Objective: This prospective study aimed to evaluate the efficacy of percutaneous needle plantar fascia release with corticosteroid injection as an outpatient procedure for chronic plantar fasciitis unresponsive to conservative treatments. Methods: Forty-three patients meeting specific inclusion criteria underwent the percutaneous needle release procedure. Demographic characteristics, Visual Analog Scale (VAS) scores, Foot and Ankle Disability Index (FADI) scores, and fascia thickness measurements were recorded preoperatively and at 1, 3, and 12 months postoperatively. The surgical procedure involved sterile preparation, ankle block anesthesia, precise needle-based release, and corticosteroid injection. Patient assessment included VAS, FADI, and Roles and Maudsley score. Ethical considerations and institutional review board approval were adhered to throughout the study. Results: Over the 12-month study period, a significant reduction in VAS scores (from 7.523 ± 0.817 to 0.944 ± 1.726, p<0.001) indicated pain relief. FADI scores demonstrated substantial improvement (from 36.028 ± 12.786 to 93.297 ± 13.641, p<0.001), reflecting enhanced functionality. Fascia thickness decreased significantly (−0.0214 cm, p<0.001), suggesting structural modifications. Demographic data provided a comprehensive understanding of the study population. Conclusion: Percutaneous needle plantar fascia release with corticosteroid injection emerged as a promising intervention for chronic plantar fasciitis resistant to conventional treatments. Significant improvements in pain, function, and structural changes support its potential as a breakthrough therapy for persistent heel pain. Despite limitations, including a small sample size and absence of a control group, this study contributes valuable insights to the evolving landscape of interventions for resistant plantar fasciitis. Further research with larger, randomized controlled trials is warranted to validate its efficacy and safety.

DOI: 10.5281/zenodo.

Background: Dengue fever  has a changing distribution trend and variable clinical presentation. The global incidence of dengue is rising. So, clinical profile and laboratory parameters should be assessed thoroughly for better outcome. Method: A retrospective type observational study was conducted in navsari civil hospital during June 2022 to October 2023. Total 370 patients were studied fulfilling inclusion and exclusion criteria. Aim: To study epidemiology of dengue fever for better prognosis. Result: In this study dengue infection was common in young adults(56.75%) and male (62.16%). The most common symptoms were  fever (100%), headache (94.59%), myalgia (89.18%). Most common serology finding was NS1 positive (73%). Laboratory findings were leucopenia (61.8%), neutropenia (56.48%), lymphocytosis (61.08%), thrombocytopenia (71.89%), raised alanine aminotransferase (67.56%), raised aspartate aminotransferase (87.5%). Conclusion: Dengue fever has varied clinical presentation and laboratory findings that may affects diagnosis. So, we should  cautiously study clinical presentation and laboratory findings of dengue fever.

DOI: 10.5281/zenodo.

Breast cancer detection has significantly advanced with the integration of digital mammography and Computer-Aided Detection (CAD) systems. This study explores the performance of four deep learning architectures—Efficient Net-B7, DenseNet-201, Mobile NetV3-Large, and ResNet-50—in classifying mammographic images of breast lesions. We used three well-established datasets: CBIS-DDSM, Brest Cancer MNIST, and UCI Mammography, evaluating models based on accuracy, precision, recall, and F1-score. EfficientNet-B7 achieved the highest accuracy of 98.5%, demonstrating superior performance in distinguishing between benign and malignant lesions. DenseNet-201, MobileNetV3-Large, and ResNet-50 also exhibited strong results, with accuracies of 97.8%, 96.9%, and 97.4%, respectively. The study highlights the effectiveness of these architectures in enhancing diagnostic accuracy and providing valuable insights into their application in clinical settings. The results suggest that deep learning models, especially EfficientNet-B7, can significantly improve the reliability and efficiency of breast cancer screening and diagnosis through advanced mammography analysis.

DOI: 10.5281/zenodo.

Pancreatic pseudocysts, usually are the sequel of an acute attack or chronic pancreatitis due to gallstones or chronic alcoholism, besides other less common causes e.g. abdominal trauma, post-ERCP, abdominal surgery, etc. Majority of pseudocysts resolve with conservative management, but in few cases, they fail to regress and add to complications viz. gastric outlet obstruction, abdominal discomfort or pain, infection and other compression effects. We present here, a series of 5 (five) cases of pancreatic pseudocyst managed by image-guided percutaneous (trans-abdominal) drainage at our centre. Material and Methods: We present a retrospective study of 5 cases of pseudocysts managed by image-guided percutaneous (transabdominal) drainage only using a pigtail catheter. The patients were followed up for 1 to 2 months in the Surgery outpatient department with repeat abdominal ultrasound. The catheter was removed once the total output from the drain was less than 15 ml. Results: All the 5 patients (100%) showed remarkable improvement with reduction in the size of the pseudocyst and negligible morbidity, without being subjected to the extensive surgical intervention.

DOI: 10.5281/zenodo.

Background and Aim: Furthermore, there has been a noticeable increase in the occurrence of ileal perforation. This can be attributed to more patients seeking medical attention at the emergency department and better identification and reporting of such cases. This study aimed to identify the clinical characteristics, causes, common types of perforations, presentations, and surgical procedures used on these patients. Material and Methods: A total of 136 patients underwent exploratory laparotomy, specifically for ileal perforation. The clinical instructor was in charge of creating the form used to document the investigations, clinical examinations, and complaints. The patients who took part in the study underwent a thorough history-taking and physical examination. In certain cases, four quadrant abdominal paracentesis was performed. In some cases, ultrasonography and abdominal CECT were conducted if it was considered appropriate. Results: Most of our patients were in their thirties and forties, totalling 85 patients, with an additional 38 patients falling between the ages of 41 and 60. In this study, researchers observed a total of 85 cases of gastroduodenal perforations, followed by 30 cases of appendicular perforations. The most notable symptom of ileal perforation was typhoid fever, and 107 patients had gas under the diaphragm. After receiving preoperative treatment, a laparotomy was performed for each case to identify and treat the primary cause based on the findings. Conclusion: Early diagnosis and treatment of the disease is linked to lower morbidity and mortality rates, as well as a reduced need for extensive procedures. Another significant factor was the presence of inflammation in the terminal ileum. Interestingly, the only time similar findings to those seen in typhoid ulcer were observed was during surgery on the patient. A laparotomy is typically the most common surgical procedure used for peptic perforations.

DOI: 10.5281/zenodo.

Introduction: Human placenta is a transient organ which plays a key role during gestation. It’s also called “diary of gestational life”. As shape of cavity and blood supply varies across different areas of uterus, placental location can be associated with adverse pregnancy and perinatal outcomes. Only a few studies have evaluated these aspects of placental position and possible impact on pregnancy outcomes. Aims and Objectives: 1. To study the impact of relationship between placental location and maternal and neonatal outcomes. 2. To assess the impact of placental location on pregnancy in terms of preterm birth, preeclampsia, gestational diabetes mellitus, mode of delivery, stillbirth, low birth weight, APGAR score, etc. Material and Methods: This retrospective observational study was conducted in the Department of Obstetrics and Gynaecology in a tertiary care hospital in Karwar. Data was retrieved from hospital records for a period of one year. Results: During the study period of 1 year, there were total 1076 deliveries in our hospital. 176 women were excluded from the study as per exclusion criteria. Placental position had significant impact only on pre-term delivery. Any pregnant women with fundal placenta, lateral placenta, posterior placenta had 4.002 times, 6.855 times, 1.989 times more chances of having pre-term delivery respectively as compared to any women with anterior placental presentation. Birth weight, APGAR score at 1min and 5mins are significantly associated with placental position. Conclusion: In summary, lateral placentation is associated with higher risk of PTB compared with central placentation in our study. Additional research is needed to elucidate the effects of lateral placentation on other pregnancy and perinatal outcomes and to determine whether these pregnancies may benefit from increased surveillance.

DOI: 10.5281/zenodo.

Diabetes Mellitus (DM) is a metabolic disease characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of different organs. Diabetic neuropathy is a descriptive term that encompasses a spectrum of clinical and subclinical syndromes with different anatomical distributions, clinical courses, and possibly, different underlying pathogenic mechanisms. Diabetic peripheral neuropathy (DPN) is by far the most common type of diabetic neuropathy. In clinical practice, diabetic peripheral neuropathy is synonymous with diabetic neuropathy. The present study was undertaken with  subjects, both males and females aged between 40-60 years. The study group consisted of 30 diabetic patients, with history of diabetes for 1-10 years and controls (Non Diabetics) were 30 age and sex matched healthy individuals. Comparison of sensory nerve parameters in Control Group (non-diabetics) and diabetics there is highly significant slowing of sensory nerves median & ulnar and decrease in amplitude of Median nerve and ulnar nerve in diabetics compared to controls. There is a progressive neuronal involvement in the diabetic process which is accelerated by poor glycaemic control. Therefore, nerve conduction studies can be employed for testing and for the early indication of neuropathy in diabetic patients.

DOI: 10.5281/zenodo.

Background: Alvarado and Modified Alvarado scores (MASS) are the commonly used scoring systems for diagnosis of appendicitis, but its performance has been found to be poor in certain populations. This study compared the efficacy of RIPASA score with MASS in diagnosing acute appendicitis in Indian population. Materials and Methods: This prospective study included 50 patients who presented with right iliac fossa (RIF) pain. Patients were evaluated by both RIPASA and MASS scoring systems. The final diagnosis was confirmed through ultrasonography (USG), a computed tomography (CT) scan if the USG results were inconclusive, intra-operative findings, or post-operative histopathological examination (HPE), which were then compared with both the RIPASA and MASS scores. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were calculated for both the scoring system. Results: It was found that RIPASA was better than MASS in terms of Specificity (96.3% v/s 89.28%) and Positive Predictive Value (91.67% v/s 78.57%), and also to some extent in terms of Diagnostic Accuracy (74% v/s 72%). Conclusion: RIPASA is a more specific and accurate scoring system in our local population, when compared to MASS. It reduces the number of missed appendicitis cases and also convincingly filters out the group of patients that would need a CT scan for diagnosis.

DOI: 10.5281/zenodo.

Aim: To assess the functional and clinical outcome of fragment-specific plating for distal radius multi-columnar fractures. Methods and Methodology: This is a prospective study. Patient admitted to SRM Medical College Hospital & Research Centre from December 2022 to December 2023 Pre-op radiological assessment using X-ray Radiograph and post operative functional and radiological outcome has been assessed .Fifteen patients have been included in this study. Results: The results were found to be age in bimodal distribution between 20 years to 54 years and more prevalent among the males than females and the most common mode of injury was found to be road traffic accidents than fall from height, most the cases were presented within 1 day, Intra articular fractures with fragment specific fractures are difficult to fix, but fragment specific plates help in good reduction by using low profile plates, intraoperatively thereby minimizing the trauma to soft tissues, and decreasing the surgical time. Radiological outcome is better with FSP, but functional outcome partially depends on rehabilitation given to the patients. Conclusion: In complex fractures, FSP always plays a superior role in the reduction of fragments and reduced intra-op tissue handling. Patients with FSPs are moving to rehabilitation sooner and the recovery period/rate is fast.

DOI: 10.5281/zenodo.

Background and Aim: Chronic lymphocytic thyroiditis is a frequently encountered cause of acquired hypothyroidism. The clinical management of thyroid nodules, whether or not accompanied by chronic lymphocytic thyroiditis, primarily relies on clinical data, ultrasonography, and fine-needle aspiration cytology (FNAC). FNAC is considered the most reliable method for diagnosing thyroid nodules prior to surgery. Our study sought to assess the range of cytomorphological features observed in lymphocytic thyroiditis and examine its correlation with clinical factors, thyroid hormone levels, and ultrasound results. Material and Methods: The study was conducted in two stages. All patients with goitre who presented to the department of pathology and underwent FNA cytology were included in Step 1 of the study. This served as the sampling frame for identifying study participants for this study. In the next phase of the study, all patients who were diagnosed with lymphocytic thyroiditis on cytology were included for further evaluation. An analysis was conducted on the demographic characteristics, clinical features, biochemical, and radiology findings of the patients. Results: During the study period, 200 individuals were referred for fine-needle aspiration (FNA) of the thyroid gland. Lymphocytic thyroiditis was diagnosed in 50 patients based on cytological findings. In 4 (8%) cases, there were associated features of pain in the neck. Out of the patients experiencing pain, there were two individuals with hypothyroidism, one with euthyroidism, and one with hyperthyroidism. Two patients were found to have cervical lymphadenopathy. Reactive hyperplasia was observed in the cytology of these. The most common cytomorphological finding was Grade II thyroiditis, which was observed in 40 (80%) of cases. Grade I was found in 8 (16%) cases, while Grade III was seen in 2 (4%) cases. Conclusion: The correlation between cytological grading of thyroiditis and clinical, biochemical, and ultrasonographic findings is quite poor. Our patients show strong serological evidence of autoimmunity through the presence of TPO antibody, which also has a strong correlation with cytology.

DOI: 10.5281/zenodo.

Peripheral arterial disease (PAD) is a critical cardiovascular condition characterized by impaired blood flow to the lower extremities, primarily due to atherosclerosis. Early and accurate diagnosis of PAD is essential to prevent complications such as limb ischemia and amputation. This study compares Duplex Doppler Ultrasonography (DUS) and Digital Subtraction Angiography (DSA) in diagnosing PAD, evaluating their effectiveness in determining the presence, location, and severity of stenosis. Additionally, the segmental agreement between these modalities in assessing the arterial tree is analyzed.

DOI: 10.5281/zenodo.

Background:   Potassium (K) is an important electrolyte that has proven essential for normal functioning of the cardiovascular system, skeletal muscle, internal organs, and nervous system. both hypo and hyperkalemia are known to induce potentially lethal arrhythmias and cardiac dysfunction, as well as other complications. Methods: Data Consists of primary data collected from the patients who are admitted in GMERS Valsad Hospital in September 2023 to July 2024 and 100 patients were taken. Outcome: In present study, Severity of hypokalemia is accociated with increased mortality in critically ill patients. Conclusions: Early detection and correction of hypokalemia reduce the overall mortality and improve outcome in critically ill patients.

DOI: 10.5281/zenodo.

Introduction: This review analyzes the possibility of breast ultrasound as a primary screening modality for breast disease, particularly in resource-limited area. It examines 50 patients and underlines ultrasound’s advantages, including radiation-free imaging. Methods: This was hospital based observational study of 50 patients done in the department of radiodiagnosis, bhavsinhji general hospital, Porbandar with use of ultrasound machine (Esaote, MY LAB X8 EXP, 8200657). Results: Breast Disease, affecting both genders, but mostly females, exhibits shifting demographic patterns, with an increasing incidence in younger age groups. Early identification through mammography, clinical examinations, and breast self-exams enhances treatment efficacy, but challenges persist in low- and medium-income area due to limited imaging resources. This review assesses breast ultrasound as the primary breast disease screening method, particularly in resource-constrained regions. Conclusion: Breast ultrasound is a commonly accepted and reliable diagnostic method for women with clinically or radiologically suspicious breast lesions. Breast ultrasound, distinct from mammography, offers advantages like radiation-free imaging, suitability for repeated screenings, and preference for younger populations.

DOI: 10.5281/zenodo.

Objective: To evaluate the laterality of antrochoanal polyps and determine the preponderance of right-sided occurrence in a study of 50 cases. Methods: A retrospective analysis of 50 cases diagnosed with antrochoanal polyps was conducted. Data on patient demographics and polyp laterality were collected and analyzed. Results: The study found a statistically significant preponderance of right-sided antrochoanal polyps. Conclusion: The findings suggest a notable right-sided dominance in the occurrence of antrochoanal polyps, warranting further investigation into underlying causes and clinical implications.

DOI: 10.5281/zenodo.

The drugs having low aqueous solubility but have high permeability is categorized in BCS Class II. The low solubility of these sorts of drugs may develop certain kinds of complications in this exclusive era of commercial pharmaceutical sciences. Whether industrial or confined system of pharmacy the hurdles of solubility sometimes arises the unavoidable risks. So, to overshadow the current or upcoming rigidity in solubility the engaged one should emphasize on the current issue to make this rigid system somewhat lenient by using certain methods such as use of cosolvents, micronization, hydrotrophy, inclusion complex and many more which are discussed in this review for efficient formulations of dosage forms which further contributes the pharmacokinetics. Some recent technologies like size reduction, porous microparticle, new drug delivery, and lipid based delivery systems are discussed separately. So, these methods or technologies are ice breaking factors regarding solubility.

DOI: 10.5281/zenodo.

Background: Polypharmacy, defined as the concurrent use of five or more medications, is increasingly common among the elderly population. While polypharmacy is often necessary to manage multiple comorbidities, it has been associated with adverse health outcomes, including cognitive decline. This study investigates the relationship between polypharmacy and cognitive decline in elderly patients. Aims and Objectives: To assess the impact of polypharmacy on cognitive function in elderly patients and to explore the association between the number of medications and the severity of cognitive decline. Methodology: A cross-sectional observational study was conducted at a Geriatric Medicine OPD in an urban setting, including 200 elderly patients aged 65 years and above. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Polypharmacy was defined as the use of five or more medications. Data on demographics, comorbidities, and medication use were collected. Statistical analysis was performed to examine the association between polypharmacy and cognitive decline. Results: The prevalence of polypharmacy in the study population was 62%. Patients with polypharmacy had significantly lower MMSE scores compared to those without polypharmacy (p < 0.01). A linear relationship was observed between the number of medications and the severity of cognitive decline, with each additional medication associated with a 0.5-point decrease in MMSE score. Conclusion: Polypharmacy is significantly associated with cognitive decline in elderly patients. This finding underscores the importance of regular medication review and deprescribing strategies to mitigate the risk of cognitive impairment in this vulnerable population.

DOI: 10.5281/zenodo.

Menopause is a phase from where bone mineralisation becomes critics because of various physiological and hormonal changes. Oestrogen deficiency and age related processes alter the rate of calcium turnover in bone that aging woman faces. Osteoporosis especially in postmenopausal women is a well-documented problem. In India lack of nutritional and health awareness makes its prevalence like tip of iceberg phenomenon. Changes in sex hormones during the menopause transition period have an impact on calcium homeostasis. This cross-sectional study was conducted in women of age 40–75 years. It is observed that serum calcium levels are low in post-menopausal as compared to pre-menopausal women. In postmenopausal women significant decrease in serum calcium level indicate remarkable risk towards negative calcium balance. They should be monitored for serum calcium levels, for reducing the risk of bone resorption.

DOI: 10.5281/zenodo.

In our institute, we came across a few unusual cases which we compiled in this case series. These cases were unlike those which we encounter in our daily practice here. These were epidermal inclusion cyst in the submandibular region, bezold abscess and jugular bulb dehiscence.

DOI: 10.5281/zenodo.

Percutaneous nephrolithotomy (PCNL) has become the preferred treatment for kidney stones larger than 2 cm in size and an alternative for smaller stones (10-20 mm) in the lower renal pole. The purpose of this dissertation is to carry out a comprehensive assessment and comparison of miniaturized percutaneous nephrolithotomy (Mini-PCNL) and the traditional standard percutaneous nephrolithotomy (standard PCNL) for treating renal stones. The study was conducted in Muzaffarnagar Medical College and Hospital, Muzaffarnagar, U.P. on 100 indoor patients of the General Surgery department by following inclusion and exclusion criteria, clinical examinations, and interpretation of laboratory results. The data obtained was analyzed by SPSS software 20.0. Mini PCNL offers a substantial advantage over Standard PCNL in that it allows the use of a ureteroscope. Mini PCNL offers a longer operating time and a better stone-free rate as compared to Standard PCNL, making it an effective treatment for renal calculi. Mini PCNL was found to be safe and equally effective in the realm of surgical treatment of renal stones considering all the parameters that make one favourable over the other.

DOI: 10.5281/zenodo.

Background: Breast cancer is a global health problem with more than 1 million cases diagnosed worldwide each year. Axillary lymph node (ALN) status is one of the most important prognostic indicators in breast cancer. Axillary lymph node dissection (ALND) is the most accurate method for evaluating the Axillary lymph node (ALN) status. Objectives: To study various Clinicopathological and radiological factors influencing Axillary lymph node metastasis in carcinoma breast. To compare clinical, pathological and radiological factors with histopathological examination report. Methodology: Hospital based case series study. Sample size is 45. Females above 18 years admitted to HSK Hospital, Bagalkot with breast cancer [stage I, II, III] from 1st August 2022 to 29th February 2024 are taken. With the consent of patients, Clinical factors like age, menstrual status, palpable, ALN, tumor size. Radiologically BIRADS, breast density, tumor size. FNAC preoperatively is assessed. These factors are compared with HPR postoperatively. Results: ALN metastasis was significantly present in menopausal women and in females with palpable ALN and in women with >4 cm tumor size clinically and radiologically. It was present significantly in women with BIRADS of 6. ALN metastasis did not vary with density of breast. Most of malignant tumors in FNAC have ALN metastasis according to HPR. Conclusion: Predicting ALN metastasis in carcinoma breast involves evaluation of various clinical and biological factors. Tumor size, age, number of palpable ALN, BIRADS, FNAC, and menstrual age play pivotal roles in assessing ALN spread and guiding treatment decisions. ALN metastasis did not vary with *reast density in our study.

DOI: 10.5281/zenodo.

Background: Anxiety disorders are the most prevalent psychiatric illnesses in the general community. Anxiety is diffuse, unpleasant, and highly vague feeling of apprehension with one or more bodily symptoms. Zinc is an essential micronutrient. It plays an important role in central nervous system physiology. Studies suggest the role of zinc in the pathogenesis of neuropsychiatric disorders. The study was undertaken to study the anti-anxiety activity of zinc oxide in animal models of anxiety and its comparison to Diazepam. Aim and Objectives: The present study aims to evaluate the anxiolytic effect of zinc oxide in albino rats. Material and Methods: Healthy albino rats of either sex weighing between 150 to 250 g were used and were divided into 7 groups. Group 1: Normal saline 0.5ml/rat Group 2: Diazepam 1mg/kg Group 3: Diazepam 2mg/kg Group 4: Zinc oxide 7.5mg/kg Group 5: Zinc oxide 15mg/kg Group 6: Zinc oxide 30mg/kg Group 7: Zinc oxide + Diazepam 7.5 + 1mg/kg. Light and dark arena model of anxiety was used. Results: Significant anti-anxiety effect is seen in the rats treated with Zinc Oxide 15mg/kg body weight. Zinc oxide was also able to potentiate the effect of low-dose diazepam as an anxiolytic. This was evident by the increase in time spent in the light arena, the number of entries in the light arena, and a decrease in time spent in a dark arena. Conclusion: The present study concludes that ZnO is an effective anxiolytic and can potentiate the action of Diazepam.

DOI: 10.5281/zenodo.

Objectives: (1). To gather feedback from 1st-year MBBS students regarding the difficulties they face in learning Embryology. (2). To identify contemporary learning needs that could help improve student performance. Materials and Methods: Participants: The study involved 150 MBBS students of 1st year MBBS. Data Collection: A specially designed questionnaire was used to collect input. The questionnaire focused on various aspects such as the curriculum and teaching methodologies used in the Embryology section of the Department of Anatomy. Results: Ease of Learning: While most students found Embryology relatively easy, a significant number of them preferred to keep the subject optional. Preferred Study Materials: Lectures were considered the best source of study material, followed by textbooks. Email information about embryology models was particularly beneficial for revision. Suggestions for Improvement: (1) Increasing the number of lectures and practical demonstrations. (2) Incorporating more visual aids, including 3D videos. (3) Conducting revision lectures at the end of the curriculum. (4) Introducing part-completion tests for Embryology. (5) Adding seminars and Multiple Choice Question (MCQ) sessions to the routine teaching. Conclusion: Students believe that integrating multimedia technology with traditional lectures would significantly enhance their understanding of Embryology. This approach is also expected to improve their exam performance and contribute to better diagnosis of congenital anomalies in the future. This study underscores the importance of adapting teaching methods to meet the evolving needs of students, particularly in challenging subjects like Embryology.

DOI: 10.5281/zenodo.