Tertiary Care Teaching Hospital Research Articles

Prevalence of ESKAPE pathogens and Antibiotic Susceptibility Status in Skin and Soft Tissue Infections from a tertiary care teaching hospital in South India

Background: ESKAPE “(Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter sp.)” pathogens are commonly found in infections affecting the skin and underlying tissues. ESKAPE pathogens often exhibit widespread multidrug resistance in hospitals, contributing significantly to Hospital-acquired infections. ESKAPE pathogen prevalence can combat the vast challenge of Antibiotic Resistance (ABR). Materials and Methods: “The microbiological statistics of ESKAPE infections and sensitivity between January 2020 and October 2022 were extracted from the laboratory records and analysed for the bacterial profile and antibiotic sensitivity pattern”. Results: Out of the 2037 pathogens isolated from Skin and soft tissue infection, 1308 were ESKAPE pathogens accounting for a prevalence of 64.2%. Staphylococcus aureus (n=340/1308; 25.99%) was the predominant pathogen followed by Pseudomonas aeruginosa (n=332/1308; 25.38%). Among Gram-negative isolates, 29.43% exhibited multidrug resistance (MDR). Carbapenemase was found to be a frequent mechanism of resistance, highest among Acinetobacter species (n=99; 64.7%), followed by Klebsiella pneumoniae (n=109; 37.07%). Amp C production was seen most commonly in Enterobacter species (n=93; 61.2%), followed by Klebsiella pneumoniae (n=172; 58.5%) whereas ESBL production was seen in Enterobacter species (n=46; 30.03%). Conclusion: ESKAPE pathogens are critical etiologic agents of Skin and soft infections. Regular studies are vital for evaluating bacterial susceptibility and highlighting the importance of policies to reduce hospital infections and enhance antibiotic prescription oversight. Understanding virulence and resistance markers is critical for tailoring treatment strategies based on local antibiograms and managing related infections.

A Cross Sectional Study on Prescription Pattern of Antiepileptic Medication among Children of Southern Rajasthan in a Tertiary Care Teaching Hospital

A Cross Sectional Study on Prescription Pattern of Antiepileptic Medication among Children of Southern Rajasthan in a Tertiary Care Teaching Hospital

Seroprevalence of transfusion -transmitted infections among blood donors in a tertiary care hospital in and around Koodapakkam, Puducherry, India

Introduction: Even though blood transfusion safety has come a long way, Transfusion-Transmitted Infections (TTI), which include bacterial, viral, parasitic, and prions, can still spread with each transfusion. The main goal of this study was to determine the seroprevalence of the five TTIs that are required to be tested in India among blood donors at our facility. Accurate estimates of the risk of TTIs are essential for monitoring the safety of the blood supply. Methodology: This was a retrospective descriptive study conducted in the blood centre of a tertiary care teaching hospital in Puducherry, from 2017 to 2023. Records from blood banks were reviewed to collect data on all donors who underwent appropriate testing for HIV, hepatitis C, Hepatitis B, syphilis, and malaria. Enzyme-linked immunosorbent assay was done for HIV, HCV, HBsAg/hepatitis B surface antigen, and rapid card testing was done for syphilis and malaria. Results: There was a total of 2570 donors during the study period. In the present study, the overall seroprevalence of TTIs was 1.40%. The individual seropositivity rates were 0.03% for HIV, 0.93 % for HBsAg, and 0.43 % for syphilis. There were no cases of malaria and HCV detected in the study period. The highest percentage of prevalence was observed for HBV, followed by Syphilis and HIV. Conclusion: The overall seroprevalence of TTI in Puducherry was smaller than those reported elsewhere in the country. It was comparatively lesser than the national average for HIV, HCV, and HBV and much higher for syphilis.

Assessment of safety and adverse events following COVID-19 vaccination and their predictors in first 30 days among healthcare workers of a tertiary care teaching hospital in North India

BackgroundThe COVID-19 vaccines were rolled out as an emergency measure, with an expedited approval to contain the pandemic. The objective of this study was to assess the incidence, pattern and severity of AEFIs reported following COVID-19 vaccination and their predictors among the healthcare workers. Materials and methodsA prospective cohort study enrolling healthcare workers of a tertiary care Institute in North India receiving COVISHIELD™ from February to May 2021 was carried out to assess the incidence, pattern and severity of AEFI over the next 30 days. Both active and passive surveillance methods were used for AEFI recording. Bivariate analysis was performed to ascertain the predictors of AEFIs. ResultsA total of 836 healthcare workers who received the first dose of COVISHIELD™ were included in the study of which 201 (24.0 %) experienced one or more AEFIs. Majority of AEFIs were of minor grade (99.8 %) and resolved spontaneously. Majority (96.0 %) had onset of the AEFIs within 48 hrs of vaccination. Serious AEFIs, leading to hospitalization was noticed in 2(0.2 %) participants, both females, with suspicion of immunization stress related response (ISRR). Both of them recovered without any sequelae. No deaths were recorded. Factors found to be significantly associated with the occurrence of AEFIs in the participants were female gender (p = 0.02), monthly income > 20,000 INR (p = 0.007), presence of any chronic illness (p < 0.0001), history of allergic reaction to any drug/vaccine (p = 0.01), history of COVID-19 infection (p < 0.00002) and history of hospitalization due to COVID-19 (p < 0.0002). ConclusionMajority of the AEFIs observed were of minor grade with spontaneous resolution of the symptoms indicating safety and well tolerability of the vaccine. Female gender, higher income, history of allergy and co-morbidities, history of COVID-19 infection and history of hospitalization were found to be major predictors for the development of adverse events and require more watchful vaccination.

FACTORS ASSOCIATED WITH ACCEPTANCE AND REFUSAL FOR PPIUCD AT TERTIARY CARE TEACHING HOSPITAL IN MAHARASHTRA

FACTORS ASSOCIATED WITH ACCEPTANCE AND REFUSAL FOR PPIUCD AT TERTIARY CARE TEACHING HOSPITAL IN MAHARASHTRA

To Evaluate the Epidemiology, Etiology, Risk Factors and Treatment Management in Chronic Kidney Disease on Children, Adult and Geriatric Patients in a Tertiary Care Teaching Hospital in Nellore, on Study-II

To Evaluate the Epidemiology, Etiology, Risk Factors and Treatment Management in Chronic Kidney Disease on Children, Adult and Geriatric Patients in a Tertiary Care Teaching Hospital in Nellore, on Study-II

Proportion of hydatidiform molar gestations among patients undergoing uterine evacuation for missed abortions, associated demographics and risk factors -Experience at a single center over 18 months

Objectives: Gestational trophoblastic diseases represent a significant obstetric morbidity among women of reproductive age, with a potential to impact women’s health substantially. Molar pregnancies present as clinical aberrations in embryogenesis and placentation during the first trimester of pregnancy. Cases with missed abortions and spontaneous incomplete abortions requiring uterine evacuation, could be an opportunity to look for molar pregnancies through histopathology which otherwise could be missed. We aim to study the proportion of hydatidiform molar gestations among patients undergoing uterine evacuation in cases of missed abortion and to evaluate the demographic and risk factors associated with hydatidiform molar gestations. Material and Methods: A prospective observational, descriptive study was conducted at the Department of Obstetrics and Gynecology of a tertiary care teaching hospital over a period of 18 months. Data was collected using a pre-tested study questionnaire which included the objectives, besides the inclusion and exclusion criteria. The abortus and uterine evacuated tissue was sent for histopathologic examination by a single histopathologist. Analysis of various epidemiological characteristics and risk factors was done using the Statistical Package for the Social Sciences software version 21. Results: Out of 67 patients presenting with missed abortions or incomplete abortions during the study period, five had hydatidiform molar gestations; an incidence of 7.5%. Upon histological examination 3 (4.5%) patients had a complete mole, 2 (3%) had a partial mole while 62 (92.5%) had non-molar histopathology. Eleven (16.4%) of the study participants had a history of previous spontaneous pregnancy loss/recurrent pregnancy losses. Three among five cases detected to have molar gestations had a history of prior spontaneous abortions (60%), and the difference observed was statistically significant (P = 0.019; Odds Ratio [95% Confidence interval] 10.25 [1.459–70.257]). Hyperthyroidism and high levels of serum beta-human chorionic gonadotrophin (β-HCG) were associated with molar gestations and this was statistically significant. Conclusion: The risk of developing molar gestation is higher in patients who had previous first-trimester losses. Importantly, this should be a differential diagnosis in instances with elevated β-HCG and high thyroid hormone levels. Histopathological examination of products of conception should be considered as an essential assessment in all presentations of spontaneous abortions requiring uterine evacuation.

Assessment of Patient Awareness Regarding Chronic Kidney Disease Management in Santhal Parganas

Background: Chronic kidney disease (CKD) is a global health challenge, and effective self-management is crucial for optimal outcomes. Assessing the prevailing knowledge about CKD in patients can help strategies information education communication program to better manage the disease. This study evaluated the current knowledge of self-management of CKD among patients suffering from CKD in Santhal Parganas of Jharkhand state in India. Materials and Methods: This cross-sectional survey was conducted in a tertiary care teaching hospital situated in Deoghar, Jharkhand, India from June to December 2023. Patients suffering from CKD were enrolled for this study from the Outpatient Department. The Chronic Kidney Disease Self-Management Knowledge Tool (CKD-SMKT) was used to measure patients’ knowledge through face-to-face interviews conducted by a trained local surveyor. Results: A total of 228 patients with a mean age of 52.63±10.65 years (men 136 [59.65%], women 92 [40.35%]) participated in the survey. All the patients (100%) gained knowledge about CKD from doctors, followed by other patients (63.6%) and relatives (41.23%). On average, 53.61% did not have proper knowledge about overall kidney disease. Correct knowledge about maintaining kidney health was among 38.1% of patients with 36.59% unsure about their knowledge and 25.31% declaring their lack of knowledge. Conclusion: A low level of knowledge about kidney health was found among the patients suffering from CKD in Santhal Parganas, a region with a tribal population with a low literacy rate. The identified knowledge gap emphasizes the need for a tailored educational program for CKD patients by doctors and patients relative.

Development and evaluation of prevention bundle for neonatal healthcare-associated infections: an interventional study

Background Neonatal healthcare-associated infection (HAI) globally is the leading preventable cause of neonatal mortality. Neonatal mortality in India is also very high. Considering that HAIs can be prevented globally, there are disparities in resources; the current study aimed at developing locally feasible and effective prevention bundles for neonatal HAIs. Methods A mixed-method study was conducted at one tertiary care teaching hospital's level IV Neonatal Intensive Care Unit. The study explores the causes of neonatal HAIs, current processes, benchmark practices, gaps in current practices with HAIs, root-cause analysis and system process mapping, and failure mode effect analysis. Observations, interviews, brainstorming activities, and a survey were conducted. Written and audio-video recorded prevention bundle was developed and implemented using a quasi-experimental study design. Results Process standardisation, healthcare worker training, hand hygiene practices, nursing care process and vascular access process were identified as key improvement areas to prevent neonatal HAIs. Out of eighteen identified processes, three processes were standardised. All the healthcare providers were trained at three-time intervals of three months each. After implementing the prevention bundle, there was a significant decline in the rate of HAIs, reducing it from 9.6 to 7.0 per 100 admissions &gt;48 hours. The bacteraemia rate fell from 5.2 per 1000 patient days to 2.6 per 1000 patient days and was statistically significant on a two-tailed student t-test with 95% CI with p-value=0.00073. Conclusions Our developed prevention bundle for neonatal HAIs was significantly effective and reproducible for healthcare workers' training and development. Considering variations in global infection control practices and resources constraint, it is effective to develop a local prevention bundle for neonatal HAIs.

Experience of nurses in Caring for patients with COVID-19: A descriptive qualitative study

IntroductionCoronavirus disease 2019 (COVID-19) had a significant impact on nursing practice. Managing a wide range of patients, with those ranging from mild infection to those with critical illness requiring mechanical ventilation, posed unprecedent challenges to nurses. MethodThe aim of the study was to explore and describe the experiences of nurses in caring for patients with COVID-19. We adopted a qualitative descriptive design to study the experiences of nurses regarding the management of patients with COVID-19. The study was conducted among ten nurses who were involved in the care of COVID-19 patients at a tertiary care teaching hospital in south-east India. The data were analyzed using the Braun and Clarke thematic analysis method. ResultsThe study participants consisted of 8 female and 2 male nurses and were in the age group of 22–31 years. Five major themes emerged during data analysis. The themes were 1. personal problems, 2. challenges in the work environment, 3. professional preparedness, 4. support systems and 5. satisfaction with patient care. ConclusionThe COVID-19 pandemic has had a significant impact on the lives of nurses. Nurses faced a plethora of problems and challenges while taking care of people with COVID-19. Nurses experienced personal problems, including fear of contracting illness and social stigma. There were various challenges in the work environment, such as difficulties in using personal protective equipment. The other major themes were professional preparedness, support systems and satisfaction with patient care. It is essential to acknowledge that continuous training is essential and that adequate provision of facilities can enhance the morale of nurses, resulting in better job satisfaction.

Exploring Biomedical Waste Management Practices Among Healthcare Professionals: A Study From a Tertiary Care Teaching Hospital in Eastern India.

The generation of biomedical waste (BMW) in hospitals presents a significant hazard to both healthcare workers (HCWs) and the environment. The management of BMW is a challenge regarding inappropriate behavior among HCWs, leading to improper segregation of the BMW, which deserves attention.The indiscriminate BMW management issue in India has attracted the attention of the highest judicial bodies. The rise in the incidence of needle stick injuries is a severe threat to waste handlers and is mainly due to improper segregation practices. This study aimed to identify the challenges in BMW management in the institute and develop a strategy to improve the knowledge and practices of healthcare professionals (HCPs) in BMW management. A process-based intervention was developed and implemented that involved facility inspection rounds, focused group discussions with HCWs, preparation of information, education, and communication (IEC) materials, signage, staff training, and improved infrastructure and supplies for waste collection. A questionnaire-based evaluation of the staff's knowledge of BMW management was conducted, and the impact of the intervention was assessed from the hospital infection control audit reports. Multiple reasons for poor compliance with BMW segregation practices were identified, and it improved from 57% to 91% with interventions. A significant difference was noted in the knowledge level of staff before and after the interventions.Post-intervention score was highest among the nurses (98.5%), followed by sanitation staff (92.7%), doctors (89.25%), and paramedics (81.7%). Incorrect segregation practices of BMW and incidents of occupational exposure to blood and body fluids are reduced with interventions in the study. Robust supply chain management with regular training of staff is vital to ensure compliance in BMW management.

Cross-sectional study of the prevalence of inter-arm blood pressure difference in offspring of normotensive and hypertensive parents among students of tertiary care teaching hospital, Hyderabad

Cross-sectional study of the prevalence of inter-arm blood pressure difference in offspring of normotensive and hypertensive parents among students of tertiary care teaching hospital, Hyderabad

Pulmonary function in Thai patients with systemic sclerosis;a single center 6-year retrospective study.

Pulmonary involvement is a major cause of internal organ complication and the leading cause of death in patients with systemic sclerosis (SSc). This study aimed to demonstrate the characteristics of pulmonary function (PF) in Thai patients with SSc and the association between PF and body mass index (BMI) and anti-topoisomerase (anti-Scl70). All patients diagnosed with SSc in our tertiary care teaching hospital database between 2016 and 2021 were reviewed and analyzed. Of 211 SSc patients, 128 patients who underwent the PF test were enrolled; 102 (79.7%) were female. The mean age was 54 years. The median BMI for all patients was 21.7 kg/m 2. Regarding anti-Scl70, 10.9% of patients were positive, 7.8% were negative, and the status was unreported for 81.3%. The mean (SD) forced expiratory volume in one second (FEV1) forced vital capacity (FVC) ratio was 0.8 (0.1). The mean (SD) % predicted values of FEV1, FVC, and diffusing capacity of the lungs for carbon monoxide (DLCO) were 76.3 (16.3), 69.1 (15.8), and 75.5 (22.8), respectively. A restrictive spirometry pattern (RSP) was found in 78.8% of the patients. DLCO had a moderate positive linear correlation with FVC (r=0.50, p <0.001) and a moderate negative linear correlation with BMI (r=-0.36, p <0.001). However, there was no correlation between FVC and BMI. There was no statistical difference in demographic data or the presence of anti-Scl70 among patients with or without RSP. RSP is common among Thai patients with SSc. However, the power of using demographic data and the presence of anti-Scl70 to determine the probability of pulmonary involvement remains limited.

Pattern of mortality in a tertiary care teaching hospital according to the 11th Revision International classification of disease

Pattern of mortality in a tertiary care teaching hospital according to the 11th Revision International classification of disease

Knowledge, Attitude, and Practice Regarding Dyslipidemia among Adult Patients Visiting Medicine Outpatient Department of a Tertiary Care Teaching Hospital in Delhi

Abstract Background: Dyslipidemia, a key risk factor for atherosclerosis, affects 25%–30% of urban and 15%–20% of rural individuals in India, as per the Indian Heart Watch study. Despite its association with cardiovascular diseases, there is insufficient understanding among the public. Given the scarcity of studies on knowledge, attitudes, and practices of dyslipidemia among the Indian population, this study aims to fill that gap. Materials and Methods: A cross-sectional observational study was conducted from September 2022 to February 2024. A total of 288 adult patients visiting the medicine outpatient department were included in the study through convenience sampling. A structured questionnaire consisting of 42 questions was designed, pretested, and administered to the participants to assess their knowledge, attitude, and practices regarding dyslipidemia. Data regarding lipid profile tests (total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein) were collected, and medication adherence was also asked from the patients. Results: The study revealed a lack of knowledge, negative attitudes, and poor practices regarding dyslipidemia among the participants. The study included 288 participants with an average age of 40 years, predominantly males (53.1%). The majority of participants lacked knowledge about dyslipidemia (81.9%), with a prevalent misconception identified, with many participants incorrectly associating dyslipidemia exclusively with obesity. Among dyslipidemic patients, medication adherence was suboptimal, with a significant proportion discontinuing medication over time (87.3%). Factors associated with better knowledge of dyslipidemia included younger age, male gender, higher education level, professional occupation, higher income, unmarried status (who tend to be younger), urban residence, absence of comorbidities, and lower body mass index. Conclusion: The findings reveal significant gaps in awareness, negative attitudes, and suboptimal practices related to dyslipidemia and its management among the study participants. The majority of participants lacked knowledge about dyslipidemia, with a prevalent misconception associating it primarily with obesity.

Outcomes from Early Experience with Laparoscopic Inguinal Hernia Repair Versus Open Technique: Navigating the learning curve.

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

An observational prospective cross-sectional study on extravascular lung water by lung ultrasound as a guide to fluid resuscitation therapy in adult septic shock in tertiary care hospital in central India

Background Septic shock is a life-threatening condition characterized by systemic inflammation and organ dysfunction, with fluid resuscitation being a cornerstone of management. However, indiscriminate fluid administration can lead to fluid overload and worsen outcomes. Extravascular lung water (EVLW) estimation by lung ultrasound has emerged as a promising tool for guiding fluid therapy in septic shock, allowing clinicians to assess pulmonary edema and tailor resuscitation strategies accordingly. Methods This prospective observational study aims to evaluate the utility of EVLW estimation by lung ultrasound in guiding fluid resuscitation therapy in adult patients with septic shock admitted to a rural tertiary care teaching hospital. Eligible patients admitted to the intensive care unit (ICU) will undergo baseline demographic and clinical assessments, including lung ultrasound, to quantify EVLW using B-line analysis. Fluid resuscitation therapy will be initiated based on EVLW findings, with subsequent adjustments guided by repeat lung ultrasound examinations at 6, 12, 24, and 48 hours post-initiation. Outcome measures include changes in mean PaO2/FiO2 ratios, respiratory parameters, renal function, fluid balance, and mortality rates. Expected Outcome We anticipate that EVLW-guided fluid resuscitation therapy will lead to more precise and tailored management of septic shock, potentially reducing the incidence of fluid overload, ARDS, and renal dysfunction. By optimizing fluid management strategies based on individual patient characteristics and responses, we aim to improve clinical outcomes and enhance the delivery of care for patients with septic shock.

Complications of placenta previa: A retrospective observational study at tertiary care hospital

: Placenta previa (PP) is condition where the placenta is inserted completely or partially into the lower uterine segment, at or after 28 weeks of gestation. Maternal and fetal risks are antepartum haemorrhage (APH), postpartum haemorrhage (PPH), abnormal adherence of placenta, low birth weight (LBW), intra uterine growth restriction (IUGR), preterm births and congenital malformations. The purpose of this study was to determine the proportion of placenta previa, the demographics of patients, types- severity, complications and the feto-maternal outcome in patients of placenta previa.: After due permission of Institutional Review Board, this retrospective observational study was carried out at tertiary care teaching hospital from July 2020 to November 2022.Proportion of pregnancies with placenta previa was 0.3%. Majority 44(91.7%) patients were registered, 38(79.2%) of patients were in age group of 21-30 years, 38(79.1%) patients were multigravida, 41 (85.4%) had major degree of placenta previa, 29(60.4%) patients admitted after 37 weeks of gestation and 47(97.9%) of patients were delivered by caesarean section. Majority of patients, 20 (41.7%) had mild anemia. Major complications were bleeding episodes during antenatal period/APH in 23 (47.9%) and PPH in 22 (45.8%) patients. Maternal mortality occurred in 1 (2.1%) patient. All babies were live at time of birth and 44(91.7%) babies were alive at the time of discharge and neonatal death occurred in 4 (8.3%) preterm babies (28-33 week gestation). Majority of patients were multigravida. No patient was severely anaemic. Majority of patients were delivered by CS. APH and PPH were major complications. About two third of patients required blood transfusion in ante/intra/post-natal period. Obstetric hysterectomy was required in about one tenth of patients. Majority of babies were alive at the time of discharge due to higher number of registered patients who took regular antenatal care, hospital delivery and good NICU facilities. Once diagnosed, placenta previa and morbidly adherent placenta should be managed at tertiary care centre with multidisciplinary approach so as to lessen the feto-maternal morbidity and mortality. Prevention is better than cure. Multiparity increases the risk of placenta previa. Hence, family planning with an aim to reduce unwanted pregnancies and abortions will help to reduce the chances placenta previa. CS increases the risk of development of placenta previa. Efforts should be made to reduce the primary caesarean section rate as it poses more risk of placenta previa, morbidly adherent placenta and its related complications in subsequent gestations.

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

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

Knowledge, Attitude, and Practice on Over-the-counter Drugs among Undergraduate Students of a Tertiary Care Teaching Hospital

INTRODUCTIONOver-the-counter drugs are those which are safe and effective for the general public to use, without consulting a health care professional. Self-medication with over-the-counter drugs is common among medicine and health science students. This study aimed to assess the knowledge, attitude, and practice on over-the-counter drugs among undergraduate students of a tertiary care teaching hospital. MATERIAL AND METHODSA descriptive cross-sectional study was conducted among first and second year undergraduate students from June 2023 to September 2023. Data was collected through self-administered questionnaire and was entered and analyzed in Statistical Package for Social Sciences version 16. Descriptive statistical analysis was carried out to find out knowledge, attitude and practice of over the counter drugs. RESULTSAmong 352 students, 272 (77.27%) had good knowledge (with mean knowledge score of 7.22±1.43 out of 9) on over the counter drugs. Almost all of the students 350 (99.43%) had a positive attitude toward over the counter drugs use, (with a mean attitude score of 27.55±2.70, out of 40). Only 195 (55.40%) students always read the instructions on the medicine’s label before use. Most commonly used over the counter drugs was antipyretics 264 (75%). CONCLUSIONMajority of the students had good knowledge and practice and positive attitude towards over the counter drugs use, however, there were few inappropriate practices. Awareness on proper use of over the counter drugs among students is necessary in medical institutions to prevent the misuse of these drugs.