SRMS JOURNAL OF MEDICAL SCIENCE <p>The SRMS Journal of Medical Sciences (SRMSJMS) is a biomedical journal with national circulation. It publishes original communications of biomedical research that advances or illuminates medical science or that educates the journal readers. It is issued six monthly, in two volumes per year.&nbsp;Manuscripts dealing with clinical aspects will be considered for publication, provided they contain results of original investigations. Articles need to be of general interest - e.g., they cross the boundaries of specialities or are of sufficient novelty and importance that the journal's readers, whatever their speciality, should be made aware of the findings. Research papers reporting original research, review articles, correspondence on published articles will also be considered. Papers of routine nature which are merely records of interesting cases as also those dealing with modifications of routine methodology will not be encouraged.</p> <div class="page-header"> <h1>Article Processing Fee/Open Access Fee</h1> </div> <p><strong>Author Fee</strong></p> <p>Indian Journal of Pharmaceutical and Biological Research is an open access journal, and then Author submission, as well as article processing and publishing, is&nbsp;<strong>free of charge</strong>.</p> <p>Readers can read and download any full-text articles for&nbsp;<strong>free of charge</strong>.</p> MRI Publication Pvt. Ltd en-US SRMS JOURNAL OF MEDICAL SCIENCE 2456-1673 Cesarean Section Rate According to Robson’s Criteria- A Retrospective Analysis in a Tertiary Care Rural Centre of North India <p>Introduction: The cesarean section rate has been rising over<br>last five decades worldwide. The reasons are electronic fetal<br>monitoring during labor, increasing number of pregnancies<br>following infertility treatment, increasing number of postcesarean<br>pregnancies, changing obstetrics trends regarding<br>vaginal breech or operative deliveries, and medicolegal<br>concerns. The present study analyses cesarean section rates<br>according to Robson’s criteria in our center.<br>Material and Methods: The obstetrics record of all women<br>admitted in the labor unit from June 2013 to May 2018 were<br>retrieved and analyzed based on their age, parity, gestation<br>age, mode of delivery and grouped according to Robson’s<br>classification.<br>Results: A total of 13392 women were delivered in the labor<br>unit in 5 years, during which 35.3% of patients had a cesarean<br>section. Among cesarean section, primary and repeat cesarean<br>were 57.3 and 42.7%, respectively. Most frequent indication was<br>fetal distress (26.7%) followed by non-progress (12.6%) and<br>scar tenderness (12.1%). Among primary and repeat cesareans<br>the commonest indications were fetal distress (38.5%) and<br>scar tenderness (28%), respectively. Robson’s group V had the<br>maximum cesarean rate (36.2%) followed by group I (16.9%)<br>and group II (15%). The annual trends of cesarean are almost<br>similar in various Robson’s categories- group I (17.3-22.5%),<br>group II (11.1-14%) and Group V (33.4-39.9%).<br>Conclusion: R obson’s g roup I , I I a nd V w ere f ound t o b e<br>contributing more than 50% of the cesarean section rate.<br>Modifiable factors for reducing cesarean rate would be to<br>improve successful induction of labor, decreasing primary<br>cesarean rate, hence the chance of repeat sections.</p> Ruchica Goel Shanti Sah Jai K. Goel ##submission.copyrightStatement## 2022-11-16 2022-11-16 3 02 29 34 Comparative Analysis of Dose Volume Histograms of Pelvic Bone Marrow and their Clinical Correlation in Patients of Cancer Cervix Treated with Conventional and 3-Dimensional Conformal Radiotherapy <p>Introduction: Radiotherapy (RT) is the treatment of choice<br>for cancer cervix in FIGO stage IIB and beyond and also in<br>selected cases in initial stages. Conventional RT is planned<br>on the basis of bony landmarks. Three-dimensional conformal<br>RT (3D CRT) is planned on computed tomography (CT)<br>which includes three-dimensional (3D) identification of visible<br>tumor and organs at risk (OAR) that need to be included or<br>avoided. Dose-volume histograms (DVH) are excellent tools for<br>evaluating and compare isodose distribution in the concerned<br>volumes. Hematological toxicity in cancer cervix is due to bone<br>marrow radiation and concurrent chemotherapy given. The<br>present study focuses on the delineation of bone marrow and<br>comparing the DVH in conventional and 3D CRT to find clinical<br>correlation in both groups.<br>Materials and Methods: A total of 50 patients were randomized<br>into two groups - Group A treated by conventional radiotherapy<br>and group B treated with 3D CRT. All patients received 50 Gy<br>in 25 fractions at 2 Gy per day along with concurrent cisplatin<br>followed by three fractions of intracavitary brachytherapy of 7<br>Gy each. Conventional planning was based on bony landmarks.<br>3D planning included the delineation of gross, clinical and<br>planning target volumes along with different Organs at risk<br>(OAR) s, including the bone marrow. Dosimetry parameters<br>evaluated were D-max, D-mean and PTV-95 for planning<br>target volumes (PTV) and V10, V20, V30, V40 and V50 for all<br>subsites of bone marrow and as a whole bone marrow. Clinical<br>correlation of hematological toxicity with dosimetric parameters<br>of bone marrow were evaluated and statistical significance was<br>seen using paired student t-test.<br>Results: Mean age of the patients was 48.22 years (range<br>28–70 years). The commonest symptom was yellowish/whitish<br>discharge per vagina 44 (88%), and most patients had FIGO<br>stage II(60%). Field sizes used in the 3D-CRT arms were<br>significantly larger than those used for the conventional plans<br>(p = 0.000). The difference in dosimetric parameters for PTV<br>in both groups were not statistically significant. After 6 months,<br>the complete response was 88% in group A and 92% in group<br>B. No grade III and IV hematological toxicity was found except<br>two patients who had grade III haemoglobin toxicity. In group<br>A the whole bone marrow and ilium showed a significant<br>correlation with the incidence of haematological toxicity for<br>V-10, LSS forV-10, V-20, V-30 and lower pelvisbonefor V-10,<br>V- 20, when compared to the other volumes. In group B, the<br>whole bone marrow and ilium showed a significant correlation<br>with the incidence of hematological toxicity for V-10, LSS and<br>lower pelvis for V-10 and V-20 when compared to other volumes.<br>Conclusion: Bone marrow sparing should be done as much as<br>possible to reduce hematological toxicity. Newer radiotherapy<br>techniques like intensity-modulated RT may help achieve bone<br>marrow's dose constraints.</p> Sankalp Naidu Piyush Kumar Arvind K. Chauhan Jitendra Nigam ##submission.copyrightStatement## 2022-11-16 2022-11-16 3 02 35 42 A Retrospective and Prospective Study on Fine Needle Aspiration Cytology and Histopathological Correlation in Diagnosis of Salivary Gland Lesions <p>Introduction: Salivary gland neoplasm accounts for 2 to 6.5%<br>of all head and neck neoplasms. The purpose of conducting<br>the study is to perceive the spectrum of various salivary<br>gland lesions and correlates it to the fine needle aspiration<br>cytology (FNAC) diagnosis with absolute sensitivity, specificity,<br>diagnostic accuracy, the positive and negative predictive value<br>of FNAC of salivary gland swellings<br>Materials and methods: The study was conducted in the<br>Department of Pathology in association with the Department<br>of ENT, Shri Ram Murti Smarak Institute of Medical Sciences,<br>Bareilly, UP and it includes a total of 140 cases. Study designing<br>has been done to compare results of preoperative FNAC<br>findings with final histopathological diagnosis, retrospectively<br>and prospectively.<br>Results: The majority of the cases of salivary gland lesions<br>(27.86%) fall in the 4th decade and 62.15% of males were<br>predominantly affected with pain and swelling as chief<br>complaints and for a time duration of &lt;6 months with 71 cases.<br>It was found that 69.20% parotid gland was the most common<br>presentation site. Out of 140 cases, 70 cases of benign tumors<br>were the most frequent type, followed by non-neoplastic lesions<br>with 38 cases and the least cases of malignant tumors, with<br>32 cases reported. Out of a total of 102 tumors most common<br>benign condition was 52.90% of pleomorphic adenoma<br>and the most common malignant condition was 10.70% of<br>mucoepidermoid carcinoma.<br>Conclusion: Fifty cases after diagnosis on fine needle<br>aspiration cytology were sent for histopathology with 20 true<br>positive cases, 22 true negative cases, 1 false positive, and<br>7 false negative cases. The following values were calculated<br>using the Gallen and Gambino method – Sensitivity – 74.07%,<br>specificity–95.60%, diagnostic accuracy – 84%, positive<br>predictive value–95.23% (PPV) and negative predictive value<br>–75.86% (NPV).</p> Varsha Chauhan Hema Pant Rohit Sharma Manisha Mendiratta ##submission.copyrightStatement## 2022-11-16 2022-11-16 3 02 43 49 Prevalence of Needle Stick Injuries and Its Association with Workload Among Health Care Providers: a Cross sectional Study from Tertiary Care Hospital of Rohilkhand Region, Uttar Pradesh <p>Introduction: Health care providers (HCPs) are prone to a<br>variety of dangers like infections, cuts, Needle stick injuries,<br>radiations, vaccines, serums, etc. Since this paper mainly<br>aims to see the prevalence of needle sticks and sharp injuries<br>(NSSIs), which are one of the occupational hazards, that occur<br>during the handling/processing of the NSSIs in the hospital. The<br>present study aims to find the prevalence of needle stick injuries<br>among the HCPs and to investigate its association with work<br>load among the HCPs in tertiary care hospitals of Rohilkhand<br>region, Uttar Pradesh.<br>Materials and methods: This cross-sectional study was<br>carried out between 2013 to 2014 in the Rohilkhand region of<br>Uttar Pradesh; 312 registered HCPs in a tertiary care hospital in<br>Bareilly city under the Rohilkhand region were randomly chosen<br>and investigated through structured questionnaire. Mainly the<br>study was based on qualitative data since data is described<br>through frequency and percentage; also Chi-square test was<br>used to test the association between workload and prevalence<br>of needle stick injuries.<br>Results: Out of 312 HCPs127 (40.70%) participants were<br>female, and 185 (59.30%) were male respondents. The<br>workload of 75.6% HCPs in terms of working hours was more<br>than 35 hours in a week, and nursing students were working<br>less than 35 hours in the hospital. Needle stick injuries were<br>reported by 53 % of the 312 HCPs. The association between<br>needle stick injuries and workload among HCPs was significant<br>(χ2=55.33, p&lt; 0.001), revealing that needle stick injuries were<br>closely linked to workload. Needlesticks injuries were found in<br>84 (80%) of the 104 HCPs with a high workload.<br>Conclusion: In this study, 53% of healthcare workers were<br>injured by needles. The highest number of injuries occurred<br>among HCPs with a heavy workload (worked more than 35<br>hours per week and night duty more than three times per week).</p> Dharmendra K. Gupta Ruchi Arun Ravi Kumar Richa Mishra ##submission.copyrightStatement## 2022-11-16 2022-11-16 3 02 50 53 Pattern of Antimicrobial Resistance in Clinical Isolates of Acinetobacter Species Isolated from Intensive Care Unit Patient’s Sample at a Tertiary Care Hospital in North India <p>Introduction: Acinetobacter species are one of the most<br>common pathogens causing hospital-acquired infections (HAIs)<br>and multi-drug resistant Acinetobacter isolates are a rapidly<br>emerging pathogen in healthcare settings and have limited<br>options for effective treatment. It is increasingly reported as<br>the cause of outbreaks and nosocomial infections such as<br>blood-stream infections, ventilator-associated pneumonia,<br>urinary tract infections and wound infections. To determine the<br>antimicrobial susceptibility/resistant pattern among isolated<br>Acinetobacter species.<br>Material and Methods: A total of 140 Acinetobacter species<br>were isolated from various clinical specimens. The isolated<br>Acinetobacter species were further processed for antibiotic<br>susceptibility testing (AST) using the Kirby-Bauer disc diffusion<br>method. All Imipenem-resistant cases were further evaluated<br>for Metallo-β-lactamase (MBL) production using Imipenem<br>Ethylenediamine tetraacetic acid (EDTA) combined disc test<br>and modified Hodge test, two phenotypic methods. Statistical<br>analysis was done using Microsoft office excel 2010.<br>Results: The present study was carried out for one and a half<br>years from 1st January 2013 to June 2014 in the microbiology<br>department on the samples received from the intensive care<br>unit (ICU) of SRMS-IMS Bareilly. During this period total of<br>140 Acinetobacter species were isolated. The majority were<br>isolated from respiratory samples, followed by urine, pus and<br>blood. Acinetobacter isolates were found to be resistant to most<br>of the commonly used antibiotics. Antimicrobial susceptibility<br>testing showed the highest resistance to cefepime 5/140<br>(96.43%), ceftazidime 6/140 (95.72%), levofloxacin 8/140<br>(94.29%), amikacin 9/140 (93.58%) and highest sensitivity<br>135/140 (96.42%) to polymyxin and colistin 132/140 (94.28%).<br>72/83 (86.7%) and 62/83 (74.7%) Acinetobacter species show<br>metallo-β-lactamase (MBL) production by Imipenem-EDTA<br>combined disc test and modified Hodge test, respectively.<br>Conclusion: The increasing trends towards antibiotic<br>resistance reflect the extensive use of antibiotics in hospitals<br>which in turn exerts selective pressure on Acinetobacter in<br>the hospital environment. Therefore, surveillance is needed<br>to detect multi-drug resistant (MDR) Acinetobacter species,<br>judicious use of antibiotics and implement appropriate infection<br>control measures to control the spread of these MDR strains<br>in hospitals.</p> Mohan S. Deopa Neelam Gupta Divakar Srivastava Rahul K. Goyal ##submission.copyrightStatement## 2022-11-16 2022-11-16 3 02 54 57