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Back flow of gastric contents from stomach to oesophagus is called Reflux disease. It is highly prevalent in India and is
caused due to LES abnormalities like losing stiffness, LES damage, delayed gastric emptying. GERD is a manageable
disease. Patient should be on continuous medications like H2 blockers, PPI’s, antacids and diet. Many studies stated that
GERD is more prevalent among 40 to 60 age group but this study finds lower percentage of adults with GERD in early and
late 60’s and also mentioned that poor quality of sleep and dietary habits are responsible for GERD and this study finds the
same but sleep factor is unclear either altered sleep caused GERD or GERD affected sleep quality, because many refluxes
occurred at night. Studies concluded that Asthma and GERD corelates somehow but unknown, in this research surprisingly
the percentage of asthma patients who also have GERD is very low although individuals with fatty liver have higher
percentage. Results claim that patients misunderstand asymptomatic state to cured and cessation of therapy causes
reappearance of GERD. As mentioned, GERD is a manageable disease which take years to cure

Necrotizing fasciitis (NF) is a term used to describe a collection of relatively infrequent but life-threatening infections of the skin, soft tissues, and muscles that tend to spread quickly across the fascia planes, causing progressive fascia destruction at a pace of 2–3 cm/h. Its rapid clinical progress is linked to polymicrobial infection and synergy, which generally co-exists in the lower or higher limbs, the perineum and genital area (Fournier's gangrene), and the abdominal wall. The major goal of this study is to evaluate risk factors, clinical symptoms, and categorise patients with necrotizing fasciitis using the LRINEC score in a tertiary care hospital. Study design: Retrospective Observational study. Study site: Department of general surgery at tertiary care hospital, Dharmapuri Study Duration: Six months. Sample Size: 200 patients. Study criteria: - Inclusion criteria: All patients who were diagnosed (confirmed either clinically or radiologically) with Necrotising fasciitis of either sex. A retrospective analysis of data obtained from case sheets, who were admitted to the surgical department with a provisional diagnosis of NF from the year Jan 2021 to Dec 2021 at a tertiary care hospital after obtaining the permission of institutional review board and ethical committee, Padmavathi College of Pharmacy, Dharmapuri, India. The overall dynamics of NF are quick, and severe illness development will become apparent within a few hours. In the present study we intended to stratify risk factors that allow for a better and initial presentation to allow for quick recognition of NF. After examining the one-year medical outcomes in 200 patients, our statistical analysis concluded that LRINEC score can be utilized for risk stratification and prognosis in addition to its diagnostic function. We finally concluded that patients in group 2 with a score of >6 are more likely to spend longer time in the hospital and are more likely to have surgery.

Antibiotic resistance is occurring everywhere in the world, compromising the treatment of infectious diseases and
undermining many other advances in health and medicine. It represents one of the biggest threats to global health today, and
can affect anyone, of any age, in any country. We aimed to conduct a KAP (Knowledge, Attitude & Practice) survey to
evaluate the existing Knowledge & beliefs regarding antibiotics among patients in a tertiary hospital at A.P. India, as a first
step to promote awareness of ABR. The study was conducted in the in-patient department of general medicine department at
a tertiary hospital, Vijayawada. Out of 300 patients, 45 have been excluded from the study because of no prior antibiotic
use. The rest of patients i.e., 255 have participated in the survey. Over 65.1% of the subjects were male & 34.9% were
female. About 62% of the subjects haven’t heard about ABR & 67% doesn’t know the reasons for ABR. This study found
that patients understanding of many aspects of antibiotic resistance was poor including what it is, causes & individual
implications. Based on each patient’s perception counselling has been done on ABR. This study provides a snapshot of
where the patients stand in terms of knowledge about ABR

Antibacterial s, popularly known as antibiotics are the class of medications that destroy, kill or slow down the process of
growth of bacteria. They are widely used all around the world to treat the diseases that are caused due to the bacteria. They
however cannot kill the most popular infections such as cold cough and flu. Alexander Fleming, as the history says in his
work accidentally discovered penicillin after he returned from a holiday in Suffolk, in 1928 he noticed that a fungus named
Penicillium Notatum, caused contamination to a plate that have another species named Staphylococcus bacteria. That plate
was left accidentally before he left for a holiday. The fungus was seen a mark of free zone where ever it grew on the Petri
plate. Widely accepted indications for antibiotic prophylaxis are contaminated and clean contaminated surgery and
operations involving the insertion of an artificial device or prosthetic material. Less well – accepted indications for
prophylaxis include clean operations in patients with impaired host defenses or patients in whom the consequences of
infection may be catastrophic, for example neurosurgery, open heart surgery and ophthalmic surgery. The present study was
aimed to acknowledge the use of antibiotics on surgical patients at secondary care hospital. A total of 100 patients were
admitted into the department of general surgery in the government hospital, Chittoor were analyzed according to the study
parameter and results were shown in the article. In conclusion, the current project reported the importance of the antibiotics
used in the surgical care during the pre-operative and post-operative procedures. This study shows that the antibiotics that
are widely used prevent the surgical site infections, reduce the recovery time and also prevent any unwanted infections
caused by the bacteria. Antibiotics are found to have shown the clinical effectiveness on the patients that undergo surgery
and there were almost negligible cases of the patients that had any serious surgical site infections. In the case of postoperative drug ‘ceftriaxone’ is the most efficient antibiotics to prevent any bacterial infection post-surgery infections.
Ceftriaxone is a third-generation antibiotic with excellent activity against the gram negative and reasonable activity with
most gram-negative organisms

Kidney stone disease, also known as nephrolithiasis or urolithiasis, is when a solid piece of material (kidney stone) develops
in the urinary tract, Kidney stones typically form in the kidney and leave the body in the urine stream. A small stone may
pass without causing symptoms. If a stone grows to more than 5 millimeters (0.2 inches), it can cause blockage of the ureter,
resulting in sharp and severe pain in the lower back or abdomen. A stone may also result in blood in the urine, vomiting, or
painful urination. About half of people who have had a stone will have another in ten years. The purpose of this prospective
observational study is to evaluate the management and outcomes of renal calculus in adult population. A total of 100
patients who were admitted in the department of urology in the hospital was analyzed according to the study parameter. The
results were obtained from 100 patients with renal calculi disease who were enrolled in the study fulfilled after selection
criteria on obtaining consent from the same among 100 subjects. The study illustrated the evaluation of different surgical
methods for managing renal calculi in various location of the urinary system and concluded that the Ureteroscopic
lithotripsy (URSL) is the most suitable technique for removing lower ureteral impacted stones and Percutaneous
nephrolithotomy is the most preferable procedure for upper ureteral impacted stones. Patients underwent Ureteroscopic
lithotripsy were associated with shorter hospital stay, lower risk of fever when compared to Percutaneous nephrolithotomy.
No significant difference was observed in terms of age and type of stent used. males are more prone to various types of renal
calculi compared to females in the age group of 20-60. Oral alkaline therapy and Extracorporeal shockwave lithotripsy are
recommended only in the absence of hydronephrosis/ hydroureteronephrosis, and the stone size is <5mm

Hepatotoxicity is a potentially serious adverse effect of isoniazid, rifampicin, and pyrazinamide-based anti-tubercular therapy regimens. Isoniazid (INH) induces asymptomatic transaminase elevations in approximately 10%-20% of individuals and hepatitis in approximately 1% of patients. After the emergence of jaundice, INH-induced hepatitis can be fatal in between 8% and 10% of individuals. An ATT regimen had been in place for the past two months for a 29-year-old female patient with a history of tuberculosis. For 45 days, she stopped taking her TB medicine, then resumed it for another 10 days before discontinuing it again. Constipation and pale skin began to show up on the patient's skin after a few days of treatment. It took only a few days of therapy before she began to show signs of malnutrition, constipation, and a pallid complexion. Scleral yellowing and vomiting were among the patient's later symptoms. Direct toxicity, idiosyncratic damage, the activation of liver enzymes, and allergic reactions all contribute to the pathophysiology of ATT-induced hepatotoxicity

Diabetes mellitus is a metabolic disorder of multiple aetiology characterized by sustained hyperglycaemia with disturbances of carbohydrate, fat, and protein homeostasis resulting from defects in insulin secretion , insulin action or both. The defects in insulin secretion are the result of inappropriate functioning of the ? cells of the pancreas while those in insulin action are generally associated with resistance of the peripheral tissues to insulin. In all cases, the end result is a defective availability of insulin. Biguanides and sulphonyl ureas are the most commonly prescribed drugs due to their safety and efficacy. They were divided into two groups based on their treatment plan – Group A and Group B. The Group A exhibited a significantly greater reduction inHbA1C as compared to Group B. The reductions in FBS and PPBS were also found to be significantly more in the Group A. In this present study we observed that the patients on Metformin plus Teneligliptin combination exhibited better control over glycemic profile when compared to patients who are on Metformin plus Glimepiride combination. Since, this study was conducted in less number of patients, to make consecutive remarks about the superiority of either of the treatment regimen, furthermore analysis of clinical trials is required for appropriate selection of best combination of anti – diabetic medication