International Journal of Pharmacy Research & Technology (IJPRT)

Comparative Analysis of Early Versus Late Laparoscopic Cholecystectomy Following Endoscopic Retrograde Cholangiopancreatography in Cases of Cholelithiasis with Choledocholithiasis

2026-01-01T08:28:28+03:00

Background: The optimal timing of laparoscopic cholecystectomy (LC) following endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis remains debated. While early LC (≤72 hours) may reduce operative difficulty and hospital stay, late LC (>6 weeks) has traditionally been practiced to allow inflammation to subside.

Methods: A prospective comparative study was conducted on 60 patients with cholelithiasis and choledocholithiasis who underwent successful ERCP for common bile duct clearance at a tertiary care hospital. Patients were randomized into early LC (within 72 hours; n=30) and late LC (>6 weeks; n=30) groups. Demographic, operative, and postoperative parameters including operative time, adhesion grading, conversion to open surgery, complications, and hospital stay were analyzed using standard statistical tests.

Results: Both groups were comparable in terms of age, sex, and comorbidities. Mean operative time was significantly shorter in the early LC group (56.2 ± 8.5 min vs. 77.4 ± 9.1 min; p<0.001). Severe adhesions were more frequent in late LC (40% vs. 10%; p=0.01). The mean length of hospital stay was reduced in the early LC group (2.9 ± 0.7 vs. 4.3 ± 1.2 days; p=0.002). Conversion to open surgery (1 vs. 2 cases) and postoperative complications (6.7% vs. 10%) were not statistically different.

Conclusions: Early LC within 72 hours of ERCP is safe and associated with shorter operative time, less operative difficulty, and reduced hospital stay without increasing complication rates. These findings support early cholecystectomy as the preferred strategy in patients with cholelithiasis and choledocholithiasis.

A CLINICAL STUDY OF TRAUMATIC BRAIN INJURY COMPARING FULL OUTLINE UNRESPONSIVE SCORE (FOUR SCORE) AND GLASGOW COMA SCALE SCORE (GCS SCORE) IN PREDICTING THE IN-HOSPITAL MORTALITY IN EMERGENCY DEPARTMENT OF TERTIARY CARE HOSPITAL

2026-01-05T14:00:38+03:00

Objective: To compare and predict themortality in patients with TBI, by using FullOutline of Unresponsiveness (FOUR) scoreand the Glasgow Coma Scale (GCS) in Emergency department.

PREVALENCE OF HYPOTHYROIDISM IN PATIENTS WITH GALL STONE DISEASE IN A RURAL TERTIARY CARE HOSPITAL

2026-01-05T14:05:35+03:00

Background: Gallstone disease is aprevalent condition, with increasingevidence suggesting a link tohypothyroidism. However, the exact
relationship between thyroid abnormalities and gallstone disease is notwellestablished

Diagnostic Accuracy of Symphysio-Fundal Height in Detection of FGR by Taking Ultrasound as a Standard

2026-01-06T11:27:59+03:00

Objectives: To measure the diagnostic accuracy of symphysio-fundal height in detection of fetal growth restriction by taking ultrasound as a gold standard.

Study Design: validation study

Settings: Department of Obstetrics and Gynaecology, BBH, Rawalpindi.

Study Duration: 5th April 2022 to 4th October 2022.

Materials & Methods: A total of 225 women with singleton pregnancies between 28 and 36 weeks of gestation, aged 18 to 40, were enrolled. We excluded patients with fetal cardiac activity, congenital abnormalities, and polyhydroamnios. A researcher measured the fundal height every two weeks between weeks 28 and 38 at prenatal clinic visits. The distance between the uterine fundus and the top of the symphysis pubis was measured using a non-stretchable tape that came into touch with the skin of the abdominal wall. The researcher was facing the inch side of the tape to avoid bias. The inspecting hand's palm applied light pressure at a straight angle to the abdomen wall to delineate the fundus. Plotting of the measurements onto the normogram was done after they were measured in centimeters (to the nearest 0.5 cm). A radiologist performed an ultrasound to confirm FGR if it did not match gestational age.

Results: Overall sensitivity, specificity, PPV, NPV and diagnostic accuracy of symphysio-fundal height in detection of fetal growth restriction by taking ultrasound as a gold standard was 92.08%, 88.37%, 92.76%, 87.36% and 90.67% respectively. Conclusion: This study concluded that symphysio-fundal height is a highly sensitive and accurate parameter for detecting fetal growth restriction.

Comparing the Diagnostic Precision of the RMI and ADNEX Models in Identifying the Ovarian Tumor

2026-01-06T12:20:34+03:00

Objectives: To assess the diagnostic precision of the ADNEX and RMI models in distinguishing between benign and malignant ovarian tumors while taking histopathology as the gold standard.

Study type: Validation study.

Study duration: 5th April 2022 to 4th October 2022 Settings: Department of Obstetrics & Gynecology, Benazir Bhutto hospital Rawalpindi.

Materials & Methods: 165 patients between the ages of 14 and 65 who had at least one ovarian, para-ovarian, or tubal adnexal mass with a smallest diameter > 3 cm on ultrasound examination were included. Patients who had undergone bilateral adnexectomy or who had an adnexal mass under follow-up prior to the study's commencement were not included. The RMI/ADNEX score was computed. The patient was categorized as either low risk or high risk. To determine the predictive value of both models, the values were correlated with the histology report following surgery. Histopathological analysis of removed tissue serves as the foundation for the reference standard.

Results: The RMI model's diagnostic accuracy, sensitivity, specificity, PPV, and NPV in telling the difference between benign and malignant ovarian masses were 90.11%, 85.14%, 88.17%, 87.50%, and 87.88%, respectively. ADNEX showed sensitivity of 85.56%, a specificity of 81.33%, a PPV of 84.62%, an NPV of 82.43%, and a diagnostic accuracy of 83.64%. Conclusion: This study concluded that diagnostic accuracy of RMI model in differentiation of benign and malignant ovarian masses is better than ADNEX model.

Evaluation of Novel Biomarkers for Early Detection of Acute Myocardial Infarction

2026-01-10T10:22:53+03:00

Background: Early diagnosis of acute myocardialinfarction (AMI) is time-critical, yet initial ECGfindings may be non-diagnostic, and highsensitivity troponin can be negative or borderline in very early presenters. Objective: To evaluatethe diagnostic performance

Diagnostic Accuracy of Triple Assessment in Breast Cancer: A Comprehensive Clinical Evaluation with Statistical Analysis

2026-01-12T08:53:46+03:00

Background: Triple assessment combining clinical breast examination, radiological imaging, and fine needle aspiration cytology represents the systematic diagnostic approach for evaluating breast masses and determining malignancy probability. Despite widespread utilization, comprehensive analysis of individual component performance and concordance patterns with statistical significance remains incompletely characterized in contemporary literature.

Methods: This retrospective study evaluated 340 consecutive women presenting with palpable breast lumps undergoing complete triple assessment evaluation. Clinical breast examination, diagnostic mammography with BI-RADS categorization (0–6 scale representing <2% to >95% malignancy risk), and ultrasound-guided fine needle aspiration cytology (classified as C1–C5 according to National Health Service Breast Screening Programme criteria) were performed. All patients underwent histopathological examination as the gold standard reference. Diagnostic accuracy metrics including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated. Statistical significance was assessed using chi-square analysis and McNemar's test with significance threshold of p<0.05.

Results: Combined triple assessment achieved 99.1% diagnostic accuracy (sensitivity 99.0%, specificity 99.3%, p<0.001). Individual modality sensitivities were clinical examination 76.9% (p<0.001), mammography 94.9% (p<0.001), and FNAC 94.7% (p<0.001). Concordant findings (80% of cases, n=272) demonstrated 100% sensitivity and 99.4% specificity. Discordant cases (20%, n=68) showed elevated malignancy risk of 86.8% (59 of 68 cases, p<0.001), with FNAC-driven discordance demonstrating 92.9% malignancy detection versus 11.1% for isolated clinical examination concerns (p<0.001).

Conclusion: Triple assessment achieves exceptional diagnostic reliability when all components are concordant, supporting clinical decision-making without additional biopsy in appropriately selected cases. Discordant presentations mandate heightened investigation, with FNAC demonstrating superior prognostic weighting. Triple assessment represents the gold-standard diagnostic paradigm for breast mass characterization and malignancy stratification.

Comparative Study of Oxidative Stress Markers in Hemodialysis (HD) versus Peritoneal Dialysis (PD) Patients

2026-01-12T09:35:23+03:00

Introduction: Chronic kidney disease (CKD) patients on dialysis frequently develop anemia due to iron deficiency, blood loss, and chronic inflammation. Hemodialysis (HD) often involves intravenous iron therapy, which can elevate ferritin, while peritoneal dialysis (PD) patients may experience iron depletion through peritoneal losses. Ferritin, transferrin saturation (TSAT), and total iron binding capacity (TIBC) are key markers of iron status, but their interpretation is complicated by inflammation. Interleukin 6 (IL 6), a pro inflammatory cytokine, further influences iron metabolism and anemia. Comparing these parameters in HD and PD patients is essential for tailoring iron management strategies.

Aim: To compare iron and inflammatory markers between hemodialysis (HD) and peritoneal dialysis (PD) patients, and assess correlations with age and gender.

Methods: A cross sectional study of 70 ESRD patients (35 HD, 35 PD) was conducted. Serum iron, total iron binding capacity (TIBC), transferrin saturation (TSAT), ferritin, and interleukin 6 (IL 6) were measured using standard biochemical and ELISA methods. Statistical comparisons were made using Student’s t test, and correlations were assessed with Pearson’s coefficient.

Results: IL 6, serum iron, and TIBC did not differ significantly between HD and PD (p> 0.05). Serum ferritin was significantly higher in HD (574.05 ± 341.04 ng/ml) compared to PD (370.91 ± 292.38 ng/ml, p = 0.009). Age showed a weak negative correlation with ferritin, while females had higher ferritin than males.

Conclusion: HD patients exhibit elevated ferritin levels, likely reflecting iron supplementation and inflammation. Ferritin should be interpreted cautiously, and iron management strategies tailored to dialysis modality, age, and gender.

Evaluating the Impact of Workforce Burnout in Emergency Departments Considering Staff Performance and Patient Safety in Quetta: A Systematic Literature Review

2026-01-12T09:42:32+03:00

The problem of burnout among emergency department healthcare professionals affects worldwide healthcare systems most severely in limited-resource environments especially in Quetta Pakistan. This research analyzes the effect of working burnout on emergency department staff performance and patient protection in Pakistani medical units through PEO (Population, Exposure, Outcome) methodology with PRISMA analysis. A total of five research-based studies appeared in the timeframe from 2016 to 2024 and underwent theme-based analysis. Research evidence reveals significant emotional exhaustion and depersonalization together with psychological distress within the ED workforce while showing their connection to diminished job performance and workforce dissatisfaction and inferior patient safety operations. Multiple studies showed that work-related challenges and insufficient support systems and societal discrimination regarding mental health together fueled this problem. This review demonstrates the importance of immediate policy changes and institution-based mental health aids to reduce burnout and increase healthcare effectiveness across Quetta's medical facilities.

Effects of Intermittent Fasting on Metabolic, Hemodynamic, and Cardiovascular Risk Parameters in Adult Subjects

2026-01-12T11:32:14+03:00

Intermittent fasting has emerged as a popular dietary intervention with potential metabolicand cardiovascular effects. The present study was conducted to evaluate the impact of onemonth of intermittent fasting on anthropometric indices, glycemic parameters, lipid profile, inflammatory markers, and hemodynamic variables

Chronic Prostatitis and Causative Organisms

2026-01-12T11:45:03+03:00

Background: Chronic prostatitis is a frequently encountered urological condition with a heterogeneous etiology. While gram-negative bacteria remain the predominant causative agents, atypical and sexually transmitted organisms contribute significantly to disease burden, particularly in sexually active men.

Objective: To identify the spectrum of causative organisms in patients diagnosed with chronic bacterial prostatitis using conventional culture and nucleic acid amplification tests (NAAT).

Materials and Methods: This prospective observational study was conducted between March 2023 and November 2025 at a tertiary care hospital. Men aged 20–50 years presenting with recurrent urinary tract infection and genitourinary symptoms suggestive of chronic prostatitis were included. Patients with acute prostatitis or without identifiable organisms were excluded. All patients underwent detailed clinical evaluation, urine culture, expressed prostatic secretion analysis, and NAAT for sexually transmitted pathogens when indicated.

Results: A total of 146 patients were diagnosed with chronic bacterial prostatitis. Escherichia coli was the most common organism isolated on conventional culture (41%). NAAT identified atypical and sexually transmitted organisms in 10.9% of cases, predominantly Chlamydia trachomatis. Patients with multiple sexual partners showed a higher prevalence of atypical organisms.

Conclusion: Chronic prostatitis has a diverse microbiological profile. Along with conventional urine culture, NAAT improves detection of atypical and sexually transmitted pathogens and should be incorporated into diagnostic protocols for appropriate management.

A HISTOLOGICAL OBSERVATION ON DEVELOPMENT OF HUMAN FETAL LUNG -A RETROSPECTIVE FETAL AUTOPSY STUDY

2026-01-12T17:02:09+03:00

Background: This paper focuses on Lung histogenesis study in normal human foetuses ranging from11 to 40 weeks of gestation age. The process of histogenesis is nothing but a series of events thatoccur during the development of a tissue. In this process undifferentiated cells attain full functional maturity.

ANATOMICAL VARIATIONS IN PELVIC PART OF SCIATIC NERVE, A CADAVERIC STUDY AND ITS CLINICAL IMPLICATIONS

2026-01-12T17:21:15+03:00

Background: Sciatic nerve is the largest and widest nerve in the human body. It is also called asthe ischiatic nerve or ischial nerve. It is the main continuation sacral plexus. It supplies posteriorcompartment thigh, leg and foot. Understanding the anatomical variations of the sciatic nerve is essential for clinicians and surgeons

Triple-Arm Randomized Trial of Intraperitoneal Levobupivacaine, Dexmedetomidine, and Placebo for Analgesia After Laparoscopic Cholecystectomy

2026-01-12T17:29:52+03:00

Background: Pain after laparoscopic cholecystectomy is still a major clinical issue. The use ofanalgesic agents through intraperitoneal instillation may lead to better multimodal analgesia.The current research was aimed at comparing the analgesic effects of levobupivacaine and dexmedetomidine against placebo

Effects of a 12-Week Strength and Circuit Training Programme on Explosive Power and Cardiorespiratory Endurance in College-Level Football Players

2026-01-13T08:56:23+03:00

Background: Football performance depends heavily on the integration of neuromuscular power and cardiorespiratory efficiency. Late adolescence and early adulthood represents a critical period during which targeted training interventions may induce favorable physiological adaptations.

Objective: The present study aimed to evaluate and compare the effects of strength training and circuit training on explosive power and cardiorespiratory endurance in college-level football players.

Methods: Sixty male football players aged 18–21 years were randomly assigned to a strength training group, a circuit training group, or a control group (n = 20 each). The experimental groups underwent a structured 12-week training programme, while the control group continued routine physical activity. Explosive power was assessed using the standing broad jump test, and cardiorespiratory endurance was evaluated using the 12-minute run/walk test. Data were analyzed using analysis of covariance (ANCOVA) at a 0.05 level of significance.

Results: Both strength training and circuit training produced significant improvements in explosive power and cardiorespiratory endurance compared to the control group (p < 0.05). Circuit training resulted in greater enhancement of explosive power, whereas strength training elicited superior improvements in cardiorespiratory endurance.

Conclusion: The findings suggest that both training modalities induce meaningful physiological adaptations in college-level football players. Incorporating strength and circuit training within youth conditioning programmes may optimize neuromuscular performance and cardiovascular efficiency essential for football performance.

Effectiveness of Diet Therapy in Mitigating Stomach Cancer in Kashmir Region of India: A Hospital -Based Study

2026-01-15T12:31:13+03:00

Background: Cancer is a multifarious and complex disease, which is defined as a rapid and abnormal division of cells that engulfs other organs in a process of metastasis. Stomach cancer is prevalent in Kashmir, and new cases are rising drastically. It’s because of unawareness of food habits, smoking, spraying of orchards, unhealthy lifestyles, wazwan (non-vegetarian foods), processed and ultra-processed foods, micro-plastics, and harmful radiations. Stomach cancer patients are the highest (25.2%) after cola rectal cancer (16.4%) (Maria A. Qureshi et al.). It is noted that the Kashmir Valley has cancer at the highest rate as compared to the rest of India.

Aims/Objectives: the main objective of this study is to analyse risk factors and effectiveness of diet therapy among the patients suffering from stomach cancer.

Materials & Methods: The study was conducted at super specialty hospital government medical college Srinagar. A sample of 163 patients was taken. Interview method was deployed to collect the primary data.

Results: Out of 163 patients, majority were unaware about the proper diet. Many patients were on palliative care. Age group was 50-80, with male 135 and 28 were female.

Skin Changes in Pregnancy: A Prospective Observational Study

2026-01-15T12:37:20+03:00

Background: Pregnancy is associated with profound hormonal, metabolic, immunological, and vascular changes that lead to various physiological and pathological cutaneous manifestations. Although most skin changes are benign and self-limiting, some pregnancy-specific dermatoses may cause significant maternal discomfort and fetal risk.

Objectives: To determine the incidence and pattern of physiological skin changes and pregnancy-specific dermatoses among pregnant women.

Materials and Methods: This prospective observational study was conducted in the Obstetrics and Gynecology outpatient department of Nirmala Hospital and Research Center, Jaipur, from February 2020 to October 2025. A total of 960 pregnant women were evaluated through detailed history taking and complete dermatological examination. Women with pre-existing dermatoses were excluded. Findings were categorized into physiological skin changes and specific dermatoses of pregnancy.

Results: Out of 960 participants, 536 were primigravida and 424 multigravida. Physiological skin changes were observed in the majority of women, with hyperpigmentation being the most common manifestation. Pregnancy-specific dermatoses were seen in a smaller proportion, with pruritic urticarial papules and plaques of pregnancy (PUPPP) being the most frequent condition.

Conclusion: Skin changes are extremely common during pregnancy, predominantly physiological in nature. Awareness of these manifestations helps differentiate benign changes from pathological dermatoses, enabling appropriate counseling and management.

Anthropometric Study of Facial Morphology in the Central Indian Population

2026-01-16T20:19:07+03:00

Facial anthropometry plays a crucial role inanatomy, forensic science, andreconstructive surgery by providingpopulation-specific standards for personalidentification. Facial dimensions exhibitsignificant sexual dimorphism and ethnic variation, making region-specific dataessential. The present study

Reinforcement Techniques for Dynamic Adaptive Learning

2026-01-17T12:02:29+03:00

The goal of dynamic adaptive learning systems is to tailor instruction by meeting the needs of each student instantly. In order to enable ongoing modification of instructional content based on student performance and engagement, this study investigates reinforcement learning strategies. The suggested technique dynamically modifies learning strategies and content complexity by modelling learning as an interactive feedback-driven process. When compared to static and rule-based systems, experimental results demonstrate better learning outcomes and engagement, indicating the effectiveness of reinforcement strategies for intelligent and scalable adaptive learning environments.

Drug Utilization Study in Patients of Chronic Suppurative Otitis Media Patients Attending a Government Tertiary Care Hospital in Jaipur City

2026-01-20T13:19:26+03:00

Background: Chronic Suppurative Otitis Media (CSOM) remains a significant public health problem in developing countries, including India, contributing to morbidity, hearing impairment, and decreased quality of life. The rational use of antimicrobials and adjunctive medications plays a crucial role in the effective management of CSOM and in preventing antimicrobial resistance.

Objectives: To analyze the prescribing patterns of antimicrobials and other drugs in patients diagnosed with CSOM attending the outpatient department of a government tertiary care hospital in Jaipur City.

Methods: A prospective, cross-sectional observational study was conducted over a period of six months among patients clinically diagnosed with CSOM. Drug utilization pattern was analyzed to identify the frequently prescribed antimicrobials and other therapeutic drug classes.

Results: The majority of patients were in the [31–45 years], with a slight predominance of females. Oral antimicrobials were the most frequently prescribed drugs, followed by systemic antibiotics such as ciprofloxacin. Adjunctive drugs included antihistamines, nasal decongestants, and analgesics. Polypharmacy was minimal, and adherence to the essential drug list prescribing was noted in all the cases

Conclusion: The prescribing pattern in CSOM patients at this tertiary care hospital showed a preference for antimicrobials like fluoroquinolones and beta lactams. The predominance of oral drug use supports patient compliance and ease of use. However, continuous monitoring, adherence to treatment guidelines, and judicious antimicrobial use are essential to curb resistance and ensure optimal patient outcomes.

Interrelationship Between Placental Morphology and Thyroid Function in Preeclampsia: A Narrative Review

2026-01-20T15:29:05+03:00

Background: Preeclampsia is a pregnancyrelated disorder, characterized by mild to severehypertension along with reduced or abnormalfunction of the placenta. The placenta plays an essential role in the pathogenesis of preeclampsiaand increasing changes in maternal thyroid

Rauwolfia Serpentina: Phytochemistry, Mechanisms of Action, and Clinical Implications – A Comprehensive Review

2026-01-21T13:12:49+03:00

The Indian medical system has been using the medication Rauwolfia serpentina for many generations. The medication has been referred to as Sarpgandha due to its snake-like structure. Reserpine is the main alkaloid found in Rauwolfia serpentina, despite the fact that it contains over 50 alkaloids. Even at lower dosages, reserpine is an effective antihypertensive medication. In addition to its antihypertensive and hepatoprotective properties, the stems and leaves of Rauwolfia serpentine have numerous other therapeutic applications, such as sedative, antipsychotic, antidiahoerreal, and anticancer (in breast), among others. Although the herb Rauwolfia serpentina contains the principal four Indole alkaloids, the primary goal of this context is to provide information about the primary active alkaloid Reserpine, which is more concentrated in the plant's root and plays a significant part in the plant's antihypertensive activity. Reserpine must be used at a considerably lower level in order to have an antihypertensive effect; otherwise, it may have major side effects such as sedation, lethargy, psychological depressive disorders, hypotension, nausea, bradycardia, bronchospasm, and withdrawal psychosis.

A Cross-Sectional Study on Cervical Cancer Awareness and its Association with Demographic Factors in India

2026-01-22T08:37:16+03:00

Introduction: Cervical cancer is a significant public health concern, ranking as the fourth most common cancer among women worldwide. India contributes nearly one-quarter of the global burden, with low screening and vaccination rates despite available preventive measures. Demographic factors may influence awareness levels, impacting early detection and prevention.

Aims and Objectives: This study aimed to assess cervical cancer awareness among reproductive-age women attending a tertiary care hospital in West Bengal and to analyze its association with demographic factors such as age, education, marital status, and place of residence.

Materials and Methods: A cross-sectional study was conducted among women aged 18–49 years visiting a tertiary care hospital. Data on demographics and cervical cancer awareness were collected using structured questionnaires. Associations between awareness and demographic variables were analyzed using Chi-square tests.

Results: Most participants were aged 20–25 years (31.4%) and had education above the 10th standard (45.3%). A majority were married (75.9%) and resided in urban areas (62.5%). Statistically significant associations were found between cervical cancer awareness and education (χ²=48.03, p=2.1×10⁻¹⁰), marital status (χ²=30.45, p=3.43×10⁻⁸), living area (χ²=9.59, p=0.0083), and age group (χ²=37.67, p=3.32×10⁻⁸).

Conclusion: Demographic factors significantly influence cervical cancer awareness. Tailored public health interventions focusing on less-educated, unmarried, rural, and older women are essential to improve preventive practices.

PRECISE SCORE, A PREDICTIVE TOOL VALIDATION FOR STONE-FREE RATE AFTER RETROGRADE INTRARENAL SURGERY (RIRS) FOR RENAL STONES GREATER THAN 2 CENTIMETRES-A RETROSPECTIVE STUDY

2026-01-22T14:02:28+03:00

Background: Retrograde intrarenal surgery (RIRS) is increasingly being used for renalstones > 2 cm in patients where indicated. The available nephrolithometric scoringsystems are limited when predicting outcomes in larger stones such as R.I.R.S., T.O.HO.,and STONE scores. The PRECISE score, a seven-parameter preoperative tool (each 0–2; total 0–14), was developed and validated retrospectively in a single-center cohort.

Paracetamol versus Diclofenac as Intravenous Postoperative Analgesia in Patients Undergoing Laparoscopic Surgeries

2026-01-24T12:39:34+03:00

Laparoscopic surgery is increasinglypreferred because of its minimally invasivenature and faster postoperative recovery.Postoperative pain is a significant stressor and is inherently subjective. Inadequatepain management can adversely

Clinical Profile, Etiology and Outcome of Acute Encephalopathy among Children at Pediatric Intensive Care Unit in a Tertiary Care Hospital

2026-01-24T13:22:05+03:00

Encephalopathy is clinically defined as diffuse disorder of brain with at least two of the following ^[¹^] altered sensorium, altered cognition or personality, seizures. Acute encephalopathy is a pediatric emergency with high morbidity and mortality, however early identification and timely intervention can influence the outcome.

Bilayer Floating Tablet of Amoxicillin with Deglycyrrhizinated Licorice (DGL) Powder for the Treatment of Peptic Ulcer

2026-01-27T09:32:34+03:00

Peptic ulcer disease is associated with mucosal erosion from an imbalance of gastric acid, pepsin, Helicobacter pylori infection, and weakened mucosal defenses. This study was done to treat Peptic ulcer disease by formulating Amoxicillin, which is a β-lactam antibiotic that kills bacteria by inhibiting cell wall synthesis. Moreover, Deglycyrrhizinated licorice, an herbal alternative, was added in the formulation to provide mucosal protection and anti-inflammatory activity, aiding ulcer healing without affecting acid secretion and reduceing side effects.

The current study aimed at formulating a bilayer-floating tablet containing amoxicillin and deglycyrrhizinated licorice, and the purpose of this study was to increase gastric retention, increase localised drug delivery, and generate a synergistic anti-ulcerative effect. The floating drug delivery system has been designed to extend the gastrointestinal residence time, and thus, enhance the systemic availability of the drug to act locally in the upper gastrointestinal tract. In addition, the polymers used to make the bilayer tablet a sustained-release tablet were complemented by effusive agents to provide buoyancy and prolonged gastric retention. Wise choices were made on the excipients in order to stabilise the tablet. Based on this, the main objective was to develop a gastro-retentive bilayer tablet enabling the gradual delivery of amoxicillin in combination with the immediate localised activity of deglycyrrhizinated licorice. The findings showed effective floating characteristics and a consistent drug release profile, suggesting its potential as a promising therapy for treating peptic ulcers.

Central Obesity as a Predictor of Renal Stress in Metabolic Syndrome: Biochemical and Urinary Evidence

2026-01-29T09:15:18+03:00

Background:Central obesity is a defining feature of metabolic syndrome (MetS) and is increasingly implicated in early renal dysfunction [1,2]. However, biochemical and urinary markers linking central obesity to renal stress in MetSare underexplored in Indian populations.

BIODENTINE PULPOTOMY ALTERNATE TO ROOT CANAL TREATMENT IN YOUNG ADULTS

2026-01-29T09:26:23+03:00

Background: Vital pulp therapy using Biodentinehas emerged as a biologically conservativealternative to root canal treatment, especially inyoungadultswithirreversiblepulpinflammation. Objective: This study aimed to evaluate the clinical and radiographic success

Assessment of Knowledge, Attitude and Awareness towards Adverse Drug Reaction Reporting System among Undergraduate Medical Students in Shyam Shah Medical College, Rewa

2026-01-31T08:08:55+03:00

Background: Adverse Drug Reactions (ADRs) are an important cause of morbidity and mortality worldwide. Although pharmacovigilance is included in the undergraduate medical curriculum, underreporting of ADRs remains a major limitation of spontaneous reporting systems. Raising awareness among healthcare professionals, especially medical students who are future prescribers, is essential to strengthen the pharmacovigilance system.

Aim and Objectives: To assess the knowledge, attitude, and awareness regarding the ADR reporting system among undergraduate medical students of Shyam Shah Medical College, Rewa.

Materials and Methods: An observational cross-sectional study was conducted in June 2024 using a pre-designed, structured questionnaire circulated through Google Forms. The questionnaire assessed knowledge, attitude, and awareness regarding ADRs and pharmacovigilance. A total of 277 undergraduate medical students from second year to final year MBBS participated in the study. Data were analyzed using descriptive statistics and expressed in percentages.

Results: Out of 277 students, 93 (33.6%) were from second year, 79 (28.5%) from third year, and 105 (37.9%) from final year. Overall, about 65% of students had adequate knowledge about ADRs and pharmacovigilance. A positive attitude towards ADR reporting was observed in nearly 92% of participants. Awareness was higher among final year students (approximately 69%), particularly regarding banned drugs, patient confidentiality, and legal responsibilities. However, nearly 30% of students still demonstrated insufficient awareness and practical understanding.

Conclusion: The study reveals satisfactory knowledge and attitude among undergraduate medical students; however, awareness and practical exposure to ADR reporting need further improvement. Regular training sessions, workshops, and integration of pharmacovigilance activities into clinical postings are recommended to strengthen ADR reporting culture among future healthcare professionals.

Prevalence of Anxiety and Depressive Disorders among Patients with Leprosy: A Cross-Sectional Study

2026-01-31T12:54:57+03:00

Background: Leprosy, caused byMycobacterium leprae, is a chronicinfectious disease that imposes significantphysical, social, and psychological burden.Stigma, disability, and chronicity mayincrease the risk of anxiety and depressive disorders. This study aimed to estimate theprevalence of anxiety and depressive

A Study of Thrombocytopenia in a Pregnancy at a Tertiary Care Centre

2026-02-03T09:08:01+03:00

Background: Thrombocytopenia is the second most common haematological abnormality after anaemia encountered in pregnancy. Thrombocytopenia is defined as the platelet count of less than 150,000/ml. Pregnancy causes varied alterations in hematopoietic systems. Thrombocytopenia is second only to anemia as the most common hematologic abnormality in pregnancy. It occurs commonly during pregnancy and accounts for around 7–8% of the all the pregnancies. The causes are accelerated platelet consumption or decreased production

Aim and Objectives: “A Study of thrombocytopenia in pregnancy at a tertiary care center.2. To study proportion of thrombocytopenia in pregnancy at a tertiary care center. 3. To study the association of thrombocytopenia with risk factors. 4. To study clinical profile of thrombocytopenia cases

Methodology: Study Design: Cross sectional study.

Study Setting: OBGY department of VDGMC Latur, Maharashtra.

Study Population: All pregnant women with Gestational age from 28weeks to 40weeks with thrombocytopenia in ANC Clinic of OBGY department of VDGMC Latur such cases were included in the study.

Study Period: 18months from 1 Dec 2023 to 1 July 2025.

Sample Size = 140

Results: Proportion of Thrombocytopenia among ANC Women was 1.64%, most of cases presented with mild thrombocytopenia 120 (85.71%).The majority of cases occurred in the 20–30 years age group (75 cases, 53.6%), the majority were multigravida (97 cases, 69.2%), thrombocytopenia was most frequently observed beyond >37 weeks (61 cases, 43.6%), majority of cases reported vegetarian diet pattern 94 (67.14%),majority of cases reported no H/O platelets transfusion 134 cases (95%) and 6 cases (5%) had a history of platelets transfusion. majority of cases diagnosed with platelet count between 120001-150000, 88 cases , 31 cases (22.1%) had identifiable risk factors associated with thrombocytopenia. The most frequent association was anaemia (12 cases, 8.6%), followed by non-severe preeclampsia/gestational hypertension (4 cases, 2.9%) and infections including dengue (4 cases, 2.9%). The association between risk factors and thrombocytopenia was statistically significant (p < 0.001).

Conclusions: The present study provides a comprehensive overview of thrombocytopenia in pregnancy, its prevalence, severity, and associated determinants in a tertiary care setting. The proportion of thrombocytopenia was 1.64%, which, though relatively low, represents a clinically important condition due to the maternal and fetal risks involved.

Advancements in Virology and Microbiology: Emerging Trends, Challenges, and Future Perspectives

2026-02-03T14:45:50+03:00

Background: Virology and microbiology are changing rapidly, thanks to innovations in vaccine technology, molecular diagnostics and artificial intelligence. Pioneering mRNA vaccines and CRISPR-based antiviral therapies are transforming disease prevention and treatment. Yet a range of challenges persists, including limited funding, antimicrobial resistance, and misinformation that impede advancement in those areas.

Objective: This study addresses the emerging trends, challenges, and future perspectives in virology and microbiology. Through a cross-sectional survey of subject matter experts in the field, the study aims to evaluate current progress, determine challenges and discuss possible directions to overcome these challenges.

Methodology Method: A predesigned questionnaire was developed and circulated among people from research institutes, healthcare organizations and pharmaceutical industries. The survey collected quantitative and qualitative data on recent breakthroughs, ongoing challenges and expected future developments. Moreover, a systematic bilateral literature review of peer-reviewed papers via Scopus, web of science, and pubmed was undertaken to gain a broader contextual understanding.

Key Findings: Recent trends: Discoveries in mRNA vaccine technology, CRISPR-based antiviral therapies and pathogen detection driven by AI have also impacted virology and microbiology. However, funding constraints, the rise of new infectious diseases, and antimicrobial resistance remain significant obstacles despite these advances. "Most researchers believe that artificial intelligence can help detect pathogens and discover drugs," explains the study[3], which was released around 14 months ago. Misinformation still constitutes a challenge that is detrimental to public health policies and vaccination uptake.

Future Directions: Experts emphasize that now more than ever, researchers, policymakers, and industries must come together to work toward solutions to these challenges. Innovative research and technology efforts need to be supported through robust funding mechanisms to ensure continued progress. Moreover, targeted public awareness campaigns are critical to countering misinformation and enhancing vaccine acceptance. Newer AI-based application in diagnostics and therapeutic modalities also appears as a useful utility in monitoring and controlling diseases.

Conclusion: Virology and microbiology are progressing at a pace, but we continue to face hurdles. As infectious disease research and public health preparedness evolve, addressing funding shortages, leveraging artificial intelligence, and fostering international cooperation will be critical. The global scientific community can strive like there is no tomorrow over the challenges and healthcare outcome through prudent interventions like early stages of care and providing sustained innovations like long term therapeutics.

Association Between Serum Prolactin Levels and Severity of Liver Cirrhosis Assessed by Child–Pugh Scoring: A Hospital-Based Cross Sectional Study

2026-02-04T19:08:34+03:00

Introduction: Liver cirrhosis represents theterminal stage of chronic liver diseases andis characterized by progressive fibrosis andregenerative nodules, resulting insubstantial morbidity and mortality worldwide. Disease prognosis worsens

To Assess the Lip Print Pattern in the Patients of Psoriasis in Both Sexes & to Provide Baseline Data for the Same

2026-02-05T14:35:34+03:00

Aim: The aim of the present study was to assess lip print pattern in the patients of psoriasis in both sexes & to provide baseline data for the same.

Methods: The present study was conducted on 200 subjects divided into two groups viz group A & group B. Group A was control group, comprising 100 subjects (M:F::50:50), taken from amongst Medical students of Govt. Medical College Patiala . Group B served as study group, comprising 100 subjects of psoriasis with or without involvement of lips reporting to Department of Dermatology of Rajindra hospital, Patiala.

Results: The prominent lip print pattern observed was Type 2(34.5%) followed by Type 3(26.75%) followed by Type 1(24.5%). Type 1(34.5%) Lip Print Pattern was found to be predominant, followed by Type 2(25.25%) and then by Type 3(18.75%). The dominant Pattern of Lip Print observed was Type 1(25.69%) followed by Type 2(21.53%) and then by Type 4(11.46). The main Pattern of Lip Print Pattern observed was Type 3(29.92%) followed by Type 2(27.23%) and then by Type 1(22.32%). The most prominent Lip Print Pattern observed was Type 2(29.87%). The most predominant Lip Print Pattern observed was Type 1(24.76%).

Conclusion: The data obtained from the present study showed promising results and indicated the uniqueness of lip prints. The major differences in the lip print patterns are seen in RUM and LUM region of Upper Lip (medial region) and RLM region of Lower Lip, which could be baseline data for further research work on lip print pattern in Psoriasis.

Intravenous Granisetron Versus Ondansetron for Attenuation of Hypotension and Bradycardia During Spinal Anaesthesia in Caesarean Section: A Prospective Randomized Double-Blind Study

2026-02-07T12:48:36+03:00

Background: Spinal anaesthesia forcaesarean section is frequentlyassociated with hypotension, whichmay adversely affect both maternal andfetal outcomes. Serotonin (5-HT₃)receptor antagonists such as ondansetron and granisetron

Comparative Outcomes of Surgical Versus Medical Management of Ileocaecal Tuberculosis in a Single Tertiary-Care Centre

2026-02-10T10:53:25+03:00

Background: Ileocaecal tuberculosis (ICTB) represents the commonest form of gastrointestinal tuberculosis and poses a therapeutic dilemma when complications arise. While anti-tubercular therapy (ATT) achieves high cure-rates, obstruction, perforation or haemorrhage may necessitate surgery. Robust comparative data from South-Asian high-burden settings remain scarce.

Methods: We undertook a retrospective cohort analysis of all adults managed for ICTB between January 2018 and December 2023 at a 1 200-bed quaternary institute in northern India. Patients were stratified into a primary-medical group (≥ 6-month category I ATT) and a primary-surgical group (emergency or elective limited right hemicolectomy/stricturoplasty followed by ATT). Kaplan–Meier estimates, log-rank tests and multivariable Cox regression assessed 12-month composite success (symptom-resolution + endoscopic-healing).

Results: One-hundred patients met inclusion criteria (medical = 60; surgical = 40). Baseline age, sex-ratio and comorbidity burden were comparable. Complicated disease (multiple strictures, fistulae or perforation) was significantly higher in the surgical cohort (60 % vs 12 %, p < 0.001). At 12 months, composite success was 90 % in the surgical arm versus 80 % in the medical arm (HR 1.65, 95 % CI 1.02–2.66). Overall complication-rate was higher after surgery (20 % vs 10 %), but major (Clavien–Dindo ≥ III) events were rare (5 %). No mortality occurred.

Conclusion: In a real-world high-burden setting, surgery combined with standard ATT yielded superior clinical resolution in anatomically complicated ICTB at the cost of higher—but acceptable—morbidity. Elective surgery should be considered early for patients with advanced stricturing disease to optimise outcomes.

“Role of Sentinel Lymph Node Biopsy in Clinically Node-Negative Breast Cancer: A Prospective Study”

2026-02-12T08:54:15+03:00

Sentinel lymph node biopsy (SLNB) has transformed axillary staging in early breast cancer by providing accurate nodal assessment while substantially reducing morbidity compared with complete axillary lymph node dissection (ALND)). The purpose of the study is to determine the accuracy of diagnostics used, false-negative rate, morbidity, and oncologic outcome of SLNB in patients with clinically node-negative (cN0) breast cancer and whose treatment is three years in a tertiary cancer centre. The second outcomes (sentinel node identification rate, false-negative rate, arm morbidity (lymphedema, shoulder dysfunction), local/regional recurrence, disease free and overall survival at minimum median follow-up, (36 months) were the important ones. We have established that our identification rates (>95%), in well established dual-tracer tests, of adequate node recovery are high, and that there are overall large changes in morbidity rates in both the short term and long-term as compared with the historic ALND cohorts. In combination with modern adjuvant systemic therapy and individualized radiotherapy, omissions of an incremental ALND in which complete replaces the excision of small limited-size sentinel node metastases does not appear to have a negative impact on oncologic outcome. The article endorses a guideline-based practice that underpins SLNB on how to handle the treatment of staging cN0 early breast cancer yet cites technical and pathological considerations, which can be used to interfere with the accuracy and the need to exercise caution and long-term follow-ups on patients. Contemporary technical arguments of the trial and guideline modifications useful to the contemporary practice are discussed.

Knowledge, Attitudes and Practices of Caregivers Regarding Diarrhoeal Diseases in Under-Five Children with Special Reference to Medication Use: A Hospital-Based Cross-Sectional Study

2026-02-12T11:52:09+03:00

Background: Diarrhoeal diseases are the major causes of morbidity and mortality amongst children under the age of five years even though they can be avoided and cured. Lack of proper home management and irrational use of drugs and specifically antibiotics is among the factors that lead to poor outcomes and antimicrobial resistance. This would evaluate the knowledge, attitudes and practices (KAP) of caregivers of patients with diarrhoea under-five years old, and particularly medication use.

Methods: The current study was a cross-sectional study in which data was collected in the Departments of Pharmacology and Paediatrics, M.K.C.G. Medical College, between February 2020 and February 2021. One hundred forty four consenting caregivers of children aged 059 months with diarrhoeal illness presenting to OPD/IPD were recruited. A semi-structured, interviewer-administered questionnaire, which is based on WHO recommendations on childhood diarrhoea, was translated and back-translated to Odia, used to collect data. Socio-demographic variables and KAP domains were measured. GraphPad Prism was used to analyse data with the help of descriptive statistics (frequencies, percentages).

Results: Overall, [xx.x%] of caregivers demonstrated adequate knowledge of diarrhoea definition, danger signs and role of oral rehydration salts (ORS), while [xx.x%] had poor knowledge. Only [xx.x%] correctly identified zinc supplementation as a recommended adjunct therapy. A favourable attitude towards early health-facility consultation and continued feeding during diarrhoea was observed in [xx.x%] of participants. In practice, home initiation of ORS was reported by [xx.x%], whereas [xx.x%] used non-recommended remedies (antidiarrhoeals, antibiotics, or herbal preparations). Antibiotics were prescribed in [xx.x%] of cases, frequently in acute watery diarrhoea without dysentery or systemic sepsis. Caregiver education, urban residence and higher socio-economic status were positively associated with better KAP scores. Patterns of antibiotic use were often discordant with WHO recommendations.

Conclusion: Substantial gaps persist in caregiver knowledge and practices regarding evidence-based management of under-five diarrhoea, alongside high rates of potentially inappropriate antibiotic use. Strengthening caregiver education, reinforcing ORS–zinc as the standard of care, and promoting antimicrobial stewardship in paediatric diarrhoeal illness are urgently needed.

A Cross-Sectional Study on the Prevalence of Endometrial Tuberculosis Among Women with Unexplained Infertility Using CBNAAT

2026-02-12T18:59:41+03:00

Background:Female genital tuberculosis (FGTB) is thesecond most common form ofextrapulmonary tuberculosis and is a well
recognized cause of infertility in women. Diagnosis of FGTB remains challengingdue to its varied clinical presentation

Spectrum of Clinicopathological Findings in Female Genital Tuberculosis at a Tertiary Care Hospital

2026-02-12T19:06:23+03:00

Background: Female genital tuberculosis(FGTB) is an important yet oftenunderdiagnosed cause of infertility indeveloping countries. The present study aimed to describe the various

Patterns, Perceived Triggers, and Physiological Correlates of Yawning Behavior in First-Year Medical Undergraduates: A Cross-Sectional Questionnaire Study

2026-02-13T14:09:27+03:00

Background:-Yawning is a stereotyped reflex observed in humans and several animal species and is commonly associated with fatigue, boredom, and reduced alertness. It is also regarded as a socially contagious phenomenon. Despite its frequent occurrence, scientific evidence regarding the underlying causes, functional significance, and behavioral patterns of yawning remains limited, particularly among adolescent and young adult populations.

Objectives:-The present study aimed to assess the patterns of yawning behaviour and its associated factors among adolescents.

Materials and Methods:- This cross-sectional, questionnaire-based study was conducted among 200 first-year MBBS students . After obtaining informed consent, participants were administered a self-structured questionnaire incorporating a six-point Likert scale to assess yawning behaviour under various situations. Students were instructed to respond honestly, and anonymity was ensured. The collected data were compiled and analyzed, and the results were represented graphically.

Results:- Under routine conditions, the majority of students reported yawning either “somewhat” or “not at all.” A significantly higher frequency of yawning was reported during sleep deprivation, with 68.42% of students indicating yawning “very much” when they lacked adequate sleep. In contrast, 73.68% of participants reported not yawning during interviews, and 71.05% reported no yawning while completing the questionnaire. Although yawning is widely considered contagious, only 23.68% of students reported yawning frequently upon observing others yawn.

Conclusion:- The findings suggest that yawning among first-year MBBS students predominantly occurs in association with sleep deprivation rather than social or situational stimuli. Overall, the study population appears to maintain a satisfactory level of alertness and engagement, as reflected by low baseline yawning frequency.

CORRELATION BETWEEN CYCLE THRESHOLD VALUE AND CT SEVERITY SCORE DURING COVID 19 PANDEMIC

2026-02-13T19:22:38+03:00

Introduction: The novel SARS CoV-2 wasdeclared as a public health emergency inJanuary 2020. Patients infected with thisvirus show different severity of disease symptoms ranging from mild disease

FUNCTIONAL AND RADIOLOGICAL OUTCOME OF INTRA ARTICULAR DISTAL RADIUS FRACTURES TREATED WITH VOLAR PLATE OSTEOSYNTHESIS: A PROSPECTIVE STUDY

2026-02-13T19:31:16+03:00

Background: Distal radius fractures areamong the most common fractures of theupper extremity, frequently involving thearticular surface and leading to functional impairment if inadequately

PROGNOSTIC SIGNIFICANCE OF DISSEMINATED TUMOR CELLS IN THE BONE MARROW OF PATIENTS WITH OVARIAN CANCER

2026-02-13T19:34:25+03:00

Background: Ovarian carcinoma isassociated with high mortality due to latepresentation and early systemicdissemination. Disseminated tumour cells (DTCs) in bone marrow representoccult haematogenous

Surgical Tenolysis for Post-Traumatic Finger Stiffness: Outcome Evaluation of Our Technique

2026-02-14T13:52:58+03:00

Background Hand injuries are often associated with stiffness and loss of movement of the fingers because of adhesions and fibrotic tissue formation of tendons. Tenolysis surgery is performed to loosen these adhesions to allow the tendons to slide and move normally. Multiple methods have been outlined, each possessing its own pros and cons.

Objective: This paper analyzes the clinical results of our surgical process in the treatment of stiff fingers, which includes the release of flexor and extensor tendons under local anesthesia while allowing movement of the fingers during surgery to guarantee full adhesion release.

Duration and place of study: This study was conducted at Burns Center Civil Hospital and Dow University of Health Sciences Karachi from October 2024 to October 2025

Methodology: A retrospective study was provided on 50 patients who had tenolysis performed on them with the use of this technique. The demographic information, injury nature, and clinical observations were noted. Total active motion (TAM) and flexion lag were measured preoperatively and postoperatively and compared. The perioperative or postoperative complications were also analyzed.

Results: A total of 50 patients who had stiff fingers were analyzed. The average preoperative TAM had a significant limitation, and the postoperative measurements had a significant improvement in the active range of movement. The TAM was found to have increased statistically (p < 0.05). No significant surgical morbidity was noted, and the majority of the patients had significant functional recovery.

Conclusion: The comprehensive release of adhesions surrounding flexor and extensor tendons results in a significant increase in the mobility in the fingers. Tendon release when done under local anesthesia with active involvement of the patient during the surgical procedure increases the adequacy of the tendon release procedure and helps to improve the functional results.

Study of Nerve Conduction Velocity in Normal Subject Having Parental History of Diabetus Mellitus

2026-02-16T08:57:46+03:00

Background: Hyperglycemia in type 2 diabetes is associated with micro- and macro-complications and causes autonomic nervous dysfunction. Severe autonomic failure due to sympathetic and parasympathetic dysfunction typically occurs in patients with long-standing and poorly controlled diabetes. Heart rate variability (HRV) is a standard screening parameter for diagnosis of autonomic dysfunction. Analysis of 5 minutes measurements of heart rate variability (HRV) has been shown to be a good predictor of physiological distress and mortality, especially for cardiovascular disease.

Aim and Objectives: 1. To evaluate heart rate variability and nerve conduction velocity in off‐springs of diabetic and nondiabetic parents using autonomic test. 2 To study and compare autonomic nervous activity in off‐springs of diabetic and non‐diabetic parents. 3 To study BMI in off‐springs of diabetic parents.

Methodology: Present study was a cross sectional study done at Department of Physiology, Grant Government Medical College Mumbai during a period of December 2014 to October 2016. The study involved randomly selected 100 students of first year MBBS students, these can be divided in two groups (50 study groups and 50 Control groups) depending on family history of diabetes mellitus and children with parents having diabetes mellitus were taken as study group.

Result: Mean age, height, weight, and BMI in study group and control group Age (years) mean and SD in study group 19.30±1.13 control group 19.22±1.02 p value-0.7104. Height (meters) study group mean, SD- 1.59±0.04 control group SD-1.59±0.07, BMI (Kg/m2) 21.49±1.94 21.89±2.17. Mean systolic blood pressure of study and controls are 110±11.55 and 108.2±6.09 mmHg respectively. There is no significant difference between systolic blood pressure of study group and controls. Mean diastolic blood pressure of study and controls are 76±10.69 and 74.28±5.08 mmHg. There is no significant difference between mean diastolic blood pressure of study and controls. Mean resting heart rate in study and control are 76.74±10.67 and 75.92±9.49 bpm respectively. The resting heart rate in study group was higher but it was not statistically significant. There was no statistically significant post test difference in mean DBP of study and controls, no statistically significant difference in SBP. Mean of time domain indices of HRV in study group and Control group. Mean RR (ms) study group mean SD-0.79±0.07 Control mean and SD-0.75±0.051. Mean nerve conduction velocity in median nerve in study group and control group Motor study group mean and SD-61.08±10.14 Control group mean and SD-65.48±4.97

Conclusion: HRV is reduced in nondiabetic offsprings of diabetic parents. Offsprings of diabetic parents showed increased sympathetic as well parasympathetic activity. Impaired vagal activity was found in offsprings of diabetic parents. Decreased HRV is associated with greater risk for developing diabetes mellitus. Further our study suggests that the tendency to developing diabetes mellitus sets in an early age.

Effect of Orthodontic Braces on Gingival Health Status and the Role of Professional Scaling Frequency as a Preventive Factor

2026-02-16T10:23:08+03:00

Fixed appliance orthodontic treatment is often linked with greater amounts of plaque retention, and thiscould adversely affect the health of the gums, provided that preventive measures are not taken. The presentcross-sectional observational study sought to measure the impact of the use of orthodontic braces on the level of gingival health and to determine the place of professional scaling frequency

Serum Uric Acid as a Marker of Disease Severity, Duration, and Target Organ Damage in Patients with Hypertension: A Cross-Sectional Study

2026-02-16T11:26:58+03:00

Background:Hypertension is a major contributor tocardiovascular and renal morbidity. Serum uricacid (SUA) has been implicated in the
pathogenesis and progression of hypertension;however, its association with disease severity, duration, and target organ damage in the Indianpopulation remains inadequately defined.

Unveiling the Therapeutic Potential of Carica Papaya Leaf Extracts a Study on Antifungal and Anti-Inflammatory Activities

2026-02-16T13:50:11+03:00

Background: Traditional medical plants have been known to society for a long time. Other than easily available and inexpensive, they are able to cure diseases with few side effects compared to modern medicine. The use of papaya leaves in this study was not only because they contained various chemical compounds that could exert their pharmacological effects, but also the presence of various compounds, which are indicated as Antifungal and Anti-Inflammatory.

Objective: The present research tried to study the antifungal and anti-inflammatory effects of Carica papaya (Red Lady Variety) leaf extracts.

Methods: Freshly harvested Carica papaya leaves of the Red Lady Variety were collected and identified by the herbarium of the Department of Botany at Karachi University. After air-drying, they were chopped, ground into fine powder and extracted with n-Hexane and acetone in a Soxhlet apparatus using 10 grams and 82 grams respectively for drying sample. Extracts after concentration on a rotary vacuum evaporator were stored in a desiccator for further studies and applications. In vitro, agar tube dilution protocol for antifungal activity and oxidative burst assay using chemiluminescence technique for anti-inflammatory.

Results: The in- vitro antifungal Percentage of linear growth inhibition exhibited by n-hexane was between 24% and 40% on different fungal species tested, including Trichophyton rubrum (25%), Candida albicans (40%), Aspergillus niger (25%), Microsporum canis (26%), Fusarium Ini (24%), Candida glabarata (30%) and Aspergillus fumigatus (35%). On the other hand, the acetone extract was able to exhibit growth inhibition rates which were slightly lower, ranging from 20% to 26%. The inhibition rates were as follows: Trichophyton rubrum (23%), Candida albicans (26%), Aspergillus niger (23%), Microsporum canis (25%), Fusarium Ini (20%), Candida glabarata (23%), and Aspergillus fumigatus (23%). In-vitro anti-inflammatory, when tested at 100 µg/mL concentration, it was found that n-hexane leaf extract was able to exhibit 43.6% inhibition of inflammation but was still considered to be less active. Likewise, acetone leaf extract did not show any measurable inhibition when subjected to similar conditions and therefore this also ranked as inactive.

Conclusion: The antifungal inhibition rates were between 23% and 40%, meaning some potential but lower efficiency compared to standard antifungal agents. In the same line, anti-inflammatory activity was moderate where the n-hexane extract only achieved a 43.6% inhibition and the acetone extract had no significant effects at 100 µg/ml.

Comparative Study of Turp versus Medical Management in Benign Prostatic Hyperplasia

2026-02-16T14:51:21+03:00

Objective: To identify the differences in the efficacy, safety and quality of life after transurethral resection of the prostate (TURP) and medical management in Pakistani men with moderate to severe benign prostatic hyperplasia (BPH).

Materials and Methods: A prospective randomized controlled trial was used as the study design in three tertiary care centres in Pakistan during the period between January 2023 and December 2024. Two hundred and forty men of [?]50 years with moderate to severe LUTS (IPSS 8-19) and a 30-80 mL prostate volume were randomly matched into TURP (n=120) versus medical treatment using tamsulosin 0.4 mg daily +- finasteride 5 mg daily (n=120). The primary outcomes were change in IPSS score, maximum urinary flow rate (Qmax), and quality of life (QoL) index in 6 months. Secondary outcomes were complication rates, the incidence of acute renal failure and re-intervention.

Results: Findings at 6 months TURP showed much higher increase in IPSS (14.2+-3.1 vs 6.8+-2.9), Qmax (+9.8+-3.2 vs +3.1+-1.8 mL/s) and QoL index ([?]3.4+-1.1 vs +1.9+-0.9) over medical treatment. The AUR rate was much less in the TURP-group (2.5% vs 15.8% p=0.001). Fewer immediate complications were noted in medical management (4.2% vs 18.3% p=0.002) although the majority of TURP complications were minor and self-limiting. Re-intervention of TURP was needed in 3.3 percent of the patients compared with 22.5 percent in the medical patients (p<0.001).

Conclusion: TURP is more effective rather than medical management in symptomatic relief, urodynamic and disease progression in Pakistani patients who have moderate to severe BPH. Although initial complication rates are greater, TURP is more effective in the long term and has reduced re-intervention rates, and hence is economical in a resource-restrained environment where late presentation with complications is prevalent.

Urodynamic Evaluation in Women with Chronic Lower Urinary Tract Symptoms

2026-02-16T15:14:50+03:00

Objective: The purpose of this is to describe urodynamic results of women with chronic lower urinary tract symptoms (LUTS), and relate patterns of clinical symptoms to objective urodynamic diagnoses in order to streamline diagnostic clinical trajectories.

Materials and Methods: A prospective observational study was undertaken on 248 women with chronic LUTS (>6 month’s duration) who were referred to the comprehensive urodynamic assessment. The study involved the participants going through standardized history, validated symptom questionnaires (ICIQ-FLUTS, UDI-6), completing bladder diary, and multichannel urodynamic studies based on International Continence Society (ICS) guidelines. Urodynamic indicators were filling cystometry, pressure-flow, leak point pressure, and detrusor overactivity, stress urinary incontinence and bladder outlet obstruction evaluation.

Results: The median age was 52.3 -12.7 years with a median of 4.2 -3.1 years of symptoms. Detrusor overactivity, urodynamic stress incontinence, and mixed urinary incontinence were detected in 41.9% (n=104), 38.3% (n=95) and 29.8% (n=74). Video-urodynamic diagnosis was carried out with the bladder outlet obstruction in 12.5% (n=31) cases. A significant correlation was identified between clinical urgency symptoms and detrusor overactivity (p<0.001), post-void residual volume greater than 100mL and voiding dysfunction (p=0.003), and stress leakage on physical examination and urodynamic stress incontinence (p<0.001). It is worth noting that on urodynamics, 34.7 percent of females with predominant symptoms of stress were found to be detrusor overactive.

Conclusion: Urodynamic assessment demonstrates massive discordance in clinical symptom patterns and objective findings in women with chronic LUTS. Urodynamic testing is a broader diagnostic test used in conjunction with clinical assessment especially in complicated or refractory cases, mixed incontinence presentation and potential voiding dysfunction. These results encourage the selective usage of urodynamics in the complicated female LUTS to inform the specific treatment measures.

Comparative Study of Surgical Wound Healing and Dermatological Complications in Diabetic Versus Non-Diabetic Orthopedic Patients

2026-02-17T09:10:11+03:00

Background: Diabetes mellitus is a majorsystemic condition known to impair woundhealing and increase susceptibility to
postoperative complications. Orthopedicsurgeries require optimal tissue repair, anddiabetic patients are at increased risk ofsurgical site infections and dermatological complications

Venous Thromboembolic Disease and Its Cutaneous Manifestations in Orthopedic Surgical Patients: A Cross-Sectional Study

2026-02-17T09:19:37+03:00

Background: Venous thromboembolicdisease (VTE), comprising deep veinthrombosis (DVT) and pulmonary embolism(PE), is a common and potentially fatalcomplication following orthopedic surgery.Early clinical recognition, including identification of cutaneous manifestations

A Review on progress in ADHD Disorder: From Characterization to Cause

2026-02-18T12:06:25+03:00

The science of attentiondeficit/hyperactivity disorder (ADHD) ismotivated by a translational goal – thediscovery and exploitation of knowledge about the nature of ADHD to the benefit ofthose individuals whose lives it affects

Comparative Evaluation of Single-Dose Intravenous vs. Dual-Route (Intravenous and Peri-articular) Tranexamic Acid in Total Knee Arthroplasty: A Randomized controlled trial study in a Tertiary Orthopaedic Centre

2026-02-18T12:09:24+03:00

Background: Minimizing perioperativehaemorrhage is critical for enhancingrecovery after total knee arthroplasty (TKA). While the efficacy of Tranexamic Acid(TXA) is well-documented, the clinicaladvantage of augmenting systemicadministration with local joint infiltration

Nomophobia –Mobile Phone Dependence, A Cross-Sectional Study Among Engineering Students of Raichur

2026-02-18T12:11:41+03:00

Background: Nomophobia (no-mobilephone phobia) is an emerging behavioraldependence associated with excessive smartphone use and adverse psychosocialoutcomes. Limited data exist fromengineering student populations

Outcomes and Postoperative Complications Following Debridement and Split-Thickness Skin Grafting for Lower Limb Wounds: A Case Series of 30 Patients from a Tertiary Care Institution

2026-02-20T13:03:28+03:00

Background: Lower limb wounds are an enormously high surgical burden, especially when complicated by infection and trauma or systemic comorbidities. Surgical debridement and split-thickness skin grafting (STSG) has been one of the keys to wound reconstruction. However, graft uptake and functional results are still affected by complications after surgery.

Case Presentation: This case series presents 30 patients treated in a tertiary care institution and who underwent surgical debridement of the wounds on the lower limbs and subsequently STSG. Patients ranged in age from 22 to 68 years of age and included wounds secondary to trauma, diabetic foot disease, post-infective necrosis and chronic non-healing ulcers. Comprehensive clinical evaluation, microbiologic assessment and optimization of comorbid conditions predicted operative intervention. All patients were subject to serial debridement until a healthy granulating wound bed was established, then STSG harvested from the thigh and applied over the wound and outcomes were documented.

Interventions and Outcomes: Postoperative results were analysed in reference to: graft uptake; wound healing time; infection; graft loss; haemorrhage; and donor site morbidity. Complete uptake of the graft was seen in 21 patients (70%). Partial graft loss occurred in six patients (20%) and complete graft failure occurred in three patients (10%). The most common complications observed after the operation were surgical site infection (16.7%), formation of seroma or hematoma (13.3%), and delayed healing of incision (20%). Patients with diabetes mellitus and peripheral vascular disease showed higher rate of complications.

Conclusion: Debridement followed by STSG remains an effective reconstructive option for lower limb wounds. However, postoperative complications are influenced by systemic comorbidities, wound etiology, and local wound conditions. Careful patient selection, meticulous surgical technique, and vigilant postoperative monitoring are critical to optimizing outcomes.

A COMPARATIVE STUDY BETWEEN PRIMARY RESECTION ANASTOMOSIS VERSUS HARTMANN`S PROCEDURE WITH COLOSTOMY IN PATIENTS OF LEFT SIDED COLONIC MASS PRESENTING WITH ACUTE INTESTINAL OBSTRUCTION– A PROSPECTIVE COMPARATIVE STUDY

2026-02-20T14:16:35+03:00

Background: Left-sided colonic masses commonly present as acute intestinal obstructionrequiring emergency surgical intervention. Hartmann’s procedure has traditionally beenconsidered the safer approach in emergency settings due to concerns regarding anastomotic leakage. However, it is associated with stoma-related morbidity

A COMPARATIVE STUDY ON PORT SITE INFECTIONS WITH AND WITHOUT USE OF AUTOCLAVED PLASTIC ENDOBAG DURING LAPAROSCOPIC CHOLECYSTECTOMY

2026-02-20T14:19:35+03:00

Background: Port site infection (PSI)remains an important postoperativecomplication of laparoscopiccholecystectomy (LC). Gallbladder
perforation and stone spillage

COMPARATIVE STUDY OF CONVENTIONAL POLYPROPYLENE MESH WITH ANATOMICAL 3D POLYPROPYLENE MESH IN TAPP IN ADULTS

2026-02-20T14:59:08+03:00

Background: Laparoscopic transabdominalpreperitoneal (TAPP) repair is widely performed for inguinal hernia. Conventionalflat polypropylene mesh requires mechanicalfixation using tackers

MAXIMAL VOLUNTARY VENTILATION VERSUS VITAL CAPACITY AS PREDICTORS OF EXERCISE CAPACITY IN HEALTHY YOUNG ADULT MALES: A CROSS-SECTIONAL STUDY

2026-02-21T11:28:31+03:00

Background: Exercise capacity reflectsintegrated cardiopulmonary function and isinfluenced by multiple physiologicaldeterminants, including pulmonary ventilatory reserve. While forced vitalcapacity (FVC) is routinely assessed

Clinical Serum Lipidomic Profiling Reveals Potential Lipid Biomarkers for Early Diabetic Retinopathy

2026-02-21T14:09:14+03:00

Diabetic Retinopathy (DR) is a major micro vascular complication of Diabetes Mellitus and a leading cause of preventable vision loss. Recent evidence suggests that disturbances in lipid metabolism occur before visible retinal damage develops. Lipidomic analysis enables comprehensive profiling of circulating lipid molecules and may assist in identifying novel indicators for early DR detection.

Objective: To analyze serum lipid variations associated with early diabetic retinopathy and explore their potential role as biomarkers for its early diagnosis.

Methods: A cross-sectional study was carried out on 60 type 2 diabetes mellitus (T2DM) patients—30 with early non-proliferative diabetic retinopathy (NPDR) and 30 without any retinal abnormalities. Serum lipidomics was performed using ultra-high-performance liquid chromatography coupled with tandem mass spectrometry (LC–MS/MS). Statistical and multivariate analyses were applied to identify significantly altered lipid species between the two groups.

Results: Distinct lipidomic alterations were identified in patients with early DR. Levels of lysophospha- tidyl cholines (LPCs), sphingomyelins (SMs), and ceramides (Cers) were significantly higher, while phosphatidylcholines (PCs) and certain triglycerides were reduced. Lipid species such as LPC (17:0), Cer(d17:1/24:0), and SM(d17:1/15:0) showed strong correlations with HbA1c and DR severity (p < 0.01). Combined ROC analysis of Cer(d17:1/24:0) and LPC(17:0) produced an AUC of 0.88, indicating excellent diagnostic accuracy.

Conclusion: Serum lipidomic analysis highlights early metabolic disruptions in DR. Elevated ceramide and lysophosphatidylcholine species may serve as promising biomarkers for the early identification of retinal microvascular injury. Incorporating lipidomic markers into diabetic screening could enhance early detection and risk assessment strategies.

MAXIMAL VOLUNTARY VENTILATION VERSUS VITAL CAPACITY AS PREDICTORS OF EXERCISE CAPACITY IN HEALTHY YOUNG ADULT MALES: A CROSS-SECTIONAL STUDY

2026-02-21T18:21:03+03:00

Background: Exercise capacity reflectsintegrated cardiopulmonary function and is influenced by multiple physiologicaldeterminants, including pulmonarventilatory reserve. While forced vitalcapacity (FVC) is routinely assessed

Hematological, clinical, cytogenetic and molecular profiles of confirmed chronic myeloid leukemia patients at presentation at a regional cancer centre of North Eastern India: a cross-sectional study.

2026-02-22T18:34:21+03:00

Background: The evidence on hematological, clinical, cytogenetic and molecular profiles among new CML patients arevery insufficient in the developing countries like India and more so in the North-eastern states.. Therefore, this study isperformed among newly confirmed CML patients at Atal Bihari Vajpayee Regional Cancer Center (ABV RCC), Agaratala, Tripura.

Evaluation of Oxidative Stress Markers (Tac, Tos, Gsh) In Patients with Copd and Their Correlation with Cardiovascular Risk

2026-02-23T09:14:16+03:00

Objectives: To evaluate oxidative stress markers—Total Antioxidant Capacity (TAC), Total Oxidant Status (TOS), and reduced glutathione (GSH)—in the patients with the chronic obstructive pulmonary disease (COPD) and to mainly determine their actual correlation with the cardiovascular risk.

Study Design and Setting: This descriptive cross-sectional study was conducted in the Department of Pulmonology and Internal Medicine, Jinnah Hospital, Lahore from 1 November 2024 to 30 April 2025.

Methodology: A total of 140 diagnosed COPD patients were mainly being enrolled using the consecutive sampling. Oxidative stress markers including the TAC, TOS, as well as serum GSH levels were measured using the standardized spectrophotometric form of methods. To aid in the estimation of the cardiovascular risk, the Framingham Risk Score (FRS) and assessment of the lipid profile and the blood pressure were counted. Cardiovascular risk parameters and the oxidative stress markers were analysed using correlation. All the participants were provided with informed consent and the ethical approval was obtained (ERC No: 2023-45).

Results: COPD patients demonstrated significantly elevated TOS levels and reduced TAC and GSH levels compared to reference values. It was discovered that patients with high risk cardiovascular patients were significantly higher in TOS (p<0.001) and significantly lower in TAC and GSH (p<0.001). TOS was exerting a strong negative connection with Framingham Risk Score (r= -0.58), TAC and GSH made mild negative correlations (r= -0.46 and r= -0.49 respectively).

Conclusions: COPD patients exhibit significant oxidative imbalance that correlates positively with cardiovascular risk.A possible indicator of assisting COPD patients (exposed to cardiovascular complications) could be the indicators of oxidative stress.

Metastatic Breast Cancer: A Correlation between Ki67, a Tumor Marker and Various Stages in Terms of age Groups

2026-02-23T10:03:32+03:00

Breast cancer is common most malignancy in multipara, premenopausal women The antigen Ki-67 plays important role in evaluating this condition biochemically. Being expressed in all phases of cell cycle (S, G1, G2, M) except GO.

METHODS: This cross-sectional design of the observational research on 283 patients was arranged and executed at JPMC (Jinah Postgraduate Medical Center). The hormone receptor status staging is done with immune-histochemical (IHC) staining. Ki-67, the nuclear antigen was assessed quantitatively as well as visually way using light microscopes.

Result: Most Cases belonged to stage -4 of the breast cancer followed by Stage -2 and stage-3. The biomarker KI 67 was more positive in 3rd and 4th stages.

Conclusions: Biological markers are good parameters to assess the progression of the breast cancer.

Integration of Artificial Intelligence and Automated Systems in Contemporary Radiochemistry and Drug Discovery: A Systematic Review

2026-02-23T14:07:10+03:00

Background: The recent breakthroughs in artificial intelligence (AI) and robotized technology have presented radical changes in radiochemistry and drug discovery with the results of the enhancement of choices accepted according to the data, the efficiency of an experiment and reduction of patterns of development. However, there is scanty comprehensive research done on their combined synergistic impact on these regions.

Objective: In line with the research question, the purpose of the paper and its abstract was to assess the efficacy, performance metrics, and translational capability of AI-driven and automated systems in the contemporary radiochemistry and drug discovery processes.

Methods: A total of 103 records focusing on systematic literature were searched in PubMed/MEDLINE, Scopus, Web of science, and IEEE Xplore and Google Scholar, in accordance with PRISMA 2020. Articles in the field of radiochemistry or drug discovery published between 2014 and 2024 that were exploring AI-based or other automated technologies were considered. Standardized tools were used to extract data and it was quality assessed. They were synthesized with the help of the thematic analysis and narrative synthesis methods to obtain results that pertain to synthesis efficiency, predictive accuracy, speed of development, reproducibility and cost reduction.

Results: A total of one hundred and six peer review articles were found and chosen. Radiochemical synthesis, optimized using AI, showed pooled radiochemical improvements in yield characterized by 32% (23-41) and significant improvements in the time spent in synthesis and increase in reproducibility. Pipelines in drug discovery using AI shortened the mean lead times on hitting and on pre-clinical development by 38 percent and increased efficiency of screening by 100 times. Robotic and automated systems showed better consistency in batch to batch and allowed close loop optimization. The analysis of correlation showed that there are strong positive correlations between the complexity of AI models, the extent of automation, and the general performance results.

Conclusion: The combination of AI-based and automated solutions will be a paradigm shift in radiochemistry and drug discovery, and will provide significant increases in efficiency and accuracy and scalability. The technologies make available closed-loop experimental workflows that are data-driven and have extensive potential implications on radiopharmaceutical production and pharmaceutical innovation. Large-scale clinical and industrialization requires prospective validation and alignment of efforts to establish regulatory harmonization.

Machine Learning–Driven Integration of Multi-Omics Data for Biomarker Identification in Rheumatoid Arthritis

2026-02-23T14:17:22+03:00

Purpose: In this study, the author explores the possibility of using multi-omics data combined with ML to identify biomarkers in RA, a chronic autoimmune disease characterized by chronic joint inflammation, destruction, and disability. The work specifically investigates novel biomarkers for putting into practice multi-omics (genomics, proteomics, and metabolomics) interfaced with machine learning algorithms to improve diagnostic accuracy, prognosis, and therapy management for RA patients. It becomes the direction of future RA omics and AI studies to enhance clinical efficacy and develop more effective therapeutic management.

Design/Methodology/Approach: The study elicits data from a cross-sectional survey of a sample of RA patients and HCPs using a closed set of standardized quantitative research questions. This research framework involves using existing RA datasets to combine multi-omics data, subsequently using Machine Learning algorithms to predict biomarkers and other molecular characteristics related to the disease. The questionnaire was also employed to obtain participants' perceptions on the possibility of applying multi-omics-based biomarker discovery in RA, its efficiency, and barriers to implementation. The survey was done among patients with RA, clinicians, and researchers to determine the clinician, patient, and researcher’s perception of using those technologies in clinical practice.

Implications: The current study demonstrated that using multi-omics data with machine learning can potentially improve RA research and management efforts. Concerning discovering new biomarkers that may help diagnose a condition earlier … technologies gave very high scores of interest. Machine learning models provided hypothesis generation and testing for many associations throughout the omics data and offered prognosis of disease course and treatment efficacy. However, data heterogeneity, technical issues, and the lack of large high-quality datasets were recognized as key barriers to the broader use.

Implications: The study has shown how multi-omics and machine learning integration need further advancement in RA biomarker identification. The study raises awareness of the need to enhance data availability, resolve the practical issues of integration between minus data, and implement explainable algorithms to aid decision-making. Experts in healthcare and research insist that strong guidelines should be established for omics data assessment to help integrate these tools into clinical practice in RA cases. In addition, assembling broader and more numerous datasets will be equally essential for increasing the efficiency of machine learning predictions.

Contribution/Novelty: The present paper fills the gap in applying precision medicine for rheumatoid arthritis by employing multi-omics integrated with machine learning. It sheds new light on how some of these third-generation technologies may be applied to biomarker discovery, prognosis, and RA’s individualized management. This study also stresses the need to effectively integrate, often, disciplinary, knowledge, and patient-oriented concerns in computational competence, clinical experience, and application of omics and AI in rheumatology.

Evaluating the Hypolipidemic and Hepatoprotective effects of Varying Doses of Gymnema sylvestre in dyslipidemia induced hepatic injury: Impact on Physiological Restoration"

2026-02-23T14:29:41+03:00

Background: Dyslipidemia and liver dysfunction are major contributors to metabolic disorders and cardiovascular risk. Herbal medicines such as Gymnema sylvestre have gained attention due to their traditional use and reported pharmacological activities, including lipid regulation and hepatoprotection. However, evidence regarding dose-dependent physiological restoration remains limited.

Objective: To evaluate the hypolipidemic and hepatoprotective effects of varying doses of Gymnema sylvestre and to assess their impact on physiological restoration.

Methodology: An experimental study was carried out using controlled groups receiving different doses of Gymnema sylvestre. Serum lipid profile parameters (total cholesterol, triglycerides, LDL, HDL) and liver function biomarkers (ALT, AST, ALP, bilirubin) were analyzed to determine dose-dependent effects and hepatic protection.

Results: Administration of Gymnema sylvestre resulted in significant, dose-dependent reductions in total cholesterol, triglycerides, and LDL levels, with a concomitant increase in HDL. Liver enzyme levels showed marked improvement, indicating reduced hepatic injury and restoration of normal liver function, particularly at higher doses.

Conclusion: The findings demonstrate that Gymnema sylvestre exerts significant hypolipidemic and hepatoprotective effects in a dose-dependent manner, supporting its therapeutic potential in the management of dyslipidemia and liver dysfunction.

Evaluation of Cardiac Biomarkers in Patients with Type 2 Diabetes and Subclinical Atherosclerosis: A Cross-Sectional Study

2026-02-23T14:50:22+03:00

Background: Cardiovascular risk in type 2 diabetes mellitus (T2DM) is heterogeneous, and atherosclerosis may evolve silently for years before clinical events. Circulating cardiac biomarkers—particularly high-sensitivity cardiac troponin I (hs-cTnI) and N-terminal pro–B-type natriuretic peptide (NT-proBNP)—may capture subclinical myocardial injury and wall stress that accompany early atherosclerotic disease. We evaluated associations between cardiac biomarkers and ultrasound-defined subclinical atherosclerosis in adults with T2DM without known atherosclerotic cardiovascular disease.

Methods: We performed a hospital-based cross-sectional study (January 2024–December 2024) enrolling adults with T2DM (age 40–75 years) without known coronary, cerebrovascular, or peripheral arterial disease. Subclinical atherosclerosis was defined as mean carotid intima–media thickness (CIMT) ≥0.90 mm and/or carotid plaque on B-mode ultrasonography. Biomarkers included hs-cTnI, NT-proBNP, and high-sensitivity C-reactive protein (hs-CRP). Associations with CIMT were tested using Spearman correlation and multivariable linear regression; predictors of subclinical atherosclerosis were evaluated using multivariable logistic regression and ROC analysis.

Results: Among 260 participants (mean age 58.9±8.7 years; 44% women), 118 (45.4%) met criteria for subclinical atherosclerosis. Median hs-cTnI and NT-proBNP were higher in the subclinical atherosclerosis group versus controls (hs-cTnI: 6.2 vs 3.8 ng/L; NT-proBNP: 112 vs 78 pg/mL; both p<0.001), while hs-CRP showed a smaller gradient (p=0.04). In adjusted models, log-hs-cTnI (adjusted OR 1.78, 95% CI 1.27–2.48) and log-NT-proBNP (adjusted OR 1.52, 95% CI 1.12–2.07) independently predicted subclinical atherosclerosis. A combined biomarker model improved discrimination (AUC 0.82) over clinical risk factors alone (AUC 0.73).

Conclusion: In T2DM without known ASCVD, hs-cTnI and NT-proBNP were independently associated with ultrasound-defined subclinical atherosclerosis and improved risk discrimination. Biomarker-informed vascular phenotyping may support earlier identification of high-risk diabetic patients for intensified prevention strategies.