SRMS JOURNAL OF MEDICAL SCIENCE

A Study on the Outcomes in Post-operative Endophthalmitis

2026-05-11T15:22:08+0530

Introduction: Post-operative endophthalmitis (POE) is a rare but serious complication of intraocular surgeries, associated with devastating visual outcomes if not promptly diagnosed and treated. This study aimed to evaluate the clinical profile, risk factors, treatment strategies, and outcomes of POE in a tertiary care center. Material and Methods: A prospective observational study was conducted at SRMS Institute of Medical Sciences, Bareilly, from May 2023 to October 2024. Over 43 patients with infectious endophthalmitis following intraocular surgery were included. Data on demographics, prior ocular procedures, systemic comorbidities, microbiology, treatment, and visual outcomes were analyzed using descriptive statistics. Results: The majority of patients were aged 51 to 70 years (76.8%), with a slight male predominance (55.8%). Cataract surgery (37.2%) was the most common preceding procedure, followed by trabeculectomy with cataract surgery (23.3%). Comorbidities included ischemic heart disease (27.9%) and renal disease (25.6%). Fungal growth was detected in 32.6% and bacterial growth in 44.2% of culture samples, with 81.4% showing mixed infections. Ciprofloxacin sensitivity was observed in 55.8% of isolates, while tobramycin showed the highest sensitivity (74.4%). Visual recovery was favorable: 79.1% achieved BCVA of 6/6 at one month, although this declined slightly to 58.1% at six months. Elevated IOP was noted in 62.8% at one week but reduced to 16.3% at six months. Conclusion: Post-operative endophthalmitis remains a vision-threatening complication, most often following cataract or combined intraocular procedures. Early diagnosis, culturebased therapy, and vigilant follow-up are critical in optimizing outcomes. Despite initial severe impairment, most patients achieved significant visual improvement, underscoring the importance of prompt and tailored management.

Epidemiological Determinants of Common and Rare Cancers: A Hospital-Based Study in North India

2026-05-11T16:09:31+0530

Background: Cancer remains a significant public health burden in India, with its incidence influenced by a complex interplay of sociodemographic and behavioral factors. Understanding these determinants is essential to tailor prevention and control strategies. The aim of the study is to identify the epidemiological determinants associated with common and rare cancers in patients attending a tertiary care center in North India. Material and Methods: This hospital-based cross-sectional study was conducted among 400 histologically confirmed cancer patients between May 2023 and October 2024 at a tertiary care hospital in Bareilly, Uttar Pradesh. Data on sociodemographic variables, behavioral factors, and clinical history were collected using a pre-tested semi-structured schedule. Statistical analysis was performed using SPSS version 25. Chi-square test was applied to explore associations between independent variables and cancer type, with p < 0.05 considered statistically significant. Results: Significant associations were observed between cancer type and age (p = 0.000), gender (p = 0.000), occupation (p = 0.000), and socioeconomic status (p = 0.000). Common cancers were more prevalent in the 41 to 60 years age group and among females, while rare cancers were frequent in older males and individuals from lower socioeconomic classes. Behavioral factors such as tobacco smoking (p = 0.019), smokeless tobacco use (p = 0.007), and alcohol consumption (p = 0.019) were significantly associated with rare cancers. Although 73% of tobacco users noticed health warnings, 58.7% showed indifference, and only 15.7% reported quitting. Conclusion: The study concludes that age, gender, occupation, and substance abuse are major determinants of cancer type. Awareness initiatives alone are insufficient; comprehensive prevention strategies must also address behavioral change, socioeconomic disparities, and targeted screening efforts.

Longitudinal Assessment of Quality of Life among Head and Neck Cancer Patients Receiving Radiotherapy

2026-05-15T16:51:42+0530

Introduction: With a significant increase in head and neck carcinomas (HNC) patients’ survival with the recent advances in treatment modalities, the impact of treatment-related morbidities often continues to have an impact on their quality of life (QoL). The aim of the study is to evaluate changes in QoL in patients with head and neck cancer undergoing radiotherapy using FACT-HN scores. Material & Methods: This longitudinal study was conducted at a tertiary care hospital from August 2023 to February 2024. A sample of 60 patients scheduled to undergo radiotherapy was selected based on previous hospital records. QoL assessment was done using the FACT-HN (Version 4) questionnaire at five follow-up points. Repeated measures ANOVA was used to assess changes in QoL scores over time. Results: Among the 60 participants, 83.33% were male, and 43.33% were aged 45 to 60 years. Tumor sites included buccal mucosa (38.33%) and tongue (26.67%). Physical well-being scores significantly declined from baseline to the 4th week of post-RT (p <0.001). Social and emotional well-being remained stable over time. Total FACT-HN score declined significantly by the 4th week and the end of RT (p <0.05). However, at 1 and 4 months post-RT, all FACT-H&N components showed improvement. Conclusion: This study concludes that the quality of life among head and neck cancer patients significantly declined during radiotherapy, with the lowest scores recorded at the end of treatment. Four months after treatment, scores improved and returned close to baseline level. There is a need of integrating psychological counselling, nutritional support, and rehabilitation programs to enhance patient outcomes.

A Study of Various Factors and Laboratory Investigations in Non-Healing Corneal Ulcer

2026-05-15T16:58:06+0530

Introduction: Corneal ulcers are a major cause of visual morbidity, particularly in developing countries. While most ulcers heal with appropriate therapy, a subset becomes non-healing or refractory, posing significant diagnostic and therapeutic challenges. These ulcers are often associated with systemic comorbidities, microbial resistance, and impaired corneal healing mechanisms. This study was undertaken to evaluate the ocular and systemic factors contributing to nonhealing corneal ulcers and to assess the role of laboratory investigations in guiding effective management. Material and Methods: A prospective observational hospital-based study was conducted in the Department of Ophthalmology, SRMS Institute of Medical Sciences, Bareilly, Uttar Pradesh, over an 18-month period (May 2023–October 2024). Patients of all ages and genders presenting with nonhealing corneal ulcers were included after informed consent. Cases with endophthalmitis or complicated corneal ulcers, such as perforation and descemetocele, were excluded. Detailed clinical evaluation, microbiological investigations (corneal scraping, bacterial and fungal cultures, antibiotic sensitivity testing), and systemic assessments, including glycemic status, were performed. Statistical analysis was carried out using the Chi-square test, with p < 0.05 considered significant. Results: The mean age of patients with non-healing corneal ulcers was 42.5 ± 10.4 years, with a higher prevalence in the 41 to 60 year age group. Diabetes mellitus was the most significant systemic risk factor (56.3%, p <0.001), followed by steroid use (28.7%, p = 0.001) and ocular trauma (41.4%, p = 0.037). A history of previous corneal surgery was significantly associated with non-healing ulcers (p = 0.006). Microbiological analysis revealed fungal growth in 55.2% and bacterial growth in 43.7% of non-healing ulcers, both significantly higher compared to healing ulcers. Corneal sensation was absent or reduced in 81.6% of non-healing cases (p < 0.001), indicating neurotrophic involvement. Elevated or reduced intraocular pressure was also significantly more common in non-healing ulcers (p <0.001). Tobramycin demonstrated the highest antibiotic sensitivity, while resistance to ciprofloxacin was noted. Conclusion: Early identification of risk factors, comprehensive microbiological evaluation, strict metabolic control, and individualized targeted therapy are essential to improve healing outcomes and prevent vision-threatening complications.

Evaluation of Computed Tomography Imaging Findings in Suspected Pulmonary Infections with its Clinicmicrobiological Association

2026-05-15T17:25:10+0530

Introduction: Pulmonary infections are one of the most common infections encountered in outpatient and inpatient clinical care. The most useful imaging modalities available for the evaluation of the patient of suspected pulmonary infections are chest radiography and computed tomography (CT). The aim of the present study is to evaluate the computed tomography imaging findings in pulmonary infections with their clinicomicrobiological association. Material an Methods: This hospital-based cross-sectional observational study included a total of 110 patients with suspected pulmonary infections referred for chest imaging. Initially, chest radiography examination was done in all the patients. Subsequently, all of the patients underwent either contrast-enhanced computed tomography or high-resolution computed tomography of the thorax as appropriate on SOMATOM definition flash 128 slice dual source energy CT or SOMATOM scope 32 slice CT. Imaging findings were interpreted independently and tabulated and subsequently associated with microbiological or pathological findings. Results: The majority of participants belonged to the 41 to 60 years age group (37.3%). Male predominance was noted with 75.5%. For bacterial infections, CT had a sensitivity of 90.62%, specificity of 96.92%, PPV of 93.55%, and NPV of 95.45%. Tubercular infections demonstrated 96.23% sensitivity and PPV, with specificity and NPV of 95.35%. Fungal infections had a sensitivity and PPV of 92.31%, and specificity and NPV of 98.77%. Conclusion: CT imaging is a valuable tool for diagnosing pulmonary infections, providing detailed insights into the nature and extent of the disease. When combined with microbiological and pathological tests, it offers a comprehensive approach to managing infections.

Study of Significance and Expression of BRCA1 in Epithelial Ovarian Cancers and Association with Clinico- Pathological Parameters

2026-05-15T17:32:52+0530

Introduction: Epithelial ovarian carcinoma (EOC) remains the most fatal gynecological malignancy, largely due to late presentation and lack of effective screening markers. BRCA1, a tumor suppressor gene involved in homologous recombination repair, plays a crucial role in maintaining genomic stability. Loss of BRCA1 expression has been implicated in tumor aggressiveness, chemotherapy response, and prognostic stratification. Immunohistochemistry (IHC) offers a practical approach to assessing BRCA1 protein status, particularly in resourcelimited settings where molecular testing is not widely available. The aim is to evaluate BRCA1 expression in epithelial ovarian carcinomas and analyze its association with various clinicopathological parameters, including histological type, tumor grade, FIGO stage, and CA-125 levels. Material and Methods: This prospective observational study included 35 histologically confirmed cases of epithelial ovarian carcinomas received as surgically resected salpingooophorectomy specimens over an 18-month period (May 2023–October 2024). BRCA1 expression was determined using immunohistochemistry and categorized as positive or negative based on cytoplasmic staining. Statistical analysis was performed using SPSS v21, with p < 0.05 considered significant. Results: BRCA1 expression was negative in 54% and positive in 46% of cases. Serous carcinoma was the most common histological subtype (68.6%), and high-grade tumors accounted for 71.4%. A significant association was observed between BRCA1 loss and histological type (p = 0.003) and tumor grade (p = 0.010). Among serous carcinomas, high-grade tumors showed significant BRCA1 loss (p = 0.027). No significant correlation existed between BRCA1 expression and CA-125 levels (p = 0.7817) or FIGO stage (p = 0.2034). Conclusion: BRCA1 loss is strongly associated with serous and high-grade epithelial ovarian carcinomas, supporting its role as a prognostic biomarker. Larger multicenter studies are required to validate its diagnostic utility.

Assessment of Radiation-Induced Xerostomia in Patients of Head and Neck Cancers: A Comparative Study of Three-Dimensional Conformal Radiotherapy and Intensity Modulated Radiotherapy

2026-05-15T17:38:05+0530

Introduction: Radiotherapy is a cornerstone in the management of head and neck cancers, but radiation-induced xerostomia remains one of the most common and debilitating late toxicities, significantly affecting long-term quality of life. With the advent of conformal radiotherapy techniques, particularly intensitymodulated radiotherapy (IMRT), better sparing of salivary glands has been achieved compared to three-dimensional conformal radiotherapy (3DCRT). This study aimed to compare the incidence, severity, and recovery of radiation-induced xerostomia between 3DCRT and IMRT using objective, subjective, and quantitative assessment tools. Materials and Methods: This prospective randomized study included 50 previously untreated patients with locally advanced head and neck cancers, randomly assigned to receive either 3DCRT (Group I, n=25) or IMRT (Group II, n=25). All patients received a total dose of 70 Gy in 35 fractions over 7 weeks with concurrent weekly cisplatin (35 mg/m²). Xerostomia was assessed at baseline, at completion of radiotherapy, and at 3 and 6 months post-treatment using RTOG morbidity criteria (objective), EORTC H&N35 quality-of-life questionnaire (subjective), and the Saxon test for quantitative salivary flow measurement. Parotid mean doses were recorded and correlated with xerostomia outcomes. Statistical analysis was performed using the chi-square test, with p < 0.05 considered significant. Results: At completion of radiotherapy, both groups demonstrated a significant reduction in salivary flow rates with no statistically significant difference in acute xerostomia. During follow-up, recovery of salivary function was observed in both groups; however, the IMRT group showed significantly better recovery at 3 months (p = 0.02) and 6 months (p = 0.01). Quantitative salivary flow rates at 6 months approached baseline values more closely in the IMRT group. Although objective RTOG xerostomia grades did not show a statistically significant difference between the two groups, subjective assessment using EORTC H&N35 revealed significantly better quality-of-life scores in the IMRT group for head and neck pain, swallowing, speech, and sensory domains. Mean parotid doses

A Comparative Study of Hyperbaric Ropivacaine with Fentanyl and Hyperbaric Bupivacaine with Fentanyl in Subarachnoid Block for Lower Limb Surgeries

2026-05-15T17:42:14+0530

Introduction: Subarachnoid block, commonly referred to as a spinal anaesthesia, is a highly effective regional anaesthesia technique that is simple to master. It provides dense sensory, motor and sympathetic block with very few adverse effects. Spinal anaesthesia involves the deposition of local anaesthetic directly into the cerebrospinal fluid. The dense sensory and motor block produced by spinal anaesthesia necessitates a low amount of local anaesthetic, thus reducing the risk of systemic toxicity. Hyperbaric bupivacaine has been a standard choice for subarachnoid block (SAB), but hyperbaric ropivacaine has gained interest due to its potentially favourable safety profile. The addition of fentanyl as an adjuvant enhances the quality and duration of analgesia. This study aims to compare the efficacy and safety of subarachnoid hyperbaric 0.75% ropivacainefentanyl with hyperbaric 0.5% bupivacaine-fentanyl for lower limb surgeries. Material and Methods: A prospective, randomized, singleblind, observational study was conducted on patients undergoing elective lower limb surgeries. Participants were divided into two groups: Group A received 2.8 mL hyperbaric ropivacaine (0.75%) with fentanyl (25 mcg), and group B received 2.8 mL hyperbaric bupivacaine (0.5%) with fentanyl (25 mcg). The onset and duration of sensory and motor blockade, hemodynamic parameters and adverse effects were recorded and analysed. Results: Both groups achieved effective anaesthesia, but group A exhibited a slower onset and shorter duration of motor blockade compared to group B. Hemodynamic stability was significantly better in the ropivacaine group, with fewer instances of hypotension and bradycardia. Conclusion: H yperbaric r opivacaine w ith f entanyl p rovides effective anaesthesia with improved hemodynamic stability and a shorter motor blockade duration compared to hyperbaric bupivacaine with fentanyl. These findings suggest that hyperbaric ropivacaine may be a safer alternative in patients where hemodynamic stability is a concern, making it a valuable option for lower limb surgeries under SAB.

Evaluation of the Spectrum of Imaging Findings in Patients Undergoing Coronary Computed Tomographic Angiography

2026-05-15T17:47:11+0530

Introduction: Coronary artery disease (CAD) remains a leading global cause of morbidity and mortality. Coronary computed tomographic angiography (CCTA) is a non-invasive imaging modality that effectively visualizes coronary anatomy, detecting stenosis, plaques, and anomalies. Its high sensitivity and negative predictive value make it suitable for ruling out CAD in patients with low to intermediate risk. The aim of the study is to evaluate the spectrum of imaging findings in patients undergoing coronary computed tomographic angiography and to correlate the findings of coronary computed tomographic angiography with catheter coronary angiography in patients who are undergoing catheter angiography. Material and Methods: This prospective study involved 100 patients undergoing CCTA at SRMSIMS, Bareilly. Findings were analyzed for coronary stenosis, plaque types, anomalies, and other abnormalities. CCTA results were compared with ICA to determine diagnostic accuracy. Results: Coronary stenosis was the most frequent finding, with LAD most commonly affected. CCTA demonstrated 100% sensitivity for LM, LAD, LCX, and RCA. Specificity was 100% for LM, LAD, and RCA, but lower (66.6%) for LCX. Several anomalies, including ectopic origin and congenital absence of LCX, were noted. Conclusion: CCTA is a highly sensitive, non-invasive tool for detecting CAD and coronary anomalies. However, its accuracy may be reduced in patients with high coronary calcium, highlighting the importance of patient selection.

The Study of Body Dysmorphic Disorder and Psychiatric Comorbidities in Patients of Topical Steroid Damaged Face Attending Dermatology OPD in a Tertiary Care Centre: Hospital-Based Study

2026-05-15T17:52:28+0530

Introduction: Topical corticosteroids are widely used for their anti-inflammatory effects in dermatology. However, prolonged and unsupervised use, particularly on the face, can result in topical steroid damaged face (TSDF), characterized by skin thinning, erythema, photosensitivity, and acneiform or rosacea-like eruptions. These visible skin changes may lead to significant psychological distress, including body dysmorphic disorder (BDD) and other psychiatric comorbidities. The study aims to assess the prevalence of BDD and associated psychiatric comorbidities among TSDF patients attending a tertiary care center. Material and Methods: A cross-sectional observational study was conducted in the Department of Dermatology at Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, from May 2023 to October 2024. A total of 200 patients with TSDF were enrolled. Screening tools included BDDQ-DV, BDD-SS, HADS, BAI, and BDI. Patients meeting BDD criteria were referred for psychiatric evaluation. Statistical analysis involved descriptive statistics, chi-square tests, t-tests, and Pearson correlation. Results: BDD was identified in 15.5% of TSDF patients. There were no significant associations between BDD and demographic variables. Strong positive correlations were observed between BDD and psychiatric scores: HADS-Anxiety (r = 0.37), HADS-Depression (r = 0.42), BAI (r = 0.44), and BDI (r = 0.52); all p-values < 0.001. Clinical anxiety and moderate depression were present in all BDD-positive cases. Among dermatological signs, photosensitivity and dryness were significantly associated with BDD. Conclusion: There is a notable psychiatric burden in TSDF patients. Routine psychiatric screening, interdisciplinary care, public awareness, and clinician training are essential for improving outcomes and preventing corticosteroid misuse.