Abstract:

Background: Neonatal morbidity and mortality remain a significant global health challenge, particularly in developing countries like India. The primary aim of this study is to analyze the profile of neonatal admissions in the Special Newborn Care Unit (SNCU) of a tertiary care hospital, GMC RAJOURI, in the state of Jammu and Kashmir.

Materials and method: By examining various aspects of neonatal admissions, the This study was conducted in the Special Newborn Care Unit (SNCU) of  GMC RAJOURI, a tertiary care hospital over a specified period. The methodology involved a detailed and systematic approach to collect, analyze, and interpret data related to neonatal admissions. Results: The majority of neonates were admitted shortly after birth: Within the first 72 hours : 980(90.6%) and Beyond 72 hours: 108 (9.4%). A significant proportion (44.3%) of admitted neonates were preterm, with late preterm infants (34–36 weeks) forming the majority (41.1%). Low birth weight (LBW) was observed in 34.6% of cases, further reinforcing the need for maternal nutritional support and strategies to prevent preterm births. Among the primary causes of neonatal admissions, perinatal asphyxia (36.1%) emerged as the leading contributor, followed by neonatal sepsis (24.6%). Respiratory distress syndrome (8.9%) and meconium aspiration syndrome (1.9%) were other major contributors to morbidity, necessitating the continued use of CPAP, surfactant therapy, and effective resuscitation techniques. Additionally, neonatal jaundice requiring phototherapy was noted in 18.6% of cases, emphasizing the importance of early screening and management of hyperbilirubinemia. Outborn neonates (36.4%) were found to have more severe clinical conditions.

Conclusion: Overall, this study highlights the urgent need for improved antenatal care, early neonatal interventions, and efficient referral and transport systems to reduce neonatal morbidity and mortality. Future multicenter studies are warranted to validate these findings and guide evidence-based neonatal healthcare policies in India. A holistic approach integrating maternal health programs, neonatal resuscitation training, and infection control measures will be pivotal in ensuring better neonatal survival rates in resource-limited settings.

Abstract: Background: The term "laryngotrachealstenosis" (LTS) refers to the partial or total constriction of the trachea or endolarynx. High morbidity and recalcitrance characterize LTS. The present study was conducted to assess balloon dilation laryngoplasty for acquired subglottic stenosis.

Materials & Methods: 56 cases of airway stenosis of both genders were selected. Etiology of stenosis, number and frequency of dilations, and interval between tracheostomy and decanulation were recorded.

Results: Out of 56 patients, 30 were males and 26 were females. Diagnosis was Post Rta in 23, post intubation in 17, Op posion in 8 and post acid ingestion in 6 cases. Grade 1 was seen in 14, grade 2 in 34 and grade 3 in 8 cases. Length of stenosis was 1-3 mm in 17, 4-7 mm in 24 and 8-10 mm in 15 cases. Interval of balloon dilation was 1-2 weeks in 31 and 2-4 weeks in 25 patients. The difference was significant (P< 0.05).

Conclusion: Balloon dilations are safe and efficient in thetreatment of subglotticstenosis and reducesthe need for open laryngeal surgery.

Abstract: Background: This study was conducted to assess the Ocular Manifestations of
Behcet's Disease Patients.
Materials & Methods: This study comprised of 20 subjects who had Behcet’s disease. The aim
of this study was to assess the ocular findings in these subjects. The subjects had been
explained about the procedure and were asked for consent. All the subjects gave consent and
were included in this study. The demographic details, the incidence of ocular findings and the
type of ocular manifestation had been investigated and the results were tabulated. Statistical
analysis had been performed using SPSS software.
Results: In this study, out of 20 subjects with Behcet’s disease, 8 subjects showed ocular
manifestations. Among the 8 subjects with ocular manifestations, 7 were males and 1 was
female. The most common ocular finding in subjects with Behcet’s disease was dry eyes
accounting for 4 cases. Other findings were retinal periphlebitis, accounting for 3 cases and
serofibrinous uveitis, accounting for 1 instance.
Conclusion: From the findings of this study, it can be concluded that out of 20 cases with
Behcet’s disease, 8 subjects showed ocular manifestations, of which the most common finding
was dry eyes. Other findings were retinal periphlebitisand serofibrinous uveitis.

Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin condition that significantly impacts the physical and psychological well-being of affected individuals, particularly adults. This article reviews the epidemiology, pathogenesis, diagnosis, and management of AD, emphasizing the need for effective strategies in primary care. AD commonly starts in early childhood, with a considerable portion of patients experiencing persistent symptoms into adulthood. Diagnosis relies primarily on clinical assessment, with no definitive laboratory tests available. Management strategies encompass both short-term treatment for flares and long-term maintenance therapy, including the use of emollients and topical corticosteroids (TCS). Non-steroidal options like topical calcineurin inhibitors (TCIs) and advanced therapies, such as systemic medications and biologics, are discussed for more severe cases. Patient education is crucial for adherence to treatment regimens, aiming to improve outcomes and reduce healthcare costs. The article also addresses the role of dietary interventions and the importance of recognizing secondary infections in managing AD.

Aims: Our aim was to investigate the practicalities and success rate of clozapine titration in the community in a large sample of patients referred to three crisis teams in a defined geographical area. Methods: We collected data retrospectively of all the referrals for clozapine initiation to three crisis teams across Manchester during a three year period. Results: Out of a total of 6542 referrals, 66 were for clozapine initiation. From these referrals only 54 patients started clozapine, as the others declined the treatment. After commencing clozapine, a total of 46 patients (86.2%) completed the titration successfully. The main reason for discontinuing the clozapine titration in the community was withdrawal of patients’ consent. Only one patient was unable to physically tolerate the titration and was admitted to hospital.

Aims: Doctors are at increased risk of developing a mental illness and at increased risk of suicide compared to the general population. Medical students when faced with psychological stress and are more likely to avoid help. This study attempts to assess Canadian consultant psychiatrists’ attitudes to disclosure and treatment preference if they were to become mentally ill. Method: Data was collected through a postal survey from all consultant psychiatrists registered in the province of Ontario in Canada. The survey package contained a covering letter, a 2 page questionnaire, and return stamped addressed envelope. Respondents were separated into 3 groups in order of experience as a consultant psychiatrist. Results: 487 out of 1231 questionnaires were returned (response rate of 40%). Respondents would be most likely to disclose their mental illness to family and friends (204, 41.9%). Those who would choose to disclose to their family physician or to family/friends were more likely to cite stigma as a factor influencing their choice than those who would choose to disclose to colleagues. Nearly a third of respondents (151, 31.0%) claimed to have experienced a mental illness. There was no association between choice of whom to disclose and previous experience of mental illness (χ²=1.22; DF=2; p=.545; Cramer’s V=.05). Conclusions: Stigma continues to play a role in how consultant psychiatrists decide the course of disclosure and treatment. Consultant psychiatrists with less than 5 years of such experience when deciding treatment for themselves are more concerned with confidentiality than their quality of care. Senior consultant psychiatrists are more likely to seek professional help than informal professional advice out the outset of a mental illness.

Patients presenting with altered mental health and behavior may be misdiagnosed with psychiatric disorders when organic causes are at play. This article discusses two case studies illustrating the psychiatric manifestations associated with acute medical illnesses, emphasizing the importance of thorough assessment before concluding a psychiatric diagnosis. The first case involves a young woman who developed acute psychotic symptoms following a recurrent ear infection, which resolved completely after antibiotic treatment, with no lasting effects. In contrast, the second case presents a woman with psychosis following confirmed herpes simplex viral encephalitis, leading to significant brain injury and ongoing psychiatric symptoms. These cases highlight the need for timely identification and management of medical conditions presenting with psychiatric symptoms to prevent long-term complications. The interplay of infections and mental health is further explored, emphasizing the necessity of integrating medical and psychiatric care.

Neuroleptic malignant syndrome (NMS) is a life-threatening neurologic disorder associated with the use of neuroleptic agents. NMS typically characterized by a distinctive clinical syndrome of mental status change, muscle rigidity, fever, and autonomic instability. Atypical cases may present without muscle rigidity and/or hyperthermia. Association of infection in atypical case can make the diagnosis challenging. We describe a case of NMS in a patient who presented with acute onset of altered mental status complicated with aspiration pneumonia.

Candida blood stream infection (candidaemia) is one of the most serious hospital acquired infections with high morbidity and mortality rates in the Intensive Care Unit (ICU). A number of risk factors have been identified in a variety of studies. ICU patients are frequently colonised with Candida species. The role of Candida colonisation as a causal factor for candidaemia remains controversial. Our objective for the study was to evaluate the risk factors for candidaemia and to evaluate the role of colonisation to predict candidaemia. We evaluated a total of 1483 patients aged over 18 years who stayed in ICU for more than 7 days. We collected various data about risk factors for candidaemia. A total of 56 patients (3.77%) developed candidaemia. We collected demographic and risk factor data including Candida colonisation of the urinary and respiratory tract. Binary logistic regression with forward likelihood ratio method model was used to analyse these risk factors. In our study, total parenteral nutrition (odds ratio (OR)- 3.274, 95% confidence interval (CI) 1.263-8.486 ), presence of central venous line (OR- 1.895, CI 1.032-3.478), previous or current antibiotic use (OR 3.268, CI 1.532-6.972), respiratory tract colonisation (OR 2.150, CI 1.078-4.289) and urinary tract colonisation (OR 3.508, CI 1.926-6.388) were significant risk factors for Candida blood stream infection (BSI). Based on the model, we calculated the candidaemia risk score and based on the receiver operative curve analysis, a score more than 2 would be associated with a higher risk of candidaemia. Candida species isolated in the respiratory tract or urine were similar to that found in Candida BSI (Kappa coefficient for agreement of 0.83 and 0.47 respectively). So, it can be concluded that Candida colonisation of the respiratory tract and/or urine is a significant risk factor for Candida BSI along with the other risk factors.

Routine pulse palpation is one of the screening method to detect asymptomatic atrial fibrillation (AF) in clinical practice. Recently new automatic sphygmomanometers with embedded algorhytms to detect irregular heart beat and possible AF have been commercialized. Whether the switch from the traditional sphygmomanometer to these devices modifies AF detection in usual care is unknown. 12294 patients of 30 GPs members of the Italian College of General practitioners working in Bologna with recorded diagnosis of Hypertension and BP recording were extracted before and after the adoption and use of an automatic device. 14 other GPs who were using a traditional device (Riva-Rocci or aneroid sphygmomanometer), volunteered to provide the same data extraction from their personal database. Heart rhythm should be evaluated while measuring BP with usual devices. This information may be lost with with a few automatic devices, therefore the use of automatic devices with algorithms which can detect possible AF is an appealing choice. Our data show that switching from the traditional device to an automatic device with algorithm for irregular beat detection increases the identification rate of previously unknown AF in hypertensive population.

Abstract: Aim: To compare the effectiveness of platelet-rich plasma (PRP) versus standard wound care (SWC) in promoting postoperative healing in orthopaedic surgeries, focusing on wound healing outcomes, pain levels, patient satisfaction, and complication rates.

Materials and Methods: This prospective comparative study included 100 patients undergoing orthopaedic surgeries. Participants were randomly divided into the PRP group (n=50) and the SWC group (n=50). PRP was prepared using a double-spin centrifugation technique and applied intraoperatively and during postoperative dressing changes on days 1, 3, and 7. Wound healing was assessed using the Southampton Wound Assessment Scale (SWAS) on days 7, 14, and 28. Pain levels (VAS), patient satisfaction scores, and postoperative complications were also evaluated. Data were analyzed using t-tests and chi-square tests, with p < 0.05 considered significant.

Results: The PRP group showed significantly better wound healing outcomes, with lower SWAS scores on day 28 (0.8 ± 0.4 vs. 1.8 ± 0.7; p < 0.001). Pain levels were consistently lower in the PRP group, with a mean VAS score of 1.1 ± 0.5 compared to 2.7 ± 0.9 in the SWC group (p < 0.001). Patient satisfaction was significantly higher in the PRP group (8.9 ± 1.2 vs. 7.1 ± 1.5; p < 0.001). Complications, including wound infections (4% vs. 16%; p = 0.04) and delayed healing (6% vs. 18%; p = 0.04), were less frequent in the PRP group. Multivariable regression analysis confirmed PRP as an independent predictor of improved wound healing outcomes (β = -0.65, p < 0.001).

Conclusion: PRP significantly improves postoperative wound healing, reduces pain, increases patient satisfaction, and lowers complication rates compared to standard wound care. These findings support the use of PRP as a valuable adjunct in orthopaedic postoperative management.