European Journal of Molecular & Clinical Medicine

Introduction: Cerebral sinus venous thrombosis (CSVT) is an uncommon condition.Its clinical presentation is varied and often dramatic. Although recognized for more than 100 years. The annual incidence is currently estimated to be 3-4 cases per 1 million people.3 out of 4 people with CSVT are women. It accounts for 10-20 % of the etiology of young strokes in india. Objectives:To study the Clinical features and imaging studies of cerebral venous thrombosis.To study the prognosis based on clinic radiological features.Methodology: Forty patients aged >18 years suspected to have cerebral venous thrombosis based on clinical history and examination were evaluated but only those with confirmed diagnosis (based on neuroimaging) of cerebral venous sinus thrombosis were taken up for the study.Meticulous history, clinical examination, laboratory investigations were carried out in all cases of cerebral venous sinus thrombosis. Cerebral venous thrombosis was confirmed by CT scan (or) conventional MRI (or) MR venogram.Results : Most common radiological finding was hemorrhagic infarction seen in 55% of cases. Empty delta sign was noted in 47.5% of cases. Cord sign was noted in 22.5% of cases. Radiologically most common sinus involved was superior sagittal sinus in 70% of cases followed by transverse sinus in 42.5% of casesLMWH was given in 65% of cases and intravenous unfractionated heparin infusion in 35% of cases, whereas 10% of the patients required decompressive craniotomy.The presence haemorrhagic infarct is associated with bad prognosis.Overall outcome is good with 69.44% of the patients having complete recovery at the time of discharge and overall mortality rate was 10%.Conclusion : The present study emphasizes that CVST is not an uncommon condition. It is an important cause of stroke especially in the peripartum settings and is one of the common causes of stroke in young people.Management with unfractionated heparin, LMWH and oral anticoagulation is appropriate.

In most circumstances, determining the cause of an open fracture is simple. A severe bleeding laceration overlaying or near the fracture of the underlying bone is common in injured patients. Because too soft tissue loss, broken bone may be revealed in some circumstances. However, not all open fractures are visible and proper diagnosis and treatment requires a thorough examination of the patient, a thorough review of the patient's medical history, the reading of radiographs, and sound clinical judgment. All patients attending the orthopedic out-patient department and casualty of MGM medical college and hospital with complaints of an open fracture grade II, IIIA, IIIB and meeting inclusion and exclusion criteria will be selected for the study. A written informed consent will be obtained from selected patients. According to Gustilo and Anderson open fracture Classification, majority of the fractures belonged to grade II (76.66%), followed by III A (16.66%) and III B (6.66%).

Aim: To study the clinical and demographic profile of the patients with brain metastases in a tertiary care centre in north India.
Material and methods: This Observational and cross sectional study was conducted among patients attending the outpatient medicine/radiotherapy department or admitted in Government Medical College, Jammu. Total number of 100 patients was taken. The study group comprised of patients with clinical and radiological signs of brain metastasis.
Results: Maximum subjects were from the age group of 51-60 years (41%) followed by 41-50 as well as >60 years (20%). Statistically significant difference was found among the subjects having brain metastasis w.r.t age group as p<0.05. Females and male comprised of 56% and 44% of the subjects respectively. Left and right side of the brain in brain metastasis was found among 33% and 28% of the subjects respectively while bilateral involvement was revealed in 39% of the subjects. Frontal, parietal, temporal occipital and cerebellar was reported among 19%, 53%, 11%, 15% and 2% of the subjects respectively. Supratentorial and infratentorial location of tumour was found among 96% and 4% of the subjects respectively. Hence dominating location of tumour was supratentorial with statistically significant difference as p<0.05. Most common symptom was headache (69%) followed by vomiting (58%) and neurological deficit (40%). Least common reported symptom was cerebellar sign (4%) followed by visual symptoms (24%) and seizures (27%). According to ECOG grading, fully active status was not found in any of the subject. ECOG grade 1, 2, 3 and 4 was reported among 11%, 42%, 33% and 14% of the subjects respectively.
Conclusion: It can be concluded from our results that brain metastases are disease of elderly people with slight female dominance in this area. Lung and breast are the most common primary sources throwing metastases in brain. Most of the patients had multiple lesions at the time of diagnosis.

The aim was to study the clinical profile and predictors of in-hospital outcome in critically ill patients with T2DM admitted in MICU. It also aimed to study the predictive value of different critical care scoring systems in T2DM patients. A prospective, cross sectional and observational study was conducted in General Medicine Department, “Dr. D. Y. Patil Medical College and Research Centre, Pimpri, Pune, India,” between September 2020 to October 2022 with a sample size of 80 T2DM cases and 80 non-T2DM controls. Overall maximum number of study participants belong to the age group of 50-69 years, Patients with T2DM had higher chances of a prolonged ICU stay and a higher mortality rate due to their critical illness compared to the non-diabetic patients. However, their mortality rate was not associated with prolonged duration of ICU stay.All the major vital parameters and biochemical parameters including RFT, Serum electrolytes, Serum Lactate and Serum Pro-calcitonin were significantly worse in diabetic patients compared to non-diabetic patients at the time of admission to the MICU.APACHE IV, SAPS3 and SOFA scores were worse on the day of admission in the T2DM patients compared to the non-diabetic patients. Except MODS all scores on day 1 and on the day of outcome were worse in diabetic patients who died in the ICU. In conclusion APACHE IV has a good predictability over SAPS III, SOFA and MODS in critically ill T2DM patients.

Background: COVID-19 is a pandemic spread all over the world. This disease has imposed a huge burden on health resources. Evaluation of clinical profiles of such patients can help in understanding and managing the pandemic more efficiently.
Methods: This was a cross sectional observational study of 100 diagnosed COVID-19 patients admitted to JIIU’s, IIMSR, from April to June 2021. All these patients were positive for COVID-19 by an oro-nasopharyngeal swab rt-PCR based testing.
Results: The mean age of the population was 45 years with a male predominance (72% patients). All the patients (100 %) were symptomatic, with fever being the most common symptom (85%), followed by cough (62%).
Conclusion: Severity based approach to COVID -19 infections, with defined criteria and treatment guidelines will help in judicious utilization of health-care resources

Aim: The aim of the present study was to assess clinical profile of ICU patients with sepsis.
Methods: The present study was conducted at Dr. D.Y. Patil medical college and hospital and research center, Pimpri, Pune from August 2020 to September 2022 and 100 patients with sepsis from ICU were included.
Results: Among the study population, 61.00% of them were 30 to 65 years, 30.00% of them were >65 years and 9.00% of them were <30 years. Among the study population, 66.00% of them were male, 34.00% of them were female. Among the study population with Present history, 90.00% of them had fever, 76.00% of them had Weakness, 57.00% of them had Abdominal Pain, 47.00% of them had Breathlessness, 29.00% of them had Burning Micturition, 27.00% of them had Altered Sensorium, 21.00% of them had Vomiting, 81.00% of them had Cough, 12.00% of them had Loose Stools, 8.00% of them had Chest Pain. Among the study population, 94.00% were febrile, 85.00% of them had pulse rate >90 bpm, 93.00% of them had respiration rate >20 cpm, 82.00% of them had SBP<=120mmHg, 81.00% of them had DBP <=80mmHg, 6.00% of them had mean arterial pressure <=65, 32.00% of them had SPO2 on RA <=90%.
Conclusion: In intensive care units, sepsis continues to be a leading cause of death. Early detection of sepsis includes symptoms and signs, such as leucocytosis or leucopenia, confusion, hypoxia, hypotension, pyrexia, and tachycardia. In general, respiratory infections are responsible for around half of all sepsis cases. Incidence of severe sepsis was high among ICU admissions and they have a high mortality. Higher SOFA scores at admission were associated with higher mortality in severe sepsis

Depending on the etiology of diabetes mellitus, factors contributing to hyperglycemia may include reduced insulin secretion, decreased glucose utilization, and increased glucose production. The metabolic dysregulation associated with diabetes mellitus causes secondary pathophysiologic changes in multiple organ systems. Diabetes mellitus is the leading cause of end-stage renal disease (ESRD), non-traumatic lower extremity amputation and adult blindness. The patients of type 2 diabetes mellitus without clinical evidence of coronary artery disease attending diabetic clinic, cardiology and medicine OPD, at medical college and hospital were enrolled in the present study. The average glycosylated hemoglobin (HbA lC) was 7.92, 7.78, 8.71 and 10.2 for the duration of diabetes equal to or less than 5 yrs, 6 to 10 yrs, 11 to 15 yrs and 16 to 20 yrs respectively. This shows that all patients had poor g1ycaemic control.

Background: Conversion disorder is defined by the presence of deficits affecting the voluntary motor or sensory functions lacking any known neurological cause. It occurs as response to any underlying stressful situation. It is clinically important to evaluate the presence, type, and temporal relation of the stressors, resulting in conversion especially among children. The objective of this study was to study the socio-demographic and clinical profile of conversion disorder in children and attempt to identify the stressors in these children.

Background: Acute renal failure (ARF) is a generic term for an abrupt and sustained decrease in renal function resulting in retention of nitrogenous (urea and creatinine) and non-nitrogenous waste products. To determine the cause, prognosis and outcome in patients of Acute Kidney Injury (AKI) admitted in a tertiary care hospital.
Materials and Methods: A Hospital based Prospective study was conducted in Department of Medicine, NRI Medical College for a 1 year period (From Septembet 2021 to Aug 2022). Universal Sampling Technique was used for selection of study subjects. All the patients coming to medicine department during the study period and fulfilling the xiii inclusion criteria were taken for study after taking prior informed consent. Final sample size was 138 subjects of Acute Kidney Injury of varied etiology.
Results: Mean of study subjects was 48.9 years (range from 19-87 years) with M:F ratio of 4.75:1. Most common etiology for AKI was Sepsis (14.5%) and Malaria infection (14.5%) followed by Dengue, AGI and Leptospirosis (11.6% each). Multi organ dysfunction (14.5%) was observed in patients of Sepsis and Lepto. Out of total patients, 92 (66.7% %) had stage II AKI, while 46 (33.3 %) had stage III AKI according to AKIN staging.A total of 11.6% patients were on dialysis. Two out of 46 patients of AKI stage III (8.7%) and one patient out of 92 (2.2%) belonging to AKI stage II died during the study.
Conclusion: AKI was observed at a relatively younger age in present study with male preponderance. Most common etiologies were Sepsis and Malaria. Most of the patient of Sepsis, MODS and Leptospirosis were having stage III AKI. Overall mortality observed was 4.34%.

In India OPC intake is the commonest method of suicide (40.5%) after hanging (49%).Hospital-based data suggest that barbiturates and copper sulfate were the commonly used agents for suicide in the years, 1972-1977; however, later they were replaced by OP compounds and aluminium phosphide. Organo phosphorus insecticides are responsible for as much as 75% of all poisonings in our country today. Observation method of primary source of information in the department of general medicine at. Secondary source of information from published articles, journals, books, case sheets, discharge summary, related websites are used in planning, developing, synopsis and during dissertation as supporting document. In our study, subjects predominantly had GI symptoms. 56% had pain abdomen, 42% had vomiting, 24% had Diarrhea, 26% had Sweating, 21% had Fasciculation and 15% had Bradycardia.

Background: The worldwide prevalence of anaemia among adolescents is high and even
higher in developing countries. The burden of anaemia is a major contributor for low
birth weight, lowered resistance to infection, poor cognitive and motor development,
weakness, fatigue, difficulty in concentrating and lower productivity. India had
reported high prevalence of anaemia among adolescent girls, which is apparently higher
when compared with the other developing nations. Objectives: To study the clinical
profile of anaemia among Adolescent (13-19 years) girl students and to determine the
factors associated with anaemia in Adolescent girl students like socio – demographic
factors, prevalence of anaemia and clinical profile.
Materials and Methods: Single centre, cross sectional study, sociodemographic and
clinical details were collected and analyzed. Blood test was done to estimate anaemia
and to classify type of anaemia. Prevalence of anaemia was compared with
sociodemographic and other details to look for association.
Results: The prevalence of anaemia in the present study was 25%, 78 (39%) girls
belonged to class IV. Students not wearing footwear, not washing hand, not consuming
jaggery, history of recurrent infections, passing worms, irregular cycle were anemic.
Majority of cases had microcytic hypochromic anaemia.
Conclusion: 25% prevalence is noted in our study which is of moderate magnitude.
Most commonly microcytic hypochromic anaemia 60% was noted followed by
normocytic normochromic 30%. High risk factors were students belonging to low socio
– economic groups, with Low BMI, not using foot wear, and present of menstrual
abnormalities like polymenorrhoea.

Introduction: Guillain–Barre Syndrome (GBS) is an acute, immune-mediated
polyradiculoneuropathy with a diverse clinical course and outcome and is the most
common cause of acute flaccid paralysis in the adult population.
Aim: To study the clinical profile, treatment response of GBS patients and to see their
association with electrophysiological subtypes of GBS.
Materials and Methods: We conducted a retrospective study of patients with Guillain-
Barre syndrome, presented at Sri Aurobindo Medical College and PG Institute, a
tertiary care centre in Madhya Pradesh, Central India, from January 2013 to January
2020. All patients diagnosed with Guillain-Barre syndrome were included in this study.
The handwritten case record files of the study population were retrieved from medical
record section of the institute.
Results: There were 70 patients with a male to female ratio of 1.4:1 and 70 % of them
were < 40 years of age. Antecedal infections were the preceding events in 31/70(44.3%).
Cranial nerve involvement was found in 25/70(17.5 %), 36/70(25.2%) patients had
dysautonomia and 17 (24.3%) cases requiring ventillatory support. The commonest
sub-type was acute inflammatory polyradiculoneuropathy 40(57.1%). Fever was seen in
more numbers of AIDP patients and preceeding GI symptoms were more seen in
AMAN and AMSAN variants . Autonomic dysfunction and need of ventillatory support
were more in axonal variants of GBS patients. High EGRIS score and long duration of
hospital stay were seen in axonal variant of GBS. Shorter duration of illness, rapidly
progressive motor weakness of the limbs, longer duration of hospital stay, cranial nerve
involvement, bladder dysfunction ,autonomic involvement, low MRC score(≤ 30), high
EGRIS score(> 4),high HDS score on admission were prone for ventillatory support.
Age >40 years, non treatment with immunomodulators, higher mEGOS on admission
were associated with poor outcome on discharge.
Conclusion: Early recognition of these risk factors helps in more vigilant management
of patients associated with high morbidity who are eligible for additional treatment in
future. AIDP variant is more common in our region and poor prognosis and long
hospital stay for AMAN and AMSAN variants of GBS.

Although the incidence of these fractures generally has been reported to be higher in boys, more recent reports indicate that the frequencies of supracondylar humeral fractures in girls and boys seem to be equalizing, and some series actually have reported higher rates in girls. As soon as the patient was admitted, a detailed history was taken and a meticulous Examination of the patient was done. The required information was recorded in the proforma prepared. The patients radiograph was taken in antero-posterior and lateral views. The diagnosis was established by clinical and radiological examination. Out of 30 extension type, 15 patients had posteriomedial displacement while 10 patients had posteriolateral displacement. 5 patient were of Type II Gartland classification with posterior displacement. We encountered loss of pulse in one patient which recovered as soon as fracture was reduced. Median and radial Nerve injury in one patient each was encountered out of 30 patients which spontaneously recovered by 4-6 weeks’ time.

Type 2 diabetes, is caused by insulin resistance which is characterized by a decreased effectiveness of insulin. In contrast to type 1 diabetes in which the pancreatic islets are destroyed and no insulin can be synthesized anymore, in type 2 diabetes insulin secretion is normal, elevated or reduced. Unlike in patients with type 1 diabetes, symptoms do not appear abruptly, but set on gradually so that the disease often remains undiagnosed for a long time. The present study included 150 patients of type 2 diabetes mellitus. Patients with Type 2 Diabetes mellitus in outpatient and inpatient departments were study subjects. The present study had diabetic patients ranging from 41 to 80 years of age. Majority of cases were in the 61 to 70 age group. Male cases were 58.7% and female cases were 41.3%. 60% of cases of Type 2 DM were associated with complications of which 66.7% were microvascular and 33.3% were macrovascular complications.

In Asian populations, Kiebsiella pneumoniae is the most frequent pathogen associated with cryptogenic PLA‘s. Diabetes mellitus is suggested to be an important risk factor, but the pathogenesis is still unclear. E. coli is the most common pathogen in Western countries, in both monomicrobial and polymicrobial isolates, followed by Streptococcus milleri. Anaerobes may also be cultured from PLA‘s and Bacteroides spp. are the most common isolated organism. After obtaining approval and clearance from the institutional ethics committee, the patients fulfilling the inclusion criteria will be enrolled for the study after obtaining informed consent. Case record form with follow up chart. All cases had undergone thorough history and detailed clinical examination at the time of admission. Total and differential leukocyte counts was measured with an auto-analyzer. In this study it is found that liver abscess presents with most common presentation as pain abdomen and fever. In this study it is found that fever, loose stools are presenting features of liver abscess in most of the individuals along with pain abdomen.

Aim: The aim of this study to determine the Presentation, etiology and viral markers in
children presenting with hepatitis at a Tertiary care hospital.
Methods: 50 cases of acute hepatitis of age 1-13yrs were included in the study. Acute
hepatitis was diagnosed on the basis of history, clinical (Jaundice, pain in upper
abdomen, anorexia, nausea, vomiting, fever, pruritis, tender/non tender hepatomegaly
with or without ascites and without any stigmata of chronic liver disease) and
biochemical evaluation (LFT i.e. serum bilirubin, Alanine
aminotransferase(ALT),Aspartate aminotransferase (AST),alkaline phosphatase(ALK),
serum albumin, PT/INR). Acute liver failure was diagnosed by PT>15sec/ INR>1.5 with
features of encephalopathy or PT > 20 sec/ INR > 2 regardless of presence of clinical
hepatic encephalopathy.. Patients were also tested for viral markers i.e. anti HAV IgM,
anti HEV IgM, HBsAg, and anti HCV.
Results: In our study total number of cases were 50 of which 70% were male and 30%
were female. The most common cause of viral hepatitis was hepatitis A (80%). Hepatitis
B was found in 2 (4%) cases and in 16% cases no viral marker was detected. The most
common clinical presentations were jaundice (96%), fever (94%), fatigue (90%) and
nausea/vomiting (78%). In 80% of cases hepatomegaly was found and splenomegaly
was seen in 2% of cases. SGPT level was increased in all cases with 30% in the range
500 – 1000 units/ml, 22% in the range of 1000 – 3000 units/ml and 12% in the range of
3000 – 5000 range. 48% of cases has total bilirubin of more than 10mg/dl and in 40% of
cases the value was in the range of 5 – 10 mg/dl. In 35cases PT was < 15sec and in 15
cases it was more than 15 sec. The disease resolved in 40(80%) cases,1(2%)had chronic
disease and 9(18%) cases expired.
Conclusions: Majority of cases in children were hepatitis A cases. Most of the cases
were Boys. Those cases with INR >3 at admission has higher mortality. Peak values of
aminotransferase i.e. ALT and AST though reflect hepatocyte damage do not correlate
with mortality.

With increasing life expectancy and prevalence of life style diseases, United States (US) has
seen a 30% increase in prevalence of chronic kidney disease (CKD) in the last decade.
Unfortunately, from India there is no longitudinal study and limited data on the prevalence of
CKD. Chronic Kidney Disease was diagnosed when at least one of the evidence of chronicity
like documented renal failure for >3 months, bilateral small kidneys, histological evidence of
chronicity or GFR < 30 ml/min for 3 or more months was present.A pre informed written
consent was obtained from every case before inclusion in the study. The clinical and
demographic profile was recorded in a specially designed proforma. On ultrasonogram
bilateral kidneys of group A, 12 patients had bilateral contracted kidneys which correspond to
60% of the study patients indicative of ESRD. 6 patients had normal or slightly enlarged
kidney size suggestive of diabetic nephropathy (30%). Findings of ultrasonogram bilateral
kidneys in group B revealed 11 patients had bilateral contracted kidneys which correspond to
55% of the study participants indicative of ESRD. 5 patients had normal or slightly enlarged
kidney size (25%) and 1 patient was having bilateral enlarged kidneys with multiple cysts of
varying sizes suggestive of autosomal dominant polycystic kidney disease (5%).

Spinal cord fills about 50% of the canal in the thoracolumbar segments. The remainder of the canal is filled with Cerebrospinal fluid, epidural fat and meninges. The spatial relationships of grey and white matter structures remain consistent throughout the length of the cord, but the proportions change based on the level. All the patients had routine X-rays of thoracolumbarspine in both Anteroposterior and Lateral views.In all the patients MRI spine and 3D CT ofspine with 2mm thick film uploaded in navigation machine which gives 3D image of the vertebrae. After registration in navigation machine, the pedicle screw trajectory, size and length planned and placed in the center of the pedicle.In our study we had 69.23% males and 30.77% female patients in conventional method and had 84.61% males and 15.39% female patients in navigation method. The average age was 36 years and 29 year in conventional method and navigation method respectively, with male predominance in each group.

Dengue virus, a mosquito-borne flavivirus, is the causative agent, currently one of the most
significant emerging disease challenges to global health. The dengue virus are single-stranded
positive-sense RNA viruses with a genome of about 11000 bases that codes for three
structural proteins, C(core protein), M (membrane protein), E (envelope protein); 7
nonstructural proteins, NS1, NS2a, NS2b, NS3, NS4a, NS4b, NS5; and short non-coding
regions on the 5' and 3' ends. This was a case control study design in which 201 cases of
dengue fever admitted in the pediatric emergency ward, were enrolled. After taking written
informed consent, data were collected in a predesigned semi structured questionnaire
regarding Socio-Demographic profile, medical history, clinical and hematological profile and
outcome. 8(4%) of cases had positive family h/o dengue fever, 3(1.5%) cases had positive
past h/o dengue fever and 8(4%) cases had positive h/o travel to dengue endemic areas.
201(100%) cases had fever, 94(46.8%) had persistent vomiting,91(45.3%) had
anorexia,78(38.8%) had abdominal pain, 59(29.4%) had headache, 30(14.9%) had rashes, 16
(8%) had facial puffiness, 14(7%) had convulsions and 12(6%) had abdominal distension.

Background:Coronary artery disease (CAD) has emerged as the major cardiovascular disease of the era and also the commonest cause of premature death. For several decades, conventional invasive angiography (CIA) has been considered as the well-established gold standard for making the diagnosis of CAD. Hence; the present study was undertaken with the aim of assessing the risk factors and clinical profile of CAD in female patients. Materials & methods:A hospital-based descriptive observational study was conducted with 100 patients to evaluate clinical profile and angiographic pattern in women with Coronary Artery Disease. Baseline demographics, clinical and risk factor profile was collected. Disease is defined as presence of stable angina, unstable angina or myocardial infarction. Baseline demographics, clinical and risk factor profile was collected. Appropriate statistical software, including but not restricted to MS-Excel. SPSS version 20 was used for statistical analysis. Graphical representation was done in MS-Excel 2010.