Shah Medical College Research Articles

Study of below knee amputation in patients with diabetic foot ulcer in a tertiary care centre in India

Background: This study aims to evaluate the predictive factors affecting the clinical outcome of below knee amputation performed in diabetic foot patients who had developed foot ulcers. Methods: This is a retrospective study of 25 random patients who underwent below-knee amputation for diabetic foot ulcers. These patients were admitted in the Department of Surgery, Shri MP Shah Medical College, Jamnagar, between November 2017 and October 2019. Results: The patient’s age ranged from 30 to 80 years, with a mean age of 62.92 years. 60% were between the ages of 51 and 70. Of the total, 14 were male and 11 were female, suggesting that males due to generally more active lifestyles, may be at higher risk for foot injuries leading to diabetic ulcers. 64% were from a lower socio-economic background. All 25 patients had previous admissions, 12 had a history of previous amputation, while 13 treated conservatively. Most patients presented with infected or non-healing ulcers, cellulitis and/or gangrene. Primary healing occurred in 13 patients, 7 required refashioning for healing, 3 required transfemoral amputation and 2 patients unfortunately passed away. The mean duration of hospital stay was 49.82±28.07 days. Conclusions: Lack of awareness, poor glycaemic control and duration of diabetes where the main factors causing diabetic foot problems. For patients with infected feet, difficulty with mobility and prolonged immobilization were common issues. Timely below-knee amputation helped restore movement and improved the ability to use prosthetic limbs, allowing for greater mobility and independence.

CESAREAN AUDIT: USING ROBSON’S 10 GROUP CLASSIFICATION AT C. U. SHAH MEDICAL COLLEGE AND HOSPITAL

Objective: The World Health Organization (WHO) has expressed concern over the rising cesarean section (CS) rate, particularly in middle-and high- income countries. The reasons behind this increase are still debated, but the WHO declared that there is no justification for a rate higher than 10–15%. The Robson classification system, advocated by WHO and FIGO, can help assess and compare CS rates. Study Design and Methods: The Gynecology Department at C.U. Shah Medical College and Hospital conducted an observational study on pregnant patients hospitalized for labor pain between January 2020 and December 2022, with a focus on CS patients. The study used Robson’s 10-group categorization technique to extract maternal features and categorize cesarean performances. Results: Between January 2020 and December 2022, C. U. Shah Medical College and Hospital delivered 4967 patients, of whom 1,572 underwent a CS section. 46.3% were nulliparous, and 53.7% were multipara. 78.31% of patients arrived at full term, with 98.8% having single conceptions. 94.8% of the cases had a cephalic presentation, 4.4% had a breech presentation, and 0.81% had a transverse position. Conclusions: Robson classification is a useful technique for analyzing cesarean delivery (CS) rates, aiding in identifying corrective methods to reduce burden on healthcare systems, and promoting accurate labor monitoring, fetal scalp electrodes, and prenatal education.

Pattern of Medical Comorbidities among Patients of Postpartum Psychosis at a Tertiary Care Center of Central India

Abstract Background and Aim: The reproductive age group is vulnerable to various preexisting psychiatric disorders as well as newly diagnosed illnesses. The stress associated during pregnancy increases the likelihood of developing psychiatric comorbidities even more. Of importance are postpartum blues, depression, and psychosis. The presence of various medical comorbidities may be a contributing factor for the development of psychiatric illnesses. This study was done to find the pattern of medical comorbidities among patients of postpartum psychosis. Materials and Methods: The study was carried out at the Department of Psychiatry and Department of Obstetrics and Gynecology, Shyam Shah Medical College, Rewa (Madhya Pradesh). Total duration of the study was 1 year, all patients diagnosed with postpartum psychosis (n = 88) were segregated using simple random sampling and every 2nd patient was included in the study (n = 44). Further, necessary assessments were carried out and patients were discharged postrecovery. Results: In the present study, 59.09% of patients (26) belonged to the age group 25–35 years, 81.81% of patients (36) were from lower socioeconomic status, housewives 79.54% (35), and 36.36% (16) were middle school educated. About 63.63% of patients (28) females were nulliparous. About 59.09% of patients (26) were delivered through cesarean section. The most prevalent medical comorbidity was postpartum infection which was present in 50% of the patients (22), followed by hypothyroidism in 43.18% of patients (19). Conclusion: Various medical comorbidities may precipitate, maintain, or aggravate underlying postpartum psychosis which may alter their course progression and outcome.

Unveiling transfusions: Analyzing blood product utilization patterns in a leading tertiary care center in Madhya Pradesh, India

Background: Blood transfusions play a pivotal role in medical care, saving millions of lives annually. The timely provision of safe blood is critical in various clinical scenarios, necessitating a careful balance between supply and demand. Despite advanced blood banking facilities globally, challenges persist in ensuring appropriate blood component utilization, prompting a need for clinical audits and optimization strategies. Aims and Objectives: This study aims to analyze the patterns of blood product utilization in a tertiary care hospital in Madhya Pradesh over 1 year, focusing on transfusion requests, cross-match-to-transfusion (C/T) ratios, transfusion indices (TIs), and indications for transfusions. Materials and Methods: A retrospective study was conducted at Shyam Shah Medical College from January 01, 2023, to December 31, 2023. Data from transfusion and cross-match requests in various departments were collected. C/T ratios, TI, and non-usage probability were computed to assess blood utilization efficiency. Results: Out of 16,682 cross-matched units, 71.93% were transfused. The overall C/T ratio was 1.39. The department of medicine demonstrated the most efficient blood usage with a C/T ratio of 1.16. Obstetrics and gynecology had the highest TI (1.06), while surgery had the lowest (0.71). Indications for transfusion included anemia (29.9%), pre-operative (17.2%), intraoperative (21.8%), and post-operative (31.1%). Conclusion: This study provides valuable insights into blood utilization patterns, offering a foundation for refining transfusion practices and enhancing the efficiency of blood management in the studied tertiary care hospital.

Alteration of liver function tests in various liver diseases

Background: The burden of liver diseases in India has witnessed a significant rise, spurred by factors such as viral hepatitis, alcoholic liver disease, non-alcoholic fatty liver disease, and a spectrum of metabolic and genetic disorders. Liver function tests (LFTs) serve as invaluable tools in the hands of clinicians, offering insights into the dynamic interplay between hepatic health and various disease processes. This study aims to provide a detailed exploration of the alterations in LFTs associated with various liver diseases prevalent in India. Aim and Objectives: (i) To Identify the various types of Liver diseases; (ii) To evaluate the various liver function tests in various liver diseases. Materials and Methods: The study involved the collection of samples from 100 liver disease patients who seek medical care at C. U. Shah Medical College and Hospital. Informed consent was obtained from all participants and the study protocol was approved by the institutional ethics committee. Results: Our study shows that the prevalence of cirrhosis of liver was 25% among study participants. Majority of liver disease were prevalent in male whereas, mostly affected age group was 51–60 years. Bilirubin was altered in cirrhosis of liver (88%), obstructive jaundice (100%), alcoholic liver disease (80%), viral hepatitis (75%), and in other liver disease (85%). Conclusion: Altered LFT is a useful tool to reach the Etiology of Liver disease. Alterations in liver enzymes as well as HbsAg reactivity are specific tests for cirrhosis of liver and viral hepatitis.

Complications and difficulties faced during laparoscopic tubal ligation using single-puncture technique in scarred abdomen

This study was carried out in Dr. MK Shah Medical College and SMS Multispeciality Hospital, a tertiary care medical center, catering to Lower middle class and middle-class communities. Objective: To evaluate the difficulties faced during laparoscopic tubal ligation and complications that occurred during or after laparoscopic tubal ligation in the scarred abdomen using the single-puncture technique and its outcome. Methodology: A prospective study was carried out in tertiary care medical center in the periphery of the metropolitan area from 1st January 2022 to 30th September 2023. Consent of the ethical committee of the hospital and written consent of the patient were taken. All patients with a history of previous pelvic/abdominal surgery undergoing laparoscopic tubal ligation with a fallopian ring were included in the study and any difficulties faced or complications that occurred were noted. Patients undergoing the concomitant procedure (MTP/D&E/Check curette) with Lap TL were also included. Results: A total of 41 patients were included in the study. 46.3% patients were in the age group of 25−30 years. There was only a marginal difference of around 3% between the age group of >30 years. The majority of patients were up to G3 (85.4%). Patients accepted laparoscopic tubal ligation if they had more than 2 children. Preoperative assessment should be done thoroughly by senior faculty. Fixed mobility is an ominous sign to take patients for Lap TL. Normally these findings are the same in patients with 3 scars on the abdomen and having a history of closure of the abdomen in single layer. 80% of patients undergoing Lap TL had a history of previous 2 CS. 12.5% of patients had a history of previous 3 Lower Segment Cesarean Section (LSCS). 1 out of 41 pt had operative h/o 2 LSCS + open appendicectomy. 1 pt had operative h/o 2 LSCS + 3 Lap surgeries for surgical pathology. 1 pt had an exclusive history of open appendicectomy. The majority of patients, 78.1%, had interval Lap TL. 17.1% had concurrent Lap TL with suction & evacuation. 4.8% had Lap TL following the 2nd trimester MTP. In 75.6% of patients, there was no difficulty in applying fallopian ring. 19.5% of patients who had peritubal adhesions were taken care of while doing single-puncture Lap TL. Complications were comparable with those of non-scarred abdomen undergoing Lap TL. Conclusion: Lap TL in a patient with a scar on the abdomen is a preferable method rather than Laparotomy. Junior gynecologists should take the help of senior gynecologists conversant with doing Lap TL in patients with scarred abdomen. Complications are comparable with those of Lap TL in non-scarred abdomen. The abdomen should be closed in layers. It should be standard protocol for all gynecologist practicing universally. Scar/scars on the abdomen is not a contraindication of Lap TL.

Serum Amylase as a Prognostic Factor in Diabetic Ketoacidosis

Abstract Objective: The study’s objectives were to learn about the impact of serum amylase levels on morbidity and mortality of diabetic ketoacidosis (DKA) patients. Methodology: This is a single-center cross-sectional study of 100 patients admitted to the Medicine Intensive Care Unit at Shyam Shah Medical College and SGM Hospital Rewa between January 2021 and June 2022. Results: Mean duration of hospital stay in DKA patients with serum amylase level <140 U/L was 10.56± 5.04 days while DKA patients with serum amylase level ≥140 U/L was 23.75 + 1.66 Days. The mean amylase level in death cases of DKA was 198.32 IU/L and in recovered cases of DKA was 87.22 IU/L. Conclusion: In our study, we discovered that as serum amylase levels rise so does the length of hospital stay. Amylase levels were extremely high in death cases.

Sociodemographic Profile of Animal Bite Cases Attending at a Tertiary Care Center, Rewa (M.P.)

Abstract Objective: The study’s objectives were to learn about the sociodemographic profile of animal bite cases in Madhya Pradesh’s Vindhya region while attending the Medicine Outpatient Department (OPD) at Shyam Shah Medical College in Rewa (M. P.). Materials and Methods: Between January 1, 2018, and December 31, 2018, this study was conducted in the Medicine OPD, Department of Medicine, at Shyam Shah Medical College in Rewa, Madhya Pradesh, India. A cross-sectional study was conducted. A total of 1440 cases of animal bites were included in the sample, and for each patient, a sociodemographic profile was obtained along with a comprehensive history of the animal’s category and type, bite type and site, duration of exposure, and category of exposure. Results: The majority of the 1440 animal bite cases were bitten by dogs 1198 (76.94%). There are 763 (52.98%) Category II bites, 605 (42.01%) Category III bites, and 72 (5%) Category I bite. Lower limbs were bitten 914 (63.47%), upper limbs 389 (27.01%), head and neck 67 (4.65%), and trunk 70 (4.86%). Conclusion: This study found that rural areas have a high number of dog bite cases, and adult males have a higher incidence of animal bites than adult females. The most common biting animal is the dog, and the most common site of bite in adults is the lower limbs.

DENTAL IMPLANTS AS AN OPTION FOR MISSING TOOTH/TEETH REPLACEMENT: A STUDY ON PATIENT AWARENESS AND SOURCES OF INFORMATION

Objectives: This study was designed with an aim to assess the level of awareness regarding dental implant as a treatment modality for the replacement of missing teeth in the patients reporting to dental outpatient department and to determine their sources of information regarding implants. Methods: This was a questionnaire-based study to assess the awareness about dental implants and the related sources of information in 350 patients who reported to Department of Dentistry, Shyam Shah Medical College Rewa, Madhya Pradesh from 1st October 2022 to 31st December 2022. Results: Only 36.86% (n=129) of participants had heard of dental implants. Among these patients (N=129), only 30.23 % (n=39) received information about dental implants from dentists. Only 4 (3.10%) patients had themselves undergone treatment with dental implants. Awareness regarding implant composition was poor with only 6.98% (n=9) participants being aware that implants are made of titanium. Fear of surgery (33.33%) and high treatment cost (30.23%) were the most common limiting factors that governed the decision of patients regarding undergoing treatment with dental implants. Conclusion: The findings of the study indicate a low level of awareness about dental implants as a treatment option for replacing missing teeth. A very less number of participants received information from reliable sources. It is important to create awareness in general population regarding feasibility of implants for prosthetic rehabilitation and to make implant treatment easily accessible and affordable.

Situational analysis of women empowerment in urban field practice area of Dr. M. K. Shah Medical College and Research Center, Ahmedabad.

Women empowerment in society and family are closely linked to decision-making. Empowerment of women is essentially the process of upliftment of economic, social, and political status of women, the traditionally underprivileged ones, in society. It involves the building up of a society wherein women can breathe without the fear of oppression, exploitation, apprehension, discrimination, and the general feeling of persecution which goes with being a woman in a traditionally male dominated society. The present study was conducted to assess women's empowerment status and factors affecting it. Community-based cross-sectional study was carried out among 175 women residing in urban field practice area of Dr. M. K. Shah Medical College and Research Centre, Ahmedabad. A pre-designed questionnaire was used for data collection by interviewing the women through house to house survey. Data were entered in Microsoft Excel and analyzed using (Statistical Package for the Social Sciences (SPSS). Around 85.71% of women were involved in decisions regarding trivial issues. A total of 17.72% of the women reported that they had suffered some form of domestic violence in their life. Around 23% of the women were not involved in any financial decisions of the family. Association between education of the women and involvement in decision-making was found statistically significant. Employment increases the participation of women in financial decision-making. 88.89% of employed women participated in financial decisions, while 71.42% of housewives were participating in these decisions. Education and employment were found to have impact on decision-making. So, education of girls should be given the priority.

Rural-urban disparities in knowledge, attitude, and practice toward child oral health among mothers of 9-36-month-old children.

Objective: To assess and compare the knowledge, attitude, and practice of mothers of pre-school children in urban and rural areas toward maintaining child oral health. Materials and Methods: A cross-sectional comparative study was conducted in a convenient sample of 400 mothers of pre-school children (aged 9 months to 3 years) visiting the outpatient department of the Department of Dentistry, Shyam Shah Medical College, Rewa (M.P), India between February 1 and April 21, 2022. The study sample was divided into two groups based on whether they belonged to a rural area (Group A) or urban area (Group B). Group A included 236 participants, and Group B 186 participants. They were served a 24-item questionnaire to assess and compare their knowledge, attitude, and practice toward child oral health. The data were represented as mean and proportions, and a student t test and analysis of variance were performed. Results: In Group A and Group B, 93.64% and 98.17% mothers respectively had the knowledge of cariogenic food. While 66.10% of mothers in Group A and 73.78% in Group B were aware that regular cleaning of teeth protects against tooth decay, only 5.49% of mothers in Group B and none in Group A reported taking their children to routine dental visits; the majority (94.07% in Group A and 78.05% in Group B) had never taken their children to the dentist. Urban background was significantly associated with better knowledge, attitude, and practice scores. Mother's' age and education level were significantly associated with better Knowledge, Attitude, and Practice scores in both groups. Conclusion: Mothers can play an important role in promoting positive attitudes and healthy practices toward oral health care in children. Knowledge, attitude, and practice score were found to be significantly low in mothers who belonged to the rural subgroup.

Utility of automated cell counter histogram in diagnosis of thrombocytopenia and pseudothrombocytopenia

Background: Automated hematology analyzers have become mainstream of complete blood count (CBC) during the past two decades; they are potential, more accurate to produce results of CBCs. However, often automated analyzers can give false results too, specially, falsely low platelet count due to platelets aggregates, which have to be confirmed on peripheral smears. Aims and Objectives: The aim and objective of the study was to diagnose thrombocytopenia (TCP) cases and differentiate them from pseudothrombocytopenia (PTCP) cases by analyzing platelet histogram and to determine the sensitivity and specificity of platelet histograms for diagnosing TCP and PTCP. Materials and Methods: The present study was conducted in the Department of Pathology at Shyam Shah Medical College, Rewa, M.P., after obtaining ethical clearance from the Institutional Ethics Committee. It was prospective study conducted for a period of 15 months from January 2021 to May 2022 on 1000 samples. Results: The sensitivity and specificity of platelet histogram flags and presence of multiple peaks to diagnose TCP and PTCP cases were calculated as 73.60% and 93.60%, respectively. The present study also interpret that mean platelet volume and platelet distribution width cannot use as indicator to differentiate between TCP and PTCP. Conclusion: The present study concludes that analysis and interpretation of histogram more specifically platelet histogram flagging provide clue for early detection of PTCP cases prior peripheral smear examination and also helpful in differentiating them from true TCP cases. These platelet histogram flagging can be used as a screening parameter for the detection of PTCP and these are helpful in preventing unnecessary stress for clinician, patients, and their relatives. However, the peripheral smear examination will remain the gold standard to differentiate TCP from, PTCP.

Significance of levels of serum proteins and serum lipids as prognostic indicators in mortality of burn patients

Background: Burn mortality is significant because of the higher metabolic and physiological abnormalities; it causes more so than because of the actual injury. Since these abnormalities persist throughout the clinical course of burns, it is believed that both the trend of change and absolute values of the serum proteins and serum lipids have an impact on the prognosis and outcome. Aims and Objectives: This study aimed to find whether serum albumin, globulin, total protein, cholesterol, and triglyceride levels are clinically relevant to determine the mortality of a burn patient and thereby the patient’s outcome. Materials and Methods: The current prospective analytical study was carried out in patients who were admitted to the burn unit, Department of Surgery, Shyam Shah Medical College, and associated Sanjay Gandhi Memorial Hospital, Rewa (M.P.), during the period of April 1, 2021–June 30, 2022 (15 months), and the results were analyzed. Results: In the present study, a total of 112 patients were studied and followed up. Among them, 86% (96/112) of total patients were survivors who were discharged/DOR in stable condition and 14% (16/112) of total patients expired during the course of treatment. It could be statistically inferred that the increase in values of albumin, globulin, total protein, and cholesterol during the clinical course reduces mortality with serum albumin acting as the best predictor with the highest sensitivity of 100% and specificity of 100% and cholesterol the least. Conclusion: It could be statistically inferred that the increase in values of albumin, globulin, total protein, and cholesterol during the clinical course reduces mortality with serum albumin acting as the best predictor and cholesterol the least.

Comparative study of laparoscopic versus open surgery in cases of liver hydatid cysts

Background: Hydatidosis is a zoonotic infection, and treatment is mandatory to avoid complications. The infection can be asymptomatic or severe, causing extensive organ damage and even death of the patient. Aims and Objectives: The main aim of this study is to find out the merits and demerits of laparoscopy over that of open surgery in the treatment of hydatid cysts of liver. Materials and Methods: This prospective observational study was done on 50 patients who had liver hydatid disease admitted in the Department of Surgery, Shyam Shah Medical College Rewa (M.P.). Patients were divided into two groups consisting of 25 cases in each. Group A: managed by laparoscopic surgery and Group B: managed by open surgery. Results: The mean operative time in Group A was 99.6 min, while in Group B, it was 140.4 min. Group A patients were mobilized early and resumed duty very fast then Group B. The mean duration of stay in hospital was 8.64 days (range: 4–20 days) in Group A and 11.84 days (range: 4–12 days) in Group B. Wound infection seen in 9 patients in Group B and 0% in Group A. General complication rate was 32% in Group B and 8% in Group A. No recurrence noticed in either group during follow-up. Conclusion: Overall laparoscopic management of liver hydatid cyst is cost-effective in terms of early mobilization, early discharge, and early resumption of work along with cosmetic benefit.

Validation of the IAC Yokohama system for reporting breast fine-needle aspiration cytology categorization of breast lesions in Vindhya region population

Background: In 2016, International academy of cytology (IAC) has established a standardized approach for reporting breast fine-needle aspiration cytology (FNAC) by categorizing the lesions in five tier system from C1 to C5 to standardize reporting, which will enhance Breast fine-needle aspiration biopsy cytology performance, interpretation, and reporting. Aims and Objectives: The aim of the study was to categorize FNAC cases according to The IAC Yokohama System and evaluate the diagnostic ability of FNAC. Materials and Methods: The current prospective analytical study was carried out in the Department of Pathology, Shyam Shah Medical College, Rewa, Madhya Pradesh, for a period of 15 months from January 2021 to March 2022 (15 months). A total of 100 cases were included in the study based on inclusion criteria. The results were analyzed based on cytological reporting and P value calculated. Results: Among the 100 cases studied highest number of cases were from the age group of 21–30 years with 29% (n=29). The most common breast laterality affected was left with 69% of affected cases. The maximum number of cases, 69% (n=69) of the total, were found to be categorized under the category C2 (benign) which was followed by Category C5 (Malignant) seen in 13% (n=13). About 9% (n=9) of the total cases were categorized as suspicious of malignancy (C4). Atypical Lesion (C3) and Unsatisfactory Lesions (C1) were categorized in 5% (n=5) and 4% (n=4) of the total cases, respectively. Conclusion: FNAC is a minimally invasive, quick, and efficient pre-operative diagnostic tool that can also be used for postoperative breast lump follow-up to prevent recurrences. FNAC using IAC Yokohama system is a rapid and effective method for the primary categorization of palpable breast lumps and provides better clarity to the clinicians in the management of the patient and can reduce unnecessary surgeries.

A correlation study of cervical cytology on pap smear with cervical biopsy in a tertiary care hospital (1 Year Study)

Introduction: Cervical cancer is the second most common cancer in women worldwide after breast cancer, and in developing countries, the leading cause of death by cancer. It is one of the most preventable and curable of all cancers. The Pap smear is the standard screening tool used to test for the presence of abnormal cells that could become cancerous. A regular Pap smear provides an opportunity to detect pre-cancerous cells in the cervix. The simplicity, effectiveness and versatility of Pap test have made it an integral part of routine clinical examination and large chunk of workload in gynaecological and pathological practice is due to this test. Aims and Objectives: To establish usefulness of pap smears examination as a diagnostic tool for detection of cervical lesions. Material and Method: In present study results of 400 PAP smears are analysed, which had been examined in cytology section (Department Of Pathology, M.P. Shah Medical College, Jamnagar) during 1 years (July 2021 to July 2022). Out of 400 pap smear 250 patients were undergone cervical biopsy or hysterectomy. So the final sample size is 250. The conventional cervical smears were fixed by 100% methanol and stained by Pap method (RAPID-PAP). The cytological smears were reported using Bethesda System 2001. The cervical biopsies or hysterectomy specimens received from the same patients were fixed in 10% neutral buffered formalin solution and processed with embedding in paraffin blocks and stained with haematoxylin and eosin (H and E) stain. The histopathological findings and Pap smear findings were correlated and histopathological diagnosis of biopsies were taken as the gold standard. Result: In present study most common complain was irregular menstrual bleeding followed by lower abdominal pain. Out of 250 pap smears maximum patient belong to 41-50 years and were multipara. Maximum cases were reported as NILM (60%), followed by ASCUS (15.2%), LSIL (12%), HSIL (8%), squamous cell carcinoma (4.8%). On histopathology, 47.6% cases were diagnosed as chronic cervicitis, 23.2% cases as chronic cervicitis with squamous metaplasia, CIN I (17.2%), CIN II (4.4%), CIN III (2.8%), squamous cell carcinoma (4.8%). Overall sensitivity, specificity, positive predictive value and negative predictive value is 95.8%, 83%, 70%, 98% respectively. Conclusion: Pap smear is a simple cheap safe and practical diagnostic tool for early detection of cervical cancer in high risk group population and therefore should be established as a routine screening procedure.

Occurrence of Oral, Oropharyngeal and Laryngeal Cancers in Saurashtra Region, Gujarat, India A study of 1,006 cases of Oral Lesions

Background: Cancer of the oral region is a major health problem in India and across the world. It is a lifestyle related cancer mainly associated with use of tobacco, alcohol, betel nut, poor oral hygiene etc. Early screening and diagnosis of premalignant and malignant lesions is important to improve patient outcome. Histopathological examination of the biopsies remains the gold standard for diagnosis. Materials and MethodsThis was a retrospective study carried out over a period of three years i.e., 2019 to 2021 in the Department of Pathology at Shree M.P. Shah Medical College, Jamnagar, Gujarat. A total of 1006 cases of oral biopsies were studied for the parameters such as age, sex, site involved, presence of risk factors (e.g., use of tobacco), type of lesion and immunohistochemistry marker positivity.Aims and Objectives 1.To study the year-wise distribution oral, oropharyngeal and laryngeal premalignant and malignant lesions in Saurashtra Region of Gujarat, India.2.To analyze cases of oral malignancies in this region with regard to gender, age, site involved, type of lesion, history of tobacco exposure etc.Results: Out of 1006 cases studied, 832 (82.7%) were malignant and remaining 174 (17.29%) were found pre-malignant on histopathological examination. The Male: Female ratio was found to be 5.1:1. The largest number of patients were seen in the age group of 41 - 60 years. The most common site involved in our study was buccal mucosa. Squamous cell carcinoma was the most common lesion among the malignant lesions.Conclusion: Cancers of oral cavity, pharynx and larynx are highly prevalent in males of this region and are associated with lifestyle related factors such as tobacco use, alcohol intake etc. Histopathological examination and typing of the lesion is important for confirmation of malignancy.

VULVOVAGINAL CANDIDIASIS- PREVALENCE AND ANALYSIS OF ASSOCIATED RISK FACTORS AMONG WOMEN OF REPRODUCTIVE AGE GROUP IN VINDHYA REGION

Background: Although it can affect all groups, vaginitis remains one of the most common ambulatory problems to occur in women of reproductive age group. It accounts for 5-10 million office visits per year throughout world. In India prevalence of vaginitis is approximately 30%. Vaginitis has substantial impact on various aspects of female reproductive health, mental health, work ability and routine physical activity. It is also associated with various obstetrical and gynecological complications. Vulvovaginal candidiasis is common form of vaginitis. So, we aim to find out prevalence and analyze risk factors associated with vulvovaginal candidiasis at tertiary care hospital in Rewa, Madhya Pradesh India. Method: An observational cross-sectional study was conducted at Department of Obstetrics and Gynecology, Shyam Shah Medical College Rewa for 18 months from January 2021 to June 2022 on 1000 women of reproductive age group, visiting routine Gynae OPD of department of Obstetrics & Gynecology. Results: Prevalence of vulvovaginal candidiasis in present study was found to be 12%. Various associated risk factors were OCP use, use of cloth during menses, douching/cleanliness habit, rural area of residence, middle and lower socioeconomic class and various occupations like factory workers and farmers. Conclusion: As it is evident that vaginitis will never be completely prevented, but incidence can be reduced. Much of the morbidity and complications can be reduced by identification and prevention of modifiable risk factors and interventional strategies directed mainly on high-risk behaviors in day-to-day life.

Correlation of automated cell counter RBC histograms and peripheral smear in anemia typing

Background: Red blood cell (RBC) indices and histogram obtained from automated hematology gives an idea about the morphological changes in anemia and therefore forms the fundamental process for diagnosis of anemia. Along with the peripheral smear, they can be used for anemia typing and to interpret the cause of anemia. Aims and Objectives: (1) Interpretation of histograms in normal persons and patients with different types of anemia. (2) Anemia typing based on RBC histograms complemented with Peripheral smear examination. Materials and Methods: The present prospective study is conducted in Haematology section of Department of Pathology, Shyam Shah Medical College and Sanjay Gandhi Medical Hospital Rewa, Madhya Pradesh. A total of 1000 patients blood sample is collected for complete blood count and anemia typing irrespective of age and gender and examined over a period of 1 year from August 2021 to July 2022. The patient’s blood sample is collected in EDTA vacutainer and analyzed on the basis of histogram obtained and peripheral smear slide prepared. Results: In the present study, we noted that the predominant age group affected was 20–30 years. Peripheral smear finding shows normocytic normochromic anemia was seen in 6% cases (60/1000), microcytic hypochromic anemia seen in 24.2% cases (242/1000), macrocytic anemia seen in 14% cases (140/1000), dimorphic anemia seen in 50.2% cases (502/1000), and hemolytic anemia seen in 5.6% cases (56/1000). This peripheral smear finding shows well correlation with findings of histogram pattern and RBC indices, where normocytic normochromic seen in 6.4% of cases (64/1000), microcytic hypochromic anemia seen in 24.4% of cases (244/1000), macrocytic anemia seen in 13.8% of cases (138/1000), dimorphic anemia seen in 49.5% of cases (495/1000), and hemolytic anemia seen in 5.9% of cases (59/1000). The most common anemia is dimorphic anemia (combined nutritional deficiency) in 49.5% cases followed by microcytic hypochromic anemia in 24.4% of cases based on histogram findings along with RBC indices. Conclusion: Histogram guides a technologist about the cases that need actual detailed peripheral smear examination by experts. Our study shows a well correlation in findings of automated hematology analyzer with the microscopic examination. Histogram alone could be used as screening method and when combined with peripheral blood smear findings, they act as useful supplement and by correlating findings of both methods, we could diagnose majority of anemia.

THE EFFECTS OF ADVERSE CHILDHOOD EXPERIENCES ON PSYCHOSOCIAL WELLBEING AND MEDIATING ROLE OF SELFESTEEM AMONG MEDICAL STUDENTS

Background: Adverse childhood experience (ACE) has cumulative consequences on physical, mental and social wellbeing. The impact of ACEs is amplified by stressors, such as academic, physical, social and emotional stressors, which medical students are constantly exposed to. Aim and Objective: This study is aimed at determining the association between adverse childhood experiences and adult psychosocial wellbeing and mediating role of selfesteem among preclinical medical students.Participants and setting:A total of 138 undergraduate medical students at C.U. Shah medical college and hospital, Surendranagar participated in the study. Methods: Participants completed online google forms having socio-demographic, an Adverse Childhood Experience, the World Health Organization's Quality of Life (WHOQOL-BREF) and the Rosenberg's self-esteem questionnaires. Data obtained were analysed using SPSS.Descriptive and inferential statistical analyses were performed. Results:At least one out of ten categories of ACEs were reported by 39.8% of respondents;physical abuse (19.1%),emotional abuse (18.2%),parental divorce (9.4%) and sexual abuse (9.0%). There was a significant association between adverse childhood experiences and adult psychosocial wellbeing (p<0.05), as well as low self-esteem (p<0.05). Respondents with previous exposure to ACEs were six times more likely to suffer from low esteem compared to non-exposed students (Adj OR:6.3, 95%CI:1.3-31.4, p=0.003).Mother's (p=0.001) and father's (p=0.028) level of education,parental separation (p<0.0001),were associated with exposure to ACEs. Conclusion: this study revealed an association between exposure to adverse childhood experiences and adult psychosocial well-being with those exposed reporting poorer wellbeing and functioning;and a strong likelihood of having low self-esteem among medical undergraduates