Background: Chronic kidney disease (CKD) is characterized by progressive loss of renal function and high cardiovascular risk. Microalbuminuria reflects glomerular and endothelial injury and is widely used for risk stratification. Oxidative stress has been implicated in CKD progression, yet the relationship between systemic antioxidant defenses and microalbuminuria across CKD stages requires clearer clinical characterization. Objective: To evaluate stage-wise changes in antioxidant biomarkers and to determine their association with microalbuminuria among CKD patients. Methods: This observational cross-sectional study included 60 CKD patients spanning stages 1–5. Participants were grouped as early CKD (stages 1–2), moderate CKD (stage 3), and advanced CKD (stages 4–5). Enzymatic antioxidants—superoxide dismutase (SOD), catalase, and glutathione peroxidase (GPx)—and total antioxidant capacity (TAC) were assessed. Microalbuminuria was measured using the urinary albumin–creatinine ratio (ACR). Stage-wise comparisons, correlation analysis, and multivariate linear regression were performed, adjusting for age, diabetes mellitus, and CKD stage. Results: Antioxidant biomarkers showed a significant progressive decline with advancing CKD stage (all p < 0.001), while ACR increased markedly across stages (p < 0.001). TAC demonstrated the strongest inverse correlation with ACR (r = −0.50, p < 0.001), followed by GPx (r = −0.48, p < 0.001). In multivariate regression analysis, TAC (β = −0.40, p < 0.001) and GPx (β = −0.35, p = 0.002) remained independent negative predictors of microalbuminuria, whereas CKD stage (β = +0.45, p < 0.001) and diabetes mellitus (β = +0.20, p = 0.01) were positive predictors. Conclusion: Declining antioxidant defense is independently associated with microalbuminuria in CKD, supporting oxidative imbalance as a mechanistic contributor to albuminuric renal injury.

Introduction: Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide. Early identification of individuals at increased risk is essential for timely intervention. Carotid intima–media thickness (CIMT), measured by high-resolution B-mode ultrasonography, reflects early atherosclerotic changes and has emerged as a reliable, non-invasive marker of systemic atherosclerosis and cardiovascular risk. Aims: To evaluate carotid intima–media thickness as an independent predictor of coronary artery disease and to assess its association with cardiovascular risk factors. Materials and Methods: This hospital-based observational case–control study was conducted in the Department of Radiology, BKL Walawalkar rural medical college, Chiplun, Ratnagiri. The study included 52 angiographically confirmed CAD cases and 26 age- and gender-matched controls without CAD. All subjects underwent clinical evaluation, biochemical investigations, and carotid ultrasonography for measurement of CIMT, carotid plaque, and degree of carotid stenosis. Statistical analysis was performed to determine the association between CIMT and CAD. Results: Mean CIMT was significantly higher in CAD cases compared to controls. Carotid plaque was present in 65.38% of cases versus 23% of controls (p < 0.05). CAD cases showed significantly higher total cholesterol, LDL-C, triglycerides, post-prandial blood sugar, and body mass index, with lower HDL-C levels. Moderate to severe carotid artery stenosis was observed exclusively among cases, supporting the role of increased CIMT as an independent predictor of CAD.

Background: Oxidative stress is increasingly recognized as a central mechanism driving the progression of Chronic Kidney Disease (CKD) and glomerular injury. While the depletion of antioxidant defenses is well-documented in uremia, the specific relationship between Glutathione Peroxidase (GPx) activity—a critical enzyme in hydrogen peroxide scavenging—and the severity of albuminuria remains under-characterized in non-dialysis populations. This study aimed to evaluate the status of GPx activity across CKD stages and determine its correlation with urinary albumin excretion. Methods: We conducted an observational, cross-sectional study involving 60 patients with non-dialysis CKD (Stages 1–5) at a tertiary care center in Central India. Patients on antioxidant supplementation or renal replacement therapy were excluded. Serum GPx activity, Total Antioxidant Capacity (TAC), and Malondialdehyde (MDA) levels were quantified. Urinary albumin excretion was assessed using the Urinary Albumin-to-Creatinine Ratio (UACR). Statistical analysis included ANOVA for stage-wise comparisons and Pearson’s correlation coefficient to assess associations between oxidative markers and renal parameters. Results: The study cohort (mean age 56.4 ± 12.3 years) exhibited a systemic reduction in mean GPx activity (6.8 ± 2.1 U/mL) compared to reference standards. We observed a significant, stepwise decline in GPx activity advancing from CKD Stage 1 through Stage 5 ($p < 0.001$). Correlation analysis revealed a robust inverse relationship between serum GPx activity and microalbuminuria ($r = -0.48, p < 0.001$), as well as 24-hour urinary albumin excretion ($r = -0.52, p < 0.001$). Conversely, GPx activity was positively correlated with the estimated Glomerular Filtration Rate (eGFR). Conclusion: Our findings demonstrate that the depletion of Glutathione Peroxidase activity is strongly associated with the magnitude of albuminuria and the severity of renal impairment. This suggests that compromised enzymatic antioxidant defense is a pivotal factor in glomerular barrier dysfunction. Monitoring GPx activity may serve as a valuable biomarker for oxidative stress, highlighting a potential therapeutic target to retard CKD progression.

Background: Caesarean section remains a major operative procedure in obstetrics, accounting for approximately 20-30% of deliveries globally. The choice of skin closure technique influences postoperative wound complications and cosmetic outcome. Interrupted vertical mattress sutures provide rapid closure with wound eversion, while continuous subcuticular sutures offer superior cosmesis but require technical expertise. Objective: To compare interrupted vertical mattress sutures with continuous subcuticular sutures regarding wound infection, dehiscence, pain, operative time, and cosmetic outcome following caesarean section. Methods: A prospective comparative study was conducted at District Hospital Kishtwar, Department of Obstetrics and Gynaecology, Jammu & Kashmir, India from January 2025 to June 2025. A total of 100 women aged 18-40 years at gestation 37-41 weeks undergoing elective caesarean section via Pfannenstiel incision were allocated into two groups: Group A (continuous subcuticular polyglactin 2-0, n=50) and Group B (interrupted vertical mattress silk 2-0, n=50). All patients received single preoperative ceftriaxone 1gm IV, IV ceftriaxone BD ×3 days, then oral cefuroxime 500mg BD ×7 days. Primary outcomes were wound infection and dehiscence at 7-10 days postoperatively. Secondary outcomes included postoperative pain (visual analogue scale), operative time, and cosmetic appearance at 6 weeks. Statistical analysis used chi-square test for categorical variables and independent t-test for continuous variables; p<0.05 was considered statistically significant. Results: Baseline demographic characteristics were similar between groups (age Group A: 27.6±5.0 years vs Group B: 27.4±3.99 years, p=0.92). Wound infection occurred in 3.4% (n=2) of subcuticular group versus 24% (n=12) in mattress group (p=0.008). Dehiscence was observed in 2% (n=1) versus 10% (n=5) respectively (p=0.204). Mean operative time was 22±7.55 minutes for vertical mattress group. Subcuticular group demonstrated reduced pain, superior cosmesis and higher patient satisfaction compared to mattress group. Conclusion: Continuous subcuticular polyglactin sutures demonstrated significantly lower wound infection rates (3.4% vs 24%), reduced postoperative pain, and superior cosmetic outcome compared to interrupted vertical mattress silk sutures. Subcuticular closure is recommended as the preferred technique for routine elective caesarean sections.

Aim: To evaluate the efficacy of skin flap anchoring (quilting) technique combined with active seroma monitoring in reducing seroma formation, aspiration requirements, and improving postoperative outcomes in patients undergoing modified radical mastectomy for breast cancer. Materials and Methods: A prospective observational study was conducted over 24 months (January 2023 to December 2024) at Department of General Surgery RKDF Medical College Hospital & Research Center, Bhopal. A total of 156 consecutive female patients undergoing modified radical mastectomy for invasive breast carcinoma were enrolled. Patients were divided into two groups: Group A (n=78) underwent mastectomy with skin flap anchoring (quilting), and Group B (n=78) underwent conventional mastectomy without flap fixation. Active Seroma Monitoring Was Performed Using Ultrasonography On Postoperative Days 3, 7, 14, 30, And 60. Primary Endpoints Included Clinically Significant Seroma (CSS) Requiring Aspiration, Total Seroma Volume, And Drainage Duration. Secondary Endpoints Included Infection Rates, Skin Dimpling, Shoulder Mobility, And Patient Satisfaction Scores. Results: Clinically Significant Seroma (CSS) Requiring Aspiration Occurred In 12.8% (10/78) Of Patients In The Flap Anchoring Group Compared To 38.5% (30/78) In The Control Group (P=0.001). Mean Drainage Duration Was Significantly Reduced In The Flap Anchoring Group (4.2±1.8 Days Vs. 6.8±2.3 Days, P<0.001). Total Seroma Volume At 14 Days Was 45.3±28.6 Ml In The Flap Anchoring Group Versus 128.7±64.2 Ml In Controls (P<0.001). Infection Rates Were Comparable Between Groups (3.8% Vs. 5.1%, P=0.64). Shoulder Mobility Was Preserved In Both Groups Without Significant Limitation. Skin Dimpling Occurred In 7.7% Of The Flap Anchoring Group But Resolved Within 6 Months In All Cases. Conclusion: Skin Flap Anchoring Combined With Systematic Seroma Monitoring Effectively Reduces Clinically Significant Seroma Formation And Shortens Drainage Duration After Modified Radical Mastectomy Without Increasing Postoperative Complications. This Technique Should Be Adopted As Standard Practice In All Mastectomy Procedures For Improved Patient Outcomes And Reduced Morbidity.