The thyroid is an endocrinal, butterfly-shaped, and biggest gland in the neck which makes and stores hormones that help in the regulation of blood pressure, heart rate, and body temperature and also help in the regulation of growth and rate of chemical reactions (metabolism) in the body. Hypothyroidism is associated with decreased thermogenesis, decreased metabolic rate, and has also been shown to correlate with a higher body mass index (BMI) and a higher prevalence of obesity. The present study was undertaken to evaluate the BMI at the time of diagnosis in hypothyroid patients and compare with that of normal individuals. A Case control study was conducted at Dinajpur Medical College Hospital, Dinajpur Bangladesh from January 2020 to December 2021. Out of 150 hypothyroid subjects 133 were females and 17 were males. Out of 150 normal individuals 70 were females and 30 were males. All subjects were in the age group of 20-40 years. Height is measured with Harpenden stadiometer, & weight is measured with standard weighing machine. BMI was calculated, data of T3, T4 & TSH levels were collected & compared between normal and hypothyroid subjects. It was found that hypothyroid subjects had a higher body mass index than the normal individuals. Hence maintenance of thyroid hormones at normal level and regular monitoring of BMI in Hypothyroid patients will help in early detection and prevention of obesity and its related complications in future. Hence maintenance of thyroid hormones at normal level and regular monitoring of BMI in Hypothyroid patients will help in early detection and prevention of obesity and its related complications in future. Awareness of weight reduction and regular physical exercise are to be advised to patients with hypothyroidism.

Background: The incidence and prevalence of osteomalacia are vastly underestimated for at‐risk populations. Increased awareness and knowledge of the disease are essential for its early diagnosis and prompt treatment. Aim: This study aimed to establish proximal myopathy, gait abnormalities, and history of pica as early presenting symptoms of osteomalacia in young women, as well as complete remission of these symptoms on adequate supplementation. Materials and Methods: This prospective study included 36 young women (18–32 years of age) clinically suspected and diagnosed with osteomalacia using the UdayHogler criteria and radiological features from December 2022 to December 2023. Baseline Harris Hip Score, visual analogue scale pain score, and power at hip extensors were also recorded. Subjects were treated with weekly vitamin D, and daily calcium and micronutrient supplementation. Adequate sun exposure was advised. Patients were followed up at four, 12, and 24 weeks post-initiation of treatment. Improvements in Harris Hip Score, visual analogue scale pain score, and power at hip extensor muscles were noted, and comparisons were made to establish statistical significance. Serum calcidiol, alkaline phosphatase, parathormone, and urine calcium levels were also monitored. Results: Of those diagnosed with osteomalacia, 26 (72%) and 23 (63.8%) presented with symptoms of proximal myopathy with early gait changes, and history of pica, respectively; both conditions were reversible on adequate supplementation with vitamin D and calcium (p=0.001). On follow-up, patients demonstrated improvement in gait, muscle power, and ability to climb up stairs and get up from the ground over a period of 4–24 weeks. Statistical analysis showed significant improvement in all the parameters under study. Hematological studies showed gradual improvement towards normal ranges. Conclusion: Osteomalacia should be considered as a differential diagnosis in young women with diffuse muscle and bone pain, early proximal muscle weakness, altered gait pattern, and history of pica, and the underlying disease should be investigated.

This study investigates the incidence, causes, and preventive measures for postoperative complications in obstetrics and gynecological surgeries conducted at SMS Medical College, Jaipur, over six months, the research identifies that approximately 10% of patients develop surgical site complications, with a higher prevalence in emergency procedures. The study emphasizes the need for preoperative correction of anemia, glycemic control, and hypertension, along with the use of Monocryl sutures, to reduce complications. The findings highlight the importance of comprehensive preoperative assessments and behavioural modifications to improve surgical outcomes.This study is significant as it provides insights into the prevention of surgical site complications, a major concern in obstetrics and gynecology. By identifying key risk factors and effective preventive strategies, the study aims to enhance patient safety and reduce the incidence of postoperative infections.

Introduction:Testicular tumors are relatively rare malignancies that primarily affect young men, typically between the ages of 20 and 40 years. Testicular lesions requiring orchidectomy can be both neoplastic and non-neoplastic conditions. Non-neoplastic lesions are more prevalent than neoplastic ones. Incidence rates of testicular tumors show considerable geographical variation, and interestingly, they exhibit aninverse pattern to most cancers, with decreasing incidence as age increases. Surgical removal of the affected testis (orchiectomy) remains the cornerstone of treatment, often followed by chemotherapy or radiation, depending on the stage and histology. Material and Method: This was a retrospective study, in which total 30 testicular cases were retrieved from database between July 2022 to June 2023, in the department of pathology, SMIMER, Surat. Results: There was a total of 30 specimens received in the department of pathology, during the study period. 30%(9 specimen) of the total specimen does not have definite diagnosis(descriptive), 16.6% (5 specimen) was of torsion of testis, 13.3% (4 specimen) was of cryptorchidism, 6.6% (2 specimen) was of atrophy of testis, 6.6% (2 specimen) was of inflammation of testis, 6.6%(2 specimen) was of granulomatous inflammation of testis, 6.6% (2 specimen) was of ectopic testis, 3.3% (1 specimen) was of classic seminoma, 3.3% (1 specimen) was of spermatolytic tumor, 3.3%(1 specimen) was of Leydig cell tumor, 3.3% (1 specimen) was of Germ cell tumors derived from germ cell neoplasia in situ (GCNIS) - mixed Germ cell tumor- Teratoma- post pubertal type (Immature teratoma) (70%) + Yolk sac tumor (30%). Conclusion: Testicular tumors are uncommon in our population.Non-neoplastic lesions are more prevalent than neoplastic ones. According to new WHO classification 2022 5 th edition there are new changes. These are the changes. Spermatocytic tumor and seminoma both are germ cell tumors. Spermatocytic tumor is included in Germ cell tumor unrelated to germ cell neoplasia in situ. Seminoma is included in Germ cell tumors derived from germ cell neoplasia in situ (GCNIS).

Aim and Objective:To evaluate the role of transactional analysis in Type 2 Diabetes Mellitus (T2DM) control using a validated transactional analysis questionnaire and assess the effect of personality type on diabetes management.

Materials and Method:This observational, cross-sectional study was conducted in a tertiary care hospital on T2DM patients (18–60 years) with a disease duration of over one year. Patients were classified as well-controlled or poorly controlled based on HbA1c levels (last three months) or recent medication changes (last month). A validated 36-item transactional analysis questionnaire identified personality types: Nurturing Parent, Critical Parent, Adult, Free Child, and Adopted Child.

Results and Discussion:Among 52 participants (24 males, 28 females, mean age 54 years), 25 were in the well-controlled and 27 in the poorly controlled group. The Nurturing Parent personality type was observed in 22 participants, 14 of whom had well-controlled diabetes. The reliability of the Nurturing Parent scale (Cronbach’s alpha = 0.654) supported its consistency. Conversely, 9 participants exhibited an Adopted Child personality, with 7 belonging to the poorly controlled group.

Conclusion:Nurturing Parent personality was associated with better diabetes control, while Adopted Child personality correlated with poor control. A concise eight-item questionnaire may help predict diabetes management outcomes in future assessments.

This study aimed to predict atherosclerosis in menopausal women based on independent variables such as age, diabetes mellitus (DM), hypertension (HTN), and body mass index (BMI). A total of 105 postmenopausal women attending the gynaecology outpatient department at SMS Medical College, Jaipur, were included in this observational study. Carotid intima-media thickness (cIMT) was measured using ultrasound to assess subclinical atherosclerosis. The results indicated that age, DM, HTN, and BMI were significant predictors of increased cIMT. Women with higher BMI, diabetes, and hypertension had significantly greater cIMT values, suggesting a higher risk of atherosclerosis. This study highlights the importance of early screening and management of these risk factors to prevent cardiovascular diseases in menopausal women.

The disadvantages of having orthodontic interventions both before and after orthognathic surgery include a long treatment time and temporary worsening of facial appearance. Nowadays, the concept of surgery‑first, followed by orthodontic treatment is applied to orthognathic surgery cases in different orthodontic centres in the world. This concept and technique is called “surgery‑first‑orthognathic‑approach” or “surgery‑first approach” (SFA).

 Rigid fixation (skeletal anchorage system) of the bony segments and regional acceleratory phenomenon were keys to broad implementation of the SFA.

This article is intended to provide an overview of SFA including Indications, Evolution, Contraindications, Favourable and Unfavourable cases, Different Protocol, Advantages and Disadvantages of Surgery First Approach

The Finite Element Method was introduced in orthodontics as a powerful computational tool for analyzing the biomechanical effects of various treatment modalities and is an approximation method to represent both the deformation and the 3D stress distribution in bodies that are exposed to stress. By constructing detailed models of teeth, periodontal ligaments, and surrounding bone, FEM enables the simulation of stress and strain distributions resulting from various orthodontic forces. This methodology enhances the understanding of tooth movement mechanics, aiding in the optimization of treatment strategies and appliance designs. The article explores the principles of FEM, its applications in orthodontics, and its potential to revolutionize patient care through evidence-based decision-making.

The field of orthodontics in its new era is venturing ahead to more up-to-date technological point of view. Digital technology has a significant effect on our lives ever since the modernization of mobile phones. The advances in technology have remodelled the diagnosis and treatment plan in the field of medicine. Digital workflows are currently increasing in the orthodontic practice and has touched every aspect of orthodontics – with transformations in the documentation, study casts, analysis of a dental malocclusion, smile designing, treatment planning and for fabrication of orthodontic appliances.

Use of computers in orthodontics has mainly changed the possibilities and paradigms in orthodontic treatment.  To keep up with changing technologies and a faster, more accurate, and more efficient workflow, there is great potential in digital dentistry. Nevertheless, it is necessary to remain aware that digital smart data and other technologies are unable to substitute humans for providing dental expertise and the capacity for patient empathy. The key still belongs to the orthodontist, who manages and directs the digital applications.

Background: Optimal timing of postoperative enteral nutrition following esophagectomy remains controversial. This study aimed to evaluate the effectiveness of immediate postoperative enteral nutritional support on clinical outcomes in patients undergoing esophagectomy for esophageal carcinoma. Methods: A prospective randomized controlled trial was conducted involving 60 patients with esophageal carcinoma undergoing curative esophagectomy. Patients were randomized to receive either immediate enteral nutrition (IEN) within 24 hours after surgery (n=30) or delayed enteral nutrition (DEN) initiated on postoperative day 5 (n=30). The primary outcome was the incidence of postoperative infectious complications. Secondary outcomes included nutritional parameters, inflammatory markers, recovery milestones, and quality of life. Results: The IEN group demonstrated a significantly lower incidence of overall infectious complications compared to the DEN group (26.7% vs 56.7%, p=0.018). Pneumonia occurred less frequently in the IEN group (16.7% vs 40.0%, p=0.045). The IEN group showed improved nutritional parameters, including higher albumin levels on postoperative day 7 (3.2 ± 0.4 g/dL vs 2.9 ± 0.5 g/dL, p=0.011), reduced inflammatory markers (CRP: 82.4 ± 28.6 mg/L vs 128.7 ± 36.2 mg/L on postoperative day 5, p<0.001), faster recovery of gastrointestinal function (time to first flatus: 2.8 ± 0.9 days vs 3.7 ± 1.2 days, p=0.002), and shorter hospital stay (12.3 days vs 16.8 days, p=0.003). The rates of anastomotic leakage (6.7% vs 16.7%, p=0.228) and feeding intolerance (26.7% vs 20.0%, p=0.542) were similar between groups. Multivariate analysis identified immediate enteral nutrition as an independent protective factor against infectious complications (OR 0.38, p=0.014). Conclusion: Immediate postoperative enteral nutrition following esophagectomy significantly reduces infectious complications, improves nutritional status, attenuates inflammatory response, and shortens hospital stay without increasing anastomotic leakage or feeding intolerance. These findings support the routine implementation of immediate enteral nutrition after esophagectomy.

Background: Ventral hernia repair remains a common surgical procedure with ongoing debate regarding optimal mesh placement. This study aimed to compare the outcomes of onlay versus sublay mesh repair techniques for ventral hernia. Methods: A prospective randomized controlled trial was conducted at a tertiary care center between January 2023 and December 2024. Adult patients with ventral hernia (fascial defect size 3-15 cm) were randomized to either onlay (n=153) or sublay (n=155) mesh repair. Primary outcome was hernia recurrence at 12 months. Secondary outcomes included perioperative parameters, complications, patient-reported outcomes, and cost-effectiveness. Results: Baseline characteristics were comparable between groups. The sublay technique was associated with longer operative time (105.6±22.4 vs. 78.3±18.7 minutes, p<0.001) and greater blood loss (110 vs. 75 mL, p<0.001). However, seroma formation (7.7% vs. 24.2%, p<0.001), surgical site infection (5.8% vs. 13.7%, p=0.018), and hernia recurrence at 12 months (3.9% vs. 11.1%, p=0.017) were significantly lower in the sublay group. Multivariate analysis identified onlay repair as an independent predictor of recurrence (aOR=3.18, 95%CI:1.18-8.57, p=0.022). Patient satisfaction (8.2±1.3 vs. 7.4±1.6, p<0.001) and physical component summary of SF-36 (49.7±7.8 vs. 46.3±8.2, p<0.001) were significantly better in the sublay group. Conclusion: Despite requiring longer operative time and higher resource utilization, sublay mesh repair for ventral hernia demonstrates superior outcomes in terms of reduced seroma formation, surgical site infection, and recurrence rates, along with better patient satisfaction and quality of life. These findings support the preferential use of the sublay technique, particularly in high-risk patients.

Background: Laparoscopic appendicectomy (LA) is widely preferred for acute appendicitis due to reduced postoperative pain, faster recovery, and lower wound infection rates. However, conversion to open appendicectomy (OA) may occur due to intraoperative challenges. Identifying preoperative predictors of conversion could optimize surgical planning and patient outcomes. Objective: This study aimed to identify preoperative factors predicting conversion from LA to OA in patients with acute appendicitis. Methods: A prospective study was conducted at SS Institute of Medical Sciences and Hospital, Davangere, from January 2023 to December 2024. Sixty patients undergoing LA were evaluated. Parameters including age, sex, comorbidities, ASA grading, Tzanaki’s score, leukocyte count, and ultrasound findings were analyzed. Conversion rates and associated factors were assessed using chi-square tests, with significance set at p2 (88.89% conversion, p=0.001), Tzanaki’s score ≤9 (52.38% conversion, p=0.02), and leukocyte count >12,000/mm³ (36% conversion, p=0.02). Sex showed no significant association (p=0.95). Conclusion: Preoperative factors such as advanced age, comorbidities, higher ASA grade, lower Tzanaki’s score, and leukocytosis reliably predict conversion to OA. These findings suggest a preoperative scoring system could guide surgical approach selection, reducing operative time and costs.

Abstract: Primary hypothyroidism or underactive hypothyroidism is a condition where the thyroid gland functions affected with elevation in thyroid stimulating hormone (TSH) >10 mU/L with free t4 level below the normal range exhibiting features like weight gain, dry skin, cold intolerance, depression etc. The prognosis of the disease has a wider impact on other system like respiratory, cardiac, gastrointestinal, metabolic, skin, renal and musculoskeletal systems exhibiting various clinical features. In Primary hypothyroidism with Obesity as per Ayurveda Samprapti, Aharaja, Viharaja, Manasika and Jatajanya nidana’s acts as a Moola karana in Vyadhi utpatti, causing Vruddi of Kapha, Vata Dosha’s and Kshaya of Pitta, leading to Agni vaishamyata (Jatharagni) further causing Rasa and Medho dhatvagni vyatyasa. In Modern science the clinical pathology is correlated to Gut brain thyroid axis disturbances linking to the disease manifestation. In present clinical study, the Chikitsa principle is Nidana parivarjana, Shamana by Krimighnadi Kashaya along with Shakotaka Taila for Pratimarsha Nasya, fuurther implementation of proper Dinacharya and Pathya Apathya which help in managing the Vyadhi by increasing Agni bala, balancing the tridosha, Rasa and Medo dhatu functions.

Background: Circumcision remains one of the most commonly performed surgical procedures worldwide. Traditional methods involve manual excision and suturing, while newer stapler techniques offer potential advantages. This study aimed to compare outcomes between classical and stapler circumcision techniques.

Methods: A prospective randomized controlled trial was conducted with 50 male patients (age range: infants to adults) randomly assigned to either classical circumcision (Group A, n=25) or stapler circumcision (Group B, n=25). Primary outcomes measured included operative time, post-operative pain using Visual Analog Scale (VAS), complication rates, and recovery time. Patients were followed up at 1 and 2 weeks post-surgery.

Results: Stapler circumcision demonstrated significantly shorter operative times compared to classical technique (12 ± 2.5 minutes vs. 37 ± 7.5 minutes, p<0.001). Mean pain scores at 24 hours (4.0 ± 0.8 vs. 6.0 ± 1.2, p<0.001) and 48 hours (2.0 ± 0.6 vs. 4.0 ± 0.9, p<0.001) were significantly lower in the stapler group. Complication rates were higher in the classical group (40% vs. 12%, p=0.024), with swelling (20%), minor bleeding (12%), and infection (8%) being most common. Mean recovery time was shorter in the stapler group (7 ± 1 days vs. 11 ± 1 days, p<0.001).

Conclusion: Stapler circumcision offers significant advantages over classical techniques in terms of operative time, post-operative pain, complication rates, and recovery time. Despite higher procedural costs, these benefits may justify the use of stapler circumcision where resources permit.

Background: The optimal surgical approach for benign thyroid nodules remains controversial. This study aimed to compare the outcomes of total thyroidectomy versus hemithyroidectomy for benign thyroid nodules to inform clinical decision-making.

Methods: A prospective observational study was conducted on 70 patients (32 total thyroidectomy, 38 hemithyroidectomy) with benign thyroid nodules who underwent surgery between January and December 2024. Outcomes assessed included perioperative parameters, complications, functional outcomes, quality of life, and recurrence rates.

Results: The total thyroidectomy group had significantly larger nodules (3.8±1.2 vs. 3.2±0.9 cm, p=0.022) and higher prevalence of multinodular goiter (75.0% vs. 44.7%, p=0.011). Total thyroidectomy was associated with longer operative time (128.4±31.2 vs. 89.6±24.5 minutes, p<0.001), greater blood loss (78.5±36.2 vs. 52.3±28.7 mL, p=0.001), and extended hospital stay (3.2±0.9 vs. 2.1±0.8 days, p<0.001). Complication rates were significantly higher in the total thyroidectomy group (43.8% vs. 15.8%, p=0.009), primarily due to transient hypoparathyroidism (28.1% vs. 0%, p<0.001). All total thyroidectomy patients required levothyroxine compared to 18.4% in the hemithyroidectomy group (p<0.001). Quality of life assessment showed better overall scores in the hemithyroidectomy group (20.5±14.2 vs. 28.4±16.8, p=0.033). Among hemithyroidectomy patients, 18.4% developed new nodules and 5.3% required completion thyroidectomy within 12 months.

Conclusion: Hemithyroidectomy is associated with lower complication rates, reduced need for hormone replacement, and better quality of life compared to total thyroidectomy for benign thyroid nodules. However, these advantages must be balanced against the risk of recurrence and need for reoperation. The choice between procedures should be individualized based on patient characteristics, preferences, and risk profile.

Background and Aim: The definition of acute organ dysfunction and infection, as well as the data sources used, influence the rates of sepsis and septic shock. This investigation was therefore carried out to highlight the relationship between morbidity and mortality and hyperuricemia in patients with clinically confirmed sepsis. Materials and Methods: The study included 150 patients in total. Blood samples were obtained from the patients in order to estimate their uric acid levels. The department of the biochemistry and medicine in RKDF Medical College Hospital & Research Center, Jatkhedi, Bhopal, Madhya Pradesh collaborated on the biochemical estimation of the uric acid level. Results: Of the 150 participants in the study, 64 patients (42.7%) had increased uric acid levels, whereas 86 patients (57.3%) had normal uric acid levels. It can be deduced that patients with type 2 diabetes mellitus were among the study population. 40% is the most prevalent comorbidity. Type 1 and type 2 diabetes, decompensated liver disease, and cerebrovascular accidents were the most common comorbidities among individuals with hyperuricemia. About 36% of research participants who had no comorbidities also experienced sepsis. Conclusion: This study shows that in patients with clinically confirmed sepsis in the intensive care unit, serum uric acid may be utilized as a predictor of death and morbidity as well as a measure of the severity of the illness. This report suggests more research on a wide foundation for verifying the observations.

Background: It has been noted that positive results from ramucirumab (RAM) plus docetaxel (DOC) combination therapy for advanced non-small-cell lung cancer (NSCLC) are linked to a history of immune checkpoint inhibitor pre-administration. Nevertheless, nothing is now known about the therapeutic importance of RAM and DOC after combined chemoimmunotherapy. Thus, following combination chemoimmunotherapy, we assessed the safety and effectiveness of RAM + DOC therapy and tried to determine the factors that might influence its results. Patients and Methods: Following combination chemotherapy and immunotherapy, this multi-center prospective trial examined the safety and effectiveness of RAM plus DOC. PFS, or progression-free survival, was the main outcome. The objective response rate (ORR), disease control rate (DCR), overall survival (OS), and adverse event incidence were secondary objectives. Serum cytokine levels were assessed at the beginning of treatment in an exploratory investigation. Results: Between April 2020 and June 2022, a total of 44 patients from 10 Japanese institutions were enrolled. The median OS was 22.6 months, whereas the median PFS was 6.3 months. Additionally, the DCR was 72.7% and the ORR was 36.4%. The PFS and OS were noticeably worse in the group with elevated vascular endothelial growth factor D (VEGF-D). A prolonged PFS was linked to both low and high levels of VEGF-D and VEGF-A. Conclusion: our findings suggested that RAM with DOC following combination chemoimmunotherapy could be a practical and successful second-line treatment for patients with advanced non-small cell lung cancer in the real world.

Background: Acute gastroenteritis can lead to significant kidney function derangement, but the incidence, risk factors, and outcomes remain incompletely characterized. This study investigated the relationship between gastroenteritis and kidney dysfunction in adult patients. Methods: This prospective observational cohort study enrolled 100 consecutive adult patients with acute gastroenteritis from January to December 2024. Comprehensive clinical, laboratory, and microbiological assessments were performed. Acute kidney injury (AKI) was defined according to KDIGO criteria. Novel biomarkers, including TIMP-2 × IGFBP7, KIM-1, and NGAL, were evaluated for AKI prediction. Renal outcomes were assessed at discharge, 30 days, and 90 days. Results: AKI occurred in 28.0% of patients, with 16.0% Stage 1, 8.0% Stage 2, and 4.0% Stage 3. Bacterial etiology was associated with higher AKI risk compared to viral (OR 3.02, 95% CI 1.24-7.37, p = 0.013), with STEC infection conferring the highest risk (OR 9.53, 95% CI 1.79-50.70, p = 0.002). Independent risk factors for AKI included age ≥65 years (aOR 2.83, p = 0.038), baseline eGFR 3 days (aOR 3.18, p = 0.022). Urinary TIMP-2 × IGFBP7 demonstrated the highest predictive accuracy for AKI (AUC 0.92, 95% CI 0.86-0.98). Complete renal recovery occurred in 53.6% of AKI patients at discharge, 78.6% at 30 days, and 89.3% at 90 days, with recovery rates inversely proportional to AKI severity (p = 0.042). Conclusion: Gastroenteritis-associated AKI is common and influenced by both pathogen-specific and host factors. Novel biomarkers outperform conventional parameters for early AKI prediction. While most patients achieve complete renal recovery, a subset develops persistent dysfunction, particularly following severe AKI.

Context : One of the most important public health issues in the world is hypertension. Hypertension was responsible for approximately half of the 2008 cardiovascular disease-related deaths. One of the main obstacles to avoiding complications and the future burden of cardiovascular illnesses is bringing blood pressure down to a normal range. Determining the prevalence, awareness, treatment, and management of hypertension and its contributing variables in Nepal is the goal of this study. Methods : This community-based cross-sectional study was carried out in Kathmandu, Nepal, as a component of a community-based intervention experiment. 1159 participants who were at least 30 years old were enrolled. Four wards were chosen at random from a total of twelve wards (administrative units). From each chosen ward, three hundred individuals were gathered. Using standard STEPS questions, a trained enumerator gathered clinical, anthropometric, and sociodemographic data. Results : Women made up 71% of the total participants, and their mean age was 47±12.6 years. The prevalence of hypertension was 40.6% when age and sex were taken into account, compared to 38.9% (95% CI: 36–41.7) overall. Of the women, 35.2% (95% CI: 32.4–37.9) and 48.1% (95% CI: 45.2–50.9) had hypertension. Significant variables linked to hypertension were found to include male gender (OR = 1.49), older age (OR = 1.04 each year), Dalit caste (OR = 1.71), history of cigarette smoking (OR = 2.78), current alcohol use (OR = 1.75), and elevated body mass index (OR = 1.17 per unit). Of the respondents with hypertension, 53.4% (95% CI: 48.7–58) were aware, 29% (95% CI: 24.8–33.1) were undergoing therapy, and 8.2% (95% CI: 5.6–10.7) had blood pressure under control. Conclusion : According to the study, hypertension is quite common in Nepal but is not well understood, treated, or controlled. Hypertension was linked to body mass index, smoking, consuming alcohol, age, gender, and ethnicity. To lessen the burden of cardiovascular diseases in the future, immediate public health and personal actions are necessary

There is considerable evidence that most (if not all) malignant tumors utilize immunomodulatory proteins that result from activating membrane progesterone receptors (mPRs) in males as well as females. Support for this concept has been provided by the demonstration that treating people with a variety of different cancers that are very advanced with no more standard or even clinical trial options to have a considerable extension of life (in several instances even more than 5 years with death unrelated to their cancer) by treatment with single agent oral mifepristone a PR receptor antagonist. Just as important, most patients, even when the cancer has damaged vital organs, so a marked extension of life is not possible, are able to experience considerable palliative benefits. Presented is a case of an 85-year-old male whose end stage cardiomyopathy was complicated by a 5.5 cm cholangiocarcinoma with lymph node metastasis. Rather than the suggestion of hospice to end life within 2- 3 weeks, or starting chemotherapy, he chose the option of mifepristone therapy. So far, he has experienced 4 months of a decent quality of life. The purpose of presenting his case is not only to introduce another type of cancer that responds to PR antagonists that has never been reported before, but to introduce this type of therapy for advanced cancer that despite many publications and presentations at scientific meetings, probably because there are no commercial interests, this highly effective therapy is relatively unknown, it may be especially of interest to countries, e.g., India and China, where mifepristone is available at a much lower price than in many other countries. The cost of healthcare could be markedly reduced by simply offering oral mifepristone to patients with advanced cancer and no need to monitor subsequent potential adverse effects because it has a very high safety profile when used at a lower dosage of 200mg/day. Thus, besides just a fraction of the cost of chemotherapy agents or immunotherapy, there would be considerable savings for cost of hospital admissions to treat the complication of most standard cancer therapeutic options.