Kurnool Medical College Research Articles

An Autopsy Based Study of Deaths Due to Snake Bite in Kurnool Region of Andhra Pradesh

Snake bite envenoming is a neglected tropical disease (NTD) that is responsible for enormous suffering, disability and premature death. This study is an autopsy based epidemiological study of deaths due to snake bite conducted in Kurnool medical college attached Government General Hospital, Kurnool, Andhra Pradesh. The results of the study indicated that snake bites are more common among middle-aged, uneducated, male agricultural laborers working in fields during monsoon season. In Majority of the them bitten by snake over lower extremities. The majority of patients could not reach the hospital in time because their habitats are rural areas and not well connected to the nearby health centers.

Knowledge, Attitude and Practices of Menstrual Health among Adolescent School Girls in Kurnool District, Andhra Pradesh

Background: The event of menarche associated with taboos and myths in our traditional society has a negativeimplication for women’s health, particularly their menstrual hygiene. Women having better knowledge regardingmenstrual hygiene are less vulnerable to reproductive tract infections.Objectives: 1) To study the Socio-demographic profile of adolescent school girls.2) To study the Knowledge, Attitude and Practices of menstrual hygiene among adolescent school girls.Materials and Methods: A descriptive, cross-sectional study was conducted among 122 adolescent girls of twosecondary schools situated in the rural field practice area of Kurnool Medical college, Kurnool with the help of apre-designed and pre-tested questionnaire. Data were analyzed statistically by simple proportions.Results: Out of 122 respondents, 48 (39.3%) girls were aware about menstruation prior to attainment of menarche.Mother and family members were the first informant regarding menstruation in case of 93 (76.2%) girls. 101(82.8%) girls believed it as a physiological process. Regarding practices, 119 (97.6%) girls used sanitary padsduring menstruation.Conclusions: Menstrual hygiene, a very important risk factor for reproductive tract infections, is a vital aspectof health education for adolescent girls. Trained health personnel, motivated school teachers and knowledgeableparents can play a very important role in transmitting the vital message of correct menstrual hygiene to theadolescent girl of today.

COVID-19 pandemic and its impact on the quality of life of MBBS students – A cross-sectional study

Background: Coronavirus disease 2019 (COVID-19) is considered an additional source of stress to the general population and especially to medical students. Medical students are known to have higher levels of psychological impairment in the form of depression, anxiety, and stress. This study assesses the impact of the COVID-19 pandemic and the quality of life of MBBS students, including their E-leaning experience. Aims and Objectives: The aim of this study was to study the effect of the COVID-19 pandemic on the quality of life of MBBS students including E-leaning experience. Materials and Methods: It is a cross-sectional survey, conducted on 343 MBBS students during second wave, at Kurnool Medical College. The survey involved a questionnaire that was distributed as an online version (Google Forms) to the medical students. Data were analyzed using SPSS software. Results: The majority of the students were from the age group of 20 years (37.3%) with female predominance (53.9%). Second-year MBBS students were in majority (n = 48.4%) are most of them were unmarried (n = 98.5%). Quality of health, life, energy, sleep, self-contentment, and study potential along with future career plans was determined. E-learning was determined by various aspects such as device, internet connection and quality, data sharing, and proficiency. Conclusion: Student recognized a significant disruption to their medical education, shared a desire to continue with in-person rotations, and were willing to accept the risk of infection with COVID-19. They feel more secure with vaccination of self. Our novel results provide a solid foundation to help shape medical student roles in the clinical environment during this pandemic and future outbreaks.

FAMILY PLANNING KNOWLEDGE, ATTITUDE, AND PRACTICE AMONG POSTNATAL WOMEN IN A TERITIARY CARE CENTER

Background: Family planning methods prevent pregnancy-related health risks for women. Aims and Objectives: The study aims to describe the socio demographic profile, knowledge, awareness, source of information, and utilization of various family planning methods among postnatal women who delivered in a kurnool Government general hospital(teritiary care center) Materials and Methods: It was a cross-sectional study conducted in the Department of Obstetrics and Gynaecology, kurnool Medical College and Hospital, kurnool,ANDHRA PRADESH over a period of 6 month from june 1,2022 to , December 30,2022. •After obtaining informed verbal consent, a predesigned standardized questionnaire was given to 500 postnatal mothers who delivered in the institution either by vaginal or by caesarean section. Data on socio demographic profile, knowledge, awareness of various family planning methods, source of information, utilization, and reasons for non-use were collected and statistical analysis was done using MS Excel. Results were expressed in terms of numbers and percentage. Result: Only 412 (82.4%) of the respondents had heard about family planning. About 65.7% of respondents have good knowledge, 34.3% have poor knowledge. Out of 500 respondents 349 (69.8%) have positive attitude towards contractive and the remaining 151 (30.2%) had negative attitude. Out of 500 respondents 152(30.4%) of respondents had a safe practice and the remaining 348 (69.6%) were unsafe practice towards contraceptive use. Conclusion: In our study •it is evident 65.7% had good knowledge regarding family planning methods•Regarding attitude gender bias having male is anasset to family having female child is curse.•This attitude has to be overcome by proper education, counseling to the elligible couple and community by health care professional•By this we can impart knowledge, practice regarding family planning methods.

KNOWLEDGE, ATTITUDE AND PRACTICE REGARDING ANAEMIA IN ANTENATAL WOMEN - A PROSPECTIVE CLINICAL STUDY

Introduction: Anaemia is one of the most common nutrition deficiency disorders affecting pregnant women. During pregnancy they need for iron for mother and foetus gradually increases and will reach its highest level at the end of pregnancy. Poor dietary practice and low compliance to iron tablets among pregnant women are major contributors for high burden of anaemia. They should be awareness of anaemia among antenatal women and association of knowledge, attitude and practice of Nutrition during pregnancy and taking iron-rich food. Objectives: To assess the knowledge, attitude and practice regarding anaemia in antenatal women. Material & Methods: It was a prospective study conducted in the department of Obstetrics and Gynaecology, Kurnool Medical College and Hospital, Kurnool ,Andhra Pradesh over a period of 3 month from November 1st 2022 to January 31st 2023. Data was collected by using a structured and Pretested questionnaire which asked question on nutrition in pregnancy,anaemia and associated factors. Results: A total of 500 antenatal women, 344 of them had heard about iron deficiency anaemia, 304 of them know that poor nutrition causes the anaemia during pregnancy , 192 agreed that iron supplement or iron tablets can prevent anaemia, 201 of them dont know that spacing of pregnancies can prevent anaemia ,331 have not taken a regular iron tablets. The study reflects the ignorance, poverty and illiteracy among majority of the child bearing women coming to the Hospital. Conclusion: Assessments of knowledge and practice and health education are essential step towards prevention of anaemia in pregnancy. Educating antenatal women about the importance of diet and implementing this into practice will help in the prevention of anaemia.

UTILITY OF FNAC IN THE EVALUATION OF BREAST LESIONS WITH HISTOPATHOLOGICAL CORRELATION

Introduction: Most of the women with breast pathology present as lump in their breast. Malignancy of Breast is the most common problem with increasing incidence in females. Early diagnosis and appropriate treatment of a breast lump is lifesaving. Fine-Needle Aspiration Cytology (FNAC) is a simple, safe, inexpensive method with wide acceptance and used as a rst-line diagnostic procedure for diagnosis of breast lesions. The main aim of the study w Aim: as to diagnose any palpable lump of the breast in females by FNAC technique and to correlate with histopathology reports. This was a retrospe Setting and Design: ctive study done out in the Department of Pathology, Kurnool Medical College, Kurnool. Study period was for 2 years (January 2021 to De Materials and Methods: cember 2022). For all breast lumps FNAC was done, processed; Haematoxylin and Eosin stain and Papanicolaou stain was done wherever necessary. For same patients who ever undergone Tru-cut biopsies, excisional biopsies, and surgical specimens were received and histopathological correlation was done. Data was collected and entered in MS excel sheet. The sensitivi Statistical Analysis: ty, specicity, positive predictive value, negative predictive value, and accuracy were calculated. Among 531 cases, 426(80.22%) were benign Results: and 105(19.77%) were malignant on cytology. Out of this, 215(40.48%) cases underwent histopathological examination, in which 118(54.88%) were benign and 97(45.11%) were malignant cases. The sensitivity, specicity, positive predictive value, negative predictive value, and accuracy of the present study were 84.82%, 98.05%, 97.93%, 85.59%, and 91.96% respectively. The FNAC is the common and most important prelimi Conclusion: nary diagnostic test in palpable breast lumps and there was high degree of correlation with a nal histopathological report

Tadalafil vs Tamsulosin for the Management of Lower Urinary Tract Symptoms in Men with Benign Prostatic Hyperplasia: A Randomised Clinical Trial

Introduction: Tadalafil and tamsulosin have both been approved for use in the management of Lower Urinary Tract Symptoms (LUTS). Limited studies have shown the efficacy of tadalafil in terms of maximum urinary output flow (Qmax) and post-void residual (PVR). Aim: To compare the efficacy of tadalafil 5 mg and tamsulosin 0.4 mg in patients with Benign Prostatic Hyperplasia (BPH). Materials and Methods: A prospective, open-label, Randomised clinical study was conducted in the Department of Urology at Kurnool Medical College, Kurnool, Andhra Pradesh, India. The study duration was one year and five months, from February 2015 to July 2016. A total of 83 patients clinically diagnosed with BPH were included, but 23 patients were excluded from the analysis due to lost follow-up. The remaining 60 patients were randomly assigned to two groups: one receiving tadalafil 5 mg (n=30) and the other receiving tamsulosin 0.4 mg (n=30) for 12 weeks. Demographic characteristics, total International Prostate Symptom Score (IPSS), individual IPSS, Quality of Life (QoL) score, Qmax, PVR, and differences in symptoms were analysed. Data were analysed using the Wilcoxon signed-rank test and Mann-Whitney U test. A p-value<0.05 was considered statistically significant. Results: The mean age for group I (tadalafil 5 mg) and Group II (tamsulosin 0.4 mg) was 62.7 and 61.0 years, respectively (p=0.147). Patients who received tadalafil showed significantly higher efficacy in all measures from baseline to 12 weeks, including increased Qmax (12.0 mL/sec vs 15.1 mL/sec), reduced QoL scores (4.2 vs 3.7), and PVR (26.5 mL vs 15.8 mL), compared to tamsulosin where the increase in Qmax was 11.6 mL/sec vs 13.6 mL/sec, reduction in QoL scores was 4.1 vs 2.4, and PVR was 24.0 mL vs 16.2 mL, between baseline and 12 weeks. Conclusion: Tadalafil 5 mg is a recent drug option available for the treatment of LUTS-BPH. The efficacy and safety of tadalafil 5 mg and tamsulosin 0.4 mg are comparable.

Risk Assessment of Type II Diabetes using Indian Diabetic Risk Score in Andhra Pradesh, India: A Cross-sectional Study

Introduction: Diabetes has emerged as a global pandemic of the 21st century, with approximately 463 million adults (aged 20- 79 years) living with diabetes worldwide in 2019. Type 2 Diabetes Mellitus (T2DM) is the most common form of diabetes compared to Type 1 and other forms. The burden of diabetes in India is expected to increase in the coming years. The Indian Diabetes Risk Score (IDRS) is a validated and cost-effective tool used to identify the risk of developing diabetes among the population. Aim: To estimate the risk of T2DM using the IDRS in adults aged 25 years and above. Additionally, the study aimed to explore the association between the risk of diabetes and other factors. Materials and Methods: An observational, community-based, cross-sectional study was conducted in the field practice area of Kurnool Medical College, Kurnool, Andhra Pradesh, India. Data collection took place from December 2022 to February 2023, using a simple random sampling technique. The study included residents aged over 25. A sample size of 100 participants was selected. The IDRS, developed by the Madras Diabetic Research Foundation (MDRF), was used as a validated tool to screen individuals at high-risk of developing T2DM. Data was collected using a semistructured questionnaire that included socio-demographic information, the IDRS tool to detect the risk of developing diabetes, and other risk factors such as Body Mass Index (BMI), family history of diabetes, physical activity, smoking, alcohol consumption, and hypertension. Data analysis was performed using the Statistical Package for Social Sciences (SPSS) version 23.0. The Chi-square test was used to determine significance, with a p-value of <0.05 considered significant. Results: A total of 100 residents aged over 25 years were included in the study. IDRS categorisation revealed that 14 (14%) were at low risk, 43 (43%) at moderate risk, and 43 (43%) at high-risk for developing T2DM, respectively. A statistically significant association was observed between diabetes risk score and individuals who smoked (p=0.04), consumed alcohol (p=0.04), and had hypertension (p<0.001). BMI showed a positive correlation with IDRS score (p=0.031), family history score (p=0.028), and waist circumference score (p=0.034). Conclusion: Early detection of the risk of diabetes through periodic screening and effective behavioural change communication could be instrumental in controlling the diabetes crisis.

Taxanes induced hypersensitivity reactions in cancer chemotherapy patients reported at adverse drug reaction monitoring centre at a tertiary care hospital

Background: Cancer chemotherapy involves highly complex regimens using antineoplastic agents like taxanes (paclitaxel, docetaxel) etc. Taxanes cause hypersensitivity reactions (HSRs) like redness, rashes, dyspnoea, severe anaphylaxis and death. In this study, adverse drug reactions (ADRs) associated with taxanes are described & analysed on their severity and preventability. The present study aims to analyse and determine the prevalence of ADRs, especially HSRs in patients treated with taxanes.Methods: After getting IEC approval, the present study is done retrospectively by assessing the HSRs in suspected ADR reporting forms from December 2019 to February 2022 in ADR monitoring centre (AMC) in the Department of Pharmacology at Kurnool Medical College, Kurnool. Descriptive statistics used to analyse patient demography, frequency, various carcinomas under treatment & organ involved, causality assessment using WHO-UMC Scale and Naranjo's Algorithm, severity assessment using modified Hartwig & Siegel’s scale and preventability by modified Schumock & Thornton scale.Results: A total of 258 ADRs were recorded, of which 30 cases reported HSRs with taxanes-paclitaxel (22) and docetaxel (8). The most commonly occurred HSR is shortness of breath. Naranjo’s algorithm showed 52.5% possible (score 1-4) HSRs. WHO-UMC causality assessment scale showed 56.4% as probable HSRs. Modified Hartwig & Siegel severity scale showed 46.6% moderate (level 3). Modified Schumock and Thornton scale showed 76.9% as not preventable.Conclusions: Chemotherapy-related ADRs among cancer patients urges the oncologists to be actively involved in ADR reporting, in the need of the hour in order to mitigate, avoid their occurrence and reducing morbidity and mortality, when practiced with diligence.

A COMPARISON OF SEQUENTIAL ORGAN FAILURE (SOFA) & QUICK SOFA SCORES IN PREDICTING HOSPITAL MORTALITY IN CRITICALLY ILL PATIENTS IN A TERTIARY CARE CENTRE

Background: To validate Q-SOFA for predicting In-hospital mortality in patients presenting with sepsis in an ICU setting and comparing it to SOFA (Sequential organ failure assessment) score. To compare the performance of the SOFA score and qSOFA scores for in-hospital mortality prediction among critically ill patients in an ICU setting in a tertiary care center. Aims And Objectives: To compare the performance of the SOFA score and qSOFA scores for in-hospital mortality prediction among critically ill patients in an ICU setting in a tertiary care center This study was done in the D Methodolgy: epartment of Medicine in Kurnool Medical College, Kurnool among patients with age > 18 years with suspected infection who were treated at the ICU of Government General Hospital. In our study Results: 2 scoring systems were used –QSOFA and SOFA –both of which are acceptable scoring systems in sepsis. Each of these scores was analyzed with mortality to determine which test predicted mortality better at discharge and at 28 days post-discharge follow-up. On comparing the SOFA score with mortality it was found that 81.82% of the patients who expired at discharge and 77.78 % of the patients who expired at 28 days postdischarge had a SOFA score more than 11(the median SOFA score). At discharge, the sensitivity along with the specicity of SOFA score was 81.8% and 97.4% respectively and at 28 days follow-up, the sensitivity, and specicity in predicting mortality were 77.78% and 100% respectively. On comparing Q-SOFA score with mortality it was found that 63.64% of the patients who expired at discharge and 77.78% of the patients who expired at 28 days post-discharge had a Q-SOFA score of more than 2. At discharge, the calculated sensitivity, as well as specicity of the Q-SOFA score, was 63.6% and 56.4% respectively and at 28 days post-discharge it was 77.78% and 66.7% respectively. AUROC was also calculated for the above-mentioned scoring systems in denoting its predictive power for mortality in sepsis patients. At both discharge and 28 days post-discharge follow-up, SOFA score was found better in predicting mortality followed by Q-SOFA score. Given that both SOFA and QSOFA have sensitivities close to each other for both In-hospital and 28-day mortality (81.8% vs. 63.6%) and (77.78% vs. 77.78%), the Q-SOFA could be used for rapid assessment before lab investigations are available for early goal-directed therapy, though SOFA is the most accurate score for predicting mortality 1. Sepsis scoring system Q-SOFA showed a sensitivi Conclusion: ty of 63.6 % at discharge and 70% at 28 days follow-up for predicting mortality in patients presenting with sepsis 2. Comparison of SOFA, Q-SOFA it was revealed that SOFA score predicted the mortality of sepsis the best both at discharge and at 28 days follow-up.

A CLINICAL STUDY OF GASTRIC OUTLET OBSTRUCTION IN ADULTS

Introduction : Gastric Outlet Obstruction implies complete or incomplete obstruction of the distal stomach, pylorus or proximal duodenum[1]. This may occur as an obstructing mass lesion, external compression or as a result of obstruction from acute edema, chronic scarring and brosis or a combination of both[1,2].Gastric outlet obstruction is not a single entity; it is the clinical and pathophysiological consequence of any disease process that produces a mechanical impediment to gastric emptying[3]. To Aims Of The Study : determine the relative incidence of benign and malignant gastric outlet obstruction.To study the modes of presentation of gastric outlet obstruction.To study the outcome of management of gastric outlet obstruction. The pat Materials And Methods : ients for this study have been selected from Kurnool medical college, KURNOOL from September 2020 to April 2022. In total, 50 in-patients of gastric outlet obstruction have been studied. An elaborate study of these cases with regard to the history, clinical features, routine and special investigations, pre-operative treatment, operative ndings, postoperative management and complications in post-operative period is done. Of the 50 cases of gastric Results : outlet obstruction 26 had carcinoma antrum, 23 had cicatrized duodenal ulcer and 1 had gastric outlet obstruction secondary to corrosive ingestion. The commonest causes of gastric outlet obstruction in adults are Conclusion : carcinoma stomach with antral growth producing gastric outlet obstruction (52%) and cicatrised duodenal ulcer (46%). Number of cases with cicatrised duodenal ulcer as the chief etiological factor for gastric outlet obstruction is diminishing and the number of cases of antral carcinoma of stomach as the cause of gastric outlet obstruction is increasing.

Challenges faced by 1st phase MBBS students during online teaching of competency-based medical education curriculum – COVID times

BACKGROUND: Competency-based medical education (CBME) is a learner-centered, outcome-based approach which motivates self-learning. Currently, the world is experiencing COVID-19 pandemic which led to shutdown of colleges, and hence, online teaching has become a key component in the continuity of medical education. The main aim of the study is to analyze the impact of COVID-19 pandemic on online teaching among 1st-year MBBS students and to assess the challenges faced during this time. METHODS: After obtaining institutional ethics committee clearance, a mixed-method study design was used to collect data from 100 respondents among 1st-year MBBS students of Kurnool Medical College, Kurnool, during the month of September 2020. A prevalidated, semi-structured questionnaire was sent to the participants through Google Forms. The quantitative analysis was done through survey questions on a five-point Likert scale. RESULTS: The reported challenges to online medical education during COVID-19 pandemic were lack of in-person communication (57%), technical issues while attending online classes (49%), difficulty in time management (50%), confusion in understanding course expectations/competencies (44%), and more focused on theory than practicals (59%). Some of them stated that “having online classes is really helpful than not having any classes at all.” CONCLUSIONS: Hence, we conclude that though challenges mentioned above were faced during online teaching of CBME curriculum, effective leadership and student teamwork would be helpful in successful online teaching.

A questionnaire-based exploratory study on self medication among second year MBBS students

Background: The practice of self-medication is expected to be higher in health science students due to their exposure to knowledge about different diseases and drugs. This study was done to assess the knowledge, attitude and practice of self-medication and to compare the impact of knowledge of Pharmacology on it, among second-year MBBS students.Methods: A semi-structured questionnaire consisting of both open-ended and close-ended questions was prepared and given to second-year medical students of Kurnool medical college, Kurnool. Data was analysed and entered in Microsoft Excel (version 2019), and associations were tested using the Chi-square test. The results are expressed as counts and percentages. Statistical significance was p<0.05.Results: Among the respondents, 37.33% are practising self- medication, 54.66% think knowledge of Pharmacology aids students to practice without any dire consequences. Most of the students take for fever (95.33%), (97.33%) for cough, cold, sore throat.84% were aware that it’s not safe to take drugs pertaining to alternate systems of medicine like Ayurveda, homoeopathy. A statistically significant association between knowledge, attitude, practice and gender and residence has been observed.Conclusions: The study shows that students are aware that self-medication is dangerous when followed by lay people. On the other hand, health professionals with knowledge about medications can take self-medication for common conditions without any dire consequences. They are also aware that it’s not safe to take medications that come under alternate systems of medicines, and WhatsApp consultation is not to be encouraged.

MANAGEMENT OF POSTERIOR URETHRAL VALVES- A CLINICAL EXPERIENCE FROM INDIAN SETTINGS

Objective: The present study aimed to highlight the current trends in the management of male patients with posterior urethral valves (PUV). Furthermore,thisstudy emphasized clinical, biochemical, and imaging patterns aswell as examined the outcomes of varioustreatment approachessuch as primary valve ablation and vesicostomy to manage PUV. Methods: This prospective clinical study was conducted in department of urology, Kurnool Medical College, Kurnool, AP. A total of 34 PU valve patients with mean age of 2.87 years with at least 6 months of follow-up were included in this study. Data related to demographic details, modes of presentation, diagnostic evaluation, presence of reux, renal status, treatment modalities and follow-up were collected. Surgical procedures included vesicostomy, and valve fulguration. Results: All the patients presented with obstructive voiding symptoms (100.00%), followed by fever with chills and rigors (67.60%) and pyuria (61.76%). Serum creatinine was normal in 13 patients and elevated in 21 patients. In all the cases PUV was diagnosed using MCUG. Overall, 12 (35.29%) patients presented with vesicoureteral reux prior to treatment. Bilateral and unilateral reux was noted in four and eight patients, respectively. Overall, 23 patients underwent primary valve fulguration and 11 patients underwent vesicostomy. In total 80% of patients maintained normal parameters at variable period of follow-up. Conclusion: The present study demonstrated favorable short-term results of primary valve ablation. However, vesicostomy was equally effective in patientswithbilateralhigh-grade reuxorsepsis despitevalve ablationand incircumstanceswhere there istechnicaldifcultyforvalve ablation.

Assessment of professionalism and ethics among final year part I undergraduate students of Kurnool Medical College, Kurnool, Andhra Pradesh

Background: Professionalism is a core competency of physicians. Erstwhile Medical Council of India envisioned competency-based medical education with Attitude, Ethics and Communication module as its forerunner. Objectives: The aim of this study was to objectively assess professionalism and ethics (P&E) by introducing multiple choice questions (MCQs) and Professionalism Mini-Evaluation Exercise (PMEX) as P&E assessment tools for MBBS students, by sensitizing the faculty and students. Materials and Methods: A mixed-method study was conducted during June to December 2019, among final MBBS part I undergraduate students, posted in the Department of Community Medicine, Kurnool Medical College, Kurnool. After obtaining IEC clearance and written informed consent from the study participants, a 3-day workshop on P&E was conducted with interactive teaching session on day 2, pretest on day 1, and posttest on day 3, in the form of five standardized patient interactions in OSCE stations rated using PMEX tool and five response stations for MCQs. Descriptive and inferential statistical analysis was done in IBM SPSS version 21.0 to see difference in pre- and posttest scores. Qualitative analysis using manual thematic coding was done to assess the perception of faculty and students. Results: A statistically significant difference in means was observed in pretest and posttest scores using PMEX tool (t test = −22.12, P value = 0.0001). 75% of students considered MCQs and PMEX as a feasible tool, out of a total of 29 study participants. Conclusion: MCQs and PMEX are effective tools to assess P&E among medical undergraduate students.

A STUDY TO EVALUATE CLINICAL OUTCOMES IN PATIENTS OF AGE BELOW 50 YEARS WITH INTRACAPSULAR FRACTURE OF NECK OF FEMUR TREATED BY CANNULATED CANCELLOUS SCREW FIXATION

Intracapsular femoral neck fractures are commonly seen in the elderly population after a trivial fall. However, femoral neck fractures in adults younger than 50 are uncommon and often result from high-energy trauma. They account for only 2-3% of all femoral neck fractures. It is crucial to understand and contrast the differences between elderly and young adult patients to evaluate and treat femoral neck fractures. Characteristic differences are seen for the osseous and vascular anatomy, the mechanism of injury, associated injuries, fracture pattern, and treatment goals. Femoral neck fractures in young adults are associated with higher incidences of femoral head osteonecrosis and nonunion. The rate of osteonecrosis reported in the literature ranges from 12-86% in young patients after femoral neck fracture. This devastating complication may lead to the collapse of the femoral head and subsequent osteoarthritis. Reoperation and salvage procedures such as osteotomy have high failure rates, and arthroplasty procedures are not ideal given the young age and higher activity levels. This study attempts to evaluate the internal xation of intracapsular fracture of the neck of the femur with multiple cannulated cancellous lag screws. Patients selected for this surgery were between 15 to 50 years old with intracapsular fracture of neck of femur who were admitted and treated in Kurnool Medical College and Hospital, Kurnool, A.P., from October 2019 to October 2021.

CARCINOMA OF BREAST IN CORRELATION WITH ESTROGEN AND PROGESTERONE RECPTOR EXPRESSION -A 3YEARS STUDY

Aims: 1.To study the incidence and age wise occurrence of carcinoma of breast, 2. To correlate ER and PR expression with Bloom Richardsons grading and TNM staging, 3. To help in therapeutic management and prognosis of the carcinoma of breast. 3Yrs study conducted in the department of Pathology, Kurnool Medical College, Materials And Methods: Kurnool. Out of 106 carcinoma of breast cases, 60 were subjected for ER and PR expression. Among 60 cases, both E Results: R+/PR+ were 34(56.66%)cases and both ER-/PR– were 21(35%)cases. Conclusion: Present study establish a correlation between ER and PR expression with tumor histomorphology, Grading and Staging of the tumor.

A study on overview of asthma-chronic obstructive pulmonary disease overlaps among patients with obstructive airway diseases

Asthma and chronic obstructive pulmonary disease (COPD) are different disease entities. They are both clinical diagnoses, with diagnostic tools to discriminate between one another.There is a need to re-evaluate the concept of asthma and chronic obstructive pulmonary disease (COPD) as separate conditions, and to consider situations when they may coexist, or when one condition may evolve into the other. A prospective study included 70 patients with chronic airway diseases who were classified into three groups (COPD, asthma and ACO). They were selected from Department of Pulmonary Medicine, Kurnool Medical College outpatient clinic during the period from January 2019 to December 2019, where patients with COPD and ACO were diagnosed according to GOLD guidelines and patients with asthma were diagnosed according to GINA guidelines. Patients enrolled in the study were subjected to full history taking, clinical examination, full laboratory examination, plain chest radiography, spirometry before bronchodilator and after bronchodilator administration (reversibility test) and sputum analysis for counting eosinophils cells. This study was conducted on 70 patients with chronic airway diseases (COPD, asthma and asthma COPD overlap) were selected. It included 47(67.1%) males and 23(32.8%) females. In our study, 30 (42.8%) patients as having COPD, 19(27.1%) patients were diagnosed as having asthma and 21(30%) patients were diagnosed as having ACO. Regarding the age difference between groups, it was found that patients who were diagnosed as having ACO were older than asthmatic patients with mean age of 49.43±5.83 and 47.23±6.73years, respectively. The men age of patients with COPD was 57.32±6.74 which was older than both ACO and asthmatic patients. ACO represents a large percentage among patients with obstructive airway diseases. It shares some features of asthma such as atopy and positive sputum eosinophilia, and some features of COPD like old age of presentation and positive smoking history.

English

BACKGROUND Nutrient foramen of humerus is an opening in the shaft of humerus which conducts nutrient vessels for medullary cavity. Major source of blood supply to long bone is the nutrient artery. Knowledge regarding nutrient foramen is important for orthopaedic surgeons while doing any procedure on humerus like bone grafting, plating and also plays an important role in fracture healing. We wanted to determine the location, number, and direction of nutrient foramen of humerus. METHODS The observational study was conducted on 72 adult humeri (36 of right side and 36 of left side) collected from Department of Anatomy, Kurnool Medical College, Kurnool, Andhra Pradesh from 15th September to 31st October 2020. Each humerus was observed for location, number, and direction of nutrient foramen in relation with surface, border andzone. RESULTS In the present study it has been observed that 61 % of humeri had a single foramen, 31 % had two foramina and 8 % had 3 foramina. Majority of nutrient foramina (54.95 %) were present on antero-medial surface, 12.08 % on anterolateral surface, 12.08 % on posterior surface, 19.78 % on medial border, and 1.09 % on lateral border. It was also concluded that most (94.50 %) of the foramina were present in the zone II followed by zone III (3.30 %) then by zone I (2.19 %). CONCLUSIONS Knowledge of number and location of the nutrient foramina in humerus will be helpful in preventing intra-operative injury of nutrient artery during orthopaedic, plastic and reconstructive surgery; and will also be relevant in medico legal practice. KEY WORDS Nutrient Foramen, Humerus, Nutrient Artery, Foraminal Index, Clinical Implications

Study of clinical and etiological profile of hypertensive emergencies in children admitted in pediatric emergency department

Background: Hypertension (HTN) in children, all though an uncommon entity is associated with end-organ damage. With increasing prevalence of hypertension and obesity in children; hypertensive emergencies are also increasing over recent years and screening is must. The primary objective of this study was to determine the incidence of hypertensive emergencies, the clinical presentation and etiological diagnosis at different age groups and to access the real burden of primary hypertension in causing hypertensive emergencies in children.Methods: This study was a prospective, descriptive, analytical cohort study done on children attending the emergency department of pediatrics, government general hospital, a tertiary referral pediatric center attached to Kurnool medical college, Kurnool, over a period of 18 months i.e., from january2016 to June 2017. Data was collected in a pre-determined proforma after institutional ethical committee clearance and appropriate informed concerned.Results: Among 98 children with hypertension; 30 had hypertensive emergency. Incidence was 0.3%. Intrinsic renal and renal vascular causes were the commonest. Headache, dizziness and vomiting were the comment presentation. Half of them had encephalopathy. Younger children had more of secondary HTN and in children (older than 7 years) primary hypertension increased as did family history of hypertension.Conclusions: With increasing primary hypertension among older children, hypertensive emergencies are increasing. As most of the children with HTN are asymptomatic; detection of target organ damage is vital.