Background: The present study aim was to determine the efficacy of lignocaine 2 mg/kg bolus and esmolol 200 mg bolus in attenuating the sympathetic responses to laryngoscopy and tracheal intubation. Objective: To determine the efficacy of lignocaine 2 mg/kg bolus and esmolol 200 mg bolus in attenuating the sympathetic responses to laryngoscopy and tracheal intubation Methods: A clinical comparative study of attenuation of sympathetic response to laryngoscopy and intubation was done in 150 patients posted for elective surgeries. Study was conducted in Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar. General Anesthesia was provided with endotracheal Intubation for all the patients. 150 cases were divided into three groups with 50 cases in each group. An informed consent was taken in all the patients. Results: The age range was 20-50 years for control and study groups. The mean values of age with standard deviations are 31.18±9.79, 32.18±10.64 and 33.66±10.83 for control, lignocaine and esmolol groups respectively. In combination of esmolol and lignocaine test dose a significant decrease in SBP occurred after 1min (p <0.001), and 3 min (p <0.001) groups respectively. Conclusion: Among the both study group's superiority of esmolol over lignocaine in attenuating the sympathetic responses to laryngoscopy and intubation is evident and statistically highly significant at all times.

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Background: Assessment of platelet counts are an important part of the routine assessment of patients, especially in bleeding disorders, thrombocytopenia, and infections such as Dengue fever, which are associated with extremely low platelet counts. The platelet counts by automated Hematology counters are generally accurate, but at times, the machine cannot differentiate between platelets and non – platelet particles such as fragments of WBC, RBC and cellular debris. Objective: We estimated the accurate platelet counts obtained by automated machine using impedance technology, after verification with platelet counts obtained by assessment of peripheral blood smears and manual counts using Neubauer chamber. Methods: Blood samples of 236 patients reported to Malla Reddy Hospital Suraram Hyderabad, from 27 May 2019 to 09 June 2019 were studied. Patients were in the age of 4 days to 85 years, of both genders and had platelet counts below 1.5 × 10³ / μl, estimated by Sysmex XNL 350. The counts thus obtained were verified by evaluation of Giemsa stained peripheral blood smears and manual platelet counts using improved Neubauer chamber. Results: The study revealed discordance between the machines generated platelet counts and manually evaluated platelet counts in 71 samples. In 63 samples the counts by Sysmex machine were lower than actual counts obtained by manual evaluation by a factor of 4 – 106 × 10³/μl. In only 8 samples, the machine generated count was higher than the manual count by a similar factor. Conclusion: It is mandatory to verify abnormal platelet counts obtained by automated hematology analyzers, by examination of peripheral blood smears and manual counts using improved Neuberger's chamber.

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Background: Health status of the humans up to some extent is controlled by the geographical factors. Certain diseases are region specific. Thus geography has a pivotal role to play in the analysis of health related issues and area specific diseases. Objective: To find out the trend in the incidence of vector borne diseases in the study area, to compare the prevalence of the diseases between the tribal (agency) and non tribal (plain) areas, to probe into the causal factors for the variations in the incidence, to offer policy measures and intervention Methods: Data with regards to incidence of Malaria, Dengue and Chikungunya from 2011 to 2015. Data for 2016 up to August was collected from the 58 public health centers (PHCs) of the district of which 38 were in tribal areas, while the remaining 18 were in plain areas. Data for 2016 is related exclusively to malaria and for the sake of comparison; data pertaining to malaria was also collected PHC wise. Simple techniques of analysis like percentages and ratios were used Results: Data with regards to malaria shows that positive cases were 3171 in 2011 out of 423040 blood samples accounting for 7.5%. They decreased in absolute number to 1153 in 2012 and increased to 1697 in 2013. Again they increased 2990 in 2014 and decreased to 1822 in 2015. A jig jag trend is evident in the prevalence. However between 2011 and 2015 total positive cases of malaria have decreased by 42.5% in the district. Further, the data reveals that PF positive represents tribal areas have been abnormally higher when compared to PV positive representing non tribal areas. It implies that the incidence of malaria in tribal area poses a threat to the health of the people. However the decreases in positive cases from 2011 to 2015 in the tribal areas were 42.83% against 20% in the non tribal area. The ratio of malaria incidence between non tribal and tribal areas is 1:78 in 2011 and it decreased to 1:56 in 2015. Conclusion: Dengue affliction showed irregular trend. In the recent months dengue has been affecting more people in the Mandal areas. Malaria is a major pubic health problem in the tribal area due to the geographical factors and its incidence is mostly in the tribal habitations

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Background: Scalp defects are mainly caused due to trauma, tumour resection and burns. The repair of such defect is dependent upon their location, size and depth Objectives: To study various reconstructive options and their complications and to provide a framework for management of scalp defects Methods: This was a prospective study done on patients who have had scalp defects requiring surgery. Total of 30 patients were included in the study. Tumor histology was confirmed by the pathology department. All patients were followed for 3 to 6 months post operatively. Free Flap was done in six patients. Anterolateral thigh flap and Radial Forearm Free Flap were done. STSG was applied in 9 patients. Tissue expander was applied in 3 patients. Local flaps like rotation, transposition etc was done in 12 patients. Results: Etiology found was Road Traffic accident in majority of patients i.e. 10. Burn and basal cell carcinoma was etiology in 6 patients each. Squamous cell carcinoma was found in 5 patients. Fall from height was etiology in 4 patients. Males were more than females. Free flap was done in six patients. Split thickness skin graft was done in nine patients. Tissue expander was used in three patients. Local flap was used in twelve patients. Three patients had tip necrosis and two patients had infection. Out of three having tip necrosis, two were operated by using free flap with conservative approach. Local flap was used in one patient. Out of two patients with infection, local flap was used in one patient and STSG was used in one. Conclusion: In small to medium sized defect with exposed bone, local flaps are a good option. In large and extensive defects, free flaps should be used.

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Background: The increase in the expectancy of the life has resulted in the increased elderly population and at the same time increase in diseases of chronic in nature and degenerative diseases. Chronic diseases like diabetes, hypertension, stroke, cancers etc are on the increase Objective: To study the associated risk factors for various morbidities among elderly population in the rural field practice area Methods: A community based cross sectional study was carried out among 832 randomly selected elderly persons in the rural area. Common morbid conditions like diabetes, hypertension, gastrointestinal diseases, respiratory diseases, psychological diseases were surveyed. Associated risk factors were studied. Data was analyzed using odds ratio, chi square. Results: the prevalence of hypertension was 42.4%. It was found to be associated with advanced age of more than 70 years. The prevalence of diabetes was 14.1%.it was found to be associated with lack of physical exercise and alcohol use. The prevalence of gastrointestinal diseases was 26.1%. It was associated with age, lack of physical exercise and alcohol use. The prevalence of respiratory diseases was 6.5%. It was associated with lack of physical exercise, alcohol use. The prevalence of psychological diseases was 2.3%. It was associated with lack of physical exercise. Conclusion: The most common morbid condition among elderly was hypertension in 42.4%. Lack of physical exercise was the most common risk factor for all the morbidities studied except hypertension.

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Background: Improvement in the sanitation is an important aspect from community point of view so that the burden of communicable diseases can be reduced. Use of sanitary latrine in a community is considered as an index for sanitation of that community. Objective: To study use of sanitary latrines in Rural Health Training Center area of a Medical College Methods: A community based cross sectional study was carried out in three randomly selected villages from November 2017 to January 2018 in the rural field practice area, Gummadidala under Department of Community Medicine, Malla Reddy Institute of Medical Sciences, Suraram. During the study period we surveyed 447 houses in these three villages. One respondent from each house was interviewed regarding the use of sanitary latrine Results: More than half of the participants were aware about the Swacch Bharat Mission. The most common source of information on SBM was television in 65.9% of the cases. 80.5% of the household members were using sanitary latrine. The most common reason for not using sanitary latrine was lack of money in 60.9% of the cases. Among 347 households having sanitary latrine at their home and using it, 53 (15.3%) told that they were able to construct sanitary latrine due to aid from Government. 39.6% received 10,000 to 15,000 INR for construction of sanitary latrine. Factors like employment status, and type of family were not found to be associated with not using sanitary latrine. Still 43.7% among them used only water to wash hand and did not use soap. Majority (57.7%) were aware that some diseases were transmitted due to open air defecation. Only 17.4% had correct knowledge of diseases transmitted due to open air defecation among those who were found aware that open air defecation leads to some diseases. Conclusion: More than half of the participants were aware about the Swacch Bharat Mission. 80.5% of the household members were using sanitary latrine. The most common reason for not using sanitary latrine was lack of money in 60.9%.

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Background: As one of the essential part of curriculum of Community Medicine subject understanding of primary healthcare by medical student will be seen as key for effective teaching of the subject. Lectures are the most economical of teaching-learning methods. It is essential to evaluate whether the learning objectives have been accomplished. In the present study pre and post lecture MCQs (Multiple choice questions) are introduced for sixth semester medical students in Community Medicine lectures and to assess the effect on gaining and retention of knowledge acquired at the end of the lecture. Objective: To assess the knowledge of primary health care in India and to know the impact of outcome of Class room teaching by pre test and post test questionnaire. Methods: A prospective study was conducted at Dr. Shankarrao Chavan Government Medical College, Nanded. A total of 23 students from sixth semester medical students were enrolled in this study. Ten single best responses multiple choice questions from primary health care topic were used to assess knowledge gained by students before and after class room teaching on primary health care lecture series by pre test and post test analysis method. Results: A total of the 20 students out of 23 sixth semester students completed both pre and post test questionnaire. The average pre test score was 4.2±0.894 and post test score was 9.5±0.945. Fischer's exact test was applied to analyze the improvement in scores between pretest and posttest which was significant at P < 0.05. The paired t-test was applied to know improvement in mean scores between pretest and post test which was significant at P < 0.001. Conclusion: There is significant increase in knowledge of student after class room teaching. Class room teaching is effective for way assessing gain in knowledge.

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