Medical College Jabalpur Research Articles

Histopathological spectrum of ovarian tumours

Background: Ovarian neoplasms include wide spectrum of various tumors, which differ in their histo-morphological features, also in their biological behaviour, tumorigenesis, clinical course, and prognosis. Aim of the study was to study the histopathological features of various ovarian tumors and correlate preoperative serum CA125 tumor marker level with histopathological types. Also to study fallopian tubes for fallopian tube precursor lesions such as serous tubal intraepithelial carcinoma (STIC) in serous carcinoma ovary. Methods: This cross-sectional observational study of the 80 specimens of ovarian tumors was conducted in department of pathology, Netaji Subhash Chandra Bose medical college Jabalpur (M.P.). The relevant data of the patients was collected and analysed as per designed proforma. Results: Out of 80 cases; majority cases 22 (27.5%) were seen in a 31-40 years age group, followed by 41-50 years age group 18 cases (22.5%). Youngest patient was 7 years old and oldest patient was 88 years old, forming the range of 7 years to 88 years. Epithelial tumors were the most common category, followed by germ cell tumors, sex cord stromal tumors and metastatic tumors. Benign tumors were much higher than borderline and malignant tumors mature cystic teratoma was the most common tumor encountered, followed by mucinous cystadenoma. The commonest malignant tumor was serous carcinoma followed by mucinous carcinoma. Conclusions: Ovarian neoplasms constitute a wide spectrum of tumors therefore exact categorization is important to adopt appropriate treatment protocols for the proper management of the patient. Histopathological examination is the gold standard for diagnosis and categorization of ovarian neoplasm.

Histopathological spectrum of uterine lesions in hysterectomy specimens of patients with abnormal uterine bleeding

Background: Abnormal uterine bleeding (AUB) is an overarching term that reflects any departure from normal menstruation or regular menstrual cycle patterns. Treatment depends upon the cause. Hysterectomy being a definite treatment for structural uterine pathology. Methods: This cross-sectional observational study was conducted in department of pathology, Netaji Subhash Chandra Bose medical college Jabalpur (M.P.). The study comprised of 140 hysterectomy specimens with or without salpingo-oophorectomy obtained from AUB patients and submitted for histopathological examination in our department during study period of 18 months. The relevant data of the patients was collected and analyzed as per designed proforma. Results: Out of 140 cases, majority of the patients were in 41-50 years age group 63 cases (45%), followed by 31-40 years age group 59 cases (42.14%). Most common clinical presentation was heavy menstrual bleeding in 83 cases (59.28%), followed by intermenstrual bleeding and pain in abdomen in 66 cases (47.14%) each. Commonest lesion found was leiomyoma, 83 cases (59.28%), second being dual pathology of adenomyosis with leiomyoma 23 cases (16.42%) followed by adenomyosis, 19 cases (13.57%). Four cases (2.85%) of benign endometrial polyp and endometrial carcinoma each and 1 case of adenomyoma, simple endometrial hyperplasia and endometrial stromal sarcoma, each, were reported. Conclusions: A wide spectrum of histopathological findings, ranging from normal cyclic endometrium to benign pathology and malignancy were seen. In some patients, dual pathologies, incidental findings and occult malignant lesions, which were missed clinically or radiologically, was diagnosed on histopathological examination, thus making it a gold standard for definite diagnosis.

PREVALENCE OF RADIATION INDUCED DERMATITIS IN ACCELERATED RADIATION GROUP AND CONVENTIONAL RADIATION GROUP IN LOCALLY ADVANCE CARCINOMA OF CERVIX, BASED ON OBSERVATIONAL CROSS SECTIONAL STUDY

Introduction-Radiation induced dermatitis severity in locally advanced carcinoma of cervix in both the group and manages symptomatically. Aim And Objective-This study was aimed at radiation oncology deparment in nscb medical college Jabalpur comparing observation cross sectional study on patient which was undergoing radiation in both the group. Methods And Meterials-This study based on observation cross sectional study in both the group conducting study at nscb medical college Jabalpur. Result-The study consisted of two group of 30 patient each and comparing the severity of radiation induced dermatis in both the group.Severity of radiation induced dermatitis slight more in accerelated group arm mostly grade 1 of 66.67% comparing 63.33% in conventional arm with a p value=0.943(insignificant). Conclusion-Both the studies are comparable with insignificant severity of radiation induced dermatis in both the group.

A PROSPECTIVE STUDY TO EVALUATE EFFECTIVENESS OF KINESIO TAPING IN NON-TRAUMATIC CHRONIC KNEE PAIN

Background: Kinesio tape has multiple benefits including decreasing pain, increasing proprioception, increasing quadriceps muscle strength, and improving lymphaticcirculation at the knee joint. To evaluate the effectiveness of kinesiotape innon traumatic chronic knee pain. Material and Methods: Aprospective study was done from august 2020 to January 2022 in nscb medical college jabalpur on 80 patients with patello femoral arthritis of knee joint and early grade medial joint line arthritis of knee joint(kellgenlawrencegrading) in which kinesio tape was applied over knee for 6 days by an orthopaedicsurgeonand followed up at end of 1st , 2nd , 3rd , 4th week and outcomes were measured using WOMAC(western Ontario and mcmaster university arthritis index) and Vas(visual analogue scale) scores. Results: VAS score(pre application:7.12, after 4 weeks:4.68)and WOMAC score( pre application:46.18, after 4 weeks:35.65)showed a statistically decrease in scores in cases of patellofemoral arthritis and early grade medial joint line arthritis of knee joint.(p value <0.001) Conclusion: Kinesio tape appears to beaneffective,easy and cheap method in early symptomaticpatello femoralosteoarthritis and early grade medial joint line arthritis of knee joint.

Prevalence of Lower Respiratory Tract Fungal Infection at a Tertiary Care Hospital in Central Madhya Pradesh, India: A Cross-sectional Study

Introduction: The incidence of fungal infections and resistant isolates has risen exponentially due to multiple factors. This makes the isolation of fungi, performing identification, and susceptibility testing a necessary routine microbiological procedure. Assessing the burden and analysing the epidemiologic trends of fungal infections is critical for patient management. Aim: To determine the prevalence of various fungal infections affecting the lower respiratory tract. Materials and Methods: In this cross-sectional study conducted at Department of Microbiology, Netaji Subhash Chandra Bose (NSCB) Medical College Jabalpur, Madhya Pradesh, India specimens from 400 patients with suspected Lower Respiratory Tract Infection (LRTI) were processed following standard microbiological methods for fungal culture and sensitivity testing. All the fungal isolates were obtained and their antifungal susceptibility pattern were recorded. The data entry was done in a Microsoft Excel spreadsheet, and the final analysis was performed using the Statistical Package for Social Sciences (SPSS) software, version 25.0, developed by IBM in Chicago, USA. Results: The majority of the assessed specimens were sputum (285, 71.2%). Out of the 115 Candida isolates, C.albicans (61, 53%) was the most common species isolated. Among the Non- Candida albicans Candida (NCAC) group, C. tropicalis (32, 27.8%) was the predominant isolate, followed by C. glabrata (16, 13.9%) and C. krusei (6, 5.2%). C. albicans was found to be the most prevalent in the elderly population (>60 years of age), whereas NCAC was prevalent in the 46-60 years age group. Regarding the antifungal drug susceptibility pattern, significantly higher drug resistance was seen in the NCAC group compared to C. albicans towards agents such as ketoconazole, fluconazole, itraconazole, voriconazole, amphotericin-B, and nystatin. None of the fungal isolates demonstrated resistance to caspofungin. Conclusion: Fungal aetiology is a significant problem in patients with LRTI, which often remains underdiagnosed, increasing morbidity and mortality. Therefore, it should be kept in mind while managing a patient with LRTI.

THERAPEUTIC EFFECT OF COCKTAIL VS PROLOTHERAPY INJECTION IN CHRONIC PLANTAR FASCIITIS, A PROSPECTIVE CONTROLLED RANDOMIZED CLINICAL STUDY

Introduction:- Plantar fasciitis is the most common cause of heel pain. It is a self-limiting condition. If causative factors are not addressed properly, it becomes chronic plantar fasciitis. Objectives:- The study aimed to evaluate the efficacy of 15 % hypertonic dextrose (treatment group) in the treatment of chronic plantar fasciitis through comparison with a cocktail group (control group). Design:- In this prospective controlled, randomized clinical study at N.S.C.B. Medical College Jabalpur, from 1 January 2020 to 31 September 2021. The statistical test used in this study isthe chi-square test and independent students t-test.A totalof 41 patients were taken intothe study. Patients were divided into two groups, In the Prolotherapy group (treating group) (n=18), a single shot of 15% Hypertonic dextrose injection was administered (1.2 ml of 50 % hypertonic dextrose, 1.8 ml distilled water and 1 ml of 2% lignocaine mixture)and the cocktail group (control group) (n=23) single shot of cocktail was given (1ml 40mg local methylprednisolone mixed with 1 ml distilled water and with 1 ml 2% lignocaine). During a 24-week follow-up period, pain intensity was measured using the visual analoguescale and American orthopaedics foot and ankle score, the measurements were undertaken before treatment and post-treatment weeks 4 and 12 and 24. Result:- In this study, both treatments were significantly effective in plantar fasciitis treatment for up to the 12th week. However the cocktail group (control group) was found to have a significantly better result at both the 4th week (AOFAS 93.17±3.33, VAS 1.65±.49 vs AOFAS 71.94±5.46, VAS 4.54±.71) and 12th week (AOFAS 90.43±2.86, VAS 1.91±.29 vs AOFAS 76.78±4.12, VAS 3.94±.64), but significantly better even up to 24th weeks (AOFAS 86.39±4.20, VAS 2.35±.71vs AOFAS 67.22±4.19, VAS 5.00±.34), (p-value <.001) in term of pain intensity and disability as compared to prolotherapy group (treating group). Conclusion:- This study showed a favourable outcome towards the cocktail injectionin terms of VAS and AOFAS score as compared to prolotherapy injection.

A PROSPECTIVE DESCRIPTIVE STUDY OF TRAUMA REGISTRY IN NETAJI SUBHASH CHANDRA BOSE MEDICAL COLLEGE, JABALPUR

Background: Trauma registries are databases of information regarding patients who have been came and treated in hospital for injuries caused by trauma. Aim: The objectives of this study to collect data related to trauma registry presenting to our center, as well as to analyze the demographic characteristics and other relevant data of patients admitted in our center. Methods: A Prospective descriptive demographic study was conducted in Tertiary care center Netaji Subhash Chandra Bose Medical College and Hospital Jabalpur from 1st January 2020 to 30th June 2021. In our study included patients who present at our center with history of recent Orthopaedic trauma and sustained fracture within 48 hours. In our study excluded isolated head injuries. The data collected was analyzed. Results: Out of 10241 patients, 7271(71%) were male and 2970(29%) were female with 2253(22%) in the 21-30 age group. Road traffic accident was the major cause of trauma (56%)followed by fall and slips (22%) and assaults(18%).The majority of these patients were brought by their family members (68%).Close to half of patients had upper extremity injury (48%) followed by lower extremity injury (45%) followed by Spinal injury (4%) and Pelvis injury(3%). Conclusion: Trauma registry is complex database of demographic, injuries and outcomes of trauma patients. This study can help to decreasing the burden of trauma and improve health system.

Environmental factors for severe acute malnutrition in under five children admitted at nutritional rehabilitation centre in central India

Malnutrition is a major public health problem in India and it effects the growth and development of young children. It is one of the leading causes of morbidity and mortality in under five children in developing countries. Globally, more than three million children under five years of age die each year from environment related causes and conditions. To study the environmental factors affecting severe acute malnutrition under five children admitted at nutritional rehabilitation centre. This was a case control study design. 350 cases were selected from N.R.C. of N.S.C.B. Medical College Jabalpur and 350 neighbourhood controls were selected from same community. The chi square test is applied for categorical variables and student t test is used to compare the continuous variables and odds ratio was calculated in statistical analysis. There was significant association between severe acute malnutrition in under five children with absence of separate kitchen (OR -3.2), kaccha house (OR-14.2), overcrowding present (OR-3.3), cross ventilation absent (OR-5.7), natural light absent in the house (OR-7.2) and open field defecation present (OR-6.5) in study subjects.

Clinicoaudiological evaluation of hearing improvement in patients with sensorineural hearing loss using intratympanic platelet rich plasma versus steroid injection

<p><strong>Background: </strong>SNHL is a heterogenous disorder, which can arise due to damage to pathway for sound impulses from the hair cells of inner ear to auditory nerve. This study is<strong> </strong>to evaluate and compare the effect of intratympanic instillation of PRP in patients having sensorineural hearing loss with steroid therapy.</p><p><strong>Methods: </strong>A<strong> </strong>prospective observational study carried out in the department of ENT, NSCB medical college Jabalpur. The cases were selected who presented with sensorineural hearing loss and mixed hearing loss with intact TM. Total of 54 cases were enrolled in the study from 1March, 2020 to 31 August 2021.Preoperative PTA was recorded. 0.5 ml of intratympanic platelet rich plasma and 0.5 ml of steroid dexamethasone administered. Postoperative PTA was done after 15 days of intratympanic injection and results recorded.</p><p><strong>Results</strong>: In our study the mean age of the participants was 40.4 years. Bilateral and gradual hearing loss were common in the present study. The improvement from baseline to follow up period was higher in PRP group compared to DEXA group. It is statistically significant (p=0.001). The improvement in hearing loss is decreasing with the increase in age. The study revealed that hearing improvement with PRP is better than steroid.</p><p><strong>Conclusions: </strong>The study concluded that the hearing improvement was more with single injection of PRP than dexamethasone.</p>

A QUASI EXPERIMENTAL STUDY TO ASSESS THE EFFECTIVENESS OF ACUPRESSURE ON LABOR PAIN DURING THE FIRST STAGE OF LABOUR AMONG EXPECTANT MOTHERS .

BACKGROUND: Women face a physiological and psychological struggle during labor. When labor approaches, it may be a time of contrasting feelings, with anxiety and anticipation coexisting with optimism and pleasure. AIM: To assess the effectiveness of acupressure on Labor pain during the rst stage of Labor among expectant mothers among experimental and control group. MATERIALS AND METHODS: The researcher adopted the evaluative research approach. Quasi experimental research design was used by the investigator. The accessible population for the study was mothers during rst stage of labor admitted in Medical College Jabalpur M.P. selected through purposive sampling technique. RESULTS: The majority of participants in the study sample had a mild level of pain, 44 percent had extreme pain, and 4 percent had very severe pain, according to the pretest score anger of pain level. The majority of participants in the control group have a moderate level of pain, 32% have an extreme level of pain, and 12% have slight pain. CONCLUSION: The ndings of this study indicate that non-pharmacologic interventions such as acupressure are successful in promoting relaxing and enhancing forces, allowing women to face the demands of labor. Acupressure is also an accurate, convenient, non-invasive, and cost-effective procedure that can be used in labor without causing harm to the mother or the baby, according to this report

STUDY OF MORPHOLOGY AND HISTOLOGY OF PLACENTA AND ITS CORRELATION WITH MATERNAL PARAMETERS AND BIRTH WEIGHT OF NEWBORN IN ANAEMIC MOTHERS

Abstract: The aim of this study was to determine whether maternal anaemia [Hb <11gm/dl]would affect the morphology and histology of placenta and and correlate it with maternal parameters and birth weight of newborn and compare this with that of non-anaemic mothers. It was a cross-sectional comparative study carried out at the maternity ward and anatomy department of NSCB MEDICAL COLLEGE JABALPUR. Background & Method: Background & Method: The study was carried out on 100 placentae, mothers and their babies. The placenta was collected from Obstetrics and Gynaecology, Department of NSCB Medical College, Jabalpur. Out of 100 placentae 50 from anaemic and 50 from NON anaemic mothers. 
 As soon as the placenta was delivered, the umblical cord was cut it was put into formal saline. It was kept in a tray, to the membranes were trimmed off cord was cut about 10 cm from the insertion. The blood clots adherent to maternal surface were picked up. Morphological parameters like placental weight, volume. diameter, thickness, no of cotyledons were measured .Any abnormality like calcification, accessory lobe, haematoma, etc were noted. histological slides were made and stained with H and stain and Masson’s Trichrome stain. Result: A Macroscopic study of the placenta revealed placental weight, placental volume, diameter, placental thickness were more than non anaemic group and number of cotyledons were less in study group. Mean placental weight in study group was 474gm and in control group was 425 (p<0.05). Mean placental volume in study group & control group were 393.23and352 ml respectively (p<0.05). Mean number of cotyledons were 13.24and 16 in study & control group significant[p<0.05] and mean diameter 18.30cms and17.05cms in study and control group. Mean placental thickness 2.4cms in study and 2.1 in control group respectively. There was an accessory lobe present in one patient of anaemic group. All morphometric parameters of placenta weight, volume, diameter, thickness were increased ,no of cotyledons were reduced .Histological findings were placental tissues shows intense congestion of septal capillaries.In the present study age, parity, height, weight, built, doesn’t found to be related with morphology of placenta. Maternal blood Hb found to be +vely correlated with weight, volume, diameter, thickness and –vely correlated with no of cotyledons and birth weight of baby. Conclusion: From the study it is concluded anaemia in pregnancy affects morphology and histology of placenta and it is correlated with various maternal parameters and birth weight of baby.
 Keywords: morphology, histology, placenta, anaemia, birth weight & mothers.

STUDY OF MORPHOLOGY AND HISTOLOGY OF PLACENTA IN HYPERSENSITIVE MOTHERS

Background: Hypertensive pregnancy may be responsible for vascular damage, enhanced systemic inflammation and insulin resistance in the placenta as oxygen and nutrient transfer is impaired and oxidative stress is generated affecting the placental growth and development. Placental growth pattern in hypertensive pregnancies shows a variable pattern owing to placental insufficiency. Method: The study was carried out on 80 sets placentae, mothers and their babies. The placentae were collected from Obstetrics & Gynecology Department of NSCB Medical College Jabalpur. Out of 80 placentae, 40 were from normal pregnant mothers and 40 from pregnancies complicated by PIH in previously normotensive women, serial number of placentae, mother and baby were same. placentae were collected soon after the normal vaginal delivery or caesarian section along with 10 cm long stump of umbilical cord. Aims and objectives: The aim of this study was to determine whether maternal PIH would affect the morphology and histology of placenta and compare this with that of normotensive mothers. It was a cross-sectional comparative study carried out at the maternity ward and anatomy department of NSCB Medical College, Jabalpur. Result: A Macroscopic study of the placenta revealed placental weight, placental volume, diameter, placental thickness and number of cotyledons were less in study group. Mean placental weight in study group was 336gm and in control group was 425 (p<0.05). Mean placental volume in study group & control group were 236and352 ml respectively (p<0.05). Mean number of cotyledons were 14.7and 16 in study & control group respectively but not significant and mean diameter15.6 cms and17.05cms in study and control group. But in the present study placental thickness was not significant (p<0.539). There was a single umbilical artery present in one patient in PIH group. All morphometric parameters of placenta weight, volume, diameter, thickness, no. of cotyledons were reduced.
 Histological findings were cytotrophoblastic cellular proliferation, syncitial knot formation, fibrin plaque formation. In 20 percent cases, villi were hypovascular. The hypovascular villi have abundance of syncitial knots, usually lack vasculosyncitial membrane and increased stromal collagen. Conclusion: PIH adversely affect both morphology and histology of placenta.
 Keywords: morphology, histology, placenta, hypersensitive & mothers.

PREVALENCE OF VITAMIN D LEVEL IN CRITICALLY ILL PATIENTS AND ITS CORRELATION WITH PATIENT OUTCOME

Background: In critically ill patients, the prevalence of vitamin D deficiency has been found to range from 26% to 80%. In critically ill patients, this deficiency may exacerbate existing immunological and metabolic dysfunctions, resulting in poorer outcomes. Aims and objectives: To study the prevalence of vitamin D level and its correlation with patient outcome. Materials and Methods: A single-center, prospective observational study was performed, including 96 patients aged >18 years admitted to Medical Intensive Care Unit (MICU) of Netaji Subhash Chandra Medical College Jabalpur from January 2018 to September 2019. Age, sex, Sequential organ failure assessment (SOFA) score, serum bilirubin, serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), serum creatinine, total leucocyte count, platelets count, serum calcium, random blood sugar, glasgow coma scale, the requirement of mechanical ventilation, and mortality were recorded. Vitamin D level was estimated and categorized into deficiency [Serum levels of 25(OH)D 30 ng/mL]. Results: Prevalence of vitamin D deficiency, insufficiency, and sufficiency was 57.3%, 19.8%, and 22.9%, respectively. Vitamin D deficient patients have a higher SOFA score (a score of >10) (p<0.0001), required more mechanical ventilation (p=0.014), and higher risk of death (p=0.001). Vitamin D deficiency was more prevalent in mostly 31 to 60 years of age group patients (p=0.009). Conclusion: Vitamin D deficiency is prevalent among critically ill patients and is more common in those with higher SOFA scores, the requirement of mechanical ventilation, death, and old age. Keywords: vitamin D deficiency, critically ill patients, mortality, SOFA score

Prevalence and Distribution of Pterion in Adult Dry Human Skull and its Clinical Importance

Introduction: The pterion is a topographic point on the lateral aspect of the skull, where frontal, sphenoid, parietal and temporal bones meet. It lies in the anterior part of floor of the temporal fossa about 4 cm above the zygomatic arch and 3.5 cm behind the fronto-zygomatic suture. Aim: To determine the prevalence of type and position of the pterion using the standard cranial anatomical points. Materials and Methods: The present cross-sectional study was conducted from July 2020 to September 2020 in NSCB Medical college Jabalpur (M.P.). One hundred and eighty dry human skull obtained from Department of Anatomy. Sutural pattern of pterion were classified into sphenoparietal, frontotemporal, epipteric or stellate type. Position of pterion was also determined in relation to three specific bony landmarks. All parameters were evaluated bilaterally, observations tabulated and analysed using SPSS software version 23. results: In present study, it was found that 84% (n=180) skull posses sphenoparietal type of pterion bilaterally, then epipteric type (7.73%) followed by frontotemporal (6.61%) and the least variety was stellate type (1.83%). The mean distance from upper end of zygomatic arch up to centre of pterion on right side was 35.12±4.1 mm and on the left side was 36.26±3.88 mm. The distance from posterolateral margin of frontozygomatic suture up to centre of pterion on right side was 28.84±5.80 mm and on the left side was 30.10±4.79 mm. conclusion: The study concluded that in present study, sphenoparietal type of pterion was most common bilaterally and stellate type was least common. The detailed data about the location of the pterion serves as a benchmark for neurosurgeons to localise the correct position for burr hole during all invasive surgeries

Study of association and prognostic correlation of cardiac troponin I estimation in acute decompensated heart failure patients

Background: Heart failure is a major public health problem since last few decades affecting significant number of people worldwide. Acute decompensated heart failure is a major cause of hospitalization in elderly people with a high mortality rate. Heterogeneity and non-specificity of symptoms makes diagnosis of heart failure by clinical presentation alone more challenging. Aim of current study was to investigate troponin biomarkers in diagnosis, prognosis and management of acute decompensated heart failure. Methods: Present study was a prospective observational study conducted on 100 patients at Department of Cardiology, Superspeciality hospital, NSCB medical college Jabalpur and Department of cardiology Superspeciality hospital, SS medical college Rewa from October 2019 to August 2020. Patients were investigated for clinical, echocardiographic parameters and NYHA classification. Cardiac functions were analyzed by color doppler echocardiography. Results: According to study findings, 65.2% of TnI positive patients were males whereas 34.8% were females. Mean age of TnI positive group was observed to be higher. Majority of troponin positive patients were in NYHA class IV. Recurrent hospitalization was observed more in TnI positive group. Logistic regression analysis depicted systolic blood pressure reduced significantly (p&lt;0.001) on follow up study in TnI positive patients, FBS was significantly more in TnI positive patients (131.4+42.9 mg/dl) (p=0.049). LVID was significantly more in TnI positive patients (p=0.022). Reduction in EF was statistically significant (p=0.03) at the three months follow up study. Conclusions: A positive prognostic correlation was established between ADHF and troponin positivity, large prospective randomized trials are necessary to recommend quantitative troponin I determination in all patients of acute decompensated heart failure for prognosis and guiding therapy.

TO CORRELATE BETWEEN BIOCHEMICAL PARAMETERS AND DIFFERENT GRADES OF OBESITY

Background &amp; Method: In this case control (observational) study we include 114 participant (n=57 cases and n=57 controls) in this case and controls taken using standard sampling procedure participants are taken who attend Medicine OPD in Netaji Subhash Chandra Bose Medical college Jabalpur in period of March 2015 to August 2016.&#x0D; Result: We didn’t found significant difference in cases on the basis of BMI and FBS,PPBS and GTT.We found correlation in cases on the basis of BMI and in Lipid Profile and we found there is significant difference in low density lipid level in overweight and moderate obese (t&gt;2.08) and Triglyceride level and Serum cholesterol/HDL ratio in overweight and sever obese (t&gt;1.97, t&gt;2.41) and moderate and severe Obese (t&gt;2.14, t&gt;2.10).&#x0D; Conclusion: In cases on the basis of Diastolic dysfunction and Lipid Profile we found significant difference between serum cholesterol/HDL levels in those who had Diastolic dysfunction compare to who don’t have Diastolic dysfunction. Diastolic dysfunction appears not to be influenced by sex. The association between diastolic dysfunction and obesity according to sex is not significant. In cases on the basis of BMI and FBS, PPBS and GTT we don’t found significant difference in cases. In grades of Diastolic Dysfunction and Lipid profile and we doesn’t found any significant difference in grade 1 and grade 2 diastolic dysfunction on the basis of lipid profile.&#x0D; Keywords: BMI, Left Ventricular, Transthoracic &amp; Echocardiography.

Study of malaria and associated co-morbidity in children admitted with fever manifestation in a tertiary care centre

Background: Children under five year of age are highly vulnerable to malaria infection and often face dire consequences such as severe malaria if they are not promptly and adequately treated with anti-malarial medications. Authors set out to evaluate malaria and associated co-morbidity among children admitted with febrile illness in tertiary care center NSCB Medical college Jabalpur, India.Methods: This prospective and analytic study focused on children admitted with fever in pediatric unit of N.S.C.B. Medical College, Jabalpur, Madhya Pradesh, India. If any co-morbidity present with malaria their manifestation was noted. Association of co-morbidity with malaria was done, and effect of co-morbidity on severity of malaria and outcome of patients was noted.Results: A total number of 1950 of children suspected to have malaria who were tested by RDT and microscopy (PSMP), out of them 100 children were positive. Mean age calculated was 7.3±4.3 years. Maximum number of severe malaria cases (40.6%) were found in 6 months to &lt;5 years age group. Most common co-morbidity associated with malaria was anemia (53%) followed by pneumonia (36%) hepatitis (26%), diarrhea (24%), enteric fever (15%), septicemia and meningoencephalitis (10%) each, UTI (4%), and AKI (6%), while dengue (3%) and severe acute malnutrition (2%). Out of 69 cases of severe malaria 46.3% cases had two and 34.7% cases had more than two co-morbidities while in 31 cases of uncomplicated malaria 38.7% cases had two co-morbidity and only 3% had more than two co-morbidity.Conclusions: All RDT positive cases have associated co-morbidity with malaria in our study, more is the co-morbidity is longer were the duration of stay and higher the complications and even mortality.

Study to assess the effectiveness of structured planned teaching programme on knowledge among second student regarding Haemodialysis in selected of area school of nursing N.S.C.B. Medical College Jabalpur (M.P.)

Study to assess the effectiveness of structured planned teaching programme on knowledge among second student regarding Haemodialysis in selected of area school of nursing N.S.C.B. Medical College Jabalpur (M.P.)

Randomized, single blinded comparative study of selective serotonin reuptake inhibitor augmentation with olanzapine v/s amisulpride for obsessive compulsive disorder

Background: Obsessive-Compulsive Disorder is classified in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) as an anxiety disorder. Serotonin reuptake inhibitors are considered to be most effective and are the first line pharmacotherapy for the treatment of OCD. However, about 40-60% of OCD patients fail to respond to SSRI mono-therapy. Further, as many as 25% of patients fails to experience any improvement from initial SSRIs mono-therapy. For non-responder’s low dose augmentation with antipsychotics (risperidone, quetiapine, olanzapine, aripirazole, amisuplride etc.) has shown promising response, as compared to serotonin enhancers. The present study is designed to evaluate and compare the efficacy and adverse drug reactions of these two antipsychotics viz. Olanzapine and amisulpride as augmentation strategy in OCD patients. Objective of present study was to compare the efficacy of olanzapine and amisulpride as add on therapy for inadequately controlled obsessive-compulsive disorder patients on selective-serotonin reuptake inhibitor.Methods: the present study was done at Medical College Jabalpur (M.P.) in the department of Psychiatry &amp; Pharmacology. It was randomized, patient blinded study. 47 patients were screened for the study out of which 36 were enrolled and randomized into either SSRI+Olanzapine or SSRI+Amisulpride group. The patients were evaluated at baseline and then biweekly for 12 weeks to assess the efficacy of these drugs as augmentation strategy using Yale-Brown Obsessive Compulsive Scale (Y-BOCS).Results: There was a significant improvement in Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Clinical Global Impression-Severity (CGI-S) score and Clinical Global impression-Improvement (CGI-I) score in both the groups but there was no significant difference (P&gt;0.05) in either of these groups on these three scale. No serious adverse drug reaction was reported in either of these groups.Conclusions: Both olanzapine and amisulpride are efficacious and well tolerated for augmentation of SSRI with no significant difference in their efficacy.

PHARMACOVIGILANCE STUDY OF ANTIRETROVIRAL THERAPY IN HUMAN IMMUNODEFICIENCY VIRUS/ACQUIRED IMMUNODEFICIENCY SYNDROME PATIENTS AT ANTIRETROVIRAL THERAPY CENTRE, JABALPUR

Objective: The objective of the study was to assess the adverse drug reactions (ADRs) of antiretroviral therapy along with its causality, severity, and preventability.Method: A prospective as well as a retrospective observational study with a sample size of 260, jointly conducted in the Department of Pharmacology and antiretroviral therapy (ART) center of N.S.C.B. Medical College Jabalpur, India, from March 2016 to July 2017. We observed various ADRs to ART in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients and assessed causality, severity, and preventability of the reported ADRs as per the standard scales.Results: A total of 260 patients were enrolled of which 220 (84.6%) patients developed a total of 425 ADRs. Maximum 51.7% of ADRs were caused by TLE followed by 37% with ZLN regimen. Most common ADRs were dizziness 18.6%, rashes 14.6%, anemia 10.6%, and vomiting 6.6%. Dizziness and rashes are mainly caused by TLE and ZLN regimen, respectively. Management of ADRs with a change in the regimen was applied as an interventional tool in 40% of the patients. Causality assessment as per the WHO-UMC scale showed that 55.5% of ADR were probable and 45.5% were possible. 84.5% of ADR was not preventable, while 15.5% of ADRs were probably preventable. 38% of ADRs were mild, 56% were moderate, and 6% were severe in nature.Conclusion: Antiretrovirals, however, the milestone for the treatment of HIV/AIDS have very high potential for developing ADRs. Hence, active pharmacovigilance is needed for not only safety of the patients but also compliance to the treatment which is necessary for optimal therapeutic outcomes and to improve quality of life.