Background: Hypertensive disorders during pregnancy remain amongst the most significant and intriguing unsolved problems in obstetrics. The study aims at testing the hypothesis that women with high serum beta hCG levels and alterations in waveforms in the uterine artery doppler in early second trimester have high risk of developing pre-eclampsia.Methods: Serum Beta hCG estimation was done by Sandwich chemiluminescence immunoassay method. All uterine artery waveforms were obtained using a Toshiba nemio ultrasound machine attached to a 3.5 MHz curvilinear transducer, with colour and pulsed Doppler abilities.Results: For prediction of preeclampsia or eclampsia uterine artery Doppler velocimetry alone shows specificity of 96.30%, sensitivity of 90%, positive predictive value of 94% and negative predictive value of 80%. When it is combined with serum beta HCG sensitivity and specificity are almost same, but alone serum beta HCG levels are showing sensitivity of 96% and specificity of just 76%.Conclusions: Abnormal waveforms on uterine Doppler studies are the better predictors for preeclampsia and eclampsia when done in early second trimester.

Background: Orthopaedic surgeons prefer calcium supplement for various pathologies like fracture, osteoporosis, chronic musculoskeletal pain, yet there is no proper evidence to support the benefits of taking them regularly. The average requirement for calcium is around 500e1000 mg/day for a healthy adult, this amount of calcium is not achieved by diet, especially in developing countries like India. Despite this, the serum calcium level remains unaltered, due to the well-controlled absorption and excretion of calcium by the human body. As there is no clarity over the dose, duration and the prefered calcium salts, we constructed a survey to find the preferred dose, duration, the preferred calcium salts among orthopaedic surgeons, and to give an in-depth review of literature about dose, duration, timing, preferred calcium salt and various other calcium-related queries. Materials and method: The survey included 15 pre-structured questionnaires; these questions were formatted and validated by senior surgeons and other specialists after a through a review of calciumrelated literature. These questionnaires were used in a pilot study conducted within the department and were later modified and separated into 7 sections. Data were collected by both online survey (google forms) and direct interviews. Result and conclusion: 128 Orthopedic surgeons responded. The total number of response obtained was 2355. Unanswered questions were 152. From the survey, it was found that most orthopaedic surgeons prefer to prescribe calcium routinely (55.46%). The commonly used calcium salt was calcium carbonate (47.65%), followed by citrate (32.8%). 42.18% were not aware of the efficiency of prescribing calcium in divided doses. Most responded that calcium is not to be given for patients with renal stones, but literature shows that calcium prescribed reduces the recurrence of commonest kidney stones, calcium oxalate stones.

Context: Supracondylar humerus fractures are one of the commonest upper limb fractures in children. Closed reduction and fixation with K wires is the most common method of treating these fractures. Stability of fixation is very important so as to prevent loss of reduction, which leads to deformity at elbow joint. Many factors contribute to the stability of fixation. Thus, considering all these factors at the fixation helps prevent loss of reduction. Aim: This prospective study was aimed at studying the functional outcome of management of supracondylar humerus fracture in the pediatric population when the management is planned as per the fracture patterns described by Bahk. Design: This is a single center prospective study conducted between July 2018 and June 2019.This study was done in a medical college and general hospital, which is a tertiary care center. Method: 100 cases of supracondylar humerus fractures in children were analyzed prospectively. Various parameters were documented to assess the functional outcome. Results: There was mean loss of motion at the elbow of 41°in conservatively managed cases and 43°in operated cases at 4th week follow up. Gradually it improved to full range.Loss of carrying angle was seen in only 8% of cases and the degree was very less. As per Flynn's criteria, 94% of cases had excellent cosmetic outcome and 6% of cases had good cosmetic outcome. Anterior humeral line passed through middle one third of capitellum in 91% of cases. Loss of Baumann's angle was seen in only 9% of cases. As per Skaggs et al criteria for loss of reduction, only 1 case had a moderate loss of reduction and 8 cases had mild displacement. Conclusion: Deciding about pin configuration for fixation should be done as per the fracture pattern and fracture comminution.

BACKGROUND Hyperglycemia is a common finding during the admission of non-diabetic patients with acute coronary syndrome. It is very essential to differentiate this stress hyperglycemia from the hyperglycemia in latent diabetics whose diabetes may have been unmasked by the stress of acute coronary syndrome (ACS). We conducted this study to evaluate stress hyperglycemia in non-diabetic patients with ACS. METHODS We conducted this cross sectional study in the Department of Medicine, KIMS Hospital, Karad, over a period of one year. Non-diabetic patients with HbA1c < 6.5 admitted in our hospital with ACS were included in the study. We included a total of 100 patients in our study, their detailed history, clinical examination and lab evaluation was done. We divided the patients into two groups, Group A were normoglycaemic patients and Group B were acute phase hyperglycemic patients with blood sugars more than 160. Correlation between the blood sugar levels and outcome of the patients was done. RESULTS Mean age was 65.23 ± 21.05 years. No significant difference in risk factor distribution in the two groups was seen. (p > 0.05) We had 47 cases of unstable angina (UA – 47%) followed by 43 cases of STEMI (43 %) and 10 cases of NSTEMI (10 %). We observed a significant difference in the presence of complications in the two groups (p<0.001), Group B patients with hyperglycemia had more complications. Significant difference was seen between the presence of heart failure, arrhythmias and shock in the two groups, with group B having more incidences of these (p<0.05). Significant difference in the outcome of the two groups was seen (p = 0.012). We observed that out of 38 patients in Group B with hyperglycemia, there were 8 deaths (21.05%) as compared to 3 deaths (4.84%) in Group A patients. CONCLUSIONS We observed that the high prevalence (38%) of stress in non-diabetic ACS patients is responsible for significantly more complications, more chances of heart failure, arrhythmia, shock and more deaths. KEY WORDS Acute Coronary Syndrome, Stress Hyperglycemia, Non-Diabetic Patients, Outcome

BACKGROUND The world is still experiencing corona virus disease-19 (COVID-19) pandemic. So far, we experienced a total of more than 23 crore cases and 47 lakh deaths from COVID 19 disease. Severe acute respiratory syndrome – corona virus – 2 (SARSCoV-2) was believed to affect lipid metabolism, with many authors reporting an increase in triglycerides and a decrease in high density lipoprotein (HDL) levels. This study gave the clinical features of COVID-19 patients with various HDL-C levels and an interrelation between HDL-C levels and the risk for adverse outcome in the form of deaths. METHODS We conducted a cross sectional study on 100 COVID-19 adult patients diagnosed by reverse transcription – polymerase chain reaction (RT-PCR) test admitted to the medicine department, from January 2020 to December 2020, who were also tested for lipid parameters. The detailed history and lab parameters of the patients were collected and the severe outcome of the same was measured in terms of deaths. RESULTS The mean age of study participants was 57.92 ± 12.41 years. Majority of the participants were from the age group of 41 to 60 years with 50 patients (50 %). There were 73 males (73 %) and 27 females (27 %) in our study. We observed that a total of 36 patients had co-morbidities (36 %), such as diabetes seen in 22 cases (22 %), hypertension in 18 cases (18 %), ischaemic heart disease (IHD) in 8 cases (8 %). A significant association was seen between the presence of co-morbidities and deaths in our study (P = 0.043). A significant association was seen between the patients who required intensive care and deaths (P < 0.001). We found a significant difference between the triglycerides and HDL parameters of lipid profiles in patients who died as compared to those who survived. (P < 0.05) The mean triglyceride level in patients who died was 223.14 ± 56.59, significantly higher than those who survived 134.43 ± 96.16. (P = 0.003) CONCLUSIONS The lipid profile evaluation in our study was found to be effective in detecting the correlation of severity and outcome in COVID-19 patients. We conclude that the severity of COVID-19 cases is associated with low HDL and high triglyceride levels. KEY WORDS COVID-19, Lipid Profile, HDL, Triglycerides, Patient Outcome.