Rheumatological emergencies, though rare, represent critical manifestations of autoimmune diseases requiring prompt diagnosis and intervention. Conditions such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), systemic vasculitis, and catastrophic antiphospholipid syndrome (CAPS) pose significant challenges due to their systemic involvement and potential for rapid progression. Recent advancements in artificial intelligence (AI) have transformed the diagnostic and management landscape by integrating clinical, serological, and imaging data to enhance precision. AI-driven tools, including machine learning models and predictive analytics, enable earlier identification of disease flares, personalized treatment planning, and global accessibility through telemedicine. This review comprehensively explores the pathophysiology, clinical manifestations, diagnostic innovations, and therapeutic strategies for 14 key rheumatological emergencies. It highlights the role of AI in optimizing care, from predictive modelling for early flare detection to personalized medicine approaches and drug discovery. The discussion integrates evidence-based insights, supported by tables and flowcharts, to provide a practical framework for clinicians and researchers. Despite significant progress, challenges such as diagnostic delays, treatment resistance, and global disparities persist, necessitating continued innovation and collaborative efforts.

DOI: 10.5281/zenodo.

Background: Hypoxemia during anesthesia induction is a critical concern, particularly in high-risk patient populations such as those with obesity, cardiopulmonary diseases, or critical illness. Traditional preoxygenation techniques frequently fall short of providing adequate oxygen reserves, leading to an increased risk of complications. Objectives: This study evaluates and compares the effectiveness of high-flow nasal oxygen (HFNO) and pressure support ventilation (PSV) against conventional facemask oxygenation in reducing hypoxemia and improving patient safety in high-risk scenarios. Methods: A prospective, randomized clinical trial was conducted involving 200 high-risk patients undergoing elective and emergency surgical procedures. Patients were allocated into three groups: HFNO, PSV with 5 cmH₂O PEEP, and traditional facemask preoxygenation. Key outcomes measured included oxygen saturation levels (SpO₂), time to desaturation (SpO₂ < 90%), and patient comfort. Statistical analysis involved ANOVA and Kaplan-Meier survival curves. Results: HFNO reduced desaturation events by 35% compared to traditional facemask preoxygenation, with an average time-to-desaturation increase of 25 seconds (p < 0.01). PSV demonstrated a 20% improvement in oxygenation safety, particularly in obese patients (BMI ≥ 30 kg/m²), with significantly higher patient comfort scores. No adverse events were reported. HFNO and PSV represent significant advancements in preoxygenation techniques, effectively mitigating hypoxemia risks in high-risk patients. These findings suggest their integration into clinical practice to enhance patient safety during anesthesia induction.

DOI: 10.5281/zenodo.

Introduction: Triple-negative breast cancer (TNBC), a prevalent aggressive subtype, accounts for 12%-17% of invasive breast cancers in Western populations, with higher prevalence in India due to lifestyle factors. Aims: To analyse the expression of biomarkers Vimentin and CD34 in triple negative breast cancer and determine its significance in relation to grade of tumour and metastatic potential. Materials and Methods: Institution based observational descriptive type of study with a cross- sectional retrospective study design. The study was conducted in the Department of Pathology, Medical College, and Kolkata in collaboration with Department of General Surgery, Medical College, and Kolkata over a period of 18 months. Study population 52 patients. Result: The two-sided P value is 0.0438, considered significant. The row/column association is statistically significant (using Fischer Exact Test). Relative risk = 3.167. 95% Confidence Interval: 0.5762 to 17.404 (using the approximation of Katz.) The two-sided P value is 0.0002, considered extremely significant. (Using Fischer Exact Test) Relative risk = 1.983, 95% Confidence Interval: 1.225 to 3.211 (using the approximation of Katz). No cases were found to have Vimentin Negative MVD High for both columns High Grade and Low Grade. Values of 0 have not been included. The P value is 0.0006. (Significant) The two-sided P value is < 0.0001, considered extremely significant. Conclusion: Triple negative breast cancers are aggressive, with high MBR Grade and Ki67 Index. They exhibit a tendency towards epithelial-mesenchymal transition and higher metastatic potential due to high microvessel density. Tumors expressing Vimentin, high microvessel density, and high Ki67 Index are more likely to be aggressive and have a higher prognostic significance.

DOI: 10.5281/zenodo.

Introduction:  Hepatitis B virus (HBV) is an infectious agent that infects the human liver cells and causes liver inflammation, which leads to chronic infection and severe problems such as cirrhosis of liver or hepatocellular carcinoma (HCC) more frequently than the other types of hepatitis viruses. Aims: To assess the efficacy and performance of Fibroscan against the Fibrosis Index Four Factors (FIB-4) in evaluating liver fibrosis stages in patients with hepatitis B. To compare the FIB-4 score with the Fibroscan score in the assessment of liver fibrosis in patients with hepatitis B. Material and Methods: This cross-sectional study was conducted in the Department of Radiodiagnosis at North Bengal Medical College and Hospital, Darjeeling, over a one-year period, including patients referred from the Model Treatment Centre, NVHCP, Darjeeling, with a sample size of 150 selected through systematic random sampling based on inclusion and exclusion criteria. Result: In patients of Coarse liver parenchyma the mean FIB4 score (mean± s.d.) was 1.7250± 0.2783. In patients of Homogenous liver parenchyma the mean FIB4 score (mean± s.d.) was 1.6933± 0.2126. Conclusion: The comparative analysis of FIB-4 and Fibroscan in evaluating liver disease severity in Hepatitis B patients highlights their diagnostic value. While Fibroscan offers more accurate liver stiffness measurements, FIB-4 remains a valuable, cost-effective, and accessible tool, especially in resource-limited settings. Combining both methods could improve liver disease assessment and patient outcomes. Further studies with larger cohorts are needed to validate these findings and optimize their clinical use.

DOI: 10.5281/zenodo.

Background: Cataract surgery, primarily performed through phacoemulsification, aims to restore vision in patients affected by cataracts. Phacomorphic angle closure (PMAC) represents a challenge in cataract surgery, particularly in managing patients with shallow anterior chambers. This study focuses on the impact of anterior chamber depth (ACD) on phacoemulsification ultrasound times and surgical outcomes. Aim: The primary objective of this study was to correlate phacoemulsification ultrasound times with ACD in patients undergoing uncomplicated cataract surgery. Methodology: The Department of Ophthalmology at Darbhanga Medical College and Hospital conducted this prospective observational study for a single center, over a specified period. A total of 80 patients with nuclear grade 3 cataracts were included, divided into two groups based on their preoperative ACD measurements. Various preoperative assessments were performed, including ACD, intraocular pressure (IOP), and other ocular parameters. Standardized phacoemulsification techniques were employed, and ultrasound times were recorded for analysis. Results: The majority of the study sample was male, with a mean age of 65. Group A (ACD 2.20–2.50 mm) demonstrated a significantly longer total ultrasound time (mean: 35 seconds) compared to Group B (ACD 2.51–3.00 mm; mean: 30 seconds). Complications such as posterior capsular rupture were observed in Group A (2.5%), while corneal edema cleared in a mean of 3 days for Group A versus 2 days for Group B, indicating a significant difference (p = 0.03). Conclusion: The study established a clear relationship between deeper ACD and shorter phacoemulsification ultrasound times, leading to improved surgical outcomes. These findings emphasize the importance of preoperative ACD assessment in optimizing cataract surgery and patient care.

DOI: 10.5281/zenodo.

Background: Blood transfusion is critical in healthcare but carries the risk of transmitting infectious diseases such as hepatitis B, hepatitis C, HIV, and syphilis. The prevalence of these infections varies significantly across populations and regions, particularly in India, where a notable number of blood donors remain at risk. Aim: This study aims to assess the seroprevalence of HIV, HBV, HCV, syphilis, and malaria among blood donors at the Bhagwan Mahavir Institute of Medical Sciences in Nalanda, Bihar. Methodology: A retrospective analysis was conducted involving 1,200 blood donors. Data were collected on demographics and medical history, and blood samples were tested for infectious diseases using ELISA and rapid tests. Inclusion criteria were healthy individuals aged 18-60, while individuals with chronic diseases or high-risk behaviours were excluded. Results: Among the donors, the prevalence rates were 3.16% for HIV, 9.48% for HBV, 0.73% for HCV, and 0.73% for syphilis, with male donors (97.38% of the sample) exhibiting significantly higher infection rates compared to females. Blood type analysis revealed that O positive donors had the highest rates of infections, particularly HBV (13.17%). Conclusion: The study reveals a significant prevalence of blood-borne infections among blood donors in Bihar, emphasizing a gender disparity and the need for targeted screening and preventive strategies, particularly for high-risk groups such as O positive donors. The findings underscore the importance of public health initiatives to mitigate transmission risks and improve the safety of blood transfusions in the region.

DOI: 10.5281/zenodo.

Background: Doppler study of the umbilical artery has a crucial role in management of IUGR cases as it is a non-invasive method’ employed to evaluate fetal well-being. This study investigates the association between fetal outcomes and umbilical artery Doppler results. Aim: To determine correlation between abnormal umbilical artery Doppler results and neonatal outcomes in pregnancies with intrauterine growth retardation. Methodology: This prospective study was conducted over a period of one year in the Department of Obstetrics and Gynecology at Patna Medical College and Hospital, Patna, Bihar, India for one year and pregnancy diagnosed with IUGR were studied in regard to risk factors, abnormal umbilical artery Doppler results and perinatal outcome. Results: Among the neonates, 25% were classified as extremely low birth weight, also 26.67% were very low birth weight. The largest group, 48.33%, comprised Low Birth Weight (LBW) neonates. Prolonged NICU stays affected 41.67% of the patients, while 25% of the neonates expired. Perinatal mortality was highest in neonates born between 26-30 weeks, with a mortality rate of 50%. The results of intubation (87.50%) and extended NICU stays (85.71%) were considerably worse when abnormal doppler readings were present. Conclusion: Abnormal umbilical artery Doppler findings strongly correlated with poor fetal outcomes, emphasizing the importance of Doppler evaluations in predicting neonatal morbidity and mortality.

DOI: 10.5281/zenodo.

Background and Aim: Unsafe abortion poses a significant public health challenge in low- and middle-income nations. Young, unmarried women represent a significant demographic at risk for unsafe abortions. The utilization of emergency contraceptive pills (ECPs) has the potential to greatly decrease the risks associated with abortion-related complications and fatalities. This study aimed to evaluate the knowledge, attitudes, and practices regarding emergency contraception pills among female medical students within the reproductive age group. Material and Methods: A cross-sectional study was carried out at a tertiary care institute in Gujarat, focusing on the Department of Gynaecology. This research involved 300 females of reproductive age and spanned a duration of one year. Every participant in the study underwent comprehensive interviews utilizing a carefully crafted and pre-tested semi-structured questionnaire. Respondents’ attitudes were assessed through a structured five-point Likert scale. Results: In this study, among 300 females surveyed, the majority, 158 (38%), fell within the age group of 25-29 years. A notable correlation emerged linking age, place of residence, educational attainment, and employment status to awareness of emergency contraceptive pills (p< 0.05). This study revealed that among 100 respondents familiar with emergency contraceptive pills (ECPs), 63% reported having used them, while 80% expressed awareness of their existence. A user of emergency contraceptive pills disclosed that their motivation for using the medication stemmed from a fear of unintended pregnancy, despite experiencing no complications. This was followed by 15% of individuals who reported engaging in unprotected sexual intercourse. Conclusion: Fostering the health of women and their infants necessitates the development of a public awareness strategy aimed at educating and encouraging behavioural changes among females of reproductive age, as well as promoting the utilization of emergency contraceptive pills.

DOI: 10.5281/zenodo.

Background: Postmenopausal women, defined as those experiencing amenorrhea for 12 consecutive months, frequently present with postmenopausal bleeding (PMB). While genitourinary atrophy accounts for 60% of cases, PMB may also signal malignancies such as endometrial cancer. Endometrial thickness (ET) measured via transvaginal ultrasonography (TVS) serves as a key diagnostic parameter, with an ET of ≥4 mm warranting biopsy. This study aims to correlate ET measured by TVS with histopathological findings to identify precancerous conditions in postmenopausal women. Methods: This prospective observational study was conducted from January to July 2024 at MDM Hospital, Jodhpur. A total of 100 postmenopausal women with PMB were enrolled after applying strict inclusion and exclusion criteria. All participants underwent detailed clinical evaluation, TVS, and endometrial biopsy. Histopathological examination (HPE) categorized findings into atrophic endometrium, polyps, proliferative or secretory patterns, hyperplasia, and carcinoma. Statistical analysis was performed using Chi-square and Fisher’s exact tests, with a p-value <0.05 considered significant. Results: The majority of participants were aged 51–55 years (34%), with a median menopause duration of <3 years. HPE revealed atrophic endometrium (40%), proliferative patterns (20%), and hyperplasia with atypia (7%). An increase in ET correlated with higher rates of abnormal HPE findings; 85.96% of cases with ET ≤5 mm was normal, compared to 80% abnormal findings with ET >10 mm. Agreement between TVS and HPE diagnoses varied across pathologies, with the highest concordance observed for atrophic and hyperplastic patterns. Conclusion: This study underscores the pivotal role of TVS in evaluating PMB and stratifying malignancy risk. Higher ET strongly correlates with abnormal histopathological findings, highlighting the need for vigilant assessment. Combining clinical, imaging, and pathological modalities optimizes diagnostic accuracy and management in postmenopausal women.

DOI: 10.5281/zenodo.

Background: Deviated Nasal Septum (DNS) is a common nasal condition requiring surgical correction. Conventional and endoscopic septoplasty are widely performed techniques. Endoscopic septoplasty offers improved visualization, precise correction, and integration with other nasal surgeries, while conventional septoplasty remains effective for correcting gross deformities. This study aims to compare the outcomes, complications, and advantages of both techniques. Methods: This prospective study included 50 patients diagnosed with DNS, divided into two groups: Group A underwent conventional septoplasty, and Group B underwent endoscopic septoplasty. Postoperative outcomes, complications, and symptom relief were analyzed over three months. Data were statistically evaluated using the chi-square test, with significance set at p<0.05. Results: Endoscopic septoplasty showed higher postoperative symptomatic relief for nasal obstruction (93% vs. 86%) and headache (100% vs. 80%). Complication rates were lower in the endoscopic group, with fewer cases of synechiae and persistent pathology. Endoscopic septoplasty facilitated better visualization and accessibility to posterior deviations and isolated spurs. However, conventional septoplasty was more effective in addressing anterior deviations and external deformities. Postoperative stay was shorter in the endoscopic group (88% discharged within 48 hours) compared to the conventional group (80%). The combination of techniques was beneficial in certain complex cases. Conclusion: Endoscopic septoplasty offers superior postoperative outcomes and fewer complications, particularly in posterior and high deviations, isolated spurs, and cases requiring intraoperative documentation. Conventional septoplasty remains effective for anterior deformities and gross injuries. Both techniques are complementary and may be combined for optimal results. Endoscopic septoplasty surpasses conventional methods in precision and teaching value but requires technical expertise.

DOI: 10.5281/zenodo.

Introduction: In India, hepatitis B virus (HBV) infection is of intermediate endemicity, with nearly 4% of the population being chronic HBV carriers, i.e. about 40 million people. Most of them are asymptomatic (high endemicity >8%, intermediate 2%–8%, low <2%). The frequency of hepatitis C virus (HCV) infection, as evaluated by anti-HCV antibody positivity, has been reported to be 1%–2% among voluntary blood donors. Hepatitis D virus (HDV) infection is found in fewer than 10% of patients with acute or chronic HBV infection. Acute Viral hepatitis, caused mainly by hepatitis viruses A, through E is also a major public health problem in India.1 Since 1955, several epidemics of hepatitis have been reported. Although hepatitis A virus (HAV)3 and hepatitis E virus (HEV), both enterically transmitted, are highly endemic in India, HEV has been responsible for most of these epidemics. Aims: To study various risk factors, clinical manifestations and outcome of acute viral hepatitis in pediatric population attending a tertiary care center in Kolkata. To identify the etiological agent of acute viral hepatitis in patients admitted in tertiary care centre. To compare the result of standard medical care for acute viral hepatitis of various   etiology. To identify extra-hepatic manifestation complications associated with acute viral hepatitis. Materials and Methods: This is a prospective observational hospital-based study. The study was conducted between 1^st January 2015 to 30^th June, 2016 (18 months). The sample size of this study is 84 patients. Result: Among 82 patients with h/o poor sanitation practice, 77(93.9%) had HAV infection, 3(3.7%) patients had only HEV infection and 2 had mixed infection (HAV + HEV). Most common GI symptom was pain abdomen (92.9%) followed by anorexia (90.5%) and nausea/ vomiting, (81%). Majority 78(92.9%) patients did not have any associated infections. 6(7.1%) patients had associated infection along with viral hepatitis, among them 2 patients (2.4%) had dengue fever along with 1(1.2%) DHF. Conclusion: We conclude that viral hepatitis, especially hepatitis A virus (HAV), is a significant health issue in India, including West Bengal, particularly among children. Most cases presented with hepatomegaly, and atypical symptoms like splenomegaly and ascites were observed. Laboratory results commonly showed increased direct bilirubin and SGPT/ALT levels; high PT levels indicated a worse prognosis. Complications, including HLH and acute pancreatitis, were rare but affected prognosis.

DOI: 10.5281/zenodo.

Introduction: Globally, most of the community-acquired and healthcare-associated infections are mainly caused by a large family of gram-negative, facultative anaerobes and non-spore-forming bacilli, named Enterobacteriaceae. Objective: Extended-spectrum β- lactamase-producing Enterobacteriaceae, especially the multi-drug resistant is a major concern now in health care. The aim of the study is to determine the prevalence of multi-drug resistance and extended-spectrum β- lactamase-producing Enterobacteriaceae among hospitalized patients at a tertiary care hospital in Siliguri, Darjeeling, West Bengal. Methods: Cross-sectional study was conducted from August 2021 to July 2022. 440 isolates of Enterobacteriaceae were collected and antimicrobial susceptibility testing was performed by the disc diffusion methods. Cefotaxime and ceftazidime discs were used for screening of ESBL production and confirmatory tests were performed by the combination disk method as per standard guidelines. Results: The multidrug resistance patterns and ESBL production rate was 55.9% and 28.9% respectively. Within the total screened ESBL producers, 89.8% were found as multidrug-resistant. Among the screened samples, E. coli (51.1% & 30.5%), Klebsiella spp. (66.4% & 32.2%), Proteus spp. (43.4% & 13.2%) and Citrobacter spp. (33.3) respectively showing a very higher rate of multidrug resistance patterns and ESBL production. It was observed that against the ampicillin (83.4%) the group of Enterobacteriaceae showed the highest antimicrobial resistance rate followed by ceftriaxone (82.3%), ceftazidime (77.9%), ciprofloxacin (71.4%), levofloxacin (65%), ampicillin-sulbactam (61.4%), gentamicin (48.9%), amikacin (45.7%), piperacillin-tazobactam (44.6%), meropenem (29.8%) and Imipenem (29.6%). Conclusions: Enterobacteriaceae gradually develop resistance against commonly used antibiotics. Ground-level deep-reach surveillance of antimicrobial resistance, continuous monitoring, and proper infection control practices are needed to shift the trend and cope with these public health threats.

DOI: 10.5281/zenodo.

Introduction: Breast cancer (BC) is one of the most common cancers of women in India. This study aimed to identify the risks such as menopausal status, age at menopause, age at menarche, parity, marital status, duration of lactation, age at first pregnancy, use of oral contraceptives, domicile status, literacy, occupation and family history of related cancers compared to women with other non-breast diseases. Methods: In this study 522 BC patients and 522 women with other non-breast diseases, who attended the Comprehensive Breast Clinic and Breast Cancer Research Unit and Surgery OPD at IPGME&R and SSKM Hospital, Kolkata, India during the period from January, 2009 to November, 2013 were included. Results: The risk of BC was significantly increased in women who attained menopause at >55yrs of age (OR-6.81). The risk was also increased in women who had early menarche (OR-4.26) or late menarche (OR-3.05). Women who were unmarried (OR-5.14), nulliparous (OR-2.03), lactated for a short duration (OR-3.74) and were >30yrs of age at first pregnancy (OR-3.77) were at a significantly higher risk. The risk was increased in rural women (OR-4.13), illiterate women (OR-2.05) and in women with a family history of related cancers (OR-2.78). No increased risk was found in relation to menopausal status, occupation and the use of oral contraceptives. Discussion: This study showed that late age at first pregnancy, early or late menarche, late menopause, nulliparity, short duration of lactation, rural background, unmarried women, family history of related cancers and illiteracy are important risk factors of BC. Use of oral contraceptives, menopausal status and occupation did not contribute to the risk of BC. This study demonstrated that premenopausal status, early menopause, hyperlactation, multiparity, early age at first pregnancy, urban background, literacy and no family history of related cancers to be associated with a significantly reduced risk of BC.

DOI: 10.5281/zenodo.

Background and Aim: These clavicle fractures can be quickly fixed, allowing for early shoulder mobility and greater patient comfort. Fixation of the clavicle improves function in situations of concomitant scapula fractures by restoring the mechanics of the shoulder. This study was to assess the functional outcome of displaced mid shaft clavicular fractures treated with plate fixation. Material and Methods: The present analysis was done in the department of the orthopedics in the medical college and hospital. The analysis of the functional outcome of the 18 cases of the displaced middle third clavicular fractures was done in the study. All patients included in this study were included under Allman group 1. All Patients were treated with plate fixation. The patients were observed every two weeks for the first three months, every four weeks for the next six, and then every eight weeks for the final twelve. Up to 12 weeks, sports and hard lifting were avoided. Results: Four patients are female and 14 patients are male out of the 18 instances. The patient’s age ranges from 22 to 54 years old. RTA (14) was the main factor in the majority of injuries, followed by an unintentional fall. Eight of the 18 instances united in 8 weeks, and all 18 cases united by 12 weeks. 12 of the 18 patients eventually resumed their normal daily activities. 16 of the 18 patients who had cases returned to work in less than three months. Conclusion: In our study, displaced midshaft clavicular fractures treated with open reduction and stiff internal fixation had excellent functional outcomes and a high percentage of fracture union.

DOI: 10.5281/zenodo.

Introduction: Antibiotic-resistant bacteria cause more than 2 million illnesses and 23,000 deaths every year in the United States. Antibiotics are widely prescribed for children; approximately 20% of all outpatient and 60% of all in-patient visits result in at least 1 antibiotic prescription. Aims: The aims to investigate the prevalence and patterns of antibiotic resistance in pediatric populations. Materials and Method: The present study was an observational Cross-Sectional Study. This Study was conducted for 1year. Total 100 patients were included in this study. Result: In infant (≤12 month), median age (years) was 0.52. In child (≥12 month), median 6.71. In infant (≤12 month), 25(50%) patients were female and 25 (50%) patients were male. In child (≥12 month), 30(60%) female and 20(40%) patients were male.  Association of Sex with Group was not statistically significant (p= 0.3148). Conclusion: In conclusion, addressing pediatric antibiotic resistance requires a multifaceted approach that includes improving stewardship practices, enhancing diagnostic accuracy, and promoting public awareness. By ensuring that antibiotics are prescribed only when necessary and in the correct doses, we can reduce the emergence and spread of resistant bacteria in children. Moreover, ongoing education for healthcare providers, along with research into alternative treatments, will play a crucial role in combating this growing threat. Ultimately, a collaborative effort from healthcare professionals, families, and policymakers is essential to safeguard the effectiveness of antibiotics for future generations.

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.