Introduction: Nonalcoholic fatty liver disease (NAFLD) is one of the most important causes of liver disease worldwide and will probably emerge as the leading cause of end-stage liver disease in the coming decades, with the disease affecting both adults and children. Objective: The present study had undertaken to study the Prevalence of Non-Alcoholic Fatty Liver Disease in Hypertensive Patients. Method: A Prospective observational study was conducted during October 2020 to October 2022 at Department of Medicine, Government Medical College and Hospital, Chh. Sambhajinagar, Maharashtra, India Patient with history of Hypertension and age more than 18 years were enrolled in this study. Results:  In present study, out of 600 cases screened only 350 cases of HTN came for follow-up and among them 90 patients were diagnosed as NAFLD. This prevalence of NAFLD among hypertensive patient was 25.71%. The Mean age of patients was found to be 42.70 ± 7.34 years. Maximum numbers of cases were females 52.22% and males 47.78%. Male to female ratio was 1.09:1. Most of patient 56.67% residing in rural area followed by 43.33% were from urban area. Majority of 56.0% patients were having NAFLD Grade II followed by 40.0% of grade I and 4% of grade III NAFLD. Conclusion: The prevalence of NAFLD among hypertensive patient was 25.71%. Most of patients had history of hypertension of 5-10 years. Majority of patients under study were obese and overweight BMI was found to be significantly associated NAFLD.  It can be inferred that a clinician should have a high index of suspicion in order to detect NAFLD early in the course of the disease as symptoms and signs of NAFLD are non-specific duration and occur later in the course of the disease. Early detection would help not only in modifying the disease course and delaying its complications but would also play a major role in preventive of disease.

DOI: 10.5281/zenodo.

Introduction: Nonalcoholic fatty liver disease (NAFLD) encompasses a spectrum of clinic-pathologic entities that have in common the presence of fat accumulation in the liver in the absence of significant alcohol consumption. The epidemiology and demographic characteristics of NAFLD vary worldwide, usually parallel to the prevalence of obesity, but a substantial proportion of patients are lean. The present study is conducted to study the clinical profile of non-alcoholic fatty liver disease in hypertensive patients. Method: A Prospective observational study was conducted during October 2020 to October 2022 at Department of Medicine, Government Medical College and Hospital, Chh. Sambhajinagar, Maharashtra, India. Patient diagnosed NAFLD with hypertension and age more than 18 years were enrolled in this study. Results: In present study, 90 patients of NAFLD with HTN were enrolled. Most of the patients 46.67% had 2nd degree of NAFLD followed by 43.33% had 1st degree and 10% had 3rd degree of non-alcoholic fatty liver disease. There was statistical significance relation between diastolic BP and degree of NAFLD (p=0.035). No mortality was seen among study patients. In multivariate analysis non-alcoholic fatty liver disease grading was significantly related with BMI (p=0.0001), W/H ratio (p=0.0001) & triglyceride (p=0.004). Conclusion: There was statistical significance relation between diastolic BP and degree of NAFLD. In multivariate analysis non-alcoholic fatty liver disease grading was significantly related with BMI, W/H ratio & triglyceride. Early detection would help not only in modifying the disease course and delaying its complications but would also play a major role in preventive cardiology as its association with metabolic syndrome is frequent and its components are well documented cardiovascular risk factors.

DOI: 10.5281/zenodo.

Background: Diabetic foot ulcers (DFUs) represent a significant complication of diabetes mellitus, often leading to prolonged morbidity, increased healthcare costs, and reduced quality of life. Conventional wound dressings may not adequately address the underlying pathophysiology of DFUs. This study evaluates the efficacy of a papain urea-based preparation in comparison to conventional saline dressing in promoting wound healing. Methods: A randomized controlled trial was conducted at a tertiary care hospital in Tamil Nadu, enrolling 100 patients with Wagner grade II-IV DFUs. Patients were randomly assigned to either the papain urea-based preparation group (n=50) or the normal saline dressing group (n=50). The primary outcomes measured were the rate of granulation tissue formation and the duration of hospital stay. Wound area measurements were taken at baseline and on day 14 post-treatment. Statistical analyses, including t-tests and chi-square tests, were performed to assess significant differences between the groups. Results: Patients treated with papain urea-based preparation demonstrated a statistically significant acceleration in healthy granulation tissue formation (p < 0.001) and a shorter duration of hospital stay compared to the normal saline group. The intervention was well-tolerated, with no observed systemic adverse effects. Conclusion: The findings indicate that papain urea-based preparation is a superior alternative to conventional saline dressings for DFU management, promoting faster healing and potentially reducing healthcare costs. Incorporating papain urea-based formulations into wound care protocols may enhance clinical outcomes for DFU patients.

DOI: 10.5281/zenodo.

Background: Breast carcinoma remains the most common cancer among women globally, with varying subtypes, clinical presentations, and responses to treatment. Estrogen receptor (ER), progesterone receptor (PR), and HER2neu are crucial biomarkers that influence prognosis and treatment strategies. This study evaluates the expression of these receptors in breast cancer patients, correlating their status with clinicopathological parameters. Methods: A cohort of 50 adult patients diagnosed with breast cancer was analyzed at Government Erode Medical College from January 2022 to December 2024. All patients underwent a triple assessment, including clinical, pathological, and radiological evaluations. Immunohistochemistry (IHC) was used to assess ER, PR, and HER2neu expression. Clinical parameters, such as age, tumor size, lymph node status, and histological grade, were correlated with receptor status. The follow-up period was six months. Results: Among the 50 patients, 66% were ER-positive and PR-positive, and 54% were HER2-positive. Tumor size varied, with 46% of tumors between 2-5 cm. A significant association was found between receptor expression and age (p=0.03), lymphovascular invasion (p=0.01), and cancer type (p=0.02). Histopathological diagnosis revealed that 98% had invasive ductal carcinoma (IDC), and 66% showed lymph node metastasis. Surgical intervention was predominantly modified radical mastectomy (86%). Immunohistochemical subtyping showed 44% of patients were ER/PR+HER2-, 22% were ER/PR+HER2+, 32% were ER/PR-HER2+, and 2% were ER/PR-HER2-. Conclusion: Hormone receptor status, particularly ER and PR expression, significantly influences treatment decisions and patient prognosis. This study highlights the critical role of immunohistochemistry in breast cancer diagnosis, offering valuable insights into tumor biology and therapeutic planning. Accurate receptor profiling, alongside clinicopathological parameters, can enhance the precision of treatment strategies and improve patient outcomes.

DOI: 10.5281/zenodo.

Aim: This study evaluates the outcomes of intertrochanteric femur fractures treated with long and short proximal femoral nails (PFN). Material and Methods: Fifty patients were included, with fractures classified according to the AO system. Surgical outcomes, including union time, complication rates, and functional recovery, were compared between the long and short PFN groups. Results: The study found that the short PFN group had a significantly shorter surgical time, lower blood loss, and better functional outcomes, as measured by the Harris Hip Score, compared to the long PFN group. No significant differences were observed in the union time between the two groups. Conclusion: The findings suggest that the short PFN offers advantages in terms of quicker recovery and fewer complications.

DOI: 10.5281/zenodo.

Introduction: Obstetric referrals are a vital component of maternal healthcare, especially in resource-limited settings, where timely transfer of high-risk cases can significantly reduce maternal and neonatal complications. This study was undertaken to analyze the spectrum, causes, and outcomes of obstetric referrals at a tertiary care center in Western Gujarat. Materials and Methods: This was a prospective observational study conducted over a period of six months in the Department of Obstetrics and Gynecology at a tertiary care hospital. All obstetric patients referred from peripheral health facilities with gestational age ≥28 weeks were included. Detailed data on socio-demographic profile, referral source, causes of referral, delays, transport mode, and maternal outcomes were collected using a structured proforma and analyzed descriptively. Results: Among 150 referred obstetric patients, the majority were aged 21–30 years, primigravida, from low socioeconomic backgrounds, and residing in rural areas. Educational status was poor, with 36.7% being illiterate. Most referrals were made after 36 weeks of gestation. Hypertensive disorders (18.7%), previous cesarean section (14.7%), and severe anemia (12%) were the most common indications for referral. Referrals predominantly came from district hospitals (32%) and private clinics (32.7%), and 63.3% of patients were transported via government ambulances. Delay in referral was observed in 44.7% of cases, mainly due to delayed decision-making and lack of transport. Maternal outcomes were favorable in most cases, with no maternal deaths reported. Conclusion: Effective referral systems, timely transportation, and strengthening of peripheral healthcare services are essential to ensure positive maternal outcomes in high-risk pregnancies.

DOI: 10.5281/zenodo.

Background: WHO core prescribing pattern indicators are widely used to analyze medicine prescribing patterns. The elderly’s involvement in multiple co-morbidities has been crucial in terms of polydrug use while being treated in the hospital. The present study aims to evaluate the prescribing pattern of drugs among hospitalized patients in the geriatric ward. Materials and Methods: A cross-sectional study was conducted among randomly selected geriatric patients at AGMC & GBP Hospital, Tripura, during 2023-24. Data were collected in a case record form which included WHO core prescribing indicators. Data were analysed using IBM SPSS 21.0. Both descriptive and inferential statistics were applied to express the data. Results: A total of 35 new cases from the Geriatric ward and their records of medical prescriptions were included in the study. The majority of cases were CVA (74.3%) followed by heart diseases (60.0%), diabetic complications (48.5%), respiratory diseases (45.7%) etc. As per WHO core prescribing indicator’s analysis, the average number per prescription was 9.74, the number of injections used per prescription was 2.11, the average number of antibiotics used was 3.45, and the average number of drugs not from the NLEM list was 3.02. Only 1.02 prescriptions were found with fixed-dose combinations. Conclusion: The study concludes the need of intellect prescribing practice, to install more rational therapy among geriatric patients including antimicrobials.

DOI: 10.5281/zenodo.