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Context: Over the past three decades, there has been a significant rise in the prevalence of noncommunicable diseases (NCDs) globally, accompanied by a relative decline in communicable diseases. Aims: With this background, the research was planned to determine the prevalence of acanthosis nigricans (AN) or skin tags (STs) in the study population and to examine the relationship between the presence of AN and ST with commonly used indicators such as waist-to-height ratio (W/Ht.), Indian Diabetes Risk Score (IDRS), and body mass index for predicting the risk of NCDs. Settings and Design: This cross-sectional study was done at a health facility in Lucknow (India). Methodology: Consecutive sampling was employed to select 152 apparently healthy adults as the participants. Data collection involved administering a questionnaire and conducting anthropometry using standardized methods. Visual inspection was conducted to identify AN or ST on the common sites. Statistical Analysis Used: Data entry was done in Microsoft Office Excel, followed by data analysis using SPSS. To test the association between variables "significance of difference of mean," Chi-square test, logistic regression analysis, and estimation of Kohen's kappa were used. A "P" value was considered statistically significant at <0.05 level. The sensitivity and specificity of AN and ST were also estimated in predicting the risk of NCDs. Results: The prevalence of AN was 19.08% (95% confidence interval [CI] = 12.76%–25.40%), while the prevalence of STs was 28.29% (95% CI = 21.05%–35.53%). AN showed a sensitivity of 22.4% and specificity of 96.3% with W/Ht. ratio as the standard, and a sensitivity of 26.44% and specificity of 90.77% with IDRS as the standard. ST exhibited a sensitivity of 32.0% and specificity of 88.89% with W/Ht. ratio as the standard, and a sensitivity of 37.93% and specificity of 84.62% with IDRS as the standard. Conclusion: AN and ST can be used as simple and time-saving tools in screening protocols for (NCDs). Further research is desirable to validate the findings. [ABSTRACT FROM AUTHOR]

Introduction: The study was aimed at identifying the incidence of unreported probable hypoglycaemia in individuals with type 2 diabetes (T2DM) on anti-diabetic medications, using the screening Stanford Hypoglycemia Questionnaire (SHQ) in real-world situations. Methods: It was a multicentre cross-sectional study on consecutive individuals attending 10 diabetes care centres in Lucknow, Uttar Pradesh, India. The inclusion criteria were as follows: known individuals with T2DM, literate, age greater than or equal to 18 years, on at least one anti-diabetic agent for more than a month and not engaged in regular self-monitoring of blood glucose (SMBG). Results: This study was conducted from August 2017 to April 2018, involving 1198 participants. The mean age of the individuals enrolled was 53.45 years (±10.83), with males comprising 55.3% of the population. It was found that 63.6% of patients were on sulphonylurea (SU), 14.5% were on pioglitazone, 92.2% on metformin, 62.3% on Dipeptidyl peptidase (DPP4i) and 12.8% on Sodium-glucose cotransporter (SGLT2i). The mean SHQ score was 1.81 (±1.59). Probable hypoglycaemia was mild in 57.59%, moderate in 14.69% and severe in 1.41%. Those with diabetic neuropathy (P = <0.001), retinopathy (P = <0.001) and nephropathy (P = <0.001) had significantly higher SHQ scores. Insulin or SU use was associated with a significantly higher SHQ score. Concomitant statin use was associated with a lower incidence of mild, moderate and severe hypoglycaemia (P = 0.01). On multivariate analysis, we found that age, sex, systolic blood pressure (SBP), insulin use and fasting blood sugar were the most important factors associated with an increased risk of hypoglycaemia with an R2 cut-off of 0.7. Conclusion: SHQ was discovered to be a simple and cost-effective screening tool for outpatient detection of hypoglycaemia in an Indian setting, and it can add value to management. [ABSTRACT FROM AUTHOR]

Background: Primary hyperparathyroidism (PHPT) is rarely associated with the occurrence of acute or chronic pancreatitis, requiring complex perioperative management. This study aimed to assess the prevalence and disease characteristics of pancreatitis in PHPT. Materials and Methods: This study is a clinicopathological analysis of the medical records of patients who were diagnosed with PHPT with pancreatitis between 1989 and 2021 in the Endocrine Surgery department, SGPGI, Lucknow. Results: Out of 548 PHPT cases, 44 (8.03%) were found to be associated with pancreatitis. The mean age was 33.57 years (15-65 years); 5 were =20 years, while 26 were =30 years of age. There were 27 males and 17 females. Twenty-one cases were of acute (11 acute, nine recurrent acute, one acute on chronic), whereas 23 were of chronic pancreatitis (six chronic calcific pancreatitis). The major clinical presentation of PHPT with pancreatitis was abdominal pain (65.91%). The mean number of attacks per patient in recurrent acute pancreatitis was two. Mean PTH levels were 68.19 pmol/L. The mean tumor size (in the largest dimension) was 2.79 ± 1.4 cm while the mean tumor weight was 4.91 g. Nephrolithiasis was associated with 25 cases. An association with multiple endocrine neoplasia type 1 syndrome was seen in one case. The final histopathological diagnosis was parathyroid carcinoma in two, hyperplasia in three, and parathyroid adenoma in 39 cases. Normocalcemia was seen in 27.2%, hypercalcemic crisis in 15.9%, and 25% of patients required semi-emergency parathyroidectomy. The outcome was favorable in all, as none had any further attacks of pancreatitis. Conclusion: In our study, the prevalence of pancreatitis in PHPT cases was 8.03%. The majority of patients were young. Normocalcemia was seen in 12 patients, so even if calcium levels are normal, PHPT should be suspected in young patients with pancreatitis. Parathyroidectomy resulted in the complete resolution of symptoms of pancreatitis in all 44 patients. [ABSTRACT FROM AUTHOR]

Aim: The main purpose was to evaluate the effect of complete denture rehabilitation on the jaw growth pattern in individuals with ectodermal dysplasia from an early age to maturity. Settings and Design: This was a prospective in vivo study performed in the Department of Prosthodontics, King George Medical University, Lucknow, India. Materials and Methods: Rehabilitation with three sets of conventional complete dentures was completed in an ectodermal dysplasia case at the age of 5, 10, and 17 years. Cephalometric and diagnostic cast analyses were the methods performed to evaluate jaw growth patterns. Linear and angular measurements obtained after denture rehabilitation were averaged and compared with mean standard values of nearly corresponding ages, as given by Sakamoto and Bolton. Conversely, alveolar ridge arch width and length were evaluated for their dimensional changes during the same age intervals. Statistical Analysis Used: Mann--Whitney U-test was used to check the difference between the groups. The significance of the level adopted was 5%. Results: Nasion-anterior nasal spine, anterior nasal spine-menton, anterior nasal spine-pterygomaxillary fissure, gonion-sella, and gonion-menton lengths were found to be not statistically significant than the mean standard values of nearly corresponding ages (P > 0.05). The decrease in facial plane angle, increase in Y-axis angle, and mandibular plane angle after complete denture rehabilitation were statistically significant when compared to their mean standard values (P < 0.05). Cast analysis showed more increase in the length compared to the width in both arches. Conclusion: Complete denture rehabilitation did not significantly affect the jaw growth pattern, although it improved facial esthetics and masticatory activity by establishing adequate vertical dimensions. [ABSTRACT FROM AUTHOR]

Introduction:Cervical carcinoma is the second most common malignancy in women worldwide. It is estimated that over a million women worldwide currently have cervical cancer. Worldwide, cervical cancer is both the fourth-most common cancer and the fourth-most common cause of death from cancer in women. In 2012, 528, 000 new cases of cervical cancer were diagnosed, and 266, 000 women died of the disease (GLOBOCAN 2012), nearly 90% of them in lowto middle-income class countries. Multifactorial causation, potential for prevention, and the sheer threat it poses make cervical cancer an important disease for in-depth studies, as has been attempted by this paper by studying the hypoxic marker. Recently, there has been increasing interest in the identification of biomarkers able to predict both response to treatment and survival. Aim: The aim of this study was to evaluate the association of hypoxic marker Carbonic anhydrase (CAIX) markers to predict the clinical outcome of patients with cervical carcinoma. Materials and methods:This study was conducted on biopsy proven previously untreated cases of cancer cervix who presented to the Department of Radiotherapy at King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India. The study was a single institution, non-randomised, prospective study to evaluate carbonic anhydrase IX as a biomarker in cancer cervix patients undergoing radiotherapy. Sample size: Total 75 samples • 25 healthy control subjects (Age and sex matched) • 25 cancer cervix patients (duplicate samples i.e. baseline and follow up). Approximately 2 ml of blood was withdrawn before initiation of treatment and at the time of first follow up. Standard treatment was given as external beam radiotherapy (EBRT) with concurrent chemotherapy followed by intracavitary radiotherapy (ICRT). Blood samples was analysed for the level of CAIX..Statistical analyses was performed with the SPSS software package v13.0. Results: Pre-treatment high level of carbonic anhydrase IX correlated with poor treatment outcome. [ABSTRACT FROM AUTHOR]

Context: Menstruation is a normal physiologic phenomenon. Due to lack of awareness regarding menstrual hygiene among adolescent girls in India, majority have unhygienic practices which make them vulnerable to various adverse health and social outcomes. Aims and Objective: The aim of this study was to compare the awareness and perception of pre- and postmenarchal adolescent girls regarding menstrual hygiene. Settings and Design: A hospital-based cross-sectional study was conducted by the Department of Obstetrics and Gynaecology and Paediatrics of a Government tertiary care center, Lucknow, Uttar Pradesh for 6 months from 1 July 2019 to 31 December 2019. Material and Methods: The study was undertaken among 120 adolescent girls between 09 and 19 years of age. Premenarchal age group was from 9 to 12 years and postmenarchal was 13–19 years. All the adolescent girls who fulfilled the inclusion criteria were subjected to a pretested prevalidated semi-structured questionnaire assessing their awareness and perceptions regarding menstrual hygiene. Result: Of 120 respondents, 43 girls were aware of menstruation prior to attainment of menarche. Mother was the first informant regarding menstruation in the case of 49 (49.65%) girls. A total of 57 girls believed it as a physiological process. 32 (53.3%) girls knew the use of sanitary pads during menstruation. Regarding restrictions practiced, 136 (85%) girls practiced different restrictions during menstruation. Conclusion: Adolescent girls, being vulnerable, need to have adequate and correct awareness regarding menstrual hygiene. This will protect them from risk of developing reproductive or sexually transmitted infections (RTI/STI) which is a burden on our society and render many females infertile and cause other adverse health outcomes. [ABSTRACT FROM AUTHOR]

Background and objectives: Hepatitis C virus (HCV) is a causative agent of hepatitis C disease of the liver. We have analysed the major risk factors including demographic, clinical and genotypic distribution among HCV seropositive patients and their distribution in Uttar Pradesh, India. Methods: This study was conducted by a questionnaire-based proforma, filled in Hepatobiliary Clinic, Department of Medicine, King Georg's Medical University, Lucknow, from 2014 to 2017. Demographic, clinical and laboratory data were recorded. Seropositivity was demonstrated through an anti-HCV IgG ELISA kit. Positive patients were further examined for HCV RNA by RT-PCR. Results: A total of 31,440 patients attended the hepatobiliary clinic. Among these, 310 (0.99%) patients were confirmed for HCV infection and there was no significant difference between males and females (50.3% vs. 49.7%). Previous surgery (49.0%), dental extraction (41.0%) and roadside shaving (38.1%) were the major risk factors for HCV infection. We also observed that previous surgery 143/154 (92.9%) in female and roadside shaving 118/156 (75.6%) in male was the commonest factor for HCV, however; dental extraction was comparable among male and female (65 [51.8%] vs 62 [48.2%], P value = 0.818). HCV RNA genotype 3 (81.6%) was the most frequent followed by 3a (11.3%), 3b (5.8%), 1 (0.7%) and 4 (0.7%). In the district-wise analysis, frequent cases were included from Lucknow with previous surgery and dental extraction as the commonest risk factor. Interpretation and Conclusions: Previous surgery among female and roadside shaving among males are the commonest risk factors for HCV. This study suggests a powerful and strict guideline, to avoid HCV infection. [ABSTRACT FROM AUTHOR]

Background: The outcome of any disease is influenced by the decisions to seek care, timely arrival at appropriate diagnostic and treatment services and the receipt of adequate care from service providers. Satisfaction in service provision is increasingly being used as a measure of health system performance. Satisfaction manifests itself in the distribution, access and utilization of health services. Objectives: To determine the areas and causes of low satisfaction among the patients and suggest methods for improvement. Materials and Methods: Multistage stratified random sampling was used to select the government allopathic health facilities of Lucknow district and systematic random sampling for the selection of the patients for the interview. Results: The accessibility was difficult in 42% patients and waiting time more than 30 min for 62.5% of those attending the tertiary level health facility. The satisfaction with the duration of the outpatient department (OPD) (64.6%) and the presence of signboards (46.6%) was also found to be low. The overall satisfaction regarding the doctor-patient communication was more than 60% at all the levels of health care facilities but that with the examination and consultation was less than 60% at the primary level as compared to more than 80% elsewhere. The most important motivating factor for the visit to the tertiary (48.2%) and secondary level (71.9%, 67.1%) of health facilities was the faith on doctors or health facility. Conclusions: The level of patient satisfaction is severely deficient in several areas and needs improvement for the achievement of optimal health of the people. [ABSTRACT FROM AUTHOR]

Objectives: Is use of tobacco a major health problem among medical students? To find out the factors associated with the use of tobacco. Materials and Methods: A cross-sectional study was done on 250 undergraduate male medical students using a pre-designed, pre-tested questionnaire to study about the problem and various correlates of the tobacco use. Data was collected and analysed using Excel and SPSS software. Results: Among the tobacco users (28.8%), smoking was found in 87.5% and tobacco chewing in the form of gutka, khaini, gulmanjan (locally available forms of tobacco) in 37.5% as the predominant means of the use of tobacco. The mean age of our sample was 23.5 years. The residential background, i.e., rural or urban, and religion were not significantly associated with the use of tobacco in the present study. Hostellers were found to be more frequent tobacco users as compared to day-scholars. There was a familial aggregation of the use of tobacco. The factor initiating the use of tobacco was usually peer pressure. Conclusion: Tobacco use is a significant problem among the male medical students and we need to take steps to stop its use by them so as to prevent them from being exposed to its hazardous effects. This will also make their role in the advocacy of the smoking cessation activities more trustworthy. [ABSTRACT FROM AUTHOR]

Study of Copper, Zinc and Selenium associated with Superoxide Dismutase, Catalase and Glutathione Peroxidase level in serum of Breast cancer patients of North India A. K. Singh, V. Jain, G. N. Singh 1Department of Surgery, King George's Medical University, 2Surgery, King Georg's Medical University, Lucknow, India I declare that my presentation : will not include discussion of unapproved or "off-label" usage of a commercial product or device. Introduction: Breast cancer in women is most common cancer world wide and second most common cancer overall. Trace elements and antioxidant enzymes have been found involved in development and prevention of malignancies including breast cancer. This study aims to find out association between trace elements: copper, zinc and selenium along with antioxidant enzymes: SOD, Catalase, Glutathione peroxidise levels in breast cancer patients of various clinical stages. Materials & Methods: This Prospective observational cohort study is conducted in department of general surgery, King George's Medical University, Lucknow, U.P., India. Blood sample of 152 breast cancer patients were analysed and age matched with 152 controls. Unpaired t-test is used to compare the antioxidant enzymesand trace elements between cases and controls. The plasma level of copper, zinc, selenium and antioxidant enzymes (SOD, Catalase, Glutathione peroxidase) were analysed in both groups to find out any statistically significant correlation. Results: Plasma copper levels (μgm/dl) are higher in cases with mean of 132.43±6.10 vs controls 113.58±11.70 with p<0.0001. Plasma zinc levels (μgm/dl) (case: 88.25±6.30, control: 109.92±8.33, p<0.0001)) and selenium (μmol/dl) (case:3.27±0.18, control: 3.33±0.22 (p<0.0001)) are lower in breast cancer patients. Mean levels of Superoxide dismutase (IU/ ml) (case: 9.49±6.25, control: 27.04±4.39, p<0.0001), Catalase (IU/ ml) (case:0.09±0.08, control: 0.29±0.24, p<0.0001) and Glutathione peroxidise (nanomolNADPH oxidase/min/mg protein) (case: 16.96±10.20, control; 46.70±14.18, p<0.0001) are observed to be lower in breast cancer patients. Blood level of selenium, Superoxide dismutase, Catalase and Glutathione peroxidase are found to have a direct correlation while Plasma levels of Copper has inverse correlation with advanced stages of breast cancer Conclusion: Lower levels of antioxidant enzymes (Superoxide dismutase, Catalase and Glutathione peroxidase) and selenium found in breast cancer patients along with higher copper levels suggest that these metals and antioxidant enzymes play role in etiopathogenesis and aggressiveness of disease. This gives insight to initiate research for additive therapy of antioxidants and selenium in patients of breast cancer to achieve better outcome. Disclosure of Interest: None Declared. [ABSTRACT FROM AUTHOR]