Dermoscopic findings in chronic venous insufficiency.

Background: Chronic venous insufficiency (CVI) causes cutaneous changes. This prospective observational study reveals dermoscopic findings in CVI.

Methods: Successive CVI patients of ≥18 years were included in the study.

Observation of a quality improvement initiative to contextually adapt and use Robson classification in real time to collect data around CS delivery and to develop strategies to reduce CS rate.

The rising trend in caesarean section (CS) rate is a global concern and, in this hospital too, it rose from 21.5% in 2010 to 32.6% in 2018.

A Prospective Multi-centric Study of Acceptance, Insertion and Follow-Up of Postpartum Insertions of IUCD.

Purpose Of The Study: The unmet need for contraception in the postpartum period is a major challenge in our country. Unintended pregnancies are highest in the first year after birth, and postpartum IUCD insertion is an effective way to counter this problem. This study was planned to build up data for acceptance and follow-up of postpartum IUCD insertions.

A retrospective study to find out the correlation between NAFLD, diabetes, and obesity in Indian patients.

Background: Nonalcoholic fatty liver disease (NAFLD) is present in the body with metabolic disorders such as Type 2 diabetes mellitus (T2DM), obesity, and cardiovascular disease. However, no significant evidence has been found till date exhibiting their association epidemiologically in Indian patients.

Objective: To assess the association among NAFLD, T2DM, and obesity, and to validate the scoring system with grades of fatty liver (severity of liver disease) estimated by ultrasound vs.

Preidentification of high-risk pregnancies to improve triaging at the time of admission and management of complications in labour room: a quality improvement initiative.

Complications can occur anytime during pregnancy and childbirth. Pregnancies associated with high-risk factors have a higher-than-normal risk for fetomaternal complications. Bhagwan Mahavir hospital is a public sector hospital catering to low-risk and high-risk pregnant women (PW) in the labour room (LR)).

Wedge-less oblique supracondylar femoral osteotomy and casting for genu valgum in older children and young adults.

Background: Genu valgum is one of the commonest deformities seen by the orthopaedicians. The most common cause is idiopathic but genu valgum secondary to nutritional deficiency is also fairly common in developing and third world countries. Supracondylar osteotomy and internal fixation with plate and screws, is the treatment of choice in older children and young adults, which is costly, requires a wide exposure, a second surgery for implant removal and risk of infection is more.

Development of a hub and spoke model for quality improvement in rural and urban healthcare settings in India: a pilot study.

Objective: Hub and spoke model has been used across industries to augment peripheral services by centralising key resources. This exercise evaluated the feasibility of whether such a model can be developed and implemented for quality improvement across rural and urban settings in India with support from a network for quality improvement.

Methods: This model was implemented using support from the state and district administration.

Evaluation of the Role of Nasal Endoscopy and Computed Tomography Individually in the Diagnosis of Chronic Rhinosinusitis.

The aims of this study were to assess the individual roles of nasal endoscopy (NE) and computed tomography (CT) in the diagnosis of chronic rhinosinusitis, to evaluate their sensitivity and specificity and determine the superiority of one over the other, if any. The study was conducted over 19 months on patients above 18 years of age attending the ENT OPD at Jaipur Golden Hospital, Rohini, Delhi with persistence of symptoms of chronic rhinosinusitis (CRS) for ≥12 weeks. NE was done in each patient followed by NCCT-PNS (4 mm cuts) evaluated with the Lund Mackay system and score ≥4 was suggestive of disease.

Association of increased risk of asthma with elevated arginase & interleukin-13 levels in serum & rs2781666 G/T genotype of arginase I.

Background & Objectives: High expression of arginase gene and its elevated level in serum and bronchial lavage reported in animal models indicated an association with the pathogenesis of asthma. This study was undertaken to assess the serum arginase activity in symptomatic asthma patients and healthy controls and to correlate it with cytokine levels [interleukin (IL)-4 and IL-13] and arginase I (ARG1) gene polymorphism.

Methods: Asthma was confirmed by lung function test according to the GINA guidelines in patients attending Allergy and Pulmonology Clinic, Bhagwan Mahavir Hospital and Research Centre, Hyderabad, India, a tertiary care centre, during 2013-2015.

Improving postpartum care in a large hospital in New Delhi, India.

Despite recent progress, the maternal mortality ratio (MMR) in India remains high at 174 per 100 000 live births. Bhagwan Mahavir Hospital (BMH) is a secondary level hospital in New Delhi. In 2013, five women died in BMH's postpartum ward.

Negative pressure wound therapy versus gauze dressings for the treatment of contaminated traumatic wounds.

Objective: This compares hospital suction negative pressure wound therapy (NPWT) with conventional gauze dressings in traumatic soft-tissue injury at a tertiary care centre.

Methods: A prospective control study was conducted between September 2012 and November 2014. Patients with one or more traumatic soft-tissue injuries with contaminated wounds were allocated to either a test group (received NPWT) or control group (received conventional gauze).

How to Proceed with Examination of a Child?

The assessment of a child is quite different from that of adults and requires knowledge of normal variations in anatomy and physiology with growth and development. An important part of initial assessment includes triage and recognizing children with emergency signs so that they can be managed at the earliest to prevent death and referred timely to the specialist. After ruling out emergency signs, the children with priority signs require prompt assessment, management and referral to the specialist.

[Postpartum hemorrhage and pregnancy induced hypertension during emergency lower segment cesarean section: dexmedetomidine to our rescue].

Dexmedetomidine is a highly selective α-2 agonist which has recently revolutionized our anesthesia and intensive care practice. An obstetric patient presented for emergency cesarean delivery under general anesthesia, with pre-eclampsia and postpartum hemorrhage. In carefully selected cases with refractory hypertension and postpartum hemorrhage, dexmedetomidine can be used for improving overall patient outcome.

Role of Joshi's external stabilization system with percutaneous screw fixation in high-energy tibial condylar fractures associated with severe soft tissue injuries.

Purpose: The treatment of high-energy tibial condylar fractures which are associated with severe soft tissue injuries remains contentious and challenging. In this study, we assessed the results of Joshi's external stabilization system (JESS) by using the principle of ligamentotaxis and percutaneous screw fixation for managing high-energy tibial condylar fractures associated with severe soft tissue injuries.

Methods: Between June 2008 and June 2010, 25 consecutive patients who were 17e71 years (mean, 39.

Association of methylene tetrahydrofolate reductase C677T genotype with type 2 diabetes mellitus patients with and without renal complications.

Diabetes is gradually getting the status of a global epidemic, with India projected as the capital of type 2 diabetes mellitus (T2DM). Nephropathy is an important complication of diabetes and a major cause of end-stage renal disease. Studies from different parts of the world have given controversial results regarding the association of methylene tetrahydrofolate reductase (MTHFR) gene variation with T2DM and diabetic nephropathy (DN).

Relevance of insulin-like growth factor 2 in the etiopathophysiology of diabetic nephropathy: possible roles of phosphatase and tensin homolog on chromosome 10 and secreted protein acidic and rich in cysteine as regulators of repair.

Background: Diabetic nephropathy (DN) is a devastating complication of diabetes, the exact molecular pathophysiology of which is not well established. Hyperglycemia increases insulin-like growth factors (IGFs), especially IGF2, which acts via the IGF1 receptor present on renal cells. Elevated glucose levels damage the kidney, which is repaired by modulators such as secreted protein acidic and rich in cysteine (SPARC).

Relationship of angiotensin-converting enzyme gene polymorphism with nephropathy associated with Type 2 diabetes mellitus in Asian Indians.

Objective: Diabetic nephropathy (DN) has become the leading cause of end-stage renal disease, but the pathogenesis of this condition is not exactly understood. Several studies from different parts of the world have examined angiotensin-converting enzyme (ACE) gene polymorphism as a candidate for DN. Two studies yielding controversial results have been reported from India.

Use of specific IgE to fractions of gynandropsis gynandra pollen inin vitro diagnostic test.

The study was aimed at presence of specific IgE antibody levelsinvitro to the identified antigen. Based on positive skin test with Gynandropsis gynandra and elevated levels of total IgE (>325 IU/ml) 104 patients were selected. Healthy, asymptomatic individuals (25) with low total IgE (<325 IU/ml) were included as controls.

Rapid detection of food-borne pathogens by using molecular techniques.

Traditional methods of identification of food-borne pathogens, which cause disease in humans, are time-consuming and laborious, so there is a need for the development of innovative methods for the rapid identification of food-borne pathogens. Recent advances in molecular cloning and recombinant DNA techniques have revolutionized the detection of pathogens in foods. In this study the development of a PCR-based technique for the rapid identification of the food-borne pathogens Salmonella and Escherichia coli was undertaken.