Index Medical College Research Articles

Factors Influencing Prevalence, C-reactive Protein Levels, and Lymphocyte Counts in Chronic Obstructive Pulmonary Disease Patients With Metabolic Syndrome.

Background This research examined the relationship between C-reactive protein (CRP) levels and lymphocyte counts in individuals with chronic obstructive pulmonary disease (COPD) comparing those with metabolic syndrome (MetS) to those without. Methodology This cross-sectional study involved 100 consecutive COPD patientsattending the outpatient wards at the Department of Medicine, Index Medical College, over 18 months. MetS was assessed using the International Diabetes Federation's guidelines. Pulmonary function tests such as spirometry were conducted following the European Respiratory Society's procedures, including measurements of forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and the FEV1/FVC ratio. The Global Initiative for Obstructive Lung Disease criteria were employed to evaluate COPD severity using post-bronchodilator FEV1. Results Our results indicated no significant differences in demographics, anthropometrics, or pulmonary function tests between COPD patients with MetS and those without. Average age, height, weight, body mass index, and blood pressure readings were similar between the groups, with no significant variations (p > 0.05). However, the total white blood cell count was significantly higher in the MetS group (9,214 ± 3,161.8 cells/µL) compared to the non-MetS group (6,657.8 ± 4,218 cells/µL, p = 0.001). CRP levels were markedly elevated in 90.9% of MetS patients compared to 21.4% of non-MetS patients. Pulmonary function tests showed no significant differences in pre- and post-bronchodilator FEV1 or FEV1/FVC ratios (p > 0.05). Conclusions The study found that individuals with COPD and MetS have elevated levels of CRP, suggesting that this association exacerbates systemic inflammation and metabolic issues. Furthermore, the risk of MetS in COPD patients did not significantly differ between smokers and non-smokers, indicating that MetS can affect all COPD patients regardless of smoking status. Additionally, more than half of the COPD patients had hypertension, a common comorbidity that reflects the oxidative stress and inflammatory processes shared by both conditions.

Evaluate Cardiopulmonary markers, oxidative stress and inflammatory markers among healthy people with and without a history of type 2 diabetes

Introduction: Type 2 diabetes mellitus (T2DM) accounts for around 90% of all cases of diabetes. In T2DM, the response to insulin is diminished, and this is defined as insulin resistance. During this state, insulin is ineffective and is initially countered by an increase in insulin production to maintain glucose homeostasis, but over time, insulin production decreases, resulting in T2DM. T2DM is most commonly seen in persons older than 45 years. Still, it is increasingly seen in children, adolescents, and younger adults due to rising levels of obesity, physical inactivity, and energy-dense diets. This is a Prospective, Cross sectional, Randomization, Observational study was conducted in the Department of Biochemistry and Medicine, Index Medical College. Inclusion Criteria: Controls without family history of type 2 diabetes: Healthy subjects in the age group of 18 - 30 years of either Gender. Cases with family history of type 2 diabetes either gender age group of 18 - 30 years of Age. Individuals who are using any medicines for any health condition to restrict in performing submaximal exercise. Total cholesterol (TC) in 18-21 years in Case Group showed an increase in Mean 209.34 + 14.85 mg/dl then control group 163.26 + 23.81 mg/dl (p=0.001), also Total cholesterol (TC) in 22-25 years in Case Group showed an increase in Mean 211.29 + 16.61 mg/dl then control group 177.42 + 27.98 mg/dl (p=0.001). HDL in 18-21 years in Case Group showed a decrease in Mean 39.35 +5.56 mg/dl then control group 40.87 + 6.20 mg/dl (p=0.167), too HDL in 22-25 years in Case Group showed a decrease in Mean 40.87 +6.22 mg/dl then control group 43.97 + 6.93 mg/dl (p=0.173). Triglycerides (TGL) in 18-21 years in Case Group showed an increase in Mean 144.07 + 9.96 mg/dl then control group 123.44 + 18.87 mg/dl (p<0.0001), in addition Triglycerides (TGL) in 22-25 years in Case Group showed an increase in Mean 147.48 + 16.70 mg/dl then control group 130.08 + 20.03 mg/dl (p=0.0147). LDL in 18-21 years in Case Group showed an increase in Mean 141.60 + 16.24 mg/dl then control group 97.71 + 16.87 mg/dl (p=0.650), similar LDL in 22-25 years in Case Group showed an increase in Mean 140.92 + 18.80 mg/dl then control group 107.43 + 19.54 mg/dl (p=0.841). VLDL in 1-21 years in Case Group showed an increase in Mean 28.74 + 2.02 mg/dl then control group 24.68 + 3.77 mg/dl (p<0.0001), moreover VLDL in 22-25 years in Case Group showed an increase in Mean 29.49 + 3.34 mg/dl then control group 26.02 + 4.01 mg/dl.

STUDY OF CORRELATION OF PLATELET INDICES IN THE MANAGEMENT OF CORONARY ARTERY DISEASE

Objectives: The current study aimed to assess whether platelet parameters are associated with the severity of coronary artery disease (CAD) and may be regarded as risk factors; therefore, this study was done to evaluate platelet parameters in patients with CAD. Methods: This study was carried out in the Department of Medicine of Index Medical College, Hospital and Research Center. 60 CAD patients were enrolled in the study and were compared with 60 normal, healthy individuals of the same age. Those fulfilling inclusion and exclusion criteria were enrolled in the study, and the blood samples were analyzed for platelet indices firstly at the time of admission and then repeated following antiplatelettherapy. Results: Significantly higher concentrations of mean platelet volume (p<0.001) and platelet distribution width (p<0.001) were found in cases beforetreatment when compared with the controls. A significantly lower value of total platelet count (p<0.001) was found in cases before treatment when compared with the controls. Conclusion: Platelets have been associated with the development of cardiovascular diseases such as atherosclerosis and its severe outcomes such as acute myocardial infarction, unstable angina, and sudden cardiac death. The evaluation of platelet indices is considered an important factor in determining the functionality of platelets and is recognized as a promising risk indicator for atherothrombosis.

Understanding the Menopausal Transition Assessing Knowledge and Preparedness Level in Women Working in Index Medical College Indore of Indore City 2023

Understanding the Menopausal Transition Assessing Knowledge and Preparedness Level in Women Working in Index Medical College Indore of Indore City 2023

Determination of serum KIM-1 in patients with chronic kidney injury

Background: Chronic kidney disease (CKD) affects more than 800 million people worldwide and is one of the leading non-communicable causes of death. Despite being a latent issue, once renal damage has started, the disease can rapidly progress to an advanced stage. Aims and Objectives: Currently, the most commonly used markers for the diagnosis of renal disease are non-specific and insensitive. As a result, the goal of the current study is to investigate whether KIM-1 could be a precise and sensitive biomarker for identifying early kidney injury in CKD patients. Materials and Methods: This case–control study recruited 155 participants from the Index Medical College Hospital v Research Centre, Indore, Madhya Pradesh, based on inclusion and exclusion criteria. 150 non-CKD subjects matched for age and sex were also taken from the hospital. The levels of KIM-1 were compared between CKD and non-CKD participants. Serum creatinine, urea, and creatinine clearance were also measured. Results: The levels of KIM-1 were substantially higher in CKD patients than in non-CKD participants. In addition, a negative relationship between KIM-1 and creatinine clearance was observed with a P<0.05. Conclusion: KIM-1 is a precise and sensitive kidney injury biomarker that can identify early kidney injury in CKD and contribute to the progression of interstitial fibrosis in kidney disease.

Prevalence of Carbapenem-Resistant Hospital Acquired Infections and Their Antimicrobial Susceptibility Pattern in a Tertiary Care Hospital

Background: The emergence of antimicrobial-resistant bacteria has become a public threat, creating a burden on medical care in hospitals. Carbapenem-resistant organisms are a source of both community-acquired and healthcare-acquired infection that poses a substantial hazard to public health. This study aimed to conclude the prevalence of carbapenem resistance gram-negative bacteria from a clinical specimen at Index Medical College -Indore.
 Methodology: This study was conducted in the Department of Microbiology, at Index Medical College, Indore, between January 2020 and January 2022.The isolates were subjected to antimicrobial susceptibility tests by Kirby Bauer’s disk diffusion test. Most of the isolates were resistant to beta-lactam drugs, cephalosporin’s and aminoglycosides. These isolates were further confirmedby phenotypic detection usingthe Modified Hodge test, Modified carbapenem Inactivation, Combined disc diffusion test and Double Disk Synergy.
 Results: The percentage distribution of health-associated infection show highest resistance in both urinary tract and respiratory tract infection, followed by skin & soft tissue infection and least in septicemia and other health associated infection. Highest percentage of resistance was seen in the age group between 21-30 and the least in less than 10 years with a statistical significance of p-value=.00001. The most common isolates recover was E.coli in Enterobacterals and in Non fermenter it was Pseudomonas aeruginosa and Acientobacter. The sensitivity of MHT, mCIM, CDDT, and DDST within CI 95% were 74%, 95%, 84%, and 95% respectively. The overall prevalence of carbapenem resistance is 17.75%.
 Conclusion: The production of carbapenemase is the major mechanism underlying carbapenem resistance around the world and represents a great health concern. More knowledge is needed to control resistant genes and resistant organisms and their dissemination. There is an urgent need for global collaboration to plan valid strategies to prevent the spread of carbapenemase and the development of new antimicrobial molecules.

Phenotypic and Genotypic Detection of Carbapenem Resistant Organism Causing Nosocomial Infection in Patients Attending Tertiary Care Hospital

Aims: Nosocomial infections are the leading cause of mortality. ESKAPE organisms are the primary causes of nosocomial infection as these organisms are more or less carbapenem resistant. This study aimed to isolate and identify the etiological agents responsible for causing nosocomial infection and determine the carbapenemase producing organism by phenotypic and genotypic detection.
 Study Design: The study design is cross-sectional study.
 Place and Duration of Study: The study was conducted in the Department of Microbiology, at Index Medical College, Indore, between January 2020 and January 2022.
 Methodology: Total of 246 samples was collected from the patients who develop symptoms after 48- 72 hrs of hospitalization. Samples were processed for identification of etiological agents. Gram negative organisms were selected and further identified for carbapenemase enzyme. Screening was done by Kirby Bauer disc diffusion test and further confirmed by Modified Hodge test, Combined Disc test, Double Disc Synergy Diffusion test and Carbapenem Inactivation method. Genotypic detection was done by using multiplex polymerase chain reaction for KPC, NDM and OXA-48 gene.
 Results: Out of 107-gram-negative organisms, 19 (17.75%) were carbapenem resistant. Among 19 carbapenem resistant GNR, 13% MHT, 15% CCDT, 17% DDST and 17% mCIM were positive. The sensitivity and specificity of MHT, CCDT, DDST, mCIM were 74%/100, 84%/100,95%/100 and 95%/100respectively. The genotypic detection shows highest percentage of blaNDM 74% which is followed by bla OXA-48 31% and blaKPC 26%.
 Conclusion: Hospitals have become the hotspot for various microorganism causing nosocomial infections and are getting carbapenem resistance due to irrational use of antibiotics. Antimicrobial stewardship is one of the effective measures that minimize the resistance. Proper universal precaution can also minimize, spread of resistance in organism. If the last resort drug gets resistant, then it could be challenging for the clinician to treat their patients. Hospitals should have regular HAI meeting and release of antibiogram to know the pattern of these notorious organisms invading infection.

Molecular Detection of Carbapenem Resistance in Clinical Isolates of Klebsiella pneumoniae in Tertiary Care Hospital

Antibiotic resistance has become a serious global threat, mainly due to misuse, overuse of antibiotics and non-compliance with infection control protocol. Superbugs are multidrug-resistant (MDR) and extended drug-resistant (XDR) bacteria, mainly Klebsiella pneumoniae and Escherichia coli from the Enterobacteriaceae family, which cause opportunistic infections and raise death rates and hospital expenditures. The present study was conducted at a tertiary care teaching hospital to study the epidemiology and molecular detection of carbapenem-resistant K. pneumoniae isolated from various clinical specimens. 240 K. pneumoniae isolates were collected from January 2020 to December 2021 at the Bacteriology laboratory, Index Medical College and Hospital, Indore. All isolates were analyzed for carbapenem resistance by the conventional disc diffusion method. All carbapenem-resistant isolates were tested for carbapenemase production using the phenotypic double-disk synergy test (DDST) and modified Hodge test (MHT) as per 2020 CLSI guidelines. All isolates were negative by phenotypic methods, further confirmed by conventional PCR to detect the gene responsible for carbapenemase production. 240 isolates of K. pneumoniae were included during the study periods. Out of 240 isolates, 102 isolates were found resistant to carbapenem drugs. All 102 isolates were confirmed carbapenemase and MBL producers by MHT and DDST tests. Among 102, 60 isolates were found to be MBL producers negative by MHT and DDST tests. Sixty phenotypic negative carbapenem-resistant isolates were tested by conventional PCR. One or more carbapenemase genes were detected in 61.0% of isolates. The blaKPC was detected in 13/60 (21%) isolates, followed by blaNDM 10/60 (16%) isolates, followed by blaVIM in 6/60(10%), blaOXA-48 in 5/60 (8%) and blaIMP in 3/60(5%) isolates. K. pneumoniae produces carbapenemase, which enhances resistance to the carbapenem class of antibiotics. The simultaneous detection of these resistance genes expressed by Klebsiella pneumoniae might be managed by early detection and adhering to antibiotic policies that limit the use of antibiotics.

CORRELATION OF PLACENTAL MORPHOLOGY WITH FETAL OUTCOME IN SINGLETON PREGNANCIES IN CENTRAL INDIA

Background : Growth and development of fetus is dependent on growth and development of placenta. This study aimed to assess the effect of placental morphology on birth weight. Materials and methods- Study was done on 200 pregnant females and their newborns at index medical college hospital and research centre Indore, M.P.it was an observational cross sectional study. Results-In our study placental weight varied between 200 to 700 gms. The mean weight was found to 466.98±76.12 gms. Fetal weight in our study ranged between 1.99 to 3.74kg with a mean of 2.72±0.32.fetal weight was found to be positively correlated with placental weight, placental volume, thickness of placenta, no. of cotyledons and cord diameter. Placental weight and thickness increases with increasing fetal weight. Conclusion- We found a strong relationship between the placenta and the fetus, so this theory can be applied in detection of low birth weight babies before delivery and also measures can be taken to reduce low birth weight babies and its complications and ultimately the perinatal morbidity and mortality

A PROSPECTIVE STUDY OF ARTERIOVENOUS FISTULA CREATION IN PATIENTS WITH CHRONIC RENAL FAILURE IN INDEX MEDICAL COLLEGE HOSPITAL & RESEARCH CENTRE, INDORE (M.P)

Background: Arteriovenous (AV) stulas are naturally occurring connections between an artery and a vein that enable for adequate blood ow during hemodialysis in patients with chronic renal failure. Compared to grafts, they have higher rates of patency and fewer complications. In order to achieve hyperdynamic circulation and ensure that regular venous access is not an issue, AV stula are created at various levels. The presents study sought to determine factors inuencing the patency rate of AV stulas, postoperative complications, and the success rate of AV stulas. Materials and Methods: After approval from the IEC, this prospective study was conducted in Department of General Surgery of Index Medical College Hospital & Research Centre, Indore on 100 patients of all age groups and both gender who visited the OPD with diagnosis of chronic kidney disease. A written pre-informed consent was taken from all patients before enrollment. Result: Out the 100 patients enrolled in the study, majority i.e., 63% revealed radiocephalic stulas while 12% had brachiocubital stulas. 80% of patients were treated by doing side-to-side anastomosis, while in rest 20% patients, end-to-side anastomosis was done. The AV stula remained patent in 65 (65%) patients, and among them, the patency rate of radiocephalic was 60% and that of brachiocephalic was 13.8%. The patency rate for side-to-side stula was 83.1% and that for end-to-side was 16.9%. Patency rate for patients with hemoglobin (Hb) > 9 g % was 93.85% with only 6.15% for patients with Hb < 9 g %. Nonsmokers were 3.5 times (95% CI: 1.58–8.23) more likely to have patent stula than smokers. Arterial diameter is also a predictor of patency. Conclusion: The success rate of AV stula by conventional vascular anastomosis technique was 65%. Side-to-side anastomosis showed higher patency rate than end-to-side anastomosis. Radiocephalic AV stula had better patency rate than other types of stulas performed in upper limb. Anemia (Hb < 9 g %), smoking, and arterial diameter were the major factors inuencing patency of stula. Thrombosis, surgical site infection, postoperative edema, aneurysm and steal phenomenon were the complications noticed in the postoperative period

EVALUATION OF MICROCYTIC HYPOCHROMIC ANEMIA BY ELECTROPHORESIS FOR HEMOGLOBINOPATHIES IN YOUNG POPULATION

Objectives: Hemoglobinopathies are serious genetic blood disorders requiring lifelong blood transfusions and treatment in its most severe and chronic form. If undiagnosed or untreated, these disorders ultimately lead to death. South Asia especially India, Pakistan, and Bangladesh has high populations of hemoglobinopathies. In India, there are an estimated 100,000 thalassemia majors patients and nearly 3.5 to 4 million carriers of this genetic disorder. Tribal populations in India have a range of 5–40% sickle cell anemia (SCA) sufferers. The aim of the study was to detect hemoglobinopathies by electrophoresis in microcytic hypochromic anemia in young population in the area covered by tertiary care center at Index Medical College and Hospital. Methods: A cross-sectional study was carried out in a hospital in rural area of Indore on young patients (10–30 years age group) who attended outpatient department from June 2018 to March 2020. Total 517 cases of moderate to severe anemia were included in the study. All cases were subjected to a series of hematological investigations, which include complete hemogram, peripheral blood smear, and some standard procedures. Sysmex XS800i fully automated Cell counter was used for complete blood count. It is the 5-part differential instrument. It reports on all the five subpopulations, namely, neutrophils, eosinophils, basophils, monocytes, and lymphocytes. A blood smear is a blood test used to look for abnormalities in blood cells. Results: In the study, out of 517 cases 34.4% cases were positive on Hb electrophoresis and 65.6% were negative. On electrophoresis, the number of sickle cell anemia cases was 34.3%, sickle cell trait – 20.8%, sickle beta-thalassemia – 29.8% and beta-thalassemia major – 29.8% was observed. In hemoglobinopathies, of the 73 females, 28.8% were having beta-thalassemia trait, 27.4% were having SCA 23.3% were having sickle beta-thalassemia, and 20.5% were having sickle cell trait. Of the 105 males, 30.5% were having beta-thalassemia trait, 9.5% were having sickle beta-thalassemia, 39.0% were having SCA, and 21.0% were having sickle cell trait. Conclusion: The ANMs, ASHA, and Anganwadis should be taught about the importance of screening of hemoglobinopathies. So that they can explain the purpose of screening to the female during pregnancy and to the families in the rural areas. At primary level, the CHCs and PHCs should be equipped with instruments for basic testing of hemoglobinopathies.

PREVALENCE AND INCIDENCE OF CONGENITAL HYPOTHYROIDISM IN NEONATES IN TERTIARY CARE CENTRE IN CENTRAL INDIA

Background: Congenital hypothyroidism is one of the most common disrupters of endocrine and metabolism, that is most important preventable cause of mental and physical disabilities. Clinical features are often lacking at birth even up to the rst few weeks or months of life. Diagnosis based on clinical features is difcult at birth without biochemical screening, resulting in delayed initiation of therapy and irreversible brain damage in the affected children. Screening during birth can help in early diagnosis and treatment. Knowledge of the country-specic prevalence of the disease can guide in establishing a universal screening program, thus improving the outcomes of affected children by timely intervention. This study aimed to describe and investigate the prevalence and incidence of CH in Central India by Cord blood screening method. A prospective observational study was conducte Material & Methods: d for a period of 9 months in the Department of Paediatrics, Index Medical College Hospital & Research Center, Indore after valid approval from Institutional ethics committee on neonates who qualied the inclusion criteria. The screening was conducted on 200 babies delivered at a tertiary care hospital, at Index Medical College Hospital & Research Center, Indore, both by normal vaginal delivery or Caesarean section were included in the study. Cord blood samples was collected on Post neonatal day 1 of these new born and sent for serum thyroid Stimulating hormone (TSH) estimation by IRMA method and followed up. Prevalence was calculated by percentage. Out of 200 ne Results: onates assessed 6 newborns detected to have serum TSH more than 20 µIU/ml, were further investigated with complete thyroid prole and out of these only one newborn detected to have congenital hypothyroidism eventually with incidence rate of 1:200. Early diagnosis of CH Conclusion: with an efcient and accurate screening method which can decrease the risks of developmental delay, mental retardation, and delayed physiological development

“A STUDY TO CORRELATE RISK FACTORS AND OUTCOMES WITH MORBIDITY AND MORTALITY PATTERN OF RESPIRATORY DISTRESS IN NEONATES IN NICU OF A TERTIARY CARE CENTRE IN RURAL SETUP”

Background: One of the most frequent illnesses in the rst 48 to 72 hours of neonatal life is respiratory distress. The most frequent reason for NICU hospitalization and the leading cause of morbidity in newborn is respiratory distress. The present study is aimed to determine and correlate the incidence, risk factors, causes and outcomes of respiratory distress in neonates in a neonatal intensive care unit of a tertiary care facility. Impressive outcomes are achieved when neonatal respiratory illness is diagnosed early and managed with appropriate interventions. Material & Methods: A prospective observational study was conducted for a period of 18 months in the inborn & outborn NICU of Department of Pediatrics, Index Medical College Hospital & Research Centre, Indore after valid approval from Institutional ethics committee on. 100 babies who presented with respiratory distress irrespective of their status at time of delivery (preterm, term or post term) and qualied the inclusion criteria were enrolled after taking written informed consent from the parents/caretakers. Following the admission of the newborn, data were recorded in the predesigned proforma. Statistical analysis was done with P value <0.05 signicant. Out Results: of 100 babies included in the study, 62 were males while 38 were females. Pulmonary cause was the most frequent cause of respiratory distress in newborn out of which TTNB (33%) was the commonest followed by RDS (20%). Prematurity (37%), MSAF (18%), Caesarean section against precipitous labour (9.5%), obstruction/non progression of labour (8%) were the major risk factors to develop. 58% of babies were born via LSCS with MSAF (24.1%), previous Caesarean section (20.7%) and obstructed labour (13.8%) as the main indications. Under treatment intervention,62 (62%) babies required only Oxygen while 20 babies (20%) required CPAP and 18 babies (18%) required mechanical ventilation. Morbidity was seen in 34% of newborns with RD which included sepsis, ROP, IVH, HIE, BPD. Out of 20 deaths,14 babies (70%) were males, and 6 babies (30%) were females. In Conclusion: cidence of respiratory distress was 9.8% among live births. Transient tachypnea of the newborn is the most common cause of respiratory distress in newborn. Antenatal risk factors increase the incidence of RD. Risk factors like Prematurity, meconium-stained liquor, cesarean delivered newborns, obstructed labour, Oligo/polyhydramnios, foetal distress, PROM was associated with respiratory distress in newborns. Prematurity is the most common and most important risk factor for the development of RD in newborn. There was male predominance & most of the babies were delivered via caesarean section. Frequency and severity of RD is inversely related to gestational age and birth weight. Early term and preterm babies constituted majority of the babies with respiratory distress. Most of the babies had mild to moderate respiratory distress with Downe's score between 2-6. RDS was the most common cause for CPAP and ventilation. The mortality rate was 20% among the respiratory distress cases admitted in NICU, rest 80% survived. The most common cause of death was RDS. Early diagnosis and identication of causes of respiratory distress in neonate is critical in the management. The neonatal outcome will improve with efforts made to prevent preterm birth, identify various maternal risk factors and intervene early with appropriate interventions.

Study of prevalence of sexual dysfunction in males with psychiatric illness compared to other medical patients

Introduction: According to DSM-5 Sexual dysfunction is defined as “a clinically significant disturbance in a person's ability to respond sexually or to experience sexual pleasure”. Aim & Objectives: To assess prevalence of sexual dysfunction in males with psychiatric illness compared to other medical patients in Psychiatry Department, Medicine Department, Respiratory Department of Index Medical College Hospital and Research Centre, and Indore. Methodology: This study is a Comparative cross-sectional study conducted at Index Medical College Hospital and Research Centre, Indore for duration of 6 Months. Subjects was taken from department of Psychiatry, Medicine Department, Respiratory Department Index Medical College, Hospital and Research Centre, Indore fulfilling the inclusion criteria. Study sample will consist of 100 cases and 100 control. Result: There was a positive relationship established between Psychiatric ill male patients and sexual dysfunction. Sexual dysfunction was significantly high in mentally ill patients i.e., 59% compared to our control group i.e. other medical patients (23%). Among the Psychiatric disorders highest frequency was observed in Schizophrenia which was 73%. Other prevalence was: bipolar disorders-49%, depressive disorders-51%, anxiety disorders–36% and Alcohol Use Disorder–58%. Among our control group the maximum frequency was observed in patients with heart diseases which was 41%. Other prevalence were liver disorders-25%, Diabetic-20%, genitourinary tract disorders-15% and resp. disorders-10%. It was also found that there was no significant difference in total testosterone level of both groups but prolactin level was significantly higher among psychiatric patients. Conclusion: Prevalence of sexual dysfunctions are higher among psychiatric ill male patients than medical patients therefore more attention should be given to the treatment of these disorders and counselling should also be done.

A study on the prevalence of internet addiction in medical students

Introduction:Internet addiction is defined as "the inability to control the use of Internet that leads to feelings of pressure, anxiety and dysfunctional behaviours in everyday activities". The phenomenon of reckless use of the Internet by young people has taken enormous dimensions and has created problems for the mental and social functioning leading them to addiction. Aim & Objectives: Study the prevalence of internet addiction in MBBS intern students in our college. Methodology: This study is a cross-sectional study conducted at Index Medical College Hospital and Research Centre, Indore for duration of 6 Months. Subjects were interns taken from MBBS batch 2017 fulfilling the inclusion criteria. Result: In the present study, 102 (52%) were from male students and 98 (48%) from female students. The age group was 18-25 and they are intern students. It was observed that student go late for night sleep, they are deprived of good sleep duration as the college starts at 8 for about 93% of the students, and 68% of the students had social media and internet as a reason for sleeping late at night for academic or non-academic purpose. In this study, 39% to 45% of the students slept for fewer hours than the recommended sleep duration because of late-night social media site use. 54% students answered that they don’t believe their life would be boring without internet, while the 18% stated they cannot live without internet use, believing that their life would be vain. 10% students said they felt very annoyed while they were busy on Internet while the remaining 18% said they were not particularly bothered. Conclusion: Internet offers incredible possibilities; it feeds us with information, news, entertainment, etc. It is a useful interactive tool, which facilitates our everyday life when used reasonably. Further our study reported that, excessive social media use decreases social face to face interaction. This has a negative impact on social well-being and can lead to depression, anxiety, and mood swings.

Prevalence of retinopathy of prematurity in a urban based tertiary hospital in central India

Background: Retinopathy of prematurity (ROP) is an important cause of preventable blindness in children. It is a serious and underestimated complication of prematurity treatment among preterm and low-birth weight babies and is preventable cause of blindness unless recognized and treated early. Objective: The objective of this study was to estimate the prevalence of ROP in preterm infants and low-birth weight in the Neonatal Intensive Care Unit (NICU) of a tertiary hospital and to increase the awareness of early screening of ROP among parents and doctors. Materials and Methods: A ROP prospective screening survey was performed enrolling all prematures and low-birth-weight Neonates delivered at Index Medical College Hospital & Research Centre from July 2018 to June 2021, with a gestational age of 37 weeks or less at birth and a birth weight of 1700 g or less. One Hundred and Eighty Six(186) preterm infants (i.e.372 eyes) were included for ROP screening .Out of these 186 preterm infants (372eyes), Forty eight (48)preterm infants (i.e.96 eyes) developed Retinopathy of Prematurity. Descriptive statistics included the mean and standard deviation for numerical variables, and the percentage of different categories for categorical variables.

CBNAAT: Advantage and Efficacy in Pulmonary Tuberculosis (PTB) atop on Traditional Methods for Diagnosis in a Tertiary Care Hospital in India

Background: Mycobacterium Tuberculosis (MTB) is one of the most ancient diseases of mankind. Pulmonary tuberculosis (PTB) is the most common, despite the diagnosis and treatment of TB. Many studies reported, a collaboration between PTB susceptibility. In our research study, we report meantime findings after enrolling 732 of a planned 212 participants.
 Study Design: A descriptive cross-sectional study.
 Methods: The study conducted on patients with TB in west India was conducted in the Department of Microbiology, Index Medical College; Indore Madhya Pradesh. Patients suspected of PTB were qualified for screening if their age varied from 25 to 60 years and with both gender, signs and symptoms associated with PTB such as cough for more than 2 weeks, fever, weight loss, chest pain, and abnormal chest X-ray findings in results and cartridge-based nucleic acid amplification test (CBNAAT) positive. All Patients were monitored monthly while they visited in TB and chest clinic for TB treatment.
 Results: A total of 937 patients were selected for the study. Out of which only 732 patients were enrolled. About 212 patents were positive for CBNAAT and 520 were found negative. The confirmed positive CBNAAT patients do not have a history of tuberculosis. In this study about 21.72% were ZN stain positive, 33.46% were culture positive and 28.96% were CBNAAT positive.
 Conclusion: The current scenario of traditionally AFB-negative PTB is not sensitive enough to establish the diagnosis of active tuberculosis without CBNAAT. They underdiagnose PTB and over-treat people without PTB.

Association between high-sensitivity C-reactive protein and lipid profile in patients with type 2 diabetes mellitus

Background: The most significant and challenging health issue of the modern era is diabetes mellitus and its complications. Inflammation plays a crucial role in the development and progression of diabetes. Type 2 Diabetes Mellitus patients(T2DM) are at significant risk of developing cardiovascular diseases. High-sensitive CRP (hs-CRP) has become a reliable indicator of low-grade inflammation. Since very little is known regarding the relationship between hs-CRP and T2DM, the goal of this study was to evaluate hs-CRP levels and lipid profile and to study their relationship to cardiovascular problems in Type 2 Diabetes Mellitus patients. Material and Methods: The current study was carried out at Index Medical College and Hospital in Indore. The study group consisted of 70 healthy controls and 70 Type 2 Diabetes Mellitus patients who had been diagnosed following WHO criteria. Serum hs-CRP concentrations as well as the lipid profile (total cholesterol, HDL, and TG) were assessed. SPSS version 26 was used to analyze the data. Results: In comparison to controls, individuals with Type 2 Diabetes Mellitus had significantly higher levels of hs-CRP, with a mean value of 2.49 + 1.15 mg/L (p <0.001).

Cutaneous manifestations Of COVID-19

The coronavirus 2019(COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2), has had enormous health, economic, and social consequences. Cutaneous manifestations associated with COVID-19 probably reflect the activation of pathogenic pathways by the virus or a response to inflammatory processes, vascular or systemic complications, or even treatments. There is no previous detailed classification or description of the cutaneous manifestations of COVID‐19. This information may prove useful to manage patients and to recognize paucisymptomatic patients and might provide prognostic information. The recognition of paucisymptomatic patients could also be helpful for epidemiological control, especially in areas where diagnostic tests are scarce. This is a cross-sectional study among the COVID positive patients admitted in Index Medical College Hospital and Research Centre (Tertiary Care Centre) Indore from 1st May 2020 – 30th November 2020. Considered initially as of little relevance, the dermatological manifestations observed in patients with COVID-19 are both heterogeneous and complex. 5 main categories of lesions identified; vesicular rashes, urticarial rashes, acral lesions, maculopapular rashes and livedoid & necrotic lesions.

Potential biomarkers for early diagnosis of nephrotic changes in type 2 diabetic patients

Introduction: Type 2 diabetes (T2D) is metabolic disease with chronically elevated glucose levels, characterized by two main abnormalities: impairment of insulin secretion and decrease in insulin sensitivity. (1) Undiagnosed or poorly controlled, leads to complications such are blindness, renal insufficiency, amputation of lower extremities, heart disease, or stroke. Approximately 150 million people worldwide are affected by type 2 diabetes, with expectancy to double in next 20 years. Two factors are participating on clinical picture of type 2 diabetes: environment and genetics. (2) Materials and Methods: This is a prospective study carried out in the Department of Biochemistry at Index Medical College, Hospital and Research center, among the people attending the OP/IP departments, based on random selection. Informed consent was taken from the patients. Institutional Ethical Clearance Certificate was obtained. Number of samples: 150 samples were collected from the study subjects, of which Group A: 50 Normo-albuminuria, Group B: 50 Microalbuminuria and Group C: 50 Microalbuminuria with type 2 diabetes.