Hospital In Chennai Research Articles

Association of Site and Recurrence in Oral Squamous Cell Carcinoma Patients Visiting Private Hospital in Chennai: A Retrospective Study.

Oral squamous cell carcinoma (OSCC) is the most commonmalignant neoplasms of the oral cavity. Tongue, buccal mucosa, and gingivobuccal sulcus are the most commonly involved sites for the local recurrence of OSCC. The site of the tumor can be a critical parameter in relation to the recurrence of OSCC because of the varied action of tumor cells in different tumor macro and microenvironments. Hence, the current study aims to evaluate the correlation between the site and recurrence of OSCC among patients visiting private oral cancer hospitals. Details of n=300 OSCC cases reported during 2019-2023, which included primary and recurrent OSCC, were collected. The sample population selected includes 261 primary and 39 recurrent oral squamous cell carcinoma cases. The demographic and clinicopathological data were retracted from the institution's common clinical database and transported to IBM-SPSS 23 software for statistical analysis. Chi-square was done to evaluate the association between site and recurrence status, and p<0.05 was considered statistically significant. Males have a high predilection for OSCC, and the recurrent cases account for 13% of the sample population. The buccal mucosa was the most commonly affected site in primary and recurrent OSCC cases. However, the association between the site of the lesion and the status of recurrence was found to be statistically significant, with a p-value of 0.001. Even though buccal mucosa was the most common site for recurrent OSCC(p value-0.001), the present study carries a small sample size and a location-specific sampling. Hence, further studies must be conducted with a large sample size to test the significant correlation between the site and recurrence rate among patients diagnosed with OSCC.

Effect of Vagal Nerve Stimulation on Cognitive Impairment Among Subjects with Anterior Cerebral Artery Syndrome: A Pilot Study

Background: Cognitive dysfunction, including impairments in attention, memory, executive function, andprocessing speed. This study was developed to determine the effectiveness of transcutaneous auricular vagalnerve stimulation on cognitive impairment among subjects with anterior cerebral artery syndrome.Purpose: The purpose of the study is to compare and evaluate the effectiveness of two non-pharmacologicalmethods of treatment for cognitive impairment patients with ACA syndrome.Material and Methods: The project was conducted as a pilot study in a private hospital in Chennai. Theexperimental group (group A) received transcutaneous auricular vagal nerve stimulation for 20 minutes andconventional strengthening exercises for the affected limb for 10 minutes. Group B got conventional cognitivetraining (20 minutes) and strengthening exercises (10 minutes). Following the four-week treatment, a post-testanalysis was performed using the Montreal cognitive assessment scale.Results: The post-test analysis obtained a mean value of about 27.25 and SD 1.5 for group A, whereas group Brevealed 22.75 ± 1.25, mean ± SD, and a significant P value of 0.004.Conclusion: Non-invasive transcutaneous auricular vagal nerve stimulation has been proven to be an effectiveapproach for preventing vascular dementia.

Effect of Vagal Nerve Stimulation and Jacobson Relaxation Technique on Agoraphobia among Post Neurological Ill-Patients: A Pilot Study

Background: This study was developed to determine the effectiveness of transcutaneous auricular vagus nervestimulation and Jacobson relaxation technique on agoraphobia among subjects with post neurological ill-patients.Purpose: The purpose of the study is to compare and evaluate the effectiveness of two non-pharmacologicalmethods of treatment for Agoraphobia patients with Post neurological ill-patients.Methods: The research project was conducted as a pilot study in a private hospital in Chennai. The experimentalgroup (group A) received transcutaneous auricular vagus nerve stimulation for approximately 20 minutes (30seconds ON and 5 minutes OFF) and a conventional Jacobson relaxation technique for 10 minutes. Group B gotconventional cognitive behavioral therapy (20 minutes) and the Jacobson relaxation technique (10 minutes).Following the four-week treatment period, a post-test analysis was performed using the Severity measure ofagoraphobia.Results: The study found that there is a positive impact of transcutaneous auricular vagus nerve stimulation andJacobson relaxation technique on agoraphobia in post neurological ill patients. The analysis obtained a mean valueof about 18 and an SD of 26 for group A, whereas group B revealed 24.8 ± 4.40, mean ± SD, and a significant Pvalue of &lt;0.001.Conclusion: When compared to group B, those in group A who received transcutaneous auricular vagus nervestimulation improved more significantly when dealing with agoraphobia of post neurological ill patients. As aresult, non-invasive transcutaneous auricular vagus nerve stimulation and Jacobson relaxation technique havebeen proven to be effective approaches for preventing agoraphobia.

Perception and Practices Related to Breast Milk Donation and Acceptance among Donor and Recipient’s Mothers of a Breast Milk Bank at a Tertiary Care Hospital in South India

Background: Human Milk Banks (HMB) ensure the availability of pasteurized donor breast milk for small forgestational age babies, low birth weight infants, sick new born and infants of mothers with failed lactation.Objectives: To assess the perception, practices and associated factors of breast milk donation and acceptanceamong donor and recipient’s mothers registered with the breast milk bank.Methodology: This hospital based cross-sectional study was conducted between July to September 2019 among70 donors and 70 beneficiaries who were mothers of children under 6 months of age, registered at the breast milkbank at a tertiary care hospital in Chennai. Data was collected by interview of the mothers with a predesignedsemi-structured questionnaire.Results: Only 74% of them were aware of breast milk bank services. Almost 47 (67.1%) had received more thantwice from breast milk bank. Proportion of recipient’s mothers who had complications during their delivery andproportion of children who were treated in NICU were significantly higher among the recipients (p &lt; 0.001).Conclusion: Awareness on breast milk bank services is required especially among the mothers of prematurebabies, low birthweight neonates, and newborn receiving treatment in NICU.

Pre-emptive Single Dose of Intramasseteric Administration of Dexamethasone Versus Methylprednisolone in Surgical Extraction of Impacted Mandibular Third Molars: Prospective Split-Mouth, Randomised Triple Blinded Clinical Study.

The study aims to contribute in reducing postoperative sequelae and to determine the optimal corticosteroid for reducing postoperative inflammation, pain, swelling, wound healing and quality of life in patients undergoing surgical extraction of impacted mandibular third molars. The study included 191 patients who presented to the Department of Oral and Maxillofacial Surgery at Thai Moogambigai Dental College and Hospital in Chennai with bilateral impacted mandibular third molars that needed surgical removal. The effects ofpre-emptivesingledose ofdexamethasone and methylprednisolone on pain, oedema, trismus, wound healing, and quality of life after surgical extraction of impacted lower third molars were investigated. There was no statistical difference between the two steroids, with both achieving identical levels of wound healing and quality of life. On the third postoperative day, there was a statistically significant difference, with methylprednisolone providing clinically superior results in mouth opening and reduction of swelling. However, by the fifth day, both corticosteroids had exhibited identical improvement. Compared to 8 mg of dexamethasone, 40 mg of methylprednisolone administered as a single preemptive dosage in the intrammaseteric region was associated with enhanced quality of life, a reduction in pain and edema, and almost normal mouth opening.

Knowledge and awareness about biomedical waste segregation and disposal among medical and paramedical students at a tertiary care hospital in Chennai

Abstract Introduction: Wastes produced by health-care facilities are unique in terms of generation, composition, treatment, and disposal when compared to other general wastes. Inappropriate handling of biomedical waste (BMW) led to several health risks from sharps injuries, the spread of infections, and the release of toxic substances into the environment. Not many studies throw insight into the difference in knowledge, attitude, and practice (KAP) across medical and paramedical students related to BMW segregation and disposal. This cross-sectional study aimed to assess the knowledge and awareness levels regarding BMW segregation and disposal among medical and paramedical students at a tertiary care hospital in Chennai, India. Methods: A structured questionnaire was administered to a sample of 632 participants, including medical (3rd and 4th years) and paramedical students. The questionnaire assessed their KAP related to BMW management. Descriptive statistics were used to analyze the data, and a comparison was made between medical and paramedical students using appropriate statistical tests. Results: The results revealed that medical students (3rd and 4th years) exhibited better KAP in BMW management than paramedical students. Medical students demonstrated a more comprehensive understanding of BMW segregation, disposal methods, and associated health risks. They also displayed a higher level of awareness regarding the importance of proper BMW management for environmental and public health protection. Conclusion: Our findings emphasize the need to strengthen educational interventions targeting paramedical students to enhance their understanding of proper BMW management practices.

Estimation Of Salivary Copper In Smokeless Tobacco Users With Oral Premaligancies And Malignancies: A Cross Sectional Study

Introduction: The estimation of serum bioelements for the identification of oral premalignant and malignant lesions has been extensively studied. Higher amounts of copper have been found in all smoking and Smokeless Tobacco (SLT) products, which are responsible for the higher incidence of premalignant and malignant lesions in the oral cavity. Limited studies have shown the significance and role of salivary bioelements in premalignant lesions, such as Oral Submucous Fibrosis (OSMF) and oral leukoplakia, and malignant lesions like Squamous Cell Carcinoma (SCC) of the oral cavity. Aim: To estimate salivary copper levels in premalignant and malignant lesions of the oral cavity. Materials and Methods: The preent cross-sectional study was undertaken in Tagore Dental College and Hospital in Chennai, Tamil Nadu, India for a period of 6 months, from March 2022 to August 2022. A total of 50 patients were recruited and divided into five groups of 10 patients each: Group I- control group; Group II- SLT chewing habit without any oral lesion; Group III10 patients with Tobacco Pouch Keratosis (TPK); Group IV- 10 patients with OSMF; and Group V- 10 patients with oral SCC. About 5 mL of salivary samples were collected and centrifuged at 3000 rpm to obtain the supernatant saliva for analysis. The levels of copper were estimated using photo calorimetry. Statistical analysis was done using One-way Analysis of Variance (ANOVA) followed by a Post-hoc test. Results: A total of 50 patients with a mean age of 40±20 years were included in present study, comprising 46% females and 54% males. There was a statistically significant difference (p &lt;0.05) between the mean salivary copper levels in the premalignant lesions of the oral cavity. Within the premalignant group, copper levels were found to be more in OSMF (Group IV: 296.64±56.08) compared to the other groups (Group II: 202.95±125.14; Group III: 229.25±73.35). In the oral cancer patients, no significant difference (p-value=0.174; not less than 0.001) obtained in salivary copper levels. Conclusion: Compared to the control group, salivary copper levels were significantly higher in cases of OSMF, followed by cases of TPK and non lesional cases.

T-cell Response after COVID-19 Vaccination: A Cross-sectional Study

Introduction: Even if antibody titers wane over time, T-cells demonstrate longevity and remain unaffected by viral variants. This study was done with the rationale of examining the virusdestroying cells post-vaccination, specifically focusing on their ability to produce the vital antiviral cytokine Interferon gamma (IFNγ) upon potential reinfection and investigates the impact of the Covishield vaccine on T-cell response, which is a largely unexplored domain due to the novelty of the disease. Aim: To study T-cell response by doing IFN γ release assay by employing Enzyme Linked Immunosorbent Spot (ELISpot) method. Materials and Methods: This was a cross-sectional study conducted from March 2021 to May 2023 at Sree Balaji Medical College and Hospital in Chennai, Tamil Nadu, India. The study included participants from all categories who were staff members of the College and Hospital. It is part of an extensive study done by the authors on immunological changes following Covishield vaccination. As part of this study, T-cell response was also separately studied by collecting an additional 2 mL of blood from 90 individuals one year after initiating the vaccination, specifically after administering the Covishield vaccine at 0 and 3 months. For T-cell response analysis, 2 mL of blood was collected and processed to separate Peripheral Blood Mononuclear Cells (PBMC). The Interferon Gamma Release assay (IGRA) was performed using ELISpot method, utilising a 96-well plate. The spots appearing in the sample wells {Spot Forming Cells (SFC) = T-cells} were quantified using an automated ELISpot reader. Sample wells demonstrating more than 12 spots were considered positive. The results were analysed using various statistical tests, including Chi-square test, One-way Analysis of Variance (ANOVA), Kruskal-Wallis Test, Karl Pearson correlation coefficient, t-test, and Mann-Whitney U-test. Results: The number of spots in the wells containing blood samples from volunteers ranged from a minimum of 2 to a maximum of 631. Importantly, all participants had detectable spots in their sample wells. Out of 90 participants, 84 (93.4%) had more than 12 SFC, while 6 (6.6%) had less than 12 SFCs. High Immunoglobulin G (IgG) levels were positively correlated with good T-cell responses (SFC). Participants under 60 years of age and females exhibited superior responses. Individuals with co-morbidities had lower levels of T-cell response compared to the healthy/normal participants. Conclusion: The volunteers in this study exhibited robust humoral and cellular immunity, with females showing a significantly better response. The T-cell response remained strong even nine months after the second dose of the vaccine.

Physical Activity, Functional Status, and Quality of Life Among Older Adults in India.

Physical activity and social engagement protect older adults against functional decline and improve their quality of life. Physical inactivity poses an increased risk for noncommunicable diseases. Globally, one in four adults is physically inactive. Enhancing the physical activity of older adults is crucial not only for increasing their life expectancy but also for improving their functional status and quality of life. This study aimed to evaluate the physical activity, functional status, and quality of life of older adults attending the medical outpatient department of a tertiary care hospital in Chennai, Tamil Nadu, India. The study adopted a descriptive cross-sectional research design. A total of 100 female and male patients above 65 years of age with comorbid conditions attending the medical outpatient department participated in the study. The sociodemographic and clinical characteristics of these patients were assessed. In addition, the Rapid Assessment of Physical Activity, Katz Index of Independence in Activities of Daily Living, Lawton Instrumental Activities of Daily Living Scale, and Older People Quality of Life Questionnaire were used to measure the physical activity, functional status, and quality of life of patients. The data were analyzed using descriptive and inferential statistics. Among the participants, only 17% were active, and 35% were underactive for regular light activities. Approximately 81% did not perform any activity to improve their muscle strength or flexibility. In 56% of the participants, disability was present. The majority mentioned that they experienced difficulties in preparing food and shopping. Regarding the quality of life of the participants, the mean ± standard deviation score was 77.38 ± 9.03. Significant results were found in the domains of independence, control over life, and freedom. The overall quality of life was not related to leisure and activities, financial circumstances, the Instrumental Activities of Daily Living Scale score, the Rapid Assessment of Physical Activity 2 score, and the Rapid Assessment of Physical Activity 1 score. The quality of life was weakly related to emotional and psychological well-being, control over life, home and neighborhood, freedom, independence, and social relationships. Limited physical activity and poor functional status impact the quality of life of older adults. Therefore, educational and physical interventions should be implemented at the hospital and community levels to improve the physical activity, functional status, and quality of life of older adults.

Prevalence of Dental Caries in Permanent Second Molars in Teenagers Using ICDAS

Introduction: Dental caries is a chronic disease of the tooth which is represented by demineralisation and destruction of the organic matter of the tooth. Dental caries are versatile, capable of affecting the crown portion of the tooth initially, and may affect the unprotected root surfaces later on. International Caries Detection and Assessment System (ICDAS) provides a systematic approach of reviewing the available clinical dental caries to evaluate the development of dental caries&#x0D; Materials and Methods: This study is a single centered retrospective study in which the data was collected from a private dental college and hospital in Chennai, India. Patient details were collected from the hospital management system and a total of 1804 samples were collected. The data was tabulated using Excel and then statistically analysed using the latest version of SPSS software.&#x0D; Results and Discussion: The prevalence of ICDAS score 3 in second molars is higher in 17 year old patients with 2.88% in maxillary right second molars, 3.33% in maxillary left second molars, 3.55% in mandibular left second molars and 3.71% in mandibular right second molars. The prevalence of dental caries in permanent second molar is 9.34%. It is seen that ICDAS score 3 is 8.71% prevalent followed by ICDAS score 5 which is 0.63%.&#x0D; Conclusion: Within the limitations of the study, it was found that the prevalence of dental caries in permanent second molars is 9.34% with ICDAS score 3 being the most prevalent followed by ICDAS score 5 which is 0.63%.

Validity and performance of cognitive scales in elderly patients with depression in a tertiary care hospital in Chennai

Background: Late-life depression in older adults can cause reversible cognitive impairment, often resulting in pseudo-dementia. Cognitive impairment can lead to executive dysfunction, reduced flexibility, and difficulty thinking and decision-making. This study aimed to assess the validity and performance of cognitive scales in late-life depression among patients attending the outpatient department of the institute of mental health, Chennai. Methods: This prospective study included 360 patients aged &gt;50 years who were diagnosed with depression and attended the OPD at the institute of mental health, Chennai. Baseline assessments were performed at the time of recruitment into the study (visit 1), and scheduled visits were performed every six months for two years (visits 2 to 5). Unscheduled visits were done every month, and adverse events were monitored and recorded periodically Results: Among 59 patients, 53.1% were female, 32.2% were diabetic, and 93.9% were experiencing subjective working difficulties. The Montreal cognitive assessment scale classified 51.4% as moderate, while the ADAS-cog and ACE scales classified 86% and 99.7%, respectively, as having abnormal mental status. However, a significant correlation and discrepancy between scores were observed for scales such as ACE, ADAS-cog, standardised mini-mental status examination, and Montreal cognitive assessment scale. A strong correlation was found between ACE, MMSE, MoCA, and ACE; however, FAST showed a significant negative correlation. The MoCA was strongly correlated with the MMSE, ACE, ADAS-cog, and Mini-Cog, indicating good alignment with the FAST. Conclusions: Cognitive scales strongly correlate with late-life depression in patients, suggesting an improvement in assessment, evaluation, and treatment to address cognitive deficits.

Comparison of the Effectiveness of Four Different Irrigation Solutions on Postoperative Sequelae in Patients Undergoing Lower Third Molar Surgery: A Prospective Study.

Introduction Oral and maxillofacial surgeons frequently perform the removal of impacted mandibular third molars. The success of this surgical intervention depends on meticulous surgical technique and the use of appropriate irrigants to minimize complications in the postoperative period. Aim The aim of this study was to evaluate the efficacy of four different irrigation solutions (povidone-iodine, metronidazole, chlorhexidine gluconate (CHX), and normal saline)on postoperative sequelae like pain, trismus, swelling, and alveolar osteitisfollowing surgical extraction of the impacted mandibular third molars. Materials and methods The current research was a randomized study carried out at Saveetha Dental College and Hospital in Chennai, India, from December 2022 to March 2023.The study population consisted of 112 participants who were referred to the Oral and Maxillofacial Surgery for the surgical removal of impacted mandibular third molars. The population was divided into four groups, with 28in each group. They were categorized as A, B, C, and D based on the final irrigation solution used after surgical removal of the impacted teeth. In group A, patients received 0.5% povidone-iodine as the final irrigation solution; group B received 1% metronidazole; group C received 0.12% chlorhexidine gluconate (CHX); and group D received 0.9% normal saline.Patients were examined on the first and seventh postoperative days to assess pain, swelling, trismus, and alveolar osteitis. The results were analyzed with SPSSStatistics for Windows, Version 23.0 (Released 2015; IBM Corp., Armonk, New York, United States) software for Windows (MicrosoftCorporation, Redmond, Washington, United States). A p-value less than 0.05 was considered statistically significant. Results Group B experienced significantly less pain than groups A, C, and D on the first and seventh postoperative days (p<0.05). The facial swelling was significantly less on the first and seventh postoperative day in groupB compared to groups A, B, and D (p<0.05). There was no statistically significant variation observed in trismus (mouth opening) across the groups on both the first postoperative and seventh postoperative days. The presence of alveolar osteitis was seen in groups A, C, and D, but no instances were reported in group B. Conclusion It can be concluded that among the four irrigation solutions used in the lower third molar surgery,metronidazole irrigation solution yielded the best results in terms of less pain, swelling, and alveolar osteitis followed by chlorhexidine.There was no difference between povidone-iodine irrigation and normal saline irrigation on the postoperative sequelae. Postoperative trismus does not depend on the irrigation solutionused in the third molar surgery.

Assessing the Risk of Occupational Hazard Using the FMEA Tool Among Hospital Staff at Multispecialty Hospital

Considering the importance of occupational hazard assessment, this study has been performed to identify the risks for employees who especially undergo a major occupational hazard that affects their efficiency and productivity. The study aimed to assess the risk of occupational hazard using Failure Mode and Effect Analysis (FMEA) and strategy to modify the healthcare packages provided by the hospital to the staff. A survey and personal interviews were done at a private multispecialty hospital in Chennai using a descriptive study methodology. The survey included 150 hospital employees from four departments: CSSD (6 participants, covering all available samples), Maintenance (41 participants, chosen at random), Nursing (60 participants, chosen at random), and Housekeeping (43 participants, chosen at random). To collect data, a standardized questionnaire aligned with the Occupational Safety and Health Administration (OSHA) was used (https://www.osha.gov/laws-regs/standardinterpretations/1987-08-06). In addition, unstructured personal interviews with key workers were undertaken. The data revealed that CSSD workers encountered most of the stated dangers, with 100% admitting to workplace risks such as needle sticks, chemical allergies, the risk of burns, and awkward ergonomic postures. Maintenance workers reported a 54% risk of pain and discomfort, 32% of sleep loss following night shifts, and 37% of chemical risks. Nursing personnel cited poor ergonomic posture (68%) as a key concern, followed by sleep loss (62%), and the risk of cuts (52%). Housekeeping personnel cited hazards of falls (69%), poor ergonomic postures (40%), and infectious disease exposure (31%). The study emphasizes the need to address occupational health risks in healthcare settings by thoroughly reviewing the many occupational health hazards that impact healthcare professionals. However, it is important to remember that the study relied on data from the previous six months, potentially leaving out undetected risks. Furthermore, the study emphasized the impact of these dangers on healthcare personnel, emphasizing the problem of events being underreported inside the institution. Notably, the study emphasized the importance of paying close attention to occupational dangers such as needle sticks, chemical exposure, burns and ergonomic concerns in healthcare professionals' daily health management.

A comparison study of maternal and perinatal outcomes with gestational diabetes mellitus, impaired glucose tolerance, and normal glucose tolerance

Gestational diabetes mellitus (GDM) and impaired glucose tolerance (IGT), which are growing health concerns globally, are the most common metabolic and endocrine perinatal issues. It is a contentious entity with competing policies and procedures. Most physicians in the United States employ a two-step procedure, starting with a 50-g non-fasting oral glucose challenge test at 24 to 28 weeks and moving on to a 100-g fasting test for women who receive a positive screening result. Instead, doctors use the Diabetes in Pregnancy Study Group India (DIPSI) technique and conduct just a 75-g, two-hour fasting oral glucose tolerance test. The prospective observational study was approved by the hospital's institutional ethics committee and was conducted from April 2020 to September 2021 at the department of obstetrics and gynecology at Stanley Medical College Hospital in Chennai, Tamil Nadu, India. The patients were chosen in accordance with the inclusion criteria, which called for first-trimester pregnant women without diabetes mellitus. Both oral and written consent were also obtained. DIPSI performed the screening. The WHO standards have been updated to be a one-step process with a single glycemic value. According to the results of this study, GDM is linked to harmful consequences that might affect both the mother and the foetus. The short- and long-term consequences in both the mother and the newborn can be greatly reduced with early detection and timely therapy of this illness. In this study, birth weights ranging from 2.5 to 3.5 kg were the same for GDM and IGT moms. IGT mothers should also be followed up on, and we should be more watchful at birth, even though we monitor GDM mothers.

Clinicodemographic profile and treatment outcomes of COVID-19 patients admitted in a designated tertiary care hospital, Chennai: A comparative analysis of first and second wave of the pandemic

Background: COVID-19 caused by severe acute respiratory syndrome (SARS)-COV 2 virus was declared a pandemic by the WHO in March 2020. India has reported 44,689,512 cases and 530,779 deaths as of March 9, 2023. Different variants may lead to varying clinical presentations and outcomes, emphasizing the need for ongoing analysis of local COVID-19 patients. Aims and Objectives: To describe the clinic-demographic profile and treatment outcomes of COVID-19 patients in a tertiary care hospital in Chennai and to compare the patient characteristics during the first two waves of the pandemic in India. Materials and Methods: A retrospective record-based study analyzed patients with SARS-CoV-2 between May 2020 and July 2021, collecting data on demographics, travel history, symptoms, hospital stay, and outcome. Data were analyzed using SPSS Version 20.0. Chi-square test and Fisher exact tests were used to ascertain significant association between variables. Results: Out of 944 cases of COVID-19, 70% were aged 20–60 years with a male predominance in both waves. The mean age during the first wave was 45.04±17.32 and during the second wave was 45.86±15.49. Intensive care and ventilatory support needs increased in the second wave. Hospital stay was longer during the first wave. Death rates were 3% and 14% in the first and second waves, respectively. Conclusion: In our study, community transmission was observed as most COVID patients did not have travel history. Males, elderly and those with comorbidities were heavily impacted. The second wave had higher ICU and mortality rates.

Prevalence of methicillin resistant staphylococcus aureus and its SCCmec type among students at a private dental college hospital in Chennai

Background: Since asymptomatic nasal carriage of Methicillin-resistant S. aureus (MRSA) is on the rise among healthcare professionals (HCPs), their prompt detection and decolonization would substantially decrease disease transmission. The study's primary goal was to identify MRSA nasal carriers among dental students/CRIs and determine their SCCmec type and their susceptibility to mupirocin. Methods: Anterior nasal swabs from 102 healthy dental students/ CRIs were collected aseptically and subjected to standard microbiological testing. The antibiotic susceptibility pattern of the S. aureus isolates was determined by Kirby Bauer disc diffusion method and mecA-mediated oxacillin (methicillin) resistance was determined using the cefoxitin disc method. PCR analysis of MRSA isolates determined the presence of mecA and their SCCmec types. D test deduced inducible clindamycin resistance. Results: Of the 102 participants screened, only 8(7.8%) carried S. aureus. Antibiotic susceptibility testing revealed that 5/8(62.5%) were MRSA isolates. Of which, only 2 MRSA isolates harbored mecA, and both belonged to the SCCmec type V. All S. aureus isolates were sensitive to Vancomycin, teicoplanin, and tigecycline when tested using agar screening method while 2/8 (25%) of the S. aureus isolates were D test positive and belonged to iMLSB phenotype. Conclusion: MRSA nasal carriers amongst HCWs/dental students are a cause of concern as they are a significant reservoir for transmission of MRSA among their co-workers as well as the community. Our results signify the need for screening for MRSA carriage and decolonization with mupirocin to substantially decrease the transmission of MRSA among dental students/patients.

A cross sectional study to assess the prevalence of non-alcoholic fatty liver disease among type 2 diabetes patients

The objective of this study was to determine the prevalence and factors associated with NAFLD among type 2 diabetes patients ; using a cross sectional study design, a representative sample of T2 DM patients were recruited from A.C.S Medical College And Hospital in Chennai. A detailed medical history as well as laboratory investigation were done NAFLD was diagnosed using abdominal ultrasonography examination. the overall prevalence of NAFLD was 59.3% (89 people) out of 150 T2DM patients. these patients had developed Intermediate fibrosis. In a multivariable regression analysis the risk of NAFLD was significantly higher among male T2DM patients with no alteration in the liver enzymes such as AST and ALT levels. Overall results shows that the most affected age group is between 40-50 years and Individual with BMI range more than 25 (obese) had higher incidence of NAFLD. It was concluded that NAFLD is a common association of T2DM, increasing BMI, poor dietary control are significant factors associated with NAFLD among type 2 DM patients. Health education to improve dietary control and testing for NAFLD among diabetic patients especially those with abnormal BMI are recommended for early detection and prevention of NAFLD.

Association of Asthma With Patients Diagnosed With Metabolic Syndrome: A Cohort Study in a Tertiary Care Hospital.

Introduction Asthma is defined as a chronic inflammatory airway disease. The prevalence of both asthma and obesity has been rising simultaneously, demonstrating a parallel trend. Obesity is a significant factor in metabolic syndrome, and numerous studies have indicated a connection between metabolic syndrome and bronchial asthma. Aims and objectives The aim of this paper is to evaluate the association of asthma with patients diagnosed with metabolic syndrome. The main objectives were to analyze the clinical profile and spirometric indices in patients with metabolic syndrome and to assess asthmatic patients among them with spirometry and clinical parameters at a tertiary care hospital in Chennai. Materials and methods This hospital-based cohort study was conducted on 73 patients attending the outpatient department who had a known case of metabolic syndrome and were evaluated for asthma through history, physical examination, and a pulmonary function test. A history of cough, expectoration, shortness of breath, wheezing, chest tightness, allergy, seasonal variation, and smoking habits was asked, and a thorough physical examination was performed. Bronchial asthma was confirmed with airflow reversibility by spirometry as per the Global Initiative for Asthma Guidelines. Metabolic and spirometry parameters were examined, such as body mass index (BMI), waist circumference, waist-hip ratio, fasting blood sugar (FBS), postprandial blood sugar, hemoglobin A1C (HbA1C), serum insulin, lipid profile, C-reactive protein (CRP), forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), and FEV1/FVC pre- and post-reversibility (baseline vs. six months). Results and discussion The average BMI of all participants was 29.6511 ±2.64564. The waist-hip ratio was 0.5512 ±0.43855, which decreased during the follow-ups, demonstrating a decline in the risk of obesity in study participants. The level of HbA1C showed a drop from 6.1% to 5.9% at the first follow-up. This exhibited a further reduction at the six-month follow-up in addition to a positive reflection in insulin sensitivity, indicating successful control of diabetes among study participants. It was discovered that this was statistically significant (p<0.001). At the third and sixth months of follow-up, the FEV1/FVC ratio increased by 38% and 37%, respectively, when metabolic syndrome was under control. The results show that controlling diabetes, hypertension, obesity, and triglyceride values improved asthmatic symptoms, and this was determined to be statistically significant (p<0.001). Conclusion The results of the current study demonstrated that the regulation and maintenance of metabolic parameters such as BMI, diabetes, hyperlipidemia, and hypertension aid in improving asthma control.

Vitamin B-12, Homocysteine, and Hematological Parameters in Ischemic Stroke Patients

Background: A cerebrovascular accident or stroke is one of the leading causes of disability and death in the world. Several risk factors have been detected and extensively studied and are part of preventive strategies. Emerging risk factors for ischemic that have recently acquired interest are vitamin B-12 and homocysteine levels. A study has been conducted in a tertiary hospital in Chennai to evaluate the levels of vitamin B-12, homocysteine, and hematological variables. Aims: The objective of the study was to estimate the serum levels of homocysteine and vitamin B-12 in patients with ischemic stroke and transient ischemic attack and to analyze hematological parameters, including complete blood counts and peripheral smear and correlate with vitamin B-12. Materials and Methods: A total of 80 individuals with either ischemic stroke or transient ischemic attack were included in the study. Vitamin B-12, homocysteine, complete blood counts, and peripheral smear were analyzed for the patients. Results: Either frank or subclinical vitamin B-12 deficiencies were noted in 59 (73.8%) of the study population. Fifty-seven (71.2%) of the study population had elevated homocysteine. Fifty (62.5%) had a high neutrophil-to-lymphocyte (N:L) ratio and 52 (65%) had elevated red cell distribution width. Conclusion: High homocysteine levels are prevalent among ischemic stroke patients and this elucidates that homocysteine has a role in the thrombus formation and is a risk factor for the development of the stroke. It was also noted that vitamin B-12 deficiency, either frank or subclinical, is prevalent among these patients and can be a target for supplementation strategies.

Prevalence, predictors, and outcome of pulmonary mucormycosis in COVID-19 associated rhino orbital mucormycosis in a tertiary care center in South India.

India witnessed an explosive rise in mucormycosis following COVID-19 infection. Pulmonary mucormycosis closely followed rhino orbital mucormycosis as the most common presentation. The need for advanced resources and lack of clinical suspicion for COVID-19-associated pulmonary mucormycosis led to widespread underdiagnosis and poor response to late therapy. The present study aimed to assess the prevalence of pulmonary mucormycosis in COVID-19-associated rhino-orbital mucormycosis using non-invasive techniques, such as sputum microscopy and chest imaging. A prospective observational study was conducted at the Institute of Internal Medicine, Rajiv Gandhi Government General Hospital in Chennai, India between June 2021 and July 2021. All hospitalized patients with proven rhino orbital mucormycosis with or without cerebral involvement within three months of confirmed COVID-19 infection who had clinical symptoms compatible with pulmonary mucormycosis were included in this study. These patients were screened for probable and possible COVID-19-associated pulmonary mucormycosis using computed tomography (CT) chest imaging and sputum microscopy within 48 h of hospital admission. Based on the findings, 8 (16%) out of 50 patients with rhino-orbital mucormycosis, had associated possible or probable pulmonary mucormycosis. All 8 patients were diabetics and had characteristic CT chest findings while only half of them had positive sputum microscopy. A higher prevalence of probably disseminated COVID-19-associated mucormycosis was noted among 51-60-year-old males with the use of corticosteroids and oxygen for COVID-19 therapy. The mortality rate was 100% in probably disseminated mucormycosis, 50% in possible disseminated mucormycosis, and only 9.5% in isolated rhino-orbital mucormycosis. Non-invasive and feasible methods, such as sputum microscopy and chest imaging can be considered for early screening and intensive management of probably disseminated mucormycosis to improve prognosis.