European Journal of Molecular & Clinical Medicine

Uterine leiomyomas (fibroids or myomas), benign tumors of the human uterus, are the single most common indication for hysterectomy. They are clinically apparent in up to 25% of women and cause significant morbidity, including prolonged or heavy menstrual bleeding, pelvic pressure or pain, and, in rare cases, reproductive dysfunction. Thus, both the economic cost and the effect on the quality of life are substantial. Surgery has been the mainstay of fibroid treatment. This case presents a 51year old, asymptomatic big fibroid diagnosed incidentally on clinical examination and imaging, which was managed timely and the patient recovered because of thorough clinical examination even in asymptomatic patients.

A common allergic reaction that more frequently affects youngsters is an asthma attack. Both the risk and the morbidity may rise as a result. It is a fatal illness that poses a serious threat to life. Children who have chronic asthma are more likely to experience drug-induced side effects, medication errors that aggravate their illness, and negative outcomes. Poor medication adherence, ignorance of the disease, and improper inhaler use can all result in a lower quality of life and make it challenging to treat a severe condition. Uncontrolled aggravation and lingering symptoms are the usual causes. Children who are in a serious state should be referred to a pulmonologist and instructed on the proper inhaler technique

To evaluate early maternal warning triggers in the detection of maternal morbidity, by using two types of Early warning systems as a bedside screening tool and comparing their efficacy in routine use. To determine the effectiveness of maternal early warning scoring system as a screening tool for maternal morbidity. To compare the effectiveness of MEOWS chart over MEWT chart as screening tools for maternal morbidity in routine use.
Methods: From September 2019 to October 2021 (two years), a descriptive observational study was conducted at the department of obstetrics and gynecology, Kamineni Academy of Medical College and Research Centre, LB Nagar Hyderabad, India. Women who met the selection criteria for antenatal and postnatal care during the study period and gave their informed consent. 500 study participants were the sample size.
Results: Majority of study participants were in the age group of 21-25 years (45.2%). Mean age of study participants was 25.00 + 4.606 years ranging from 17 to 42 years.MEOWS colour coding and MEWT colour coding were matching in all the 500 cases in screening maternal morbidity (Kappa value of 1.00) and it was found to be statistically significant (P value <0.05).
Conclusion: We discovered that when screening for maternal morbidity, both the MEOWS and MEWT color coding matched in every instance. In order to identify early maternal warning signs by all healthcare professionals and thereby aid in the prevention of obstetric morbidity, we can use MEWT color coding, which is straightforward and simple to use with only 5 components as opposed to MEOWS color coding, which had 7 components.

The objective of this study is to look for various and common electrolyte imbalances in critically ill children admitted to Paediatric Intensive Care Unit(PICU) and to study the outcome among those cases. Methods: This was a prospective observational study done on 84 critically ill children  in the age group of 1 month to 12 years admitted in PICU of a tertiary care hospital. Under aseptic conditions venous samples were obtained for estimating serum levels of sodium, potassium, chloride, magnesium and phosphorus. The commonly occurring electrolyte imbalance was observed and the outcome is compared by morbidity, cure and mortality. Results: Electrolyte abnormalities were observed in 84 children(100%). Most common electrolyte abnormality observed was hypocalcemia in 70.2% cases (n=59). Morbidity was seen in 35.7% cases (n=30) and mortality associated with dyselectrolytemia was seen in 25.1% cases(n=21). Conclusion: This study showed increased incidence of dyselectrolytemia in critically ill children admitted to PICU. But the signs and symptoms are often difficult to recognize an electrolyte imbalance as the imbalances may be primary or secondary to underlying systemic illness. Early recognition and prompt management of electrolyte imbalances can lead to decrease in morbidity and mortality
Dyselectrolytemia, Critically ill, PICU, Mortality, Morbidity 

Aim: To determine the role of risk factors for increased morbidity and mortality  in perforated peptic ulcer
Methods and materials: All patients aged 18 and above who had abdominal surgery for PPU were included in this research. Intravenous fluids, nasogastric suction, and intravenous antibiotics were then administered to the patients. After proper resuscitation, the perforation site was located and a laparotomy was performed via a midline incision. The hole was simply closed and reinforced with a pedicle omental patch. Peritoneal lavage with 4 to 5 litres of normal saline was performed. An intraperitoneal drain is placed at the discretion of the operating surgeon. All patients were placed on a double antibiotic regimen that included Ceftriaxone (1gm bid), Metronidazole (500 mg tid), and Omeprazole (20 mg bid). Patients were monitored for up to six months following surgery. The research covered morbidity and mortality during the hospital stay as well as the following 6-month follow-up

Background:Compared with term infants, infants born late preterm are at increased risk for neonatal intensive care unit (NICU) admission. The present study was conducted to assess early neonatal morbidity in late preterm.
Materials & Methods: 54 all live inborn late preterm infants (34 0/7 to 36 6/7 weeks) and term infants (37 0/7 to 41 6/7 weeks) of both genders were included. Group I comprised of late pre- term and group II had term infants. In all infants, mode of delivery, APGAR score, hypoglycemia, morbidity, jaundice, weight loss >10% and sepsis etc. was recorded
Results: Group I had 17 boys and 10 girls and group II had 14 boys and 13 girls. Weight loss >10% was seen in 2 in group I and 1 in group II, sepsis was seen 1 in group I, respiratory morbidity 2 in group I and 1 in group II, hypoglycemia was seen in 2 in group I and 3 in group II and jaundice in 1 in group I and 0 in group II. The difference was significant (P< 0.05). The mean gestation weeks in group I was 35.0 weeks and in group II was 38.2 weeks, mode of delivery was vaginal in 22 in group I and 15 in group II, cesarean in 5 in group I and 12 in group II, APGAR score at 1 minute was 7.32 in group I and 7.95 in group II, at 5 minute was 8.41 in group I and 8.68 in group II. The difference was significant (P< 0.05).
Conclusion: Incidence of hypoglycemia, sepsis, respiratory morbidity and jaundice and weight loss >10% was more among late preterm infants.

Background: Geriatric population requiresspecial needs for theirlife support and health care. Understanding their health-seeking behavior, quality of life (QOL), and morbidities is thus essential for reinforcing health-care services delivery for them.
Objective: To assess the health status of geriatric population with special reference to QOL in urban and urban slum population.
Methodology: This community based, comparative, cross-sectional studyincluded 288geriatricindividual of either gender, aged≥60 years, from urban (n=153) and urban slum (n = 135) areas. Data was collected through interview for personnel details, family, social and psychological background as per proforma. Medical examination was carried out at home. The QOL was assessed by using tool comprised of Assessment of Quality of Life(AQoL) instrument (Australian Centre for Quality of Life). Statistical analysis was performed by using R software (Version. 3.6.0).
Results: Majority of individuals from both the area were in the age group of 60-64 years (35.76%) with female preponderance (Male: Female = 1: 1.2). A significant difference was noted in the demographic and social variables, and HR-QoL(Score) between urban and urban slum area (P<0.05). Most individuals in both the area suffered with arthritis. In urban area diabetes and hypertension, and in urban slum area cataract was common morbidity. The mean score for assessment of QOL instrument was higher in case of urban (13.05 ± 7.85) then urban slum area (9.44 ± 7.95). A significant association was observed between HR-QoL (score) and different variables viz. gender, type of family, marital status from urban, and gender, marital status from urban slum area (p <0.05).
Conclusion: Due to lack of awareness and poor living conditions the proportion of morbidities is more among geriatric populationin urban slum. However, high expectations from society and believe in having good living conditions along with high expectations, older people in urban area tend to have more depressed life.

Background: The study is done to have a better understanding of the morbidity profile and outcome in a Paediatric Intensive Care Unit (PICU) of a rural-based tertiary care centre which can enable the caretakers to plan and plant possible interventions to enhance patient care. The study was carried out in a retrospective manner.
Methods: This retrospective study was carried out in the department of paediatrics in children aged 1 month to 12 years, who were admitted to the PICU during the period of 1st September 2021 to 31st August 2022. A total of 925 children were admitted and data were collected from PICU records using predesigned proforma and analysed accordingly.
Results A total of 925 children were admitted during the study period. The 61.62% of children were male and the rest 38.38% were female. The male to female ratio was 1.6:1. The infants excluding neonates constituted 59.89% of total admission.  The mean age of presentation was 2.63 ± 3.41 years. 67.46% of children were admitted with infections of different organ systems and the rest 32.54% with diseases of non-infectious aetiology. So far outcome is concerned, 13.62%, 56.10%, 3.24%, 3.78%, and 23.24% of children were discharged, transferred to the paediatric ward, referred out to elsewhere, left against medical advice (LAMA) and death respectively. Infants excluding neonates constituted 69.30% of total death and the most common aetiology of death being documented was infections (84.19%).
Conclusion: In our study, most of the admitted children were found to have died of infective causes and most of them were infants. This puts a much necessary focus on the control of infections among infants by various means and should be addressed promptly and meticulously.

Introduction: A scoring system which can compare patient populations and severity of illness, objectively predict mortality, morbidity and can help to evaluate the treatment strategy is the dire need for evaluative research of intensive care. Thus, present study was undertaken to access the role of Mannheim Peritonitis Index (MPI) system in evaluation of morbidity and mortality among patients with hollow viscus perforation.
Materials and Methods: The present prospective comparative study was carried among 50 patients in whom diagnosis was of peritonitis. Using history, clinical examination and laboratory values risk factors found in MPI were classified according to values indicated and individual variable scores were added to establish MPI score. The data was analyzed, each variable in the MPI score along with other patient variables was analyzed using chi square analysis with various outcomes that were noted in the study. P value <0.05 was taken as significant in this study.
Results: In this study, 50 patients with diagnosis of secondary peritonitis were included. Patients with age 15 years to 70 years were part of study. Majority of patients (42%) belong to age group 20-35 years. Patient with less MPI score required less number of ICU stay. Around 80% of high-risk group (MPI > 29) required more than 5 days of ICU stay. Mortality rate was 40% in high-risk group (MPI score >29). There was no mortality in low-risk group (MPI score <21). Mortality rate was 5.26% in intermediate risk group. Chi-Square test value is 15.601, p-value is 0.000, < 0.05 indicates significant Mortality vs MPI Scores.
Conclusion: Mannheim peritonitis index scoring system is accurate for predicting the morbidity and mortality in patients with peritonitis due to hollow viscus perforation. It helps in identification of high-risk patients and it helps to identify the patients using for intensive post-operative or ICU care.

Background: Fournier's gangrene is aec necrotizing fasciitis of the genitalia and perineum that can lead to polymicrobial infection and organ failure or death. The goal of this study was to identify the pre presence systemic and local predisposing factors, management challenges, and outcome in Telangana. Fournier gangrene is a urologic emergency that has a high mortality rate. It is a polymicrobial necrotizing fasciitis of the perineal, perianal, and genital regions with a mortality rate ranging from 15% to 50%.
Aims & Objectives: This study was undertaken to find out the age and sex incidence, etiological and risk factors, clinical features and outcome of patients, and evaluate the treatment options for Fournier’s gangrene.
Methods: It is a prospective observational study conducted in hospitals attached to Govt Medical College &Hospital, Siddipet in Department of General Surgery from June 2020 to May 2022. A total of 40 cases fulfilling the inclusion criteria were included in the study. Factors like age, gender, etiology, risk factors, clinical features, site of involvement, type of bacterial flora, reconstructive procedure used, duration of hospital stay and mortality were studied.
Results: A total of 40 patients were studied. 26 male and 4 female patients were in the study. Males are most afflicted (82.5%). M:F-4.7:1 In females, vulval induration, necrosis, perineal and perianal abscess were found. Scrotum (most common site) was afflicted in 26, perineum in 8, penis in 5, groyne in 3, and vulva in 2 patients. Six in research group suffered total scrotum loss. Only 2 patients came within 24 hours following RTA with degloving injuries to scrotum, penis and perineum. Most were approximately 1 week with a mean presentation of 6.8 days following disease onset. Those who came after 1 week experienced severe morbidity, late recovery, numerous debridements and prolonged hospital stays.
Conclusions: This study suggests that earlier presentation, early diagnosis and treatment with prompt debridement and appropriate antibiotics are the main stay of treatment. The resulting soft tissue defects following debridement required surgicall reconstruction, thus decreasing morbidity, hospital stay and early return of patients to regular life

Background:To study the distribution, pathology, clinical features, various mod es of
investigations and overall management of varicose veins of lower limbs.
Materials and Methods: The study was carried out Govt Medical College/General
Hospital, Suryapet from October 2021– March 2022 to evaluate the ―Clinical
presentation and management of varicose vein in lower limbs. 50 cases of varicose veins
of lower limbs were presented and analysed in our study. Fifty cases of varicose veins of
the lower limb have been studied in detail.
Results: Varicosity of the lower limb is a common clinical entity. The number of cases
reporting to the hospital is much less than the real incidence; because in the absence of
symptoms due to varicose veins patients do not seek treatment in our country. The
commonest age group of patients suffering from varicose veins is 41 to 50 years. Most of
the patient presented to the hospital for one or the other complications and not for
cosmetic reasons. The majority of the patients were male. A definite relationship exists
between the occupation and the incidence of varicose veins as most of our patients are
workers standing for longer duration. The involvement of long saphenous system is
more common than the short saphenous system. Left limb is affected more common.
The cause for the same is not known but could be attributed to the longer course
traversed by the left iliac veins. Clinical examination has a high predictive accuracy. It
gives sufficient information to treat the patients in centres where colour Doppler is not
available or affordable. The use of colour Doppler is a valuable supplement to clinical
examination for effective treatment of varicose veins and its use is strongly
recommended to prevent recurrences and reduce morbidity as it is effective tool in
detecting venous incompetence and to rule out deep vein thrombosis. SPJ junction and
perforators are highly variable and should always be marked pre- operatively using
USG Doppler. Operative line of treatment is a primary procedure in the management of
varicose veins of lower limbs.Venous ulcer heals well after surgery. Surgery is a quality
modality for varicose veins patients with ulcer with low recurrence rate. Complications
are negligible if cases are meticulously selected and operated. The present procedures
enable the patient to lead almost normal life after surgery with few recoverable
morbidities.
Conclusion: There is need for general health education and awareness about varicose
veins in the society in order to achieve timely treatment with good outcome and to
reduce the morbidity.

Fetal growth restriction (FGR) is a pathological condition in which a fetus has not achieved his genetic growth potential, regardless of fetal size (1) Worldwide FGR is observed in about 24% of newborns; approximately 30million infants suffer from FGR every year. The burden of FGR is concentrated mainly in Asia which accounts for nearly 75% of all affected infants. National neonatal perinatal database of India reported the incidence of FGR to be 9.65% among hospital born live birth infants. Study was conducted for all cases with clinical/ Sonological term FGR admitted under department of OBG. A detailed history as per questioner will be taken with general physical examination and investigations will be done as per requirement. The accumulated data was evaluated and statistically analyzed. In the present study 70 patients with term gestation with FGR were recruited. Maternal (74.28%) was the commonest cause followed by Idiopathic (11.43) and Placental (10%) and Fetal (4.29%) causes. Among Maternal causes Pre Eclampsia was found to be in 50% cases. Most of the patients (50.7%) required caesarean section. A total of 9 (12.86%) neonate had birth weight of <1.5 kg, 48.6% had Birth weight between 1.6 to 1.9kg, 38.5% had birth weight between 2-2.4kg and 95.8% had asymmetrical FGR, 4.2% were symmetrical. 26 (40%) neonates had morbidity with 17(24.3%) neonatal mortality with Respiratory distress syndrome (41.18%) being most common cause. No Maternal Mortality.

Background:The advanced instruments like harmonic shears have made laparoscopic cholecystectomy (LC) a safe option. The present study determined twoyearsexperience of patients after laparoscopic cholecystectomy in cirrhosis patients.
Methods: A total of 50 cirrhotic patients underwent LC from August 2020 to February 2022. The type of surgery performed was laparoscopic cholecystectomy. The parameters recorded were,presence of adhesions,use ofharmonic devices, amount of bleeding during surgery,rate of conversion to open surgery and the reasons thereof, operative time in minutes, plasma and platelet transfusion postoperatively and duration of hospital stay .
Results:Majority of the patients were of Child-Pugh class A. The cause of cirrhosis was hepatitis C virus (HCV) in most of the patients. Biliary colic was found to be the most common presentation. Higher CTP, model for end-stage liver disease (MELD) scores, higher mean international normalization ratio (INR) value, lower mean platelet count, higher operative bleeding, higher blood, and plasma transfusion rates, longer mean operative time and postoperative hospital stays were found to be statistically significantand  correlated well with 30-day morbidities and mortalities.
Conclusion: LC could be a better surgery performed in patients with cirrhosis. However, higher CTP and MELD scores, greater operative bloodloss, largerno of  blood and plasma transfusion in units, longer operative time, lower platelet count, and higher INR values can be considered factors resulting in poor outcome. 

Background: Diarrhea is widely recognized as a major cause of childhood morbidity and
mortality in many developing countries, particularly in India. According to World Health
Organization (WHO) report, diarrheal diseases are still leading causes of mortality and
morbidity in children under five years of age.
Objective: The present study attempts to estimate the association between maternal factors
and prevalence of Acute Diarrhoeal Diseases in children below 5 years of age in Indian
settings.
Methods: This community-based, cross-sectional epidemiological and single-center study
conducted in the rural field practice area attached to Department of Community Medicine of
Topiwala National Medical College, Mumbai, Maharashtra, India from March 2017 to
February 2018 was aimed to estimate the association between maternal factors and
prevalence of Acute Diarrhoeal Diseases in children below 5 years of age in Indian settings.
Ethics approval was obtained from Ethics Committee for Academic Research Projects
(ECARP). Research tools included a pre-structured questionnaire. Baseline information of
study area was taken from the Primary Health Centre. Data was entered in Microsoft Excel
spreadsheet to perform analysis.
Results: In our study, 340 mothers who used to take bath daily of which 61(17.9%) had
diarrhoeal episodes, whereas out of 30 mothers who do not take bath daily, 15(50%) had
diarrhoeal episodes. Further, 340 mothers of children who used to wash their hands daily
before the meals of which 58(15.8%) children had diarrhoeal episodes, whereas out of 30
mothers who did not wash their hands before meals, 18(60%) children had diarrhoeal
episodes
Conclusion: The present study indicated that maternal factors bear a significant impact on
morbidity caused by diarrhea.

Background: Diarrhoeal diseases which are one of the leading reasons behind global
mortality and morbidity is more threatening for infants and young children. Childhood
diarrhoea is becoming increasingly prevalent disease in developing countries like India.
Moreover, it is a major cause of malnutrition that contributes towards third major cause of
under 5 mortalities. This has raised a serious concern in the domain of public health.
Objective: The present study attempts to identify the prevalence of acute diarrhoeal diseases
in children below 5 years of age in Indian settings.
Methods: This community-based, cross-sectional epidemiological and single-center study
conducted in the rural field practice area attached to Department of Community Medicine of
Topiwala National Medical College, Mumbai, and Maharashtra, India from March 2017 to
February 2018 was aimed to identify the prevalence of acute diarrhoeal diseases in children
below 5 years of age in Indian settings. Ethics approval was obtained from Ethics Committee
for Academic Research Projects (ECARP). Research tools included a pre-structured
questionnaire. Baseline information of study area was taken from the Primary Health Centre.
Data was entered in Microsoft Excel spreadsheet to perform analysis.
Results: In our study, a total of 370 living children aged <12–59 months were included in the
analysis. Most of the children who belonged to in Class III socioeconomic status (61.4%),
affiliated to joint family (54.6%), belonged to Hindu religion (94.6%). Only 9.2% of mothers
were illiterate whereas remaining 91.8% mothers had completed at least primary education.
The prevalence of diarrhoea in children under 5 years of age was recorded as 20.5%.
Conclusion: The present study contributed to providing the prevalence of acute diarrhoeal
diseases in children below 5 years of age in Indian settings

Allergy is a pathology of countries with a high index of socio-economic development and most of all residents of large cities. By 2025, according to the WHO, 50% of the world's population will suffer from allergies [14]. This article examines the main risk factors for the development of allergic diseases in children under the age of 18 in Tashkent. The most significant factors were: the presence of an inherited predisposition on the line of one (RCh 1.9) or both parents (OR 5.6), closely related marriages between parents (RCh 2.8), the age of parents over 40 at the time of conception of the child (RCh 1.4) and some others.

Abstract. Occupational risks affect the health of miners and up to 40% of labor losses
are caused by diseases directly or indirectly connected with unfavorable working conditions.
The research aimed to determine the degree of connection of the disease incidence by
temporary loss of working capacity of coal mine workers with working conditions, which was
estimated for all classes of diseases and the relative risk (OR) value was 1.69 units, etiological
share (EF) - 41% and was estimated as average. These incidence rates for the disease classes
were almost complete: Class XIII (OR=5.08 units; EF=80%) and Class XIX (OR=5.03 units;
EF=80%), and high for the disease classes: Class XI (OR=2.57 units; EF=61%) and Class X
(OR=2.46 units; EF=59%). This relationship by day was almost complete among: Class X
(OR=6.18 units; EF=100%), Class XI (OR=7.27 units; EF=100%), Class XIII (OR=7.79
units; EF=100%), and Class XIX (OR=17.87 units; EF=100%). Among workers engaged in
underground coal mining, the value of ОR=1.4 units, EF=29.3%, was occasionally observed
and assessed as small. Relationship of the disease to underground working conditions was
assessed as very high by disease classes: Class X (OR=3.6 units; EF=72.1%), Class XI
(OR=3.8 units; EF=73.5%) and Class XIII (OR=4.8 units; EF=79.1%). The disease
relationship by day was almost complete: in Grade XI (OR=5.3 units; EF=100%) and Grade
XIII (OR=8.9 units; EF=100%), and high in Grade X disease (OR=3.0 units; EF=100%). The
risk of eating disorders of workers was identified by class XI disease and was assessed as very
high in cases (OR=3.8 units; EF=73.8%). A high degree of occupational conditionality was
determined for Class XIII disease (OR=2.2 units; EF=55.3%).

The methods of control and assessment of professional risk applied in
the republic do not include the method of assessment of the degree of impact
of harmful and dangerous factors of working conditions on specific
employees, as well as the analysis of actual loss of working capacity of
employees after long periods of labor activity. As a result of incorrectly
chosen assessment methods and methodological approach, working
conditions have a high risk of developing professional and professionally
conditioned morbidity among groups of professions in industries. The purpose
of this work was to determine the improved approaches to professional risk
assessment and instrumental control over their implementation. Assessment
of workers' health indicators depending on working conditions at the
workplace is based on recommendations of the International Labor
Organization. We have developed a package of normative and methodical
documents, including 14 methodical recommendations, as well as Sanitary
Rules and Norms, providing requirements to the hygienic assessment of the
impact of various physical, chemical and biological factors on the health of
workers. Conclusions were made to integrate the characteristics of the factors
of working conditions through the transition from the normalization of
individual parameters of the factors to complex indicators, changing the
methodology of recording the working conditions at the working places to
ensure a comprehensive assessment of all risks in a single procedure and their
systematic monitoring. The use of modern software complexes as part of
special devices for instrumental measurements have a loaded algorithm of
measurements, pre-compiled a special computer program control planning,
which offers the performer an operational hint on the choice of place and
number of measuring points.

Abstract. The scientific work presents the results of dynamic research to study the structure,
level and dynamics of the general, professionally conditioned and professional morbidity of
employees of SE “Ferghana Oil Refinery”, SE “Ferghana Heat and Power Plant” and JSC
“Ferghanaazot”, which are part of the Kyrgyz Industrial Zone of the Ferghana region for 5
years (2010-2014). The main professional qualification groups working at the enterprises
under research at the age of 19 to 40 years with the work experience from 1 to 20 years were
surveyed. 6000 man-days of working observations were made. High morbidity rates were
revealed among the employees of Ferghana Oil Refinery and JSC “Ferghanaazot” in the
groups with the experience of up to 5 years and 11-20 years. The analysis of morbidity rate
among age groups of workers showed high indices at the age above 35 years. In the structure
of morbidity for the period of 2010-2014, the first leading places were occupied by diseases of
respiratory organs, then by diseases of circulatory and digestive organs, traumas and
poisoning, then by diseases of the nervous system, skin and subcutaneous tissue. High
respiratory diseases are associated with long-term exposure to occupational risk factors, where
chemical contamination is the most dangerous.