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Objective: To validate a better scoring system between CURB- 65 and the pneumonia severity index (PSI) to predict the need for intensive care unit admission and 30-day mortality in patients with COVID-19 pneumonia. Methods: A retrospective cohort study was conducted on patients in a tertiary care hospital in Kota, Rajasthan. Relevant data about history, and general and systemic examination with laboratory investigations was collected. Patients were categorized into different risk groups for ICU admission and 30-day mortality according to CURB-65 and PSI. Sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve were calculated. Continuous variables, means and percentages were compared using the t -test for numerical data and the Chi- square test for nominal data. Results: 100 patients who tested positive for SARS-CoV-2 by RT- PCR were included; 67 were male and 33 were female. 58 patients had severe disease (SpO2≤90%) and 30 patients died. CURB- 65 had an area under the curve (AUC) of 0.81 for predicting ICU admission, with a sensitivity of 92% and a specificity of 54% for high risk patients. Meanwhile, PSI had an AUC of 0.88, with a sensitivity of 83% and a specificity of 73% in high risk patients. In addition, CURB-65 had an AUC of 0.79 for predicting 30-day mortality, with a sensitivity of 60% and a specificity of 89% in high risk patients. PSI had an AUC of 0.71 for predicting 30-day mortality, with a sensitivity of 90% and a specificity of 46% in high risk patients. Conclusions: This single-centre retrospective study involving a cohort of COVID-19 patients demonstrates that CURB-65 and PSI are powerful tools for predicting mortality. However, PSI appears to be slightly better at predicting the need for intensive care unit admission in high-risk patients. [ABSTRACT FROM AUTHOR]

Objective: To study Clinico-epidemiological parameters of adult acute poisoning at tertiary care centre in Hadoti region of Rajasthan. Methodology: A prospective cross sectional was conducted on 50 patients, presenting to the Government medical college and associated group of hospitals of Kota, Rajasthan. The data about demography and laboratory parameters were collected after admission of the patient and analyzed. Results: The mean age of patients was 28.4(13.0-58.0) years. The proportion of male was 62%. Most common mode of poisoning was ingestion(98%). suicidal circumstance was in 45 (90%) (Male: Female=2:1) and accidental in 5 (10%) patients (Male:Female=1:4). Most of the suicidal poisoning cases (34%) from the age group 20 to 29 years. Insecticidal poisoning was the most common poisoning. In drug poisoning most common from sedative group or benzodiazepine group, in corrosive poisoning most common was Phenyl. The most common symptom was Vomiting (90%). 48 patients were successfully discharged from ward or ICU and 2 were expired from ICU. Conclusion: Study has provided a comprehensive overview of poisoning in Rajasthan, focusing on hospital data. The findings indicate that male gender and longer delays in seeking treatment at primary care facilities are associated with lower survival rates. The study highlights the need for increased public awareness about the importance of promptly transferring poisoning cases to hospitals, calling for attention from planners and policymakers. [ABSTRACT FROM AUTHOR]

Objective: To explore the predictive value of neutrophil-to-lymphocyte ratio (NLR) in in-hospital mortality in sepsis patients. Methods: A prospective observational cross-sectional study was conducted on 100 patients with septicemia. The data about the patient's demography, medical history, general examination including pulse rate, blood pressure, etc , use of vasopressor support, need for renal replacement therapy, mechanical ventilation, outcome, and lab parameters including total lymphocyte count with neutrophil-to-lymphocyte ratio were recorded. And parameters between survivals and non-survivals were compared. Results: Out of 100 patients, 80% were from rural backgrounds. Most patients were 50 to 59 years old. 26 Patients were dead. The patients in the nonsurvivor group were older and more had a history of diabetes mellitus when compared with the survivor group. The non-survivor group had a higher NLR, APACHE II, and SOFA score. Conclusions: NLR is a readily available parameter and can be used as a good prognostic indicator for mortality in sepsis patients. [ABSTRACT FROM AUTHOR]

Background: Sleep deprivation include physical effects (sleepiness, fatigue) cognitive impairment (deterioration of performance, attention and motivation) and mental health issues. Objectives: To assess and compare sleep duration and sleep hygiene with their associated factors among rural and urban residents of a district of Uttar Pradesh. Material and Methods: This cross-sectional study was conducted in Etawah district, UP, from January 2022 to June 2022. All residents of rural and urban areas were included using multistage sampling. Study tool included a questionnaire which collected sociodemographic information, sleep duration, and sleep hygienic practices using sleep hygiene index. Results: In this study, 240 participants each from the rural and urban areas were included. The mean duration of sleep among the participants in rural and urban areas was 7.40±1.22 and 8.18±1.30 h during the workdays whereas, 7.30±1.30 and 8.11±1.35 h during the weekends respectively. About 40% were having unhygienic sleep practices. Most of the study participants had the history of sleep duration less than 8 hr. among the comparison groups. Graduated participants had the more sleep problems. Conclusions: Particularly among the elderly, inadequate sleep duration and differences in sleep rhythm between weekdays and weekends were seen. [ABSTRACT FROM AUTHOR]

Primary hydatid of spinal cord is a very rare presentation of relatively common disease. We present the case of 23-year-old female with cauda equina syndrome diagnosed to have a primary spinal hydatid which mimicked Pott's spine. Initial diagnosis was made with the help of history taking, clinical examination and investigations like MRI and later confirmed with the help of biopsy. High suspicion is required for diagnosis, as it is a rare disease. Complete resection along with Albendazole therapy is the current choice of treatment. Further studies are required for the same as there is a lack of guidelines for management. [ABSTRACT FROM AUTHOR]

Aim of the study: determine the pattern of prescription of Anti Diabetic Drugs in a cohort of patients at a tertiary care centre of East Nimar region of Central India. Methods: The study was a Prospective observational study and was conducted in the Outpatient department of Medicine conducted for a period of 6 Months. Demographic and clinical data of total 82 patients were collected and Prescription of these Diabetic patients were analysed. Result: Out of Total 82 Patients, the maximum percentage of Diabetic patients, including both males and females belonged to the age group of 51 to 60 years (36.58%). Majority of Patients received Two Drug Anti-diabetic Drug combination (i.e. Metformin and Glimepiride combination) which were the most prescribed drugs (65.85%, 54 Patients out of total 82 Patients) followed by Mono-therapy with Metformin (13.41%, 11 Patients out of total 82 Patients). Among the three drugs combination therapy prescribed in 15 patients (18.29%), often Metformin + Glimepiride + Pioglitazone combination were prescribed (6 patients, 7.31%), followed by Metformin + Glimepiride+ Vildagliptin/Tenegliptin/Sitagliptin (DPPIV Inhibitors) (5 patients, 6.09 %). As far as comorbid conditions are concerned 62 Patients (75.60 %) had no comorbid disease along with Diabetes, 20 patients (24.39 %) had Hypertension and 3 patients (3.65 %) had Hyperlipidaemia along with Hypertension and Diabetes and received concomitant medications for the same. Conclusions: The present study represents the current prescribing pattern of Anti-Diabetic Drugs in our Hospital. Our findings showed that Metformin and Glimepiride combination dominated thescenario followed by Monotherapy with Metformin among the elderly populations of Diabetes. The use of Anti-Diabetic drugs largely confirms the guidelines as most of the patients belonged to the category of elderly populations, but still there is a significant room of improvement in terms of rational prescribing. [ABSTRACT FROM AUTHOR]

Aim of the study:The present study aims to determine the pattern of prescription of Anti Hypertensive in a cohort of patients at a tertiary care centre of East Nimar region of Central India. Methods:The study was a Prospective observational study and was conducted in the Outpatient department of Medicine conducted for a period of 6 Months. Demographic and clinical data of Total 86 patients were collected and Prescription of these Hypertensive patients were analysed. Result:Out of Total 86 Patients, the maximum percentage of Hypertensive patients, including both males and females belonged to the age group of 60 to 70 years. As majority of Patients belonged to the elderly age group, Calcium channel Blocker/Amlodipine was the most prescribed drug class/drug, followed by Telmisartan and Metoprolol. Among the combination therapy prescribed in 35 patients (40.69%), often two drug combination were prescribed (25 patients, 29.06%), ARBs Combination with CCBs dominated the scenario with 16 patients (18.60 %) followed by CCBs + Beta Blockers (5 patients, 5.81 %). Conclusions: The present study represents the current prescribing pattern of Anti-Hypertensive Drugs in our Hospital. Our findings showed that CCBs dominated the scenario of Monotherapy among the elderly populations of hypertension followed by combination therapy of CCBs and ARBs. The use of Anti-hypertensive drugs largely confirms the guidelines as most of the patients belonged to the category of elderly populations, but still there is a significant room of improvement in terms of rational prescribing. [ABSTRACT FROM AUTHOR]

Background: The resurgence of interest in the intricate relationship between nutrition and health reflects the escalating burden of lifestyle diseases on the healthcare system. The imperative for medical students to embody a healthy lifestyle is underscored by their pivotal role as future advocates of health promotion. Aims & Objectives: This study aims to assess the knowledge, attitude, and practices regarding dietary habits and physical activity among undergraduate medical students of district Etawah of Uttar Pradesh. Material and Method: A cross-sectional survey was carried out in UPUMS, Saifai, Etawah and 153 study subjects were recruited using the purposive sampling method. All the first-year undergraduate medical students who had given consent to participate were included in the study. Results: Approximately half of the participants were able to identify healthy foods, with 84.4 percent recognizing the hypertensive risks associated with excessive salt intake. The majority exhibited positive attitudes, such as the importance of daily water consumption (85.7%), awareness that sweet foods/drinks could be detrimental to health (79.8%), and the acknowledgment that fast foods have adverse health effects (70.1%). Conclusion: While a substantial majority of medical students showcased awareness regarding the significance of a healthful diet and regular exercise, the translation of this knowledge into consistent practices warrants attention. [ABSTRACT FROM AUTHOR]

Soil is one of the largest carbon reservoirs sequestering more carbon than vegetation and atmosphere. Due to the enormous potential of soil to sequester atmospheric CO2, it becomes a feasible option to alleviate the current and impending effects of changing climate. Soil is a vulnerable resource globally because it is highly susceptible to global environmental problems such as land degradation, biodiversity loss, and climate change. Therefore, protecting and monitoring worldwide soil carbon pools is a complicated challenge. Soil organic carbon (SOC) is a vital factor affecting soil health since it is a major component of SOM and contributes to food production. This review attempts to summarize the information on carbon sequestration, storage, and carbon pools in the major terrestrial ecosystems and underpin soil carbon responses under climate change and mitigation strategies. Topography, pedogenic, and climatic factors mainly affect carbon input and stabilization. Humid conditions and low temperature favor high soil organic carbon content. Whereas warmer and drier regions have low SOC stocks. Tropical peatlands and mangrove ecosystems have the highest SOC stock. The soil of drylands stores 95% of the global Soil Inorganic Carbon (SIC) stock. Grasslands include rangelands, shrublands, pasturelands, and croplands. They hold about 1/5th of the world’s total soil carbon stocks. [ABSTRACT FROM AUTHOR]

Background: Elevated lipid levels during late pregnancy are associated with complications and adverse outcome for both mother and newborn. However, it is inconclusive whether a disturbed lipid profile during early pregnancy has similar negative associations. Aim: To evaluate the association of altered lipid levels and development of adverse maternal and fetal outcomes. Materials and methods: This is a Cohort study conducted in the Department of Obstetrics and Gynecology, in a Tertiary Care Teaching Hospital, Central India. Women attending outpatient department (OPD), antenatal care (ANC) and in patient department (IPD) in our hospital during the period of study were included. History clinical examination and all relevant investigation were done. All data were calculated and analyzed statistically. Result: Mean age of pregnant women in the study group was 24.89 ± 3.12 years, whereas in the control group, it was 24.72 ± 3.76 years. The levels of total cholesterol, triglycerides (TG), low density lipoprotein (LDL) and VLDL were significantly high in women who developed gestational diabetes mellitus (GDM) and preeclampsia as compared to those who did not develop GDM and preeclampsia (p<0.001). The levels of total cholesterol, TG, LDL and VLDL in women who developed preterm labor were found to be significantly high in women who developed preterm labor (p<0.01) as compared to women who did not have PTL. Women who developed small for gestational age (SGA) had statistically significant high levels of total cholesterol, TG, LDL and VLDL (p<0.05). The levels of total cholesterol, TG, LDL, VLDL, in women who developed macrosomia were not statistically significant when the two groups were compared (p>0.05). Conclusion: It was seen that third trimester maternal dyslipidemia is associated with various maternal and fetal complications such as gestational diabetes mellitus, preeclampsia, IHCP, preterm labor and SGA babies. [ABSTRACT FROM AUTHOR]

Background: Diabetic patients with concomitant dyslipidemia are often soft targets for cardiovascular disease and deaths. An early intervention to normalize circulating lipids has been shown to reduce cardiovascular morbidity and mortality. Hence, this study aimed to determine the relationship between dyslipidemia and glycemic status in patients with type 2 DM (T2DM) patients. Material and Methods: This was a cross-sectional and prospective study was carried out at Tertiary Care Teaching Hospital over a period of 01 year. Total of 70 T2DM patients with dyslipidemia enrolled in this study. Fasting blood glucose (FBG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride (TG) and glycosylated hemoglobin (HbA1c) levels were evaluated. Test of significance was calculated by unpaired Student's 'test. Correlation studies (Pearson's correlation) were performed between glycosylated hemoglobin (HbA1c) and serum lipid profile. Results: Distribution of Glucose Triad results of FBS, PPBS and HbA1c levels of patients presented as Mean± SD, mean FBS was 173.59±39.64, mean PPBS was CBYU 234.59±94.59 and mean HbA1c was 7.78±0.83. Mean total cholesterol was 226.53 ± 19.53, mean total triglyceride was 213.83 ± 20.65, Mean HDL was 35.63 ± 3.96, mean LDL was 148.14 ± 7.63 and VLDL was 42.76 ± 3.69. HbA1c positively and significantly correlated with total cholesterol (r=0.213), LDL (r=0.304), HbA1c negatively and significantly correlated with HDL (r=-0.128), and did not show any show correlation with VLDL (r=0.049) and total triglycerides (r=0.049). Conclusion: The study indicates the usefulness of HbA1c as a marker for lipid profile for screening of diabetic patients at high risk of developing cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Several emerging evidences have documented cardiovascular disease arise due to multifactorial causes with elevated diagnostic serum levels such as Lactate dehydrogenase (LDH). LDH could be a useful marker of systemic inflammation, as it is a cytoplasmic enzyme that is widely expressed in tissues. As elevated LDH levels reflect cardiac damage and is used to diagnose acute myocardial infarction, valve heart disease, heart failure, and coronary heart disease, therefore, present study was aimed to evaluate the serum LDH levels in the pathogenesis of CAD. Present study was carried out at Manva Kheda, Udaipur, Rajasthan from 2013 to 2014 on 100 patients suffering from myocardial infarction and for comparative study 50 controls were included after checkup at our hospital and after explaining about the examination, a signed informed consent was obtained. So from all the participants, 5ml of blood was obtained and serum was extracted for further LDH analysis. It was observed that, total mean age of controls and patients is 54.64 ± 7.75 and 57.36 ± 11.96 years respectively. LDH level was 157.74 ± 23.11. Males had 158.08 ± 23.37 and females had 156.40 ± 23.16 U/L. With biochemical parameters done on MI Patients, the value of LDH was 317.25+36.91 U/L. The males had 316.71+41.53 and females had 318.88+17.21. The t and p value of patients (male) and control (male) was statistically highly significant with 26.20; P<0.001 and t and p value of patients (female) and control (female) was also statistically highly significant 20.08; P<0.001. Hence, concluded that, LDH in myocardial infarction revealed increased serum levels for all patients with myocardial infarction and remained to be a significant marker in predicting MI. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases (CVD) are major contributors to global burden of chronic diseases with 29.3% of global deaths and 9.9% of total disease burden. The diagnosis of the Myocardial infarction (MI) was based upon the electrocardiogram (ECG) and even if not indicated then different cardiac marker for example Serum Aspartate Transaminase (AST) was done for the confirmation of MI. Therefore, the present study was conducted on 50 normal and 100 patients suffering from myocardial infarction attending /admitted to various wards of Manva Kheda, Udaipur. Patients with known cases of Diabetes mellitus and obese person were also included in study. The diagnosis of MI was confirmed by ECG changes and cardiac biomarkers. Controls were 50 normal healthy age and sex matched individuals without any major illness and not on any medications. 5 ml blood sample was obtained from both the groups and was subjected to centrifugation for serum separation and appropriate test analysis was performed. The total mean age of controls and patients is 54.64 ± 7.75 and 57.36 ± 11.96 years respectively. The value of serum AST was 25.76 ± 5.82, in which males had 26.08 ± 5.28 and females had 24.5 ± 7.82 IU/L. With biochemical parameters done on MI patients, AST was 79.51+23.06. The males had 81.57+23.89 and females had 73.32+19.51 IU/L. The t and p value of patients (male) and control (male) was statistically highly significant with 19.25; P<0.001 and t and p value of patients (female) and control (female) was also statistically highly significant 10.57; P<0.001. Hence, concluded that AST in myocardial infarction revealed increased serum levels for all patients with myocardial infarction and remained to be a significant marker in predicting MI. [ABSTRACT FROM AUTHOR]