Sri Siddhartha Medical College Research Articles

Cross-Sectional Study of Placental Surface Area and Umbilical Cord Attachment on Placenta in Normal and PIH Pregnancy and Its Effects on Foetal Weight

Introduction: Pregnancy-induced hypertension (PIH) is one of the risk factor in pregnancy leading to placental insufficiency which in turn is responsible for maternal and foetal morbidity and mortality. PIH causes morphological changes in placenta. Decreased placental surface area and variation in the attachment of umbilical cord on placenta are more commonly noted in PIH which hampers the uteroplacental perfusion resulting in foetal mortality and morbidity. Hence afforts were made to study the incidence of reduced placental surface area and mode of cord attachment on placenta. Materials and methods: The study was conducted in the Department of Anatomy, Sri Siddhartha medical college and Hospital, Tumakuru, Karnataka. A total of 100 (50 normal and 50 PIH) human placentae were studied. Placental surface area and mode of attachment of umbilical cord in normal and PIH pregnancy were measured and noted. This study was analysed statistically by using Unpaired t-test and Chi-square test. Results: The study revealed significantly decrease in placental surface area and also there is increased incidence of central and marginal attachment of umbilical cord in PIH cases. Conclusion: Study reveals, PIH cause morphological changes in placenta, it decreasing the uteroplacental blood flow which reduces foetal nutrition ultimately decreasing the neonatal weight. KEY WORDS: PIH, uteroplacental blood flow, neonatal weight, placental surface area and Umbilical cord.

Abstract- Poster

:Introduction:Pierre Robin sequence (PRS) comprises of mandibular micrognathia, glossoptosis and airway obstruction, leading to life-threatening obstructive apnoea and feeding difficulties during the neonatal period.About 17.9% children with PRS were reported to have Autism Spectrum Disorder (ASD). The finding that almost one fifth of the male patients with PRS had a diagnosis of ASD should be investigated further. Here we report a case of Autism in male child with PRS.Case Description:This child was a second born of a non-consanguineous marriage to 27 year old mother who was Rh negative and ICT negative.The child had delayed cry at birth, with SVT. He was born with opisthotonic posturing and required bag and mask ventilation for 15 seconds.There was retrognathia, cleft palate, glossoptosis and caput succedaneum with prominent frontal bones. There were no low set ears, no chest or abdominal wall deformity or limb or spine abnormality.The child at age of 3 years was now brought to our OPD with mild delay in all domains of development with an intellectual level of 2 and half years at the age of 3 years. The child had inconsistent reciprocal response to name calling, poor joint attention, fleeting eye contact with poor instrumental and reciprocative gesturing.He had a vocabulary of 15-20 words, could count 1-15, could tell his name which was now deteriorated to just bi-syllabic babbling and producing variety of sound. There was a sudden regression in social, language and cognitive domain of development. Possibility of neurological cause was ruled out. MRI brain was suggestive of dolichocephalic skull with trigonocephaly with aqueductal stenosis with mild supratentorial ventriculomegaly and giant cisterna magna.Future research should explore a possible genetic double association or any causal links that are not yet identified between ASD and PRS.Authors: Dr. Dron K. Bhandutia, Dr. Dhanashree Akshatha (LOM), Prof. Dr. Sathyanarayana M.T.(LF 19204)Sri Siddhartha Medical College, Tumakuru-572107, Karnataka.Dr. Dron K. Bhandutia, Final year Postgraduate, Dept. of Psychiatry, Sri Siddhartha Medical College, Tumakuru-572107 Karnataka.Contact Details: 8200297318/8401841054 (Whatsapp) E-mail: landmark.bhandutia@gmail.com

A prospective study to evaluate the functional outcome of metacarpal shaft fracture treated with mini plates

Background: Metacarpal fractures are among the most common fractures of the hand. They may lead to loss of function if treated improperly. These injuries can be treated conservatively. However, if significant shortening, rotational deformity and angulation occur, surgical treatment is required. Recent studies have shown good functional results with surgical treatment of metacarpal fractures using miniplates and screws as compared to the conservative treatment or K –wire fixation. Hence the study aims to assess the functional outcomes of patients with metacarpal fractures, who will be undergoing open reduction and fixation with low profile titanium plates in our department.Materials and Methods: Patients coming to the Department of Orthopaedic, at Sri Siddhartha MedicalCollege, Tumakuru with metacarpal shaft fractures who are treated with open reduction and internal fixation with mini-plate. All patients are operated in supine position and under infraclavicular block or general anesthesia. After the tourniquet is inflated, the forearm is placed in pronation, a dorsal longitudinal incision is made and the fracture is exposed with adequate soft tissue dissection. A low profile 2.0 mm titanium miniplate is applied with four screws, two on each side of the fracture. In oblique or spiral type of fractures, initially fixed with inter fragmentary screws and then by plate. Metacarpal alignment and angulation will be confirmed with fluoroscopy. The plate and screws was covered with periosteum and soft tissues.Results: The maximum subjects had injury on the right side (58.3%) and commones tbone to be involved was fracture of shaft of 5th metacarpal (37.5%). Transverse type (39.6%) was the commonest fracture pattern. Our study showed excellent functional outcome (54.2%) with lower complication rates and bone union was seen in minimum 6 weeks. Mean DASH score at 1 month (18.56), 3 month (11.56),6 months(3.02) with p value = 0.001.Conclusion: Plate and screw fixation is a good option for treating closed unstable metacarpal fractures, where other modalities of fixation are less effective. The rigid stable fixation provided by plating which withstands load without failure allowed early mobilization and achieved good functional results. Detailed clinical and radiological assessment of fracture, careful preoperative planning, meticulous dissection, precision in surgical technique (coverage of plate with soft tissue) and choosing the correct implant (low profile plate) are critical in achieving good results and minimizing the complication.

A COMPARATIVE STUDY OF LUND-MACKAY SCORING AND POSE SCORING IN CHRONIC RHINO-SINUSITIS PATIENTS.

INTRODUCTION: To compare preoperative Computed Tomography scan ndings of Para nasal sinuses using Lund-Mackay scoring and intra operative Functional endoscopic sinus surgery ndings in patients with Chronic Rhino-sinusitis using the POSE scoring and to correlate maximum scores obtained in Perioperative sinus endoscopy (POSE) scoring system and Lund-Mackay scoring system. MATERIALS AND METHODS:AProspective study was done for 1 year on 48 patients attending outpatient department of ENT, Sri Siddhartha Medical College aged between 18-60 years, who were clinically diagnosed to have Chronic Rhino-sinusitis, underwent pre-operative CT scan of nose and paranasal sinuses and thereafter FESS were enrolled for the study after obtaining the due consent. RESULTS: From our study group of 48 patients who underwent endoscopic sinus surgery for CRS, the minimum value of Lund-MacKay Scoring was 3 whereas the maximum was 18 (maximum obtainable is 24) with a mean value of 12.02 and standard deviation of 3.987. The minimum POSE Score obtained was 7 and the maximum POSE Score obtained was 37 (maximum obtainable being 40), with a mean value of 16.31 and standard deviation of 5.095. CONCLUSION: Pre operative CT scan combined with per operative endoscopy ndings has made the approach to Chronic rhinosinusitis more specic, rational and accurate. The results of our study highlights that CT scan is an important investigation tool to detect Chronic rhinosinusitis . CT scan has very much emerged as the gold standard in preoperative diagnosis and allows for accurate patient selection for FESS. In our study, POSE Scoring has shown a good correlation with Lund MacKay scoring system

Anatomical Variations of Origin of Femoral Nerve- A Cross-sectional Observational Study

Introduction: Femoral nerve is an important nerve supplying the lower limb. Variations in the origin and course of femoral nerve are frequently encountered. The knowledge of these is of vital importance for orthopaedic surgeons and anaesthetists to prevent iatrogenic injury and debilitating postoperative complications. Aim: To document the variations in origin and course of femoral nerve and its clinical significance. Materials and Methods: A cross-sectional study was conducted on 50 specimens by dissecting 25 embalmed adult human cadavers of South Indian population out of which 20 were male and five were female cadavers. The study was conducted by dissection method done in the Department of Anatomy in Sri Siddhartha Medical College, Tumkur and Sri Siddhartha Institute of Medical Sciences and Research Centre, T Begur, Bangalore Rural, Karnataka, India. Results were expressed in terms of frequency and percentages. Results: Out of the 50 specimens, in 47 specimens femoral nerve was found to be originating normally from dorsal divisions of L2, L3, L4 spinal nerves, whereas in three specimens it was found to be originating from dorsal divisions of L1, L2, L3. In two specimens femoral nerve was seen emerging from behind the psoas major muscle. Conclusion: A good knowledge about the embryological basis and variations in the branching pattern of femoral nerve is essential because of its numerous clinical implications, especially in localising neurological lesions of nerves, for their early and accurate diagnosis and thus preventing iatrogenic anaesthetic complications.

Including near peer mentoring - Does it make a greater sense to mentoring program

Background: Students entering into medical education encounter many difficulties right from adjustment to the new environment, peer pressure, and home sickness to difficulty in coping with their studies. A helping hand in the form of a mentor can ease the situation with confidence. A peer mentor is also a student of the same profession of higher phase who would be of help to the juniors to overcome difficult situations. Aim and Objective: Our study was done to assess the opinion of the students on peer mentoring and to improve the effectiveness of the mentoring program. Materials and Methods: It is a cross-sectional study. It was done on 150 MBBS students which included both males and females. It included students of all the years studying in MBBS at Sri Siddhartha Medical College and Sri Siddhartha Institute of Medical sciences, T-Begur. About 107 students were willing to participate in the study. A questionnaire was provided to them which was answered and returned back. Data were summated and descriptive statistics were applied. Responses of the students to the questionnaire were represented as percentages. Results: About 56% of the students knew what peer mentoring is. Almost all the students were of the opinion that peer mentoring will provide positive lifestyle changes. About 79.43% of students suggested that peer mentoring would prevent ragging. Finally, there was a positive notion from the students side to add on peer mentoring to the mentoring program. Conclusion: Students entering into the medical curriculum are burdened with voluminous subjects, stressed with peer pressure, and depressed with homesickness. In our study, we could assess the need for the mentoring program and conclude that a peer mentor can help them to resolve the lacunae of the mentor-mentee relationship and help them handle the situation better.

Knowledge, attitude, and practice of first year medical students toward Novel Coronavirus disease

Background: The coronavirus disease (COVID) also known as COVID-19 caused by a novel human coronavirus Severe Acute Respiratory Syndrome Corona Virus-2 is transmitted from person to person through inhalation of aerosols from the infected individual. The WHO has declared as public health emergency of international concern and has put forth certain norms and rules to prevent the spread of the disease such as hand washing, social distancing, and wearing masks to control the outbreak along with lockdowns at periodic intervals. Aim and Objectives: The aim of the study was to assess knowledge, attitude, and practice (KAP) of 1st year medical students of 19–20 batch aged 19–20 years toward Novel Coronavirus disease during lockdown. Materials and Methods: Our study was conducted among fresher’s of 150 students of 1st year MBBS 19–20 batch of Sri Siddhartha Medical College, Tumkur, aged 19–20 years. A link from Google form was posted and circulated using various social media such as WhatsApp group and e-mail address of the students. The questionnaire consisted of 29 questions which included KAP assessment. Results: Descriptive analysis and Chi-square test are applied to analyze the data. Among 160 respondents, 98.1% were aware of COVID-19, majority of them showed positive attitude and social distancing to prevent COVID-19 pandemic according to the WHO norms. Conclusion: Our study showed that during COVID-19 pandemic 98.1% of the students had good knowledge about the novel coronavirus infection and 89.7% had a positive attitude toward COVID-19. Although the students showed a very good KAP toward COVID-19, still some grey areas regarding KAP toward COVID-19 were still left.

A Study of Chromosomal Abnormality Patterns in Patients with Primary Amenorrhea in a Tertiary Care Referral Hospital

Introduction: Congenital absence of uterus, inability of the ovary to produce the eggs and any malformations of ovary, fallopian tube, uterus and adnexal tissue may lead to Primary Amenorrhea (PA). The genetic and chromosomal abnormalities are the main cause of PA. Endocrine causes like abnormal function of pituitary gland and hypothalamus also lead to PA. Other causes like stress, extreme physical activity and psychological causes or a combination of these causes may lead to delayed onset of menarche. Aim: To study the frequency and type of chromosomal abnormalities in PA patients. Materials and Methods: In the present descriptive study, subjects included patients referred with PA for chromosomal analysis to Sri Siddhartha Medical College Genetic Laboratory. Pedigrees with details were drawn and in-depth clinical evaluation and clinical information were obtained from all subjects. Results: Of the 77 females with amenorrhea, 65 (84.4%) had a normal karyotype (46, XX) while 12 (15.58%) had abnormal karyotype. The age group of the patients with PA ranged from 16-27 years. Mean age of PA was 21 years. In the present study, among 12 abnormal karyotyping patients 7 (58,3%) patients showed XY, sex reversal. This study also identified a X chromosome homogeneous monosomy, (Turner’s) 45 X in one (8.3%) case. Turner’s mosaic 45, X/46, XX in three cases (25%), and one case (8.3%) showed inversion 46, XX, inv (11), (P15q11). Conclusion: A significant number of patients had sex chromosomal abnormalities; thus, early cytogenetic investigation is prudent to guide further management. Genetic counselling should include the risk of premature menopause for patients with Turner’s syndrome and the use of hormonal replacement therapy, the risk of gonadal malignancy for patients with XY gonadal dysgenesis and the possibility of infertility in the future children of patients with mosaic Turner.

A clinic-epidemiological study of organophosphorus poisoning in children in a tertiary care medical college hospital

Background: Acute organophosphorus (OP) pesticide poisoning is widespread and is the most common poisoning in many developing countries and varies in different geographic regions. Organophosphorus compounds are anti acetyl cholinesterase which exert their toxicity by interfering with the normal function of acetylcholine, an essential neurotransmitter throughout the autonomic and central nervous system.Methods: The present study was conducted in department of pediatrics Sri Siddhartha medical college, Tumkur. All children with OP poisoning admitted in the pediatric ward were included in the study. Unknown compound/tablet poisoning, which was contradictory to the diagnosis of OP compound were excluded.Results: Out of 5,274 cases which were admitted in pediatric ward, 15 children were diagnosed as OP poisoning. In the present study the incidence of OP poisoning was 2.84%. Out of 15 cases 3 cases were below 1 year of age, 2 cases were in the age group of 1-5 years, 5 cases were in the age group of 6-10 years and 5 cases were seen in above 11 years of age. Among 15 cases 13 (86.7%) cases were accidental poisoning and 2 (13.3%) cases were attempt to suicide. Out of 15 cases 4 (26.7%) cases were seen in monsoon, 4 (26.7%) cases were seen in winter and 7 (46.6%) in summer season. Out of 15 cases 14 (93.3%) cases improved with treatment and 1 (6.7%) case discharged against medical advice.Conclusions: Most cases of accidental poisoning are preventable by close watch on the toddlers and younger children who have a habit of tasting unknown things. Educate school children in all aspects of childhood poisoning.

Duplication of optic canal (a figure of eight anomaly) – case report with review of literature

A duplication of optic canal was discovered on the right side of the skull during routine osteology class of Head and Neck in the Department of Anatomy at Sri Siddhartha Medical College (SSMC). The main canal was larger and situated as usual in the normal position, gives passage to the optic nerve whereas the accessory canal was smaller than the main canal and was positioned inferolateral to it, transmits the ophthalmic artery. The bony septum separating the two canals was approximately 3mm in length and 1mm in thickness. The duplicated optic canal is a rare anomaly of the optic canal which every radiologist, ophthalmologist, and neurosurgeon needs to be aware of. Imaging studies may aid in elucidating its true etiology corresponding with the age and time of onset of the duplicate optic canal. Keywords: Accessory optic canal, Duplicate optic canal, Figure of eight, Optic canal, Optic canal anomaly.

Prevalence of anemia in pregnancy and its outcome in rural Tertiary Care Centre in India

Anemia in pregnancy is a major health problem in developing countries. Haemorrhage ranks first in the list of maternal mortality in developing countries. Materials and Methods: A prospective study on all anaemic pregnant patients (according to WHO) admitted to labour room of more than 28 weeks gestational age from May 2015 to May 2017 in Sri Siddhartha Medical College, Tumkur were included in the study and appropriately treated. Demographic factors like age, education, socioeconomic status, parity, birth spacing and intake of iron supplements was studied. Maternal and perinatal outcome was also studied. Results: Among 2982 deliveries, 32 cases were excluded according to exclusion criteria. About 1903 were found to be anemic. In these cases, 61% were in 20-24yrs age group, 35% patients educated upto middle school, 71% belonged to low socioeconomic status, 62.1% had less than 2 years of birth spacing. All these factors were statistically significant. But 38% cases had not received iron supplements. Although mild anemia cases were uneventful, moderate and severe anaemia cases had maternal complications. In moderate anemia, 4% patients had PPH and received blood and blood products, 10 % had puerperial fever and rest uneventful. Severe anemia had significant outcome: preterm labour (38%), preeclampsia (20%), IUGR (10%), intrauterine fetal demise (8%), abruption placenta (7%), placenta previa (1%), puerperal fever (7.2%), cardiac failure (0.8%), PPH (8%). Maternal mortality was noted in 3 patients. About 35 neonates of mild anaemic cases,65 neonates of moderate anaemic cases and nearly 46.5% of severe anaemia cases had complications. Conclusion: Prevalence of anemia is most common in rural population. Demographic factors also play a very important role. Effective management of anemia cases definitely prevents maternal and perinatal mortality. Keywords: Severe anaemia, Demographic factors, Maternal mortality, Perinatal mortality.

Health profile and health insurance coverage among a defined rural population of Tumkur, Karnataka: A cross sectional study

To study the health profile of the population under study 3. To assess the health insurance coverage and utilization patterns in the study population. Materials and Methods: It is a Cross - sectional study. This study was undertaken in the rural field practice area of Sri Siddhartha Medical College, Tumkur, Karnataka .Six villages were chosen randomly. Multi stage sampling method was used. Sampling units were households. Oral questionnaire was used to collect the data and physiological parameters were measured. Results: According to this study 80% were Hindus, 15% were Muslims, 5% Christians.57% of the families belonged to OBC (other backward castes). Average family size: = 3.5409 (SD±1.1861) Anaemia was present in 64.9% of the population. Major recent illness were URTI 53%, head ache 12% and myalgia 9%. Health insurance coverage is 20% in the study area. Conclusion: The major illnesses in the population were anaemia 65%, 58% had dental caries, hypertension was 24%, 15% of them had diabetes mellitus. Health insurance coverage was around 20%. Majority of the households( 93%) were not aware about any health insurance schemes Only 13% of the insured were aware about the benefits of health insurance scheme and 8% of those who insured utilised the health insurance scheme benefits. Keywords: Health Profile, Universal Health Coverage, Rural Population, India, Health Insurance.

Estimation of stature by morphometry of percutaneous tibia

Introduction: Stature estimation is an indispensable part of the identification process of human skeletal remains or body parts. Height is also fundamental to assess growth and nutrition and calculating body surface area. Studies on anthropometric measurements of lower limbs among living people have been used as an important tool by forensic anthropologists to reconstruct the living stature of unidentified skeletal remains. Aims and Objectives: The aim of the present study was to estimate the stature from percutaneous tibial length (PCTL) by formulating linear regression equations and also by using multiplication factors, which would be useful in the field of forensic anthropology. Materials and Methods: Sample size measured 350 subjects of Sri Siddhartha Medical College, Tumkur, age group ranging from 17 to 22yrs were considered for the study. Height and PCTL were measured using the standard anthropometric technique. Results: Stature was estimated from PCTL using simple regression analysis. The height of males was significantly higher than that of females. The mean height in females and males was 158.87cm and 170.88 cm respectively; and mean PCTL was 38.54cm and 33.99cm in male and female respectively which was significantly (p Conclusion: Stature can be estimated using the anthropometric measurements of tibia in an intact mutilated leg. Keywords: Height, Tibial length, Anthropometry, Regression equation.

To Determine the Safety and Efficacy of Transdermal Nitroglycerine Patch as Shortterm Tocolytic in Preterm Labor

Background and Objectives: Preterm labour complicates 5-10% of pregnancies and is a leading causeof neonatal morbidity and mortality worldwide. It is a major public health problem in terms of loss of life,long-term disability (cerebral palsy, blindness, deafness, chronic lung disease) and health care costs both inthe developing and the developed world.There is need for tocolytic therapy to reduce perinatal mortality and morbidity by delaying delivery at leastfor 48 hours to allow time for therapeutic effects of corticosteroidsMethodology : This study was undertaken at Sri Siddhartha medical college and hospital research centretumakuru between October 2017 to October 2019.76 Antenatal cases with gestational age 28weeks-37weeks as per the inclusion and exclusion criteria’s whowere admitted and clinically diagnosed as preterm labour were selected . The selected patients were treatedwith Nitro-glycerine patchResults : Success rate for acute tocolysis was 88.2%.Mean prolongation of pregnancy was 14.46 days andmean birth weight of babies was 2.19 kilograms. Most common side effect with Nitroglycerine patch washeadache (5.3%).Conclusion: Nitroglycerine patch is effective in suppression of preterm labor as short term tocolytic inprolongation of pregnancy. Nitroglycerine is well tolerated and safe for the mother and fetus with minorside effects

Assessment of occurrence of metabolic syndrome among post-menopausal women

Background: Metabolic syndrome is described by the clustering of several risk factors for cardiovascular disease such as hypertension, dyslipidemia, obesity, Insulin resistance, and high fasting plasma glucose. Objective of this study was to determine the frequency and evaluate the components of metabolic syndrome in post-menopausal women.Methods: This Descriptive study was conducted in OPD as well as IPD of Department of Medicine, Sri Siddhartha Medical college Hospital and Research Centre, Tumkur After obtaining written informed consent. Period of study was 24 months. Purposive sampling was used.Results: Mean age of post-menopausal women was 54.19±8.454 years. Mean age of menopause was 45.41±2.428. Majority of patients between were between 45-50 years (33.7%). There were high number of women (34.6%) whose postmenopausal duration ranged between 6-10 years. In our study 10(9.6%) postmenopausal women had type 2 DM and 15(14.4%) postmenopausal women had HTN. Metabolic syndrome was present in 65(62.5%) postmenopausal women and absent in 39(37.5%) postmenopausal women. Waist circumference >80 cm (68.3) was the most prevalent component of metabolic syndrome followed by HDL <50 mg/dl (53.8%), BP>130/80 mmHg (51%) triglycerides >150 mg/dl (44.2%)/ and FBS>100 mg/dl (39.4%). There was statistical significance observed between the components of metabolic syndrome and metabolic syndrome in postmenopausal women.Conclusions: The prevalence of metabolic syndrome was high in our study. The components of metabolic syndrome such as waist circumference, FBS, blood pressure, triglycerides were significantly raised and HDL levels were significantly reduced in post-menopausal women with metabolic syndrome.

Clinico-epidemiological study of melasma in tertiary care centre

<p class="abstract"><strong>Background:</strong> Melasma is common pigmentary disorder and affect patient quality of life due to its presentation over the face. It mostly affects sun exposed area and present as grey-brown pigmentation over the face.</p><p class="abstract"><strong>Methods:</strong> In this observational or descriptive study, total 110 patients were enrolled which was carried out in the Department of Dermatology from February 2019 to January 2020 at Sri Siddhartha Medical College and Sciences, Tumkur, Karnataka.<strong></strong></p><p class="abstract"><strong>Results:</strong> Mean age group affected was 31-40 years of age (41.8%). Out of 110 patients 18 patients were male and 92 patients were females. Total 15 patients had positive family history (13.6%). 30 patients had history of taking oral contraceptive pills (27.3%). 22 patients had sun exposure history (20%). 59 patients had epidermal pigmentation (53.6%) and 62 patients had malar region distribution (56.4%).</p><p class="abstract"><strong>Conclusions:</strong> During third decade of life, females were more commonly affected. Pathogenesis of melasma is multifactorial. In our study, we found that oral contraceptive pills and sun exposure may predispose or trigger the melasma. Most common area affected was malar. Epidermal pigmentation was more common.</p>

An etiological study of respiratory distress in neonates in a tertiary care medical college hospital

Introduction: Respiratory distress is the most common cause of NICU admissions in newborns. Early diagnosis of cause of respiratory distress is important in the management of neonatal distress for better outcome. The high incidence of maternal risk factors and newborn receiving poor antenatal care continues to test the abilities of the neonatologist. Inspite of re¬cent advance in clinching diagnosis and management there are very less clinical studies on the neonatal respiratory distress in our country. Therefore, there is a need to know the etiological factors of the babies with respiratory distress. Materials and methods: A descriptive study of 150 neonates admitted to NICU of Sri Siddhartha Medical College and Hospital with clinical features suggestive of respiratory distress. All the newborn babies who developed respiratory distress within 72 hours of life were included in the study and those who developed respiratory distress after 72 hours of life was excluded from the study. Results: The commonest cause of neonatal respiratory distress in the present study was Respiratory distress syndrome (34%), followed by Transient tachypnoea of the newborn (30%), and Meconium aspiration syndrome (22.66%). LSCS was most common mode of delivery. Conclusion: The most common causes of respiratory distress were RDS, TTNB, MAS, and birth asphyxia. Proper antenatal care and early diagnosis of the antenatal complication and avoiding preterm deliveries will aid in the better outcome of the newborns. Early detection and appropriate management are essential to ensure better outcome in all infants presenting with respiratory distress.

A study of clinical spectrum of patterns of cutaneous adverse drug reactions in a tertiary care hospital

<p class="abstract"><strong>Background:</strong> Adverse drug reactions are unwanted pharmacodynamic effects following administration of a drug. With an increase in number of newer drugs adverse drug reactions have become very common in recent times. Among them cutaneous reactions have been steadily gaining importance and constitute a major proportion of all the adverse drug reactions.</p><p class="abstract"><strong>Methods:</strong> This observational study was conducted at Sri Siddhartha Medical College and Hospital Tumkur, Karnataka, India, involving 73 patients with cutaneous adverse drug reaction (CADR) during November 2016 to May 2018. The aim of the study is to identify the causal drug and categorised into definite/probable/possible Naranjo Algorithm scale was used.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age of study participants was 35 years. Majority of cases observed had fixed drug eruptions (FDE: 37%), followed by maculo papular drug reaction (MPDR: 26%). Antimicrobials (42%), non-steroidal anti-inflammatory drugs (NSAIDs: 26%), anticonvulsants (9.5%) were commonly implicated drugs causing CADR. Among those with FDE, definite causality was highest for NSAIDs (9.6%) predominantly paracetamol whereas in MPDR definite causality was noted with anti-tubercular drugs (rifampicin 1.4%) and probable causality was highest for cephalosporins (5.5%) predominantly cefpodoxime. In present study it was observed female patient aged ≥35 years showed statistically significant mucosal involvement and past history of CADRs.</p><p class="abstract"><strong>Conclusions:</strong> A wide range of clinical spectrum of CADRs ranging from FDE to serious toxic epidermal necrolysis was observed. Most of these drug eruptions were caused by antimicrobials. Eliciting past history of CADRs with causal association will help to prevent and manage cases in a better way.</p>

Clinico-pathological assessment of breast lump: A clinical study

Background: Breast is a glandular organ influenced by hormones in females with various structures giving rise to different types of lesion and lumps. The present study was conducted with the aim of clinico-pathological assessment of breast lump. Materials & Methods: The present study was conducted in the department of General pathology, at Sri Siddhartha Medical College, Tumkur. It comprised of 120 breast specimens obtained from surgery department. Results: Maximum patients were seen in age group 20-40 years (70) followed by 40-60 years (30) and >60 years (20). The difference was significant (P< 0.05). Histological diagnosis was fibroadenoma in in 43, fibrocystic disease in 38, chronic abcess in 7, duct ectasia in 5, fat necrosis in, granulomatous in 3, lactating adenomas in 1, lipomas in 1, benign phyllodes in 2, DCIS in 3, ductal carcinoma in 12 and invasive lobular carcinomas in 2 cases. The difference was significant (P< 0.05). Conclusion: We found that most common age of occurrence of breast lumps was in third decade. The most common breast lump lesion was fibroadenoma followed by fibrocystic disease. Carcinoma was seen in 14 cases suggesting that a histopathological evaluation is essential to rule out malignancy.

Hematological parameters in fever evaluation - A prospective study

Introduction: The common causes of acute febrile illnesses (AFI) are malaria, dengue, typhoid, Chikungunya fever, meningitis, Urinary Tract Infection (UTI) and other miscellaneous diseases. Aim: To detect if certain hematological parameters would increase the probability to reach a provisional diagnosis of various acute febrile illnesses and prompt institution of specific therapy. Materials and Methods: This prospective study was conducted in Department of Pathology, for 2years in Sri Siddhartha Medical College, TUMKUR, from June 2016 to May 2018 and included total 100 cases of acute febrile illnesses in age group 21 to 60 years. Complete blood count and malarial parasite microscopy were performed for each patient. Other relevant tests wherever required, were done for confirmation of diagnosis. Results: Among 100 cases of AFI, malaria was detected in 17%, dengue in 26%, typhoid in 16.%, UTI in 17%, meningitis in 6% and non-specific fever in 18%. There were 55/100 males and 45//100 females. Maximum number of cases (44%) were seen in age group 21 to 30 years. Thrombocytopenia, anemia, increased Red Cell Distribution Width (RDW) and Platelet Distribution Width (PDW) while reduced Packed cell volume (PCV) showed a statistically significant correlation in malaria. A relatively more thrombocytopenia, anemia and reduced RBC and PCV were noted in P. falciparum in comparison to P.vivax. In dengue, a more reduction in platelet count, leucopenia with lymphocytosis and 56% cases with reduced PCV were noted. Increase in TLC and neutrophil count was consistent features seen in UTI and meningitis. In typhoid patients normal platelet count, mild anemia and mildly reduced PCV was observed while comparing with malaria. Conclusion: We conclude that routinely used laboratory tests such as hemoglobin, PCV, leukocyte count, platelet count and even red cell indices can act as diagnostic indicators in patients with acute febrile illness.