BackgroundPercutaneous renal biopsy (PRB) can result in serious complications. The study is aimed to compare the biopsy yield and complications rate of the real-time ultrasonagram (USG)-guided PRB and needle tracking with and without needle guide in two different study periods.MethodsWe compared the yield and complications of 2138 kidney biopsies performed in two different periods, 1510 biopsies during the first period from April 2004–December 2010 and 628 biopsies during second period from January 2011–March 2013. All biopsies in both periods were performed by nephrologists. Radiologists provided the real-time image without needle guide during the first period while nephrologists performed both imaging and biopsy with needle guide during the second period.ResultsOf all the 2138 patients, 226 (10.5%) patients developed 118 minor and 108 major complications. Only 13 (2.1%) major complications occurred in the second period and 95 (6.7%) in the first period (P < 0.001). The relative risk of developing a major complication without guide was 3.04 times greater than that of the biopsies performed with use of the guide. The mean number of glomeruli per biopsy obtained during the second period (17.98 ± 6.75) was significantly greater than that of the first period (14.14 ± 6.01) (P = 0.004). The number of passes to acquire adequate tissue (P = 0.001) and percentage of cortex on biopsy (P = 0.001) were also significantly better in the second period. The optimal observation period post biopsy is 24 h.ConclusionsReal-time USG imaging supported by needle guide device is associated with better biopsy yield and fewer complications.

Background: Tetanus still remains a major public health problem in India like in most other developing countries, with a high morbidity and mortality.Objectives: To study the socio-demographic profile and the clinical profile that they presented with, as well as the outcome of the tetanus patients who were admitted to the E.D Hospital, Mysore in India. Methodology:The data of all the patients of tetanus who were above the age of 15 years, who were admitted from January 2001 to December 2010, were collected, compiled and analyzed from the Medical Records Department of the Hospital. Results:Out of the 512 cases of tetanus, 379 (74%) were males and 133 (26%) were females. Their ages varied from 15 to 81 years, with a mean and a standard deviation respectively of 47.7 and 15.0 years. The overall mortality rate was 42.2%. The most common presenting symptoms were trismus (95.7%), neck stiffness (89.3%), body spasms/stiffness (73%) and dysphagia (38.9%). The ages of the patients and the presence of complications had a statistically significant relationship with respect to the outcome (survival versus death).

We undertook this study to compare subjective global assessment (SGA) and nutrition risk index (NRI) as malnutrition screening tools in peritoneal dialysis (PD) patients. Nutrition status of the patients was categorized into low, moderate and high risk of malnutrition based on both NRI and SGA. The sensitivity, specificity and predictive values of NRI were compared with SGA, an already validated tool of nutrition status assessment in PD patients. Two hundred and eighty-three end-stage renal disease patients (age 50.02 ± 13.76 years; 204 males, 150 diabetic) were included. Based on SGA, 71/283 (25.08%) had normal nutrition, 192/283 (67.84%) mild–moderate and 20/283 (7.07%) severe malnutrition. Based on NRI, 38/283 (13.43%) patients had normal nutritional status, 193/283 (68.20%) mild-moderate and 52/283 (18.37%) severe malnutrition. Twenty-three of 283 (8.1%) were correctly classified as normal by NRI (true negative) and 197/283 (69.6%) as malnourished (true positive), 15/283 (5.3%) as false negative, 48/283 (16.96%) were misclassified as malnourished (false positive). NRI has sensitivity of 92.9% and specificity of 32.39%. Positive predictive value and Negative predictive values (NPVs) of NRI are 80.41% and 60.53%, respectively. Accuracy of the test is 78%. The receiver operating characteristic curve of NRI is 0.63. To conclude, NRI carries high sensitivity but low specificity as compared to SGA. It can be used as screening tool but not as a diagnostic tool for assessment of nutritional status in PD patients because of its low specificity and NPV.

It becomes necessary for the students to have a good knowledge of mental health problems, their early symptoms, the most effective options for treatment and ABSTRACT Background: Medical College is recognized as a stressful environment that often exerts a negative effect on the academic performance, physical health and psychological wellbeing of the student. The objective of the study was to assess the depression, anxiety and stress levels among the medical students by using DASS. To compare the depression, anxiety and stress levels among the medical students. Methods: The cross sectional study was conducted in JSS medical college and Mysore Medical College of Mysore city. All the students studying in first year and final year MBBS who had spent more than six months in the medical college and willing to participate in the study were included. The Depression Anxiety Stress Scales (DASS), was used to assess the levels of depression, anxiety and stress among medical students. Results: Among 332 students enrolled in the study, majority 213 (64.1%) were in the age group of 17-20 years, 193 (55.0%) were females and 215 (64.8%) were studying in second term. The prevalence of depression, anxiety and stress were found to be 124 (37.3%), 168 (50.6%) and 109 (32.8%) respectively. Most of the students were having mild degree of depression, anxiety and stress. Conclusions: Prevalence of mental health problems like depression, anxiety and stress were more than 30% among medical students. As majority of the students were having milder degrees of illnesses they need to be addressed immediately before they manifest into severe forms.

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