Online ISSN: 2515-8260

Issue 1,

Issue 1


Functional Outcome of Column Specific Fixation for Intraarticular Distal Radius Fractures with K Wires

Dr. A Manikandarajan, Dr. Dhanpal Singh, Dr. M.Gurumoorthy,Dr. J B Beffrin Rex,Dr. M.Gurumoorthy .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1-7

Background: Distal radius fractures shows Bimodal distribution about 25% of the fractures in paediatric age group and 18% fractures in adults. The goals of treating distal radius fractures include articular congruity, radial alignment and length, functional mobility, stability.
Aim: To assess the functional outcome of column specific fixation for intraarticular distal radius fractures with k wire
Material and Methodology: Study was conducted between July 2019 and July 2021 in department of orthopaedics, RMMCH, 23 patients with intra articular distal radius fracture were included in our study. Follow up was done for a minimum of 6 months period, functional outcome was assessed using the Quick DASH scoring system
Results: Of the 23 patients based on our quick DASH scores

Excellent to good results were obtained in 20 patients
Satisfactory results were seen in 3 patients
None of the patients had poor results
Two patients had wrist stiffness attributed to the non compliance with physiotherapy for mobilisation
One patient had mal union due to malreduction attributed to the late presentation to hospital

Conclusion: Column specific fixation with k wire is a less invasive method of treatment of intraarticular distal radius fractures. Although complications like stiffness and malunion were noted it was due to non compliance and late presentation. Hence we would like to conclude that column specific fixation of intraarticular distal radius fractures with k wire shows good long term functional outcome.

Identification of the External Branch of Superior Laryngeal Nerve during Thyroid Surgery – an Observational Study

Dr. R.Jayaraman, Dr. Palanikumar.B .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 8-11

Background: Thyroid swelling is a condition commonly encountered by General Surgeons. Some patients need only Medical Management, whereas others need Surgical management in the form of Hemi or Total Thyroidectomy. Compared to RLN the EBSLN is less studied in terms of course and relation to thyroid gland intraoperatively. In our study we observed the course and relation of EBSLN with respect to the thyroid gland during surgery.
Materials and Methods: A prospective analysis of 60 patients who underwent thyroidectomy in General Surgery department in Rajah Muthiah Medical College was done. Intraoperatively, the EBSLN was visually identified and preserved before proceeding to ligate the superior thyroid vessels. The nerve was classified according to the Cernea classification.
Results: In 60 patients, 95 nerves were planned to be identified. The nerve was type 1 in 28/95 (29.5%), Type 2a in 46/95 (48.5%), and Type 2b in 11/95 (11.5%) patients. The nerve could not be identified in 10/95 (10.5%) patients.
Conclusion: The course and relation of EBSLN with respect to thyroid gland varies in different thyroid pathologies.

Functional and Radiological Outcome of Proximal 1/3rd Tibial Fractures Managed with Intramedullary Through Suprapatellar Approach

Dr.M.Gurumoorthy, Dr Dhanpal Singh, Dr A.Manikandarajan, Dr S. Dharani .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 12-24

Aim: To evaluate the clinical and radiological outcome of proximal third tibia fractures managed by intramedullary nailing in knee semi-extended position via the suprapatellar approach.
Methodology: Our study consists of proximal one third tibial shaft fractures which were treated with nailing via suprapatellar approach. The study was done under Rajah Muthiah Medical College and hospital, Duration of the study from May 2019 to December 2021. The patients were followed at intervals of 1 and 6 months and 1 year. Patients were observed for affect in daily day to day activities, union, shortening. The functions were assessed using Lower Extremity Functional Scale (LEFS).
Results: In 20 patients of proximal 1/3rd fracture of tibia within the study with a mean follow-up of 1 year. On an average of 6-7 months the fractures united radiologically. At the top of 1 year, the typical LEFS was 86%. 4 patients had delayed union in that 1 patient had significant bone loss followed by bone grafting and transpositional gastrocnemius flap was done, one patient pre-operatively had anterior skin discolouration which was debrided. Eventually all the fractures were united. There were no post-operative knee pain seen.
Conclusion: Suprapatellar nailing performed with proper instrumentation, proper surgical technique is a viable option in management of proximal 1/3rd tibial fractures. Which has excellent radiological and clinical outcomes with lower complications on comparing to other management. This may be a viable option for proximal 1/3rd (extra-articular) tibia fractures thanks to its inbuilt advantages of placement, perfect nail entry and positioning.

The effects of addition of dexmedetomidine to intrathecal hyperbaric 0.5% bupivacaine in elective lower segment caesarean section:A prospective, randomized, double blinded, placebo-controlled study

Dr. Ajay V Patil,Dr. SangameshKunakeri,Dr. Subodh S Kamtikar,Dr. Rajkumar GB

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 25-30

Background: Spinal anaesthesia is the most commonly used technique for lower abdominal
surgeries as it is very economical and easy to administer. Dexmedetomidine, a new highly
selective α2-agonist, is under evaluation as a neuraxial adjuvant as it provides stable
hemodynamic conditions, good quality of intraoperative and prolonged postoperative
analgesia with minimal side effects.
Methods: Prospective double blinded, placebo-controlled study was undertaken in 60
patients allocated randomly by envelop method, divided into 2 groups (30 in each) between
18-50 years of age of either gender belonging to ASA class I and II scheduled for elective
lower segment caesarean section. Group A received 2 mL of 0.5% hyperbaric bupivacaine
and 0.2ml dexmedetomidine and Group B received 2ml of 0.5% hyperbaric bupivacaine with
0.2ml normal saline. The comparison was studied using the Chi-square test or Fisher's exact
test as appropriate, with the P value reported at the 95% confidence interval. P<0.05 was
considered statistically significant.
Results: The addition of dexmedetomidine resulted in a dose dependent prolongation of
sensory regression to S1 segment, prolonged motor block, the time to first analgesic rescue
was significantly prolonged in Group B as compared to Group A and showed Lower pain
scores as compared to placebo group.
Conclusion: Based on study results we recommend addition of dexmedetomidine 5 μg to
intrathecal hyperbaric 0.5% Bupivacaine 9 mg in elective lower segment caesarean section.

Effect of priming principle on the induction dose requirement of propofol-a randomized clinical trial

Dr. Rajkumar GB,Dr. Subodh S Kamtikar, Dr. SangameshKunakeri,Dr. Ajay V Patil

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 31-36

Background: Based on well-known properties of propofol over last few years this study was
undertaken to evaluate whether priming principle applied for the induction dose of propofol
would affect the total induction dose requirement and reduce the associated side effects.
Methods: The prospective randomized study was undertaken in 100 patients allocated
randomly by envelop method, between 18-55 years of age of either gender belonging to ASA
class I and II scheduled for elective surgeries under general anaesthesia. In group I Inj.
fentanyl 2 μg/ kg administered over a period of 30 seconds intravenously and then induced
with the calculated dose of Inj. Propofol 2mg/kg until the loss of eyelash reflex. In group II,
30 % of the total calculated dose of Inj. propofol 2mg/kg 30 seconds after the administration
of Inj. Fentanyl 2μg/kg over 30 seconds, which will be followed by the administration
remaining calculated dose till the loss of eyelash reflex. Statistical analysis of the
demographic data was done using chi-square test. Comparison between the groups for the
induction dose and haemodynamic parameters was done using student ‘t’ test.
Results: The average induction dose required was 1.53mg/kg with a mean reduction of
23.89%in the induction dose requirement of propofol was observed in the study group. The
haemodynamic parameters were better in study group II compared to the control group I.
Conclusion: Based on study result we recommend application of ‘priming principle’ for
induction dose of propofol.

A study on comparison of anthropometrical measurements in oraon and non-oraon boys

Dr. Kunj Bihari Patel, Dr. Meet Krishna, Dr. Avinash Thawait

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 37-45

A few studies based on published data have indicated patterns of anthropometric variation
along ethnic, geographic, latitude, longitude and altitude, nutrition and several confounding
variables.Many growth studies have been published for the tribal populations of Chhattisgarh.
However, no study, especially with regard to the growth status of the Oraons of Chhattisgarh
has been undertaken. Cases taken in this study were registered cases in government schools
of Jashpur district. 200 boys (100 Oraon and 100 Non Oraon) were included in the study
according to inclusion and exclusion criteria. Age range was 5-18 yrs. At most of the ages
BMI was less for OT boys than NO boys, except at the age periods of 17+ and 18+ where the
BMI of OT boys was more than NO boys. In the age period of 15+ the BMI of OT and NO
boys was found to be same. The difference was statistically significant at age periods of 7+,
8+ and 10+and highly significant in age period of 17+

PSYCHOLOGICAL MORBIDITY IN PREGNANCY DURING COVID-19 LOCKDOWN

Dr.Saima Sadiq,Dr. Rajesh Chandel,Dr.Heena Mir,Dr. Anil Mehta, Dr Sonali Sharma,Dr Rouf Gul6,Mr.Pawan kumar,Mr. Ravi kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 46-53

AIM: Study aimed to assess the burden of psychological morbidity due to lockdown in
the pregnant females.
MATERIAL AND METHODS: It was an observational study conducted in the
department of obstetrics &gynecology, GMC Kathua during the covid lockdown period
from June 2020 to August 2020. 100 antenatal patients attending OPD were included
in the study after excluding those with hypertension, diabetes, heart disease, bleeding
pv,IUGR,oligohydramnios,threatened preterm labour, known psychiatric illness or
taking psychotropic medication, prior sleep disorder. The patients were assessed using a
questionnairewhich was framed using various scales such as PHQ-9 for Depression,
GAD7 for anxiety, Perceived Stress Scale and Insomnia severity index , in addition to
incorporating various sociodemographic and obstetrical details.The arbitrary division
of PHQ‑ 9 scores into ratings of minimal (0–4),mild (5–9), and moderate to severe
depression (≥10) suggested by Reddy et al. was used in this study. Cutoff points of 5, 10,
and 15 were interpreted as representing mild, moderate, and severe levels of anxiety on
the Generalized Anxiety Disorder-7 (GAD-7). Insomnia severity index scored on a fivepoint
Likert’s scale (0 = no problem to 4 = very severe problem). Score of 0–7 depicted
absence of insomnia, 8–14 showedsubthreshold insomnia, 15–21 represented moderate,
and 22–28 showed severe insomnia.

To Evaluate The Role Of Early Vs Delayed Laparoscopic Cholecystectomy In Mild And Moderate Acute Gallstone Pancreatitis

Dr SandipkumarChaudhari, Dr NayanPancholi, Dr LatifBagwan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 54-59

Aim: To evaluate the role of early Vs delayed laparoscopic cholecystectomy in mild and
moderate acute gallstone pancreatitis
Methods:This randomized prospective study conducted in the Department ofSurgery after
taking the approval of the protocol review committee and institutional ethics committee. 100
patients were included in the study. They were divided into two groups with 50 patients in
each group. Patients with mild and moderate acute gallstone pancreatitis were included in this
study.
Results: The age distribution in both the groups was comparable with no statistically
significant difference observed. The mean age in Group A was 42.9±9.24 years and in Group
B was 43.025±9.56 years (p=0.857). Out of 100 cases 21 were males and 79 were females.
There was no statistically significant difference in the sex distribution between the two
groups. There was no statistically significant difference between the two groups with p-value
=0.079 and 0.707 for amylase and lipase respectively. Modified CECT severity index was
used to assess severity of acute pancreatitis. Group A had a mean score of 3.2±1.20 and
Group B had mean score of 3.3±1.28 p-value=0.757 and there was no statistically significant
difference between two groups. 16% in Group A and 22% in Group B underwent preoperative
ERCP and the difference was statistically not significant. There was no recurrence
of pancreatitis in group A, however 16% cases of group B had recurrent pancreatitis and
the results were statically significant which are tabulated as under.There was no
recurrence of cholecystitis in group A, however 16% cases of group B had recurrent
cholecystitis and the results were statistically significant which are tabulated as under.
Conclusion: We conclude that, early laparoscopic cholecystectomy in the index admission in
mild and moderate gallstone induced pancreatitis is a feasible and a safe modality for the
treatment of acute mild and moderate gallstone pancreatitis and early cholecystectomy
decreases the incidence of recurrent episodes of pancreatitis and cholecystitis in patients with
gallstones.

Design and Implementation of AR/VR (Mixed Reality) For Education

Mr. Kushal A. Sawadhakar, Prof. S. A. Murab, Prof. A.A. Kolpykwar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 60-66

Students in today’s generation used technological gadgets a lot. Engaging these tech-savvy students in the
learning process with their preferred learning style is a daunting task. The differences in teaching and learning
styles result in problems such as disengagement of students, loss of learning aptitude, and loss of knowledge
retention. Recent innovations in visualization technologies such as Virtual Reality (VR)and Augmented reality
(AR) provide avenues that allow these students to engage in a social, collaborative and active learning
environment. AR/VR refers to an immersive digital environment that simulates physical presence in places in
the real or imagined worlds whereas MR represents the merger of real and virtual worlds to produce new
environments and visualizations. Using three controlled experiments these two emerging technologies are
investigated to enhance the educational experience. The results indicated that these technologies significantly
enhance the learning experience and engage students in an active learning process.

To evaluate the fundus changes in patients with hypertensive disorders of pregnancy: Gestational hypertension, preeclampsia, eclampsia

Dr. Tania Sadiq, Dr.Saima Sadiq, Dr.Erum Khateeb

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 67-73

Aim: To evaluate the fundus changes in patients withGestational
hypertension,preeclampsia oreclampsia.
Methods: All the patients who fulfilled the diagnostic criteria of Gestational
hypertension, preeclampsia or eclampsia(>20 weeks of pregnancy, high arterial blood
pressure of more than or equal to 140/90 , proteinuria more than or equal to
300mg/day or protein creatinine ratio more than or equal 30 mg/mmol or evidence of
maternal organ dysfunction or uteroplacental dysfunction , convulsions or coma) were
included in this study. After taking history for any eyesymptoms, anterior segment was
examined with torch light on the bed itself. Both pupils were dilated with 1%
tropicamide eye drops and fundus examination was done by ophthalmologist with direct
ophthalmoscope in a semi dark room in the ward. Hypertensive retinopathy changes
seen in right or left or both eyes, was taken as positive findings in that patient.
Results: A total of 100 patients were examined. The mean age of patients was 31.2±6.2
years (range 20-50 years). The gestation period ranged between 25 and 41 weeks. 45
(45%) were primigravidas , 33 (33%) were multigravidas and 22(22%) were
grandmultiparas. 41(41%) had mild preeclampsia, 56(56%) had severe preeclampsia
and 3(3%) had eclampsia. Retinal changes (hypertensive retinopathy) were noted in
58(58%) patients . There was statistically significant positive association between the
presence of retinal changes and blood pressure (P =0.001), proteinuria (P=0.021) and
severity of hypertensive disorders( P=0.027). However, age(P = 0.44), race ( P=0.89) and
gravida (P =0.37 were not associated with occurrence of retinopathy in our study.
Conclusion: Fundus examination in gestational hypertension , preeclampsia and
eclampsia is important in monitoring and managing cases as it correlates with severity
as it indirectly implies severity of changes in placental micro-circulation that can help to
predict the foetal outcome and ocular morbidity.

A comparative study of topical amorolfine, sertaconazole and terbinafine in patients with tineacorporis and tineacruris

Dr Laxman Kumar, Dr Pankaj Kumar, Dr ArshadHasan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 74-78

common infection. The disease is caused by dermatophytes belonging to genera of
Trichophyton, Microsporum and Epidermatophyton. The present study was conducted
to compare topical amorolfine, sertaconazole and terbinafine in patients with tinea
corporis and tinea cruris.
Materials & Methods: 90 patients with tinea corporis and tinea cruris of both genders
were included. Patients were divided into 3 groups of 30 each. Group I were prescribed
topical application of amorolfine (0.25%) once daily, group II were given sertaconazole
(2%) twice daily and group III were given terbinafine (1%) twice daily. Response to
treatment was assessed after 3 weeks.
Results: Group I had 14 males and 16 females, group II had 17 males and 13 females
and group III had 12 males and 18 females. The mean value of scaling was 0.92 in group
I, 1.14 in group II and 0.78 in group III. The mean value of erythema was 0.94 in group
I, 1.42 in group II and 0.56 in group III. The mean value of pruritus was 1.12 in group I,
1.32 in group II and 0.65 in group III. The response was poor seen in 42% in group I,
22% in group II and 44% in group III. Moderate seen in 40% in group I, 46% in group
II and 48% I group III and good seen in 18% in group I, 32% in group II and 8% in
group III. The difference was non- significant (P> 0.05).
Conclusion: Sertaconazole found to be effective as compared to other agents in
management of cases of tinea corporis and tinea cruris.

Assessment of adverse drug reactions in known population

Dr Laxman Kumar,Dr Pankaj Kumar, Dr ArshadHasan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 79-84

Background: Pharmacovigilance relates to the activities concerning the detection,
assessment, understanding and prevention of these adverse drug reactions. The present
study was conducted to asses adverse drug reactions in known population.
Materials & Methods: 250 adverse drug reactions reported in 1 year were recorded.
The data were obtained from the ADR monitoring centre. Each ADR was assessed for
demographic data, relationship to drugs as per causality assessment, and frequency of
ADRs.
Results: Age group 20-40 years had 35 male and 30 female, 40-60 years had 40 male and
55 females and >60 years had 45 male and 45 females. ADRs were reported in oncology
in 12, dermatology in 45, ENT in 30, orthopaedics in 20, general surgery in 50, general
medicine in 43, gynaecology in 35 and psychiatry in 15 cases. Type of reaction was
nausea/ vomiting in 45%, rash in 30%, headache in 12%, abdominal pain in 4%,
diarrhoea in 5% and constipation in 4%. Common drugs leading to ADRs were
NSAIDs in 35%, antibiotics in 20%, anti- hypertensive in 8%, anti- diabetics in 12%,
anti- tubercular in 15% and CNS drugs in 10%. The difference was significant (P<
0.05).
Conclusion: Common drugs leading to ADRs were NSAIDs, antibiotics, antihypertensive,
anti- diabetics, anti- tubercular and CNS drugs.

Efficacy of topical 0.05% cyclosporine in Vernal Keratoconjunctivitis

Dr. Tania Sadiq, Dr.Saima Sadiq, Dr.Erum Khateeb

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 85-89

Background: Vernal keratoconjunctivitis (VKC) is a chronic recurrent non-infectious
allergic disease that generally affects children and young adults. The present study was
conducted to assess efficacy of topical 0.05% cyclosporine in
Vernalkeratoconjunctivitis.
Materials & Methods: 86 patients diagnosed with Vernalkeratoconjunctivitis (VKC) of
both genderswere enrolled. All were prescribed topical 0.05% cyclosporine 4 times a
day. Patients underwent complete ophthalmic examination and symptoms and signs and
intraocular pressure using rebound tonometer. The patients were evaluated at weeks 4,
8 and 12 after the initiation of therapy. Symptoms and signs before and after treatment,
during the four-week intervals, were recorded and scores between 0 and 3 were
assigned.
Results: Out of 86 patients, males were 56 and females were 30. Median of symptoms
score at baseline was 11, at 4 weeks was 4, at 8 weeks was 5 and at 12 weeks was 4. Sign
score at baseline was 6, at 4 weeks was 4, at 8 weeks was 3 and at 12 weeks was 3. The
difference was significant (P< 0.05).
Conclusion: Topical cyclosporine 0.05% help to reduce corticosteroid usage, is an
effective and safe alternative for the treatment of resistant VKC.

Oxiport laryngoscope blade versus miller laryngoscope blade for intubation in neonates and infants during general anesthesia

Dr Kapil Lamba

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 90-95

Aim: To compared the oxiport laryngoscope blade versus miller laryngoscope blade for
intubation in neonates and infants during general anesthesia.
Methods: This controlled interventional single-blind study conducted in the,
Department of Anesthesiology. 60 neonates/infants in groups of 30 each posted for
surgery in paediatric operation theatre over a period of 6 months were included in the
study. Full-term neonates and infants up to 6 months of age of either sex requiring
general anaesthesia with endotracheal intubation for elective as well as emergency
surgery were included in the study.
Results: Out of the 60 patients 30 patients in Miller group and 30 patients in Oxiport
group were included. Both groups were comparable with respect to age, sex, weight,
mean time to intubation (P = 0.61) and anaesthesiologist performing the laryngoscopy
(P = 0.69).Mean lowest SpO2 recorded was 97.21% ± 3.69% in Miller group and 99.77%
± 2.63% in Oxiport group. This difference was statistically significant (P = 0.039). The
incidence of mild desaturation (SpO2 up to 90%) was 86.67% in Miller group and
93.33% in Oxiport group. The incidence of moderate desaturation (SpO2 between 85%
and 92.5%) was 3.33% in Miller group and 5% in Oxiport group. Incidence of severe
desaturation (SpO2<85%) was 16.67% in Miller group and 0 in Oxiport group.
Correlation between time to intubation and SpO2 in Miller group (Pearson’s R2 =
−0.14) was statistically not significant at P = 0.39. Correlation between time to
intubation and SpO2 in Oxiport group (Pearson’s R2 = −0.38) was statistically
significant at P = 0.001. Both groups were comparable with respect to the type of
surgery (abdominal, thoracic, miscellaneous) (P = 0.68). Abdominal surgeries were
associated with a higher number of severe desaturations (80%) compared to thoracic
(10%) and miscellaneous (10%) surgeries.
Conclusion: we concluded that the apnoeic laryngeal oxygen insufflation with Oxiport
laryngoscope blade decreased the incidence of severe desaturation while intubating
neonates and infants. This was easily done as it was non-cumbersome and did not
increase the overall cost of anaesthesia.

Approach to Multiple Injuries of Foot and Ankle (Single stage procedure for lisfranc injury, pan metatarsal fractures with distal tibia fracture and medial malleolus fracture): A rare case report

Dr.K.Vijaya shankar, Dr.A.Senthilnathan, Dr.R.Prabhakar, Dr.M.Chakravarthi .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 96-101

Objectives:

Outlines the necessity of early diagnosing and management of lisfranc injury and metatarsal fracture to avoid chronic instability.
Advantages of plate fixation for (proximal) fifth metatarsal fracture in addition to k-wire.
To assessing the functional outcome and duration of union using MIPPO technique in the management of distal third tibia fracture.

Materials and Methods:
Case Report: We report a case of 32 year old man presenting with multiple injuries to foot and ankle diagnosed as comminuted distal third tibia fracture (with medial malleolus fracture) with panmetatarsal fracture with lifranc dislocation of right lower limb. A single stage procedure done for fixation of all these injuries.
Result; The patient follow up for one year, mean duration union of all fractures noted radiologically by 11±2 weeks. Patient allowed to weight bear after 3 months, Functional range of motion improved from the end of 3 months to 8 months. Prospective functional evaluation of this patient assessed by American orthopaedic foot and ankle society score (AOFAS) 96/100 at the end of 6 months and Pain relief is evaluated periodically by visual analogue scale.
Conclusion: Best results are obtained by immediate anatomical reduction and fixation of lisfranc injuries. In addition to k-wire, plate fixation for fifth metatarsal provides alignment with high union rate, especially when the fracture is comminuted. MIPPO technique is reliable fixation in fracture of distal tibia preserving most osseous (periosteal) blood supply and haematoma  in fracture site and in turn provides  more biological repair.

Fixing an open volar radiocarpal fracture dislocation -a narrow literature to debate

Dr.K.Vijaya Shankar, Dr.A.Senthilnathan, Dr.R.Prabhakar, Dr.R.Rajheiman .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 102-107

Introduction: In the overview of literature studies, radiocarpal fracture dislocations are very rare injuries and accounts only 0.2% 1 of dislocations. The mechanism of injury includes motor vehicle accident, fall from height and work place injuries. These injuries were thought to have poor outcomes and high morbidity.
Purpose of study:-

To enumerate the practical difficulties in fixing a volar radiocarpal fracture dislocations.
To give a functionally mobile joint and prevent the complications of osteoarthritis and arthrosis.

Case report: A 56 years old male, electrician by occupation sustained a self fall from height                (10 feet) while climbing an electric post. He had an open injury to left wrist joint, radius and ulna were dislocated volarly. It was classified as Type 2 radiocarpal fracture dislocation. We fixed it with k-wires and external fixator via dorsal and volar approaches.
Conclusion: Our case study as an adjunct to previous literatures, the outcome came to be good. Radiocarpal fracture dislocation with ulna dislocation needs an earlier intervention with proper preoperative planning. DRUJ instability was common in these patients and required radioulnar pinning.

SURGICAL MANAGEMENT OF ADHESIVE OTITIS MEDIA AND OUTCOME

Dr. Dharmendra Kumar, DrSurbhi .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 108-112

Introduction: Tympanic  membrane forms a important part of middle ear hearing mechanism .Long standing middle ear inflammation leads to atelectasis of the membrane which gradually results in adhesive otitis media .Material and methods : This is a prospective research was done over 50 candidates of adhesive otitis media to study the outcome of the management of adhesive otitis media tympanoplasty with or without canal wall up mastoidectomy .Results : Both the group showed comparable results with improvement in hearing and state of middle ear on subsequent long term follow up .Conclusions :The outcome of surgical management of adhesive otitis media depends upon patient’s factor and surgeon competency .Moreover it depends patient’s benefit from different approaches

PATTERN OF DRY EYE IN POSTMENOPAUSAL WOMEN IN A TERTIARY CARE HOSPITAL IN JAMMU REGION

Dr. Pallavi Sharma, Dr. Amit Sharma, Dr. Sanjay Kai

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 113-117

Background: Dry eye is one of the most important causes of ocular
morbidity.Postmenopausal women often present with dry eye symptoms. The purpose of
this study is to assess the pattern of dry eye in post menopausal women attending
ophthalmology OPD in GMCJammu.
Material and methods:A cross-sectional study was conducted on 200 patients attending
ophthalmology OPD in GMCJammufrom June 2018 to December 2018.After the detailed
history,patients were subjected to complete ophthalmic examination,dry eye tests for
example schirmer’s test and tear film breakup time were done, for the assessment of dry
eye.
Results:Out of the 200 patients,most commonly dry eye was seen in the age group 61 to 65
years and mostly in patients engaged in outdoor occupation.
Conclusion: If the symptoms are detected early,patients can be benefitted. The optimal care
includes early detection and adequate use of lubricants in these patients.

Efficacy of topical 0.05% cyclosporine in Vernalkeratoconjunctivitis

Erum Waris Khateeb, Tania Sadiq, Sheikh Sajjad

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 118-122

Background: Vernal keratoconjunctivitis (VKC) is a chronic recurrent non-infectious
allergic disease that generally affects children and young adults. The present study was
conducted to assess efficacy of topical 0.05% cyclosporine in Vernalkeratoconjunctivitis.
Materials & Methods:86 patients diagnosed with Vernalkeratoconjunctivitis (VKC) of both
genderswere enrolled. All were prescribed topical 0.05% cyclosporine 4 times a day.
Patients underwent complete ophthalmic examination and symptoms and signs and
intraocular pressure using non contact tonometer. The patients were evaluated at weeks 4,
8 and 12 after the initiation of therapy. Symptoms and signs before and after treatment,
during the four-week intervals, were recorded and scores between 0 and 3 were assigned.
Results: Out of 86 patients, males were 56 and females were 30. Median of symptoms score
at baseline was 11, at 4 weeks were 4, at 8 weeks were 5 and at 12 weeks were 4. Sign score
at baseline was 6, at 4 weeks were 4, at 8 weeks were 3 and at 12 weeks were 3. The
difference was significant (P< 0.05).
Conclusion: Topical cyclosporine 0.05% help to reduce corticosteroid usage, is an effective
and safe alternative for the treatment of resistant VKC.

A comparative study between Nifedipine and magnesium sulfate for treatment of preterm labor

DikshaAmbedkar, VimleshKushwaha

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 123-128

Aim: A comparative study between Nifedipine and magnesium sulfate for treatment of
preterm labor.
Methods: Eligible women with preterm labor between 24-37 week gestations were selected
for the study. Nulliparous and multiparous pregnancies with intact membranes, showing
clinical signs of preterm labor were included in this study. The diagnosis of preterm labor is
based on the presence of 4 uterine contractions or more over 30 minutes, each lasting at least
30 seconds, and documented cervical change (dilatation of 0-4 cm and effacement of at least
50%).
Results: 5 patients (5%) after 24 hours, 9 patients (9%) after 48 hours, 7 patients (7%)
after 72 hours and 54 patients (54%) after 7 days had delivery in the nifedipine group and 11
patients (11%) after 24 hours, 5 patients (5%) after 48 hours, 5 patients (5%) after 72 hours
and 62 patients (62%) after 7 days had delivery in the magnesium sulfate group. This
characteristic was not statistically different between the two groups. In this study, 28 patients
(28%) in nifedipine group and 14 patient (14%) in magnesium sulfate group had a failure
treatment (contractions did not subside) and needed to take other tocolytic medications. This
characteristic was also not statistically different between the two groups.
Conclusion: we concluded that the oral nifedipine is a suitable alternative for magnesium
sulfate with the same efficacy and side effects in the management of preterm labor.

A comparative study of Bilateral Accessory Renal Artery in Male and Females with different parameters

Dr. Bhimsen Tyagi, Shaily Saxena, Dr.(Major)Vinay Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 129-139

Background- Accessory renal arteries are very common variant in humans, it may be or not
bilateral, vestigial structure that develops during the ascent of the kidney from the pelvis to
the lumbar region. The purpose of this study to evaluate and compare the frequency, Length,
Diameter of Accessory renal artery in male and females of Western U.P. Population.
Method and Material- The data was collected by using CT Scan machine G.E 64 slice with
software Syngo angiography of 100 patients was collected. CT angiography scan was made
and thin slices (0.6 mm) axial images were obtained. The frequency of accessory renal
arteries, Length and Diameter can be evaluated & compared in male and females subjects. A
correlation is considered significant when p < 0.05. For comparing continuous variables, the
t-test was applied. All the statistical analysis was done by SPSS software.
Result- In this study, Ct angiogram more than 50 males and 50 females subjects were
included and 37 ARA out of 100 subjects is present. Accessory renal arteries are present in
31% of cases. 5% ARAs present at Rt side, 20% ARAs present at left side, and 6% ARAs
present Bilaterally. The frequency of accessory renal arteries are present in male cases(21%)
more than female(10%).
Mean length of ARA in RT side in case of male is 41.57±10.41mm and in case of female
39.32±11.7mm. and on LT side length of ARA in male is 48.36±15.44mm and female is
44.33±12.17mm. Diameter of ARA from origin in RT side in case of male is 2.30±0.40 mm
and in case of female is 1.82±0.45mm and on LT side in case of male is 2.26±0.78mm and in
case of female is 2.38±0.78mm.
Conclusion- This Publication highlights the importance of the recognition of the presence of
renal artery variants if surgical procedures are indicated in Western UP. Moreover, CT
Angiography can reveal pathologies of the renal arteries of the kidneys.

PATTERN OF DRY EYE IN POSTMENOPAUSAL WOMEN IN A TERTIARY CARE HOSPITAL IN JAMMU REGION.

Dr. Pallavi Sharma, Dr. Amit Sharma, Dr. Sanjay Kai

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 140-144

Background:Dry eye is one of the most important causes of ocular
morbidity.Postmenopausal women often present with dry eye symptoms. The purpose of
this study is to assess the pattern of dry eye in post menopausal women attending
ophthalmology OPD in GMCJammu.
Material and methods:A cross-sectional study was conducted on 200 patients attending
ophthalmology OPD in GMCJammufrom June 2018 to December 2018.After the detailed
history,patients were subjected to complete ophthalmic examination,dry eye tests for
example schirmer’s test and tear film breakup time were done, for the assessment of dry
eye.
Results:Out of the 200 patients,most commonly dry eye was seen in the age group 61 to 65
years and mostly in patients engaged in outdoor occupation.
Conclusion: If the symptoms are detected early,patients can be benefitted. The optimal care
includes early detection and adequate use of lubricants in these patients.

Efficacy of topical 0.05% cyclosporine in Vernalkeratoconjunctivitis.

ErumWaris Khateeb, Tania Sadiq, Sheikh Sajjad

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 145-149

Background: Vernal keratoconjunctivitis (VKC) is a chronic recurrent non-infectious allergic disease that generally affects children and young adults. The present study was conducted to assess efficacy of topical 0.05% cyclosporine in Vernalkeratoconjunctivitis. Materials & Methods:86 patients diagnosed with Vernalkeratoconjunctivitis (VKC) of both genderswere enrolled. All were prescribed topical 0.05% cyclosporine 4 times a day. Patients underwent complete ophthalmic examination and symptoms and signs and intraocular pressure using non contact tonometer. The patients were evaluated at weeks 4, 8 and 12 after the initiation of therapy. Symptoms and signs before and after treatment, during the four-week intervals, were recorded and scores between 0 and 3 were assigned. Results: Out of 86 patients, males were 56 and females were 30. Median of symptoms score at baseline was 11, at 4 weeks were 4, at 8 weeks were 5 and at 12 weeks were 4. Sign score at baseline was 6, at 4 weeks were 4, at 8 weeks were 3 and at 12 weeks were 3. The difference was significant (P< 0.05). Conclusion: Topical cyclosporine 0.05% help to reduce corticosteroid usage, is an effective and safe alternative for the treatment of resistant VKC.

The prevalence of transfusion transmitted infections in a tertiary care centre

Dr. Ramu Thakur,Dr. Karuna Thakur,Dr. Ashok Yadav,Dr. Sachin Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 150-153

Background: The five most common transmissible infections in all the blood banks included
HIV, HBV, HCV, syphilis and malaria. This study aims to evaluate the prevalence of prevalence
of transfusion transmitted infections in a tertiary care centre.
Material and methods: The present study was conducted to assess the prevalence of transfusion
transmitted infections in a tertiary care centre. A total number of 1200 donors were analyzed for
the seroprevalence of Transfusion Transmitted Diseases over a period of 6 months. Basic
information was obtained using donor form. Physical examination was done Blood was screened
for HIV, HBV, HCV, syphilis and malaria by ELISA according to manufactures instructions.
Results: A total number of 1200 blood donations were taken in this study. In our study, Males
outnumbered females with 93.33% donations while only 6.66% donors were females. 24 (2 %)
were reactive for blood transmitted infection. In our study, HBV and HCV were the major
infections in blood donors and the seroprevalence were 1.5%, and 0.16% respectively. Only
0.33% was positive for malaria.
Conclusion:The present study concluded that 2 % donars were reactive for blood transmitted
infection. HBV and HCV were the major infections in blood donors.

Variation in the origin of renal arteries from vertebral level in Western U.P. Population: An Angiographic Evaluation.

Dr. Bhimsen Tyagi, Shaily Saxena, Dr. (Major)Vinay Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 154-162

Background- Variations of renal artery are common in general population and gained
importance because of the wide spread development in renal transplantation surgery. The
purpose of this retrospective study was to evaluate the prevalence of variations in the origin
of right and left Renal arteries at Vertebral level.
Method and materials- The data was collected by using CT Scan machine G.E 64 slice with
software Syngo angiography of 100 patients was collected. CT angiography scan was made
and thin slices (0.6 mm) axial images were obtained. The variation in the origin of renal
arteries at the level of vertebral column can be evaluate by 3-D CT angiography results were
analyzed. A correlation is considered significant when p < 0.05. Most of the possible
correlations were examined. For comparing continuous variables, the t-test was applied. All
the statistical analysis was done by SPSS software.
Result - The most frequent position of RRA origin at vertebral level L1 LP are 32 %, L1 MP
are 16%, L1UP are 8% and also L2 UP are 32%, L2 MP are 10%, L2 LP are 2% cases.
Vertebral levels of left renal arteries L1 LP are maximum in 38 % cases. Others are L2 UP in
32%, L1 MP 20%, L2 MP 6% and L1 UP & L2 LP are 2% in each cases.
Conclusion- In our study, Mostly renal arteries are arising in between upper part of L1 to the
lower part of the L2 vertebrae.

INTRICATE ASSESSMENT OF EFFECTIVENESS OF MRI & USG PROCEDURES FOR VARIOUS PATHOLOGIES RELATED TO FEMALE PELVIC: AN ORIGINAL RESEARCH STUDY

Dr. Sunny Goyal, Dr. Prachi Jain, Dr. Dalip Singh Dhiman, Dr. Rajender Punia, Dr. Deergha Singh, Dr. Fayaz Khan H

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 163-169

Aim: To evaluate efficiencies of magnetic resonance imaging & ultrasonographyprocedures for various pathologies related to female pelvic region.
Materials & Methods: This study was performed on total sixty patients. All patients reported for various clinical issues of pelvic region. Magnetic resonance imaging & ultrasonography procedures were used as diagnostic imaging modality. Scanning outcomes of magnetic resonance imaging & ultrasonography have been categorized as group one and group two respectively. All suggestive findings of both imaging modalities were correlated with clinical diagnosis. Based on these existences of correlations, Results thus obtained was compiled and sent for basic statistical analysis. P value less than 0.05 was considered significant (p< 0.05).   
Results: Among all sixty studied patients, females were 14 in age group of 25-28 years. 13 patients were seen in age range of 33-36 years. P value was reported to be significant for this (0.01). Magnetic resonance imaging confirmed Inborn Anomalies in 3 patients. Uterine Mutilation was confirmed in 16 patients by magnetic resonance imaging. Pathologies related to Adnexa were noted in 28 patients. P value was reported to be significant for this (0.002). Endometrial Malignancies were noted in 2 patients. P value was reported to be significant for this (0.001). Pathologies related to Adnexa were noted in 25 patients by Ultrasonography. P value was reported to be significant for this (0.010).
Conclusion: Magnetic resonance imaging was able to detect and confirm almost all studied pathologies related to female pelvic region. Ultrasonography procedure was unable to detect few of those pathologies. Therefore, magnetic resonance imaging is superior and accurate option for scanning pelvis region.

Characteristics and Features of Epics in Pashto Literature

Jamshed Khan Rashidi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 170-183

This researchdiscovers the epics and characteristics of it in Pashto literature. Epics contains
stories of war, battles, bravery, wrestling and heroism, commemorating the great deeds of heroes
and praising them, killing great animals by heroes and performing extraordinary deeds. The
mystic has supernatural and unseen powers, as well as the ability of a hero in Epic to confront
other heroes, for heroes to remain committed to national values and to accept any sacrifice for it
from various weapons and in certain circumstances. The use of deception, predictions about the
future and so on are the trademarks of Epic. In Pashto literature, Epic is considered to be one of
the earliest, but according to all the standards of writing 11th century was considered the time of
invention of Epic.

Clinical profile of patients with benign parotid disease at a tertiary care hospital

Dr. Arunkumar Tukaram,Dr. Md. Zaheeruddine Ather,Dr. Arunkumar Bhavikatti,Dr sharankumar Jabshetty

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 184-189

The analogue of the parotid gland is the first gland to form in humans. Lesions of the parotid
gland are fairly easy to recognize mainly because of the location and limited number of
structures present here. Tumors of parotid gland are believed to represent approximately 2%
of head and neck tumors. Parotid gland tumors account for 70- 80% of all tumors of salivary
glands. Patients visiting to surgery department with parotid swelling were subjected to careful
history taking, complete clinical examination, and examination of facial nerve integrity.
Clinical diagnosis made was confirmed with USG (ultra sonography) parotid and FNAC (fine
needle aspiration cytology). 14(70%) patients in antegrade group vs. 13(76.47%) patients in
retrograde group had pleomorphic adenoma, 5 (25%) patients in antegrade group vs.2
(11.76%) patients in retrograde group had Warthin’sTumor,1(5%) patients in antegrade group
vs.2 (11.76%) patients in retrograde group had Recurrent Pleomorphic Adenoma.

A study to compare retrogrades facial nerve dissection and conventional antegrade technique for parotidectomy in benign parotid disease

Dr. Arunkumar Tukaram,Dr. Md. Zaheeruddine Ather,Dr. Arunkumar Bhavikatti, Dr sharankumar Jabshetty

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 190-197

The antegrade approach is the conventional/standard technique of identification and
dissection of the facial nerve. It is usually the standard procedure for a trainee to master6. The
technique involves identification of the facial nerve trunk as it leaves the stylomastoid
foramen. This is accomplished through identification of the nerve trunk via its relationship
with the tympanomastoid suture, the tragal pointer or the posterior belly of the digastric.
During the study period of 20 month 37 patients with benign parotid disease who underwent
surgery were included in study group. Based on the surgeon expertise and familiarity with the
technique of facial nerve dissection 17 patients underwent retrograde dissection of facial
nerve for parotidectomy and was grouped as retrograde group. In retrograde group, surgeons
with a good experience of retrograde technique performed all surgery. 45% patients in
antegrade group vs. 2 (11.76%) patients in retrograde group recovered completely at 1 month
interval. We tested difference between the groups in facial nerve injury recovery at 1month
by applying Fischer’s exact test p= 0.028 and it was found to be statistically significant.

Prospective comparative study of visual internal urethrotomy and visual internal urethrotomy with intralesional triamcinolone and mitomycin c in treatment of stricture urethra

Dr. Abhilash, Dr. Srilakshmi N, Dr. Padmaraj Stalin Hegre, Dr. Kiran Kumar Nayak S

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 198-204

Urethral stricture disease has always been a challenge for urologists. Different treatment
modalities that are used for treatment of urethral stricture disease are dilatation, urethrotomy,
stent placement. Internal urethrotomy is a safe first line treatment for urethral strictures
independent of etiology and location, with an overall primary success rate of 60-70%.Visual
internal urethrotomy was done in usual manner using cold knife. Injection is prepared by
diluting triamcinolone 40mg, mitomycin 2mg in 5-10mL of saline according to length of
stricture and was injected intralesional at the site of urethrotomy using William’s endoscopic
needle. At every site 1-2mL was injected. After confirming free passage of cystoscope into
the bladder, an 16 or 18 Fr foley’s catheter was left in place for 2-3 days.In our study total of
7 patients lost follow up and among remaining 37 patients total of 10 patients had recurrence,
8 patients in group A had recurrence at end of 6 months, 1 patients at 3 months after
procedure and 7 patients at 6 months after procedure where as in group B only 2 patients had
recurrence 1 at 3 months and 1 at 6 months post procedure, both groups were statistically
comparable with respect to age stricture length,site and etiology.From our study we can
conclude that, Injection of both triamcinolone, mitomycin C at stricture site after VIU can be
considered as safe and effective adjuvant modality compared to VIU alone for short term
management of stricture urethra.

Comparative study of role of bupivacaine instillation into the operative bed for post-operative pain analgesia in modified radical mastectomy

Dr.Kiran Kumar Nayak S, Dr.Srilakshmi N, Dr.Vinay G,Dr. Abhilash

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 205-211

Surgery still has a pivotal role in the management of breast cancer, even though recent
advances in oncology are trending towards more conservative techniques followed by
chemotherapy.The consensus development conference on the treatment of breast cancer in
1979 stated that modified radical mastectomy was the standard of treatment for stage 1 and 2
disease. 60 patients of either sex between age group 30 to 60 years undergoing elective
Modified Radical Mastectomywere divided into two groups of 30 patients each randomly
who fulfilled the inclusion and exclusion criteria. In this study, When we look closer, we
could see that, despite of being statistically significant, the VAS and VRS scores at initial
intervals (1hr, 4hrs) were low in group A when compared to group B. At 8 hours and, there
was a marked increase in VAS and VRS score in group B and thereafter it was akin in two
groups.

Effect of ropivacaine and bupivacaine on heart rate for supraclavicular brachial plexus

Dr. Shivakumara K C, Dr. Vishal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 212-216

The brachial plexus is enveloped by a fascial sheath, formed by prevertebral and scalene
fascia, extending from the intervertebral foramina to the upper arm. The foramina of a sheath,
at any anatomical point, will allow for the spread of local anaesthetics and subsequent
blockade. Each approach to the brachial plexus impacts specific anatomical areas of the upper
extremity. Patients were kept Nil per orally for 6 hours before the time of surgery and on the
previous night premedicated with Diazepam 5 mg and Ranitidine 150mg. 60 patients ASA I
and ASA II were randomly allocated with sealed envelope method into two different groups
of 30 each. Both observer and participant were blinded. GROUP A- received (n=30) 25 ml of
0.5% bupivacaine, GROUP B-received (n=30) 25 ml of 0.5% ropivacaine. There was no
statistically significant difference in heart rate between both groups (p>0.05). There is no
significant difference of heart rate clinically.

Morphological landmarks of proximal humerus fracture in functional outcome post fixation by philos plate

Dr.NilaySaha, Dr.M Ayyub Khan,Dr.Ajay VM

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 217-224

Proximal humerus fractures present with different configurations in patients with varying
comorbidities and expectations. Various treatment options are available for treating proximal
humerus fractures. A good functional outcome with context to the early joint mobilisation and
rigid fixation of the fracture can be achieved with PHILOS plate in proximal humerus
fractures.Patients admitted with proximal humerus fractures as inpatient in department of
orthopaedics were included in the study satisfying the inclusion and exclusion criteria.30
patients with proximal humerus fracture were treated by open reduction internal fixation with
PHILOS plate. Improvement of Constant-Murley score at 6 weeks of 47.83 to 64.67 at 12
weeks(p=<0.001), 75.27 at 24 weeks(p=<0.001) and 78.33 at final follow up(p=<0.001).
Most of the patients had excellent (43.3%) followed by good (33.3%), poor (16.7%) and fair
(6.7%) outcome. Varus malunion 6(20%) was the most common complication.Proximal
humeral internal locking system (PHILOS) is the implant of choice for treating displaced
proximal humerus fractures which leads good functional outcome in patients.

Association between second trimester maternal serum alphafetoprotein in 14-22 weeks and adverse pregnancy outcome

Heena Mir, Saima Sadiq,Sabha Malik

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 225-230

Background:Many screening tests are available for predicting adverse pregnancy outcome
and these range from non- invasive to invasive and serum alpha-fetoprotein level
estimation is one of them. The present study was conducted to assess association between
second trimester maternal serum alpha-fetoprotein in 14-22 weeks and adverse pregnancy
outcome.
Materials & Methods: 250 patients of gestational age between 14-22 weeks were included.
Maternal serum alpha-fetoprotein was measured in human serum by microplateimmunoenzymometric
assay by EIA-AFP kit. Maternal serum alpha-feto protein level was
expressed in IU/ml.
Results: 23 (9.2%) participants out of 250 developed preterm labor. 21 out of 23 had raised
value of maternal serum alpha-fetoprotein. 20 (8%) patients out of 250 patients developed
oligohydramnios. 13 out of 20 had raised value of maternal serum alpha-fetoprotein. 14
(5.6%) patients out of 250 developed pre-eclampsia, 11 out of 14 had raised values of
maternal serum alpha-fetoprotein. 7 (2.8%) patients out of 250 developed premature
rupture of membrane (PROM). 4 out of 7 had raised values of maternal serum alphafetoprotein.
Conclusion: There is an increased risk of pre-eclampsia, preterm delivery,
oligohydramnios and premature rupture of membrane with elevated maternal serum
alpha-fetoprotein levels

High and low-pressure carbon dioxide in patients undergoing laparoscopic cholecystectomy

Dinesh Maheshwari, Avinash Maheshwari, Anjali Maheshwari, Kopal Agarwal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 231-236

Background:Laparoscopic cholecystectomy is considered the gold standard for gallbladder
removal and is the most common laparoscopic procedure worldwide. The present study was
conducted to compare high and low-pressure carbon dioxide in patients undergoing
laparoscopic cholecystectomy.
Materials & Methods:86 patients undergoing laparoscopic cholecystectomy of both
genders were classified into 2 groups of 43 each. Group I comprised of high-pressure
carbon dioxide and group II low pressure carbon dioxide. In both groups, abdominal pain,
nausea and vomiting were evaluated on the verbal rating scale (VRS) at 1, 3, 6, 12, and 24
hours.
Results: The mean nausea/vomiting score at 1 hour, 3 hours, 6 hours, 12 hours and 24
hours in group I and II was 5.6, 5.0, 4.5, 3.8 and 3.2 and 4.2, 3.4, 3.0, 2.6 and 2.0
respectively. The mean abdominal pain in group I was 7.5, 6.5, 6.0, 5.4 and 4.6 and in
group II was 6.8, 4.6, 5.2, 3.6 and 2.2 in group I. The mean shoulder tip pain was 6.2, 5.4,
4.6, 3.8 and 2.4 in group I and 6.0, 4.8, 4.4, 3.6 and 1.8 in group II respectively. The mean
pre- operative ALT level in group I was 20.5 and post- operative level was 40.5 and in
group II was 20.4 and 45.6. AST level found to be 21.4 and 38.2 and in group II was 20.4
and 45.3, ALP level was 185.4 and 170.5, BILLT level was 0.62 and 0.70 in group I and
0.61 and 0.69 in group II, BILLD level was 0.21 and 0.34 in group I and 0.23 and 0.35 in
group II respectively. The difference was significant (P< 0.05).
Conclusion: Low pressure group had less pain score and nausea and vomiting score as
compared to high pressure group. Hence, it can be considered as treatment of choice in
patients undergoing laparoscopic cholecystectomy.

Pediatric ocular trauma and its outcomes:Rajasthan,India

Dr.Prabha, Dr. Priyanka Aggarwal,Dr. Himanshu Goyal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 237-242

Aim:To identify the trend of ocular trauma in pediatric age-group and evaluate final visual
outcome.
Materials and Methods: Prospective interventional study at Government medical College,
Bharatpur from November 2019 toOctober 2020,patients up to age 16 years attended the
casualty department of eye and undergone intervention with follow-up period of 1to3months
or till better recovery.
Results: Total 118 eyes of 115 patients were enrolled. The age-group more affected was
above 5 years (67.80%, i.e.,80 eyes)and below 5years (32.20%, i.e.,38eyes). Boys (62.71%)
were affected more than girls (37.29%). Most of the children reported to casualty within
24hours(80.50%eyes),remaining patients reported later within 2days to 1 week (19.50%eyes).
Most of the ocular injuries occurred by household objects (22.3%), blunt objects(13.56%),
playground/sports (13.56%),accidental fall(11.02%), projectile(7.63%)and others. Best
corrected visual acuity(VA)of more than 6/18 achieved in 61.02%eyes, 6/18-6/60
in18.64%eyes,<6/60-counting finger close face(CFCF)in5.93%eyes, projection of
light(PL)+perception of rays(PR)in5.93%eyes,and noPLin8.47%eyes.
Conclusion: Pediatric ocular trauma is still higher in Rajasthan. It requires early presentation
and intervention so that prognosis can be enhanced and impact of trauma can be reduced as
much aspossible.

Efficacy of Saroglitazarin patients with diabetic dyslipidemia

Surendra Kumar Ghintala, Pradeep Kumar, Ajeetkumar Gadhwal, Ratan Kumar Agarwal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 243-247

Background:Type 2 diabetes mellitus (T2DM) is a complex metabolic disorder
characterized by persistent hyperglycaemia due to relative insulin deficiency, insulin
resistance. This study assessed efficacy of Saroglitazar in patients with diabetic
dyslipidemia
Materials & Methods:120 patients with type 2 diabetes mellitus of both genders were
assessed for serum fasting plasma glucose, post prandial glucose, glycated hemoglobin
(HbA1c), blood urea, serum creatinine, S.G.O.T, S.G.P.T and lipid profile. Patients were
treated with Saroglitazar 4 mg once daily and the follow-up data were available for 12
months.
Results: Out of 120 patients, males were 80 and females were 40. The mean triglyceride
level was 610.4, 208.4 and 224.4, total cholesterol was 312.2, 244.7 and 172.1, non- HDLC
was 274.8, 199.6 and 126.3, LDL- C was 165.6, 116.8 and 104.17, HDL- C was 41.4, 42.1
and 42.5, HbA1C was 8.02, 7.8 and 7.1, FPG was 156.2, 130.5 and 120.4, PPG was
234.6, 172.1 and 160.5, SGOT was 46.6, 42.3 and 40.3, SGPT was 34.2, 38.4 and 37.4, S.
Creatinine was 0.7 and CPK was 74.3, 71.6 and 68.3 at baseline, 12 wees and 52 weeks
respectively. The difference was significant (P<0.05).
Conclusion: Saroglitazar is a very effective therapeutic option in diabetic dyslipidemia with
very high triglycerides level.

A Recurrent Benign Osteochondroma of ventral scapula associated with Snapping Scapula and Pseudoparalysis - A case report

Dr.K.Vijaya Shankar, Dr.A.Senthilnathan, Dr.R.Prabhakar, Dr.S.Navin Chander .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 248-256

Introduction: Osteochondromas (often referred to as exostosis) are usually an incidental finding and are characterized by a benign bony protuberance covered with a cartilaginous surface in the metaphyseal region of long bones. Though they do not affect the patients directly; but cause indirect complications of varying degree of severity such as bursitis, neurovascular impingement, fracture of peduncle or malignant transformation. Imaging studies such as an MRI or CT, are useful aids in the diagnosis; however, biopsy is a mandatory requisite for a definitive diagnosis. Treatment modalities include open surgical or an arthroscopic resection and has good prognosis. Recurrence follows incomplete excision.
Presentation of case: In this report, we present a rare case of a recurrent, symptomatic scapular osteochondroma associated with scapular pseudowinging and snapping scapular syndrome in a 16-year-old female. Radiological findings exhibited by this tumour was highly characteristic. The tumour was then managed with surgical resection thereby resulting in an entire resolution of the patient's symptoms.
Discussion: This case was unique because she presented with recurrence 5 years after her previous surgery as she neared her age of skeletal maturity raising a suspicion of malignant transformation. And also she was having associated pain, pseudowinging and snapping scapula syndrome.
Conclusion: By reporting this rare case of a scapular osteochondroma that presented with scapular winging, we aim to increase the awareness of the unusual manifestations of osteochondroma, particularly atypical sites, signs, and symptoms. Furthermore, we've given a comprehensive description of this case and its management to help other surgeons who face similar cases.

RIPASA score in diagnosis of suspected cases of acute appendicitis

Dinesh Maheshwari, Avinash Maheshwari, Anjali Maheshwari, Kopal Agarwal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 257-261

Background:Appendicitis occurs most commonly between the ages of 10 and 20 years and it has a male-to-female ratio of 1.4:1. The present study assessed validation of RIPASA score in diagnosis of suspected cases of acute appendicitis. Materials & Methods:86 patients with right iliac fossa pain and suspected to have acute
appendicitis of both genders were assessed. All were assessed using the RIPASA scoring system on the basis of clinical assessment and hospital protocol, histopathological correlation done with a score. A score of 7.5 was considered a cut-off value for high probability of acute appendicitis. Results: Out of 86 patients, males were 52 and females were 34. RIPASA score <5 was seen in 15, 5-7 in 20, 7.5- 11.5 in 38 and >12 in 13. Emergency appendectomy was performed on 62, positive HPE reports for appendectomy was seen in 54, negative HPE for appendectomy in 8, perforated appendix in 4 and wound sepsis in 7 cases. Conclusion: RIPASA score is a better, easy, safe, and non-invasive diagnostic method for diagnosis of acute appendicitis.

Role of X-Ray in the Evaluation Of Asthma And Wheezing Severity

Hussameddin Hasan Alali, Mohamad NourM.Nael Ammaneh, Fisal Haritani

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 262-271

Patients with asthma experience exacerbations due to the airflow obstruction caused by the narrowing of lung passages. The exacerbations vary between simple and lifethreatening, which is unpredictable. As a result, visits to the emergency department and hospitalization incur an enormous health care expenditure. Prediction on the severity of exacerbations is primarily vital to decide on the further course of treatment where conventional tests like spirometry provide mechanical aspects of the lung pathway obstruction. The advent of imaging modalities provides an advanced notion of the severity. Hence, in this review, the epidemiology of asthma, a diagnostic procedure using the different radiological techniques, various factors leading to lung pathway obstruction, and suitable medicines were discussed.

Clinical profile of patients with benign breast disease

Dr. Avinash Chandra S

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 272-276

The nomenclature of benign breast disease is very confusing.This is because over the last
century a variety of clinicians and pathologist have chosen to describe a mixture of
physiological changes and disease processes according to a variety clinical, pathological and
aetiologicalterminology. The study includes patient attending surgical out patient department
and admitted to surgical wards with breast lump during the study period. Most of patients
presented in OPD with complaints of breast lump 66 (60%) followed by patients presenting
with lump and pain of 33(30%). Some patient show engorgement of breast 8 (7.2%).Few
Patients also presented with lump, pain and discharge 3 (2.7%).

Histopathological study and management of benign breast disease at a tertiary care hospital

Dr. Avinash Chandra S

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 277-283

Benign breast disease is primarily a phenomenon seen in reproductive age group. They are
thought to be largely hormone induced. Benign breast disease is 4-5 times more common then
breast cancer. The study includes patient attending surgical outpatient department and
admitted to surgical wards with breast lump during the study period. Most of the patients
underwent excision-85 patient (77.27%) followed by microdochotomy-4 (3.63%)and I & D-4
(3.63%).Simple mastectomy also done in 4 (3.63%) patients. Wide excision biopsy was done
in 3 (2.72%) patient. Majority of the patients 90 patients (81.81%) did not have any postoperative
complications, whereas 12 patients (10.90%) had discharge from wound and 5
patients (4.54%) had wound gape due to infection.

Diagnosis and Pathology Characterization of Thyroid Gland Using Different Radiological Techniques

Mohamad Nour M.Nael Ammaneh, Hussameddin Hasan Alali, Fisal Haritani

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 284-294

The normal endocrine function is primarily for the quality of life of people, irrespective of
age, sex, and race. Detrimental thyroid function leads to multiple disorders, including
cardiovascular, renal, neurologic, foetal development, and sexual drive. Moreover, if left
untreated may aggravate the formation of thyroid nodules and subsequently to cancer.
Therefore, periodic assessment of thyroid glandfunction may eliminate these complications
and improve the patients' quality of life. In this review, we have discussed the different
thyroid disorders, their complications, radiological techniques, and invasive procedures for
assessing the thyroid gland.

Clinical profile of patients of chronic kidney disease undergoing regular twice weekly maintenance hemodialysis

Dr.Raghu Nandan,Dr.Anil Kumar,Dr.Vinay Durgad

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 295-300

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%).

Pegylated erythropoietin and darbepoetin Alfa: A study on comparison of renal parameters among CKD patients on maintenance hemodialysis

Dr.Raghu Nandan,Dr.Anil Kumar,Dr.Vinay Durgad

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 301-307

Chronic inflammation is a common feature of CKD and is a major cause of its associated
morbidity and mortality. Erythropoiesis is inhibited by several pro-inflammatory cytokines
such as interleukin-1, tumor necrosis factor-alpha (TNF-α) and interferon gamma (IFN-γ).12
These cytokines are particularly involved in the inflammatory process as they are directly
produced by macrophages (TNF-α, IL-1) or because their production by another cell is
induced by a macrophage cytokine (IFN-γ). Several studies have shown that markers of
inflammation are associated with a decreased response to erythropoietin. Out of these 52
patients, 12 patients couldn’t complete the study. 5 patients (2 in group A and 3 in group B)
left the study in between due to some unknown causes and 7 patients (4 in group A and 3 in
group B) expired during the study.So finally 40 patients (20 in each group) completed the
study. In group A there was a slight decrease in systolic and diastolic blood pressure from
baseline values of 153.5±12.06 and 92.3±6.06 mm of Hg to 150.4±12.62 and 89.2±5.36 mm
of Hg at 3 months, but the decrease was not significant statistically (p >0.05). In group B also
there was a slight decrease in systolic and diastolic blood pressure from baseline values of
156.2±8.72 and 92.4±6.31 mm of Hg to 149.1±18.20 and 93.6±4.75 mm of Hg at 3 months,
but the decrease was not significant statistically (p >0.05).

Assessing risk factors of 1 year mortality in patients with hip fractures: A hospital-based retrospective cohort study from a developing level 1 trauma centre in Northern India

Dr. Chethan MH,Dr.Himanshu Agrahari,Dr. Arvind Kumar Yadav, Dr.Bhaskar Sarkar, Dr.Siddharth Dubey, Dr. MD Quamar Azam

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 308-313

Purpose: Proximal femoral fracture is one of the major causes of morbidity and mortality in
elderly group patientswith 11-23% of mortality is reported to occur at 6 months and 22-29%
at 1 year. Despite the huge burden of osteoporosis, there is paucity of data regarding
epidemiology, risk factors and outcome of fragility hip fractures in Indian population. As
most of the published literature are from western world, we conducted the study to look for
risk factors for early-mortality in hip fracture in Indian sub-continent and compare the same
with published literature.
Methods: Total of 174 patients were available for final evaluation. Primary outcome was to
see the mortality in elderly patients undergoing operative treatment and the secondary
outcome measures were predictors of mortality in this age group with regard to age, sex,
Charlson comorbidity index, injury severity score, pre-operative ASA grading, injury-surgery
duration and length of hospital stay. Cox proportional regression hazards regression
modelling was performed to assess the effect of different variables on time of mortality.
Results: Mean age of the patients was 70.56 (± 8.05) years. Mean Charlson Comorbidity
Score was 1.68 (± 1.54; 2SD). Mean time from injury to operation time was 35.59 (±19.02; 2
SD) hours and the mean length of hospital stay was 4.78 (± 1.68; 2 SD) days. Mortality at
one-year after surgery was 18.4%.On univariate and multivariate regression analysis variables
significantly associated (p<0.05) with ‘Mortality’ are: Age, Charlson Index, Charlson Index
Category, Injury to operation time(Hours), Length of hospital stay and pre-operative ASA
grade.
Conclusion: We suggest that, without a dedicated hip-fracture protocol in a resource-poor
set-up, early aggressive management to optimize patients for surgery and surgical
intervention as soon as feasible lead to early return to pre-fracture status and reduces early
mortality.

A study comparing preoperative intra incisional antibiotic infiltration and prophylactic intravenous antibiotic administration for reducing surgical site infection

Dr. Jambukala AY, Dr. Mahadevaswamy KM, Dr. Ashok Ganiger S,Dr. Shiv Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 314-320

Many methods have been evolved to combat wound infection during last century. Shortly
after the introduction of the first antimicrobial agent Penicillin alone was shown to reduce the
infection rate in abdominal surgery to 10% from a control rate of 25%.Initially, the antibiotics
were only used post-operatively for treatment of already established SSI. Later, the concept
of antibiotic prophylaxis was introduced. Many studies established the fact that preoperative
prophylaxis with antibiotics reduces wound infection. All patients were given spinal
anaesthesia all patients were painted with 10%povidone and recleaningwith spirit Surgical
field was drappedproperly and aseptic precautions followed group a: prophylaxis by
preoperative intraincisional infiltration of the antibiotic. One gram of cefotaxime diluted in 10
ml of distilled water will be infiltrated along the skin and the subcutaneous tissue in the
proposed line of incision, 20 minutes before surgical incision. In Group 1, wound discharge
was present in 1% on day 5. In group 2, wound discharge was present in 2% on day 5. There
was no significant difference in wound discharge between two groups. At other intervals
there was no discharge in both the groups.

Oral gabapentin (600mg) versus oral pregabalin (75mg) for orthopedic surgery under spinal anesthesia: Hemodynamic changes

Dr. Rahul Bankapur, Dr. Preeti Lamba, Dr. Rahul Jain

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 321-326

The myelinated A δ (sharp pain, first pain) peripheral nociceptors and unmyelinated C
nociceptors (delayed pain, second pain) respond to strong mechanical, thermal, chemical
stimuli that act as transducers, converting chemical, mechanical or thermal energy at the site
of stimulus to electrical activity, which are conducted to the dorsal horn of CNS. Based on
previous study by Usha Bafna et al., sample size was calculated to be 30 patients, to be
randomly included in each group to demonstrate a 40% difference in duration of analgesia
with a power of 0.8 and type-1 error of 0.05. To allow for study error and attrition, 35 patients
were included in each group. In Group A, 3 (8.57%) patients and in Group B, 4 (11.42%)
showed hypotension that is mean SBP was less than 20% of the base line, were as none of
patients in either group showed hypertension that is more than 20% of the baseline SBP
(intraop and postop). There was no statistically significant difference between two groups P
value (0.6903).

A study on side effects oral gabapentin versus oral pregabalin for orthopedic surgery under spinal anesthesia

Dr. Rahul Bankapur, Dr. Preeti Lamba, Dr. Kushank Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 327-332

Pregabalin is a structural analogue of gamma aminobutyric acid, substituted at the 3-position;
this facilitates diffusion across the blood-brain barrier. Efficacy of pregabalin has been
proven in neuropathic pain, incisional injury, inflammatory injury. Its mechanism of action is
probably the same as gabapentin but it is more lipid soluble and has superior pharmacokinetic
profile. Due to its sleep modulating effects, it has been used as an anxiolytic. Pregabalin
increases stages III-IV sleep phases and also decreases awakening at night. Patients were
counselled regarding the tablet used in preemptive analgesia its advantages and
disadvantages, the purpose of its use, they were also explained regarding the follow up till
24hr and spinal anaesthesia procedure to be used in the study and consent was taken for the
same. Ramsey sedation score of all the patients was score = 2. None of patients complained
of dizziness in group A. Ramsey sedation score of all the patients was score = 2.2.85% (1
patient) complained of dizziness in group B.

Quality control of blood components-a step towards efficient supply of blood products

Dr. Sachin Sharma, Dr. Ashok Yadav, Dr. Radhika Rai, Dr. Yogesh Pawde

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 333-336

Objective: The aim of study was to ensure supply of safe and efficient blood transfusion to
patient and to prevent Transfusion Transmitted Diseases.
Methods: The present study included data of routine monthly analysis of whole blood and
blood components which was collected from archives of blood bank from the period of 1st
January 2018 to 31st December 2019. Data was collected for the above mentioned period in
which blood was collected from 2520 healthy donors in sterile single, double or triple blood
bags with anticoagulant Citrate Phosphate Dextrose Adenine 1 (CPDA 1) after taking written
consent.
Result: Mean volume was 65.5 mL with range of 50-70 mL. Mean WBC contamination was
1.4×108/unit with a range of 0.15-5.5×108/unit. Mean RBC contamination was
0.077×1012/liter with a range of 0.05- 0.14x1012/liter.
Conclusion: Quality indicators should be well-defined, regularly monitored and properly
documented. Quality Control is an important tool to ensure maximum benefit to patient with
minimum cost and maximum advantage and minimizing requirement of transfusion to patient
and Prevention of risk of Transfusion Transmitted Diseases.

Assess the analgesic efficiency of rectal diclofenac after caesarean section

Dr. Harsh Kasliwal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 337-342

Background: Pain management following caesarean section still remains a challenge in our
environment. Diclofenac suppository is an effective adjunct analgesic for post-operative pain
control. Over the last two decades the number of caesareans being performed has increased
dramatically. High quality postoperative analgesia is important because the new mother has
to recover from major intra-abdominal surgery while also caring for her newborn baby. Many
options are available but tailoring the method to the individual can be problematic because it
has been difficult to predict the severity of postoperative pain or the individual response to a
regimen.

A Prospective Study of Restricted Use of Episiotomy in Primigravida Patients

Dr. Syeda Nishat Masiha, Dr. Meenakshi Devarmani, Dr. Sanjana Patil

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 343-346

Aim: There is extensive disagreement about the necessity and benefits of routine episiotomy for all. The American Congress of Obstetricians and Gynecologists Committee on Practice Bulletins, 2006 based on good scientific evidence recommends restricted use of episiotomy to be preferred, yet its restricted use is not being practiced. Keeping these in mind, the study was done with the aim to assess the effects of restrictive use of episiotomy during vaginal birth.
Materials and methods: This was a prospective study. Single- ton primigravida term vaginal deliveries over 18 months(June 2020-Dec2021) were included. Under the policy of restricted use of episiotomy, great restraint was observed in giving an episiotomy. Mediolateral epi- siotomy was given in women where expected baby weight >3 kg or perineal tear was anticipated, and in cases of instrumental deliveries. Perineal tears, postpartum status, and satisfaction level of women were compared between patients with or without episiotomy. Data so obtained were analyzed
Results: About 29.8% women delivered with episiotomy, 65.5% had intact perineum; 5.67% women had first-degree perineal tear and only 1.42% women had second-degree perineal tear using a policy of restricted use of episiotomy. None of the women had third- and fourth-degree perineal tear. Patients delivered without episiotomy were more comfortable in terms of less perineal pain, early evacuation of bladder, and ambulation
Conclusion: With the restricted use of episiotomy using precise clinical judgment, the unnecessary episiotomies could be avoided, giving better care and patient satisfaction with minimum maternal morbidity
Clinical significance: The policy of restricted use of episiotomy would result in considerable reduction in maternal morbidity, decreased hospital stay and overall cost, and good patient satisfaction level

Bone Marrow Necrosis: Report of five Cases from a Tertiary Centre During a Period of four years.

Ngangom Bikumar Singh, Rajkumari Jayshree Devi, Irom Anil Singh, Rajkumari Banashree Devi, Kshetrimayum Achouba Singh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 347-353

Background: Bone marrow is the major hematopoietic organ and is one of the largest organ in human body.1The causes of bone marrow necrosis (BMN) is varied & diverse. Among these cases, hematopoietic malignancy is the commonest. As it is a potential target organ of various disorders, the examination of blood and bone marrow becomes one of the important component for the evaluation of certain disorders.1 It is a rare finding accounting for about 0.3 to 2.2%2,3. Bone marrow necrosis is defined as  necrosis of the medullary stroma and myeloid tissues in large areas of the hematopoietic bone marrow (BM), leaving an amorphous eosinophilic background, poorly defined necrotic cells and preserved cortical bone.4
Objectives: The objective wasto highlight these rare phenomenon of bone marrow necrosisand to analyse the underlying disease producing bone marrow necrosis.
Methods: All cases of bone marrow examination performed in the Pathology Department, JNIMS, Imphal Manipur where analysed during the four years period starting  from 1st November 2017 to 30 November 2021. The clinical details and other parameters of all the cases were traced retrospectively from hospital record section. Archived bone marrow aspirate smears and biopsy sections were reviewed whenever required.
Result: A total of 346 bone marrow aspirations were performed in the department of Pathology during the study period. Five cases of bone marrow necrosis were detected producing a prevalence of 1.4%.
Conclusion: In our series of five cases, 2 cases (40%) of acute myeloid leukemia, 1 case (20%) of MDS-EB II, 1 case (20%) of disseminated tuberculosis and 1 case (20%) of hepatits B viral infection were included. To conclude, in cases of bone marrow necrosis, further investigations including ancillary techniques are strongly suggested to come to conclusive diagnosis as the causes of bone marrow necrosis vary from patient to patient.

MRI Evaluation of Spinal TB: A Cross-Sectional Study.

Dr. Khumanthem Shailendra Singh, Dr. Pheiroijam Robindro, Dr. Okram Pusparani Devi, Dr. Ngangom Lilavati

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 354-358

Background: Tuberculosis of spine is one of the commonest musculoskeletal TB. It not only causes back pain but also causes functional disability.
Methodology: A cross-sectional study was conducted in the department of Radiology and Imaging, JNIMS, Imphal East in collaboration with the Departments of Orthopedics and Microbiology, JNIMS from March 2017 to June 2021. Fifty patients appeared as tuberculosis spondylitis on clinical and X-ray findings were included in the study. MRI (3 Tesla, Phillips), microbiological tests and preoperative biopsy were done from each patient and 45 of them were confirmed as the patients of spine TB by these procedures. Maximum of the patients were from the age group 31-40 years with a mean age of 36.25±6.33 years. Males were predominant. Results: Multiple and continuous vertebral involvement was seen more common. Conclusions:  MRI should be considered to be the imaging modality of choice for patients with suspected TB spondylitis, because of its high specificity, sensitivity and accuracy as it provides necessary information to the surgeon for proper management by providing vertebral intra-osseous abscess, vertebral disc collapse, skip lesions, dural and intradural diseases and involvement of posterior elements more precisely.

An Observational Study of Epidemiological Factors Among Acute and Chronic Renal Failure Patients in Gujarat.

Dr Shikha Goyal, Dr. Syed Javed Arshi, Dr. Bharat Agarwal, Dr. Pranveer Rao, Dr. Sunanda Chauhan, Dr. Amit Haritwal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 359-363

Introduction: Renal failure is a complex disorder that occurs in a variety of settings with clinical manifestations ranging from a minimal elevation in serum creatinine to anuric renal failure. Recent epidemiological studies demonstrate the wide variation in etiologies and risk factors for acute renal disease, describe the increased mortality associated with this disease (particularly when dialysis is required), and suggest a relationship to the subsequent development of chronic kidney disease (CKD) and progression to dialysis dependency Aim: to find out the epidemiological parameters responsible for acute and chronic renal failure in a Government Hospital of Gujarat. Methodology: This was a cross sectional study  done in the department of Pathology, M. P. Shah Medical College, Jamnagar. These patients were above the age of 18 years.  Verbal consent was taken from all patients. 50 patients with acute renal injury were included along with 100 patients with chronic renal failure. Results: maximum incidence of acute renal failure was in the age group of 31-40years (24%) followed by the age group of 41-50 years(18%) . The maximum incidence of chronic renal failure was in the age group of 41-50years (26%) followed by the age group of 51-60 years(24%) followed by the age group of 31-40 years(20%).

A Systematic Review of Omicron Outbreak in Indonesia: A Case Record and Howthe Country is Weathering the New Variant of COVID-19

Abdul Kadir, Stevan Deby Anbiya Muhammad Sunarno .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 364-373

Most countries have been struggling in facing the coronavirus. In Indonesia, various proposals and regulations have been introduced as a strategy in handling and preventing the spread of COVID-19, such as the instruction to use masks and for social distancing, travel limitations, area-based restrictions, and vaccination. Unfortunately, COVID-19 has continuedto be an issue since a new variant of concern, known as Omicron (B.1.1.529), was identified. Literature review was conducted in this study, featuring254 cases of Omicron in Indonesia by January 4, 2022. Indonesian government has developed at least fivecriteria to prevent the spreading of the COVID-19 virus,in particular the Omicron variant. Testing rate in Indonesia still below Malaysia, while tracing and treatment control conducted by the Indonesian government is quite similar, and massive in comparison to Malaysia and Singapore, with the PeduliLindungi mobile application launched in 2021. Conducting health promotion has become a necessity, with an understanding of the health belief model, engaging the religious leaders, and providing psychological support for mental health issues.
Keywords: Omicron, COVID-19, Outbreak, Indonesia, Case Record

Pattern of repeat kidney biopsy findings in quiescent proliferative lupus nephritis

Dr. Ravi N Sangapur, Dr. GN Ravikumar Patel

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 374-380

Background: The optimal duration of maintenance therapy is controversial in proliferative
lupus nephritis. Discordance between clinical parameters of renal remission and histological
findings in immediate post induction phase as well as maintenance phase has made repeat
biopsy a compulsory tool to confirm the histological remission. But timing of repeat kidney
biopsy is debatable. Aim of this study was to find the pattern of repeat kidney biopsy findings
proliferative lupus nephritis.
Methods: Repeat biopsy (biopsy 2) performed on patients of biopsy proven (biopsy 1)
proliferative lupus nephritis (ISN/RPS 2004 class III/IV±V) between November 2011 to
September 2017 on maintenance therapy and in complete clinical remission for at least 2-
years. Clinical and histologic findings at biopsy 1 and biopsy 2 of 29 patients were compared
Results: Average time taken achieve complete remission was 9(2-24) months. Average
duration of follow up, maintenance therapy and complete clinical remission the cohort was
68±17.8, 62.5±14.2 and 58.9±17.3 months respectively. Histological remission was observed
in 93.1%. Other than duration of complete remission on maintenance therapy none of the
variables failed to predict the histological remission.
Conclusion: Majority of patients were in complete histological remission in repeat kidney
biopsy proliferative lupus nephritis following sustained clinical remission on maintenance
immunosuppressive therapy

Prospective Observational Study On Maternal And Perinatal Outcome In Antepartum Haemorrhge

Dr. Prof. Sumitra Yadav, Dr. Nidhi Bamnia

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 382-388

Antepartum hemorrhage is an obstetric emergency contributing to significant amount of perinatal and maternal mortality.APH is defined as any bleeding from the genital tract between 24 weeks of gestation and delivery of the baby. Maternal consequences of antepartum hemorrhage are grave including shock, postpartum hemorrhage, coagulation failure, preterm labour, and increased rate of cesarean section.
AIMS AND OBJECTIVE-This study was done with the objective of studying the maternal and perinatal outcome in antepartum hemorrhage.
MATERIAL AND METHODOLOGY - A three year prospective observational study was conducted in Department of Obstetrics and Gynecology at MGM medical college and MYH hospital indore in women with antepartum hemorrhage between January 2018 to January 2021 .The study group includes 840 patients antepartum hemorrhage who admitted with complain of bleeding per vaginum in late pregnancy. Record of mode of delivery, associated maternal and perinatal complications were noted.
RESULT - Total 840 cases were admitted, 270 were placenta previa ,510 was abruption placentae, out of which 390 have LSCS, 450 delivered vaginally. In majority of LSCS done the indication was placenta previa240/390. Obstetric Hysterectomy was done in 3 patient and postpartum hemorrhage with severe anemia in abruption placentae was the indication.30 patients landed in AKI due to abruption.
CONCLUSION- In developing countries, like India, APH contributes a major part, there was very high maternal morbidity with increased rates of anemia and postpartum hemorrhage. Hence Universal institutional antenatal care of all women should be targeted to improve their general health, family planning and limitation of births should be encouraged along with focused multidisciplinary approach and facilities can improve maternal and perinatal outcome in APH.

To determine difference of pain-free range of motion in patient of total knee replacement with midvastus vs subvastus approach at 6 months

Dr. Sandip Rathod, Dr. Mitul Mistry, Dr. Chirag Prajapati, Dr. Bimal Modi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 389-394

Background: Total knee arthroplasty (TKA) is the best choice for the treatment of end-stage
osteoarthritis, and it can restore knee function, relieve pain, and improve quality of life
(QOL), with 95% of patients achieving a good prosthesis survival rate. The aim of the study
is to determine difference of pain-free range of motion in patient of total knee replacement
with midvastus vs subvastus approach at 6 months.
Methods: 200 patients were included in the present study who were scheduled to undergo
bilateral total knee arthroplasty during a single anesthetic session were followed for 6 months
postoperatively
Result: There were more females than males in the present study. All patients were followed
up for 6 months. No significant differences were found for demographic parameters between
the MV group and the SV group.The VAS, and KSS in the MV group were better than those
in the SV group within 6 months (p < 0.05), but no significant differences were found at 1
month, and 6 months after surgery (p > 0.05)
Conclusion: The better quality of life can be achieved by performing a TKA via the MV
approach. In addition, compared with the SV approach, the MV approach may offer less
postoperative pain and a faster recovery

To determine difference between radiological and functional outcome in TLIF surgery with use of BMP 2 VS without bmp 2 in adult patients

Dr. Mitul Mistry, Dr. Sandip Rathod, Dr. Bimal Modi, Dr. Manish Shah

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 395-400

Background: Bone morphogenetic proteins (BMP) are multi-functionalgrowth factors that
belong to the transforming growth factor beta (TGF-beta) superfamily. The purpose of the
study is to determine difference between radiological and functional outcome in TLIF surgery
with use of BMP 2 vs without BMP 2 in adult patients.
Methods: The present study evaluated data obtained between May 2016 and July 2017 on
patients in whom BMP-2 was used in conjunction with TLIF. 150 fulfilled the study criteria
whose mean age was 54.6 years [range 25–65 years]). Twenty-five patients (33.8%) had
previously undergone lumbar surgeries (discectomy, fusion, and decompression).
Result: Both groups had similar gender distribution and average age at surgery (48.9 ±
12.2years for the BMP group and 44.6 ± 13.7 years for the non-BMP group, p>0.05). As
expected, the BMP group had a shorter median follow-up time of 5.05 ± 7.10 years while the
non-BMP group was followed for a median of years 5.06 ± 12.6.
Conclusion: It is important that clinicians explain these findings to patients so that they can
make informed choices about the type of surgery they would prefer. The use of BMP safe and
effective in the context of TLIF procedures, and thoughtful discussion with patients about the
pros and cons of BMP utilization during surgery is recommended

ASSESSING THE CORRELATION BETWEEN LEVELS OF GLYCOSYLATED HB AND SERUM ALBUMIN IN SUBJECTS WITH TYPE 2 DIABETES MELLITUS

Dr. Bharat Kumar Parmer,Dr. Roshan Mandloi, Dr. Sanjay Kumar Dubey

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 401-406

Background: Diabetes mellitus has a high prevalence globally with rising incidence in the
world. Despite the identification of diabetes mellitus and associated complications for a long
time, the measures to reduce mortality and morbidity in subjects with diabetes mellitus are
focused only for a few decades.
Objective: The present study was conducted to assess the correlation between levels of
glycosylated Hb and serum albumin in subjects with type 2 diabetes mellitus.
Method: The present institution-based observational study included subjects with a
confirmed diagnosis of diabetes mellitus type 2 where levels of glycosylated hemoglobin
(HbA1c) and serum albumin were assessed and correlated.
Result: It was seen that in subjects with glycosylated hemoglobin of <7%, mean serum
albumin level was 3.87±0.88 mg/dl, in subjects with glycosylated hemoglobin of 7-9%, mean
serum albumin level was 2.95±0.53 mg/dl, and in subjects with hemoglobin of >9%, it was
seen that mean serum albumin was 2.46±0.69 mg/dl. A negative correlation was noted where
lesser HbA1C% was related to higher mean values of serum albumin.
Conclusion: The present study concludes that subjects having higher values of glycosylated
hemoglobin have lower serum albumin levels compared to subjects where lower glycosylated
hemoglobin levels in subjects were associated with near-normal or normal serum albumin
levels.

MAPPING THE CARDIAC BIOMARKERS IN SUBJECTS HAVING SEVERE SEPTIC SHOCK AND SEPSIS

Dr. Bharat Kumar Parmer,Dr. Roshan Mandloi,Dr. Sanjay Kumar Dubey

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 407-412

Background: Sepsis is a disease characterized by rapid disease process advancement
needing immediate therapy adjustments. Assessment of disease severity is vital for
appropriate disease management, preventing and decreasing the incidence of complications,
decreasing mortality rates, and attaining a better prognosis.
Aims: The present study was conducted to assess laboratory and clinical parameters in
subjects with severe septic shock and sepsis. Also, the study assessed Acute Physiology and
Chronic Health Evaluation-II score (APACHE-II) with Echocardiographic evaluation of
cardiac functions. Cardiac biomarkers including creatine phosphokinase myocardial band
(CPK-MB)and Troponin-T were also assessed in the present study.
Materials and Methods: The present prospective clinical study was conducted to assess the
cardiac biomarkers, clinical, and laboratory parameters in subjects with severe septic shock
and sepsis.
Result: It was seen that significant mortality was seen in subjects with positive Troponin-T
and high CPK-MB levels. In subjects with septic shock and sepsis, CPK-MB levels were
raised. Increased levels of CPK-MB and Troponin-T were also indicative of myocardial
injury which could lead to coronary insufficiency in subjects with septic shock and sepsis.
Conclusion: The present study concludes that in critically ill subjects, levels of Troponin are
usually raised. However, more data is needed to prove prognostic and diagnostic significance
with its implications in subjects with septic shock and sepsis.

Apprehension and Analysis of Pollution Under Control Certificate using ID3 algorithm greedy method

Dr. Neeru Bhardwaj, Er Harpreet Singh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 413-421

Inductive learning was found to depend on acceptance. The basis of induction research is the
decision tree method . This method uses inductive methods to correctly classify objects based on the quality they
provide. These calculations are very useful for characterizing articles and are often used in the main frame. When
any new quality is added, the ID3 decision tree learning calculation is used to see if there is any progress in the
selection principle currently granted to PUCC (Pollution Treatment Certificate). Three studies were conducted on
the PUCC issuance, each of which added a new feature to the data set, thereby providing decision rules.

Correlation of vitamin D and Parathyroid hormone with insulin resistance in PCOS women

Govind Kahar, Akanksha Shrivastava,Rupali Sharma, Sonal Prasad

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 422-427

Aim: To investigate the relation of vitamin D concentration and parathyroid hormone with insulin resistance in PCOS women.
Methods: In the department of Obstetrics and Gynecology at Dr. Baba Saheb Ambedkar Medical College & Hospital, Rohini, Delhi, a one-year observational study was conducted. The levels of 25, hydroxyvitamin D and PTH, as well as the levels of fasting sugar and insulin in the blood, were tested.
Results: There was a 91.0 percent prevalence of vitamin D insufficiency (<20 ng/ml) in the study, whereas 67.9 percent of participants had an elevated parathyroid hormone level.
According to the study, vitamin D insufficiency (r=-0.64, p=0.01) had a significant negative connection with the HOMA-IR. Increased PTH levels were shown to have a positive correlation with HOMA-IR.
Conclusion: Women with PCOS who have high parathyroid hormone levels or vitamin D insufficiency have a higher incidence of glucose intolerance.
If vitamin D insufficiency and insulin resistance are strongly linked, it may be possible to treat insulin resistance by raising vitamin D levels.

Clinical profile of patients treated with cholecystectomy at a tertiary care hospital

Dr.SadiqHusainKachavi, Dr.CG Sunil, Dr.Sandeep Patil

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 428-432

Gallstones are composed predominantly of cholesterol, bilirubin and calcium salts with lesser amounts of other constituents. The most popular classification system uses the relative amount of cholesterol as the main criterion and designates gallstones as being either cholesterol or non-cholesterol. The latter are further classified as black or brown pigment stones. A thorough preoperative anaesthetic evaluation was done and patient fitness for general anaesthesia assessed. A dose of antibiotics (usually a cephalosporin) was given 30 minutes before surgery. A nasogastric tube was inserted routinely. The most common indication for open cholecystectomy was symptomatic cholelithiasis (68%). In the laparoscopic group also cholelithiasis (76%) was the most common cause.

Safety and Efficacy of laparoscopic cholecystectomy in comparison to open cholecystectomy

Dr.SadiqHusainKachavi,Dr.Sandeep Patil,Dr.CG Sunil

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 433-438

The first open cholecystectomy was performed by Langenbuch in1882 in Berlin. The first laparoscopic cholecystectomy was performed by Muhe in 1985. However the first laparoscopic cholecystectomy recorded in medical literature was performed in March 1987 by Mouret in Lyon, France. The technique was perfected a year later in March 1988 by Dubois in Paris. Preoperatively patient’s history was assessed with special reference to pain, fever, nausea, vomiting, dyspepsia, jaundice, mass per abdomen, weight loss and decreased appetite. A careful emphasis was made to record the physical findings particularly icterus tenderness in right hypochondrium and gallbladder mass. Laboratory testing and USG of gallbladder and CBD was done. CBD stone was ruled out by USG. Mean patient satisfaction score is significantly less in Group OPEN with P =0.009.Significant number of patients responded with good to excellent grading (80%) in LAP group when compared to those patients in group OPEN (44%).For statistical analysis purpose we combined excellent+good as above average, and average+poor as below average satisfaction. Significant numbers of patients are satisfied with laparoscopic surgery when compared with open surgery.

Chronic subdural hematoma: Twist drill craniostomy versus burr hole craniostomy a prospective study

Dr. Kumar Lakshman, Dr. Abhishek Vijayan, Dr. Triza Kumar Lakshman, Dr. Dominic Anto,Dr. Raju Paul Manjooran, Dr. Rajeev Aravindakshan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 439-446

Back ground: Chronic subdural hematoma (CSDH) is a common neurological condition that mainly occurs in the elderly. The minimally invasive procedure-twist drill craniostomy (TDC) is theoretically more suitable to treat CSDH than the traditional procedure-burr hole craniostomy (BHC). Compared with burr hole craniostomy (BHC), twist drill craniostomy (TDC) is getting increasingly popular because of its minimal invasiveness in evacuating chronic subdural hematoma (CSDH) under Local Anaesthesia. However, the TDC technique varies and is continually developing; moreover, no consensus yet exists regarding the optimal protocol and the efficacy and safety of TDC is still controversial.
Methods:A randomized study involving 83 patients with CSDH who underwent surgical evacuation at a single center was conducted, involving 41patients undergoing Twist Drill Craniostomy (TDC group) and 42 patients treated by Bur Hole Craniostomy (BHC group). The neurological outcome was studied to evaluate the efficacy of surgery and the radiological outcome was assessed as a supplement to the surgical efficacy. In addition, complications, recurrence, and reoperation, as well as pneumocrania, duration of operation and length of stay, were studied to evaluate the advantages of the modified TDC compared with BHC. Independent sample t tests or rank-sum tests were used to compare the outcomes between the 2 groups.
Results: There was significant improvement in both Markwalder grading scale and Glasgow coma scale in both twist drill and burr hole group within 24 hrs of intervention.The recurrence rate was 17.1% in the twist drill group and 11.9% in the burr hole group. There were 8 deaths in the twist drill group and 1 death in the Burr hole group but none were attributable to the procedures. All deaths that occurred were attributable to pre-existing co-morbidities.
Conclusions: TDC is a minimally invasive surgical technique to treat CSDH; this procedure isas effective as BHC, but safer and simpler than BHC and should be considered for patients with CSDH, especially the elderly.

Micro and Macro vascular complications in type 2 diabetic patients with non-alcoholic fatty liver disease

Dr.Anil Kumar, Dr.J Nagajyothi, Dr.Raghu Nandan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 447-453

NAFLD is a spectrum of liver lesions ranging from simple hepatic steatosis to NASH with progressive fibrosis leading to cirrhosis and liver failure in some patients and eventually hepatocellular carcinoma. The different parts of this spectrum are probably best regarded as parts of a histological continuum. All patients underwent ultrasound (USG) of the abdomen to detect fatty changes in the liver, performed by aexperienced radiologist, using a high-resolution B-mode ultrasonography system, having an electric linear transducer mid frequency of 3-5 MHz.The scanning was done for an average of 20 minutes.
In our study out of 50 patients,22(44%) patients were having diabetic neuropathy on the basis of clinical examination,out of them 10 (45.45%) patients were males & 12 (54.54%) patients were females. There was higher prevalence of diabetic neuropathy in female patients. 28 (56%) patients were negative for neuropathy. Out of total 50 diabetic patients with NAFLD, 31 (62%) patients were having evidence of CAD, out of 31 patients, 17 (54.8%) were male & 14 (45.2%) were female. 19 (38%) patients having no evidence of CAD.

Clinical profile of non-alcoholic fatty liver disease in type 2 diabetic patients

Dr.Anil Kumar, Dr.Vinay Durgad,Dr.Raghu Nandan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 454-458

NAFLD may progress through three different stages, from hepatic steatosis to steatohepatitis and finally to cirrhosis. Hepatic steatosis represents simple increase in accumulation of fat in liver, without evidence of inflammation or liver damage. Inflammation and liver damage is however present in steatohepatitis. NAFLD was defined as any degree of fatty liver in the absence of alcohol intake. NAFLD, if present, was classified based on standard ultrasonographic criteria as: Grade 1 (mild steatosis): slightly increased liver echogenicity with normal vessels and absent posterior attenuation. Prevalence of high Waist circumference, which is important marker of central obesity, according to ATP III guidelines for male waist circumference is(≥102 cms) & for female is (≥88 cms) consider as central obesity. In our study,14(58.33%)males patients had waist circumference is ≥102cms &25(96.15%)females patients had waist circumference is ≥88cms. Mean waist cicumference in male were 102.58cms & in female were 96.5cm

Study on outcomes of immediate post-partum intrauterine contraceptive device at a tertiary hospital

Dr.Dhanalakshmi KR, Dr.Narayani BH, Dr.Shruti

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 459-463

Background: Immediate postpartum intrauterine contraceptive device (IPPIUCD) is an effective postpartum family planning method. It provides reversible contraception and also helps in adequate birth spacing. This study examines the outcomes of IPPIUCD and evaluates the reasons for removal of IUCD in the study population.
Methods: This study was done at District Hospital, Koppal from October 2020 to march 2021. Women who underwent IPPIUCD insertion were included in the study. They were followed up for a period of 8months and outcomes in terms of continuation or removal or expulsion of the IUCD were studied.
Results: A total of 548 women underwent IPPIUCD insertion out of which 332 (60.6%) had post placental IUCD insertion and 216 (39.4%) had intra caesarean IUCD insertion. 54 cases (9.8%) had IPPIUCD removed and 30 cases (5.5%) had IPPIUCD expulsion.Reasons for IPPIUCD removal included pain abdomen (7.4%), menorrhagia (29.6%), fear of complications (35.2%), husband refusal (22.2%) and post sterilisation (5.6%).
Conclusions: IPPIUCD is an effective method of contraception for spacing and limiting births. Proper education and counselling regarding this method of contraception and regular follow up and motivation can help reduce the rates of removal and improve acceptance rates.

Hypertensive disorders of pregnancy and feto-maternal outcomes in a tertiary health care centre, Koppal

Dr.Dhanalakshmi KR,Dr.Seema BN, Dr.Narayani BH

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 464-472

Background: Hypertensive disorders of pregnancy are known to cause adverse maternal and fetal complications and outcomes. In view of assessing its burden and feto-maternal complications and outcomes in the current study setting, the study was conducted.
Material and Methods: This is a retrospective study conducted among 8941 women with more than 20 weeks of gestation, admitted for delivery under the department of Obstetrics and Gynaecology at Koppal Institute of Medical Sciences during the study period of 2 years from July 2019 to June 2021. The primary outcome was assessed in terms of proportions of hypertensive disorders of pregnancy and eclampsia. Secondary outcomes were assessed in terms of feto-maternal complications and outcomes among those with hypertensive disorders of pregnancy. All the quantitative data were presented in percentages.
Results: The proportions of hypertensive disorders of pregnancy were 10.64% and eclampsia was noted to be 1.9%. Majority (63.1%) of the study subjects were between 18 to 23 years, mostly from rural areas (89.8%) and belonged to lower socio-economic status (95.1%). The highest proportion of them (87.9%) had crossed a gestational age of 34 weeks and also primigravida formed the majority (68.4%). None of them were booked and 41.7% of them underwent lower segment caesarian section. 5.3% of the study subjects had maternal complications with common complications being HELLP syndrome, renal complications, pulmonary edema and cerebral venous thrombosis. 0.7% of them died. 28.9% of neonates had complications viz., low birth weight, preterm and small for date babies. Intrauterine deaths were noted among 8.1%.
Conclusion: 1 in 10 mothers had hypertensive disorders of pregnancy and nearly 2 of such 100 hypertensive mothers landed in eclampsia. Feto-maternal complications were documented among 5.3% mothers and 28.9% neonates. Maternal mortality was reported in 0.7% and 8.1% of fetuses had intrauterine deaths contributing to perinatal deaths.

A study on clinical presentation of MDR-TB and Its treatment pattern

Dr.Raghu BP, Dr.Raghavendra MK,Dr.Aravindh Ram VR,Dr.Yunus Sheriff, Dr.Deepak UG

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 473-477

There are several reports that many co morbidities can both accelerate TB disease and complicate TB treatment. It is therefore important to identify these co morbidities in people diagnosed with TB in order to ensure early diagnosis and improve co-management. When these conditions are highly prevalent in the general populations they can be important contributors to the TB burden. The research students attended ward rounds on a daily basis and collected the cases which are mentioned under the inclusion criteria. All the required parameters were analyzed thoroughly and data was pooled and analyzed. Identified adverse drug reactions and drug interactions were reported to the consultant physician on time and on daily basis. Among 250 patients, majority 182(72.8%) of the patients were found to be without any comorbidities & 68(27.2%) were with co morbidities. Patients with co morbidities were 68, out of which male patients 62(91.2%) were more in number compared to female patients 6(8.82%). There were 55 (80.88%) DM patients followed by COPD-7 (10.29%) and HIV-6 (8.83%).

Clinical profile of COPD patients at a tertiary care hospital

Dr.Raghu BP, Dr.Raghavendra MK, Dr.Aravindh Ram VR,Dr.Deepak UG, Dr.Yunus Sheriff

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 478-481

COPD currently is considered the 11th leading cause of disability worldwide. Current projectionssuggest that by the year 2020, COPD will be the 5th leading cause of disability worldwide, behind only ischemic heart disease, major depression, traffic accidents, and cerebrovascular disease. The research students will attend ward rounds on a daily basis and collect cases which are under inclusion criteria. The patients will be randomly divided into intervention and control group. The intervention group of patients will be analysed. Majority of the patients came with complaints of dry cough, wheezing and breathlessness, and a very few patients had complained of fever. Most of the patients were admitted for exacerbation of COPD. It was observed that the patients with exacerbation of COPD were more in number in intervention group.

Anatomical study of nutrient foramina present in dried specimens of human fibulae of Eastern Odisha

Santosh Kumar Sahu, Sujita Pradhan, Lopamudra Nayak

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 482-487

Introduction & Aim:The fibula is a long bone present lateral to tibia in leg. It is used in grafting and reconstructing surgeries in case of large bony tumour resection, grossly fractured mandible, spine surgeries and even stabilizing the tibia. Aim of the study is to describe the relative location, number & course of fibular nutrient foramina and observe any variations by comparing with earlier studies by various authors.
Materials and Methods:Study was done by examining 51 adult dried fibulae consisting of 31 right sided bones and 20 left side bones. Each bone was carefully observed for various parameters as regards the surface anatomy of nutrient foramina present in the shaft. Foramen index was computed and compared with others.
Results:Nutrient foramina were found singly in 82.35% fibulae, 7.84% fibulae showed two foramina and 9.8% fibulae were devoid of any nutrient foramen. 16% foramina proceeded towards the growing end while 84% nutrient foramina were directed opposite to the growing end. 6% foramina were detected in upper zone and 94% were detected in the middle zone. Grossly the total nutrient foramina were placed on the posterior aspect of the fibulae, out of which, 72% surfaced on the medial crest, 20% were present between the posterior border and the elevated medial crest and 8% were sited between the interosseous border and the medial crest. Worked out Mean foramen index of the study was 50.02.
Conclusions: The anatomical knowledge of nutrient foramina aids the orthopaedic and plastic surgeons in planning bone grafting and bone reconstruction surgeries.

A study of risk stratification in head and neck carcinomas in a tertiary care hospital

Dr. Aswathappa Dasappa, Dr. Purushotham Chavan, Dr. Ravi Arjunan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 488-494

Introduction: Head and neck cancer is a common disease worldwide. The prevalence varies among different regions of the world and mirrors the occurrence of risk factors for head and neck cancers. The chronic exposure of risk factors of head and neck cancer to upper aerodigestive tract mucosa leads to cancer or less commonly to field cancerisation, a process of premalignant dysplastic lesions that are at high risk of progression to cancer. Aims: To evaluate the influence of vital pre-treatment variables employed in evaluation and treatment of head and neck carcinomas in predicting prognosis. To assess the feasibility of stratifying head and neck cancer patients into risk groups based on significant variables affecting survival endpoints.
Material and Methods: This is a prospective study conducted in the Department of Surgical oncology at Kidwai Memorial Institute of Oncology over a period of 1 year. Patients attending the cancer OPD were assessed for inclusion in the study. The eligibility criteria were set as given below: Biopsy proven non-metastatic carcinomas of oral cavity, pharynx and larynx, Squamous cell carcinoma-Histology.The protocols included primary chemo RT for the pharyngeal cancers followed by surgery for salvage. For early oral cavity cancers surgery alone or surgery followed by adjuvant CRT and for locally advanced disease surgery followed by CRT was administered.
Result: Regarding site specificity oral cavity cancers were the commonest (59.4%), followed by hypopharynx (20%), oropharynx (11.6 %), and larynx (8.8%)Overall majority of the patients had locally advanced cancers with stage IV (49.5%) and stage III (23.3%) disease. Early head and neck cancers constituted about 27.1% of the study with stage I and stage II cancers contributing 9.4% and 17.7% respectively. Most of the lesions were moderately differentiated carcinomas (63.3%), while poorly differentiated tumors and well differentiated tumors comprised of 9.4% and 27.2% respectively.
Conclusion: Risk stratification of head and neck cancer patients using certain patient, tumor and treatment related variables is feasible. Tumor stage, degree of tumor differentiation, ECOG performance status, treatment related weight loss and treatment interruption are proven prognostic factors affecting survival outcomes.

Characteristics of surgically treated benign breast disease

Hemanth Gudur, Shanker Dharmaraj Basa

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 495-499

Introduction: Benign breast condition refers to a lump, cyst, or nipple discharge (fluid) of the female or male breast that is not cancerous. Benign breast conditions are generally caused by a number of factors. Those factors include the makeup of breasts (fatty tissue vs. dense or thick tissue), age, hormone problems.
Methods and Materials: This is a prospective study and observation study conducted in the Department of General Surgery at Prathima Institute of Medical Sciences over a period of 1 year.All patients who underwent surgery for benign breast disease were included. Patients who did not undergo surgery for benign breast disease were excluded. All the data were collected in predesigned proforma by observation of the files and operation notes of patient who underwent surgery for benign breast disease. The files were retrieved from the case sheet and histopathological examination reports were obtained from the department of pathology and relevant information were noted.
Result: In our study, most of the patients were 21-30 years i.e., 38 out of 70 (54.2%), followed by 10-20 years, i.e., 17 out of 70 (24.2%) and least were 1 (1.4%) belongs to 51-60 years.Patients with lump in left breast were more in number (31) than those with lump in right breast (29). Bilateral lump presentation as the least common 10 (14.2%) patients. In our study, 42 was firm 60% followed by 9 were soft while 19 were hard in consistency.Fibroadenoma was the most frequently diagnosed lesion, followed by fibrocystic change. Epidermoid cyst was the third most commonly diagnosed. Other histological diagnoses were fat necrosis, lactating adenoma and tuberculosis of the breast.
Conclusion: Benign breast disorders are a group of conditions that are commonly managed by surgeons. Benign breast pathologic conditions rarely increase the risk of malignancy. As knowledge of benign breast pathologic conditions improves, many conditions can be managed without the need for open surgery. Collaborative care models including nurse practitioners can improve patient experience and education about their breast health.

Profile of patients with orbital fracture following road traffic accident

Dr. Dhananjaya KH, Dr. Girish Kulkarni

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 500-504

A direct blow to the eye and the surrounding tissue will result in a contusional injury of
varying severity; from “black eye” to severe intraocular disruption. When the eye is struck, an
anteroposterior compression will result with concomitant stretch in the equatorial plane with
subsequent contusional and tearing damage. A pre-structured and pretested questionnaire was
used to gather information after obtaining an oral informed consent from the study subject
and maintaining confidentiality. The relatives or attendants will be interviewed where the
condition of the victims did not warrant the interview. In our study we found that 68% of the
orbital fractures were unilateral while 32% were bilateral. Out of which the most common
wall to be fractures was the floor 59(59%) patients followed by 34(34%) lateral wall fracture
31(31%) medial wall and 11(11%) had roof fracture.

study on ocular complications following orbital fracture at a tertiary care hospital

Dr. Dhananjaya KH, Dr. Girish Kulkarni

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 505-508

Trauma can result in fracture of one or more wall of the orbit, floor being most common
affected, followed by combined floor and medial wall fracture, followed by combined floor
and lateral wall fracture, combination floor, lateral wall and medial wall together, isolated
lateral wall and isolated medial wall in decreasing frequency. Pupils were checked for both
direct and indirect light reflex and swinging flash light test was done to rule out any relative
afferent pupillary defect. Slit lamp biomicroscopy and indirect ophthalmoscopy was done to
rule out involvement of Posterior segment. Inspection palpation and auscultation of the orbit
and orbital margins were done Hertelsexophthalmometer was done to check Enophthalmos
and exophthalmos. Extra ocular movements were examined in all nine gazes both ductions
and versions. Forced duction test was done in case of restricted ocular movement. Our study
had 8 patients with diplopia. Out of which 3(37.5%) had floor fracture, 4(37.5%) had
combined medial, lateral and floor, 4(37.5%) had combined medial and lateral and 1(12.5%)
medial wall fracture.

Clinical profile of adult patients with chronic dacryocystitis

Dr. Girish Kulkarni, Dr. Dhananjaya KH

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 509-512

Obstruction of the nasolacrimal duct from whatever source results in stasis with the
accumulation of tears, desquamated cells, and mucoid secretions superior to the obstruction in
a pathologically closed lacrimal drainage system. This creates a fertile environment for
secondary bacterial infection and can result in dacryocystitis which is a constant threat to the
cornea and orbital soft tissue. The study included 50 patients who attended ophthalmology
out-patients and in-patients departments at. The patients were randomly selected and studied
from the clinical and bacteriological point of view. Patients were examined with special
reference to the lacrimal apparatus. Present study shows majority 18 cases (36%) were
suffering from their symptoms mainly epiphora between 6 months-1year, followed by 3-6
months (34%) and 16% had their symptoms between 1-2 years. 6% of the cases had
symptoms since 1-3 months, > 2-5yrs was the duration of the disease in 6% cases. This shows
the chronic nature of the disease which progresses to various stages unless treatment is
instituted.

Spectrum of aerobic bacterial pathogens causing chronic dacryocystitis and their antibiotic sensitivity patterns

Dr. Girish Kulkarni, Dr. Dhananjaya KH

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 513-518

The studies have shown that bacterial pathogens differ in chronic and acute dacryocystitis.
Acute dacryocystitis is caused by gram negative rods. In chronic dacryocystitis mixed flora is
isolated. The percentage of culture positive was found to be higher in chronic dacryocystitis
with single or mixed growth. All patients included in the study underwent basic evaluation as
mentioned in the standard proforma after obtaining written informed consent. Routine
ophthalmic examination was conducted by the investigator, including slit lamp examination,
paying special attention to the presence of discharge and epiphora. In the present study
bacterial growth was seen in 42 (84%) cases. Gram positive organisms were isolated in 27
(54%) cases and Gram negative organism in 13 (26%) cases. 2 (4%) cases showed mixed
growth pattern. Staph Aureus and CONS accounted for 22% each and Streptococcus 10%
cases. Among Gram negative organisms Klebsiella was isolated in 10% cases. Citrobacter
and Pseudomonas were isolated in 6%.

Estimation of Age by Epiphyseal Union of Lower end Humerus, Upper end Radius and Ulna

Dr. Nidhi, Dr. Dhananjay Kumar, Dr. Birendra Kumar Sinha

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 519-525

Background: Determination of age of majority is essential at the time of employment, marriage, fixation of criminal responsibility, judicial punishment, exercise of adult franchise etc. Determination of age forms a major help in solving many medico legal issues. The study of epiphyseal union of bone is considered a reasonable scientific & accepted method of estimation of age by the court of law all over the world. It is the maximum of age estimation that we should combine information from as many epiphyses as possible to provide the most accurate estimate of biological age and therefore chronological age.
Material and methods: The study was conducted at the department of Anatomy with the help of department of Radiology, PMCH, Patna. The material for study consisted of 100 subjects between the age of 11 and 18 years (52 males, 42 females) Source of subjects were from a nearby school. Students of Patna Bihar region were taken for study. The age was verified by checking the date of birth from school admission records. Among these students of 11 to 15 years were students who were in fifth to tenth standards.
Conclusions: There was difference between the age of epiphyseal union of lower end humerus and upper end ulna and upper end radius among the males and females. In general the fusion of epiphyses occurs 3-4 years earlier in females as compared to the fusion in males.

Study of Prevalence of Delirium Tremens in Alcohol Related Disorders

Dr. Rahul Rakesh, Dr. Upendra Paswan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 526-531

Background: Delirium tremens is one of the severe complications of alcohol withdrawal syndrome which is associated with a high morbidity and mortality.
Material and methods: A prospective cross sectional study was conducted, Department of Psychiatry, at Darbhanga medical college and Hospital, Darbhanga. for a period of one  year , A total of 160 cases that were referred to psychiatry department with alcohol dependence syndrome were assessed and 153 cases were included for the final analysis after taking written informed consent.
Conclusion: The prevalence of DT in cases with alcohol dependence syndrome was 21% in the patients admitted in a general hospital setup for alcohol de-addiction. Occurrence of withdrawal seizures and higher scores on CIWA-Ar predicated the occurrence of DT in the current sample. 

Study of Effect of Betamethasone in Preterm Fetus on Heart Rate

Dr. Reshita, Dr. Meena Samant

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 533-538

Background: To recognize and understand the short term effects of administration of prophylactic betamethasone, to the mother, on the foetal heart rate pattern.
Material and methods: This study was a cross sectional study. It was conducted over two years in department of Obstetrics and  Gynaecology, at Patna medical college and Hospital, Patna. After admission, a baseline Electronic Foetal Monitoring (FEM) test was done and repeated at 12 hourly intervals for the next 84 hours. Two doses of betamethasone intramuscularly were given at 24 hours interval. Foetal Heart Rate pattern like baseline, beat to variability, acceleration and deceleration were monitored. If FHR pattern showed any non-reassuring findings, EFM was repeated after 1 hour and followed up with Biophysical Profile (BPP).
Conclusion: betamethasone, induces changes in foetal physiology. These changes are not brought about by foetal hypoxia. Knowledge of the transient effects of betamethasone, will avoid unnecessary preterm delivery of babies. This will also reduce the number of caesarean sections in future pregnancies.

A Double Blinded Randomised Clinical Trial to Compare the Effect of Intravenous Tranexamic Acid and Misoprostol for Postpartum Haemorrhage

Dr. Anupma Kumari, Dr.(prof) Renu Rohatgi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 539-545

Aim: Comparison effect of intravenous tranexamic acid and misoprostol for postpartum haemorrhage.
Methods: This double blinded randomised clinical trial study was done the Department of Obstetrics and Gynaecology, Hi-Tech Medical College, Rourkela, Odisha, India from February 2021 to November 2021. 80 women with PPH (500-1500 ml) diagnosis after caesarean or normal delivery, according to their haemorrhage level after usual therapies for controlling haemorrhage, after getting consent were included in the study. They were divided into two equal intervention and control groups randomly. Patients in group A were treated with intravenous TXA and patients in group B with rectal Misoprostol. Intervention group (group A) which were receiving intravenous TXA (1gr) and if there was relieve in haemorrhage, next TXA dose was repeated after 30 minutes and in patients of control group (group B) after usual therapies, 5 rectal 200 micrograms Misoprostol pills were used. The bladder was emptied before therapy in both groups.
Results: Mean age of all studied patients was 27.7 ± 5.5 years which ranged from 15 to 41 years. As distinct groups mean age of women in group A, was 28.1 ± 5.3 years and in group B it was 27.7 ± 5.8 years. Mean age difference between two groups of under study patients was not statistically significant (P = 0.87). Based on sonography mean gestational age in group A, was 37.8 ± 3.5 and in group B, was 37.5 ± 3.4 weeks. Difference of two groups in terms of gestational age and amount of haemorrhage, was not statistically significant (P = 0.34 and P = 0.47 respectively). In group A, natural vaginal delivery (NVD) was performed, while in group B there in 38 patients (95%) NVD and in 2 patients (5%) caesarean delivery was performed. According to analysis, the difference between two groups was not statistically significant considering mentioned aspects. NVD in 30 cases (75%) in group A and in 36 patients (90%) in group B, was together with episiotomy or laceration and its difference was statistically significant (P = 0.003). Mean massaging time for patients in group A was 25 ± 17.9 minutes and in group B, was 25.5 ± 13.6 minutes. In terms of clinical consequence, 37 patients (92.5%) in group A and 36 patients in group B were discharged without any specific problem.
Conclusions: It is possible to state that misoprostol has no specific preference over TXA, but it is better to investigate its effect with other studies with more sample size and associated with misoprostol.

A Prospective Interventional Comparison of Astigmatism Correction Following Straight and Frown Incisions in Manual Small Incision Cataract Surgery

Dr. Ojaswita Singh, Dr. Pradeep Karak, Dr. Alok Ranjan, Dr. Farhat Perween

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 546-552

Aim: Comparison of astigmatism correction following straight and frown incisions in manual small incision cataract surgery
Materials and methods: A prospective interventional cross-sectional study was conducted in the Department of Ophthalmology, Nalanda Medical College and Hospital, Patna, Bihar, India for 1 year. 100 patients admitted for cataract surgery between the age group of 45 to 70 years were only considered for the study.
Results: The observation of astigmatism in diopters preoperatively revealed 48% had astigmatism -0.25 D, 36% has astigmatism range from 0.26 to 0.50 D, 14% had astigmatism range from 0.51 to 0.75 D, and 2% had astigmatism range from 0.76 to 1.00 D. The course of post-operative astigmatism in relation to preoperative status in patients with frown incision revealed majority showed shift toward WTR astigmatism in the first postoperative week, then the ATR astigmatism increases progressively up to 3 weeks and starts stabilizing at 3 weeks. However, in straight incision, the patients showed a shift toward WTR astigmatism at first postoperative week; then the ATR astigmatism increases progressively up to 3 weeks and stabilizes at 4 to 6 weeks. The best corrected visual acuity at 6 weeks of 6/9 or better following frown and straight SICS were 50 and 37% respectively, 1st week postoperatively; 77 and 53% respectively, 3rd week postoperatively; and 83 and 77% respectively, 6th week postoperatively. In our study, we found that frown incision had significantly better (p < 0.001) mean net astigmatism as compared with the straight incision.
Conclusion: We conclude that small incision size and absence of suture are the most important factors that contribute to less astigmatism and faster stabilization of SICS. The duration for stabilization of postoperative astigmatism in straight incision group is 6 weeks, whereas it is 3 weeks in frown incision.

Primary Open angle Glaucoma in Diabetic Patients: Prevalence and Risk Factors

Dr. Shambhu Suman, Dr. Ashish Kumar Sharma, Dr. Prakash Kumar, Dr.Priya, Dr Nidhi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 553-558

Aim: Prevalence and risk factors associated with primary open angle glaucoma in diabetic patients in a tertiary care centre.
Methods: This Cross sectional study was done in the Department of Ophthalmology, Narayan Medical College & Hospital, Sasaram, Bihar, India. All documented diabetic cases attending Department of  Ophthalmology giving consent for work up for the study, IOP > 21 mmHg (by Schiotz tonometry) with visual field defects, IOP > 21 mmHg (by Schiotz tonometry) with optic nerve head changes,Optic nerve head changes with visual field defects and Normal IOP with no visual field defects or optic nerve head changes, with asymmetry of IOP in both eyes of > 5 mmHg were included in this study.
Results: The results of the study show clear cut evidence of increased incidence of POAG in diabetic patients, which was 8%. The distribution of age in the study population ranges from 35 to 71 years. The mean age of study participants was 52.69 years and a SD of 10.69 years. There is a significant association between age and POAG. No significant association was found between gender and POAG. No significant association was found between duration of DM and prevalence of POAG. POAG was found to be more in patients with a family history of glaucoma.
Conclusion: Patients with diabetes are at increased risk of open-angle glaucoma. Glaucoma family history and retinopathy are the main risk factors for open-angle glaucoma in the early years of diabetes. Gender of patients, duration of diabetes and medication used for control of diabetes were found to be insignificantly related to glaucoma.

A Retrospective Evaluation of the Clinical Profile of Ocular Injuries following RTA

Dr. Ojaswita Singh, Dr. Pradeep Karak, Dr.priyanka Bharti, Dr. Alok Ranjan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 559-562

Aim: Clinical profile of ocular injuries following road traffic accidents.
Materials and methods: A retrospective study was conducted in the Department of Ophthalmology, Nalanda Medical College and Hospital, Patna, Bihar, India. Visual acuity at the time of presentation was recorded using Snellen’s chart. Pupillary reaction, presence or absence of RAPD was noted. Patients who required surgical intervention were admitted and surgery performed after obtaining informed consent. Visual acuity was recorded after the surgery. All these data were tabulated and analysed.
Results: Ecchymosis was the commonest type of ocular injury which was seen in 49% of the patients. Out of 24% patients who had posterior segment involvement,   27%  patients   had   vitreous   haemorrhage. Traumatic optic nerve injury was seen in 16 patients. Eyelid ecchymosis was seen in 49% of patients making it the most common ocular presentation. Lid tear was seen in 28% of cases whereas 5% had lid tear with tissue loss. 2% showed canalicular tear. Orbital fractures were seen in 10% of the cases. 20% had extraocular injuries. Majority of the patients were managed conservatively. Only 36% patients required surgical intervention. Lid repair, canalicular tear repair, corneal tear repair, scleral tear repair, cataract surgery, intravitreal antibiotics, retinal detachment surgery were the various surgical procedures performed. In case of traumatic optic neuropathy intravenous methyl prednisolone was given. Visual acuity was assessed after the surgery. 48% show ed improvement in visual acuity, 36% had no change whereas 16% showed deterioration in visual acuity in the immediate postoperative period. 5% of the patients were totally blind.
Conclusion: It is a preventable public health problem. Henceforth ocular injuries as and when they occur have to be tackled efficiently and methodically.

A Prospective Interventional Assessment of the Visual Outcomes and Complications After Neodymium-doped Yttrium Aluminium Garnet Laser Capsulotomy

Dr. Pradeep Karak, Dr. Ojaswita Singh, Dr. Farhat Perween, Dr.Priyanka Bharti

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 563-569

Aim: Visual outcomes and complications after Neodymium-doped yttrium aluminium garnet laser capsulotomy in Posterior capsular opacification
Materials and methods: A prospective interventional study was conducted in the Department of Ophthalmology, Nalanda Medical College and Hospital, Patna, Bihar, India. Total 100 patients who were previously operated for cataract by routine ECCE/SICS or Phacoemulsification with or without intraocular lens attending OPD in Ophthalmology department and satisfied the eligibility criteria, were included in this study. After through ocular examination Nd-YAG capsulotomy for PCO was done.
Results: In this study maximum number 43(43%) patients who were having PCO, had a history of cataract surgery >24 month back. 32(32%) patients developed PCO in a period 0f 12 months to 24 months of cataract surgery. In 18 patients duration between cataract surgery and PCO was 6-12 months. In 7(7%) patients PCO developed within 6 months of cataract surgery. As table 2 showed, Capsular fibrosis were found in 61(61%), Elschenig’s pearls in 22 (22%), capsular wrinkling in 15 (15%) and pigmentary deposits on capsule in 2 (2%) of cases.The maximum number of patients were having grade 2 PCO 50(50%), followed by grade 1 with 26 (26%) and grade 3 with 24 (24%) cases. In this study, majority of patients 71(71%) had VA of 6/36 or less before capsulotomy. Among these 71(71%) patients, 43(43%) had VA of less than 6/60 ranging from hand movement to counting of fingers. The VA after Neodymium-YAG laser capsulotomy showed dramatic improvement.
Conclusion: The posterior capsular opacification is a common complication after cataract surgery worldwide and it can be managed safely by Nd:YAG Laser posterior capsulotomy. Nd: YAG laser capsulotomy is a safe and effective method to treat PCO. It is non-invasive and avoids all the complications associated with surgical capsulotomy and local anaesthesia.

A Study of Maternal Outcome in Case of HELLP and Partial HELLP Syndrome in a Tertiary Care Hospital - Kalaburagi

Dr. Radhika, Dr.Hema patil, Dr. Pooja Mise

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 570-577

HELLP syndrome is  a severe complication of pregnancy with high risk for both fetus and mother , some pregnant women develop just one or two of the characteristics of this syndrome which is called as partial HELLP  syndrome ,Maternal morbidity and mortality are due to consequences such as pulmonary oedema ,renal failure  ,DIC ,this study evaluates the maternal outcome in HELLP syndrome so that  the management is improved  resulting in reduced mortality and morbidity
Objectives: This study was designed to understand maternal outcome in HELLP and  Partial HELLP  syndrome in pregnant women at GIMS hospital kalaburgi
Methodology: This study  is a Prospective analytical study conducted in OBG department in GIMS Kalaburgi from April 2021 to September 2021 (  6 month) .
Inclusion criteria: Antenatal women above 20 week gestation  who fulfilled the criteria for HELLP  and  Partial HELLP  syndrome were included in study
Detailed history , clinical examination, BP measurement  Obstetric Examination , blood investigation were done  and categorized by Missiippi Classification for better evaluation
Maternal outcome were noted and subjected to Statistical analysis .
Exclusion criteria: all antenatal women with mild pre-eclamsipa who does not fulfill the Lab criteria of HELLP syndrome.
Conclusion: Once diagnosis of HELLP syndrome is confirmed management  depends on several obstetric and maternal variables like gestation age , severity  of lab abnormalities, fetal  status , early detection and prompt management of preeclampsia is the most important approach to prevent HELLP and  Partial HELLP  syndrome, we have to increase grass route level antenatal care

A Prospective Study to Identify the Risk Factors for Failure of Brachio-cephalic Arterio-venous Fistula (BC AVF), at a Tertiary Care Hospital in Haryana.

Dr Devendra Choudhary, Dr. Nilesh Patira, Dr. Kiran Palsania, Dr. Govind Prasad

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 578-583

Introduction: Chronic kidney disease (CKD) is increasingly being recognized as a global public health problem. The focus in CKD has changed from treating a terminally ill patient, to dealing with a person who has a manageable chronic disease that requires long term care. Hemodialysis (HD) is the most commonly used method of dialysis. Arteriovenous fistulas (AVF) are considered the gold standard for hemodialysis access based on their superior patency, low complication rates, improved adequacy, lower cost to the healthcare system and decreased risk of patient mortality. Aim: to identify the risk factors for failure of Brachio-cephalic arterio-venous fistula (BC AVF). Methodology: This was a single centre, observational longitudinal study done on 98 patients with Brachio-cephalic arterio-venous fistula (BC-AVF). Results: We observed that majority patients were between 51-70 years of age. Two  fistulas that failed during the 15 days follow up were in age group >70 years, 3 fistulas that failed at 30days follow up were in age group between 51-70 years.

A CLINICAL STUDY ON MORPHOMETRIC ANALYSIS OF THE FIRSTCERVICAL VERTEBRA

Dr Sravanthi Repalle

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 584-601

BACKGROUND AND OBJECTIVE: Various decompressive and stabilising methods such atlas and axis vertebra (C1 and C2) transarticular screw fixation and posterior screw placement on the lateral mass are used in CVJ surgery. These operations usually target the C1, which is part of the CVJ's bony architecture.Thus, complete understanding of atlas vertebra anatomy is required for surgical planning and fracture analysis. The dimensions of the vertebral artery groove are rare in Indian literature, and even rarer in South Indian literature. This project will gather and give atlas anatomical data that may be useful for surgical planning and assessing C1 fractures.The current study sought to make the following findings:1. Examine and measure atlas vertebra specimens for morphological criteria.2. To offer anatomic data for surgical planning of the CVJ. METHODOLOGY : During 18 months, 120 human dry adult complete atlas vertebrae were gathered from the Department of Anatomy, Kakatiya Medical College.R ESULTS: The mean transverse diameter of the spinal canal was 27.012 mm, and the mean anteroposterior diameter of the vertebral canal was 26.17 mm.In the vertebral artery groove, the midline to lateral most point distance was 23.78 mm on the right and 23.87 mm on the left, while the midline to medial most point distance was 12.98 mm on both sides.The morphology revealed 4 SAF kinds. Oval (45%) and bi-lobed (26%) aspects (13.33 percent right and 7 percent ).ANALYSIS AND SUMMARY :The current research adds to the existing knowledge of atlas vertebra anatomy. Understanding the normal structure of the atlas vertebra is critical for diagnosis and treatment.