Tertiary Care Hospital In Haryana Research Articles

Profile of unnatural deaths in adult females – A retrospective study conducted at a tertiary care hospital in Haryana

Unnatural deaths, including unintentional and intentional events, require post-mortem examinations to rule out foul play. Women aged 18 to 30 are particularly vulnerable to mental, physical, psychological, and social challenges, including dowry-related deaths and occupational hazards. Unfortunately, female victimization is often underreported and research on the topic is limited. This study took into account 1564 post-mortem records of cases conducted in 5 years and analysed cases of unnatural deaths in adult females aged over 18 years to understand the gravity of female victimization in the region. Of the 204 identified cases, poisoning was the leading cause of death, and suicide was the most common manner of death. Accidental deaths were the second most common manner.: The study highlights the need for policies to address socio-economic and human rights deprivation, domestic violence, and mental health issues that contribute to these deaths. Measures to promote female economic independence and effective prevention and support strategies are necessary to reduce the prevalence of unnatural deaths among women in India.

Comparison of operative outcome of open versus laparoscopic inguinal hernia in rural tertiary care hospital in Haryana: A randomized controlled study

Background: Hernia surgery is one of the commonly done procedures in General surgery. A hernia is defined as an abnormal protrusion of an organ or tissue through a defect in its surrounding walls. Aims and Objectives: Comparison of morbidity in terms of total analgesic usage, mean length of hospital stay, comparison among open and TEP repair of hernias in primary inguinal hernias among males. Material and Methods: This study was done on 80 patients with clinical diagnosis of primary inguinal hernia over a period of one year to compare the result of two surgeries, open lichenstein repair (n=40) and TEP repair (n=40). Results: Postoperative pain using VAS was found to be lower in patients having laparoscopic TEP hernia repair when compared to open lichenstein tension free repair (p <0.01). Operating time was observed to be more with TEP group with mean of 59 ± 17.02 minutes compared with open group which had mean of 44.92±12 minutes. Mean number of analgesic in open cases was 6.65 ± 1.81 whereas in case of TEP group it was 4.35±1.47 over a period of one month. Conclusion: Lichtenstein tension free mesh hernioplasty still remains the gold standard operation done for inguinal hernia. TEP repair has proven to be superior in terms of perioperative hemorrhage and post-operative analgesia requirement. Study concluded that laparoscopic TEP repair of inguinal repair have a considerable clinical advantage over open hernia repair in terms of postoperative pain and analgesia requirement, hospital stay and postoperative complications.

Study on Spectrum of Hemoglobinopathies in A Tertiary Care Hospital in Haryana, India

Background: Hemoglobinopathies are the most common inherited disorders and are major public health problem in many parts of the world. According to WHO, 5% of the world population is carrier for hemoglobinopathies. High Performance Liquid Chromatography (HPLC) is a sensitive, specific and rapid method aiding in detection of hemoglobinopathies.Objective: To evaluate the spectrum of various hemoglobinopathies by using HPLC in a rural tertiary care hospital in Haryana, India.Methods: This prospective study was conducted for detection of hemoglobinopathies using BioRad D-10 for patients visiting various OPDs in Bhagat Phool Singh Government Medical College for Women, Haryana, India.Results: A total of 160 patients were included in the study. 25 (15.6%) cases were detected to have hemoglobinopathies. Most common hemoglobinopathy was beta thalassemia trait found in 9 cases (36%) followed by beta thalassemia major in 4 cases (16%), Hemoglobin D Punjab heterozygous in 3 cases (12%), Hemoglobin E heterozygous in 2 cases (8%).Conclusion: Our study provides an overview on the spectrum of hemoglobinopathies in Haryana region of India. Hemoglobinopathies pose considerable economic and psychosocial burden on the affected individuals, society, and the country. It is concluded that HPLC is a versatile, reproducible technique for the estimation of hemoglobinopathies.International Journal of Human and Health Sciences Vol. 08 No. 01 Jan’24 Page: 49-55

Term delivery through Partial Annular Cervical Tear in a Multigravida with history of Genital Prolapse: A Case Report

Injury to the cervix is one of the common complications of pregnancy and delivery, but partial annular tear of the cervix is a rare entity, let alone vaginal delivery through it. A 32-year-old second gravida presented to a tertiary care hospital in Haryana, India in early labour. Her intrapartum course was uneventful. Following delivery of the baby and after-births, a third degree prolapse of the cervix was noted along with partial annular cervical tear of about 10cm involving the posterior cervical lip and 2cm away from the external os. There was mild bleeding from the edges of the tear and it was repaired with intermittent simple suture using 2-0 chromic catgut. On further probing, the patient denied any cervical trauma or surgery in the past but she gave history of something coming down per vaginum on straining for the last two years. She had not taken any treatment for the management of prolapse. She was given prophylactic oral antibiotics for 5 days and was advised Kegel’s exercise during the postpartum period. On discharge, she was stable, the cervical repair appeared healthy and was asked to follow-up after 6 weeks. This case highlights the possibility of cervical tear in patients having genital prolapse during delivery, first such being reported.

Prevalence of multidrug-resistant Gram-negative bacteria causing pyogenic infections at a tertiary care hospital in Haryana

Abstract Background: The growing occurrence of antibiotic-resistant bacteria, especially those resistant to multiple drugs found in pyogenic infections, presents considerable challenges in effectively managing and curing these infections. Objective: This current research aimed to determine the prevalence of Gram-negative bacteria with multidrug resistance in cases of pyogenic infections treated at a tertiary care hospital located in Haryana, India. Materials and Methods: An observational cross-sectional investigation was conducted over 8 months, from June 2022 to January 2023, at a tertiary care hospital located in Haryana, India. Throughout the study, 376 samples of pus and wound swabs were gathered from patients visiting the outpatient and inpatient departments. Subsequently, specimens that exhibited noteworthy aerobic bacterial growth were identified following established bacterial testing procedures, and their antibiotic susceptibility profiles were determined using the Kirby-Bauer disc diffusion method. Results: Out of the total 376 collected pus and wound swab specimens (n = 376), significant aerobic bacterial growth was observed in 116 cases (30.9%), with 113 instances (97.4%) showing monomicrobial growth and the remaining three cases (2.6%) exhibiting polymicrobial growth. Consequently, a sum of 119 bacterial isolates was obtained, with 70 (58.8%) being Gram-negative bacilli (GNB) and 49 (41.2%) being Gram-positive cocci. Among the GNB isolates, 37 (52.9%) were identified as Gram-negative fermenters (belonging to the Enterobacteriaceae family), while the remainder were categorized as Gram-negative non-fermenters. The prevalent isolate was Pseudomonas aeruginosa, accounting for 42.9% of the cases, Escherichia coli at 25.7%, and Enterobacter species at 7.1%. Of these isolates, 31 (44.3%) were multidrug-resistant, 24 were Gram-negative fermenters, and seven were Gram-negative non-fermenters. Approximately three-quarters of the Enterobacteriaceae isolates showed potential for producing extended-spectrum β-lactamases, whereas a quarter exhibited potential for producing carbapenemases. Similarly, a quarter of the Gram-negative non-fermenters were identified as potential carbapenemase producers. Conclusion: The present study underscores the prevalence of multidrug-resistant strains within the pathogens, particularly among Enterobacteriaceae isolates responsible for pyogenic infections. Additionally, these findings will play a pivotal role in shaping a community-specific antimicrobial stewardship initiative, which stands as one of the most essential strategies for addressing the challenge of antimicrobial resistance.

Knowledge and Awareness About Diabetes Mellitus Among Urban and Rural Population Attending a Tertiary Care Hospital in Haryana.

Diabetes mellitus (DM) is one of the fastest-growing public health problems in the twenty-first century. The ignorance among people about their disease may be related to their low socioeconomic status and lack of quality education available to them about the disease. It is a serious condition leading to several complications if the individual does not follow up regularly for check-ups and blood sugar monitoring. Lifestyle modifications such as a healthy diet, regular exercise, reducing weight, stress management, and smoking cessation can play a critical role in managing diabetes and improving the health and well-being of diabetic patients.Thus, through this study, we want to assess and create awareness among diabetic patients. It is a hospital-based cross-sectional study conducted at a tertiary care hospital on diagnosed cases of DM. The patients aged 18 years or above of either genderwho had already been diagnosed with DM type 1 and type 2 were included, and patients with gestational DM were excluded from the study. Informed consent was taken from the patients, and all the required details were obtained using a well-structured questionnaire. After obtaining all the answers, the level of knowledge and awareness was analyzed, and the data was entered into an MS Excel sheet (Microsoft, Redmond, Washington) and analyzed by Statistical Package for the Social Sciences (SPSS)version 22.0 (IBM Corp., Armonk, NY). In our study, the maximum prevalence of diabetes was seen in males (55.5%) than females (44.5%), and the mean age of our study population was 53.3 ± 16.4 years. In our study, participants from rural areas made up the majority (59%) compared to those from urban areas (41%), and the majority of participants had a high school education. Among 211 diabetics, about 84%, 79%, and 41% of the patients knew about diabetes, symptoms of diabetes, and complication of diabetes. Only 18% of the patients were aware of the symptoms of hypoglycemia, and 38% of the patients possess their own glucometers and monitor their blood sugar levels on a regular basis. Merely 38% of the diabetics were aware of the various DM treatment choices. About 52% of patients had some awareness of insulin therapy. Out of 211 patients, about half skipped their antidiabetic prescriptions, and of those, 22% took a double dose the next day. A total of 121 patients (57%) combined the use of alternative and allopathic medications, and among these, 22% of patients had replaced the allopathic with alternative medicines. Almost 53% of patients had a positive family history of diabetes; 54% of patients believe that obesity is unrelated to diabetes, and 79% of diabetics are aware of the lifestyle changes that must be done for diabetes. Almost 67% of the patients believed that diabetes could be permanently treated, and 84% of patients believed that eating too much sugar caused their diabetes. In our study, a significant number of patients suffering from diabetes had less knowledge and awareness about it. The prevalence of myths about the onset of diabetes was noticeably higher among diabetic patients. It was observed that a greater number of patients were shifting to alternative medications instead of allopathic ones, and in the long run, it can lead to various complications. Therefore, there is an immediate need to promote awareness about diabetes among the general population.

Prevalence and antibiogram of non-urinary isolates among patients attending a tertiary care hospital

Introduction and Aim: Gram-negative bacterial infections have emerged as a global health problem in clinical care. They account for the majority of community and hospital acquired infections which are resistant to various antimicrobials. The present study aimed to investigate the prevalence and antibiotic susceptibility pattern of Gram-negative bacteria (GNB) isolated from various non-urinary samples at a tertiary care hospital in Haryana. Materials and Methods: A total of 228 isolates were obtained from various clinical samples from January 2018 to July 2018 and were identified by standard bacteriological techniques. Antibiotic susceptibility testing was done using the disc diffusion technique by the Kirby Bauer method. Results: Adult patients showed higher isolation of GNB (31%) as compared to paediatric patients (16.3%). The most common GNB isolated from blood was Pseudomonas spp.(62%) and Klebsiella spp.(66.7%) from respiratory samples isolated in our study showed resistance to common antibiotics like gentamicin and ceftriaxone. Polymyxin B and Tigecycline were found to be sensitive. Conclusion: Strict compliance with antimicrobial stewardship policy should be followed to reduce the menace of antibiotic resistance.

Psychosocial Functioning in Patients of Major Depressive Disorders in Tertiary Care Hospital in Haryana

Psychosocial Functioning in Patients of Major Depressive Disorders in Tertiary Care Hospital in Haryana

Epidemiological profile and management practices of animal bite cases in a tertiary care hospital of Haryana: A cross-sectional study.

Rabies is one of the oldest and deadliest diseases known to man. After the clinical occurrence of rabies, there is no comprehensive treatment possible. However, the development of rabies can be prevented to a large extent if animal bites are managed appropriately and in time. The post-exposure treatment of animal bite cases is of prime importance in this regard. India has the highest burden of animal bite and rabies cases in the world. This imposes a substantial burden on the healthcare delivery services of the country. This was a cross-sectional study conducted in the immunization clinic of a tertiary care hospital in Haryana from January 2018 to December 2018. A total of 614 cases were interviewed using a pre-designed, pre-tested, and semi-structured interview schedule. Around 80.5% of the bites were inflicted by stray animals, among which 70% of cases were by stray dogs. Precisely, 97.7% of cases took anti-rabies vaccine and 96.6% of cases took Tetanus Toxoid. 204 (33.2%) of victims were category III cases, who needed local infiltration of immunoglobulin but only 46% of them got it. The association of time lag between bite and reporting to the first health facility with socio-economic status, residence, and education was found to be statistically significant. To conclude it was observed that proper wound management practices were lacking in the people of the study area and there is a need to strengthen the availability of provision of free-of-cost life-saving immunoglobulin at the health facility, under the rabies control program.

Determinants of delay in initiation of post exposure prophylaxis for rabies prevention among animal bite cases attending a rural tertiary care hospital of Haryana

Introduction : Rabies is a fatal but vaccine-preventable viral disease. Animal bite victims who report in primary and secondary level health care lack some measures which can help in protecting and preventing deaths due to rabies. The most important factor for prevention of death due to rabies is the timely administration of post-exposure prophylaxis (PEP) among animal bite victims. Therefore, in addition to an understanding of the epidemiological distribution of animal bites, it is necessary to explore the factors leading to delay in PEP initiation. Objective: To determine the determinants of delay in initiation of post exposure prophylaxis for rabies prevention among animal bite cases attending anti-rabies clinic of a ruraltertiary care hospital in Sonepat, Haryana. Method: This cross-sectional study was conducted at an Immunization-cum-antirabies clinic of Bhagat Phool Singh Government Medical Collegefor Women, Khanpur Kalan, Sonepat, Haryana. A pre tested, structured questionnaire was used to collect information among 410 participants after taking consent. The Institutional Ethics Committee of institute approved the study. The groups were compared with Chi-square test for categorical data. Results: Delay was present among 27.3% of participants. Significant factors of delay were no local wound treatment, any treatment taken prior to anti-rabies vaccine administration, rabies clinic closed on holidays, unawareness about PEP, non-availability of accompaniment, transportation issues and money problem for transportation. Knowledge also played significant role as delay was significantly more among the participants not having knowledge regarding source of infection, mode of transmission and incubation period of rabies. Conclusions: Delay ininitiation of PEP was common and were significantly associated with lack of knowledge and unawareness, closure of rabies clinic on Sundays/holidays, non-availability of accompaniment and money problem during transportation.

Prevalence of HIV Infection among Blood Donors in a Tertiary Care Hospital of Haryana: A Retrospective Study

Introduction: Blood is a scarce, but life saving resource. At the same time, unsafe transfusion practice also puts millions of people at risk of Transfusion Transmissible Infections (TTIs). Aim: To determine the prevalence and trend of blood borne infection namely Human Immunodeficiency Virus (HIV) among blood donors donating blood in a tertiary care hospital of Haryana, India. Materials and Methods: A retrospective study was conducted from September 2012 to August 2014 to calculate the prevalence and trend of HIV positivity among blood donors over a period of five years (2008-2012). Results were expressed in terms of frequency and percentage. Results: There were a total of 1,59,077 donations, including both voluntary and replacement donors. The overall prevalence of HIV infection among blood donors was found to be 0.26% over a period of five years (2008-2012). The HIV prevalence among blood donors showed an increased trend from 2008 (0.18%) to 2011 (0.34%), and then there was a dip in the year 2012 (0.23%). Conclusion: The number of female blood donors were less in comparison to male blood donor. The maximum number of donors were voluntary males followed by replacement males.

Clinical profile of patients with hypertensive crisis in a tertiary care hospital in Haryana, India – A retrospective cross-sectional study

Background: A hypertensive crisis may manifest as hypertensive emergency or urgency. Hypertensive emergency is characterized by target organ damage and poses immediate threat to life, a situation not seen in urgency. Aims and Objectives: The aims of the study were as follows: (1) To determine the prevalence of hypertensive crisis classified as emergency, urgency, and pseudocrisis. (2) To assess the various systems (neurological, cardiovascular, and renal) affected in relation to a particular type of hypertensive crisis. Materials and Methods: The retrospective study comprised analysis of medical records of 100 patients of hypertensive crisis admitted to emergency unit of BPS Government Medical College and Hospital for Women, Sonepat, Haryana, India, in the 2 years period from January 2018 to December 2019 and study their prevalence among hospital emergencies and clinical presentation. Results: Total number of clinical emergencies analyzed during this time interval was 6666. The prevalence of hypertensive crisis accounted to 1.5% of all the clinical emergencies received. About 66% presented as hypertensive emergencies, 32% as hypertensive urgency, and 2% presented as hypertensive pseudocrisis. Males of the fifth decade of life while females of the sixth decade of life were most affected by hypertensive crisis. Headache (58%) followed by giddiness (44%) was the most common clinical presentation in the emergency. About 34% of patients had associated neurological deficit. Only 16% of patients had cardiovascular system involvement. Conclusion: Symptoms provided by patients in the emergency department are of paramount importance for the outcome of hypertensive crisis. Severe complication of hypertensive crisis can be prevented if hypertension is timely diagnosed and appropriately managed.

Evaluation of Expulsion and Continuation Rate of Immediate Postpartum Intrauterine Contraceptive Devices: A Prospective Hospital-based Study

Introduction: Family planning can avert nearly one-third of maternal deaths and 10% of child mortality when couples space their pregnancies more than two years apart. With increased institutional deliveries, Postpartum Intrauterine Contraceptive Devices (PPIUCD) can play an important role in addressing the unmet needs of spacing methods in India. Moreover, in this digital age, generalised awareness of the female population about contraception has increased considerably, so the acceptance and continuation rate might be high. Aim: To evaluate expulsion and continuation rate of immediate PPIUCDs at a tertiary care hospital in Haryana, India. Materials and Methods: The prospective, hospital-based study was conducted from October 2020 to September 2021 in the Department of Obstetrics and Gynaecology at Kalpana Chawla Government Medical College, Karnal, Haryana, India. Ninety women who underwent IUCD insertion within 10 minutes of delivery of the placenta were enrolled, irrespective of the mode of delivery. Patients were followed-up at six weeks, three months, and six months. The expulsion and continuation rate of immediate PPIUCD and reasons for removal were studied. Descriptive variables were expressed in percentages. The Chi-square test was used to determine the continuation rate and expulsion/ removal rates in vaginal versus cesarean deliveries and a p-value less than 0.05 was taken as statistically significant. Results: A continuation rate of 84.4% was observed at six months. A statistically significant difference was observed in the continuation rate of participants of vaginal delivery versus caesarean section (82.67% vs 93.33%, p-value <0.01). Overall, the expulsion rate was 6.66%. Conclusion: Immediate PPIUCD insertion has high continuation rates and can play an important role in family planning.

Anthropometric and Micronutrient Assessment in Pediatric Patients with Cleft Lip and Palate in a Tertiary Care Hospital of Haryana, India

Introduction: Cleft lip (CL) and/or cleft palate (CP) are the most common visible craniofacial anomalies throughout the world. CL and CP occur due to a failure of the skeletal components of the mid-face to fuse. The affected individual may have an isolated defect or a combination of both. These children can be undernourished due to feeding difficulties after birth. The growth problems of children with clefts have largely been attributed to inadequate nutrition. The aim of the study is to assess the anthropometric status and micronutrient deficiencies in children with cleft lip and palate. Methods: This is a cross-sectional study of 18 months duration conducted at SGT medical college, Gurugram, a tertiary care center in Haryana, India between June 2020 to December 2021 involving the assessment of patients with cleft lip and palate between the age of 3 months to 5 years of either gender who visited pediatric unit for complete evaluation before surgery. A total of 100 patients were enrolled in the study and the following information was recorded: age, gender, hemoglobin, serum vitamin D3 level, serum ferritin, and serum vitamin B12 level. Results: A total of 100 patients were included in the study, of which, 53 (53%) were males and 47 (47%) were females. Anthropometrically, in our study, 83% of patients had moderate to severe wasting, according to WHO classification. Anemia was prevalent in 71.1% of cases in the current study. Vitamin D3 deficiency was seen in 88% of the study population, while 37% of cases had Vitamin B12 deficiency. The correlation between anthropometric assessment and nutritional deficiency suggested that children of cleft lip and palate with severe wasting had significant iron deficiency anemia as well as vitamin B12 deficiency. However, vitamin D deficiency was not statistically significant in severe wasting group. Conclusion: A large number of children with cleft lip and/or palate are not exclusively breastfed due to anatomical deficits. They need supplemental Iron and vitamin D to meet the demands. Macro and micronutrient deficiencies along with recurrent infections, lead to moderate to severe wasting and stunting in these children causing severe malnutrition with complications and failure to thrive.

Clinical and Hematological profile of Paediatric Patients with Cleft Lip and Palate in a Tertiary Care Hospital of Haryana, India

Introduction: Cleft lip and/ or cleft palate are the most common visible craniofacial anomalies. These patients often have feeding difficulties and recurrent infections leading to an altered immune system which can be assessed by the variations in hematological parameters. We intended to assess the clinical profile and the hematological parameters in patients with cleft lip and palate. Methods: This is a three-year cross-sectional study conducted at SGT Medical College, Gurugram, Haryana, India from January 2017 to December 2019 involving assessment of patients with cleft lip and palate who visited the paediatric unit for complete evaluation before surgery. Syndromic children or those with associated deformities were excluded .A total of 115 patients were enrolled in the study and the following information was recorded: Age, Gender and type of cleft (Cleft lip and alveolus, cleft lip, alveolus and palate, and isolated cleft palate). Hematological parameters including hemoglobin, total leukocyte count, differential leukocyte count, absolute eosinophil count, and red cell indices were evaluated and compared amongst the anatomical subtypes. Results: A total of 115 patients were included in the study, of which 66 (57.4%) were males and 49 (42.6%) were females. 57 (49.6%) had a cleft lip, alveolus, and palate, 36 (31.3%) had a cleft lip and alveolus and 22 (19.1%) had cleft palate only. Anaemia was present in 71.1% of cases. 83.4% cases of cleft lip and alveolus while81.8% of isolated cleft palate were anaemic. Microcytic hypochromic anaemia was present in 63.4% of cases while 36.6% had normocytic normochromic anaemia. The total leukocyte count was elevated in 60 children (52.2%) which was highest in cleft lip and alveolus (66%). Absolute neutrophil count was significantly high in the lip and alveolus groups.(13.9%) Absolute lymphocyte count was highest in lip and alveolus (30.56%). Absolute monocyte count and the absolute eosinophil count was low in the majority of cases. Conclusions: A large number of children with cleft lip and/ or palate are not exclusively breastfed due to anatomical deficits. They need supplemental iron to meet the demands. A standard policy to provide auxillary iron by health care professionals should be made at the first visit to the health centre because nutritional anaemia negatively affects the physical and cognitive development of a child. It also unnecessarily prolongs the date for optimum and safe surgery.

An observational study for appraisal of clinical outcome and risk of mother-to-child SARS-CoV-2 transmission in neonates provided the benefits of mothers' own milk.

This observational study done during April–December 2020 at a tertiary-care hospital in Haryana (India) enrolled 152 SARS-CoV-2-exposed neonates. Among them, 150 neonates had perinatal SARS-CoV-2 exposure and 2 neonates had late postnatal exposure. Stable infant-mother dyads were roomed-in with precautions to support breastfeeding. Nasopharyngeal swabs collected from neonates were tested for SARS-CoV-2 by reverse transcriptase–polymerase chain reaction (RT-PCR) test. There was a high incidence of prematurity (23%), low birth weight (31%), intrauterine fetal distress (16%), perinatal asphyxia (6%), admission to neonatal intensive care unit (24%), and mortality (1.3%) among neonates with perinatal SARS-CoV-2 exposure. In this sub-group, 20 neonates tested positive for SARS-CoV-2 in nasopharyngeal swab sample(s). A recent official publication by the World Health Organization emphasizes that the perinatal SARS-CoV-2-exposed neonates found RT-PCR positive once in upper respiratory (non-sterile) sample must document viral persistence in another non-sterile sample for confirmation of mother-to-child virus transmission. With this approach, only one neonate was confirmed intrapartum transmission. A telephonic follow-up in discharged neonates at 1 month of age or 1 month postexposure recorded them all to be asymptomatic and doing well.Conclusion: Neonates with perinatal SARS-CoV-2 exposure constitute a high-risk group and it is not uncommon to get a positive RT-PCR report in upper respiratory sample(s) from these babies. Majority of them do not demonstrate viral persistence. Clinical outcomes are favorable in breastfed infants roomed-in with their asymptomatic-mild symptomatic SARS-CoV-2-infected mothers following appropriate safety protocols. What is Known:•Neonates with perinatal exposure suffer a high burden of morbidities and mortality.•Still, an uncertainty exists about rooming-in and breastfeeding among neonates born to SARS-CoV-2 positive mothers.What is New:•With the policy of mother-infant rooming-in and supporting breastfeeding, none of the neonate suffered clinical illness compatible with postnatal SARS-CoV-2 transmission and infection.•Around 13% perinatal exposed neonates demonstrated SARS-CoV-2 RNA in nasopharyngeal swab samples but the majority of them did not demonstrate viral persistence.

Symptomatology and Outcome of Acute COVID-19 Illness in Children at Faridabad, India

Introduction: The surveillance case definitions for coronavirus disease 2019 (COVID-19) in children adapted from adult guidelines emphasized the presence of fever and/or respiratory symptoms as the criteria for suspicion and testing. The clinical course of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in Indian children is still not well described. Materials and Methods: This observational study was done at a dedicated COVID-19 tertiary care hospital of Haryana, India, between April 1, 2020 and December 31, 2020, with due approval of Institutional Ethics Committee. A total of 86 SARS-CoV-2 positive inpatient children in the age group of 1 month − 12 years were enrolled to outline the clinical course and outcome of acute illness longitudinally over initial 2 weeks of infection. Clinical management and hospital discharge policy was guided by public health authorities and prevailing scientific evidence which were updated and notified time to time as the pandemic evolved. Descriptive statistics were applied to analyze the study variables. Results: Majority children (48/86; 56%) remained asymptomatic throughout 2-week surveillance period, 35 (41%) suffered mild, 2 (2%) moderate, and 1 (1%) severe disease. All children had intact survival. Comorbid condition(s) were present in five (6%) children. Among infants and the subset of children with premorbid condition(s), the proportion of children suffering symptomatic illness (88% and 80%, respectively) and moderate-severe illness (25% and 40%, respectively) was quite high. Respiratory symptoms (68%) and fever (50%) were the most common symptoms. Gastrointestinal symptoms were present in 26% symptomatic children. Fever was the only symptom in 11% children; and 16% children had only gastrointestinal symptoms without any fever or respiratory symptom(s). Conclusion: Acute SARS-CoV-2 infection in children is commonly asymptomatic, or a mild illness with not only respiratory but also non-respiratory manifestations. Thus, a high index of suspicion for SARS-CoV-2 infection is required by the treating physicians in this subgroup of population as they might play an important role in virus transmission and amplification. In case the testing is deferred among asymptomatic contacts or children with mild symptoms, they may be presumed SARS-CoV-2 infected, isolated, and managed accordingly.

COMPARISON OF THE EFFECTS OF ANTIDEPRESSANTS ON COGNITION FUNCTIONS IN PATIENTS OF MAJOR DEPRESSIVE DISORDERS IN TERTIARY CARE HOSPITAL IN HARYANA

Objective: Depression is one of the most common mood disorders. Patients with major depressive disorder (MDD) usually present alterations in various cognitive functions. Several cost-effective interventions have shown favorable recovery and positive outcomes in the care and management of depression. The objective of the study was to compare the effect of fluoxetine (selective serotonin reuptake inhibitors), and venlafaxine (serotonin-norepinephrine reuptake inhibitors) on cognitive functioning in patients with MDD.
 Methods: This prospective, single-blinded, randomized, and comparative interventional clinical study was conducted in a tertiary care hospital in Haryana. Fifty-two patients of MDD (ICD-10) were randomly divided into two groups: Group F and Group V, allocated to receive fluoxetine and venlafaxine, respectively. The assessment was done during the enrolment and at the end of the 3rd, 6th, 9th, and 12th weeks of treatment using the ABC-Hamilton Depression Rating Scale (HAM-D) and Montreal Cognitive Assessment (MoCA) Scale.
 Statistical Analysis Used: The intragroup analysis was performed using repeated measures ANOVA while intergroup analysis was performed using unpaired “t”-test. p<0.05 was considered statistically significant.
 Results: Mean HAM-D score was clinically as well as statistically significant at the end of the 12th week of treatment as compared to baseline in both the groups while on the intergroup comparison, there was no statistically significant difference in both groups. The mean MoCA score was (25±2.19) in Group F and (23.76±6.97) in Group V at the end of the 12th week. On intergroup analysis at the 12th week, a statistically significant improvement in cognitive functions was observed in patients Group F as compared to Group V (p<0.05).
 Conclusions: The study of fluoxetine comparatively better improves cognition functions as compared to venlafaxine.

A Comparative Analysis of Outcomes of Conventional Cold Dissection Versus Laser Tonsillectomy in Pediatric Cases in a Tertiary Care Hospital in Haryana

Tonsillectomy is one of the commonest ENT procedures done in paediatric population, the technique of which has evolved over years to decrease the morbidity associated with the surgery. This prospective randomized comparative study is done to evaluate the efficacy of two different techniques of this surgery, conventional cold dissection and laser tonsillectomy based on operative time, blood loss, post-operative pain and occurrence of secondary complications. The study was done in 68 patients of paediatric age group, 34 in each group underwent cold dissection and laser tonsillectomy. Operative time and bleeding were significantly low for laser group. Pain score was comparable in early post-operatives days, but was high towards the end of first week. Our study reported only one incidence of complication in the form of a secondary bleeding.

Complementary and Alternative Medicinal Use amongst Antenatal in a Rural Tertiary Care Hospital of Haryana

Background - WHO defines ‘Traditional medicine’ as the sum total of the knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health, as well as in the prevention, diagnosis, improvement or treatment of physical and mental illnesses. Aims and Objective - To study Complementary and alternative medicinal use in addition to allopathic medicine amongst pregnant women visiting antenatal clinics in a rural tertiary care hospital of Haryana. Material and Method – Antenatal women attending the Outpatient Department in a tertiary care hospital situated in a rural area in Haryana. Study Design – A prospective , cross sectional study Result – A total of 128 pregnant women participated in the study. Majority of these i.e 83% reported use of CAM during pregnancy. However pregnant women came forward with history of CAM use only after great persuasion. Conclusion –CAM is commonly used by majority of pregnant women in antenatal period. Rural women with low sociodemographic status with lesser education , home maker and unbooked pregnancy are vulnerable group for the CAM use. Moreover extremely low level of communication between CAM user and health care provider is worrisome and demands that physician should inquire their patients about the use of CAM.