Background: Breast abscesses are a common complication of lactation, often necessitating drainage. While incision and drainage (I&D) is the traditional approach, ultrasound-guided needle aspiration (USGA) offers a less invasive alternative. This study aimed to compare the efficacy and outcomes of USGA and I&D in managing breast abscesses in women. Methods: The study included 100 women with breast abscesses, who underwent either USGA or I&D. Data on demographics, clinical presentation, treatment outcomes, and breastfeeding continuation were collected and analysed. Results: The majority of patients (90%) were between 18 and 35 years old. Pain was the most common presenting symptom (90%), followed by swelling (69%). Staphylococcus aureus was the predominant pathogen isolated (94%). USGA was associated with significantly less pain (VAS 1.08 vs 3.62, p<0.0001), shorter hospital stays (1 day vs 5.68 days, p<0.0001), and no scarring. A higher proportion of women in the USGA group (90%) were able to immediately continue breastfeeding compared to the I&D group (10%). The recurrence rate was zero in both groups. At 4-week follow-up, there was a small residual collection in the USGA group (mean 0.78cc) but none in the I &D group. Conclusion: USGA offers a safe and effective alternative to I&D for breast abscesses in women, with advantages in terms of pain, recovery time, cosmetic outcomes, and breastfeeding continuation.

DOI: 10.5281/zenodo.

Background: Postoperative pain is a major concern after laparoscopic cholecystectomy. Pain after LC has traditionally been managed by a multimodal approach as the causes are multifactorial. Many approaches have been tried to reduce the pain after LC (Laparoscopic Cholecystectomy). Intraperitoneal irrigation on the diaphragmatic surface and gall bladder bed using local anaesthetics has been found to be a novel and effective way of reducing visceral pain. There are many studies showing the efficacy of intraperitoneal irrigation of different local anaesthetics. Although many adjuvants have been tried that showed promising results, there have been no robust studies comparing adjuvants when instilled with local anaesthetics intraperitoneally. Hence we compared the analgesic efficacy of dexamethasone versus ondansetron as adjuvants to 0.25% bupivacaine instilled intraperitoneally during laparoscopic cholecystectomy. Materials and Methods: After receiving ethical committee clearance, a total of 90 patients were randomly allocated to 3 groups. Each group received either 2 ml of dexamethasone, 2 ml of ondansetron, or 2 ml of normal saline along with 30 ml of 0.25% bupivacaine via intraperitoneal instillation over the gallbladder bed by the surgeon. The intensity of postoperative pain was recorded by the NRS score at 0, 1, 2, 4, 6, 12, and 24 hours. Time for first rescue analgesic and number of rescue analgesics given over 24 hours were also recorded. Also, intensity and incidence of postoperative nausea and vomiting were recorded at 0, 1, 2, 4, 6, 12, and 24 hours via a 4-point scale. Results: Patients who received intraperitoneal dexamethasone as adjuvant to bupivacaine demonstrated a statistically significant decrease in NRS pain scores over 24 hours compared to those receiving ondansetron (p<0.001). Additionally, there was a notable reduction in the need for rescue analgesics over 24 hours (p<0.05). Moreover, a significant proportion of patients experienced reduced postoperative nausea and vomiting over a period of 12 hours (p<0.05) with intraperitoneal dexamethasone as adjuvant to bupivacaine. Conclusion: In patients undergoing elective laparoscopic cholecystectomy under general anesthesia, intraperitoneal instillation of dexamethasone and ondansetron as adjuvants to 0.25% bupivacaine reduced postoperative pain, nausea, and vomiting. Compared to ondansetron, dexamethasone significantly reduced postoperative pain, nausea, and vomiting when analyzed over 0, 1, 2, 4, 6, 12, and 24 hours postoperatively. This effect is likely due to the local anti-inflammatory properties of dexamethasone.

DOI: 10.5281/zenodo.

Background and Aim: Programmed labour and Intrathecal labour analgesia are straightforward, convenient, and highly effective methods for achieving a painless and safe delivery. The objective of this study was to examine the impact of administering a single low dose of intrathecal labour analgesia on both maternal and foetal outcomes. Investigating the impact of programmed labour on maternal and foetal outcome. Material and Methods: A study was conducted at a Department of Gynaecology and Paediatrics in a Tertiary Care Teaching Institute in India for a duration of one year. The purpose of the study was to examine the impact of a single low dose intrathecal labour analgesia on the outcomes for both mothers and their babies. A total of 160 pregnant women with uncomplicated pregnancies who were in spontaneous or induced labour and had cervical dilatation between 4-6cm were included in the study. The participants were divided into two groups of 80 each, using computer-based block randomisation. Group 1 (N=80) was administered intrathecal labour analgesia, which included Fentanyl (25µg), bupivacaine (2.5mg), and morphine (250µg). On the other hand, Group 2 (N=80) underwent programmed labour. Results: Intrathecal labour analgesia was discovered to have a positive impact on labour duration, resulting in faster cervical dilatation. The duration of labour did not show any significant difference between the two groups. The mean duration of the active phase of the first stage of labour was 193.78±24.50 minutes in Group 1 and 191.221±36.48 minutes in Group 2. In both Group 1 and Group 2, the duration of the second stage was similar, with Group 1 lasting an average of 50.85±16.40 minutes and Group 2 lasting an average of 50.48±21.20 minutes. The difference between the two groups was not statistically significant (P value 0.59). The duration of the third stage of labour in Group 1 (4.75±1.3 min) and Group 2 (4.85±1.5 min) was similar. Conclusion: The single shot intrathecal labour analgesia, which combines bupivacaine, fentanyl, and morphine, proves to be an effective method of pain relief during labour and delivery. Spinal block has proven to be a reliable method for achieving effective pain relief in a timely manner and providing adequate analgesia throughout the delivery process. This makes it a favourable choice in settings with limited resources.

DOI: 10.5281/zenodo.

Background: Uveitis is the inflammation of the Uveal tract. It can be accompanied by inflammation of adjacent ocular structures like the Retina, Cornea, Vitreous and optic nerve. Its prevalence is around 730 per 100,000 population in India. Among the patients visiting tertiary care institutes in North and South India, the incidence is around 1.31% and 0.8% respectively. In developing countries, the complications can contribute to 25% of blindness.  Uveitis can be caused by both infectious and non-infectious etiological causes. But the etiology remains unknown in majority of the cases. The current International uveitis study group (IUSG) is based on anatomical location of inflammation and not on etiology. Purpose: To study the clinical characteristics of uveitis in patients presenting to a Rural hospital in Southern part of India. Methods: An Institutional based Retrospective study was conducted by us on 306 Uveitis patients from June 2023 to May 2024. Patients and the pattern of Uveitis was analysed in a tertiary care hospital in Bangalore, South India. Patients were diagnosed, named and meshed as per Standardization of Uveitis nomenclature and individualized according to clinical picture. Results: Mean age of presentation was 31.5 years in males and 29.8 yrs in females with a range of 2-60 years. A male predominance was noted 207. The most common type was Anterior Uveitis (46.7%), followed by Posterior Uveitis (29.9%), Intermediate Uveitis (11.78%) and Panuveitis (9.00%). Toxoplasmosis (39.21%) had highest incidence among posterior Uveitis cases. A frequent occurrence in the subset of Panuveitis was Vogt Koyanagi Harada Disease. Conclusion: The working age group of the population was significantly affected. Etiology remained unknown in many cases of uveitis, in spite of the evolution in diagnostic investigations. Infectious etiology was more common. The most common anatomical location in our study was the Anterior uveitis.

DOI: 10.5281/zenodo.

Chronic obstructive pulmonary disease is of increasing concern now a days, due to increase in air pollution and smoking habits. Conventionally chronic obstructive pulmonary diseases are evaluated through pulmonary function tests. It tells about ventilatory and oxygenation abnormalities in COPD patients.  But COPD patients have other co-morbidities, which can be contributing factor for exercisee limitation. Hence, Cardiopulmonary Exercise Testing helps to know pulmonary, cardiac and other causes of breathlessness like musculoskeletal limitation. In this study done on 99 patients, we compare PFT values and CPET values (VO2 max), that is maximum oxygen consumption in exercise in COPD patients. And, CPET can determine limitation in exercise before Pulmonary function tests. Cardiopulmonary exercise testing can be used to evaluate all cases of breathlessness. In this study, after careful history and radiological examination, spirometry and cardiopulmonary exercise testing was done and values compared. VO2 max was below 80% in 78.8% of mild and 100% of moderate COPD patients.

DOI: 10.5281/zenodo.

Background: A corneal ulcer is potentially a vision-threatening ocular emergency. It is the second most common cause of blindness in India (9.3%).^[1] The visual prognosis of keratitis patients depends on the size, location and depth of the ulcer, the risk factors, immune status of the patient and the organism isolated. Objectives: To analyse the epidemiological pattern, prevalence of known risk factors and the common etiological agents in bacterial and fungal keratitis and to evaluate the initial response to treatment. Methodology: All patients with the clinical diagnosis of corneal ulcer attending the ophthalmology casualty and OPD of a Tertiary healthcare hospital in South India, who gave consent to participate in the study were included in the study. Detailed history and examination of patients was taken. Visual acuity was measured using Snellen chart. The morphological characteristics of ulcer were recorded using slit lamp biomicroscopy. Nasolacrimal syringing, Schirmer test were also done. Corneal scraping was taken, and examined using 10% potassium hydroxide and Gram stain, blood agar and Sabouraud’s dextrose agar. Clinically bacterial and fungal keratitis were treated with topical broad-spectrum antibiotics and antifungals respectively. Response to treatment was recorded at the end 1st and 2nd week. Ulcers showing reduction in above parameters were considered healing. Results: Eighty patients were evaluated during the study period. 75% of study population were males, and the mean age was 53.25+/-0.856 years. Farmers (30%) were found to be maximally affected by corneal ulcers and mostly presented within 3 to 6 days after development of symptoms. Ocular trauma was the commonest risk factor (72.5%). Vegetative matter injury(22.5%) was the commonest cause for trauma and also more common in mycotic keratitis (31%). The culture positivity rate in this study was 43.75%, out of which fungal isolates were 45.71% and bacterial isolates were 54.28%. Most commonly isolated microorganism was Fusarium species (22.85%), followed by Coagulase negative Staphylococcus (17.14%). Mean size of the ulcer in the study population came down from 4.99mm at presentation to 4.55mm at second week. Conclusion: Trauma with the vegetative matter was the predominant cause of fungal keratitis. In this study, fungal keratitis was found to be more common. Fusarium was the most common isolate.

DOI: 10.5281/zenodo.

Introduction: There are many risk factors which make lap surgery difficult like old age, male sex, attacks of acute cholecystitis, obesity, previous abdominal surgery. Clinical signs of acute cholecystitis & certain ultrasonographic findings, i.e. thickened gall bladder wall, distended gall bladder, peri cholecystic fluid collection, impacted stone. In case of Laparoscopic cholecystectomy, surgeons deciding whether to proceed with a minimally invasive approach, perform an open procedure or make a referral to a more experienced surgeon. Aims: To validate pre-operative scoring system that will predict difficult laparoscopic cholecystectomy. To predict level of difficulty of laparoscopic cholecystectomy pre – operatively by the use of proposed scoring system. To assess intraoperative difficulty during laparoscopic cholecystectomy.  To evaluate conversion of laparoscopic cholecystectomy. Materials and Methods: This is an Observational study with prospective study design. The study was conducted in Department of General Surgery, Bokaro General Hospital, Bokaro, Jharkhand and study duration was 18 months. The sample size of this study is 75. Result: In Difficult Intraoperative Evaluation, 8 (34.8%) patients were hospitalized for acute cholecystitis. In Easy Intraoperative Evaluation, 30 (81.1%) patients were hospitalized for acute cholecystitis. In Very Difficult Intraoperative Evaluation, 15 (100.0%) patients were hospitalized for acute cholecystitis. Association of History of Hospitalization for Acute Cholecystitis with Intraoperative Evaluation was statistically significant (p<0.0001). Conclusion: The pre-operative scoring system demonstrated reliable predictive ability for identifying cases of difficult laparoscopic cholecystectomy. By analyzing patient data pre-operatively, this scoring system allows surgeons to anticipate potential challenges, improve perioperative planning, and communicate more effectively with patients regarding surgical risks.

DOI: 10.5281/zenodo.

Background: Pleural effusion can occur with varied clinical presentation Objective: The purpose of the study was to see the demographic characteristics and clinical profile of patients presented with undiagnosed exudative pleural effusion. Methodology: This cross sectional study was conducted in Bangalore medical college and research institute. Demographic details of the patient was noted and chest x-ray was done. Diagnostic thoracocentesis was done and sent for Analysis. Result: Total of 77 patients were included, among the age groups the 51-60 years category has the highest representation at 29.9 %, followed by those over 60 years at 28.6%. Males constitute a larger portion of the sample at 59.7%, while females make up 40.3%. Most patients 85.7% experienced breathlessness, chest pain was reported by 77.9% of patients, 71.4% experienced cough, additionally 61% had loss of weight, 53.2% had loss of appetite, and 46.8% had fever. Among the study population 44.2%(34) of the individuals has hypertension, 42.9%(33) of individuals have diabetes, 27.3%(21) of the individuals is affected by ischemic heart disease and 6.5%(5)of the individuals has chronic kidney disease.  29.9% of the population does not have any comorbidities. 1.3% of the population experienced just one symptom, 20% of individuals experienced two symptoms, 11.8% had three symptoms, 24.7%, experienced four symptoms, 10.4% had five symptoms and 31.2% of individuals experienced all six symptoms. Conclusion: In conclusion adult male with multiple symptoms and comorbidities were most commonly suffering from exudative pleural effusion.

DOI: 10.5281/zenodo.

Background: Surgical site infections (SSIs) are a significant cause of postoperative morbidity and mortality in patients undergoing abdominal surgeries. Identifying the incidence and risk factors associated with SSIs is crucial for developing effective preventive strategies. This study aims to evaluate the incidence of SSIs and identify the risk factors contributing to their development in patients undergoing abdominal surgeries in a rural tertiary care centre. Methods: This prospective study was conducted in the Department of General Surgery, Bhagwan Mahavir Institute of Medical Sciences, Pawapuri, Nalanda, Bihar, India from 05/09/2023 to 06/09/2024, enrolling 80 patients undergoing elective abdominal surgeries. Comprehensive data were collected on patient demographics, clinical history, surgical details, and postoperative outcomes. The study adhered to the STROBE guidelines to ensure accuracy and reliability. SSIs were defined according to the CDC criteria, and a detailed multivariate logistic regression analysis was performed to identify significant risk factors associated with SSIs. Results: A total of 80 patients were included in the study, with an overall incidence of SSIs observed at 17.5% (14 patients). The most common type of SSI was superficial incisional SSI, accounting for 64.3% of cases. Significant risk factors identified included prolonged surgical duration (OR = 2.3, 95% CI: 1.5–3.8), presence of diabetes (OR = 3.0, 95% CI: 1.9–4.6), and emergency surgery (OR = 2.7, 95% CI: 1.8–4.1). Multivariate analysis revealed that these factors were independently associated with an increased risk of SSIs. Conclusion: The study highlights a significant incidence of SSIs in abdominal surgeries and identifies key risk factors that should be addressed to reduce their occurrence. Implementing targeted preventive measures, particularly for high-risk patients, could significantly improve postoperative outcomes.

DOI: 10.5281/zenodo.

Aim: This research investigates the prevalence and classifications of anemia among a cohort of 64 individuals in a hospital environment, emphasizing its public health ramifications. Methodology: A Retrospective study research was undertaken at Ajay Sangaal Institute of Medical Sciences. Individuals aged 16 years and older were recruited according to WHO criteria for anemia. A thorough assessment, encompassing medical history, physical examination, and laboratory analyses, was conducted. Statistical analyses were performed with SPSS software. Results: The research had an equal distribution of gender, consisting of 32 males and 32 females, with a mean age of 45.2 years. Iron deficiency anemia was diagnosed in 30 individuals (46.9%), succeeded by vitamin B12 insufficiency (28.1%) and folate deficiency (15.6%). Laboratory findings revealed aberrant hemoglobin levels in all subjects, with a majority displaying irregularities in MCV and MCH. Initial therapy resulted in a full response in 62.5% of patients, whilst 12.5% had no response. Conclusion: The results indicate a significant incidence of anemia, mostly due to iron deficiency, highlighting the necessity for focused public health interventions and improved diagnostic methods. The research underscores the necessity of continuous monitoring and customized management strategies, especially for resistant cases, to successfully tackle anemia in at-risk groups.

DOI: 10.5281/zenodo.

Background: Hepatitis B virus infection poses a serious global health threat, with over one-third of the population estimated to be infected. It can lead to severe liver complications and poses significant risks, particularly during pregnancy. Aim: This study aimed to determine the prevalence of Hepatitis B virus infection among pregnant women and assess their knowledge regarding the disease, its transmission, and associated complications. Methodology: Conducted over one year at Department of Microbiology Netaji Subhas Medical College and Hospital, Bihta, Patna, Bihar, India, this prospective study enrolled 70 pregnant women attending antenatal care. Data on sociodemographic characteristics, medical history, and HBV screening (including HBsAg, HBeAg, and HIV) were collected. Results: The study revealed varying HBV seroprevalence rates among different age groups, peaking at 1.35% in women aged 26-30. Urban areas displayed a higher prevalence (75%) compared to rural regions (25%). Despite these rates, only 1.5% of participants demonstrated adequate knowledge regarding HBV transmission and prevention, underscoring a critical gap in awareness. Conclusion: The findings highlight a significant prevalence of HBV infection among antenatal women, particularly in urban settings and younger age groups. This underscores the urgent need for targeted public health interventions to enhance education about HBV, its transmission, and the importance of vaccination. Improving maternal knowledge and implementing effective screening strategies can mitigate the risk of mother-to-child transmission, ultimately enhancing health outcomes for mothers and infants.

DOI: 10.5281/zenodo.

Background: Tuberculosis caused by the Mycobacterium TB bacterium, is one of the most widespread infectious causes of morbidity and death worldwide, particularly in poor nations like India, despite its curability and preventability. Sputum microscopy remains the principal approach for diagnosing pulmonary tuberculosis; nevertheless, it is less sensitive than culture. Aim: The purpose of this research is to identify Mycobacterium tuberculosis utilizing sputum evaluation techniques. Methods: A total of 80 sputum samples were obtained from inpatients and outpatients, with two samples collected from each patient and assessed by microscopy, culture, and molecular methods. Ziehl-Neelsen and fluorescence microscopy facilitated the rapid identification of MTB by staining, while Lowenstein-Jensen and Mycobacteria Growth Indicator Tube cultures provided a more sensitive albeit slower method for MTB growth detection. Molecular methods, such as the Line Probe assay and the RTPCR, MTB/RIF test, made it easier to identify Mycobacterium tuberculosis quickly and accurately. Results: This research evaluated several sputum procedures for the diagnosis of Mycobacterium tuberculosis (MTB) in 80 individuals. Molecular approaches, namely RTPCR and Line Probe Assay (LPA), had the greatest sensitivity and specificity, with sensitivity values of 90% and 88%, respectively, and yielded findings rapidly—within two hours to four days. RTPCR identified rifampicin resistance in 30 instances, illustrating its effectiveness in addressing drug-resistant tuberculosis. Microscopy methods were more cost-effective and efficient (1-2 hours), while exhibiting diminished sensitivity (58-65%). The culture techniques, namely MGIT, demonstrated great sensitivity (88%) but had prolonged turnaround times of 1-2 weeks. Conclusion: Mycobacterium tuberculosis detection employing sputum assessment techniques in accuracy and speed showed that culture techniques are slower but more specific than molecular technologies such as RT-PCR, LPA and Faster microscopy is less sensitive. Combining techniques enhance diagnostic efficiency while using the same resources.

DOI: 10.5281/zenodo.

Background: Anemia is a serious health problem that affects approximately 1.6 billion people worldwide. It is especially prevalent in poor nations like India, where it mostly affects children and women that are of reproductive age. Anemia, traditionally diagnosed through peripheral blood smear (PBF), has seen its assessment shift due to developments in automated hematology analyzers. Aim: The present research examines the relative effectiveness of RBC histograms against peripheral smear analysis in the diagnosis of anemia. Methodology: This research was conducted at the Department of Pathology, Bhagwan Mahavir Institute of Medical Sciences Pawapuri Nalanda Bihar India for one year , included 70 anemic patients and employed the Sysmex XN 1000 automated analyzer for complete blood count (CBC) and red blood cell histogram analysis. Peripheral blood smears were analyzed to evaluate red blood cell morphology. Results: Our study results demonstrated a greater incidence of anemia in females and people aged 31 to 40 years and also indicated that microcytic anemia was the predominant form (40%), followed by dimorphic anemia (30%), normocytic anemia (20%), and macrocytic anemia (10%). RBC histograms exhibited broad patterns in 40% of cases, showing a diverse range of red blood cell sizes, and a leftward trend in 30% of patients, suggesting an elevated presence of younger red blood cells. Normal histograms were detected in 16%, but right shift (5%), short peak (3%), and bimodal peak (6%) patterns were less prevalent. Although advancements in automated methods, conventional peripheral smear examination is crucial for precise anemia diagnosis. Conclusion: The present research highlights the necessity of integrating automated hematology analyzers with manual peripheral blood smear examination for thorough diagnosis and management of anemia, especially in women of reproductive age. It underscores the necessity for both technical advancement and physical proficiency in contemporary hematology.

DOI: 10.5281/zenodo.

Aim: The purpose of this research is to examine many aspects of head injuries, including their patterns, epidemiology, radiological findings, and therapeutic options. Method: Using a convenient non-random sampling strategy, the study included 70 cases of head injuries that matched the inclusion criteria. Supervising at the Department of General Surgery, Bhagwan Mahavir Institute of Medical Sciences, Pawapuri, Nalanda, Bihar, India. Appropriate statistical procedures were carried out while patients were being monitored for their outcomes. Result: A road accident accounted for 20% of patients, with a home or outdoor fall coming in second 25.2%, and assault (22%). The majority of road accidents are in males (54%) majority of head injuries during falls from bus/train accidents (30%). A total no. of 11 people were found injured with EDH head injuries. Conclusion: To implement prospective measures such as raising traffic rule awareness, increasing helmet and seat belt use, enhancing road construction and maintenance, enhancing traffic monitoring, decreasing drunk driving, and enhancing road traffic sense.

DOI: 10.5281/zenodo.

Background: Cervical cancer remains a significant public health concern globally, particularly in low- and middle-income countries (LMICs) like India. Despite a decline in incidence rates, it continues to be the third most prevalent cancer among women in India, with a notable mortality rate. In 2020, India reported approximately 123,907 new cases, indicating a pressing need for effective screening and early detection strategies. Aim: This study aimed to evaluate the patterns of cervical smear abnormalities among women attending cancer screening camps in Jharkhand, India, with a focus on understanding the demographic and clinical factors influencing these results. Methodology: Conducted over one year, this retrospective study included 60 women aged 25 to 65 who consented to participate in cancer screening camps. Clinical examinations and Pap smears were performed, with results classified according to the Bethesda 2014 system. Results: The findings revealed that the majority of participants (65.9%) were aged 30 to 50 years, with high educational attainment influencing health awareness. Normal smear results were most prevalent in the 31-50 age group (41.67%), whereas older women (over 50) exhibited higher inflammatory findings (20%). Alarmingly, no normal results were recorded in women under 30, underscoring potential healthcare access issues. Conclusion: The study underscores the necessity for targeted cervical cancer screening and awareness initiatives, especially for older women and younger populations. Enhancing access to screening programs in rural areas could significantly reduce cervical cancer incidence and mortality, ultimately improving women’s health outcomes in India.

DOI: 10.5281/zenodo.

Aim: The purpose of the study was to determine the impact of iron deficiency anemia on non-diabetic persons’ HbA1c levels as well as the correlation between the two. Method: The cross-sectional study involved a total of 60 nondiabetic subjects divided into two groups: iron deficiency anemic and non-anemic. Patients were selected for the study on the basis of clinical features and laboratory findings of iron deficiency anemia (IDA). Hemoglobin, serum iron, serum ferritin, and total iron binding capacity were measured. The levels of HbA1c were recorded at the baseline and during follow-up. Tests of significance included the t-test and Pearson’s correlation, while the statistical significance was set at a p-value of <0.05. Results: Iron-deficient participants had significantly lower serum iron (45 ± 15 mcg/dl) and ferritin (20 ± 10 ng/ml) compared to controls (p<0.01). Total iron-binding capacity (TIBC) was elevated in the anaemic group. Mean HbA1c levels were higher in the anaemic group (6.8 ± 1.1%) associated to the non-anaemic group (5.6 ± 0.9%, p=0.003). HbA1c levels increased with the severity of anemia, reaching 7.3 ± 1.2% in the severely anemic group. Conclusion: Anemia is significantly raises HbA1c levels in non-diabetic individuals, suggesting that IDA may lead to an overestimation of glycemic control. The severity of anemia correlates with higher HbA1c values, highlighting the need for careful interpretation of HbA1c results in iron-deficient patients.

DOI: 10.5281/zenodo.

Background: Pelvic fractures, often resulting from high-energy trauma, significantly impact women’s physical, sexual, and reproductive health. Understanding these consequences is crucial for tailoring treatment strategies and rehabilitation programs. Objective: To evaluate the impact of pelvic fractures on physical functioning, sexual health, and reproductive outcomes in women. Methods: A retrospective study was conducted on 120 women aged 18–45 years with pelvic fractures admitted to SNMMCH, Dhanbad, Bihar, India. Physical functioning was assessed using the Musculoskeletal Function Assessment (MFA) questionnaire. Sexual health was evaluated through the Female Sexual Function Index (FSFI), and reproductive outcomes were monitored for two years post-injury. Data were analyzed to identify the prevalence and severity of functional, sexual, and reproductive impairments. Results: Among the 120 participants, 68% reported significant physical limitations six months post-injury, with 40% showing residual impairments at two years. Sexual dysfunction was prevalent in 52% of women, with arousal and pain disorders being the most common issues. Regarding reproductive health, 22% experienced menstrual irregularities, and 12% reported difficulties conceiving post-injury. The severity of the fracture and the involvement of pelvic organs correlated strongly with poor outcomes. Conclusion: Pelvic fractures have profound and multifaceted effects on women’s physical, sexual, and reproductive health. Comprehensive rehabilitation programs and multidisciplinary care are essential to improving quality of life and addressing these challenges effectively.

DOI: 10.5281/zenodo.

Background: Osteoporosis is a progressive skeletal disorder characterized by decreased bone mass and micro architectural deterioration, leading to increased fracture risk. Postmenopausal women are particularly vulnerable due to hormonal changes, necessitating a deeper understanding of associated risk factors. Objective: To identify and evaluate the key risk factors contributing to osteoporosis in postmenopausal women. Methods: A cross-sectional study was conducted on 100 postmenopausal women aged 45–75 years at Department of Orthopaedics and Obstetrics and Gynaecology, SNMMCH, Dhanbad, Jharkhand, India. Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry (DEXA) scans. Demographic, clinical, and lifestyle factors were collected through structured questionnaires and medical records. Multivariate regression analysis was used to identify significant predictors of low BMD. Results: Osteoporosis was diagnosed in 40% of participants, while 35% had osteopenia. Key risk factors for low BMD included advanced age (OR: 2.0, p < 0.01), low body mass index (BMI <20; OR: 1.8, p < 0.05), sedentary lifestyle (OR: 2.5, p < 0.01), and low calcium intake (OR: 2.7, p < 0.01). Early menopause (<45 years) and a family history of osteoporosis were strongly associated with increased risk (OR: 2.9, p < 0.01 and OR: 3.1, p < 0.01, respectively). Conclusion: Advanced age, low BMI, sedentary lifestyle, inadequate calcium intake, and early menopause are significant risk factors for osteoporosis in postmenopausal women. Proactive lifestyle modifications and early screening are essential to mitigate the burden of osteoporosis.

DOI: 10.5281/zenodo.

Background: Anemia is a condition marked by a reduction in red blood cells, commonly observed due to various underlying causes. It is prevalent globally, especially in women and the elderly, with a significant impact on morbidity and mortality. This study focuses on the diagnostic utility of red blood cell (RBC) histograms and peripheral blood smear (PBS) in patients with anemia, aiming to explore their roles in anemia classification and severity determination. Aim: This study aims to evaluate the diagnostic value of RBC histograms and PBS in classifying and determining the severity of anemia among patients. Methodology: This prospective observational study was conducted over six months at the Department of Pathology, B.M.I.M.S., Pawapuri, Bihar. A total of 547 anemic patients were included, with hemoglobin levels below 13.5 gm/100ml in men and 12.0 gm/100ml in women. Blood samples were analyzed using an automated hematology analyzer, and PBS was examined microscopically. The study categorized anemia into five types: microcytic hypochromic, normocytic normochromic, macrocytic, dimorphic anemia, and pancytopenia. Histogram abnormalities were also recorded. Results: Among the 547 patients, females accounted for 64.4% of cases, with the 31-40 age group most affected (29.3%). The most prevalent anemia type was microcytic hypochromic anemia (38.4%), followed by normocytic normochromic (29.3%). Broad base histograms were observed in 32.9% of patients, and severe anemia (hemoglobin <7 g/dL) was present in 53% of the population. Conclusion: RBC histograms and PBS are crucial diagnostic tools for anemia classification and severity assessment. The study demonstrates the predominance of microcytic hypochromic anemia and highlights the necessity of early intervention in severe cases.

DOI: 10.5281/zenodo.

Aim: This study aims to assess the quality of antenatal care and its impact on adverse pregnancy outcomes in women. Methodology: This observational research was performed at Sri Krishna Medical College in Muzaffarpur, Bihar, India, encompassing 70 parturient women. Participants were classified into booked (those who received antenatal care) and un-booked groups (those who did not). Data were gathered using structured questionnaires and analyzed using SPSS version 27, utilizing the Chi-square test for categorical variables. Results: Among the participants, 64.3% were scheduled, whilst 35.7% were unscheduled. Only 17.1% received high-quality antenatal care, while 54.3% reported moderate quality and 28.6% reported low quality. Negative outcomes were 14.3% of individuals experiencing anemia, 25.7% suffering from severe preeclampsia, and a stillbirth incidence of 2.9%. The findings underscore the significant connection between the quality of antenatal care and pregnancy problems. Conclusion: The study indicates a significant necessity for enhancements in ANC quality to mitigate negative pregnancy outcomes. Improving care delivery might substantially enhance maternal and newborn health, in accordance with global health objectives to reduce maternal death rates. Additional study is necessary to investigate effective approaches for improving ANC quality in resource-constrained environments.

DOI: 10.5281/zenodo.

Background: Cervical cancer prevention programs have been successful in developed countries, but in developing regions, logistical, financial, and social challenges hinder their effectiveness. Increasing participation in screening is crucial to lowering incidence and mortality, but barriers such as lack of knowledge, cultural beliefs, and limited access to care persist. Aim: This study aimed to identify the determinants of cervical cancer screening adherence among rural women of Muzaffarpur District, India. Methodology: This prospective study was conducted at Sri Krishna Medical College over one year, involving 60 eligible women. Participants were divided into intervention and control groups, with structured questionnaires gathering socio-demographic data. Screening clinics were organized in villages, with free testing, treatment, and educational services provided. Results: The majority of participants were aged 40–49 years, with 30% having completed secondary school and 51.7% semi-skilled workers. Knowledge about cervical cancer was low, with only 17.7% aware of the disease and its risk factors. A mere 10% had undergone screening in their lifetime. Higher education and middle-aged women were more likely to utilize screening services, while fear of diagnosis and misconceptions about cervical cancer prevented participation. Conclusion: This study highlights the need for culturally sensitive education and community engagement to improve cervical cancer screening adherence. Addressing fears and misconceptions, particularly in low-resource settings, will be key to enhancing participation and reducing the disease’s burden.

DOI: 10.5281/zenodo.

Background: Congenital hypothyroidism is a leading cause of preventable intellectual disability, especially in newborns with hypothyroid mothers. This cross-sectional study evaluates the prevalence of hypothyroidism in newborns born to hypothyroid mothers, utilizing cord blood TSH levels as a screening tool. It also explores associated factors such as gestational age, birth weight, delivery type, and maternal health conditions that may influence neonatal thyroid function. Methods: Conducted over 18 months at a secondary care hospital, this study included 120 newborns delivered to hypothyroid mothers. Cord blood samples were collected immediately post-delivery for TSH measurement. Additional data on demographics, birth weight, type of delivery, and maternal complications were obtained from clinical records. Statistical analysis was performed to evaluate the association between TSH levels and factors like gestational age, birth weight, and risk factors, including pregnancy-induced hypertension (PIH) and premature rupture of membranes (PROM). Results: Elevated TSH levels were noted in a significant number of newborns, highlighting the prevalence of thyroid dysfunction in this high-risk population. No significant differences in TSH levels were observed based on delivery type, but a notable association was found between elevated TSH and PIH in mothers. Additionally, a modest correlation between TSH and cord bilirubin levels was observed, suggesting a potential interaction between thyroid function and bilirubin metabolism. Conclusion: This study emphasizes the need for routine neonatal thyroid screening, particularly in newborns born to hypothyroid mothers. The results highlight the importance of managing maternal thyroid function during pregnancy and the effectiveness of cord blood TSH as an initial screening tool for early detection. Further research is warranted to explore long-term developmental outcomes and optimize screening practices in high-risk newborn populations.

DOI: 10.5281/zenodo.

Background: Peptic ulcer disease refers to ulcers in parts of the gastrointestinal tract exposed to acid, most commonly in the stomach (gastric ulcer) and small intestine (duodenal ulcer). Perforated peptic ulcer (PPU) is a severe complication with high morbidity and mortality if not treated promptly. The incidence of PPU is increasing, with Helicobacter pylori infection and NSAIDs usage identified as major risk factors. Though surgical treatment has remained similar over time, PPU continues to pose a dangerous challenge. Aim: This study aimed to evaluate the epidemiological features, clinical manifestations, complications, risk factors, and predictors of complications in patients with perforated peptic ulcers. Methodology: A retrospective study was conducted over three years, involving 80 patients diagnosed with PPU. Data were collected from hospital records, including demographics, clinical findings, laboratory results, surgical outcomes, and complications. Patients underwent laparotomy for perforation repair. Statistical analysis was performed using SPSS, with Chi-square tests for categorical data and logistic regression to identify predictors of complications. Results: The most common symptoms were severe abdominal pain (51.25%) and abdominal tenderness (50%). Shock on admission occurred in 17.5% of cases. The study found significant postoperative complications, including atelectasis (37.5%), acute renal failure (26.3%), and surgical site infections (23.8%). Risk factors included age under 40 years (45%) and a history of smoking (27.5%) and NSAIDs use (30%). Conclusion: Perforated peptic ulcers present with severe abdominal symptoms and can lead to significant complications, particularly respiratory and renal issues. The study highlighted the increased risk in patients with prolonged perforation (>48 hours), especially those under 40. Early intervention is critical to reducing complications and improving outcomes, emphasizing the need for prompt diagnosis and treatment.

DOI: 10.5281/zenodo.

Background: Infectious skin disorders (ISDs) are a major health concern in children, particularly in developing regions with inadequate hygiene and healthcare access. These diseases, caused by bacteria, viruses, fungi, and parasites, lead to significant morbidity and impact on children’s quality of life. Understanding the epidemiology of ISDs is essential for creating effective prevention and control strategies. Aim: To identify and analyze the prevalence and patterns of ISDs in children attending a tertiary care hospital in Gujarat, India. Methodology: A retrospective study was conducted involving 341 children under 18 years of age who visited the dermatology outpatient department between [year]. Data was collected from hospital records using a standardized proforma. The study categorized the conditions into bacterial, fungal, viral, and parasitic infections. Descriptive statistics and Chi-square tests were used to analyze the data, with a significant threshold of p < 0.05. Results: Among 296 children diagnosed with ISDs, scabies were the most common condition (21.28%), followed by pediculosis capitis and impetigo (12.84% each). Other prevalent conditions included tinea corporis, pityriasis versicolor, and tinea capitis. Gender distribution revealed a higher prevalence in males, but the difference was not statistically significant. The highest prevalence occurred in children aged 5-10 years. Conclusion: This study highlights the high burden of ISDs in children, with scabies being the most common disorder. Gender and age did not significantly influence the prevalence of ISDs. Hygiene promotion, early detection, and timely treatment are crucial in managing these diseases, particularly in resource-poor settings.

DOI: 10.5281/zenodo.