Nijalingappa Medical College Research Articles

Diabetic Distress in Adults with Type II Diabetic Mellitus: A Community Based Study

Abstract Background: Diabetes is a challenging disease that is considered to be hard to live with as it encompasses a lot of restrictive instructions. Diabetic distress (DD) refers to an emotional state where people experience feelings such as stress, guilt, or denial that arise from the living with diabetes and the burden of self-management. This study was done to assess the DD in rural and urban area of north Karnataka. Methodology: A nonrandomized educational interventional study (before and after comparative study without control) with 129 urban and 63 rural study participants was conducted in urban and rural field practice area of S. Nijalingappa Medical College, Bagalkot. Data were collected using pretested and predesigned pro forma which included sociodemographic details and DD score scale. Health education intervention was followed by postintervention data collection. Results: Most of the participants were in their old age. Male predominance was seen. Most of the participants belonged to Hindu religion (57% in rural and 69% in urban) and illiterate (46.5% in rural and 41.3% in urban). There was a significant reduction in DD (mean difference = 0.7, standard deviation = 0.7), when the study participants were given educational intervention. Conclusion: To combat the stress associated with diabetes, it is important to educate the patient to adapt with change in their lifestyle following the diagnosis of diabetes.

Utility of paediatric logistic organ dysfunction score in predicting mortality in children admitted to PICU at a tertiary care centre

Background: Critically ill children are typically characterized by multiple organ dysfunctions. The use of Paediatric logistic organ dysfunction-2 (PELOD-2) scoring systems has recently been replicated in the paediatric population for morbidity and mortality predictions. Objective of the study was to study the PELOD 2 score in predicting mortality in paediatric intensive care unit within 1 hour of admission. Methods: This was prospective observational study conducted at S Nijalingappa Medical College and Hanagal Shri Kumareshwar Hospital, Bagalkot for period of 16 months. Children aged from 1 month to 14 years admitted to PICU were included in the study and patients whose parents refuse to give consent, age less than 1 month or more than 14 years, those discharged against medical advice were excluded from the study. Venous blood sample were collected within one hour of admission and were analyzed for serum creatinine, serum lactate, total leukocyte count and platelet count and arterial blood sample were collected and paO2 and paCO2 were analysed. Results: Total sample size of study was 80, out of which 52 patients had PELOD 2 score of (<4), 14 patients had score of (5-9), 11 patients had score of (10-14) and 3 patients had score >15.Among total 80 patients 66 survived and 14 died (17.5%). Of the 14 deaths, 3 patients had PELOD 2 score of >15 and 9 had score of 10-14. Pelod-2 score >9 had requirement of mechanical ventilation in 68.4%. Conclusions: Higher the PELOD-2 score on day 1of admission has higher the mortality.

A randomized controlled trial to compare the success rates and efficacy of high flow nasal cannulae versus nasal continuous positive airway pressure in post extubation period in neonates

Background: Nasal continuous positive airway pressure (nCPAP) is the mainstay for non-invasive respiratory support for all respiratory distress neonates. Recent advances in Heated humidified high flow nasal cannula (HHHFNC) usage with enhanced humidity, and improved comfort factors have led to its widespread use, at times replacing nCPAP in many neonatal settings. The present study was to assess the efficacy and safety of HHHFNC compared with nCPAP for non-invasive respiratory support in post-extubation period. Methods: A hospital based randomized controlled trial was conducted in neonatal intensive care unit (NICU) of S. Nijalingappa Medical College and HSK Hospital, Bagalkot from January 2019 to June 2020. 140 post-extubated neonates were enrolled for the study after obtaining informed consent from parents, and those who were directly extubated to no support and with major congenital anomalies were excluded from the study. Randomization was done by computer generated random number allocation method. Results: Of the140 babies, 60% were males and 40% were females. Out of 84 male neonates, 47 (67.1%) were on nCPAP and 37 (32.9%) on HHHFNC and out of 56 female neonates 23 (32.9%) were on nCPAP and 33 (47.1%) on HFNC. In this study, 4 babies on nCPAP required re-intubation within 72 hours. 5 babies on HHHFNC, 3 babies required re-intubation within 72 hours and 2 babies within 5 days. The incidence of nasal trauma, hospital stay and duration of NIV support were less in HHHFNC group as compared to nCPAP group. Conclusions: HHHFNC therapy is as effective as nCPAP therapy for the facilitation of extubation in neonates.

Diagnostic Accuracy of the RIPASA Score in Suspected Acute Appendicitis in Adults: A Cross-sectional Study Comparing it with Histopathological Findings from Bagalkot, India

Introduction: Acute appendicitis remains the most commonly occurring surgical emergency, with a prevalence rate of approximately 8% among individuals aged 10-30 years. The Raja Isteri Pengiran Anak Saleha for Appendicitis (RIPASA) scoring system appears to be an accurate, simple, and rapid parameter for predicting Acute Appendicitis (AA). Aim: To determine the validity and diagnostic efficiency of the RIPASA scoring system for acute appendicitis and compare it with histopathology. Materials and Methods: A cross-sectional study was conducted on patients admitted to Nijalingappa Medical College in Bagalkot, Karnataka, India, from January 2020 to June 2021. The study included patients of both genders above 18 years of age, presenting with right iliac fossa pain. Detailed history was obtained, and a thorough clinical examination was performed. Appropriate investigations were conducted, and the RIPASA score was calculated. Qualitative data were represented as frequency and percentage. Sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), and diagnostic accuracy were calculated to assess the validity of the tool. An ROC curve was plotted to determine the area under the curve. Results: A total of 90 patients had RIPASA scores of ≥7.5, and the majority of them (75.6%) were under the age of 40 years, with a mean age of 39.9 years. The male-to-female ratio was 48.9:51.1, approximately 0.95. The sensitivity, specificity, and diagnostic accuracy of the RIPASA scoring system were 82%, 100%, and 82%, respectively. Conclusion: The RIPASA scoring system demonstrates good applicability and efficiency in diagnosing acute appendicitis. It is easily accessible and non-invasive, thereby reducing the cost of radiological investigations and unnecessary economic burden.

Diagnostic Accuracy of the RIPASA Score in Suspected Acute Appendicitis in Adults: A Cross-sectional Study Comparing it with Histopathological Findings from Bagalkot, India

Introduction: Acute appendicitis remains the most commonly occurring surgical emergency, with a prevalence rate of approximately 8% among individuals aged 10-30 years. The Raja Isteri Pengiran Anak Saleha for Appendicitis (RIPASA) scoring system appears to be an accurate, simple, and rapid parameter for predicting Acute Appendicitis (AA). Aim: To determine the validity and diagnostic efficiency of the RIPASA scoring system for acute appendicitis and compare it with histopathology. Materials and Methods: A cross-sectional study was conducted on patients admitted to Nijalingappa Medical College in Bagalkot, Karnataka, India, from January 2020 to June 2021. The study included patients of both genders above 18 years of age, presenting with right iliac fossa pain. Detailed history was obtained, and a thorough clinical examination was performed. Appropriate investigations were conducted, and the RIPASA score was calculated. Qualitative data were represented as frequency and percentage. Sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), and diagnostic accuracy were calculated to assess the validity of the tool. An ROC curve was plotted to determine the area under the curve. Results: A total of 90 patients had RIPASA scores of ≥7.5, and the majority of them (75.6%) were under the age of 40 years, with a mean age of 39.9 years. The male-to-female ratio was 48.9:51.1, approximately 0.95. The sensitivity, specificity, and diagnostic accuracy of the RIPASA scoring system were 82%, 100%, and 82%, respectively. Conclusion: The RIPASA scoring system demonstrates good applicability and efficiency in diagnosing acute appendicitis. It is easily accessible and non-invasive, thereby reducing the cost of radiological investigations and unnecessary economic burden.

HAZARD FREE PAP IN ENDOMETRIAL CYTOLOGY

Introduction: Pap stain is a universal stain which is used for cytological screening. It is a very reliable technique. There are certain limitations of routine PAP staining like using of ethanol as dehydrating agent which is costly, hazardous and color preservation is not long standing. Our aim Aim: was to design a method using a limited amount of ethyl alcohol and it had to be rapid and economical as standard Papanicolaou stain without compromising staining quality. Materials And Merhods: A total of 200 smears collected from the endometrium of 100 unxed total hysterectomy specimens, 2 smears from each specimen, received in Pathology department of S Nijalingappa Medical College, Bagalkot. Of these, 100 smears underwent standardization of the Hazard free Pap staining and their counterparts underwent routine Papanicolaou staining. Results: The two methods were compared in respect of staining quality, cytoplasmic, nuclear details, time, cost and its ecofriendly feature. Staining time was minimized to 4 minutes from 20 minutes.In Hazard free staining, the nuclear and cytoplasmic staining was optimal in 90 and 93 respectively. Conclusion: Hazard free Pap stain provides a suitable, excellent and rapid alternative for cytological screening with minimum cost, lesser time and being ecofriendly by avoiding ethanol.

Study of bacteriology of chronic suppurative otits media in a teaching hospital: a prospective observational study

<p class="abstract"><strong>Background:</strong> Otitis media (OM) is an infectious disease that frequently affects all age brackets, including children and adults. The morbidity and complication rates of OM have been increasing in developing countries due to poor medical environments for early treatment, resulting in reductions in quality of life. Appropriate early treatment, including the use of appropriate antibiotics, is essential, requiring information on bacteriology and antibiotic sensitivity. The objective of this was to study the bacteriology of chronic suppurative otitis media (CSOM) and provide recommendations according to susceptibility pattern to commonly used antibiotics based on the experience of ENT department in S. Nijalingappa Medical College.</p><p class="abstract"><strong>Methods:</strong> Ear swabs were subjected to culture on specific culture media for bacterial growth for CSOM outpatients in S. N. Medical College, Bagalkot. </p><p class="abstract"><strong>Results:</strong> The most effective antibiotic is amikacin followed by gentamicin and cefotaxime in both isolates namely <em>Pseudomonas</em> spp and <em>Staphylococcus aureus</em> in infected ear discharge of CSOM patients in the ENT OPD.</p><p class="abstract"><strong>Conclusions:</strong> It was observed that varieties of colonies were grown on the specific cultured medium. Appropriate antibiotics can thus be found to control infection in CSOM patients.</p>

UTILITY OF SERUM ALBUMIN AND C-REACTIVE PROTEIN FOR ASSESSING THE SEVERITY OF DENGUE INFECTION- A RECORD BASED CASE SERIES STUDY.

Background: Dengue is the most rapidly spreading mosquito borne viral disease in the world. Dengue viruses are avivirus, which include four serotypes 1, 2, 3 and 4. Clinical expression of dengue virus infection vary from asymptomatic infection to severe dengue with shock. Incidence has increased 30- fold in the last 50 years with increasing geographic expansion to new countries and, in the present decade, from urban to rural settings. At present, dengue fever (DF) causes more illness and death than any other arboviral disease of humans. Aims and objectives: To determine the value of serum albumin and C-reactive protein (CRP) in the assessment of severity of dengue infection in patients admitted to SNMC and HSK hospital. Materials and methods: Record based study done on patients admitted to general medicine department of S Nijalingappa Medical College and HSK hospital, bagalkot, Karnataka. Patients with Dengue NS1 Ag or IgM positive are included in the study after meeting inclusion and exclusion criteria. Results: A total of 65 patients were studied according to the inclusion criteria. Majority of the patients were between 20-40years of age with 56.9% being male patients and 43.1% were females. 40% of the patients had dengue without warning signs, 52.3% had dengue with warning signs and 7.7% had severe dengue. Mean serum albumin of 2.66g/dl was seen in severe dengue group whereas a value of 3.65g/dl and 3.06g/dl was seen in dengue without warning signs and dengue with warning signs respectively. Mean CRP of severe dengue group was 98.84mg/L whereas it was 9.49mg/L and 53.60mg/L among dengue without warning signs and dengue with warning signs respectively. Conclusion: Serum albumin and C-reactive protein can be used as potential markers to predict severity of illness in dengue infection.

STUDY OF HEMATOLOGICAL MANIFESTATIONS IN COVID-19 INFECTED PATIENTS AND THEIR OUTCOME-OBSERVATIONAL RETROSPECTIVE LONGITUDANAL STUDY

Background COVID-19 is an ongoing global pandemic. Changes in haematological characteristics in patients with COVID-19 are emerging as important features of the disease. We aimed to explore the haematological characteristics and related risk outcome in patients with COVID-19. 1.To stud Objectives: y haematological manifestations in patients withCOVID-19 infected patients. 2.To study the severity of covid 19 infection with respect to thrombocytopenia. Observational retrospective longitudinal study done on patients admitted to Materials and methods: general medicine department of S Nijalingappa Medical College and HSK hospital, Bagalkot, Karnataka. Patients with COVID-19 Pneumonia are included in the study after meeting inclusion and exclusion criteria Data from Results: 96 patients admitted to hospital with conrmed COVID-19 were analysed in our study .The patients with severe and critical disease were older than those with moderate disease. Women had more severe disease than men. Of the haematological parameters neutrophil count, lymphocyte count, neutrophil to lymphocyte ratio(NLN ) and platelet count were signicantly different across all comparisons. Counts of platelets were signicantly lower in patients with severe disease.(p<0·0001). In the present study majority of the patients have NLN ratio >3.5(59.4%).Death have occurred more in patients with >3.5 NLN ratio i,e; 52% in patients with NLN ratio >3.5. In the present study most of the patients have platelets between 1.5lakh to 2 lakh.But the mortality is more in between 50,000-1,00,000 platelet i,e; 32.4%. The study of haematolog Conclusion: ical parameters mainly thrombocytopenia and NLN ratio helps in assessing the severity of disease and the outcome. An early diagnosis and recognition of severe COVID-19 infection with these parameters helps in preventing future mortality and helps in the proper management of the disease.

CRP COMPARISON WITH RDW AS A PROGNOSTIC MARKER FOR OUTCOME OF OP POISONING

Background: Organophosphate (OP) compounds are frequently used as pesticides in countries. This ease of availability of the OP compounds has resulted in a gradual increase in unintentional and 1 suicidal poisoning, mainly in developing countries . Elevated RDW is associated with systemic inammation and oxidative stress More severe poisoning means more production of free radicals and more oxidative stress. In AOPP, toxins may cause 2,5 lesions in tissues and organs in the body, leading to increased plasma CRP levels . Aim: 1-To measure CRP, serum acetylcholinesterase, red cell distribution width, in acute organophosphorus poisoning.2- To analyze the correlation between these biochemical parameters and serum acetylcholinesterase levels. 3-To analyze the validity of these biochemical parameters in prediction of severity and prognosis in op poisoning. Hospital based Methods: prospective study was conducted from OP compound consumption patients attending casualty and admitted patients in S. Nijalingappa Medical College Hospital and Research center, BAGALKOT. Patients less than 18 years, Co-ingestion of organophosphorus with other agents, Pre hospital cardiac arrest, Prior history of Iron deciency anemia, Vitamin B12 deciency and folate deciency anemia, Recent hemorrhage, Chronic liver disease, Prior chemotherapy, Patient on oral contraceptive pills, Patient on estrogen therapy is excluded. Results: a total of 60 patients who diagnosed with history of poisoning were involved in the study among them 29 (48.3%) were male and 31 (51.7%) were female. 75% of study population has attempted suicide by taking the poisoning and 10% of study population had accidental consumption of poisoning, and 5% of study population had occupational exposure. There is negative correlation between the cholinesterase, RDW and CRP as cholinesterase in Conclusion: creases RDW and CRP decreases and severity of poisoning decreases and as cholinesterase decreases RDW and CRP increases and severity of op poisoning increases and morbidity and mortality increases.

Cadaver as an Effective Tool for Simulation Based Procedural Skill Learning Compared to Manikin- An Interns Perspective

Introduction: Procedural skill learning is fundamental part of medical education. Simulation based learning helps students acquire the competencies without putting patients at risk. Manikins and cadavers are available resources of medical simulation. Which one is more effective in learning the skills with acceptable confidence, competence and satisfaction is to be elucidated. Establishing a cadaver based Procedural Skill Lab (PSL) may play a role in early exposure of procedural skills to medical students. Aim:To study the intern’s perceptions of effectiveness of procedural skill learning on cadaver and manikins and to record their opinion on need for establishing PSL in Anatomy Department. Materials and Methods: An observational study conducted at S. Nijalingappa Medical College, Bagalkot, Karnataka, India. Twenty five (n=25) interns who volunteered to participate in the study were included. After collecting the baseline data about exposure to said skills, students were divided into two groups. Students learnt six procedural skills on manikins (M group) and on cadavers (C group). Post-test data was collected. Then crossover was done and survey about the satisfaction, preferred mode of learning and need of the PSL in anatomy was collected. Non parametric test were applied: Wilcoxon signed rank test for paired data Mann-Whitney U test for unpaired data, using Medcalc and Statistical Package for the Social Sciences (SPSS) software. Results: Perceived confidence and competence of students after training in both the groups (M and C) increased for all the six skills which was statistically significant (M group p<0.0005 and C group p<0.0002). Satisfaction score was more for cadaver group (p<0.0001). Students chose cadaver based learning as the preferred method of learning and wanted PSL. Conclusion: Soft embalmed cadaver can be an effective tool to learn procedural skills at all level. Establishing a cadaver based PSL in anatomy can provide undergraduates with early exposure of skills develop the requisite knowledge, postgraduates can learn the speciality concerned procedural skills and faculty can venture upon innovative procedures and prevent de-skilling.

Effect of Ageing on Midbrain to Pons Area Ratio Using MRI: A Cross-sectional Study

Introduction: There is brainstem atrophy with normal ageing. It is pertinent to determine, if this atrophy with ageing, is associated with significant alteration in the midbrain to pons ratio. Aim: To determine sizes and ratio of midbrain and pons area among adults and elderly. Materials and Methods: A cross-sectional, analytical study was done in a tertiary care hospital, S Nijalingappa Medical College, Bagalkot, Karnataka, India from January 2022 to March 2022, including 200 apparently healthy adult and elderly participants. They were divided into two groups, 100 men (M1≤50 years and M2>50 years) and 100 women (F1≤50 years and F2>50 years). Each underwent multiplanar T1 Magnetic Resonance Imaging (MRI) of the brain. An experienced Radiologist identified midsagittal image, and measured midbrain and pons areas on that image. Mean and standard deviations of midbrain and pons area and midbrain to pons area ratio were estimated for each of the groups. Independent Sample t-test was used to determine significance of differences between groups. Results: A total of 200 participants were included in the study with mean age of 51 years and 3 months. The midbrain to pons area ratio among M2 and F2 groups ranged from 0.20 to 0.39, and in M1 and F1 groups it ranged from 0.23 to 0.47. Midbrain areas and midbrain to pons area ratio were significantly more among participants aged less than 50 years among both males (p-value = 0.014 and 0.024) and females (p-value = 0.011 and 0.032) in comparison with participants aged more than 50 years. Conclusion: Midbrain to pons area ratio decreases significantly in older age, and hence, age needs to be accounted for, while interpreting the ratio.

Estimation of Stature from Foot Print Length among Students and Staff of S. Nijalingappa Medical College of Age Group 21-30 Years

Identity means the determination of the individuality of a person. Identification of a person is one of the mostimportant issues for a forensic expert in solving many medico-legal cases. The present studies was undertaken to estimate the stature from foot print length and to evolve regression equation for the same in both thegender. 100 healthy subjects (50 males and 50 females) of age group 21-30 years, who are resident of northKarnataka, were included in the study. The foot print lengths of both the feet of the participants were taken.The readings were subjected to statistical evaluation and regression formulae were established for statureestimation from foot print lengths in males and females.

Intracranial and extracranial complications of chronic otitis media and their management at a tertiary care center: a descriptive study

<p><strong>Background: </strong>In the pre-antibiotic era complications from otitis media occurred abundantly, accompanied by high morbidity and mortality. With availability of higher antibiotics, morbidity and mortality due to chronic otitis media (COM) has reduced, but still complications due to COM remain a significant problem in developing countries. The aim is to study clinical presentation, management and outcomes of intracranial and extracranial complications of COM. Study design is retrospective case series study.</p><p><strong>Methods:</strong> Patients admitted in department of otorhinolaryngology and head and neck surgery, S. Nijalingappa medical college and H.S.K hospital and research center, Bagalkot from May 2018 to April 2020 with COM associated with intracranial or extracranial complications were included in the study. Data of clinical presentation, associated complications, management, and follow-up were analyzed.</p><p><strong>Results:</strong> A total of 20 patients were reviewed during study period. Of these seventeen patients had extracranial (EC) complications, while one had intracranial (IC) complications and two had both. Otalgia, otorrhea and fever were the main presenting symptoms. The encountered IC complication were lateral sinus thrombophlebitis, cerebellar abscess. Among the EC complications most common were post-auricular subperiosteal abscess, lateral semicircular canal fistula and facial paralysis. Most commonly isolated organism was staphylococcus. Surgery was main modality of treatment.</p><p><strong>Conclusions:</strong> COM is still a significant problem in developing countries in spite of availability of antibiotics and early diagnosis is crucial in the management of complications associated. This study emphasizes the importance of early diagnosis and prompt treatment to limit the morbidity.</p>

Pattern of hand injuries: a two year review of cases in S. Nijalingappa Medical College and HSK Hospital, Bagalkot

Background: Hand injuries are common, leading to loss of function with attendant psychological consequences. The pattern of the injuries varies from place to place, responsible for a significant hospital emergency visit and most of which are seen by non-hand specialists. It is pertinent that those who may come across the patients understand this pattern.Methods: A retrospective review of records of patients presenting with hand injuries to the plastic surgery department over a two year period was carried out highlighting the pattern of the injury.Results: A total of 95 patients predominantly males sustained hand injuries. Most of the patients were in their 20s. Road traffic injury been the commonest cause of injury followed by machines with high incidence of injury of the Right hand which was 53.6%. Soft tissue injuries occurred in 79% of cases, bony injuries occur 14% of cases and tendon injuries in 7% cases.Conclusions: Understanding the pattern of injury can impart positively on the management of hand injuries and for its preventive measures of safe road and education of the people on the use of tools and machines in our environment.

English

BACKGROUND Anaemia is a worldwide problem which has major consequences on human health. It also poses a huge social and economic burden. World Health Organisation defines a haemoglobin level of less than 8 gm / dL as severe anaemia. It affects multiple organs, cardiovascular system being one of them. The clinical features of anaemia are a result of diminished oxygen carrying capacity of the blood. The clinical presentations vary depending on the age of the patient, rapidity of onset of anaemia and its severity. The cardiac changes are reflected as electrocardiographic abnormalities. In clinical practice such electrocardiographic findings simulate those of ischemic heart disease leading to a battery of investigations. METHODS This was a retrospective study. Forty five anaemia patients admitted in medicine wards of S. Nijalingappa Medical College and HSK hospital over a period of 6 months from 1st July 2019 to 31st Dec 2019 were studied. Complete hemogram and electrocardiography were obtained and analysed. RESULTS Anaemia was more common among females who constituted 30 (66.66 %) patients as compared to males constituting 15 (33.33 %) patients. 31 patients (68.88 %) with severe anaemia showed ECG changes. Most common finding was sinus tachycardia seen in 17 (37.77 %) of patients followed by T inversions 11 (24.44 %) and ST depressions 4 (8.88 %). Anaemia was most commonly seen in the age group of 15 - 30 years constituting 23 (51.11 %) patients. ECG findings were more common in females as compared to males. 22 (73.33 %) of female patients had ECG changes as compared to 9 (60 %) in males. CONCLUSIONS ECG abnormalities are common in patients with severe anaemia more so in females. These mimic changes seen in patients with ischemic heart disease. KEYWORDS Severe Anaemia, Electrocardiographic Findings, Sinus Tachycardia

SEVERITY OF SNAKE BITE WITH EARLY PREDICTORS OF THROMBOCYTOPENIA AND ALBUMINURIA IN ACUTE KIDNEY INJURY

Snakebites are very common public health problems which is caused by venomous arthropods effecting many organs and causing fatal emergencies. Snakebite can cause direct or indirect nephro toxicity, especially hematotoxic snakebites. It is important to know the early predictors of acute kidney injury so as to prevent the complications early. Methods: This is a prospective case series study conducted at S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Research center, Bagalkot from June 2018 to June 2019. Results: Total of 51 patients were included in this study who satisfied the inclusion and exclusion criteria. It was found that 35 patients had thrombocytopenia with p value of <0.002, which was highly significant. Serum creatinine was found to be more than 1.2mg/dl in 35 patients and the p value was <0.002 which was highly significant and urine albumin was also found to be more which p avalue was<0.001. among the study subjects 70% of them were found to have thrombocytopenia with albuminuria and increase in serum creatinine.

PATTERN AND CLINICAL PROFILE OF PATIENTS WITH Β- THALASSEMIA IN REPEATED BLOOD TRANSFUSION

Chronic transfusions inevitably lead to iron overload as humans cannot actively remove excess iron. The cumulative effects of iron overload lead to significant morbidity and mortality, if untreated. The combination of transfusion and chelation therapy has dramatically extended the life expectancy of thalassemia patients, but with complications like hypocalcaemia. Hence, present study was undertaken to determine pattern and clinical profile of patients with β- thalassemia who are receiving repeated blood transfusion Methods: Hospital based study conducted at S. Nijalingappa Medical College and Hanagal Shri Kumareshwar hospital, Bagalkot. The study period was one and half year from 2015 to 2016. 53 beta thalassemia major cases fulfilling inclusion criteria were investigated after an informed consent, for serum calcium, serum phosphorous, serum ALP and paratharmone levels. Result: Among 53 transfusion dependent children studied, the mean age is 5.249 years. The study consisted of 32 (60.4%) males and 21 (39.6%) females. Maximum number of cases i.e. 29 (54.7%) were diagnosed at the age of 4-6 months. 50 (94.3%) were on iron chelation therapy. The mean serum calcium is 8.28 + 0.89 mg/dl. The mean serum phosphate is 6.40 + 0.80mg/dl, mean PTH is 14.96 + 15.49ng/L. The mean value of serum phosphate level is 14.96 + 15.49 ng/L. The mean ALP is 166.789 U/L. Conclusion: To get better results, regular testing is needed to detect the complications of the early stages with proper treatment of the factors and complications. Therefore, should be monitored to avoid complication related to hypocalcemia.

Management of ear, nose, and throat out patient department in COVID-19 pandemic, experience: a descriptive study

<p><strong>Background:</strong> Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19) has a predilection for infecting the mucosa of the upper and lower airways. Otolaryngologists and supporting health care workers (HCWs) are particularly at high risk of becoming infected while treating patients as many in-office procedures and Aerosol Generating Medical Procedures (AGMP). Based on a review of the literature and various guidelines, recommendations are made to mitigate the risk to health care workers from becoming infected with SARS-CoV-2 while providing clinical care. During the COVID-19 pandemic, all elective and non-time sensitive Otolaryngology procedures should be deferred to mitigate the risk of transmission of infection to HCWs. Objective of the study was to describe outpatient presentations requiring otolaryngology consultation and provide recommendations for protective measures based on the experience of ENT department in S Nijalingappa Medical College.</p><p><strong>Methods</strong>: Personal protective equipment (PPE) use and infection control strategies implemented for ENT outpatients in S. N. Medical College, Bagalkot.</p><p><strong>Results:</strong> After implementation of infection control strategies for outpatient clinics, no health care workers were infected in the ENT OPD.<strong></strong></p><p><strong>Conclusion:</strong> Otolaryngologists play an indispensable role in the treatment of COVID-19 patients but, due to their work, are at high risk of exposure. Appropriate protective strategies can prevent infection to otolaryngologists.</p>

A prospective study of proportion of Helicobacter pylori infection in patients presenting with dyspeptic symptoms in S. Nijalingappa Medical College and H.S.K. Hospital, Bagalkot

Background: More than half of the world’s population is infected with Helicobacter pylori, the primary cause of chronic gastritis. Chronic gastritis is associated with peptic ulcer and in advanced stages with an increased risk of developing gastric adenocarcinoma. The aim of the study was to determine the prevalence of Helicobacter pylori infection in dyspeptic patients and its relationship with gastroduodenal pathologies using gastric biopsy histology.Methods: A cross sectional prospective study was conducted from 1st January 2018 to 30th June 2019. It included out-patients and in-patients, presenting with dyspeptic symptoms and undergoing upper GI Endoscopy, at S. Nijalingappa Medical College and HSK hospital, Bagalkot, Karnataka, India. Endoscopic impressions were noted. In case of any abnormal findings on upper gastrointestinal endoscopy, endoscopic biopsy was obtained. Histopathological assessment of gastric mucosa was done after staining with H and E stain and Giemsa stain. The histopathological diagnosis of Helicobacter pylori infection in biopsy specimen will be mainly done using the Modified Giemsa stain.Results: 105 patients with dyspepsia were studied in total. Out of which, 44 patients (41.9%) were detected positive for Helicobacter pylori infection.Conclusions: The burden of Helicobacter pylori infection in patients with dyspepsia was high. Early diagnosis and eradication of Helicobacter pylori not only improves symptoms but also help to prevent complications associated with Helicobacter pylori infections.