Navodaya Medical College Research Articles

Efficacy of autologous platelet rich plasma injection in plantar fascitis

Background and Objectives: Platelet-rich plasma has been used in sports medicine, for cartilage degeneration and chronic enthesopathies like plantar fasciitis. Platelet-rich plasma exhibited the biological healing capacity. Methods: The study was conducted from December 2019 to December 2021, patients at the department of orthopedics at Navodaya Medical College and Research Center, Raichur. Approval was taken from ethical committee. 30 patients were selected based on the inclusion criteria and exclusion criteria. Platelet rich plasma injection intralesionally given to all patients. All patients are evaluated with the use of a numerical pain score. Results: The numerical pain scоre wаs аssessed at the time of injection. The mean numerical pain score of all patients was 8.52 in plantar fasciitis. The mean numerical pain score for plantar fasciitis at 0, 1, 2, 4, and 6 months was 8.52, 4.15, 2.38, 0.61, and 0.33, respectively. From the аbоvе dаtа, it can be concluded that раtient receives mаximum relief оf sуmрtоms аt the fourth month аnd is sustained until sixth mоnth. Conclusion: In this study, we observed that platelet-rich plasma has significantly better results in safe and effective plantar fascitis. This was observed maximum at 4 months and sustained for atleast 6 months.

Comparison of Dermoscopic Findings of Chronic Hand Eczema and Palmoplantar Psoriasis: A Cross-sectional Study

Introduction: Differentiation between Chronic Hand Eczema (CHE) and Palmoplantar Psoriasis (PP) is a diagnostic challenge. Dermoscopy can helpto distinguish between the two conditions. Aim: To establish and compare the dermoscopic findings of the CHE and PP using DermLite DL4 dermoscope and to confirm the accuracy of the dermoscopic findings with the histopathological findings. Materials and Methods: A cross-sectional study was conducted at Navodaya Medical College, Hospital and Research Centre, Raichur, Karnataka, India, from January 2017 to June 2018. Fifty patients each of CHE (26 male and 24 female subjects) and PP (25 male and 25 female subjects) were included in the study. A detailed clinical history, cutaneous clinical and dermoscopic findings of each case were noted. A 4 mm punch biopsy was taken from 30 patients for histopathological analysis. The data was tabulated, analysed and tested for significance using the Chi-square test. Results: The mean age of the patients was 46±4 years. On dermoscopic examination, diffuse white scales in 45 (90%) patients, over a red background in 49 (98%) patients with regularly arranged dots and globules in 45 (90%) patients was seen in PP. Patchy yellow scales 46 (90%), yellow dots, globules and yellow to brown crusts against a yellow background was seen in all patients (100%) of CHE (p-value <0.001). Histopathological findings are in agreement with dermoscopic findings in 9/16 and 10/14 cases of CHE and PP respectively. Conclusion: Dermoscope is a useful non invasive clinical aid to differentiate between CHE and PP. The presence of diffuse white scales over a red background and regularly arranged vessels indicates PP, whereas the presence of patchily distributed yellow scales, yellow dots and globules; and yellow to brown crusts against a yellow background is more suggestive of CHE.

Functional outcome of tension band wiring in transverse patella fracture

Background: Patellar fractures constitute about 1% of all skeletal injuries resulting from either direct or indirect trauma. The subcutaneous nature of the patella makes it vulnerable to direct trauma, whereas violent contraction of the quadriceps results in indirect fractures of the patella. Patella is the largest sesamoid bone in the body and forms an integral part of the extensor mechanism of the knee joint. The functional outcome of patella fractures depends on age, the severity of the injury, treatment modality, anatomical reduction and restoration of articular congruity, post-operative rehabilitation. The study aims to assess the functional outcome of tension band wiring in transverse patella fracture. Materials and Method: This study was carried out at the Department of Orthopaedics, Navodaya Medical College, Raichur over a period of 2 years. In this study, 30 patients (23 male, 7 females) with transverse patella fracture were admitted and were treated by tension band wiring. Functional outcome was assessed as per knee pain score, good fellow grading for a range of motion. Results: A total of thirty patients were evaluated in our study, of which there were 23 males and 7 females. Out of which 24 patients had excellent results, 4 had good results and 2 had fair results. At the end of the 6th month, the majority of patients show excellent results according to good fellow grading range of motion. Conclusion: The tension band wiring is safe and effective in the management of transverse patella fracture because of the good stability of the implant and easier postoperative rehabilitation.

Assessment of Drug-Related Problems in Chronic Disease Patients in a TertiaryCare Teaching Hospital

Introduction Drug-related problem is an undesirable event experienced by a patient associated with drug therapy that interferes with achieving the specified goals of therapy. Drug-related problems are usually seen in chronic disease patients who are taking a greater number of medicines as a part of their therapy. Thus it is necessary to assess these problems.Objective To collect information regarding drug-related problems occurring in chronic disease patients in different wards of the hospital and to identify its potential causes.Methodology A prospective observational study was conducted for six months in Navodaya Medical College Hospital amp Research Centre involving 160 participants. Data were collected from the case sheets using data entry forms from all the hospitalized patients who were diagnosed with chronic diseases in the hospital during the study period.Results In this study most of the problems were observed in patients aged above 60 years. The antihypertensive agents were producing 31 of the problems during drug therapy. Thirty six percent of the study population was experiencing untreated symptoms. In this study 38 of the study population experienced incomplete drug treatment despite existing indications.Conclusion The study points the necessity for improved practices in appropriate prescribing to scale back the drug therapy problems in chronic disease patients. The study will help in reducing the issues in chronic disease patients.nbsp

Screening for various non communicable diseases: a community based multi-diagnostic mega camp approach study from Raichur, Karnataka

Background: The 77% of all non-communicable illnesses (NCDs) deaths are in low-and middle-income countries. Cardiovascular diseases account for most NCD deaths, or 17.9 million people annually, followed by cancers (9.3 million), respiratory diseases (4.1 million), and diabetes (1.5 million). These 4 groups of diseases account for over 80% of all premature NCD deaths. Objective was to study prevalence of NCDs and its trends with respect to age and gender.Methods: The present community based descriptive observational study was conducted at Navodaya medical college hospital and research centre, Raichur that caters Urban and rural area of Raichur. The 4063 apparently healthy population from urban and rural part of Raichur were screened during the multi diagnostic mega camp at urban and rural areas around Raichur during the period of January to September 2021. Results: Prevalence of diabetes in our study was 46.3%, hypertension 45.3%, cataract 46.3% and COPD as 20.7%. Prevalence of diabetes was more in 41-60 years i.e., 41.6%. Prevalence of hypertension was more in 41-50 years i.e., 25.3%. Prevalence of diabetes was more in males i.e., 54.1%. Prevalence of hypertension was more in males i.e., 50.8%.Conclusions: Prevalence of all NCDs was more in above 40 years and more in males except COPD.

A STUDY ON VISUAL PROGNOSIS IN LENS INDUCED GLAUCOMAAFTER MEDICAL & SURGICAL MANAGEMENT.

OBJECTIVE:To assess the visual prognosis in lens induced glaucoma after medical & surgical management. MATERIALS AND METHODS: This is a prospective study on patients with LIG attending OPD in department of Ophthalmology at Navodaya medical college hospital and Research centre & willing to participate this study. RESULTS:In all the 100 cases of LIG included in the study, the lens was removed & depending upon the condition IOLwas implanted. Majority of the patients were having IOPin the range 31-50mmHg (64%), post-operative IOPreduced to normal in most of the cases. As the duration of attack increases the best corrected V/Adecreases. In present study when duration of attack <10 days, 90% showed best corrected V/Abetter than 6/60 but in cases with longer than >10 days, 40% showed V/Abetter than 6/60. CONCLUSION: Despite high IOP at the initial presentation in cases of LIG, IOP came down to normal limits after lens extraction. The results of LIG in response to visual recovery & IOPcontrol are quite satisfactory & encouraging.

ROLE OF ABSOLUTE EOSINOPHIL COUNT AS A MODALITY OF INVESTIGATION IN SUSPECTED CASES OF HELMINTHIC INFESTATION IN CHILDREN AGED BETWEEN 5 TO 15 YEARS WITH COMPARISON TO STOOL ROUTINE AND MICROSCOPY

Introduction: Eosinophilia is a well-known host immune response in helminthic infestation. This study was carried out to investigate whether a correlation exists between absolute eosinophil count in children with stool specimen positive for helminthic infestation. Aim And Objective: To determine average raised absolute eosinophil count in children who were having various helminthic infestation with stool specimen positive. Materials And Methods: A hospital based cross sectional study done at Navodaya medical college hospital and research centre during 2019 October to 2020 September for a period of 12 months. Both blood and stool samples were obtained from a total of 69 suspected children after examined, categorised into 2 groups. Among them 24 cases were positive of helminthic infestation and 45 cases were negative. T-test and descriptive statistics were used to analyse the data. Results: The study revealed that children infested with helminths found to have higher absolute eosinophil count (mean 4644/µl (95%CI; 3474-4212) than not infested (mean 801/µl (95%CI; 616-945) with p value <0.001. In this helminth's family; nematodes, trematodes, cestodes showed mean values of absolute eosinophil count were 5206/µl (4806-7151/µl), 4930/µl (4500-5382/µl) and 2179/µl (2500-1669/µl) respectively. Conclusions: Raised absolute eosinophil count has been observed in stool specimen positive cases of helminths, especially more in nematodes. Therefore, should be considered for a single dose of albendazole.

SPO2/FIO2 RATIO AND TRIAGE SCORE IN PREDICTING OUTCOME OF CRITICALLY ILL CHILDREN

Introduction: Non-invasive nature of pulse oximetry allows much affordable, rapid assessment of degree of hypoxemia and helps in identication of the patients at risk. Mortality in a pediatric intensive care unit (PICU) depends on the severity of illness. A good scoring system for identifying the severity of illness can help to prioritize care. Triage is sorting out of patients, the main objective of which is early patient assessment to obviate harmful delay in the management. Aims And Objectives: To predict the outcome of critically ill children in pediatric ICU by using the Triage scoring system and Spo2/Fio2(SF) ratio. Materials And Methods: A hospital based prospective observational study done at Navodaya Medical College Hospital & Research Centre during January 2020 to June 2021 for a period of 18 months. A total of 125 children were studied. Data is described in terms of mean (+SD), frequencies (number of cases) and percentages. Statistical analysis was done using SPSS software version 26. Results: Out of 125 children studied, 8 died. Except temperature, all other variables showed signicant association with mortality (p <0.001). Mortality was 0%, 4.88%, 28.57%, 75%, 25% and 50% for scores of 0, 1, 2, 3, 4 and 5 respectively. Children of score 3 or more had signicant high mortality. Among the 113 subjects who survived, mean SpO2/FiO2 ratio is 340 and among 12 subjects who died, SpO2/FiO2 ratio is 184. SpO2/FiO2 ratio is less among the children who died and can predict mortality. Conclusions: Many deaths in under ve children occurring in hospitals can be prevented if triage is followed, if any sick children are identied soon on their arrival and treatment is started immediately. SpO2/FiO2 ratio is a non-invasive and reliable tool for hypoxemia screening and predicting outcome among patients admitted to the ED.

Study of functional outcome of cemented modular Bipolar Hemiarthroplasty in Intracapsular fracture neck femur in elderly

Introduction: The fracture neck of femur is one of the most common fractures in the elderly. The time-tested unipolar prosthesis is being slowly replaced by bipolar prostheses, which are claimed to have a lower incidence of complications. In the last two decades, bipolar replacements of the femoral head have gained popularity for treating femoral neck fractures. This study was conducted to analyse the results of the surgical management of the fracture neck of femur using cemented modular bipolar hemiarthroplasty.Objective: To assess and analyse the results of the management of fracture neck of femur with cemented modular bipolar hemiarthroplasty.Methodology: The present study was a prospective study of 22 cases of fracture neck of femur admitted to Navodaya Hospital, attached to Navodaya Medical College, Raichur, between the study period of Sept 2019 to May 2021. Cases were selected according to inclusion and exclusion criteria, i.e., patients with intra-capsular fracture neck of femur above the age of 50 yrs. Medically unfit patients and patients not willing for surgery were excluded from the study. Follow up was done after 6 weeks and for further at 3 months, 6 months, 9 months, and 1 year.Results: In our series of 22 cases there were 7 males and 15 females, with a maximum age of 85 yrs, minimum age of 55yrs. There was a slight predominance of left sided fractures when compared to the right. The mean duration of hospital stay was 22 days. At the final one year follow up assessment with Harris Hip Score 8 patients (36.36) achieved 'Excellent' result, 11 patients (50%) achieved 'Good' result, 2 patients (9.09%) achieved 'fair' result and 1 patients (4.54%) achieved 'poor' result. In our series, at the end of final follow-up, there was no evidence of loosening, radiolucent zones, distal migration or subsidence of prosthesis.Conclusion: We conclude that bipolar cemented modular hemiarthroplasty produces good functional outcomes with minimal complications for displaced intracapsular femoral neck fractures and has several advantages; these results are comparable to the other studies. However long term results using cemented modular bipolar hemiarthroplasty needs further study for a longer period in a larger sample.

Distal tibia metaphyseal fractures treated with minimally invasive percuatneous plate osteosynthesis

Background: Tibia is the most commonly fractured bone amongst all long bones of the body. Fractures of the distal tibia are unique as the bone is subcutaneous with decreased muscular cover and decreased vascularity. Minimally invasive percutaneous plate osteosynthesis is a technique which is based upon the principles of limited soft tissue stripping, maintenance of the osteogenic fracture hematoma, and preservation of vascular supply to the individual fracture fragments while restoring the axial and the rotational alignment, and providing sufficient stability. Materials and Methods: This study was carried out at the Department of Orthopaedics, Navodaya Medical College Hospital and Research Centre, Raichur between the period Dec 2019 to Oct 2021. In this study, 30 patients with Distal Tibia Metaphyseal fracture were admitted at Navodaya Medical College Hospital and Research Centre, Raichur and examined according to protocol. The patients underwent Minimally invasive percutaneous plate osteosynthesis with Locking Compression plate. All cases were assessed using the IOWA ankle score and TEENY WISS radiological scoring. Results: The average fracture healing time was 16 weeks (range 12–20 weeks). According to the IOWA ankle score, excellent results were found in 16 (53%) patients, Good results were found in 11(37%) patients and fair results were found in 3(10%) patients. Superficial infection occurred in 5 patients (16%), no cases of deep infection, implant failure and malunion. Conclusion: Minimally invasive percutaneous plate osteosynthesis proves to be a safer technique in the management of Distal tibia metaphyseal fractures by providing good fracture healing, enabling rapid functional recovery, and avoiding major skin complications.

Prevalence of subclinical hypothyroidism in metabolic syndrome: our experience from Karnataka

Background: Metabolic syndrome is a collection of factors which can increase the risk of heart disease, stroke and diabetes. Subclinical hypothyroidism is a state of mild thyroid failure. There are few factors which increase the risk for developing subclinical hypothyroidism such as female gender, advanced age and greater dietary iodine intake. Subclinical hypothyroidism as it is more common than overt hypothyroidism. Objectives were to study prevalence of subclinical hypothyroidism in patients of metabolic syndrome and its association with demographic and clinical parameters.Methods: This cross-sectional observational study was conducted on patients attending General Medicine OPD and in-patients admitted at Navodaya Medical College and Hospital, Raichur including 103 cases of metabolic syndrome. The data was analyzed using statistical package for the social sciences (SPSS) 24.0 version.Results: Prevalence of subclinical hypothyroidism in our study was 30.1%. Majority were from 41-50 years age group i.e., 9 (29%) and majority were females i.e., 17 (54.8%). We did not find any association between Subclinical hypothyroidism and gender (p>0.05). Prevalence of overweight in our study among SCH was 35.5% compared to 18.1% of normal patients. Elevated levels of TG were observed in 64 i.e., 62.1%, elevated TC 23.3%, elevated levels of LDL in 30.1% patients.Conclusions: Prevalence of subclinical hypothyroidism in our study was 30.1%. Majority were from 41-50 years age group i.e., 29% and majority were females i.e., 17 (54.8%). We did not find any association between subclinical hypothyroidism and body mass index (BMI) in our study.

Effect of vitamin D levels in benign paroxysmal positional vertigo

<p class="abstract"><strong>Background:</strong> Benign paroxysmal positional vertigo (BPPV) is a common cause of disabling vertigo with a high rate of recurrence. BPPV is the most common cause of neurotological disorder. It is caused by dislodged otoconia which fall from the utricular macula and float into the semicircular canals there by making them sensitive to gravity. It has been shown that elderly people may suffer from unrecognized, chronic BPPV. Patients with unrecognized BPPV were more likely to have reduced activity of daily living scores, to have sustained a fall in the previous 3 months and to have depression.</p><p class="abstract"><strong>Methods:</strong> A prospective study of 100 patients with clinical diagnosis of BPPV visiting Navodaya medical college and hospital between June 2019 to May 2020 were included in the study.</p><p class="abstract"><strong>Results:</strong> Patients taking both vitamin D supplementation and rehabilitation therapy improved better than patients taking rehabilitation therapy alone.</p><p class="abstract"><strong>Conclusions:</strong> Both rehabilitation therapy and supplementation of vitamin D is helpful in patients with vitamin D deficient BPPV patients.</p>

HYPERBILIRUBINEMIA AS AN INDICATOR IN PERFORATED APPENDICITIS

Introduction: Acute appendicitis is one of the most common causes of urgent admission to the hospital.In appendicitis, elevated intra-luminal pressure and ischemic necrosis of mucosa causes tissue gangrene or perforation. This leads to cytotoxin facilitated progressive bacterial invasion or translocation into the hepatic parenchyma through portal system. This phenomenon interferes with the bilirubin excretion into the bile canaliculi. The rate of misdiagnosis of appendicitis and the rate of appendicular perforation has remained constant, inspite of increased use of ultrasonography, computed tomography scanning and laparoscopy. Among commonly used inammation markers of Acute appendicitis, bilirubin concentration is not well studied and thus is rarely applied. Every investigation that can contribute towards a diagnosis of appendicitis is valuable to the emergency general surgeon Aim: 1. To study the relationship between hyperbilirubinemia and acute appendicitis; and to evaluate its credibility as a diagnostic marker for acute appendicitis. 2. To evaluate whether elevated bilirubin levels have a predictive potential for the diagnosis of Appendicular perforation. Material and methods: The study was conducted in the Department of General Surgery, Navodaya Medical College & Research centre, Raichur during the period of January 2020 to December 2020.Patients admitted with clinical diagnosis of acute appendicitis or appendicular perforation under the Department of Surgery, Navodaya Medical College & Research centre, Raichur during the study period. A total of 100 patients with clinical diagnosis of acute appendicitis or appendicular perforation were studied. Results: .Normal bilirubin values were seen in 26% patients while, 74% had raised bilirubin levels (Hyperbilirubinemia). Of 81 patients with acute appendicitis, 71.6% had raised bilirubin levels, while 28.4% had normal levels. 19 patients were diagnosed as Appendicular perforation, 16 patients (84.21%) had raised bilirubin levels, while the remaining 03 patients (15.79%) had normal levels.Amongst the patients diagnosed with Acute appendicitis without perforation (n=81), 58 patients (71.6%) were found to have elevated bilirubin (>1.0 mg/dL) while only 23 patients (28.4%) had normal bilirubin levels (≤1.0 mg/dL). In patients diagnosed with Appendicular perforation (n=19), 16 patients (84.21%) had bilirubin elevated (>1.0 mg/dL), while only 3 patients (15.79%) had normal levels (>1.0 mg/dL). Thus, Hyperbilirubinemia was found in most of the patients diagnosed with acute appendicitis (71.6%) or Appendicular perforation (84.21%). Conclusion: The present study suggests- Serum bilirubin levels appears to be a promising new laboratory marker for diagnosing acute appendicitis, however diagnosis of appendicitis remains essentially still - clinical. Its level come out to be a credible aid in diagnosis of acute appendicitis and would be helpful investigation in decision making. Patients with clinical signs and symptoms of appendicitis and with hyperbilirubinemia higher than the normal range should be identied as having a higher probability of Appendicular perforation suggesting, serum bilirubin levels have a predictive potential for the diagnosis of Appendicular perforation.

Prescribing Patterns of Drugs in Geriatric Patient

A prospective observational study on prescribing pattern of drugs in the geriatric patients was conducted in Navodaya Medical College Hospital and Research Centre. The present study aimed to study prescribing patterns of various drugs in elderly patients and to evaluate inappropriate prescribing with the help of beers criteria. A total of 100 patients of geriatric age group(>/65 years) was included in the study for the period of 3 months of which, most of the patients were in the age group of 65-70 years (79.24%), out of which 52 were male and 48 were females. Maximum subjects were prescribed with antibiotics and proton pump inhibitors followed by analgesics. A minimum of 5 drugs were prescribed in 46 cases, followed by 5-8 drugs in 36 cases, then more than 8 drugs were prescribed in around 18 cases. Based on beers criteria 23 patients received potentially inappropriate prescription of at least 1 drug and all these belongs to category A. The study concluded that there is need for careful application of the criteria by health care professional, consumers, payers and health systems should lead to closer monitoring of drug use.
 Keywords: Prescribing pattern, geriatrics, beers criteria, antibiotics, analgesics.

Study on specific species of malaria in relation to haematological changes

Background: As malaria is a potential medical emergency, prompt and accurate diagnosis is criticalfor its effective management. Conventional microscopic examination of peripheral thick and thinblood smear examination remains the “gold standard” for malaria diagnosis. Material: A 2 yearprospective study from 2011 to 2013 was conducted at Navodaya Medical College Hospital andResearch Centre, Raichur. The study comprised of a total number of 150 cases positive for Malaria,collected from above mentioned centre and those referred from peripheral referral centres. Clinicalhistory regarding age, sex, nature and duration of illness were elicited. Blood sample forhaematological study was taken before starting anti-malarial drugs in all these cases. Result: Out oftotal cases, P. vivax infected cases (62%) were common than P. falciparum (34%) and mixedinfection cases [PV & PF] (4%). Most common presenting symptom of cases affected by PV, PF andmixed infection were fever and chills & rigors and least common symptom was cough. Mostimportant haematological changes observed were anaemia and thrombocytopenia (77.3% each) andleucopenia (31.3%). All the above mentioned changes in haematological parameters were speciesspecific and statistically significant, except for red cell indices, DLC and ESR. Conclusions: Inconclusion, changes in haematological profile can help in early diagnosis of specific species ofmalaria for timely and appropriate treatment that can reduce the severity and prevention ofadditional consequences.

Clinico-haematological Profile in Acid Fast Bacilli Positive Pulmonary Tuberculosis Patients at Tertiary Care Centre in Raichur, Karnataka

Introduction: Tuberculosis (TB) is a major public health problem in India and it remains an epidemic, affecting one third of the population. It manifests with diversified haematological manifestations of varying severity like anaemia, leukocytosis, thrombocytosis and raised erythrocyte sedimentation rate levels. Therefore, monitoring clinical and haematological alterations in sputum positive Pulmonary Tuberculosis (PTB) patients necessitates the need for deliberation of supportive care and varied treatment options that would amplify the treatment outcome. This study was carried out to explore the early changes and the relationship between the social risk factors like smoking, alcohol intake and the haematological profile of TB patients which will help in early identification of altered haematological parameters and in minimising the risk of transmission among susceptible population. Aim: To do analysis of various haematological manifestations in sputum positive PTB patients and to evaluate diagnostic and prognostic significance. Materials and Methods: A prospective study was conducted over a period of six months between November 2019 to April 2020 on 50 PTB patients referred by Department of Respiratory Medicine, Navodaya Medical College, Raichur. Patients who were on Anti-Tubercular Treatment (ATT), extra-PTB patients, pregnant women and those with any other major co-morbid condition were excluded from the study. All patients were thoroughly examined clinically and investigated with plain chest x-ray, complete blood count; ESR, PS examination and sputum for acid-fast bacilli stained with Ziehl-Neelsen (Z-N) stain and AFB grading charts were used according to Revised National Tuberculosis Control Programme (RNTCP). Data collected was analysed by SPSS software version 16.0 and Chi-square test was used to calculate the sample size. Results: Of total 50 cases of PTB, there were 30 males and 20 females and mean age of patient was 44 years. Commonest haematological parameters raised were ESR (48 cases; 96%) followed by anaemia (45 cases; 90%), neutrophilia (36 cases; 72%), leukocytosis (24 cases; 48%) and thrombocytosis (12 cases; 24%). The frequent peripheral smear picture was Microcytic Hypochromic Anaemia (MHA) (27 cases; 54%) followed by normocytic normochromic anaemia (21 cases; 42%) and least common was macrocytic anaemia (2 cases; 4%). There was significant improvement in all haematological parameters after three months of treatment, with sputum conversion of PTB cases (75%). Conclusion: TB can lead to heterogenous and diversified haematological abnormalities like anaemia, leukocytosis, neutrophilia, thrombocytosis and raised ESR. These haematological parameters can be a guide to assess the improvement of TB patients after ATT which indirectly speaks about the improvement in immune response.

Low Dose Vaginal Misoprostol in the Mangement of Intrauterine Fetal Death: Two Years Retrospective Study at Navodaya Medical College, Raichur

Introduction: Management of intrauterine fetal death (IUFD) poses dilemma for obstetrician.1 Options for health care are either to await for spontaneous labour or to induce labour.2 Medical consequences of postponing delivery can be significant in view of complications like disseminated intravascular coagulopathy or haemorrhage and even maternal death. Aims and Objectives: To evaluate effectiveness and side effects of repeated vaginal administration of small doses of misoprostol in termination of second and third trimester pregnancies.1 Methods: This study carried out on 100 women with IUFD in second and third trimester pregnancies collected from NMC Medical college, RAICHUR, from October 2017 to October 2019. Patients history taken, physical examination, Bishop scoring assessed. 25µg of misoprostol in the posterior fornix of vagina was placed every 4th hourly over 24 hours. The progress, and outcomes were assessed. Results: The success rate was 92.76% and 64.52% in women with third and second trimesters respectively. The mean induction-delivery interval was 15.67+9.64 and 24.94+8.23. The induction delivery interval correlated negatively with the duration of gestation age. The mean value x of total required dose of misoprostol was 192.42 +128.99 and 361.29 + 139.92 for 2nd trimester and 3rd trimester women. Conclusion: Low dose Misoprostol appears safe, effective, practical and inexpensive method for termination of third trimester pregnancies compared to second trimester pregnancies complicated with Original Research Article Indian Journal of Obstetrics and Gynecology Volume 8 Number 4, October–December 2020 DOI: http://dx.doi.org/10.21088/ijog.2321.1636.8420.7 intrauterine fetal death and its effects increases with duration of gestation.

Prevalence of anencephaly associated anomalies

Introduction: Defective closure of rostral pore of neural tube leads to anencephaly. Folic acid deficiency is most common cause anencephaly. In most of the cases of Anencephaly is associated with other systemic anomalies. Objectives: Aim of present study was to find out the incidence of anencephaly associated systemic anomalies and their correlation with maternal age, sex of the foetus. Materials and Methods: 32 anencephaly foetuses obtained from the Department of obstetrics and gynaecology Navodaya Medical College. The period of study was from January 2013 to December 2016. Results: Out of 32 cases, 25(78.12%) cases showed presence of systemic anomalies associated with anencephaly, 53.12% of the cases were observed in primigravida. Most common associated anomaly was spinabifida 28.12% followed by gastrointestinal anomalies 6.25%. Conclusion: Incidence of anencephaly associated anomalies is not uncommon; hence gross systemic examination of the anencephalic abortus is required to find out incidence of anencephaly associated anomalies. Keywords: Anencephaly, Craniospinal rachinoschisis, Exomphalos, Spina bifida.

A comparative study of efficacy of resurfacing with fractional carbon dioxide laser versus derma roller in the treatment of post acne scars

<p class="abstract"><strong>Background:</strong> Acne vulgaris is a chronic skin disease which can present as non-inflammatory lesions, inflammatory lesions, or a mixture of both, resulting in distressing and difficult to treat scars. The objective of this study is to compare the efficacy of fractional carbon dioxide (CO<sub>2</sub>) laser technique (FCLT) versus derma roller therapy (DT) with respect to post-acne scars and to study their respective side effects.</p><p class="abstract"><strong>Methods:</strong> A total of 200 patients of post acne scars were enrolled for this study from the outpatient Department of Dermatology, Venereology and Leprology, Navodaya Medical College Hospital and Research Centre, Raichur. The patients were randomly allocated into two groups of 100 patients each in which one group was treated with derma roller therapy and the other group was treated with fractional CO<sub>2</sub> laser every 4 weeks over a period of 24 weeks each.<strong></strong></p><p class="abstract"><strong>Results:</strong> In the derma roller group, 89 patients completed the treatment with 11 drop out cases. The percentage reduction in the mean objective scores was found to be 37.63%. In the fractional CO<sub>2 </sub>laser group, 93 patients completed the treatment with 7 drop out cases. The percentage reduction in mean objective scores was found to be 41.22%.</p><p class="abstract"><strong>Conclusions:</strong> Comparing the efficacy of derma roller therapy and fractional CO<sub>2</sub>laser resurfacing method in the treatment of post acne scars, both the modalities were found to be equally efficacious.</p>

The study of Cellulitis in non-diabetic

Lower limbs are commonly involved in cellulitis as they are more susceptible to injuries. This study analyzes the various causes and risk factors for cellulitis in the non-diabetics. Methods: This prospective study was conducted at the Department of General Surgery, Navodaya Medical College and included 100 non-diabetic patients with cellulitis. The severity of cellulitis was graded as per the CREST guidelines. Demographics, risk factors, grades, management and treatment outcomes were recorded and analyzed.Results: Cellulitis was more common in females (56%) and old age group (39%). It was more unilateral (87%) and resulted more from post bite wounds (22%). 76% had culture-positive wound infections. Severe grades of cellulitis needed surgical intervention and many patients needed skin grafting.Conclusions: Non diabetic patients with lower limb cellulitis can also result in severe morbid consequences but in the absence of co-morbid illness, they usually recover with minimal residual disabilities. Non diabetic elderly patients have to be motivated to take care of their feet as the diabetic patients, as neglect of minor trauma or bites can lead to morbid illness necessitating major treatment like skin grafting.