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Srivastava, RakeshKumar, VaddiSuman Babu, and MukeshKumar Sharma. "Burn Unit at ABVIMS and Dr. Ram Manohar Lohia Hospital, New Delhi, India." Indian Journal of Burns 27, no. 1 (2019): 5. http://dx.doi.org/10.4103/ijb.ijb_30_19.
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Bhaskar, Anurag. "Ambedkar, Lohia, and the Segregations of Caste and Gender: Envisioning a Global Agenda for Social Justice." CASTE / A Global Journal on Social Exclusion 1, no. 2 (October 31, 2020): 63–72. http://dx.doi.org/10.26812/caste.v1i2.208.
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Dalit women in India suffer multilayered form of marginalization. They are discriminated not only based on their gender, but also because of their caste identity. This impacts their literacy, life expectancy, among other human indicators. Despite the emphasis on the intersectionality between caste and gender by Dr. BR Ambedkar and later by other social reformers like Dr. Ram Manohar Lohia, the mainstream movements have failed to provide a separate discourse on safeguarding the rights of Dalit women. The question of caste-based discrimination has by and large focused on the identity of a Dalit, irrespective of the gender, and the injustices inflicted on the social group as a whole. The upper caste led feminist discourse has been equally ignorant of the multiple oppressions faced by Dalit women. This paper deals with the critique of the Dalit movement as well as the feminist movement, and attempts to envision a broader global social justice by reading the ideas of Ambedkar and Lohia together.
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Chatterjee, Arindam, and Vinka Maini. "Study of deaths due to hanging in ABVIMS and Dr Ram Manohar Lohia Hospital New Delhi." MedPulse International Journal of Forensic Medicine 14, no. 3 (2020): 16–18. http://dx.doi.org/10.26611/10181432.
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Al Harbi, Mutaz Minwer Halal. "INFLUENCE OF WORK LIFE BALANCE ON PERFORMANCE OF EMPLOYEES IN JORDAN HOSPITALS." International Journal of Research -GRANTHAALAYAH 8, no. 1 (June 3, 2020): 53–58. http://dx.doi.org/10.29121/granthaalayah.v8.i1.2020.247.
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This paper examines the impact of WLB on performance of employees in Jordan hospitals. This study is a quantitative research and made use primary data using a research questionnaire as instrument was administered to a total number of 500 respondents selected from four governments and four privates hospitals namely: Al-Bashir hospital (Government), Al Mafraq Government Hospital (Government), Ram Manohar Lohia Hospital (Government),Jawaharlal Nehru Medical College (Government),Philadelphia hospital (private), Haramain Hospital (Private), Jordan hospital (private) and Fortis Hospital (Private) from Jordan. The result of the study reveals that impact of WLB on performance of employees was significant and joint impact of WLB and motivation significantly influence performance of employees. In conclusion, motivation plays an important role in encouraging employees to perform; a well-motivated employee has a possibility of performing better than an employee that is not well motivated.
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Agnihotri, Anurag, and Shagun Arora. "Study of corporate governance in government hospitals: A case study of the emerging market." Corporate Governance and Sustainability Review 5, no. 1 (2021): 8–14. http://dx.doi.org/10.22495/cgsrv5i1p1.
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Governance in a government hospital setup is complicated due to its economic and financial dimensions but also incorporates societal responsibility. The current study focuses on the processes and procedures as the key factor of corporate governance. This paper presents evidence of a comprehensive range of procedures related to governing healthcare quality undertaken at the corporate governance level. The study explores the viewpoint of the stakeholders including patients, doctors, and the management. The aim of the study is to identify indicators of effective governance in an emerging country like India where the state regulates the health system. For this purpose, three major hospitals of Delhi – AIIMS, Safdarjung, and Ram Manohar Lohia hospitals – were studied. The response of 582 respondents was analyzed using logit regression. The study documents the comfort level of patients with the doctor, the ability of the doctors to address the concern of patience, registration time in the hospital, and easy availability of the medicine improves the corporate governance of the hospital. The main contribution of the research is analyzing the health care system in an emerging market like India which is characterized by the complexity of interaction between the environment and policies related to health care.
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Yadav, P., M. Sen, J. K. Srivastava, A. Das, and T. Chatterji. "Bone marrow invasion by cryptococcus in HIV infected patients with asymptomatic meningitis: a case report." Research Journal of Biotechnology 17, no. 8 (July 25, 2022): 78–81. http://dx.doi.org/10.25303/1708rjbt78081.
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Cryptococcal infection is one of the common opportunistic fungal infections seen in HIV patients. It is the second leading cause of mortality in Acquired Immuno deficiency Syndrome (AIDS) patients worldwide. The cryptococcal infection occurs in subacute meningitis, patients having CD4+ T Lymphocytes count below 100 cells/micro liter. However, in severe immunosuppressed patients, Cryptococcus neoformans can infect any human organ including the bone marrow. This case presents the disseminated cryptococcosis with bone marrow involvement and asymptomatic meningitis, focusing on the role of bone marrow aspirate and biopsy study in HIV infected patients. A 42 year old HIV infected male patient with a CD4+ T Lymphocyte count of 25 cells/μl was admitted to the emergency department of Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India. The patient underwent a CSF examination to rule out the infection of meningitis patient had no signs of meningeal irritation and neurological examinations were normal. The CSF culture showed Cryptococcus sp. The patient was given Amphotericine B plus Fluconazole therapy according to IDSA guidelines. However, the patient developed acute kidney injury stage 3 and was given fluconazole monotherapy. The symptoms disappeared and CSF culture for fungi was negative after 2 weeks of treatment. Bone marrow infection caused by Cryptococcus neoformans is a rare presentation of cryptococccosis.
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Garg, Paridhi, and Bani Sarkar. "Comparative evaluation of urodynamic profile in cases of cystocele alone or associated with uterovaginal prolapse before and after surgery." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 12 (November 26, 2020): 4980. http://dx.doi.org/10.18203/2320-1770.ijrcog20205233.
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Background: Pelvic organ prolapse is a bulge or protrusion of pelvic organs and their associated vaginal segments into or through the vagina. There may be structural and functional changes in the bladder and urethra post-operatively.Methods: It was a prospective type of cohort study. The study was conducted on 30 patients with cystocele with or without uterovaginal prolapse undergoing surgery for same under Department of Obstetrics and Gynecology of Dr. Ram Manohar Lohia Hospital. Comparison of various pre-operative and post-operative urodynamic parameters were done using appropriate statistical tests.Results: Post-operatively, statistically significant increase was observed in the bladder volumes at which patients had first and strong desire to void as well as in the maximum cystometric capacity, increase in mean compliance, increase in mean average flow rate, decrease in post-void residual volume. Though, no significant improvement was seen on peak flow rates on uroflowmetry, maximum filling detrussor pressure, mean peak flow rates, maximum voiding detrussor pressure, mean detrussor pressure at peak flow rate.Conclusions: A pre-operative urodynamic study may be helpful in planning the site-specific repair surgery. It will also help in predicting the post-operative outcome. Urge related symptoms may not be corrected by cystocele repair alone and may require additional treatment.
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Singh, Neetu, Devyani Misra, and Shubhi Srivastava. "Postdated pregnancy: its maternal and fetal outcome." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 8 (July 23, 2020): 3223. http://dx.doi.org/10.18203/2320-1770.ijrcog20203299.
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Background: Postdated pregnancy is one of the commonest obstetric conditions. Pregnancy is called term when it lies between 37 weeks to 42 weeks from the last menstrual period. If the pregnancy exceeds 40 weeks it is called as postdated pregnancy. The overall incidence of post term pregnancy is 7% of all pregnancies.Methods: This observational study was carried out in the department of obstetrics and gynecology in Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India from September 2019 to February 2020. Total 100 postdated pregnancy enrolled in the study those willing to participate and fulfilling the inclusion and exclusion criteria. Aim is to assess maternal and fetal outcome in postdated pregnancy.Results: In present study, incidence of postdated pregnancy was found to be 5% and number of normal deliveries was 66 (66%), LSCS were 32 (32%) and 2 (2%) were instrumental delivery. Maternal complications were seen in 14 (14%) cases and fetal complications were found in 23 (23%) cases.Conclusions: Postdated pregnancy was associated with perinatal complications like fetal distress, meconium aspiration syndrome and fetal asphyxia. There was increased risk of obstetrics complications like postpartum haemorrhage (PPH), perineal tear, cervical tear and shoulder dystocia. Management of postdated pregnancy is a challenge to obstetrician and a careful advice and monitoring can alleviate maternal anxiety and untoward complications.
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Saxena, Prarthana, Sharad Pandey, Pankaj Kumar, Kaviraj Kausik, and Shiv Lal Soni. "Endoscopic Third Ventriculostomy in Cases of Hydrocephalus: An Institutional Experience." Indian Journal of Neurosurgery 08, no. 03 (October 21, 2019): 151–54. http://dx.doi.org/10.1055/s-0039-1697898.
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Abstract Background With the recent advances in optical and mechanical instrumentation, endoscopic third ventriculostomy (ETV) has emerged as the procedure of choice for the treatment of hydrocephalus in selected patients. Objective: To study the role of ETV in therapeutic management of hydrocephalus in a tertiary care center. Materials and Methods The present study was conducted in the Department of Neurosurgery at Dr. Ram Manohar Lohia Hospital. Endoscopic third ventriculostomy was performed as a therapeutic procedure in patients diagnosed with hydrocephalus requiring surgical intervention and admitted from June 2017 to July 2018. ETV success was defined by resolution or improvement in clinical symptoms and ETV failure was considered in patients whose symptoms either deteriorated or did not improve from the baseline and required ventriculoperitoneal shunt. Results A total of 85 patients were included in this study who underwent the therapeutic ETV. In the present study, the overall ETV success rate was 75.2% (64/85). 86.7% cases of aqueductal stenosis, 74.4% cases of post meningitis (including tubercular meningitis) hydrocephalus, and 71% of posterior fossa tumors showed resolution or improvement in clinical symptoms. Conclusion ETV is an effective treatment modality for obstructive hydrocephalus and with better results in post meningitis hydrocephalus and post tubercular meningitis hydrocephalus. However, more extensive studies dedicated to ETV with a larger sample size are required to further study its efficacy in various etiologies.
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Arora, Sonia. "A Study to Examine the Medication Error, Causes and Reporting Behaviour as Perceived by Staff Nurses Working in the Selective Units of Dr. Ram Manohar Lohia Hospital, New Delhi." Indian Journal of Surgical Nursing 9, no. 1 (April 1, 2020): 9–15. http://dx.doi.org/10.21088/ijsn.2277.467x.9120.1.
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Sobti, Shivender, Sondev Bansal, Ajay Choudhary, and Laxmi Gupta. "Clinicoradiologic Predictors of Outcome of Posterior Fossa Extradural Hematoma: An Institutional Experience." Indian Journal of Neurotrauma 14, no. 02/03 (December 2017): 142–44. http://dx.doi.org/10.1055/s-0038-1649282.
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Abstract Introduction Posterior fossa extradural hematomas (PFEDH) comprise 4 to 7% of all intracranial extradural hematomas (EDHs). Material and Methods A prospective study of 25 patients who presented with PFEDH was conducted in PGIMER, Dr. Ram Manohar Lohia (RML) Hospital, New Delhi in department of neurosurgery from January 2011 to July 2012. The patients were analyzed in relation to age, sex, mode of injury, Glasgow coma scale (GCS) at the time of presentation, computed tomography findings of the head, and therapeutic outcome. Duration of follow-up was 6 months. Results In the authors’ study, male-to-female ratio was 22:3. Age range was 6 months to 62 years and mean age was 23.70 years. Mode of trauma was fall from height in 12 patients, road traffic accident (RTA) in 12, and assault in 1. Most patients had acute course (80%) followed by subacute course (20%). GCS was between 8 and 15. Fracture was associated in 21 patients out of 25. Associated intracranial injury was present in 22 patients. Conclusion In this series, PFEDH is a result of direct impact injury as 88% of patients had overlying fracture. PFEDH should be suspected in patients who have got external injury to the occiput as it is commonly associated with formation of extradural hematoma in the posterior fossa. The neurologic status and outcome were associated with GCS, volume of hematoma, and associated intracranial injury. PFEDH rarely occurs as an isolated injury.
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Jauhari, Nidhi, Deepak Chopra, and Siraj Ahmad. "Study of preventable causes of blindness in a tertiary care institute in Lucknow." International Journal of Scientific Reports 6, no. 4 (March 24, 2020): 163. http://dx.doi.org/10.18203/issn.2454-2156.intjscirep20201272.
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<p class="abstract"><strong>Background:</strong> World Health Organization (WHO) in 2019, released the estimates which show that approximately 80% of the causes of blindness and severely reduced visual acuity are preventable and avoidable. The aim of the study was to assess the prevalence of preventable causes of blindness in an OPD setup in the city of Lucknow.</p><p class="abstract"><strong>Methods:</strong> Descriptive cross-sectional study was done from January, 2019 to March, 2019 at the ophthalmology department OPD, Dr Ram Manohar lohia hospital, Lucknow. Patient presenting with complains of Blurring of vision or blindness during the defined OPD days at the study place, sample size- 550. Convenience sampling, all the eligible patients who were attending the OPD on defined days during the study period. </p><p class="abstract"><strong>Results:</strong> The current study found the prevalence of blindness in the OPD based patients to be 13.5% and 25% (WHO and NPCB standards) respectively which is higher than the other reported statistics and found cataract to be the single most contributor of cause of blindness in accordance with other literature.</p><p class="abstract"><strong>Conclusions:</strong> The study demonstrates that even after the implementation of a national program (NPCB), the prevalence of blindness continues to be on the higher side and cataract remains to the most common cause of preventable blindness.</p>
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Neha Rai, Narendra Rai, Virinder Singh Gogia, and Devesh Kumar Shukla. "Cerebral Palsy in Children - an indicator of maternal care in pregnancy - How far are we from attaining continuum of care." Asian Journal of Medical Sciences 13, no. 9 (September 1, 2022): 207–12. http://dx.doi.org/10.3126/ajms.v13i9.44237.
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Background: Cerebral palsy (CP) is an umbrella term covering a group of disorders arising from a non-progressive injury to the brain during its development. It results from injury to developing brains. These injuries can be both intrauterine or peripartum. Better antenatal and peripartum care will help in decreasing the number of children with CP. Aims and Objectives: The objective of the study was to evaluate antenatal as well as post-natal risk factors of CP in children in Uttar Pradesh. Materials and Methods: Observational cross-sectional study was conducted on children aged 2–14 years with CP visiting Pediatric Neurology clinic of Dr. Ram Manohar Lohia Institute of Medical Sciences. Results: 104 children were enrolled in the study. Mean age of children enrolled for the study was 2.8 years. About 66% were vaginally delivered. About 83% (n=86) were term deliveries. Intrapartum complication was seen in 33% (n=34) of mothers. Most common peripartum complication was prolonged labor (100%, n=34) followed by meconium stained liquor (85%, n=29). Cord around neck was seen in 24% (n=8) of cases. About 25% of were low birth weight. About 49.4% (n=42) were attended by Angan Wadi workers. Most common motor type of CP was spastic quadriplegia (57.6%, n=60), followed by spastic diplegia (23%, n=24), spastic hemiplegia (10.57%, n=11), and hypotonic CP (7.6%, n=8). Conclusion: Majority of study were delivered vaginally and at term yet 82% had perinatal asphyxia and nearly 50% were received by Anganwadi workers. Better antenatal and perinatal care are the road to prevention of CP.
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Aggarwal, Sanya. "Estimating Disability Adjusted Life Years using Survival Models in HIV/ AIDS Risk Groups." Journal of Communicable Diseases 53, no. 04 (December 31, 2021): 36–47. http://dx.doi.org/10.24321/0019.5138.202172.
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Introduction: Advances in human immunodeficiency virus (HIV) treatment have led to greater survival rates and have brought about a shift in the burden of disease from mortality to morbidity. The main purpose of this study is to estimate the Disability Adjusted Life Years (DALYs) of HIV infected patients associated with different modes of transmission. Methods: Non-parametric Kaplan-Meier estimate has been utilised to develop survival function, and the mean residual life model has been utilised to estimate the life expectancy of patients alive at the end of the study. The impact of factors such as age, sex, hepatitis B and syphilis on life expectancy has also been assessed by fitting a proportional mean residual life model. DALYs have been calculated based on the results of both models. Results: Retrospective time to event data of HIV patients undergoing Antiretroviral Therapy (ART) in Dr Ram Manohar Lohia Hospital, New Delhi, India has been utilised to illustrate the modelling technique. The study suggests that in total, 42300.15 DALYs were lost which includes 39765.10 years of life lost due to premature death and 2535.05 years of life lived with disability. When the covariates were taken into consideration, 47592.14 DALYs were found to have been lost with an average of 17.64 DALYs lost per patient. Conclusion: Our results suggest that the high-risk groups such as homosexuals and parent to child transmission are a major cause of concern, which are in accordance with the existing national policies. Also, we would suggest that gender-based and age-based policies should be incorporated to reduce the burden of disease.
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Das, Anupam, Vikramjeet Singh, Pranshu Pandey, Manodeep Sen, and Jyotsna Agarwal. "Transformation of commensal to a pathogen: Blood stream infection due to coagulase negative staphylococci among patients attending tertiary care hospital in North India." IP International Journal of Medical Microbiology and Tropical Diseases 7, no. 2 (June 15, 2021): 71–76. http://dx.doi.org/10.18231/j.ijmmtd.2021.016.
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Aim of this study was to know the prevalence of Coagulase Negative Staphylococci (CoNS) in Blood Stream Infection (BSI) among patients attending a Superspeciality hospital in North India. Objective of this study was to compare incidence of CoNS in ICU and ward patients suffering from BSI and their antimicrobial susceptibility pattern. This retrospective hospital based study was conducted in the Microbiology Department, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow for a period of two years (January, 2017 -December, 2018). Blood samples from a total of 6498 patients from Out-Patient, In-Patient and Intensive care unit departments were subjected to aerobic and anaerobic bacterial culture. Culture positive broth was subcultured on Blood Agar and MacConkey Agar to isolate pathogens in pure culture. Pure cultured isolates were tested for antimicrobial susceptibility pattern by Kirby Bauer Disk Diffusion method as per CLSI 2018.During the study period, out of total 3284 samples in 2017 and 3214 in 2018, 663 and 595 were found to be culture positive respectively.Staphylococci were isolated from 636 (9.78%) patients (10.2% in 2017 and 9.2% in 2018). Staphylococcus aureus was isolated from 18.8% and CoNS from 81.2% of total Staphylococcal isolates. Among CoNS isolates 70.7% were found to be Methicillin Resistant CoNS (MRCoNS). This study observed CoNS as a major cause of BSI as compared to Staphylococcus aureusThe significance of CONS bacteremia should be evaluated better in light of clinical profile of the patient. Better screening and infection control practices in the future can decrease the rate of methicillin resistant CoNS in our centre.
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Vaid, Harvinder kaur. "A Study to Determine the Nature and Risk Factors for Road Traffic Injuries." Prehospital and Disaster Medicine 34, s1 (May 2019): s169. http://dx.doi.org/10.1017/s1049023x1900387x.
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Introduction:In 2010, an estimated 1.3 million road traffic injury (RTI) deaths occurred worldwide, accounting for about 2.5% of all deaths. Mortality in serious injuries is 6 times worse in a developing country such as India compared to a developed country. Strengthening and undertaking research on the public health burden and impact and understanding the risk factors of trauma is the need of the hour.Aim:To identify the nature of injury in terms of causes and severity of injury.Methods:Using a quantitative approach, a retrospective cross-sectional survey was conducted at the emergency and trauma center in Ram Manohar Lohia (RML) Hospital, New Delhi. The information of all the injured patients seeking health care during the past one year from October 2015 - September 2016 at Emergency and trauma center was collected from the trauma registry forms filled at the time of registration.Results:A total of 1952 cases of road traffic injury sought health care during the study period. The average number of cases reported per day was five. Maximum of the cases (40%) were reported between 12-6PM. Among the injured, 82% were males and the majority of victims were between 20-30 years age group followed by 30-40 years.Discussion:Trauma services need to be coordinated in infrastructure and human resources so that the right patient is taken to the right hospital at the right time. This calls for a lead agency at the district, state, and finally national level. Safety education regarding road safety should be imparted, especially to all victims, relatives, and the general public to make the care comprehensive. Students in schools and colleges should also be the target for intense safety education.
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Gulati, Sonia, Hariprasath Pandurangan, and Pulin Kumar Gupta. "To explore patients’ perceptions about motivators and barriers of adherence to highly active antiretroviral therapy among people living with HIV: A qualitative study." Journal of Integrative Nursing 5, no. 4 (2023): 256–65. http://dx.doi.org/10.4103/jin.jin_81_23.
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ABSTRACT Objective: For people living with HIV (PLHIV), strict adherence to highly active antiretroviral therapy (HAART) is the key to effective treatment and retention in human immunodeficiency virus (HIV) care. There are many factors which promote or halt the antiretroviral therapy (ART) adherence practices. Therefore, the present study aimed to examine the HAART adherence levels and to explore patients’ views about barriers and facilitators to HIV treatment adherence. Methods: Semi-structured interviews were conducted among 15 PLHIV at the ART clinic of Dr. Ram Manohar Lohia Hospital, New Delhi. Interviews were audio-recorded in the local Hindi language, and bilingual experts (English and Hindi) transcribed verbatim. Qualitative data were coded for themes and subthemes and analyzed using a phenomenological approach as per thematic content analysis. Results: Feeling of hopelessness, delayed ART initiation, difficult initial phase of ART, forget to take ART on time, fear of disclosure of HIV diagnosis, lack of privacy and negative social support, and impact of lockdown due to COVID-19 were revealed as significant barriers to ART adherence. At the same time, commitment to raise and educate children, ART to increase life span, maintain oneself to be physically fit and healthy, only a single pill per day, very supportive counselors and health-care professionals, and hope to give birth to a healthy child were identified as facilitators of HIV retention. Conclusion: Understanding patient’s perception about ART adherence, its motivational and barrier factors which are directly affecting ART adherence and retention of PLHIV in HIV treatment and follow-ups are of utmost importance to improve ART adherence during HIV patient care services.
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Nandan, Devki, Prachi Kansal, Neha Patharia, and Parul Goyal. "Induced Sputum Nitrite Levels Correlate with Clinical Asthma Parameters in Children Aged 7–18 Years with Mild to Moderate Persistent Asthma." Journal of Laboratory Physicians 8, no. 02 (July 2016): 090–95. http://dx.doi.org/10.4103/0974-2727.180788.
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ABSTRACT Purpose: The objective of this study is to measure levels of nitrites in induced sputum in children with asthma and correlate it with clinical asthma parameters. Method: This prospective observational study was done in PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, on 91 children aged 7-18 years with mild and moderate persistent asthma. Patients were specifically evaluated for five clinical parameters of asthma (i.e. Days of acute exacerbations, use of salbutamol as rescue medication, emergency visits, nights with cough, days of school absence) and induced sputum nitrite levels was done at the time of enrollment and 3 months after treatment with inhaled budesonide. Results: The mean age of subjects was 10.79 ± 2.563yrs. Six (6.59%) patients were not able to perform induced sputum, eighty five (93.41%) patients were suitable for data analysis. There was significant reduction in sputum nitrite levels from 33.42 ± 22.04nmol/ml at enrollment to 11.72 ± 5.61 nmol/ml (P < 0.0005) after 3 months of inhaled budesonide therapy. Significant positive correlation was found between reduction in sputum nitrite level and control of asthma symptoms: Days of acute exacerbations(r value = 0.548, P value = 0.0001), Days of salbutamol use as rescue medication (r value = 0.431, P value =< 0.0001), Number of emergency visits(r value = 0.414, P value = 0.0001), Nights with cough (r value = 0.259, P value = 0.0169), Days of school absence(r value = 0.411, P value = 0.0001). Sputum nitrite levels were significantly higher in moderate persistent asthmatics as compared to mild at the time of enrollment (P < 0.0005), which shows that induced sputum nitrite levels correlate with asthma severity. Conclusions: This study confirms that nitrites in induced sputum correlate well with clinical asthma parameters and asthma severity in children and is a simple, non invasive, and cheap method which can be used as a parameter for monitoring of asthma.
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Narain, Anupriya, Alka Goel, and Parul Goyal. "Estimation of maternal serum vitamin D levels and its correlation with gestational diabetes mellitus." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 8 (July 26, 2018): 3348. http://dx.doi.org/10.18203/2320-1770.ijrcog20183343.
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Background: Several studies in the past two decades have proved beyond doubt that there is a high prevalence of hypovitaminosis D worldwide including India which has almost taken the shape of a pandemic. The study aims to determine the prevalence of hypovitaminosis D in the pregnant population of Delhi and its correlation with gestational diabetes mellitus.Methods: This prospective cross sectional observational study was conducted at the Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research (PGIMER), Dr R.M.L Hospital, New Delhi over a period of 1 year and 4 months. Four hundred term patients were enrolled randomly from amongst the patients admitted in labor room or antenatal ward at PGIMER, Dr. Ram Manohar Lohia Hospital who fulfilled the inclusion and exclusion criteria. 3-4ml of fasting blood samples were collected of all the enrolled women and were analysed for total serum calcium levels and serum vitamin D levels. History of presence of gestational diabetes mellitus was noted along with any treatment history. The 25(OH)D levels for each subject was recorded and correlation of vitamin D levels with gestational diabetes mellitus was analysed. Statistical analysis was done using ANOVA/ Kruska Wallis test and Chi-Square test/ Fisher’s exact test. A p value of <0.05 was considered statistically significant.Results: The overall prevalence of vitamin D deficiency in the present study was 86.25%. The overall mean serum vitamin D level was 14.06±9.43 ng/ml. Thirty five out of 37 GDM patients had hypovitaminosis D i.e. 94.59%. The prevalence of hypovitaminosis D among non-GDM population was 85.40%. The association between GDM and Vitamin D deficiency was statistically non- significant in the present study with p value=0.186.Conclusions: There is a very high prevalence of hypovitaminosis D in pregnant females attending present institute i.e. 86.25%. Although 94.59 % of Gestational Diabetes Mellitus patients had vitamin D deficiency, there is no statistically significant association between Gestational diabetes mellitus and serum vitamin D levels.
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Bansal, P., V. Singhal, H. Lal, D. Mittal, and RK Arya. "A Convenient Way to do Valgus Osteotomy for Neglected Fracture Neck of Femur." Kathmandu University Medical Journal 11, no. 2 (May 3, 2015): 147–51. http://dx.doi.org/10.3126/kumj.v11i2.12491.
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Background Neglected fracture of neck of femur in young adults is a major problem in developing countries. Existing treatment options varies from osteotomy to various graft techniques (muscle pedicle, vascularized and nonvascularized fibula etc.). There is paucity of literature regarding the use of double angle barrel plate and hip screw in such cases. We conducted a prospective longitudinal observational study with displaced, neglected fracture neck of femur in young adults and compared the results with literature. Objectives The aim of this study was to determine feasibility and effectiveness of 120° double angle barrel plate and hip screw fixation in neglected fracture neck of femur. Effectiveness of fixed 30 degree closed wedge osteotomy in neglected fracture neck of femur. Methods Thirty cases of neglected (more than three weeks) femoral neck fracture (Pauwel II and III) of age 20-60 years were included in the study conducted at Postgraduate Institute Of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India in year 2004-06. Average age of the patient was 35.4 years (range, 22yrs-55yrs). In all cases internal fixation was done by 120° double angle barrel plate and hip Screw. At the end of follow-up, results were evaluated according to Askin Bryan Criteria and Harris-hip score. Results Union was achieved in 28 of 30 patients. Two patients that went into nonunion were later treated with hemireplacement arthroplasty. According to Askin Bryan Criteria at the end of study, 35% patients had excellent results, 50% patients had good results. Minimum follow-up in our study was 12 months and maximum was five years. Conclusion This study validates the use of double angled screw plate configuration for successful outcome in patients with neglected fracture neck of femur. Valgus osteotomy is also technically easy operation in hands of average trauma surgeon with the use of a fixed angle plate and hip screw.DOI: http://dx.doi.org/10.3126/kumj.v11i2.12491 Kathmandu University Medical Journal Vol.11(2) 2013: 147-151
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Chauhan, Rohit, Devadatta Poddar, and Prateek Lohchab. "Necrotizing Fasciitis: Risk Factors and Outcomes in the COVID-19 Era." International Journal of Research and Review 8, no. 8 (August 26, 2021): 645–49. http://dx.doi.org/10.52403/ijrr.20210885.
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Background: Necrotizing Fasciitis is a severe, rapidly spreading soft tissue infection with high morbidity and mortality. Diabetes mellitus, hypertension, and immune suppression are the some of the predisposing factors for the disease. The objective of this study was to study the risk factors and outcomes of necrotizing fasciitis in the COVID-19 era. Methods and Materials: a retrospective analysis of the data of forty-four patients admitted with the diagnosis of NF from April 2020 to April 2021was done at Dr Ram Manohar Lohia Hospital, New Delhi. Data was recorded in MS Excel spreadsheet program. SPSS v23 (IBM Corp.) was used for data analysis. Descriptive statistics were elaborated in the form of means/standard deviations and medians/IQRs for continuous variables, and frequencies and percentages for categorical variables. Chi-square test (X2) was used for group comparisons of categorical data. Results: Out of forty-four patients, 26 (59.10%) were male and 18 (40.9%) were female. The mean age was 54.2 years (+ 14.4 years). Extremities (68.2%) were the most commonly involved site followed by perineum (29.5%) and abdominal wall (2.2%). Diabetes mellitus (DM) was the most prevalent comorbidity. 10 patients had both DM and hypertension (HTN). Fourteen patients (32%) had a polymicrobial infection on tissue culture. Rest thirty patients had involvement of gram positive (44%) and gram negative (24%) organisms. Twenty-two patients (50%) had healthy granulation tissue as the final outcome. However, the rest 50% patients had a poor outcome in form of amputation (13.63%) and mortality (36.36%). Average duration from onset of symptoms to presentation at the hospital was 7.11 (+ 3.47) days. Patients who presented early to the hospital within 7 days of symptom onset had a good outcome in the form of healthy granulation tissue (X2= 7.62 and p <0.05). Conclusions: Early diagnosis and prompt surgical intervention in necrotizing fasciitis is the key to its management. Delayed presentation was because of restricted movement, government-imposed lockdowns, patients ignoring their symptoms, and resorting to self-medications. The delay in diagnosis leading to a delay in treatment is one of the major factors contributing to poor outcomes in the COVID-19 era. Keywords: necrotizing fasciitis, risk factors, COVID 19.
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Mehta, Pawan, and Vishwa Deepak Tripathi. "Evaluation of left and right ventricular functions pre and post balloon mitral Valvuloplasty using speckled tracking echocardiography." International Journal of Research in Medical Sciences 5, no. 9 (August 26, 2017): 3807. http://dx.doi.org/10.18203/2320-6012.ijrms20173953.
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Background: Rheumatic heart disease remains a considerable cause of cardiovascular morbidity and mortality in developing countries such as India. The aim of the present study was to compare ventricular (LV and RV) function in patients with severe mitral stenosis (MS) undergoing balloon mitral Valvuloplasty (BMV) with those on medical management and also with healthy controls and to assess the burden of ventricular (LV and RV) systolic dysfunction, its determinants, and its reversibility with percutaneous balloon mitral Valvuloplasty using speckle tracking echocardiography in patients with severe MS.Methods: This prospective study was performed in a tertiary care center, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow in patients with severe MS, from September 2014 to September 2015. A total of 60 were divided into three groups. Cases (n=30), patients with severe MS undergoing BMV; case controls (n=20), patients with severe MS who did not give consent for BMV and chose medical management and healthy controls (n=10). Cases who underwent BMV were analyzed pre and post BMV and detailed echocardiographic and speckle-tracking echocardiography (STE) was done at baseline, 24-48 hours after BMV and at post one month after BMV. Appropriate statistical analysis was applied and different parameters were compared.Results: Most of the cases (56.7%) control (65%) and healthy controls (40%) were between 21-30 years of age. Female preponderance was observed in the study. A significant (p=0.01) decrease in the LA size, PASP (p=0.0001), MV PG area (p=0.0001) and significant (p=0.0001) increase in the LVEF, MVA area was observed from baseline to post 24-48 hours and at post one month after BMV among cases. Significant improvement was noticed in longitudinal strain and regional rotation in different LV segments as assessed by STE at post 24-48 hours and post one month after BMV (p value 0.001) among cases. No significant (p>0.05) difference in the 2D echo parameters was seen from baseline to follow-ups among the case controls. No significant improvement was observed in regional rotation, global rotation in different LV and RV segments after one month as assessed by STE among case controls whereas significant improvement was seen in cases.Conclusions: BMV results in marked improvement in LV and RV GLS immediately post BMV with improvement towards normalization at follow up after one month and the same can be easily assessed by Speckle tracking echocardiography.
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Verma, Jyoti, Abhishek Kumar, and Anil Upadhyay. "A Study on Differential Alteration Trend of Monocyte Count and Other Blood Parameters Among Dengue Patients During Hospitalisation in a Tertiary Care Centre of North India - A Prospective Cohort Study." International Journal of Health Sciences and Research 14, no. 2 (February 16, 2024): 82–92. http://dx.doi.org/10.52403/ijhsr.20240211.
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Introduction: Dengue fever is a viral infection that spreads through mosquito bites. It is a serious public health concern in many tropical and subtropical regions around the world. This study aimed to investigate and analyze differential alteration in various blood parameters specially monocyte count and its trend during the course of hospitalisation among individuals diagnosed with Dengue, providing valuable insights into the hematological alterations associated with the disease. Assessment of Severity of Dengue patients was also done by Dengue scoring. The dengue score is a model for predicting severity of dengue as ascites and / or pleural effusion. This is calculated by using four parameters: Hct > 15.1%, Serum Albumin < 3.49 mg/dl, platelet count < 49,500/ µl and AST ratio > 2.51. 1 score each is given if present and 0 if absent. The study analyzed several key parameters such as complete blood count (CBC), platelet count, monocyte count, hematocrit levels, and serum biochemical markers. The main objective was to identify patterns and trends in these parameters during various stages of Dengue infection, starting from the early febrile phase to the critical phase, and finally to the recovery phase. The study found that Dengue patients experience significant changes in their blood parameters, indicating that the disease has a dynamic impact on the hematological system. During the febrile phase, patients with Dengue exhibited a noticeable decrease in platelet count and hematocrit levels, which are typical symptoms of Dengue-induced thrombocytopenia and plasma leakage. Additionally, the study revealed variations in CBC parameters, such as monocytosis, leukopenia and changes in differential leukocyte counts, which offer further insights into the immune response against the Dengue virus. Materials and Methods: Study population consisted of 100 adults with Dengue fever and Severe dengue (including those with warning signs and shock). Patients were taken from the wards, and OPD of Dr. Ram Manohar Lohia Institute of Medical sciences, Lucknow, UP. Patients were selected after excluding other causes of acute febrile illness and other causes of severe disease. They were included after ELISA confirmed NS1 and IgM positive cases. Blood sampling was done for other hematological parameters. Clinical and demographic profile were noted after taking proper consent. Results: Analysis of hematological profile of dengue patients showed Lymphocytosis (67%) and Monocytosis (82%) besides thrombocytopenia. 32((96.9%) had monocytosis in severe dengue and 52(77.6%) in dengue fever patients without warning signs. Though results were not statistically significant for the two groups but were important markers for deciding in-patient management SGOT was statistically significant with P-value of 0.008. Bleeding manifestations were significant with P-value <0.00001. Conclusions: Thrombocytopenia is important parameter to diagnose Dengue fever from other febrile illness but monocytosis and its trend over days is an important marker for the prognosis of the severity of dengue patients besides Leucopenia. Key words: Dengue fever, monocytosis, Thrombocytopenia, severe dengue,
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Prasad, Manish. "Re-covering the Problems of Caste and Untouchability in U. R. Ananthamurthy’s Samskara." Contemporary Voice of Dalit, November 14, 2023. http://dx.doi.org/10.1177/2455328x231198727.
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The problem of caste and the struggle of literary voices for a solution against casteism has been a topic of concern in Dalit Literature. U. R. Ananthamurthy is one among such writers who looks upon the caste division as a challenge against the rise of social inequality and through his works tries to critique such modern existentialist crisis based on caste and untouchability. It should be noted that being a member of the Navya Kavya movement, U. R. Ananthmurthy was under the impression of Ram Manohar Lohia and Mahatma Gandhi for their concern about the problem of caste and untouchability in the Post-independent Indian society. In a similar context, U. R. Ananthamurthy’s Samskara: A Rite for a Dead Man (1965) echoes the evil social practices based on caste and Brahminical hierarchy by presenting the existential and intellectual crisis of Pranesacharaya, the most learned Brahmin of Durvashapura village. Keeping due attention to the views of Gandhi and Lohia, the proposed article would like to explicate how far Ananthamurthy was influenced by the views of these socialists and to which level his method of presenting casteism in Samskara follows the criterion style of Munshi Premchand and Mulk Raj Anand who were also the disciple of Gandhian ideology about caste and untouchability. This article would also like to focus on how this discrimination in caste based on social superiority and inferiority has constructed an exploitative relationship between the Brahmins and other upper castes, and the untouchable; and how it functions and would finally lead to nothingness where everything would be at a terrible situation of destroying the very society itself.
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Chaudhary, Poras, Rajeev Kumar, Chandrakant Munjewar, Utsav Bhadana, Gyan Ranjan, Shailesh Gupta, Sanjay Kumar, and Mohinder P. Arora. "Typhoid ileal perforation: a 13-year experience." Healthcare in Low-resource Settings 3, no. 1 (July 8, 2015). http://dx.doi.org/10.4081/hls.2015.4677.
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Typhoid fever is endemic in many developing countries with a high rate of complications. Aim of this study is to analyse epidemiological features, clinical presentations, complications and therapeutic outcomes of enteric perforation peritonitis diagnosed and treated in our hospital. Records of total number of 646 patients, who presented with perforation peritonitis due to enteric fever in the surgical emergency unit of Dr Ram Manohar Lohia hospital, New Delhi between January 2001 and December 2013, were reviewed retrospectively. Descriptive statistics was used to analyze the data. Out of 646 patients, 62 (9.59%) presented in shock. Stomal, peristomal, local and systemic complications were high in these patients. Primary closure was done in 212 (33.12) patients, primary ileostomy was created in 410 (64.06) patients, and resection and anastomosis was done in 24 (3.75) patients. Thirteen patients (2.01%) died of typhoid intestinal perforation. To prevent complications of typhoid fever, in addition to control sanitation, it is also important to control quackery and malpractices. Awareness and education about the disease, its nature and complications will also be of great help.
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Sethi, Divina, Namrita Sachdev, and Rupali Bhardwaj. "EVALUATION OF SLEEP QUALITY INDEX IN POSTGRADUATE MEDICAL STUDENTS IN INDIA." INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, July 1, 2021, 32–33. http://dx.doi.org/10.36106/ijsr/5234798.
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Background: Sleep quality is dened as the satisfaction of the sleep experience, integrating aspects of sleep initiation, sleep maintenance, sleep quantity, and refreshment upon awakening. It is important to measure sleep quality in postgraduate medical students and this study aims to monitor it across the various years of the course. Methodology: A cross-sectional study involving medical postgraduates students at the Postgraduate Institute of Medical Sciences and Research & Dr. Ram Manohar Lohia Hospital, New Delhi was conducted. All rst- to third-year postgraduate students were invited to participate. It was a self rated questionnaire based study using the Pittsburgh Sleep Quality Index (PSQI). Results: Poor sleep quality as observed using raised global PSQI of more than 5 was seen in 104 students (74%). Of this, 39 students belonged to third year (88.6%), 37 students were from second year (74%) and 28 students were from rst year (59.6%). Only 26% of students showed an adequate sleep quality with global PSQI <5.The mean global PSQI scores for students in rst, second and third year were 6.2, 6.6 and 7.8 respectively reecting that third year students were most affected. Conclusion: Postgraduate medical students have more sleep disturbance with impaired sleep quality. Sleep quality has a strong inuence on physical and mental health. Active intervention is required to improve sleep hygiene in these students.
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Arora, Stuti Kansra, Mala Chhabra, Anuradha Anuradha, Arvind Achra, and Nandini Duggal. "COMPARISON OF FOURTH GENERATION ELISA AND RAPID DIAGNOSTIC TEST FOR DIAGNOSIS OF HEPATITIS C VIRUS(HCV) INFECTION IN A TERTIARY CARE HOSPITAL." PARIPEX INDIAN JOURNAL OF RESEARCH, March 15, 2021, 15–17. http://dx.doi.org/10.36106/2000717.
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Introduction:Hepatitis C virus (HCV) infection has emerged as one of the major global health challenge affecting about 2 - 3% of the world population. Epidemiological studies have shown that HCV infection is a major risk factor for development of Acute hepatitis,chronic liver disease,cirrhosis and Hepatocellular carcinoma (HCC).Early diagnosis of HCV is important to link hepatitis testing to care and treatment initiation. Aim:To compare sensitivity and specificity of rapid diagnostic test (RDT) with fourth generation ELISA Material and Method: This study was conducted in the Department of Microbiology at Atal Bihari Vajpayee Institute of Medical Sciences (formerly Post Graduate Institute of Medical Education and Research) and Dr Ram Manohar Lohia Hospital from January 2018 to December 2018.Blood samples of patients suspected with hepatitis were tested using ELISA and rapid diagnostic test Results: In our study 26378 blood samples were tested for HCV,using fourth generation ELISA.Of these,581(2.20%) samples were found to be positive by ELISA.These HCV positive samples along with equal number of ELISA negative samples were tested by rapid diagnostic test. Sensitivity and specificity of the rapid diagnostic test was found to be 72.98 % and 100% respectively. Discussion:Rapid diagnostic test can be used during emergency hours but their results must be followed by ELISA test results in a tertiary care hospital.Reporting of false negative results should be minimized for rapid linkage to treatment initiation and to avoid silent transmission of infection.
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Pandey, Bharti, Poonam Tiwari, Mahima Gupta, and Deep Shikha. "Assessment Of Awareness About Importance Of Millets Amongst Nursing College Students Of Dr. Ram Manohar Lohia Institute Of Medical Sciences In Lucknow City: An Observational Study." Journal for ReAttach Therapy and Developmental Diversities, October 9, 2023. http://dx.doi.org/10.53555/jrtdd.v6i10s.2579.
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Choudhary, Ajay, Ashok Kumar, Rajesh Kumar Sharma, Rahul Varshney, Satya Shiva Munjal, Kaviraj Kaushik, and Laxmi Narayan Gupta. "Emergency Department Management of Mild Traumatic Brain Injury in New Delhi–A Single Institute Cohort Management Data." Indian Journal of Neurosurgery, March 11, 2021. http://dx.doi.org/10.1055/s-0040-1719236.
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Abstract Introduction The purpose of this study is to compare the current clinical management practices and decision guidelines of the Brain Trauma Foundation (BTF) for mild traumatic brain insult with line of treatment followed at our center to identify the clinically significant treatment outcome in pediatric to elderly patients. Materials and Methods This is a questionnaire-based prospective observational study at the emergency department of neurosurgery in Dr. Ram Manohar Lohia (RML) Hospital, New Delhi. A registry questionnaire was administered to all the eligible subjects by the neurosurgery resident in emergency department (ED) to correlate clinical status, severity of traumatic brain injury (TBI) and associated comorbid conditions and its outcome after management. Results Out of 154 mild TBI cases attending ED, 115 (74.7%) were males and 39 (25.3%) were females, with average age of 27 years. Of the patients with mild TBI, road traffic accidents (RTA) were the main cause (50.6%), followed by fall from height (42.9%), assault and sports-related injury (6.4%). Of the total, 96.1% underwent CT. Of these, 31.8% found abnormal CT results, 27.5% received wound treatment care, and 9.1% received emergency care. Nearly 30.5% were admitted and 1.3% patients were died in the hospital, 75.3% patients were discharged and 23.4% were referred to other department for associated co morbid conditions. Conclusion The present study identified deficiencies in and variation around several important aspects of ED care. The development of BTF guidelines specific for mild TBI could reduce variation and improve emergency care for this injury.
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Mohan R, Ram, Vaddi Suman Babu, Shivasharana Biradar, and Shreeja Jha. "INJURIES IN THE NATIONAL CAPITAL REGION – A CROSS-SECTIONAL STUDY OF THE CHALLENGING EPIDEMIC." INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, November 1, 2022, 5–8. http://dx.doi.org/10.36106/ijsr/0906060.
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Background: Injuries are an emerging public health problem that has grown into epidemic proportions. Many injuries are linked to social, environmental, cultural, and biological issues in causation; recognized as man-made and behaviour-linked disorders, and linked to sociodemographic transition. Prevention, acute care, and rehabilitation are the major challenges we are facing today. Materials & Methods: A crosssectional study was conducted at the National Injury Surveillance Centre (NISC) Department of Dr. Ram Manohar Lohia Hospital, New Delhi. Data was collected from 2861 participants (>18 years) of injury cases during 12 months (Jan-Dec 2019). Participants were selected using the Convenience Sampling Technique. The data were analysed statistically using SPSS software to assess the risk factors and pattern of injury among the population of the National Capital Region, Delhi. Results: In this study, the mean age was 36.6 years. The male to female ratio was 2.1:0.7. The age group 18-45 years is affected predominantly (71.1%). Around 48.8% were students (matriculation/junior school). 39.5% (1131) were unemployed. 1999 (69.9%) were accidental (unintentional), 1671 (58.4%) were having moderate to severe injury, 1675 (58.5%) happened onroad, and 1341 (46.9%) were having soft tissue injury. 1198 (41.9%) were RTI cases and 816 (28.5%) were assault/quarrel cases, the second most common mode of injury. Conclusion: With the realization that injuries are caused by a complex interaction among agents (vehicle, product), and human and environmental factors operating in complex social and economic systems, injury prevention and control depending on evidence-based research is gaining momentum. There is an urgent need for developing comprehensive, integrated, and intersectoral approaches based on scientic understanding.
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Singh, Deepak Kumar, Kuldeep Yadav, Rakesh Kumar, Arun Kumar Singh, and Vipin Kumar Chand. "Comparative analysis of anterior third ventricle approaches." Romanian Neurosurgery, December 16, 2020, 544–49. http://dx.doi.org/10.33962/roneuro-2020-093.
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Background. Third ventricle tumors are uncommon and account for only 0.6 - 0.9% of all the brain tumors7. In 1921, Dandy was the first neurosurgeon who successfully removed a colloid cyst from the third ventricle through a posterior transcallosal approach. Despite their unfavourable locations, these tumours can be removed successfully by proper knowledge of anatomical landmarks and by choosing the appropriate approach. Methods. We performed a retrospective analysis of all patients (17 patients) who underwent surgery for anterior third ventricular masses between March 2018 to March 2020 in the Dr Ram Manohar Lohia Institute of Medical Science Lucknow, Uttar Pradesh. Results: The most common symptom in our cases was headache, which was present in all (100%) patients, nausea/vomiting in 7 (41%), history of recurrent episodes of drop attacks in 4 (23%), h/o seizure in 2 (11.7%), visual disturbance in 1 (5.4%), memory disturbance in 1 (5.4%) and urinary incontinence in 1 (5.4%) patient. 6 patients were operated with transcallosal-transforaminal approach, 1 patient was operated with transcallosal interforniceal approach, 3 patients were operated with transcortical-transforaminal approach, 1 patient was operated with subfrontal translamina terminalis approach, 1 patient was operated with transcallosal-transchoroidal approach, 5 patients were operated with endoscopically. Gross total excision was achieved in 15 (88%) patients while in 2 (11.7%) patients subtotal resection was done due to their adherence to choroid plexus and optic chiasm. The most common post-operative complication was endocrine dysfunction in the form of diabetes insipidus. Conclusions. Anterior Third ventricular tumours are mostly benign and best treatment modality is surgical resection. When we analyzed the results of various approaches, we found that despite their unfavourable location, the results were satisfactory for different tumours of different location in the anterior third ventricle, when treated with the carefully planned microsurgical or endoscopic approach with proper knowledge of anatomical landmarks.
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Gupta, Srajan, Ashok Kumar, Gaurang Singhal, and Pallika Kumar. "A study on tympanoplasty with or without canaloplasty." Egyptian Journal of Otolaryngology 38, no. 1 (August 9, 2022). http://dx.doi.org/10.1186/s43163-022-00282-2.
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Abstract Background Chronic otitis media is a highly prevalent disease in developing as well as developed countries, causing hearing disabilities to the patients and causing huge problems to the patients in their daily routine lives. The patients are routinely advised for tympanoplasties in the specialized centers. Canaloplasties are routinely performed in such patients to get wide exposure while doing tympanoplasties. The present study seeks to determine the impact of canaloplasty on the outcome of the tympanoplasty. Material and methods The study was conducted in Department of Otorhinolaryngology at the Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, between 2018 and 2020, in which 70 patients were included. These patients were randomly divided into two groups. Group A patients underwent type I tympanoplasty with canaloplasty while group B patients underwent type I tympanoplasty alone. Patients in both the groups were followed up with pure tone audiometry and otoscopy at 6 weeks and 12 weeks postoperatively. Hearing was compared in both the groups in terms of air bone gap closure. Air bone gap closure at 12 weeks was considered final. Final analysis was done using SPSS version 21.0. Results The patients were randomly divided into two groups. Group A patients underwent type 1 tympanoplasty with canaloplasty, and group B comprises of case l graft tympanoplasty alone. Graft uptake was better in group A with a success rate of 94.3% as compared to group B which had a success rate of 88.57%. Air bone gap closure was better in group A as compared to group B (15.76 dB ± 6.75 v/s 14.87 dB ± 5.99) at 12 weeks postoperatively. Conclusion Tympanoplasty with canaloplasty showed advantageous outcome over tympanoplasty alone and thus should be considered with limited exposures. However, the final decision resides with the operating surgeon.
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Kumar, Hemant, Preeti Gupta, Shobhit Shakya, Sumeet Dixit, Manoj Kumar Pandey, Nikhil Gupta, and Amiya Pandey. "Predictors of Mortality in Patients of COVID-19 Pneumonia in Intensive Care Unit: An Observational Study in a Tertiary Care Hospital, Lucknow, India." JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2021. http://dx.doi.org/10.7860/jcdr/2021/49061.15189.
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Introduction: Coronavirus Disease-2019 (COVID-19) is caused by the Severe Acute Respiratory Coronavirus-2 (SARS-CoV-2) which is an enveloped positive-sense single-stranded RNA virus. Initial steps of the infection involve binding of the spike protein (S) of the virus to Angiotensin Converting Enzyme-2 (ACE-2) receptor on the mucosal surfaces of various organs like lungs, kidney, heart, intestine. Pathogenesis of complications are still poorly understood. Aim: This study was designed to find out the baseline biochemical parameters at the time of admission which may predict outcome in COVID-19 patients. Materials and Methods: This observational study was conducted in a dedicated COVID-19 hospital, Dr. Ram Manohar Lohia Institute of Medical Sciences (Dr. RMLIMS), Lucknow, Uttar Pradesh, India, from 1st July, 2020 to 30th November, 2020. A total of 109 moderate to severe COVID-19 pneumonia patients who required Intensive Care Unit (ICU) admission, were enrolled. Based on their outcome, patients were divided into two groups: “Survived” and “Expired”. Biochemical characteristics of patients were compared among the two groups using univariate and multivariate analysis. Results: On Univariate analysis Coagulation profile, Prothrombin Time (PT), International Normalised Ratio (INR), Activated Partial Thromboplastin Time (APTT) and D-Dimer values were raised significantly in the expired group. Among other acute phase reactants Lactate Dehydrogenase (LDH), C-Reactive Protein (CRP), Interleukin-6 (IL-6), and Creatinine Phosphokinase-MB (CPKMB) were raised in expired group and this difference was significant statistically too. On Multivariate analysis among all acute phase reactant only IL-6 was increased significantly. All other variables were found to be non significantly associated with mortality, statistically (p-value <0.05). Conclusion: Baseline biochemical parameters have prognostic values in COVID-19 patients. Raised IL-6 levels can be viewed as an independent predictor of mortality among COVID-19 patients at the time of admission in ICU.
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Kumar, Tushant, Pramod Kumar Dixit, and Pramod Kumar Singh. "Assessment of Malignant Biliary Obstruction by Percutaneous Transhepatic Cholangiography: A Prospective Cohort Study." JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2021. http://dx.doi.org/10.7860/jcdr/2021/50270.15137.
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Introduction: Malignant Biliary Obstruction (MBO) is caused by hepatic metastasis, gall bladder carcinoma, other distant metastasis, icteric hepatocellular carcinoma and lymphoma. Different signs and symptoms of obstruction includes pruritus, jaundice, altered food taste, renal dysfunction, anorexia, malnutrition which ultimately leads to impaired immune dysfunction and impaired quality of life. Aim: To determine the extent of biliary ductal involvement in patients with MBO through Magnetic Resonance Cholangiopancreatography (MRCP) and Percutaneous Transhepatic Cholangiography (PTC) technique and to compare the number of biliary drainage required. Materials and Methods: A prospective cohort study was undertaken at Department of Radiodiagnosis, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India. It included total 40 patients (24 females and 16 males) with strong clinicopathological and laboratory investigation suspicious of MBO. Patients with suspected MBO were examined with MR cholangiography. All patients then underwent PTC and Biliary Drainage (PTBD) and/or stent placement after MR cholangiography. The statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. Results: As out of 40 patients, 16 (40%) were males and 24 (60%) were females and the mean age was 53.87±9.49 years with maximum age noted to be 75 years and minimum age of patient in study was 35 years. The most common block observed on MRCP was type IIIA (35%) and after MRCP the distribution of level of hilar block on PTC was obtained with the most common block found was of type II (32.5%). Maximum number of biliary drains during PTBD was three. In MRCP three biliary drain were used in 47.5% patients while in PTC it was used only in 40% patients. Conclusion: Based on diagnostic performance, PTC was found to be superior for the assessment of MBO. PTC played an important role in scheduling the therapeutic strategy for malignant biliary stricture.
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Mishra, Dewansh, Gaurav Raj, Bhanupriya Singh, Dewanshi Mishra, and Rahul Kumar Nayak. "Prevalence and Distribution of Coronary Dominance and Ramus Intermedius in North Indian Population on CT Coronary Angiography- A Cross-sectional Study." INTERNATIONAL JOURNAL OF ANATOMY RADIOLOGY AND SURGERY, 2021. http://dx.doi.org/10.7860/ijars/2021/47806:2699.
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Introduction: The Computed Tomography (CT) coronary angiography is a non invasive method to evaluate coronary artery stenosis in patients presenting with cardiac symptoms. It can also be used to decide coronary artery dominance which has various clinical implications like relatively higher death rates in left dominant coronary circulation. The most common variation of left coronary artery is ramus intermedius seen in approximately 30% of cases. Aim: To find the type of coronary artery dominance in male and female patients and to look for the prevalence of ramus intermedius in patients undergoing CT angiography for coronary artery disease following cardiac symptoms and to look for predominance based on gender if any. Materials and Methods: This cross-sectional study was done on 161 patients who visited the Department of Radiodiagnosis, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India from January 2020 to October 2020 for CT coronary angiography on 64 slice CT scan machine and were evaluated for the type of coronary dominance and the presence or absence of ramus intermedius. Results: Of 161 patients (108 males and 53 females), right, left and co-dominance was present in 77%, 14.9%, and 8%, respectively with no significant difference between the sexes. Ramus intermedius was present in 20.4% cases, it was found to be more in males (16.77%) compared to females (3.73%). significantly more in males (Chi-square=4.0820, p=0.0430), and co-dominance (Chi-square=6.2930, p=0.0430). Conclusion: Right dominance was found to be in a greater number of subjects as compared to left dominance and co- dominance with no significant difference between both the sexes. Ramus intermedius came out as a common variation and is significantly more in co-dominance.
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Singh, Shashikant, Prajwala Gupta, and Anukrishnaa Kannappan. "Application of the International System for Reporting Serous Fluid Cytopathology: An Experience at a Tertiary Care Centre in India." Journal of Medical Evidence, February 23, 2024. http://dx.doi.org/10.4103/jme.jme_23_23.
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Abstract Background: The cytological analysis of body fluids is the preliminary investigation performed for the diagnostic evaluation of body fluids, helping the physician make the diagnosis and plan proper treatment. The International System for Reporting Serous Fluid Cytology (ISFRSFC) was created using best international practises, current literature and expert consensus to make a uniform reporting system for serous fluids. Aims: The present study was conducted with the aim of recategorising the effusion fluids as per the guidelines prescribed by ISRFRC, knowing the distribution of cases into various categories and assessing their feasibility in day-to-day reporting. Patients and Methods: This study was performed on serous fluids (ascitic, pleural, peritoneal and pericardial) received over a period of 5 years, from January 2017 to April 2022, in the cytology unit of the Department of Pathology, ABVIMS, Dr. Ram Manohar Lohia Hospital, New Delhi. Wherever possible, clinicoradiological and histopathological data were obtained and correlated with cytological findings. Serous fluids were categorised into reporting formats as prescribed by ISRFRC and its feasibility was assessed in day-to-day reporting. Results: A total of 1115 cases of serous effusion fluid were examined. The male-to-female ratio was 1:1.12. Pleural fluid constituted the majority of the sample (436, 39.10%). Overall, 56 (5.02%) cases were non-diagnostic (ND), 1013 (90.85%) cases were negative for malignancy, 8 (0.72%) were atypia of undetermined significance, 11 (0.99%) were suspicious of malignancy and 27 (2.42%) were malignant (MAL). Conclusion: The current study emphasises the significance of cytological analysis of serous fluid as a comprehensive diagnostic investigation that also aids in determining the cause and monitoring the disease process. With the introduction of ISFRSFC, serous fluid reporting is now uniform and more comprehensive, both for cytopathologists and clinicians.
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Jilowa, Sarita, Wezode Wezah, Yashvant Singh, and Ajay Chauhan. "Association of the Severity of Emphysema Based on HRCT Scoring System with Clinical Profile and Pulmonary Function Test Parameters: A Cross-sectional Study." INTERNATIONAL JOURNAL OF ANATOMY RADIOLOGY AND SURGERY, 2023. http://dx.doi.org/10.7860/ijars/2023/61780.2943.
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Introduction: Chronic Obstructive Pulmonary Disease (COPD) is commonly observed in middle aged and elderly individuals. Dyspnoea, with or without expectoration, or isolated dyspnoea, is the primary respiratory symptom. Clinical signs, symptoms, and Pulmonary Function Tests (PFTs) are non specific. Chest radiography poorly correlates with disease severity and extent compared to clinical and functional impairment. High-Resolution Computed Tomography (HRCT) has been widely adopted to detect, characterise, and quantify emphysema. HRCT scoring is a useful radiological method for assessing emphysema severity in COPD patients and can provide prognostic information. Aim: To assess the severity of emphysema based on the HRCT scoring system and its association with clinical profile and PFTs. Materials and Methods: The present cross-sectional observational study was conducted in the Department of Radiodiagnosis at Atal Bihari Vajpayee Institute of Medical Sciences and Ram Manohar Lohia Hospital, New Delhi, India. It included 30 clinically diagnosed COPD patients referred for HRCT lung scans from November 1,2018, to March 31, 2020. HRCT assessment was performed at three levels: carina, 5 cm above carina, and 5 cm below carina. The severity of lung parenchyma was evaluated using the “Sakai Scoring Method.” The emphysema score was correlated with clinical profile (duration of illness, COPD severity, smoking, and pack-years smoked) and PFT parameters (FEV1, FEV1/FVC). Results: The mean age of the cases was 60±9.44 years. There was a strong positive linear correlation between the duration of illness (r=0.67, p=0.001) and COPD severity (r=0.452, p=0.02) with HRCT emphysema score. Significant correlation was found between HRCT emphysema score and pack-years smoked (r=0.558, p=0.004). The emphysema score showed an inverse correlation with FEV1 (r= -0.56, p=0.002) but no correlation with Forced Expiratory Volume 1 / Forced Vital Capacity (FEV1/FVC) (r= -0.16, p=0.430). Conclusion: The HRCT semi-quantitative scoring system is valuable for the initial assessment of disease severity and is significantly correlated with the PFT parameter FEV1.
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Handa, Nishtha, Kamna Datta, Neha Pruthi Tandon, and Bani Sarkar. "Role of Anterior Colporrhaphy in Post Void Residual Urine Volume and Stress Urinary Incontinence: A Prospective Interventional Study." JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2022. http://dx.doi.org/10.7860/jcdr/2022/58187.16903.
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Introduction: Pelvic floor disorders are quite debilitating for middle aged and elderly women. Post Void Residual (PVR) urine volume is a key marker for the efficacy of emptying of bladder. Both, preoperative and postoperative assessment of PVR volume helps to know about the voiding dysfunction and help to detect Stress Urinary Incontinence (SUI). There is a paucity of data available regarding postoperative outcome assessment of surgical intervention in terms of PVR urine volume. Aim: To identify the risk factors for elevated PVR and to evaluate the rate of resolution of elevated PVR in patients undergoing vaginal hysterectomy with anterior colporrhaphy for Pelvic Organ Prolapse (POP). Materials and Methods: A prospective interventional study was conducted at Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, Delhi from June 2019 to June 2021. A total of 50 patients with POP meeting the inclusion criteria were enrolled. Preoperative grade of prolapse, SUI and PVR urine volume was assessed. All patients enrolled in study, underwent vaginal hysterectomy with anterior colporrhaphy. Postoperative PVR urine volume and de novo SUI and occult stress urinary incontinence (OSUI) was assessed. Data was analysed using Statistical Package for the Social Sciences (SPSS) version 21.0. The p-value <0.05 was considered significant. Qualitative variables were analysed using Fischer's exact test. Results: Preoperative PVR (≥50 mL) was seen in 28 (56%) women. Advancing age (p-value 0.043) higher Body Mass Index (BMI) (p-value=0.033) higher POP (p-value=0.003) and higher degree of cystocele (p-value<0.001) staging were significantly associated with elevated preoperative PVR. In this study, only 22% of patients (11/50) had preoperative SUI and 12% (6/50) had preoperative OSUI. In this study amongst the six patients with preoperative OSUI, 100% had significant preoperative PVR. None of the patients with preoperative SUI and preoperative OSUI had postoperative persistent SUI or de novo SUI after undergoing anterior colporrhaphy with vaginal hysterectomy (p-value <0.001). Conclusion: PVR urine volume is increased with degree of prolapse. Raised PVR is also associated with OSUI, which is usually seen in patients with advanced prolapse and cystocele. Vaginal hysterectomy with anterior colporrhaphy significantly reduced postoperative PVR and SUI.
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Chhabra, Anuj, Deepak Kumar Singla, Deepak Kumar Singh, Surender Kumar Gupta, Mohd Kaif, Kuldeep Yadav, and Farhan Ahmad. "Efficacy of neuronavigation guided biopsy in deep seated brain lesions." Romanian Neurosurgery, September 15, 2022, 296–301. http://dx.doi.org/10.33962/roneuro-2022-050.
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Localisation of brain lesions and prevention of damage to vital structures are important goals in the operation of brain pathologies, which can be aimed after the development of many techniques (e.g. angiography, MRI, sonography, frame base stereotaxy). In spite of current developments in radiological imaging techniques, accurate histological diagnosis is required to determine the appropriate treatment methods for intracranial lesions.
The study was conducted in the Department of Neurosurgery, Dr Ram Manohar Lohia Institute of Medical Sciences, over a period of 18 months. Descriptive statistics (frequencies and percentages) were used to interpret the collected data. After editing, data was entered into SPSS free versions for statistical studies. The results from various sites of the biopsy were compared based on sensitivity, specificity, positive and negative predictive values.
In this study, 4 patients were found to be below 20 years, 7 patients in the 20 – 40 years age group, 10 patients in the age group of 40 to 60 years and 4 patients were above sixty years. 22 (88%) patients were found to have positive yield when the biopsy was taken from the core area while 3 (12%) patients were not having any positive results from the biopsy. Sensitivity, specificity, positive predictive value, and negative predictive value of various sites of the biopsy were calculated Sensitivity of the periphery came out to be 68.2 % while specificity was 67.7%. The positive predictive value of the periphery was found to be 93.8 % while the negative predictive value was
22.2%. The sensitivity of the contrast-enhanced area came out to be 72.7 %, with specificity being 67.7%. The positive predictive value of periphery in such cases was found to be 94.1 % and the negative predictive value was 25%. The most common system-related complication was the inability to show choline peak properly, which was present in 7 patients.
Hence, it can be concluded safely that the use of neuronavigation is beginning to have a vital role in a variety of intracranial procedures with precise localisation of both intracranial as well as spinal lesions and prevention of damage to vital structures intraoperatively thereby significantly reducing procedure-related morbidity and mortality.
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Bahl, Dheeraj, Varun Alwadhi, Parasdeep Kaur, and Hema G. Mittal. "Impact of COVID-19 Pandemic on Routine Children Immunisation: Experience from a Tertiary Care Centre, in New Delhi, India." INDIAN JOURNAL OF NEONATAL MEDICINE AND RESEARCH, 2023. http://dx.doi.org/10.7860/ijnmr/2023/57574.2376.
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Introduction: Coronavirus Disease-2019 (COVID-19) pandemic was a global emergency in 2019 with multiphasic national lockdowns in most countries. Poor accessibility to travel and disease scare led to major fall in routine children vaccination. Aim: To study the impact of COVID-19 pandemic on routine children immunisation at a tertiary care centre in New Delhi, India. Materials and Methods: This retrospective cross-sectional study was carried out in May and June 2022, by collecting retrospective data from Immunisation Clinic of Paediatric Department of Dr. Ram Manohar Lohia hospital, a tertiary care public hospital from January 2018 to December 2021. The data of routine immunisation was further analysed to know the impact of the COVID-19 pandemic in children from birth to 5 years of age in 2019 i.e., before the lockdown versus the first and second major waves of COVID-19 in 2020 and 2021, respectively. The data was entered in an excel chart and statistical testing was conducted with Statistical Package for the Social Sciences (SPSS) version 27.0. Unpaired t-test of equal variance was used for data analysis and p <0.05 was considered as statistically significant. Results: There was a sharp fall in children receiving routine immunisation during COVID-19 pandemic in 2020(30.5%) and 2021 (24.9%) as compared to PreCOVID-19 period (2019). The overall vaccination coverage was significantly lower (p<0.001) in postlockdown-1 phase (July/Aug 2020; n=521) and postlockdown-2 phase (July/Aug 2021; n=735) in comparison to pre COVID-19 period (July/Aug 2019; n=899). Significant fall in vaccination (p<0.05) was seen in postlockdown phase 1 for birth dose vaccines, primary doses of combination vaccines, Measles-Rubella (MR-1) vaccine 1st dose, MR-2 and booster doses of Diphtheria, Pertussis, Tetanus (DPT) and for primary doses of combination vaccines, MR-1 vaccine 1st dose, MR-2 for postlockdown phase 2 (p<0.05). Conclusion: Routine immunisation for all vaccines had a major setback during unlockdown period in 2020 and 2021. There is an urge for national drive for routine Vaccine Preventable Diseases (VPD) to prevent their re-surgence.
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Daima, Mahesh, Himanshu Agrawal, Raghav Yelamanchi, Nikhil Gupta, Arun Kumar Gupta, Himanshu Tanwar, GS Divya, and CK Durga. "Active Drainage versus Passive Drainage after Modified Radical Mastectomy in Patients with Breast Carcinoma: A Randomised Controlled Trial." JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2023. http://dx.doi.org/10.7860/jcdr/2023/64440.18580.
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Introduction: Postoperative seroma formation is a common complication following Modified Radical Mastectomy (MRM), with an incidence ranging from 15-60%. There is a hypothesis that the negative pressure created by the suction drain used in MRM opens the damaged capillaries, preventing them from spontaneously closing and thereby increasing postoperative secretions. Aim: To compare active suction drains with passive drains in MRM in terms of postoperative outcomes. Materials and Methods: A randomised controlled trial with two arms, consisting of 15 patients in each arm, was conducted from November 2018 to March 2020 at the Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital in New Delhi. Patients diagnosed with localised breast carcinoma and scheduled for MRM were invited to participate. Pregnant females, patients with metastatic disease, those lost to follow-up, recurrent breast cancer patients, and those taking anticoagulants and antiplatelet agents were excluded from the study. The outcomes measured were drain output and duration of hospital stay, and postoperative morbidity, including flap necrosis, surgical site infection, seroma, and volume of seroma aspiration. The data acquired was analysed using the Statistical Package for Social Sciences (SPSS) version 21.0. Quantitative variables were compared using the Independent t-test and Mann-Whitney test as appropriate. Nominal categorical data was compared using the Chi-square or Fisher’s-exact test as appropriate. Results: Drain output was higher in the active group than in the passive group, but there was no significant difference in the average daily drain output and the average total output (652 mL versus 540 mL), except for the first two postoperative days. There was no statistically significant difference between the two groups in terms of hospital stay (6.67 days and 6.27 days), duration of drains in situ (6.67 days and 6.27 days), flap necrosis (13.3% vs. 13.3%), seroma formation (26.67% vs. 20%), and surgical site infection (26.67% vs. 20%). Conclusion: The use of suction in drains during MRM surgery is not compulsory and can save costs in resourcepoor settings. However, larger sample size studies with multicentre participation should be undertaken before making any recommendations.
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Chaturvedi, Poonam, Ajai K. Singh, Dinkar Kulshreshtha, Pradeep K. Maurya, and Anup K. Thacker. "Abstract 102: Effects of Proprioceptive Neuromuscular Facilitation Exercises on Upper Extremity Function in the Patients With Acute Stroke." Circulation: Cardiovascular Quality and Outcomes 9, suppl_2 (March 2016). http://dx.doi.org/10.1161/circoutcomes.9.suppl_2.102.
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Background: Stroke leads to impairment in upper extremity function and hence impairment in performance of activities of daily living. The studies that emphasize the effects of PNF (Proprioceptive Neuromuscular Facilitation) in acute stroke are still lacking. Aim: In this study we aim to investigate the effects of PNF exercises on upper extremity function in acute stroke. Methods: Total 35 patients were recruited from the OPD of Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow. Written informed consent was obtained from their legal relatives. Patients were given PNF exercises for scapula from the first day of their admission to the hospital and then arm pattern (D1 and D2 flexion , extension) by using rhythmic initiation technique until discharge from the hospital (Mean 15.2+ 3.9days). PNF was given twice daily for 30 minutes for 5 days a week. Arm recovery was assessed by Fugl- Meyer scale and arm function was assessed by Arm Motor Ability Test (AMAT). Patients were followed up in neurology OPD on monthly basis up to 6 months. Results: Out of 35, 26 were of ischemic stroke and 9 were of haemorrhagic stroke. 17 were left sided and 18 were right sided hemiplegics. 15 were females and 20 were males. Mean age of the patient was 56.45 + 12.14. Glasgow coma scale at the time of admission was 14.6+ .338. Mean NIH stroke severity was 7.48 + 3.95, shows all the patients were of mild to moderate stroke. The mean Fugl- Meyer score before the intervention was 151.60+ 41.72 with SE= 7.05 and after intervention was 209.9. Paired t - test was run to determine if PNF is effective in improving upper extremity function in acute stroke t (34)= - 9.920, p= .001. There was significant improvement in upper extremity functions. The mean AMAT score before intervention was 63.53+ 28.32 and after intervention was 120.22+ 12.12 and t(34)= 5.92 p= .026 which shows significant improvement in upper extremity function. Conclusion: Proprioceptive neuromuscular facilitation exercises are very effective in generating voluntary control and improving functional activities of daily living if given from the first day of stroke. For improvement in arm function the intervention should be started first from scapula. Due to the irradiation effect, there is generation and improvement of tone and power in upper extremity. Acknowledgements: This study was supported by the department of Science and Technology, New Delhi, India.
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Mishra, Madhusudan, Swagat Mahapatra, Vineet Kumar, Pankaj Aggarwal, Sachin AvaVasthi, Mohd Ammar Aslam, and Prabhat Kumar. "Functional Outcome Analysis of Cubitus Varus Deformity Treatment in Children undergoing Modified French Osteotomy with Technical Modification: A Retrospective Cohort Study." JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2023. http://dx.doi.org/10.7860/jcdr/2023/63239.18112.
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Introduction: Lateral closing wedge osteotomy is an accepted correction method for cubitus varus deformity. The techniques used to fix the osteotomy mostly lead to either angulation or loss of correction during the final tightening of the Stainless Steel (SS) wire at the osteotomy site. The records for patients undergoing two modifications in a conventional modified French Osteotomy were analysed. Four wires, two proximal and two distal to the osteotomy site for precision and guided compression over the other additional Kirschner wire (K-wire) at the osteotomy site, were the two modifications in these patients. Aim: To analyse the functional outcome of cubitus varus deformity in children treated with technical modifications of modified French osteotomy. Materials and Methods: This was a retrospective cohort study done at the Department of Orthopaedics, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India. The study duration was three years (from April 2019 to April 2022). A total of 34 cubitus varus deformity patients were included in this study who were operated with lateral closing wedge-modified French osteotomy with technical modification by K-wires. The patients were followed-up for a minimum of six months. The results were analysed using Quick Disabilities of the Arm, Shoulder and Hand (DASH) and Flynn’s criteria. Statistical Package for the Social Sciences (SPSS) version 21.0 was used and p-value<0.05 was considered statistically significant. Results: Twenty-three (67.65%) cases were male, and 11 (32.35%) were female. Twenty-eight (82.4%) patients were children aged 5 to 10 years, 20 (58.8%) cases involved a rightsided deformity, while the remaining 14 (41.2%) had left-side involvement. The mean age was 7.58±2.49 years (ranging from 3 to 12 years). The mean time since they had initial trauma was 2.42±1.28 years. The preoperative mean cubitus varus angle was 11.73±2.39°, the mean hyperextension was 13.27±2.69°, and the mean internal rotation was 36.48±5.01°. Postoperative six months’ corrective mean carrying angle (valgus) was 5.79±2.46°, corrective hyperextension was 2.18±1.06°, and corrective internal rotation was 5.39±2.74°. Out of 34 cases, all had excellent results as analysed by Quick DASH and Flynn’s criteria. Conclusion: The technical modifications by K-wires in conventional modified French osteotomy provided guided compression over the osteotomy site, ensured perfect implant placement without cutting out the screw, and improved 3D (Dimensional) correction of cubitus varus deformity. So, it’s safe, simple, and effective.
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Pasricha, Navbir, Eti Sthapak, Ashish Thapar, and Rajan Bhatnagar. "Morphometric Analysis of Age and Genderrelated Variations of Corpus Callosum by using Magnetic Resonance Imaging: A Cross-sectional Study." JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2023. http://dx.doi.org/10.7860/jcdr/2023/63555.18078.
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Introduction: The Corpus Callosum (CC) is the largest commissural bundle connecting the two cerebral hemispheres which is involved in learning, memory, thinking, three-dimensional visual ability, executive functions as well as behavioural patterns. Exact morphometric dimensions are a prerequisite before surgical interventions and stereotactic approaches to the foramen of Munro and also in cases of callosectomy for intractable epilepsy as inconsistencies exist regarding gender and age related changes of CC. Also, most published studies are from the western world and very few studies are from South-east Asia and India. Aim: To study the morphometry of CC and possible age, gender related variations using Magnetic Resonance Imaging (MRI) in the North Indian population. Materials and Methods: An observational, cross-sectional study was done in Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India from January 2019 to October 2019. A total of 200 head MRI scans, using PACS (Picture Archiving and Communication System) System Viewer software were evaluated. In all the scans, length, height, minimum and maximum thickness of CC were studied. The data were statistically analysed using STATA Software for age and gender-related differences. Student’s t-test, one-way Analysis of Variance (ANOVA), linear regression and Pearson correlation coefficient were applied. Results: The study showed decrease in thickness of body, rostrum and splenium with age, linked to generalised degeneration of cortical neurons or atrophy of white matter with advancing age. Also, there was increase in length with age, possibly due to age mediated structural dilatation in lateral ventricles. Statistically significant sexual dimorphism was observed as a larger CC length in males (74.24±4.26 mm) than females (72.67±4.16 mm) (p-value<0.001) and larger brain length in males (171.75±5.51 mm) as compared to females (163.70±5.75 mm) (p-value<0.001). Males also showed greater splenial thickness (10.15±1.79 mm) in comparison to females (9.68±1.51 mm) (p-value<0.001) which may represent the importance of distribution of fibres of visual cortex in males due to larger occipital lobe. Conclusion: The present study documented morphometry of normal CC in different gender and age groups and observed sexual dimorphism, especially greater CC length and splenial thickness in males than females. With age increase in the length and decrease in thickness of CC was seen.
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Singh, Neha, James Marak, Pranjali Joshi, and Deepak Kumar Singh. "Morphological and Distribution Pattern of Calcifications on Full Field Digital Mammography versus Digital Breast Tomosynthesis and Comparison of Diagnostic Abilities of the Two Modalities: A Retrospective Study." JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2023. http://dx.doi.org/10.7860/jcdr/2023/55632.17675.
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Introduction: Microcalcification (MC) is an effective and sometimes the only indicator of breast cancer. Early detection and characterisation of malignant MC can facilitate early diagnosis and timely treatment of breast cancer. However, due to the small size and low contrast as compared to the background parenchyma, it is difficult and time-consuming for radiologists to accurately evaluate MC. Aim: To compare the diagnostic abilities of Full Field Digital Mammography (FFDM) and Digital Breast Tomosynthesis (DBT) in the detection and characterisation of breast calcifications. Materials and Methods: This retrospective descriptive study was conducted in the year 2022 at the breast imaging unit of Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India and data of patients who had undergone FFDM and DBT between March 2019- September 2020 was collected. Mammograms of 702 women with 1217 breasts were evaluated and MC was detected in 622 breasts. Based on the morphology and distribution pattern, Breast Imaging Reporting and Data System (BI-RADS) assessment Category was assigned from 2 to 5. Cases with BI-RADS 2 and 3 were followed-up by repeat Mammograms at 6-month to 1-year intervals. Cases with BI-RADS 4 and 5 were biopsied under stereotactic or ultrasound guidance. Histopathology findings and the stability of the calcifications on sequential mammograms were considered the gold standard for final BI-RADS categorisation. The Chi-square test was applied for the comparison of FFDM and DBT. Results: Typically benign morphology MC was noted in 508 (81.67%) of breasts on FFDM and 505 (80.67%) on DBT. Suspicious morphology MC was noted in 114 (18.33%) of breasts on FFDM and 121 (19.33%) on DBT. Vascular calcification was the most common benign MC seen in 233 cases (37.45%) on FFDM and 244 cases (38.9%) on DBT. Similarly, fine pleomorphic was the most common suspicious morphology MC on FFDM and DBT both seen in 47 cases (7.5%) and 44 cases (7.02%), respectively. The most common distribution pattern was diffuse seen in 582 cases (93.56%) on FFDM and 583 cases (93.13%) on DBT, respectively. No significant difference was observed (p=0.283) in the rate of detection or characterisation of MC by FFDM or DBT. The sensitivity of both modalities were almost similar (97.7% and 97.9%) without any significant difference (p=0.278). Similarly, there was no difference in the specificity (94.9% and 94.4%, respectively, p=0.289). Conclusion: The performance of FFDM and DBT for the detection and characterisation of MC is not significantly different.
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Avasthi, Sachin, Swagat Mahapatra, Pankaj Aggarwal, Vineet Kumar, Ammar Aslam, Prabhat Kumar, and Madhusudan Mishra. "Outcome Analysis of En-bloc Excision and Endoprosthetic Replacement among the Cases Operated for Distal Femoral and Proximal Tibial Giant Cell Tumour around the Knee: A Retrospective Study." JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2023. http://dx.doi.org/10.7860/jcdr/2023/62529.17792.
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Introduction: Giant Cell Tumour (GCT) around the knee joint is the most common site for this locally malignant bone tumour and, in advanced stages, requires excision of the tumour mass. Current recommendations promote joint salvage procedures in allograft or mega prosthetic replacement. Patients undergoing this surgery need massive changes in their lifestyle to cope with their activities of daily living. The psychological and social impact following these procedures has not been extensively studied. Aim: To observe the long term functional results as well as the impact on quality of life in patients undergoing endoprosthetic replacements in GCT around the knee with emphasis on any difference in results among the cases operated for distal femoral and proximal tibial GCT. Materials and Methods: This retrospective study was conducted at Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow from June 2015 to June 2019 with a total sample size of 21 cases. The two groups formed were; one having GCT of distal end femur and the other group with GCT of proximal end tibia. The evaluation was done for outcome measures by Oxford Knee Score (OKS) and Musculo Skeletal Tumour Society score (MSTS) for their functional outcome and Short Form Health Survey (SF12) for their quality of life effect at two years postoperatively. Students unpaired t-test was performed for intergroup analysis and Analysis of Variance (ANOVA) was done for within the group analysis for subsequent follow-up visits. Data was analysed using Statistical Package for Social Sciences (SPSS) version 21. Results: The mean age of study population was 33.67±8.674 years. The male-female distribution was insignificant (p=0.673), providing us with a homogenous study group. Recurrent GCT was found significantly more commonly in the proximal tibia group than in the distal femur group (p=0.031). Comparison of OKS and MSTS preoperatively, at six months, at one year, and two years showed statistically significant improvement in successive follow-ups in both the distal femur and proximal tibia groups (p<0.001 in both groups). Intergroup analysis also showed significantly better scores in the distal femur group compared to the proximal tibia group in the preoperative period and all successive follow-ups. On intergroup analysis at 2 years, both the OKS (p=0.020*) and MSTS score (p<0.0001) were found to be statistically significant. SF-12 mental and physical scores preoperatively also showed statistically significant improvement in all cases (p<0.001 for mental and physical components. Conclusion: Early functional outcomes of en-bloc excision and reconstruction with modular endoprosthesis are good in terms of joint function and the patient’s overall mental and physical well-being.
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Prasad, Archa, Himanshu Agrawal, Nikhil Gupta, Arun Kumar Gupta, Minakshi Bharadwaj, and CK Durga. "Association of CD10 and VEGF Expression with Tumour Characteristics and Treatment Response in Patients of Carcinoma BreastA Prospective Cohort Study." JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2023. http://dx.doi.org/10.7860/jcdr/2023/62235.17833.
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Introduction: Majority of breast cancer patients receive systemic therapy. This has led to an extensive search for effective factors to predict the outcome. Two such markers for breast cancer are Cluster of Differentiation 10 (CD10) and Vascular Endothelial Growth Factor (VEGF). There is limited data available in the literature to support these parameters in breast cancer patients, especially from the Indian subcontinent. Aim: To ascertain the association of pre-chemotherapy levels of CD10 and VEGF with tumour load in breast cancer and treatment response. Materials and Methods: A prospective cohort study was conducted in the Department of Surgery in collaboration with the Department of Pathology at Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India, from November 2015 to February 2017. A total of 39 patients with Locally Advanced Breast Cancer (LABC) were included in the study. Preoperative levels of CD10 and VEGF were estimated in large needle core biopsy specimens. Standard anthracycline based chemotherapy was given to all patients as a 21 days cycle for three cycles. All patients underwent modified radical mastectomy after Neoadjuvant Chemotherapy (NACT). Levels of CD10 and VEGF were estimated again in the mastectomy specimen. Increase/decrease or no change in VEGF and CD10 expression percentage was ascertained for each patient after systemic therapy. Variables that were studied in the present study were Tumour, Nodes, and Metastasis (TNM) staging of patient, expression of VEGF and CD10 in large needle core biopsy specimens and its association with tumour load, response to NACT and its association with CD10 and VEGF and histopathological characteristics like presence or absence of lymphovascular invasion oestrogen, progesterone and Human Epidermal Growth factor Receptor 2 (HER2)/neu receptor status. Statistical analysis was done using the Statistical Package for Social Sciences (SPSS) version 22.0. Association between two ordinal variables was established using Kruskal-Wallis test. A comparison of ordinal paired data was done using Wilcoxon signed-rank sum test. The p-value <0.05 was taken as significant. Results: The mean age of study participants was 42.0±11.4 years. Increase in TNM staging lead to higher CD10 and VEGF expression (p-value<0.05 and <0.029, respectively). There was a significant reduction in CD10 and VEGF expression postchemotherapy (p-value<0.05). CD10 expression was found higher in subjects with ER-negative status (22 patients) with p-value=0.014 and HER2/neu positive status (19 patients) with p-value=0.028. Subjects with HER2/neu positive status had higher VEGF expression (20 patients) with p-value=0.032. Conclusion: CD10 and VEGF can be used as independent markers for indicating poor prognosis and can be used as target for development of novel therapies in carcinoma breast.
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Pulukool, Sujith Kumar, Sai Krishna Srimadh Bhagavatham, Sudarshan K. Vijay, Abdulrahman I. Almansour, Sandeep Chaudhary, Farah Abuyousef, Na’il Saleh, and Pratima Tripathi. "Noninvasive cardiac-specific biomarkers for the diagnosis and prevention of vascular stenosis in cardiovascular disorder." Frontiers in Pharmacology 15 (April 25, 2024). http://dx.doi.org/10.3389/fphar.2024.1376226.
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Background:The most frequent lesion in the blood vessels feeding the myocardium is vascular stenosis, a condition that develops slowly but can prove to be deadly in a long run. Non-invasive biomarkers could play a significant role in timely diagnosis, detection and management for vascular stenosis events associated with cardiovascular disorders.Aims:The study aimed to investigate high sensitivity troponin I (hs-TnI), cardiac troponin I (c-TnI) and high sensitivity C-reactive protein (hs-CRP) that may be used solely or in combination in detecting the extent of vascular stenosis in CVD patients.Methodology:274 patients with dyspnea/orthopnea complaints visiting the cardiologists were enrolled in this study. Angiographic study was conducted on the enrolled patients to examine the extent of stenosis in the five prominent vessels (LDA, LCX, PDA/PLV, RCA, and OM) connected to the myocardium. Samples from all the cases suspected to be having coronary artery stenosis were collected, and subjected to biochemical evaluation of certain cardiac inflammatory biomarkers (c-TnI, hsTn-I and hs-CRP) to check their sensitivity with the level of vascular stenosis. The extent of mild and culprit stenosis was detected during angiographic examination and the same was reported in the form significant (≥50% stenosis in the vessels) and non-significant (<50% stenosis in the vessels) Carotid Stenosis. Ethical Clearance for the study was provided by Dr. Ram Manohar Lohia Institute of Medical Sciences Institutional Ethical Committee. Informed consent was obtained from all the participants enrolled in the study.Results:We observed that 85% of the total population enrolled in this study was suffering from hypertension followed by 62.40% detected with sporadic episodes of chest pain. Most of the subjects (42% of the total population) had stenosis in their LAD followed by 38% who had stenosis in their RCA. Almost 23% patients were reported to have stenosis in their LCX followed by OM (18% patients), PDA/PLV (13%) and only 10% patients had blockage problem in their diagonal. 24% of the subjects were found to have stenosis in a single vessel and hence were categorized in the Single Vessel Disease (SVD) group while 76% were having stenosis in two or more than two arteries (Multiple Vessel Disease). hs-TnI level was found to be correlated with the levels of stenosis and was higher in the MVD group as compared to the SVD group.Conclusion:hs-TnI could be used as a novel marker as it shows prominence in detecting the level of stenosis quite earlier as compared to c-TnI which gets detected only after a long duration in the CVD patients admitted for angiography. hs- CRP gets readily detected as inflammation marker in these patients and hence could be used in combination with hs-TnI to detect the risk of developing coronary artery disease.
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Sinha, Nitin, Divesh Jalan, and Princi Jain. "Role of Modified RALES and Brixia Scores Section in Predicting the COVID-19 Positivity among the Suspected Patients: A Cross-sectional Observational Study." JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2022. http://dx.doi.org/10.7860/jcdr/2022/51204.16102.
Full textAbstract:
Introduction: Computed Tomography (CT) chest plays an important role in triaging and managing patients of suspected COVID-19, especially in those where Coronavirus Disease 2019 (COVID-19) report is pending but CT chest has constraints of availability and cost. Chest X-ray (CXR) is a readily available investigation and is cheaper than a CT chest. Hence, any scoring on CXR which proves to be helpful in triaging and managing suspected COVID19 patients will alleviate the dependency on CT chest. Modified Radiographic Assessment of Lung Edema Score (mRALES) and Brixia scores have been used to assess severity of disease and prognosis in COVID-19 confirmed cases. However, these two scores have never been used as a method to predict the confirmed COVID-19 pateints among the the suspected COVID-19 cases. Aim: To evaluate the role of mRALES and Brixia score along with clinical and laboratory parameters in predicting confirmed positive cases among suspected COVID-19 patients. Materials and Methods: This retrospective cross-sectional, observational study was conducted in Department of Medicine at Atal Bihari Vajpayee Institute of Medical Sciences (ABVIMS) and Dr. Ram Manohar Lohia Hospital, New Delhi, India, from 1st to 15th December 2020. Case records of patients admitted with severe acute respiratory illness (suspected COVID-19) were accessed and used to fill up a proforma where clinical and laboratory parameters were recorded. Chest radiographs (posteroanterior and anteroposterior) of the patients were evaluated to calculate mRALES and Brixia scores. Sensitivity, specificity, positive preditive value and negative predictive value were calculated. The p-value <0.05 was considered as statistically significant. Results: Out of the 113 patients, 62 were males and 51 females. The COVID-19 positivity rate was 15.04% (n=17). Mean age of patients was 52.64±15.63 years. Overall, the mean mRALES and Brixia scores were not statistically different between suspected (mRALES=3.94±2.51, Brixia=7.29±4.642), and confirmed COVID19 (mRALES=4.25±2.56, Brixia=7.73±4.84) patients. However, in the subgroup of patients with history of obstructive airway disease, Brixia score was significantly higher among COVID-19 positive patients (7.09±4.70) as compared to COVID-19 suspected patients (0.53±4.31). Presence of low TLC {<9550/mm3 with sensitivity of 70.62%, specificity of 67.3%, Positive Predictive Value (PPV) of 26.7% and Negative Predictive Value (NPV) of 92.4%} and low ANC {< 7580/mm3 with sensitivity of 64.7%, specificity of 63.2%, PPV of 22.9% and NPV of 90.5%} significantly predicted the COVID-19 positivity among the suspected COVID-19 patients. Conclusion: mRALES and Brixia scores on CXR are not significantly different between suspected and confirmed COVID-19 patients and hence, cannot be used to judge who among suspected COVID-19 patients will turn out to be COVID-19 positive later. However, a TLC of less than 9550/ mm3 and an ANC of less than 7580/mm3 can predict COVID-19 positivity among suspected patients.