European Journal of Cardiovascular Medicine

Background: Atopic Dermatitis (AD), commonly known as eczema, is a chronic inflammatory skin disease characterized by itching, dry skin, and recurrent flare-ups. It affects both children and adults and can significantly reduce quality of life. Beyond genetic and environmental factors, socioeconomic status (SES)—including income, education, occupation, and living conditions—plays a major role in the prevalence, severity, and management of AD. Atopic dermatitis (AD) is a chronic inflammatory skin condition that significantly affects the quality of life, particularly in its moderate-to-severe forms. Objective: This study aims to investigate the impact of socioeconomic factors on treatment atopic dermatitis at a tertiary care hospital. Methods: A cross-sectional study was conducted involving 120 patients diagnosed with moderate-to-severe AD. Data were collected through patient interviews, medical records, and self-reported questionnaires. Socioeconomic factors (income, education level, and psychological status) and treatment adherence patterns were analyzed. Results: The study found that 50% of patients were non-adherent to their treatment regimen. Non-adherence was significantly associated with lower socioeconomic status, lower education levels, and the presence of psychological distress, such as anxiety and depression. Financial constraints were the most common reason for non-adherence, cited by 50% of non-adherent patients. Patients with lower education levels and those from low-income backgrounds were more likely to be non-adherent. Conclusion: Socioeconomic factors, including income, education, and mental health, significantly influence treatment adherence in patients with moderate-to-severe atopic dermatitis. Addressing these barriers through targeted interventions, such as financial assistance, health education, and psychological support, may improve adherence and clinical outcomes.

Background: Hypertension is increasingly prevalent in India’s urban population due to the convergence of lifestyle and metabolic transitions. Understanding the clustering of multiple behavioural and metabolic risk factors provides a framework for comprehensive prevention strategies. Objectives: To determine the prevalence and clustering patterns of behavioural and metabolic risk factors and evaluate their combined effect on hypertension among urban adults. Methods: A community-based cross-sectional study was conducted among 340 adults (≥18 years) residing in the urban field-practice area of SVS Medical College, Mahabubnagar (June–December 2020). Data on behavioural (tobacco, alcohol, diet, physical inactivity, salt intake) and metabolic (overweight, central obesity, dysglycaemia, dyslipidaemia) risk factors were collected using WHO STEPwise protocols. Hypertension was defined as SBP ≥140 mmHg and/or DBP ≥90 mmHg or current antihypertensive use. Risk-factor clustering was analysed by frequency distribution, and predictors of hypertension were identified using multivariable logistic regression. Results: Mean (SD) age was 41.3 (±12.7) years; 52.4 % were men. Low fruit/vegetable intake (57.9 %), high salt intake (43.8 %) and physical inactivity (37.4 %) were the commonest behavioural risks. Overweight/obesity (40.3 %) and central obesity (37.9 %) were the leading metabolic abnormalities. Hypertension prevalence was 61.2 %. Nearly 90 % had ≥ 1 behavioural or metabolic risk, and 22.6 % had ≥ 4 total risks. In multivariable analysis, age (aOR 1.42 per 10 years; 95 % CI 1.17–1.72; p < 0.001) and total cluster ≥ 4 (aOR 2.29; 95 % CI 1.19–4.39; p = 0.012) were independent predictors of hypertension. Conclusions: Behavioural and metabolic risk-factor clustering is highly prevalent in urban adults, and individuals with four or more concurrent risks have more than double the odds of hypertension. Integrated, multi-component interventions addressing both behavioural and metabolic domains are crucial for effective urban hypertension prevention.

Background: Hypertension is a major risk factor for cardiovascular morbidity and mortality, yet control rates remain suboptimal in low- and middle-income countries. Primary care settings offer an opportunity to improve outcomes through structured, evidence-based interventions. Objective: To evaluate the effectiveness of a multifaceted intervention program in improving hypertension control rates in a primary care clinic. Methods: A quasi-experimental pre–post study was conducted over 12 months among 320 hypertensive adults, of whom 300 completed follow-up. The intervention included physician training, patient education on lifestyle modification, medication adherence support, simplified treatment protocols, and structured follow-up. Blood pressure (BP) was measured monthly, and adherence assessed using the Morisky Medication Adherence Scale (MMAS-8). Results: At baseline, 38.7% of participants had controlled BP (<140/90 mmHg). Following intervention, control rates increased significantly to 67.3% at 9 months (p<0.001). Mean systolic BP decreased from 152.4 ± 12.3 to 135.6 ± 10.1 mmHg, and diastolic BP from 94.1 ± 8.4 to 83.2 ± 7.6 mmHg. High adherence improved from 46% to 78%. Patients with ≥80% follow-up attendance achieved higher control rates (74.8%) than poor attenders (47.9%). Conclusion: Structured, low-cost interventions significantly improved hypertension control in a primary care setting. Scaling such models may reduce the cardiovascular burden in resource-limited health systems.

Background: Antipsychotic medications are essential in managing schizophrenia but are frequently associated with metabolic side effects. These adverse effects increase the risk of cardiovascular disease, diabetes, and mortality in affected patients. Objective: To evaluate the prevalence and progression of metabolic side effects in schizophrenia patients undergoing antipsychotic treatment over a six-month period. Methods:A retrospective observational study was conducted on 100 schizophrenia patients receiving antipsychotic therapy at a tertiary care hospital. Demographic details, medication history, and metabolic parameters were collected from patient records at baseline and after 6 months of treatment. Parameters assessed included body mass index (BMI), fasting blood glucose, lipid profile, and blood pressure. The presence of metabolic syndrome was determined using NCEP-ATP III criteria. Statistical significance was assessed using paired comparisons and chi-square tests. Results: Among 100 patients (mean age: 36.2 ± 9.4 years; 57 males, 43 females), 74% were on atypical antipsychotics. Olanzapine (32%) and Risperidone (24%) were the most frequently prescribed. Significant increases were observed in weight gain (14% to 38%), BMI >25 (22% to 49%), fasting glucose >100 mg/dL (18% to 41%), and triglycerides >150 mg/dL (27% to 46%) (p < 0.01). Atypical antipsychotics were associated with a higher incidence of metabolic abnormalities. The prevalence of metabolic syndrome rose from 8% to 28% over the treatment period (p < 0.001). Conclusion: Antipsychotic therapy, particularly with atypical agents, is strongly associated with metabolic side effects in schizophrenia patients. Routine monitoring and early intervention are essential to mitigate long-term health risks.

Background: Generalized Anxiety Disorder (GAD) is a prevalent and debilitating psychiatric condition. Selective Serotonin Reuptake Inhibitors (SSRIs) are commonly prescribed as first-line pharmacological treatments. This retrospective study evaluates the efficacy and tolerability of SSRIs in managing GAD. Objective: To assess the clinical outcomes and adverse effect profile of SSRIs in patients with GAD over a 12-week treatment period. Methods: This retrospective analysis included 100 adult patients diagnosed with GAD who were prescribed SSRIs and followed for 12 weeks. Data were extracted from electronic medical records over a one-year period. Efficacy was assessed using changes in Hamilton Anxiety Rating Scale (HAM-A) scores at baseline, week 6, and week 12. Tolerability was evaluated based on reported adverse events and treatment discontinuation rates. Results: The mean baseline HAM-A score was 25.4 ± 4.2, which significantly decreased to 11.8 ± 3.5 at week 12 (p < 0.001), representing a 53.5% reduction. Clinical response (≥50% reduction in HAM-A) was achieved in 68% of patients, and 34% reached remission (HAM-A ≤7). Escitalopram was the most prescribed SSRI and showed the highest efficacy. Adverse effects included nausea (20%), insomnia (14%), and sexual dysfunction (12%). Seven patients (7%) discontinued treatment due to side effects. No serious adverse events were reported. Conclusion: SSRIs demonstrated substantial efficacy and acceptable tolerability in the management of GAD. Escitalopram appeared to be the most effective among the SSRIs used. These findings support the continued use of SSRIs as a primary pharmacological treatment for GAD.

Background: Tympanoplasty is the primary surgical intervention for chronic tympanic membrane (TM) perforations. Traditional postauricular approaches, although effective, are associated with prolonged surgical time, increased bleeding, and potential scarring. Endoscopic transcanal cartilage myringoplasty is emerging as a minimally invasive alternative, potentially offering superior outcomes with reduced complications. Method: This prospective, interventional study evaluated the effectiveness of percutaneous endoscopic transcanal cartilage myringoplasty compared to the traditional microscopic postauricular approach in 40 patients with unilateral dry subtotal tympanic membrane perforation (STMP). Patients were divided into two groups: Group A (n=20) underwent transcanal underlay grafting, while Group B (n=20) received microscopic postauricular grafting. Both groups utilized autologous thin (0.2 mm) cartilage covered with temporalis muscle fascia. Primary outcomes included graft success rate and tympanic membrane closure at six months, with secondary outcomes assessing audiological improvements using pure-tone audiometry (PTA) and complication rates. Results: Group A demonstrated a 100% graft success rate compared to 90% in Group B. The average surgical time was significantly shorter in Group A (40 ± 5.50 minutes) versus Group B (55 ± 10.50 minutes, p < 0.0001). Audiological outcomes revealed better air-bone gap (ABG) closure in Group A, with 85% achieving ABG closure ≤ 10 dB compared to 70% in Group B (p < 0.05). Complications, including postoperative infections, were observed only in Group B. Conclusion: Percutaneous endoscopic transcanal cartilage myringoplasty is an effective, minimally invasive technique for repairing subtotal tympanic membrane perforations, offering superior graft success rates, enhanced audiological outcomes, shorter surgical time, and reduced complications compared to the traditional postauricular approach. The enhanced visualization and precision provided by the endoscopic technique support its broader adoption in clinical practice for tympanic membrane perforation repair.

Introduction Nail involvement is an often-overlooked clinical symptom of Psoriasis. It causes psychologic stress, pain, impairment of manual dexterity and a significant negative impact on a patient’s quality of life.  Objective: The present study was conducted to study the prevalence of nail changes in psoriasis patients, assessment of the severity of nail involvement using NAPSI score and to correlate the relationship between NAPSI and BSA in those patients Materials and Methods This observational, cross-sectional study was conducted in the Department of Dermatology Venereology and Leprosy, Guntur Medical College over a period of 6 months. A total of 90 patients of psoriasis with nail changes were recruited in this hospital. Cutaneous severity was assessed using psoriasis area severity index (PASI). NAPSI was used to determine the severity of nail involvement. Nails of the patients with psoriasis were examined clinically and onychoscopically.  Results The total number of patients included in the study was 90. Of these, the male-to-female ratio was 1.3:1. The maximum number of patients were in the age group of 31–45 years (28.0%). Psoriasis (50 cases) was the most common papulosquamous disorder followed by lichen planus (20 cases). Among the papulosquamous disorders, nail changes were present in 59 (65.5%) patients. Out of the 59 patients with nail changes, 69.9% were male, and 30.1% were female. Pitting was overall the most common finding in both clinical and dermoscopic examinations. In 9 (10%) cases, a biopsy was done to confirm the diagnosis. Conclusions Dermoscopy allows for better visualization of nail findings. Evaluating NAPSI and mNAPSI scores in conjunction with dNAPSI and dmNAPSI increases their helps detect early psoriasis, detection of worsening moderate-to-severe psoriasis (PASI >10) and predict joint involvement and their severity

Introduction: Seizures are one of the most common medical problems affecting children, and epilepsy is the most common chronic neurological condition in children. Materials and Methods: This was a hospital based retrospective study carried out in the data retrieved from the records maintained in the Department of Pediatrics, Tertiary Care Teaching Hospital over a period of 1 year. Variables collected were demographics, clinical presentations, laboratory tests, brain imaging studies, electroencephalography, diagnosis and hospital course. Results: The male–female ratio was 0.8. Mean age was 5.4. The most common causes of seizures were acute symptomatic. Most frequent coexistent diagnosis was infectious diseases, and 53.3% had recurrent seizures. Medications were administered to 51.1% of the patients before admission. Seizures were focal in 21 (46.7%), generalized in 11 (24.4%) and 13 (28.9%) had status epilepticus. Intravenous midazolam was first-line therapy in 48.9%. Acute symptomatic seizures were usually new-onset, and duration was shorter. Epileptic seizures tended to be recurrent and were likely to progress to status epilepticus. However, type of seizures did not change severity of the disease. Also, laboratory test results, medications administered before admission, requirement and duration of ventilation, mortality and length of stay were not significant between epileptic/acute symptomatic patients. Conclusion: Seizures in critically ill children, which may evolve into status epilepticus, is an important condition that requires attention regardless of cause. Intensified educational programs for PICU physicians and international guidelines are necessary for a more efficient approach to children with seizures

Background: Melasma is a commonly acquired circumscribed hyperpigmentary disorder mainly involving sun-exposed areas, especially the face with a predilection for the cheeks, forehead, upper lip, nose, and chin manifests as symmetrical, hyperpigmented macules with irregular, serrated, geographic spreading borders

Introduction: Infertility is a public health problem associated with medical, emotional, social, and financial consequences. Recent study on infertility suggests that in India, approxi- mately 15 to 20% of married couples in the reproductive age group suffer from infertility and its incidence is on the rise. Artificial reproductive techniques (ARTs) including IVF/ICSI and ET have been a major development in the treatment of infertility. Objective: To compare reproductive outcomes of day 2 and day 3 embryo transfer (ET). Materials and methods: In this retrospective records study, all couples who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) and ET cycles at International Fertility Center, Delhi, India over a period of 1 year were studied. Data were collected and analyzed by chi-square test and unpaired t-test by Statistical Package for the Social Sciences, version 19. Results: There was no statistically significant difference between the clinical and demographic parameters of group day 3 and day 2 ET. In our study, clinical pregnancy rate was 45% in day 3 ET and 36.5% in day 2 ET group [odds ratio (OR) 1.43, p-value 0.49]. The ongoing pregnancy rate was 39.2% in day 3 ET and 26.9% in day 2 ET group (OR 1.75, p-value 0.26). We observed that the miscarriage rate was 5.9% in day 3 ET and was 5.8% in day 2 ET group (p-value 0.69, OR 1.02). We observed one case each of multiple pregnancies, ectopic pregnancy, and fetal anomaly (anencephaly) in day 2 ET group, while in day 3 ET group, no such case was detected. Conclusion: There are chances that day 3 ET has better clinical and ongoing pregnancy rates than day 2 ET, but the difference is not statistically significant. Study showed similar miscarriage rates in both groups and very low incidence of complications like multiple pregnancy, ectopic pregnancy, and fetal anomaly. So, it is safe to schedule and transfer embryos either on day 2 or on day 3 for planning and programming cycles in coordination with patient and IVF team and for adjusting weekends (nonworking days).

Rapid transmission of corona virus throughout the globe has put many more on risk of contracting this virus so prevention & prophylaxis became an important part of this pandemic so the role of Hydroxychloroquine is being discussed here.The CDC On March 24th , both Hydroxychloroquine have in vitro activity against SARS-CoV-2, and other coronaviruses, with HCQ having higher potency against SARS- CoV-2. The drug also raised the risk of heart problems. But based on the available evidence, it has been opined that HCQ is relatively safe, when certain contraindications are avoided, and has some beneficial effect as a prophylactic option.

Computed tomography is one of the most sensitive imaging techniques for the segmentation of lung cancer. Since lung cancer has the high mortality rate among all the cancers so it becomes so important to detect and diagnose the cancer at beginning stage itself. Segmentation is an important step in medical image analysis and classification for radiological evaluation or computer aided diagnosis. The CAD (Computer Aided Diagnosis) of lung CT generally first segment the area of interest (lung) and then analyse the separately obtained area for nodule detection in order to diagnosis the disease. In this work, implemented a semantic segmentation method using region based convolutional neural network in order to segment the lung nodule part separately from the lung which will enhance the chances of detection of lung cancer and will optimize the extraction of candidate nodules. R-CNN is developed to be used to segment lung regions. The network consists of total 4 convolution layers and 2 max pooling layers. This network has provided an accuracy of 98.28%.

Acute abdominal pain in children represent a diagnostic dilemma, generally although many causes of acute abdomen are benign, other require rapid diagnosis and treatment to minimize morbidity. Numerous disorders can cause abdominal pain. The most common surgical cause is acute appendicitis. This study tries to evaluates the distribution of cases through the age and the fate of the management and complications that may occur during the course of the disease. This is a prospective study over a period of six months starting from March 15th to September 15th 2018. A total of 82 child were included in this study who are presented to our hospital complaining of acute appendicitis. The patients divided in to three groups according to their age, undergo careful clinical evaluation supplemented by laboratory and radiological investigations followed by surgical intervention and histopathological study. Eighty – two child suffering from acute appendicitis were included in this study, 44 male and 38 female , those 82 case undergone surgical line of appendectomy, no line of conservative treatment was applied and no any case of appendicular mass was included in this study, seven cases from those patients were presented with generalized peritonitis due to perforated appendices. From estimation of the cases we found that acute appendicitis in pediatrics age groups. during comparing the examination of child with adult patient has revealed that any child with abdominal pain should be carefully examined and the examination may be repeated more than one time to cover the area of examination in order to enhance good management through perfect diagnosis because the examination is more difficult than in older patients and need skills of communication between the surgeon and the child.

Background: A home-based intervention is a promising approach for early intervention about HAV that aims at improving mothers-child outcomes. The aim of this study was to examine the effect of home based intervention on improving mothers' perception about Hepatitis A virus. Methods: Design: A quasi-experimental (pre-post) design was utilized. Subjects: A multi stage random sample of 360 mothers through home visits in Shranees village, Quesna district at Menoufia Governorate, Egypt. Instruments: 1) Hepatitis A virus Interview Questionnaire to assess socio- demographic data and mother's perception of hepatitis A virus which included mothers' knowledge about hepatitis A virus and mothers' practices about HAV and 2) Observational checklist to assess home environment and to assess home feeding environment. Results: It was revealed that there was improvement in total knowledge post intervention than pre intervention (14.60±5.53, 10.13±5.50) respectively and there was a change in knowledge in the study group than control group at post intervention (4.48±5.16, 0.17±0.96) respectively. There was improvement in total practice post intervention than pre intervention (3.94±1.17, 2.98 ±1.90) respectively and there was a change in practice in the study group than control group at post intervention (0.97±1.34, 0.13±2.37) respectively. Conclusion: the present study revealed that application of home based intervention proved to be effective in raising the women's perception regarding Hepatitis A. Hence, it can lead to improving knowledge and practice. Recommendations: health educational programs should be launched to nursery workers, school workers and women in rural areas about infectious diseases. Also, it was recommended vaccination against hepatitis A for children at the preschool and school period.