Integrative Approach to COVID-19: An Indian Facebook Recipe for Mental Health

The COVID-19 pandemic has given the world a big blow and has forced the entire world to develop a new thought process. To cope with the stress of lockdown, it was important for people to indulge in educational and health activities to save them from the threats being caused by the news and social media. A Facebook page named Yoga scholars Post Graduate Institute of Medical Education and Research (PGIMER) was created where three sessions were held per day for 225 days regularly. This activity resulted in people adopting an integrative approach towards alternative medicine. This also made possible a trial of Ashwagandha for COVID-19 treatment by the Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homeopathy (AYUSH) ministry.

A Hospital-Based Study of EGFR and ALK Mutations in Patients with Lung Adenocarcinoma in Odisha

Background: Patients with advanced non-small cell lung cancer (NSCLC) have considerably benefited from the molecular identification of epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) mutations and subsequent targeted therapy against these biomarkers. Few studies have been undertaken in the Indian population on the analysis of both EGFR and ALK mutations in lung adenocarcinoma cases. Aim and Objectives: The aim of this study was to determine the prevalence of EGFR and ALK mutations in lung adenocarcinoma patients, as well as to link mutational status with age, sex, and smoking history. Materials and Methods: This single hospital-based retrospective study was conducted at the Department of Medical Oncology, Acharya Harihar Post Graduate Institute of Cancer, Cuttack, on histologically proven lung adenocarcinoma cases over a duration of two years from 01.08.2019 to 31.07.2021. Results: Out of a total of 164 cases, males comprised 89 (54.26%) of the 164 lung adenocarcinoma cases, while females comprised 75 (45.73%). EGFR mutations were found in 42 (26.75%) of the patients. In 9 cases, the ALK gene rearrangement was also determined to be positive (5.66%). In terms of EGFR and ALK mutations, there was no statistically significant relationship between patient age and gender. (P-value < 0.05). In our research, we found a link between nonsmokers and EGFR and ALK mutations. (P-value <0.05). The deletion of exon 19 (76.19%) was the most prevalent mutation, followed by the exon 21 L858R mutation (14.28%). Conclusion: This study was found to have a significantly higher rate of EGFR and ALK mutation in the Indian population with adenocarcinoma of lung compared to Western populations. To get the maximum benefit from targeted therapies, all patients of adenocarcinoma of the lung should have mutational testing for EGFR and ALK as part of a broad molecular pannel.

TO STUDY THE DIFFERENT COMPLICATIONS DURING ANTEPARTUM, INTRAPARTUM AND POSTPARTUM PERIODS WITH POSSIBLE MEASURES TO MANAGE TWIN PREGNANCY

Background: The present study of twins was done among the patients admitted in the department of Obstetrics and Gynecology at Sri Aurobindo Medical College and Post Graduate Institute, Indore. Method: Blood sample from the mother was collected for estimation of hemoglobin percentage to diagnose anemia, ABO & Rh typing for blood transfusion if necessary. Urine examination for albumin, sugar & acetone. Special investigations like USG done whenever possible. In maximum cases ultrasonography was done to detect or confirm presence of twins, their lie, maturity, gestational age, rule out congenital anomaly & to note any IUGR, Discordant growth. Amount of liquor also noted. Result: 143 (85.10%) babies were LBW. The main factors responsible for LBW were IUGR and prematurity. Intrauterine growth retardation affected 42 cases (24.41%) while prematurity affected 42 cases (24.41%) and 8 (9.3%) cases aborted. Intrauterine death was more common in first baby, because of malpresentations. Asphyxia was found to be slightly more in second baby in our study. Congenital anomalies were found in total 3 cases (1.78%). In one case, baby-2 was Anencephalic and in the other case baby-2 had fetal ascites. In one case baby-1 had multiple congenital anomalies with imperforate anus. Cord prolapse was present in one case. In one case (Case No. 17) first baby was presented by footling with cord prolapse LSCS was done, baby had SBA and died 1 day after birth. There were 8 abortions. All were second trimester abortions (12 weeks and 22 weeks). Conclusion: In the present study, incidence of various antepartum and intrapartum complications were less in booked cases, which shows that availability of antenatal care to more patients will further reduce their incidence and thus will decrease maternal morbidity. Keywords: Complications, Antepartum, Intrapartum & Postpartum.

Disseminated TB in inpatient deaths at a tertiary care centre: an autopsy study over three decades

BACKGROUND: One of the most severe forms of TB, disseminated TB (dTB) is associated with significant mortality. A retrospective study was undertaken to assess the proportion of dTB among inpatient deaths and to describe the pathological spectrum of lesions. Associated comorbidities and missed dTB cases ante-mortem were also sought.METHODS: Data on autopsy-confirmed cases of dTB from over three decades (1988–2016) obtained from the departmental archives of the Post Graduate Institute of Medical Education and Research, Chandigarh, India, were reviewed for clinical details, as well as gross and histopathological findings. The proportion of autopsy-confirmed dTB were reported.RESULTS: During this period, a total of 243 autopsy-confirmed cases were retrieved. The organs most commonly involved in these cases were the lungs (90.1%), followed by the liver (72%), spleen (44%), kidneys (37%), bone marrow (17%), adrenals (12.2%), intestine (11.4%), pancreas (8.5%) and reproductive organs (6.9%). The brain was involved in 73.3% cases. In one third of cases, the diagnosis of TB was not suspected ante-mortem. Comorbid conditions were noted in 36.2% cases.CONCLUSION: A significant burden of dTB was noted among hospital inpatient deaths. Due to multi-organ involvement, dTB has atypical symptoms and may remain undiagnosed ante-mortem. Increased awareness and robust screening of TB cases are mandatory, particularly in patients with underlying comorbidities.

Study Regarding Conceptualisation of Dermatology Operation Theatre Based on Perception of the Five Human Senses

Background: In general a pleasant enviornment has a positive effect on the occupant’s feeling of well-being and this can affect patient recovery and staff performance. Therefore lighting, colour design, aroma and good behaviour of doctors are very essential Based on these ideas we conducted a study in our hospital premises as to how our 5 senses can help to conceptualise a dermatology operation theatre. Method: The study was carried out in the Department of Dermatology, Employees State Insurance – Post Graduate Institute of Medical Sciences & Research (ESI-PGIMSR), Basaidarapur, New Delhi. 120 was the sample size which was divided in to 3 groups of doctors, nurses and patients of 40 each. All cases were evaluated using case record proforma comprising of their demographic profile and 21 questions which was prevalidated. Results: In choosing colour of wall paint, 60% doctors opted white and 32.5% yellow. 53.3% selected white in total followed by yellow 21.7% followed by blue 15.8% and vibrant colour 9.2%. While choosing colour of linen (bed sheets) most doctors chose green colour (55%). All (100%) preferred provision of windows/ ventilator in OT for natural light. Hearing calming words by doctors before surgery was appreciated by all nurses and patients (100%). Conclusion: Five senses of human body play an important role while conceptualising the operation theatre.

Frequency of opportunistic infection in PL HIV and its role in monitoring of ART 1 failure

Background: There is so many opportunistic infection is present in PL HIV patient when patient immunity disturbed and their CD4 count decreased .this study was conducted for frequency of opportunistic infection in PL HIV and its role in monitoring of ART 1 failure. Aims and objective was to study the frequency of opportunistic infection in PL HIV and its role in monitoring of ART1 failure.Methods: This study was conducted in ART plus centre K.P.S. Post Graduate Institute of Medicine (G.S.V.M. Medical College, Kanpur) tertiary care teaching hospital and is clinical (assessment with investigation) continuous longitudinal, prospective and retrospective, observational, single centre hospital based study at ART Centre, Kanpur and considered All the patient on 1st line ART treating attending in centre were screened for treatment failure decided by SACEP from 2016 to 2018.Results: In this study there was opportunistic infection present that maximum in oral candidiasis but overall tuberculosis is maximum that is considered pulmonary tuberculosis, extra pulmonary tuberculosis, tubercular lymphadenitis and tubercular pericarditis, Abdominal knocks, TBM. LRTI and chronic diarrhea is also present. The male and rural area are more having opportunistic infections and all are have CD4 count 100 to 200 micrometer /Litre.Conclusions: The opportunistic infection mostly are oral candidiasis and tuberculosis, present in CD4 count in the range of 100-200 /ml.it is the indication of ART failure during treatments.

Evaluation of the predisposing factors and cause of resistance which are associated with ART 1 failure and shifted to ART 2 regime

Background: This study is to evaluate the predisposing factors and cause of resistance which are associated with ART1 failure and shifted to ART 2 regime.Methods: This study was conducted in ART plus centre K.P.S. Post Graduate Institute of Medicine (G.S.V.M. Medical College, Kanpur, India) tertiary care teaching hospital (G.S.V.M. Medical College, Kanpur, India). It will be a clinical (assessment with investigation), continuous, longitudinal, prospective and retrospective, observational, single centre hospital-based study at ART Centre, Kanpur, India. All the subjects who were on 1st line ART regime, attended in our centre were screened for treatment failure of based on clinical, immunological and virological criteria as decided by SACEP. Duration of this study was DEC 2016 TO DEC 2018.This study was taking as regime ART2 as TLATV/R, ZLATV/R, TLLP/R and ZLLP/R.Results: In this study there is PL HIV subjects that are considered for ART2 are mostly living in rural area and more are female having less adherence to ART1. Smoking, alcohol and tobacco chewing were also having less adherence to ART and cause resistance to ART1.Conclusions: In this study subjects were having associated with predisposing factor as Alcohalic 53 (45%), Tobacco Chewing 8 (07%), SMOKING 13 (11%). Alcohalic, Tobacco Chewer and Smoker have significant association of predisposing factor for low adherence to ART1 and resistance to ART1 drugs. There is also concluded that females and rural areas subject are having low adherence and cause ART1 failure.

IS THERE A CORRELATION BETWEEN THE OUTCOME OF REFERRED SICK NEONATES AND PERIPHERAL UTILIZATION OF RESOURCES DURING TRANSPORT? EVIDENCE FROM THE NICU OF A TERTIARY CARE HOSPITAL OF EASTERN INDIA USING TOPS SCORE

BACKGROUND: This study was conducted at the NICU of Dr B C Roy Post Graduate Institute of Paediatric Sciences, a tertiary care children's hospital in Kolkata, West Bengal, India, to study the immediate outcome of the referred sick neonates and peripheral utilization of resources before and during transport. METHODOLOGY: Aprospective observational study on 250 new born babies referred to Dr. B. C. Roy Post-Graduation Institute of Paediatric Sciences, Kolkata, India during the period of June 2016 to May 2017. At the admission detailed clinical assessment of the baby has been done and clinical physiological parameters (TOPS- Temperature, Oxygenation (Airway & Breathing), Perfusion, Sugar) were recorded. Pre transport TOPS and transport TOPS were noted. The babies were followed up for the next seventy two hours to study the correlation between the utilization of the resources and immediate outcome of the babies in terms of death, cardiorespiratory support (mechanical ventilation, CPAP, inotrope therapy), supportive care and discharge within next 72 hours. RESULTS: Out of 250 babies, 62% were boys, 58.4% were pre term,65% were low birth weight. 60% were transported in government ambulance. 100% mortality was present in babies taking > 2 hrs to reach the hospital. 44 babies had no alteration of TOPS parameters while one parameter was affected in 115 babies (46%), two parameters were affected in 51 babies (20.4%), three parameters were affected in 30 babies (12%) and all four parameters were affected in 10 babies (10%). Hypothermia was present in 65%, hypoxia in 34.8%, hypoperfusion in 23% and hypoglycemia in 16%. 44.8% were discharged with in 72 hours, 23.6% received supportive care, 17.2% required cardio-respiratory support and 14.4% died. CONCLUSION: Emphasis on stabilization of sick new born before and during transfer should be done. Training modules to all the personnel involved in the care of a sick new born and regular practise of the same should be encouraged. In-utero transport by identifying the high-risk pregnancies is beter way to decrease the requirement of transport should be supplied. Longer duration of transportation has a high mortality