Background: High risk factors during pregnancy adversely affect the maternal and foetal outcome increasing perinatal morbidity and mortality. Antepartum foetal surveillance can detect foetal hypoxia and acidemia before it becomes irreversible. Non- stress test (NST) is simple and cost-effective method of antepartum foetal surveillance. The objective of the study was to analyse the predictive value of NST in evaluating perinatal outcome in high-risk pregnancies. Materials and Method: Present study was carried out on 100 high-risk pregnant women with singleton pregnancy, of more than 34 weeks period of gestation.All participants underwent prenatal non-stress testing (NST). Based on the results, the cases were categorized into two groups: reactive NST and non-reactive NST. Perinatal outcomes were then assessed and compared between the two groups. Results: The common risk factorsobserved in our study were gestational hypertension (19%), anaemia (17%), hypothyroidism (14%), pre-eclampsia (10%), oligohydramnios (10%).Around 66% of the participants had reactive prenatal NST while 34% cases had non-reactive NST. Around 41% of the infants were low birth weight in non-reactive NST group while 13.6% in reactive group. Total 20.59% babies in non-reactive NST group had low Apgar at 5 minutes requiring NICU admission while 6.06% babies in reactive NST group had low Apgar requiring admission. Conclusion: Present study reveals significant difference in perinatal outcomes in highrisk cases with reactive and non-reactive NST. NST can be used for identifying the foetuses at risk of asphyxia and avoiding unnecessary delay in intervention. It can be used as single best screening in low resource centres to screen high risk antenatal cases.

The benzimidazole nitrogen containing heterocyclic ring which possess biological and pharmaceutical. These heterocycles are key components to functional molecules that are used in a variety of everyday applications. Synthesis of Benzimidazole and their derivatives using microwave irradiation.An efficient and green synthesis carried out using microwave gives high yield in short reaction time. Importance of the synthesized compound were screened for antimicrobial activity. Newly synthesized compound characterized by IR, H1NMR, U.V- visible.

Purpose: Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder which cause hyperandrogenism, anovulation, and also polycystic ovaries. The effect of PCOS can reach several organs such as cardiovascular, immune system, reproductive, metabolic, and psychological. This study investigates the effect of moringa leaves on insulin level within rats model with PCOS. Methods: Data were collected through Post Test Only Control Group Design with Wistar rats (Rattus norvegicus) model from the insulin level in the body. The rats are injected with testosterone and then given Moringa leaf extract. Results: The analysis revealed that the PCOS rats have an increased insulin levels than the normal rats and there isa significant decrease in insulin levels in rats given Moringa leaf extract with the PCOS rats. Normal rats and rats given Moringa leaf extract have almost the same Insulin level. Conclusions: These findings suggest that Moringa leaf extract decreased the insulin levels with PCOS rats. Further research needed to find more about the impact of Moringa leaf extract on rats insulin levels.

Objectives: The aim of the study is to evaluate the role of MRI in diagnosis of painful hip joint. Role of MRI in evaluation of painful hip joint and to establish a differential diagnosis of various painful hip joint pathologies on MRI. Materials & Methods: This prospective/retrospective study was carried out on 50 patients over a period of 2 years from 2021 to 2022. Study was carried out using SEIMENS 1.5 Tesla machine in Department of Radiodiagnosis at DR. PSIMS & RF, Gannavaram. Conclusion: MRI is a valuable tool in evaluation of hip disorders as it enables assesment of articular structures, extra articular soft tissues & osseous structure that can be affected in hip disorders.MRI of hip shall be performed out early in patients with persistent pain and negative radiographic findings.

Background: The management of wounds is a significant healthcare burden associated with large expenditures. Foam dressings are said to be a better and economical in exudating wound healing compared to other conventional dressings.The purpose of this study is to evaluate the evidence for the effectiveness of foam dressings compared to other regularly used dressings.Methods: 100 patients with exudative wounds were selected and divided into 2 groups. One treated with conventional dressings and the second with foam dressings. The objectives are reduction of exudate, bacterial growth, development of granulation tissue and finally the split skin graft uptake. Results: The foam dressings show better results in reduction of exudate, bacterial growth and development of the granulation tissue with no difference in the graft uptake. It is found to be economical and comfortable to the patient. Conclusion: The foam dressings show better results compared to conventional dressings and are advisable for patients with exudative wounds.

Background: Congenital torticollis is a pathological condition involving an abnormal tilt and rotation of the head and neck, often due to dysfunction of the sternocleidomastoid muscle. While conservative treatment is typically effective in early stages, surgical intervention becomes necessary for refractory cases or when fibrosis develops. This report highlights the anaesthetic challenges and management strategies for a patient with congenital torticollis undergoing Ferkel's bipolar sternocleidomastoid muscle release. Methods: A 15-year-old female patient with cervical scoliosis, atlanto-axial subluxation, and a Mallampati Grade III airway underwent a detailed preoperative evaluation. Anaesthesia was induced with fentanyl, glycopyrrolate, and propofol, followed by succinylcholine for muscle relaxation. Intubation was achieved using video laryngoscopy to ensure optimal visualization. Maintenance anaesthesia included oxygen, nitrous oxide, 1% sevoflurane, and vecuronium. Ultrasound-guided superficial cervical plexus block with 0.25% bupivacaine was administered for postoperative analgesia. Results: The surgery, lasting two hours, was conducted with the patient in a supine position with careful head alignment. Despite airway challenges, successful intubation was achieved on the first attempt. Intraoperative and postoperative management ensured stable vital signs, adequate analgesia, and an uneventful recovery. Conclusion: This case underscores the importance of individualized anaesthetic planning in patients with congenital torticollis. Combining general anaesthesia with regional techniques enhances intraoperative conditions and postoperative outcomes. Video laryngoscopy proved invaluable in overcoming airway challenges, while targeted regional anaesthesia reduced systemic analgesic requirements.

Neck masses are usually defined as growth or swelling over the Neck region.Neck masses can be benign or malignant, so thorough examination and investigation is needed to reach a final diagnosis and treatment. At the present series all the Neck masses are rare due to tumour presentation, site, size and Histopathological findings.

Background: Digital screen use has become ubiquitous in modern workplaces, potentially increasing the risk of dry eye syndrome (DES).Objective: To determine the prevalence of DES among urban office workers and identify associated risk factors, particularly focusing on screen time and workplace environmental conditions.Methods: A cross-sectional study was conducted among 460 office workers using digital screens. Participants underwent comprehensive ophthalmic examination including tear break-up time (TBUT) and Schirmer's test. Environmental factors were measured, and symptoms were assessed using the Ocular Surface Disease Index (OSDI).Results: The prevalence of DES was 53.9% (95% CI: 49.3-58.5%). Mean daily screen time was 8.5 ± 1.7 hours. DES prevalence increased significantly with screen time (p<0.001), from 39.1% in those using screens 6-7 hours to 69.4% in those exceeding 9 hours daily. Multivariate analysis identified significant risk factors including female gender (OR=1.6, p=0.002), low humidity (OR=2.1, p<0.001), and close screen distance (OR=1.7, p=0.012).Conclusion: DES is highly prevalent among urban office workers, with screen time duration and workplace environmental factors serving as significant modifiable risk factors. Implementation of workplace environmental modifications and screen time management strategies may help reduce DES prevalence.

Cerebral palsy (CP) is a multifaceted neurodevelopmental disorder affecting motor functions and associated domains. This study explores the correlation between the Gross Motor Function Classification System (GMFCS), Gross Motor Function Measure (GMFM), and Manual Ability Classification System (MACS) in children with CP across Eastern Uttar Pradesh. A total of 2,139 children aged 2–18 years were evaluated using standardized tools. Results demonstrated significant correlations between functional classifications and measures, highlighting progressive declines in self-care abilities with increasing GMFCS levels. These findings underline the importance of integrated assessments to guide personalized interventions and improve care outcomes.

Globally, arboviruses are the cause of viral encephalitis. Japanese encephalitis is common throughout India. Tamil Nadu, Andhra Pradesh, Uttar Pradesh, Bihar, Assam, West Bengal, Karnataka, Goa, and Maharashtra are among the Indian states where cases have been documented. The current study intended to determine the prevalence of Japanese encephalitis in patients at a tertiary care facility who had received a clinical diagnosis of viral encephalitis. The disease was first identified in Nagpur (1952) which is closer to chandrapur, where it was found that an unidentified viral encephalitis, later identified as JEV, a flavivirus spread by mosquitoes, had killed about 16 people. In the current study, amongst 68 samples,7 males and 2 females were tested positive. In September month the highest number of suspected cases were noted. Children aged 1 to 5 accounted for most JEV-affected individuals, and as age increased, fewer seropositive instances were reported. In places affected by the JE epidemic, immunizations' crucial role might also be cross-checked. Therefore, it may also be advantageous to include the JE Vaccine in routine vaccination programs in places where JEV is an epidemic.

Among heterocyclic compounds, quinoline is an advantage that appears as a significant assembly motive for the development of new drug entities. Quinoline and its derivatives tested with diverse biological activity constitute an important class of compounds for new drug development. Therefore, many scientific communities have developed these compounds as intent structure and evaluated their biological activities. The present, review provides brief natural sources of quinoline and including a new extent of quinoline-based marketed drugs. This review also confers information about the biological activities of quinoline derivatives such as antibacterial, antifungal, antimycobacterial, antiviral, anti-protozoal, antimalarial, anticancer, cardiovascular, CNS effects, antioxidant, anticonvulsant, analgesic, anti-inflammatory, anthelmintic and miscellaneous activities.

Summary Diabetic foot ulcers (DFUs) are a significant complication of Diabetes Mellitus, leading to reduced quality of life and even mortality in severe cases. Factors such as the immunocompromised state of the patient, hyperglycemia, and ischemia contribute to microbial colonization of DFUs, often resulting in severe complications like gangrene, osteomyelitis, and sepsis. Despite advancements in treatment modalities, the standard treatment still involves the use of parenteral broad-spectrum antibiotics. This dependency contributes to the emergence of antibiotic resistance. This prospective observational study aims to isolate and identify microorganisms from DFUs and determine their antibiotic susceptibility patterns. Swab samples collected from 15 diabetic patients undergo Gram staining, culture, and biomedical testing for microbial identification. This is followed by testing for antibiotic sensitivity to determine the pattern of antibiotic resistance in the isolated organisms. Results indicate Escherichia coli as the most common organism isolated. Notably, all Staphylococcus isolated were methicillin-resistant (MRSA), and 60% of the E. coli isolates exhibit Extended-spectrum beta-lactamase (ESBL) production. Resistance of Proteus mirabilis to Tetracycline and Polymyxin B and that of Enterococcus faecalis to Tetracycline is also noteworthy. In conclusion, this study shows the complexity of Diabetic foot ulcers and the increasing threat of antibiotic resistance in clinical practice.The findings indicate the importance of developing a more targeted and effective treatment strategy tailored to individual patients, there by reducing the risk of antimicrobial resistance, and enhancing patient outcomes in DFU management.

Introduction: The oral flagellate Trichomonas tenax has been identified as an important etiological agent of periodontal diseases.Method: In this study the publication data was determined by using the phrase “Trichomonas tenax in oral diseases” as the primary search keyword. Associated articles indexed in the Scopus Core Collection between January, 1970 and February, 2024 was retrieved. The evaluation was performed based on productivity, publication years, authors, research topic, institutions, countries, documents by source, type of article, subject area and funding sponsor.Results: Out of 79 publications in the given period, maximum numbers of publications were done in 2023, Poland being the country with maximum number of publications where Anna J Kurnatowska has published most of the aricles in Annals of Parasitology. Conclusion: Trichomonas tenax is one of the most commonly found parasites of the oral cavity. Further research with more specific tests and larger sample size shall be conducted.

Phenytoin, an antiepileptic drug with nonlinear pharmacokinetics, can cause toxicity, especially with drug interactions that affect its metabolism.Here, A 70-year-old man with a history of stroke and epilepsy developed worsening ataxia and falls after starting cimetidine. His serum phenytoin level was 30 mcg/ml, above the therapeutic range. MRI showed mild cerebellar degeneration. while his Phenytoin toxicity, exacerbated by cimetidine inhibiting phenytoin metabolism, leading to cerebellar dysfunction and he managed with Phenytoin was discontinued, and valproate was initiated. The patient's condition improved with supportive care. Chronic phenytoin use can cause cerebellar ataxia. Drug interactions, like with cimetidine, can increase phenytoin levels and toxicity risk. In short, Monitoring phenytoin levels and avoiding drug interactions is crucial to prevent toxicity. Switching to alternative antiepileptic drugs can improve outcomes in affected patients.

Background: Pancytopenia is not a disease entity but a triad of findings that may result from various disease processes, primarily or secondarily involving the bone marrow. Bone marrow aspiration plays an important role in identifying the various causes of pancytopenia. Hence the present study was undertaken to evaluate bone marrow findings in pancytopenia cases and causes of pancytopenia on the basis of bone marrow findings. Method: Total 50 patients of aged between 18-70 years presented with pancytopenia in the Department of Pathology, at tertiary care teaching hospital in central India during a period from September 2018 to October 2020 were enrolled and evaluated for physical findings, primary hematological investigation and bone marrow aspirations. Results: Commonest age group affected was 41-50 years (28%) with male predominance (68%). General weakness (90%) was the chief complaint and pallor (96%) was commonest physical finding. Megaloblastic anemia (48%) was the common cause of pancytopenia, followed by dimorphic anemia (18%). Lowest hemoglobin range was 3gms/dl-3.5gms/dl noted in case of nutritional and megaloblastic anemia. Lowest leukocyte count was 570cells/mm3 and noted inmegaloblastic anemia. Lowest platelet count was 10,000cells/mm3 and noted in nutritional anemia. Hypercellular marrow was found in 41(82%) patients and common cause was megaloblastic anemia. Hypocellular marrow was seen in 4(8%) cases and normocellular marrow was seen in 5(10%) cases. Conclusion: Detailed primary hematological investigations along with bone marrow aspiration and biopsy in cytopenic patients is helpful for understanding of the disease process, to diagnose or to rule out the causes of cytopenia and helpful in planning further investigations and management of cytopenic patients.

Background: Due to the widespread use of tobacco in India Head and Neck cancer(HNC) cases are on the rise and it account for 30% of all cancer cases, based on geographical locations usage patterns of tobacco. Despite being more common in males, research has shown that there are variations based on anatomical subsites. AIM: The aim of the present study is to evaluate clinical presentation of Head and Neck malignancy among patients attending Agartala Government Medical College and their histopathological attributes would be analysed. METHODS and MATERIALS: This is a hospital based prospective observational study of 96 cases consecutive biopsy proven HNC patients from a large comprehensive Tertiary care centre from Tripura during the period of September 2021 to 2022 December. Data collected for the study included age, gender, site of the disease, use of tobacco and histopathological characteristics. The categorical data were analysed by a chi square test using SPSS(version 22). RESULTS: In the present study, 42.7% of Head and Neck cancers were found in the age of 51-60 years with strong male preponderance (78%) compared to females (22%). Mostly patients were from rural (65%) backgrounds. The most common type of carcinoma is Squamous Cell Carcinoma (88%) and most common subsite involved are Supraglottis (21.9%). There is a strong and significant association found between use of tobacco and Head and Neck malignancies. CONCLUSION:Most of Head and Neck malignancies are Squamous Cell Carcinoma and supraglottis and oral cavity were commonly involved.Commonly affected the age group of 40-60 years with male predominance. Strong correlations were observed between tobacco use and Head and Neck malignancy.

Recent developments in molecular and cellular biology hold promise for creating innovative approaches to treat and potentially cure type 1 diabetes. Specifically, the restoration of insulin secretion through gene therapy or cell replacement techniques is now a conceivable goal. However, the complexity of the β- cell must be acknowledged, as many characteristics of this highly specialized secretory cell need to be accurately replicated in alternative cell types. Insulin secretion is typically regulated and occurs rapidly in response to the metabolic demands of the body, particularly in relation to fluctuations in blood glucose levels. This regulated secretion is crucial to prevent both hyperglycemic and hypoglycemic episodes and relies on the capacity of cells to store insulin in secretory granules, which are released through exocytosis in response to physiological cues. Additionally, any newly engineered insulin-secreting cells must be capable of adjusting to changes in insulin needs that arise from factors such as physical activity, body weight fluctuations, and aging. Long-term regulation of insulin secretion is also vital to prevent "clinical shifting," which may result from excessive insulin production, leading to increased fat accumulation and cardiovascular issues. Lastly, it is essential to ensure that any newly created or transplanted surrogate β-cells are safeguarded against detection by the immune system, particularly to prevent autoimmune destruction.

Background and Objectives: Out-of-hospital cardiac arrest (OHCA) is a major global public health concern, especially in India, where the lack of an official registry makes it difficult to gauge the full extent of the problem. With a focus on young cardiac arrest patients, this study intends to shed light on OHCA at MMI Narayana Multi-speciality Hospital in Raipur by examining survival rates and important affecting factors. Materials and Techniques: Data from January through December 2023 were analyzed using the Utstein OHCA registry as part of a registry-based observational study that was carried out in the emergency department of the urban Indian tertiary care MMI Narayana Multi-speciality Hospital in Raipur. Non-traumatic OHCA patients of all ages who were admitted to the hospital met the inclusion criteria. Results: Of the 123 non-traumatic OHCA instances, 8.1% involved laypeople doing bystander cardiopulmonary resuscitation (CPR). Young adults (18–49 years old) had a 3.1% survival rate, whereas the overall survival rate was 0.8%. Notably, increased survival rates were linked to continued CPR. Conclusion: Immediate action is needed to address low survival rates, particularly among young people in India who are experiencing OHCA. Given that citizen education takes a lot of time, our main suggestion is to focus on quick and focused interventions to increase public awareness and training. Putting emergency physicians at the center of these initiatives enables them to handle complex obstacles, maximize short-term results, and support ongoing OHCA care development in India.

Introduction: Platelet transfusion is a lifesaving procedure for thrombocytopenia, can be either prophylactic or therapeutic. Evaluation of the response to platelet transfusion by calculating Corrected count increment (CCI).The corrected count increment (CCI) is a laboratory evaluation of the effectiveness of Platelet concentrate transfusion. Corrected count increment (CCI) is the most widely used surrogate marker for evaluating refractory patient’s responses to platelet component transfusions which is measured at 24 hour post transfusion.Aim and Objectives: 1) To study the number of platelet transfusion that was done during the study period. 2) To study the indications for the platelet concentrate transfusions in cases of thrombocytopenia. 3) To evaluate efficacy of platelet concentrate transfusion for increment of platelet count. 4) To evaluate the causes of refractoriness to platelet transfusion. Material and Methods:The present study included 100 cases having thrombocytopeniaadmittedat SMIMER hospital whoreceived platelet concentrate transfusion during the study period from 1st June 2024 to 31st November 2024.Patient information was collected from blood bank component register and from ward.Investigations including pre and post transfusion platelet counts were noted using following formula, Results: Majority of the platelet recipient were transfused prophylactically when platelet count were > 20000/ul. The most common among them is infectious causes. The most common category of diagnosis among these patients was infectious agent. Conclusion: The usage of platelet concentrates in thrombocytopenia found in the study reveals infectious cause as predominant and common finding.CCI values is found to be useful in evaluating response in cases of thrombocytopenic patients receiving platelet concentrate transfusion.It was noticed that platelet count does not increase to the expected level after platelet transfusions in certain patients due to refractoriness to the platelet transfusion (in cases of fever, sepsis etc).

Introduction: Stroke is defined as rapidly developing symptoms and/or signs of focal and global loss of cerebral function lasting for at least 24 hours with no apparent cause other than of vascular origin. It constitutes a dreadful burden of disability. Modifiable risk factors include hypertension, diabetes and hypercholesterolemia, atrial fibrillation, smoking, drug abuse, and alcohol intake. Changes in the lipid profile have been suggested with formation of atherosclerosis. Aims and objective: To evaluate lipid profile levels in patient with acute ischemic stroke and to compare this parameter with severity of stroke. Materials and methods: The cross-sectional study of one and half year duration (Feb2021-Aug2022) was done on 100 patients of acute ischemic stroke presented to K.R. Hospital, Mysore. The main goal was to determine whether hypercholesterolemia is a risk factor for high severity.Lipid profile was measured by collecting the patients’ blood after fasting for 9 to 12 hours. Severity of stroke was assessed by NIHSS. Based on NIHSS scores divided into minor (1-4), moderate (5-15), moderate to severe (16- 20), severe (21-42) groups. Along with assessment with severity, lipid profile was compared between severity of stroke. Statistical analysis: Data analysed using SPSS software version 22.0 and it will be presented as descriptive statistics in form of frequency table and graphs. Association between variables will be done using chi-square test and unpaired t test for qualitative and quantitative variables. Result will be expressed as mean+/-SD. Correlation of parameters is done by Pearson’s correlation formula. A p value of <0.05 is considered statistically significant. Results and conclusion: Among 100 cases higher levels of TC, TGL, LDL were associated with more severity of stroke. 9 were in minor group, 47 were in moderate group, 29 were in moderate to severe group, 15 were in severe group. As the severity increases the mean level of TC, TGL, LDL, VLDL also increases, mean HDL level decreases. P value being <0.05, statistically Significant, showing clinical correlation with severity of stroke. Higher TC, TGL, LDL and lower HDL increases the risk of severity of stroke. Association Were strong for higher level of TC and LDL Early detection and treating with lipid lowering drugs helps to reduce the risk and prevent morbidity and mortality.

Gallbladder adenomyomatosis (GA) is a benign, proliferative condition characterized by gallbladder wall thickening and the presence of Rokitansky-Aschoff sinuses. Though generally asymptomatic, GA can mimic acute cholecystitis, leading to diagnostic challenges. We present a case of a 32-year-old male with a year-long history of recurrent right hypochondriac pain radiating to the shoulder, accompanied by nausea and vomiting. Initial clinical and laboratory findings suggested acute cholecystitis. Imaging studies, including ultrasonography and magnetic resonance cholangiopancreatography, revealed diffuse gallbladder wall thickening with cystic spaces, indicative of adenomyomatosis. The absence of gallstones and the presence of a dilated cystic duct further supported the diagnosis. The patient underwent elective laparoscopic cholecystectomy, and histopathological examination confirmed diffuse adenomyomatosis with smooth muscle hypertrophy and Rokitansky-Aschoff sinuses. The postoperative recovery was uneventful, and the patient remained asymptomatic during a six-month follow-up. Gallbladder adenomyomatosis is benign and can be detected by imaging or during cholecystectomy. Theoretically, adenomyomatosis doesn't need any special care unless it presents symptoms, whether or not cholecystolithiasis is present.

Background:Seroma development, also referred to as "pseudorecurrence," is a frequent postoperative issue following TAPP treatment of inguinal hernias, menace to operating surgeon answering questions to patients either be a self-limiting, asymptomatic event or a painful, long-term issue. In order to better understand incident of postoperative seroma following laparoscopic transabdominal preperitoneal hernia repair (TAPP), which involves fixing transversalis fascia to Cooper ligament, a research investigation has been done.Methods:For direct inguinal hernias, TAPP was incorporated from October 2022 - December 2023. After cavity created by direct reduction of hernia had been closed in each patient by transversalis fascia fixation to coopers, a lightweight mesh was inserted. Data from clinical as well as demographic studies have been obtained as well as examined.Results: A total of 72 individuals that had TAPP repair during study period. Mean age of patients, who were all male, was 65.1 ± 10.7 yrs. Average hospital stay lasted between two and four days. Neither seroma nor recurrence was discovered 30 days after discharge, nor was chronic pain after 3–12 months mean follow-up.Conclusions: To avoid postoperative seromas, it is safe, practical, and advised to anchor transversalis fascia to Cooper ligament while treating a direct inguinal hernia with TAPP

Introduction: Diabetic retinopathy, most common complication of diabetes mellitus, isa microvascular disorder and ranks as the fourth major cause of blindness globally. According to the Early Treatment Diabetic Retinopathy Study (ETDRS)and Diabetic Retinopathy Study (DRS) timely intervention can reduce vision loss. Nursing and Pharmacy students serve as the resource persons for diabetic patients seeking information regarding diabetes and diabetic retinopathy. Hence, this study aimed to assess the knowledge, attitude and practices regarding diabetic retinopathy among nursing and pharmacy students in tertiary care teaching hospital. Objectives:To evaluate knowledge, attitude and practice regarding diabetic retinopathy among Nursing and Pharmacy students in tertiary care teaching hospital and to compare awareness between Nursing and Pharmacy students. Methods: This cross-sectional study was conducted among 360 Nursing and Pharmacy students by convenience sampling in a tertiary care teaching centre in Puducherry, India, from August 2023 to January 2024. Data was collected by administering the semi-structured questionnaire after taking consent and entered in Excel sheet and analysis was done using SPSS software version 23.0 Results: About 63.9% of the participants were found to be males and 36.1% were females. 52.8% were nursing students and 47.2% were pharmacy students. 62.5% of the participants had good knowledge about diabetic retinopathy and 60% had a positive attitude towards the disease. However, good practices were found in only 52.2% of the study participants. On comparison, nursing students had better knowledge, attitude and practice regarding diabetic retinopathy than pharmacy students Conclusion: According to our research, nursing and pharmacy students demonstrated a satisfactory knowlegde and positive attitude towards diabetic retinopathy. However, there is room for improvement in terms of practice level which will contribute to the early detection and treatment of diabetic retinopathy, ultimately reducing the risk of vision-threatening complications.

Introduction: The imperative to address the high mortality rates associated with coronavirus disease (COVID-19) prompted a swift development of vaccines. By 2021, multiple vaccines had been introduced. However, a lack of conclusive long-term evidence regarding their effectiveness, coupled with apprehensions about potential effects on pregnancy, contributed to a diverse public reaction.Aim: To assess the perception of pregnant and postpartum/ postnatal women with respect to the COVID19 vaccine.Materials and Methods: A cross-sectional study was conducted among antenatal and postnatal mothers at a tertiary healthcare center, with data collection initiated only upon securing consent from study participants. The study, determining a sample size of 373, administered a 33-item questionnaire to the selected participants. Subsequently, the collected data underwent analysis utilizing SPSS software version 24.0.Results: The majority of participants in the study fell within the 28-32 age group (41.9%). When evaluating participant concern levels, 34.6% expressed moderate concern, with a notable association among those with college-level education. Notably, individuals testing positive for COVID-19 and those with COVID-19-positive family members displayed reduced likelihood of vaccine hesitancy. Concerns regarding the safety of COVID-19 vaccines emerged as a significant predictor of vaccine hesitancy. Moreover, participants exhibiting an enhanced sense of safety post-vaccination demonstrated a positive correlation with vaccine acceptance. Conclusion: COVID-19 vaccination acceptance remains suboptimal, with variations observed across demographic variables such as age, location, income, and occupation. Utilizing news and social media platforms can serve as effective tools to

Background: Endothelial dysfunction serves as an early indicator of atherosclerosis, preceding structural changes. Its assessment offers insight into the preclinical phase of cardiovascular disease, particularly crucial in Type 2 Diabetes Mellitus (T2DM) due to its association with glycemic control and disease duration. Flow-mediated dilation (FMD), reliant on endothelial nitric oxide release in response to shear stress, reliably gauges endothelial function across various conditions. Aim of the Study: This study aimed to evaluate endothelial dysfunction in T2DM patients compared to age- and sex-matched healthy controls. Additionally, it sought to correlate the duration of diabetes with the prevalence of endothelial dysfunction and examine its association with atherosclerosis risk factors in T2DM. Methodology: Non-invasive assessment using high-resolution Duplex Doppler Ultrasound of the Brachial Artery was conducted on 50 T2DM cases with or without vascular complications and 20 healthy controls. FMD, calculated as percentage increase in brachial artery diameter with increased flow, was employed to quantify endothelial function. Results: Endothelial dysfunction was observed in 20% of diabetics but absent in controls. Mean FMD values were significantly lower in diabetics (8.38 ± 12.32%) compared to controls (17.12 ± 10.53%; p < 0.007). FMD decline was noted across diabetes durations (10 years: 3.50 ± 1.61%), though prevalence did not escalate with longer duration. Conclusion: T2DM patients exhibit significantly impaired endothelial function compared to healthy counterparts, as evidenced by reduced FMD. The prevalence of endothelial dysfunction did not correlate with diabetes duration but was associated with hypertension, family history of diabetes, and smoking. Early intervention targeting these risk factors and optimizing glycemic control may mitigate vascular complications in T2DM.

Cancer of the oral cavity is one of the most common malignancy worldwide. The oral cavity cancer is a major public health problem in the Indian subcontinent, where it ranks among the top three cancer types in both incidence and mortality. The substantial risk factor includes tobacco products, alcohol, poor oral hygiene, nutrition, viral and dentition. There is high prevalence of oral cancer in western Odisha due to rampant use of tobacco. Oral cancer generally refers to squamous cell carcinoma of oral mucosal origin, which accounts for more than 90 percent of all malignancies. Early detection is easy and associated with improvement in survival whereas late detection results in significant morbidity and mortality. Well differentiated carcinomas have minimal pleomorphism and few mitosis. Surgery and radiotherapy being the main modality of treatment. In our study the focus is to determine risk factors associated with oral cancer, to determine the commonest site of presentation, to find out the gender and age group with highest incidence, to find the presenting stage at the time of hospital visit.

Background: Lymphomas are malignant clonal neoplasms of lymphocytes and their precursor forms. They are mainly of two types – non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL). Incidence of lymphomas, especially NHL is increasing worldwide and also in India, therefore morbidity due to the disease is also increasing. Thus, knowledge of its pathogenesis, histomorphology and immunophenotype will lead to possible early diagnosis and treatment of this potentially curable disease. In this background, a study has been conducted. Objective: 1) To study the histomorphological features of malignant nodallymphomas. 2) To evaluate the expression of a panel of immunohistochemical markers for categorisation of nodal malignant lymphomas and theirsubtypes. Methods:A study was conducted for a period of 6 and a half years from January 2012 to June 2018 at the Department of Pathology, ESIC Medical College and PGIMSR with a sample size of 75 cases. All the cases diagnosed as nodal lymphomas during that period, were included in the study. Immunohistochemistry (IHC) was performed. Data was compiled onto a masterchart and descriptive statistics performed. Results: Majority patients presented with cervical lymphadenopathy. NHL was morecommon than HL among nodal lymphomas. Among NHL, diffuse large B cell lymphoma was the most common.AmongHL,nodularsclerosiswasthemostcommonsubtype.BothHLandNHLhad a male predominance. The mean age in HL was lower than that inNHL. Interpretation and Conclusion: Clinicopathological correlation and a goodhistomorphological diagnosis,supplementedbyimmunohistochemistrywillenableefficientdiagnosisofmaligna nt nodal lymphomas, and enable application of targeted therapyoptions

Background: Acute pancreatitis is a disease with high rate of morbidity and mortality and is known to run an unpredictable course. Computed tomography is the gold standard technique not only for its global picture of the pathology and for the non-invasive method of evaluating the morphology of pancreas and peripancreatic regions in an acute situation. The purpose of the study was to determine the value of computed tomography evaluation in early diagnosis of severity, differences between pancreatitis & acute pancreatitis caused by mass lesions. Methodology: A prospective study comprise of 60 patients on clinical suspicion/diagnosis of acute pancreatitis, altered biochemical parameters (serum amylase, serum lipase) in favor of acute pancreatitis, Ultrasonography suggestive of acute pancreatitis and known case of chronic pancreatitis with features of acute symptoms referred to Department ofRadiology & Imaging, BSMMU, Dhaka, Bangladesh from January to June 2024. Plain and post-contrast series of the abdomen and pelvis were taken. Results: Outof 60 patients, 45 were male and 15 were female patients. Among these edematous pancreatitis was in 20% patients and pancreatic necrosis was in 23.3% patients. Other features like diffuse/focal pancreatic enlargement in (75%), peri-pancreatic fat stranding in (63.3%) and peri-pancreatic fluid collection in (40%). Among this alcohol was the most common cause of AP (83.3%). The accuracy and sensitivity of serum amylase and serum lipase in diagnosing AP were 40% and 63.3% respectively with CT showing 100% accuracy and sensitivity. Modified CT severity index was classified as mild (2 and 4), moderate (6) and severe (8 and 10) of which majority were mild (66%), moderate (22%) and severe (12%). Conclusion: Computed tomography is a sensitive, non-invasive imaging in early diagnosis and staging of severity of acute pancreatitis which help in prediction of prognosis of the disease. It helps to differentiate between edematous and necrotizing pancreatitis as serum lipase and amylase levels do not help to differentiate the type of AP. Modified CT severity index helps in evaluating the percentage pancreatic necrosis and to predict the possibility of developing local and systemic complications and necessity of tertiary care.

This study aimed to compare the clinical effects of hyperbaric ropivacaine alone and in combination with dexmedetomidine for spinal anesthesia in elective lower limb orthopedic procedures. A prospective, randomized, double-blind study was conducted on 100 patients undergoing elective lower limb orthopedic surgeries. Patients were randomly allocated into two groups: Group R received hyperbaric ropivacaine 0.75% (3 mL)+0.5 ml normal saline(total volume 3.5ml), and Group RD received hyperbaric ropivacaine 0.75% (3 mL) with dexmedetomidine (10μg) (total volume 3.5ml). The onset and duration of sensory and motor block, hemodynamic parameters, time to first analgesic request, and side effects were recorded. Results showed that the addition of dexmedetomidine to hyperbaric ropivacaine significantly prolonged the duration of sensory and motor block (p < 0.001), extended the time to first analgesic request (p < 0.001), and provided better intraoperative conditions compared to ropivacaine alone. Hemodynamic parameters remained stable in both groups, with no significant differences in side effects. This study concludes that the addition of dexmedetomidine to hyperbaric ropivacaine for spinal anesthesia in lower limb orthopedic procedures provides superior analgesia and prolonged motor and sensory block without significant hemodynamic alterations or increased side effects.

Ovarian cancer is one of the most lethal gynecological cancers in the world, and its incidence is increasing gradually in Asian countries as a consequence of demographic factors and lifestyle changes. Ovarian cancer epidemiology, risk factor profiles, treatment aspects, and challenges may vary significantly between Asian countries. Hence, this study aims to summarize the current evidence on these topics in Asia including gaps which need stratified healthcare responses. A thorough literature search was performed on PubMed, Scopus and Web of Science for studies published between the years 2000 to 2023. Eligibility criteria Studies conducted on ovarian cancer in Asian populations (incidence, mortality and treatment disparities). Regional differences were observed in risk determinants, methods of diagnosis, and access to treatment based on results from a health-related quality of life analysis. In 2020, 40.5% (125,629/310,991) of global cases of ovarian cancer were from Asia with China (6.6 per 100000) and India (4.9 per 100000) contributing a large burden to the disease. Industrialized countries have a much more reported higher incidence rate as Japan (ASR 8.5) and Singapore (ASR 9.0), which is also due to change in lifestyle and availability of medical treatment. Frequent risk factors are BRCA1/2 mutations, advanced maternal age, and rising obesity. Poor access to healthcare causes patients in many low-income regions to be diagnosed with their illness only at later stages, and rural areas may lack further treatment options. As promising as the new molecular diagnostics and novel targeted therapies are, they will largely remain unavailable in world-wide resource–limited settings. Phase I and II studies of a novel olaparib-based regimen following first-line chemotherapy for advanced ovarian cancer in Asia show promising efficacy with manageable adverse events; however, further improvement is needed for public health initiatives towards early detection, genetic testing offering access to treatment and equitable access to evidence-based medicine.

INTRODUCTION: Asymptomatic bacteriuria is the significant presence of bacteria in the urine of an individual without symptoms. This study was carried out to determine the prevalence of asymptomatic bacteriuria in pregnant women attending RIMS hospital, Imphal. MATERIAL AND METHODS: The study was conducted in the Department of Microbiology, RIMS hospital from August 2017 till January 2019.A total of 380 urine samples were collected from pregnant women attending Obstetrics and Gynaecology OPD, RIMS Imphal. Culture of the urine was done on Cysteine lactose electrolyte deficient agar. For positive growth, conventional methods were performed to identify the bacteria and antibiotic susceptibility testing was done on Mueller Hinton Agar. RESULTS:Significant bacteriuria was found in 9.1% of the asymptomatic cases. 30 urine samples were contaminated and number of positive growth was 32 (17 Escherichia coli, 7 Staphylococcus saprophyticus, 4 Staphylococcus aureus, 2 Enterococcus faecium, 1 Klebsiella pneumoniae, 1 Acinetobacter baumannii. CONCLUSION: Routine urine culture should be carried out on all antenatal patients in order to identify any unsuspecting infection. This will help in reducing maternal and obstetrics complications associated with pregnancy.

Introduction: Microbiological contamination of various operation theatres of tertiary care hospitals by potential pathogens has led to the rise in incidence of health care associated infections. The aim of the present study is to assess, compare and correlate microbial contamination levels in operation theatres using both an active and passive sampling methods. Material &Methods: A prospective study conducted in the Department of Microbiology, Modern Government Maternity Hospital, Hyderabad, Telangana, for a period of 1 month from July 1st to August 1st, 2023. Sampling was performed in 7 Operation theatres both at rest (before beginning the surgical activity) and during surgery. Air from one operating room per day was sampled by both Active and Passive methods at the same time, at rest and during surgery for one month. In Active sampling method, microbiological air sampler is used which physically draws a known volume of air over a particle collection device media i.e., Sheep blood agar and the number of colonies grown on the media is measured in CFU/m3of air. In passive sampling method, Sheep blood agar plates were placed in OTs, according to 1/1/1 rule and results are expressed in CFU/m2 /hour. Results: The mean number of colonies is 17.4 CFU/ m3 and 63.1 CFU/m2 /hour at rest; 42.4 CFU/ m3 and 186.69 CFU/m2 /hour during surgery for active and passive air sampling methods respectively. Statistical analysis (spearmen’s rank correlation coefficient) confirmed that the two methods are correlated with each other in a comparable way with the quality of air. Conclusion: The microbiological quality of the air in operating theatres is a significant parameter to control healthcare associated infections, and regular microbial monitoring can represent a useful tool to assess environmental quality and to identify critical situations which require corrective intervention. Hence, it is possible to conclude that both the methods are correlated with each other, but passive method can be used for general monitoring of air contamination, such as routine surveillance programs.

Introduction: A vocal cord nodule (Singer’s or screamer’s or preacher’s nodes) is a common laryngeal benign lesion and also a common cause of hoarseness of voice in adults. A common space shared by Anesthesiologist in view of airway management and surgeons in view of excision or biopsy for vocal cord nodules. Objective: Describe the Airway management with advantages of Microlaryngeal Tracheal Tube in Vocal Cord Nodules. Method: A literature review was conducted using databases such as PubMed, Elsevier, and Google Scholar to identify relevant studies comparing Microlaryngeal Tracheal Tube with Portex Endotracheal Tube in Vocal Cord Nodule biopsy or excision. Result: We present a case of 63 years old male with Vocal Cord Nodule who underwentVocal Cord Nodule biopsy or excision under General Anesthesia using a Microlaryngeal Tracheal Tube for airway management. Conclusion: This case report highlights the superiority of Microlaryngeal Tracheal Tube (MLT) for airway management allowing better visibility and access to the surgical site.

Background: Both bone diaphyseal fractures of the forearm are common injuries in children. This study aimed to compare the functional outcomes and complications of conservative management and surgical treatment with titanium elastic nailing system (TENS) for these fractures. Methods: A total of 40 children (aged 4-14 years) with both bone diaphyseal fractures of the forearm were included in this study. Twenty patients were treated conservatively, and 20 underwent surgical treatment with TENS nailing. Functional outcomes, time to union, and complications were assessed at 6 months post-treatment. Results: The surgical group had a significantly higher proportion of patients aged ≥ 10 years (75% vs. 15%; p=0.0001) and required longer duration of surgery (95% requiring 90 minutes vs. 100% requiring < 20 minutes; p<0.001). The mean time to union was significantly shorter in the surgical group (6.70 ± 1.867 weeks) compared to the conservative group (8.80 ± 1.642 weeks) (p=0.01). The functional outcome at 6 months was excellent in 90% and good in 10% of the surgical group, compared to 80% excellent and 20% good in the conservative group (p=0.3753). Complication rates were minimal and comparable between the two groups (p=0.1060). Conclusion: TENS nailing is an effective treatment option for both bone diaphyseal fractures of the forearm in children, particularly in older children, providing faster union times with comparable functional outcomes and complication rates to conservative management.

Background: To determine the Presepsin level in clinically suspected neonatal sepsis.To Evaluate the efficacy of Presepsin as a early diagnostic marker of sepsis with previously existing other neonatal sepsis markers like CRP, Total leucocyte count, Platlet count.To correlate Presepsin with conventional blood culture method for diagnosis of neonatal sepsis.

Methods: Blood samples were taken from 100 clinically suspected neonatal sepsis and were processed for blood culture, detection of serum level of CRP by latex agglutination test and detection of serum level of PRESEPSIN by ELISA

Results: In the present study, Serum C-Reactive protein was elevated in 16 out of 29 culture proven sepsis. The Abnormal WBC count was seen in 7 out of 29 cultures with proven sepsis and Platlet count was reduced in 12 out of 29 neonatal sepsis .Presepsin was elevated in 24 out of 29 cultures with proven sepsis. The sensitivity of Presepsin in detecting sepsis was 82.8%, its specificity was 77.5%, its positive predictive value was 60% and its negative predictive value was 41.4%.

Conclusion: The estimation of Presepsin also helps in avoiding unnecessary antibiotic usage where it is not required and thereby reducing the hospital cost and the occurrence of bacterial resistance. Estimation of Presepsin could be a milestone in the continuing research for a definitive diagnostic biomarker in neonatal sepsis.

Introduction: Peripheral ossifying fibroma (POF) is a nonneoplastic enlargement of the gingiva precipitated by local irritation and minor trauma. POF represents 9.6% of all gingival tumors and 3.1% of the oral lesions which are biopsied. Dental calculus, plaque, microorganisms, dental appliances, and restorations are some of the etiological factors. Case Report: This case report deals with a 35-year-old female presented with a complaint of a growth on the maxillary right posterior gingiva. Clinical examination revealed a firm, pinkish-red, pedunculated lesion interdentally over tooth 16. The lesion was tender and measured approximately 1.2 cm in diameter. Histopathological analysis confirmed the diagnosis of peripheral ossifying fibroma, characterized by fibroblastic connective tissue with focal areas of mineralization. Management: The lesion was surgically exercised using the conventional scalpel method, and postoperative healing was uneventful. The patient was advised to maintain oral hygiene and regular follow-ups to monitor for recurrence.

Background: Early skin-to-skin contact (SSC) between mother and baby immediately after birth has been widely recognized for its benefits in promoting breastfeeding initiation, regulating neonatal body temperature, and enhancing maternal-infant bonding. However, in cases of cesarean delivery, the implementation of SSC is often delayed due to various medical and procedural challenges. This study aimed to assess the effectiveness of a planned teaching program on the knowledge and attitude of staff nurses regarding early SSC and its role in the promotion of immediate initiation of breastfeeding after cesarean delivery. Methods: A quasi-experimental pre-test and post-test design was used. A purposive sample of 100 nursing students from New Civil Hospital, Surat, was selected. Data were collected using a structured questionnaire and an attitude scale before and after the intervention. The planned teaching program consisted of lectures, demonstrations, discussions, and audiovisual aids. Data were analyzed using descriptive and inferential statistics. Results: The study revealed a significant improvement in knowledge and attitude scores among participants post-intervention. Pre-test results showed that only 20% of participants had good knowledge, while this increased to 93.33% post-intervention. Similarly, attitude scores showed a positive shift, with a significant increase in mean values. The paired t-test analysis confirmed the statistical significance of these improvements (p < 0.05). Conclusion: The study demonstrates that a structured educational intervention can effectively enhance the knowledge and attitudes of staff nurses regarding early SSC and immediate breastfeeding initiation after cesarean delivery. These findings emphasize the need for continuous training programs for nursing staff to improve neonatal and maternal outcomes in maternity care settings.

Introduction: Lipoma Arborescens (LA) is a rare, benign synovial condition, primarily affecting the knee, characterized by the growth of adipocytes within the synovial membrane. Case Presentation: Patient 1:A23 year-old male presented with left knee pain and swelling for three months. . Symptoms included stiffness, particularly after rest, and progressive limitation of joint mobility. Patient 2 :A 25 -year-old male presented with right  knee pain and swelling for 8 years. Symptoms included stiffness, particularly after rest, and progressive limitation of joint mobility. Patient 3 :A 22-year-old male presented with progressive swelling and intermittent pain in the leftknee for duration of  2 years . The symptoms were associated with mild stiffness and reduced range of motion. Patient  4 : A 32-year-old male presented with chronic swelling and intermittent pain in the rightknee over the past  5 years . Symptoms included stiffness, particularly after rest, and progressive limitation of joint mobility. There was no history of trauma, systemic symptoms, or prior joint disease in these patients. On examination, a soft, mobile, non-tender mass was palpable, with reduced range of motion Conclusion: Recognizing the MRI features of LA is crucial for accurate diagnosis. Arthroscopic synovectomy offers effective treatment with excellent outcomes.MRI showed characteristic frond-like synovial masses, leading to a diagnosis of LA, confirmed by arthroscopic biopsy.

Myelin oligodendrocyte glycoprotein (MOG), a member of the immunoglobulin (Ig) superfamily, is a protein found exclusively on the outer surface of myelin sheaths and oligodendrocyte membranes. Because of this specific localization, MOG can become a target for both cellular and humoral immune responses in inflammatory demyelinating diseases. Its expression occurs later in postnatal development, making it a key marker for the maturation of oligodendrocytes. Autoantibodies targeting myelin oligodendrocyte glycoprotein (MOG) can result in various autoimmune disorders, including optic neuritis, transverse myelitis, brainstem encephalitis, and acute disseminated encephalomyelitis.In this case report we present a 19 year old male patient presented with complaints of bilateral lower limb numbness with acute urine retention since 1 day.

Background: This study aimed to investigate whether the diameter of antral follicles, specifically comparing those with diameters of 6 mm or less (AFC≤6) versus those greater than 6 mm (AFC > 6), can predict ovarian responsiveness, as assessed by the Follicular Output Rate (FORT) in women undergoing IVF treatment.138 women with regular menstrual cycles and no ovarian abnormalities, undergoing controlled ovarian hyperstimulation (COH) were included in this study. Number and size of antral follicles were noted on day 2 of cycle. Number of pre ovulatory follicles were noted and FORT was calculated on day of trigger with HCG. The correlation among FORT with age, AFC ≤ 6, AFC > 6, number of oocytes, body mass index (BMI), and antiMullerian hormone (AMH) were also assessed. Result: The mean age of the women was 31.36  (± 3.28) years, the mean FORT was 53.453. We found positive correlation between the FORT and antral follicles with diameter ≤6mm (r= 0.467, P  6mm in diameter (r = − 0.436, P<0.001). Conclusion: Ovarian responsiveness, as indicated by the Follicular Output Rate (FORT), was positively correlated with the presence of smaller antral follicles (AFC ≤6mm).

Background: Uterine leiomyomas are common benign tumors of the female reproductive system, but cervical fibroids are rare, accounting for 1–2% of all cases. This case report highlights a diagnostic challenge where a large exophytic intramural fibroid mimicked a cervical fibroid, termed as "pseudo cervical fibroid." Methods: A 50-year-old woman presented with a two-year history of white vaginal discharge without menstrual or pressure symptoms. Clinical examination revealed a suprapubic mass, assessed as a cervical fibroid. Investigations, including ultrasonography and MRI, identified multiple fibroids, with the largest (9×8×3 cm) located in the cervix. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed, and the specimen was analyzedhistopathologically. Results: Intraoperative findings included a bulky, vascular uterus with multiple fibroids and a large cervical fibroid, displaying the "lantern on dome of St. Paul’s cathedral" appearance. Histopathology revealed chronic cervicitis and confirmed the diagnosis of pseudo cervical fibroid. The surgical procedure was completed successfully without bladder or ureteric injury. Conclusion: Pseudo cervical fibroids pose a diagnostic and surgical challenge due to their atypical presentation and close proximity to vital pelvic structures. Comprehensive preoperative evaluation and surgical expertise are crucial for successful management. This case underscores the importance of distinguishing pseudo cervical fibroids from true cervical fibroids to guide treatment strategies effectively.

Background: Postoperative infections remain a significant challenge in obstetrics and gynecological surgeries, leading to increased hospital stays and healthcare costs. Antibiotic prophylaxis aims to reduce microbial colonization during surgery. This study compares the effectiveness of short-term and long-term antibiotic regimens in preventing infections following elective caesarean sections and abdominal hysterectomies. Methods: An interventional prospective study was conducted over a year with 100 participants. Group 1 (50 patients) received a short-term regimen of ceftriaxone, while Group 2 (50 patients) underwent a long-term regimen. Key metrics, including wound infection rates, febrile morbidity, duration of hospital stay, and the need for additional antibiotics, were analyzed. Results: Wound infections were more frequent in Group 1 (14%) compared to Group 2 (2%), with febrile morbidity similarly higher in Group 1 (16% vs. 4%). The mean hospital stay was significantly shorter for Group 1 (3.12 days vs. 5.24 days). However, Group 2 demonstrated better infection control overall. Conclusion: While both regimens were effective, the short-term regimen was associated with reduced hospital stay and costs but increased infection rates. Long-term antibiotics offered superior infection control but at the expense of prolonged hospitalization and higher risk of nosocomial infections. Patient selection remains critical in determining the appropriate prophylactic approach.

The cough is one of the most common problem faced all people. There are mainly two type of cough, one is Dry cough and another one wet cough. Dry cough is no mucous secretion while in wet cough there is cough with mucous secretion. Syrup is commonly used and popular dosage form which is used to cure cough and cold, because it having easy to patient compliance. The herbal cough syrup was. Formulated using crude drugs as Marshmallow root (as a anti-irritant), Elderberry (as a anti-bacterial), Pineapple (as a anti-inflammatory) & Ivy (as a anti-viral).

Quality of herbal cough syrup was evaluated for pre-formulation and post formulation like density, viscosity, pH and various organoleptic characteristics

The clinical presentation of ascariasis depends on the intensity of infection and the organs involved.  Although most individuals are asymptomatic, few can present acutely with intestinal obstruction and extra-intestinal complications.  Extra-intestinal complications can involve the pulmonary, hepato-biliary, renal and central nervous systems. [1-3] Encephalopathy as a presenting feature of ascariasis is unusual and rarely described.

We encounter an 8-year-old girl with severe acute malnutrition with a rare presentation of encephalitis with multiple episodes of convulsion because of heavy infestation with roundworms

Avipattikar churna is well known Ayurvedic formulation in India for Amalpitta. Voluminous dose leading to poor patient compliance, less residence time in stomach and less stability are the major limitations of the Churna. Thus, the objective of research work was to develop a novel gastroretentive floating drug delivery system of Avipattikar churna. The churna was prepared and evaluated for phytochemical analysis. The main constituents, Jalap, and Clove, contained scopoletin and eugenol as active markers. A floating tablet of Avipattikar churna was optimized using a 32 factorial design, with HPMC K4M and HPMC K100M concentrations as independent factors and floating lag time (FLT) and % release of scopoletin and eugenol at 1 h, at 4 h and at 8h as dependent variables. The optimized formulations were evaluated by physical parameters. The optimized formulation was selected based on factorial design and numerical desirability Index values. In-vitro dissolution study was performed for optimized formulation and compared with marketed Avipattikar churna. Release mechanisms of markers were determined using various kinetic models and DD solver. The stability studies followed ICH guidelines. The preliminary trial batches were formulated by using direct compression method. 15% of the mixture of HPMC K100M and HPMC K4M was finalised based on the factorial design results and desirability index. Optimized formulation showed FLT of 88 ± 0.3 sec, with cumulative eugenol release at 1h (18.78%), 4h (60.23%), and 8h (95.36%). Scopoletin cumulative release was 21.43%, 68.51%, and 89.34% at 1h, 4h, and 8h, respectively. In a release kinetics, formulation showed diffusion mechanism followed by anomalous diffusion. The formulation was stable as revealed by 3 months accelerated stability studies as per ICH guidelines. From the experiments, 15% of HPMC K100M and HPMC K4M gave shorter floating lag time, good consistency and extended the duration of drug release over time frame of 8h. The formulation was found to be stable.

Background and Objective: Rhomboid muscle pain is a common condition that can significantly affect an individual's functional ability and quality of life. InstrumentAssisted Soft Tissue Mobilization (IASTM) and joint mobilization are therapeutic techniques that have garnered attention for their effectiveness in pain management. To assess the effectiveness of IASTM combined with Maitland scapulothoracic joint mobilization against other conventional physiotherapy in alleviating pain among patients suffering from rhomboid muscle pain. Methods: A total of 30 subjects with rhomboid muscle pain were randomly assigned to two groups: Group A received IASTM combined with Maitland mobilization, while Group B received conventional physiotherapy. Pain levels were assessed pre- and postintervention using the Visual Analog Scale (VAS) and Numerical Pain Rating Scale (NPRS). The paired t-test was utilized to analyze differences between pre- and postintervention scores within each group. Results: There was a marked improvement in both groups. For Group A, the VAS scores significantly decreased (t-statistic = 9.92, p-value = 1.03 times 10^{-7}, and NPRS scores reflected a marked improvement (t-statistic = 11.82, p-value = 1.14 times 10^{-8}, showing high efficacy of the combined intervention. Group B achieved considerable reductions both in VAS (t-statistic = 8.40, p-value = 7.68 times 10^{-7} ) as well as in NPRS score (t-statistic = 16.36, p-value = \1.60 times 10^{-10 }. All these prove the fact that treatment with conventional physiotherapy enhances pain management and also proved in the present analysis that it even outshines this benefit. Conclusion: The results of this study suggest that the combination of IASTM and Maitland mobilization is more effective than conventional physiotherapy alone in managing rhomboid muscle pain. These techniques may be added to clinical practice to facilitate better outcomes for patients who experience pain and functional limitations.

BACKGROUND: Chronic suppurative otitis media (CSOM) is commonly treated with tympanoplasty, which has a reported success rate of 85-90%. Success is influenced by various factors, including graft material and surgical technique. The Eustachian tube, vital for middle ear function, can be affected by nasal issues such as deviated nasal septum (DNS), which may impact middle ear ventilation. DNS prevalence is around 22.83%, leading to questions about its effect on tympanoplasty outcomes. MATERIALS AND METHODS: A prospective study was conducted on 50 CSOM patients, divided into two groups based on DNS presence (25 with DNS, 25 without). Patients underwent tympanoplasty using the underlay technique with temporalis fascia graft and were followed for six months to assess graft uptake through otoscopy, microscopy, and audiometry. RESULTS: No significant differences in hearing gain (p=0.3) or graft uptake (p=0.13) were found between the two groups. The A-B gap(air-bone gap) also showed no significant difference (p=0.08). CONCLUSION: The study suggests that DNS may not significantly affect tympanoplasty outcomes, challenging the need for pre-tympanoplasty septoplasty. Larger studies are recommended for further exploration.

Polycystic Ovarian Syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age, often leading to complications in pregnancy. This study evaluates the maternal and neonatal outcomes in women diagnosed with PCOS. The study was conducted at a tertiary care hospital, involving pregnant women with PCOS, tracking their pregnancy progress, complications, and neonatal outcomes. Findings suggest an increased prevalence of gestational diabetes, hypertensive disorders, preterm birth, and neonatal complications such as low birth weight and NICU admissions. Early diagnosis and proper antenatal care are crucial in improving both maternal and neonatal outcomes.

Background: Early initiation of breastfeeding (EIBF) within the first hour of birth is crucial for neonatal health and survival. Despite global recommendations, EIBF rates remain suboptimal due to various maternal, medical, and environmental factors. Objective: This study aimed to identify barriers to early initiation of breastfeeding among healthy late preterm and term infants in a tertiary care hospital in Himachal Pradesh, India. Methods: A prospective observational study was conducted from November 2022 to October 2023. A total of 1,020 mother-infant dyads were enrolled, and data were collected at the time of discharge. Statistical analysis was performed using SPSS version 17, with chi-square tests used to determine associations between breastfeeding initiation and maternal factors. Results: Among the participants, 66.1% initiated breastfeeding within one hour of birth, while 33.9% had delayed initiation. The most common reasons for delayed breastfeeding included time taken for postnatal transfer (41%) and delayed milk production (40.1%). Other significant factors included maternal discomfort (11.5%), difficulty with positioning/attachment (2.6%), and anatomical challenges such as flat or inverted nipples (1.7%). Early initiation was significantly associated with maternal age (p = 0.003), education level (p = 0.006), and occupation (p = 0.010). Mode of delivery and peripartum complications also had a significant impact (p = 0.001), with cesarean deliveries contributing to delays. Conclusion: While breastfeeding initiation rates in the study population were higher than national averages, logistical barriers, maternal discomfort, and cesarean deliveries contributed to delays. Strengthening postnatal support, improving breastfeeding education, and addressing hospital-related delays can further enhance EIBF rates.

Background: The subarachnoid block is a preferred regional modality for patients undergoing surgeries of below umbilical region. In this perspective, we aimed to compare the efficacy and safety of 40 mg intrathecal chloroprocaine1% alone versus in combination with nalbuphine 0.8mg and fentanyl 20 mcg as an adjuvant in day care surgeries performed under subarachnoid block. Method: Overall, 150 patients were enrolled in this research. They were randomly divided into three groups of 50 each with the help of computer-generated random tables. Both the patient and the observer were blinded to the study. Group C, NC and FC received 40mg of 1% chloroprocaine (4ml) with 1 ml normal saline, nalbuphine 0.8 mg in 1 ml, fentanyl 20μg in 1 ml intrathecally respectively. Result: The time of onset of sensory block was calculated when sensory block was achieved at the level L1. No significant difference was observed between groups in onset of sensory block, peak sensory block level and time to reach peak sensory block level. The time for two-segment regression and regression to S2 was statistically significant between groups as the mean time was fastest in group C followed by group FC and NC. The VAS score was greater in control group as compared to group FC and NC at 120 minutes. Conclusion: Thus, we conclude that addition of opioids as an adjuvant to intrathecal short acting local anaesthetic 1% chloroprocaine have synergistic effect on analgesic action without affecting motor block.

Systemic review and meta-analysis of grey lesions in breast pathology.The current systematic review & meta-analysis adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, making sure that reporting is rigorous and transparent. Our search strategy focused on identifying relevant studies published between May 2020 and May 2021, with an emphasis on English language articles. Medline was systematically queried, and an extensive search of the PubMed Central (PMC) literature was conducted to pinpoint journal articles featuring both FNAC and HPE comparisons. Particularly in a situation where resources are limited, this systematic review and meta-analysis that compares the effectiveness of Fine Needle Aspiration Cytology (FNAC) against Histopathological Examination (HPE) is unique. FNAC exhibits substantial predictability in identifying malignancies within the grey zone of breast lesions, reinforcing its efficacy in resource-limited settings.

Aim: To assess the radiographic proximity of impacted mandibular third molars to the inferior dental canal(IDC) with its radiographic predictors on digital panoramic radiographs and to evaluate pattern of impacted third molars. Materials & Methods: Preoperative 50 orthopantomograms (OPGs) were examined. The radiographic relationship of the root apex of mandibular third molars and the IDC was assessed and categorized according to the following criteria: adjacent, superimposed, perforation, grooving, notching, or none. The type of impaction, age, and sex of the patient were also noted. Results: The prevalence of adjacent position of IDC with respect to third molar was most common i.e. 60% followed with superimposed (24%). Least common was grooving position (2%). This difference in proportion is statistically significant (p <0.05). Adjacent position was seen more in males (60%) than females (40%). Superimposed was seen more among females (66.7%) as compared to males (33.3%). However there was no significant association between gender and position of IDC (p = .337). The prevalence of vertical pattern of impaction was most common (52%) followed with horizontal (32%) and least common was mesio-angular (16%). This difference was statistically significant (p = .008).Vertical pattern of impaction was prevalent more in male (61.5%) in comparison to female (38.5%). Horizontal pattern was seen more in female (68.8%) than in male (31.3%). However there was no significant association between gender and pattern of impaction (p=0.69). Conclusion: The IDC are mostly bilaterally symmetrical, and the position of the IDC varies with respect to the apices of the roots of the impacted mandibular third molars with the majority being adjacent followed by superimposed. The most common impaction is vertical type. The variation should be appreciated, particularly by the oral surgeon when undertaking surgical removal of the impacted mandibular third molars.

Immunization is a key part of primary health care and global health security.Every year ,infectious diseases claim millions of lives,primarily in developing nations,and might be largely avoided with the use of vaccines.Vaccines work by stimulating the body’s immune system to produce antibodies that fight diseases-causing germs. The development of vaccines involves careful consideration of antigen classes, formulation, and delivery routes. Vaccine administration can be mucosal (nasal, oral, buccal, sublingual, rectal, vaginal) or parenteral (intramuscular, subcutaneous, intravenous, intradermal), depending on the site of infection, transmission route, and desired immune response. Vaccination remains one of the most cost-effective medical interventions, continuously evolving to enhance efficacy and accessibility. Microneedles (MNs) are medical devices primarily used for drug delivery, disease diagnostics, and collagen induction therapy. Consisting of micro-sized needles (25–2000 μm), MNs offer precise and minimally invasive applications. Though first proposed in the 1970s, their popularity has grown due to advancements in materials and applications. Since the 2000s, MNs have been developed using materials such as silicon, metal, and polymers, and they exist in various forms, including solid, hollow, coated, and hydrogel types. MNs facilitate drug, vaccine, and therapeutic delivery through microneedle patches or microarray patches, with applications spanning ophthalmic, vaginal, transdermal, cardiac, vascular, and gastrointestinal drug administration. Among the most economical medical procedures, microneedle vaccination continues to evolve, improving its effectiveness and accessibility in disease prevention.

CT imaging has evolved significantly, moving from single-slice scanners to multi-slice, dual-energy, and now photon-counting CT (PCCT). Artificial Intelligence (AI) has been integrated into the imaging workflow to improve image reconstruction, diagnostic accuracy, and patient outcomes. This study focuses on the evolution of CT scanners with an emphasis on the advancements brought by PCCT and AI, particularly in a tertiary care setting. Conclusion: Photon-counting CT and AI offer revolutionary advancements in radiology by improving image quality, reducing radiation dose, and enhancing diagnostic precision. Their integration into clinical practice is crucial for personalized patient care and efficient workflow management in tertiary care centers. Introduction CT imaging has undergone remarkable transformation since its inception in the 1970s. The introduction of photon-counting technology and the integration of artificial intelligence are two major milestones that have redefined the diagnostic potential of CT scanners. This evolution is essential for tertiary care centers where high patient volumes and diagnostic accuracy are critical. Aim To study the evolution of CT scanners, focusing on photon-counting technology and AI integration, and their impact on clinical outcomes in a tertiary care setting. Objectives To evaluate the technological advancements from conventional CT to photon-counting CT. To assess the role of AI in improving CT imaging quality and diagnostic accuracy. To analyze the impact of PCCT and AI on radiation dose reduction and patient outcomes. Materials and Methods The study involves a retrospective analysis of the progression of CT technology within a tertiary care center, focusing on the transition from traditional to photon-counting CT and the incorporation of AI-based solutions for imaging and diagnostics. Results Image Quality: PCCT showed a significant improvement in image resolution compared to conventional CT, with sharper images and better material differentiation. Radiation Dose: A reduction in radiation dose was observed with PCCT, with a 20-40% decrease compared to traditional CT techniques. AI Integration: AI-assisted image reconstructions reduced noise and enhanced the diagnostic accuracy, particularly in complex cases. Clinical Outcomes: The combined use of PCCT and AI led to earlier detection of pathologies and more accurate diagnoses, reducing the need for repeat scans. Conclusion: the ongoing advancements in CT technology, marked by the introduction of PCCT and AI, are set to transform medical imaging, offering improved diagnostic accuracy, faster scanning, and reduced radiation exposure, paving the way for more efficient and personalized healthcare solutions.

Background: Heart rate and blood pressure play an important role to determine the cardiac health of the patient during the treatment. Significant alterations in these parameters enable us to take appropriate actions during emergencies and comprehend the potential risks associated with dental procedures. The objective of this study is to determine the changes in the heart rate and blood pressure of the patient before and after dental extraction. Through a thorough evaluation and analysis, researchers endeavour to discern whether there are discernible patterns of alterations in the vital signs in the patient following extraction. Materials and method: A total of 60 patients were selected for the study out of which 34 were males and 26 were females. All the patients were in an age group of 17 till beyond 77 of the age. Prior to the procedure, blood pressure and heart rate were measured. Dental extraction of the tooth was subsequently performed, followed by post-operative measurement of blood pressure and heart rate. Results: Significant difference in post operative pulse was noticed after extraction where there was decrease in post operative pulse. A decrease in post-operative blood pressure was observed, but these variations remained within the normal range. Conclusion: The vital signs exhibited alterations before and after tooth extraction. Thus, it is concluded that various factors such as dental anxiety, stress, local anaesthesia alter the blood pressure and heart rate of a patient post dental extraction.

Dental fear and anxiety (DFA) are prevalent psychological issues that significantly affect patients undergoing dental procedures, particularly in the context of tooth extractions. These emotional responses can range from mild discomfort to severe distress, influencing patients’ willingness to seek dental care and potentially leading to avoidance of necessary treatments. A prospective and descriptive clinical study was performed on. All patients who underwent the conventional dental extraction. DA levels were assessed by virtue of the modified dental anxiety scale (MDAS) and dental fear survey (DFS). Tests were made in an isolated room preoperatively. The differences in anxiety levels according to age and gender were also evaluated. Understanding the psychological aspects of dental fear and anxiety is crucial for improving patient outcomes, enhancing the overall dental experience, and fostering a more positive therapeutic relationship between dentist and patient.

Background: Infection control in dentistry is a critical aspect of clinical practice due to the continuous emergence of transmissible infectious agents. Cross-infection remains a significant concern, particularly through aerosols, bloodborne pathogens, and contaminated dental unit waterlines (DUWLs). Compliance with infection control protocols is essential to minimize occupational risks. This study assesses the awareness and adherence to cross-infection control measures among dentists in their workplace in Bhopal City. Materials and Methods: A descriptive cross-sectional study was conducted among 312 dentists practicing in solo, group, and hospital-based settings in Bhopal City. A structured, pre-validated questionnaire was distributed online, covering aspects such as demographic characteristics, awareness of cross-infection control, preferred preventive measures, sterilization practices, and concerns regarding infection risks. The data were analyzed using SPSS Version 29, with statistical significance set at p ≤ 0.05. Results: Out of 312 participants, 175 (56.1%) were female and 137 (43.9%) were male. The majority (51.6%) were clinical specialists, while 48.4% were general practitioners. Among the respondents, 51.0% practiced solo, 14.1% worked in group clinics, and 34.9% were in hospital-based settings. The study found no significant difference in infection control awareness across gender, professional status, or practice type. A high proportion of dentists (88.8%) consistently followed universal precautions, while 93.3% reported strict adherence to avoiding exposure to sharp devices. Notably, 92.3% of respondents expressed concern about cross-infection risks, and 85.9% recognized the role of high aerosol suction in minimizing contamination. However, 31.4% lacked awareness of cross-infection protocols, and 11.2% had not been vaccinated against hepatitis B. Conclusion: The study indicates a high level of awareness and compliance with infection control measures among dentists in Bhopal. However, gaps exist in practices like high-volume suction use, handpiece sterilization, and waste disposal. Regular training and audits are crucial for improved adherence.

Galactorrhea is defined as milky discharge from breast in men or women who are not breastfeeding for more than one year. It may result from excessive secretion of prolactin from anterior pituitary or from increased sensitivity of breast tissue to prolactin. There are many causes of hyperprolactinemia and galactorrhea and the most sinister being pituitary tumours. Occasionally certain drugs can cause hyperprolactinemia leading to galactorrhea and irregular menstrual cycles. Levosulpiride which is commonly used for its antiemetic and antidyspeptic actions can also rarely cause hyperprolactinemia and galactorrhea. We present a case of galactorrhea in a female of 35 years who was on treatment for dyspeptic symptoms with a combination of pantoprazole and levosulpiride, which subsided after stopping the offending drug. Critical review of prescription in dealing with a case of galactorrhea can avoid unnecessary investigations.

The liver is a metabolically adaptable organ that is essential for controlling blood glucose and cholesterol levels. Fatty acids (FAs) are continuously flowing into the liver from a variety of sources, such as dietary sources, adipose tissue, endogenous synthesis from non-lipid precursors, intrahepatic lipid droplets, and recycling of triglyceride-rich leftovers. Triglycerides, which can be oxidised, stored, or released into the bloodstream as very low-density lipoproteins, are produced in the liver using FAs. Many factors can influence intrahepatic FA partitioning, and while there is good evidence that both phenotype (e.g., sex, ethnicity, and adiposity) and dietary macronutrient composition can play a role in intrahepatic triglyceride accumulation, their interaction is still poorly understood. The processes of FA uptake, FA synthesis, and the intracellular partitioning of FAs into storage, oxidation, or secretory pathways are tightly regulated; an imbalance in these processes leads to intrahepatic triglyceride accumulation and is linked to the development of metabolic dysfunction-associated steatotic liver disease. This review's objectives are to investigate how phenotypes affect the delivery, synthesis, and disposal of FAs and to comprehend how the makeup of dietary macronutrients may affect how FAs are partitioned in the human liver in vivo.

Objective: Although the effectiveness and adverse effects of long-term therapy are still mostly unknown, patients are increasingly using and seeking LT4/LT3 combination treatment for persistent hypothyroid symptoms. The purpose of this study was to assess the quality of life (QoL) and hypothyroid symptoms of the patient group that was affected by LT4/LT3 in a long-term manner. Methodology: A cross-sectional study of 66 hypothyroid patients who had starting LT4/LT3 combination medication earlier was conducted. The patients were divided into two groups based on their current treatment: T3 responders, who were still getting LT4/LT3 treatment, and T3 non-responders, who had stopped LT3 treatment since it was not working. Hypothyroid symptoms were measured using a validated symptom score, and QoL was assessed using ThyPRO. The article presents a real-world study that shows dissatisfied people being treated at an outpatient clinic. Results: The subjects started LT4/LT3 combination therapy 5.4 years ago, and their median age was 56. Twelve patients stopped LT3 treatment because it was ineffective, whereas fifty-four patients remained to undergo LT4/LT3 therapy. The QoL of the patients in the T3 responder group was similar to that of the background population. Remarkably, the T3 responder group's symptom scores were comparable to those of Nepalese women with overt hypothyroidism. In the T3 responder group, 38% of patients had thyroid stimulating hormone (TSH) levels below 0.4 mU/L, which suggests over-treatment. Conclusion: Patients still had numerous symptoms even though LT4/LT3 medication was well-tolerated, had no adverse effects, and had a great quality of life.

Contractile function is primarily determined by the myosin heavy chain (MyHC). The β-isoform is the most often expressed in human ventricular cardiomyocytes (CMs). We previously showed that following long-term incubation on glass coverslips covered with laminin, approximately 80% of human embryonic stem cell-derived cardiomyocytes (hESC-CMs) express just β-MyHC. In order to characterise cellular function, we examined the effects of enzymatically separating hESC-CMs following prolonged growth and then replating them. In a micro-mechanical setting, we found that force-related kinetic characteristics reflected variations in calcium transients and resembled α- rather than β-MyHC-expressing myofibrils. According to single-cell immunofluorescence analysis, replating hESC-CMs caused α-MyHC to be rapidly upregulated, as evidenced by increases in hESC-CMs that expressed α-MyHC solely and α/β-MyHC mixed. Individual CMs generated from human induced pluripotent stem cells (hiPSCs) similarly showed a similar increase in the variability of MyHC isoform expression following replating. During the second week following replating, the alterations in cardiomyocyte function and MyHC isoform expression brought on by replating were reversible. The expression profile of genes and pathways relevant to mechanosensation/transduction, particularly integrin-associated signaling, changed, according to gene enrichment analysis based on RNA-sequencing data. Thus, focal adhesion kinase (FAK), an integrin downstream mediator, enhanced β-MyHC expression on a rigid matrix, thereby confirming gene enrichment analysis. In conclusion, long-term cultivated human stem cell-derived CMs underwent significant changes in gene expression, MyHC isoform composition, and function as a result of detachment and replating. This led to changes in mechanosensation/transduction, which should be taken into account, especially for subsequent in vitro tests.