Background and Objective: Proper care of the newborn babies form the foundation of the subsequent life not only in terms of longevity or survival but also in terms of qualitative outcome without any physical and mental disabilities. A study was done to evaluate the knowledge and practice regarding neonatal care among primipara mothers in Dehradun, Uttarakhand. Methodology: A nonexperimental descriptive research approach was applied for the study. The patients were 155 primipara mothers, selected by nonprobability purposive sampling technique. Sociodemographic proforma, self-structured questionnaire, and practice checklist were used to collect data regarding neonatal care among primipara mothers. Results: The study communicated that out of 155 samples that mostly (76.1%) had average knowledge level. Moreover, practices of the mothers illustrated that the majority of participants (87.09%) hadpoor practice, whereas only 12.90% hadgood practice. Furthermore, a significant moderate positive correlation (P = 0.0001) was highlighted between knowledge scores and practices scores regarding neonatal care among primipara mothers. In addition, Chi-square value showed that no association found between knowledge score when scored a significant association was reported between knowledge score of primipara mothers with their age and education. Furthermore, practice scores of primipara mothers were significantly associated with the religion. Conclusion: Findings emphasis the need of educational/teaching programs and awareness campaigns, which in turn may enhance the overall knowledge and practice regarding neonatal care. These initiatives may be significant in declining neonatal morbidity and mortality.

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Coronavirus disease 2019 (COVID-19) is highly infectious and primarily a respiratory infection. The presentation is often in the form of atypical pneumonia which if not detected and managed effectively, progresses to acute respiratory distress syndrome (ARDS). Due to the atypical nature, rapid spread and sheer magnitude of the COVID-19 pandemic, the guidelines for mechanical ventilation in COVID-19 ARDS are still evolving. In this review, we have attempted to examine the emerging evidence on the same to further our knowledge on the subject.

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Background: Data show that the prevalence of depression, anxiety, and stress is more among medical students compared to general population and thus proving that the community of the medical students is a vulnerable group or high-risk group, where we need to take adequate measures to counter this issue among this particular community. Objective: The objective of the study was to study the prevalence of depression, anxiety, and stress among one of the private Medical college students. Materials and Methods: An institution-based cross-sectional study was conducted in a private medical college among 450 medical students of 1^st, 2^nd, 3^rd, and 4^th year and interns and postgraduate (PG) students for 6 months. “Depression Anxiety Stress Scale 21” which was already validated and standardized was used for the present study. “The internal consistency, i.e., Cronbach's alpha value was 0.87 that was suggestive of high reliability.” Data collection was done in batches for undergraduates and for interns and PGs, whenever they were free and available. Anonymity was maintained. Results: Prevalence of depression, anxiety, and stress among medical students was 58.2%, 68.7%, and 35.3%, respectively. The most common was moderate grade of depression (30.7%), severe anxiety (39.6%), and moderate stress (15.8%). After testing for associated factors with depression, anxiety, and stress, it was fond that only belonging to joint family type and being undergraduate were found to be significantly associated with high levels of stress (P < 0.05). Conclusion: Prevalence of depression, anxiety, and stress among medical students was very high in this medical college. These results cannot be generalized to other medical students of other medical colleges but definitely reflect that medical students are depressed, anxious, and stressed.

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Background: Correct incidence of the spinal cord injuries in India is not known. Prevention is better than cure as there is no proper cure for the spinal cord injuries. Hence, study of clinical profile of patients with spinal cord injuries is required. Objectives: The present study was undertaken to study the clinical profile of spinal cord injuries in tertiary care hospital in rural area. Materials and Methods: This was a hospital-based cross-sectional study conducted among 56 patients with spinal cord injuries. Detailed history, required investigations were recorded. The data was analyzed using proportions. Results: Younger age groups from 20 to 49 were more commonly affected than older age group of 50 years and above. The most common site of spinal cord injuries was at the level of thorax (64.3%) followed by lower cervical level in 21.4% of the cases. 39.2% of the study subjects had complete spinal cord injury and 60.8% had incomplete spinal cord injury. Majority had both variety of injuries in the thoracic cord. Conclusion: It can be concluded that spinal cord injuries are common in the younger age group, thoracic site being the most common for injury and incomplete type of injury is common.

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Background: Simple practices such as appropriate washing of the hands, supply as well as use of clean water, excreta disposal in a scientific manner, sanitary latrine use, persona hygiene, etc., help to maintain health and promote the quality of life by preventing a number of diseases. Objective: The objective of this study is to study knowledge, attitude, and practices on sanitation, water and hygiene among mothers of under five children in rural area. Materials and Methods: A community-based cross-sectional study was carried out among 347 mothers of under five children in villages around the Rural Health Training Center. Data were collected in semistructured questionnaire where the information was obtained by face-to-face interview. Results: Majority mothers belonged to 21–30 years (87.3%); educated up to intermediate level (69.7%); were home makers (77.5%) and majority (94.5%) belonged to lower class of socioeconomic status. 43.8% used boiling method to purify water at household level. For the baby food, 31.1% were using boiled water. Majority (84.7%) had adequate knowledge on hand-washing. 71.5% told that hand washing is necessary to keep oneself away from the diseases. 97.1% were washing their hands after defecation and 85.9% expressed the need of soap for hand washing. 33.7% told that flies over food are the cause of worm infections. For diarrhea, 44.4% told that unhygienic food is the cause of diarrhea. 87.1% used dumping for disposal of waste water from kitchen and general household; 82.7% were dumping solid waste. Using the sanitary latrine was seen in 83.3%. Conclusion: It was observed that the knowledge on purification of water was poor. Second, very few people use boiled water for preparing baby's food. The knowledge about washing of hands after defecation was good.

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Tuberculosis is probably the oldest disease known to humankind. Globally, efforts are being made to eliminate the disease by 2030, while the Government of India has committed to achieve this in 2025 (5 years before). A critical evaluation has been made of the strategic plan outlining various activities to attain this goal.

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Introduction: Maternal and child health is an important public health issue, especially in developing countries like India. Maternal and child health services help to determine maternal and neonatal morbidity and mortality in a country. The second stage of labor is the most stressful part of childbirth process and the proper maternal position during this period is paramount for women's safe vaginal birth. Midwives play a pivotal role in managing maternal positions during the second stage of labor. However, there is limited evidence to support an ideal maternal position during the second stage of labor. Methodology: All studies that explored the effects of positioning during the second stage of labor were retrieved. Only four major databases, Google Scholar, ResearchGate, PubMed, and Shodhganga, were searched. The keywords used for search included the second stage of labor, maternal position, upright position, left lateral position, squatting position, and maternal outcomes. The search criteria included studies published from 2008 to 2021. Out of 154 research articles, only 14 studies were included for the review process. Results: The positions such as maternal upright, lateral position, squatting position, and sitting position are beneficial for the maternal and neonatal outcome. The mean length of the second stage of labor was shorter in squatting primiparas and multiparas than in semirecumbent women, whereas lithotomy and supine positions during labor are associated with poor maternal and fetal outcomes. Conclusion: The selected positions during the second stage of labor have shown positive outcomes for the pregnant and her child. The findings should be introduced in midwifery education programs and in clinical practice as a method to improve the care of women during the second stage of labor.

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Introduction: Tuberculosis (TB) has been haunting humanity for decades. Even with the existing treatment modalities and preventive measures, it continues to be among the top 10 killers in the world. India had 2.69 million cases in the year 2018, with 440,000 deaths due to TB alone. Hence, in this scenario, the knowledge of the health-care providers play a crucial role in the efforts of the Stop TB strategy of the National TB Elimination Program. This study aims to assess baseline knowledge and impact of TB sensitization program among nurses, interns, and postgraduate students in a Medical College Hospital in Karnataka. Materials and Methods: The methodology involved a questionnaire to assess the baseline knowledge of the participants of the RNTCP sensitization program. The same was repeated after completion of the program. Analysis: Data were entered into excel spreadsheets and analyzed using SPSS software. Proportions and paired t-test were used to assess the impact of the training on the participants. Results: The mean baseline knowledge among nurses, interns, and postgraduate students was 38.02%, 30.61%, and 34.04%, which improved by 40%, 57%, and 60%, respectively, after the training program. Conclusions: A highly significant (P < 0.001) difference was found in the pretest and posttest scores of the nurses, interns, and postgraduate students, indicating that training increased the knowledge scores of the Health Care Workers (HCW's) significantly. Hence, regular trainings are recommended to keep the HCWs updated on TB facts and strategies in the country.

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Background: Dysmenorrhea is a medical condition of pain during menstruation. A variety of factors effect dysmenorrhea which include early menarche, younger age, diet, prolonged and aberrant menstrual flow, psychological disturbances, and pelvic infections; these interfere with dysmenorrhea symptoms. Genetic factors, exertion, and activity patterns affect prevalence and severity of dysmenorrhea. Various studies in India revealed that the prevalence of dysmenorrhea varies from 33 to 79.67. Objective: To study the prevalence, characteristics, and determinants of dysmenorrhea. Materials and Methods: Community-based cross-sectional study was carried out which included 165 women from urban field practice area who have attained menarche but not completed menopause aged 15-50 years. Data were collected using semi-structured questionnaire by direct interview. The data were analyzed by percentages, proportions. Chi-square test was used. Results: The prevalence of dysmenorrhea was 60%. The correlation between the age and the dysmenorrhea grades was statistically not significant while the correlation between the age at menarche and the dysmenorrhea grades was found to be statistically significant. Majority of the participants had less than two hours of pain (33.3%) and most of them experienced the pain in the abdomen region (36.4%) and majority, i.e. 46.5% had mild pain. The duration of menstruation and duration of menstrual cycles were comparable in two groups but the heavy flow was significantly more in dysmenorrhea group compared to the normal group (P < 0.05) Conclusion: The prevalence of dysmenorrhea was high and it was related with age at menarche. Heavy flow was significantly more in dysmenorrhea patients.

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Background: Oral submucous fibrosis (OSMF) affects all age groups in Orissa. Rampant use of tobacco, gutka, and betel chewing made it a significant public health problem. Various modalities of treatments have been tried to ameliorate consequences of disease including antioxidants, local and systemic steroid, physiotherapy alone or with assisted devices, placental extract injection, and split skin grafting with varying success rate. Objective: The objective of the study was to compare effect of antioxidants and intralesional steroid infiltration in OSMF. Materials and Methods: Hospital-based prospective study was carried out among fifty patients presenting with OSMF. Only Stage two patients with Grade 2 and 3 trismus were included. History, clinical examination, and punch biopsy were taken. They were divided into two groups of 25 each irrespective of age and sex. Patients in Group A were given injection hyaluronidase (1500 IU) mixed with triamcinolone (40 mg/ml). It was injected submucosally once a week for 8 weeks over multiple sites in oral cavity. Patients in Group B were given oral antioxidant capsule (containing lycopene 4 mg, zinc 7.5 mg, and selenium 35 mg) once daily for 8 weeks. All patients were followed up for 8–12 weeks at weekly intervals and then monthly once for 1 year. Results: Majority belonged to 26–35 years. Majority were consuming areca nut with Pan (52%). Burning sensation on taking food and trismus were common symptoms. Most common sign was fibrosis (70%). Injection hyaluronidase (1500 IU) mixed with triamcinolone (40 mg/ml) injected submucosally once a week for 8 weeks over multiple sites was significantly effective in trismus compared to oral antioxidant capsule daily once for 8 weeks. Conclusion: Injection hyaluronidase (1500 IU) mixed with triamcinolone (40 mg/ml) injected submucosally once a week for 8 weeks over multiple sites was more effective than oral antioxidant capsule daily once for 8 weeks.

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Background: Physicians and faculty working in Medical Colleges play a major role in tuberculosis (TB) control. Their knowledge, attitude, and practices can affect the treatment and care of TB patients significantly. Objectives: The objectives were to assess the awareness about new guidelines of National TB Elimination Program (NTEP) among medical college faculty. Methods: A cross-sectional study was carried out among 95 faculties. They were given anonymous self-administered questionnaire with 23 questions. One mark was given for each correct answer. We classified correct knowledge as score >10 and poor knowledge as score <10. Yates-corrected Chi-square was used to study the association between variables and outcomes. P 0.05 was considered as statistically significant. Results: Questions about case detection rate, cure rate, incentives to private practitioner, bedaquiline, and follow-up of patients after completion of treatment were very poorly answered (<10 persons had correct knowledge). Only 17 could answer about the fixed-dose combinations, 10 about 99 Directly Observed Treatment Short-Course (DOTS) chemotherapy, and 13 about the choice of treatment in HIV-TB. Best answered questions were about the drugs used in each DOTS category, categories of DOTS, what are multidrug-resistant TB, extensive drug-resistant TB, and definition of presumptive case of TB. Overall, 58 faculties (61.1%) had poor knowledge with a score <11. The remaining 37 (38.9%) had correct knowledge with a score 11 or more. Correct knowledge was not found to be associated with age, sex, and designation but was associated with professional experience, with higher experience being associated with poor knowledge (P < 0.05). Conclusion: Majority of the faculty in the studied medical colleges had poor knowledge about new updates/guidelines in the NTEP. Professional experience was found to be significantly associated with the correct knowledge on recent updates in NTEP.

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Neural tube defects (NTDs) are the most common congenital malformations (CMFs) in developing fetus. The study was done to determine the incidence and clinical profile of NTDs at a tertiary care hospital. The study was done at Malla Reddy Institute of Medical Sciences, Suraram, Hyderabad, from June 2019 to June 2020. Ten pregnant women with confirmed NTDs were admitted and subjected to medical termination of pregnancy. Fetuses with NTDs were collected and observed externally for sex, type of NTD, and other associated anomalies. Anencephaly was the most prevalent anomaly among all NTDs. Ten babies with NTD were observed; male predominance was seen. Prenatal screening of the fetus is important to rule out the CMF of fetus.

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Background: Vector-borne diseases (VBDs) have been a worrying factor among the tropical and subtropical parts of the world which include diseases such as dengue, malaria, chikungunya, and Japanese encephalitis wherein mosquitoes acts as vectors, transmitting the disease-causing pathogen. Dengue which spreads through mosquitoes belonging to the Genus Aedes has been on the rise for the past few years in the Greater Hyderabad Municipal Corporation (GHMC) limits. While the symptoms range from mild-to-escalated complications such as hemorrhagic fever and dengue shock syndrome, there is no antiviral therapy currently in use. Symptomatic and supportive treatment is the key for the treatment of dengue patients. Objective: This research article attempts to track the malaria and dengue incidence over the years, To track the malaria and dengue incidence over the years, more specifically the last 5 years across the GHMC limits. Materials and Methods: Data on the dengue and malaria cases over the years are usually gathered and preserved by the Health and Entomology Departments of GHMC Head Office. Data of its incidence for the past 10 years, especially taking note of the previous 5 years, from 2014 to June 2020, were collected from these sources and analyzed, using basic statistical techniques. Results: Within the GHMC limits, there has been a significant drop in the number of malaria cases, but dengue cases rose to an alarming level (3366 cases in 2019). Based on the disease incidence, dengue hotspot areas have been marked so as to effectively take up vector control interventions by using both workforce as well as latest technology (internet of things (IoT), artificial intelligence (AI)). Conclusion: Consistent efforts in a structured way should be made to control the mosquito population, coupling it with community compliance and awareness among the masses on keeping the environment clean and hygienic.

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Background: Since anemia is the most prevalent disorder in India, it got the significance to be studied and understood about. It is necessary to make people aware of the causes, the preventive measures, and the importance of nutritional supplements, proper diet required to prevent anemia. Objective: The objective of the study was to study prevalence, knowledge, and risk factors of anemia among school-going adolescent girls. Materials and Methods: This was a school-based cross-sectional study among 260 randomly selected adolescent school girls (10–19 years) from different private and government schools were included in the study. Study subjects were interviewed using a preformed and pretested, semi-structured questionnaire. Hemoglobin was measured using hemoglobinometer. Results: Mean age was 12.64 ± 1.53 years. Only 10% knew about anemia. Only 20% opined that decrease in red blood cells causes anemia. Majority did not know which mineral deficiency causes anemia. Nearly 10% said that hemoglobin is measured to find anemia. Only one-fourth felt that heavy blood loss during menstruation can cause anemia. Nearly 50% felt that anemics have weakness, breathlessness, and are more prone to infectious diseases. Less than 10% of the study participants knew about iron-rich foods. Less than 5% knew that coffee, tea, and milk hamper iron absorption and Vitamin-C enhances. Half of them knew that anemia is a life-threatening condition in severe cases and may require blood transfusion. Only 20% knew about anemia prophylaxis program. There was no significant difference among different variables such as different age groups, religion, socioeconomic status, type of family, and diet. However, there was a significant difference among different categories of body mass index and anemia. Conclusion: Prevalence of anemia is higher (96.5%) among school-going adolescents in a rural community of Telangana. Overall, the knowledge levels are quite low.

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The Internship in Medical Education is one of the vital and important time during this medical knowledge gets transformation into the practice. The opportunities make you learn and that experience is the worth sharing. Learning opportunities come in front of medical student in many ways, ultimately taught many aspects of practice medicine.

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Background: The majority of adolescents lack basic knowledge about puberty, growth during puberty, safe sex, and hygiene. Unawareness about safe sex and protection and contraceptives may increase the risk of sexually transmitted diseases (STDs), unwanted pregnancies, etc. Objective: The objective of this study was to study knowledge, attitude, and practices related to reproductive and sexual health among adolescent girls in a rural community of Telangana. Methods: A community-based cross-sectional study was conducted in secondary schools which were located in the rural field practice area of a medical college. All schools in the village were included in the study. Study participants were 6^th–10^th standard adolescent school girls, with the age group of 10–19 years. A questionnaire regarding knowledge, attitude, and practices related to reproductive and sexual health was used. Results: The mean age was 13.6 ± 1.386 years. Eighty-four percentage were from nuclear families and only 10% were from below poverty line families, with a mean per capita income of 2626 ± 1708 international normalized ratio. Seventy-five percentage were aware about puberty; source of information was mothers (67%). Ninety percentage did not know how women become pregnant, STDs, and HIV/AIDS. Only 30% said that oral pills were effective against pregnancy and 95% did not know that condoms prevent STDs. Sixty percentage said their schools covered classes regarding normal anatomy, physiology, menstrual hygiene, and reproductive health, of which only 52% attended this topic. About 82.4% of the subjects felt that it is necessary to maintain cleanliness during menstruation. Seventy-five percentage were using sanitary napkins, and 80% were washing hands after changing sanitary napkins with soap and water. Twenty percentage were throwing directly into drainage or dustbin. Conclusion: Knowledge related to reproductive and sexual health among adolescent girls in these adolescent girls was poor and their attitude and practices were also poor.

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Background: The SARS-CoV-2 pandemic with a high contagion potential poses a pathological threat to the community but has a larger psychological impact, elemental in the aggravation of blood pressure and blood glucose levels. The aim of this study is to examine and interpret the effect on individuals, with or without preexisting diabetes and hypertension, of depression, anxiety, and stress and to assess the factors associated with exacerbation of blood pressure and blood glucose levels. Materials and Methods: A cross-sectional observational study was carried out through a snowball sampling method in Faridabad. A predesigned and pretested questionnaire was circulated on Google Forms. A total of 1002 responses accorded with our inclusion criteria and were involved in the final analysis. Results: In the general population, 20.7%, 42.4%, and 39.4% of individuals experienced moderate-to-severe stress, anxiety, and depression, respectively. The prevalence of stress (22.6%) and anxiety (52.9%) was higher in people with preexisting hypertension and diabetes as compared to people without these preexisting comorbidities. Participants with severe depression and severe anxiety had blood sugar level aggravation 5.55 times and 10.10 times more than the ones with lower depression and lower anxiety. Individuals with severe anxiety experienced exacerbation of blood pressure levels 7.35 times more than individuals with lower anxiety. Conclusion: Individuals experienced high mental distress during the lockdown period, especially the ones with preexisting health conditions, who displayed a higher incidence of depression, anxiety, and stress. The results further point toward a bidirectional relationship between hypertension and diabetes with mental health as people with preexisting health conditions experienced greater psychological stress than others.

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Background: Apart from the risk of morbidity and mortality from osteoarthritis, it has been noted that resources of the health care and the increased costs of the health care are consumed by the osteoarthritis. Studies are required on the clinical profile of patients with osteoarthritis which focus on different clinicoepidemiological characteristics, identifying risk groups in different settings. Objective: The present study was carried out to study the clinical profile of patients with osteoarthritis at a tertiary care hospital. Methods: A hospital-based cross-sectional study was carried out over a period of 1 year among 170 confirmed cases of osteoarthritis. Detailed history, thorough clinical examination, necessary investigations, and X-ray of the affected joint were taken in all cases. Data were analyzed using proportions. Chi-square test was applied. Results: Females were more than males. The most commonly affected age group was 70–80 years in 35.3% of the cases. A linear trend is seen as per the age group with the least prevalence of osteoarthritis in the age group of 40–49 years, i.e., 12.9%–35.3% in the age group of 70–80 years. Most commonly involved were the small joints in 52.4% of the cases, followed by the knee joint in 38.8% of the cases and other joints in 8.8% of the cases. The most common occupation affected was laborer in 41.8% of the cases, followed by civil construction workers in 22.9% of the cases, supervisors in 20% of the cases, and executives in 17.6% of the cases. Conclusion: Osteoarthritis was more common in Females than males. Osteoarthritis was more common in the elderly age group and laborers. Small joints were more commonly affected than the large joints.

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Background: Vitamin D deficiency (VDD) is not only common globally but is more rampant in Libya. Assessment and management of it can help prevent many other conditions and serious diseases. Objective: This stuay aimed to study the prevalence of VDD among patients attending private clinics in Zawia city of Libya. Methods: A Cross-sectional study was carried out among 71 apparently healthy patients from different private clinics laboratory, Zawia city, Libya. After obtaining informed consent and confirming the willingness of the patients to give the blood samples, the data were recorded in the pre-designed, pre-tested, and semi-structured study questionnaire. Variables such as age and sex were recorded. Vitamin D status was ascertained for all included participants in the present study. Results: Female participants were more than male participants in the present study (63.4% vs. 36.6%). Majority (45.1%) belonged to the age group of 41–64 years followed by 1–18 years of age (39.4%). The mean value of Vitamin D among females (19.8 ± 2 nmol/L) was significantly lower when compared to males (25.7 ± 3 nmol/L). The mean value of Vitamin D was significantly lower in the age group of 41–64 years and more than 64 years of age compared to 1–40 years of age (P < 0.05). Conclusion: The prevalence of VDD was more in females compared to males. The values decreased with increasing age.

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Antepartum death of one twin is an infrequent obstetric complication. It complicates about 6% of twin pregnancies. Death of one twin in second or third trimester is more deleterious with risk for the surviving twin and also risk of disseminated intravascular coagulation to the mother has been reported. Risks are far higher in monochorionic pregnancy than in dichorionic pregnancy. The common foetal circulation between the live and the dead twins may result in foetal cerebral, renal and skin abnormalities. Management depends on the gestational age, chorionicity and the condition of the surviving fetus. High risk obstetric management is required and a careful neonatal and paediatric follow up is advocated.

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Background: Patellar fractures are injuries of a serious nature. Among the skeletal injuries, they constitute about 1%. Males are affected double than that compared to the females. It is not easy to perform a stable form of reconstruction of the facture of the patella, and it is a major challenge to the surgeons. Objective: The objective of the study was to study the clinical profile of patients with patellar fractures. Materials and Methods: We conducted this study on forty patients with fracture patella in 2-year duration. The period of follow-up was 4–14 months. Management options included partial and/or total patellectomy and internal fixation with tension band wiring with K wire. All the fracture of patella cases by accident or due to fall were included. Careful clinical examination and history taking was carried out. X ray of the knee joint, anterior posterior, lateral view was also advised. Results: Male-to-female ratio was 4:1. Twenty percent of patients underwent conservative management. Among them, internal fixation with K wire banding was done in 60% of the cases, while 5% required total patellectomy and 15% required partial patellectomy. Majority, i.e., 85% had fracture of the patella due to road traffic accidents. Fifty-five percent of the cases had no complications. The most common complication was infections in 20% of the cases, followed by effusion in 10% and wire breakage in 10% of the cases. Only two cases had delayed union. Conclusion: As for as possible patella should be preserved with good surgical techniques, proper antibiotics and with good physiotherapy results are excellent.

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Background: Significant morbidity and mortality is caused by acute pesticide poisoning. Reliable data are not available regarding the morbidity and mortality from India. Objective: The objective of this study is to study the clinical spectrum of organophosphorus poisoning. Materials and Methods: A hospital-based, cross-sectional study was carried out among 120 patients admitted with organophosphorus poisoning at a rural medical college. Patients with acute poisoning were included. Detailed history, clinical examination, and required investigations were done and noted in the study questionnaire. Results: Males (56.7%) were more than females (40.8%). Majority of the study participants belonged to the age group of 30–39 years (43.3%) followed by 20–29 years of age, i.e., 29.2%. The most common clinical feature was miosis 88.2% in males and 86.5% in females followed by nausea and vomiting (76.5%) in males and pain abdomen (63.5%) in females. The most common poison consumed by both males and the females was malathion, i.e., it was consumed by 42.6% of males and 36.5% of females. The next most common poison consumed was diazinon by 32.4% of males and 30.8% of females. In males, it has been observed that the incidence of organophosphate (OP) poisoning decreased from 42.6% in the rainy season to 27.9% in the summer season. However, in females, it was the same, i.e., 38.5% for both rainy season and the winter season, but like in males, it decreased in the summer season. Conclusion: Males are more affected than females, miosis was most common and malathion was most commonly consumed agent. The incidence of OP poisoning was more in the rainy season.

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Background: The physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) is widely used to predict the morbidity and mortality in a variety of surgical settings and provides a tool for risk adjustment and comparison. The aim of this study was to assess the predicting morbidity and mortality in hollow viscus perforation by applying POSSUM and Portsmouth modification of POSSUM scores. Methods: This study was a prospective study conducted on 33 patients admitted in the Department of General Surgery, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar, from September 2016 to August 2017, and present detailed records of the parameters under evaluation of patients admitted to surgical wards with the clinical diagnosis of hollow viscus perforation (gastric/duodenal/ileal perforation). Results: During the present study period, a total of 136 patients were operated on small bowel, and of these 33 cases fulfilled all the criteria and were selected for this study. The overall mortality in this study was 6 (18.18% of the study), while the morbidity was noted in 17 cases (51% of study). Mortality rates differed with POSSUM scores over predicting the mortality. On applying POSSUM, using exponential analysis, we found that the expected number of deaths for our study group is 10 (O:E = 1.66). Conclusion: On applying POSSUM using the exponential analysis, we found that the expected number of deaths for our study group is 10 (O:E = 1.66). We found the difference between expected and observed mortality rates using the exponential analysis.

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Background: Stenotrophomonas maltophilia, once regarded as an organism of low virulence, has evolved as a significant opportunistic pathogen causing severe human infections in both hospital and community settings, especially among highly debilitated patients. Objectives: (1) Identification of S. maltophilia in sepsis and (2) assessment of sensitivity pattern/minimum inhibitory concentration (MIC) of S. maltophilia and its multidrug resistance by VITEK 2 Compact system and by Kirby–Bauer (KB) disk diffusion method. Materials and Methods: This is a retrospective laboratory-based study analysis conducted in a tertiary care center, i.e., Bangalore Medical College and Research Institute, from July 2018 to June 2019. Samples from clinically suspected sepsis patients were processed by standard microbiological methods. VITEK 2 compact (Biomerieux) was used for final identification and MIC. Antibiotic susceptibility was tested by KB disk diffusion method for cotrimoxazole (1.25/23.75 μg) and levofloxacin (5 μg) following the Clinical and Laboratory Standards Institute guidelines M100. Results: Among 18,949 samples collected from suspected sepsis patients, during a 1-year period, 50 isolates were identified as S. maltophilia. Nineteen were isolated from blood; 6 from pus and ascitic fluid; 4 from cerebrospinal fluid, endotracheal aspirate, and pleural fluid; 1 from urine and cornea; and 4 from other sites. The organisms showed multidrug resistances and were sensitive to trimethoprim-sulfamethoxazole and levofloxacin. Conclusion: S. maltophilia was found to be the third most common nonfermenters after Acinetobacter spp. and Pseudomonas aeruginosa with multidrug resistance. As its isolation is increasing, it is important to study the epidemiology, antimicrobial susceptibility profile, and clinical outcomes of these isolates.

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