Background and Objectives: Acute ischemic stroke (AIS) is a leading cause of morbidity and mortality worldwide. Inflammation plays a crucial role in the pathogenesis of AIS. High-sensitivity C-reactive protein (HS-CRP) is a sensitive marker of inflammation.  Use of serum markers has been a established practice in medicine. CRP levels have been known to provide a estimate of inflammation. The present study was formulated to ascertain if levels of CRP in acute ischaemic stroke cases can be a prognostic or diagnostic marker for the condition. Methods: The study was a prospective case control format and utilized a subject pool of 50 subjects as case and control each. The study observed a significantly elevated level of CRP in cases with an acute ischaemic stroke. The study concluded that use of CRP can be a an effective modality in clinical practice in managing such cases. To investigate the relationship between HS-CRP levels and AIS. To evaluate the predictive value of HS-CRP for AIS. To examine the association between HS-CRP and stroke severity.

DOI: 10.5281/zenodo.

Background: Five phenomena constitute the primary clinical components of dissociative psychopathology: amnesia, depersonalization, derealization, identity confusion, and identity alteration. There is a high degree of phenomenological overlap and functional interplay between schizophrenic syndromes, posttraumatic conditions and dissociative disorders. The present study aimed to see if there is any association between adult dissociative symptoms and general psychopathology in patients with schizophrenia. Materials & Methods: The study had a cross-sectional design with purposive sampling with a sample size of 60 patients with schizophrenia who were assessed by the Dissociative Experiences Scale (DES-II) and Positive and Negative Syndrome Scale (PANSS) for Schizophrenia. Results: The Mean DES score was14.67 ±9.90. Total 8.3% of the subjects reported high dissociation (Mean DES score ≥30). There was a significant positive correlation between Dissociative symptoms (measured by Mean DES score) and Psychopathology (measured by PANSS positive symptoms and Total PANSS score) in patients with schizophrenia. Conclusion: The concept of dissociation or dissociative symptomatology is widely associated with psychotic symptoms. The present study emphasizes the importance of assessing dissociative symptoms in patients with schizophrenia to ensure that the most appropriate and effective interventions are provided to this patient group.

DOI: 10.5281/zenodo.

Infections caused by VRE are difficult to treat because different gene clusters are known to confer Vancomycin resistance. Van A and Van B genes are transferable and clinically relevant. This study aimed to identify Vancomycin resistant genotypes in strains causing U.T.I. Out of 250 Enterococci 37 (14.8%) of the isolates were Vancomycin Resistant Enterococci (VRE) of which 17(45.94%) were from male and 20 (54.05%) were from female Patients. Total species distribution in VRE isolates was 3(8.1%), 31(83.78%) and 3(8.1%) for E. faecalis, E. faecium, other sps. Antibiotic resistance profile of VRE isolates was evaluated. All the VRE strains were 100% resistant to Ampicillin whereas 89.18% VRE strains were resistant to Ciprofloxacin and 78.3% VRE strains were resistant to High Level Gentamicin. Van A and Van B genes were detected in 14(37.8%) and 1(2.7%) of strains respectively. The present study showed prevalence of Van A and Van B genes carrying Enterococcus in urinary isolates.

DOI: 10.5281/zenodo.

Objective: This study aims to identify Gram-negative organisms from endotracheal (ET) tube secretions in ICU patients, focusing on their antimicrobial resistance profiles, especially carbapenemase production. Methods: A cross-sectional study was conducted over 20 months in the Department of Microbiology, JNMC, Sawangi. ET secretions from 104 patients were processed for microbiological culture and antimicrobial susceptibility testing. Special resistance mechanisms, including ESBL, AmpC, and carbapenemase production, were identified. Results: The study showed a predominance of Acinetobacter spp. (42.3%) among isolates, followed by Klebsiella pneumoniae (22.1%) and Pseudomonas aeruginosa (18.3%). Resistance to imipenem was 100%, and carbapenemase production was noted in 30.7% of isolates. ESBL and AmpC production were seen in 19.2% and 11.5% of isolates, respectively. Conclusions: This study emphasizes the high prevalence of MDR organisms in ICU patients and highlights the urgent need for antimicrobial stewardship and robust infection control practices.

DOI: 10.5281/zenodo.

Background: The development of isolates of Klebsiella pneumoniae and Escherichia coli that produce metallo-beta-lactamase (MBL) is a serious problem in clinical microbiology because of their resistance to carbapenems and other beta-lactam antibiotics. For these illnesses to be properly managed, quick and accurate identification techniques are essential. Methods: A cross-sectional observational study was conducted over two years at a tertiary care hospital in Central India. A total of 10,320 clinical specimens were analyzed, yielding 480 non-duplicate isolates of E. coli (260) and K. pneumoniae (220). Imipenem resistance was screened using a 10-µg disk, and MBL production was detected using CDT and E-test. Results: imipenem resistance was found in 168 (35%) of the 480 isolates, including 72 (15%) K. pneumoniae and 96 (20%) E. coli. In 80 (47.62%) of the isolates that were imipenem-resistant, MBL production was verified. 37% of K. pneumoniae and 42% of E. coli had MBL identified by CDT, whereas the E-test had somewhat higher detection rates (41.66% and 48%, respectively). Conclusion: This study highlights the growing prevalence of MBL-producing E. coli and K. pneumoniae in clinical settings. The E-test showed superior sensitivity compared to CDT, making it a more reliable method for MBL detection. Routine screening and confirmation of MBL production are essential for implementing effective infection control measures and guiding antimicrobial therapy.

DOI: 10.5281/zenodo.

Background: Dacryocystitis, an inflammatory condition of the lacrimal sac, presents in both acute and chronic forms. Chronic dacryocystitis is more prevalent, accounting for 87.1% of epiphora cases, often causing social discomfort due to persistent eye-watering. Identifying the antibiogram of causative microorganisms is crucial for guiding effective antimicrobial therapy. This study aimed to evaluate the clinical profile and antibiogram of acute and chronic dacryocystitis. Method: This prospective observational study included patients with acute or chronic dacryocystitis attending the ophthalmology outpatient department. Eligible participants were enrolled, and samples were collected for microbiological analysis, including gram staining, culture, and sensitivity testing. Results: A total of 50 cases of acute and chronic dacryocystitis were included in the study. The majority of cases were observed in the >40-50 age group for both acute (25%) and chronic (34.2%) dacryocystitis. Staphylococcus aureus was the most common organism isolated in both acute and chronic cases. Staphylococcus epidermidis was also frequently isolated, particularly in chronic cases. Pseudomonas aeruginosa was the most common gram-negative organism isolated. Staphylococcus aureus showed a high susceptibility to vancomycin and gentamicin. Staphylococcus epidermidis showed a high susceptibility to vancomycin. Streptococcus pneumoniae: was highly susceptible to beta-lactam antibiotics. Pseudomonas aeruginosa: had a high susceptibility to beta-lactam antibiotics, moderate susceptibility to aminoglycosides, and variable susceptibility to fluoroquinolones. Conclusion: The most commonly isolated bacterial pathogen in dacryocystitis in this region was Staphylococcus (Gram-positive), followed by Pseudomonas, Pneumococcus, and Staphylococcus epidermidis. Vancomycin showed the highest efficacy against Gram-positive bacteria, while third-generation cephalosporins, gentamycin, and amikacin were most effective against Gram-negative bacteria.

DOI: 10.5281/zenodo.

Background: Numerous studies suggest that serum adenosine deaminase (ADA) activity could serve as a potential diagnostic marker for rheumatoid arthritis (RA). However, no independent study has validated this finding in our population. This study aims to measure total ADA activity in the serum of our RA patients and assess its diagnostic potential. Methods: The study included 50 RA patients who sought medical care at Prathima Institute of Medical Sciences, Karimnagar. An equal number of age- and sex-matched healthy controls were also enrolled. Blood samples were collected from all participants and analyzed for serum total ADA activity, C-reactive protein (CRP), and rheumatoid factor (RF). Results: Serum total ADA activity was significantly higher (p<0.01) in RA patients (30.9 ± 10.6 U/L) compared to healthy controls (13.66 ± 3.75 U/L). However, no significant difference (p>0.05) in ADA activity was observed between smokers and non-smokers within the RA group. Among the 50 RA patients, only 13 (26%) tested positive for CRP, and 11 (22%) tested positive for RF. Conclusion The significant difference in ADA activity between RA patients and healthy controls highlights its potential utility as a marker in diagnosing the disease within our population, especially when considered alongside clinical background.

DOI: 10.5281/zenodo.

Introduction: One of the microvascular side effects of hypertension that develops gradually is hypertensive retinopathy (HR). Gout is predisposed to by hyperuricemia, which is associated with metabolic syndrome. Additionally, it was considered a stand-alone risk factor for hypertension. SUA may be linked to certain eye conditions, according to a number of studies. The purpose of this study is to highlight how metabolic parameters affect heart rate, and it is hypothesized that SUA gave doctors valuable information about when to perform fundoscopic exams on hypertensive patients. Aim: To study the serum uric acid concentration (SUA) in patients of hypertensive retinopathy and relationship between both. Methodology: Observational cross sectional study was conducted to observe the relationship between serum uric acid and hypertensive retinopathy. Two groups cases 120 (with HR) and controls 120 (without HR) were compared. Serum uric acid was measured by Erba Mannheim XL 640 machine at MBS Hospital Kota. Hypertensive Retinopathy was assessed using indirect ophthalmoscope. Results & Conclusion: The data analysis of the cases showed the mean SUA level to be 6.2398(mg/dl) and the controls showed the mean SUA level of 5.5926(mg/dl).   A two sample t-Test to compare the means of Serum Uric Acid Level (mg/dl) for Cases and Controls.  Significance value (p value) for the test was achieved 0.015 (significant). Thus the study conclude that serum uric acid level is associated with incidence of Hypertensive Retinopathy. And according to ANOVA test it was also found that serum uric acid is associated with severity of Hypertensive Retinopathy. It was hypothesized that SUA gave doctors helpful information for scheduling funduscopic exams in hypertension patients and highlighted the impact of metabolic variables on HR.

DOI: 10.5281/zenodo.

Background: One of the main causes of avoidable blindness is diabetic retinopathy (DR), which is a serious worldwide health hazard associated with type 2 diabetes mellitus. Serum vitamin D levels in Type 2 diabetes patients with and without diabetic retinopathy will be assessed in this study, and the relationship between vitamin D levels and the severity of DR will be examined. Methods: 200 participants were split into two groups for this analytical cross-sectional study: Group A consisted of diabetic patients with DR, and Group B consisted of diabetic patients without DR. In accordance with ETDRS norms, participants received thorough ocular examinations and DR grading. Other biochemical and clinical indicators were examined in addition to serum vitamin D levels. To compare groups and find correlations, statistical analysis was done. Results: Group A exhibited significantly lower serum vitamin D levels (17.03 ± 5.11 ng/mL) compared to Group B (27.72 ± 3.81 ng/mL, p < 0.001). An inverse relationship was observed between serum vitamin D levels and DR severity, with the lowest levels seen in patients with proliferative DR (15.33 ± 4.4 ng/mL). Additionally, patients with longer diabetes duration, poorer glycemic control, and higher BMI were more likely to develop DR. Conclusion: In Type 2 diabetes, the presence and severity of diabetic retinopathy are linked to lower serum vitamin D levels. The degree of DR may be predicted by serum vitamin D levels. The possible impact of vitamin D supplementation in halting or slowing the progression of DR requires more research.

DOI: 10.5281/zenodo.

Aim The aim of this study was to measure early changes in anterior chamber morphology, including depth and angle, after phacoemulsification and foldable intraocular lens (IOL) implantation using Anterior Segment Optical Coherence Tomography (AS-OCT). Methods: A prospective observational study was conducted at the Outpatient Department of the Department of Ophthalmology, Govt. Medical College, Kota, Rajasthan, from December 2022 to May 2024. The study included 50 patients diagnosed with senile cataract who underwent phacoemulsification and foldable PCIOL implantation. Preoperative and postoperative evaluations, including ACD and ACA measurements using AS-OCT, were performed. Statistical analysis was carried out using paired t-tests and Tukey tests. Results: The mean age of participants was 69 ± 2.91 years, with a higher incidence of cataract among females (68%). Significant increases were observed in both ACD and ACA after surgery. The mean ACD increased from 2.51 ± 0.19 mm preoperatively to 3.95 ± 0.21 mm postoperatively (p < 0.05). The mean nasal angle increased by 11.68° (p < 0.05) and the temporal angle by 10.74° (p < 0.05). These changes were consistent across different grades of nuclear sclerosis (NS) cataracts. Gender-based analysis revealed greater increases in ACD and ACA in females. Conclusion: AS-OCT provides accurate, non-invasive imaging of anterior chamber parameters, showing significant increases in both ACD and ACA after cataract surgery. This tool plays a vital role in optimizing surgical outcomes by improving IOL placement and aiding in postoperative assessments, ultimately enhancing patient care.

DOI: 10.5281/zenodo.

Introduction: Hypertension is the health related risk factor in India with an increasing proportion of elderly people, a sedentary lifestyle and obesity associated with increasing urbanization and other lifestyle factors like high levels of salt intake, alcohol and tobacco consumption are contributing to this burden of hypertension. Hypotension following antihypertensive treatment is associated with retinal nerve fibre loss. Altered autoregulation of retinal circulation in hypertension and hypotension leading to hypoprfusion and ischemia of the tissues of retinal nerve fibres. Aim and Objectives: (1). To Compare RNFL thickness in hypertensive Patients on antihypertensive treatment and normotensive (Control Groups) by using Optical Coherence Tomography. (2). To comparison of RNFL thickness in hypertensive patients on different anti-hypertensive agent by using cirrus HD-OCT 500. (3). To comparison of RNFL thickness in different long duration of hypertension in patients by using cirrus HD-OCT 500. Materials and Methods: In a tertiary care facility, this cross-sectional study was carried out. The study included age-matched normotensives and patients with a diagnosis of hypertension. Therefore, a total of 100 patients, 50 patients with systemic hypertension and 50 age matched normotensives (above 40 years) were studied. Blood pressure measured using sphygmomanometer. Systolic BP, diastolic BP and pulse pressure measurement. Difference between (systolic, diastolic, mean arterial) blood pressure and IOP defined as ocular systolic perfusion pressure, ocular diastolic perfusion pressure and mean ocular perfusion pressure. Photography of the RNFL finding will be captured using OCT. Results: In our study statistically significant average RNFL thickness was detected in hypertensives on antihypertension treatment 98.31±7.01, when compared to the normotensives 102.51±8.72. Significant RNFL thickness reduction in hypertensives using antihypertensive medication suggests altered autoregulation, and low mean, diastolic, and systolic ocular perfusion pressure have raised the risk of optic nerve head damage. Furthermore, a number of studies have demonstrated that antihypertensive medications will lower the ocular perfusion pressure, which could potentially harm the perfusion of the optic nerve head. In the hypertensives group, the average RNFL thickness showed the reduction was significant over time (P < 0.001). Conclusion: In conclusion, the RNFL thickness in hypertensives patients on antihypertension treatment statistically significant reduced than average RNFL thickness in normotensives patients. The RNFL thickness of all four quadrant showed a significant reduction over time.

DOI: 10.5281/zenodo.

Background: Age-related macular degeneration (ARMD) is a leading cause of vision loss in the elderly, with systemic inflammation, as indicated by elevated C-reactive protein (CRP) levels, implicated in its pathogenesis. This study examines the association between serum CRP levels and stages of  ARMD, and related risk factors. Methods: This analytical cross-sectional study was conducted over 18 months at the Ophthalmology Department, Government Medical College, Kota. A total of 140 participants aged 40 years or older were included, with 70 ARMD cases and 70 controls. Detailed ocular and systemic evaluations were performed, including fundus examination and OCT. Serum CRP levels were measured using a latex-enhanced turbidimetric immunoassay. Statistical analysis, including t-tests and ANOVA, was conducted using SPSS, with p < 0.05 considered significant. Results: ARMD patients had significantly higher CRP levels (0.378 ± 0.26 mg/dL) compared to controls (0.19 ± 0.08 mg/dL, p < 0.05). CRP levels increased with ARMD severity: 0.15 ± 0.06 mg/dL in early, 0.50 ± 0.09 mg/dL in intermediate, and 0.84 ± 0.02 mg/dL in advanced stages (p < 0.05). Risk factors including age, smoking, hypertension, diabetes, cardiovascular disease, and alcohol consumption were significantly associated with higher CRP levels and advanced ARMD stages. Older age (>71 years) and cardiovascular disease were particularly linked to advanced ARMD. Conclusion: Elevated serum CRP levels are strongly associated with ARMD severity, emphasizing systemic inflammation’s role in its progression. Monitoring CRP may aid in ARMD prevention and treatment.

DOI: 10.5281/zenodo.