Netaji Subhash Chandra Bose Subharti Medical College is an Indian medical school located at Meerut in the state Uttar Pradesh. It is a constituent of Swami Vivekanand Subharti University. The college was earlier affiliated to Dr. Bhimrao Ambedkar University in Agra.
The CBAC is a simple, low-cost screening tool developed under India’s National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS) to identify individuals at risk of non-communicable diseases (NCDs) at the community level. A systematic search across six databases (PubMed/MEDLINE, Embase, Scopus, Web of Science, CINAHL, and Google Scholar) identified 1,842 records, of which 1,219 unique records were screened after de-duplication and automated exclusion; 47 full-text reports were assessed for eligibility and 11 studies met all inclusion criteria. The prevalence of individuals classified as high-risk for non-communicable diseases using the CBAC varied substantially, ranging from 14.4% to 68.6%. Higher CBAC scores were consistently associated with advancing age, tobacco and alcohol use, physical inactivity, increased waist circumference, family history of NCDs, and lower educational attainment. The diagnostic performance of CBAC showed moderate accuracy, with area under the curve values ranging from 0.62–0.73, and this variation was systematically related to the reference standard used: performance was weakest against a disease-specific standard (diabetes) and strongest against broader risk constructs (metabolic syndrome, general NCD risk). The reported sensitivity ranged from 42.9% to 84.7%, while the specificity ranged from 48.8% to 87.5%.
Introduction:Hoffa fractures, accounting for 0.65% of femoral fractures, are rare injuries to the distal femur, typically affecting the lateral condyle. These fractures are often overlooked in radiographs and pose challenges in classification, as traditional systems like Letenneur's may not adequately address certain unique fracture patterns, as seen in the present case. Case Presentation:A 25-year-old male with trauma to the left knee and pelvis was diagnosed with a pelvic open-book injury and a coronal split Hoffa fracture of the lateral femoral condyle. Surgical fixation involved external fixation for the pelvis and a posterolateral approach for the knee fracture, followed by a nonweight-bearing regimen and rehabilitation exercises. Results:The patient showed significant improvement in both range of motion (ROM) and functional outcomes over follow-up visits. Flexion increased from 25° preoperatively to 125° at 6 months, and the Neer score improved from 30 to 90, indicating an excellent outcome (p value-0.0077 for Neer score, 0.0144 for ROM). Discussion:Hoffa fractures are often missed on standard radiographs and require CT for accurate diagnosis. Existing classification systems offer limited guidance, as these fractures can present with varied patterns. In our case, a unique fracture pattern necessitated a posterolateral approach with lag screws from posterior to anterior, ensuring a proper reduction and fixation, in line with the principles of anatomical reduction and early mobilization. Conclusion:Hoffa fractures are challenging to diagnose and treat due to their atypical patterns. Preoperative CT planning and flexible surgical approaches, such as our use of posterior-to-anterior lag screws, are crucial. Focusing on anatomical reduction and early mobilization can optimize recovery, with further research needed to refine classifications and improve outcomes.
Background Antimicrobial resistance is a major public health concern caused largely by irrational antibiotic use, especially in primary healthcare. Monitoring prescribing patterns with WHO/INRUD indicators helps assess rational drug use. Objectives To evaluate antibiotic prescribing patterns, assess rational use of antibiotics, and identify factors influencing antibiotic prescribing in selected primary health facilities. Methods This retrospective observational study reviewed 147 outpatient prescriptions from primary health clinics in Meerut, Uttar Pradesh, over one year. Data on demographics, diagnoses, drug use, WHO/INRUD indicators, and antibiotic prescribing were analyzed using descriptive statistics and logistic regression. Results Most patients were females (60.9%) and aged 25–44 years (23.9%). Malaria was the most common diagnosis (61.8%), followed by upper and lower respiratory tract infections. Antibiotics were prescribed in 59.9% of encounters, and the average number of drugs per prescription was 4.0, indicating polypharmacy. Generic prescribing was 79.2%, Essential Medicines List use was 88.1%, injections were prescribed in 22.9% of cases, and possible drug interactions were found in 4.9%. Younger age, greater number of drugs, lack of antimalarial therapy, and certain diagnoses significantly predicted antibiotic use. Conclusion Antibiotic overuse and polypharmacy were common. Although injection use was acceptable, generic prescribing and adherence to WHO standards were suboptimal. Regular prescription audits, adherence to treatment guidelines, and antimicrobial stewardship programs are needed to improve rational antibiotic use.
Background: Communicable diseases continue to pose a major public health challenge in Uttar Pradesh, India, despite implementation of various state and national disease-control programmes. Evaluation of hospital-based management strategies is essential for understanding disease burden and treatment outcomes during peak transmission periods.Objectives: To assess the pattern of diagnosis and management of selected communicable diseases in a tertiary care hospital of central Uttar Pradesh during the peak seasonal period.Materials and Methods: A prospective hospital-based observational study was conducted at a district hospital attached to a Government Medical College in central Uttar Pradesh from July 2023 to December 2023. However, analysis for seasonal trend assessment was restricted to the peak transmission period from September 2023 to November 2023. All patients attending outpatient departments (OPD) and inpatient departments (IPD) who underwent diagnostic testing for selected communicable diseases were included. Diseases assessed included dengue, malaria, scrub typhus, leptospirosis, chikungunya, and Japanese encephalitis. Data regarding diagnostic tests, confirmed positive cases, admissions, discharges, referrals, and mortality were collected from hospital laboratory and clinical records. Descriptive statistical analysis was performed using frequencies and percentages.Results: During the study period, 4,287 patients underwent diagnostic testing for communicable diseases. Malaria accounted for 965 (30.9%) confirmed cases, while dengue accounted for 363 (31.2%) confirmed cases among those tested. Only two cases of scrub typhus were identified, and no confirmed cases of leptospirosis, chikungunya, or Japanese encephalitis were reported during the peak study period. Most patients were managed at the OPD level, while a smaller proportion required IPD admission. No mortality was reported among the studied communicable disease cases during the study period.Conclusion: The majority of communicable disease cases in the study setting were successfully managed at the outpatient level, with limited need for hospitalization and no reported mortality. Strengthening diagnostic surveillance, inpatient management facilities, and disease-monitoring systems may further improve communicable disease management in tertiary care settings.
