European Journal of Cardiovascular Medicine

Background: Adenoid cystic carcinoma is a rare epithelial tumor of Salivary glands and comprises about 1% of all malignant tumors of the head and neck region. They are commonly detected in the major salivary gland, oral cavity, pharynx, and paranasal sinus where it presents as a slow growing firm nodular mass. The aim of this case is to highlight the unique presentation of adenoid cystic carcinoma as a large ulceroproliferative mass over the cheek.

Background: The mandibular canal (MC) and mental foramen (MF) are critical anatomical landmarks of the mandible that house the inferior alveolar neurovascular bundle. Accurate identification of their morphology, position, and course is essential for safe dental and maxillofacial surgical procedures. Variations in these structures have been documented across populations, necessitating region-specific morphometric data.  Aim: To evaluate the morphology, course, length, and positional variations of the mandibular canal and mental foramen in the South Indian population of Telangana using digital orthopantomograms (OPGs). Materials and Methods A retrospective cross-sectional radiographic study was conducted using 400 high-quality digital OPGs collected from a private diagnostic center in Telangana. Subjects aged 20–75 years were divided into two age groups: Group A (20–40 years) and Group B (41–75 years). Measurements were performed using E-Soft Dent 2.0 software. Statistical analysis was done using SPSS version 26.0. Descriptive statistics, Kolmogorov–Smirnov test, Mann–Whitney U test, and Chi-square test were applied. Results The majority of mental foramina evaluated belonged to Group A (20–40 years) constituting 54.5% of the study population, whereas Group B (41–75 years) accounted for 45.5%. Out of 400 mental foramina evaluated, 203 (50.7%) were from males and 197 (49.3%) were from females. On the right side, the mental foramen was predominantly round in shape (98.5%), while only 1.5% were oval. On the left side, the mental foramen was predominantly round (98.5%), with only 1.5% presenting an oval shape. The mental foramen was predominantly round in shape on both right and left sides (98.5%), while only 1.5% were oval. No significant side-wise variation was observed. Conclusion

The study highlights significant age-related and morphological variations in the mandibular canal and mental foramen. Accurate localization is crucial to prevent neurovascular injury during dental procedures. Population-specific anatomical data enhances surgical safety and implant planning in the Telangana region.

Introduction: Sepsis is a life-threatening condition with high morbidity and mortality, requiring early identification of patients at risk of poor outcomes. Red cell distribution width (RDW), a routinely measured hematological parameter, has emerged as a potential prognostic marker in critical illnesses.  Aim: This study aims to evaluate the association between RDW levels and clinical outcomes in patients with sepsis admitted to a tertiary care center in Eastern India. Materials and Methods: This is a retrospective study conducted at Nalanda Medical College and Hospital, Patna, Bihar, over a duration of nine months from 1st February 2025 to 31st October 2025. The study will include 200 adult patients (≥18 years) diagnosed with sepsis and admitted during this period. Patients with hematological disorders, chronic liver disease, malignancy, or recent blood transfusions will be excluded. Relevant data, including demographics, RDW at admission, comorbidities, and clinical outcomes, will be collected retrospectively from hospital records. Results: Among 200 sepsis patients, those with RDW >14% had significantly worse outcomes compared to patients with RDW ≤14%. Elevated RDW was associated with older age, longer ICU stay, higher need for mechanical ventilation, and increased in-hospital mortality (p < 0.001). Laboratory parameters showed higher WBC counts and serum creatinine with lower haemoglobin levels in the high-RDW group. On multivariate analysis, RDW >14% emerged as an independent predictor of mortality. Conclusion: RDW, an inexpensive and readily available laboratory parameter, may serve as a valuable prognostic marker in sepsis. Early identification of patients with elevated RDW could aid in risk stratification and guide timely interventions. Further prospective studies are warranted to validate these findings and explore the underlying pathophysiological mechanisms.

Background: Post-operative pain and post-anaesthetic shivering are the major concerns during the post-operative period. Post-operative pain management is of utmost importance as it prevents patient discomfort, anxiety, prolonged hospital stay. 2-10% of the acute post-operative pain if not treated adequately will go into chronic post-surgical pain. Shivering is a common complication of regional anesthesia due to impaired thermoregulation which in turn leads to increase in oxygen consumption, arterial hypoxemia, and lactic acidosis and is specifically detrimental in cardiac patients. Methodology: A randomized prospective single-blind case-control study with the objective to compare the incidence of post-anesthetic shivering with the use of magnesium sulfate in both groups and also to compare the effectiveness of magnesium sulfate in reducing postoperative pain for 24 hours. The study was conducted with sample size of 350, patients were randomized by chit selection method, all even numbers taken into study group and odd numbers into control group. Group M (n=175) received magnesium sulfate as an infusion, and Group S(n=175) received normal saline as an infusion. ASA grade1 patients undergoing lower abdominal and lower limb surgery under subarachnoid block, age group of 20-60years were included. Patients with severe cardiovascular and musculoskeletal disorders, history of any drug allergy, Bradyarrhythmia, those on calcium channel blockers and with renal disease were excluded. Infusion of magnesium sulfate was started intra operatively and was continued for total 6 hours. Shivering and pain score was assessed post operatively at 2nd, 4th,6th,12th,18th and 24th hour respectively. The observations were tabulated, results derived and thus concluded that low dose infusion of magnesium sulfate helps in prolonging the duration of analgesia also decreases the incidence of post anesthetic shivering in patients undergoing surgeries under spinal anesthesia. RESULTS- In the magnesium group, requirement of analgesics were reduced and the incidence of shivering was also comparatively lesser than those patients among the control group. CONCLUSION- Magnesium sulfate when given as a low dose infusion intraoperatively and immediate post-operative period is effective in decreasing the requirement of analgesics also incidence and severity of post-anesthetic shivering.

Background: Acute Coronary Syndrome (ACS) is a group of heart conditions caused by a sudden decrease in blood flow to the heart muscle. Although ACS was once mainly seen in older adults, more young people (aged 40 and under) are now being affected. This trend is linked to modern lifestyle changes and a growing number of risk factors like smoking, obesity, and unhealthy cholesterol levels. Objectives: This study aimed to investigate the risk factors, clinical characteristics, and laboratory parameters associated with ACS in patients aged less than 40 years. Methods: Researchers followed 61 patients under 40 years old who were diagnosed with ACS at Aakash Healthcare Super Speciality Hospital, New Delhi, between February 2024 and October 2025. The team collected and analyzed information about each patient’s medical history, risk factors, lab tests, ECG results, and heart scans. Results: The mean age of the study population was 35.00 ± 4.36 years, with a strong male predominance (81.97%). ST-Elevation Myocardial Infarction (STEMI) was the most common presentation (80.33%), with Anterior Wall MI (AWMI) being the most frequent ECG finding (59.18%). Smoking was the leading risk factor (55.74%), followed by dyslipidemia (52.46%). Multiple risk factors were present in 68.85% of patients. Angiographic patterns predominantly showed single-vessel disease. Conclusion: ACS in young adults is characterized by a high prevalence of modifiable risk factors, particularly smoking and dyslipidemia. The presentation is predominantly STEMI with significant myocardial dysfunction. Early risk stratification and aggressive lifestyle management are crucial for this demographic