Rajarajeswari Medical College Research Articles

Pregnancy Preparedness and Complication Preparedness of Pregnant Women in Prenatal Clinics of Tertiary Hospitals

This study assesses the level of Birth Preparedness and Complication Readiness (BPACR) among pregnant women attending antenatal clinics at a tertiary care center. Conducted through an analytical cross - sectional approach from August to October 2023 at Rajarajeswari Medical College Hospital, Bengaluru, it involved 194 participants who were 32 weeks gestation or more. The research utilized a questionnaire covering sociodemographic characteristics, knowledge of birth preparedness, and complication readiness, with data analyzed using descriptive statistics. Results indicated a low BPACR index with significant gaps in awareness and preparedness for childbirth and emergency situations. Only a fraction of participants had initiated antenatal care in the first trimester, and a majority were unaware of severe preeclampsia signs. The study underscores the need for enhanced education and awareness programs at both community and health center levels to improve birth preparedness and complication readiness among pregnant women.

Prevalence of osteoarthritis knee among elderly in rural field practice area of Rajarajeswari Medical College, Bengaluru, India

Background: The most prevalent kind of arthritis and a highly common disease of the elderly is osteoarthritis (OA). It is a major contributor to disability among elders. The cervical and lumbosacral spine, the hip, the knee, and the first metatarsal phalangeal joint are the joints most frequently afflicted by it. Objective was to estimate the prevalence of osteoarthritis knee and to assess the risk factors associated with osteoarthritis knee among elderly persons in rural field practice area of Rajarajeswari Medical College, Bangalore. Methods: A cross-sectional study was conducted by visiting house to house among 150 elderly people selected by purposive sampling technique at Chunchunnakuppe village which is located on South Bangalore from June 2023 to July 2023. A detailed clinical examination of knee using American College of Rheumatology (ACR) criteria and Socio demographic information were also elicited. Results: A total of 150 elder respondents were interviewed out of which 63 (42%) had OA knee. Female gender, history of a knee injury, family history of knee pain, other chronic illness, current physical activity, BMI, and smoking status were found to be significantly associated with knee OA (p<0.05). Conclusions: In the study area, osteoarthritis of the knee was quite prevalent. Some of the modifiable factors like physical activity, smoking, BMI are significantly associated with OA knee.

Short-term memory assessment by visual tasks in yoga practitioners and non-yoga practitioners: A comparative study

Background: Memory is the storage of acquired knowledge for later recall. Learning and memory form the basis by which individuals adapt their behavior to their particular external circumstances. Without these mechanisms, it would be impossible for individuals to plan for successful interactions and to intentionally avoid predictably disagreeable circumstances. Yoga unites the individual self with the cosmic consciousness, which can be achieved by pranayama, asanas, and meditation. Aims and Objectives: To compare the short-term memory in yoga practitioners and Non yoga practitioners by visual tasks and to assess by visual tasks, the improvement in short-term memory after applying memory-improving methods in yoga practitioners and non-yoga practitioners. Materials and Methods: 50 female subjects performing yoga at least 5 days a week for the past 3 months with no any morbidities and 50 female subjects as controls with no any morbid illness were selected randomly from the general population for the study. The memory assessment and memory-improving methods were applied as per Washington’s Chudler memory assessments. Results: The present study was conducted in the Department of Physiology at Rajarajeswari Medical College Bengaluru on 50 yoga practitioners and 50 controls aged 20–65 years who volunteered for the study. Short-term memory status by the visual task before and after application of certain memory improvement methods by using four tests i.e. Alphabetical test (six trials), Numerical test (six trials), Words test, and Object test were done and analyzed both for the controls and yoga practitioners. The mean age of controls and yoga practitioners was 37.78 ± 9.83 years and 37.16 ± 9.53 years respectively. There is no significant age difference in between the groups. The P = 0.74 (Student’s unpaired t-test). Short-term memory status in yoga practitioners significantly increased in Alphabetical and Numerical tests in Trials 5 and 6 and also in word and object tests, The P = 0.0001 (analysis of variance test), meanwhile, their short-term memory status were compared before and after the practice of yoga for 3 months. In the present study we found there is increase in the short-term memory of the yoga practitioners when compared to their own memory before and after the practice of yoga. Conclusion: The present study was undertaken to compare the short-term memory status in yoga practitioners and non-yoga practitioners and also to evaluate the use of memory-improving methods to improve the short-term memory in them. On the basis of the study results we can conclude that the short-term memory can be improved by practicing yoga. The study showed an improved memory status when the non-yoga practitioners were compared with yoga practitioners after practicing yoga. The memory-improving methods showed improved memory status in the control group.

Adherence to tuberculosis treatment among patients attending national tuberculosis elimination centre in tertiary care hospital, Bangalore

Background: Annually ten million cases of tuberculosis (TB) and 1.8 million mortalities are recorded. Adherence to TB treatment not only reduces death outcomes but prevents prolonged sickness, transmission to others and development of multi drug resistant TB. This study was aimed at determining the rate of treatment adherence and possible factors influencing adherence to TB treatment in the NTEP Centre at Rajarajeswari medical college and hospital, Bangalore. Methods: It was a cross sectional study design. A validated 8 item Morisky medication adherence scale was used to obtain data from respondents. Adherence to TB treatment was assessed. Chi square test was used to determine the variables that were associated with treatment adherence. Results: Out of 60 patients, majority i.e. 18 (30%) were in the age group 25-34 years, males were more compared to females. Majority i.e. 21 (35%) were studied up to post high school diploma, 31(51.67%) were unemployed, majority i.e. 48 (80.00%) were married, 42 (70.00%) were from nuclear family. Out of 60 patients, majority 54 (90.00%) were Hindus 24 (40.00%) were from lower middle class. Conclusions: The adherence rate for TB treatment in this study was 68.33%. There was no significant association between socio demographic variables, personal habits, health status, current TB status, type of TB, and common symptom with treatment adherence. An intensified health education on the adherence of TB treatment therefore recommended.

A cross sectional study to assess the severity of meibomian gland dysfunction and its association with dyslipidemia

Background: Studies have linked increased cholesterol esters in meibomian secretions to patients with meibomian gland dysfunction. Dyslipidemia has been linked to the development of MGD. This study of serum lipid profile in established cases of MGD. Methods: A cross sectional study was conducted in department of ophthalmology at Rajarajeswari medical college and hospital Kambipura, Bengaluru from January 2021 to June 2022. 75 study participants with clinical diagnosis of MGD were included. Results: The mean age of the study participants was found to be 55.97±14.019. Mild MGD grade was found in 32% and 26.7% of the study participants in the right eye and left eye respectively. Moderate MGD grade was 38.7% and 42.7% of the study participants in the right and left eye respectively. 4% each of the study participants had very severe MGD grade in the right and left eye respectively. Marx line grading of 1 was found in 40% and 46.7% of the study participants in the right eye and left eye respectively. Marx line grading of 2 was found in 54.7% and 36% of the study participants in the right and left eye respectively. Marx line grading of 3 was 5.3% and 17.3% of the study participants in right left eye respectively. severity of MGD grading of the study participants increases, the Lipid profile values also increases. The association was statistically significant between the MGD grading and lipid profile. Conclusions: MGD patients exhibit a higher degree of total cholesterol, LDL, lower degree of HDL in their serum lipid profiles than normal reference levels and the severity of MGD increases, the values of lipid profile increase. Elevated serum cholesterol was associated with MGD.

PERCEIVED ILLNESS INTRUSION AND FACTORS ASSOCIATED WITH PATIENTS ONHEMODIALYSIS IN ATERTIARY CARE HOSPITAL

Background/Purpose: Dialysis is a medical procedure that is very nerve-wracking as it interferes with the day-to-day activities of the patients suffering from kidney disease. Our study is aimed at finding the association between illness intrusion among patients on dialysis, the effect of duration of dialysis, and patient demographics. Materials/Methods: A cross-sectional study was conducted on 60 Chronic Kidney Disease patients who were on maintenance hemodialysis in RajaRajeswari Medical College and Hospital, tertiary care center in Bangalore, Karnataka for a period of two months. The patients were interviewed using a pre-tested and semi-structured interview schedule. Data was entered and analysed using Tableau software. The results were visualized in percentages and proportions. Results: Out of 60 patients, 42 patients were males and 95% of total patients were married. 61.7% were from urban areas and the majority (81.7%) of the patients funded their dialysis through their own/family income and 75% reported an intrusion in the area of work. Conclusion: A high percentage of people were from urban areas and very few from rural areas. Therefore, setting up Nephrology units in government hospitals would reduce the economic burden on the patient. Categories: Nephrology, Epidemiology/Public Health.

Prevalence of meconium-stained amniotic fluid in SARS COVID-19 positive pregnant mothers and its manifestations in newborns

Background: This study is being conducted to find out whether coronavirus disease 2019 (COVID-19) is associated with an increased incidence of MSAF in COVID-positive pregnant women. Finding implications for operative delivery and perinatal outcome. The evidence will help in managing COVID-positive women in pregnancy. Methods: This prospective observational study was conducted from July 1, 2020 to October 20, 2020 at Rajarajeswari Medical College and Hospital, Bangalore. A total 38 newborns born to SARS-COVID-19 infected mothers were included. Data collected from pregnant women, patient records, birth registries, operating room/delivery room records and NICU registries. Results: The clinical characteristics of 38 mothers and their newborns were analyzed. The mode of delivery was normal vaginal delivery (NVD) in most (N=21) cases. All newborns tested negative for SARS-CoV-2. 18 babies required only routine newborn care, and 20 babies required neonatal intensive care unit (NICU) admission at birth for management of meconium-stained amniotic fluid (MSAF)(11pregnancies), prematurity (3 cases), dyspnea (6 cases), stage 2/3 hypoxic ischemic encephalopathy (HIE) (2 cases), and Jaundice (9 cases). 18 of 38 stable babies held mother's side and breastfeeding started, with no signs and symptoms attributed to SARS-CoV-2. Conclusions: In our study, the prevalence of MSAF is higher (28%) in COVID-19 Positive mothers, resulting in low APGAR scores and poor perinatal outcomes. Vigilant intrapartum care is recommended to reduce the risk of poor neonatal outcomes. No newborns developed signs and symptoms of SARS-CoV-2 infection during rooming-in, breastfeeding and during admissions at neonatal intensive care unit (NICU).

Management of chronic fissure in ano-lateral internal sphincterotomy versus 2% diltiazem gel local application: a prospective comparative study

Background: Fissure-in-ano is one of the most common benign anorectal disorders often encountered in surgical outpatient department. Various pharmacological agents and surgical interventions have been tried in the management of fissure in ano. In this study we have compared medical management by topical diltiazem gel with established surgical procedure of lateral internal sphincterotomy (LIS) in the management of chronic anal fissure. Methods: A total of 50 patients with chronic fissure in ano involved in this prospective comparative study, between December 2020 to May 2022, at Rajarajeswari Medical College and Hospital, Bengaluru. Selected patients were put under two groups of 25 participants each, A (2% diltiazem group) and B (lateral internal sphincterotomy - LIS group) using simple randomization technique and were to receive treatment accordingly. Fissure healing and pain relief were recorded on presentation and during follow up visits. Results: The results were compared weekly for 4 weeks and monthly for 2 consecutive months. Fissure healing and pain relief were recorded. Conclusions: Both 2% diltiazem group and LIS group are equally effective and did not show any difference in pain relief or fissure healing with p value not significant (>0.05).

A PROSPECTIVE STUDY ON THE FUNCTIONAL OUTCOME OF PROXIMAL FIBULAR OSTEOTOMY IN GRADE 2 AND 3 MEDIAL COMPARTMENT ARTHRITIS OF THE KNEE.

Introduction: Osteoarthritis of the knee is a common musculoskeletal diseases affecting a major population in India. It can impact the individual's functions and activities of daily living. Total knee arthroplasty may raise controversy when treating the younger, athletic patient with arthritis. Arthroscopic debridement, high tibial osteotomy, unicondylar knee arthroplasty, and total knee arthroplasty allow younger patients to maintain an active, healthy lifestyle but can take a longer time to rehabilitate. PFO could be used as an alternative procedure. The Proximal Fibular Osteotomy, which provides immediate short term relief in cases with medial compartment osteoarthritis. Resecting a segment of bula, loosens the lateral side allowing the upper tibia to settle into a more favorable lateral alignment, shifting the mechanical axis towards neutral or valgus. Aims & objectives: Ÿ To assess the functional, clinical and radiological outcome of proximal bular osteotomy in grade 2 and 3 OA of knee and followed up for 1 year. Ÿ The clinical and functional outcome is accessed by Knee Society Score and VAS observed pre-op , post-op ,3 months ,6 months and 12 months. Ÿ The improvement in radiology is accessed using change in the medial joint space improvements in CP angle, change in the ratio of medial joint space to lateral joint space observed pre-op and post-op Methodology: The patients selected had grade 2 and 3 Osteoarthritis of knee according to Kellgren Lawrence classication between the age groups 20yrs-80yrs and are admitted to RajaRajeswari Medical College and Hospital, Bangalore. The Sample Size is 30 and is calculated based on previous studies as well as approximate availability of number of cases in the above mentioned duration satisfying inclusion and exclusion criteria. Clinical, functional and radiological outcome were used, Results were calculated using Knee Society Scoring Scale score. This study Conclusion: suggested that Proximal Fibular Osteotomy is an alternative procedure that can be used to treat medial compartment knee Osteoarthritis, if the patients are selected carefully. Patients followed up for one year showed a signicant improvement in radiological, clinical and functional outcomes and thereby is an effective method of treatment in younger patients with Grade 2 and Grade 3 Osteoarthritis with an average BMI of 26.2

“A 2 YEAR PROSPECTIVE STUDY EVALUATING DIAGNOSTIC ACCURACY OF MAGNETIC RESONANCE IMAGING (MRI) IN DETECTION OF RAMP LESIONS OF MEDIAL MENISCUS”

The purpose of this study is to Correlate the characteristic pattern of lesions affecting posterior horn of medial meniscus in MRI with Arthroscopic findings and calculate sensitivity, specificity and accuracy in diagnosis of ramp lesions. Methodology:It is a 2-year prospective study conducted in department of orthopedics, Rajarajeswari Medical college and Hospital, Banglore. Patients who were diagnosed with meniscal injuries were posted for arthroscopy surgery after obtaining the informed consent. In this study we compared MRI findings with arthroscopic findings of medial meniscal ramp lesions of knee. The data is prepared and sensitivity, specificity, accuracy of MRI were calculated. Results:A total of 112 patients of knee injuries were evaluated in which the Medial meniscus was injured in 64.96% of cases. The MM tear with ramp lesion was present in 26(65%) cases, of which 5 (12.5%) cases had grade I tear, 8 (20%) cases had grade II tear and 13 (32.5%) cases had grade III tear. The sensitivity, specificity, PPV and NPV were calculated and we found Sensitivity 88.89%, Specificity 84.62%, Positive predictive value 92.31%, Negative predictive value 78.57%, Accuracy 87.50%. Conclusions:The Meniscal Ramp lesions need to evaluation of the knee injuries accurately is very crucial for the proper management and outcome. MRI shows moderate sensitivity, specificity and accuracy in the diagnosis of ramp lesions in posterior horn of medial meniscus with more false positives and false negative values. Common causes of false positive findings in MRI is due to misinterpretation of intra meniscal signal changes (grade II signal changes) or normal anatomy as tears. The arthroscopic evaluation of ramp lesions was done using a postero-medial and trans-notch view and other accessory portals.

STUDY OF OCCURANCE OF GALL BLADDER STONES AMONG PATIENTS WITH TYPE 2 DIABETES MELLITUS IN A TERITIARY CARE HOSPITAL

Background: Diabetes could form cholesterol gallstones more frequently because of a reduced gallbladder contraction and increased biliary cholesterol secretion. A meta -analysis study suggested that there is a strong association between diabetes mellitus and the occurrence of gallstone disease. The incidence of gallstones is higher in Type 2 Diabetes both in males and females than the non-diabetics. To study the frequency of gallbladder stones among patients with Objective: Method: type 2 Diabetes mellitus. After institutional ethical committee approval and obtaining written informed consent from the patients, an observational cross-sectional study was conducted on patients admitted in Raja Rajeswari medical college and hospital over a period of one and half year on 100 known case of type II diabetes mellites for more than or equal to 5 years. In the present study, the Results: occurrence of gallbladder stones was 21% among Type 2 diabetes mellitus participants. Even though statistical association could not be proven, a higher HbA1c level was found to be among the study participants with gall stones when compared with the study participants without gall stones. 21% of the study participants were Conclusion: diagnosed with Gall stones. 79% of the study participants were not diagnosed with gall stones

Correlation of magnetic resonance imaging findings and arthroscopy findings in diagnosis of intra articular ligament injuries of knee joint

Background: The knee is the largest synovial joint in body with extra and intra articular ligaments which act as supporting structures around the joint. The intra articular ligaments of knee are more commonly injured. An accurate and early diagnosis of the internal derangement of knee is necessary for planning the treatment. In this study we compare the findings of magnetic resonance imaging (MRI) with arthroscopy and evaluate the accuracy of MRI in diagnosing intra-ligament injuries of knee. Methods: It is a prospective study conducted in the department of orthopaedics, Raja Rajeswari medical college and hospital, Bangalore from July 2018 to May 2021. Selection criteria include 80 patients who presented with history of ligamentous injury to the knee. The MRI was obtained and selected cases were posted for arthroscopic surgery after obtaining the informed consent. The MRI findings and Arthroscopy findings were correlated and statistical data analysis is prepared to obtain accuracy of MRI. Results: In this study 80 patients were selected and data was prepared. ACL tear presented with 100% sensitivity and 95% accuracy, PCL injuries shows 100% sensitivity and 97% accuracy, medial meniscus tears presented with sensitivity 96.15% and accuracy 95%, lateral meniscus tears presented with sensitivity 95.83% and accuracy 97.50% of MRI. Conclusions: In our study the MRI has more capable in detecting anterior horn tears, multiple tears and underneath tears that may be overlooked in arthroscopy. However, appropriate sequences, analysed in different planes, newer techniques, powerful tomograms will improve the diagnostic accuracy and reduce errors.

Possible Involvement of Cellular Pathway and Cytokines in Manganese Induced Neurotoxicity in Neuroblastoma Cells via KH–Type Splicing Regulatory Protein

Pharmacognosy Research,2023,15,2,307-314.DOI:10.5530/pres.15.2.033Published:February 2023Type:Original Article Authors:Sharad Singh, Sunil More, G. S. Latha, Himanshu Agrawal, Veena S M, and Francois Niyonzima Author(s) affiliations:Sharad Singh1, Sunil More1,*, G. S. Latha2, Himanshu Agrawal3, Veena S M4, Francois Niyonzima5 1School of Basic and Applied Sciences, Dayananada Sagar University, Bangalore, Karnataka, INDIA. 2Department of Physiology, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, A Constituent College under Dr. M.G.R. Educational and Research Institute, Chennai, Tamil Nadu, INDIA. 3Jubilant Biosys Limited, Bangalore, Karnataka, INDIA. 4Department of Biotechnology, Sapthagiri College of Engineering, Bengaluru, Karnataka, INDIA. 5Department of Mathematics, Sciences and Physical Education, University of Rwanda-College of Education (UR-CE), Kayonza Rukara Campus, RWANDA. Abstract:Background: Manganese is a toxic essential trace element and too high concentration instigates the neurodegenerative disease known as parkinsonism. Effects of manganese may lead to apoptosis. However, a detailed mechanism of manganese toxicity has not been fully elucidated. Previous published articles have highlighted the augmentation of KHSRP expression following Mn exposure. Objectives: In this work, the importance of KHSRP in Mn–induced toxicity was checked along with the impact of other known neurotoxicity inhibitors on KHSRP. Materials and Methods: KHSRP expression, pro and anti-inflammatory cytokines, chemokines, and pharmacological inhibitors (SAHA, Quercetin, and MCC950) were determined by exposing N2a cells to various MnCl2 concentrations. ANOVA and Dunnett’s test were used to decide on the significance. Results: MnCl2 treatment led to the augmentation of the KHSPR mRNA expression and protein increase in N2a cell line. The MnCl2 treatment of N2a cells also showed an elevated liberation of IL-6, TNF-α, MCP–1, and IL-1β. Pharmacological agents like quercetin inhibiting PI3K, MAPK, and WNT pathways, MCC950 blocking NLRP3 pathways, and SAHA showed a decrease in KHSRP expression post Mn treatment. With the inhibition of KHSRP, a decline in the release of IL-1β, IL-6, MCP–1, and TNF-α was also observed. Conclusion: These results suggested that MnCl2 treatment of N2a cells induce the expression of KHSRP via the PI3K–or NLRP3 pathway. Furthermore, this elevated expression of KHSRP is responsible for an increment in the liberation of pro-inflammatory markers in N2a cells. More exploration is needed to throw light on the pathway driving the KHSRP. Keywords:KH–type Splicing Regulatory Protein, Manganese Neurotoxicity, Neuroblastoma, Neurodegeneration, Neuroinflammation.View:PDF (1.26 MB)

COMPARISION OF CORD BLOOD LIPID PROFILES BETWEEN IDM AND NON IDM NEONATES

Background: Gestational diabetes mellitus ( GDM ) is one of the serious causes for feto maternal morbidity and long term complications in both mother and child. Due to better screening modalities, early detection and better treatment option like insulin have helped to lower the complications in Infants born to diabetic mothers ( IDM ). As atherosclerotic diseases in adulthood have become rampant, early detection of high risk groups is necessary. Based on Barker's hypothesis, atherosclerosis in adulthood have predisposing factors starting from in-utero. So this study was taken up to compare the cord blood lipid prole levels in IDM babies and infants born to normal mothers. Methods: This prospective (case-control) study was carried out on 60 infants born in Rajarajeswari Medical College and Hospital, from July 2022 to December 2022. The study group consisted of 30 IDM babies, and the control group of 30 infants who were born to healthy mothers. Results: The results of this study demonstrated that there are signicant differences between IDM and infants of healthy mothers regarding lipid prole, maternal age and birth weight. Conclusion: This study conrms that cord serum lipid prole (serum cholesterol, serum triglycerides and low-density lipoprotein) is higher at birth in IDM. Moreover, this study shows a signicant association between lipid prole and body weight and maternal age.

STUDY OF CLINICAL PROFILE OF PATIENTS OF NON ALCOHOLIC FATTY LIVER DISEASE AND ITS ASSOCIATION WITH METABOLIC SYNDROME

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver problems in the western world. It is known to be associated with various metabolic abnormalities, but not much information regarding association between the metabolic disease and the severity of fatty liver is available. We conducted a study on 100 consecutive patients aged >18 years attending the outpatient and inpatient Department of General Medicine, Rajarajeswari Medical College and Hospital according to the inclusion and exclusion criteria. The study was an observational and analytical study of patients diagnosed as NAFLD. All patients diagnosed as NAFLD were investigated for metabolic syndrome according to the NCEP ATP III criteria and a relationship between NAFLD and metabolic syndrome was studied. We found that 53% of the patients of NAFLD had metabolic syndrome and statistical signicance was found in waist circumference, blood pressure, triglycerides, and fasting glucose. Its early detection will help CONCLUSION: in modifying the disease course, delaying complications and will also play a major role in preventive cardiology. It has been observed that there is high prevalence of all the components of metabolic syndrome in cases of NAFLD

STUDY OF EFFECT OF ANTENATAL STEROIDS ON MECHANICALLY VENTILATED LOW BIRTH WEIGHT NEONATES WITH RESPIRATORY DISTRESS ADMITTED TO NEONATAL INTENSIVE CARE UNIT(NICU)

Background: Low birth weight (LBW) is dened as a birth weight of less than 2.5kg as per World Health Organization (WHO)1. Low birth weight (LBW) is a major public health problem in developing countries including India. In India, 30-35% of babies are LBW and more than half of them are full term babies2. Reduction of low birth weight forms an important contribution to the Millennium Development Goal (MDG) for reducing child mortality3. Corticosteroids administration before anticipated preterm births is one of the most important antenatal therapies available to improve neonatal outcomes. Corticosteroids alter the structural and biochemical physiology of neonates, like surfactant production and lung maturation and thus reduces the requirement and duration of mechanical ventilation. Aims And Objectives: 1.To know the effect of antenatal steroids in minimizing the duration of ventilation in LBW neonates 2.To know the effect of antenatal steroids on assisting in early extubation of LBW neonates. All Low birth weight neonates <2.5 kg who were intubated and on vent Inclusion Criteria: Exclusion Criteria: ilator support. 1.Major congenital anomalies 2.Extubated as a part of withdrawal of care. This Materials And Methods: study was a Prospective Observational Study and was conducted in Rajarajeswari Medical College and Hospital, Bangalore for a duration of 18 months between January 2021 and June 2022.SAMPLE SIZE: n=54, Sample size calculated using considering 95% condence interval and 10% precision. All the parameters Results: i.e., birth weight, gestational age, gender, presence of maternal comorbidities, surfactant and antenatal steroids showed signicant association with number of days of mechanical ventilation in the study. This study was conducted Conclusion: to study the effect of antenatal steroids on mechanical ventilation in low-birth-weight neonates admitted to neonatal intensive care unit and it was found that antenatal steroids had signicant effect on duration of mechanical ventilation; this study has also recognized the factors involved in prolonging the days of mechanical ventilation such as prematurity, doses of antenatal steroids received, low birth weight, lower gestational ag . Recognising such factors can help in preventing complications among the newborns thereby reducing the number of days of mechanical ventilation

Clinical presentation and fungal species distribution in otomycosis in a tertiary care hospital

Abstract Objective: Otomycosis is a common fungal ear infection in tropical and subtropical regions worldwide. This study aimed to perform mycological analysis on fungal debris from the external auditory canals of the patients to study the most common clinical presentation and fungal species distribution in otomycosis. Materials and Methods: Patients who met the inclusion criteria for this cross-sectional study were included and evaluated after providing written informed consent. After obtaining a thorough medical history, ear swabs for culture, sensitivity, and potassium hydroxide were provided. Patients with positive culture results were studied between September 2019 and March 2021. Results: Among 103 cases observed for 18 months in the Department of ENT, Rajarajeswari Medical College, and Hospital, Bengaluru, India, we found that males (56.31%) were more affected than females (43.68%). Itching (67.96%) was the most primary and common symptom that was observed, followed by pain (20.38%), and the most common predisposing factor was the usage of earbuds (26.21%) followed by water in the ear (23.3%) and oil in the ear (16.50%). Unilateral infection was most common (96%), and the left ear was most affected (64.07%). Aspergillus niger was the most common fungal isolate (60.19%), and otomycosis was very common in postmonsoon (October–December) (58.25%). Conclusion: The most frequent fungal isolates in otomycosis are from the Aspergillus and Candida species. The left ear was typically affected by otomycosis, which frequently had a unilateral predominance. The most common clinical symptoms were itching and pain.

Morphometric Study of Martin-Gruber Anastomosis and Its Surgical Implications: A Cross-sectional Cadaveric Study

Introduction: The Martin-Gruber anastomosis is a median- ulnar nerve communication in the upper part of the forearm. This anastomosis is classified into four types. Aim: To determine the incidence and morphometry of the Martin- Gruber anastomosis and recognise its surgical implications in the South Indian population. Materials and Methods: This cross-sectional study was conducted on 60 cadaveric upper limb specimens obtained from the Department of Anatomy, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India between November 2022 and March 2023. The median and ulnar nerves were traced, and the Martin-Gruber anastomosis was identified and documented. The classification devised by Nakashima T was used in present study. The distance from the medial epicondyle of the humerus to the point of anastomosis on the ulnar nerve was measured using Vernier calipers. The data were analysed using the statistical software Stastistical Packages for the Social Sciences (SPSS) version 23.0. Categorical variables were expressed as frequency and percentage, while continuous data were expressed as mean and standard deviation. Results: The Martin-Gruber anastomosis was observed in 11 out of 60 upper limb specimens (18.33%). Type I anastomosis was observed in 3 specimens (27.27%), Type II in 2 specimens (18.18%), and Type III in 6 specimens (54.4%). Type IV was not documented in present study. The distance from the location of the anastomosis on the ulnar nerve to the medial epicondyle of the humerus ranged from 2.2 cm to 13.2 cm, with an average of 3.5 cm. Conclusion: The findings of present study might be useful for neurosurgeons during nerve transfer techniques for chronic ulnar neuropathy, which is seen in the general population as well as athletes.

A Study on Sensitivity of Angiogenic Factors as Predictors of Preeclampsia and Role of Aspirin in Preventing Preterm Preeclampsia

Background Preeclampsia is one of the hypertensive disorders of pregnancy causing maternal and perinatal mortality and morbidity. The global burden of Pre-eclampsia and eclampsia is 5-10. The prevalence of preeclampsia-complicating pregnancy in India is 7.8. Early prediction of preeclampsia and prophylactic use of aspirin reduces morbidity and mortality.Objectives To study the role of angiogenic factors and biophysical markers to identify women at high risk for developing preterm preeclampsia. To study the diagnostic value of angiogenic factors as predictors of preterm preeclampsia in early pregnancy. To compare the benefits of prophylactic use of 150mg of Aspirin versus 75mg of Aspirin from 11-16 weeks of gestation in reducing the incidences of preterm preeclampsia.Methods It was a two year study conducted at Rajarajeswari Medical College and Hospital. Data for the study was collected from women attending antenatal clinics at 11 weeks 0days to 13weeks 6days after taking informed consent. Screening for preeclampsia was done using biophysical and biochemical tests. Screen-positive women were grouped randomly into Group A and Group B. They were given 7mg and 150mg aspirin and maternal and fetal outcome was analysed.Results In our study 489.6 women were screened positive for preeclampsia. There were no significant differences between the 75mg aspirin group and the 150mg aspirin group with regard to demographic characteristics. Pre-eclampsia occurred in 27.2 of participants in the 75mg aspirin group compared with 4.1 in the 150 mg aspirin group. There was a significant difference in the incidence of PE p0.0293 its severity and the period of gestation at delivery in the two groups. The positive predictive value of the screening method in our study is 12.7 and the negative predictive value is 91.6.Conclusion Our study showed that screening test was beneficial in identifying high-risk cases but the study population was very less. Early screening and use of prophylactic aspirin reduce the development preterm preeclampsia. Aspirin is a safe economical and easily available drug.

Association of Lipid Accumulation Product with Insulin Resistance in Type 2 Diabetes Mellitus: A Cross-sectional Study

Introduction: The increased incidence of diabetes and Cardiovascular Disease (CVD) is attributed to the rising obesity rates, which is one of the major factors contributing to Insulin Resistance (IR). Although there is a close relationship between obesity and IR, not all cases of obesity lead to cardiometabolic complications. Visceral fat is considered to be the primary cause of IR. Lipid Accumulation Product (LAP) is postulated as a new continuous biomarker of visceral adiposity. Aim: To determine the association between LAP and IR in T2DM. Materials and Methods: This institution-based cross-sectional study was conducted over a period of three months at the Department of Biochemistry, Rajarajeswari Medical College and Hospital in Bengaluru, Karnataka, India. A total of 60 Type 2 diabetic patients (including newly diagnosed and known cases) were recruited as cases, along with 30 healthy controls. Height, weight, and Waist Circumference (WC) were measured. Fasting blood samples were collected for laboratory biochemical estimation of glucose, Total Cholesterol (TC), Triglycerides (TG), High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL), and fasting insulin. Statistical analysis for continuous variables was performed using unpaired Student’s t-test, and Analysis of Variance (ANOVA) test was used for group comparisons. Results: Fasting serum insulin (p-value=0.007), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (p-value=0.001), and LAP index (p-value<0.001) were significantly higher in the case group. LAP index was divided into quartiles, Insulin and HOMA-IR showed statistical significance across the quartiles (p-value=0.005). The lipid profile analysis across LAP quartiles revealed a progressive increase in TG levels (p<0.001) and a decrease in HDL levels from Q1 to Q4 quartiles. Conclusion: The study concludes that increased LAP levels are associated with IR in T2DM. LAP can serve as a useful marker for cardiometabolic risk in early-stage T2DM, enabling better disease stratification for improved prognosis.