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.

Background: Tennis elbow, sometimes referred to as lateral epicondylitis, is a degenerative overuse ailment brought on by eccentric stress of the extensor carpi radialis brevis (ECRB) tendon. It primarily affects individuals engaged in repetitive wrist extension, forearm supination, and radial deviation, such as tennis, squash, and badminton players. The condition is characterized by pain and functional impairment at the lateral epicondyle of the elbow. Nonoperative treatments like corticosteroid and platelet-rich plasma (PRP) injections are common approaches to manage this condition. Aim: This study aims to compare the clinical efficacy of corticosteroid injections and PRP injections in treating lateral epicondylitis, evaluating their impact on pain reduction and functional improvement over time. Methodology: A prospective study was conducted over one year in the Department of Orthopaedics at Anugrah Narayan Magadh Medical College and Hospital, Gaya, India. The sample consisted of 100 patients with lateral epicondylitis unresponsive to 6 weeks of conservative management. Patients received either corticosteroid or PRP injections, and their progress was monitored using the Visual Analog Scale (VAS) and Disabilities of the Arm, Shoulder, and Hand (DASH) scores at 4-, 8-, and 12-weeks post-treatment. Results: ‘Both groups showed significant improvements in pain (VAS) and disability (DASH)’. The PRP group demonstrated a progressive reduction in both scores, with the VAS score decreasing from 72.3 pre-injection to 42 at 12 weeks, and the DASH score reducing from 58.7 to 31. The corticosteroid group showed initial improvement, but the effects plateaued by 12 weeks, with the VAS score dropping from 70.3 to 42.4 and the DASH score improving from 58.7 to 38.3. Conclusion: Both corticosteroid and PRP injections are effective in reducing pain and improving function in patients with lateral epicondylitis. However, PRP demonstrated more sustained and long-term benefits, with the most significant improvement observed at 12 weeks. These findings suggest that while corticosteroids provide short-term relief, PRP may offer more durable outcomes for managing tennis elbow.

DOI: 10.5281/zenodo.

Background: Femoral neck fractures are prevalent, especially among the elderly, with displaced fractures posing considerable difficulties. Hemiarthroplasty, which involves substituting the femoral head with a prosthetic device, is the recommended intervention for older individuals with displaced femoral neck fractures. The decision between cemented and uncemented femoral stems is contentious, with contradictory information about option yields superior outcomes, especially in relation to functional recovery, comorbidities, and death rates. Aim: This study aims to evaluate the morbidity, mortality, and functional results of cemented and uncemented hemiarthroplasty in elderly patients with displaced femoral neck fractures. Methods:  Seventy-four patients aged 55 years or older, designated for hemiarthroplasty, were randomly allocated to receive either a cemented or uncemented femoral stem. Functional results were evaluated with the Harris Hip Score during the one-year follow-up. Postoperative complications, death rates, patient satisfaction, and hemoglobin levels were documented. Statistical analysis was conducted utilizing SPSS software, with a significance threshold established at p<0.05. Results: No significant variations in baseline parameters were observed between the groups. At the one-year follow-up, functional results, as measured by the Harris Hip Score, were comparable, exhibiting no significant differences in pain alleviation or hip functionality. The incidence of complications, such as dislocation, infection, and thromboembolism, were minimal and comparable across the two groups. One-year mortality rates were comparable (cemented 5.4%, uncemented 2.7%). Patient satisfaction, weariness, energy, and self-efficacy were similar among the groups. Conclusion: Cemented and uncemented hemiarthroplasties yield similar functional results, safety, and patient satisfaction in older individuals with displaced femoral neck fractures. The choice between the two approaches should be tailored to individual patient circumstances, rather than determined by the superiority of one method over the other.

DOI: 10.5281/zenodo.

Background: Pulmonary hypertension (PH) during pregnancy is associated with high maternal morbidity and mortality, ranging from 30-56%. In countries like Pakistan and India, inadequate management and lack of local guidelines for anesthetic care pose significant risks. This study evaluates the challenges of managing pregnant women with idiopathic pulmonary arterial hypertension (IPAH) during cesarean deliveries. Aim: To assess the anesthetic management of pregnant women with pulmonary hypertension during cesarean sections and explore maternal and fetal outcomes in rural India. Methodology: A prospective study conducted over one year at Anugrah Narayan Magadh Medical College, Bihar, India, involving 80 patients with pulmonary hypertension who underwent obstetric surgery. Demographic and clinical data, including echocardiography and right heart catheterization findings, were collected. A tailored anesthetic approach, combining spinal-epidural techniques, central and arterial monitoring, and inotropic support, was employed. Post-operative monitoring included intensive care unit (ICU) care and echocardiography. Results: The study found that most patients, aged 21-31, presented with dyspnea or fatigue and had elevated right ventricular pressures. Anesthetic techniques, including combined spinal-epidural anesthesia and the use of inotropes like noradrenaline, proved effective. No maternal deaths were recorded, though some fetal outcomes required neonatal intensive care. Hospital stays ranged from 10 to 40 days, with varied fetal outcomes, including birth weights between 2.2-3.0 kg. Conclusion: This study demonstrates the effectiveness of careful preoperative planning and multidisciplinary management in improving maternal outcomes for pregnant women with PH. However, fetal outcomes were underlining the need for robust perinatal monitoring. Further research is required to develop localized guidelines for managing high-risk pregnancies in resource-limited settings.

DOI: 10.5281/zenodo.

Background: Patient safety is a critical concern in neurosurgery, given the complexity and high-risk nature of the procedures. Neurosurgery-specific checklists have been introduced to standardize practices, reduce errors, and improve outcomes. Evaluating the impact of such checklists on patient safety is essential to understand their effectiveness in clinical settings. Aim: This study aims to assess the impact of applying and adhering to a neurosurgery-specific checklist on patient safety outcomes, including error reduction and postoperative complications. Methods: A prospective observational study was conducted over 12 months in the neurosurgery and Department of Anesthesia, Adesh medical College and Hospital, Mohri, Shahbad, Haryana, India. Data from 150 neurosurgical procedures were analyzed. The checklist included preoperative, intraoperative, and postoperative items covering patient identification, surgical site verification, equipment checks, and postoperative care planning. Adherence to the checklist was evaluated, and its association with patient safety outcomes was statistically analyzed. Results: Adherence to the checklist was observed in 85% of cases. A significant reduction in errors was noted in high-adherence cases compared to low-adherence cases (10% vs. 25%, p < 0.05). Postoperative complications, including infections and neurological deficits, were significantly lower in the high-adherence group (15%) compared to the low-adherence group (30%). Enhanced communication among surgical teams and improved documentation were also observed in high-adherence cases. Conclusion: The application and adherence to a neurosurgery-specific checklist significantly improved patient safety by reducing errors and postoperative complications. These findings support the integration of customized checklists into routine neurosurgical practice to standardize procedures and optimize outcomes.

DOI: 10.5281/zenodo.

Background: Postoperative pain is a critical concern impacting recovery, involving sensory and emotional dimensions. Effective management is essential to enhance recovery and prevent complications. Patient-Controlled Analgesia (PCA) is a widely used approach offering tailored pain relief, with opioids like butorphanol and fentanyl being common choices. However, a comparative analysis of their efficacy and safety remains underexplored. Aim: To compare the efficacy and safety of butorphanol and fentanyl delivered via PCA for postoperative pain relief in patients undergoing total abdominal hysterectomy. Method : A double-blind, randomized study was conducted with 62 patients at Department of Anesthesiology and Critical care, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India for one year  to compare the efficacy of butorphanol and fentanyl administered via patient-controlled analgesia (PCA). Participants were divided into two groups: Group A received butorphanol, while Group B received fentanyl. Haemodynamic parameters, including pulse rate and blood pressure, postoperative recovery, and adverse effects, were monitored during critical perioperative phases such as induction, intubation, and extubation to assess safety and effectiveness. Results: No significant differences were observed in intraoperative pulse rates between the groups. However, Group B (fentanyl) showed higher pulse rates and systolic blood pressure during induction and intubation compared to Group A (butorphanol). Butorphanol demonstrated greater haemodynamic stability during critical phases, indicating better safety and efficacy. Conclusion: Butorphanol offers effective postoperative pain management with improved haemodynamic stability compared to fentanyl in PCA regimens. These findings highlight butorphanol as a safer alternative, warranting further validation in varied surgical scenarios.

DOI: 10.5281/zenodo.

Background: Distinguishing between pyogenic and non-pyogenic meningitis is critical for guiding appropriate treatment. Conventional diagnostic methods may have limitations in terms of accuracy and turnaround time. Cerebrospinal fluid (CSF) lactate levels have emerged as a potential biomarker for differentiating pyogenic meningitis, characterized by bacterial infection, from non-pyogenic causes, including viral and tubercular etiologies. Aim: To evaluate the diagnostic utility of CSF lactate levels in differentiating pyogenic meningitis from non-pyogenic meningitis and establish its sensitivity and specificity. Methods: A prospective observational study was conducted on 80 patients clinically diagnosed with meningitis. CSF samples were analyzed for lactate levels, protein, glucose, and cell counts. Patients were categorized into pyogenic and non-pyogenic meningitis based on microbiological and clinical criteria. The diagnostic performance of CSF lactate was assessed using receiver operating characteristic (ROC) curves. Results: CSF lactate levels were significantly higher in the pyogenic group (mean 6.8 ± 1.2 mmol/L) compared to the non-pyogenic group (mean 2.4 ± 0.8 mmol/L, p < 0.001). A cut-off value of 4 mmol/L provided a sensitivity of 92% and specificity of 88% for diagnosing pyogenic meningitis. CSF glucose levels were significantly lower in the pyogenic group (mean 30 ± 8 mg/dL) compared to the non-pyogenic group (mean 58 ± 12 mg/dL, p < 0.05). Conclusion: CSF lactate is a reliable diagnostic marker for differentiating pyogenic from non-pyogenic meningitis, with high sensitivity and specificity. Its inclusion in routine diagnostic protocols could improve the accuracy and timeliness of meningitis diagnosis.

DOI: 10.5281/zenodo.

Background: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition characterized by airflow limitation and systemic inflammation. Acute exacerbations of COPD (AECOPD) significantly contribute to morbidity, mortality, and healthcare burden. Serum bilirubin, a by-product of heme metabolism with known antioxidant properties, has been implicated as a potential biomarker for oxidative stress and inflammation during exacerbations. Aim: To evaluate the association between serum bilirubin levels and clinical outcomes in patients with COPD during acute exacerbations. Methods: A retrospective  study included 100 COPD patients presenting with acute exacerbations to a Department of General Medicine , Nalanda Medical College and Hospital, Patna, Bihar, India for one year. Serum bilirubin levels, including total, direct, and indirect bilirubin, were measured upon admission. Clinical parameters, including arterial blood gases (ABG), pulmonary function tests (PFT), and severity scores (Modified Medical Research Council [mMRC] dyspnea scale), were recorded. Patients were stratified based on serum bilirubin levels, and their association with clinical outcomes was analyzed. Results: Patients with elevated serum bilirubin levels demonstrated significantly higher mMRC dyspnea scores and prolonged hospital stays (p < 0.05). Indirect bilirubin showed a strong positive correlation with markers of systemic inflammation, such as C-reactive protein (CRP). In contrast, patients with normal bilirubin levels had better oxygenation (PaO2: 78.6 ± 10.4 mmHg) and quicker recovery times. Conclusion: Elevated serum bilirubin levels in COPD patients during acute exacerbations are associated with greater disease severity and worse clinical outcomes. These findings suggest that serum bilirubin could serve as a biomarker for risk stratification and prognosis in AECOPD.

DOI: 10.5281/zenodo.

Background: Fixed dosage combinations come with a variety of focus points and disadvantages. Fixed dosage combination increase the effectiveness of individual medications, reduce the likelihood of medication resistance, boost patient adherence, and relieve patients’ pill burden. Aim: The aim of this study to examine and evaluate the pattern of fixed-dose combinations in a medical outpatient clinic. Methods: Prescriptions from many Outdoor Patient Departments during the study period were used for the research. The pharmaceuticals were categorized based on the Anatomical Therapeutic Chemical categorization system. Results: The largest proportion of FDCs was seen in the alimentary tract at 22%, followed by anti-infectives at 18%.  The predominant category of alimentary medications was antacid combinations, followed by combinations of proton pump inhibitors and prokinetic agents.  The anti-infective category mostly included amoxiclav, norfloxacin-tinidazole, and ofloxacin-ornidazole. Conclusion: A considerable quantity of medications is being given as fixed-dose combos, which also include certain nonsensical pairings.

DOI: 10.5281/zenodo.

Background: Glaucoma, a major cause of irreversible blindness, includes Normal-Tension Glaucoma (NTG) and Primary Open-Angle Glaucoma (POAG). NTG occurs normal intraocular pressure (IOP), while POAG is associated with elevated IOP. Both exhibit optic nerve damage and visual field loss but differ in pathophysiology and progression. Aim: To compare the structural and functional differences between NTG and POAG, focusing on demographic, clinical, and diagnostic parameters. Method: This prospective observational study at Department of ophthalmology, Mahatma Gandhi memorial medical college and hospital, Jamshedpur, Jharkhand, India for one year  included 80 patients (40 NTG, 40 POAG). Comprehensive ophthalmic examinations were performed, including visual acuity, IOP measurement, optic nerve head evaluation, and retinal nerve fiber layer (RNFL) thickness assessment using optical coherence tomography. Statistical analyses compared findings between groups. Results: NTG was more prevalent among older females, while POAG affected younger males. NTG eyes had thinner RNFL and lower IOP, whereas POAG showed higher cup-to-disc ratios and elevated IOP. Structural damage correlated with functional deficits, with POAG exhibiting faster progression. NTG was associated with systemic vascular risk factors, while POAG had distinct ocular parameters. Conclusion: NTG and POAG show significant differences in demographic, structural, and functional parameters. NTG is linked to systemic vascular factors, while POAG involves elevated IOP and faster optic nerve damage. Understanding these distinctions is crucial for personalized diagnosis and treatment.

DOI: 10.5281/zenodo.

Background: The common cold is one of the most frequent illnesses affecting school-aged children, leading to significant absenteeism and reduced quality of life. Zinc supplementation has been proposed as an effective strategy for reducing the severity and duration of symptoms. However, evidence supporting its efficacy remains varied and region-specific. Aim: This study aims to evaluate the role of zinc supplementation in managing the severity and duration of common cold symptoms in school-aged children. Methods: A randomized controlled trial was conducted involving 100 school-aged children diagnosed with the common cold. Participants were divided into two groups: the zinc supplementation group and the control group receiving standard symptomatic treatment. Data on symptom severity, duration, and recovery rates were collected over a two-week period. Statistical analysis was performed to determine the impact of zinc supplementation. Results: Children in the zinc supplementation group exhibited a 25% reduction in symptom severity and a 30% shorter duration of illness compared to the control group (p < 0.05). Recovery rates were significantly higher in the zinc group (80%) than in the control group (60%). No adverse effects of zinc supplementation were reported. Conclusion: Zinc supplementation is a safe and effective adjunctive therapy for managing common cold symptoms in school-aged children. These findings support the incorporation of zinc into paediatric nutritional guidelines for reducing the burden of upper respiratory infections.

DOI: 10.5281/zenodo.

Background: Iron deficiency anemia (IDA) is one of the most common nutritional disorders affecting children, particularly those aged 6 months to 2 years. Maternal nutritional awareness plays a pivotal role in preventing IDA by promoting healthy dietary practices and timely interventions. Understanding the relationship between maternal knowledge and childhood anemia is essential for developing effective strategies to combat this public health challenge. Aim: This study aims to evaluate the level of maternal nutritional awareness and its association with the prevalence of iron deficiency anemia in children aged 6 months to 2 years. Methods: A retrospective study was conducted among 100 mother-child pairs attending the paediatric outpatient department of Government Medical College & Hospital, Bettiah, W. Champaran, Bihar,India . Data were collected using a structured questionnaire assessing maternal knowledge of nutrition, feeding practices, and anemia prevention. Hemoglobin levels of children were measured, and iron deficiency anemia was diagnosed based on WHO criteria. Statistical analysis was performed to explore the relationship between maternal awareness and anemia prevalence. Results: The prevalence of iron deficiency anemia among children was 45%. Mothers with higher nutritional awareness demonstrated significantly lower rates of IDA in their children (30%) compared to those with low awareness (70%, p < 0.05). Factors such as exclusive breastfeeding, timely introduction of complementary foods, and iron-rich dietary intake were positively correlated with better hemoglobin levels. However, gaps in maternal knowledge regarding iron supplementation and dietary diversity were observed. Conclusion: Maternal nutritional awareness plays a critical role in mitigating iron deficiency anemia in children. Interventions aimed at improving maternal education on nutrition and anemia prevention can significantly reduce the burden of childhood anemia. This study underscores the need for targeted health education programs to empower mothers with the knowledge required for effective dietary practices.

DOI: 10.5281/zenodo.

Background: This study examines the healthcare systems to address hypertension in pregnancy, especially in developing nations such as India, where Pregnancy-Induced Hypertension (PIH) and Intrauterine Growth Restriction (IUGR) are widespread. These disorders pose considerable dangers to maternal and fetal health, resulting in elevated morbidity and death rates. Objective: To investigate the frequency and effects of IUGR in individuals with PIH, employing Doppler ultrasonography to deepen comprehension of their interactions and refine prenatal treatment approaches. Methods: The study involved 60 people divided into low-risk and high-risk groups, utilizing Doppler evaluations to evaluate umbilical and middle cerebral artery blood flow during pregnancy. Results: The findings showed that 60% of individuals had intrauterine growth restriction (IUGR), 40% encountered pregnancy-induced hypertension (PIH), and 20% were afflicted by both disorders. Doppler findings indicated a normal Umbilical Artery Pulsatility Index (PI) average of 1.4; however, the Middle Cerebral Artery PI average was 0.9, suggesting possible fetal distress. Perinatal outcomes comprised 80% live births, a 10% stillbirth rate, and 20% with neonatal problems. Conclusion: The research highlights the necessity of proactive screening and intervention methods, promoting the incorporation of Doppler ultrasonography in clinical practice to enhance outcomes for high-risk pregnancies. Improved prenatal care practices are crucial to reduce risks linked to hypertension diseases during pregnancy.

DOI: 10.5281/zenodo.

Background and Objectives: Cholelithiasis, or gallstone disease, is a common gastrointestinal disorder that has been associated with various risk factors, including obesity and body fat distribution. Body Mass Index (BMI) and Waist-to-Hip Ratio (WHR) are two key indicators of obesity, and their role in the development of cholelithiasis has been widely studied. This study aims to explore the relationship between cholelithiasis, BMI, and WHR in a cohort of patients at a tertiary care hospital. Methods: A cross-sectional study was conducted in Department of General Surgery, Bhagwan Mahavir Institute of Medical Sciences Pawapuri, Nalanda, Bihar, India for six months involving 200 patients diagnosed with cholelithiasis. Data on BMI, WHR, and other demographic and clinical characteristics were collected. Patients were categorized into groups based on their BMI and WHR, and the prevalence of cholelithiasis was analyzed in relation to these variables. Results: The prevalence of cholelithiasis was higher in patients with a BMI ≥ 25 kg/m² (70%) and those with an elevated WHR (≥ 0.85 in females and ≥ 0.90 in males) (65%). A positive correlation was found between BMI and WHR with the incidence of cholelithiasis. Multivariate analysis revealed that both BMI and WHR were significant predictors of cholelithiasis (p < 0.05). Conclusion: This study confirms the association between obesity, as measured by BMI and WHR, and the risk of developing cholelithiasis. These findings underscore the importance of weight management and monitoring of body fat distribution in the prevention of gallstone disease.

DOI: 10.5281/zenodo.

Background: Neonatal seizures are a common neurological emergency in neonatal intensive care units (NICUs), often signifying underlying neurological or metabolic disturbances. Early identification of clinical and biochemical profiles is essential for prompt diagnosis and management to improve outcomes. Aim: To analyze the clinical presentations, biochemical abnormalities, and outcomes of neonates admitted with seizures in the NICU of Upgraded Department of Pediatrics, Patna Medical College and Hospital, Patna, Bihar, India. Methods: This cross-sectional observational study included 100 neonates admitted with seizures over a 12-months period. Data on clinical presentations, etiologies, and biochemical parameters such as glucose, calcium, and electrolyte levels were collected. Outcomes were assessed based on seizure control and neonatal survival. Results: Subtle seizures were the most common type (40%), followed by clonic (35%) and tonic (20%) seizures. Hypoxic-ischemic encephalopathy (HIE) was the leading cause (50%), followed by metabolic disturbances (30%) and infections (15%). Hypocalcemia (25%), hypoglycemia (20%), and hyponatremia (15%) were frequently observed biochemical abnormalities. Mortality was 18%, primarily in neonates with severe HIE or sepsis. Conclusion: Neonatal seizures in the NICU are primarily due to HIE and metabolic disturbances. Routine monitoring of biochemical parameters and early intervention can improve outcomes in affected neonates.

DOI: 10.5281/zenodo.

Background: Ventilator-associated pneumonia (VAP) is a significant cause of morbidity and mortality in critically ill paediatric patients admitted to intensive care units. Characterizing the clinical and microbiological profile of VAP is essential for timely diagnosis, appropriate antibiotic therapy, and improving patient outcomes. Aim: To evaluate the clinical features, microbiological profile, and outcomes of pediatric patients diagnosed with VAP in the Pediatric Intensive Care Unit (PICU) at PMCH, Patna. Methods: A prospective observational study was conducted on 100 children aged 1 month to 14 years, who were mechanically ventilated for more than 48 hours and developed VAP. Clinical, radiological, and microbiological parameters were recorded. The pathogens isolated and their antibiotic resistance patterns were analyzed. Results: The incidence of VAP was 35%. The most common clinical features included fever (90%), increased respiratory secretions (80%), and worsening oxygenation (70%). Gram-negative bacteria were the predominant pathogens, with Klebsiella pneumoniae (40%) and Pseudomonas aeruginosa (35%) being the most frequently isolated. Multidrug-resistant organisms were identified in 60% of cases. Mortality among VAP patients was 25%, significantly associated with multidrug resistance and delayed initiation of appropriate therapy. Conclusion: Ventilator-associated pneumonia in children is associated with high morbidity and mortality, predominantly caused by Gram-negative pathogens with multidrug resistance. Early diagnosis and tailored antimicrobial therapy based on local microbiological profiles are essential to improve outcomes.

DOI: 10.5281/zenodo.

Lymphadenitis is a common clinical condition characterized by the inflammation of lymph nodes due to various infectious, inflammatory, and neoplastic causes. Fine Needle Aspiration Cytology (FNAC) is a minimally invasive diagnostic tool that plays a pivotal role in differentiating between reactive, infectious, and malignant lymphadenopathies. Aim: To evaluate the diagnostic utility of FNAC in lymphadenitis and determine the spectrum of cytological findings across different etiologies. Methods: A cross-sectional study was conducted on 100 patients with lymphadenopathy at Government Medical College and Hospital, Purnea, Bihar, India. FNAC was performed on all cases, and cytological diagnoses were categorized into reactive lymphadenitis, tubercular lymphadenitis, granulomatous lymphadenitis, and malignancy. Results were correlated with clinical and radiological findings, and diagnostic accuracy metrics were assessed. Results: FNAC successfully diagnosed 92% of cases, with tubercular lymphadenitis being the most common (45%), followed by reactive lymphadenitis (30%) and granulomatous lymphadenitis (15%). Malignant lesions accounted for 10%. Sensitivity and specificity for tubercular lymphadenitis were 94% and 96%, respectively. Complications were negligible, making FNAC a safe and effective diagnostic modality. Conclusion: FNAC is a highly effective, cost-efficient, and minimally invasive diagnostic tool for evaluating lymphadenitis. Its high sensitivity and specificity make it invaluable in resource-limited settings, aiding early diagnosis and treatment.

DOI: 10.5281/zenodo.

Lymphadenitis is a common clinical condition characterized by the inflammation of lymph nodes due to various infectious, inflammatory, and neoplastic causes. Fine Needle Aspiration Cytology (FNAC) is a minimally invasive diagnostic tool that plays a pivotal role in differentiating between reactive, infectious, and malignant lymphadenopathies. Aim: To evaluate the diagnostic utility of FNAC in lymphadenitis and determine the spectrum of cytological findings across different etiologies.Methods: A cross-sectional study was conducted on 100 patients with lymphadenopathy at Government Medical College and Hospital, Purnea, Bihar, India. FNAC was performed on all cases, and cytological diagnoses were categorized into reactive lymphadenitis, tubercular lymphadenitis, granulomatous lymphadenitis, and malignancy. Results were correlated with clinical and radiological findings, and diagnostic accuracy metrics were assessed. Results: FNAC successfully diagnosed 92% of cases, with tubercular lymphadenitis being the most common (45%), followed by reactive lymphadenitis (30%) and granulomatous lymphadenitis (15%). Malignant lesions accounted for 10%. Sensitivity and specificity for tubercular lymphadenitis were 94% and 96%, respectively. Complications were negligible, making FNAC a safe and effective diagnostic modality. Conclusion: FNAC is a highly effective, cost-efficient, and minimally invasive diagnostic tool for evaluating lymphadenitis. Its high sensitivity and specificity make it invaluable in resource-limited settings, aiding early diagnosis and treatment.

DOI: 10.5281/zenodo.