Tertiary Care Hospital In Chennai Research Articles

Exploration and Evaluation of Adverse Drug Reactions Documented in a Tertiary-Care Hospital in Chennai: An In-Depth Retrospective Observational Study.

While drugs are intended to benefit patients, adverse drug reactions (ADRs) represent a significant negative outcome of drug consumption. They rank as the sixth leading cause of death among hospitalized patients. Many harmful effects are preventable and can reduce morbidity, mortality, and hospitalization duration. This study is a valuable resource for physicians, aiding in the safe and optimal use of medications. This retrospective observational study, conducted at the Pharmacovigilance Center of Saveetha Medical College and Hospital, Chennai, India, received approval from the Institutional Ethics Committee. All adverse drug interactions reported in our hospital from January 2019 to February 2024 were included after screening for inclusion and exclusion criteria. The collected reactions were analyzed, assessed, and evaluated between February 2024 and April 2024. Data on the drugs causing adverse reactions, the types of reactions, and the treatments administered were collected and documented. The reactions were categorized using the Rawlins and Thompson classification, while causality and severity were assessed using the standard Naranjo causality and modified Hartwigand Siegel severity assessment scales. During the study, 252 ADRswere documented by the Central Drugs Standard Control Organization. The gender distribution showed 123 cases (48.8%) in males and 129 cases (51.2%) in females, with a higher prevalence in the 20-40 age group. The departmentwise distribution revealed the highest number of ADRs in Obstetrics and Gynecology (60 cases, 24%), followed by General Surgery (52 cases, 21%), General Medicine (44 cases, 17%), Pediatrics (22 cases, 9%), and Emergency Medicine (20 cases, 8%). Antimicrobial drugs constituted the majority of ADRs (149 cases, 59.1%), followed by vitamins and mineral supplements (21 cases, 13.8%), contrast dye (15 cases, 6%), antituberculosis drugs (15 cases, 6%), analgesics (13 cases, 5.2%), and gastrointestinal (GIT) drugs (8 cases, 3.2%). Cefotaxime was the most commonly reported antibiotic (42 cases, 28.2%), followed by Ciprofloxacin (41 cases, 27.5%). Among vitamins and mineral supplements, iron sucrose was implicated in the highest number of ADRs (15 cases, 71.4%). The parenteral route of drug administration showed the highest incidence of ADRs (229 cases, 91%), followed by oral (20 cases, 8%) and topical routes (3 cases, 1%). Dermatological manifestations were most frequently reported (196 cases, 77.8%), followed by GIT symptoms (27 cases, 10.7%), and other manifestations such as shivering, fever, seizures, and dyspnea (29 cases, 11.5%). Based on the Naranjo causality assessment scale, 179 ADRs (71%) were categorized as probable, 55 (22%) as possible, 10 (4%) as certain, and 8 (3%) as doubtful. Approximately 47.2% of ADRs were self-limiting, while 44.1% required symptomatic treatment and 8.7% necessitated aggressive treatment, leading to a prolonged hospital stay or admission to the intensive care unit. The pattern of ADRs in our hospital aligns with findings from other studies. While many of these reactions are unpredictable and mild, they underscore the importance of raising awareness among clinicians and regulatory authorities to promote safe medication use and prevent potentially serious outcomes.

Prevalence of Bacterial Vaginosis and Its Association With Preterm Birth in a Tertiary Care Hospital in Chennai: A Cross-Sectional Study.

Background The most common preventive cause of premature labour is ascending infections.This study was conducted to evaluate the association between bacterial vaginosis (BV) and preterm labour in antenatal women and determine the significance of using the Amsel criteria to screen for BV. Methods This was a hospital-based cross-sectional study conducted among 100 antenatal mothers in the second trimester attending the antenatal OPD at a tertiary care hospital in Chennai from October 2019 to September 2021 after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. Data were entered in Excel (Microsoft Corporation, Redmond, WA) and analysed in SPSS (IBM Corp., Armonk, NY). Results According to the Amsel criteria, BV was detected in 21 women (21%). Neither maternal age nor parity had an effect on the study group. There was a statistically significant relationship (p < 0.05) between the mode of delivery, preterm labour, and the study group. Of the 21 positive BV cases, 95% were positive for clue cells and only 5% were positive for gram-negative bacteria. Consequently, BV was found to be associated with early labour. There is no association between BMI and BV (p > 0.005). Conclusion In the current study, BV was shown to be associated with preterm labour. Our study underscores the significance of the Amsel criteria as a valuable tool for screening BV in antenatal women.

EVALUATION OF INCOMPATIBLE CROSSMATCHES AT A TERTIARY CARE HOSPITAL IN CHENNAI – A PROSPECTIVE STUDY

Objectives: The primary goal in blood transfusion is that the transfused blood unit be compatible with the patient during crossmatching. This compatibility testing is performed before every administration of blood component. This cross-matching test helps to detect the presence of antibodies in the recipient against antigens over red blood cells of donor. The aim of this study was to evaluate the incidence and causes of in compatible crossmatches in patients by tube agglutination method. Methods: This was a retrospective cross-sectional study conducted by analyzing incompatible crossmatches encountered during routine compatibility testing between January and December 2021 at the Department of Transfusion Medicine, Government Kilpauk Medical College and Hospital, Chennai, Tamil Nadu, India. The analysis was done in March and April 2022. All crossmatches were done by tube agglutination technique. Data were entered in Microsoft Excel and analyzed. Descriptive statistics were given in summary statistics. Results: Out of the total of 12943 crossmatches performed, 0.3% (n=39/12943) were incompatible. About 76.9% (n=30/39) were seen in females while 69.2% (n=27/39) were seen in the age group 20–60 years. About 35.9% (n=14/39) of the incompatible crossmatches were due to autoimmune hemolytic anemia (AIHA). A root cause analysis protocol was formulated to resolve the incompatibility and ensure safe transfusion. Conclusion: AIHA was the most common cause of incompatible crossmatch. The root cause analysis protocol involves a thorough evaluation of the patient’s clinical condition, underlying pathology, and errors during technical procedure to identify the cause of incompatibility. Protocols should be developed in each blood center and a logical stepwise approach will enable the provision of safe transfusion.

Effectiveness and usage of written and verbal counselling information on anxiety in MRI at a tertiary care hospital in Chennai

Background: Many people have considerable anxiety when having magnetic resonance imaging (MRI). Fear during an MRI causes the process to drag on longer and the quality of the images to decline, which increases expenses and requires labor loss. Objective: This study sought to determine how vocal and written information affected patients' anxiety during MRI procedures. Materials and Methods: A prospective cross-sectional study with 300 participants was conducted. The investigation occurred in March and April of 2022 at the tertiary care hospital's radiology department. Three participant groups were formed: group 1 received textual material, group 2 served as the control group, and so on; and group 3 learned about counseling. The State-Trait Anxiety Inventory (STAI), a measure of anxiety levels, was used to determine the people's traits and state of anxiety. Results: The three groups' trait anxiety scores did not significantly differ (p = 0.20) from each other's demographic features. Statistically speaking, group 3's state anxiety levels were lower than those of group 2 and the control group. Group 2's state anxiety levels were statistically lower (p&amp;lt;0.001) than those of the control group. Conclusion:Verbal and written information can help to lessen MRI anxiety. Written information may not be as good at lowering MRI anxiety as verbal information.

Association Between Serum Ferritin and the Duration of Type 2 Diabetes Mellitus in a Tertiary Care Hospital in Chennai.

Hyperinsulinemia has been linked to increased ferritin production and iron absorption in type 2 diabetes mellitus, ultimately leading to increased iron storage. Glucose intolerance is intimately linked to this issue. Increased oxidative stress from iron decreases insulin's ability to be taken into cells and used for energy. Researchers suggest that increased iron levels in the body play a role in the emergence of insulin resistance, glucose intolerance, and vascular repercussions associated with diabetes. The aim of this study is to assess the levels of serum ferritin and fasting plasma glucose in both diabetic and nondiabetic individuals while establishing a relationship between the two. Exploring the connection between serum ferritin levels and the duration of diabetes mellitus in individuals diagnosed with diabetes is our objective. In this study, 80 men diagnosed with type 2 diabetes mellitus were included, and they were compared with 70 male volunteers who were in good health. We took blood samples while the subjects fasted, and we analyzed the plasma glucose and serum ferritin levels. In the diabetic group, there were notably higher levels of serum ferritin and fasting plasma glucose compared to the nondiabetic subjects. Furthermore, a correlation was observed between the duration of diabetes among participants with diabetes and elevated serum ferritin levels. The findings suggest that low-grade inflammation and increased body iron stores are positively related to hyperglycemia in type 2 diabetes mellitus.

Perception and Practices Related to Breast Milk Donation and Acceptance among Donor and Recipient’s Mothers of a Breast Milk Bank at a Tertiary Care Hospital in South India

Background: Human Milk Banks (HMB) ensure the availability of pasteurized donor breast milk for small forgestational age babies, low birth weight infants, sick new born and infants of mothers with failed lactation.Objectives: To assess the perception, practices and associated factors of breast milk donation and acceptanceamong donor and recipient’s mothers registered with the breast milk bank.Methodology: This hospital based cross-sectional study was conducted between July to September 2019 among70 donors and 70 beneficiaries who were mothers of children under 6 months of age, registered at the breast milkbank at a tertiary care hospital in Chennai. Data was collected by interview of the mothers with a predesignedsemi-structured questionnaire.Results: Only 74% of them were aware of breast milk bank services. Almost 47 (67.1%) had received more thantwice from breast milk bank. Proportion of recipient’s mothers who had complications during their delivery andproportion of children who were treated in NICU were significantly higher among the recipients (p &lt; 0.001).Conclusion: Awareness on breast milk bank services is required especially among the mothers of prematurebabies, low birthweight neonates, and newborn receiving treatment in NICU.

Validity and performance of cognitive scales in elderly patients with depression in a tertiary care hospital in Chennai

Background: Late-life depression in older adults can cause reversible cognitive impairment, often resulting in pseudo-dementia. Cognitive impairment can lead to executive dysfunction, reduced flexibility, and difficulty thinking and decision-making. This study aimed to assess the validity and performance of cognitive scales in late-life depression among patients attending the outpatient department of the institute of mental health, Chennai. Methods: This prospective study included 360 patients aged &gt;50 years who were diagnosed with depression and attended the OPD at the institute of mental health, Chennai. Baseline assessments were performed at the time of recruitment into the study (visit 1), and scheduled visits were performed every six months for two years (visits 2 to 5). Unscheduled visits were done every month, and adverse events were monitored and recorded periodically Results: Among 59 patients, 53.1% were female, 32.2% were diabetic, and 93.9% were experiencing subjective working difficulties. The Montreal cognitive assessment scale classified 51.4% as moderate, while the ADAS-cog and ACE scales classified 86% and 99.7%, respectively, as having abnormal mental status. However, a significant correlation and discrepancy between scores were observed for scales such as ACE, ADAS-cog, standardised mini-mental status examination, and Montreal cognitive assessment scale. A strong correlation was found between ACE, MMSE, MoCA, and ACE; however, FAST showed a significant negative correlation. The MoCA was strongly correlated with the MMSE, ACE, ADAS-cog, and Mini-Cog, indicating good alignment with the FAST. Conclusions: Cognitive scales strongly correlate with late-life depression in patients, suggesting an improvement in assessment, evaluation, and treatment to address cognitive deficits.

Clinicodemographic profile and treatment outcomes of COVID-19 patients admitted in a designated tertiary care hospital, Chennai: A comparative analysis of first and second wave of the pandemic

Background: COVID-19 caused by severe acute respiratory syndrome (SARS)-COV 2 virus was declared a pandemic by the WHO in March 2020. India has reported 44,689,512 cases and 530,779 deaths as of March 9, 2023. Different variants may lead to varying clinical presentations and outcomes, emphasizing the need for ongoing analysis of local COVID-19 patients. Aims and Objectives: To describe the clinic-demographic profile and treatment outcomes of COVID-19 patients in a tertiary care hospital in Chennai and to compare the patient characteristics during the first two waves of the pandemic in India. Materials and Methods: A retrospective record-based study analyzed patients with SARS-CoV-2 between May 2020 and July 2021, collecting data on demographics, travel history, symptoms, hospital stay, and outcome. Data were analyzed using SPSS Version 20.0. Chi-square test and Fisher exact tests were used to ascertain significant association between variables. Results: Out of 944 cases of COVID-19, 70% were aged 20–60 years with a male predominance in both waves. The mean age during the first wave was 45.04±17.32 and during the second wave was 45.86±15.49. Intensive care and ventilatory support needs increased in the second wave. Hospital stay was longer during the first wave. Death rates were 3% and 14% in the first and second waves, respectively. Conclusion: In our study, community transmission was observed as most COVID patients did not have travel history. Males, elderly and those with comorbidities were heavily impacted. The second wave had higher ICU and mortality rates.

Association of Asthma With Patients Diagnosed With Metabolic Syndrome: A Cohort Study in a Tertiary Care Hospital.

Introduction Asthma is defined as a chronic inflammatory airway disease. The prevalence of both asthma and obesity has been rising simultaneously, demonstrating a parallel trend. Obesity is a significant factor in metabolic syndrome, and numerous studies have indicated a connection between metabolic syndrome and bronchial asthma. Aims and objectives The aim of this paper is to evaluate the association of asthma with patients diagnosed with metabolic syndrome. The main objectives were to analyze the clinical profile and spirometric indices in patients with metabolic syndrome and to assess asthmatic patients among them with spirometry and clinical parameters at a tertiary care hospital in Chennai. Materials and methods This hospital-based cohort study was conducted on 73 patients attending the outpatient department who had a known case of metabolic syndrome and were evaluated for asthma through history, physical examination, and a pulmonary function test. A history of cough, expectoration, shortness of breath, wheezing, chest tightness, allergy, seasonal variation, and smoking habits was asked, and a thorough physical examination was performed. Bronchial asthma was confirmed with airflow reversibility by spirometry as per the Global Initiative for Asthma Guidelines. Metabolic and spirometry parameters were examined, such as body mass index (BMI), waist circumference, waist-hip ratio, fasting blood sugar (FBS), postprandial blood sugar, hemoglobin A1C (HbA1C), serum insulin, lipid profile, C-reactive protein (CRP), forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), and FEV1/FVC pre- and post-reversibility (baseline vs. six months). Results and discussion The average BMI of all participants was 29.6511 ±2.64564. The waist-hip ratio was 0.5512 ±0.43855, which decreased during the follow-ups, demonstrating a decline in the risk of obesity in study participants. The level of HbA1C showed a drop from 6.1% to 5.9% at the first follow-up. This exhibited a further reduction at the six-month follow-up in addition to a positive reflection in insulin sensitivity, indicating successful control of diabetes among study participants. It was discovered that this was statistically significant (p<0.001). At the third and sixth months of follow-up, the FEV1/FVC ratio increased by 38% and 37%, respectively, when metabolic syndrome was under control. The results show that controlling diabetes, hypertension, obesity, and triglyceride values improved asthmatic symptoms, and this was determined to be statistically significant (p<0.001). Conclusion The results of the current study demonstrated that the regulation and maintenance of metabolic parameters such as BMI, diabetes, hyperlipidemia, and hypertension aid in improving asthma control.

Prevalence of Dermatophyteic Infection in A Tertiary Care Hospital in Chennai in India

Dermatophytes are fungi that infect keratinized tissues in animals and humans. The group's most prevalent and only anthropophilic species is Trichophyton rubrum, whereas species from the Trichophyton mentagrophytes complex are zoophilic and anthropophilic. The prevalence of dermatophyte infections varies depending on environmental factors and location, with higher rates observed in tropical countries like India. Hence, this study was conducted to comprehend the distribution of various species and clinical symptoms to assess the prevalence and features of dermatophyte infections in patients receiving tertiary care. This study's main objective was to identify the frequency of dermatophyte species in clinical samples taken from suspected patients in a tertiary care centre.1000 patients attending Sree Balaji Medical College in Chennai were the subjects of cross-sectional observational research. The prevalence of dermatophyte infection was assessed using clinical sample data. The analysis included information on gender, age group, and clinical symptoms. In the examined samples, dermatophyte infection was shown to be clinically prevalent (14.2%). More men (64.7%) than women (35.2%) were impacted. The most common age group for dermatophyteic infection was those between 31 and 40 years. The most typical clinical presentation was tinea corporis, characterized by scaly, red areas on the skin. The most frequent dermatophyte species found was Trichophyton rubrum. The study revealed that the clinical samples taken from the tertiary care centre had a significant prevalence of dermatophyteic infection. These infections were more likely to affect men and those in the age range of 31 to 40 years. The most commonly noticed clinical sign was tinea corporis, caused by Trichophyton rubrum. These findings emphasize the need to detect and treat dermatophyteic infections, particularly tinea corporis, highlighting the need for suitable treatment techniques in the population under study.

Incidence and risk factors of Retinopathy of Prematurity – a prospective observational study

Objective Retinopathy of Prematurity (ROP) is a vasoproliferative retinopathy that affects the developing retinal vessels of premature infants. Identification of risk factors is essential for its early detection and intervention. The study was aimed to assess the incidence of ROP and to determine the risk factors associated with ROP. Methods It was a prospective observational study which included preterm neonates admitted in neonatal intensive care unit of a tertiary care hospital in Chennai,Tamil nadu,India from December 2020 to September 2021. Screening for ROP was performed for all neonates below 34 weeks gestation and between 34 to 36 weeks with risk factors for ROP. Association between risk factors and ROP was determined using chi square test for categorical variables and students t test for continuous variables. A p value less than 0.05 was considered significant. Results Of the 140 neonates screened, 45(32.1%) neonates were diagnosed to have ROP. Among the neonates detected to have ROP there were 24(53.3%) male. 34(75.6%) neonates had a birth weight less than 1.75 kg, 27(60%) neonates had a gestational age less than 34 weeks,22 (48.9%)neonates were born to primi mothers, 25(55.6%) neonates were delivered by normal vaginal delivery. Among the neonatal risk factors studied, sepsis was found to have a significant association with ROP (p=0.02). ). Risk factors like apnoea, respiratory distress syndrome, intraventricular hemorrhage, oxygen therapy and blood transfusion did not have a significant association with ROP. Conclusion The present study revealed an incidence of ROP of 32% and there was significant association with sepsis.

Seroprevalence of Hepatitis C Virus Infection among Hemodialysis Patients in A Tertiary Care Hospital in South India

Hepatitis C virus (HCV) infection in hemodialysis patients is mainly associated with insufficient precautionary measures. Compared with the general population, the prevalence of HCV infection is high among hemodialysis patients. HCV infection in these patients is typically associated with increased morbidity and mortality; however, the early detection of HCV may retard disease progression and reduce morbidity and mortality. In this study, we sought to estimate the seroprevalence of HCV infection among patients undergoing hemodialysis in a tertiary care hospital in Chennai, Tamil Nadu, South India. This was a prospective, observational, cross-sectional study that included 82 hemodialysis patients. Blood samples were collected from each patient, and the serum was separated for detection of the presence of HCV antibodies, HCV core antigen, and HCV RNA using an enzyme-linked immunosorbent assay, enzyme immunoassay, and polymerase chain reaction, respectively. Relevant socio-demographic, clinical, and laboratory information was also obtained. Among samples collected from the 82 patients, seven were found to be positive for HCV antibodies, whereas nine and eleven samples were found to be positive for HCV core antigen and HCV RNA, respectively. Long durations of renal failure and hemodialysis were identified as being positively associated with HCV infection in these hemodialysis patients, and a statistically significant reduction in hemoglobin levels and an increase in creatinine levels were detected among the HCV-positive patients. The overall seroprevalence of HCV infection in hemodialysis patients was found to be 13.4%. Given that high rate false-negative reactions were detected using ELISA and EIA, screening of HCV RNA during the early stages of HCV infection can contribute to preventing its nosocomial spread in these patients. Moreover, it is imperative that stringent universal precautionary measures are implemented in all health care settings and hemodialysis units to minimize the risk of HCV transmission.

Glycemia and New-Onset Diabetes among COVID-19 Patients with Prediabetes: A Follow-Study of Case Series in India

Studies have shown that COVID-19 patients with prediabetes frequently present with high plasma glucose levels on hospital admission. However, whether the glycemic abnormalities are temporary or persist after recovery from the illness is unclear. We conducted a follow-up study of the case series of 69 COVID-19 patients with prediabetes (HbA1c 5.7–6.4%) who were admitted to a tertiary care hospital in Chennai, India, from May to October 2020 and were discharged alive. Over a mean follow-up of 146.6 (SD: 72.5) days, the mean fasting plasma glucose rose significantly by 16.8 mg/dL (from 119.3–136.1 mg/dL), 2-hr post-prandial glucose by 61.0 mg/dL (from 176.2–237.2 mg/dL), and HbA1c by 0.6% (5.9–6.5%). Of the 49 (84.5%) patients who were discharged with glucose-lowering medications, 40 (81.6%) continued taking them at the first follow-up visit (mean of 50.1 days from admission), and 39 (79.6%) continued taking them at the second follow-up visit (mean of 114.3 days from the first follow-up visit). In addition, 12.1% of patients developed new-onset diabetes after recovery from the illness. These findings underscore the importance of regular monitoring of glycemic parameters in COVID-19 patients with prediabetes after recovery.

Association between Admission Blood Glucose Levels and Clinical Outcomes among Diabetic Adults Admitted to a Tertiary Care Hospital in Chennai, India: A Retrospective Study

Introduction: Admission blood glucose levels have an impact on hospitalisation and Length Of Stay (LOS). Uncontrolled blood glucose levels have been found to affect patients’ outcomes. Elevation of the initial blood glucose level during critical diagnosis was identified as an independent risk factor for in-hospital mortality in critical cases. Aim: To examine the association between admission blood glucose levels and clinical outcomes in adult diabetic patients. Materials and Methods: This retrospective study was conducted at a tertiary care hospital in Chennai, Tamil Nadu, India. Data were collected between July 1, 2021, and August 31, 2021, using non-probability convenience sampling from 522 records of adult diabetic patients admitted between January 2019 and March 2020. Capillary random blood glucose levels at the time of admission and their effects on LOS, both in the hospital and Intensive Care Unit (ICU), readmission, and mortality data were collected. Statistical analysis was performed using the Chi-square test. Results: Analysis of the records of 522 adult diabetic patients revealed that the mean and standard deviation (SD) of admission Capillary Blood Glucose (CBG) level were 177.46±49.42 mg/ dL, and the mean LOS in the hospital was 4.54±3.89 days. It was found that 340 (65.1%) patients had an admission duration of ≤4 days. There was a statistically significant association between admission blood glucose levels and LOS in the hospital (p-value=0.01), LOS in the ICU (p-value=0.008), readmission to the hospital (p-value=0.001), and mortality rate (p-value=0.0001). Conclusion: The study demonstrates that admission blood glucose levels are associated with the clinical outcomes of patients. These findings substantiate the need for maintaining normal glycemic levels through patient education and a proactive team approach to improve patient outcomes.

Seroprevalence of Human Papillomavirus Infection among Female Sex Workers in a Tertiary Care Hospital in Southern India

Introduction: Sexually Transmitted Infections (STIs) are generally acquired through sexual contact, and the risk is very high for Female Sex Workers (FSWs). The most common STI in FSWs is Human Papillomavirus (HPV) infection. Majority of the HPV infection is asymptomatic, while a minority of the infection is responsible for causing cervical cancer. High-Risk HPV (HR-HPV) serotypes, HPV 16 and HPV 18, are known to cause cervical cancer. Aim: To determine the seroprevalence of HPV infection among FSWs attending STD clinic at a tertiary care hospital in Southern India. Materials and Methods: This cross-sectional study was done during the period between September 2015 and August 2016 in a total of 65 FSWs in Govt. Stanley Medical College, a tertiary care hospital in Chennai, Southern India. The serum was separated after 5 mL of blood was drawn to test for the presence of HPV 16 and 18, Human Immunodeficiency Virus (HIV), and syphilis. Endocervical and vaginal swab specimens were taken to look for the presence of other STIs. Necessary socio-demographic and clinical information such as mode of sex, any sexual exposure, extramarital or premarital, protected sex or not, history of associated STIs, and any history of blood transfusion, i.v. drug abuse, or surgery was also obtained. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) 20.0 software. Probability value (p-value) &lt;0.05 was considered statistically significant. Results: Analysis of the blood samples showed that four samples were found positive for HPV infection, while two samples each were positive for HIV and syphilis. Analysis of the swab specimens showed the presence of other associated STIs in 20 samples. Among the four HPV positive samples, three were found positive for HPV 16, and one was positive for HPV 18. Risk factors such as age, marital status, HIV, and syphilis had a very strong association with HPV infection (p-value&lt;0.01). Conclusion: The prevalence of HR-HPV serotype HPV 16 was higher than HPV 18. Hence, education about STIs, safer sexual practices, and HPV vaccination are essential in this population in order to prevent the transmission of infection to the general population.

Non venereal Female Genital Dermatoses: Beyond Sexually Transmitted Infections: A Cross-sectional Study

Introduction: Genital dermatoses can be categorised as either venereal or non venereal. Non venereal genital dermatoses have various causes, and their presentation may differ from that of cutaneous lesions due to local factors. Therefore, it is crucial to have a proper understanding in order to differentiate non sexually transmitted genital dermatoses from sexually transmitted ones. Aim: To study the clinical patterns of non sexually transmitted genital dermatoses in females aged above 18 years. Materials and Methods: A cross-sectional study was conducted at the Outpatient Department (OPD) of Dermatology at a Tertiary Care Hospital in Chennai, India, over a period of one year and six months. It involved 120 female patients above 18 years of age who were diagnosed with non venereal genital dermatosis. All patients were included in the study after providing informed consent. Patients with a history of significant anatomical alterations due to trauma or surgery were excluded. A detailed clinical history was obtained, followed by a thorough dermatological examination. After diagnosing non venereal genital dermatoses, classification based on aetiology and site of involvement was performed. The presence, distribution, and any associated conditions were also studied. Data was entered into a Microsoft Excel datasheet and analysed using Statistical Package for Social Sciences (SPSS) version 22.0. Categorical data was presented as frequencies and proportions. Results: The mean age of the study participants was 43.08 years. The present study identified 21 different types of non venereal dermatoses, with infectious dermatosis being the most common in 60 (50%) cases, followed by inflammatory dermatosis 33 (27.5%) cases, miscellaneous conditions in 19 (15.83%) cases, benign and physiological conditions in 7 (5.83%) cases, and malignancies in 1 (0.83%) case.. Vulvovaginal candidiasis was the most common dermatosis observed in the present study, accounting for 21 cases (17.5%) of the entire study population. Conclusion: Genital diseases can cause significant psychological trauma and anxiety for patients. It is important to note that not all genital dermatoses are sexually transmitted. Non-venereal dermatoses affecting the external genitalia in females encompass a spectrum of diseases with diverse aetiologies. Therefore, accurate diagnosis of these non venereal dermatoses is crucial to alleviate the patient’s concerns regarding sexually transmitted diseases and the associated stigma.

Various Prognostic Factors in Metastatic Brain Tumours: A Cross-sectional Study

Introduction: The most common type of intracranial neoplasms seen in neurosurgical practice is metastatic brain tumours. Adults with cancer have an 8-10% lifetime risk of developing symptomatic metastases. Breast cancer and lung cancer are the commonest to give brain metastases. However, the number of reported cases in India is still a portion of the true prevalence of brain metastases. In order to better understand the clinical presentation of brain metastases, their distribution, and other variables that impact their survival, this research was planned and conducted. Aim: To analyse the distribution of metastatic brain tumours, their primary source, characteristics of imaging, the different modalities of treatment and the factors which affect their survival like Karnofsky’s performance score, time interval between diagnosis of primary and metastasis, treatment method adopted. Materials and Methods: The cross-sectional study was carried out in a tertiary care hospital in Chennai, Tamil Nadu, India during the period from June 2018-May 2021 and included 102 metastatic brain tumour patients with proven biopsy of either of the primary or secondary lesions. Individuals who neither had the main nor the secondary lesion verified by biopsy are excluded. Among these patients, the parameters studied were incidence of various primary tumours, demographic profile, clinical features, imaging characteristics, performance status of the patient, treatment options, patient survival in relation to performance status, pathology, time interval between diagnosis of primary malignancy and the onset of secondary lesions. The results were analysed for the factors which affect survival like nature of systemic disease, source of primary, number of metastatic lesions, treatment methods adopted. Results: The commonest age group involved was 40-69 years (81, 79.41%). Female to male ratio of 4:1 in the age group of less than 40 years and the overall male to female ratio was 1:1.04. Lungs being the commonest primary source (42%) followed by breast and unknown primary. Ring lesion was the commonest appearance of metastasis (51, 50%), followed by cystic lesions (8, 7.84%) and haemorrhagic secondaries (3, 2.94%). Breast primary had a survival rate of 58.3% with better prognosis. Good karnofsky performance score, longer interval between diagnosis of primary and secondaries brain, combining surgery along with radiotherapy were also found to have good prognosis. Conclusion: Metastatic brain tumours are the commonest intracranial tumours. The favourable prognostic factors are the breast primary, younger age patients with good karnofsky’s score. Surgery along with radiation shows promising results than radiation alone even in poor grade patients

Mortality and Morbidity among Neonates Born to COVID-19 Positive Mothers in a Tertiary Care Hospital, Chennai: An Ambispective Cohort Study

Introduction: The Coronavirus Disease-2019 (COVID-19) pandemic, caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) virus, has had varied clinical impacts across different age groups. Understanding the morbidity and mortality rates among neonates born to COVID- 19 positive mothers is crucial for ensuring preparedness within the healthcare system. Aim: To compare the morbidity and mortality rates of newborns born to COVID-19 positive and negative mothers. Materials and Methods: This ambispective cohort study was conducted at a tertiary care hospital in Chennai, Tamil Nadu, India between August 2021 and October 2022. Newborns born to mothers with COVID-19 at the time of delivery were classified as cases, while newborns born to the next two COVID-19 negative pregnant women who delivered immediately after the COVID-19 positive mother were considered as controls. The study included a sample of 214 COVID-19 positive mothers and 426 COVID-19 negative mothers. Clinical data were recorded, and all newborns were followed for one week to assess their morbidity and outcomes. Logistic regression analysis was performed to determine whether COVID-19 infection is a risk factor for adverse neonatal outcomes. Results: Among the newborns, 357 (55.8%) were females, and 333 (52%) were delivered via caesarean section. Of the newborns, 39 (6.1%) were preterm and 95 (14.8%) had low birth weight. The overall mortality rate was 1.25%. Four (1.8%) neonates tested positive for COVID-19. Logistic regression analysis revealed that caesarean section, respiratory distress syndrome, and prematurity were statistically significant morbidities associated with maternal COVID-19 positive status. The odds ratios (with 95% confidence intervals) were 4.090 (2.840-5.882) for caesarean section, 2.291 (1.508-3.480) for respiratory distress syndrome, and 2.359 (1.181-4.712) for prematurity. The mortality and other morbidities were similar between the two groups. Conclusion: Respiratory distress syndrome and prematurity were the common morbidities observed in newborns born to COVID-19 positive mothers.

A Comparative Study of Work Stress among Working Females Getting Paid and Working Women Unpaid (Housewives) During Pregnancy.

The potential impact of employment on pregnancy is an important issue as several occupational factors have been reported to be associated with adverse pregnancy outcomes through increased work stress. The current study was undertaken among pregnant women to understand the difference in pregnancy-related stress among pregnant working women getting paid (WWP) and working women unpaid (WWU) (housewives) and to assess workplace stress among working WWP. A total of 426 study participants which included 213 participants in each group were recruited from a tertiary care hospital in Chennai. All the study participants were interviewed using an A-Z scale to understand pregnancy-related stress while WWP were also interviewed using Workplace Stress Questionnaire (WSQ). It was observed that the mean score of WWP was significantly higher than the mean scores of WWU (t = 94.63; df = 1, P = 0.000). Those WWP who were working for >8 h daily had higher scores as compared to those working for ≤8 h. The study shows that the WWP had work stress in addition to background pregnancy-related stress.

Association of prolactin and insulin with obesity in women with polycystic ovarian syndrome

Introduction and Aim: Polycystic Ovarian Syndrome (PCOS) manifests with menstrual irregularities, infertility, galactorrhoea and hirsutism. Hormonal irregularities are found to be the pathogenesis behind PCOS. The study was aimed to evaluate whether obesity is associated with serum prolactin and insulin levels in PCOS women. Materials and Methods: This case control study was conducted in a tertiary care hospital in Chennai. Control group included 30 apparently healthy women and cases included 30 PCOS patients, diagnosis based on Rotterdam criteria. The individuals were of 20-40 years of age in both the groups. The serum prolactin and insulin were analysed by ELISA. The obtained data were checked for normality of distribution and subjected to statistical analysis. Receiver Operating Characteristics (ROC) curve was done. Statistical analyses were performed using SPSS version 16.0. P less than 0.05 was considered statistically significant. Results: The median and interquartile range (IQR) of serum insulin were 11.5 (1.8-70) and 5 (1.8-44) mIU/L in cases and controls respectively. The cut-off level of insulin was 7.0 mIU/L. The median and IQR of serum prolactin were 12.5 (4.5-53.0) and 12 (3.5-20) ng/mL in cases and controls respectively. BMI was positively correlated with age of the participants and prolactin. Conclusion: PCOS is prevalent among obese reproductive individuals. Insulin was markedly elevated in PCOS individuals. Insulin resistance alters levels of luteinizing hormone and sex hormone binging globulins. Hyperprolactinemia is associated with anovulation or oligoovulation, galactorrhoea and hirsutism. In obese PCOS women, prolactin and insulin could be diagnostic markers of PCOS.