Nehru Medical College Research Articles

Comparison of clinical tests versus electrodiagnostic testing in the diagnosis of pregnancy-related carpel tunnel syndrome

Background: Pregnancy-related carpal tunnel syndrome (PRCTS) is a persistent mononeuropathy in pregnancy. The incidence of PRCTS has a wide fluctuation range of 0.8% to 70%. Their incidence depends on the diagnostic technique. The nerve conduction study (NCS) is a very specific test for the diagnosis of PRCTS. There have been very few studies to compare the results of diagnosing PRCTS via NCS with clinical tests. Aims and Objectives: To assess the most reliable technique in the diagnosis of PRCTS by comparing clinical tests with the nerve conduction studies in electrodiagnostic (EDX) testing. Materials and Methods: As per inclusion and exclusion criteria, 100 subjects were included in the study. Out of 75 pregnant females, 25 were agematched non-pregnant females as controls. All were enrolled in the ANC clinic and gynecology outpatient department of Jawahar Lal Nehru Medical College and Hospital, AMU, Aligarh. All the females were assessed for CTS by the clinical tests as well as the EDX test performed in the department of physiology at JNMCH and AMU. The testing was done at the wrist joint in order to assess the normal functioning of the median nerve. Results: There was a highly significant difference between the two methods for the diagnosis of PRCTS. Out of the total 75 pregnant females enrolled, only 2 were found to be positive for PRCTS via clinical testing, whereas in the EDX techniques, 48% of the pregnant females were diagnosed as having PRCTS. Conclusion: Clinical tests are not emerging as a good method for PRCTS diagnosis, while EDX testing is the gold standard and a prudent method to diagnose PRCTS.

Assessing the Role of Status Epilepticus Severity Score in Predicting Outcome in Patients with Convulsive Status Epilepticus: A Cross-sectional Study

Introduction: Status Epilepticus (SE) is a neurological emergency that necessitates prompt intervention and treatment. The Status Epilepticus Severity Score (STESS) is a clinical tool developed to assess the mortality rate among patients diagnosed with Convulsive Status Epilepticus (CSE). Aim: To assess the accuracy of STESS in predicting the outcome of CSE. Materials and Methods: This cross-sectional study was conducted at Jawaharlal Nehru Medical College, Aligarh, Uttar Pradesh, India from December 2020 to November 2022, involving 110 patients aged more than 15 years presenting with CSE lasting more than five minutes. Age, gender, seizure type, history of epilepsy, Glasgow Coma Scale (GCS), and STESS at presentation were assessed and associated with the outcome. Results: Among the 110 patients included in the study, there was a higher number of male patients compared to female patients. The mean age of the patients was 35.77±17.9 years. The most prevalent type of seizure observed was generalised tonic-clonic seizures, accounting for 65.45% of the cases, 9.09% of the patients expired, 89% of the patients had a STESS below 2. The Receiver-Operating Characteristic (ROC) curve for STESS at presentation to predict in-hospital mortality had an area under the curve of 0.859, 95% Confidence Interval (CI) from 0.780 to 0.918, and p-value<0.0001. It had a sensitivity of 70%, specificity of 95%, Positive Predictive Value (PPV) of 58.3%, Negative Predictive Value (NPV) of 96.9%, and diagnostic accuracy of 92.73%. Conclusion: Assessment of in-hospital mortality at the onset of SE was reliably determined by STESS and is an useful clinical score. To fully comprehend the reasons for the high overall mortality rate following SE and potential prognostic factors, more research is required.

A Cross-sectional Analysis of Conventional Leishman’s Stain versus Modified Leishman’s Stain: A Study Protocol

Introduction: The conventional Leishman’s stain and modified Leishman’s stain are widely used in medical laboratories for the microscopic examination of blood smears. The conventional stain provides good visualisation of cellular morphology, aiding in the identification of various blood cell types. The modified Leishman’s stain, on the other hand, incorporates alterations to enhance specific cellular structures, improving diagnostic accuracy. Need of the study: In the present study, the authors will observe the differences between the conventional staining method and the modified Leishman's stain method, as well as the advantages of the modified Leishman's staining over the conventional staining method. Aim: To compare Conventional Leishman’s Stain with Modified Leishman’s Stain. Materials and Methods: The cross-sectional study will be conducted from October 2022 to October 2024 at the Department of Pathology, Jawaharlal Nehru Medical College (JNMC), Sawangi (Meghe), Wardha, Maharashtra, India. Ethylenediamine Tetraacetic Acid (EDTA) blood samples will be used for staining. Conventional Leishman’s Stain employs the traditional Leishman’s staining method, while Modified Leishman’s Stain incorporates specific modifications aimed at improving staining quality and enhancing the detection of eosinophils and leukocytes. Several quality control parameters will be assessed, including staining quality, eosinophil and leukocyte visibility, and overall diagnostic accuracy for both peripheral blood smear samples. A panel of experienced haematologists, blinded to the staining technique, independently examines the slides to minimise potential bias. The numbers and morphological characteristics of eosinophils and leukocytes are meticulously recorded, and statistical analysis will be conducted to compare the two staining methods.

A Prospective Study of Total Extra Peritoneal Inguinal Hernia Repair Fixation versus no Fixation of Mesh

Background: The necessity of mesh fixation in laparoscopic totally extra peritoneal (TEP) inguinal hernia repair remains controversial. We performed a single-center prospective study to compare the effectiveness of mesh fixation versus nonfixation in laparoscopic TEP repair. Materials and Methods: This study was conducted in the Department of Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India, from August 2021 to July 2023. All patients admitted to the General surgical unit with uncomplicated inguinal hernias were included. A total of 96 patients were included in the study, of which 44 patients underwent TEP repair with fixation of mesh using tacks (GROUP A) and the remaining 52 patients whose mesh was not fixed (GROUP B). Results: Ninety-six patients were randomized to fixation or non-fixation group in TEP. The pain scores at 24 hours, 72 hours, 7 days, 1 month, and 3 months were comparable, but not statistically significant (Day 1 Fixation, 2.7 ± 0.79; Non-fixation 2.48 ± 0.78, P = 0.104, 1 week (Fixation, 0.02 ± 0.15; Non-fixation, 0.08 ± 0.27, P = 0.236). The length of hospital stay (Fixation, 2.07 ± 0.59 days; Non-fixation, 2.1 ± 0.41 days, P = 0.785) and days taken to resume normal activities (Fixation, 3.7 ± 1.02 days; Non-fixation, 3.54 ± 0.94 days, P = 0.41) were also similar for both groups. There was no recurrence in either group at a minimum follow-up of 12 months. The cost of surgery was significantly different between the fixation group and the nonfixation group with a p-value <0.0001. Conclusion: There was no statistical significance between the fixation and non-fixation groups in terms of postoperative pain, requirement and dosage of analgesics, duration of in-hospital stay, time to return to normal activity, complications, recurrence of hernia, except the cost of surgery which was higher in the fixation group.

Study of Methicillin-resistant Staphylococcus aureus Isolated from Various Clinical Specimens from Tertiary Care Hospital

ABSTRACT Introduction: Staphylococci are Gram-positive bacteria, with a diameter of 0.5–1.5 μm and individual cocci, which are divided in more than one plane from the grape-like cluster. In the genus staphylococci, 32 species and 8 subspecies are present in many of which are present as a commensal in the human body. Staphylococci are frequently found as a normal flora of skin mucosal, surface of respiratory, upper elementary, and urogenital tract of the human body. In immunocompromised condition, the infection can be spread by skin-to-skin contact and also by excretion such as saliva aerosol releasing during sneezing and coughing. Infection of staphylococci may also spread from the animal product such as nonpasteurized milk and milk products. Over the last few decades, Staphylococcus aureus has emerge as the most dangerous organism, which is known as methicillin-resistant S. aureus (MRSA). Some strains show vancomycin resistance by S. aureus in hospitalized patients. The present study was conducted to study the prevalence and antibiogram of MRSA isolates in a clinical sample from Acharya Vinoba Bhave Rural Hospital. Materials and Methods: This study was conducted in the Department of Microbiology at Jawaharlal Nehru Medical College (Datta Meghe Institute of Higher Education and Research), Wardha, from August 2020 to December 2021. The samples received in the microbiology laboratory were inoculated on blood agar and MacConkey’s agar, and incubated for 24 h at 37°C for staphylococcal isolation. A total of 145 Staphylococcal aureus were isolated and confirmed by Gram stain and various biochemical tests such as catalase test, oxidase test, coagulase test, and mannitol salt agar. Antibiotic susceptibility test was examined on the Mueller–Hinton agar plate using the modified Kirby–Bauer disc diffusion method. Screening of methicillin resistant was performed by cefoxitin (30 μg) disc diffusion method and interpreted according to CLSI guideline. Results: The prevalence of MRSA was 76 (52.41%) to methicillin-susceptible S. aureus. The highest MRSA was found in the age group >50 years (26.31%). Out of 76 MRSA isolates from different departments, the medicine and orthopedic departments show maximum MRSA as 19.74% each followed by pediatrics (17.11%) and surgery (13.16). Out of 76 MRSA isolates, vancomycin showed 93.42% sensitivity followed by linezolid (85.52%), Gentamicin (71.05%), tetracycline (56.57%), clindamycin (46.05%), and erythromycin (31.57%). Conclusion: With the advancement of new therapeutic agent, MRSA is also being easily resistant. Due to increasing cases of MRSA, there is an increase in the rate of morbidity and mortality. Moreover, except vancomycin, other drugs are resistant, as their MIC is not in the susceptible range. Thus, the results of this study indicate that vancomycin is a suitable medication to take when MRSA cases rise. In such cases, MRSA can be controlled by regular monitoring and checking the irrational use of antibiotics.

Dermatoglyphic Patterns in Undergraduate Medical Students and their Association with Academic Performance: A Cross-sectional Study

Introduction: Dermatoglyphics is the study of fingerprint patterns, which are unique to each individual and remain unchanged after birth. It has been used in criminology for decades. In recent years, its role in screening various medical conditions has been established. Dermatoglyphics has also been associated with cognitive ability, making it a potential predictor of academic potential. Aim: To investigate the association between dermatoglyphic patterns and the academic performance of medical students. Materials and Methods: A cross-sectional study was conducted in the Department of Anatomy, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India on 200 undergraduate medical students (94 males and 106 females) from January 2019 to December 2020. Fingerprint patterns were obtained using the standard ink method. The parameters studied included arches, loops, whorls, composites, Total Finger Ridge Count (TFRC), and the 'atd' angle. The academic performance of participants was assessed based on the marks obtained in the National Eligibility Cum Entrance Test (NEET) and the overall marks scored in the first-year university examination. Statistical analysis involved the use of arithmetic mean, standard deviation, Chi-square test, and one-way Analysis of Variance (ANOVA). Results: In present study, the most common fingerprint pattern in the right hand was an arch (30.9%), followed by a whorl (24.5%). In the left hand, the most common fingerprint pattern was a whorl (40.6%), followed by an ulnar loop (20.1%), with no gender difference observed. Thumb, index finger, middle finger, ring finger, and little finger exhibited different fingerprint patterns between the right and left hand, indicating asymmetry. This asymmetry was associated with lower academic performance. Higher academic performers in the NEET had a higher frequency of whorls and composites. TFRC showed no association with academic performance. Students with an ‘atd’ angle between 41 and 50° demonstrated higher academic performance. Conclusion: The present study found that asymmetry of fingerprint patterns and a higher ‘atd’ angle (≥51°) were correlated with lower academic performance among medical students. These findings suggest potential directions for early academic intervention, provided multicentric studies are conducted in the future.

Assessment of Pulmonary Function in COVID-19 Recovered Health Science Students: A Descriptiv Cross-sectional Study

Introduction: Coronavirus Disease-2019 (COVID-19) impacts multiple organs like the kidneys, heart, and liver, but primarily affects the respiratory system, leading to symptoms such as cough with sputum production, fever, and in severe cases, respiratory failure. Research on Severe Acute Respiratory Syndrome (SARS)-Coronavirus-2 (CoV-2) has revealed impairments in lung function during the early recovery phase following COVID-19 infection. The aim is to understand the virus’s impact and identify any obstructive, restrictive, or mixed pulmonary alterations in medical professionals six weeks after recovery. Aim: To assess Pulmonary Function Tests (PFTs) six weeks after COVID-19 recovery in health science students at a medical college in North Karnataka. Materials and Methods: A descriptive cross-sectional study was conducted in the Department of Physiology at Jawaharlal Nehru Medical College in North Karnataka, India, from January 2021 to December 2021. A total of 155 COVID-19-recovered health science students were included, and their anthropometry, physiological parameters, and pulmonary parameters were recorded. The “Spirometer Helios 401” was used to estimate an individual’s PFT. Data were analysed using independent sample t-tests, with a p-value <0.05 considered statistically significant. Results: The mean age of the participants was 21.73±3.04 years. The Mean±Standard Devaiation (SD) of Forced Vital Capacity (FVC) (L), Forced Expiratory Volume (FEV) at the end of one second (L), Peak Expiratory Flow Rate (L), forced mid expiratory flow 25-75 (L/s), forced mid expiratory flow 25% (L/s), forced mid expiratory flow 50% (L/s), forced mid expiratory flow 75% (L/s), Inspiratory Reserve Volume (IRV) (L), Expiratory Reserve Volume (ERV) (L), Inspiratory Capacity (IC) (L), and Maximum Voluntary Ventilation (MVV) (L) ± SD of post-COVID-19 subjects were less compared to their corresponding predicted values. The Mean±SD of FEV1/FVC (%) and tidal volume (L) of COVID-19 recovered subjects were higher than their corresponding expected value. The FEV, Forced Expiratory Flow (FEF), and FEV1 values were significantly less in females compared to males. Conclusion: Coronavirus Disease-19-recovered subjects showed altered respiratory functions even after six weeks, with the majority having restrictive disease, followed by a mixed pattern and obstructive diseases, while the remaining showed no changes in lung function. Altered pulmonary functions in COVID-19 patients may be due to alveolar destruction or pulmonary interstitial fibrosis.

Comparative Evaluation of Conventional Nasolabial Flap with and without Fishtail Modification in Patients with Oral Submucous Fibrosis: A Research Protocol

Introduction: Oral Submucous Fibrosis (OSMF) is a longterm condition characterised by the gradual buildup of fibrous tissue in the oral cavity, often extending to the throat and upper oesophagus. The primary symptoms include progressive limitation in mouth opening due to the formation of stiff fibrous bands in the oral mucosa, accompanied by muscle atrophy. However, the most concerning aspect of this restriction, known as trismus, is its hindrance to effective cancer monitoring. Surgical approaches typically aim to release these fibrotic bands, while medical interventions focus on managing inflammation and preventing further fibrosis. Need of the Study: A modification of the nasolabial flap has been suggested for the reconstruction of intraoral defects following ablative surgery for OSMF. The study will assess its merits in comparison to the conventional nasolabial flap. Aim: To evaluate and compare the aesthetic and functional outcomes of the rima oris between the Conventional Nasolabial Flap and the Nasolabial Flap with Fishtail Modification in patients undergoing surgical intervention for OSMF. Materials and Methods: A prospective, double-blinded, randomised controlled trial will be conducted in the Department of Oral and Maxillofacial Surgery at Acharya Vinoba Bhave Rural Hospital, associated with Jawaharlal Nehru Medical College, Wardha, Maharashtra, India, from November 2023 to November 2024. Patients older than 18 years of age diagnosed with OSMF, without any superimposing cancerous lesions, will be included in the study. They will be divided into two groups: Group A will be treated with bilateral fibrotomy, coronoidotomy and reconstruction with the conventional nasolabial flap, while Group B will undergo the same surgical intervention, except that the reconstruction will be performed using the fishtail modification of the nasolabial flap. The parameters that will be compared include interincisal mouth opening, intercommissural width, dehiscence and flap necrosis. The analysis will be conducted using the Chi-square test and Fisher’s-exact test for categorical data and the independent t-test for continuous data that follow a normal distribution. These statistical tests will help evaluate the association between different demographic, clinical and etiological factors and the outcomes under consideration. A p-value of <0.05 will be considered statistically significant.

Predictive Value of CT Perfusion Parameters in Traumatic Brain Injury Patients: A Longitudinal Study

Introduction: Traumatic Brain Injury (TBI) is the most common cause of mortality and morbidity worldwide. Moreover, cerebral contusions, Subdural Haemorrhages (SDH), Extradural Haemorrhages (EDH), and Subarachnoid Haemorrhage (SAH), which are secondary injuries that occur due to alterations in cerebral haemodynamics, remain unevaluated and unchecked by plain non contrast scans. Timely delineation of the cerebral perfusion status of the patient can assist in modifying treatment plans and could lead to a better recovery of the patient. Aim: To assess the cerebral haemodynamics of patients with TBI at admission and evaluate the predictive value of Computed Tomography (CT) perfusion. Materials and Methods: The present prospective longitudinal study was conducted in the Department of Radiodiagnosis and Neurosurgery, Jawaharlal Nehru Medical College and Hospital (JNMCH), Aligarh Muslim University (AMU), Aligarh, Uttar Pradesh, India, from September 2019 to September 2020. A total of 40 participants were included in the study using a purposive sampling method. CT Perfusion (CTP) was performed within 72 hours of head injury, followed by Glasgow Outcome at Discharge Scale (GODS) assessments at discharge and one month later. Cerebral perfusion parameters such as Cerebral Blood Flow (CBF), Cerebral Blood Volume (CBV), Mean Transit Time (MTT), and Time To Peak (TTP) were measured, and correlations were established using Spearman’s rank correlation coefficients to determine the relationship of GODS with CTP parameters. Results: The mean age of study subjects was 35.8±13.4 years, with a median (25th-75th percentile) of 32 (25-42.75). Among a total of 40 patients, 22 (55%) were males and 18 (45%) were females. Significant positive correlations were observed between GODS at discharge and CBF (mL/100 gm/min) at presentation, CBV (mL/100 gm/min) at presentation, and the number of normal/hyperemic territories, with correlation coefficients of 0.398, 0.329, and 0.504, respectively. A significant negative correlation was found between GODS at discharge and TTP (seconds) at presentation, with a correlation coefficient of -0.392. Similarly, significant positive correlations were observed between GODS at one month with CBF (mL/100 gm/min) at presentation and the number of normal/ hyperemic territories, with correlation coefficients of 0.407 and 0.827, respectively. A significant negative correlation was seen between GODS at one month and MTT (seconds) at presentation, with a correlation coefficient of -0.344. CBV (mL/100 gm/min) at presentation exhibited a sensitivity of 100%, followed by MTT (seconds) at presentation (71.43%), and CBF (mL/100 gm/min) at presentation (57.14%). Conversely, CBF (mL/100 gm/min) at presentation showed a specificity of 92.31%, followed by TTP (seconds) at presentation (92.31%), and CBV (mL/100 gm/min) at presentation (53.85%). In predicting unfavourable outcomes, MTT (seconds) at presentation had the lowest specificity of 7.69%. Conclusion: Perfusion CT provides additional information compared to Non Contrast Computed Tomography (NCCT) with insights into the pericontusional areas. Therefore, it can be a potential tool in the evaluation of TBI. Perfusion parameters have prognostic value, and thus, this modality should be studied with a larger sample size for more precise results.

Effect of antenatal corticosteroids on daily fetal movement count in pregnant women

Background: Fetal well-being is reflected in the fetal movements perceived by the mother. Corticosteroids are the most common therapy in clinical practice which can affect fetal activity. Aims and Objectives: The aim of this study was to evaluate the effect of dexamethasone administration on daily fetal movement count (DFMC) in pregnant women. Materials and Methods: A prospective and cohort study was performed in the Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College and Hospital. A total of 100 pregnant women between gestational ages of 28 weeks and 38 weeks were enrolled in the study. They were asked to count DFMC on day 0, that is, before administration of injection dexamethasone, on day 2 (after 48 h of first dose), and during day 4 to 7. Women received injection dexamethasone 6 mg i.m. 4 doses at an interval of 12 h for various indications such as pre-term pre-labor rupture of membranes, placenta previa, pre-term labor, and previous cesarean. Outcome measures were changes in DFMC before and after dexamethasone administration. Results: DFMC was significantly reduced on day 2 of injection dexamethasone administration and returned to baseline values after 4th–7th days of receiving dexamethasone. Conclusion: Dexamethasone administration resulted in transient reduction in DFMC that mimics fetal compromise; hence, clinicians should be aware of this phenomenon to prevent iatrogenic pre-term birth of the fetus.

A rare presentation of Rubinstein-Taybi syndrome

Objective. Taybi syndrome is a rare genetical disorder with the symptoms of small stature, broad thumbs and first toes, a moderate to severe intellectual handicap, and unique facial traits. The present case study aimed with diagnose and therapeutic management of pediatric patients having Rubinstein-Taybi syndrome. Study area. The case study was carried out in Jawaharlal Nehru Medical College, Acharya Vinoba Bhave Rural Hospital, Sawangi Meghe, Wardha, Maharashtra, in department of Pediatrics. The present study follows case of male child, diagnosed with different degrees of compliance, in which the therapeutic approach was determined by the severity of the patient’s conditions. Outcomes. Case study on 3 years old male child was carried out and observed with some behavioural changes like unstable mood, distractibility and impulsivity along with attention problem, aggressive nature and self-injurious behavior etc. As the syndrome does not have a particular treatment but some therapies are applied to address issues that are frequently connected to the illness. The thumbs or toes surgically repaired might enhance grip or ease pain. The study was performed as per the scientific way, based on research literatures study.

Reliability of RUT done on endoscopy guided gastric biopsy in detecting Helicobactor Pylori

Introduction: This study was done to identify the reliability of RUT in detecting H. Pylori in patients of gastritis by performing Histopathological examination. Endoscopic biopsy samples were taken from gastritis lesions present in the stomach. Methods: This was a prospective observational study done at Jawaharlal Nehru Medical College (JNMC), Aligarh Muslim University (AMU), Aligarh between May 2021 and May 2022 with a sample size of 230 patients. The endoscopists performed RUT on biopsy samples taken from gastritis lesions and sent another biopsy sample from the same patient for histopathological examination. On the basis of histopathological report, results were compared and analyzed. Results: In our study the specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of RUT were 60.81%, 67.31% ,78.36%, 46.88% , and 65.22%, respectively. Conclusion: Our study suggests that RUT can reliably identify Helicobacter pylori infection in gastric mucosa.

Preferences and perceptions of MBBS students towards blended learning in medical education

Introduction: With the advent of COVID-19 pandemic there has been a rapid shift in the mode of delivering education. A swift transition from place-based offline classes to virtual online learning platforms has emerged during the pandemic. The present study explored the acceptance, perceptions and preferences of blended learning among medical undergraduate students. Methods: MBBS undergraduate students of second and final professional (Part I & II) phases from Jawaharlal Nehru Medical College, AMU, Aligarh, UP were enrolled in the study. We studied acceptance, perception and preferences regarding blended mode of learning of MBBS students using online Google Form. Semi structured questionnaire was drafted by the research team, based on thorough and critical review of pertinent literature and other similar survey tools. Each item was discussed separately and changes were made where required. Then, it was transformed to an online form through Google Forms. Results: Out of a total of 432 students, more than 3/4th of students (78.2%) believed that combined approach would lead to improvement in learning. Around half (53.6%) of the female students were relying predominantly on offline learning compared to 37.0% of male students (p = 0.004). Flexible schedule and personal convenience was reported as the most common benefit of online learning while lack of interaction with peers and connectivity issues were found to be the major disadvantages. Conclusion: Majority of the students echoed a positive attitude towards blended mode of teaching and learning. Medical education is largely demonstration and application based for acquiring skills. Therefore, a combined approach where the theoretical aspect of the curriculum is made online, might offer a more convenient, flexible and effective alternative way of teaching and learning. IMC J Med Sci. 2024; 18(1):009. DOI: https://doi.org/10.55010/imcjms.18.009 *Correspondence: Mohd. Yasir Zubair, Department of Community Medicine, Jawaharlal Nehru Medical College, AMU, Aligarh, Uttar Pradesh, India. Email: yasmuhsin@gmail.com

Triad of serum PSA, DRE and biopsy in diagnosing prostatic diseases- How useful it is?

Prostate specific antigen (PSA) is a glycoprotein produced by prostatic acini and prostatic tissue. Its concentration increases in prostatic diseases. Concentration above 4 ng/ml is considered abnormal but there is no clear-cut point between normal and abnormal PSA levels. PSA is considered as serum marker for prostatic cancer but it is organ specific, not cancer specific. Digital rectal examination (DRE) is a routine part of prostate cancer screening. Biopsies are performed when PSA test and DRE are abnormal. The study is an attempt for comparative analysis among serum PSA, age, DRE, and biopsy results for the institution of specific treatment at an early stage. Study was performed on 200 patients with different prostatic lesions in the Department of Pathology, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh. Clinical, DRE, PSA and histopathological biopsy were performed and analyzed by correlating the data. In our study 77.5% had normal (0-4 ng/ml) PSA level and 13.5% had >10 ng/ml PSA levels. BPH was the most common diagnosis (54.0%), followed by prostatitis (20.0%), BPH with prostatitis in 16.0% and carcinoma (10.0%). Serum PSA with positive DRE ranged from 1.2 ng/ml to 56 ng/ml while in negative DRE ranged from 0.18 ng/ml to 9.6 ng/ml. PSA is specific for prostate but not for prostatic diseases. With increasing age serum PSA also increases. Conjunction of serum PSA with other variables like age, DRE and biopsy makes a better diagnosis of prostatic diseases.

Maternal and Perinatal Outcome in Severe Pre-eclampsia in a Tertiary Care Center

Background: Pre-eclampsia is the leading reason for referrals to a specialized healthcare facility, as it represents a significant contributor to maternal and perinatal morbidity and mortality. Objective: The objective of this study is to examine the maternal and fetal outcomes associated with severe pre-eclampsia in a Tertiary Care Center. Design: Prospective observational study. Methodology: This prospective observational study took place at Dr. Prabhakar Kore Hospital and MRC, located in Belagavi and affiliated with KAHER's Jawaharlal Nehru Medical College, Belagavi. The study spanned from January 1, 2021, to December 31, 2021. Pregnant women diagnosed with severe Pre-eclampsia, which met the specified inclusion and exclusion criteria, and were admitted to the labor room at the tertiary care center, were enrolled in the study. Results: Participants in the study ranged in age from 19 to 41 years, with a mean gestational age at diagnosis of 35.32 weeks ±3.7 weeks. Among the participants, 73.4% underwent lower segment cesarean section (LSCS), while 22.4% had vaginal deliveries, including 3 cases with instrumental delivery (ventouse). The study observed increased incidences of Hemolysis, Elevated Liver enzymes, and Low Platelet count (HELLP) syndrome (32.4%), placental abruption (30%), postpartum hemorrhage (22%), partial HELLP syndrome (16.2%), pulmonary edema (11%), eclampsia and disseminated intravascular coagulation (DIC) (8.1%). The incidence of prematurity was 55%, and intrauterine fetal demise (IUFD) occurred in 7% of the cases. Conclusion: Maternal and perinatal problems are more common in eclampsia patients. Better prenatal care, early detection, and timely treatment of severe pre-eclampsia can lower the incidence of eclampsia.

An insight into genes responsible for fosfomycin resistance among uropathogens of asymptomatic bacteriuria during pregnancy: A North Indian study.

Asymptomatic bacteriuria (ASB) is a common finding during pregnancy. Effective antibiotic treatment could reduce its adverse effects on both mother and fetus. However, emerging antimicrobial resistance limits the treatment options. Fosfomycin might be a promising drug in this regard, as its resistance is still low. The aim of the study was to determine the antimicrobial susceptibility pattern of fosfomycin in isolates causing ASB by disc diffusion and agar dilution (in selected isolates), determine minimum inhibitory contribution (MIC) by agar dilution in isolates resistant by disc diffusion and detect the genes responsible for fosfomycin resistance. This was a 2-year study carried in the Department of Microbiology, Jawaharlal Nehru Medical College and Hospital (JNMCH), Aligarh Muslim University (AMU), Aligarh. A total of 10 252 urine samples from asymptomatic pregnant females (18-45 years) attending the antenatal care (ANC) outpatient department (OPD) were submitted. Identification of pathogen and antimicrobial susceptibility testing (AST) was carried out as per standard methods of CLSI. There was phenotypic detection of methicillin-resistant Staphylococcus aureus (MRSA) and other Staphylococcus species (MRSS), high-level aminoglycoside resistance (HLAR), vancomycin resistant Enterococci (VRE) and S. aureus (VRSA), extended spectrum β-lactamase (ESBL) and carbapenem-resistant Enterobacterales (CRE). All the fosfomycin-resistant isolates (by disk diffusion) were tested by agar dilution. Conventional PCR was performed for murA, fosA, uhpT and glpT genes on all resistant isolates. In this study, the prevalence of ASB among pregnant females was 1173(11.4 %), in which Escherichia coli 495(42 %) was the predominant organism. The overall sensitivity of fosfomycin among Gram-positive cocci (GPC) and Gram-negative bacilli (GNB) was 99 % and 97.6 %, respectively. MRSA and MRSS accounted for 50 (66.6 %) and 71 (76 %), respectively. The highest rates of MIC >2048 µg ml-1 were shown by most isolates (mainly E. coli ) on agar dilution. PCR studies revealed four E. coli strains possessed both murA (also present in one K. pneumoniae strain) and glpT genes. While only one isolate ( E. faecalis ) was positive for fosA gene. But none of the strain possessed the uhpT gene. According to this study, murA and glpT genes were more frequent than fosA. We cannot comment on the prevalence and regional distribution of fosfomycin-resistant genes based on this preliminary study. Therefore, more Indian studies should be carried out to create awareness about the presence of genes in a particular area.

A cross sectional study of high-resolution ultrasound and magnetic resonance imaging findings in shoulder joint pain in a tertiary care hospital in central India

Introduction: Shoulder joint injuries are frequent. The shoulder joint is particularly prone to joint dislocation because of its distinctive anatomy. There are several causes of the sore shoulder, however shoulder impingement is the most common one due to its widespread causes. High-resolution ultrasonography (USG) and magnetic resonance imaging (MRI) are the primary imaging modalities for assessing suspected rotator cuff injuries. Ultrasonography is a method of first choice for evaluating rotator cuff injuries due to its widespread availability, lower price, and improved tolerance. Patients with questionable USG results may be given an MRI. Aim and objective: To evaluate high-resolution ultrasound and MRI findings in shoulder joint pain. Methods: A prospective cross-sectional study will be conducted on 93 patients, who come to Acharya Vinoba Bhave Rural hospital associated with Jawaharlal Nehru medical college, a tertiary care center situated in the state of Maharashtra in India between the time frame of July 2022 to July 2024. Patients with shoulder joint pain will be submitted to a primary investigation ultrasound, followed by an MRI if there is any concern, according to the inclusion criteria. Using statistical methods, the strength of agreement between ultrasound and MRI will be found out. Outcome measures: The outcome will correlate ultrasound and MRI findings in shoulder joint pain and describe the relationship between the two.

A prospective comparative study of preoperative and postoperative clinicopathological correlation of fibroadenoma of breast: A study protocol

Fibroadenoma of the breast most often arises during the late teens and early reproductive years. It is the most prevalent tumor in women < 30 years. After the age of 40 to 45, fibroadenomas are rarely observed as new masses in women. Fibroadenomas are made up of both epithelial and stromal components. Fibroadenoma is the most frequent type of breast tumor. It is crucial to diagnose preoperatively, both clinically and pathologically, by using F.N.A.C. Postoperatively, Fibroadenoma is confirmed histopathology. However, malignant transformation is very rare in Fibroadenoma of the breast. Early identification, accurate analysis, and appropriate management are advantageous. The current study's goal is to examine preoperative and postoperative clinicopathological aspects of Fibroadenoma and to assess any differences between preoperative and postoperative diagnosis in patients admitted to Jawaharlal Nehru Medical College, Sawangi (M), Wardha, Maharashtra, India.

A cross sectional study to assess prevalence of internet addiction and its relationship with personality traits and associated psychiatric conditions in undergraduate medical students of an Indian university

Background: In India, 622 million internet users were found out of which our nationally representative data suggest that about 20% to 40% of college students in India are at risk for internet addiction (IA). Therefore, the research on its addiction is on the rise and is an established concern. Objectives: To study the prevalence of internet addiction in undergraduate medical graduates associating its impact, on personality traits and psychiatric conditions like depression, anxiety and stress. Methods: It is a cross sectional study based on undergraduate medical students of Jawaharlal Nehru Medical College, Wardha. It is a convenience based sampling method and a Krejcie-Morgan Formula is used. Using this, the sample size came out to be 300. Clearance from the ethics committee will be obtained. An informed consent from the students will be taken, thereafter they will be asked to fill socio demographic data and then will be subjected to the following questionnaires: 1)Young’s Internet addiction test 2) DASS 21 3)Brief Big Five inventory scale Results: We will be able to determine the prevalence of internet addiction among medical students after we have the results from the aforementioned questionnaires, their personality traits and development of psychiatric co- morbidities like depression, anxiety and stress. Conclusions: We’ll be able to know the prevalence of internet addiction in medical students, their personality traits and the development of psychiatric co- morbidities like depression, anxiety and stress.

Assessment Of Serum Progesterone And Serum Prolactin In Patients With Carcinoma Thyroid Before And After Thyroidectomy: A Pilot Study

Introduction: To assess the effect of total thyroidectomy on Serum progesterone and Serum prolactin present in patients with thyroid carcinoma. Method: This is a hospital-based prospective study carried out between November 2020 to November 2022 on patients diagnosed with a case of carcinoma thyroid who were admitted to J.N. Medical college and hospital. This study was done in the Department of Surgery, Jawaharlal Nehru Medical College and Rajiv Gandhi Centre of Diabetes and Endocrinology, Aligarh Muslim University, Aligarh. The patient's blood samples were collected and assessed for serum progesterone and serum prolactin (S. PRL) prior to and after 3 months postoperatively after total thyroidectomy. Result: There was an increase in the value of S. PRL. There was no change in the value of S. Progesterone. Conclusion: There was a significant change in the hormonal status after thyroidectomy. Serum PRL increased and Serum Progesterone showed no change. To our best knowledge, this was the first of a kind study to evaluate hormones following thyroidectomy in cancer patients.