Sri Devaraj Research Articles

Quantification of Microsomal Triglyceride Transfer Protein in Non Alcoholic Fatty Liver Disease Patients: A Cross-sectional Study

Introduction: Non Alcoholic Fatty Liver Disease (NAFLD) is one of the common liver disease characterised by fat accumulation in hepatocytes. NAFLD is a broad spectrum of simple steatosis, Non Alcoholic Steatohepatitis (NASH), cirrhosis and hepatocellular carcinoma. Triglycerides (TG) are exported in the form of Very Low Density Lipoprotein (VLDL). VLDL are formed by incorporation of TG into apo-B by Microsomal Triglyceride transfer Protein (MTP). Therefore, MTP is a key protein for lipid transport. Estimation of MTP protein levels and its correlation with simple steatosis and steatohepatitis can be helpful in understanding its role in NAFLD progression. Aim: To estimate the serum levels of MTP in simple steatosis and steatohepatitis and also to check its correlation with TG and VLDL in NAFLD patients with and without co-morbidities. Materials and Methods: The present cross-sectional study was carried out in Department of Cell Biology and Molecular Genetics, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India, between November 2019 to January 2021. Study participants included 60 NAFLD subjects which were divided into simple steatosis (group 1, n=10) and steatohepatitis (group 2, n=50). These subjects were further subdivided into cases with co-morbidities and cases without co-morbidities. Serum levels of MTP, high sensitivity C Reactive Protein (hsCRP), Fasting Blood Sugar (FBS), liver enzymes, lipid profile were assessed. Statistical analysis was done by using unpaired Student’s t-test and Pearson’s correlation. Results: The mean age was 46.5 years in steatosis group and 48.85 years in steatohepatitis group. In steatosis group, there were 5 (50%) males and 5 (50%) females, whereas in steatohepatitis group 32 (64%) were females and 18 (36%) were males. The serum levels of MTP were significantly decreased in simple steatosis cases with co-morbidities as compared to cases without co-morbidities (p=0.006). A significant negative correlation was observed between MTP v/s TG and MTP v/s VLDL (r=-0.665, p=0.036) in simple steatosis cases with and without co-morbidities. Same trend was observed in steatohepatitis cases but the correlation was insignificant (r=-0.08, p=0.563). Conclusion: The serum levels of MTP decreases as the NAFLD progresses. A significant decrease in serum levels of MTP was also observed in cases with co-morbidities as compared to cases without co-morbidities. Serum levels of MTP showed negative correlation with TG and VLDL in simple steatosis cases.

Neurobehavioural and Neurochemical Changes in Arsenic Induced Cerebellar Toxicity in Male Sprague-Dawley Rats: An Experimental Study

Introduction: Sodium arsenite, an inorganic arsenic, is naturally present at high level (>50 μg/L) in ground water. Drinking ground water is the biggest threat to public health. Though, there are numerous reports on arsenic neurotoxicity, the arsenic effect on cerebellar neurotoxicity remains vague especially its chronic effect on its neurobehavioural and neurochemical alterations. Aim: To evaluate the neurobehavioural and neurochemical alterations caused by sodium arsenite in cerebellum of rats. Materials and Methods: This experimental study was conducted in the Central Animal House at Sri Devaraj Urs Academy of Higher Education and Research (SDUAHER) from November 2019 to February 2020 for a period of 90 days. Total 16 male spraguedawley rats were randomised into two equal groups. Group I: Control, received normal saline. Group II: Sodium arsenite, Doses of 50 Parts per Millions (PPM) for 90 days through oral gavage. Rats were subjected to Open Field Test (OFT) for locomotor and exploratory behaviour and Beam Walking Test (BWT) for motor coordination and balance. Following behavioural tests, rats were anaesthetised. Blood was drawn from a retro-orbital puncture. Brains were dissected and cerebellum was separated. Concentration of Malondialdehyde (MDA), Nitric Oxide (NO) and activity of Glutathione Peroxidase (GPx) were assessed spectrophotometrically in serum and cerebellum of rats. Mean±SD was used for normally distributed data and groups were compared using independent t-test, whereas for non normally distributed data, Median (25th-75th Percentile) was used and Mann-Whitney U-test was used to compare between two groups. Results: Arsenic-treated rats showed a significant increase in arsenic concentration in serum and cerebellum (5.5±1.6 ng/mL, 2.76±0.56 µg/g, respectively) compared to control (1.14±0.43 ng/mL, 0.65±0.29 µg/g, respectively). There was a significant decrease in locomotor and exploratory behaviour and impairment in motor coordination and balance in arsenic treated rats with a p-value <0.001 in comparison with control rats. The arsenic treated rats had significantly enhanced concentration of MDA and NO level and reduced activity of GPx in serum {16.84 (13.84-18.87), 33.79 (30.05-37.17) nmol/mL, and 6.89 (5.24- 8.5) mmoles of Reduced glutathione (GSH) oxidised/min/mL, respectively} compared to control {8.81 (8.36-9.48), 17.66 (15.33-21.29) nmol/mL, and 15.16 (12.77-16.59) mmoles of GSH oxidised/min/mL, respectively} and also found increased concentration of MDA and NO level and reduced activity of GPx in tissue {7.98 (7.14-8.92), 24.67 (21.4-28-22) nmol/mg of protein and 2.66 (1.19-3.86) mmoles of GSH oxidised/min/ mg protein, respectively} compared to control {3.02 (2.35-3.61), 13.93 (11.0-16.16) nmol/mg of protein and 7.63 (7.08-9.19) mmoles of GSH oxidised/min/mg protein, respectively}. Conclusion: The oral administration of sodium arsenite at the doses of 50 PPM for 90 days showed interesting alterations in neurobehavioural and neurochemical parameters related to cerebellum of rats.

Evaluation of CD9 Expression of Tumour Cells and Stromal Immune Cells in Breast Carcinoma by Immunohistochemistry

Introduction: Cluster of Differentiation 9 (CD9), known as Motility Related Protein (MRP-1) regulates cell adhesion, motility, migration and proliferation. Many studies have stated conflicting results on prognostic significance of invasive breast carcinomas with CD9 expression that had performed on tumour tissues. Aim: To assess the inter-relationship of CD9 expression of tumour cells and stromal immune cells in breast carcinoma with clinicopathological parameters which include age, tumour size, grade, histological type, lymph nodes, tumour staging and molecular classification. Materials and Methods: An observational prospective (2020 July to 2021 June) and retrospective (2019 October to 2020 June) study was done in 71 cases of resected primary invasive breast carcinoma over a period of one and half year at Sri Devaraj Urs Medical College, Karnataka, India. Immunohistochemistry (IHC) staining was done using CD9 antibody. Tumour cells (T-CD9) expression was evaluated by Immunoreactivity scoring (IS= Intensity score × Extent of staining). The stromal cells (S-CD9) expression was evaluated by Percentage (%) of stromal area occupied by CD9 stained immune cells. Chi-square test was used as test of significance for qualitative data. The p-value of <0.05 was considered as statistically significant. Results: Out of 71 cases, T-CD9 expression was noticed in 40 cases (56.34%) and IS <4 considered as negative was observed in 31 cases (43.66%). However there was no association with age, tumour size, grade and molecular markers for the expression of both T-CD9 and S-CD9. Human Epidermal growth factor receptor 2 neu (HER2neu) negative was associated with T-CD9 expression (p-value=0.05). Hence CD9 can be used as prognostic marker for Her2neu negative cases. Conclusion: CD9 expression was not significantly associated with tumour cells (T-CD9) and stromal cells (S-CD9) in breast carcinoma cases. However it was significantly associated with Her2neu negative tumour cells. T-CD9 showed more positivity in Luminal A followed by Triple negative whereas S-CD9 showed more positivity in Luminal B. CD9 did not show association with any parameters except Her2neu negative.

Midline Shift and Haematoma Thickness as a Prognostic Factor of Mortality in Patients with Acute Subdural Haematoma

Introduction: Acute Subdural Haematoma (ASDH) is a type of intracranial haematoma, which has the highest mortality rate. The ASDH generally presents as a secondary consequence of Traumatic Brain Injury (TBI) and can be classified as traumatic or non traumatic and acute or chronic. Aim: To assess the Midline Shift (MLS) and Subdural Haematoma (SDH) thickness as a prognostic factor of mortality on initial cranial Computed Tomography (CT) scan of patients with ASDH. Materials and Methods: This cross-sectional study analysed the computed CT of 61 patients who were admitted due to traumatic SDH in Sri Devaraj Urs Medical College, Kolar, Karnataka, India. Thickness of MLS (mm) and SDH (mm) were estimated from the CT scan (SIEMENS SOMATOM Emotion 16 Slice) of patients admitted during the study period from June to August 2021. The thickness of the SDH and MLS were compared separately with the survival status. The Area Under the Curve (AUC) was estimated from the Receiver Operating Characteristic (ROC) curve. The sensitivity, specificity, predictive values and diagnostic accuracy of the screening test along with their 95% Confidence Interval (CI) were presented. The p-value <0.05 was considered statistically significant. Results: The predictive validity of MLS (mm) was excellent (AUC=0.936) and that of SDH thickness (mm) was fair (AUC=0.799) in predicting survival. The cut-off value derived from the ROC curve for MLS was 3.95 mm and for SDH thickness was 3.35 mm; above which the number of people died was more and was statistically significant (p<0.001). The sensitivity and specificity of the MLS in predicting the survival was 90.32% and 90.00%, respectively and sensitivity and specificity of the SDH thickness was 74.19% and 76.67%, respectively. Conclusion: The sensitivity and specificity of MLS was found to be superior when compared to the SDH thickness. The cut- off value derived from ROC curve for MLS was 3.95 mm and for SDH was 3.35 mm, above which the chance of survival was poor.

Knowledge and Attitude towards Vitiligo and Psoriasis in the Undergraduate Medical Students: A Cross-sectional Observational Study

Introduction: Understanding the perspective on vitiligo and psoriasis of undergraduate medical students enables us to focus on lacunae areas in their knowledge, and train them to disseminate accurate information to the public. A positive attitude towards vitiligo and psoriasis in society will reduce the psychosocial burden on the patients and deliver better clinical outcomes. Aim: To assess medical student’s knowledge and attitudes towards vitiligo and psoriasis. Materials and Methods: This cross-sectional, questionnairebased, observational study was conducted on 351 undergraduate medical students (third semester onwards) at Sri Devaraj Urs Medical College, Kolar, Karnataka, India, from January 2021 to March 2021. Questionnaire consisted of 28 questions about knowledge and 18 about attitude towards vitiligo and psoriasis, presented through Google docs to the medical students. A score of 75% was considered as having ‘good knowledge’ and ‘positive attitude.’ Fischer’s-exact test was used as a test of significance for qualitative data. Analysis of Variance (ANOVA) was used as a test of significance to identify the mean difference between more than two quantitative variables. The p-value <0.05 was considered as statistically significant. Results: The study included 351 participants, of which 171 (48.7%) were females and 180 (51.3%) were males. There were 89 (25.4%), 133 (37.9%), and 129 (36.8%) respondents from the second, third, and fourth years, respectively. Good knowledge was observed in 80.9% and 71.5%, and 87.7% and 72.4% had positive attitudes towards vitiligo and psoriasis, respectively. A statistically significant difference (p-value=0.002) was found in attitude between vitiligo and the year of MBBS. A statistically significant difference (p-value=0.004) was found in knowledge between psoriasis and the year of MBBS. Overall, 55.84% thought that psoriasis only concerns the skin. Good knowledge was directly proportional to a positive attitude. Conclusion: The majority of the undergraduate medical students had ‘good knowledge’ and ‘positive attitude’ towards vitiligo and psoriasis. Good knowledge was highly proportional to a positive attitude. Unfortunately, a considerably high number of participants reported that they would not marry a person with vitiligo or psoriasis.

Neutrophil-lymphocyte Count Ratio as Section an Indicator of Culture Positive versus Culture Negative Sepsis: A Singlecentre Cross-sectional Study

Introduction: In sepsis patients, the Neutrophil-lymphocyte Count Ratio (NLCR) is a laboratory statistic that can indicate bacterial infection. Aim: To measure NLCR in patients with sepsis and compare the NLCR in patient with culture positive and culture negative sepsis. Materials and Methods: This single-centre, cross-sectional study was conducted in the Department of General Medicine at R.L. Jalappa Hospital (Sri Devaraj URS Medical College), Kolar, Karnataka, India, from October 2021 to December 2021. A total of 120 patients above 18 years of age with sepsis, diagnosed as per the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3), were included in the study. Participants were evaluated for sepsis and septic shock (society of critical care medicine conference definitions) the principles of initial resuscitation (fluid therapy, vasopressors, inotropic support), and infection issues (source identification and control, appropriate antibiotic therapy) were followed regularly and the outcome studied. Neutrophil count, lymphocyte count, and calculation of NLCR were done at the time of admission. The correlation studies of NLCR in culture-positive and culturenegative was done and compared. Data was analysed by using coGuide software (version 1.03). Results: The mean age of patients was 58.98±17.78 years, ranged from 20 to 96 years, 47 (39.17%) were male and 73 (60.83%) were female, majority 93 (77.50%) out of 120 patients had fever. Majority 78 (65%) had type 2 diabetes mellitus. Neutrophilto-Lymphocyte ratio (NLR) was 10±1.67, ranging from 7.40 to 14.50. The area under the ROC curve was 0.522. There was no statistically significant relationship between the NLCR and culture report (p-value=0.216). The NLCR had poor predictive validity in predicting culture positive, as indicated by the area under the curve {0.522 (95% CI: 0.417 to 0.626, p-value= 0.988)}. Conclusion: NLCR can be considered as predictor for the initiation of treatment of patients with sepsis.

Effect of Interleukin 28B SNP rs12979860 Genotype on Viral Load in Hepatitis C Virus in Kolar Population, Karnataka, India

Introduction: The natural course of Hepatitis C Virus (HCV) infection is influenced by a number of host and viral variables. Interleukin 28B (IL28B) is a kind of interleukin. A Single Nucleotide Polymorphism (SNP) designated as rs12979860 was reported to predict viral clearance with and without treatment. Subjects with the GG (favourable) IL28B rs12979860 genotype were more likely to clear the infection spontaneously and respond well to therapy. These findings imply that people who have the “favourable” GG genotype have a lower viral burden than those who have the “unfavourable” AA genotype. Aim: To determine the effect of IL28B SNP rs12979860 genotype on HCV viral load in Kolar population, Karnataka, India. Materials and Methods: The present study was a case-control study which was carried out in Department of Microbiology, Sri Devaraj Urs Medical College, Kolar, Karnataka, India. Subjects were enrolled from Department of Medicine of R. L. Jalapa Hospital and Research centre, teaching hospital of Sri Devaraj Urs Medical College between November 2020 to March 2021. A total of 248 were taken of which 124 were HCV antibody-positive and 124 were controls. The effect of IL28B rs12979860 SNP on HCV viral load and clearance among HCV-infected patients were examined. Detection and quantification of HCV-RNA was determined by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). IL28B rs12979860 genotyping was performed using PCR and Restriction Fragment Length Polymorphism (RFLP) technique and specific primers. Statistical analysis was done by using open epi tool. The frequency, percentage and Chi-square test were used to analyse categorical variable. A p-value <0.05 was considered as significant. Results: In this study the frequency of G/G genotype was considerably high 83 (67%) compared to G/A 17 (13.7%) and A/A 24 (19.3%) and in group 2 the frequency of G/G genotype 84 (67.7%), G/A genotype 34 (27.4%) and A/A genotype 6 (4.9%). There was a statistically significant difference in both the HCV infected and healthy controls groups (p=0.002). The average (±SEM) HCV viral load was 4.6±3.6×107 , 9.4±7.7×107 and 5.5±5.2×107 IU/mL in patients with the IL28B rs12979860 GG, GA and AA respectively. Also there was a significance between the viral load and IL28B rs 12979860 (p-value <0.05). Conclusion: Thus, present study results indicate that the IL28B rs12979860 genotype has an effect on viral load in untreated HCV patients. These findings highlight the importance of viralhost interactions in influencing the outcome of HCV infection.

Nutrient Composition and Radical Scavenging Activities of Watermelon Seed-based Nutribar

Aims: The present study is aimed to develop watermelon seed nutribars (WMSNB) and to determine proximate content, antioxidant activity, free fatty composition and also sensory evaluation in order to create awareness of its potential nutritional values and increase its consumption in the form of nutraceuticals, functional foods and pharmaceuticals.
 Study Design: Proximate analysis, total phenolic, antioxidant activity and free fatty acid profile was carried by using well established in-vitro assay.
 Place and Duration of the Study: Department of Clinical Nutrition and Dietetics, Sri Devaraj Urs Academy of Higher Education and Research. Kolar, between June 2021 and November 2021
 Methodology: The developed nutribars samples were evaluated for proximate analysis (moisture, crude protein, ash, total fat, crude fibre, and total carbohydrate), total phenolic, antioxidant activity by using DPPH assay, free fatty composition by using GC-MS, and sensory characteristics based on hedonic scale point. The ingredients used for preparation of WMSNB were Watermelon seeds (100gm), jaggery (50gm), coconut flakes (15gm), sesame seeds (10gm) and ghee (5gm). Peanut nutribars (PNB) were also developed by replacing Watermelon seeds (WMS) with peanuts which was used for comparison purpose.
 Results: The proximate screening indicated that protein (15.72%) and carbohydrate content (52.49%) was high in WMSNB compared to PNB. The prepared WMSNB showed rich in phenolics and also possessed good antioxidant activity against DPPH. The free fatty acid composition showed that linolenic acid, stearic acid and lauric acid of oil extracted from WMSNB were 51.15%, 10.65% and 6.49% respectively, while oleic and palmitic acid extracted from PNB were 38.11% and 14.62% respectively. The overall sensory evaluation showed that there was no significant difference (P<0.05) between WMSNB and PNB.
 Conclusion: The antioxidant capacity of the WMSNB constituent underlines the potential source of natural antioxidants and bioactive compounds for the therapeutic purposes.

A STUDY OF CORRELATION OF PRAGMATIC RISK SCORE WITH MORTALITY IN PATIENTS ADMITTED TO RLJH AND RC ICU WITH CORONAVIRUS DISEASE 2019 (COVID-19)

Background : In many people the disease is mild and self-limiting, but in a considerable portion of patients the disease is severe and fatal. Determining which patients are at high risk of severe illness or mortality is an essential part of understanding this illness Aims and Objective : Study of correlation of prognostic risk score with mortality in patients admitted to RLJH and RC ICU with coronavirus disease 2019 (COVID-19) . Methodology : This was a Retrospective observational study in the patients tested RT-PCR positive for COVID 19 and admitted at SRI DEVARAJ URS MEDICAL COLLEGE Tamaka, Kolar during the two month duration i.e. June 2021 to July 2021 in the 50 patients .The statistical analysis was done by Graph pad prism 6 version from that we have calculated correlation co-efcient and Survival graph Result : In our study we have seen that The majority of the patients were in the age group of 61-70 were 28% , followed by 51-60 were 24%, 71-80 were 22%, 41-50 were 14% , 30-40 & >80 were 6%. The majority of the patients were Male i.e. 68% and Female were 32%. There was strong correlation between Prognostic score and mortality of the patients which was statistically highly signicant i.e. Spearman r= 0.8450, P value (two-tailed) was < 0.0001*** . survival rate for the Score 0, 2 was almost 100% and as the score increases i.e. 3,4,5,6 there survival percentage also decrease approximately to 25 %, 5% and 0%,0% respectively. Conclusion :It can be concluded from our study that there was signicantly higher coreltaion between the Prognostic score and mortality of the patients hence this score could be reliable tool for the assessment of the severe patients and prompt and aggressive treatment for the better outcome

THE ROLE OF TRIGLYCERIDE GLUCOSE INDEX AS PREDICTOR OF GLYCEMIC CONTROL IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Objectives- To explore the association of Triglyceride Glucose index with HbA c and To evaluate their 1 potential role as predictors of glycemic control in patients with type 2 diabetes mellitus. Design: observational study Setting: Conducted in the Department of General Medicine at Sri Devaraj Urs medical college, Kolar, Karnataka. Subjects: 98 diabetic subjects were studied and were evaluated for predicting glycemic control using triglyceride glucose index. Results: Among subjects with good glycaemic control (HbA1c <7%) mean Triglyceride was 136 + 21.78 mg/dl and Among subjects with poor glycaemic control (HbA1c >7%) mean Triglyceride was 190.35 + 62.94 mg/dl. there was a statistically signicant difference found between Triglyceride and HbA1c. Among subjects with good glycaemic control (HbA1c <7%) mean Triglyceride glucose index was 9275.06 + 2154.22 mg/dl and Among subjects with poor glycaemic control (HbA1c >7%) mean Triglyceride glucose index was 24223.63+ 15794.73mg/dl. there was a statistically signicant difference found between Triglyceride glucose index and HbA1c Conclusion: We can use Triglyceride glucose index in predicting glycaemic control in type 2 DM which is inexpensive and cost effective.

Maternal serum Apelin 13 and APLN gene promoter variant -1860T > C in preeclampsia

Objective To evaluate the apelin (APLN) −1860 T > C (rs56204867) polymorphism and maternal serum apelin 13 levels in preeclampsia and its association with blood pressure. Methods This case-control study was conducted in department of Biochemistry, Sri Devaraj Urs Medical College, Karnataka, India. A total of 181 subjects were enrolled in the study from department of Department of Obstetrics and Gynecology. The recruited women were grouped as: Group–I (n = 91) cases with preeclampsia and Group–II (n = 90) normotensive healthy pregnant women as controls. Under aseptic conditions, the collected 5 mL blood was distributed for serum separation (3 mL) and genetic analysis (2 mL). Serum was stored at −80 °C after centrifugation at 3000 rpm for 10 min. The collected five mL urine sample was used for urinary protein analysis by dipstick method. The APLN gene −1860 T > C polymorphism and Apelin 13 levels were analyzed by molecular methods and ELISA technique respectively. Birth weight and demographic details were recorded. Results In the present study, no significant difference was observed for mean gestational age and maternal age. Systolic (158.7 ± 14.0 mmHg) and diastolic (104.9 ± 10.7 mmHg) blood pressure, and mean arterial pressure (MAP) (123.0 ± 11.1 mmHg) (p-value .001) were significantly increased in preeclamptic women compared with healthy pregnant women. Birth weight (2.4 ± 0.5 kg) (p-value .001) was significantly decreased in babies born to preeclamptic mothers. Birth weights were also expressed in centiles, according to Fenton Chart. Number of small for gestational age (SGA) babies were more in preeclampsia (n = 55) than healthy pregnant women (n = 28). Mean maternal serum apelin 13 (239.4 ± 126.3 pg/mL) (p-value .001) concentrations were significantly lower in preeclampsia compared with healthy controls. Maternal serum apelin 13 concentration in preeclampsia was negatively correlated with systolic blood pressure (r = −0.235), diastolic blood pressure (r= −0.172) and mean arterial pressure (r = –0. 206). However, maternal serum apelin 13 levels showed insignificant positive correlation with age, gestational age and birth weight. The genotype and allele frequencies of APLN gene were found significant between study groups as in preeclampsia (χ2 = 11.69; df = 2; p = .0028 and χ2 = 14.27; df = 1; p = .00013 respectively). CC genotype and C allele of APLN − 1860 T > C site was high in preeclampsia. Conclusion Study concludes that preeclamptic women have low level of serum apelin 13 and −1860 T > C polymorphism at APLN gene promoter site with increased allelic frequency of CC genotype and C allele compared to normotensive pregnant women. And this evidence may link to cardiac complications in preeclamptic women after delivery in later stage.

Evaluation of olfactory fossa depth using computed tomography in South Indian population: A retrospective study

Context: Anatomical variations are very important in planning a paranasal sinus (PNS) surgery. Currently, there are limited data on olfactory depth in the South Indian subpopulation. Aim: The aim of this study was to determine the olfactory fossa (OF) depth using Computed Tomography (CT) in the South Indian population. Settings and Design: This retrospective study was conducted in radiology, Sri Devaraj URS Medical College, Tamaka, Kolar. Materials and Methods: A single radiologist analyzed computed tomography (CT) and medical records of 287 patients from October 2020 to March 2021. OF depth (Keros classification) was considered the primary outcome variable. Statistical Analysis Used: Descriptive analysis was carried out by mean and standard deviation for quantitative variables, frequency, and proportion for categorical variables. P

Utility of island bipaddle pectoralis major myocutaneous flap in reconstruction of full thickness lower gingivo-buccal sulcus defects

<p class="abstract"><strong>Background:</strong> Aims of the study was to evaluate the usefulness of island bipaddle pectoralis major myocutaneous flap in the reconstruction of through and through lateral gingivobuccal sulcus defects.</p><p class="abstract"><strong>Methods:</strong> This was a retrospective study carried out from 2013 - 2019 in the department of otorhinolaryngology and head and surgery at Sri Devaraj Urs Medical College and Hospital. After obtaining institutional ethical committee clearance. Sixty-one patients diagnosed with stage IV a lateral Gingivobuccal squamous cell carcinoma with skin involvement and reconstructed using island bipaddle pectoralis major myocutaneous flap were included in the study. </p><p class="abstract"><strong>Results:</strong> Majority of our patients were females. Nearly 50% of our patients had skin involvement secondary to Level-I nodal metastasis. Nine patients in our study developed complications. Among them seven patients had minor complications and in two patients the flap failed.</p><p class="abstract"><strong>Conclusions:</strong> In resource constraint places where microvascular reconstruction facilities are not available and where replacing bone is not mandatory, island bipaddle pectoralis major myocutaneous flap can be used effectively as single stage reconstruction option for full thickness lower gingivo-buccal sulcus defects.</p>

Outcomes after posterior fixation of iris?claw lens in aphakic eyes

Purpose: To analyze and determine the postoperative visual acuity and complications after intraocular implantation of an iris-claw lens in aphakic patients. Setting: Sri Devaraj Urs Medical College, Kolar, Karnataka, India. Design: Retrospective study. Materials and Methods: Medical records of cataract and aphakic patients who underwent posterior fixation of iris claw lens over a five-year period were reviewed for collection and analysis of data. Results: The study comprised 138 eyes of 57.25% female and 42.75% male with mean age of 62.84 ± 8.649 years. The follow up period was 6 to 24 months. The mean preoperative CDVA was 0.44 + 0.23 logMAR. After 1 year of follow up period the mean postoperative CDVA was 0.3+ 0.15 logMAR which was statistically significant (p Conclusions: This study showed the merits of retrofixated iris claw lens over AC IOL and SF IOL in terms of simple technique, short learning curve, satisfying overall visual outcome, less risk of complications and good safety profile. Keywords: Aphakia, Enclavation, Iris claw, Retrofixation.

Prognostic value of pre-treatment routine hematological parameters in breast carcinoma: Advantageous or deleterious?

Introduction: The most common malignancy which endangers the quality of life in females is breast cancer. It is also the major public problem in society and despite advances in treatment strategies, it still leads to high mortality. In all breast cancer patients, the first assessment done before surgery is the complete blood count (CBC). There exists a strong relationship between immune response of the body and clinical staging of breast cancer. This study aimed to determine the most reliable hematological markers for the prognosis of breast cancer, and to evaluate the correlation between hematological parameters and disease staging.
 Methods: This study was a case control study conducted for a period of 3 years from Jan 2016 to December 2018 in the Department of Pathology (R.L. hospital and Research Center attached to Sri Devaraj Urs medical college, Tamaka, Kolar, Karnataka). The comparison of the hematological parameters was done between the study group (70 cases) and the control group (20 cases). The relation between the hematological parameters and the various stages of breast cancer was analyzed before initiating the treatment.
 Results: The majority of the breast cancer patients were of stage 2. The hemoglobin concentration, red blood cell (RBC) count, lymphocyte count, and were reduced in the study group, with a significant difference (p < 0.05) when compared to the controls. Hemoglobin concentration, RBC count, hematocrit, white blood cell (WBC) count, and absolute lymphocyte count were inversely proportional to the stage of breast cancer. The absolute count, ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were directly proportional to the progression of disease.
 Conclusion: Hemoglobin, RBC count, WBC count (including differential count), NLR, and PLR are the key hematological indicators which predict the severity and mortality risk of breast carcinoma.

A study of geriatric dermatoses in a rural based tertiary care hospital in South India

Dermatological problems in the geriatric population are common and often underestimated.A few studies are available on the dermatologic diseases in this population. Hence, this study is undertaken to evaluate the spectrum of skin changes in the elderly population.This study was conducted in the Department of Dermatology, Sri Devaraj Urs Medical College, attached to RL Jalappa Hospital, Kolar, Karnataka, India. A total of 300 patients were recruited for this study, among them 185 (61.6 %) were males and 115 (38.4%) were females. All the patients aged more than 60 years with skin disorders attending the dermatology OPD were included in the study. A detailed physical and clinical examination was performed for all the study subjects. Patients with genodermatoses, albinism, premature aging and inherited disorders of DNA which may interfere with chronological aging skin were excluded from the study.Out of 300 patients, 185 cases (61.6%) were males and 115 cases (38.4%) were females. Pruritus was the commonest complaint in 186 patients (62%). Among the chronological changes of aged skin, wrinkling was the commonest manifestation observed in 282 (94%) cases. The most commonly observed diseases were eczematous dermatitis in 133 (44.3%) cases, followed by infections and infestations in 122 (40.6%) and papulo-squamous diseases in 33 (11%). A total of 46 (15.3%) patients were found to have papulo-squamous disorders. Psoriasis vulgaris was observed in 21 (7%) cases. Among premalignant and malignant disorders, 4 (1.3%) cases had actinic chelitis, 2 (0.6%) cases of basal cell carcinoma and 1 (0.3%) case of squamous cell carcinoma. A total of 5 patients had connective tissue disorders. The comorbid conditions included hypertension in 49 (16.3%) cases, followed by diabetes mellitus in 31 (10.3%) and 5 (1.6%) patients had hypothyroidism.Dermatological findings in geriatric population are universal and cause considerable morbidity. This would necessitate the need for conducting an exclusive evaluation for these patients.

A prospective study on role of hydraulic distension along with steroid under local anaesthesia in the management of frozen shoulder

Introduction: Frozen shoulder” is a chronic condition characterized by gradually progressive, painful restriction of all shoulder joint movement, with slow spontaneous recovery of either partial or complete movement over a period of time. Although many treatment options have been proposed for the frozen shoulder syndrome, each has limitations. Hydro dilation technique was developed in order to loosen the reported contraction and adhesion. we evaluated the Range of movement and pain relief of shoulder following “Hydraulic distension under local anaesthesia along with a steroid” pre and post distension. Material and methods: A prospective observational study was conducted in the department of orthopaedics at RLJ hospital attached to Sri Devaraj Urs Medical College between June 2018 to November 2019 for a period of 1.5 year. All the Patients with Peri arthritis shoulder and age above 30 years were included in the study. After obtaining the informed consent from the patients, Demographic data, History, Clinical Examination and details of investigations were recorded in study proforma. The pain and functional scoring used as per “The society of American Shoulder and elbow surgeons” and follow-up was done at 3 weeks, 6 weeks and 12 weeks after procedure. IBM SPSS version 22 was used for statistical analysis. Results: Total 50 patients were included in the study. The average age of the study population was 52.68 ± 9.79. There were no patients with complete disability. Marked pain (grade 1) was observed on presentation in 46(92%) of the subjects. Post distension only 9(18%) had pain. Flexion, abduction, internal rotation, external rotation movements of the shoulder have improved post distention and were statistically significant at 3rd, 6th, 12 th week. The mean ASES was 36.04 ± 5.84 at base line, it was 67.6 ± 7.64 at 6th week and 91.04 ± 8.68 at 12th week. The differences in the ASES score at 6th week and 12th week follow up period with baseline value were statistically significant (P value

Medical students and marijuana, attitudes and beliefs: A comparative study

Background and Objectives: Various studies indicating that cannabis is associated with various psychiatric disorders despite which is a controversy existing regarding the legalisation of cannabis by all the promoters and consumers of the substance. Our objective was to find out the knowledge and awareness among the 1st year and final year medical students toward the effects and experiences with the consumption of cannabis. Methodology: It was a cross-sectional study done on first and final year medical students between July 2019 and August 2019 in Sri Devaraj Urs higher education and research center, who are assessed using a structured and validated instrument, Marijuana Effect Expectancy Questionnaire-Brief (MEEQ-B) questionnaire. Results: Both the first-year and final-year medical students in our study had poor awareness and inadequate knowledge about the various adverse effects of cannabis, especially on all the six parameters of the MEEQ questionnaire. Conclusion: Extensive and elaborative teaching regarding substance use, especially of cannabis and its implication must be updated in the curriculum of both UG teaching and PG teaching in other specialities as well.

Effectiveness of Beetroot Juice in Increasing the Haemoglobin level among adolescent girls in Selected Colleges at Kolar.

Introduction Adolescence is the transitional stage from childhood to adulthood that occurs between ages 13 and 19.Many adolescence girls are having poor attack to proper health care and nutrition. Beetroot juice is a healthy portion that can do wonders for your overall health. Most of the studies have proved that even beetroot juice plays an important role in improving the haemoglobin level in the blood.Objective To evaluate the effectiveness of beetroot juice on the haemoglobin level among adolescent girls by comparing the pre -test and post- test haemoglobin level.Methods The research design used for the study was True experimental design. Adolescent girls studying at Sri Devaraj Urs College of Nursing Tamaka Kolar aged 17-19yrs n60 were selected by using simple random sampling technique. The feasibility of the study refinement of the tool was assessed through pilot study. The blood haemoglobin level among adolescent girls was assessed by using Clinical laboratory test and communication checklist. A freshly prepared beetroot juice was given for experimental group for 30 alternative days in the midmorning. Post-test was done after intervention period for both experimental and control group.Results In Experimental group the mean score on level of anaemia was 8.7 in pre-test and 11.04 in posttest. The pairedlsquotrsquo value was 6.58 which is significant at p lt0.05 in comparison with control group. It shows that beetroot juice was effective in improving the level of haemoglobin among adolescent girls.Conclusion The study findings revealed that the regular consumption of beetroot juice could bring out desired changes in the level of haemoglobin.

Clinico-pathological correlation of AUB patients undergoing hysterectomy in a rural tertiary care centre

Clinico-pathological correlation of AUB patients undergoing hysterectomy in a rural tertiary care centre - IJOGR- Print ISSN No: - 2394-2746 Online ISSN No:- 2394-2754 Article DOI No:- 10.18231/j.ijogr.2019.107, Indian Journal of Obstetrics and Gynecology Research-Indian J Obstet Gynecol Res