Fast dissolving tablets (FDTs) are an advanced drug delivery system designed to disintegrate or dissolve rapidly in the mouth without the need for water. This innovative dosage form enhances patient compliance, especially for those who have difficulty swallowing conventional tablets. FDTs offer numerous advantages, including rapid onset of action, convenience, and improved bioavailability for certain drugs. This research provides evaluation of fast dissolving tablet of Zidovudine, various types of preformulation parameters like melting point, solubility study, compatibility study, DSC investigation and FTIR investigation of the drug as well as precompression evaluations for the powder blend such as angle of repose, bulk density, tapped density, compressibility index along with hausner’s ratio. Post compression parameters has been also evaluated like hardness, thickness, diameter, drug content, weight variation, friability, wetting time, disintegration, dissolution of fast dissolving tablets.

DOI: 10.5281/zenodo.

Background: Acute appendicitis is one of the most common surgical emergencies worldwide, often necessitating an appendicectomy, which can be performed via an open or laparoscopic approach. The laparoscopic appendicectomy has gained popularity due to its minimally invasive nature, offering benefits such as reduced postoperative pain, shorter hospital stays, and quicker return to normal activities. In cases of non-perforated appendicitis, where the appendix has not ruptured, the risk of postoperative complications like surgical site infections (SSIs) is generally lower compared to perforated cases. Approximately 30% of appendectomies are for complicated acute appendicitis (CAA). With laparoscopy, the main post-operative complication is deep abscesses (12% of cases of CAA, versus 4% for open surgery. Aim: The aim of this study is to determine whether the routine administration of postoperative antibiotics is necessary in preventing postoperative complications in patients with non-perforated appendicitis who undergo laparoscopic appendicectomy. Material and Method: A total of 120 patients with non-perforated appendicitis undergoing laparoscopic appendicectomy divided into two groups. Group B (n=60) patients received single dose of preoperative antibiotic and group A (n=60) patients received preoperative dose, as well as three postoperative doses of antibiotics. Patient demographics, comorbidities, preoperative antibiotic use, and operative details. Incidence of SSIs, other complications, hospital stay, readmission, and antibiotic-related adverse effects. Following laparoscopic appendicectomy, surgical wound was inspected after 48 h, 72 h, and on day 7 to look for any signs of postoperative SSI. Group B patients received a single dose of preoperative antibiotics and group A patients received the same regimen, in addition, antibiotics were administered 24 hours postoperatively. Patients of both groups were followed-up for 30 days to assess the postoperative infectious complications. Results: The mean age in group A was 22.24±6.29 years compared to 25.32±6.55years in group B. No significant difference was observed between the two groups regarding mean age, gender distribution, pain, fever, nausea/vomiting, Mc Burney’s tenderness, bowel sounds, total leukocyte count, ultra-sonography, diagnosis, and histopathology report.  The difference between both the groups for incidence of SSIs was statistically insignificant. Both groups comprised 120 patients, as well both groups were compared in baseline characteristics. Statistically, there was no significant difference in rates of SSIs between both groups. Conclusion: Single dose of preoperative antibiotics was sufficient in reducing SSIs after appendectomy for NPA. Depending on the results, the study could either support the continued use of postoperative antibiotics or suggest that they may be unnecessary in non-perforated appendicitis cases, potentially leading to changes in clinical practice guidelines. This study would provide valuable evidence to guide the management of postoperative care in laparoscopic appendicectomy for non-perforated appendicitis.

DOI: 10.5281/zenodo.

Background: Preeclampsia is a major global cause of morbidity and mortality among mothers and perinatals, especially in areas with limited resources. It has been suggested that low-dose aspirin can prevent preeclampsia, particularly in high-risk individuals. The purpose of this research is to determine whether low-dose aspirin can prevent preeclampsia in pregnant patients who are admitted to a tertiary care hospital in Kolkata. Aims: To determine the effectiveness of low dose aspirin in the prevention of preeclampsia in pregnant women with risk factors at Calcutta National Medical College and Hospital, Kolkata Methods: Our study was carried out at the Department of Obstetrics and Gynaecology of C.N.M.C&H, Kolkata after obtaining approval from the Institutional Ethical Committee. All patients who met the above mentioned criteria were included in the study. The study included 200 post-natal mothers with risk factors of preeclampsia were selected from the high risk ward of our hospital. They were divided into cases and controls each containing 100 subjects with the same risk factors. Results: In Cases, 84(84%) patients had not taken low dose aspirin and 16(16%) patients had Taken low dose aspirin. In Controls, 72(72%) patients had not taken low dose aspirin and 28(28%) patients had Taken low dose aspirin. Association of regular intake of low dose aspirin in their recent pregnancy with preeclampsia and intake of low dose aspirin was statistically significant (p=0.04052). In with FGR, 4 patients had Taken low dose aspirin and 40 patients had not taken low dose aspirin. In without FGR, 40 patients had Taken low dose aspirin and116 patients had not taken low dose aspirin. Association of FGR with preeclampsia and intake of low dose aspirin was statistically significant (p=0.02). Conclusion: The only effective treatment for preeclampsia, which is a major cause of maternal morbidity and mortality globally, is delivery of the fetus and placenta. There are various opportunities in the fields of improved risk classification, preventative measures, and treatments, and several innovations are on the horizon. When begun after 12 weeks of gestation in individuals with preeclampsia risk factors, low dose aspirin 75 mg once daily is very successful in reducing the risk of preeclampsia and improving the outcomes for both the mother and the fetus.

DOI: 10.5281/zenodo.

Introduction: Despite a significant improvement in diarrheal disease management by early initiation of inexpensive oral replacement therapy, mass education and improved generalized sanitation, still diarrhea is the second leading cause of death among children aged less than 5 years. Aims: the changes in the epidemiology and etiology of diarrheal diseases among children aged less than 5 years in the post vaccination period and alterations in pathogenic rotavirus strains. Materials and Method: This study provides comprehensive data on the changes in clinical-epidemiological conditions associated with acute diarrhea among children aged less than 5 years since the introduction of the rotavirus vaccine in the National Immunization Program from September 2019. Result: Four children (1.1%) died—all of them are malnourished and had comorbidities such as Congenital heart disease (1), postadenovirus bronchiolitis obliterens (1) and undiagnosed congenital anomalies (2). The detected enteropathogens among the 4 succumbed children were adenovirus, rotavirus and mixed infections of E. coli and Salmonella. On nutritional assessment of admitted children, 364 (95.8%) were appropriate for age, 11 (2.9%) had moderate malnutrition, and 5 (1.3%) had severe malnutrition (SAM), of which 4 children died. Conclusion: The decline in rotaviral diarrhea among children in the post immunization period is evident in almost all the studies. The simultaneous emergence of newer viruses, such as norovirus and adenovirus, for which we have no vaccines, creating a new burden on the public health system necessitates continuous monitoring in both hospital and community settings. This database will aid health authorities in identifying appropriate preventive strategies to lower the incidence of pediatric diarrhea and death.

DOI: 10.5281/zenodo.

Introduction: 5–10% of pregnancies are complicated by hypertensive problems. The triple threat of hypertensive problems, bleeding, and infections is a major cause of morbidity and mortality among mothers. Aims: To compare the efficacy between Pritchard and Zuspan regimen in eclampsia and pre- eclampsia patients. To compare the complications of Pritchard and Zuspan regimen including the magnesium toxicity. To study the feto maternal outcome of eclampsia and pre-eclampsia patients with both the regimen. To prove the feasibility of Zuspan regimen in a tertiary care hospital like ours, which is not been routinely practiced here. Materials & Methods: It is an observational study. Study period was one and half years, Sample size was 90 and study area was Department of Obstetrics and Gynaecology, Calcutta National Medical College and Hospital. Result: In Zuspan, the mean S.Mg Levels after 4 Hrs of Loading Dose (mg/dl) (mean± s.d.) of patients was 3.82±.55.In Pritchard, the mean S.Mg Levels after 4 Hrs of Loading Dose (mg/dl) (mean± s.d.) of patients was 4.95±2.18. Distribution of mean Variables with Regimen was statistically significant (p=.001). Conclusion: We concluded that Pregnancy-related hypertensive diseases are always dangerous, putting the mother’s life in danger as well as the fetus’s survival in jeopardy. Effective intervention and therapy are necessary to reduce perinatal morbidity and mortality. Both pre-eclampsia and eclampsia are potentially fatal illnesses that require immediate attention and treatment in order to preserve the mother’s life and lower the risk of morbidity and death.

DOI: 10.5281/zenodo.

Introduction: Despite a significant improvement in diarrheal disease management by early initiation of inexpensive oral replacement therapy, mass education and improved generalized sanitation, still diarrhea is the second leading cause of death among children aged less than 5 years. Aims: Changes in the epidemiology and etiology of diarrheal diseases among children aged less than 5 years in the post vaccination period and alterations in pathogenic rotavirus strains. Materials and Method: This study provides comprehensive data on the changes in clinical-epidemiological conditions associated with acute diarrhea among children aged less than 5 years since the introduction of the rotavirus vaccine in the National Immunization Program from September 2019. Result: Four children (1.1%) died—all of them were malnourished and had comorbidities such as Congenital heart disease (1), postadenovirus bronchiolitis obliterens (1) and undiagnosed congenital anomalies (2). The detected enteropathogens among the 4 succumbed children were adenovirus, rotavirus and mixed infections of E. coli and Salmonella. On nutritional assessment of admitted children, 364 (95.8%) were appropriate for age, 11 (2.9%) had moderate malnutrition, and 5 (1.3%) had severe malnutrition (SAM), of which 4 children died. Conclusion: The decline in rotaviral diarrhea among children in the post immunization period is evident in almost all the studies. The simultaneous emergence of newer viruses, such as norovirus and adenovirus, for which we have no vaccines, creating a new burden on the public health system necessitates continuous monitoring in both hospital and community settings. This database will aid health authorities in identifying appropriate preventive strategies to lower the incidence of pediatric diarrhea and death.

DOI: 10.5281/zenodo.

Background and Aim: Chronic dacryocystitis is a very common cause of lacrimal passage obstruction, which suggests that there is inflammation of the lacrimal sac. DCR is a commonly performed surgical procedure that involves connecting the lacrimal sac to the nasal mucosal flap, bypassing the nasolacrimal duct. In this study, we aimed to assess the efficacy of both conventional DCR and DCR implant methods in treating chronic dacryocystitis. Material and Methods: A comparative study was conducted among 100 patients over a period of 1 year. The 100 cases were divided into two groups: Group A, which included 50 cases that underwent conventional DCR, and Group B, which included 50 cases that underwent Pawar’s implant DCR technique. An analysis was conducted on data related to post-operative complications. Results: After undergoing conventional DCR, some patients experienced post-operative complications. These included lip oedema in 8% of patients, incisional oedema in 10% of patients, nasal mucosa haemorrhage in 6% of patients, wound gape in 4% of patients, passage obstruction in 8% of patients, hypertrophic scar in 14% of patients, and thankfully, no cases of sac infection. For group B, specifically Implant DCR, the patients experienced various post-operative complications. These included lip oedema in none of the patients, incisional oedema in 4% of patients, nasal mucosa haemorrhage in none of the patients, wound gape in none of the patients, passage obstruction in 10% of patients, hypertrophic scar in 4% of patients, and sac infection in 4% of patients. Conclusion: D.C.R. implant method has shown significantly improved results compared to the conventional D.C.R. method. Complications were found to be reduced with Implant DCR compared to conventional DCR.

DOI: 10.5281/zenodo.

Aim: Present study aims to report the effectiveness of a suture-less, glue-free, dry amniotic membrane graft in managing pterygium and preventing its recurrence. Material and Methods: This study was conducted as a prospective interventional study in the department of Ophthalmology and Surgery at the medical college and associated hospital. 42 consecutive patients with 42 various grades and types of pterygia were studied. The patients had pterygium excision with adjunctive suture-less dehydrated glue-free amniotic membrane graft. Complications such as pyogenic granuloma, inclusion cyst, or scleral thinning were documented. The occurrence of any fibrovascular growth extending from the limbus onto the cornea was evaluated by another observer (HON) using slit lamp examination. Results: Thirty patients were diagnosed with primary pterygia, while twelve patients had a history of recurrent pterygia. The total number of patients was categorized into four distinct groups according to their stages. In stage 3, a total of 28 patients were enrolled, while in stage 4, 8 patients were enrolled. A total of ten cases of pyogenic granuloma were observed. Eight of the pyogenic granulomas were effectively resolved with the use of topical 0.1% dexamethasone. However, the remaining two granulomas required surgical excision as they did not respond to conservative treatment. Conclusion: Using a suture- and glue-free technique, limbal conjunctival auto-grafting after pterygium excision proves to be a reliable, efficient, and cost-effective solution for treating both initial and recurring pterygium cases that require surgery.

DOI: 10.5281/zenodo.

Aim: To Study whether prior instillation of 0.5% Topical proparacaine potentiates mydriasis by 0.8% Tropicamide- 5% phenylephrine-induced mydriasis Objectives: 1) To compare the mydriatic efficacy of a 0.8% Tropicamide and 5% Phenylephrine combination with or without prior instillation of 0.5% Topical Proparacaine in patients attending the Outpatient Department of Ophthalmology, ACSR Government General Hospital, Nellore. 2) To Study the rate and magnitude of pupillary dilation. Methodology: In this study, 60 patients and a total of 120 eyes were examined as a part of a routine eye evaluation. The right eye was considered the study eye, and the left eye was considered the control eye. The study eye was given proparacaine 0.5% eye drops before receiving commercially available tropicamide 0.8% – phenylephrine 5% eye drops, while the control eye received only the combination drops. The size of the pupils was measured and recorded at baseline, 10, 20, and 40 minutes after instilling the mydriatic agent. The endpoint was considered to be a dilation of 8mm or at the end of 40 minutes. Results: In both the study group and the control group, the baseline (0 minutes) pupil diameter was 2.5±0.5 mm. After 20 minutes, the mean pupillary diameter in the study group was 5.5±0.5 mm, while in the control group, it was 5 ± 0.5 mm. At 40 minutes, the pupillary diameter was 8±0.5 mm in the study group and 7.5 ± 0.5 mm in the control group. Conclusion: Therefore, we recommend using Topical proparacaine 0.5% before applying Topical 0.8% Tropicamide-5% Phenylelphrine to achieve faster dilation of the pupil.

DOI: 10.5281/zenodo.

Background: Breast lump is one of the commonest complaints with which patients present in breast clinics. As approximately 10% of breast masses ultimately lead to a diagnosis of breast cancer, it is important for women with a breast lump to receive appropriate evaluation. A confident diagnosis can be made in 95% of the cases through a combination of clinical examination, imaging and fine needle aspiration cytology. Method: This is a data analysis study conducted at the Department of Pathology, C.U. Shah medical college, Surendranagar on 50 patients who presented with clinically palpable breast lump. Lesions of breast were compared according to their BIRADS score and FNAC findings. Result: FNAC of breast lumps is reliable method to diagnose breast lump. Conclusion: FNAC could be considered as the first method to evaluate breast lesions, recognized by means of imaging techniques.

DOI: 10.5281/zenodo.

Introduction: Intrauterine foetal death is means- intrapartum death after the foetus has reached the age of viability.  Intrauterine fetal death is one of the most devastating obstetrics complications. A clinically accepted definition of IUFD is the death of fetus at or after 20 weeks of pregnancy, but for international comparison WHO has now as a baby born with no sign of life at or after 28 weeks of gestation. Aims: To compare efficacy, safety and tolerance of combination of mifepristone and misoprostol versus misoprostol-only in induction of late intrauterine foetal death (IUFD) from 20th weeks. Materials & Methods: Study design was Randomize control study place of study was Department of obstetrics and gynaecology, Murshidabad medical college & hospital, Berhempore, Murshidabad. Period of study from 2020- 2023 and total sample size 220. Result: In Conservative, the mean Induction to Delivery time(HRS) (mean± s.d.) of patients was 102.2740 ±21.6992. In Surgery, the mean Induction to Delivery time(HRS) (mean± s.d.) of patients was 109.3636 ±26.1633. Distribution of mean Induction to Delivery time(HRS) with Group was statistically significant (p=0.0302). Conclusion: Mifepristone combined with misoprostol is more effective than misoprostol alone in reducing the induction-to-delivery interval and increasing the rate of successful vaginal delivery in cases of IUFD. Both regimens are safe, with similar complication profiles. Mifepristone-misoprostol combination may offer a more efficient approach to labor induction in IUFD.

DOI: 10.5281/zenodo.

Background: Pediatric dermatoses encompass a wide range of skin conditions, often varying in prevalence and severity depending on the geographic location, socioeconomic status, and genetic factors. These skin conditions can significantly impact the quality of life of children, causing physical discomfort and psychological stress. The purpose of this study was to analyze the spectrum, clinical features, and demographic profiles of pediatric dermatoses cases in a tertiary care center. Methods: This observational study was conducted over a two-year period at two Medical Colleges. A total of 500 Pediatric and Dermatology patients, aged 0 to 18 years, presenting with various dermatoses were included. Clinical evaluation, diagnosis, and demographic data were collected and analyzed. Results: Eczematous conditions (30%), infections (25%), infestations (20%), and hypersensitivity reactions (15%) were the most common dermatoses observed. The most affected age group was 5-10 years, and boys were more frequently affected than girls. Seasonal variation was observed, with a higher incidence of infectious and eczematous conditions during the monsoon season. Conclusion: Pediatric dermatoses are a common concern in tertiary care centers, with infections and eczematous conditions being the most frequently observed. Early diagnosis and appropriate management of these conditions are essential to prevent complications and improve the quality of life in children.

DOI: 10.5281/zenodo.

Background: Hypopigmented and depigmented skin lesions represent a significant dermatological concern in children, potentially indicating a wide range of underlying conditions, from benign developmental anomalies to serious systemic disorders. Understanding the epidemiological characteristics and clinical patterns of these lesions is essential for accurate diagnosis and management. Objective: This study aimed to analyze the clinical and epidemiological patterns of hypopigmented and depigmented lesions in pediatric patients, identify the most common etiologies, and evaluate the impact of demographic factors on the prevalence and distribution of these lesions. Methods: A cross-sectional study was conducted at two Medical Colleges over two years, including 500 Pediatric and Dermatology patients aged 0-18 years presenting with hypopigmented or depigmented lesions. Detailed clinical evaluations were performed, and diagnoses were confirmed through relevant laboratory investigations. Statistical analyses, including chi-square tests, logistic regression, and ANOVA, were conducted to assess associations between patient demographics, lesion types, and clinical outcomes. Results: The most common diagnoses were vitiligo (30%), pityriasis alba (25%), and tinea versicolor (20%). Statistically significant associations were observed between lesion type and age group (p < 0.05) as well as lesion type and gender (p < 0.05). Multivariate analysis revealed that family history of autoimmune diseases significantly increased the likelihood of developing vitiligo (OR: 3.2, 95% CI: 1.8-5.7). Conclusion: Hypopigmented and depigmented lesions are common in the pediatric population, with distinct epidemiological patterns that vary by age and gender. Early identification and management are crucial in minimizing psychological impact and preventing complications.

DOI: 10.5281/zenodo.

Objective: This study aims to evaluate the diagnostic accuracy of the Apparent Diffusion Coefficient (ADC) obtained from Diffusion-Weighted Imaging (DWI) in differentiating between benign and malignant gynecologic lesions. Methods: A retrospective analysis was conducted on 29 female patients who underwent pelvic MRI at a tertiary care hospital between august 2020 and September 2023. The study included cases with histopathological confirmation of gynecologic lesions. ADC values were measured from the DWI sequences, and their diagnostic performance in distinguishing benign from malignant lesions was assessed. Statistical analysis was performed to determine the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy of the ADC values. Results: The mean ADC value for malignant lesions was 0.761± 0.13×10−3 mm2/s and for benign lesions 1.318 ± 0.20×10−3 mm2/s, where the cut-off ADC value was 1.007×10−3 mm2/s. At this threshold, the ADC demonstrated a sensitivity of 82.3%, specificity of 83.3%, PPV of 87.5%, and NPV of 76.9%. Conclusion: The findings of this research underscore the potential of ADC values as a valuable tool in the non-invasive differentiation of gynecological lesions. The results demonstrated a correlation between ADC values and the nature of lesions, with malignant lesions generally exhibiting lower ADC values compared to benign ones. This supports the notion that ADC values can serve as a quantitative measure to aid clinicians in making more informed decisions regarding patient management and treatment planning.

DOI: 10.5281/zenodo.

Introduction: Diabetic foot infection is one of the most common complications of Diabetes mellitus which results in hospitalization. Globally, it is the most prevalent cause of non-traumatic amputation. Among all diabetics, 15% have diabetic foot infection and 28% of them require amputation. Aim: To determine the bacterial profile of infected diabetic foot ulcers and antibiotic sensitivity and resistant patterns of isolates. Materials and Methods: This is a Prospective Observational study conducted for a period of 6 months from July 2022 to December 2022. A total of 100 pus swabs were collected from IP and OP infected Diabetic foot ulcer patients attending surgery department in Government General Hospital of Kakinada. Collected swabs were cultured and isolates were identified by Standard microbiological techniques and an antibiogram of isolated was done by Kirby-Bauer disc diffusion method. Results: A total of 110 isolates were obtained from 100 swab samples. Among them 100 were Gram negative bacilli 6 were Gram positive cocci and 4 were Gram negative cocci-bacilli. Two organisms were obtained in 10 swab cultures. The most common isolate was Pseudomonas species 36(32%), followed by Klebsiella species 30(27%), Escherichia coli 20(18%),Proteus species 14(12%), Staphylococcus aureus 6(5%), Acinetobacter species 4(3%). Majority of Gram negative isolates (104) were sensitive to cefaperazone-sulbactum (71%), Meropenem (40%). All Gram Positive isolates (6) were sensitive to Linezolid, Amoxy-clav. Conclusion: Present study confirmed the presence of Multidrug resistant pathogens in diabetic foot ulcers. This knowledge of antibiotic susceptibility patterns of the isolates from the wound helps in guiding clinicians for better planning of treatment with appropriate antibiotics, reducing the resistance patterns and minimizing healthcare costs.

DOI: 10.5281/zenodo.

Objective: To evaluate the predictive value of maternal serum beta hCG levels at 12-20 weeks of gestation for the development of hypertensive disorders of pregnancy (HDP). Design: A prospective observational study. Setting: Malabar Institute of Medical Sciences, Kozhikode, Kerala, India. Participants: A total of 200 antenatal women aged 18-35 years, with singleton pregnancies at 12-20 weeks of gestation, were enrolled. Results: Serum beta hCG levels >2 MoM were significantly associated with an increased risk of developing hypertensive disorders of pregnancy. Among women with beta hCG levels >2 MoM, 93.1% developed HDP compared to only 2.3% of those with beta hCG levels ≤2 MoM. Introduction: Hypertensive disorders of pregnancy (HDP) are one of the most critical complications that can arise during pregnancy. They include a spectrum of conditions such as gestational hypertension, preeclampsia, and eclampsia, which together account for a significant portion of maternal and fetal morbidity and mortality worldwide. The World Health Organization (WHO) has reported that hypertensive disorders of pregnancy (HDP) are significant contributors to maternal and fetal morbidity and mortality. Identifying early biomarkers that can predict the development of HDP is crucial for improving outcomes. Elevated maternal serum beta hCG levels have been suggested as a potential predictor of these disorders. Methods: This prospective observational study was conducted at the Malabar Institute of Medical Sciences, Kozhikode, Kerala, India. A total of 200 antenatal women aged 18-35 years, with singleton pregnancies at 12-20 weeks of gestation, were enrolled. Maternal serum beta hCG levels were measured using chemiluminescence immunoassay. Participants were followed up for the development of hypertensive disorders, including gestational hypertension, preeclampsia, severe preeclampsia, and eclampsia. Results: Of the 200 participants, 31 (15.5%) developed hypertensive disorders. Women with serum beta hCG levels >2 MoM had a significantly higher risk of developing HDP (93.1%) compared to those with levels ≤2 MoM (2.3%). The correlation between elevated beta hCG levels and the severity of hypertensive disorders was statistically significant (p < 0.001). Conclusion: Elevated maternal serum beta hCG levels at 12-20 weeks of gestation are strongly associated with an increased risk of developing hypertensive disorders of pregnancy. Screening for beta hCG levels during early pregnancy could serve as an effective tool for identifying women at high risk for HDP, allowing for closer monitoring and early interventions.

DOI: 10.5281/zenodo.

Background: Anemia is prevalent among chronic kidney disease patients on or not on dialysis. Other than various other causes like Erythropoietin deficiency, nutritional deficiency of vitamins, uremia-induced erythropoiesis inhibitors, disordered Iron metabolism, absolute Iron deficiency is an important factor. This study has been done to find out the magnitude of anemia and Iron deficiency in maintenance hemodialysis patients in a tertiary health care center of North-Eastern region. Materials and Methods: Chronic Kidney Disease patients those who are on dialysis for more than 3 months and excluding other causes of anemia like gastro-intestinal bleeding, patients have been evaluated for hemoglobin level and Iron status by Transferrin saturation. Both prescribed dose of Iron and Erythropoietin have been administered by the staff of the dialysis unit, as per dialysis unit protocol, so that the compliance with the drug is ascertained. All the patients were on intra-venous multivitamin supplementation to restore the deficiency of dialyzable water-soluble vitamins. Results: Out of 456 patients 401 patients (87.94%) have a hemoglobin level of less than 11.0 g/dL and 55 patients (12.06%) have a hemoglobin level of 11.0 g/dL or more. Out of 456 patients 447 patients (98.03%) have a TSAT of less than 30% and 9 patients (1.97%) have TSAT of 30% or more. Conclusion: Even after presumed adequate management at tertiary care level, significant proportion of patients are having anemia. The main cause is found to be iron deficiency, though few cases anemia other than iron deficiency has also been found. The study reveals that the magnitude of anemia and iron deficiency is huge among chronic kidney disease patients on dialysis, which needs to be evaluated and managed in more efficient way.

DOI: 10.5281/zenodo.

Introduction: Otitis externa is defined as a diffuse inflammation of the skin of the external auditory canal with or without involvement of the pinna and the tympanic membrane. It is common with a prevalence rate of 1% of ENT practice. There are many evidence-based treatment guidelines leading to variation in its management. Aim & Objectives: The aim of this study is to compare the efficacy of Group A (hydrocortisone-Neosporin) eardrops in patients with otitis externa with Group B (hydrocortisone-acetic acid) ear drops. Material and Methods: A total of 100 patients were divided into two treatment groups with AOE, according to severity of signs and symptoms. Clinical response to treatment is assessed by resolution of infection and Briton grading system. By calculating P-value, Standard statistical analysis is performed. Treatment protocols showing P<0.05 is considered as significant. Results: On day 7, 48% of participants in Group A and 47.92% in Group B were cured. By the end of 14th day, Group A, 81.63% of participants were cured, while in Group B, it was 77.08%. After 21 days, 85.71% of participants in Group A and 89.58% were cured. Conclusion: Local treatment (external auditory meatus) plays a pivotal role in controlling, preventing and recurrence of AOE. The results of this study clearly indicate that there was no significant difference in treatment results between the two treatment groups. Both treatments were safe and effective in treating the signs and symptoms of AOE as proved by the assessments performed throughout the treatment period.

DOI: 10.5281/zenodo.

Introduction:  Despite being one of the most common fractures encountered in practice, Fractures of distal end of radius continue to pose a therapeutic challenge. The purpose of this study was to evaluate the surgical outcome through comparison between both the methods, External Fixator and Open reduction Internal fixation with plating, in order to conclude the advantages and disadvantages of each of them. Materials and Methods: This study is a randomized comparative prospective study. It was conducted in Department of Orthopedics, GMERS Medical College & Hospital Vadodara from September 2023 to June 2024 on 78 patients undergoing Distal end radius fracture surgery. Results: On comparison of functional outcome between external fixator and vlcp with cooney’s score for type C fractures with chi square test p value was 0.4386, which was statistically significant. Conclusion: Treatment of Type C distal end radius fractures fixation with volar plate and screw system is a superior method to maintain the reduction till union and prevent the collapse of the fracture fragments, even in grossly comminuted, unstable and osteoporotic bones as compared with external fixator augmented with K – wires.

DOI: 10.5281/zenodo.

Background: Adverse drug reactions (ADRs) represent significant public health concerns, contributing to nearly 50% of hospital admissions in India. Current monitoring techniques, primarily spontaneous reporting, are hindered by underreporting and bias. The Trigger Tool Method (TTM), developed by the Institute for Healthcare Improvement, offers a proactive approach to ADR detection and has shown superior efficacy in global studies. Aim: This study aims to evaluate the effectiveness of TTM in identifying ADRs compared to the conventional spontaneous reporting system in a tertiary care teaching hospital in Bihar, India. Material and Methods: A prospective, single-center study was conducted over 15 months, divided into an observational phase (Phase I) and an interventional phase (Phase II). The study included 300 consenting patients, and various triggers were utilized to assess ADR occurrences. Feedback from resident doctors regarding their experience with both methods was collected and analyzed. Results: TTM identified 65 ADRs (21.7% detection rate), significantly surpassing the 35 ADRs (11.7%) identified through spontaneous reporting (p < 0.001). The positive predictive value (PPV) for drug triggers was 23.3%, while patient triggers had a PPV of 42.5%. Sensitivity and specificity of the TTM were 68.4% and 75.5%, respectively. Feedback indicated a preference for TTM due to its perceived ease of use (mean score 4.2 vs. 3.1) and higher frequency of ADR detection (70% vs. 45%). Conclusion: The Trigger Tool Method significantly enhances the detection of adverse drug reactions compared to spontaneous reporting. The study underscores the need for more active monitoring strategies in clinical settings to minimize the risks associated with ADRs.

DOI: 10.5281/zenodo.

Introduction: Maternal deaths in India from hypertensive diseases vary between 8–14%. The maternal near-miss approach helps to discover potential areas for clinical care improvement by assessing significant (acute) pregnancy issues. Aims: To analyse the nature of obstetric complications in hypertensive disorder, presence of organ system failure or dysfunction, ICU admission, role of antenatal check-up, and perinatal outcome. Materials and Method: This observational study was conducted in Obstetrics & Gynecology department, CNMC from April 2022 to March 2023. Women >16 years with hypertensive disorder of pregnancy of 3rd trimester admitted to hospital were included in the study. Result: The study involved 180 women, with a mean gestational age of 36 weeks and a mean maternal age of 23 years. Twenty people had eclampsia and 152 had preeclampsia. Mothers died in 8 cases (4.4%). Of the patients, 61 (38.6%) had hematological malfunction and 23 (14.8%) had respiratory dysfunction. The majority of instances (85%) were cesarean sections; 148 (93%) had preterm deliveries; and 16 (8.8%) involved infant deaths. Conclusion: This observational study concludes by highlighting the strong correlation between hypertensive problems during pregnancy and unfavorable outcomes for mothers, such as maternal deaths and near-miss incidents. The results highlight the vital requirement of early identification, timely intervention, and sufficient healthcare resources to reduce the risks related to hypertension problems in pregnancy. This study offers useful insights for healthcare professionals and policymakers to improve maternity care and lower avoidable maternal mortality and morbidity by identifying the critical elements that lead to catastrophic outcomes.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to assess the FNAC findings in lymphadenitis. Methods: This study was done in the Department of Pathology, B.M.I.M.S Pawapuri, Nalanda, Bihar, India and conducted from August 2023 to July 2024. All slides and reports which were collected from the Department of Pathology and MRD were reported. The total sample size was thus 200. The design of the study was retrospective cross sectional study. Results: In the present study, 70% lymphadenopathy was at cervical followed by axillary. According to cytological study, 104 had nonspecific reactive lymphadenitis followed by tuberculous lymphadenitis. Conclusion: Enlarged lymph nodes are easily accessible for aspiration. Fine needle aspiration cytology (FNAC) is advocated for the initial diagnosis and management of patients with lymphadenopathy. The technique is being simple with minimal complications. It has been found that it offers a nearly accurate diagnosis of various pathologies including reactive lymphadenitis/inflammatory conditions, granulomatous disorders and neoplastic diseases.

DOI: 10.5281/zenodo.

Background: Post-term pregnancy beyond 40 weeks gestation also carries increased risks of fetal and neonatal mortality and morbidity along with maternal complications. Antepartum stillbirths occurring at or beyond term are major contributors to perinatal mortality when compared to other causes. IOL can reduce risks, but complications associated with its use, such as uterine hyper stimulation and increased Caesarean section rates, raise several concerns. Objective: To compare outcomes of post-term pregnancies with term pregnancies, focusing on maternal and fetal complications and delivery type. Methods: This research is an observational retrospective one conducted in Department of Obstetrics and Gynaecology, Netaji Subhas medical College and Hospital, Bihta, Patna, Bihar, India .A total sample size of 64 patients consists of two groups. In addition, the measurements of clinical and pathological parameters for fetal weight, amniotic fluid index, and placental grading were obtained and analyzed on SPSS v.20.0. Results: Post-term pregnancies were more common among older women and primigravidas. Acute foetal distress was a prevalent indication for Caesarean section rates in the post-term group. Maternal complications such as postpartum hemorrhage and sepsis were more frequent. Adverse fetal outcomes, including asphyxia and NICU admissions, were higher in the post-term group. Conclusion: Both mothers and fetuses are at increased risks with post-term pregnancy. Though the care of post-term pregnancies will always be challenging owing to potential problems, accurate pregnancy date and appropriate inductions of labor (IOL) may lessen those risks. Further refinement of the strategies in managing post-term pregnancies is needed.

DOI: 10.5281/zenodo.

Background: Jaundice, or hyperbilirubinemia, is prevalent in neonates, affecting 80% of preterm and 60% of term newborns in their first week. While most cases resolve without intervention, 5-10% require treatment due to significant bilirubin levels. This study explores hypocalcaemia in neonates undergoing phototherapy for jaundice. Aim: To evaluate the incidence of hypocalcaemia in newborns, both term and preterm, undergoing phototherapy for hyperbilirubinemia. Methodology: This Prospective observational research was carried out at Government Medical College and Hospital, Bettiah, Bihar, India. Eighty neonates with jaundice were included, categorized into preterm (34-<37 weeks) and term (37-40 weeks) groups. Serum calcium levels and total bilirubin were measured at baseline, 12 hours, and 48 hrs. post-phototherapy. Statistical analysis was performed using SPSS, with significance set at p<0.05. Results: Among the 80 neonates, the incidence of hypocalcaemia at 12 hrs. was 5.3% in preterm and 6.6% in term infants (p=0.95), and at 48 hours, it was 5.3% in preterm and 9.8% in term infants (p=0.75). Serum calcium levels significantly increased from baseline to 12 and 48 hrs. in both groups, indicating effective calcium retention. Conclusion: The study found low rates of hypocalcaemia in both term and preterm newborns receiving phototherapy, suggesting that while monitoring is essential, severe hypocalcaemia may not be a prevalent concern during phototherapy.

DOI: 10.5281/zenodo.

Aim: This study aimed to relevance of leukocyte and platelet counts in pregnancy-related hypertension disorders: A retrospective analysis. Methodology: This retrospective study enrolled 84 women with hypertensive disorders, including chronic hypertension, gestational hypertension, mild preeclampsia, and severe preeclampsia. The total leukocyte counts, differential leukocyte counts, and platelet counts were extracted from their medical records. Then, NLR and PLR were calculated. The correlations of these hematological parameters with the severity of hypertensive disorders were evaluated statistically. Results: Leukocyte and neutrophil counts increased gradually with the severity of hypertensive disorders, whereas platelet counts decreased. The neutrophil-to-lymphocyte ratio (NLR) and Platelet: lymphocyte ratio (PLR) were significantly higher in severe pre-eclampsia (NLR: 4.1; PLR: 74) compared to chronic hypertension and gestational hypertension. Both NLR and PLR showed a positive correlation with the severity of the hypertensive disorder (p < 0.05). Conclusion: NLR and PLR are effective markers of systemic inflammation in pregnancy hypertensive disorders, with higher values correlating to greater disease severity. These markers may assist in identifying and monitoring patients with severe hypertensive conditions during pregnancy.

DOI: 10.5281/zenodo.

Background: Acute biliary pancreatitis is a common condition necessitating hospitalization and prompt intervention to avert complications. The primary etiology is gallstones, and the standard treatment to prevent recurrence is cholecystectomy. Nonetheless, the optimal timing for surgery-early versus delayed remains contentious, particularly concerning outcomes such as length of hospital stay and postoperative complications. Aim: This study aims to assess the outcomes associated with early versus delayed cholecystectomy in patients presenting with mild to moderate acute biliary pancreatitis, focusing on metrics such as length of hospital stay, clinical parameters, and postoperative complications. Methodology: A retrospective cohort study was conducted involving 90 patients diagnosed with biliary pancreatitis who underwent cholecystectomy during their index admission. The patients were categorized into two groups: early cholecystectomy (performed within 72 hours, n=36) and delayed cholecystectomy (conducted after 14 days, n=54). Demographic information, clinical parameters, biliary-related interventions, and surgical outcomes were analyzed using SPSS software, with statistical significance defined as P<0.05. Results: The delayed cholecystectomy group (Group 2) exhibited a significantly higher proportion of males (38.9% vs. 16.7%, P=0.02). The two groups did not differ significantly in age, BMI, prevalence of hypertension, diabetes, or ASA scores. However, the duration from presentation to surgery was significantly longer in the delayed group (5±1.5 days vs. 2±1.5 days, P<0.001). Although the operative time was slightly longer in the delayed group (88 minutes vs. 83 minutes, P=0.09), this difference did not reach statistical significance. The rates of postoperative complications were comparable between both groups (3.7% vs. 5.6%, P>0.8). In contrast, the length of hospital stay was significantly greater in the delayed group (7 days vs. 4 days, P<0.001). Conclusion: Performing early cholecystectomy in patients with mild biliary pancreatitis significantly reduces the duration of hospital stay without extending operative time or increasing the rate of postoperative complications. These findings advocate for early surgical intervention as the preferred strategy for managing acute biliary pancreatitis.

DOI: 10.5281/zenodo.

Background: Perforation peritonitis is a prevalent surgical emergency with significant morbidity and mortality, often stemming from various etiological factors such as peptic ulcer disease, appendicitis, trauma, and infections. Despite advancements in surgical techniques and postoperative care, the condition remains a major health concern, particularly in developing countries. Aim: This study aims to evaluate the clinical presentations, epidemiology, surgical management principles, and outcomes of patients with perforative peritonitis. Methodology: Conducted over 12 months at Jannayak Karpoori Thakur Medical College and Hospital, Madhepura, Bihar, India, this clinical study included 70 patients diagnosed with perforative peritonitis. Patients aged above 15 years, managed through surgical interventions, were included based on clinical evaluation, laboratory investigations, and imaging. Data on demographics, clinical profiles, surgical procedures, and outcomes were collected and analyzed using SPSS version 23.0. Results: Of the 98 patients studied, the primary etiology of perforative peritonitis was acid peptic disease (35.71%), followed by typhoid (16.30%) and trauma (13.30%). Duodenal perforations were most common (35.70%). A significant number (47.0%) experienced postoperative complications, with a mortality rate of 11.2%. Wound infections were the most frequent complication (34.8%). Factors significantly influencing mortality included tuberculosis (p=0.004) and trauma (p=0.03), while age and gender did not show a significant impact. Conclusion: The findings underscore the complexities of managing perforative peritonitis, highlighting that, despite some patients recovering successfully, nearly half faced complications. Effective postoperative monitoring and tailored surgical approaches are crucial in improving outcomes for patients with this condition.

DOI: 10.5281/zenodo.

Background: Distal radius fractures are among the most common upper extremity injuries, making up 75% of forearm fractures. Severely comminuted fractures, particularly those with intra-articular components, present significant therapeutic challenges. This study evaluates the outcomes of using volar fixed angle locking plates for treating these fractures. Aim: To assess the effectiveness of volar fixed angle locking plates in managing unstable distal radius fractures. Methodology: A prospective study was conducted over one year with 70 patients at the Department of Orthopaedics, MRMCH Medininagar, Jharkhand, India . Inclusion criteria were patients above 18 years presenting with simple or compound fractures without vascular injury. Surgery was performed using the volar fixed-angle plating technique, and patients were followed for up to 12 months. Data were analyzed using SPSS version 27. Results: Types III/B3 and VII/C2 fractures were the most prevalent (20% each). Most patients (52.86%) underwent surgery within one day of injury. The majority (82.86%) were followed for six months. While 47.14% had excellent outcomes, 12.86% had fair results. Most patients regained normal range of motion, though grip strength recovery was limited. Conclusion: Early mobilization is made possible by the efficacious treatment of distal radius fractures with volar fixed angle locking plates. While most patients showed excellent range of motion recovery, grip strength remained a challenge, indicating a need for strength-focused rehabilitation.

DOI: 10.5281/zenodo.

Aim: The present research aims to assess the criteria for several surgical therapy techniques and their results in addressing local complications of acute pancreatitis. Methodology: This hospital-based observational research was performed at Department of  General Surgery, Jannayak Karpoori Thakur Medical College in Bihar, India, comprising 80 patients requiring surgical intervention for local complications of acute pancreatitis. Patient demographics, complication types, surgical treatments, and post-operative outcomes were evaluated, with all surgeries conducted by a proficient surgical team. Results: The cohort’s average age was 55 years, with a predominance of males (male-to-female ratio of 1.3:1). Pancreatic pseudocysts (30 individuals) and necrotizing pancreatitis (25 individuals) were the predominant sequelae. Drainage operations were the most often executed surgical treatments (40 patients), resulting in a 75% postoperative improvement rate. Nonetheless, 18.75% exhibited no change, while 6.25% saw worsening. Conclusion: The surgical therapy of local complications in acute pancreatitis demonstrates positive results, while considerable heterogeneity is seen. It is essential to prioritize least invasive procedures and personalized treatment strategies. Ongoing surveillance following surgery is crucial to enhance healing and mitigate complications, underscoring the necessity for customized approaches in the management of acute pancreatitis.

DOI: 10.5281/zenodo.

Background: Preeclampsia is a significant pregnancy complication characterized by hypertension and proteinuria, leading to severe maternal and fetal outcomes. The pathophysiology of preeclampsia is complex and multifactorial, with recent studies suggesting a potential link between androgen levels, particularly serum-free testosterone, and the development of this condition. This study aims to investigate the association between serum-free testosterone levels and the incidence of preeclampsia in pregnant women. Methods: A case-control study was conducted at Department of Obstetrics and Gynaecology, Patna Medical College and Hospital, Patna, Bihar, India  over 12 months. A total of 100 pregnant women were enrolled, with 50 cases of preeclampsia and 50 normotensive controls matched for gestational age. Serum-free testosterone levels were measured in all participants during the third trimester. The primary outcome was the correlation between serum-free testosterone levels and the presence of preeclampsia. Secondary outcomes included the assessment of testosterone levels concerning the severity of preeclampsia and maternal and fetal outcomes. Results: Serum-free testosterone levels were significantly higher in the preeclampsia group (mean: 4.3 ± 1.1 pg/mL) compared to the control group (mean: 2.7 ± 0.8 pg/mL) (p<0.01). A positive correlation was observed between elevated testosterone levels and the severity of preeclampsia (r = 0.62, p<0.01). Additionally, higher testosterone levels were associated with adverse maternal outcomes such as increased need for antihypertensive therapy and higher rates of cesarean delivery, as well as adverse fetal outcomes, including lower birth weights and higher incidence of neonatal intensive care unit (NICU) admissions. Conclusion: Elevated serum-free testosterone levels are significantly associated with the presence and severity of preeclampsia in pregnant women. These findings suggest that free testosterone could be a potential biomarker for predicting the risk of preeclampsia as well as a target for therapeutic intervention. Further research is needed to explore the mechanisms underlying this association and to evaluate the potential clinical applications of measuring free testosterone in pregnancy.

DOI: 10.5281/zenodo.

Background: Effective postoperative analgesia is crucial for enhancing patient comfort, accelerating recovery, and minimizing complications following lower limb surgeries. This study aims to compare the analgesic efficiency and safety of intrathecal fentanyl and clonidine in patients undergoing lower limb surgical procedures. Methods: A randomized controlled experiment was carried out at the Department Of Anesthesiology, Vydehi Institute of Medical Sciences & Research Centre, Bangalore, India. Ninety adult individuals, ages 18 to 65, who were scheduled for elective lower limb procedures were split into two groups at random and given intrathecal bupivacaine with either 25 mcg of fentanyl or 150 mcg of clonidine. The (VAS) was used to measure pain reduction at many postoperative time points. Results: Demographic characteristics were comparable between the two groups. At baseline, pain scores were similar (Group A: 6.7 ± 1.3; Group B: 6.8 ± 1.2, p = 0.79). However, significant differences emerged postoperatively, with Group A reporting lower pain scores at all time points (e.g., 1 hour: Group A: 3.2 ± 1.0 vs. Group B: 4.9 ± 1.1, p < 0.001). Fentanyl demonstrated a faster onset of analgesia (9.5 ± 2.1 minutes vs. 15.8 ± 3.2 minutes for clonidine, p < 0.001) and longer duration of analgesia (7.2 ± 1.8 hours vs. 4.9 ± 1.5 hours for clonidine, p < 0.001). Conclusion: Intrathecal fentanyl provides superior postoperative analgesia compared to clonidine in lower limb surgical procedures, characterized by faster onset and prolonged pain relief. These findings underscore the importance of selecting appropriate analgesic techniques to optimize postoperative outcomes. Additional studies are warranted to explore the long-term implications of these analgesic strategies.

DOI: 10.5281/zenodo.

Background: Thalassemia patients, particularly those with transfusion-dependent conditions such as Hb E β-thalassemia also β-thalassemia major, face numerous complications, including endocrine dysfunction. Hypothyroidism is a significant concern among these individuals, with variable prevalence across populations. This study investigates the thyroid function in transfusion-dependent thalassemia patients. Aim: The study aims to assess the prevalence of hypothyroidism in children with transfusion-dependent thalassemia aged 5-14 years also its association with serum ferritin levels. Methodology: This prospective study was conducted at Department of Pediatrics, Darbhanga Medical College and Hospital, Bihar, India. A total of 75 participants were selected, excluding those with pre-existing thyroid disorders or other relevant exclusions. Blood samples were collected for thyroid function (TSH, FT3, FT4) and serum ferritin analysis. Results: The mean age of participants was 9.87 years, with 86.67% diagnosed with β-thalassemia major. Of the total, 92% were euthyroid, 6.67% had compensated hypothyroidism, and 1.33% showed uncompensated hypothyroidism. Higher serum ferritin levels were observed in hypothyroid patients, with a mean ferritin level of 4700.0 ng/ml compared to 3600.0 Nanograms per millilitre in euthyroid patients. Conclusion: Thyroid dysfunction is present in a small subset of thalassemia patients, with a higher prevalence of compensated hypothyroidism. Elevated serum ferritin levels may contribute to thyroid dysfunction, highlighting the need for regular thyroid screening in this population.

DOI: 10.5281/zenodo.

Background: Perinatal asphyxia is a significant cause of neonatal morbidity and mortality, associated with negative outcomes such as poor Apgar scores, hypoxia-ischemic encephalopathy, and neonatal sepsis. Assessing umbilical cord blood gas analysis (UCGS) helps to evaluate the oxygenation and metabolic status of newborns. Aim: This study aimed to evaluate the predictive value of cord blood gas analysis, specifically pH, for short-term neonatal outcomes in high-risk deliveries. Methodology: A retrospective study was conducted on 70 neonates at Department of Pediatrics,  Darbhanga Medical College and Hospital, Bihar, India. Newborns from high-risk deliveries were included, and umbilical cord blood pH was measured at birth. Clinical interventions and outcomes were assessed, including NICU admission, resuscitation, and feeding difficulties. Data analysis used SPSS version 27, applying independent t-tests to compare outcomes between groups. Results: Neonates with pH < 7.25 had significantly higher rates of resuscitation, delayed feeding, encephalopathy, convulsions, and NICU admissions compared to those with pH > 7.25. The mean pH for infants requiring resuscitation was 7.16, compared to 7.3 in those not needing intervention. Conclusion: Umbilical cord blood pH < 7.25 is a significant predictor of neonatal morbidity, associated with increased need for intensive care and adverse outcomes. While convulsions and encephalopathy were more common in the lower pH group, these findings were not statistically significant, suggesting additional contributing factors.

DOI: 10.5281/zenodo.

Aim:  The aim of the study was to assess the incidence and association of serum magnesium levels, serum uric acid levels and microalbuminuria in patients with type 2 DM. Methods: The present study was a hospital based, cross-sectional study, conducted for a period of one year carried out on 200 patients diagnosed with type 2 diabetes mellitus at Department of General Medicine, Rama Medical College Hospital and Research Centre, Hapur, Uttar Pradesh, India from January 2022 to December 2022. The study was done in the department of General Medicine who satisfied the inclusion criteria, after taking an informed written consent from all the subjects. Results: In our study, 42% of the population belonged to 51-60 years of age group followed by 23% in 31-40 age group. There were 192 males and 18 females in the study. Serum magnesium levels were on the lower side in 93% of the population and only 7% had levels within the normal range in our study. Serum uric acid levels were elevated in 70% of the study population whereas 30% were within the normal range or low. Out of 200, 80% were having Microalbuminuria and 15% were having macroalbuminuria. In our study, there was a strong positive correlation between, hypomagnesemia and microalbuminuria, with highly significant p value of 0.000. Out 160 study population with microalbuminuria, 186 patients had elevated serum Mg levels, i.e., 93%. In our study, there was a positive correlation between, high uric acid levels and microalbuminuria with a highly significant value of 0.000. Out of 160 study population with microalbuminuria, 140 had elevated serum uric acid levels. Conclusion: There was a significant microalbuminuria in patients with type 2 DM, with reduced serum Mg levels and elevated serum uric acid levels as compared with patients who had serum Mg and uric acid levels within the normal range.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to correlate the Cord Blood Bilirubin (CBB) level with subsequent neonatal Hyperbilirubinemia. Methods: This was an Observational Study conducted in Department of Pediatrics of Jannayak Karpoori Thakur Medical, College and Hospital, Madhepura, Bihar India. 100 healthy full-term newborns were included after satisfying eligibility criteria. Results: Significant NH in our study was 4%. Most of the mothers belonged to the age group 21-30 years and 52% belonged to multi parity. 32% had B+ blood group. In neonates, 52% were male and 78% were in 37-38 weeks of gestation. 80% had weight between 2.50-3.00 kg and 32% had B+ blood group. Mean total bilirubin on second postnatal day was 10.58 mg/dl and on fifth post-natal day was 10.81 mg/dl. Total bilirubin, haemoglobin and PCV on day 2 were 10.58±2.54, 14.51±1.22 and 43.29±3.36, respectively. Using CBB level of ≥3 mg/dl as a cut-off, NH can be predicted with sensitivity of 100%, specificity of 98.17 %, positive predictive value of 66.67 % and negative predictive value of 100%. Conclusion: A 100% Negative Predictive Value in the present study suggests that in Healthy Term babies (without RH and ABO incompatibility with Cord Blood Bilirubin ≤3mg/dl) cord serum bilirubin can help to identify those newborns who are unlikely to require further evaluation and intervention. These newborns can be discharged with assurance to Parents. Babies with CBB level ≥3mg/dl should be followed more frequently.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to assess the effect of pregnancy induced hypertension on maternal and fetal outcomes. Methods: A prospective observational study was conducted in the Department of Obstetrics and Gynaecology Jannayak Karpoori Thakur Medical, College and Hospital, Madhepura, Bihar for the period of one year. One hundred women with pregnancy-related hypertensive disorders admitted for delivery were included in the study. Results: There were 2,000 deliveries conducted in the hospital during the study period. Out of these, 100 (5%) were diagnosed cases of pregnancy-related hypertensive disorders, which were included in the study. The mean age of participants was 22 ± 6 years. Mean systolic pressure was 158.92 ± 13.87 mmHg, mean diastolic pressure was 104.66 ± 6.34 mmHg, and mean gestational age was 35.95 ± 2.849 weeks. The major pregnancy-related hypertensive disorder was eclampsia (n=43; 43%) and preeclampsia (n=25; 25%). All of these women were observed for the development of any complication. There were no complications in 33 (33%) women. Among the women who developed one or more complications during or after delivery, postpartum hemorrhage (PPH) was the most frequent. Most of the women with PPH were either preeclamptic or eclamptic. After PPH, placental abruption was the second most frequent maternal complication. Most of the women who developed placental abruption had PIH. Conclusion: The most prevalent hypertensive disorders were preeclampsia and eclampsia. The most common associated maternal complications were placental abruption and PPH. The most common associated fetal complications were meconium aspiration syndrome, followed by preterm birth, IUGR, and LBW.

DOI: 10.5281/zenodo.

Background: Infertility is a major concern affecting women in their reproductive years, and thyroid dysfunction, particularly subclinical hypothyroidism, has been linked to fertility challenges. Understanding the prevalence of subclinical hypothyroidism in infertile women is essential to improving outcomes. This study examines the thyroid function, specifically subclinical hypothyroidism, in women with infertility in a tertiary care setting. Aim: The primary aim of this study was to investigate the prevalence and impact of subclinical hypothyroidism in infertile women and its association with various clinical parameters, including age, type of infertility, duration of infertility, menstrual history, serum prolactin levels, PCOS, diabetes mellitus, and additional interventions like ovulation induction requirements. Methods: This cross-sectional study was conducted at MKCG MCH between June 2022 and June 2024, analyzing 195 women presenting with infertility. Detailed evaluations included assessments of thyroid function (serum T3, T4, and TSH levels), type and duration of infertility, menstrual history, prolactin levels, presence of PCOS, diabetes mellitus status, and the requirement for ovulation induction. Statistical analyses were conducted to determine significant associations between these parameters and subclinical hypothyroidism. Results: The mean age of the participants was 29.3 years, with an average infertility duration of 3.14 years. A significant proportion (65.1%) had primary infertility. SCH was identified in 73.3% of the patients. Significant associations were observed between SCH and age group (p=0.020), type of infertility (p=0.006), menstrual irregularities (p<0.001), elevated prolactin levels (p<0.001), PCOS (p<0.001), and diabetes mellitus (DM) (p=0.050). SCH was present in all patients diagnosed with DM (5.1% of the total). Ovulation induction was required in 31.3% of patients with SCH. Treatment with levothyroxine (LT4) and additional interventions, including ovulation induction, were significantly associated with SCH (p<0.001). Conclusion: Subclinical hypothyroidism is highly prevalent among infertile women, particularly those with primary infertility, irregular menstrual cycles, elevated prolactin levels, PCOS, and diabetes mellitus. Thyroid screening should be an integral part of infertility evaluations. Levothyroxine treatment and ovulation induction appear to be beneficial, particularly in women with SCH requiring ovulation assistance. Recommendations: Routine screening for thyroid function, particularly subclinical hypothyroidism, should be integrated into infertility workups for women of reproductive age. Further research is recommended to explore the effects of thyroid hormone treatment on infertility outcomes.

DOI: 10.5281/zenodo.

Background: Infertility is a major concern affecting women in their reproductive years, and thyroid dysfunction, particularly subclinical hypothyroidism, has been linked to fertility challenges. Understanding the prevalence of subclinical hypothyroidism in infertile women is essential to improving outcomes. This study examines the thyroid function, specifically subclinical hypothyroidism, in women with infertility in a tertiary care setting. Aim: The primary aim of this study was to investigate the prevalence and impact of subclinical hypothyroidism in infertile women and its association with various clinical parameters, including age, type of infertility, duration of infertility, menstrual history, serum prolactin levels, PCOS, diabetes mellitus, and additional interventions like ovulation induction requirements. Methods: This cross-sectional study was conducted at MKCG MCH between June 2022 and June 2024, analyzing 195 women presenting with infertility. Detailed evaluations included assessments of thyroid function (serum T3, T4, and TSH levels), type and duration of infertility, menstrual history, prolactin levels, presence of PCOS, diabetes mellitus status, and the requirement for ovulation induction. Statistical analyses were conducted to determine significant associations between these parameters and subclinical hypothyroidism. Results: The mean age of the participants was 29.3 years, with an average infertility duration of 3.14 years. A significant proportion (65.1%) had primary infertility. SCH was identified in 73.3% of the patients. Significant associations were observed between SCH and age group (p=0.020), type of infertility (p=0.006), menstrual irregularities (p<0.001), elevated prolactin levels (p<0.001), PCOS (p<0.001), and diabetes mellitus (DM) (p=0.050). SCH was present in all patients diagnosed with DM (5.1% of the total). Ovulation induction was required in 31.3% of patients with SCH. Treatment with levothyroxine (LT4) and additional interventions, including ovulation induction, were significantly associated with SCH (p<0.001). Conclusion: Subclinical hypothyroidism is highly prevalent among infertile women, particularly those with primary infertility, irregular menstrual cycles, elevated prolactin levels, PCOS, and diabetes mellitus. Thyroid screening should be an integral part of infertility evaluations. Levothyroxine treatment and ovulation induction appear to be beneficial, particularly in women with SCH requiring ovulation assistance. Recommendations: Routine screening for thyroid function, particularly subclinical hypothyroidism, should be integrated into infertility workups for women of reproductive age. Further research is recommended to explore the effects of thyroid hormone treatment on infertility outcomes.

DOI: 10.5281/zenodo.