Darbhanga Medical College and Hospital is a government medical college having hospital facilities at Darbhanga, Bihar. It was established in the year 1946. College is currently affiliated with Aryabhatta Knowledge University.
Introduction: Hepatitis B is a viral infection of global health significance, with 1.2 million new infections occurring annually leading to approximately 1.1 million deaths, primarily from cirrhosis and hepato-cellular carcinoma. It can be effectively prevented through safe and widely available vaccines. Under the National Immunization Schedule, hepatitis B vaccine birth dose (HBV-BD) is recommended within 24 hours of birth, but coverage remains sub-optimal, with Bihar reporting 68.2% and Darbhanga district 61.3%.This study aimed to identify factors associated with missed HBV-BD among children. Methods: A cross-sectional study conducted at the Routine immunization OPD under Community Medicine Department, DMCH, Darbhanga during August–September 2025. Universal sampling included all children(upto 2 years of age) accompanied by mothers/caregivers attending the OPD. Data collection was done by face-to-face interviews using a pre-tested semi-structured questionnaire and immunization status was confirmed after checking the immunization cards. Statistical analysis was performed using MS Excel 2024 and Jamovi 2.6.44.0. Chi‑square (X2) test was used to measure the association of missed HBV-BD with mother's and father's education, occupation, family income, joint or nuclear family, place of residence, gender of child, mode of delivery, place of birth, birth order, birth weight, immunization counselling during ANC visits, knowledge of birth/zero dose, HBV-BD recommendation. A p-value ≤0.05 was considered statistically significant. Results: Among 218 study participants 37.2% missed HBV-BD. Majority of participants belonged to rural areas (66.5%) and joint families (68.8%). Significant associations (p≤0.05) were found between missed HBV-BD and lack of immunization counselling during antenatal care (ANC) visits, poor knowledge about birth/zero dose among mothers/caregivers and absence of recommendation to administer HBV-BD within 24 hours of birth. Conclusion: Improving HBV-BD coverage requires its targeted recommendation and immunization counselling of pregnant women/caregivers during ANC visits, at the time of delivery, and immediately post-delivery. Keywords: Hepatitis B birth dose, cross-sectional studies, vaccine coverage, public health.
Background: Oral submucous fibrosis (OSMF) is a chronic, progressive, and potentially malignant disorder characterized by fibrosis of the oral mucosa leading to restricted mouth opening and burning sensation. Intralesional corticosteroid therapy combined with hyaluronidase has been widely used as a conservative treatment modality. However, limited retrospective data exist evaluating the effectiveness of this combination therapy using objective pre- and post-treatment comparisons. Aim: To evaluate the effectiveness of intralesional dexamethasone combined with hyaluronidase in patients with oral submucous fibrosis by comparing pre- and post-treatment clinical parameters. Materials and Methods: This retrospective observational study was conducted in the Department of ENT DMCH over a period of one year. A total of 100 patients with Grade II and Grade III OSMF were included. Weekly bilateral intralesional injections of dexamethasone (4 mg/mL, 2 mL) and hyaluronidase (1500 IU) were administered for 6 weeks. Clinical parameters assessed included maximal interincisal mouth opening, burning sensation using Visual Analog Scale (VAS), and cheek flexibility. Pre- and post-treatment values were compared using paired Student’s t-test. A p-value <0.05 was considered statistically significant. Results: The mean mouth opening improved significantly from 23.6 ± 4.1 mm to 33.1 ± 4.8 mm (p < 0.001). Burning sensation decreased from 7.5 ± 1.2 to 2.4 ± 1.0 (p < 0.001). Cheek flexibility increased from 6.4 ± 1.3 mm to 9.8 ± 1.7 mm (p < 0.001). All parameters showed highly significant improvement following treatment. Conclusion: Intralesional dexamethasone combined with hyaluronidase is an effective and reliable non-surgical treatment modality for moderate oral submucous fibrosis. Significant improvements in mouth opening, mucosal flexibility, and symptomatic relief were observed.
Background: The brachial plexus shows frequent anatomical variations that may complicate diagnosis, regional anesthesia, and upper-limb surgery, potentially leading to incomplete nerve block or iatrogenic injury. Aim: To document the anatomical variations of the brachial plexus in adult cadavers and determine the frequency of common and uncommon patterns. Methodology: A descriptive cross-sectional cadaveric study was conducted on 20 adult cadavers (40 upper limbs). Bilateral dissections were performed following standard protocols, and variations at roots, trunks, divisions, cords, and terminal branches were recorded and analyzed using descriptive statistics. Results: The usual root pattern was observed in 85% of limbs; variations included prefixed plexus (12.5%) and postfixed plexus (2.5%). Trunks and divisions showed no variation (100%). Cord variations occurred in 10%, including communications and a two-cord pattern. Branch variations were seen in 10%, including absence of the musculocutaneous nerve and communicating branches with the median nerve. Variations were most frequent at the roots and branches. Conclusion: Although the classical pattern predominated, clinically significant variations were common at roots, cords, and terminal branches. Awareness of these patterns is essential to improve surgical safety and anesthetic success.
Background: Pigmentary disorders are common dermatological conditions resulting from abnormalities in melanin production or distribution. In India, these disorders represent a significant proportion of dermatology outpatient visits and can have considerable psychosocial impact due to their visible nature. Aim: To evaluate the clinical and epidemiological profile of pigmentary disorders among Indian patients attending a dermatology outpatient department. Methodology: A cross-sectional observational study was conducted for one year in the Department of Skin and VD at Darbhanga Medical College and Hospital, Bihar, India. A total of 160 patients with clinically diagnosed pigmentary disorders were included. Demographic data, clinical history, and risk factors were recorded using a structured proforma. Dermatological examination was performed, and data were analyzed using SPSS version 25. Results: The mean age of participants was 36.8 ± 10.1 years, with females constituting 62.5% of cases. The most common pigmentary disorder was melasma (34.4%), followed by post-inflammatory hyperpigmentation (23.8%) and vitiligo (18.8%). Facial involvement was the predominant clinical presentation across most conditions. Average daily sunlight exposure among participants was 4.0 ± 1.4 hours. Conclusion: Pigmentary disorders are prevalent among dermatology OPD patients, particularly among females, with melasma being the most common condition. Facial involvement and significant sun exposure were frequent findings, highlighting the need for early diagnosis, patient education, and appropriate management.
