Background: It is known that Pseudoexfoliation causes corneal endothelial cell loss, increased anterior chamber inflammation and glaucoma. The associated features of Pseudoexfoliation includes iris transillumination defects in the pupillary margins, poor pupillary dilatation, heterochromia iris. Purpose: The purpose of present study is performing SICS in psedoexfoliation patients and its complications. Methods: We have conducted cross sectional study in all the patients with visual disturbances attending ophthalmology outpatient department GGH, Ananthapur. Study duration five months, sample size 50 patients.
All patients were subjected to detailed slit lamp examination and following were looked for:- (1) Conjunctiva‐ congestio. (2) Cornea‐ edema, pigmentation, exfoliation material, pigment disper. (4) Iris‐ pattern, transillumination defect. (5) Pupil‐ size, reaction to light, exfoliation material, dilatation with mydriasi. (6) Lens‐ exfoliation material, cataract type, phacodonesis, subluxation or dislocation of lens.
Fundus was examined with direct ophthalmoscope and slit lamp biomicroscopy to look for glaucomatous change in the disc and gonioscopy and IOP were measured. If patient undergoes cataract surgery A scan, keratometry, IOL calculation with SRK 2 formula. Results: Pseudoexfoliation syndrome is a significant risk factor for development of glaucoma. Conclusion: Pseudoexfoliation Syndrome is a significant risk factor for development of glaucoma, with good visual outcome.

DOI: 10.5281/zenodo.

Fingerprints and dermal ridge pattern are unique with each individual. Even fingerprints are different between similar twins also. The fingerprints of both hands are not the same. Fingerprints do not change size or shape throughout a person’s life, except in cases of serious injuries that scar the dermis. Therefore our objective to study the patterns of finger print among the students of FAAMC, Barpeta in relation to blood groups by using 10 finger attributes. After analysis the present study reveals that there is significant association between different fingerprint patterns in  ABO blood group. In our study the commonest fingerprint pattern observed was whorls followed by loops and then arches. Whereas in Rh +ve blood group same findings were observed but in Rh –ve blood group only loops were recorded. This study is an attempt to associate fingerprints with different blood groups and Rh blood types which will enhance the authenticity of fingerprints in identification in forensic medicine. Hence we can strive to use the study to link fingerprints with blood types which can augment the accuracy of fingerprints in recognition and revelation of culprit and help in forensic medicine to identify the victim.

DOI: 10.5281/zenodo.

Introduction: The epidemic of tobacco use is one of the paramount threats to global health today. Tobacco is chewed, smoked, sucked, and sniffed and is the one product which is deleterious to the populaces, when it is used entirely as intended. Aims: Evaluation of Tobacco Use in oral cavity and periodontal health in patients visiting Tobacco Control Unit. Materials and Methods: The present study was an Observational Descriptive Study. This Study was conducted from January 2020‐December 2023. Total 1036 patients were included in this study. Result: Our study showed that, most of patients had habit Type Bidi with Provisional Diagnosis (Pd) Periodontitis Group [581 (69.3%)] compared to without Pd Periodontitis [113 (57.1%)] but this was statistically significant (p=0.0009). Conclusion: We concluded that the substantial negative consequences of tobacco usage on patients’ oral and periodontal health in Burdwan are highlighted by this observational study. Deeper periodontal pockets, more clinical attachment loss, and poor oral hygiene were all substantially correlated with tobacco use and the severity of periodontal disease. Furthermore, tobacco users had a significantly greater prevalence of tobacco-related oral diseases such leukoplakia and oral submucous fibrosis.

DOI: 10.5281/zenodo.

Background: Bladder cancer is one of the common neoplasms of lower urinary tract with significant morbidity and mortality rates. Parameters like tumour grading, size, staging alone have minimal role to specify progression, disease recurrence and treatment response. Ki67 immunoexpression represents proliferative subsets of tumour cells indirectly denoting aggressiveness of the tumour. As molecular alteration precedes phenotypic change, immunohistochemical study may be a valuable tool for screening patients and early identification of aggressive cancers. This study aims to compare Ki67 immunoexpression and histopathological grading in urothelial neoplasms of bladder. Aim: The primary objective is to correlate the grading of tumor with Ki 67 immunoexpression in various urothelial neoplasms of bladder. Study Design: This is an Observational study which was done at department of Pathology, Dr. S. N. Medical College, Jodhpur, and Rajasthan, India. Total 40 paraffin embedded tissues of urothelial carcinoma cases were taken for the study. The intensity of Ki 67 nuclear staining was graded and compared with histopathological grading. Results: In present study high grade carcinomas have high ki67 expression and graded as 3+ and 4+, whereas low grade carcinomas have low Ki67 expression and graded as 1+ and 2+. Out of 40 cases pTa, cases had 2+ Ki-67 positivity, with none showing higher positivity. In contrast, pT1 cases showed 4+ ki67 positivity. pT2a, and pT4a stages exclusively exhibited 4+ positivity, while pT2b had mix of 3+ and 4+ positivity. This indicated that higher stages generally correlate with increased Ki-67 positivity. Conclusion: The observations of the study emphasize the use of Ki 67, in addition to tumour grade and stage to predict the clinical outcome of patients and thereby helps in identifying high risk patients. These patients are frequently followed up and may benefit by additional adjuvant therapies.

DOI: 10.5281/zenodo.

Background: Lung cancer continues to be the cause of most deaths due to cancer worldwide. Of all lung cancers, non-small cell lung cancer (NSCLC) accounts for the largest proportion. The purpose of this study is to evaluate the role of immunohistochemistry in the subtyping of lung carcinoma and the prevalence of EGFR mutations in different histological types. Methods: The samples included 60 lung cancer patients who were screened from the Department of Pathology, Dr. S.N. Medical College, Jodhpur, within the period between March 2023 and March 2024. Each subgroup included 20 patients of adenocarcinoma, squamous cell carcinoma, and small cell carcinoma, respectively. For subtyping, IHC markers were applied-TTF-1, Napsin-A, p63, synaptophysin, and chromogranin-and EGFR mutation status through IHC analysis. Results: The mean age of patients was 63.05 years, with a male-to-female ratio of 3.6:1. Most were right medial and left upper lobes carcinomas (21.67%). Of the IHC-proven adenocarcinomas, 100% showed EGFR positivity, whereas 80% of squamous cell carcinomas exhibited EGFR positivity. No small cell carcinoma cases demonstrated the presence of EGFR mutations. A majority (69%) of EGFR-positive cases were scored as 3+. Conclusion: EGFR mutation status is the most significant marker for targeted therapy in selected patients. This study highlights the value of using IHC panels to accurately sub-type lung carcinomas, especially when small biopsy specimens are taken into consideration and can also serve as a gateway to EGFR-targeted therapy for advanced cases of lung cancer.

DOI: 10.5281/zenodo.

Background: Gliomas are the most common and aggressive brain tumors; they have a diverse histopathological subtype with variable clinical behavior. This study aimed at evaluating the epidemiological, histopathological, and molecular characteristics of gliomas with particular respect to expression IDH-1 mutation. Methods: The study was carried out from March 2023 to March 2024 at the Department of Pathology, Dr. S.N. Medical College, and Jodhpur. A total of 60 different cases with glioma were taken, and the study recorded their respective histopathological diagnoses. Their IDH-1 mutation status was assessed using immunohistochemistry, and the distribution of gliomas was analyzed according to age, gender, WHO grade, and tumor site. Result: The maximum number of gliomas were detected in the 41-50 years age group, and male-to-female ratio was found to be 2.52:1. The most common histopathological type was glioblastoma. IDH-1 positivity was more prevalent in low-grade gliomas as compared to high-grade gliomas. The most common site for gliomas was found to be the frontal lobe, and out of these, 83.33% of cases showed positivity for IDH-1. There was a statistically significant association between the presence of IDH-1 positivity and the lower WHO grades. Conclusion: In this study, IDH-1 mutations play a significant role in glioma pathogenesis, especially in glioblastoma. The marker is valuable for prognosis and prediction and thus constitutes a putative therapeutic target, especially in high-grade gliomas.

DOI: 10.5281/zenodo.

Background: Distal femur fractures are complex injuries requiring stable fixation to restore function and mobility. Locking compression plates (LCP) have emerged as an effective surgical solution, offering rigid fixation and enabling early mobilization. Evaluating the functional outcomes after LCP fixation is crucial to guide clinical practice and optimize patient care. Aim: To assess the functional outcomes of patients undergoing open reduction and internal fixation (ORIF) of distal femur fractures using locking compression plates. Methods: A retrospective study was conducted on 100 patients with distal femur fractures treated with LCP fixation. Clinical, radiological, and functional outcomes were evaluated using the Knee Society Score (KSS) and range of motion (ROM) measurements at regular intervals over a 12-month follow-up period. Results: The majority of patients (75%) achieved good to excellent functional outcomes based on the KSS. The mean knee flexion achieved was 120° ± 10°. Complications included infection in 5% of cases and implant failure in 2%. Factors influencing outcomes included fracture type, patient comorbidities, and adherence to postoperative rehabilitation. Conclusion: LCP fixation for distal femur fractures provides reliable functional outcomes, with most patients regaining significant mobility. Early mobilization and adherence to rehabilitation protocols are essential for optimizing recovery.

DOI: 10.5281/zenodo.

Introduction: Spinal anesthesia is a widely used technique for lower abdominal surgeries due to its effectiveness and safety. Adjuvants such as nalbuphine hydrochloride and fentanyl enhance the efficacy of local anesthetics like bupivacaine. This study compares the efficacy and safety of nalbuphine hydrochloride and fentanyl as adjuvants to bupivacaine in spinal anesthesia for lower abdominal surgeries. Aims:  Evaluate the effectiveness of nalbuphine hydrochloride and fentanyl as adjuvants to bupivacaine in achieving optimal intraoperative surgical anesthesia during lower abdominal surgeries. Materials and Methods: It was a comparative study this study was conducted from One Year at Department of Anaesthesiology at Radha Devi Jageshwari Memorial Medical College and Hospital, Dr. Kalam Nagar, Manariya Chhajan, Turki, Muzaffarpur, Bihar -844127.100 Patients were included in this study. Results: Onset, duration of sensory and motor block, and duration of effective analgesia were comparable between both groups. Postoperative visual analog scale score was 4.8 ± 1.12 in Group BN, and in Group BF, it was 3.86 ± 1.04 which was statistically highly significant (P = 0.0007). The number of patients demanding rescue analgesia in early postoperative period was 18 (60.0%) in Group BN and 7 (23.33%) in Group BF which was statistically significant (P = 0.004). Conclusion: Fentanyl was more efficient than nalbuphine in providing early postoperative analgesia when used as an adjuvant to hyperbaric bupivacaine.

DOI: 10.5281/zenodo.

Introduction: Postoperative nausea and vomiting (PONV) are defined as any nausea, retching, or vomiting occurring during the first 24-48 hrs after surgery in in patients. Causes that may contribute to post operative nausea and vomiting (PONV) are Anesthesia related causes like the use of opioid drugs, nitrous oxide. Aims: The aim to test the efficacy between Dexamethasone and Amisulpride on reducing Postoperative Nausea and Vomiting incidence in patients undergoing laparoscopic surgery under general anaesthesia. Materials and Method: The present study was a Prospective, randomized, double-blind study. This Study was conducted from 6 months at JNM Hospital. Total 74 patients were included in this study. Result: In Group A, the mean Age (mean± s.d.) of patients was 20 ± 10, the mean Gestational age (weeks) (mean± s.d.) of patients was 38 ± 2.5, the mean Duration of surgery (min) (mean± s.d.) of patients was 58 ± 11.  In Group B, the mean Age (mean± s.d.) of patients was 15 ± 4, the mean Gestational age (weeks) (mean± s.d.) of patients was 37± 2, the mean Duration of surgery (min) (mean± s.d.) of patients was 60 ± 12 which was not statistically significant. Conclusion: In conclusion, both dexamethasone and amisulpride have been found to be effective in reducing the incidence of postoperative nausea and vomiting (PONV) in patients undergoing general anesthesia. Dexamethasone, a corticosteroid, has demonstrated strong antiemetic properties, likely due to its anti-inflammatory and anti-chemotactic effects. Amisulpride, an atypical antipsychotic with dopamine antagonistic properties, also effectively reduces PONV by blocking dopamine receptors involved in the vomiting reflex.

DOI: 10.5281/zenodo.

Background: The choice of surgical approach for primary indirect inguinal hernia repair remains a critical consideration in achieving optimal outcomes. Two commonly utilized techniques are the open one-inch incision mesh plug repair and the laparoscopic trans-abdominal preperitoneal (TAPP) repair. Each method offers distinct advantages in terms of invasiveness, recovery time, and complication rates. Aim: To compare the clinical outcomes, complications, and recovery profiles of one-inch incision mesh plug repair and laparoscopic TAPP repair in patients with primary indirect inguinal hernias. Methods: This prospective study included 100 patients diagnosed with primary indirect inguinal hernia at Department of General Surgery, Jagannath Gupta Institute of Medical Sciences & Hospital, Budge Budge, Kolkata, West Bengal, India for one year . Participants were divided into two groups: one-inch incision mesh plug repair (n=50) and laparoscopic TAPP repair (n=50). Key outcomes, including operative time, postoperative pain, return to normal activities, complications, and recurrence rates, were analyzed. Results: The mean operative time was significantly shorter in the mesh plug group (45 ± 10 minutes) compared to the TAPP group (70 ± 15 minutes, p<0.05). Postoperative pain scores were higher in the mesh plug group on Day 1 but comparable by Day 7. The TAPP group demonstrated a faster return to normal activities (7 ± 2 days vs. 10 ± 3 days, p<0.05). Complication rates were similar between the two groups (10% vs. 8%), with no significant difference in recurrence rates at 12-month follow-up. Conclusion: Both one-inch incision mesh plug repair and laparoscopic TAPP repair are effective techniques for primary indirect inguinal hernia repair. While the mesh plug approach offers shorter operative times, the TAPP technique provides faster recovery and comparable long-term outcomes. Surgical choice should be tailored to patient preferences and clinical scenarios.

DOI: 10.5281/zenodo.

Background: An increasing number of acute gastroenteritis (AGE) cases are now being diagnosed with acute kidney injury (AKI). Recent years have highlighted that even slight increases in serum creatinine across various clinical settings are linked to poorer outcomes. In this study, we aimed to examine the clinical profile of patients with AKI following AGE at our tertiary hospital. Methods: Patients above 18 years diagnosed with AKI. After the selection of the patient, a detailed history of the case was recorded and the patient was subjected to a thorough clinical examination. Records included information on gastroenteritis duration, onset of renal failure, hydration status at admission, and daily blood tests for urea, serum creatinine, sodium, and potassium levels. Additional tests included CBC, ESR, urine, stool (including hanging drop), HIV, blood glucose, total and differential leukocyte counts, and liver function tests (serum bilirubin, total serum protein, albumin, SGOT, SGPT, ALP). Results: Most cases (56.7%) were classified as stage 1 AKI, characterized by mild elevations in serum creatinine or reduced urine output. Stage 2 AKI was observed in 30% of patients, indicated by a more pronounced rise in serum creatinine and persistent oliguria. Only 16.7% of cases progressed to stage 3 AKI, requiring renal replacement therapy or meeting other criteria for severe kidney injury. Conclusion: Early identification and intervention can often prevent progression from stage 1 AKI. The KDIGO classification provides a framework to stratify patients by risk of adverse outcomes, guiding tailored management strategies. Close monitoring of stage 2 and 3 AKI patients is essential to detect worsening renal function early and implement timely interventions, such as dialysis.

DOI: 10.5281/zenodo.

Background: Polycystic ovarian syndrome (PCOS) is a common endocrine disorder that can manifest with acne due to hyperandrogenism. Acne in PCOS patients is primarily caused by elevated androgen levels, which influence sebaceous gland activity. This study investigates the clinical profile of patients with acne and PCOS, focusing on acne severity and hormonal imbalances. Objective: To evaluate the clinical features and hormonal profiles of patients presenting with acne and diagnosed with PCOS. Material and Methods: The study was conducted on 100 female patients diagnosed with PCOS, as confirmed by clinical, biochemical, and ultrasound criteria. Hormonal profiles (serum testosterone, LH/FSH ratio) and acne severity (Global Acne Grading System) were assessed. Results: The study found that 70% of patients had moderate to severe acne, with elevated serum testosterone levels in 65% of the cases. Acne severity was strongly correlated with elevated androgen levels. Conclusion: Acne in PCOS is associated with hormonal disturbances, particularly elevated androgens. Early detection and treatment are crucial for better management of acne in PCOS patients.

DOI: 10.5281/zenodo.

Background: Oral lesions are common manifestations of various systemic and dermatological conditions, often indicative of underlying systemic disorders. The prevalence of oral lesions in patients visiting the dermatology department remains underexplored in many healthcare settings, despite their potential impact on the quality of life. This study aims to evaluate the prevalence of oral lesions in dermatology patients and explore the association between these lesions and dermatological conditions. Objective: The primary objective of this study is to assess the prevalence of oral lesions in patients attending the dermatology department. Secondary objectives include identifying the most common types of oral lesions and determining their association with dermatological disorders. Material and Methods: This cross-sectional study was conducted among patients attending the dermatology department at Tertiary care hospital. A total of 200 patients were selected based on inclusion and exclusion criteria. Oral examinations were conducted by trained professionals, and oral lesions were classified into various categories. Data on dermatological diagnoses, demographic characteristics, and oral findings were collected and analyzed using descriptive and inferential statistics. Results: Of the 200 patients, 48 (24%) exhibited oral lesions. The most common oral lesions included aphthous stomatitis (35%), candidiasis (20%), and lichen planus (18%). Oral lesions were most commonly observed in patients with systemic dermatological conditions such as lichen planus, psoriasis, and systemic lupus erythematosus. A significant association was found between oral lesions and certain dermatological conditions (p < 0.05). Conclusion: The prevalence of oral lesions in patients attending the dermatology department is relatively high. Regular oral examinations in dermatological practice are recommended to identify and manage these lesions, particularly in patients with systemic dermatological conditions.

DOI: 10.5281/zenodo.

Objective: To identify the effects of chewing tobacco on retinal nerve fiber layer thickness (RNFL) and to find an association between the duration of tobacco chewing with changes in RNFL thickness using Optical Coherence Tomography (OCT). Methodology: A hospital-based case-control study was performed in 170 eyes of 85 cases and 170 eyes of 85 age and gender-matched healthy controls. Cases were selected from patients attending Ophthalmology OPD of PGIMER and CH Bhubaneswar addicted to chewing tobacco for 10 or more years of both genders. The cases were interviewed with structured questionnaires of the Fagerstrom Nicotine Dependence -Smokeless Tobacco scale (FTND-ST) and scoring was done. The RNFL thickness was measured by SD Optical Coherence Tomography (OCT). Results: A total of 170 eyes of cases and 170 eyes of controls were included in the study. The average RNFL thickness of the superior quadrant was 93.31 ±16.2 microns temporal quadrant was 50.64±7.5 micros, the inferior quadrant was 108.62±11.29 microns and the nasal was 69.40±10.23. The statistically significant RNFL thinning was noted in all quadrants in all cases (p<0.0001). Statistically significant thinning was noted in all quadrants except the superior quadrant with an increased FTND-ST scale. Conclusion: Chronic tobacco chewing is likely to cause thinning of RNFL. OCT can be used for screening among chewing tobacco users.

DOI: 10.5281/zenodo.

Background: Celiac disease (CeD) is an immune-mediated systemic disorder triggered by gluten ingestion in genetically predisposed individuals. It is characterized by specific clinical, serological, and histopathological features. While micronutrient deficiencies are well-documented in CeD, there is limited data on serum vitamin B12 and folate levels in newly diagnosed pediatric patients, particularly in India. Methods: A hospital-based, cross-sectional comparative study was conducted in the Department of Pediatric Medicine, S.M.S. Medical College, Jaipur, from June 2018 to May 2019. A total of 100 participants, comprising 50 biopsy-confirmed CeD patients aged ≤18 years and 50 age- and gender-matched healthy controls, were included. Detailed clinical evaluations, serological tests, duodenal biopsies, and serum micronutrient measurements were performed. Vitamin B12 and folate levels were measured using chemiluminescence immunoassay. Statistical analysis was performed to assess differences between the groups, with a significance level set at p < 0.05. Results: The mean age of CeD patients was 5.82 ± 3.48 years, and the most common presenting symptoms were pallor (86%), failure to thrive (62%), and abdominal distension (56%). Undernutrition was noted in 28% of CeD patients while there was none in the control group, p < 0.001. Folate serum levels in the CeD patients were significantly lower than that noted in controls at 9.31 ± 7.26 ng/ml compared to 14.36 ± 4.59 ng/ml in controls, p < 0.001. Among the CeD patients, 26% had low levels of folate, <3 ng/ml. Vitamin B12 deficiency (<211 pg/ml) was observed in 24% of CeD patients, though the mean serum vitamin B12 levels did not differ significantly between groups (374.1 ± 280.3 pg/ml in CeD cases vs. 418.08 ± 128.01 pg/ml in controls, p = 0.278). Conclusions: Micronutrient deficiencies, particularly folate and vitamin B12, are prevalent in pediatric CeD patients, with significant implications for growth and development. Routine assessment of these nutrients should be integrated into the diagnostic and therapeutic approach for CeD. Early diagnosis and nutritional intervention are crucial in preventing long-term complications associated with these deficiencies.

DOI: 10.5281/zenodo.

Background and Objectives: Inappropriate disposal of unused and expired medications presents considerable environmental and public health hazards, including water contamination and accidental poisoning. Healthcare students, as prospective professionals, are strategically positioned to promote safe disposal protocols. This study was aimed at assessing the knowledge, attitudes, and practices (KAP) of first- and second-year medical and nursing students about drugs disposal, as well as to identify barriers and provide solutions. Methods: A cross-sectional study was done using 300 students (150 from medicine and 150 from nursing) by using a standardized questionnaire. Data were evaluated by using descriptive statistics (frequency, percentage, mean, and standard deviation) for summarizing demographic and KAP variables. Chi-square tests were performed to analyse relationships between categorical variables, and t-tests were applied to compare KAP scores between medical and nursing students. A p-value of <0.05 was considered for statistical significance. Results: The mean age of participants was 21.2 ± 1.8 years, with a female majority (66.7%). While 80% of students were aware of the consequences of improper disposal, only 65% displayed knowledge about safe techniques. Medical students showed considerably superior knowledge scores compared to nursing students (p < 0.01). Positive attitudes were prominent across both groups, with mean attitude scores above 4.0. However, reported practices were skewed, with many students dumping drugs in the garbage (50%) or flushing them down through the toilet (20%). Barriers were lack of awareness (60%) and inconvenient disposal places (50%). Participants recommended greater awareness efforts (80%) and the creation of more accessible disposal facilities (70%). Conclusion: Despite positive attitudes, gaps in knowledge and practices regarding medicine disposal are obvious among healthcare students, particularly nursing students. These findings underline the need for standardized educational initiatives and infrastructural enhancements to promote safe disposal habits. Future initiatives should focus on integrating disposal education into curricula and enhancing disposal infrastructure to counteract environmental and health risks.

DOI: 10.5281/zenodo.

Given its substantial influence on treatment results and patient prognosis, the connection between migraine and mental health issues is essential in medical practice. The present study was undertaken to gauge the association between migraine and psychiatric disorders and drug prescription analysis for these conditions. This prospective observational study examined mental comorbidities among migraine patients who regularly visited the psychiatry outpatient department (OPD) of a tertiary care hospital of central India between September and December 2024. Majority of the patients in present study belonged to age group 36-50 years, comprising of 64 (58%) patients. Of the 110 patients in the present study, 48 (44%) had associated psychiatric comorbidities. On further analysis, it was found that depression was most common psychiatric comorbidity accounting for 24 (22%) patients, followed by 16 (15%) patients with anxiety disorder as comorbidity. Most common route of drug administration prescribed was oral. On analysing the prescriptions of enrolled patients, it was found that fixed dose combination (FDC) of naproxen + domperidone was most commonly prescribed accounting for 101 (92%) of the patients. The study concludes by offering important new information about the pharmaceutical treatment of migraine with psychiatric comorbidity. NSAIDs are the most often recommended class of drugs in the midst of prescribed medications.

DOI: 10.5281/zenodo.

Introduction: Screen media has become an integral part of children’s lives, with increased accessibility contributing to greater media exposure and reduced parent-child interaction. Excessive screen time is associated with sedentary behaviour, poor diet, sleep disturbances, cognitive delays, and increased risk of psychiatric disorders. This study aims to evaluate screen media usage patterns among Indian children and adolescents and their association with physical and psychological health outcomes. Materials & Methods: A cross-sectional study was conducted among children and adolescents attending psychiatric OPD services at a tertiary care center in Gujarat. Participants were recruited through convenient sampling. Screen media use was assessed using the Problematic Media Use Measure-Short Form (PMUM-SF). Results: Television (51.1%) was the most used media device, followed by mobile phones (45.9%). Most participants (59.2%) had their first screen exposure between 1 to 3 years, with an average daily screen time of 1.98 ± 0.67 hours, and 63.2% exceeding recommendations. Higher screen time was linked to lower maternal education, non-working mothers, urban living, nuclear families, early exposure, and firstborn status. The most common issues were visual disturbances (44.1%), eye dryness (38.9%), and headaches (38.1%). Problematic screen media use was observed in 19.2% of participants. Conclusion: Educating parents, especially those with lower education levels, on the risks of excessive screen time is essential. Minimizing early exposure, promoting outdoor activities, and setting screen time limits can help mitigate its negative impact on children’s health and development.

DOI: 10.5281/zenodo.

Background and Aim: While infrequent in contemporary obstetric practice, emergency obstetrics hysterectomy continues to be a critical intervention in situations involving significant hemorrhage. This study aimed to assess the incidence, risk factors, indications, outcomes, and complications associated with obstetric hysterectomy conducted in a tertiary care hospital. Material and Methods: A retrospective evaluation was conducted on the medical records of 36 patients who underwent obstetric hysterectomy at a civil hospital in Ahmedabad, covering the period from June 2015 to June 2017. The study meticulously documented and assessed various factors including maternal age, parity, and gestational age, characteristics of the current pregnancy, mode of delivery, reasons for hysterectomies, operative complications, postoperative conditions, as well as maternal and neonatal outcomes. Results: The study revealed that among 15,682 deliveries, there were 36 obstetric hysterectomies performed, resulting in a rate of 0.22 per 1,000 deliveries. A total of twenty-seven hysterectomies were conducted following caesarean deliveries, while nine were carried out after vaginal deliveries. Uterine atony emerged as the leading reason for hysterectomy, accounting for 36% of cases (13 out of 36). This was closely followed by uterine rupture at 30.5% (11 out of 36), with placenta previa and retained placenta each representing 13.8% (5 out of 36). Lastly, placenta percreta was noted in 5% of cases (2 out of 36). There were five reported maternal deaths. Conclusion: Obstetric hysterectomy saves lives. In my study, uterine atony was a major cause of emergency obstetric hysterectomy. Significant bleeding from aberrant placentation, placenta previa, and uterine rupture due to multiparity and Caesarean delivery were further risk factors. Preventing massive hemorrhage, aberrant placentation, and uterine rupture requires proper antenatal care, high-risk identification, and timely referrals to competent facilities. Emergency obstetric hysterectomy may be preferred, reducing maternal morbidity and mortality.

DOI: 10.5281/zenodo.

Background: Childhood asthma is a major public health issue globally, affecting millions, in Bihar, where asthma prevalence in urban children has significantly increased over the past few decades. Asthma exacerbations are often asymptomatic, making objective measures, such as Peak Expiratory Flow (PEF), crucial in asthma management. PEF is a valuable tool for monitoring asthma and predicting exacerbations, particularly in children who struggle to self-assess symptoms. Aim: This study aims to evaluate the impact of Lower Respiratory Tract Infections (LRTI) on pulmonary function in children, particularly using Peak Expiratory Flow Rate (PEFR) as an objective measure. The study also investigates the correlation between PEFR and anthropometric variables like age, height, and weight. Methodology: This prospective study involved 100 children aged 7-18 years, divided into two groups: the LRTI group (n=50) and the control group (n=50). The study was conducted at  Upgraded Department of Pediatrics, Patna Medical College and Hospital, Patna, Bihar, India. PEFR was measured at multiple intervals before treatment using a Mini Wright’s Peak Flow Meter. Data were analyzed using SPSS, with mean values and correlation coefficients calculated for various variables. Results: The study found significant reductions in PEFR among children with LRTI compared to healthy controls, particularly in younger age groups. Age and height were the most significant predictors of PEFR, with a stronger correlation observed in boys. PEFR was notably lower in girls with LRTI compared to boys, suggesting gender-specific variations in pulmonary function during respiratory infections. Conclusion: LRTIs significantly impair pulmonary function in children, as evidenced by lower PEFR values. Early intervention is essential to manage LRTIs and prevent long-term respiratory impairment. The findings advocate for regular PEFR monitoring and suggest that gender and age-specific strategies may improve asthma and LRTI management. Further research is needed to refine treatment protocols and enhance outcomes.

DOI: 10.5281/zenodo.

Background: Proper feeding is a critical component of neonatal care, particularly for preterm infants, who may face difficulties with feeding due to underdeveloped coordination of sucking, swallowing, and breathing. Feeding methods such as gavage, spoon/paladai, and breastfeeding are used based on gestational age and clinical status, with ongoing monitoring of vital signs like “heart rate (HR), respiratory rate (RR), and oxygen saturation (SpO₂)”. Aim: This study seeks to evaluate the effects of various feeding approaches on “heart rate (HR), respiratory rate (RR), oxygen saturation (SpO₂)”, and respiratory effort in stable preterm infants, while analysing these parameters in relation to postmenstrual age (PMA). Methods: A prospective observational study was conducted at Upgraded Department of Pediatrics, Patna Medical College and Hospital, India, for 12 months. Seventy preterm neonates were grouped according to their feeding methods: “gavage feeding (GF), spoon/paladai feeding (SF), breastfeeding (BF)”, and combinations (e.g., BF & SF). Vital parameters were recorded before and after feeding at multiple intervals. Results: Significant changes in RR and HR were observed across the groups. The BF and SF groups showed notable decreases in RR, while the GF group remained stable. Significant variations in HR and RR were noted in the BS and BSG groups post-feeding. Conclusion: Different feeding techniques impact vital signs in preterm neonates, with breastfeeding and spoon feeding causing more significant changes in RR and HR than gavage feeding. Further studies are needed to establish standard reference ranges for vital parameters in preterm infants based on PMA.

DOI: 10.5281/zenodo.

Introduction: An estimated 253 million people globally have visual impairment, with 81% aged 50 or older. Age-related retinal diseases, such as age-related macular degeneration (AMD), are significant contributors. This study evaluates the diagnostic accuracy of structural and functional tests, comparing sensitivity, specificity, and predictive values, aiming to enhance early detection and clinical management. Methods: This cross-sectional study at GITAM Vizag between September to November 2024, assessed diagnostic accuracy of structural (optical coherence tomography (OCT), fundus imaging, Heidelberg retinal tomography) and functional tests (standard automated perimetry (SAP), contrast sensitivity) in detecting age-related eye diseases. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic (ROC) curve were calculated against reference standards. Results: OCT’s highest sensitivity (92%) and specificity (85%) for AMD, with SAP excelling in glaucoma diagnosis. Structural tests proved more reliable than functional tests. Table 2 highlights multimodal approaches, with combined tests enhancing sensitivity (95%), specificity (90%), and overall accuracy (AUC = 0.96), improving diagnostic precision and clinical management. Conclusion: The study highlights the superior diagnostic accuracy of structural tests like OCT for age-related eye diseases, with combined structural-functional approaches offering the highest reliability. Multimodal diagnostics significantly improve sensitivity, specificity, and overall accuracy, providing robust tools for early detection, monitoring, and management, ultimately enhancing clinical outcomes and reducing visual impairment.

DOI: 10.5281/zenodo.

Introduction: Posterior polar cataracts (PPC) pose surgical challenges due to their predisposition to complications, particularly posterior capsular rupture (PCR). Advanced imaging, careful surgical techniques, and intraoperative measures like viscoelastic protection are crucial for minimizing risks. Despite challenges, proper management can lead to favourable postoperative visual outcomes, depending on surgeon expertise and planning. Methods: This prospective study, conducted at Sarojini Devi Eye Hospital (Dec 2018–June 2020), included patients >18 years with PPC. Preoperative evaluation involved visual acuity, slit-lamp examination, and biometric assessments. MSICS and phacoemulsification were performed by experienced surgeons, with postoperative monitoring of visual outcomes and complications. Results: The study included 50 patients (age 18-74), with 80% in the 30-60 age group. Most cases had right eye involvement (62%) and PPC (56%). Phacoemulsification (52%) and SICS (48%) were performed. At six weeks, 96.15% (Phaco) and 91.67% (SICS) achieved BCVA ≥6/12, with statistically significant improvement (P<0.001). Conclusion: In conclusion, both Phacoemulsification and Small Incision Cataract Surgery demonstrated significant visual acuity improvement in posterior polar cataract cases, with most patients achieving BCVA ≥6/12 by six weeks. The findings highlight the effectiveness of these surgical techniques, with careful management leading to favorable postoperative outcomes.

DOI: 10.5281/zenodo.

Introduction: Thrombocytopenia, a common hematologic abnormality in pregnancy, can be mild, moderate, or severe. While most cases are mild and do not lead to adverse outcomes, severe thrombocytopenia may result in significant morbidity. The condition primarily arises from gestational thrombocytopenia and hypertensive disorders. This study aims to investigate the impact of thrombocytopenia on pregnancy outcomes and maternal-fetal health. Methods: This prospective, observational study, conducted from September 2022 to August 2024 at Kakatiya Medical College, Hanumakonda, involved pregnant women with thrombocytopenia, including those with ITP or pancytopenia. Excluded were cases with multiple pregnancies, infectious causes, or normal platelet counts. Data on clinical history, physical examination, laboratory investigations, antenatal and intrapartum complications, delivery mode, and fetal outcomes were collected. Results: The study included 100 pregnant women, with a mean age of 26.93 years and a mean BMI of 21.85 kg/m². Most were between 26-30 years, and 47% were at >37 weeks of gestation. The majority had mild thrombocytopenia (58%) and gestational thrombocytopenia (65%). Postpartum hemorrhage was the most common maternal complication (57.14%). Of 22 cesarean sections, 88% received spinal anesthesia. Platelet normalization rates were 75% immediately postpartum, with 23% by day 10. Conditions like gestational thrombocytopenia showed 74% normalization, while 1 case of ITP required transfusion and remained thrombocytopenic. Conclusion: This study found thrombocytopenia in pregnancy to be most commonly linked to hypertensive disorders and PIH, with less frequent contributions from HELLP syndrome and ITP. Maternal complications like PPH (57.14%) were prominent. Spinal anesthesia was preferred for cesarean sections, with postpartum platelet normalization varying across conditions, emphasizing the need for individualized management.

DOI: 10.5281/zenodo.

Introduction: Chronic kidney disease (CKD) is a progressive condition characterized by a glomerular filtration rate (GFR) <60 mL/min/1.73 m² for over three months. CKD patients often present with diverse cutaneous manifestations, including hyperuricemia and electrolyte imbalances. This study aims to explore these dermatological issues in CKD patients. Methods: This hospital-based cross-sectional study was conducted at Konaseema Institute of Medical Sciences, Amalapuram, from January 2021 to October 2022. It included CRF patients over 18 years, focusing on dermatological manifestations. Comprehensive history, general and systemic examinations, and relevant laboratory tests were performed, including specialized tests for infections. Results: The study included 100 patients, 57% male, with a mean age of 49.25 years. Among them, 54 had diabetic nephropathy (DN), 19 had hypertensive nephropathy (HN), and 11 had NSAID-induced nephropathy. Common dermatological findings included pruritus, xerosis, pigmentation, infections, pallor, and nail changes in varying frequencies. Conclusion: The study highlights the significant prevalence of dermatological manifestations in chronic kidney disease patients, particularly those with diabetic nephropathy, hypertensive nephropathy, and NSAID-induced nephropathy. Early recognition and management of these cutaneous abnormalities can improve patient well-being and enhance overall care in CKD management.

DOI: 10.5281/zenodo.

Introduction: Hoarseness, or dysphonia, reflects various laryngeal pathologies, with changes in voice quality due to structural or functional abnormalities. Risk factors include smoking, GERD, and vocal strain. Laryngoscopy, complemented by stroboscopy, aids diagnosis by assessing vocal fold mobility, symmetry, and lesions. This study evaluates clinical and laryngoscopic parameters in hoarseness. Methods: This prospective hospital-based study, conducted from June to November 2024, assessed hoarseness in ENT patients using history-taking, laryngoscopy (indirect, direct, video), imaging (X-rays, CT, MRI), and histopathology. Data collection and analysis focused on clinical, imaging, and histopathological correlations to identify etiologies and evaluate management outcomes. Results: The study included 100 patients (male-to-female ratio 1.5). Most (45%) were aged 21–40 years, and 75% reported hoarseness >2 weeks. Throat pain (50%) was the most common symptom. Laryngoscopy revealed benign (40%) and malignant (25%) lesions. Imaging confirmed lesions in 45%, with histopathology showing benign (50%) and malignant (20%) conditions. Conclusion: The study highlights the prevalence of benign lesions as the leading cause of hoarseness, with malignancies comprising a significant portion. Comprehensive evaluation using laryngoscopy, imaging, and histopathology enhances diagnostic accuracy. Early diagnosis and tailored management, including conservative and surgical approaches, are essential for improving outcomes in patients with laryngeal pathologies.

DOI: 10.5281/zenodo.

Introduction: Preeclampsia (PE), a leading cause of hypertensive disorders of pregnancy, poses significant maternal and fetal risks. Maternal serum C-reactive protein (CRP), an inflammation marker, has been linked to PE. This study aimed to evaluate CRP as a biochemical predictor of PE in pregnant women from the newly formed Telangana state. Methods: This prospective study, included pregnant women (13–16 weeks gestation, <35 years) with nil proteinuria. CRP levels were measured using particle-enhanced turbidimetric immunoassay. Exclusion criteria included high BMI, diabetes, renal disease, infections, corticosteroid use, and multiple gestations. CRP levels were analysed in blood and protein in urine. Student’s t-test was used to compare means. P < 0.05 was considered to be statistically significant. Results: The study included 100 participants, with 24% multipara and 10% developing PE. At 36 weeks, PE participants showed significantly higher DBP (84 ± 12.65 mmHg) and SBP (128 ± 22.51 mmHg). CRP levels were lower in the PE group initially but increased at 26 weeks, approaching significance (P = 0.07). Conclusion: The study concluded that while CRP levels showed an increasing trend in the PE group, the differences were not statistically significant at most intervals. Elevated CRP levels at 26 weeks approaching significance suggest a potential predictive value, but further research is needed to establish CRP as a reliable biomarker for PE.

DOI: 10.5281/zenodo.

Background: Ocular trauma is a significant cause of visual impairment and blindness, particularly in low- and middle-income countries. It disproportionately affects males and working-age individuals, with common causes including occupational hazards, road traffic accidents, and assaults. This study determined the epidemiology of ocular trauma reporting to our Tertiary Care Hospital. Methods: Patients with a history of injury to the orbit and periorbital region in all age groups. A detailed ocular examination was performed using a slit lamp biomicroscope for anterior segment examination and pupillary responses. Fundus examination was done using a 90D lens and an indirect ophthalmoscope if required imaging modalities such as X-ray, computed tomography (CT), and B-scan ultrasonography were employed to identify underlying structural damage or hidden injuries. Results: The highest incidence of ocular trauma occurred in the 21–30 age group (29%), with 76% seeking care within 24 hours. Road traffic accidents (22.5%) and workplace injuries (14.2%) were the leading causes. Subconjunctival hemorrhage (30.8%) and anterior chamber injuries, including traumatic uveitis (19.1%), were common. Visual acuity improved from 60% (6/6–6/12) at presentation to 75% at 12 weeks. Conclusion: This study found that road traffic accidents are the leading cause of ocular trauma. Closed-globe injuries, particularly those involving the conjunctiva and anterior chamber, were more frequent than open-globe injuries.

DOI: 10.5281/zenodo.

Background: Medication adherence is critical in managing diabetes mellitus (DM) to prevent complications and improve quality of life. Non-adherence remains a significant barrier to achieving optimal glycemic control, necessitating an exploration of influencing factors. Objectives: This study aimed to identify demographic, clinical, and socioeconomic factors associated with medication adherence in DM patients. Methods: A retrospective observational study was conducted using medical records (MRs) from 500 DM patients at Department of General Medicine, Maharshi Vishwamitra Autonomous State Medical College, Ghazipur, Uttar Pradesh, India for one year . Adherence was measured using the proportion of days covered (PDC), with ≥80% considered adherent. Logistic regression analysis was performed to determine the predictors of adherence. Results: Among the 500 patients, 65% were adherent. Significant factors influencing adherence included age (OR: 0.97, p=0.01), HbA1c > 8% (OR: 0.45, p<0.001), low income (OR: 0.58, p=0.003), and insurance coverage (OR: 1.72, p=0.006). Interventions like medication counselling were simulated to improve adherence rates, showing potential increases of 20%. Conclusions: Adherence in DM patients is influenced by various demographic, clinical, and socioeconomic factors. Addressing these barriers through targeted interventions can improve outcomes.

DOI: 10.5281/zenodo.

Background: Pre-donation deferral of blood donors is a critical issue faced by blood banks, leading to a reduced donor pool and impacting the availability of blood for transfusion. Understanding the factors influencing pre-donation deferral is essential to optimize donor management and retention strategies. Aim: This study aimed to identify and analyze the demographic, medical, and behavioral factors contributing to pre-donation deferral among blood donors in South India. Methods: A cross-sectional study was conducted involving 400 prospective blood donors at blood donation camps and hospital-based blood banks across South India. Data were collected using structured questionnaires and medical screening forms. Demographic information, medical history, and reasons for deferral were recorded and analyzed. Statistical analyses, including chi-square tests and logistic regression, were employed to identify significant factors associated with pre-donation deferral. Results: Among the 400 donors screened, 60 (15%) were deferred. The most common reasons for deferral included low hemoglobin levels (40%), recent illness (25%), and high blood pressure (15%). Younger donors (18–25 years) had higher deferral rates compared to other age groups (p < 0.05). Females were deferred more frequently due to anemia (p < 0.01), while males were more commonly deferred due to high blood pressure (p < 0.05). Behavioral factors such as insufficient sleep before donation and alcohol consumption within 24 hours also contributed to deferrals. Logistic regression identified low hemoglobin as the strongest predictor of deferral (OR: 4.2; 95% CI: 2.8–6.5). Conclusion: This study highlights the prevalence and determinants of pre-donation deferrals among blood donors in South India. Addressing modifiable factors such as anemia and educating donors about preparation for donation can reduce deferral rates and enhance donor retention. Blood banks should implement targeted interventions to address these issues and improve the efficiency of donor recruitment programs.

DOI: 10.5281/zenodo.

Aim: This study examines the correlation between blood concentrations of pregnancy-specific glycoproteins (PSGs), namely PSG1, and preeclampsia by contrasting levels in afflicted patients with those in healthy gestation-matched controls. Methods: This observational research was performed at Department of Obstetrics and Gynaecology,  Patna Medical College and Hospital, Patna, Bihar, India, involving 74 patients aged 17 to 40 years with single viable pregnancies between 28 and 36 weeks of gestation. The exclusion criteria encompassed chronic illnesses and associated consequences. Serum PSG1 concentrations were quantified with an enzyme immunometric technique. Statistical analysis was conducted utilizing SPSS, with a significance level recognized at p less than 0.05. Results: Thirty-seven of the individuals were controls and 37 had a PE diagnosis. The average PSG1 level in individuals with preeclampsia was 12.5 ng/mL (SD 3.2), substantially above the controls’ average of 8.9 ng/mL (SD 2.5; p < 0.001). The results demonstrate a significant correlation between increased PSG1 levels and preeclampsia. Conclusion: This research identifies PSG1 as a prospective biomarker for preeclampsia diagnosis, recommending its integration into clinical practice. The heightened levels in PE patients necessitate additional exploration of PSG1’s involvement in the pathogenesis of PE, potentially augmenting diagnostic precision and enhancing maternal and fetal outcomes.

DOI: 10.5281/zenodo.

Background: Hypocalcemia is a typical complication following total thyroidectomy, frequently observed about because of transient or long-lasting hypoparathyroidism. Early postoperative evaluation of parathyroid hormone (PTH) levels has been proposed as a important diagnostic marker for hypocalcemia, allowing early intervention and decreasing the complications. Aim: This study aims to assess the prognostic value of early postoperative PTH estimation in foreseeing hypocalcemia in patients going through complete thyroidectomy. By corresponding serum calcium levels with early postoperative PTH levels, the review looks to lay out a prescient model for directing early intervention and working on understanding results. Methods: The study was carried out at the Department of General Surgery,  Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, including 50 patients going through complete thyroidectomy. Venous blood tests were collected three hours postoperatively to measure serum calcium and PTH levels. Patients were checked for hypocalcemia, arranged as transient, delayed, or permanent hypoparathyroidism, and followed up at one and a half year postoperatively. Measurable investigations, including connection and relapse models, were utilized to assess the prescient worth of early postoperative PTH levels. Results: Early postoperative PTH levels were essentially associated with the improvement of hypocalcemia. Among the 50 patients, 30% developed hypocalcemia, with a strong negative correlation with PTH and calcium levels (r = – 0.72, p = 0.001). Patients with postoperative PTH <10 pg/ml had the most elevated hazard of hypocalcemia (53.3%). At the one-month follow-up, 16% of patients had transient hypoparathyroidism, and on further follow ups at 6 weeks and 6 months  10% had delayed/prolonged hypoparathyroidism, and 4% permanent hypoparathyroidism. Calcium supplementation actually further developed serum calcium levels, and 85% of patients showed recuperation without long haul difficulties. Conclusion: Early postoperative PTH estimation is a strong indicator of hypocalcemia following total thyroidectomy. A PTH level <10 pg/ml is related with a higher chance of hypocalcemia, supporting its usability as an early indicator for intervention. Executing routine PTH testing can improve postoperative consideration, decrease emergency clinic stays, and work on tolerant security.

DOI: 10.5281/zenodo.

Background: Geriatric women in rural areas often experience a spectrum of gynecological disorders that remain underdiagnosed and undertreated due to socio-cultural barriers, lack of awareness, and limited access to healthcare facilities. These conditions significantly impact their quality of life and overall well-being. Aim: To assess the prevalence, clinical presentations, and healthcare-seeking behavior for gynecological disorders among geriatric women in rural areas. Methods: This cross-sectional study was conducted over 12 months, involving 100 women aged 60 years and above from rural communities at Bhagwan Mahavir Institute of Medical Sciences, Pawapuri, Nalanda. Data were collected through structured interviews and clinical examinations. Common gynecological disorders, including pelvic organ prolapse, urinary incontinence, genital infections, and postmenopausal bleeding, were identified. Results: The most prevalent disorders were pelvic organ prolapse (40%), followed by urinary incontinence (30%), genital infections (20%), and postmenopausal bleeding (10%). Healthcare-seeking behavior was poor, with only 25% of women consulting a healthcare provider for their symptoms. Factors such as low educational levels and cultural stigma significantly influenced healthcare utilization (p<0.05). Conclusion: Gynecological disorders are highly prevalent among geriatric women in rural areas, with low healthcare-seeking behavior exacerbating the problem. Awareness campaigns and improved access to healthcare services are critical to addressing these issues and enhancing the quality of life for this vulnerable population.

DOI: 10.5281/zenodo.

Background: The determination of ABO and Rh blood group distribution is crucial for effective transfusion services and the establishment of a reliable blood donor database. Regional variations in blood group frequencies influence blood bank management and transfusion strategies. Aim: This study aims to analyze the distribution of ABO and Rh blood groups among blood donors registered at a government hospital blood bank in Bihar, providing insights into donor demographics and blood group prevalence. Methods: A retrospective analysis was conducted on data from blood donors at a government hospital blood bank in Bihar over a one-year period. Donor details, including ABO and Rh typing, were collected and analyzed. Descriptive statistics were applied to assess the frequency and distribution of blood groups. Results: Among 2,500 blood donors analyzed, blood group O was the most prevalent (38%), followed by B (30%), A (22%), and AB (10%). Rh-positive donors constituted 94%, while Rh-negative donors accounted for 6%. Male donors predominated (80%), and the age group 18–30 years represented the largest donor category (45%). Conclusion: The study highlights the predominance of blood group O and Rh positivity among donors in Bihar, aligning with trends observed in other Indian states. These findings underscore the importance of regional data in optimizing blood bank inventories and ensuring efficient transfusion services.

DOI: 10.5281/zenodo.

Background: Chronic pelvic pain (CPP) in females is a common and debilitating condition with multifactorial etiologies, including gynecological, urological, gastrointestinal, and musculoskeletal disorders. Understanding its prevalence, underlying causes, and impact on quality of life is crucial for guiding effective diagnostic and therapeutic strategies. Aim: This prospective observational study aims to evaluate the clinical profile, etiological factors, and quality-of-life implications of chronic pelvic pain in females attending a tertiary care hospital. Methods: A prospective observational study was conducted at Department of Gynaecology and Obstetrics, Koshi Hospital, Biratnagar, Nepal from January 2020 to December 2020, enrolling 100 female patients aged 18–50 years presenting with chronic pelvic pain lasting more than six months. A structured questionnaire was used to collect demographic, clinical, and psychosocial data. Diagnostic evaluations included gynecological examinations, imaging studies, and laboratory investigations. Pain intensity and quality-of-life scores were assessed using the Visual Analog Scale (VAS) and the Short Form-36 Health Survey (SF-36), respectively. Results: Out of 100 patients, 60% had gynecological causes, including endometriosis (30%) and pelvic inflammatory disease (20%). Non-gynecological causes accounted for 40%, with irritable bowel syndrome (15%) and interstitial cystitis (10%) being the most common. Psychological factors such as anxiety and depression were observed in 50% of the cases. The mean VAS score was 7.2 ± 1.5, indicating moderate to severe pain. Quality-of-life assessments showed significant impairment, particularly in physical functioning and mental health domains. Conclusion: Chronic pelvic pain in females is a multifactorial condition significantly affecting quality of life. A multidisciplinary approach is essential for comprehensive diagnosis and management. This study emphasizes the need for early identification and targeted interventions to improve patient outcomes.

DOI: 10.5281/zenodo.

One reason for the fertilization failure for our patient could be chromosome polymorphism. As both the partners exhibited 9qh+ polymorphism. Another reason for fertilization failure could have been the failure of the activation of the oocytes due to a defective response to oscillation or related factors. We could not identify whether a sperm and/or oocyte defect exist because the couple had objections to using their gametes for fertilization with or by those of another person. Using of Calcium ionophore for oocyte activation proved to be a good method for fertilization, embryonic development as the oocytes continued to develop, and a certain proportion of high-quality embryos were obtained giving successful pregnancy. For patients whose oocytes are completely unfertilized or poorly fertilized, calcium ionophore (A23187) activation can give the patient usable embryo in that cycle reducing the patient’s financial & emotional burden and waiting time.

DOI: 10.5281/zenodo.

Introduction: Recurrent pregnancy loss (RPL) affects 1-5% of couples globally and is particularly severe in India. Investigating the serum calcium and vitamin D levels in women with RPL may reveal modifiable nutritional deficiencies and improve reproductive health outcomes. This study aimed to estimate serum calcium and vitamin D3 levels in women with recurrent pregnancy loss. Methods: This cross-sectional study included 100 pregnant women at the Institute of Obstetrics and Gynecology, Egmore, the Institute of Social Obstetrics and Government Kasturba Gandhi Hospital, Triplicane, between April 2023 and March 2024. Participants were evaluated through a questionnaire, clinical examination, and laboratory tests, including blood samples for haemoglobin, blood count, blood sugar, thyroid function, and serum Vitamin D3 and calcium levels. Anthropometric measurements and vital signs were also recorded. Results: Most participants had two abortions, and the gestational age at the time of examination ranged from 8 to 11 weeks. Serum calcium levels were predominantly in the 7-8.5 mg/dL range, whereas vitamin D3 levels varied between 10-20 ng/mL. Significant associations were found between serum calcium levels and birth maturity (p=0.008) and birth weight (p=0.03). Similarly, significant associations were observed between serum vitamin D3 levels and birth maturity (p=0.001) and birth weight (p=0.01). The mean serum calcium was 8.74±1.52 mg/dL, and the mean vitamin D3 level was 20.04±5.97 ng/mL. Conclusion: Our study highlights that low serum calcium and vitamin D levels were significantly associated with recurrent abortions, preterm births, and low birth weights. Early screening and supplementation of these nutrients can help to prevent adverse pregnancy outcomes.

DOI: 10.5281/zenodo.

In this study, we assess the effectiveness of liquid-based cytology (LBC) compared to conventional cytology in identifying cervical neoplasia in a group of 94 postmenopausal women at the Regional Institute of Medical Sciences, Imphal. The study was conducted from September 2017 to March 2019. The results showed that LBC had a higher rate of detecting severe neoplastic changes (HSIL and carcinoma) and had better sample adequacy (94% vs. 85%) compared to conventional cytology. However, there was no significant difference in the overall detection rates between the two methods. These findings indicate that LBC could be beneficial in clinical settings, especially for postmenopausal women. It may help decrease the need for additional testing and enhance diagnostic accuracy. Additional research involving larger groups of participants is advised to validate these findings and provide guidance for screening recommendations.

DOI: 10.5281/zenodo.

Background: Many differences in the structure was observed in the human body. Many variations have been documented in anatomical literature. One such structure is dorsal scapular artery originating from subclavian artery. Objective: To study the various sites of origin of dorsal scapular artery (DSA) and also relationship with brachial plexus. Methods: The Dorsal scapular artery is examined in 60 upper limbs in 30 cadavers. Results: Dorsal scapular artery is either a direct branch of Subclavain artery or branch from Thyrocervical trunk, and also from axillary artery. Results showed that Dorsal Scapular Artery originated most frequently from third part of subclavian artery in 58.3%,from Thyrocervical trunk -33.3%,from costocervical trunk in 3.3.% and also from axillary artery in 5%.In relation to the brachial plexus ,Dorsal scapular artery lie above Brachial plexus in 35%,dorsal scapular artery running below or between the trunks in 65%. Conclusion: Variations in the origin of dorsal scapular artery and its relation with brachial plexus plays an important role in clinical and surgical aspects.

DOI: 10.5281/zenodo.

Background: Cervical cancer is a leading cause of cancer-related deaths in women, with early detection through screening being crucial for prevention. This study aimed to assess cervical cancer screening practices and identify the associated factors influencing the screening behavior of women in Eastern India. Methods: A cross-sectional study was conducted over one year at PGIMER & Capital Hospital Bhubaneswar. A total of 100 women were surveyed using a structured questionnaire, gathering data on demographic characteristics, knowledge, awareness, and screening practices. The collected data were analyzed using descriptive and inferential statistics. Results: The study found that 90% of women had heard of cervical cancer, but only 60% had undergone screening, with 40% never having been screened. Financial constraints, lack of awareness, and limited healthcare access were identified as the major barriers to screening. Higher education and income were significantly associated with increased screening uptake. Conclusion: Cervical cancer screening remains underutilized in Eastern India due to socio-economic and cultural barriers. Improving awareness, making screening more accessible, and addressing financial constraints could enhance participation and reduce the burden of cervical cancer.

DOI: 10.5281/zenodo.

Background: Placenta previa, a significant obstetric complication, involves the placenta covering the cervix, with risks varying by the placental location. This study evaluates the impact of placenta previa location on pregnancy outcomes. Methods: A prospective observational study was conducted at PGIMER & Capital Hospital Bhubaneswar, involving 150 pregnant women diagnosed with placenta previa. Data on demographic information, type of previa, and outcomes were collected and analyzed over one year. Results: The study found that complete previa had the highest association with adverse outcomes, including a 58.3% rate of preterm delivery and a 96.7% cesarean section rate. Partial placenta previa, marginal, and low-lying previa also demonstrated elevated risks but to a lesser extent. Antepartum hemorrhage was notably higher in complete placenta previa at 50%. Conclusion: The location of placenta previa significantly influences pregnancy outcomes, with complete previa presenting the highest risk. These findings suggest the need for tailored management strategies to mitigate risks associated with different types of placenta previa.

DOI: 10.5281/zenodo.

Background: The present study was conducted to evaluate the effectiveness of conservative treatment, to compare the treatment outcomes and complications between conservative treatment and surgical management in patients of uncomplicated acute appendicitis. Methods: Out of 60 uncomplicated acute appendicitis patients, 30 patients underwent conservative treatment (Group A) and 30 patients underwent appendectomy (operative management). All the treated patients of uncomplicated acute appendicitis were observed for complications after treatment received, length of hospital stay and pain intensity before and after the treatment. Pain intensity was analyzed by using Wong Baker Faces pain rating scale. Complications to be looked for were perforation, abscess/phlegmon and gangrene in the conservative treatment group and surgical site infections, intra-abdominal abscess, faecal fistula and paralytic ileus in the operative management group. Results: Mean age of group A and group B cases were 30.78±11.64 and 33.12±12.84 years respectively. Mean Alvarado score of group A and group B cases were 8.54±0.87 and 8.23±0.46 respectively. Phlegmon was seen in 5(16.67%) patients of conservative treatment group and SSI was seen in 7(23.33%) patients of operative group. Mean Visual Analogue Score of pain at the time of admission (day 0) in hospital of group A and group B patients was not statistically significant (p=0.635). However on day 7, mean Visual Analogue Score of pain of group A and group B patients was highly significant (p=0.004). Mean hospital stay of conservative group and operative group patients was highly significant (p=0.0001). Hospital stay of Conservative group patients was shorter than operative group patients. Conclusion: The results of the present study suggests that in uncomplicated acute appendicitis, conservative management is associated with lesser complications, lesser severity of pain and shorter hospital stay than operative management and also prevents the morbidity of a major surgery and its associated complications. Therefore conservative treatment is a viable and safe option in the treatment of patients associated with uncomplicated acute appendicitis. However this is a single institutional study with a small sample size. Further larger randomized controlled trials are required to establish the efficacy of this approach.

DOI: 10.5281/zenodo.

Aim: Pregnancy induced hypertension is one of the most common causes of both maternal and fetal morbidity and mortality. This study Aims to determine the fetal outcome and correlation with severity of PIH. Material and Methods: 200 cases of PIH were studied and divided according to severity. The maternal and fetal outcome parameters were documented and Analyzed using statistical methods. Results: Higher the severity of PIH , more the chances of fetal complications .earlier onset of PIH was also seen more in severe cases as were the number of inductions. Conclusion: The clinical course of PIH is progressive and is characterized by continuous deterioration that is ultimately stopped only by delivery. Early detection and appropriate management of pregnancy may improve the outcome for both mother and fetus.

DOI: 10.5281/zenodo.

Aim: The present study was undertaken with the following aims and objectives: (1) To evaluate the risk factors and clinical presentation in women with imminent eclampsia and eclampsia. (2) To analyze the maternal outcome in patient with imminent eclampsia and eclampsia. Material and Methods: The present study will be carried out in the Department of Obstetrics & Gynecology of Choithram Hospital & Research Centre, Indore from October 2012 to September 2014. The study will be conducted on the antenatal and postnatal women admitted in the inpatient department of Choithram Hospital & Research Centre, Indore (M.P.). Women willing to give voluntary consent for participation in the study. Pregnant women with BP of >140/90 mm Hg with proteinuria, edema with convulsion. Pregnant women with BP of > 140 / 90 mm Hg with proteinuria, edema with signs and symptoms suggestive of imminent eclampsia i.e. characterized by visual disturbance, headache or epigastric pain and / or signs of brisk reflexes. Result: Incidence of eclampsia and imminent eclampsia Total number of Obstetric admissions 3980, Total number of eclampsia cases seen 46, Total number of imminent eclampsia cases seen 54, Incidence of eclampsia 46 / 3980 * 100, 1.15%, Incidence of imminent eclampsia 54 / 3980 * 100 1.35%. Conclusion: Eclampsia and imminent eclampsia are a major health problem in pregnant women. And it carries high morbidities and mortality. Eclampsia is more complicated than imminent eclampsia. Most common maternal complication of eclampsia and imminent eclampsia was PPH followed by HELLP syndrome, renal dysfunction, pulmonary edema, pulmonary embolism, abruption placenta, and DIC. Maternal mortality was 4.35% of eclampsia and 3.70% in imminent eclampsia women.

DOI: 10.5281/zenodo.

A year after cataract surgery, 100 diabetic patients at Patna Medical College and Hospital were examined for retinal thickness alterations. OCT showed a transitory increase in macular thickness, peaking one month postoperatively and returning to baseline by one year. Despite these oscillations, best-corrected visual acuity (BCVA) improved significantly, indicating successful surgery. Diabetic patients need careful postoperative surveillance to treat temporary macular edema and optimize visual recovery, according to the study. This study emphasizes the usefulness of OCT for monitoring retinal changes in diabetic cataract patients, suggesting more personalized postoperative therapy.

DOI: 10.5281/zenodo.

Background: Body mass index (BMI)-measured obesity is a major global health concern that is closely associated with cardiovascular risks. Atrial conduction heterogeneity is reflected by the non-invasive ECG measure P-wave dispersion (PWD), which is linked to atrial arrhythmias. Understanding the relationship between BMI and PWD is crucial for identifying at-risk individuals and preventing arrhythmic complications. Aim: To  assess how BMI affects the dispersion of electrocardiogram P-waves in healthy persons. Methods: At Darbhanga Medical College and Hospital in Laheriasarai, a cross-sectional study was carried out between June 2024 to December 2024. One hundred healthy adults were divided into three groups according to their BMI: normal weight, overweight, and obese. The difference between the highest and minimum P-wave durations was used to compute P-wave dispersion from ECG recordings. Analysis of the data was done with SPSS version 23.0. Pearson’s correlation coefficient was computed to evaluate the association between BMI and PWD, and P-wave dispersion across BMI categories was compared using a one-way ANOVA. Results: The mean P-wave dispersion was 28.5±4.2 ms in the normal weight group, 34.2±5.1 ms in the overweight group, and 39.7±6.3 ms in the obese group, showing a significant difference across BMI categories (F = 15.4, p = 0.002). A strong positive correlation was observed between BMI and PWD (r = 0.78, p < 0.001). Conclusion: Increased P-wave dispersion is linked to higher BMI, indicating a higher risk of atrial conduction anomalies and possible arrhythmias in people who are overweight or obese. These results emphasize how crucial it is to keep an eye on atrial conduction in those with high body mass indexes. Recommendations: Efforts to maintain a healthy BMI through lifestyle modifications, regular physical activity, and balanced nutrition should be prioritized to reduce arrhythmic risk. To investigate the long-term impacts of weight control on atrial conduction parameters, more research is advised.

DOI: 10.5281/zenodo.

Background: Type 2 Diabetes Mellitus, or T2DM, is a common metabolic disease that can lead to long-term issues. The pathogenesis of diabetes has been linked to serum uric acid (SUA), an emerging biomarker, because of its correlation with inflammation and oxidative stress. Understanding the correlation between SUA and glycemic control, as measured by HbA1c, may enhance diabetes management strategies. Aim: To assess the relationship between T2DM patients’ serum uric acid levels and glycemic management. Methods: 100 patients with type 2 diabetes participated in a cross-sectional observational study between March  to September of 2024. Clinical and demographic information was gathered, and fasting blood samples were examined for HbA1c and SUA levels. To evaluate the link between SUA and HbA1c, statistical analysis was conducted using SPSS version 23.0 and Pearson’s correlation coefficient. Results: The participants’ average age was 55.3 ± 8.2 years, and 58% of them were men. The average HbA1c was 8.5 ± 1.2%, and the average SUA level was 6.8 ± 1.4 mg/dL. SUA and HbA1c levels showed a somewhat positive connection (r = 0.45, p = 0.001). SUA levels were considerably greater (7.2 ± 1.3 mg/dL) in participants with uncontrolled glycemic status (HbA1c > 7%) than in those with controlled glycemia (5.8 ± 1.2 mg/dL, p = 0.002). Conclusion: In T2DM patients, the study found a strong favourable association between SUA levels and glycemic control. Poor glycemic control was linked to elevated SUA levels, indicating that it may serve as a biomarker for diabetes treatment. Recommendations: Individuals at risk of poor glycemic control may be identified early with the help of routine SUA level monitoring in T2DM patients. It is advised that future longitudinal research examine the therapeutic implications and causal link of adjusting SUA levels.

DOI: 10.5281/zenodo.

Background: Thyroid swellings are a common clinical issue, with the potential to be either benign or malignant. Fine-needle aspiration Cytology (FNAC) and histopathological examination are crucial for accurate diagnosis. Methods: A retrospective study was conducted at GMERS Medical College & Hospital, Junagadh, analyzing 450 patients from January 2018 to December 2022 who underwent FNAC and subsequent histopathological evaluation. The study assessed the concordance between FNAC results and histopathological diagnoses, examining sensitivity, specificity, and predictive values. Results: FNAC showed a high concordance rate with histopathological findings, with 92% for benign and 95% for malignant lesions. The sensitivity and specificity of FNAC were 94% and 89%, respectively. Discrepancies were noted in 8% of cases where FNAC indicated benign conditions later found to be malignant upon histopathological review. Conclusion: FNAC is a reliable, cost-effective method for the initial evaluation of thyroid swellings. While it demonstrates high diagnostic concordance with histopathological examination, the integration of molecular diagnostics and AI could potentially refine diagnostic accuracy, especially in indeterminate cases.

DOI: 10.5281/zenodo.

Background: Unstable intertrochanteric femoral fractures are a common and serious health issue in the elderly, often requiring surgical intervention to optimize outcomes and quality of life. Objective: This retrospective cohort study compares the functional outcomes and complication rates of Proximal Femoral Nail anti-rotation (PFNA) and Primary Hemiarthroplasty (PHA) in treating these fractures. Methods: The study at GMERS Medical College & Hospital, Junagadh, involved 200 65-year-olds treated between January 2018 and December 2022. Patients were evenly split between PFNA and PHA. Harris Hip Scores, 6-month and 1-year mobility scores, complications, and revision operations were examined. Results: At 6 months and 1-year post-operation, PHA outperformed PFNA in functional results. Although PHA required longer surgical times and hospital stays, fewer revision operations were performed, suggesting longer-term stability and patient satisfaction. Conclusion: Despite the extended healing time, PHA may improve functional outcomes for elderly patients with unstable intertrochanteric femoral fractures. Individual patient profiles should guide surgical procedures to maximize benefits.

DOI: 10.5281/zenodo.

Background: Intertrochanteric fractures are a common and challenging injury in the elderly. Proximal femoral nailing (PFN) is widely used, but achieving optimal varus correction remains difficult. Methods: This prospective randomised controlled trial enrolled 120 elderly intertrochanteric fracture patients in two groups: PFN plus PFCS and PFN alone. Over six months, the study analyzed alignment, Harris Hip Score functional recovery, fracture union, and complication rates. Results: The PFCS group showed significantly better outcomes in terms of alignment (4.2 ± 2.1 degrees varus) compared to the PFN alone group (9.8 ± 3.5 degrees varus), higher Harris Hip Scores (85 ± 10), higher rates of fracture union (58/60), and fewer complications (4/60). Conclusion: The use of PFCS in PFN for intertrochanteric fractures significantly improves postoperative alignment, accelerates functional recovery, and reduces complications, highlighting its potential as a standard adjunct in hip fracture management.

DOI: 10.5281/zenodo.

Background: Diabetes is one of the largest global health emergencies of this century, ranking among the 10 leading causes of mortality together with cardiovascular disease (CVD), respiratory disease, and cancer. Aims & Objectives: The aim of this study was to assess the serum lipid profile & serum liver enzymes (AST, ALT, ALP, GGT) and to find out the correlation between liver enzymes and lipid profile in type 2 diabetes mellitus patients and comparable healthy controls. Methods: This study was a cross-sectional study in which clinically diagnosed cases of Type-2 DM from Diabetes Clinic and Medical OPD, SMS Medical College and Hospital, Jaipur were taken as cases. Results: 30 cases of Type-2 Diabetes Mellitus & comparable healthy controls in age group of 40-70 years were analyzed in this study. In this study the mean age in control group was 53.27 ± 7.39 years while in cases group it was 52.47 ± 8.26 years. The mean Triglycerides for cases was 190.30 ± 27.02mg/dl & for controls 97.00 ± 29.81mg/dl, mean Total Cholesterol for cases was 225.53 ± 24.77mg/dl & for controls 153.83 ± 26.15 mg/dl, mean LDL levels for cases was 149.01 ± 25.25mg/dl & for controls 81.07 ± 28.72mg/dl, mean HDL levels for cases was 38.47 ± 5.89mg/dl & for Controls 53.37 ± 7.07mg/dl.  The mean Alkaline phosphatase level for cases was 133.93 ± 31.07U/L and for controls was 78.87 ± 23.01U/L, mean GGT level for cases was 54.13 ± 11.78U/L and for controls was 29.27 ± 7.60U/L. There was statistically significant Positive correlation between Alkaline Phosphatase, GGT and Triglycerides, Cholesterol & LDL while statistically significant Negative correlation between ALP, GGT and HDL. Conclusion: In this study, there was significant dyslipidemia &  altered Liver function tests were observed in Type-2 DM patients as compared to healthy controls. In conclusion, the routine monitoring of lipid profile and LFT among patients with T2DM is of paramount importance, early recognition and appropriate treatment of dyslipidemia and altered LFT’s can reduce impending complications.

DOI: 10.5281/zenodo.

Background: Oral myiasis is caused by flies’ larvae.Which is rare but predominantly affects patients with open malignant wounds, such as those with oral carcinoma. This condition is prevalent in warm humid climates and is exacerbated by poor oral hygiene, neglected open wound, lower socioeconomic status, immunocompromised status, addiction and psychiatric illness. Objective: To analyze the demographic, clinical and treatment characteristics of oral myiasis in patients with oral carcinoma and identify risk factors, seasonal trends and outcomes. Materials and Methodology: This retrospective observational study was conducted in the Department of Otorhinolaryngology, GMERS Medical College, Navsari from January 2020 to December 2024.Total 20 cases were enrolled for the study. Proper history-taking and general physical examination was performed. Turpentine-oil- soaked gauge piece was used as an asphyxiating agent, and all the maggots were removed mechanically with toothed forceps. Regular dressing was performed. Results: In this study, it was found that males are more prone to myiasis. People from rural areas were mainly affected and mostly from lower socioeconomic backgrounds. September to December was the period when the number of admissions of such patients was higher. Two death was reported due to systemic complications. Conclusion: Chronically open wounds were the common infestation site in all cases of oral myiasis. Therefore, this study provides clues to identify etiological risk factors and helps us manage conditions under observation. Such conditions can be prevented by creating adequate awareness about wound hygiene, proper sanitation, and a clean environment around patients.

DOI: 10.5281/zenodo.

Amphotericin B (AmB) is a powerful antifungal agent commonly used to treat invasive fungal infections. However, its oral administration is often associated with low bioavailability and significant gastrointestinal side effects. Suppositories provide an alternative delivery method, bypassing the digestive system and potentially enhancing drug absorption. This review examines the formulation of Amphotericin B suppositories incorporating gelatin, glycerin, and methanol as key components. The selection of excipients plays a vital role in ensuring effective drug release, stability, and patient adherence. Gelatin, a biocompatible polymer derived from collagen, serves as a widely used suppository base due to its availability and ease of use. Glycerin functions as a plasticizer, improving flexibility and solubility, while methanol acts as a solvent, aiding in drug dissolution and uniform distribution within the suppository matrix. Key formulation parameters, including drug concentration, the gelatin-to-glycerin ratio, and methanol content, significantly impact the suppository’s drug release profile, melting characteristics, and overall stability. Optimizing these factors is crucial for achieving the desired therapeutic effect and ensuring formulation reliability. In conclusion, developing Amphotericin B suppositories with gelatin, glycerin, and methanol offers a promising strategy to enhance drug delivery, improve patient compliance, and reduce the adverse effects associated with oral administration. Further research is needed to refine formulation parameters and facilitate clinical translation.

DOI: 10.5281/zenodo.

Background: Elderly persons frequently experience unstable intertrochanteric femoral fractures (IFF), which are challenging to manage due to their intricacy and compromised health status. Restoring mobility and alleviating issues necessitates efficient care. Contemporary surgical options encompass PFNA and primary hemiarthroplasty, each possessing advantages and disadvantages. Aim: This study seeks to compare the clinical and functional outcomes of PFNA with primary hemiarthroplasty in the treatment of unstable intertrochanteric femoral fractures in elderly patients. Methodology: 180 elderly patients with unstable IFF (AO types 31 A2 and A3) were treated for the study. People were divided into two groups: hemiarthroplasty (n=90) and PFNA (n=90). SPSS software was used to gather and analyse data on demographics, post-operative complications perioperative information and functional outcomes (Harris Hip Score). Results: The PFNA group experienced a significantly shorter operating time (79.5 ± 10.6minutes) and less intra-operative blood loss (151.3 ± 30.5mL) than the hemiarthroplasty group (113.7 ± 15.9 minutes, 281.8 ± 50.7 mL; p<0.001). They also needed fewer perioperative blood transfusions and had a shorter hospital stay (9.5 ± 2.4 days vs. 11.6 ± 2.9 days; p=0.0019). Additionally, the PFNA group had significantly better functional outcomes, as measured by the Harris Hip Score, at 3, 6, and 12 months after surgery, with a slightly higher incidence of post-operative complications, though not significant statistically. Conclusion: PFNA provides enhanced functional outcomes, reduced surgical durations, diminished intra-operative blood loss, fewer blood transfusions, and abbreviated hospitalisations for older patients with unstable intertrochanteric femoral fractures. Both treatment modalities possess advantages and should be selected based on patient circumstances and surgeon proficiency. Recommendations: Future study with a larger participant pool is recommended to validate these findings and enhance treatment suggestions. Furthermore, personalised patient evaluation should inform the selection of surgical procedures to enhance results.

DOI: 10.5281/zenodo.

Objective: To measure the prevalence of and factors that contribute to delaying treatment in emergency obstetrics in women who were pregnant. Materials and Methods: Facility-based cross-sectional research using a quantitative approach was carried out. A sample size of 500 was determined using a single population proportion formula. Data was entered using the Epi Info 3.3.2 software and then exported to SPSS version 20 for statistical analysis. If value of P is less than 0.05, a variable is considered significant statistically with a 95% confidence interval. Results: Out of the 500 women, 410 (82%) said they were having trouble determining whether to seek emergency obstetric care. 90 minutes was the average delay time, with a range of 40 minutes to 19 hours. Antenatal Care follow-up status, mother’s age, and educational attainment all significantly influenced whether a mother postponed seeking emergency obstetric care. Conclusion: When it came to the decision to receive obstetric care, husbands were crucial. This implies that women don’t have much control over their own health-related decisions. Health extension workers, district officers health centre employees, and programmers should prioritise increasing awareness, creating revenue-generating strategies, and strengthening mothers’ decision-making abilities to combat maternal delay.

DOI: 10.5281/zenodo.

Background: Distal tibial fractures, or Pilon fractures, account for around 5 to 10 percent of tibial fractures. These fractures are challenging to treat. The MIPO (Minimum Invasive Plating Osteosynthesis) approach is appropriate for fractures exhibiting minimum articular comminution and those with minor soft tissue injury. It operates on the principle of biological fixation, wherein the blood supply to the fracture pieces is optimally maintained. Aim: To assess the clinical and radiological results of individuals with distal tibia fractures management by the MIPO approach. Materials and Methods: 182 patients (122 males and 60 females, mean age 40 years) who received MIPO treatment for distal tibia fractures were incorporated in this retrospective cohort study. People with closed distal tibia fractures between the ages of 20 and 66 years were qualified for participation; those with pathological fractures, open fractures, significant soft tissue injuries, or prior same limb operations were not. Healthcare records were used to gather information about factors like complications, AOFAS scores, and union time. SPSS version 21.0 was used for statistical analysis, and p<0.05 was chosen as the significance level. Results: The mean age of the182 patients in the MIPO study for distal tibia fractures was 40 years. The average union period was 24 weeks, and 83.3% of unions were formed in less than 24 weeks. A mean AOFAS score of 83 indicated positive functional results. The most prevalent complications were plate irritation (11%) and superficial infections (13.2%). Type C fractures exhibited prolonged durations of union compared to Type A fractures, although statistical analysis revealed no discernible gender differences in complications. All things considered, MIPO turned out to be a successful therapeutic choice with tolerable side effects and a strong functional recovery. Conclusion: MIPO is a useful method for the treatment of fractures of the distal tibia that minimise soft tissue problems and offer acceptable functional results. However, to minimise the risk of complications, meticulous preoperative planning is essential. Recommendations: To confirm these results and improve the methodology, more research with bigger sample sizes and longer follow-up times is advised.

DOI: 10.5281/zenodo.

Background: A major cause of cancer-related death for women in low- and middle-income nations, such as India, is cervical cancer. Cervical cancer screening uptake is still poor in many areas, especially Eastern India, despite the availability of efficient screening techniques. Access hurdles, low awareness, and sociodemographic characteristics all contribute to this problem, which calls for a targeted research. Aim: This study intends to evaluate the cervical cancer screening habits of women in Eastern India and pinpoint the sociodemographic variables linked to these behaviours. Methodology: After being randomly chosen, 188 women between the ages of 21 and 66 were questioned using a structured questionnaire. In order to determine the factors linked to cervical cancer screening practices, data were analysed using statistical approaches, including multivariate logistic regression, chi-square tests, and descriptive statistics. Results: A study including 188 female patients revealed that 80% possessed knowledge regarding cervical cancer. Obstacles to screening comprised financial constraints, insufficient knowledge, societal shame, and limited access to medical treatments. The research identified an association between screening participation and socioeconomic position as well as educational achievement, indicating that more educational attainment is associated with increased screening rates. Conclusion: The study emphasises the inadequate cervical cancer screening rates in Eastern India attributable to financial, educational, and cultural obstacles, underscoring the necessity for focused interventions.

DOI: 10.5281/zenodo.

Background: Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide. Identifying vulnerable carotid plaques can help predict acute coronary events, making diagnostic advancements crucial. Methods: This observational study utilized contrast-enhanced ultrasound (CEUS) to evaluate carotid plaques in 100 patients with CAD, comparing symptomatic and asymptomatic individuals. CEUS was employed to assess plaque characteristics such as intraplaque neovascularization, fibrous cap thickness, and lipid core presence. Results: Significant associations were found between CEUS characteristics and symptomatic CAD. Notably, plaques with higher contrast enhancement, indicative of neovascularization and lipid-rich necrotic cores, were more common in symptomatic patients. These features correlated with a greater severity of CAD. Conclusion: CEUS is a potent tool for identifying high-risk plaques in CAD patients, offering valuable insights into the risk of acute coronary syndromes. The study supports the integration of CEUS into routine cardiovascular risk assessments to enhance early detection and management of CAD.

DOI: 10.5281/zenodo.

Background: Jaw tumors pose significant diagnostic challenges due to their varied presentations and complex locations. Dual-energy computed tomography (DECT) with contrast enhancement may provide superior diagnostic accuracy compared to conventional CT. Methods: In this prospective observational study at the Indira Gandhi Institute of Medical Sciences (IGIMS), 100 patients with diagnosed or suspected jaw tumors underwent both conventional CT and contrast-enhanced DECT over one year. Data on sensitivity, specificity, and accuracy were compared with histopathological results. Results: DECT with contrast enhancement significantly improved sensitivity (92% vs. 78%), specificity (96% vs. 82%), and accuracy (94% vs. 80%) in tumor characterization over conventional CT. It provided enhanced delineation of tumor borders, internal structures, and invasion of adjacent tissues. Conclusion: Contrast-enhanced DECT demonstrates enhanced diagnostic performance in jaw tumor characterization, suggesting its potential integration into standard diagnostic protocols for more accurate surgical planning and improved patient management.

DOI: 10.5281/zenodo.

Background: Differentiating solid pseudopapillary neoplasms (SPNs) from pancreatic ductal adenocarcinomas (PDAs) with cystic changes is challenging but crucial for appropriate management. Methods: This retrospective study analyzed CT imaging characteristics of 95 patients diagnosed with either SPN or cystic PDA at the Indira Gandhi Institute of Medical Sciences over one year. Imaging features assessed included lesion size, cystic components, and enhancement patterns. Results: Our analysis revealed that SPNs commonly affect younger females and typically present as well-defined, homogeneous lesions. In contrast, cystic PDAs occur predominantly in older males and exhibit heterogeneous enhancement patterns, associated with a more aggressive clinical course. Conclusion: The distinct CT imaging characteristics identified between SPNs and cystic PDAs can assist in their differential diagnosis, influencing both surgical planning and prognosis. These findings highlight the need for precise imaging diagnostics to improve treatment outcomes for pancreatic tumor patients. Future studies should explore the integration of advanced imaging and molecular diagnostics to further enhance diagnostic accuracy.

DOI: 10.5281/zenodo.

Meningiomas are the most common extra-axial tumours of Central Nervous System (CNS) and most commonly observed in females. They arise from the meningothelial cells of the arachnoid membrane. The clinical symptoms develop due to mass effect on brain structures. They can be diagnosed radiologically by Computed Tomography (CT) and Magnetic Resonance Imaging scans (MRI). The characteristic features include extra-axial location, hyperdense lesion, calcification, hyperostosis of overlying bony calvaria and usually show homogenous enhancement after contrast administration. The perilesional oedema is usually seen with grade II and III lesions, however can be extensive with secretory type. The MRI scan gives better soft tissue detail and is useful in grade II and III lesions for better depiction of invasion of brain parenchyma. This study presents seven cases of tumour on non-contrast CT scan with different locations of tumour with characteristics ranging from typical to complex and atypical features.

DOI: 10.5281/zenodo.