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

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