Introduction: CAUTIs are common ICU infections caused by bacterial colonization and biofilm formation on catheters, leading to increased morbidity and antimicrobial resistance. Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa are predominant pathogens. Prolonged catheterization and poor aseptic practices heighten infection risks. Early catheter removal and strict infection control are key to reducing CAUTI rates in ICU patients. Materials and Methods: This hospital-based prospective observational study was conducted in a 15-bedded Medical ICU over one year, enrolling 100 patients requiring Foley’s catheterization. Patients were followed from catheter insertion to discharge or death. Inclusion criteria included >48 hours of catheterization and clinical signs of infection, while those with pre-existing UTIs or fungal infections were excluded. Urine samples were collected aseptically and processed using standard microbiological techniques, with antibiotic susceptibility testing (AST) conducted per CLSI guidelines. Data analysis was performed using SPSS version 21.1, with statistical significance set at p<0.05. Results: In our study, 12% of catheterized patients developed CAUTI, with a rate of 8.4 per 1000 urinary catheter days. The majority of patients were 51–70 years old (36%), with a male predominance (55%). Escherichia coli was the most common pathogen (6%), followed by Enterococcus (4%) and Pseudomonas (3%). CAUTI incidence increased with catheter duration, rising from 2.86% in 1–5 days to 50% beyond 11 days. Antibiotic susceptibility testing showed high efficacy of Nitrofurantoin (100%), Imipenem (91.67%), and Colistin (91.67%) against Gram-negative bacteria, while Enterococcus exhibited 100% susceptibility to High Gentamycin and Linezolid. Conclusion: CAUTI remains a significant concern in ICU patients, with prolonged catheterization increasing infection risk. Strict infection control measures, timely catheter removal, and targeted antibiotic therapy are essential to reducing CAUTI rates and improving patient outcomes.

Fowl adenovirus (FAdV) infects chickens and leads to hepatitis, in a condition called inclusion body hepatitis (IBH), and hepatitis with accumulation of fluids in the pericardial sac of the heart in a condition known as hepatitis hydropericardium syndrome (HHS). Both conditions are associated with other pathologies in several organs in addition to these stated features. However, the fluid in pericardial sac distinguishes HHS from IBH. IBH is caused by Fowl adenoviruses group D, serotype 2-11, and group E, serotypes 8a, 8b and 11. The adenoviruses that cause HHS is of group C, serotype 4. In this study, the postmortem and pathologic findings found characteristic hepatitis and hydro pericardium of HHS. Hepatitis and hydropericardium were confirmed grossly, histologically and biochemically by testing ALT and AST in infected chickens. Deformity In the heart, renal and hepatic hemorrhages, necrosis in liver, kidney and heart muscle, and expansion of the pericardial sac, inclusion body in hepatocytes are reported in this study. The PCR, Hexone gene sequence and phylogenic tree confirmed the involvement of adenovirus group E in HHS. This finding was reported for the first time. The discovery that HHS is caused by group E will have implications for vaccine usage in the field.

Introduction: Stroke is a leading cause of disability and mortality worldwide, with a rising incidence in young adults. Stroke in young adults has significant socio-economic and health impacts. Modifiable risk factors such as hypertension, diabetes, obesity, smoking, and alcohol consumption contribute to this rise. This study aims to analyze the risk factors, clinical features, and outcomes of stroke in young adults. Materials and Methods: This cross-sectional study was conducted at a tertiary care hospital over six months, including young adults aged 18-45 years diagnosed with acute stroke. Data were collected from medical records and clinical evaluations using a semi-structured questionnaire, covering demographic details, risk factors, and clinical features. Stroke severity was assessed with the NIHSS (National Institutes of Health Stroke Scale) and functional outcomes with the MRS (Modified Rankin Scale). Results: Mean age of the patients was 37.2 ± 8.23 years with male predominance (66.3%). Modifiable risk factors such as overweight and obesity (55.0%), hypertension (38.8%), smoking (27.5%), and diabetes mellitus (26.3%) were commonly observed. The anterior circulation was the most commonly affected (70.0%). At the time of admission, 32 patients (40.0%) presented with moderate stroke (NIHSS score: 5 to 15), and 35 patients (43.8%) had moderate disability (MRS score: 3 to 4). The majority of patients survived (95.0%), with significant improvement in their NIHSS and MRS scores at discharge. Conclusion: Early intervention and lifestyle changes, including weight management, smoking cessation, and blood pressure control, are vital in preventing stroke recurrence. Regular screening for risk factors in high-risk populations and prompt, aggressive treatment can improve outcomes and reduce disability in young stroke patients.

Introduction and Background: Chronic kidney Disease (CKD) is defined as the presence of Kidney damage or a decreased level of kidney function for a period of 3 months or more. Auditory system abnormalities commonly occur in patients with Chronic Kidney Disease and End Stage Renal Disease patients undergoing hemodialysis. This Study was done to evaluate Brainstem Auditory Evoked Potentials in CKD patients, and patients undergoing hemodialysis and to document the reversibility of the BAEP changes after successful Renal Transplantation. Aims: The aim of our study was to evaluate Brainstem Auditory Evoked potentials in chronic kidney disease patients and patients on hemodialysis and in those who have undergone Renal transplantation. Methodology: The Experimental Group included 20 patients with CKD, 20 patients with CKD stage 5 undergoing hemodialysis and 20 Pateints who have undergone Renal Transplantation within one year of Diagnosis of CKD. Control Group Had 20 Healthy volunteers. Measurements included Absolute Peak Latencies I, II, III, IV & V and Inter peak Latencies I-III, III-V & I-V of the Auditory Brainstem Responses. Results: Abnormal BAEP Recordings were seen in CKD patients and hemodialysis patients in the form of Prolonged Absolute Peak Latencies and Interpeak Latencies. There was a significant improvement in the BAEP Waveforms after Renal Transplantation. Hence this study showed that neural conduction along the Auditory Pathway is delayed in patients with CKD and CKD patients who were on hemodialysis. Renal transplantation significantly improves the auditory function.

Background: Chronic Rhinosinusitis (CRS) is a common illness that reduces a patient’s quality of life. When medication is inadequate, Functional Endoscopic Sinus Surgery (FESS) can improve quality of life and symptoms of sickness both temporarily and permanently. However, 65% of patients with FESS experienced mild to severe pain on postoperative Day 1 (POD1). Although Remimazolam is a new ultrashort-acting benzodiazepine with minimal side effects and hemodynamic stability, it is rapidly becoming a sedative-anesthetic in clinical practice. Remimazolam have anti-inflammatory, immunomodulatory and analgesic properties. Aim: The current study aims to compare the effects of remimazolam and dexmedetomidine with respect to the QoR-40 score of patients who have undergone FESS. Method: GMERS Medical College in Junagadh, Gujarat, was the place to conduct a single-blind, randomized controlled clinical trial for this investigation. The university’s ethical committee accepted the study, and regular procedures were followed to ensure the research’s validity. A 1:1:1 random assignment was used to place the 120 eligible patients in Group R, Group D, or Group C.  Age between 18 and 65 years, synchronous sinonasal symptoms that have persisted for more than 12 weeks, sinusitis as shown by a sinus computerized tomography (CT) scan, physical status I or II as defined by the American Society of Anesthesiologists (ASA), and a scheduled elective FESS were the criteria used to prospectively enroll CRS subjects. Results: QoR-40 scores of Groups R (154.5, 152.0–159.0) and D (155.0, 154.8–159.3) had lower QoR-40 (median, IQR) scores overall at POD1 than Group C (139.0, 136.8–142.0) (P < 0.001). The overall QoR-40 score did not differ significantly between Groups R and D. Moreover, the emotional intelligence scores on POD1, Groups R and D had lower state, physical comfort, and pain dimensions than Group C (P < 0.005). Moreover, the maximal VAS pain score was lower in the PACU and ward in Groups R and D than in Group C (P < 0.001). The RASS score was lower upon PACU arrival in Groups R and D than in Group C (P < 0.001). Conclusion: From the analysis of study, it has been concluded that after FESS, remimazolam and dexmedetomi-dine may lower the intensity of pain and enhance the quality of recovery. Remimazolam’s efficacy and safety are on par with dexmedetomidine.

Introduction and background: The percentage of senior citizens in India has been growing at an increasing rate in recent years and the trend is likely to continue. Traumatic Brain Injury (TBI) still remains a major cause of morbidity and mortality. In developing countries like India where motorized travel is quickly growing without accompanying safety precautions and adherence to traffic rules and regulations, road traffic accidents are more frequent leading to increase in traumatic brain injuries. Elderly patients sustaining TBI have higher morbidity and mortality and prolonged recovery trajectories than younger patients. The current “One size fits all” approach to traumatic brain injury management of adult patients neglects special issues of elderly population. Aims: Aim of the study is to analyze demographic data, clinico-radiological features, co-morbid illness of elderly patients with traumatic brain injuries treated either with surgical or conservative management, to evaluate the risk factors predicting poor prognosis among elderly TBI patients, to study the outcome and mortality among elderly (65-75) and very elderly ( >75 years) age groups and to study the validation of eTBI (Elderly Traumatic Brain Injury) score in predicting mortality. Methodology: This is a prospective single center study conducted at the Institute of Neurosurgery, Madras Medical College, Chennai, Tamilnadu, India. We enrolled 200 patients of ≥ 65 years of age with Traumatic brain Injury between May 2021 and October 2021. Information about patients, demographic data, clinical and radiological features, co-morbid conditions, in-hospital course of treatment and associated complications as well as outcome was recorded. The collected data were analyzed with IBM-SPSS statistics software 23.0 Version. To find the significance in categorical data Chi-Square test was used. The probability value .05 is considered as significant level. Results: Mean age among the patients is 70.16 and maximum age enrolled in this study is 88. 144 were males and 38 were females. There were 91 patients with mild injury (50%), 68 patients with moderate injury (37.4%) and 23 patients with severe injury (12.6%). About 127 (69.8%) patients had favorable outcome and 55 (30.2%) patients had unfavorable outcome. Road traffic accidents accounted for most injuries (n=100) followed by ground level falls (n = 74) with other causes accounting for very few numbers. Most common associated comorbidity found was systemic hypertension which was seen in 34.1% followed by diabetes in 25.3%. Statistical analysis showed poor GCS score at admission, absent/effaced basal cisterns and/or presence of midline shift in CT, presence of co-morbidities like diabetes, hypertension and CAD, preinjury intake of antiplatelets or anticoagulants or beta blockers were all associated with unfavorable outcome. Lower eTBI scores were associated with unfavorable outcome. Prolonged ICU stay and prolonged mechanical ventilation both of which was found to adversely affect the clinical outcome in our study.

Introduction and Background: Sural nerve can be used for diagnostic purposes like nerve conduction velocity study and for nerve biopsy for various neuromuscular disorders. It is also widely used for electrophysiological studies. Knowledge about the course of the sural nerve and variations in its course would be hugely helpful in carrying out the aforementioned studies. This knowledge will also be helpful while performing procedures like autologous peripheral nerve grafting and nerve biopsy. Aims and Objectives: The aim of this study is to study the variations of sural nerve formation, its course in the leg and its relations with Tendo-Calcaneus, short saphenous vein and lateral malleolus for its clinical application. Methodology: This was a descriptive study done in the Institute of Anatomy, Madras Medical College, Chennai, Tamilnadu, India. The study was conducted by following the guidelines of Cunningham’s manual. This study included 50 lower limb specimens from 25 cadavers fixed in 10% formalin. Both male and female cadavers were included in the study. The data was collected by dissection method by using dissection instruments and parameters (measurements) were obtained by using measuring tape and Vernier’s calliper. Results: The mean length of leg measured from flexor crease to heel in our study was 43.96 cm. The most common type of sural nerve formation is Type-A. In males, Type-A sural nerve formation was most commonly located at lower 1/3rd of leg with 63.7% specimens (n=7) on right side. In females, Type-A sural nerve formation was most commonly located at lower 1/3rd of leg with 71.4% specimens (n=5) on right side and 75% specimens (n=6) on left side. The symmetricity of sural nerve formation between right and left lower limbs was noted in 11 male cadavers (78.6%) and 6 female cadavers (n=54.5%). Sural nerve formation was asymmetric in 3 male (21.4%) and 5 female (45.5%) cadavers. Sural nerve pierced deep fascia most commonly at lower 1/3rd of leg as noted in 50% of specimens. The mean distance between the site of sural nerve piercing deep fascia and lower border of lateral malleolus was 18.07 cm. The mean length of sural nerve measured from its formation to lateral malleolus was 31.54 cm. the mean distance between sural nerve and posterior border of lateral malleolus at its midpoint was 0.95 cm. The mean distance between the site of sural nerve crossing lateral border of Tendo-calcaneus and lower border of lateral malleolus was 4.82 cm. The mean distances noted at 5cm reference point was 0.17 cm lateral to Tendo-calcaneus. At 7cm and 10cm reference points, sural nerve was medial to lateral border of Tendo-calcaneus with mean distances -1.5cm and -3.92 cm respectively.

Background: Medication adherence and compliance are crucial for effective chronic disease management. Poor adherence can lead to disease progression, increased hospitalizations, and higher healthcare costs. This study examines the patterns and factors influencing medication adherence among chronic disease patients. Objectives: To assess medication adherence levels, identify barriers to compliance, and explore strategies to improve adherence in chronic disease patients. Methods: A cross-sectional survey was conducted with 150 chronic disease patients. Medication adherence was evaluated using a standardized questionnaire. Statistical analyses, including Chi-square tests and logistic regression, were performed to identify factors influencing adherence. Results: The study found that 62% of patients were non-adherent to their prescribed medication regimen. Key barriers included forgetfulness (32%), medication cost (27%), and side effects (21%). Patients with higher health literacy showed better adherence rates (p < 0.05). Conclusion: Medication non-adherence is prevalent among chronic disease patients, primarily due to forgetfulness, cost, and side effects. Interventions focused on patient education and cost reduction could improve adherence.

Introduction: Surgical site infections (SSIs) pose a major challenge in orthopedic surgeries in India, with infection rates varying across hospitals. High infection rates in certain settings emphasize the need for effective surveillance and infection control measures. The presence of multidrug-resistant strains further complicates treatment, making continuous monitoring and antibiotic stewardship essential. This study aimed to determine the bacteriological profile, SSI rates, antibiotic susceptibility, and associated risk factors to improve infection prevention and management strategies in orthopedic surgeries. Material and Methods: This study was conducted as an active surveillance program in a tertiary care hospital to monitor surgical site infections (SSI) in orthopedic patients. Patients were systematically assessed post-operatively, and suspected SSIs were identified based on clinical symptoms. Data collection included demographic details, surgical and anesthesia type, risk factors, and wound classification. Standard preoperative protocols, antibiotic prophylaxis, and microbiological analysis were followed for infection detection. Statistical analysis using SPSS software assessed SSI incidence and associated risk factors, with p < 0.05 considered significant. Results: Our study found an SSI incidence of 5.5% among 180 orthopedic patients, with the highest infection rate observed in patients aged 0-25 (8.82%). Staphylococcus aureus (60%), was the most frequently isolated pathogen, followed by Pseudomonas aeruginoa (30%) and Acinetobactor spp. (10%), indicating the need for targeted infection control strategies. Among surgical procedures, Plate/K-wire fixation had the highest SSI rate (9.45%), followed by implant removal (5.26%). The SSI rate was significantly associated with prolonged hospital stay (>6 days: 13.8%), emergency surgeries (66.6%), general anesthesia (25%), dirty wounds (75%), and prolonged surgical duration (>2 hours: 50%) (p < 0.0001). While diabetes (50%) showed an increased risk, their association was not statistically significant (p = 0.4003). Conclusion: Effective infection control strategies, risk assessment, and optimized surgical protocols are essential to reduce SSIs in orthopedic patients, particularly in high-risk cases such as emergency surgeries, prolonged hospital stays, and contaminated wounds.

Background: Male infertility is noted Up to 50% vitro studies revealed that, bacteria can negatively impact on sperm function. Hence the human microbe and dysbiosis have to be ruled out. Method: 65 (sixty-five) infertile adults aged between 25 to 40 years were studied. Semen samples were collected in a sterile container by masturbation after the minimum obstinate of 3 days. Semen parameters included appearance, volume, pH, viscosity, liquefaction, motility, and morphology, which were analyzed microscopically. Results: Out of 65, 55 (84.6%) were primary infertility, and 10 (15.3%) were secondary infertility. In a comparative study of semen parameters of bacteriological culture of positive and negative studies, mean volume, pH, sperm concentration, progressive motility, normal formation of sperm, had significant p-value (p<0.001). In comparison of PCR semen concentration, progressive motility morphology had a significant p-value (p<0.01). Conclusion: Present bacteriological and PCR studies will help the clinician to rule out the etiology of abnormal semen parameters and to treat efficiently such infertile male cases.

Background: Cord clamping is a crucial step in the third stage of labor, influencing both neonatal and maternal outcomes. While early cord clamping (ECC) has been the standard practice, delayed cord clamping (DCC) is gaining recognition for its potential benefits. Aim This study compares the effects of DCC and ECC on neonatal hemoglobin levels, incidence of neonatal jaundice, and maternal postpartum blood loss. Material and Methods: A prospective comparative study was conducted on 200 term deliveries, with participants randomly assigned to ECC (clamping within 30 seconds) or DCC (clamping after 2–3 minutes). Neonatal hemoglobin and bilirubin levels were measured at 24 and 48 hours post-delivery, while maternal blood loss was assessed through postpartum hemoglobin changes. Results: DCC significantly increased neonatal hemoglobin levels, reducing neonatal anemia incidence. However, neonatal bilirubin levels were slightly higher in the DCC group, leading to a moderate increase in jaundice cases requiring phototherapy. Maternal blood loss and postpartum hemorrhage rates were not significantly different between the two groups. Conclusion: DCC provides substantial benefits in neonatal iron status while posing a manageable risk of jaundice. Given its advantages, DCC should be considered a routine practice with adequate neonatal jaundice monitoring.

Introduction: Catheter-associated urinary tract infection (CAUTI) is a major healthcare-associated infection (HAI), significantly contributing to prolonged hospital stays, increased morbidity, and antimicrobial resistance. The widespread use of indwelling urinary catheters in intensive care units (ICUs) makes CAUTI a critical concern, particularly in critically ill patients. As the risk of bacteriuria increases with each day of catheter use, early removal and adherence to infection control measures are crucial in preventing CAUTI-related complications. Aim and objectives: To evaluate the incidence, risk factors, microbial profile, and antibiotic resistance patterns of catheter-associated urinary tract infections (CAUTI) in ICU patients to enhance infection control strategies and antimicrobial stewardship. Materials and Methods: This hospital-based prospective observational study was conducted in the Medical Intensive Care Unit (MICU) of a tertiary care center in Western Gujarat, enrolling 100 catheterized patients. Urine samples were collected and processed for microbial identification and antibiotic susceptibility testing. Patients were monitored for clinical symptoms of CAUTI, and relevant demographic and clinical data were recorded. Bacterial isolates were identified using standard microbiological techniques, and antibiotic susceptibility was assessed following CLSI guidelines. Statistical analysis was performed using descriptive methods and chi-square tests, with a p-value <0.05 considered statistically significant. Results: A total of 100 catheterized MICU patients were monitored for CAUTI incidence, microbial profile, and antibiotic susceptibility patterns. The majority of patients were in the 51–70 years age group (34%), followed by 11–30 years (26%), with the lowest representation in those above 70 years (18%). CAUTI cases were most frequently observed in the third week of catheterization (55%), followed by the second week (35%), with the lowest occurrence in the first week (10%). Microbial analysis identified Escherichia coli (6%) as the most common pathogen, followed by Enterococcus species (4%) and Pseudomonas species (3%), while 83% of urine cultures were sterile. Antibiotic susceptibility testing revealed high sensitivity of Imipenem (90%) and Colistin (95%) against Gram-negative bacilli, while Nitrofurantoin showed 100% efficacy. Resistance was noted with Ceftazidime (55%) and Piperacillin/Tazobactam (60%), highlighting the need for judicious antibiotic use and infection control measures. Conclusion: Our study emphasizes the significant role of prolonged catheterization in CAUTI development and highlights the importance of early catheter removal, infection control measures, and antimicrobial stewardship to reduce incidence and combat antibiotic resistance in ICU settings.

Wives of alcoholics’ coping mechanisms are an important part of negotiating the difficulties in homes where alcoholism is prevalent. These women adopt a variety of techniques to deal with the practical, psychological, emotional, and other stresses brought on by their spouse’s addiction. These people use a variety of intricate coping strategies, ranging from self-care activities and social support seeking to denial and enabling. In order to meet the needs of alcoholic spouses and provide focused interventions that aim to build resilience, encourage healthy coping mechanisms, and improve family well-being overall, it is essential to comprehend these coping habits. Researchers examined the coping mechanisms used by alcoholics’ spouses in this publication.

Background: After total hip replacement, analgesic demand is very significant due to its link to severe early postoperative pain. Enhancing rehabilitation protocols and pain management strategies has a major influence on the results of the surgery. Aims and Objectives: This study compares the duration of motor block, the time it takes for sensory block to start, the duration of sensory block to start, the adverse effects of drugs in two groups, post-operative analgesia and the amount of time it takes to take the first dose of analgesic needed during the recovery period. Methods: This is a double-blinded randomized and comparative study for which 60 patients were selected out of which 30 patients had in group BD and 30 patients had in group BF. Patients were allocated into 2 groups: group-BD (0.25% bupivacaine 15 ml and dexmedetomidine-1 ml, i.e., 50 micrograms)- 30 patients and group-BF (0.25% bupivacaine 15 ml and fentanyl-1 ml, i.e., 50 micrograms)-30 patients and compared. Results: There was a statistically significant difference (p<0.0001) in the mean length of sensory block, motor block, and mean time commencement of sensory block between the two groups. Conclusion: The study concludes that dexmedetomidine, when used as an adjuvant to epidural bupivacaine, exhibits a quick start of sensory block, a shorter time to reach maximal sensory level, a longer duration of analgesia, and a longer duration of motor blockade than fentanyl.

Background: Vitamin B12 deficiency is increasingly being recognized as a common concern in patients with type 2 diabetes mellitus (T2DM). Vitamin B12 plays a critical role in red blood cell formation, neurological function, and DNA synthesis. Aim: This review focuses on the prevalence of vitamin B12 deficiency in newly diagnosed T2DM patients, exploring potential mechanisms, clinical implications, and recommendations for screening and treatment. Method: Patients in OPD with new onset diabetes mellitus type 2 who were between age group of 18-50 years with no history of any OHA uptake or any other risk factor to cause vit B 12 deficiency were taken into study Result: 64(32%) patients of newly diagnosed type 2 diabetes were found to be vit B12 deficient, 87(43.5%) patients range in border line category and in 49(24.5) patients vit b12 levels are in normal limit. Conclusion: Vitamin B12 deficiency is prevalent among newly diagnosed T2DM patients. Due to the overlap of clinical symptoms between B12 deficiency and diabetic complications such as neuropathy, it is crucial for healthcare providers to consider B12 deficiency in their diagnostic workup.

In the Asia-Pacific region, scrub typhus is a major public health concern. It makes one million people sick every year and poses a hazard to one billion people worldwide. Scrub typhus is caused by Orientia tsutsugamushi and, if left untreated, can cause severe multiorgan failure with a 75-80% case fatality rate. O. tsutsugamushi’s antigenic heterogeneity permits reinfection and prevents generic immunity. Scrub typhus is a neglected disease, and the little epidemiologic data and other relevant public health information on the disease in its endemic areas show that we still don’t fully understand it. We studied the infection’s clinical characteristics in 90 individuals who visited this tertiary care facility over a 16-month period. The ELISA’s seropositivity rate was 11.11%, whereas the rapid test analysis revealed a rate of 22.22%. Scrub typhus was found to be substantially correlated with both eschar and animal exposure in this study. The PROGEN OXK antigen suspension (Weil-Felix) and the InBios scrub typhus IgM ELISA kit showed a significant difference in scrub typhus diagnosis (p<0.05). The results of the quick agglutination test showed that the sensitivity, specificity, positive predictive value, and negative predictive value were 60.0%, 82.5%, 30.0%, and 94.28%, respectively. Reducing morbidity and death from this condition will be greatly aided by raising awareness of it and managing it promptly.

Lower urinary tract symptoms (LUTS) are a common complaint among women, and their prevalence increases with age. This study aimed to evaluate the urodynamic parameters of 150 female patients presenting with LUTS, considering age-related bladder dynamic changes. Our results show that the urodynamic parameters varied significantly across different age groups, with older women exhibiting decreased bladder capacity, increased detrusor pressure, and reduced flow rates. These findings highlight the importance of considering age-related bladder dynamic changes in the diagnosis and management of LUTS in women.

Background: The common cold is one of the most frequent illnesses affecting school-aged children, leading to significant school absenteeism and healthcare burden. While symptomatic treatments are commonly used, there has been growing interest in the potential role of zinc supplementation in reducing the severity and duration of the common cold. Zinc plays a crucial role in immune function, modulating inflammatory responses, and inhibiting viral replication. However, existing literature on its efficacy in pediatric populations remains inconclusive. Objectives: This study aims to evaluate the role of zinc supplementation in reducing the severity, duration, and recurrence of the common cold in school-aged children. The study also seeks to determine whether zinc administration at the onset of symptoms provides measurable benefits in mitigating cold-related morbidity. Methods: A prospective study was conducted at Department of Pediatrics, Darbhanga Medical College and Hospital, Laheriasarai, Darbhanga, Bihar, India, involving 120 school-aged children (6–12 years) presenting with symptoms of the common cold. Participants were randomly assigned to two groups: the zinc supplementation group, which received 15 mg of zinc sulfate daily for seven days, and the control group, which received a placebo. The primary outcomes measured included the duration of cold symptoms (cough, nasal congestion, and fever), the severity of symptoms using a standardized symptom severity score, and the recurrence rate within the subsequent three months. Statistical analyses were conducted to assess the differences between groups. Results: Children receiving zinc supplementation showed a statistically significant reduction in the duration of symptoms compared to the control group. The mean duration of symptoms was 4.2 days in the zinc group compared to 6.1 days in the control group (p < 0.001). The severity scores were also significantly lower in the zinc group after three days of treatment (p = 0.02). Additionally, the recurrence of cold episodes within three months was lower in the zinc group (15% vs. 30%, p = 0.04), suggesting a possible protective effect of zinc supplementation against future infections. Conclusion: Zinc supplementation significantly reduces the duration and severity of the common cold in school-aged children and may contribute to reducing recurrence rates. These findings support the potential inclusion of zinc in therapeutic and preventive strategies for managing common cold symptoms in pediatric populations. However, further large-scale studies are recommended to validate these findings and determine optimal dosing strategies.

Background: Low birth weight (LBW), defined as a weight of less than 2500 grams at birth, poses a substantial risk for infant mortality and morbidity, as well as long-term adverse health outcomes. Early identification and subsequent management of LBW are critical, especially in developing countries where resources are limited and healthcare challenges are significant. Traditional methods for identifying LBW babies can be impractical in scenarios lacking immediate and precise weighing mechanisms. This study proposes the use of mid-arm circumference (MAC) and chest circumference (CC) as potentially reliable indicators for early detection of LBW infants, which could be particularly useful in resource-constrained environments. Objectives: The primary aim of this research is to explore the efficacy of MAC and CC measurements taken within the first 24 hours of life as predictive tools for determining LBW in neonates. This study seeks to establish statistically significant correlations between these anthropometric measurements and actual birth weights, thereby providing a basis for developing a simple, rapid, and cost-effective screening tool to identify LBW babies soon after birth. Methods: This prospective cohort study was conducted at Department of Darbhanga Medical College and Hospital for six months  involved a sample of 120 neonates born , MAC and CC were measured for each newborn within 24 hours of delivery using standardized anthropometric techniques and equipment. Birth weight was recorded using a calibrated neonatal weighing scale. The study utilized multiple linear regression models to analyze the relationship between the circumferences and birth weight, adjusting for confounders such as gestational age, sex of the newborn, and maternal health factors. Results: It is anticipated that the study will demonstrate a strong positive correlation between the measurements of MAC and CC and the neonatal weight, with higher circumferences being indicative of higher birth weights. The regression analysis will help refine the predictive model by quantifying the strength of the association and adjusting for possible confounders. This will include calculating sensitivity, specificity, positive predictive value, and negative predictive value of MAC and CC measurements in predicting LBW. Conclusion: Should the correlations be statistically significant and strong, MAC and CC could be validated as practical, non-invasive screening tools for early detection of LBW in neonates. This would be especially beneficial in settings where traditional weighing scales are unavailable or impractical to use immediately after birth. Implementing such a screening tool could lead to quicker and more efficient neonatal care interventions, ultimately improving survival rates and health outcomes for LBW infants.

Background: Neonatal sepsis is a major cause of morbidity and mortality, particularly among preterm and low birth weight infants in developing countries like India. The condition is difficult to diagnose early due to nonspecific clinical manifestations, leading to delayed treatment and poor outcomes. Early and reliable laboratory markers are critical for timely diagnosis and intervention. Aim: This study aims to evaluate the diagnostic utility of various hematological parameters in neonatal sepsis and assess their correlation with blood culture positivity. Methodology: A prospective study was conducted in the Department of Pathology and Pediatrics, GMCH, Purnia, Bihar, India for one year. A total of 90 neonates aged 0–28 days with suspected sepsis were included. Blood samples were collected and analyzed for complete blood count (CBC), differential count, C-reactive protein (CRP), micro erythrocyte sedimentation rate (ESR), and morphological changes in neutrophils. Blood culture was performed to confirm^’ bacterial sepsis. Sensitivity and specificity of individual and combined hematological parameters were statistically analyzed using SPSS version 27. Results: Among 18 culture-positive cases, significant markers included an elevated immature-to-mature neutrophil ratio (94.44%), increased CRP levels (94.44%), and thrombocytopenia (88.89%). Elevated CRP exhibited the highest sensitivity (95.2%) but low specificity (14.3%), while combining multiple positive markers yielded the best diagnostic performance (sensitivity: 96.1%, specificity: 84.2%). Conclusion: Hematological parameters, particularly the combination of multiple markers, can serve as reliable screening tools for early neonatal sepsis diagnosis. Their prompt use can improve neonatal outcomes by facilitating early intervention.

Background: Lymphadenopathy, which is defined as the swelling of lymph nodes, is a frequent clinical presentation with a wide differential diagnosis that includes both cancers and benign reactive processes. Fine needle aspiration cytology (FNAC) is a less invasive, economical diagnostic method for assessing lymphadenopathy, facilitating the identification of various causes. Objective: The objective of this study was to evaluate the cytomorphological spectrum of enlarged lymph nodes in patients at a tertiary healthcare facility, emphasizing the incidence of neoplastic and non-neoplastic lesions and their distribution across various age groups and genders. Methodology: A cross-sectional research was performed in the Department of Pathology at Darbhanga Medical College and Hospital, Bihar, India. Seventy-four individuals exhibiting lymphadenopathy received fine needle aspiration cytology (FNAC). Aspirates were processed and stained with conventional cytological methodologies, including Hematoxylin & Eosin, Papanicolaou, Giemsa, and Ziehl-Neelsen stains. Cytological diagnosis were classified into non-neoplastic and neoplastic lesions, with additional sub classification as warranted. Results: The largest prevalence of lymphadenopathy occurred in the 21–30 years age range (20.3%), with a male preponderance (56.8%). The cervical region was the most often impacted area (54.1%). Non-neoplastic lesions comprised 70.2% of cases, with reactive lymphoid hyperplasia (32.4%) and tuberculous lymphadenitis (27.0%) as the most prevalent. Neoplastic lesions constituted 29.8% of patients, with metastatic carcinoma (13.5%) being the most prevalent, followed by Non-Hodgkin’s lymphoma (6.7%) and Hodgkin’s lymphoma (5.4%). Conclusion: FNAC serves as an efficient preliminary diagnostic tool for assessing lymphadenopathy, offering significant insights into the underlying disease. The research indicates an increased occurrence of non-neoplastic diseases, including reactive hyperplasia and TB, among the examined group. The prevalence of metastatic carcinoma highlights the necessity of evaluating secondary malignancies in differential diagnosis, particularly in elderly individuals.

Introduction: Diabetes has emerged as one of the fastest growing global health emergencies of the 21st century. The real burden of diabetes is due to its micro and macrovascular complication which lead to increased morbidity and mortality. Judicious use of antidiabetic drugs by adhering to guidelines will decrease the complication and cost of drug therapy. Aims and Objectives: The objective of this study was to evaluate drug utilization pattern of antihyperglycemic agents in Type 2 diabetes mellitus (T2DM). Materials and Method: A single centric cross sectional prospective observational study was conducted over a period of 6 months (May 2017 to October 2017) in the diabetic clinic of Assam Medical College and Hospital (AMCH), Dibrugarh, Assam. The data were analyzed using descriptive statistics. Continuous data were expressed as mean percentage and nominal data were expressed as frequency and percentages. Results: In this study a total of 207 prescriptions were analyzed and was observed that Metformin was the most common drug prescribed both as monotherapy (53.7%) and in combination with Gliclazide (50%). Amlodipine (16.9%) was the most common non-diabetic drug prescribed in our patients. Average number of drugs per prescription was 4.06, while average number of antihyperglycemic agents per prescription was 1.92. Average cost of antihyperglycemic agents per prescription was under Rs 100/month (55.5 %) with 42.45 % of drugs prescribed as generic drugs. Conclusion: Metformin being the most commonly prescribed antihyperglycemic drug in T2DM should be available in sufficient quantities in health care system. Polytherapy is given adequately for the various macro and microvascular complications due to long standing diabetes mellitus. Generic drugs should be used to reduce the cost of treatment.

Background: Hemiarthroplasty is a widely performed surgical intervention for displaced femoral neck fractures, particularly in elderly patients with osteoporosis and functional limitations. The choice between cemented and uncemented prostheses remains a subject of debate, as both approaches have unique advantages and risks. Cemented hemiarthroplasty provides superior initial fixation, better pain relief, and lower implant subsidence, while uncemented implants reduce operative time and avoid cement-related complications such as bone cement implantation syndrome (BCIS). This study compares the clinical, functional, and radiological outcomes of cemented versus uncemented hemiarthroplasty in elderly patients with displaced femoral neck fractures. Objectives: To compare functional outcomes, intraoperative and postoperative complications, and implant stability between cemented and uncemented hemiarthroplasty in elderly patients with displaced femoral neck fractures. Secondary objectives include evaluating surgical time, intraoperative blood loss, early postoperative mobility, and long-term prosthesis survivorship. Methods: This prospective comparative study was conducted at the Department of Orthopaedics, K S Hegde Medical Academy, Nitte University, Mangalore, India. A total of 120 patients (≥60 years) with displaced femoral neck fractures were enrolled, with 60 patients undergoing cemented hemiarthroplasty and 60 receiving uncemented hemiarthroplasty. Clinical outcomes were assessed over a 12-month follow-up period using the Harris Hip Score (HHS) and Visual Analog Scale (VAS) for pain at 6 weeks, 3 months, 6 months, and 12 months. Radiological evaluations assessed implant positioning, periprosthetic fractures, and aseptic loosening. Surgical parameters, including operative time, intraoperative blood loss, hospital stay duration, and postoperative complications, were documented. Results: The cemented hemiarthroplasty group exhibited better early functional recovery, with higher HHS scores at 6 weeks (82.5 ± 4.3 vs. 75.8 ± 5.1, p = 0.002) and 3 months (85.7 ± 3.8 vs. 79.1 ± 4.5, p = 0.001). The VAS pain scores were also lower in the cemented group at 6 weeks (3.2 ± 1.1 vs. 4.7 ± 1.3, p = 0.004). However, the cemented group had a longer operative time (74.6 ± 10.3 min vs. 62.1 ± 9.8 min, p = 0.001) and higher intraoperative blood loss (325.4 ± 58.2 mL vs. 210.3 ± 49.5 mL, p = 0.002) compared to the uncemented group. The uncemented hemiarthroplasty group showed higher rates of early periprosthetic fractures (10% vs. 3.3%, p = 0.03) and initial postoperative instability (15% vs. 6.7%, p = 0.04). In contrast, the cemented group had a slightly increased incidence of thromboembolic events (8.3% vs. 3.3%, p = 0.08, not statistically significant). Long-term implant survival and complication rates at 12 months were comparable, with no significant difference in aseptic loosening (cemented: 3.3% vs. uncemented: 5%, p = 0.62). Conclusion: Cemented hemiarthroplasty provides better early functional outcomes, superior pain relief, and enhanced implant stability, making it the preferred option in elderly patients with osteoporotic bone. However, it is associated with longer operative time and increased intraoperative blood loss. Uncemented hemiarthroplasty, while reducing cement-related complications and operative time, carries a higher risk of periprosthetic fractures and early postoperative instability, especially in patients with poor bone quality. The decision between cemented and uncemented prostheses should be individualized, considering bone quality, patient comorbidities, rehabilitation potential, and surgeon expertise, to optimize functional outcomes and minimize complications.

Background: Urbanization, lifestyle, and stress have led to an increase in hypertension, a risk factor for cardiovascular disease, among young adults. The determinants analysis and prevalence of hypertension among adults aged 20–40 years in urban Gujarat is as follows. Objective: To assess the prevalence and risk factors of hypertension among adults aged 20–40 years in urban Gujarat to enable early intervention and prevention. Methods: Cross-sectional study was conducted among 440 participants of urban field practice area. Information was collected by semi-structured questionnaire, anthropometric parameters, and blood pressure. JNC 8 guidelines were applied for categorization of the hypertension status, and statistical analysis was employed to determine the relationship between sociodemographic parameters and hypertension. Results: Prevalence of Stage 1 and Stage 2 hypertension was 17.9%, and another 51.6% was pre-hypertensive. The significant risk factors were advancing age (30–40 years: OR = 2.5, 95% CI: 1.66 – 4.25), chewing of tobacco (OR = 4.7, 95% CI: 2.62 – 7.59), stress (OR = 3.1, 95% CI: 1.77 – 4.91), and obesity (OR = 3.5, 95% CI: 1.49 – 7.11). The family history of hypertension was highly significant (P < 0.001). Conclusion: Pre-hypertension and hypertension are common in young urban adults, and this calls for early intervention and screening. Lifestyle modification, stress reduction, and public health education programs are required to avert the rising burden of hypertension and minimize long-term cardiovascular risk.

Background: The increasing prevalence of type 2 diabetes mellitus (T2DM) poses a significant public health challenge worldwide, with India being recognized as the diabetes capital of the world. Hyperuricemia, a condition characterized by elevated serum uric acid (SUA) levels, has been implicated as a potential risk factor for T2DM. However, conflicting evidence exists regarding the association between SUA levels and diabetes. This study aims to evaluate the relationship between SUA levels and the duration of T2DM.  Aim: To assess the association between serum uric acid levels and the risk of developing type 2 diabetes mellitus, while considering the duration of the disease. Methodology: A prospective study was conducted over six months at Anugrah Narayan Magadh Medical College, Gaya, Bihar, India. A total of 80 patients with T2DM were randomly selected from the medicine outpatient department. Inclusion criteria included patients above 40 years of age with T2DM, while individuals with cardiovascular, metabolic, or endocrine disorders were excluded. Blood samples were collected after an 8-hour fasting period, and SUA levels were estimated using the Uricase-peroxidase method. Statistical analysis was performed using SPSS version 27, with a p-value of <0.05^’ considered significant. Results: The study revealed a significant association between SUA levels also diabetes duration (<5 years: p=0.02; >10 years: p=0.01). Gender differences in SUA levels were also noted, with males having higher SUA levels than females (p=0.03). Patients with normal BMI exhibited significant variations in SUA levels (p=0.04), while hypertensive individuals were excluded from analysis. Conclusion: The study findings suggest a potential role of hyperuricemia in the pathophysiology of T2DM. Elevated SUA levels may serve as an independent biochemical marker for diabetes risk. Further large-scale studies are necessary to establish a definitive causal relationship.

Background: Laryngoscopy and tracheal intubation induce significant hemodynamic changes, which can be detrimental in patients with cardiovascular or neurological conditions. Various pharmacological agents, includ-ing fentanyl and dexmedetomidine, have been used to mitigate this response. However, limited studies have compared their efficacy when administered via nebulization. Aim: This study aims to evaluate and compare the effectiveness of fentanyl and dexmedetomidine nebulization in attenuating the hemodynamic stress response to laryngoscopy and intubation. Methodology: A prospective study was conducted at the Department of Anesthesia, Bhagwan Mahavir Institute of Medical Sciences, Pawapuri, Bihar, India, from October 2023 to October 2024. A total of 85 patients, aged 18–60 years, classified as ASA I and II, were randomized into two groups. Group A received fentanyl nebuliza-tion (2 µg/kg), while Group B received dexmedetomidine nebulization (1 µg/kg) before induction. Hemody-namic parameters, including heart rate (HR) and mean arterial pressure (MAP), were recorded at various time points. Statistical analysis was performed using SPSS version 27. Results: Group B exhibited a significantly lower HR at 1, 5, and 10 minutes post-intubation (p < 0.0001). MAP reduction was more pronounced in Group B at 10 minutes (p < 0.0001). Propofol consumption was sig-nificantly lower in Group B (p < 0.0001). Conclusion: Dexmedetomidine nebulization demonstrated superior efficacy in blunting hemodynamic responses to laryngoscopy’ and intubation while reducing anesthetic requirements, suggesting a potential advantage over fentanyl nebulization.

Background: Acute pancreatitis (AP) is a common gastrointestinal emergency with significant morbidity and mortality. Local complications, including pancreatic “fluid collections (PFC), necrosis, and vascular issues, often require surgical intervention. This study evaluates the surgical management of local complications of AP and associated outcomes. Methods: A retrospective study was conducted at  Department of General Surgery, AIIMS, Patna, India, involving 80 patients who underwent surgical procedures for local complications of AP between 2021 and 2024. Patients were selected using purposive sampling. Clinical, laboratory, and imaging data were collected, and surgical outcomes were assessed using the Clavien-Dindo classification. Data were analyzed using SPSS version 27. Results: Of the 80 patients, 52.5% were male and 47.5% were female. The leading cause of AP was ethanol consumption (52.5%), followed by biliary causes (42.5%). Pseudocyst (40%) and acute necrotic collection (33.75%) were the most common complications. The body and tail of the pancreas were more frequently involved (67.5%) than the head (32.5%). Video-assisted retroperitoneal drainage (VARD) and open cysto-enterostomy were the most common procedures (17.5% each). Postoperative complications included surgical site infection (10%), hospital-acquired pneumonia (7.5%), and re-exploration (3.75%). Conclusion: Ethanol and biliary causes were the primary etiologies of AP. Minimally invasive procedures, including VARD, were associated with favorable outcomes and low complication rates. Early diagnosis and a multidisciplinary approach are essential for optimizing clinical outcomes.

Background: Chronic pelvic pain (CPP) is a prevalent and multifactorial condition affecting women of all ages, significantly impairing quality of life and placing a substantial burden on healthcare systems. The diagnostic complexity of CPP arises from its diverse etiologies spanning gynecological, urological, gastrointestinal, musculoskeletal, and psychosocial domains. This prospective observational study aimed to comprehensively assess CPP in both reproductive-aged and postmenopausal women, emphasizing clinical characteristics, diagnostic pathways, and associated factors. Methods: The study was conducted at the Department of Obstetrics and Gynaecology, Netaji Subhas Medical College and Hospital, Bihar. Ninety women aged 18 to 70 years presenting with CPP were enrolled after informed consent. Data collection included detailed history, physical examination, imaging studies, and laboratory investigations. The causes of CPP were classified into gynecological, gastrointestinal, musculoskeletal, and psychosocial categories. Statistical analysis was performed using SPSS version 20. Results: The majority (36.7%) of participants were aged 31-40 years, and 53.3% belonged to lower socioeconomic status. Gynecological causes predominated (62.3%), with chronic pelvic inflammatory disease (25.6%), endometriosis (21.1%), and adenomyosis (15.6%) being common. Associated symptoms such as dysmenorrhea (63.3%) and abnormal vaginal discharge (40%) were frequent. In postmenopausal women, urogenital atrophy and pelvic organ prolapse emerged as prominent contributors. Conclusion: CPP in women requires a holistic diagnostic approach integrating physical, psychological, and social factors. Differences in underlying causes between reproductive-aged and postmenopausal women highlight the need for age-specific diagnostic and therapeutic strategies to improve patient outcomes.

Background: Ovarian lesions encompass a wide spectrum of non-neoplastic and neoplastic conditions. As ova-ries are a common site for both benign and malignant tumors, histopathological evaluation plays a vital role in diagnosis, management, and prognosis. Aim: This study aims to analyze the histopathological spectrum of ovarian lesions in a tertiary care center, fo-cusing on their distribution and frequency across age groups. Methods: A retrospective study was conducted in the Department of Pathology, Netaji Subhas medical College and Hospital, Amhara, Bihta, Patna, Bihar. A total of 94 ovarian specimens with Histo-pathologically proven lesions were included. Data were collected, reviewed, and analyzed for clinical and histopathological correlation using SPSS version 27.0. Results: Non-neoplastic lesions were the most common (68.1%), particularly in younger women. Benign tu-mors (13.8%) peaked in the 41-50 years age group, while malignant tumors (7.4%) were most frequent in wom-en aged 61-70 years. Surface epithelial tumors dominated the neoplastic lesions, with serous tumors being the most common (59.2%). Among germ cell tumors, mature teratomas accounted for 80%, whereas immature tera-tomas contributed 20%. Conclusion: The study highlights the predominance of non-neoplastic ovarian lesions in reproductive-age women and the increasing incidence of malignancy in older women. Surface epithelial tumors, especially serous tumors, are the most frequent neoplastic lesions. Histopathological examination remains the cornerstone for accurate diagnosis and management. The findings emphasize the importance of early detection and screening programs, particularly for postmenopausal women, to improve patient outcomes.

Introduction & Objectives: India has experienced a notable rise in its elderly population since 1991. With advancing age, individuals face heightened risks of developing various skin disorders, including cancers. Despite global focus on geriatric healthcare, there remains a lack of comprehensive statistical studies on skin diseases in India. Methods: We conducted a study involving 181 consecutive patients, aged 60 years and above who visited the Dermatology outpatient Department. Each patient provided informed written consent before data collection. A detailed medical history was obtained, followed by thorough cutaneous and systemic examinations. Investigations were carried out wherever necessary, and statistical analysis was performed using the Chi-square test. Result: Out of the 181 patients, 119 (65.7%) were male and 62 (34.3%) were female, resulting in a male-to-female ratio of 2:1. The most frequently reported complaint among the patients was pruritus, which affected 68.5% of them. Fungal infections were noted in 60 patients (33.1%), followed by eczematous disorders in 35 patients (19.3%). Diabetes mellitus was diagnosed in 105 patients (58%). The most common age-related changes observed were wrinkling (100%) and graying of hair (100%). The prevalence of malignancy was 1%. Alopecia affected 76.2% of the patients. About 20.99% of patients had nail involvement. Conclusion: The majority of elderly individuals seeking dermatological advice are males in the 60-69 year age group. Dermatoses in this demographic can be either age-related changes or pathological conditions. Given the unique needs of this population, a comprehensive examination is crucial to identify potential indicators of skin or systemic diseases. Prompt recognition and management of senile dermatoses play a pivotal role in enhancing the longevity and quality of life among the geriatric population.

Introduction: Because to advancements in therapy and early identification, the number of cancer survivors has climbed in tandem with the rise in the disease’s prevalence over the past ten years. Despite these developments, one of the most dreaded and unwanted side effects of chemotherapy are cancer therapy-related heart dysfunction (CTRCD), which affects about 10% of patients. Aims: To compare between Two Dimensional Transthoracic Echocardiography and Two Dimensional Speckle Tracking Echocardiography in early detection of cardiotoxicity in patients receiving cardiotoxic chemotherapy for breast cancer. Materials & Methods: This study is a prospective, observational study for a period of 18 months (1st November 2022 to 31st April 2024) from Department of Cardiology (OPD, IPD, Echocardiography room) and Department of Radiotherapy (OPD and IPD) in NRS Medical College, Kolkata. Result: In our study, 8 (14.3%) patients had hypertension. The value of z is 7.5593. The value of p is < 0.00001. The result is significant at p < 0.05. In our study, 4 (7.1%) patients had Diabetes mellitus. The value of z is 9.0711. The value of p is < 0.00001. The result is significant at p < 0.05. In our study, 4 (7.1%) patients had dyslipidemia. The value of z is 9.0711. The value of p is < 0.00001. Conclusion: We concluded that evaluating patients receiving chemotherapy for cancer, 2D speckle tracking echocardiography can evaluate the global longitudinal strain in the left ventricle. When it comes to detecting patients with CTRCD, LVGLS is more sensitive and effective than 2D-LVEF.

Aim: This study aims to estimate the prevalence of anaemia among pregnant women in Purnea, Bihar, and to identify the demographic and clinical variables affecting this condition. Methodology: This observational study was carried out at the Department of Obstetrics and Gynaecology at Government Medical College and Hospital, Purnea, Bihar, India  from October 2023 to September 2024 including 74 pregnant women aged 18 to 35 years. Employing a convenience sampling approach, haemoglobin levels among the chosen samples were classified to determine the degree of anaemia. The chi-square test for statistical significance was conducted using SPSS version 27 software. Results: Upon evaluation, 74.3% of patients were identified as anaemic, with 33.8% classed as mild, 27% as moderate, and 13.5% as severe. The prevalence rates among the 18-25 age range have risen. In comparison to primigravida, multigravida saw a greater impact, indicating that this group need highly targeted medications. Conclusion: This study highlights the high prevalence of anemia in pregnant women, particularly first-time mothers, emphasizing the need for targeted nutritional support, regular screening, and improved prenatal care. Addressing dietary deficiencies and enhancing healthcare access are crucial to improving maternal and fetal outcomes while mitigating anemia-related risks.

Background: Vitamin D insufficiency is a widespread global nutritional problem, particularly prevalent among youngsters.  In addition to its established function in preserving bone health, vitamin D plays a vital role in regulating the immune system.  Vitamin D deficiency has been associated with heightened vulnerability to recurrent respiratory tract infections during childhood.  Suboptimal nutritional status, encompassing shortages in critical nutrients like zinc, iron, and vitamin A, may contribute to increased vulnerability to infections. Objective: The purpose of this study is to assess the correlation between the prevalence of RRTI among children aged 1–5 years, the status of vitamin D, and the overall nutritional status. Methodology: A non-randomized, prospective, two-group design study was conducted in the Department of Pediatrics at Kurji Holy Family Hospital in Patna, India.  A total of 64 youngsters were examined, comprising 32 cases and 32 controls.  Serum 25-hydroxyvitamin D was evaluated using the Radioimmunoassay (RIA) technique.  Statistical techniques were employed for the comparison between cases and controls. Results: 84.4% of the children with vitamin D deficiency (<20 ng/mL) were categorized in the RRTI group, while 34.4% were in the non-RRTI group (p < 0.001).  The vitamin D concentration in the RRTI group was markedly reduced (40.5 nmol/L) compared to the non-RRTI group (66.8 nmol/L).  Exposure to sunlight and exclusive breastfeeding correlated with improved vitamin D levels and a reduced incidence of recurrent respiratory tract infections (RRTI). Conclusion: Early in childhood, vitamin D deficiency is closely linked to an increased risk of RRTI.  Optimal vitamin D levels through a balanced diet, supplementation, or solar exposure will reduce the incidence of infections.

Background: The performance of second-trimester abortion presents significant clinical challenges in patients with a prior history of caesarean sections.  The combination of Foley catheter and mifepristone demonstrates synergistic effects in facilitating cervical ripening.  Data regarding the effectiveness of their combination may be crucial for optimizing termination practices. Objective: The purpose of this study was to evaluate the efficacy of Mifepristone in conjunction with Foley’s catheter and Foley’s catheter alone for second-trimester abortion in women who have undergone previous caesarean sections. Methodology: A randomised controlled trial (RCT) was conducted at the Department of Obstetrics and Gynaecology, Patna Medical College and Hospital, India.  In this study, 84 singleton pregnant women requiring termination of pregnancy between 14 and 28 weeks, with a history of one or two prior caesarean operations, were randomised into two groups: the experimental group receiving Mifepristone in conjunction with a Foley’s catheter, and the control group receiving a Foley’s catheter alone.  Data analysis utilized SPSS version 26.0, with statistical significance defined as p < 0.05. Result: The experimental group had a higher successful abortion rate (83.3% vs. 61.9%, p=0.031) and a lower induction failure rate (7.1% vs. 19.0%, p=0.031) than the control group.  The experimental group exhibited a significantly shorter mean induction-to-abortion interval (53.2 ± 15.1 hours) in comparison to the control group (63.5 ± 16.8 hours, p=0.027).  The complication rates of retained placenta and excessive haemorrhage were similar in both groups. Conclusion: The combination of Mifepristone and Foley’s catheter markedly enhances success rates and decreases the induction-abortion interval compared to the use of Foley’s catheter alone.  This method is a safe and effective approach for second-trimester abortion in women with a history of caesarean sections.

Background: Glycometabolic alterations in coronary artery disease (CAD) patients have been linked to increased mortality and complications in acute coronary syndrome (ACS). Glycosylated hemoglobin (HbA1c) is recognized as a marker of long-term glucose regulation and a potential predictor of cardiovascular outcomes. However, its prognostic significance in CAD remains unclear. Aim: This study aims to assess the relationship between HbA1c levels and clinical outcomes in ACS patients. Methodology: A hospital-based observational study was conducted in the Department of General Medicine, ESICMCH, Bihta, Patna, Bihar, India, involving 80 ACS patients admitted to the Coronary Care Unit (CCU). Patients were categorized into two groups based on HbA1c levels: normal (<5.6%) and high-normal (5.7%-6.4%). Clinical parameters, including BMI, lipid profile, left ventricular ejection fraction (LVEF), and troponin T levels, were recorded. Statistical analysis was performed using SPSS version 27. Results: Among the 80 patients, 65% had high-normal HbA1c levels. A higher prevalence of STEMI (76.92%) was observed in this group compared to NSTEMI (23.08%). Elevated HbA1c levels correlated with increased troponin T levels and a higher incidence of heart failure (68.75%). The findings suggest a strong association between HbA1c and adverse cardiovascular outcomes in ACS patients. Conclusion: Elevated HbA1c levels in ACS patients are associated with more severe cardiovascular manifestations, including STEMI and heart failure. HbA1c may serve as an independent prognostic marker for ACS outcomes.

Background: Displaced fractures of the femoral neck in elderly patients are associated with high morbidity and mortality. Hemiarthroplasty remains the preferred surgical option in this population, but the choice between cemented and uncemented implants continues to be debated, particularly in terms of postoperative function, pain, and complication rates. Objective: To compare the clinical and functional outcomes of cemented versus uncemented hemiarthroplasty in elderly patients with displaced neck of femur fractures treated at a tertiary care institution in Eastern India. Methods: This prospective comparative study was conducted at All India Institute of Medical Sciences (AIIMS), Patna, Bihar. A total of 60 patients aged 60 years and above with displaced femoral neck fractures were enrolled and randomly allocated to undergo either cemented or uncemented hemiarthroplasty. Patients were followed for a period of one year. Functional outcomes were assessed using the Harris Hip Score (HHS) and Visual Analog Scale (VAS) for pain. Operative time, intraoperative blood loss, early mobilization, and complication rates were also recorded and analyzed. Results: Patients in the cemented group demonstrated significantly better functional outcomes at 6 and 12 months as per Harris Hip Scores. They also reported lower VAS pain scores during early postoperative follow-up. However, the uncemented group had shorter operative time and less intraoperative blood loss. Complication rates were comparable in both groups, though early postoperative thigh pain was more frequent in uncemented cases. Conclusion: Cemented hemiarthroplasty offers superior mid-term functional outcomes and pain relief in elderly patients with displaced femoral neck fractures, albeit with a longer operative time. Uncemented implants may be preferable in patients with higher intraoperative risk or compromised cardiorespiratory reserve. Careful patient selection remains essential to optimize surgical outcomes.

Background: The aim of this studyis to assess and compare between ultrasound guided, peripheral nerve stimulator and combined technique for supraclavicular brachial plexus block in patients undergoing elbow and below elbow surgeries with respect to ease of administration, success rate and quality of block. Materials and Methods: 75patients belonging to ASA I and II grades and presenting for elective upper limb surgeries in the age group of 20-60 years were included in the study. They were randomly divided into one of the following three groups. Patients who received supraclavicular block through PNS technique were labeled asGroup A. Patients who received supraclavicular block through USG technique were labelled as Group B. Patients received supraclavicular block through combined method were labeled as Group C. We used 20-35 ml of local anesthetics for all 3 groups which was a mixture of Lignocaine, Bupivacaine, Hyalase, Dexa with distilled water. In all 3 groups we noted block execution time, time taken for achieving complete nerve block, onset of sensory block, onset of motor block, duration of sensory block, duration of motor block, need for supplementation, safety profile, success and failure. Observation and Results: There were no significant changes noted in all 3 groups with respect to demographic parameters. Mean time required for performing block was significantly lesser in combined group (6.32 +/- 1.60 min). Similarly, onset of sensory block was minimum in combined technique (5.56+/-2.56min). Mean duration of sensory block was observed to be more in combined technique (8.54 +/- 2.79 hours). Conclusion: We observed shorter procedure time, faster onset time of sensory and motor block with combined USG and PNS guided supraclavicular block. There was no incidence of complications such as arterial puncture, nerve injury and pneumothorax with any of the techniques.

Background and Objectives: Neuraxial techniques are the gold standard for intra partum labour analgesia. Epidural route is probably the most commonly used method for achieving labour analgesia. The present study was designed to find out which one out of Fentanyl and Clonidine is better as an adjuvant to Levobupivacaine for epidural labour analgesia in respect of quality of analgesia, duration of analgesia, maternal satisfaction, total dose required, maternal & fetal safety. Methodology: Total 80 pregnant women of age group between the range of 18 to 35 years, without any comorbidities willing for labour analgesia were included in the study. Patients who received bolus epidural Inj. Levobupivaciane (0.125%) plus Inj Fentanyl (25microgram), total volume of 10cc were included in Group A. Patients who received bolus epidural Inj Levobupivacaine (0.125%) plus Inj Clonidine (50 microgram), total volume of 10cc were included in Group B. Maternal blood pressure, maternal heart rate, FHR, cervical dilatation, Visual Analog Score (VAS) score and Numerical Rating Scale (NRS)score was measured every5 mins till the onset of analgesia after the administration of bolus dose. Study subjects were given top up dose of 3ml containing same combination of drugs when NRS>4 and then maternal blood pressure, maternal heart rate, FHR, cervical dilatation, VAS score and NRS score was measured every 15 minutes till the delivery of fetus.
Observations and Result: The following observations were noted:

1. There was no significant difference found in demographic characteristics and parity wise distribution between the two groups.
2. P value was not significant in either groups with respect to average maternal heart rate & average systolic blood pressure and average diastolic blood pressure.
3. There was a significant difference between mean values of duration of onset of analgesia, duration of action of bolus dose and duration of active labor when Group A compared with Group B (p=0.0001). There was early onset of analgesia and significantly longer duration of action in group B as compared to group A. The duration of labor was significantly shorter in group B as compared to group
4. There was no significant difference found in modes of delivery among the two
5. There was no significant difference found in FHS and APGAR scores among the two groups.
6. There was a significant difference between mean values of Total dose of Inj.Levobupivacaine, and the total number of top ups given when Group A compared with Group B (p=0.001) The total dose of local anesthetics required, and total number of top ups given was less in group B as compared to group A.
7. There was a significant difference between mean values of VAS and NRS score at 30 mins as compared to the baseline values in the individual groups. But no significant difference was noted in the VAS and NRS scores between the two
8. When compared the complications and side effects among the two groups, overall safety of the patients was observed in both the groups.

Conclusion: In conclusion, Levobupivacaine is an S (-) enantiomer to bupivacaine with a less cardiotoxicity and neurotoxicity and has a promising safety profile for the patients. Clonidine can be considered as a useful adjunct in labour analgesia with Levobupivacaine as it provides early and longer analgesia than Levobupivacaine with fentanyl combination. It also has local anaesthetic sparing effect without any significant side effects.

Background: Lateral epicondylitis, commonly referred to as tennis elbow, is a degenerative condition affecting the extensor tendons of the forearm. Non-surgical interventions such as corticosteroid injections have long been used for symptom relief; however, recent advances suggest that platelet-rich plasma (PRP) may offer longer-term benefits due to its regenerative potential. Objectives: To compare the clinical efficacy of platelet-rich plasma (PRP) injections versus corticosteroid injections in terms of pain reduction, functional improvement, and recurrence rates in patients with lateral epicondylitis. Methods: This prospective comparative study was conducted over a period of 12 months in the Department of Orthopaedics at Sri Krishna Medical College, Muzaffarpur, Bihar, India. A total of 120 patients clinically diagnosed with lateral epicondylitis were randomly assigned into two equal groups: Group A received PRP injections, while Group B received corticosteroid injections. Patients were evaluated using the Visual Analogue Scale (VAS) and the Disabilities of the Arm, Shoulder and Hand (DASH) score at baseline, 2 weeks, 6 weeks, and 12 weeks. The results were statistically analyzed using paired and unpaired t-tests. Results: Both groups demonstrated significant improvement in VAS and DASH scores post-injection. However, the PRP group showed sustained improvements through 12 weeks, whereas the corticosteroid group exhibited early relief that plateaued or regressed slightly after 6 weeks. Recurrence was higher in the corticosteroid group (18%) compared to the PRP group (5%). Conclusion: PRP injections are a more effective and sustainable treatment option than corticosteroid injections in the management of lateral epicondylitis. Their regenerative properties contribute to prolonged symptom relief and lower recurrence.

Aims: This research aims to investigate the impact of hemoglobin A1c levels in iron deficient anemia using a cross-sectional study. Methods: A cross-sectional research was conducted with 100 patients, including 50 with Iron Deficiency Ane-mia and 50 in the control group. They had an investigation for serum ferritin, iron levels, blood samples, HbA1c, and total iron-binding capacity. Results: The mean HbA1c values in the IDA group are marginally elevated at 6.1 ± 0.4% in contrast to the controls at 5.7 ± 0.3%, with this disparity being statistically significant. Total iron binding capacity was ele-vated in the iron deficiency anemia group (460 ± 25 μg/dL) compared to controls (310 ± 20 μg/dL), which is characteristic of iron deficiency conditions. The Pearson correlation value between HbA1c and serum ferritin was -0.25, and between HbA1c and hemoglobin was -0.35. Conclusion: Increased HbA1c levels as compared to controls suggest that iron deficiency may influence the HbA1c WAs viewed as a measure of glycemic management. Clinicians must consider their iron levels when analyzing HbA1c values in non-diabetic individuals with iron deficiency anemia.

Background: Neonatal intestinal obstruction is a significant surgical emergency requiring prompt diagnosis and intervention to prevent life-threatening complications. Various congenital anomalies, including anorectal malformation (ARM), Hirschsprung’s disease (HD), intestinal atresia, meconium ileus, and gut malrotation, contribute to this condition. Aim: This study aimed to analyze the etiological patterns, gender distribution, and postoperative complications of neonatal intestinal obstruction in the Jharkhand region. Methodology: A prospective comparative study was conducted at the Department of General Surgery, Rajendra Institute of Medical Sciences, Ranchi, India, from Jan 2022 to December 2022. Eighty neonates who underwent surgery for congenital intestinal obstruction were included. Data were collected retrospectively from hospital records and analyzed using SPSS version 27.0. Statistical tests such as Student’s t-test, Mann-Whitney U test, Chi-square, and Fisher’s exact test were applied, with significance set at p < 0.05. Results: The most common cause of neonatal intestinal obstruction was ARM (28.8%), followed by HD (21.3%), intestinal atresia (17.5%), and meconium ileus (15.0%). Male predominance (55%) was observed. Short-segment HD (53.8%) was the most frequent subtype. Ileal atresia (38.8%) was the most common type of atresia. Postoperative complications were primarily sepsis (58.8%), wound infection (17.5%), and aspiration pneumonia (11.3%). Conclusion: ARM and HD were the leading causes of neonatal intestinal obstruction in this study. Early diag-nosis, timely surgical intervention, and effective postoperative care are essential in improving survival rates and outcomes in affected neonates.

Background: The non-progressive motor impairment condition known as cerebral palsy (CP) is brought on by brain lesions during early development, making it a major cause of childhood disability. CP is commonly asso-ciated with comorbidities like epilepsy, learning disabilities, and behavioral disorders. The incidence of epilepsy in CP kids ranges from 20-45%, with an increased incidence in those with spastic quadriplegia. Epilepsy in CP is often drug-resistant and can significantly affect the quality of life, requiring polytherapy for control. Aim: This study aimed to determine the prevalence of epilepsy in children with CP and to identify the correlat-ed risk aspects, including demographic, clinical, and aetiological factors. Methodology: A cross-sectional study was conducted at the Christian Medical College, India, with a sample size of 100 kids diagnosed with CP. The children were categorized based on the category of CP, severity of movement disorders, and brain imaging results. Psychological assessments were used to evaluate intellectual development. Epilepsy was diagnosed following the International League Against Epilepsy (ILAE) criteria. The study utilized statistical analyses to determine significant associations between selected parameters and epilepsy. Results: Children with epilepsy showed a higher prevalence of microcephaly, lower social quotient, neonatal seizures, and a family history of seizures. Perinatal and neonatal disorders were the most common aetiologies, with perinatal asphyxia and intrauterine growth restriction being prevalent. The majority of CP children with epilepsy had generalized seizures, and a significant portion exhibited drug-resistant epilepsy. Conclusion: Epilepsy is highly frequent in kids with CP, particularly those with microcephaly, developmental delays, and perinatal risk factors. The study highlights the need for early diagnosis and intervention to manage epilepsy and improve outcomes in this vulnerable population.

Background: Wound dehiscence is a significant postoperative complication following caesarean sections, leading to increased morbidity, prolonged hospital stays, and higher healthcare costs. Various maternal, surgical, and postnatal factors contribute to wound dehiscence, making early identification of high-risk cases crucial for improving surgical outcomes. Factors such as obesity, diabetes, hypertension, anemia, prolonged labor, chorioamnionitis, surgical technique, and improper postoperative wound care have been implicated in wound healing complications. This study aims to evaluate the risk factors associated with wound dehiscence following caesarean sections at a tertiary care hospital in Bihar. Objectives: This study aims to assess the prevalence and risk factors of wound dehiscence in post-caesarean patients, evaluate the impact of maternal comorbidities and surgical factors, and analyze the relationship between intraoperative and postoperative complications and wound healing. Methods: A prospective observational study was conducted at the Department of Obstetrics and Gynaecology, Patna Medical College and Hospital, Patna, Bihar, India, over twelve months. A total of 120 post-caesarean patients who developed wound dehiscence were included in the study and compared with 120 matched controls who had uneventful wound healing. Data on patient demographics, maternal comorbidities (diabetes, hypertension, anemia), BMI, nutritional status, duration of labor, presence of chorioamnionitis, intraoperative factors (type of incision, duration of surgery, blood loss), and postoperative care were collected and analyzed. The wound was assessed using standard criteria, including signs of infection, gaping, and serous or purulent discharge. Statistical analysis was performed to determine significant risk factors. Results: The incidence of wound dehiscence was 8.5% among post-caesarean patients. Obesity (BMI > 30 kg/m²) was observed in 32% of cases, while diabetes mellitus (24%) and anemia (36%) were also significantly associated with wound dehiscence. Prolonged labor (>12 hours) and emergency caesarean sections (60%) were identified as independent risk factors (p < 0.01). Chorioamnionitis was present in 18% of cases, contributing to infection-related wound breakdown. The use of vertical midline incisions (22%) and increased intraoperative blood loss were significantly associated with dehiscence. Patients with inadequate postoperative wound care and early mobilization had a higher risk of wound complications. Conclusion: Wound dehiscence following caesarean section is influenced by multiple risk factors, including obesity, diabetes, anemia, prolonged labor, emergency surgeries, and surgical technique. Optimizing maternal health, improving intraoperative hemostasis, and ensuring adequate postoperative wound care can significantly reduce the incidence of wound complications. Preventive strategies, including better glycemic control, nutritional support, and the use of standardized surgical techniques, are essential in improving maternal surgical outcomes in caesarean deliveries.

Background: Cervix cancer is one of the most preventable yet prevalent cancers affecting women in India. Despite the availability of effective screening methods like the Pap smear and preventive vaccines against human papillomavirus (HPV), the burden of cervix cancer remains high due to poor awareness and underutilization of screening services, especially in low-resource settings. Urban women, though with relatively better access to healthcare, may still lack adequate knowledge regarding cervix cancer prevention. Objectives: To assess the level of knowledge and awareness among urban women regarding Pap smear screening, cervix cancer, and HPV infection and to identify factors associated with awareness levels. Methods: A cross-sectional, questionnaire-based study was conducted at the Department of Obstetrics & Gynaecology, Jawaharlal Nehru Medical College & Hospital, Bhagalpur, Bihar, India, over a period of 12 months. A total of 480 urban women aged 21–60 years were selected using stratified random sampling. Data were collected through a pre-validated structured questionnaire and analyzed using SPSS v25. Descriptive statistics, chi-square tests, and logistic regression analysis were used to evaluate associations between sociodemographic factors and awareness levels. Results: Overall, only 41.7% of women had heard of Pap smear screening, while 27.3% were aware of HPV as a causative agent of cervix cancer. Educational level, occupation, and monthly income were significantly associated with awareness (p < 0.001). Despite being from urban settings, misconceptions were common regarding the symptoms, risk factors, and prevention methods for cervix cancer. Conclusion: The study highlights a critical gap in knowledge regarding cervix cancer screening and HPV among urban Indian women. Health education campaigns targeting urban populations are essential to improve awareness and promote early detection through screening practices.

Aim: The present study is to assess the effectiveness of urine luteinizing hormone (LH) surge kits in comparison to transvaginal ultrasonography (TVS) for the detection of ovulation in ovulatory infertile women. Methods: This observational research, conducted at Department of Obstetrics and Gynaecology,  Patna Medical College and Hospital, Patna ,Bihar, India involved 84 ovulatory infertile women aged 18 to 35 with normal semen analysis. Patent tube Participants were randomized into two groups: Group 1 utilized urine LH surge kits, whereas Group 2 received transvaginal sonography monitoring. All participants were administered letrozole for the purpose of ovulation induction. The primary objectives were the rates of ovulation confirmation; the secondary outcomes encompassed letrozole dose, conception rates, and follicular size at the time of ovulation. Statistical analyses were conducted with SPSS. Results: Ovulation was verified in 83.3% (35/42) of Group 1 and 90.5% (38/42) of Group 2 (p=0.35). The mean time to ovulation detection was consistent at 20 hours (p=0.92). Conception rates were comparable: 51.4 percent in Group 1 and 52.6 percent in Group 2 (p=0.92). The mean follicular diameters at ovulation were 20.5 mm for Group 1 and 20.3 mm for Group 2, demonstrating no significant differences. Conclusions: Urinary LH surge kits are equivalent to transvaginal ultrasound for identifying ovulation in ovulatory infertile women, offering a less intrusive and more economical option without jeopardizing fertility results. These findings endorse the use of LH surge kits into fertility treatment strategies.

Background: Neonatal intestinal obstruction is a significant surgical emergency requiring prompt diagnosis and intervention to prevent life-threatening complications. Various congenital anomalies, including anorectal malformation (ARM), Hirschsprung’s disease (HD), intestinal atresia, meconium ileus, and gut malrotation, contribute to this condition. Aim: This study aimed to analyze the etiological patterns, gender distribution, and postoperative complications of neonatal intestinal obstruction in the Jharkhand region. Methodology: A prospective comparative study was conducted at the Department of General Surgery, Rajendra Institute of Medical Sciences, Ranchi, India, from Feb 2022 to Jan 2023. Eighty neonates who underwent sur-gery for congenital intestinal obstruction were included. Data were collected retrospectively from hospital rec-ords and analyzed using SPSS version 27.0. Statistical tests such as Student’s t-test, Mann-Whitney U test, Chi-square, and Fisher’s exact test were applied, with significance set at p < 0.05. Results: The most common cause of neonatal intestinal obstruction was ARM (28.8%), followed by HD (21.3%), intestinal atresia (17.5%), and meconium ileus (15.0%). Male predominance (55%) was observed. Short-segment HD (53.8%) was the most frequent subtype. Ileal atresia (38.8%) was the most common type of atresia. Postoperative complications were primarily sepsis (58.8%), wound infection (17.5%), and aspiration pneumonia (11.3%). Conclusion: ARM and HD were the leading causes of neonatal intestinal obstruction in this study. Early diag-nosis, timely surgical intervention, and effective postoperative care are essential in improving survival rates and outcomes in affected neonates.

Background: Feeding preterm neonates poses unique challenges due to their immature physiological systems. Various feeding methods such as gavage, spoon, and paladai feeding are commonly employed in neonatal intensive care units (NICUs). These methods can have varying impacts on vital parameters like pulse rate, oxygen saturation (SpO₂), and respiratory effort. This study aims to evaluate and compare these physiological responses in preterm neonates based on different feeding techniques. Objectives: To assess and compare the changes in pulse rate, oxygen saturation, and respiratory effort in preterm newborns after feeding via gavage, spoon, and paladai methods. Methods: A prospective observational study was conducted  at Neonatal Intensive Care Unit (NICU) of the Department of Paediatrics, Nalanda Medical College and Hospital, Patna, Bihar, over a period of 12 months from July 2018 to June 2019. involving 90 preterm neonates admitted to the NICU. The newborns were divided into three groups based on the feeding method used: gavage (n=30), spoon (n=30), and paladai (n=30). Pulse rate, SpO₂, and respiratory effort were recorded pre-feeding, during feeding, and post-feeding at defined intervals. Statistical analysis was performed using ANOVA and paired t-tests to assess intra-group and inter-group differences. Results: All three feeding methods were associated with transient variations in vital parameters. Gavage feeding resulted in minimal changes, while spoon and paladai feeding showed statistically significant increases in pulse rate and respiratory effort, along with mild decreases in SpO₂ during feeding. Post-feeding, most parameters returned to baseline within 15 minutes. Gavage feeding was better tolerated in terms of physiological stability. Conclusion: Among the feeding methods studied, gavage feeding caused the least physiological stress in preterm neonates. Spoon and paladai feeding, while more interactive, may transiently affect oxygen saturation and increase respiratory effort. Monitoring of vital signs during and after feeding is essential to ensure safety in preterm infants, and the choice of feeding method should be individualized based on the neonate’s maturity and clinical condition.

Background: Anemia is one of the most common medical complications during pregnancy and is a significant contributor to maternal and perinatal morbidity and mortality, especially in developing countries like India. The severity of anemia plays a crucial role in determining obstetric and neonatal outcomes. Objectives: To evaluate the impact of varying degrees of anemia in pregnancy on maternal health and perinatal outcomes in a tertiary care setting. Methods: This prospective observational study was conducted at the Department of Obstetrics and Gynecology, PMCH, Patna, Bihar, India, from August 2022 to July 2023. A total of 130 pregnant women beyond 28 weeks of gestation were enrolled. Hemoglobin levels were measured at admission and categorized as per WHO criteria into mild (10–10.9 g/dL), moderate (7–9.9 g/dL), and severe (<7 g/dL) anemia. Maternal outcomes such as mode of delivery, postpartum hemorrhage, sepsis, and ICU admissions were documented. Neonatal outcomes included birth weight, APGAR score, NICU admission, and neonatal mortality. Statistical analysis was conducted using SPSS version 25. Results: Among the participants, 38% had mild anemia, 45% had moderate anemia, and 17% had severe anemia. Severe anemia was significantly associated with higher rates of preterm labor, postpartum hemorrhage, maternal ICU admission, low birth weight, NICU admission, and neonatal mortality. Blood transfusion was required in 79% of women with severe anemia, while the remaining patients either declined transfusion or were managed conservatively. The correlation between anemia severity and adverse maternal and perinatal outcomes was statistically significant (p < 0.01). Conclusion: The severity of anemia in pregnancy is a strong predictor of adverse maternal and perinatal outcomes. Strengthening antenatal screening, nutritional interventions, and timely management is essential to reduce the burden of anemia-related complications in pregnancy.

Background: Metabolic syndrome (MetS), a cluster of cardiovascular risk factors including obesity, hypertension, dyslipidemia, and insulin resistance, has emerged as a significant concern in patients with epilepsy, particularly those on long-term antiepileptic drugs (AEDs). Certain AEDs are known to alter metabolic profiles, potentially increasing the risk for cardiovascular disease and diabetes in this population. Objective: To assess the prevalence of metabolic syndrome among epilepsy patients on antiepileptic medications and to analyze the association between AED type and metabolic abnormalities. Methods: A cross-sectional descriptive study was conducted over a one year  period at the Department of Neurology, Paras HMRI Hospital, Patna, Bihar, India. A total of 120 adult patients with epilepsy on AEDs for more than 6 months were evaluated. Clinical assessments, anthropometric measurements, and laboratory investigations were carried out. Metabolic syndrome was diagnosed based on the NCEP ATP III criteria. Results: The prevalence of metabolic syndrome was found to be 38.3% among the study participants. The most common components were abdominal obesity (64%) and hypertriglyceridemia (56%). Patients receiving valproate (52%) and carbamazepine (44%) had a higher prevalence of MetS compared to those on newer AEDs like levetiracetam (18%). The duration of AED use >2 years was significantly associated with increased MetS risk (p < 0.05). Conclusion: A substantial proportion of epilepsy patients on antiepileptic therapy exhibit metabolic syndrome, particularly those on older-generation AEDs. Regular metabolic screening and individualized AED selection are recommended to mitigate long-term cardiovascular risks in this vulnerable group.

Background: Pneumonia remains one of the leading causes of morbidity and mortality in children under five years of age, especially in developing countries. Zinc, an essential micronutrient, plays a crucial role in maintaining immune function. Deficiency of zinc has been associated with increased susceptibility to respiratory tract infections, including pneumonia. This study was conducted to assess serum zinc levels in children aged 2 months to 5 years hospitalized with pneumonia. Methods: This prospective observational study was carried out in the Department of Paediatrics, Nalanda Medical College and Hospital, Patna, Bihar, over a period of 12 months from July 2018 to June 2019. A total of 100 children aged between 2 months and 5 years, admitted with clinically and radiologically confirmed pneumonia, were enrolled. Serum zinc levels were estimated within 24 hours of admission using atomic absorption spectrophotometry. Children were categorized based on their zinc levels into normal and deficient groups, and correlations were made with the severity of pneumonia and clinical outcomes. Results: Out of the 100 children included, 64% were found to have low serum zinc levels (<70 µg/dL). A significant association was found between low zinc levels and increased severity of pneumonia. Children with zinc deficiency had a higher incidence of complications, longer hospital stays, and delayed recovery. The majority of zinc-deficient children were below the age of two and belonged to lower socioeconomic groups. Conclusion: Serum zinc deficiency is highly prevalent among children with pneumonia and is associated with increased disease severity and prolonged recovery. Routine screening for zinc levels and consideration of zinc supplementation may be beneficial in the management and prevention of pneumonia in young children.

Background: Thalassemia trait screening often relies on the quantification of Hemoglobin A2 (HbA2) levels, which are typically elevated in beta-thalassemia carriers. However, iron deficiency, a highly prevalent condition in India, especially among females, has been postulated to reduce HbA2 levels, potentially leading to false-negative screening results. Understanding the impact of iron deficiency on HbA2 values is critical to ensuring accurate detection of thalassemia carriers, especially in population-level screening programs. Objectives: To evaluate the effect of iron deficiency on HbA2 levels and determine whether iron deficiency can mask the diagnosis of beta-thalassemia trait in individuals undergoing screening. Methods: This observational cross-sectional study was conducted in the Department of Pathology, Darbhanga Medical College and Hospital, Bihar, from August 2022 to July 2023. A total of 130 individuals aged 18–40 years undergoing anemia evaluation or thalassemia screening were included. Participants were grouped into iron-deficient and non-iron-deficient groups based on serum ferritin, transferrin saturation, and complete blood count findings. HbA2 quantification was done using high-performance liquid chromatography (HPLC). Statistical analysis was performed to assess the correlation between iron status and HbA2 levels. Results: Out of 130 participants, 72 were iron-deficient while 58 had normal iron stores. The mean HbA2 level in the iron-deficient group was 2.3 ± 0.4%, significantly lower than the non-iron-deficient group which had a mean HbA2 level of 3.1 ± 0.5% (p < 0.001). Among iron-deficient individuals with suspected thalassemia trait, HbA2 levels were found to be within normal or borderline ranges, indicating the possibility of masked diagnosis. Upon iron repletion and re-evaluation in a subset, HbA2 levels rose significantly, unmasking latent beta-thalassemia trait in some cases. Conclusion: Iron deficiency significantly lowers HbA2 levels and may obscure the diagnosis of beta-thalassemia trait in screening programs. Screening for thalassemia should either follow correction of iron deficiency or incorporate parallel iron status assessment to avoid misclassification. This is particularly relevant in high-prevalence regions like Bihar where iron deficiency anemia is common.

Background: Fine Needle Aspiration Cytology (FNAC) is a well-established, minimally invasive, rapid, and cost-effective diagnostic tool used in the initial evaluation of palpable breast lumps. It plays a pivotal role in the preoperative diagnosis of both benign and malignant breast lesions. However, its diagnostic accuracy is best evaluated when correlated with histopathological findings, which remain the gold standard. Objectives: The aim of this study was to analyze the morphological spectrum of various breast lesions diagnosed on FNAC and to evaluate the diagnostic accuracy by correlating the cytological findings with subsequent histopathological outcomes. Methods: This prospective study was conducted in the Department of Pathology, Darbhanga Medical College and Hospital, Bihar, over a period of one year. A total of 120 patients with palpable breast lumps underwent FNAC followed by excisional biopsy or lumpectomy. The cytological findings were categorized according to standard reporting systems, and histopathological correlation was performed wherever tissue diagnosis was available. Results: Among the 120 cases evaluated, 68 (56.7%) were benign, 42 (35%) were malignant, and 10 (8.3%) were suspicious or indeterminate on cytology. The most common benign lesion was fibroadenoma, while invasive ductal carcinoma was the predominant malignant entity. The overall concordance rate between FNAC and histopathology was 91.7%. The sensitivity, specificity, positive predictive value, and negative predictive value of FNAC in diagnosing malignant lesions were 94.6%, 97.1%, 95.2%, and 96.7% respectively. Conclusion: FNAC is a reliable, rapid, and highly accurate diagnostic modality for the initial evaluation of breast lesions. When interpreted by experienced cytopathologists and correlated with clinical and radiological findings, it offers excellent concordance with histopathological diagnosis and can significantly aid in planning appropriate patient management.

Background: Eyes trauma represents a significant source of visual disability and blindness, offering a formidable public health challenge, mainly in developing areas with poor ophthalmic facilities. In spite of its socio-economic importance, it is lacking in well-structured epidemiological information on the prevalence, risk factors, and clinical outcomes of eye injuries. Knowledge of the distribution, causes, and consequences of ocular injuries will be highly important in developing preventive measures and enhancing early intervention practices. Aim: To evaluate the epidemiological profile, risk factors and clinical outcomes of ocular trauma in patients reported at a tertiary care center in Patna, Bihar, India. Methods: A tertiary care hospital in Patna, Bihar, hosted this hospital-based observational study from November 2019 to April 2021. Patients with mechanical and non-mechanical ocular trauma (150) were included. All patients underwent anterior and posterior segment exams and in-depth ocular evaluation. Ultrasound B-scan, CT scan, and X-ray were done as needed. Compare data to determine demographics, injury kinds, causes, and clinical outcomes. Results: Trauma to the eyes was more prevalent among males (83%), particularly between the age group 20-30 (38%).  Rural communities recorded 80% of the cases, illustrating more susceptibility within limiting environments.  Closed globe injury resulted in 18% contusions and 20% lamellar lacerations, and open globe injury resulted in 16% penetrating trauma, 6% rupture, and 34% adnexal injuries.  The most frequent eye trauma came from road traffic crashes (42%), followed by injuries sustained in occupations (28%). The majority of patients (75%) presented within 6 hours, and prompt therapy enhanced visual outcomes.  Analysis (χ² = 8.21, p = 0.016) reaffirmed a close association between early presentation and good prognosis. Conclusion: Ocular trauma is most common in young men and caused by car accidents. Its significant prevalence in rural areas highlights the need for increased awareness, early treatment, and traffic safety policies. Delaying medical care increases the chance of severe visual loss and permanent blindness, according to the study. Reduce the ocular trauma load by improving preventive measures, traffic safety, job safety, and ophthalmic care, especially in rural regions.

Background: Post-operative astigmatism significantly impacts visual outcomes and patient satisfaction in manual small incision cataract surgery (MSICS). The location of the scleral incision plays a crucial role in determining the magnitude of surgically induced astigmatism (SIA). Comparative analysis between superior and superotemporal incisions can guide surgeons in optimizing refractive stability and visual recovery. Aim: The aim of this study is to compare post-operative astigmatism and visual recovery in patients undergoing MSICS with superior versus superotemporal scleral incisions and to evaluate which incision site yields better refractive outcomes and patient satisfaction. Methods: A prospective comparative observational study was conducted over 12 months in the Department of Ophthalmology, Esic Model Hospital, bapunagar, Ahmedabad, Gujarat, India. One hundred patients aged 40–80 years undergoing MSICS were randomly allocated into two groups: 50 patients with superior scleral incisions and 50 with superotemporal scleral incisions. Preoperative keratometry, standardized surgical techniques, and post-operative evaluations at 1 week, 1 month, and 3 months were performed. Uncorrected and best-corrected visual acuity along with post-operative keratometry readings were recorded. Statistical analysis included independent t-tests and repeated measures ANOVA to assess differences and trends over time. Results: Patients in the superotemporal incision group demonstrated significantly lower post-operative astigmatism values at all follow-up intervals (1.12 D at 1 week, 0.98 D at 1 month, and 0.85 D at 3 months) compared to the superior incision group (1.45 D, 1.30 D, and 1.20 D, respectively). Additionally, a higher number of patients in the superotemporal group achieved uncorrected visual acuity of 6/12 or better (90% at 3 months) compared to the superior group (76%). Conclusion: Superotemporal scleral incisions in MSICS result in significantly lower surgically induced astigmatism and faster visual recovery compared to superior incisions. These findings suggest that superotemporal incisions offer greater refractive stability, reduced spectacle dependence, and improved patient satisfaction, supporting their wider adoption in clinical practice for cataract surgery.