Tertiary Care Hospital In Kashmir Research Articles

Clinical Profile of Acute Poisoning Cases at a Tertiary Care Hospital in Kashmir, India: A Descriptive Cross Sectional Study

Acute poisoning from a variety of substances is common in every part of the world. The sooner the initial resuscitation, decontamination, and use of specific antidotes, the better the outcome. The main objective of this study was to describe the clinical profile and outcome of poisoning cases admitted to SKIMS Medical college, a tertiary care hospital located in central part of Jammu and Kashmir India. Descriptive cross sectional evaluations were conducted on all cases that were admitted to the hospital’s emergency room over a period of one year from March 2022 to February 2023. The following parameters were examined using data taken from hospital medical records: socioeconomic factors, substances consumed, routes of intake, clinical symptomatology and severity of poisoning.300 patients were included in the study with different poisonings of which 35% were males and 65% were females. The most common form of poisoning was due to pesticides followed by rodenticides and opioid intoxication respectively. Majority of the patients had suicidal intent followed by accidental ingestion reported mainly in children. Few patient required intensive care admissions rest all were managed in general ward depicting mild severity of poisoning in majority of the patients. Three patients were brought dead to hospital secondary to opoid overdose and one patient died in hospital who had pesticide ingestion complicated by ventilator associated pneumonia. The less mortality in this study was likely due to mild severity of poisoning, early gut lavage and easy access to hospital. The effects of poisoning on the human body are negative regardless of the agents or method used and this has an impact on the treatment and outcome. Due consideration must be given to clinical, toxicological and epidemiological profiles. Therefore precise and prompt diagnosis, adequate treatment and effective preventative efforts are required. This study highlighted the importance of awareness and for the establishment of poison information centre for the better management and prevention of all poisoning cases.

Early Blood Gas Analysis in SARS-COV-2 Infected Patients Admitted to SMHS Hospital: A Tertiary Care Hospital in Kashmir

Inroduction: Blood gases are a measurement of how much oxygen and carbon dioxide is in blood. These determine the acidity of blood. The blood gas testing is generally used for detecting and monitoring lung and kidney problems. The blood gas testing measures partial pressure of oxygen (o2), partial pressure of carbon dioxide (CO2),oxygen saturation(O2Sat), bicarbonate(HCO3) concentration .
 Materials and Methods: Here in study Patients aged more than 18 years confirmed Covid 19 positive by reverse transcription, PCR (RT-PCR). Patients suffering from moderate to severe Covid 19 as per WHO diagnostic guidelines and underwent at least one ABG were included in the analysis. The ABG test was done on ABG analyzer in department of Biochemistry, SMHS hospital. All the data which was related to study was gathered and recorded in case record forms using files. As well as reports of patients from medical record section.
 Results: Alkaline pH was found in 57.33% individuals.36% individuals were having normal pH and the percentage of individuals having acidic pH was 6.66%. Low PaO2 was found in 45.33% individuals. Normal PaO2 levels were found in 21.33% and high PaO2 levels were found in 33.33% individuals .Low PaCO2 (<35 mmHg) were found in 56%, normal (35-45mmHg) levels were found in 37.33% and high levels (>45mmHg) were found in 6.66%. Low HCO3- (<22mmol/L) were found in 16%, normal (22-26mmol/L) in 38.66% individuals and high (>26mmol/L) were found in 45.33% individuals would be expected in the case of respiratory alkalosis.
 Conclusion: Regular ABG monitoring can aid in the early detection of silent hypoxia, and respiratory injury. With early management start-up, many lives can be spared with early diagnosis.

Clinical Profile and Outcome of Drug Abuse Patients Admitted in Intensive Care Unit of a Tertiary Care Hospital in Kashmir: A Prospective Observational Study

Introduction: Drug abuse is a global public health issue that poses significant challenges to healthcare systems particularly in intensive care units (ICU). This study aims to assess the clinical profile and outcomes of drug abuse patients admitted to ICU of a tertiary care hospital in North India.Methods: A prospective observational study was conducted over period of 3 years involving drug abuse patients admitted to the ICU. Demographic data, clinical characteristics, substance abuse patterns, co-morbidities, severity scores and outcomes were recorded.Results: A total of 35 patients were included in the study. All patients were males with a mean age of 29.1(± 11.68).25 patients were from rural areas. 42.8% were unemployed. Most of the patients (85.7%) were unmarried. 34.3% were students. Mean APACHE II score on ICU admission was 13. Most of patients were admitted for heroin overdose (60%). All 35 patients admitted in ICU had low Glasgow coma scale (GCS< 7). 32 (91.4%) patients had associated respiratory failure. 7 patients had cardiovascular instability. 4 (11.4%) patients developed multi-organ failure during the ICU stay. Mean duration of ICU stay was 3.4 (± 2.68). 23 (65.7%) patients got extubated within 24 hours of ICU admission. 4 patients expired (11.4% mortality) in study group. Sepsis was cause of death in one patient, 3 patients died of multi-organ failureConclusion: Most of the overdose was due to opioids specifically of heroin. CNS depression was found in all drug overdose patients followed by respiratory failure. Multi organ involvement have poor outcome. Mortality ensued in 11.4% of admitted patients as a result of sepsis and multi-organ failure. Majority of the patients had good outcome especially patients who presented early to healthcare facility.

Nosocomial SARS-COVID-19 Outbreak During the Third Wave of COVID-19 in an Oncology Facility at a Tertiary Care Hospital in Kashmir, India.

Coronavirus disease 2019 (COVID-19) emerged as a life-threatening respiratory condition, especially in immunocompromised patients, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Initially detected in China in December 2019, the first case in India was diagnosed on January30, 2020. Here we report a nosocomial COVID-19 outbreak among cancer patients and healthcare workers(HCWs) in a medical oncology unit of a tertiary care hospital from our region. This was a descriptive study of the nosocomial COVID-19 outbreak and was conducted in the month of January 2022 at the medical oncology unit of a tertiary care hospital in Srinagar, Jammu and Kashmir (J&K), India.The study included 25 COVID-19 cases, including patients and HC/non-HCWs (NHCWs). The confirmation of diagnosis was done through real-time polymerase chain reaction (RT-PCR) using nasopharyngeal/oropharyngeal swabs as the test sample. Twenty-five COVID-19 cases, including 14 admitted patients, nine HCWs, and two NHCWs were confirmed by COVID-19 RT-PCR in a span of 11 days. The first case was a positive HCW. The patients were admitted for management of various hematological as well as solid organ malignancies. Of the 14 patients, eight were in the pediatric age group with a mean age of 6.9 years, and six were adults with a mean age of 55.2 years. Thirteen patients were on different chemotherapy protocols, and one was undergoing an autologous stem cell transplant. Of the 14 patients, four were asymptomatic for COVID-19 symptoms, eight had mild disease, and two had severe disease with respiratory failure. Two patients with severe diseases needed COVID-19-designated high-dependency unit (HDU) admission. There was one COVID-19-related death. Among the healthcare workers, the mean age was 33.8 years, of which six were males and three were females. All the HCWs and NHCWs had mild disease, and all of them recovered completely. Nosocomial COVID-19 illness is a new entity and is preventable. COVID-19 illness will remain in society after the pandemic is over, like the influenza B viral illness, and there can be seasonal flares in the future. Proper measures should be taken to prevent its clustering in hospital settings.

CLINICOETIOLOGICAL STUDY OF HEMOLYTIC ANAEMIA IN CHILDREN PRESENTING TO A TERTIARY CARE HOSPITAL OFKASHMIR

Anemia is said to be present when the hemoglobin levels are more than two standard deviations below the mean for the childs age and sex. Hemolytic anemias arise when red blood cells have decreased survival either due to an intrinsic abnormality of the cell or due to extrinsic factors or both. Hemolytic anemias constitute important cause of mortality and morbidity in developing countries. These group of anemias have various clinical presentations starting from their age of onset of symptoms, failure to thrive, anemia, jaundice, splenomegaly, cholelithiasis, cardiomegaly, congestive cardiac failure, severe life-threatening infections and chronic disabilities leading to distress in the families. The present study attempts to reveal the clinical and etiological profile of patients with different types of hemolytic anemia admitted in a pediatric tertiary care hospital of Kashmir. Review of literature shows only few epidemiological studies particularly in this part of the country, and no such study in our state though the disease is fairly prevalent. We undertook this study with this idea. Aims and Objectives: The aims and objectives of this study was to determine clinical and etiological profile of hemolytic anemia in children aged 1month to 18 years admitted in tertiary care hospital of Kashmir. Materiaals & Methods: This prospective observational study was carried out in a pediatric tertiary care hospital in Kashmir over a period of two years. Prior to initiation of study, ethical clearance was obtained. All patients admitted in the indoor of department of pediatrics between age group of 1 month to 18 years with evidence of hemolysis were included in the study. 50 cases were included in the study after obtaining written informed consent from parent or guardian. A detailed history, examination and required investigations were collected. Data was entered and assessed in MS Excel. Results: The study was based on 50 patients, almost equal males and females, 1month to 18 years of age. The most common hemolytic anemia was beta thalassemia major (n=17, 34%), followed by autoimmune hemolytic anemia(n=10,20%), hereditary spherocytosis (n=5,10%), thalassemia trait (8%), pyruvate kinase deficiency (8%) and glucose 6 phosphate dehydrogenase (8%), thalassemia intermedia (4%), sickle cell trait (2%), microangiopathic hemolytic anemia (2%), hereditary xerosis (2%) and hereditary stomatocytosis (2%). Highest number of the cases was less than 3 years old (56%). The most common clinical presentation was jaundice, which was present in all cases, followed by splenomegaly (60%), hepatomegaly (30%), hemolytic facies (26%). Splenomegaly was seen in all cases of thalassemia major, thalassemia intermedia, beta thalassemia trait, hereditary spherocytosis, 2 cases of pyruvate kinase deficiency and 3 cases of glucose 6 phosphate dehydrogenase deficiency. Spleen >5cm was seen in 10 patients. Massive splenomegaly with abdominal discomfort was seen in 3 cases. The mean hemoglobin was least in beta thalassemia major followed by beta thalassemia intermedia, Hereditary spherocytosis, autoimmune hemolytic anemia, glucose 6 phosphate dehydrogenase deficiency and the highest mean hemoglobin was seen in pyruvate kinase deficiency. Means for serum ferritin and serum bilirubin were calculated.

ERCP practice at a tertiary care hospital in Kashmir, North India: a large single-center cross-sectional study with focus on quality indicators, success rate, and indications.

An audit of our endoscopy center at the start of the study for quality and performance indicators and a retrospective analysis of the 4 years of the prospectively maintained data of patients who underwent ERCP regarding procedural success and indications was done. The study showed that ERCP is performed by meeting good quality standards, but structured training, sedation practice, and microbiological surveillance are subpar. A total of 3544 procedures were carried out with successful cannulation of the naive papilla in 93%, with 60% of procedures carried out on females, 80.5% of procedures done for benign diseases, and 19.5% on suspected or proven malignancy (47% men and 53% women) with perihilar obstruction being commonest in both sexes (32-33%) followed by carcinoma gallbladder in women (21%) and distal cholangiocarcinoma in men (27%). Among benign diseases (2711), 12% had benign pancreatic diseases, and 64.8% had common bile duct (CBD) stones, with 31% of CBD stones requiring more than one session for clearance. ERCP at our center is performed by meeting quality standards and by competent endoscopists with good procedural success. Improving sedation strategies, microbiological surveillance, and training programs remains an unmet need.

Abstract #1406850: Prevalence of Primary and Sub-clinical Hypothyroidism and Impact of Metformin on Thyroid Hormones in Patients with Type 2 Diabetes Mellitus in a Tertiary Care Hospital in Kashmir

Diabetes mellitus and hypothyroidism are the commonest endocrine disorders worldwide and tend to coexist and mutually influence each other. We aim to determine the prevalence of overt (OH) and subclinical hypothyroidism (SCH) and impact of metformin on thyroid hormones in patients with type 2 diabetes mellitus (T2DM). In this cross-sectional observational study, 257 adult patients of T2DM enrolled were evaluated for thyroid dysfunctions by testing thyroid profile. The levels of fT3, fT4, serum TSH, and anti-TPO antibody were estimated by chemiluminescent micro-particle immunoassay (CMIA). The correlation analysis of prevalence of thyroid disorder with age distribution, gender distribution, BMI, duration of diabetes and glycated hemoglobin (HbA1C) was done. The mean age in our study was 56.3±7.82 (28-74) years with female to male ratio of 1.62:1(159 females vs. 98 Males). The mean (± SD) duration of diabetes HbA1c of the study cohort was 6.7±2.19years and 8.1±2.53% respectively. The prevalence of OH and SCH was 7.4% (Female vs. Male; 10.7% vs. 2%; p=0.013) and 12.1 % (Female vs. Male; 15.7% vs. 6.1%; p=0.021) respectively. The prevalence of anti-TPO positivity was 94.7%, 51.6%and 10.6% in OH, SCH and euthyroid patients respectively. The prevalence of hypothyroidism and subclinical hypothyroidism was higher in patients of female gender, age >60 years, long duration and uncontrolled diabetes. Among 257 patients, 63% (n=163) patients were on metformin. The mean TSH of patients who were on metformin was significantly lower (1.34±0.95 vs. 3.19±1.41; p < 0.001). However, the mean free T4 and free T3 levels were not significantly different between the two groups. There is high prevalence of hypothyroidism especially subclinical hypothyroidism in diabetic patients. Patients on metformin therapy had significantly lower TSH levels. Screening for thyroid dysfunction among patients with diabetes mellitus should be routinely considered for early diagnosis and effective management.

RISK PROFILE OF KERATOCONUS: A TERTIARY CARE HOSPITAL BASED STUDY

Background: The study aimed to assess the risk factors implicated in the causation of keratoconus and the demographic profile of the patients diagnosed as keratoconus. Materials and Methods: This retrospective, observational, hospital-based study included 376 patients presenting to the ophthalmology outpatient department of a tertiary care hospital in Kashmir from January 2022 to December 2022. Written informed consent was obtained from all participants after explaining the nature of the study.A well-designed questionnaire was used to collect the data of the recruited patients.The demographic characteristics like age, gender, residence were noted and the role of certain risk factors associated with causation of keratoconus was noted. Results: The mean age of participants was 21.8 ± 4.7 years (range, 9-32). The study participants were 58.6% (n = 220/376) males and 41.4% (n = 156/376) females. Majority of the participants belonged to urban areas(55.60%) than rural areas(44.4%). The maximum association of keratoconus was found with eye rubbing(61.2%) followed by male gender (58.6%) and age group 21-30 years (51%). Conclusion: We conclude that eye rubbing is the most significant risk factor, followed by exposure to sunlight and ocular allergy. The findings of our study corroborate that the etiology of keratoconus is multifactorial.

Epidemiology and clinical course of bronchiolitis in hospitalized children in tertiary care hospital in Kashmir

Background: Bronchiolitis is the commonest lower respiratory tract infection in children &lt; 2 years of age and is responsible for the majority of their pediatrician visits and hospital admission during the winter season. The aim of this study was to describe the epidemiological data, seasonal trends, clinical characteristics, and outcomes of children admitted with bronchiolitis in pediatric hospital GMC Srinagar. Methods: This was a retrospective observational study in children less than 2 years of age admitted in department of pediatrics in GMC Srinagar. Data were collected through review of the medical records of patients with a diagnosis of bronchiolitis on discharge and analyzed through SPSS 20. Results: A total of 228 infants were enrolled in the study. The majority were males (60.08%). The median age on admission was 5.5 months, exclusive breastfeeding was the mode of feeding in majority and 8.77% were ex-preterm. Respiratory syncytial virus (RSV) was identified in majority (103) and admission peak was from October to March. Most of the patients presented on day 3 of the illness. Most patients 45.17% were having feeding difficulties and chest auscultation was normal in about 22% of the children. Oxygen supplementation was administered to 85.52% of the children. The 32 children (14.03%) required admission to PICU. Mechanical ventilation was required in 6 children (18.75%). No death occurred in infants while in the hospital. Conclusions: RSV has been found to be the main responsible virus. Management of bronchiolitis is usually symptomatic as recommended by most of the guidelines.

Clinical profile of mumps in children in a tertiary care hospital in Kashmir

Background Mumps is one of the oldest human illnesses known to humans. Mumps is caused by a paramyxovirus, which is a single-strand RNA virus. Mumps is characterized by painful, unilateral, or bilateral swelling of the salivary glands, in particular, the parotid glands. Methods: This is a hospital-based prospective observational study. All children of age ≤18 years, both males and females with acute onset of unilateral or bilateral tender, self-limited swelling of the parotid or other salivary gland without other apparent cause. Results: Of the 150 clinically diagnosed mumps cases, 87 (58%) were male and 63 (42%) were female (male-to-female ratio of 1.4:1). There was no case below 1 year but there were 40 cases between 1 and 5 years. The 40% belonged to the lower middle class of socioeconomic status as per Kuppuswamy’s scale, followed by the upper-middle and lower-middle class. Only 15 patients (10%) were completely immunized whereas the immunization status of 8% patients was not known, and the rest of the patients were non immunized (82%). Fever was the most common presentation (150 patients;100%), followed by parotid involvement. Parotitis was present in 146 (97.3%) cases at some point during the illness, 36 patients (24%) had unilateral and 110 patients (73.3%) had bilateral involvement. 16% of patients had multiple salivary gland involvement. Mean duration of illness was 9.0±2 days. Conclusions: Mumps is a significant public health problem to warrant investment in prevention through vaccination.

A cross sectional study to assess the vaccination practices regarding hepatitis B among health care personnel of a tertiary care hospital in Kashmir

Background: Vaccination is one of the most successful public health interventions that has saved millions of lives so far. Due to the occupational exposure, health care workers have an increased risk of contracting hepatitis B. Objectives were to assess the vaccination practices regarding hepatitis B among healthcare personnel (HCP) and to study the factors associated with the vaccination practices regarding hepatitis B of these HCP. Methods: This cross sectional hospital based study was conducted for a period of 1 year at Sher-I-Kashmir Institute of Medical Sciences (SKIMS) among 450 HCP including doctors, nursing staff, laboratory staff and others and the required sample was drawn from each category on the basis of probability proportionate to size technique. Information was collected from participants by using predesigned, pretested structured and validated questionnaire. Results: It was found that only 34.9% were vaccinated against hepatitis B. The coverage was highest among doctors 55.5% followed by technicians 25.6%, nurses 23.6%. The main reasons for not receiving this vaccine were: taking all necessary precautions (49.1%), hospital does not provide the vaccine (20.8%), not aware about hepatitis B vaccine (20.5 %). Conclusions: The study revealed that the hepatitis B vaccination coverage of these healthcare personnel was quite low in spite of the importance of the vaccine for healthcare personnel who are always at risk of getting exposed to the virus during their duties.

Breastfeeding practices among mothers attending a tertiary care hospital in Kashmir

Background: According to world health organization (WHO), exclusive breastfeeding (EBF) for the first 6 months of life is vital for optimal growth and development of a child. During this period, other liquids or breastfeeding substitutes should not be given to infants except for medicine or oral rehydration solution. Methods: This cross-sectional study was conducted in the child health clinic of the department of community medicine, SKIMS. The study participants were mothers accompanying their infants coming for immunisation at the child health centre. A semi-structured, questionnaire was used to interview the mothers regarding breast feeding practices of their infants. The data was entered in Microsoft excel 2010 and analysed using SPSS Version 20. Results: The prevalence of EBF was 38.7%. Mixed feeding was received by 54% and 7.3% were formula-fed. Variables that were significantly associated with EBF include residence and mother’s education. Infants from rural area were more likely to be exclusively breastfed compared to those from urban area (OR=0.365; 95% CI=0.166-0.802; p=0.012). Mothers with up to 9 years of formal education were more likely to exclusively breastfed their children than those with more than 9 years of formal education (OR=0.300;95% CI=0.121-0.744, p=0.009). Conclusions: To ensure that the rate of EBF among the mothers is increased, all the stakeholders (spouse, family and government) as well as the people at work place must play their part to the best extent.

PREVALENCE OF KERATOCONUS IN KASHMIR IN NORTH INDIA: A VIDEOKERATOGRAPHIC STUDY

Purpose: To detect the incidence of keratoconus by videokeratography in patients in Kashmir in North India and to describe the clinical characteristics associated with it. Design: Cross sectional study Methodology: This study was carried out on eyes of 212 patients between 5 to 20 years of age presenting to tertiary care hospital of Kashmir in north India over a period of two years. Best Corrected Visual Acuity (BCVA), slit lamp examination, pachymetry, refraction, fundus examination, and corneal topography was done in all the patients and clinical ndings recorded. To detect keratoconus, corneal topography maps were analysed using Rabinowitz-McDonnel criteria. Maps with central corneal power(Kmax) greater than 47.2 diopters and the inferosuperior asymmetry value greater than 1.4 were considered to have a keratoconus pattern. Results: Out of 212 patients, 145 were males and 67 were females. Majority were in the age group of 5- 10 years. Among the study eyes, Kmax&gt; 47.2 D was seen in 10.1 %, Sim K astigmatism &gt; 1.5D in 29%, I-S difference &gt; 1.4 D in 11.79 % , SRAX &gt; 21° in 20% and K max&gt;47.2 D + I-S Difference &gt;1.4 i.e keratoconus pattern was seen in 93 eyes i.e 21.9% Conclusion: Incidence of keratoconus in allergic patients is more when compared to general population of the same age group from previous studies. The videokeratographic examination of patients leads to early detection of mild keratoconus by interpretation of color-coded maps.

Protective Antibody Titer against Hepatitis B in Healthcare Workers: A Cross-sectional Study from Tertiary Care Hospital of Kashmir

Introduction: Hepatitis B is not only the most transmissible blood borne viral infection, but also the only one that is preventable by vaccination. In developing countries, Hepatitis B vaccination coverage among Healthcare Workers (HCWs) is very low for various reasons. Aim: To evaluate Hepatitis B Virus (HBV) immunisation status and Hepatitis B surface antibody (anti-HBs) titer among HCWs in a tertiary care hospital in Kashmir. Materials and Methods: This cross-sectional study was conducted in the Department of Microbiology, Government Medical College, Srinagar, India from April 2019 to June 2019. Serum samples were collected from 196 HCWs and their vaccination history was collected. Those who had taken all three doses of hepatitis B were considered to be fully vaccinated those that had taken two doses as partially vaccinated. Triple serology was done for all which included testing for HBV, Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) infection, one HCW turned out to be Hepatitis B Surface Antigen (HBsAg) positive and was dropped out of study. Those negative (195/196) were further tested for anti-HBs titer by enzyme immunoassay method. Parametric data are expressed as mean±Standard Deviation (SD) and categorical values as percentages. Results: Out of 195 HCWs selected for the study, 112 (57.4%) were males and 84 (43%) were females with mean age 38.4±6.9 years. Among them fully vaccinated were 46 (23.5%), partially vaccinated were 84 (43.07%) and not vaccinated were 65 (33.33%). Anti-HBs titers were protective in 54 (27.7%) which belonged 81.5% (44/54) to vaccinated category and 18.5% (10/54) to partially vaccinated category. Conclusion: Fully vaccinated HCWs (95.6%) had a protective antibody titer but unfortunately there are low vaccination rates among HCWs. There is a need for well-planned and clear policies for HBV screening and vaccination in HCWs, especially those who are at a greater risk of exposure to blood or other potentially infectious material.

Delay in Diagnosis of Stomach Cancer patients attending a Tertiary Care Hospital in Kashmir: a Hospital Based Cross Sectional Study

Introduction: The incidence of cancer is increasing throughout the world. However, early detection of cancers is associated with a favourable outcome. Stomach cancer is one of the most common cancers of gastrointestinal tract. Majority patients visit physicians in developed stages. Objective: To evaluate the reporting pattern of stomach cancer patients living in Kashmir valley in order to determine the median time of delay from the beginning of symptoms to diagnosis. Method: Total 116 proven stomach cancer patients were evaluated for the pattern of presentation at endoscopy laboratory of Super Speciality Hospital, Shireen Bagh Kashmir from April 2019 to September 2020.Results: In this study, the mean age (SD) of participants was 60.22 ± (11.90) years. Majority of the participants (69.8%) were males. Cases were predominantly from the rural area (58%).Only 15.5 % of the cases were diagnosed within one month of their symptoms while as 3.4% of the cases had a total delay of more than 12 months. The study found a considerable total delay in the diagnosis of stomach cancer. The mean of the patient delay was 45.6 days. The median total delay was 20 weeks. Conclusion: Since stomach cancer has high mortality and morbidity rates associated, creating awareness among the population and training of physicians regarding timely referral of patients seems important.

CLINICAL PROFILE OF POSTERIOR BLEPHARITIS – A HOSPITAL-BASED STUDY

Purpose: To study the clinical prole of Posterior Blepharitis in a Tertiary Care Hospital in Kashmir. Methods: In this prospective study, patients presenting with Posterior Blepharitis visiting Out Patient Department (OPD) of Government Medical College, Srinagar from January 2021 to June 2021 were enrolled and evaluated. A complete history and detailed ophthalmological evaluation was done. Results: 50 patients were evaluated. The mean age of patients was 58.36±6.42 years. Males were 56% and females 44%. Most of the cases from our study had complaints of dryness/grittiness (30%), swollen lids (18%), itching (16%), and crusted lashes (16%).

The pattern of Patients Presenting as Vertigo to the OPD Services at a Tertiary Care Hospital in Kashmir: A Hospital-Based Cross-Sectional Study

Vertigo is a symptom of vestibular dysfunction with a sensation of motion (most commonly rotational motion). It is one of the common presenting complaints in primary care institutions and emergency departments.

PROFILE OF OCULAR TRAUMA IN A TERTIARY HOSPITAL IN KASHMIR

Purpose: To study the common causes and manifestations of ocular trauma in a Tertiary Care Hospital in Kashmir. Methods: In this prospective study, patients presenting with ocular trauma visiting Out Patient Department (OPD) and Emergency Department of Government Medical College, Srinagar from January 2021 to January 2022 were evaluated. A complete history and detailed ophthalmological evaluation was done. Results: 520 patients were evaluated. The mean age of patients was 26.42 ±14.7 years. Males were 72.6% and females 27.4%. The majority of the patients (29.53%) were between 21-30 years of age. Students were most commonly affected (38.57%). Road Trafc Accidents (17.14%) and sportsrelated injuries (10.5%) were the most common causes

Surgical outcomes of canalicular tear repair with self-retaining Mini-Monoka stent in a tertiary care hospital in Kashmir in North India

Background: Canalicular lacerations contribute to approximately 16% of the eye lid injuries. The torn medial end is to be identified, cut end sutured, and then the canaliculus intubated to restore patency. Silicone being inert, flexible, easily available, and cost effective is the material of choice for lacrimal stenting. Aims and Objectives: The aim of this study was to determine the surgical outcomes of the canalicular tear repair with the self-retaining Mini-Monoka stent in a tertiary care hospital in North India. Materials and Methods: Patients presenting to tertiary care hospital in Kashmir, North India with canalicular tear from August 2019 to December 2020 were included in this prospective study and repaired with self-retaining Mini-Monoka stent under microscope. All the patients were analyzed for demographic data, mode of injury, complications, and outcomes and followed up after a week, 6 weeks, and 3 months and stent removed after 6 weeks. Results: The study was conducted on 18 patients. The mean age of the patients was 37.5 years with male: female ratio of 5:1. The lower canaliculus was most commonly involved and road traffic accidents was the most common mode of injury (27.7%). The most common associated injury was lid injury (50%). The mean time of stent removal was 6 weeks±2 weeks. Syringing was done in all the patients except children. At last follow-up, 17 out of 18 patients had functional and anatomical success in terms of absence of epiphora and patent syringing and all the patients were cosmetically satisfied. Conclusion: Our study concludes that surgical repair of canalicular tear with Mini-Monoka stent is a safe and simple reliable technique, cosmetically satisfying with minimal manipulation giving high functional and anatomical success rate post repair.

PATTERN OF PATIENTS PRESENTING AS VERTIGO TO THE OPD SERVICES AT A TERTIARY CARE HOSPITAL IN KASHMIR. : A HOSPITAL BASED CROSS-SECTIONAL STUDY

Background: Vertigo is a symptom of vestibular dysfunction with a sensation of motion (most commonly rotational motion). It is one of the common presenting complaints in primary care institutions and emergency departments. Different words are used by different patients about the type of motion being perceived. Vertigo affects both men and women &amp; all age groups. Diagnosis of the underlying disease demands that the complaint of vertigo be analyzed correctly. To determine the 1. Associated presenting symptoms, 2. Pattern of diseases &amp; 3. Risk fac Objectives: tors of Vertigo among patients attending the OPD services at a Tertiary Care Hospital in Kashmir. A cross-s Methods: ectional Study was conducted among the patients attending the OPD services of the Post Graduate Department of Otorhinolaryngology and Head and Neck surgery (ORL AND HNS), Government SMHS Hospital Srinagar for a period of 18 months from May 2020 up to October 2021. All the patients of peripheral vertigo attending the ENT OPD in the age group of 21 to 70 years of age of either sex were included. Patients of Central vertigo, Severe Cervical Spinal disease, Uncontrolled Hypertension and active Heart ailments were excluded. 68 patients (61.8%) were Results &amp; Discussion: females while as 42 patients (38.2%) were males. Majority of patients presented as Vertigo associated with change in position (41.8%) followed by Vertigo associated with change in position &amp; Nausea vomiting (20.9%); Vertigo &amp; Tinnitus (10.9%) &amp; Vertigo &amp; Nausea vomiting (9.1%). Vertigo associated with Change in position was the most common symptom present in 62.7% followed by Nausea/Vomiting (30%). Mean age of participants was 43.4 years with an SD of 10.2 years. The minimum age was 22 years &amp; maximum age was 70 years. Out of 110 patients in this study 75 Patients (68.2%) had BPPV, 30 Patients (27.3%) had Meniere's disease &amp; only 5 Patients (4.5%) had Vestibular neuritis. The mean age was highest among patients of Meniere's disease (49.50 Years), followed by patients of Vestibular neuritis (44.80 Years) &amp; BPPV (40.85 Years); and this difference was statistically significant as the p value was less than 0.05. Vertigo with change in position was specifically associated with BPPV, while as Vertigo with Tinnitis/ Aural Fullness/ Fluctuating hearing was specifically associated with Meniere's disease. Vertigo with Nausea and vomiting was specifically associated with Vestibular neuritis. All these associations were statistically significant with a p value of &lt;0.001. The Vertigo of BPPV presented for Seconds, the Vertigo of Meniere's disease presented for Minutes and Hours; &amp; the Vertigo of Vestibular Neuritis presented for days. This study was devised to determine the pattern of patie Conclusion: nts presenting as vertigo to the OPD services at government SMHS hospital Srinagar. A total of 110 patients aged 22 to 70 years of age of either sex presenting with the complaint of vertigo were included in the study. Vertigo associated with change in position was the most common presentation &amp; BPPV was the most common diagnosis (68.2%) followed by Meniere's disease (27.3%). Vertigo with change in position was specifically associated with BPPV, while as Vertigo with Tinnitis/ Aural Fullness/ Fluctuating hearing was specifically associated with Meniere's disease. The Vertigo of BPPV usually presented for Seconds, the Vertigo of Meniere's disease for Minutes to Hours &amp; that of Vestibular Neuritis for days.