Medical Research Institute Research Articles

An assessment of turnaround times of infant Deoxyribonucleic acid-Polymerase Chain Reaction testing and the associated factors in Western Kenya: A mixed methods study.

The HIV/AIDS continues being a significant global public health priority in the 21st century with social and economic consequences Mother-to-child transmission (MTCT) occurs when an HIV-infected woman passes the virus to her infant and about 90% of these MTCT infections occurs in Africa where children and infants are still dying of HIV. Early definitive diagnosis using Deoxyribonucleic acid reaction of HIV infection in infants is critical to ensuring that HIV-infected infants receive appropriate and timely care and treatment to reduce HIV related morbidity and mortality. To assess the Infant Deoxyribonucleic acid-Polymerase Chain Reaction (DNA-PCR) Turnaround Time (TAT) of dry blood spots and associated factors in Vihiga, Bungoma, Kakamega and Busia counties, in Kenya. A mixed methods study using a) retrospectively collected data from Ministry of Health Laboratory registers, Early Infant Diagnosis (EID) database from 28 health facilities and b) 9 key informant interviews with laboratory in-charges were conducted. A total of 2,879 HIV exposed babies' data were abstracted from January 2012 to June 2013. The mean TAT from specimen collection and results received back at the facilities was 46.90 days, Vihiga county having the shortest mean duration at 33.7days and Kakamega county having the longest duration at 51.7days (p = 0.001). In addition, the mean transport time from specimen collection and receipt at Alupe Kenya Medical Research Institute (KEMRI) reference Laboratory was 16.50 days. Vihiga County had the shortest transport time at 13.01 days while Busia had the longest at 18.99 days (p = 0.001). Longer TAT was due to the batching of specimens at the peripheral health facilities and hubbing to the nearest referral hospitals. The TAT for DNA-PCR specimen was 46.90 days with Vihiga County having the shortest TAT due to lack of specimen batching and hubbing. Discourage specimen batching/hubbing and support point-of-care early infant diagnosis (EID) tests.

Introducing: Ulrich J. Lorenz, Radoslav I. Enchev, Clare F. Megarity, Helen Ginn, Patrick Rabe, Alice R. Walker, and Kartik Ayyer

In this Voices article we introduce seven impressive young group leaders who spoke at the recent Ringberg Workshop on Structural Biology organized by Ilme Schlichting from the Max Planck Institute for Medical Research, Heidelberg. We asked them to tell us more about their careers and their exciting research.

Super-specialty Medical Teleconsultations to Remote Areas of Ladakh, India via E-Sanjeevani under Hub-and-Spoke Model: A Pilot Study

Objectives: To assess the feasibility, spectrum, outcomes and challenges of delivering super-specialty consultations to remote areas of the Union Territory (UT) of Ladakh through telemedicine. Design: Prospective, observational (descriptive), pilot study Methodology: Super-specialty medical teleconsultations were provided to healthcare providers in UT Ladakh by specialists in the Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh from October 2021 to May 2022, employing the hub-and-spoke model of the Ayushman Bharat Digital Mission. Doctor-to-doctor teleconsultations were initiated by treating doctors at healthcare facilities in UT Ladakh on the eSanjeevani™ platform. Audio-video model was used for teleconsultation and digitally signed prescriptions were shared. Setting: India – Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh (hub) and healthcare providers in UT Ladakh (spokes) Participants: Healthcare providers in UT Ladakh and specialists in the Department of Telemedicine, PGIMER, Chandigarh Interventions: Super-specialty medical consultations using telemedicine (eSanjeevani™ platform) Main Outcome Measures: Demand and spectrum of superspecialty teleconsultations, outcome of consults (whether managed successfully at teleconsultation level, or required referral for in-person visits), and technical challenges faced. Results: A total of 26 super-specialty teleconsultations were provided; 14 (54%) were for women. Patient distribution was uniform across all age groups. The super-specialty-wise distribution of consultations was - 9 from endocrinology, 9 from neurology, 3 from hepatology, 2 from cardiology, and 3 from neonatology. Reasons for seeking consultation were assistance in diagnosis (3, 12%), optimization of therapy (10, 38%), or both diagnostic evaluation and treatment optimization (13, 50%). Five cases (19%) were referred for physical visits to a higher center for advanced diagnostic testing like liver biopsy, brain biopsy, upper GI endoscopy, etc.; other cases were managed remotely. Problems with audio-visual connectivity were encountered in three patients. Conclusion: This pilot study demonstrates that complex, super-specialty medical consultations can be effectively delivered to remote areas through telemedicine. Future research should focus on assessing long-term outcomes, patient satisfaction, and cost-effectiveness to better evaluate the impact of this model.

Assessment of frequency and factors associated with low back pain among undergraduate medical students in Bangalore Medical College and Research Institute: a cross-sectional study

Background: A large percentage of young adults suffer from low back pain. Due to their demanding curriculum, medical students are most susceptible. This study aims to assess the frequency and factors associated with low back pain among undergraduate medical students at a college in Bangalore. Methods: An online cross-sectional study using a questionnaire was conducted among undergraduate medical students at Bangalore Medical College and Research Institute. SPSS 26.0 was used to analyze the data with a significance level of p <0.05. Results: Of the 250 students enrolled, 45.6% had low back pain. Long hours of sitting were the common factor aggravating the pain. The logistic regression analysis revealed that Phase 3 (part 2) MBBS (OR=2.53, 95% CI: 1.34 - 4.66), overweight (BMI>25) (OR=3.03, 95% CI: 1.42-6.50), coffee consumption regularly (OR=1.761, 95% CI: 1.007-3.009), Family history of LBP (OR=5.900, 95% CI: 3.182-10.939), duration of exercise/sports 1-2 hours per week (OR=1.691, 95% CI: 1.023-2.794), spending >8 hours for electronic gadgets daily (OR=2.02, 95% CI: 1.14-3.59) were found to be independently associated with low back pain. These results demonstrate an increased risk of low back pain among medical students with high BMI, lack of physical activity and increased electronic device usage. Conclusions: It highlights the necessity of focused treatments to control stress, minimize extended periods of sitting, enhance physical activity, and support proper posture among medical students. By preventing and managing low back pain, medical students can improve overall performance and quality of life.

Clinical and Polysomnographic Profile of Patients with Sleep Disordered Breathing in a Tertiary Care Hospital

Background: Obstructive Sleep Apnea (OSA) is a prevalent sleep disorder associated with various health complications, yet it often remains undiagnosed. Understanding its clinical and polysomnographic profiles is crucial for effective management. Objective: To investigate the clinical characteristics, including demographic factors and comorbidities, of patients diagnosed with Obstructive Sleep Apnea (OSA). To analyze the polysomnographic profiles of individuals with OSA, focusing on respiratory events, sleep architecture alterations, and cardio metabolic parameters, to provide insights into the severity and manifestations of the disorder. Methodology: Data were collected from patients who underwent Level 1 polysomnography at a Sleep Laboratory in Bangalore Medical College And Research Institute from January 2021 to September 2023. Clinical profiles and polysomnographic data were analyzed using IBM SPSS software. Results: The study included 112 patients with a median age of 52 years and a high median BMI of 33.29. Polysomnographic analysis revealed a mean AHI of 36.709, indicating severe OSA. Respiratory events during REM and NREM sleep showed variations in apnea and hypopnea occurrences. Cardio metabolic parameters indicated potential subclinical cardiac dysfunction and dyslipidemia. Conclusion: In conclusion, our study demonstrates a strong correlation between Obstructive Sleep Apnea (OSA) and cardiovascular health, characterized by respiratory disturbances and obesity. Notably, elevated Pulmonary Artery Systolic Pressure (PASP) highlights the potential risk of pulmonary hypertension in this population, warranting close monitoring and targeted therapies. The findings underscore the importance of multidisciplinary management approaches in addressing OSA and its associated health conditions to improve patient outcomes and quality of life.

COVID-19 Research Output from South Asia: A Scientometric Analysis of Highly Cited Papers

Background and Aims: Highly cited papers (HCPs) can influence both research and clinical practice. They help to identify core literature and important advances in a field. This study aimed to assess the current status and prospects of South Asia COVID-19 research from the HCPs using bibliometric indicators. Methodology: COVID-19 literature from South Asia published between December 2019 and 29 November 2023 in the Scopus database was analysed. The top HCPs, having more than 200 citations, were evaluated. Information about citation counts, authors and organisations and their affiliations, year of publication, source journal, geographical origin, subject, article type, funding details, etc. were retrieved and analysed. Data and visualisation analysis was undertaken using Microsoft Excel and other bibliometric software. Results: The 298 South Asia HCPs were published from 2020 to 2023 and were cited 200–3,596 times, with a mean average of 413.9 citations per paper (CPP). Around 24.5% and 51.3% of HCPs received external funding support and were involved in international collaboration, respectively. The most productive organisations were the Postgraduate Institute of Medical Education and Research, Chandigarh, and the Indian Institute of Technology, New Delhi, while the most impactful organisations were Bai Jerbai Wadia Hospital for Children, Mumbai, and Kokilaben Dhirubhai Ambani Hospital & Medical Research Institute, Mumbai. The most productive journals were Diabetes and Metabolic Syndrome: Clinical Research & Reviews. Conclusions: This study has identified core and significant authors, organisations, journals, subject fields and significant keywords, collaborators and funding agencies involved in South Asia’s COVID-19 research.

High-Frequency Audiovestibular Dysfunction in Long-Standing Diabetes Mellitus: Insights from a Cross-Sectional Study.

This study investigates audiovestibular dysfunction in individuals with long-standing diabetes mellitus (DM). A cross-sectional study was conducted involving 100 patients (DM for ≥ 10years) at the Department of E.N.T. in Prakash Institute of Medical Sciences and Research, Sangli, Maharashtra. A mean age of 43.09years among patients, with 64% male and 36% female participants. Hearing loss was the most common complaint, affecting 46% of subjects, followed by vertigo in 23%. Pure tone audiometry revealed that 34% of patients had sensorineural hearing loss, with varying degrees of severity. Vestibular dysfunction was observed in 10% of cases. Correlation analysis indicated a significant positive relationship between the duration of DM and hearing thresholds at various frequencies, as well as with HbA1c levels. This suggests a worsening of hearing with longer DM duration and higher HbA1c levels. The prevalence of hearing impairment was higher at higher frequencies, with vestibular dysfunction also noted in a subset of patients.

Long-Term Outcome Analysis of Surgically Treated Talus Fractures in a Tertiary Care Hospital.

Aim The present study aims to look at the long-term clinical and radiological outcomes of surgically treated talus fractures. We have compared the outcomes and complications between simple and complex talar fracture patterns. Additionally, patients' ability to return to activity following surgical treatment of these fractures was also analysed. Materials and methods Retrospective analysis of surgically treated talus fractures at the PSG Institute of Medical Sciences and Research from 2012 to 2015. The fractures were classified as neck and body fractures. The fractures were classified anatomically (neck and body) based on their severity (simple and complex) fracture patterns. A radiological assessment was done at follow-up to assess for complications of malunion, avascular necrosis (AVN), and arthritis. The outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score and the Maryland foot score (MFS). Results Twenty patients were included in the analysis. There were 12 talar neck and eight body fractures, subclassified into simple (10) and complex fracture patterns (10). The surgical approach involved either a medial malleolus osteotomy/via fractured medial malleolus (55%) or a non-osteotomy-based approach (anteromedial (AM)/anterolateral (AL)/combined AM and AL) (45%). The average AOFAS score was 71.34, while the MFS was 74.35. The outcomes were consistently unfavourable for patients with complex fractures with a higher propensity for complications, but no difference was observed when comparing neck and body fractures. There was a 10% incidence of malreduction in the non-osteotomy-based approach group. AVN was found in 35% of cases, and post-traumatic arthritis occurred in 75% of cases during the five-year follow-up period. Conclusion The findings of the present study consistently reiterate the propensity for complex talus fractures to develop complications like AVN and post-traumatic arthritis in the long term. This study serves to help predict talus fractures based on their severity, with poor outcomes noted with more complex fracture types. We also advocate a more extensile medial malleolus osteotomy-based approach to better visualise complex body fractures of the talus and obtain more anatomical reduction.

Clinical Pertinence and Determinants of Potential Drug–Drug Interactions in Chronic Kidney Disease Patients: A Cross-sectional Study

Background: Chronic kidney disease (CKD) is one of the major health issues effecting around 15% of world population, and its further complications has raised the need of polypharmacy for management. But this polypharmacy also upsurges the risk of potential drug-drug interactions (pDDIs) in CKD patients, which may further be responsible for increased morbidity and mortality. Objective: The main objective is therefore to evaluate the distribution, severity, causes, associated drug interactions, and clinical relevance of determination of pDDIs in CKD patients. Methods: Medical files of CKD patients examined at nephrology department, Maharishi Markandeshwar Institute of Medical Sciences and Research (MMIMSR), Mullana, between December 2022 and May 2023 were cross-sectionally assessed for this study. Medscape drug interaction checker was used to study patient profiles for pDDIs, and suggestive measures to minimize those pDDIs were studied using DDInter to ensure better clinical decision-making and patient safety. IBM SPSS (version 24) was utilized for statistical analysis. Results: The data reveal that 74.5% of the 200 medical files being evaluated had 839 pDDIs in total, out of which nearly 78.3% of patients had moderate, 15.6% had minor, and 6.07% had serious interactions. The potential adverse outcomes of pDDIs included an irregular heartbeat, hypokalemia, central nervous system (CNS) adverse effects, hypoglycemia, and a decline in therapeutic efficacy. The prevalence of pDDIs was discovered to be substantially correlated with age ≥60 years, (odds ratio [OR] = 0.65; 95% CI = 0.4-0.9; P = 0.040), length of stay ≥10 days (OR = 4.0; 95% CI = 1.29-6.1; P = 0.016), and number of prescribed drugs ≥10 (OR = 5.5; 95% CI = 2.45-10.69; P = 0.004). Conclusion: Patients with CKD have a high incidence of pDDIs (mainly mild to moderate). Older age, duration of hospital stays, and polypharmacy all raise the risk of pDDIs. Healthcare professionals (physicians and clinical pharmacist) should use drug interaction checker software programs like Medscape and DDInter to acquire knowledge about different pDDIS and their alternative measures so that the associated adverse drug reactions (ADRs) can be controlled and rational drug combination can be prescribed for management of CKD ensuring better patient care.

Perceptions on Medical Professionalism Among Future Healthcare Professionals: A Mixed Method Study.

Background Accreditation councils across the world constantly examine policies and practices in professionalism in their medical curriculum. The National Medical Commission (NMC) in India has recognized the pressing need to reform and include professionalism in its undergraduate curriculum. Objectives The objective of this study was to explore the perspectives of medical and nursing students on professional behavior, suitable teaching-learning methods, and assessment strategies for curriculum integration. Methodology The study utilized a concurrent triangulation mixed method design, collecting both qualitative and quantitative data simultaneously to gain a comprehensive understanding of medical and nursing students' perceptions of professionalism. It included 83 final-year undergraduate medical students and 42 final-year undergraduate nursing students. The approval of the Institutional Review Board of Meenakshi Medical College Hospital & Research Institute was obtained. A semi-structured questionnaire consisting of demographic characteristicsand opinions regarding academic professional behavior, teaching-learning, and evaluation of professionalism was used. Perceptions regarding the meaning of professionalism, behavior of professionalism to be emphasized in teaching, and pressing challenges of professionalism were explored. Students were also asked to rank the best behavior associated with professionalism. Frequency and percentages were used for descriptive statistics. Means and standard deviations were calculated for continuous variables. An unpaired t-test was used to determine a statistically significant difference between the means in the two groups. The quantitative data was analyzed with R programming and content analysis was performed for the qualitative data using ATLAS.ti qualitative data analysis software. Results Unexplained/unauthorized absence from academic activities (2.39 ± 1.553), not following the timeline (2.41 ± 1.560), making fun of patients and peers (2.16 ± 1.619), cheating in the exams (2.37 ± 1.651), and inebriation (2.39 ± 1.666) were unacceptable behaviors by undergraduate medical students compared with nursing students. Clinical experience (1.54 ± 0.857) and role models (1.74 ± 0.935) were the highly acceptable methods of teaching professionalism and interprofessional interactions (1.58 ± 0.650) and awards (1.98 ± 1.100) were the most common suggestions to improve the course curriculum by both groups. Community/field activity (1.78 ± 0.860) and clinical examination (1.89 ±1.123) were the most preferred methods of evaluation of professionalism. According to the students, dedication, honesty, respect, and self-improvement were identified as the best behaviors associated with professionalism. Conclusions The study revealed that students had a wide range of perspectives about professionalism. Different unprofessional acts were acceptable to students. The causes of these perspectives need to be explored and resolved to promote professionalism. Students identified the need for strong positive role models and frequent clinical experiences, along with improved interprofessional interactions and awards to improve teaching and learning professionalism. Community/field activity was the preferred assessment method proposed by the students. Medical institutions must promote these components in curriculum, faculty development, and clinical settings to foster the development of professionalism among students.

IJCM_390A: A study to assess body weight perception, weight control practices, and their association with menstruation among adolescent girls in the rural field practice area of Bangalore medical college and research institute

Background: Adolescent girls are concerned about their weight, physical appearance, and how society perceives them. The identities they seek and create in this phase influence society and their peers. In this process, a lot of Emotional, Biological, and Social problems are faced by them. One such problem is Menstrual disorders. Keeping this rationale in mind, the above study was undertaken to Assess Body weight perception, Weight control practices, and their association with Menstruation among Adolescent girls. Objective: 1. To assess Body weight perception and Weight Control Practices, among Adolescent girls 2. To compare Body weight perception and Weight control practices among Adolescent girls with normal and abnormal Menstrual cycles Methodology: A Cross-sectional study was conducted among Adolescent girls residing in the rural field practice area of Bangalore Medical College and Research Institute, Bengaluru. A Sample size of 192 was determined based on a previous study done by Bhurtun DD et al, and Simple random sampling was used for participant recruitment. Data collection utilized a pre-tested structured questionnaire. Data analyzed using SPSS 21.0 Results: Among the 192 participants, based on Body mass index (BMI), 13(6.7%) were Overweight and the rest of the participants 135(70.3%) were of Normal weight. Out of 118(61.5%) respondents reported trying to lose weight, reducing fat intake 100(84.7%) was the most common method. The majority of the Adolescent girls had a positive perception of weight control but had problems accepting their body image as healthy. Body weight perception and Weight control practices affected normal menstrual cycles as well as girls with Menstrual disorders. Conclusion: The findings revealed Body weight perception affected the girls with Normal Menstruation as well as with Menstrual disorders. Therefore, Adolescent girls need to be educated on the need for a Healthy body image as well as a Healthy lifestyle.

IJCM_124A: A cross sectional study to assess the prevalence, pattern and predictors of complementary and alternative medicine use among non – communicable disease patients in the urban field practise area of a Government Medical College, Bengaluru

Background: In the current century, a significant challenge is addressing the escalating global burden of Non-Communicable Diseases. Integrating Alternative and Complementary Medicine into the existing healthcare system is a major initiative to combat this issue. Despite increased access to free healthcare facilities, heightened disease awareness, and widespread exposure through electronic and print media, the popularity of unprescribed alternative medicine persists in India. Objectives: To assess the Prevalence, Patterns, and Predictors of Complementary and Alternative Medicine use among non-communicable disease patients in the urban field practice area of Bangalore Medical College and Research Institute, Bengaluru. Methodology: A cross-sectional study conducted among non-communicable disease patients residing in the urban field practice area of Bangalore Medical College and Research Institute, Bengaluru. A sample size of 250 was determined based on a pilot study and systematic random sampling used for participant recruitment. Data collection utilized a pre-tested structured questionnaire. Data analysed using SPSS 21.0 Results: Among the 250 participants, 55 (22%) used both Allopathic and Alternative medicines, only 11 (20%) exclusively relying on Alternative systems. Ayurveda was the most utilized alternative medicine 15(27.2%), followed by Sidda 8(14.5%). Statistically significant associations were observed between the usage of Alternative medicine and patients’ religion and education. Conclusion: A relatively small percentage of adults exclusively used Alternative systems of medicine in this study. Ayurveda emerged as the predominant alternative medicine, followed by Sidda. The prevalence of alternative medicine was higher among Hindus and participants with education below the primary level. These findings shed light on the complex dynamics of healthcare.

Assessment of Epidemiology and Clinical Profile of Psoriatic Arthritis Patients in India.

Psoriasis is an inflammatory skin disease associated with significant comorbidity. However, the characteristics of patients with psoriasis are not well documented in India, and a more detailed understanding is needed to delineate the epidemiologic profile at the regional level for better management of psoriasis. Herein, we reported the clinical profile and demographic pattern of psoriasis to further understand its burden in the Indian setting. We conducted a retrospective observational study of patients diagnosed with psoriasis who fulfilled the classification criteria for psoriatic arthritis (CASPAR) criteria. Patients were included from the rheumatology outpatient department of Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute in Mumbai, India. The outcomes included demographic and clinical profiles, patterns of joint involvement, and comorbidities associated with psoriasis. A p-value of <0.05 was considered significant. We enrolled 60 patients, with a mean age of 50.87 years and a higher proportion of females (62%). The majority of patients with less than five joints had associated comorbidities (40 out of 60). Psoriatic arthritis (PsA) occurred in 41 patients [mean ± standard deviation (SD) age of onset-38.88 ± 13.24 years], with the highest occurrence in the 30-50 years (53.3%). The majority of patients with PsA developed it within 2 to ≥5 years of psoriasis occurrence. We did not find any significant correlation between the occurrence of PsA and comorbidities, as well as the duration of PsA and the number of joints (p = 0.152). Pitting and enthesitis were the most common morphological changes noted in almost half of the patients. Our study provides an overview of the epidemiologic and clinical characteristics of psoriasis patients in India. These findings could be useful for early diagnosis of PsA and help clinicians in assessing the progression of psoriasis into PsA.

IJCM_402A: Assessment of sleep quality and risk factors associated with poor sleep quality among medical students- A cross sectional study

Background: Sleep is a periodic resting state of natural arousable unconsciousness of body and mind, which leads to the returning of body and mind. A good sleep has been shown to be essential component of health, and its deprivation linked to various diseases. Sleep deprivation is defined as getting inadequate sleep, less than 7-9 hours per day. Although, sleep deprivation is generally a disorder of elderly and sick, it has increasingly been reported among college students and is considered a global health problem Objective: To evaluate sleep quality among medical students and identify risk factors associated with poor sleep quality among them. Methodology: Study design: Cross sectional study, Study setting: GITAM Institute of medical sciences and research, Study population :Medical students from MBBS first year to final year, Study period:2 months, Inclusion criteria :Medical students of 1st,2nd,3rd,4th year Exclusion criteria: Students who has not given consent Sampling method: Convenient sampling method Sample size: prevalence=68.6%==176, Pittsburgh Sleep Quality Index (PSQI) scale was used to measure sleep quality. SPSS software is used for analysis. Results: The mean age of study participants is 20±4. PSQI score is Good sleep in 24.4%, Fairly good sleep in 49.4%,Fairly bad sleep in 10.8%,Poor sleep in 15.3%. Conclusion: Poor sleep quality among medical students is 26.1%,factors associated are mobile use and presence of chronic illness.

Exploring central serous chorioretinopathy: Insights from a series of pigment epithelial detachment cases

ABSTRACT Aim: This study aimed to investigate central serous chorioretinopathy (CSCR) by analyzing clinical patterns using spectral-domain optical coherence tomography (SD-OCT). Methods: A retrospective study on individuals diagnosed with CSCR was conducted at the Gitam Institute of Medical Sciences and Research between January 2022 and December 2022. Comprehensive medical and ocular histories were documented, including best-corrected visual acuity, slit-lamp examination, indirect ophthalmoscopy, and SD-OCT analysis. Macular thickness and the presence of pigment epithelial detachments (PED) were carefully recorded, while patients with other macular conditions were excluded. Results: The study comprised nine patients (nine eyes) aged 31 to 48 (mean age: 41.33). Of these, seven were male (77.78%), and two were female (22.22%). Three cases (33.33%) affected the left eye, while six (66.67%) involved the right eye—the mean macular thickness measured 502.56 μm, from 406 to 819 μm. Notably, five out of the nine eyes exhibited PEDs. Among these cases with PED, four of the five eyes demonstrated macular thickness exceeding 482 μm, with only one eye measuring 406 μm in thickness. Conclusion: CSCR predominantly affects males at an average age of 41. The integration of SD-OCT with indirect ophthalmoscopy is imperative for comprehending CSCR patterns. The substantial variation in macular thickness underscores the necessity for individualized assessment and treatment strategies. The presence of PED correlates with heightened macular thickness, potentially influencing recovery duration and visual acuity outcomes. While this study contributes to the existing knowledge base, further extensive research is essential to validate and enhance our understanding of CSCR.

IJCM_166A: A cross sectional study to assess knowledge, attitude and practices about dietary supplements among gym going medical students.

Background: Nutrition plays equal role as physical activity in maintaining good health and improving fitness. According to FDA, Dietary supplements are products intended to supplement the diet. They are not medicining and are not intended to treat, diagnose, mitigate, prevent, or cure diseases. Adolescents may be vulnerable to misleading nutritional information and adopt unhealthy food habits. Food habits of the youth could be influenced by specific features related to physical training, either aimed to improve fitness or to comply with sport demands. Use of protein supplementation without professional guidance can cause adverse effects on kidney and liver functions. Objectives: 1) To assess knowledge about dietary supplements among gym going medical students. 2) To assess the attitude and practices about dietary supplements among gym going medical students. Methodology: A cross-sectional study was conducted among 150 gym going medical students of Mysore Medical College and Research Institute from October to November 2023 using a predesigned and pretested semi-structured questionnaire. Subjects were selected using convenient sampling method. Data was entered in Microsoft Excel and was analyzed using SPSS trial version 29. Results: The study included 150 participants who completed the questionnaire. More than 70% of the participants were males and around 30 % of the study population used at least 1 dietary supplement. More than 95% of them knew about the dietary supplements. Most commonly used dietary supplements were whey protein and creatine powder. Only 10% of participants consuming dietary supplements have taken a dietician’s or expert’s opinion. Conclusion: The study showed that significant number of participants were using dietary supplements. But majority does not take an expert’s opinion before consuming dietary supplements. Both users and non-users of dietary supplements would benefit from improved understanding of the health effects of dietary supplements through health education.

IJCM_357A: Smartphone addiction and physical activity among students of a Medical College in Bengaluru-a cross-sectional study

Background: Smartphones have become an indispensable necessity for medical students because of their various demands and comforts. The excessive use of smartphones may lead to addiction which can negatively affect physical and mental health including physical activity. The relationship between smartphone addiction and physical activity needs exploration. Hence this study was undertaken to assess the magnitude of smartphone addiction and to explore its association with physical activity among students of a medical college in Bengaluru. Objective: To assess smartphone addiction and its association with physical activity among students of a medical college in Bengaluru. Methodology: A cross-sectional study was conducted among students of Bangalore Medical College and Research Institute. Based on a study done in Maharashtra(p=46.15%), the sample size was calculated as 382. Study subjects were recruited by stratified random sampling and probability-proportional to size sampling was used to select study participants across various strata. Data was collected using a pretested semi-structured questionnaire. Smartphone addiction was assessed by smartphone addiction scale-short version (SAS-SV) and physical activity by international physical activity questionnaire-short form (IPAQ-SF). The data collected was entered in MS Excel and analyzed using SPSS 21.0. Results: Among 382 students 164(43%) were found to have smartphone addiction. The primary use of smartphones was for social networking. Physical activity, duration of smartphone usage, and use of the smartphone right before sleeping were associated significantly with smartphone addiction. Conclusion: The problem of smartphone addiction has reached an alarming level. There is a need to create awareness about the problem and plan effective strategies to address it.

IJCM_10A: Role of male spouse in antenatal care of pregnant women in the urban field practice area of Bangalore Medical College and Research Institute, Bengaluru – A Cross-Sectional study

Background: The husband has a great role to play in the antenatal care of his wife during pregnancy. Male spouse involvement is crucial and essential in utilization of the services and benefits, antenatal services to the maximum by the woman. The male spouse involvement will have positive impact on reproductive and child health. The extent of involvement of male spouse depends on the gender role attitudes and the social network. Objective: To assess the involvement of Male spouse in Antenatal care. Methodology: A community based cross-sectional study was conducted in the month of June to November 2023 among 263 Male partners of parous women between the reproductive age 15-45yr, in the urban slum area of BMCRI, Bangalore through simple random sampling technique. A pre-tested, semi-structured, questionnaire was used to collect the data, to assess their involvement during antenatal care. Data collected was entered in MS Excel and analysis was done using SPSS version 21.0. Results: In our study, 84% were actually present at the hospital during the delivery and 82.5% had good practice of taking appointment for ANC visits of their wives. About 77.6% were aware of pregnancy related danger signs. But only 35% participants accompanied their wives to ANC visit at least four times. Conclusion: There is a need to recognize importance and positive impact of male participation in antenatal care. Knowledge and attitude of men are the prime determinants of their level of participation in antenatal care.

An In-Depth Analysis of Public and Private Research Funding in Orthopaedic Surgery from 2015 to 2021.

Understanding the trends and patterns of research funding can aid in enhancing growth and innovation in orthopaedic research. We sought to analyze financial trends in public orthopaedic surgery funding and characterize trends in private funding distribution among orthopaedic surgeons and hospitals to explore potential disparities across orthopaedic subspecialties. We conducted a cross-sectional analysis of private and public orthopaedic research funding from 2015 to 2021 using the Centers for Medicare & Medicaid Services Open Payments database and the National Institutes of Health (NIH) RePORTER through the Blue Ridge Institute for Medical Research, respectively. Institutions receiving funds from both the NIH and the private sector were classified separately as publicly funded and privately funded. Research payment characteristics were categorized according to their respective orthopaedic fellowship subspecialties. Descriptive statistics, Wilcoxon rank-sum tests, and Mann-Kendall tests were employed. A p value of <0.05 was considered significant. Over the study period, $348,428,969 in private and $701,078,031 in public research payments were reported. There were 2,229 unique surgeons receiving funding at 906 different institutions. The data showed that a total of 2,154 male orthopaedic surgeons received $342,939,782 and 75 female orthopaedic surgeons received $5,489,187 from 198 different private entities. The difference in the median payment size between male and female orthopaedic surgeons was not significant. The top 1% of all practicing orthopaedic surgeons received 99% of all private funding in 2021. The top 20 publicly and top 20 privately funded institutions received 77% of the public and 37% of the private funding, respectively. Private funding was greatest (31.5%) for projects exploring adult reconstruction. While the amount of public research funding was more than double the amount of private research funding, the distribution of public research funding was concentrated in fewer institutions when compared with private research funding. This suggests the formation of orthopaedic centers of excellence (CoEs), which are programs that have high concentrations of talent and resources. Furthermore, the similar median payment by gender is indicative of equitable payment size. In the future, orthopaedic funding should follow a distribution model that aligns with the existing approach, giving priority to a nondiscriminatory stance regarding gender, and allocate funds toward CoEs. Securing research funding is vital for driving innovation in orthopaedic surgery, which is crucial for enhancing clinical interventions. Thus, understanding the patterns and distribution of research funding can help orthopaedic surgeons tailor their future projects to better align with current funding trends, thereby increasing the likelihood of securing support for their work.

Short-term impact of a healthy and typical Australian dietary pattern on cardiometabolic outcomes: insights from a randomised, cross-over feeding study

Immune Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305 Australia.Cardiovascular disease (CVD) remains a major cause of global mortality. Poor diet quality, characterised by excessive consumption of energy-dense, nutrient-poor foods and insufficient intake of fruits, vegetables, and whole grains, is associated with an increased risk of CVD(1). This study compares the impact of two short-term dietary interventions, a Healthy Australian Diet adhering to national guidelines and a Typical Australian Diet representing current national consumption patterns, on several cardiometabolic outcomes. These outcomes include body weight, waist circumference (WC), body fat percentage (BFP), blood pressure (BP), fasting blood lipids and glucose concentrations. Data from an eight-week randomised, cross-over feeding study involving 34 adults (53% female, age 38.4 ± 18.1 years) were analysed, with participants randomly assigned to consume each diet for two weeks, separated by a two-week washout period. During each feeding phase, all food items were provided to ensure compliance. The Healthy Australian Diet adhered to the Australian Dietary Guidelines(2), including a balanced intake of the five food groups and meeting Acceptable Macronutrient Distribution Range targets(3), with saturated fat limited to ≤10% of energy. The Typical Australian Diet was formulated based on apparent consumption patterns in Australia(4), setting total fat intake at 40% of energy and total saturated fat at 15% of energy. Comprehensive data collection occurred at four key visits: week 0 (end of run-in; baseline 1), week 2 (post-feeding phase 1), week 4 (end of washout, baseline 2), and week 8 (post-feeding phase 2). Trained personnel measured WC using a tensible tape, while body weight and BFP measurements were obtained using bioimpedance analysis (Inbody 270; Biospace Co, Seoul, Korea). Blood pressure was recorded using the Uscom BP+ supra-systolic oscillometric central blood pressure device. Blood glucose and lipid (triglycerides, total-, low-density lipoprotein- [LDL] and high-density lipoprotein- [HDL] cholesterol) concentrations were measured after a 12-hour fast by an accredited pathology service. Differential changes in cardiometabolic variables between intervention groups were evaluated using linear mixed-effect models, adjusting for diet sequence, feeding phase, and subject ID as a random variable to account for potential autocorrelation. Post-hoc pairwise comparisons were conducted to assess the impact effects of each diet. There were no significant differences between the Healthy Australian Diet and the Typical Australian Diet with respect to weight, BFP, WC, blood triglycerides, systolic and diastolic BP. However, the Healthy Australian Diet led to a significantly greater decrease in total-, LDL-, HDL- and non-HDL cholesterol, and fasting blood glucose relative to the Typical Australian Diet (p&lt;0.001). The results underscore the importance of promoting dietary intakes that align with Australian Dietary Guidelines for optimising the risk of CVD and impaired glucose tolerance. Conversely, the Typical Australian Dietary pattern demonstrated detrimental cardiometabolic effects over a short period of just two weeks.