Medico Research Chronicles
https://medrech.com/index.php/medrech
<p style="text-align: justify;"><code></code><strong>Medico Research Chronicles (Medrech) ISSN No. 2394-3971</strong>, as the official journal of Medico Edge Publications, serves as a catalyst for advancing medical and health sciences. With its commitment to excellence, the journal invites diverse manuscripts that contribute to the ever-evolving landscape of medical, health science, and clinical research. Through its rigorous peer review process, open-access policy, and timely publication, Medico Research Chronicles continues to be a trusted platform for researchers and practitioners, driving innovation and shaping the future of healthcare.</p> <p>Indexed by the <a href="https://www.ncbi.nlm.nih.gov/nlmcatalog/?term=Medico+Research+chronicles"><strong>United States' NLM Catalogue, NCBI</strong></a></p> <p><strong><a href="https://journals.indexcopernicus.com/search/details?id=31567&lang=pl">Index Copernicus</a>, </strong>Medico Research Chronicles, the esteemed journal of Medico Edge Publications, has received a positive evaluation from Index Copernicus, Poland for the year 2021. With an impressive IC Value of 84.43, the journal reaffirms its position as a reputable platform for groundbreaking research in the field of medical and health sciences. This recognition underscores the journal's commitment to scientific excellence and its significant contribution to advancing healthcare knowledge. Researchers and practitioners can rely on Medico Research Chronicles as a trusted source of innovative research findings.</p> <p><strong>Academicians and Researchers interested in reviewing the article are requested to join us on Publons: <a title="Publons by Web of Science" href="https://publons.com/journal/102220/medico-research-chronicles/">https://publons.com/journal/102220/medico-research-chronicles/</a></strong></p> <p><strong><a href="https://www.nmc.org.in/e-gazette">Click Here </a></strong>for the notification details.</p> <p> </p> <p> </p> <p> </p>Medico Edge Publicationsen-USMedico Research Chronicles2394-3971Prevalence and Pattern of Anemia and Micronutrient Deficiencies in Children with Severe Acute Malnutrition at a Tertiary Care Center: A Cross-sectional Study
https://medrech.com/index.php/medrech/article/view/741
<p><strong>B</strong><strong>ackground:</strong> Severe acute malnutrition (SAM) remains a major health concern in developing countries like India, significantly contributing to pediatric morbidity and mortality. Children with SAM are particularly vulnerable to infections and anemia due to impaired immune response and nutritional deficiencies. This study aimed to assess the prevalence and severity of anemia in children under 60 months diagnosed with SAM.</p> <p><strong>Method:</strong> A cross-sectional study was conducted over 11 months at Pravara Institute of Medical Sciences DU, Loni involving 48 children with SAM. Detailed demographic profiles and medical histories were collected using a predesigned proforma. Anthropometric measurements and laboratory investigations, including hemoglobin, serum iron, ferritin, folate, and vitamin B12 levels, were performed. Anemia was classified based on hemoglobin levels into mild, moderate, and severe categories.</p> <p><strong>Results: </strong>Results revealed that 37 (77.1%) children were anemic, with 9 (24.3%) having mild anemia, 25 (67.6%) moderate anemia, and 3 (8.1%) severe anemia. Low serum iron levels were identified in 21 (43.8%) children, with a higher prevalence in females. Abnormal ferritin levels were observed in 24 (50%), folate deficiency in 15 (31.3%), and vitamin B12 deficiency in 29 (60.4%) children.</p> <p><strong>Conclusion:</strong> Addressing anemia in children with SAM requires early interventions, starting with maternal nutrition during pregnancy and promoting exclusive breastfeeding for the first six months. Continued breastfeeding, appropriate complementary feeding, and caregiver education during routine child health visits are essential. Preventing, detecting, and managing anemia in children with SAM can significantly reduce associated morbidity and mortality.</p>Dr Chinmaya G SDr Bhushan A DeoDr Jayashree Jadhav
Copyright (c) 2025 Dr Chinmaya G S, Dr Bhushan A Deo, Dr Jayashree Jadhav
2025-01-042025-01-04121010910.26838/MEDRECH.2024.12.1.755Study on various anthropometric parameters in Beta-thalassemia Major Patients in tertiary rural hospital, Loni
https://medrech.com/index.php/medrech/article/view/742
<p>BMI, mid-upper arm circumference (MUAC), and waist-to-hip ratio were recorded. These parameters were analyzed in relation to clinical variables such as serum ferritin levels, transfusion history, and pre-transfusion hemoglobin levels. Data analysis was performed using IBM SPSS statistics version 28.0.</p> <p><strong>Results:</strong> The study revealed significant growth retardation with 51.4% of patients showing height-for-age z-scores below -2 SD (mean -2.1 ± 1.3). The mean age of the study population was 8.4 ± 2.1 years, with an average transfusion dependency of 6.6 ± 2.3 years. Weight-for-age and BMI z-scores were also compromised (-1.8 ± 1.1 and -1.2 ± 0.9 respectively). Strong negative correlations were observed between serum ferritin levels and growth parameters (r = -0.45 for height-for-age z-score, p < 0.01). Duration of transfusion therapy showed moderate negative correlation with height-for-age z-scores (r = -0.42, p = 0.012) and weight-for-age z-scores (r = -0.38, p = 0.024).</p> <p><strong>Conclusion:</strong> This study highlights significant anthropometric deficits in young BTM patients from rural settings, with growth retardation evident even in early childhood. The findings suggest that optimization of chelation therapy and nutritional support, along with strengthening rural healthcare infrastructure, are crucial for improving growth outcomes in these patients. Regular monitoring of growth parameters and early intervention strategies are essential for managing growth abnormalities in young thalassemic patients.</p>Dr. Pachchalla Hari ChandanaDr. Bhushan DeoDr. Jayashree Jadhav
Copyright (c) 2025 Dr. Pachchalla Hari Chandana, Dr. Bhushan Deo, Dr. Jayashree Jadhav
2025-01-272025-01-27121112010.26838/MEDRECH.2024.12.1.756Surgical Management of Non-malignant Cases by Tracheostomy in a Tertiary Care Hospital
https://medrech.com/index.php/medrech/article/view/745
<p><strong>Background:</strong> Tracheostomy is a commonly performed surgical procedure that involves creating an opening through the neck into the trachea to establish an airway. It can be performed for both malignant and non-malignant conditions. In non-malignant cases, tracheostomy is typically indicated in scenarios where long-term airway management is necessary, and it is often performed in tertiary care hospitals, where specialized expertise is available. <strong>Objectives:</strong> The aim of the study was to evaluate the surgical management of non-malignant cases by tracheostomy in a tertiary care hospital. <strong>Methods:</strong> This cross-sectional study was carried out in the Department of ENT, Mymensingh Medical College Hospital, Mymensingh, Bangladesh during June 2022 to May 2023. A total of 100 patients participated in the study. Statistical analyses of the results were obtained by using window-based Microsoft Excel and Statistical Packages for Social Sciences (SPSS-24). <strong>Results:</strong> In this study, according to the age distribution, 10% of the patients were aged 15 to 24 years. Furthermore, 38% were between the ages of 35 and 44, with 12% between the ages of 55 and 64. And the majority 57% of the patients were male, while 43% were female. According to the socioeconomic position of the study population, 27% come from low class, 42% from middle class, and 31% from high class families. <strong>Conclusion:</strong> The surgical management of non-malignant cases requiring tracheostomy in tertiary care hospitals is highly specialized and ensures optimal outcomes through a multidisciplinary approach.</p>Dr. Mohammad NuruzzamanDr. Miraj AhmedDr. Mazharul Alam SiddiqueDr. Md. Mominur IslamDr. Ashraful AlamDr. Debopran Roy
Copyright (c) 2025 Dr. Mohammad Nuruzzaman, Dr. Miraj Ahmed, Dr. Mazharul Alam Siddique, Dr. Md. Mominur Islam, Dr. Ashraful Alam, Dr. Debopran Roy
2025-02-052025-02-05121323910.26838/MEDRECH.2025.12.1.748Presumptive Tuberculosis In Children Below 12 Years At Tertiary Care Rural Hospital
https://medrech.com/index.php/medrech/article/view/746
<p><strong>Background:</strong> Tuberculosis remains a significant public health challenge, particularly affecting children in India with an estimated 2.2 lakh cases annually. The clinical presentation of tuberculosis in pediatric populations differs markedly from adults, presenting unique diagnostic challenges. This study aimed to investigate presumptive tuberculosis in children below 12 years at a tertiary care rural hospital following the NTEP 2020 protocol.</p> <p><strong>Objectives:</strong></p> <ol> <li>To diagnose tuberculosis according to NTEP 2020 protocol</li> <li>To study the clinical profile and nutritional status of these patients</li> <li>To identify confirmed cases of tuberculosis from presumptive cases</li> </ol> <p><strong>Materials & Methods:</strong> We conducted an observational, descriptive cross-sectional study of 120 patients over two years (June 2022 - May 2024) at a tertiary care rural hospital. Children presenting with persistent fever or cough exceeding two weeks, significant weight loss, or contact history with pulmonary TB patients were enrolled. A standardized study proforma captured detailed clinical information. Comprehensive evaluation included anthropometric measurements, laboratory investigations, tuberculin testing, radiological assessment, and microbiological studies following NTEP 2020 guidelines.</p> <p><strong>Results</strong>: Among 120 children with presumptive tuberculosis, 75 (62.5%) were confirmed cases. The majority (86.66%) of confirmed cases occurred in children under five years. Males showed higher prevalence (65.33%) compared to females. Persistent cough was the predominant symptom (82.66%), followed by fever (57.33%). Severe acute malnutrition was present in 46.77% of confirmed cases aged 6 months to 5 years. Hilar lymphadenopathy was the most common radiological finding (76%). Mantoux test positivity was observed in 33.33% of confirmed cases. Pulmonary tuberculosis constituted 94.66% of confirmed cases, while 5.33% presented with extrapulmonary manifestations.</p> <p><strong>Conclusion</strong>: Implementation of the NTEP 2020 protocol demonstrates effectiveness in early tuberculosis detection among children. The strong association between malnutrition and tuberculosis emphasizes the need for systematic TB screening in malnourished children. The study supports a comprehensive diagnostic approach combining clinical, radiological, and microbiological criteria, particularly focusing on children under five years who represent the most vulnerable group.</p>Dr. Sakthi. DDr. Bhagyashree BoraDr. Jayashree Jadhav
Copyright (c) 2025 Dr. Sakthi. D, Dr. Bhagyashree Bora, Dr. Jayashree Jadhav
2025-02-082025-02-08121405010.26838/MEDRECH.2024.12.1.758Clinical Profile and Outcome of Infant of Diabetic Mother in Tertiary Care (NICU) in Rural Maharastra.
https://medrech.com/index.php/medrech/article/view/744
<p><strong>Background</strong>: Infants of diabetic mothers (IDMs) face unique challenges that require specialized care. The management of these high-risk neonates in rural tertiary care settings presents additional complexities due to resource limitations. This study aimed to evaluate the clinical profile and outcomes of IDMs in a rural tertiary care Neonatal Intensive Care Unit (NICU) in Maharashtra.</p> <p><strong>Methods:</strong> This observational analytical study included 50 infants born to mothers with preexisting or gestational diabetes mellitus admitted to our rural tertiary care NICU. We analyzed maternal characteristics, neonatal complications, and short-term outcomes. The study evaluated various parameters including gestational age, birth weight, metabolic complications, respiratory morbidities, and immediate outcome.</p> <p><strong>Results:</strong> Among the study population, 54% were male infants, with 30% being preterm. Birth weight distribution showed 16% small for gestational age, 62% appropriate for gestational age, and 22% large for gestational age infants. Major complications included hypoglycemia (36%), respiratory problems (38% combined, including 14% requiring surfactant), and hyperbilirubinemia (30%). Congenital anomalies were observed in 12% of cases. The survival rate was 94%, with a median NICU stay of 7 days. Poor maternal glycemic control significantly correlated with adverse neonatal outcomes (adjusted OR 2.8, 95% CI 1.4-5.6, p=0.003).</p> <p><strong>Conclusion:</strong> Despite resource limitations, rural tertiary care centers can achieve favorable outcomes in managing IDMs through systematic protocols and vigilant monitoring. The study highlights the importance of maternal glycemic control and early intervention in preventing complications. The findings provide valuable insights for developing standardized protocols tailored to rural healthcare settings, though larger multicenter studies are needed to validate these results.</p>Dr. Amata PraneethDr. Jayashree P Jadhav
Copyright (c) 2025 Dr. Amata Praneeth, Dr. Jayashree P Jadhav
2025-02-112025-02-11121516010.26838/MEDRECH.2025.12.1.759To study the relationship between the presence and location of intracardiac echogenic foci (ICEF) and their potential association with congenital heart defects (CHDs)
https://medrech.com/index.php/medrech/article/view/747
<p><strong>Background</strong>: Intracardiac echogenic foci (IEF) are common findings during second-trimester fetal ultrasound examinations, yet their relationship with congenital heart defects (CHDs) remains incompletely understood. This study investigated the association between the anatomical location of IEF and the presence of CHDs to enhance current risk assessment strategies. <strong>Methods</strong>: In this prospective observational study, we examined 100 pregnant women between 18-24 weeks of gestation who presented with fetal IEF during routine anatomical scanning. Detailed fetal echocardiography was performed in all cases, documenting the precise location of echogenic foci within the cardiac chambers. All cases underwent postnatal cardiac evaluation to confirm prenatal findings. The relationship between IEF location and CHDs was analyzed using multivariate logistic regression. <strong>Results</strong>: Among the study population, IEF were predominantly located in the left ventricle (48%), followed by the right ventricle (28%), both ventricles (16%), and other cardiac chambers (8%). Congenital heart defects were identified in 15 cases (15%), with a significantly higher prevalence in fetuses with bilateral IEF (adjusted OR: 3.8; 95% CI: 1.6-9.2; p = 0.002) and right ventricular IEF (adjusted OR: 2.4; 95% CI: 1.1-5.3; p = 0.038). Ventricular septal defects were the most common anomaly (40% of CHD cases), followed by atrial septal defects (20%). <strong>Conclusion</strong>: The anatomical location of IEF demonstrates significant association with the risk of congenital heart defects, with bilateral and right ventricular IEF carrying higher risks compared to isolated left ventricular IEF. These findings suggest the need for location-specific risk stratification in prenatal counseling and follow-up protocols.</p>Smita ShalineDr. Bora B. D.Dr. Jayashree Jadhav
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2025-02-032025-02-03121616910.26838/MEDRECH.2022.12.1.760Frequency and Patterns of Eye Diseases in Outpatient Department in a Sub-Urban Clinic
https://medrech.com/index.php/medrech/article/view/749
<p><strong>B</strong><strong>ackground: </strong>Eye diseases are a major cause of visual impairment and blindness worldwide. In Bangladesh, conditions such as refractive errors, cataracts, and dry eye syndrome contribute significantly to vision-related morbidity. Understanding the frequency and patterns of eye diseases in outpatient settings is crucial for early diagnosis, effective treatment, and the prevention of avoidable blindness.</p> <p><strong>Objective:</strong> This study aimed to assess the prevalence and patterns of eye diseases among patients attending the outpatient department of Bashundhara Ad-din Medical College Hospital, Dhaka from January 2024 to December 2024.</p> <p><strong>Methods: </strong>A cross-sectional study was conducted among 98 patients aged 2 years and older who presented with eye-related complaints. Data were collected using structured questionnaires, clinical examinations, and medical records. Statistical analysis was performed using SPSS-26, and results were presented in text, tables, and charts.</p> <p><strong>Results</strong>: Refractive errors (61.2%) were the most prevalent eye condition among patients, followed by dry eye syndrome (24.5%) and cataracts (16.3%). The most commonly reported symptoms included blurred vision (71.4%), eye pain (49%), and watering/tearing (44.9%). In terms of management, medications (71.4%) were the primary treatment approach, followed by spectacle prescriptions (59.2%) and surgical interventions (20.4%). Notably, no cases of diabetic retinopathy, uveitis, corneal ulcer infections, or trauma-related injuries were observed in the study population.</p> <p><strong>Conclusion:</strong> The study highlights the high prevalence of refractive errors, dry eye syndrome, and cataracts among OPD patients. These findings emphasize the need for regular vision screening programs, early detection strategies, and improved access to corrective eyewear and treatment options. Strengthening public health initiatives and referral systems can help reduce the burden of preventable blindness and improve eye care services in sub-urban healthcare facilities.</p>Ferdousi TabassumS. A WadudMG Faruk HossainMohammad Mazaharul IslamTajmeh Mehtaj
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2025-02-102025-02-10121818710.26838/MEDRECH.2025.12.1.763Comparing Outcomes of Lifestyle Modifications Versus Pharmacological Interventions on Metabolic Syndrome in Obese Individuals: A Cohort Analysis
https://medrech.com/index.php/medrech/article/view/750
<p><strong>B</strong><strong>ackground:</strong> Metabolic syndrome in obese individuals presents a significant global health challenge, with ongoing debate regarding the optimal treatment approach. This study aimed to compare the effectiveness of lifestyle modifications versus pharmacological interventions in managing metabolic syndrome among obese individuals over a 24-month period.</p> <p><strong>Methods:</strong> This prospective cohort study enrolled 490 obese adults (BMI ≥30 kg/m²) with metabolic syndrome across three tertiary care centers. Participants were allocated to either lifestyle modification (n=245) or pharmacological intervention (n=245) groups. The lifestyle modification group received structured dietary counseling, supervised exercise programs, and behavioral support, while the pharmacological group received standardized medication regimens including metformin, antihypertensives, and statins. Primary outcomes included changes in body weight, waist circumference, blood pressure, and metabolic parameters. Secondary outcomes encompassed treatment adherence, quality of life, cost-effectiveness, and adverse events.</p> <p><strong>Results</strong>: At 24 months, the lifestyle modification group demonstrated superior outcomes in weight reduction (-8.4 ± 4.2 kg vs. -6.1 ± 3.8 kg, p=0.008) and waist circumference reduction (-7.8 ± 3.9 cm vs. -5.4 ± 3.6 cm, p=0.006). The pharmacological intervention group showed greater improvements in blood pressure (systolic: -14.8 ± 8.9 vs. -12.3 ± 8.4 mmHg, p=0.042) and glycemic control (HbA1c: -0.7 ± 0.4% vs. -0.5 ± 0.3%, p=0.018). Treatment adherence was higher in the pharmacological group (83.2% vs. 68.9% at 24 months, p=0.002). The lifestyle modification group demonstrated better cost-effectiveness (ICER: $2,834 vs. $4,256 per QALY gained) but higher dropout rates. Adverse events were more frequent in the pharmacological group (32.4% vs. 18.7%, p<0.001) but were predominantly mild to moderate in severity.</p> <p><strong>Conclusions:</strong> Both interventions demonstrated distinct advantages in managing different aspects of metabolic syndrome. Lifestyle modifications showed superior outcomes in anthropometric measures and cost-effectiveness, while pharmacological interventions achieved better results in blood pressure control, glycemic parameters, and treatment adherence. These findings suggest that personalized treatment approaches, potentially combining elements of both strategies, may be optimal for managing metabolic syndrome in obese individuals.</p>Angela B
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2025-02-062025-02-061218810010.26838/MEDRECH.2025.12.1.765Efficacy and Safety of Platelet-Rich Plasma Therapy for Erectile Dysfunction: An Observational Study
https://medrech.com/index.php/medrech/article/view/751
<p><strong>B</strong><strong>ackground:</strong> Erectile dysfunction (ED) is a prevalent ailment that significantly impacts one's quality of life. An effective regenerative treatment for the underlying pathophysiological mechanisms of ED is platelet-rich plasma (PRP) therapy. Assessing PRP therapy's effectiveness, safety, and patient-reported results in mild to moderate ED was the goal of this study.</p> <p><strong>Objective:</strong> to evaluate how PRP treatment for mild to moderate ED affects patient satisfaction, safety profile, and erectile function.</p> <p><strong>Methods: </strong>This 12-month prospective observational study was carried out at Ashiyan Medical College Hospital. The study included 60 male patients with mild to moderate ED. One month apart, two intrapenile injections of PRP therapy were given. The International Index of Erectile Function (IIEF) scores were used to assess erectile function at baseline, one, three, and six months. Additionally, adverse events and patient satisfaction were evaluated.</p> <p><strong>Results: </strong>PRP treatment significantly improved erectile function; at 6 months, the mean IIEF score increased by +5.1 points over baseline (p < 0.001). 60% of participants said they were satisfied with the therapy, and 70% said they had seen improvement. According to subgroup analysis, patients with lower BMIs and no hypertension had better results. With only minor side effects like mild pain (16.7%) and hematoma (5%), PRP therapy was well tolerated and did not result in any significant complications.</p> <p><strong>Conclusion: </strong>PRP therapy offers notable and long-lasting enhancements in erectile function with a high level of patient satisfaction, making it a safe and effective option for mild to moderate ED. PRP appears to be a promising restorative treatment based on these findings. It will take more randomized controlled trials to confirm these findings and investigate long-term advantages.</p>Dr. Mohammed Arif ChowdhurySyed E. ShaudeDr. Sumona HaqueDr. Farhana Jahan
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2025-02-132025-02-1312110110810.26838/MEDRECH.2025.12.1.762Comparative Study of TB Treatment Outcomes Among Non-Diabetics, Controlled Diabetics, and Uncontrolled Diabetic Patients
https://medrech.com/index.php/medrech/article/view/752
<p>Objectives: This study was done to compare the clinical characteristics, bacteriological pattern and treatment outcomes, among non-diabetics, controlled and uncontrolled diabetics. Theoretical Framework: TB continues to be a major global public health concern, with millions of cases reported annually. While there are treatment regimens with high cure rates, achieving optimal outcomes can be significantly challenged by the presence of co-morbidities like DM. Methods: This study was an observational type of analytical study conducted in the Department of Respiratory Medicine, SNMC Agra. Patients who were sputum positive and registered under NTEP were included in this study, PTB patients were screened for DM using Fasting and 2 hour Post Prandial Blood glucose test and Hba1c. Results and Discussion: Patients with DM both controlled and uncontrolled experienced more severe clinical manifestations, delayed sputum conversion, and poorer treatment outcomes as compared to non-diabetics . There were higher cases of drug resistance, treatment failure, loss to follow-up cases and mortality in uncontrolled diabetics while best Treatment outcomes were observed in Non-Diabetics. Research Implications: Given the growing epidemic of DM worldwide it is necessary to add DM prevention and control strategies to TB control programmes during the course of TB treatment, Proper management of DM with improved glucose control and regular monitoring can affect the treatment outcomes in TB patients, as evidenced in our study. Originality: By meticulously evaluating treatment success rates, and exploring potential influencing factors, this study aims to establish a clearer picture of the link between diabetes control and TB treatment.</p>Pragati RautelaSantosh KumarGajendra Vikram SinghAK NigamRenu Agrawal
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2025-02-172025-02-1712110911510.26838/MEDRECH.2025.12.1.767Karyotype Analysis among Selected Bangladeshi Azoospermic Male Infertile Patients
https://medrech.com/index.php/medrech/article/view/753
<p><strong>B</strong><strong>ackground:</strong> Male infertility is a global health concern, with genetic factors playing a crucial role in its etiology. Azoospermia, the absence of sperm in ejaculate, is often associated with chromosomal abnormalities. Karyotyping is a key diagnostic tool for identifying chromosomal alterations linked to male infertility. This study aimed to evaluate the karyotypic profiles of Bangladeshi azoospermic male infertile patients, highlighting the prevalence and clinical implications of chromosomal abnormalities.</p> <p><strong>Methods:</strong> This cross-sectional descriptive study was conducted at the Genomic Research Laboratory, Department of Anatomy, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from March 2022 to February 2023. Sixty-four azoospermic male patients aged 21–60 years were recruited through purposive sampling. Karyotyping was performed using the Giemsa banding (G-banding) technique following ISCN (2009) guidelines. Hormonal profiling and ultrasonographic assessments were conducted to evaluate testicular and endocrine abnormalities. Data analysis was performed using IBM SPSS Statistics (version 25).</p> <p><strong>Results:</strong> Among the 64 patients, 6.25% had Klinefelter syndrome (47,XXY), while 93.75% exhibited a normal karyotype (46,XY). Hormonal analysis showed that 6.3% of patients had abnormal testosterone, FSH, and LH levels, while 3.1% had abnormal prolactin and TSH levels. Ultrasonography revealed testicular abnormalities in 12.5% of patients, including bilateral small testes (6.25%) and epididymal cysts (3.1%). Antichlamydia antibodies were detected in 15.63% of patients, suggesting past or ongoing infections.<br><strong>Conclusion:</strong> This study underscores the importance of karyotyping in azoospermic males, detecting Klinefelter syndrome in 6.25% of cases, aligning with global prevalence rates. Given that 93.75% had a normal karyotype, further genetic screening, including Y-chromosome microdeletion analysis and whole-genome sequencing, is recommended. Integrating karyotyping, molecular diagnostics, and genetic counseling into infertility management can improve clinical decision-making and reproductive outcomes.</p>Dr. Masuma Rashid RakaProf. Laila Aujuman BanuDr. Md. Ashif IqbalDr. Md. Rezaul Karim
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2025-02-192025-02-1912111612710.26838/MEDRECH.2025.12.1.770Clinical Characteristics and Outcomes of Diabetic Ketoacidosis in School-Age Children: A Single-Center Analysis of 60 Cases
https://medrech.com/index.php/medrech/article/view/754
<p><strong>B</strong><strong>ackground:</strong> Diabetic ketoacidosis (DKA) remains a significant complication in pediatric diabetes, yet specific data focusing on school-age children is limited. This study analyzed the clinical characteristics and outcomes of DKA in this distinct age group to enhance our understanding and improve management strategies.</p> <p><strong>Methods:</strong> We conducted a retrospective analysis of 60 cases of DKA in children aged 6-12 years admitted to our tertiary care center between January 2022 and December 2023. Clinical characteristics, laboratory parameters, treatment outcomes, and complications were evaluated. DKA severity was classified according to venous pH values, and outcomes were analyzed using standardized protocols based on ISPAD guidelines.</p> <p><strong>Results:</strong> The study included 60 patients (mean age 9.3 ± 2.1 years, 56.7% female), with 31.7% being newly diagnosed cases. DKA severity distribution showed 36.7% mild, 41.7% moderate, and 21.6% severe cases. The median time to DKA resolution was 16.8 hours (IQR: 12.4-22.6), with a mean hospital stay of 3.2 ± 1.4 days. Complications occurred in 13.3% of cases, including cerebral edema (3.3%), hypokalemia (6.7%), and hypoglycemia (3.3%). Among established diabetes cases, insulin omission (46.3%) and technical insulin pump issues (14.6%) were the primary precipitating factors. Multivariate analysis identified severe initial acidosis (pH <7.1) as a significant predictor of prolonged DKA resolution (adjusted OR 2.9, 95% CI 1.3-6.5).</p> <p><strong>Conclusions:</strong> Our findings reveal distinct patterns of DKA presentation and outcomes in school-age children, with notably lower rates of severe cases and complications compared to general pediatric populations. The emergence of insulin pump-related issues as a significant precipitating factor highlights the need for enhanced technical support and education programs. These results support the development of age-specific management protocols and preventive strategies for DKA in school-age children.</p>Dr. Nagaraju YakkalaDr. Prashant V NigwekarDr. Jayashree Jadhav
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2025-02-152025-02-1512112813710.26838/MEDRECH.2025.12.1.771Risk Factors and Clinical Outcomes of Acute Kidney Injury in Pediatric Intensive Care Unit: A Prospective Observational Study
https://medrech.com/index.php/medrech/article/view/755
<p><strong>B</strong><strong>ackground:</strong> Acute kidney injury (AKI) is a significant complication in pediatric intensive care units (PICU), associated with increased morbidity and mortality. Understanding its risk factors and outcomes is crucial for improving patient care.</p> <p><strong>Objective</strong>: To evaluate the incidence, risk factors, and clinical outcomes of AKI in PICU patients through a prospective observational study.</p> <p><strong>Methods:</strong> We prospectively studied 40 children aged 1 month to 18 years admitted to the PICU. AKI was defined and staged according to KDIGO criteria. Clinical parameters, laboratory values, and outcomes were monitored. Risk factors were analyzed using multivariate logistic regression.</p> <p><strong>Results:</strong> AKI developed in 15 patients (37.5%), with 46.7% classified as Stage 1, 33.3% as Stage 2, and 20% as Stage 3. Significant independent risk factors included nephrotoxic medication exposure (adjusted OR 4.1, 95% CI 1.9-8.8), mechanical ventilation (adjusted OR 3.2, 95% CI 1.6-6.4), and sepsis (adjusted OR 2.9, 95% CI 1.4-6.0). AKI patients demonstrated longer PICU stays (median 12 vs 7 days, p=0.003), increased mechanical ventilation duration (median 8 vs 4 days, p=0.001), and higher mortality (26.7% vs 8%, p=0.04). Among survivors with AKI, 26.7% showed persistent renal dysfunction at discharge.</p> <p><strong>Conclusion:</strong> AKI occurs frequently in PICU patients and is associated with worse clinical outcomes. Early recognition of risk factors and implementation of preventive strategies may help improve patient outcomes. Regular monitoring of renal function and post-discharge follow-up are essential for high-risk patients.</p>Dr. Geddam AvinashDr. Jayashree Jadhav
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2025-02-162025-02-1612113814610.26838/MEDRECH.2025.12.1.769Iron Deficiency Anemia as a Risk Factor for Simple Febrile Seizures in Children Between 6 Months and 5 Years: A Case-Control Study
https://medrech.com/index.php/medrech/article/view/756
<p><strong>B</strong><strong>ackground</strong>: Iron deficiency anemia and febrile seizures are common pediatric conditions, yet their relationship remains incompletely understood. This study investigated the association between iron deficiency anemia and simple febrile seizures in children aged 6 months to 5 years.</p> <p><strong>Methods</strong>: A case-control study was conducted with 90 children (45 cases with simple febrile seizures and 45 age and sex-matched controls with fever without seizures). Complete blood count, serum iron, total iron-binding capacity, and serum ferritin levels were measured in all participants. Iron deficiency anemia was defined according to WHO criteria, and statistical analysis included multivariate logistic regression to adjust for potential confounders.</p> <p><strong>Results</strong>: Iron deficiency anemia was significantly more prevalent in the case group (71.1%) compared to controls (31.1%). Children with febrile seizures had lower mean hemoglobin (9.8 ± 1.4 g/dL vs. 11.2 ± 1.2 g/dL, p<0.001) and serum ferritin levels (median 8.6 ng/mL vs. 18.4 ng/mL, p<0.001). Multivariate analysis revealed iron deficiency anemia as an independent risk factor for febrile seizures (adjusted OR: 3.28, 95% CI: 1.75-6.12, p<0.001). A significant negative correlation was observed between serum ferritin levels and peak temperature during febrile episodes (r = -0.42, p<0.001).</p> <p><strong>Conclusion</strong>: This study demonstrates a strong association between iron deficiency anemia and simple febrile seizures in young children. The findings suggest that screening for iron deficiency may be warranted in children presenting with febrile seizures, and iron supplementation could potentially play a role in preventing such episodes.</p>Dr. Jinal N PatelDr. Prashant V NigwekarDr. Jayashree Jadhav
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2025-02-202025-02-2012114715410.26838/MEDRECH.2022.12.1.772Pediatric Pyogenic Meningitis: A Comprehensive Analysis of Clinical Course and Outcomes
https://medrech.com/index.php/medrech/article/view/758
<p><strong>Background</strong>: Pediatric pyogenic meningitis remains a significant global health challenge despite modern therapeutic advances. This prospective observational study aimed to analyze the clinical course, microbiological profile, treatment outcomes, and prognostic factors in children with pyogenic meningitis.</p> <p><strong>Methods</strong>: We conducted a comprehensive analysis of 157 children aged 1 month to 12 years diagnosed with pyogenic meningitis at Department of Pediatrics, DBVP RMC, PIMS(DU), Loni. The study evaluated clinical presentations, laboratory findings, microbiological profiles, treatment responses, and outcomes through a structured follow-up period of 6 months.</p> <p><strong>Results: </strong>The median age of presentation was 2.8 years, with male predominance (58.6%). Causative organisms were identified in 71.3% of cases, with Streptococcus pneumoniae (42.9%) being the most prevalent pathogen, followed by Neisseria meningitidis (27.7%) and Haemophilus influenzae (16.1%). Significant antibiotic resistance was observed, with 22.9% of S. pneumoniae isolates showing penicillin resistance. The overall mortality rate was 10.8%, while 26.8% of survivors developed neurological sequelae. At 6-month follow-up, hearing impairment emerged as the most common long-term complication (17.2%). Multivariate analysis identified age <1 year (OR 2.8, 95% CI 1.4-5.6), admission Glasgow Coma Scale <12 (OR 3.5, 95% CI 1.8-6.9), and delayed presentation (OR 2.4, 95% CI 1.2-4.8) as significant predictors of adverse outcomes.</p> <p><strong>Conclusions</strong>: Our findings highlight the persistent burden of pediatric pyogenic meningitis and identify critical prognostic factors that can guide clinical management. The emergence of antibiotic resistance and high rates of neurological sequelae emphasize the need for enhanced surveillance, updated treatment protocols, and structured follow-up programs. Early recognition and prompt intervention remain crucial for improving outcomes in this serious infection.</p>Dr. Hitarth KariaDr. Chatterjee RajibDr. Jayashree Jadhav
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2025-03-282025-03-2812116417410.26838/MEDRECH.2025.12.1.768Distribution and Severity of Dengue Serotypes in Pediatric Cases: Analysis of Clinical Outcomes in Children 1-12 Years in Endemic Regions
https://medrech.com/index.php/medrech/article/view/759
<p><strong>B</strong><strong>ackground:</strong> Dengue fever remains a significant public health concern in pediatric populations across endemic regions. Understanding serotype-specific disease patterns and their correlation with clinical outcomes is crucial for improving patient care and reducing mortality.</p> <p><strong>Objective</strong>: To analyze the distribution of dengue serotypes and their relationship with disease severity in pediatric cases aged 1-12 years, examining clinical manifestations, laboratory parameters, and outcomes across different serotypes.</p> <p><strong>Methods</strong>: This prospective observational study enrolled 100 children (ages 1-12 years) with laboratory-confirmed dengue infection. Serotype identification was performed using RT-PCR, and patients were classified according to WHO 2009 guidelines. Clinical features, laboratory parameters, and outcomes were systematically documented and analyzed in relation to viral serotypes.</p> <p><strong>Results</strong>: DENV-2 emerged as the predominant serotype (38%), followed by DENV-1 (30%), DENV-3 (22%), and DENV-4 (10%). The 6–9-year age group represented 45% of cases, with a slight male predominance (54%). DENV-2 infections showed the highest rate of severe dengue (21%) and demonstrated more severe clinical manifestations, including significant thrombocytopenia (mean nadir: 35,000 ± 15,000/μL) and elevated hematocrit levels (mean peak: 45 ± 5%). The overall mortality rate was 2%, exclusively associated with DENV-2 infections.</p> <p><strong>Conclusion</strong>: The study reveals significant associations between dengue serotypes and disease severity in children, with DENV-2 consistently associated with more severe clinical manifestations and poorer outcomes. These findings emphasize the importance of early serotype identification in clinical settings and suggest the need for serotype-specific management approaches in pediatric dengue cases.</p>Sudini Uttej Sai Anu Kumar Reddy Dr. Chatterjee Rajib Dr. Jayashree Jadhav
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2025-03-292025-03-2912117518310.26838/MEDRECH.2025.12.1.773Verilich hair serum in reducing hair shedding: A Case Report series
https://medrech.com/index.php/medrech/article/view/757
<p><strong>Background: </strong>Hair shedding disorders, including Telogen Effluvium (TE) and Female Pattern Hair Loss (FPHL), are common dermatological concerns with limited effective treatment options. This case series evaluates the efficacy of Verilich hair serum in reducing hair shedding among female patients diagnosed with these conditions.</p> <p><strong>Methods: </strong>A clinical study was conducted on 20 female patients (aged 18–60) experiencing hair loss exceeding 80 strands per day. Patients underwent baseline assessments, including trichoscopic imaging, hair pull tests, and laboratory evaluations (thyroid profile, vitamin D, ferritin levels). Diagnoses were categorized based on hair diameter diversity, with TE defined by diversity <10% and FPHL by diversity >10%. Enrolled participants applied 1ml of Verilich serum twice daily for one month. Efficacy was measured by comparing pre- and post-treatment daily hair loss counts, with a ≥40% reduction considered a positive response.</p> <p><strong>Results: </strong>After one month of Verilich serum application, 75% of patients exhibited a significant reduction in hair shedding (≥40% reduction in daily hair count). Among TE patients, those with acute TE showed a higher response rate than those with chronic TE (CTE). Patients with FPHL also experienced substantial improvements in hair fall reduction. No adverse effects were reported during the study.</p> <p><strong>Conclusion: </strong>Verilich hair serum demonstrated significant efficacy in reducing hair shedding in both TE and FPHL patients. The formulation, containing anti-inflammatory, antioxidant, vasodilatory, and hair growth-promoting ingredients, effectively reduced active shedding and improved overall hair health. These findings support its potential as a safe and well-tolerated treatment for diffuse hair loss disorders.</p>Ruchita DhuratRicha SharmaSrushti Zatakia
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2025-03-262025-03-2612115516310.26838/MEDRECH.2025.12.1.766Coffin-Siris Syndrome Type 1 with ARID1B Mutation: A Case Report of an 8-Year-Old Female with Seizure
https://medrech.com/index.php/medrech/article/view/760
<p><strong>B</strong><strong>ackground</strong>: Coffin-Siris Syndrome (CSS) is a rare genetic disorder characterized by developmental delays, distinctive facial features, and digital abnormalities. Mutations in the ARID1B gene account for the majority of genetically confirmed cases.</p> <p><strong>Case Presentation</strong>: We report an 8-year-old female who presented with seizure-like activity and was previously diagnosed with global developmental delay. Clinical examination revealed distinctive facial features including bushy eyebrows, depressed nasal bridge, thick nasal alae, and everted thick lips. Anthropometric assessment showed significant growth deficiencies with weight and BMI below -3SD, and height at -2SD. Developmental evaluation demonstrated severe delays across all domains, with developmental quotients ranging from 15% for gross motor skills to 40% for social milestones. Genetic testing confirmed a heterozygous mutation in the ARID1B gene (OM*614556), establishing the diagnosis of Coffin-Siris syndrome type 1 (OMIM#135900). Neurological workup including MRI and EEG yielded normal results despite the seizure presentation.</p> <p><strong>Discussion</strong>: This case exemplifies both typical and atypical features of CSS, highlighting the clinical heterogeneity of the syndrome even within genetically confirmed cases. While the patient demonstrated the characteristic facial phenotype and severe developmental delays consistent with CSS, she notably lacked several common features including fifth digit hypoplasia and hypertrichosis. The seizure episode at age 8 aligns with the known neurological manifestations of CSS, affecting approximately 50% of patients.</p> <p><strong>Conclusion</strong>: This case reinforces the importance of genetic testing in the diagnosis of CSS, particularly when the clinical presentation is incomplete. It emphasizes the need for multidisciplinary management including developmental interventions, neurological monitoring, and nutritional support. Long-term follow-up is essential to address emerging complications and optimize developmental outcomes.</p>Aparna Suresh MDr. Chatterjee RajibDr. Jayashree Jadhav
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2025-02-272025-02-2712118419110.26838/10.26838/MEDRECH.2024.12.1.774