International Journal of Pharmacy Research & Technology (IJPRT)

Flipped Classroom Model Versus Conventional Teaching in Neurology Clerkship: A Comparative Randomized Study

Mon, 16 Jun 2025 00:00:00 +0300

A randomized prospective study evaluated the educational impact of a flipped-classroom (FC)model versus conventional didactic teaching in a 4-week neurology clerkship among 104 medicalstudents. Participants were randomized to FC (n = 49)—comprising pre-class videos, readings

Assessing Long-Term Efficacy and Recurrence Rates of Endovenous Laser Therapy Compared to Surgical Stripping for Varicose Veins

Mon, 16 Jun 2025 00:00:00 +0300

A prospective randomized controlled trial evaluated long-term efficacy and varicose veinrecurrence in adults treated with endovenous laser therapy (EVLT; n = 100) versus surgicalstripping (SS; n = 100) of the great saphenous

Evaluation of Fecal Calprotectin as a Non-Invasive Marker of Disease Activity in Ulcerative Colitis

Mon, 16 Jun 2025 00:00:00 +0300

A cross-sectional analysis assessed the diagnostic accuracy of fecal calprotectin (FC) in 200ulcerative colitis (UC) patients undergoing surveillance colonoscopy. FC levels were comparedwith Mayo endoscopic subscore

Comparative Outcomes of Catheter Ablation and Antiarrhythmic Drugs in Elderly Patients with Atrial Fibrillation

Mon, 16 Jun 2025 00:00:00 +0300

In a prospective cohort of 400 elderly patients (≥70 years) with symptomatic atrial fibrillation(AF), 200 underwent catheter ablation

Pyrazoline Derivatives: Potential Therapeutic Agents against Parkinson's disease

Fri, 20 Jun 2025 00:00:00 +0300

Parkinson's disease (PD) is a neurodegenerative disorder that results in the gradual death of dopaminergic neurons in the human brain, leading to both motor impairment and a variety of non-motor symptoms. Pyrazoline is a heterocyclic compound known for its pharmacological spectrum and anti-inflammatory, antioxidant, and neuroprotective properties. Recent studies have highlighted its potential in modulating key pathways involved in PD, such as oxidative stress, mitochondrial dysfunction, and neuroinflammation, all of which are central to the progression of Parkinson's disease. These derivatives have shown promise in preclinical models by mitigating neuronal damage and preserving motor function, making them attractive candidates for further research. This review included the background on Parkinson’s disease, current treatment options, common synthetic route of Pyrazoline ring, current medicines used for the treatment of PD, and recent studies done on Pyrazoline ring as anti-Parkinson's.

Antibiotic Resistance Patterns in Pediatric and Adult Urinary Tract Infections

Tue, 24 Jun 2025 00:00:00 +0300

Antimicrobial resistance in urinary tract infections (UTIs) poses a major challenge to effectivetreatment across age groups. This cross-sectional study examined resistance patterns in 240patients (120 pediatric, age 1–17; 120 adult, age 18–75) presenting with culture-confirmed UTIs.

Clinical Outcomes of Resorbable vs. Titanium Plates in Mandibular Fracture Fixation: A Prospective RCT

Tue, 24 Jun 2025 00:00:00 +0300

A prospective randomized controlled trial compared clinical outcomes of resorbable versus
titanium plate fixation in mandibular fractures among 100 adult patients (aged 18–60 years) with
symphyseal or angle fractures

Forensic Investigation of Drowning, Biochemical Markers and Diatom Testing for Confirming Cause of Death. A cross-sectional study

Tue, 24 Jun 2025 00:00:00 +0300

A cross-sectional forensic study evaluated the utility of biochemical markers (serum surfactant D,NT-proBNP, D-dimer) and diatom quantification for confirming drowning as the cause of death.Eighty postmortem cases were investigated

Assessment of Patient Satisfaction and Pain Control in Regional Anaesthesia with and Without Sedation During Orthopaedic Procedures

Tue, 24 Jun 2025 00:00:00 +0300

A randomized controlled trial evaluated 180 adults undergoing elective distal-limb orthopaedicsurgery under regional anaesthesia (RA) with sedation (n=90) versus RA without sedation (n=90).Primary outcomes were patient satisfaction

Association of Serum Adiponectin and Leptin Levels with Glycemic Control in Type 2 Diabetes Mellitus

Tue, 24 Jun 2025 00:00:00 +0300

Emerging evidence implicates adiponectin and leptin in glucose homeostasis and metabolicregulation among individuals with type 2 diabetes mellitus (T2DM). The present experimentalstudy investigated their association with glycemic control in a cross-sectional cohort of 120 adult

Salivary Alkaline Phosphatase as a Non-Invasive Biomarker in Early Detection of Oral Submucous Fibrosis

Wed, 25 Jun 2025 00:00:00 +0300

Oral submucous fibrosis (OSF) is a chronic precancerous condition marked by progressive fibrosis
of the oral mucosa and restricted mouth opening. Early detection

Visual Recovery Following Primary Corneal Tear Repair in Penetrating Ocular Trauma: A Prospective Observational Study

Wed, 25 Jun 2025 00:00:00 +0300

Penetrating ocular trauma frequently results in corneal tears requiring urgent globe repair topreserve anatomical integrity and visual function. This study investigates the visual outcomesfollowing corneal tear repair in patients presenting with penetrating eye trauma.

A Randomized Trial on the Efficacy of Topical Estrogen vs. Vaginal Laser Therapy for Postmenopausal Vaginal Atrophy and Urinary Incontinence

Wed, 25 Jun 2025 00:00:00 +0300

A randomized controlled trial evaluated the efficacy of topical estrogen (TE) versus fractional CO₂
vaginal laser therapy (VLT) in treating postmenopausal vaginal atrophy (PVA) and urinary
incontinence (UI). One hundred twenty postmenopausal women

Visual Outcomes of Keratoprosthesis Versus Keratoplasty in Infective and Degenerative Corneal Opacifying Disorders

Wed, 25 Jun 2025 00:00:00 +0300

Infective and degenerative corneal opacities compromise visual acuity and pose therapeuticchallenges. This experimental comparative study evaluated visual outcomes of keratoprosthesis

Comparative Study of Analgesic and Haemodynamic Spectrum Of 0.5% Ropivacaine Vs 0.5% Levobupivacaine in Ultrasonography Guided Supraclavicular Brachial Plexus Block

Yogini Ramdas Adhau, Benhur Premendran, Pradeep Dhande, Sucheta Tidke — Sat, 14 Jun 2025 00:00:00 +0300

Background: Regional anesthesia via peripheral nerve blocks is widely used for providing effective intraoperative and postoperative analgesia in upper limb surgeries. The supraclavicular brachial plexus block offers reliable anesthesia for such procedures. Newer local anesthetics such as levobupivacaine and ropivacaine have been introduced to reduce cardiotoxicity concerns associated with bupivacaine while maintaining efficacy. This study aims to compare the analgesic efficacy and hemodynamic effects of 0.5% levobupivacaine versus 0.5% ropivacaine in ultrasound-guided supraclavicular brachial plexus blocks. Methods: A prospective, randomized, double-blind comparative study was conducted on 60 ASA grade I and II patients aged 20–60 years undergoing elective upper limb surgery. Patients were randomized into two groups: Group L received 0.5% levobupivacaine, and Group R received 0.5% ropivacaine via ultrasound-guided supraclavicular brachial plexus block. The onset and duration of sensory and motor blockade, time to first rescue analgesia, and intraoperative hemodynamic parameters (heart rate, blood pressure, oxygen saturation) were recorded and analyzed. Results: Group L (levobupivacaine) demonstrated significantly earlier onset of sensory (11.13 ± 1.00 min) and motor blockade (13.20 ± 1.12 min) compared to Group R (ropivacaine) with sensory onset of 13.60 ± 0.81 min and motor onset of 15.60 ± 0.81 min (p=0.0001). Duration of both sensory and motor blockade was longer in Group L. Time to first rescue analgesia was also significantly prolonged in Group L (11.80 ± 0.40 hours) versus Group R (10.20 ± 0.55 hours) (p=0.0001). Hemodynamic parameters remained stable and comparable between groups throughout the study with no significant adverse events. Conclusions: 0.5% levobupivacaine provides faster onset, longer duration of sensory and motor blockade, and prolonged postoperative analgesia compared to 0.5% ropivacaine in ultrasound-guided supraclavicular brachial plexus block, without significant hemodynamic compromise. Levobupivacaine is thus an effective and safe option for upper limb regional anesthesia.

Anatomical Variations of Renal Vessels- A Cadaveric Study with Clinical Relevance

Dr Amudalapalli S Narayana, Dr Kiran Kumar P, Dr Anitha T — Tue, 01 Jul 2025 00:00:00 +0300

Introduction: Blood supply to the kidneys is characterized by more frequent presence of variations in arteries and veins supplying them. Normally each kidney is supplied by single renal artery and drained by single renal vein. Variation in the number, origin, pathway and branching pattern of renal arteries is common. Frequently seen anatomical variation is additional renal artery. Aim: To identify the presence of variations of renal vessels in the human cadavers. Material and methods: An observational cadaveric study was conducted on 80 kidneys from 40 formalin-fixed human cadavers from 2019 to 2025 in the Department of Anatomy, Chalmeda Anandarao institute of medical sciences, Karimnagar, Telangana, India. The number of cadavers showing variations of renal vessels was determined. Results: The study included 80 kidneys from 40 formalin-fixed human cadavers. Eight (20%) cadavers were found to have variations in renal vessels while 32 (80%) cadavers show presence of single renal vessel going to each kidney. The double renal artery variations were present bilaterally in 01 (2.5%) cadaver and aberrant renal artery in 02 (5%) cadavers but both are in left side. The superior polar artery was present in 01 (2.5%) cadaver right side and inferior polar artery was present in 01 (2.5%) cadaver left side. Early divisions of renal artery were present in 2 (5%) cadavers. Accessory renal vein were present in right side 1 (2.5%) cadaver. Conclusion: Variations of renal vessels supplying to the kidneys it is necessary to have prior knowledge of them as now a day’s more number of patients is undergoing renal transplants, angiography procedures. The knowledge of these variations is also useful for treatment of renal trauma and tumors.

Foix–Chavany Marie syndrome-A rare entity

Wed, 02 Jul 2025 00:00:00 +0300

Foix–Chavany Marie syndrome (FCMS), is a rare cortical type of pseudobulbar palsy that results in paralysis of orofaciopharyngeal muscles, wwhilethe autonomic, involuntary, and reflexive functions of the above muscles are preserved. Here we present a case of 65-year-old right-handed male patient presented with sudden inability to speak and swallow, or move the tongue, along with difficulty in chewing. While his verbal and reading comprehension were intact, and he communicated through writing and gestures. Neurological examination showed preserved pupillary and corneal reflexes, normal extraocular movements, and loss of voluntary facial and tongue motor control. Early recognition and comprehensive management, including supportive therapy and addressing underlying conditions, are paramount for optimising patient outcomes.

Exploring Skin Manifestations in Women with Polycystic Ovary Syndrome: A Cross-sectional Analysis.

Savita Pannu Rathi, Punit Pratap, Pravesh Yadav — Mon, 30 Jun 2025 00:00:00 +0300

Polycystic ovary syndrome (PCOS) is a complex multisystem metabolic disorder thatsignificantly affects fertility and overall quality of life. Cutaneous manifestations suchas acne, hirsutism, androgenetic alopecia,

A STUDY OF GROWTH PARAMETERS IN THE BABIES BORN TO HYPOTHYROID MOTHERS

Dr Rajesh Rathi, Dr Monica Deswal, Dr Savita Pannu Rathi — Mon, 30 Jun 2025 00:00:00 +0300

Background: Normal maternal thyroid function is crucial for fetal growth andneurocognitive development. Intrauterine growth restriction (IUGR) is a multifactorialcondition resulting from maternal, placental, or fetal factors. Any imbalance in maternalthyroid function may adversely affect both mother and fetus.

Sustainable Development, Green Chemistry, and Its Applications

Thu, 03 Jul 2025 00:00:00 +0300

Green chemistry (GC)–the design of chemical processes that reduce or eliminate hazardous substances – provides a framework for achieving sustainable development in industry and technology. This review summarizes recent advances (2020–2024) and emerging trends in green chemistry, highlighting how new catalysts, solvents, and biotechnologies are enabling cleaner processes. Key topics include alternative solvents (water, supercritical CO₂, ionic liquids, deep eutectic solvents), novel catalysts (metal, photocatalytic, and biocatalytic systems), and renewable feedstocks (biomass, CO₂). We discuss case studies such as plant-based PET (“Plant Bottle”) and biodegradable polymers, and note how industry adoption of GC principles has already reduced waste and emissions. We also examine current challenges – economic, regulatory, and technical barriers that slow implementation – and outline future directions (AI-driven process design, electrification of synthesis, circular economy). The content is presented for an audience of chemistry and environmental science students, with references to recent literature.

A Case Controlled Trial Comparing Biologic Therapy vs. Immunomodulators in Moderate-to-Severe Crohn’s Disease

Mon, 30 Jun 2025 00:00:00 +0300

Moderate-to-severe Crohn’s disease (CD) remains therapeutically challenging, with escalatingcosts and variable outcomes between biologic and immunomodulator (IMM) strategies. Thepresent case-controlled trial enrolled 120 adult patients with active

Visual outcomes of medical and surgical modalities in secondary glaucomas (inflammatory vs pigmentary) compared to primary open-angle glaucoma. A multi-factorial comparative study

Mon, 30 Jun 2025 00:00:00 +0300

Secondary glaucomas, particularly inflammatory glaucoma (IG) and pigmentary glaucoma (PG),demonstrate greater clinical variability and treatment complexity compared to primary open-angleglaucoma (POAG). This prospective, multifactorial cohort study

A Histological Study of Myocardial Fiber Disruption and Serum CK-MB in Ischemic Heart Disease

Mon, 30 Jun 2025 00:00:00 +0300

Ischemic heart disease (IHD) precipitates disruption of myocardial fiber integrity and elevatesserum creatine kinase–MB (CK-MB), yet precise correlation remains underexplored. In thisexperimental study, myocardial biopsy specimens from 60 adult patients undergoing coronaryartery bypass grafting were compared

Efficacy of Bile Acid Sequestrants in Treating Bile Acid Diarrhea: A Double Blind, Placebo-Controlled RCT

Mon, 30 Jun 2025 00:00:00 +0300

A double-blind, placebo-controlled randomized clinical trial evaluated the efficacy of colesevelam1.875 g twice daily in adults with bile-acid diarrhea (BAD) confirmed by SeHCAT retention≤10 %. Eighty participants were randomized

Assessment of Pulp Vitality Using Pulse Oxymetry Versus Electric Pulp Testing in Traumatized Teeth

Mon, 30 Jun 2025 00:00:00 +0300

A randomized clinical trial evaluated diagnostic accuracy of pulse oximetry (PO) versus electricpulp testing (EPT) in 80 traumatized permanent incisors. Participants were randomized to testingat 1 week, 1 month, and 3 months post-trauma. Primary outcomes included pulp vitality status

Assessing the Benefits of Mobile Application-Based Psychoeducation for Patients with Schizophrenia: A Randomized Controlled Trial

Mon, 30 Jun 2025 00:00:00 +0300

A randomized controlled trial evaluated the efficacy of a mobile application–basedpsychoeducation program for improving treatment adherence and symptom management among120 adult patients with schizophrenia. Participants were allocated to either the interventiongroup—receiving eight weeks of daily

Evaluation of Idiopathic Late Onset Nephrotic Syndrome in Children

Dr. P. Ravindranath Reddy, Dr. Grace Aparanji, Dr. D. Nagarjuna — Mon, 07 Jul 2025 00:00:00 +0300

Introduction: Idiopathic nephrotic syndrome is defined by the combination of a nephrotic syndrome (proteinuria, hypoalbuminemia, hyperlipidemia, and edema) and non-specific histological abnormalities of the kidney. The prevalence of NS is estimated at 2 to 7 per 100,000 children around the world. Children between 2 to 7 years of age get affected by this condition more often, particularly boys.

Materials and Methods: A Retrospective study of hospital records. Case sheets of children admitted in department of pediatrics, Government General Hospital, Kurnool with nephrotic children above the age of 10 years From January 2020 to December 2024. Children aged more than 10 years at onset fulfilled in the diagnostic criteria for nephrotic syndrome were included in the study. Secondary causes of nephrotic syndrome. (eg:SLE, Hepatitis B/C, Diabetic mellitus) were excluded from the study. Clinical data including age at onset, gender, presenting sympotoms and laboratory findings will be recorded histopathlogical finding will be categorized. Treatment response to steroids will be evaluated.

Results: The study included 108 children who were followed for a minimum duration of one year. The mean (±sd) age of the population was 13.3 (±1.4) years. The gender distribution of the population was males accounting for 66.7% and females at 33.3%. Hypertension was observed in 8(14.8%). Haematuria in microscopy was found in 28 (51.9%) study participants. Anti-Nuclear Antibodies investigation was done for 50 children and only 3(5.6%) were found to be positive. After the six weeks of steroidal therapy complete remission was found in 58 (53.7%) participants. No remission and partial remission were observed in 26 (24.1%) and 24 (22.2%) members of the study population respectively. Based on the response to steroidal therapy the participants were diagnostically classified as SRNS in 52 (48.1%) children followed SSNS in 50 (46.29%) children.

Conclusion: In our study most of the patients were diagnosed with SRNS and SSNS, and most common histological findings were MCNS, MES HC, FSGS and MESPGN. Late onset NS has higher frequency of atypical features, steroid resistance, and histopathology showing lesions other than MCD. Early biopsy may be useful guide to management.

ESOPHAGEAL LEIOMYOSARCOMA PRESENTING WITH RECURRENT LARYNGEAL NERVE PALSY AND GREAT VESSEL ENCASEMENT: A CASE REPORT

Dr Indujaa Rajkumar, Dr Baskar A, Dr G Murugan — Tue, 08 Jul 2025 00:00:00 +0300

Background: Esophageal leiomyosarcoma is an extremely rare malignancy of the esophagus of esophageal tumors) and typically presents with dysphagia and weight loss in middleaged or older patients. Hoarseness of voice due to recurrent laryngeal

Histomorphological Evaluation of Vitamin E’s Protective Role Against Bisphenol A-Induced Testicular Toxicity in Wistar Rats

Sadia Saqib, Nadia Haq, Raafea Tafweez, Ahmed Fawad Syami, Irfan Ali — Tue, 08 Jul 2025 00:00:00 +0300

Bisphenol A (BPA) exposure has been broadly implicated in male reproductive dysfunction,primarily via oxidative damage to testicular tissues. This experimental study aimed to evaluatetesticular histomorphological alterations induced

COMPARATIVE STUDY OF TARLEKAR’S ABHYANGA NASO LACRIMAL SNAN (BATH) VERSUS LACRIMAL SAC SYRINGING AFTER ENDONASAL DACRYOCYSTORHINOSTOMY (DCR)

Major Dr Ganesh Mohan Tarlekar (R), Sandesh Baburao Bagadi — Tue, 08 Jul 2025 00:00:00 +0300

Background: Endonasal dacryocystorhinostomy (DCR) is a widely performed surgery fornasolacrimal duct obstruction. Postoperative care typically involves lacrimal sac syringing tomaintain ostium patency, but this can be uncomfortable and requires

EVALUATION OF THE EFFICACY OF BUPIVACAINE WITH CLONIDINE IN BILATERAL SUPERFICIAL CERVICAL PLEXUS BLOCK FOR THYROID SURGERY- A PROSPECTIVE OBSERVATIONAL STUDY

Dr. P. Rajkumar, Dr. M. Bhaskar, Dr. S. Manojkumar, Dr. K. Murugesan — Tue, 08 Jul 2025 00:00:00 +0300

Background: Effective postoperative pain management is crucial for patients undergoingthyroid surgery to improve recovery and satisfaction. Systemic opioids, a traditional methodfor pain relief, are often associated with adverse effects like nausea, respiratory depression, andvomiting. A superficial cervical plexus block offers an alternative by providing targeted pain

COMPARATIVE STUDY OF INTRAVENOUS PARACETAMOL AND TRAMADOL IN MANAGEMENT OF POST-OPERATIVE ANALGESIA IN PERCUTANEOUS NEPHROLITHOTOMY- RANDOMIZED CLINICAL STUDY

Wed, 09 Jul 2025 00:00:00 +0300

Postoperative pain is a critical aspect of surgical recovery, especially inprocedures like percutaneous nephrolithotomy (PCNL), where inadequate pain managementcan delay healing and increase complications. Common analgesics such as intravenous

EFFICACY OF STANDALONE ORAL METHYLCOBALAMIN IN THE MANAGEMENT OF DIABETIC DISTAL SYMMETRIC POLYNEUROPATHY IN INDIA: A SYSTEMATIC REVIEW

Dr Himadri Pathak, Dr Mukuta Medhi — Thu, 10 Jul 2025 00:00:00 +0300

Background: Diabetic distal sensory Polyneuropathy (DSPN) is an annoying and disablingcomplication of long standing type 2 diabetes mellitus (T2DM). These patients are also deficient invitamin B12. Methylcobalamin (MeCbl), an active form of vitamin B12, is widely used in Indiaespecially by prim

Comparison of Mifepristone-Misoprostol versus Dinoprostone-Misoprostol for Second-Trimester Pregnancy Termination: A Randomized Controlled Trial

Dr Mandeep Bayan — Sat, 12 Jul 2025 00:00:00 +0300

Background: Second-trimester abortions account for 10–15% of induced abortions globally.Misoprostol is widely used due to its efficacy and accessibility, with sublingualadministration often preferred for convenience. Cervical priming with oral mifepristone(inducing collagen breakdown) or endocervical Dinoprostone/PGE2 gel (promoting cervicalremodelling) may improve outcomes, but comparative data are limited.

Ophthalmic Artery Pulsatility Index Between 24–34 Weeks as a Diagnostic Predictor for Late-Onset Preeclampsia: High ROC Accuracy Despite Non-Significant Mean Differences

Thu, 26 Jun 2025 00:00:00 +0300

Background: Late-onset preeclampsia remains a diagnostic challenge. Maternal ophthalmic arteryDoppler Pulsatility Index (PI) has emerged as a non-invasive surrogate marker for systemic vascularresistance

Camouflaged Myasthenia Gravis: Case Report

Sat, 12 Jul 2025 00:00:00 +0300

Myasthenia Gravis is an anti-acetylcholine receptor antibody-mediated neuromuscular junction disorder. Fluctuating fatiguability, diplopia, ptosis, dysphagia, and dysphonia are characteristic symptoms seen in patients with this disorder. Although uncommon, this illness can affect any skeletal muscle, from those in the neck to the proximal muscles of the limbs. Very few cases of myasthenia manifesting as neck weakness only have been documented.

Comparison of ccq, cat score & bode index in assessing severity and exacerbations of copd - a comprehensive study

Sat, 12 Jul 2025 00:00:00 +0300

Background: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality worldwide. While spirometry remains the cornerstone for diagnosis, it does not adequately capture symptom burden or predict quality of life. Hence, tools like the Clinical COPD Questionnaire (CCQ), COPD Assessment Test (CAT), and BODE Index have been developed to offer a more comprehensive assessment of disease severity and progression. This study aimed to compare these tools in evaluating severity and exacerbations among COPD patients.

Methods: A cross-sectional study was conducted on 60 COPD patients attending PES Institute of Medical Sciences & Research, Kuppam. Participants were assessed using CAT, CCQ, and BODE Index. Spirometry was used to determine FEV₁ levels. Statistical analysis was done using SPSS software. Pearson correlation and Chi-square tests were applied to analyze associations between scoring tools and FEV₁ values.

Results: Most participants were male (75%) and aged above 60 years. Smoking (70%) and biomass fuel exposure (36.7%) were common risk factors. The most frequent FEV₁ category was mild obstruction (43.3%). Strong positive correlations were found between CCQ and CAT (r = 0.788), CCQ and BODE Index (r = 0.759), and CAT and BODE Index (r = 0.766), all statistically significant (p < 0.01). Significant associations were observed between all three scoring tools and spirometric severity.

Conclusion: CCQ, CAT, and BODE Index are strongly correlated and effective in assessing COPD severity. These tools offer practical alternatives to spirometry in evaluating symptom burden and predicting functional status. Their integration into clinical practice can enhance comprehensive management of COPD patients.

Serum N-Terminal Pro-Brain Natriuretic Peptide, D-Dimer Levels In Community-Acquired Pneumonia and Its Correlation with CURB-65 as a Prognostic Marker

Sat, 12 Jul 2025 00:00:00 +0300

Background: Community-acquired pneumonia (CAP) is a common medical condition, especially in older adults, and is usually associated to systemic inflammatory response syndrome (SIRS). The study aimed to study serum N-terminal pro-brain natriuretic peptide (NT -probnp) and D-dimer levels in community acquired pneumonia and its correlation with CURB-65 as a prognostic marker.

Methods: A prospective study was conducted for 18 Months among 96 patients admitted with community-acquired pneumonia. All eligible patients underwent relevant investigations like renal function tests, liver functions tests, complete blood count, blood –culture and sensitivity, sputum or tracheal aspirate – gram stain, culture and sensitivity, ECG, Chest X ray, USG abdomen. The scoring will be done in these patients to assess the severity and the need for admission in these patients including CURB 65 and PSI.

Results: Among 96 patients, Comorbidities are present in 67% of the study population. The mean and SD NT pro-BNP levels are 336.58±109.78pg/ml. Survivors' mean NT-proBNP levels were 321.37 pg/ml. 425.71 pg/ml with an SD of 108.74 pg/ml are found in non-survivors. Survivors have mean D-dimer levels of 1410.39 ng/ml, while non-survivors have mean D-dimer levels of 2334.29 ng/ml with SD of 1173.00 ng/ml.

Conclusions: The values of NT proBNP and D-dimer in the survivors of patients with higher CURB-65 are lower in this study and in non survivors even with a lower CURB-65 the values of D-dimer and NT pro BNP are higher indicating that NT pro BNP and D-dimer levels are slightly better in predicting the mortality and prognosis which is statistically significant.

A role of MR Elastography in Assessment of Liver Fibrosis in North in India in tertiary care centre

Dr Karan Singh, Dr Phool Singh Sagar, Dr Aneeta Agrahari — Thu, 26 Jun 2025 00:00:00 +0300

Background: Liver fibrosis is a common outcome of various chronic liver diseases,including viral hepatitis, alcohol-related liver disease, and non-alcoholic fatty liverdisease (NAFLD). If left untreated, progressive fibrosis can lead to cirrhosis

Comparative Efficacy of Oral Clonidine versus Intravenous Esmolol for Attenuating the Pressor Response to Laryngoscopy and Tracheal Intubation: A Randomised Controlled Trial

Mon, 14 Jul 2025 00:00:00 +0300

Background: Direct laryngoscopy and endotracheal intubation elicit a brisk sympathetic surge that may precipitate myocardial ischaemia or cerebrovascular events in high-risk patients. Although several pharmacologic strategies exist, the relative effectiveness of an α<sub>2</sub>-agonist versus an ultra-short-acting β-blocker in routine elective surgery remains uncertain.

Objective: To compare the haemodynamic-stabilising efficacy and safety of oral clonidine (2 µg kg⁻¹) and intravenous esmolol (0.5 mg kg⁻¹) administered before anaesthetic induction.

Methods: In this single-centre, parallel-group trial, 116 ASA I–II adults (18–60 y) scheduled for elective surgery under general anaesthesia were randomised to receive clonidine 90 min pre-induction (Group C, n = 58) or esmolol 90 s pre-intubation (Group E, n = 58). Standardised anaesthesia (fentanyl–propofol–atracurium, sevoflurane MAC 1•0) was used. Heart rate (HR), systolic (SBP), diastolic (DBP) and mean arterial pressure (MAP) were recorded at baseline, post-induction, immediately after intubation, and 1, 3, 5, 7 and 10 min thereafter. Primary end-points were peak HR and SBP within 3 min of intubation.

Results: Baseline variables were comparable. Peak HR (mean ± SD) rose to 92 ± 6 bpm in Group E but fell to 66 ± 5 bpm in Group C (p < 0.001). Corresponding SBP values were 143 ± 8 vs 116 ± 8 mmHg (p < 0.001). MAP, DBP and rate-pressure product followed similar patterns. Haemodynamics in Group C returned to baseline by 10 min; Group E remained significantly elevated. No clinically important bradycardia, bronchospasm or hypotension occurred.

Conclusions: A single pre-operative oral dose of clonidine 2 µg kg⁻¹ provides superior attenuation of intubation-induced tachycardia and hypertension compared with esmolol 0.5 mg kg⁻¹. Clonidine is a simple, inexpensive, and well-tolerated option for routine adult elective surgery.

Examining the Link between Serum Uric Acid Levels and Coronary Artery Disease (CAD) Severity in Patients Undergoing Elective Coronary Angiography

Mon, 14 Jul 2025 00:00:00 +0300

Background: High serum uric acid (SUA) is prevalent in subjects with obesity, renal disease, glucose intolerance, hyperlipidemia, hypertension, and atherosclerosis, all of which are established risk factors for coronary artery disease (CAD). Uric acid is a significant antioxidant in the initial atherosclerosis but can potentially switch to a pro-oxidant in advanced cases, depending on the factors like tissue acidity and oxidative stress. This paradoxical behavior, in addition to its association with inflammation and insulin resistance—a characteristic of metabolic syndrome—requires further investigation. Therefore, the aim of this study was to examine the relationship between SUA levels and the presence and severity of CAD.

Study design: An observational cohort study.

Duration and place of study: This study was conducted in People’s University of Medical and Health Sciences Nawabshah (PUMHS) from January 2023 to January 2024.

Objective: To explore the relationship between serum uric acid level and the presence and seriousness of coronary artery disease (CAD) in individuals undergoing elective coronary angiography

Methodology: This cohort study of 200 consecutive hospitalized patients with CAD symptoms, all undergoing elective coronary angiography, was observational. Patients were divided into CAD-positive (with stenosis) or CAD-negative (without stenosis) groups according to their angiographic findings. CAD severity was graded using the Gensini grading system, and two blinded cardiologists assessed the angiograms. Risk factors like age, gender, smoking, diabetes, hypertension, hyperlipidaemia, family history, and hyperuricemia were documented and biochemical tests such as lipid profiles, fasting glucose, and uric acid were performed employing routine methods after 10 hours.

Results: Observational cohort study included 200 patients who underwent coronary artery disease (CAD) assessment via coronary angiography. Out of these, 175 had CAD, whereas 25 did not. CAD patients had significantly higher levels of blood uric acid compared to non-CAD patients (358.23 µmol/L vs. 251.32 µmol/L, p < 0.001). In accordance with logistic regression analysis, elevated levels of uric acid, smoking, decreased levels of HDL-C, and hypertension were all significantly related with the presence of CAD. These findings reflect a significant correlation between elevated serum uric acid and the presence and seriousness of CAD.

Conclusion: In short, serum uric acid level was significantly correlated with the presence and seriousness of coronary artery disease (CAD).

Evaluating the Relative Risk of Pulmonary Microaspiration in Sedated Versus Intubated Patients During ERCP Procedures

Mon, 14 Jul 2025 00:00:00 +0300

Objectives This study aims to compare the risk of pulmonary microaspiration in patients undergoing ERCP under general anesthesia versus deep sedation.

Study design: Prospective comparative study

Duration and place of study: This study was conducted in Liaquat National Hospital and Medical College Karachi from December 2022 to December 2023

Methodology: One hundred and fifty patients (ASA I-III) undergoing ERCP were selected and randomly distributed in two groups of 75 each: Group I (n= 75) received a general anesthesia (endotracheal intubation) and Group S (n = 75) received deep sedation. All patients were carefully observed in a high-dependency unit (HDU) within 48 hours after the procedure to detect the symptoms of hypoxia. The number of chest CT scans was also taken 48 hours after ERCP to determine if there are new pulmonary infiltrates that indicate microaspiration.

Results: Similarly, evidence of microaspiration on CT was much more severe in the sedation group (24%) than in the intubation group (5.3%), at a p-value of 0.002. Although postoperative hypoxic incidents were seen more frequently in sedation group (26.6%) compared to intubated group (6.6%), the difference was found statistically significant with p-value 0.001. Microaspiration was observed to a greater extent in patients in the sedation group who were between 65 years and more (50%) than in the younger category (6.7%) with a p-value of 0.0008. Other parameters that included incidences of postoperative fever, cough, tachypnea, or obligation to oxygen therapy were alike in the two groups.

Conclusion: The prevalence of postoperative CT alterations that seemed suggestive of microaspiration was increased in sedated patients compared to patients with tracheal intubation who underwent ERCP, especially those aged 65 or more. This notwithstanding, there were no clinical evidences of overt chest infection in any of the groups. These are the findings that advocate that one should be cautious in the selection of patients and close observation in the postoperative period in choosing deep sedation as an option in ERCP.

Impact of Type and Duration of Alcohol Consumption on the Severity and Outcomes of Alcoholic Liver Disease in Women

Dr. Suraj Bhutada, Dr. Snehal Pallod — Mon, 14 Jul 2025 00:00:00 +0300

Background: The prevalence of alcoholic liver disease (ALD) in women has increased over the past decades, mirroring shifts in drinking patterns and social norms. Women are known to be more susceptible to alcohol-related liver injury at lower consumption thresholds than men. Yet, the specific impact of the type and duration of alcohol intake on ALD severity, progression, and clinical outcomes in women remains understudied.

Methods: In this prospective observational study, we enrolled 160 adult women with ALD from a tertiary care center. Detailed alcohol use histories, including type of alcoholic beverage (wine, Desi Darus, beer) and duration of heavy drinking, were obtained. Baseline assessments included clinical evaluation, liver function tests, and imaging studies. Patients were followed for two years to assess disease progression and outcomes, including decompensation events, hospitalization, and mortality. Multivariate analyses examined the relationships between beverage type, duration of heavy drinking, severity of ALD (fibrosis stage, MELD score), and clinical endpoints.

Results: At baseline, mean age was 48.5 ± 9.2 years. Women who primarily consumed Desi Darus had more advanced fibrosis and higher MELD scores compared to those favoring wine or beer (p<0.01). A prolonged duration (>10 years) of heavy alcohol intake correlated with higher rates of cirrhosis and hepatic decompensation (p<0.001). After adjusting for confounders such as BMI and viral co-infections, both beverage type and drinking duration independently predicted disease severity. During follow-up, patients with long-term Desi Darus intake experienced higher rates of variceal bleeding and hepatic encephalopathy, leading to increased hospitalizations and mortality.

Conclusion: In women with ALD, both the type and duration of alcohol consumption significantly influence disease severity and clinical outcomes. Desi Darus consumption and prolonged heavy drinking pose a greater risk for advanced liver damage and worse prognosis. Recognizing these patterns may guide more tailored interventions and preventive strategies.

A Forward-Looking Study on the correlates of Postoperative Pain after Retrograde Intrarenal Surgery with FANS for Kidney Stones

Dr. Kaustubh Gupta, Dr. Akash Verma, Dr. Nishant Ranjan, Dr. Nikhil Kumar Gupta — Mon, 14 Jul 2025 00:00:00 +0300

Background: Retrograde Intrarenal Surgery with FANS (flexible and navigable suction ureteric access sheath) is increasingly favored for treating renal calculi due to its minimally invasive nature and high stone-free rates. Despite reduced morbidity compared to traditional methods, postoperative pain remains a challenge. This prospective study aimed to evaluate patient-related, stone-related, and operation-related factors that predict severe postoperative pain following RIRS with FANS.

Methods: A total of 97 patients (aged 18–65) with radiologically confirmed renal stones underwent RIRS at our center between March 2021 and September 2022. Preoperative data included demographics, stone characteristics (number, size, location, density), hydronephrosis, and stent status. All procedures utilized a 7.5 Fr flexible digital ureteroscope, Holmium:YAG laser lithotripsy and 10/12 fr flexible and navigable suction ureteric access sheath . Postoperative pain was assessed via the Visual Analogue Scale (VAS) at 6, 12, and 24 hours. Patients requiring additional analgesia with VAS ≥7 were categorized as having severe pain (Group II), whereas those with VAS <7 were grouped as mild pain (Group I). Associations between potential predictors and pain scores were analyzed using SPSS version 25 (p<0.05 was considered significant).

Results: Among the 97 participants, 84.5% had VAS <7 (Group I) and 15.5% reported VAS ≥7 (Group II). No significant differences were noted in age, gender, stone location, stone size, or preoperative hydronephrosis between the groups (p>0.05). Two operation-related factors emerged as significant: smaller-diameter ureteral access sheaths (p=0.027) and prolonged sheath indwelling time exceeding 60 minutes (p=0.043) correlated with higher postoperative pain.

Conclusion: Technical factors—namely ureteral access sheath size and sheath indwelling time—were key predictors of postoperative pain following RIRS with FANS. Identifying high-risk patients preoperatively may guide refined surgical approaches and more targeted analgesic protocols, ultimately improving patient comfort and overall satisfaction.

Comparison of Low-Dose Granisetron (0.1 Mg) and Dexamethasone (8 Mg) With Ondansetron (4 Mg) and Dexamethasone (8 Mg) for Prevention of Postoperative Nausea and Vomiting Following Laparoscopic Surgery

Dr. Abhinav Banerjee, Dr. Gesu Mehrotra — Mon, 14 Jul 2025 00:00:00 +0300

Background: Postoperative nausea and vomiting (PONV) are common complications following laparoscopic surgery, adversely affecting patient recovery and satisfaction. Effective prophylaxis is essential to enhance postoperative outcomes.

Methods: This double-blind, prospective, randomized study was conducted at the Department of Anaesthesia and Critical Care, Tata Main Hospital, Jamshedpur. Eighty adult patients (ASA I-II, aged 18-60 years) undergoing elective laparoscopic surgery under general anesthesia were randomized into two groups. Group I received dexamethasone 8 mg and ondansetron 4 mg intravenously, while Group II received dexamethasone 8 mg and granisetron 0.1 mg intravenously. PONV incidence, nausea scores (Verbal Rating Scale), vomiting episodes, rescue antiemetic and analgesic requirements, and side effects were monitored at multiple postoperative intervals up to 48 hours.

Results: Group A (dexamethasone + ondansetron) demonstrated significantly lower nausea scores at 30 minutes, 1 hour, 2 hours, and 4 hours postoperatively (p<0.05). The incidence of moderate to severe nausea was higher in Group B (dexamethasone + granisetron) (p=0.01). Complete response rates were significantly greater in Group A (20%) compared to Group B (5%) (p=0.01). The requirement for rescue antiemetics was higher in Group B (30% vs. 10%, p=0.01). No significant differences were observed in vomiting incidence or side effects between the groups.

Conclusion: The combination of low-dose granisetron (0.1 mg) with dexamethasone (8 mg) is less effective than ondansetron (4 mg) with dexamethasone (8 mg) in preventing PONV following laparoscopic surgery. Ondansetron with dexamethasone provides superior prophylaxis, resulting in lower nausea scores and reduced need for rescue antiemetics.

To Estimate the Risk of Cardiovascular Disease in Healthcare Workers

Mon, 14 Jul 2025 00:00:00 +0300

Background: A major cause of mortality around the world, cardiovascular diseases (CVDs) are most prevalent in countries like South Asia, Central Asia, and Eastern Europe, including Pakistan, with a twin disease burden of communicable and non-communicable disease. HCWs, even though they are at the forefront of fighting CVDs, are most vulnerable because of work-related stress and uneven shifts. By employing the QRISK2 calculator, in the present research CVD risk among healthcare workers is attempted to be measured. By identifying those at risk, special measures can be implemented for their well-being over the long term and their capacity to provide high-standard treatment.

Study Design: A descriptive cross-sectional study.

Duration and Place of Study: This study was conducted in People’s University of Medical and Health Sciences for Women Nawabshah from February 2024 to February 2025.

Objective: To estimate the risk of cardiovascular disease in healthcare workers.

Methodology: In this cross-sectional descriptive study, 200 health profession workers aged 25-60 years had their cardiovascular disease (CVD) risk factors determined. Biochemical and modified QRISK2 questionnaires were used to gather data. Demographic, lifestyle, and physiological variables were processed with SPSS 22. Descriptive statistics, Chi-square, and Independent Sample T-tests were used, with p<0.05 as the level of significance. To establish study validity, ethical approval and informed consent were sought.

Results: Using the QRISK2 calculator, the cardiovascular disease (CVD) risk was estimated in 200 health care workers (HCWs). They were predominantly men aged 36 years on average. Paramedics, light smokers, males, and individuals with diabetes or a positive family history were at increased risk of CVD. Very few of them were categorized as high-risk subjects, and the majority were low-risk. The findings indicate the need for individually addressed preventative measures in the at-risk groups among the healthcare workers.

Conclusion: Healthcare workers involved in this research had a low overall risk of cardiovascular disease (CVD).

Determinants of Survival and Mortality Patterns in 99 Consecutive Burn Admissions at a North-Indian Tertiary Network: A Retrospective Cohort Study

Dr Anubhav Goel, Dr. Prakhar singh, Dr. Shivam khandelwal, Dr Nikhil — Mon, 14 Jul 2025 00:00:00 +0300

Background. Burns remain a major cause of injury in low- and middle-income countries, yet granular outcome data from North-Indian districts are scarce.

Methods. We retrospectively analysed 99 consecutive acute thermal-injury admissions (January 2023 – March 2024) to four linked tertiary units in western Uttar Pradesh. Demographic, clinical-burn and outcome variables were extracted from prospectively maintained ward registers and validated against referral slips. Primary outcome was in-hospital survival; secondary outcomes were timing and proximate cause of death. Categorical data were compared with χ² or Fisher’s exact test and continuous variables with t- or Mann–Whitney-U tests; p<0.05 was significant.

Results. Mean age was 32 ± 15 years (range 10 months–75 years); 57 patients were male (57.6%). Median total body surface area (TBSA) burned was 38 % (IQR 22–60 %). Overall survival was 38 % (38/99). Survival exceeded 80 % for TBSA < 20 % but fell sharply to 14 % for 60–80 % TBSA and nil for > 80 % (Table 2, Figure 2). Of 61 deaths, 26 (42.6 %) occurred within 72 h (early deaths), predominantly from airway obstruction with inhalational injury, whereas 35 (57.4 %) were delayed, chiefly due to septic and/or hypovolaemic complications (Table 3). Increasing TBSA, third-degree depth, and inhalation injury were independent predictors of mortality on multivariable analysis (all p<0.01).

Conclusion. In this under-resourced regional network, survival remains unacceptably low once TBSA exceeds 40 %, and deaths shift from airway-related to septic aetiology after 72 h. Extending critical-care capacity and infection-control bundles beyond the first week is likely to yield the greatest mortality benefit.

Snake-Bite Envenomation and Early Kidney Risk: Duration to Hospital, Coagulation Indices and Species as Predictors of Acute Kidney Injury in Southern India – A Prospective Observational Study

Mon, 14 Jul 2025 00:00:00 +0300

Background Snake-bite is a neglected medical emergency in the tropics. Acute kidney injury (AKI) is its gravest systemic complication and is potentially preventable if patients at risk are recognised early. Simple, rapidly available indices—time-to-hospital, 20-min whole-blood-clotting-time (WBCT20), pro-thrombin time/international normalised ratio (PT-INR) and offending species—may offer reliable bedside predictors but have not been examined in a single analytic framework.

Methods We prospectively studied 100 consecutive adults (> 15 y) with proven or strongly suspected envenomation admitted to Gulbarga Institute of Medical Sciences (June 2023–Dec 2024). Demography, bite-to-hospital interval, species (clinical identification or dead specimen), WBCT20, PT-INR (at admission and 24 h) and serum creatinine were recorded. AKI was defined by KDIGO criteria. Indices independently associated with AKI were explored with multivariable logistic regression.

Results Median age was 55 y (IQR 38–68) and 53 % were male. Median bite-to-hospital interval was 11 h (IQR 7–16). Krait (29 %), Russell’s viper (26 %) and cobra (21 %) accounted for 76 % of bites. AKI developed in 24 patients (24 %) at a mean of 0.7 ± 1.4 days. Russell’s viper accounted for 54 % of AKI (adjusted OR 5.4, 95 % CI 2.0–14.7, p = 0.002). A bite-to-hospital interval > 12 h was present in 67 % of AKI versus 32 % of non-AKI patients (aOR 3.1, 1.2–7.8, p = 0.018). All AKI cases showed incoagulable WBCT20 and prolonged PT-INR at baseline; PT > 15 s or INR > 1.2 at 24 h remained independently associated with AKI (aOR 4.6, 1.3–16.0). Model-AUROC was 0.87. Dialysis was required in 6/24 (25 %) AKI cases and overall mortality was 8 %, confined to the AKI cohort.

Conclusion (1) Delay > 12 h, (2) Russell’s viper bite, (3) incoagulable WBCT20 and (4) persistent PT-INR derangement at 24 h reliably identify victims at very high risk of AKI. These bedside variables should prompt pre-emptive renal-protective strategies and early transfer to dialysis-capable centres in resource-limited settings.

Post-Vaccination Adverse-Effect Profile Among Adult Beneficiaries of a Tertiary-Care Hospital in Rajasthan: A Prospective

Dr. ravi kumar singodia, Dr. Anusha Vohra, Dr. Danish Shaikh Qureshi — Mon, 14 Jul 2025 00:00:00 +0300

Background: Robust pharmacovigilance is essential to sustain public confidence in India’s COVID-19 immunisation drive. Published data from northern India remain limited, and heterogeneity persists in reporting practices.

Methods: We undertook a six-month, single-centre, prospective, comparative cohort study at Mahatma Gandhi Medical College & Hospital, Jaipur (IEC No. MGMC&H/IEC/JPR/2021/508; 21 June 2021). All consecutive adults (≥18 y) receiving either dose of Covishield™ or Covaxin™ between July-December 2021 were observed on-site for 30 min and contacted telephonically on day 1, 3 and 7. Adverse events following immunisation (AEFI) were graded (mild/moderate/severe) using Government of India guidelines. Primary outcome was cumulative incidence of any AEFI after dose 1 versus dose 2. Predictors were explored using multivariable logistic regression.

Results: Of 613 recipients (mean age 36.4 ± 12.1 y; 53.2 % male), 54.5 % reported ≥1 AEFI after dose 1 versus 35.5 % after dose 2 (p < 0.001). Local pain (41 %), fever (23 %), myalgia (13 %), fatigue (12 %) and headache (8 %) predominated. Almost 83 % of AEFI were mild and self-limiting; no anaphylaxis or thromboembolic events were recorded. Independent predictors of systemic AEFI were female sex (aOR 1.43, 95 % CI 1.02-2.00), age <30 y (aOR 1.57, 1.08-2.28) and previous SARS-CoV-2 infection (aOR 1.68, 1.05-2.70).

Conclusion: Both vaccines exhibited favourable short-term safety profiles; reactogenicity declined significantly after the second dose. Active surveillance should be continued to capture rarer, late-onset events and to strengthen public trust.

Admission High-Sensitivity Cardiac Troponin T as an Independent Predictor of 28-Day Mortality in Adult Sepsis: A Prospective Cohort Study

Dr Basavaraj G Yatanoor, Dr Sachin Patil, Dr G B Doddamani — Mon, 14 Jul 2025 00:00:00 +0300

Background: Sepsis remains a leading cause of critical-care mortality. Mounting evidence suggests that biomarkers of myocardial injury may refine risk-stratification.

Methods: This is a prospective observational study of 120 adults with Sepsis-3 who were recruited in a tertiary intensive-care unit. Patients were measured within 6 h of admission in the authors measured high-sensitivity cardiac troponin-T (hs-cTnT), creatine-kinase MB (CK-MB) and lactate-dehydrogenase (LDH) and re-evaluated the outcomes after 28 days. Organ failure was determined by way of SOFA (Sequential Organ Failure Assessment) score.

Results: There was a significantly higher median hs-cTnT in non-survivors (n = 39, 32.5 %) (0.202 ng mL 1) in comparison to those that survived (0. 048 ng mL 1; p < 0.001). The same tendency was seen with CK-MB and LDH. hs-cTnT was strongly correlated with SOFA ( 28 = 0.78, AUC of 28 days mortality was 1.00 with an optimal cut-off of 0.10 ng mL 1 delivering 97 % sensitivity/99 % specificity. Another excellent discrimination was apparent in CK-MB (AUC = 0.96) and LDH (AUC = 0.99). Multivariable modelling substantiates hs-cTnT as the overwhelming predictor after being adjusted to age, sex and SOFA.

Conclusion: Early elevation of cardiac enzymes—particularly hs-cTnT—portends poor short-term prognosis in sepsis and may complement clinical scores.

Analysis of Clinical Predictors for Mortality in Severe Organophosphate Poisoning

Dr. Aswin Madhusoodanan, Dr. Veeresh Salgar, Dr. G B Doddamani — Mon, 14 Jul 2025 00:00:00 +0300

Background: Severe organophosphate (OP) pesticide poisoning remains a major public-health problem in many low- and middle-income countries, with reported in-hospital mortality rates of 10–40 % despite antidotal therapy. Accurate early prediction of fatal outcome could optimise triage and critical-care resource allocation.

Methods: We conducted a prospective cohort study of 150 consecutive adults (≥ 18 y) with confirmed severe OP poisoning admitted to two tertiary toxicology centres between January 2024 and December 2024. Demographic, clinical and laboratory variables collected within 1 h of admission were analysed. Primary outcome was all-cause in-hospital death. Multivariate logistic regression, Kaplan–Meier survival analysis and receiver-operating-characteristic (ROC) curves were applied to identify independent predictors and evaluate existing scoring systems.

Results: Overall mortality was 20 % (30/150). Independent predictors of death were (i) time-to-presentation > 3 h (adjusted OR 3.4, 95 % CI 1.5–7.8), (ii) Glasgow Coma Scale ≤ 10 (OR 4.8, 2.0–11.4), (iii) serum butyryl-cholinesterase < 3 000 U/L (OR 6.1, 2.2–16.9), (iv) arterial pH < 7.25 (OR 5.2, 2.0–13.2) and (v) shock on admission (OR 10.2, 3.1–34.3). Kaplan–Meier curves showed significantly poorer 14-day survival for patients with low cholinesterase (log-rank p < 0.001; Fig. 1). The APACHE II score demonstrated the best discrimination (AUC 0.94; Fig. 2), followed by a modified SOFA-Lac (AUC 0.88) and Poisoning Severity Score (AUC 0.85).

Conclusion: Easily measurable bedside variables—particularly shock, profound acidaemia, low cholinesterase activity and delayed presentation—identify OP-poisoned patients at highest risk of death. Incorporating these factors into standard assessment, alongside APACHE II, could enhance early critical-care referral in resource-limited settings.

SERUM CHLORIDE-TO-SODIUM RATIO AND OUTCOMES IN HYPONATRAEMIC ACUTE DECOMPENSATED HEART FAILURE: A PROSPECTIVE COHORT STUDY

Dr. Marinna Ponnachan, Dr. Anil Kumar, Dr. G B Doddamani, Dr. Santosh M Hegde — Mon, 14 Jul 2025 00:00:00 +0300

Background: Hyponatraemia frequently accompanies acute decompensated heart failure (ADHF) and portends poor outcome. Emerging data suggest that chloride—long overshadowed by sodium—may carry independent prognostic weight. We assessed whether the admission serum chloride-to-sodium ratio (Cl⁻/Na⁺) improves risk‐stratification in hyponatraemic ADHF.

Methods: In this prospective cohort (January 2022–June 2024) we enrolled 302 consecutive adults (age 66 ± 12 years, 38 % women) hospitalised with ADHF and serum Na⁺ < 135 mmol L⁻¹. Baseline demographics, comorbidities, natriuretic peptides and full metabolic panels were recorded. The primary end-point was 180-day all-cause mortality; secondary end-points were in-hospital worsening HF and 30-day readmission. Patients were stratified by admission Cl⁻/Na⁺ tertiles (T1 ≤ 0.98, T2 0.99–1.03, T3 ≥ 1.04). Multivariable Cox and logistic models adjusted for age, sex, eGFR, LVEF, NT-proBNP and diuretic dose evaluated associations.

Results: Mean admission Na⁺ was 129 ± 4 mmol L⁻¹ and Cl⁻/Na⁺ 1.01 ± 0.04. During follow-up, 71 deaths (23.5 %) occurred. Crude 180-day mortality rose step-wise across tertiles (T1 14 %, T2 21 %, T3 35 %; p < 0.001). Each 0.01-unit decrement in Cl⁻/Na⁺ conferred a 6 % relative risk reduction (adjusted HR 0.94, 95 % CI 0.90–0.99, p = 0.02). Adding Cl⁻/Na⁺ to a validated ADHF score improved C-statistic from 0.77 to 0.81 (p = 0.01) and yielded a net reclassification improvement of 0.18. Low Cl⁻/Na⁺ also independently predicted in-hospital worsening HF (OR 1.42 per 0.01-unit drop, p = 0.008) and 30-day readmission (OR 1.27, p = 0.04).

Conclusion: Among hyponatraemic ADHF patients the admission Cl⁻/Na⁺ ratio is an easily obtainable, independent predictor of short- and medium-term outcomes and meaningfully enhances existing risk scores. Routine reporting and therapeutic trials targeting chloride homeostasis merit consideration.

Comparative Evaluation of Hemodynamic Responses and Ease of Intubation with Tuoren Video Laryngoscope Vs Macintosh Laryngoscope in Patients Undergoing Coronary Artery Bypass Graft Surgery

Tue, 15 Jul 2025 00:00:00 +0300

Background: Cardiac patients are highly vulnerable to the hemodynamic alterations that follow the laryngoscopy and endotracheal intubation making it beneficial to use methods which can mitigate these effects. This randomized study aimed to compare the eﬃcacy and associated hemodynamic variations between the Macintosh and Tuoren Videolaryngoscope for airway management in patients undergoing coronary artery bypass graftingsurgery.

Method: 60 patients undergoing elective CABG were evenly distributed into Group A (Tuoren Video laryngoscope) and Group B (Macintosh laryngoscope). Hemodynamic parameters, including systolic blood pressure (SBP), diastolicblood pressure (DBP), mean arterial pressure (MAP), pulse rate (PR), rate-pressure product (RPP) and peripheral oxygen saturation (SpO2) were recorded. Laryngoscopy and intubation time, ease of intubation assessed by Krieg’s scale, and intubation diﬃculty score (IDS) were documented.

Results: There was a greater increase in hemodynamic parameters in group B from 1 minute followingintubation until 5 minutes (p<0.05). Group A provided better glottic visualisation as assessed by CL grade (p<0.05) in significantly shorter laryngoscopy time (p=0.001). Group A had a significantly lower Krieg’s score (p=0.02) and IDS (p=0.04) than group B. The total intubation time, number of attempts, and complications were comparable between both groups, but the need for stylet was higher in group A (p=0.04).

Conclusion: The use of Tuoren video laryngoscope has been associated with faster laryngoscopyand improved glottic visualization, contributing to reduced hemodynamic alterations duringintubation but using a stylet is recommended to enhance the first-attempt successrate during intubation.

Levetiracetam Vs Sodium Valproate as First-Line Monotherapy in Childhood Epilepsy: An Open-Label Randomised Controlled Trial from Western India

Dr. Ramkesh Meena, Dr Tarang Kaleria, Dr. Sanjay Mandot, Dr Rekha Rathore — Tue, 15 Jul 2025 00:00:00 +0300

Background: Epilepsy affects nearly 10 million Indian children and is often treated empirically. Evidence comparing broad-spectrum agents in paediatric‐onset epilepsy is limited. We compared the efficacy and tolerability of levetiracetam (LEV) versus sodium valproate (VPA) as initial monotherapy.

Methods: In this open-label parallel RCT (October 2022–March 2024, Udaipur, India) 52 drug-naïve children (1–18 y) with newly diagnosed epilepsy were randomised 1:1 to LEV (20 mg kg⁻¹ day⁻¹) or VPA (20 mg kg⁻¹ day⁻¹). Primary outcome was seizure-free interval over 6 months. Secondary outcomes were seizure recurrence latency, episode duration, need for rescue/adjunctive AEDs, and adverse events (AEs).

Results: Baseline characteristics were comparable (mean age 9.0 ± 4.9 y vs 9.3 ± 5.0 y; males 50 % vs 54 %; generalised-onset 62 % each). Six-month seizure freedom occurred in 77 % (LEV) vs 85 % (VPA) (p = 0.47). Mean time to first recurrence was shorter with LEV (39.7 ± 5.4 days) than VPA (59.4 ± 5.7 days; p < 0.001), yet mean repeat-episode duration favoured LEV (1.7 ± 0.6 min vs 4.0 ± 1.2 min; p < 0.001). No child on LEV required add-on therapy; one VPA recipient did (4 %). AEs were mild: behavioural symptoms predominated with LEV (15 % personality change, 12 % aggression) whereas metabolic/GI effects predominated with VPA (8 % weight-gain, 12 % abdominal pain). No serious or irreversible toxicity occurred.

Conclusion: Both agents provided high seizure-freedom rates. LEV shortened individual seizure duration and eliminated rescue AED need but showed earlier recurrences and more behavioural AEs. VPA achieved longer recurrence-free spans at the cost of metabolic/GI issues. Tailoring first-line therapy to individual comorbidity risk is essential.

Novel Validated Uhplc-Dad Method for Quantification of Leptosperin in New Zealand Mānuka Honey: A Definitive Chemical Marker for Authentication and Quality Control Incorporating Sustainable Practices with Minimal Sample and Plastic Usage for Cost-Effectiv

Tue, 15 Jul 2025 00:00:00 +0300

Leptosperin is a unique floral marker compound found exclusively in the Leptospermum genus, with particularly high concentrations in Leptospermum scoparium (mānuka) honey from New Zealand. Due to mānuka honey’s global demand and valued therapeutic properties, reliable authentication methods are essential to ensure product quality, traceability, and prevent adulteration. This study reports the development and full validation of a sensitive and robust Ultra-Performance Liquid Chromatography with Diode Array Detection (UPLC-DAD) method for the quantification of Leptosperin in honey samples. The method employs a straightforward aqueous extraction followed by reverse-phase chromatography, enabling accurate and selective detection of Leptosperin at 282 nm.

Validation was conducted in accordance with international guidelines, encompassing specificity, linearity, precision, accuracy (expressed as recovery), trueness, limit of detection (LOD), and sample stability. The method exhibited excellent linearity (R² > 0.99) over a concentration range of 5 to 436 mg/kg. Precision studies showed relative standard deviations (%RSD) below 3% for both intra-day and inter-day measurements. Recovery rates ranged between 90% and 94%, demonstrating the method’s accuracy in complex honey matrices. The LOD was established at 10 mg/kg, sufficient to detect typical Leptosperin levels in mānuka honey. Stability testing confirmed that extracted samples remain stable for up to 36 hours’ post-preparation under refrigerated conditions, facilitating flexible laboratory workflows. Method performance was further corroborated through comparative analysis with accredited external laboratories, yielding strong concordance with relative standard deviations below 10.1%. This validated UPLC-DAD method offers a rapid, reliable, and cost-effective analytical tool for mānuka honey authentication and quality control. Its applicability extends to both monofloral and multifloral mānuka honey types, supporting research, regulatory compliance, and commercial quality assurance efforts. In summary, the method provides a scientifically rigorous approach to quantify Leptosperin—a definitive chemical marker of Leptospermum species—thus enabling robust authentication of mānuka honey to maintain consumer confidence and uphold export quality standards.

Endodontic Cryotherapy: A Review

Tue, 15 Jul 2025 00:00:00 +0300

Endodontic cryotherapy involves using cold therapy during root canal treatments to reduce inflammation, pain, and improve patient comfort. This review examines the efficacy, mechanisms, and clinical outcomes of cryotherapy in endodontics. Preliminary findings suggest it enhances analgesic effects post-treatment, warranting further research for standardized protocols and long-term benefits.

Clinicopathological Profile and Hormone Receptor Status of Malignant Surface Epithelial Tumours of the Ovary: A Prospective Retrospective Study from A Tertiary Military Centre

Dr Nalin Shankar Singh, Dr M K Patra, Dr Amarinder Singh — Wed, 16 Jul 2025 00:00:00 +0300

Background. Surface epithelial tumours account for ~90 % of malignant ovarian neoplasms, yet data on the expression of oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2 neu) in Indian patients remain limited. This study characterises the clinicopathological spectrum of malignant surface epithelial ovarian tumours and evaluates ER, PR and HER2 neu expression in relation to established prognostic markers.

Methods. After institutional ethics approval, a combined prospective–retrospective observational study was performed in the Department of Pathology, Command Hospital (Northern Command). Fifty consecutive patients operated for ovarian tumours between May 2024 and May 2025 were screened; four were excluded because of scant tumour in deeper sections, yielding 46 analysable cases. Detailed clinical data were retrieved, tumours were classified per WHO 2020 and FIGO 2021 criteria, and immunohistochemistry for ER, PR (nuclear) and HER2 neu (membranous) was performed and scored independently by two pathologists. Associations were tested with χ²/ Fisher’s exact test, t test or one way ANOVA; p < 0.05 was considered significant.

Results. Median age was 52 years (range 26–74). High grade serous carcinoma predominated (71.7 %), followed by mucinous carcinoma (17.4 %). ER and PR positivity were seen in 65.2 % and 58.7 % respectively, while HER2 neu over expression (3+) occurred in 30.4 %. ER and PR correlated strongly with tumour grade (high > low; p < 0.001 each) but not with age or FIGO stage. HER2 neu positivity was significantly enriched in high grade tumours (p = 0.001) and in mucinous histology (50 %, p = 0.92). Triple positive phenotype (ER+ PR+ HER2+) comprised 10.9 % of cases—exclusively high grade—whereas triple negative tumours constituted 26.1 %. No significant correlation was found between receptor status and pre operative CA 125 levels.

Conclusion. ER and PR are expressed in nearly two thirds of malignant surface epithelial ovarian tumours, especially high grade lesions, underscoring the potential utility of endocrine therapy. HER2 neu over expression, although less common, clusters within high grade and mucinous carcinomas and may identify candidates for anti HER2 therapy. Routine assessment of these biomarkers could refine risk stratification and open avenues for targeted treatment in Indian ovarian cancer patients.

A Prospective Study of Circumcision by Plastibel Technique in Neonates and Infants

Dr. Suresh Patil, Dr. Sangmeshwar Patil, Dr. Abdul Khalique — Wed, 16 Jul 2025 00:00:00 +0300

Background: Male circumcision (MC) is among the oldest surgical procedures, historically practiced across several continents for cultural, religious, and medical reasons. Plastibel circumcision has gained popularity due to its relative simplicity, reduced complication profile, and suitability for use under local anesthesia. Despite these advantages, complications such as bleeding, infection, and delayed plastibel separation are reported. Neonates are believed to experience fewer complications and faster recovery due to thinner prepuce and simpler anatomy compared with older infants.

Methods: We conducted a prospective study of 488 neonates and infants undergoing plastibel circumcision for cultural or religious indications at the Department of General Surgery, Basaveshwar Teaching and General Hospital, attached to M.R. Medical College, Kalaburagi, between January 2023 and March 2024. Children with congenital penile abnormalities, deranged coagulation profiles, or unstable medical conditions were excluded. Perioperative details including operation time, plastibel device separation day, and postoperative complications were recorded. Follow-up visits were scheduled on post-procedure day 3 and the day of plastibel separation.

Results: Of 488 participants, 66 (13.52%) were neonates and 422 (86.47%) were infants. Mean operative time was 6±2 minutes, and the plastibel fell off at a mean of 6.2 days (range 3–12 days). Neonates showed a shorter mean ring separation time compared with older infants. Successful plastibel circumcision without complications was observed in 408 (83.6%) cases, while 80 (16.4%) experienced minor complications. Delayed ring separation and mild bleeding were the most commonly observed adverse events.

Conclusion: Plastibel circumcision in neonates and infants is a safe, quick, and effective procedure with a favorable complication profile. Neonates generally demonstrate fewer complications and earlier ring separation than older infants, underscoring the potential benefits of early circumcision.

ASSESS THE COMPLICATIONS AND OPERATING TIME TAKEN BY HOLMIUM LASER AND PNEUMATIC LITHOTRIPSY USING SEMIRIGID SCOPE IN MANAGING URETERIC CALCULUS

Mohit Kumar Patel, Tushar Dani , Dipak Purohit, Sanscriti Tripathi — Wed, 16 Jul 2025 00:00:00 +0300

Background: Technology has made it possible to successfully access and treat virtually any stone within the ureter in a relatively atraumatic fashion. Different lithotriptors can be used for intracorporeal lithotripsy including electrohydraulic (EHL), ballistic (pneumatic), ultrasonic (US), laser (Ho: YAG). In the last few years lasers have been increasingly replacing others for intracorporeal lithotripsy.

COMPARISON OF COLD PRESSOR TEST IN CHILDREN OF HYPERTENSIVE AND NON HYPERTENSIVE PARENTS

Dr.B.V.Surendra,Dr.Thyelnai Dawn Khaling,Dr.T.Hari Prasad — Mon, 02 Jun 2025 00:00:00 +0300

INTRODUCTION: Early diagnosis of hypertension risk may enable a person to live a healthier lifestyle. Subjects with predisposing characteristics for hypertension had greater and longer-lasting blood pressure responses to stress. The Present study was conducted to examine the blood pressure response to cold pressor test in the medical students of hypertensive parents and compare it with the controls of normotensive parents

Ultrasound-Guided Versus Peripheral Nerve-Stimulator-Guided Supraclavicular Brachial Plexus Block for Elective Upper-Limb Surgery: An Observational Comparative Study

Dr. Deep Das — Thu, 17 Jul 2025 00:00:00 +0300

Background: Ultrasound (USG) visualisation of the brachial plexus has revitalised the supraclavicular approach, yet many centres still use peripheral-nerve stimulators (PNS). High-quality comparative data remain limited.

Methods: In a single-centre observational study, 84 ASA I–II adults undergoing elective upper-limb surgery were randomised to USG (n = 42) or PNS (n = 42) guidance. Primary outcomes were block-execution time and success rate. Secondary outcomes were onset of sensory and motor block and complications. Thirty millilitres of 0.5 % bupivacaine + 2 % lignocaine (1:1) were injected in both groups. Data were analysed with Wilcoxon-Mann-Whitney, t-test or χ² as appropriate; p < 0.05 was significant.

Results: Groups were comparable for age, sex and baseline vitals. Median block-execution time was shorter with USG (6 min [IQR 5–6.8]) than PNS (7 min [6–9]; p < 0.001). Motor-block onset was faster with USG (median 8 min [7.3–9] vs 9 min [8–9]; p = 0.019). Sensory-block onset did not differ (≈5.5 min, p = 0.51). Success reached 97.6 % with USG and 92.9 % with PNS (ns). One vascular puncture occurred in PNS; no pneumothorax or neurological injury was noted.

Conclusion: For supraclavicular blocks, ultrasound shortens execution time and hastens motor blockade while maintaining a high success rate and safety profile. These findings support adopting US guidance where resources allow.

Case Report of a Mega Appendix

Dr. Proff Surendra Pathak (MS), Dr. Shubham tiwari, Dr. Shiv kumar — Thu, 17 Jul 2025 00:00:00 +0300

Surgeons maintain continuous interest about the appendix due to its multiple presentation types and potential pathologies and functional aspects. The acute appendicitis condition represents one of the main reasons for sudden abdominal pain. Open appendectomy remains the preferred treatment and is a commonly performed emergency surgery, especially among trainees. The appearance of the appendix during surgery can be misleading, even for experienced surgeons. The standard surgical practice takes each appendicitis situation as an individual expulsion that requires specific treatment. Each person possesses an appendix of different sizes which generally measure between 6–9 cm in length with 7–8 mm in diameter. Previously, the longest appendix recorded in India was 17.5 cm, and the global record was a perforated appendix measuring 55 cm. This report highlights a rare case of non perforated inflamed appendix measuring 9.8 cm in length and 5.5 cm in diameter at its widest point,which appeared as a sealed off perforated appendicular mass on USG AND CECT ,was removed .Highlighting the fact that diagnosing acute appendicitis remains clinically challenging despite medical advances.

Impact of Mouthwash Type, Exposure Time and Application Frequency on Esthetic Degradation of Composite Restorations

Wed, 25 Jun 2025 00:00:00 +0300

Although mouthwashes are frequently used for dental hygiene, little is known about their affect on theaesthetic qualities of composite restorations. Objective: To investigate the impact of exposure duration,application frequency, and mouthwash type on the aesthetic deterioration of composite restorations in patients who use different mouthwashes

Effects of Ph and Temperature on Dental Materials in Saliva and Oral Fluids

Thu, 17 Jul 2025 00:00:00 +0300

The oral environment exposes dental materials to a range of pH and temperature, therefore influencing their durability and functionality. This research investigates how pH and temperature influence the dental materials in oral fluids and saliva.

Objective: To determine the impact of temperature and pH fluctuation on physical and chemical characteristics of dental materials.

Methodology: 60 dental materials specimens including composites, ceramics, and metals was employed in this in-vitro experimental study that was performed in a dental materials lab. SEM, EDX, and nanoindentation were used to examine the surface morphology, chemical composition and mechanical characteristics of the materials. The specimens were placed and pH levels (acidic, neutral, and alkaline) and temperatures included room temperature, body temperature and elevated temperature were applied.

Result: Exposure to high temperatures (p 0. 001) and acidic pH (p 0. 05) significantly modified the material's properties. Under acidic conditions, the surface roughness increased by 35. 2% 5. 1% while the mechanical strength dropped by 22. 5% 3. 2% at high temperatures.

Conclusion: The findings highlight the need of taking pH and temperature fluctuations in the oral environment into account while choosing and producing dental materials. Knowing this helps one to improve the durability and efficacy of dental restorations.

An Observational Study of Drug Prescription Pattern in Outdoor Patients of Hypertension in Department of Medicine at Sms Hospital, Jaipur

Dr. Purooshottam, Dr. Anuj Pareek, Dr. Chandan Verma, Dr. Akhilesh swami — Fri, 18 Jul 2025 00:00:00 +0300

Background: Hypertension represents a leading contributor to global morbidity and mortality, with an estimated 1.28 billion adults affected worldwide. In India, prevalence exceeds 30% among adults aged ≥18 years, imposing substantial economic and clinical burdens. Rational pharmacotherapy guided by prescribing indicators can optimize therapeutic outcomes and resource utilization. This study aimed to characterize antihypertensive prescription patterns among outpatients in the Department of Medicine at SMS Hospital, Jaipur, using WHO prescribing indicators and national treatment guidelines.

Methods: A study design (descriptive study) was to recruit 400 consecutive outpatients with a diagnosis of hypertension (systolic blood pressure values in excess of 160mmHg, or diastolic values greater or equal to 100mmHg). Demographic, comorbidities and prescribed medications information were obtained after ethical approval. The indicators that were measured based on prescriptions are the average number of drugs per encounter, the percentage of drugs prescribed by generic name, encounters with antibiotics or injections, and the percentage of the drugs in the Rajasthan Essential Drugs List of 2022. The comparisons of the patterns were done against the Standard Treatment Guidelines (6th Ed). The mean (SD) of continuous variables and percentages of categorical variables were reported and compared using a Student t-test or 2-way anova and 2-sample and 2-way 2-sample chi2 tests, respectively; p < 0.05 the level of significance.

Results: The average age was 54.3 years +- 10.2, male to female ratio was 1.2:1. The mean encounter drugs were 2.4 0.7. Generics comprised 78.5% of prescriptions, antibiotics in 12.0%, injections in 4.5%, and 85.2% from the Essential Drugs List. Monotherapy prevailed in 38%, dual therapy in 46%, and ≥3 drugs in 16% of encounters. ACE inhibitors (35%), calcium channel blockers (28%), and diuretics (22%) were most frequently prescribed. Overall adherence to national guidelines was 72.5%.

Conclusion: Prescription patterns at our center demonstrate moderate adherence to WHO indicators and national guidelines; however, scope exists for improved generic use and guideline conformity. Continuous prescriber education and periodic audit are recommended to promote rational antihypertensive therapy.

Prescription Patterns and Antimicrobial Susceptibility in Complicated Urinary Tract Infection at a North Indian Tertiary Care Hospital: A Descriptive Study

Dr. Anuj Pareek, Dr. Purooshottam, Dr. Uma Advani, Dr. harshil patel — Fri, 18 Jul 2025 00:00:00 +0300

Background Complicated urinary tract infection (cUTI) increases morbidity, length of stay and antimicrobial resistance. Indian data on real world prescribing and susceptibility trends remain limited .

Methods A hospital based descriptive study (March 2023 – Feb 2024) enrolled 100 consecutive adults admitted with cUTI to the Urology ward of a 2200 bed tertiary hospital. Demographics, comorbidities, prescriptions (admission, culture directed, discharge) and adverse drug reactions (ADRs) were captured prospectively on a structured pro forma. World Health Organization (WHO) prescribing indicators were applied. Isolates underwent standard CLSI urine culture and antimicrobial susceptibility testing. Data were analysed with SPSS v16 using descriptive statistics and χ² as appropriate.

Results Mean age was 45.7 ± 17.0 years; 90 % were male. Stones (45 %) and hydronephrosis (38 %) were common risk factors. Median drugs/prescription = 4 (IQR 3–5); all were generic and Essential Drug List compliant. Antimicrobial use was universal at admission; ceftriaxone (61 %) and amikacin (100 %) predominated. After culture, de escalation occurred in 43 % and carbapenems were initiated in 50 % of culture guided regimens. Escherichia coli (56.7 %) and Klebsiella spp. (10.2 %) were leading pathogens. Overall susceptibility (%) was highest for colistin (94), nitrofurantoin (84) and piperacillin tazobactam (77); fluoroquinolone resistance exceeded 60 %. Thirty three patients (33 %) experienced ≥ 1 ADR, most commonly dyspepsia and headache with diclofenac/paracetamol or pantoprazole; no serious ADRs occurred.

Conclusion High third generation cephalosporin and aminoglycoside use with limited culture directed de escalation was observed. Rising fluoroquinolone resistance underscores the need for protocol driven, carbapenem sparing stewardship. Continuous surveillance and clinician feedback can optimise empirical choices and curb resistance.

Selective Nerve Root Block versus Caudal Epidural Block in Single-Level Lumbar Intervertebral Disc Prolapse

Fri, 18 Jul 2025 00:00:00 +0300

Background: Chronic lumbar radiculopathy due to intervertebral disc prolapse is prevalent and causes significant morbidity. Interventional pain management techniques like Selective Nerve Root Block (SNRB) and Caudal Epidural Block (CEB) are commonly used when conservative treatments fail. This study compares the efficacy of SNRB and CEB in managing pain and improving function in patients with single-level lumbar disc prolapse.

Methods: Sixty-six patients with single-level lumbar disc prolapse-induced radiculopathy were assigned according to surgeons choice to receive either SNRB or CEB. Pain intensity was measured using the Visual Analog Scale (VAS), and functional disability was assessed using the Oswestry Disability Index (ODI) and the Roland-Morris Disability Questionnaire (RMDQ) at baseline, 3 weeks, 6 weeks, 3 months, and 6 months post-intervention. Statistical analyses compared outcomes between the two groups.

Results: Both SNRB and CEB groups showed significant reductions in VAS, ODI, and RMDQ scores over time (p < 0.001). However, no statistically significant differences were observed between the groups at any follow-up point (p > 0.05). The mean age and sex distribution were comparable between groups (p > 0.05).

Conclusion: Both SNRB and CEB are effective in reducing pain and improving function in patients with single-level lumbar disc prolapse. No significant difference was observed between the two interventions over six months, suggesting that either technique can be utilized based on clinical judgment and patient preference.

Comparative Gross and Histopathological Evaluation of Ante Mortem versus Post Mortem Electrocution Burn Marks: A Two Year Observational Study at Aiims, New Delhi

Sat, 19 Jul 2025 00:00:00 +0300

Background: Differentiating ante mortem (AM) from post mortem (PM) electrocution burn marks is a recurring forensic challenge, especially when only a single suspicious lesion is present at autopsy. The present study prospectively analysed gross and light microscopic characteristics of AM and experimentally produced PM electrocution marks to identify discriminative features.

Methods: In a comparative observational design (July 2018 – June 2020) we examined 25 AM electrocution fatalities and 30 fresh cadavers on which a standardised PM electroburn (220 V, 400–1000 mA, 3–4 s) was created following ethical approval. Systematic documentation of demographic context, lesion size/shape/location and quantitative histomorphology (16 predefined variables) was performed. Pearson’s χ² test with Yates’ correction determined significance (SPSS v24.0; p<0.05).

Results: AM victims were predominantly male (92%) and aged 21–50 years. AM lesions most frequently involved the palmar hand (72%), were elongated (60%) and >1 cm in 52% of cases. Histology revealed significantly higher frequencies of epidermal necrosis (72% vs 43%, p=0.03), streaming of nuclei (72% vs 53%, p=0.04), and dermo epidermal separation (28% vs 13%, p=0.01) in AM compared with PM samples. Vascular nuclear elongation was common in AM (72%) but only occasional in PM (33%). No inflammatory infiltrate, metallisation or sebaceous gland involvement was observed in either group.

Conclusion: While several microscopic criteria overlap, a constellation of pronounced epidermal necrosis, nuclear streaming, and dermo epidermal separation strongly favours an AM origin. The proposed algorithm incorporating five key variables yielded 84% sensitivity and 80% specificity for AM diagnosis in our cohort. Multicentric validation is recommended.

A Study on Leprosy Reactions in a Tertiary Hospital in Northeast India

Joydeep Roy, Arup Paul, Shromona Kar, Bhaskar Gupta — Fri, 18 Jul 2025 00:00:00 +0300

“Leprosy reactions are acute inflammatory episodes occurring in leprosy patients, significantly affecting morbidity and long-term disability.”The objective of this study is to assess the clinical and epidemiological profile of leprosy reactions in a tertiary care hospital in Northeast India. A retrospective analysis of medical records of leprosy patients presenting with reactions was conducted. The study categorizes cases based on age, sex, classification of leprosy, type of reaction, duration of treatment, and clinical symptoms. Prompt diagnosis and management are crucial for preventing permanent disabilities.

Comparative Efficacy of Intranasal Corticosteroids vs. Antihistamines in Allergic Rhinitis: A Randomized Biochemical-Based Study

Sat, 19 Jul 2025 00:00:00 +0300

Allergic rhinitis (AR) significantly impairs quality of life and presents with chronic nasalinflammation. This randomized open-label study compared intranasal corticosteroids (INCS) andoral second-generation antihistamines (AH) in 120 adult patients over 8 weeks

Serum Vitamin D and Anti-Müllerian Hormone Levels in Patients with Ovarian Dysfunction: A Cross-Sectional Analysis or metaanalysis

Sat, 19 Jul 2025 00:00:00 +0300

Objective: To investigate the association between serum 25-hydroxyvitamin D [25(OH)D] and
Anti-Müllerian Hormone (AMH) in women with ovarian dysfunction.

Topical Corticosteroid vs. Leukotriene Antagonist Therapy in Recurrent Nasal Polyps: A case control: study with Biochemical Inflammatory Markers

Sat, 19 Jul 2025 00:00:00 +0300

Recurrent nasal polyps (RNP) impose substantial morbidity and recurrence despite surgicalintervention. While topical corticosteroids (TCS) are frontline therapy, leukotriene antagonists

Diagnostic Accuracy of Serum Amylase, Lipase, CRP, and Correlative Histopathological and Microbiological Findings in Assessing the Severity of Acute Pancreatitis

Sat, 19 Jul 2025 00:00:00 +0300

Diagnostic Accuracy of Serum Amylase, Lipase, CRP, and CorrelativeHistopathological and Microbiological Findings in Assessing the Severity ofAcute Pancreatitis

Association of Serum IL-6 and CRP Levels with Disease Severity in Acute Exacerbation of COPD

Sat, 19 Jul 2025 00:00:00 +0300

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) carry significantmorbidity and mortality. This study evaluated the diagnostic and prognostic utility of seruminterleukin-6 (IL-6) and C-reactive protein (CRP) levels in 150 patients admitted with AECOPD

Association between Early Body Weight Loss and Development of Hyperbilirubinemia in Term Neonates at 72 Hours

Dr Deepak Sankhwar, Dr. Praveen Anand, Dr Koushik Ray — Sat, 19 Jul 2025 00:00:00 +0300

Background: Neonatal hyperbilirubinemia affects approximately 60% of term and 80% of preterm newborns according to AIIMS NICU protocols, representing one of the most common neonatal conditions requiring clinical intervention. Early body weight loss patterns may serve as predictive indicators for subsequent jaundice development, particularly in resource-limited settings where simple monitoring tools are essential for timely intervention.

Methods: A prospective observational cohort study was conducted at the Autonomous State Medical College, Fatehpur, Uttar Pradesh, from January to December 2024. Term neonates (≥37 weeks gestation, birth weight >2500g) were enrolled and monitored for body weight loss patterns during the first 72 hours. Total serum bilirubin levels were measured at 72 hours, with hyperbilirubinemia defined as ≥12 mg/dL for term infants, following AIIMS NICU protocol guidelines. Receiver operating characteristic curve analysis determined optimal weight loss thresholds, and multivariate logistic regression identified independent risk factors.

Results: Among 380 enrolled neonates, 228 (60.0%) developed hyperbilirubinemia at 72 hours, consistent with AIIMS protocol observations. Hyperbilirubinemic neonates experienced significantly higher weight loss at all-time points (day 3: 9.2±2.8% vs 5.8±2.1%, p < 0.001). The optimal predictive threshold was 7.8% weight loss at 72 hours (sensitivity 78.5%, specificity 81.2%, AUC=0.863). Independent risk factors included maximum weight loss >7.5% (OR = 4.12, 95% CI: 2.48-6.85), decreased gestational age (OR = 1.75 per week), primiparity (OR = 1.89), and reduced breastfeeding frequency (OR = 2.28).

Conclusion: Early neonatal body weight loss patterns, particularly exceeding 7.8% at 72 hours, strongly predict hyperbilirubinemia development in 60% of term neonates. This simple anthropometric assessment provides a practical screening tool for identifying high-risk neonates, enabling timely interventions and optimized clinical management consistent with AIIMS NICU protocols.

HISTOMORPHOMETRICAL STUDY OF THE PANCREAS

Dr Shashwati Geeta Deka — Sun, 20 Jul 2025 00:00:00 +0300

The pancreas is a digestive gland with both endocrine and exocrine functions. The endocrine units called the Islets of Langerhans, contain cells like alpha, beta, etc. and produce hormones like glucagon, insulin-having direct effect on glucose homeostasis. The beta cell failure or insulin resistance can lead to a common serious disease called Diabetes Mellitus.

HISTOMORPHOLOGY OF THE PANCREAS IN FIVE MAMMALS

DR SHASHWATI GEETA DEKA — Sun, 20 Jul 2025 00:00:00 +0300

Pancreatic transplantation is the only reliable therapy that can help a diabetic patient establish euglycemia without exogenous insulin. The potential of animal tissues as a source for organ transplantation has been advocated for the perennial shortage of human donors, posing problem in establishing viable transplantation programmes.

Lesion Sterilization and Tissue Repair: A Comprehensive Review

Mon, 21 Jul 2025 00:00:00 +0300

Lesion Sterilization and Tissue Repair (LSTR) is an innovative therapeutic approach designed to manage deep dental caries and necrotic pulp, particularly in pediatric patients. This review explores the fundamental principles, clinical applications, and effectiveness of LSTR in preserving natural tooth structure while promoting tissue regeneration. The technique involves the application of a combination of antimicrobial agents, such as metronidazole, ciprofloxacin, and minocycline, to eliminate pathogenic bacteria and create an optimal environment for healing. The review highlights the indications and contraindications of LSTR, as well as factors affecting its success. Collectively, the findings suggest that LSTR can significantly improve treatment outcomes in pediatric dentistry, providing a less invasive alternative to traditional methods. Ongoing research and clinical trials are essential for refining LSTR protocols and establishing its long-term efficacy and safety.

STUDY OF DRUG UTILIZATION PATTERN OF ANTIEPILEPTIC DRUGS AT TERTIARY CARE HOSPITAL

Rahul Wagh, Sudhir Padwal, Shrikant Dharmadhikari,Vinod Deshmukh — Sun, 20 Jul 2025 00:00:00 +0300

The World Health Organization (WHO) defined Drug Utilization Research(DUR) in 1977 as “The advertising, dissemination, prescription, and utilization of drugs in asociety, with an exceptional accentuation on the subsequent medical, social and monetaryresults.

PATTERN AND EXTENT OF ADVERSE DRUG REACTIONS (ADRS) WITH ANTIEPILEPTIC DRUGS AEDS

Rahul wagh, Sudhir Padwal, Shrikant Dharmadhikari, Vinod Deshmukh — Sun, 20 Jul 2025 00:00:00 +0300

There are additional challenges associated with anti-epileptic medications,such ADRs and compound interactions. The findings of systematic reviews and metaanalyses examining prospective research

Role of Transvaginal Sonographic Measurement of Uterocervical Angle in The Prediction of Preterm Labour

Dr Tomesh Shrimali, Dr. Shruthi S. S, Dr Sharda Patra — Mon, 21 Jul 2025 00:00:00 +0300

Background: Spontaneous pre-term labour (sPTL) remains the leading cause of neonatal morbidity and mortality despite advances in perinatal care. Trans-vaginal sonographic (TVS) cervical length (CL) has modest predictive value. Recent work suggests that the uterocervical angle (UCA)—the angle between the lower uterine segment and the cervical canal—may better capture the vector of intra-uterine force.

Methods: In this prospective observational study we enrolled 100 consecutive women with singleton pregnancies at 16–24 weeks who had ≥ 1 historical risk factor for sPTL (prior sPTB, prior PPROM or mid-trimester loss). After exclusions, 96 women underwent standardized TVS assessment of CL, cervical width (CW) and UCA. Participants were followed until delivery. Primary outcome was birth < 37 weeks. Diagnostic accuracy was assessed with ROC analysis; optimal cut-offs were determined by Youden index.

Results: Twenty women (20.8 %) delivered pre-term. Mean (±SD) UCA was significantly wider in the pre-term versus term group (113.5 ± 17.9° vs 91.6 ± 14.0°, p < 0.001), whereas mean CL did not differ (3.20 ± 0.61 cm vs 3.35 ± 0.55 cm, p = 0.14). An obtuse UCA > 98.5° predicted sPTB with sensitivity 85 %, specificity 79 %, AUC 0.86 and odds ratio 21.3 (95 % CI 6.9-65.0). CW > 3.05 cm was a moderate predictor (AUC 0.74). Combining UCA > 98.5° and CW > 3.05 cm improved sensitivity to 90 % but reduced specificity to 54 %.

Conclusion: In high-risk singleton gestations the mid-trimester UCA outperforms traditional CL screening and, in combination with CW, yields the highest overall sensitivity for sPTB. Routine measurement of UCA at the anatomy scan may enable targeted prophylaxis.

Ottawa Ankle Rule as a Tool for Reducing Radiation Exposure in Pregnant Trauma Patients

Dr. Anand Srivastav, Dr. Shivam Pathak, Dr. Imran khan, Dr. Saurabh Saxena — Mon, 21 Jul 2025 00:00:00 +0300

Background Ionising-radiation‐based imaging is avoided whenever possible in pregnancy, yet ankle injuries remain common after falls or vehicular collisions. The Ottawa Ankle Rule (OAR) reliably rules out fracture in the general population, reducing unnecessary radiographs. Its impact on maternal–fetal radiation exposure in pregnant trauma patients has not been formally quantified.

Methods We performed a prospective cohort study (January 2019 – December 2024) at a level-1 trauma centre. Consecutive pregnant women (gestational age ≥ 6 weeks) presenting with ankle trauma were assessed by emergency physicians trained in the OAR. Primary outcomes were (i) diagnostic performance of OAR versus reference-standard radiography or CT and (ii) cumulative effective fetal radiation dose avoided. Secondary outcomes included emergency department (ED) length-of-stay and 30-day missed-fracture rate.

Results Two-hundred-and-twenty participants (mean age 28.7 ± 4.8 years; median gestation 22 weeks) were enrolled. OAR was positive in 94 (42.7 %) and negative in 126 (57.3 %). Forty-four fractures were confirmed, all in the OAR-positive group (sensitivity 100 %, 95 % CI 92–100 %; specificity 43 %, 95 % CI 36–51 %). Application of OAR reduced radiographs from 220 theoretical to 98 actual exams, yielding a 55.4 % reduction and an estimated fetal dose saving of 5.9 mSv (median 0.03 mSv per patient). No fractures were missed at 30 days. ED stay was shorter in the OAR-negative group (mean difference −41 min, p < 0.001).

Conclusion OAR maintains 100 % sensitivity in pregnant trauma patients and more than halves ionising-radiation exposure. Incorporating OAR into obstetric trauma protocols is a simple, evidence-based measure aligned with ALARA principles. Keywords: Ottawa Ankle Rule; pregnancy; radiation dose; trauma; diagnostic decision rule; ankle fracture.

High-Risk Pregnancies and Their Outcomes in a Tertiary-Care Centre in South India

Dr. Shruthi S. S, Dr. Roshini P, Dr Ashok Kumar — Mon, 21 Jul 2025 00:00:00 +0300

Background: High-risk pregnancies (HRP) account for a disproportionate share of maternal and perinatal morbidity and mortality in low- and middle-income countries. India’s Maternal Mortality Ratio (MMR) has fallen to 97 / 100 000 live births in 2018–20, yet preventable deaths persist, particularly among women with multiple risk factors.

Methods: A prospective observational study was conducted in the Department of Obstetrics & Gynaecology, ESIC Medical College & PGIMSR, Bengaluru (January 2023 – January 2025). All singleton or multifetal HRP admissions (n = 1 250) were enrolled after informed consent. Risk factors were classified as demographic, medical, obstetric or fetal. Primary outcomes were maternal morbidity/mortality and neonatal morbidity/mortality up to day 7 postpartum. Data were analysed with descriptive statistics; categorical variables were expressed as frequencies and percentages.

Results: HRP constituted 33 % (1 250 / 3 780) of obstetric admissions. The commonest risk factors were thyroid disorders (36.1 %), previous caesarean (28.1 %), anaemia (22.9 %), liquor abnormalities (14.9 %) and hypertensive disorders (11.8 %). Overall caesarean rate was 53.7 % (671 / 1 250), predominantly for scarred uterus (51 %) and iatrogenic indications such as severe pre-eclampsia and fetal growth restriction. Maternal morbidity was 5.8 %; postpartum haemorrhage (1.7 %) and eclampsia (1.8 %) were leading complications. There were no maternal deaths. Neonatal admission rate was 19.1 %; jaundice (11.6 % of all neonates) and respiratory distress (2.2 %) predominated. Perinatal mortality was 0.8 % (intra-uterine death 0.24 %, neonatal death 0.56 %).

Conclusion: Although HRP burden remains high, multidisciplinary management in tertiary centres can achieve zero maternal deaths and low perinatal loss. Targeted interventions—early anaemia correction, thyroid screening, VBAC counselling and strict hypertensive surveillance—could further improve outcomes. Strengthening peripheral referral and continuity of antenatal care under initiatives such as PMSMA and e-PMSMA is imperative.

Anterior Bridge Plating for Humeral Shaft Fractures: A Single-Arm Interventional Study

Dr. SAGAR, Dr. Mohammed Ibrahim — Mon, 21 Jul 2025 00:00:00 +0300

Background: Humeral shaft fractures represent a significant portion of upper extremity injuries. Treatment options range from conservative methods to surgical interventions. Anterior bridge plating, a minimally invasive surgical technique, has gained attention for its potential to provide stable fixation while minimizing soft tissue disruption.

Methods: A single-arm interventional study was conducted at Gulbarga Institute of Medical Sciences, Kalaburagi, from June 2021 to July 2024. Twenty patients with isolated diaphyseal humerus fractures were treated using anterior bridge plating. Functional outcomes were assessed using the Constant score for shoulder function and the Mayo Elbow Performance Score (MEPS) for elbow function. Radiological union time and associated complications were also evaluated.

Results: The study included 14 males and 6 females with a mean age of 51.6 years. The majority of fractures resulted from road traffic accidents (55%) and were left-sided (65%). The mean radiological time to union was 25.6 weeks. Functional assessment revealed a mean Constant score of 84.8, indicating good shoulder function, and excellent elbow function in 76.5% of patients based on MEPS. Three cases (15%) developed atrophic non-union, and four patients exhibited moderate shoulder stiffness, which improved with physiotherapy.

Conclusion: Anterior bridge plating for humeral shaft fractures demonstrates satisfactory functional outcomes. The technique offers stable fixation while preserving soft tissue integrity, making it a viable option for managing diaphyseal humerus fractures.

Risk Factor Profile and Clinical Characteristics of Acute Coronary Syndrome in Adults ≤45 Years: A Cross Sectional Study from Western India

Tue, 22 Jul 2025 00:00:00 +0300

Background Young adults form a growing fraction of acute coronary syndrome (ACS) admissions in South Asia, yet granular data on their risk factor constellation remain sparse.

Methods We analysed prospectively collected data from 46 consecutive patients ≤45 years (mean 40.2 ± 4.0 y; 84.8 % men) admitted with STEMI, NSTEMI or unstable angina to a tertiary cardiac centre in Mumbai (2019 2021). Demographic, behavioural, anthropometric, biochemical and echocardiographic variables were recorded using a prespecified pro forma; associations with ACS phenotype were examined by χ²/Fisher tests (α = 0.05).

Results Half the cohort were active smokers and 54 % were obese (BMI ≥30 kg m⁻²). Hypertension and previously known diabetes were present in 24 % each, but HbA1c screening unmasked diabetes in an additional 30 %. High sensitivity CRP (hsCRP) >1 mg dl⁻¹ was seen in 83 % and was the only variable significantly associated with presentation type (STEMI/NSTEMI/UA, p < 0.001). Low HDL C (<40 mg dl⁻¹) affected 80 %, whereas LDL C was high in 57 %. Mean left ventricular ejection fraction was 45 ± 9 %.

Conclusion Young Indian ACS patients exhibit an adverse mix of modifiable risks—smoking, obesity, subclinical diabetes and systemic inflammation—underscoring the need for aggressive primordial prevention beginning in early adulthood.

Baseline Clinical and Angiographic Profile of Patients Undergoing Left Main Coronary Artery Percutaneous Intervention in an Indian Tertiary Centre

Tue, 22 Jul 2025 00:00:00 +0300

Background Left main coronary artery disease (LM CAD) accounts for 4–9 % of diagnostic angiograms and carries the highest risk among coronary lesions.[1] High quality baseline data from low and middle income settings remain sparse.

Methods We prospectively enrolled 35 consecutive adults (August 2022 – July 2023) undergoing unprotected LM percutaneous coronary intervention (PCI) at Jagjivan Ram Railway Hospital, Mumbai. Detailed demographic, laboratory, echocardiographic and quantitative angiographic variables were captured.

Results Mean age was 66.2 ± 6.3 years; 63 % were male. Hypertension (71 %), diabetes (63 %) and dyslipidaemia (43 %) predominated, with 43 % reporting current smoking. Distal bifurcation involvement occurred in 68 % of cases; 43 % had double vessel and 20 % triple vessel disease in addition to LM stenosis. Median SYNTAX score was 29 (IQR 24–33); IVUS/OCT guidance was used in 100 % of procedures. Left ventricular ejection fraction (LVEF) was preserved (>45 %) in 40 %, moderate (35–45 %) in 31 %, and severely reduced (<35 %) in 20 %.

Conclusion Patients undergoing LM PCI in this single centre Indian cohort were older, burdened with multiple cardiometabolic risk factors and presented predominantly with complex distal bifurcation disease. These data provide a contemporary regional baseline against which procedural strategies and outcomes can be benchmarked.

Comparative Hemodynamic Stability in Low-Dose versus Conventional-Dose Bupivacaine for Spinal Anaesthesia in Elderly Patients

Tue, 22 Jul 2025 00:00:00 +0300

Background: Spinal anaesthesia is favoured for lower-limb and lower-abdominal surgery in the elderly, yet conventional doses of hyperbaric bupivacaine frequently precipitate hypotension and bradycardia. Reducing the intrathecal dose may mitigate these effects while preserving surgical anaesthesia.

Methods: In this prospective, randomised, double-blind trial we enrolled 120 patients aged ≥ 65 years (ASA II–III) scheduled for elective hip or knee arthroplasty. Participants received either low-dose (LD, 6 mg) or conventional-dose (CD, 12 mg) 0.5 % hyperbaric bupivacaine with 25 µg fentanyl. Primary outcome was incidence of clinically significant hypotension (≥ 20 % fall in mean arterial pressure or MAP < 65 mmHg) during the first 30 min after block. Secondary outcomes included bradycardia (HR < 50 beats•min⁻¹), vasopressor usage, sensory-motor block characteristics, surgeon satisfaction, and major adverse events.

Results: Baseline characteristics were comparable. Clinically significant hypotension occurred in 17 % of LD versus 48 % of CD patients (relative risk 0.35; p < 0.001). Mean MAP at 5, 10, 20 and 30 min was consistently higher in LD (84 ± 9, 82 ± 8, 80 ± 7, 79 ± 6 mmHg) than CD (72 ± 11, 70 ± 10, 68 ± 9, 67 ± 8 mmHg; p < 0.01 at all points). Bradycardia was less frequent in LD (10 % vs 28 %; p = 0.02). Ephedrine requirements (median 0 mg [IQR 0–6] vs 12 mg [6–18]; p < 0.001) and atropine administration (2 % vs 12 %; p = 0.04) were reduced in LD. Surgical anaesthesia was adequate in both groups; time to two-segment regression was shorter in LD (78 ± 14 min vs 103 ± 18 min; p < 0.001) but did not prolong recovery room discharge. No patient required conversion to general anaesthesia.

Conclusion: In elderly patients, intrathecal low-dose 0.5 % bupivacaine (6 mg) supplemented with fentanyl provides satisfactory surgical conditions while significantly improving haemodynamic stability compared with the conventional 12 mg dose. Routine dose reduction should be considered to diminish peri-operative cardiovascular morbidity in this population.

Intrathecal Dexmedetomidine 5 µg Prolongs Post-Spinal Analgesia in Elective Lower-Limb Orthopaedic Surgery: A Prospective, Randomised, Double-Blind Trial

Dr. Arvind Patel, Dr. Rashmi Kumari, Dr. Deepesh — Tue, 22 Jul 2025 00:00:00 +0300

Background: Prolonging spinal-anaesthetic analgesia without raising complication rates remains a central goal in orthopaedic anaesthesia. Α-2-agonist dexmedetomidine (DEX) is increasingly injected intrathecally as an adjuvant, yet evidence in lower-limb orthopaedic surgery is heterogeneous.

Methods: In this prospective, double-blind, parallel-arm trial, 60 adults (ASA I–II) scheduled for elective lower-limb fixation under spinal anaesthesia were randomised to hyperbaric bupivacaine 0.5 % 3.5 mL plus 0.5 mL saline (Control) or plus DEX 5 µg (DEX group). Primary end-point was duration of effective analgesia (time from intrathecal injection to first rescue analgesic). Secondary outcomes included onset times, block characteristics, haemodynamics, adverse events and 24 h opioid-sparing.

Results: All patients completed follow-up. Mean analgesia duration increased from 258 ± 44 min to 327 ± 41 min (∆ ≈ 69 min, P < 0.001). Sensory onset was faster (3.1 ± 0.5 vs 3.8 ± 0.6 min, P = 0.002) and two-segment regression slower (212 ± 35 vs 153 ± 38 min, P < 0.001) with DEX. Post-operative morphine equivalents fell by 38 %. Haemodynamic profiles were comparable, although bradycardia occurred more often with DEX (5 vs 1 patients, NS). No neuro-toxic events were observed.

Conclusion: A single 5-µg dose of intrathecal dexmedetomidine significantly and safely prolongs analgesia after lower-limb orthopaedic surgery, reduces rescue-opioid need and accelerates block onset without increasing major adverse effects. The findings support routine use of low-dose DEX as an effective spinal adjuvant in lower-extremity trauma and reconstructive procedures.

Study on the Clinical Spectrum of Respiratory Conditions Presenting with Hypercapnic Respiratory Failure – A Cross-Sectional Observational Study

Dr kauser mohd Yaseen shaikh, Dr. K. Bhaskar, Dr G.K.Paramjyoth — Tue, 22 Jul 2025 00:00:00 +0300

Background: Hypercapnic respiratory failure (HRF) reflects failure of pulmonary ventilation and confers substantial short-term morbidity and mortality. Patterns of disease precipitating HRF vary geographically and influence outcome.

Methods: We performed a prospective cross-sectional study at a tertiary centre in Hyderabad (Sept 2022 – Feb 2023). Sixty-nine consecutive adults (≥18 y) with respiratory-cause HRF (PaCO₂ > 45 mmHg, pH < 7.35) were enrolled. Clinical variables, comorbidity, arterial blood-gases, radiology, echocardiography and hospital course were recorded. Non-invasive ventilation (NIV) was first-line; failure was defined as need for endotracheal intubation or in-hospital death. Descriptive statistics and logistic regression explored factors associated with NIV failure and mortality.

Results: Mean age was 55 ± 16 y; 50.7 % were male. Leading aetiologies were acute exacerbation of COPD (AECOPD, 26 %), bronchiectasis (9 %), and OSA/OHS (7 %); mixed phenotypes accounted for 42 % (Figure 2). Hypertension (39 %) and diabetes (25 %) were common comorbidities. Median hospital stay was 7 days (IQR 6–8). NIV succeeded in 85.5 % (59/69). NIV failure (14.5 %) was strongly associated with prior-year HRF admission (OR 4.3, p = 0.029) and in-hospital mortality (100 % vs 3 %, p < 0.001). Overall mortality was 11.6 %; AECOPD contributed 62.5 % of deaths.

Conclusion: In this South-Indian cohort, AECOPD—often co-existing with other airway diseases—was the commonest precipitant of HRF and the principal driver of mortality. NIV was effective in the majority; previous HRF admission heralded NIV failure and death, highlighting a target group for enhanced post-discharge care.

Severity of Cad and Duration of Diabetes in Patients Undergoing Coronary Angiography

Tue, 22 Jul 2025 00:00:00 +0300

Background: Diabetes mellitus, including prediabetes, links to a higher risk of coronary artery disease (CAD). The longer the illness lasts and the worse blood sugar control, the more complex and widespread coronary problems become. Research using tools like the Gensini score and coronary CT scans shows that high blood sugar over time, insulin resistance, age, and gender all play a big role in how CAD gets worse. New markers (hs-CRP, NT-proBNP) and imaging methods (CCTA, EAT checks) help predict risk better.

Objective: Investigating the relationship between diabetes duration and the severity of coronary artery disease (CAD) in patients undergoing coronary angiography Study design: Cross-sectional observational study Duration and place of study: This study was conducted in Peoples University of Medical and Health Sciences for Women Shaheed Benazirabad Nawabshah February 2024 to February 2025

Methodology: Researchers conducted this cross-sectional study in the Cardiology Department. They included 240 patients between 40 and 70 years old who had type 2 diabetes for 5 years or more. The main participants for this study were people who had a history of high blood pressure, were either smokers, or had a history of smoking as well as dyslipidemia. All patients taken for this study were preparing to undergo a coronary angiography, the results of which coupled with Gensini scores were used to establish and study the link between the severity of coronary artery disease and patients that suffer from chronic diabetes. Extensive statistical analyses were being done to understand this connection. The control group for this study was limited to various factors which included the age and gender of the participants, as well as their reported hypertension and dyslipidemia. Their smoking status was also taken into consideration.

Results: The control group for this study consisted of 240 participants that were diagnosed with diabetes at least 5 years ago. The study was age restrictive, hence participants in the control group were all between 40 and 70 years of age. This study observed that there exists an established connection between the length of chronic diabetes and a higher Gensini score, at r = 0.65. This study includes multiple regression analysis to understand the correlation between the duration of diabetes with high Gensini scores. This was coupled with patients diagnosed with hypertension and dyslipidemia.

Conclusion: This study has quantitatively established that there exists a significant link between the length of a diagnosis of diabetes mellitus, and the more severe the risk of a chronically diabetic patient suffering from coronary artery disease (CAD).

Adenosine Vs Verapamil: Treating No-Reflow Phenomenon in Individuals with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention (PCI)

Tue, 22 Jul 2025 00:00:00 +0300

Background: A condition that results from an imbalance between coronary blood supply and myocardial oxygen demand is called acute coronary syndrome (ACS). The no-reflow phenomenon is one of the most challenging complications for ACS which occurs during percutaneous coronary intervention (PCI). A few microvascular dysfunction mechanisms are included in the pathophysiology of the no-reflow phenomenon. These medicines include two names that are commonly used; adenosine and verapamil. Adenosine is a strong drug which is used to activate special A2 receptors that eventually help in opening up small blood vessels in the heart. On the other hand, verapamil is also used to relax the small blood vessels. Through this drug, the amount of calcium that enters into the muscle cells in the vessel walls is reduced.

Objective: To compare the efficiency of adenosine with verapamil to treat no-reflow phenomenon in individuals with acute coronary syndrome undergoing percutaneous coronary intervention (PCI).

Study design: An observational study

Duration and place of study: This study was conducted in Peoples University of Medical and Health Sciences for Women Shaheed Benazirabad Nawabshah from August 2023 to August 2024

Methodology: This is an observational study which was performed in the Cardiology Department of the hospital. There were a total of 120 individuals who were a part of this study. They all were having an age of 18 years or older. All the participants of this study were having acute coronary syndrome (ACS). Along with this, they required percutaneous coronary intervention (PCI). All the patients were divided into 2 groups equally. Each group had 60 individuals. One group received intracoronary verapamil while the other group received adenosine.Variables such as IMR, TIMI, and FMD were expressed in terms of mean with standard deviations. To analyse the data, SPSS version 25 was used.

Results: There were a total of 160 people included in this research. They all were having an age of 18 years or older. All the participants of this study were divided into 2 groups with each group having 60 individuals. One group received intracoronary verapamil while the other group received adenosine. The majority of the individuals were males in both the groups. The average age of the verapamil group was 60 years while it was 61 years for the adenosine group. Conclusion: In our study, both drugs, adenosine and verapamil, are effective but verapamil was found to be statistically significant in helping improve TIMI flow grades.

Management Strategies for Spondylolisthesis: A Contemporary Review of Emerging Techniques

Wed, 23 Jul 2025 00:00:00 +0300

Background: Spondylolisthesis—the anterior or posterior translation of one vertebra on another—affects up to 11 % of older adults and 6 % of adolescent athletes. While most low-grade slips respond to conservative measures, a sizeable minority progress or become symptomatic, prompting rapid evolution of both fusion and motion-preserving technologies over the past decade. Methods: A systematic search of PubMed, Scopus, and Cochrane Library (January 2015–May 2025) identified 412 records; 78 high-quality observational studies, randomized trials, and systematic reviews met inclusion criteria (English language, ≥30 patients or IDE data). Primary outcomes were pain (VAS), disability (ODI), fusion or implant success, complication profiles, and return-to-activity. Data were synthesized narratively; where primary articles overlapped, the most recent, highest-level evidence was favored. Results: Conservative programmes combining core-stabilising physiotherapy, activity modification, and bracing relieved pain in 69 % of Meyerding I–II cases, with only 10–15 % requiring delayed surgery. Minimally invasive fusion (MIS-TLIF) matched open-TLIF fusion rates (93–98 %) while halving blood loss and shortening hospital stay by 2 days. Unilateral biportal endoscopic TLIF (UBE-TLIF) produced equivalent 2-year fusion (95 %) with lower blood loss but longer operative and fluoroscopy times josr-online.biomedcentral.com. Motion-preserving options gained regulatory traction—the TOPS™ facet arthroplasty demonstrated 77 % composite clinical success versus 24 % after fusion at 24 months (FDA PMA, 2023) premiaspine.com. Direct pars repair yielded >90 % fusion and full return-to-sport in young athletes. For high-grade (III–V) slips, in-situ L4–S1 fusion maintained 88 % long-term patient-reported success. Robotics and navigation reduced pedicle-screw error to <2 %, while AI-assisted imaging improved diagnostic accuracy for subtle slips by 12 % over expert radiologists bmcmusculoskeletdisord.biomedcentral.comsciencedirect.com. Conclusion: Management of spondylolisthesis has shifted toward patient-specific algorithms—escalating from structured physiotherapy to MIS fusion and, increasingly, motion-sparing implants. Evidence supports MIS-TLIF or UBE-TLIF for most surgical candidates, with TOPS and direct pars repair expanding indications where segmental mobility is paramount. Technologies such as robotics, 3-D printing, and AI promise further individualisation and safety.

Effectiveness of Neurodevelopmental Therapy on Trunk Control and Sitting Balance in Children with Spastic Quadriplegic Cerebral Palsy: A Quasi-Experimental Study

Wed, 23 Jul 2025 00:00:00 +0300

Background: Spastic quadriplegic cerebral palsy (CP) severely limits trunk control and sitting balance. Neurodevelopmental therapy (NDT) is widely used, yet its added value over conventional physiotherapy remains debated. Methods: Thirty children (6–10 years; GMFCS III–IV) with spastic quadriplegic CP were allocated to NDT + conventional therapy (n = 15) or conventional therapy alone (n = 15) for 6 weeks, three 45-min sessions per week. Gross Motor Function Measure-88 (GMFM-88) and Trunk Control Measurement Scale (TCMS) were recorded pre- and post-intervention. Paired and unpaired t-tests compared within- and between-group change. Results: Both groups improved significantly. In the NDT arm GMFM rose from 30.22 ± 5.79 to 35.19 ± 5.81 (p < 0.001) and TCMS from 11.07 ± 1.90 to 15.34 ± 2.60 (p < 0.001). Conventional therapy produced smaller gains (GMFM 30.05 ± 4.97 → 31.47 ± 5.21, p = 0.0003; TCMS 11.18 ± 3.05 → 12.71 ± 2.97, p < 0.001). Between-group comparison showed a clinically relevant but non-significant difference for GMFM (p = 0.075) and a significant advantage for NDT on TCMS (p = 0.015). Conclusion: Adding NDT to conventional exercises yields greater improvements in trunk control and sitting balance than conventional therapy alone in children with spastic quadriplegic CP.

An In-Vivo Study of the Accesory Bands of Hamstring Tendons

Dr. Pyntngen Kharbamon, Dr. Rajeev Raman, Dr. Abhijeet Sen, Dr. Umesh Kanade — Wed, 23 Jul 2025 00:00:00 +0300

Background. The objective of our study is to determine the characteristics of accessory bands of hamstring tendons and their implications for a successful graft harvest during Arthroscopic ACL reconstruction

Method. 30 middle-aged patients,17 males and 13 females with Anterior cruciate ligament injuries posted for arthroscopic ligament reconstruction were included in this study. Both semitendinosus and gracilis graft were harvested in all patients. The number of bands in each tendon and their location from the tendon insertion is measured and recorded

Results. The majority of patients in the study had two accessory bands of semitendinosus (66.67%). Other enrolled patients either had one accessory band (20%) or three accessory bands (13.33%). On the other hand, the majority patients (76.67%) had no accessory bands of gracilis, while the remaining had one accessory band. Of all the gracilis tendons, a single accessory band was observed in 7 tendons. They were found arising at a distance ranging from 4-6 cm from the tendon insertion at the tibial crest. For the semitendinosus, there was always a constant distal band arising at distance ranging from 3-7 cm. 13% of semitendinosus had a 3 accessory band with the most proximal band arising at 9-11 cm. 66.67% had only 2 accessory bands with the proximal band found at a distance of 8-10 cm measured from the insertion point

Conclusion Although accessory bands are highly variable in their location, we have observed that none of the bands were located more than 11 cm from the tendon insertion point. Tendon stripper can be safely advanced beyond this point

A Case Report of Right Pulmonary Artery Agenesis Presentation in an Adult Female

Dr Vinjamuri Anuhya, Dr Raghuramulu Ananthoju, Dr Uma MA, Dr Aditya Challapalli — Thu, 24 Jul 2025 00:00:00 +0300

Unilateral pulmonary artery agenesis (UPAA) is a rare congenital anomaly resulting from maldevelopment of the sixth aortic arch. Its presentation in adulthood, particularly in the absence of associated congenital cardiac anomalies, is uncommon and often poses a diagnostic challenge.

A STUDY ON CLINICAL PATTERN OF DERMATOSES IN PAEDIATRIC AGE GROUP IN A TERTIARY CARE HOSPITAL IN ASSAM

Divya J N, Bhaskar Gupta, Johnson Cyriac , Joydeep Roy, Arup Paul, Shromona Kar — Thu, 24 Jul 2025 00:00:00 +0300

Paediatric dermatoses are a distinct group of disorders,comprising skin problems encountered during both childhood and adolescence.
Skin diseases are a major health problem in the paediatric age group and areassociated with significant morbidity and mortality.

An observational study evaluates neonatal outcomes in infants born to mothers with pre-eclampsia

Dr. Valluri. Sireesha, Dr. Srinivasa S, Dr. Akshatha, Dr. Bhavana, Dr. Apoorva — Thu, 24 Jul 2025 00:00:00 +0300

Background: Pre-eclampsia is a leading cause of maternal and neonatal morbidity and mortality. This study evaluates neonatal outcomes in infants born to mothers with pre-eclampsia.

Methods: A prospective observational study was conducted on 84 neonates born to pre-eclamptic mothers in tertiary care hospital. The study was conducted for the duration of 12 months. Maternal and neonatal parameters were recorded, including gestational age, birth weight, Apgar scores, NICU admissions, and complications.

Results: The mean gestational age was 35.2 ± 2.4 weeks, with 62% preterm deliveries. Low birth weight (<2500g) was observed in 58.3% of neonates. Respiratory distress syndrome (RDS) (26.2%), neonatal jaundice (19%), and intrauterine growth restriction (IUGR) (21.4%) were common complications. NICU admission was required in 45.2% of cases.

Conclusion: Neonates born to pre-eclamptic mothers have higher risks of prematurity, low birth weight, and neonatal complications. Early antenatal monitoring and timely delivery can improve outcomes.

Clinicopathological and Radiological Evaluation of Cervical Lymph Node Metastasis in Head & Neck Malignancies

Dr Yash Garg, Dr Chanderdutti, Dr Manprakash Sharma, Dr Amit Modwal — Thu, 24 Jul 2025 00:00:00 +0300

Background: Head and neck cancers, highly prevalent in Asia and India, often present with cervical lymph node metastasis, impacting prognosis. This study evaluates the diagnostic accuracy of clinical examination, CT, ultrasonography, and pathological findings in detecting nodal metastasis, emphasizing imaging's role when clinical assessment is inconclusive.

Objectives: The objectives are to assess the role of radiological imaging, pathological results and clinical examination in evaluating cervical lymph node metastasis and to assess the diagnostic accuracy of radiological imaging when clinical examination produces negative results

Material methods: This cross-sectional study, conducted over 18 months in the Department of Otorhinolaryngology, included 157 patients with suspected head and neck malignancies. Patients aged 21–80 were included based on strict criteria. Radiological imaging was assessed using standardized criteria, and statistical analysis determined diagnostic accuracy.

Results: In this study involving 157 patients with suspected head and neck malignancies, oral cavity carcinoma was the most common diagnosis. Cervical lymph node metastasis was evaluated using clinical examination, CT, ultrasonography, and fine needle aspiration cytology, with histopathology serving as the reference standard. USG demonstrated the highest sensitivity (93.3%) for detecting metastasis, followed by FNAC (90%) and CT (83.3%).

Conclusion: This study emphasizes a multidisciplinary diagnostic approach for cervical lymph node metastasis in head and neck cancers. Ultrasound showed highest sensitivity, while CT provided anatomical precision. Combining clinical examination, USG, CT, FNAC, and histopathology enhances diagnostic accuracy, improves staging, guides treatment planning, and leads to better patient outcomes and prognosis.

Determinants Influencing Surgical Outcomes in Chronic Osteomyelitis: A Clinical Evaluation

Sat, 26 Jul 2025 00:00:00 +0300

Background: Chronic osteomyelitis is a persistent infection of bone and bone marrow which results from trauma, surgery, or hematogenous spread. The condition is complicated by microbial biofilm formation, host immune evasion, and the presence of implants. It poses a significant clinical challenge due to high recurrence rates and difficulties in eradication.

Objective: To evaluate the risk factors associated with chronic osteomyelitis, assess surgical outcomes, and determine the influence of these risk factors on patient recovery.

Methodology: This prospective observational study was conducted at PES Institute of Medical Sciences and Research, Kuppam, from June 2023 to June 2024. Thirty-four patients diagnosed with chronic osteomyelitis of long bones were included. Data were collected on demographic characteristics, comorbidities, injury and implant history, microbiological findings, and laboratory parameters. Functional outcomes were assessed using LEFS and DASH scores at 1-, 2-, and 3-month follow-ups. Statistical analysis was performed using SPSS v26 with ANOVA and chi-square tests.

Results: The majority of participants were males (85.3%) aged 40–60 years. Most cases were associated with the presence of implants (94.1%), particularly nails and plates. Common risk factors included diabetes mellitus and smoking. Among microbiological isolates, Staphylococcus aureus, E. coli, and coagulase-negative staphylococci were predominant. Significant associations were found between functional outcomes and factors such as age, duration of symptoms, implant status, hemoglobin levels, and Cierny-Mader classification.

Conclusion: Implant-related infections and host factors such as anemia, diabetes, and smoking significantly influence the development and outcome of chronic osteomyelitis. Early identification and aggressive surgical management combined with targeted antibiotic therapy are essential for favorable recovery.

Comparative Evaluation Of 0.25% Levobupivacaine with and Without Dexmedetomidine for Ultrasound-Guided Adductor Canal Block In Postoperative Analgesia for Knee Surgeries: A Randomized Controlled Trial

Sat, 26 Jul 2025 00:00:00 +0300

Background: The Adductor Canal Block (ACB) is an effective regional anesthesia technique for managing postoperative pain following knee surgeries. It provides sensory analgesia while preserving quadriceps motor function. Levobupivacaine, a commonly used local anesthetic, offers a moderate duration of pain relief. Dexmedetomidine, an alpha-2 adrenergic receptor agonist, has the potential to prolong the duration of nerve blocks. Therefore, perineural administration of dexmedetomidine may enhance the quality and duration of analgesia when used as an adjuvant.

Objective: To compare the efficacy and duration of postoperative analgesia using 0.25% levobupivacaine alone versus 0.25% levobupivacaine combined with dexmedetomidine (0.5 micrograms per kilogram) for Adductor Canal Block (ACB) in patients undergoing Total Knee Replacement (TKR) or knee arthroscopy.

Methods: In this prospective, double blind, randomized study, 60 ASA I–II adults scheduled for elective unilateral knee surgery under spinal anaesthesia were allocated to Group L (20 mL levobupivacaine 0.25%) or Group LD (20 mL levobupivacaine 0.25% + dexmedetomidine 0.5 mg/kg-1). Primary outcome was time to first rescue opioid (NRS > 3). Secondary outcomes included pain scores (NRS 0–10) at predefined intervals, haemodynamics, opioid consumption, and adverse events.

Results: Baseline demographics were comparable between groups. Median (IQR) time to first rescue analgesia was significantly longer in Group LD for both TKR [7.7 (6.0–9.0) h vs 6.3 (5.0–7.5) h; p = 0.036] and arthroscopy [11.3 (9.3–12.5) h vs 8.6 (7.1–10.0) h; p < 0.001]. Group LD demonstrated lower NRS scores from 4 h to 12 h post block (all p < 0.05). Total 24 h morphine requirement was reduced by 29% in Group LD. Haemodynamic variables remained within 20% of baseline; systolic blood pressure was modestly lower in Group LD at 2–6 h. No hypotension, bradycardia, nausea, vomiting, or neurological deficits were recorded.

Conclusion: Addition of 0.5 µg kg⁻¹ dexmedetomidine to levobupivacaine for ACB significantly prolongs analgesia and decreases opioid consumption without compromising haemodynamic stability or increasing adverse effects. Dexmedetomidine enhanced ACB represents an effective component of multimodal analgesia after knee surgery.

Supracondylar Nailing In Floating Knee Injuries - A Case Series and Review of Literature

Sat, 26 Jul 2025 00:00:00 +0300

Background: Floating knee injuries are defined as ipsilateral fractures of the femur and tibia and are frequently the result of high-energy trauma. These injuries pose substantial challenges in treatment and rehabilitation due to the complexity of associated fractures and high morbidity. This study aimed to evaluate the efficacy of supracondylar nailing for femoral shaft fractures in floating knee injuries, focusing on operative duration, intraoperative blood loss, and the benefits of a single surgical exposure.

Methods: We reviewed three cases of floating knee injuries treated with femoral supracondylar nailing and tibial intramedullary interlocking (imil) nailing. Postoperative assessments included the knee society score (kss), knee range of motion (rom), average surgical time, mean drop in hemoglobin, and fracture union.

Results: All patients underwent surgery in a single operative session. Fracture union was achieved in each case without postoperative infection. Functional outcomes were favorable, with excellent kss scores at six-month follow-up.

Conclusion: While multiple surgical techniques exist for floating knee injuries, supracondylar nailing offers a promising approach for femoral fracture management, reducing operative time, minimizing blood loss, and facilitating early mobilization through single-incision surgery.

A Comparative Study to Assess the Efficacy and Safety of Oxytocin, Misoprostol and Carboprost In Active Management of Third Stage of Labour at A Tertiary Care Hospital

Dr. Lalitha A, Dr. Mamatha K. R, Dr. Yuvarani R, Dr. Kavya B. S — Sat, 26 Jul 2025 00:00:00 +0300

Background: Third stage of labour is the most perilous for woman because of the risk of postpartum haemorrhage (PPH) and the primary cause being uterine atony. Active management of the third stage of labour is a well-established protocol.

Objectives: To assess the efficacy and safety of oxytocin, misoprostol and carboprost in active management of third stage of labour.

Methods: One hundred and eighty pregnant women with term gestation were recruited and randomised into three groups. Group A received intravenous infusion of 10U of oxytocin in 500ml normal saline, Group B received 600µg of Misoprostol per rectally and Group C received 125µg of Carboprost intramuscularly at the delivery of anterior shoulder of the baby. Primary outcomes were duration of third stage, amount of blood loss and incidence of PPH.

Results: Misoprostol and carboprost were associated with shorter durations of the third stage of labor (5.16 ± 1.85 and 5.25 ± 1.73 minutes, respectively) compared with oxytocin (6.43 ± 2.6 minutes). Blood loss was also significantly lower in the carboprost group (157.41 ± 49.43 ml) than in the misoprostol (183.25 ± 51.93 ml) and oxytocin (206.16 ± 56.81 ml) groups. Additionally, the carboprost group required the fewest additional uterotonic agents and experienced the smallest decreases in hemoglobin and hematocrit levels.

Conclusion: This study highlights the superior uterotonic profile of carboprost 125µg compared to other agents studied. Prophylactic carboprost may therefore be a valuable alternative for the active management of the third stage of labor.

Bilateral Septic Arthritis of the Knees in an Immunocompetent Elderly Female: A Rare Case Report and Literature Review

Sat, 26 Jul 2025 00:00:00 +0300

Septic arthritis (SA) is a medical emergency requiring early recognition and prompt intervention to avoid irreversible joint damage and systemic complications. While monoarticular SA is most common, bilateral knee involvement is rare, particularly in immunocompetent individuals. This case report presents a 64-year-old woman with bilateral knee SA in the absence of traditional risk factors and negative synovial fluid cultures. Diagnosis was guided by clinical presentation and elevated inflammatory markers and elevated ASLO. Surgical management via mini-arthrotomy combined with empirical antibiotics led to a full recovery. This report highlights the need for a high index of suspicion in atypical presentations and reviews relevant literature, including the role of the Kocher criteria for SA of knee joint.

Combining Dexmedetomidine and Airway Blocks for Awake Airway Access: Insights from Three Clinical Cases

Dr. Raju Shakya, Dr. Sunny Aggarwal, Dr. Mukul Garg — Sat, 26 Jul 2025 00:00:00 +0300

Airway management in patients with anticipated difficult airway anatomy poses significant challenges to anaesthesiologists. Techniques such as conscious sedation with dexmedetomidine and regional airway blocks offer an alternative to general anesthesia, providing adequate sedation while preserving spontaneous ventilation and airway reflexes. This case series presents three patients with challenging clinical case scenarios and airway anatomy managed successfully using combination of conscious sedation and regional airway blocks.

Bacteriological profile and antibiotic susceptibility pattern in neonatal sepsis in a tertiary care hospital

Rajkumar khati,Dr.Harshada Shah,Dr.Chaudhary Devendra — Mon, 28 Jul 2025 00:00:00 +0300

Neonatal sepsis is a significant cause of morbidity and mortality worldwide,yet there is no clear consensus definition, with positive blood cultures serving as thegold standard for diagnosis. Diagnosing sepsis in neonates is challenging due tovarying definitions of “culture negative” or “suspected” sepsis.

Dermatologic Presentation of Intrahepatic Cholestasis in Pregnancy: A Meta-Analysis Linking Serum Bile Acids, Pruritus, and Neonatal Outcomes

Mon, 28 Jul 2025 00:00:00 +0300

Intrahepatic cholestasis of pregnancy (ICP) is a liver disorder found only in pregnancythat results from a mulitfactorial interplay of genetic, hormonal, and environmentfactors. Dysfunction in hepatocellular transport systems causes impaired bile acid

Impact of Community-Based Oral Health Education Programs on Periodontal Disease Awareness and Prevention

Mon, 28 Jul 2025 00:00:00 +0300

Community-based oral health education programs have emerged as a promising strategy toenhance periodontal disease awareness and prevention. This experimental study evaluated theimpact of a structured three-month interactive education intervention on periodontal knowledge

Efficacy of Probiotic Lozenges in Reducing Periodontal Pathogens in High-Risk Populations

Mon, 28 Jul 2025 00:00:00 +0300

Elevated colonization by periodontal pathogens such as Porphyromonas gingivalis andAggregatibacter actinomycetemcomitans contributes to chronic periodontal disease and systemichealth risks. This double-blind, randomized, placebo-controlled trial evaluated the impact of dailyprobiotic lozenges containing Lactobacillus reuteri DSM 17938 and ATCC PTA 5289 on

Effect of Angiotensin Receptor Blockers on Renal Function Biomarkers in Early-Stage Diabetic Nephropathy

Mon, 28 Jul 2025 00:00:00 +0300

Angiotensin receptor blockers (ARBs) are established agents in slowing diabetic nephropathyprogression; however, their impact on emerging biomarkers in early-stage disease remains underexplored. In this randomized experimental trial, 140 type 2 diabetic patients

Combined Diagnostic Workflow for Lymphadenopathy: Correlation Between FNAC, Culture, Histopathology, Peripheral Blood Findings, Microbiological Analysis with Inclusion of Pediatric and Genetic Considerations

Mon, 28 Jul 2025 00:00:00 +0300

Lymphadenopathy encompasses diverse etiologies, including infectious, neoplastic, autoimmune,and genetic disorders. This prospective cross-sectional study assessed a combined diagnosticworkflow—including fine-needle aspiration cytology (FNAC), microbial cultures, histopathology,

Outcome Analysis of Day-Care vs. Inpatient Breast Lump Excision Surgeries

Mon, 28 Jul 2025 00:00:00 +0300

This prospective cohort study compares surgical outcomes, patient satisfaction, cost-effectiveness,and complication rates between day-care and inpatient breast lump excision in 150 adult women.Patients were assigned to either day-care (n=75) or overnight-stay inpatient (n=75) pathways.Primary outcomes included postoperative complications (seroma, hematoma, infection)

Epidemiological Profile and Inpatient Management of Pediatric Dengue Hemorrhagic Fever

Mon, 28 Jul 2025 00:00:00 +0300

This prospective observational study details the demographic trends, clinical presentation, andinpatient management outcomes of pediatric dengue hemorrhagic fever (DHF) in a tertiary-carehospital in Pakistan. Between July and October 2023, 200 children aged 1–15 years with RT-PCRor NS1-confirmed DHF were enrolled. Key findings include a male predominance (60%),

Incorporating Digital Tools to Facilitate Self-Directed Learning in Medical students and family medical residents

Mon, 28 Jul 2025 00:00:00 +0300

Digital technologies are transforming medical education by fostering self-directed learning (SDL).This prospective, quasi-experimental study examined the effects of a structured digital toolkit—comprising virtual-reality anatomy modules, AI-simulated clinical cases, and spaced-repetition

Early - onset type 1 diabetes in children: challenges in diagnosis and long term HbA1c based glycemic control

Mon, 28 Jul 2025 00:00:00 +0300

Early-onset type 1 diabetes in children presents distinct diagnostic challenges and often leads topersistently elevated HbA1c levels due to rapid β-cell decline and metabolic instability. Theobjective of this experimental cohort study was to analyze early diagnostic biomarkers

Assessment of Serum Lipoprotein-Associated Phospholipase A2 in Statin Treated Hypertensive Patients with Cardiovascular Risk

Mon, 28 Jul 2025 00:00:00 +0300

Statin‐treated hypertensive patients remain at risk for cardiovascular events despite achievementof lipid-lowering goals. Lipoprotein-associated phospholipase A₂ (Lp-PLA₂), an enzyme linked tovascular inflammation and plaque instability, may serve as an independent biomarker in this

Improving Oral Health in Special Needs Populations: Challenges and Solutions

Mon, 28 Jul 2025 00:00:00 +0300

Individuals with intellectual, developmental, or physical disabilities often encounterdisproportionate barriers to oral healthcare, including reduced access to preventive services,diminished capacity for daily hygiene, and behavioral or communication limitations. In this mixed

Physiological Role of Vitamin D and Magnesium Deficiency in Modulating Glycemic Variability and Biochemical Profiles in Type 2 Diabetes Mellitus Patients

Mon, 28 Jul 2025 00:00:00 +0300

Vitamin D and magnesium exert critical regulatory influence on glucose metabolism. Thisexperimental study evaluated the diagnostic significance of serum 25-hydroxyvitamin D, ionizedmagnesium, and their effects on glycemic variability and key biochemical parameters in Type 2diabetes mellitus (T2DM). One hundred adult T2DM patients were prospectively recruited

Predictive Role of Total Bilirubin, Alkaline Phosphatase, and Biliary Microbiota in Detecting Extra-Hepatic Biliary Obstruction

Mon, 28 Jul 2025 00:00:00 +0300

Extra-hepatic biliary obstruction (EHBO) poses significant diagnostic uncertainty, particularlywhen radiologic imaging is equivocal. This prospective experimental study evaluates thepredictive power of serum total bilirubin (TBil), alkaline phosphatase (ALP), and biliary

Comparison of Hemodynamic Stability in Spinal versus General Anesthesia During Lower Abdominal Surgeries

Mon, 28 Jul 2025 00:00:00 +0300

Lower abdominal surgeries are commonly performed under either spinal anesthesia (SA) orgeneral anesthesia (GA), yet comparative data regarding intraoperative hemodynamic stabilityremain limited. In this randomized controlled study, 160 patients undergoing elective lowerabdominal procedures were allocated to receive SA with 12.5 mg hyperbaric bupivacaine or GAwith propofol-remifentanil maintenance. Primary endpoints included intraoperative mean arterial

Prevalence of Smokeless Tobacco Usage among Adult Population in Rural Area

Sangeetha R, G Kalyan Chakravarthy, Sunitha Sreegiri — Tue, 29 Jul 2025 00:00:00 +0300

Background: Tobacco is a leading risk factor for deaths due to non-communicable diseases in developing countries. India accounts for 70% of the global burden of smokeless tobacco which also attributes to 27% of all cancers in India. Tobacco usage is a major public health issue which needs to be addressed effectively. Objectives were to estimate the prevalence of smokeless tobacco usage in study population and to assess awareness regarding the harmful effects of tobacco usage and COTPA in the study population. Methods: A community based cross-sectional study was conducted among all adults aged 18 years & above residing in Chandragiri Mandal during March-April 2025. Using simple random sampling, 190 participants were selected and interviewed using pretested semi- structured questionnaire. Data was entered in MS Excel and analysed using Epi Info software. The differences between the qualitative variables were analysed using Chi-square test. Results: Out of the 190 participants interviewed, 37.9% were using smokeless tobacco at present. Most of the users were above 60 years of age. Smokeless tobacco consumption was more among females. Majority of the participants i.e. 85.1% knew about the harmful effects of tobacco. Almost 44.4% knew about COTPA, 92.9% were in favour of the act and 45.8% believed that pictorial warning helps reduce smokeless tobacco use. Conclusion: Smokeless tobacco usage was higher among females than males and in the older age group (>60 years). Health education and counselling need to be provided regarding the harmful effects of tobacco.

EVALUATION OF EFFICACY OF EPIDURAL MAGNESIUM SULPHATE AS AN ADJUVANT TO EPIDURAL LEVOBUPIVACAINE FOR POSTOPERATIVE ANALGESIA IN PATIENTS UNDERGOING FEMUR SURGERIES: A PROSPECTIVE OBSERVATIONAL STUDY

Dr. P. Rajkumar, Dr. M. Bhaskar, Dr. A. RaniPriya, Dr. K. Murugesan — Wed, 30 Jul 2025 00:00:00 +0300

Epidural anaesthesia is a versatile central neuraxial technique. There is growinginterest in enhancing its analgesic efficacy by using adjuvants. Magnesium sulphate hasemerged as a promising agent for improving postoperative analgesia. This study aims to

Evaluation of Atherogenic Index of Plasma and Lipid Ratios in Patients with Head and Neck Squamous Cell Carcinoma in North Indian Study Group

Wed, 30 Jul 2025 00:00:00 +0300

Cancers have become a leading cause of morbidity and mortality in today’s world.With time the incidence of cancers is rapidly rising. Head and neck carcinomas pose real threatbeing very aggressive in their course and also poor prognosis adds on to their occurrence. India

CHROMOSOMAL ABNORMALITIES IN RECURRENT PREGNANCY LOSS – A STUDY IN NORTH-EASTERN PART OF INDIA.

Dr. Shashwati Geeta Deka ,Dr. Kunja Lal Talukdar — Mon, 07 Jul 2025 00:00:00 +0300

Recurrent Pregnancy Loss (RPL) is a cause of childlessness affecting 2-5% women across theglobe. Among the varied known and unknown causative factors of RPL, chromosomalabnormalities are often detectable ones with cytogenetic tests.

Association Between Maternal Vitamin D Levels and Cord Blood pH in Term Neonates: A Case-Control Study

Dr. Panchanan Das, Dr. Gautam Medhi, Dr. Manish R Ratan — Thu, 31 Jul 2025 00:00:00 +0300

Background: Maternal vitamin D deficiency has been increasingly recognized as amodifiable risk factor influencing neonatal outcomes. Cord blood pH is a criticalparameter indicating neonatal acid-base status and potential perinatal hypoxia.

CLINICAL OUTCOME OF ANEMIA MANAGEMENT WITH AND WITHOUT TRANSFUSION IN HOSPITALIZED MEDICAL PATIENT

Thu, 31 Jul 2025 00:00:00 +0300

Hospitalised patients frequently suffer from anaemia, which frequently results in morecomplications and longer hospital stays. The conventional treatment has been bloodtransfusions, but conservative methods are becoming more popular due to worriesabout the risks involved. In order to assess the efficacy and safety of non-transfusion

Cidofovir as a Potential Antiviral Agent against Monkeypox A Systematic Review

Maria Farooqi, Jameel Sayed, Urooj Mirza, Feroza Fatima, Sufia Sayed, Omar Imran — Fri, 01 Aug 2025 00:00:00 +0300

Background: There are a number of large and complex viruses in the poxviridae family. Among these viruses are orthopoxvirus under which monkeypox virus (MPXV) falls. Monkeypox virus is transmitted through either getting exposed to contaminated objects or direct contact with infected humans or animals. For its treatment, specifically two antiviral drugs are used which are tecovirimat and cidofovir. In AIDS patients, cytomegalovirus (CMV) retinitis is present which is treated by using cidofovir.

Objective: To evaluate the effectiveness of cidofovir in treating monkeypox

Study design: A systemic reivew

Methodology: This is a comprehensive study which was performed by using a number of research studies conducted by different authors. The information was gathered through searching different research articles based on monkeypox and cidofovir. The outputs which were assessed were a negative MPXV PCR test, plague suppression, symptom relief without side effects, MPXV replication, and prevention of mortality and morbidity.

Results: The research studies that were included in this article were all related to monkeypox and cidofovir which were published between 2002 and 2024. Initially, there were more than 300 studies but after deleting the duplicate ones, 200 were left. Among these 200 articles, only a few were selected after screening titles and abstract.

Conclusion: It was found that cidofovir is an effective drug to treat monkeypox.

Outcomes of Closed Diaphyseal Humeral Fractures Treated by Dynamic Compression Plate versus Intramedullary Nail

Fri, 01 Aug 2025 00:00:00 +0300

Background: Compression plates and intramedullary nails are commonly used devices for stabilizing humeral shaft fractures. Nailing is often associated with postoperative shoulder pain and stiffness due to impingement from prominent implants. Plate fixation may reduce the risk of shoulder problems and the likelihood of reoperation.

Objective: This study aims to compare the outcomes of closed diaphyseal humeral fractures treated with dynamic compression plates versus intramedullary nails.

Methods: A total of 40 patients with closed diaphyseal humeral shaft fractures, reported within two weeks of injury, were included in the study. Clinical examinations and X-rays were utilized for diagnosis. Patients were divided into two groups: Group A received dynamic compression plates, while Group B received intramedullary nails. Postoperative assessments included severity of pain, complications, and hospital stay. The Chi-square test was applied, with a p-value of <0.05 considered significant.

Results: Postoperatively, in the dynamic compression plate group, 50% experienced mild pain, 35% moderate pain, and 15% severe pain. In the intramedullary nail group, 30% had mild pain, 50% moderate pain, and 20% severe pain. Complications were observed in 4 patients in Group A and 7 in Group B. Hospital stays ranged from 1-10 days for 40% of Group A patients and 11-20 days for 60%. For Group B, 55% stayed 1-10 days and 45% stayed 11-20 days.

Conclusion: The management of closed diaphyseal humeral fractures with dynamic compression plates is superior to intramedullary nails, exhibiting lower rates of pain severity and complications.

A CROSS-SECTIONAL STUDY TO EVALUATE CORRELATION BETWEEN NCV OF RIGHT UPPER LIMB AND LEFT UPPER LIMB IN A TERTIARY HEALTH CARE CENTRE OF WEST BENGAL

Dr. Washim Bari Rahaman, Dr. Tamal Chakraborty,Dr. Krishnendu Saha — Thu, 31 Jul 2025 00:00:00 +0300

Nerve conduction velocity (NCV) is a vital neurophysiological parameter usedin the diagnosis and monitoring of peripheral nerve function. While inter-limb symmetry inNCV is generally assumed in healthy individuals, subtle differences may exist due to factorssuch as handedness, age, sex, and body composition. The present study aims to evaluate

Outcomes of Metacarpal Fracture Fixation: A Comparison between Dual Intra-Medullary 1.5mm Kirschner's Wire and Single 2.0mm K-Wire Techniques

Fri, 01 Aug 2025 00:00:00 +0300

Objective: This study aims to evaluate and compare the outcomes of two fixation techniques for metacarpal fractures: dual intra-medullary 1.5mm flexible Kirschner's wire (K-wire) fixation versus single 2.0mm K-wire fixation.

Methods: Conducted at the Department of Orthopedic in Muhammad Medical College / Ibn-E-Sina University Mirpurkhas Pakistan, this prospective study spanned from January 2024 to December 2024. A total of 40 patients, aged between 18 and 60 years, with either single or multiple metacarpal fractures were enrolled. Participants were randomly assigned to one of two treatment

groups: Group 1 received dual intra-medullary 1.5mm flexible K-wire fixation, while Group 2 was treated with a single 2.0mm K-wire.

Results: The mean age of participants was 34.89 ± 6.45 years, with a predominance of male patients. In Group 1, 50% (n=10) of patients achieved excellent outcomes, 25% (n=5) had good outcomes, and 20% (n=4) reported fair outcomes. Conversely, in Group 2, 40% (n=8) had excellent outcomes, 25% (n=5) had good outcomes, 25% (n=5) had fair outcomes, and 10% (n=2) experienced poor outcomes, as classified by Strickland's criteria. While no statistically significant differences were found between the two fixation methods, those treated with dual 1.5mm K-wires exhibited better functional results.

Conclusion: The findings suggest that dual K-wire fixation offers a superior approach for managing metacarpal fractures compared to single K-wire fixation, attributed to quicker healing times and reduced complications.

Effect of Heartfulness Meditation on Vital Parameters among Experienced and New Meditators

Fri, 01 Aug 2025 00:00:00 +0300

Background: Meditation has been key component of Eastern spiritual practices. Heartfulness meditation is a unique heart based system with key practices like cleaning and meditation aided by yogic transmission. Meditation includes a state of deep relaxation and calmness due to changes produced in pertinent areas of brain which improves the performance of brain and circulatory system.

Objectives: To analyze and compare the effect of 30-minute heartfulness meditation session on vital parameters of experienced and new meditators.

Methods: An observational study was conducted for a period of 1 month among experienced and new meditators at Heartfulness Training Center, Tirupati with an estimated sample size of 45 in each group (N=90). All the participants were selected by simple random sampling and were subjected for personal interview by using semi structured questionnaire. Anthropometric measurements and vital parameters like pulse rate, blood pressure were recorded. The difference between means was analyzed by using paired and unpaired t-test.

Results: Mean age of study participants was 56.7±13. Mean heart rate among experienced meditators was decreased from 82.0±8.8 to 80.3±9.9. The mean systolic blood pressure among experienced meditators and new meditators after meditation was found to be 128.1±17.2 and 121.5±12.8 respectively. Statistically significant difference was found in systolic blood pressure levels among both the groups.

Conclusion: Heartfulness meditation session was found to have favourable effect on vital parameters especially systolic blood pressure.

Impact of Resin-Based versus Glass Ionomer Restorations on Adjacent Gingival Tissues in Cervical Lesions

Thu, 31 Jul 2025 00:00:00 +0300

Restorative materials in class V cervical lesions may influence adjacent gingival tissues. Thisexperimental randomized clinical trial compared resin-based composite (RBC) and resin-modifiedglass ionomer cement (RMGIC) restorations for their effects on gingival inflammation

Incidence of Hypothyroidism (High Tsh) In Newborns Delivered Through Lscs In A Government Medical College Sindhudurg

Sat, 02 Aug 2025 00:00:00 +0300

Congenital Hypothyroidism is most common cause of preventable mental retardation in neonates. The incidence of congenital hypothyroidism is approximately 1:2000 to 1:4000 newborns worldwide.

Incidence in India is 1: 2500 – 1:2800 live births. Clinical manifestations of hypothyroidism in newborns are subtle, or not present at birth. Early diagnosis and treatment are of paramount importance to prevent mental retardation.

Aim and Objectives: 1. Incidence of Hypothyroidism (High TSH) in Newborns delivered through LSCS in a Government Medical College Sindhudurg.2.Study the risk factors of congenital hypothyroidism.3.Study clinical profile of Hypothyroidism in newborns

Material and Methods: Study design: Prospective study,

Study settings: Pediatric department of GMC Sindhudurg.

Study population: All newborns with hypothyroidism among LSCS cases in a GMC Sindhudurg during study period such cases were included in the study.

Study period: June 2023 To June 2025

Result: majority of cases were Females 43 (58.10%) cases and 30 (41.89%) cases were males. most of the newborn presented with 2 to 2.5 kg birth weight 49 (66.21%) cases. most of the cases Apgar score at 1 minute was >5 56 cases, most of the newborn status was AGA 67 (90.54%) most common maternal complication was anemia 23 (31.08%), Hypothyroidism in 10 (13.51%) cases, all cases presented with congenital hypothyroidism 74 followed by hypoglycemia 6, birth asphyxia 5 cases, respiratory distress 5, neonatal seizures 4,hypocalcemia 2 cases and birth trauma in 1 case. Incidence of Hypothyroidism (High TSH) in Newborns delivered through LSCS was 8.70%. There is statistically significant association between clinical outcomes with Neonatal status.

Conclusion: majority of cases were Females, Incidence of Hypothyroidism (High TSH) in Newborns delivered through LSCS was 8.70%. There is statistically significant association between clinical outcomes with Neonatal status.

Effectiveness of Dialkyl Carbamoyl Chloride (DACC)-Coated Dressings in Reducing Surgical Site Infections and Promoting Wound Healing: A Randomized Controlled Trial

Dr Priyanka sekar, Dr Manoj Kumar, Dr J Sharath Kumar — Mon, 04 Aug 2025 00:00:00 +0300

Background: Surgical site infections (SSIs) are a significant cause of morbidity, mortality, and extended healthcare costs following surgery. Effective prevention strategies are essential to reduce the risk of SSIs. This study evaluates the effectiveness of dialkyl carbamoyl chloride (DACC)-coated dressings in reducing SSIs, promoting faster wound healing, and improving patient comfort compared to traditional non-coated dressings.

Methods: A prospective, randomized controlled trial was conducted with 100 patients undergoing elective abdominal, orthopedic, or vascular surgery. Patients were randomly assigned to either the DACC-coated dressing group (n = 50) or the control group (traditional non-coated dressings, n = 50). The primary outcome was the incidence of SSIs within 30 days post-surgery. Secondary outcomes included time to healing, bacterial load at Day 1 and Day 7 post-surgery, and patient-reported pain scores at Days 2, 7, and 14 post-surgery. Bacterial cultures and visual analogue scale (VAS) scores were used to assess infection and pain levels.

Results: The incidence of SSIs was significantly lower in the DACC-coated group (6%) compared to the control group (14%) (p < 0.05). The average time to healing was 10 days in the DACC-coated group, compared to 12 days in the control group. Bacterial load at Day 1 was lower in the DACC-coated group (5.5 CFU/mL) compared to the control group (7.8 CFU/mL), and by Day 7, the DACC-coated group showed a greater reduction in bacterial load (1.2 CFU/mL vs. 3.5 CFU/mL). Pain scores were also significantly lower in the DACC-coated group, with an average VAS score of 2.1 at Day 2 and 1.3 at Day 7, compared to 3.7 at Day 2 and 2.9 at Day 7 in the control group.

Conclusions: DACC-coated dressings significantly reduce the incidence of SSIs, promote faster wound healing, reduce bacterial load, and alleviate pain compared to traditional non-coated dressings. These findings suggest that DACC-coated dressings can be an effective tool in enhancing surgical wound care and preventing SSIs, offering a promising option for post-operative management, particularly in high-risk surgical patients. Further studies are needed to confirm the long-term benefits and cost-effectiveness of DACC-coated dressings.

Comparative Study of Four Layer Vs Short Stretch Bandage for Venous Leg Ulcer Healing

Dr Arun Kumar R, Dr J Sharath Kumar — Mon, 04 Aug 2025 00:00:00 +0300

Background: Venous leg ulcers (VLUs) are a significant cause of morbidity worldwide. Compression therapy is the cornerstone of treatment, with Four-Layer Bandage (FLB) and Short Stretch Bandage (SSB) being the two most commonly used modalities. This study aims to compare the efficacy of FLB versus SSB in terms of ulcer healing rates.

Methods: A prospective, randomized comparative study was conducted in a tertiary care hospital. Thirty-five patients with chronic venous leg ulcers were recruited and randomly assigned to receive either FLB or SSB. Patients were followed for 12 weeks with ulcer size, pain score, and quality of life (QoL) assessed at baseline and at regular intervals.

Results: The mean ulcer size reduction was significantly greater in the FLB group compared to the SSB group at 12 weeks (p<0.05). Pain scores improved significantly in both groups, but patients in the FLB group reported better QoL. The rate of complete healing was higher in the FLB group (60%) compared to the SSB group (40%).

Conclusion: FLB demonstrated superior healing outcomes compared to SSB in the treatment of VLUs. Further large-scale studies are recommended.

CARBOPLATIN INDUCED ISCHEMIC OPTIC NEUROPATHY

Dr. Nitin Mehrotra, Dr. Rachit Rastogi, Dr. G.S. Titiyal — Mon, 04 Aug 2025 00:00:00 +0300

Cisplatin and carboplatin are the two platinum based alkylating agents usedwidely as anti-cancer therapy. Carboplatin is more chemically stable and better tolerated withcomparatively favourable profile. Reports of Carboplatin precipitating optic neuropathy israrely reported.

A Clinico-Epidemiological Study on Peripheral Arterial Disease in Diabetes Mellitus

Dr. Amartya Kumar Misra, Dr Sudeshna Mallik, Dr Sourav Kundu — Tue, 05 Aug 2025 00:00:00 +0300

Background: Peripheral arterial disease (PAD) is an under-diagnosed macrovascular complication of diabetes mellitus (DM) that accelerates lower-limb morbidity and heightens cardiovascular risk. Contemporary Indian data on the clinico-epidemiological profile of PAD in DM remain scarce.

Methods: We performed a cross-sectional observational study of 100 consecutive adults with established DM attending a tertiary centre in Kolkata (January–December 2023). Detailed history, examination, biochemical indices, and duplex Doppler of lower-limb arteries were recorded. PAD was graded by ankle–brachial index (ABI) and segmental stenosis (0 = normal; 4 = occlusion). Descriptive statistics, χ² tests and Pearson correlations were generated using SPSS v26; p ≤ 0.05 signified statistical significance.

Results: Mean age was 55.4 ± 18.5 years; 72 % were men. Smoking (60 %), hypertension (42 %) and hyperlipidaemia (38 %) predominated. PAD symptoms lasted 4–8 weeks in 42 % of participants; intermittent claudication was most frequent (46 %), followed by ulceration (32 %) and rest pain (24 %). ABI indicated mild, moderate and severe PAD in 60 %, 32 % and 8 % respectively. Disease severity correlated strongly with diabetes duration (r = 0.85, p < 0.0001) and inversely with receipt of PAD-directed medical therapy (r = –0.47, p = 0.002). No significant association was observed for age, sex, socio-economic markers or family history.

Conclusion: In this Eastern-Indian cohort, PAD occurred early (two-thirds < 60 years) and was chiefly driven by modifiable factors—smoking, hypertension, dyslipidaemia and longer diabetes duration. Routine ABI screening and aggressive risk-factor modification could curb progression to critical limb-threatening ischaemia.

Comparative Evaluation of Hardinge’s And Moore’s Approaches in the Surgical Management of Femoral Neck Fractures in Elderly Patients

Wed, 06 Aug 2025 00:00:00 +0300

Background: Femoral neck fractures are common in the elderly and increasingly managed with hemiarthroplasty. The optimal surgical approach—either the direct lateral (Hardinge’s) or posterior (Moore’s)—remains a subject of debate.

Objectives: This prospective study compares the two approaches regarding perioperative complications, surgical parameters, and functional outcomes.

Methods: Sixty elderly patients with femoral neck fractures were enrolled and treated via either Hardinge’s (n=30) or Moore’s (n=30) approach for bipolar hemiarthroplasty. Outcomes were evaluated using the Modified Harris Hip Score (HHS) at 1, 3, and 6 months postoperatively. Parameters such as duration of surgery, blood loss, dislocation, infection, and abductor strength were analyzed.

Results: The mean HHS scores for the Hardinge group were 36.8, 66.0, and 76.6, while for the Moore group they were 35.9, 63.1, and 73.7 at 4 weeks, 3 months, and 6 months, respectively. Dislocation occurred in one case in the Moore group, whereas the Hardinge group had five instances of abductor weakness. No significant differences were noted in operative time or intraoperative blood loss.

Conclusion: Both approaches provided comparable outcomes in terms of surgical safety and hip function. Hardinge’s approach may reduce dislocation risk, while Moore’s approach appears to better preserve abductor function. Surgical approach selection should be tailored based on individual patient anatomy and surgeon expertise.

Oral versus Injectable Anticoagulants- a Prospective Study Evaluating Apixaban as a Patient-Friendly Alternative to Enoxaparin for DVT Prevention in Orthopaedic Trauma

Wed, 06 Aug 2025 00:00:00 +0300

Background: Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a major cause of morbidity and mortality in hospitalized orthopaedic and trauma patients. Its multifactorial pathogenesis—venous stasis, endothelial injury, and hypercoagulability (Virchow’s triad)¹—necessitates timely prophylaxis. Low molecular weight heparins (LMWH) have been standard, but limitations such as injection-site issues and bleeding risks have led to increased use of direct oral anticoagulants (DOACs) like apixaban²˒⁴. Apixaban offers oral administration, predictable pharmacokinetics, and minimal monitoring². Evidence suggests it is as effective as LMWH with potentially lower bleeding risk³˒⁵. In trauma patients, anticoagulation must be tailored due to variable bleeding risk⁵. This study compares apixaban and enoxaparin in hip fracture patients to assess safety and effectiveness.

Methods: A prospective comparative study was conducted over 18 months at a tertiary orthopaedic centre. A total of 120 patients aged >45 years with fractures around the hip joint were enrolled and divided into two equal groups receiving either apixaban (2.5 mg orally twice daily) or enoxaparin (40 mg subcutaneously once daily) for DVT prophylaxis. Pre and post-intervention assessments included coagulation profile (PT, aPTT, INR) and Doppler studies. Safety was assessed through patient-reported bleeding and side effects; effectiveness was assessed through Doppler-confirmed absence of DVT.

Results: There were no statistically significant changes in PT, aPTT, or INR in either group post-intervention (p > 0.05). No episodes of DVT or major bleeding were reported in either group during the early postoperative period (~11th postoperative day). Patients in the apixaban group preferred oral administration over subcutaneous injection. Both groups demonstrated comparable safety and effectiveness profiles for DVT prophylaxis in the early postoperative period.

Conclusion: Apixaban was found to be as effective and safe as enoxaparin for DVT prophylaxis in patients undergoing orthopedic procedures for hip fractures. The convenience of oral administration favored patient preference, supporting apixaban’s role as a viable alternative to enoxaparin. Larger randomized controlled trials with longer follow-up are recommended to confirm these findings and evaluate long-term outcomes.

Autoantibody profile in first trimester recurrent pregnancy loss - a tertiary care hospital study in North East India

Wed, 06 Aug 2025 00:00:00 +0300

Background: Recurrent pregnancy loss (RPL), defined as the loss of two or more pregnancies before 20 weeks, is often linked to genetic, anatomical, endocrine, or autoimmune causes, though the reason remains unknown in about 50% of cases. This study aimed to assess the burden of autoimmune disease in RPL patients attending antenatal OPD and to profile associated autoimmune antibodies. A strong association was found between RPL and the presence of antiphospholipid (APA), antinuclear (ANA), and anti-thyroid peroxidase (Anti-TPO) antibodies.

Methodology: 121 pregnant women in first trimester with a history of RPL were screened for Anti phospholipid, Anti Cardiolipin, Anti Thyroid Peroxidase and Anti Beta 2 Globulin 1 antibodies. The levels of Complement C3 and C4 were also evaluated.

Results: 65(53.7%) cases were positive for either of the autoantibodies. Anticardiolipin IgG, Anticardiolipin IgM, Anti Phospholipid IgM, Anti Phospholipid IgG, Beta-2 glycoprotein IgM and Beta-2 glycoprotein IgG were found to be positive in 41(33.8%),3(2.4%), 10(8.2%), 4(3.3%),6(5%) and 1(0.8%) respectively. Anti TPO was positive in a significant number of participants 25(21%) despite having normal TSH levels. Complement C3 and C4 were however within normal ranges in all participants. Significant finding of the current study is that with one unit change in Anticardiolipin IgG, the level of C3 was increased by more than two times. Additionally mutual positive association was observed among the antibodies.

Conclusion: Current study throws light on the prevalence of autoantibodies in recurrent pregnancy loss and opens avenues for further research to facilitate early management of RPL and better pregnancy outcomes.

Retinal Manifestations of Hypertensive Disorders in Pregnant Women: Insights from a Rural Antenatal Cohort

Dr Sanjana Reddy, Dr Shivani Namala, Dr Rupanjali J, Dr Narayan Hod — Wed, 06 Aug 2025 00:00:00 +0300

Pregnancy-Induced Hypertension (PIH) poses serious risks to maternal and foetal health. This cross-sectional study evaluated retinal changes in 103 hypertensive pregnant women in a rural tertiary care setting. Fundus abnormalities were found in 37.9% of cases, with AV crossing changes and Grade 2 hypertensive retinopathy being most common. Significant associations were observed with blood pressure, gestational age, visual acuity, and occupational status. Fundoscopic screening can aid in early detection and management of systemic hypertension during pregnancy

Background: Pregnancy-Induced Hypertension (PIH) is a prevalent complication during pregnancy, contributing significantly to maternal and foetal morbidity and mortality. Ocular changes, particularly fundus findings, can serve as early indicators of systemic vascular compromise.

Introduction: This study explores the retinal manifestations of hypertensive disorders in pregnant women, with a focus on a rural antenatal cohort. Pregnancy-Induced Hypertension (PIH), including preeclampsia and eclampsia, remains a major contributor to maternal and fetal morbidity. Given the accessibility and non-invasive nature of fundus examination, this study evaluated ocular changes in 103 antenatal women with hypertension at PES Hospital using direct and indirect ophthalmoscopy. Fundus abnormalities were observed in 37.9% of cases, with AV crossing changes and Grade 2 hypertensive retinopathy being most common. Statistically significant associations were found between retinal findings and factors such as blood pressure, gestational age, gravida status, visual acuity, and occupation. The results emphasize the importance of integrating routine retinal screening into antenatal care, especially in resource-limited rural settings, to facilitate early detection and intervention for systemic hypertension and improve pregnancy outcomes.

Aim: To study the fundus changes in various hypertensive disorders during the antenatal period in a rural population.

Methods: A cross-sectional study was conducted on 103 antenatal women with hypertension at PES Hospital. Participants underwent visual acuity testing and fundus evaluation using direct and indirect ophthalmoscopy. Demographic, clinical, and fundoscopic data were collected and analysed using SPSS software.

Results: Fundus changes were present in 37.9% of participants. The most common abnormalities were AV crossing changes (23.3%), AV narrowing (6.8%), retinal hemorrhages (4.9%), and papilledema (2.9%). Grade 2 hypertensive retinopathy was the most frequent (61.5%). Significant associations were found between fundus changes and blood pressure levels, visual acuity, gestational age, and occupational status (p<0.05).

Conclusion: Fundoscopic examination is a non-invasive, cost-effective tool that provides valuable insight into the systemic impact of hypertension in pregnancy. Routine retinal screening in antenatal care—especially in rural settings—can aid in early detection, timely intervention, and improved maternal and fetal outcomes.

ULTRASOUND MEASUREMENT OF LARYNGEAL STRUCTURES IN THE PARASAGITTAL PLANE FOR THE PREDICTION OF DIFFICULT LARYNGOSCOPY

Rakshik Vailaya, Sucharita Das, Samanvitha Karupakula — Wed, 06 Aug 2025 00:00:00 +0300

Airway management is one of the major concerns for all anaesthesiologists.Failure in securing the airway increases the morbidity and mortality of patients undergoingsurgery under general anaesthesia. Patients undergoing cardiac surgical procedures have higher

Optimisation Cesarean Section Rates Using Robson Ten Group Classification

Dr. Manali Kagathara, Dr Stuti Shah, Dr. Ayush Patel — Thu, 07 Aug 2025 00:00:00 +0300

Background: Cesarean section (CS) rates are increasing globally, leading to concerns about maternal and neonatal complications, rising healthcare costs, and adverse long-term reproductive outcomes. The Robson 10-Group Classification System (TGCS) is widely endorsed as a standard tool for auditing and comparing CS rates.

Objective: To evaluate the impact of targeted interventions—guided by Robson Classification analysis—on reducing CS rates in a tertiary care hospital over a six-month period. Methods: A prospective pre-post interventional study was conducted over six months. In the pre-intervention phase (July–September 2024), CS rates were audited using the Robson Classification to identify high-contributing groups. Based on this analysis, three key interventions were implemented during the intervention phase (October–December 2024): 1. Enhanced Intrapartum Monitoring: Continuous evaluation of labor progression. 2. Bishop Score–Based Induction: Optimized induction decision-making to minimize unnecessary CS. 3. Antenatal Strategies: Aggressive management of genitourinary infections, increased antenatal care visits with targeted counseling on danger signs, and promotion of maternal exercises to prevent preterm labor. Data from 3,527 deliveries (all deliveries ≥24 weeks’ gestation) were compared between the two phases. Statistical significance was assessed using Chi-square tests and multivariate regression (p < 0.05 considered significant). Results: Pre-intervention, the overall CS rate was 45.42%. Post-intervention, the CS rate declined significantly to 37.54% (p < 0.05). The major contributors to CS were: - Robson Group 5: Women with previous CS (single cephalic, term pregnancies). - Robson Group 2: Nulliparous women with induced labor or prelabor CS. - Robson Group 10: Preterm pregnancies, which showed a significant reduction in CS rates following enhanced antenatal management. Additionally, an increase in the vaginal birth after cesarean (VBAC) rate was observed in Group 5 post-intervention.

Conclusion: A structured audit using the Robson Classification combined with targeted intrapartum and antenatal interventions significantly reduced CS rates in our tertiary care hospital. These findings support the broader adoption of similar quality-improvement strategies to optimize maternal and neonatal outcomes.

Eating Behaviour and Body Mass Index in Children with Attention-Deficit Hyperactivity Disorder

Dr Tafheem Kanwar, Dr. Tamanna Hooda, Dr Pooja Bhatia — Thu, 07 Aug 2025 00:00:00 +0300

Background: ADHD has been associated with impaired reward processing and self-regulation that can incline the patient to distorted meals and a weighty excess. Data indicate a greater body mass index (BMI) and obesogenic eating in Indian children regarding ADHD, but limited data are available regarding Indian children. We analysed the relationship between eating behaviours and BMI between offspring with ADHD and normally developing peers.

Methods: In a case control study at a Child and Adolescent Guidance Clinic (April 2021 July 2022), 30 drug naive children with ADHD (DSM-5; age 611 years) and 30 age, sex and income matched controls were recruited. They were asked to give their ADHD assessment using Vanderbilt ADHD Parent Rating Scale, the Conner index Parent 10-item Conner and Child Eating behavior Questionnaire (CEBQ). The same standard procedures were used to measure height and weight; BMI was determined (kg/m 2). Comparisons between groups were done using t test/WilcoxonMann Whitney test, Chi-square/Fisher exact test; correlations, using Spearman rho test (PSPP v23; -0.05).

Results: Mean age did not differ (ADHD 8.17±2.21 vs controls 8.16±2.17 years; p=0.870); 83.3% were male. Mean BMI was higher in ADHD (17.02 vs 14.68 kg/m²; Wilcoxon W=610.5, p=0.018). Weight categories differed (underweight 16.7% vs 40.0%; overweight 23.3% vs 6.7%; obese 16.7% vs 3.3%; Fisher’s exact p=0.039). On CEBQ, enjoyment of food (83.3% vs 60.0%; χ²=4.022, p=0.045) and food responsiveness (70.0% vs 43.3%; χ²=4.344, p=0.037) were more frequent in ADHD. Emotional under-eating scores were lower in ADHD (11.93±3.55 vs 14.10±3.97; p=0.030). A moderate, statistically significant correlation was observed between ADHD severity (Conner’s score) and emotional overeating (r=0.32). No significant associations were found between eating behaviours and age, sex, family income, or neighbourhood.

Conclusion: Indian children with ADHD show higher BMI and greater prevalence of overweight/obesity than controls, accompanied by increased food responsiveness and enjoyment of food. Emotional overeating correlates with ADHD symptom severity. Routine screening for eating behaviours and weight status should be integrated into ADHD care, with early behavioral and nutritional interventions. Larger, community-based longitudinal studies are warranted.

“Level of Caregivers Burden among Family Members of Mentally Ill Patients Visiting Psychiatric Outpatient Department”

Thu, 07 Aug 2025 00:00:00 +0300

Background and

Objectives: Mental health is a vital possession that needs to be cherished, promoted, and conserved. According to the WHO, around 450 million people worldwide suffer from mental or behavioral disorders. In India, approximately 20% of the population suffers from psychiatric or mental disorders. Caregivers play a crucial role in caring for mentally ill patients, but they often face significant emotional, physical, and financial burdens. The researcher aims to assess the level of caregiver burden among family members of mentally ill patients visiting the psychiatric outpatient department (OPD) at Dr. D.Y. Patil Medical College Hospital and Medical Research Institute, Kolhapur. The study seeks to understand the impact of care giving on family members and identify ways to support them.

Objectives: The present study is aimed that to assess the level of caregivers burden among family members of mentally ill patients visiting psychiatric OPD at Dr. D. Y. Patil Medical College Hospital and Medical Research Institute, Kolhapur. The objectives are as follows, 1. To assess the level of care givers burden among family member of mentally ill patients. 2. To find the association between level of care givers burden with selected demographic variables among family member of mentally ill patients.

Methods: A quantitative descriptive survey approach was used, with a non-experimental descriptive research design. A sample of 60 family members of mentally ill patients was selected using non-probability purposive sampling technique. The Zarit Caregivers Burden Scale was used to collect the data on level of caregivers burden among family member of mentally ill patients.

Result: The majority of respondents (46.66%) experienced a mild to moderate level of burden. 30%, had no or minimal burden, while 20% experienced moderate to severe burden. Only 3.33% of individuals experienced a severe level of burden. Significant associations were found between caregiver burden and age, residence, and education.

Interpretation and conclusion: The study concludes that the Level of Caregiver’s Burden among Family Member of Mentally Ill Patients Visiting Psychiatric OPD at Dr. D. Y. Patil Medical College Hospital and Medical Research Institute at Kolhapur, isthe majority of respondents (46.66%) experienced a mild to moderate level of burden. There is a need for healthcare professionals to assess and address caregiver burden among family members of mentally ill patients. The findings have implications for nursing practice, education, administration, and research, as well as general education in schools and colleges. Recommendations for future studies and interventions to support caregivers are also provided.

Orthogeriatric Care in Hip Fracture Patients: Outcomes from Two Randomized Controlled Trials

Thu, 07 Aug 2025 00:00:00 +0300

Hip fractures in older adults often lead to significant functional decline and increased dependency.This study evaluates the impact of comprehensive geriatric care (CGC) compared to standardorthopedic care (OC) on functional outcomes in hip fracture patients.

Assessing the Impact of Community-Based Oral Health Education and Preventive Programs on Awareness and Treatment Compliance in Underserved Populations

Thu, 07 Aug 2025 00:00:00 +0300

Underserved populations face substantial barriers to oral health awareness and treatmentadherence. This experimental study evaluates the effectiveness of community-based oral healtheducation and preventive programs on improving awareness and treatment compliance

Nasal Saline Irrigation with vs. without Additives in Chronic Rhinosinusitis: A Trial of Symptom Relief and Mucociliary Clearance

Thu, 07 Aug 2025 00:00:00 +0300

Chronic rhinosinusitis (CRS) significantly impairs quality of life due to persistent inflammationand impaired mucociliary function. Nasal saline irrigation is a standard adjunctive therapy, yet thebenefit of adding agents such as sodium bicarbonate

Serum Gamma-Glutamyl Transferase and Ferritin as Early Predictors of Non-Alcoholic Fatty Liver Disease in Obese Adults

Thu, 07 Aug 2025 00:00:00 +0300

Elevated serum gamma-glutamyl transferase (GGT) and ferritin levels may serve as earlybiochemical predictors of non-alcoholic fatty liver disease (NAFLD) in obese adults. In a crosssectional cohort of 180 obese participants

Investigating the Predictive Value of Lipoprotein(a) for Atherosclerotic Plaque Burden in Stable Angina Patients: A Mechanistic and Imaging-Based Study

Thu, 07 Aug 2025 00:00:00 +0300

Carotid intima-media thickness (CIMT) and plaque burden via ultrasound provide validatedmarkers of subclinical atherosclerosis.

Comparative Effectiveness of Ketamine Versus Electroconvulsive Therapy in Treatment-Resistant Major Depressive Disorder

Thu, 07 Aug 2025 00:00:00 +0300

This randomized, noninferiority trial evaluates the clinical efficacy, cognitive outcomes, andtolerability of intravenous ketamine versus electroconvulsive therapy (ECT) in 365 adults withnonpsychotic, treatment-resistant major depressive disorder

Correlation Between Arterial Blood Gases and ICU Mortality in Patients with Acute Respiratory Distress Syndrome Undergoing General Anesthesia

Thu, 07 Aug 2025 00:00:00 +0300

Acute Respiratory Distress Syndrome (ARDS) presents a critical challenge in intensive care, withelevated mortality rates exacerbated by perioperative instability during general anesthesia. Thisexperimental observational study investigates

Association of Serum Vitamin D Levels with Disease Severity in Chronic Plaque Psoriasis and Coexisting Obstructive Pulmonary Disease

Thu, 07 Aug 2025 00:00:00 +0300

Serum vitamin D deficiency has been implicated in both chronic plaque psoriasis (CPP) severityand chronic obstructive pulmonary disease (COPD) progression. This mixed-design studycomprised a meta-analysis of observational studies quantifying associations between serum25-hydroxyvitamin D [25(OH)D] and disease severity

Knowledge and Awareness of Obstructive Sleep Apnea and Its Related Complications Among Patients Visiting Outpatient Departments in a Tertiary Care Center: A Cross-Sectional Study

Thu, 07 Aug 2025 00:00:00 +0300

Obstructive Sleep Apnea (OSA) is a common but often underdiagnosed sleep disorder with serioushealth implications, including cardiovascular disease, metabolic disorders, and neurocognitiveimpairment. Despite its high prevalence, public knowledge and awareness remain poor in mostpopulations.

PREVALENCE OF CANDIDA INFECTIONS AND THEIR RESISTANCE PROFILE AMONG PATIENTS AT TERTIARY CARE HOSPITALS, NORTH-INDIA

Ashu Rajput, Dr. Madhurendra Rajput, Chaman Parveen, Dr. Vishal Jain — Fri, 08 Aug 2025 00:00:00 +0300

The term mycology is derived from the Greek word ‘mykes’, a direct counterpart of the Latin word‘fungus’, which is in turn thought to be a modification of the Greek word ‘sponges’, from which our word “sponge”is derived. In last 30 years there has been a significant

A prospective case-controlled study on the outcome of cataract surgery in diabetic and non-diabetic patients

Dr Devesh Sharma, Dr Anand Derashri, Dr Shiv Kumar Gharu — Mon, 11 Aug 2025 00:00:00 +0300

Background: Diabetes mellitus (DM) significantly influences cataract development and may adversely affect visual outcomes and postoperative recovery. This study aimed to evaluate and compare the outcomes of small incision cataract surgery with intraocular lens implantation in diabetic and non-diabetic patients.

Methods: A prospective case-controlled study was conducted at the Department of Ophthalmology, Government Medical College, Chittorgarh, Rajasthan, involving diabetics and non-diabetics patients). Patients were evaluated for preoperative visual acuity, intraoperative and postoperative complications, and visual outcomes at 4 weeks post-surgery. Statistical comparisons between the groups were performed using chi-square and t-tests, with p < 0.05 considered significant.

Results: The mean age was 51.39 years in the diabetic group and 52.88 years in the non-diabetic group. Preoperative best corrected visual acuity (BCVA) was poorer among diabetics (logMAR 1.72 ± 0.48) than non-diabetics (1.51 ± 0.51), though not statistically significant (p > 0.05). Postoperative complications were significantly higher in diabetics (72%) compared to non-diabetics (36%) (p = 0.001), with corneal oedema, anterior chamber reaction, and posterior capsular opacification more prevalent in the diabetic cohort. Despite this, visual improvement was substantial in both groups, and no complication led to permanent vision loss.

Conclusion: Cataract surgery in diabetic patients, even with a higher rate of postoperative complications, yields comparable visual outcomes to non-diabetics when diabetic retinopathy is absent. Complications are generally self-limiting and manageable with conservative treatment. Enhanced perioperative care and monitoring in diabetic individuals are recommended to optimize outcomes.

A PROSPECTIVE STUDY OF KNOWLEDGE, AWARENESS, AND PRACTICE OF DIFFERENT NERVE BLOCKS FOR MANDIBULAR MOLAR ROOT CANAL TREATMENT

Dr Mohsin Kamaal, Dr Ayush Garg, Dr. Sourav Agarwal, Dr Rahul Chaudhari — Wed, 15 Jan 2025 00:00:00 +0300

The most important skill required of all dental practitioners is the ability toprovide safe and effective local anesthesia. Local anesthetic agents block the peripheral nervesand prevent the conduction of pain perception

PREVALENCE OF THE TYPES OF ORAL LICHEN PLANUS IN PATIENTS OF A PRIVATE DENTAL INSTITUTE

Dr Mohsin Kamaal, Dr Ayush Garg, Dr. Sourav Agarwal, Dr Rahul Chaudhari — Tue, 20 May 2025 00:00:00 +0300

The mouth is a mirror of health or disease, a sentinel or early warning system.The mouth might rather be thought of as a window to the body because oral manifestationsaccompany many systemic diseases.

Comparative Analysis of Hemodynamic Responses and Perfusion Index during Tracheal Intubation Using Macintosh and McCoy Laryngoscopes

Tue, 12 Aug 2025 00:00:00 +0300

Background: Tracheal intubation, a cornerstone of airway management during general anaesthesia, is associated with transient but significant hemodynamic responses. The type of laryngoscope used can influence the magnitude of this response.

Aim: To compare the hemodynamic parameters and perfusion index (PI) following tracheal intubation with Macintosh and McCoy laryngoscopes.

Methods: Sixty patients aged 20–40 years with ASA I–II status undergoing elective surgeries under general anaesthesia were randomized into two groups (n=30 each) for intubation using either a Macintosh or McCoy laryngoscope. Hemodynamic variables—heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and PI—were measured at baseline, during, and after intubation.

Results: No significant differences in baseline demographics or ASA status were observed between groups. Post-intubation HR, BP, and PI values showed variations within both groups; however, the McCoy group exhibited comparatively lower hemodynamic fluctuations and a more stable perfusion index.

Conclusion: Macintosh and McCoy laryngoscopes demonstrated comparable performance in terms of hemodynamic stability and perfusion index changes during intubation in ASA I–II patients. While McCoy is hypothesized to reduce sympathetic stimulation, our findings suggest either device may be used without significant difference in low-risk patients.

Efficacy of Platelet-Rich Plasma Vs Corticosteroid Injection in Biceps Tendinitis: A Prospective Comparative Study

Wed, 13 Aug 2025 00:00:00 +0300

Introduction: Biceps tendinitis is a common cause of anterior shoulder pain. Corticosteroids provide short-term relief but may impair tendon healing. Platelet-rich plasma (PRP), rich in growth factors, offers a regenerative alternative.

Objective: To compare the efficacy of PRP versus corticosteroid injections in managing biceps tendinitis over 12 weeks.

Methods: A prospective comparative study was conducted on 40 patients diagnosed with biceps tendinitis. Participants received either PRP (n=20) or corticosteroid (n=20) injections under ultrasound guidance. Pain, function, and mobility were assessed using the Visual Analog Scale (VAS), Shoulder Pain and Disability Index (SPADI), and Range of Motion (ROM) at 0, 4, 8, and 12 weeks.

Results: Both groups showed significant improvement in all parameters. At 12 weeks, PRP group had significantly lower VAS scores (1.15 vs. 2.45, p < 0.001) and higher ROM (138.9° vs. 130.15°, p = 0.02). SPADI scores were comparable between groups. Conclusion: PRP provided superior pain relief and mobility improvement compared to corticosteroids. PRP, being autologous and regenerative, is a promising option for long-term management of biceps tendinitis.

Comparative Evaluation of Intrathecal Buprenorphine Versus Dexmedetomidine as Adjuvants to Hyperbaric Ropivacaine in Infraumbilical Surgeries: A Randomized Controlled Trial

Dr. Avula Manasa, Dr. Hassaan Muhammed, Dr. ARUN K.C, Dr. Rani Parvathi — Wed, 13 Aug 2025 00:00:00 +0300

Background: Hyperbaric ropivacaine provides effective spinal anaesthesia, and adjuvants like dexmedetomidine and buprenorphine may enhance its efficacy. Objective: To compare the intrathecal effects of buprenorphine and dexmedetomidine with hyperbaric ropivacaine.

Methods: Ninety ASA I–II patients (aged 20–60 years) undergoing infraumbilical surgeries were randomized into two groups. Group B received 0.75% hyperbaric ropivacaine with 60 µg buprenorphine, while Group D received 0.75% hyperbaric ropivacaine with 5 µg dexmedetomidine. We compared onset and duration of sensory/motor blocks, time to rescue analgesia, and side effects.

Results: Group D had significantly faster onset of sensory (2.3±0.5 min vs 3.2±0.6 min) and motor blocks (3.0±0.4 min vs 4.1±0.5 min), and longer duration of sensory (503.2±38.5 min vs 323.7±32.4 min) and motor blocks (441.7±35.2 min vs 297.1±30.6 min). Time to rescue analgesia was longer in Group D (520.5±40.1 min vs 335.4±34.3 min). Side effects were fewer in Group D.

Conclusion: Dexmedetomidine is a superior intrathecal adjuvant to buprenorphine with hyperbaric ropivacaine for infraumbilical surgeries.

Evaluating The Predictive Role Of C-Reactive Protein In Assessing The Severity Of Acute Pancreatitis

Thu, 14 Aug 2025 00:00:00 +0300

Objective: To evaluate the predictive value of C-reactive protein (CRP) levels, including absolute values and interval changes at 24, 48, and 72 hours, in assessing the severity of acute pancreatitis (AP) according to the Revised Atlanta Classification.

Study Design: Cross-sectional observational study.

Study Duration: This study was conducted at Shaheed Mohtarma Benazir Bhutto Medical College Lyari Karachi Hospital from January 2024 to January 2025.

Methods: This study included 166 patients aged 12-60 years selected via non-probability consecutive sampling. CRP was measured at admission and 24, 48, 72 hours. Severity was stratified as mild (no organ failure/complications), moderate (transient organ failure <48 hours or local complications), or severe (persistent organ failure >48 hours). Data analysis used SPSS v21.0, with frequencies/percentages for categorical variables, means ± SD for continuous, Shapiro-Wilk for normality, Pearson’s correlation for CRP-severity associations, and chi-square tests (p<0.05 significant).

Results: The cohort had a mean age of 40 years (±5 SD), with 63.9% males (n=106). Disease severity distribution comprised mild cases at 19.9% (n=33), moderate at 51.2% (n=85), and severe at 28.9% (n=48). CRP levels increased progressively across groups: mild from 165 mg/dL to 202 mg/dL, moderate from 191 mg/dL to 263 mg/dL, and severe from 220 mg/dL to 342 mg/dL over 72 hours, achieving statistical significance at 72 hours (p=0.032). Interval changes were most pronounced in severe cases (+122 mg/dL total), compared to moderate (+72 mg/dL) and mild (+37 mg/dL).

Conclusion: CRP exhibits substantial predictive capability for AP severity, as interval changes prove equally effective as absolute values. Continuous monitoring facilitates early interventions, which may improve clinical outcomes in diverse settings.

Association of Hepcidin Levels in Type 2 Diabetes Mellitus Treated with Metformin or Combined Anti-Diabetic Agents

Thu, 14 Aug 2025 00:00:00 +0300

Objective: This research aims to investigate the relationship between ferritin and hepcidin levels and their implications for the pathophysiology and prognosis of Type 2 Diabetes Mellitus (T2DM) in patients treated with metformin alone or in combination with other anti-diabetic agents.

Study Design: A case-control study. Duration and Place of Study: This study was conducted in Bhitai Dental and Medical college Mirpurkhas from January 2024 to January 2025

Methodology: The study involved 150 participants divided into six groups: non-diabetic controls, newly diagnosed T2DM patients without treatment, T2DM patients receiving oral hypoglycemic agents (metformin), T2DM patients on a combination of metformin and another oral hypoglycemic agent, T2DM patients treated with insulin (with or without oral hypoglycemic medications), and T2DM patients receiving insulin alone. Insulin resistance, lipid profiles, glycated hemoglobin (HbA1c), and fasting plasma glucose were assessed using standard laboratory procedures. Hepcidin, insulin, and ferritin levels in serum were measured using an enzyme-linked immunosorbent assay (ELISA).

Results: Among the 150 participants, 72 were male and 78 were female. The control group had a significantly lower mean age compared to the diabetic groups. Hepcidin levels were notably higher in the control group. Ferritin levels were elevated in newly diagnosed T2DM patients but decreased across all treatment groups. In patients taking metformin alone, a significant negative correlation was observed between hepcidin levels and HbA1c (r = -0.27, p = 0.05).

Conclusion: Anti-diabetic therapy, particularly metformin, not only improves glycemic control but also influences ferritin and hepcidin concentrations. These findings suggest that hepcidin and ferritin may play a significant role in the development and management of Type 2 Diabetes Mellitus.

To Assess the Time Taken to Provide Ideal Intubating Conditions during Rapid Sequence Intubation of Different Doses of Rocuronium Compared to Single Dose of Succinylcholine

Nishant Gautam, Dr. Sanskriti — Thu, 14 Aug 2025 00:00:00 +0300

Aim: The aim of the present study was to assess the time taken to provide ideal intubating conditions during rapid sequence intubation of different doses of rocuronium compared to single dose of succinylcholine.

Methods: This prospective, comparative randomized study was conducted at Rajindra hospital, Patiala. A total of 160 patient aged between 18-60 yrs of either gender and ASA physical status I and II who were scheduled to undergo elective surgery under general anaesthesia were divided under 4 categories with each category having 40 people [n=40].

Results: The demographics among the four groups were comparable. The comparison of intubating conditions at 60, 90 and 120 seconds was found to be statistically highly significant. The onset of action with rocuronium at 0.6, 0.9 and 1.2 mg/kg were 71.03 ± 24.05, 65 ± 21.9 and 51.30 ± 17.70 seconds and succinylcholine 39.78 +/- 8.04 seconds.

Conclusion: Rocuronium at a dose of 1.2 mg/ kg is very effective and is a great asset to have during rapid sequence intubation. It provides adequate intubating conditions within a minute of injectio, avoiding the side effects of succinylcholine. So we recommend that rocuronium at a dose of 1.2 mg/kg is better than succinylcholine for the purpose of RSI.

A Comparative Study of Effectiveness of 0.125% Levobupivacaine with Fentanyl 2mcg/ml versus Levobupivacaine with Dexamethasone 4mg in Epidural Labor Analgesia

Dr. Rani Parvathi, Dr. Hassaan Muhammed, Dr. Aswin Mohanram, Dr. Avula Manasa — Thu, 14 Aug 2025 00:00:00 +0300

Background: Epidural analgesia is widely accepted as the gold standard for pain relief during labor due to its superior efficacy and maternal satisfaction. Levobupivacaine, a safer alternative to bupivacaine, is often combined with adjuvants like fentanyl or dexamethasone to enhance its analgesic profile.

Objective: To compare the effectiveness and safety of 0.125% levobupivacaine with fentanyl 2 mcg/ml versus 0.125% levobupivacaine with dexamethasone 4 mg for epidural labor analgesia.

Methods: Sixty primigravida women in active labor were randomly divided into two groups: Group LF received 0.125% levobupivacaine with fentanyl 2 mcg/ml, and Group LD received 0.125% levobupivacaine with dexamethasone 4 mg. Parameters assessed included onset and duration of analgesia, total number of top-ups, maternal hemodynamic stability, motor blockade, maternal satisfaction, and neonatal APGAR scores.

Results: Both combinations provided effective labor analgesia. Group LF had a significantly faster onset of analgesia (7.93±1.01 vs 8.83± 0.70), longer duration of analgesia (90.03± 5.14 vs 58.37± 4.80), lesser total drug usage (30.42± 2.71 vs 39.17± 3.26) required fewer top-ups (2.87± 0.43 vs 4.27± 0.52) and less VAS scores with greater maternal satisfaction and fewer opioid related side effects. Hemodynamic parameters and neonatal outcomes were compared and major adverse effects were observed in either group.

Conclusion: Both regimens are safe and effective for epidural labor analgesia. However, the addition of fentanyl to levobupivacaine prolongs the duration of analgesia and reduces the need for additional doses, making it a valuable alternative to opioid-based combinations.

A COMPARATIVE ANALYSIS OF OUTCOMES OF MYRINGOPLASTY WITH AND WITHOUT PLATELET RICH PLASMA (PRP)

Fri, 15 Aug 2025 00:00:00 +0300

Chronic suppurative otitis media (CSOM) with tympanic membrane perforation often requiressurgical intervention, with myringoplasty being the standard procedure. However, graft uptake andhearing outcomes vary

Mifepristone versus Dienogest in Medical Management of Endometrioma Up to 6 Cm Diameter: A Prospective Observational Study

Bansi Bisal, Bansi Bisal, Shyamali Dutta, Palash Mazumder, Tarasankar Bag — Sat, 16 Aug 2025 00:00:00 +0300

Background: Endometriosis, the presence of endometrial tissue outside the uterus, is a chronic estrogen-dependent condition affecting ~10% of reproductive-age women, peaking at 25–30 years. It accounts for ~60% of pelvic pain and 50% of infertility cases. Lesions may occur on pelvic peritoneum, ovaries, recto vaginal septum, ureter, and rarely elsewhere. Ovarian endometriosis, often associated with endometriomas (55% of cases), can cause adhesion and symptoms such as dysmenorrhea, premenstrual pain, dyspareunia, and fatigue. Objective: To compare Dienogest and Mifepristone in reducing pain and endometrioma .size in endometriosis. Materials & Methods: This randomized clinical trial was conducted in the G&O OPD, Medical College Kolkata (June 2020–May 2021). Women with dysmenorrhea, diagnosed with endometrioma ≤6 cm, and not seeking conception were included. Those with severe pain needing hospitalization or requiring surgery were excluded. A total of 236 patients were randomized equally: Group 1 received Dienogest 2 mg/day; Group 2, Mifepristone 25 mg/day. Follow-up at 3 and 6 months assessed endometrioma size and pain using the Visual Analogue Scale (VAS). Results: Reduction in endometrioma size showed no statistical significance between groups at 3 or 6 months (p=0.2024, p=0.0522). Pain reduction at 3 months was greater with Dienogest (VAS 3.92±1.65) vs Mifepristone (4.69±1.45), p<0.0001. At 6 months, scores further declined (0.53±0.64 vs 0.82±0.71), p=0.0012. Overall pain reduction was greater with Dienogest (8.10±0.99 vs 7.82±1.03), p=0.0342. Conclusion: Dienogest was more effective than Mifepristone in relieving endometriosis-associated pain, with no significant difference in endometrioma size reduction.

Outcome of Non-Invasive Ventilation and Its Predictors in COPD Patients with Acute or Acute On Chronic Type 2 Respiratory Failure

Sat, 16 Aug 2025 00:00:00 +0300

Background: Noninvasive ventilation (NIV) constitutes a primary therapeutic modality in the management of chronic obstructive pulmonary disease (COPD) patients presenting with acute or acute-on-chronic type 2 respiratory failure [1,4–6]. Despite its clinical utility, considerable variability in patient outcomes persists, and the early identification of reliable predictors of NIV success or failure remains a significant clinical challenge [7,13,14].

Objective: To evaluate the outcomes of noninvasive ventilation and identify clinical and biochemical predictors of its success or failure in patients with chronic obstructive pulmonary disease (COPD) presenting with acute or acute-on-chronic type 2 respiratory failure.

Methods: A prospective observational study was conducted on 85 patients with chronic obstructive pulmonary disease (COPD) presenting with acute or acute-on-chronic type 2 respiratory failure, admitted between May 2023 and May 2024. All patients were initiated on noninvasive ventilation (NIV) as per institutional protocol [4,6,9]. Baseline clinical parameters, arterial blood gas values, and comorbidities were recorded. Patients were monitored throughout the course of NIV therapy, and outcomes were classified as success (clinical improvement without need for intubation) or failure (requirement of invasive mechanical ventilation or death). Statistical analysis was performed to identify clinical and biochemical predictors associated with NIV outcomes [7,13,14]. Results: Among the 85 COPD patients included in the study, NIV was successful in 65 patients (76.5%) and failed in 20 patients (23.5%). Patients in the failure group had significantly lower baseline pH and PaO₂ levels, and higher PaCO₂ and respiratory rates compared to those in the success group (p < 0.05). PaCO2 at 12, 24, 48, 72 hrs in NIV success are 52.04±2.93, 49.63±2.89, 44.78±4.31, 43.22±5.20 and in NIV failure are 54.78±2.33, 54.89±1.83, 54.44±1.27, 55.44±1.33, respectively with a significant P value.

Conclusion: Noninvasive ventilation was effective in the majority of COPD patients with acute or acute-on-chronic type 2 respiratory failure [4–6,9,12]. Higher baseline PaCO₂ and respiratory rate, along with lower pH, were significantly associated with NIV failure [13,14]. Early identification of these predictors may aid in timely clinical decision-making and improve patient outcomes.

A Comparative Interventional Study of the Changes in Astigmatism and Corneal Aberrations between 2.4mm and 3mm Opposite Clear Corneal Incisions During Phacoemulsification With IoL Surgery In Cataract Patients At SMS Hospital

Dr. Sahil Jain, Dr. Pankaj Sharma, Dr. Mahima Panwar, Dr. Bhumika Sharma — Sat, 16 Aug 2025 00:00:00 +0300

Aim: The aim of the present study was to assess and compare changes in astigmatism and corneal aberrations between 2.4mm and 3mm opposite clear corneal incisions during phacoemulsification with IOL surgery.

Methods: The present study was conducted in the Upgraded Department of Ophthalmology, S.M.S. Medical College and Hospital, Jaipur, Rajasthan from 1st November, 2022 to 31st July, 2023 after IEC approval. All patients attending OPD in SMS Medical College, Jaipur Eye department were included. A total of 80 cases were enrolled in the study.

Results: The age distribution revealed that the largest proportion of patients fell within the 61-70 years age group (43.8%), with a relatively balanced distribution between the 2.4 mm (45.0%) and 3 mm (42.5%) groups. The gender distribution was nearly equal, with 47.5% female and 52.5% male patients. Both the 2.4 mm and 3 mm groups had identical gender distributions, with 47.5% of females and 52.5% of males in each group.

Conclusion: This study demonstrated that 3.0 mm OCCIs provide better astigmatic correction and visual outcomes than 2.4 mm OCCIs, with minimal long-term impact on HOAs. The findings reinforce the role of OCCIs as a reliable and accessible technique for managing preexisting astigmatism during cataract surgery. Future research should explore the use of OCCIs in combination with other techniques to enhance outcomes in patients with higher degrees of astigmatism. The 2.4 mm group had slightly more right-eye surgeries (55.0%), while the 3 mm group had a slightly higher proportion of left-eye surgeries (52.5%), showing a well-distributed allocation across both groups.

An Observational Study to Assess the Relationship between Retinopathy of Prematurity and Thrombocytopenia

Dr. Sandeep Parwal, Dr. Sunil Gurjar, Dr. Sahil Jain, Dr. Kavita Bajiya — Sat, 16 Aug 2025 00:00:00 +0300

Objective: This study aimed to evaluate the relationship between thrombocytopenia (platelet count <150,000/μL) and the severity of Retinopathy of Prematurity (ROP) in preterm infants, focusing on disease progression and clinical outcomes.

Methods: A prospective observational study was conducted at SMS Medical College, Jaipur, involving 70 preterm infants (≤30 weeks gestation, birth weight ≤1500 g) stratified into thrombocytopenic (n=35) and non-thrombocytopenic (n=35) groups. ROP screening was performed using indirect ophthalmoscopy at baseline and follow-up visits (weeks 3, 6, 9, 12). ROP was classified per ET-ROP criteria (Type 1: treatment-required; Type 2: observation). Data on gestational age, birth weight, oxygen therapy, platelet counts, ROP stage/zone and plus disease were collected and analyzed statistically.

Results: Thrombocytopenic infants had significantly lower mean platelet counts (0.93 ± 0.35 vs. 2.34 ± 0.65 lakh/mm³, p<0.001). Type 1 ROP was more prevalent in thrombocytopenic infants (14.29% vs. 0% at week 3, p=0.01), with earlier treatment requirements (14.29% vs. 0% by week 3, p=0.08). Thrombocytopenic infants exhibited rapid ROP progression, with Stage 1 peaking at week 6 (40%) and resolving by week 12 (p<0.0001). Zone 3 involvement increased significantly in thrombocytopenic infants by week 12 (85.71% vs. 34.29% at baseline, p<0.0001). Plus disease was transient and more frequent in thrombocytopenic infants (5.71% vs. 0% at week 3, p=0.53).

Conclusion: Thrombocytopenia is associated with more severe and rapidly progressive ROP, necessitating earlier interventions. These findings highlight the potential role of platelet counts in risk stratification and optimizing screening protocols for preterm infants. Further research is needed to elucidate the underlying mechanisms and refine clinical management strategies.

HISTOPATHOLOGICAL SPECTRUM OF SKIN LESIONS IN CENTRAL INDIA: INSIGHTS FROM A TERTIARY CARE CENTER

Dr. Pooja Gulhane, Dr. Arunima Cladius, Dr. Rajendra Kumar Chandrakar — Sat, 16 Aug 2025 00:00:00 +0300

Skin lesions represent a diverse group of conditions ranging from non-neoplastic toneoplastic disorders. Due to overlapping clinical features, histopathological examination isessential for accurate diagnosis.

Evaluating Maternal Mental Health as a Determinant of Child Behavioral Outcomes

Dr Sunita Mor, , Dr Rajesh Rathi, Dr Savita Pannu Rathi, Dr Pooja Rathee — Fri, 15 Aug 2025 00:00:00 +0300

Postpartum mental illness has gained increasing attention fromresearchers, clinicians, and public health professionals. Early detection allows timelyintervention, reducing adverse consequences for the mother, her newborn, otherchildren, and spouse.

Estimation of expected fetal weight using symphysio- fundal height and ultrasonography and comparison of it with actual birth weight – A prospective study

Dr Nidhi Singhvi, Dr Nidhi Singhvi, Taufiq Ullah, Mr. Tariq Khan — Fri, 15 Aug 2025 00:00:00 +0300

Fetal weight estimation is a crucial component of obstetric planning andmanagement. Accurate estimation assists clinicians in making informed decisionsregarding the timing and mode of delivery, thereby optimizing maternal and neonataloutcomes.

Post-Surgical Outcomes and Complication Patterns in Lens-Induced Glaucoma: A Prospective Observational Study from South India

Tue, 19 Aug 2025 00:00:00 +0300

Background: Lens-induced glaucoma (LIG) is an important cause of secondary glaucoma in developing countries, usually occurring in association with neglected cataracts and presenting with a sudden rise in intraocular pressure (IOP). Despite advances in cataract surgery, delayed presentation and intervention remain major barriers to achieving good visual prognosis.

Aim: This study assesses post-surgical visual outcomes and complication rates in various subtypes of LIG.

Objective: To study the different types of LIG, preoperative clinical features, postoperative complications, and visual outcomes following cataract extraction.

Methods: A prospective observational study including 80 patients (age >45 years) with clinically confirmed LIG was conducted at PESIMSR, Kuppam, over 18 months. All patients underwent cataract extraction with IOL implantation. Outcomes were evaluated at day 1, week 1, and week 4 post-surgery, focusing on changes in intraocular pressure (IOP), visual acuity, and surgical complications.

Results: Phacomorphic glaucoma was the most common subtype (48.75%), followed by phacolytic (30%). The mean pre-op IOP (38.59 ± 8.91 mmHg) significantly reduced to 16.69 ± 3.91 mmHg at 4 weeks (p < 0.05). Visual acuity improved markedly, with 65% achieving 6/6–6/24 vision. Corneal edema (31.25%) was the most frequent complication. A significant association was found between LIG subtype and complication incidence (p = 0.02).

Conclusion: Cataract surgery provides favorable visual outcomes in LIG if performed timely. Early diagnosis and aggressive post-op management are key in minimizing complications and preventing irreversible vision loss.

A COMPARATIVE STUDY OF LATERAL INTERNAL SPHINCTEROTOMY VERSUS FISSURECTOMY IN THE TREATMENT OF CHRONIC ANAL FISSURE

Dr. Mahadeo R Patil, Dr. Sandhyarani M Patil, Dr Abhijit R Patil — Tue, 12 Aug 2025 00:00:00 +0300

An anal fissure is linear tear extending from mucocutaneous junction to thedentate line which is a very common problem in general population. Anal fissures are eitheracute or chronic. Chronic fissures not responding to conservative treatment typically requiresurgical treatment. The surgical options include lateral internal sphincterotomy (LIS) andfissurectomy. The aim of the study is to compare lateral internal sphincterotomy andfissurectomy in terms of postoperative pain relief, healing of fissure, and postoperativecomplications.

CROSS-SECTIONAL STUDY ON THE ASSOCIATION BETWEEN INTERNET ADDICTION AND DEPRESSIVE SYMPTOMS IN ADOLESCENTS

Dr Rohan Gautam Shah, Dr Neil Gautam Shah, Dr Jagdish Nandkishore Gindodia — Sat, 09 Aug 2025 00:00:00 +0300

Internet addiction (IA) is an emerging public health concern amongadolescents, often associated with adverse mental health outcomes such as depression.Understanding this relationship is critical for early detection and intervention. Aim: To assessthe association between Internet addiction and depressive symptoms among adolescents.Methods: A cross-sectional study was conducted among 200 adolescents aged 13–18 years

Serum Iron Status, Total Iron Binding Capacity, and Ferritin in Preeclampsia: A Cross Sectional Comparative Study from Northern India

Sidhi Parmar, Dr. Chitra Upadhyay, Dr. Rekha Bagla, Ms. Jaya Sharma — Tue, 19 Aug 2025 00:00:00 +0300

Background: Dysregulated iron metabolism and oxidative stress are implicated in the pathogenesis of pre eclampsia (PE), yet evidence from South Asian populations remains limited.

Objective: To compare serum iron, total iron binding capacity (TIBC) and ferritin concentrations between women with PE and normotensive pregnant controls receiving routine antenatal iron prophylaxis.

Methods: In a hospital based cross sectional study at a tertiary centre (September 2023 – August 2024), 64 singleton pregnancies ≥ 20 weeks’ gestation were enrolled (32 PE; 32 controls). PE was defined as blood pressure ≥ 140/90 mmHg plus proteinuria ≥ 1+ on dipstick. Venous blood was analysed for serum iron (ferrozine method), TIBC (saturating–precipitating assay) and ferritin (two site chemiluminescent immunoassay). Between group comparisons used Student’s t test; significance p < 0.05.

Results: Mean gestational age was lower in the PE group (36.2 ± 1.1 weeks) than controls (37.9 ± 1.2 weeks; p < 0.001). Serum iron was significantly higher in PE (126.4 ± 39.5 µg/dL) versus controls (83.9 ± 25.5 µg/dL; p < 0.001), while TIBC was lower (354.6 ± 52.6 vs 417.0 ± 59.2 µg/dL; p < 0.001). Ferritin was more than doubled in PE (88.0 ± 37.8 vs 38.6 ± 26.4 ng/mL; p < 0.001).

Conclusions: In iron supplemented pregnancies, PE is associated with raised circulating iron and ferritin together with reduced TIBC, supporting a role for iron mediated oxidative stress in its pathophysiology. Routine indiscriminate antenatal iron supplementation may warrant re evaluation, and iron indices may serve as inexpensive early markers for risk stratification.

Evaluation Of Laboratory Errors And Other Causes In Spurious Thrombocytopenia

Chaithra V, Vanisri H , K T Athulya Krishna Kumar, Ravi Teja C N — Sat, 28 Jun 2025 00:00:00 +0300

Pseudothrombocytopenia (PTCP) is an in vitro phenomenon characterized byspuriously low platelet counts without associated clinical bleeding. It often results from preanalyticalerrors, particularly ethylenediaminetetraacetic acid

Effectiveness of Calisthenic Exercises on the Stress Level of B.Sc. Nursing 1st Year Students

Mr. Vishal Chougule, Dr. Sunil Kumar Awate — Wed, 20 Aug 2025 00:00:00 +0300

Background of the Study: Stress is normal psychological and physical reaction to the demands of life. Thinking stress as a spectrum distress has been identified as a 20th century disease and viewed as a complex and dynamic transaction between individuals and environment. Stress or anxiety is not only workplace problem but different stressors affect the students. Especially nursing students experience high level of stress throughout their education. Exercise has been shown to improve your mood and decrease feeling of anxiety and stress. Calisthenics are aerobic and dynamic exercises. Which are rhythmic and smooth and enjoyable which improves mood status of an individual. So, the researcher felt that this study needs to be conducted to evaluate the effectiveness of Calisthenic exercise on stress level among of B.Sc. Nursing 1st year students in selected college of Nursing at Kolhapur.

Objectives: 1. To assess the stress level of B.Sc. Nursing 1st year students. 2. To evaluate the effectiveness of calisthenic exercises on the stress level of B.Sc. Nursing 1st year students. 3. To find out association between pre-assessment stress level score of B.Sc. Nursing 1st year students and selected socio-demographic variables.

Research method: The research approach adopted for the study was quantitative evaluative and research design was quasi-experimental, one group pre-test, post-test design. By using Probability, Simple random sampling technique 60 B. Sc. Nursing 1st year students were selected for the study. Modified Students Stress Rating Scale was used to assess the stress level of B. Sc. Nursing 1st year students. The reliability of the tool was tested by using Cronbach’s alpha. The reliability computed was r = 0.7. Data were analysed by using mean, median, mode, range, standard deviation, paired‘t’ test & chi square test.

Analysis and Interpretation: In the pretest, majority of 27(45%) participants had moderate stress, 21(35%) participants had high stress level and 12(20%) participants had low stress level where none of them had severe. In the post-test, majority of 44(73.3%) participants had low stress level and 16(26.6%) participants had moderate stress level. The calculated paired‘t’ value is (14.73) significance at level p (0.0003) < 0.05. Hence, H1 is

accepted. This indicates that Calisthenic exercise is effective in reducing the stress. Therefore, the findings revealed that Calisthenic exercises are effective in reducing stress level of B.Sc. Nursing 1st year students at selected college of Nursing. In present study in B.Sc. Nursing 1st year students, none of the sociodemographic variables are associated with stress level scores, Hence, H2 is rejected and H02 is accepted. There is no significant association between preintervention stress level scores with the selected socio demographic variables among B.Sc. Nursing 1st year students studying in selected college of Nursing at 0.05 level of significance.

Summary and conclusion: In the pretest, majority of 27(45%) participants had moderate stress, 21(35%) participants had high stress level and 12(20%) participants had low stress level where none of them had severe. In the post-test, majority of 44(73.3%) participants had low stress level and 16(26.6%) participants had moderate stress level. findings revealed that Calisthenic exercises are effective in reducing stress.

Effectiveness of Planned Teaching Programme (PTP) On Knowledge Regarding “FAST HUGS BID” Mnemonic among B.Sc. Nursing Final Year Students

Miss. Monika Bhonde, Mr. Amos Talsandekar — Wed, 20 Aug 2025 00:00:00 +0300

Background and objectives: A critical care unit is a constantly overcrowded ward where terminally ill patients get life-sustaining treatment while being closely monitored. Innovative therapeutic approaches are frequently implemented in ICUs to enhance patient care so FASTHUGSBID mnemonic used in Intensive care unit for proper management of patient care by the health care personnels. The FAST HUG mnemonic was created by Sir JL Vincent. He wrote an article named “Give your patient a FAST HUG (at least) once a day” in the year 2005. Later it was modified by WR Vincent and Hatton and made FAST HUGS BID1. The FAST HUGS BID, has been established to promote communication among nursing and physician caregivers in the ICU5. Critical care nursing demands a structured and evidence-based approach to ensure comprehensive patient management. The mnemonic FAST HUGS BID (feeding, analgesia, sedation, thromboembolic prophylaxis, head-of-bed elevation, ulcer prophylaxis, glycemic control, spontaneous breathing trial, bowel regimen, indwelling catheter removal, de-escalation of antibiotics) serves as valuable checklist for optimizing intensive care unit (ICU) patient care. It helps health care providers systematically assess and address key aspects of critical care, reducing complications and improving patient outcome. Hence, there is need to provide knowledge on FASTHUGSBID among B.Sc. Nursing Final Year students studying in D.Y. Patil College of Nursing, Kolhapur.

Objectives of the study were, To Assess the Pre-Test Knowledge scores regarding “FAST HUGS BID” mnemonic among B. Sc. Nursing Final year students, To evaluate the effectiveness of Planned teaching Programme on “FAST HUGS BID” mnemonic among B. Sc Nursing Final year students, To find out an association between mean pre-test knowledge score on “FAST HUGS BID” mnemonic and selected sociodemographic variables of B.Sc. Nursing final year students.

Methods: The research approach adopted for the study was quantitative evaluative and design was quasi-experimental, one group pre-test post-test design. By using simple random sampling technique 80 students were selected from B.Sc. Nursing final year at D. Y. Patil College of Nursing, Kolhapur. Structured knowledge questionnaires were used to assess the knowledge regarding FAST HUGS BID mnemonic. The reliability of the tool was tested by using test-retest method and Spearman`s Brown formula. The reliability computed was r = 0.80. Data were analysed by using mean, median, mode, range, standard deviation, paired‘t’ test, chi square test.

Result: In the pretest, majority of 43(56.3%) participants had average knowledge,25 (31.3%) participants had poor knowledge and 10(12.5%) participant had good knowledge. In the post-test, majority of 45(56.3%) participants had good knowledge and 30(37.5%) participants had average knowledge and 5(6.3%) had poor knowledge score regarding FAST HUGS BID mnemonic. The p value (0.001) is less than 0.05 level of significance and (ttab value -24.32). The findings reveals that the planned teaching programme (PTP) is effective in improving knowledge score among students. There is significant association between knowledge score and gender. (p value = 0.008). There is significant association between knowledge score regarding FAST HUGS BID mnemonic and selected sociodemographic variables among B.Sc. Nursing final year students studying in selected college of nursing at 0.05 level of significance.

Interpretation and conclusion: The overall findings showed that in pretest the majority of students had average knowledge score and in post-test the majority of students had good knowledge score. There was significant association between knowledge score regarding FAST HUGS BID and gender. So it conclude that the planned teaching programme (PTP) was effective in improving the knowledge regarding FASTHUGSBID mnemonic among B. Sc Nursing Final year students.

An Assessment of Vitamin B12 Deficiency in Infants under Six Months with Severe Acute Malnutrition

Dr. Lipi Roat, Dr. R.L. Suman, Dr. Mukesh Kumar Jat — Wed, 20 Aug 2025 00:00:00 +0300

Background - NFHS-5 shows improved nutrition indicators for children under 5, with lower rates of stunting, wasting, and underweight. However, interventions primarily target older children, neglecting the high prevalence of infant malnutrition. Vitamin B12 deficiency during infancy can cause anemia, poor growth, neurological damage, and developmental delays.

Methodology - This prospective observational study was conducted at Balchikitsalaya from June 2021 to December 2022. It includes 100 infants under 6 months with severe acute malnutrition, and data on demographics, clinical features, and vitamin B12 levels were collected. Descriptive statistics and statistical tests were used to analyze the data and assess the prevalence of vitamin B12 deficiency and its association with clinical features.

Result – Maximum number of infants with vitamin B12 deficiency were in age of 5-6 month. Loose stool and vomiting were the most common complaints. Low vitamin B12 level was found in 48% of infants. Clinical manifestations such as pallor, hyperpigmentation, and tremor were significantly associated with Vitamin B12 deficiency. There was significant association between vitamin B12 deficiency and anemia (p<0.001) and, thrombocytopenia (p<0.001). 29 infants had tremor, out of them 25 patients had vitamin B12 deficiency. This study shows significant association between tremor and low vitamin B12 deficiency (P<0.001). There was significant association between BMI and vitamin B12 level in mother (P=0.012).

Conclusion: Prevalence of vitamin B12 deficiency in less than six months infants with SAM was 48 % and tremors have significant association (p:001).

A PROSPECTIVE STUDY OF URINARY TRACT INFECTION IN CHILDREN WITH NEPHROTIC SYNDROME IN A TERTIARY CARE HOSPITAL

Dr.T.Santoshini Devi, Dr Lelsani Poorna Chandra Rao, Dr.K.Bheemeshwar — Tue, 19 Aug 2025 00:00:00 +0300

Nephrotic syndrome characterized by the presence of heavy proteinuria,hypoalbuminemia, edema and hyperlipidemia, is a common renal disorder in pediatricpopulation. In developed countries, its incidence is20 to 40 and 20 to 70 per million populationsin UK and USA respectively, whereas in Asian countries it is 90 to 160 per million populations.

Predictive Modeling Using AI for Implant Failure Based on Patient Risk Factors and CBCT Data

Fri, 20 Jun 2025 00:00:00 +0300

Dental implant therapy has become a widely accepted treatment for tooth replacement.However, implant failure remains a concern due to patient-related and procedural riskfactors. Advances in artificial intelligence

A Comparative Evaluation of Intrathecal 0.75% Hyperbaric Ropivacaine versus Intrathecal 0.5% Hyperbaric Bupivacaine for Elective Infraumbilical Surgeries

Thu, 21 Aug 2025 00:00:00 +0300

Background: With the current emphasis on ambulatory surgeries, bupivacaine has limited usefulness. Ropivacaine has low lipid solubility and is less cardiotoxic and neurotoxic than bupivacaine. It is gaining popularity because of its recovery profile. Hence, we designed a study to compare the clinical efficacy of 3 mL of 0.75% hyperbaric ropivacaine versus 3 mL of 0.5% hyperbaric bupivacaine under spinal anaesthesia for elective infraumbilical surgeries.

Aim: To compare the clinical efficacy of 3ml of 0.75% hyperbaric ropivacaine versus 3ml of 0.5% hyperbaric bupivacaine under spinal anaesthesia for elective infraumbilical surgeries.

Material and Methods: After approval from the institutional Ethics Committee, 80 adults aged 18-70 years with ASA I and II grades who presented for elective infraumbilical surgeries under spinal anaesthesia and fulfilled the inclusion criteria were enrolled in this study. According to the randomisation, patients were divided into two groups of 40 each. They received an intrathecal injection of 0.75% hyperbaric ropivacaine (3 mL) in group A or 0.5% hyperbaric bupivacaine (3 mL) in group B. Vital signs were monitored, and block parameters were observed. Adverse events and the time to first micturition were noted. The data were presented as means with standard deviations and frequencies with percentages. The data were analysed using statistical software SPSS version 21.

Result: Ropivacaine produced a slower mean onset of sensory block (11.55 vs 6.63 mins; p<0.01), and the mean total duration of sensory block was significantly shorter (234.75 vs 288.75 mins; p<0.01) as compared to bupivacaine. Patients in the bupivacaine group achieved a higher level of peak sensory block (p-0.048). The onset of motor block was significantly slower (10.45 vs 6.3 minutes; p < 0.01) and the duration was shorter (206.25 vs 258.75 minutes; p < 0.01) in the ropivacaine group. Post the induction, SBP and MAP were significantly lower in the bupivacaine group as compared to ropivacaine from the 4th min onwards till the 15th min (p<0.01), and DBP was substantially lower in the bupivacaine group as compared to ropivacaine from the 2nd min onwards till the 15th min (p<0.01). The time to first micturition was significantly faster with ropivacaine compared to bupivacaine (357.87 vs 403.97 minutes; p < 0.01).

Conclusion: The study concludes that 0.75% hyperbaric ropivacaine, despite its slower onset of action, can serve as a good alternative to 0.5% hyperbaric bupivacaine for spinal anaesthesia in elective infraumbilical surgeries of short to intermediate duration, offering the added advantages of earlier recovery and more stable hemodynamics.

SMALL INCISION CATARACT SURGERY TRABECULECTOMY WITH PHACOEMULSIFICATION TRABECULECTOMY: A RANDOMISED CONTROLLED TRIAL

Srishti Jain , Ashutosh Dokania — Thu, 21 Aug 2025 00:00:00 +0300

Cataract and glaucoma frequently coexist, and their combined management remains asurgical challenge. Small incision cataract surgery (SICS) combined with trabeculectomy, aswell as phacoemulsification combined with trabeculectomy, are common approaches.Comparative data on their efficacy and safety are limited

PATTERN AND CAUSALITY ASSESSMENT OF ADVERSE DRUG REACTIONS IN PEDIATRIC POPULATION IN AND AROUND KANNAUJ

Thu, 21 Aug 2025 00:00:00 +0300

To report, assess and compare Adverse Drug Reactions (ADRs) inhealthy, malnourished and low birth weight children and to perform causality assessment of reported ADRs.

A Comparative Study of the Predictive Accuracy of Four Iol Power Calculation Formulae in Phacoemulsification with Foldable Iol Surgery in Eye with Axial Length Less Than 22 Mm.

Dr. Hitesh Suthar, Dr Mahima Panwar, Dr. Bhumika Sharma, Dr Ashima Mehndiratta — Fri, 22 Aug 2025 00:00:00 +0300

Purpose: To compare the predictive accuracy of four intra-ocular lens power calculation formulae—Hoffer Q, Holladay 1, Haigis, and Hill-RBF—in cataractous eyes with axial length (AL) < 22 mm.

Methods: In this single-centre prospective study, 80 eyes of 80 patients underwent uneventful phacoemulsification with a single-piece hydrophilic acrylic IOL. Pre-operative biometry (IOLMaster 500) provided AL, keratometry and anterior chamber depth. IOL power was calculated with all four formulae, but implantation was based on Hoffer Q. Manifest refraction was recorded on postoperative day 7 and day 30. Absolute prediction error (AE = |predicted – achieved spherical-equivalent|) was the primary outcome. Differences were analysed with one-way ANOVA and Bonferroni post-hoc testing (α = 0.05).

Results: Mean age was 57.9 ± 5.8 years; 60% were women. Mean AL was 21.48 ± 0.40 mm and mean implanted IOL power was 24.76 ± 1.76 D. Spherical equivalent stabilized between day 7 and day 30 (p = 1.000). Mean ± SD AE differed significantly between formulae (p < 0.001): Hill-RBF 0.034 ± 0.217 D; Haigis 0.097 ± 0.403 D; Hoffer Q 0.231 ± 0.492 D; Holladay 1 0.403 ± 0.669 D. Hill-RBF out-performed Haigis (p = 0.031) and both surpassed Hoffer Q and Holladay 1 (all p < 0.001). Ninety-one percent of eyes calculated with Hill-RBF were within ±0.50 D of target versus 84% (Haigis), 65% (Hoffer Q) and 57% (Holladay 1).

Conclusions: Hill-RBF provided the most accurate refractive prediction in short eyes, followed by Haigis. Surgeons managing AL <22 mm should preferentially employ modern formulae that incorporate anterior segment metrics and artificial-intelligence modelling.

THE IMPACT OF INTERMITTENT FASTING ON CARDIOVASCULAR HEALTH IN YOUNG ADULTS

Mohd. Ahmad, Ashutosh Jain, Manila Jain — Fri, 22 Aug 2025 00:00:00 +0300

Cardiovascular disease (CVD) is the leading cause of global mortality,particularly burdening low- and middle-income countries like India. Rising rates of obesity,diabetes, and sedentary lifestyles significantly contribute to this trend. Intermittent fasting (IF),a time-restricted eating pattern

Osteoma of left Temporal Bone - A Rare Case Report

Dr Gurumani Sriraman,Dr Deepthi E — Mon, 18 Aug 2025 00:00:00 +0300

Osteoma is a benign, slow-growing tumour that develops from mature lamellarbone tissue. It is a single pedunculate mass which often happens unilaterally. The externalauditory canal is more frequently affected by osteomas than other parts of the temporal bone.
The purpose of this case report is to review this rare mastoid osteoma and discuss differential diagnosis and treatment

KNOWLEDGE, ATTITUDES, AND PRACTICES REGARDING KANGAROO MOTHER CARE AMONG HEALTH CARE PROVIDERS: A SINGLE-CENTER STUDY AT VASHI GENERAL HOSPITAL, NAVI MUMBAI

Dr. Madhavi Ingale, Dr. Rajesh Mhatre, Dr. Priyanka Late, Dr. Sarika Kangralkar — Tue, 05 Aug 2025 00:00:00 +0300

Background: Kangaroo Mother Care (KMC) is an evidence-based, cost-effectiveintervention that significantly improves outcomes in preterm and low-birth-weight infants.Despite national and international recommendations, implementation remains limited due to knowledge gaps and systemic barriers

DIAGNOSTIC EVALUATION AND COMMON PRESENTATIONS OF VULVAR PRURITUS: EXPERIENCE FROM A TERTIARY CARE DERMATOLOGY OUTPATIENT DEPARTMENT

Mon, 18 Aug 2025 00:00:00 +0300

Background: Vulvar pruritus is a frequent yet underreported symptom encountered indermatology practice, with a wide etiological spectrum encompassing infectious and noninfectious dermatoses. Prompt and accurate diagnosis is essential to alleviate symptoms and prevent complications.

PREVALENCE AND PATTERN OF RHEUMATOLOGICAL DISORDERS IN CHILDREN’S LESS THAN 18 YEARS OF AGE IN A TERTIARY CARE HOSPITAL

Dr.Y.Grace Gnana Aparanji, Dr. C.Shashi Kumar, Dr.M.Prakash Kumar — Sat, 23 Aug 2025 00:00:00 +0300

Rheumatological diseases in children are chronic intractable inflammatorydiseases that impede growth and development, and are often associated with systemic lifethreatening complications. The common pediatric rheumatological disorders include Juvenile
idiopathic arthritis (JIA),

A COMPARATIVE STUDY OF ASPIRIN AND RIVAROXABAN FOR VENOUS THROMBOEMBOLISM PROPHYLAXIS AFTER TOTAL JOINT ARTHROPLASTY

Dr Pradeep Palavalasa, Dr M. Pavan kumar, Dr Dinesh babu Alaparthi — Sat, 23 Aug 2025 00:00:00 +0300

Patients undergoing major orthopedic surgery, such as total knee arthroplasty (TKA),total hip arthroplasty (TKA), and hip fracture surgery (HFS), are at an elevated risk of developingvenous thromboembolism (VTE).

Comparison of Ct PCI Score and Intraoperative PCI Score in Ovarian Cancer

Dr. Aishwarya Sharma, Dr. Aparna Khadelia — Mon, 25 Aug 2025 00:00:00 +0300

Background: Ovarian Cancer is the sixth most common cancer in the world2. Of all the gynecological malignancies, it is most lethal. Factors which can cause ovarian cancer are infertility, family history/genetic factors and previous hormone therapy. It has a poor prognosis because most of them are diagnosed in advanced stages. For ovarian cancer search for an ideal screening test has been going on. Transvaginal ultrasound, CA 125, and bimanual pelvic examination have been used in various screening studies to evaluate their role as screening tests but have not found much supportive evidence

Aim and Objectives: 1.Comparison of CT PCI score and intraoperative PCI score in ovarian cancer.2. To know the extent of peritoneal disease in patients of ovarian cancer in north Indian population.3. To know the sensitivity and specificity of CT PCI score

Methods: Study Design: Prospective study. Sample Size: 70

Results: Mean of Group CT PCI and Intraoperative PCI by unpaired t- test. Mean of group CT PCI were 9.3571with standard deviation of 6.64424 whereas mean of group Intraoperative PCI were 12.7857 with standard deviation of 10.73109. On descriptive analysis of CT PCI score the frequency percentage of LS 0 ( no tumor) was 4.3%, LS 1 ( upto 0.5 cm) was 0%, LS 2 ( upto 5cm) was 28.6% and LS 3( > 5cm) was 67.1%. On descriptive analysis of Intraoperative PCIscore the frequency percentage of LS 0 ( no tumor) was 7.1%, LS 1 ( upto 0.5 cm) was 2.9%, LS 2 ( upto 5cm) was 21.4% and LS 3( > 5cm) was 71.4%. histological type in ovarian cancer the frequency percentage of Papillary Adenocarcinoma was 14%, Adenocarcinoma was 8.5%, Serous Adenocarcinoma was 9.9%, Papillary Serous Carcinoma was 8.5% and majority of cases was found with Atypical Cells that is 59.1%.

Conclusions: found that there is some discrepancy in CT PCI scores and surgical PCI score in individual regions because of which some of metastatic nodules are missed in CT PCI but can be seen intraoperatively.

0.5% CARBOXYMETHYLCELLULOSE VERSUS 0.4%POLYETHYLENE GLYCOL / 0.3% PROPYLENE GLYCOL AS TEAR SUBSTITUTES FOR THE TREATMENT OF DRY EYE

Dr Shweta Sinha ,Dr Ritu Jain — Sat, 23 Aug 2025 00:00:00 +0300

Background: Dry eye disease (DED) is a multifactorial disorder characterized by tear filminstability, ocular surface inflammation, and discomfort, leading to impaired vision and qualityof life. Artificial tear substitutes are the cornerstone of management, with
Carboxymethylcellulose (CMC) and Polyethylene Glycol/Propylene Glycol (PEG/PG) beingwidely used.
Objective: To compare the efficacy of 0.5% CMC and 0.4% PEG/0.3% PG eye drops in patientswith mild to moderate DED.

COMPARISON OF CENTRAL CORNEAL THICKNESS IN NORMAL TENSION GLAUCOMA AND PRIMARY OPEN ANGLE GLAUCOMA- A CROSS-SECTIONAL STUDY

Dubey Harshita, Dokania Ashutosh — Sat, 23 Aug 2025 00:00:00 +0300

Background: Primary Open-Angle Glaucoma (POAG) and Normal TensionGlaucoma (NTG) are the two most prevalent subtypes of glaucoma, which is aleading cause of permanent blindness. The corneal thickness (CCT) significantlyaffects the measurement of IOP and development of glaucoma.
The goal of this study is to compare the thickness of the Ganglion Cell Complex(GCC) and CCT in patients with NTG and POAG.

PREVALENCE OF RAISED INTRAOCULAR PRESSURE IN POST CATARACT SURGERY FOLLOWING TOPICAL STEROID USAGE-A CROSS SECTIONAL STUDY

Kumar Arun, Jain Ritu — Sat, 23 Aug 2025 00:00:00 +0300

Background: Cataract is the leading cause of blindness globally, and cataract surgery withintraocular lens implantation is the definitive treatment. Postoperatively, topicalcorticosteroids are frequently prescribed to control inflammation, but they may induce a risein intraocular pressure (IOP), posing a risk of secondary glaucoma.
Aim: To assess the prevalence of raised IOP following topical steroid usage afteruncomplicated cataract surgery and to categorize patients based on steroid response.

"Ropivacaine With or Without Dexamethasone for Ultrasound-Guided Pericapsular Nerve Group Block in Hip Surgery: A Comparative Study"

Dr. Sravani M, Dr. Sahana S, Dr. Kiran Kumar O — Mon, 25 Aug 2025 00:00:00 +0300

Background: The pericapsular nerve group (PENG) block is a novel, ultrasound-guided regional anaesthesia technique targeting the articular branches of the femoral, obturator, and accessory obturator nerves. It has demonstrated efficacy in providing analgesia for hip surgeries while preserving motor function. Adjuvants such as dexamethasone have been explored to prolong analgesic duration and improve outcomes when combined with local anaesthetics. Aim of this study is to compare the efficacy and duration of analgesia of ultrasound-guided PENG block using 0.5% Ropivacaine alone versus 0.5% Ropivacaine with Dexamethasone in patients undergoing hip surgery.

Methods: A prospective, randomized, double-blind clinical study was conducted on 60 patients aged 18 to 65 years belonging to ASA I–II scheduled for elective hip surgery between June 2023 and May 2024 in the Department of Anaesthesiology at Sri Balaji Medical College and Hospital, Tirupati. Patients were randomly divided into two groups (n=30 each): Group A: Received 20 ml of 0.5% Ropivacaine. Group B: Received 20 ml of 0.5% Ropivacaine + 8 mg Dexamethasone. The PENG block was performed under ultrasound guidance preoperatively. Patients were monitored for 24 hours postoperatively for visual analogue scale (VAS) pain scores, duration of analgesia (time to first rescue analgesic), total analgesic consumption, motor function, and any complications.

Results: The duration of analgesia was significantly longer in Group B (mean: 18.2 ± 2.4 hours) compared to Group A (mean: 11.6 ± 1.8 hours, p < 0.001). VAS scores at 6, 12, and 18 hours postoperatively were significantly lower in Group B (p < 0.05). Total rescue analgesic consumption was reduced in the dexamethasone group. No significant motor blockade or adverse effects were observed in either group.

Conclusion: The addition of dexamethasone to ropivacaine in ultrasound-guided PENG block significantly prolongs the duration of analgesia and reduces postoperative pain and analgesic requirements without increasing adverse effects. This combination may enhance perioperative pain management in hip surgeries.

Serum Uric Acid and Radiological Markers as Predictive Biomarkers in Psoriatic Arthritis Development

Mon, 25 Aug 2025 00:00:00 +0300

Serum uric acid concentration and radiological features were assessed as prospective biomarkersfor the development of psoriatic arthritis in a cohort of psoriasis subjects. Prospectiveobservational study enrolled 180 adults with plaque psoriasis, including 60 who developedpsoriatic arthritis (PsA) at one-year follow-up versus

Biochemical, Microbiological, and Physiological Markers of NAFLD in Obesity: The Role of GGT, Ferritin, and Gut Microbial Dysbiosis, Including LPS-Producing Bacteria and SCFA Alterations

Mon, 25 Aug 2025 00:00:00 +0300

Evaluation of gamma-glutamyl transferase (GGT), serum ferritin, and specific gut microbiomealterations—including lipopolysaccharide (LPS)-producing bacteria and short-chain fatty acid(SCFA) profiles—was conducted in obese individuals to identify biomarkers predictive of nonalcoholic fatty liver disease (NAFLD).

Evaluating CRP and Procalcitonin in Pediatric Sepsis: Diagnostic Markers with Surgical Implications

Mon, 25 Aug 2025 00:00:00 +0300

Pediatric sepsis is a critical condition with significant morbidity and mortality, especially whenearly diagnosis is delayed. This prospective analytical study investigates the diagnostic utility ofC-reactive protein (CRP) and procalcitonin (PCT) in differentiating sepsis severity and predictingsurgical outcomes in pediatric patients

Evaluating Serum Uric Acid as a Predictive Marker for Outcomes in Pediatric Acute Lymphoblastic Leukemia

Mon, 25 Aug 2025 00:00:00 +0300

A prospective cohort of 150 children aged 2–16 years newly diagnosed with acute lymphoblasticleukemia (ALL) was followed to assess the prognostic role of baseline serum uric acid (SUA)levels in treatment response, early tumor lysis syndrome (TLS), and survival outcomes. BaselineSUA was measured prior to induction therapy.

Histological Alterations in Bronchial Epithelium and Serum IgE in Bronchial Asthma

Saira Aslam, Uzma Hanif, Sadia Saqib, Ahmad Farzad Qureshi, Amrat, Kanwal Khalid — Mon, 25 Aug 2025 00:00:00 +0300

A prospective cross-sectional study assessed histological alterations in bronchial epithelium andtheir correlation with serum total IgE in 120 adult patients with bronchial asthma compared to 60healthy controls. Bronchial biopsies obtained via bronchoscopy were evaluated for epithelialshedding, goblet cell hyperplasia

Pediatric Beta-Thalassemia Major: Chronic Transfusion, Oxidative Stress, and the Overlooked Surgical Burden

Mon, 25 Aug 2025 00:00:00 +0300

Association between chronic transfusion therapy, oxidative stress biomarkers, and surgicalinterventions in pediatric patients with beta-thalassemia major was evaluated in a prospectivecohort of 200 children aged 5–16 years receiving regular transfusions and chelation therapy. Serummarkers including malondialdehyde

A Case-Control Study on Risk Factors for Early Dental Implant Failure in Smokers and Non-Smokers

Mon, 25 Aug 2025 00:00:00 +0300

A case-control study evaluated risk factors associated with early dental implant failure in smokersversus non-smokers. Seventy patients with early failure (implant loss or mobility within 12months) were matched by age and implant site to 140 controls with successful implants at 12months. Baseline data included smoking status

Association between periodontitis and cardiovascular disease

Mon, 25 Aug 2025 00:00:00 +0300

Association between clinical periodontitis and incident cardiovascular events was prospectivelyevaluated in a cohort of 250 middle-aged adults free of known cardiovascular disease at baseline.Periodontal status, including clinical attachment loss (CAL), probing depth, bleeding on probing(BOP), and serum inflammatory markers

Comparative Evaluation of Corneal Endothelial Changes after Phacoemulsification versus Manual Small-Incision Cataract Surgery in Grade-4 Nuclear Cataracts: A Randomised Observational Study

Dr. Bhumika Sharma, Dr Ashima Mehndiratta, Dr. Sahil Jain, Dr Hitesh Suthar — Tue, 26 Aug 2025 00:00:00 +0300

Purpose: To compare postoperative corneal endothelial morphology and visual outcomes after phacoemulsification (PHACO) and manual small-incision cataract surgery (SICS) in eyes with grade-4 nuclear cataract. Methods: In this single-centre, randomised observational study, 90 eyes of 90 patients were allocated to PHACO (n = 45) or SICS (n = 45). Pre-operative and postoperative (1 week, 6 weeks, 3 months) assessments included endothelial cell density (ECD), coefficient of variation (CV), hexagonality (%Hex), central corneal thickness (CCT), uncorrected (UCVA) and best-corrected visual acuity (BCVA) using specular microscopy and logMAR charts. Primary outcome was percentage ECD loss at 3 months. Secondary outcomes were changes in CCT, CV, %Hex, and visual acuity. Results: Baseline characteristics were comparable between groups (mean age 54.0 ± 4.7 y vs 56.0 ± 3.9 y; p = 0.07). Mean ECD loss at 3 months was 13.6 ± 2.5 % (PHACO) versus 13.0 ± 1.5 % (SICS) (p = 0.16). CCT increased transiently at week 1 (PHACO +42 µm; SICS +22 µm) before returning to near-baseline by month 3 (p > 0.05 for all inter-group comparisons). CV and %Hex changed similarly in both groups, indicating comparable endothelial remodelling. Median BCVA improved from 0.64 to 0.06 logMAR (PHACO) and 0.71 to 0.09 logMAR (SICS) at 3 months (p = 0.39). No sight-threatening complications occurred. Conclusions: PHACO and SICS yield equivalent endothelial preservation and visual rehabilitation in dense nuclear cataracts when performed by an experienced surgeon. Given its lower cost and technology dependence, SICS remains a pragmatic alternative to PHACO in resource-limited settings.

Navigating Adolescence: Effectiveness of the YRBSS Tool in Addressing High-Risk Behaviours in India

Dr. Merlyn Grace Ankala, Dr Gurmeet Kaur, Dr Atul Goel (Late) — Thu, 28 Aug 2025 00:00:00 +0300

Adolescence is a critical developmental stage characterized by rapidtransitions and vulnerability to health-risk behaviors that may persist into adulthood.Monitoring these behaviors is essential for timely interventions. This study assessed theprevalence of high-risk behaviors amongadolescents in Ludhiana, India, and evaluated theeffectiveness of the Youth Risk Behavior Surveillance System (YRBSS) tool in the Indiancontext.

Association of Gamma – Glutamyl Transpeptidase to HDL-C ratio with Severity of Non – Alcoholic Fatty Liver Disease

B. Roopa Neeharika , Bhumika Upadhyay, Jaspreet Kaur , Afreen Khan , Kajal Nandi — Fri, 29 Aug 2025 00:00:00 +0300

Non-Alcoholic Fatty Liver Disease (NAFLD) is a growing health concernglobally. The Gamma-glutamyl transpeptidase to HDL-C ratio (GGT/HDL-C) has beenproposed as a potential marker of oxidative stress and liver dysfunction.

Measurement of various morphometric parameters of the ulna and analyzing its variations will help in sex determination & can play important role in forensic science

Amarjyoti Chaturvedi, Dr.Pawan Kumar Mahato, Rajendra Singh — Fri, 29 Aug 2025 00:00:00 +0300

Aim: In this work, we will examine a number of ulna morphometric features, look for genderdifferences in these parameters, and find that the measurements of male and female bones are significantly different.

Knowledge Regarding Cataract among Young Adults

Sat, 30 Aug 2025 00:00:00 +0300

Cataract is a visual impairment characterized by lens opacification, leading to blurred vision. Age-related cataracts are the most prevalent type in adults, whereas hereditary and metabolic factors are the primary causes in children. Cataracts disproportionately affect populations from low-to-medium socioeconomic backgrounds, with a significant burden in developing countries. The present study was conducted to assess the knowledge regarding cataract among young adults residing in a selected village of Shiroli, with a view to develop an information booklet.

Objectives: 1. To assess the level of knowledge regarding cataract among young adults. 2. To find out the association between knowledge levels and selected socio-demographic variables.

Methods: A non-experimental descriptive correlational research design was adopted. A total of 100 young adults residing in Shiroli village were selected by non-probability convenient sampling technique. Data was collected using a structured knowledge questionnaire.

Results: The findings revealed that 61 participants (61%) had average knowledge, 9 participants (9%) had good knowledge, and 30 participants (30%) had poor knowledge regarding cataract. Chi-square analysis showed a significant association between knowledge level and gender (χ² = 11.567, p < 0.05). No significant association was found with other socio-demographic variables such as age, religion, marital status, and source of information.

Interpretation and Conclusion: The study concludes that the majority of young adults had an average level of knowledge regarding cataract. This highlights the need for educational interventions. An information booklet can serve as an effective tool to enhance awareness among young adults.

Systems-based-Protocol-Driven Integration study of Surgical and Critical Care in Cardiovascular Patients: Advancing Anesthesia and ICU Monitoring

Sat, 30 Aug 2025 00:00:00 +0300

Cardiovascular surgery remains associated with high rates ofperioperative morbidity and mortality. A major contributor to adverse outcomes isvariability in anesthetic management and postoperative intensive care unit (ICU)monitoring, leading to inconsistent practices across institutions and clinicians

Critical Analysis of Post-Operative Morbidity and Mortality in Patients of Carcinoma Rectum Following Neoadjuvant Concurrent Chemoradiation Therapy

Wed, 03 Sep 2025 00:00:00 +0300

Background: Carcinoma rectum is a prevalent malignancy that often presents at a locally advanced stage. Neoadjuvant Concurrent Chemoradiation Therapy (NACCRT) has become the cornerstone of management in locally advanced rectal cancers, potentially downstaging tumors and improving resectability. Despite these benefits, the impact of NACCRT on short-term postoperative outcomes—morbidity and mortality—warrants thorough investigation.

Methods: This prospective, observational study was conducted at a tertiary care center over two years. Patients with T3/4 or N+ rectal cancer received NACCRT, followed by definitive surgery (Abdomino-Perineal Resection, Low Anterior Resection, or Total Pelvic Exenteration). Perioperative data, including operative time, blood loss, postoperative complications, and 30-day mortality, were collected. Statistical analyses were performed using SPSS, and comparisons were made between open versus laparoscopic surgical approaches.

Results: A total of 67 patients with carcinoma rectum were included. The mean patient age was 50.87±16.63 years, and 65.7% were male. Most tumors (55.2%) were located in the lower rectum. After NACCRT, 47.8% of patients underwent Abdomino-Perineal Resection and 47.8% Low Anterior Resection. Laparoscopic surgery accounted for 52.2% of cases, with significantly lower intraoperative blood loss (p=0.019) and fall in hemoglobin (p=0.001) compared to open surgery. Overall short-term morbidity was comparable between laparoscopic and open groups regarding ICU stay, postoperative pain scores, and complication rates (e.g., anastomotic leak in 1 patient, re-exploration in 3). There was no 30-day mortality.

Conclusion: NACCRT followed by curative resection in locally advanced rectal cancer is feasible with acceptable short-term morbidity with no observed 30-day mortality. Laparoscopic surgery appears to confer certain intraoperative advantages, notably lower blood loss, without increasing complication rates. Further multicenter studies with larger cohorts are warranted to confirm these findings and refine perioperative management protocols.

Assessment of Functional Outcome of Cubitus Varus Deformity Treatment in Children Undergoing Modified French Osteotomy

Wed, 03 Sep 2025 00:00:00 +0300

Background: Cubitus varus is the most common late complication following supracondylar fractures of the humerus in children, primarily resulting from improper fracture reduction and conservative management. Although largely a cosmetic concern, surgical correction is often required to restore anatomical alignment. Modified French osteotomy is among the preferred techniques for its effectiveness and safety. Objective: To assess the functional and radiological outcomes of children with cubitus varus deformity treated using modified French osteotomy. Materials and Methods: This prospective study included 25 pediatric patients with established cubitus varus deformity. The deformity was corrected using the French osteotomy and its modifications, such as a lateral approach without triceps splitting and preservation of the medial cortex. Preoperative evaluation included clinical and radiographic assessment of the carrying angle and range of motion. Postoperative follow-up was conducted at 10 days, 1 month, 2 months, and up to 6 months with emphasis on clinical-radiological parameters including Baumann’s angle, carrying angle, and movement range. Results: The mean age was 10.8 years, with a male predominance (76%). The left elbow was more commonly affected (64%). The average interval between injury and corrective surgery was 2.4 years. Most patients (68%) had severely restricted motion (>20° loss). Postoperative assessment revealed 76% of patients achieved a valgus carrying angle. Excellent outcomes were noted in 60% of patients, fair in 24%, and poor in 16% based on modified Bellemore criteria. The most common complication was residual deformity (16%), followed by lateral elbow bulge (12%) and minor infections (8%). Conclusion: Modified French osteotomy is a reliable, technically feasible, and cosmetically acceptable technique for correcting cubitus varus deformity in children. It provides excellent to fair outcomes in the majority of patients, with a low incidence of complications.

A Cross-Sectional Study to Identify the Prevalence of Obesity and Its Selected Influencing Factors among Adults Residing At Shiroli Village of Kolhapur

Mr. Shivagouda Patil, Mrs. Sheetal Kamble, Dr. Sunil Kumar Awate — Wed, 03 Sep 2025 00:00:00 +0300

Background: Obesity is a major public health issue worldwide and is associated with various lifestyle and dietary factors. This study was conducted to assess the prevalence of obesity and its selected influencing factors among adults residing at Shiroli village, Kolhapur. Objectives: 1. To identify prevalence of obesity among adults residing at Shiroli village. 2. To identify the factors influencing obesity among adults residing at Shiroli village. Methods: A cross-sectional study was conducted among 800 adults aged 21–45 years in PulachiShiroli village, Kolhapur district, to identify the prevalence and factors influencing obesity. The village was divided into four geographic quotas, from which 200 participants were selected using convenient sampling. Data collection tools included a structured questionnaire covering socio-demographic details, dietary habits, and physical activity, along with anthropometric measurements (height and weight) based on WHO BMI classifications. Dietary habits (10 items) and physical activity (4 items) were assessed using a 5-point Likert scale. Dependent variable: obesity prevalence; Independent variables: age, gender, religion, education, occupation, dietary habits, family income, and lifestyle factors. Adults aged 21–45 years were selected as this group is prone to obesity due to sedentary lifestyle and reduced physical activity. Results: Among the 800 participants, the majority 379 (47.4%) were aged 41–45 years, while the smallest group 47 (5.9%) belonged to 21–25 years. More than half of the respondents were female 437 (54.6%), and most were Hindus 556 (69.5%). In terms of occupation, 373 (46.6%) were housewives, and only 13 (1.6%) were engaged in government jobs. A mixed diet was reported by 594 (74.3%) participants, and 405 (50.6%) reported sleeping more than 8 hours daily. According to BMI classification, 43.3% of the participants were in the pre-obesity category, 39.8% had normal weight, 11.1% were obese (Class I and II), and 5.9% were underweight. Analysis of lifestyle and dietary factors revealed that 47.4% consumed sweetened beverages 2–3 times a month and 5% consumed daily, while 42.6% consumed sweets monthly and 5.4% daily. Nearly half of the respondents (48.5%) consumed fried foods weekly, with 6.4% consuming daily, and 20.6% regularly added sugar or honey to beverages. Intake of refined foods such as pizza or burgers was low (95.9% consumed rarely), while fruit and salad intake was moderate, with 53.1% consuming 3–4 times a week and only 8% daily. Regular intake of sprouted pulses and green vegetables was reported by 39.8%, whereas 13.8% consumed rarely. Regarding meal frequency, 42.1% ate three meals daily, while 30.9% limited intake to two meals, indicating risk of unhealthy snacking patterns. Eating out was infrequent, with 79.8% reporting less than once per month. Physical activity patterns showed that 37.1% exercised 3–4 times a week, but only 7.8% exercised daily, and yoga practice was negligible, with 84.3% never practicing. Sedentary behavior was high, with 83% spending at least 2 hours daily sitting, while sleep duration was adequate in most, as 53% reported sleeping ≥9 hours. Overall, the findings highlight that while some respondents maintained healthy habits, obesity risk factors were evident in frequent intake of high-calorie foods, inadequate fruit and vegetable consumption, limited physical activity, and high sedentary lifestyle patterns. Conclusion: Pre-obesity and obesity are highly prevalent in the studied community. Poor dietary habits, insufficient exercise, and sedentary lifestyles were major contributing factors. Targeted interventionsfocusing on lifestyle modificationhealth education and community-basedStrategies are recommended.

Prognostic Value of Arterial Blood Gases in Predicting ICU Mortality in Patients Under General Anesthesia

Sat, 30 Aug 2025 00:00:00 +0300

Arterial blood gas parameters during general anesthesia possess prospective value in forecastingintensive care unit mortality. This experimental investigation evaluated the prognostic significance of intra-operative arterial blood gases—specifically pH, PaO₂, PaCO₂, bicarbonate, base excess,and lactate—in adult patients undergoing

Clinical Patterns and Surgical Outcomes of Hypospadias Repair

Sat, 30 Aug 2025 00:00:00 +0300

The clinical presentation and operative outcomes of hypospadias repair were evaluated through aprospective observational study. Male children presenting with various hypospadias phenotypeswere assessed for anatomical features

Evaluation of Serum Cortisol and Thyroid Hormone Levels in Patients with Major Depressive Disorder

Sat, 30 Aug 2025 00:00:00 +0300

Serum cortisol and thyroid hormone levels were examined in patients diagnosed with majordepressive disorder (MDD) to evaluate their potential role as endocrine biomarkers. A case-controlstudy enrolled treatment-naïve adults with MDD and matched healthy controls.

GLP-1 Receptor Agonists for Hepatic Steatosis and Fibrosis in Type 2 Diabetes with NAFLD.

Sat, 30 Aug 2025 00:00:00 +0300

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) may attenuate hepatic steatosis andmodify fibrosis risk in type 2 diabetes mellitus (T2D) with nonalcoholic fatty liver disease. Thisprospective, parallel-group study evaluated once-weekly semaglutide added to standard diabetes care versus standard care alone over 48 weeks in adults with T2D

Evaluation of Serum Zinc, Copper, and Hematological Parameters (Hemoglobin, Total Leukocyte Count, Neutrophil-to-Lymphocyte Ratio) in Acne Vulgaris: A Case-Control Study

Sat, 30 Aug 2025 00:00:00 +0300

Serum zinc and copper concentrations along with hematological markers—hemoglobin, totaleukocyte count (TLC), and neutrophil-to-lymphocyte ratio (NLR)—were investigated to assesstheir associations with acne vulgaris in a case-control design

Laser vs. Conventional Surgical Treatment of Hemorrhoids AComparative Study of Outcomes and Complications

Sat, 30 Aug 2025 00:00:00 +0300

A new randomized controlled experimental comparison between laser and conventional excisionalhemorrhoidectomy demonstrates improved outcomes and reduced complications. The objective ofthe study was to evaluate operative time, postoperative pain scores, wound healing time,complication rates, and recurrence between laser hemorrhoidectomy and conventional excisional technique. A total of 1 20 adult patients

Diagnostic Accuracy of Multiparametric MRI versus TRUS Biopsy in Clinically Significant Prostate Cancer: Correlation with PSA Derivatives, Urinary PCA3, and Renal Function

Sat, 30 Aug 2025 00:00:00 +0300

Multiparametric magnetic resonance imaging (mpMRI), transrectal ultrasound (TRUS) biopsy,PSA derivatives, urinary PCA3, and renal function were prospectively evaluated to determine theircollective diagnostic performance in detecting

Transcranial Magnetic Stimulation as an Adjunct to Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder.

Sat, 30 Aug 2025 00:00:00 +0300

This randomized controlled trial investigated whether augmenting cognitive behavioral therapy(CBT) for obsessive-compulsive disorder (OCD) with repetitive transcranial magnetic stimulation(rTMS) over the supplementary motor area (SMA) enhances symptom reduction and modulatesbrain network connectivity. Eighty adults with moderate to severe OCD were randomized toreceive 8 weeks of CBT plus real rTMS or CBT plus sham stimulation

Evaluating the Efficacy of Virtual Reality Exposure Therapy in Treating Social Anxiety Disorder with functional neuroimaging insights

Sat, 30 Aug 2025 00:00:00 +0300

This randomized controlled trial examined the clinical efficacy of virtual reality exposure therapy(VRET) in treating social anxiety disorder (SAD) and investigated associated neural changes usingfunctional magnetic resonance imaging (fMRI). One hundred participants diagnosed withmoderate to severe SAD were randomized to receive either VRET or traditional cognitive behavioral exposure therapy over eight weeks. Symptom

Comparison of Alpha-Blocker Monotherapy Versus Combination Therapy in Moderate to Severe LUTS: A Real-World Study

Sat, 30 Aug 2025 00:00:00 +0300

Lower urinary tract symptoms (LUTS) in men significantly impair quality of life and arecommonly managed using α-blockers as first-line therapy, with or without the addition of 5αreductase inhibitors (5-ARIs). This real-world, prospective comparative study evaluated the effectiveness of α-blocker monotherapy versus α-blocker plus

Impact of Clean Intermittent Catheterization on Renal and Lower Urinary Tract Outcomes in Spinal Cord Injury Patients

Sat, 30 Aug 2025 00:00:00 +0300

Neurogenic bladder dysfunction following spinal cord injury (SCI) is a major source of morbidity,predisposing patients to recurrent urinary tract infections (UTIs), renal deterioration, andcompromised quality of life. Clean intermittent catheterization (CIC) is widely recommended asthe gold standard for bladder emptying in this population

Correlation of Prostate Volume with Lower Urinary Tract Symptoms Using Transabdominal Ultrasound in Men Over 50

Sat, 30 Aug 2025 00:00:00 +0300

Lower urinary tract symptoms (LUTS) are common in aging men and are often attributed to benignprostatic enlargement (BPE) secondary to benign prostatic hyperplasia (BPH). Accurateassessment of prostate size is crucial for evaluating the severity of LUTS, determining therapeuticstrategies, and predicting treatment outcomes

Evaluation of Procalcitonin and CRP in Diagnosing Acute Pelvic Inflammatory Disease

Sat, 30 Aug 2025 00:00:00 +0300

Acute pelvic inflammatory disease (PID) is a common gynecological emergency resulting frominfection and inflammation of the upper genital tract. Early diagnosis is essential to preventcomplications such as infertility, ectopic pregnancy

Comparative Study of Oxidative Stress Markers, Clinical Chemistry Indicators, and Neurological Biomarkers Implicated in Disease Progression in Progressive and Stable Vitiligo

Sat, 30 Aug 2025 00:00:00 +0300

Vitiligo progression is thought to reflect a convergence of redox imbalance, metabolicsusceptibility, and neuro-immune dysregulation. This prospective comparative study enrolled 180adults with nonsegmental vitiligo, stratified at baseline

High-Resolution CT Thorax and Serum IL-6 Levels in Patients with Interstitial Lung Disease

Sat, 30 Aug 2025 00:00:00 +0300

Background: Interstitial lung diseases (ILDs) represent a diverse group of chronic lung disorderscharacterized by inflammation, fibrosis, and impaired gas exchange. High-resolution computedtomography (HRCT) is considered the imaging gold standard for diagnosis andcharacterizationof ILDs. Meanwhile, interleukin-6 (IL-6), a pro-inflammatory cytokine, has emerged as a potentialbiomarker.

Clinical and Histopathological Assessment of Hepatocellular Injury in Pediatric Hepatitis A and E Infections: Insights from a Comparative Study

Sat, 30 Aug 2025 00:00:00 +0300

Acute hepatocellular injury caused by hepatitis A and E represents a significant burden in pediatricpopulations, yet comparative histopathological data remains scarce. Present investigation aimedto characterize clinical and histopathological features of pediatric hepatitis A versus E infectionswithin a prospective cohort, employing rigorous comparative analysis. A total of 120 children with

Evaluating the Role of Flap Fixation Techniques in Reducing Seroma Formation After Mastectomy

Sat, 30 Aug 2025 00:00:00 +0300

Seroma remains the most common complication following mastectomy, often prolonging hospitalstay, delaying adjuvant therapies, and increasing morbidity. This study aimed to evaluate the roleof flap fixation techniques in reducing seroma formation compared to conventional closure. Aprospective randomized controlled trial was conducted including

Forensic Challenges in Diagnosing Meningococcal Sepsis Postmortem

Sat, 30 Aug 2025 00:00:00 +0300

Neisseria meningitidis septicemia remains a critical cause of sudden death, yet postmortemdiagnosis is frequently obscured by nonspecific autopsy findings and postmortem bacterialovergrowth. In a retrospective case control forensic analysis of 25 suspected meningococcal sepsiscases, conventional cultures yielded confirmatory results in only

Mentoring Dynamics: Medical Student’s Perspectives in a Private Medical College Setting

Dr. Sadaf Sajid, Dr Syma Arshad, Azqa Ali, Dr Umera Saleem, Dr. Anwar. Ul Haq — Thu, 04 Sep 2025 00:00:00 +0300

Background: Mentoring in medical education is an evolving strategy to support students’ academic, personal, and professional development. In Pakistan, structured mentoring programs are still limited, and students face diverse academic, emotional, and social challenges during medical training. Understanding their perceptions can inform the improvement of such initiatives.

Objective: To evaluate medical students’ perceptions of mentoring with respect to academic support, personal development, emotional and psychological support, and to compare perceptions between pre-clinical and clinical years as well as between genders.

Methods: A cross-sectional study was conducted at Rashid Latif Medical College, Lahore, after one year of implementing a formal mentorship program. Using a validated questionnaire (Cronbach’s α = 0.67; item range 0.62–0.93), data were collected from 300 MBBS students (150 pre-clinical; 150 clinical) through universal sampling. Responses were recorded on a five-point Likert scale. Independent sample t-tests were applied to compare mentoring domains across academic years and gender.

Results: Among participants (53.7% females, 44.7% males), most reported positive perceptions toward mentoring (pre-clinical: 45.3–54.6%; clinical: 45.6–63.8%). Academic support was the most highly endorsed domain (46.6–68.7% pre-clinical; 50.6–75.4% clinical), particularly in receiving constructive feedback. Personal development was positively perceived by 25.4–64.7% (pre-clinical) and 34–60% (clinical), while emotional/psychological support was endorsed by 34–74.6% and 26–69%, respectively. No statistically significant difference was observed between pre-clinical and clinical students across domains (p>0.05). Gender comparison showed significant difference only in academic support (p<0.05), with females reporting greater benefit.

Conclusion: Medical students generally perceived mentoring positively, especially regarding academic support. While no difference existed between academic years, female students benefited more in terms of academic support. Formal mentoring programs should be expanded in Pakistani medical colleges, with greater emphasis on personal, emotional, and career-related guidance.

Knowledge and Attitude regarding Artificial Intelligence in Health Care among Nursing Students

Fri, 05 Sep 2025 00:00:00 +0300

Background of Study The earliest research into thinking machines was inspired by a confluence of ideas that became prevalent in the late 1930s, 1940s, and early 1950s.The idea of “artificial intelligence” goes back thousands of years, to ancient philosophers considering questions of life and death. In ancient times, inventors made things called “automatons” which were mechanical and moved independently of human intervention. The field of "artificial intelligence research" was founded as an academic discipline in 1956. AI plays a crucial and vital role in healthcare because it can significantly improve diagnostic accuracy, personalize treatment plans, streamline administrative tasks, enable remote patient monitoring, identify high-risk populations, accelerate drug discovery, and ultimately enhance patient care quality while potentially reducing costs by optimizing resource allocation, all by leveraging its ability to analyse vast amounts of medical data rapidly and efficiently. AI in the health care system helps not only in expediting diagnosis and management but also injudicious resource all location. Researches on artificial intelligence (AI) in healthcare are essential because it can greatly enhance the knowledge and skills of health care workers and improve patient outcomes by facilitating early disease detection, personalized treatment plans, faster and more accurate diagnoses, effective drug discovery, and optimized healthcare management which will eventually result in better preventative and curative intervention Developing countries like India are lagging in the implementation of AI-based solutions in healthcare. There is a need of educational interventions, researches on AI to bridge the knowledge gaps and develop a favourable attitude among healthcare professionals regarding AI in health care.

Research Objectives

1) To assess the knowledge and Attitude regarding Artificial Intelligence in healthcare.

2) To find out a correlation between knowledge & attitude regarding Artificial Intelligence in health care.

3) To find out the association between knowledge score regarding Artificial Intelligence in health care with selected socio demographic variables.

4) To find out the association between Attitude regarding Artificial Intelligence in health care with selected socio demographic variables.

Methods The research approach adopted for the study was a quantitative survey approach. Research design was Nonexperimental, Descriptive Correlational research design. By using probability stratified random sampling technique 120 nursing students studying in D. Y. Patil College of Nursing were selected for the study. Structured knowledge questionnaire and Structured attitude scale was used to assess the knowledge and attitude of nursing students regarding Artificial Intelligence in Healthcare. The reliability of the tool was tested by using Karl Pearson’s Correlation coefficient. The reliability computed was r = 0.81. Data was analysed by using mean, median, mode, range, standard deviation, paired ‘t’ test & chi square test.

Results: The findings of the study revealed thatmajority of the subjects 73 (60.83%) had good knowledge, 46 (38.33%) had average knowledge and minimum 01 (0.83%) had poor knowledge.In attitude majority of the subjects 111 (92.50%) had positive attitude and minimum 9 (7.50%) had negative attitude. Thecalculatedcorrelation value of knowledge and attitude was (tcal=0.132) greater than 0, which shows a weakly positive relationship. This indicated that there was a strongly positive correlation between knowledge and attitude which was statistically significant at p <0.05 level, regarding artificial intelligence in healthcare. There was no any significant association between knowledge scores and selected socio-demographic variables. The calculated Chi-square values was lesser than tabulated value at p< 0.05 level of significance. This indicated that there was no any significant association between knowledge scores with their selected socio-demographic variables at p< 0.05 level of significance. There was no any significant association between attitude scores and selected socio-demographic variables. The calculated Chi-square values was lesser than tabulated value at p< 0.05 level of significance. This indicated that there was no any significant association between knowledge scores with their selected socio-demographic variables at p< 0.05 level of significance.

Interpretation and Conclusion: The overall finding shows that majority of nursing students had good knowledge and positive attitude regarding artificial intelligence in health care and there was no any significant association between knowledge and attitude regarding artificial intelligence in healthcare with their socio demographic variables.

Comparison between Tragal Cartilage and Temporal Fascia in Tympanoplasty

Girish Tapadiya, Aakanksha Tapadiya, Archana Tapadiya — Sat, 06 Sep 2025 00:00:00 +0300

Introduction: Tympanoplasty is a widely performed procedure to repair tympanic membrane perforations and improve hearing. Among the commonly used graft materials, Tragal Cartilage and Temporal Fascia have shown varying outcomes. Aims: This study aims to compare the surgical and audiological results of tympanoplasty using Tragal Cartilage versus Temporal Fascia grafts.

Methods: This prospective, randomized, comparative study was conducted in the Department of ENT at Dr. Panjabrao Deshmukh Memorial Medical College, Amravati and at Aakanksha ENT clinic, Amravati, over a period of 19 months from January 2024 to July 2025. A total of 100 patients diagnosed with chronic suppurative otitis media (CSOM), tubotympanic type with dry central perforation, were enrolled in the study. Patients were randomly divided into two equal groups for surgical intervention. Group A (n = 50) underwent tympanoplasty using tragal cartilage graft, while Group B (n = 50) underwent tympanoplasty using temporal fascia graft.

Results: The comparison of audiological outcomes between the two groups revealed significant differences in hearing improvement. The mean preoperative Pure Tone Average (PTA) was comparable between the Tragal Cartilage (42.6 ± 6.8 dB) and Temporal Fascia (43.1 ± 7.1 dB) groups (p = 0.697). However, the mean postoperative PTA was significantly better in the Temporal Fascia group (24.3 ± 5.1 dB) compared to the Tragal Cartilage group (29.8 ± 5.9 dB) (p < 0.001). Consequently, the mean hearing gain was significantly higher in the Temporal Fascia group (18.8 ± 4.2 dB) than in the Tragal Cartilage group (12.8 ± 3.4 dB) (p < 0.001). These findings indicate superior audiological outcomes with the use of Temporal Fascia grafts.

Conclusion: While both Tragal Cartilage and Temporal Fascia are effective graft materials for tympanoplasty, Temporal Fascia offers superior hearing improvement, reduced operative time, and higher patient satisfaction, making it the preferred choice in suitable cases.

Comparative study of autonomic nervous system activity in overweight, normal and underweight school children in eastern Odisha basing on BMI criteria

Debasish Das , Laba Kumar Naik ,Nayan Ranjan Hansda — Sun, 07 Sep 2025 00:00:00 +0300

Aim: This study was undertaken to investigate and compare the autonomic nervous system activity in agematched overweight, underweight and normal weight school going boys in eastern Odisha.Material and method: 90 Boys between age group of 11yr-16yr were subjected to study out of which 30wereoverweight (BMI>25), next 30 were underweight (BMI<18.5), rest 30 were control group having normal BMI. Coldpressure test and handgrip dynamometer test were performed and blood pressure was measured during and after the tests as measures of cardiovascular parameter.

Awareness and Attitude toward Cervical Cancer and HPV Vaccination among Female Medical Students

Tue, 09 Sep 2025 00:00:00 +0300

Background: Cervical cancer is one of the leading causes of cancer-related deaths among women worldwide, with persistnt infection by high-risk strains of the human papillomavirus (HPV) being the primary cause. Despite the availability of the HPV vaccine, there remains a gap in knowledge and vaccine uptake, particularly among medical students who will eventually educate others on preventive health measures. This study aims to assess the awareness and attitudes toward cervical cancer and HPV vaccination among female medical students.

Methods: A cross-sectional study was conducted at [Name of University/Institution] involving 100 female medical students. Data was collected using a structured questionnaire, which assessed demographic characteristics, knowledge of HPV causes, cervical cancer risk factors, vaccine effectiveness, and attitudes toward vaccination. Barriers to vaccination were also identified, and statistical analyses, including Chi-square tests, were applied to determine associations between awareness, attitudes, and demographic factors.

Results: The study found that 60% of students had high awareness of HPV causes, 50% understood cervical cancer risk factors, and only 30% were knowledgeable about the effectiveness of the HPV vaccine. While 70% of participants expressed willingness to receive the vaccine and 80% perceived it as safe, 40% expressed concerns about potential side effects. The primary barriers to vaccination were lack of information (55%), cost (40%), and cultural beliefs (30%).

Conclusions: The findings highlight a significant gap in knowledge regarding the effectiveness of the HPV vaccine, despite relatively high awareness of HPV and cervical cancer. Although attitudes toward vaccination were generally positive, concerns about side effects and structural barriers such as cost remain significant challenges. These results align with previous studies and suggest the need for targeted educational interventions and strategies to address these barriers, particularly in medical training, to enhance HPV vaccination uptake.

A Comparative Study of Barbed Sutures vs. Conventional Sutures in Laparoscopic Surgery: Efficiency, Infection Rate, Cost, and Handling

Dr. R. Varahini, Dr. J. Sharath Kumar — Tue, 09 Sep 2025 00:00:00 +0300

Background: Laparoscopic surgery has revolutionized surgical procedures by reducing recovery time and enhancing patient outcomes. Suturing during these procedures remains a critical step that impacts surgical efficiency, infection rates, and overall cost. Barbed sutures, which eliminate the need for knot tying, are proposed as an alternative to conventional sutures. This study aimed to compare barbed sutures with conventional sutures in terms of suturing time, ease of handling, infection rates, and cost in laparoscopic surgeries.

Methods: A prospective randomized controlled trial was conducted with 100 patients undergoing elective laparoscopic surgery at Venkateshwara Medical College, Puducherry. Participants were randomly assigned to either the barbed suture group (n=50) or the conventional suture group (n=50). The primary outcomes assessed included suturing time, ease of handling, infection rates, and cost. Statistical analyses were performed using independent t-tests and chi-square tests.

Results: The barbed suture group showed a significant reduction in suturing time (9.4 ± 2.1 minutes) compared to the conventional suture group (14.7 ± 3.5 minutes, p<0.001). Handling was rated significantly higher for barbed sutures (4.3/5 vs. 3.2/5). Infection rates were similar in both groups (4% vs. 8%, p=0.43), but costs for barbed sutures were higher (₹1,200 vs. ₹500), though the overall surgical cost was slightly lower in the barbed suture group.

Conclusion: Barbed sutures provide significant time savings and ease of handling compared to conventional sutures, with similar infection rates. Despite higher upfront costs, barbed sutures offer improved surgical efficiency and can be considered a beneficial alternative in laparoscopic surgery.

Comparative Efficacy of Negative Pressure Wound Therapy Combined with Artificial Skin Substitutes or Autogenous Skin Grafts in the Treatment of Diabetic Foot Ulcers

Dr. R. Jaya Preetha, Dr. J. Sharath Kumar, Dr. Manoj Kumar — Tue, 09 Sep 2025 00:00:00 +0300

Background: Diabetic foot ulcers (DFUs) are a common and debilitating complication of diabetes mellitus, often leading to prolonged healing times, high recurrence rates, and an increased risk of infection, potentially requiring amputation. Negative Pressure Wound Therapy (NPWT) has shown effectiveness in DFU treatment, but the combination of NPWT with either artificial skin substitutes or autogenous skin grafts remains a subject of ongoing investigation.

Objective: To evaluate and compare the efficacy of NPWT combined with artificial skin substitutes and NPWT combined with autogenous skin grafts in promoting wound healing in patients with chronic, non-healing DFUs.

Methods: This prospective, comparative study was conducted at Venkateshwara Medical College, enrolling 100 patients with chronic DFUs. The patients were randomly assigned to two groups: Group A (NPWT + Artificial Skin Substitute) and Group B (NPWT + Autogenous Skin Graft). Wound healing progress was monitored over 12 weeks, assessing wound closure, time to complete closure, infection rates, and the need for further interventions. Statistical analysis was conducted using SPSS, with a significance level of p < 0.05.

Results: At the end of 12 weeks, Group B (NPWT + Autogenous Skin Graft) demonstrated superior outcomes with 90% wound closure compared to 85% in Group A (NPWT + Artificial Skin Substitute). Group B also achieved complete wound closure significantly faster (48 days vs. 56 days, p < 0.05). Both groups had low infection rates, but Group B required fewer additional interventions (4% vs. 8%, p = 0.04). Granulation tissue formation was faster and more consistent in Group B, contributing to quicker healing.

Conclusion: NPWT combined with autogenous skin grafts offers superior healing outcomes for diabetic foot ulcers, with faster wound closure, fewer complications, and a reduced need for additional interventions compared to NPWT combined with artificial skin substitutes. Autogenous skin grafting remains the gold standard for DFU treatment, especially for more severe wounds.

Effectiveness of Self-Instructional Module (SIM) On Knowledge Regarding Pregnancy Induced Hypertension (PIH) Among Staff Nurses

Sunayana Sangram Holkar, Priyanka Dhumale, Jyoti Aurwade — Tue, 09 Sep 2025 00:00:00 +0300

Background and

Objectives: Pregnancy is one of the most significant phases in a woman's life, requiring systematic and continuous care to ensure a safe delivery, early identification of complications, and timely medical intervention. Women, particularly during pregnancy, are considered a vulnerable segment of the population. In India, approximately 23 million births occur annually, with an estimated 24 million pregnancies. Of these, 7–15% are complicated, contributing to a significant burden of maternal health issues. Globally, about 529,000 women lose their lives each year due to pregnancy-related complications, and for every death, nearly 118 women experience life-threatening conditions or severe acute health issues. Pregnancy-induced hypertension (PIH) is a significant contributor to maternal, fetal, and neonatal morbidity and mortality. Women affected by PIH are more susceptible to conditions such as placental abruption, cerebrovascular accidents, organ dysfunction, and disseminated intravascular coagulation. Additionally, fetuses of mothers with PIH are at a heightened risk of experiencing intrauterine growth restriction, preterm birth, and intrauterine death. Pregnancy-induced hypertension (PIH) is a medical condition that develops during pregnancy, characterized by elevated blood pressure. Also referred to as toxemia, PIH typically arises after 20 weeks of gestation in women who previously had normal blood pressure levels. It is clinically defined as a systolic blood pressure exceeding 140 mmHg or a diastolic blood pressure above 90 mmHg. This condition involves increased vascular resistance, often accompanied by vasospasm in both small and large arteries. PIH is observed in approximately 5% to 8% of pregnancies and can impair blood flow to multiple organ systems, including the liver, kidneys, brain, uterus, and placenta. Objectives: 1. To assess the level of knowledge regarding pregnancy induced hypertension (P.I.H) among staff nurses. 2. To evaluate the effectiveness of SIM on knowledge regarding pregnancy induced hypertension (P.I.H) among staff nurses. 3. To find out an association between mean pretest knowledge score regarding pregnancy induced hypertension (P.I.H) with their selected socio- demographic variables.

Methods: A quantitative evaluative survey approach was adopted for the present study, utilizing a pre-experimental one-group pre-test and post-test design. After obtaining ethical clearance, prior permission was sought from D.Y. Patil Hospital in Kolhapur. The intervention focused on pregnancy-induced hypertension, aiming to evaluate the effectiveness of a self-instructional module on this topic. According to Slovin's formula, the target population for the study was 124 staff nurses, from which 80 staff nurses were selected as the sample population, considering a margin of error of 0.10. After obtaining consent from the participants, 80 subjects were chosen using a non-probability purposive sampling technique. A pre-test was conducted to assess their knowledge regarding pregnancy-induced hypertension. Subsequently, the self-instructional module was administered to the subjects. A post-test was conducted seven days later, on the eighth day, using the same tool as the pre-test. After data collection, the data were tabulated and analyzed. Based on the interpretation, a scale of Good, Average, and Poor was applied.

Results: The findings of this study revealed that the mean post-test knowledge score of the subjects was higher than their mean pre-test knowledge score. The paired t-value was 14.82, with a p-value of 0.01*, which is considered extremely significant. This indicates a notable improvement in knowledge regarding pregnancy-induced hypertension following the intervention. Therefore, the research hypothesis (H₁) was accepted.

Interpretation and Conclusion: Descriptive statistics, including the mean and standard error difference for the pre- and post-test, revealed a deficit in knowledge regarding pregnancy-induced hypertension among staff nurses. However, the post-test knowledge scores indicated a significant gain in knowledge following the administration of the self-instructional module. The paired ‘t’ test and 'p' values were computed to assess the effectiveness of the self-instructional module, and the results clearly indicated that the intervention was effective.

Effectiveness of a Structured Teaching Program on Attitudes toward Air Pollution among Shopkeepers

Rohan Janardan Kamble, Richa Jadhav, Shivagouda Patil — Tue, 09 Sep 2025 00:00:00 +0300

Background: Air pollution is a major environmental health issue, contaminating the atmosphere with harmful pollutants that adversely affect human health, ecosystems, and materials. In India, over 76% of the population is exposed to ambient particulate matter exceeding national guidelines, contributing to millions of disability-adjusted life years (DALYs). Shopkeepers in urban areas like Kolhapur face heightened exposure due to traffic and industrial activities, yet their attitudes toward air pollution remain understudied. The present study aimed to evaluate the effectiveness of a structured teaching programme (STP) on attitudes regarding air pollution among shopkeepers in selected areas of Kolhapur, Maharashtra, India.

Objectives: 1. To assess the attitude scores regarding air pollution among shopkeepers. 2. To evaluate the effectiveness of STP on attitudes toward air pollution among shopkeepers. 3. To find the association between mean pre-test attitude scores and selected socio-demographic variables.

Methods: A quantitative evaluative approach was used, with a pre-experimental one-group pre-test-post-test design. A sample of 60 shopkeepers was selected using non-probability purposive sampling technique. Attitudes were measured using a structured 5-point Likert scale (28 items; Cronbach's alpha = 0.75). Data were collected via pre-test on September 10, 2024, followed by STP implementation, and post-test on September 16, 2024.

Result: The majority of shopkeepers (65%) had negative attitudes in the pre-test, with a mean score of 85.5 ± 7.54. Post-test showed 80% positive attitudes, with a mean score of 110.7 ± 5.27. Paired t-test indicated significant improvement (t = 20.65, p = 0.01). No significant associations were found between pre-test scores and socio-demographic variables (p > 0.05).

Interpretation and conclusion: The study concludes that shopkeepers in Kolhapur exhibited deficient attitudes toward air pollution pre-intervention, but the STP significantly improved these attitudes. There is a need for healthcare professionals, particularly nurses, to implement educational programs addressing air pollution awareness among vulnerable occupational groups. The findings have implications for nursing practice, education, administration, and research. Recommendations for future studies and interventions to enhance community health are also provided.

Study of Extra Pulmonary Tuberculosis using Gene X-pert and Fluorescent Microscopy at Vasantrao Naik GMC Yavatmal

Dr. Satish Laxmanrao Kodape, Dr. Durgesh Deshmukh — Wed, 10 Sep 2025 00:00:00 +0300

Background: Tuberculosis remains a major global health problem with 1/3 of world’s population being infected with tuberculosis Along with HIV, Diabetes mellitus and recently evolved drug resistant tuberculosis, it is a big threat for mankind. TB can involve any organ system in the body. While PTB is the most common presentation, EPTB is also an important clinical problem.

Aim and Objectives: 1. Study of Extra Pulmonary Tuberculosis using Gene X-pert and Fluorescent Microscopy at Vasantrao Naik GMC Yavatmal.2. Study the age and gender wise distribution of Extra pulmonary tuberculosis patient.3. Finding associated risk factors with extra pulmonary tuberculosis

Methods: Study Design: Cross sectional study. Study Population: All extra pulmonary suspected patients admitted in Vasantrao Naik GMC Yavatmal during study period such cases were included in the study. Study Duration: 2023-2025 Sample size: 246

Results: Most of the EPTB cases found in 26-40 years age group 87 (36.25%) followed by 62 cases (25.83%) in 41-55 years age group, 39 (16.25%) in 12-25 age group,37 (15.41%) in 56-65 age group and 21 cases found in above 66 years age group. majority of EPTB cases were males 149 (60.56%) and females were 97 (39.44%). EPTB cases as per diagnosis majority of cases were males 149 and 97 cases were females. In males most of cases diagnosed pleural TB 69 (46.30%) followed by lymph node TB 32 (21.47%), abdominal TB 27 (18.12%), potts spine 12 (8.05%), TB meningitis 4 (2.68%), peritoneal TB 4 (2.68%) and genital TB 1 (0.67%). Association of Pleural TB cases with age was statistically significant at p<.05. Sensitivity and specificity of Gene X-pert and Fluorescent Sensitivity=89.43%, Specificity= 70.58%, Positive Predictive value = 94.82% and Negative Predictive value = 16.12%

Conclusions: Most of the EPTB cases found in 26-40 years age group, majority of EPTB cases were males, In males most of cases diagnosed pleural TB, Association of Pleural TB cases with age was statistically significant at p<.05. Sensitivity and specificity of Gene X-pert and Fluorescent Sensitivity=89.43%, Specificity= 70.58%, Positive Predictive value = 94.82% and Negative Predictive value = 16.12%

ROLE OF RENAL ANGINA INDEX IN PREDICTING THE SEVERITY AND OUTCOME OF ACUTE KIDNEY INJURY IN NEONATES

Mon, 25 Aug 2025 00:00:00 +0300

Introduction: The diagnosis of AKI is a problem, as diagnosis depends on two functionaldefects; increase in serum creatinine and decrease in urine output (oliguria) especially inneonates. Both are late outcomes of the injury and not predictors of the injury. Regardless ofappropriate treatment, the mortality rate may range from 25-50%, while survivors may sufferfrom problems in the long run. Recogn izing early parameters that are able to detect kidney injurybefore the rise of serum creatinine,

UTILITY OF FDG PET SCAN VIABILITY ASSESSMENT OF AKINETIC MYOCARDIAL SEGMENTS ON ECHO FOR PREDICTION OF CONTRACTILITY RECOVERY AT SIX MONTHS AFTER CORONARY ARTERY BYPASS SURGERY: A PROSPECTIVE OBSERVATIONAL STUDY

Imran Akram Khanday, Abdul Majid dar, Dr Aamir Rashid, Dr Imran Hafeez — Sat, 23 Aug 2025 00:00:00 +0300

Introduction: Heart failure (HF) is a complex clinical syndrome resulting from structural andfunctional impairment of ventricular filling or ejection of blood. Approximately half of the patients with HF have normal left ventricular function, that is, HF with preserved ejection fraction(HFpEF), the balance have HF with reduced ejection fraction (HFrEF). HFpEF generally is defined as a left ventricular ejection fraction of 50% or greater

Correlation of Serum Cholinesterase Levels with Clinical Severity and Outcomes in Paediatric Organophosphorus Poisoning

Dr. Ayush Muzalda, Dr. Ranjeet Ghasal — Tue, 09 Sep 2025 00:00:00 +0300

Background: Organophosphorus (OP) poisoning is a significant cause of morbidity and mortality in children, particularly in agricultural regions. Serum cholinesterase (ChE) activity is widely used for diagnosis, but its prognostic value in paediatric patients remains uncertain.

Methods: A retrospective analysis was conducted on paediatric patients with confirmed OP poisoning admitted to a tertiary care centre over one year. Severity was assessed based on presenting symptoms, need for mechanical ventilation, and ICU stay duration. Serum ChE levels were measured at admission and serially thereafter. Correlations between ChE levels and clinical outcomes were analysed.

Results: All patients had reduced serum ChE levels at admission (mean: XX ± SD U/L). No statistically significant correlation was found between baseline ChE levels and mortality, need for ventilatory support, or ICU stay duration (p > 0.05). Patients with extremely low ChE (<400 U/L) tended to have prolonged recovery and higher complication rates. Most survivors showed substantial improvement in ChE activity within 24–36 hours.

Conclusion: In paediatric OP poisoning, serum ChE levels confirm the diagnosis but have limited prognostic value. Clinical assessment remains essential for severity grading and management.

ABO Genotyping and Anthropology: A Study of The Population of NorthEastern Algeria

Bouzenda Khaled, Ouelaa Hanifa, Sifi Karima, Deba Tahria — Wed, 25 Jun 2025 00:00:00 +0300

With the development of molecular biology techniques, several researchers have become interestedin the study of genetic polymorphism of the ABO system. Our work consists in studying the geneticpolymorphism of the ABO system in the population of the Constantine region in northeast Algeria,and to compare it with other populations

A Comparative Study of Effect of Oral Myoinositol Plus Topical Lactic Acid versus Oral Alpha Lipoic Acid plus Topical Lactic Acid in Patients with Acanthosis Nigricans

Dr. Bulbul Yadav — Thu, 11 Sep 2025 00:00:00 +0300

Background: Acanthosis nigricans (AN) is a cutaneous marker of insulin-resistant states. Alpha-lipoic acid (ALA) and myo-inositol (MI) both improve metabolic profiles, yet comparative evidence in AN is limited.

Objective: To compare the clinical efficacy of oral MI + topical lactic acid (LA) versus oral ALA + topical LA in patients with AN.

Methods: In this hospital-based, prospective, comparative study (July 2022–December 2023), 72 consecutive AN patients were alternately allocated to MI + LA (Group A) or ALA + LA (Group B) for six months. Primary outcome was change in neck-lesion severity grade (0–4 scale). Secondary endpoints included insulin resistance (HOMA-IR) and safety. Data were analysed with χ², t-tests, and one-way ANOVA (α = 0.05).

Results: Mean age was 31.5 ± 8.2 years; 70.8 % were male. Baseline characteristics, HOMA-IR (mean 1.68), and grade distribution were comparable between groups. After 6 months, 58.3 % of all patients achieved ≥1-grade reduction; 13.9 % achieved ≥2 grades. Mean grade reduction was 1.36 ± 0.79 (ALA + LA) versus 0.89 ± 0.71 (MI + LA); between-group difference 0.47, F = 0.40, p = 0.53. No serious adverse events occurred.

Conclusion: Both regimens significantly improved AN severity, with numerically greater—but statistically non-significant—improvement in the ALA + LA arm. Either combination may be chosen according to patient preference and tolerability. Larger randomized trials are warranted.