Tertiary Care Hospital In Chennai Research Articles

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.

COVID-19-associated Neurological Manifestations and Complications: An Observational Study.

Coronavirus disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), led to one of the deadliest pandemics faced by mankind. The typical manifestation of COVID-19 infection includes respiratory distress. However, we know that the characteristic immunologic pathways of SARS-CoV-2 infection inflict systemic disorders and eventually multi-organ dysfunction in a subgroup of patients. The disease can affect both central and peripheral nervous systems. The aim of our study was to describe the wide spectrum of neurological manifestations associated with SARS-CoV-2 infection and its clinical characteristics. We conducted a retrospective, single-center, observational study to analyze neurologic manifestations associated with COVID-19 patients from May 2020 to September 2021 at a tertiary care hospital in Chennai, South India. A total of 80 COVID-19-confirmed patients with neurological disorders were included in our study. The most reported neurological manifestation was altered sensorium (29.6%). Twenty-nine (34.4%) patients were on noninvasive ventilation and a significant number of patients (22) (26.8%) needed invasive ventilation. The mortality rate was 34.1% and the large vessel involvement in stroke patients was 10%. Neurological issues in COVID-19 patients are relatively common and have the propensity to manifest later as post-acute COVID-19 syndrome.

HISTOMORPHOLOGICAL EVALUATION OF TUMOURS OF FEMALE GENITAL TRACT AND ITS CHANGE IN TUMOUR PROFILE OVER A PERIOD OF 12YRS IN A TERTIARY CARE REFERRAL HOSPITAL IN CHENNAI.

Background: The most common cause of morbidity & mortality among females are due to cancers arising from female reproductive organs next to breast cancers. The most common sites include uterine cervix, corpus uteri & ovary followed by least common sites like vulva, vagina, fallopian tubes and gestational trophoblastic diseases. Aim of the study: 1. To evaluate the trend in the prole of benign, premalignant & malignant lesions of female genital tract (FGT) tumours at primary tertiary care hospital in Chennai. 2. To study frequency, age distribution & diverse histomorphological spectrum of tumours of female genital tract. 3. To compare and analyze our data with other published studies in the literature. Materials & Methods: This cross sectional retrospective observational study was conducted at tertiary care gynaecological center at Chennai over a period of 12 years from Jan 2008 to Dec 2019. The medical records were retrieved, data analyzed and the results were expressed in descriptive statistics. Results: During the study period we received 44752 histopathological specimens out of which 12477 cases were gynaecological malignancies. Cervix uteri (66.38%) was the most common site followed by ovary (16.65%), corpus uteri (10.71%), gestational trophoblastic disease (4.13%), vulva (0.82%), vagina (0.36%), fallopian tube (0.02%), and vault carcinoma (0.93%). Squamous cell carcinomas were most common type of malignancy in cervix (93.15%), vulva (91%), vagina (82%) & vault (78%). Endometrial adenocarcinomas (81%) were more frequent tumour in corpus uteri while surface epithelial tumours constitute 78.72% of cases in ovary. For gestational trophoblastic disease, 78.25% of cases had complete molar pregnancy. 41-50yrs of age groups were commonly affected for cervical, ovarian & endometrial malignancies where as in vulval lesions the most common age group was 61-70yrs. In case of gestational trophoblastic disease the majority of patients were presented at 21-30yrs of age. Conclusion: This is one of the largest studies conducted with more than 10000 cases being reported in female genital tract. Cervical carcinomas are the leading gynecological malignancy followed by ovary & corpus uteri at our institute. There is a declining trend in the distribution of cases among cervical cancers were as there is an increasing trend in distribution of cases in other site like ovary & corpus uteri.

Significance of Bcl-2 expression in breast cancer

Introduction and Aim: The most prevalent and lethal form of cancer in women, breast carcinoma is thought to account for 2,088, 849 (11.6%) of all new cases each year. Protooncogene Bcl-2 is primarily present in the perinuclear membrane. Examining the significance of Bcl-2 expression as a predictive factor in breast cancer is the goal of the current investigation. Materials and Methods: From December 2019 to January 2021, a tertiary care hospital in Chennai conducted this investigation on 42 cases of mastectomy specimens. Using tools from Path Insitu, Bcl-2 marker immunohistochemistry was carried out. Scores were taken after observing Bcl-2 expression in the cytoplasm of tumor cells. Results: Total 42 cases were studied, and the age of patient ranged from 33-80 years. Out of 42 cases of IDC-NST (Invasive ductal carcinoma- No special type) 19 cases (45%) showed positive expression and 23 cases (54%) showed lack of staining for Bcl-2. Tumor size and grade of IDC-NST has significant relationship with Bcl-2 expression with p value of 0.05. No correlation has been found between lymph nodes harboring malignant cells and Bcl2 expression with p value >0.05. Conclusion: The staging and prognosis of breast cancer depend heavily on the size, grading based on histopathology, and lymph node harboring tumor cells. Hormonal receptor tests are frequently used in the process of treating breast cancer. The goal of the current investigation was to assess Bcl2's value as an additional marker for prognosis. Significant Bcl-2 expression was seen in tumors of modest histologic grade and size.

The influence of pica practice on nutritional status, stress and anxiety of pregnant women

Pica is a minor disorder in pregnancy associated with strong craving for food or non -food substances of little or no nutritional value. ObjectiveThe study assesses the characteristics of pica practice among pregnant women and evaluates its influence on the nutritional status, anxiety and stress of pregnant women. MethodsA cross-sectional study was conducted among pregnant women attending the antenatal unit of a tertiary care hospital in Chennai, India. Pregnant women took a survey for presence of pica practice. Women with pica practice were assessed for dietary information, haemoglobin, pre-pregnant body mass index and stool analysis. Women's anxiety and stress were assessed using Beck anxiety inventory scale and Lipp Stress Inventory Scale. ResultsOut of 739 pregnant women screened, 220 (29.7%) women were found to practice pica. Of the 220 women, 42.2% ingested food substances, 41% ingested non-food substance and 16.8% consumed both. The most common substances craved for were: unripe mango (42.2%), pagophagia (23.8%), ash (41%) and geophagia (19%). Amongst the women with pica, 67.3% women had anaemia, 36% were underweight and 9.5% were overweight. About 40% women had low anxiety, 43% had moderate anxiety and 17% had severe anxiety. Distribution of women based on phases of stress found 15.4% in alert phase, 65% in resistance phase, 1.4% in near exhaustion phase, and 18.2% in exhaustions phase. ConclusionThe study identified that pica practice is not limited to ingestion of edible substances alone. Women practicing pica during pregnancy had anaemia, increased levels of stress and anxiety.

Detection of multidrug resistance and associated genes among <em>Salmonella</em> species from enteric fever cases

Background: Salmonella spp. has rapidly gained resistance to ampicillin, chloramphenicol, co-trimoxazole, and tetracycline (ACCoT) which necessitated the use of fluoroquinolones and cephalosporins. However, there are reports on emergence of fluoroquinolone-resistant Salmonella isolates in various parts of Asia and low resistance to third-generation cephalosporins. The incidence of multi-drug resistant (MDR) Salmonella enterica serovar Typhi (S. Typhi) in India increased in the 1990s. After a decade, studies showed reduced MDR percentage. Hence this study was performed to detect antibiotic resistance patterns and associated genes among clinical isolates of Salmonella. Methods: A total of 171 clinical isolates of Salmonella isolates collected between 2011 to 2016 from a tertiary care hospital in Chennai, India were included. Antibiotic susceptibility testing and screening for extended-spectrum β-lactamase production was performed. Genes encoding resistance to β-lactam antibiotics (blaTEM, blaSHV, and blaCTX-M), chloramphenicol (cat, cmlA, and floR), co-trimoxazole (sul1, sul2, sul3, and dfr), and tetracycline (tet(A), tet(B), tet(C), tet(D), tet(E), and tet(G)) were detected using PCR and nucleotide sequencing analysis. Results: The majority of the isolates were susceptible to ACCoT antibiotics, cephalosporins, and carbapenems. Most of the isolates were resistant to nalidixic acid and 1.7% were sensitive to ciprofloxacin. All the isolates (n=171) were negative for ESBL. Multidrug resistance was seen in 4.1% isolates and all the MDR Salmonella isolates were found to contain blaTEM-1(TEM-1-type β-lactamase), cat, dfrA17, sul1, and tet(B) genes. Conclusion: We have observed a low MDR prevalence and reduced susceptibility to the fluoroquinolone, ciprofloxacin. This changing susceptibility pattern of Salmonella species over time warrants continuous monitoring and judicious use of antibiotics to prevent the emergence of resistant strains.

Role of secondary sepsis in COVID-19 mortality: Observations on patients with preexisting diabetes mellitus and newly diagnosed hyperglycemia.

Diabetics who develop severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) are more likely to have severe disease, higher odds of intensive care requirement and mortality. Fifteen percent of patients have new onset hyperglycemia. We studied the comparative outcomes between prior DM, newly detected hyperglycemia and assessed role of secondary sepsis on mortality. RWe performed a r etrospective study of confirmed SARS-CoV-2 patients at a tertiary care hospital in Chennai, India. Patients were divided as 2 groups (Group 1: With preexisting diabetes mellitus, Group 2: With newly diagnosed hyperglycemia due to newly detected diabetes mellitus or non-diabetic hyperglycemia. Clinical and laboratory data was analysed. Two hundred and thirty eight patients had prior-diabetes mellitus (Group 1) and 40 had newly diagnosed hyperglycemia (Group 2). Thirty four of group 1 and 7 of group 2 patients required intensive care. Mean capillary blood glucose (MCBG) during hospital stay was 207 mg/dl (Group 1) and 192 mg/dl (Group 2). Twentysix patients (9.3%) had secondary sepsis of which sixteen died. Logistic regression identified secondary sepsis(p<0.0001), elevated D-dimer >6 fold (p= 0.0001), elderly p=0.0045), male (p=0.0006), NLR >5 (p=0.01),serum creatinine ≥2 mg/dl (p=0.0004), FiO2 requirement >0.6 in first 48 hours (p=0.001) as mortality predictors.Our study observed a 14.38 % prevalence of newly diagnosed DM or non-diabetic hyperglycemia. Secondary sepsis and >6 fold elevation in D-dimer were strong predictors of mortality. Steroid use possibly contributed to secondary sepsis. Early identification and aggressive management of secondary sepsis are necessary for diabetics.

A study to assess the knowledge, attitude, and practice on occupational blood and body fluid spill management awareness among nursing students in a tertiary care hospital in Chennai, Tamil Nadu

Background: Nurses form a major taskforce of healthcare providers in hospitals and are hence at a great risk of such exposure. Occupational exposure in the context of this study is the exposure of skin to blood and body fluids. Transmission of these infections puts healthcare providers at major risk. Proper decontamination and taking measures to prevent occupational exposure to blood, mercury and body fluids is a primary method of prevention of disease in a healthcare setup. Aims and Objectives: To estimate, the level of knowledge, attitude&amp; practice of nursing students regarding the management of blood and body fluid spill. Methodology: A Cross sectional –KAP among Second and third years from Nursing school, Chennai. Result: Among 98 nursing students, second year nursing 40%, 61%, 40 % shows knowledge, attitude and practice respectively. Third year students shows better than second year which was 57%, 71%, 71 % shows knowledge, attitude and practice respectively. The studied participants had a median (IQR) percentage KAP score of 8(7-9) and 11 (10-13) for second and third year students respectively. Comparison KAP score of the excellent and fair among second and third year students showed the significant p-value (&lt;0.001*) by the Mann- Whitney U test. Conclusion: Majority of third year nursing students showed better KAP than second year students hence we recommend more mock training classes to improve the knowledge and practice.

Health-related Quality of Life and Domain-specific Associated Factors among Patients with Type2 Diabetes Mellitus in South India.

OBJECTIVEType 2 diabetes mellitus (T2DM) is a chronic metabolic disorder that has a major impact on health-related quality of life (HRQOL). The economic burden of the disease, along with its complications, negatively impact the individual, family, and society of Indian diabetic patients. This study explored the perception of the diabetic HRQOL of South Indian type2diabetic patients.METHODSThis study was a cross-sectional descriptive quantitative study conducted in a tertiary care hospital in Chennai, Tamil Nadu, South India. Using the simple random sampling technique, we collected data from 352 T2DM patients aged ≥ 30 years of age who were diagnosed for a minimum of one year. Data collection occurred from June to August 2017. Data were analysed using IBM SPSS, Version 22.RESULTSOverall, 90% of patients with T2DM perceived poor HRQOL. The total and the domain- specific mean scores of HRQOL were high indicating poor HRQOL in energy mobility, diabetes control, anxiety and worry, social burden, and sexual functioning domains. Being female, increasing age, lower education levels, lower family income, and uncontrolled fasting blood glucose levels predicted poor HRQOL of patients with T2DM.CONCLUSIONST2DM impacted the HRQOL in all measured domains of participants. A patient-centred approach to diabetes management can be incorporated to improve or enhance the health-related quality of patients’ lives. Improved HRQOL also may lead to fewer hospitalizations, and hence, reduce healthcare costs.

Novel biomarkers of inflammation for endothelial dysfunction in chronic kidney disease patients

Introduction and Aim: One of the main complications of chronic kidney diseases (CKD) resulting in morbidity and mortality is cardiac complications. High-sensitive C -reactive protein (hs- CRP), a novel biomarker of systemic inflammation is elevated in all the stages of kidney impairment. This leads to endothelial dysfunction resulting in cardiovascular complications. The aim is to evaluate the levels of novel inflammatory biomarkers for endothelial dysfunction which could predict cardiovascular risk in CKD patients. Materials and Methods: This cross-sectional study was conducted among 50 CKD patients at a tertiary care hospital in Chennai. Study participants were from both sexes, aged between 20 and 65 years. Fasting blood samples were drawn for analysis of lipid profile, hs- CRP, calcium and phosphorus. Results: The participants were grouped into three based on the hs-CRP Levels, as Low (&lt;0.80 mg/L), Medium (0.81–1.76 mg/L) and High (&gt;1.76 mg/L). Serum creatinine was significantly increased (P=0.007) across the groups. hs-CRP showed positive correlation with creatinine, while it showed negative correlation with HDLc. Conclusion: Highly sensitive CRP is a marker of endothelial dysfunction. Elevated hsCRP levels in CKD patients indicate that they are prone for cardiovascular complications. Early detection of systemic low-grade inflammation may prevent future cardiovascular complications.

Immunological Response to ChAdOx1 nCoV-19 Vaccine among Health Care Workers at a Tertiary Care Hospital in Chennai

ChAdOx1 nCoV-19 Vaccine (Covishield) has shown good efficacy data but the presence of non responders to the vaccine and the duration of protection conferred by the vaccine has not been clearly documented. To study the immunological response to ChAdOx1 nCoV-19 Vaccine among Health Care workers (HCWs) at a tertiary care hospital in Chennai. Materials and Methods: A Prospective study was conducted to analyze the duration of protection conferred by ChAdOx1 nCoV-19 Vaccine by testing the serum samples for Anti SARS IgG Antibody to spike protein by EUROIMMUNE ELISA Kit protocol by testing the pre vaccine sample, samples 2 weeks and 4 weeks following 1st dose,3 months and 6 months post 2 doses of vaccination and to study the association of waning immune response with comorbidities. A total of 265 Health Care Workers (HCWs) involving Nurses (35%), Doctors (32%), Technical staffs (17%) and House keeping staffs (16%) were included in the study. Majority were in age group of 41-50 Years (33%). Associated comorbidity was noticed in 19 % of HCWs. All 100% had sero conversion 4 weeks following Covishield but only 88 % had sero conversion 2 weeks following the 1st dose of Covishield. 100% of the HCWs had detectable levels of Anti SARS IgG antibody to spike protein 3 months following 2nd dose of Covishield but 6 months post 2nd dose only 90.5 % detectable levels of Anti SARS IgG antibody to spike protein. Among the 9.5% with waning immune response 68% had associated comorbidity like obesity (47%), Diabetes Mellitus (41%), Hyperlipidemia (6%) and Chronic lung disease (6%). It is important to maintain the protective antibody titers by vaccinating all the individuals with booster dose of the vaccine and considering population with comorbidities a high risk group for early priority.

Awareness about Early Menarche and Its Associated Problems among Female Medical Students of a Tertiary Care Hospital in Chennai, Tamil Nadu

Background: In many developing countries, the age of menarche is declining due to various factors. Early pubertal development or early menarche among girls could be associated with higher risks of poor health, so it is important to bring awareness and gain knowledge about early menarche and it's associated problems.&#x0D; Aim: To assess the awareness and knowledge about early menarche and its associated problems among female medical students.&#x0D; Settings and Design: Cross-sectional study was done among the 1st year, 2nd year and 3rd year girls studying in a medical college in Chennai.&#x0D; Methods: This study was conducted among 232 participants. A convenient sampling method was used. A pretested semi-stricter questionnaire was used to assess the knowledge and awareness about early menarche and its associated problems.&#x0D; Statistical Analysis Used: Data was entered in an excel spreadsheet and analysed using SPSS software version 16, statistical analysis was done using the Chi-square test.&#x0D; Results: Out of 232 participants 33.7% had good knowledge about early menarche and its associated problems. There was a significant association between the year of study and the level of knowledge of the participants. 42.35% were aware that “early menarche can lead to breast cancer and ischemic heart disease”.&#x0D; Conclusion: Thus, this study helps us to bring more awareness about early menarche and its associated problems and to prevent it by gaining knowledge about the factors resulting in early menarche.

A Cross Sectional Study on Prevalence of Postpartum Depression among Recently Delivered Women in a Tertiary Care Hospital, Chennai, India

Background: Postpartum depression is a common type of depression most people are not much aware and the most important causes being poverty, unwanted child/gender, marital disharmony and lack of family support.&#x0D; Aim: The aim of the study was to assess the prevalence of postpartum depression among recently delivered women in a tertiary care hospital in an urban setup.&#x0D; Methodology: It was a cross sectional type of study in urban population in a tertiary care hospital in Chennai. Data on postpartum depression was collected using Edinburgh Postnatal Depression Scale (EDPS).&#x0D; Results: A total 165 postpartum women participated in the study. The prevalence of postpartum depression was found to be 19.23% (an EPDS score of 10 and above) and it was noted in our study that none of these women sort to any medical help.&#x0D; Conclusion: The study shows prevalence of postpartum depression is quite high and none of those women seeked appropriate medical help. All health care professionals have to be trained to raise awareness, detect and treat postpartum depression among women promptly.

A Cross Sectional Study on Awareness of Risk Factors of Maternal Obesity among Women in a Tertiary Care Hospital in Chennai, Tamil Nadu, India

Background: There has been a rise in prevalence of obesity all around the world. Obesity during pregnancy has various adverse outcomes on both the child and mother. Maternal affects include pregnancy induced hypertension, gestational Diabetes, pre-eclampsia and foetal outcomes includes macrosomia, pre term birth and obstructed labour.&#x0D; Aim: Of this study is to assess the knowledge and awareness of complications of obesity during pregnancy among women.&#x0D; Materials and Methods: This is a cross sectional descriptive questionnaire study conducted among 384 women attending the out-patient’s department of obstetrics and gynaecology during a time period of January 2021 to June 2021.&#x0D; Results: Average level of awareness was found among the participants. 53.3% women were aware and 46.6% participants were not aware of the adverse effects of maternal obesity.&#x0D; Conclusion: In this study, it was observed that half of the participants were unaware, hence perinatal counselling and awareness camps needs to be conducted to raise the awareness and knowledge levels among general population for a healthier society.

Prevalence of Endocrine Abnormalities in Adolescent Girls with Menstrual Disorders in a Tertiary Care Hospital in Chennai

Purpose: To identify endocrine abnormalities such as hyperandrogensim, thyroid disorders, and hyperprolactinemia in adolescents with menstrual disorders.&#x0D; Methods: This was a case–control study carried out in adolescent girls aged 10–19 years in the gynecology outpatient department of a tertiary care hospital. The participants’ demographic details, medical, surgical, family, and personal history was obtained. Data of hormonal evaluation, namely serum T3, T4, TSH, serum prolactin and serum testosterone was also collected. &#x0D; Results: The most common menstrual abnormality was oligomenorrhea at 66% followed by menorrhagia at 10%. Primary amenorrhea was seen in 8% cases, metrorrhagia was seen in 4% and polymenorrhea in 4% of cases. Secondary amenorrhea and hypomenorrhea were both seen in 2% of cases. 10% adolescents with menstrual abnormalities had biochemical hyperandrogenism. Only 2% had hyperandrogenism in the control group. Thyroid dysfunction was more prevalent in the adolescents with menstrual disorders (14%) when compared to controls (4%). Among those with oligomenorrhea, only in one case was serum prolactin raised (3.0%).&#x0D; Conclusion: Immaturity of hypothalamic pituitary ovarian axis is considered to be the most common cause of menstrual irregularities in adolescent girls, but endocrine abnormalities may be responsible in some cases. Therefore it is paramount to examine the prevalence endocrine abnormalities among among adolescents with menstrual problems to promote their quality of life, lower her risks for future disease, and ill health.

A Study to Compare the Efficacy of Back Strengthening Therapy in Patients with Lower Back Pain on Analgesics to that of those on Placebo in a Tertiary Care Hospital in Chennai

Aim: Isometric and Core strengthening exercises for lower back pain provides relief to patients, whereas combing it with analgesics also provides relief of pain, thereby in this study the efficacy of isometric and core strengthening exercises alone is evaluated.&#x0D; Method: A cross-sectional study involving 200 subjects was conducted in the OPD of department of Orthopaedics, Saveetha Medical college and hospital. Assessment of lower back pain was done using ODI (Oswestry Disability Index) among patients receiving Isometric and Core strengthening exercises with and without analgesics for a period of 3 months.&#x0D; Results: There is no significance difference in the reduction of pain among group A who received analgesics along with isometric and core strengthening exercises and group B who received only isometric and core strengthening exercises.&#x0D; Conclusion: Isometric and core strengthening exercises alone is as effective as its combination with analgesics.