Nehru Hospital Research Articles

Quasi-experimental study on effect of ‘clutch hold’ method of breast feeding on comfort level of post cesarean mothers admitted in obstetrics units of Nehru Hospital, Pgimer, Chandigarh

Statement: A Quasi-Experimental Study on Effect of ‘Clutch Hold’ Method of Breast Feeding on ‘Comfort Level’ of Post Cesarean Mothers Admitted in Obstetrics Units of Nehru Hospital, PGIMER, Chandigarh. Objectives: Main Objective- To study the effect of ‘clutch hold’ method of breast feeding on comfort level of post caesarean mothers. Sub-objectives- 1) To select tool and use it to measure comfort level in caesarean mothers while breast feeding. 2) To develop protocol of clutch-hold method for breast feeding and use it among experimental study subjects. 3) To assess and compare the findings. Methodology: A quasi- experimental research approach was used with cross-over study design. Population was 76 cesarean mothers who met the inclusion criteria and were admitted in obstetrics unit of Nehru Hospital, PGIMER, UT, Chandigarh (India). Result: The present study revealed that that comfort level in post caesarean mothers while breast feeding is independent of methods of breast feeding as it is evident by ‘p’ value 0.122, i.e., ‘p’ value is not significant. Mothers who were exposed to ‘clutch-hold’ & ‘cradle-hold’ methods of breast feeding after caesarean section, experienced no significant difference on comfort level while breast feeding.

Incidence and outcomes of acute kidney injury in term neonates with hypoxic ischemic encephalopathy: an observational study

Background: Hypoxic ischemic encephalopathy (HIE) is one of the devastating birth related complication. It predisposes the babies to serious outcomes, an important one being acute kidney injury (AKI).Methods: A prospective crossectional observational study was conducted in Jawaharlal Nehru Medical College and Hospital, AMU, Aligarh between November 2019 and October 2020. 153 term neonates with perinatal asphyxia were enrolled. HIE staging and AKI staging done according to Sarnat and Sarnat classification and KDIGO classification respectively. Outcome in terms of recovery, persistent deranged renal function at discharge or mortality noted.Results: In our study, incidence of Acute Kidney Injury in Hypoxic Ischemic Encephalopathy neonates was 37.7%. There was around 39-fold increase risk of developing AKI in HIE stage III versus HIE stage I. Mortality rate was found to be 51.6%. Mortality was significantly high in HIE stage III. There was around 5-fold increase risk of mortality in HIE neonates with AKI as compared to HIE neonates without AKI. 50% of the subjects who had AKI and discharged recovered of renal function before discharge and 50% recovered at 1 month follow up. In addition, there was no association found between different stages of HIE with different stages of AKI.Conclusions: It is better to screen all the birth asphyxia cases for AKI so that they can be detected early and managed accordingly.

Study on Determinants of Contraceptive Use: A Community Based Study in Eligible Couples


 
 Background: family planning methods are influenced by a variety of interrelated factors such as age at marriage, education, economic status, religion, number of living children, knowledge about contraceptives, availability, accessibilityand quality of services In spite of many programmes, couples are not aware of contraceptive methods even though they are wish to follow small family norm and still there is a gap between knowledge, attitude and practice. In a developing country like India, despite widely available contraception methods, still there is poor acceptance due to ignorance or fearof complications using them.
 Methodology: The present cross sectional study was conducted at PHC, field practice area of Department of community medicine, Jawahar Lal Nehru medical college and Hospital Bhagalpur. Study duration of two years. According to DLHS-3 prevalence of contraceptive acceptance in Bihar state was 63.2%. Sample size is calculated by taking prevalence rate of contraceptive use (63.2%) at 5% significance level and 10% allowable error. There are 28 anganawadi centers in ourstudy area. A list of eligible couples was obtained from each anganawadi and 10 eligible couples was selected randomly by Stratified Random Sampling.
 Results; The total prevalence of contraceptive use in the study area was 58.6%. It was found that practice of family planning methods was high among Hindu (87.2%) compared to Muslims (12.8%). It has been found that 40% of study population was from nuclear family. Forty six percent of the acceptors of contraceptives were held from nuclear family ascompared to 32% from joint family. 
 Conclusion: The Female literacy rate is exceptionally higher than national average. Early marriage is a prominent featurein the study area. Different factors namely age at marriage, type of family, number of living children, literacy status of female partner, and socioeconomic status significantly affect contraceptive behaviour of the studypopulation. 
 
 
 Keywords: Eligible couple, contraception, sterilization.

Differential Gene Expression of Efflux Pumps and Porins in Clinical Isolates of MDR Acinetobacter baumannii.

Background: Acinetobacter baumannii is an opportunistic pathogen associated with healthcare infections and high mortality rates in intensive care units all over the globe. Porins and efflux pumps over-expression have been reported as contributing factors in escalating drug resistance and rendering treatment ineffective. In this study, we investigated the mechanisms of multidrug resistance (MDR) in A. baumannii clinical isolates. Methods: A total of 30 A. baumannii isolates were included in the present study from Nehru Hospital (PGIMER-Chandigarh) located in North India. Kirby Bauer disk diffusion assay and MIC were performed to determine the antimicrobial susceptibility pattern. Screening of beta-lactamases was performed using PCR. Relative gene expression of four RND, one MATE efflux pump, and two outer membrane proteins were determined using RT-PCR. Molecular typing of 22 isolates was carried out using MLST Oxford scheme. Results: CarO porin genes showed over-expression in 63% isolates followed by adeGandabeM efflux pump downregulation/underexpression (<0.5 fold), suggesting the carbapenem-susceptible phenotypic nature of the isolates. High prevalence of VIM-2, NDM-1, and OXA-23 genes was observed in A. baumannii isolates. Interestingly, NDM-1 and OXA-58 were traced in 10 and3 A. baumannii isolates respectively; 13 of 22 (59%) isolates showed novel Sequence Types (STs) in the Multi-Locus Sequence Typing (MLST) analysis. ST 1087 was most commonly found ST among all others (16 STs). Conclusions: This study indicated a possible role of carO porin genes and adeG (RND) andabeM (MATE) efflux pumps in carbapenem susceptibility of A. baumannii. New STs were also reported in the majority of the isolates.

Spectrum of Preterm Birth in Tertiary Care Hospital in Shimla District of Himachal Pradesh

Background: Globally, Prematurity or preterm birth is the leading cause of death in under the age of 5 years but this has been often overlooked and neglected problem. The present study aimed to study the trends of preterm birth in Shimla district of Himachal Pradesh, India. Methods: Retrospective review of records of Kamla Nehru Hospital, Shimla covering the period January 2016 to December 2020 was conducted. The total number of preterm birth were retrieved. Results: A total of 34769 live birth took place in Kamla Nehru Hospital, Shimla from 2016 to 2020. Among the total live births, 5654(16.26%) were premature birth (&lt;37 weeks) while 29115(83.74%) were term birth. There was continuous decline in premature birth from 32.24% in 2016 to 17.41% in 2017and 10.84% in 2018, slightly rose to 10.87% in 2019 and 11.75% in 2020. Conclusions: The study concluded that over a period of 5 years there was continuous decrease in premature birth and now it reached almost near to the global average of preterm birth. Keywords: Trends, Preterm birth, Kamla Nehru Hospital, Shimla.

TRENDS OF CESAREAN DELIVERIES IN TERTIARY CARE HOSPITAL IN SHIMLA DISTRICT OF HIMACHAL PRADESH

Background: The rate of cesarean births in India is steadily rising. It has already crossed the World Health Organization (WHO) threshold of 15 percent. The present study aimed to study the trends of cesarean birth in the Shimla district of Himachal Pradesh, India. Methods:Aretrospective review of records of Kamla Nehru Hospital, Shimla covering the period January 2016 to December 2020 was conducted. The total number of deliveries and cesarean deliveries conducted were retrieved. Results:Atotal of 34,799 deliveries were conducted in Kamla Nehru Hospital, Shimla from 2016 to 2020. There was a continuous increase in the number of deliveries conducted in Kamla Nehru Hospital, Shimla from 2016 to 2020. A total of 6476 deliveries were conducted in 2016, 6539 in 2017, 6926 in 2018, 7339 in 2019, and 7519 in 2020. Among the total deliveries, 9848 were done through cesarean section. On average, 28.30 % of deliveries were conducted through cesarean section. There was a constant increase in cesarean deliveries in Kamla Nehru Hospital, Shimla from 2016 to 2020. A total of 1820 (28.1%) deliveries conducted through cesarean section in 2016, 1947(29.78%)in 2017, 1964(28.36%) in 2018, 1978(26.95%)in 2019 and 2139(28.45%) in 2020. Conclusions: The study concluded that over 5 years there has been a rise in institutional deliveries in Himachal Pradesh. Trend analysis for the cesarean section has also shown an increasing trend.

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.

Clinical profile of COVID-19 patients and their length of stay: Tertiary care hospital experience.

ABSTRACTBackground:SARSCoV-2, a coronavirus that causes COVID-19, is spreading rapidly. By the middle of August-2021, it has affected over 3 million confirmed cases in India. The main aim of this study was to examine the clinical profile of COVID-19 patients and their length of stay during treatment in a hospital.Materials and Methods:It was a hospital-based retrospective study conducted by using a total enumeration technique in July–August 2021 at Nehru Hospital, Postgraduate Institute of Medical Education and Research (PGIMER) in India. The present study was conducted on 72 COVID-19 patients who took treatment in 4C and 5C wards. Structured questionnaires were used to collect data, which included bio-demographic factors and questions about their treatment and length of stay.Results:The majority of the 72 COVID-19 positive patients were men (62%), belonged to the age group of 41–60 years (35%), had SpO2 levels ranging from 91%–95% (45%), and received room air O2 therapy (63%) during their treatment in the hospital. Female patients had a longer length of stay (7.33 days), patients under the age of 20 years had the longest hospital stay (11.5 days), patients with SpO2 less than 70% had the longest hospital stay (8 days), and patients who received oxygen using a non-rebreathing mask had the longest hospital stay (11 days).Conclusion:To avoid panic situations, regular admission and discharge of patients was essential due to the considerable increase in cases during the second wave. Patient length of stay was reduced as a consequence of collaboration and cooperation among all physicians, residents, staff nurses, and paramedics, with the goal of discharging the patient after a room air trial and follow up if needed.

Totally extraperitoneal versus transabdominal preperitoneal approach

Background: Groin hernia surgery is one of the most common procedures performed by surgeons worldwide. With the advent of minimal access surgery, the procedure for repair is now done either by transabdominal preperitoneal approach Transabdominal preperitoneal (TAPP) or totally extraperitoneal (TEP) approach. The advantage of one procedure over the other is still controversial. Objectives: This prospective study was conducted to find out the intraoperative and postoperative outcomes of TEP and TAPP for inguinal hernia repair in terms of operative time, intraoperative complications, conversion to open, visual analog scale (VAS) score, postoperative complications, length of hospital stay, and recurrence of hernia and chronic pain. Materials and Methods: A total of 88 patients of inguinal hernia enrolled prospectively between November 2017 and November 2019 and patients aged 18 years and above admitted in Jawaharlal Nehru Medical College and Hospital were included in this study. Forty-four patients were included in TEP group, while 44 patients were allocated to TAPP group. Results: The statistical analysis was done using Chi-square test and unpaired t-test, respectively. The mean operative time in TEP was 91.14 ± 11.14 min and in TAPP repair was 103.16 ± 6.79 min, which was found to be significantly significant. The mean pain score on VAS score on postoperative day 1 was 5.70 ± 0.95 in laparoscopic TEP group and 5.86 ± 0.97 in laparoscopic TAPP group. The mean pain score on VAS score on postoperative day 2 was 3 ± 1.27 in laparoscopic TEP group and 2.95 ± 1.29 in laparoscopic TAPP group. Similarly, the mean pain score on VAS scale on postoperative day 7 was 0.863 ± 1.26 in laparoscopic TEP group and 0.659 ± 1.21 in laparoscopic TAPP group. No significant difference was observed in VAS between TEP and TAPP groups during follow-up. Both TEP and TAPP mesh techniques were comparable in terms of the intraoperative complications and postoperative complications (seroma [during hospital stay, after 1 week of discharge, after 1 month of follow-up]; hematoma [during hospital stay, after 1 week of discharge]; wound infection) and in conversion to open and length of hospital stay. The difference in mean cost of surgery was found to be statistically significant. Conclusion: Although the mean operative time and cost of surgery were significantly more in TAPP than in TEP group, no significant difference could be found between the intraoperative and postoperative complication rates, conversion to open, and length of hospital stay. Recurrence was observed in one case of TEP groups during follow-up. Our study supports the view that both laparoscopic TEP and TAPP mesh repairs of inguinal hernia are safe and efficacious.

Mycoplasma pneumoniae Infection and Subsequent Wheezing in Childhood Asthma- A Cohort Study

Introduction: Prevalence of asthma in children &lt;18 years is approximately 7-8%. Mycoplasma pneumoniae has also been found to be an important trigger of asthma. Many studies have shown the association of Mycoplasma pneumoniae with acute exacerbation of asthma in adults. But the data is limited to determine the role of Mycoplasma pneumoniae in causing subsequent wheezing in children with asthma. Aim: To study the role of Mycoplasma pneumoniae infection in causing subsequent wheezing episodes in asthma in children between 1-14 years of age. Materials and Methods: This was a prospective cohort study conducted from October 2019 to October 2021 at the Paediatric Division of Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India. Consecutively 60 patients with bronchial asthma aged between 1 to 14 years were included during the first year of study period. The diagnosis of bronchial asthma was as per Global Initiative for Asthma (GINA) guidelines. Venous sample was tested for Immunoglobulin M (IgM) Mycoplasma pneumoniae antibody with Calbiotech Mycoplasma pneumoniae IgM Enzymelinked Immunosorbent Assay (ELISA) kit. Clinical follow-up for subsequent wheeze was done at 3 months, 6 months, and 12 months starting after 2 weeks of being declared symptom free. All data were recorded and analysed by Statistical Package for Social Sciences software (SPSS) version 22.0. Results: Out of 60 patients, males comprised of 46 (76.67%) and females 14 (23.33%) with the mean age 5.56±4.21 years. Family history of wheeze was also taken and found to be 38.33% among asthamatics (23/60). Among asthmatics, 23 cases (38.33%) were IgM positive. Episodes of subsequent wheeze were present in all the patients with a mean of 4.5±2.7 episodes in one year. On subgroup analysis, mean wheezing episodes were documented as 5.43±3.00 in IgM positive group which was statistically higher than IgM negative group in which mean wheezing episodes were 3.92±2.42 (p-value=0.036). Conclusion: Subsequent wheeze was observed in all patients with asthma. The mean wheezing episodes were statistically more in Mycoplasma pneumoniae infected asthmatics in comparison to non Mycoplasma pneumoniae infected asthmatics.

To Assess Knowledge and Perception of Pregnant Women Regarding Excess Maternal Weight, Gestational Weight Gain and their Impact on Foetomaternal Outcomes: A Cross-sectional Study

Introduction: Well recognised associations exist between maternal obesity, Gestational Weight Gain (GWG) and adverse health outcomes for mothers and their babies. Studies regarding women’s knowledge of the risks of excess maternal weight and GWG are limited in both the populations assessed and also in their description of knowledge. Aim: To examine women’s perception of their own weight in pregnancy and to assess pregnant women’s knowledge of complications of obesity and excess GWG and ways to manage the appropriate GWG. Materials and Methods: A total of 216 pregnant women were recruited in this cross-sectional study from the antenatal clinic of Jawaharlal Nehru Medical College and Hospital, Aligarh, India between May and June 2018. Data was collected using an interviewer administered prestructured and pretested questionnaire. Statistical analyses were performed using Statistical Package for the Social Sciences (SPSS) version 20.0. Results: Mean age of study population was 25.02±4.6 years. Mean Body Mass Index (BMI) was 24.55±4.07 kg/m2 . Frequent misclassification of their own BMI and inappropriate estimation of GWG by pregnant women was found in the present study. Overweight and obese women were more prone to inaccurate self-classification as 68.7% of overweight women and 62.5% of obese women underestimated their weight. Women had optimum knowledge for complications of obesity (69.4%) to mothers but knowledge is poor regarding complications to babies (45.5%). Also, awareness is significantly lower in obese women as compared to normal weight women p&lt;0.05. Conclusion: Notable deficiencies in the knowledge and perceptions of pregnant women regarding their weight, obesity, GWG and their impact on foetomaternal outcomes were found in the present study. Bridging this knowledge gap would be an important step towards improving short and long-term adverse maternal and perinatal outcomes.

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.

An observational study on patient compliance and adverse drug reactions of antihypertensives drugs in a tertiary care center of Bihar

Hypertension is among the most common non-communicable and lifestyle disease in our country that affects adult population of both the genders from all socio-economic backgrounds and urban and rural population. In-spite of this, early diagnosis and appropriate treatment are suboptimal. Adherence of prescribed treatment has been studied in patients of hypertension in this study. : An observational and cross-sectional study was conducted in the Department of Pharmacology, Jawahar Lal Nehru Medical College and Hospital, Bhagalpur, Bihar. Prior to the initiation of the study, clearance was obtained from the Institutional Ethics Committee. Study period was between January 2021 and June 2021.A predesigned pretested interview schedule was used to collect the data from the 247 study participants. This schedule contained information related to socio-demographic variables, comorbidity, a format to assess the compliance to antihypertensive drugs prescribed and any adverse event. : A significant improvement in maintain optimal in blood pressure was observed in patients treated with one pill per day as compared to patients prescribed with two and three pills per day. Compliance was significantly better in patients in combination therapy as compared to monotherapy. : Low dose combination therapy has been stated to be more effective than high dose monotherapy in controlling blood pressure. It shows better compliance and lesser incidence of side-effects.

An observational and cross-sectional study on drug utilization pattern in the ophthalmology out-patient department of a tertiary care center of Bihar

Making affordable drugs accessible to all strata of society is an inevitable part of health care. This situation makes Drug Utilization Study inevitable. With this background, the current study was planned to obtain knowledge on the prescribing pattern and drug utilization trend in ophthalmology department at a tertiary care teaching hospital with ultimate goal to promote rational use of drugs among prescribers. An observational cross-sectional study was conducted in the Department of Pharmacology, Jawahar Lal Nehru Medical College and Hospital, Bhagalpur, Bihar. Prior to the initiation of the study, clearance was obtained from the Institutional Ethics Committee. Study period was between March 2021 and August 2021. Prescriptions of 550 patients who were treated during the course of the study were surveyed prospectively by using a specially designed form. The WHO drug use indicators like prescribing indicators and patient care indicators were determinedThe average number of drugs per prescription was 2.6, ranging from 0-7 drugs. The dosage forms, the frequency of administration and duration of treatment of the drugs were recorded for 99.9% of the prescriptions given. This analysis of the prescriptions showed that 93.8% of the prescriptions were written in the form of various trade names. Antibiotics were prescribed in 52.5% of the prescriptions. The present study revealed certain lacunae in the prescribing practices of the Ophthalmologists at the selected institute and this is evident by the low generic prescribing in many prescriptions.

English

BACKGROUND The high incidence of global neonatal mortality has triggered several efforts to improve facility-based neonatal care but despite these many advances in perinatal and neonatal care, the outcomes achievable at different levels are comparable. This study was undertaken to compare the mortality pattern among both the inborn and outborn neonates admitted to the special new born care units (SNCU)s of tertiary care hospital of Shimla city, in the hilly state of Himachal Pradesh. METHODS A cross-sectional study involving a record review of all neonates admitted to the specialized neonatal care units of the paediatric ward of IGMC, Shimla &amp; Kamla Nehru Hospital (KNH) over five years from January 2016 to December 2020 was conducted. The most important causes of mortality and its associated factors were analysed, and a statistical inference was made. RESULTS Among the 4018 outborn neonates admitted to the SNCU of the pediatric ward of IGMC, Shimla, 2440 (60.73 %) were males and 1578 (39.27 %) were females while 6607 inborn neonates were admitted to the SNCU of KNH Shimla and among them 3655 (55.32 %) were males and 2952 (44.68 %) were females. In the outborn SNCU of IGMC Shimla, 307 (7.64 %) died while in the inborn SNCU of KNH Shimla, 366 (5.54 %) neonates died over a span of 5 years. In outborn SNCU of IGMC Shimla, a maximum of 110 (35.83 %) neonates died due to sepsis/pneumonia/meningitis, followed by 60 (19.54 %) due to respiratory distress syndrome and 50 (16.29 %) due to HIE/moderate-severe birth asphyxia while in case of inborn SNCU of KNH, maximum deaths of 115 (31.42 %) were due to respiratory distress syndrome, followed by 93 (25.41 %) due to sepsis/pneumonia/meningitis and 69 (18.85 %) due to HIE/moderate-severe birth asphyxia. At outborn SNCU of IGMC, Shimla, most of the neonates who died 118 (38.44 %) weighed about 1500-2499 gm, while in inborn SNCU of KNH, Shimla, most of the neonates 147 (40.16 %) had weight between 1000-1499 gm. At outborn SNCU of IGMC Shimla, 131 (42.67 %) were preterm while at inborn SNCU of KNH, 305 (83.3 %) were preterm. CONCLUSIONS Sepsis, birth asphyxia and RDS are the important causes of mortality, which must be urgently addressed. Improving antenatal care, improved access to health facilities, early identification of danger signs, timely referral, capacity building, can reduce neonatal mortality. KEY WORDS Comparison, Neonatal Mortality, SNCUs, Tertiary Care Hospital, Inborn Neonate, Outborn Neonate.

CONGENITAL MALFORMATION OF THE CENTRAL NERVOUS SYSTEM : INCIDENCE, MANAGEMENT AND OUTCOME

INTRODUCTION MATERIAL AND METHODS This study has been conducted on the patients suffering from the congenital malformations of the central nervous system attending/admitted in the department of Surgery/ Pediatrics /Neurosurgery, Nehru hospital, B.R.D. Medical College, Gorakhpur for a period of 12 months. CONCLUSION

Finding Correlation in Clinical and Pathological Diagnosis in Reemerging Context of Leprosy in India: A Tertiary Care Center Experience

Background:&#x0D; Leprosy was supposed to be eliminated by WHO from the world by the end of the year 2000. However, it still affects the major population in India. It is well realized that even after elimination target has been achieved, new leprosy cases will keep coming for at least some years due to continuation of some level of disease transmission or manifestation of disease by subclinical cases. Hence there is the need to review this disease with proper understanding.&#x0D; Objective:&#x0D; To determine the current leprosy profile and its relation between clinical and pathological diagnosis, at our centre catering the population of Western Uttar Pradesh.&#x0D; Methods and Material: &#x0D; It’s a retrospective study and was carried out on skin biopsy samples sent for histopathological diagnosis in clinical suspicion of leprosy at Jawaharlal Nehru Medical College and Hospital, Aligarh, from June 2015 to November 2017. Tissue Sections were stained with Haematoxylin and Eosin stain for morphological studies, and modified fite stain to identify acid fast bacilli.&#x0D; Results:&#x0D; Out of 325 clinically suspected leprosy cases, we diagnosed leprosy in 282 cases with 86.7% parity. Most commonly affected age group was between 16 -30 years (110 cases). Tuberculoid leprosy was the most common histological subtype (69/282, 24.4%) followed by lepromatous leprosy (58/282, 20.56%), borderline tuberculoid (53/282, 18.7%), borderline lepromatous (42/282, 14.8%), indeterminate leprosy (34/282, 12%) and mid borderline leprosy (22/282, 7.8%). Additionally, histioid type of leprosy was diagnosed histologically in 1.4% (4/282) of the cases.&#x0D; Conclusions:&#x0D; Identification of suspicious skin patch as leprosy with prompt histological diagnosis especially in population of below 30 years is required for timely intervention and eradication. Both clinician and pathologist should have a focused approach especially in diagnosing indeterminate leprosy.

Prospective and Observation Study of Selective Nerve Root Block on Patients with PIVD

Introduction: PIVD is the most common cause of lower back pain in old age. The most common site is L4 L5 to L5 S1 in about 95% cases, and about 90% cases are associated with radiculopathy.&#x0D; Methodology: This prospective study was conducted on 150 patients at the Jawahar Lal Nehru Hospital and Research Center between 2019 and 2021. We used 2–3 ml xylocaine and methylprednisolone. Results were assessed through clinical examination.&#x0D; Result: Of the 150 patients, 130 experienced excellent results with no pain for more than six months.&#x0D; Conclusion: We conclude that for mild cases, patients with PIVD have an alternative option of selective nerve root block other than surgery.

THE EFFECT OF SOCIO-DEMOGRAPHIC WITH AUB IN PERIMENOPAUSE

Background: The effect of socio-demographic on AUB in perimenopause.&#x0D; Methods: Prospective interventional study conducted at Kamla Nehru Hospital for State Mother and Child, IGMC Shimla.&#x0D; Results: In the present study according to the modified kuppuswamy socioeconomic scale AUB was found maximum in women belonging to lower middle class i.e 93 (40.6%) with confidence interval of 34.19-47.95% followed by upper lower class i.e 90 (39.3%) with confidence interval of 32.93-45.95% and least in upper class i.e 7 (3.05%) with confidence interval of 1.24-6.20%.&#x0D; Conclusion: In summary, abnormal uterine bleeding in perimenopausal patients is a common and important part of clinical practice for health-care providers of women.&#x0D; Keywords: AUB, SES, Bleeding

THE MENSTRUAL PATTERN OF AUB IN PERIMENOPAUSE

Background: The Menstrual pattern of AUB in perimenopause.&#x0D; Methods: Prospective interventional study conducted at Kamla Nehru Hospital for State Mother and Child, IGMC Shimla.&#x0D; Results: Menorrhagia was the most common presentation of AUB patients accounting for 65.5% of cases with confidence interval of 58.96-71.64% followed by continuous bleeding per vagina(BPV) accounting for 17.9% with confidence interval of 13.17-23.49% with the least being oligomenorrhea 0.87% with confidence interval of 0.11-3.12%.&#x0D; Conclusion: Abnormal uterine bleeding in perimenopausal patients is a common and important part of clinical practice for health-care providers of women.&#x0D; Keywords: AUB, Menstrual pattern, Bleeding