Background: Despite being one of the most useful therapeutic agents for a dermatologist, the topical corticosteroids continue to be used inappropriately as “fairness or cosmetic” creams. Also, there is a major lack of adequate knowledge about the possible adverse effects and the phenomenon of steroid addiction among a great portion of the Indian population. The adverse effects are mainly attributed to the impact on the biophysical profile of the skin due to their prolonged use. TEWL, skin hydration and skin pH are most affected parameters. Objective:To study the biophysical profile of the patients of topical corticosteroid abuse, and compare the same with age and sex matched controls and study their clinical implications. Methods: A case control study was carried out at our tertiary center for a period of 6 months.160 cases of topical corticosteroid abuse and 160 age and sex matched controls were evaluated for TEWL, skin hydration and skin pH by using tewameter, corneometer and pH meter respectively. The findings were compared and p value was determined. Results:107 patients in the case group, showed abnormal TEWL, whereas in the control group, 11 patients showed abnormal TEWL values. Abnormal hydration of the stratum corneum was seen in 100 patients in the case group, whereas in the control group, 21 patients showed abnormal hydration of the skin. Abnormal pH was seen in 140 patients in the case group, whereas in the control group, 47 patients showed abnormal pH value. The p value was significant in all our findings (<0.05). Conclusions: Long term application of topical corticosteroids has significant effects on the biophysical parameters of skin such as TEWL, hydration and pH.

Strongyloides stercoralis is a unique parasite. It can complete its life cycle entirely within the human host and set up autoinfection cycle. As long as there is an intact immune system, the host can control the parasitic burden, and the organism may persist for years. When cell-mediated immunity becomes impaired, the parasite burden will grow, disseminate, and cause hyper infection. We report a case of pulmonary strongyloidiasis in a Chronic obstructive pulmonary disease patient who presented with acute exacerbation of breathlessness and productive cough. Sputum cytology and stool wet smears showed Strongyloides stercoralis larvae. Clinical improvement was achieved with Albendazole and Ivermectin treatment. This case emphasizes the importance of maintaining a high index of suspicion for the diagnosis of pulmonary strongyloidiasis in non endemic areas and also the possibility of presentation even without peripheral blood eosinophilia.

Background: Jaundice in pregnancy is an important medical disorder, commonly seen in developing countries like India . The objective of the study is to evaluate the causes leading to jaundice in pregnancy and to analyse the feto maternal outcome in patients with jaundice in pregnancy. Methods: This is an prospective observational study over a period of 1 year, conducted in the Department of Obstetrics and Gynaecology , KGH , Vizag. Antenatal patients who presented with Jaundice were included in this study. Results: Total of 82 cases . Majority of patients were of age group 20 – 25 years . Max no. of cases were primi gravida . most common cause was pre eclampsia . 52.4% patients improved and discharged. Vaginal deliveries – 56.1% . Most common reason for maternal mortality in this study was Hepatic Encephalopathy

Background: Patients  presenting with clinical and radiological features  suggestive of pleural  effusion will have to be managed by diagnostic and therapeutic aspirations . Underlying pleural effusion is either exudative or transudative which is determined by light’s criteria. Our study is meant to see the effectiveness of simple and rapid bed side diagnostic test that is H2O2 test in the place of light’s criteria.

AIMS: Bed side Hydrogen peroxide test to differentiate exudative and transdudative  pleural effusion.

Objectives: 1) To differentiate between exudate and trasudate pleural effusion through this simple bed side H2O2 test.

2) To compare the hydrogen peroxide test of pleural fluid to that of standard analysis as per light’s criteria.

Materials &Methods: This is a prospective observational study carried out in a tertiary care hospital from December 2023-April 2024.A total of 96 patients presenting with clinical and radiological features of pleural effusion who met the eligibility criteria are included in the study were subjected to routine diagnostic workup ,chest imaging, pleural fluid analysis and rapid H2O2 test of pleural fluid.

Result: There were 96 patients who had pleural effusion,of them  32 patients had nil or minimal reaction indicating transudative  pleural effusion while 64 patients had bubbling reaction indicating of exudative pleural effusion based on drop hydrogen peroxide test.  Pleural fluid analysis based on light’s criteria showed 21 patients as  transudative pleural effusion while 75 patients had exudative pleural effusion based on Light’s criteria .Sensitivity of A drop Hydrogen peroxide test was 81.3%, Specificity was 85.74%, Positive Predictive Value(PPV) was 95.3%.Negative Predictive Value (NPV) was 56.25% .  The diagnostic accuracy of A Drop hydrogen peroxide test in our study is 82.29% to differentiate the nature of pleural fluid into exudative and transudative.

Conclusion: This bedside test allows for more rapid determination of the nature of pleural effusions as an exudate or transudate  and can be used as a screening test while waiting for results through light’s criteria.Further reaserch have to be done to know the validity of this bed side test.

Background: Type 2 Diabetes Mellitus (T2DM) is a prevalent metabolic disorder associated with significant cardiovascular risk, partly due to dyslipidemia. Dyslipidemia, characterized by abnormal lipid levels, is a common complication in T2DM patients and can contribute to the development of cardiovascular and cerebrovascular diseases. Aim & Objective: To determine the prevalence of dyslipidemia in newly diagnosed type 2 diabetes mellitus patients. Methodology: This cross-sectional study included 140 patients with newly diagnosed T2DM. Lipid profiles were measured, including total cholesterol, LDL-C, HDL-C, and triglycerides. Glycemic control was assessed via HbA1c levels. Demographic data such as age, gender, and Body Mass Index (BMI) categories were recorded. The prevalence of dyslipidemia and its association with these factors were analyzed using appropriate statistical tests. Results: The study found that 71.40% of patients had dyslipidemia. Elevated triglycerides were present in 57.10% of patients, low HDL-C in 50%, elevated LDL-C in 42.90%, and elevated total cholesterol in 35.70%. Dyslipidemia was more prevalent in males (78.6%) compared to females (64.3%) and increased with age and higher BMI. Poor glycemic control (HbA1c ≥ 7%) was significantly associated with a higher prevalence of dyslipidemia (80% vs. 50% with HbA1c < 7%, p=0.02). Conclusion: The study highlights a high prevalence of dyslipidemia among newly diagnosed T2DM patients, particularly in males, older individuals, those who are overweight or obese, and those with poor glycemic control. These findings underscore the need for integrated management strategies to address both glycemic and lipid abnormalities to improve cardiovascular health in T2DM patients. Routine monitoring of blood glucose and lipid profiles is essential for early detection and intervention

The study was conductedto assess theeffectiveness of Self Instructional Module (SIM) on knowledge and skill regarding prevention ofHIV/AIDS amongGeneral Nursing and Midwifery students of Ancillary Medical Training School ,Shireenbagh, Kashmir.Methodology:-Aquantitativeapproachwithpre-experimentalonegrouppre-test post-test design was used to conduct the study. Sample comprised60General Nursing and Midwiferyfulfilling the Inclusion criteria by using simple random sampling technique.Data was collected using structured questionnaireto assess the knowledge regarding prevention of HIV/AIDS and Observational checklist to assess skill onPersonal protective equipments. Pre-test was conducted to assess the existing knowledge and skill of the study subjects by structured Questionnaire and observational checklist followed bySelf Instructional Module (SIM)and demonstration .Post test was conducted on 7th day by using same structured. Questionnaire and observational checklist. The data collected were analysed by descriptive & inferential statistics. Results:Out of 60 subjects majority(78.3%) were in theage group of above 20 years , (66.7%)werefromrural area,38 .(63.3%)were from nuclear family, (40.0%)were secondary parental education.Overallmean post-test knowledge score (28.38±3.46) was greater than mean pre-test knowledge score of studysubjects (14.63±4.17).Mean difference of 13.75at (p value <0.001)which indicates a there is significant difference between pre-test and post– test mean knowledge scores and Overallmean post-test skillscores (18.15±1.97) wasgreaterthanmeanpre-testskillscoresofsubjects(6.52±2.51).Meandifferenceof 11.63at(pvalue<0.001)whichindicatesathereissignificant differencebetweenpre- test and post–test mean skill scores. There was no significant associationbetweenpre- test knowledgeandskill scoreswiththeirdemographicvariables(age, ,habitat,Type of family , education of parents).Conclusion:The study showed that there was a significant improvement in the knowledge scores after the administration of Self Instructional Module (SIM) and demonstration.Hence it can be concluded that the Self Instructional Module (SIM) and demonstration was effective in improving the knowledge and skillof General Nursing and Midwifery studentsregarding prevention ofHIV/AIDS.

Aim: The aim of this study was to examine the frequency of lung cancers presenting with misleading chest X-rays in primary care. Background: Lung cancer is a common cause of cancer death. Misleading chest x rays are resulting in delay in the diagnosis and thereby increasing the mortality. Early diagnosis can help in curative treatment and thereby decreasing the mortality rate. Design of study and setting: this study is a prospective study. It is carried out in 52 lung cancer patients, who were diagnosed in the department of pulmonary medicine between june2012 to august 2014. Method: All diagnosed cases of lung cancer patients in MIMS medical college were included in the study. Chest X-rays and radiologist reports of the patient’s were analyzed. Chest X-rays were categorized into two groups depending on the primary care physician’s notes and radiologist’s report: abnormal but no malignancy suspected (unsuspected malignancy cases); or abnormal with possible malignancy. Results: Of the 52 patients, in 30 patients chest x ray presentation was atypical, not suggestive of malignancy. 22 cases presented with typical radiological features of malignancy. Pneumonia (n=9, 17.3%) was the most common misdiagnosis of lung cancer followed by Collapse (n=7), Pleural effusion (n=6), Lymphadenopathy (n=3), Lung abscess/Cavitation (n=5). Conclusion: Chest X-rays of more than half of malignancy cases are negative. Further investigation is warranted with continuing or changing symptoms, even if the X-ray is not suggestive of malignancy.

Tuberculosis(TB) of tonsils is an extremely rare variety of extra pulmonary TB (EPTB) frequently simulating tonsillar malignancy especially in the elderly. Chronic or recurrent tonsillitis with enlarged tonsils and sore throat is usually the main clinical presentation especially in children ( Das A et al 2015),(Chang J et al 2019),(Moisa SM et al 2021). Histological diagnosis is mandatory for diagnosis . Anti-tuberculous chemotherapy is adequate for its complete resolution. Here we report a rare case of primary tonsillar TB with solitary posterior auricular lymphadenopathy with histopathologic diagnosis made after tonsillectomy and excision biopsy. Patient was immunocompetent and thorough evaluation excluded pulmonary and systemic TB .

Background: Lung cancer is one of the most common cancer types worldwide. More than 70% of patients are diagnosed in advanced stages of disease, with options based on cytological and histopathological material.Objectives:1)To study the cytological features of lung malignancy by Broncho-alveolar lavage (BAL) and Imprint smears; 2) To compare cytological diagnosis with final histopathological diagnosis as gold standard; 3) To assess the sensitivity, specificity and accuracy of cytological diagnosis in detection of lung malignancy.Methods: The present study comprises of bronchoscopic cytology and histopathology of bronchial biopsy in 50 patients suspected of lung malignancies which were obtained between January 2022 to July 2023. Bronchial cytology was evaluated by Papanicolaou society of cytopathology (PSC) system for reporting respiratory cytology. Results:The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of bronchial cytology sample was was53.49%, 85.71% , 95.83%, 23.08% and 58.00%.Conclusions: Lung carcinomas are most common worldwide. Analysis of cytology samples provides rapid, safe and inexpensive method of diagnosis.

Introduction:According to the World Health Organization blindness is defined as "visual acuity of less than 3/60, or a corresponding visual field loss to less than 10 degree, in the better eye with the best possible correction" [1]. The National Program for Control of Blindness (NPCB) was renamed as National Program for Control of Blindness and Visual Impairment in 2017 also the definition of blindness was adopted in accordance with the definition that is used by the World Health Organization which is" presenting distance visual acuity less than 3/60 (20/400) in the better eye and limitation of field of vision to be less than 10 degree from centre of fixation” [3, 4]. WHO defines Quality of Life as "an individual’s perception of their position of life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns.” [4] From the patient's own perspective the impact of the disease or disability on their life helps give a holistic view of assessment of QoL. QoL can also provide decisionmaking in health care at the micro and macro [5]. Understanding the challenges faced by blind people on a regular basis in their lives from their own perspective and their own experiences is important to help orient and improverehabilitation services, health care services and governmentschemesthat are more responsive to the needs of the blindpersons in the community. Methodology: The present study was a cross-sectional, descriptive study conducted in non-governmental organizations that were working for the welfare and /or rehabilitation for the blind in Delhi. The study population consisted of blind residents, people with blindness who were employed at organizations and blind people receiving vocational training at organizations working for the welfare and /or rehabilitation for the blind. Findings: Out of total 215 participants, most of the participants were male. Majority of them were in the age group 18 - 25 years. Most of the participants were unmarried or single (79.1%) and (20.9%) of the participants were married. Most of the participants had received secondary education and very few them had received higher education. Most of them (79.1%) were unemployed and were receiving vocational training in order to get employed. Only 20.9% of the participants were employed /working. Most of the participants had below average income (52.6%), 3.2% had average income and the remaining (44.2%) had well below average income. The mean overall quality of life of the participants was 3.30 ±0.935. The quality of life of the male participants was significantly higher than the female participants. The quality of life of the participants who had congenital blindness was significantly higher than those participants who had acquired blindness. The quality of life was also higher among participants that had received higher education, and were employed /working. Conclusion:Low education, unemployment/not working and being unmarried was associated with poor quality of life. The quality of life was positive in the social domain, spiritual domain and the psychological domain. The physical domain score was low. The domain with low scores were level of independence and environment. Transport was a major obstacle in their view and most of them them felt that public transport was not friendly and needed to be improved. Therefore there is a need to focus on making public transport more user friendly and creating more job opportunities for the blind. Recommendations: Planning for providing services to blind should focus primarily ontransport, improvement in the range and quality of vocational training and skills provided for securing employment and creating more job opportunities as these were the areas which the blind people felt posed maximum hurdles in their lives. There is a need for more information, education and communication campaigns to provide more awareness and sensitization to the public regarding blindness so that there is ideally no or minimum possible stigma and more acceptance of blind persons. In the workplace, they should be sensitization so that there is more acceptance of people with disability like the blind.

Introduction: The COVID-19 pandemic has caused a global crisis both social and economic. In a country like India where already the nutritional status in young children is poor, Covid-19 can have a more adverse impact on the nutritional status of under 5 children .According The State of Food Security and Nutrition in the World, 2020’s report, 14 per cent of India’s population is undernourished and 34.7 per cent of the children aged under five in India are stunted. The report also states that 20 per cent of India’s children under the age of 5 suffer from wasting (their weight is too low for their height). According to NFHS-4 data children under 5 who are underweight (wt for age):28.1%, children under 5 who are stunted (ht for age):33.8% and children under 5 who are wasted (wt for ht):15.3%.COVID-19 pandemic poses risks on nutritional status of young children and there is concern of increase in child malnutrition, including wasting due to decline in household incomes, lockdown and interruption to health, nutrition services. The present study tried to find out the hidden impact of COVID-19 on children’s health and nutrition to find the current status of malnutrition in 3-5 year old children and to compare the current nutritional status of 3-5 year old children with pre- COVID-19 status.Methodology: The study was a cross -sectional descriptive study. It was conducted in Dausa district of Rajasthan. From theDistrict Household survey of Dausa, 5 Primary Health Centers were selected randomly and from each of the 5 PHC’s, 2Agawadis were randomly selected for the study. In each Aganwadi 10 children between 3-5 years were selected randomly so total of 100 children between the ages of 3- 5 years were chose for the study. The exclusion criteria consisted of those children who had any associated illness and those children whose parents did not give consent for the study were not toincluded in the study.Findings: The study found that proportion of underweight children increased from 32% to 41%, the proportion of Stunted increased from 39 to 42 and the proportion of wasted increased from 2% to 7%. Conclusion: By considering wt for age and ht forage, measurements of malnourished children were found nearly 40% were found below -2 SD. It was also found that, during COVID-19 period the nutritional status of children were deteriorated as compare to the previous year.Recommendations: Supply of ration should be increased from higher authority as per the target children. Amount of ration provided should be appropriate as per the age instead of equal quantity ...consider equality. Counsel parents to increase other sources of nutrients by Aaganwadi workers (AWWs.) and AWWs can do house to house check weekly and assess the dietary intake of children.

Introduction: The knowledge and practices for Anti Natal Checkup during pregnancy is a key indicator of Health care facility in a community. The study was conducted in a Tijara block of Alwar district, Rajasthan about Anti Natal Care among ASHAs and Pregnant females.Materials and Methods: The study was cross sectional study. Total 50 ASHAs and 105 pregnant females were studied about knowledge and practices during ante-natal care checkup.Result: It was found that knowledge regarding Ante-natal care was good among ASHAs, while it was poor among pregnant female. There was inadequate knowledge regarding JananiSurakshaYojana (Monetory benefit).

Introduction: The pericapsular nerve group block (PENG) is a versatile regional anaesthesia technique described in 2018, developed primarily in total hip arthroplasties (THA) for postoperative analgesia with motor sparing benefits. The block is thought to provide more complete analgesia to the hip by depositing local anaesthetic within the myofascial plane of the psoas muscle and superior pubic ramus. Objectives: To compare the efficacy of 0.25 % bupivacaine and 0.2% ropivacaine in Pericapsular nerve group block in positioning for Spinal Anaesthesia and also perioperative analgesia. Methodology: The present RCT was carried out in patients undergoing unilateral surgeries in and around the hip joint at Navodaya Medical College Hospital, Raichur from January 2021 and June 2022 with 2 groups, one group with 0.25 % bupivacaine and other group with 0.2% ropivacaine with 30 patients in each group. Results: Mean age of Group B and Group R was 50.50±9.72 and 52.50±7.70 years. Mean VAS at rest in Group B and Group R 10 minutes after block was 4.57±1.55 and 2.47±1.76 respectively (p<0.05). Mean VAS at rest in Group B and Group R 20 minutes after block was 2.07±1.23 and 1.33±0.84 respectively (p<0.05). Mean VAS at movement at 10, 20 and 30 minutes in Group B and Group R was (5.57±1.72 vs 3.63±2.11), (2.83±1.18 vs 1.77±0.90) and (2.40±0.93 vs 1.47±0.78). Mean duration of analgesia was 8.03±2.19 vs 9.87±3.06 minutes in Group B and R respectively. Conclusion: In this study, Ropivacaine group has given better results than Bupivacaine group in terms of Lower VAS scores at rest and movement in the initial 30 minutes after block administration Duration of action. The perioperative analgesia in terms of VAS scorefrom 30 minutes to time of rescue analgesia were comparable in both groups with no statistically significant difference.

Background: Post-operative pain management is a major concern in TKA. Periarticular infiltration in TKA is a technique in which a cocktail of drug combination is injected into the periarticular soft tissues such as posterior capsule, medial and lateral collateral ligaments, quadriceps mechanism, and peripatellar tissue at the end of the surgery. Recent studies found that periarticular injection significantly improved pain relief from 24hr to 1wk and straight leg raise in the early postoperative period. Therefore in our study, we evaluated a combination of local anaesthetic (Ropivacaine), alpha agonist (clonidine), cox-2 inhibitor (ketorolac) as a multimodal analgesic to effect on various pain receptors. We also added epinephrine to reduce their absorption and prolongation of their effect (analgesics).Methods: This study was conducted on 80 patients who were randomly divided into 2 groups, group’s 42 patients (received local infiltration analgesia) and group c 38 patients (received normal salineinjection) based on softwarederived random numbersequence. The data was revealed to the investigators at the end of the study. The statistical analysis of the data set was performed with KolmogorovSmirnov test (p < 0.05) for normality and an unpaired-t test was used to compare mean of the group for the significance of differences of outcome variable. Dichotomous data were analyzed using chi-square test or Fisher’s exact test, as appropriate. A p-value of< 0.05 was considered statistically significant. Results: We observed that the mean VAS score in Group S was lower (2.57) as compared to the Group C (4.66). Patients in group ‘S’ were more satisfied and felt less pain with increased range of motion andphysiotherapy. The patients in group ‘S’ were discharged earlier as they had less pain on physiotherapy as well as on rest and also there is increased mobility of knee joint. Conclusion: Our study suggests that periarticular injection of cocktail of drugs is a safe and effective multimodal analgesia technique that can be used for the management of pain in patient of total knee arthoplasty.

Introduction: Thyroid diseases are major health problems in society, which are manifested by alteration in hormone secretion, enlargement of the thyroid gland, or both. This study was designed to evaluate different patterns of thyroid lesions in surgically resected specimens and biopsies received at department of pathology and correlate it with Fine needle aspiration cytology findings and radiology reporting. We also evaluated discordant cases and analyzed them.Materials and Methods: 29 patients with thyroid nodule who underwent thyroidectomy and biopsy taken for an observational study from July2022 to June2023 at SMIMER Medical College, Surat. Cytological findings and radiological imaging were correlated with histopathological diagnosis. Patients who only underwent FNAC were excluded. Results:Histocytological correlation was done in 29 cases, amongst them 21 benign cases and 08 malignant lesions were diagnosed. The mean age of presentation of cases was 40.4 years with male: female ratio of 1:8.67. Malignancy was diagnosed among (66.67%) male and (23.08%) females. Histological patterns were nodular goiter (44.83%), thyroglossal cyst (6.9%), thyroiditis (10.34%), adenoma (10.34%), (Non Invasive Follicular Thyroid Neoplasm with papillary like nuclear features) NIFTP (10.34%), Hurthle cell carcinoma (3.45%), papillary carcinoma (13.8%). Concordance and discordance was noted in 82.15%, 17.85% cases respectively with radiology and cytology.Conclusion: Nodular goiter is most prevalent thyroid disease, while papillary thyroid carcinoma is most frequent cancer seen in this study. Taking into consideration of our study having discordant rate of 17.85% with radiology and cytology findings, we conclude histopathology report as a gold standard method for diagnosis of thyroid lesions.

Aims and Objective: To compare the outcome between autologous blood and fibrin glue fixated conjunctival autograft in pterygium surgery. Methods and Materials: A retrospective comparative study was carried out in 40 eyes that had a primary nasal pterygium excision in tertiary hospital in South Gujarat from January 2023 to June 2023. The patients were divided into 2 groups, in Group 1 autograft was attached with autologous blood and in Group 2 with fibrin glue. Groups were compared for surgical time, postoperative discomfort and recurrence. Result: The average surgical time was least with glue i.e 37.5 min, and 45.2 min for without glue. The postoperative discomfort was minimal in both groups. No recurrence was found in both groups till 6months follow up. Conclusion: The fibrin glue is most effective method for attaching autograft with least surgical time and postoperative discomfort. Autologous blood is an effective alternative easily available, economical than glue with less surgical time and postoperative discomfort.

Introduction:Sickle Cell Disorder (SCD), marked by abnormal haemoglobin Hb S, causes rigid, sickle-shaped erythrocytes, blocking circulation and leading to multiorgan damage. Globally, over 3,00,000 infants are born with SCD every year, with India ranking second in prevalence, affecting 20 million people. While advanced nations benefit from neonatal screenings and immunization, low-income regions, including rural India, face high childhood mortality rates (50-80%). Lack of awareness, delayed diagnosis, and inadequate management contribute to elevated mortality, particularly in less-educated rural and tribal areas. This study aims to evaluate public awareness of SCD to address the pressing issue in India. Material and Methods: This was a cross-sectional study of both known cases of Sickle Cell Disorder (SCD) and non-SCD individuals. A total of 169 consenting individuals were interviewed using a structured validated questionnaire. Results: We observed lack of awareness regarding Sickle Cell Disorders (SCD) in 40% of the participants, while 60% were found to be aware of its existence. Conclusion: The study reveals a notable lack of awareness about Sickle Cell Disorder (SCD), including its causes, diagnosis, and treatment. Given the substantial contribution of central India to annual SCD cases, addressing these awareness gaps is imperative. Targeted educational efforts, screenings and awareness campaigns are vital to bridging this knowledge deficit and improving outcomes in the region.

Hypoalbuminemia is generally defined as a serum albumin concentration ≤3.0 g/dl. Hypoalbuminemia is linked to poor outcomes, including an increase in complications, regardless of the underlying processes, also reduced short-term and long-term survival in critical patients. Malnourished patients have high protein needs, and research shows that providing them enough protein can lower mortality and enhance quality of life. Egg whites contain all the essential amino acids required, and it has many beneficial effects on the body. Peptides generated from egg whites maintain the nutritional value of egg whites and are easily absorbed in the body. We reported three cases studies to demonstrate the effectiveness of oral administration of egg white passed formulation in hospitalized patients with hypoalbuminemia and observed that, administration of High Protein Albumin Formula (Albuwise) is safe and effective in improving serum albumin level among hospitalized patient with low serum albumin levels

Background and Objectives: Dyspepsia is a common condition that clinicians encounter in their practice and it has a great impact on the patients quality of life. The incidence of upper gastrointestinal tract malignancy in patients with dyspepsia and their predictability based on history is unknown. This study helps to evaluate the incidence of upper GIT malignancy, different endoscopic presentation of dyspepsia, to reduce unwanted prescriptions, and to study importance of upper GI endoscopy. Methodology: Study includes 140 dyspeptic patients attending the OPD and admitted to all the units in Department of General Surgery in SSIMS & RC, Davangere with the complaints of upper abdominal pain/discomfort, nausea, vomiting, bloating/fullness of upper abdomen and were evaluated by detailed history & clinical examination followed by upper GI Endoscopy after getting written consent from patients. Biopsy were taken for HPE if any suspicious lesion of malignancy is present. This study conducted over period of two years. Results: A total of 140 patients 84 are males and 56 are females. Maximum of these were in age groups between 25 to 55 years. Most common symptoms were epigastricpainac counting for 81.4%, followed by nausea/vomiting, heartburn, food intolerance, in digestion and weight loss. The endoscopy were normal in 72(51.4%) patients. The abnormal findings included gastritis accounting for 19.3%, gastritis with duodenitis (7.1%). hiatus hernia (4.3%), duodenal ulcer (3.6%) esophagitis (2.9%), Ca esophagus (2.9%), Ca stomach (2.1%) and gastric ulcer (1.4%) Incidence of malignancy is increased in patient with dyspepsia along with alarming symptoms. Conclusion: Dyspepsia with alarm symptoms increases risk of malignancy, whereas in dyspepsia without alarm symptoms there is reduced risk of malignancy. Incidence of upper GIT malignancy in dyspeptic patient with significant upper GIs copy findings is 5.7%.

Purpose: To compare the safety and efficacy of intrastromalvoriconazole injection with topical voriconazole in management of fungal corneal ulcer not responding to conventional therapy.Patients and methods: A comparative and randomized study performed on patients with resistant fungal keratitis.Half of the patients (Group A) were given intrastromal injection in the dose of 0.1 ml (50 microgram/0.1ml) in each injection , Half of the patients (Group B) were given topical voriconazole eye drops (1%) once hourly. Healing of keratitis was considered as primary outcome measure.Results: Each group included 35 eyes with resistant fungal keratitis. Complete healing of fungal keratitis was higher in group A (88.6%) than in group B (31.4%) and the difference was statistically significant (P0.05).Conclusion: Voriconazole topically might be effective for treatment of resistant fungal keratitis. Adding intrastromal injection to topical drops could significantly raise the healing rate and hasten the resolution period without significant complications related to injection.

Introduction: Family members especially their spouses suffer intense psychological, physical and social trauma due to core drinking problem. Intimate partner violence (IPV) is a globally acknowledged public health problem. In this background the study was carried out to assess IPV and depression in spouses of Alcohol Dependence Syndrome (ADS). Methodology: A hospital-based study of 100 participants with alcohol dependence syndrome and their spouses were interviewed. Patient with other psychiatric illnesses and substance dependence except nicotine were excluded. Spouses diagnosed with any psychiatric illness were excluded. Severity of alcohol dependence questionnaire (SADQ) Hamilton depression rating scale (HAM-D) and Hamilton anxiety rating scale (HAM-A) were used for the participants and WHO-IPV scale was used for their spouses. Results: A positive association of the severity of alcohol consumption with IPV. We also found a significant association with HAM-A and HAM-D to spouse who were exposed to IPV. Conclusion: This study highlights that depression and anxiety disorders co-morbid in patients with ADS and IPV is higher spouses of patients with ADS.

Introduction: Intraoperative frozen sections (IFS) play a vital role in guiding surgical procedures, especially in gynaecological oncology. The rapid diagnosis provided by frozen sections allows surgeons to make real time decisions during surgery, which can significantly impact patient outcomes. It is a demanding task for pathologists, requiring keen observation skills and the ability to make quick yet accurate assessments. The information gleaned from frozen sections helps surgeons determine the extent of the surgery needed and whether further interventions such as lymph node dissection, are necessary. This approach enables a more precise and tailored treatment plan for each patient, improving overall care and potentially reducing the need for additional surgeries. Objectives: To compare the results of intraoperative frozen section examination with the final histopathology report and assess its accuracy in diagnosing uterine tumors. Methods: After Institutional Ethics Committee approval, a cross sectional study was carried out on 10 frozen section specimens of uterine origin. Later histopathological evaluation was done. Both frozen section diagnosis and histopathological diagnosis were compared to find out the accuracy of frozen section examination. Results: Fromthe10 cases studied on frozen section, 5 cases were diagnosed as Endometrial adenocarcinoma. Others included 1 of Low grade endometrial stromal sarcoma, 1 of Smooth muscle tumour of uncertain malignant potential (STUMP) and 3 cases of Cellular leiomyoma. The diagnosis given on frozen section matched the final histopathological diagnosis in all the cases. Conclusion: We found that frozen section diagnosis in uterine tumors were accurate in all the cases we studied, because it matched the diagnosis given on subsequent histopathology. Hence frozen section can be a useful tool for intraoperative diagnosis of uterine tumors.

Introduction: Opioid is commonly used analgesics for postoperative pain. Various modes of delivering drug are present but transdermal drug delivery system is safe, sustained, non-invasive, better absorption and lack of first-pass metabolism. Bolus dosing results in toxic plasma levels and inadequate duration of analgesia.Methods: It is prospective, randomized, double blind comparative study, conducted after obtaining approval from institutional ethics committee and written informed consent from patients. Patients of age 18-60yrs, undergoing lower limb surgeries under Spinal Anesthesia (SA) with ASA-1 status were included in study. Patients with drug allergy or intolerance to opioids were excluded. Patients’ were randomly assigned into 2groups of 45 each, Group B received Buprenorphine 10mcg/h TDS and group F received 25mcg/h Fentanyl TDS, 6 hours prior to surgery. Patients were followed for three days for postoperative pain relief and adverse effects. Statistics used was Student t-test, Fischer-exact test and Chi-square test.Results: Baseline and demographic variables are comparable in both groups. Mean level of VAS was significantly lower in group Fentanyl as compared to group Buprenorphine. Mean level of sedation score was significantly lower in Group Fentanyl than Group Buprenorphine. Haemodynamic variables in both groups (SBP, DBP and HR) showed no significant difference. 6 out of 45(13.3%) patients in group Buprenorphine required single dose of rescue analgesic while 0 patients in group fentanyl and requirement is statistically significant (pvalue=0.026). 20% patient in Group Fentanyl and 17.8%patients in Group Buprenorphine experienced some adverse effects.Conclusion: Fentanyl and buprenorphine TDS were effective and safe in controlling postoperative pain but Fentanyl is better than buprenorphine in this respect

Nasal obstruction is one of the most common complaints in patients attending Otorhinolaryngology outdoor. The most common cause of nasal obstruction is deviated nasal septum [1]. Apart from nasal obstruction, a significantly deviated nasal septum has been implicated in epistaxis, sinusitis, obstructive sleep apnea headache and otitis media [1-3]. Septoplasty is a surgical procedure used to correct a deviated nasal septum and its one of the commonly performed. Nasal packing after nasal septal surgery has been practiced for decades to prevent post-operative bleeding, septal hematoma pain and discomfort likes epiphora, sleep disturbance, headache and dryness of mouth that the patient has to undergo in the 48 hours post operatively. Aim & Objectives: To compare the intra-operative and post-operative outcome of trans-septal suture and nasal packing performed during Septoplasty. Materials and Methods: A Cross sectional observational study was taken up in the Department of Otorhinolaryngology, Head & Neck Surgery, Agartala Government Medical College & GBP Hospital in 78 patients with DNS underwent septoplasty surgery. Results: Amongst the patients who underwent Trans-septal suturing none of the patients reported Epiphora, Headache or dryness of mouth. Only 1 (2.6%) patient each reported sleep disturbance, post operative bleeding or synechia. Whereas All the patients who underwent Nasal packing reported Epiphora and Headache, 31 (79.5%) patients reported sleep disturbance whereas 38 (97.4%) reported dryness of mouth, 28 (71.8%) reported pain on pack removal, 2 (5.1%) reported post operative bleeding whereas synechia was seen in 1 (2.6%) patient.

abstractHypertensive conditions during pregnancy contribute greatly to maternal morbidity and mortality around the world. Hypertension complicates approximately one out of every ten pregnancies. Ten million women develop pre-eclampsia each year around the world. Worldwide about 76,000 pregnant women die each year from pre-eclampsia and related hypertensive disorders. In developing countries, a woman is seven times as likely to develop preeclampsia as a woman in a developed country. The increasing prevalence of the disease and hereby also increasing social costs combined with the fact that the disease is associated with increased morbidity and mortality of antenatal mothers emphasizes the importance of effective care. This study is aimed at assessing the effectiveness of structured teaching programme on self-care management of antenatal mothers with mild pregnancy induced hypertension.Title of the study:“A Study To Assess The Effectiveness Of Structured Teaching Programme on Knowledge Regarding Self-Care Management Of Pregnancy Induced Hypertension Among Antenatal Mothers Attending The Antenatal Clinic In Selected Hospital Of Srinagar Kashmir. Objectives: 1) To assess the existing knowledge of antenatal mothers regarding self-care management of pregnancy induced hypertension.2) To assess the knowledge regarding self-care management of pregnancy induced hypertension among antenatal mothers after the implementation of structured teaching programme.3) To compare the pre-test and post-test knowledge scores regarding self-care management of pregnancy induced hypertension among antenatal mothers. 4) To determine the association of pre-test knowledge score regarding self-care management of pregnancy induced hypertension among antenatal mothers with their selected demographic variables i.e., age, education, occupation, type of family, residence, Family Income per month, gravidity. Hypothesis:The Hypotheses are tested at a 0.05 level of significance: 1) Research hypothesis (H1): There is significant difference between the mean pre-test and post- test knowledge scores of antenatal mothers regarding self-care management of pregnancy induced hypertension at p≤0.05% level of significance. 2) Research hypothesis (H2): There is significant association of pre-test knowledge scores of antenatal mothers with their selected demographic variables i.e. age, education, occupation, type of family, residence, gravidity, at p≤0.05% level of significance.Methods: A quantitative approach with pre-experimental one group pretest post-test design was used for the study. Sample size was 60 subjects with pregnancy induced hypertension, who attended the Antenatal clinic of Obstetric and Gynaecological of Sheri-I-Kashmir Institute of Medical Sciences Srinagar, were selected by using Purposive Sampling technique. Pre-test was conducted to assess the existing knowledge of the subjects by structured interview schedule, followed by structured teaching programme. Post test was conducted on 7th day by using same structured interview schedule. The data collected were analysed by descriptive ORIGINAL ARTICLE OPEN ACCESS Tabasum, A. R. A.To Assess the Effectiveness of Structured Teaching Programme on Knowledge Regarding Self-Care Manageme of Pregnancy Induced Hypertension among Antenatal Mothers Attending the Antenatal Clinic in Selected Hospital of Srinagar Kashmir. Int. J Med. Pharm. Res., 5(4): 194‐206, 2024 195 &inferential statistics. Results: Out of 60 subjects majority (70%) were in the age group of 20-30 years, (61.6%) were educated. Majority of subjects (68%) were house wives. Majority of subjects (63.3%), had family income/month.

Background: The increasing prevalence of gadget use among adolescents has raised concerns about its potential impact on their development and well-being. Objective: To investigate patterns of gadget usage among children aged 13-15 years and examine associations with sociodemographic factors. Methods: A cross-sectional study was conducted with 280 children aged 13-15 years. Data were collected using a structured questionnaire assessing gadget usage patterns and sociodemographic characteristics. Results: Television (91.1%) and smartphones (82.1%) were the most commonly used devices. The average daily time spent with gadgets was 4.2 ± 1.8 hours. Non-academic use was predominant (46.4%), with video watching being the most common activity (53.6%). Significant associations were found between gadget usage scores and paternal education (p=0.01), socioeconomic status (p<0.001), and gender (p=0.02). Children from lower socioeconomic backgrounds and those with less educated fathers showed higher gadget usage scores. Males had significantly higher scores compared to females (45.8 ± 10.4 vs 42.9 ± 9.9, p=0.02). Conclusion: The study reveals complex patterns of gadget usage among adolescents and significant associations with sociodemographic factors. These findings highlight the need for targeted interventions to promote healthy gadget use, particularly among vulnerable populations

Background: Serum sodium levels have been recognized as a prognostic marker in chronic liver disease, particularly in decompensated cirrhosis. This study aimed to investigate the association between serum sodium levels and clinical outcomes in patients with chronic decompensated cirrhosis.Methods: A prospective observational study was conducted on 90 patients with chronic decompensated cirrhosis. Serum sodium levels were measured, and patients were categorized into four groups: <125 mEq/L, 125-129 mEq/L, 130-134 mEq/L, and ≥135 mEq/L. The relationship between serum sodium levels and various clinical parameters, complications, mortality, hospital stay, and ICU requirement was analyzed. Results: The majority of patients (57.8%) were in the age group of 40-59 years, and males constituted 82.2% of the study population. Serum sodium levels showed a significant inverse correlation with ChildPugh scores (r=-0.723, p<0.001) and MELD scores (r=-0.739, p<0.001). Patients with lower serum sodium levels had a significantly higher prevalence of complications, including hepatorenal syndrome (18.8% in patients with serum sodium <125 mEq/L), spontaneous bacterial peritonitis (12.5%), hepatic encephalopathy (68.8%), and coagulopathy (81.3%). Lower serum sodium levels were also associated with increased mortality, prolonged hospital stay, and higher ICU requirement (p<0.001). Conclusion: Serum sodium is a valuable prognostic marker in patients with chronic decompensated cirrhosis. Lower serum sodium levels are associated with more advanced liver disease, higher prevalence of complications, increased mortality, prolonged hospital stay, and higher ICU requirement. Incorporating serum sodium levels into the assessment and management of these patients can aid in risk stratification and treatment decisions

Empyema necessitansis a condition where the empyema has diffused and is loculated in the extra pleural space. Empyema necessitans is a very rare and morbid condition requiring urgent intervention to promote optimal outcomes. It is usually caused by Tuberculosis (TB) infection or immunocompromised condition. Its manifestation, which is often vague in the beginning, leads to diagnostic dilemmas and delays in management. We describe a rare case of empyema necessitans in a 51 years-old male who presented with leftside chest wall swelling. Ultrasonography of the anterior chest wall revealed a left anterior chest wall collection with intrathoracic extension. HRCT shows segmental collapse with cavitary changes with atelectatic bands in left upper lobe and left costo-pleural thickening with minimal left pleural effusion with hypodenseloculated collection of 36cc in left anterior chest wall region Percutaneous drainage of the collection was performed, and the pus sent for Mycobacterium tuberculosis culture was negative.

Background: Corticosteriods nasal sprays are the mainstay of treatment for allergic rhinitis. Most common reasons for patients to be dissatisfied with treatment for allergic rhinitis are inadequate symptom relief and bothersome side effects with intranasal corticosteroids. Bilastine tablet has high specificity and prolong duration of binding to H1 receptor and hence demonstrates antihistamine and antiallergic properties and hence the present study is to compare the efficacy, safety and compliance of bilastine tablet, fluticasone and mometasone nasal spray in allergic rhinitis. Objective : To determine the efficacy, safety and clinical outcome of bilastine tablet, fluticasone and mometasone nasal spray in allergic rhinitis. Material and Methods: This single-center, open label randomized interventional clinical trial was conducted in the department ofOtorhinolaryngology (ENT) and department of Pharmacology, Indira Gandhi Medical College and Hospital, Shimla. For this study 240 allergic rhinitis patients aged 18-50 years, satisfying the eligibility criteria were randomized into 3 groups in a 1:1:1 ratio to receive either the bilastine tablet 20mg or fluticasone furoate 50mcg or mometasone furoate 50mcg nasal spray. Baseline lab investigations of absolute eosinophill count, hemoglobin, random blood sugar, renal function test, liver function test, nasal endoscopy and SNOT-22 score were documented. After 6 weeks of active treatment, the study drugs were withdrawn, lab investigations of hemoglobin, renal function test, liver function test were done and documented. SNOT-22 and Medication Adherence Rating Scale (MARS) questionnaire were completed.Results: In bilastine group the mean baseline SNOT-22 score was 37.85+ 15.818 which decreased to 3.35 + 7.388 after 6 weeks. (P value 0.001). In mometasone nasal spray group the mean baseline SNOT-22 score was 37.79 + 11.829 which decreased to 2.8 + 4.772 after 6 weeks. (P value 0.001). In fluticasone nasal spray group the mean baseline SNOT-22 score was 37.68 + 15.475 which decreased to 2.34 + 5.116 after 6 weeks. (P value 0.001). Mean of baseline and post intervention vitals and laboratory parameters in bilastine, mometasone and fluticasone groups was statistically non significant. (P value > 0.05). No ADR/AE reported in any group. Only 1 patient in bilastine and 4 in mometasone and fluticasone group were non-compliant. Hence, 6 weeks of therapy with these three medications, were 100% efficacious and safe. Conclusion: Bilastine tablet once daily is equally efficacious and safe to use as compared to twice daily regime of fluticasone and mometasone nasal spray. Compliance to intranasal corticosteroids, mometasone and fluticasone nasal spray is compromised as compared to oral anti histaminic tablet bilastine in allergic rhinitis. Hence therapy may be based on patient preference, convenience and cost.

TrialRegistration : The clinicalTrials.gov Identifier is CTRI/2023/10/058841.

Peripartum hysterectomy is the rescue resort performed in modern obstetrics to arrest or prevent haemorrhage from intractable uterine atony or abnormal placentation. The aims and objectives of this study were to determine incidence, risk factors, indications and maternal outcome. An observational study conducted in KING GEORGE HOSPITAL, Visakhapatnam for a period of one year from September 2022 to August 2023.Total cases n=14 with 2.3 per 1000 deliveries. Risk factors observed were age group of 26-30 years, multiparous, vaginal mode of delivery in the current pregnancy and referred cases. Postpartum haemorrhage (PPH) was the most common indication. Out of 14 cases there were 4(28%) maternal deaths and Near miss were 9(72%). Good antenatal and intrapartum care and early referral would bring down cases of PPH as most of these cases are referred from peripheries and decreasing c section rates would help us to decrease incidence of peripartum hysterectomy.

Introduction: Infertility has become a significant social and medical concern affecting couples worldwide. Over decades, assisted reproductive technique has become a boon for couples to help them with conception. Despite the widespread clinical use and success of In vitro fertilization, its effects on pregnancy, maternal and fetal outcomes are still contentious. With a rise in concerns over increased risk of adverse maternal and fetal/neonatal outcome, this retrospective study was designed with an aim to study and compare the maternal and fetal outcomes in IVF pregnancies versus spontaneous conception. Methods: This is a retrospective cohort study. After taking informed and written consent, 100 patients conceived by IVF/ICSI with frozen embryo transfer are taken as cases and 100 patients with spontaneous conception who delivered during this period as controls. Data was analyzed using chi square test and results expressed by p value. p value less than 0.05 was considered as significant. Results: Mean age among study group was 28.59 ±4.74 years and in control group was 24.81±4.77 years with significant p value of <0.001. Incidence of maternal and fetal complications like multiple pregnancy (21% vs 6%), PIH (20% vs 9%), preterm (25% vs 13%) deliveries and intrauterine growth restriction (16% vs 11%) was significantly higher in study group compared to control group with p value of <0.05. no statistically significant differences were found in the incidence of GDM (7% vs 3%), spontaneous abortions (18% vs 8%), IHCP (5% vs 6%), anemia (9% vs 14%), blood transfusion (7% vs 9%), PROM (8% vs 13%), APH (2% vs 6%), sudden IUFD (1% vs 2%), PPH (4% vs 7%) and surgical site infection (3.7% vs 13%) among two groups. Significant higher low birth weight rate was noted among study group (44.44%) compared to control group (19.56%). No statistical significance was established regarding nicu admissions and cause of neonatal admission among two groups. Conclusion: In our study, we concluded that IVF conceived pregnancies are associated with higher maternal and neonatal complications compared to spontaneously conceived pregnancy. And we emphasized on need for shift of trend towards choosing fresh embryo transfers and natural cycle stimulated cycles instead of frozen embryo transfer whenever possible with single embryo transfer and focusing on attaining a healthy singleton pregnancy.

Background: Nursing and midwifery workforce accounts for nearly 50% of the global health workforce. Nurses play a critical role in health promotion, disease preventionand primary care. Unfortunately, few studies on the training and adherence of health personnel to hygiene recommendations have been done, despite the obvious implications forpatientsafety. Objectives:Toassesstheknowledgeofnursingstudents regarding nosocomial infections, standard precautions and hand hygiene & thenconduct training & assess the effectiveness of the intervention. Materials & Methods: A crosssectional cum interventional study with 92 nursing students were targeted for lecture on nosocomial infections, standard precautions, and hand hygiene based on the CDC and WHO guidelines. Infection Control Standardized Questionnaire ICSQwas administered as a pre and post-test. Results: Pretest score mean = 35.8 with SD = 3.95, Post test score mean = 41.52 with SD = 6.28. On applying paired T test there was statistically significant difference in pretest and post test score with p value = 0.04, t value = 8.169. Conclusion: There was significant increase in knowledge of students as a result of the intervention lecture hence repeated sessions of such trainings can help in reduction of nosocomial infections which will improve the overall quality of patient health care

Purpose: To compare the efficacy of an intracameralmydriatic agent with a topicalmydriatic eye drop during phacoemulsification cataract surgery.Methods: All the patients with age group between 40 to 80 years with immature senile cataract, who came to the Ophthalmology OPD & were posted for surgery, were randomized into two groups. One group received topical mydriatics (Group-A) & the other group received intracameralmydriatic (Group-B), for pupil dilation prior to surgery. Parameters compared among both the groups,werethe size of pupilat different time points during the surgery;the onset of action of mydriasis& mean changes of variation in the pulse rate, systolic & diastolic blood pressures, at various time points during the surgery.Result: A total of 204 patients were enrolled in this study, who were randomly divided among both the groups (102 each). In Group-A, it was observed that the mean pupil size was maximum at 30 minutes after the start of topical drug administration i.e.- (7.81 +/-1.03) mm.; which gradually decreased towards the end of surgery. Whereas, in Group-B, the pupil size measured during the same time was (7.45 +/-0.81) mm., which also decreased gradually towards the end of surgery. But, following nucleus removalfrom the anterior chamber &corticalaspiration, the mean pupil size in Group-B was observed to be (6.45 +/-0.91) mm., which was greater than that of Group-A, i.e.- (6.01 +/-0.70)mm. Also, the time duration for which the pupil was larger during the surgery was found to be better in Group-B, compared to Group-A. Moreover, blood pressure & pulse rate, measured during various time points during the surgery, were observed to be within the permissible limits in both the groups.Conclusion: Intracameralmydriasis is a rapid, safe & effective alternative for pupil dilatation, during cataract surgery, with lesser systemic side effects; compared to the traditional topical eye drops.

Introduction: Neonatal sepsis is a clinical syndrome of systemic illness accompanied by bacteraemia in thefirst 28 days of life (neonates). Early onset sepsis is the culture positive infection within the first 72hours of life while late onset sepsis is the culture positive infection after 72 hours of life.Materials and Methods: 166 neonates, of which 83 suspected of early neonatal sepsis and 83 suspected of late onsetsepsis were included in the study over a period of two months. Blood culture andqualitative assessment of CRP was done for all the subjects.Results: Out of the 166 Neonates, 2(1.2%) were both Blood culture positive and CRP positive; 21(12.8%) were only Blood culture positive, CRP negative; 19(11.5%) were only CRP positive, Blood culture negative. Among 83 early onset sepsis cases, both CRP and blood culture was positive in 2(2.4%) cases. Blood culture alone was positive in 9(10.8%) cases and only CRP was positive in 19(22.8%) cases. Among 83 late onset sepsis cases, only Blood culture positive were seen in 14(16.8%) cases and only CRP was positive in 2(2.4%) cases. Conclusion: CRP plays a major role as acute phase reactant in diagnosis of early onset sepsis. But in lateonset sepsis, Blood culture plays a major role. So Blood culture is the gold standard fordiagnosis of neonatal sepsis.

This cross-sectional study aimed to determine the prevalence of hypothyroidism among Type 2 Diabetes Mellitus (T2DM) patients at a tertiary healthcare center. The study also examined the association of various risk factors with hypothyroidism in these patients. A total of 101 T2DM patients were included, and data on thyroid function, blood glucose levels, and other metabolic parameters were collected. The results indicated a high prevalence of hypothyroidism among T2DM patients, with significant associations found between hypothyroidism and factors such as diabetes duration, BMI, and blood glucose levels. These findings highlight the need for routine thyroid function screening in T2DM patients to manage and mitigate complications.

Objectives: Mesh-related long-term morbidity like chronic groin pain and vas entrapment in patients with an inguinal hernia is a concern. So tissue-based repairs should be revaluated. There have been few prospective studies comparing the outcomes of Lichtenstein's technique and Desarda's technique for the repair of uncomplicated inguinal hernias. So, we conducted this prospective study comparing the two techniques. Methods: This is a single-center prospective observational study conducted for a period of two years (June2022 to May 2024). The patients who underwent surgery for uncomplicated inguinal hernia either by Lichtenstein's technique or Desarda's technique were included in the study. The two techniques were compared with respect to recurrence rates, immediate postoperative pain, chronic groin pain, wound infection, and the time taken to return to activities of daily living (ADL). Results: There was no significant difference in the recurrence rates, wound infection, chronic groin pain, or return to ADL between Lichtenstein's technique and Desarda's technique of inguinal hernia repair. The mean duration to return to ADL was lesser when patients underwent Desarda's repair though this difference was not significant. Conclusion: Desarda's tissue repair was found comparable to Lichtenstein's mesh repair in terms of recurrence and postoperative morbidity, immediate postoperative pain, chronic groin pain, wound infection, and the time taken to return to ADL. Desarda's technique may be considered as an alternative to mesh-based repairs to avoid long-term mesh-related morbidity for uncomplicated indirect hernias in the younger population.

Background: Double J (DJ) stents are used post-ureteroscopy to maintain ureteral patency and prevent strictures, but can cause significant morbidity. Removal with an extraction suture avoids cystoscopy, though data on effectiveness and discomfort is limited. Objective: To evaluate the outcomes of using a customized suture stent compared to a conventional DJ stent, focusing on complications and patient comfort. Method: This quasi-experimental study was conducted at the Department of Urology, Dhaka Medical College Hospital, from May 2021 to April 2022. Ninety-one patients with lower and mid ureteric stones were enrolled using purposive sampling. Patients were alternately assigned to either the traditional DJ stent group (6 Fr DJ stent) or the customized suture stent group (6 Fr customized DJ suture stent). Urinary symptoms were assessed, and pain during stent removal was measured using the Visual Analogue Scale (VAS). Urinary tract infections were detected through urine routine microscopy examination (RME) and culture/sensitivity (C/S). Adverse effects, including stent migration, were recorded. Results: The mean ages were 32.4 (±13.0) years in the customized suture stent group and 37.1 (±13.7) years in the traditional DJ stent group. Males comprised 71.1% of the customized suture stent group and 52.2% of the traditional DJ stent group. The traditional DJ stent group had a significantly longer stent duration (p=0.015). Median VAS scores were 1.0 (1.0-2.0) for the customized suture stent group and 3.0 (3.0-5.0) for the traditional DJ stent group (p<0.001). There were no significant differences between groups regarding urine RME, C/S, frequency, dysuria, hematuria, incontinence, and urgency. Conclusion: The VAS score during stent removal was significantly higher in the traditional DJ stent group compared to the customized suture stent group, which enabled early self-removal 4 to 7 days postureteroscopy. No significant differences were observed between groups regarding urinary complications.