Regional Institute of Medical Sciences

Pediatric intestinal obstruction is a surgical emergency in which delayed treatment increases morbidity and mortality. Therefore, it is of interest to compare the outcome of early and delayed intervention in 126 children treated between 2019 and 2024. Early intervention within 24 hours significantly reduced bowel gangrene, bowel resection, surgical site infection and mortality. Children receiving early treatment also had a significantly shorter hospital stay than those managed after 24 hours. Thus, timely resuscitation and early operative or non-operative management improve clinical outcomes in pediatric intestinal obstruction.

Introduction: Chronic Kidney Disease (CKD) is a leading cause of morbidity and mortality worldwide. Oxidative stress and chronic inflammation are important factors in the development of CKD. Gamma-Glutamyl Transferase (GGT) and ferritin are emerging biomarkers of oxidative stress and inflammation, respectively. However, their synergistic role in CKD remains understudied, and there is limited regional evidence on their association with kidney function in CKD. Aim: To estimate and compare serum levels of GGT and ferritin in individuals with and without CKD, and to assess their correlation with serum creatinine as a marker of renal function. Materials and Methods: This was a hospital-based, cross-sectional study conducted at the Department of Biochemistry in collaboration with the Nephrology Department at the Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, India, from March 2023 to March 2025. A total of 200 participants were included- 100 diagnosed CKD patients and 100 age- and sex- matched healthy controls. Serum GGT, ferritin, urea, creatinine, and electrolytes were analysed using the Beckman Coulter DxC 700 AU autoanalyser. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 27.0. Student’s t-test and Pearson’s correlation were applied, and a p-value <0.05 was considered statistically significant. Results: The average age was 55.47±15.07 years. Serum GGT (61.29±43.12 IU/L) and ferritin (391.35±205.05 ng/ml) levels were significantly higher in CKD patients compared to controls (23.48±9.28 IU/L and 78.11±39.46 ng/ml, respectively; p-value <0.001). GGT showed a moderate positive correlation with serum creatinine (r-value=0.364), while ferritin exhibited a strong positive correlation (r-value=0.585). A significant positive correlation was also observed between GGT and ferritin (r-value=0.527, p-value <0.001). Conclusion: GGT and ferritin levels were significantly elevated in CKD and correlated positively with serum creatinine. These findings reflect the potential role of these markers in assessing oxidative stress, inflammation, and disease progression in CKD. They may serve as add-on markers for early CKD detection and monitoring. Further longitudinal studies are needed to establish the causality and therapeutic implications of these biomarkers in CKD.

Background: Cardiac arrhythmias are common health problems around the world. Nonetheless, knowledge gaps in arrhythmia recognition and electrocardiogram (ECG) interpretation among critical care nurses is a worldwide problem. While there is little evidence from properly designed randomised controlled trials linking nurses education with patient-related outcomes, structured training programmes are being shown promising effects. The objective of the study was to determine if a structured arrhythmia training programme for critical care nurses increase nurse knowledge, clinical response efficiency, bedside skill accuracy and patient-related outcomes. Methods: A multicentric prospective parallel-arm cluster randomised controlled trial was conducted at 22 hospitals in Ranchi district, Jharkhand, India (September 2021–November 2025) registered with CTRI (CTRI/2023/05/053190). A sample of 506 critical care nurses (253 intervention, 253 control) representing 22 clusters (11 intervention, 11 control) were enrolled through multistage sampling. The intervention consisted of a classroom training session (3-4 hours) with structured education on ECG interpretation, lethal arrhythmia recognition and emergency management, an educational booklet and demonstration of skills. There were no additional interventions offered. The arrhythmia knowledge score, base and week 3. The other outcomes were assessed which included physician feedback scores, time duration from door to ECG, nurses’ emergency response time, ECG lead placement accuracy, defibrillator use, timely reperfusion and average length of hospital stay (ALOS). The data was evaluated through independent t-test paired t-test Chi-square test and repeated measures ANOVA on IBM SPSS version 16. Results: There was no significant difference in the pre-test knowledge scores of both groups (8.72 ± 3.93 vs 8.84 ± 2.94; p = 0.711). After the training the knowledge post-test of intervention group was significantly higher (post score 18.11 ± 4.80), the mean gain of the intervention group was also significantly higher (9.47 ± 5.39) (p<0.001) along with significantly higher physician feedback (14.23 ± 3.06 v/s 7.44 ± 2.78) (p<0.001). Door-to-ECG time under 10 minutes was achieved by 81.2% in the intervention versus 17.8% in controls (p < 0.001). Nurse emergency response within a 5-minute period showed a significant statistical increase of 86.3% against 13.7% (p < 0.001). The correctness of ECG lead placement was enhanced to 70.3% against 29.7% (p < 0.01) and proper use of defibrillator (≥2 settings) scaled to 79.8% versus 20.2% (p < 0.01) Of the patients assigned to the intervention group, 81.9% underwent reperfusion within 30 minutes, compared with 18.1% of controls (p < 0.01) ALOS has improved marginally only by around 1-2% as there were delays in processing of Ayushman Bharat. Conclusion: A structured arrhythmia training programme for critical care nurses produces significant and measurable improvements in knowledge, clinical response efficiency, bedside skill accuracy, and reperfusion timeliness. The results of our study provide robust evidence, to overcome bias, for integrating competency-based arrhythmia training into the routine education of critical care nursing to improve patient safety and outcomes.

Cardiovascular diseases, particularly arrhythmias, remain a leading global cause of mortality, necessitating continuous monitoring via the Internet of Medical Things (IoMT). However, state-of-the-art deep learning approaches often impose prohibitive computational overheads, rendering them unsuitable for resource-constrained edge devices. This study proposes a resource-efficient, data-centric framework that prioritizes feature engineering over complexity. Our optimized pipeline makes the complex, high-dimensional arrhythmia data linearly separable. This is achieved by integrating time-frequency wavelet decompositions with graph-theoretic structural descriptors, such as PageRank centrality. This hybrid feature space, combining wavelet decompositions and graph-theoretic descriptors, is then refined using mutual information and recursive elimination, enabling interpretable, ultra-lightweight linear classifiers. Validation on the MIT-BIH and INCART datasets yields 98.44

Abstract Hookworm as a cause of anemia in the postmenopausal women has been often neglected and only evaluated for when all other causes have been excluded. Here, we report a series of four cases of severe anemia needing blood transfusions due to hookworm infection in postmenopausal women who presented at a tertiary care hospital in Northeast India. These cases highlight the problem of hookworm infection in this age group who are otherwise not regarded as vulnerable group and not prioritized in national deworming program. There is a need to recognize hookworm as the cause of anemia for the early diagnosis of infection and prevention of severe consequence.