International Archives of BioMedical and Clinical Research 2021-05-03T12:00:49+00:00 Dr. Farhan Ahmad Khan, MD Open Journal Systems <p style="text-align: justify;">International Archives of Biomedical and Clinical Research (IABCR) is an open access, international, peer-reviewed, quarterly multidisciplinary medical research journal that focuses on communicating high quality research articles, reviews, Short communications, case reports, Letter to Editor, Drug News and updates in the field of Medical, Dental and other allied health and BioMedical Sciences. The Journal publishes 4-four issues in a year.</p> <h3>Connecting Researchers Globally</h3> <p style="text-align: justify;">IABCR offer Researchers, Academicians a better option when it comes to Open Access Journal publishing. Our platform vies to become the standard for all open access publications, irrespective of subjects or branches and aims to bring together researchers from all over the world and under a single global organization to form a community that actively creates new data and shares it with everyone with the utmost ease and simplicity.</p> <h3>Ethical guidelines for journal publication</h3> <p style="text-align: justify;">The Editor-in-Chief/Editor of International Archives of BioMedical and Clinical Research (IABCR) is responsible for determining which of the research papers/articles submitted to the journal should be printed. The publication decision is based on the recommendation of the journal's reviewers. The Editor-in-Chief /Editor may be maneuvered by the policies of the journal's editorial board and constrained by such legal requirements as shall then be in force regarding libel, copyright infringement and plagiarism. The Editor-in-Chief/Editor may consult with other editors or reviewers in getting to this determination.</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> Covid 19 and surgical care practices: Experience from a tertiary care hospital 2021-04-06T19:28:30+00:00 Luv Kumar savita verma Jyoti Sharma <p>The raging pandemic of COVID -19 has affected millions of people globally including frontline Healthcare Workers and Surgeons. The confusion and chaos created by the disease forced the medical fraternity around the world to shift its focus and energy on tackling the disease, be it searching for the cure, repurposing existing medications or developing a vaccine. COVID-19 pandemic has reduced the ability to perform surgical procedures worldwide. Surgeons faced unique specialty-specific challenges during this pandemic. Apart from personal risk, there was also professional challenge of prioritization of the limited surgical care available. Challenges faced by the surgeons included impact of the delay on primary surgical outcomes, like increased risk of complications, threat to patient life, threat of permanent organ dysfunction, risk of rapidly progressing severe symptoms and disease progression. This pandemic has not only caused a burden on healthcare workers but the patients have also been severely affected. Non Covid patients bore the maximum brunt of Covid pandemic. As whole focus was shifted to management of Covid patients, non Covid patients felt sidelined. COVID-19 can also complicate the perioperative course with diagnostic challenges and potentially increase the fatality rate. Different societies and bodies have tried to make protocols for this pandemic but our response to and management of this situation will evolve over time.</p> 2021-03-30T00:00:00+00:00 Copyright (c) 2021 Luv Kumar, savita verma, Jyoti Sharma Effect of Sudarshan Kriya Yoga on Cardio-Respiratory Parameters in Young Adults 2021-04-06T19:28:30+00:00 Sonu Kumar Enam Ahmad Vikas Kumar Abid Ahsan <p><strong><em>Background:</em></strong><em>The present study was conducted to determine the effect of Sudarshan kriya yoga (SKY) on heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory rate, SPO2 and stress level. The daily life stress is associated with many physiological changes resulting in various ailments and significant decrements in human performance. The yogic breathing techniques may positively impact our compensatory mechanisms to restore functional cognitive reserves and other physiological systems are not completely understood. It is very likely that meditation and intentional rhythmic breathing like Sudarshan Kriya Yoga (SKY) may, in part, reduce the overall physiological strain and mental workload on these human systems. By reducing the physical and cognitive workloads on the organ systems, optimal human performance is accomplishable. </em></p> <p><strong><em>Methods: </em></strong><em>A total of 102 subjects were performed the SKY for 6 months. The cardio-respiratory parameters, as cited above were measured before and after the Yoga.</em></p> <p><strong><em>Results: </em></strong><em>Our results showed the statistically significant decrease in the values of heart rate, SBP, DBP, Pulse rate, respiratory rate as well as SPO2 after the six months of comprehensive SKY practice.</em></p> <p><strong><em>Conclusion: </em></strong><em>It has beneficial effects on cardiorespiratory physiology so it can be used as adjuvant therapy for management of lifestyle diseases such as hypertension, diabetes mellitus, and psychiatric disorders.</em></p> 2021-03-30T00:00:00+00:00 Copyright (c) 2021 Sonu Kumar, Enam Ahmad, Vikas Kumar, Abid Ahsan Comparative Study of Heart Rate Variability Between Smokers and Gutka Chewers 2021-04-06T19:28:31+00:00 Bipin Kumar Meenakshi Gupta M. Mobarak Hossain <p><strong><em>Background:</em></strong><em>There is an established link between smoking, gutka chewing and impaired cardiovascular health in middle-aged or older population.</em></p> <p><strong><em>OBJECTIVE:</em></strong><em> Evaluation of Heart rate variability (HRV) in smokers and gutka chewers for assessing cardiac autonomic nervous system.</em></p> <p><strong><em>Methods: </em></strong><em>This was a cross-sectional case-control study involving 40 male smokers (age group 20-60 years), 40 gutkha chewers (age group 20-60 years) along with 40 age matched healthy male controls. Case and control subjects were evaluated for Time domain parameters: Mean RR interval(s); Mean HR(ms); RMSSD(ms) and Frequency domain HRV parameters: LF (ms<sup>2</sup>); HF (ms<sup>2</sup>); LF/HF ratio; LF(n.u); HF(n.u) and LF/HF ratio. Level of significance derived using unpaired student “t” test.</em></p> <p><strong><em>Results: </em></strong><em>Changes seen in Heart rate variability (HRV) were more significant in smokers&nbsp; than gutkha chewers when results&nbsp; were compared with control subjects.</em></p> <p><strong><em>Conclusion: </em></strong><em>Decreased Heart rate variability indicates deranged cardiovascular autonomic nervous system in smokers and gutkha chewers subjects.</em></p> 2021-03-30T00:00:00+00:00 Copyright (c) 2021 Bipin Kumar, Meenakshi Gupta, M. Mobarak Hossain A Study to Record the Changes in Blood Pressure and Blood Glucose Levels on Vitamin C and E Supplementation in Urban Population 2021-04-06T19:28:31+00:00 Shalini Rastogi Rinku Garg Anurag Prasad <p><strong><em>Background:</em></strong><em>Antioxidants are chemical compounds that giving an electron to free radical molecules convert them to a harmless configuration, avoiding damaging chain reaction, which involve lipids, proteins enzymes carbohydrates, DNA, cell and nuclear membranes lead to cell death. Either exogenous or endogenous they are addressed to prevent the oxidation induced damage, a process that causes damage in all tissues through free radicals chemical reactivity. Our aim was defining the state of the art of antioxidant therapy, with specific reference on the evidence based clinical use of Vitamin C &amp; E in diabetic, hypertensive&amp; nutritional anemic patients in rural population.</em></p> <p><strong><em>Methods: </em></strong><em>It is an interventional study done on 420 patients. These were divided in six groups each 70 patients both control &amp; test in rural population which is of low density. Control group comprises of diabetic, anemic &amp; anemic patients on treatment without supplementation &amp; test group of 70 patients with supplementation. Both groups received treatment for 12 weeks.</em></p> <p><strong><em>Results: </em></strong><em>Combined doses of both vitamins showed improvement in hemoglobulin; however post prandial blood sugar &amp; HbA1c levels in type 2 diabetics showed moderate glycaemia control.</em></p> <p><strong><em>Conclusion: </em></strong><em>Patients with diabetes, heart diseases &amp;anaemia showed marked improvement in various parameters with supplementation of antioxidants with therapy.</em></p> 2021-03-30T00:00:00+00:00 Copyright (c) 2021 Shalini Rastogi, Rinku Garg, Anurag Prasad Assessment of Salivary Glucose Levels as a Metabolic Control Marker in Patients with Type 2 diabetes 2021-04-06T19:28:31+00:00 Jaseetha S Mayank Hans <p><strong><em>Background:</em></strong><em>Diabetes mellitus comprise of a group of metabolic diseases which is characterized by chronic hyperglycaemia consequential from defects in insulin secretion, insulin action, or both. This study aimed to determine any alterations in the salivary glucose levels and to assess for a correlation between salivary glucose levels and blood glucose levels in both diabetic and non-diabetic patients.</em></p> <p><strong><em>Methods: </em></strong><em>100 diabetics and 100 non-diabetic aged matched healthy control were included into the study. Unstimulated saliva and blood samples were obtained from all subjects. Every sample was analysed for glucose straightaway or stored at –20°C in case of delay in analysis. Before evaluating, the saliva samples were centrifuged at 3500 rpm for 5 minutes, and resulting supernatant was assessed for presence of glucose. Data collected was analysed using statistical software. A p value of &lt; 0.05 was taken as significant.</em></p> <p><strong><em>Results: </em></strong><em>Mean serum glucose (220.8 ± 66.64) and mean salivary glucose (8.94 ± 3.52) in the diabetics were higher than the mean serum glucose (91.63 ± 12.96) and mean salivary glucose (4.53± 2.56) in the non-diabetic group and the difference was highly significant (p&lt; .001). A highly significant correlation existed between serum and salivary glucose levels in both diabetics and non-diabetics when assessed through Spearman’s Correlation coefficient (R = 0.70016 and the two-tailed value of P was 0 [highly significant]).</em></p> <p><strong><em>Conclusion: </em></strong><em>The salivary glucose levels of diabetics are significantly higher than the non-diabetics and the salivary glucose levels are correlated significantly with blood glucose levels. Thus, saliva could act as a potential non-invasive adjunct to monitor glycemic control in diabetic patients.</em></p> 2021-03-30T00:00:00+00:00 Copyright (c) 2021 Jaseetha S, Mayank Hans A Study of Work Environment & Social Problems of Female SafaiKaramcharis Registered in Nagar Nigam Aligarh 2021-04-11T06:14:06+00:00 Saleem Mohammad Khan Anees Ahmad Najam Khalique Yasir Alvi Nafis Faizi <p><strong><em>Background:</em></strong><em>SafaiKaramchari refers to all sorts of workers engaged in cleaning jobs, including those who handle dry and wet waste, and those who sweep. Among all sort of works, this profession is considered the lowest and being a Female SafaiKaramchari is bound to be associated with various problem. We did this study to explore Work environment &amp; Social problems among them. </em></p> <p><strong><em>Methods: </em></strong><em>A cross sectional study was done selecting female safaikaramchari across wards of Nagar Nigam Aligarh city. A closed-ended, semi-structured questionnaire was used to assess work environment &amp; Social problems among them</em>.</p> <p><strong><em>Results: </em></strong><em>A total of 35 female safaikaramchari were found during the study. Majority were middle aged, Married, group, hindu, living in the nuclear family, and were illiterate. All were street sweepers, about half (45.7%) were working on a contractual basis, Nearly half of them study faced ill-treatment from the employer and abused at their workplace. None were given any safety equipment for their jobs. Prevalence of alcoholism was 5.7% and 22.9% said they used tobacco for chewing although none reported to be smoker. Almost one-third (34.3) of the female safaikaramchari had Pscychiatric problem. </em></p> <p><strong><em>Conclusion: </em></strong><em>The female SafaiKaramcharis were regulary suppressed and abused at work. They are cleaning the city without the safety equipment makig them at risk for infectious disease and injuries. All these are contributing towards Pscychiatric problem in them. Authority should take note and should work towards uplifting the condition of Female SafaiKaramchari.</em></p> <p><em>&nbsp;</em></p> 2021-03-30T00:00:00+00:00 Copyright (c) 2021 Saleem Mohammad Khan, Anees Ahmad, Najam Khalique, Yasir Alvi, Nafis Faizi Association of Sociodemographic Factors with Feeding Practices among Infants in Urban Area of Kanpur District 2021-04-11T06:13:05+00:00 Anupama Srivastava Mili Sengar <p><strong><em>Background: </em></strong><em>National Guidelines on Infant and Young Child Feeding should become an integral part of nation-wide integrated child development Services (ICDS) and the Reproductive and Child Health (RCH) Programme. These need to be effectively operationalized through the programme managers and field functionaries of these on-going programmes. This can happen only when they are practically oriented to the correct norms of IYCF. </em><strong><em>Methods: </em></strong><em>A cross sectional study of feeding practices amongst77 mothers of infants was conducted in the Rama medical college hospital and research centre Kanpur. This study was conducted over a period of&nbsp; six months.</em></p> <p><strong><em>Results: </em></strong><em>Out of 77 mothers, 46.7 %of the mothers were in the age group of less than 25 years followed by 52% of the mothers in the age group 25 -34 years and only 1.3 % of the mothers were more than 35 years of age.. All of the respondents in the study group had delivered in hospital.</em></p> <p><strong><em>Conclusion: </em></strong><em>Time of complementary feeding initiation varied according child’s gender, predominant caregiver of the child, mother’s parity and socio economic status of the family, which were found to be statistically significant.</em></p> <p>&nbsp;</p> <p>&nbsp;</p> 2021-03-30T00:00:00+00:00 Copyright (c) 2021 Anupama Srivstava, Mili Sengar A Hospital Based Prospective Study to Evaluate the Relationship of Micro Vascular and Macro Vascular Complications with Magnesium Levels in Patients with DM-2 2021-04-06T19:28:32+00:00 Manish Kumar Singhal Arun Gaur <p><strong><em>Background:</em></strong><em>Micronutrients have been explored as a probably preventive and curative agents for T2DM and their complexity. Not all studies, however, observed a correlation between glycemic control and serum magnesium levels or improvement of diabetic control with magnesium replacement.</em></p> <p><strong><em>Methods: </em></strong><em>A hospital based prospective study was done on 30 patients with DM type 2 attending medicine OPD and admitted in Government (RVRS) Medical College, Bhilwara were taken as cases also of Age group above 30 years. Presence of diabetes mellitus was defined as per Indian Diabetes Federation [IDF] Criteria and Dyslipidemia as per NCEP ATP III and IDF guidelines.</em></p> <p><strong><em>Results: </em></strong><em>In this study the commonest age group for type 2 DM was more than 41-60 years which comprised of 63.33% of the patients. The male to female ration was 3:1. The mean serum magnesium levels in patients with HbA1c levels ≥ 9.5% were significantly low (1.559±0.389 mg/dL) compared to patient with HbA1c levels 6.5 to 6.99% (1.622 ± 0.591mg/dL). This difference was statistically non significant (p&gt;0.05).</em></p> <p><strong><em>Conclusion: </em></strong><em>Our study suggested that hypomagnesemia is widely prevalent in patients with type 2 diabetes mellitus and also related with poor glycaemic control and longer duration of diabetes.</em></p> <p><em>&nbsp;</em></p> 2021-03-30T00:00:00+00:00 Copyright (c) 2021 Manish Kumar Singhal, Arun Gaur Best Risk Score in Predicting Hard Cardiovascular Events in Patients with First Myocardial Infarction 2021-04-06T19:28:32+00:00 Amit Chaudhary Akanksha Verma <p><strong><em>Background:</em></strong><em>Although a number of risk assessment models are available for estimating 10-year risk of cardiovascular (CV) events in patients requiring primary prevention of CV disease, the predictive accuracy of the contemporary risk models has not been adequately evaluated in Indians.</em></p> <p><strong><em>Methods: </em></strong><em>412 patients [mean age 55.7±12.8 years; 320 (77.7%) males] without prior CV disease and presenting with acute myocardial infarction (MI) were included. The six clinically relevant risk assessment models [Framingham Risk score (Risk<sub>FRS-L</sub>), Framingham Risk score (Risk<sub>FRS-B</sub>), World Health Organization risk prediction charts (Risk<sub>WHO</sub>), American College of Cardiology/ American Heart Association pooled cohort equations (Risk<sub>ACC/AHA</sub>) and the 3rd Joint British Societies' risk calculator (Risk<sub>JBS</sub>), Predicting cardiovascular risk in England and Wales(Risk<sub>QRISK2</sub>)]. Risk scores were applied to estimate what would have been their predicted 10-year risk of CV events if they had presented just prior to suffering the acute MI.</em></p> <p><strong><em>Results: </em></strong><em>Risk<sub>ACC/AHA</sub> provided the lowest risk estimates with 74.4% patients estimated to be having &lt;20% 10-year risk. Risk<sub>JBS</sub> provided intermediate risk (67.3% with risk, 20%).&nbsp; In comparison, Risk<sub>FRS-L</sub> and Risk<sub>FRS-B, </sub>Risk returned higher risk estimates (53.6% and 50.1% with risk &lt;20%, respectively; p values &lt;0.001 for comparison with Risk<sub>WHO</sub>). However, Risk<sub>QRISK-2</sub> identified the highest proportion of the patients as being at high-risk the (only 51% at &lt;20% risk, p values 0 &lt; 0.01 for comparison with Risk<sub>ACC/AHA</sub>, Risk<sub>JBS</sub> risk scores).</em></p> <p><strong><em>Conclusion: </em></strong><em>This is the first study to show that in Indian patients presenting with acute MI, Risk<sub>QRISK-2</sub> is likely to identify the largest proportion of the patients as at high-riskas compared to Risk<sub>WHO</sub>, Risk<sub>FRS-L</sub>, Risk<sub>FRS-B</sub> and Risk<sub>ACC/AHA</sub>. However, large-scale prospective studies are needed to confirm these findings.</em></p> 2021-03-30T00:00:00+00:00 Copyright (c) 2021 Amit Chaudhary , Akanksha Verma Coronary Collateral Circulation in Patients of Coronary Ectasia with Significant Coronary Artery Disease 2021-04-06T19:28:33+00:00 Amit Chaudhary Akanksha Verma <p><strong><em>&nbsp;</em></strong></p> <p><strong><em>Background:</em></strong><em>Patients with coronary ectasia (CE) usually have coexisting coronary stenosis resulting in myoischemia. Coronary collateral plays an important role in protecting myocardium from ischemia and reducing cardiovascular events. However, limited studies investigate the role of CE in coronary collaterals development.</em></p> <p><strong><em>Methods: </em></strong><em>We evaluated 838 consecutive patients undergoing coronary angiography and 251 patients with significant coronary artery disease (SCAD), defined as diameter stenosis more than 70%, were finally analyzed. CE is defined as the ectatic diameter 1.5 times larger than adjacent reference segment. Rentrop collateral score was used to classify patients into poor (grades 0 and 1) or good (grades 2 and 3) collateral group.</em></p> <p><strong><em>Results: </em></strong><em>130 patients (51.7%) had CE lesions which were most located in the right coronary artery (58.4%). Patients with CE had a lower incidence of diabetes (33.0% vs 41.3%, p= 0.03), lower incidence of smoking (13.8% vs 27.2%, p=0.021), higher incidence of dyslipidaemia (32.3% vs 13.2%, 0.010) and poorer coronary collateral (85.0% vs 25.6%, p&lt;0.0001). Patients with poor collateral (n= 142) had a higher incidence of CE (78% vs 17.4%, p&lt;0.0001) and fewer diseased vessels numbers (1.76 vs 2.00, p,0.001). Multivariate analysis showed diabetes (odd ratio (OR) 0.630, p= 0.026), CE (OR= 2.44, p= 0.001), and number of diseased vessels (OR= 2.488, p=0.001) were significant predictors of coronary collaterals development.</em></p> <p><strong><em>Conclusion: </em></strong><em>The presence of CE was associated with poorer coronary collateral development in patients with SCAD.</em></p> 2021-03-30T00:00:00+00:00 Copyright (c) 2021 Amit Chaudhary, Akanksha Verma Diagnostic Role of Global Sleep Assessment Questionnaire in Stable Chronic Obstructive Pulmonary Disease Patients 2021-04-06T19:28:33+00:00 Sunil Kumar Manish Advani Jyoti Kumari <p><strong><em>Background:</em></strong><em>There is a complex interaction among COPD symptoms, sleep problems, ongoing medicines and other comorbidities in COPD patients so it is noteworthy whether the GSAQ may be used in COPD patients in the same way as in general population. We did a study on stable COPD patients with the aim to investigate the utility of GSAQ in stable COPD patients. We also investigated various sleep disorders in stable COPD patients and their relationship with patient’s demographics, smoking status and diseases severity. </em></p> <p><strong><em>Methods: </em></strong><em>This prospective observational study was carried out on clinically stable COPD patients.&nbsp; A Hindi translation of GSAQ was self-administered by each patient. The sensitivity and specificity of GSAQ in COPD patients were calculated, using diseases defining criteria as the gold standard.&nbsp; The sleep disorders ware also compared to patient demographics, smoking status and diseases severity.</em></p> <p><strong><em>Results: </em></strong><em>The sensitivity and specificity of GSAQ in identifying insomnia, RLS, daytime sleepiness and anxiety-depression were 91/95%, 91.7/90%, 70.5/79.2% and 81.1/96.5% respectively. In this study the prevalence of sleep disorders was 56.4%. The commonest sleep problem was insomnia (35%) followed by RLS (31%), parasomnia (18%) and sleep apnoea (11.7%). These were no significant difference between GSAQ positive and negative group in patient’s demographics, smoking status and diseases severity. The COPD patients with insomnia had significantly lower FEV<sub>1</sub> as compared to those without insomnia. </em></p> <p><strong><em>Conclusion: </em></strong><em>GSAQ may be used in COPD patients for both screenings and to rule out core intrinsic sleep disorders and depression- anxiety. Sleep disorders are frequent problems in stable COPD patients and insomnia is the most common among them. </em></p> 2021-03-30T00:00:00+00:00 Copyright (c) 2021 Sunil Kumar, Manish Advani, Jyoti Kumari Epidemiology of Type 1 Bipolar Disorder and Associated Personality Traits in a Tertiary Level Psychiatry Centerorder and Associated Personality Traits in a Tertiary Level Psychiatry Center 2021-04-06T19:28:33+00:00 JK Verma Anurag Agrawal <p><strong><em>Background:</em></strong><em>Bipolar disorders are frequently associated with diverse Axis I psychiatric co- morbidities and Axis II personality disorders which affect treatment strategies and outcome in such patients. Present study was undertaken with the aim to study regarding Epidemiology and associated personality traits in patients of Bipolar 1 disorder in full remission.</em></p> <p><strong><em>Methods: </em></strong><em>This was a single point cross-sectional study of patients of Bipolar 1 disorder in remission attending a Tertiary level Psychiatry Center; to assess Epidemiology of Type 1 Bipolar Disorder and associated Personality Traits by using appropriate tools.</em></p> <p><strong><em>Results: </em></strong><em>Total study sample was 107. The mean age of onset, mean number of episodes, mean duration of affective episode and mean duration of inter episodic symptom free period was 22.68±2.95 years, 4.34±2.35, 2.88 ± 2.03 months and 2.14 ± 1.96 years respectively for the total sample. Mean number of episodes was 5.33±2.72 for Axis II disorder group. Mania was the first episode in 82.24% patients. 22.43% subjects were diagnosed with Axis II disorder while 42.99% subjects had axis II traits. 70.83% of the patients with axis II disorder had a history of suicidal ideation as compared to 40.54% of patients without any axis II disorder/trait.</em></p> <p><strong><em>Conclusion</em></strong><em>: </em><em>Mean age of onset of Bipolar 1 disorder was in early twenties with Mania being much more common. Presence of comorbid axis II disorders and traits led to increased duration and number of affective episodes as compared to those without any co-morbid axis II disorder/trait. Suicidal behaviour was frequent even more in the patients with comorbid axis II disorders.</em></p> <p><em>&nbsp;</em></p> 2021-03-30T00:00:00+00:00 Copyright (c) 2021 JK Verma, Anurag Agrawal Reliability and Validity of Palmar, Mucosal, Nail Bed and Conjunctival Pallor for Anemia Detection in School Children Aged 6-14 Years of Age 2021-04-06T19:28:33+00:00 Natasha Ahmed Khurshida Khan Padmanabh Reddy Uma Raju <p><strong><em>Background:</em></strong><em>Anemia is widely prevalent in developing world and also is a public health challenge in India. Children in India remain affected with anemia. It is a serious concern because it can result in impaired cognitive performance, behavioral and motor development, coordination, language development, and scholastic performance. It also leads to increased morbidity from infectious diseases. The present study was designed to assess the accuracy for various sites in screening for anemia in school children. </em></p> <p><strong><em>Methods: </em></strong><em>A descriptive observational cross-sectional study was conducted in urban school going children in government schools aged 6-14 years. This study was conducted over a period of 1 year in the government schools of Hyderabad city, this study was completed during 5 planned visits to school. The 450 children were enrolled on planned visits to school out of which 394 students were included in study. Detailed history and clinical examination was carried out in all children. Pallor be graded as No anemia, Mild, Moderate and Severe. In all children haemoglobin estimation done by Sahli’s hemoglobinometer. Two technicians were given the task to assess the hemoglobin level in the children examined for pallor.&nbsp; Data entry and statistical analysis was performed with the help of&nbsp;Microsoft excel 2016 and R Project v3.5. A Regression Model was built, between Lab Bracket &amp; Site Readings for the 2 observers using 85% of the sample set using a random distribution logic.</em></p> <p><strong><em>Results: </em></strong><em>In this study out of 450 students, 394 urban government school children in age group of 6-14 years were included. The incidence of anemia was 60% i.e. 237 children out of 394. Both doctors found that palm pallor had highest sensitivity when anemia was severe whereas sensitivity for mild &amp; moderate was quite low. Specificity of all sites was high and for severe pallor was 100%. Fleiss Kappa was used as a measure to review inter observer reliability at the different sites. It is to be noted that the Kappa for all sites are above 0.8 which indicates an almost perfect agreement on the pallor between the 2 observers.</em></p> <p><strong><em>Conclusion: </em></strong><em>In this study prevalence of anemia was high in school children. According to our study conjunctiva and palm were the most sensitive to assess the severity of anemia. Clinical assessment of pallor can be used as initial screening tool for diagnosing anemia in school children especially in places where prevalence in high and early incorporation of treatment.&nbsp; </em></p> <p><em>&nbsp;</em></p> 2021-03-30T00:00:00+00:00 Copyright (c) 2021 Natasha Ahmed, Khurshida Khan, Padmanabh Reddy, Uma Raju A Hospital Based Observational Study to Evaluate the Efficacy of Melatonin in Preventing Postoperative Delirium and Decreasing Analgesic Requirement in Lower Limb Surgery Performed Under Spinal Anaesthesia in Geriatric Patients 2021-04-06T19:28:34+00:00 Ratan Lal Yadav Richa Singh Deepika Meena <p><strong><em>Background:</em></strong><em>Delirium leads to acute and fluctuating disturbance in mental state leading to reduction in awareness and attention disturbance. Medications is most common reversible cause of delirium. The aim of this study to evaluate the efficacy of melatonin in preventing postoperative delirium and decreasing analgesic requirement in lower limb surgery performed under spinal anaesthesia in geriatric patients.</em></p> <p><strong><em>Methods: </em></strong><em>A Hospital based observational study done on 50 patients divided in two groups: Group P (N=25) &amp; Group M (N=25) in Department of Anaesthesiology, Jawahar Lal Nehru Medical College and Hospital, Ajmer, Rajasthan. In the recovery room sedation score and Abbreviated mental test {AMT} was noted prior to administration of morning dose of melatonin.AMT repeated on the same day of operation (POD-0) and in the three postoperative days (POD) followed (POD-1, POD-2 and POD-3). </em></p> <p><strong><em>Results: </em></strong><em>The present study showed that the mean age of patients was 66.23±8.62 in group P and 67.48±8.13 years in group M but statistical non-significant (p&gt;0.05). The sedation score in group P and group M was statistically non-significant (P=0.7111 NS) at baseline but statistically significant (p&lt;0.05 &amp; p&lt;0.05 respectively) at 60 minutes and after 130 minutes. The melatonin group differed significantly compared with group P, having less number of patients developed delirium.</em></p> <p><strong><em>Conclusion: </em></strong><em>We concluded that many of patients if left unattended may develop postoperative delirium.&nbsp; Melatonin was helpful in treating and preventing postoperative delirium.</em></p> <p><em>&nbsp;</em></p> 2021-03-30T00:00:00+00:00 Copyright (c) 2021 Ratan Lal Yadav, Richa Singh, Deepika Meena Lympho-nodo-venous Shunt for Filarial Lymphoedema 2021-04-06T19:28:34+00:00 Jayant D Mohite Yatindra Kashid <p><strong><em>Background:</em></strong><em>Treatment for lymphoedema is a lifelong process. Conservative treatments often fail, and no surgical procedures offer complete cure. Several patients reported in miserable condition seeking help for heaviness of limb, discharge, disfigurement, lymphangitis, elephantiasis, and restricted mobility. Hence, we decided to undertake this prospective study of lymphonodovenous shunt (LNVS) for various stages of lymphoedema.</em></p> <p><strong><em>Methods: </em></strong><em>Thirty–one patients underwent LNVS in three years duration study. Six patients underwent debulking surgery a week later. Nine patients underwent bilateral procedure.</em></p> <p><strong><em>Results: </em></strong><em>More than 50% reduction in oedema occurred in 24/31 (77.41%) patients within first five days. Three of six patients with Grade IV lymphoedema who had undergone debulking surgery and skin grafting at follow–up showed hypertrophic scarring, ulceration and exophytic keratosis at split skin grafting (SSG) area.</em></p> <p><strong><em>Conclusion: </em></strong><em>LNVS is a procedure not free from complications like infection and hematoma. Yet the procedure was found to be safe, simple, and easy. It also helped to reduce the incidences of postoperative lymphangitis attacks. We recommend the procedure for Grade II–III lymphoedema and for Grade IV lymphoedema in combination with debulking surgery.</em></p> 2021-03-30T00:00:00+00:00 Copyright (c) 2021 Jayant D Mohite, Yatindra Kashid Introduction of Structured Interactivity in General surgery Lectures for Final Year MBBS Students 2021-05-03T12:00:49+00:00 Ajay Kr. Thakral Musharraf Husain Divya Prasad <p><strong><em>Background:</em></strong><em>Teaching in medical college is mostly on large group of students, which is usually done through didactic lectures. Large group teaching is always a challenge for the facilitator to make it effective. Preparation and organization are key to the lecture’s success. Objectives: Adoption of structured interactive lecturing method in the large group teaching and evaluating the perception and view of medical students about the concept of structured interaction during the lecture session.</em></p> <p><strong><em>Methods: </em></strong><em>The present study was carried out from July to Oct. 2019 in a private medical college of Delhi on 100 students of final MBBS. Ethical committee clearance was taken. Complete batch of 100 students were divided into 10 subgroups. Structured interactive sessions on hepato-pancreato-biliary system were undertaken in 10 lecture classes of 60 minutes each. At the end of ten sessions of structured interactivity lecturing, formative assessment was done with the help of MCQ’s. Feedback was taken from the participants in the form of questionnaire on structured interactive teaching method using Likert’s scale.</em></p> <p><strong><em>Results: </em></strong><em>Out of 100 students 92 were considered for final data analysis from the assessment and feedback questionnaire session.</em></p> <p><strong><em>Conclusion: </em></strong><em>Introduction of structured interactive lecture for large group teaching will be helpful in achieving better learning outcomes like retention of knowledge, improvement in self-confidence and communication skills of the learners</em></p> 2021-03-30T00:00:00+00:00 Copyright (c) 2021 Ajay Kr. Thakral, Musharraf Hussain, Divya Prasad Analysis of Prevalence of Gestational Diabetes Mellitus in Pregnant Females in a Tertiary Care Hospital 2021-04-06T19:28:34+00:00 Priyanka P. Kamble Preeti Jain Hemendra Singh <p><strong>Background:</strong> The prevalence of diabetes mellitus (DM) is increasing worldwide and more in developing countries including India. The increasing prevalence in developing countries is related to increasing urbanization, decreasing levels of physical activity, changes in dietary patterns and increasing prevalence of obesity. The present study was conducted to assess prevalence of gestational diabetes mellitus in pregnant females in a tertiary care hospital.</p> <p><strong>Materials and Methods:</strong> The present study was conducted to assess prevalence of gestational diabetes mellitus in pregnant females in Department of Obstetrics and Gynaecology, Amaltas Institute of Medical Sciences, Dewas, Madhya Pradesh, India. Detailed history, physical examination and routine investigations were carried out. The screening was done by GTT in the patients with risk factors for GDM using 50gms of oral glucose. Gestational diabetes was diagnosed if two or more of following venous plasma values were met or exceeded. The recorded data was compiled, and data analysis was done using SPSS Version 20.0 (SPSS Inc., Chicago, Illinois, USA). P-value less than 0.05 was considered statistically significant.</p> <p><strong>Results:</strong> In the present study a total of 540 randomly selected pregnant females who met the inclusion criteria were subjected to oral glucose challenge test. 20.37% women were found to have GDM and 79.62% women were Non-GDM. According to age group maximum prevalence of GDM was in the age group &gt;30 yrs (49.09%).</p> <p><strong>Conclusion: </strong>The present study conclude that 20.37% women were found to have GDM and maximum prevalence of GDM was in the age group &gt;30 yrs. This may be due to GDM shows a positive association with increasing maternal age.</p> <p>&nbsp;</p> 2021-03-30T00:00:00+00:00 Copyright (c) 2021 Priyanka P. Kamble, Preeti Jain, Hemendra Singh Assessment of Hormonal and Reproductive Factors Associated with Low Back Pain in Reproductive Female in A Tertiary Care Teaching Hospital 2021-04-06T19:28:35+00:00 Jini Gupta Vikas Gupta <p><strong><em>Background:</em></strong><em>Low back pain related disability and work absence accounts for high economical costs in modern society. A prevalence of 28-80% has been found with increase of prevalence with age and female preponderance.</em></p> <p><strong><em>Methods: </em></strong><em>The present study was conducted on 150 non pregnant women complaining of low back pain attending Department of Obstetrics and Gynaecology, Pacific Institute of Medical Sciences during the period of one year. A brief questionnaire was used to screen, among the respondents, the occurrence of low back pain in the past year.</em></p> <p><strong><em>Results: </em></strong><em>Low back pain was associated with high BMI, high waist circumference, more number of children, irregular and prolonged duration of menstruation, young maternal age at first birth and with history of abortion.</em></p> <p><strong><em>Conclusion: </em></strong><em>The present study conclude that </em><em>Hormonal and reproductive factors are associated with low back pain.</em></p> 2021-03-30T00:00:00+00:00 Copyright (c) 2021 Jini Gupta, Vikas Gupta Role of Intraarticular Injection as Compared to Conventional Treatment in Frozen Shoulder 2021-04-06T19:28:35+00:00 Alam M. S Sherwani MKA <p>Background: Frozen shoulder is a common painful condition of shoulders frequently encountered by most orthopaedic surgeons. Among various treatment protocols for frozen shoulder, definitive treatment is still uncertain.<br>Methods: this study was a randomised prospective clinical study on frozen shoulder on 147 patients which were divided into two groups Group 1: conventional treatment (NSAID) followed by physiotherapy. Group 2: Intraarticular corticosteroids injection followed by physiotherapy. Aim was to know in depth about frozen shoulder, to compare treatment modality (intraarticular corticosteroid injection with NSAIDs) to provide appropriate treatment to patients of frozen shoulder<br>Results: Most patients with adhesive capsulitis (95%) can be successfully treated with non-operative treatment programme. Intraarticular corticosteroid injections have excellent and faster recovery up to three months in all respect (ROM, pain, and SST) as compared to NSAIDs but overall recovery at 6 months or longer duration is comparable in both the groups<br>Conclusion: overall intra articular corticosteroid injection are better than NSAIDs. Intraarticular corticosteroid injection has excellent effect in stage 1</p> 2021-03-30T00:00:00+00:00 Copyright (c) 2021 Alam M. S, Sherwani MKA L, Kumar Multiple sebaceous cyst over scrotum: A case report 2021-04-06T19:28:35+00:00 Luv Kumar <p>Multiple sebaceous cysts over scrotum is a rare condition and excision need to be done if infected. There are many surgical approaches to epidermoid cysts. Total excision of scrotal wall may need to be done if the cyst is grossly enlarged or infected. In this case, Sub dartos pouch was created after removing fibrous tissue and necrotic debris and the remaining scrotal skin was sutured together.</p> 2021-03-30T00:00:00+00:00 Copyright (c) 2021 Luv Kumar