The rapid spread of COVID 19 across the globe gave no country any chance to stay guard of what consequences it would follow. India, with 462 million of its 1.3 billion people living in densely populated urban settlements with high contact rates, was at risk of catastrophic spread of the virus. Extensive testing for SARS CoV 2 set the precedent for managing the vicious cycle of COVID 19. The study focuses on the COVID-19 testing and positivity rates across the country to attain information on whether we are testing enough or we need to be more rigorous in approach. What's the pattern so far and what follows in future. COVID 19 health portals, original articles, reviews, and case studies were studied to identify articles which correspond to the COVID 19 database comprising statistics of various Indian states published during the ongoing pandemic. The study reveals that nine states had tested more than 100% of their population with the highest 399.3 from Lakshadweep, followed by Ladakh (209.7), Delhi (175.5), Chandigarh (151.4), Jammu and Kashmir (134.3), Puducherry (126.9), Kerala (121.5), Goa (112.7), and Mizoram (107.6). It becomes pertinent to note only one of the above states (Goa 1.7) among the above list falls into the category of high death rate which can be attributed to the fact that early testing and tracing formula have suited most of these states well.

This meta-analysis investigated the significant association between human leukocyte antigen (HLA)-G 14-bp insertion/deletion and +3142G>C polymorphisms with susceptibility to rheumatoid arthritis (RA). This relationship has been scrutinized in several studies, and the findings are controversial. The association studies related to HLA-G gene polymorphisms and RA were extracted from PubMed, Mendeley, ScienceDirect, and Google Scholar databases up to December 31, 2020. Finally, a total of 1516 cases and 1683 control samples were chosen from 7 published research articles for this meta-analysis. A significant association was evaluated using the pooled odds ratios (ORs) and 95% confidence intervals (CIs) under allelic, dominant, recessive, and additive models. Overall, there is absence of significant association between 14-bp ins/del polymorphism and RA (recessive model: OR = 1.012, 95% CI = 0.841–1.217, P = 0.900; dominant model: OR = 1.068, 95% CI = 0.919–1.241, P = 0.393; ins/ins vs. del/del: OR = 1.059, 95% CI = 0.861–1.303, P = 0.587). In the case of +3142G>C polymorphism, the recessive model (OR = 1.332, 95% CI = 1.083–1.640, P = 0.007) showed a significant association with RA susceptibility. When subgroup analysis was done by ethnicity, +3142G>C polymorphism was found to be significantly associated with RA susceptibility in the Asian population under the recessive model (OR = 1.450, 95% CI = 1.048–2.006, P = 0.025). This meta-analysis brings to light that there was no significant association between 14-bp ins/del polymorphism and RA susceptibility. Whereas, +3142G>C polymorphism was found to be significantly associated with susceptibility to RA.

PURPOSE: The purpose of this article is to provide a synthesized review of the models for analyzing data with ordinal response as the outcome variable and to evaluate their usefulness in examining the association of obesity with erectile dysfunction (ED) among type 2 diabetes mellitus patients. MATERIALS AND METHODS: A total of 204 married men aged 20–60 years with a diagnosis of type 2 diabetes at the outpatient unit of the Department of Endocrinology at PSG Hospitals during May and June 2019 were studied. We examined the association between obesity and ED using binary, ordinal, and polytomous regression models. RESULTS: Logistic regression model revealed that patients with diabetes who are obese, have a higher odds of ED (odds ratio = 2.508) after adjusting the effect of age and physical activity. In proportional odds model, obesity as compared with normal, independently increased the odds of ED (odds ratio = 2.264) across three severity categories. In the polytomous regression model, it was observed that mild ED has an odds ratio of 3.136 with respect to normal erectile function. It was observed that a cutoff value of waist circumference more than 92.71 cm would be suitable for the classification of ED in diabetic patients. CONCLUSION: The study considered the ordinal nature of the outcome variable investigated and supported the association of obesity and ED among type 2 diabetes. In addition, we have also suggested an optimum cutoff value to waist circumference among diabetic patients with high ED.

BACKGROUND: Every pregnancy is special and each and every pregnant woman must receive special care. It was estimated, by the WHO that deaths due to hypertensive disorders of pregnancy represented 13% of all maternal deaths. The study was conducted with an aim to assess the effect of music therapy on anxiety among antenatal mothers with pregnancy-induced hypertension (PIH). MATERIALS AND METHODS: A true experimental research approach with Pretest posttest control group design was adopted for the study. Simple random sampling technique was applied to select 60 participants (30 experimental and 30 controls) but assignment of participants to the respective group was done through odd and even methods. Data was collected by using standardized Speilberger's state trait anxiety inventory and structured observation schedule for demographic data and clinical profile. RESULTS: The present study investigated that in the experiment group, mean anxiety scores in pretest and posttest were 55.23 ± 9.09 and 27.53 ± 4.56 respectively. While in control group, pretest mean anxiety score was 50.73 ± 9.34 and the posttest score was 43.53 ± 8.4. Furthermore, the obtained “t” value was 9.17 with P < 0.00001 which indicated that music therapy was significantly effective in reducing the anxiety scores among pregnant women. In addition, posttest anxiety scores have no significant association with age (P = 0.51), parity (P = 0.82), and period of gestation (P = 0.06). CONCLUSION: Music therapy is effective in reducing anxiety of antenatal mothers with PIH. The therapy can be implemented in clinical settings to decline the levels of anxiety among women with PIH.

Background: Knowledge of ethics has a significant influence on the professionalism and moral qualities of doctors and also helps them to face ethical issues. The first step in incorporating ethics on a bigger scale in our curriculum will be to determine the level of the basic knowledge and attitude among medical students on ethics. Hence, this study was planned at a medical college among students to evaluate the level of knowledge and attitude about medical ethics. Objectives: The objective of the study was to assess and to compare the level of knowledge and attitude about medical ethics among students and interns. Materials and Methods: A cross-sectional questionnaire study was conducted among 147 second-year students, 104 interns, and the questionnaire consisted of 14 questions, five questions on knowledge and nine on attitude domain. The data were analyzed using Statistical Package for the Social Sciences (SPSS) version 10, and knowledge comparison between students was done using Chi-square test, while the attitude was compared using Mann–Whitney U-test and P < 0.05 was considered statistically significant. Results: Nearly 77.9% of interns and 39% of students knew about the basic principles of ethics and 82.9% of students and 60.6% of interns told that doctors should maintain patient's confidentiality and there was a significant statistical difference in knowledge and attitude between the students and interns. Conclusion: The knowledge and attitude of undergraduate students on medical ethics was found to be satisfactory, and the results of this study can be used to further strengthen the medical curriculum and such initiatives will help in developing ethically competent doctors.

OBJECTIVE: To study the etiological and clinical profile of children presenting with short stature and to assess growth velocity in children after 6 months of treatment. METHODS: This prospective observational study was conducted between January 2017 to May 2018. One hundred consecutive children attending the outpatient department for short stature were thoroughly evaluated clinically and investigations were done as deemed necessary. The cases were followed up for 6 months to assess the growth velocity. RESULTS: Female to male ratio was 1.56. Nutritional short stature (NSS) and normal variant short stature were the most prevalent, with the equal frequency of 19% each, followed by endocrine and other causes. The significant number of children had Vitamin D deficiency/insufficiency (92%). mid-parental height (MPH) was below-1 standard deviation score (SDS) from the national standard in all the children studied. CONCLUSION: In the present study, normal variants of short stature and NSS were the most common causes of short stature, followed by endocrine disorders. Vitamin D status was low in the majority of the children (92%), with possible contribution to short stature in all groups irrespective of primary diagnosis and needs further exploration. Growth hormone (GH) therapy in select non GH deficiency short stature can be promising. We also noted that maternal, paternal heights, and consequently, MPH was below the national standard in 100% of children. This may implicate ethnic variations and maybe a call for local growth charts. It needs further studies to look for factors responsible for lower MPH in our cohort.

BACKGROUND: Chronic periodontitis is much more common than the general public realizes. In the US, about 80% of adults have at least one attachment loss site and about 35% of the population suffers from severe chronic periodontitis. Surprisingly, only a small portion of this population seeks periodontal care. In terms of oral health treatment, India has a lot of inequalities, and periodontitis affects 95% of the population. In rural areas, the dentist-to-population ratio of about 1:200000 necessitates the development of dental infrastructure at the primary health-care level. Periodontitis affects about 20%–50% of the global population. METHODS: This cross-sectional analysis was done to determine the spread of chronic periodontitis and its association with systemic disease. A total number of 146 individuals comprising of both sexes ≥40 years of age were selected from two areas in Vantmuri, Belagavi. Age, sex, family history, smoking and alcohol habits, systemic disease, etc., were recorded by giving a questionnaire. The investigation was done to assess body mass index, BOP, CAL, DMFT, OHI, etc., Chronic periodontitis was assessed along with its association with systemic disease. The information collected was entered into Microsoft Excel and evaluated with the help of SPSS 26. RESULTS: It was evident from the sample population that periodontal disease (41.78%) was highly prevalent. Periodontitis was found to be significantly correlated with age, cigarette/beedi smoking (regular), and OHI scores among study participants (P < 0.05). CONCLUSION: More research into the underlying mechanisms and risk factors of chronic periodontitis, as well as its link to systemic diseases, is required.

AIM: The aim of this study was to assess knowledge, attitude, and practices about online education during COVID-19 outbreak among dental professionals in India. MATERIALS AND METHODS: A sample of 200 participants was taken comprising interns, postgraduate, faculty, and private practitioners of dental specialty. A prevalidated 15-item questionnaire incorporating four domains was distributed among the participants. It was followed by statistical analysis of the data. RESULTS: The results were tabulated using descriptive analysis. Association was determined using the Chi-square test, whereas one-way analysis of variance is used for comparison between the groups. The correlation between knowledge, attitude, and practices among dental professionals was assessed using Karl Pearson's correlation coefficient. The results of the study showed that the attitude and practices among dental professionals were statistically significant (P > 0.05). Moreover, statistically significant results were obtained when correlation was done between knowledge, attitude, and practices (P < 0.0001). CONCLUSION: The study concludes the need to enhance the level of knowledge, attitude, and practices about online education during COVID-19 outbreak among dental professionals in India.

BACKGROUND AND OBJECTIVES: Apropos of the initiative by the Medical Council of India (MCI), a month-long Foundation Course was implemented in our institute for the Phase 1 MBBS batch (2019). The index study was carried out to assess the perceptions of faculty members teaching Phase 1 MBBS students about the usefulness and effectiveness of this course, and their suggestions for further improvement. METHODOLOGY: The study was conducted online using a predesigned, pretested questionnaire in the form of Google Forms. A total of 41 faculty members were invited to participate in the study. RESULTS: Thirty-six faculty members responded, i.e. a response rate of 88%. Majority of the faculty (69.4%) considered the Foundation Course as a useful addition to MBBS course but felt that the duration is too long. Faculty members found almost all of the sessions to be very useful for the students. However, they also felt that some of the sessions such as spirituality, alternate health systems, disability competency, national health policies, and use of information technology were not relevant for the newly joined MBBS students. INTERPRETATION AND CONCLUSIONS: Foundation Course recommended by MCI for MBBS students at the entry level is a positive addition. Incorporating the suggestions from the faculty members can enhance its usefulness further.

BACKGROUND AND AIMS: Although left ventricular ejection fraction (LVEF) is the most commonly studied echocardiographic parameter for predicting postoperative outcome, its utility is limited by its preload dependency and ability to measure the only systolic function of the left ventricle. The myocardial performance index (MPI), a ratio obtained by summing up the time required for isovolumetric contraction and relaxation against the systolic ejection phase of the cardiac cycle, is the least studied parameter of left ventricular performance in perioperative settings. So, being a composite measure of systolic and diastolic function of the heart, we hypothesized that MPI can be a better predictor of postoperative outcome following coronary artery bypass grafting (CABG). The present study aimed at finding a correlation of LVEF and MPI with postoperative outcome indicators such as vasoactive inotropic score (VIS), the requirement of intra-aortic balloon pump (IABP) to maintain cardiac output, duration of mechanical ventilation, stay in the intensive care unit (ICU), postoperative morbidity and mortality. METHODS: A prospective, observational study was conducted on 110 subjects, scheduled for elective CABG. Transesophageal echocardiography (TEE) was performed after induction of anesthesia and before coronary grafting. Patients with no or grade I mitral regurgitation (vena contracta-VC <0.3 cm, effective regurgitant orifice area <0.2 cm²) and those in normal sinus rhythm were included. Patients with arrhythmia and MR of more than grade I (VC >0.3 cm, EROA >0.2 cm²) were excluded. Pre-CABG LVEF was measured using Simpson's biplane method. MPI was measured using Pulsed-wave Doppler across mitral inflow and left ventricular outflow tract. Subjects were labeled as “good” and “poor” outcomes based on standard criteria for defining the immediate postoperative outcome. Pre-CABG MPI and LVEF were correlated with these postoperative outcome variables following CABG. RESULTS: Of 110 subjects, 14 were excluded due to the presence of more than grade I MR (n = 8) and arrhythmias (n = 6) before CABG. Out of 96 subjects, 66% (n = 63) had “good” outcome and 34% (n = 33) had a “poor” outcome. Pre-CABG MPI and LVEF were (0.51 ± 0.12 and 47.2% ± 8.8%) in subjects with “good” compared to (0.57 ± 0.13 and 42.00% ± 8.70%) (P = 0.032 and 0.007 respectively) “poor” outcome following CABG. A higher pre-CABG MPI (0.57 ± 0.13) alone significantly correlated with increased VIS (r = 0.325, P = 0.001) in contrast to lower LVEF (42% ± 8.7%) (r = −0.181, P = 0.077). Both, lower precardiopulmonary bypass LVEF (40.46% ± 8.81%) and higher MPI (0.6 ± 0.11) were significantly correlated with increased ICU stay in days (r = −0.218 and r = 0.287, respectively). The mean MPI was 0.57 ± 0.08 and LVEF was 39.55% ± 4.05% in those subjects who succumbed in the postoperative period following CABG. CONCLUSION: MPI was a relatively better predictor of postoperative outcome following CABG. Increased Pre-CABG MPI was more consistent with the postoperative inotropic and vasopressor requirement. The requirement of an IABP to maintain cardiac output following CABG and mortality was correlated well with both low preoperative LVEF and higher MPI values.

BACKGROUND: Obesity is increasing worldwide due to decreased physical activity and easy availability of high-energy foods. Increased adiposity is a risk factor for the development of cardiovascular disease. One of the characteristic cardiac adaptations to obesity is the left ventricular hypertrophy. We evaluate the echocardiography changes in the left ventricular structure and function in uncomplicated young obese. MATERIALS AND METHODS: The study was conducted in age-matched 24 young male obese and 26 male controls. Anthropometric parameters such as height (cm) and weight (kg) were measured. Body mass index (BMI) was calculated. A group of obese subjects with BMI ≥30 of kg/m² compared with a group of controls with BMI of 18.50–24.99 kg/m². Echocardiograms were performed using GE Vivid T8 by standard techniques. Left ventricular (LV) mass, LV mass/body surface area index, LV mass/height, Posterior wall thickness, and relative wall thickness (RWT) were found out. Statistical analysis was done using “t”-test. RESULTS: The mean values of LV mass, LV mass/body surface area index, LV mass/height, posterior wall thickness, and RWT were greater in the group of obese when compared with the controls. The linear regression analysis showed a strong association between the degree of obesity and LV mass. CONCLUSION: The present study suggests that the LV mass parameters are increased in obese when compared with the controls. Echocardiographic study should be included in the evaluation of obese for the early detection of subclinical structural and morphological changes in the left ventricle because obesity itself is an independent predictor for left ventricular hypertrophy. Preventive measures should be taken in the control of obesity, thus, contributing to decrease the morbidity and mortality and reducing the cardiovascular disease burden on our society.

Globally, millions of people are rapidly infected with COVID-19 and it has spread worldwide from January 2020 to till date. Coronavirus mostly affects the respiratory system; it can also result in several multisystem complications. This is a case series of four patients admitted in the department of medicine with post-COVID-19 Guillain–Barre syndrome (GBS). SARS-CoV-2 mainly affects the respiratory system but multiple organ damage is being reported recently, neurologic damage is one of them. SARS-CoV-2 causes neurologic damage including, by direct attack the nervous system through angiotensin-converting enzyme receptor, secondary to an immune reaction against SARS-CoV-2, retrograde transport, cytokine, and hypoxia-related injury. However, pathogenesis is not fully understood. It is hypothesized that the cause of GBS in covid patients is due to immune-mediated. It is hypothesized that inflammatory cytokines may play a role in an immune-mediated neuropathy. In this era of pandemic, we are concern about the involvement of respiratory and gastrointestinal systems only, involvement of other systems is underestimated. It is very important to be aware of association of GBS with COVID-19. Although neurological involvement in COVID-19 is rare, early diagnosis and treatment can reduce morbidity and mortality. We should always think about COVID-19 infection in a patients presented with GBS after respiratory or gastrointestinal involvement.

A 46-year-old post-COVID-19-positive male patient presented with sudden onset painless loss of vision in the left eye (LE). There was history of oral tadalafil intake 10 days before vision loss. Clinical and imaging examinations led to the diagnosis of central serous chorioretinopathy with torpedo maculopathy in LE. No active intervention was done. There was complete resolution of neurosensory detachment with improvement of vision 1 month following the presentation.

Primary neuroendocrine carcinoma of the breast is a very rare occurrence accounting for <0.1% of all breast cancers. For the diagnosis, it requires the diffuse expression of neuroendocrine markers (chromogranin, synaptophysin, neuron-specific enolase) and the lack of simultaneous neuroendocrine carcinoma in extramammary sites. The breast carcinomas with focal neuroendocrine differentiation are defined as scattered tumor cells that stain positive with neuroendocrine markers. These tumors are usually seen in elderly women around sixth or seventh decade of life, as reported in literatures. The high nuclear grade and regional lymph node metastasis was also significant negative prognostic factors for overall survival. We study a case of primary neuroendocrine carcinoma of breast in a 46-year-old lady, on the basis of histopathology and immunohistochemistry.

Pregnancy is a physiological condition and is expected to bring joy to the lives of individuals and their family. The available global estimates suggest that almost 50% of the reported pregnancies around the world are unintended. We must note that unintended pregnancies pose a major health risk to women, including a higher risk of maternal deaths, and adverse health and financial outcomes for family and society. Moreover, it is a fact that the delivery of contraceptive services, measures targeting sexual and reproductive health needs of women, and access to life-saving health services during humanitarian crisis takes a toll. In general, women are subjected to gender-based violence, including sexual violence and various types of intimate partner violence in the regions that are experiencing conflict. There is an immense need to strengthen the delivery of contraceptives, including condoms, so that such unintended pregnancies can be averted. To conclude, unintended pregnancy is a major public health burden and has been associated with a wide range of adverse outcomes, especially in settings experiencing a humanitarian crisis. The need of the hour is to take specific measures to reduce the incidence of unintended pregnancy and adopt a multi-sectoral approach to improve the quality of life of women.