European Journal of Cardiovascular Medicine

Background: Statin intolerance is an important cause of inadequate lipid-lowering therapy and premature treatment discontinuation. Reported prevalence varies widely because definitions, symptom ascertainment, and diagnostic confirmation differ substantially between studies. Objective: To determine the incidence of confirmed statin intolerance, compare estimates obtained using different operational definitions, examine associations with statin type and intensity, and identify independent predictors of intolerance. Materials and Methods: This prospective observational longitudinal cohort study included 500 statin-naïve adults with an established indication for lipid-lowering therapy at a tertiary care centre. Participants were followed for 12 months using structured clinical assessment and laboratory monitoring. Suspected intolerance was evaluated by symptom characterization, creatine kinase and hepatic testing, exclusion of secondary causes, dechallenge, and rechallenge where appropriate. Statin intolerance was classified according to National Lipid Association (NLA), International Lipid Expert Panel (ILEP), European Atherosclerosis Society (EAS), and Luso-Latin American Consortium/Canadian Consensus Working Group (LLAC/CCWG) criteria. Multivariable logistic regression was used to identify predictors of confirmed intolerance. Results: Of 500 enrolled participants, 462 completed follow-up. Ninety-seven participants (21.0%) reported at least one suspected statin-related adverse effect, whereas 48 met the NLA definition of confirmed intolerance, giving a cumulative incidence of 10.4% (95% CI 7.9–13.5). Estimates varied from 8.0% with LLAC/CCWG criteria to 11.3% with ILEP criteria. Complete intolerance occurred in 3.7% and partial intolerance in 6.7%. Intolerance was more frequent with high-intensity therapy than moderate-intensity therapy (14.8% vs 7.9%; p=0.002). Concomitant CYP3A4-interacting medication was associated with an intolerance rate of 21.1% compared with 8.9% in its absence (p=0.003). Independent predictors included prior exposure to negative information regarding statins (adjusted OR 3.04), CYP3A4-interacting medication (aOR 2.76), vitamin D deficiency (aOR 2.41), high-intensity statin therapy (aOR 2.18), age ≥65 years (aOR 1.94), and female sex (aOR 1.87). Conclusion: Approximately one in ten statin-naïve patients developed confirmed statin intolerance, substantially fewer than the proportion reporting suspected adverse effects. Diagnostic definition materially altered the estimated frequency. Several predictors were potentially modifiable, supporting systematic evaluation before permanent statin discontinuation

Introduction: Lymphadenopathy is a common clinical presentation with etiologies ranging from benign reactive conditions and infections to malignant neoplasms. Fine needle aspiration cytology (FNAC) is a rapid, minimally invasive, and cost-effective diagnostic technique that serves as the initial investigation for superficial lymph node enlargement. This study aimed to evaluate the cytomorphological spectrum of lymph node lesions diagnosed by FNAC in a tertiary care hospital. Methods: A retrospective observational study was conducted in the Department of Pathology, ESIC Medical College and Hospital, Namkum, Ranchi, from January 2024 to January 2026. Ninety-six patients with palpable superficial lymphadenopathy underwent FNAC using a 22–23-gauge needle. Smears were stained with May–Grünwald–Giemsa, Giemsa, and Papanicolaou stains. Ziehl–Neelsen staining was performed when tuberculosis was suspected. Cytological diagnoses and demographic data were analyzed using descriptive statistics. Results: The study included 96 patients aged 5–85 years, with the majority (67.7%) belonging to the 20–39-year age group. Males predominated (62.5%), with a male-to-female ratio of 1.7:1. Inflammatory lesions constituted 94.8% of cases, while neoplastic lesions accounted for 3.1%, and 2.1% were nonspecific. Reactive lymphadenitis was the most common diagnosis (67.7%), followed by acute suppurative lymphadenitis (12.5%) and granulomatous lymphadenitis, including tuberculosis (10.4%). Metastatic malignancy was identified in 3.1% of cases. Conclusion: FNAC is a reliable, safe, and economical first-line diagnostic modality for evaluating superficial lymphadenopathy. It effectively differentiates inflammatory from neoplastic lesions, enables early therapeutic intervention, and reduces the need for unnecessary surgical biopsy, making it particularly valuable in resource-limited healthcare settings.

INTRODUCTION: Neonatal septicemia is a systemic critical life challenging disease caused by bacterial, viral or fungal origin, manifesting with clinical features related to hemodynamic changes and responsible for severe morbidity and mortality. The prevalence of multidrug resistance (MDR) is increasing day by day poses significant challenges to clinicians. The aim of this study was to know the gram negative bacteria responsible for neonatal infections in this region and its antibiotic sensitivity pattern. MATERIALS AND METHODS: Neonates less than 28 days of life suspected to have sepsis were selected in this Cross sectional observational study. All blood cultures were inoculated into blood culture bottles, loaded in automated method - BACT/ALERT 3D culture system (BioMerieux). Processing and identification of the colonies was done as per the standard guidelines. Antibiotic susceptibility testing of all isolates was done by Vitek2 compact system.  RESULTS: The total number of microorganisms isolated in the blood cultures was as Staphylococcus aureus (9%), Coagulase Negative Staphylococci (27.9%), Enterococcus faecium (9%), Escherichia coli (4.6%), Klebsiella pneumoniae (4.6%), Klebsiella aerogenes (4.6%), Pseudomonas aeruginosa (9%), Acinetobacter baumanii (9%), Serratia marcescens (4.6%), Candida albicans (4.6%), Non albicans Candida (13.7%). All the gram negative isolates of Neonatal sepsis were sensitive to penems, cotrimoxazole and resistant to remaining antibiotics. CONCLUSION: A scrupulous monitoring and implementation of infection control practices, antibiogram and epidemiology of the health care system definitely reduce this burden on community.

Background: Ebstein anomaly is a rare congenital cardiac malformation with an estimated prevalence of 1 in 200,000 live births, accounting for less than 1% of all congenital heart diseases. It is characterized by apical displacement of the tricuspid valve leaflets — particularly the septal and posterior leaflets — into the right ventricle, resulting in "atrialization" of a portion of the right ventricle. This anatomical derangement leads to varying degrees of tricuspid regurgitation, right atrial dilatation, right ventricular dysfunction, and a spectrum of arrhythmias. While classically presenting with cyanosis in neonates due to right-to-left shunting through a patent foramen ovale or atrial septal defect, the clinical phenotype in adults is considerably more heterogeneous. Adult presentations may range from incidental discovery on echocardiography to debilitating exertional dyspnea, palpitations, or frank right heart failure. The diagnosis of Ebstein anomaly in a 70-year-old individual represents an exceptionally unusual occurrence, underscoring the wide variability in disease severity and the capacity of milder forms to remain undetected for decades.

Introduction: Depression and perceived stress are common but frequently under-recognized mental health concerns among elderly individuals. Community-level assessment is essential for identifying vulnerable older adults and planning early supportive interventions. Objectives: To estimate the prevalence of depression and perceived stress among elderly individuals in a community setting and to assess the relationship between depression, perceived stress and selected socio-demographic and clinical variables. Methods: This community-based cross-sectional study was conducted among 100 elderly individuals aged 60 years and above from the Sangareddy population between November 2025 and March 2026. Socio-demographic details, living arrangement, marital status, education and chronic illness history were recorded using a structured proforma. Depression was assessed using the Geriatric Depression Scale and perceived stress was assessed using the Perceived Stress Scale. Data were analysed using descriptive statistics and chi-square test, with statistical significance considered at p < 0.05. Results: The mean age of the study population was 70.4 ± 7.1 years, and females constituted 52.0%. Depressive symptoms were present in 46.0% of participants. Mild depression was observed in 28.0%, moderate depression in 14.0% and severe depression in 4.0%. Moderate perceived stress was reported by 52.0%, while 25.0% had high perceived stress. Depression was significantly associated with advanced age, living alone, widowed/single/separated status, chronic illness and higher perceived stress. Conclusion: Depression and perceived stress were common among elderly individuals in this community setting. Screening older adults for psychological distress, especially those living alone or having chronic illness, can strengthen early identification and community-based mental health support.