Lata Mangeshkar Hospital Research Articles

The Effectiveness of a Tailored Faculty Development Program for Undergraduate Mentoring and Its Impact on Mentor's Perceptions: A Mixed Methods Study.

"Anubandh" the existing mentorship program at our institute used to start with enthusiasm but lacked sustainability throughout the year. This study aimed to assess the need for designing and conducting a faculty development program (FDP) and evaluating its impact on effective mentoring. FDP was designed by assessing the perception of 50 teachers regarding undergraduate (UG) mentoring at a tertiary care teaching institutein central India, the NKP Salve Institute of Medical Sciences and Research Center and Lata Mangeshkar Hospital, Nagpur, India.It was developed and conducted by focusing on the global overview, mentoring policies of the instituteand rationale while implementing mentorship. The effectiveness of FDP was tested by a change in pretest-posttest scores for assessing their knowledge and reflections on undergraduate mentoring. In the pre-FDP perceptions by mentors, the majority agreed that mentorship should be an integral part of the UG curriculum. Teachers felt that mentorship is an additional workload that needs to be given weightage in self-appraisal forms. A total of 81.2% of mentors emphasized on need for academic, social, and personal mentoring. After the FDP, there was a statistically significant improvement in the knowledge and attitude of mentors in all the assessed domains (χ2=2.648; df=6; p<0.05) like the need for UG mentoring in medical college and the role of faculties as a mentor. FDP sessions were appreciated by mentors for being motivating, interactive, and highly engaging with speakers having good oratory skills and using inspiring techniques with an overall rating of 9.2/10. There was an overall positive attitude about mentoring but many expressed the need for training in mentorship. The FDPwas highly effective in improving the knowledge and attitude of mentors for effective mentoring.

Enhancing Classification Performance through FeatureBoostThyro: A Comparative Study of Machine Learning Algorithms and Feature Selection

Early-stage prediction of a disease is an important and challenging task. The application of machine learning techniques is playing an important role in this era. Thyroid is one of the chronic endocrine diseases, and approximately 42 million people in India are affected by this disease. This paper presents a comprehensive investigation into the enhancement of classification performance through the novel ‘FeatureBoostThyro’ (FBT) model. The study evaluates various machine learning algorithms, including stochastic gradient descent (SGD), K nearest neighbor (KNN), logistic regression (LR), naive bayes (NB), and support vector machine (SVM), in conjunction with diverse feature selection methods. The research systematically explores the impact of feature selection techniques such as information gain, relief F, chi-square, gini index, forward selection, backward selection, recursive feature elimination, and LASSO on model performance across the chosen algorithms. The analysis reveals notable variations in performance metrics, including accuracy, precision, recall, and F1-score, providing valuable insights into the interplay between algorithm and feature selection. One main contribution of this research is the introduction of the FBT model, which consistently outperforms other models across various feature selection methods, making it a promising tool for addressing complex classification tasks. The findings contribute to a broader understanding of model selection and optimization in machine learning applications. The proposed model undergoes evaluation using two distinct datasets: the primary dataset acquired from Lata Mangeshkar Hospital in Nagpur and the secondary dataset obtained from the UCI dataset.

Surgical outcome of type I tympanoplasty in different types of mucosal chronic otitis media: a prospective study

Background: Chronic otitis media (COM) is a long-standing infection of middle ear cleft, causes severe destruction and leading to irreversible sequelae. The interval to convert discharging ear into dry is variable. Extensive counselling is required to keep these patients motivated for prolonged treatment duration. Hence, the study was conducted. Methods: A prospective study was carried out at NKP Salve and Lata Mangeshkar Hospital Nagpur, Maharashtra, between the age group of 16-60 years, who underwent type 1 tympanoplasty. Results were statistically analysed with respect to graft uptake, hearing improvement and size of perforation over a period of 2 years. Temporalis fascia was taken as a graft material. Results: Out of 70 cases, 38 cases had inactive ears and 32 cases had minimal, mucoid ear discharge (Active ear), which bacteriologically showed no organism. M:F ratio was 1.12:1. Graft uptake was successful in 92.11% of the cases in inactive group and 93.75% of the cases in active group. Graft uptake was 100% in small and moderate perforation. Hearing improvement was achieved in 71.05% of cases in the inactive group and 78.12% of cases in the active group, as measured by closure of the air-bone gap (ABG) and improvement in conductive hearing (significant &gt;10 dB). We found no difference in the success rates. Conclusions: Presence of minimal discharge will not affect the surgical outcome of type 1 tympanoplasty in terms of graft uptake, hearing improvement and size of perforation.

PREVALANCE OF FUNGAL SEPSIS IN LOW BIRTH WEIGHT AND VERY LOW BIRTH WEIGHT NEONATES AND ITS CORRELATION WITH HIGH RISK FACTORS IN A TERTIARY CARE CENTRE IN INDIA

BACKGROUND: Candidemia refers to the isolation of pathogenic species of Candida from a blood culture specimen. Candidemia in hospitalized patients especially in ICU patients is emerging as a signicant problem worldwide. Isolation of an organism from a blood culture of a neonate with clinical symptoms of infection constitutes the common denition of sepsis. The change in epidemiology and pattern of antifungal susceptibility of Candida infection has made identication of aetiological agent compulsory along with its antifungal susceptibility. MATERIALS AND METHODS: This retrospective cross - sectional study was carried out in the neonatal intensive care unit of tertiary health care centre, Lata Mangeshkar Hospital, Nagpur during the period of March 2021 to September 2021 with the primary objective to determine the incidence of fungal sepsis in very low birth weight neonates in neonatal intensive care unit (NICU) setup and secondary objective to study the correlation with the risk factors in a tertiary care center in India. RESULTS: In the present study, between march 2021 to September 2021, out of total 47 very low birth neonates, 18 very low birth weight neonates were blood culture positive for candida species . Hence, the incidence of candidemia in Very Low Birth Weight neonates in this study was 36%. DISCUSSION: The increase in resistance to antifungal agents among Candida isolates has resulted in increased mortality and morbidity. Prevention of risk factors in Candidemia patients with early removal of central line, timely fungal culture, Candida speciation and antifungal susceptibility are necessary for appropriate treatment and better outcome. CONCLUSION: Neonatal Candida colonization is the rst step that predisposes to invasive candidiasis. Pregnancies complicated by preterm labor or possible delivery should be considered for screening and treatment of maternal vaginal colonization to decrease the occurrence of neonatal colonization and its sequences

Changing patterns of Oral & Maxillofacial injuries before and during COVID-19 pandemic: A retrospective study

IntroductionOral and maxillofacial injuries can be defined as injuries involving soft and hard tissue structures of the facial region and oral cavity, including the teeth and vital structures of the head and neck area as a result of trauma. The maxillofacial injuries are multifactorial and vary from one country to another and even from region to region. Despite, societal restrictions imposed by the government in the form of lockdowns and curfews, patients still experienced trauma and required significant healthcare services for management. MethodsPatients of either gender reporting to the emergency department of Lata Mangeshkar Hospital with maxillofacial injuries, attended by residents of OMFS from October 2019 to August 2020 were included in the retrospective study. The demographic data about age, gender and status pertaining to under the influence of alcohol was recorded. The aim of this retrospective study was to evaluate the changing patterns of the maxillofacial injuries during the Covid-19 pandemic. ResultsIn the present study, the road traffic accidents were 72.50% pre-lockdown which reduced to 47.37% during the alcohol ban and nationwide lockdown and gradually increased to 63.83% post-lockdown. The second most common cause of maxillofacial injury was falls which showed a significant increase from 22.50% before the lockdown to 31.58% during the lockdown and decreased to 26.6% after lockdown during the pandemic. There was an increase in the number of assaults from 2.50% pre-lockdown to 15.79% during the lockdown and again a decrease to 6.38% post-lockdown. DiscussionOur study demonstrates the impact of nationwide lockdown in the month of April and May 2020, may have an association with the significant statistical decrease in the monthly average number of trauma admissions. There was a significant decrease in the number of road traffic collisions and falls during the “lockdown period”. ConclusionThe etiology and pattern of maxillofacial injuries reflect the trauma pattern within the community. We need more coordinated strategies of action to minimize maxillofacial injuries and its implication on physical and psychological wellbeing of patients.

Awareness of Osteoporosis among Indian Women Aged 30 Years &amp; Above by Using Osteoporosis Health Belief Scale - A Cross Sectional Study

Background: Osteoporosis is a prominent condition present in ageing females characterised by decreased bone mass and micro-architectural deterioration of bone tissue, leading to fractures and disability. Osteoporosis is on rise due to increased life expectancy because of good medical care, it has become crucial to know awareness about osteoporosis in women aged 30 years and above so that preventive steps can be taken, therefore, objective of the study was to evaluate the awareness in Indian women by using Osteoporosis Health Belief Scale. Methods: 219 women volunteered in the study with mean age of 49.07 years. Cross sectional descriptive study was conducted by collecting convenient sample at V.S.P. M’s College of Physiotherapy and Lata Mangeshkar hospital, Nagpur between 2021-2022 as per covid19 norms. Result and Discussion: The result revealed that surveyed population was aware about osteoporosis, but overall bone health was the new concept. Osteoporosis Health Belief Scale fetched the data about knowledge of participants about lifestyle modifications, dietary changes, weight gain, at the same time they were knowing about importance of physical activity, but implementation of these activities in their daily routine was a difficult task. All participants were very much positive about improving bone health. The study indicated adequate knowledge on osteoporosis in the age group of 40-50 years. Conclusion: Majority of the population had modest knowledge on osteoporosis. Overall affirmative response was observed on osteoporosis health belief scale. Perceived susceptibility for osteoporosis was low. Practices towards preventing osteoporosis were adequate. Keywords: Osteoporosis Health Belief Scale.

Ultrasound guided technique versus landmark technique for caudal epidural block in children: A randomized controlled study

The aim of this study was to compare the two modalities of performing caudal block – ultrasonography guidance and conventional landmark technique in terms of time taken to perform the block, number of attempts to perform the block, block success at first puncture, haemodynamic changes and complications.: The study was conducted in Department of Anaesthesiology, NKP Salve Institute of Medical Sciences and Research Centre and Lata Mangeshkar Hospital, Nagpur. It was a prospective randomized single blinded study.: This study was conducted in 62 grade ASA I and II patients of both sexes between age group of 2 - 8 years posted for elective surgeries below the level of umbilicus. Patients were randomized into 2 groups: Group C (Conventional technique) (n = 31) and group U (Ultrasound technique) (n=31) Caudal solution was prepared as Inj 0.2% Ropivacaine with Inj Fentanyl 2 mcg/kg with dosage according to Armitage formula, and was administered to both groups. The block performing time, the block success rate, the number of needle puncture, the success at first puncture and the complications were recorded. The analysis was 2 tailed and significance level was set at 0.05.: The mean block performance in group C was 39.3 ± 10.9 seconds while that of the Group U was 52.2 ± 11.4 seconds (P = 0.001). The time taken for identification of the caudal epidural space in Group C was 15.74 + 8.05 seconds while that of the Group U was 24.26 + 8.89 seconds (p = 0.0002). There was no significant difference noted in the number of attempts taken for the block in between both the groups. C group had a success rate of 61.29% in the first attempt while U group has a success rate of 90.32%. (p = 0.008). C group had a success rate of 83.87% while U group has a success rate of 100%. (p = 0.008). The only complication seen in the study was subcutaneous bulging which was seen significantly more in patients of C group compared to U group. Subcutaneous bulging was seen in 8 patients of C group and in 2 patients of U group. Despite the limitations in central neuraxial anesthesia we recommend the use of ultrasound since it reduces the complications and increases the success rate of first puncture in pediatric caudal injection.

To Assess the Effectiveness of Planned Teaching on Knowledge Regarding Harlequin Ichthyosis among Post Basic B.Sc Nursing Students

Background: Harlequin ichthyosis is an uncommon, extreme type of skin issue related with gigantic thickening of skin over whole body. The primary case was accounted for in 1750 by Reverend Oliver Hart. The general occurrence is 1 out of 300,000 births. Around 200 cases have been accounted for all through the world. In 1984, a newborn child with this issue was brought into the world in Pakistan and the child lived till 2008. One more such birth was recorded in the USA in 1994. As of late, one case was accounted for in June 2016 at Nagpur, India. A Harlequin child was brought into the world to a youthful couple in Lata Mangeshkar Hospital.&#x0D; Objectives: To assess the existing knowledge regarding Harlequin Ichthyosis among P.B.Bsc nursing students. To assess the effectiveness of planned teaching on knowledge regarding Harlequin Ichthyosis among P.B.Bsc nursing students. To associate the post-test knowledge regarding Harlequin Ichthyosis among P.B.Bsc nursing students with selected demographic variables.&#x0D; Materials and Methods: A one group pre-test and post-test research design study will undertaken to assess the effectiveness of planned teaching on knowledge regarding harlequin ichthyosis among P.B.B.Sc nursing students of selected colleges.&#x0D; Expected Results: There will be significant association between pre-test and post-test knowledge regarding Harlequin ichthyosis among P.B.Bsc nursing students.

Identification and antibiotic susceptibility pattern of urinary isolates in out-patients at a tertiary care center in a rural set up

Urinary tract infection (UTI) is most common infections described in out- patients settings. In almost all cases empirical antimicrobial treatment initiates before the laboratory results of urine culture are available, thus antibiotic resistance may increase in uropathogens due to frequent use of antibiotics. To identify and to determine antibiotic susceptibility pattern of bacterial pathogens of urinary tract infection reporting at a tertiary care hospital in OPD only. Cross-sectional. Department of microbiology, NKP salve institute of medical science, Lata Mangeshkar hospital, Nagpur from July to September 2018. A total of 33 culture positive bacterial isolates from 300 urine samples, submitted over a period of 2 months were included in this study. Identification of bacterial isolates was done by standard biochemical profile of the organism. The antibiotic susceptibility of culture positive bacterial isolates was performed by disk diffusion method as recommended by CLSI. Out of 33 culture positive samples the most prevalent bacterial isolate was E. Coli(48%) followed by klebsiella(18%), staphylococcus coagulase negative(12%). The susceptibility pattern of E. Coli showed that 81% of bacterial isolates were sensitive to Nitrofurantoin,75% to CIS and 50% to Gentamicin. Klebsiella was most sensitive to Gentamicin and CIS. Staphylococcus coagulase negative was most sensitive to Cd and Vancomycin. Majority of bacterial isolates were sensitive to nitrofurantoin, CIS, Gentamicin. Among the oral antibiotics, nitrofurantoin showed good susceptibility against Enterobacteriaceae family and gram positive organisms.

Finding a way for airway: a retrospective study.

Maxillofacial trauma is complex kind of injury that requires complex treatment, hence it is difficult in selecting the type of intubation technique depending on trauma. With the advent of various technologies and devices, surgeon and anesthetist should select right method of intubation that will benefit patient. In a retrospective study, patients of either sex, admitted in Lata Mangeshkar Hospital under Oral and Maxillofacial Surgery unit for treating maxillofacial trauma operated during year 2018 to year 2019 as elective basis were studied. Of 78 patients, the majority (37, 47.4%) were in the 21-30 age group, followed by the young adults 31-40 years age group (19, 24.3%). Mandible fracture was found to be the most common injury in 35 patients (44.3%) followed by fracture zygoma in 26(33.3%) patients and panfacial in eight patients (10.2%). There was frontal bone fracture in three patients (3.8%). Fiberoptic intubation under sedation was carried out in 34 (43.5%) and submental intubation in 20 (25.6%) and nasal intubation with direct visualization of vocal cords in 14 (17.9%) and blind nasal intubation was performed in eight (10.2%). The results of this study suggest that the old concept of securing the airway in difficult situation by tracheostomy should be revised.

Finding a way for airway: a retrospective study

Background Maxillofacial trauma is complex kind of injury that requires complex treatment, hence it is difficult in selecting the type of intubation technique depending on trauma. With the advent of various technologies and devices ,surgeon and anesthetist should select right method of intubation that will benefit patient. Methods In a retrospective study, patients of either sex , admitted in Lata Mangeshkar Hospital under Oral and Maxillofacial Surgery unit for treating Maxillofacial trauma operated during year 2018 to year 2019 as elective basis were studied. In total 78 patients [Table 1], majority of patients were in the age group of 21-30 years 37(47.4),followed by age group of young adults 31-40 years-19(24.3)Fracture mandible [Table 2] was found to be the most common injury in 35 patients (44.3%) followed by fracture zygoma in 26(33.3%) patients and panfacial in 8 patients (10.2%) There was frontal bone fracture in 3 patients (3.8%). Fiberoptic intubation under sedation was carried out in 34(43.5%) and submental intubation in 20(25.6%) and nasal intubation with direct visualization of vocal cords in 14(17.9%) and blind nasal intubation was done in 8(10.2%). Conclusions The results of this study suggest that the old concept of securing the airway in difficult situation by tracheostomy should be revised.

Laparoscopic versus open appendicectomy: a non-randomized comparative study

Background: Appendicectomy is one of the most common surgical procedures performed in emergency surgery. Despite this, there is still lack of consensus about the most appropriate technique for appendicectomy. In this longitudinal analysis, we aimed to compare the outcomes of laparoscopic appendicectomy (LA) and the conventional technique or open appendicectomy (OA) in the treatment of acute appendicitis.Methods: A non-randomized longitudinal comparative study was conducted in NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, India. From November 2017 to October 2019, 53 patients underwent OA and 59 underwent LA, making a total number of patients included in this study to be 112 (n). The two groups were compared for operative time, length of hospital stay, postoperative pain, post-operative ileus and complication rate.Results: Laparoscopic appendicectomy was associated with a shorter hospital stay (4.34±1.37 days in LA and 5.09±1.71 days in OA, p&lt;0.01), with a lower post operative pain score [VAS] (2.93±0.80 in LA and 4.62±0.92 in OA, p&lt;0.001). Operative time was shorter in the open group (42.70±12.05 min in OA and 43.39±16.59 in LA). Complications were lesser in the LA group with a significantly lower incidence of wound infection (3.4% in LA and 13.2% in OA).Conclusions: Laparoscopic approach is safe and efficient in appendicectomy and it provides clinically advantages over open method (shorter hospital stays, lower post op pain, early food tolerance, earlier return to work and lesser wound infection) against only marginally longer operative time.

Clinical, laboratory, and imaging predictors of surgical exploration in nontraumatic acute abdomen

Introduction: Acute abdominal pain (AAP) accounts for a substantial proportion of patients arriving at a surgical emergency department. As AAP may be caused by both life-threatening diseases and conditions that are spontaneously resolved, a correct diagnosis is of importance for the prognosis of the patient. Materials and Methods: Clinical, laboratory, and imaging studies were done in patients presenting with a history of acute, nontraumatic pain in the abdomen in the Department of Surgery of NKP SIMS and Lata Mangeshkar Hospital, Nagpur, over a period of 2 years. Results: A total of 400 patients with a mean age of 38.05 ± 11.45 with a male: female ratio of 2.07:1 were enrolled. Of them, 233 patients underwent exploration and 167 were managed conservatively. During univariate analysis, age group, pulse rate, temperature, hemoglobin, total leukocyte count (TLC), tenderness, guarding, distension, bowel sounds, chest radiograph, and abdominal radiograph were found to be significant. On multivariate analysis, hemoglobin, TLC, tenderness, distension, and abdomen radiograph were significantly associated with exploration. Conclusion: In a patient of nontraumatic acute abdomen, clinical predictors such as tenderness and distension, laboratory predictors such as hemoglobin and TLC, and abdominal standing radiograph as an imaging predictor were the most statistically significant for exploration.

Functional outcome of modified technique of intramedullary fixation of diaphyseal humeral fractures

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The aim of this study was to evaluate the functional outcomes with intramedullary fixation using flexible nails and to follow up for any other complications.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Study was a prospective study in Lata Mangeshkar Hospital, Nagpur during 2014 to 2016. All the patients enrolled in the study were briefed about the nature of the study. All cases in this series were operated by combined antegrade and retrograde approach.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Total of 30 patients of closed diaphyseal humeral fractures was studied. Maximum i.e., 16 (53.33%) were in the age range of 21-40 years, followed by 10 (33.33%) patients in the range of 41-60 years. 21 (70%) cases had fracture union between 10-16 weeks with a score&lt;strong&gt; &lt;/strong&gt;of 8 points, followed by 8 (26.67%) patients with fracture union duration&lt;strong&gt; &lt;/strong&gt;of less than 10 weeks with a score of 10 points. Only one of the patients landed up with non-union. The mean functional score of patients at 3rd month was 64.03±4.99, 9th month was 73.46±2.56. 86.66% patients had good to fair outcome, 3.33% patient each had excellent and poor outcome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Comparing results of our study with other studies, we found that our results are almost comparable but not better than open reduction and plating. Complications encountered in our series are comparatively less compared to those encountered during interlock nailing. The trauma to rotator cuff is minimum and this method is good alternative method. Thus, multiple nailing gives better functional outcomes as compared to locked nail. &lt;/p&gt;

Application of screening test for obstructive sleep apnoea detection in systemic hypertensive patients

Obstructive sleep apnoea (OSA) is prevalent in patients with hypertension (HTN). There is a lack of OSA screening in patients with HTN. Diagnosis and treatment of OSA in patients with HTN may improve blood pressure control and avoid complications of undiagnosed and untreated OSA. Hence, this study was conducted with the aim to screen OSA suspects in high risk groups of patients with hypertension using Stop Bang Questionnaire and Epworth sleepiness Scale (ESS). This was a cross sectional study carried out in OPD and IPD in Department of Respiratory Medicine, Lata Mangeshkar hospital, Hingna after obtaining approval from institutional ethics committee. Total 100 patients fulfilling the inclusion criteria were included after taking informed consent. The patients were screened according to ESS and Stop Bang Questionnaire. Out of 100, 53% of hypertensive patients were overweight / obese with mean BMI of 25.49 ± 5.43 kg/m2. According to Stop bang questionnaire, 56% and 34% of patients had high risk and intermediate risk of OSA respectively with mean score of 4.69 ± 1.68. According to ESS, 61% patients had low probability of OSA, 15% patient on borderline and 24% abnormal patients with mean score of 8.38 ± 4.688. BMI along with stop bang score showed high probability of OSA which was statistically significant. Screening with Stop bang questionnaire and ESS is helpful for diagnosing OSA in case of strong clinical suspicion with high BMI. This will avoid complications of undiagnosed OSA in patients with hypertension. Keywords: Obstructive sleep apnoea, Stop Bang Questionnaire, Systemic hypertension.

Study of prescription patterns of antihypertensive agents in preeclampsia patients: Central India study

Background: The main objective of this study was to evaluate prescription patterns of antihypertensives in preeclampsia patients at a tertiary care hospital in Central India.Methods: The study belongs to retrospective observational type. he study was conducted by department of Pharmacology in association of department of Obstetrics &amp; Gynaecology department at Nkp Salve Institute of Medical Sciences &amp; Research Centre, Lata Mangeshkar Hospital, Nagpur. Permission from Institute Ethics Committee was taken for studying the prescribing patterns of drugs. The study was conducted for a period of 6 months. Inclusion and Exclusion criteria were added.Results: The maximum number patients seen in age groups 36-41 (28.6%). The main drug prescribed in our study was Labetalol followed by methyldopa. In our study most of the patients were of moderate and mild type corresponding to 48% and 32% respectively and only 20% of patients belong to severe cases. In our study highest number of patients was seen in second gravida i.e. 33.33%.Conclusions: Labetalol was the most common anti hypertensive prescribed in pre eclampsia patients. Rationale prescribing of drugs were done.

Prevalence and incidence of asthma among underprivileged children in polluted urban areas of India: a childhood asthma intervention and referrals study

Background: Childhood asthma has emerged as an important public health issue which is often under diagnosed or undertreated, especially in underprivileged children from slum communities in India. This study aims to increase awareness and facilitate early diagnosis and treatment of childhood asthma.Methods: Americares India Foundation organized 167 asthma screening camps in the city of Bengaluru, Bhubaneswar, Cochin, Lucknow and Nagpur in India from August to November 2016. A total of 10,017 underprivileged children aged ≤16 years were screened for asthma; symptomatic treatment was provided else the children were referred for further investigations and treatment. The camps were organized in collaboration with St. Philomena’s Hospital, Bengaluru; Lourdes Hospital, Cochin; Indian Institute of Public Health, Bhubaneswar; Lata Mangeshkar Hospital, Nagpur; and St. Mary’s Polyclinic, Lucknow.Results: New and known cases of asthma were diagnosed in 199 and 166 children, respectively. The prevalence of asthma was found to be 2.7% in Bhubaneswar, 3.7% in Bengaluru and Lucknow, 3.9% in Cochin and 4.3% in Nagpur.Conclusions: Due to increase in the prevalence of childhood asthma in India, it is important to create awareness and communicate with families/caregivers about asthma and related disorders.

The Importance of Early Identification and Intervention for Children with Developmental Delays

The purpose of the study to examine a)To identity the prevalence of developmental delays involving physical development (specifically gross and fine motor skills); communication skills; and social and personal skills; b)Educate parents about the connection between brain growth and the normal stages of development, and the importance of the first three years of life to the overall development of the brain, c) Provide a means for early detection of children slipping behind in their milestone development d) Provide individualised developmental strategies based on the results of the extensive milestone checking in attempt to facilitate development in areas where the child may be slipping behind. Children (boys & girls) who referred by doctors for early intervention assessment and skill development, referred at NKPSIMS and Lata Mangeshkar Hospital central India Nagpur were included in the study (n=41 boys 20 and21 girls). An Analysis of variance showed early childhood intervention programmes in improving learning capacities for children with developmental delays are positive significant. Conclusion and recommend - Early intervention program parental involvement was significant component. Of particular importance is measures of social competence, motivation, family functioning, and problem-solving skills.

Rationale for near total thyroidectomy in patients with nodular goitre

Aims: To find out the results of near-total thyroidectomy in patients with nodular goitre with benign lesions. Material and Methods: A prospective study was carried out on 42 cases with nodular goitre at NKP Salve Institute of Medical Science & Research Centre and Lata Mangeshkar Hospital, Nagpur from October 2010 to October 2012. Results: In this prospective study of 42 cases with nodular goiter, clinically 29 patients had solitary thyroid nodule and 13 patients had multinodular goiter. Out of these 42 patients 35 (83.33%) were female and 7 (16.67%) were male with ratio of 5:1. The age of the patients ranged from 18 years to 65 years.In this study out of 42 patients, 3 patients had papillary carcinoma on FNAC and were treated by total thyroidectomy. 2 patients had colloid cyst and 7 patient had follicular neoplasm in which hemithyroidectomy was done. 30 patients were treated with near total thyroidectomy. After near total thyroidectomy transient hypoparathyroidism was present in 7(23.33%) patients and transient recurrent laryngeal nerve palsy in 2(6.67%) patients. No patient had permanent recurrent laryngeal nerve palsy or permanent hypoparathyroidism. Conclusion: Near-total thyroidectomy achieves a lower complication rate of hypoparathyroidism and a similar complication rate of recurrent laryngeal nerve palsy when compared with the rates reported in the literature for total thyroidectomy. It is an effective and safe surgical treatment option for various benign thyroid diseases.

Role of Laparoscopy in uncertain diagnosis of right lower abdominal pain

Aim: Aim of the study was to evaluate role of laparoscopy for diagnosis & management of patients with pain in right lower abdomen with uncertain diagnosis.Material and Methods: A prospective study was carried out on 36 patients with right lower abdominal pain who had uncertain clinical diagnosis, whose diagnosis was not established by clinical examination and laboratory investigations at Lata Mangeshkar Hospital, Digdoh Hills, Hingna Road, Nagpur for a period of one year.Results: Total 36 patients were subjected for diagnostic laparoscopy out of which 25 were females and 11 were males. Mean age of presentation was 31.52 years. Out of 36 patients, 27 patients have appendicitis, 2 patients have appendicitis and right ovarian cyst, 1 patient have only right ovarian cyst, 2 patients have pelvic inflammatory disease and in 4 patients no abnormality detected. Appendicitis was found on laparoscopy in 29 patients with 93.1% diagnostic accuracy. In our study, sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of laparoscopy in acute appendicitis comes out to be 100%, 66.6%, 96.2%, 100% and 93.1% respectively. Out of36 patients, the sensitivity of Alvarado score comes out to be 46.1 %, specificity 90 %, positive predictive value 92.3 %, negative predictive value39.1 % and diagnostic accuracy 58.3%. Negative appendicectomy was avoided in one male patient out of 11 patients (9.09%) and six female patients out of 25 female patients (24%). The use of laparoscopy as diagnostic tool can cut down unnecessary appendectomies especially in females. In our study, total seven (19.44%) negative appendectomies were avoided. Laparoscopy can detect pelvic inflammatory disease, ovarian cyst in patients of uncertain diagnosis of right lower abdominal pain.Conclusion: Laparoscopy has definite role in evaluation of pain in right lower abdomen with uncertain diagnosis. Diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value are more than Alvarado score in detecting acute appendicitis. It is useful especially in female patients to diagnose pelvic disease and rule out other pathology. With the help of laparoscopy therapeutic intervention can also be done at the same time with its advantages over open appendicectomy. We can reduce the no of negative appendectomies. Diagnostic laparoscopy can also be therapeutic with its advantages.