International Archives of BioMedical and Clinical Research <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> <div class="page-header" style="text-align: justify;"> <h3>Connecting Researchers Globally</h3> </div> <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> <div class="page-header" style="text-align: justify;"> <h3>Ethical guidelines for journal publication</h3> </div> <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> en-US (Dr. Farhan Ahmad Khan) (Mohd Waseem) Wed, 20 Dec 2017 00:00:00 +0000 OJS 60 Abnormal Papanicolaou Test: Results and Risk Factors Among Women of Uttarakhand <p><strong><em>Background: </em></strong><em>Cervical cancer is a significant health issue worldwide. About 493 million new cases of cervical cancer are diagnosed each year. About 274 thousand women die from this disease annually and 83% of these cases are in developing countries. The aim of this study was to determine the frequency of abnormal cervical cytology among women attending Gynaecology OPD and to assess the presence of associated risk factors. </em><strong><em>Methods</em></strong><em>: </em><em>This hospital-based cross-sectional study was conducted using a questionnaire involving women attending Gynaecology OPD of HIMS, Dehradun from January to December 2016. All pap smears cytological examination was conducted using Bethesda system of classification. <strong>Results</strong>: 248 (11.6%) women had abnormal cytological findings with a mean age of 36.84 years. Duration of marriage was found be significantly longer among those with abnormal Pap smear (18.34 years verses 15.72 years (p&lt;0.05). <strong>Conclusions</strong>: Early marriage, increasing parity and longer duration of marriage are strongly associated with abnormal Pap smear results.</em></p> Manju Lal, Rupali Sharma, Priyanka Goyal, Saba Shamim ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Vitamin D Status Among the Elderly Persons of South Rajasthan – A Prospective Observational Study <p><strong><em>Background: </em></strong><em>Vitamin D a fat soluble unique micronutrient. Deficiency of vitamin D is widely prevalent in Indian Subcontinent despite wide exposure to sunlight round the year. Vitamin D is considered to be most under evaluated and under treated micronutrient round the world. Elderly persons are more prone to develop Vitamin D deficiency because of risk factors. </em><strong><em>Methods</em></strong><em>: </em><em>This study was done to study the prevalence of vitamin D deficiency in healthy adults for southern Rajasthan and its correlation with gender, dietary habits and habitat (urban or rural residence).We evaluated apparently healthy adults of age more than 50 years presenting to hospital for routine evaluation or as accompanying person with patient between January to July 2015.The serum -25 OH CHOLECALCIFEROL (D2+D3) levels were estimated in all the subjects by COBAS e411 (Hitachi, Roche). <strong>Results</strong>: The study (Males 121, Females 83), aged 50 – 82 years shows normal level (20-32 nag/ml) in only 26% (53), while 74% (151) had &lt;20ng/ml.&nbsp; Women were more deficient (64%) than males (36%); vegetarians more [93% (140)] than non-vegetarians [7% (11)]; urban more 90% (51/56) than rural 69% (100/148). All those who received supplementation improved clinically and bio chemically. <strong>Conclusions</strong>: Despite abundant sunshine Vitamin D deficiency prevalence is very high among females, vegetarians and urban subjects, for which presumably conventional female over clothing, strict vegetarianism and urban crowdedness are responsible. Supplementation normalizes Vitamin D deficiency. Therefore, proper food fortification in healthy looking and diseased elderly persons is advised.</em></p> K R Sharma, Ram Kumar Singh, Abhishek Laddha, Chitra Purohit, Y K Bolya ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Assessment of Haematological Markers in Relation with Blood Urea Nitrogen and Serum Creatinine in Pre-dialysis Patients with Chronic Kidney Disease <p><strong><em>Background: </em></strong><em>To investigate the hematological and biochemical parameters in pre – dialysis chronic kidney disease (CKD) patients and compared with the normal individuals. </em><em>&nbsp;Methods: </em><em>The samples of CKD patients (n= 30) belong to both genders were collected from different tertiary care hospitals of Karachi, Pakistan and compared with normal individuals (n = 30) not suffering from any disease used as control.</em> <strong><em>Results: </em></strong><em>18 of CKD patients and 19 from normal groups were male and 12 from CKD and 11 from normal group were female. The average age (yr) was 38 ± 12.06 for normal group and 44 ± 09.10 for CKD. The mean height (cm) of normal subjects was 163 ± 6.87 and body weights (kg) were 71.04 ± 10.12. Mean height of CKD group was 165.3 ± 7.79 and weights were 64.35 ± 12.23. Higher magnitudes of blood urea nitrogen (BUN) and serum creatinine were found as 85.63 ± 56.11 and 6.86 ± 3.42 mg/dL respectively in CKD group. Hemoglobin, red blood cells (RBCs), pack cell volume, lymphocytes and eosinophils were found significantly (p&lt;0.01) very low while white blood cells, monocytes and neutrophils were found high (p&lt;0.01) in CKD patients.<strong> Conclusions</strong>: Findings concluded that hematological parameters were severely affected in CKD patients as compared to normal controls. Kidney dysfunction in turn not only affects the erythropoietin synthesis that normally stimulates the bone marrow to produce RBC’s but also the synthesis of rennin and Vitamin D that normally regulates blood volume and blood pressures and involves in making bones respectively.</em></p> Shamim A Qureshi, Muhammad Bilal Azmi, Rabia Gulzar, Ali Zia, Hina Akram Mudassir ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Prevalence of Cardiovascular Disease Risk Factors in Postmenopausal Women: A Cross-sectional Prospective Study <p><strong><em>Background: </em></strong><em>Cardiovascular disease caused by atherosclerosis is rare in premenopausal women; the incidence steeply increases after menopause. Unresolved issue remains if these changes are caused rather by chronological aging or by menopause accompanied by decrease in the estrogen concentration</em><em>. </em><strong><em>Methods</em></strong><em>: This study was conducted during the period of 2 year in one of the rural health centre in Sothern&nbsp; India. This is observational, cross-sectional prospective study. a total of 400 consecutive postmenopausal women (cessation of menstruation for 1 year) were recruited.&nbsp;</em><strong><em>Results</em></strong><em>: </em><em>Mean age at menopause was 48.25 years, mean number of menopausal symptoms was </em><em>8.97 </em><em>± </em><em>3.68,</em> <em>and mean duration since menopause was</em> <em>(MDSM = 3.10 years).</em> <em>Fatigue, lack of</em> <em>energy</em> <em>(80%), cold h</em><em>and </em><em>and feet, rheumatology-related symptoms (70%) cold sweats, weight gain, irritability and nervousness (60%), palpitation of heart, excitable/anxiety (40%) each were common complaints. Hypertension was diagnosed or a person was a known hypertensive (72%). Diabetes was diagnosed, or a person was known diabetic in 37%. BMI&nbsp; 25 kg/m2 in 65%. Truncal obesity with WHR &gt; 0.8 in 59% females, whereas abdominal obesity with waist size &gt;88 cm was in 54% women.</em></p> <p><strong><em>Conclusions</em></strong><em>: </em><em>In postmenopausal women from rural areas high prevalence of most of the conventional CVRFs, especially diabetes, hypertension, dyslipidaemia, obesity, and other risk factors.</em></p> P Leelakumari ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 A Cross-sectional Study on Gestational Diabetes Mellitus and its Associated Risk Factors in Pregnant Women in a Tertiary Care Teaching Hospital in Udaipur <p><strong><em>Background: </em></strong><em>Gestational Diabetes Mellitus (GDM) is the most common complication of pregnancy that may results into chronic hypertension, increased rate of cesarean delivery, fetal mortality and morbidity. Therefore, early diagnosis of GDM is very essential to reduce maternal and fetal morbidity. Moreover, it can reduce the onset of type 2 diabetes. Objectives: The main objective of this study was to determine the prevalence of GDM in pregnant women. </em><strong><em>Methods</em></strong><em>: </em><em>A cross-sectional study was carried out at </em><em>Department of Obstetrics and Gynaecology, Pacific Medical College &amp; Hospital, Bhilo ka bedla, Udaipur </em><em>&nbsp;using a sample size of 46 pregnant women. Blood glucose levels were measured using glucose oxidase method with a glucometer. Data were analyzed by using Microsoft Office Excel and SPSS version 20.</em></p> <p><strong><em>Results</em></strong><em>: Out of 46 pregnant women who participated in the study, 10.8% were found to have GDM with the mean ± 2SD of 198.12 ± 35.53 mg/dl of their blood glucose results. The highest proportion of GDM was revealed in pregnant women aged between 21 - 35 years. The lowest proportion of GDM fell in age group of 36 - 45 years. <strong>Conclusions</strong>: The findings of this study revealed that the prevalence of GDM was 10.8% and the most affected pregnant women were in the age group of 31 - 40 years.</em></p> Shalini Bansal, Kshiti Baxi ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Social Determinants of Low Back Pain in Females of Reproductive Age Group Residing in Urban Lahore, Pakistan <p><strong><em>Background: </em></strong><em>Nonspecific low back pain (LBP) is a common problem among females of reproductive age group that leads to low quality of life to a greater extent. Nonspecific LBP is other than any diagnosed pathological or structural cause of back pain. <strong>Objectives:</strong> 1) to determine trends of back pain in females of reproductive age group 2) to identify association between social determinants and LBP. </em><strong><em>Methods</em></strong><em>: </em><em>It was a cross sectional study conducted in one town of Lahore, Pakistan; selected randomly. Convenient sampling technique was applied to recruit the study subjects. Sample size was calculated on Sample Size Determination in Health Studies Software by WHO. Calculated sample size was 89, and researcher had taken a sample of 100 females. Target group for current study was females of reproductive age (15-49 years); and age was categorized into two categories i.e.≤30 years and ≥30 years for frequency determination.&nbsp; Data collection tool was self-developed questionnaire and data collection was done through interview method. Data analysis was done using SPSS 20. <strong>Results</strong>: Age range was 18-46 years; Mean age was 32.59 ± 7.73. 27% females had LBP in the ≤30 year category and 60% females had LBP in the ≥30 year category. A total of 87% females were found to have LBP, whereas 13% females did not have LBP. Chi square application revealed statistically significant association (P-value ˂0.05) between LBP and variables studied: marital status, onset age of menarche, number of children, pressure of daily additional home chores, feeling fatigued by 2pm after doing work since morning, and irregular sleep pattern. <strong>Conclusions</strong>: Significant association between LBP and social determinants in present study emphasize upon further research in this area with a representative sample of the total population and more detailed and comprehensive questionnaire. This will help to plan and implement health education and preventive plan in this age group. </em></p> Saadia Shahzad ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 A Prospective Observational Study on Maternal and Fetal Outcome in Eclampsia in a Tertiary Care Hospital <p><strong><em>Background: </em></strong><em>To study maternal outcome in eclampsia in relation to respiratory complications, fever, DIC, renal system affection and electrolyte imbalance. (2) To study the fetal outcome in eclampsia in relation to small for gestational age, intrauterine death, neonatal mortality, perinatal mortality and need for NICU admission.</em> <strong><em>Methods</em></strong><em>: </em><em>It was a cross-sectional prospective study conducted at Department of Obstetrics and Gynaecology at </em><em>Department of Gynaecology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India.</em><em> All patients admitted with eclampsia was enrolled for the study as per the criteria given. It was a a cross-sectional prospective study conducted on women admitted with eclampsia after the gestational age of 20 weeks and presented with convulsions. The outcome in relation to maternal and neonatal morbidity and mortality was studied on the basis of various complications and defined parameters. <strong>Results</strong>: A total of 50 patients were enrolled in the study. The most common age group of patients who had eclampsia after 20 weeks of gestation belonged to age group of 31-35 years followed by 26-30 years and the least common age group was between 41- 45 years of age. The mean age was found to be 28.23 years. The most common indication of LSCS in patients with eclampsia was fetal distress followed by Unfavourable cervix, failure of induction and contracted pelvis. The most common complications seen in patients with eclampsia included Respiratory complications like aspiration pneumonia, pleural effusion and pulmonary edema. <strong>Conclusions</strong>: Less ANC visits were associated with more threat and complications. Eclampsia was found to be associated with preterm delivery. Increase in convulsion to delivery interval lead to increase severity of complications. </em></p> Pradeep Sharma ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Prevalence and Predictors of Metabolic Syndrome in Polycystic Ovarian Syndrome in Uttarakhand <p><strong><em>Background: </em></strong><em>Woman with polycystic ovarian syndrome (PCOS) are at increased risk of developing Metabolic syndrome (MS). MS is a clustering of factors known to increase the risk of diabetes mellitus and cardiovascular disease. Aim of this present study was to determine the prevalence and predictors of MS in PCOS women of Uttarakhand. <strong>Methods</strong>: This prospective observational study was conducted in department of Obtstetrics &amp; Gynecology, SHRU from May 2016 till May 2017. A total of 200 women, diagnosed with PCOS between the ages of 15-40years were involved (by Rotterdam’s criteria). Clinical and biochemical parameters for MS, were defined by National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Statistical analysis were performed with descriptive analytical methods using SPSS software version 16. <strong>Results</strong>: The prevalence of MS in PCOS was 22</em> <em>&nbsp;(44 cases). The rate of central obesity, FBS more than 110mg/dl, triglycerides more than 150mg/dl, high density lipoproteins cholesterol levels (HDL-C) less than 50mg/dl and blood pressure ≥130/85mmHg in PCOS women were 30</em> <em>&nbsp;(60), 3.5</em> <em>(7), 34</em> <em>(68), 70</em> <em>(140) and 11</em> <em>(22), respectively.&nbsp; PCOS has evolved as a risk factor for endocrinal and metabolic derangements. <strong>Conclusions</strong>: Special strategies are required to prevent MS and its associated complications in PCOS women.</em></p> Manju Lal, Priyanka Goyal, Saba Shamim ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Impact of Knowledge, Attitude and Practice on Iron Deficiency Anaemia Status Among Females of Reproductive Age Group (20-21-year-old) Studying in Government Home Economics College Lahore, Pakistan <p><strong><em>Background: </em></strong><em>Iron deficiency anemia has emerged as a major public health issue in developed and developing countries. According to WHO 29% of all women of reproductive age group are diagnosed to have anemia. <strong>Objectives:</strong>1) to determine Hemoglobin (Hb) levels among girls 20-21-year-old by Sahli’s method 2) to identify correlation between Hb levels and KAP scores among girls 20-21-year-old. <strong>Methods</strong></em> <em>cross sectional study design applied with convenient sampling technique; and sample of 150 girls 20-21 year old was taken. Standardized KAP questionnaire was developed from FAO Guidelines upon iron deficiency anemia, and administered. Hb levels were determined in laboratory by Sahli’s method and classification of anemia was made according to WHO guidelines 2011. Frequency trend of anemia was noted, and Pearson product correlation was applied to Hb levels and KAP scores for risk analysis. <strong>Results</strong>19.3% had mild, 51.3% had moderate, and 13.3% had severe anemia. Only 16% girls had normal Hb levels. 54% had good knowledge about anemia with Pearson correlation (r) = 0.092, P=0.263. 79% had positive attitude towards self-awareness of anemia as a disease but correlation (r) was found to be in inverse relation (-0.005), P= 0.95. Highly significant positive correlation was found between dietary practices and Hb levels; where 53% had shown desired dietary practices with r= 0.174, P= 0.033. <strong>Conclusions</strong>: increasing trend of iron deficiency anemia among young girls of reproductive age group was seen; mostly related to life style and behavior towards importance of taking balanced diet. Representative sample study is strongly suggested. </em></p> Saadia Shahzad, Kiran Islam, Sameen Azhar, Shireen Fiza, Wasifa Ahmed, Zoya Murtaza ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 A Prospective Study on Platelet Counts – APrognostic Marker to Predict the Feto-Maternal Outcome in Pre-eclampsia and Eclampsia <p><strong><em>Background: </em></strong><em>Hypertensive disorders represent the most common medical complication of pregnancy affecting 7-15 % of all gestations and a leading cause of maternal and fetal morbidity and mortality especially in cases of pre-eclampsia and eclampsia. Out of all the haematological changes that occur in pre-eclampsia and eclampsia, thrombocytopenia is the most common haematological abnormality. Assessment of platelet count is a simple, cheap and relatively sensitive method to know the prognosis and to predict the feto-maternal outcome in pregnancy complicated by pre-eclampsia and eclampsia. </em><strong><em>Methods:</em></strong><em>This was a prospective study conducted in the </em><em>Department of Obstetrics and Gynaecology, Pacific Medical College and Hospital, Udaipur </em><em>over a period of 1 year which included 50 cases of pre-eclampsia and eclampsia and 50 cases of normotension in 3rd trimester of pregnancy. <strong>Results: </strong>Total 50 cases of pre-eclampsia and eclampsia were studied. Platelet count was significantly reduced with the severity of pre-eclampsia and eclampsia and it reflects feto-maternal outcome. <strong>Conclusions</strong>:Estimation of platelet count can be a reliable, rapid, easy and cheap method for early detection and assessment of severity at earlier gestational age which can help us to improve fetomaternal outcome.</em></p> Sanchita Dashora, Rajrani Sharma ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Ranson's Scoring System and Modified CT Severity Index in the Evaluation of Acute Pancreatitis: A Prospective Hospital Based Study <p><strong><em>Background: </em></strong><em>Acute pancreatitis is an acute abdominal emergency condition that need immediate hospital stay and intensive care. In 80% of cases it runs a mild course and rest of the patients have severe pancreatitis. It's severity is assessed by using Ranson's scoring system and Modified CT severity index<strong>. </strong>This study was carried out to evaluate role of Ranson's scoring system and modified CT severity index in assessing severity of acute pancreatitis. <strong>Methods: - </strong>This is a prospective observational study which is conducted on patients with acute pancreatitis admitted in Department of Surgery, </em><em>Geetanjali Medical College and Hospital, Udaipur</em><em>. 30 patients of acute pancreatitis enrolled. Ranson's criteria and modified CT severity index apply to all of them.<strong> Results</strong>: Out of 30 patients, 20 patients have mild pancreatitis. 4 patients have moderate pancreatitis. 6 patients have severe pancreatitis.<strong> Conclusion: </strong>We conclude that Ranson's criteria and modified CT severity index have significant role in predicting the severity of acute pancreatitis and the chances of developing complications as regards morbidity and mortality.</em></p> Nilesh Mehta, Ajay Chauhan ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Evaluation of Hematological Abnormalities in HIV Patients in Kosi Zone of Bihar <p><strong><em>Background: </em></strong><em>Hematological abnormalities are among the most common complications of HIV.&nbsp; Anaemia is the most common hematological abnormality in HIV patients, and is strongly associated with the progression of the disease, followed by leucopenia and thrombocytopenia. The objective of the study is to find out the magnitude &amp; type of hematological abnormalities and its correlation to CD4 Count. <strong>&nbsp;</strong></em><strong><em>Methods</em></strong><em>: </em><em>The study was done on 80 HIV patients, above the age of 15 yrs, including both males and females, attending ART Centre, at Katihar Medical College, Katihar, Bihar. Various haematological parameters were recorded and studied with respect to CD4 count. Results: Among the total patients, 57.5% had anaemia, 23.75% had leucopenia and 12.5% had thrombocytopenia. The magnitude of these abnormalities were directly proportional to low CD4 counts. <strong>Results</strong>: </em><em>Among the total patients, 57.5% had anaemia, 23.75% had leucopenia and 12.5% had thrombocytopenia. The magnitude of these abnormalities were directly proportional to low CD4 counts.&nbsp;</em></p> <p><em><strong>Conclusions</strong>: These hematological parameters can be used to assess the severity and progression of HIV as they are directly associated with CD4 count. Anaemia being the single most independent factor associated with high mortality. Aggressive treatment of these haematological abnormalities can lead to substantial decline in morbidity and mortality associated with HIV patients.</em></p> Abhishek Kumar, P.K. Agrawal, Vishal Parmar, Faiyaz Alam, Farogh Haidry, Yogesh Kumar Dubey, Saad Bin Saif ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Determination of the Impact of Functional Instability of Parathyroid Hormone and the Calcium-Phosphorus Ratio as Risk Factors during Osteoarthritic Disorders using Receiver Operating Characteristic Curves <p><strong><em>Backgrounds</em></strong><em>: The disease risk factor prediction with calcium-phosphorus ratio (CPR) and/or parathyroid hormone (PTH) levels are suitable biomarkers. The aim of the present study was to investigate the functional instability of these biomarkers in the blood on the risk of osteoarthritic disorder (OAD) by using receiver operating characteristic (ROC) curves. <strong>Methods</strong>: Separate evaluations were performed for subjects 132 with OAD and 109 without OAD symptoms using questionnaires, standardized physical and radiographic examinations, and risk factor identification (hypoparathyroidism, hypocalcaemia and hyperphosphatemia diseases). The blood levels of PTH, calcium, and phosphorus were measured by using appropriate kits. ROC curve and logistic regression analyses were performed for the PTH and CPR levels. <strong>Results</strong>: The area under the ROC curve (AUC), 95% CI for the AUC, for the OAD compared with the non-OAD cohorts were 0.985, 0.969-1.000, and P&lt;0.001 for the PTH analysis and 0.579, 0.506-0.652, and P&lt;0.05 for the CPR analysis. In the OAD cohort, the AUC and the PTH risk were higher for men than for women; AUC=1.000 for men, and AUC=0.977 for women, with both AUC values highly significant (P&lt;0.001). The CPR risk was higher for men (AUC=0.614, 95% CI=0.483-0.746, P=0.079) than for women (AUC=0.516, 95% CI=0.419-0.613, P=0.736) but was not statistically significant in either sex. <strong>Conclusion</strong>: A functional instability risk that is higher in male than female OAD cohorts causes lower PTH and CPR levels during OADs, which can be considered one of the OAD diagnostic protocols besides radiological images.</em></p> Apurba Ganguly ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 A Study on Assessment of Family Burden, Quality of Life and Mental Health in Caregivers of Patients with Schizophrenia <p><strong><em>Background: </em></strong><em>Caregivers of patient with schizophrenia face a lot of burden which hampers their quality of life as well as mental health. This study was conducted to evaluate perceived burden of care, quality of life, and mental health in caregivers of schizophrenia patients and to explore the correlation between above parameters and total duration of illness of the patient with schizophrenia. <strong>&nbsp;</strong></em><strong><em>Methods</em></strong><em>: </em><em>The study was conducted at a tertiary care center. Participants were 99 caregivers of the patient with schizophrenia that were screened to ascertain whether they met the selection criteria. Perceived burden was scored by Family burden scale which is a semi structured interview schedule. Quality of life scale (WHO QoL-BREF Hindi version), was used to assess Quality of life. Modified Mini International Neuropsychiatric Interview was used to examine mental health of caregivers. <strong>Results</strong>: In the present study, total duration of schizophrenia showed statistically significant negative correlation with quality of life of caregiver. In the study, though the correlation between perceived family burden and total duration of schizophrenia was positive but it was not statistically significant. The burden also had statistically significant negative correlation with socioeconomic status and quality of life of the caregiver. The caregivers with high likelihood of mental illness scored significantly higher burden than other two groups. <strong>Conclusions</strong>: Caregivers of persons with schizophrenia do perceive burden, on account of which and along with lower socioeconomic status they experience poor quality of life and compromised mental health.</em></p> Sunil Kumar, Paramjeet Singh, Raghav Shah, Ajitabh Soni ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Psychological Impacts of Skin Diseases in Comparison to Chronic Diseases <p><strong><em>Background: </em></strong><em>Suffering from skin diseases is more than a cosmetic nuisance. Patients with chronic skin diseases often experience significant psychological and social distress and fear of stigma. The aim of this study was to determine the psychological impact (depression, anxiety and stress) of skin diseases in comparison to chronic diseases among patients at an academic tertiary healthcare centre in Jeddah, Saudi Arabia. <strong>Methods</strong>: A cross sectional study involving 125 patients with chronic skin-related disorders recruited from the dermatology clinic at King Abdulaziz University Hospital (KAUH) and 100 patients with non-skin-related chronic disease were recruited from the medical, surgical and day care clinics at KAUH using the self-administered Depression Anxiety Stress Scales (DASS) Arabic questionnaire. <strong>Results</strong>: There was no significant difference in the level of depression, anxiety and stress in the group of subjects with skin diseases in comparison to the group with chronic diseases. However, subjects who have chronic disease were more likely to have severe and extremely severe stress compared to those who have skin disease when the levels of depression, anxiety and depression were categorized into normal, mild, moderate, severe and extremely severe levels. <strong>Conclusions</strong>: The association of depression, anxiety and stress in skin diseases are similar to chronic diseases. Subjects who have chronic disease were more likely to have severe and extremely severe stress compared to those who have skin disease. Patients with skin diseases need to be assessed regarding the psychological impact of their diseases.</em></p> Bashair M. Al-Wasiyah, Nada S. Alzahrani, Reem H. Alenazi, Sarah K. AlHarbi, Haythum O. Tayeb, Amal A Kokandi ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Echocardiographic Changes in Type 2 Diabetes Mellitus with Reference to Body Mass Index and Waist Hip Ratio <p><strong><em>Background: </em></strong><em>Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycaemia. India alone had 65.1 million diabetics by the year 2013. DM with high BMI &amp; increased central obesity (WHR) have changes in the cardiac geometry evidenced in echocardiography. AIM OF STUDY: Estimation of Body Mass Index (BMI) and Waist Hip Ratio (WHR) &amp; Establish a relationship between obesity, particularly central obesity in type 2 diabetes mellitus patients and cardiac changes with the help of echocardiography. <strong>&nbsp;</strong></em><strong><em>Methods</em></strong><em>: </em><em>30 Subjects with type 2 DM attending the OPD or admitted in Katihar Medical College indoor department &amp; 30 control patients were also be taken from the same, all of age &gt;40 years. The cases and the controls were examined thoroughly with respect to BMI (&gt;30) &amp; WHR (&gt; 0.85 for females and &gt; 0.95 for males) and echocardiography was done. <strong>Results</strong>: The cases i.e. type 2 diabetes with high WHR and BMI had highly significant alteration in LV geometry as compared to the controls &amp; had significantly high mean LV mass 189.10grams as compared to 134.04 grams of the controls. There was significant early diastolic dysfunction found in the cases group while no significant difference was found in systolic dysfunction between cases &amp; controls. The incidence of changes in left ventricular geometry was higher in female type 2 diabetic subjects with high waist hip ratio and BMI as compared to males. <strong>Conclusions</strong>: Form the data of the present study it can be concluded that type 2 diabetics with obesity, particularly central type, have an increased predisposition to the development of left ventricular structural or geometrical abnormality. They have significantly higher left ventricular Mass. Obese type 2 diabetics also have higher incidence of diastolic dysfunction. All these abnormalities occur with greater frequency in females. Thus, type 2 diabetics with high BMI and Waist hip ratio have higher risk of development of cardiovascular disease, which is higher for female than males.</em></p> Saad Bin Saif, M Ghosh, P K Agrawal, Faiyaz Alam, Abhishek Kumar, Yogesh Kumar Dubey, Tabrez Alam ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Amblyopia and Arc with Central and Eccentric Fixation Before and After Surgery <p><strong><em>Background: </em></strong><em>Adaptation may be defined as a process of advantageous variation and progressive modification whereby an organism becomes adjusted to the conditions of life in harmony with environment. A sensory adaptation to an ocular deviation is the process in which a patient adapts to an interruption in normal binocular vision. <strong>&nbsp;</strong></em><strong><em>Methods</em></strong><em>: </em><em>Cases of EXO and ESO deviation in various age groups and different sexes having central and eccentric fixation were taken. Out of 53 case, 28 were of ESO. <strong>Results</strong>: Of all the strabismic cases maximum number of cases reported in age group of 11-20 with male preponderance. <strong>Conclusions</strong>: Because of high sensitivity and very high specificity cuppers test would be the test of choice to find arc in patients with amblyopia.</em></p> Kaiser Ali, Dhawal Agrawal, Malhar Vyas, Azra Ali ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Extradural Haematoma: Protocol Needs Revision for Conservative Management <p><strong><em>Background: </em></strong><em>Brain Trauma Foundation recommends EDH volume of greater than 30 cm3 warrants surgical evacuation irrespective of Glasgow Coma Scale. Often it is observed that Not all cases of acute EDH require immediate surgical evacuation, cases with lesser than 5 mm midline shift, no focal neurological deficits and GCS&gt;8 and can be managed conservatively provided the patients are closely observed for any deterioration in GCS. For EDH with a volume more or less than 30ml in the supratentorial space and, a midline shift 6-10 mm, with a GCS score &gt; 10, was attempted non-surgical management, with close observation and serial CT scanning. Aim: The aim of this study was to discover the most important factors influencing the management strategy and outcome of EDH. </em><strong><em>Methods</em></strong><em>: </em><em>70 adult patients treated for EDH were included in this retrospective study, 26 cases (37%) underwent urgent surgery, 44 cases (62.8%) were managed conservatively out of which one third of patient required delayed surgery. <strong>Results</strong>: Our study showed that out of 62 % of the patients who&nbsp; were conservatively managed, 72 % had a favorable outcome despite the presence of a midline shift of 6- 10 mm and an EDH volume of &gt;30 ml but having a good GCS score. Conservatively managed patients with GCS &gt;10, 77% had Good Recovery. Those with high EDH volume, 61% had a good outcome. 84 % of the patients having a midline shift between 6-10 mm had a good recovery. Patients with GCS &lt; 8 had a poorer outcome than patients in good neurological status, regardless of the therapy. <strong>Conclusions</strong>: Hence we conclude, EDH must be promptly diagnosed by CT scan and considered as an emergency lest misdiagnosed and should be admitted into a neurosurgical care unit. Close neurological monitoring, appropriate follow up CT scans in the setting of improved GCS score resulting in&nbsp;&nbsp; good outcome in patient&nbsp; on conservative management.</em></p> Alok Gupta, Avanish Kumar Saxena, Ankur Saxena, Chandroday Kumar, Amrita Gupta ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Study on Association Between Hyperuricemia and Albuminuria in Patients with Type II Diabetes Mellitus <p><strong><em>Background: </em></strong><em>Hyperuricemia and albuminuria is very common among the patients of type II diabetes mellitus. The casual association between hyperuricemia and type II diabetes may be mediated by kidney dysfunction as well as insulin resistance. The objective of the study is to find association between serum uric acid level and albuminuria level in type II diabetic patient. <strong>&nbsp;</strong></em><strong><em>Methods</em></strong><em>:</em><em> 60 diabetic patients were taken having both serum uric acid level and albuminuria level increased considerably. Incidence of hyperuricemia and albuminuria were compared taking into association the age, sex, BMI, FBS, HbA1C, serum lipid profile, urinary ACR of the patients. <strong>Results</strong>: Hyperuricemia was associated with the greater probability of albuminuria in patients with type II diabetes mellitus. <strong>Conclusions</strong>: Serum uric acid and albuminuria is prevalent among patients of type II Diabetes mellitus, hence strict control of blood glucose level will significantly reduce the level of uric acid and albuminuria preventing further related micro and macrovascular complications of diabetes. </em></p> Mohd. Kaifee, Krishna Baruah, Pramod Kumar Agrawal, Faiyaz Alam, Usman Rasool, Raghib Hassan, Manish Kumar ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Study of Lipid Profile and High Sensitivity C Reactive Protein in Women with Polycystic Ovary Syndrome <p><strong><em>Background: </em></strong><em>This study was undertaken to assess the lipid profile parameters and serum levels of high sensitivity C reactive protein (hsCRP) in women with polycystic ovary syndrome. (PCOS). </em><strong><em>Methods</em></strong><em>: </em><em>80 women diagnosed with PCOS based on Rotterdam ESHRE/ASRM criteria and 40 age matched healthy controls were selected for the study. Anthropometric and biochemical parameters like serum lipid profile and hsCRP were evaluated among these women. <strong>Results</strong>: Women with PCOS were found to have significantly higher levels of total cholesterol, triglycerides, LDL-C and hsCRP and significantly lower levels of HDL-C as compared to controls. <strong>Conclusions</strong>: Targeted screening and timely interventions to reduce cardiovascular risk in women with PCOS is necessary to attenuate the complications of the disease. </em></p> Richa Lath, Aniruddha Jibhkate, Reshakiran Shendye ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Depression in Elderly Patients Attending the Psychiatry OPD: A Prospective Hospital Based Study <p><strong><em>Background: </em></strong><em>Cognitive impairment is a common clinical issue among elderly patients suffering with depression and has a more obscure etiology. The present study aimed to determine the prevalence of cognitive impairment and depression in geriatric patients attending Psychiatric OPD. </em><strong><em>Methods</em></strong><em>: </em><em>This Prospective cross-sectional study was carried out on elderly people (n=110) attending the Psychiatry OPD of Govt Doon Medical college Dehradun (UK). The cognitive function and depression were assessed by applying standardized Mini-Mental State Examination of Folstein (MMSE) and the Geriatric Depression Scale (GDS), respectively. <strong>Results</strong>: Prevalence of cognitive impairment was 35.71% (36.41% women, 24.5% men), whereas the prevalence of depression was 45.45% (51.02% women, 39.89% men) significant differences were observed. <strong>Conclusions</strong>: Cognitive impairment and depression were found to be more prevalent in the females than in the males. Hence, psychiatrist should pay special attention for early detection and treatment of depressive symptoms in elderly people with cognitive impairment.</em></p> (Lt. Col) Jeetpal Singh Rana, Jaya Sharma ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Clinical Study on Falij-E-Nisfi (Hemiplegia) with A Combination Therapy of Munzij (Concoction); Mushil (Purgation); Dal’k (Massage); and Riyazath (Exercise) <p><strong><em>Background: </em></strong><em>Falij-e-Nisfi (Hemiplegia) is one of the major neurological disorder usually caused by the occlusion of blood vessels to atherosclerotic thrombosis and embolism .other Causes are cerebral hemorrhage; neoplasms and infections. </em><strong><em>Methods</em></strong><em>: </em><em>A Clinical study to assess the effect of MUNZIJ (concoction) and MUSHIL (purgation) internally along with DAL’K (Massage) and RIYAZATH (exercise) externally was conducted on 24 patients in the inpatient department of&nbsp; Dr. Ahmed Ashraf Memorial Unani Specialty Treatment Center for paralysis, Hyderabad; a Center of Excellence by Ministry of AYUSH, Govt. of India. <strong>Results</strong>: The Observations of the Study indicated that in between 55 to 65 years of age; the disease is more common. In this Study 46% of cases showed good response; 12% of cases Showed poor response. <strong>Conclusions</strong>: These results indicated that further more study would be carried out to provide a clean picture. </em></p> Afshan Jabeen, Syed Abrar, Abul Hasan Ashraf, Fazlul Mohsin Khan ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Efficacy of Oral Tranexamic Acid in the Treatment of Melasma: A Pilot Study <p><strong><em>Background: </em></strong><em>Melasma a common skin pigmentary disorder poses a great challenge to clinicians due to unsatisfactory results and high recurrence rate. Many treatment modalities have been tried by clinicians without significant improvement in the lesion. <strong>Methods: </strong>This cross sectional study was done on 90 patients including both male and female and were diagnosed with moderate to severe melasma. TA 250 mg (thyrodin) bid for six months was prescribed along with topical sunscreen. Digital photography was performed at the first visit and at subsequent visits. The effects of treatment were evaluated by two dermatologists independently. Results were assed clinically and photographically.</em></p> <p><strong><em>Result: </em></strong><em>90 patients with moderate to severe melasma were enrolled in the study. The average age was 36 years. 44patients (48.8%) had good improvement, 25 patients (27.7%) had excellent improvement and 17 patients (18.8%) had fair improvement and 4 patients (4.4%) had no improvement.</em></p> <p><em>Three patients complained about gastric upset. None of the patients had serious systemic side effects, only few had oligomenorrhoea, palpitation. Patient’s satisfaction was similarly noted. <strong>Conclusion: </strong>oral administration of TA is effective and safe treatment for melasma.</em></p> Shafia N Kakru, Md Raihan, Mirza Aumir Beg, Basit Kakroo ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Study of Non-Alcoholic Fatty Liver Disease with Special Reference to Liver Enzyme and Radiological Finding <p><strong><em>Background: </em></strong><em>Non-alcoholic fatty liver disease (NAFLD) is a distinct hepatic condition characterized by abnormal fat accumulation in liver cells; histologically resembling alcohol induced liver damage. The term NAFLD is used to describe a wide array of fatty liver changes from simple steatosis to steatohepatitis, cirrhosis and hepatocellular carcinoma (HCC), in the absence, of excessive alcohol intake. <strong>Methods: </strong>312 suspected patients of NAFLD above the age group of 15 and irrespective of sex were screened during the study. Total 60 patients were selected according to the inclusion and exclusion criteria designed for our study. Further clinical (history, BMI, BP,etc.), biochemical (blood sugar profile, lipid profile, serum transaminases, Serum uric acid etc.), histopathological (liver biopsy) and radiological profiling (USG) was done.</em></p> <p><strong><em>Result : </em></strong><em>Our 60 recruited patients had a mean age of 52.53±11.68 years with 21 (35%) male subjects and 39 (65%) female subjects. We found that fatigue, malaise and abdominal pain were the commonest whereas heart burn as the second commonest complain among the study group. Further clinical examination of 26 (43.3%) patients with RUQ abdominal pain revealed that 14 (53.8%) had abdominal tenderness, 10 (38.5%) had abdominal tenderness with hepatomegaly and 2 (7.7%) had no significant clinical findings. Our study revealed mean BMI to be 27±6.32 kg/m2 with more than half of our patients were pre-obese (33.3%) and obese (28.3%). Lipid profiling revealed 13 (21.7%) patients had hypertriglyceridemia. Serum transaminases revealed 22 (36.7%) and 39 (65%) had raised SGPT/ALT and SGOT/AST levels respectively. Ultrasonographically, 30 (50%) had grade-I, 23 (38.3%) had grade-II and 7 (11.7%) had grade-III fatty liver. Due to low patient compliance, only 3 (5%) had their liver biopsy done which revealed steatosis and dense fibrosis. <strong>Conclusion: </strong>Current absence of specific treatment further for NASH and NAFL emphasizes the need of healthy diet, yoga and daily exercise in order to control insulin resistance/metabolic syndrome.</em></p> Yogesh Kumar Dubey, Mrityujay Pratap Singh, P.K Agrawal, Faiyaz Alam, Raghib Hasan, Saad Bin Saif, Abhishek Kumar ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Efficacy of Epidural Analgesia and Intravenous Tramadol in Relieving Labour Pain: A Prospective Hospital Based Study <p><strong><em>Background: </em></strong><em>Labour Pain during pregnancy is a painful experience for nearly all women. The aim of this study is to compare the efficacy, safety and adverse effects of epidural analgesia, tramadol in pain relief. <strong>Material and Methods: </strong>A total of 90 cases were studied. They included primi- as well as multigravidae, belonging to ASA grade 1 and 2 between the ages of 20-40 years, 37-41 weeks of pregnancy were selected. They were in established active stage of labor (uterine contraction 3 per 10 minutes, lasting for 30 to 40 seconds, cervical dilation more than 3 cm and up to 5 cm and cervical effacement more than or equal to 60%) with singleton fetus presenting by vertex and agreeable for analgesia. The selected patients were divided into three groups of Group I (control group, n=30), labour was carried out without using any analgesic technique, Group II (epidural Group, n=30) – Inj. bupivacaine 0.25% was given epidurally for analgesia, Group III (Tramadol Group, n=30) – Inj. Tramadol was given intravenously for analgesia. <strong>Result: </strong>From the observations gathered from this study, this can concluded that epidural analgesia provides much better analgesia than non-conventional methods of analgesia during labour. <strong>Conclusion</strong>: Tramadol have also a fair to good role in pain relief in labour, but mainly in first stage of labour when the pain is not severe enough.</em></p> Abeezar Hussain, Sangeeta Goyal ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Fine Needle Aspiration Cytology: A Reliable Tool for Diagnosis of Spectrum of Breast Lesions in a Tertiary Care Teaching Hospital <p><strong><em>Introduction: </em></strong><em>Breast or mammary gland is under the influence of hormones resulting in physiological changes throughout reproductive life and thereafter various structures give rise to different lesions. FNAC can be used as an OPD procedure in diagnosis of breast lesions without the need to hospitalize the patient. AIM: To study the spectrum of breast lesions. </em></p> <p><strong><em>Methods</em></strong><em>: Breast Lump is the commonest presenting symptom in various types of Breast lesions ranging from inflammation to carcinoma. </em></p> <p><strong><em>Result : </em></strong><em>The most common lesion encountered in our study on FNAC was fibroadenoma (47.07%) followed by benign proliferative mammary lesion (Commonly fibrocystic disease) 29.47%. Tuberculous mastitis was 11%. Malignancy was 11.19%.</em></p> <p><strong><em>Conclusion: </em></strong><em>Benign breast lesions form the bulk in this study and fibroadenoma is the most common lesion. FNAC is useful and reliable in early diagnosis of neoplastic and non-neoplastic lesions avoiding the need of biopsy. It has an important role in rural and semi-urban areas with fewer facilities and for the poor. </em></p> Amulya Singh, Sunil Kumar ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Proximal End of Femur: A Morphometric Study in a Tertiary Care Teaching Hospital <p><strong><em>Introduction: </em></strong><em>Femur bone can be used for anthropometric analysis in the cases of unidentified parts if available. As it is very difficult to identify sex by an individual bone. Therefore this study was done to calculate a range of anthropometric parameters of the proximal end of dried femora for sex determination.</em></p> <p><strong><em>Methods: </em></strong><em>The study was carried out on undamaged, dried, non-pathological350 dried femora of both sexes at </em><em>Anatomy at SMBT Institute of Medical Sciences and Research Centre, Nashik</em><em>. Total length of femur, vertical diameter of Neck, vertical diameter of Head measured through osteometric board and Vernier caliper.</em></p> <p><strong><em>Result: </em></strong><em>The outcome was statistically significant. All bones were found to be symmetrical.</em></p> <p><strong><em>Conclusion: </em></strong><em>P value of present study point towards symmetrical femora. Femoral length were next best sex discriminatory parameter after Vertical diameter of Head.</em></p> Pravin Jayram Tayde, Suhasini Pravin Tayde ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 A Prospective Study on Prevalence and Management of Inguinal Hernia in Infants and Children <p><strong><em>Introduction: </em></strong><em>Inguino-scrotal swellings are frequently observed in patients of pediatric age group. Inguinal hernia and Hydrocele are the most common causes of such swellings in children. For their effective management, it is essential to study various factors like age, sex etc. associated with inguinal hernia in pediatric age group. <strong>Objectives: </strong>To study the epidemiology, management and outcome of inguinal hernia in children. </em><strong><em>Methods: </em></strong><em>A prospective study was conducted on pediatric patients with inguinal hernia for a period of 18 months. Patients from newborn to 14 years of age were selected for this study on the basis of inclusion and exclusion criteria. &nbsp;</em><strong><em>Result: </em></strong><em>Inguinal hernia can occur at any age, but the majority of patients are seen between 1 to 5 years of age. It is more commonly seen in male children and incidence is slightly higher on right side. Almost all of the inguinal hernia in pediatric age group is of indirect type, which develops due to congenitally patent processus vaginalis. </em><strong><em>Conclusion: </em></strong><em>Early surgical intervention in form of Inguinal herniotomy is the most appropriate management of inguinal hernia in children.</em></p> Ram Nagina Sinha, Amanjee Bharti ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Analysis of Retinal Nerve Fibre Layer Changes in Cases of Phacomorphic Angle Closure Post Phacoemulsification <p><strong><em>Introduction: </em></strong><em>To investigate the retinal nerve fibre layer (RNFL) changes after an acute attack of phacomorphic angle closure. </em><strong><em>Methods: </em></strong><em>This prospective study involved 25 cases of phacomorphic angle closure that underwent phacoemulsification and intraocular lens insertion after intraocular pressure lowering. Apart from visual acuity and intraocular pressure (IOP), RNFL thickness was measured by optical coherence tomography (OCT) at 3–6 months post attack. </em><strong><em>Result: </em></strong><em>All cases had mean phacomorphic duration of &lt;10 days. Postoperatively, best correct Snellen visual acuity was 0.42</em><em>±</em><em>0.23 and IOP at 6 months was 13.92 ± 2.41 mmHg. There was no difference RNFL between the attack and contralateral eye at 3 months post attack (both</em><em>
</em><em>p </em><em>= 0.102). At 6 months post attack, there was significant thinning in the average (p &lt;0.001), superior (p =&lt;0.001), and inferior (p = 0.001) RNFL. Patients with &lt;5 days duration of phacomorphic angle closure are likely to have reasonable postoperative vision. </em><strong><em>Conclusion: </em></strong><em>An acute episode of phacomorphic angle closure can trigger an accelerated RNFL thinning despite normal IOP and open angles, most noticeable in the superior and inferior quadrants, occurring between 3 and 6 months post attack. There is a need of long term follow up of such patients.</em></p> Anshu Sahai, Shaheen Farooq, Mohammad Abid Shamshad, Meenakshi Sharma, P Ratan Kumar ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Osteological and Radiological Study of Femoral Bicondylar Angle among Nepalese Population <p><strong><em>Introduction: </em></strong><em>The femoral bicondylar angle of femur is an angle between the axis of shaft of the femur and a line perpendicular to the infracondylar plane. The bicondylar angle was studied from earliest known bipedal human ancestors: australopithecines from about 4.2 million years ago. The bicondylar angle of the femur of australopithecines is often used as a marker of bipedality and is therefore an indicator of human lineage.</em> <strong><em>Objectives: </em></strong><em>The main objective was to study the femoral bicondylar angle by osteological and radiological method as to show their relation between different measured parameters as well as the angle under respective method. </em><strong><em>Methods: </em></strong><em>A total sample of 200 (100 dried femurs-for osteological method and 100 radiological films-for radiological method) from Medical colleges of Nepal were included in this study. Femoral bicondylar angle was measured by using osteometric board, goniometer, vernier caliper and accessories. Collected data were analyzed statistically and presented in the form of tables and graph. The mean of femoral bicondylar angle was calculated and correlated with other parameters using the Pearson’s correlation. </em><strong><em>Result: </em></strong><em>The mean value of femoral bicondylar angle obtained were 9.31</em><em>⁰</em><em>±2.13 and 9.37</em><em>⁰</em><em>±2.25 for right and left femurs respectively by the osteological method. The mean value calculated from radiological method were 8.96</em><em>⁰</em><em>±2.24 for right and 9.40</em><em>⁰</em><em>±2.44 for left in males whereas in females 8.70</em><em>⁰</em><em>±2.48 for right and 9.31</em><em>⁰</em><em>±2.58 for left. Apart from the average value and standard deviation, the mean angle correlation with height and side, showed statistically insignificant (P&gt;0.005). </em><strong><em>Conclusion: </em></strong><em>The finding of the study showed the femoral bicondylar angle was greater in left femur than right in osteological method whereas it was greater in both right and left femur of male when compared to female as per radiological method. Overall, the bicondylar angle was found to be greater in left femur than right. Thus, obtained observation of the bicondylar angle could be useful in forensic discipline to ascertain the age and sex of the dried femur in controversial situation.</em></p> Chandan Sintakala, Prabina Manandhar, Ajya Sah ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Clinical Study for the Efficacy of Unani Formulation in the Management of Vaginal Discharge Associated with Cervicitis (Iltehab-E-Unqur Rehm) <p><strong><em>Background:&nbsp; </em></strong><em>Cervicitis is one of the commonest lesions of female genital tract affecting more than half of all women at some point during their adult lives and has been seen in 80% of women with any gynaecological complaint. It refers to the inflammation of the cervix which may be acute or chronic and vaginal discharge is the commonest complaint in patients of patients of cervicitis. <strong>Objectives: </strong>The aim of the study was to evaluate the clinical efficacy of Unani formulation in the management vaginal discharge due to cervicitis.</em></p> <p><strong><em>Methods: </em></strong><em>A randomized observational study was carried out at the Department of Amraz e Niswan wa Atfal, AKTC, AMU, Aligarh. Thirty (n=30) patients of 18-40 years of age with chronic cervicitis were selected and intervened with Unani formulations prepared from Joshanda Mazu (Quercus infectoria) administered locally in the form of intra vaginal tampon (pessary) for 7 consecutive nights after menses. Pre and post treatment analysis was done on subjective and objective parameters and were assessed by paired t-test. <strong>Result: </strong>This Unani formulation showed highly statistically significant improvement in all the subjective (p&lt;0.001) and objective (p&lt;0.001) parameters of chronic cervicitis after completion of treatment. <strong>Conclusion: </strong>The study results suggest that the trials formulations are quite effective and hence can be used as an alternate therapy in the management of cervicitis. No Adverse effects were noted during the complete course of the study trial.</em></p> Saman Anees, Suboohi Mustafa ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Distribution of ABO, Rh Blood Groups amongst the Medical Undergraduate Students in a Tertiary Care Hospital <p><strong><em>Background: </em></strong><em>The importance of knowing blood groups is very essential for every individual. Therefore, in order to promote the awareness of the same in a medical college among medical undergraduate students will have impact on them. Therefore, this study was conducted to document the frequency of ABO &amp;Rh (D) blood groups. <strong>Methods: </strong>This prospective study was conducted on first year medical undergraduate students in the department of Physiology at VIMS, Gajraula, U.P. A total of 80 subjects of both genders were enrolled on the basis of inclusion and exclusion criteria. A finger prick blood sample of both genders was tested for ABO and Rh (D) blood groups by routine slide method. <strong>Result: </strong>Blood group ‘O’ was dominant in both Rh⁺ and Rh⁻ subjects</em> <em>followed by group B, A and AB occurs with lowest frequency in both males and females. The percentage of Rh⁺ and Rh⁻ subjects was 95% and 5% respectively. <strong>Conclusion: </strong>the frequency of ABO blood groups in both Rh⁺ and Rh⁻ subjects in Uttar Pradesh was O&gt;B&gt;A&gt;AB. Rh⁺ blood group was much more common than Rh⁻ blood group.</em></p> Sameer Srivastava, Parag Rastogi ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Efficacy of Intra-articular Injection Hyaluronic Acid in Osteoarthritis of Knee: A Hospital Based Study <p><strong><em>Background: </em></strong><em>Osteoarthritis (OA) is the most common disease of joints in adults around the world. The aim of the study was to assess functional outcome and results of injection of hyaluronic acid in symptomatic osteoarthritis knee.</em></p> <p><strong><em>Methods</em></strong><em>: </em><em>It was a prospective clinical study with 3 months of follow-up was conducted in the Dept. of Orthopaedics, Pacific Medical College and Hospital, Udaipur. Clinically proven n=35 patients of osteoarthritis knee (OA) included in study on the basis of&nbsp; inclusion and exclusion. Enrolled patients were treated by weekly intra articular injection of Hyaluronic acid (20 mcg/2ml) in affected knee joint for 5 weeks. Functional outcome and clinical assessment was done by pain at visual analogue score (VAS) and by knee range of movements, patients global assessment of treatment and physician global assessment of treatment. </em></p> <p><strong><em>Results: </em></strong><em>Thirty Five patients participated in study and reported statistically significant improvement in VAS score in mild and moderate osteoarthritis of knee from 4.46±0.52 and 7.17±0.96 points respectively pre-treatment level to 3.36±0.63 and 5.26±0.44 points respectively at three months post Hyaluronic acid injection follow up, improvement in joint tenderness and patients &amp; physician’s global assessment score also improved significantly clinically as well as statistically in mild to moderate group while in severe group no clinical and statistically significant improvement was observed in any parameter.</em></p> <p><strong><em>Conclusions: </em></strong><em>We concluded that &nbsp;intra articular injection hyaluronic acid should be considered as safe and effective modality of treatment in selected group of mild to moderate osteoarthritis only.</em></p> Saleh Mohammed Kagzi, Anurodh Shandilya, Naveen Rathor, R N Laddha ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000 Incidence of Surgical site infections in IPD Orthopedics patients undergoing implant surgery <p><strong><em>Background: </em></strong><em>Prevalence of </em><em>Surgical site infections (SSI) in orthopedic implant surgery is ranges from 1 to 22%. It leads to increase case cost, prolongs antibiotic use/abuse, increases morbidity and rehabilitation.</em></p> <p><strong><em>Methods</em></strong><em>: </em><em>This prospective study was conducted on 130 patients with closed fracture cases undergoing clean and elective orthopedic implant surgeries admitted in the department of Orthopedics at Govt. Medical College, Nagpur, India between october-2016 to march-2017. </em><strong><em>Results: </em></strong><em>The surgical site infection was diagnosed in 11 (4.435%) patients within 3 months after surgery. Staphylococcus aureus was most common infective organism isolated in 54.54% cases. On data analysis SSI was significantly associated with increasing age, diabetes mellitus, smoking and anemia. </em><strong><em>Conclusions: </em></strong><em>Incidence of SSI in implants surgeries are quite high, proper measure are needed to control it.</em></p> Nitin Kimmatkar, Jaya T. Hemnani ##submission.copyrightStatement## Wed, 20 Dec 2017 00:00:00 +0000