Jhalawar Medical College Research Articles

MORBIDITY AND MORTALITY PROFILE OF NEONATES ADMITTED IN NEONATAL INTENSIVE CARE UNIT IN A TERTIARY CARE HOSPITAL, SOUTH-EASTERN RAJASTHAN, JHALAWAR MEDICAL COLLEGE, JHALAWAR: A RETROSPECTIVE STUDY

Objective: The objective of this study was to study the morbidity and mortality patterns in a special newborn care unit (SNCU)/neonatal intensive care unit (NICU) of a tertiary care teaching hospital. Methods: A retrospective study was carried out in the SNCU/NICU of Jhalawar Medical College, Jhalawar. The duration of the study was 3 years. A retrospective case record review and analysis was done. Secondary data collected from the online SNCU Software (National Health mission Government of India). Results: Eight thousand seven hundred and forty-eight neonates were admitted in NICU. 2488 (59.9%) were male and 1657 (40.1%) were female, 4047 (46.3%) were normal birth babies, and 4701 (53.7%) were low birth weight babies. According to the outcome, total 6753 (77.19%) were discharged successfully, 1464 (16.66%) died, 382 (4.36%) were referred, and 149 (1.7%) were leave against medical advice. Birth asphyxia was the most common morbidity 2404 (27.36%) followed by neonatal sepsis (18.06%) and neonatal jaundice (15.44%). Birth asphyxia were more in inborn unit (p<0.0001). Sepsis is more prevalent in out born unit (p<0.0001). Hypoxic ischemic encephalopathy/moderate-to-severe birth asphyxia was the most common cause of death (28.23%), followed by neonatal sepsis (20.62%) and respiratory distress syndrome (19.35%), and major congenital malformations were cause of death in 106 (7.24%). Mortality due to neonatal sepsis was significantly high in outborn unit (p<0.0001). Conclusion: Birth asphyxia, neonatal sepsis, and respiratory distress syndrome were the leading causes of mortality in this study. These leading causes of mortality in the study could be prevented by adequate training of nursing staff and doctors, timely referral to tertiary care if required.

A study to assess the knowledge level of immunization among antenatal mother’s in selected Heera Kunwar Baa Janana Hospital & Jhalawar Medical College at Jhalawar (Raj)

A study to assess the knowledge level of immunization among antenatal mother’s in selected Heera Kunwar Baa Janana Hospital & Jhalawar Medical College at Jhalawar (Raj)

Antenatal care and its association with pregnancy outcomes at tertiary care hospital, Jhalawar

Background: Low birth weight is a major public health problem in India. Amongst several many factors affecting birth weight, the two factors are demographic characteristics of mothers and utilization of antenatal care services after timely registration of pregnancy. Aims were to access ANC and its association with pregnancy outcomes at Jhalawar medical college, Jhalawar Rajasthan. Methods: All the pregnant women were admitted to the maternity ward for delivery in November 2022. The interview consisted of a demographic characteristic of mothers, utilization of ANC services, live birth weight of the baby, and records of the mother from the hospital. Data collection was done from the maternity ward and vaccination site. It was a hospital-based cross-sectional study. Results: Among mothers who registered in 1st trimester, 81.6% delivered at full term, 77% of new-born were normal birth weight and only 8.5% of new-born needed NICU admission; compared to those who registered in 2nd and 3rd trimesters delivered at full term 67.1% and 55% respectively, 63.3% and 50% new-born had normal birth weight and NICU admission needed by 17.7% and 55% new-born needed NICU admission respectively. Those mothers who received ≥4 ANC visits had delivered 186 (78.8%) new-born with normal birth weight and required NICU admission for 24 (10.2%) new-born as compared to those who had <4 ANC visits delivered 109 (64.9.8%) new-born with normal birth weight. Conclusions: Early registration of pregnancy prevents chances of LBW baby, long stay in NICU also leads to a reduction in preterm delivery.

Impact of functional endoscopic sinus surgery on otologic symptoms associated with chronic rhinosinusitis

Background: The study was aimed at observing the impact of FESS on otologic symptoms associated with Chronic rhinosinusitis. Otitis media and other otologic symptoms develop frequently during the evolution of CRS. The evolution of middle ear disease in the setting of chronic rhino-snusitis possibly reflects the role of a dynamic conduit, eustachian tube, normal functioning of which, is crucial to keep the middle ear functions within physiologic limits. Methods: The study was conducted in the Department of Otorhinolaryngology, Jhalawar Medical College and SRG hospital, Jhalawar (Rajasthan) between August 2021 and November 2022. 53 patients of CRS with associated otologic symptoms were included in the study. Patients were subjected to functional endoscopic sinus surgery and septoplasty where relevant. Results: The majority of the study patients presented with ear discharge (72%), earache (41%) and ear fullness (41%). The most common sinusitis related symptoms were Nasal blockage (77%), frontal headache (53%) and nasal discharge (49%) with relatively lower proportion of post nasal drip (23%), facial pain (21%) and halitosis (15%). All participants were subjected to FESS which was combined with septoplasty and sub-mucous diathermy of the inferior turbinate where it was relevant. Patients were followed at 1st, 3rd and 6th week post-operatively. Conclusions: Majority of the patients (89%) shown a statistically significant subjective improvement in the otologic symptoms following the initial optimum medical therapy for the CRS. Endoscopic sinus surgery was found to improve symptoms on a statistically significant scale.

Assessment of nutritional status of elderly in rural field practice area of Jhalawar medical college, Jhalawar, India

Background: Worldwide, the population of elderly people is constantly increasing. Elderly population is at risk of under nutrition due to age related physical, cognitive, functional decline and lack of financial support. Malnutrition contributes to decline in health status, increased utilization of healthcare services and increased mortality. Aim of this study was to assess nutritional status of the elderly by MNA and to find association between nutritional status and socio- demographic profile of elderly. Methods: After ethical approval, a community based cross sectional study was conducted among elderly people residing at Mandawar village, rural field practice area of JMC, Jhalawar during August to October 2022. Complete enumeration technique was used to enrolled participants in study. Door to door household survey was conducted using predesigned questionnaire. Nutritional status was assessed by using standard mini nutritional assessment questionnaire. The data was analyzed through SPSS28.0 (trail version). Results: Out of 287 elderlies, 139 (48.4%) were male and 148 (51.6%) were female. According to MNA, 73 (25.4%) were found malnourished while 119 (41.4%) were at risk of malnutrition and 95 (33.1%) were well nourished. A statistically significant (p<0.05) association was found between nutritional status with increasing age, gender, marital status, education, occupation, morbidity, financial dependance and substance abuse. Conclusions: This study showed that malnutrition has multidimensional background. So, to improve nutritional status of elderly approach should be focus on those who are older, illiterate or low educational status, female gender and financially dependance.

Thyroid dysfunction in patients with diabetes mellitus in a tertiary care center of south-eastern Rajasthan, India

Abstract Background: Most common endocrine disorder in day-to-day life are diabetes and thyroid disorder. In long term, these patients may lead to development of cardiovascular disease and other metabolic derangements. In diabetics prevalence of thyroid dysfunction is 10 to24%. Thyroid dysfunction prevalence in diabetics patient was objective of the present study conducted at Jhalawar medical college and SRG Hospital Rajasthan. Materials and Methods: Retrospective study conducted in patients admitted between July 2017 to December 2018 at department of medicine Jhalawar medical college and SRG Hospital, Jhalawar Rajasthan. 130 patients (age group ≥ 30 yrs.) of diabetes mellitus and 125 of same age group & having glucose levels normal were taken for the study. The Ethical committee clearance was taken. Fasting plasma glucose (FPG) levels of more than 126 mg/dl twice at different occasions were labeled diabetics and subjects having FPG levels less than 126 mg/dl at two occasions were controls. Result: Prevalence of thyroid dysfunction in case group (diabetic mellitus patient) was 24.6% and prevalence of thyroid dysfunction in control group was 6.4%. Among thyroid dysfunction, prevalence of subclinical hypothyroidism was highest. Conclusion: Thyroid dysfunction had higher prevalence in diabetes patients. Keywords: thyroid dysfunction, glycosylated hemoglobin (HbA1c), diabetes mellitus

ESTIMATION OF PREVALENCE AND PATTERN OF TOBACCO USE: A CROSS-SECTIONAL STUDY AMONG SCHOOL ADOLESCENTS

Background: Over the world, tobacco kills more than 8 million people every year. A WHO report on tobacco consumption mention that tobacco consumption in India will continue to increase at 2.4% per annum and most of the new users will be school children. Objectives: The objective of the study was to estimate prevalence and pattern of tobacco use among school-going adolescents and to assess their knowledge of harmful effects of tobacco. Methods: A cross-sectional study was carried out at government schools in urban and rural field practices areas of Jhalawar Medical College, Jhalawar. A semi-structured questionnaire pertaining information regarding age, sex, use of tobacco, knowledge of hazards, etc., was used for data collection. Results: Out of the 337 students, 15.1% reported an experience of any type of tobacco use. 8.61% students use smoking form of tobacco, 6.52% student use smokeless tobacco, and 1.48% of students use both form of tobacco. The difference of tobacco use among boys and girls student was statistically significant. Most common influential factor for tobacco use was peer pressure among the tobacco user. Out of the 51 tobacco users, adolescent students 31.37% have desire to quit tobacco. Conclusion: High prevalence of tobacco use among school-going students was alarming situation. The desire to quit tobacco among adolescent was very low.

Morphological Spectrum of Anemias in Pregnant Women Attending at Jhalawar Medical College

Morphological Spectrum of Anemias in Pregnant Women Attending at Jhalawar Medical College

Lifestyle behavior among Post Graduate medical students in Jhalawar Medical College A cross-sectional study

Lifestyle behaviour can be defined as the reactive, habitual, or intentional forms of human activity, which remain significantly intertwined with health. Non-communicable diseases (NCD) are determined to be increasing around the globe due to lifestyle-related behavioral risk factors including physical inactivity and dietary transitions such increased intake of high-fat and low-fiber diets. Medical students are prone to poor dietary habits, inactivity, lack of sleep, and the development of new habits like drinking alcohol and smoking. Since post-graduate medical students will eventually deliver healthcare, it is crucial to evaluate their lifestyle choices.

STUDY OF RED CELL DISTRIBUTION WIDTH AS A NOVEL PREDICTIVE INDICATOR IN PREHYPERTENSIVE AND HYPERTENSIVE PATIENTS

Background: An increased RDW mirrors a profound deregulation of erythrocyte homeostasis involving both impaired erythropoiesis and abnormal red blood cell survival, which may be attributed to a variety of underlying metabolic abnormalities such as shortening of telomere length, oxidative stress, inflammation, poor nutritional status, dyslipidaemia, hypertension, erythrocyte fragmentation and alteration of erythropoietin function. High blood pressure does damage to endothelial cells that leads to the secretion of inflammatory cytokines which supresses erythropoiesis and inhibit red cell maturation and anisocytosis. Therefore, as a sensitive marker of inflammatory status in this process, RDW can be a potential predictor of hypertension in pre-hypertensive and normal individual. To provi Aim: de general information about RDW and its routine assessment, to review the most relevant implications in prehypertensive and hypertensive patients and give some insights about its potential clinical applications. Current Material and methods: study was observational cross sectional study conducted at the Department of Medicine in SHRI RAJENDRA GENERAL HOSPITAL (SRGH), Jhalawar Medical College, Jhalawar Rajasthan. A total 100 newly diagnosed hypertensive and pre hypertensive patients were included in the study. Data were analysed in SPSS 21. Independent t-test and Chi-square test were applied. P value <0.05 was considered statistically significant. In this study, mean age of st Results: udy participants was 46.4±19.1 years and out of the 100 participants, maximum 40 were belongs to age <40 years followed by 37 in age of 41-60 years, 47 were male and 53 were female, 75 participants were diagnosed as hypertensive and 25 diagnosed as prehypertensive. In this study, mean RDW-CV and RDW-SD was 19.2±3.8 and 54.8±10.7 respectively and a statistically significant high RDW-CV and RDW-SD was found among hypertensive compare to pre-hypertensive patients. Also a statistically significant positive correlation of SBP and DBP was found with RDW-CV and RDW-SD. Conclusion: Our study concluded that RDW is significantly positively correlated with the blood pressure and increases as SBP and DBP increases. So RDW can be predictive marker for hypertension. This can be done routinely and easily in the laboratories, thereby giving the clinician a good supportive tool for diagnosing and preventing an adverse outcome.

CLINICAL PROFILE OF ISCHEMIC STROKE AND ITS OUTCOME IN RELATION TO GLYCEMIC STATUS ON PRESENTATION AT A TERTIARY CARE CENTRE: A PROSPECTIVE OBSERVATIONAL STUDY

Background: Stroke, also known as a cerebrovascular accident, is common in patients and can be a major cause of morbidity and mortality. Stroke and hyperglycemia appear to be linked in two ways. Diabetics are known to have a greater stroke rate than non-diabetics. Even in non-diabetics, a mild degree of hyperglycemia early in a stroke has been reported to increase infarct size and lead to a bad prognosis. Aim: To study the clinical prole, infarct size on CT scan, and clinical outcome of cerebral infraction in relation to glycemic status at presentation. Material and Methodology: This prospective observational study was conducted in the medicine department of Jhalawar Medical College, Jhalawar, a tertiary care center in south-east Rajasthan, from January 2020 to June 2021. The study included all ischemic stroke patients. Data were analyzed in SPSS 21. Independent t-tests and Chi-square tests were applied. A p value of < 0.05 was considered statistically signicant. Results: The current study revealed that out of 100 participants, 39 were euglycemic, 27 had stress hyperglycemia, and 34 had diabetes; a small, medium, or large infarct was present in 39, 27, and 34 patients, respectively. Diabetes patients had a statistically signicant high NIHSS score, blood sugar level, and deaths, followed by stress hyperglycemia, and euglycemic patients had the lowest. Conclusion: Hyperglycemia, including stress hyperglycemia and diabetes, was a common nding in patients with ischemic stroke, and NIHSS, blood sugar, and death were associated with hyperglycemia in ischemic stroke patients.

CORRELATION BETWEEN BITE TO NEEDLE TIME AND COMPLICATIONS IN SNAKE BITES

INTRODUCTION: The World Health Organization (WHO) estimates that 81,000–138,000 people die each year from snakebites worldwide,approximately half of global snake bite deaths,estimated at 100,000 per year,occur in India.The present study was carried to analyze correlation between the time delay in administering Anti Snake Venom (ASV) in patients with symptomatic evidence of snake bite and subsequent development of complication.MATERIAL:The study was carried out on forty patients admitted with snake bite in the Department of Medicine in Jhalawar Medical College. Detailed clinical history, clinical examination and investigations were carried out. ASV administered in symptomatic patients and bite-to-needle time was noted.And patients were followed for subsequent development of complications. OBSERVATION:Forty patients of snake bites became eligible for the study over a period of 5 months,15 patients (37.5%) had developed complications while remaining 25 patients (62.5%) were uncomplicated.The Chi square test was used to find the significance of the relationship between the timing of ASV administration after bite due to late arrival at hospital (bite to needle time) with subsequent development of complications. It was found to be significant at 5% level of significance (p<0.05) (i.e.,p=0.04 at degree of freedom 2).CONCLUSIONS: In our study we came to a conclusion that the incidence and severity of post snake bite complications is directly proportional to Bite-to-needle time.To prevent this complication and reduce health care burden, timely arrival at health care centres and prompt administration of ASV is encouraged.

ECG CHANGES IN DENGUE FEVER

Background: Dengue is one of the most important viral diseases globally and a majority of symptomatic infections result in a benign course. However, a small number of patients develop severe manifestations, including myocardial impairment, arrhythmias, and fulminant myocarditis. Dengue is known to affect various systems. The cardiovascular system is one of them. This study was conducted to observe the presence of electrocardiographic (ECG) changes in patients presenting with dengue fever. Material and method: This was a cross sectional analytical study conducted at Jhalawar medical college and hospital, Jhalawar, Rajasthan. 146 cases were selected after taking into account the inclusion and exclusion criteria from serologically confirmed dengue cases. The details of the patient's clinical presentation and examination was noted.ECG was carried out to all patients. Results: Out of 146 patients,58 patients had normal ECG. Abnormal ECG findings like sinus bradycardia ,tachycardia ,ST-T changes,bundle branch block were noted among 88 patients. Conclusion: ECG changes can occur in dengue infection, most common finding were sinus bradycardia. ECG abnormalities were common but all the ECG changes were reversible. There was no evidence of myocarditis in any of the patients

ECHOLOGICAL ABNORMALITIES IN SEVERE SCRUB TYPHUS PATIENTS

Background: Jhalawar is an endemic area for scrub typhus.Scrub typhus presents as an acute,febrile,exanthematous illness.If not treated early,it can lead to life threatening complications,affecting various systems of the body.Hence,this study was done with an objective to study the cardiovascular abnormalities in patients of severe scrub typhus. Methods: We conducted a hospital-based study in the Department of Medicine, of a tertiary care hospital in jhalawar medical college in patients of severe scrub typhus from July 2021 to November 2021. Results: Echocardiographic changes included tricuspid regurgitation in 8(16.66%), pericardial effusion in 5(10.41%), myocarditis in 11(22.91%) and Regional wall motion abnormality in 4(8.33%). Left ventricular ejection fraction >45% in 38 (79.16%) and <45% in 10(20.83%). Conclusions: Severe scrub typhus manifested with tricuspid regurgitation, myocarditis, pericardial effusion and Regional wall motion abnormality.

EFFICACY OF CORE DECOMPRESSION WITH AUTOLOGOUS CANCELLOUS BONE GRAFTING ON HEALING IN AVN OF THE FEMORAL HEAD

Introduction:- Avascular necrosis (AVN) of the hip is a condition caused by interruption in the blood supply to the subchondral region of the head of the femur leading to death of the osteoblasts and osteocytes. the term osteonecrosis is now preferred. To study the efcacy of core decompression wi Aims And Objectives th autologous cancellous bone grafting on healing in AVN of the femoral head This study was conducted Material and methods:- in the Department of Orthopaedics, Jhalawar Medical College, Jhalawar (Raj.). 21 patients were admitted in the department of orthopaedics with avascular necrosis of femoral head and treated with core decompression autologous cancellous bone grafting from September 2019 to August 2020. Present study consisted of 21 Results:- patients of AVN femoral head , between age 20 to 60 years treated with core decompression and autologus bone grafting excellent results were obtained in 23.8% , good in 47.6%, fair in 19% while 9.5% patients had poor outcome Core decompression wi Conclusion:- th autologous cancellous bone grafting in early stages of AVN of femoral head is an effective modality to delay the progression of the disease, postpone the femoral head collapse and eventual arthritis, and also helps in revascularization of the femoral head.

PREVALENCE OF ANEMIA IN TYPE 2 DIABETIC PATIENTSS

Background: The aim of the study was to determine the prevalence of anemia in patients with type 2 diabetes and to assess the risk of anemia according to gender,age and glycemic control. Method :This is a Cross Sectional study of 200 cases of type 2 diabetes mellitus in the General medicine OPD and medicine ward of Jhalawar Medical College Jhalawar from July 2022 to december 2022 All the tests are done with permission from the Institutional Ethical Committee and informed consent from the subjects. Result: In our study, a statistically significant anaemia was found in female participants compared to male.In the present study,a statistically significant high HbA1C was found among the patients who had anaemia.(p value<0.033) In this study , the prevalence of anaemia increases with increasing duration of disease.(p value<0.00000001).Conclusion: Anaemia is one of the most common preventable conditions especially in diabetes mellitus.This study concludes that the need for periodic hematological screening in all diabetics presenting to hospital and adequate cost effective remedial measures in the form of supplementation of iron and vitamins will result in better outcome and prognosis and prevention of major complications

Ntrathecal Hyperbaric Bupivacaine 0.5% with Varying Dose of Buprenorphine in Elective Adult Lower Limb Orthopaedic Surgeries: A Randomised Control Study

Introduction: Postoperative pain is a universal phenomenon and usually under treated and its intensity varies widely among patients. Spinal anaesthesia with opioid and local anaesthetics to prolong postoperative analgesia is common practice in recent years. Buprenorphine is an agonist - antagonist opioid. Intrathecal buprenorphine (30-150 µg) along with local anaesthetics is safe and known to increase the postoperative analgesia without affecting sensory or motor blockade and with lesser side effects. Aim: To compare the anaesthetic characteristics and its side effects in subarachnoid block with bupivacaine 0.5% heavy and varying dose of buprenorphine (90 µg and 120 µg). Materials and Methods: This randomised control study was conducted in the Jhalawar Medical College, Jhalawar, Rajasthan, India, from March 2019 to November 2019. The study included 90 patients belonging to American Society of Anaesthesiologists (ASA) class I and II of either sex age between 18 to 60 years posted for elective lower limb orthopaedic surgeries.The patients were divided into three groups; group A which included a patient count of 30 received plain hyperbaric bupivacaine 0.5% (2.5mL) with 0.5 mL saline. Group B which included 30 patients, receive plain hyperbaric bupivacaine 0.5% (2.5 mL) along with buprenorphine 90 µg diluted in 0.5 mL saline. Group C with a patient count of 30 received hyperbaric bupivacaine 0.5% (2.5 mL) with buprenorphine 120 µg mixed with 0.5 mL saline. Analgesic characteristics, haemodynamic parameters, side effects, sedation scores by Ramsay sedation score and pain scores by Visual Analogue Score (VAS) (0-10) were measured postoperatively till 24 hours.Statistical analyses of data were done by one Way Analysis of Variance (ANOVA) test and chisquare test where p-value less than 0.05 was considered to be a statistically significant value. Results: The onset time of sensory blockade (group A: 5.14±1.34, group B: 4.54±1.10, group C: 4.50±1.18 in minutes), time of onset of motor blockade (group A: 10.10±1.00, group B: 9.43±1.30, group C: 9.21±1.49 in minutes) and maximum level of sensory block at T6 level (group A: n-01/30, group B: n-04/30, group C: n-04/30) were comparable between the three groups and were not statistically significant. Sensory recovery time was significantly (p<0.0001) delayed in group B and C (178.9±7.18 min and 189.23±7.4), while in group A it was 152.86±8.9 min. Duration of postoperative analgesia was significantly (p<0.0001) prolonged in group C (group A 165.53±8.5, group B 391.49±19.8, group C 493.23±18 in minutes). Side-effects like Postoperative Nausea and Vomiting (PONV) and sedation were increased with dose of buprenorphine but easily treatable and not significant (p>0.05). Conclusion: A higher dose of buprenorphine shows to provide an adequate and longer postoperative analgesia without any major side effects.

Perceptions of 1st-year MBBS students and 1st-year medical faculties toward AETCOM-based medical curriculum

Background: The field of medical education is constantly evolving to meet the demands of an ever-changing health-care landscape. To address the dynamic challenges faced by medical professionals, medical colleges across the globe are adopting innovative and comprehensive approaches to curriculum design. One such approach that has gained significant attention is the attitude, ethics, and communication (AETCOM) based medical curriculum, which emphasizes developing not only clinical knowledge and technical skills but also ethical values, empathetic communication, and a patient-centric approach among medical students. Aim and Objective: This study aims to record the perceptions of medical students and faculties regarding the effectiveness of AETCOM modules. Materials and Methods: This is an analytical cross-sectional study performed in October 2022 where a pre-validated questionnaire consisting of components of AETCOM was e-mailed to the 1st-year MBBS students of Jhalawar Medical College and teaching faculties of Jhalawar Medical College through Google Forms. The results were analyzed by statistics is a statistical software suite 23.0 (trail version) and the Chi-square test was used for data analysis and P < 0.05 is considered significant. Results: About 95% of students have positive perceptions regarding the mandatory inclusion of AETCOM competencies. However, only 73.3% of faculties have positive perceptions regarding the mandatory inclusion of AETCOM competencies and 26.7% completely disagree with the beneficial role of mandatory inclusion of AETCOM competencies in competency-based medical education curriculum. Conclusions: A hybrid problem-oriented approach is one of the most effective ways for students to promote communication skills, in building doctor-patient relationships and understanding the professional qualities and roles of a physician.

Electrolyte Disturbance with Severity of Dengue Infected Patient. A Study in Jhalawar Medical College & SRG Hospital, Jhalawar, Rajasthan

Background: Dengue is considered to be the most rapidly spreading mosquito borne viral disease in the world. The dengue viruses are members of the genus Flavivirus and family Flaviviridae. Electrolyte imbalance is commonly encountered in this disease. There had been only a few worldwide research studies investigated on electrolyte disturbances with severity of dengue infection. Methods: Cross sectional prospective study was carried out in medicine department of Jhalawar Medical College & SRG Hospital, Jhalawar, Rajasthan. All cases of dengue confirmed by detection of either NS1Ag or IgM/IgG by ELISA method during study period will be included in study. This study was conducted to find relation between electrolyte disturbances in patients with dengue fever. Results: Out of 90 patients, majority i.e. 48 (53.3%) patients in total had mild hyponatremia, 37 (41.1%) had normal and 3 (3.33%) and 2(2.22%) patients had moderate, severe hyponatremia respectively. The prevalence of dengue patients with hyponatremia was 58.9 % in the present study. Out of 90,77 Dengue fever patients, 32(41.6%) had normal, 45(58.4%) had mild decrease in sodium level. Out of 90, 50 (55.6%) having normal potassium,32(35.6%) were mild decrease in level,4 cases(4.5%) were moderate and 1(1.1%) were severe and 3(3.3%) had Hyperkalaemia. Conclusion: This study provides an insight regarding Electrolyte Disturbance With Severity Of Dengue Infected Patient. Considering the variations in serum electrolyte levels in patients of dengue and high incidence of dengue in India, it is necessary to have a degree of suspicion in patients of dengue about electrolyte disturbances and treat them accordingly.

Prevalence of hypertension and its associated modifiable risk factors among rural and urban adults of field practice area of Jhalawar Medical College, Jhalawar

Background: The behavioral and biological risk factors, with a predisposition to the development of high blood pressure, are use of tobacco and alcohol, physical inactivity, obesity, increased fat, sodium intake, low fruit and vegetable intake. HT is called a “silent killer”. Majority of people with hypertension are unaware of the problem because it may have no warning signs or symptoms. Objectives were assessment of the prevalence of hypertension and associated modifiable risk factors among adults in the practice area of rural and urban area of Jhalawar Medical College, Jhalawar.Methods: The present observational cross-sectional study was conducted on adults of rural and urban dwellers of field practice area of Jhalawar Medical College, Jhalawar. By stratified random sampling method, 1418 participants were selected and included in our study during the study period that fulfilled our inclusion and exclusion criteria.Results: The overall prevalence of hypertension found was 18.6%. In the present study, the association of hypertension with risk factors like tobacco use, BMI, and waist hip ratio was found to be significant in rural areas. While in urban areas, the prevalence of hypertension was found to be statistically significant with calorie intake, tobacco use, and BMI and waist hip ratio. The risk factor for calorie intake was found to have an insignificant association with rural areas.Conclusions: The present study revealed that around one fifth of adults had hypertension. The prevalence of hypertension was significantly higher in urban areas than in rural areas.