Moti Lal Nehru Medical College Research Articles

Comparison of the Incidence of Surgical Site Infection in Abdominal Wound Closure: Antibiotic-Coated Polyglactin 910 Suture Versus Polyglactin Suture With Local Infiltration of Antibiotic Along the Incision Line.

Aim and objectives The purpose of this study is to compare the incidence of surgical site infection (SSI) rates in abdominal wound closure utilizing antibacterial-coated(triclosan-coated) suture material versus conventional suture material with subcutaneous antibacterial infiltration along the incision line. Materials and method This prospective and comparative (randomized, non-blinded clinical trial) was conducted at the Postgraduate Department of Surgery, Swaroop Rani Nehru Hospital, associated with Motilal Nehru Medical College, Prayagraj, India. The sample size was calculated to be one hundred. The patients in Group A underwent laparotomy using polyglactin 910 coated with triclosan. The patients in Group B underwent normal suture closure and local infiltration of broad-spectrum antibiotics (1 gram of ceftriaxone in 10 ml distilled water, along with the incision). Results There was no discernible difference between the various groups onpostoperativeday (POD) 14, 21, and 30. In Group A, 100.0% of individuals had healed wound status (POD 30). Group B had healed wound status among the 96.0% of members (POD 30). Twenty percent of the people in Group A had SSI whereas 38.0% of the participants in Group B had SSI. There was no discernible difference between the two groups regarding the distribution of culture (χ² = 7.741, p = 0.127). Conclusion Triclosan-coated sutures are more effective than subcutaneous antibiotic infiltration along the incision line in lowering the frequency of SSI during primary laparotomy wound closure.

Improvement of laboratory testing services by implementation of quality assurance scheme

Introduction: The National AIDS Control Organization (NACO), Government of India and the Uttar Pradesh State AIDS Control Society (UPSACS) established the State Referral Laboratory (SRL) in the Department of Microbiology, Motilal Nehru Medical College, Prayagraj for HIV testing and monitoring of linked HIV Counselling and Testing Services (HCTS) in Uttar Pradesh.Methods: This is a retrospective study conducted from 2008 to 2021. In this evaluation period 10144 serum samples (9580 HIV negative, 555 HIV positive and 9 discordant) were received for retesting at SRL. The Quality Control serum samples received from testing sites consisted of 5% negative and 20% positive from all tested samples collected in the first seven days in the External Quality Assurance Scheme (EQAS) quarter month i.e. January, April, July and October. All samples were tested using rapid diagnostic kits procured by NACO/UPSACS with NACO testing strategy. All linked centres with SRL received 4 coded serum samples for proficiency testing (PT) which were tested similarly.Results: Of 10144 serum samples, 99.92% reported correct results and 0.08% reported discrepancy due to various issues. Similarly in the proficiency testing programme, of 4072 samples tested between 2010 to 2021 by testing sites, 4061 (99.07%) reported concordant results and the remaining14 (0.34%) samples reported indeterminate results. Of the 4072 samples, 14 shows discordant results by three different rapid tests based on different principles. Hands on training were provided for technicians who reported indeterminate results in PT or retesting.Conclusion: The tremendous increase in quality testing at peripheral centrally linked centres increase the reliability of HIV diagnosis at ground level. The study also concluded that continuous monitoring and mentoring of technicians of the diagnostic laboratories under EQAS improves their quality for HIV diagnosis.

Study of the Socio-Demographic Profile, Pattern of Substance Abuse and Criminal Behaviour in Patients with Opioid Use Disorder

With the ongoing increase in supply, temptations, stressful lifestyle and easy availability, substance abuse is growing amongst different populations at an alarming rate. Its demand is increasing alarmingly in the younger generation due to various socio-economical reasons. Substance abuse has also been found to be associated with violent behaviour and infectious diseases. The aims of this study were to find out the socio-demographic profile, pattern of substance abuse and criminal behaviour associated with Opioid Use Disorder. 106 diagnosed patients of Opioid Use Disorder registered at the OSTCentre, Department of Psychiatry, S.R.N. Hospital, associated with Moti Lal Nehru Medical College, Prayagraj were included. All patients were interviewed according to a semi-structured questionnaire prepared for the purpose of collection of information regarding patterns of opioid abuse and history of criminal behaviour, if any. Out of 106 cases, 48 were found with a history of criminal behaviour. Criminal behaviour was found mostly amongst the cases of unemployed and uneducated cases. Cannabis was found to be the most common substance used prior to initiation of opioid abuse. The 20-29 years age group was found to be the most vulnerable age group for initiation of opioid abuse and commission of crime. Accordingly, the 2nd and 3rd decade of life needs better familial and social support along with strict law enforcement related to the supply of illicit substances.

A Comparative Study of Solifenacin, Mirabegron, and Their Combination as Bladder Relaxants in the Management of Overactive Bladder.

Introduction Overactive bladder (OAB) is a medical state that presents as the urgency of urine and increased frequency of micturition and is diagnosed on the basis of the presence of these symptoms in the absence of other explainable diagnoses. The management of this condition includes conservative management, medical management/pharmacotherapy, and surgical management. The overactive bladder has been treated with smooth muscle relaxants, but there are conflicting results. Hence, this study aimed to assess the result of the two smooth muscle relaxants, mirabegronand solifenacin, and their combination to manage an overactive bladder. Methodology A clinical trial was conducted at Swaroop Rani Nehru Hospital, Motilal Nehru Medical College, Prayagraj, India, over the period from November 2019 to December 2020. Ninety patients with OAB were divided into three groups: G1, G2, and G3. These groups were administered solifenacin, mirabegron, and a combination of mirabegron and solifenacin (S+M), respectively. Follow-ups were conducted at 2, 4, 12, and 18 weeks for evaluation. Data were entered into IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York, United States). Appropriate statistical tests, including the chi-square and ANOVA, were employed in this study. Observation The combination of mirabegron and solifenacin was significantly more effective in terms of response compared to solifenacin alone. There was no significant difference between solifenacin versus mirabegron, or between mirabegron (M) and the combination of mirabegron (M) and solifenacin (S). Side effects were more severe in patients taking high doses of solifenacin. Conclusion The S + M combination has higher efficacy than solifenacin and mirabegronwhen given alone.

Comparative study of knowledge, attitude, and practices towards COVID-19 among MBBS Prof 1 students of two successive years in Motilal Nehru Medical College, Prayagraj, Uttar Pradesh

Background: Coronavirus disease 2019 (COVID-19) is an acute respiratory disease caused by a novel coronavirus. Three waves of COVID 19 have hit us so far. With repeated waves of any disease, it has been observed that panic in the community and healthcare personnel decreases and knowledge and attitude towards the disease and diseased improves. Keeping this in mind, the following study was conducted with the following objective. Aim of this study was to assess and compare knowledge, Attitude and Practices of students of MBBS phase I of two consecutive years- 2020 batch and 2021 batch regarding COVID-19. Methods: Data was collected from two successive MBBS first professional batch students by using questionnaire and assessment of knowledge, attitude and practice was done on the basis of scoring system described by Kaliyaperumal. Results: It was observed that among phase I MBBS students (2020 batch) majority i.e. 55.89% were having medium level of knowledge, with a range of score 11‐15. While among phase I MBBS students (2021 batch), majority i.e. 62.82% were having high knowledge score in the range of 16-21. Regarding the attitude scores, majority of students in both the batches (52.82% in phase I (2020 batch) and 65.45% in phase I (2021 batch)) were having good attitude (score >6). Practice scores were mostly satisfactory (score 3-5) among both batches’ MBBS students. Conclusions: The study revealed that the attitude among students was good while knowledge and practice were satisfactory.

COMPARATIVE ANALYSIS OF COBAS 6800, RT-PCR, AND TRUENAT SARS-COV-2 IN ROUTINE DIAGNOSIS OF COVID19.

Introduction - In December 2019, a group of patients of unknown aetiology with atypical pneumonia emerged in Wuhan, China [1]. Severe Acute Respiratory Syndrome Corona Virus 2 (SARS CoV-2), a novel beta-coronavirus was identied as the cause of these cases [2]. RTPCR testing leads to delay in diagnosis in cases where early and rapid diagnosis of COVID-19 is warranted which leads to tension and anxiety both among patient and treating health care workers. Material And Methods- This retrospective observational study was designed and conducted at the Department of Microbiology; Moti Lal Nehru Medical College (MLNMC), Prayagraj Uttar Pradesh. This study was approved by the Institutional Ethics Committee (IEC). All study data was retrieved from Hospital Information System of medical college. Result - Among 200 patients, sample for Truenat, RT-PCR and Cobas 6800 testing were collected during study period. Out of 200 samples 57(28.5%) samples were positive by Cobas 6800 with 15(7.5%) invalid results and 128(64%) negative results. In RT-PCR 71(35.5%) samples were positive and 129(64.5%) samples were negative with no invalid results. 200 positive samples were then selected from the RTPCR and COBAS 6800 positive samples for Truenat testing. Out of these 200 positive samples results of 60(30%) samples were presumptive positive and 128(64%) were negative invalid results 12(6%). Conclusion- we have concluded that RT-PCR is the best diagnostic method for the detection of COVID-19 in a country like India, where there is shortage of trained man power, well equipped labs and poor infrastructure. It also reduces the nancial burden in the era of pandemics, where whole population needs to be catered.

Evaluation of Triple Drug Administration for Lymphatic Filariasis in Prayagraj District, Uttar Pradesh, India: A Cross-sectional Study

Introduction: Unplanned urbanisation and improper sanitary system in many cities in a developing country increase cases of vector borne diseases. Among these, filariasis is a major health problem in India. Campaign for triple drug therapy to eliminate the lymphatic filariasis was launched by government of India but, data assessing the Mass Drug Administration (MDA) coverage and compliance is scarce. Aim: To assess coverage and compliance of triple drug administration for Lymphatic Filariasis (LF) in Prayagraj district. Materials and Methods: This community based crosssectional study was conducted in the Department of Community Medicine at Moti Lal Nehru Medical College, Prayagraj, Uttar Pradesh, India. The duration of the study was 8 days, from 30th October 2021 to 6th November 2021. A total of 1739 individuals belonging to rural and urban area of district Prayagraj. Systematic selection was used for selection of subunit. Random selection of 30 subunits from the survey area was done and also Probability Proportional to Estimate Size (PPES) was used, sampling to give everyone in the survey population an equal probability of being selected. A segment of households was randomly selected (typically-10 household) from each subunit (30 subunits, e.g., village). The number and percentage of characteristics were calculated. The data has been entered in MS excel and analysis was done using Statistical Package for Social Sciences (SPSS) version 23.0. Results: The mean age of the study participants was 30.78±18.18 years for males and 30.04±17.48 years for females. A total of 1739 persons were covered in post MDA coverage evaluation survey out of which, 1361 persons belonged to rural area and 378 persons belonged to urban area. Ivermectin, albendazole and Diethylcarbamazine (DEC) were swallowed more in urban area (53.27% for each drug) as compared to rural area (18.25% for each drug). Overall, estimated 45.66% drugs were swallowed in district Prayagraj. Adverse drug effect was not found. Conclusion: The overall coverage of mass drug administration was low (45.66%) and far behind the national target of >85% and it was even worse in urban area where only one-third of the population were offered mass drug administration.

RHEUMATIC MANIFESTATION IN HIV PATIENT AND EFFECT OF ART ON IT: SINGLE CENTRED STUDY

Background HIV (Human Immunodeciency Virus) infection has now become a chronic illness due to antiretroviral therapy (ART). The prevalence of rheumatic manifestations with disease has been gradual rises. Aim and Objective: Aim of this study was to Find the relation between the rheumatic manifestations and ART drug regimens. This was a Material and methods: cross sectional study carried out on 104 patients of either sex with HIV conrm status attending a tertiary care hospital (Motilal Nehru Medical College and associated hospital). During the study period (June 2020 to August 2021) patients were assessed by clinical examination and with relevant laboratory investigation, to diagnose the rheumatological manifestation, & detailed history of ART therapy and duration of ART therapy. Out of 104 HIV patients 54.8% of the participants were male and 45.2% were Result: male most common rheumatic manifestation was arthritis (65.8%). The mean SD of CD4 count in HIV patients with rheumatic manifestation was 283.12(86.46). This was signicantly lower than HIV patients with no rheumatic manifestation, showed that lower CD4 count increase the incidence of Rheumatic manifestation. Rheumatic manifestation was more in those patients who were on longer duration of ART. There was no signicant difference between ZLN group and TLN group in terms of distribution of rheumatic disease.

Postherpetic granulomatous dermatitis and herpes zoster necroticans triggered by Covid‐19 vaccination

Dermatologic TherapyVolume 35, Issue 10 e15707 LETTER Postherpetic granulomatous dermatitis and herpes zoster necroticans triggered by Covid-19 vaccination Durga Madhab Tripathy, Durga Madhab Tripathy Department of Dermatology, Military Hospital, Agra, IndiaSearch for more papers by this authorSushil Kumar, Sushil Kumar Department of Dermatology, Motilal Nehru Medical College, Allahabad, IndiaSearch for more papers by this authorNeerja Saraswat, Corresponding Author Neerja Saraswat [email protected] Department of Dermatology, Military Hospital, Agra, India Correspondence Neerja Saraswat, Department of Dermatology, Military Hospital, Agra, India. Email: [email protected]Search for more papers by this authorShobhit Goel, Shobhit Goel Department of Pathology, Military Hospital, Agra, IndiaSearch for more papers by this authorEeshaan Ranjan, Eeshaan Ranjan Department of Dermatology, Military Hospital, Jammu, IndiaSearch for more papers by this author Durga Madhab Tripathy, Durga Madhab Tripathy Department of Dermatology, Military Hospital, Agra, IndiaSearch for more papers by this authorSushil Kumar, Sushil Kumar Department of Dermatology, Motilal Nehru Medical College, Allahabad, IndiaSearch for more papers by this authorNeerja Saraswat, Corresponding Author Neerja Saraswat [email protected] Department of Dermatology, Military Hospital, Agra, India Correspondence Neerja Saraswat, Department of Dermatology, Military Hospital, Agra, India. Email: [email protected]Search for more papers by this authorShobhit Goel, Shobhit Goel Department of Pathology, Military Hospital, Agra, IndiaSearch for more papers by this authorEeshaan Ranjan, Eeshaan Ranjan Department of Dermatology, Military Hospital, Jammu, IndiaSearch for more papers by this author First published: 10 July 2022 https://doi.org/10.1111/dth.15707Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume35, Issue10October 2022e15707 RelatedInformation

H-FABP as a diagnostic marker for early detection of young myocardial infarction among Indians.

It is of interest to document the point-of-care test using heart-type fatty-acid binding protein (H-FABP) in comparison with CK-MB, Troponin T and hsCRP. This is a more sensitive and specific cardiac biomarker than cTnT and CK-MB, and it has a higher diagnostic effectiveness for detecting early acute myocardial infarction (AMI). The case-control study enrolled 220 participants (110 myocardial infarction patients as cases and 110 healthy subjects as control) > 18 years of either sex after ethical clearance and informed consent form. The study conducted was conducted in the OPD and IPD of Medicine and Biochemistry Department at Moti Lal Nehru Medical College and Swaroop Rani Nehru Hospital Prayagraj, Uttar Pradesh; Index Medical College & Hospital, Malwanchal University, India. The amount of H-FABP, CKMB and cTnT was measured using the Sandwich ELISA method and hs-CRP was evaluated using the immune-turbidimetry method. H-FABP correlation with selected markers (CK-MB, hs CRP and TnT) and CK-MB was significant. A positive correlation (r=0.2 to 0.29) was found when H-FABP was compared with CK-MB (p<0.05). Similar positive correlation was found in CK-MB with cTnT. H-FABP is a useful cardiac marker for the early diagnosis of young AMI and thus prediction of myocardial injury is possible. H-FABP compared with CK-MB showed positive correlation. CK-MB with cTnT also showed statistically significant relation. Thus, H-FABP and CK-MB, as well as the correlation between CK-MB and TnT, reflects utility in early-stage diagnosis of myocardial injury.

To compare the effect of non-steroidal anti-inflammatory drugs (NSAIDS) and opioids in KNEE pain

Introduction: Osteoarthritis is a most painful condition mostly seen in old age people in knee and hip joints. This painful condition may causes change in physical activity and reduces quality of life. There are some topical and oral non steroidal anti-inflammatory drugs such as paracetamol, diclofenac sodium and opioid analgesic drugs tramadol. The main aims of the study compare the effect of NSAIDs and opioid analgesic in treatment of knee pain. Aim: To Compare The Effect of Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) and Opioid In Reducing Knee Pain. Materials and Methods: The present was conducted at Moti Lal Nehru Medical College, Prayagraj in orthopedics department. Total of 50 patients were included in the study aged 40-60 years. Results: Patients were prescribed with NSAIDs such as paracetamol prescribed to 4 patients, diclofenac 13 patients, ibuprofen 8 patients and opioid analgesic Oxycodone 07 patients, Acetaminophen/hydrocodone 14 patients and tramadol 04 patients. Patients were followed for every 15 days. On the 1st visit after prescribing paracetamol 0 patients were got relief from the pain, diclofenac 3 patients, ibuprofen 02 patients, Oxycodene 0 patients, Hydrocodene 04 patients, tramadol 01 patient.

SERUM TESTOSTERONE LEVELS IN CKD AND EFFECT OF ITS REPLACEMENT ON eGFR

Background: Testosterone deciency is common and impairs quality of life in patients with chronic kidney disease. However, there are very few studies about whether testosterone replacement therapy can improve quality of life in patients with chronic kidney disease. Therefore, the present study was designed to correlate the testosterone levels with the stages of chronic kidney disease and to observe the effect of testosterone replacement on eGFR. Methods: This is a prospective study, conducted in Moti Lal Nehru Medical College, Prayagraj and Tejas Microdiagnostics, from September 2017 to August 2022. Adult male patients, who were diagnosed with chronic kidney disease, were included while patients with diabetes and patients on maintenance hemodialysis were excluded from the study. Results: We included 100 diagnosed cases of chronic kidney disease however, 25 patients did not follow the study. Out of 75 patients 42.6% patients having serum testosterone level below 300 ng/dl, 42.6% were found to have serum testosterone levels in range of 300-400 ng/dl and 14.6% patients were having level above 400 ng/dl. Improvement in eGFR level of stage 3 and stage 4 were observed statistically signicant (p-value 0.03 &amp; 0.01 respectively). Staging of the disease improved after testosterone supplementation Conclusion: Present study clearly states that supplementation of testosterone in the patients with chronic kidney disease may leads to improvement in eGFR values and improves the staging of disease, consequently the quality of life. Further studies with more number of patients will clear the doubts about clinical benet and adverse outcomes of the therapy.

RHEUMATIC MANIFESTATIONS IN HIV PATIENTS IN TERTIARY HOSPITAL

Background: HIV infection is a common disease in India. Rheumatological manifestations ( RM) are very common in HIV infected patients. Rheumatological manifestations are signicant cause of morbidity in these patients. Aim &amp; Objective: To study the clinical spectrum of rheumatic diseases in HIV positive patients and correlate the above with CD4+ counts. Method &amp; Materials: This study was a cross-sectional study carried out in Motilal Nehru Medical College and associated hospitals, Prayagraj. This study was carried out on 104 patients with HIV. After obtaining informed consent, demographic characteristics and details of the diagnosis of HIV will be ascertained. Patients with self-reported history of previous diagnosis of HIV and those on treatment with anti-retroviral agents will be consider to have HIV would need to have further testing of HIV. After this the patients will go through needed investigations to fulll aims and objective of the study. Statistical analysis and interpretation of the data was done by using SPSS Software version 23. Result: This study was carried out on 104 patients with HIV. The mean (SD) of age (Years) of participant in my study was 38.95 (8.93). The maximum number of participants was in age group of 31 -40 years that were 36.5% of total case. The 54.8% of the participants were Male and 45.2% were Female. Patients with rheumatic manifestation, 6 (5.8%) of the participants had Arthritis/Arthralgia and 1 (1.0%) of the participants had Septic Arthritis and 1 (1.0%) of the participants had Osteomyelitis and 1 (1.0%) of the participants had Avascular Necrosis. 0 (0.0%) of the participants had Systemic Lupus Erythematosus and 2 (1.9%) of the participants had Rheumatoid Arthritis and 0 (0.0%) of the participants had Psoriatic Arthritis. Conclusion: The clinical spectrum of rheumatic disease in HIV patients was that, Arthritis/Arthralgia was most common rheumatic manifestation followed by Septic Arthritis and Osteomyelitis. Study showed that with increase in duration of ART regimen the incidence of rheumatic manifestation was decreases.

Myeloperoxidase and troponin T are linked with myocardial infarction among young Indians.

It is of interest to document the correlation of myeloperoxidase (MPO) and Troponin T (TnT) in young Indian patients with myocardial infarction using epidemiological data. A study with 220 (110 case and 110 control) participants with Acute Coronary Syndrome (both males and females) was completed. Patients were identified using a pre-designed PROFORMA at the OPD and IPD of the Medicine Department at the Index Medical College & Hospital, Malwanchal University and Moti Lal Nehru Medical College and Swaroop Rani Nehru Hospital in India. MPO and TnT were measured using the Sandwich ELISA (Sandwich Enzyme linked immunosorbent Assay) kit. TnT (pg/ml) (Mean ± SD) were high in the case group than control 134.7 ± 8.57 vs 96.6 ± 2.82; F = 145.9; t = 44.3; p < 0.01). Moreover, MPO was 3-fold high in case group than control (157±30.1 and 42.4±14.82, respectively). The differences was found statistically significant (p<0.001). This suggests a link between TnT and MPO among young Indian patients with myocardial infarction.

Study of Suicidal Death due to Hanging in District Prayagraj, U.P.

Hanging is one of the common methods of commiting suicide and it is considered suicide unless contrary is proved. The present study was conducted at the mortuary of Swaroop Rani Nehru Hospital associated with Moti Lal Nehru Medical College Prayagraj (U.P.), from 1st March, 2020 to 28th February, 2021. Total 299 cases of hanging were found in this duration. The different aspects of hanging cases like sex ratio, age group involved, ligature material used, position of knot, features of ligature mark, point of suspension, type of hanging and other Postmortem findings have been discussed in detail in this study.

A CONTINUED STUDY TO DERTERMINE THE ASSOCIATION BETWEEN CHRONIC KIDNEY DISEASE AND NON-ALCOHALIC FATTY LIVER DISEASE AND ITS EFFECT ON eGFR

Background: The present study was conduct in Motilal Nehru Medical College, Swaroop Rani Nehru Hospital Prayagraj, a tertiary care center and data was collected over a period from January 2019 to April 2020. All 78 patients of CKD attending OPD &amp; IPD of General Medicine and Nephrology, diagnosed by suggestive symptoms and conrmed by physical examination and laboratory investigations were taken , Among the subjects, those having NAFLD were grouped as cases. Patients of Chronic Kidney disease not having NAFLD were grouped as controls. Aim &amp; Objective: To study the prevalence of NAFLD in patients of CKD and establish the association between NAFLD and CKD by studying the effect of NAFLD on eGFR. Methodology: This was a 16 month case control study. Total 78 patients with age 18-65 years , Either sex with Chronic kidney disease diagnosed by USG, KFT, physical examination and having NAFLD Patients with known diagnosis of metabolic syndrome, diabetes and/or hypothyroidism. Those on hepatotoxic medication (amiodarone, barbiturates, glucocorticoids, etc.). The data so collected was entered into computer using Microsoft Excel 2013 software and was subjected to statistical analysis. Result : The ndings of present study thus reafrm the observations of previous studies that highlight a high prevalence of NAFLD in CKD patients and link it to the deranged metabolic factors. In present study we could not found a convincing evidence supporting a relationship between NAFLD and its severity with progression of CKD, probably owing to three major factors – rst, owing to Discussion 71 limitation of study population in only CKD stage 3 and secondly, owing to absence of retrospective data tracing the time of development of NAFLD in these patients and thirdly, inability to carry out long-time follow-up of patients. In present study, though minor changes in eGFR values in patients were seen, however, during the limited period of follow-up no shift from Stage 3 to other stages of CKD was observed. All the patients were regular in follow-up and had a good medical compliance and in general did not show a phenomenal deterioration in renal function within the short span of study. Keeping in view these limitations, further studies are recommended on a larger sample size with inclusion of patients from different stages of CKD spanning over a longer duration of follow-up to see whether NAFLD presence and its severity has a relationship with long-term progression of CKD. Conclusion: The present study showed that, CKD patients had a high prevalence of NAFLD. The ndings also show that FIB-4 scores are useful noninvasive methods for detection of NAFLD in CKD patients. The ndings showed a possible signicant association between NAFLD and lower eGFR rates. One of the limitations of the present study was presence of only Stage 3 CKD patients, owing to which the linear correlations between eGFR and NAFLD severity could not be assessed properly. Further studies on larger sample size with inclusion of patients with other CKD stages too are recommended.

Epidemiology and Outcome of Death Due to Burn Injuries –A Prospective Study

A burn is an injury which is caused by application of heat or chemical substances to the external or internal surfaces of the body, which causes destruction of tissues. Thermal deaths are those which result from the effects of systemic and/ or localized exposure to excessive heat and cold The present study has been carried out on 150(39 males and 111 females) cases of death due to burn, brought to the mortuary of Swaroop Rani Nehru Hospital, Moti Lal Nehru Medical College, Prayagraj for medico legal autopsy during the study period of one year extending from 01 July 2019 to 30 June 2020. Female outnumbered males i.e. 111(74.00%) females and 39(26.00%) males. Maximum number of burn deaths i.e., 56(37.33%) cases occurred in the young age group 21–30. Accidental burn injuries can be reduced by bringing about regulations to develop safer cooking appliances, promoting less inflammable fabrics to be worn at home and educating the community especially women.

Catching Gall Bladder Cancer Early- Importance of Cholelithiasis and Radiologist

Introduction: Increased relative risk of Gall Bladder (GB) cancer in patients with gall stones has been reported in literature but there are few reports on nature of stones. However, it is difficult to predict which patient suffering from cholelithiasis and cholecystitis may develop or already has early stages of carcinoma. Aim: The present study was undertaken to assess the malignant potential and relevance of gall stones, age and gender in GB carcinoma to propose a screening protocol and early intervention for high risk patients. Materials and Methods: This was a retrospective study done at Moti Lal Nehru Medical College, Prayagraj, Uttar Pradesh, India from May 2012 to May 2019. This study included 200 histopathologically- Fine Needle Aspiration Cytology (FNAC) or postoperative specimen biopsy proven GB carcinoma and 200 control patients with upper abdominal pain but without any evidence of neoplastic changes on USG. All cases and controls were subjected to USG evaluation first followed by plain CT scan with oral contrast only and Contrast Enhanced CT (CECT) scan of whole abdomen as per protocol. Scans were evaluated for detection of gall stone profile in terms of number (solitary/multiple), size (small/large) and density (radio-opaque/ radiolucent). The statistical analysis was done by using IBM Statistical Package for the Social Sciences (SPSS) version 18.0. Results: Male to female ratio in this study was 1:2. GB calculi cannot be considered as bystander as overall 25% patients of both sexes had cholelithiasis. In the present study, 25% who were having carcinoma GB have been detected to have gall stones and out of which 74% were having small calculi. The study showed the association between GB cancer and solitary and multiple large calculi over different age groups to be not statistically significant (p-value=0.3976; χ2=0.716). Association of small and multiple calculi came out to be highly significantly associated with carcinoma in 67% of patients. Furthermore, it was observed that the association between multiple small calculi and GB cancer over the different age groups came out to be extremely statistically significant (p-value=0.0001; χ2=28.62). The association between gall stones in GB cancer patients differ statistically significant over the age groups from cases with gall stones in control group (p-value=0.005497; χ2=7.7082). Conclusion: From the findings of the study author proposed screening via ultrasound and guided FNAC for females over 40 years of age with multiple small calculi not undergoing immediate cholecystectomy to detect early emergence of carcinoma. It is also suggested that clinicians should post patients with multiple, small GB calculi for cholecystectomy on a priority basis and histopathology should be done in each case of GB wall thickening.

Predictive value of C - reactive protein levels during pregnancy in adverse pregnancy outcomes: One year study at Swaroop Rani Nehru Hospital &amp; Kamla Nehru Hospital (Motilal Nehru Medical College Allahabad)

Objective: To evaluate the association, if any, between serum CRP levels in first and early second trimester of pregnancy and adverse pregnancy outcomes. Materials and Methods: The present study was carried out in 300 antenatal cases attending the department of Obstetrics and Gynaecology at Swaroop Rani Nehru Hospital & Kamla Nehru Hospital (Motilal Nehru Medical College Allahabad), over a period of one year. Inclusion Criteria: Pregnant women < 20> Exclusion Criteria: Multiple gestation, previous H/O PTL or mid trimester abortions, endocrine disorder, medical illnesses, HIV infection and substance abuse. Serum C-Reactive protein levels were tested and the participants were divided into 2 groups. Group1 included all pregnant ladies with CRP level > 5mg/L (Study Group) and Group2 with CRP level < 5mg> Result: Raised level of serum CRP had positive correlation with adverse pregnancy outcomes and effect of elevated CRP level was maximum on PPROM (p value-0.002), preeclampsia (p value-0.004) and low birth weight (p value-0.002). Elevated CRP had no significant impact on still birth (0.06). Conclusion: Early detection of higher level of serum CRP in pregnancy can be used as predictor of inflammation and may help in early intervention and follow up of the patients to minimize adverse maternal and fetal complications. Keywords: C - reactive protein, Preterm labour, Fetal growth restriction, Preeclampsia, Low birth weight, Still births.

Prospective study on outcome and advantage of primary skin grafting in cases of avulsion scalp injury following trauma

Background: Traumatic avulsion injury poses severe risk as the overlying protective covering is lost and the raw tissue is exposed to the environment. Avulsion injuries involving the scalp are even more complicated to treat because of significant cosmetic concern involved. Aim of the study was to find a better solution than the existing method, we conducted a prospective study involving 13 patients with isolated traumatic scalp avulsion injury.Methods: This prospective study was conducted in Motilal Nehru Medical College and associated Swaroop Rani Nehru Hospital, Prayagraj, after taking written and informed consents from the patients, between June 2017 and June 2019.These were divided into two groups (A and B) based on whether the underlying periosteum was intact or not.Results: Patients with intact periosteum (Group A) underwent primary thin thickness skin grafting within a few hours of their admission while the other group (Group B) was treated with a traditional conservative approach. We compared the results of both the groups and found that Group A patients not only had satisfactory graft uptake (≥85 TBSA) but also had significant decreased risk of infection, lesser hospital stay, overall decreased healthcare cost, better cosmoses and early return to routine activity.Conclusions: For the surgeon, this single step procedure is safe and technically easy. Thus this approach was found to be superior than the current traditional approach.