Baba Raghav Das Medical College, Gorakhpur is a medical college in Gorakhpur, India. It is run by the government of Uttar Pradesh. The hospital affiliated to the College is the only tertiary care centre in a 300 km2 region around Gorakhpur.
Factitious Disorder Imposed on Another (FDIA), previously termed Munchausen Syndrome by Proxy (MSBP), is a severe form of child abuse in which a caregiver fabricates or induces illness in a dependent child. Dermatological manifestations may mimic accidental injury, leading to delayed diagnosis. We report two female siblings aged 11 months and 3 years who presented with recurrent burn-like lesions over four months. The lesions involved atypical anatomical sites and appeared in multiple stages of healing. Histories provided by the caregiver were inconsistent with the clinical findings. Differential diagnoses, including accidental burns, phytophotodermatitis, bullous disorders, and caustic injuries, were considered. Lesions improved during supervised separation from the caregiver, raising suspicion of inflicted injury. During multidisciplinary evaluation, the elder sibling disclosed that a “grown-up” had applied a hot object to both children. Based on clinical findings and child-protection assessment, a diagnosis of FDIA was established.
Background- Healthy lifestyle practices are important components of disease prevention, health promotion and improvement of quality of life. Unhealthy dietary habits, physical inactivity, tobacco use, harmful alcohol consumption, inadequate sleep and poor stress management are important modifiable risk factors for noncommunicable diseases. The World Health Organization identifies unhealthy diet, insufficient physical activity, tobacco use and harmful alcohol use as major behavioural risk factors contributing to noncommunicable diseases. Regular physical activity contributes to the prevention and management of cardiovascular diseases, diabetes and several cancers, while healthy dietary practices help reduce the risk of several chronic diseases. Aim- The aim of the study was to assess the effectiveness of nurse-led health education on knowledge regarding healthy lifestyle practices among patients attending an urban hospital in Dahod. Objectives- To determine the effectiveness of nurse-led health education by comparing pre-test and post-test knowledge scores. Methods- A quantitative evaluative research approach was adopted using a pre-experimental one-group pre-test and post-test research design. For this model paper, 60 patients attending an urban hospital in Dahod were selected by purposive sampling. A structured knowledge questionnaire consisting of 30 items was used for data collection. A pre-test was conducted, followed by a nurse-led health education session covering healthy diet, physical activity, weight management, sleep, stress management, tobacco and alcohol avoidance, personal hygiene and preventive health practices. A post-test was conducted after the intervention. Results- The illustrative analysis showed that before the intervention, 38 patients (63.33%) had poor knowledge, 18 (30.00%) had moderate knowledge and only 4 (6.67%) had good knowledge. Following nurse-led health education, only 2 patients (3.33%) remained in the poor knowledge category, 14 (23.33%) had moderate knowledge and 44 (73.34%) demonstrated good knowledge. The hypothetical mean pre-test knowledge score was 12.40 ± 4.10, whereas the post-test mean score increased to 23.80 ± 3.20. The mean gain was 11.40 points. The calculated paired t value was approximately 21.70, indicating a statistically significant improvement in knowledge at the 0.05 level. Conclusion- The findings of this illustrative study suggest that nurse-led health education may be an effective strategy for improving knowledge regarding healthy lifestyle practices among patients attending an urban hospital. Nurses can play an important role in strengthening health-promoting behaviours through structured education, counselling and reinforcement.
In intracerebral hemorrhage (ICH), an elevated oxidant level may lead to perihematoma edema (PHE) and adversely affect its outcome. We report circulating oxidative stress markers in ICH patients at different time points and their association with PHE on computerized tomographic (CT) scans. A total of 87 patients with CT confirmed ICH within 24 h of ictus were prospectively included, and a follow-up CT scan was performed on day 7. The location and volume of hematoma, hematoma edema complex (HEC), PHE, and intraventricular extension of hemorrhage were noted on both CT scans. Blood samples were collected on days 1, 7, and 15, and reactive oxygen species (ROS), malondialdehyde (MDA), catalase (CAT), and glutathione peroxidase (GPx) levels were measured using a microplate reader. These biomarkers were also measured in 57 age-matched healthy controls. The patients had elevated ROS (p < 0.001) and MDA (p < 0.001) levels, whereas CAT (p < 0.001) and GPx (p < 0.001) levels were reduced compared to the controls. The oxidants remained elevated on day 7 and decreased on day 15 but did not reach the control levels. Furthermore, the CAT and GPx showed recovery on day 7 and day 15 but did not achieve the control levels. ROS (r = 0.28, p = 0.02) and GPx (r = -0.29, p = 0.02) correlated with PHE, suggesting their role in the pathogenesis. The hematoma volume, HEC, and PHE at day 1 correlated with the day 15 CAT level and MDA with PHE. At one month, 15 (17.24%) patients died, 56 (64.36%) had poor recovery, and 16 (18.39%) had good recovery. The patients with higher antioxidant levels had better survival and good outcomes. Future studies may investigate the efficacy of antioxidant therapy in improving clinical outcomes and modulating oxidative stress biomarkers in ICH patients.
Objectives This study aimed to investigate an outbreak of mumps, analysing the demographic, clinical and epidemiological characteristics of affected individuals.Design Retrospective observational study.Setting The study was conducted from April to August 2024 at two tertiary healthcare centres.Participants Patients presenting to the Otorhinolaryngology (ENT) outpatient department with signs and symptoms of mumps were included in the study. Laboratory-based and epidemiological links were adopted for diagnosing mumps cases.Interventions All patients were given symptomatic treatment such as antipyretics (paracetamol), plenty of fluid, vitamin C/citrus fruit. Patients were followed up weekly.Main outcome measures Laboratory confirmation was performed for suspected cases by IgM antibody detection for mumps, while epidemiological links were established for others. Demographic and clinical data were collected, and statistical analysis was conducted to identify significant associations between demographic and clinical characteristics.Results A total of 32 cases were identified, with a male predominance (59.4%). The majority (68.8%) were below the age of 18 years, with a mean age of 13.34±7.50 years. Laboratory confirmation was obtained for 40.6% of cases, while the remaining 59.4% were epidemiologically linked. Most cases were reported in May 2024, with two sporadic cases occurring in the first and second weeks. Fever was common among both children and adults, with a significantly longer duration in children. Upper respiratory tract infection symptoms were more prevalent among children (68.2%) compared with adults (30%) (p=0.045). Parotid swelling was the most common clinical feature, with bilateral involvement observed more frequently in children (59.1%) and unilateral swelling predominating in adults (50%). No cases of hearing loss were reported.Conclusion These findings highlight the clinical variations in mumps presentation across age groups and underscore the need for enhanced surveillance and immunisation strategies.
