Teaching Hospital In South India Research Articles

Outcomes from Early Experience with Laparoscopic Inguinal Hernia Repair Versus Open Technique

Objectives: This study aimed to evaluate the outcomes of laparoscopic inguinal hernia repair (LIHR) regarding postoperative pain, recurrence rates, duration of hospital stay and other postoperative outcomes within the context of a tertiary care teaching hospital in South India, and the initial experience of laparoscopic repairs. The current consensus in the literature often suggests LIHR as superior to open inguinal hernia repair (OIHR). Methods: This single-centre, retrospective, observational study was conducted at the Jawaharlal Institute of Postgraduate Education and Research, Puducherry, India, from January 2011 to September 2020. All patients who underwent elective OIHR and LIHR were included. Data on the patients demographics, comorbidities, hernia type, mesh characteristics, surgery duration, hospital stay and immediate postoperative complications were collected and analysed. Results: A total of 2,690 OIHR and 158 LIHR cases were identified. The demographic profiles, hospital stay and complication rates were similar in both groups. However, surgical site infection was present exclusively in the OIHR group (3.55% versus 0.0%; P <0.05). The timeline for returning to normal activities was statistically shorter for the LIHR group (6 versus 8 days; P <0.05). The most frequent immediate complication in the LIHR group was subcutaneous emphysema (6.54% versus 0.0%; P <0.05). Recurrence (9.23% versus 3.61%; P = 0.09) and chronic pain (41.53% versus 13.55%; P <0.05) were higher in the LIHR group. Conclusion: Lower recurrence and chronic pain rates were observed with OIHR in the initial experience with LIHR in the hospital. However, LIHR had significant advantages concerning faster patient recovery and lower rates of surgical site infections. While the results contribute an interesting deviation from the standard narrative, they should be interpreted within the context of a learning curve associated with the early experience of the research team with LIHR. Keywords: Hernia; Inguinal Hernia; Laparoscopy; India.

Early identification of thyroid illness and its intricate relationship to renal function may be crucial for therapy planning

An epidemiological shift has occurred in India, where the burden of chronic illnesses is increasing, and communicable diseases are declining. Chronic diseases such as diabetes mellitus, cancer, and chronic respiratory disorders are on the rise, and this trend has been attributed to unhealthy lifestyles, increased urbanization, and changes in society and the environment. Such a category did not include chronic kidney disease (CKD). End-stage renal disease (ESRD) is defined as glomerular filtration rate (GFR) <15 ml/min/1.73 m2, while chronic kidney disease (CKD) is defined as a sustained eGFR of <60 ml per minute per 1.73 m2 of body-surface area for more than three months irrespective of the underlying cause while glomerular filtration rate (GFR) <15 ml/min/1.73 m2 is considered as end-stage renal disease (ESRD). CKD is classified into five stages ranging from mild dysfunction to complete failure. Globally, CKD is a significant cause of morbidity and death and there is a 38% increase in mortality linked to renal failure in developing nations like India. It has been shown that the epidemiology of CKD in India differs from that in the West; patients in India were, on average, five to twenty years younger Pregnancy-related malnutrition, environmental variables, genetics, or postponed medical care that accelerates the course of CKD are among the likely reasons and birth weight.The present hospital-based, cross-sectional, observational study was conducted in the a tertiary care teaching hospital in South India from December 2020 to January 2024. The study comprised 50 patients of CKD between 30 and 70 years of age of both sexes with no previous history of any thyroid dysfunction, while 50 apparently healthy age and sex-matched individuals from the same ethnic population with normal renal function and no past history of thyroid disorders served as a control group.The results of this study and most others, there is a possibility that abnormal thyroid hormone activity may result in a decline in renal function. Early identification of thyroid illness and its intricate relationship to renal function may be crucial for therapy planning.The current cross-sectional hospital-based observational study discovered that uremic patients had considerably lower mean TT3 and TT4 and higher mean TSH when compared to healthy controls, regardless of the kind of medication or duration of the disease. Based on the results of this study and most others, there is a possibility that abnormal thyroid hormone activity may result in a decline in renal function. Early identification of thyroid illness and its intricate relationship to renal function may be crucial for therapy planning.

The prevalence of pulmonary and extrapulmonary tuberculosis in forensic autopsies in a teaching hospital in South India

ABSTRACT Introduction: An autopsy is a valuable tool for finding the cause of death, exploring the clinical diagnosis, documenting unexpected findings, and resolving diagnostic questions. However, this may subject the forensic pathologist and other workers to a wide variety of blood-borne and aerosolized pathogens. Tuberculosis (TB) is the most common cause of illness and death, resulting in infection transmission in the autopsy room. Our objective in this study was to estimate the prevalence of pulmonary and extrapulmonary tuberculosis among forensic autopsies in a tertiary care hospital in South India. Material and Methods: We identified positive TB cases from acid-fast bacteria staining and culture (Mycobacterium Growth Indicator Tube and Lowenstein–Jensen medium) out of 380 autopsy cases. Results: The prevalence of tuberculosis was 2.4% (n = 9), among which 2.1% of cases were positive for only pulmonary tuberculosis (n = 8), and 0.3% of cases had both pulmonary and extrapulmonary involvement (n = 1). In the bivariate analysis of TB cases, sex, occupation, family history of TB, habit of smoking, BCG vaccine scar, period of hospital stay, and cause of death were potentially significant. Conclusion: The prevalence of TB in forensic autopsy cases were similar to forensic autopsy-based studies, and it was less as compared to the prevalence of TB in the general population.

Prevalence and determinants of post-COVID-19 syndrome among patients 6 months post-discharge from a teaching hospital in South India

ABSTRACT Background: The coronavirus disease 2019 (COVID-19) infection has affected millions of people worldwide in the last 4 years. Among those infected, the long-term COVID-19 syndrome, in which symptoms of COVID-19 persist for a variable period, is posing new challenges to the health system, but few studies are available in India that examine the post-COVID-19 syndrome, that is, 6 months and beyond COVID-19 infection. This study aimed to find the prevalence and determinants of post-COVID-19 syndrome among patients 6 months and beyond their infection. Methodology: This cross-sectional study was conducted among 300 patients who were admitted and discharged from Government Medical College, Thrissur, at least 6 months before with a diagnosis of COVID-19 infection. The data collection was performed using a semi-structured interview schedule through a telephonic interview. The analysis was performed using the Statistical Package for the Social Sciences (SPSS) software. Results: 21% of the patients studied had at least one persistent symptom at the end of 6 months, and 4.1% had more than one symptom. Among the symptoms persisting most commonly were fatigue (11%) and dyspnea (7.7%). Other than persisting symptoms, 21% of patients developed exertional dyspnea and 19% developed sleep disturbances during the 6 months after discharge. The factors that were associated with persistent symptoms in univariate analysis were increasing age, presence of chronic obstructive pulmonary disease (COPD), presence of chronic kidney disease (CKD), and admission to the intensive care unit (ICU). Conclusion: The study concludes that one-fifth of the patients still suffer from post-COVID-19 syndrome even 6 months after the COVID-19 infection. Our health systems should be prepared for the long-term management of COVID-19-infected people and prepare policies for the same.

Patterns of Physical Activity and its Association with Gender and Academic Year Among Undergraduate Medical Students

Aim This study aimed to determine the patterns of physical activity (PA) and its association with gender and academic year among undergraduate medical students of a tertiary care hospital in South India. Materials and Methods A cross-sectional study was conducted among undergraduate medical students from August to October 2022 at a tertiary care teaching hospital in South India. PA was determined using the self-administered long form of the International Physical Activity Questionnaire (IPAQ). Statistical analysis was performed using SPSS software. Results A total of 223 students aged 18 to 25 years completed the questionnaire, with the majority being females (59.2%). Their median total PA (metabolic equivalent [MET] minutes/week) was 1320, with 2073 and 771 MET minutes/week among male and female students, respectively. Fourth-year students were the most physically active, with higher energy expenditure per week, followed by second-year, third-year, and first-year students ( p = 0.007). Out of the total 223 students, 141 (63.2%), 62 (27.8%), and 20 (9%) students belonged to low, moderate, and high PA levels, respectively. There was a greater proportion of students with low PA among females (70.5%) compared to male (52.7%) participants ( p < 0.001). Conclusion Most undergraduate medical students had a low level of PA, especially females and students in the first academic year. To increase the PA levels among medical students, curricular reforms by incorporating sports/exercise training, and ensuring the availability of adequate facilities and trainers for sports in every college/university is warranted. Future research focusing on the exploration of barriers to PA and designing innovative strategies to promote PA among medical students is the need of the hour.

Cardiovascular Risk Profiling Using the Globorisk Calculator among Noncommunicable Disease Patients Attending Primary Health Centers of a Tertiary Care Teaching Hospital in South India: A Cross-Sectional Analytical Study.

Cardiovascular diseases (CVDs) account for over three-quarters of all deaths taking place in developing nations. The present study aims to stratify noncommunicable disease (NCD) patients using the Globorisk chart for predicting their 10-year risk of a major (fatal or nonfatal) CVD event and to estimate the level of agreement between this country-specific chart and the existing World Health Organization (WHO)/International Society of Hypertension (ISH) risk strata. A record-based cross-sectional analytical study was conducted in 2018 among adults attending the NCD clinic of one rural and one urban primary health center in Puducherry. Laboratory and office risk calculators of the Globorisk chart were used to calculate the risk. The median age (interquartile range (IQR)) of the 760 study participants was 58 (50-65) years. When calculated using the Globorisk prediction chart, 22.1% (n = 168) of the participants had a <10% risk for any CVD event in the next 10 years, whereas the same risk was found in 71.1% (n = 540) by using the WHO/ISH risk chart. There was no agreement found between the two risk charts (k = 0.0174; P-value = 0.26). The Globorisk chart was found to identify more patients as belonging to the higher risk category as compared to WHO/ISH charts.

Correlation Between Depression and Quality of Life Among Patients With Parkinson's Disease: An Analytical Cross-Sectional Study.

Introduction Parkinson's disease (PD) is a progressive complex degenerative disorder characterised by several motor and non-motor symptoms that result in disability and deterioration of the patient's quality of life (QOL). Depression is the most common non-motor symptom that may severely alter the QOL. The objective of this study was to examine the correlationbetween depression and QOL among patients with PD who received treatment from a movement disorder clinic of a tertiary care teaching hospital in South India. Methods This was an analytical cross-sectional study conducted among 220 PD patients who received treatment from a movement disorder clinic of a tertiary care teaching hospital inSouth India. The participants aged between 40 and 80 years, who can comprehend Malayalam or English and were clinically diagnosed with PD according to United Kingdom PD Society Brain Bank criteria were included in the study. Depression was assessed using the Hospital Anxiety and Depression Scale, motor function using the Movement Disorder Society Unified Parkinson's Disease Rating Scale Part III, and the quality of life was assessed using the Parkinson's Disease Questionnaire 39. Results The results of this study showed that there was a significant positive correlation between depression andQOL (r=0.699, p<0.01) among patients with PD who received treatment from a tertiary care teaching hospital.The correlation with domains of QOL also identified that depression was significantly correlated with all domains of QOL and more to the emotional domainof QOL (r=0.799, p<0.01). Conclusion Depression is the most common neuropsychiatric condition in PD and the most important determinant of QOL.Depression mayoccur at any stage of PD and can significantly impact the QOL of patients and their caregivers.Hence it should be recognized early and managed by pharmacological and nonpharmacological measures to improve the QOL.

Improving the emergency services using quality improvement project and Donabedian model in a quaternary teaching hospital in South India

IntroductionThe primary goal of quality improvement is to enhance patient outcomes, particularly in the emergency department (ED). Timely and effective care is crucial in these situations. By comprehending the challenges,...

Urinary megalin levels in patients with type 2 diabetic nephropathy and its correlation with renal function.

Megalin is a glycoprotein molecule found on proximal renal tubular epithelial cells. The objectives of this study were to determine urinary megalin levels in non-diabetic subjects and in patients with and without type 2 diabetic nephropathy and to assess the correlation between urinary megalin, urinary albumin, and estimated glomerular filtration rate (eGFR) in diabetic patients. This was a cross-sectional comparative study conducted at a tertiary care teaching hospital in South India for 2 years. Study subjects were divided into three groups: non-diabetic subjects, diabetics with normoalbuminuria, and diabetics with microalbuminuria. Urinary albumin was detected by the dipstick technique in a spot urine sample for all study subjects. Nephelometry was used to quantify urinary albumin levels. The enzyme-linked immunosorbent assay technique estimated urinary megalin. Urinary megalin levels were higher in non-diabetic subjects compared to diabetic study subjects. There was a significant difference in urinary megalin levels between non-diabetic subjects and diabetic patients with microalbuminuria. No correlation was found between urinary megalin, urinary albumin, and eGFR in patients with diabetic nephropathy. Urinary megalin levels were higher in non-diabetic subjects than in type 2 diabetic patients. There was no correlation between urinary megalin, urinary albumin, and eGFR in patients with diabetic nephropathy.

Predictors of biomedical waste management practices among staff nurses of a tertiary care teaching hospital in India.

Inappropriate handling of biomedical waste (BMW) may pose serious threats to the health of patients and hospital personnel. Among all healthcare workers, staff nurses play a vital role in BMW management (BMWM). Thus, the present study aimed to determine the predictors of BMWM practices among staff nurses of a tertiary care teaching hospital in India. A prospective cross-sectional study was conducted among 150 staff nurses, working at a tertiary care teaching hospital in South India, from July to August 2018. Data were collected using a pretested, semi-structured, and self-administered questionnaire after taking their written informed consent. Regression analysis was carried out to identify the predictors of satisfactory BMWM practice status. Of the total 150 staff nurses, most of them were young females with a work experience of ≤ 5 years. Concerning knowledge scores, most staff nurses (63.3%) belonged to the moderate category, whereas a few (24%) were in the high category. Also, most of them (62.7%) were in the high category of attitude scores. For practice scores, half of the participants were in moderate and high categories, each. Female gender, attended training status, and moderate and high knowledge scores were significantly associated with satisfactory BMWM scores in unadjusted analysis. After adjusting for other independent variables, all these three factors were found significantly associated with satisfactory BMWM practice scores. The present study shows that the female gender, attending training in BMWM, and having a moderate and high knowledge of BMWM were significant predictors of satisfactory BMWM practice among staff nurses. Thus, all hospitals must periodically train their staff nurses to strengthen their BMWM practices. Safe BMWM leads to environmental protection and safeguards the health of patients, hospital personnel, and the public.

To assess the knowledge, attitude, and practice about prescribing fixed-dose combinations among medical doctors in a tertiary care hospital in Karnataka: A cross-sectional study

Background: Fixed-dose combinations (FDCs) constitute a substantial portion of prescribed medications worldwide and offer benefits such as enhanced efficacy, reduced pill burden, and improved patient compliance. However, their improper utilization can lead to inefficacies, increased costs, and adverse health outcomes. The assessment of clinicians’ understanding, attitudes, and practices regarding FDC prescription at a tertiary care teaching hospital in South India serves as a crucial step toward ensuring informed and rational medication practices. Aims and Objectives: The aim and objectives of the study are to evaluate the knowledge, attitude, and practice of prescribing FDCs among medical doctors. Materials and Methods: Following approval from the Ethics Committee at Mysore Medical College and Research Institute, as well as obtaining written informed consent from medical doctors working in the institute, a selfadministered, structured, and pre-tested questionnaire was utilized. This questionnaire had been adapted from prior studies with similarities and was adjusted to align with the specific context of the present study. Results: The study of 72 doctors highlighted high FDC awareness (91.7%). The generic name of FDC was employed by 69.4% of the participants in the study. Most advocated proper prescriptions (84.8%). 57% of them identified FDC rationality. 22.2% relied on drug indexes, among other varied sources, for FDC information. Conclusion: It is essential to emphasize gaps in knowledge, attitude, and practice as it increases the risk of irrational prescriptions. Measures aiming to educate and rectify this issue, particularly in a tertiary hospital setting, help in mitigating the irrational use of drugs and optimizing patient care.

Evaluation of parenteral injection skills of medical undergraduates on mannequins in a tertiary care teaching hospital in South India – A cross-sectional study

Abstract Appropriate knowledge and expertise of parenteral injection is vital in the medical field. Hence we impart training on mannequins before the students practice on patients. This study was conducted to evaluate the skill exhibited by the students in parenteral injection skills, namely intravenous, intramuscular, intradermal and subcutaneous injections. The students were assessed for step based on the pre-validated check list created for Objective Structured Practical Examination. In this study, 16 % of the students failed to check the prescription order before starting the procedure. The name and the expiry date of the drug was not checked by 22 % of the students. Hundred percent of the students sterilized their hands. Loading of drug was done properly by 80 % of the students and 88 % of the students checked for air bubbles in the syringe and removed them properly. The site for injection was not sterilized by 26 percent of the students. Tourniquet was not applied by 19 percent of the students and 28 % of the students did not hold the bevel up during insertion for intravenous route. The steps where frequent faltering happened needs to be emphasized for them to perform better in a more efficient manner during the summative assessment as well as for future practice.

Empiric Antibiotic Use and the Outcome in Infants at Risk of Early Onset Neonatal Sepsis in a Teaching Hospital in South India: A Retrospective Cohort Study

Background Neonatal sepsis continues to be an important cause of mortality and morbidity in low- and middle-income countries. The identification and early treatment of infants at risk of early-onset neonatal sepsis (EONS) with empiric antibiotics is a preventive strategy. Objectives To study the use of empiric antibiotics in infants at risk for EONS and assess their outcome in terms of the development of sepsis, mortality, and duration of hospital stay. Materials and Methods This retrospective cohort study was done at the Special Newborn Care Unit, GMC Thrissur. The data of babies at risk of EONS over a period of 3 years (2020–2022) was collected. One thousand two hundred and thirty-two babies with at least one risk factor for sepsis, as defined by the National Neonatology Forum (NNF) 2021 guidelines, were enrolled in the study. The antibiotic prescription pattern and the outcomes were measured. Results Empirical antibiotic treatment was received by 61.2% (754/1232) of infants, and of those, 39.5% (298/754) developed EONS. Infants treated with Piperacillin/Tazobactam and Amikacin had a higher incidence of sepsis and mortality than those started on Ampicillin and Gentamicin ( p &lt; .001). In infants less than 32 weeks, the incidence of sepsis increased significantly with increase in number of risk factors ( p &lt; .001). Infants with lower birth weight and gestational age were more susceptible to developing sepsis ( p &lt; .001). EONS was significantly associated with neonatal resuscitation, umbilical vein catheterization, and invasive ventilation ( p &lt; .001). Infants who received empirical antibiotics had a longer hospital stay, with a mean duration of 4.38 days more compared to the no antibiotics group. Conclusion In infants at risk of EONS, the empirical use of antibiotics alone did not show a favorable effect on the incidence of EONS or sepsis-related mortality.

Effect of non-traumatic first trimester per vaginal bleeding on maternal and fetal outcomes in Indian tertiary care teaching hospital

Background: Aim of study was to assess the maternal and perinatal outcomes in first trimester vaginal bleeding. Methods: This prospective observational study was done on 112 patients with first trimester vaginal bleeding at a tertiary care teaching hospital in South India over a period of two years. All the patients who satisfied the inclusion and exclusion criteria were evaluated for the outcomes like hypertensive disorders, post partum and anter partum haemorrhage, rupture of menbranes, anemia, gestational diabetes, pre term delivery, low birth weight, small for gestational age, NICU admissions, intra-uterine growth restriction and mode of delivery. Results: Maximum patients with bleeding per vagina in first trimester belonged to 26-30 years age group out of which majority had spotting. No specific significance was found to be associated between gravida score and bleeding or bleeding types. Out of 75 patients who continued pregnancy, 57 (76.0%) patients had one or the other complication in pregnancy which was significant (p&lt;0.05). Regarding fetal outcomes, 19 had preterm delivery, 10 were LBW while 4 were SGA, 26 required NICU admissions and 8 had IUGR. 48 patients had recurrent bleeding PV which showed no significant correlation with abortion or APH. Conclusions: Study shows that per vaginal bleeding in first trimester may lead to maternal and foetal complications. We recommend training pregnant women regarding those complications and their prevention.

Knowledge, Attitude and Acceptance towards Coronavirus Disease 2019 (COVID-19) Vaccines among Healthcare Students of a Tertiary Care Teaching Hospital in South India: A Cross-sectional Study

Knowledge, Attitude and Acceptance towards Coronavirus Disease 2019 (COVID-19) Vaccines among Healthcare Students of a Tertiary Care Teaching Hospital in South India: A Cross-sectional Study

Clinical Profile, Severity and Intensive Care needs of Children Admitted with Respiratory Syncytial Viral Infections in PICU: Post COVID Trend

Aims: Epidemiology of RSV infection have shown changing trends in the post covid times. Changing pattern in its seasonality have been reported following relaxation of lockdown measures after SARS COVID. Literature describing severity and intensive care needs of pediatric RSV infections are scarce. Our study aims to describe the clinical profile, severity and intensive care needs of pediatric RSV infections requiring PICU admission in post COVID period.&#x0D; Study Design: Retrospective Study.&#x0D; Place and Duration of Study: Paediatric Intensive Care Unit of a tertiary care teaching hospital in south India. Study period was from May 2022 and October 2022, over 6 months.&#x0D; Methodology: All children with clinical diagnosis of viral pneumonia or bronchiolitis were screened. RSV positive cases were taken for the study. The data including age, gender, symptoms, duration of each symptom, respiratory support, duration of oxygen requirement, number of days of PICU stay and outcome of all the children was entered into a structured proforma and data was analysed. The primary objective was to see clinical profile, severity and intensive care needs of RSV affected children aged 1month-12 years admitted in PICU with RSV infections. The secondary objective was to see mortality and length of PICU stay among them.&#x0D; Results: Out of 36 children with clinical diagnosis of viral pneumonia or acute bronchiolitis, 21 tested positive for respiratory virus, out of which 11 were RSV positive. There was a slight male preponderance. All children were aged less than 18 months. All had respiratory failure and required oxygen support (n=11, 100%). Intensive care needs were high flow nasal cannula requirement in 9 patients (n=9,82%), oxygen via nasal prongs (n=1,9%) and mechanical ventilation (n=1, 9%). Median (IQR) duration of oxygen requirements was 6 (5,9) days. Median (IQR) duration of PICU stay was 6(5,8) days. All 11 children survived.&#x0D; Conclusion: In the Post Covid era, RSV was the most identified viral etiology behind viral pneumonia or bronchiolitis in our PICU. All children had respiratory failure, which improved with High Flow Nasal Cannula in majority of the children.

Development of evidence-based indicators for the detection of drug-related problems among ovarian cancer patients.

Background: Antineoplastic drugs produce serious drug-related problems and their management is challenging. DRPs are critical, for saving on therapeutic costs, particularly in resource poor settings within low-middle-income countries such as India. Indicators are clues that helps to detect DRPs within the healthcare organization and minimize overall harm from medications. Indicators enable healthcare professionals to determine the future therapeutic course. And enable healthcare professionals to take a proactive stand, and stay informed and empowered to both prevent and manage DRPs. This study aims to develop evidence-based indicators for detecting potential drug-related problems in ovarian cancer patients. Patients and Methods: A retrospective study was conducted in the Department of Oncology of a tertiary care teaching hospital in South India. Based on literature search, we developed a list of indicators, which were validated by a Delphi panel of multidisciplinary healthcare professionals (16 members). Based on 2years of ovarian cancer data, we performed a feasibility test retrospectively and classified the DRPs according to the Pharmaceutical Care Network Europe classification of DRPs version-9.1. Results: The feasibility test identified 130 out of 200 indicators. A total of 803 pDRPs were identified under four main categories: drug selection problem, drug use problem, adverse drug reaction and drug-drug interaction The most frequently observed were ADR 381 (47.45%), DDIs 354 (44.08%), and drug selection problems 62 (7.72%). Conclusion: Indicators developed by us effectively identified pDRPs in ovarian cancer patients, which can potentially help healthcare professionals in the early detection, timely management, and attenuating severity of DRPs. Identifying the pDDIs can potentially improve interdisciplinary involvement and task sharing, including enhanced pharmacists' participation within the healthcare team.

Detection of potential drug-drug interactions among ovarian cancer patients in a tertiary care teaching hospital in South India- A retrospective approach

BackgroundPotential drug-drug interactions (pDDIs) can alter therapeutic efficacy, involve adverse reactions, and generate novel responses not elicited when either agent is used alone. pDDIs can contribute to morbidity and mortality. Cancer patients are at high risk of pDDIs because of polypharmacy necessitated by chemotherapy, hormone therapy, and supportive care medications. Our study was designed to quantify the prevalence of pDDIs among ovarian cancer patients in a tertiary care teaching hospital in South India. Materials and methodsWe retrospectively analysed data gathered over two years on ovarian cancer patients 18 years and above undergoing antineoplastic therapy (other than radiation and surgery). The patient's treatment charts were reviewed, and the drugs prescribed were analysed for the possible pDDIs using UpToDate software (Lexicomp® database). ResultsA total of 354 pDDIs were detected among 92 patients included in the study, with (56.5%; n = 200) experiencing moderate severity. (52.3%; n = 158) pDDIs fell under pDDIs risk category D, and pDDIs reliability rating was 'fair' in (76.8%; n = 272). Most commonly observed pDDIs for neoplastic agents occurred between paclitaxel and carboplatin (16.4%; n = 58) and between ondansetron and domperidone under supportive therapy (20.9%; n = 74). Polypharmacy accounted for 100% of inpatient prescriptions and 50% of prescriptions at discharge. ConclusionOvarian cancer poses a significant risk of pDDIs and requires an interdisciplinary vigilance policy to prevent, minimize, and manage unwanted effects of pDDIs.

An assessment of quality of life among stroke survivors at tertiary care teaching hospital in South India: A randomized clinical trial

AbstractThe study's primary aim was to examine how a stroke affects health‐related quality of life (QoL), and a secondary aim was to link this event with clinical and sociodemographic factors. Stroke patients were included in the study. First, 94 patients underwent a quantitative analytical cross‐sectional study 3 months after starting medication. Using multivariable linear regression, relationships between the severity of the initial stroke were investigated. From the raw data, we determined the standard deviation and the standard error of the mean. If the p‐value is less than .05, it is considered significant, and if it's less than .0001, it is extremely significant. The majority 94.68% were diagnosed with ischemic stroke, and only 5.32% were hemorrhagic stroke; 56.32% of the patients were male, and 43.68% were female; one‐third of the patients were found to be smokers and alcoholics; 9.57% of the patients had a family history of stroke; and 9.5% of the patients had a history of stroke. Patients with stroke comorbidities, including high blood pressure 88.19%, diabetes 51.06%, high cholesterol 22.34%, coronary artery disease 23.40%, smoking 30.85%, and alcoholism 24.46%. Significant dangers were posed by both hypertension and smoking. There was a statistically significant improvement in quality of life between the two groups, with the intervention group showing a mean difference of 112. The p‐value for this improvement was less than .0001. The quality of life of stroke survivors can be improved through direct screening, monitoring of the patient, planned therapy, and management.

Estimation of Time Since Death From Potassium Levels in Vitreous Humor in Cases of Unnatural Death: A Facility-Based Cross-Sectional Study.

Background Estimation of time since death/postmortem interval (PMI) forms a crucial component for all autopsy surgeons. With the subjectivity that is prevalent with conventional morphological and physical signs of death, newer-age modalities such as chemical analysis providebetter precision. The easy accessibility and the resistance to putrefactionmakevitreous humor the best choice for such chemical analysis. Thus, the present study's aim is to estimate the time since death in cases of unnatural death by investigating the potassium level changes in the vitreous humor. Methodology This is a facility-based cross-sectional study conducted in the mortuary under the Department of Forensic Medicine in a public tertiary healthcare teaching hospital in South India between August and September 2022. Deceased individuals fulfilling the inclusion and exclusion criteria were recruited in the study. Vitreous samples were collected from a single eye and analyzed using an autoanalyzer for potassium values. After due derivations, postmortem intervals were calculated from potassium values, then they were compared with the PMIs estimated using physical signs and those determined using official police records. Data were entered using MS Excel 20 (Microsoft Corporation, Redmond, Washington) and analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 20 (IBM Corp., Armonk, NY). Results Of the 100 deceased individuals included in the study, 68%were men, and the majority (24%) belonged to the age group of 53-62 years. A linear relationship is said to exist between vitreous potassium concentration and postmortem interval. No correlation was seen between the ambient temperature and the potassium levels of the vitreous humor. PMI confirmed by the potassium levelsseconded the PMI given by the police records andphysical signs (Rigor mortis) (Spearman's rho was statistically significant at the two-tailed level or at the 0.01 level with a kappa value of 0.88). Conclusion Potassium measurements in the vitreous humor to estimate the PMI are associated with improved accuracy and precision in determining the time since death. They are not affected by external factors, makingthem a reliable marker for the same.