Knowledge of body mass index and its correlates among the patient at a tertiary care hospital

Background: In spite of the numerous chronic diseases that have been linked to obesity, studies focusing on awareness regarding Body mass index (BMI) and its correlates to prevent and control obesity are lacking in the literature, especially in developing countries such as India, where obesity is culturally accepted and nurtured in the society.Methods: A cross-sectional prospective survey was done between November 2018 and November 2019 in a tertiary care research institute after approval from institutional ethics committee. A pre-designed questionnaire was used to collect data in excel sheet (Microsoft Corp, Redmond, WA) and analysed using SPSS.Results: total 264 (80.3% urban and 19.7% rural background) patients with mean age of 42 years with different educational level participated in the study. 1.1% patients were underweight, 2.7% mean BMI of studied population was 34.76. BMI distribution curve was bilaterally symmetrical. No one in the study population was well aware of about the BMI and related comorbidities. 98.5% patients confirmed that their doctor had never discussed their BMI with them.Conclusion: There is a significant gap of knowledge among patients regarding obesity and BMI, and physicians also have to take initiatives to discuss about this for primary control of the disease (obesity) and related comorbidities

Gargantuan primary scrotal calcinosis – Surgical, cosmetic, and sociopsychiatric concern

A 47-year-old healthy male had a scrotal lesion for about 10 years which was gradually increasing in size and not associated with pain or tenderness. It was dwarfing the penis and attained its present size of 14 cm × 7.5 cm × 6 cm. There were no discharging sinuses, tenderness, or ulceration. He had no significant past or family history. Laboratory examination revealed unremarkable serum calcium, serum phosphate, serum total protein, serum uric acid, and serum parathormone levels. A clinical diagnosis of epidermal inclusion cysts was suggested. The lesion was entirely excised and sent for histopathologic examination

Combined hyperdense gallbladder wall-lumen sign : new computed tomography sign in acute gangrenous cholecystitis

Purpose: The objective of our study was to evaluate the combined hyperdense gallbladder wall-lumen sign on computed tomography (CT) in diagnosing gangrenous cholecystitis. Material and methods: We retrospectively reviewed the unenhanced CT scans of surgically proven cases of acute gangrenous (GCh) and non-gangrenous cholecystitis (nonGCh). Eleven cases of pathologically proven acute gangrenous cholecystitis and 12 consecutive cases of surgically proven acute non-gangrenous cholecystitis that underwent CT at our institute were included in the study so as to have 1 : 1 control. The Hounsfield unit (HU) value of the gallbladder wall and intraluminal bile was measured. Interobserver variability for individual CT findings was also assessed. Results: The gangrenous cholecystitis group had significantly higher HU values of wall and bile (median value of 33 HU vs. 21 HU and median value of 21 HU vs. 8.5 HU, respectively, p < 0.05). The area under the receiver operator characteristic curve for HU lumen was 0.80 (95% CI: 0.62-0.98, p = 0.014) with an ideal cut-off at 31.5 HU, where the sensitivity was 54.5% and specificity was 91.7%. HU lumen has an even better assessment for gangrenous cholecystitis with AUC of its ROC as 0.92 (95% CI: 0.80-1.00, p = 0.001) with an ideal cut-off at 12.5 HU, where the sensitivity was 81.8% and specificity was 91.7%. The combined wall-lumen cut-off is 35 HU with sensitivity of 100% and specificity of 75%. Conclusion: A cut-off CT density value of the gallbladder wall of more than 31.5 HU, intraluminal bile more than 12.5 HU, and combined wall-lumen HU of more than 35 can predict GCh

Analyzing the Association of Visceral Adipose Tissue Growth Differentiation Factor-15 and MicroRNA in Type 2 Diabetes Mellitus

Background : Growth differentiation factor-15 (GDF-15) is involved in insulin resistance and diabetes. In this study, we determine the associations of GDF-15 with miR-181b-5p, miR-330-3p, mothers against decapentaplegic homolog 7 (SMAD7), and insulin resistance in visceral adipose tissue (VAT) and peripheral blood mononuclear cells (PBMCs) in type 2 diabetes mellitus (T2DM) patients. Methods : Sixty patients, equally divided into those with T2DM and non-diabetic controls, were recruited for gene expression analysis. Protein-protein interaction (STRING), target prediction (miRNet), and functional enrichment were conducted accordingly. Results : Our study showed that VAT and PBMCs had similar expression profiles, where GDF-15 and miR-181b-5p were upregulated, whereas SMAD7 and miR-330-3p were downregulated. Serum GDF-15 could differentiate between T2DM and non-diabetic patients (P<0.001). Target prediction revealed a microRNA (miRNA)-messenger RNA regulatory network, transcription factors, and functional enrichment for the miRNA that suggested involvement in T2DM pathogenesis. Conclusion : VAT GDF-15 is associated with insulin resistance and is possibly regulated by miR-181b-5p, miR-330-3p, and SMAD7 in T2DM

Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries

Background: This study assessed the potential cost-effectiveness of high (80-100%) vs low (21-35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, published literature, and a cost survey in Nigeria, India, and South Africa. Effectiveness was measured as percentage of SSIs at 30 days after surgery, a healthcare perspective was adopted, and costs were reported in US dollars ($). Results: High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was$216 compared with 222 for low FiO2 leading to a -6 (95% confidence interval [CI]:&nbsp;-13 to -1) difference in costs. In India, the average cost for high FiO2 was $184 compared with$195 for low FiO2 leading to a&nbsp;-$11 (95$15 to&nbsp;-$6) difference in costs. In South Africa, the average cost for high FiO2 was$1164 compared with 1257 for low FiO2 leading to a -93 (95% CI:&nbsp;-132 to -65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a&nbsp;-1.05 (95% CI:&nbsp;-1.14 to&nbsp;-0.90) percentage point reduction in SSIs. Conclusion: High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this