King George's Medical University Research Articles

Is International HIV Dementia Scale good enough to diagnose HIV-associated neurocognitive disorders?

Human immunodeficiency virus (HIV)-associated neurocognitive disorders (HAND) comprise impairment of multiple cognitive domains and cause significant morbidity. International HIV Dementia Scale (IHDS) is a quite sensitive and specific method for screening for HAND, and Modified Mini-Mental State Examination (3MS), though nonspecific, contains more parameters for screening for neurocognition. Hence, we compared 3MS and IHDS as screening tools for HAND with an aim to find out which was a better screening tool for HAND. Using 3MS and IHDS, we assessed the cognitive status of 200 HIV-positive patients (65% males) and 84 controls, presenting to the Department of Medicine, King George's Medical University, Lucknow, India from September 2015 to September 2019. According to 3MS, 42 (21%) HIV-positive patients were neurocognitively impaired (mean 76.24 ± 1.51), and 158 (79%) patients were not (mean 87.02 ± 4.16). As per IHDS, 185 (92.5%) HIV patients were neurocognitively impaired (mean 8.45 ± 0.88), and 15 (7.5%) patients were not (mean 11.13 ± 0.35). The mean 3MS score of controls was 87.56 ± 4.26, and the IHDS score was 9.73 ± 1.00. According to Patient Health Questionnaire-9 (PHQ-9), moderate depression occurred in only 3.5% of the patients, and the rest had only minimal or mild depression. In IHDS, psychomotor speed was the most affected parameter, whereas in 3MS, similarities were the most affected. IHDS may be over diagnosing neurocognitive impairment in HIV patients due to difficulty in understanding the test, especially psychomotor speed testing. 3MS may be more accurate for detecting neurocognitive impairment in HIV patients, and scale combining both these methods may be a still better choice.

Anxiety among doctors during COVID-19 pandemic in a tertiary care center in India.

Background and Objectives:The ongoing pandemic of COVID-19 has a severe impact on the health-care system worldwide bringing doctors under immense pressure to work under stressful conditions. The main objective of this study was to assess anxiety among doctors and to understand the perceived causes of anxiety.Methodology:Questionnaires were made available to all willing doctors of SN Medical College, Agra; King George's Medical University, Lucknow, and GSVM Medical College, Kanpur, between May 12, 2020, and June 20, 2020 (during nationwide lockdown). The questionnaire consists of three main sections: details about respondents’ working status, questions regarding respondents’ reasons for concern, and Becks’ Anxiety Inventory (BAI) scale.Results:Two hundred and fifty responses were received from about 599 doctors presented with the questionnaire. About 32% of the respondents have already done duties in COVID facilities and the rest are awaiting deployment at those facilities. Forty-two percent reported concern regarding transmitting the illness to close ones/loved ones/family members to be a cause of anxiety and 40% were worried about the quality of protective gear closely followed by examination-related worries. About 28.8% of the respondents scored >7 on BAI with 62.5% of these (18% of total respondents) reporting “moderate” levels of anxiety.Conclusions:Our findings underline the fact that pandemics such as COVID-19 cause significant levels of anxiety among doctors. The levels of anxiety differed for age, sex, and specialty. The perceived causes were the risk of transmitting to loved ones and concerns regarding protective gear. These outcomes highlight the need for early interventions to address anxiety and to provide support for doctors during such crises.

Comparison of Haloperidol and Quetiapine for Treatment of Delirium in Critical Illness: A Prospective Randomised Double-blind Placebo-controlled Trial

Introduction: Delirium is associated with an increased chance of death, prolonged hospitalisation, higher healthcare costs, and possibly long-term brain damage in survivors. Antipsychotics, both conventional and atypical, are the cornerstone of pharmacologic treatment for delirium in adults. Aim: To find out whether typical and atypical antipsychotic medication would result in a shorter duration of delirium than placebo and would improve other outcomes. Materials and Methods: This is a randomised, double-blind, placebo-controlled trial conducted on patients with delirium in Intensive Care Unit (ICU) of King George's Medical University, Lucknow, Uttar Pradesh, India from February 2021 to February 2022. Out of 45, 15 received enteral haloperidol (maximum dose 30 mg daily), 15 received quetiapine (maximum dose 300 mg daily) and 15 were controls receiving placebo through Ryle’s tube. Delirium was detected with the use of Confusion Assessment Method for the ICU (CAM-ICU), and side effects of the drugs were noted. Dose of a trial drug or placebo was placed halved or doubled at 12-hour intervals using these parameters. The primary end point was the number of days alive without delirium during the 14 day intervention period. Secondary end points included time to freedom from mechanical ventilation, time to ICU, hospital discharge and 30 day and 90 day survival. Results: Out of 45 patients screened, 25 were males and 20 were females with no comparable differences. The mean number of days alive without delirium or coma was 9.45 in the haloperidol group, 8.64 in the quetiapine group, and 8.57 in the placebo group (p-value=0.63) for overall effect across trial groups. The use of haloperidol or quetiapine as compared with placebo, had no significant effect on the primary end point. There were no significant between-group differences in respect to the secondary end points . Conclusion: The use of enteral haloperidol or quetiapine, as compared with placebo, did not significantly alter the duration of delirium in the critically-ill patients admitted in ICU.

Protective Role of Vitamin C Against Biochemical Enzymes Alterations Induced by Exposure of Allethrin Based Mosquito Coil Smoke on Cerebellum of Male Albino RatsAn Experimental Study

Introduction: Among synthetic pyrethroids allethrin is widely used as active ingredient in mosquito coils. Many experimental studies have proved that pyrethroids cause neurotoxicity and result into derangements of biochemical enzymes including oxidative stress markers and antioxidant levels in brain. Aim: To study alterations in biochemical markers (oxidative and antioxidant enzymes) in cerebellum of male albino Wistar rats induced by the exposure of allethrin based mosquito coil smoke along with protective role of withdrawal and exogenously administered vitamin C on these markers. Materials and Methods: This experimental study was conducted in the Department of Anatomy, King George's Medical University, Lucknow, Uttar Pradesh, India, during October 2014-September 2015. Total 42 male albino Wistar rats were divided into four groups. The first group contained 12 rats was used as control, group II with 12 rats was given 8 hours daily exposure of allethrin based mosquito coil smoke via whole body inhalation for 6 days in a week for a total of 12 weeks. Group III contained eight rats and was given exposure same as group II and were further kept for 8 weeks to see the withdrawal effect. Group IV with 10 rats was given same exposure as group II, along with oral administration of 20 mg/kg body weight vitamin C. After 12 weeks of exposure cerebellum was dissected and then sent for biochemical enzyme estimation. Rats in group III were dissected after 8 weeks post 12 weeks of exposure. Comparisons were made between groups by using one way Analysis of Variance (ANOVA). Results: The exposure Group II showed significant rise (p<0.001) in level of oxidative stress marker enzyme Malondialdehyde (MDA) and significant (p<0.001) reduction in activities of antioxidants Glutathione Peroxidase (GPO), reduced Glutathione (GSH), Superoxide Dismutase (SOD) and Catalase (CAT) in comparison to Group I, III and IV. In vitamin C administered group IV the above parameters were found to be less affected. Intergroup comparison of oxidative stress markers level showed significant intergroup difference between Group I, II, group II, III and group II, IV. Conclusion: Allethrin based mosquito coil smoke causes oxidative stress in cerebellum of albino Wistar rats and vitamin C has ameliorative effect on biochemical alterations induced by sub-chronic whole body exposure of mosquito coil smoke.

Impact of Lockdown on Autopsy Cases in a Tertiary Medical Centre in Northern India: A Retrospective Analysis

2020 will be remembered not only for the COVID-19 pandemic but also for introducing some entirely new concepts like “lockdown” and “social distancing” which brought the entire world to a standstill. Lockdown approach can have a wide range of implications not just on the economy but also on the physical, mental and social well-being of the people. We investigated the impact of 78 days nationwide lockdown in 2020 on profile of the post-mortem cases being brought for autopsy to the mortuary of King George's Medical University, Lucknow, India. Further 78 days of post lockdown period in 2020 were also included in the study and compared with the corresponding time periods in 2019. Atotal of 3657 cases were included in the study, 2042 in 2019 and 1615 in 2020. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) from logistic regression modeling were used to compare the mortality due to different causes across the four study timeperiods.

Analysis of Risk Factors and Association of Cluster of Differentiation (CD) Markers With Conventional Markers in Delayed Fracture Related Infection for Closed Fracture.

Background: Fracture-related infections (FRI) remain a difficult consequence for orthopedic trauma patients, their relatives, the treating physicians, and the healthcare systems. Delayed fracture-related infection is an important step in the infection process that can be controlled by diagnosing and preventing it from moving to the next level. Neutrophils CD64 and CD66b were identified as sensitive indicators in the event of infection. Normal sequential changes, on the other hand, occur after surgery and are extremely high. They are back to normal on the 10th day after the operation. The aim of this study was, therefore, to examine the risk factors associated with fracture-related infection by comparing cluster of differentiation (CD) indicators with conventional markers and comparing them with gold standards culture reports. As a result, it could be an early sign of a closed fracture infection.Material & Methods: Between February 2020 and March 2021, 510 patients from the Department of Orthopedics at King George Medical University in Lucknow agreed to participate in the study. The study included patients who had a closed fracture and had undergone elective or emergency surgery. Blood was withdrawn before the surgery (baseline) on day one and again on the third, seventh, and 10th day after the operation to measure the quantitative measurements of the biomarkers (total leucocyte count [TLC], erythrocyte sedimentation rate [ESR], C reactive protein [CRP], CD64, and CD66b) in all follow-up examinations. Patients were monitored for delayed signs of the infection for 2 to 10 weeks. The biomarkers were evaluated and linked to the culture reports.Results: Of the 510 patients included, 272 were men (53.3%) and 238 women (46.7%), the mean age was 40 (20-78), the mean age for fracture related infection with positive culture (FRI POS) was 48.0 (SD: 19.47), for fracture related infection with negative culture (FRI NEG) was 46.20 (SD: 17.18), and for patient with no signs of infections (NON-FRI) was 45.13 (SD: 17.62) (p <0.001), the mean duration of the fracture to admission (in hours) was 4.90 (SD: 1.92), 4.91 (SD: 2.65), and 5.14 (SD: 2.66) (p <0.001), respectively. The mean duration of admission to surgery (in hours) was 31.54 (SD: 85.14), 43.14 (SD: 105.64), and 61.84 (134.14), respectively (p <0.001). The mean duration of surgery was 4.63 (SD: 1.85), 5.14 (SD: 2.16), and 5.05 (SD: 2.16) (p <0.001). The risk factors such as bone type (p = 0.04) and addiction (p = 0.01) were identified as statistically significant. There was no correlation between the CD66b markers on the third, seventh, and 10th days. CD64 was significantly correlated with ESR, TLC, and CRP on the 10th day in the FRI-positive group (r = 0.638; p = 0.03) (r = 0.744; p = 0.009) (r = 0.817; p = 0.002).Conclusion: The risk factors for infection in fracture patients are significantly influenced by the type of bone and addiction the patient is using. Elevated CD64 levels could be used as a diagnostic marker for infection early on the 10th day after surgery before the appearance of clinical signs.

Estimates of Prevalence of Pulmonary Hypertension according to Different International Definitions.

Background Pulmonary hypertension is a dreaded disease associated with considerable morbidity and mortality. The pulmonary hypertension developing due to chronic respiratory disease is a unique subset with symptoms often getting masqueraded by the underlying respiratory condition. The importance of early detection of this complication has been realized worldwide, and recently, the definition of pulmonary hypertension was revised to set the cutoff of mean pulmonary artery pressure (mPAP) at 20 mmHg instead of 25 mmHg at rest. In our study, we have tried to estimate the difference this new definition brings to the prevalence of pulmonary hypertension among interstitial lung disease patients at our centre. Methods This was a cross-sectional study in which all the patients of ILDs (n = 239) attending the outdoor and indoor Department of Respiratory Medicine, King George's Medical University, India, for the duration of one year were subjected to transthoracic echocardiography along with measurement of serum pro-B-type natriuretic peptide (BNP) and troponin T values. The data were analyzed using the different definitions, and the prevalence was compared. Result Incidence of pulmonary hypertension among ILD patients at mPAP cutoff ≥ 25 was 28.9%, while that at value ≥20 mmHg, incidence of pulmonary hypertension increased to 46.0%. An increment of 15–20% in incidence of pulmonary hypertension was observed among different types of ILD when cutoff of mPAP was changed. Conclusion The new definition helps in a significant increase in the detection of pulmonary hypertension, which certainly helps in earlier detection and better management of patients.

Estrogenic Effect of Asparagus racemosus, Cissus quadrangularis, Punica granatum and Pueraria tuberosa in Post-menopausal Syndrome

Pharmacognosy Research,2021,13,4,238-245.DOI:10.5530/pres.13.4.17Published:October 2021Type:Original ArticleAuthors:Seema Singh, Santosh Kumar, Sunita Singh, Chetna Mishra, Dinesh Tripathi, and S K Verma Author(s) affiliations:Seema Singh1,*, Santosh Kumar1, Sunita Singh2, Chetna Mishra3, Dinesh Tripathi3, SK Verma1 1Department of Respiratory Medicine, King Georges Medical University, Lucknow, Uttar Pradesh, INDIA. 2Department of Microbiology, King Georges Medical University, Lucknow, Uttar Pradesh, INDIA. 3Department of Physiology, King Georges Medical University, Lucknow, Uttar Pradesh, INDIA. Abstract:Background: Asparagus racemosus, Cissus quadrangularis, Punica granatum and Pueraria tuberosa are employed for their supposed properties in treatment in alleviating symptoms of menopause traditionally from ages. The aim of the present study is to evaluate the estrogenic effect of Asparagus racemosus, Cissus quadrangularis, Punica granatum and Pueraria tuberosa in ovariectomized (OVX) rats. Materials and Methods: Female wistar rats were divided into sham control and ovariectomized (OVX), OVX rats receiving standard drug, raloxifene (5.4 mg/kg) and groups treated with 500 mg/kg and 700 mg/kg of test drug (containing equal quantity of Asparagus racemosus, Pueraria tuberose, Cissus quadrangularis and Punica granatum extracts) daily for 90 days. The vaginal cornification, uterine weight, bone loss, biomechanical, biochemical and histopathological observation were carried out to ascertain the effect of test drug in post-menopausal syndrome. Results: The experimental animals treated with mixture of extract of four drugs showed dose dependent activity. The significant increase in uterine weight, femur BMD, femur hardness, was observed. In addition, increased levels of calcium and phosphorus in serum and significant decreased in urine were observed as compared to control OVX group. The histopathological results also confirm the protective effect of extracts. Conclusion: The present findings strongly suggest that Asparagus racemosus, Cissus quadrangularis, Punica granatum and Pueraria tuberosa possess the potent estrogenic activity in ovariectomized rats and substantiate the ethnic use in treatment of postmenopausal osteoporosis. Keywords:Biochemical, Estrogenic, Histopathological, Menopause, Ovariectomized (OVX) rats, Post menopausal syndromeView:PDF (994.49 KB)

The Effect of Cognitive Behaviour Therapy on Sleep and Circadian Rhythm in Young College Students

The present study is to study the effect of cognitive behaviour therapy on various sleep parameters and circadian phase rhythmic in young college going adults. Fifty young college going adults were chosen from the MBBS and BDS students of King George's Medical University Lucknow, their polysomnography was conducted along with it salivary melatonin estimation was conducted to find the time of Dim light melatonin onset (DLMO), the subjects were administered cognitive behaviour therapy (CBT),after completing the sessions of cognitive behaviour therapy another Polysomnographic study and DLMO estimation was conducted, various sleep parameters were compared before and after the CBT. The study showed an improvement in the steep quality, a decrease in daytime sleepiness along with this total sleep time significantly increased, sleep efficiency also improved and there was a decrease in the REM sleep latency. The Dim light melatonin onset advanced for the subjects and the chronotype showed an inclination towards an earlier timings.

Molecular characterisation of Hepatitis E virus isolates from north India

PurposeHepatitis E virus (HEV) is responsible for >50% of acute viral hepatitis (AVH) in developing countries. It has 4 major genotypes and various subtypes which vary in geographical distribution, clinical manifestations and epidemiological patterns. This study was conducted to characterise HEV isolates from north India to study the effect of host and viral factors on HEV infection. MethodsSerum samples collected from 536 AVH patients admitted to Department of Medicine, King George's Medical University, Lucknow from July 2016 to June 2017 were screened for anti HEV IgM, anti HAV IgM, HBsAg and anti HCV antibodies using commercial ELISA kits. Samples either positive for anti HEV IgM antibodies (n ​= ​204) or negative for all 4 hepatotropic viruses (n ​= ​37) were enrolled and tested by real time PCR for HEV RNA. HEV RNA positive samples with high viral load were further subjected to nested PCR for amplification of capsid gene. Sequencing and phylogenetic analysis were performed. HEV strains isolated from this study were deposited to GenBank under accession numbers MG571274 to MG571283. ResultsAnti HEV IgM positivity was observed among 38% clinically suspected AVH cases. HEV RNA was detected in 31.8% seropositive HEV cases and additional 3 seronegative cases. Males outnumbered females and the most affected age group was of young adults. Maximum number of cases were seen during the months of June to September. Phylogenetic analysis showed that HEV strains in our study belonged to genotype 1a. Mortality in HEV infected pregnant females was 23.5% as compared to 2.4% in non-pregnant females. Adverse fetal outcome was recorded in 51% of HEV infected pregnancies. ConclusionsHEV genotype 1a is prevalent in our setting. HEV during pregnancy is associated with adverse maternal and fetal outcome.

“CRANIO-VERTEBRAL JUNCTION ANOMALIES- SPECTRUM ON MAGNETIC RESONANCE IMAGING”

OBJECTIVE: This prospective study was done in the Department of Radiodiagnosis, King George Medical University, Lucknow, over the period of one year from September 2007 to July 2008. The purpose of this study was to evaluate the spectrum of cranio-vertebral junction anomalies on Magnetic resonance imaging (MRI). Fourty patients for whom MRI of cervical spine inc METHODS: luding cranio-vertebral junction was done for varying symptoms and showed imaging features of cranio-vertebral junction anomalies were selected for the study. Results were presented in numerical and percentage forms. There were 34 males and 6 female patients i RESULTS: n the age range of 3-60 years. Maximum number of patients were in the age group between 11-20 years (18 patients-45%) followed by age group of 21-30 years (7 patients-17.5%). Most common presenting symptom was weakness of both upper &amp; lower limbs seen in 16 patients (40 %) followed by neck pain &amp; stiffness in 15 patients (37.5%) and sensory symptoms in 11 patients (27.5%). Weakness of lower limbs, lower cranial nerve dysfunction &amp; bladder bowel symptoms were the least common presenting symptoms seen only in 1 patient (2.5%). Atlanto-axial instability was the most common abnormality present in 30 patients (75%). Occipitilisation of atlas was the second most common abnormality seen in 20 patients (50%) and basilar invagination; third most common abnormality seen in 14 patients (35%). Other less commonly found abnormalities were ossiculum terminale (in 6 patients-15%), platybasia (in 5 patients-12.5%), aplasia of atlas arches(in 3 patients-7.5%), os odontoideum(in 3 patients-7.5%), segmentation failure of C2-C3 (in 3 patients7.5%), clivus segmentation (in 2 patients-5%). Atlanto-axial fusion(in 1 patient 2.5%) &amp; hypoplasia of dens (in 1 patient 2.5%). Most common associated feature was syrinx formation found in 9 patients (22.5%). Out of 40 patients, 34 patient had developmental anomalies (85%) while 6 patients had acquired causes, including tubercular in 5 patients-12.5% &amp; rheumatoid arthritis in 1 patient -2.5%. Myelopathic changes were found in 28 patients (70%) out of which motor symptoms were present in 25 patients (89.29%) .

P–638 Status of insulin resistance in infertile women and its effect on ovulation induction

Abstract Study question Is insulin resistance ( IR) a confounding variable in infertile women, other than those those having polycystic ovarian syndrome (PCOS) Summary answer IR was identified in 20.5% of infertile women. The presence of IR did not affect response to ovulation induction but reduced chances of conception What is known already Obesity is strongly correlated with insulin resistance. Obesity also has an adverse effect on fertility. In 2008 Steeg et al reported 5% reduction in chances of spontaneous conception with each unit increase in body mass index (BMI). Tetsurou Sakumoto et al (2010) reported hyperinsulinemia to affect granulose cells in small follicles inducing early response to luteinising hormone and anovulation. Adverse effect on endometrial function and implantation was also postulated. Insulin resistance has been studied in cases of PCOS but has not been studied in infertile women not fulfilling criteria for diagnosis of PCOS . So the present study was planned Study design, size, duration A prospective cohort study was conducted in infertility unit, King George Medical University, Lucknow, India over a period of one year from August 2018 to July 2019. Total 102 women with unexplained infertility were enrolled. Ethical clearance was obtained from institutional ethical committee Participants/materials, setting, methods Women with PCOS; diminished ovarian reserve documented by antral follicle count &amp;lt;7 and anti Mullerian hormone &amp;lt; 1.1ng/ml; bilateral tubal block; abnormal semen analysis; untreated hypothyroidism, hyperprolactinaemia; known diabetes were excluded. All women underwent ovulation induction with clomiphene citrate followed by single intrauterine insemination. Homeostasis model assessment insulin resistance index (HOMA IR) was calculated HOMA-IR = Fasting S. Glucose (mg/dl) x Fasting insulin (µlU) / 405. Value ≥ 2 denoted insulin resistance Main results and the role of chance : IR was identified in 21/102 (20.5%) cases. Fasting insulin levels were in the range of 5 – 9.9 mIU/ml in 53/102 women; &amp;lt;5mIU/ml in 29 and &amp;gt;10mIU/ml in 20. Fasting insulin &amp;gt; 9.45mIU/ml was found to have 90.5% sensitivity and 96.3% specificity in predicting insulin resistance. None of the cases had abnormal fasting and post prandial plasma glucose levels. IR was seen to be significantly correlated with BMI &amp;gt; 25kg/m2 (p = 0.0018) and waist hip ratio of &amp;gt; 0.85 (p = 0.0024).All women had follicular development and follicle rupture irrespective of presence of IR. Women with IR were more likely to have monofollicular development (17/21 IR cases). Correlation of endometrial thickness with IR was not seen. Mean endometrial thickness was 8.9mm. There were 6 pregnancies among the 102 women studied. None of the women with IR conceived. So IR was found to be affecting one fifth of women with unexplained infertility. Failure of any woman with IR to conceive was significant but the finding needs to be further studied. Limitations, reasons for caution : It was a small study with only 102 cases and the women were followed for only one cycle of ovulation induction and intrauterine insemination so results need to be validated in a larger study with a longer follow up. Wider implications of the findings: If further larger studies corroborate the role of IR in women with unexplained infertility it could elucidate the possibility of using insulin sensitisers in management of such cases. IR may emerge as an important gamechanger in management of unexplained infertility. Trial registration number Not applicable

Development of craniofacial surgery at postgraduate department of plastic surgery, King George's medical university, lucknow

Development of craniofacial surgery at postgraduate department of plastic surgery, King George's medical university, lucknow

A STUDY OF THE EFFECT OF TIME RESTRICTED MEAL INTAKE ON ANTHROPOMETRIC AND BIOCHEMICAL PARAMETERS IN PATIENTS OF TYPE 2 DIABETES

Objective: 1. To study effect of time restricted meal intake on anthropometric and biochemical parameters in Type 2 diabetes patients. 2. To study if time restricted meal intake can act as an adjunct along with the standard conventional treatment of diabetes in patients of Type 2 diabetes mellitus. Design and method: 384 Type 2 diabetes patients enrolled from OPD Endocrinology, King George's Medical University were randomly divided based on whether the patients consented to having early dinner TRM (time restricted meal) group (192 patients) or not (control group) (192 patients). Follow up was done at 6 and 12 months for anthropometric measurement, height, weight, waist hip ratio, neck size, fasting, post prandial blood sugar, HbA1c, serum urea, serum creatinine and lipid profile. The patient was given a clear understanding about chronomedicine. A single intervention was done - timing of dinner was at or around 7 pm in the evening for TRM group. Both groups were given standard conventional treatment of diabetes. Result: 65% of TRM group, 40 % (non- TRM) had normal HbA1c after 12 months. BMI, Hip size, systolic blood pressure, HbA1c, blood sugar (fasting and post- prandial) were significantly different (p &lt; 0.05) in TRM Group as compared to the p value of control group. p value &lt;0.0167 observed in values of blood sugar (fasting) in TRM Group, p value &lt; 0.8113 in control group. Blood sugar (post- prandial) in TRM Group a p value &lt;0.0001 (highly significant), control group p value&lt;0.6938. Hip size (TRM Group) p value &lt; 0.0012 (Significant) (Difference between means=2.762 ± 1.261). BMI (TRM Group) p value = 0.0030, significant. Neck Size (TRM Group) p value= 0.9697, not significant. Waist Size (TRM Group)p value= 0.2832, not significant. Hip Size (TRM Group) p value = 0.0012, significant, correlation coefficient=0.8380. Systolic Blood Pressure (TRM Group) p value = 0.0211, significant. Diastolic Blood Pressure (TRM Group) p value = 0.536, not significant. Results: One of the first studies which has been undertaken in Indian diabetics, although the initial data obtained is encouraging yet further study is required to corroborate results.

Serological and molecular study of Leptospira in pediatric patients at a tertiary care centre of northern India

Leptospirosis is considered as one of the most neglected zoonotic tropical diseases. Animals and humans acquire this infection through direct contact with contaminated urine or body fluids of infected animals. This prospective study was undertaken to know the proportion of leptospirosis in pediatric patients presented with acute febrile illness at the Post Graduate Department of Microbiology, King George's Medical University, Lucknow, Uttar Pradesh. Blood samples were collected over a period of one year from January to December 2018 from 70 pediatric patients aged up to 0–12 years presented with febrile illness for 3–14 days. Out of the 70 samples, 7 (10%) samples were found positive by IgM ELISA, 4 (5.7%) samples were positive by MAT and 3(4.3%) were found positive by PCR. Risk factors such as contact with infected animals and contaminated environment were highly associated with seropositivity of leptospirosis. Clinical symptoms such as fever, chills, myalgia, headache, abdominal pain and cough were significantly associated (p < 0.05) with the seropositivity of leptospirosis.

Etiological diagnosis of microbial keratitis in a tertiary care hospital in Lucknow

Context: Microbial keratitis is a sight-threatening infection which can lead to devastating outcome if not managed timely and rightly. Aim: The aim is to study the etiology and assess the risk factors of infectious keratitis in patients presenting to the Ophthalmology Department in King George's Medical University, Lucknow (Uttar Pradesh), India. Setting and Design: The study was conducted at the Microbiology and Ophthalmology Department of King George's Medical University, Lucknow. This was a prospective, observational study. Subjects and Methods: A total of 120 corneal scrapings were performed in patients presenting with corneal ulcers between August 2016 and July 2017. Gram staining, KOH mount, and culture on blood agar and Sabouraud's dextrose agar were done for all the scrapings for the identification of bacterial and fungal isolates. Statistical Analysis: None. Results: Microbial etiology was established 34.17% of scrapings. The most common risk factor was trauma (56.7%) of which vegetative trauma was maximum (31/68). Among 41 positive cultures, 34.14% were bacterial while 65.85% were fungal in etiology. The most common bacterial and fungal isolates were coagulase-negative Staphylococcus spp. (50%) and Aspergillus spp. (25.93%), respectively. Conclusion: Trauma was the most common predisposing factor for microbial keratitis in our setting. Fungal infections were more common than bacterial. The “regional” findings play an important role in public health implications to understand the etiology better and to initiate appropriate treatment.

Association between Sleep Spindles and IQ of College Students

ABSTRACT Introduction Sleep spindles are short burst-like waveform of signals generated in the electroencephalogram (EEG) recorded during sleep, and these are the electrical representation of an oscillatory neuronal activity of thalamic neurons. Some studies have linked different sleep spindle parameters with intelligence quotient (IQ). But there is a lack of uniformity in different studies, as spindle parameters may be positively associated with cognition variables in one study, but those same parameters might be negatively associated or even unrelated in other studies. The present study was conducted to further throw light on the correlation of sleep spindle activity with IQ. Objective To find the association between different sleep spindle parameters and IQ. Method The sleep spindle data of 50 healthy young medical students aged between 18 and 23 years were taken from previously conducted sleep studies (polysomnography), which were available in the sleep lab in the department of physiology (King George's Medical University). The participating students underwent a Wechsler IQ test. The result of the test was correlated with sleep spindle parameters available with us to see any correlation. Results and conclusion Sleep spindle frequency was negatively correlated with the IQ, and the number of spindles in deep sleep (N3) was positively associated with the IQ of an individual. How to cite this article Vardhan R, Ghidiyal A, Tiwari S, et al. Association between Sleep Spindles and IQ of College Students. Indian J Sleep Med 2021;16(1):10–13.

Histological changes at the commissure of the lip on approaching from its cutaneous to the mucosa region in males

Introduction:The morphology of the epithelium of the oral lips comprised keratinized external epithelium (anteriorly) and nonkeratinized or sometimes parakeratinized mucous membrane epithelium (posteriorly). Knowledge of morphometry of the lip lining helps in deciding the best site for choosing graft for its better uptake during several dermal grafting procedures following trauma or tumor excision following craniofacial cancers or cosmetic procedures.Materials and Methods:Ten human male cadavers were procured at the Department of Anatomy King George's Medical University, Lucknow, Uttar Pradesh. The rectangle-shaped skin specimen through the right commissure of the lip which included the skin, mucocutaneous junction, and mucosa was stained with hematoxylin and eosin stain. A total of 30 slides were prepared. Thus, the readings were obtained for three regions, respectively, with the help of CAT-CAM E-series HD cameras which were installed in a light microscope.Results:Thickness of skin (epidermis + dermis) of the lip ranged from 756 μm to 1068 μm among males. Epidermal thickness increases on moving from the cutaneous region to the mucosa region of the lip. The lowest contribution of the stratum corneum in thickness of the epidermis was observed in the vermillion region, while the highest contribution was observed in the skin region. It was found to be absent in the mucosa region of the lip. Rete pegs at the dermoepidermal junction was found to be maximum in the vermillion region and minimum in the skin region. Its depth increased as we move from the skin to the mucosa region of the lip. Depth of the dermis was found to be maximum in the skin region, while minimum in the vermillion region. It ranged between 291 μm and 693 μm.Conclusion:Care should be taken while using dermal fillers in lip augmentation surgeries, especially in the vermillion region due to its close proximity to musculature in the core of the lip.

Uterine parameters of clinical importance in North Indian females of reproductive age – An ultrasonographic evaluation

Introduction: The uterine size is important during planning of assisted reproductive techniques and hysterectomy and there is no established normative data from the women of northern India, this study was undertaken with the objective to report the normal length, width and anteroposterior lengths of non-gravid uterus. Methodology: In a prospective observational study, conducted in Department of Anatomy in collaboration with Departments of Radiology, Obstetrics and Gynecology of King George's Medical University, Lucknow, the ultrasonographic measurements of non-gravid uterus were noted. The ultrasonography was performed on females in dorsal decubitus position having full urinary bladder. Uterine position was identified by placing the probe on suprapubic area Length and anteroposterior diameter of uterus were measured by placing the probe in longitudinal direction (sagittal plane). Length was measured from fundus to external os. The anteroposterior diameter is maximum measurement in mid sagittal plane of body of uterus. The transducer was rotated up to 90 degree to measure the transverse diameter. Transverse diameter is the maximum measurement in transverse plane across the fundus. The volume of uterus was calculated. Results: The study included transabdominal ultrasonographic measurements of 100 females of age range 19-49 years (mean age 34.06 ± 0.35 years). Mean length, transverse diameter, anteroposterior diameters and volume noted were 7.71 (±0.47) cm, 4.63 (±0.33) cm, 3.75 (±0.31) cm and 70.54 (± 9.68) cm3. Conclusion: Normative values of uterine length, width and anteroposterior diameters of one-hundred non-pregnant women of northern India reported. Accurate measurement of uterine parameters is useful in timely management of various pathologies associated with abnormal size of uterus, infertility related procedures; such as in-vitro fertilization (IVF), embryo transfer (ET) and intrauterine device insertion.

Clinical and biochemical profile of scrub typhus patients at a tertiary care hospital in Northern India.

Background:Scrub typhus is a neglected rickettsial disease in India. Every year, we are facing outbreaks of Scrub typhus after Monsoon season. Patients present with a wide clinical spectrum ranging from pyrexia of unknown origin to multiple organ dysfunction. Some of these clinical features overlap with presentation of other tropical infections prevalent in Indian subcontinent, which leads to diagnostic dilemma and delay in diagnosis. Hence, we planned this study to know the demographic, clinical and biochemical profile of scrub typhus patients.Methods:This was an observational study conducted in department of Medicine, King George's Medical University Lucknow, India a leading tertiary care hospital of Northern India. All scrub typhus patients were evaluated by detailed history, examination and laboratory tests.Results:We enrolled 52 patients in our study. The mean age of the patients was 35.17 ± 16.90 years with majority (82.7%) of patients from rural background. All the patients had fever with an average duration of 9.6 ± 2 days. Most of the patients developed hepatitis (69.2%) followed by acute encephalitis syndrome (47%), acute kidney injury (23.1%) and acute respiratory failure (19.2%). Eschar was found in 11 patients (21.2%).Conclusion:Scrub typhus is often misdiagnosed or diagnosed late due to its wide clinical spectrum overlapping with clinical presentation of other commonly prevalent tropical diseases. One should always consider the differential diagnosis of scrub typhus while evaluating a young febrile patient of rural background, with features of single or multiple organ dysfunction and laboratory findings of leucocytosis, thrombocytopenia and elevation of transaminases.