Trends in Clinical and Medical Sciences

This cross-sectional analytical study aimed to investigate the possible association between extended high-frequency hearing and mastoid pneumatization. A total of 206 patients were involved in the study, and a statistically significant difference was found that the patients with higher mean mastoid volume had a response to that particular frequency when compared to patients with lesser mean mastoid volume in both the right and left ear. However, there was no statistically significant association between various age groups and responses and between gender and responses at all frequencies. The study concludes that there is a correlation between mastoid pneumatization and extended high-frequency hearing.

This study aimed to compare the efficacy of Midazolam and Dexmedetomidine as premedication agents in pediatric patients administered via the intranasal route. 100 children in ASA physical status I and II, aged 2-8 years, planned for surgery under general anesthesia, were randomly assigned to Group D, which received 1 mcg/kg of Intranasal dexmedetomidine, or Group M, which received 0.2 mcg/kg of Intranasal midazolam for premedication. The patients’ sedation status, separation anxiety, and mask acceptance were evaluated using UMSS, PSAS, and MAS, respectively, along with hemodynamic parameters and side effects. The mean sedation score was higher in Group D than Group M, and the mean parental separation anxiety score and mean mask acceptance score were also higher in Group D than Group M. All hemodynamic parameters were comparable and stable in both groups. In conclusion, intranasal dexmedetomidine was found to provide better sedation, relieve preoperative anxiety, make parental separation easier, and promote better mask acceptance, without any significant side effects.

The study aimed to compare the analgesic efficacy of USG-guided versus landmark-based transversus abdominis plane (TAP) block using 0.25% bupivacaine in abdominal surgeries. A total of 100 patients undergoing elective abdominal surgery were included in the study, with 50 patients receiving USG-guided TAP block and the other 50 patients receiving landmark-guided TAP block. The patients were evaluated post-operatively for up to 24 hours for their VAS score, amount of analgesic required, and time for the first rescue analgesia. The results showed that the USG-guided TAP block group had a significant decrease in pain at 4 and 8 hours following surgery compared to the landmark group, with a lower total analgesic demand in the postoperative period. The study concluded that USG-guided TAP block is an efficient and safe addition to multimodal post-surgical analgesia compared to landmark-guided block. The study was conducted at the Department of Anesthesiology of the M. G. M. Medical College and M. Y. Hospital in Indore, Madhya Pradesh, and was approved by the Institutional Ethical and Scientific Review Committee.

Preoperative anxiety is a common occurrence in patients undergoing surgery, and it can lead to a range of negative effects, including an increased requirement for anesthetic agents, hemodynamic instability, and delayed recovery. Melatonin has been shown to have an anxiolytic and hypnotic effect with fewer side effects. This study aimed to explore the potential of oral melatonin to reduce preoperative anxiety levels and the dose requirement of propofol for the induction of general anesthesia. The study included 150 patients who were equally divided into two groups: Group M and Group C. Group M received oral melatonin 6mg and vitamin B complex tablets, while Group C received a sip of water and vitamin B complex tablets 90 minutes before the surgery. Anxiety levels were measured using the VAS score preoperatively and 90 minutes after drug administration. Propofol was given until the BIS value was sustained for 1 min at 48\(\pm\), and the total dose was measured in both groups. Postoperative pain was assessed using the VAS score just after extubation and every hour for the next 4 hours, with Inj. Diclofenac given if the score was \(\geq\)4. The time of first rescue analgesia was noted. Results showed that Group M had a significantly reduced VAS score and required a lower dose of propofol for induction compared to Group C (p\(\leq\)0.0001). The time of first rescue analgesia was also prolonged in Group M compared to Group C (p\(\leq\)0.0001). Therefore, oral melatonin is an effective premedicant that reduces preoperative anxiety, the required induction dose of propofol, and provides postoperative analgesia.

This prospective observational study aimed to assess the role of transvaginal ultrasound (TVS) in diagnosing the cause of abnormal uterine bleeding (AUB) and characterizing benign and malignant lesions. 130 patients were included and underwent TVS and histopathological examination. TVS showed sensitivity of 59%, specificity of 93%, positive predictive value of 81%, negative predictive value of 82%, and accuracy of 58% for diagnosing malignant lesions. The study provided TVS imaging features for early identification, characterization, and extent of uterine pathologies, as well as relevant information for clinicians to make reasonable decisions. TVS is a good primary imaging modality due to its non-invasiveness, low cost, and wide availability.

Introduction: Cytomegalovirus (CMV), a double-stranded DNA virus belongs to a family called herpesviridae or human herpesviruses (HHVs). CMV is spread by direct contact with infectious body fluids such as nasal secretions, saliva, tears, urine, genital secretion or breast milk. After contamination, the virus initially replicates in the epithelial cells at the site of entry, followed by hematogenous spread to numerous organs and cell types.
Aims: to estimate prevalence of CMV in a population of male partners of infertile couples attending a tertiary care hospital of Kolkata and also to determine the impact of CMV infection on sperm parameters.
Materials and method: The proposed study is an observational and descriptive study of cross-sectional study was conducted in department of Physiology, R.G. Kar Medical College & Hospital, Kolkata. The study period was One year January 2021 – January 2022. 56 patients were included in this study.
Result: We showed that, lower number of patients had Normal Morphology in with Cytomegalovirus [4 (100.0%)] this was not statistically significant (p=0.6895). Association of Addiction with Cytomegalovirus was statistically significant (p=0.0059) and Infertility DX with Cytomegalovirus was not statistically significant (p=0.6088). It was found that, higher number of patients had Height in without Needed Mechanical Ventilation [29 (65.9%)] compared to with Needed Mechanical Ventilation [4 (44.4%)] It was not statistically significant (p=0.0504).
Conclusion: we concluded that cytomegalovirus was associated with in male partner of infertile couple and its impact on seminal analysis a tertiary care hospital.

Background: Diabetic foot ulcer (DFU) is a major complication of Diabetes Mellitus. The International Working Group on Diabetic Foot defines DFU as a “full-thickness lesion of the skin distal to the malleoli in a person with Diabetes Mellitus”.
Objective: The objective of this study was to evaluate the clinico-microbial profile of patients with diabetic foot ulcers and the pattern of antimicrobial susceptibility.
Methods: This hospital-based, prospective observational study was conducted among patients with diabetic foot ulcers in the Department of General Surgery at Era’s Lucknow Medical College \& Hospital, Lucknow, after taking written informed consent.
Results: Pseudomonas was found in 39 (18.2%) cases, coagulase-negative Staph aureus was found in 23 (10.7%) cases, Acinetobacter was found in 80 (37.3%) cases, E. coli was found in 56 (26.1%) cases, Proteus spp was found in 13 (6%) cases, Staph aureus was found in 23 (10.7%) cases, Acetobacter was found in 1 (0.46%) case, and Enterococcus was found in 2 (0.93%) cases. A single organism was involved in 48 (47.1%) cases, while multiple organisms were involved in 54 (52.9%) cases in our study. In our study, 83 (81.3%) cases were gram-negative and 11 (10.7%) cases were gram-positive.
Conclusions: According to microbial culture, Pseudomonas, Klebsiella, E. coli, and coagulase-negative Staph aureus were the most commonly found organisms in diabetic foot ulcers. These findings suggest that appropriate management of diabetic foot ulcers should involve selecting an appropriate antimicrobial agent based on microbial culture and susceptibility testing.

Introduction: The frontotemporal type is characterised by a pterional sutural configuration between the frontal and temporal bones. The stellate kind of suture is formed by the fusion of the flat sphenoid, frontal, parietal, and temporal bones.
Methods: The kind of pterion based on sutural pattern was determined using Murphy’s classification into sphenoparietal, frontoparietal, stellate, and epipteric kinds on both the left and right sides of each skull. The centre of the circle, which connects the four bones that make up the pterion, is thought to be the centre of the pterion. Distance between the pterion’s centre and the external auditory meatus’s anterosuperior margin, P-PM: the distance between the pterion’s centre and the lateral margin of the optic canal, P-AM.
Results: The current investigation was carried out using 115 dried adult skull bones that were gathered from the central Karnataka region. On the right side, there were 115 pterions, and on the left, there were 115. The most frequent type of pterion was sphenoparietal (82.1%), followed by epipteric (26.1%), stellate (18.6%), and frontotemporal (17.8%).
Conclusions: The findings of this study may be useful for forensic pathologists, neurosurgeons, anatomists, and anthropologists in the region of the population under study.

Background: Severe acute malnourishment (SAM) is a significant public health problem in India and many developing countries. The World Health Organization (WHO) defines – Severe acute malnutrition (SAM) as very low weight-for-height or a mid-upper arm circumference (MUAC) of less than 115 mm or the presence of nutritional edema. According to the most recent NFHS-5 survey (2019- 2021) covering 36 states and union territories (UTs), the prevalence remains at an alarming 7.7%. Malnutrition slows down the myelination process, thus preventing the increase in the calibre of myelinated nerve fibres. Motor nerve conduction, auditory evoked potential and visual evoked potential changes caused by severe acute malnutrition can be evaluated clinically and electrophysiologically. These changes are produced mainly due to a deficiency of micro and macronutrients like vitamins, minerals, protein, fat & Carbohydrates.
Aim: Severe acute malnutrition affects the myelination and growth of the central and peripheral nervous systems. This study aimed to assess the effects of severe acute malnutrition on peripheral motor median and ulnar nerve conduction, auditory evoked potential and visual evoked potential in children.
Materials & Methods: The study group included 50 severely acute malnourished children (SAM) of 6 – 59 months of age, recruited from SMTU, J.A. Group of the Hospital, G.R.M.C. Gwalior (M.P.), based on WHO classification for severe acute malnutrition. The Control group consisted of 50 normally nourished healthy children of the same age group. The case-control study period was extended from January 2021 to December 2021. Ethical clearance from the Institutes and written informed consent were taken from the parents/guardians of SAM patients. The family, immunization, birth, metabolic, endocrinal disorder, and history of neuromuscular disease were taken in detail. The study was performed using the four-channel RMS – EMG EP MARK- II. The electrophysiological parameters were evaluated for velocity, distal latency, and amplitudes. Results were analyzed statistically using the unpaired student’s t-test.
Results: This study showed decreased motor nerve conduction velocity ( p < 0.05 ) and delayed distal latencies in the median and ulnar motor nerves of both upper limbs in children with severe acute (SAM) malnutrition. There were significant differences in the mean latencies of the waves I to V and the mean interpeak latencies (IPLs) of the waves I-III and I-V on the right and left ears between the study and control groups (P < 0.05). We observed significant alteration in mean latencies of wave p 100 in VEP.
Conclusion: The present study shows a statistically significant alteration in electrophysiological parameters in children with severe acute malnutrition. This may be due to nutritional deficiency affecting the myelination of peripheral nd central nerves depending on the duration and severity of malnutrition.

Non-healing ulcers can cause significant health problems and impair quality of life. Standard treatment procedures have been found to be ineffective in curing such lesions. Autologous platelet-rich fibrin matrix (PRFM) has been cited in many research papers as an effective treatment for non-healing ulcers. This study aims to evaluate the efficacy of PRFM in treating chronic non-healing ulcers. A prospective study was conducted in patients with trophic ulcers due to Hansen’s disease or diabetes mellitus, traumatic ulcers, and venous ulcers, aged between 18-85 years. PRFM was applied to healthy ulcers at weekly intervals, repeated for a maximum of five sittings as per requirement. Photographs were taken before treatment and at every subsequent sitting, and area and volume were calculated at baseline and every subsequent sitting until closure was achieved. The results of the study will help to determine the efficacy, feasibility, and cost-effectiveness of PRFM in the treatment of non-healing ulcers.