Background: Chronic leg ulcers often present with bacterial colonization, which can interfere with the success of skin grafting procedures. The presence of comorbidities such as diabetes and advanced age further complicates wound healing and graft integration. Aim: To estimate the impact of bacterial colonization on the success rate of skin grafts in leg ulcers and to evaluate the modifying effects of diabetes and age on wound healing. Materials and Methods: This observational study included 60 patients undergoing split-thickness skin grafting for leg ulcers. Wound swabs were collected prior to grafting for aerobic bacterial culture. Participants were categorized based on colonization status, diabetes presence, and age groups. Graft uptake was clinically assessed on postoperative day 7 and 14. Data were analyzed using descriptive statistics and independent t-tests, with p < 0.05 considered statistically significant. Results: The most common isolate was Staphylococcus aureus (45%), followed by Klebsiella and Acinetobacter. Culture-negative wounds showed relatively better graft uptake. Diabetic patients exhibited lower mean graft take (76.4%) compared to non-diabetics (83.2%), though the difference was not statistically significant (p = 0.120). Infection was the leading cause of ulcers (48.3%), and males were predominantly affected (66.7%). Conclusion: Bacterial colonization, especially with S. aureus, negatively impacts graft success in chronic leg ulcers. Diabetes may further impair graft uptake. These findings highlight the importance of microbiological evaluation and glycemic control prior to surgical grafting to optimize wound healing outcomes.

Background: Preeclampsia and eclampsia are significant hypertensive disorders during pregnancy, contributing notably to maternal and neonatal morbidity and mortality worldwide. In India, the incidence of preeclampsia is estimated to be 7 times higher as compared to global range. Knowledge of the placental pathology in these cases is of utmost significance in understanding its pathogenesis. However, no relevant studies were done in this north eastern region of India. Aims and Objectives: To study the spectrum of histopathological changes in the placenta in patients of Pre-eclampsia and Eclampsia. To see the outcome of pregnancies associated with Pre-eclampsia and Eclampsia. Materials and Methods: This cross-sectional analytical study was conducted in the Department of Obstetrics & Gynaecology and the Department of Pathology, Tezpur Medical College over a period of two years from January 2019 to December 2020. Detailed clinical and laboratory evaluation was done in each of the patient. After delivery their placentas were sent for histopathological examination and results were recorded. Results: A total of 120 pregnancies, comprising of 40 cases each of Pre-eclampsia, eclampsia and normal pregnancies were evaluated. Mean gestational age at delivery was found to be 36 weeks and 32 weeks in Pre-eclampsia and Eclampsia group respectively. 55% of newborns were found to be low birth weight in eclampsia as compared to 7.5% in normotensive control groups. The mean placental weight was statistically reduced (p<0.001) in pre-eclampsia and eclampsia groups as compared to control group. Placental necrosis was found to be the most common histopathological features in both preeclampsia (75%) and eclampsia (100%). Other changes include increased syncytitial knots, perivillous fibrin deposit, calcification, hypertrophy of spiral arterioles. Conclusion: Hypertensive disorders of pregnancies are associated with significant pathological changes in the placenta and has significant effect in the pregnancy outcome.

Introduction: Laparotomies are among the most common surgical procedures.  It is widely acknowledged that patients in these situations have bad outcomes.  Although emergency laparotomies are among the most frequently performed urgent surgical operations, little is known about their results.  The post-operative mortality rate for peritonitis is still high, currently estimated to be between 14.9 to 19.4%, despite countless advancements in surgical techniques, antimicrobial medications, and supportive care. Aims: To compare POSSUM and P-POSSUM scoring in predicting mortality in patients undergoing emergency abdominal surgery. Materials & Methods: Prospective study. Department of General Surgery, Agartala Government Medical College, Agartala, West Tripura from December 2019 to June 2022 and total sample size 150 patients. Result: The average Possum score (mean± s.d.) for patients who died was 92.7000± 5.8678. The mean Possum score (mean± s.d.) for patients who survived was 35.4343± 19.6384. The mean Possum score and outcome distribution was statistically significant (p<0.0001). Conclusion: We came to the conclusion that POSSUM and P-POSSUM scores are statistically significant predictors of death (p < 0.0001 for both) for patients undergoing emergency abdominal surgery at AGMC & GBP Hospital.   The mean scores of patients who expired were substantially higher than those of survivors (POSSUM: 35.4, P-POSSUM: 18.9).

Objectives: Among the Vulvular heart diseases, Mitral valve disease is the most frequent form of Vulvular heart diseases leading to cardiovascular morbidity and mortality globally. Mitral valve repair (MVr) has gained more attention since mitral valve replacement (MVR) is associated with some critical complications. The present study was conducted to evaluate and compare MV repair and replacement on recovery from surgery, with a focus on postoperative quality of life and health status over one year of follow up period. Methods: The present descriptive observational study with prospective design was conducted at a tertiary level healthcare institute in the city of Kolkata, West Bengal, over a period of one year. A total of 65 patients with mitral regurgitation admitted for mitral valve surgery in the department of Cardio-thoracic and Vascular surgery at the institute were interviewed using a pre-tested and pre-designed schedule and observing and recording the clinical variables after obtaining the ethical clearance from the institute and informed consent from each subject. Quality of life was evaluated with the Medical Outcomes Trust Short-Form 36-item Health Survey (SF-36) scale. Inferential statistics either by parametric or non-parametric tests according to the data distribution for continuous variables and Chi-square test categorical variables was performed to elicit association; p value of less than 0.05 was considered statistically significant. Results: The mean age (SD) of the study population among MV repair was 53.4 (±12.4) years and among MV replacement was 57.2 (±11.6) years. There was a gradual improvement in the NYHA functional class from baseline to 12 months follow-up time for both treatment groups. The mean value of various parameters of the SF-36 scores increased more among the patients of MV repair than replacement over one year of follow up period. Conclusion: There was marked and significant improvement in parameters like Physical function, Role limitation, Bodily Pain, General health and Social function among the patients with MV repair than replacement.

Background: Although there are many different contraceptive methods available, tubal ligation is now the most common one. It plays a significant role in India’s National Family Planning Programme. Tubal sterilization techniques range from laparoscopic sterilization to traditional Pomeroy’s fimbriectomy depending on the level of expertise available. 1% to 3% of these women later ask to have their sterilization reversed, even though it is done as a permanent technique of sterilization. . Many western centres have showed success using improved laparoscopic methods, and this is now commonly considered as a substitute method for carrying out microsurgical reversal of a ligated tube. Purpose: The study had two objectives. First, it was determined whether the tubal recanalization was appropriate and what circumstances would lead to a successful laparoscopic recanalization. The second goal was to examine how laparoscopic tubal recanalization affected reproductive results and pregnancy rates. Methods: 43 women who were prospectively monitored and sought tubal sterilization reversal at a tertiary care facility between May 2015 and February 2020 were included in a retrospective chart assessment. Results: Only 14 unilateral tubes were suitable and in 2 women bilateral tubes were suitable. For recanalization, all patients requiring laparoscopic tubal sterilization were suitable, whereas all cases requiring fimbriectomy were not. Salpingostomy was used as an alternative to tubal re anastomosis in 10 (23.25%) cases. Pregnancy rates were 58.8% overall. 4 out of 12 women who had sterilization using Pomeroy’s procedure became pregnant, compared to 5 out of 8 women who underwent laparoscopic tubal ligation (P=0.24). No patients with a final tubal length of less than 5 cm became pregnant (P=0.042). When comparing the age at recanalization, 82.3% of women less than 30 years old conceived, compared to 45% of women over 30 years old. Conclusions: Sterilization method and the length of the tube after recanalization are significant determinants of recanalization success. Gynaecologists must sterilize patients with minimal stress while also minimizing failure rates. They must also work to maintain the length of the tube so that, should the patient’s circumstances alter, reversal is more likely to be successful.

Introduction: Lower bowel symptoms, including chronic abdominal pain or discomfort with diarrhea or constipation, are common presenting features in both primary and secondary care settings. These symptoms may be caused by a number of different conditions, including inflammatory bowel disease (IBD), of which ulcerative colitis (UC) and Crohn’s disease (CD) are the most common, and irritable bowel syndrome (IBS). Aims: To evaluate the utility of fecal calprotectin (FC) levels as an early indicator for diagnosing inflammatory bowel disease (IBD) and differentiating it from other gastrointestinal disorders. Materials & Methods: The present study was a Observational, cross-sectional study. This Study was conducted from One year January 2024- December 2024 at department of General Medicine, Murshidabad Medical College & Hospital, Station Road, Berhampore, Murshidabad, West Bengal, Pin-742101. Total 50 patients were included in this study. Result: Endoscopic findings revealed a correlation between the severity of inflammation and mean fecal calprotectin (FC) levels. Patients with normal endoscopic results (n=10) had a mean FC level of 45.2 μg/g, while those with mild inflammation (n=14) showed a mean of 165.3 μg/g. Moderate inflammation was observed in 16 patients with a mean FC level of 325.5 μg/g, and severe inflammation was present in 10 patients, who had the highest mean FC level of 487.7 μg/g. Conclusion: We concluded that, fecal calprotectin (FC) has proven to be a valuable non-invasive biomarker for the early detection of inflammatory bowel disease (IBD). This study demonstrated a strong correlation between elevated FC levels and both endoscopic severity and confirmed IBD diagnoses, particularly in cases of ulcerative colitis and Crohn’s disease.

Introduction: Peripheral artery disease (PAD) is a common manifestation of systemic atherosclerosis and is associated with significant morbidity and mortality. The ankle-brachial index (ABI) is a simple, noninvasive tool used to diagnose PAD. This study evaluates the utility of both traditional and alternative ABI calculation methods in diagnosing PAD and predicting long-term mortality outcomes. Aims: To evaluate the diagnostic utility of the Ankle-Brachial Index (ABI) in identifying Peripheral Artery Disease (PAD) using both traditional and alternative calculation methods. Materials and Methods: This was an observational, cross-sectional study. This Study was conducted from One year January 2024- December 2024 at department of General Medicine, Murshidabad Medical College & Hospital, Station Road, Berhampore, Murshidabad, West Bengal, Pin-742101. A total of 120 patients were included in the study. Results: The prevalence of PAD was 16.7% using the traditional ABI and 37.5% using the alternative ABI method. Compared to the no-PAD group, both the traditional-PAD and alternative-PAD groups showed significantly higher all-cause and cardiovascular mortality. The C-index for cardiovascular mortality prediction was significantly higher with the alternative method (0.665; 95% CI: 0.595–0.734) compared to the traditional method (0.575; 95% CI: 0.508–0.641; p=0.013). Patients with severely decreased ABI (<0.40) in either method had over a threefold increased risk of death. Conclusion: The ABI is a valuable diagnostic and prognostic tool for PAD. The alternative ABI method improves identification of high-risk individuals and provides superior predictive capacity for mortality compared to the traditional method. These findings support broader implementation of alternative ABI in clinical practice for better risk stratification.

Background: The objective of the proposed study was to develop and validate a stability-indicating greener chromatographic method for the simultaneous analysis of anti-hypertensives drugs for amlodipine besylate (AML) and folic acid (FOL) in synthetic mixtures , assessing its environmental impact using various greenness evaluation tools — an emerging advancement in the field of analytical chemistry. AML, a calcium channel blocker used for hypertension management, is currently under investigation in Phase III clinical trials (CN111481554A) in combination with FOL. This combination has demonstrated potential for enhanced blood pressure reduction, reduced cardiovascular and cerebrovascular risk, and improved protection of vital organs, including the heart, brain, and kidneys. Methods: Chromatographic separation was achieved using a Shimadzu P-series C18 column (250 mm × 4.6 mm, 5 µm particle size). The mobile phase, consisting of methanol, acetonitrile, and buffer (adjusted to pH 3.5 using orthophosphoric acid) in a 30:50:20 (v/v/v) ratio, was delivered at a flow rate of 1.0 mL/min. Detection was carried out at a wavelength of 235 nm using a PDA detector. The method validation was performed according to ICH Q2 (R2) guidelines. Forced degradation studies were conducted under acidic (0.1N HCl), alkaline (0.1N NaOH), oxidative (3% H₂O₂), thermal (60°C for 3 hours), and photolytic (UV light exposure) conditions. Results and Discussion: Retention times were recorded as 2.011 minutes for AML and 4.019 minutes for FOL. The method exhibited linear calibration curves over the concentration ranges of 50–300 µg/mL for AML and 8–48 µg/mL for FOL, with correlation coefficients (R²) of 0.9967 and 0.9975, respectively. Sensitivity was demonstrated through low detection and quantification limits. Accuracy and precision were within acceptable limits, and the results were reproducible. Forced degradation studies indicated significant degradation under acidic, alkaline, and oxidative conditions, while thermal and photolytic conditions induced comparatively minor degradation. This validated method is suitable for stability and simultaneous quantification studies of AML and FOL in pharmaceutical formulations. Assessment of method was carried out using the two different tools. The developed method is anticipated to be eco-friendly, alternative to developed method in regard to safe solvent, less toxic and less run time. Conclusion: The stability-indicating method is reliable and ideal for routine analysis and stability studies in quality control lab user greener solvent.

Background: Dengue is a mosquito-borne viral infection posing significant public health challenges, particularly in tropical and subtropical regions. It presents with a range of clinical symptoms, from mild fever to severe complications, and early diagnosis and monitoring are crucial to reduce morbidity and mortality. Objectives: This study aimed to analyze the clinical presentation and hematological parameters of patients diagnosed with dengue fever admitted to a tertiary care hospital over a one-year period. Methods: A total of 105 patients diagnosed with dengue fever were included in this observational study conducted from April 2024 to March 2025. Clinical symptoms, pulse rate, and platelet counts were recorded and analyzed. Data collection was performed at a tertiary care hospital with standardized diagnostic criteria. Results: Fever was the most common symptom, reported in 100 patients, followed by vomiting (43), headache (18), and abdominal pain (14), with fewer cases of body ache, malaise, joint pain, rashes, and diarrhoea. Most patients (63) had a pulse rate between 61–100 bpm, while 25 had rates between 41–60 bpm, 14 had rates over 100 bpm, and 3 were below 40 bpm. Platelet counts were notably reduced in many cases, with 36 patients showing levels below 50,000/µL and 39 between 50,000–100,000/µL. Discussion: The findings show that fever and vomiting are common in dengue, with many patients experiencing thrombocytopenia. Monitoring platelet counts and pulse rate is vital for effective management and preventing complications.

Aim: This study aimed to measure medication non-adherence and to assess the perceived barriers, and facilitators. Objectives: (1). To measure the rate of medication non-adherence. (2). To assess medication-taking behaviors, attitudes towards medication adherence, and reasons for non-adherence. Study design: The MARS questionnaire was used in this cross-sectional study, which was conducted in the non-communicable diseases department of a tertiary care hospital in Vizianagaram After the evaluation, patients and referring clinicians received a report that included tailored suggestions for lifestyle, psychological, and pharmaceutical therapies. Study Sample Size: During the study period from October 2024 to December 2024, a total of 306 fully completed questionnaires from outpatients visiting our GGH’s non-communicable diseases department were obtained. Descriptive statistics were used for review and analysis. Results: Descriptive statistics were used to analyze the 306 completed questionnaires received throughout the study period. Over half (51%) of the participants were men. The patient’s average age was 56.8 years. The MARS Questionnaire states that a score of greater than six denotes good medication adherence, while a score of less than six denotes poor medication adherence. Of the 306 participants, 282 received a rating higher than six. The majority of study participants (92.15%) generally adhered to their drug regimens well, although 7.84 percent showed poor medication adherence. Conclusion: The majority of patients with chronic non-communicable disorders (92.15%) in this study had good drug adherence. Patients’ medication adherence was found to be influenced by their personal opinions; those who strongly believed that medications were necessary were less likely to have poor medication adherence. Potential contributing factors for medication adherence include age, disease stage, severity of sickness, and income stability.

Introduction: General anesthesia has been the gold standard and backup form of anesthesia for all surgical procedures since the beginning of anesthesia, when it was a field with few resources and equipment. The well-known induction medication etomidate, is used extensively for  induction and has a better stable cardiovascular profile with fewer respiratory adverse effects than propofol. Despite being regarded as a safe induction drug with a little risk of hypotension, etomidate has two common side effects: myoclonus and injection pain. Aims: A comparative study between dexmedetomidine and propofol in reduction of etomidate induced myoclonus in patients undergoing general anesthesia for supraumbilical surgery. Materials & Methods: This is a prospective, comparative, observational study. Place of study and Duration: Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal. This study was conducted over a period of 18-month (Jan 2019- July 2020) and total sample size 80 patients. Result: In our study mean duration of myoclonus at first, second, and third minutes of our investigation revealed significant difference between the ED (Dexmedetomidine group) and EP (Propofol group).  The mean duration of myoclonus at first, second, and third minute readings of ED were 1.675, 1.425, and 1.15, respectively.  At EP, on the other hand, there was a notable rise to 3.975 in the first minute, a little rise to 1.625 in the second, and a fall to 0.7 in the third.  These findings point to a noticeable initial peak in the first minute at EP, which was followed by a slow drop in the minutes that followed. There is also notable early increase in symptom severity at EP1, followed by a significant reduction in symptoms by EP3. Conclusion:  The study led us to conclude that both propofol and dexmedetomidine are effective in reducing the incidence and severity of etomidate-induced myoclonus in patients undergoing general anesthesia for supra-umbilical procedures. However, dexmedetomidine had a stronger effect than propofol, with increased hemodynamic stability and a significantly lower incidence of myoclonus.

Introduction: General anesthesia has been the gold standard and backup form of anesthesia for all surgical procedures since the beginning of anesthesia, when it was a field with few resources and equipment. The well-known induction medication etomidate, is used extensively for  induction and has a better stable cardiovascular profile with fewer respiratory adverse effects than propofol. Despite being regarded as a safe induction drug with a little risk of hypotension, etomidate has two common side effects: myoclonus and injection pain. Aims: A comparative study between dexmedetomidine and propofol in reduction of etomidate induced myoclonus in patients undergoing general anesthesia for supraumbilical surgery. Materials & Methods: This is a prospective, comparative, observational study. Place of study and Duration: Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal. This study was conducted over a period of 18-month (Jan 2019- July 2020) and total sample size 80 patients. Result: In our study mean duration of myoclonus at first, second, and third minutes of our investigation revealed significant difference between the ED (Dexmedetomidine group) and EP (Propofol group).  The mean duration of myoclonus at first, second, and third minute readings of ED were 1.675, 1.425, and 1.15, respectively.  At EP, on the other hand, there was a notable rise to 3.975 in the first minute, a little rise to 1.625 in the second, and a fall to 0.7 in the third.  These findings point to a noticeable initial peak in the first minute at EP, which was followed by a slow drop in the minutes that followed. There is also notable early increase in symptom severity at EP1, followed by a significant reduction in symptoms by EP3. Conclusion:  The study led us to conclude that both propofol and dexmedetomidine are effective in reducing the incidence and severity of etomidate-induced myoclonus in patients undergoing general anesthesia for supra-umbilical procedures. However, dexmedetomidine had a stronger effect than propofol, with increased hemodynamic stability and a significantly lower incidence of myoclonus.

Background: Stroke is the second leading cause of global mortality and a major contributor to long-term disability. Ischemic stroke accounts for approximately 87% of all strokes. Hyperuricemia, defined as elevated serum uric acid (SUA) levels, has shown conflicting associations with ischemic stroke outcomes in prior research. This study aimed to assess the association between SUA levels at presentation and clinical outcomes among patients with acute ischemic stroke (AIS). Methodology: This observational cross-sectional study included 60 adult patients diagnosed with Acute Ischemic Cerebrovascular Accident via CT/MRI at Government General Hospital, Kadapa, from April 2023 to March 2024. Patients with hemorrhagic stroke, infection, liver/kidney disease, gout, or relevant comorbidities were excluded. Clinical data, including SUA, demographic variables, risk factors, duration of hospital stay, mortality, ECG changes, and re-admission, were recorded. Statistical analysis was performed using Epi Info v7.2.5. Results: Hyperuricemia (>6.8 mg/dL) was observed in 20% of patients. Mean age was 57.25 years, and mean SUA was 6.15 mg/dL. Elevated Serum Uric Acid was significantly associated with longer hospital stays (p < 0.05) and hypertension (p = 0.013), but not with age, gender, smoking, or re-admission rates. Diagnostic accuracy analysis revealed a specificity of 100% and a positive predictive value of 100% for SUA >9 mg/dL in predicting mortality. Conclusion: Elevated SUA is prevalent among AIS patients and is significantly associated with prolonged hospitalization and mortality. Although not linked with common vascular risk factors, hyperuricemia may serve as a potential prognostic biomarker. Regular monitoring of Serum Uric Acid levels in Acute Ischemic Cerebrovascular Accident patients is recommended.

Introduction: Pediatric tracheostomy is a vital airway intervention performed for conditions such as airway obstruction, neuromuscular weakness, or prolonged ventilation. The procedure poses unique challenges due to pediatric anatomical differences and associated risks. Materials and Methods: A prospective observational study was conducted over three years at a tertiary care hospital in Gujarat, including 30 children aged 6 months to 12 years who underwent tracheostomy. Clinical data were recorded, and descriptive analysis was performed using SPSS v25. Ethical clearance and informed consent were obtained. Results: Out of 30 patients, 63.3% were males. The most affected age group was 8.1–10 years. TMJ ankylosis (23.3%), diphtheria (20%), and brain tumors (13.3%) were the leading indications. A total of 16 complications (53.3%) were observed, with reinsertion due to blockage (13.3%) and tracheitis (10%) being most common. The mortality rate was 20%, with 13.3% due to primary illness and 6.6% due to tracheostomy-related complications. Conclusion: TMJ ankylosis, diphtheria, and tumors were the major indications for pediatric tracheostomy. While complication and mortality rates were notable, outcomes largely depended on the underlying condition, underscoring the need for timely management and meticulous postoperative care.

Methods The present study was carried out in Department of Pathology, in Ruxmaniben Deepchand Gardi Medical College, Ujjain. In which biopsies of 51 cases of clinically and histologically diagnosed leprosy cases were included. All the cases were subjected to special stains like Fite Faracco and Auramine ‘O’ to know the bacterial Index. Results In most of the cases male’s predilection is seen especially in third decade with clinical symptoms of anaesthetic hypopigmented lesion. On Histopathology most of the cases were of Borderline group (BT, BL). On Fite Faracco and Flourescent staining Histoid leprosy and Lepromatous leprosy showed highest bacterial load. In study of 51 cases, clinically and histologically diagnosed as hansen’s showed a male preponderance with Male: Female ratio approximately 2:1. It was observed that Auramine ‘O’ stain is better than Fite Faracco. Conclusion Histopathological examination of skin lesions remains the mainstay in diagnosing and classifying leprosy. Majority of cases were Borderline Tuberculoid Leprosy on histology of the biopsies. Bacterial load can be easily judged by Fite Faracco and Auramine ‘O’ staining. Fluorescent stain, Auramine ‘O’ is better than Fite Faracco stain.

Background: Vision loss and cranial nerve palsies in young individuals can have a broad differential diagnosis, ranging from infectious to autoimmune and inflammatory conditions. Recognizing patterns and timely investigations are crucial for appropriate management. Objective: To present a series of five cases with acute or subacute visual symptoms and cranial nerve involvement with varied etiologies including infectious, inflammatory, autoimmune, and idiopathic causes.
Methods: Retrospective observational series of five young female patients presenting to a neurology department over 1 year with visual complaints and/or cranial nerve involvement. Clinical evaluation, neuroimaging, CSF analysis, and serological workup were done. Results: Etiologies included HHV6-associated cavernous sinus thrombosis, presumed tubercular pituitary hypophysitis, multiple sclerosis, Tolosa-Hunt syndrome, and neuroretinitis. All patients responded well to targeted therapy based on etiology. Conclusion: A systematic approach integrating neuroimaging and CSF analysis aids in early diagnosis and tailored treatment in cases of cranial neuropathies with vision loss.

Background: Lower motor neuron (LMN) syndromes and motor neuropathies are often attributed to autoimmune, genetic, or idiopathic causes. However, infectious etiologies such as leprosy, hepatitis B, and hepatitis C can closely mimic these presentations. Objective: To highlight rare infectious causes of LMN syndromes through three diverse clinical cases. Methods: Retrospective case series of three patients presenting to a neurology department over one year with predominant LMN symptoms. Extensive investigations were performed to rule out autoimmune, metabolic, and genetic causes, eventually revealing infectious origins. Results: The cases were diagnosed as tuberculoid leprosy, occult hepatitis B-associated axonal GBS, and hepatitis C-related motor neuronopathy mimicking MND. Timely antimicrobial therapy led to significant clinical improvement. Conclusion: Neurologists must maintain high clinical suspicion for infectious causes even in chronic or atypical presentations of LMN syndromes.

Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract (GIT), originating from the interstitial cells of Cajal, which act as pacemaker cells in the muscularis propria. They are frequently associated with gain-of-function mutations in the KIT or PDGFRA genes, resulting in constitutive activation of receptor tyrosine kinases. Objective: This study aims to evaluate the clinico-histopathological features of GIST variants with a focus on tumour size, site of origin, mitotic index, and immunohistochemical expression of CD117 and DOG-1. Methods: A retrospective analysis was conducted on 12 Indian patients diagnosed with GIST at FAAMCH, Barpeta, between 2022 and 2024. Clinical data including age, gender, tumour site, and size were recorded. Histopathological examination and immunohistochemistry for CD117, DOG-1, S-100, Desmin, and SMA were performed. Results: The stomach was the most frequent site of GISTs (41.67%), followed by the colon (33.33%). The spindle-cell variant was the most prevalent histological subtype (7/12 cases). All cases showed diffuse positivity for CD117 and DOG-1, with negative staining for S-100, Desmin, and SMA. Conclusion: The immunoprofile supports the diagnosis of GIST, with the majority showing classical features. Observed differences from global data may reflect genetic or ethnic variations in the Indian population, highlighting the need for further multicentric studies to refine diagnostic and therapeutic strategies.

Introduction: Bipolar disorder, particularly during manic episodes, has been increasingly linked to abnormalities in purinergic metabolism. Serum uric acid (SUA), a final product of purine degradation, is hypothesized to be elevated during mania and may serve as a state marker or potential predictor of manic episodes. Aims & Objectives: To evaluate serum uric acid levels in patients during manic episodes and to assess its potential as a predictive biomarker for mania. Materials & Methods: This prospective study was conducted over a period of one year, from January 2024 to December 2025, in the Outpatient Department (OPD) of Nil Ratan Sircar Medical College & Hospital. A total of 36 patients were included in the study, selected based on predefined inclusion and exclusion criteria to ensure the reliability and validity of the findings. Result: The study population had a male predominance (54.05%) with a mean age of 31.06 ± 6.78 years. Treatment led to a significant reduction in Young Mania Rating Scale (YMRS) scores (from 43.32 ± 6.29 to 20.92 ± 3.51) and serum uric acid levels (from 6.15 ± 0.85 mg/dL to 5.45 ± 0.72 mg/dL). No significant difference was observed in serum uric acid levels among patients on different mood stabilizers—Lithium Carbonate, Sodium Valproate, and Carbamazepine (p = 0.779). However, serum uric acid levels significantly decreased from the manic phase (6.8 ± 1.2 mg/dL) to the remission phase (5.5 ± 1.0 mg/dL; p = 0.001). Responders to treatment had significantly lower uric acid levels (5.3 ± 0.9 mg/dL) compared to non-responders (6.4 ± 1.0 mg/dL; p = 0.004). Conclusion: The findings of this study suggest that serum uric acid levels are closely associated with the manic phase of bipolar disorder and may serve as a potential state marker for mania. A significant reduction in both YMRS scores and serum uric acid levels following treatment highlights the therapeutic impact on manic symptoms. Although no significant differences were found in uric acid levels across different mood stabilizers, the marked decline in levels from the manic to the remission phase and the significantly lower levels in responders compared to non-responders underscore the potential utility of serum uric acid as a predictive biomarker for treatment response in mania.

Obsessive Compulsive Disorder (OCD) is a common condition that causes significant impairment worldwide. The aim of the present study is to compare and evaluate executive functioning between healthy controls and OCD patients with good and poor insight. A total of 120 individuals were divided into three groups: OCD with good insight, OCD with poor insight, and healthy control group (n = 40 individuals per group). Executive functions of the participants were evaluated using standard neuropsychological tests (Digit Span Test forward and backward, Stroop Color Test, and Trail Making Tests A and B). There were statistically significant differences in all test scores among the three groups, indicating substantial differences between poor insight OCD patients, good insight patients and healthy control in terms of executive performance. OCD patients with poor insight demonstrated deficiencies in working memory, cognitive flexibility, processing speed, and inhibitory control. These results demonstrate how insight level and cognitive performance are related in OCD, and suggest that patients with low insight may benefit from specialized treatments that address their cognitive deficiencies.

Introduction: Despite being a temporary condition, neonatal jaundice is still the most common cause of hospitalization in the first week of life. Physiological jaundice is due to the developmental insufficiency of bilirubin uptake, transport, and conjugation in the new-born liver. Aims: To identify and analyse the factors influencing the duration of hospital stay in neonates diagnosed with hyperbilirubinemia. Materials & Methods: The present study was Prospective study. This Study was conducted from January 2017 – June 2018 for one year at Tertiary Care Paediatric Hospital of Kolkata. Total 150 Hyperbilirubinemia patients were included in this study. Result: Among the neonates studied, 53.3% had ABO incompatibility, while 46.7% did not. Rh incompatibility was observed in 14.7% of cases, with the majority (85.3%) showing no Rh incompatibility. These findings suggest ABO incompatibility was more common than Rh incompatibility among hospitalized neonates with hyperbilirubinemia. Among neonates with a long hospital stay, 36.5% had ABO incompatibility, while 63.5% did not. In contrast, 75.4% of those with shorter stays had ABO incompatibility. This suggests that the absence of ABO incompatibility was more frequently associated with prolonged hospitalization. Conclusion: The duration of hospital stay in neonates with hyperbilirubinemia is influenced by multiple factors. ABO incompatibility and G6PD deficiency are significant contributors to prolonged hospitalization, while Rh incompatibility appears less prevalent.

The majority of people consume alcohol, and alcoholism is a leading cause of premature death worldwide. The current study was a cross-sectional observational study conducted in the outpatient/inpatient setting of the Department of Psychiatry, SMS Medical College, Jaipur, on 100 patients with Alcohol Use Disorder after obtaining written informed consent. In the present study, 48% of respondents were found to have a psychiatric comorbidity (assessed using MINI), the most common being Major Depressive Disorder (13%). 54% of individuals had severe AUD, as measured by the SADQ (score >30). Results from the study showed that psychiatric disorders were associated with gender, history of psychiatric illness, and family history of psychiatric illness among AUD patients. In individuals with AUD, psychiatric comorbidity also contributes to higher degrees of dependency severity. The majority of individuals without psychological comorbidities were moderately or mildly dependent, with few falling into the severe range. Major Depressive Disorder, Antisocial Personality Disorder, and Generalized Anxiety Disorder were the associated psychiatric illnesses that were present in the majority of individuals in the severe dependency group. These findings suggest that alcohol dependency may worsen in the presence of coexisting mental health issues.

Background: Visual impairments have physical, emotional, social and economic consequences and are crucial elements influencing the quality of life. Diabetic Retinopathy (DR) is a micro vascular complication of Diabetes Mellitus (DM) and a leading cause of visual impairment globally. Objectives: To estimate the proportion of Diabetic Retinopathy, to describe clinical profile of patients with diabetic retinopathy and to describe diagnostic profile of patients with diabetic Retinopathy. Material and Methods: Present Observational study was conducted at the tertiary care teaching hospital at Surendranagar in the month of September in100 patients diagnosed with Diabetes Mellitus (DM) who were admitted medicining ward and who attended the outpatient department of ophthalmology. Results: The study highlights the proportion of Diabetic Retinopathy among various sociodemographic variables. Males being affected more than females with proportion of 74.6 in males and 25.4 in females. Among 100 patients of diabetes, 45. 5% were diagnosed with NPDR while 25. 5% had PDR. There was a strong, positive association between development of DR with duration of disease and glycemic control. Conclusion: Our study highlights the alarming prevalence of diabetic retinopathy in patients with diabetes mellitus, particularly those with type 1 diabetes, longer duration of disease, poor glycemic control.

Background: It is crucial to conduct a thorough clinical examination together with supportive supplementary studies in order to determine the cause of ocular motor nerve palsies. With this background, the present study was carried out on the etiological pattern of 3rd, 4th, and 6th ocular motor nerve palsies. Methods: This was a hospital-based, prospective, observational study conducted with 40 patients over a period of 18 months. Data regarding the disease and sociodemographic characteristics was gathered. The history of the mode of onset, time and course of the symptoms of the disease, history of fever, comorbidities like DM, HTN, tuberculosis, stroke, hypercholesterolaemia, coronary artery disease and personal habits like tobacco consumption and alcoholism was noted. Routine ophthalmological examinations and blood investigations were carried out. Data collected was entered in Microsoft Excel 2010 and analysed using Epi Info software. Results: The mean age of the patients studied was 50.22 ± 11.76 years, with 72.5% of cases being males. There was a slight right-eye preponderance. The most common nerve to be affected was the abducent nerve, followed by the oculomotor nerve and multiple nerve palsies. The trochlear nerve was the least frequently involved. The most common aetiology identified was microvascular in origin, followed by trauma, inflammation and idiopathic. While trauma was more common in the younger age group (less than 40 years old), microvascular aetiology was more prevalent in the fifth and sixth decades. At least one vasculopathic risk factor was present in 67.5% of the participants in this study, and 17.5% had several risk factors. 71% of the patients with oculomotor nerve palsy had pupillary involvement. The most common fundus changes were NPDR (15%) followed by no DR changes (17.5%), hypertensive changes (5%) and PDR changes (2.5%). Conclusion: According to numerous earlier research studies, abducens nerve palsy was the most prevalent type of nerve palsy seen, and the most common aetiology was discovered to be microvascular in nature. Cranial nerve palsies and associated effects can be avoided with early detection and efficient treatment of these systemic disorders.

Aim: The aim of this study was to find the causes of deferral of blood donors, which can help prospective donors better understand the requirements for blood donation and the dangers of receiving transfusions. Methodology: Through a combination of medical history, physical examination, and serological testing for transfusion-transmissible infections (TTIs), 159 rejected blood donors were examined cross-sectionally in order to determine the causes of deferral. Results: 130 (81.8%) of the 159 deferred donors were  rejected due to medical and temporary criteria.29 (18.2%) were deferred because of positive TTI screening results. Males made up 93.85% of deferred donors, while females made up 6.15%. The age group of 26–40 years old accounted for 43.08 percent of all deferrals. Hypertension was the most common reason for deferral (39.23%), followed by recent vaccination (15.38%) and low haemoglobin (6.92%), which only affected female donors. Conclusion: High deferral rates emphasize how crucial careful donor screening is to guaranteeing the safety of blood donors. The main causes were transient conditions like recent vaccinations and hypertension. The results highlight the necessity of focused health education to increase donor eligibility and reduce avoidable deferrals.

Background: In this study we wanted to compare the post-operative pain in patients given a single infiltration of bupivacaine (0.5%) subcutaneous vs inter fascial vs no local anaesthetic before closure after midline laparotomy and compare the incidence of SSI and to compare the amount of analgesia used. Methods: Patients undergoing midline laparotomy was randomly divided into one of the 3 groups (local anaesthetic vs subcutaneous vs inter fascial). Pain was assessed using VAS post operatively after 12hrs, 24hrs and 24hrs with cough. The amount of analgesia used. The time of first analgesic use after surgery were noted. Results: There were 60 patients participated in the study (20 in each group). The median VAS score at 24hrs and 24hrs with cough was significantly lower in the interfascial group than the subcutaneous group with p-value of 0.009 and 0.012 (p < 0.05) using Mann-Whitney U test. Using the Fischer’s Exact test comparing the amount of analgesia used there is a significant difference (p < 0.05) in the proportion of the amount of analgesia used in between the groups with difference between no local anaesthetic and administration of local anaesthesia but there is no significant difference between the interfascial and subcutaneous group (p = 0.161). Kruskalwallis test showed significant difference in the median time of first analgesia used (p = 0.001) between the groups but there was no difference between subcutaneous and interfascial. Conclusions: Infiltration of local anaesthetic (0.5% bupivacaine) was found to be effective in reducing post operative pain after midline laparotomy wound in the immediate post operative period. Interfascial infiltration is superior to subcutaneous infiltration. There is reduction in the amount of analgesia required after the administration of local anaesthesia.

Background: Atypical antipsychotics are the cornerstone of schizophrenia management but are increasingly associated with adverse metabolic effects. Metabolic syndrome (MetS) in schizophrenia patients elevates the risk of cardiovascular disease and diabetes, necessitating early identification and monitoring. Aim: To evaluate the prevalence and biochemical profile of metabolic syndrome among schizophrenia patients receiving atypical antipsychotic therapy. Methods: This cross-sectional observational study was conducted over one year at a tertiary care hospital in West Bengal. A total of 30 patients diagnosed with schizophrenia and on atypical antipsychotics for at least six months were enrolled using purposive sampling. Clinical data, anthropometric measurements, and fasting blood samples were collected to assess glucose levels, lipid profile, and blood pressure. Metabolic syndrome was diagnosed as per IDF criteria. Statistical analysis was done using SPSS v25.0 with a significance threshold of p<0.05. Results: Metabolic syndrome was present in 43.3% of patients. Central obesity (56.7%), low HDL cholesterol (50%), and hypertriglyceridemia (40%) were the most common abnormalities. Significant associations were found between metabolic syndrome and increasing age (p=0.041), longer illness duration (p=0.019), and olanzapine use (p=0.048), but not with gender (p=0.402). Conclusion: The study underscores a high burden of metabolic syndrome in schizophrenia patients on atypical antipsychotics, particularly olanzapine. Regular metabolic screening, early intervention, and integrated care models are essential for reducing long-term morbidity in this vulnerable group.

Background: Inguinal hernia is the most prevalent surgical condition affecting young and elderly guys across the globe. Both tissue-based hernia repair and the routinely performed prolene mesh inguinal hernia repair provide several surgical options for treatment. An un-detached strip of external oblique aponeurosis is utilized to reconstruct the posterior wall of the inguinal canal in the newly discovered desarda hernia repair procedure. This research compares the outcomes of Desarda and Litchenstein mesh hernia repairs. Methods: 150 patients with inguinal hernia detected in a hospital-based interventional trial were separated into two groups, D (75 patients) for desarda method and L (75 patients) for lictenstein repair. Postoperative complications such as seroma, hematoma, orchitis, early and late postoperative discomfort, chronic pain, and recurrence were assessed as outcomes. Hospital stay was also considered, and patients are followed up on day 7, one month, and six months following surgery. Results: During follow-up, 15 patients in the lictenstein group and 5 patients in the desarda group had chronic pain, which was not statistically significant (p = 0.260). In both groups, two recurrences were observed (p = 1). Seroma was seen in 5 individuals receiving desarda but none in the L group, although hematoma was more prevalent in the L group. Conclusion: Desarda, being a novel procedure, may be utilized in young patients to prevent the issues that are most likely to occur with mesh hernia repair.

Background: The differential diagnosis between uterine fibroid and adenomyosis is sometimes difficult; a precise diagnosis is required in women with infertility because of the different choice of treatments. Ultrasound elastography (UE) is a novel technique to evaluate the elasticity or the stiffness of the tissue of interest. The present study aims to compare UE shear wave velocity (SWV) among normal uterine myometrium, uterine fibroid, and adenomyosis, and assess the accuracy of shear wave elastography in the diagnosis of adenomyosis. Materials and Methods: This cross-sectional study recruited 25 subjects for each group (control, adenomyosis, and fibroid) from April 2024 to April 2025. Transvaginal UE with ultrasound mapping for point of tissue biopsy was performed for all subjects. The diagnosis was confirmed by histology. Results: The mean ± standard deviation (SD) for SWV was 3.44 ± 0.95 m/seconds (control group), 4.63 ± 1.45 m/ seconds (adenomyosis group), and 4.53 ± 1.07 m/seconds (fibroid group). The mean SWV differed when comparing normal myometrium and adenomyosis after adjustments for age and endometrial pathology (P=0.019). The cut-off point of SWV at 3.465 m/seconds could differentiate adenomyosis from the normal uterus with an 80% sensitivity, 80% specificity, and an area under the curve (AUC) of 0.80 (95% confidence interval [CI]: 0.68-0.93) (P<0.001). No significant difference in SWV between the adenomyosis and fibroid groups was detected. Conclusion: Shear wave elastography could be an alternative tool to distinguish between normal myometrium and adeno- myosis; however, it could not differentiate adenomyosis from uterine fibroid or uterine fibroid from normal myometrium.

Background: Acute myocardial infarction (AMI) remains a leading cause of morbidity and mortality worldwide. High-sensitivity Troponin I (Hs-TnI) is a key biomarker for early diagnosis of myocardial injury. Recent studies also suggest a possible link between elevated serum uric acid levels and cardiovascular events. This study aims to evaluate the levels of Hs-TnI and uric acid in patients presenting with myocardial infarction and assess their potential clinical correlation. Aim and Objectives: To assess serum Hs-Troponin I and uric acid levels in patients diagnosed with AMI and determine their relationship with severity and clinical profile. Materials and Methods: This hospital-based cross-sectional observational study was conducted over a 12-month period from April 2024 to March 2025 at the Department of Biochemistry, NMCH, Jamuhar, Sasaram. A total of 150 AMI patients were included. Serum Hs-TnI and uric acid levels were measured using chemiluminescence immunoassay and enzymatic methods respectively. Data were statistically analyzed for correlation with clinical parameters and risk factors. Results: A significant elevation in serum Hs-TnI and uric acid levels was observed in all AMI patients. Hs-TnI levels were markedly higher in STEMI patients compared to NSTEMI. Elevated uric acid levels were more prevalent in patients with a history of hypertension and metabolic syndrome. A positive correlation was found between uric acid levels and severity of myocardial infarction, as evidenced by ECG and echocardiography findings. Conclusion: Hs-Troponin I remains a sensitive and specific biomarker for AMI diagnosis. Elevated uric acid levels may serve as an adjunct marker indicating increased cardiovascular risk and worse outcomes in myocardial infarction. Dual assessment of Hs-TnI and uric acid may enhance early risk stratification and guide therapeutic decisions.

Aim: The aim of this study is to assess the techniques used to determine the minimum inhibitory concentration of colistin in multidrug-resistant Gram-negative bacteria. Methods: In a teaching hospital for tertiary care, a comparative study was conducted. Using the colistin agar dilution method and the E test method, 150 non-repetitive MDR-GNB were found and their colistin MIC was determined. The gold standard was the broth microdilution method. Results: Eleven isolates out of 150 MDR-GNB isolates demonstrated colistin resistance using the BMD and Colistin agar dilution methods. In contrast, two of the BMD-resistant isolates had intermediate sensitivity, or a MIC of 2µg/dl by the E test, which led to a significant mistake. Conclusions: Although the E test is simple to use, it has revealed VME in two isolates and is more expensive than agar dilution. Agar dilution demonstrated 100% categorical agreement, and with technician training, it can be used in laboratories with limited resources to evaluate several samples on a single plate.

Background: Kikuchi-Fujimoto Disease (KFD), also known as Kikuchi Cervical Lymphadenitis, is a rare, benign, self-limiting condition that predominantly affects young adults, often mimicking more serious disorders such as lymphoma or tuberculosis. Case Presentation: We report a case of a 35-year-old female who presented with a painful, progressively enlarging neck swelling and intermittent low-grade fever. Clinical examination and imaging revealed multiple enlarged right cervical lymph nodes with necrotic features. Despite empirical antibiotic therapy, symptoms persisted and leukopenia worsened. An excisional biopsy of the cervical lymph nodes was performed, and histopathological examination confirmed the diagnosis of Kikuchi-Fujimoto Disease. The patient showed significant postoperative improvement, with normalization of laboratory parameters and complete clinical recovery. Conclusion: Due to its varied presentation and close resemblance to other infectious or neoplastic conditions, Kikuchi Cervical Lymphadenitis remains a diagnostic challenge. Histopathology remains the gold standard for diagnosis. Early recognition can prevent unnecessary treatments and ensure appropriate management.

Background: Abnormal uterine bleeding (AUB) is one of the most frequent complaints among women of reproductive and peri-menopausal age, often indicating underlying endometrial pathology. Histopathological examination of endometrial tissue remains the cornerstone in diagnosing the cause of AUB and guiding management. The pattern of histological changes in endometrial biopsies can vary with age, hormonal status, and associated systemic or gynecological conditions. Understanding regional patterns of endometrial pathology and their clinical correlation is essential for timely and accurate diagnosis, especially in resource-limited settings like Bihar. Objectives: (1) To evaluate the spectrum of histopathological patterns seen in endometrial biopsies from patients presenting with abnormal uterine bleeding. (2) To correlate the histological findings with clinical parameters such as age, menstrual history, and presenting symptoms. (3) To identify the most common causes of AUB in different age groups. Materials and Methods: This retrospective observational study was conducted in the Department of Pathology at Netaji Subhas Medical College and Hospital, Patna, Bihar, over a period of 12 months. A total of 186 endometrial biopsy samples from women presenting with AUB were retrieved and reviewed. Clinical details were obtained from patient records. Biopsy specimens were fixed in 10% formalin, processed, and stained with hematoxylin and eosin. Histopathological findings were categorized into normal cyclic endometrium, hyperplasia, atrophy, chronic endometritis, disordered proliferative endometrium, and malignancy. Data were analyzed using SPSS version 26.0, and correlation between clinical and histological parameters was studied. Results: The most common age group presenting with AUB was 41–50 years. Proliferative phase endometrium was the most frequent histological finding, followed by secretory phase and endometrial hyperplasia. Disordered proliferative endometrium and chronic endometritis were common in perimenopausal age, while atrophic endometrium and malignancies were more frequently seen in postmenopausal women. A significant clinico-pathological correlation was observed, emphasizing the diagnostic role of biopsy in management of AUB. Conclusion: Histopathological examination of endometrial biopsies remains a reliable and cost-effective tool in evaluating abnormal uterine bleeding. The study highlights age-specific patterns of endometrial pathology in AUB cases and reinforces the importance of timely biopsy for appropriate clinical management. Clinico-pathological correlation enhances diagnostic accuracy and improves therapeutic outcomes.

Dengue is a mosquito-borne, RNA virus of the family Flaviviridae. The vector is Aedes aegypti mosquito. Clinical manifestations range from an asymptomatic state to haemorrhagic fever. Guillain-Barré syndrome (GBS), myositis, myelitis, and encephalitis are among the neurological symptoms that have been previously described. These symptoms are mostly linked to infections with DENV-2 and DENV-3. These serotypes have been identified in myelitis, meningitis, and encephalitis cases. Rarely, as a result of the humoral immune reaction, it may appear as neuritis. Cranial neuropathies which have been encountered earlier in dengue fever are optic neuritis, oculomotor nerve palsy, abducens nerve palsy, lower motor neuron motor facial nerve palsy. Although the precise cause of dengue-associated cranial neuropathy is uncertain, immune-mediated processes are believed to be involved. A neurotropic virus, dengue can proliferate in the central nervous system after passing through the blood-brain barrier. Following direct infection of endothelium cells, dendritic cells, and monocytes, it would cause an excess of cytokines, which would lead to immune-mediated endothelial dysfunction. Guillain–Barré syndrome (GBS) is an infrequent neurological complication of dengue viral infection. GBS is an acute immune mediated polyradiculoneuropathy characterised by rapidly progressing ascending paralysis and hypo or areflexia. The most common antecedent pathogen is Campylobacter jejuni, which is followed by Mycoplasma pneumoniae, Epstein-Barr Virus, and Cytomegalovirus (CMV). Previous studies have shown AMAN and AMSAN variant to be most frequently associated GBS types following dengue in Asian countries. We herein report a case of a 36 year old female who presented to us with dengue fever and left oculomotor nerve palsy and developed GBS after the onset of dengue fever.

Background: Retinal vein occlusion (RVO) is the second most common retinal vascular disorder after diabetic retinopathy and a significant cause of visual impairment, particularly in individuals with diabetes mellitus. Aim: This study aimed to evaluate the systemic and ocular risk factors associated with RVO in diabetic patients and to assess their visual prognosis following treatment. Methods: A hospital-based observational study was conducted on 100 diabetic patients diagnosed with RVO. Detailed demographic, clinical, and systemic data were collected. All patients underwent comprehensive ocular examinations including best-corrected visual acuity (BCVA), optical coherence tomography (OCT), and fluores-cein angiography where indicated. Visual outcomes were assessed at baseline and after a 3-month follow-up pe-riod. Multivariate logistic regression was used to identify independent predictors of poor visual prognosis. Results: The mean age of the participants was 61.4 ± 8.9 years, with a male predominance (58%). Branch RVO was the most common subtype (62%), and macular edema was present in 68% of cases. Systemic comorbidities included hypertension (77%), poor glycemic control (HbA1c > 7.0%) in 81%, and hyperlipidemia (53%). At follow-up, 71% of patients showed visual improvement. Ischemic RVO, macular edema, and HbA1c > 8% were independently associated with poor visual outcomes. Conclusion: RVO in diabetic patients is strongly associated with systemic vascular comorbidities. Early detec-tion, prompt ophthalmologic management, and strict metabolic control are essential for improving visual out-comes in this high-risk population.

This study aimed to evaluate the effect of gender on pulmonary functions forced vital capacity [FVC], forced expiratory volume in 1st s [FEV1] and peak expiratory flow rate [PEFR]) and to emphasise the need for further research on the aetiology and the prevention of respiratory diseases, This cross‑sectional study was conducted in the Department of Physiology, D.Y Patil medical college Kolhapur , India, from May 2011 to May 2013. A total of 100 participants, were included via random sampling method. The participants filled out a questionnaire with general information about previous diseases, medication and family history. Fifty male participants were enrolled in the study group according to inclusion and exclusion criteria. 50 female participants were included. Respiratory parameters such as FVC, FEV1 and PEFR were measured by a digital spirometer. Readings were taken in normal upright sitting posture.

Objectives: Mandible is the most prominent and mobile bone of the facial skeleton; therefore, mandibular fracture is more common than any other facial fractures. This study aims to compare the efficacy of lag screws & miniplates in open reduction & internal fixation of mandibular symphyseal & Para symphyseal region fractures. Material and Methods: Thirty patients were alternately divided into two groups according to treatment modality. Clinical & radiological evaluations were made at 7^th day;1 month & 3 months follow up post operatively. Parameters like duration of surgery, bone healing, a return of normal occlusion; infection rate, intersegmental mobility, and nerve paresthesia were evaluated. Results: The clinical examination showed stable fixation with no mobility in all cases. one patient in group B showed a moderate occlusal discrepancy that was managed by giving IMF for a month. One patient in group A and two patients in group B had infection which was subside by change of antibiotic and one patient require hardware removable in group B. Duration of surgery was more in group A as compare to group B. No significance difference was noted (p>.05) between the 2 groups in the development of postoperative complication. Conclusions: It was concluded that lag screw fixation is a cost-effective procedure, with minimal hardware, functional stability but technically sensitive. Lag screw is a reliable & safe procedure in treating interforaminal fracture of mandible.

Background: β-thalassemia major is a common inherited blood disorder requiring regular blood transfusions, which often lead to iron overload. This iron accumulation, measured by serum ferritin, can damage vital organs, especially endocrine glands, potentially leading to growth retardation, hypothyroidism, and glucose intolerance. Aim: To assess the association between serum ferritin levels and growth parameters, thyroid function, and oral glucose tolerance in children with β-thalassemia major. Materials and Methods: This cross-sectional study included 100 β-thalassemia major patients (<12 years) at-tending the Pediatric Department at DMCH, Laheriasarai. Anthropometry, thyroid profile (TSH, fT4), OGTT, and serum ferritin were evaluated. Data were analyzed using SPSS v25 with appropriate statistical tests (p<0.05 considered significant). Results: A significant inverse correlation was found between serum ferritin and fT4 (R = -0.27), and a positive correlation with TSH (R = 0.41), indicating hypothyroidism in 12% of patients—most notably when ferritin >2000 ng/mL. Growth retardation was more prevalent in males (54.2% underweight), and short stature was as-sociated with higher ferritin levels (median: 2934 ng/mL vs. 1343 ng/mL; p<0.001). Additionally, patients with abnormal OGTT (7%) had significantly elevated ferritin (median: 3090 ng/mL; p<0.001). Conclusion: Elevated serum ferritin in β-thalassemia major is strongly linked to hypothyroidism, impaired growth (especially in males), and glucose intolerance. Routine monitoring and individualized chelation therapy may help prevent long-term endocrine complications.

Background: Central neuraxial block and general anaesthesia in patients with significant comorbidities are associated with considerable peri-operative morbidity and mortality. This study aims to determine the efficacy of combined popliteal sciatic and adductor canal nerve block for postoperative pain relief in patients undergoing below-knee surgeries. Objectives: Time for the first requirement of rescue analgesia. Total Dose of analgesia required in 24 hours after surgery, patient Satisfaction score. Methods: Sixty-four patients with the American Society of Anesthesiologists’ (ASA) physical status grades I and II, aged 18–60 years, scheduled for below-knee surgery from April 2024 to April 2025, were enrolled in this prospective study. All patients received an ultrasound-guided popliteal sciatic block with 20 mL of 0.25% bupivacaine and an adductor canal block with 10 mL of 0.25% bupivacaine. Postoperative analgesia was assessed using visual analogue scores at 2, 6, 12, and 24 hours. Rescue analgesia with inj. Tramadol 0.5- 1 mg/kg IV was given when the VAS score was more than 5. Patient’s satisfaction was assessed using Likert’s satisfaction scale (5-point scale) from dissatisfied to extremely satisfied. The first analgesic requirement time and total tramadol used in the first 24 hours were noted. Descriptive statistics for the study were calculated, and the data were analysed using the SPSS Statistics 21.0 program. Results: VAS scores were significantly lower. The p-value for the VAS score was <0.0001. The mean duration of postoperative analgesia was significantly longer. Analgesic consumption was also very low and statistically significant. Patient satisfaction scores were also substantial and very much comfortable. Conclusion: Ultrasound-guided combined popliteal sciatic and adductor canal block is an effective analgesic technique for patients undergoing below-knee surgeries.

Background: This is the second leading causes of preventable blindness worldwide. It is associated frequently but not invariably with the raised intra-ocular pressure 3, eventually resulting in loss of vision and blindness. Methods: Structured questionnaire were given in English and Malayalam. Questionnaire contains two parts first part for name age gender demographic data and second part regarding awareness and knowledge of glaucoma. Hospital-based cross-sectional study. Participants grouped as Group 1: Not heard of glaucoma and we collected the demographic data only. Group 2: Heard of glaucoma, were given the full questionnaire for answering. Illiterate participants were assisted by trained personnel. Awareness about glaucoma is analysed by those who all Responded “Yes” to Q1 (Have you heard of glaucoma) Knowledgeable about glaucoma is analysed depending on the Correct responses to glaucoma-related questions Descriptive statistics used. Percentages were calculated for each response. Results: Among 690 participants attending the ophthalmology outpatient department, 280 individuals (40.6%) were found to be aware of glaucoma and were further assessed for knowledge regarding the disease. Significant gaps in glaucoma-related knowledge, only 47.1% correctly identified high intraocular pressure as a key feature of glaucoma. A large proportion 63.6% either wrongly equated glaucoma with cataract or were unsure, suggesting a common misunderstanding between the two conditions. Similarly, awareness of risk factors was suboptimal: only 45% recognized increasing age as a risk, and 38.6% understood the significance of family history. Alarmingly, just 34.3% were aware that glaucoma is often asymptomatic in its early stages, and only 29.3% correctly denied that glaucoma always causes defective vision from the outset.  When participants were asked whether they had ever undergone glaucoma screening by an eye doctor, 30.0% reported that they had been screened. In contrast, a significant 60% had never undergone any form of glaucoma screening. Importantly, when asked whether they had advised their family members to get screened for glaucoma, only 46.4% had encouraged family screening. Conclusion: This there is considerable gap between glaucoma awareness and actual participation in screening practices, underscoring the need for proactive screening programs and patient education initiatives to promote early detection. Community-level glaucoma awareness programs are urgently needed. And also utilizing OPD visits for patient education and focused health education campaigns addressing key misconceptions can bridge the knowledge gap. More focus on educating about asymptomatic nature and irreversible blindness may help in improving early diagnosis and compliance.

Introduction: Klebsiella species are ubiquitous Gram-negative bacilli responsible for a variety of healthcare-associated infections, including bloodstream infections (BSIs) that can lead to septicaemia. Drug-resistant Klebsiella pneumoniae strains are emerging as significant pathogens, contributing to increased morbidity and mortality. Objectives: This study aimed to assess the prevalence of Klebsiella pneumoniae in bloodstream infections and to determine its antibiotic susceptibility pattern among patients attending a tertiary care hospital in South Bihar. Materials and Methods: This cross-sectional study was conducted in the Department of Microbiology, NMCH, Sasaram, Bihar, from December 2022 to December 2023. Blood samples from patients admitted to various wards and ICUs were processed using an automated blood culture system. Positive bottles were subjected to Gram staining and subculture on Blood and MacConkey agar, followed by overnight incubation. Preliminary identification was done based on colony morphology, Gram staining, and basic biochemical tests like catalase and oxidase. Further identification included conventional biochemical tests such as indole, citrate, TSI, urease, and motility etc. Antimicrobial susceptibility testing was performed by the Kirby–Bauer disc diffusion method on Mueller–Hinton Agar, and results were interpreted as per CLSI guidelines (CLSI M100, 33rd Edition, 2023). Results: Out of 639 blood samples processed, 320 (50.07%) were from patients with clinically suspected BSI. Total of 103 (16.11%) were culture-positive for Klebsiella species, of which Klebsiella pneumoniae accounted for 92 (88.23%) and Klebsiella oxytoca for 12 (11.76%). Among the 103 isolates, Gram-positive cocci were found in 61(59.22%) cases, and Gram-negative bacilli in 42 (40.78%), with 36 (85.71%) from the Enterobacteriaceae family and 6 (14.28%) being non-fermenters. The antibiotic susceptibility profile of Klebsiella pneumoniae revealed the highest sensitivity to Piperacillin/tazobactam 75 (82.35%), followed by Co-trimoxazole 54 (58.82%), Ciprofloxacin 27 (29.41%) and least sensitive to Amoxiclav 5 (5.88%). Resistance was highest to Amoxiclav 86 (94.11%), followed by Cefuroxime 64 (70.58%) and Piperacillin/tazobactam 16 (17.64%).

Background: Neonatal hyperbilirubinemia is a frequent condition in approximately 60% of term neonates and often necessitates phototherapy. While helpful in reducing serum bilirubin, phototherapy has been reported to be associated with complications such as hypocalcemia, particularly in preterm babies. Melatonin suppression and the resultant hormonal changes could be the foundation for this effect. Objective: The aim of this research was to assess the correlation of phototherapy with the occurrence of hypocalcemia in neonates with hyperbilirubinemia, comparing results between term and preterm neonates. Methodology: Prospective observational study was conducted at Department of Pediatrics, Delhi Hospital and Nursing Home, Bahadurgarh, Haryana, India. 96 neonates undergoing phototherapy for unconjugated hyperbilirubinemia were included and categorized into two groups: Group A (48 preterm) and Group B (48 term). Serum ionized calcium and bilirubin were measured before and after 48 hours of phototherapy. Clinical presentations of hypocalcemia were noted. Results: Group A was born with lower birth weight and gestational age and was subjected to phototherapy later compared to Group B. Group A had more decrease in serum ionized calcium (0.5 ± 0.3 mg/dL) compared to Group B (0.3 ± 0.2 mg/dL), which was significant (p = 0.002). Group A also received phototherapy treatment for longer duration and had more decrease in bilirubin. Conclusion: Phototherapy is associated with an impressive drop in neonatal serum calcium levels, particularly in pre-term infants. The results necessitate daily calcium monitoring in the context of phototherapy, particularly in high-risk populations.

Introduction: Zebu is a French term that was translated into English. The word may have originated in Tibet and refers to a particular kind of bull. Originating in South Asia, specifically India, the zebu (Bos indicus), often referred to as Indigenous cattle, is a species or subspecies of domestic cattle that can also be found in portions of Africa and other tropical countries. Aims: To establish early diagnostic protocol. To study different physiological parameters (for PD etc). To study beneficial effects of cow urine, if any. To develop inexpensive diagnostic tool, if possible. Materials and Methods: The present study was an experimental study. Department of Veterinary Pathology, West Bengal University of Animal and Fishery Sciences, 37 & 68 K. B. Sarani, Belgachia, Kolkata, West Bengal. Total 80 Zebu Cows were included in this study. Result: In Group-1, the mean Monocyte (%) (mean± s.d.) of Zebu cow was .9300 ± .3524. In Group-2, the mean Monocyte (%) (mean± s.d.) of Zebu cow was .9550 ± .3121. Distribution of mean Monocyte (%) with Group was not statistically significant (p=0.7379). Conclusion: In conclusion, urine analysis in Zebu cattle is a crucial tool for evaluating health, diagnosing diseases, and monitoring metabolic and organ functions. It provides valuable insights into the presence of infections, toxins, and diseases, helping in early diagnosis and disease progression tracking. This method also aids in assessing the impact of environmental and nutritional factors on cattle health. When combined with other diagnostic techniques, urine analysis enhances disease management and preventive care, improving overall animal health. Future advancements in this field could further refine diagnostic accuracy, benefiting Zebu cattle health management.

Background: Appendicitis is one of the most common surgical emergencies worldwide, frequently affecting young adults and requiring prompt diagnosis and intervention to prevent serious complications. Aim: To assess the clinical presentation, diagnostic accuracy, surgical management, and outcomes of appendicitis in the adult population of^’ Bihar. Methodology: A prospective observational study was conducted at Department of General Surgery, Department of General Surgery, Netaji Subhas Medical College and Hospital, Bihta, Patna, Bihar, India, including 90 adult patients diagnosed with appendicitis and undergoing surgery. Data on demographics, clinical features, diagnostic methods, surgical interventions, and postoperative outcomes were collected and analyzed using SPSS v27.0. Results: The mean age was 34.9 years, with 54.4% male patients. Right lower quadrant pain was the most frequent symptom (64.4%). Ultrasonography was used in 85.6% of cases (sensitivity 85%), and CT in 30% (sensitivity 90%). Most patients (95.6%) underwent appendectomy—70% open and 30% laparoscopic. Intraoperative findings showed inflamed (60%), gangrenous (20%), and perforated appendices (15.6%). Postoperative complications occurred in 10% of cases, with wound infection (5.6%) being the most common. The average hospital stay was 4.2 days, with no reported mortality. Conclusion: Appendicitis remains a prevalent surgical condition among adults in Bihar, often presenting with classical symptoms but with a notable proportion of complicated cases due to delayed diagnosis. Despite limited resources, favorable outcomes were achieved. Strengthening early diagnostic strategies, enhancing laparoscopic access, and resource optimization are essential to improve management in rural regions.

Background: Diabetes mellitus is a global epidemic, with India having one of the highest diabetic populations worldwide. Diabetic foot ulcers (DFUs) are a common and serious complication, often associated with peripheral vascular disease (PVD), which significantly impacts patient morbidity and risk of amputation. Aim: This study aimed to assess the incidence and characteristics of peripheral vascular disease among patients presenting with diabetic foot ulcers in a tertiary care hospital. Methodology: A retrospective observational study was conducted at AIIMS Patna, including 120 patients aged ≥18 years with diabetic foot ulcers (Wagner Grades I–IV). Patient records were reviewed for demographic, clinical, and vascular assessment data, including Doppler ultrasonography and Ankle-Brachial Pressure Index (ABPI). Results: The majority of patients were males (60%) aged 51–80 years (85.8%). Common presenting symptoms included abscess (36%), swelling (35%), and gangrene (29%). PVD was diagnosed by ultrasound in 26.7% of cases. ABPI values indicated that 24% of patients had arterial insufficiency (ABPI <0.8), while most had normal or elevated ABPI. Smoking was prevalent only among males, while tobacco use was more common among females. The duration of diabetes was predominantly 10–20 years in nearly half of^’ the patients. Conclusion: Peripheral vascular disease is a significant complication in diabetic ^‘foot ulcer patients, especially among older males with long-standing diabetes. Routine vascular assessment using ultrasound and ABPI is critical for early detection of PVD, enabling timely interventions to reduce severe complications and improve patient outcomes.

Background: Diabetic ketoacidosis (DKA) is a potentially life-threatening complication more commonly associated with type 1 diabetes but increasingly reported in type 2 diabetes mellitus (T2DM) as well. Understanding the biochemical derangements in T2DM patients with DKA is essential for timely diagnosis, appropriate management, and improved outcomes. Aim: To evaluate the biochemical profile of patients with type 2 diabetes mellitus presenting with diabetic ketoacidosis in a tertiary care Institute. Materials and Methods: A retrospective study included 100 adult patients diagnosed with T2DM and DKA at the Department of General Medicine, AIIMS, Patna. Demographic data and biochemical parameters including blood glucose, serum ketones, arterial blood gas (ABG) analysis, serum electrolytes, renal function, and lipid profile were collected and analyzed. Results: The mean age of patients was 54.3 ± 11.7 years, with a slight male predominance. The most common precipitating factors were infection (48%) and poor medication compliance (32%). Mean blood glucose was 436.5 ± 96.2 mg/dL, serum bicarbonate was 11.8 ± 3.9 mmol/L, and arterial pH was 7.18 ± 0.07. Moderate to severe hypokalemia was observed in 38% of cases, while elevated serum creatinine was seen in 29% of patients. Conclusion: DKA in T2DM patients presents with characteristic biochemical disturbances, predominantly marked hyperglycemia, metabolic acidosis, and variable electrolyte imbalances. Early recognition of these biochemical markers is essential for effective clinical management and reduction of morbidity and mortality.

Background: Teaching is an emotionally and physically exhausting profession and factors such as rurality add to the stress of the occupation. Even though they are essential, rural school teachers across the United States, as well as other regions of the world, experience many occupational and psychosocial stressors that remain under-researched. Objective: This study examines stress levels and determine associated risk factors among teachers in rural schools. Methods: A cross-sectional descriptive study was carried out August 2023 through December 2024 in three rural schools in Hazaribagh, Jharkhand. A total of 94 full-time teachers met the inclusion criteria and agreed to participate in this study. Data was collected via a validated semi-structured questionnaire which asked background information, job stress, musculoskeletal disorders (MSDs), and job satisfaction. Statistical analysis was conducted in SPSS v25 with significance set at p < 0.05. Results: The sample of 94 respondents was comprised of 70.2% females and 66% permanent teachers. The following factors were associated with responding with job stress: Male (p = 0.038), more than five classes a day (p < 0.01), unequal workload (p = 0.02), work pressure (p < 0.01), large classes (p < 0.01) travel time over 30 minutes (p = 0.02). Those with lower job satisfaction reported significantly higher stress scores. Conclusion: There are a number of organizational and workload related workplace stressors impacting rural school teachers rather than teacher demographic factors. Any future interventions to address the harmful effects of workplace stress for rural school teachers should focus on managing workload, fairly distributing tasks and responsibilities, and increasing supportive workplace mechanisms to alleviate stress and improve educational quality and teacher well-being.

Background: Diabetic nephropathy (DN) is one of the most serious microvascular complications of type 2 diabetes mellitus (T2DM), leading to end-stage renal disease (ESRD) and increased cardiovascular risk. In India, delayed diagnosis and poor glycemic control significantly contribute to early-onset renal deterioration. This study aimed to assess the pattern and severity of diabetic nephropathy in patients with poorly controlled T2DM and identify associated clinical factors. Methods: This cross-sectional study was conducted over a 12-months period from March 2024 to February 2025 at Dr. BSK Institute of Medical Sciences, Kanpur. A total of 140 patients with known T2DM and poor glycemic control (HbA1c ≥8%) were enrolled. All patients underwent clinical evaluation, biochemical testing including serum creatinine, estimated glomerular filtration rate (eGFR), and urinary albumin-to-creatinine ratio (UACR). Staging of diabetic nephropathy was based on KDIGO guidelines. Results: Among the 140 patients, 64 (45.7%) had microalbuminuria and 32 (22.9%) had overt proteinuria, indicating progression of nephropathy. Stage 1 and 2 DN was present in 36.4% of patients, stage 3 in 42.1%, and stage 4 or higher in 21.4%. Duration of diabetes >10 years, presence of hypertension, and HbA1c ≥10% were significantly associated with advanced nephropathy stages (p<0.01). Additionally, 28.6% of patients with macroalbuminuria had elevated serum creatinine levels (>1.5 mg/dL), while 14.3% had eGFR <30 mL/min/1.73 m². Conclusion: A substantial proportion of patients with uncontrolled type 2 diabetes mellitus exhibit progressive stages of diabetic nephropathy. Poor glycemic control, prolonged disease duration, and coexisting hypertension significantly contribute to renal function decline. Regular screening using UACR and eGFR is essential for early detection and intervention to prevent irreversible renal damage in diabetic patients.

Background: Patients with ^‘type 2 diabetes mellitus (T2DM) are increasingly recognized as being at risk for thyroid dysfunction, particularly hypothyroidism, due to shared metabolic and inflammatory pathways. The bidirectional relationship between these conditions may worsen glycemic control and contribute to complications. Aim: To assess the prevalence and pattern of thyroid dysfunction among T2DM patients and its association with age, duration of diabetes, and diabetic complications. Methodology: This cross-sectional observational study^’ was conducted ^‘over 12 months at NMCH, Sasaram, Bihar,India and Sheikh Bhikhari Medical College, Hazaribagh, India, involving 90 T2DM patients aged above 30. Clinical, biochemical, and thyroid parameters were assessed and analyzed using SPSS v25. Results: Thyroid dysfunction was present in 17.77% of participants, with hypothyroidism being predominant. Elevated TSH and decreased Free T3 were more common among those with longer diabetes duration and higher HbA1c (>9%). No statistically significant associations were found between thyroid status and diabetic neuropathy (p=0.56) or retinopathy^’ (p=0.47). Conclusion: A significant proportion ^‘of T2DM patients exhibited thyroid abnormalities, especially in the presence of poor glycemic control and longer disease duration. Routine screening is warranted for early detection and better metabolic control.