Annals of International Medical and Dental Research (AIMDR) 

Vol-7, Issue-6 | November-December2021

Test- Retest Reliability of Y-Balance Test in Collegiate Students

Md. Farhan Alam1

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 1-9

Test- Retest Reliability of Y-Balance Test in Collegiate Students

Md. Farhan Alam1*

Abstract

Background: Y Balance Test (YBT) is a device which is used to assess dynamic balance and has been used for various purposes including lower limb injury prediction, assessment of post-rehabilitation improvement, analysis of neuromuscular performance and functional effects of training. It has three reach directions Anterior, posteromedial and posterolateral. In order to improve the measurement protocol of the Star Excursion Balance Test (SEBT), the YBT has been developed. Objectives: To assess the test-retest reliability, standard error of measurement (SEM), and smallest detectable difference (SDD) associated with the YBT. Methods: Maximum reach distances were measured using the YBT in all the three direction on a sample of 20 sedentary collegiate students (10 male, 10 female; age 18-35 years). Intraclass correlations coefficients (ICC), SEM and SDD values were calculated to obtain reliability and measurement error.Results:Test-retest reliability for YBT was excellent, with ICCs ranging from 0.93 to 0.95. The values of 95% confidence intervals (CI), SEM and SDD ranged from 0.83 to 0.98, 1.37 to 1.93 and 3.8 to 5.32 %, respectively. Conclusions:The YBT is an extremely reliable tool for measuring dynamic balance in collegiate students. Result of the present study substantiates the opinion that change in YBT scores are due to change in an individual’s performance and are not due to random error. Changes in normalized scores greater than SDD are needed to confidently ascertain a real change in YBT performance.

Dynamic Balance, Y Balance Test (YBT), Dominant Limb, Limb Length.

Echocardiographic Assessment of Cardiovascular Hemodynamics in Pre-eclampsia and Normal Pregnancy

Jyothi1, Harpoonam Manku2*,Amritpal Kaur3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 10-19

Echocardiographic Assessment of Cardiovascular Hemodynamics in Pre-eclampsia and Normal Pregnancy

Jyothi1, Harpoonam Manku2*,Amritpal Kaur3

Abstract

Background: To assess maternal cardiovascular function using echocardiography in normal and preeclamptic women in the third trimester of pregnancy. Methods: 100 subjects of which 50 with preeclampsia, not on medication and 50 normotensive women with >34 weeks gestation with singleton pregnancy were recruited. baseline characterstics were studied with systolic and diastolic parameters on echocardiography. Results:The following parameters were significantly higher in preeclamptic subjects as compared to normotensive controls-mean cardiac output (7.69±0.33 vs 6.39±0.31l/min); mean LV mass (144.62 ±9.12 vs 116.92±5.15g); total vascular resistance (1224.44±73.59 vs 1073.6±54.85dyne/sec/cm5.). mean Ewave(0.99±0.12 vs 0.65±0.80 m/sec); mean A wave(0.64±0.12 vs 0.51±0.007m/sec);meanIVRT(96.59±4.76 vs 82.71±3.38ms) Student ‘t’ test was used as a test of significance. Conclusions:Women with preeclampsia have significant systolic and diastolic dysfunction compared to normotensive controls. Blood pressure monitoring alone is insufficient to identify risk of cardiovascular complications effectively in these subjects.

Echocardiography, Maternal, Diastolic, Systolic, Normal, Preeclampsia.

A Study of Neonatal Septicaemia Based on CRP and Blood Culture and Sensitivity in NICU of Tertiary Care Centre

Shruti Dhale2, Mohammed Kashif Ali1*,,Fouziya Sultana S3, Kuldip Shimpi4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 20-25

A Study of Neonatal Septicaemia Based on CRP and Blood Culture and Sensitivity in NICU of Tertiary Care Centre

Shruti Dhale2, Mohammed Kashif Ali1*,,Fouziya Sultana S3, Kuldip Shimpi4

Abstract

Background: In neonates, septicaemia is one of leading cause of morbidity and mortality. Therefore, timely diagnosis is important to prevent fatal outcome. C-reactive protein is an important biomarker that aids in the timely diagnosis of neonatal septicaemia.Aim: The present study was carried out to compare the accuracy of CRP in the diagnosis of neonatal septicaemia with blood culture. Methods: Two hundred and one neonates with clinical suspicion of sepsis were prospectively studied over a 6 month period. Blood was obtained from each subject recruited for the qualitative estimation of CRP. Blood culture was used as gold standard for diagnosis of NNS. Results:Of the 201 neonates studied, 54 were blood culture positive while 71 were CRP positive. The sensitivity, specificity, positive and negative predictive values of CRP were 92.5%, 97.2%, 92.5%, 97.2% respectively. Conclusions:The specificity and sensitivity of CRP against blood culture strengthen the use of this acute phase protein in the diagnosis of neonatal sepsis.

CRP and Blood culture and sensitivity.

Study of Acute Kidney Injury in Children Admitted In Pediatric ICU

Sucheta Munshi1, Bhavesh Patel2, Shaishav Patel3*, Vrajana Parikh4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 26-35

Study of Acute Kidney Injury in Children Admitted In Pediatric ICU

Sucheta Munshi1, Bhavesh Patel2, Shaishav Patel3*, Vrajana Parikh4

Abstract

Background: Acute Kidney Injury(AKI) has been traditionally defined as abrupt loss of kidney function leading to a rapid decline in the glomerular filtration leading to a rapid decline in the glomerular filtration rate(GFR), accumulation of waste products such as blood urea nitrogen(BUN) and creatinine, and dysregulation of extracellular volume and electrolyte homeostasis. AKI is defined as: Increase in serum creatinine by >=0.3 mg/dl from baseline within 48 hours; or increase in serum creatinine to >=1.5 times baseline within the prior 7 days; or urine output<=0.5 ml/kg/hr for 6 hours.Aim:To study the incidence of AKI in children admitted in PICU in civil hospital Ahmedabad, To various clinical features and complications of AKI in children, To study short term outcome of AKI in children. Methods: It is prospective observational study done over study period of 1/8/2019 to 5/2/2020. Total 50 patients admiited in PICU were enrolled in study after taking consent of their guardians and investigations for AKI were done and managed accordingly and outcomes was recorded.Patients having pre existing chronic renal diseases are excluded from study. Results:In present study, out of total patients admitted in PICU over a given study period, the incidence of AKI is 11%. And highest number of patients were noted in age group of 1 to 5 years. In this study, most common etiology of AKI is found to be Septicemia, which comprises 44% of total patients of AKI.  In this study, oliguria is the commonest symptom seen in 94% patients of AKI, Hyperkalemia is the commonest electrolyte abnormality seen in 36% patients of AKI and Dyselectrolytemia is the most common complication seen in 64% patients of AKI in present study. Outcomes in form of discharge, Expiry and DAMA is noted as 66%,24%, and 10% respectively in this study. Conclusions:AKI affects a large proportion of critically ill children, especially the younger age group. Thus, all such patients should be monitored for development of AKI. Monitoring of electrolytes should be done as dyselectrolytemia is most common complication in AKI. Proper monitoring and early detection of AKI and timely treatment reduces the mortality of patients.

Acute Kideny Injury, Dyselectrolytemia.

Ventricular Morphometry and Resistive Index in Pre and Post Treatment Evaluation of Hydrocephalus Using Ultrasonogram

Manu Srinivas Hunasanahalli1, Vinodh Damala2*,Ramesh Ramagatta Lakshmana Nayak3,Shramana Bagchi4,Rashmi Devaraj5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 36-42

Ventricular Morphometry and Resistive Index in Pre and Post Treatment Evaluation of Hydrocephalus Using Ultrasonogram

Manu Srinivas Hunasanahalli1, Vinodh Damala2*,Ramesh Ramagatta Lakshmana Nayak3,Shramana Bagchi4,Rashmi Devaraj5

Abstract

Background: Germinal matrix hemorrhage (GMH) represents one of the most important adverse neurologic event for preterm and very low birth weight (VLBW) newborns during neonatal period. Hydrocephalus is a mechanical complication of different pathologic conditions and a disease process in itself. Morphologic imaging is used to evaluate suspected hydrocephalus. Hence; the present study was conducted to measure the size of lateral ventricles using ultrasound and to assess the resistive index of anterior cerebral artery using Doppler sonography. Methods: Infants (0-1year age) who presented to the Department of Pediatric Radiology, Indira Gandhi Institute of Child Health, Bengaluru, for neurosonogram with clinical suspicion of hydrocephalus were enrolled in the present study. Transcranial color doppler sonography provides a non-invasive method of monitoring of the blood flow velocities in cerebral vessels. The data was entered in MS Excel 2007 and analysed in Statistical Package for Social Science (SPSS) software, version 20.0 (SPSS Inc., Chicago, IL, USA). Results:Out of 50 subjects, 29 were males while the remaining 21 were females. Mean age was 2.3 months. Mean Levene ventricular index during pre-treatment and post-treatment phase was 3.6 cm and 2.3 cm respectively. Mean Ventricular- hemisphere ratio during pre-treatment and post-treatment phase was 0.61 and 0.45 respectively. Mean Davies anterior horn width during pre-treatment and post-treatment phase was 3.7 cm and 2.6 cm respectively. Mean resistive index of the anterior cerebral artery was 0.78 and 0.71 during pre-treatment and post-treatment respectively. Conclusions:Duplex Doppler ultrasonography thus provides us with a non-invasive and easily repeatable means of monitoring for further increase in ventricular size as well as a method of monitoring cerebral haemodynamic change in hydrocephalus patients.

Hydrocephalus, Ultrasound.

Role of Plain Computed Tomography in Evaluation of the Spectrum of Intracranial Calcification in Pediatric Population

Manu Srinivas Hunasanahalli1, Shramana Bagchi2*, Ramesh Ramagatta Lakshmana Nayak3, Vinodh Damala4,Rashmi Devaraj5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 43-52

Role of Plain Computed Tomography in Evaluation of the Spectrum of Intracranial Calcification in Pediatric Population

Manu Srinivas Hunasanahalli1, Shramana Bagchi2*, Ramesh Ramagatta Lakshmana Nayak3, Vinodh Damala4,Rashmi Devaraj5

Abstract

Background: Intracranial calcification (ICC) refers to calcification within the cranial cavity, and is most commonly represented by calcification within the parenchyma of the brain or its vasculature. Hence the present study was undertaken for assessing the role of plain computed tomography in evaluation of the spectrum of intracranial calcification in pediatric population. Methods: A total of 118 pediatric subjects were enrolled in the present study. A Proforma was made and complete demographic and clinical data of all the subjects was noted. CT findings were recorded in separate Proforma. All the results were recorded in Microsoft excel sheet and were subjected to statistical analysis. SPSS software was used for data assessment. Results:Out of 118 patients with intracranial calcification, physiologic calcification and pathologic calcification was seen in 22% percent and 78% percent of the patients respectively. Out of 26 patients with physiologic calcification, Dural, choroidal and habenular calcification was seen in 9.3% , 6.8% and 6% percent of the patients respectively. Among 78 patients with pathologic calcification, TORCH, Metabollic, Tuberus sclerosis and mineralisingmicroangiopathy were seen in 32%, 13.5 %, 10.1 % and 5.0 % respectively Non-significant results were obtained while correlating Age and gender-wise distribution of patients with different intracranial calcification. Conclusions:It can be concluded that plain computed tomography is an important modality in the evaluation of pediatric intracranial calcifications. It can help differentiate physiologic from pathologic calcifications. Based on the location, pattern and morphology of the calcification and with relevant clinical information, it is possible to arrive at an accurate etiology.

Intracranial calcification, Pediatric.

Monoclonal Gammopathy of Undetermined Significance in a Case of Type 2 Diabetes Mellitus

Mohanvir Kaur1, Swati Saini2*, Kanwardeep Kau3, Shaina Goyal4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 53-56

Monoclonal Gammopathy of Undetermined Significance in a Case of Type 2 Diabetes Mellitus

Mohanvir Kaur1, Swati Saini2*, Kanwardeep Kau3, Shaina Goyal4

Abstract

Background: A case of Non-insulin dependent diabetes mellitus (NIDDM) in the clinical setting presented with proteinuria, hypoalbuminemia, paraproteinemia, deranged renal functions and possibility of Multiple Myeloma in bone scan. The diagnostic challenge was resolved by bone marrow aspiration and serum protein electrophoresis. This case demonstrates the differential diagnoses of paraproteinemia in clinical scenario of NIDDM which include diabetic nephropathy, multiple myeloma and Monoclonal gammopathy of undetermined significance (MGUS).

Diabetes mellitus, Monoclonal gammopathy, Non-insulin dependent diabetes mellitus.

Screening of Hypertension as a Predictable Risk Factors in Metabolic Syndrome in Urban and Rural Populations

Yatish1, DhemendraPratap Singh2*, Pranav Singhal3, Ankit Jain4, Anil K Kem5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 57-65

Screening of Hypertension as a Predictable Risk Factors in Metabolic Syndrome in Urban and Rural Populations

Yatish1, DhemendraPratap Singh2*, Pranav Singhal3, Ankit Jain4, Anil K Kem5

Abstract

Background: The Global Burden of Diseases study has reported that hypertension is the most important cardiovascular risk factor in this region and responsible for the largest burden of disease and mortality. Present estimates suggest that a 2 mm Hg population -wide decrease in systolic BP can lead to prevention of more than 181,000stroke and 183,000 coronary heart disease deaths in India. Hypertension is the new era pandemic which is the leading cause of mortality in the world and is ranked third as a cause of disability-adjusted life years. HTN (also known as high blood pressure) affects millions of people. High BP is defined as BP = 140/90 mmhg. Approx. 77.9 million American adults & approx. 970 million people worldwide have high Bp. It is estimated that by 2025, 1.56 billion adults will be living with HTN. The overall is similar b/w both men & women but differ with age. For those younger than 45 years old, high BP is more common in men than women. For those 65 years old or older, high b p affects women more than men. BP value increases with age and HTN is very common with elderly. The life time risk of developing HTN among those 53 yrs of age and older who currently have normal BP is 90%. African Americans (47% women 43 % in men) develop high blood pressure more often & at an earlier age, followed by concussions (31% in women, 33 % in male) & Mexicans Americans (29% in women, 30 % in men). HTN costs the nation approx. 147.5 billion each year. This includes the cost of health care services, Medicare’s to treat high b p and missed days of workers.Escalating cardiovascular risk factors such as smoking, high blood pressure (BP), high low- density lipoprotein (LDL) cholesterol, low high-density lipoprotein (HDL) cholesterol, metabolic syndrome and diabetes are the major risk factors associated with the increasing CVD in India. Aim: The aim and objectives of the study were to estimate and compare the prevalence of hypertension among urban and rural population; and to assess the factors associated with Hypertension among the study population. The present study will estimate the prevalence of hypertension and identify & compare some socio- demographic and lifestyle risk factors associated with urban and rural population of Hapur. Methods: The present study was a across-sectional study conducted in Saraswathi institute of medical Sciences, district Hapur. Hapur is a small town in western U.P. Study included a total of1000 subjects from urban and rural population of Hapur. Individuals greater than 18 years of age were included. Data regarding basic demographic characteristics were collected along with anthropometric measurements including height and weight. They were randomly selected from urban and rural populations of Hapur using modified luster sampling method. Three Blood Pressure readings were recorded using mercury sphygmomanometer in the sitting position and the mean of two was considered for analysis. Data entry and analysis was done using SPSS20 for windows version 8.1.

Results:The prevalence of hypertension was high in urban area (31.4%). Though prevalence of hypertension in rural area is low when compared to urban, it can be observed that it is increasing over time to match the urban rate. Most of the study population belonged to age group of2 0–29yrs (27%) followedby50–59yrs (19%).45% of the study population was constituted by males and the rest 55% by females. The prevalence of hypertension was 23% in the present study, which is compare able to the estimates given by World Health Organization (23%).Around 33% o the population had blood pressure in the normal range and 47% of the population had pre-hypertension. The prevalence of hypertension was 30% in the urban areas and 16% in the rural areas. This difference was found to best artistically insignificant. Conclusions:ANO. of risk factors were attributed for the development of hypertension–increasing age, sedentary occupation, higher socio – economic status, extra salt intake, family history of hypertension, reduced physical activity, tobacco smoking, smokeless tobacco consumption, alcohol consumption,BMI≥25and high waist- hip ratio.

Hypertension, stroke, risk factors, population.

Assessment of Influenza Associated Neurological Diseases in Children

Priyanka Jain1*, Ashish Jain2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 66-71

Assessment of Influenza Associated Neurological Diseases in Children

Priyanka Jain1*, Ashish Jain2

Abstract

Background: To assess influenza associated neurological diseases in children. Materials & Methods: One hundred twenty- eight children age ranged 2 months to 14 years with influenza and associated neurological disease of both genders were selected. Parameters such as length of stay, complete blood count, CSF biochemistry and clinical features were recorded. Results: The mean time between flu-like symptoms and neurological manifestations was 1.2 days, duration of hospitalization was 9.2 days. Clinical presentation at admission was fever seen in 120, neurologic manifestations were seizures in 84, altered consciousness in96, ataxia in 52 and respiratory manifestations were cough in 34 and dyspnea in 67. Complications were acute necrotizing encephalitis (ANE) in 68, hemorrhagic shock in 34 and mild encephalopathy with reversible splenial lesions (MERS) in 26. A significant difference was observed (P< 0.05). Conclusion: All children with acute neurological features during influenza season should be assessed for influenza-associated CNS complications. Most common complication was acute necrotizing encephalitis.

Acute necrotizing encephalitis, Hemorrhagic shock, Influenza, Neurological diseases.

Assessment of Corneal Endothelial Morphology and Central Corneal Thickness in Patients with Type 2 Diabetes Mellitus

Ashish Jain1*, Priyanka Jain2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 72-76

Assessment of Corneal Endothelial Morphology and Central Corneal Thickness in Patients with Type 2 Diabetes Mellitus

Ashish Jain1*, Priyanka Jain2

Abstract

Background:To assess corneal endothelial morphology and central corneal thickness in patients with type 2 diabetes mellitus (T2DM).Methods: Ninety- four type II diabetes mellitus patients (Group I) and normal subjects without diabetes were selected as control (group II). Visual acuity, slit‑lamp examination, intraocular pressure measurement, corneal endothelial structure and central corneal thickness (CCT) were recorded by noncontact specular microscopy. Results: Visual acuity was 0.56 dm in group I and 0.64 dm in group II, IOP was 18.2 mm Hg in group I and 15.8 mm Hg in group II, FBG was 124.8 mg/dl in group I and 90.2 mg/dl in group II and PPBG was 184.2 mg/dl in group I and 132.0 mg/dl in group II. CCT was 516.2 µm in group I and 512.6 µm in group II, CV was 32.4% in group I and 31.1% in group II, ECD was 2784.2 cells/mm2 in group I and 2790.4 cells/mm2 in group II and HEX was 56.2% in group Iand 56.9% in group II. Conclusion: Diabetes mellitus patients had higher intra- ocular pressure and corneal cell thickness as compared to healthy control.

Cornea, Diabetes, Intra- ocular pressure, Visual acuity.

Relative Efficacy and Safety of Homologous Autoimplantation in Multiple and Recalcitrant Verrucae Vulgaris

Rahul Thombre1, S. K. Malhotra2*

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 77-85

Relative Efficacy and Safety of Homologous Autoimplantation in Multiple and Recalcitrant Verrucae Vulgaris

Rahul Thombre1, S. K. Malhotra2*

Abstract

Background: Warts are benign tumors involving skin and mucous membrane that are caused by human papillomavirus (HPV). Several treatment modalities are available for treating multiple warts, but without any significant response or cost-effectiveness. Aims: This study aimed to evaluate the safety and efficacy of autoimplantation therapy in the treatment of recalcitrant and multiple warts. Methods: A total of 40 patients of multiple warts (more than five warts per patient), palmoplantar warts, recurrent warts, and resistant warts were enrolled in this study. A small piece of warty tissue was introduced in the wound with the help of 26 no. needle. Patients were assessed monthly and resolution after 3 months was considered complete clearance. Results:Out of 40 patients, 26 (65%) patients showed complete clearance at the end of follow up. 10 (25%) patients had grade 2 improvement, 2 (5%) had grade 3 improvement. Conclusions:Autoimplantation of wart using the pared stratum corneum of wart is a safe, efficacious, less painful, and in-office procedure for the treatment of multiple, recurrent, and palmoplantar warts.

Autoimplantation, Recalcitrant, Warts.

A Comparative Study in Treatment of Anal Fissure – Topical Diltiazem vs Topical Nitroglycerin

Rommel Singh1, Reetinder Kaur Chahal2*, Kuldip Singh3, Gagandeep4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 86-92

A Comparative Study in Treatment of Anal Fissure – Topical Diltiazem vs Topical Nitroglycerin

Rommel Singh1, Reetinder Kaur Chahal2*, Kuldip Singh3, Gagandeep4

Abstract

Background: Anal fissure is a common condition in surgical practice. The present study was conducted in the Department of General Surgery, Govt. Medical College, Patiala in 60 patients with diagnosis of anal fissure on outdoor basis. The treatment was done with topical application of 2% Diltiazem ointment and topical 0.2% Nitroglycerine ointment in 30 patients respectively. Patients were followed up for three months in OPD. The two groups were compared for degree of symptom relief, healing, any adverse drug effect and reccurence if any and analysed statistically. Methods: 60 cases were studied. The study population was divided into two groups of 30 patients each.Group A: This group of patients were be treated with topical application of 2% diltiazem per rectally twice daily for a period of 6 weeks with sitz bath and Oral antibiotics .Group B: This group patients were treated with topical application of 0.2% nitroglycerin/ Glyceryl trinitrate application over the anal verge twice daily for a period of 6 weeks along with sitz bath and Oral antibiotics. Results:On completion of therapy at 6 weeks healing was observed in 26(86.6%) patients in group A and in 21(70%) patients in group B, so there was no statistically significant difference between diltiazem and nitroglycerin group in healing of anal fissure at 6 weeks therapy. At 6 weeks follow up headache occurred in 15 patients, out of which 1 was in group A and 14 were in group B. Itching occurred in 4 patients, Out of which 3 were in group A and one was in group B. So there was no statistically significant difference between Diltiazem and Nitroglycerin group in adverse effect profiling except headache which came out as statistically significant in group B. Conclusions:Chemical sphincterotomy with topical 2 % Diltiazem gel is an effective first-line treatment for anal fissures, achieving symptom relieving and healing rates comparable to those achieved with 0.2 % Nitroglycerin ointment but with relatively few, generally acceptable side effects as compared to distressing adverse effects of nitroglycerin as headache.

Anal Sphincter tone,Chronic anal fissure, External Anal Sphincter, Nitroglycerin, Internal Anal Sphincter, Nitric oxide.

Changing Presentation of the Hypertensive Disorders of Pregnancy Over 25-year Period

Amritpal Kaur1*, Harpoonam  Manku2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 93-103

Changing Presentation of the Hypertensive Disorders of Pregnancy Over 25-year Period

Amritpal Kaur1*, Harpoonam  Manku2

Abstract

Background: To determine changes in the incidence, clinical pattern, laboratory parameters, maternal and perinatal complications of hypertensive disorders of pregnancy over a 25-year period.Methods: This study compared the incidence, clinical pattern, laboratory parameters, maternal and perinatal complications in two groups of patients. Group I comprises of 75 patients of hypertensive disorders of pregnancy with or without HELLP syndrome, identified out of 1084 pregnant women in the year 1991-92 at the Dept. of Obstetrics and Gynaecology, Government Medical College, Amritsar. Group II includes 200 hypertensive patients selected from 2949 pregnant women studied between 2016-17 in the same department.Results:The clinical presentations varied over the years. The Group I had 75(6.92%) cases of hypertensive disorders out of 1084 pregnancies, with 20(26.67%) cases of mild preeclampsia (Subgroup A), 29 (38.67%) cases of severe preeclampsia (Subgroup B) and 26 (34.67%) cases of eclampsia. According to the classification of hypertension in pregnancy twenty five years back, there was no separate category of atypical preeclampsia or posterior reversible encephalopathy syndrome hence no such cases were categorised in Group I. The Group II had 200(6.78%) cases of hypertensive disorders out of 2949, with 66(33.0%) of mild preeclampsia (Subgroup A), 74(37.0%) with severe preeclampsia and 34(17.0%) had eclampsia. Apart from these, 26 patients had atypical preeclampsia. One (0.5%) patient was diagnosed with posterior reversible encephalopathy syndrome. Over the years, better identification parameters and improvement in the management guidelines gave better maternal and perinatal outcome in Group II. The Caesarean section rate was 45.5% in Group II as compared to 33.33% in Group I. The incidence of intrauterine death was 31.7%in partial HELLP and 37.5%in complete HELLP in Group I as compared to 32.44%in partial HELLP and 66.67%in complete HELLP in Group II. Similarly, the maternal complications were less in Group II as compared to Group I, e.g. postpartum haemorrhage being 6.5% in Group II and 18.67%in Group I and disseminated intravascular coagulation being 2.5% in Group II and 5.33% in Group I.Conclusions:Atypical preeclampsia and posterior reversible encephalopathy syndrome (PRES) were not included as separate entities in the classification of hypertensive disorders of pregnancy twenty five years back. Over the years the classification has undergone a vast change due to the change in the guidelines and management of this serious obstetrical condition. Awareness of the spectrum of the disease process of hypertensive disorders of pregnancy is necessary so that proper diagnosis is made and therapy initiated as early as possible. The trend in the recent years of earlier termination of pregnancy in complicated cases of hypertensive disorders of pregnancy, especially complete or partial HELLP syndrome by Caesarean section or vaginal route results in better maternal and foetal outcome. Expediting the delivery results in a better prognosis for the mother and the baby, although the postoperative maternal complications were many, due to the basic pathology in hypertensive disorders of pregnancy.

Preeclampsia, eclampsia, gestational hypertension, HELLP Syndrome.

Neurological Dysfunctions in Hypothyroidism a Clinico-Investigational Appraisal in Hypothyroid Patients

DhermendraPratap Singh1, Yatish2*, Anil Kem3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 104-110

Neurological Dysfunctions in Hypothyroidism a Clinico-Investigational Appraisal in Hypothyroid Patients

DhermendraPratap Singh1, Yatish2*, Anil Kem3

Abstract

Background: Thyroid hormones have a major influence on all major organs/systems and adequate levels are important for optimal function. This study was done to evaluate the clinical features, and investigations from neurological point of view in recently detected hypothyroidism patients.Results:We conducted this study on 100 patients of 16–60-year age group with hypothyroidism. Detailed clinical evaluation was combined with electrophysiological and radiological evaluation.Conclusions:Out of 100 patients who fulfilled the criteria for study 40% were male and 60% were female. Average age of the participants was 44.2 years and average weight of patients was 64.5 kg. Complaint of pain in hand was present in 40% of total assessed patients. Paresthesia in hand was present in 42%of patients. The complaints of sensory loss in hand and muscle cramps were 28% and 56% respectively. Nervousness was present in 42% of the patients. Tests like Electrophysiology was abnormal in about 58% of the total assessed patients, of which 65% were female subjects and 35% were male subjects, which is quite a significant proportion of patients. Similarly tests for Carpel Tunnel Syndrome also suggested that about 42% of the patients tested positive for CTS, of which 62% were female subjects and 38 % were male subjects. Neuroimaging test showed only 12% of total patients tested positive, of which again female percentage was more than males 64% and 36% respectively. Similarly, Phallen’s sign was elicited in 26% of the total patients, of which 60% were female and 40% were male.Conclusion:This study  quite firmly indicates that many patients who are diagnosed with Hypothyroidism also have neurological manifestations. Approach with this set of mind can help the clinicians to detect these neurological findings early and associate them with hypothyroidism for initiation and management of patient complaints.

Hypothyroidism, Neurological Dysfunctions, Electrophysiology.

Assessment of the Microleakage of CGIC, RMGIC, and Nano Filled RMGIC in Class V Cavities: An invitro Study

Ankush Jasrotia1, Kanchan Bhagat2*, Ravinder Kumar Bhagat3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 111-116

Assessment of the Microleakage of CGIC, RMGIC, and Nano Filled RMGIC in Class V Cavities: An invitro Study

Ankush Jasrotia1, Kanchan Bhagat2*, Ravinder Kumar Bhagat3

Abstract

Background: Microleakage is the major factor responsible for the failure of Class V restorations. The present study assessed the microleakage of CGIC, RMGIC, and nano filled RMGIC in Class V cavities.Methods: 30 standardized Class V cavity preparations were prepared on sound extracted human molar teeth. Teeth were randomly assigned to three experimental groups of 10 teeth each and restored as follows: Group I, CGIC; Group II, RMGIC; and Group III, Nano-filled RMGIC. The specimens were placed in a solution of 2% Rhodamine-B dye for 24 h at room temperature under vacuum. Staining along the tooth restoration interface was recorded. Results were analyzed using Kruskal-Wallis one-way analysis of variance (ANOVA).Results:There were no statistically significant differences in dye leakage between all the three restorative materials for occlusal margins. Statistical difference was found between all the three restorative materials for gingival margins.Conclusions:All restorative materials exhibited some microleakage. However, Nano filled RMGI showed less leakage than CGIC and RMGIC at gingival margins.

Class V, GIC, Microleakage.

Surgery in Patient with Takayasu Arteritis: A Challenge for Anaesthesiologists

Archna Sharma1, Kamlesh Bains2*, Manish Kumar Sharma3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 117-120

Surgery in Patient with Takayasu Arteritis: A Challenge for Anaesthesiologists

Archna Sharma1, Kamlesh Bains2*, Manish Kumar Sharma3

Abstract

This case report describes successful anesthetic management of a known case of takayasu arteritis patient presented for lower segment caesarean section. On her angiography, there was narrowing of common carotid artery at origin and non visualization of left subclavian artery. She had a bad obstetric history. Her thorough pre operative evaluation was done. She was successfully anaesthetized with low dose spinal anesthesia with 7.5 milligram injection bupivacaine and 25 micrograms injection fentanyl. Epidural catheter was inserted for post operative analgesia. Her intra-operative and post-operative period was uneventful. In these cases, if blood pressure is well maintained, low dose spinal anesthesia with epidural remains a good option. This allows the patient to remain awake and thus allows monitoring of brain perfusion which is particularly important in patients with stenosed carotid arteries.

Takayasu arteritis, Regional anesthesia, Low dose spinal anesthesia, Caesarean section.

Outcome of Fractures of Distal Femur Treated Using Retrograde Multidirectional Interlocking Nail

Maninder Singh1, Manpreet Singh2*, Mohit Gera3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 121-129

Outcome of Fractures of Distal Femur Treated Using Retrograde Multidirectional Interlocking Nail

Maninder Singh1, Manpreet Singh2*, Mohit Gera3

Abstract

Background: Aims: To study the “Outcome of Fractures of Distal Femur Treated Using Retrograde Multidirectional Interlocking Nail”. Study design: A prospective study. Place and duration of study: Department of Orthopaedics at Government Medical College, Amritsar between November 2018 to December 2020. Methods: The study included a total of 30 cases of either sex >20 years old with a mean of 44.33 years with closed fracture of distal 1/3rd femur type A admitted in Department/Casualty of Orthopaedics at Government Medical College, Amritsar treated with retrograde multidirectional intramedullary interlocking nail. Results:Mean union time in our study was found to be 18.62 weeks. In 56.67% of the patients (17 patients) knee flexion was between 111 to 120 degrees. Mean knee flexion of the patients was 113.23°. excellent to good results were seen in 80 percent of the patients (24 patients) while fair to poor results were seen in 20 percent of the patients (6 patients). Conclusions:Retrograde multidirectional nailing is a good option in the management of distal femoral fractures (especially type A fractures) due to less invasive procedure and hence lesser blood loss and infection, lesser operative time and exposure to c-arm radiations, early mobilization and weight bearing with very decreased overall complications and good anatomical and functional outcome.

Distal 1/3rd femur fractures, AO type A fractures, retrograde multidirectional nailing.

Type of Facial Fractures in two Wheeler Riders with or Without Helmet: A Prospective Study

MohdYounis Bhat1*, Shahid Farooq2, Ajaz Ahmad Shah3, Saima Farooq4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 130-134

Type of Facial Fractures in two Wheeler Riders with or Without Helmet: A Prospective Study

MohdYounis Bhat1*, Shahid Farooq2, Ajaz Ahmad Shah3, Saima Farooq4

Abstract

Background: Road traffic injuries have come to be epidemics in present day society. Motorbike injuries constitute more or less 50 % of all traffic accidents. AIM: The main purpose of this study was to evaluate the helmets used and in relation to the type of facial injuries in a Kashmiri population of two wheeler accidents. Methods: This study was conducted in the department of Oral and Maxillofacial Surgery, from 1st July 2020 to 20th March 2021. The study comprised patients of all ages and both sexes admitted in the Oral and Maxillofacial region due to two wheeler accidents. Total of 236 patients were included in this study. Results:Most common age group affected was 17–35 years (80 %) and the mean age of the victims was 24.42 years. Male to female ratio was 11:1, 66 patients (28%) were below 18 years of age hence not allowed to ride as per traffic norms. 0 patients who were wearing a helmet at the time of accident had an ISI mark on their helmets i.e.: helmets were not up to the mark. Conclusions:Our Study revealed common age group affected was 17–35 years (80 %) and the mean age of the victims was 24.42 years. The percentage of riders wearing was extremely low as low as 6%. The younger generation of our country need to be made aware of traffic rules and regulations, they should be made aware regarding safe riding measures particularly regarding use of helmet during two wheeler driving.

Facial Fractures, Dentistry.

A Study on Acute Viral Hepatitis in Pregnancy; Seroprevalence and Fetomaternal Outcome in a Tertiary Care Hospital

Chandni1, Shailpreet K Sidhu2*, Amritpal Kaur3, Kanwardeep Singh4, Loveena Oberoi5, Sapna Soneja6, Anuradha Malhotra7

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 135-144

A Study on Acute Viral Hepatitis in Pregnancy; Seroprevalence and Fetomaternal Outcome in a Tertiary Care Hospital

Chandni1, Shailpreet K Sidhu2*, Amritpal Kaur3, Kanwardeep Singh4, Loveena Oberoi5, Sapna Soneja6, Anuradha Malhotra7

Abstract

Background: Viral hepatitis is the major cause of jaundice in pregnancy. It can lead to coagulation defects, postpartum haemorrhage, organ failure and high maternal mortality and poor outcomes of their newborns, so early diagnosis and treatment is required for better management of the patients. Objective: To assess the prevalence of viral hepatitis in pregnant women and their fetomaternaloutcome.Methods:A total of 293 pregnant women presented with clinical and biochemical evidence of jaundice in Obstetric and Gynaecology Department were included in this study. All the patients were followed during their hospital stay and maternal morbidity, mortality and fetal outcome were recorded.Results:Out of 293 women, 178 (60.8%) were serologically diagnosed for AVH in pregnancy. HEV was the major cause of viral hepatitis 67.98%(121/178) followed by HAV 22.47%(40/178), HBV 8.43%(15/178, HCV 1.12%(2/178). No case of HDV and co-infection was found. Maternal mortality rate was 14.61%.Conclusions:HEV is found to be the common cause of AVH in pregnancy and was associated with high maternal mortality and poor fetal outcome. Through better sanitation, safe potable water supply, personal hygiene and awareness regarding substance abuse, viral hepatitis infection can be minimized in pregnant women.

Acute Viral Hepatitis, Maternal Mortality, Pregnancy.

To Study the Efficacy of Early Enteral / Oral Feeding in Acute Pancreatitis

Sanjeev Gupta1, Lakshay Goyal2*, Rakesh Kumar Chanania3, Shaina4, Gagan Bansal5, Anamika Verma6

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 145-150

To Study the Efficacy of Early Enteral / Oral Feeding in Acute Pancreatitis

Sanjeev Gupta1, Lakshay Goyal2*, Rakesh Kumar Chanania3, Shaina4, Gagan Bansal5, Anamika Verma6

Abstract

Background: Aim: The present preospective, observational Study was conducted to evaluate the efficacy of Early Enteral / Oral Feeding in Acute Pancreatitis.Methods:the study population consisted of 50 patients of either sex with the diagnosis of pancreatitis (mild, moderate and severe) made clinically, biochemically & radiologically. Patients were divided into two groups, the study group A (25 patients) were put on early enteral / oral feeding (within 48 hours) and control group B (25 patients) were put on parentral feeding (IV fluids) or NPO. In both the groups, patient demographics, duration from onset of symptoms, clinical findings, investigations, length of hospital stay, complications were assessed and compared. The data from both groups were compared. Data was collected & analyzed by using SPSS statistics software 22 version.Results:The results showed that the mean age of the patients was 45.27± 17.5 and male predominance was seen. Alcohol (38%), gall stones(40%) and post ERCP(20%) were the main aetiological factors for Acute Pancreatitis. Pain abdomen, nausea /vomiting, ileus and diarrhea after enteral feeding was less while it was more in patients on parentral feed . It was observed that all the features were significantly more in control group. It was observed that patients with EN feeding were significantly more tolerant to diet then PN feeding group. Similar trends were seen in length of hospital stay, patients with enteral feeding had less hospital stay duration then other group.Conclusions:Thus our study showed that pancreatitis patients can be safely started on early enteral feeds and it showed lesser number of gastro intestinal adverse effects, better oral tolerance to feeds, lesser complications, and hence lesser duration of stay which is in concordance to various studies.

Early Enteral, Oral Feeding, Acute Pancreatitis.

To Clinically And Radiographically Compare Regenerative Effectiveness of Open Flap Debridement Alone and in Combination with PRF in the Treatment of Periodontal two and Three Wall Infrabony Defects

Khushboo Shah1*, Bela Dave2, Viral Thakker3, Mihir Patel4, Heena Narsinghani5, Kuldeep Jadeja6

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 151-157

To Clinically And Radiographically Compare Regenerative Effectiveness of Open Flap Debridement Alone and in Combination with PRF in the Treatment of Periodontal two and Three Wall Infrabony Defects

Khushboo Shah1*, Bela Dave2, Viral Thakker3, Mihir Patel4, Heena Narsinghani5, Kuldeep Jadeja6

Abstract

Background: Periodontitis is characterized by microbially-associated, host-mediated inflammation that results in loss of periodontal attachment. Objectives: To clinically evaluate the clinical attachment level, PPD, gingival marginal position , wound healing , VAS scale , plaque index , sulcus bleeding index and radiographically evaluate the bone fill of the selected site treated with open flap debridement alone and with PRF.Methods:A total of 30 sites, split mouth study within age group  ≥18-55 ≤ years with chronic periodontitis patients were selected. Surgical sites were identified and divided into 2 groups: Group I control site (n=15)–the site was treated with open flap debridement. Group II test site(n=15) – the site was treated with open flap debridement along with PRF.Results:There was statistical significant probing depth reduction and better bone fill in test site as compared to control site. This can be attributed to beneficial effects of P.R.F.Conclusions:P.R.F shows added benefits in soft tissue healing and bone regeneration.

P.R.F, Periodontitis.

Detection and Prevalence of Common Intestinal Parasites in Stool Samples

Kakumanu Pradeep Kumar1*

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 158-162

Detection and Prevalence of Common Intestinal Parasites in Stool Samples

Kakumanu Pradeep Kumar1*

Abstract

Background: To detect and record prevalence of common intestinal parasites in stool samples.Methods:A total of 1012 stool samples collected in the department of Microbiology in last 6 months was taken into the study. The samples were grossly examined for color, consistency, mucus, frank blood and presence of proglottids. Stool concentration with ethyl acetate was carried out when there was clinical suspicion of parasite infection.Results:Type of parasites detected was Entamoeba histolytica in 8.5%, Entamoeba coli in 1.1%, Giardia lamblia in 2.4%, Ascaris lumbricoides in 0.25% and Taeniain 0.04%. A significant difference was observed (P< 0.05). Sensitivity of different parasitic examination methods used was 40% in simple salt floatation, 34% in Routine wet and iodine mount, 53% in Zinc sulphate centrifugal floatation and 65% in Formol-ether concentration. A non- significant difference was observed (P> 0.05).Conclusions:Common parasites found to be Entamoeba histolytica, Entamoeba coli, Giardia lamblia, Ascaris lumbricoides and Taenia.

Entamoeba coli, Intestinal parasites, Stool.

To Study the Modifications of Sagittal Split Osteotomy In Mandible

Mastan Shaik1*

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 163-167

To Study the Modifications of Sagittal Split Osteotomy In Mandible

Mastan Shaik1*

Abstract

Background: Sagittal split mandibular osteotomy had become a standard procedure in the management of both mandibular prognathism and retrognathism. Various modifications have been made to increase bone interface, thus assuring adequate bone healing, stability, to diminish the risk of damage to the neurovascular bundle of the mandibular canal.Methods:The study group in this investigation consisted of 5 treated patients who presented to the Department of Oral and Maxillofacial Surgery, St.Joseph Dental College, Eluru for surgical correction of mandibular prognathism and retrognathism. The mean age was 20-30 years.Results:Number of female participants in this study was 2 and number of male participants was 3. Number of males was 3 between the age of 20 -25 years and number of females was 2 between the age group of 25-30 years.Conclusions:Bone plates and screws were used for stabilization of sagittal split osteotomy. It was concluded that Neurologic alteration is one of the major complications of sagittal split osteotomy.The likelihood of nerve injury is mainly dependent on manipulation during surgery.

Sagittal Split Osteotomy, Modifications, Mandible.

Awareness About Postpartum Insertion of Intrauterine Device Among Antenatal Cases

Kamlesh1, Rahul Bains2, Varsha Sapehia3*

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 168-173

Awareness About Postpartum Insertion of Intrauterine Device Among Antenatal Cases

Kamlesh1, Rahul Bains2, Varsha Sapehia3*

Abstract

Background: In spite of many contraceptives device available numerous unwanted and unplanned pregnancies occur. Though the couples desire contraception but are not able to accept it due to their ignorance and misconceptions. Intrauterine Contraceptive Device (IUCD); an effective contraceptive is usually inserted six weeks after delivery. It can be inserted within 48 h of delivery called postpartum insertion for which government has started the program in many states. The study was undertaken to find out the choices about contraception after delivery and awareness about postpartum insertion.Methods: The present observational study was conducted in one of the Civil service hospitals. 250 antenatal cases were included in the study. Their choice of contraception after delivery and awareness was determined through a questionnaire. Reasons for refusal of postpartum insertion were recorded. Results:250 cases were included in the study, a large number had decided about contraception; mainly breast feeding supplemented by barrier contraceptive. 46 of 250 were willing for insertion of contraceptive device but not immediately after delivery due to apprehension in general and fear of side effects. Conclusions:Knowledge and acceptance of postpartum insertion is very low among antenatal women; probably because the concept is new in the community. There is a strong need to increase the knowledge and awareness about this by health education and counseling.

Postpartum, Intrauterine Device, Contraception.

Prevalance of PPROM and its Outcome

Kamlesh1, Kushla Pathania2, Anoop Sharma3,Varsha Sapehia4*

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 174-179

Prevalance of PPROM and its Outcome

Kamlesh1, Kushla Pathania2, Anoop Sharma3,Varsha Sapehia4*

Abstract

Background: Prematurity is the leading cause of perinatal morbidity and mortality in developed as well as in underdeveloped countries. Premature rupture of membranes is associated in one third of the patients with preterm labour. The present prospective observational study was conducted to determine the prevalence of preterm premature rupture of membrane (PPROM) and its association with the demographic risk factors and its neonatal outcome.Methods: There were 9000 deliveries from july 2018 to june 2019 in the department of Obstetrics and Gynecology, Kamla  Nehru state Hospital for mother and child, Shimla.  Detail history and examination along with the demographic risk factors were recorded on a performa. Every patient was followed till her delivery and the mode of delivery and foetal outcome was recorded.Results:Out of these, 113 patients were confirmed to have PPROM at 26-34 weeks. The overall rate of PPROM was 2.9% (260/9000), of which 43.4% (113/260) occured at ≤ 34 weeks . It was seen to be common among patients between 20-30 years (58.8%), with upper lower class socioeconomic status (40.7%). Risk of PPROM was seen to be highest among patients giving birth to their first child (53.9%), with gestational age between 32–34 weeks (54.9 cases). 18.5% cases there was history ofurinary tract infection(UTI), 17.6% history of hypothyrodism, while in 12.3% cases, there were one, two, or more previous preterm deliveries and 10.6% cases there was history of anemia. 73.4% patients went into spontaneous labour and 26.5% were induced. Normal vaginal delivery occurred in (75.2%), wand caesarean section rate was 24.8%. Twenty- five neonates had no complications. More than one complications present in one neonate. The most common neonatal complication was Respiratory distress syndrome in 48(31.8%) neonates followed by neonatal jaundice 31(20.6%). Mean birth weight was 1.58 ±.3313kg and 77% babies required neonatal intensive care. Perinatal mortality rate was (18.6%) of total births. Conclusions:PPROM is an important cause of preterm birth, resulting in large number of babies with low birth weight, requiring neonatal intensive care.

Preterm premature rupture of membrane, PPROM, preterm birth.

Correlation of Serum Soluble CD40 Ligand Level with Inflammatory Marker in Primary Hypertension

SaradaAsis Dash1, RasmitaKumari Padhy2, Nirupama Devi3*, PramilaKumari Mishra4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 180-188

Correlation of Serum Soluble CD40 Ligand Level with Inflammatory Marker in Primary Hypertension

SaradaAsis Dash1, RasmitaKumari Padhy2, Nirupama Devi3*, PramilaKumari Mishra4

Abstract

Background: Primary hypertension accounts for 90% cases of all hypertensions. Essential hypertension, which is considered to be one of the syndromes that include an increase in blood pressure (BP), systemic inflammation, abnormal lipid metabolism, abnormal sugar metabolism, abnormal blood coagulation, and left ventricular hypertrophy. Aim of the study. To measure serum sCD40 ligand and serum hs CRP in primary hypertensive cases and controls. To correlate serum sCD40L with both systolic and diastolic blood pressure and hs CRP in essential hypertension.Methods:The study was carried out in M.K.C.G. Medical College and Hospital Berhampur. Serum sCD40L and serum hs CRP has been measured by ELISHA methods. The comparision and correlation of result has been done. P value < 0.05 was considered as significant.Results:Maximum cases and controls are within the range of 41-50 yrs. Male to female ratio is 3:1. The Mean hs CRP and sCD40L levels were higher in hypertensive patients than control groups which is found to be statistically significant (p <0.001). sCD40L and hsCRP had significant positive correlation with both systolic and diastolic blood pressure. sCD40L and hsCRP had significant positive correlation with both systolic and diastolic blood pressure.Conclusions:Our study suggest that the estimation of Serum soluble CD40 ligand may be used as a pro thrombotic marker for early diagnosis. Soluble CD40L as a marker  of platelet activation and hs-CRP as a inflammatory marker may have a prognostic value in hypertension. The timely therapeutic intervention may reduce morbidity and mortality in essential hypertensive individuals.

Hypertension, hs – CRP, inflammation, sCD40L – Soluble Cluster Differentiation 40 ligand.

Role of Neutrophil- Lymphocyte Ratio and Other Routine Hematological Parameters in Determining Severity of Disease in Covid-19 Positive Patients

Jashan Sandhu1*, Anureet Kaur2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 189-194

Role of Neutrophil- Lymphocyte Ratio and Other Routine Hematological Parameters in Determining Severity of Disease in Covid-19 Positive Patients

Jashan Sandhu1*, Anureet Kaur2

Abstract

Background: Coronavirus disease 2019 (COVID-19) is an ongoing global pandemic with second and third waves sweeping through different countries. Patients with severe disease have a poor prognosis and it is essential for us to identify these cases to initiate timely management. Neutrophil-to-lymphocyte ratio (NLR) has been documented to be higher in the severe patients.Aim: The aim is to assess the NLR and other routine hematological parameters in severe versus Non severe patients on admission to the hospital.Methods:The blood counts at admission of 551 RT PCR positive Covid-19 patients (Non severe and Severe) were documented including Hemoglobin, Hematocrit, red cell indices, White blood counts (WBC), Platelet count, Absolute neutrophil count (ANC), Absolute lymphocyte count (ALC), Neutrophil-Lymphocyte ratio (NLR) and Platelet-Lymphocyte ratio (PLR).Results:A total of 551 patients were grouped into Non severe (450) and Severe (61) and complete blood counts were assessed. The two groups showed a statistically significant difference (p<0.05) between Hemoglobin, WBC, ANC, ALC, NLR, Platelet count and PLR.Conclusions:These routine blood count parameters especially NLR play an important role in determining disease severity and progression.

COVID-19, Complete blood counts, Neutrophil Lymphocyte ratio, Hemoglobin.

Prospective Forensic Autopsy Study of Abdominal and Pelvic Trauma Due To Road Traffic Injuries

Kuldip Kumar1, Alok Kandpal2, JaspinderPratap Singh3, Kamaljeet Singh4, Jatinder Pal Singh5*, Sunny Basra6

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 195-200

Prospective Forensic Autopsy Study of Abdominal and Pelvic Trauma Due To Road Traffic Injuries

Kuldip Kumar1, Alok Kandpal2, JaspinderPratap Singh3, Kamaljeet Singh4, Jatinder Pal Singh5*, Sunny Basra6

Abstract

Background: Vehicular injuries are one of the most common contributory factors to the abdominopelvic trauma. Injuries to the abdomen and pelvis are often associated with injuries to other body parts like the head, chest, spine, and extremities. AIMS& objectives: To study the pattern, prevalence of abdominal and pelvic injuries in relation to age, sex, type of vehicle, and organ injured.Methods:For the present prospective study, 500 cases were collected from the autopsies, showing abdominal and/or pelvic injuries, carried out at the mortuary of Government Medical College, Amritsar.Results:The maximum no. of cases 245(49%) were found in the age group of 21-40 years and males constituted 420(84%) of the total cases. The majority of cases were from rural 340(68%) background.  The most injured organ was the liver having contusions in 20 cases (4%) and laceration in 125 cases (25%), followed by the spleen, which had contusions in 10 cases (2%) and laceration in 70 cases (14%).Conclusions:Abdominal and Pelvic injuries being the potential factor in increasing morbidity and mortality, therefore the main objective is to pay proper attention towards the early, accurate diagnosis and satisfactory management to reduce morbidity and mortality in all road side accident injury cases.

Road Traffic Injuries, Abdomino-Pelvic Injuries, Road Safety.

Evaluation of Outcome Parameters of Using Remdesivir in Patients with SARS- COV-2 Infection

Bhanu Prakash1*, Kiran Sharma2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 201-206

Evaluation of Outcome Parameters of Using Remdesivir in Patients with SARS- COV-2 Infection

Bhanu Prakash1*, Kiran Sharma2

Abstract

Background: To assess outcome parameters of using Remdesivir in patients with SARS- COV-2 infection.Methods:A total of 62 patients (males- 38, females- 24) were assigned into two groups – group 1 (Remdesivir group (31) who received intravenous (IV) remdesivir for 5 days along with standard care (SC) and group 2 (SC group (31) who did not receive remdesivir, but received SC. Patient’s clinical status was assessed by estimating serum alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels and serum creatinine level were estimated in all patient.Results:The mean number of admission days in group 1 was 11.2 days and in group 2 was 12.6 days. AST level in group 1 patients was 37.5 U/litre and in group 2 patients was 38.9 U/litre. ALT level in group 1 patients was 38.1 U/litre and in group 2 patients was 35.4 U/litre. Serum creatinine level was 0.97 and 1.05 in group 1 and 2 respectively. Low flow supplemental oxygen requirement was 80% in group 1 and 72% in group 2, non-invasive ventilation or high-flow oxygen requirement was 21% in group 1 and 28% in group 2 and both groups did not require invasive mechanical ventilation. Conclusions:Remdesivir therapy for 5 days did not produce improvement in clinical outcomes in moderate to severe COVID-19 cases.

Remdesivir, Severe Acute Respiratory Coronavirus, Covid-19, Invasive Ventilation.

Assessment of relationship between Serum 25 (OH) Vitamin D and Insulin Resistance in Prediabetes

Gurpal Singh Sachdeva1, Ashish Bhagat2, Vijay Kumar3*

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 207-212

Assessment of relationship between Serum 25 (OH) Vitamin D and Insulin Resistance in Prediabetes

Gurpal Singh Sachdeva1, Ashish Bhagat2, Vijay Kumar3*

Abstract

Background: To assess relationship between insulin resistance and serum 25 (OH) vitamin D in prediabetic subjects.Methods:A total of forty diabetics, thirty- five pre-diabetes and thirty- five healthy control subjects were recruited in the study. HbA1C and lipid profile such as LDL- C, HDL- C and triglyceride, waist circumference (WC), hip circumference (HC) and waist- hip ratio, vitamin-D, serum insulin and HOMA2-IR level was estimated.Results:The level of HbA1C was 7.4%, 6.2% and 5.2%, LDL- C level was 96.3 mg/dl, 105.2 mg/dl and 95.9 mg/dl, HDL- C was 43.1 mg/dl, 45.6 mg/dl and 46.5 mg/dl, TG was 148.4 mg/dl, 143.2 mg/dl and 116.4 mg/dl was found in diabetes, pre-diabetes and control subjects respectively. A BMI of 23.4 kg/m2, 24.1 kg/m2and 22.8 kg/m2, waist circumference of 90.6 cm, 87.4 cm and 85.6 cm, waist- height ratio of 0.84, 0.52 and 0.51, waist- hip ratio of 0.94, 0.89 and 0.85 was found in diabetes, pre-diabetes and control subjects respectively. HOMA2-IR was 2.52, 1.48 and 0.78, HOMA2-β was 59.5, 80.2 and 82.5 and 25 (OH) D level was 24.5 ng/ml, 21.1 ng/ml and 19.7 ng/ml in diabetes, pre-diabetes and control subjects respectively. A significant difference was observed (P< 0.05).Conclusions:There was association of diabetes and vitamin D. Vitamin-D deficiency resulted in insulin resistance in individuals with prediabetes.

Insulin resistance, hypovitaminosis-D, blood glucose.

Assessment of Renal Function in Patients of Acute Stroke- A Clinical Study

Gurpal Singh Sachdeva1, Ashish Bhagat2*, Vijay Kumar3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 213-219

Assessment of Renal Function in Patients of Acute Stroke- A Clinical Study

Gurpal Singh Sachdeva1, Ashish Bhagat2*, Vijay Kumar3

Abstract

Background: Aim: To assess renal function in patients with acute stroke.Methods:Eighty- five adult patients of stroke (males- 50, females- 35) were selected and routine blood and biochemical examination such as serum creatinine, sodium, potassium, calcium, phosphorous, uric acid, fasting blood glucose, cardiac markers such as HDL, LDL, cholesterol, triglycerides were estimated.Results:Out of 85 cases, ischaemic stroke contributed 45 (males- 30, females-15) and haemorrhagic 40 (males- 15, females-20). Out of 85 cases of stroke, 30 had no AKI while 55 had different stages of AKI (stage 1- 35, stage 2- 15 and stage 3- 5). A significant difference was observed (P< 0.05). Calcium in non- AKI was 8.91 mg/dl and in AKI was 9.34 mg/dl, Phosphorous in non- AKI was 3.8 mg/dl and in AKI was 4.1 mg/dl, Uric acid in non- AKI was 6.3 mg/dl and in non- AKI was 6.7 mg/dl, FBG in non- AKI was 106.5 mg/dl and in AKI was 110.6 mg/dl, TG in non- AKI was 143.5 mg/dl and in AKI was 152.8 mg/dl, Cholesterol in non- AKI was 185.4 mg/dl and in AKI was 191.0, HDL in non- AKI was 46.5 mg/dl and in AKI was 48.7 mg/dl, LDL in non- AKI was 96.0 mg/dl and in AKI was 98.2 mg/dl. A non- significant difference was observed (P> 0.05).Conclusions:The level of cardiac markers was higher in AKI patients than non- AKI patients.  There was high prevalence of AKI in patients with stroke.

Cardiac Markers, Acute Kidney Injury, Renal Function, Cholesterol.

To Study the Risk Factors of Coronary Artery Disease in Rural Patients and Its Comparison with Urban Patients

Mohar Singh Uchariya1*, Manju Pandey2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 220-226

To Study the Risk Factors of Coronary Artery Disease in Rural Patients and Its Comparison with Urban Patients

Mohar Singh Uchariya1*, Manju Pandey2

Abstract

Background: Coronary artery disease is an emerging health problem in India. The high incidence of risk factor for CAD in young individuals is hypertension, where as diabetes is in the elderly patients. Coronary risk factors such as hypertension, diabetes mellitus, alcohol intake hypercholesterolemia, obesity and sedentary lifestyle were highly prevalent in the urban subjects and they were 2 or 3 times less common among rural subjects.Aims and Objectives: To study the various risk factors of coronary artery disease in rural patients and its comparison with urban patients.Methods:This Cross-Sectional Study was conducted at tertiary care hospital, Jabalpur during October 2014 to October 2015, in which 81 cases and controls were taken from rural and urban population.Results:Study shows presentation of risk factors of coronary artery disease in rural and urban patients. ln rural cases there was history of CAD 4 (11.1%), hypertension 14 (38.8%), diabetes 5(13.8%), family history of CAD 3 (8.3%), smoking 23 (63.9%), tobacco chewing 13 (33.3%) and alcoholism 5(16.1%). In urban history of CAD 9 (20%), hypertension 14 (31.1 %), diabetes 12(26.7%), family history of CAD 6 (15.3%), smoking 18 (40%), tobacco chewing 10 (22.2%) and alcoholism was found 12 (26.6%). Family history of CAD, diabetes as a risk factors was predominant in urban patients as compared to rural population and diabetes was found to be statistically significant (P-value<0.01 ) as a risk factor in urban patients as compared to rural patients. Smoking and tobacco chewing is predominantly seen in rural patients as compared to   urban patients, but alcohol addiction is higher in urban patients, and  smoking was statistically significant in rural patients (P value- 0.02). Body mass index(BMI) was statistically significant in urban patients as compared to rural patients (P value- 0.0008, highly significant).Conclusions:This study demonstrates that history of diabetes was statistically significant risk factor in urban patients as compared to rural patients. (P value <0.01) But in rural patients smoking was statistically significant risk factor. Body mass index (BMI) was significantly higher in urban patients as compared to rural patients (P VALUE <0.0008).

Coronary Artery Disease, General Medicine.

Management of Hydatidiform Mole with or Without Methotrexate: A Hospital Based Cohort Study

Sandhya Rani Behera1*, Madhusmita Sahoo2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 227-234

Management of Hydatidiform Mole with or Without Methotrexate: A Hospital Based Cohort Study

Sandhya Rani Behera1*, Madhusmita Sahoo2

Abstract

Background: To study the rate of gestational trophoblastic neoplasia in the complete hydatidiform mole with and without methotrexate and to observe any side effects of methotrexate as prophylactic chemotherapy.Methods:It is a prospective study of 72 patients registered as cases of complete hydatidiform mole admitted in SCB medical college, Cuttack from July 2018 to July 2020 out of which  after suction and evacuation of all patients, 16 patients categorised as high risk groups were given Methotrexate and folinic acid and rest were only followed up.Results:Total 72 cases of complete molar pregnancy were registered with 22010 deliveries in this period with an incidence of 3.2 per 1000 pregnancies. The mean age of presentation was 27.73 ± 6.9 years. Maximum patients were primigravida(40%) and most patients (88.89%) patients presented with vaginal bleeding. Maximum patients presented in the first trimester with average gestational age of presentation 12.2 weeks ± 4.2 weeks. Out of 16 patients who received Methotrexate and folinic acid none had developed gestational trophoblastic neoplasia but 21.42% cases (n=12) who did not received methotrexate developed GTN (p value = 0.043). Only 3 patients developed minor side effects like stomatitis and pruritus.Conclusions:Prophylactic chemotherapy with methotrexate and folinic acid in high risk molar pregnancy patients may be beneficial in preventing gestational trophoblastic neoplasia where there is a high chance of patients being lost to follow up without imparting major toxic effects.

Molar Pregnancy, Gestational Trophoblastic Neoplasia, Methotrexate, Prophylactic Chemotherapy.

A Comparative Study to Evaluate the Efficacy and Safety of Azilsartanand Olmesartanin Stage 1 Hypertension

Vijay Kumar1, Sunil Pawar2, Avneesh3*, Kanwalpreet4, Pardeep5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 235-242

A Comparative Study to Evaluate the Efficacy and Safety of Azilsartanand Olmesartanin Stage 1 Hypertension

Vijay Kumar1, Sunil Pawar2, Avneesh3*, Kanwalpreet4, Pardeep5

Abstract

Background: Hypertension is sustained elevation of systemic arterial pressure. Hypertension is defined as systolic blood pressure >130mmHg and diastolic blood pressure >80mmHg according to AHA-2017 guidelines. Aim: To evaluate the efficacy and safety of azilsartan and olmesartan in stage 1 hypertension patients. Methods:This study was carried out in a tertiary care teaching hospital (in Punjab in northern India) consisted of 100 patients of newly diagnosed stage 1 hypertension as per the guidelines of 7th report of Joint national committee on Prevention, Detection, Evaluation and treatment of high blood pressure. The patients were enrolled in study following the inclusion and exclusion criteria after taking informed consent. The patients were subjected to thorough history, physical examination and relevant investigation. 50 patients were put on azilsartan (group 1) 40mg/80mg and 50 patients on olmesartan (group 2) 20mg/40mg for the treatment of stage 1 hypertension. The patients were followed at weekly intervals for 8 weeks. The patients were monitored for response to treatment by recording their blood pressure and doses were increased if the response is suboptimal after two weeks. Adverse effects of both the drugs were noted and compared. Data thus obtained was analyzed statistically to compare the efficacy and safety of azilsartan and olmesartan.Results:There was a gradual significant reduction in SBP and DBP in both the groups at 2 weeks, 4 weeks, 6 weeks, and 8 weeks after the treatment. On Comparison of fall in SBP and DBP between Group 1 and Group 2 at different time intervals the difference in SBP and DBP reduction between azilsartan and olmesartan was not statistically significant. Drug side effects like diarrhea, dizziness, headache and rashes were reported. There was a significant increase in side effects with olmesartan as compared to azilsartan.Clinical Signifance:Azilsartan is a new drug as compared to Olmesartan. So this study will help to compare and evaluate their efficacy and side effects in treatment of stage 1 hypertensive patients. It will help to promote the rational use of drugs.Conclusions:Both Azilsartan and Olmesartan were equally effective in reducing systolic and diastolic blood pressure but Azilsartan was tolerated better with fewer incidences of side effects as compared to Olmesartan.

Azilsartan, Drug Efficacy, Hypertension, Olmesartan.

Esophageal and Stomach Lesions: A Prospective Study on Endoscopic and Histopathological Diagnosis

Nazmul Islam1*, FatemaTuz Zohora2, ABM Masud Jahid3, Saem AM4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 243-247

Esophageal and Stomach Lesions: A Prospective Study on Endoscopic and Histopathological Diagnosis

Nazmul Islam1*, FatemaTuz Zohora2, ABM Masud Jahid3, Saem AM4

Abstract

Background: Upper Gastrointestinal tract disorders are one of the most commonly encountered problems in clinical practice with a high degree of morbidity and mortality and endoscopic biopsy is common procedure performed in the hospital for a variety of benign and malignant lesions. Endoscopic procedure is incomplete without biopsy and histopathology is the gold standard for the diagnosis endoscopically detected lesions. Methods:This prospective study was conducted at a private diagnostic and research institute at Cumilla, Bangladesh. 60 endoscopic biopsy samples from the lesions of esophagus and stomach received from January 2020 to July 2021 were included in this study. Endoscopic biopsy specimens were processed by conventional method and the slides were stained with H & E stain and examined under the light microscope and reviewed by another consultant histopathologist. All the relevant data were noted in a pre-designed sheet and analyzed statistically.Results:Out of 60 cases, 63.3% were male and 36.7% were female and the age of study population ranged from 22 years to 78 years with the mean of 55.5. Among 60 cases, 18 (30%) cases were esophageal biopsy and 42 (70%) cases were gastric biopsy. Among esophageal cases- 11 (61.1%) diagnosed as esophageal malignancy by endoscopic procedure and on histopathological examination 12 (80%) cases diagnosed as squamous cell carcinoma and 03 (20%) cases as adenocarcinoma. Regarding above findings, 61.1% cases were diagnosed as carcinoma endoscopically but the histopathological diagnosis of esophageal carcinoma was 83.3%. In this study, 42 biopsy samples were taken from the stomach and enoscopist reported 5 (12.0%) cases as suspected for malignancy and 16 (38.1%) cases as malignancy. On histopathological examination 22 (52.4%) cases were diagnosed as adenocarcinoma of stomach where 15 (68.2%) were intestinal type and 07 (31.8%) were diffuse type. Other histopathological diagnosis were gastritis 08 (19.0%), non-specific gastric ulcer 08 (19.0%) and hyperplastic polyp 04 (9.6%).Conclusions:Endoscopy followed by histopathological examination play important role for the diagnosis and management of upper GIT lesions. We agree with other authors who have concluded that histopathology is mandatory for accurate diagnosis.

Esophageal and stomach lesion, Endoscopy, Histopathology.

A Clinico- Pathological Study of Enteric Enteric Perforation with Special Reference to Prognostic Factors

Garima1, Abhay2*

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 248-254

A Clinico- Pathological Study of Enteric Enteric Perforation with Special Reference to Prognostic Factors

Garima1, Abhay2*

Abstract

Background: Aim: To assess clinical and pathological cases of typhoid enteric perforation with special reference to prognostic factors.Methods:Sixty- four patients with typhoid perforation of either gender were selected in the study. All patients underwent emergency exploratory laparotomy via a midline incision under general anaesthesia. Operative findings were recorded, and the amount of pus and fecal material drained were estimated.Results:Out of 64 patients, mortality was noted in 6 cases. Timing of surgery <24 hours had 1and >24 hours had 5 mortalities. Duration of symptoms within 2 weeks had 2 and after 2 weeks had 4, no. of perforation single had 3 and multiple had 3. Amount of peritoneal Fluid <1000 ml had 1 and >1000 ml had 5 mortalities. Ileal resection had 2 and simple closure had 4 mortalities. A significant difference was observed (P< 0.05).Conclusions:Prognostic factors in cases of typhoid enteric ileal perforation were Timing of surgery >24 hours, duration of symptoms after 2 weeks, multiple number of perforation and amount of peritoneal Fluid >1000 ml.

Enteric fever, ileal perforation, exploratory laparotomy, Salmonella.

Risk Prediction for Abdominal Wound Infection in Colorectal Surgery

Shaon Shahriar1*, Muhammad Tanvir Mohith2, Abdullah Md Abu Ayub Ansary3, Nusrat Jahan Choudhury4, Shahana Sarwar5, Mehdi Hassan6, Akhter Ahmed7

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 255-265

Risk Prediction for Abdominal Wound Infection in Colorectal Surgery

Shaon Shahriar1*, Muhammad Tanvir Mohith2, Abdullah Md Abu Ayub Ansary3, Nusrat Jahan Choudhury4, Shahana Sarwar5, Mehdi Hassan6, Akhter Ahmed7

Abstract

Background: Post surgical wound infections are still among the most common serious complications of colorectal surgery and have serious consequences for outcomes and costs. Different risk factors may be involved including age, sex, nutrition, diabetes mellitus, type of disease, operation type and some operative factors like spillage of intestinal contents, gangrenous gut etc. This study aimed to determine the risk factors affecting abdominal wound infections in colorectal surgery and their rate at Shaheed Suhrawardy Medical College Hospital, a major referral teaching hospital in Bangladesh.Methods:Patients (n=50) who had undergone colorectal abdominal surgery were studied. Data were collected through pre & postoperative examinations. The subjects were followed till discharge. The relationships among variables were analyzed by percentage, ratio and odds ratio. To test the independence of the risk factors, the significant variables (p ≤.05) in the univariate analyses were entered into a binary logistic regression equation.Results:Of the 50 patients, 17 suffered from wound infection or SSI (34%). Infection subtype is as follows: superficial SSI 11 cases (64.7%), deep SSI 4 cases (23.5%), and organ/space SSI 2 (11.7%) cases. Overall mean postoperative hospital stay was 9.7 days (SD±5.9days). Additional postoperative hospital stay in patients who developed wound infection was 13.5 days. In multivariate analysis Underweight (p<0.029), Diabetes mellitus (p<0.017), Older age group (p<0.013) were proved to be independent risk factor for wound infection.Conclusions:This study suggests that, optimizing the patients’ condition preoperatively by correcting anaemia, hypoalbuminaemia, controlling diabetes mellitus, reducing intraoperative spillage of intestinal contents, the SSI may be reduced to a more acceptable level. Furthermore, prospective study of larger scale in this issue has been recommended.

Abdomen, Infection, Wound.

An Assessment of the Outcome of the Superior Lateral Genicular Artery Flap for Soft Tissue Reconstruction around the Knee

Md. Shakhawat Hossain1*, Salek Bin Islam2, Maruf Alam Chowdhury3, Mst. Rezwana Khatun4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 266-274

An Assessment of the Outcome of the Superior Lateral Genicular Artery Flap for Soft Tissue Reconstruction around the Knee

Md. Shakhawat Hossain1*, Salek Bin Islam2, Maruf Alam Chowdhury3, Mst. Rezwana Khatun4

Abstract

Background: Soft tissue defect around the knee is common following trauma, burns especially electric burn, excision of neoplasm etc. Thigh flap is based on the superior lateral genicular artery flap (SLGA) is a fasciocutaneous flap used for knee reconstruction with minimum donor site morbidity. Such a flap is an effective option for reconstruction of soft-tissue defects around the knee and proximal calf. Objective: To assess the outcome of superior lateral genicular artery flap for soft tissue reconstruction after coverage of the soft tissue defects around the knee. Methods: It was a prospective observational study carried out in the Department of Plastic Surgery & Burn Unit, Dhaka Medical College Hospital, Dhaka duration 1 January 2015 to 31 December 2016. Fifteen patients who presented with defects around the knee in the Department of Plastic Surgery and Burn Unit were included for the study. Result: Mean age was 39.53±13.1 years ranged from 18 to 65 years. Maximum patients were male 10 (66.7%), rest of the patients 5 (33.3%) were female. In this series, RTA were found 4(26.7%), injury due to machinery injury were found in 2(13.3%) cases, after release of postburn scar contracture in popliteal fossa 2(13.3%), electric burn 2(13.3%). In the present series, most common site was popliteal fossa 7(46.7%). All the flaps survived well, except three developed mild venous congestion, which subsided after removing compressive dressings. Outcome after SLGA flap was excellent in 93.3% and satisfactory 6.7% cases. Primary closure of donor site was possible in 8 cases and split thickness in skin graft in 7 cases. Conclusion: The SLGA flap provides adequate coverage of soft tissue defects around the knee. The donor site on the lateral aspect of the thigh is inconspicuous. The SLGA flap is a reasonable option for reconstruction of skin defect around the knee.

Superior Lateral Genicular Artery Flap and Soft Tissue Reconstruction around the Knee.

Evaluation of Oral Hygiene Status After Cementation of Modified Crown on Mandibular Molar Tooth

Md. Masudur Rahman1, Utpalendu Biswas2, Mohammad Abid3, Rajib Kumar Banik4, Md. Nurul Islam5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 275-281

Evaluation of Oral Hygiene Status After Cementation of Modified Crown on Mandibular Molar Tooth

Md. Masudur Rahman1, Utpalendu Biswas2, Mohammad Abid3, Rajib Kumar Banik4, Md. Nurul Islam5

Abstract

Background: Maintains oral hygiene is the main important factor for the success of any prosthesis. The prosthesis should always be favorable for oral hygiene and it should not be detrimental to the oral health status. The contour of artificial crowns has and continues to be highly controversial. Most of the controversy centered on whether the under contoured or the over contoured crown is more favorable for the maintenance of oral hygiene. Objective: The purpose of this study was to evaluate the effects of modified crown contour (over contoured and under contoured) on oral hygiene status.Methods:This study was conducted in the department of Prosthodontics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh to find out the successful artificial crown contour that is favorable for oral hygiene status. 50 patients (Group-A) whose full veneer crown was fabricated with under contouring form and cemented on mandibular molar teeth and another 50 patients (Group-B) whose full veneer crown was fabricated with over contouring form and cemented on mandibular molar teeth. Clinical examination and evaluation were done after three (3) weeks, six (6) weeks, three (3) months, and six (6) months of post prosthesis follow up period.  Data were collected on the basis of flowing parameters like Plaque index, Calculus index and gingival index on a predesign data collection sheet.  Statistical analysis (Chi- Square Test and unpaired t-test) was done to find out the significance value (P<0.001).Results:It is observed that the result was highly significant (p<0.001) between two groups regarding Plaque accumulation, Calculus deposition and gingival inflammation.Conclusions:This study revealed that under contoured crown is more favorable for the maintenance of oral hygiene than over contour crown on mandibular molar tooth.

Modified crown; Crown contour; Oral hygiene; Restoration.

Early Rehabilitation Can Prevent Long COVID Pulmonary Complications

Badrunnesa Ahmed1*,Md Ahsan Ullah2, MdShafiqul Alam3, Md Ali Emran4, Farzana Khan Shoma5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 282-293

Early Rehabilitation Can Prevent Long COVID Pulmonary Complications

Badrunnesa Ahmed1*,Md Ahsan Ullah2, MdShafiqul Alam3, Md Ali Emran4, Farzana Khan Shoma5

Abstract

The long-term sequelae of coronavirus disease 2019 (COVID-19) are only now beginning to be defined, but it is already known that the disease can have direct and indirect impacts mainly on the cardiorespiratory system. The aim of the narrative review is to derive concepts for the treatment based on the experience gained from the early rehabilitation in the treatment of patients with COVID-19, and to prevent long COVID respiratory complications in connection with currently available sources and experiences. An online literature search was conducted June 2020 to January 2021 using Medline, PubMed ,Google scholar and manual search to retrieve meta-analyses, systematic reviews, randomized trials, guidelines, recommendations, state of the art, and other peer-reviewed studies investigating the relationship between COVID-19 and early Rehabilitation/mobilization or exercises. Thirty-four articles met the established criteria and the main findings were summarized and described, including indication, contraindication and recommendation for early rehabilitation and exercises prescription. after a detailed observation this review study can predict that long COVID pulmonary complications can be prevented in worth of early rehabilitation.

COVID, Pulmonary Complications.

Arsenic Contamination in Rice Production Irrigation Water in Bangladesh

ForhadulHoque Mollah1*, Mohammad Masum Alam2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 294-301

Arsenic Contamination in Rice Production Irrigation Water in Bangladesh

ForhadulHoque Mollah1*, Mohammad Masum Alam2

Abstract

Background: As a developing country, Bangladesh is totally dependent on irrigation water in respect of food production. This study aimed to assess the arsenic concentration in rice production irrigation water in Bangladesh. Methods:The cross-sectional analytical study was carried out in the Department of Biochemistry and Molecular Biology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Total 100 water samples from the deep tube-wells (Used for irrigation) were collected. No major Ethical Implication was required. Statistical analysis was done by SPSS 24 version. Result: Maximum arsenic concentration in water was found in Bancharampur 132 µg/L and Minimum arsenic concentration in water was found in Sirajdi khan 4 µg/L. In Bajitpurmean±SD was 48±15.56, in Arihajarmean±SD was 64±23.6, in Bancharampurmean±SD was 47±35.2, in Shariyatpurmean±SD was 43±28.3 and in Sirajdi khan mean±SD was found 70±47.2. Inferential statistics was done at a 95% confidence interval and 5% level of significance. Conclusion: On account of arsenic-contaminated irrigation water, any adverse effects on the nutrient content of food would only enhance not only produce the nutritional problem but also produced chronic arsenicosis followed by various health hazards.

Arsenic, Contamination, Rice production, Irrigation water.

Accumulation, Distribution and Source Analysis of Arsenic in Rice in Different Growing Areas of Bangladesh

Mohammad Masum Alam1*, ForhadulHoque Mollah2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 302-308

Accumulation, Distribution and Source Analysis of Arsenic in Rice in Different Growing Areas of Bangladesh

Mohammad Masum Alam1*, ForhadulHoque Mollah2

Abstract

Background:Being a leading dietary source of arsenic, the importance of exposure to arsenic through rice must be considerable. This study aimed to assess the accumulation, distribution and source analysis of arsenic in rice in different growing areas of Bangladesh.Methods:The cross-sectional analytical study was carried out in the Department of Biochemistry and Molecular Biology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka. Total sample 260, among them 100 water samples from the arsenic-contaminated deep tube-well (Used for irrigation), 100 rice samples produced here off and 60 (0–20 cm depth) soil samples were collected. No major Ethical Implication was required. Statistical analysis was done by SPSS 24 version.Result:The present study revealed the mean value of arsenic concentration found in soil at the selected plot was ranging from 8-14 mg kg−1. In the study, the highest value of arsenic concentration in irrigation water was found in Sirajdikhan was 70 ± 47 (μg L−1) and the utmost value of arsenic concentration in rice was 173 ± 236 µg kg−1 found in Shariyatpur. Inferential statistics was done at a 95% confidence interval and 5% level of significance. An independent T-test was found significant (p<0.01) and results showed the arsenic concentration was more in rice than in water and soil.Conclusion:Rice exposure can contribute to the total daily intake of arsenic. Rice and water consumption patterns and arsenic levels in rice is needed to refine human exposure assessment.

Arsenic, Accumulation, Distribution, Source analysis, Typical growing area.

Evaluation of the Safety Profile of Concurrent Chemoradiation with Cisplatin versus Capecitabine of the Patients through Observation of the Toxicities in Locally Advanced Carcinoma Cervix

Most.Rokaya Sultana1*, Sadia Sharmin2, Nazir Uddin Mollah3, Md. Serazul Islam4, Tusar Das5, AfsanaSharmin Anika6

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 309-319

Evaluation of the Safety Profile of Concurrent Chemoradiation with Cisplatin versus Capecitabine of the Patients through Observation of the Toxicities in Locally Advanced Carcinoma Cervix

Most.Rokaya Sultana1*, Sadia Sharmin2, Nazir Uddin Mollah3, Md. Serazul Islam4, Tusar Das5, AfsanaSharmin Anika6

Abstract

Background:Uterine cervical cancer is the second most common female malignancy in the world. And in Bangladesh, this is the most common malignancy among the female population. Concurrent chemoradiation plays an important role in the treatment of locoregionally advanced carcinoma uterine cervix. The success of treatment depends on a careful balance between megavoltage external beam radiotherapy and high dose rate intracavitary brachytherapy that optimizes the dose to the tumor. Aim of the study: The aim of the study was to compare the complete and partial responses of CCRT with capecitabine against CCRT with cisplatin.Methods:This was a prospective analytical study conducted at the Department of Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from January 2014 to February 2015. A total of 60 patients with clinically and histologically diagnosed locally advanced squamous cell carcinoma cervix were selected for this study. The participants were equally divided into two groups based on treatment method. Arm-A group was treated with cisplatin, while the Arm-B group was treated with capecitabine. The treatment duration for each participant of both groups was 8 weeks from the start of chemoradiation.Result:In this study, the majority of the participants were from the age range of 46-55 years, and the mean age of the participants was 47 years. In total, over 80% of the participants were married before the age of 21. It was observed that out of 30 cases in each arm the overall response (complete and partial) in both groups were more or less equal. The complete response of Arm-A group was 22 (73.33 %) and Arm- B was 25 (83.33 %). Regarding toxicity, common toxicities associated with concurrent chemoradiation were more or less the same, and no severe unwanted reaction was noted in most patients. Reversible vomiting (grade 3) 13.3%, nephrotoxicity 20%, neurotoxicity 3.33% patients of Arm- A, only 16.6 % reversible grade 2 hand-foot syndrome seen in patients of Arm-B, which means the use of concurrent chemoradiation with capecitabine is equally effective and a well-tolerated option for patients of locoregionally advanced carcinoma uterine cervix.Conclusion:Capecitabine-based concurrent chemotherapy was arithmetically proven in achieving complete response better than cisplatin-based CCRT. Acute toxicities were observed in this study and there was a statistically significant difference in vomiting and nephrotoxicity. There were no nephrotoxic patients seen in capecitabine-based concurrent chemoradiation in the period of toxicity evaluation. considering effectiveness, safety profile, convenience the capecitabine-based concurrent chemoradiotherapy is the better treatment option than cisplatin-based concurrent chemoradiotherapy for treatment of locally advanced carcinoma of the uterine cervix.

Carcinoma, Cervix, Cervical Cancer, Capecitabine.

Out-of-Pocket Expenditures: Sources and Impacts on the Children’s Family Undergone Pediatric Surgical Treatment

Md.Shamsuzzaman Khan1*, Shamima Hamid2, Mahbuba Akhter3, Nirupama Saha4, Ashraf   Uddin5, Mohammad Mahabubul Alam6, Mafia Afsin Laz7, Mohammad Saiful islam8

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 320-333

Out-of-Pocket Expenditures: Sources and Impacts on the Children’s Family Undergone Pediatric Surgical Treatment

Md.Shamsuzzaman Khan1*, Shamima Hamid2, Mahbuba Akhter3, Nirupama Saha4, Ashraf   Uddin5, Mohammad Mahabubul Alam6, Mafia Afsin Laz7, Mohammad Saiful islam8

Abstract

Background:Financial risk protection is vital for universal health coverage and out-of-pocket (OOP) expenditures of patients are one of the major sources of funding for healthcare particularly for sustainable surgical care in low- and middle-income countries like Bangladesh. This study was aimed to find out the sources and the effects of out-of-pocket (OOP) expenditure among the hospital admitted pediatric surgical patients undergone for surgery.Methods:Datawaswere collected to the family members of as a part of a household level survey of three public hospitals of Dhaka city, Bangladesh. Descriptive analysis was undertaken to assess socio-demographic characteristics, sources and impacts of OOP expenditure.Result:Among total 400 respondents of the study, 62.5% of the families came from low socioeconomic class where only 23.5% had formal occupation and 37.5% had sustainable income. 94.5% and 88.5% correspondingly did not have any health budget allocation and health insurance coverage. 97% families there had only 1-2 earning member. Monthly family income was the major source for health expenditure and 30.5% families spent this from internal sources, 14.5% from external sources and 55% from both external and internal resources. Loan was the major way (55.3%) for external expenditure however, only 32.1% had the capability to repay. Among total OOP expenditure, 77.5% cost was of operative cost, 16.5% for postoperative, 3.5% preoperative and 2.5% for others. Considering the effects of OOP expenditure, among 400 participant families, 74.5% were affected either temporarily (53%) and permanently (4%) or in both (17.5%) in several ways and majority (93.4%) had to change their food habit practices.Conclusion:The study findings illustrate that hospitalization for surgical treatment of pediatric patients resulted a significant OOP expenditure for their families, leading to catastrophic health effects (CHEs) and impoverishment of households. The impacts were unevenly more on the vulnerable groups and majority of the families were affected both temporarilyandpermanently.

Out of pocket expenditure; catastrophic health effects; Pediatric Surgical Patients; Sources; Impacts.

The Efficacy and Safety of Dobutamine Stress Echocardiography in a Tertiary Hospital, Dhaka, Bangladesh

S M Ear-E-Mahabub1*, Md. Fakhrul Islam Khaled2, Mohammad RayhanMasum Mandal3, Ariful Islam Joarder4, Md. Ghias Uddin5, Khaled Mohammad Iqbal6

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 334-339

The Efficacy and Safety of Dobutamine Stress Echocardiography in a Tertiary Hospital, Dhaka, Bangladesh

S M Ear-E-Mahabub1*, Md. Fakhrul Islam Khaled2, Mohammad RayhanMasum Mandal3, Ariful Islam Joarder4, Md. Ghias Uddin5, Khaled Mohammad Iqbal6

Abstract

Background:Stress echocardiography with a pharmacologic agent such as dobutamine allows patients who are unable to exercise due to musculoskeletal or pulmonary comorbidities to simulate greater heart rate and increased myocardial physiologic demands. Dobutamine Stress Echocardiography, like exercise echocardiography, has primarily been used in the diagnosis of obstructive epicardial coronary artery disease, the detection of viable myocardium, and the evaluation of the efficacy of anti-ischemic medical therapy in patients with known coronary artery disease. Objective: The aim of the study was to assess the efficacy and safety of Dobutamine Stress Echocardiography.Methods:The prospective observational study was performed with Dobutamine Stress Echocardiography in 188 cases of the study population in between 30-80 years, from January 2018 to December 2018. A graded dobutamine infusion is given typically at a starting dose of 10 µg/kg per minute for 3 minutes. The goal of the dobutamine infusion is to achieve a heart rate 85% of the maximal predicted heart rate for the patient’s age. Accordingly, the dobutamine dose is increased every 3 minutes to doses of 10, 20, and 30, and finally to 40 µg/kg per minute. Dobutamine is metabolized hepatically and in peripheral tissues, but there is no set dose reduction for those with hepatic or renal dysfunction.Result:The total study population was 188 aged ≤30 years to >70 years. 5(2.7%) were ≤30, 16(8.5) were 31 years to 40 years 45(23.9) were 41 years to 50 years, 76(40.4%) were 51 years to 60 years, 34(18.1%) were 61 years to 70 years and 12(6.4%) were >70 years. [Table I] Dobutamine Stress Echocardiography performed 122 (64.9%) males and 66 (35.1%) females. [Figure I]. Baseline characteristics Mean±SD value were (55.45±11.041) age, (1.35±0.479) sex, (63.57±11.281) weight and (139.70±8.71). Incidence of the complication of Dobutamine Stress Echocardiography were <0.01% mortality, <0.01% Cardiac Rapture, 0.14 Coronary spasm and 1.3% Hypertension.Conclusion:Dobutamine allows performance of an echocardiographic stress test in patients who would not otherwise be able to exercise. This technique has evolved over the years with technological advancements, including development of contrast echocardiography for endocardial definition. Contrast can also be used for myocardial perfusion analyses.

Stress echocardiography, Dobutamine, Coronary artery disease; Myocardial ischemia.

“Groin Flap” for Reconstruction of Defects on Dorsum of the Hand

Romana Parvin1*, Mohd Fazle Rubby2, Mohammad Abul Kalam Azad3, Md. Toriqul Islam4, Md Shahidul Islam Farhad5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 340-351

“Groin Flap” for Reconstruction of Defects on Dorsum of the Hand

Romana Parvin1*, Mohd Fazle Rubby2, Mohammad Abul Kalam Azad3, Md. Toriqul Islam4, Md Shahidul Islam Farhad5

Abstract

Background:The groin flap has been using in reconstructive surgery for more than 4 decades. As hand injury is common occurrence and proper management of hand give active manpower and thereby reduce burden on country’s economic status. So, this study was aimed to find out the outcome of groin flap for coverage of a wound over dorsum of the hand. Objective: The aim of the study was to evaluate the Groin Flap” for Reconstruction of Defects on Dorsum of the Hand.Methods:This Prospective observational study was conducted among the patients of Department of Plastic Surgery and Burn unit of Dhaka Medical College & Hospital, Dhaka, from August, 2017 to July, 2019. Total 60 patients having defects over dorsum of the hand resulting from traumatic injury, post electric burn wound, post burn deformity and hand infection admitted during study period were included into the study following ethical approval from ERC of DMC. Data were compiled, edited, managed and analyzed. The results were tabulated in table. Data analysis was done by Pearson’s chi square test. P value was significant at <0.05. Then data analyzed using the software SPSS (statistical package for social sciences).Result:The mean age of the respondents was 30.68±12.24 years with a majority in age group 20-29 years with male predominance 38(63.3%). The mean length and width of the wound was 8.15 (±2.60) cm and 6.00 (±1.86) cm respectively. The mean length and width of flap was 8.97 (±2.82) cm and 6.30 (±1.83) cm. Maximum length of flap was 18 cm and maximum width of flap was 10 cm. About 10% patients experienced marginal necrosis and only 2% experienced total flap loss while 86.67% patients had no flap related complication. In donor site, only10% had wound dehiscence. Results of reconstruction, 83.3% patients had excellent wound coverage, 13.3% patients had satisfactory wound coverage and only 3.3% patients had poor wound coverage.Conclusion:Considering the overall outcome of groin flap may be a good option for reconstruction of defects on dorsum of hand.

Pedicled; Groin flap; Dorsum of hand.

Surgical Outcome of Thoracolumbar Fractures Treated with Short Segment Posterior Screw Fixation

Md. Yousuf Ali1*, Chowdhury Iqbal Mahmud2, Shahida Akter3, Md. Ashraful Islam4, Tariqul Matin5, Shaikh Sadiul Islam6, M Zawad7

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 352-359

Surgical Outcome of Thoracolumbar Fractures Treated with Short Segment Posterior Screw Fixation

Md. Yousuf Ali1*, Chowdhury Iqbal Mahmud2, Shahida Akter3, Md. Ashraful Islam4, Tariqul Matin5, Shaikh Sadiul Islam6, M Zawad7

Abstract

Background:The success of surgical treatment of thoracolumbar fractures is directly dependents upon the choice of operative techniques. Now a day, a good number of surgeons using short segment posterior pedicle screw fixation technic in such cases. But we have very few research-based data regarding the effectiveness of this operative technic in treating thoracolumbar fractures. Aim of the study: The present study aimed to assess the effectiveness of short segment posterior screw fixation technic in treating thoracolumbar fractures.Methods:This prospective, experimental observational study was conducted on 217 patients with thoracolumbar fractures during the period from July 2006 to June 2020. The centers were Bangabandhu Sheikh Mujib Medical University (BSMMU) and different private hospital of Dhaka, Bangladesh. Only those patients treated with posterior decompression stabilization by posterior short segment fixation and posterolateral fusion were included as the study people. All data regarding the mentioned methods were processed, analyzed and disseminated by using MS word and SPSS version 26 as per need.Result:In analyzing the Frankel scores of the participants in different stages of treatment we observed, in pre-operative stage, majority of the patients had ‘A’ to ‘C’ scores. At the immediate post-operative stage majority of the patients had Frankel score of ‘C’ or ‘D’. But at the end of one year follow-up, majority of the patients (n=198) achieved ‘E’ score which was found in 91%. The mean preoperative angle of injured vertebra was 19.7°, the mean postoperative angle was 8.6°, the mean angle at 6 month’s follow-up was 11.9°, the mean initial correction was 11.1°, and the mean loss of correction was 3.3°. So, the mean overall correction was found 7.8°. In analyzing the average percentages of the anterior body compression, we observed, in preoperative stage it was 48.1%, and was improved to 29.9% postoperatively, but slightly declined to 32.7% at the latest follow-up.Conclusion:Posterior decompression stabilization by posterior short segment fixation with pedicle screw and posterolateral fusion technic may be considered as an effective treatment method in treating thoracolumbar fractures. The chances of kyphotic angle failure are high.

Posterior decompression, Stabilization, Posterior short segment fixation, Posterolateral fusion. Thoracolumbar fractures.

Outcome of Management of Diabetic Foot Ulcers

Vipin Kumar1*, Vinod Kumar2, E. Debaraju Reddy3, Madhu Sinha4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 360-364

Outcome of Management of Diabetic Foot Ulcers

Vipin Kumar1*, Vinod Kumar2, E. Debaraju Reddy3, Madhu Sinha4

Abstract

Background: To assess outcome of management of diabetic foot ulcer.Methods:Eighty- six diabetic patients (males- 54, females- 32) with occurrence of diabetic foot ulcers were enrolled and managed with collagen as primary dressing. It was covered with gauge and bandage and tape. The size of the ulcer was measured at 1 month and 2 months interval.Results:Mean age of patients was 45.8 years, duration of diabetes was 10. 2 years, Wagner grading 1 was seen in 5, 2 in 22, 3 in 36, 4 in 16 and 5 in 7. Fasting blood glucose level was 132.4 mg/dl and random blood glucose was 180.2 mg/dl. The mean size of ulcer was 10.2 cm2 at 1 month and it decreased to 3.2 cm2 at 2 months. Healing response was complete responders was seen in 62, partial responders was seen in 18 and non- complete responders were 6. A significant difference was observed (P< 0.05).Conclusions:Collagen dressing found to be effective in management of diabetic foot ulcer. A reduction in size of ulcer was achieved, hence collagen dressing can be used safely.

Collagen dressing, Diabetes, Wagner grading.

Comparison of Management of OSMF Patients

Vipin Kumar1*, Amit Kumar2, Arshad Jamal3, Madhu Sinha4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-6 | November-December 2021| Page: 365-370

Comparison of Management of OSMF Patients

Vipin Kumar1*, Amit Kumar2, Arshad Jamal3, Madhu Sinha4

Abstract

Background: To compare colchicine with hydrocortisone and hyaluronidase in cases of OSMF.Methods:60 patients of OSMF (grade II and above) were classified into 2 groups. In group 1, patients were administered 0.5 ml intralesional injection Hyaluronidase 1,500 IU and 0.5 ml intralesional injection hydrocortisone acetate 25 mg/ml and in group 2, patients were administered tablet colchicine orally, 0.5 mg twice daily and 0.5 ml intralesional injection Hyaluronidase 1,500 IU into each buccal mucosa once a week. Parameters such as mouth opening (inter- incisor distance in mm) was recorded and burning sensation (VAS) was recorded at 2nd, 3rdand 4thweeks of treatment and compared in both groups.Results:At 2nd week, 20 patients in group 1 and 28 in group 2 showed reduction in burning sensation, at 3rd week, 7 in group 1 and 6 in group 2 and at 4th week, 8 in group 1 and 4 in group 2 showed reduction. It was seen that none patient in group 1 and 2 patients in group 2 had >35 mm opening. 4 in group 1 and 6 in group 2 had 30-35 mm opening whereas 12 in group 1 and 10 in group 2 had 25-30 mm opening. Conclusions:Colchicine found to be effective in management of cases of OSMF as compared to other treatment modalities.

Colchicine, Oral submucous fibrosis, Mouth opening, Hydrocortisone.