Rural Tertiary Care Hospital Research Articles

A study on the prevalence of scrub typhus among pediatric population in a rural tertiary care hospital in West Bengal

A study on the prevalence of scrub typhus among pediatric population in a rural tertiary care hospital in West Bengal

Cartridge-Based Nucleic Acid Amplification Test Compared to Fine Needle Aspiration Cytology in Suspected Cases of Tubercular Lymphadenitis (the Indian Experience)

INTRODUCTION: Diagnosis of tubercular lymphadenitis is daunting as there are varied clinical presentations and no single confirmatory gold standard test. Cartridge-based nucleic acid amplification test (CBNAAT) of the lymph node is a rapid molecular diagnostic test for simultaneously detecting tuberculosis (TB) and rifampicin resistance. AIM: To evaluate the performance of the CBNAAT test for detecting M. tuberculosis in lymph node specimens compared to fine needle aspiration cytology (FNAC). MATERIALS AND METHODS: The study was conducted in a rural tertiary care hospital in central India. A total of 180 patients clinically suspected of tubercular lymphadenitis were included. The male-to-female ratio was 1:1.3. The average age was 33.3 years. The age group 21–40 years had the highest number of cases. The most common complaints among the patients were fever (29.4%), followed by loss of appetite (9.5%), weight loss (9.5%), and cough (6.6%). However, most patients presented to the hospital with only lymphadenopathy (44.4%). The most common site involved was the anterior cervical lymph node (78.8%), followed by the axillary group (10.5%), submandibular (2.8%), inguinal (2.8%), supraclavicular (2.2%), submental (1.7%) and infraclavicular (1.1%) group of lymph nodes. The patients were subjected to both FNAC and CBNAAT testing. Results were reported as positive or negative for M. tuberculosis as CBNAAT gives a semiquantitative estimate of the concentration of bacilli. Rifampicin resistance results were reported as detected or not detected. RESULTS: Cytological examination of the lymph node aspirates revealed that most were tubercular lymphadenitis cases. Cytomorphological analysis of the cases of tubercular lymphadenitis revealed Type 6 (tubercular abscess) as the predominant pattern. CBNAAT testing detected 26 cases of M. tuberculosis and three cases of rifampicin resistance. The study reported a specificity of 92.92% and low sensitivity of 26.86% of combined FNAC and CBNAAT is much higher compared to only CBNAAT. CONCLUSION: CBNAAT, along with FNAC, is a valuable addition in first-line investigations of tubercular lymphadenitis to make a timely diagnosis.

Clinical Manifestations and Laboratory Parameters Of Prevailing Dengue Serotypes At Rural Tertiary Care Hospital

Clinical Manifestations and Laboratory Parameters Of Prevailing Dengue Serotypes At Rural Tertiary Care Hospital

Epidemiology of Communicable Diseases in a Tertiary Care Rural Hospital in Konkan Region of Maharashtra: An Instrument for the Effective Health Planning

Epidemiology of Communicable Diseases in a Tertiary Care Rural Hospital in Konkan Region of Maharashtra: An Instrument for the Effective Health Planning

Buffer Stock Inventory Control Mechanism: An Approach of Minimizing the Buffer Stock Level Through Segmentation at a Tertiary Care Rural Hospital.

Background Efficient management of hospital inventories, particularly pharmaceuticals, is essential for ensuring timely patient care and optimizing resource allocation.Buffer stock is the backup stock, which is kept for providing a supply of drugs when the main stock is consumedand new stock is in the process of procurement.The buffer stock is sometimes kept in excess, which causes unnecessary overutilization of the financial resources. Therefore, the author's team aimed to optimize the inventory control of the buffer stock.This study addressed these challenges by integrating always better control (ABC) and vital, essential, and desirable (VED) analysis to categorize drugs based on consumption patterns and clinical importance to minimize buffer stock and ensure optimum resource allocation. To overcome these challenges, there is a need to integrate financial and clinical factors into inventory management decisions. Methods This study was done at the pharmacy of an apex hospital situated in a rural region of western India. The study aimed at the categorization of drugs that require strict inventory management control. The drugs and consumables used in the month of April 2024 in the hospital pharmacy were considered for the study& inventory control methods were applied. Results The study discovered that a subgroup of drugs accounted for a significant portion of the pharmacy's budget, with 12.18% categorized as high-value (Category A), 22.07% as moderate-value (Category B), and 65.74% as low-value (Category C) items. ABC analysis showed that Category A drugs consumed 70.1% of the average daily expenditure (ADE) of the pharmacy, while Category B and Category C drugs contributed 19.9% and 9.98% of the ADE, respectively. VED analysis classified drugs into vital (11.34%), essential (58.26%), and desirable (30.39%) categories. The ABC-VED matrix further categorized drugs into subgroups, with class I items constituting 20.62% of the inventory and accounting for 73.82% of the ADE. Class II items comprised 56.69% of the inventory, consuming 22.91% of the ADE, while class III items constituted 22.68% of the inventory and consumed 3.28% of the ADE. Conclusion ABC and VED analysis integration provides a comprehensive framework for optimizing drug inventory management in healthcare facilities. By considering both financial and clinical factors, this approach enables tailored management strategies, minimizing buffer stock, eliminating stockouts, and enhancing patient care. The rural hospital's location is responsible for maintaining the buffer stock level and the reorder level quantity. This study highlighted the role of inventory control techniques in healthcare facilities, particularly in pharmacies, to ensure the availability of essential medications while optimizing resource utilization. By integrating segmentation techniques such as ABC and VED analysis, this study provided valuable insights into categorizing drugs based on their consumption patterns, criticality, andimportance in the clinical area.

Cancer masquerading as an intussusception: Experience at tertiary care rural hospital

One segment of the intestine telescopes into another, resulting in obstruction or intestinal ischemia. A pathological lead point, such as a tumor, causes the disease. A pathologic lead point in the lumen, wall, or outside the wall can cause adult intussusception (AI). Retrospective case series of eight patients diagnosed with AI over 18 years in a tertiary rural tertiary a decade (2010-2020). Out of 8 AI cases6 were women, and 2 were men. The median age at diagnosis was 44 years. AI was verified by USG (25%), with CT scan being (100%) sensitivity preoperatively. AI distribution (2 in the small bowel, four at the ileocecal region, and 2 in the colon). The most commonly reported presenting symptom was abdominal pain. (8/8,100%). 75% (6/8) of patients underwent urgent surgery after presenting with acute intestinal obstruction. At the same time, two cases underwent elective surgery. Out of them, five cases were malignant (adenocarcinoma) (62.5%), and three cases were benign tumors (37.5%). (Inflammatory myofibroblastic tumor, a Meckel’s diverticulum, and appendicitis). Due to the lack of specific symptoms, the diagnosis of AI by clinicians and surgeons is frequently missed out. When dealing with acute abdominal pain and signs of bowel obstruction, it's important to consider this less common diagnostic possibility because intussusception is a surgical emergency with high mortality rates in the case of delayed treatment. A surgical approach must be practiced to avoid missing underlying causes like neoplasm.

Retrospective Analysis of Hospital Deaths in a Rural Tertiary Care Hospital

Retrospective Analysis of Hospital Deaths in a Rural Tertiary Care Hospital

Comparison of operative outcome of open versus laparoscopic inguinal hernia in rural tertiary care hospital in Haryana: A randomized controlled study

Background: Hernia surgery is one of the commonly done procedures in General surgery. A hernia is defined as an abnormal protrusion of an organ or tissue through a defect in its surrounding walls. Aims and Objectives: Comparison of morbidity in terms of total analgesic usage, mean length of hospital stay, comparison among open and TEP repair of hernias in primary inguinal hernias among males. Material and Methods: This study was done on 80 patients with clinical diagnosis of primary inguinal hernia over a period of one year to compare the result of two surgeries, open lichenstein repair (n=40) and TEP repair (n=40). Results: Postoperative pain using VAS was found to be lower in patients having laparoscopic TEP hernia repair when compared to open lichenstein tension free repair (p <0.01). Operating time was observed to be more with TEP group with mean of 59 ± 17.02 minutes compared with open group which had mean of 44.92±12 minutes. Mean number of analgesic in open cases was 6.65 ± 1.81 whereas in case of TEP group it was 4.35±1.47 over a period of one month. Conclusion: Lichtenstein tension free mesh hernioplasty still remains the gold standard operation done for inguinal hernia. TEP repair has proven to be superior in terms of perioperative hemorrhage and post-operative analgesia requirement. Study concluded that laparoscopic TEP repair of inguinal repair have a considerable clinical advantage over open hernia repair in terms of postoperative pain and analgesia requirement, hospital stay and postoperative complications.

Utility of Hemogram-based Parameter in Predicting Hospital Stay in Liver Cirrhosis: A 2-year Prospective Observational Study

Abstract Introduction: Hospitalized cirrhosis patients are a major financial burden on health-care systems. In this study, we attempted to evaluate the regular laboratory parameter like absolute eosinophil count (AEC), in liver cirrhosis in relation to length of hospital stay and severity grading systems such as the Child–Turcotte–Pugh (CTP) score and the model for end-stage liver disease (MELD). Materials and Methods: A prospective observational study was done in patients at a rural tertiary care hospital in central India, from October 2019 to September 2020. Calculation of AEC was done by automated complete blood counts in hemogram. Demographics of the patient, laboratory investigations, and outcomes of hospital stay were taken into consideration in the study. To identify predictors of hospital stay, a multivariate Cox regression analysis was used. Results: Among hemogram, with a cutoff value of ≤138, the AEC was found to be a significant predictor of lengthy hospital stays (≥7 days), with a 63.70% likelihood of properly predicting such stays. If AEC ≤138, then there was a 69.80% probability of prolonged hospital stays. Distribution of CTP score was comparable between hospital stay duration, i.e. <7 days and ≥7 days. Proportion of patients with MELD score with ≤9, was significantly higher if duration of hospital stay was <7 as compared to hospital stay duration ≥7 in MELD score 10-19. Conclusions: In hospitalized cirrhotic patients, among the hemogram, the AEC may be used as a low-cost warning indicator for clinical outcomes such as hospital stay.

Acute Diarrhoea in Children Aged Up to 2 Years Age Group: Assessment of Therapeutic Strategies and Hospital Stay Variance, in Tertiary Care Rural Hospital – An Observational Study

Acute Diarrhoea, it is one of the leading causes of under 5 childrens’ morbidity and mortality in India. It is most common in children especially those between 6 months and 2 years. Antimicrobials are mostly used drug for acute diarrhoeal cases according to many studies but according to WHO antibiotics are not required for all the diarrhoeal cases except few bacterial diarrhoeas. Other way, WHO recommends Zinc with low osmolarity ORS for acute diarrhoea. So, this study was designed for assessing the treatment pattern and its outcome in our setup. Objectives: - To assess the use of antibiotics and Zinc among children under 2 years suffering from acute Diarrhoea by analysing average of use and hospital stay. Materials and Methods: - This observational study includes 76 patients, admitted under Paediatric Department of Mahatma Gandhi Institute of Medical Sciences, in the period of 6 months. All the patients admitted during the study period having acute Diarrhoea with moderate dehydration as per definition of WHO was included in the study. Patients with other existing diseases, bloody diarrhoea and seriously ill were excluded. Data was collected from Paediatric ward and was analysed by using GraphPad software. Results: - Over all among the 76 patients, 25(32.89%) patients received antimicrobials only and 31(40.79%) received Zinc only and11(14.47%) patients received both. Hospital stay difference was not statistically significant in culture negative acute diarrhoea cases with the use of zinc and antimicrobials (p = 0.08) but it was significant in culture positive cases (p = 0.03). Conclusion: - In culture negative acute diarrhoeal cases Zinc was mostly used and hospital stay was not found to be significant with and without antimicrobials. Implication: - Uncomplicated acute diarrhoeal cases may be treated with Zinc alone effectively.

Analyzing the Expectant Management of Redefined Active Phase of Labor (WHO 2018 Guidelines) in Nulliparous Women: A Randomized Control Trial

BACKGROUND:The World Health Organization (WHO) in their 2018 guidelines favored a noninterventional approach toward the labor process. The active phase of labor will be initiated when the cervix is 5 cm dilated and during obsoleted use of a 1 cm/hour cervical dilation rate as a diagnostic test for abnormal birth outcomes.OBJECTIVES:The aim of the study is to compare an active interventional labor management approach to a noninterventional labor management approach in nulliparous parturient women in terms of need of intervention, mode of birth, and maternofetal outcome.METHODOLOGY:This randomized control study was conducted at a rural tertiary care hospital for a period of 1.5 years. Nulliparous low-risk pregnant women presenting in latent labor were randomly allocated into two groups on the basis of cervical dilation and labor intervention. WHO 2014 guidelines with partograph were followed in group 1, and 2018 WHO guidelines with labor care guide were followed in group 2.RESULT:Both the groups were comparable with age, parity, and Bishop score at the time of admission. The incidence rates of intervention in the active first stage of labor in group 1 and group 2 were 31% and 10% with an odds ratio of 0.192 (95% confidence interval [CI] [0.079, 0.466]), and the rates of lower segment cesarean section in both the groups were 17.6% and 5.8%, respectively. The odds ratio with 95% CI for postpartum hemorrhage and neonatal intensive care unit admission in group 1 compared with group 2 was 0.313 [0.061, 1.610] and 1.057 [0.143, 7.832], respectively.CONCLUSION:This study showed that the shifting of the active first-stage threshold by 1 cm and letting labor progress at its natural pace significantly reduced the need for intervention and affected the fetal and maternal outcome positively.

Assessing Cardiometabolic Disease Risk Factors Among Healthcare Workers in a Rural Tertiary Care Hospital in Wardha, India: A Study Protocol.

Background Cardiometabolic diseases pose a significant public health challenge globally, particularly among healthcare workers, who often face heightened occupational stress and lifestyle challenges. This study aims to assess the prevalence of cardiometabolic risk factors and their determinants among healthcare workers at Acharya Vinoba Bhave Rural Hospital, a tertiary care hospital in rural Wardha, Maharashtra, India. Methods A cross-sectional study design was employed, involving the recruitment of healthcare workers from various job roles. Data on demographic characteristics, behavioral risk factors, anthropometric measurements, biochemical parameters, and mental health status was collected using standardized instruments and procedures. Statistical analysis included descriptive statistics, inferential tests, and multivariate analyses to identify significant associations and predictors of cardiometabolic risk factors. Expected results Anticipated findings include a notable prevalence of cardiometabolic risk factors among healthcare workers, including elevated BMI, fasting blood glucose, dyslipidemia, and hypertension. Behavioral risk factors such as physical inactivity, unhealthy dietary habits, tobacco use, and alcohol consumption are expected to be prevalent. Additionally, varying degrees of psychological distress, including depression, anxiety, and stress, are anticipated. Significant associations between cardiometabolic risk factors and demographic variables are expected to be identified. Conclusion The study findings provide valuable insights into the prevalence and determinants of cardiometabolic risk factors among healthcare workers in a rural setting. These insights can inform targeted interventions and public health strategies aimed at improving the cardiovascular health and overall well-being of healthcare workers, ultimately contributing to the enhancement of healthcare delivery and outcomes in rural areas.

A comparative study between first three waves of COVID-19 pandemic with respect to risk factors, initial clinic-demographic profile, severity and outcome

ABSTRACT Introduction: During the 2 years and 9 months from March 2020 to December 2022, the SARS-CoV-2 virus raged across the country. Cases occurred in three particular time clusters recognised by World Health Organisation as coronavirus disease 2019 (COVID-19) waves. In this study, we compare the clinical parameters of adult non-obstetric COVID-19 patients admitted to our rural tertiary care hospital during the three distinct waves of the pandemic. Materials and Methods: Retrospective chart analysis of 272, 853 and 97 patients admitted with SARS-CoV-2 infection to the only rural medical tertiary care centre in the Sunderbans of West Bengal in the first, second and third waves, respectively, was done after obtaining ethical and scientific clearance. Clinical [vital parameters, oxygen requirement, mental status, risk factor assessment, duration of hospital stay, modified-emergency warning score (m-EWS), quick Sequential Organ Failure Assessment (qSOFA), confusion, uraemia, respiratory rate, blood pressure, age ≥ 65 years (CURB65)], epidemiological variables (age, gender, and vaccination status), laboratory parameters and in-hospital outcome were recorded and analysed statistically. Results: Statistically significant (P < 0.05) m-EWS and qSOFA scores were recorded during the second wave of the pandemic. The second wave also recorded the highest mortality (14.89%) compared to the first (12.87%) and third (11.96%) waves, though this was not statistically significant. The highest duration of hospital stay was recorded in the first wave of the pandemic (mean = 9.99 days, P < 0.01). The difference in mortality rates between patients with and without co-morbidity (P < 0.05) was observed during Wave-1, across any pandemic wave, and overall but not in Wave-2 and Wave-3. Conclusion: The second wave of the COVID-19 pandemic was the most severe in comparison with the other two waves, while the outcome was poorer in those with co-morbidities, especially in the first wave.

Profile of gastroduodenal perforation patients admitted in a rural tertiary care hospital: An observational cross-sectional study.

Gastro-duodenal perforation is a common surgical emergency that remains a formidable health burden worldwide with significant morbidity and mortality. Ulcer disease remains the most common cause of gastro-duodenal perforation. Diagnosing the presence of H. pylori can help eradicate the infection from the community at large and thereby reduce the chances of gastro-duodenal perforation. To assess the clinical presentation of gastro-duodenal perforation patients and to evaluate the detection of Helicobacter pylori infection by available investigations. A descriptive observational study was conducted among 80 patients presenting with clinical features suggestive of gastro-duodenal perforation and confirmed by clinical, radiological basis and operative findings admitted at a rural tertiary care hospital during 2019-2020. Detailed history was taken from the patient/party, clinically examined, and blood/tissue samples were investigated. The patients were managed with standard treatment modality in the studied institute. Data were collected, compiled, and entered MS Excel and analyzed using appropriate software. Descriptive analysis was done in the form of proportion for categorical variables, mean or median for continuous variables. Cases of gastro-duodenal perforations were more among middle to later age of life, mostly affecting married male patients hailed from rural area and unskilled workers. History of intake of spicy food, prolonged starvation, history of NSAID use were common among them. Majority of the patients had history of pain abdomen in the past suggesting of PUD and history of taking variety group of acid reducing agents. Most of them presented with epigastric pain, vomiting, abdominal distension along with other signs of peritonitis. Obliteration of liver dullness and free gas under right dome of diaphragm was also noted in large proportion among them. Majority of cases were found positive for H. pylori on Histology (85%), followed by rapid urease test (RUT) (80%) and a positivity of 72.5% and 68.8% on serum IgG and IgA antibody respectively. Rapid Urease Test was more sensitive as well as specific in diagnosing of H. pylori than antibody detection test. Early detection of H. pylori infection and treatment with potent anti H. pylori therapy postoperatively has been found to be adequate.

Study of acute kidney injury in children with nephrotic syndrome in a rural tertiary care hospital

Background: Acute kidney injury (AKI) is a common comorbidity in critically ill children and is associated with an increased risk of morbidity and mortality in children with nephrotic syndrome. The etiology of AKI in nephrotic syndrome is complex and multifactorial. Aims and Objectives: To determine the proportion, risk factors, and outcomes of patients with AKI in children hospitalized with nephrotic syndrome. Materials and Methods: This cross-sectional study was done on children between 1 month and 14 years of age attending the pediatric department for 1 year from October 2020 to June 15, 2022. Detailed history, physical examination, and investigations were done in children with nephrotic syndrome as per pro forma. Information was collected on demographic variables, vital signs, anthropometry, diagnosis, comorbidities, therapies, presence of hypovolemia, sepsis or shock, use of diuretics or nephrotoxic medications, need for oxygen, mechanical ventilation, vasopressors or renal replacement therapy, length of hospital stay, and outcome at discharge. For those children having AKI, clinical outcomes were measured in terms of duration of hospital stay, recovery of S.creatinine, and urine output. Results: A total of 64 patients with nephrotic syndrome were enrolled in this study. Fifteen patients had AKI (23.4%) among children with nephrotic syndrome. The most common etiology being sepsis accounting for 4 out of 15 (26.7%) of total cases followed by acute respiratory distress syndrome (13.3%), nephrotoxic medications (13.3%), renal parenchymal disease (13.3%), Post-streptococcal glomerulonephritis (13.3% each) and Sickle cell disease with nephritis and acute fulminant hepatitis (6.7%). There was significantly more mortality among subjects with stage 2 (14.3%) and 3 (14.3%) kidney disease. Conclusion: AKI is common in our children with nephrotic syndrome and the main risk factors of AKI include sepsis, gross hematuria, urinary tract infections, peritonitis, and exposure to potentially nephrotoxic medications. There is a need to identify the patients with nephrotic syndrome at risk of AKI and apply strategies to prevent AKI in focused at-risk groups.

Profile of Mortal Injuries in Vehicular Accidents: An Autopsy-Based Study.

Background It is crucial to analyze the trends of fatal injuries amongpedestrians, passengers, motorcycle riders, and drivers of three- and four-wheelers in traffic accidents. Objective To ascertain the trend of fatal injuries to the head, chest, and abdomen across different victim categories in vehicular accidents. Materials and methods An autopsy-based prospective study was carried out in the mortuary of a rural tertiary care hospital. A total of 108 fatal cases of vehicular accidents were taken into consideration. All natural and unnatural deaths, other than those stemming from vehicle crashes, were excluded from this study; only the victims of fatal vehicularaccidents were included. Results Males outnumbered female victims by 8.8:1. The age range of 41-60 years was the most affected (38.9%). The greatest number of victims (17, or 15.8%) were male motorcycle riders in the range of 21-40 years. Most vehicular mishaps (61;56.5%) occurred during the evening. The most frequent injury pattern reported was head injuries (53.4%). Conclusions Motorcycle riders constituted the most severely injured victim category in a vehicular accident. Most mishaps occurred in the dark because of inadequate lighting or bad road conditions in rural areas. Furthermore, the most frequently occurring type of injury was an injury to the head, which may be an outcome of riders' lack of compliance with the mandatory helmet-use policy.

Study on Management of Diabetic Foot Ulcer in a Rural Tertiary Care Hospital

Abstract Background: Diabetic foot ulcer is a common complication among diabetic patients. Diabetes is prone to multiple complications related to microvascular, macrovascular, and metabolic etiologies. Diabetic foot ulcers can ultimately lead to infection, gangrene, amputation, and even death. Methods: This is a prospective observational study, that was carried out on 100 adult patients between July 2022 and January 2023 diagnosed with diabetic foot ulcer, treated at MVJ Medical College and Research Hospital. Inclusion criteria were all patients aged above 18 years. Exclusion criteria were patients with peripheral vascular disease not arising due to diabetes, patients with varicose veins, and patients who are undergoing chemotherapy or immunocompromised and in sepsis. Routine blood investigation, blood sugar levels, and liver function test were done. Specific investigation including discharge from wound/biopsy for culture, urine routine, x- ray of foot and doppler studies was done. The patient underwent standard surgical procedure and was followed up. The collected data were analyzed using SPSS-21 software. Results: The data collected were analyzed and documented. In our study, we noted that male cases were about 64% and female cases were about 36%, and the ratio of male:female is 1.7. The maximum number of cases were observed in the age group of more than 65 years, and the most common site of involvement was right foot. Conservative treatment involved diabetes control with drugs and insulin followed by wound management by dressing, debridement, amputation, and split skin grafts. Conclusion: Foot ulcer is preventable, and relatively simple interventions can reduce the risk of amputations by 80%. Management is primarily concerned about wound healing, and stopping the spread of infection, this is achieved by various methods such as split skin grafting, amputations, and conservative methods like dressing.

Assessment of Macular Thickness in Different Grades of Myopia: An Optical Coherence Tomography Study in a Rural Tertiary Care Hospital

Abstract Background: Myopia is a condition related to the refractive error that causes visual disability. Due to its high prevalence, it can contribute to complicated cataracts and related conditions such as primary open-angle glaucoma. The risks of retinal detachment, chorioretinal atrophy, pigmentary degeneration, vitreous degeneration and retinal breaks may increase with an increase in axial length and severity of myopia, among other long-term effects of high myopia. The aim of this study was to assess the role of macular thickness and myopia in non-invasive optical coherence tomography (OCT). Materials and Methods: This was a prospective, hospital-based observational study conducted for 18 months in a tertiary care centre in Karnataka. A total of 155 consecutive myopia patients aged ≥10 years attending the outpatient Department of Ophthalmology were included in the study. The data were analysed using the Statistical Package for Social Sciences (SPSS) for Windows, version 22.0 (SPSS Inc., Chicago). Result: The participants aged from 10 to 75 years with a female preponderance of 60%. The mean age of participants is 31.95 yrs. The majority of the patients had mild myopia (91.6%), compared with moderate (5.8%) and high (2.6%) myopia. The mean value of best-corrected visual acuity improved from 0.67 to 0.08 in high, 0.94 to 0.22 in mild and 0.71 to 0.26 in moderate myopia patients. The mean maximum retinal thickness was 472 micrometres, and the mean minimum retinal thickness was 178 micrometres. Conclusion: There is a high prevalence of mild myopia cases, especially at extremes of age. Myopia was more common among females. There was a significant difference among different classes of myopia with respect to uncorrected and best-corrected visual acuity. The parafovea was thinner and the fovea thicker among myopia.

Myths Pertaining to COVID-19 Vaccination in Pregnant Women Attending a Rural Tertiary Care Hospital.

Background The outbreak of the COVID-19 pandemic led to the rise of various social issues apart from medical ones. Several myths regarding COVID-19 vaccination were found worldwide, and some of the common ones identified were abortions, birth defects, bad pregnancy outcomes such as abortions, ectopic pregnancy, risk of infertility, and irregular menstrual cycles. Although no scientific theories or data backed those myths, pregnancy was still omitted from trials for a long time as any drug/vaccine given during pregnancy may affect the fetus. Objective The objective of this study was to evaluate the vaccination status of pregnant women (PW) regarding COVID-19 and explore the factors influencing those who chose not to get the initial dose, second dose, or booster dose. Methodology A total of 747 PW were enrolled in the current study. Information related to sociodemographic data, clinical data, COVID-19 vaccine status, and rationale for choosing not to receive the COVID-19 vaccination was analyzed using a prestructured and validated Performa. Results The mean age and gestational age of the women enrolled for the study was 27.39 ± 3.75 years and 30.21 ± 7.30 weeks, respectively. The first dose of the COVID-19 vaccine was not receivedby 40 (5.4%) subjects, and the second dose was pending in 142 (19%) women, and none of them received booster dose. The prevalent cause for abstaining from receiving the COVID-19 vaccination was the fear of abortion in 179 (24%) subjects, followed by the fear of vaccine-related side effects in 142 (19%) subjects. There was a significant correlation between acceptance of COVID-19 vaccination and education and employment. Conclusion The present study indicated that most women have taken the COVID-19 vaccine before conception and that none received the first, second, or booster dose during pregnancy, even if it was due. Women need to be educated about the benefits of vaccination to enhance the compliance rate of COVID-19 vaccination and reduce COVID-19-related morbidity and mortality during pregnancy.

Estimation of Atraumatic Hip Microinstability Among Long Distance Truck Drivers in Western Maharashtra : A Cross-Sectional Study

Introduction: Hip micro-instability is an upcoming concern and is gaining acceptance as an important contributing factor for hip joint dysfunction among adults and is a major risk factor for the development of early osteoarthritis. Around 20-25% of people at the age of 50 suffer hip pain and knee pain because of chronic wear and tear of joint articular cartilage. is typically described as painful extra-physiologic hip movements, either alone or in combination with symptoms of unstable hip joints. Truck drivers travel long routes for an extensive duration of time with their hips in an ergonomically compromised position. Occupational stress can cause pain which is an effect of vibrational forces and postural stress. Investigation suggests that hip musculoskeletal pain as a whole is one of the main causes of hip micro-instability. Hence, it is important to evaluate the presence of hip micro-instability among long-distance truck drivers. Methods: A cross-sectional study was conducted from 4 May 2023 in a rural tertiary care hospital in Karad for about 6 months. Wherein a total of 103 long-distance truck drivers were randomly selected based on the inclusion criteria which included truck drivers by occupation within the age group of 35-45 years, working for more than 12 hours in a day and for 5 days/week with no history of trauma. They were assessed by using the Anterior Apprehension Test, Prone Apprehension Test, and AB-HEER test. The data was then analyzed using statistical procedures, and the results were obtained. Results: The present study shows that over 12% of participants showed positive results for hip micro-instability. A significant positive correlation was observed between the number of years of driving in relation to pain (P value < 0.0001). On assessment, there was an increase in flexion, adduction, and internal rotation ranges which hence revealed anterior hip micro-instability (P value = 0.0121) as compared to extension, abduction and external rotation ranges which revealed posterior instability. Conclusion: The study concluded that over 12% of participants showed positive results for hip micro-instability. Also, anterior hip micro-instability was more as compared to posterior hip micro-instability amongst the truck drivers due to capsular relaxation which was affected due to prolonged hours of poor ergonomics. This study also showed the existence of micro-instability despite the presence or absence of ligamentous laxity.