Western Maharashtra Research Articles

Clinicopathological analysis of sinonasal lesions

The sinonasal tract is exposed to a variety of infections, chemical irritants, antigens and trauma giving rise to diverse inflammatory as well as neoplastic lesions. The aim was to study the clinicopathological profile of lesions of nose and paranasal sinuses in this area of western Maharashtra. The study included 59 biopsies/resection specimens received in the department during Jan 2015 to June 2019. Clinical and pathological details were analysed. There were 33 females and 26 males. Out of 59 cases, 46 were nonneoplastic and 13 neoplastic, with 10 benign and three malignant. The most common nonneoplastic lesion was sinonasal polyp (42 cases). Other nonneoplastic lesions included three cases of mucormycosis and one case of rhinosporidiosis. In the benign neoplasms, there were three cases of hemangiomas, two hamartomas, two inverted papillomas with one case each of hidradenoma, angiofibroma and schwannoma. We had three malignant tumors, one case each of, melanoma, poorly differentiated carcinoma and squammous cell carcinoma. Nonneoplastic lesions were much more common than neoplastic ones in the sinonasal tract. Histopathological examination plays an important role in correct diagnosis and management.

Liver function tests in COVID 19: A retrospective record-based study from a tertiary care centre in urban Maharashtra, India

BackgroundCOVID-19 is a multi system disorder and causes various abnormalities in liver function tests. The aim of this study was to estimate the prevalence of abnormal liver function tests in patients of COVID-19 and to describe the association of liver function tests with clinical features and disease severity in these patients. MethodsWe retrospectively evaluated and analyzed the liver function tests of all real-time polymerase chain reaction (RT-PCR) positive COVID-19 patients admitted to a tertiary care hospital in Western Maharashtra. The Institutional Ethics Committee of our hospital approved the study. ResultsOf the 533 patients included in our study, 50% had abnormal albumin levels while 40.1%, 43.5%, 9.3%, and 6.3% patients had deranged alanine transaminase (ALT) aspartate transaminase (AST), total protein and bilirubin levels, respectively. Hepatocellular injury was observed in 21 (3.9%) patients, and cholestatic liver injury was observed in seven (1.3%) patients. Abnormal liver function test (LFT) was significantly associated with disease severity but not with mortality. ConclusionAbnormal LFT in patients of COVID-19 is associated with severe disease but not mortality. Liver injury is common in patients of COVID-19.

Epidemiological correlates of unmet need for contracep-tion in slum dwellers in Karad Town, Western Maharash-tra

Background: Unmet need is one of the challenges to meet the contraceptive use among slum dwellers. The study was conducted among married women in the reproductive age group (18-49 years) in slum dwellers Karad town, western Maharashtra. Objective:-1) To assess the prevalence of unmet need for family planning among married women living in slum area of Karad town.2) To identify the different variables which are associated with unmet need for contraception. 3) To find out reason for unmet need for family planning. Methods: This was a Community based, Observational Analytical cross -sectional study. By systematic random sampling method, 201 reproductive sexually active women were included. A predesigned, and pretested questionnaire by personal interview method data was collected from the respondents with written consent. Results: Study showed, 71(35.3%) of women had an unmet need for family planning. While 130(64.7%) had showed met need for family planning. More than 34 years of age (OR=4.633, CI 1.6- 12.6), Hindus (OR=2.039, CI 0.91 - 4.5), < 5years of women married life (OR=8.37, CI 2.2 - 31), all were found to be risk factor for unmet need (OR>1). The most prevalent reason for not using contraceptives was ignorance i.e. 33(46.5%).

Prospective study to evaluate pediatric ocular trauma and its assessment with pediatric ocular trauma score at a tertiary carecentre in western Maharashtra

Vision” is a very much valuable gift given by the God. It is most cared for the function of a person and is possible only with healthy eyes. Eyeball is a well secured tissue in our body, but a minute trauma can cause such a damage that can lead to severe morbidity than any other organ. Eyes are protected by anatomical as well as physiological factors. The anatomical factors elastic fatty tissue and the bony orbit. Head turning reflex, blink reflex and lacrimation which following intrusion of any irritant material are the physiological factors. Ocular Injury represents a major threat to vision in the house, work,school, playground and in sports. 4 As Krishna Hospital, Karad is located on National highway we come across many cases of vehicle accidents. Also the presence of a school and playing ground nearby has led to increase in number cases of sports related ocular injuries. Therefore, this study is done to assess the clinical profile of ocular injuries in paediatric age group presenting to us, to estimate the visual prognosis with the help of Paediatric Ocular Trauma Score and to assess visual prognosis following effective treatment.

Qualitative and Quantitative Evaluation of Donor Corneal Tissue by Slit Lamp and Specular Microscopy.

BackgroundIn India, donor eye collection and promotion of eye banking are insufficient to meet the needs. By adequately evaluating donor corneas, eye banks can maximize the number of viable corneas for transplantation. This study evaluated donor corneal tissue based on age, lens status, and cause of death by their morphology and endothelial cell count via slit lamp and specular microscopy.MethodsWe conducted a prospective observational study of all eye bank donor corneas indicated for eye donation at a tertiary hospital and research center in Western Maharashtra between September 2019 to December 2021. We evaluated the corneoscleral discs by slit-lamp microscopy specular microscopy. We analyzed donor corneas quantitatively and qualitatively and graded them accordingly. We also collected blood samples for serological testing and the donor's behavioral and family medical histories.ResultsWe collected 94 eyes from 47 donors; the mean age of the donor population was 48.2 years, and most donors were aged 41 to 80 years. Thirty-one donors (65.96%) were male, and 16 were female (34.04%. For preservation, we used Cornisol (Aurolab, Madurai, India) in 36 cases (77%) and McCarey-Kaufman medium in 11 cases (23%). We found a mean endothelial cell density (ECD) of 2214.40/mm2, with hexagonality of 53.05%, and a coefficient of variation of 38.01. Further, we observed that ECD and hexagonality of cells in phakic donors were significantly greater than that of pseudophakic (PP) donors. Moreover, ECD and hexagonality significantly decreased in donors with the chronic disease compared to those who had a sudden, unexpected death.ConclusionCorneal grafts from younger donors, phakic donors, and donors who experienced an acute cause of death were qualitatively and quantitatively significantly better than those of older donors, PP donors, and donors who experienced sudden, unexpected death. Therefore, eye bank specular examination can improve tissue utilization and transplantation success. Therefore, we strongly recommend that eye bank personnel evaluate their donor tissue with a specular microscope to enhance the quality of eye care.

Evaluation of Serum Biochemical Profile in Heifer and Adult Sahiwal Cows Reared in Maharashtra

Background: The Sahiwal cattle, one of the best dairy breeds of Zebu cattle in India and Pakistan, originated from the Montgomery district of Pakistan. The performance of this breed in the tropical environment is also better than other cattle breeds. Now a day Sahiwal is choice of farmers in Maharashtra as it is a milch type breed mostly preferred for Deshi cow milk production and for organic farming. Blood profile of an individual is an important indicator of an individual’s well-being. Normal blood levels of various biochemical components are essential for normal function of various systems in the body including reproductive system. Hence, the current study was aimed to evaluate of serum biochemical profile of Sahiwal cows reared in Pune district of Maharashtra. Pune district of Maharashtra comes under western Maharashtra plain zone with Grayish black soils. The annual rainfall ranges from 150 to 700 mm. Soils formed from trap rock are grayish black in colour and varying texture. The natural vegetation is of shrub. The area mostly grows paddy, sugarcane, pearl millet, sorghum and groundnut. Methods: Serum biochemical profile of Sahiwal heifers and cows were evaluated at different stages i.e. below 1 year heifer, above 1 year heifer, early lactating cow, mid lactating cow, late lactating cow, dry pregnant cow and dry non pregnant cows. Total seventy (70) animals was selected i.e. ten (10) animals from each group stage. All animals were maintained under standard feeding and management conditions. The blood samples of selected cows were collected by puncturing in jugular vein in heparinized vacationer tubes. Analysis of serum profile of 70 blood samples were carried out by using automatic blood analyzer machine (Miura 200 I.S.E. group, Italy). Result: The concentrations of serum cholesterol, glucose, triglyceride, uric acid, calcium, phosphorus, copper, zinc, total protein, globulin, A: G ratio ALP, ALT and AST were significant in different stages of Sahiwal cows. The non-significant difference was observed in different stages of Sahiwal cows in regards to serum concentration of amylase, bilirubin direct, bilirubin total, creatinine, urea, albumin, magnesium, iron and GGT.

Vision centre helps reduce blindness and vision impairment. Proof of concept in a four-year longitudinal study in an urban area in India.

Purpose:To estimate the prevalence of blindness and severe visual impairment (SVI) by using a door-to-door screening and vision center (VC) examination strategy in an urban area in western Maharashtra (Pune), India and repeat the exercise after 4 years to study its impact.Methods:Four trained community health workers measured the visual acuity and performed an external ocular examination in patients’ homes. People with vision <6/18 were requested to visit the VC for a comprehensive eye examination by an optometrist. An ophthalmologist examined people whose vision did not improve to 6/12. A home examination was done for people who did not visit the VC despite two requests. The same population was examined twice in an interval of 4 years.Results:In the study, 44,535 people in 2015–16 and 98.14% (n = 43,708) of them in 2018–19 were examined. Blindness (vision < 3/60 in better eye), and moderate-to-severe visual impairment (MSVI, vision 6/18–6/60 in better eye) were 0.26% and 1.3%, respectively, in the first cohort, and 0.16% and 1.1%, respectively, in the second cohort (P < 0.001). When the worse eye was considered, the prevalence of blindness reduced from 0.72% to 0.44%, SVI reduced from 0.1% to 0.07%, and MVI decreased from 1.7% to 1.49% between 2015 and 2019 (P < 0.001). Females (P < 0.001) and older individuals (P < 0.001) were more likely to have blindness or SVI. In the VC, 8211 people were examined in 4 years.Conclusion:The reduction of blindness and MSVI in the urban area of Pune can be partly ascribed to the presence of a VC and attendant screening in this locality.

Epidemiological analysis of SARS-COV-2 B.1.617.2 (delta variant) transmission in an educational institute

BackgroundDespite having an effective COVID-19 vaccine, the COVID-19 pandemic is far from over and the delta variant continues to cause havoc across several continents. The present study was conducted to analyze and describe the occurrence of COVID-19 cases among completely vaccinated individuals. MethodsIn an educational institute in Western Maharashtra, we analyzed a cluster of RTPCR positive COVID-19 cases among fully vaccinated students which occurred in 12 days. The cases were linked to a series of curricular and co-curricular events in the institute. A detailed epidemiological investigation and genome sequencing of cases were conducted. IgG antibodies against S1 protein of novel SARS-CoV-2 were estimated for cases and age, sex, and vaccination status matched controls. ResultsAll 37 identified cases were mild COVID. 188 high risk (HR) contacts of the cases were identified. The overall secondary attack was 9.5%. Out of 31 cases and 50 controls, 09 (29%) cases and 08 (16%) controls were found to have IgG antibodies against S1 protein of novel SARS-CoV-2 titer of more than 60 U/ml. Whole-genome sequencing of 15 samples of the cluster showed the presence of the Delta variant of SARS-CoV-2. No correlation was observed between Ct value and IgG S1 antibody titers. ConclusionThe study provides significant evidence that only vaccination alone does not completely protect against SARS-CoV-2 B.1.617.2 (Delta) variant infection. An all-encompassing multicomponent strategy involving implementation of NPIs, robust contact tracing, early identification and isolation of cases, and high vaccination coverage is the way forward for the prevention of COVID-19.

Gendered Impacts of Increasing Land Sale in Western Maharashtra, India

This article presents a nuanced understanding of the contemporary phenomenon of increasing land sale in Western India and its impacts on a rapidly changing social context. It focuses on perspectives of rural women who often lack a voice in matters related to land. The research was undertaken in Maval tehsil (administrative unit) of Pune district, Maharashtra, where the incidence of land sale has increased in the last few years. The article explores the perceived impacts of land sale on rural society in the region. Physical changes such as fencing have affected sanitary practices, collection of fuel wood and fodder and access routes. Individualisation of property rights has resulted in conflicts within patrilineal systems as well as influenced the overall social fabric of village life.

Comparative study to evaluate use of apache ii and sofa score in sepsis patients in intensive care unit of a tertiary level hospital in western Maharashtra

Background: Intensive care units (ICU) in most settings consume very high cost and sophisticated devices but mortality rates are still very high. There is no specific literature comparing APACHE II score and SOFA score in sepsis patient and this research topic will help to identify the score more appropriate to predict the seriousness, outcome and mortality of patients suffering from sepsis, which has been evaluated in our study. Methodology: This was a single centre hospital based cross sectional, observational, descriptive study conducted in patients in ICUs of our institute. 100 patients over age 16 years old admitted in intensive care unit who have fulfilled the criteria for sepsis were included in our study. Their clinical profile, APACHE II and SOFA scores were evaluated and compared with respect to patients’ outcome in the form of survival. Results: The mean age was 56.71 ± 16.77 years. Majority of patients were males (69%). 52 of patients were survivors (52%) and non-survivor were 48%. The mean SOFA score of survived patients was 3.54 ± 2.57 lower than non-survivor patients of 6.02 ± 3.17.

Study of COVID-19 laboratory findings and chest CT findings in assessing disease severity in patients in western Maharashtra

Coronavirus disease-19 (COVID-19) has become a world health threat. Early detection of high-risk patients with laboratory and radiological parameters can aid in reducing mortality. Aims and objectives: To assess the clinical, laboratory, radiological parameters in patients with COVID-19 and to compare them with the outcome. The study was conducted in 200 patients presenting with COVID-19 infection in a tertiary care hospital over one month during month of October 2021. Enrolled patients underwent inflammatory markers, haematological markers and CT scan of the thorax on admission. Statistical analysis: Appropriate statistical tests were applied using SPSS software v21 for analysis; p-value&lt;0.05 was considered statistically significant. Mean age of the study population was 51.84(SD±16.02). D-dimer, CRP, ferritin, TLC, NLR, CTSS has shown significant correlation with mortality. Mean CTSS was 9.75 (SD±5.32), mean D-dimer was 0.79 (SD±1.69), mean sr. ferritin was 320.68 (SD±328.04), the mean CRP level was 2.08 (SD±5.86) and mean neutrophil-lymphocyte ratio (NLR) was 5.01 (SD±5.53). The PaO2/FiO2 ratio was identified as an independent risk factor (odd ratio [OR] = 0.992, 95% confidence interval [CI]: 0.986–0.998, p = 0.006). The area under curve of the receiver operator characteristic (AUROC) of PaO2/FiO2 with mortality as outcome was 0.795 (95% CI: 0.684–0.906, p &lt; 0.0001).

Study of Risk Factors for Noncommunicable Diseases Among Urban Slum Population of Western Maharashtra Using WHO STEPS Approach

Background: Noncommunicable diseases NCDs are considered to be the leading cause of death worldwide. These are the cause for almost 85% of premature deaths occurring in low- and middle-income countries. Materials and Methods: Community-based cross-sectional study was conducted among 125 randomly selected people ≥18 years in the urban slum area which is the field practice area of the Department of Community Medicine, KIMS, Karad, Maharashtra, India. The World Health Organization developed STEPwise approach for the surveillance of NCDs and its risk factors were used. STEP 1 (behavioral risk factors), STEP 2 (physical measurements), and STEP 3 (biochemical measurements) were included in our study. Data were analyzed using SPSS software. P &lt; 0.05 was considered to be statistically significant. Results: The prevalence of behavioral risk factors such as smoking was 11.2% among males, smokeless tobacco use was 29.6% among females, alcohol use was 16.8% among males, sedentary lifestyle was 16.8% among the age of 26–45 years, ≥5 fruit and vegetable servings/day was consumed by only 4%. Prevalence of hypertension, diabetes, hypercholesterolemia, and hypertriglyceridemia was 36%, 11.2%, 37.6%, and 31.2%, respectively. Conclusion: Various NCD risk factors assessed from our study showed high prevalence among urban slum population. Surveillance of risk factors and adequate awareness among urban slum population is essential to prevent spread of NCDs.

Prevalence of Methicillin Resistant Staphylococcus aureus and its Associated SCCmec Types among Healthcare workers and Patient Visitors from Western Maharashtra, India

Staphylococcus aureus is one of the major pathogen causing infections in human ranging from mild to severe life-threatening conditions. Methicillin-Resistant Staphylococcus aureus (MRSA) is an important nosocomial pathogen with high morbidity and mortality in both hospital and community settings. Total 600 nasal swabs were collected from patient visitors and Healthcare workers. Of these, 184 S.aureus (30.66%) were isolated. All S.aureus isolates screened for MRSA and 73 (39.67%) isolates showed MRSA by Cefoxitin disc diffusion method and PCR. 21 (28.76%) isolates detected pvl gene of the 73 isolated MRSA i.e., CA-MRSA. All MRSA isolates were typed into SCCmec element (I to V). Of these SCCmec type III was found more prevalent than other SCCmec types and 3 isolates were not typeable. MRSA still remains a significant problem in public Healthcare settings. Screening of MRSA among Healthcare Workers and patient visitors is mandatory to prevent the spread of CA-MRSA in hospitals.

Clinico-epidemiological study of burn patients admitted in a tertiary care hospital of Solapur, Western Maharashtra

Background: Burn injuries constitute a major public health problem and account for a significant cause of high mortality and morbidity amongst the Indian population. This results in heavy social, economic and clinical burden to the nation. The aim of the study was to evaluate the demographic and clinical profile of burns patients admitted in a tertiary care center and to study the socio-demographic and clinical profile of burn patients and to assess the outcome of burn patients.Methods: Hospital based descriptive study with cross sectional design was done using the records of all burn patients admitted in burn ward of surgery department during 1st January 2019 to December 31st 2019.Results: Burn injuries were most common in the age group of 41-60 years. The male to female ratio was 0.65: 1. Most of the burn incident took place in rural area (73%) and rest (27%) in urban area. Most of the mode of burn injury (88.7%) were accidental burns, 8.2% had alleged history of suicide and in rest 3.1% homicide was suspected. Mortality ratio was 33.30% and 66.70% of patients got discharged from the hospital. A higher TBSA involvement is statistically associated with an increased risk of mortality (p&lt;0.05).Conclusions: The prevention strategies for burns should address the hazards of specific burn injuries, awareness education for vulnerable population and targeted first aid training. The burn units should be established well to reduce the mortality.

Knowledge, attitude and preventive behaviours regarding COVID-19 infection among medical students of Solapur, Maharashtra

Background: It is important for medical students to know about COVID-19 in order for them to be a well-versed future health workers. The aim of the study was to assess the knowledge, attitude, and practice regarding COVID-19 infection among medical students at government medical college in western Maharashtra. To study the knowledge, attitude and practice regarding COVID-19 infection among medical students and to find the association between KAP levels and demographic variables.Methods: An observational descriptive study with cross sectional design was conducted during July 2021 on 400 Under Graduate medical students of a Government medical college.Results: Out of 400 students 53%- female (212); 47%- male (188). Most of the students belong to Hindu religion 86.75% (347), rest Muslim 39 (9.75%), Christians 14 (3.5%). Overall, 92%, 81%, 90.5% of surveyed medical students had adequate knowledge, attitude and practice towards COVID 19 pandemic respectively.Conclusions: In our study, students exhibited good knowledge, positive attitude, and sensible practices regarding COVID-19. Such KAP studies should be conducted across other medical college and we should educate our medical students so that we can use the help of medical students for management of mild covid cases if manpower crisis occurs.

Clinical profile of patients with the first presentation as anterior nodular scleritis — a case series

Background: The aims of this study was to report the clinical profile of five patients with features of anterior nodular scleritis as initial presentation in residents of Western Maharashtra. Material and methods: A retrospective review of medical records was done from February 2019 to December 2019. Five new anterior nodular scleritis cases were reported at the tertiary-eye care centre within two months. The slit-lamp examination, anterior-segment photographs, and laboratory data were collected and analysed. Results: A majority of cases (4/5) were presented in females. Three patients had a unilateral presentation, while 2 — had bilateral involvement. The most common presenting symptom was ocular pain and redness. Corneal involvement was seen in 1 case. Two female patients were diagnosed with rheumatoid arthritis, one female had multinodular goitre, and the other two were idiopathic. Three patients responded very well to oral non-steroidal anti-inflammatory drugs NSAIDs), while the rest two were managed with steroids. No patient had to be started on immunosuppressives. All the cases showed complete resolution with the treatment provided. All these patients presented at our centre in the autumn season. All these patients presented at our center in the autumn season only and no new case of anterior scleritis reported before or after this season. Conclusion: Management of scleritis may need a multidisciplinary approach as it may be the only presentation of an underlying systemic disease. It is to be considered in the differentials of red eye that presents with a substantial amount of ocular pain or with the known systemic disorder that leads to scleritis development. Also, there could be a seasonal association of anterior-nodular scleritis like episcleritis.

Haematological Patterns of Anaemia in Geriatric Patients and Its Etiology: A Study of 500 Cases

Introduction: Anaemia in the elderly is a global health problem, since it is associated with significant morbidity and mortality. The World Health Organization’s criteria consider anaemia when level of haemoglobin is less than 13g/dl in male and 12g/dl in female. Anaemia is easier to miss among the elderly because symptoms such as fatigue, generalized weakness, or mental confusion can be linked to the ageing process. However, anaemia should never be considered as a natural part of growing older.&#x0D; Aim: To investigate the haematological pattern of anaemia and its underlying etiology in elderly Indian patients.&#x0D; Materials and Methods: A prospective study undertaken over a span of 2 years in a tertiary care hospital in Western Maharashtra. The study included 500 geriatric (&gt;65years) anaemic patients who underwent a complete haemogram and the results were correlated with peripheral blood smear findings. Other diagnostic tests were done as indicated.&#x0D; Results: The spectrum encompassed all patterns of anaemia with the most common being normocytic normochromic pattern (57.26%). Overall, there was slight male preponderance (53%) with 65-74 years (69%) being the most common age group afflicted. Maximum number of elderly people had moderate anaemia(56%) in this study; and chronic disease (27.2%) was the most common etiological cause of anaemia followed by iron deficiency (23.4%). Upper gastrointestinal lesions (59%) were the most common causes of iron deficiency anaemia in the present study followed by nutritional deficiency (31.6%).&#x0D; Conclusion: Correlation of haemogram and peripheral blood smears is a crucial first step to identify the haematological pattern of anaemia and advise subsequent investigations for assessing and diagnosing it’s etiology. Thus, it plays a role in deciding the management protocol and contributes towards a better quality of life for geriatric anemic patients.

Feeding behavior and prey of Common Kraits, Bungarus caeruleus (Schneider 1801), from Western Maharashtra, India

Feeding behavior and prey of Common Kraits, Bungarus caeruleus (Schneider 1801), from Western Maharashtra, India

Borehole magnetic fabric anomalies in KBH 07 Deccan basalt core from Deep Continental Drilling, western Maharashtra, India

Borehole magnetic fabric anomalies in KBH 07 Deccan basalt core from Deep Continental Drilling, western Maharashtra, India

Evaluation of Knowledge, Attitude and Practice about Oral Hygiene Aids among Dental Hygienists in Western Maharashtra, India

Introduction: Everyday use of oral hygiene aids and annual or biannual oral prophylaxis by dental professionals (Dentists, Dental hygienists, Dental assistants) are two effective ways of maintaining good oral hygiene. The present study was conducted to assess the knowledge, attitude, and practice about oral hygiene among working dental hygienists in Western Maharashtra, India. Materials and Methods: A questionnaire study was conducted for three months in 2021 among 52 working dental hygienists from different areas of Western Maharashtra. The structured, self-administered, close-ended questionnaire was designed to collect the data which consist of two parts and comprised 31 questions. Statistical analysis was done using descriptive statistics. Results: In this study, more than 50% of participants were known the importance of oral hygiene maintenance and different types of oral hygiene aids and correct methods of using those oral hygiene aids. About 96% participants thought that proper brushing technique is necessary to maintain good oral hygiene. Conclusion: The study participant’s overall knowledge, attitude and practise regarding oral hygiene aids were seen at average level.