European Journal of Cardiovascular Medicine

Background: Tuberculosis (TB) remains a significant global health problem with potential cardiovascular involvement in approximately 2% of cases. This study aimed to evaluate the cardiovascular manifestations in pulmonary TB patients without pre-existing cardiac disease and assess changes following anti-tubercular therapy. Methods: This prospective descriptive study included 72 newly diagnosed sputum-positive pulmonary TB patients aged ≥18 years. Participants underwent comprehensive clinical examination, laboratory testing, electrocardiography, and echocardiography at baseline, during the post-intensive phase, and after completion of anti-tubercular therapy. Patients with pre-existing cardiovascular conditions, other pulmonary diseases, or extra-pulmonary TB were excluded. Results: The study population had a mean age of 43.64±15.00 years with male predominance (61.1%). Electrocardiographic abnormalities were observed in 59% of patients, with sinus tachycardia (50%), ST segment elevations (5.6%), and T wave inversions (9.7%) as common findings. Echocardiographic abnormalities were present in 23.6% of patients, including pulmonary hypertension (13.9%), right ventricular hypertrophy/dilation (11.1%), left ventricular systolic dysfunction (9.8%), and pericardial effusion (5.6%). Following anti-tubercular therapy, significant improvements were observed in tachycardia (reduced to 13.9%, p=0.000), ST segment elevations (complete resolution, p=0.045), and left ventricular systolic dysfunction (reduced to 5.6%, p=0.028), with complete resolution of pericardial effusion.Conclusion: Pulmonary tuberculosis can induce various cardiovascular abnormalities detectable through electrocardiography and echocardiography, even in patients without pre-existing cardiac disease. Most of these abnormalities improve significantly with anti-tubercular therapy, highlighting the importance of cardiac evaluation in TB patients and the role of effective treatment in reversing TB-associated cardiac manifestations.

Introduction: Artificial intelligence (AI) has increased application in the field of medicine in the recent days. The use of AI in other fields like finance, diagnosis and treatment is gaining importance. It is applied along with many other branches of medicine like pathology and radiology in giving better care to the patients. This study was done to assess knowledge on AI among medical undergraduate students who have increased access to the technology these days and to assess the use of this in various aspects in their education and providing care to the patients. Materials and methods: In a tertiary care teaching hospital, a cross-sectional study was conducted in undergraduate medical students, to assess their knowledge and use of AI in the medical field using a self-designed, semi-structured questionnaire. Results were expressed in frequencies or percentages. Results: In this study, 158 (63.2%) of the students have knowledge on the use of AI in medical field and among them many use Chat GPT as the source. The knowledge on the other modalities of AI was 31.6% among these students. AI was used mainly for studying followed by assignments and research work. Conclusion: This study shows that there was wide variation in the knowledge and practice of AI in medical field among the study participants. Medical students in this study use AI mainly for studying and their assignments rather than on increasing their knowledge on patient care.

Background: Postoperative acute kidney injury (AKI) remains a significant complication in high-risk surgical patients, contributing to increased morbidity, prolonged hospital stays, and higher mortality rates. Fluid management during the perioperative period plays a critical role in maintaining renal perfusion and preventing ischemic kidney injury. Goal-Directed Fluid Therapy (GDFT), an individualized approach using hemodynamic monitoring to optimize fluid administration, has been proposed as a strategy to improve renal perfusion and organ function in surgical patients. However, its impact on postoperative renal function, particularly in high-risk populations, remains a subject of ongoing investigation. This study aims to evaluate the effectiveness of perioperative GDFT in preserving renal function and reducing the incidence of postoperative AKI in high-risk surgical patients. Objective: To assess the impact of perioperative Goal-Directed Fluid Therapy (GDFT) on postoperative renal function, determine its role in reducing AKI incidence, and compare it with standard fluid management protocols in high-risk surgical patients. Methods: This prospective observational study was conducted over six months in the surgical and critical care units of a tertiary care hospital, enrolling 50 high-risk surgical patients undergoing major non-cardiac surgery. Patients were divided into two groups based on intraoperative fluid management strategy: •GDFT Group: Patients managed using non-invasive hemodynamic monitoring (stroke volume variation, cardiac output, dynamic fluid responsiveness) to guide fluid administration. •Standard Fluid Therapy (SFT) Group: Patients managed using a fixed, weight-based fluid administration approach. Preoperative renal function was assessed using serum creatinine, estimated glomerular filtration rate (eGFR), and urine output. Postoperative renal function was evaluated using Acute Kidney Injury Network (AKIN) criteria, comparing serum creatinine changes, urine output, and AKI incidence between the two groups at 24 hours and 72 hours postoperatively. Secondary outcomes included length of hospital stay, need for renal replacement therapy (RRT), and overall morbidity and mortality rates. Results: The incidence of postoperative AKI was significantly lower in the GDFT group (12%) compared to the SFT group (32%) (p < 0.05). Patients in the GDFT group maintained better renal function, as indicated by lower serum creatinine elevation (mean increase of 0.2 ± 0.1 mg/dL vs. 0.5 ± 0.2 mg/dL in SFT, p < 0.05) and higher urine output (mean 1.2 ± 0.4 mL/kg/hr vs. 0.7 ± 0.3 mL/kg/hr, p < 0.05). The requirement for renal replacement therapy (RRT) was lower in the GDFT group (4%) compared to the SFT group (12%), although this difference was not statistically significant. Additionally, the length of ICU stay, and total hospital stay were significantly shorter in the GDFT group, suggesting an overall improved recovery trajectory. Conclusion: The findings of this study suggest that perioperative Goal-Directed Fluid Therapy (GDFT) is associated with improved renal function, reduced incidence of postoperative AKI, and shorter hospital stays in high-risk surgical patients. The use of dynamic hemodynamic monitoring for individualized fluid administration appears to be superior to standard fixed-volume resuscitation strategies, potentially leading to better renal perfusion and organ protection. These results support the implementation of GDFT protocols in high-risk surgical populations to improve postoperative outcomes. Further multi-center trials with larger patient cohorts are needed to establish standardized GDFT guidelines for optimizing perioperative renal protection strategies.

Background: Neonatal sepsis remains a significant cause of morbidity and mortality in neonates, particularly in developing countries. Despite advances in neonatal care, the burden of neonatal sepsis persists, necessitating novel preventive strategies. Probiotics have emerged as a potential intervention to enhance neonatal gut health and immunity, thereby reducing the incidence of sepsis. Objective: This study aims to evaluate the efficacy of probiotic supplementation in preventing neonatal sepsis among preterm and low-birth-weight neonates admitted to a tertiary care centre. Methods: A prospective, randomized controlled trial was conducted over six months at a tertiary care center. A total of 500 neonates were enrolled, with 250 assigned to the probiotic group and 250 to the control group. Neonates in the probiotic group received Lactobacillus rhamnosus GG (LGG) and Bifidobacterium breve orally once daily for 28 days. The primary outcome was the incidence of neonatal sepsis, diagnosed based on clinical signs, blood cultures, and inflammatory markers (CRP >10 mg/L, Procalcitonin >2 ng/mL). Secondary outcomes included hospital stay duration, mortality rate, and adverse effects. Results: Neonates receiving probiotics demonstrated a 54.5% relative risk reduction in neonatal sepsis compared to the control group (p < 0.001). Inflammatory markers were significantly lower in the probiotic group (CRP: 8.6 ± 3.2 vs. 15.4 ± 4.1 mg/L, p < 0.001; Procalcitonin: 1.8 ± 0.7 vs. 3.2 ± 1.2 ng/mL, p < 0.001). The probiotic group also had a significantly shorter hospital stay (15.2 ± 3.1 vs. 20.5 ± 4.2 days, p < 0.001). Mortality was lower in the probiotic group (4% vs. 9%, p = 0.03), with a sepsis-related mortality reduction of 55.6%. Probiotics were well-tolerated, with no cases of probiotic-associated infections or severe adverse effects. Mild feeding intolerance occurred in 6% of probiotic neonates vs. 4% in controls (p = 0.32, not significant). Conclusion:  Probiotic supplementation significantly reduces the incidence of neonatal sepsis, lowers inflammatory markers, shortens hospital stay, and improves survival outcomes. Given these findings, probiotics should be considered as apreventive strategy in high-risk neonates. However, further multicentre trials are warranted to confirm these results and establish standardized probiotic protocols in neonatal intensive care.

Introduction: Neonatal sepsis is one of the major causes of morbidity and mortality in the newborn, more so in the developing countries. The incidence of neonatal sepsis has been reported to be 30/1000 live births according to National Neonatal Perinatal Database. Certain neonatal characteristics are predictive of Early Onset Neonatal Sepsis (EOS). The objectives of this study were to perform haematological tests for detection of neonatal sepsis and to evaluate the validity of single and combined haematological parameters in case of proven septicaemia. Methods: 95 neonates admitted to NICU with signs suggestive of sepsis or who developed signs of sepsis while in the ward, were included in the present study. The neonatal sepsis screen included Total Leukocyte Count (TLC), raised micro- ESR, CRP. I/T Ratio>0.2, remained significant markers for early diagnosis of culture positive EOS(P<0.5) .  Results: Out of 95 newborns presenting with EOS, 46(48.4%) had positive blood culture. EOS was seen predominantly in preterm, males, LBW neonates. Among the various neonatal haematological parameters raised Micro–ESR, I/T Ratio >0.2 significant markers for early diagnosis of culture positive EOS (p<0.5). Conclusion: It is critical to diagnose sepsis early on and to rule out sepsis to avoid unnecessary antibiotic use. In predicting early onset newborn sepsis, a high index of suspicion combined with simple, cost-effective haematological screening measures is a sensitive and satisfactory approach.

Background: Transfusion of blood and its products is one of the important pillars in the treatment of patient in Emergency Department. Methods: The study is Cross Sectional study over a period of 12 months from March 2021 to February 2022. A total of 348 cases were assessed from Emergency Department (Casualty) of SAIMS Hospital, Indore. Results: Out of 348 cases,most common indication for transfusion was massive blood loss due to roadside accident in 167(47.98%) patients, followed by heart disease patient on antiplatelet medication in 128(36.78%) patients followed by Hemato-oncological disease patients 31(8.9%) and then patients with chronic anemia 22 (6.33%).180(51.72%)patients received RCC transfusion, 105(30.17%)patients received platelet transfusion and 63(18.10%)patients received FFP transfusion. The most common indication for RCC transfusion was Anaemia due to massive blood loss, for PC transfusion was Thrombocytopenia due to Heart failure and DIC and for FFP is Hypoproteinemia. Transfusion was done in patients with Hb <7g/dl even if they had no co-morbidities. Patients with co-morbidities transfused at Hb between 7-10g/dl. 267(76.72%) patients had a pre-transfusion Hb of 5-7g/dl, 73(20.97%) patients had pre-transfusion Hb of 8-10 g/dl and 8(2.29%) patients had a Hb of 11-12 g/dl. Most of the patients Post Transfusion Hb were around 11-12 g/dl. When patients pre-transfusion Hb was 5-7 g/dl, 3-4 units of RCC transfused and when it was 8 -10 g/dl,2-3 units of RCC transfused. Conclusion: For better utilisation and to reduce wastage of blood and blood products, a protocol has to be formulated.

Background: To assess the neuroprotective efficacy of therapeutic hypothermia in infants with moderate to severe hypoxic-ischemic encephalopathy (HIE) utilizing phase-changing material as a cost-effective equipment. Method: Retrospective cohort study conducted in 21 infants aged up to 2 years who underwent therapeutic hypothermia employing phase-changing materials with distinct melting points (29°C and 21°C) during the neonatal period. The 24-month Age and Stage Questionnaire was employed to evaluate neurodevelopmental outcomes. Results: Among the 21 infants, 90% developed seizures, and all exhibited HIE (85% as HIE II, 15% as HIE III). The short-term outcome was survival or non-survival at the conclusion of the hospital stay. 81% of neonates survived. The long-term outcome was normal or abnormal development at the age of 2 years. 81% of infants demonstrated normal development, as determined by the 24-month ASQ score. Conclusion: Phase-changing material can be effectively utilized as a method for providing therapeutic hypothermia in resource-constrained settings and can enhance long-term neurological outcomes.

Background: Family accommodation in obsessive-compulsive disorder (OCD) is a prevalent yet under-researched phenomenon that significantly impacts the quality of life (QoL) of caregivers. This study investigates the relationship between family accommodation and QoL in caregivers of adult OCD patients. Methods: A cross-sectional analysis was conducted among 150 caregivers of OCD patients recruited from tertiary psychiatric center. Validated instruments, including the Family Accommodation Scale (FAS) and the World Health Organization Quality of Life-Brief (WHOQOL-BREF), were employed. Data analysis employed descriptive and inferential statistics. Results: Caregivers with higher levels of family accommodation exhibited significantly lower QoL scores, particularly in the psychological (p < 0.01) and social domains (p < 0.05). Key predictors of family accommodation included patient symptom severity (Y-BOCS scores) and caregiver burden. A strong inverse correlation was observed between FAS scores and WHOQOL-BREF scores (r = -0.72, p < 0.01). Conclusion: Interventions aimed at reducing family accommodation have the potential to enhance caregivers’ QoL. Psychoeducational programs tailored specifically for caregivers are essential for comprehensively addressing this issue.

Background: Epilepsy is associated with significant psychiatric and cognitive comorbidities. This cross-sectional study evaluates the prevalence of cognitive impairment (CI) and psychiatric disorders in 100 individuals with epilepsy (PWE) attending a tertiary neurology clinic in India. Methods: Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and Addenbrooke’s Cognitive Examination-III (ACE-III). Psychiatric morbidity was evaluated using the Mini-International Neuropsychiatric Interview (MINI). Results: CI was identified in 66% (MoCA <26) and 90% (ACE-III <83) of participants. Psychiatric comorbidities were present in 17%, with major depressive disorder (64.7%) and social anxiety disorder (35.3%) being most prevalent. CI correlated with lower education (p<0.001), unemployment (p=0.001), polytherapy (p=0.03), and longer epilepsy duration (p<0.001). No significant association was found between CI and psychiatric morbidity (p=0.12). Conclusion: High rates of CI and psychiatric disorders highlight the need for routine screening and multidisciplinary care in epilepsy management.

Background: This cross-sectional investigation examined parenting approaches and coping mechanisms among caregivers of children with Attention-Deficit/Hyperactivity Disorder (ADHD) in Hyderabad, India, focusing on socioeconomic and clinical correlates. Methods: Participants included 100 caregivers (60 mothers, 40 fathers) of children aged 6–14 years diagnosed with ADHD per DSM-5 criteria. Validated instruments—Vanderbilt ADHD Diagnostic Parent Rating Scale (VADPRS), Parenting Style Questionnaire, and Brief COPE Inventory—were administered. Data were analyzed using Pearson correlations and multivariate regression models.  Results: Authoritarian parenting predominated (70%), followed by permissive (20%) and authoritative styles (10%). Emotion-focused coping (e.g., self-blame) was prevalent (65%), while problem-focused strategies were underutilized (15%). Socioeconomic status positively correlated with adaptive parenting (r = 0.209, p = 0.039), and treatment adherence predicted authoritative approaches (r = 0.455, p < 0.001). Older caregivers favored adaptive coping (r = 0.258, p = 0.010), whereas familial psychiatric histories were linked to maladaptive patterns (r = -0.405, p = 0.016).  Conclusion: Findings underscore the need for culturally tailored interventions to promote authoritative parenting and problem-focused coping, particularly in low-resource settings.

Background: Antenatal depression (AD) significantly affects maternal and fetal health. Despite its profound impact, AD remains underdiagnosed in many resource-limited settings, including India. This study aimed to assess the prevalence of antenatal depression and its associated risk factors among pregnant women attending a tertiary care hospital in Hyderabad. Methods: A cross-sectional, hospital-based study was conducted at Gandhi Medical College & Hospital, Secunderabad, Telangana, from November 2020 to June 2022. The study included 300 pregnant women who completed the Edinburgh Postnatal Depression Scale (EPDS). A score ≥13 indicated antenatal depression. Risk factors, including sociodemographic and psychosocial determinants, were evaluated using the Hurt, Insult, Threaten, Scream (HITS) tool and the Presumptive Stressful Life Events Scale (PSLES). Results: The prevalence of antenatal depression was 13.3% among the 300 participants. Significant risk factors included intimate partner violence (HITS score >10, p < 0.001) and experiencing stressful life events as measured by PSLES (p = 0.047). Sociodemographic variables, including age, education, socioeconomic status, type of family, and obstetric factors, were not statistically significant. Conclusion: Antenatal depression is prevalent among pregnant women in Hyderabad, with intimate partner violence and stressful life events being significant predictors. Routine screening and timely psychosocial interventions during antenatal care are vital to ensure better maternal and fetal outcomes.

Background: Infective endocarditis (IE) is a multifaceted disease characterized by cardiac involvement and a spectrum of systemic complications affecting multiple organs. With an annual incidence reaching up to 10 cases per 100,000 individuals in the general population, IE remains a formidable clinical challenge. Despite advancements in diagnosis and management, the condition continues to carry a significant burden, with mortality rates soaring as high as 30% within the first 30 days. Staphylococcus aureus is the most common causative microorganism. The prognosis of this disease depends on prompt and accurate diagnosis that leads to an aggressive therapeutic management combining antibiotic therapy and early cardiac surgery when indicated. Diagnosis of IE is usually based on modified Duke criteria. There are multiple modalities to assess infective endocarditis with trans-thoracic echocardiography (TTE) being the first-line modality. The improved temporal and spatial resolution of electrocardiographically (ECG) synchronized cardiac CT has resulted in increasing use of CT in the setting of IE.

Background: The term aneurysm is derived from the Greek word ἀνεύρυσμα, meaning dilatation or widening [1]. An abdominal aortic aneurysm (AAA) is a widening of the abdominal aorta and is generally defined as a dilatation beyond a diameter of 3.0 cm. Due to the asymptomatic nature of most Aneurysms, diagnosis is commonly a result of screening or during routine examination with abdominal palpation. MATERIAL &METHODS:   During a routine cadaveric dissection of the abdomen in the anatomy wet lab for medical students of St, James School of Medicine, Anguilla, an abnormal finding was seen in a 77-year-oldfemale cadaver. RESULTS: The aneurysm was fusiform in shape (Fig. 1) and was found to be unruptured.  Its location was found between origin of renal arteries and the aortic bifurcation into common iliac arteries. CONCLUSION: A thorough knowledge of the anatomy and pathophysiology of aneurysms is required for successful endo-vascular grafts and good prognosis in unruptured cases.

Keywords: AAA(Abdominal aortic aneurysm), Aortic wall Thickening, Fusiform

Background: Alcohol consumption is a significant public health concern, contributing to injuries and fatalities worldwide. In medico-legal cases, assessing alcohol intoxication is crucial for forensic and clinical decision-making. Breath alcohol analyzers offer a rapid, non-invasive method for estimating blood alcohol concentration (BAC), potentially replacing traditional blood alcohol testing. This study compares the effectiveness of breath alcohol analysis with blood alcohol testing in emergency department medico-legal investigations and explores the association of alcohol levels with the severity and nature of injuries. Materials and Methods: A cross-sectional analytical study was conducted in the Emergency Department of a tertiary care hospital over two years. A total of 246 medico-legal cases were included. Breath alcohol levels were assessed using the AlcoMate Premium (Model AL 7000) breathalyzer. The study recorded socio-demographic data, injury characteristics, and alcohol levels. Statistical analysis was performed using SPSS software to determine correlations between alcohol consumption, injury severity, and other risk factors. Results: Among 246 medico-legal cases, 205 (83.3%) were males and 41 (16.7%) were females. Breath alcohol analysis was positive in 49 cases (19.92%), with a higher prevalence among males (22.0%) compared to females (9.8%). Road traffic accidents (RTA) were the most common type of injury (71.1%), followed by accidental injuries (16.3%) and burns (4.1%). Breath alcohol positivity was significantly associated with RTAs (75.5%) and assault cases (4.1%). The majority of alcohol-positive cases (73.46%) had a BAC of <0.3%, while 26.53% had levels >0.3%. Breath alcohol positivity was more frequent in the 21-30 age group (46.9%). Smokers had a significantly higher likelihood of being alcohol-positive (OR = 3.31, 95% CI: 1.73-6.31, p = 0.0003). Most alcohol-related medico-legal cases occurred between 6 PM and 6 AM (63.5%). Conclusion: Breath alcohol analysis is a rapid and effective screening tool for detecting alcohol intoxication in emergency department medico-legal cases. Its non-invasive nature and ease of use make it preferable to blood alcohol testing. The study highlights a strong association between alcohol consumption and RTAs, particularly among young males and smokers. Implementing routine breath alcohol screening in emergency settings could aid in injury prevention and medico-legal documentation.

Background: Alcohol consumption is a significant public health concern, contributing to various forms of injuries and medico-legal cases. Blood Alcohol Concentration (BAC) is commonly measured to assess the influence of alcohol on injury severity and clinical outcomes. Breath alcohol analyzers provide a non-invasive, rapid method for estimating BAC. This study aimed to assess alcohol levels using a breath alcohol analyzer in medico-legal cases reporting to the casualty of a tertiary care hospital and to evaluate its association with injury severity and socio-demographic factors. Materials and Methods: A cross-sectional analytical study was conducted in the Emergency Department of a tertiary care hospital over two years. A total of 246 medico-legal cases were analyzed, and breath alcohol levels were measured using a handheld breath alcohol analyzer (AlcoMate Premium Model AL 7000). Data on age, gender, occupation, smoking status, time of incident, nature, and severity of injuries were collected and statistically analyzed using SPSS software. Results: Among the 246 medico-legal cases, 205 (83.3%) were males, and 41 (16.7%) were females. A total of 49 (19.92%) cases tested positive for breath alcohol, with a higher proportion among males (22.0%) than females (9.8%). The majority of alcohol-positive cases (46.93%) were aged 21–30 years. The most common injury type among alcohol-positive cases was road traffic accidents (75.5%), followed by accidental injuries (10.2%). Breath alcohol positivity was significantly associated with smoking (OR = 3.31, 95% CI: 1.73–6.31, p = 0.0003). Of the alcohol-positive cases, 57.14% sustained simple injuries, while 42.8% had grievous injuries. The highest proportion of cases (63.5%) occurred between 6 PM and 6 AM. Conclusion: The study found a significant association between alcohol consumption and injury severity, particularly in road traffic accidents and assault cases. Young adults and service-class individuals were the most affected groups. Breath alcohol analysis is an effective, non-invasive tool for rapid alcohol estimation in medico-legal cases. The findings highlight the need for stricter regulations on alcohol use, especially in high-risk populations, and the integration of alcohol screening into emergency department protocols.

Background: Introduction: India's National Program for Control of Blindness, initiated in 1976, aimed to reduce blindness to 0.3% by 2020. However, approximately 4.9 million are blind and 32.9 million visually impaired, primarily due to untreated refractive errors and colour vision deficiency, significantly impacting children's education and quality of life. Regular vision screenings enable early intervention and educational adjustments tailored to affected students' needs. Objective: To determine the prevalence of visual impairment and colour blindness among primary school going children in the rural areas of Barpeta District. Materials and Methods: A descriptive, cross-sectional study was conducted among 1,324 school children aged 11 to 15 in Barpeta. Five government schools with high enrollments were selected. Students were assessed for refractive errors and colour blindness, with referrals made for those needing ocular care. Parents and school authorities were informed, and a list of affected students was provided to the District Early Intervention Centre for follow-up actions. Results: Gender distribution was observed as 52% being boys and 48% girls. Most were identified as Hindu (85%), and 76.9% came from nuclear families. Socioeconomic analysis revealed 34.4% were from lower middle class. Alarmingly, 85.2% had never undergone an eye examination, with a 2.7% prevalence of colour blindness, more common in boys. Conclusion: The study highlights the urgent need for targeted interventions to improve eye health awareness and access to examinations for school children, particularly those from lower socioeconomic backgrounds, impacting their academic performance and well-being.

Background: During our routine cadaver dissection in the dissection hall, we met with a case of lower division of sciatic nerve. Inspired by this, we checked the other limb of the cadaver. There also, we found a lower division of sciatic nerve, but at a slightly different level. This led us to the study on sciatic nerve division in previously dissected specimens.A study on variations in the division of sciatic nerve in forty specimen reveals that, while it typically splits into the tibial and common peroneal nerves at the superior angle of the popliteal fossa, which is  at the junction of the middle and lower 3rds of the thigh, significant anatomical variations can occur, including higher divisions within the pelvis or thigh, where the nerve splits before exiting the piriformis muscle, potentially causing complications during injecting local or regional anaesthesia to block the nerve; during surgical procedures; or contributing to conditions like piriformis syndrome due to nerve compressions. These variations are important to consider, for accurate diagnosis and treatment of sciatic nerve related pathologies. Many lower division cases were also found in cadavers.

Background: Thrombocytopenia in adults is a common condition frequently encountered in day care and indoor patients. Its etiology can be various conditions. Clinical manifestations can be subtle to life threatening. Hence determining the exact cause of thrombocytopenia is necessary to prevent any untoward outcome. Materials and Methods: The present study attempts to determine the various causes of thrombocytopenia in adults by collecting data from 120 patients from July 2022 to December 2022. Final diagnosis was made by complete blood count, manual platelet count by peripheral blood smear, malarial parasite antigen, Widal test, dengue serology, Coombs test, abdominal ultrasound. Result: The most common cause of thrombocytopenia in adults was found to be malaria (27.5%) followed by dengue (25%) and megaloblastic anemia (20%). The other causes were found to be leukemia (14.2%), septicemia (3.3%), chronic liver disease (2.5%), enteric fever (2.5%), aplastic anemia (1.7%), hypersplenism (1.7%), myelofibrosis (0.8%) and drug induced (0.8%). Conclusion: Our study found that malaria and dengue were the most common causes of thrombocytopenia both of which are caused due to mosquitoes. Megaloblastic anemia was the third most common cause, which is most commonly caused by due to nutritional deficiency of vitamin B12 and folate. All these causes are potentially preventable.

Background: The identification of individuals, whether living or deceased, is a fundamental aspect of forensic science, relying on unique physical attributes such as fingerprints and blood groups. Fingerprints, formed by epidermal ridges during fetal development, remain unchanged throughout life, making them a reliable tool for personal identification. Similarly, blood groups, determined by specific antigens on red blood cells, provide another stable biological marker. This study explores the relationship between primary fingerprint patterns, gender, and ABO and Rh blood groups among healthcare workers in Eastern India, aiming to enhance forensic identification methods and contribute to the development of local biometric databases. Materials and Methods: This cross-sectional observational study included 200 medical students aged 18 years and above from the Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar, India. Participants with known ABO and Rh blood groups and clear, legible fingerprints were enrolled after obtaining informed consent. Fingerprints were collected using the ink method and classified into loops, whorls, and arches, while blood groups were determined using Karl Landsteiner's conventional method. Data were analyzed using GraphPad version 8.4.3; the P-value<0.05 was taken as statistically significant. Results: The study included 200 participants (54% male, 46% female), with blood group B +ve being the most common (36%) and A -ve the least (1%). Loops were the predominant fingerprint pattern (55.8%), followed by whorls (34.65%), arches (6%), and composites (3.55%), with no significant gender differences (p=0.42). Analysis by blood groups revealed loops as the most common pattern across all ABO and Rh groups, with no statistically significant differences in distribution (p>0.05). These findings suggest a consistent prevalence of loops and whorls across genders and blood groups, highlighting their potential utility in forensic identification. Conclusion: This study finds that loops are the most common fingerprint pattern in both genders, followed by whorls, with composites being the least common in Eastern India. The distribution of primary fingerprint patterns is associated with the ABO blood group but not with gender or the Rh blood group. This relationship can enhance the accuracy of personal identification, making it possible to predict an individual's ABO blood group from their fingerprint pattern.

Background: In this study we evaluated the utility of RAPID score in Parapneumonic effusion and empyema. Both of which are most common causes of exudative pleural effusion and this score was developed by Rahman et al by using multicentre intrapleural trial 1[MIST1 and MIST2]. Most of the patients with parapneumonic effusion usually recovers but mortality rate still around 10% along with long hospital stay, surgical interventions requirement, morbidity (3‑month follow up) despite of advances in treatment specially in empyema cases. For this reason, this study was done as there is no such study have done by anyone in our knowledge specially in India. After calculating RAPID score in pleural infection then patients were stratified in the different risk categories and association was compared with these risk categories with different variables. Methods: This is a prospective study at tertiary in which clinical utility of RAPID score in pleural infection in INDIAN population where tuberculosis infection is predominant. Baseline RAPID score was calculated on admission and stratified into risk category according to RAPID score. Primary outcome both mortality and morbidity, secondary outcome need of surgical interventions, length of hospital at 3‑months in different risk category. Results: Overall, 120 patients were included in this study. Mortality was 7 (5.83%) in our study. Total 17 (14.17%) patients needed surgery and length of hospital study was compared in all three categories of RAPID score. Total 26 (21.67%) patients had <7 days and 94 (78.33%) >7 days hospital stays. Most common organism isolate was mycobacterium tuberculosis. RAPID score was compared in Tubercular And non‑tubercular organisms. Conclusion: Prognostic utility of RAPID score is well established especially in non‑tubercular organisms. Here, in our study management utility of RAPID score also found useful. It performs good some aspects in tubercular aetiology.

Background: COPD (Chronic Obstructive Pulmonary Disease) is a chronic inflammatory illness. Air trapping and gradual airflow limitation are two consequences of these pathological alterations that can directly result in dyspnoea and other hallmark symptoms, as well as a decline in health. The CAT is a useful tool for assessing a patient's health and the severity of their COPD symptoms. CAT is a patient-completed questionnaire; certain issues including subjectivity and unilaterally are unavoidable during the assessment. We aim to study the relationship between COPD Assessment Test (CAT) score and severity of Airflow obstruction in stable COPD patients and to determine whether higher CAT score correlates with the frequency of COPD exacerbation. Method: Hospital based cross-sectional observational study conducted among 131 patients, age range between 43 to 90 years, in all stable COPD patients. Assessment was done by CAT (COPD assessment test) score and severity of airflow obstruction by spirometry in the Department of Respiratory Medicine, from January 2023 to December 2024. Results: Mild airflow obstruction was found in 46.6% of cases, moderate in 42.7%, severe in 10.7%, and none had very severe obstruction. The severity distribution was significantly related to gender, history of childhood respiratory infections, disease impact level based on CAT scores, and frequency of exacerbations. Higher CAT scores correlated with more severe airflow obstruction. Patients with a "very high" CAT score had a significantly higher prevalence of severe airflow obstruction (P-value < 0.05). A significant relationship was observed between the frequency of exacerbations and both the CAT scores and airflow obstruction severity. Patients with more frequent exacerbations exhibited higher CAT scores and more severe airflow obstruction (P-value < 0.05).There was a significant inverse relationship between the CAT score levels and the mean FEV1 (% predicted), indicating that a higher disease impact level correlates with worse lung function (P-value < 0.05). Conclusion: The importance of regularly using CAT scores in clinical practice to better understand the severity of COPD and to tailor treatment plans according to individual patient risk factors, such as age, gender, smoking history, and past respiratory health. This approach can help improve disease management and outcomes for COPD patients

Background: Perinatal asphyxia is the second leading cause of neonatal mortality after infection, accounting for around thirty percent of all deaths globally. The current study was designed to comprehensively investigate the cardiac dysfunction associated with perinatal hypoxia and its relationship to hypoxic ischemic encephalopathy. MATERIAL & METHOD: This prospective observational study was carried from January 2019 to December 2020 in the NICU of the Department of Paediatrics, civil hospital Ahmedabad, Gujarat, after approval by Institutional ethical committee (IEC). All newborns (intramural and extramural) admitted in NICU with history of perinatal asphyxia within first 72 hours of life were included. Myocardial dysfunction was evaluated using clinical examination, electrocardiogram, echocardiography (2D &M mode) and cardiac enzymes (CPK MB, CPK total &troponin I). RESULT  : Present study enrolled 135 neonates, among them 28.1% were female and 71.8% were male, out of which 14.8% neonates developed mild HIE, 37.7% neonates developed moderate HIE and 47.4% had severe HIE. Significant positive correlation was seen between the levels of the cardiac markers and the degree of adverse outcome in terms of HIE staging. 2D echo showed that patients with valvular regurgitation and pulmonary hypertension had more adverse outcome and chances of these findings being there increased with the severity of HIE grading. On assessing the outcome of the patients with HIE a positive correlation between the adverse outcome and raised cardiac marker levels were seen.82.6% of the patients who developed valve regurgitation and 90.9% who developed pulmonary hypertension expired. CONCLUSION:  Myocardial dysfunction was found in 53.3% of patients, Significant Positive Correlation was seen between the levels of the cardiac markers and the degree of adverse outcome in terms of HIE staging. Functional 2D ECHO done at bedside can be a reliable tool to diagnose and monitor the clinical progress of patients.

Background: Acute Myocardial Infarction (AMI) is a leading cause of morbidity and mortality globally, with arrhythmias representing a frequent and significant complication. These arrhythmias, which can range from benign to life-threatening, are closely associated with the severity of myocardial injury and contribute to poor short- and long-term outcomes. This prospective observational study aimed to investigate the incidence, types, and outcomes of arrhythmias in patients with AMI admitted to the intensive coronary care unit at SVRRGGH, Tirupati. A cohort of 100 patients was assessed based on clinical features, ECG evidence, blood biomarkers, and imaging. The study found that the majority of patients were aged 41-70 years, with a significant male predominance (83%). Lifestyle factors such as smoking and alcohol use were common, and hypertension and diabetes were prevalent comorbidities. The most common type of myocardial infarction was Inferior Wall Myocardial Infarction (INFWMI). Arrhythmias, particularly ventricular premature contractions (VPCs), were observed in a significant number of patients, with spontaneous resolution noted in some cases. The study highlighted the relationship between the location of the myocardial infarction and the occurrence of specific arrhythmias, with no significant correlation found between MI type and mortality. Additionally, factors such as age, gender, and comorbidities influenced arrhythmic patterns and outcomes. These findings suggest that arrhythmias in AMI patients can often resolve spontaneously but require careful monitoring and timely intervention. The study underscores the importance of personalized treatment strategies and further research to refine management techniques and improve patient outcomes, particularly for those with high-risk factors such as comorbidities and lifestyle behaviors.

Background: Aim: This study aimed to determine the prevalence, severity, and contributing factors of iron deficiency anemia among school-aged children (6-14 years). The findings provide insights into anemia prevalence and its correlation with iron deficiency, emphasizing the need for preventive interventions. MATERIALS AND METHODS: This observational study was conducted in the Department of Pediatrics over one year (January 1, 2024 – December 31, 2024). A total of 150 children were enrolled from outpatient pediatric clinics and school health programs. Demographic data, dietary habits, and clinical history were collected using a structured questionnaire. Laboratory investigations included a Complete Blood Count (CBC), serum ferritin, serum iron, total iron-binding capacity (TIBC), and a peripheral blood smear. Anemia classification was based on WHO criteria. Statistical analysis was performed to evaluate the association between anemia and various demographic and clinical parameters. RESULTS: The prevalence of anemia among the participants was 45.33%, with mild anemia in 35.82%, moderate anemia in 50.75%, and severe anemia in 13.43% of anemic children. Age and gender did not show a significant effect on hemoglobin levels (p > 0.05). Serum ferritin levels indicated that 10.00% of children had iron deficiency, highlighting that other factors, such as vitamin deficiencies or infections, may contribute to anemia. CONCLUSION: Iron deficiency anemia remains a significant health concern among school-aged children, affecting nearly half of the study population. While iron deficiency plays a role, other nutritional and health-related factors may contribute to anemia. The study underscores the importance of early screening, dietary interventions, and public health initiatives to mitigate the impact of anemia on children's health and academic performance

Background: Non-traumatic small intestinal perforation is a critical surgical emergency associated with significant morbidity and mortality. The study aims to evaluate its clinical presentation, surgical management, and postoperative outcomes. Methods: A descriptive observational study was conducted on patients presenting with non-traumatic small bowel perforation. Demographic data, clinical presentation, laboratory and radiological findings, intraoperative observations, surgical interventions, and postoperative outcomes were analyzed. Results: The study included 40 patients, with a mean age of 36.36 years. The most affected age group was 31-40 years (40%). Unlike most studies reporting male predominance, this study observed a higher incidence in females (54%). Abdominal pain (100%) was the most common symptom, followed by fever (82%), vomiting (68%), and abdominal distension (68%). Pneumoperitoneum was observed in 84% of cases on abdominal X-ray. Single perforations (58%) were most common, with the majority occurring within 100 cm of the ileocecal junction (72%). Primary repair was performed in 12% of cases, resection with anastomosis in 30%, and stoma formation in 58%. The most common postoperative complication was wound infection (58%), followed by anastomotic leakage (26%) and respiratory complications (46%). The overall mortality rate was 10%, with delayed presentation significantly impacting outcomes. The predominant etiology was typhoid (40%), followed by tuberculosis (26%) and non-specific causes (26%). Conclusion: Early diagnosis, aggressive resuscitation, and appropriate surgical decision-making significantly influence outcomes in non-traumatic small bowel perforation. Stoma formation in high-risk cases helped reduce morbidity and mortality. Optimizing patient care with timely intervention remains crucial in improving survival rates.

Background: Non-invasive ‘Multi-detector Computed Tomography’ (MDCT) of abdomen is a primary imaging modality to look for small bowel pathologies with additional assessment of extraluminal structures.A Contrast Enhanced CT (CECT)study using diluted iodine and mannitol have been used to achieve bowel distension, improve image quality, and facilitate the diagnosis of bowel wall abnormalities. An ideal endoluminal contrast agent should provide uniform intraluminal attenuation, high contrast between bowel wall and luminal content, minimal mucosal absorption with maximum distension, no significant artifact formation or adverse effects. The purpose of this study is to compare quantitatively and qualitatively using the diluted mannitol and diluted iodine-based diatrizoate meglumine as oral endoluminal contrast agents. Materials and methods: A prospective comparative study done for a period of 2 years involving 108 subjects for analysis of the bowel by two endoluminal contrast agents, viz. diluted mannitol and iodine with an objective to compare their performance. Imaging was done using 128-slice MDCT and study was performed after the administration of oral and intravenous contrast. The images were analyzed for maximum bowel distension, bowel distension uniformity, mucosal fold/ wall visibility and homogeneity of luminal contents for mannitol and iodine groups. MS Excel and SPSS version 23 (IBM SPSS Statistics) were used to analyse data.  Results: The mean of maximum and average bowel distension with the mannitol group was significantly higher compared to the iodine group. Similarly, greater number of cases showing excellent uniformity in bowel distensibility, mucosa fold visibility and homogeneity of luminal contents were noted among the mannitol group in all quadrants, compared to the iodine group. Conclusion: Oral diluted mannitol performs better than iodine solution as an oral contrast agent for evaluating small and large bowel loops both quantitatively and qualitatively. The diluted mannitol was also better tolerated, and had fewer mild side effects.

Background: It was discovered that thyroid hormones, which are classified as catabolic hormones, control several metabolic processes, such as lipid synthesis, mobilization, and breakdown. Thyroid hormones significantly affect lipoprotein metabolism as well as some CVD risk factors, thus influencing the overall CVD risk. Objectives: To find relation between abnormal thyroid functions and lipid levels Methods: It is a Cross-sectional study. Analysis of Total Cholesterol, Triglycerides and HDL Cholesterol was made using a fully automated Biochemistry analyzer. Serum T3, T4, and TSH were analyzed using Chemiluminescence assay. Correlation of Thyroid hormone and lipid ration were done. Results: Majority of them (39.2%) were 41-50 years age group, with female predominance (62.7%). Mean serum levels of TC, TG VLDL, LDL cholesterol and LDL/HDL ratio indicated significantly higher among hypothyroid group as compared to euthyroid group, whereas mean HDL level were significantly lower in hypothyroid group as compared to euthyroid group (p<0.05). Mean serum levels of TC, TG, VLDL, LDL cholesterol and LDL/HDL ratio were significantly lower among hyperthyroid group as compared to euthyroid  group (p<0.05), whereas mean HDL level were significantly higher in hyperthyroid group (p<0.05). Conclusion: Screening for lipid profiles is crucial in all patients with thyroid dysfunction, and it is essential to identify and address underlying lipid abnormalities

Introduction: Thalassemia is a group of genetic disorders characterized by an imbalance in alpha and beta globin chain production, leading to hypochromic, microcytic red blood cells with a shorter half-life and resulting anemia. AIM: To evaluate lipid profile changes, carotid intimal medial thickness, age correlation, and duration from first blood transfusion with atherosclerotic changes in beta thalassemia major cases compared to controls. Methodology: This case-control study was conducted in the Department of Paediatrics, JLN Medical College, Ajmer, from February 2023 until the completion of the required sample size. Result: Our study found that beta thalassemia major cases had significantly higher triglyceride, VLDL, serum ferritin, serum iron, CIMT, and AIP levels, while cholesterol, HDL, LDL, and hemoglobin levels were lower compared to controls. These findings suggest an increased risk of atherosclerosis and cardiovascular complications in thalassemia patients, aligning with previous studies. Conclusion: Our study concluded that serum ferritin, serum iron, triglycerides, cholesterol, and duration since the first blood transfusion significantly correlate with increased CIMT in thalassemia patients, indicating a strong link between iron overload and atherosclerotic changes, highlighting the need for early intervention to prevent disease progression.

Background: Inclisiran inhibits PCSK9 production by mimicking body’s process of RNA interference mechanism and is targeted towards the hepatocytes by binding to GalNac leading to greater uptake of LDL-C by the hepatocytes. This study aims to assess the efficacy and safety of Inclisiran in 16 Indian ASCVD patients from day 0 to day 90. Methods: The study included 16 Indian patients with documented ASCVD treated with Inclisiran in addition to oral LLTs. ESC 2019 recommendation for risk stratification was performed to classify the patients into different risk categories and the LDL-C goals appropriate to each risk categories were set as benchmark to be achieved. The patients were followed up-to 90 days and lipid profile was checked prior to the initiation of Inclisiran and at day 90. Results: The mean age of patients included was 53 years contributed by 13 males and 3 females. All the patients received maximally tolerated oral lipid lowering therapies post discharge. Inclisiran was administered in these patients who were unable to achieve the guideline recommended LDL-C targets despite being administered with maximally tolerated oral LLTs. The baseline mean LDL-C value observed in the patients was 124.5 mg/dl prior to initiation of Inclisiran. The mean LDL-C reduction was found to be 66.2% from the baseline in a span of 3 months. 5 out of 7 extreme risk patients achieved the ESC guideline recommended LDL-C target of < 40 mg/dl, 9 out of 9 very high-risk patients achieved < 55mg/dl. Conclusion: Inclisiran 284mg SC offered an effective and safe LDL-C reduction without any adverse CV events reported during the study period.

Background: Herlyn- Werner- Wunderlich (HWW) syndrome is a rare congenital anomaly of the Mullerian and Mesonephric ducts characterised by a triad of uterine didelphys, obstructed hemivagina and ipsilateral renal agenesis.1 Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome. Etiology is unknown. Incidence is 0.1%–3.8%. We present a case report of this rare syndrome of HWW syndrome in a 38 years old, nulligravida, came to OBGYN - OPD at KIMS & RF, Amalapuram, with primary infertility. On examination, cervix found deviated to left side, with blind vaginal dimpling on right side, which was confirmed byMRI & diagnostic hysterolaparoscopy. The diagnosis was made by usg- abdomen and pelvis, MRI, diagnostic hysterolaparoscopy. It was noted the uterine didephys with incompletely obstructed hemivagina on right side and absence of Ipsilateral right kidney. Chromopertubation (CPT)done through the visible left sided cervical OS shown spillage at left sided fallopian tube, no spillage on right sided fallopian tube.

Background & Objectives: Peripheral Arterial Disease (PAD) is a common and severe complication in diabetic patients, often leading to significant morbidity and mortality. Early detection of PAD in asymptomatic patients is crucial for preventing severe outcomes such as ulcers and amputations. The study aims to compare the effectiveness of Pulse Oximetry and Ankle Brachial Index (ABI) in detecting PAD among asymptomatic diabetic patients. Methods: A cross-sectional study was conducted involving asymptomatic diabetic patients. Participants underwent both Pulse Oximetry and ABI tests, followed by Duplex Ultrasonography of the Lower Limb arteries, which served as the reference standard. The sensitivity, specificity, and predictive values of Pulse Oximetry and ABI were calculated and compared. Results: Pulse Oximetry demonstrated a sensitivity of 84.6% and specificity of 73.9% in detecting PAD, whereas ABI showed a sensitivity of 83.3% and specificity of 71.9%. The combination of both tests improved the overall diagnostic accuracy, with the combined sensitivity and specificity reaching 70.47% and 91.77% respectively. Interpretation & Conclusion: Pulse Oximetry is a useful, non-invasive tool for the initial screening of PAD in asymptomatic diabetic patients, especially when used in combination with ABI. The combination enhances early detection, potentially reducing the risk of severe complications and improving patient outcomes.

Background: Deep vein thrombosis (DVT) is a significant complication following venous interventions. While these procedures are essential for various medical conditions, the risk of DVT remains a concern. Prophylactic anticoagulation is widely used to mitigate this risk, yet its effectiveness and associated challenges require further investigation.  Aim: This study aims to assess the incidence of DVT following venous interventions and evaluate the impact of prophylactic anticoagulation in preventing DVT. Methods: A prospective observational study was conducted at a single tertiary care center. Patients undergoing venous interventions, including central venous line (CVL) placement, temporary pacemaker (TPM), permanent pacemaker (PPM), implantable cardioverter defibrillator (ICD), and cardiac resynchronization therapy pacemaker (CRT-P), were included. Patients received prophylactic anticoagulation based on institutional protocols. The incidence of DVT was assessed using clinical evaluation and Doppler ultrasonography.  Results: The most common indication for venous intervention  was PPM 30%, followed by CVL and TPM 25% each, then CRT-P  15%, least was ICD 5%. The most common site of venous catheter insertion was  left subclavian vein 50%, followed by right femoral vein 30%, least  was internal jugular vein 20%.   Out of the total study population, the incidence of post-procedural DVT was found to be very low at 0.5%. The use of prophylactic anticoagulation was associated with a significant reduction in DVT occurrence.  Conclusion:  Venous interventions pose a minimal risk for DVT when appropriate prophylactic anticoagulation is administered. The results reinforce the importance of thromboprophylaxis in preventing post-intervention thrombotic complications. However, multicentric studies with larger sample sizes are warranted to validate these findings further. 

Background & Objectives: OSMF is a high risk potentially malignant disorder caused due to areca nut (AN). Reactive oxygen species (ROS) produced during auto oxidation of A poly-phenols in the betel quid chewer’s saliva, are crucial in the initiation and promotion of oral cancer and are countered by salivary antioxidants .With scanty literature on their role in OSF, salivary enzymatic antioxidant catalase and non- enzymatic antioxidant uric acid were planned to be evaluated. Materials & Method: The study comprised of 30 OSMF subjects subdivided into 10 each of stages I, II and III as per Pindborg’s clinical classification and 30 controls. Salivary CAT activity and UA levels using ELISA and automated biochemistry auto analyzer respectively were evaluated and obtained data statistically analyzed. Results: Classical features of OSMF were observed with increasing number of subjects experiencing oral mucosal burning as OSMF advanced. A statistically insignificant decreased salivary catalase activity (1.42±2.42 ng/dl v/s1.48±1.92 ng/dl) and statistically significant (p < 0.05) decreased salivary uric acid levels (2.85±2.31 md/dl v/s 4.18±2.19 md/dl) in OSMF subjects compared to controls was noted, both of which decreased linearly from stage I to stage III OSF. Interpretation and Conclusion: Decreased salivary antioxidants, catalase and uric acid in OSF reflect their augmented consumption by increased reactive oxygen species produced during areca nut and tobacco chewing.

Background: Central corneal thickness (CCT) is a crucial parameter in ophthalmology due to its importance as an indicator of corneal physiological status, influencing intraocular pressure (IOP) reading and the evaluation of risks associated with eye disorders like glaucoma and keratoconus. Aim: The present study aimed to determine CCT to age, gender, refractive errors, and axial length among patients visiting tertiary care center in South India. Materials & methods: An observational, prospective study was conducted at Sri Venkateshwara Medical College Hospital and Research Centre in Puducherry to examine the correlation between CCT with age, gender, refractive errors, and axial length among patients visiting the ophthalmology outpatient department. The study included participants aged 20 to 70 years who received standard ophthalmologic evaluations with a sample size of 100 eyes (55 patients). The study was approved by the Institutional Ethics Committee. Ophthalmologic evaluation, including acuity assessment, refraction assessment, axial length measurement, and central corneal thickness measurement was done. Results: The mean CCT varies among different age groups, with the highest values in the 20-30 age group (562.14 ± 32.4 microns), followed by the 41-50 age group (546.88 ± 21.56 microns), the 51-60 age group (537.12 ± 34.89), and the 61-70 age group (543.56 ± 34.87 microns). The mean CCT in males is 540.64 ± 23.7.2 microns, while in females it is 547.76 ± 34.21 microns. The mean CCT in low myopia is 530.23 ± 48.2 microns, moderate myopia is 560.56 ± 45.43 microns, high myopia is 562.88 ± 33.71 microns, hypermetropia is 542.12 ± 27.61 microns. The average axial length was 23.47± o.80 mm among males, and 23.20±0.57 mm among females. Conclusion: The study concludes that CCT varies significantly by age, gender, refractive errors, and axial length. CCT significantly decreases with age. No significant difference in CCT was found among myopia, hypermetropia, and emmetropia. We found no statistically significant correlation between CCT and axial length. Understanding regional differences can improve eye care and intraocular pressure measurements.

Background: Intrathecal administration of local anaesthetic drug for spinal anaesthesia can achieve adequate sensory and motor blockade required for lower limb orthopaedic surgeries. However, the traditionally used drug bupivacaine has been associated with severe cardiovascular and CNS toxicity. Newer long-acting local anaesthetics, levobupivacaine and ropivacaine due to their three-dimensional structure seem to have lesser toxic effects on the central nervous system and the cardiovascular system. Through our study we intend to clinically compare the efficacy of 0.75% hyperbaric ropivacaine and 0.5% hyperbaric levobupivacaine in spinal anaesthesia. Materials and methods:  A prospective, randomized, double blinded, clinical, parallel arm study was conducted including a total of 70 patients posted for lower limb orthopaedic surgery. The patients were randomly divided into 2 groups of 35 patients each. Group A received 15 mg 0.5% (3ml) hyperbariclevobupivacaine for spinal anaesthesia. Group B received 22.5 mg 0.75% (3ml) hyperbaricropivacaine for spinal anaesthesia. The total duration of analgesia along with time taken for onset and regression of sensory block and motor block was recorded and statistical analysis was performed. The two groups were also compared based on peri-operative hemodynamic parameters and adverse effects encountered. Results & conclusion: The findings in the 2 groups were comparable regarding duration of analgesia, the maximum dermatomal height of sensory block and the time required to achieve maximum dermatomal height. However, hyperbaric 0.75% ropivacaine was found to produce faster onset as well as regression of sensory and motor block compared to hyperbaric 0.5% levobupivacaine.

Background: Chronic obstructive pulmonary disease (COPD) significantly impacts cardiac function, particularly affecting the right ventricle, left ventricle, and pulmonary vasculature. Cardiovascular complications contribute substantially to COPD-related mortality. Echocardiography provides a non-invasive and effective method for evaluating cardiac changes in COPD patients. To analyze the cardiac alterations associated with COPD using echocardiography and to determine the correlation between echocardiographic findings and COPD severity based on GOLD classification. Materials and Methods: This prospective observational study was conducted over 16 months at the Department of Respiratory Medicine, MIMS, Vizianagaram. A total of 50 COPD patients aged above 40 years were enrolled. Exclusion criteria included active tuberculosis, HIV, terminal cancer, hepatic or renal diseases, and pregnancy. Patients underwent clinical evaluation, electrocardiography (ECG), spirometry, arterial blood gas (ABG) analysis, and echocardiography. Data were analyzed for associations between echocardiographic findings and COPD severity. Results: Echocardiographic findings revealed that 24% of patients had pulmonary hypertension, 24% had increased right ventricular (RV) thickness (>0.5 mm), and 20% had left ventricular diastolic dysfunction (LVDD). The mean ejection fraction did not significantly differ between patients with and without pulmonary hypertension (61.6% vs. 60.5%). Echocardiographic abnormalities were more frequent in severe and very severe COPD cases. Conclusion: COPD is associated with significant cardiovascular changes, including pulmonary hypertension, RV hypertrophy, and LV dysfunction. Routine echocardiographic screening every six months is recommended to detect early cardiac complications and improve clinical outcomes.

Background: This study assesses the knowledge, awareness, and preparedness of non-medical graduates in Ghaziabad City regarding Cardiopulmonary Resuscitation (CPR). It identifies knowledge gaps and sources of information to recommend strategies for improving CPR proficiency among this demographic. Methods: A quantitative research design was employed, utilizing an observational approach. A purposive sampling technique was applied to select 101 non-medical graduates from Ghaziabad. Data collection was conducted via a structured questionnaire developed using Google Forms. Statistical analysis was performed using IBM SPSS, incorporating descriptive statistics and regression analysis. Results: The findings indicate that 88.12% of participants had received CPR training, yet only 25.74% correctly identified the initial step in CPR. A significant portion (74.26%) mistakenly believed that CPR begins with 30 chest compressions instead of checking for breathing. 86.14% of respondents had encountered situations requiring CPR, and 89.11% reported performing CPR. However, 27.72% refrained from performing CPR due to discomfort, and 25.74% cited a lack of knowledge. Awareness of Automated External Defibrillators (AEDs) was limited, with 46.53% unfamiliar with the device. Conclusion: Although CPR training is widespread, critical knowledge gaps persist in understanding correct procedures. There is a need for structured and practical training programs tailored for non-medical graduates to improve their competency and confidence in performing CPR. Public health initiatives should focus on bridging the knowledge gap and promoting AED awareness to enhance emergency response effectiveness.

Background: The choice of vascular access in PCI affects procedural success, complications, and outcomes. Radial access (RA) is preferred for reduced bleeding and faster recovery, while femoral access (FA) remains crucial for complex cases. This study compares the impact of RA versus FA on procedural and clinical outcomes. Methods: A prospective observational study was conducted at a tertiary care hospital, over one year of period, enrolling 228 patients undergoing PCI. Patients were categorized into RA-PCI (n = 115) and FA-PCI (n = 113) groups based on access strategy. Primary outcomes included 30-day major adverse cardiovascular and cerebrovascular events (MACCE). Secondary outcomes assessed procedural efficiency (fluoroscopy time, contrast volume), access-site complications (bleeding, hematoma), and recovery parameters (ambulation time, hospital stay) Results: RA-PCI had lower fluoroscopy time (11.4 ± 3.8 min vs. 14.7 ± 4.2 min, p < 0.001), contrast use (130.5 ± 18.3 mL vs. 148.7 ± 22.1 mL, p < 0.001), and procedure duration (37.2 ± 6.1 min vs. 42.8 ± 7.4 min, p = 0.002). RA-PCI also had fewer major bleeding events (2.6% vs. 8.0%, p = 0.03), lower hematoma rates (3.5% vs. 10.6%, p = 0.02), shorter ambulation time (3.1 ± 0.9 h vs. 8.4 ± 2.3 h, p < 0.001), and reduced hospital stay (1.7 ± 0.5 days vs. 2.6 ± 0.8 days, p < 0.001). MACCE at 30 days was lower in RA-PCI (6.1% vs. 11.5%) but not statistically significant (p = 0.08). Conclusion: RA-PCI offers better procedural efficiency, fewer bleeding complications, and faster recovery than FA-PCI. While MACCE rates were lower with RA, significance was not reached. These findings support a radial-first approach, with further studies needed for long-term validation.

Introduction: The spleen is the haemo - lymphatic organ of the reticulo-endothelial system and is the commonest organ to get enlarged in infections. Spleen can have many anatomical variations pertaining to its notches, weight, length, breadth and thickness. This anatomical knowledge is important for Surgeons, Radiologists and Anatomists. Aim of the study: Morphometric analysis of adult human cadaveric spleens was done in this study and compared with the available literature. Material and Methods: This present study was done on 40 formalin fixed human adult cadaveric spleens of both the sexes obtained from cadavers during routine dissection for undergraduate students in PESIMSR ,Kuppam A.P The spleens were carefully examined to determine the presence of splenic notches , clefts, weight, length measured between two poles , breadth measured between superior and inferior borders and thickness between two surfaces Results : In this study out of 40 cadaveric spleens 26 spleens were observed to have the notch on their superior borders. There were no notches in 5 spleens. 2 spleens were having notch in the superior border along with the cleft in there inferior border. 1 spleen had notch only in the intermediate border. Only one spleen was found to have notch only in the inferior border. The weights of the 40 spleens were recorded and it was ranging from 20.39g to 328.96g. One spleen with the least weight was 24.6g and the largest one was measuring 328.96g. The length of the spleens was ranging from 6.4cm to 12.1cm. The breadth of the spleens was ranging from 3.7cm to 9.5cm. The thickness of the spleen was ranging from 1.3cm to 5.5cm. Conclusion: The finding of the present study contributes significantly to the existing literature on splenic morphology, highlighting the importance of spleen’s size its notches and weight.

Background: Direct laryngoscopy and tracheal intubation can result in severe effects such as tachycardia, hypertension, cardiac ischaemia, and cerebral haemorrhage.Clonidine is an α-2 adrenergic receptor agonist that exerts a central sympatholytic action. Clonidine premedication mitigates the haemodynamic stress reactions associated with direct laryngoscopy and tracheal intubation. Pregabalin, a gabapentinoid, seems to exert an inhibitory effect on neuronal excitability.

Aim: The purpose of this study was to compare the effect of oral pregabalin 150 mg & oral clonidine 0.2 mg given 90 minutes before surgery, on haemodynamic stress response resulting from laryngoscopy and endotracheal intubation. Materials and Method:The present study was a prospectiveobservational randomizedcomparativestudy performed conducted for a period of one year in a tertiary care centre. The study comprised 60 patients classified as ASA I and II, scheduled for diverse elective operations under general anaesthesia. The participants were randomised into two groups, A and B, each consisting of 30 patients: the Pregabalin group (Group A) and the Clonidine group (Group B). Group A received premedication with 150 mg of capsaicin pregabalin, whereas Group B was administered 0.2 mg of clonidine. Subsequently, the haemodynamic parameters including heart rate(HR), systolic blood pressure(SBP), diastolic blood pressure(DBP) and mean arterial pressure(MAP) were compared between the two groups during induction, laryngoscopy, and intubation.Result wasanalysed using SPSS 20.0 version and the association was tested using t test. A p value less than 0.05 was considered statistically significant.  Results:  Administration of oral clonidine 0.2 mg 90 minutes before to surgery mitigated sympathetic stimulation and catecholamine responses during laryngoscopy and tracheal intubation. Our investigation revealed that the increase in HR, SBP, DBP, and MAP after laryngoscopy and endotracheal intubation was considerably lower in the Clonidine group compared to the Pregabalin group. The Clonidine group exhibited superior haemodynamic stability throughout surgery compared to the pregabalin group. Conclusion: When compared to oral pregabalin, oral clonidine substantially reduces the sympathetic responses that occur during laryngoscopy and endotracheal intubation, while simultaneously preserving the stability of the cardiovascular system during surgery.

Background: Fournier's gangrene is a severe form of necrotizing fasciitis of the perineum and genitalia, typically caused by a polymicrobial infection.Most individuals with Fournier's gangrene also associated with comorbid conditions, such as diabetes, alcoholism, and other related disorders.The Fournier’s Gangrene Severity Index (FGSI) is a valuable prognostic tool for predicting mortality and survival outcomes in patients with Fournier’s gangrene. Reconstructive interventions are required when significant tissue defects arise from extensive tissue damage. AIM:To study the etiology, microbiological factors and reconstructive procedures performed in patients with Fournier’s gangrene, and to assess the outcomes and mortality rates of Fournier’s gangrene based on the Fournier’s Gangrene Severity Index (FGSI). Results:Among 40 patients treated at KMCH from May 2022 to May 2024. Most commonly occurred in the fourth and fifth decades of life, with a mean age of 50.2 years. The mean age for deceased patients was 63 years, significantly higher than the 48.3 years among survivors. The male-to-female ratio was 34:6.The most common source of infection was genitourinary (40%), followed by anorectal (27.5%) and 20% of cases being idiopathic. Diabetes mellitus (47.5%) was the most prevalent comorbidity, followed by chronic alcoholism (22.5%) and HIV (10%). Polymicrobial infections were seen in 80% of cases, with E. coli (47%),streptococci (41.1%), and Klebsiella (35.3%) being the most frequently isolated pathogens. Bacteroides were the most common anaerobes (8.9%). In most cases, the infection was confined to the genitalia (52.9%). The Fournier’s Gangrene Severity Index (FGSI) was a reliable predictor of survival, with a score above 10.5 associated with 100% mortality, while a score below 10.5 correlated with 93.3% survival. Conclusion: Fournier’s gangrene (FG) predominantly affects middle-aged and elderly males, with genitourinary infections as the most common source. Diabetes mellitus is the leading comorbidity, and infections are typically polymicrobial. Early diagnosis, repeated debridement, and reconstructive procedures for tissue loss are essential for improving survival outcomes. Despite aggressive treatment, mortality remains significant. The Fournier’s Gangrene Severity Index (FGSI) is a key predictor of survival, with higher scores correlating to increased mortality

Background: Breast cancer is the most common cancer amongst women with no regional variation and the second most cancer worldwide. Stromal contribution to progression of cancer will identify specific signals which promotes growth, differentiation, invasion and ectopic survival of tumour cells. Stromal cells in breast carcinoma express CD10 which can cleave the matrix and help tumour invasion and metastasis. Methods:Study group comprised 30 casesthat were subjected to histopathological examination using routine haematoxylin and eosin stain, and further confirmation was made by immuno-histochemical staining for CD10 of breast carcinoma diagnosed on 14-gaugecore needle biopsy specimen. Results :Among 30 cases, the 19 cases 0ut of 30 (63.3%) with Intraductal breast carcinoma (Not specific type) with extensive in situ component was clearly highlighted by strong CD10 positivity in myoepithelial cells.8 out of 30 cases (26%) cases showing weak positive results and 3 cases (10%) showed negative results. Conclusion :Strong CD10 positivity is significantly associated with lymphovascular invasion in the patients. Lymphovascular invasion is an independent prognostic marker which is associated with worse clinical outcome in breast cancer. Core needle biopsy should be an important part of preoperative work up and along with the traditional panel of markers, CD10 can put up routinely as a prognostic marker in all breast cancer patients.

Background: A Complete Blood Count (CBC) and Peripheral Blood Picture (PBP) are essential diagnostic tools in assessing the severity and outcomes of dengue infection. Dengue, a mosquito-borne viral illness caused by the dengue virus (DENV), can range from mild dengue fever (DF) to severe forms such as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). The CBC and PBP provide critical information about hematological changes that correlate with disease progression and severity. The objective is to observe the trends of recovery of white blood cells (WBCs) and platelets in dengue fever  Materials and Methods: This is a prospective and cross-sectional study conducted in the Department of Pathology at Uma Nath Singh Autonomous State Medical College, Jaunpur, Uttar Pradesh over period of 1 year. Patients diagnosed with dengue fever, dengue hemorrhagic fever (DHF), or dengue shock syndrome (DSS) based on WHO criteria were included. Cases confirmed by serological tests (NS1 antigen, IgM/IgG ELISA) or RT-PCR. Patients with recorded laboratory parameters, including hemoglobin, hematocrit, white blood cell count, platelet count, and peripheral blood smear findings were included. Results : A total of 560 patient data were analyzed in this study, comprising 280 males and 280 females. The mean age of the study population was 34.2 years, with a standard deviation of 13.7, and the age range was between 16 and 84 years. Among these patients, 245 did not develop DHF during hospitalization, while 315 progressed to DHF in the ward. During the acute febrile phase (Days 2–3) of the illness, leucopenia (WBC < 5000 cells/mm³) was observed in 72.4% of the patients. The average WBC counts for DF and DHF patients were 4.22 and 4.57, respectively. Neutrophil counts showed mean values of 2.85 in DF patients and 3.21 in DHF patients. Lymphocyte counts were lower in DHF patients, with a mean of 0.92 compared to 1.07 in DF patients.Conclusion: In conclusion, DF is an increasing, global problem with a growing footprint on millions of lives. At this time, monitoring decreases in hemoglobin and increases in WBC counts, particularly neutrophils, through routine CBC testing in hospitalized patients with suspected DF may identify those young children at higher risk of severe

Background: Venous malformations (VMs) are the most common slow-flow congenital vascular anomalies, comprising approximately 70% of vascular malformations. Percutaneous sclerotherapy is the preferred treatment, but the optimal sclerosing agent remains uncertain. Bleomycin and Polidocanol are commonly used due to their efficacy and favorable safety profiles, while their combination as Bleomycin-Polidocanol Sclerotherapy (BPS) has been proposed to enhance treatment outcomes. This study compares the efficacy and safety of BPS versus Bleomycin or Polidocanol alone in pediatric patients with VMs. Methods A prospective, comparative study was conducted on 60 pediatric patients (aged 1 month to 12 years) with VMs. Patients were randomly assigned into two groups: BPS (n=30) and Bleomycin or Polidocanol alone (n=30). Sclerotherapy was performed under ultrasound guidance, with multiple sessions as required. Clinical improvement, treatment response, recurrence, and adverse events were recorded. Statistical analysis was conducted, with p-values <0.05 considered significant. Results Both groups demonstrated comparable outcomes. Complete resolution was observed in 50% of the BPS group and 43% of the Bleomycin or Polidocanol group (p=0.59). Partial improvement rates were 40% and 47%, respectively (p=0.60). Recurrence was reported in 13% of BPS patients and 17% of Bleomycin or Polidocanol patients (p=0.71). Adverse event rates were similar, with pain (33.3% vs. 30%), swelling (43.3% vs. 40%), and skin hyperpigmentation (30% vs. 26.7%) being the most common. No statistically significant differences were noted between groups. Conclusion BPS and Bleomycin or Polidocanol alone were equally effective and safe in the treatment of pediatric VMs. Both approaches resulted in similar symptom resolution, recurrence, and complication rates. This study suggests that either method can be chosen based on clinician preference, lesion characteristics, and patient-specific considerations. Further research with larger sample sizes and extended follow-up is warranted to optimize treatment protocols.

Background: This research investigates the perceptions of medical educators regarding the teaching of AETCOM to undergraduate MBBS students at a tertiary care hospital. Using a qualitative methodology, data were collected through semi-structured interviews with 15 faculty members across various departments. Thematic and content analyses were employed to uncover recurring patterns and quantify key themes. The findings highlighted both the transformative potential and the systemic barriers of AETCOM. Faculty members recognized its role in enhancing professionalism, empathy, and communication skills among students. However, challenges such as curriculum overload, lack of structured faculty training, resource constraints, and cultural misalignment were frequently cited. The study concludes with actionable recommendations, including structured faculty training programs, integration of AETCOM into clinical practice, and the cultural adaptation of teaching materials to better align with Indian healthcare settings. These recommendations aim to bridge gaps in AETCOM implementation, ultimately fostering holistic medical education.

Background: This study is carried out to assess the effect of  fenugreek (methi) on  blood pressure , blood  sugar , serum cholesterol and serum triglycerides in non insulin dependent diabetes  mellitus.Methods:A total of 10 patients of noninsulin dependent diabetes mellitus was taken to study the effect of fenugreek in their blood sugar,serum triglycerides and serum cholesterol level .Initially a detailed clinical examination of patients was carried out and all the drugs were discontinued for 2 weeks(washout period).All the patients were administered 2.5gm of methi powder twice a day after food with a glass of water daily for 2 months.Conclusion:We concluded that fenugreek has hypoglycaemic effect in mild NIDDM and no significant effect in severe NIDDM.

Background: Ambulatory blood pressure monitoring (ABPM) is increasingly recognized for its ability to capture circadian variations in blood pressure, which are pivotal for managing patients with acute heart failure (AHF). This observational study investigates the utility of ABPM in a clinical setting to correlate blood pressure patterns with clinical outcomes in patients admitted with AHF. Methodology: This prospective observational cohort study was conducted at a tertiary care center, encompassing a sample of 100 patients diagnosed with AHF. ABPM was employed 24 hours prior to discharge post initial stabilization to monitor blood pressure fluctuations over a 24-hour period. Data were analyzed to correlate these fluctuations with clinical parameters including heart failure severity and cardiac structural changes, as evidenced by echocardiographic data. Results: The study findings highlighted that NYHA Class III or IV at admission was significantly higher in HFmrEF risers (96.2%) compared to non-risers (88.9%) (p = 0.02).  ABPM measurements showed that HFpEF patients had the highest average 24-hour SBP (124.9 ± 17.8 mmHg), followed by HFmrEF (112.4 ± 15.2 mmHg) and HFrEF (102.8 ± 13.9 mmHg). HFpEF patients had the highest prevalence of nocturnal hypertension (52.7%), followed by HFmrEF (34.1%) and HFrEF (27.4%). The differences were significant (p=0.01). The differences in LVEF between the AHF groups were statistically significant, with HFpEF showing the best heart function and HFrEF showing the worst. Conclusion: ABPM provides valuable insights into the prognostic implications of blood pressure variability in patients with AHF. The data suggests that ABPM should be considered as part of the routine assessment in AHF patients to better tailor therapeutic interventions and potentially improve clinical outcomes.

Background and Aim: Low birth weight (LBW) is a significant public health concern, particularly in developing regions, as it is associated with increased neonatal morbidity and mortality. Early detection of LBW can improve outcomes by enabling timely interventions. This study aimed to assess the correlation between head circumference (HC) and foot length (FL) with birth weight in neonates, and to determine the more reliable indicator for detecting LBW.  Material and Methods: A hospital-based cross-sectional study was conducted at a tertiary care center in South Gujarat, involving 122 live-born neonates with LBW. The study evaluated the correlation between HC and FL with birth weight, using Pearson’s correlation and ROC curve analysis to determine the most effective indicator. Results: The study found a strong correlation between HC and birth weight (R = 0.84), with HC showing higher sensitivity and accuracy compared to FL. FL demonstrated a moderate correlation with birth weight (R = 0.49), with lower specificity. The ROC curve analysis confirmed HC’s superior ability to predict LBW.   Conclusion: Both HC and FL are valuable anthropometric indicators for detecting LBW. HC is a more reliable predictor, offering higher sensitivity and accuracy, while FL provides a useful alternative in resource-limited settings.

Background:  Sepsis-related mortality remains high due to delayed diagnosis and suboptimal treatment strategies. N-terminal pro-brain natriuretic peptide (NT-proBNP) is a known marker which prognosticates heart failure, but its role in sepsis prognosis is less explored. Objectives: This study aimed to evaluate the prognostic significance of NT-proBNP levels as an in-hospital severity indicator in patients with sepsis. Methods: This hospital-based prospective cross-sectional study was carried out at Silchar Medical College and Hospital, Assam, over one year, including 100 patients diagnosed with sepsis. Patients were assessed for demographic details, clinical parameters and laboratory investigations, including NT-proBNP levels, measured using the VITROS 5600 autoanalyzer. The primary result measured was in-hospital mortality at the end of 28 days. The prognostic value of NT-proBNP was compared with other clinical parameters and SOFA scores. Results: The study population comprised 49% males and 51% females, with no significant gender differences in outcomes. Elevated NT-proBNP levels were correlated with higher mortality, with non-survivors showing mean levels of 32,630.83 pg/mL compared to 9,005.16 pg/mL in survivors. Elevated NT-proBNP levels were linked with higher SOFA scores and greater severity of organ dysfunction. The ROC curve for NT-proBNP demonstrated an AUC of 0.84, indicating good predictive power. Logistic regression analysis confirmed NT-proBNP and SOFA scores as significant predictors of mortality, with each unit increase in SOFA score increasing odds of mortality by approximately 70% (p < 0.001). Conclusions: NT-proBNP levels are a valuable prognostic marker for assessing the severity and predicting outcomes in septic patients. Integrating NT-proBNP measurements into clinical practice can enhance early risk stratification, allowing for timely therapeutic strategies to enhance sepsis patient outcomes.

Background: The burden of diabetes, particularly diabetic foot complications, is a growing concern globally. This study aimed to assess the knowledge and attitude towards diabetic foot care among primary caregivers of diabetic patients. A mixed-method approach, combining a cross-sectional survey and qualitative analysis, was conducted at a tertiary care hospital in India. The study included 403 participants, majority being females and married and belonging to the age group of 28-37years with high school education. Results revealed that participants displayed good knowledge and positive attitudes towards diabetic foot care. Significant associations were found between age groups, gender, marital status, education levels, and religious affiliations with knowledge levels. Education emerged as a key factor influencing awareness of diabetic foot complications and preventive measures. These findings underscore the importance of tailored education and interventions for promoting diabetic foot care awareness among primary caregivers.

Background: Tuberculosis (TB) remains a major global health challenge, with the World Health Organization (WHO) estimating 10 million new cases and 1.4 million deaths annually due to TB. Despite advances in healthcare, the burden of pulmonary tuberculosis (PTB) is particularly significant in developing nations,  where socio-economic factors, including poverty and malnutrition, exacerbate disease incidence. One of the major complicating factors in the management of TB is the rising prevalence of Type II diabetes mellitus (T2DM), a condition that is often intertwined with TB and further complicates its treatment and prognosis. Methodology: This study is a prospective, randomized clinical trial conducted over a 12-month period. With sample size of 50 patients diagnosed with both pulmonary tuberculosis and Type II diabetes mellitus were enrolled. The patients were randomized into two groups● Group A (Control group): Received standard antitubercular therapy (ATT) for 6 months.● Group B (Intervention group): Received standard ATT plus Levofloxacin (500 mg daily) for 6 months.  Results: A total of 50 patients were enrolled in the study, divided into two groups:● Group A (Control group, n = 25) received standard ATT for six months.● Group B (Intervention group, n = 25) received standard ATT plus Levofloxacin (500 mg daily) for six months. Patients in the intervention group, who received Levofloxacin in addition to standard ATT, experienced a faster time to sputum conversion and a significantly larger reduction in cavity size compared to the control group. CONCLUSION: This study demonstrates that Levofloxacin as an add-on to standard antitubercular therapy significantly enhances treatment outcomes in pulmonary tuberculosis patients with Type II diabetes. The drug appears to improve both the microbiological and clinical recovery of these patients, making it a valuable addition to TB treatment regimens in such complicated cases.

Introduction And Aim: Distal radius fractures are the most common upper limb fractures treated in emergency rooms, accounting for over 16% of all fractures. These fractures have a bimodal age distribution, with high-energy trauma common in younger patients and low-energy trauma more prevalent in the elderly. Treatment approaches for distal radius fractures involve conservative management, which was historically the primary approach, and surgical intervention, now recognized as beneficial for certain patient groups. Patient-specific considerations include pursuing anatomic reduction for younger patients and high-demand elderly patients, while focusing on joint movement for low-demand elderly patients, reserving surgery forseverely displaced intra-articular fractures or median nerve compression.The objective of this study is to analyze and compare the functional outcomes of distal radius fractures treated with volar locking plates versus dual plating, with a focus on evaluating joint congruity, assessing the restoration of normal or near-normal wrist range of motion, and determining the time required for fracture union. Materials And Methods: In this observational study conducted over a period of 2years, 40 patients in the age group of  18 to 75 years with distal end  bicolumnar radius fracture who requires operative fixation were  alternatively treated with volar locking plate and dual plating. Joint congruity, time required for union and restoration of normal or near normal range of movements at wrist were assessed usingGartland and werley scoring system postoperatively. Results: Demographic data was comparable between 2 groups. joint movements , time required for union  were excellent in both groups, duration of hospital stay and less complications in volar locking plate compared to Dual locking plate. Conclusion: This study demonstrates that both dual plating and volar locking plate techniques are effective in treating unstable bicolumnar distal radius fractures, with excellent radiological and clinical outcomes. While both techniques show similar results, volar locking plate is preferred due to its advantages, including shorter operative time, reduced blood loss, and lower risk of complications. However, long-term follow-up is necessary to confirm these findings.

Preterm birth remains a significant global health challenge, with increasing incidence despite advances in medicine. It accounts for approximately 70% of neonatal deaths, 36% of infant deaths, and 25-50% of cases of neurological impairment in children. This study aimed to identify maternal risk factors and neonatal outcomes associated with preterm deliveries in KIMS & RF, Amalapuram. A cross-sectional study was conducted over a period of 1-year from December-2023 to December 2024 among 110 pregnant women attending  antenatal opd and labour room  at KIMS&RF, Amalapuram.Detailed histories and obstetrical examinations were undertaken, neonatal outcomes were analysed using SPSS software.The incidence of preterm birth was 27.5%, categorized into late preterm (19.75%), moderate preterm (3.75%), very preterm ( 10%) and extremely preterm (1.5%).More commonly observed in women who were underweight(34.54%) compared to women who were overweight (9.08%). More commonly observed in unbooked  cases (76.36%) when compared to booked cases(23.63%). Neonates delivered preterm had significantly lower Apgar scores at 1 and 5 minutes compared to term babies. Maternal risk factors included anemia, hypertensive disorders of pregnancy, PPROM and UTI. Poor neonatal outcomes, such as low birth weight, low APGAR scores, IUGR, respiratory morbidity were observed.

Syphilis is a treponemal infection which is a major public health issue. This can be tested serologically by syphilis rapid diagnostic test (RDT) which can be easily used in remote areas to evaluate syphilis. However single test is insufficient to diagnose syphilis .This study aims to assess the diagnostic value of syphilis rapid diagnostic test (RDT) in diagnosing syphilis and to evaluate the efficacy of Treponema pallidum Haemagglutination Assay (TPHA) and Flourescent  Treponemal Antibody-Absorption Test to confirm the diagnosis of Syphilis. The Study was conducted in (Sexually transmitted diseases) STD Outpatient department, at a Tertiary Care Hospital, Hyderabad from 05 Feb 2024 to 12 January 2025.

Background: Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of morbidity and mortality globally. Serum lipid profiles play a crucial role in ASCVD risk assessment, but the predictive value of traditional and non-traditional lipid markers requires further investigation. Objectives: This study aims to determine the relationship between serum lipid profiles (total cholesterol, LDL-C, HDL-C, triglycerides) and ASCVD risk. Secondary objectives include analyzing lipid ratios (TC/HDL-C, LDL-C/HDL-C) as predictors, evaluating the role of non-traditional lipid markers, and identifying demographic and lifestyle factors influencing lipid profiles and ASCVD risk. Methods: This observational study included 100 adults (30–70 years) without pre-existing ASCVD, recruited from a single-center healthcare facility. Baseline demographic, lifestyle, and biochemical parameters were recorded. Lipid profiles, lipoprotein(a), apolipoproteins, fasting glucose, and HbA1c were assessed. Participants were followed for six weeks to monitor incident ASCVD events. Data were analyzed using SPSS and R software, with logistic regression applied for risk assessment. Results: The mean ASCVD risk score was 10.3 ± 4.7%. Elevated LDL-C (132.5 ± 21.6 mg/dL) and unfavorable lipid ratios correlated with higher ASCVD risk. Incident ASCVD events occurred in 15% of participants, including myocardial infarction (7%), stroke (4%), and peripheral arterial disease (4%). Lipoprotein(a) and apolipoproteins showed potential value in risk stratification. Conclusion: Dyslipidemia and unfavorable lipid ratios significantly predict ASCVD risk. Non-traditional lipid markers may enhance risk assessment. Routine lipid monitoring and targeted interventions are essential for early prevention.

Background: Cervical cancer remains a leading cause of cancer-related morbidity and mortality among women globally, with early detection playing a key role in reducing its impact. The current study evaluates the diagnostic accuracy of Pap smear and colposcopy in detecting cervical lesions, compared with histopathology as the gold standard. Objectives: To correlate Pap smear and colposcopic findings with histopathological diagnosis in patients with unhealthy cervix, and to assess the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of both screening methods. Methods: This prospective observational study was conducted from December 2019 to September 2021, involving 100 women with abnormal cervical findings attending the Obstetrics and Gynaecology department of KIMS, Amalapuram. Participants underwent Pap smear and colposcopy, followed by colposcopy-directed biopsy for histopathological examination. Data analysis included calculation of diagnostic performance metrics. Results: Among the study participants, 58% were in the 40–49 years age group, with the majority having studied up to 10th grade (38%). Most women (71%) attained menarche between 12–13 years. The sensitivity and specificity of Pap smear and colposcopy were found to be significantly correlated with histopathological findings, with a higher detection rate for CIN in women with prolonged marital duration and lower socio-economic status. The study found that Pap smear and colposcopy, when combined, offer enhanced diagnostic performance. Conclusion: Pap smear and colposcopy are reliable methods for the early detection of cervical lesions, with histopathology confirming their diagnostic accuracy. This study highlights the need for routine screening, particularly among high-risk groups, to reduce the incidence of cervical cancer.

Background: Cardiovascular diseases (CVDs) are among the leading causes of mortality worldwide, with a significant burden in rural areas due to limited healthcare access and awareness. Poor oral health has been linked to an increased risk of CVDs, highlighting the importance of dental care in managing cardiovascular conditions. This study aims to assess the prevalence of dental treatment in individuals with CVDs residing in rural areas of the Varanasi district and to evaluate the correlation between oral health and cardiovascular conditions. Materials and Methods: A cross-sectional study was conducted among 500 individuals diagnosed with cardiovascular diseases in rural areas of Varanasi. Participants were selected using a stratified random sampling method. Clinical oral examinations were performed to assess periodontal status, dental caries, and treatment needs. Data on sociodemographic factors, medical history, and oral health behavior were collected through structured questionnaires. The association between oral health status and cardiovascular conditions was analyzed using chi-square tests and logistic regression models. Results: Out of 500 participants, 65% exhibited poor oral hygiene, 42% had moderate to severe periodontitis, and 30% had untreated dental caries. Only 25% had undergone professional dental treatment in the past year. A significant association was observed between periodontitis and CVD severity (p < 0.05). Awareness regarding oral health and its link to cardiovascular disease was low among 70% of the participants. Logistic regression analysis indicated that individuals with severe periodontitis had a 2.5 times higher risk of worsening cardiovascular conditions compared to those with good oral hygiene. Conclusion: The study highlights a high prevalence of untreated dental conditions among individuals with CVDs in rural areas of Varanasi. The findings emphasize the need for integrating oral health promotion into cardiovascular disease management programs. Increasing awareness, improving accessibility to dental care, and implementing preventive strategies can help reduce the oral health burden in this vulnerable population.

Background: This study aimed to evaluate the effectiveness of a low dose of hyperbaric ropivacaine administered with and without fentanyl via intrathecal injection in elderly patients undergoing mesh hernioplasty. Method: Eighty patients were randomly assigned to two groups of 40. Group RP received 2ml of 15mg hyperbaric Ropivacaine (0.75%) combined with 0.2ml normal saline (total volume of 2.2ml), while Group RF received 2ml of 15mg hyperbaric Ropivacaine (0.75%)  with 10ug of fentanyl (also total 2.2ml), both administered intrathecally. The onset, duration, quality of sensory-motor block, and any side effects were recorded for both groups. Results: The onset of sensory-motor block was significantly early in the RF group compared to the RS group (p<0.05). In terms of peak sensory dermatome level, 80% of patients in the RF group reached T8, compared to 65% in the RS group. Additionally, the duration of sensory-motor block was significantly longer with prolonged postoperative analgesia in the RF group (p<0.05), with better overall anesthesia quality reported. Both groups maintained hemodynamic stability with no difference in side effect between both group. Conclusion: The findings of our study strongly support the use of a low dose of hyperbaric ropivacaine combined with fentanyl for spinal anesthesia in elderly patients undergoing mesh hernioplasty. This combination offers rapid onset, superior quality of anesthesia, and a lack of side effects, reinforcing its effectiveness in elderly patients.

Introduction: Sex determination of unknown skeletal remains come across in forensic or archeological situations, is one of the prime tasks of experts like forensic anthropologists and bioarcheologists involved in such examinations. In a study carried out on morphometric studies of x-rays of the sternum, sex determination of a sufficient certainty was possible using measurement of length and breadth obtained from x-rays of the human sternum if a wide range of dispersion is given. The given relations and formula are valid only when measuring the sternum of adults.  Method: This study has been conducted on the total 100 subjects, 50 male (02-15 yrs) and 50 female (02-15 yrs) of healthy living children from general population of north India as well as in and around the Lucknow of Uttar Pradesh. Result: The inter correlation between variables in 02-15 yrs is summarized in Table 3 and 4. Pearson correlation analysis showed a significant and negative (inverse) correlation of length of manubrium with BMI (r=-0.32, p<0.05), length of mesosternum with age (r=-0.30, p<0.05) and height (r=-0.31, p<0.05), and length of sternum with age (r=-0.42, p<0.01). On the basis of observation and result in my present study it was fully supported and agree of the previous researchers,  who has done the work in measurement of sternum bone in cadaver and skeletal of human, because they told that the sterna has distinguish in different zone of India, as well as it is shorter than European country. Conclusion: The significant and negative correlation was found between length of manubrium and length of mesosternum while a significant and positive correlation between length of mesosternum and length of sternum respectively.

Background: HIV/AIDS has still maintained its 21st century risk. The overall rate of new HIV infections continues to decline in several countries especially the developing countries. The aim of this study was to identify the degree of HN manifestation in HIV-infected patients based on age, gender and CD4 count at a tertiary hospital in India. Materials and Methods:This was a descriptive cross-sectional study conducted at a tertiary hospital inIndia involving HIV-infected patients who attended HIV clinics from July 2022 to January 2023. Convenient sampling was employed to get study participants, and 400 patients were recruited in the study. Data were collected through a questionnaire from patients, and results were analyzed using SPSS version 20. Results: 136 (34%) of 200 HIV-infected patients had ENT manifestations. The most affected age group was 0–9 years. ENT manifestations were more prevalent in females (23.5%) than in males (10.5%). Those with CD4 count less than 200cells/µL also it was a high prevalence (56.3%). Conclusion:This study observed that one-third of the studied HIV population had ENT manifestations. All medical practitioners should be aware of ENT manifestations in HIV-infected patients in order to assure early and appropriate intervention.

Background: Children from tribal communities face unique socio-cultural and environmental challenges that can significantly impact their emotional and behavioral well-being. Limited access to healthcare, poverty, and parental substance use contribute to increased psychological distress in these populations. Despite the growing recognition of childhood mental health concerns, there is a lack of studies assessing emotional and behavioral issues in tribal children using validated screening tools like the Pediatric Symptom Checklist-17 (PSC-17). Objectives: This study aimed to evaluate the prevalence of emotional, behavioral, and attention problems among tribal children using the PSC-17. Additionally, it sought to identify socio-demographic factors associated with these psychosocial problems to inform appropriate intervention strategies.Methods: A cross-sectional observational study was conducted in the tribal communities of Chamarajanagar District between May 2023 and December 2024. A total of 146 children aged 4 to 17 years were assessed using the PSC-17, a parent-reported screening tool. Sociodemographic data, including parental education, socioeconomic status, and parental substance use, were collected. Statistical analysis was performed using SPSS, with chi-square tests applied to examine associations between socio-demographic factors and psychosocial issues. Results: Emotional problems were observed in 2.7% of children, behavioral problems in 2.1%, and attention problems in 4.8%. Paternal alcoholism and substance abuse were significantly associated with emotional (p < 0.001) and behavioral problems (p = 0.002). Attention problems were significantly associated with male gender (p = 0.011). Other socio-demographic factors, including socioeconomic status and family structure, were not significantly associated with emotional or behavioral issues. Conclusion: The study highlights the influence of parental substance use on emotional and behavioral difficulties in tribal children. Attention problems were more prevalent in males, reinforcing gender-based differences in mental health concerns. Early identification and intervention programs, particularly targeting families affected by substance abuse, are essential for promoting child mental health in tribal communities.

Background: This study investigates the impact of water, sanitation, and hygiene (WASH) practices on stunting in children aged 6 months to five years. In India, the burden of stunting is compounded by the widespread prevalence of poor WASH practices. According to NFHS-5, only 58.6% of households have access to improved sanitation facilities, and 49.8% practice safe disposal of child feces. Furthermore, handwashing with soap and water is practiced by only 60.6% of households, highlighting significant gaps in hygiene behaviors. These deficiencies are particularly pronounced in rural areas and among marginalized populations, where access to basic WASH infrastructure is often limited. Material and Methods: The study was conducted over 12 months in the outpatient department of pediatrics at a tertiary care hospital in India. A total of 230 children aged 6 months to five years and their caregivers participated. Data collection involved structured questionnaires on household water sources, sanitation facilities, hand hygiene practices, and caregiver knowledge of gastrointestinal diseases. Anthropometric measurements, including height and weight, were taken using standard procedures, and z-scores were calculated using WHO AnthroPlus software. Results: Key findings indicate that children from households with inadequate WASH practices exhibited higher rates of stunting. Significant associations were found between caregiver hand hygiene, toilet type, and knowledge of gastrointestinal diseases with stunting outcomes. Conclusion: The study highlights the need for targeted public health interventions to improve WASH practices, promoting better child growth outcomes.