Background: Anaemia during pregnancy remains a major public health problem and is associated with adverse maternal and fetal outcomes, including fatigue, poor pregnancy tolerance, preterm birth, low birth weight, and increased perinatal morbidity. Its causes are multifactorial and commonly include iron deficiency, folate deficiency, vitamin B12 deficiency, poor dietary intake, short birth spacing, and socioeconomic factors. Objective: The present study aims to assess the prevalence and severity of anaemia among antenatal women attending a tertiary care hospital and to evaluate associated haematological and nutritional parameters, including haemoglobin level, complete blood count, iron profile, serum ferritin, vitamin B12, and folate levels. Materials and Methods: This prospective, observational, hospital-based study will be conducted in the Department of Obstetrics and Gynaecology, Phulo Jhano Medical College and Hospital, Dumka, Jharkhand, India, over a period of one year from January 2025 to December 2025. A total of 130 antenatal women diagnosed with anaemia during routine antenatal outpatient visits will be included. Anaemia will be classified according to World Health Organization criteria as mild, moderate, or severe based on haemoglobin concentration. Relevant demographic details, obstetric history, dietary pattern, symptoms, and laboratory findings will be collected using a structured questionnaire and clinical records. Data will be analysed using appropriate statistical methods, and a p-value of less than 0.05 will be considered statistically significant. Conclusion: The study is expected to provide useful information regarding the burden, severity, and nutritional profile of anaemia among pregnant women attending a tertiary care hospital. The findings may help in planning early screening, targeted nutritional interventions, iron-folic acid supplementation, and improved antenatal care strategies to reduce anaemia-related maternal and fetal complications.

Background: Sacrococcygeal pilonidal sinus is a chronic inflammatory condition of the natal cleft that commonly affects young adults and is associated with pain, discharge, recurrent infection, and loss of productivity. Various surgical techniques are available for its management, with open excision and flap-based procedures being among the most commonly performed approaches. Objective: To compare the outcomes of flap surgery and open surgery in the management of sacrococcygeal pilonidal sinus. Materials and Methods: This ambispective observational study was conducted in the Department of General Surgery, District Hospital, Sawai Madhopur, and Rajasthan. A total of 58 patients with sacrococcygeal pilonidal sinus were included, of whom 21 underwent flap surgery and 37 underwent open surgery with excision and secondary wound healing. Parameters evaluated included operative duration, wound healing time, hospital stay, return to normal activity, postoperative pain, patient satisfaction, and postoperative complications. Results: The mean operative duration was significantly higher in the flap surgery group than in the open surgery group (48.2±7.6 vs 22.4±5.1 minutes; p<0.001). However, wound healing time (16.8±3.5 vs 42.6±10.4 days; p<0.001) and return to normal activity (17.4±4.2 vs 37.5±10.2 days; p<0.001) were significantly shorter in the flap surgery group. Postoperative pain scores were significantly lower and patient satisfaction scores were significantly higher in the flap surgery group at all follow-up intervals (p<0.001). Conclusion: Flap surgery was associated with faster wound healing, earlier return to normal activity, lower postoperative pain, and higher patient satisfaction compared with open surgery. Despite a longer operative duration, flap surgery may be considered a preferred surgical option.

Background: The menstrual cycle involves significant hormonal fluctuations that influence various physiological systems, including the autonomic nervous system (ANS). Estrogen and progesterone levels vary across phases, potentially modulating sympathetic and parasympathetic balance. Understanding these variations is crucial for interpreting clinical data in women and managing conditions linked to hormonal changes. Material and Methods: This one-year observational study was conducted in the Department of Physiology at a medical college in Western Gujarat, India. One hundred healthy female volunteers aged 18-30 years with regular menstrual cycles (21-35 days) participated after providing informed consent. Autonomic function tests, including resting heart rate, blood pressure, and short-term HRV analysis (5-minute ECG recordings), were performed during four phases: menstrual (days 1-5), follicular (days 6-12), ovulatory (around day 14), and luteal (days 20-25). Standardized protocols ensured consistency, with ethical approval from the institutional review board. Data were analyzed using appropriate statistical methods. Result: Significant variations were observed across phases. Heart rate increased and HRV parameters like RMSSD and SDNN decreased progressively from menstrual to luteal phase, indicating sympathetic predominance in the latter. Blood pressure showed mild elevation in the luteal phase. Frequency domain parameters revealed a higher LF/HF ratio during the luteal phase. These changes were statistically significant (p<0.05) and aligned with hormonal influences. Conclusion: The study demonstrates notable autonomic function variations across menstrual cycle phases in women from Western Gujarat, with sympathetic dominance in the luteal phase. These findings underscore the importance of considering menstrual phase in clinical assessments involving ANS. Further longitudinal studies could explore underlying mechanisms and clinical implications.

Background: Road traffic accidents remain an important cause of injury, disability and death, particularly in low- and middle-income countries. Vehicle- and transport-related factors such as type of vehicle, speed, overcrowding, maintenance status, first aid and mode of transport to hospital can influence both accident occurrence and post-crash outcome. Aim: To study vehicle- and transport-related risk factors among road traffic accident victims presenting to a tertiary care hospital in Jodhpur. Material and Methods: This hospital-based cross-sectional study was conducted in the Accidental Emergency Department of a tertiary care hospital in Jodhpur, in coordination with the Department of Community Medicine, from November 2020 to January 2021. A total of 200 road traffic accident victims presenting within 24 hours of the accident were included. Data were collected using a semi-structured proforma after informed consent. Information regarding victim’s vehicle, opposite colliding vehicle, speed, vehicle occupancy, maintenance status, first aid and transport to hospital was recorded. Data were analysed using MS Excel and Epi Info software. Results: Motorised two-wheelers were the most common victim’s vehicle, 97 (48.5%), followed by pedestrians, 58 (29.0%). The opposite colliding vehicle was most commonly a motorised four-wheeler, 102 (51.0%). Among non-pedestrian victims, speed of 61–80 km/h was most common, 76 (54.3%). Overcrowding was seen in 20 (14.1%) vehicles, and 103 (78.6%) motorised vehicles had not been serviced within the last 6–12 months. Private vehicles transported 105 (52.5%) victims to hospital, while ambulance was used in 66 (33.0%) cases. First aid was provided to 103 (51.5%) victims. Victim’s vehicle and opposite colliding vehicle showed significant association (p=0.002). Conclusion: Two-wheeler involvement, higher speed, poor maintenance and limited ambulance use were important findings. Regular vehicle fitness checks, speed control and improved pre-hospital care are recommended.

Remarkable transformation has been observed in separation science with the evolution in the design of stationary phases, observing a transition from conventional silica-based columns to monoliths, engineered polymers, metal-organic frameworks (MOFs), and many others. Many of these stationary phases have seen routine or specialized application in industrial and research settings. In this review article, a critical examination of the evolution in stationary phases employed in separation methods is conducted, emphasizing the surface chemistry, analyte retention mechanisms, and emerging sustainability considerations. A comparison of columns shows an evolution in analytes from just molecules and proteins to a wider range of analytes, including cells. While these evolutions have brought significant advances in research, advances in stationary phases have yet to come to a halt, with research being performed in MOFs and more.

Background: Laparoscopic cholecystectomy (LC) is the gold standard treatment for symptomatic gallstone disease because of its minimal invasiveness and faster recovery. However, conversion to open cholecystectomy is occasionally required in technically difficult cases to ensure patient safety. Identifying preoperative clinical predictors may help anticipate conversion and improve surgical outcomes. Aim: To evaluate the clinical predictors, conversion rates, and surgical outcomes of laparoscopic cholecystectomy converted to open cholecystectomy in a tertiary care hospital. Methodology: This retrospective hospital-based study was conducted over a period of one year at a Department of General Surgery, Anugrah Narayan Magadh Medical College and Hospital, Gaya ji, Bihar, India. A total of 115 patients who underwent laparoscopic cholecystectomy for symptomatic gallstone disease were included. Demographic characteristics, clinical predictors, operative details, conversion rates, postoperative complications, length of hospital stay, and treatment outcomes were retrieved from hospital medical records and analyzed using descriptive and inferential statistics. Results: The majority of patients were females (63.5%) aged 41–50 years (30.4%). Acute cholecystitis (33.9%), thickened gallbladder wall (29.6%), and dense pericholecystic adhesions (27.0%) were the most common predictors of conversion. The overall conversion rate was 13.0%. Dense adhesions (33.3%) and unclear Calot’s triangle anatomy (26.7%) were the leading reasons for conversion. Surgical site infection (10.4%) was the most frequent postoperative complication. Overall, 97.4% of patients recovered successfully, while mortality was 2.6%. Conclusion: Laparoscopic cholecystectomy remains a safe and effective procedure with a low conversion rate and favorable outcomes. Early recognition of high-risk patients and timely conversion when indicated are essential to minimize complications and improve surgical outcomes.

Background: A knee injury is one of the most prevalent musculoskeletal complaints, and frequently involves the ligaments, menisci, and articular cartilage of the knee. Determining an accurate diagnosis of internal derangements of the knee is crucial for effective treatment planning. There is no best treatment, but arthroscopy is considered the gold standard, and is an invasive procedure, whereas Magnetic Resonance Imaging (MRI) is a non-invasive alternative. Aim: To evaluate the diagnostic accuracy of MRI in detecting knee injuries by correlating its findings with arthroscopic observations. Methodology: Prospective observational study was done in department of Radio-Diagnosis, Netaji Subhas Medical College and Hospital Adityapur, Jharkhand for one year. In all, 105 patients were evaluated with an MRI scan and had an arthroscopy performed. The MRI results were correlated with the arthroscopic results, and the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were computed. Results: MRI was found to be highly accurate in the diagnosis of ligamentous and meniscal injuries and had an excellent correlation with tears of the ACL, PCL, medial meniscus and lateral meniscus. PCL tears had the greatest diagnostic accuracy, and relatively low sensitivity was seen for chondral and osteochondral lesions. Conclusion: MRI is a very reliable non-invasive imaging tool to assess knee injuries and is a good correlation with arthroscopic findings. It’s helpful for diagnosis prior to surgery and can prevent unnecessary diagnostic arthroscopies.

Background: Sleep deprivation is a condition in which a person don’t get enough sleep. He can become sleep deprived due to medical conditions, environmental conditions (stress, long work hours, excess caffeine intake, etc.), or a combination of both. Without regular and sufficient sleep, the wear and tear on our physiology accumulates. This can result in short-term consequences as well as longer term health risks. Sleep quality is critical for optimal health, mental acuity, and performance. By studying quality of sleep and its effects, researchers can examine ways to ensure university students and healthcare professionals get adequate sleep each Night. Methodology: An observational, cross-sectional study, (an Epidemiological study) Conducted in the Department of Physiology and Medical colleges around the health university, Vijayawada. The study was conducted for duration of 2 months November 2025 to December2025 by using A semi structured questionnaire which includes SATED questionnaire &Functional Outcomes of Sleep. The subjects are included by Convenience sampling method those were willing to participate in the study will be included with Sample size: 100. After obtaining Institutional Ethics Committee approval, eligible students were recruited. M.B.B.S students within the age group of 19–24-years. The purpose of the study was explained and written informed consent was obtained. Participants were administered a semi-structured questionnaire consisting of demographic details, general health history, and sleep-related questionnaires. Sleep quality was assessed using the SATED questionnaire, and the functional impact of sleep deprivation was evaluated using the Functional Outcomes of Sleep Questionnaire-10 (FOSQ-10).  Data were entered in Microsoft Excel and analyzed using appropriate statistical software. Results were expressed as percentages and proportions. Associations between variables were analyzed using Chi-square test where applicable. Results:  Among The Study Population, 82% Does not Have Any Severe Symptoms of Sleep Deprivation, Where As Few Have Impulsive Behaviour(5%), Micro sleeps (5%), Drooling Eyelids (3%), Hallucinations (2%), Trouble Speaking Clearly (2%), Impaired Judgement (1%) Respectively. Almost (78%) of the studied subjects are found to be having mild to moderate sleep, whereas (17%) have good sleep and very few (5%) have poor sleep. Assessment of impact of Sleep Deprivations among Medial graduates: It is done using FOSQ- 10 (Functional outcomes of sleep deprivation). Out of the 100 studied subjects, only 2 (2%) expressed as having sleep related functional impairment. It is on par with the results of FOSQ-10. Strengths: Medical students were chosen as the focus of the study because they represent an at-risk population. Validated assessment tools, including the SATED scale and the FOSQ-10 questionnaire, were used to ensure reliable measurement. Limitations: The cross-sectional study design limits the ability to establish causal relationships. Reliance on self-reported questionnaires may lead to underestimation of the true level of impairment. The absence of objective assessments, such as actigraphy or sleep logs, is another limitation. Additionally, the study included a limited evaluation of modifiable factors, such as screen time and caffeine intake. Implications: The findings highlight the urgent need for: Sleep-hygiene education in medical colleges, Screening for sleep disorders in students, Structuring academic schedules to reduce chronic sleep debt, Stress-management and mental wellness programs. Conclusions: In this study on sleep deprivation prevalence and assessment of consequences of sleep deprivation, it is found that A total of 100 participants were included in the study. Sleep quality assessment showed that 5% of participants had poor sleep, 78% had mild to moderate sleep impairment, and 17% reported good sleep quality. Thus, 83% of the study population exhibited some degree of sleep disturbance. Functional outcomes were assessed using the FOSQ-10 scale. Only 2% of the participants demonstrated sleep-related functional impairment, while 98% reported no functional impairment. The findings indicate that although sleep quality was sub optimal for a large proportion of participants, functional impact on daily activities remained minimal. The study reveals a high prevalence of mild to moderate sleep impairment among participants but minimal functional consequences as measured by FOSQ-10. These findings emphasize the need for early screening and preventive strategies to address sleep disturbances before they lead to significant cognitive or functional deficits.

Introduction: Fetal biometry is a methodology devoted to measuring several parts of fetal anatomy and their growth. The present study was carried out to assess gestational age in the second and third trimesters with the help of ultrasonographic measurements of four fetal biometric parameters (i.e., biparietal diameter [BPD], head circumference [HC], abdominal circumference [AC], and femur length [FL]) in the local population Hyderabad, and also to evaluate efficacy and significance of these four fetal biometric parameters in the prediction of gestational age by ultrasound. Materials and Methods: The present study was carried out in 100 normal pregnant women with singleton uncomplicated pregnancy, with the known last menstrual period (LMP). Results: FL was found to be more reliable parameter as compared to HL in both second trimester of pregnancy. Conclusions: Variation in predicted gestational age by ultrasonography (USG) is attributed to the anthropometric difference between the two populations due to racial, genetic, nutritional, and socioeconomic factors. Therefore, population-specific measurements should be made to generate tables and regression equations for more precise reporting of gestational age and EDD by USG.

Introduction: The intrauterine existence of fetus is dependent on one vital organ “THE PLACENTA”. Placenta is a vital organ for maintaining pregnancy & promoting normal foetal development. Materials and Methods: The present study was conducted in the department of Anatomy, Fathima institute of medical sciences, kadapa in collaboration with the Department of Obstetrics and Gynecology. Results: Various observations on gross appearance of human placentae were recorded in specially designed data sheets (annexure) and analysed. The study is done in 50 placentae for each of the above method. The observation made during the course of the present study with relevance to the shape of placentae, consistency, cord attachment, thickness and diameter, weight, fetoplacental weight ratio are tabulated in the foregoing pages for the sake of convenience and to gain an insight into the data. Conclusion: In the current study 50 full term normal term placentae were collected from S.V.S Hospital, Mahaboobnagar and subjected for gross inspection and dissection with relevance to shape and consistency, cord insertion, thickness, diameter, weight etc.

Background: Axillary Artery is a continuation of subclavian artery, extending from outer border of first rib to lower border of teres major muscle where it continues as brachial artery. The axillary artery is conventionally described as giving off six branches but the number arising independently from it, is subject to considerable variations.

Introduction: Purpose of this study is to find out clinical profile of low-grade spondylolisthesis at L4-L5 and L5-S1 vertebrae in rural south Indian population. Co-relation between grades of spondylolisthesis and Modic change (MC) is not extensively researched. In heavy workers incidence of low back ache is common. Low grade spondylolisthesis has more options of treatment than high grade spondylilosthesis. Material and Methods: Cross sectional study was carried out in a span of 2 years in 40 patients with age 20-70 years with single-level L4/L5 and L5/S1 low grade (Meyerding’s grade I and II) spondylolisthesis, with clinical and neurological examination, assessment of pain by Visual Analogue Score (VAS) and investigations like X ray CT scan & MRI. Statistical analysis: Descriptive statistics like tables and percentages were used to present the data. Mean and standard deviations are calculated for quantitative parameters. Chi-square test was used to find co relation between MC & grades of lumbar spodylolisthesis. Results: Out of 40 cases, 27.5% were males and female were 72.5%. The most affected age group was 40-60 years (65%). Lower back pain (LBP) was the most common symptom (100%). Straight leg raise test was positive in 81.25%. Sensory and motar deficit was seen in 45% of patients.  Average slip angle was 16. L4-L5 level is affected in 60%. Incidence of Meyerding’s grade I & II were 67.5% & 32.5% respectively. In both grades females were more in distribution than males and L4-L5 vertebral level was involved significantly. Isthmic (IS) & Degenerative (DS) spondylolisthesis was 82.5% & 17.5% respectively and seen significantly in females. In IS the level affected was L5-S1 and in DS L4-L5 level. Incidence of MC type1 is 15%, type 2 is 85% and type3 were not found in any cases. Incidence of females was higher in type 1 & 2 M.C (83.3% & 70.6%) as compared to males (16.6% & 29.4%). MC were found to be common in grade II spondylolisthesis (48%) at L4-L5. Conclusions: Incidence of spondylolisthesis, grade and MC are gender specific. This study elucidates the clinical presentations of low-grade spondylolisthesis and specific changes associated with it and that will help in tracing factors responsible for it and assessing treatment outcome.

Introduction: Industrialization is a major breakthrough in development of any country, demanding maximum efficiency of work from people involved, this led to a separate branch of science called ergonomics and anthropometry being an integral part of it. Materials & Methods: This study was done randomly with the students and faculty members in the age  group of 18 years to 30 years. Sample size is 310, out of which 155 are males and 155 females. It was estimated considering the correlation, coefficient between foot length, breadth and height, weight of person (r = 0.869). The precision considered here was confidence interval as 95%, power as 90% and expecting the population co-relation as 0.92. Results: The data was collected after the measurements of the foot were carried out and compiled in a tabular form. The compiled data was subjected to statistical analysis using Statistical package for social  sciences (SPSS)  , and results obtained were analysed meticulously and the following observations were obtained. Multiple linear regression was used to find the independent predictors of height using length of right foot in sitting and standing position, length of left foot in sitting and standing position, breadth of right foot in sitting and standing position, and breadth of left foot in sitting and standing position. Conclusion: Height estimation by measurement of various long bones has been attempted by several workers. However foot dimensions have not frequently been used for this. Ossification and maturation in foot occurs earlier than the long bones and therefore during adolescence age, height could be more accurately predicted from foot dimensions as compared to long bones.

Introduction: The cause of venous compromise is multifactorial. The venous system variations are generally explained on the basis of their embryological basis. Variations of azygos venous system is not clearly described in the literature. Multiple variations like mode of formation of azygos vein formed mostly by the union of ascending lumbar and subcostal veins, position of azygos vein which courses normally to the right side forms in the midline and on left side in some cases. Variations in the mode of termination of Azgos vein, in formation of Hemi azygos vein, mode of termination of Hemi azygos vein are explained in view of their embryological development. Venous abnormalities often complicate mediastinal  sugary with intra operative haemorrhage. Prior knowledge of possible anatomical variations may help the surgeons to reduce the risk of such events. Material and Methods: The study was conducted in the department of Anatomy,. 50 cadavers used for the study were allotted for medical undergraduates. Results: The position of Azygos vein in on right side in 53.33%, in midline in 46.66% of subjects. In the present study the level of termination of the Azygos vein is between third and fourth thoracic vertebra. Hemiazygos, the left lower complement of the Azygos vein formed by the union of left ascending lumbar and subcostal veins usually. Conclusion: Knowledge of the variability of the azygos venous system in an important anatomical sign post in radiological diagnosis and in the surgical treatment of thoracic aorta aneurysms and tumors of the posterior mediastinum.

Fine-needle aspiration cytology (FNAC) is widely used for the stratification of thyroid nodules Results of FNAC were reported as per the Bethesda System for Reporting of Thyroid Cytopathology  Rapid on-site evaluation (ROSE) has been proposed to improve the overall adequacy of FNA. ROSE is a simple technique, which helps in the immediate assessment of sample adequacy. This reduces the turnaround time for reporting the cases. And hence, in turn, allowing early intervention and treatment of the patient.

Fine-needle aspiration cytology (FNAC) is widely used for the stratification of thyroid nodules . Results of FNAC were reported as per the Bethesda System for Reporting of Thyroid Cytopathology  Rapid on-site evaluation (ROSE) has been proposed to improve the overall adequacy of FNA. ROSE is a simple technique, which helps in the immediate assessment of sample adequacy. This reduces the turnaround time for reporting the cases. And hence, in turn, allowing early intervention and treatment of the patient.

Background: Viral hemorrhagic fevers (VHFs), caused by Arenaviruses, Filoviruses, Bunyaviruses, and Flaviviruses, are globally distributed. In India, Dengue fever, Dengue hemorrhagic fever (DHF), and Kyasanur Forest Disease (KFD) are endemic, with Dengue being hyperendemic in many regions. VHFs are highly infectious and potentially fatal, presenting with symptoms such as fever, vomiting, bleeding, edema, and hypotension. Diagnosis of Dengue fever primarily relies on NS1 antigen detection, while thrombocytopenia is a common finding due to bone marrow suppression, platelet destruction, and viral replication. Platelet indices, including mean platelet volume (MPV) and platelet distribution width (PDW), serve as important markers for assessing platelet activation and bleeding risk. Methods: A prospective observational study at Ballari Medical College and Research Center (June 2022–December 2024) includes 200 febrile thrombocytopenia patients in the early defervescence stage. EDTA blood samples are analyzed for hematological parameters, including hemoglobin, leukocyte count, red cell indices, and platelet count. Platelet indices (MPV, PDW, PCT) are assessed within two hours of venipuncture. Serological tests (dengue NS1, IgM, IgG) and additional renal and liver function tests are also conducted. Results: In this prospective study of 200 pediatric patients with viral hemorrhagic fever, the most affected age group was 6–10 years, with a male predominance (59.5%). Fever was universal, and common symptoms included abdominal pain (90%), right hypochondrial tenderness (81.5%), vomiting (68.5%), and nausea (64%). Most children were hemodynamically stable at presentation, though 68% had hepatomegaly. Platelet indices showed significant trends over 11 days: platelet count and plateletcrit progressively increased, while mean platelet volume (MPV) and platelet distribution width (PDW) decreased (p<0.001), indicating hematological recovery. Liver dysfunction was common (57%), but renal involvement was rare (1%). NS1 antigen was positive in 91%, confirming dengue as the major etiology. Confirmed diagnoses included classic dengue fever (74%), dengue hemorrhagic fever (9%), Dengue Shock syndrome(7%) and rare cases of dengue encephalitis (1%). Conclusion: This study demonstrates that serial monitoring of platelet indices—rising platelet count, Plateletcrit and declining MPV & PDW and plateletcrit—effectively correlates with disease severity and recovery in pediatric viral hemorrhagic fever. The findings justify the study’s objective, highlighting these indices as reliable, non-invasive prognostic tools that aid in clinical assessment, timely intervention, and improved outcomes in affected children.

Background: Viral hemorrhagic fevers (VHFs), caused by Arenaviruses, Filoviruses, Bunyaviruses, and Flaviviruses, are globally distributed. In India, Dengue fever, Dengue hemorrhagic fever (DHF), and Kyasanur Forest Disease (KFD) are endemic, with Dengue being hyperendemic in many regions. VHFs are highly infectious and potentially fatal, presenting with symptoms such as fever, vomiting, bleeding, edema, and hypotension. Diagnosis of Dengue fever primarily relies on NS1 antigen detection, while thrombocytopenia is a common finding due to bone marrow suppression, platelet destruction, and viral replication. Platelet indices, including mean platelet volume (MPV) and platelet distribution width (PDW), serve as important markers for assessing platelet activation and bleeding risk. Methods: A prospective observational study at Ballari Medical College and Research Center (June 2022–December 2024) includes 200 febrile thrombocytopenia patients in the early defervescence stage. EDTA blood samples are analyzed for hematological parameters, including hemoglobin, leukocyte count, red cell indices, and platelet count. Platelet indices (MPV, PDW, PCT) are assessed within two hours of venipuncture. Serological tests (dengue NS1, IgM, IgG) and additional renal and liver function tests are also conducted. Results: In this prospective study of 200 pediatric patients with viral hemorrhagic fever, the most affected age group was 6–10 years, with a male predominance (59.5%). Fever was universal, and common symptoms included abdominal pain (90%), right hypochondrial tenderness (81.5%), vomiting (68.5%), and nausea (64%). Most children were hemodynamically stable at presentation, though 68% had hepatomegaly. Platelet indices showed significant trends over 11 days: platelet count and plateletcrit progressively increased, while mean platelet volume (MPV) and platelet distribution width (PDW) decreased (p<0.001), indicating hematological recovery. Liver dysfunction was common (57%), but renal involvement was rare (1%). NS1 antigen was positive in 91%, confirming dengue as the major etiology. Confirmed diagnoses included classic dengue fever (74%), dengue hemorrhagic fever (9%), Dengue Shock syndrome(7%) and rare cases of dengue encephalitis (1%). Conclusion: This study demonstrates that serial monitoring of platelet indices—rising platelet count, Plateletcrit and declining MPV & PDW and plateletcrit—effectively correlates with disease severity and recovery in pediatric viral hemorrhagic fever. The findings justify the study’s objective, highlighting these indices as reliable, non-invasive prognostic tools that aid in clinical assessment, timely intervention, and improved outcomes in affected children.

Background: Postoperative orthopaedic surgical site infections are important causes of morbidity, delayed wound healing, prolonged hospitalization and increased treatment cost. Emergence of methicillin-resistant Staphylococcus aureus and multidrug-resistant Gram-negative bacilli has made their management more difficult. Aim: To detect MRSA among Staphylococcus aureus isolates and to determine the antibiotic susceptibility pattern of bacterial isolates from postoperative orthopaedic wound infections. Materials and Methods: This bacteriological study included 100 clinically diagnosed postoperative orthopaedic surgical site infection samples. Specimens were collected aseptically using sterile swabs and processed by Gram staining, aerobic culture and standard biochemical tests. Antibiotic susceptibility testing was performed by Kirby–Bauer disc diffusion method. MRSA detection among Staphylococcus aureus isolates was done using oxacillin screen agar. Results: Of 100 samples, 56 showed aerobic bacterial growth. Gram-positive cocci accounted for 33 isolates (58.92%) and Gram-negative bacilli for 23 isolates (41.07%). Staphylococcus aureus was the predominant isolate, 30 cases (53.57%). Among these, 18 (60%) were MRSA. Gram-positive isolates showed highest resistance to penicillin, while Gram-negative isolates showed highest resistance to ciprofloxacin and ceftriaxone. Conclusion: Staphylococcus aureus, especially MRSA, was the major pathogen in postoperative orthopaedic wound infections. Routine culture and sensitivity testing is essential for appropriate antibiotic therapy.

Background: Pediatric dermatoses are common causes of outpatient morbidity and may reflect underlying socioeconomic, environmental, hygienic and nutritional factors. They can also affect school performance, sleep, self-esteem and psychosocial wellbeing. Aim: To study the clinical spectrum, sociodemographic determinants and quality-of-life impact of pediatric dermatoses in a tertiary care hospital. Methods: This prospective cross-sectional study was conducted in the Departments of Dermatology and Pediatrics, GSL Medical College, from December 2025 to April 2026. A total of 300 children aged birth to 16 years with clinically evident skin disorders were included. Demographic details, socioeconomic status, residence, overcrowding, hygiene practices, nutritional status and clinical diagnosis were recorded. Dermatoses were classified into infectious, eczematous, allergic, pigmentary, appendageal, nutritional, genetic and miscellaneous groups. Children aged 4–16 years were assessed using the Children’s Dermatology Life Quality Index. Data were analyzed using appropriate statistical tests. Results: Infectious dermatoses were the most common group, accounting for 39.3% of cases, followed by eczematous disorders in 20.7%. Infectious dermatoses were significantly associated with rural residence, lower socioeconomic status, overcrowding, poor hygiene and undernutrition. The mean CDLQI score was 8.4 ± 5.1. Conclusion: Pediatric dermatoses were strongly influenced by sociodemographic determinants and produced considerable quality-of-life impairment.

Background: Cervical cancer remains a major cause of morbidity and mortality among women, particularly in low-resource settings lacking organised cytology-based screening. The Papanicolaou (Pap) smear has long been the standard screening method, while visual inspection with acetic acid (VIA) offers a simple, inexpensive, immediately reportable alternative. This study compared the screening performance of Pap smear and VIA in women attending a tertiary care hospital. Methods: This hospital-based observational study, conducted in the Department of Pathology, Bundelkhand Medical College, Sagar, included 123 women who underwent both Pap smear and VIA testing. Pap smears were reported per the Bethesda system; VIA was performed using 5% acetic acid, with the cervix examined for acetowhite areas after one minute. Results of the two tests were tabulated and cross-correlated. Results: Of the 123 women studied, 61.8% were aged 21-40 years, with a mean age of 39.4 years. VIA was positive in 5 cases (4.1%). On Pap smear, 101 cases (82.1%) were negative for intraepithelial lesion or malignancy (NILM), 3 (2.4%) were unsatisfactory, and 19 (15.4%) showed epithelial cell abnormality (ASCUS 6, ASC-H 5, LSIL 3, HSIL 4, squamous cell carcinoma 1). All five VIA-positive cases occurred among women with abnormal Pap smears; VIA positivity rose with cytological severity, from 16.7% in ASCUS to 50% in HSIL and 100% in the single carcinoma case. No VIA positivity occurred among NILM or unsatisfactory smears. Conclusion: Pap smear detected a considerably larger proportion of epithelial cell abnormalities than VIA. However, VIA positivity tracked the severity of cytological abnormality and identified the only case of frank malignancy. These findings support Pap smear as the primary screening method where cytology services are available, with VIA serving as a useful adjunct or triage tool — particularly for immediate identification of high-grade or malignant lesions in low-resource settings.

Background: Metabolic Syndrome is a cluster of cardiovascular risk factors such as obesity, insulin resistance, dyslipidemia, impaired glucose tolerance and hypertension, leading to increased cardiovascular morbidity and mortality. Gamma-glutamyl transferase or gamma-glutamyl transpeptidase (GGT) is a cell surface enzyme expressed in the liver, kidney, cerebrovascular endothelium and extracellular catabolism of antioxidant glutathione. Elevated GGT levels is the reflection of high degree of oxidative stress, seen in central obesity. Also epidemiological studies have shown increased GGT with increased risk for cardiovascular morbidity and mortality. Hence GGT is found to be good predictor of susceptibility to cardiovascular risk factors like type II DM and hypertension. Aims and Objectives: To estimate the level of serum GGT and its association with metabolic syndrome. Materials and Methods: This is a case control study done in 50 cases of metabolic syndrome patients and 50 apparently healthy normal subjects in the age group between 18 – 60 years, attending Sree Mookambika Institute of Medical Sciences were included. Anthropometric measurements such as height, weight, waist circumference and BMI were measured for both the study and control groups and serum levels of fasting blood glucose, total cholesterol, triglycerides, HDL, GGT were measured using enzymatic methods. Patients with alcoholic liver disease, cholestasis, cardiac disease, known alcoholics, severely ill and on anti-epileptics were excluded. Results: The serum levels of fasting blood glucose, total cholesterol, triglycerides and HDL and GGT showed statistically significant levels in metabolic syndrome patients when compared to controls with a p value < 0.05. Conclusion: Metabolic syndrome is a significant public health problem even in low socio-economic states of India that needs to be tackled with proven strategies. Patients with metabolic syndrome have significantly elevated levels of GGT showing a significant association with metabolic syndrome, probably due to the presence of insulin resistance, oxidative stress. Thus serum GGT levels serves as a marker for assessing metabolic syndrome.

Background: Total abdominal hysterectomy is commonly performed under either spinal or general anaesthesia. Selection of the anaesthetic technique influences intraoperative haemodynamics, postoperative pain, recovery, and patient satisfaction. Aim: To compare spinal and general anaesthesia in patients undergoing elective total abdominal hysterectomy with respect to haemodynamic changes, postoperative analgesia, recovery profile, complications, and patient satisfaction. Methods: This prospective randomized comparative study included 100 women undergoing elective total abdominal hysterectomy. Patients were randomly allocated into two groups: Group S (spinal anaesthesia, n=50) and Group G (general anaesthesia, n=50). Demographic variables, intraoperative haemodynamic parameters, blood loss, postoperative pain scores, analgesic requirement, recovery characteristics, complications, and patient satisfaction were evaluated and statistically compared. Results: Baseline demographic characteristics were comparable between the groups. Spinal anaesthesia resulted in significantly lower intraoperative blood loss (312 ± 58 vs. 356 ± 64 mL; p<0.001), lower postoperative pain scores (VAS 2.9 ± 0.9 vs. 4.8 ± 1.1; p<0.001), prolonged time to first rescue analgesia (5.8 ± 1.2 vs. 2.9 ± 0.8 hours; p<0.001), reduced postoperative analgesic consumption, earlier ambulation, and shorter hospital stay. However, hypotension (30% vs. 12%; p=0.028) and bradycardia (16% vs. 4%; p=0.046) were significantly more common in the spinal anaesthesia group. General anaesthesia was associated with a significantly higher incidence of postoperative nausea and vomiting (28% vs. 10%; p=0.022). Patient satisfaction was significantly greater following spinal anaesthesia (9.3 ± 0.6 vs. 8.4 ± 0.8; p<0.001). Conclusion: Spinal anaesthesia provides superior postoperative analgesia, improved recovery, reduced blood loss, and greater patient satisfaction compared with general anaesthesia for elective total abdominal hysterectomy. Although associated with transient haemodynamic changes, spinal anaesthesia remains a safe and effective technique when appropriate monitoring and perioperative management are employed.

Background: Ultrasound-guided femoral nerve block and adductor canal block are widely used regional analgesic techniques for lower limb orthopaedic surgery. Although both provide effective postoperative analgesia, preservation of quadriceps muscle strength remains an important consideration for early rehabilitation. Aim: To compare ultrasound-guided femoral nerve block and adductor canal block regarding postoperative analgesia, quadriceps muscle strength, functional recovery, complications, and patient satisfaction in lower limb orthopaedic surgery. Methods: This prospective randomized comparative study included 80 patients undergoing elective lower limb orthopaedic surgery. Patients were randomly allocated into two groups: Group F (ultrasound-guided femoral nerve block, n=40) and Group A (ultrasound-guided adductor canal block, n=40). Postoperative pain scores, rescue analgesic consumption, quadriceps muscle strength, ambulation, complications, and patient satisfaction were evaluated. Results: Baseline demographic characteristics were comparable between the groups. Both nerve blocks provided similar postoperative analgesia, with no significant differences in Visual Analogue Scale scores or rescue analgesic consumption (p>0.05). Quadriceps muscle strength was significantly better preserved in the adductor canal block group (MRC grade 4.4 ± 0.5 vs. 3.2 ± 0.6; p<0.001). Patients receiving adductor canal block achieved earlier ambulation (15.6 ± 3.9 vs. 22.4 ± 4.8 hours; p<0.001), higher independent ambulation within 24 hours (87.5% vs. 52.5%; p=0.001), and greater patient satisfaction (9.2 ± 0.6 vs. 8.4 ± 0.8; p<0.001). Quadriceps weakness occurred significantly more frequently in the femoral nerve block group (35.0% vs. 7.5%; p=0.003), while other complications were similar between the groups. Conclusion: Ultrasound-guided adductor canal block provides postoperative analgesia comparable to femoral nerve block while significantly preserving quadriceps muscle strength, promoting earlier ambulation, and improving patient satisfaction. It represents a safe and effective regional analgesic technique for lower limb orthopaedic surgery, particularly within enhanced recovery protocols.

Background: Musculoskeletal soft tissue lesions encompass a broad spectrum of benign and malignant conditions that often present with overlapping clinical features. Early and accurate diagnosis is essential for appropriate treatment planning. High-Resolution Ultrasound (HRUS) with Color Doppler has emerged as a valuable, non-invasive imaging modality for evaluating these lesions because it provides excellent soft tissue resolution and real-time assessment of lesion vascularity. Aim: To evaluate the diagnostic accuracy of High-Resolution Ultrasound with Color Doppler in the diagnosis and characterization of musculoskeletal soft tissue lesions using histopathology and/or magnetic resonance imaging (MRI) as the reference standard. Materials and Methods: A prospective observational study was conducted in the Department of Radiodiagnosis of a SAL hospital over a period of 12 months. Fifty patients with clinically suspected musculoskeletal soft tissue lesions were enrolled consecutively. All patients underwent gray-scale HRUS followed by Color Doppler examination. Sonographic findings, including lesion size, margins, echogenicity, internal architecture, and vascularity, were recorded and correlated with histopathological examination and/or MRI findings. Diagnostic performance was assessed by calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy. Results: Among the 50 patients, the majority were aged 21–40 years (36%), with a slight male predominance (56%). The lower limb (42%) was the most common site of involvement. Most lesions demonstrated well-defined margins (72%) and hypoechoic echotexture (48%), while internal vascularity was observed in 38% of lesions on Color Doppler. Histopathological examination revealed that benign lesions accounted for 76% of cases, with lipoma (28%) being the most common diagnosis. Malignant lesions comprised 24% of cases. HRUS with Color Doppler demonstrated a sensitivity of 91.7%, specificity of 94.7%, positive predictive value of 84.6%, negative predictive value of 97.3%, and an overall diagnostic accuracy of 94.0%. HRUS findings showed excellent agreement with the reference standard, correctly diagnosing 47 of the 50 lesions. Conclusion: High-Resolution Ultrasound with Color Doppler is a highly accurate, safe, and cost-effective imaging modality for the evaluation of musculoskeletal soft tissue lesions. It provides reliable differentiation between benign and malignant lesions and serves as an excellent first-line investigation. Correlation with histopathology and MRI confirms its diagnostic value, making HRUS with Color Doppler an effective tool for early diagnosis and treatment planning, particularly in resource-limited settings.

Background: Diabetes mellitus is a major public health problem, and many individuals remain undiagnosed until complications develop. Early identification of high-risk individuals through simple community-based screening tools can help in timely lifestyle modification and prevention. The Indian Diabetes Risk Score (IDRS) is a simple, inexpensive and non-invasive tool used to assess the risk of type 2 diabetes in the Indian population. Objectives: To assess the risk of developing type 2 diabetes among apparently healthy adults using IDRS and to determine its association with socio-demographic and anthropometric factors. Materials and Methods: A community-based cross-sectional descriptive observational study was conducted in the field practice area of the Urban Health Training Centre from June 2018 to May 2019. A total of 400 adults aged 20 years and above were selected by random sampling. Known diabetics, pregnant women, lactating mothers and seriously ill individuals were excluded. Data were collected using a pre-tested structured questionnaire. IDRS was calculated using age, waist circumference, physical activity and family history of diabetes. Data were analysed using descriptive statistics and chi-square test, with p<0.05 considered statistically significant. Results: Out of 400 participants, 150 (37.5%) were at high risk, 214 (53.5%) at moderate risk and 36 (9.0%) at low risk of developing type 2 diabetes. Age, marital status and occupation showed significant association with IDRS category. Among anthropometric and risk-related factors, BMI, family history of diabetes, waist circumference and physical activity were significantly associated with diabetes risk. Conclusion: More than one-third of apparently healthy adults were at high risk of developing type 2 diabetes. IDRS is a useful, simple and low-cost community screening tool. Lifestyle modification, regular physical activity and health education should be emphasized for prevention.

Background: Tinea corporis is a common superficial dermatophyte infection affecting keratinized tissues of the skin. Oral antifungal therapy is indicated in extensive, recurrent, or treatment-resistant infections. Terbinafine and itraconazole are widely used systemic antifungal agents, but their comparative efficacy and cost-effectiveness remain important considerations in clinical practice. Aim: To compare the efficacy and cost-effectiveness of oral terbinafine and itraconazole in the treatment of patients with tinea corporis. Methods: A prospective, randomized, single-blinded interventional study was conducted over one year in the Dermatology outpatient department of Government General Hospital, Kadapa. One hundred patients with KOH-positive tinea corporis were randomly allocated into two groups of 50 each. Group A received oral terbinafine 250 mg once daily, while Group B received oral itraconazole 100 mg once daily for four weeks. Clinical parameters including erythema, scaling, itching, lesion size, lesion margins, KOH microscopy, mycological cure, adverse effects, and overall clinical scores were assessed weekly. Statistical analysis was performed using SPSS version 21, with p<0.05 considered statistically significant. Results: Both terbinafine and itraconazole produced significant clinical and mycological improvement. However, itraconazole demonstrated significantly greater reductions in erythema, scaling, itching, lesion size, and total clinical scores during the third and fourth weeks of therapy. At four weeks, KOH negativity was achieved in 84% of patients receiving itraconazole compared with 66% receiving terbinafine. Itraconazole also showed superior overall clinical response and excellent tolerability, whereas terbinafine was more economical, costing approximately ₹252 per patient compared with ₹300 for itraconazole. Conclusion: Both oral terbinafine and itraconazole are effective treatments for tinea corporis. However, itraconazole provides superior clinical and mycological cure with excellent tolerability, making it the preferred therapeutic option. Terbinafine remains a cost-effective alternative, particularly for patients from lower socioeconomic groups. Larger multicentric studies are recommended to validate these findings.

Background: Serum uric acid has traditionally been regarded as a metabolic end product primarily relevant to gout and nephrolithiasis. Increasing evidence, however, suggests that elevated serum uric acid may coexist with hypertension, obesity, dyslipidaemia, insulin resistance, renal dysfunction, and increased cardiovascular risk. The present study evaluated the relationship between serum uric acid concentrations and established cardiovascular risk factors among adults attending a tertiary-care hospital. Methods: An analytical cross-sectional study was conducted among 240 adults aged 30–70 years attending the departments of general medicine at a tertiary-care hospital. Demographic characteristics, smoking status, anthropometric indices, blood pressure, fasting plasma glucose, glycated haemoglobin, lipid profile, serum creatinine, estimated glomerular filtration rate, and serum uric acid were recorded. Hyperuricemia was defined as serum uric acid >7.0 mg/dL in men and >6.0 mg/dL in women. Ten-year cardiovascular risk was estimated using the Framingham general cardiovascular disease risk equation. Correlations were assessed using Pearson or Spearman coefficients. Independent predictors of hyperuricemia and elevated cardiovascular risk were evaluated using multivariable regression. Results: The mean age was 51.8 ± 10.6 years, and 132 participants (55.0%) were men. Hyperuricemia was observed in 78 participants (32.5%). Serum uric acid correlated positively with body mass index (r=0.36), waist circumference (r=0.41), systolic blood pressure (r=0.34), triglycerides (r=0.38), fasting glucose (r=0.27), and Framingham risk score (r=0.43), while correlating negatively with high-density lipoprotein cholesterol (r=−0.31) and estimated glomerular filtration rate (r=−0.39); all p<0.001. Participants with hyperuricemia had a higher prevalence of hypertension, obesity, diabetes, metabolic syndrome, and high 10-year cardiovascular risk. After adjustment, abdominal obesity, hypertension, hypertriglyceridaemia, and reduced renal function remained independently associated with hyperuricemia. Conclusion: Elevated serum uric acid was significantly associated with clustering of metabolic and cardiovascular risk factors and with higher estimated 10-year cardiovascular risk. Serum uric acid may function as an inexpensive supplementary marker for identifying adults who require comprehensive cardiovascular risk evaluation.

Background: High-energy road traffic accidents (RTAs) resulting in complex lower limb fractures represent a significant global healthcare burden. While surgical management has advanced considerably, functional outcomes are frequently hindered by profound and under-recognized psychological morbidity, including post-traumatic stress disorder (PTSD), depression, and pain-related fear-avoidance behaviour. This study investigated whether an integrated Early Psychiatric Intervention (EPI) model, initiated within the acute 21-day post-surgical window, improves functional and psychological recovery compared with treatment-as-usual (TAU). Methods: We conducted a prospective, single-centre, randomized controlled trial at Jhalawar Medical College (n=120). Patients with complex lower limb fractures (Gustilo-Anderson grade II/III open fractures or AO/OTA type-C patterns) were randomized 1:1 to a 12-week manualized EPI programme, initiated within 21 days of definitive fixation, or to treatment-as-usual. The primary endpoint was the PROMIS Physical Function (PF) T-score at 6 months. Secondary endpoints were PTSD symptoms (PCL-5), depressive symptoms (PHQ-9), and time to unrestricted weight-bearing. Results: Of 120 randomized participants, 57 in the EPI group and 55 in the TAU group completed 6-month follow-up. The primary intention-to-treat analysis (n=120) used linear mixed-effects models, which accommodate missing data under the missing-at-random assumption; last-observation-carried-forward imputation was applied only as a sensitivity analysis among early dropouts who had contributed at least one post-baseline assessment. Baseline characteristics were well balanced between groups. At 6 months, the EPI group demonstrated significantly greater PROMIS-PF scores than the TAU group (48.2 vs. 41.5; between-group difference 6.7 points) and reached unrestricted weight-bearing earlier (11.2 vs. 14.8 weeks; p=0.012). The EPI group also showed significantly greater reductions in depressive symptoms (PHQ-9: 8.4 vs. 12.1 at 6 months; p=0.005) and PTSD symptoms (PCL-5: 18.2 vs. 24.5 at 6 months; p=0.008), despite equivalent baseline severity on both measures. Conclusion: Integrated psychiatric care, delivered within the acute 21-day post-operative window, was associated with superior physical function, faster return to weight-bearing, and greater reduction in depressive and post-traumatic stress symptoms compared with standard care. These findings support consideration of early psychiatric integration as a component of the orthopaedic trauma care pathway, pending replication in larger, multi-centre trials.

Background: Sepsis is a life-threatening syndrome with high early mortality. Early inflammatory biomarkers may facilitate rapid risk stratification and improve clinical outcomes. Aim: To evaluate the association between early inflammatory biomarker levels and seven-day mortality in patients with sepsis. Methodology: This hospital-based retrospective observational study included 90 adult patients with sepsis diagnosed according to Sepsis-3 criteria. Early inflammatory biomarkers measured within 24 hours of admission, including WBC, CRP, procalcitonin, ESR, serum ferritin, and fibrinogen, were analyzed. Binary logistic regression and receiver operating characteristic (ROC) analyses were performed using SPSS version 27.0. Results: Seven-day mortality was 28.9%. Non-survivors had significantly higher levels of all inflammatory biomarkers than survivors (p<0.001). Advanced age (>60 years), elevated WBC (AOR=1.15), CRP (AOR=1.03), procalcitonin (AOR=1.27), and serum ferritin (AOR=1.002) independently predicted mortality. Procalcitonin demonstrated the highest predictive accuracy (AUC=0.903; sensitivity 88.5%; specificity 84.4%), followed by CRP (AUC=0.846). Conclusion: Elevated early inflammatory biomarkers, particularly procalcitonin and CRP, are strongly associated with seven-day mortality in sepsis and provide valuable prognostic information for early risk stratification and timely clinical management.

Background: Preeclampsia (PE) is a major cause of maternal and perinatal morbidity and mortality, particularly in low-resource settings, with outcomes influenced by clinical and laboratory factors. Aim: To evaluate determinants of maternal and fetal outcomes in women with preeclampsia. Methodology: A retrospective analytical study was conducted on 86 women with PE at Department of Obstetrics and Gynaecology, Bankura Sammilani Medical College and Hospital, West Bengal, India, over a period of six months. Maternal demographics, clinical parameters, laboratory findings, and neonatal outcomes were analyzed using SPSS. Results: Mean age was 26.8±4.9 years; 55.8% had irregular antenatal care. Preterm delivery occurred in 62.8%, and cesarean section in 69.8%. Low birth weight was observed in 45.3%, and 36% required NICU admission. Higher systolic and diastolic BP, elevated urea and creatinine, and severe proteinuria were significantly associated with lower birth weight, earlier gestation, and increased NICU admission (p<0.05). Proteinuria showed a strong inverse relationship with birth weight and gestational age. Conclusion: Elevated BP, renal dysfunction, and severe proteinuria are key predictors of adverse maternal and fetal outcomes in PE. Early detection and regular antenatal care are crucial for improving outcomes.

Background: HPV vaccination and screening knowledge are key to preventing cervical cancer, which is still a public health concern among women. Aim: The purpose of this study was to evaluate the knowledge and awareness of reproductive-age women who visit the Department of Obstetrics and Gynaecology at Netaji Subhas Medical College and Hospital in Jamshedpur regarding HPV vaccination and cervical cancer screening. Method: 135 women between the ages of 15 and 49 participated in cross-sectional research done in a hospital utilizing a semi-structured interview schedule. While the chi-square test looked at relationships between factors and awareness level and acceptability of the HPV vaccination, descriptive statistics summarized frequencies and percentages. Result: Among 135 participants, 87.4% were familiar with cervical cancer, 71.1% understood its preventability, 60.7% acknowledged risk factors, 56.3% identified symptoms, and 65.9% were aware of the possibility of early identification. Nonetheless, just 15.2% were informed of cervical cancer screening, 6.7% were cognizant of the Pap smear, and 12.5% of the informed individuals had previously participated in screening. Knowledge about the HPV vaccine was exceedingly low (3.8%); yet 90.5% acknowledged its advantages, 90.5% would consent to vaccination if provided at no cost, and 82.9% expressed a willingness to pay for it. In all, 48.1% possessed sufficient knowledge, whereas 51.9% exhibited insufficient knowledge. Age, education, and marital status were strongly correlated with knowledge, whereas awareness of screening and the HPV vaccination was significantly linked to vaccine acceptance. Conclusion: Although awareness of cervical cancer was comparatively high, there was a lack of specific information, awareness of screening, and understanding of the HPV vaccination. To increase prevention and lower the incidence of cervical cancer, more information, counselling, screening services, and vaccinations are required.

Background: Typhoid fever remains an important public health problem in India, and emerging antimicrobial resistance in Salmonella typhi poses challenges to effective treatment. Local surveillance of antibiotic susceptibility is essential for guiding empirical therapy. Aim: To evaluate the antibiotic sensitivity pattern of Salmonella Typhi isolated from blood cultures over a one-year period in a tertiary care hospital in Bihar. Methodology: This hospital-based retrospective observational study was conducted in the Department of Microbiology, Indira Gandhi Institute of Medical Sciences (IGIMS), Patna. A total of 153 blood culture samples from clinically suspected typhoid fever patients were analyzed. Salmonella Typhi isolates were identified by conventional microbiological methods and confirmed using MALDI-TOF MS system. Antimicrobial susceptibility testing was performed using Kirby-Bauer disk diffusion and VITEK 2 AST system according to CLSI guidelines. Data was analyzed using descriptive statistics. Results: Salmonella Typhi was isolated from 3 of 153 blood culture samples, giving an overall positivity rate of 1.96%. Among the culture-positive cases, the mean age was 17.3 years. All isolates showed 100% sensitivity to ceftriaxone, cefixime, and azithromycin. Ampicillin, cotrimoxazole, and chloramphenicol showed 66.7% sensitivity, while all isolates were resistant to ciprofloxacin and nalidixic acid. Conclusion: The study showed low Salmonella Typhi blood culture positivity with preserved sensitivity to third-generation cephalosporins and azithromycin. Fluoroquinolone resistance remains a concern, emphasizing the need for continued surveillance, accurate identification, and rational antibiotic use.

Aim: Acute decompensated heart failure (ADHF) is followed by a vulnerable period in which recurrent congestion, rehospitalization and death are common. This systematic review evaluated whether early initiation and optimization of guideline-directed medical therapy (GDMT), compared with delayed or usual-care optimization, improves clinical outcomes after an ADHF hospitalization. Early optimization was defined prospectively as initiation or meaningful dose escalation during hospitalization or within 14 days after discharge, with a planned reassessment pathway. Delayed optimization was defined as usual care, discharge without a structured rapid-titration plan, or initiation more than 14 days after stabilization. Materials and methods: A protocol-informed review was structured according to PRISMA 2020 and a PICO framework. Eligible studies were randomized trials and comparative observational studies of adults hospitalized with ADHF or acute heart failure that compared an early strategy with delayed/usual care. MEDLINE/PubMed, Embase, CENTRAL, Web of Science, Scopus, CINAHL, ClinicalTrials.gov, WHO ICTRP and reference lists were prespecified. The primary outcome was all-cause death or heart-failure readmission; secondary outcomes included individual mortality, readmission, length of stay, quality of life, renal dysfunction, hyperkalemia, hypotension and treatment attainment. Risk of bias was planned with RoB 2 for randomized trials and ROBINS-I for nonrandomized studies. A random-effects meta-analysis was planned when at least three sufficiently homogeneous estimates were available; otherwise, findings were synthesized narratively. Results: The most direct randomized evidence was the multinational STRONG-HF trial, which enrolled 1,078 patients recently hospitalized for acute heart failure and compared high-intensity care with rapid up-titration and close follow-up against usual care. The composite of all-cause death or heart-failure readmission at 180 days occurred in approximately 15.2% versus 23.3%, favoring early optimization, with an adjusted risk ratio of about 0.66. Adverse events, particularly hypotension, hyperkalemia and renal impairment, were more frequent, although serious adverse events were similar. Supporting evidence from hospitalization-initiation trials of sacubitril/valsartan and sodium-glucose cotransporter-2 inhibitors, together with observational cohorts, generally supports earlier treatment, but indirectness, open-label designs, selection of clinically stable patients and variable definitions limit certainty. Conclusion: Early, structured GDMT optimization after stabilization from ADHF probably reduces the combined risk of death or heart-failure readmission compared with delayed optimization. Benefit appears to depend on clinical stability, residual congestion assessment, renal and electrolyte surveillance, and early outpatient contact rather than medication escalation alone. The evidence is strongest for a bundled strategy involving rapid initiation, dose escalation and frequent monitoring; it is less certain whether one drug class should universally precede another or whether the same approach applies to severe shock, marked renal dysfunction, active ischemia or predominantly HFpEF. Future trials should compare operational definitions of early care, include under-represented populations, report patient-important safety outcomes, and evaluate implementation in resource-limited settings.

Background: Coronary heart disease (CHD) is a chronic cardiovascular condition whose impact extends beyond physical manifestations. Persistent concerns regarding recurrent cardiac events, functional limitations, treatment requirements, and long-term health may contribute to psychological distress. Depression and anxiety may adversely affect quality of life and influence how patients adapt to chronic cardiac illness. Coping strategies may further contribute to differences in psychological adjustment and perceived well-being. Methodology: A hospital-based cross-sectional observational study was conducted among 120 patients with established CHD at Jawaharlal Nehru Medical College & Hospital, Bhagalpur, Bihar, India, from 5 January 2025 to 31 October 2025. Sociodemographic and clinical information was collected using a structured proforma. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), anxiety using the Generalized Anxiety Disorder-7 (GAD-7), quality of life using the WHOQOL-BREF, and coping responses using the Brief COPE inventory. Associations between psychological symptoms, quality of life, and coping patterns were assessed using appropriate descriptive and inferential statistical methods. Multivariable linear regression was performed to identify factors independently associated with overall quality of life. Results: Among the 120 participants, the mean age was 57.6 ± 10.8 years, and 78 (65.0%) were males. Clinically relevant depressive symptoms (PHQ-9 ≥10) were identified in 43 (35.8%) participants, while clinically relevant anxiety symptoms (GAD-7 ≥10) were present in 39 (32.5%). Participants with clinically relevant depressive symptoms had significantly lower WHOQOL-BREF scores across the physical, psychological, social-relationship, and environmental domains (p≤0.001). Similarly, clinically relevant anxiety was associated with significantly poorer quality-of-life scores across all assessed domains (p≤0.004). PHQ-9 scores demonstrated a significant inverse correlation with overall quality of life (r = −0.62, p < 0.001), while GAD-7 scores showed a similar inverse correlation (r = −0.55, p < 0.001). Adaptive coping was positively associated with overall quality of life (r = 0.48, p < 0.001), whereas maladaptive coping showed an inverse association (r = −0.51, p < 0.001). In multivariable analysis, higher PHQ-9, GAD-7, and maladaptive coping scores were independently associated with poorer quality of life, whereas greater adaptive coping was associated with better quality-of-life scores. Conclusion: Psychological distress represents an important component of the overall burden experienced by patients with CHD. Depressive and anxiety symptoms were associated with poorer quality of life, while adaptive coping was associated with more favourable quality-of-life outcomes. These findings support the incorporation of psychological and coping assessment into comprehensive cardiovascular care to facilitate identification of patients who may benefit from additional psychosocial support. Recommendation: Routine screening for depressive and anxiety symptoms should be considered in patients with established CHD, particularly those experiencing persistent distress or impaired functioning. A multidisciplinary approach incorporating psychological counselling, social support, patient education, and coping-focused interventions may help address the psychosocial needs of patients with chronic coronary disease.