Nehru Medical College Research Articles

Study on Hydroxychloroquinine Sulfate Being Given to the Admitted COVID -19 Positive Patients at Institute of JLNMCH, Bhagalpur, Bihar, India.

BackgroundAs the global death toll from new coronavirus illness (COVID-19) rises, the scientific community and healthcare systems are under massive pressure to manage the outbreak and develop effective medical remedies. Meanwhile, desperation has pushed practitioners, scientists, and authorities to recommend and attempt medicines with little or no proof. Despite the lack of clear and unequivocal facts supporting its efficacy and safety, hydroxychloroquine-sulfate (HCQS) has recently received substantial public and political interest in treating and prophylaxis new infectious diseases COVID-19.AimTo analyze the impact of HCQS in COVID-19-positive patients admitted at tertiary level government-owned Jawaharlal Nehru Medical College and Hospital (JLNMCH, Bhagalpur) Bihar.MethodsTwo hundred two RT-PCR-positive COVID-19 patients were included in this research. The study participants were randomly distributed into the intervention category and control category, each consisting of 101 study subjects. Study participants in the intervention category were administered hydroxychloroquine in 200 mg tablets. The control category was given placebo tablets that looked similar to tablets of hydroxychloroquine and were given in the same pattern. Chest X-ray PA view, 12 lead ECG, baseline hemogram including a concentration of CD4 cells, ratio between the concentration of CD8 cells and CD4 cells and concentration of CD8 cells, the concentration of C-reactive protein, RT PCR test of samples obtained from the oropharyngeal region and nasopharyngeal region nasopharyngeal for verification COVID-19 were done. These measurements were carried out in both the control and intervention categories at baseline and at the moment of obtaining a negative RT-PCR report.ResultsThe confirmed cases of COVID-19 was 52.9% in the intervention category and 53.4% in the control category at the end of the administration of drugs. Symptoms related to COVID-19 were observed in 11.6% of subjects in the intervention category and 13.5% in the control category. Other new symptoms were observed in 16.8% of subjects in the intervention category and 14.5% of study subjects in the control category. One death was reported in the control category. Emergency hospitalization was required for one subject in the intervention category, while two subjects in the control category required emergency hospitalization. 12.4 days was the mean duration of recovery in the intervention category, while 13.6 days were the mean duration of recovery in the control category. The recovery duration and COVID-related symptoms were lesser in the intervention category than in the control category; however, the variation between the two categories was statistically non-significant (p˃0.01).ConclusionAccording to this research, no statistically significant difference was noticed in COVID-19 incidence between the control category and intervention category, showing that hydroxychloroquine sulfate cannot be utilized as the main curative agent in the treatment of COVID-19. However, there was a reduction in recovery days and symptoms related to COVID-19 in study subjects administered with HCQS.

Evaluating Energy Efficiency in a Hospital Building with Reference to GRIHA: Case of Trauma Centre at Aligarh, India

With the rise in problems mainly ecological as well as energy crises that are intensifying today, the concept of green has become essential concerning sustainable development. The hospital building consumes much more energy and generates more waste, as compared to the other types of buildings. The climate change, contamination of chemicals, and use of unsustainable resources are all making health worse day by day over the world. The health sectors are themselves causing these problems on a broad scale. So, hospitals, health sectors must be green, there must be proper management of resources, waste etc., which means that it must have a minimum negative impact on the environment. The term Green Hospital has evolved as a way of addressing environmental issues, overcoming them and meeting society’s need. In India, Green Rating for Integrated Habitat Assessment (GRIHA) is one of the tools that provides green building certification to hospital buildings also. This paper aims at analyzing and investigating a hospital building (Trauma centre), Jawaharlal Nehru Medical College, Aligarh, based on major criteria of the GRIHA variant for existing buildings. This hospital building had been provisionally-rated by GRIHA in the year 2016 as 3 stars. This paper includes the analysis of building based on various calculations and in depth study of how this 3 star rating was provisionally achieved. This paper involves two main calculations, one regarding peak heat gain and the other is EPI.

Incidence and outcomes of acute kidney injury in term neonates with hypoxic ischemic encephalopathy: an observational study

Background: Hypoxic ischemic encephalopathy (HIE) is one of the devastating birth related complication. It predisposes the babies to serious outcomes, an important one being acute kidney injury (AKI).Methods: A prospective crossectional observational study was conducted in Jawaharlal Nehru Medical College and Hospital, AMU, Aligarh between November 2019 and October 2020. 153 term neonates with perinatal asphyxia were enrolled. HIE staging and AKI staging done according to Sarnat and Sarnat classification and KDIGO classification respectively. Outcome in terms of recovery, persistent deranged renal function at discharge or mortality noted.Results: In our study, incidence of Acute Kidney Injury in Hypoxic Ischemic Encephalopathy neonates was 37.7%. There was around 39-fold increase risk of developing AKI in HIE stage III versus HIE stage I. Mortality rate was found to be 51.6%. Mortality was significantly high in HIE stage III. There was around 5-fold increase risk of mortality in HIE neonates with AKI as compared to HIE neonates without AKI. 50% of the subjects who had AKI and discharged recovered of renal function before discharge and 50% recovered at 1 month follow up. In addition, there was no association found between different stages of HIE with different stages of AKI.Conclusions: It is better to screen all the birth asphyxia cases for AKI so that they can be detected early and managed accordingly.

Epithelial myoepithelial carcinoma in an ectopic salivary gland: A diagnostic dilemma

The ectopic Salivary Gland is the presence of salivary tissue in unusual locations which do not normally host it. Moreover, neoplasms arising from these ectopic tissues are very rare, however, tumourigenic changes in these inclusions have been observed in a few cases.We present a clinically unsuspected case of an ectopic salivary gland tissue present on the mid-neck, which was diagnosed as Small lymphocytic leukaemia outside Jawaharlal Nehru Medical College, Aligarh. On further evaluation, a definitive diagnosis of epithelial myoepithelial carcinoma arising in ectopic salivary gland tissue within the cervical lymph node was made. Therefore, these tumours need to be included in the differential diagnosis of neck masses, for a prompt diagnosis and adequate treatment.

A Study on the Correlation Between Endoscopic Findings and Symptoms of Gastroesophageal Reflux Disease (GERD).

BackgroundGastroesophageal reflux disease is a common disorder affecting a large section of the community. In addition, the numerous complications of chronic gastroesophageal reflux disease (GERD) necessitate adequate diagnosis and treatment of this common entity. Thus, to analyze the spectrum of GERD on the basis of symptoms and endoscopic findings along with the contributory effects of various risk factors including obesity, this specific study has been carried out.Study designA descriptive type of observational study was conducted on the patients visiting the outpatient department (OPD) at Acharya Vinoba Bhave Rural Hospital (AVBRH), affiliated with Datta Meghe Institute of Medical Sciences (DMIMS), Wardha, Maharashtra. The clinical symptoms, suspected risk factors, and endoscopic findings of the patients were studied, assessed, and correlated.Methods and materialPatients, more than 18 years of age complaining of a minimum of two typical symptoms of GERD for at least one month, were included in the study. Demographic data, clinical symptomatology, and personal history of the patients were noted. All the patients were subjected to esophagogastroduodenoscopy, and findings were recorded. Correlation and analysis were done on clinical and endoscopic findings.Statistical analysisThis descriptive study has been conducted after the approval of the Ethics Committee Department of Medical Education, Jawaharlal Nehru Medical College, Deemed University, Sawangi (DMIMS(DU)/IEC/Sept-2019/8403). The outcomes were recorded and analyzed at the end of the study using a Microsoft Excel Spreadsheet (version 16.40, Microsoft Corporation, Redmond, Washington, USA).Results and conclusionA total of 100 patients were included in the study. A number of male patients (58%) were more than that of female patients. Most of the patients were in the age group of 30-60 years (70%). The most common symptoms were epigastric pain (78%), regurgitation (71%), and heartburn (63%). Forty-five percent of the patients had erosive lesions suggestive of reflux esophagitis on endoscopic evaluation.

A Clinicopathological Study of Thrombocytopenia, Acute-Phase Reactants, and Blood Culture in Neonatal Sepsis

Introduction: Neonatal sepsis is a clinical syndrome described as any systemic bacterial infection in neonates documented by positive blood culture. However, blood culture is positive in only 5.0%–10.0% of suspected cases. Serum concentration of many acute-phase reactants rises in response to infection, which can be used as a non-specific indicator of bacterial sepsis. Aim and Objectives: The aim of this study was to correlate the levels of serum markers C-reactive protein (CRP), serum ferritin, and thrombocytopenia with neonatal sepsis. Materials and Methods: This was a prospective cross-sectional study conducted in the Neonatal Intensive Care Unit, Department of Paediatrics and Pathology, Jawaharlal Nehru Medical College (JNMC), Aligarh from 2019 to 2021 on 172 babies (cases =142; controls = 30). Neonates with sepsis who presented with clinical signs or symptoms of sepsis were taken as case group and healthy neonates served as control. Result: Blood culture was positive in 58 (40.8%) neonates in the case group and Klebsiella was present in maximum number of cases. Blood culture was positive in only 8 (13.8%) cases out of 31 cases of mild thrombocytopenia. The total culture-positive organism was 58 (40.8%), with 09 (15.5%) gram-positive, 46 (79.3%) gram-negative organisms, and 03(5.2%) fungus. Positive CRP was seen in 88 (61.9%) neonates in the case group, out of which, positive culture was noted in 38 (65.5%) neonates and negative in 50 (59.5%) neonates. Serum ferritin values >400 µgm/L was seen in 97 (68.3%) neonates in the case group and 6 (20.0%) neonates in control group. The mean serum ferritin in culture positive neonates was 1024 ± 309 µgm/L and in culture-negative neonates was 999 ± 301 µgm/L. Conclusions: The signs and symptoms of neonatal sepsis are non-specific, leading to difficulty in diagnosis and treatment. Biomarkers such as hematological indices, blood culture, and acute-phase reactants could be more reliable in rapid evaluation and early diagnosis of sepsis and may provide a new diagnostic strategy for the neonates with sepsis.

Clinico-epidemiological study of safe and unsafe chronic suppurative otitis media

Introduction: Chronic Suppurative Otitis Media (CSOM) remains one of the most commonest chronic infectious diseases worldwide particularly in children and adolescents. India has been classified as the high prevalence country with national prevalence of 4%. Knowledge of differential regional prevalence of risk factors is required for adequate health education of masses and for customised preventive and control measures in respective areas. Aims: To study the clinical and socio-demographic profile of patients with CSOM. Methods: The study was carried out in the department of Otorhinolaryngology, Jawaharlal Nehru Medical College, AMU, Aligarh from November, 2017 to December, 2019. Patients with CSOM attending the otorhinolaryngology OPD and those admitted in IPD were included in the study. Results: A total 200 cases of chronic suppurative otitis media including both safe (mucosal) and unsafe (squamous) type were studied. The mean age of participants was 22.8 ± 15.18 years. Of the total participants, 111 (55.5%, 95% CI 48.6 to 62.2) were males, 89 (44.5%, 95% CI 37.8 to 51.4) were females and the majority (60.5%, 95% CI 53.6 to 67) of them were from rural background. Around one-fourth of the patients were illiterate (23%, 95% CI 17.7 to 29.3) and the patients mostly belonged to lower side (lower middle, upper lower and lower) of the spectrum of Kuppuswamy socioeconomic classification. The distribution of age-group, gender and laterality (side of involvement) was similar (P>0.05) in both safe and unsafe type. Overall, 151(75.5%, 95% CI 69.9 to 80.9) patients were found to have conductive hearing loss, 30 (15%, 95% CI 10.7 to 20.6) with mixed and 19 (9.5%, 95% CI 6.2 to 14.4) did not have any hearing loss at presentation. The distribution of patients with regards to hearing loss was found to be similar in both safe and unsafe groups (P = 0.311). Conclusion: CSOM particularly afflicts younger age populations from rural background with poor socioeconomic status. Appropriate timely interventions in the form of health promotion, education about the risk factors and improvement in the living conditions will result in decrease in incidence and prevalence of the disease. Moreover, knowledge of symptoms and signs of the disease is likely to result in early seeking of healthcare and hence better treatment outcomes and prevention of complications.

Study on Determinants of Contraceptive Use: A Community Based Study in Eligible Couples


 
 Background: family planning methods are influenced by a variety of interrelated factors such as age at marriage, education, economic status, religion, number of living children, knowledge about contraceptives, availability, accessibilityand quality of services In spite of many programmes, couples are not aware of contraceptive methods even though they are wish to follow small family norm and still there is a gap between knowledge, attitude and practice. In a developing country like India, despite widely available contraception methods, still there is poor acceptance due to ignorance or fearof complications using them.
 Methodology: The present cross sectional study was conducted at PHC, field practice area of Department of community medicine, Jawahar Lal Nehru medical college and Hospital Bhagalpur. Study duration of two years. According to DLHS-3 prevalence of contraceptive acceptance in Bihar state was 63.2%. Sample size is calculated by taking prevalence rate of contraceptive use (63.2%) at 5% significance level and 10% allowable error. There are 28 anganawadi centers in ourstudy area. A list of eligible couples was obtained from each anganawadi and 10 eligible couples was selected randomly by Stratified Random Sampling.
 Results; The total prevalence of contraceptive use in the study area was 58.6%. It was found that practice of family planning methods was high among Hindu (87.2%) compared to Muslims (12.8%). It has been found that 40% of study population was from nuclear family. Forty six percent of the acceptors of contraceptives were held from nuclear family ascompared to 32% from joint family. 
 Conclusion: The Female literacy rate is exceptionally higher than national average. Early marriage is a prominent featurein the study area. Different factors namely age at marriage, type of family, number of living children, literacy status of female partner, and socioeconomic status significantly affect contraceptive behaviour of the studypopulation. 
 
 
 Keywords: Eligible couple, contraception, sterilization.

Red Blood Cell Morphology in Diabetic Patients: A Case-control Study

Introduction: According to earlier studies, patients suffering from diabetes frequently experience haematological changes. India is the diabetes capital, with 69.1 million residents suffering from the disease. Aim: To study Red Blood Cell (RBC) morphological changes and grading on percentage of cells that differ in size and shape from normal erythrocytes in diabetic patients. Materials and Methods: The case-control study was conducted at Division of Central Clinical Laboratory in Department of Pathology in coordination with Department of General Medicine at Jawaharlal Nehru Medical College, Wardha, Maharashtra, India, from October 2019 to October 2021. Total 90 known cases of diabetes mellitus, aged between 18-80 years and 90 subjects (control group) with normal blood glucose levels were included for the study. Demographic details, anthropometric, parameters i.e, Fasting Plasma Glucose (FPG), Random Blood Sugar (RBS), Glycated haemoglobin (HbA1c) and morphology of blood smear were assessed. Results: The mean age of study group was 54.98±2.31 years and control group was 50.45±17.94 years (p-value= 0.0004). The mean random blood sugar of study group was 163.92±91.31 mg/dL and of control group was 96.92±22.31 mg/dL (p-value=0.0001). Mean HbA1c for the study group was 7.73±1.71%, while in control group was 5.24±0.62% (p-value=0.0001). In the study group, 9 (10%) cases showed a slight anisocytosis (1+) and 3 (3.3%) cases showed moderate anisocytosis (2+), 2 (2.2%) cases showed marked anisocytosis (3+) (variation in size of RBCs with respect to normal) in respect to Mean Corpuscle Volume (MCV), and 11 (12.2%) cases showed MCV <80 fL, 2 (2.2%) cases showed MCV >80 fL, while majority of the cases; 77 (85.5%) had normal sized RBCs, had MCV between 80-99 fL. Conclusion: The findings of the study suggest that there is need for some simple and effective techniques like ectocytometry, micropore filtration for routine haematological tests in type 2 diabetes mellitus.

Aerobic bacterial study of postoperative lower segment cesarean site wound infection

INTRODUCTION: Cesarean section wound infection illustrates a significant load to the health system as it carries an increased risk of infection as compared to normal vaginal delivery. Hence, it is necessary to identify the agents responsible as well as their extent of susceptibility for commonly used antibiotics.MATERIALS AND METHODS: The study was carried out at the Department of Microbiology, Jawaharlal Nehru Medical College. The specimens were inoculated on the blood and MacConkey agar. The colonies were identified by their morphological characteristics and the biochemical tests, antibiotic susceptibility test was carried for the isolated aerobic bacterial isolates.RESULTS: In the present study, Staphylococcus aureus (13, 56.68%) was the most common pathogen isolated, followed by Klebsiella pneumoniae (5, 21.9%). Gram-positive isolates showed greater sensitivity to tetracycline 11 (73.33%), followed by doxycycline (11, 73.33%) and clindamycin (9, 60%). Gram-negative bacteria showed the highest sensitivity meropenem (7, 77.78%), imipenem (6, 66.66%), and piperacillin + tazobactam (6, 66.66%).CONCLUSION: Frequent antimicrobial audit and qualitative research could give an insight into the current antibiotic prescription practices and the factors governing the same.

Hemodynamics of superior mesenteric artery by doppler flow velocimetry in enterally fed moderately asphyxiated newborns

Introduction: Asphyxia is an important cause of neonatal mortality and morbidity. The disturbed hemodynamics caused by asphyxia can damage a number of organ systems including gastrointestinal system. Enteral feedings can therefore be risky in the asphyxiated newborns with jeopardized blood supply. Objective: The objective of this study was to estimate the abnormal Doppler flow indices of splanchnic circulation in moderately asphyxiated term newborns on the 1st day of life. Design: This was a prospective case–control study. Study setting: This study was conducted in the Neonatology Division, Department of Pediatrics and Department of Radiodiagnosis, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh. Materials and Methods: This study included thirty hemodynamically stable asphyxiated babies as cases. The controls were gestation- as well as weight-matched normal newborns. Blood flow in the superior mesenteric artery (SMA) was estimated by Doppler ultrasonography within the first 24 h of birth of the baby. The peak systolic velocity, end-diastolic velocity, time-averaged mean velocity, and the resistive index were recorded. The measurement was done before and 1 h after giving feed to the baby. The pre- and postfeed Doppler indices of the SMA were measured and compared with the controls. The tolerance of oral feeds by the babies was regularly monitored. Results: The baseline velocity in the study group prior to feeding was comparable to the control group. None of the cases developed feed intolerance and showed a similar postfeed hemodynamic response in the SMA as that of controls. Conclusion: Enteral feeds could be safely started and continued in all the moderately asphyxiated term neonates within the 1st day of life after demonstrating establishment of splanchnic flow in the Doppler study.

Inculcating research methodology related skills and aptitude amongst medical undergraduates- An interventional study.

The present project was carried out at Jawaharlal Nehru Medical College (JNMC), Datta Meghe Institute of Medical Sciences (DMIMS, deemed to be University), Wardha, Maharashtra, as part of the training programme as per the advanced course in medical educational research, the theme of the project was based on skill training. The project was titled "Inculcating research methodology related skill and aptitude amongst medical undergraduates". The basic aim of the study was to make the medical undergraduates competent and apprised with certain basic research skills in research methodology and to develop aptitude amongst the undergraduates for research. The present research project took Bachelor of Medicine and Bachelor of Surgery (MBBS) students from the 2016 batch, from the sixth and seventh term of their professionals and the project was conducted for 6 months duration from October 2018 to March 2019. From the batch of 200, a randomised selection of students was carried out and 57 students in total were selected. The study was carried out in three phases as follows: Phase one (assessment and sensitization); phase two (skill training/mentoring); phase three (research outcome/culmination). In the primary endpoint, the assessment of pretest and posttest were tabulated as well as feedback was taken; in the secondary endpoint the research projects conducted were translated into publications and the student's response were applied for funded research projects like the Indian Council of Medial Research (ICMR) that was evaluated. Pretest score of 1 out of 10 (average score of 57 responses), that is, 10% and a posttest score of 6.9 out of 10, that is, 69.1%, the absolute learning gain was 59.1% and relative learning gain was 59.1%, the classroom averaged learning gain was 0.59. In the present study, the learning gain score was 0.59 which is in medium range according to Hake's learning gain criteria. The present study concluded that there was a lack of understanding amongst medical undergraduates pertaining to the basic nuances of the research and how to go about carrying out the same. An ideal environment, mentorship is necessary for inculcating interest for research.

Effect of Head Rotation on Efficiency of Face Mask Ventilation among Apnoeic Patients: A Cross-sectional Study

Introduction: Respiratory function is crucial in the practice of anaesthesia. An in depth understanding of respiratory physiology is a must because it aids in the proper execution of daily general anaesthesia practice. Head and body postures have long been known to affect the patency of the upper airway. Head extension and a lateral recumbent position help to clear the upper airway. Head rotation is known to expand the upper airway’s cross-sectional area. Aim: To determine the effect of head rotation on efficiency of face mask ventilation among apnoeic patients, by measuring expiratory tidal volume. Materials and Methods: This cross-sectional study was conducted in the Department of Anaesthesiology at Jawaharlal Nehru Medical College, Acharya Vinoba Bhave Rural Hospital, Sawangi, Wardha, Maharashtra, India, from May 2021 to November 2021. Total 40 patients belonging to the age group of 20 to 40 years, American Society of Anaesthesiologists’ (ASA) class I and II, undergoing surgeries requiring general anaesthesia with endotracheal intubation, were selected as study subjects. They were administered inj. fentanyl at a dose of 1 to 2 μg/kg, inj.propofol at a dose of 1 to 2 mg/kg, and inj.vecuronium bromide (0.08 to 0.1 mg/kg). Patients were mask ventilated with pressurecontrolled ventilation, for a total of 3 minutes, during which they were ventilated in a neutral head position for 90 seconds and then rotated for another 90 seconds. Following induction, the expiratory tidal volume was measured every 30 seconds in both postures Software used was Statistical Package for Social Sciences for windows (SPSS Inc., Chicago, IL, USA), version 17.0. A p-value <0.05 was considered statistically significant. Results: The mean age of patients was 48±8.3 years. The 45° head rotation was beneficial to all patients, the mean expiratory tidal volume was 423±62.5 mL in the rotated head position compared to 397±52.5 mL in the neutral head position (p-value=0.045). It was also observed that some individuals profited more than others. Patients with airway obstruction, for example, had a greater VTE at 45° head rotation than in a neutral head position. Conclusion: The most notable conclusion is that in apnoeic adult patients, a 45° head rotation showed a significant enhancement in VTE when compared to a neutral position ofthe head.

Spectrum of Biopsy-proven Native Kidney Disease in Central India.

Spectrum of native renal biopsy reports varies geographically. Here, we tried to determine the prevalence of renal biopsy disorders and compare it with other studies. Retrospective study was performed at Saraswati Kidney Care Center, Nagpur and Jawaharlal Nehru Medical College, Sawangi, India. All the native kidney biopsies from January 2017 to March 2020 were included in the analysis. Demographic details of all the patients were recorded. Renal diseases were classified as glomerular, tubulo-interstitial, predominant vascular involvement and other disease categories. Total 347 native kidney biopsies were performed during the study period. Mean age of the patients at the time of biopsy was 41.41 ± 15.75 years. Majority of patients were males (58.5%). Most common indication for kidney biopsy was nephrotic syndrome (36.3%) followed by nephritic syndrome (19.9%). Among the glomerular diseases (GDs), 69% were primary glomerulopathies and 31% were secondary GDs. Immunoglobulin (IgA) nephropathy (30.85%) was the most common primary GD followed by membranous nephropathy (MN) (26.59%), focal segmental glomerulosclerosis (FSGS) (17.02 %) and minimal change disease (14.36 %). Among secondary glomerulopathies, lupus nephritis was the most common histopathological diagnosis (31.8%) followed by diabetic nephropathy (26.1%), amyloidosis (17%), infection related glomerulonephritis (11.3%), light chain deposition disease (4%) and anti-neutrophil cytoplasmic antibody associated vasculitis (3.4%). In tubulointerstitial disease, 33.3% had acute tubulointerstitial nephritis, whereas each 26.6% had acute tubular injury and cast nephropathy. The most prevalent diagnosis in our only study from central India was IgA nephropathy followed by MN and FSGS. Data analysis at regular intervals helps in understanding the changing trend of prevalence of native kidney disease and also gives understanding of geographical variations.

Prevalence of Congenital Colour Vision Deficiency in Belagavi, Karnataka, India: A Hospital-based Cross-sectional Study

Introduction: Colour vision deficiency is a common ocular disorder, but it often goes unnoticed due to lack of awareness and screening programmes. If detected early in life, it can help people choose suitable career paths and genetic counselling can help reduce the birth of colour-blind children and future disappointments in life. Aim: To determine the prevalence of congenital Colour Vision Deficiency (CVD) among the general population in Belagavi at a tertiary level hospital and to spread awareness regarding CVD. Materials and Methods: This was a hospital-based crosssectional study, conducted at Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (tertiary care hospital), from February 2022 to July 2022. The study population constituted 3131 people who visited the Ophthalmology Outpatient Department for routine eye examinations. A detailed ophthalmological examination was done, and colour vision was tested using Ishihara’s (38 plate) pseudoisochromatic test. Data was analysed using statistical software version 4.2.1 and Microsoft excel. Results: The mean age of the study population was 40.74±15.86 years. The overall prevalence of congenital CVD was 150 (4.79%). The prevalence of congenital colour vision defects was 13 (0.9%) in females, and 137 (8.12%) in males (p-value <0.001). Deuteranomaly was the most common type of congenital CVD, found among 88 (58.67%), followed by protanopia among 28 (18.67%), followed by protanomaly and deuteranopia, each accounting for 17 (11.33%). Conclusion: The prevalence of CVD among people belonging to the Belagavi district was remarkable. The p

Comparative Study of Clinical and Radiological Profile and Outcome of COVID-19 Patients with and without Co-morbidities: A Cross-sectional Study

Introduction: Coronavirus Disease-2019 (COVID-19) had devastating effects on the healthcare and economic sector worldwide. India stands second in the list of most number of COVID-19 cases. Most of the deaths due to COVID-19 were seen in patients with associated co-morbidities like hypertension, diabetes, chronic kidney disease and obesity. This study would like to examine specific co-morbidities in relation to the COVID19 disease progression and outcomes. Aim: To compare the clinicoradiological profile and outcome of COVID-19 in patients with and without co-morbidities (diabetes and hypertension). Materials and Methods: The present observational, crosssectional study was conducted at Jawaharlal Nehru Medical College, Aligarh, Uttar Pradesh between June 2020 to September 2020, after obtaining Institutional Ethics Committee (IEC) approval. A total of 148 patients with COVID-19 were included in the study. The COVID-19 patients admitted in the hospital were divided into four groups as those having only diabetes, only hypertension, both diabetes and hypertension, and those without any comorbidities. Those with any other co-morbidity were excluded from the study. The general clinical characteristics, laboratory parameters, disease severity, morbidity and mortality were compared among various groups and the data was analysed. Categorical data were analysed using the Chi-square test. Results: A total of 148 patients with COVID-19 were included in the study, of which 26 patients were diabetic, 36 were hypertensive, 24 were both hypertensive and diabetic and 62 patients didn’t had any significant co-morbidity. Severe COVID-19 disease was most commonly observed in those with diabetes (n=14) (53.8%). The highest proportion of patients requiring oxygen (84.6%) and Non Invasive Ventilator (NIV) support (46.1%) was also seen among diabetics. The presence of diabetes, severe disease and leukocytosis at presentation increased the risk of mortality. The association of hypertension with COVID-19 does not seem to affect the in-hospital mortality. Conclusion: COVID-19 in diabetics is associated with both increased risk of severe disease and increased odds of death. In diabetics, those with uncontrolled diabetes were more prone to severe disease and death than those with good glycaemic control. Hypertension, on the other hand, showed no association.

Bronchial Hyper-responsiveness in Post-tubercular Patients: A Case-control Study

Introduction: Bronchial hyper-responsiveness is the manifestation of excessive bronchoconstriction in response to diverse types of stimuli both physical and chemical. It is the most characteristic feature of bronchial asthma; it also occurs in a spectrum of other diseases like Chronic Obstructive Pulmonary Disorders (COPD) and reactive airway syndrome and may be provoked by a variety of stimuli like histamine and methacholine. Patients of healed pulmonary Tuberculosis (TB) show varying extent of lung impairment such as fibrosis, collapse, emphysema and broncho alveolar destruction. Aim: To assess the incidence and severity of obstructive airway diseases in previously treated TB patients. Materials and Methods: This was a prospective case control study, carried out in the Department of Tuberculosis and Respiratory Diseases, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India, from September 2017 to September 2019, this study included 120 patients of previously treated TB, who were divided into two groups. The case group (71) included patients who completed treatment for TB and had dyspnoea. The control group (49) consisted of patients who completed the treatment but did not have dyspnoea. The patients were subjected to spirometry, histamine bronchial challenge test and computed chest tomogram along with routine investigations including sputum for Acid Fast Bacilli (AFB). Results: The present study showed significant histamine hypersensitivity among post TB patients. In the case group, 34 (56%) patients showed positive response to bronchial challenge test with histamine; while in control group only 7 (14%) showed a positive response (p-value=0.004). Pulmonary function test (spirometry) showed an obstructive pattern in 35 (49%) case group patients, while normal pattern was the most common finding seen in 23 (47%) in the control group followed by obstruction in 10 (21%) patients. Among the cases, the mean Forced Expiratory Volume in the first second (FEV1) was 65.77±15.98, while among the controls, it was 80.02±8.81. The case group had a mean Forced Expiratory Volume in the first second/Forced Vital Capacity (FEV1/FVC) of 78.09±15.75, as against 81.33±16.79 in the control group. Conclusion: Airway bronchial hyper-reactivity is a prominent feature in previously treated tubercular patients. This underlines the need for proper attention towards post-tubercular lung function impairment and proper treatment of such patients so as to lessen the impact of bronchial hyper-reactivity on patient symptoms and their quality of life.

Learning gain in web (internet) sourced seminars versus textbook sourced seminars in postgraduate medical students.

BACKGROUND:In the past, textbook or printed material was the only source of information for medical students or post-graduate students. After the introduction of internet, knowledge can be accessed easily which is updated with various aids such as animation, videos which improve the learning efficiency. This study was conducted to compare the learning efficiency between textbook-based seminar to that of internet-based seminar in postgraduate students of the department of dermatology.MATERIALS AND METHODS:It was a non-randamized controlled study. The postgraduate students in the department of dermatology, Jawaharlal Nehru Medical college, DMIMS(DU),Sawangi (Meghe), Wardha, Maharashtra, India were divided into two equal groups by simple randomization method by flipping the coin. Totally 20 seminar topics were divided into two groups (A and B) consisting of 10 seminars in each group. Postgraduate students assigned in group A were asked to prepare seminar solely from textbooks while in group B, students were asked to prepare seminar by referring internet. Feedback form which consists of 7 points, i.e. appearance, completeness of preparation, clarity of presentation, appropriate use of audio visual aids, understanding of subject, ability to answer questions, and overall performance were filled up from faculties and postgraduate students after completion of each seminar. Pretest and post-test were filled up from postgraduate students before and after each seminar respectively. Learning gain was calculated by comparing the scores of pretest and posttest. Paired t-test was used to compare results in the group and unpaired t-test was used to compare results between the two groups.RESULTS:Faculties' feedback on overall performance was higher (4.59 ± 0.15) in web-based seminars as compared to in textbook-based seminars (3.85 ± 0.1) with significant P = 0.008. Furthermore, postgraduate students' feedback showed statistical significant value of 0.02 in web-based seminars (4.65 ± 0.06) compared to textbook-based seminars (3.2 ± 0.06). Learning gain was significantly higher in web-based seminar compared to textbook-based seminar with P = 0.02.CONCLUSION:It can be concluded that web-based learning can improve the learning efficiency in postgraduate medical students.

Totally extraperitoneal versus transabdominal preperitoneal approach

Background: Groin hernia surgery is one of the most common procedures performed by surgeons worldwide. With the advent of minimal access surgery, the procedure for repair is now done either by transabdominal preperitoneal approach Transabdominal preperitoneal (TAPP) or totally extraperitoneal (TEP) approach. The advantage of one procedure over the other is still controversial. Objectives: This prospective study was conducted to find out the intraoperative and postoperative outcomes of TEP and TAPP for inguinal hernia repair in terms of operative time, intraoperative complications, conversion to open, visual analog scale (VAS) score, postoperative complications, length of hospital stay, and recurrence of hernia and chronic pain. Materials and Methods: A total of 88 patients of inguinal hernia enrolled prospectively between November 2017 and November 2019 and patients aged 18 years and above admitted in Jawaharlal Nehru Medical College and Hospital were included in this study. Forty-four patients were included in TEP group, while 44 patients were allocated to TAPP group. Results: The statistical analysis was done using Chi-square test and unpaired t-test, respectively. The mean operative time in TEP was 91.14 ± 11.14 min and in TAPP repair was 103.16 ± 6.79 min, which was found to be significantly significant. The mean pain score on VAS score on postoperative day 1 was 5.70 ± 0.95 in laparoscopic TEP group and 5.86 ± 0.97 in laparoscopic TAPP group. The mean pain score on VAS score on postoperative day 2 was 3 ± 1.27 in laparoscopic TEP group and 2.95 ± 1.29 in laparoscopic TAPP group. Similarly, the mean pain score on VAS scale on postoperative day 7 was 0.863 ± 1.26 in laparoscopic TEP group and 0.659 ± 1.21 in laparoscopic TAPP group. No significant difference was observed in VAS between TEP and TAPP groups during follow-up. Both TEP and TAPP mesh techniques were comparable in terms of the intraoperative complications and postoperative complications (seroma [during hospital stay, after 1 week of discharge, after 1 month of follow-up]; hematoma [during hospital stay, after 1 week of discharge]; wound infection) and in conversion to open and length of hospital stay. The difference in mean cost of surgery was found to be statistically significant. Conclusion: Although the mean operative time and cost of surgery were significantly more in TAPP than in TEP group, no significant difference could be found between the intraoperative and postoperative complication rates, conversion to open, and length of hospital stay. Recurrence was observed in one case of TEP groups during follow-up. Our study supports the view that both laparoscopic TEP and TAPP mesh repairs of inguinal hernia are safe and efficacious.

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Conversion disorder, previously known in the medical literature as “hysteria” has engaged prominent individuals in the history of medicine, neurology and psychiatry. There have been recent studies indicate that cognitive phenomenon may be inadequate in conversion disorder and trying to utilize neuroimaging or other neurophysiological measures in an attempt to understand the underlying functional neuroanatomical basis of conversion disorder.Aim:Present study planned to explore sociodemographic profile and cognitive impairment in patients of conversion disorder attending psychiatry out patient department or admitted in psychiatric ward at JN Medical College, Aligarh Muslim University (AMU) Aligarh. In this study, we will assess the correlation between socio-demographic profile and cognitive impairment in conversion disorder patients.Materials and methods:• The present study has been conducted in the Department of Psychiatry, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh.• The patients are assessed as per semi-structured proforma, in which their socio-demographic details, clinical history and mental status examination have been recorded.• Relevant laboratory tests and neuroimaging studies were done on each patient.• Neuropsychological tools have been applied to assess cognitive functions.Result:Most of the patients of conversion disorder were females belonging to rural population & lower socioeconomic status, having less education and have history of sexual abuse. Cognitive deficits are found in significant number of patients. Statistical significance of particular(s) will be discussed at the time of presentation.