Prevalence of hypothyroidism in patients with type 2 diabetes mellitus attending a tertiary care hospital in a rural area of Bihar, India

Background: Diabetes has become a major health challenge all over the world. Previous studies have found that diabetes and thyroid disorders mutually influence each other and both disorders tend to coexist. The aim of this study was to find out prevalence of hypothyroidism and its associated factors in type 2 diabetes mellitus patients.Methods: Consecutive 200 patients with type 2 diabetes mellitus attending outpatient department of medicine in a tertiary care centre in Sasaram, Bihar were evaluated clinically and biochemically. Subclinical hypothyroid and overt hypothyroidism was diagnosed as per standard definitions. The results obtained were statistically analysed by using chi square test and finding odds ratio.Results: Out of 200 patients, 75.5% were euthyroid while 24.5% were hypothyroid. Out of 49 hypothyroid patients, subclinical hypothyroid (SC-Hypo) was present in 41 patients and overt hypothyroid (C-Hypo) was present in only 8 patients. The prevalence of hypothyroidism was found more in males, age ≥60 years, patients with HbA1c value ≥7%, patients with diabetes duration less than 5 years and in hypertensive patients.Conclusions: Thyroid dysfunction screening should be done in all type 2 diabetic patients periodically and appropriate individualized treatments in addition to thyroid function test should be given to diabetes mellitus patients with subclinical hypothyroidism as well

A study on neutrophil lymphocyte ratio as a prognostic predictor in patient with acute ischaemic stroke visiting tertiary care hospital of southern Bihar

Introduction: The Neutrophil- Lymphocyte Ratio (NL Ratio) is one of potential early markers that can be correlated to mortality or morbidity in acute ischaemic stroke , being readily available, cost effective and routinely requested in laboratory Aim and Objectives: To study the clinical presentation and risk factors of acute Ischaemic stroke And To study the pattern of stroke and neutrophil lymphocyte correlation. Methodology: This was a Retrospective study, conducted on 100 study subjects of stroke at medical ward of Narayan medical college and Hospital, Rohtas, South Bihar. Data was collected from the record of Narayan medical college, Rohtas,NLR was calculated as the ratio of neutrophils to lymphocytes in peripheral blood. Result: There was correlation between NLR value of patients and GCS score with R square 0.593. On applying multivariate analysis for seeing the effect of age, Time duration, Total count, and NLR over GCS score, we found significant correlation with R square 0.636.There was also correlation between SSR score and NLR with R square 0.661. On applying multivariate analysis for seeing the effect of age, Time duration, Total count, and NLR over SSS score, we found significant correlation with R square 0.686. Conclusions: An elevated NLR at the time of hospital admission may be a predictor of morbidity and  mortality in acute stroke patients. Because of its routine use, low cost and easy-to-measure nature, NLR can be used for prediction of prognosis and in-hospital mortality in stroke patients. Keywords: Stroke, NLR, GCS score, SSS score, TIA

A study on clinical, etiological and laboratory profile in patients with jaundice at a tertiary care centre in south bihar

Introduction: Jaundice is a major components of the syndrome of liver failure, which can be acute, subacute or chronic. Subacute and chronic liver failure are well-recognized syndromes with known causes of liver disease. While viral hepatitis and acetaminophen overdose are major causes of acute liver failure, there are many other infections and non-infectious causes that can mimic this presentation especially in a tropical country like India. Aim and objective: To study the clinical profile, etiology and laboratory findings in different patients with jaundice. Methodology: An observational study was conducted in General Medicine department in Narayan Medical College and Hospital, Jamuhar. Total 100 patients were selected from OPD and IPD of Narayan medical college and hospital with jaundice being treated and fulfilled inclusion and exclusion criteria. The study was conducted between  Dec 2019 to June 2020. Result: Most common cause of jaundice came out to be viral hepatitis making a total of 60 cases (60%), with 23 cases of females (23%) and 37 cases of males (37%). Among the viral hepatitis the highest number of cases were of HEV (26%), followed by HBV (21%), HAV(16%) and HCV(1%). Next most common cause of jaundice came out to be Malaria (12%), Dengue (5%), and drug induced hepatitis (15%).Conclusion: Jaundice is very common disease with male predominance, varied etiology most common being viral hepatitis, Alcoholic liver diseases. Most common presentation is anorexia followed by myalgia, fatigue. Keywords: Jaundice, viral hepatitis, SGOT, SGPT

A study on the prevalence of helicobacter pylori infection by rapid urease test in patients undergoing upper gastro intestinal endoscopy for dyspepsia in a tertiary care hospital of Southern Bihar

Background:  The epidemiology of H.pylori is poorly understood and it is a major health issue in developing countries such as India. There is a high incidence of morbidity and mortality due to complications of H.pylori infection. Prevalence of H.pylori differs from country to country, as well as from region to region in the same country. Methods: This observational study was carried out in an outpatient department in a tertiary care hospital of Southern Bihar, and included 163 patients who presented with dyspepsia and fulfilled the criteria of the study and were willing to undergo upper gastrointestinal endoscopy. Result:There is a high prevalence of H.pylori in southern Bihar with significant incidence in the male population and most commonly associated with dyspeptic symptoms.Increased incidence of gastritis was found in RUT positive patients on endoscopic examination

Study of platelet count in covid-19 positive patients admitted in a tertiary care hospital of South Bihar

Aim and objective: The aim of this study was to investigate platelet count in COVID-19 positive patients. Material and methods:This is an institution based retrospective type of cross sectional observational study were done in  Narayan medical college and hospital, jamuhar, Sasaram. 500 covid 19 positive patients were include in this study. Results: The study is conducted in Narayan medical college and hospital, jamuhar, Sasaram for 6 months period including in-hospital patients (average of stay in hospital 9.32 ± 7.56) with covid 19 diagnosed by PCR & non-enhancing chest CT scan, the including patients were 500 with mean age 44.24 ± 16.42 years with 50% male & 50% female the majority with pneumonia but non critical & no one had clinically significant bleeding with the majority did not need RCU. For all patients included in the study (PCR&CT+vecases) the platelets count show statistically significant increment when compare between the admission & discharge. Conclusion: We concluded that the  increase in platelets level is a good indicator for recovery from covid in both PCR & CT + ve patients. The CT +ve patients show more platelets level on admission & on discharge. The increase in platelets level not reflect mortality 6- The age show –ve correlation with admission platelets levels. Keywords: platelet, coronavirus, thrombocytopenia

A comparative study of subclinical hypothyroidism in metabolic syndrome with patient not having metabolic syndrome

Aim: To evaluate the thyroid status in metabolic syndrome in comparison to healthy controls. To correlate the components of MetS with thyroid status.Material and methods: This was a cross-sectional study was done in the Department of General Medicine, Narayan Medical College and Hospital, Sasaram, Bihar, India, for 1 year. A total sample size of 100 (50 cases of metabolic syndrome matched with 50 controls) were included in the study. T3, T4 and TSH was analysed by chemiluminiscence assay in Access-2 hormone analyser. The biochemical assays were routinely monitored through internal and external quality programs. Results: The study population comprised of 56% male and 44% female among controls whereas cases had a slight female predominance with 58% being female and 42% being male. The mean age of the study population was 51.21±11.21 among cases and 48.36 ± 9.87 among controls. Difference of each of the component of Met S between the patients of Met S and control was tested using Student t-test. Significant difference with p value < .00001 was observed in each of the component of Met S between cases and controls. TSH showed significant difference (p= 0.02) with the mean TSH in cases group as 8.42 ± 3.12 and in control as 3.11 ± 0.42 whereas T3 and T4 showed no significant difference between both the groups shown in Table 2. Subclinical hypothyroidism (SCH) is the predominant pattern of thyroid dysfunction observed in 24 % of patients having Met S, followed by overt hypothyroidism in 6% as shown in while there where were no cases of overt hyperthyroidism. The correlation of TSH with the components of Met S was assessed using Pearson correlation coefficient. Waist circumference positively correlated with high TSH and was statistically significant (p = 0.02). Conclusion: The prevalence of TD in patients with Metabolic syndrome was high, indicating a possible interplay between thyroid status and MetS. Hypothyroidism was the most common TD in Indian patients with MetS

Awareness regarding covid 19 disease among healthcare workers in a Tertiary Care Hospital in Southern Bihar

Background: The SARS-COVID-19 virus is a highly infectious and life threatening which has taken the form of a global pandemic since march 2020. It presents with symptoms similar to comman respiratory illness like sore throat,fever,cough,weakness,myalgia and dyspnoea. At presentno definitive treatment is available for this deadly virus. Hence prevention is the most effective intervention. This global pandemic is causing severe burnout and exhaustion in health care workers. Hence, this study was conducted based on a questionnaire to assess the skills and attitudeof the health care professionals. Materials and methods: A cross sectional study was conducted from October to December 2020 after approvalby the ethics committee of Narayan Medical College and Hospital, Jamuhar ,Bihar. A written and informed consent was obtained from the respondents before administering the questionnaire using WHO course materials on emerging respiratory viruses, including COVID-19, a 13- item based survey questionnaire was developed. Health care workers features, memory, information sources, skills, and attitudes were all addressed in the survey questionnaire. The data was coded, validated, and analysed using open source software that is static. To measure frequencies and proportions, descriptive analysis was used. The chi-square test was used to determine the degree of correlation between variables. Statistical significance was described as a P value of less than 0.05. Results: The majority of the sample population (50.8 percent) was between the ages of 21 and 30, with 67.7% males and 32.3 percent females. Non-clinical/administrative employees made up 51.5 percent of The workforce, while nursing made up 48.5 percent (students and faculty). Among the sample population, the most common source of knowledge was Family/ Peers (64.6%), followed by News and Blogs (43.8%) and Social Media (40.8%). Corona virus transmission and prevention were not well understood. Nursing (students and faculty) performed substantially better than Non-clinical/personnel in charge of administration. Conclusion: It is critical that the health care workers community members knowledge and preparedness be strengthened. For reaching out to staff, directed educational interventions are needed, as well as the evolution and evaluation of these interventions

A study on the bleeding tendencies in patients diagnosed with dengue fever in a tertiary care hospital of southern bihar

Background: Dengue is one of the most common cause of fever associated with thrombocytopenia, and it presents clinically in various forms of bleeding manifestations, which acts as a warning sign of declining platelet count values. Timely intervention in such patients help in reducing the mortality rates in patients suffering from dengue. Methods: This observational study was carried out on admitted patients in the Department of General Medicine in a tertiary care hospital of Southern Bihar and included 150 patients above the age of 18 years and who were diagnosed to be suffering from dengue. Result: The study showed that there was a preponderance in the male patients suffering from dengue, with higher incidence in the age group of 21-30 years. 32.67% patients suffering from dengue manifested with bleeding tendencies, with rash/petechiae being the most common bleeding manifestation. Most of the patients presented with moderate level of thrombocytopenia