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.

Introduction: The significance of frozen section in diagnostic accuracy holds a crucial role not only in the effective management of surgical patients but also serves as a key gauge for intra operative diagnosis within the realm of surgical pathology. This technique aids in evaluating surgical margins, detecting lymph node metastasis, and recognizing unknown pathological processes. Aims and Objectives: The aim of this study is to establish the diagnostic precision of intraoperative frozen sections across a one-and-a-half-year duration at SRMS IMS Bareilly. The objective is specifically designed to evaluate the accuracy, sensitivity, specificity, and predictive values inherent in the analysis of frozen sections. Materials and Methods: This is a cross-sectional study, involving the analysis of 90 frozen section samples conducted at the Department of Pathology, SRMS Institute of Medical Sciences (IMS) in Bareilly, from August 1, 2022, to January 31, 2024. The inclusion criteria encompassed frozen section samples alongside their corresponding permanent tissue specimens, which were subsequently subjected to final histopathological evaluation. Diagnostic accuracy was assessed by sensitivity, specificity and predictive values utilizing the histological diagnosis on permanent section as the benchmark. Results: A total of 90 frozen section specimens from different surgical cases were evaluated. In the diagnoses were deferred. The accuracy of the intraoperative frozen section analysis was remarkably high at 91.07%. The sensitivity attained was 90.91%, and the specificity reached 91.18%. Positive predictive value was 86.96%, and the negative predictive value stood impressively at 93.94%. Conclusion: Intraoperative frozen section analysis remains invaluable for prompt surgical decision-making. This study contributes to advancing the quality of intraoperative pathological assessments and, in turn, enhancing patient care. The utilization of H & E staining as the gold standard test further sets the significance of our findings in enhancing diagnostic precision. This study contributes to advancing the quality of intraoperative pathological assessments.

DOI: 10.5281/zenodo.

Background: Effective postoperative analgesia is crucial for patient recovery following Lower Segment Cesarean Section (LSCS). While bupivacaine is widely used for intrathecal anesthesia, combining it with adjuncts like midazolam may enhance analgesic duration and quality. This study compares the efficacy and safety of intrathecal bupivacaine combined with midazolam versus bupivacaine alone. Methods: A randomized controlled trial was conducted on 100 patients undergoing elective LSCS, divided into two groups. Group A received intrathecal bupivacaine (10 mg) alone, while Group B received bupivacaine (10 mg) combined with midazolam (2 mg). Postoperative pain was assessed using the Visual Analog Scale (VAS) at regular intervals, and the duration of analgesia, side effects, and patient satisfaction were recorded. Results: Group B exhibited a significantly longer duration of postoperative analgesia (mean: 6.8 ± 1.2 hours) compared to Group A (mean: 4.3 ± 1.1 hours; p < 0.001). VAS scores were consistently lower in Group B, indicating superior pain control. Minimal side effects were observed in both groups, with no significant difference in complications. Conclusion: The addition of midazolam to intrathecal bupivacaine significantly enhances postoperative analgesia in LSCS patients without increasing adverse effects. This combination offers a safe and effective option for improving postoperative pain management.

DOI: 10.5281/zenodo.

The tongue, a critical organ for speech, taste, and swallowing, is susceptible to a spectrum of pathologies, including rare and unusual lesions that often challenge clinical diagnosis. This case series describes five uncommon tongue lesions encountered at the Department of Pathology, SRMS IMS, over 1.5 years. The conditions include lingual lipoma, lymphoepithelioma-like carcinoma, cartilaginous choristoma, spindle cell rhabdomyosarcoma, and B-cell non-Hodgkin lymphoma. Each case underwent comprehensive diagnostic evaluation involving clinical examination, imaging, histopathological analysis, and, where necessary, immunohistochemistry.

By detailing these cases, the series contributes to the existing knowledge of rare lingual pathologies and provides insights to aid in similar diagnostic challenges.

DOI: 10.5281/zenodo.

Introduction: Plantar fasciitis is the most common cause of heel pain and can be difficult to treat. Results from platelet-rich plasma (PRP) injections are encouraging. We compared PRP with conventional corticosteroids in the treatment of plantar fasciitis resistant to nonsurgical treatments. The aim of this study was to compare the effectiveness of PRP with steroids at 2 weeks, 6 weeks and 3 months after injection. Methods: Sixty heels with plantar fasciitis were randomly allocated into two groups of 30 each. Group A patients were given local PRP injections, and Group B patients were given local corticosteroid injections. Both groups were evaluated for pain via the visual analog scale (VAS) and the Roles–Maudsley (RM) scale. Data were collected prospectively between groups; before treatment; and 2 weeks, 6 weeks and 3 months after injection, and the results were compared. Results: Before injection, the two groups were well matched, with no statistically significant difference. At two weeks, the steroid group scored better than the PRP group. There was no significant difference between the two groups at week 6, but there was a trend for the PRP scores to be better than the steroid scores. At 3 months, the RM and VAS score of the PRP group (1.56 and 1.96) were better than those of the steroid group (2.03 and 3.13), with P values of 0.019 and 0.022, respectively. Conclusions: PRP is as effective as steroid injection at achieving symptom relief at 6 weeks after injection for the treatment of plantar fasciitis, but unlike steroids, its effect does not weaken over time. At 3 months, PRP is significantly more effective than steroids, making it better and more durable than cortisone injection.

DOI: 10.5281/zenodo.

Background and Aim: Individuals with type 2 diabetes mellitus (T2DM) may face an increased risk of developing non-alcoholic fatty liver disease. This study aimed to investigate the prevalence of non-alcoholic fatty liver disease (NAFLD) among individuals with type 2 diabetes mellitus (T2DM) and to evaluate the associated risk factors contributing to diabetic fatty liver. Material and Methods:  This prospective study involved a cohort of 150 patients diagnosed with Type 2 Diabetes Mellitus (T2DM), aged between 18 and 75 years, who attended a medical outpatient clinic over the course of one year. Patients underwent abdominal ultrasonography to assess for the presence of fatty liver. The participants were categorised into two groups: those with fatty liver and those without. Further evaluations included assessments of body mass index, central obesity, HbA1c levels, and lipid profiles. Results: The findings indicate that 91% of patients with NAFLD are affected by obesity, in contrast to 85.90% of those without NAFLD. In a striking observation, the prevalence of obesity among patients diagnosed with NAFLD stands at 91%, while it is slightly lower at 85.90% for those without the condition. The prevalence of CAD was notably higher in the NAFLD subgroup when compared to those without the condition. The occurrence of metabolic syndrome was notably elevated in individuals with NAFLD when compared to those without the condition (p>0.05). Conclusion: the prevalence of T2DM and NAFLD is escalating at an alarming rate, approaching pandemic proportions in nations such as India. The rise in the prevalence of NAFLD correlates with the various components of metabolic syndrome.

DOI: 10.5281/zenodo.

Background: Preterm labor is a significant cause of neonatal morbidity and mortality. Cervical cerclage and vaginal progesterone are two commonly used interventions aimed at preventing preterm birth in women at risk. This study aims to compare the efficacy of cervical cerclage and vaginal progesterone in preventing preterm labor. Objectives: To evaluate and compare the effectiveness of cervical cerclage and vaginal progesterone in reducing the incidence of preterm labor in high-risk pregnancies. Methods: This comparative observational study was conducted over a period of one year in the department of Obstetrics and Gynaecology at Ruby General Hospital. A total of 100 pregnant women with a history of preterm labor or a short cervix (<25 mm) were enrolled and divided into two groups. Group A (n=50) received cervical cerclage, while Group B (n=50) was treated with vaginal progesterone. Results: We showed that the mean BMI was very similar between the two groups, with the cerclage group having a mean BMI of 25.5 ± 3.22 and the progesterone group having a mean BMI of 25.88 ± 2.26. This small difference was also not statistically significant (P = 0.39, NS)the mean cervical length was slightly shorter in the cerclage group (1.877 ± 0.41 cm) compared to the progesterone group (1.986 ± 0.141 cm). However, this difference was not statistically significant (P = 0.52, NS).A similar percentage of participants in both groups had undergone a previous cerclage, with 27.5% in the cerclage group and 30.4% in the progesterone group. This difference was not statistically significant (P = 0.69, NS). Conclusion: Vaginal progesterone is more effective than cervical cerclage in preventing preterm labor in high-risk pregnancies. This study suggests that vaginal progesterone should be considered as a first-line treatment for women at risk of preterm labor.

DOI: 10.5281/zenodo.

Background: Low birth weight (LBW) is a major public health problem which needs to be addressed. Birth weight is an important determinant of child survival and development. This study was conducted to know the maternal and biosocial factors that influence low birth weight babies. The maternal factors play a major role in the babies birth weight. The resulting neonatal weight of the newborn is considered as a health indicator since the nutritional status of the neonate can have repercussions on the growth and development of the child until adulthood. Aim: To estimate the frequency of low birth weight babies and  maternal variables and disorders affecting them. The main aim of this study was to identify the maternal risk factors influencing the weight of the baby in a tertiary care teaching rural center. Objective: To study the association of maternal variables and maternal disorders with the outcome of birth weight. Study Design: Retrospective study of mothers booked in department of obstetrics & pediatrics at a rural tertiary care teaching hospital, Narayan Medical college and hospital Jamuhar in south west Bihar during the period 01 Jan 2021 to 31 Dec 2023. Mothers and babies details were collected from case sheets. Participants: All the mothers delivered in rural tertiary care teaching hospital, Narayan Medical college and hospital Jamuhar in south west Bihar during the period 01 Jan 2021 to 31 Dec 2023. Results: The prevalence of low birth weight as well as prematurity was very high as quoted from other rural centers.

DOI: 10.5281/zenodo.

Introduction: Angle-closure primary Glaucoma is a visually damaging form of the disease where increase in intraocular pressure and glaucomatous optic neuropathy are caused by the CLOSED anterior chamber angle (ACA) . Gonioscopy, which may be  rapidbut requires contact with the cornea and is frequently regarded as a laborious examination in a busy clinical practice, is currently the reference standard for assessing the ACA configuration. Aims: to evaluate how well anterior segment (AS) optical coherence tomography (OCT) and gonioscopy perform in identifying angle closure in the various quadrants of anterior chamber angle (ACA). Materials & Methods: The study design was Cross-sectional observational study. Place of study was DMCH OPD, Darbhanga. Period of study from June 2019 to November 2021 and total sample size was 100. Result: Twenty (20.0%) patients in our study had 6/24 visual acuity in their left eye, twenty-one (21.0%) had 6/9 visual acuity in their left eye, and fifty-nine (59.0%) had 6/12 visual acuity. Z has a value of 5.4848. P has a value of less than.00001. At p <.05., the outcome is significant. Conclusion: We concluded thatin various quadrant of anterior chamber angle, gonioscopy and AS-OCT both are useful methods for identifying angle closure. Because AS-OCT is objective and non-invasive, it can be a helpful supplement to gonioscopy, particularly when there is a suspicion of slight angle closure.

DOI: 10.5281/zenodo.

Background: imbalances in the optimum levels of trace elements adversely affect biological processes in lung tissue and may play a role in the pathogenesis of lung cancer. Objective: To evaluate the correlation of serum trace elements status (copper, iron, magnesium, zinc) in patients with lung carcinoma. Materials & Methods: Present study was carried out at institute of respiratory diseases (IRD), SMS Medical College Jaipur, Rajasthan. Patients attending IRD- OPD and IPD were enrolled in this study. Based on the inclusion and exclusion criteria 40 cases and 40 controls of age and sex-matched individuals were included in this study after obtaining informed consent. Serum zinc & copper levels were estimated using colorimetric method on Erba semi auto analyzer and serum Iron and Magnesium were measured using Beckman Coulter AU 680 fully auto analyzer. Results: A significant association (p-value <0.05) of Copper, Zinc and Magnesium with metabolic syndrome was observed. We have found increased level of Serum Copper and decreased level of serum Iron, Zinc and magnesium in patients with Lung Cancer. Conclusion: Serum levels of Iron, Zinc and Magnesium were significantly lower while level of serum Copper was significantly higher in patients with Lung Cancer. We have also found Anaemia in these patients as haemoglobin level was also lower than that of controls. Imbalance of trace elements causes oxidative stress and may contribute in occurrence of lung cancer.

DOI: 10.5281/zenodo.

Benign breast diseases have varied presentation in various age groups. We carried out retrospective study in 80 patients who attended and were treated in surgery departments. We studied the incidence of BBDs, their relative frequency, clinical features in different age group and correlated the findings with that of USG, FNAC and Histopathology.

DOI: 10.5281/zenodo.

Introduction: Hearing loss is a significant global health concern and the third largest contributor to disability. High-risk newborns are particularly vulnerable due to prenatal and perinatal complications. Early detection and intervention are critical to mitigate adverse developmental outcomes. Objectives: This study aimed to assess the prevalence of hearing impairment among high-risk newborns and evaluate the efficacy of Otoacoustic Emissions (OAE) and Brainstem Evoked Response Audiometry (BERA) in detecting hearing loss. Methodology: An observational analytical study was conducted over 18 months at a tertiary care hospital. A total of 306 newborns aged 1 to 7 days were screened using OAE, followed by confirmatory BERA testing for those referred. Sociodemographic data and high-risk factors were analyzed. Results: Of the 306 newborns, 14 (4.6%) were identified with hearing impairment. Preterm birth (57.1%) and neonatal hyperbilirubinemia (35.7%) were the most significant predictors of hearing loss (p<0.05). OAE exhibited a referral rate of 4.6%, and BERA confirmed all cases of hearing impairment, underscoring its superior diagnostic accuracy. Conclusion: The combined use of OAE and BERA ensures reliable detection of hearing impairment in high-risk newborns. Integrating these protocols into neonatal care can improve early diagnosis and intervention, reducing the long-term burden of hearing loss.

DOI: 10.5281/zenodo.

Introduction: In this study, we studied histopathology of biopsy sent from ENT department and classify that lesions according to site and their nature either neoplastic or non-neoplastic lesion. Aim: To describe histopathological findings of biopsies received from ENT department. Material and Method: A study was done from January, 2022 to April 2023 on histopathological findings of biopsies sent from department of ENT and head & neck region. In our study total 170 cases are studied. Biopsy sent for histopathological examination is undergoing for tissue fixation and processing and then stain with haematoxylin and eosin. Result: In our study, we studied 170 cases during January-2022 to April-2023. In our study lesions are most common in age group of 31-40 year with male to female ratio is 1.5:1 is found. According to site of lesions mostly from buccal mucosa followed by ear, tongue, nose, lip, lymph node and thyroid. Most of cases are non-neoplastic in which chronic inflammatory lesions are most common. In neoplastic lesions malignancy is more common than benign condition. In malignant lesions squamous cell carcinoma are most common. Malignant lesions are more common in male. Two cases of lymphoma are also studied. Lesions of thyroid are more common in female and goitre is more common than benign follicular lesion. Conclusion: In our study of 170 cases non-neoplastic and benign neoplastic combined are more common than malignant lesion. Chronic inflammatory lesions are more common finding in non-neoplastic lesions whereas squamous cell carcinoma is most common malignant lesion in our study. 3^rd – 5^th decade of male are more common patients in ENT department.

DOI: 10.5281/zenodo.

Background and Aim: Neonatal Respiratory Distress (NRD) stands as the leading cause for hospital admissions to Neonatal Intensive Care Units (NICUs). This study sought to identify the risk factors, causes, and hospital outcomes associated with respiratory distress among neonates admitted to the NICU of a tertiary hospital. Material and Methods: This cross-sectional study took place over the course of one year at the Neonatal Intensive Care Unit within the Department of Paediatrics at Nootan general hospital Visnagar, Gujarat from April 2024 to September 2024.  A total of 120 newborns, all under 28 days of age, were admitted due to respiratory distress and subsequently enrolled in the study. Respiratory distress was classified into three categories: mild, moderate, and severe, based on Downe’s scoring system. Findings indicate that a notable proportion of infants experienced a delay in their crying response. In our study, the predominant cause of respiratory distress (RD) was pneumonia (PNA), accounting for 68 cases. This was followed by 31 instances of respiratory distress syndrome (RDS), 30 cases of pneumonia, 24 cases of transient tachypnea of the newborn (TTN), 20 cases of sepsis, 10 cases of congenital heart disease (CHD), 9 cases of meconium aspiration syndrome (MAS), and 2 cases of congenital diaphragmatic hernia (CDH). Results: The analysis revealed no notable difference in the mode of oxygen support for respiratory distress and the resulting outcomes (p>0.05). No significant association was observed between the causes of RD and the outcome (p>0.05). The analysis revealed a statistically significant difference (p≤0.05) in patient outcomes associated with irregular antenatal visits, delayed crying, the need for resuscitation, and the onset of respiratory distress. Conclusion: The incidence of PNA and transient tachypnoea in neonates was notably elevated among those with term gestational age, while RDS was significantly more prevalent in preterm infants and those with low birth weight. The severity of retinal detachment was notably linked to unfavourable outcomes.

DOI: 10.5281/zenodo.

Introduction: The most prevalent endocrine condition affecting women of reproductive age and the leading cause of anovulatory infertility is polycystic ovarian syndrome, or PCOS. 5–10% of women in the reproductive age range have polycystic ovarian syndrome, with a frequency of 11-26% even among teenagers. Aims: To ascertain the relationship between PCOS and serum anti-Mullerian hormone levels in females aged 15–44. Materials & Methods: The present study was A Prospective, observational, Clinical study. This Study was conducted from 18 months after getting approval from institutional ethics committee from (March 2021 to August 2022) at Out-patient department and emergency of Obstetrics and Gynaecology department in Burdwan Medical College and Hospital. Total 100 patients were included in this study. Result: Oligo- or anovulation (OA) which is a necessary condition for diagnosis was observed in all cases along with clinical or biochemical hyperandrogenemia in 80% and Polycystic ovary morphology (PCOM) under ultrasound in 43% cases. All 3 criteria were fulfilled in 23% cases. On assessing the correlation between AMH and various study parameters, we observed that only age is inversely proportional with AMH levels. No significant correlation was observed with any other parameter (p>0.05). Conclusion: According to the study’s findings, AMH is a reliable indicator of PCOS. AMH levels were higher in women with more PCOS traits than in those with less, indicating that AMH may be a measure of diagnostic certainty.

DOI: 10.5281/zenodo.

Introduction: Non-alcoholic fatty liver disease (NAFLD) is a distinct hepatic condition characterized by abnormal fat accumulation in liver cells, mostly in the form of triglycerides, which exceed 5% of liver weight, histologically resembling alcohol induced liver damage. Nonalcoholic fatty liver disease (NAFLD) appears to be the hepatic manifestation of metabolic syndrome, and is increasingly recognized as a major contributor to the burden of chronic liver disease world-wide. Aims: To provide a well —powered prospective validation of a relationship between Non-Alcoholic Fatty Liver Disease in Type-2 Diabetes Mellitus Patients with risk factors like increased BMI and abnormal lipid profile for diagnosis, prognosis, tailoring and management of Non Alcoholic Fatty Liver Disease. Materials and Methods: It was a Cross Sectional Observational Study this study was conducted from 18 months from April 2020 to October 2021 at IPGME&R and SSKM Hospital, Kolkata-20. 100 patients were studied. Result: We examined that, in NAFLD Group, the mean ALT of patients was 54.5833± 7.7750 and in without NAFLD Group, the mean ALT of patients was 50.9500± 4.8461 which was statistically significant (p=0.0099) and in NAFLD Group, the mean HDL of patients was 51.7333± 4.1817 and in without NAFLD Group, the mean HDL of patients was 51.4750± 4.4375 which was not statistically significant (p=0.7684). Conclusion: The study found a strong positive correlation between Type-2 Diabetes Mellitus severity and NAFLD severity, suggesting older age, high BMI, elevated lipid profile, and TSH level as predictors for NAFLD severity, necessitating early diagnosis and timely management.

DOI: 10.5281/zenodo.

Background: Meniscal injuries are among the most common orthopedic problems, and repairing the meniscus is crucial for preserving knee joint function and preventing osteoarthritis. Various repair techniques, including inside-out, outside-in, and all-inside methods, have been developed, but their clinical and functional outcomes vary based on the injury and patient factors. Aim: To evaluate and compare the clinical and functional outcomes of different meniscus repair techniques in patients with meniscal injuries. Methods: This prospective observational study included 100 patients with meniscal tears treated using either inside-out, outside-in, or all-inside repair techniques. Clinical outcomes were assessed using the Visual Analog Scale (VAS) for pain, and functional outcomes were measured using the Lysholm Knee Score (LKS) and Tegner Activity Level Scale over a 12-month follow-up period. Results: The all-inside repair technique demonstrated superior outcomes in terms of reduced pain (mean VAS: 1.5 ± 0.5) and improved knee function (mean LKS: 92 ± 6). The inside-out and outside-in techniques showed comparable results but were associated with higher complication rates, such as nerve irritation (inside-out: 8%) and suture site discomfort (outside-in: 5%). Overall, 85% of patients returned to their pre-injury activity levels within one year. Conclusion: All-inside meniscus repair offers better clinical and functional outcomes compared to inside-out and outside-in techniques. However, technique selection should consider tear characteristics, patient activity level, and surgeon expertise.

DOI: 10.5281/zenodo.

Background: Chronic ectopic pregnancy (CEP) is characterized by low blood HCG levels. CEP histologically exhibits a dense adnexal mass characterized by compromised chorionic villi, necrosis, and an abundance of blood clots resulting from recurrent minor ruptures of the fallopian tube wall. Asymptomatic pelvic mass and low serum HCG concentration. Aim: The objective of this research was to evaluate the clinical characteristics and outcomes of chronic ectopic pregnancy at a tertiary care hospital. Methods: A total of 84 cases of chronic ectopic pregnancy out of 9,940 deliveries. Comprehensive clinical examinations and investigations were performed, culminating in surgical intervention, often unilateral salpingectomy, for hemodynamically unstable patients with ruptured ectopic pregnancies. Results: The overall incidence of ectopic pregnancy was 84 in this study. The baseline characteristics of 84 married patients indicated that 47.62% were aged 21-30 years and 52.38% were aged 31-40 years. Common symptoms included abdominal pain and fainting attacks, each reported by 29.76% of the patients. A significant majority (66.67%) tested positive on the urine pregnancy test, while 52.38% had Beta-HCG levels below 1500 m IU/ml. Most ectopic pregnancies were found in the ampulla (76.19%). Treatment approaches varied, with laparotomy being the most common intervention at 47.62%, followed by laparoscopy and medical management. Overall, the data provide insight into the clinical profile and management strategies for this patient cohort. Conclusion: Ectopic pregnancy remains a significant problem in obstetrical practice due to its unusual clinical presentation. The maternal outcome hinges on quick diagnosis and rapid therapy of these individuals.

DOI: 10.5281/zenodo.

Introduction: Oral cancers are among the leading neoplasm in developing countries with rising trends in the incidence. Majority of patients have advanced cancer at the time of presentation and are not amenable for surgery upfront. We therefore evaluated the feasibility of achieving operability by giving neoadjuvant taxane based chemotherapy. Materials & Methods: We conducted a hospital based prospective study. All locally advanced cases of oral cavity cancer received taxane based NACT followed by response evaluation and definitive surgery or radiation. Comprehensive clinic epidemiological data was recorded. Results: A total of 90 symptomatic patients of OSCC were recruited. Oral cancers affect considerable number of young adults. )ie Smokeless tobacco is the commonest etiological factor. More than 70% patients responded to three drug chemotherapy regimen. Younger patients experienced more disease progression and less response. Response was more in borderline operable patients than inoperable cases. Among responders, more tumor reduction was achieved in patients with smaller T and N stage. Responders enjoyed significant survival advantage. Conclusion: NACT can be an effective treatment modality in carefully selected and highly motivated locally advanced oral cancer patients. Larger prospective randomized trials are needed to find out clinical, pathological and molecular predictors of response to help us in better patient selection and hence better outcomes.

DOI: 10.5281/zenodo.

Background: Distal radius fractures are common upper extreme injuries, often impacting wrist function and quality of life. The introduction of locking compression plates (LCP) has improved fracture fixation, but the effectiveness of early mobilization in enhancing outcomes requires further evaluation. Aim: To assess the functional outcomes of distal radius fractures treated with LCP and the role of early wrist mobilization in recovery. Method: This prospective study was conducted at Department of Orthopaedic, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India for two years  Forty patients aged 18–70 years with AO Muller type 23 A1–C3 fractures underwent surgical fixation using LCP. Exclusion criteria included pathological fractures, polytrauma, and delayed presentations. Clinical and radiological evaluations were conducted preoperatively and during follow-ups at six weeks, three months, and six months. Outcomes were assessed using the Gartland and Werley scoring system. Results: The study included 30 patients (mean age 43 years, 65% male). Type C2 fractures were the most common. Early mobilization significantly improved wrist range of motion and functional outcomes. By three months, most fractures achieved union, with 85% of patients reporting excellent or good outcomes. Minimal complications were observed, with extensor pollicis longus irritation being the most frequent. Conclusion: Surgical fixation with LCP combined with early mobilization provides effective restoration of wrist function and satisfactory outcomes in distal radius fractures. Proper postoperative care is essential to minimize complications.

DOI: 10.5281/zenodo.

Background: The knee is a weight-bearing and highly mobile joint, and thus most susceptible to meniscal injuries. Left untreated, meniscal tears lead to long-term degeneration of the joint, especially osteoarthritis. Previous practices involved meniscectomy as the primary treatment, although now, there is an increasing trend toward meniscal repair to preserve knee functionality. Aim: This study aims to assess the clinical and functional outcome of different surgical techniques for meniscal repair, particularly the effectiveness of arthroscopic suturing techniques. Methodology: This is a prospective observational study carried out at Department of Orthopaedic, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India, on 30 patients aged between 16 to 60 years with peripheral meniscal tears diagnosed by MRI. Functional outcome at 6 weeks, 9 weeks, 12 weeks, and 12 months after surgery is evaluated using Lysholm Knee Scoring Scale. Statistical analysis was done with IBM SPSS software. Results: Road traffic accidents had been the most common etiology of meniscal injuries, being 50%. At 6 weeks, 66.7% of the patients have a fair outcome which goes up to 43.3% excellent outcomes at 12 months. The increase in functional scores was 72.17 ± 6.83 at 6 weeks and reached 91.26 ± 2.16 at 12 months with p < 0.001. Conclusion: This study demonstrated that arthroscopic meniscal repair improves significantly knee function at final follow-up from most patients at a good to excellent outcome by 12 months. Therefore, it supported the efficacy of modern surgical methods for restoring normal knee function with subsequent prevention of long-term degenerative changes of the joint.

DOI: 10.5281/zenodo.

Aim: This study aimed to assess the effectiveness of the trigger tool technique in identifying adverse drug reactions in hospitalized patients and to juxtapose it with traditional spontaneous reporting. Methods: An observational research was undertaken at the Department of Pharmacology at Anugrah Narayan Magadh Medical College, Bihar, India. A total of 84 patients aged 18 years and older who given informed permission were included. Data on ADRs were obtained from patient case sheets and laboratory data, with certain triggers recognized for additional examination. The severity of adverse drug reactions was classified according to the National Coordinating Council for Medication Error Reporting and Prevention  damage categories, and causation was evaluated using the Naranjo Scale. Results: Among the 84 patients, 40 adverse drug reactions (ADRs) were found, with 75% categorized as provoked. The severity evaluation indicated that 50% of adverse drug reactions (ADRs) caused little harm, while others resulted in lifelong injury and mortality. The total positive predictive value (PPV) of drug triggers was 50 percent. Conclusions: The study showed the efficacy of TTM in detecting ADRs, underscoring the need for thorough monitoring measures in clinical practice. The results underscore the necessity of proactive strategies to enhance patient safety and diminish the prevalence of adverse drug reactions in hospitalized individuals. Ongoing attention and investigation in this domain are crucial for improving treatment results.

DOI: 10.5281/zenodo.

Background and Objectives: Breast abscesses are a common complication of mastitis, particularly in lactating women. Traditionally, incision and drainage (I&D) have been the standard treatment; however, ultrasound-guided aspiration (UGA) has emerged as a less invasive alternative. This study aims to compare the effectiveness, recurrence rates, and patient outcomes of ultrasound-guided aspiration versus incision and drainage in the management of breast abscesses. Methods: A prospective study was conducted in  Department of General Surgery, Bhagwan Mahavir Institute of Medical Sciences Pawapuri, Nalanda, Bihar, India for nine months involving 100 patients with breast abscesses. Patients were randomized into two groups: 50 underwent ultrasound-guided aspiration, and 50 underwent incision and drainage. Data on treatment success, recurrence, duration of symptoms, and patient satisfaction were collected and analyzed. Results: Ultrasound-guided aspiration had a success rate of 88%, with a recurrence rate of 12%. In comparison, incision and drainage had a success rate of 94%, with a recurrence rate of 6%. Patients in the UGA group reported shorter symptom duration and higher satisfaction levels. The mean recovery time was significantly shorter in the UGA group (5.2 ± 1.8 days) compared to the I&D group (8.4 ± 2.3 days). Conclusion: Both ultrasound-guided aspiration and incision and drainage are effective in the management of breast abscesses. While incision and drainage have a slightly higher success rate, ultrasound-guided aspiration offers a less invasive option with quicker recovery and higher patient satisfaction. The choice of treatment should be individualized based on patient preference, abscess characteristics, and resource availability.

DOI: 10.5281/zenodo.