MGM Medical College Research Articles

STUDENTS’ FEEDBACK ON YOGA TRAINING AS PART OF THE FOUNDATION COURSE IN THE MBBS CURRICULUM

Objectives: The objective of this study is to take responses in the form of feedback from the students with regard to yoga training during the foundation course (FC). Methods: It was a cross-sectional study. After taking consent from the students, the data were collected using self-administered and semi-structured questionnaires. The feedback form with the FC was distributed to all the newly joined 1st year MBBS students of MGM Medical College, Jamshedpur, Jharkhand, India. Results: The majority (48.84%) of 1st year MBBS students liked Dhyana. All the participants agreed that yoga benefitted them. Conclusion: Yoga helped students reduce stress and anxiety and improve overall physical health. It should be continued in MBBS foundation curriculum.

Spectrum of non-neoplastic skin diseases: a histopathology-based clinicopathological correlation study

Abstract Background: Non-neoplastic skin diseases encompass a wide array of pathologies ranging from autoimmune to infectious to diseases of unknown etiology. Clinical and microscopic examinations are the two most critical diagnostic modalities for managing skin disorders. The aim was to study the correlation between clinical and histopathological appearances of non-neoplastic skin lesions. Materials and Methods: This retrospective study was conducted at MGM Medical College and Hospital, Navi Mumbai, Maharashtra, India. Three hundred punch biopsies from the skin were studied for 3 years, from January 2014 to January 2017. The patient’s clinical details, including age and sex, along with other relevant findings, were taken from the requisition forms received. Results: Maximum cases were of infectious diseases 128 cases (43%), followed by non-infectious inflammatory diseases 92 cases (31%), vesico-bullous disorders 34 cases (11%), vascular diseases 14 cases (5%), connective tissue diseases 13 cases (4%), 6 cases (2%) each of pigmented lesions, congenital disorders, and miscellaneous. Male preponderance was seen with 177 cases (59%), with the male-to-female ratio being 1.43:1. The most typical affected age group was 21–40 years. Our study’s most common clinical presentation was plaque 122 (40.7%), followed by clinicopathological concordance in 218 cases (72.6%). Conclusion: Histopathological examination is essential for confirming numerous non-neoplastic skin diseases, along with comprehensive clinical history and the use of specific stains, which helped validate the diagnosis.

Role of PPH clamp as a first aid in management of PPH in central India population

PPH is most significant and common cause of maternal morbidity and mortality in developing and developed countries both due to uncontrolled bleeding. It is responsible for 30% of maternal death. Around, two-thirds of the obstetric morbidity is related to haemorrhage. From many studies, found that PPH 50 times increases the risk of the morbidity and 5 times higher morbidity than mortality.: This is a prospective cohort study, which is done in the Department of Obstetrics & Gynaecology of MGM Medical College and M.Y. Hospital, Indore over a period of one year in 60 patients.All the patients who developed PPH with failed medical management and give proper consent for application of clamp included. Patients with cervical cancer and patients who do not give consent are excluded.: All the data analysis was performed using IBM SPSS ver. 20 software. Frequency tables and cross tabulation is used to prepare the tables. Categorical data was expressed as number and percentages whereas quantitative data was expressed as mean and standard deviation. Categorical data was compared using chi square test whereas means were compared using one-way Anova. Microsoft word and excel used to generate graph, table etc. P value of less than 0.05 was considered as significant. In our study, more than half (56.7%) clamping were successful. In this study, more than half (56.7%) clamping were successful. Patients with lower parity had more chances of successful clamp as compared with those with higher parity. Blood loss was significantly less in those with successful clamp (1127.94) as compared to without successful clamp (1384.62) as revealed by the highly significant p value of <0.001.In the present study, we evaluated requirement of further surgical procedure and clamp success rate and results showed that majority of the patients who had successful clamp does not require further surgical procedure to undergo as compared to those without successful clamp. Blood loss was significantly less in those with successful clamp as compared to without successful clamp.

Otitis media and its associated risk factors: An investigation into patients’ knowledge, attitudes, practices, and information sources at a hospital setting

Abstract Background: Otitis media (OM) is a substantial healthcare issue globally, including in India. Despite its widespread occurrence, there has been only one prior investigation into the knowledge, attitude, practices, and sources of information (KAPS), as well as information sources regarding OM among patients in India, and this study dates back to 2009. This article unveils the findings of a recent KAPS study conducted among patients residing in Navi Mumbai, Maharashtra, India. Objectives: The primary goal of this study was to evaluate the KAPS regarding OM and its associated risk factors, with a specific focus on individuals diagnosed with this ailment. Settings and Design: This research was conducted in the Ear, Nose, and Throat (ENT) Outpatient Department (OPD) of MGM Medical College and Hospital, Navi Mumbai, Maharashtra, India. A cross-sectional study, the KAPS study, was conducted on 91 patients diagnosed with OM. Materials and Methods: This study used a cross-sectional methodology to assess KAPS. The research included 91 patients diagnosed with OM receiving care at the ENT-OPD of MGM Medical College and Hospital, Navi Mumbai, Maharashtra, India. Statistical Analysis: Descriptive statistics were used, and data normality was evaluated. Independent T-tests and analysis of variance methods were employed to compare means, followed by post hoc analysis using the Bonferroni test. Pearson coefficient test was utilized to estimate correlations, and associations were examined using the Chi-square test. Results: Most participants (47.3%) exhibited a low level of knowledge, with an average Knowledge score of 11.98 ± 4.64 out of a possible 23. The mean Attitude score was 5.37 ± 1.37 out of seven. Regarding Attitude scores, there were significant differences in educational level (P = 0.003) and socioeconomic status (P = 0.0001). The mean Practice score was 0.51 ± 0.6 out of a maximum score of three. There was a significant correlation between Knowledge and Attitude scores (P < 0.0001). Only 17.6% of the participants reported receiving any education on ear health. Conclusion: Most patients in the study demonstrated a lack of comprehensive knowledge. While a positive attitude was common among the majority, the average Practice score remained relatively modest. This research underscores the significance of community education initiatives focused on OM to boost awareness and reduce the burden of this condition.

Endocrine dysfunction in transfusion dependent thalassemia patients from central India

Background: Thalassemia refers to a group of genetically inherited diseases characterized by decreased or absent synthesis of normal globin chains resulting in defective globin chains. Most of the available studies in the literature have been done in adults and there is a paucity of studies highlighting the prevalence of hormonal dysfunction in transfusion dependent patients in pediatric age group. We conducted the present study with an aim to estimate the prevalence of hormonal dysfunction in transfusion dependent thalassemia (TDT) patients at a tertiary care center of Central India. Aims and Objectives: The aim of the study was to estimate the prevalence of hormonal dysfunction in TDT patients at a tertiary care center of central India. Materials and Methods: It is descriptive cross-sectional study conducted at tertiary care hospital MGM Medical College, Indore, Madhya Pradesh, conducted over a period of 12 months (August 2021–July 2022). Results: Our study recruited a total of 100 children with age ranging from 9 year to 18 years with the mean age of 13.16±2.86 years. Sixty percent (n=60) of our study population were males and 40% (n=40) were females. The prevalence of hypogonadism was 35.18% analyzed in 54 patients, hypothyroidism was 10%, and diabetes was 5%. Although serum ferritin was very elevated in all patients with endocrine dysfunction; statistically significant association was found between serum ferritin and hypothyroidism (P=0.020). Conclusion: Patients with TDT are often associated with endocrinopathies; most commonly hypogonadism, followed by hypothyroidism and diabetes. Early screening and treatment is necessary to improve their outcome.

A case series of IPOM-AS – intraperitoneal mesh fixation technique for ventral hernia using straight needle suture nylon 2–0

Intraperitoneal onlay mesh (IPOM) technique of mesh fixation using tackers for ventral hernia is widely done. But using tackers is costly (266.29 USD) and causes early and late post-operative pain. The aim of the study was to choose the better method of surgery for ventral hernia using composite mesh and straight needle suture nylon 2–0 for intraperitoneal mesh fixation (IPOM-AS) and will compare it with conventional IPOM technique in which Fixation of mesh is done by Tacker. Ten patients who were diagnosed with ventral hernia between November 2022 and December 2022 in the Department of Surgery, MGM Medical College and MY Hospital, Indore were taken in our study and IPOM-AS technique was performed using three ports on the left side of the abdomen, after reducing the contents of hernia, the axis for internal attachment of composite mesh is identified and marked with pair of sutures (vicryl and rapid vicryl) and intraperitoneal transabdominal fixation of mesh is done using straight needle suture nylon 2–0 with the help of suture passer. This technique was taken in our study and was assessed for cost-effectiveness, early and late post-operative pain, learning curve, early mobilization, early discharge, early return to work, and long-term complications. All the patients had less early and late post-operative pain according to VAS score (mean VAS score 2 on post-operative 1 and 1 on post-operative 2, no pain during the follow-up period), patients were discharged earlier (mostly on post-operative 1) and early return to work was possible and this technique of intraperitoneal mesh fixation using straight needle suture (2.03 USD) is more cost-effective when we compared these patients with those in whom conventional IPOM was done with the help of a tacker (266.29 USD). Good patient compliance was seen. IPOM using composite mesh and straight needle suture (IPOM-AS) for intraperitoneal mesh fixation in ventral hernia is better accepted by patients than the conventional IPOM using tacker for mesh fixation.

TO ASSESS SUBCLINICAL UREMIC ENCEPHALOPATHY IN NEWLY DIAGNOSED CHRONIC KIDNEY DISEASE PATIENTS BY USING COGNITIVE PARAMETERS IN TERTIARY CARE CENTRE

Background: Chronic kidney disease(CKD) is one of the leading cause of death in the world because of its late or end stage presentation. In our study we assessed patients of CKD for cognitive dysfunction with Addenbrooke scale and other biochemical parameters. Methods: This crosssectional study was conducted on 60 newly diagnosed CKD patients at MGM Medical College and MY Hospital Indore, MP, India, from 2019 to 2021. Baseline parameters like serum urea, creatinine, bilirubin and sodium were done and patients were subjected to Addenbrooke scale to assess subclinical uremic encephalopathy and data were analysed using SPSS statistics version 22.0 and p value <0.05 and condence interval more than 95% were considered signicant. Results: In my study of 60 patients, we have different mean of Addenbrooke scale according to stages. In stage 1 of CKD the mean value of scale is 94.33%. In CKD stage 2 the mean scale is 96.833% . In stage 3 CKD mean value is 94.5%. In CKD stage 4 the mean value is 91.2%. In CKD stage 5 the mean value is 86.88%. Conclusions: This study supports the fact that as CKD stages progresses, there is propensity of Addenbrooke score to decrease which helps in early detection of subclinical uremic encephalopathy and therefore the risk of uremic seizures

Conservative management of acute fissure in ANO and conversion into chronic fissure: A comparative study

Background: The aim of the study was to choose best method for the management of acute fissure-in-ano, by comparing among zinc oxide cream and lidocaine ointment and conversion of acute fissure into chronic fissure-in-ano. Aims and Objectives: The aim of the study was to compare the effect of zinc oxide cream and lidocaine ointment in acute fissure and conversion of acute fissure into chronic fissure-in-ano requiring surgery. Materials and Methods: Two hundred patients who were diagnosed with acute anal fissure between November 2021 and November 2022 at MGM Medical College and M. Y. Hospital were undertaken for this prospective randomized trial. All cases randomized into two groups. Group 1 where the patients of acute anal fissure who applied 15% of zinc oxide cream twice a day. Group 2 where the patients would apply 5% of lidocaine ointment twice a day. Healing rates, pain relief, recurrences, changes in symptoms after the treatment, and complications were recorded. Results: There was no statistical difference among groups in terms of age and gender. The healing and symptomatic relief with the conservative method for acute anal fissure was significantly much more. Recurrence rate was very less in symptomatic group. There was a significant reduction in conversion of acute anal fissure into chronic anal fissure with the use of conservative management. Conclusion: Conservative management is better treatment option for acute fissure-in-ano with reduced conversion into chronic fissure-in-ano.

AN OBSERVATIONAL STUDY OF ASSOCIATION OF SUBCLINICAL HYPOTHYROIDSIM AND ABNORMAL UTERINE BLEEDING

Introduction Abnormal uterine bleeding is a common gynecological presentation, accounting for atleast 20% of all new outpatient visits. It has been recognized that thyroid dysfunction may have profound effects on the female reproductive system. Both hypothyroidism and hyperthyroidism are associated with a variety of changes, including delayed onset of puberty anovulatory cycles, and abnormally high fetal wastage. Hence,this study was conducted to know the thyroid status of the patient with abnormal uterine bleeding. Aim & Objective: 1. To estimate the Prevalence & association of subclinical hypothyroidism among women presenting with abnormal uterine bleeding.Methods: A descriptive cross-sectional study was conducted in 250 patients with abnormal uterine bleeding in a tertiary care hospital. Data was collected using a questionnaire which includes patients prole ,the pattern of abnormal uterine bleeding, and thyroid prole. Settings and Design: This study was done in a MGM medical college indore & myh hospital in Madhya Pradesh. Results: Out of 250 patients presenting with AUB, 163 (71.6%) were euthyroid, 20 (3.6%) were overt hypothyroid, and 10 (0.5%) was hyperthyroidism and 57 ( 24.2%) were subclinical hypothyroidsim. the mean levels of the thyroid-stimulating hormone were 4.28 ± 2.76 mIU/L. The mean triiodothyronine and thyroxine were 132.6 ± 34.90 and 9.81 ± 3.60, respectively The most common symptom abnormal uterine bleeding was menorrhagia 74 (29.8%), followed by polymenorrhoea 53 (21.4%), hypomenorrhoea 32 (12.9%) , intermenstrual bleeding 31(12.5%), acyclicalbleeding 6 (2.8%) and oligomenorrhea 3 (1.2%). The maximum number of patients was between 41-50 years with the mean age of 41years. Conclusion: There is signicant association between subclinical hypothyroidism and abnormal uterine bleeding The prevalence of subclinical hypothyroidism in the study group was 24.2% It is suggested that women with early onset menorrhagia and oligomenorrhea with or without symptoms & signs attributable to thyroid dysfunction should be offered thyroid function testing to detect subclinical stage Early detection by selective screening and specic pharmacotherapy for subclinical thyroid disease early in the course of the disease will prove to be a superior alternative to surgical treatments like hysterectomy

A PROSPECTIVE STUDY OF CASES OF PREGNANCY INDUCED HYPERTENSION AND MATERNAL AND PERINATAL OUTCOME AT TERTIARY CARE HOSPITAL

Background: Pregnancy Induced hypertension continues to be rampant globally and is associated with high perinatal and maternal mortality and morbidity. It is still one of the most important and intriguing unsolved problems in obstetrics. Hypertensive disorders in pregnancy account for approximately 7 to 15% of all pregnancies and nearly 25% of antenatal ward admissions. The condition complicates about 10% of pregnancies and is responsible for 14% of maternal deaths, 15% of perinatal deaths, and 30% of maternal near misses worldwide. Hypertensive disorders in pregnancy (PIH) are a group of disorders that range from pre-existing chronic hypertension in the index pregnancy to complex multisystem disorders such as preeclampsia, which can lead to complications such as eclampsia, HELLP syndrome, acute renal failure, pulmonary edema, stroke, and left ventricular failure. Though not preventable, early detection and proper intervention can signicantly reduce complications. This is achievable with Prenatal care at all levels. However, there is an unmet need in recognizing and managing PIH and its complications in low and middle-income countries due to pregnancy myths and misconceptions, transportation challenges, low socioeconomic status, and a lack of easy and expert antenatal care requiring a multidisciplinary approach, a lack of accurate prediction methods, and a scarcity of high dependency units (HDU). Early detection of a milder form of disease, corticosteroid administration, and careful timing of delivery can all help improve the outcome. In light of this, we designed and conceived the current study with the goal of studying the maternal and perinatal outcomes of Hypertensive Disorders of Pregnancy at a tertiary care hospital. Furthermore, data from antenatal females with PIH admitted for safe connement were collected and classied into the following categories: GHTN, Preeclampsia, Chronic Hypertension, Chronic Hypertension superimposed with preeclampsia, and eclampsia. Finally, the method of delivery (vaginal/caesarean section) in each category of patients was examined. The study's ndings will assist us in determining the scope of the problem in our area and estimating the fetal and maternal complications associated with it. Methods: All patients beyond 20 weeks of pregnancy with pregnancy induced hypertension admitted in department of Obstetrics and Gynaecology of MGM Medical College over a period of 18 months after approval from Institutional ethical committee was taken into consideration. The objective of the study was to analyze the cases of gestational hypertension, Chronic Hypertension, Chronic Hypertension superimposed with preeclampsia, pre-eclampsia and eclampsia and their maternal outcome in terms of mode of delivery and complications. Perinatal outcome in relation to neonatal complications was also studied. The frequency and percentage for socio-demographic variables, mode of delivery and complications were analyzed. Results: Pregnancy Induced Hypertension cases accounted for 415 cases were enrolled during study period; The most common PIH presentation was pre-eclampsia, followed by severe pre-eclampsia, gestational hypertension, antepartum eclampsia. Maternal morbidity and mortality were observed in 37.6% of the women and 3.6%, respectively in our study. Abruption, wound infection, and eclampsia were the most common complications, accounting for 11%, 9%, and 7.7% of all cases, respectively. 48.2% of babies were shifted to mother side, followed by 41.6% were shifted to SNCU, 7.9% were Intrauterine deaths and least 2.1% were Still birth respectively Conclusions: Though the incidence of pre-eclampsia and eclampsia is on the decline, still it remains the major contributor to poor maternal and fetal outcome. Regular antenatal checkups, early diagnosis, prompt multidisciplinary treatment, optimum timing of delivery reduces the incidence of complications and the maternal mortality. Early referral and management of these cases at centers with advanced neonatal facilities will reduce the perinatal mortality

DOPPLER INDICES OF FETAL MIDDLE-CEREBRAL AND UMBILICAL ARTERIES IN NORMAL 28–40 WEEKS PREGNANCIES

Objectives: The aim of the study was to establish normative data for the pulsatility index (PI), resistive index, and cerebro placental ratio of umbilical artery (UA), and fetal middle cerebral artery (MCA) of Indian pregnant women in the third trimester of pregnancy using multiples of the median and percentile reference range. Methods: It was a cross-sectional study; the study was carried out at the Department of Obstetrics and Gynaecology and Radiology in MGM Medical College and LSK Hospital, the tertiary care and teaching hospital. A total of 200 cases were enrolled for this study. Patients with Singleton low-risk pregnancies with confirmed gestational age, normal anatomy, normal estimated fetal weight, and born at term with birth weight between 10th and 90th percentile and gestational age was based on LMP date, corrected if required by trimester first/second (Before 20 weeks) fetal sonographic parameters were included in the study. Results: We found from 28 weeks to 39 weeks of gestational age, MCA PI showed a significantly positive correlation with the cerebro-placental ratio (CPR) 40th week of gestational age. We found no significant correlation. While from 28 weeks to 40 weeks of gestational age, UA PI showed a significantly negative correlation with the CPR. Conclusion: Doppler ultrasound is used as a part of the clinical protocol in the surveillance of pregnancies. The UA and MCA Doppler indices and CPR are currently used to modify the scheduling of antepartum surveillance and, in some cases, to timely delivery of the compromised fetus. Researchers measured the pulsatility, resistivity, and cardiac indices of the UA and the fetal MCA between 28 and 40 weeks of gestation to establish a normal range.

COMPARATIVE ANALYSIS OF HAEMATOLOGICAL, IMMUNOHAEMATOLOGICAL PARAMETERS AND CLINICAL CHEMISTRY PROFILE AMONG LUPUS ANTICOAGULANT POSITIVE AND LUPUS ANTICOAGULANT NEGATIVE COVID-19 CASES

Introduction: Coronavirus disease 2019 (COVID-19) is characterised by a pro-coagulant state that can lead to thromboembolic events. A high prevalence of Lupus Anti-coagulant has been shown in several studies, that may atleast partially explain the procoagulant prole of COVID-19. Few people infected by Coronavirus have become seriously ill while others showed little or no signs or symptoms related to COVID-19. This study was undertaken to analyze Haematological, Immunohaematological parameters and clinical Chemistry prole among LA positive and LA negative COVID -19 cases. Objectives: 1. To assess clinical, hematological and coagulation prole in COVID-19 lupus anticoagulant positive cases and lupus anticoagulant negative cases .. 2. To correlate ndings amongst lupus anticoagulant positive and negative cases. 3. To assess inammatory status amongst Covid-19 lupus anticoagulant positive and negative cases with markers like Crp-q, LDH, D-Dimer and Ferritin. Materials and Methods: The study was conducted as a prospective observational study with search data forms from the case records of patients hospitalized as ICU/ non- ICU COVID-19 cases in MGM Hospital and Medical College, Aurangabad during the pandemic for a total duration of 2 years from December 2020 to December 2022. A total of 90 patients with conrmed diagnosis of COVID-19 by RTPCR/RAT were studied. To assess Lupus Anti-Coagulant positivity- Dilute Russel Viper venom time (DRVVT) technique is used for established COVID-19 cases Conclusion: In conclusion, the current study conrmed no statistical correlation for parameters such as age, gender, comorbidities (hypertension, diabetes mellitus, COPD, IHD) in LA positive and LA negative cases. There was no statistical correlation found for ANA, RA factor, Inammatory markers and Coagulation prole among LA positive and LA negative cases. Neutrophil : Lymphocyte ratio and Lymphocyte : CRP ratio did not statistically differ in LA positive and LA negative cases. Complications (stroke, IC bleed, DVT, PTE) were observed in 16.27% LA negative patients while none of the above complications were seen in LA positive patients. Further large scale studies are required to comment on differences in Haematological, Immunohaematological and Clinical Chemistry prole between LA positive and LA negative cases.

Snot-22 a Predictive and Assessment Tool for Subjective Improvement After Fess in Patients of Chronic Rhinosinusitis.

Chronic Rhinosinusitis (CRS) is a common health problem with an estimated prevalence of 6.8% in Asia. The treatment of CRS involves an initial course of maximal medical therapy followed by Functional Endoscopic Sinus Surgery (FESS). Here, we are assessing the outcomes of FESS on CRS using most recent Sino Nasal Outcome Test (SNOT-22) questionnaire, for quantifying changes in symptoms and predicting extent of postoperative improvement. 75 patients who reported in the tertiary health care centre in Department of ENT, MGM Medical College & M.Y. Hospital, Indore and were diagnosed with CRS that did not relieve on medication were selected on the basis of inclusion and exclusion criteria. The selected cases were asked to answer the SNOT-22 questionnaire before the surgery. FESS was done and after three months, the patients were again subjected to the SNOT-22 questionnaire. There was 83.67% overall improvement in postsurgical SNOT-22 evaluations, which was statistically significant (p value < 0.00001). Most common SNOT-22 symptom was the need to blow nose, which was seen in 28 (93.34%) cases, while ear pain was found in 10 (50%) patients and was the least common SNOT-22 symptom. FESS seems to be effective treatment of CRS patients. We observed SNOT-22 to be very effective and reliable in assessing the Quality of Life in CRS patients and to measure the improvement after FESS.

EFFECT OF YOGIC EXERCISES ON SERUM CRP AND RF LEVELS OF RA PATIENTS IN URBAN PART OF MP

Introduction: Rheumatoid Arthritis (RA) is a chronic inammatory auto immune disorder, where immune system attacks synovial lining of joints, resulting into, stiffness and dysfunction. In response to this the body releases CRP (C-Reactive Protein) in the bloodstream. Present study has Aim: been planned to see the effect of yogic exercises in order to subside the intensity of the RA symptoms and to determine the effects of yogic exercises on serum CRP and RF levels in RA patients. Present study was carried out in MGM Medical College and Material and method: Government Holkar Science College, Indore during December 2020-February 2022. Total 100 study subjects were taken out of which 50 were control and 50 RA cases. Fasting blood samples were collected from subjects and analyzed for CRP levels on fully automated biochemistry analyzer. Blood samples were also subjected for testing of RF. Medically healthy people of Inclusion criteria: 30-50 years of age and RA patients with 30-50 years of age. RA patients with diabetes, CHD and other major complications. Resul Exclusion criteria: Results: ts reveal that; Ÿ Increased level of CRP and RF has been observed in RA patients in comparison to healthy control. Ÿ Signicant decrease in levels of CRP and RF has been observed in RA patients with Yogic exercises as compared to RA patients without yogic exercises. Conclusion: Yogic exercises brought down the CRP and RF levels and because of which complications and pain in RA patients can be reduced. Some yogic exercises should be practiced as an add on therapy in management of RA

“COMPARISON OF USE OF IV OXYTOCIN INFUSION WITH AND WITHOUT SUBLINGUAL MISOPROSTOL FOR POSTPARTUM HEMORRHAGE PREVENTION IN LOWER SEGMENT CAESARIAN SECTION”

Background: Postpartum hemorrhage (PPH) is a major cause of maternal mortality. The current study is to compare the efcacy of oxytocin with and without sublingual misoprostol for PPH prevention in lower segment caesarian section. Methods: It was a prospective study conducted in MGM Medical College, Navi Mumbai including all Female patients with singleton pregnancy for a period of 2 years of total 100 cases. Results: All deliveries conducted during the study it was observed mean reduction of 1.41 g/dl in hemoglobin level in Oxytocin with sublingual misoprostol group, and 1.93 g/dl in hemoglobin level in Oxytocin without sublingual misoprostol. The decline was signicantly greater in Oxytocin without sublingual misoprostol group. The side effects noted was that shivering among 16% subjects in Oxytocin with misoprostol group, which is greater as compared to Oxytocin without misoprostol group (4%). Conclusions: The decline in hemoglobin level was signicantly greater in Oxytocin without sublingual misoprostol group as compared to with sublingual misoprostol group. It can be concluded that sublingual misoprostol with oxytocin is more effective than oxytocin alone in the prevention of PPH in the developing countries

HISTOPATHOLOGICAL STUDY OF NEOPLASTIC BREAST LESIONS IN A TERTIARY CARE CENTRE.

We have studied 194 cases of neoplastic breast lesions over a period of 2 years (1 Jan 2020 to 31 December 2021) in MGM Medical college and Hospital, Aurangabad. The specimens were received in histopathology section of pathology department. Specimens were received in different forms such as Lumpectomy, trucut biopsy, simple mastectomy and MRM. Detailed gross examination of specimens (grossing of MRM: - according to AJCC protocol) followed by xation, thorough sampling and tissue processing. The different lesions were studied by histopathological examination and analysed. Neoplastic lesions were classied according to WHO classication (2017).Out of 194 cases, 75 cases had benign breast tumours and 119 had malignant tumours. Fibroadenoma (68 cases) was most common benign tumour followed by benign phyllodes (4cases), lactating adenoma (2 cases) and multiple ductal papilloma(1 case). Invasive carcinoma with no special type (104 cases) was most common malignant tumour. Special subtypes of invasive carcinoma found in our study were:- Invasive metaplastic carcinoma (1 case) Invasive lobular carcinomas (2cases), Invasive papillary carcinoma (1 case), Invasive mucinous adenocarcinoma (1 case), Solid papillary carcinoma (1 case), Invasive carcinoma with mucinous component (1 case) , Invasive carcinoma with neuroendocrine features (1 case) and Intracystic papillary carcinoma (2cases). Other malignant tumours included malignant phyllodes (2 cases) and malignant spindle cell neoplasm (3 cases). In our study, we found that malignant neoplasms were more common than benign neoplasms with Invasive breast carcinoma with no special type being the commonest malignant tumour. Histopathological study plays an important role in diagnosis of breast neoplasms and hence in treatment and prognosis.

COMPARISON OF ULTRASOUND AND THE ALVARADO SCORE IN THE DIAGNOSIS OF ACUTE APPENDICITIS : A PROSPECTIVE COMPARATIVE STUDY IN A TERTIARY CARE CENTRE IN WESTERN MAHARASHTRA

Background :Acute appendicitis is one of the most common surgical emergencies with a lifetime prevalence of approximately 1 in 7. The Alvarado scoring system and ultrasonography play a definite role in diagnosis of acute appendicitis, because of the easy availability, cost effectiveness and being radiation free. According to the analysis, the percentage of Appendicectomies done for a normal appendix mistaken to be Acute Appendicitis was found to be as high as 20%.The following study compares the accuracy of the Alvorado scoring system and Ultrasonography in the diagnosis of Acute appendicitis and examines the value of using both modalities together. Materials and Methods :In this study 100 patients were included with provisional diagnosis of acute appendicitis and admitted and operated in the Department of General Surgery, MGM Medical College, Navi Mumbai between January 2021 to November 2022. Alvarado score was applied and ultra sound abdomen was done pre operatively. The decision for surgery was made independent of the score and ultra sound finding. Diagnosis of patients who underwent appendicectomy was confirmed by histopathology report. Results :In the present study, 100 cases were provisionally diagnosed of having acute appendicitis and were operated during the study period.Itwas seen that 95.52% of patients who were thought to be positive by Alvarado score &gt;=7 usually had appendicitis by histopathology where as 4.08% of the patients were normal by histopathological examination. This accounted for 47.96% and 33.33% of the total patients respectively. From this the sensitivity of the Alvarado score is calculated to be 47.96%. Ultrasound alone showed a PPV of 67% and a NPV of 66.7%. Conclusion :In our study, Alvarado score had better sensitivity than ultrasonography. Alvarado score has a high diagnostic value (97.7%). USG has role in ruling out normal appendix and other pathology, with a specificity of 66.67% When we diagnose acute appendicitis based on the individual results of Alvarado score and USG, we get a statistically significant value. Hence as a conclusion of this study, alvaradoscore and USG together could be applied in the diagnosis of acute appendicitis for better outcomes and decision making.

Assessment of Menopausal Symptoms using Modified Menopause Rating Scale among women coming to MGM Medical College and Hospital, Aurangabad.

Assessment of Menopausal Symptoms using Modified Menopause Rating Scale among women coming to MGM Medical College and Hospital, Aurangabad.

TO STUDY THE CORRELATION BETWEEN SERUM ALBUMIN LEVEL AND OUTCOME IN PATIENTS ADMITTED WITH ACUTE ISCHEMIC STROKE

Background Stroke is becoming an important cause of premature death and disability in low- income and middle-income countries like India, largely driven by demographic changes and enhanced by the increasing prevalence of the key modiable risk factors. Despite early initiation of treatment protocols, there may be long lasting debilitating sequel. Therefore, there has been a search for neuroprotective agents which might improve the prognosis of stroke. Methods Study was conducted at MGM Medical College and Hospital, Navi-Mumbai where in 75 patients admitted with acute ischemic stroke selected for the study. Proper consent was taken from the patients after checking the inclusion criteria. Their serum albumin levels were checked at the time of admission and discharge and Modied Rankin score was calculated to assess functional status. Results The mean serum albumin levels at the time of admission was 3.86 ± 0.49 g/dL and the mean serum albumin levels at discharge were 3.95 ± 0.47 g/dL. Approximately 73.32% of the cases had MRS score up to 3 had serum albumin levels of 4.0 to 4.49 g/dL and 27% had MRS score more than 3 had albumin level 3 – 3.99 g/dL. Conclusion It is concluded that low serum albumin levels are associated with poor functional outcomes as reected by an increase in MRS score. Thus, in general, low serum albumin levels are associated with worse functional outcomes.

Evaluation of Carotid Arteries in Stroke Patients using Colour Doppler Sonography: A Cross-sectional Study

Introduction: Cerebral ischaemic stroke is a neurological condition that can be fatal and debilitating and is one of the leading causes of morbidity and mortality. The major benefit of sonography is its capacity to describe plaque and identify plaques with increased risk of embolisation, in addition, to evaluate the degree of stenosis. Aim: To diagnose and characterise the plaque morphology in extracranial portion of carotid arteries using colour Doppler sonography in patients with stroke. Materials and Methods: A time-bound, hospital-based cross-sectional study was conducted in the Department of Radiodiagnosis, MGM Medical College and MY Hospital, Indore, Madhya Pradesh, India from August 2021 to July 2022. There were 80 stroke patients in the study. Risk factors like smoking, diabetes, hypertension, and family history were recorded. B- mode ultrasonography was used to assess carotid arteries and various Doppler parameters like Peak Systolic Velocity (PSV). Plaque characteristics and morphology like smooth margin, irregular margin, ulceration and haemorrhage were evaluated. Statistical parameters such as Student’s t-test were used for association between ICA PSV and ICA/CCA PSV with degree of stenosis. Results: Hypertension was the most common risk factor 57 (71.1%). A total of 54 (67%) stroke patients were found to have plaque in their carotid vasculature. A total of 21 (38.8%) of patients had type-3 plaque followed by type-1 plaque 14 (25.9%). Out of 67% of patients who had plaque, majority of patients 38 (47.5%) had &lt;50% stenosis and 16 (29.6%) of patients had significant stenosis (&gt;50%). Conclusion: It was shown that carotid Doppler ultrasonography can be used as a screening tool for patients, who have risk factors for stroke to find asymptomatic carotid disease.