Sri Aurobindo Medical College Research Articles

TO STUDY THYROID DYSFUNCTION IN PATIENTS WITH METABOLIC SYNDROME

Background: Metabolic syndrome (MetS) is a cluster of risk factors associated with increased cardiovascular disease and diabetes risk. Thyroid dysfunction (TD), especially hypothyroidism, has been observed more frequently in individuals with MetS. However, the relationship between thyroid function and metabolic syndrome components remains debated. This study aimed to explore the prevalence of thyroid dysfunction and its association with metabolic syndrome components in patients. Methods: A cross-sectional study was conducted at Sri Aurobindo Medical College & P.G. Institute, Indore. A total of 120 patients meeting the International Diabetes Federation (IDF) criteria for metabolic syndrome were included. Detailed history, anthropometric measurements, blood pressure recordings, fasting blood sugar, lipid profile, and thyroid assays were performed. Statistical analysis using SPSS22 and Excel was employed to assess thyroid dysfunction prevalence and its correlation with metabolic syndrome components. Results: Among 120 patients with metabolic syndrome, 28% had thyroid dysfunction. Hypothyroidism was predominant, with subclinical hypothyroidism being the most common type. Females and older individuals (>45 years) showed a higher prevalence of thyroid dysfunction. Patients with thyroid dysfunction exhibited altered metabolic syndrome components, including increased waist circumference, decreased HDL-C, elevated blood pressure, fasting glucose, and triglyceride levels. Conclusion: The study highlights a high prevalence of thyroid dysfunction, especially hypothyroidism, among patients with metabolic syndrome. These findings suggest a potential association between thyroid status and metabolic syndrome components. Screening for thyroid dysfunction in individuals with metabolic syndrome could aid in optimizing clinical management strategies. Further research with larger sample sizes and prospective designs is warranted to explore the impact of thyroid dysfunction management on metabolic syndrome outcomes.

A Study of Quality of Life Improvement in Videonystagmography Guided Epley's Manoeuvre in Posterior Canal Benign Paroxysmal Positional Vertigo.

To assess Quality of life improvement in Videonystagmography guided Epley's Manoeuvre in posterior canal benign paroxysmal positional vertigo. The design of present study is cross-sectional analytical study. The study is conducted in the Department of Otorhinolaryngology, Sri Aurobindo Medical College and Post Graduate Institute, Indore in association with Sri Aurobindo Institute of speech and hearing, Indore. Current study done to assess the effectiveness of canalolith repositioning procedures (Epley's maneuver) with and without drug therapy in posterior canal benign paroxsymal positional vertigo and to assess the patients based on Dizziness Handicap Inventory. All Patients who come to ENT OPD at Sri Aurobindo Medical College and Post Graduate Institute, Indore in the specified duration and according to the inclusion criteria were chosen in the study. Majority of the patients were in the age group of 18-58years with the median age of 32 and subjective symptomatic relief on Epley's manoeuvre and DHI on day 15, 46 out of 60 subjects reported symptomatic relief with a percentage of 76.6%. This group of 46 subjects with symptomatic relief was labeled as resolved group. The age range in resolved group was between 18 and 58years. Remaining 14 subjects, labelled as relapsed group were prescribed beta-histine and repeat Epley's maneuver was performed to assess the effectiveness of adjunct therapy. We conclude that a single Videonystagmography guided Epley's maneuver is an excellent tool for effective rehabilitation of majority of posterior canal BPPV alone and combined with adjunct betahistine therapy can even cure refractory cases providing them with better quality of life.

FUNCTIONAL AND RADIOLOGICAL OUTCOME OF DIFFERENT PINNING CONFIGURATION (CROSS PINNING VERSUS DIVERGENT PINNING) IN FIXATION OF EXTRA-ARTICULAR FRACTURE OF DISTAL ENDRADIUS IN ELDERLY PATIENTS

Objective: The objective of the study is to compare the functional and radiological outcomes of different pinning configuration (cross pinning versus divergent pinning) in the fixation of extra-articular fracture of distal end radius in elderly patients. Methods: An observational prospective study was conducted at Sri Aurobindo Medical College and PG Institute, Indore, MP, from December 2019 to May 2021. After the approval of the Institutional Ethics Committee, informed consent was obtained from the 40 elderly patients of the both sex in the age group of more than 50 years with closed fracture. 20 Patients were subjected to divergent pinning and 20 patients were subjected to cross pinning. Regular follow-up with the X-ray imaging. Results: Statistically no significant difference was found in palmar tilt, radial shortening, and loss of radial deviation. Mayo wrist score compare between the two groups. The result showing the functional outcome of configuration B (cross-pinning) is better than that of configuration A (divergent pinning). The only significant complication is pin migration, pin site infection, and stiffness. Pin tract infections are resolved by oral antibiotics, good pin tract care and wrist stiffness treated with vigorous physiotherapy. Conclusion: Cross pinning had better functional and radiological outcome as compared to the divergent pinning in extra-articular fracture of the distal end of the radius. The percutaneous pinning technique is less time-consuming and allows earlier rehabilitation without jeopardizing the fracture alignment.

COMPARISON OF ORAL CLONIDINE AND ORAL MIDAZOLAM AS PRE-MEDICATION FOR PEDIATRIC SURGERY IN CHILDREN

Objectives: The objectives of the study are to compare the efficacy and safety of oral midazolam (0.5 mg/kg) and oral clonidine (3 μg/kg) as pre-medicant in pediatric age children undergoing surgical intervention. Methods: The present study was conducted at the Department of Anesthesiology and Critical Medicine, Sri Aurobindo Medical College and Postgraduate Institute, Indore (M.P.). We had included 60 children undergoing pediatric surgical intervention during the study period of 1–1/2 years of age 2–10 years. These children were randomized to receive either midazolam or clonidine. After obtaining consent from the parents, these children were included in the study. Pediatric separation anxiety score (PSAP) was used for the assessment of anxiety and mask acceptance scale was used for the assessment of mask acceptance. Comparison of means between the two groups was done using unpaired “t” test, and association between two non-parametric variables was done using Pearson Chi-square test. A p<0.05 was taken as statistically significant. Results: The mean age in midazolam group was 5.50±3.18 years and in clonidine group was 5.56±4.44 years. The mean age was comparable between the two groups (p=0.954). In both groups, there was male predominance. Mask acceptance was also better in clonidine group compared to midazolam group (p=0.001). Sedation was more in clonidine group compared to midazolam group, but it was not statistically significant (p=0.136). Wake-up behaviors of the patients were comparable between the two groups (p=0.777). The hemodynamics were comparable between the two groups at majority of the time intervals (p>0.05). We found clonidine to be better in comparison to midazolam in providing sedation and patients were easily consolable compared to midazolam group patients. Conclusion: We conclude that clonidine as a pre-medicant in patients undergoing pediatric surgical intervention is better as compared to midazolam with slightly higher sedation in clonidine group. We recommend the use of clonidine as a pre-medicant in patients undergoing pediatric surgical intervention.

Clinical and histopathological study of cutaneous lichen planus in a tertiary care center of central India

Abstract Background: Lichen planus (LP) is an idiopathic, chronic inflammatory disease of the skin, mucous membrane, and nails. Worldwide distribution is seen, with 0.38% of the lesions prevalent in India. Objective: The present study was conducted to study the demographic profiles (such as age and gender) and histopathology of LP and their clinical presentation. Materials and Methods: The present study was conducted in the Department of Pathology at Sri Aurobindo Medical College and Post Graduate Institute, Indore. All cases presenting with LP and undergoing skin biopsy from December 2018 to May 2021 were included in the study. Detailed clinical history was taken, and histomorphological evaluation was performed for all the included cases. Results: A total of 155 cases of LP were analyzed. The mean age of presentation was 34.89 ± 16.02 years, with slight male predominance. The mean duration of the disease was 7.82 ± 5.34 months. Clinically, most cases presented with mild to moderate pruritis (64.51%), followed by intense pruritis (25.16%). Violaceous papules and plaques were the predominant findings in 80.64% of patients, followed by hyperpigmented papules and macules (13.54%). Histomorphologically, hyperkeratosis was observed in almost all cases (99.35%), followed by wedge-shaped hypergranulosis (65.80%). The most common variant found was classic LP (30.96%), followed by hypertrophic LP (29.6%) and LP pigmentosus (26.4%). Clinicopathological discordance was seen in ~14 (10%) cases. Conclusion: Detailed history, clinical examination, and careful histological assessment help diagnose LP and differentiate its variants.

ASSESSMENT OF FACTORS INCREASING THE RISK OF PRELABOUR RUPTURE OF MEMBRANES AND ITS EFFECT ON FETOMATERNAL OUTCOME

Background: Premature rupture of membranes (PROM) refers to a patient who is beyond 37 weeks gestation and has presented with rupture of membranes (ROM) prior to the onset of labor. Patient with PROM presents with leakage of fluid, vaginal discharge and pelvic pressure, but they are not having contraction. It occurs in 3 percent of pregnancies and is the cause of approximately one third of preterm deliveries. It can lead to significant perinatal morbidity, including respiratory distress syndrome, neonatal sepsis, umbilical cord prolapse, placental abruption, and fetal death. Appropriate evaluation and management are important for improving neonatal outcomes. The risk of intrauterine infection increases with the duration of ROM. Evidence supports the idea that induction of labor, as opposed to expectant management, decreases the risk of chorioamnionitis without increasing the cesarean delivery rate. Methods: - This present observational study was conducted at Obstetrics & Gynecology, Department at Sri Aurobindo Medical College and Post Graduate Institute, Indore and who satisfy the inclusion criteria will be studied from 1st April 2021 to 30th September 2022 (18 months). After were Institutional ethical committee. among the patients diagnosed as premature rupture of membrane with women complain of leaking attending antenatal OPD and antenatal ward. On admission detailed history was taken. General and Systemic examination were done including Per Abdomen, Per Speculum and per vaginum carried out and investigations were done as per protocol. Diagnosis of PROM was confirmed by any of this method. Continuous monitoring of maternal and fetal condition done, antibiotics was given intra/ post natal period. P/ V exam were done when necessary. Investigations done and maternal and fetal outcome were noted. Results: The prevalence of premature rupture of membranes (PROM) was found to be 4.1%, with a corresponding perinatal mortality rate of 0.18 per 1000 deliveries. Approximately 33% of the cases involved pre-term premature rupture of membranes (PROM), while the remaining 67% were term PROM. Among the cases with preterm PROM, 10% of the perinatal deaths occurred. The average age of the female participants was 36.9 years, with a standard deviation of 2.1 years. The median number of children per participant was 1, with a range of 1 to 5 children. A notable correlation was observed between the gestational age at which premature rupture of membranes (PROM) occurred in women and the latency period (p< 0.001). There was a significant association between the gestational age at which premature rupture of membranes (PROM) occurred and foetal birth weight, APGAR score, and Neonatal Intensive Care Unit (NICU) admission (p<0.05). A statistically significant distinction was observed between the implemented intervention and the method of delivery (p=0.009). Conclusion: The incidence of PROM at term was high and conservative/ expectant management was effective. The latency period and fetal outcomes such as birth weight, apgar score and NICU admission were determined by the gestational age at which PROM occurred.

To study correlation between the tip apex distance and the functional outcome of fracture intertrochanteric femur treated with trochanteric femoral nail

Introduction: Tip Apex Distance (TAD) is well established method of prediction of outcome in intertrochanteric fractures managed by Dynamic Hip Screw. This retrospective study was done to assess the significance of Tip Apex Distance in the management of the intertrochanteric fractures by proximal femoral nail.Methodology: Selection of Cases-An informed written consent will be taken from all the patient/relatives/guardian after the approval of Institutional Ethics Committee.Source of Data: Patients admitted to Sri Aurobindo Medical College and PG Institute, Indore for fracture proximal humerus in adult patients.Conclusion: This study indicates that the Tip Apex Distance can be used as a useful predictor of the outcome of the proximal femoral nail in intertrochanteric fractures.

Endometrial Histopathology in Abnormal Uterine Bleeding and Its Relation With Thyroid Profile and Endometrial Thickness.

Abnormal uterine bleeding (AUB) is a common complaint in postmenopausal and perimenopausal women, caused by a range of disorders, including structural and systemic diseases. The evaluation of endometrial thickness (ET) via radiological methods, followed by a histopathological examination of the endometrium, is useful for proper diagnosis. Among systemic diseases, thyroid dysfunction, specifically hypothyroidism and hyperthyroidism, contribute significantly to AUB cases. This descriptive cross-sectional study was conducted at Sri Aurobindo Medical College, Indore, Madhya Pradesh, India, over a period of 16 months, from May 2021 to September 2022. Patients presenting with abnormal uterine bleeding and undergoing thyroid function tests (TFTs), ultrasonography, and endometrial biopsy/hysterectomy at the gynecological outpatient department were included. Hospital records were used to obtain clinical details and investigation results. Endometrial thickness and thyroid status were recorded, and descriptive statistics were used to analyze the collected data. This study included 150 patients with abnormal uterine bleeding, with a mean age of 44 years and 80.6% of patients in the premenopausal age group. A total of 48% of patients had a deranged thyroid profile, with hypothyroidism being more common (91.6%). Structural causes of AUB were identified in 81.3% of cases, with adenomyosis (33.65%), concomitant adenomyosis and leiomyoma (31.5%), and leiomyoma (14.8%) being the most common. Endometrial polyps (4.6%) and endometrial carcinoma (0.6%) were also observed and were consistent with the final histopathology. The remaining 18 patients had no structural causes and were categorized as cases of dysfunctional uterine bleeding (DUB). Increased ET was more commonly observed in postmenopausal patients (4.3%) compared to premenopausal patients (0.7%) among those with AUB, while the reverse was true for patients with DUB. Increased ET was commonly associated with hypothyroidism in both groups. Histopathological examination of endometrial biopsies/hysterectomy specimens revealed additional findings in some patients, including hyperplasia of the endometrium with (0.7%) and without atypia (4%), leading to a more accurate diagnosis. AUB is a prevalent condition affecting women in both pre-menopausal and postmenopausal stages, frequently caused by structural anomalies. However, thyroid dysfunction, especially hypothyroidism, is also a significant contributing factor. As such, thyroid function tests (TFTs) are an effective and economical means of identifying potential underlying causes of AUB. Hypothyroidism is frequently associated with increased endometrial thickness, and histopathological examination remains the gold standard for determining the precise cause of AUB.

CROSS SECTIONAL STUDY OF COVID 19 CONVALESCENT PLASMA (COPLA) DONOR CHARACTERISTICS

Background: Although many trials are currently investigating the safety and efcacy of convalescent plasma (CP) in critically ill COVID-19 patients, there is a paucity of ongoing and published studies evaluating the CP donors' side. In this regard, this study was aimed to nd out how SARS-CoV2 IgG antibodies are inuenced by demographic and clinical characteristics of donors such as age, sex, ABO/Rh blood group, disease severity, post recovery duration, ethnicity. After approval from the IEC Material & Methods: and consent from the study participants, the study was performed in Department of Pathology and Blood Bank of Sri Aurobindo Medical College and PG Institute, Indore (M.P) on a total of 785 COVID-19 recovered patients. A total Results: of 785 COVID-19 recovered patients were telephonically contacted for COPLA donation, out of which 103 donor candidates refused for the plasma donation while 82 donors were deferred by blood bank authorities for convalescent plasma donation. 600 donors successfully donated convalescent plasma in the present study. The most common reason for refusal of COPLA donation by the donors was Fear of reinfection (26.2%) followed by diabetes mellitus on insulin (16.5%). Whereas low antibody titre (53.7%) was the most common reason for COVID- 19 COPLA donor deferral in the present study. Majority were in age group 26-35 with higher prevalence of males. Donors' age and COVID-19 severity were positively associated with greater antibody responses. The awareness of CP donor characteristics, post-screening deferrals, and c Conclusion: orrelates of antibody values with age, gender, body weight, severity of COVID-19 disease and blood groups will help improve collection outcomes and give better preparedness for future recurrent waves due to evolution of more virulent SARS-CoV-2 strains and ll treatment gap till availability of more specic treatment.

STUDY ON CLINICAL PRESENTATIONS, LEVEL OF STRESS & ROLE OF FAMILY ENVIRONMENT AMONG DISSOCIATIVE DISORDER PATIENTS

Background: Dissociative disorder is a stress-related disorder usually present in adolescent and younger age group. It is also accompanied with significant impairment in activity of daily living and family relationship. Family environment plays important role in initiation and maintenance of symptoms and this put significant burden on family. To assess different types of clinical presentations, level of stress and role of family environment among dissociative disorder patients and check for association between sex distributions. Material and Method: This cross-sectional descriptive study was carried out on patients with primary diagnosis of dissociative disorder as per ICD-10 criteria coming to psychiatry outpatient department of Sri Aurobindo Medical College and Postgraduate Institute, Indore a premier tertiary care hospital situated at northern part of India, covering, and serving a large catchment area, during the period of 18 months. 80 patients were recruited for the purpose of study. The procedure and rationale for the study was explained to all subjects and informed written consent were taken in their local language. Patients were included after fulfilling inclusion criteria from both inpatients and outpatient department of psychiatry. Result: In our study, majority of the patients (48.75%) belonged to the age group 18-30 years. The prevalence rates decrease with age. 37.5% of the patients were between the age group 31-40 years and 13.75% were over the age of 40 years. In a study of 80 patients with dissociative (conversion) disorder, 77.5% were females and 22.5% were male. There was female predominance. Conclusion: Dissociative disorders are more common in females than males. It always occurs in the background of increased stressful life events and in the presence of significant psychosocial stressors. Future studies should be undertaken in a large sample with a prospective design to examine the impact of disease duration and other mediators, such as family type and coping style.

ROLE OF CT PULMONARY ANGIOGRAPHY IN EVALUATION OF PULMONARY THROMBOEMBOLISM IN COVID-19 POSITIVE PATIENTS

Introduction- COVID-19 disease has been strongly associated with a pro thrombotic state and vascular endothelial damage resulting into wide range of thromboembolic phenomena including deep venous thrombosis involving extremeties, pulmonary artery thrombo-embolism and eventually pulmonary infarctions. Computed tomography pulmonary angiography (CTPA) was used at our hospital for assessment of patients with risk of pulmonary embolism. It plays a vital role in its establishing its diagnosis, defining its extent, stage and thereby guiding towards further management. Materials and Methods- A Retrospective study was performed in Sri Aurobindo Medical College and Post graduate Institute, Indore, Madhya Pradesh, India and was approved by the ethical committee. It was performed on 250 COVID-19 patients with clinically suspected pulmonary thromboembolism who underwent CTPA between the months of December 2021 and May 2021. The scans were analysed by skilled radiologists, having good experience in the field of CT reporting. Results- Our study demonstrated that approx. 14% of the patients had pulmonary thromboembolism and these cases were observed in patients with moderate to severe lung involvement. ConclusionIn this study, we have thoroughly tried to assess the presence of pulmonary thromboembolism using CTPA and establish its relationship with severity of lung involvement on HRCT

RISK ASSESSMENT OF DIABETES USING INDIAN DIABETES RISK SCORE IN NON DIABETIC INDIVIDUALS

Background and Objectives: Diabetes has emerged as a major health challenge in India due to a rapid rise in the number of diabetes cases. Early identification of high risk individuals through screening and early interventions in the form of lifestyle modifications and treatment would help in the prevention of diabetes and its complications. This study was done to assess the risk of type 2 diabetes mellitus (T2DM) in an urban slum population using the Indian Diabetes Risk Score (IDRS) and to determine the factors associated with high risk score. Methods: A cross-sectional study was conducted among Department of Gen. Medicine Sri Aurobindo Medical College and Post Graduate Institute, Indore (18 Months). With the institutional ethical committees permission. A total of 100 study participants were selected randomly. A pre-designed and pre-tested structured questionnaire was used for data collection. Assessment of risk of T2DM was done using the IDRS. Results: Of the 100 study participants, 74% were at high risk (IDRS ≥60) followed by 24% at moderate risk (IDRS 30-50) and 2% at low risk (IDRS <30). 45 individuals in the age group ≥50 yr were at high risk compared to 25 in 35-49 yr age group. Most (n=25, 87.5%) of sedentary workers were at high risk compared to those employed in moderate (n=38, 75.4%) and strenuous work (n=10, 51.9%). Interpretation & Conclusions: 74.3 percent of study participants were high-risk for T2DM. High-risk IDRS scores were associated with age, occupation, abdominal obesity, general obesity, and high blood pressure.

Characteristics of Deep Vein Thrombosis on Ultrasound in Mechanically Ventilated SARS-Cov-2 Patients

Aim: To evaluate the prevalence of asymptomatic DVT and its characteristics on venous doppler and grey scale ultrasound in lower limbs in mechanically ventilated SARS-Cov-2 Patients with high levels of D-dimer. Methods: This cross-sectional observational study was carried out in the Department of Radiodiagnosis Sri Aurobindo Medical College and P.G. Institute, Indore over the period of one year. Doppler ultrasound (DU) was performed on critically ill SARS-COV-2 patients (n =45) with severe respiratory failure, with the diagnosis of severe pneumonia and high levels of D-dimer by bedside US examination was performed with a high-frequency linear transducer on GE-logiq E machine. DU protocol includes grayscale, colour and spectral Doppler evaluation. The examination included the deep venous system of the thigh, calf, and saphenous veins. Result: Out of Forty-five patients [age, mean age 47.1 years; female/male ratio, 0.66; DVT was diagnosed in 24 patients (53.3%), 6 (25%) in proximal venous territory femoral vein, 4 (16.66%) in popliteal veins and 14 (58.33%) in distal venous territory beneath popliteal vein. CFV diameter was increased to a mean of 13.2 mm (10.8-14.6) (normal range, 9.1-12) and PBFV reduced to a mean of 10.8 cm/s (8.1-14.5) (normal range, 21.3-49.2) on doppler in positive DVT patients. Conclusion: We propose that DU allows the detection of DVT in asymptomatic mechanically ventilated SARS-Cov-2 Patients with elevated D-dimer patients. Low resistant venous return evidenced by larger than normal CFV diameters and lower than normal PBFVs may have facilitated proximal DVT occurrence.

Clinicopathological Profile of Patients with Multiple Myeloma: An Ambispective Study

Introduction: Multiple Myeloma (MM) is a clonal expansion of B lineage plasma cells in bone marrow. MM accounts for 10- 15% of haematological malignancies and 1% of all malignant diseases. Though, the aetiology of the disease is largely unknown, various factors have been found to increase the incidence of MM. The present comprehensive research work on MM in the Malwa region of central India is an attempt to establish on clinicodemographic, haematological, biochemical and radiological parameters and finally to stage them according to Durie Salmon Staging (DSS) system. Aim: To study clinicopathological profile of patients with MM. Materials and Methods: The present ambispective study was conducted on total 70 cases of MM reported in the Department of Pathology at Sri Aurobindo Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India, from July 2012 to June 2020. The study design included retrospective studies from July 2012 to December 2018 (six years and five months) and prospective studies from November 2017 to April 2019 (one year and five months). The demographic data of patients’ including history and clinical findings were recorded. Complete Blood Count (CBC) was done in all cases. Biochemical investigations were also done. Urine samples of all patients were screened for the presence of Bence Jones protein. Biochemical parameters and staging of MM patients was done. Statistical analysis prepared in excels spreadsheet and quantitative data were presented as proportions. Results: The study included a total of 70 cases of MM diagnosed on peripheral smear and/or bone marrow examination. The male:female ratio was 2.1:1, with a male preponderance. The results of the present study, reported 48 (68.57%) patients were male and 22 (31.43%) patients were females. In the present investigation, the authors diagnosed serum Lactate Dehydrogenase (LDH) levels were estimated in 63, out of 70 patients. Out of which, 25 (39.69%) patients had levels <240 U/L, while 23 (33%) and 17 (23.81%) patients had levels between 241-480 U/L and >480 U/L, respectively. Conclusion: The present study, underlines the association between clinical presentation, laboratory parameters and radiological findings in establishing the diagnosis of MM. The present study emphasises not only the role of a bone marrow aspiration and biopsy in establishing a diagnosis of MM, but also, assessing the plasma cell burden in the marrow.

Genotype Study of Filaggrin Gene Loss-of-Function Mutations in Central India Population with Atopic Dermatitis and Ichthyosis Vulgaris.

A genotype study of filaggrin gene loss-of-function mutations in central India can provide valuable insights into the prevalence and association of these mutations with atopic dermatitis (AD) and ichthyosis vulgaris (IV) in the region. The FLG R501X and 2282del4 are both genetic variants in the human gene called filaggrin gene (FLG), which encodes a protein that plays an important role in the formation and maintenance of the skin barrier. In this study, we determined the FLG R501X and 2282del4 variants association with both AD and IV in Central Indian populations. This case-control study was conducted in the Departments of Dermatology and Molecular and Virology Research and Diagnostic Laboratory at Sri Aurobindo Medical College and Post Graduate Institute, Indore (Madhya Pradesh). The study was approved by the Clinical Research and Ethics Committee. A total of 180 patients aged between 3 months - 60 years who attended the skin outpatient department between March-2021 to June-2022 were recruited in this study. Among them, 60 patients were in AD-group, 60 patients in IV-group, and 60 patients were in the healthy control group. Polymerase chain reaction followed by restriction fragment length polymorphism (PCR-RFLP) was used in genotyping for FLG mutations (R501X and 2282del4). The most common FLG mutations were R501X (31.6% and 23.3%) and 2282del4 (18.3% and 13.3%) in AD and IV patients with heterozygous (AT) genotype, respectively. The combined mutation (FLG R501X and 2282del4) association was 10% and 5% in the AD and IV groups with heterozygous (AT) genotype, respectively, and in all the patients of control group with wild genotype (AA). There were no significant (P = 0.09) associations found with 2282del14 genotype. The R501X mutation in the gene encoding filaggrin is one of the robust genetic associations of AD and IV. The 2282del4 polymorphism was marginally less as compared to R501X.

Incidence and outcome of benign bone tumor experience from tertiary care institute in central India

Purpose: Nonmalignant bone tumors represent a wide variety of different entities but maintain many common features. They usually affect young patients, and most can be diagnosed through imaging exams. Often asymptomatic, they can be discovered incidentally. Due to their similarities, these tumors may be challenging to diagnose and differentiate between each other, thus the need for a complete and clear description of their main characteristics. The advances in in clinical and careful treatment modalities have brought about a major change in the prognosis of such benign harmful bone growths. The aim of this review is to give a picture of the benign bone tumors that clinicians can encounter more frequently in their everyday work and the management for the same.Method: The study is Observational done in Sri Aurobindo Medical College and PG Institute, Indore using REST score to differentiate between benign and malignant tumours on radiograph.Result: The Radiological Assessment Score for Bone Cancers (REST) is an organized revealing and objective technique for the evaluation of radiographs in patients with suspected bone growths. This strategy is a solid and accommodating instrument for clinicians in their outside understanding division to separate a radiograph of a speculated harmless growth from a dangerous bone cancer.Implications: The study will prove useful to clinicians in their outpatient facility where using REST they will be able to differentiate between a speculated harmless growth from a malignant lesion.

LUNG CAVITATION: AN UNWANTED COMPLICATION OF COVID-19 LUNG DISEASE

Aim & objective: To assess the incidence of pulmonary cavitatory lesion in patients with COVID-19 and describe its characteristics and evolution. The present descriptive observational study Methodology: was conducted on 1105 RT-PCR Conrmed cases of SARS-COV-19 in Sri AUROBINDO MEDICAL COLLEGE AND PG INSTITUTE, INDORE, Madhya Pradesh january 2021 to june 2021. This study highlights t Conclusion: hat lung cavitatory lesion in patients with severe COVID-19 lung disease can occur, is associated with secondary complications of hemoptysis, pneumothorax, and confers a poor prognosis. Early cross sectional imaging should be considered if there is suspicion of cavitatory lesion on plain radiographs, and a more aggressive investigation and treatment of possible invasive fungal infection undertaken. Further studies are needed to determine whether treatment with tocilizumab, systemic glucocorticoids or a combination of both may increase the risk of developing lung cavitatory lesion in patients with COVID-19.

Morphological Study of Foetal Thymus: A Cross-sectional Study

Introduction: Thymus is a primary central lymphoid organ and a key regulator of the immune system. It develops from the ventral aspect of the 3rd pharyngeal pouch and also gets contribution from the 4th pharyngeal pouch. It migrates caudally into thorax due to its attachment to the pericardium and the aortic sac. Aim: To determine the morphometry of thymus gland in human foetuses. Materials and Methods: It was a cross-sectional study which included 33 human foetuses available in the Department of Anatomy, Sri Aurobindo Medical College and Postgraduate Institute (SAMC and PGI), Indore, Madhya Pradesh, India, over a period of three years. The samples were divided into four groups as per the Gestational Age (GA), (13-16, 17-20, 21-24, 25-29 weeks), based on measuring the Crown Rump (CR) length. After making a midline incision extending from the neck to the chest wall, the thoracic and cervical part of the thymus were displayed and its height and width were measured. For statistical analysis Statistical Package for the Social Sciences (SPSS), version 20.0 was used to analyse the association between the present findings in the given study groups. Results: Cervical extension showed great variability in different groups. It was either bilateral (16), unilateral (9) or even absent (8) in some cases. Cervical extension showed variable appearances like, coiled, lobulated or cord-like. In four cases, it reached upto the lower pole of thyroid. The shape of the thoracic part of the thymus was either vertically elongated or curved, lobulated or retort shape. Conclusion: The present findings of morphometry of foetal thymus are important for radiologists to differentiate thymus from other mediastinal structures and for surgeons during thymectomy. With increasing foetal age, there is regression in the cervical part of the thymus.

The study of clinical profile of acute kidney injury in COVID-19 patients

Aim:All prior studies have demonstrated that acute renal damage in People who have the coronavirus disease of2019 (COVID-19) are often diagnosed and have a dismal prognosis. Acute renal injury in COVID-19 patients hasnot been well reported in developing countries like India. Examining the clinical traits, biochemistry, and prognosisof acute kidney injury (AKI) in COVID-19 patients is the aim of this article. Methods:The Department of Nephrology at the Sri Aurobindo Medical College and Graduate Institute (M.P.) inIndore, India, conducted this study from April 1, 2020, to January 31, 2021. We examined 130 COVID-19 casesof AKI recorded by SAMC and PGI in Indore. Included 18 year-old and older COVID-19 patients verified by real-time reverse polymerase chain reaction (RT-PCR). The term “sepsis” was employed in its conventional sense. TheKidney Disease Improving Global Outcomes (KDIGO) guidelines of AKI were adhered to. Patients under the age of18 undergoing renal replacement therapy for CKD in stages I to IV and ESRD were not eligible. Results:A total of 12,438 COVID patients were admitted to our hospital during this period. The incidence ofAKI was 1.04% (130). The mean age was 51.2 years. The male-to-female ratio was 1.4:1 (76:54). Commonestsymptoms were fever in 71.5% (93) of patients, headache in 62% (81) of patients, and cough in 51.5% (67) ofpatients, followed by breathlessness in 37.5% (49) patients. The typical creatinine values at the time of admissionwere 3.57 mg/dl. AKI stage 1 was seen in 30% (39) cases, stage 2 in 45.5% (59) cases, and stage 3 in 24.5%(32) cases. The most common etiology was sepsis in 65% (84) and drugs in 14% (18). T2DM was the mostcommon comorbidity in 42% (55) of patients, HTN in 41.5% (54) of patients, Coronary Artery Disease (CAD) in9.2% (12) of patients, and malignancy in 5% (7) of patients. Oxygen by nasal mask/nasal prongs was requiredin 59% (77) of patients, BIPAP in 16% (21) of patients, and ventilatory support in 12.5% (16) of patients. Theaverage hospitalization was 12.3 days. Dialysis was required in 16% (21) of patients. Notably, 87% (113) of patientsrecovered completely, and 13% (17) of patients expired. The majority of patients had elevated inflammatorymarkers. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were elevated in 81% (105) of patients,and ferritin was raised in 71% (92) of patients. Conclusion:Hospitalized COVID-19 patients commonly get AKI, which is associated with a poor prognosis andhigh mortality. In COVID-19 patients, increased inflammatory markers, type 2 diabetes, sepsis, older age, and malesex were the main risk factors for developing acute renal injury.

The Study of Clinical Profile of Acute Kidney Injury in COVID-19 Patients

All prior studies have demonstrated that acute renal damage in People who have the coronavirus disease of 2019(COVID-19)areoftendiagnosedandhaveadismalprognosis.AcuterenalinjuryinCOVID-19patientshasnot been well reported in developing countries like India. Examining the clinical traits, biochemistry, and prognosis of acute kidney injury (AKI) in COVID-19 patients is the aim of this article. Methods: The Department of Nephrology at the Sri Aurobindo Medical College and Graduate Institute (M.P.) in Indore, India, conducted this study from April 1, 2020, to January 31, 2021. We examined 130 COVID-19 cases of AKI recorded by SAMC & PGI in Indore. Included 18-year-old and older COVID-19 patients verified by real-time reversepolymerasechainreaction(RT-PCR).Theterm“sepsis”wasemployedinitsconventionalsense.TheKidney Disease Improving Global Outcomes (KDIGO) guidelines of AKI were adhered to. Patients under the age of 18 undergoing renal replacement therapy for CKD in stages I to IV and ESRD were not eligible. Results: A total of 12,438 COVID patients were admitted to our hospital during this period. The incidence of AKI was 1.04% (130). The mean age was 51.2 years. The male-to-female ratio was 1.4:1 (76:54). Commonest symptoms were fever in 71.5% (93) of patients, headache in 62% (81) of patients, and cough in 51.5% (67) of patients, followed bybreathlessnessin37.5%(49)patients.Thetypicalcreatininevaluesatthetimeofadmissionwerewere3.57mg/dl. AKIstage1wasseenin30%(39)cases,stage2in45.5%(59)cases,andstage3in24.5%(32)cases.Themostcommon aetiology was sepsis in 65% (84) and drugs in 14% (18). T2DM was the most common comorbidity in 42% (55) of patients, HTN in 41.5% (54) of patients, Coronary Artery Disease (CAD) in 9.2% (12) of patients, and malignancy in 5% (7) of patients. Oxygen by nasal mask/nasal prongs was required in 59% (77) of patients, BIPAP in 16% (21) of patients, and ventilatory support in 12.5% (16) of patients. The average hospitalization was 12.3 days. Dialysis was required in 16% (21) of patients. Notably, 87% (113) of patients recovered completely, and 13% (17) of patients expired. The majority of patients had elevated inflammatory markers. Erythrocyte sedimentation rate (ESR) and Creactive protein (CRP) were elevated in 81% (105) of patients, and ferritin was raised in 71% (92) of patients. Conclusion: Hospitalized COVID-19 patients commonly get AKI, which is associated with a poor prognosis and high mortality. In COVID-19 patients, increased inflammatory markers, type 2 diabetes, sepsis, older age, and male sex were the main risk factors for developing acute renal injury.