MGM Medical College Research Articles

Clinical spectrum and short-term outcome of post-COVID multisystem inflammatory syndrome in children after the 2019 pandemic: a longitudinal cohort study

Background As a post-COVID complication in children, multisystem inflammatory syndrome in children (MIS-C) is important because of its varied and life-threatening manifestations. With this background, this study attempts to focus on MIS-C cases in an underprivileged rural setting in north-eastern India, with most patients being treated with methylprednisolone rather than intravenous immunoglobulin due to financial constraints. Methods In this prospective longitudinal cohort study at MGM Medical College, 27 MIS-C cases diagnosed following WHO criteria were included. Laboratory and radiological investigations, including echocardiography, were performed as required for diagnosis and to assess prognosis. Most patients were treated with methylprednisolone. A follow-up assessment was done six weeks after discharge for any residual impairment. Results The most frequently affected age group was 5–10 years (59.28%), while respiratory (48.14%) and cardiac (40.74%) were the most commonly involved systems. Logistic regression studies established a significant association between serum ferritin level and prolonged hospital stay (coefficient 0.0674, p=0.0041), possibly due to greater complications in cases with high ferritin levels. Organ impairment was found to increase the need for inotrope use (coefficient 3.8797, p=0.00584). Most cases were treated with methylprednisolone alone (85.18%) with a favourable response and no death occurred. Conclusion The favourable response in cases treated with methylprednisolone only affirms the effectiveness of the drug as a cheaper alternative in a resource-poor setting. The study highlights that higher ferritin levels in complicated cases leads to prolonged hospitalisation and the increased need for inotropes in cases with organ impairment.

Wellness and its correlation with vitamin D

Abstract Background: Wellness encompasses various interconnected physical, mental, and social dimensions beyond the traditional definition of health. Vitamin D deficiency is a widespread nutritional deficiency, with a prevalence of 80%–90% in India, and is often under-diagnosed and under-treated worldwide. While vitamin D is classically known for its role in bone health, it also has significant extra-skeletal effects, including maintaining muscle function, immunity, anti-inflammatory activity, and cell proliferation and differentiation. Recent studies have linked vitamin D deficiency to fatigue, myalgia, low-energy fractures, muscle weakness, anxiety, and depression. Furthermore, it is implicated in the development of type 1 and type 2 diabetes mellitus (DM) and hypertension. Vitamin D deficiency is also associated with recurrent exacerbations of bronchial asthma, autoimmune diseases, and malignancies. Addressing this deficiency can substantially enhance patient well-being, prevent serious health outcomes, and improve overall wellness. Aim: This study aims to investigate the relationship between wellness and vitamin D levels. Materials and Methods: This prospective nonrandomized therapeutic study was conducted at MGM Medical College and Hospital, Navi Mumbai, Maharashtra, India, and included 246 participants from July 2021 to December 2022. The study included patients reporting generalized weakness, fatigue, myalgia, low mood, lack of motivation, and decreased interest in life by the inclusion and exclusion criteria. Their serum vitamin D levels were tested. Participants with vitamin D deficiency (<30 ng/mL) completed a pre-structured well-being questionnaire and received vitamin D supplementation for 10 weeks. Wellness in these patients was evaluated using a pre-structured post-supplementation well-being questionnaire. Results: The results revealed that out of 324 patients included in the study, 253 (78.1%) were deficient in vitamin D. The highest deficiency rate was among those aged 18–35 years (85.5%). Vitamin D deficiency was more prevalent in females (79.5%, 167 out of 210 females) compared with males (75.4%, 86 out of 114 males). The paired t test results showed a significant increase in post-test vitamin D levels (t = -219.922, P < 0.001) and a significant decrease in post-test Fatigue Assessment Scores (t = 31.328, P < 0.001) and Fatigue Severity Scores (t = 33.066, P < 0.001). Additionally, there was a significant improvement in post-test World Health Organization-Five Well-Being Index (WHO-5) scores (t = -28.495, P < 0.001) and Warwick–Edinburgh Mental Well-being Scores (WEMWBS; t = -28.996, P < 0.001). Karl Pearson’s correlation coefficient indicated that post-supplementation vitamin D levels were positively correlated with post-supplementation Fatigue Assessment Scores (r = 0.315) and Fatigue Severity Scores (r = 0.334). Conversely, they negatively correlated with the WHO-5 Well-being Index (r = -0.322) and the WEMWBS (r = -0.294). Conclusion: This study concludes that wellness is directly correlated with vitamin D levels. There is a significant improvement in the Fatigue Assessment Scale, Fatigue Severity Scale, WHO-5 Well-being Index, WEMWBS, and overall physical, mental, and social wellness following vitamin D supplementation in patients, both with and without comorbidities (hypertension and DM).

A CROSS-SECTIONAL STUDY TO ASSESS THE PATTERN OF SELF-MEDICATION USED FOR DIARRHEA AMONG MEDICAL STUDENTS IN TERTIARY CARE TEACHING HOSPITAL OF CENTRAL INDIA

Objective: The objective of the study is to assess the drug usage pattern, personal hygiene, and sanitation practices among day scholars and hosteller medical students. Methods: A questionnaire-based cross-sectional study was conducted at MGM Medical College and M.Y. Hospital, Indore. Undergraduate and postgraduate medical students who experienced episodes of diarrhea in the past 6 months were included in the study. Diarrhea occurring due to organic causes was excluded. Data were collected using a Google or physical form and were analyzed using descriptive statistics. Results: 254 students who suffered from diarrhea in the past 6 months participated in the study, out of which 56% were hostellers. Commonly used drugs were ofloxacin, metronidazole, etc. 50.2% of them took self-medication; the majority of them were hostellers. Students were found to eat outside at least once a week. Personal hygiene and sanitation were more compromised among hostellers than day scholars. Conclusion: Personal hygiene and sanitation practices should be improved among medical students, especially hostel students. These students, despite being from medical backgrounds, still take irrational medication. Therefore, there is a need for increased awareness regarding drug usage, and self-medication should be discouraged.

KNOWLEDGE, ATTITUDE, AND PRACTICE ABOUT STORAGE AND SAFE DISPOSAL OF UNUSED MEDICINES AMONG MEDICAL AND DENTAL PERSONNEL: ECOPHARMACOVIGILANCE PERSPECTIVE

Objective: This study aimed to evaluate the knowledge, attitudes, and practices related to the storage and safe disposal of unused medicines among students at MGM Medical and Government Dental College, Indore, marking the first such assessment among this population. Method: A cross-sectional survey, approved by the Institutional Ethics Committee, utilized a questionnaire-based approach. Medical and dental students provided 509 responses, yielding a response rate of 96%. The pre-validated questionnaire, administered through Google Forms, encompassed sociodemographic details and sections on knowledge, attitudes, and practices. Statistical tools were employed for the analysis of response frequencies. Results: A response rate of 96% was achieved, with 509 participants providing insights. While participants exhibited awareness regarding medication expiry, storage conditions, and environmental contamination, a significant knowledge gap existed concerning standardized medication disposal methods. Despite a high acknowledgment (above 80%) of the reduction in efficacy post-expiry, safe drug disposal practices were found to be lacking. Conclusion: The prevailing practice of storing medicines at home until expiry, followed by disposal in the trash, persists despite awareness of the hazards associated with pharmaceuticals in the environment. This underscores a deficiency in knowledge and the absence of secure disposal methods. Respondents expressed a preference for evidence-based and environmentally friendly approaches to dispose of unwanted medications.

Comparing the Efficacy of Probiotic Nutraceuticals and Probiotic Food (Curd) in Combination with Antidepressants for Depression

Background and Aim: Depression is a widespread mental health condition with a significant global impact. Recent research has explored the gut–brain axis, emphasizing the role of microbiota in neurotransmitter production. This study aims to explore the effectiveness of two complementary probiotic interventions: probiotic-rich curd and probiotic capsules, used in combination with the antidepressant escitalopram over 4 weeks. The primary objectives include assessing their impact on reducing the severity of depression, comparing their effectiveness, and discussing the clinical implications of findings. Materials and Methods: We conducted a 4-week prospective observational study at the Department of Psychiatry, MGM Medical College, and the associated Mental Hospital in Indore. Ninety individuals aged 18–60, diagnosed with depression (International Classification of Diseases-10) and assessed using the Hamilton Depression Rating Scale, participated. Subjects were divided into three groups: escitalopram 10 mg (n = 30), escitalopram 10 mg + 120 mL curd (n = 30), and escitalopram 10 mg + probiotic capsule (n = 30). Assessments were conducted on days 0, 14, and 28 using the Hamilton Depression Rating Scale. Results: All treatment groups exhibited a significant reduction in mean Hamilton Depression Rating Scale scores over the study duration (P < 0.001). Notably, the probiotic group showed a slightly greater reduction in scores between day 0 and day 28 compared to the curd and escitalopram-only groups. Conclusion: The study demonstrates the potential for slightly better outcomes with probiotic interventions alongside the antidepressant escitalopram over 4 weeks. Beyond symptom relief, this approach may offer lower side effects, potentially enhancing patient adherence. Future research should investigate long-term effects and specific probiotic strains in a larger, diverse population.

PREVALENCE OF ANEMIA AND ITS ASSOCIATION WITH BODY MASS INDEX AND PLASMA PROTEIN IN MEDICAL STUDENTS OF KOLHAN REGION OF JHARKHAND – A CROSSSECTIONAL STUDY

Objectives: Anemia is one of the major public health concerns affecting almost 30% of the global population. Past studies have indicated that anemia is linked to lower body mass index (BMI) and plasma protein levels. This study aims to determine the prevalence of anemia among medical students and also to investigate its association with BMI and plasma proteins. Methods: A cross-sectional study of 177 medical and paramedical students aged 18–21 years was done at MGM Medical College in Jamshedpur from September 2018 to July 2019. A Transasia EM200 automated chemical analyzer was used to identify plasma protein using the biuret approach. HemoCOR-D (cyanmethemoglobin) was quantified by a colorimetric instrument. A colorimetric apparatus measured hemoglobin (Hb) with HemoCOR-D (cyanmethemoglobin). Results: There are a total of 177 pupils. The study included 48% (n=85) females and 52% (n=92) males. Males had a mean age of 20.03± 0.99 years while females had a mean age of 20.16±0.937 years. Males had greater Hb levels and protein levels than females, with averages of 13.61 ± 1.43 and 7.77± 0.93, respectively. Males had a frequency of anemia of 15.4%, while females had a prevalence of 70.9%. The researchers discovered a statistically significant link between anemic and non-anemic girls’ plasma protein levels (p=0.07), protein intake and plasma protein (p=0.048), and BMI and Hb (p=0.022). Conclusions: A significant association was found between daily protein intakes with plasma protein. The association between BMI and hemoglobin was also found significant.

Herringbone stitch technique versus interrupted suturing technique for rectus closure in emergency laparotomy: A comparative study

Background: Midline laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery and effective closure of the abdominal wall is crucial for optimal healing and reduced complications. Secure abdominal wall closure after any laparotomy is every surgeon’s aim. Aims and Objectives: The aim of the study was to choose the better method of rectus closure by comparing the herringbone stitch technique with the interrupted suturing technique for rectus closure in emergency laparotomy. Materials and Methods: Fifty patients who underwent midline emergency laparotomy at MGM Medical College and MY Hospital, Indore, between January 2023 and April 2023 were included in our study. In 25 patients (Group A) herringbone stitch technique was used whereas in the other 25 patients (Group B) interrupted suturing technique for rectus closure was used and they were assessed based on the incidence of surgical site infection (SSI), superficial wound dehiscence, fascial dehiscence, and incidence of incisional hernia. Results: The incidence of SSI was comparable in both groups but the incidence of superficial wound dehiscence, fascial dehiscence, and incisional hernia is less in Group A. Conclusion: The herringbone stitch technique is better as compared to the interrupted suturing technique for rectus closure in emergency laparotomy.

A study comparing the effectiveness of ondansetron versus ondansetron combined with dexamethasone for preventing postoperative nausea and vomiting in laparoscopic surgeries

Abstract Background: Postoperative nausea and vomiting (PONV) frequently occur as a side effect of general anesthesia, which can be intensified by the introduction of gas into the peritoneal cavity to create pneumoperitoneum during laparoscopic surgeries. Aims and Objectives: This study examines the comparative effectiveness of ondansetron as a standalone treatment versus its combination with dexamethasone in preventing PONV during laparoscopic surgeries. The research aims to assess the efficacy and duration of anti-nausea and anti-vomiting effects provided by ondansetron alone and in combination with dexamethasone. Materials and Methods: The Institutional Ethics Committee (IEC) approved the trial materials and methods following thorough deliberation. Before surgery, written informed consent was obtained from all patients. Sixty patients were recruited for the study and randomly allocated into groups, denoted as Group O and Group D, each consisting of 30 patients. Group O received intravenous administration of 4 mg of ondansetron, while Group D received a combination of 4 mg of ondansetron and 4 mg of dexamethasone intravenously 30 min before extubation. Duration of Study: The research was conducted at MGM Medical College and Hospital, located in Navi Mumbai, Maharashtra, India, from May 2016 to May 2017. Results: In this study, mild and moderate nausea were more prevalent in Group O at the 4-h mark, but there was no notable difference at 24 h. Mild and moderate retching showed no significant variance at 4 h, but Group O exhibited significantly more at 24 h. Mild, moderate, and severe vomiting were inconsequential in both groups at 4 h, but Group O showed a higher incidence of mild and moderate vomiting at 24 h. Instances of severe vomiting were absent in both groups. The need for rescue antiemetics after 24 h and medication-related side effects did not show significant differences between the two groups. Conclusion: The incidence of PONV was reduced in the combination group (ondansetron + dexamethasone) compared to ondansetron alone. Consequently, the combination group had a lower requirement for rescue antiemetics. Thus, the effectiveness of combination therapy surpassed that of ondansetron alone.

ANTIFUNGAL STEWARDSHIP: MITIGATING INAPPROPRIATE PRESCRIPTIONS IN VULVOVAGINAL CANDIDIASIS IN TERTIARY CARE HOSPITAL, CENTRAL INDIA

This study aims to reduce the inappropriate prescriptions of antifungal medications for vulvovaginitis candidiasis in a tertiary care hospital in central India. An ambispective, observational study was conducted in the Department of Pharmacology of MGM Medical College and Maharaja Yashwantrao Hospital in Indore, MP, over three months (i.e.,12 w from August to October 2023). The study encompassed a retrospective analysis of prescriptions for vaginal candidiasis over a period of five weeks in August-September 2023, followed by a prospective analysis over the subsequent five weeks of September-October 2023post-implementation of interactive training sessions, discussions, and antifungal guidelines for two weeks. From a total of 130 randomly selected prescriptions, 69 prescriptions were perused retrospectively, while 61 prescriptions received prospective analysis. The post-implemented audit showed a marked reduction in antifungal prescriptions with a difference of 12.4%. An increase in the documentation of examination findings was also observed, from 46.7% to 69.7%. This implementation successfully mitigated inappropriate prescriptions of antifungals, with sustained reductions demonstrated over the 3 mo of the study period, emphasizing the effectiveness of educational interventions.

TO PREDICT THE NEED FOR AMPUTATION IN DIABETIC FOOT ULCER USING SVS - WIFI SCORING SYSTEM

Analysis of svs wifi scoring as a predictor for amputation in diabetic foot ulcer dr. Shibani chandiramani, dr lisha suraj department of general surgery mahatma gandhi medical college, navi mumbai introduction : Critical limb ishchemia in diabetic patients is defined as a clinical syndrome of ischemic pain at rest and/or ischemic tissue loss such as non healing ulcers or gangrene for more than 2 weeks with ankle pressure of < 40mmhg. It differs from acute limb ischemia which is sudden loss of perfusion typically due to embolus or in situ thrombus. The svs wifi scoring system stratifies cli on the basis of perfusion , extent of wound and superadded infection to provide a composite score wich guides further management and predicts final prognosis. Aim:- to predict the need for amputation in diabetic foot ulcer using svs wifi scoring. Objectives:- To study the predictive role of svs wifi scoring system in diabetic foot ulcers undergoing amputation material and methods :- the subjects were 30 patients with diabetic foot ulcers, gangrene, wound presenting to general surgery, diabetic clinic or vascular surgery at mgm medical college , navi mumbai. Wifi scring of diabetic foot ulcers were done at the time of presentation after obtaining consent from the patient/ relatives.the wifi categories according to risk of limb loss were identified with endpoint being major/ minor amputations. Result:- The composite wifi score (a summmation of wound , infection and ischemia sub-scores) was a good predictor of need for amputation in diabetic ulcer patients.

Socio-Demographic and Clinical Study of Suicide Attempt Patients Admitted to MGM Medical College and Maharaja Yashwant Rao Hospital, Indore (M.P)

Socio-Demographic and Clinical Study of Suicide Attempt Patients Admitted to MGM Medical College and Maharaja Yashwant Rao Hospital, Indore (M.P)

Spontaneously reported adverse drug reaction pattern in a tertiary care teaching hospital: A cross-sectional study

Background: Adverse drug reactions (ADRs) are unintended and harmful reactions to medications that occur at doses normally used for therapeutic purposes. The reporting of ADRs is essential for the identification and prevention of ADRs. Aims and Objectives: The aim of the study was to estimate the frequency and distribution of spontaneously reported ADRs in the tertiary care teaching hospital. Materials and Methods: A retrospective cross-sectional study was conducted from July 2020 to June 2023, from spontaneously reported ADRs by the ADR Monitoring Centre, MGM Medical College, Kishanganj, Bihar. Distribution of age, gender, department, medication groups, and systems involved were examined. Utilizing certain scales, causality, severity, and preventability were evaluated. Results: Total 47 ADRs were reported during the study period. The most common ADRs were cutaneous ADRs (n = 19,40.43%) followed by the central nervous system (CNS) (n = 12, 25.53%), gastrointestinal system (GI) (n = 9, 19.15%), musculoskeletal (n = 4, 8.51%) and others. The most commonly implicated drugs were Antibiotics (21.28%) followed by analgesics (12.77%), DMARD (12.77%), antihypertensive (12.77%), and others shown in the study. The severity assessment of ADRs was done by Modified Hartwig et al. severity assessment scale and was found mild (87%), followed by moderate (8.5%) and severe (4.3%). Using the modified Schumock and Thronton preventability scale preventability assessment of ADRs was done and was found 51.06% of ADRs were definitely preventable, 38.30% were probably preventable and 12.77% of ADRs were not preventable. Conclusion: The findings of this study emphasize the significance of pharmacovigilance and the requirement that medical personnel be knowledgeable about the indications and symptoms of ADRs.

Faith Healing Practices in Patients with Psychiatric Disorders Attending a Tertiary Care Hospital in Madhya Pradesh, India: A Cross-sectional Survey

Introduction: Faith healing has been practiced in various cultures for many decades and is an accepted mode of treatment in different cultures. Beliefs about mental illness can affect patients’ willingness to seek and adhere to treatment, so it is important to consider cultural, traditional, and folk methods for conceptualising and managing mental illnesses. Aim: To assess the clinical and socio-cultural factors associated with faith healing and the effect of faith healing methods on the patients. Materials and Methods: A cross-sectional survey was conducted at the Department of Psychiatry, MGM Medical College, Indore, Madhya Pradesh, India from January 2023 to March 2023. The sample comprised 100 consecutive patients selected by convenient sampling who had visited a faith healer for their disorder. A semi-structured proforma was administered to participants and their informants, which contained sociodemographic details, clinical information, and details of the faith healing practices they underwent. Descriptive statistics were used to assess the sample distribution, and measures of central tendency were applied. Results: The mean age of patients was 28.6±2.3 years, and the majority (66%) were male. The majority (48%) suffered from psychotic and mood disorders (28%). The majority (64%) contacted a faith healer as their first point of treatment contact. Most visited a healer on the advice of their family or friends (82%), followed by having supernatural or religious beliefs towards their illness (52%). The most common method of healing was offering a “Tabeej”/Talisman (82%), followed by “bhabooti”/“prasad”/ sacred water (77%). About 20 participants, or one-fifth of the sample, reported some improvement with faith healing, while most (74%) reported no improvement. Conclusion: The majority of the sample in the study believed in supernatural causation and resorted to faith healers before seeking medicinal treatment. Thus, awareness of and sensitivity to belief systems and faith healing practices in different cultures are important for mental health professionals.

Contact screening of children exposed to active pulmonary tuberculosis: A hospital-based study in Navi Mumbai, India

Abstract Background: Contact investigation is a proactive method employed for active case-finding to improve the detection of active tuberculosis (TB) cases, constituting a crucial component of National TB Programs. Household contacts face a higher exposure risk than individuals in the general population. Although integrated into national policy, the execution of contact investigations is not regularly undertaken, and the outcomes of these investigations are inadequately characterized. Objective: To evaluate risk factors and determine the occurrence of TB disease among household contacts of individuals diagnosed with sputum smear-positive TB in Kamothe, Navi Mumbai, India. Materials and Methods: From December 2018 to November 2020, active screening was carried out for 120 household contact children aged up to 18 years, linked to 52 index cases receiving care at MGM Medical College and Hospital in Navi Mumbai, India. Results: Out of the 120 screened children, 10 (8.3%) showed symptoms, whereas 110 (91.6%) were asymptomatic. Among those exhibiting symptoms, 5 (50%) had abnormal chest X-ray findings. The diagnosis of TB was established in eight cases, including five with pulmonary TB, two with lymph node TB, and one with central nervous system TB. All confirmed TB-positive cases underwent antitubercular treatment, with children under 5 years receiving Isoniazid Preventive Therapy. Conclusion: The study resulted in a 6.67% incidence rate, offering an opportunity to initiate chemoprophylaxis among children. This research identified risk factors associated with the development of TB disease, encompassing female gender, underweight status, residing in crowded conditions, prolonged contact, and extended duration of exposure.

To Assess Caregiver Burden of Patients with Dementia: Its Sociodemographic and Clinical Correlates

Background and Aim: To assess the primary caregiver burden in the patients of dementia. Dementia is a chronic neurodegenerative disorder that refers to a disease process marked by progressive cognitive impairment in clear consciousness. The morbidities associated with dementia accounts for the poor quality of life. Equally affected are caregivers of these patients. The study aims to assess the caregiver burden (CGB) and how the care of these patients affect them. This further includes sociodemographic and clinical features of the caregivers. Materials and Methods: The cross-sectional study was conducted from June 2021 to May 2022 in the Department of Psychiatry, MGM medical college, Indore (M.P.) after approval from the institutional ethical committee. The study included 60 patients and 60 caregivers attending Psychiatry outpatient department (OPD). They were assessed using a semi-structured proforma consisting of socio-demographic and clinical variables. Clinical rating scale i.e., burden assessment schedule (BAS) was applied for caregivers and dementia severity rating scale (DSRS) for the patients. Pearson's and Spearman's correlation coefficient was applied with P-value < 0.05 considered as significant. Result: The study finds that the mean age of the caregiver is 55.6 ± 10.01 years and that of patient is 69.81± 0.71 years. The mean BAS score is 68.3 ± 11.77. A negative correlation is established between BAS and income of the caregiver and is statistically significant (P < .001), while a positive correlation between BAS and age, number of hospitalization, total duration of illness, and the mean of time spent with the patient during the day and is statistically significant (P < .001). Factors like low income, advancing age, and time spent with the patients in the caregivers had affected the BAS score, and the score was found to be raised. Factors related to the patients affecting the BAS score was total duration of illness and number of hospitalization. Both factors played a key role in the addressed the overall care burden among the caregivers. Conclusion: Factors such as low income, advancing age, and time spent with the patients in the caregivers had affected the BAS score, and the score was found to be raised. Factors related to the patients affecting the BAS score was the total duration of illness and number of hospitalization. Both factors played a key role in the addressed the overall care burden among the caregivers.

An observational study of drug utilization pattern in patients with diabetes mellitus in tertiary care hospital

Background: Diabetes will be the 7th leading cause of death by 2030 as per the World Health Organization (WHO). Encouraging the populace to use drugs rationally is the main goal of research on drug usage. Aims and Objectives: The objective of this study is to determine drug utilization pattern among patients with diabetes mellitus using the WHO Core Indicators in a tertiary care hospital, Indore. Materials and Methods: A prospective and observational study was done in the Department of Pharmacology along with the Department of Medicine in MGM Medical College and Hospital, Indore. After taking informed consent from diabetic patients visiting the outpatient department, their demographic details and prescriptions were recorded in case record form and analyzed using WHO core indicators. Results: In our study, total prescription assessed was 123. The total drugs prescribed were 652, out of which a total of 278 were anti-diabetic drugs. The average number of drugs per encounter = 5.3. Percentage of drugs prescribed by generic name = 92.4%. Percentage of encounters with an antibiotic prescribed = 10.5%. Percentage of encounters with an injection prescribed = 34.9%. The percentage of drugs prescribed from the essential drugs list (2015) = 72.3%. Conclusion: Prescribing pattern of antidiabetic drugs vary a little from the WHO standards. Rational prescription should be encouraged and such studies should be done regularly for periodic auditing of prescription.

Estimation of Gestational Age from Human Fetal Diaphyseal Length of Femur

Introduction: Length of femur is the good marker of late gestational age. Femur length denotes exact gestational age and helps in classification of fetus as pre-term, term or post-term. Also, it is an important parameter in medicolegal cases like decomposed fetuses, infanticide and mutilated parts of fetus. This study was mainly conducted to estimate the gestational age from human fetal diaphyseal length of femur. Material and Methods: Study was conducted on 35 human aborted fetuses obtained from OBGY department of MGM Medical college, Aurangabad and 70 femurs of right and left side were dissected out in Anatomy department of same institute for the fetal femur morphometry and its correlation with gestational age. Fetuses were divided into 4 groups as A, B, C, D according to their gestational age and diaphyseal length i.e., measurement from greater trochanter to lateral condyle (L1) was measured. Results: In each group following parameter was analyzed by descriptive statistics. The Mean +SD, minimum and maximum values for diaphyseal length of femur (L1) was calculated in each group. L1 of right femur increases gradually from 38.96 mm in group A to 74.294 mm in 32 in group D. Similarly for left femur, the diaphyseal length increase gradually from 38.971 mm in group A to 76.594 mm in group D. The mean diaphyseal length L1 of both right and left side is 38.95 in group A and 75.44 in group D, shows linear correlation with gestational age. It was found that femur length gives a positive correlation with gestational age. Conclusion: Diaphyseal length of fetal femur, is one of the most important parameter for the estimation of gestational age in 2nd and 3rd trimester.

Risk factors and etiology of early-onset neonatal sepsis in Northeastern part of India: Case-control study.

Sepsis, the second most common cause of neonatal mortality, causes more than one million deaths annually. India has the highest incidence of clinical sepsis (17000/100000 live birth). This study aimed to determine the risk factors and organisms of early-onset neonatal sepsis (EONS) in a tertiary care hospital in Northeast India. It was a case-control study conducted in the neonatal unit of MGM Medical College, Kishanganj, Bihar, from January 2022 to April 2023. All neonates admitted to the neonatal intensive care unit (NICU) within 72 hours of life constituted the study population. Neonates diagnosed as EONS by clinical and laboratory parameters were considered as cases and those not diagnosed for EONS as controls. Maternal and newborn information and laboratory parameters were collected and analyzed. For risk factor identification, the bivariate logistic regression was used. An equal number of cases (78) and control (78) were enrolled in the study. Maternal age >30 years (adjusted odds ratio [aOR] = 3.017, confidence interval [CI]: 1.238 to 7.352; P < 0.015), maternal urinary tract infection (UTI) in the third trimester (aOR = 5.435, CI: 2.647 to 11.158; P < 0.0001), and premature rupture of membranes (PROM) (aOR = 2.918, CI: 4.61 to 33.73, P < 0.004) were significant predictors of EONS. Pseudomonas (41.02%), Klebsiella (16.66%), and coagulase-negative Staphylococcus aureus (20.51%) were commonly isolated organisms, which were highly resistant to cephalosporin, meropenem, aminoglycosides, and quinolones. Proper and adequate antenatal screening for diagnosis and treatment of maternal infection and high-risk pregnancies for perinatal management of newborn is recommended to prevent neonatal sepsis-related morbidity and mortality. Rational use of antibiotics may minimize the hazard of antibiotic resistance.

Achievement of the Critical View of Safety in Laparoscopic Cholecystectomy &amp; Its Outcome in MGM Medical College, Aurangabad

Achievement of the Critical View of Safety in Laparoscopic Cholecystectomy &amp; Its Outcome in MGM Medical College, Aurangabad

Management of non-tubal ectopic pregnancy: A case series

The aim of this study is to review the various modalities used for management of non-tubal ectopic pregnancies. Ectopic pregnancy is a rare occurrence comprising 1-2% of all pregnancies. However, the most common site for ectopic implantation is fallopian tube. Tubal ectopic pregnancies 95% of all ectopic pregnancies while rest 5% are non-tubal pregnancies. Common sites for non-tubal ectopic pregnancy are cervical, cornual, interstitial, caesarean scar, ovarian and abdominal. Often misdiagnosed, however, detailed history taking, clinical examination and ultrasound helps to establish diagnosis. In this article, we discuss various cases of non-tubal ectopic pregnancy managed with medical treatment using methotrexate or surgical intervention or a combination of both. This study is a retrospective study carried out at MGM Medical College, Navi Mumbai, India between the years 2020-2022A total of 10 patients were diagnosed using clinical, laboratory and radiological methods and were then managed using medical and surgical management modalities ranging from methotrexate therapy to obstetric hysterectomy.There should be a clear protocol for management of non-tubal ectopic pregnancies in hospitals since there is an anticipated rise in the near future because of an increased rate of risk factors.