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Background:There are wide number of diseases of almost every system in the body which can affect heart in a number of different ways including increasing demands on the heart ,ventricular dysfunction ,rhythm abnormalities ,valve abnormalities ,pulmonary pressures and lot more.Cardiac involvement in systemic diseases is usually silent or oligosymptomatic and includes different pathophysiological mechanisms such as myocardial inflammation, infarction ,subendocardial vasculitis,valvular disease and different patterns of fibrosis. Objective : To study association between systemic illnesses (hematological, endocrinal , renal) and cardiac function abnormalities as ventricular function,cardiac dimensions ,pulmonary artery pressure and pericardial effusion,for early diagnosis and treatment to decrease morbidity and mortality in patient with systemic illness. Design/Method:It was a cross sectional,descriptive study The present study was conducted in the Department of Pediatrics, LLRM Medical College,Meerut,Uttar Pradesh over a period of 1 year (June 2019-June 2020) Results: Cardiac findings in all three groups show ECG abnormalities and echocardiographic changes compared to general population. ECG abnormalities were prolonged PR interval and sinus tachycardia while echocardiographic changes mainly left ventricular(LV) dilatation and hypertrophy ,increased cardiac output ,ventricular dysfunction and pulmonary arterial hypertension(PAH),were noted in a significant proportion of patients. Conclusion:Systemic illnesses affect cardiac parameters in various ways including prolonged PR interval,cardiac dilatation,chamber hypertrophy ,high cardiac output,high cardiac index ,PAH and ventricular dysfunction.

Angioedema is a self-limited, localized swelling that involves subcutaneous tissue or mucosa of the face and other areas. It affects males and females equally, usually during the 3rd and 4th decades of life. We present a patient with angioedema of the head, neck, upper trunk and both upper limb with a typical clinical picture of an acquired type and with a low level of C1-INH. Initially the patient was treated with a combination of drugs for allergy. However, the swelling did not respond to the therapy and patient had a history of recurrent admission in our hospital with the complaint swelling over face and shortness of breath. After the 3rd day, the edema began reducing progressively

Introduction Chronic tendinopathies involves majority of patients in clinical practice of orthopaedic surgeons and sports physicians. The burdens of these problems to a society adversely effect the social, economical,occupational, recreational and physical aspect of patients. Translational medicine confers an emerging medical advances efficiently towards the clinician directly from scientists which may used as a targeted therapy. Objectives: The main objective of translational research from “bench to bedside” is to test novel inventions in humans. Our purpose in this article to understand the translational medicine approach for chronic tendinopathies in clinical aspects. This fulfill the basic objectives of translational science to promote further medical and surgical care with ease. Methods We conducted search in electronic database of google scholar, pubmed ,Embase, web of science, Elsevier and science direct with reviews till October 2020. After obtaining search we narrowed our search for articles in terms of getting a literature specifically mentioned about translational medicine ,translational sciences, chronic tendinopathies. Methodological quality assessment and analysis were done in order to obtain relevantrepresenatation that best suited to our objectives for this article. As this is a narrative review we tried to accommodate important aspect of research and future directives for clinical implications as well as future research in the fields. Discussion: Translational research in chronic tendinopathies is required certainly due to plenty of reasons. Newer advances and targeted approach to these tendon disorders may curtail the further degenerative process. It aids in earlier diagnosis and prevention of morbidity, early occupancy of occupational activity, lack of economical as well as recreational failure. Pre-disease level activity is ultimate goal of any therapy. Current guidelines are lacking in agreement for any single guidelines for tendinopathies. Moreover, there aren’t any clearly defined ideal treatment protocol. Tendon pathophysiology is constantly evolving researched topic in both biochemical as well as molecular aspect. Clinical implications of such emerging techniques and treatments where “bench to bedside” and “bedside to bench” motto of translational medicine should be fastened in order to achieve a newer approach. Conclusions: The basic fundamental understanding of complex process of tendon healing and regeneration is necessary for formulating a newer guidelines. The cornerstone of treatment of tendinopathies is still non-operative management. Physical therapy, better pain control, NSAIDS are still primary choice for these conditions. Various biological therapy whenever used one should combined them with other appropriate options to obtain an optimum outcome.

Background: Immunization, a powerful and cost effective intervention against vaccine preventable diseases needs to be sustained with higher coverage for desired benefits. Despite the ongoing Universal Immunization Programme, the immunization coverage in India is low. Objectives: To determine the immunization status of children aged 1-6 years, to study its association with various sociodemographic factors and the reasons for partial and no immunization. Methods: This prospective study was conducted from September 2019 to February 2020 at a tertiary care hospital in Ahmedabad, India. Sociodemographic data and immunization history were recorded in a structured proforma. Children were classified as being completely, partially or unimmunized based on the vaccines (as per National Immunization Schedule) received as applicable for age. Results: Of the 608 enrolled children, 467 (76.8 %) were fully immunized, 134 (22 %) partially immunized and 7 (1.2 %) were unimmunized. 87.8 % children had complete primary immunization up to first measles containing vaccine. Lower socioeconomic status, home delivery, birth order more than 2, low maternal education and occupation status were found to be significant risk factors (p

Introduction: Septoplasty for nasal septal deviation is one of the most commonly performed surgeries by the otolaryngologist. Though various surgical techniques have evolved for correction of a deviated septum, complications are still common. Method: A prospective study of 90 patients of symptomatic nasal septal deviation was done to investigate for development of complications after endoscopic septoplasty. Complications were catagorised into early, occurring within 7 days and late, usually detected within three months after surgery. Results; Most common early complication was haemorrhage seen in overall 16.66% of patients. 6.66% had primary hemorrhage during surgery and 8.88% had reactionary hemorrhage within 24 hours of surgery. Secondary hemorrhage and septal hematoma was rare(1.1%) . Most common late complication was persistence of subjective symptom of nasal blockage(15.55%) followed by nasal synache(5.55%). Septal perforation and vestibular stenosis are less common(1.1%). CSF leak, saddle nose, nasal tip ptosis or any ocular complications were not seen in any patient. Conclusion:. Meticulous preoperative planning with precise surgical techniques during endoscopic septoplasty can reduce the risk of complications that may have a profound effect on the functional and aesthetic aspects of a person’s life.

Lateral epicondylitis is also known as a Tennis elbow is a common disease of middle age which is painful and functionally limiting entity affecting the upper extremity & causes decreased productivity. The rst line treatment for LE is topical and oral anti-inammatory drugs from ice st applications and brace used. If the 1 line treatment fails second line treatment generally invasive are offered and second-line therapeutic regimens include saline, corticosteroid or platelet-rich plasma injections. Dry needling is relatively new for treating the same. We hypothesized that dry needling would be as effective as second-line treatment for LE. Here we compared the outcomes of second-line treatment, local steroids and dry needling. MATERIALS AND METHODS: The study involved 50 patients having LE, dividing into 2 groups. Patients in group 1 received dry needling, where as those in group 2 received second-line treatment, consisting of local corticosteroid injections. The patients were evaluated after 2 and 4 weeks on the bases of Patients – rated tennis elbow evaluation score (PRTEE). RESULTS:Both treatment were equally effective at 2 and 4 weeks. The effectiveness of both are same and both intervals but someone dry needling has low complications rate in compare to local steroids. CONCLUSION: Because of the low complication rate, dry needling is a safe method, and it might be an effective treatment option for LE same as the second line treatment of local corticosteroid injections.

INTRODUCTION: Seizure is dened as paroxysmal involuntary disturbance of brain function. It may manifest as impairment or loss of consciousness, abnormal motor activity, behavioural abnormality, sensory disturbance or autonomic dysfunction. Any abnormal, repetitive and stereotypic behaviour in neonates should be evaluated as possible seizure. Neonatal seizures is a common neurological problem with a frequency range from 0.95 to 3.5/1000 live births. AIMS & OBJECTIVES:To assess the importance of biochemical abnormalities in neonatal seizures and to evaluate clinical presentation & time of onset of seizures in term and preterm neonates. MATERIAL & METHODS: A total of 90 neonates presenting with seizures admitted to NICU of National Institute of Medical Sciences & Research, Jaipur from conducted from 1st January 2019 till 30 th June 2020 were enrolled in the study. Detailed antenatal, natal, postnatal history along with detailed examination was done. Baseline characteristics of convulsing neonate including sex, gestational age, birth weight, head circumference & length were recorded at admission. Clinical details of each seizure episode reported by the mother and subsequently observed by the resident doctors on duty were recorded i.e. age at onset of seizures, duration of seizure, number and type of seizure. Relevant investigations including biochemical parameters were done immediately after baby had seizures and before instituting any specic treatment. Etiology of neonatal seizures and associated biochemical abnormalities were diagnosed. RESULTS: In the present study, out of 90 neonates studied, 64 were full term of which 49(76.5%) were AGAand 15(23.5%) were SGA, whereas 26 cases were preterm. The male: female ratio is 1.3:1. Most neonatal seizures occur in rst 3 days of life, i.e. 60 %. Most of them occurred on rst day of life (34%). Birth asphyxia was the cause of neonatal seizures in 82 % neonates who developed seizures on day-1 of life. Birth asphyxia and septicemia are common cause of neonatal seizures in our study, followed by pure metabolic disturbances 20 %. In pure metabolic seizures, hypoglycemia (47.8%) is most common more in preterm babies (55%) followed by hypocalcemia. In cases of non- metabolic seizures, which showed associated biochemical abnormalities, hypoglycemia was most common abnormality 24 of 52 cases (46.15%). 12 cases (52.1%) are associated with birth asphyxia and 11 cases (47.9%) are associated with septicemia. CONCLUSION: Biochemical abnormalities are common in neonatal seizures and often go unrecognized. These abnormalities may signicantly contribute to seizure activity correction of these abnormalities may play a signicant role in seizure control. Hence, a biochemical work up is necessary for all cases of neonatal seizures.

Dermatomyositis is rare autoimmune inammatory myositis, carries an increased risk of malignancy. Dermatomyositis is a rare case characterized by skin changes and muscle weakness. Magnetic resonance imaging is the modality of choice in the diagnostic work-up and monitoring of dermatomyositis affecting muscles, fasciae, and the subcutis. We are reporting a rare case of dermatomyositis in patient, who came for check up in medicine department and diagnosed on the basis of MRI pelvis with both thigh, Xray PBH, clinical examination and history and conrmed by histopathological examination

Objective: The aim of the study was to compare open and closed method in terms of time require for creation of pneumoperitoneum and to ascertain safety in laparoscopic surgery. Methodology: This was a prospective comparative study carried out at a tertiary care hospital from January 2019 to December 2019.We selected 100 patients who were planned for laparoscopic surgery and divided them into two equal groups using the envelop method of randomization. Group A comprised of patients in whom we created pneumoperitoneum by classical veress needle insertion and in Group B by open method. Results: In our study, the mean time require for closed method was 6.92 minutes while by open method it was 4.36 minutes. Complication rate was 18% in closed and 16% in open method. Conclusion: open method is quick but comparable to closed method in terms of complications.

Introduction: India being a developing country has a high incidence of thermal burns. Severe burn injury is followed by a state of hypermetabolism, which causes increased cardiac workload and increased resting energy expenditure causing muscle wasting, leading to increased morbidity. The aim of this study is to test the effect of propranolol in modulating the state of hypermetabolism in the acute post burn phase using various clinical and laboratory parameters. Patients and Methods: This is a prospective randomized control study which includes 84 patients of burns with total burn surface area 20-40% conducted at Department of surgery ,SSG Hospital, Baroda over a period of 1.5 year. The patients were divided into test (propanolol) and control groups. Similar burn treatment was continued in both groups and change in the laboratory, and clinical parameters were noted. Results were compared within the groups using paired t-test and in between the groups using unpaired t-test. Result: This study shows a significant reduction of 25% in the heart rate and 26% in the sleeping pulse rate with 2 weeks of propranolol therapy (P < 0.001). There was a 3.33% increase in the weight along with 2.5% increase in mid-arm circumference. There was a 5.7% increase in total serum albumin concentration and C-reactive protein was found to be reduced by 8.2%. Conclusion: The results prove propranolol as an effective modulator of hypermetabolism by counteracting the effect of catecholamine, reducing infection and inflammation hence improving the overall outcome of severe burn patients.

PURPOSE- To analyse various ocular diseases leading to permanent visual handicap in a district based on visual handicap certification issued by ophthalmologist at tertiary care center after verification of the domicile of the person. METHOD – This is a retrospective analysis of patients attending outpatient department of tertiary care center for visual handicap certification. It was done over the period of one year with total recruitment of 311 patients. All patients were examined for best corrected visual acuity according to Snellen’s chart, anterior and posterior segment examination. Ultrasonography and/or Optical Coherence Tomography and/or electroretinography / visual evoked potential was done in selected cases. After diagnosis, percentage of blindness was determined according to the categories of visual disability and blindness certificate was issued. RESULT- Maximum of the certified visually disabled individuals are of 21- 30 years (73 patients, 23.47%). 212 patients were males and 99 were females. Visual disability of 100% was seen in 258 cases. Retinitis Pigmentosa was the most common cause seen in 67(21.54%) cases. Other major causes include congenital ocular malformation(16.40%) optic atrophy(13.83%), phthisis bulbi (8.68%), corneal opacities(8.36%), glaucoma(6.75%). CONCLUSION- The burden of the blindness can be decreased by public educationand genetic counselling regarding common and preventable causes of blindness, as early diagnosis, treatment and visual rehabilitation can help to improve visual outcome and ultimately visual handicap in the society for the better future.

This is a study to correlate vitamin D levels in Covid positive patients admitted in GCS medical hospital, Ahmedabad .Covid 19 can vary in clinical presentation in different patients owing to their age , comorbidities and various other factors. It is now being studied whether Vitamin D levels have any bearing on initial presentation, duration of hospital stay, oxygen requirement and clinical outcome. It is a cross sectional observational study taking into account 100 patients. After applying inclusion criteria, 94 patients were selected ,out of which 37 were vitamin D decient.(39.36%). Mean vitamin D was 17.16 ±10.85 ng/ml. Out of 94 patients 55 were males and 39 were females.34% males(18) were found to be vitamin D decient and in females 51%(19)were vitamin D decient. 38% (14)of vitamin D decient people required oxygen and 48%of vitamin D decient Covid positive patients(17) required prolonged hospitalisation.

Splenic abscess is a rare entity. Delay in its diagnosis and treatment can lead to high morbidity and mortality. Here, we describe a case of a female patient with air-uid level in the parenchyma of the spleen caused by a gas forming bacterial infection. There was no preceding history of trauma or instrumentation in our case. This case was managed by prompt diagnosis followed by percutaneous drainage under broad spectrum antibiotic coverage. Agas forming infection of the spleen without manipulation or trauma is extremely rare, with only 3 reported cases in the literature

Aim: To study the clinical and laboratory profile of patients having systemic lupus erythematosus (SLE) at Civil Hospital, Ahmedabad. SLE is an autoimmune multisystem disease which mainly affects young females in their child bearing age leading to decreased productivity and increased economic burden Methods: -Type of study: Cross sectional study. Patients fulfilling revised American College of Rheumatology criteria (1982) for SLE were included in the study. Detailed history, clinical examination and laboratory results of the patients were noted. Data analysis was carried out using Statistical Package for Social Sciences. Results: 25 patients were enrolled in the study. Females (84%) were more commonly affected, maximum patients being in the age group of 20 – 30 years. Arthritis was amongst the commonest initial manifestation (84%) followed by anemia (76%). Other manifestations included involvement of Renal, Cardiopulmonary, Dermatologic and Nervous System. ANA antibody was found positive in all patients while anti dsDNA was positive in 80% patients. Conclusion: The incidence of anemia and lupus nephritis was higher in our study as compared to other studies. Early intervention and close follow up is vital to prevention of morbidity and mortality. Arthritis and Anemia were amongst the most common clinical features.

Introduction: Post-cholecystectomy syndrome (PCS) comprise of a group of abdominal symptoms that occur after cholecystectomy. Post cholecystectomy syndrome is defined as group of heterogeneous symptoms. It is consists of upper abdominal pain, vomiting and dyspepsia, which occur after cholecystectomy. Although, this term is not accurate, as it comprises biliary and non-biliary disorders, possibly not related to cholecystectomy. AIM : To analyse the clinical evaluation for post cholecystectomy Symptoms. Objectives : To identify the causes for post cholecystectomy symptoms.To identify pre-operative factors (h/o ERCP, attacks of cholecystitis) associated with post cholecystectomy symptoms. Materials & Methods : A Prospective clinical hospital based study was done in 100 patients at tertiary care referral hospital in the department of general surgery. All cases of post- cholecystectomy who had clinical symptoms of PCS Cases in which on follow up USG and LFT were done. Result: In our study 100 patients were taken who developed PCS after cholecystectomy. Among all patients, 16% patient developed PCS due to biliary etiology. Among 16% patients most common cause is recurrent CBD stone (6%) and second most common causes is retained CBD Stone (3%) & spincter Of Oddi dysfunction (3%). Discussion : This analysis provides a qualitative overview of etiologies of abdominal symptoms after cholecystectomy. Based on the etiologies of persistent and incident symptoms after cholecystectomy provided in this review, we identified the cause of long-term symptoms after cholecystectomy. Conclusion : In our study, PCS developed mainly due to non-biliary etiology considered 84% and biliary etiology considered only 16%. Female has higher risk to developing post cholecystectomy symptoms compared to male after cholecystectomy.

Health Care Industry is the largest service industry in the world. Health is very important and vital factor for the prosperity of a country. Hospitals provide different type of services to their patients. Hospitals have operational problems in functioning day to day work. So it is important to study and identify the operational problems of the Hospitals. In this paper an attempt is made to study operational problems of selected Government Hospitals, Private Hospitals and Trust Hospitals functioning in Gujarat state. Data has been collected through Schedule for Hospitals. Operational problems identify in the main area of hospital services like Casualty and Emergency Services, Out Patient Services, In Patient Services, Diagnostic Services, Nursing Services, Pharmacy Services, Medical Records and Dietary Services. Ranks are given to problems faced by Hospitals. Police cases, overcrowding of patients, high turnover ratio of manpower, commission of doctors, lack of trained staff, lack of proper infrastructure facilities etc. problems faced by Hospitals functioning in Gujarat state. Hospitals should try to remove all this problems for the benefit of patients’ health. Government should provide trained staff to Trust Hospitals. Government should arrange special training programmes for medical, paramedical staff and office staff for all type of hospitals without any fees. Gujarat government should provide more infrastructure facilities in Government Hospitals and sanction special loan at lower interest rate to Trust and Private Hospitals ABSTRACT