A Forensic Autopsy Study of Dead Foetuses and Newborns

Background: The term abandonment refers to babies or foetuses which are found abandoned at various unwanted places such as gutter, rubbish dumps, railway tracts and bushes. It does not refer to live born babies left in places, such as hospitals where care can be given by someone other than the mother. Aims and Objectives: To find out the distribution of death cases of newborns/feotuses and to trace its probable reason and its relationship with female foeticide.Methods:A retrospective study of all the medico-legal autopsies of foetuses and newborns was conducted in Forensic medicine and Toxicology department, Government Medical College, Amritsar (Punjab) from Jan 1, 2014 to Jul 31, 2021. During this period, 46 cases of fetal and newborn deaths had been studied.Results:The dead bodies of known foetuses/newborns is 43.5% cases while total unknown cases were 56.5% cases. 32.6% cases were non viable foetuses while 10.8% cases died as a result of prematurity. All the unknown cases (56.5%) were found from the abandoned places like street, bushes, canal side, water bodies that mainly includes pond and railway tract.Conclusion:Despite, the problem is present in every corner of the nation, there is dearth of research studies on this issue. Stringent measures and strict checks are required against antenatal sex determination. The motive behind the abandonment of foetuses can be any, but this grave issue needs urgent attention.

An insight into predominance of pulmonary complications on right side in supracostal percutaneous nephrolithotomy

Purpose: To analyse pulmonary complications following supracostal percutaneous nephrolithotomy especially after right sided supracostal punctures, both in initial and relook PCNL. Material and methods: From February 2016 till date, 90 patients underwent PCNL in Government Medical College, Jammu through supracostal puncture – 53 on right side and 37 on left side. All supracostal punctures were made about 7–8.5 cm from midline. Tract dilatation was done using metal dilators and calculi were fragmented using pneumatic lithotripsy. Patients with supracostal superior calyceal punctures were evaluated for chest complications intraoperatively by fluoroscopy, X-ray chest on evening of postoperative day 0 and repeated thereafter on third and seventh postoperative days. Results: Stone configuration included complete staghorn in 16, partial staghorn in 23, multiple stones in 16 and pelvic stone in 35 cases. Age range of patients was 07–76 years. There was 14.4% (13 out of 90) incidence of early or delayed chest complications – 20.8% (11 out of 53) on right side and 5.4% (2 out of 37) on left side. Conclusion: Pulmonary complications in supracostal punctures; especially on right side should not be underestimated. There are always chances of delayed hydrothorax after supracostal puncture. A chest X-ray should be repeated after 1 week in patients with supracostal PCNL punctures.

Incidence of tubercle of Zuckerkandl of the thyroid and it’s surgical relation with recurrent laryngeal nerve and the superior parathyroid gland

Background: This study was carried out with the objective to identify the tubercle of Zuckerkandl in patients undergoing thyroidectomy and to establish the relationship of TZN with the recurrent laryngeal nerve and superior parathyroid gland.Methods: 100 patients posted for thyroidectomy for various causes in Government medical college, Kozhikode for a period of 1 year between March 2014 and March 2015. 92 patients underwent total thyroidectomy, 4 patients underwent left hemithyroidectomy and 4 patients underwent right hemithyroidectomy. A total of 192 lobes i.e. 96 right lobes and 96 left lobes were studied.Results: Of the 100 patients studied TZN was identified in 63 (63%) patients. Of the 192 lobes studied, TZN was identified in 100 lobes (52.08%). This was 59 of 96 (61.40%) lobes on the right side and 41 of 96 (42.70%) lobes on the left side. Of the 92 Total Thyroidectomies, TZN was found bilaterally in 36 (39.10%) cases. RLN was identified ‘posteromedial’ in relation in 99 of the 100 (99%) TZNs studied and not visualized in relation to TZN in 1 (1%) case. The Superior Parathyroid was identified ‘superolateral’ in relation in 93 (93%), ‘lateral’ in 6 (6%) and ‘inferolateral’ in 1 (1%) of 100 TZNs studied.Conclusions: Zuckerkandl’s tubercle is a posterior extension of lateral lobes of the thyroid gland, maintains a constant relationship with the RLN and the superior parathyroid gland. It can be used as an anatomical landmark to assist in preservation of the RLN and the superior parathyroid gland during thyroid surgery.

Prevalence of Abnormal Glucose Tolerance in Obese Pregnant Women - A Study from a Tertiary Care Centre

BACKGROUND Obesity has emerged as an important risk factor in modern obstetrics and poses a major threat to pregnancy by causing complications including gestational diabetes. It also increases the risk of cardiovascular diseases and diabetes mellitus in later life. Obesity creates major technical challenges in providing maternity services too. The objective of the study was to assess the prevalence of abnormal glucose tolerance in obese pregnant women in a Government Medical College over one year. METHODS A prospective observational study was conducted among obese pregnant women, registered at the Outpatient department of Obstetrics and Gynaecology at the Government Medical College, Kottayam from January 2017 to December 2017. 450 women were considered for the study after satisfying inclusion and exclusion criteria. BMI was calculated using pre-pregnant weight. An oral glucose test was performed with 75 gm glucose at 24 to 28 weeks of pregnancy after 8 hours of fasting. International Association of Diabetes and Pregnancy Study Group cut-offs i.e., fasting blood sugar values more than 92 mg/dl, 1hr value more than 180 mg/dl, 2 hr value more than 153 mg/dl were used as the criteria. Oral glucose tolerance was considered abnormal if any of the above values were impaired. RESULTS The prevalence of abnormal glucose tolerance among the 450 pregnant women was 35.6 %. The incidence of abnormal GTT increased with increasing age and in those with a history of menstrual irregularities and infertility treatment. No relation was found between economic status, family history of diabetes, preeclampsia and abnormal GTT. CONCLUSIONS Obesity turns to be a menace in the reproductive life of women that begins by affecting the fertility, continues to cause complications in pregnancy, increases morbidity in the long-term future and reduces the quality of life. Since more than one-third of the study population was affected by gestational diabetes, active intervention to reduce the weight preconceptionally is needed. KEY WORDS Obesity, Glucose Tolerance Test, Gestational Diabetes Mellitus, Body Mass Index, Pregnancy

CLINICAL PROFILE OF PATIENTS WITH SINONASAL MASSES - A CROSS SECTIONAL STUDY

It is challenging to diagnose and distinguish sinonasal masses as they can have varying clinical presentations. This study was done to see if sinonasal masses can be detected by clinical symptoms, signs and examination itself without resorting to investigations. This cross sectional study was conducted in the department of Otolaryngology, Government Medical College Thrissur, Kerala for a period of one year from December 2017 to December 2018. Total 104 cases were studied. Most of the sinonasal masses were identied by doing proper anterior and posterior rhinoscopy which don’t require much expertise to master. This can be considered only as a screening because any intervention should be preceded by radiological investigations and biopsy for a denitive management.

HEMATOLOGICAL PARAMETERS AND CLINICAL OUTCOME IN INTENSIVE CARE UNIT OF A DEDICATED COVID HOSPITAL: A SPECIAL CONSIDERATION TO HEMOGLOBIN CONCENTRATION.

Introduction:The world is currently facing the threat of the COVID-19 pandemic.It is well established that hemoglobin deficient state is associated with severe form of Covid19 disease. the present study was done assess the changes in hematological parameters with special reference to hemoglobin and clinical outcome in intensive care unit of a Dedicated COVID Hospital, Government Medical College,Jalgaon.Materials and Methods: The present study was of retrospective, analytical type conducted at Government Medical College, Jalgaon which was a Dedicated COVID hospital. We collected the data of demographics, co-morbidities, laboratory investigations, drug prescription and clinical outcome from the record section of medicine department after taking required permission.Results: Out of 111 patients with confirmed Covid19 infection, majority belonged to age group of 51-60 years (24.3%). Mean hemoglobin was not statistically different in survivor versus non-survivor analysis. Conclusion: Although the hematological parameters and inflammatory markers were significantly deranged in deceased patients as compared to cured patients, mean hemoglobin was not significantly different.Thus,as per the findings of present study mean hemoglobin cannot be considered as marker of prognosis in patients with moderate to severe Covid19 disease.

A study of psoas minor muscle morphology

Psoas minor is long, slender skeletal muscle it lies anterior to psoas major. It is an inconstant muscle. It was absent in 40-70% of subjects. To determine the frequency and morphometry of psoas minor muscle.: 20 cadavers were dissected during routine dissection for undergraduate students at Ayaan institute of medical sciences, Moinabad, Hyderabad and Government medical college, Mahabubnagar. Bilateral variations were observed in one specimen, unilateral variations were observed in two specimens.: Out of forty specimens Psoas minor was present in three specimens. In one specimen bilateral variations observed, other two specimens unilateral. If it is present, clinical importance to radiologists, surgeons and physiotherapists as it can mimic certain abdominal emergencies.

Assessment of Professionalism Attitudes in Students of Government and Private Medical College Using Learner’s Attitudes to Medical Professionalism Scores (LAMPS)

Objectives: To assess and compare the student’s attitude to professionalism among government and private medical colleges. Research question: Are there any differences in Professionalism attitudes of students studying in government and Private medical colleges of Pakistan? Hypothesis: Professionalism attitudes of Medical students studying in government and Private medical colleges do not differ from each other. Method: A government medical college of Sargodha & a Private medical college of Lahore were chosen for the study. Study was conducted from May to June 2019. 200 Final year MBBS students were given a questionnaire named Pakistani LAMPS validated through a pilot study. Non probability purposive sampling technique was used. We applied statistical test chi square used for analysis in SPSS 21 version. Results: Out of the study participants, there were 76(38%) were male &124(62%) female. The Pakistani LAMPS had an acceptable reliability index with a Cronbach’s alpha of 0.71. The items mean scores vary between (1.93+ 1.03 and 3.00+ SD 3.78, scale 1–5). The score was high significantly in Private medical college students (107/140) than Public medical college (95/140) with p value of 0.0001. Conclusion: The null hypothesis was rejected because the professionalism score of private medical college students was higher than that of government medical college students. Keywords: Professionalism, Attitudes, LAMPS Government, Private, Medical Education

Study of the Various Factors Involved in Monteggia Fractures Treated by Open Reduction and Internal Fixation in Government Medical College, Trichur

BACKGROUND The various factors involved in Monteggia fractures treated by open reduction and internal fixation (ORIF) were studied in patients presenting to Government Medical College, Trichur. Its distribution based on age, gender, and nature of trauma, were observed in the patients. METHODS This study was a prospective descriptive study, conducted in Department of Orthopaedics, Medical College, Thrissur from 1, January, 2016 to 1, July, 2017. Patients were assessed according to age, sex, side of injury, co-morbidities and final functional assessment was made according to Broberg and Morrey score. A total of 37 patients were observed. The patients were assessed, deemed fit for the study, and subjected to operation. Radial head reduction, fixation if needed, then ulna fracture was opened, reduced, and fixed with plate and screws. Postoperative plaster slab was applied, then converted to full above elbow cast, and retained for as long as needed. Post-operative mobilization was by home physiotherapy only. RESULTS Our study showed that open reduction and internal fixation of ulna outcome in Monteggia fractures leads to good elbow function and minimal loss of physical capacity. Immobilization of more than 2 months have very high chances of elbow stiffness. Early active mobilization after surgery is necessary for good functional outcome. Other than mild stiffness and loss of range of motion in some cases, very few other complications were found in our series. CONCLUSIONS Rigid internal fixation of ulna and early active mobilization is the key to achieve a good functional outcome and minimal loss of physical capacity in Monteggia fractures. Very few of the complications that were described in the literature were seen in the study. Even with restricted resources and minimal facilities, almost no permanent or debilitating morbidity or complications were seen in our series. Early active mobilization after surgery was the most important deciding factor for good functional outcome. Prolonged immobilization of more than one month consistently produces poor results. KEYWORDS Monteggia, Broberg and Morrey, Bado Classification, Internal Fixation, Ulna Fracture