anxiety and stress, respectively. Psychiatric morbidities were slightly higher in female patients and were significantly associated with age, marital status, sedentary lifestyle, history of substance abuse, duration of diabetes, presence of complications and underlying morbidities (P < 0.05). The prevalence of anxiety and depression among rural diabetic patients was found to be quite high. Diabetic patients need thorough screening for psychiatric evaluation, and there is an urgent need for psychiatric counselling at regular intervals.

EFFECT OF NALBUPHINE AND TRAMADOL IN POST-SPINAL ANAESTHESIA SHIVERING: A COMPARATIVE STUDY

Background: In Spinal anaesthesia, a consequence of impaired thermoregulatory control, shivering is one of the most frequently reported complications of central neuraxial blockade, affecting 40–70% of patients. Nalbuphine is a mixed opioid agonist–antagonist with high afnity for the opioid receptor that functions as both a competitive opioid antagonist and a partial opioid agonist. Theoretically, nalbuphine could have signicant anti-shivering effects on post-anaesthetic shivering. This prospecti Methods: ve randomised (computer-generated) double-blinded study was conducted at Department of Anaesthesiology and Intensive Care, Government Medical College Jammu J&amp;K, after obtaining approval from hospital ethical committee. Randomisation was done using a computer-generated number where patients were randomly allocated into two groups: Group-N and Group-T. We conned our investigation to 84 patients divided into two equal groups of 42 people. The non- Results: signicant difference was observed in age, gender, BMI, ASA physical status, duration of surgery, and duration of spinal anesthesia between the groups. The drug was found to signicantly reduce SBP, increase DBP, and increase MAP in the group given the drug compared to the nalbuphine group. The time taken to control shivering was signicantly shorter in the group-T. The group-T also had a lower Ramsay Sedation Scale score, indicating less sedation compared to the group-N group. The drug did not cause any adverse effects, while sedation, hypotension, and bradycardia were observed in the group-N. Nausea, vomiting, and dizziness were reported in the group-T, but not in the group-N. There was no signicant difference in the effectiveness of shivering control between the two groups. Both i Conclusion: ntravenous nalbuphine 0.05 mg/kg and tramadol 1 mg/kg are effective in managing post-spinal anesthesia shivering. However, tramadol had a shorter time to control shivering than nalbuphine. Both drugs had minimal effects on blood pressure and heart rate, and the side effects observed were minor and treatable

Incidence of Rhomboid Impression in the Adult Human Clavicles

Background and Aims: The attachment of the ligament on the inferior surface of medial two third of clavicle produce various patterns like tubercles, grooves etc. called as the rhomboid impression. This impression although a normal morphological variant may be misdiagnosed as pathological lesion like necrosis, tumour in radiological images besides this, the study of rhomboid impression is very scanty in North Indian population. So a curious desire has developed to conduct this study. Material and methods: The present cross-sectional descriptive study was done on dried specimens of adult human clavicles (60) obtained from the department of Government medical college Jammu. This study was done over a period of one year. The morphology of the clavicles was studied, and various types of rhomboid impression were observed. Results: The various patterns of rhomboid impressions found in our study were flat and rough, flat and smooth, depressed and rough, depressed and smooth, elevated and rough and elevated and smooth. Conclusions: The results of present study concluded that the impression on the inferior surface of medial two third of clavicle i.e. Rhomboid impression was present in all clavicle bones. The predominant type of rhomboid impression on both sides was type1 (flat and rough). Keywords: Clavicle, costoclavicular ligament, rhomboid impression

Limb Loss: Facts and Statistics – Diabetes Mellitus and Vascular Insufficiency, a Real Harbinger of Major Limb Amputations – A Cross-sectional Study among Amputees Reporting to a Tertiary Care Center

Abstract Background: Limb loss to amputation is a major problem, especially in developing countries where the majority of the cases are preventable. It is a burden, not just for the patient but also for their caregivers. Today, when amputation is necessary, surgery is undertaken with consideration for the functional aspects of the residual limb. The purpose of this study was to describe the etiology and characteristics of major limb amputees at a tertiary care center in North India. Methods: This prospective observational study was conducted by the Government Medical College Jammu, for 2 years. Eighty-one patients underwent major limb amputations in our hospital during the study. In this study, we studied several variables including age, sex, side of the limb, level of the amputation, and etiology. Results: In this study, dysvascular disease was the major reason of amputation, diabetes mellitus being the most common cause (39.5%), followed by trauma, with a male preponderance, with peaking at the age of 51–70 years. Lower limb is the most common with the predominance of transtibial amputation. Younger individuals who underwent amputation were mostly due to the trauma. The most common postoperative complication was surgical site infection (21%) and the most common organism cultured from the wound was Pseudomonas (50%). The most common additional procedure done was wound debridement. The mortality rate was 10% and the mean duration of hospital stay was 23 days. Conclusion: In contrast to declining rates of trauma-related and cancer-related amputations, we found evidence of a significant increase in the incidence of amputations due to diabetic foot syndrome. Overall, the risk of amputations increased with age. This was true for all etiologies and for both sexes. Males with an average age of 50 years are generally at higher risk for limb loss than women.

AN ANALYSIS OF RISK FACTORS ASSOCIATED WITH LIVER ABSCESS

Introduction:Liver abscess is a common clinical entity and a significant health concern frequently encountered in the daily emergency admissions in Indian hospitals. Despite the introduction of minimally invasive techniques in its management, liver abscesses still contribute to the significant morbidity in the affected patients. We performed this study to analyze the role of various risk factors contributing to the development of liver abscess in the present world. Materials and Methods: The study was a hospital based descriptive, Cohort study performed in Government Medical College Jammu. All patients with ultrasonography or Computed tomography documented liver abscess presenting to the out patient department of Govt. Medical College Jammu were included in the study. The patients were admitted and were evaluated for the presence of various risk factors related to the disease with a particular focus on Alcohol intake, Diabetes, Age, Intravenous drug abuse and smoking. Results Observations: In a total of 100 patients included in our study, 93 were males and 7 were females.75 out of 100 patients with liver abscess were alcoholic and all were males in our study. While 54 patients in our study were diabetic we noticed that about 29 patients had poorly controlled diabetes with HbA1c &gt; 7 and 17 had HbA1c between 6-7. Only one patient had HbA1c &lt;6 in our study but he was a chronic Alcoholic. 47 patients in our study were Alcoholic with diabetes and most of these patients had HbA1c values between 6-8. 61.7% of such patients had HbA1c between 7-8 while as 36.2% had values between 6-7. 6 patients in our study had history of IV drug abuse and all were alcoholic also. 9 patients in our study who presented with more toxic symptoms had viral hepatitis. Conclusion: we concluded that though diabetes with poorly controlled blood sugar is a significant risk factor for the development of liver abscess. The significant burden of the disease in the community is due to synergistic effect of alcoholism and diabetes in individuals. We suggest that all alcoholic patients with diabetes should have a strict regulation of their blood sugar done with 4 monthly HbA1c levels not allowed shoot beyond 6 U/dl.

Prevalence and clinic hematological profile of vitamin B12 deficiency associated megaloblastic anemia in children of Jammu region - A hospital based observational study

: Vitamin B12 deficiency (VBD) Megaloblastic Anemia (MA) is a relatively common disease encountered by pediatricians in Jammu region of north India, yet the data on prevalence of VBD in this age group remains scarce. Hence this study was conducted to study the prevalence and clinic hematological profile of VBD associated MA in children between 6 months to 18 years of age. To estimate the prevalence and clinico hematological profile of vitamin B12 deficiency associated MA in children between 6 months to 18 years, who were admitted in SMGS Hospital, Government Medical College Jammu. A Retrospective cross sectional study was conducted in children between 6 months to 18 years, who were admitted in SMGS Hospital, Government Medical College Jammu with diagnosis of Nutritional Anemia from April 2020 - March 2021.Case records of patients were reviewed for vitamin B12 deficiency as a cause of MA who were included in study. Vitamin B12 deficiency was diagnosed by measuring B12 levels in blood and by bone marrow examination if required. Clinic hematological profile of the participants was observed by reviewing their records for age, sex, socioeconomic status, food habits, presenting complaints, clinical signs and symptoms, peripheral smear findings and need for transfusion. All descriptive data collected was represented by tables and evaluated for statistical outcomes. The prevalence of vit. B12 deficiency associated MA in our study is 16.66 %. Among them 60% were females and 40% males. Age wise distribution was 6months -1 year 20 %, 1-5 years 22%, 6-10years 16% and 11-18 years was 42%. Vitamin B12 deficiency was more prevalent in lower socioeconomic group 80% and in those who were vegetarians 60%. Anorexia, generalised weakness, pallor was observed in 100% subjects. Neurologic involvement in the form of irritability, tremors was present in 30%. Icterus was seen in 10% while hepatomegaly and splenomegaly was present in 20 % and 22% respectively. Edema was seen in 2% of the subjects. Hyperpigmentation of knuckles was observed in 86% of the patients. Macrocytic anemia (MCV &amp;#62;100 ug/L) was observed in 100%. Bicytopenia was seen in 80% while Pancytopenia was present in 20%. Among 150 cases of Megaloblastic Anemia 80% of the patients were diagnosed by Vitamin B12 essay, 20% were diagnosed by Bone marrow examination. Blood transfusion secondary to severe anemia was required in about 10%. Vitamin B12 deficiency is not that uncommon in our population with prevalence of 16.66% in hospitalized children. However true prevalence can only be estimated by population based surveys in pediatric age group. The most common presenting complaint in Megaloblastic Anemia is anorexia, generalised weakness, irritability manifesting clinically as pallor, hyperpigmentation of knuckles and hematologically as macrocytic anemia with 80% bicytopenia and 20% pancytopenia. Thus vitamin B12 addition in anaemia control and prophylaxis programmes may be considered.

Biomedical waste management: assessment in health facility of a tertiary care teaching hospital in Jammu, union territori of Jammu and Kashmir, India

Background: Biomedical waste (BMW) management has, of late, emerged as an important health as well as environmental concern. It is imperative upon all the health facilities, irrespective of their size and number of patients catered, to ensure appropriate BMW management at all levels starting from its generation to its final disposal. The study intended to assess the management of BMW generated in one health facility of a tertiary care teaching hospital.Methods: The present cross-sectional study was conducted w.e.f. 1st January 2020 to 30th June 2020. The BMW generated in the Shri Maharaja Gulab Singh (SMGS) hospital-a health facility of government medical college (GMC) Jammu was collected at a designated place after its segregation. Then it was weighed before its transportation and final disposal. The BMW was weighed to generate monthly rates which were then converted to daily rates. Finally, BMW generation per bed per day was calculated.Results: It was found that BMW generated per bed per day was 0.197 kg. Infectious waste comprised 15% of the total whereas non-infectious component was 85%. The color-coded bags collection rate per day was 48.8 kg, 28.4 kg, 17.02 kg and 7.75 kg for yellow, red, blue and white containers, respectively.Conclusions: The authors found that the health facility was adhering to guidelines of BMW management. The need for continuous education and awareness promotion about BMW management among sanitation workers, nurses, technicians and doctors cannot be underestimated.

Microbiological surveillance of hospital environment in tertiary care hospital in north India

Background: Hospital acquired infection (nosocomial infection) are commonly occurring in developing as well as developed countries almost 50% of patients in developed countries and 75% in developing countries get infected inside the hospital to which they are not exposed earlier. The problem occurring in treatment to these patients is the resistance to certain antibiotics among these bacteria.Methods: A swab soaked in nutrient broth was used to collect samples from the floor, walls, equipments, instruments, operation tables, etc. All the samples were labelled properly and immediately transported to the microbiology laboratory in Government medical college Jammu for processing.Results: Out of 29 air samples positive is 9 and the percent is 31.0 swabs are 92. Out of 92 samples positive is 28 and the percent is 30.43. Out of 29 samples 3 samples are taken from orthopaedic OT there is no growth. 3 samples are taken from gynaecology OT no growth. 4 samples are taken from urology theatre 2 are Staphylococcus aureus and the percent is 50. 2 samples are taken from eye OT there is no growth.Conclusions: These findings demonstrate that the microbiological quality of air and surfaces in operation theatre may be considered a mirror image of the hygienic conditions of the operating theatre.

Prevalence of Metabolic Syndrome and its Association with Hypertension and Diabetes: An Observational Study on Women Police Personnel of Jammu

Background: Metabolic syndrome is comprised of endocrine metabolic disturbances characterized by Type-2 Diabetes Mellitus due to insulin resistance and impaired glucose regulation, hypertension, obesity and altered lipid profile consisting of elevated levels of triglyceride (TG) and low levels of high-density lipoprotein cholesterol [HDL-C]. In this present study, we aimed to explicitly evaluate the prevalence of MetS and its association with diabetes and hypertension among J&amp;K women police personnel. Materials and Methods: The present study was conducted to find the prevalence of metabolic syndrome as per hypertension and diabetes among female police personnel of J&amp;K Police. It was carried out in Post Graduate Department of Physiology, Government Medical College Jammu from 2019 to 2020. A total of 101 female subjects from female battalion of J&amp;K Police were included in the study as per the laid down inclusion and exclusion criteria. These subjects were actively involved in law and order duties. The study was under taken after approval by the institutional Ethical committee. Results: Systolic hypertension is one of the parameters found to have highly significant association with metabolic syndrome with p-value &lt;0.001. Around 21 out of total 101 were found to have systolic hypertension. Among these 11 were having metabolic syndrome. A total of 12 subjects were found to have diastolic hypertension, with 6 having metabolic syndrome. Evidently, we also found a significant association of diastolic blood pressure with metabolic syndrome but BSF was insignificantly associated with MetS. Conclusion: The present study demonstrated that the prevalence of metabolic syndrome among study subjects was around 20% and the most prevalent age group was (41-45) year. Although the prevalence of metabolic with diabetes was 60% but the association was insignificant. Although the prevalence of metabolic with diabetes was 60% but the association was insignificant. However, both systolic and diastolic blood pressures were significantly associated with MetS. Keywords: Metabolic syndrome, SBP, DBP, BSF.

Role of Lipid Parameters among Women Police Personnel of Jammu: A Comparative Observational Study among Subjects with Metabolic Syndrome and Without Metabolic Syndrome

Background: There are few studies that have explicitly studied the role of lipid parameters in developing MetS. In this present study, we will find out the prevalence of patients with respect to abnormal lipid parameters among study subjects and then a possible association between lipid parameters and metabolic syndrome will be evaluated. Materials and methods: The present study was conducted to find the prevalence of metabolic syndrome as per lipid parameters among female police personnel of J&amp;K Police. It was carried out in Post Graduate Department of Physiology, Government Medical College Jammu from 2019 to 2020. Results: We observe that from a total of 17 subjects with TG ≥150mg/dl, 10 subjects had MetS and out of 84 subjects with TG &lt;150mg/dl, only 10 subjects were found to have MetS. We observe that out of total 20 subjects with MetS, 10 subjects were having triglycerides levels more than 150 mg/dl and 10 were having levels less than 150mg/dl. Clearly, there is a high significant association between MetS and triglycerides (p-value&lt;0.001). We observe that out of 67 subjects with HDL&lt;50, 18 subjects were found to have MetS and out of 34 subjects with HDL ≥50, only 2 had MetS. We observe that 18 subjects out of total 20 with metabolic syndrome had HDL cholesterol levels less than 50 mg/dl. Conclusion: The present study revealed that the prevalence of MetS is higher among patients with low HDL-C and high triglyceride levels. Therefore, primarily evaluation of lipid parameters may help health care providers to identify and recognize patients who are at high risk of developing MetS. Keywords: Metabolic syndrome, Lipid parameters, HDL-C, TG.

A Comprehensive Comparative Study among Jammu Women Police Personnel between the Subjects with Metabolic Syndrome and without Metabolic Syndrome on the Basis of Demographic, Anthropometric and Clinical Parameters

Background: Police officers are civil servants meant for peace preservation, citizen protection, and promotion of violence reduction. Pre-employment examination of police officers includes intellectual, cognitive and personality assessment, physical examination, laboratory tests and social evaluation. In this study, we will compare subjects with MetS and without MetS among female police personnel on the basis of demographic parameters, anthropometric parameters and clinical parameters related to dyslipidemia, hypertension and overweight/ obesity. Materials and methods: The present study was conducted to find the prevalence of metabolic syndrome as per lipid parameters among female police personnel of J&amp;K Police. It was carried out in Post Graduate Department of Physiology, Government Medical College Jammu from 2019 to 2020. Results: We observe that there is a significant difference between the groups with respect to age, duration of service, weight, BMI, WC, Hip circumference, WHR, SBP, BSF, TG, HDL, TC/ HDL and LDL/HDL. Conclusion: The present study on women police of Jammu demonstrated that metabolic syndrome is comprised of endocrine metabolic disturbances characterised by Type-2 Diabetes Mellitus due to insulin resistance and impaired glucose regulation, hypertension, obesity and altered lipid profile consisting of elevated levels of triglyceride (TG) and low levels of high-density lipoprotein cholesterol [HDL-C]. Keywords: Metabolic syndrome, Lipid parameters, hypertension, diabetes.

A tertiary care prospective of epidemiology and aetiopathogenesis of acute pancreatitis

Background: Acute pancreatitis is a potentially lethal condition resulting from an acute inflammatory process in the pancreas usually manifested by upper abdominal pain and raised concentration of pancreatic enzymes in blood, urine and peritoneal fluid. Aims and objectives were to study the epidemiology and aetiopathogenesis of acute pancreatitis in Jammu region of Northern India.Methods: This was a descriptive cross-sectional hospital based study, conducted in the postgraduate department of surgery, Government Medical College Jammu for a period of 3 years and included all admitted patients with diagnosis of acute pancreatitis. The main outcome variable was to find the various etiological factors associated with acute pancreatitis.Results: In our study acute pancreatitis was found to be more common in younger people. Most of the patients in the study population were below 40 years of age. Majority of the patients presented first time to the hospital with the chief complaints of pain upper abdomen. In this study, we found that the two principal causes of acute pancreatitis in our population were gall stones and alcoholism which contributed a total of about 68% cases followed by other causes such as hyperlipidemia, drug induced pancreatitis, worm induced acute pancreatitis, post-surgical pancreatitis, post traumatic pancreatitis, and hypercalcemia.Conclusions: Acute pancreatitis is a disease with high morbidity and mortality, and is quite common in Northern India. As such there is a need to make our population aware regarding the impact of alcoholism and bad dietary practices in causation of acute pancreatitis.

Prevalence of vitamin D deficiency in burn patients: an observational study

Background: Burns are one of the most common and devastating forms of trauma in life. Patients with serious thermal injury require immediate specialized care in order to minimize morbidity and mortality. Thermal injury creates a breach in the surface of the skin. It is difficult to evaluate the immediate effects of burn injury on serum levels of vitamin D metabolites because the binding proteins for 25-hydroxyvitamin D (25(OH)D), the main circulating form of the vitamin, and for 1,25-dihydroxyvitamin D (1,25(OH)2D) are low.Methods: This study is a cross-sectional study. It was carried out in burn ward of Government medical college Jammu during June to November 2020. 52 burn patients of both sexes and all age groups were enrolled in this study.Results: Fifty-two patients were evaluated in this study including 36 males and 16 females. In second degree superficial burns the mean level of 25(OH)D was 13.60 ng/ml (SD=7.27) ,in second degree deep burns the mean level of 25(OH)D was 13.88 ng/ml (SD=7.03) and in third degree burns the mean level of 25(OH)D was 14.71 ng/ml (SD=7.08).Conclusions: Based on the results of this study, we can conclude that 25-hydroxyvitamin D levels are low in patients after acute burns, and these patients should be given vitamin D sup­plementation.

Study on impact of duration of tympanic membrane perforation on hearing loss and audiological outcome after surgery

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The aim of the study was to assess impact of duration of tympanic membrane perforation on hearing loss and postoperative audiological outcome using pure tone audiogram.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; The present study was conducted on 100 patients in department of ENT and HNS, SMGS Hospital, Government Medical College Jammu during a time period of November 2018 to October 2019. All the patients with age 15 to 60 years who presented with tympanic membrane (pars tensa) perforation were included in the study. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; In our study, mean preoperative hearing loss (AC threshold) of group A was 36.23±1.07 dB and of group B was 25.67±6.38 dB. Group C had mean preoperative hearing loss (AC threshold) of 28.78±6.50 dB. Mean preoperative air-bone gap (AB gap) of group A was 12.9±8.05dB and of group B was 13.86±4.19 dB. Group C had mean preoperative air-bone gap (AB gap) of 16.47±5.51 dB. Postoperatively, pure tone threshold at three months was least in group B (15.09±5.80 dB), followed by group C (15.68±4.66 dB) and group A (19.33±2.81 dB). Whereas, postoperative AB gap at 3 months was least in group C (10±3 dB), followed by group C (8.44±3.59 dB). Group B had maximum postoperative AB gap of 8.49±4.34 dB.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; This study did not show any correlation between duration of disease and degree of hearing loss.&lt;/p&gt;

Functional outcome of arthroscopic meniscal repair in meniscal tears: a prospective study in tertiary care hospital in North India

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; A Meniscal injury can result in intra articular damage and which can eventually result in osteoarthritis if not treated on time and the objective should be to save the meniscus wherever possible. This study was done to analyse the functional outcome of arthroscopic meniscal repair done in different types of Meniscal tears.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; The study was conducted on a group of 28 patients with meniscal injury admitted in government medical college Jammu from November 2018 to October 2020. All the tears were located in the red-red and red-white zones. The functional outcome was assessed on the basis of Lysholm Tegner scoring. A standard rehabilitation protocol was followed post repair.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; Twenty-eight patients were included in the study. Male patients outnumbered the females and the incidence of injury was more on the right side. Sports injuries were the most common mode of injury, followed by road traffic accidents and falls. Bucket handle tears were most commonly seen in the group of patients. ACL injury was the major associated injury to be noted. The functional outcome between pre and post operation was statistically significant (p&amp;lt;0.05). In one of the patient failures was seen. Two patients were lost to follow up and were not included in the study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Arthroscopic meniscal repair is a has a very good functional outcome according to our study and should be preferred over meniscectomy (subtotal or total), as meniscus being a very important shock absorber present between the knee joint can lead to delay in osteoarthritis of knee joint. Therefore, our priority should be to save the meniscus and restore the normal anatomy of the knee joint for its biomechanical stability and normal function.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;

COMPARISON OF PREGABALIN AND NORTRIPTYLINE ON SLEEP, QUALITY OF LIFE IN POSTHERPETIC NEURALGIA: A PROSPECTIVE, RANDOMISED, OPEN-LABEL, PARALLEL STUDY

Objective: Aim of the present study was to compare the effects of pregabalin and nortriptyline on sleep and quality of life in patients of postherpetic neuralgia (PHN).&#x0D; Methods: The present study was conducted in 48 patients of PHN attending the outpatient department (OPD) of Dermatology, Government Medical College Jammu. Based on inclusion/exclusion criteria patients were randomized into two treatment groups. One group received pregabalin 150 mg/day and the other group was treated with nortriptyline 25 mg/day. The patients were followed up to eight weeks and assessed for Sleep (Medical Outcomes Study sleep scale) and quality of life (Euro QOL-5D-5L score). Clinicians Global Impression of Change (CGIC) score and Patient Global Impression of Change (PGIC) score were used to evaluate overall clinical improvement.&#x0D; Results: Both drugs significantly improved all parameters studied (p&lt;0.0001). On comparison, both drugs had similar effects on sleep and quality of life. However, pregabalin was found to be better than nortriptyline at eight weeks on CGIC (p&lt;0.004) and PGIC (p&lt;0.0003) scores.&#x0D; Conclusion: Both pregabalin and nortriptyline were equally effective in improving sleep and quality of life. Overall clinical improvement was better with pregabalin than nortriptyline at eight weeks.