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.