International Journal of Pharmacy Research & Technology (IJPRT)

Comparative Analysis of Early Versus Late Laparoscopic Cholecystectomy Following Endoscopic Retrograde Cholangiopancreatography in Cases of Cholelithiasis with Choledocholithiasis

2026-01-01T08:28:28+03:00

Background: The optimal timing of laparoscopic cholecystectomy (LC) following endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis remains debated. While early LC (≤72 hours) may reduce operative difficulty and hospital stay, late LC (>6 weeks) has traditionally been practiced to allow inflammation to subside.

Methods: A prospective comparative study was conducted on 60 patients with cholelithiasis and choledocholithiasis who underwent successful ERCP for common bile duct clearance at a tertiary care hospital. Patients were randomized into early LC (within 72 hours; n=30) and late LC (>6 weeks; n=30) groups. Demographic, operative, and postoperative parameters including operative time, adhesion grading, conversion to open surgery, complications, and hospital stay were analyzed using standard statistical tests.

Results: Both groups were comparable in terms of age, sex, and comorbidities. Mean operative time was significantly shorter in the early LC group (56.2 ± 8.5 min vs. 77.4 ± 9.1 min; p<0.001). Severe adhesions were more frequent in late LC (40% vs. 10%; p=0.01). The mean length of hospital stay was reduced in the early LC group (2.9 ± 0.7 vs. 4.3 ± 1.2 days; p=0.002). Conversion to open surgery (1 vs. 2 cases) and postoperative complications (6.7% vs. 10%) were not statistically different.

Conclusions: Early LC within 72 hours of ERCP is safe and associated with shorter operative time, less operative difficulty, and reduced hospital stay without increasing complication rates. These findings support early cholecystectomy as the preferred strategy in patients with cholelithiasis and choledocholithiasis.

A CLINICAL STUDY OF TRAUMATIC BRAIN INJURY COMPARING FULL OUTLINE UNRESPONSIVE SCORE (FOUR SCORE) AND GLASGOW COMA SCALE SCORE (GCS SCORE) IN PREDICTING THE IN-HOSPITAL MORTALITY IN EMERGENCY DEPARTMENT OF TERTIARY CARE HOSPITAL

2026-01-05T14:00:38+03:00

Objective: To compare and predict themortality in patients with TBI, by using FullOutline of Unresponsiveness (FOUR) scoreand the Glasgow Coma Scale (GCS) in Emergency department.

PREVALENCE OF HYPOTHYROIDISM IN PATIENTS WITH GALL STONE DISEASE IN A RURAL TERTIARY CARE HOSPITAL

2026-01-05T14:05:35+03:00

Background: Gallstone disease is aprevalent condition, with increasingevidence suggesting a link tohypothyroidism. However, the exact
relationship between thyroid abnormalities and gallstone disease is notwellestablished

Diagnostic Accuracy of Symphysio-Fundal Height in Detection of FGR by Taking Ultrasound as a Standard

2026-01-06T11:27:59+03:00

Objectives: To measure the diagnostic accuracy of symphysio-fundal height in detection of fetal growth restriction by taking ultrasound as a gold standard.

Study Design: validation study

Settings: Department of Obstetrics and Gynaecology, BBH, Rawalpindi.

Study Duration: 5th April 2022 to 4th October 2022.

Materials & Methods: A total of 225 women with singleton pregnancies between 28 and 36 weeks of gestation, aged 18 to 40, were enrolled. We excluded patients with fetal cardiac activity, congenital abnormalities, and polyhydroamnios. A researcher measured the fundal height every two weeks between weeks 28 and 38 at prenatal clinic visits. The distance between the uterine fundus and the top of the symphysis pubis was measured using a non-stretchable tape that came into touch with the skin of the abdominal wall. The researcher was facing the inch side of the tape to avoid bias. The inspecting hand's palm applied light pressure at a straight angle to the abdomen wall to delineate the fundus. Plotting of the measurements onto the normogram was done after they were measured in centimeters (to the nearest 0.5 cm). A radiologist performed an ultrasound to confirm FGR if it did not match gestational age.

Results: Overall sensitivity, specificity, PPV, NPV and diagnostic accuracy of symphysio-fundal height in detection of fetal growth restriction by taking ultrasound as a gold standard was 92.08%, 88.37%, 92.76%, 87.36% and 90.67% respectively. Conclusion: This study concluded that symphysio-fundal height is a highly sensitive and accurate parameter for detecting fetal growth restriction.

Comparing the Diagnostic Precision of the RMI and ADNEX Models in Identifying the Ovarian Tumor

2026-01-06T12:20:34+03:00

Objectives: To assess the diagnostic precision of the ADNEX and RMI models in distinguishing between benign and malignant ovarian tumors while taking histopathology as the gold standard.

Study type: Validation study.

Study duration: 5th April 2022 to 4th October 2022 Settings: Department of Obstetrics & Gynecology, Benazir Bhutto hospital Rawalpindi.

Materials & Methods: 165 patients between the ages of 14 and 65 who had at least one ovarian, para-ovarian, or tubal adnexal mass with a smallest diameter > 3 cm on ultrasound examination were included. Patients who had undergone bilateral adnexectomy or who had an adnexal mass under follow-up prior to the study's commencement were not included. The RMI/ADNEX score was computed. The patient was categorized as either low risk or high risk. To determine the predictive value of both models, the values were correlated with the histology report following surgery. Histopathological analysis of removed tissue serves as the foundation for the reference standard.

Results: The RMI model's diagnostic accuracy, sensitivity, specificity, PPV, and NPV in telling the difference between benign and malignant ovarian masses were 90.11%, 85.14%, 88.17%, 87.50%, and 87.88%, respectively. ADNEX showed sensitivity of 85.56%, a specificity of 81.33%, a PPV of 84.62%, an NPV of 82.43%, and a diagnostic accuracy of 83.64%. Conclusion: This study concluded that diagnostic accuracy of RMI model in differentiation of benign and malignant ovarian masses is better than ADNEX model.

Evaluation of Novel Biomarkers for Early Detection of Acute Myocardial Infarction

2026-01-10T10:22:53+03:00

Background: Early diagnosis of acute myocardialinfarction (AMI) is time-critical, yet initial ECGfindings may be non-diagnostic, and highsensitivity troponin can be negative or borderline in very early presenters. Objective: To evaluatethe diagnostic performance

Diagnostic Accuracy of Triple Assessment in Breast Cancer: A Comprehensive Clinical Evaluation with Statistical Analysis

2026-01-12T08:53:46+03:00

Background: Triple assessment combining clinical breast examination, radiological imaging, and fine needle aspiration cytology represents the systematic diagnostic approach for evaluating breast masses and determining malignancy probability. Despite widespread utilization, comprehensive analysis of individual component performance and concordance patterns with statistical significance remains incompletely characterized in contemporary literature.

Methods: This retrospective study evaluated 340 consecutive women presenting with palpable breast lumps undergoing complete triple assessment evaluation. Clinical breast examination, diagnostic mammography with BI-RADS categorization (0–6 scale representing <2% to >95% malignancy risk), and ultrasound-guided fine needle aspiration cytology (classified as C1–C5 according to National Health Service Breast Screening Programme criteria) were performed. All patients underwent histopathological examination as the gold standard reference. Diagnostic accuracy metrics including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated. Statistical significance was assessed using chi-square analysis and McNemar's test with significance threshold of p<0.05.

Results: Combined triple assessment achieved 99.1% diagnostic accuracy (sensitivity 99.0%, specificity 99.3%, p<0.001). Individual modality sensitivities were clinical examination 76.9% (p<0.001), mammography 94.9% (p<0.001), and FNAC 94.7% (p<0.001). Concordant findings (80% of cases, n=272) demonstrated 100% sensitivity and 99.4% specificity. Discordant cases (20%, n=68) showed elevated malignancy risk of 86.8% (59 of 68 cases, p<0.001), with FNAC-driven discordance demonstrating 92.9% malignancy detection versus 11.1% for isolated clinical examination concerns (p<0.001).

Conclusion: Triple assessment achieves exceptional diagnostic reliability when all components are concordant, supporting clinical decision-making without additional biopsy in appropriately selected cases. Discordant presentations mandate heightened investigation, with FNAC demonstrating superior prognostic weighting. Triple assessment represents the gold-standard diagnostic paradigm for breast mass characterization and malignancy stratification.

Comparative Study of Oxidative Stress Markers in Hemodialysis (HD) versus Peritoneal Dialysis (PD) Patients

2026-01-12T09:35:23+03:00

Introduction: Chronic kidney disease (CKD) patients on dialysis frequently develop anemia due to iron deficiency, blood loss, and chronic inflammation. Hemodialysis (HD) often involves intravenous iron therapy, which can elevate ferritin, while peritoneal dialysis (PD) patients may experience iron depletion through peritoneal losses. Ferritin, transferrin saturation (TSAT), and total iron binding capacity (TIBC) are key markers of iron status, but their interpretation is complicated by inflammation. Interleukin 6 (IL 6), a pro inflammatory cytokine, further influences iron metabolism and anemia. Comparing these parameters in HD and PD patients is essential for tailoring iron management strategies.

Aim: To compare iron and inflammatory markers between hemodialysis (HD) and peritoneal dialysis (PD) patients, and assess correlations with age and gender.

Methods: A cross sectional study of 70 ESRD patients (35 HD, 35 PD) was conducted. Serum iron, total iron binding capacity (TIBC), transferrin saturation (TSAT), ferritin, and interleukin 6 (IL 6) were measured using standard biochemical and ELISA methods. Statistical comparisons were made using Student’s t test, and correlations were assessed with Pearson’s coefficient.

Results: IL 6, serum iron, and TIBC did not differ significantly between HD and PD (p> 0.05). Serum ferritin was significantly higher in HD (574.05 ± 341.04 ng/ml) compared to PD (370.91 ± 292.38 ng/ml, p = 0.009). Age showed a weak negative correlation with ferritin, while females had higher ferritin than males.

Conclusion: HD patients exhibit elevated ferritin levels, likely reflecting iron supplementation and inflammation. Ferritin should be interpreted cautiously, and iron management strategies tailored to dialysis modality, age, and gender.

Evaluating the Impact of Workforce Burnout in Emergency Departments Considering Staff Performance and Patient Safety in Quetta: A Systematic Literature Review

2026-01-12T09:42:32+03:00

The problem of burnout among emergency department healthcare professionals affects worldwide healthcare systems most severely in limited-resource environments especially in Quetta Pakistan. This research analyzes the effect of working burnout on emergency department staff performance and patient protection in Pakistani medical units through PEO (Population, Exposure, Outcome) methodology with PRISMA analysis. A total of five research-based studies appeared in the timeframe from 2016 to 2024 and underwent theme-based analysis. Research evidence reveals significant emotional exhaustion and depersonalization together with psychological distress within the ED workforce while showing their connection to diminished job performance and workforce dissatisfaction and inferior patient safety operations. Multiple studies showed that work-related challenges and insufficient support systems and societal discrimination regarding mental health together fueled this problem. This review demonstrates the importance of immediate policy changes and institution-based mental health aids to reduce burnout and increase healthcare effectiveness across Quetta's medical facilities.

Effects of Intermittent Fasting on Metabolic, Hemodynamic, and Cardiovascular Risk Parameters in Adult Subjects

2026-01-12T11:32:14+03:00

Intermittent fasting has emerged as a popular dietary intervention with potential metabolicand cardiovascular effects. The present study was conducted to evaluate the impact of onemonth of intermittent fasting on anthropometric indices, glycemic parameters, lipid profile, inflammatory markers, and hemodynamic variables

Chronic Prostatitis and Causative Organisms

2026-01-12T11:45:03+03:00

Background: Chronic prostatitis is a frequently encountered urological condition with a heterogeneous etiology. While gram-negative bacteria remain the predominant causative agents, atypical and sexually transmitted organisms contribute significantly to disease burden, particularly in sexually active men.

Objective: To identify the spectrum of causative organisms in patients diagnosed with chronic bacterial prostatitis using conventional culture and nucleic acid amplification tests (NAAT).

Materials and Methods: This prospective observational study was conducted between March 2023 and November 2025 at a tertiary care hospital. Men aged 20–50 years presenting with recurrent urinary tract infection and genitourinary symptoms suggestive of chronic prostatitis were included. Patients with acute prostatitis or without identifiable organisms were excluded. All patients underwent detailed clinical evaluation, urine culture, expressed prostatic secretion analysis, and NAAT for sexually transmitted pathogens when indicated.

Results: A total of 146 patients were diagnosed with chronic bacterial prostatitis. Escherichia coli was the most common organism isolated on conventional culture (41%). NAAT identified atypical and sexually transmitted organisms in 10.9% of cases, predominantly Chlamydia trachomatis. Patients with multiple sexual partners showed a higher prevalence of atypical organisms.

Conclusion: Chronic prostatitis has a diverse microbiological profile. Along with conventional urine culture, NAAT improves detection of atypical and sexually transmitted pathogens and should be incorporated into diagnostic protocols for appropriate management.

A HISTOLOGICAL OBSERVATION ON DEVELOPMENT OF HUMAN FETAL LUNG -A RETROSPECTIVE FETAL AUTOPSY STUDY

2026-01-12T17:02:09+03:00

Background: This paper focuses on Lung histogenesis study in normal human foetuses ranging from11 to 40 weeks of gestation age. The process of histogenesis is nothing but a series of events thatoccur during the development of a tissue. In this process undifferentiated cells attain full functional maturity.

ANATOMICAL VARIATIONS IN PELVIC PART OF SCIATIC NERVE, A CADAVERIC STUDY AND ITS CLINICAL IMPLICATIONS

2026-01-12T17:21:15+03:00

Background: Sciatic nerve is the largest and widest nerve in the human body. It is also called asthe ischiatic nerve or ischial nerve. It is the main continuation sacral plexus. It supplies posteriorcompartment thigh, leg and foot. Understanding the anatomical variations of the sciatic nerve is essential for clinicians and surgeons

Triple-Arm Randomized Trial of Intraperitoneal Levobupivacaine, Dexmedetomidine, and Placebo for Analgesia After Laparoscopic Cholecystectomy

2026-01-12T17:29:52+03:00

Background: Pain after laparoscopic cholecystectomy is still a major clinical issue. The use ofanalgesic agents through intraperitoneal instillation may lead to better multimodal analgesia.The current research was aimed at comparing the analgesic effects of levobupivacaine and dexmedetomidine against placebo

Effects of a 12-Week Strength and Circuit Training Programme on Explosive Power and Cardiorespiratory Endurance in College-Level Football Players

2026-01-13T08:56:23+03:00

Background: Football performance depends heavily on the integration of neuromuscular power and cardiorespiratory efficiency. Late adolescence and early adulthood represents a critical period during which targeted training interventions may induce favorable physiological adaptations.

Objective: The present study aimed to evaluate and compare the effects of strength training and circuit training on explosive power and cardiorespiratory endurance in college-level football players.

Methods: Sixty male football players aged 18–21 years were randomly assigned to a strength training group, a circuit training group, or a control group (n = 20 each). The experimental groups underwent a structured 12-week training programme, while the control group continued routine physical activity. Explosive power was assessed using the standing broad jump test, and cardiorespiratory endurance was evaluated using the 12-minute run/walk test. Data were analyzed using analysis of covariance (ANCOVA) at a 0.05 level of significance.

Results: Both strength training and circuit training produced significant improvements in explosive power and cardiorespiratory endurance compared to the control group (p < 0.05). Circuit training resulted in greater enhancement of explosive power, whereas strength training elicited superior improvements in cardiorespiratory endurance.

Conclusion: The findings suggest that both training modalities induce meaningful physiological adaptations in college-level football players. Incorporating strength and circuit training within youth conditioning programmes may optimize neuromuscular performance and cardiovascular efficiency essential for football performance.

Effectiveness of Diet Therapy in Mitigating Stomach Cancer in Kashmir Region of India: A Hospital -Based Study

2026-01-15T12:31:13+03:00

Background: Cancer is a multifarious and complex disease, which is defined as a rapid and abnormal division of cells that engulfs other organs in a process of metastasis. Stomach cancer is prevalent in Kashmir, and new cases are rising drastically. It’s because of unawareness of food habits, smoking, spraying of orchards, unhealthy lifestyles, wazwan (non-vegetarian foods), processed and ultra-processed foods, micro-plastics, and harmful radiations. Stomach cancer patients are the highest (25.2%) after cola rectal cancer (16.4%) (Maria A. Qureshi et al.). It is noted that the Kashmir Valley has cancer at the highest rate as compared to the rest of India.

Aims/Objectives: the main objective of this study is to analyse risk factors and effectiveness of diet therapy among the patients suffering from stomach cancer.

Materials & Methods: The study was conducted at super specialty hospital government medical college Srinagar. A sample of 163 patients was taken. Interview method was deployed to collect the primary data.

Results: Out of 163 patients, majority were unaware about the proper diet. Many patients were on palliative care. Age group was 50-80, with male 135 and 28 were female.

Skin Changes in Pregnancy: A Prospective Observational Study

2026-01-15T12:37:20+03:00

Background: Pregnancy is associated with profound hormonal, metabolic, immunological, and vascular changes that lead to various physiological and pathological cutaneous manifestations. Although most skin changes are benign and self-limiting, some pregnancy-specific dermatoses may cause significant maternal discomfort and fetal risk.

Objectives: To determine the incidence and pattern of physiological skin changes and pregnancy-specific dermatoses among pregnant women.

Materials and Methods: This prospective observational study was conducted in the Obstetrics and Gynecology outpatient department of Nirmala Hospital and Research Center, Jaipur, from February 2020 to October 2025. A total of 960 pregnant women were evaluated through detailed history taking and complete dermatological examination. Women with pre-existing dermatoses were excluded. Findings were categorized into physiological skin changes and specific dermatoses of pregnancy.

Results: Out of 960 participants, 536 were primigravida and 424 multigravida. Physiological skin changes were observed in the majority of women, with hyperpigmentation being the most common manifestation. Pregnancy-specific dermatoses were seen in a smaller proportion, with pruritic urticarial papules and plaques of pregnancy (PUPPP) being the most frequent condition.

Conclusion: Skin changes are extremely common during pregnancy, predominantly physiological in nature. Awareness of these manifestations helps differentiate benign changes from pathological dermatoses, enabling appropriate counseling and management.

Anthropometric Study of Facial Morphology in the Central Indian Population

2026-01-16T20:19:07+03:00

Facial anthropometry plays a crucial role inanatomy, forensic science, andreconstructive surgery by providingpopulation-specific standards for personalidentification. Facial dimensions exhibitsignificant sexual dimorphism and ethnic variation, making region-specific dataessential. The present study

Reinforcement Techniques for Dynamic Adaptive Learning

2026-01-17T12:02:29+03:00

The goal of dynamic adaptive learning systems is to tailor instruction by meeting the needs of each student instantly. In order to enable ongoing modification of instructional content based on student performance and engagement, this study investigates reinforcement learning strategies. The suggested technique dynamically modifies learning strategies and content complexity by modelling learning as an interactive feedback-driven process. When compared to static and rule-based systems, experimental results demonstrate better learning outcomes and engagement, indicating the effectiveness of reinforcement strategies for intelligent and scalable adaptive learning environments.

Drug Utilization Study in Patients of Chronic Suppurative Otitis Media Patients Attending a Government Tertiary Care Hospital in Jaipur City

2026-01-20T13:19:26+03:00

Background: Chronic Suppurative Otitis Media (CSOM) remains a significant public health problem in developing countries, including India, contributing to morbidity, hearing impairment, and decreased quality of life. The rational use of antimicrobials and adjunctive medications plays a crucial role in the effective management of CSOM and in preventing antimicrobial resistance.

Objectives: To analyze the prescribing patterns of antimicrobials and other drugs in patients diagnosed with CSOM attending the outpatient department of a government tertiary care hospital in Jaipur City.

Methods: A prospective, cross-sectional observational study was conducted over a period of six months among patients clinically diagnosed with CSOM. Drug utilization pattern was analyzed to identify the frequently prescribed antimicrobials and other therapeutic drug classes.

Results: The majority of patients were in the [31–45 years], with a slight predominance of females. Oral antimicrobials were the most frequently prescribed drugs, followed by systemic antibiotics such as ciprofloxacin. Adjunctive drugs included antihistamines, nasal decongestants, and analgesics. Polypharmacy was minimal, and adherence to the essential drug list prescribing was noted in all the cases

Conclusion: The prescribing pattern in CSOM patients at this tertiary care hospital showed a preference for antimicrobials like fluoroquinolones and beta lactams. The predominance of oral drug use supports patient compliance and ease of use. However, continuous monitoring, adherence to treatment guidelines, and judicious antimicrobial use are essential to curb resistance and ensure optimal patient outcomes.

Interrelationship Between Placental Morphology and Thyroid Function in Preeclampsia: A Narrative Review

2026-01-20T15:29:05+03:00

Background: Preeclampsia is a pregnancyrelated disorder, characterized by mild to severehypertension along with reduced or abnormalfunction of the placenta. The placenta plays an essential role in the pathogenesis of preeclampsiaand increasing changes in maternal thyroid

Rauwolfia Serpentina: Phytochemistry, Mechanisms of Action, and Clinical Implications – A Comprehensive Review

2026-01-21T13:12:49+03:00

The Indian medical system has been using the medication Rauwolfia serpentina for many generations. The medication has been referred to as Sarpgandha due to its snake-like structure. Reserpine is the main alkaloid found in Rauwolfia serpentina, despite the fact that it contains over 50 alkaloids. Even at lower dosages, reserpine is an effective antihypertensive medication. In addition to its antihypertensive and hepatoprotective properties, the stems and leaves of Rauwolfia serpentine have numerous other therapeutic applications, such as sedative, antipsychotic, antidiahoerreal, and anticancer (in breast), among others. Although the herb Rauwolfia serpentina contains the principal four Indole alkaloids, the primary goal of this context is to provide information about the primary active alkaloid Reserpine, which is more concentrated in the plant's root and plays a significant part in the plant's antihypertensive activity. Reserpine must be used at a considerably lower level in order to have an antihypertensive effect; otherwise, it may have major side effects such as sedation, lethargy, psychological depressive disorders, hypotension, nausea, bradycardia, bronchospasm, and withdrawal psychosis.

A Cross-Sectional Study on Cervical Cancer Awareness and its Association with Demographic Factors in India

2026-01-22T08:37:16+03:00

Introduction: Cervical cancer is a significant public health concern, ranking as the fourth most common cancer among women worldwide. India contributes nearly one-quarter of the global burden, with low screening and vaccination rates despite available preventive measures. Demographic factors may influence awareness levels, impacting early detection and prevention.

Aims and Objectives: This study aimed to assess cervical cancer awareness among reproductive-age women attending a tertiary care hospital in West Bengal and to analyze its association with demographic factors such as age, education, marital status, and place of residence.

Materials and Methods: A cross-sectional study was conducted among women aged 18–49 years visiting a tertiary care hospital. Data on demographics and cervical cancer awareness were collected using structured questionnaires. Associations between awareness and demographic variables were analyzed using Chi-square tests.

Results: Most participants were aged 20–25 years (31.4%) and had education above the 10th standard (45.3%). A majority were married (75.9%) and resided in urban areas (62.5%). Statistically significant associations were found between cervical cancer awareness and education (χ²=48.03, p=2.1×10⁻¹⁰), marital status (χ²=30.45, p=3.43×10⁻⁸), living area (χ²=9.59, p=0.0083), and age group (χ²=37.67, p=3.32×10⁻⁸).

Conclusion: Demographic factors significantly influence cervical cancer awareness. Tailored public health interventions focusing on less-educated, unmarried, rural, and older women are essential to improve preventive practices.

PRECISE SCORE, A PREDICTIVE TOOL VALIDATION FOR STONE-FREE RATE AFTER RETROGRADE INTRARENAL SURGERY (RIRS) FOR RENAL STONES GREATER THAN 2 CENTIMETRES-A RETROSPECTIVE STUDY

2026-01-22T14:02:28+03:00

Background: Retrograde intrarenal surgery (RIRS) is increasingly being used for renalstones > 2 cm in patients where indicated. The available nephrolithometric scoringsystems are limited when predicting outcomes in larger stones such as R.I.R.S., T.O.HO.,and STONE scores. The PRECISE score, a seven-parameter preoperative tool (each 0–2; total 0–14), was developed and validated retrospectively in a single-center cohort.

Paracetamol versus Diclofenac as Intravenous Postoperative Analgesia in Patients Undergoing Laparoscopic Surgeries

2026-01-24T12:39:34+03:00

Laparoscopic surgery is increasinglypreferred because of its minimally invasivenature and faster postoperative recovery.Postoperative pain is a significant stressor and is inherently subjective. Inadequatepain management can adversely

Clinical Profile, Etiology and Outcome of Acute Encephalopathy among Children at Pediatric Intensive Care Unit in a Tertiary Care Hospital

2026-01-24T13:22:05+03:00

Encephalopathy is clinically defined as diffuse disorder of brain with at least two of the following ^[¹^] altered sensorium, altered cognition or personality, seizures. Acute encephalopathy is a pediatric emergency with high morbidity and mortality, however early identification and timely intervention can influence the outcome.

Bilayer Floating Tablet of Amoxicillin with Deglycyrrhizinated Licorice (DGL) Powder for the Treatment of Peptic Ulcer

2026-01-27T09:32:34+03:00

Peptic ulcer disease is associated with mucosal erosion from an imbalance of gastric acid, pepsin, Helicobacter pylori infection, and weakened mucosal defenses. This study was done to treat Peptic ulcer disease by formulating Amoxicillin, which is a β-lactam antibiotic that kills bacteria by inhibiting cell wall synthesis. Moreover, Deglycyrrhizinated licorice, an herbal alternative, was added in the formulation to provide mucosal protection and anti-inflammatory activity, aiding ulcer healing without affecting acid secretion and reduceing side effects.

The current study aimed at formulating a bilayer-floating tablet containing amoxicillin and deglycyrrhizinated licorice, and the purpose of this study was to increase gastric retention, increase localised drug delivery, and generate a synergistic anti-ulcerative effect. The floating drug delivery system has been designed to extend the gastrointestinal residence time, and thus, enhance the systemic availability of the drug to act locally in the upper gastrointestinal tract. In addition, the polymers used to make the bilayer tablet a sustained-release tablet were complemented by effusive agents to provide buoyancy and prolonged gastric retention. Wise choices were made on the excipients in order to stabilise the tablet. Based on this, the main objective was to develop a gastro-retentive bilayer tablet enabling the gradual delivery of amoxicillin in combination with the immediate localised activity of deglycyrrhizinated licorice. The findings showed effective floating characteristics and a consistent drug release profile, suggesting its potential as a promising therapy for treating peptic ulcers.

Central Obesity as a Predictor of Renal Stress in Metabolic Syndrome: Biochemical and Urinary Evidence

2026-01-29T09:15:18+03:00

Background:Central obesity is a defining feature of metabolic syndrome (MetS) and is increasingly implicated in early renal dysfunction [1,2]. However, biochemical and urinary markers linking central obesity to renal stress in MetSare underexplored in Indian populations.

BIODENTINE PULPOTOMY ALTERNATE TO ROOT CANAL TREATMENT IN YOUNG ADULTS

2026-01-29T09:26:23+03:00

Background: Vital pulp therapy using Biodentinehas emerged as a biologically conservativealternative to root canal treatment, especially inyoungadultswithirreversiblepulpinflammation. Objective: This study aimed to evaluate the clinical and radiographic success

Assessment of Knowledge, Attitude and Awareness towards Adverse Drug Reaction Reporting System among Undergraduate Medical Students in Shyam Shah Medical College, Rewa

2026-01-31T08:08:55+03:00

Background: Adverse Drug Reactions (ADRs) are an important cause of morbidity and mortality worldwide. Although pharmacovigilance is included in the undergraduate medical curriculum, underreporting of ADRs remains a major limitation of spontaneous reporting systems. Raising awareness among healthcare professionals, especially medical students who are future prescribers, is essential to strengthen the pharmacovigilance system.

Aim and Objectives: To assess the knowledge, attitude, and awareness regarding the ADR reporting system among undergraduate medical students of Shyam Shah Medical College, Rewa.

Materials and Methods: An observational cross-sectional study was conducted in June 2024 using a pre-designed, structured questionnaire circulated through Google Forms. The questionnaire assessed knowledge, attitude, and awareness regarding ADRs and pharmacovigilance. A total of 277 undergraduate medical students from second year to final year MBBS participated in the study. Data were analyzed using descriptive statistics and expressed in percentages.

Results: Out of 277 students, 93 (33.6%) were from second year, 79 (28.5%) from third year, and 105 (37.9%) from final year. Overall, about 65% of students had adequate knowledge about ADRs and pharmacovigilance. A positive attitude towards ADR reporting was observed in nearly 92% of participants. Awareness was higher among final year students (approximately 69%), particularly regarding banned drugs, patient confidentiality, and legal responsibilities. However, nearly 30% of students still demonstrated insufficient awareness and practical understanding.

Conclusion: The study reveals satisfactory knowledge and attitude among undergraduate medical students; however, awareness and practical exposure to ADR reporting need further improvement. Regular training sessions, workshops, and integration of pharmacovigilance activities into clinical postings are recommended to strengthen ADR reporting culture among future healthcare professionals.

Prevalence of Anxiety and Depressive Disorders among Patients with Leprosy: A Cross-Sectional Study

2026-01-31T12:54:57+03:00

Background: Leprosy, caused byMycobacterium leprae, is a chronicinfectious disease that imposes significantphysical, social, and psychological burden.Stigma, disability, and chronicity mayincrease the risk of anxiety and depressive disorders. This study aimed to estimate theprevalence of anxiety and depressive

A Study of Thrombocytopenia in a Pregnancy at a Tertiary Care Centre

2026-02-03T09:08:01+03:00

Background: Thrombocytopenia is the second most common haematological abnormality after anaemia encountered in pregnancy. Thrombocytopenia is defined as the platelet count of less than 150,000/ml. Pregnancy causes varied alterations in hematopoietic systems. Thrombocytopenia is second only to anemia as the most common hematologic abnormality in pregnancy. It occurs commonly during pregnancy and accounts for around 7–8% of the all the pregnancies. The causes are accelerated platelet consumption or decreased production

Aim and Objectives: “A Study of thrombocytopenia in pregnancy at a tertiary care center.2. To study proportion of thrombocytopenia in pregnancy at a tertiary care center. 3. To study the association of thrombocytopenia with risk factors. 4. To study clinical profile of thrombocytopenia cases

Methodology: Study Design: Cross sectional study.

Study Setting: OBGY department of VDGMC Latur, Maharashtra.

Study Population: All pregnant women with Gestational age from 28weeks to 40weeks with thrombocytopenia in ANC Clinic of OBGY department of VDGMC Latur such cases were included in the study.

Study Period: 18months from 1 Dec 2023 to 1 July 2025.

Sample Size = 140

Results: Proportion of Thrombocytopenia among ANC Women was 1.64%, most of cases presented with mild thrombocytopenia 120 (85.71%).The majority of cases occurred in the 20–30 years age group (75 cases, 53.6%), the majority were multigravida (97 cases, 69.2%), thrombocytopenia was most frequently observed beyond >37 weeks (61 cases, 43.6%), majority of cases reported vegetarian diet pattern 94 (67.14%),majority of cases reported no H/O platelets transfusion 134 cases (95%) and 6 cases (5%) had a history of platelets transfusion. majority of cases diagnosed with platelet count between 120001-150000, 88 cases , 31 cases (22.1%) had identifiable risk factors associated with thrombocytopenia. The most frequent association was anaemia (12 cases, 8.6%), followed by non-severe preeclampsia/gestational hypertension (4 cases, 2.9%) and infections including dengue (4 cases, 2.9%). The association between risk factors and thrombocytopenia was statistically significant (p < 0.001).

Conclusions: The present study provides a comprehensive overview of thrombocytopenia in pregnancy, its prevalence, severity, and associated determinants in a tertiary care setting. The proportion of thrombocytopenia was 1.64%, which, though relatively low, represents a clinically important condition due to the maternal and fetal risks involved.

Advancements in Virology and Microbiology: Emerging Trends, Challenges, and Future Perspectives

2026-02-03T14:45:50+03:00

Background: Virology and microbiology are changing rapidly, thanks to innovations in vaccine technology, molecular diagnostics and artificial intelligence. Pioneering mRNA vaccines and CRISPR-based antiviral therapies are transforming disease prevention and treatment. Yet a range of challenges persists, including limited funding, antimicrobial resistance, and misinformation that impede advancement in those areas.

Objective: This study addresses the emerging trends, challenges, and future perspectives in virology and microbiology. Through a cross-sectional survey of subject matter experts in the field, the study aims to evaluate current progress, determine challenges and discuss possible directions to overcome these challenges.

Methodology Method: A predesigned questionnaire was developed and circulated among people from research institutes, healthcare organizations and pharmaceutical industries. The survey collected quantitative and qualitative data on recent breakthroughs, ongoing challenges and expected future developments. Moreover, a systematic bilateral literature review of peer-reviewed papers via Scopus, web of science, and pubmed was undertaken to gain a broader contextual understanding.

Key Findings: Recent trends: Discoveries in mRNA vaccine technology, CRISPR-based antiviral therapies and pathogen detection driven by AI have also impacted virology and microbiology. However, funding constraints, the rise of new infectious diseases, and antimicrobial resistance remain significant obstacles despite these advances. "Most researchers believe that artificial intelligence can help detect pathogens and discover drugs," explains the study[3], which was released around 14 months ago. Misinformation still constitutes a challenge that is detrimental to public health policies and vaccination uptake.

Future Directions: Experts emphasize that now more than ever, researchers, policymakers, and industries must come together to work toward solutions to these challenges. Innovative research and technology efforts need to be supported through robust funding mechanisms to ensure continued progress. Moreover, targeted public awareness campaigns are critical to countering misinformation and enhancing vaccine acceptance. Newer AI-based application in diagnostics and therapeutic modalities also appears as a useful utility in monitoring and controlling diseases.

Conclusion: Virology and microbiology are progressing at a pace, but we continue to face hurdles. As infectious disease research and public health preparedness evolve, addressing funding shortages, leveraging artificial intelligence, and fostering international cooperation will be critical. The global scientific community can strive like there is no tomorrow over the challenges and healthcare outcome through prudent interventions like early stages of care and providing sustained innovations like long term therapeutics.

Association Between Serum Prolactin Levels and Severity of Liver Cirrhosis Assessed by Child–Pugh Scoring: A Hospital-Based Cross Sectional Study

2026-02-04T19:08:34+03:00

Introduction: Liver cirrhosis represents theterminal stage of chronic liver diseases andis characterized by progressive fibrosis andregenerative nodules, resulting insubstantial morbidity and mortality worldwide. Disease prognosis worsens

To Assess the Lip Print Pattern in the Patients of Psoriasis in Both Sexes & to Provide Baseline Data for the Same

2026-02-05T14:35:34+03:00

Aim: The aim of the present study was to assess lip print pattern in the patients of psoriasis in both sexes & to provide baseline data for the same.

Methods: The present study was conducted on 200 subjects divided into two groups viz group A & group B. Group A was control group, comprising 100 subjects (M:F::50:50), taken from amongst Medical students of Govt. Medical College Patiala . Group B served as study group, comprising 100 subjects of psoriasis with or without involvement of lips reporting to Department of Dermatology of Rajindra hospital, Patiala.

Results: The prominent lip print pattern observed was Type 2(34.5%) followed by Type 3(26.75%) followed by Type 1(24.5%). Type 1(34.5%) Lip Print Pattern was found to be predominant, followed by Type 2(25.25%) and then by Type 3(18.75%). The dominant Pattern of Lip Print observed was Type 1(25.69%) followed by Type 2(21.53%) and then by Type 4(11.46). The main Pattern of Lip Print Pattern observed was Type 3(29.92%) followed by Type 2(27.23%) and then by Type 1(22.32%). The most prominent Lip Print Pattern observed was Type 2(29.87%). The most predominant Lip Print Pattern observed was Type 1(24.76%).

Conclusion: The data obtained from the present study showed promising results and indicated the uniqueness of lip prints. The major differences in the lip print patterns are seen in RUM and LUM region of Upper Lip (medial region) and RLM region of Lower Lip, which could be baseline data for further research work on lip print pattern in Psoriasis.

Intravenous Granisetron Versus Ondansetron for Attenuation of Hypotension and Bradycardia During Spinal Anaesthesia in Caesarean Section: A Prospective Randomized Double-Blind Study

2026-02-07T12:48:36+03:00

Background: Spinal anaesthesia forcaesarean section is frequentlyassociated with hypotension, whichmay adversely affect both maternal andfetal outcomes. Serotonin (5-HT₃)receptor antagonists such as ondansetron and granisetron

Comparative Outcomes of Surgical Versus Medical Management of Ileocaecal Tuberculosis in a Single Tertiary-Care Centre

2026-02-10T10:53:25+03:00

Background: Ileocaecal tuberculosis (ICTB) represents the commonest form of gastrointestinal tuberculosis and poses a therapeutic dilemma when complications arise. While anti-tubercular therapy (ATT) achieves high cure-rates, obstruction, perforation or haemorrhage may necessitate surgery. Robust comparative data from South-Asian high-burden settings remain scarce.

Methods: We undertook a retrospective cohort analysis of all adults managed for ICTB between January 2018 and December 2023 at a 1 200-bed quaternary institute in northern India. Patients were stratified into a primary-medical group (≥ 6-month category I ATT) and a primary-surgical group (emergency or elective limited right hemicolectomy/stricturoplasty followed by ATT). Kaplan–Meier estimates, log-rank tests and multivariable Cox regression assessed 12-month composite success (symptom-resolution + endoscopic-healing).

Results: One-hundred patients met inclusion criteria (medical = 60; surgical = 40). Baseline age, sex-ratio and comorbidity burden were comparable. Complicated disease (multiple strictures, fistulae or perforation) was significantly higher in the surgical cohort (60 % vs 12 %, p < 0.001). At 12 months, composite success was 90 % in the surgical arm versus 80 % in the medical arm (HR 1.65, 95 % CI 1.02–2.66). Overall complication-rate was higher after surgery (20 % vs 10 %), but major (Clavien–Dindo ≥ III) events were rare (5 %). No mortality occurred.

Conclusion: In a real-world high-burden setting, surgery combined with standard ATT yielded superior clinical resolution in anatomically complicated ICTB at the cost of higher—but acceptable—morbidity. Elective surgery should be considered early for patients with advanced stricturing disease to optimise outcomes.

“Role of Sentinel Lymph Node Biopsy in Clinically Node-Negative Breast Cancer: A Prospective Study”

2026-02-12T08:54:15+03:00

Sentinel lymph node biopsy (SLNB) has transformed axillary staging in early breast cancer by providing accurate nodal assessment while substantially reducing morbidity compared with complete axillary lymph node dissection (ALND)). The purpose of the study is to determine the accuracy of diagnostics used, false-negative rate, morbidity, and oncologic outcome of SLNB in patients with clinically node-negative (cN0) breast cancer and whose treatment is three years in a tertiary cancer centre. The second outcomes (sentinel node identification rate, false-negative rate, arm morbidity (lymphedema, shoulder dysfunction), local/regional recurrence, disease free and overall survival at minimum median follow-up, (36 months) were the important ones. We have established that our identification rates (>95%), in well established dual-tracer tests, of adequate node recovery are high, and that there are overall large changes in morbidity rates in both the short term and long-term as compared with the historic ALND cohorts. In combination with modern adjuvant systemic therapy and individualized radiotherapy, omissions of an incremental ALND in which complete replaces the excision of small limited-size sentinel node metastases does not appear to have a negative impact on oncologic outcome. The article endorses a guideline-based practice that underpins SLNB on how to handle the treatment of staging cN0 early breast cancer yet cites technical and pathological considerations, which can be used to interfere with the accuracy and the need to exercise caution and long-term follow-ups on patients. Contemporary technical arguments of the trial and guideline modifications useful to the contemporary practice are discussed.

Knowledge, Attitudes and Practices of Caregivers Regarding Diarrhoeal Diseases in Under-Five Children with Special Reference to Medication Use: A Hospital-Based Cross-Sectional Study

2026-02-12T11:52:09+03:00

Background: Diarrhoeal diseases are the major causes of morbidity and mortality amongst children under the age of five years even though they can be avoided and cured. Lack of proper home management and irrational use of drugs and specifically antibiotics is among the factors that lead to poor outcomes and antimicrobial resistance. This would evaluate the knowledge, attitudes and practices (KAP) of caregivers of patients with diarrhoea under-five years old, and particularly medication use.

Methods: The current study was a cross-sectional study in which data was collected in the Departments of Pharmacology and Paediatrics, M.K.C.G. Medical College, between February 2020 and February 2021. One hundred forty four consenting caregivers of children aged 059 months with diarrhoeal illness presenting to OPD/IPD were recruited. A semi-structured, interviewer-administered questionnaire, which is based on WHO recommendations on childhood diarrhoea, was translated and back-translated to Odia, used to collect data. Socio-demographic variables and KAP domains were measured. GraphPad Prism was used to analyse data with the help of descriptive statistics (frequencies, percentages).

Results: Overall, [xx.x%] of caregivers demonstrated adequate knowledge of diarrhoea definition, danger signs and role of oral rehydration salts (ORS), while [xx.x%] had poor knowledge. Only [xx.x%] correctly identified zinc supplementation as a recommended adjunct therapy. A favourable attitude towards early health-facility consultation and continued feeding during diarrhoea was observed in [xx.x%] of participants. In practice, home initiation of ORS was reported by [xx.x%], whereas [xx.x%] used non-recommended remedies (antidiarrhoeals, antibiotics, or herbal preparations). Antibiotics were prescribed in [xx.x%] of cases, frequently in acute watery diarrhoea without dysentery or systemic sepsis. Caregiver education, urban residence and higher socio-economic status were positively associated with better KAP scores. Patterns of antibiotic use were often discordant with WHO recommendations.

Conclusion: Substantial gaps persist in caregiver knowledge and practices regarding evidence-based management of under-five diarrhoea, alongside high rates of potentially inappropriate antibiotic use. Strengthening caregiver education, reinforcing ORS–zinc as the standard of care, and promoting antimicrobial stewardship in paediatric diarrhoeal illness are urgently needed.

A Cross-Sectional Study on the Prevalence of Endometrial Tuberculosis Among Women with Unexplained Infertility Using CBNAAT

2026-02-12T18:59:41+03:00

Background:Female genital tuberculosis (FGTB) is thesecond most common form ofextrapulmonary tuberculosis and is a well
recognized cause of infertility in women. Diagnosis of FGTB remains challengingdue to its varied clinical presentation

Spectrum of Clinicopathological Findings in Female Genital Tuberculosis at a Tertiary Care Hospital

2026-02-12T19:06:23+03:00

Background: Female genital tuberculosis(FGTB) is an important yet oftenunderdiagnosed cause of infertility indeveloping countries. The present study aimed to describe the various

Patterns, Perceived Triggers, and Physiological Correlates of Yawning Behavior in First-Year Medical Undergraduates: A Cross-Sectional Questionnaire Study

2026-02-13T14:09:27+03:00

Background:-Yawning is a stereotyped reflex observed in humans and several animal species and is commonly associated with fatigue, boredom, and reduced alertness. It is also regarded as a socially contagious phenomenon. Despite its frequent occurrence, scientific evidence regarding the underlying causes, functional significance, and behavioral patterns of yawning remains limited, particularly among adolescent and young adult populations.

Objectives:-The present study aimed to assess the patterns of yawning behaviour and its associated factors among adolescents.

Materials and Methods:- This cross-sectional, questionnaire-based study was conducted among 200 first-year MBBS students . After obtaining informed consent, participants were administered a self-structured questionnaire incorporating a six-point Likert scale to assess yawning behaviour under various situations. Students were instructed to respond honestly, and anonymity was ensured. The collected data were compiled and analyzed, and the results were represented graphically.

Results:- Under routine conditions, the majority of students reported yawning either “somewhat” or “not at all.” A significantly higher frequency of yawning was reported during sleep deprivation, with 68.42% of students indicating yawning “very much” when they lacked adequate sleep. In contrast, 73.68% of participants reported not yawning during interviews, and 71.05% reported no yawning while completing the questionnaire. Although yawning is widely considered contagious, only 23.68% of students reported yawning frequently upon observing others yawn.

Conclusion:- The findings suggest that yawning among first-year MBBS students predominantly occurs in association with sleep deprivation rather than social or situational stimuli. Overall, the study population appears to maintain a satisfactory level of alertness and engagement, as reflected by low baseline yawning frequency.

CORRELATION BETWEEN CYCLE THRESHOLD VALUE AND CT SEVERITY SCORE DURING COVID 19 PANDEMIC

2026-02-13T19:22:38+03:00

Introduction: The novel SARS CoV-2 wasdeclared as a public health emergency inJanuary 2020. Patients infected with thisvirus show different severity of disease symptoms ranging from mild disease

FUNCTIONAL AND RADIOLOGICAL OUTCOME OF INTRA ARTICULAR DISTAL RADIUS FRACTURES TREATED WITH VOLAR PLATE OSTEOSYNTHESIS: A PROSPECTIVE STUDY

2026-02-13T19:31:16+03:00

Background: Distal radius fractures areamong the most common fractures of theupper extremity, frequently involving thearticular surface and leading to functional impairment if inadequately

PROGNOSTIC SIGNIFICANCE OF DISSEMINATED TUMOR CELLS IN THE BONE MARROW OF PATIENTS WITH OVARIAN CANCER

2026-02-13T19:34:25+03:00

Background: Ovarian carcinoma isassociated with high mortality due to latepresentation and early systemicdissemination. Disseminated tumour cells (DTCs) in bone marrow representoccult haematogenous

Surgical Tenolysis for Post-Traumatic Finger Stiffness: Outcome Evaluation of Our Technique

2026-02-14T13:52:58+03:00

Background Hand injuries are often associated with stiffness and loss of movement of the fingers because of adhesions and fibrotic tissue formation of tendons. Tenolysis surgery is performed to loosen these adhesions to allow the tendons to slide and move normally. Multiple methods have been outlined, each possessing its own pros and cons.

Objective: This paper analyzes the clinical results of our surgical process in the treatment of stiff fingers, which includes the release of flexor and extensor tendons under local anesthesia while allowing movement of the fingers during surgery to guarantee full adhesion release.

Duration and place of study: This study was conducted at Burns Center Civil Hospital and Dow University of Health Sciences Karachi from October 2024 to October 2025

Methodology: A retrospective study was provided on 50 patients who had tenolysis performed on them with the use of this technique. The demographic information, injury nature, and clinical observations were noted. Total active motion (TAM) and flexion lag were measured preoperatively and postoperatively and compared. The perioperative or postoperative complications were also analyzed.

Results: A total of 50 patients who had stiff fingers were analyzed. The average preoperative TAM had a significant limitation, and the postoperative measurements had a significant improvement in the active range of movement. The TAM was found to have increased statistically (p < 0.05). No significant surgical morbidity was noted, and the majority of the patients had significant functional recovery.

Conclusion: The comprehensive release of adhesions surrounding flexor and extensor tendons results in a significant increase in the mobility in the fingers. Tendon release when done under local anesthesia with active involvement of the patient during the surgical procedure increases the adequacy of the tendon release procedure and helps to improve the functional results.

Study of Nerve Conduction Velocity in Normal Subject Having Parental History of Diabetus Mellitus

2026-02-16T08:57:46+03:00

ABSTRACT: Background: Diabetes Mellitus (DM) is defined as a metabolic abnormality characterized by hyperglycaemia and disturbances of carbohydrate, fat and protein metabolism that are associated with absolute or relative deficiency in insulin secretion and/or insulin action. When fully evolved, it is characterized by fasting hyperglycaemia but it can also be characterized in the less overt stages and before fasting hyperglycaemia appears, most usually by the appearance of glucose intolerance.

Aim and Objectives:1. To evaluate nerve conduction in off-springs of diabetic and non-diabetic parents.2.To study BMI in off-springs of diabetic parents.

Methodology: Present study was a cross sectional study done at Department of Physiology, Grant Government Medical College Mumbai during a period of December 2014 to October 2016. The study involved randomly selected 100 students of first year MBBS students, these can be divided in two groups (50 study groups and 50 Control groups) depending on family history of diabetes mellitus and children with parents having diabetes mellitus were taken as study group.

Result: The study groups were comparable in terms of age and other physical parameters. There was no significant difference in mean ± S.D. of height, weight, Body mass index (BMI) between study group and controls but there was significant decreased in nerve conduction velocity in study group.

Conclusion: We find that neuropathy can be started at early age in study groups.

Effect of Orthodontic Braces on Gingival Health Status and the Role of Professional Scaling Frequency as a Preventive Factor

2026-02-16T10:23:08+03:00

Fixed appliance orthodontic treatment is often linked with greater amounts of plaque retention, and thiscould adversely affect the health of the gums, provided that preventive measures are not taken. The presentcross-sectional observational study sought to measure the impact of the use of orthodontic braces on the level of gingival health and to determine the place of professional scaling frequency

Serum Uric Acid as a Marker of Disease Severity, Duration, and Target Organ Damage in Patients with Hypertension: A Cross-Sectional Study

2026-02-16T11:26:58+03:00

Background:Hypertension is a major contributor tocardiovascular and renal morbidity. Serum uricacid (SUA) has been implicated in the
pathogenesis and progression of hypertension;however, its association with disease severity, duration, and target organ damage in the Indianpopulation remains inadequately defined.

Unveiling the Therapeutic Potential of Carica Papaya Leaf Extracts a Study on Antifungal and Anti-Inflammatory Activities

2026-02-16T13:50:11+03:00

Background: Traditional medical plants have been known to society for a long time. Other than easily available and inexpensive, they are able to cure diseases with few side effects compared to modern medicine. The use of papaya leaves in this study was not only because they contained various chemical compounds that could exert their pharmacological effects, but also the presence of various compounds, which are indicated as Antifungal and Anti-Inflammatory.

Objective: The present research tried to study the antifungal and anti-inflammatory effects of Carica papaya (Red Lady Variety) leaf extracts.

Methods: Freshly harvested Carica papaya leaves of the Red Lady Variety were collected and identified by the herbarium of the Department of Botany at Karachi University. After air-drying, they were chopped, ground into fine powder and extracted with n-Hexane and acetone in a Soxhlet apparatus using 10 grams and 82 grams respectively for drying sample. Extracts after concentration on a rotary vacuum evaporator were stored in a desiccator for further studies and applications. In vitro, agar tube dilution protocol for antifungal activity and oxidative burst assay using chemiluminescence technique for anti-inflammatory.

Results: The in- vitro antifungal Percentage of linear growth inhibition exhibited by n-hexane was between 24% and 40% on different fungal species tested, including Trichophyton rubrum (25%), Candida albicans (40%), Aspergillus niger (25%), Microsporum canis (26%), Fusarium Ini (24%), Candida glabarata (30%) and Aspergillus fumigatus (35%). On the other hand, the acetone extract was able to exhibit growth inhibition rates which were slightly lower, ranging from 20% to 26%. The inhibition rates were as follows: Trichophyton rubrum (23%), Candida albicans (26%), Aspergillus niger (23%), Microsporum canis (25%), Fusarium Ini (20%), Candida glabarata (23%), and Aspergillus fumigatus (23%). In-vitro anti-inflammatory, when tested at 100 µg/mL concentration, it was found that n-hexane leaf extract was able to exhibit 43.6% inhibition of inflammation but was still considered to be less active. Likewise, acetone leaf extract did not show any measurable inhibition when subjected to similar conditions and therefore this also ranked as inactive.

Conclusion: The antifungal inhibition rates were between 23% and 40%, meaning some potential but lower efficiency compared to standard antifungal agents. In the same line, anti-inflammatory activity was moderate where the n-hexane extract only achieved a 43.6% inhibition and the acetone extract had no significant effects at 100 µg/ml.

Comparative Study of Turp versus Medical Management in Benign Prostatic Hyperplasia

2026-02-16T14:51:21+03:00

Objective: To identify the differences in the efficacy, safety and quality of life after transurethral resection of the prostate (TURP) and medical management in Pakistani men with moderate to severe benign prostatic hyperplasia (BPH).

Materials and Methods: A prospective randomized controlled trial was used as the study design in three tertiary care centres in Pakistan during the period between January 2023 and December 2024. Two hundred and forty men of [?]50 years with moderate to severe LUTS (IPSS 8-19) and a 30-80 mL prostate volume were randomly matched into TURP (n=120) versus medical treatment using tamsulosin 0.4 mg daily +- finasteride 5 mg daily (n=120). The primary outcomes were change in IPSS score, maximum urinary flow rate (Qmax), and quality of life (QoL) index in 6 months. Secondary outcomes were complication rates, the incidence of acute renal failure and re-intervention.

Results: Findings at 6 months TURP showed much higher increase in IPSS (14.2+-3.1 vs 6.8+-2.9), Qmax (+9.8+-3.2 vs +3.1+-1.8 mL/s) and QoL index ([?]3.4+-1.1 vs +1.9+-0.9) over medical treatment. The AUR rate was much less in the TURP-group (2.5% vs 15.8% p=0.001). Fewer immediate complications were noted in medical management (4.2% vs 18.3% p=0.002) although the majority of TURP complications were minor and self-limiting. Re-intervention of TURP was needed in 3.3 percent of the patients compared with 22.5 percent in the medical patients (p<0.001).

Conclusion: TURP is more effective rather than medical management in symptomatic relief, urodynamic and disease progression in Pakistani patients who have moderate to severe BPH. Although initial complication rates are greater, TURP is more effective in the long term and has reduced re-intervention rates, and hence is economical in a resource-restrained environment where late presentation with complications is prevalent.

Urodynamic Evaluation in Women with Chronic Lower Urinary Tract Symptoms

2026-02-16T15:14:50+03:00

Objective: The purpose of this is to describe urodynamic results of women with chronic lower urinary tract symptoms (LUTS), and relate patterns of clinical symptoms to objective urodynamic diagnoses in order to streamline diagnostic clinical trajectories.

Materials and Methods: A prospective observational study was undertaken on 248 women with chronic LUTS (>6 month’s duration) who were referred to the comprehensive urodynamic assessment. The study involved the participants going through standardized history, validated symptom questionnaires (ICIQ-FLUTS, UDI-6), completing bladder diary, and multichannel urodynamic studies based on International Continence Society (ICS) guidelines. Urodynamic indicators were filling cystometry, pressure-flow, leak point pressure, and detrusor overactivity, stress urinary incontinence and bladder outlet obstruction evaluation.

Results: The median age was 52.3 -12.7 years with a median of 4.2 -3.1 years of symptoms. Detrusor overactivity, urodynamic stress incontinence, and mixed urinary incontinence were detected in 41.9% (n=104), 38.3% (n=95) and 29.8% (n=74). Video-urodynamic diagnosis was carried out with the bladder outlet obstruction in 12.5% (n=31) cases. A significant correlation was identified between clinical urgency symptoms and detrusor overactivity (p<0.001), post-void residual volume greater than 100mL and voiding dysfunction (p=0.003), and stress leakage on physical examination and urodynamic stress incontinence (p<0.001). It is worth noting that on urodynamics, 34.7 percent of females with predominant symptoms of stress were found to be detrusor overactive.

Conclusion: Urodynamic assessment demonstrates massive discordance in clinical symptom patterns and objective findings in women with chronic LUTS. Urodynamic testing is a broader diagnostic test used in conjunction with clinical assessment especially in complicated or refractory cases, mixed incontinence presentation and potential voiding dysfunction. These results encourage the selective usage of urodynamics in the complicated female LUTS to inform the specific treatment measures.

Comparative Study of Surgical Wound Healing and Dermatological Complications in Diabetic Versus Non-Diabetic Orthopedic Patients

2026-02-17T09:10:11+03:00

Background: Diabetes mellitus is a majorsystemic condition known to impair woundhealing and increase susceptibility to
postoperative complications. Orthopedicsurgeries require optimal tissue repair, anddiabetic patients are at increased risk ofsurgical site infections and dermatological complications

Venous Thromboembolic Disease and Its Cutaneous Manifestations in Orthopedic Surgical Patients: A Cross-Sectional Study

2026-02-17T09:19:37+03:00

Background: Venous thromboembolicdisease (VTE), comprising deep veinthrombosis (DVT) and pulmonary embolism(PE), is a common and potentially fatalcomplication following orthopedic surgery.Early clinical recognition, including identification of cutaneous manifestations

A Review on progress in ADHD Disorder: From Characterization to Cause

2026-02-18T12:06:25+03:00

The science of attentiondeficit/hyperactivity disorder (ADHD) ismotivated by a translational goal – thediscovery and exploitation of knowledge about the nature of ADHD to the benefit ofthose individuals whose lives it affects

Comparative Evaluation of Single-Dose Intravenous vs. Dual-Route (Intravenous and Peri-articular) Tranexamic Acid in Total Knee Arthroplasty: A Randomized controlled trial study in a Tertiary Orthopaedic Centre

2026-02-18T12:09:24+03:00

Background: Minimizing perioperativehaemorrhage is critical for enhancingrecovery after total knee arthroplasty (TKA). While the efficacy of Tranexamic Acid(TXA) is well-documented, the clinicaladvantage of augmenting systemicadministration with local joint infiltration

Nomophobia –Mobile Phone Dependence, A Cross-Sectional Study Among Engineering Students of Raichur

2026-02-18T12:11:41+03:00

Background: Nomophobia (no-mobilephone phobia) is an emerging behavioraldependence associated with excessive smartphone use and adverse psychosocialoutcomes. Limited data exist fromengineering student populations

Outcomes and Postoperative Complications Following Debridement and Split-Thickness Skin Grafting for Lower Limb Wounds: A Case Series of 30 Patients from a Tertiary Care Institution

2026-02-20T13:03:28+03:00

Background: Lower limb wounds are an enormously high surgical burden, especially when complicated by infection and trauma or systemic comorbidities. Surgical debridement and split-thickness skin grafting (STSG) has been one of the keys to wound reconstruction. However, graft uptake and functional results are still affected by complications after surgery.

Case Presentation: This case series presents 30 patients treated in a tertiary care institution and who underwent surgical debridement of the wounds on the lower limbs and subsequently STSG. Patients ranged in age from 22 to 68 years of age and included wounds secondary to trauma, diabetic foot disease, post-infective necrosis and chronic non-healing ulcers. Comprehensive clinical evaluation, microbiologic assessment and optimization of comorbid conditions predicted operative intervention. All patients were subject to serial debridement until a healthy granulating wound bed was established, then STSG harvested from the thigh and applied over the wound and outcomes were documented.

Interventions and Outcomes: Postoperative results were analysed in reference to: graft uptake; wound healing time; infection; graft loss; haemorrhage; and donor site morbidity. Complete uptake of the graft was seen in 21 patients (70%). Partial graft loss occurred in six patients (20%) and complete graft failure occurred in three patients (10%). The most common complications observed after the operation were surgical site infection (16.7%), formation of seroma or hematoma (13.3%), and delayed healing of incision (20%). Patients with diabetes mellitus and peripheral vascular disease showed higher rate of complications.

Conclusion: Debridement followed by STSG remains an effective reconstructive option for lower limb wounds. However, postoperative complications are influenced by systemic comorbidities, wound etiology, and local wound conditions. Careful patient selection, meticulous surgical technique, and vigilant postoperative monitoring are critical to optimizing outcomes.

A COMPARATIVE STUDY BETWEEN PRIMARY RESECTION ANASTOMOSIS VERSUS HARTMANN`S PROCEDURE WITH COLOSTOMY IN PATIENTS OF LEFT SIDED COLONIC MASS PRESENTING WITH ACUTE INTESTINAL OBSTRUCTION– A PROSPECTIVE COMPARATIVE STUDY

2026-02-20T14:16:35+03:00

Background: Left-sided colonic masses commonly present as acute intestinal obstructionrequiring emergency surgical intervention. Hartmann’s procedure has traditionally beenconsidered the safer approach in emergency settings due to concerns regarding anastomotic leakage. However, it is associated with stoma-related morbidity

A COMPARATIVE STUDY ON PORT SITE INFECTIONS WITH AND WITHOUT USE OF AUTOCLAVED PLASTIC ENDOBAG DURING LAPAROSCOPIC CHOLECYSTECTOMY

2026-02-20T14:19:35+03:00

Background: Port site infection (PSI)remains an important postoperativecomplication of laparoscopiccholecystectomy (LC). Gallbladder
perforation and stone spillage

COMPARATIVE STUDY OF CONVENTIONAL POLYPROPYLENE MESH WITH ANATOMICAL 3D POLYPROPYLENE MESH IN TAPP IN ADULTS

2026-02-20T14:59:08+03:00

Background: Laparoscopic transabdominalpreperitoneal (TAPP) repair is widely performed for inguinal hernia. Conventionalflat polypropylene mesh requires mechanicalfixation using tackers

MAXIMAL VOLUNTARY VENTILATION VERSUS VITAL CAPACITY AS PREDICTORS OF EXERCISE CAPACITY IN HEALTHY YOUNG ADULT MALES: A CROSS-SECTIONAL STUDY

2026-02-21T11:28:31+03:00

Background: Exercise capacity reflectsintegrated cardiopulmonary function and isinfluenced by multiple physiologicaldeterminants, including pulmonary ventilatory reserve. While forced vitalcapacity (FVC) is routinely assessed

Clinical Serum Lipidomic Profiling Reveals Potential Lipid Biomarkers for Early Diabetic Retinopathy

2026-02-21T14:09:14+03:00

Diabetic Retinopathy (DR) is a major micro vascular complication of Diabetes Mellitus and a leading cause of preventable vision loss. Recent evidence suggests that disturbances in lipid metabolism occur before visible retinal damage develops. Lipidomic analysis enables comprehensive profiling of circulating lipid molecules and may assist in identifying novel indicators for early DR detection.

Objective: To analyze serum lipid variations associated with early diabetic retinopathy and explore their potential role as biomarkers for its early diagnosis.

Methods: A cross-sectional study was carried out on 60 type 2 diabetes mellitus (T2DM) patients—30 with early non-proliferative diabetic retinopathy (NPDR) and 30 without any retinal abnormalities. Serum lipidomics was performed using ultra-high-performance liquid chromatography coupled with tandem mass spectrometry (LC–MS/MS). Statistical and multivariate analyses were applied to identify significantly altered lipid species between the two groups.

Results: Distinct lipidomic alterations were identified in patients with early DR. Levels of lysophospha- tidyl cholines (LPCs), sphingomyelins (SMs), and ceramides (Cers) were significantly higher, while phosphatidylcholines (PCs) and certain triglycerides were reduced. Lipid species such as LPC (17:0), Cer(d17:1/24:0), and SM(d17:1/15:0) showed strong correlations with HbA1c and DR severity (p < 0.01). Combined ROC analysis of Cer(d17:1/24:0) and LPC(17:0) produced an AUC of 0.88, indicating excellent diagnostic accuracy.

Conclusion: Serum lipidomic analysis highlights early metabolic disruptions in DR. Elevated ceramide and lysophosphatidylcholine species may serve as promising biomarkers for the early identification of retinal microvascular injury. Incorporating lipidomic markers into diabetic screening could enhance early detection and risk assessment strategies.

MAXIMAL VOLUNTARY VENTILATION VERSUS VITAL CAPACITY AS PREDICTORS OF EXERCISE CAPACITY IN HEALTHY YOUNG ADULT MALES: A CROSS-SECTIONAL STUDY

2026-02-21T18:21:03+03:00

Background: Exercise capacity reflectsintegrated cardiopulmonary function and is influenced by multiple physiologicaldeterminants, including pulmonarventilatory reserve. While forced vitalcapacity (FVC) is routinely assessed

Hematological, clinical, cytogenetic and molecular profiles of confirmed chronic myeloid leukemia patients at presentation at a regional cancer centre of North Eastern India: a cross-sectional study.

2026-02-22T18:34:21+03:00

Background: The evidence on hematological, clinical, cytogenetic and molecular profiles among new CML patients arevery insufficient in the developing countries like India and more so in the North-eastern states.. Therefore, this study isperformed among newly confirmed CML patients at Atal Bihari Vajpayee Regional Cancer Center (ABV RCC), Agaratala, Tripura.

Evaluation of Oxidative Stress Markers (Tac, Tos, Gsh) In Patients with Copd and Their Correlation with Cardiovascular Risk

2026-02-23T09:14:16+03:00

Objectives: To evaluate oxidative stress markers—Total Antioxidant Capacity (TAC), Total Oxidant Status (TOS), and reduced glutathione (GSH)—in the patients with the chronic obstructive pulmonary disease (COPD) and to mainly determine their actual correlation with the cardiovascular risk.

Study Design and Setting: This descriptive cross-sectional study was conducted in the Department of Pulmonology and Internal Medicine, Jinnah Hospital, Lahore from 1 November 2024 to 30 April 2025.

Methodology: A total of 140 diagnosed COPD patients were mainly being enrolled using the consecutive sampling. Oxidative stress markers including the TAC, TOS, as well as serum GSH levels were measured using the standardized spectrophotometric form of methods. To aid in the estimation of the cardiovascular risk, the Framingham Risk Score (FRS) and assessment of the lipid profile and the blood pressure were counted. Cardiovascular risk parameters and the oxidative stress markers were analysed using correlation. All the participants were provided with informed consent and the ethical approval was obtained (ERC No: 2023-45).

Results: COPD patients demonstrated significantly elevated TOS levels and reduced TAC and GSH levels compared to reference values. It was discovered that patients with high risk cardiovascular patients were significantly higher in TOS (p<0.001) and significantly lower in TAC and GSH (p<0.001). TOS was exerting a strong negative connection with Framingham Risk Score (r= -0.58), TAC and GSH made mild negative correlations (r= -0.46 and r= -0.49 respectively).

Conclusions: COPD patients exhibit significant oxidative imbalance that correlates positively with cardiovascular risk.A possible indicator of assisting COPD patients (exposed to cardiovascular complications) could be the indicators of oxidative stress.

Metastatic Breast Cancer: A Correlation between Ki67, a Tumor Marker and Various Stages in Terms of age Groups

2026-02-23T10:03:32+03:00

Breast cancer is common most malignancy in multipara, premenopausal women The antigen Ki-67 plays important role in evaluating this condition biochemically. Being expressed in all phases of cell cycle (S, G1, G2, M) except GO.

METHODS: This cross-sectional design of the observational research on 283 patients was arranged and executed at JPMC (Jinah Postgraduate Medical Center). The hormone receptor status staging is done with immune-histochemical (IHC) staining. Ki-67, the nuclear antigen was assessed quantitatively as well as visually way using light microscopes.

Result: Most Cases belonged to stage -4 of the breast cancer followed by Stage -2 and stage-3. The biomarker KI 67 was more positive in 3rd and 4th stages.

Conclusions: Biological markers are good parameters to assess the progression of the breast cancer.

Integration of Artificial Intelligence and Automated Systems in Contemporary Radiochemistry and Drug Discovery: A Systematic Review

2026-02-23T14:07:10+03:00

Background: The recent breakthroughs in artificial intelligence (AI) and robotized technology have presented radical changes in radiochemistry and drug discovery with the results of the enhancement of choices accepted according to the data, the efficiency of an experiment and reduction of patterns of development. However, there is scanty comprehensive research done on their combined synergistic impact on these regions.

Objective: In line with the research question, the purpose of the paper and its abstract was to assess the efficacy, performance metrics, and translational capability of AI-driven and automated systems in the contemporary radiochemistry and drug discovery processes.

Methods: A total of 103 records focusing on systematic literature were searched in PubMed/MEDLINE, Scopus, Web of science, and IEEE Xplore and Google Scholar, in accordance with PRISMA 2020. Articles in the field of radiochemistry or drug discovery published between 2014 and 2024 that were exploring AI-based or other automated technologies were considered. Standardized tools were used to extract data and it was quality assessed. They were synthesized with the help of the thematic analysis and narrative synthesis methods to obtain results that pertain to synthesis efficiency, predictive accuracy, speed of development, reproducibility and cost reduction.

Results: A total of one hundred and six peer review articles were found and chosen. Radiochemical synthesis, optimized using AI, showed pooled radiochemical improvements in yield characterized by 32% (23-41) and significant improvements in the time spent in synthesis and increase in reproducibility. Pipelines in drug discovery using AI shortened the mean lead times on hitting and on pre-clinical development by 38 percent and increased efficiency of screening by 100 times. Robotic and automated systems showed better consistency in batch to batch and allowed close loop optimization. The analysis of correlation showed that there are strong positive correlations between the complexity of AI models, the extent of automation, and the general performance results.

Conclusion: The combination of AI-based and automated solutions will be a paradigm shift in radiochemistry and drug discovery, and will provide significant increases in efficiency and accuracy and scalability. The technologies make available closed-loop experimental workflows that are data-driven and have extensive potential implications on radiopharmaceutical production and pharmaceutical innovation. Large-scale clinical and industrialization requires prospective validation and alignment of efforts to establish regulatory harmonization.

Machine Learning–Driven Integration of Multi-Omics Data for Biomarker Identification in Rheumatoid Arthritis

2026-02-23T14:17:22+03:00

Purpose: In this study, the author explores the possibility of using multi-omics data combined with ML to identify biomarkers in RA, a chronic autoimmune disease characterized by chronic joint inflammation, destruction, and disability. The work specifically investigates novel biomarkers for putting into practice multi-omics (genomics, proteomics, and metabolomics) interfaced with machine learning algorithms to improve diagnostic accuracy, prognosis, and therapy management for RA patients. It becomes the direction of future RA omics and AI studies to enhance clinical efficacy and develop more effective therapeutic management.

Design/Methodology/Approach: The study elicits data from a cross-sectional survey of a sample of RA patients and HCPs using a closed set of standardized quantitative research questions. This research framework involves using existing RA datasets to combine multi-omics data, subsequently using Machine Learning algorithms to predict biomarkers and other molecular characteristics related to the disease. The questionnaire was also employed to obtain participants' perceptions on the possibility of applying multi-omics-based biomarker discovery in RA, its efficiency, and barriers to implementation. The survey was done among patients with RA, clinicians, and researchers to determine the clinician, patient, and researcher’s perception of using those technologies in clinical practice.

Implications: The current study demonstrated that using multi-omics data with machine learning can potentially improve RA research and management efforts. Concerning discovering new biomarkers that may help diagnose a condition earlier … technologies gave very high scores of interest. Machine learning models provided hypothesis generation and testing for many associations throughout the omics data and offered prognosis of disease course and treatment efficacy. However, data heterogeneity, technical issues, and the lack of large high-quality datasets were recognized as key barriers to the broader use.

Implications: The study has shown how multi-omics and machine learning integration need further advancement in RA biomarker identification. The study raises awareness of the need to enhance data availability, resolve the practical issues of integration between minus data, and implement explainable algorithms to aid decision-making. Experts in healthcare and research insist that strong guidelines should be established for omics data assessment to help integrate these tools into clinical practice in RA cases. In addition, assembling broader and more numerous datasets will be equally essential for increasing the efficiency of machine learning predictions.

Contribution/Novelty: The present paper fills the gap in applying precision medicine for rheumatoid arthritis by employing multi-omics integrated with machine learning. It sheds new light on how some of these third-generation technologies may be applied to biomarker discovery, prognosis, and RA’s individualized management. This study also stresses the need to effectively integrate, often, disciplinary, knowledge, and patient-oriented concerns in computational competence, clinical experience, and application of omics and AI in rheumatology.

Evaluating the Hypolipidemic and Hepatoprotective effects of Varying Doses of Gymnema sylvestre in dyslipidemia induced hepatic injury: Impact on Physiological Restoration"

2026-02-23T14:29:41+03:00

Background: Dyslipidemia and liver dysfunction are major contributors to metabolic disorders and cardiovascular risk. Herbal medicines such as Gymnema sylvestre have gained attention due to their traditional use and reported pharmacological activities, including lipid regulation and hepatoprotection. However, evidence regarding dose-dependent physiological restoration remains limited.

Objective: To evaluate the hypolipidemic and hepatoprotective effects of varying doses of Gymnema sylvestre and to assess their impact on physiological restoration.

Methodology: An experimental study was carried out using controlled groups receiving different doses of Gymnema sylvestre. Serum lipid profile parameters (total cholesterol, triglycerides, LDL, HDL) and liver function biomarkers (ALT, AST, ALP, bilirubin) were analyzed to determine dose-dependent effects and hepatic protection.

Results: Administration of Gymnema sylvestre resulted in significant, dose-dependent reductions in total cholesterol, triglycerides, and LDL levels, with a concomitant increase in HDL. Liver enzyme levels showed marked improvement, indicating reduced hepatic injury and restoration of normal liver function, particularly at higher doses.

Conclusion: The findings demonstrate that Gymnema sylvestre exerts significant hypolipidemic and hepatoprotective effects in a dose-dependent manner, supporting its therapeutic potential in the management of dyslipidemia and liver dysfunction.

Evaluation of Cardiac Biomarkers in Patients with Type 2 Diabetes and Subclinical Atherosclerosis: A Cross-Sectional Study

2026-02-23T14:50:22+03:00

Background: Cardiovascular risk in type 2 diabetes mellitus (T2DM) is heterogeneous, and atherosclerosis may evolve silently for years before clinical events. Circulating cardiac biomarkers—particularly high-sensitivity cardiac troponin I (hs-cTnI) and N-terminal pro–B-type natriuretic peptide (NT-proBNP)—may capture subclinical myocardial injury and wall stress that accompany early atherosclerotic disease. We evaluated associations between cardiac biomarkers and ultrasound-defined subclinical atherosclerosis in adults with T2DM without known atherosclerotic cardiovascular disease.

Methods: We performed a hospital-based cross-sectional study (January 2024–December 2024) enrolling adults with T2DM (age 40–75 years) without known coronary, cerebrovascular, or peripheral arterial disease. Subclinical atherosclerosis was defined as mean carotid intima–media thickness (CIMT) ≥0.90 mm and/or carotid plaque on B-mode ultrasonography. Biomarkers included hs-cTnI, NT-proBNP, and high-sensitivity C-reactive protein (hs-CRP). Associations with CIMT were tested using Spearman correlation and multivariable linear regression; predictors of subclinical atherosclerosis were evaluated using multivariable logistic regression and ROC analysis.

Results: Among 260 participants (mean age 58.9±8.7 years; 44% women), 118 (45.4%) met criteria for subclinical atherosclerosis. Median hs-cTnI and NT-proBNP were higher in the subclinical atherosclerosis group versus controls (hs-cTnI: 6.2 vs 3.8 ng/L; NT-proBNP: 112 vs 78 pg/mL; both p<0.001), while hs-CRP showed a smaller gradient (p=0.04). In adjusted models, log-hs-cTnI (adjusted OR 1.78, 95% CI 1.27–2.48) and log-NT-proBNP (adjusted OR 1.52, 95% CI 1.12–2.07) independently predicted subclinical atherosclerosis. A combined biomarker model improved discrimination (AUC 0.82) over clinical risk factors alone (AUC 0.73).

Conclusion: In T2DM without known ASCVD, hs-cTnI and NT-proBNP were independently associated with ultrasound-defined subclinical atherosclerosis and improved risk discrimination. Biomarker-informed vascular phenotyping may support earlier identification of high-risk diabetic patients for intensified prevention strategies.

Effectiveness Of Oral Micronized Progesterone in The Prevention of Preterm Labour in Women with Previous History of Preterm Birth

2026-02-24T08:50:11+03:00

Background: Births that happen before term still account for a large proportion of neonatalmorbidity and mortality around the world. Women who have experienced a history of preterm birth are recurrence candidates

Incidence and Arthroscopic Patterns of Meniscal Injuries Associated with Anterior Cruciate Ligament Tears: A Prospective Observational Study of 30 Patients

2026-02-24T09:07:51+03:00

Background: Meniscal injury is a frequent comorbidity in anterior cruciate ligament (ACL) tears and strongly influences stability, repairability, and long-term osteoarthritis risk. Reported prevalence and tear patterns vary by chronicity, mechanism, and diagnostic intensity. This study quantified the incidence and arthroscopic patterns of meniscal injuries in ACL-deficient knees and explored associations with time-from-injury and patient factors.

Methods: A prospective observational study was conducted on 30 consecutive patients with MRI-confirmed ACL tear undergoing arthroscopic ACL reconstruction at a tertiary centre (January–December 2025). Meniscal status was defined intraoperatively (gold standard) using standardized mapping of side (medial/lateral/both), location (anterior horn/body/posterior horn/root), and morphology (longitudinal, radial/oblique radial, bucket-handle, complex, root tear, ramp lesion). Patients were categorized as acute (<6 weeks) or delayed (≥6 weeks) from injury to surgery. Descriptive statistics were reported; associations were tested using Fisher’s exact test and independent-samples t-test, with α=0.05.

Results: Mean age was 26.7±6.1 years; 73.3% were male. Overall, 18/30 (60.0%) had meniscal injury: medial only 10 (33.3%), lateral only 5 (16.7%), both 3 (10.0%). The posterior horn was the commonest site (medial 72% of medial tears; lateral 67% of lateral tears). Delayed presentation showed higher medial meniscal injury than acute (50.0% vs 14.3%, p=0.040). Acute cases showed a trend toward higher lateral tears (28.6% vs 6.3%, p=0.082). Ramp-type lesions constituted 4/13 (30.8%) of medial injuries, consistent with under-recognized posteromedial pathology described in the literature.

Conclusion: In this 30-patient cohort, meniscal injury accompanied ACL tears in 60%, with a posterior-horn predominance. Delay to reconstruction was associated with a significantly higher rate of medial meniscal injury, supporting early stabilization strategies to reduce secondary medial damage.

Comparison of Day-Care Versus In-Patient Acl Reconstruction in Terms of Postoperative Pain and Patient Satisfaction: A Prospective Randomized Study (N=30)

2026-02-24T09:24:45+03:00

Background: Health systems increasingly favor same-day discharge after anterior cruciate ligament reconstruction (ACLR) to reduce costs and improve patient flow; however, concerns persist regarding early postoperative pain control and patient experience. Prior randomized evidence suggests outpatient ACLR can yield equal safety and higher satisfaction, but results vary across pathways and settings.

Methods: A prospective randomized study was conducted in a tertiary orthopedic center over 12 months. Thirty adults undergoing primary arthroscopic ACLR with hamstring autograft were randomized 1:1 to day-care discharge (DC) or in-patient admission (IP). Pain was measured using a 0–10 visual analogue scale (VAS) at 6, 24, and 48 hours. Satisfaction was measured at postoperative day 7 using a 0–100 satisfaction VAS (higher scores indicating greater satisfaction). Secondary outcomes included rescue opioid use, postoperative nausea/vomiting (PONV), unplanned contacts, and readmissions within 7 days. Between-group comparisons used independent-samples tests; pain trajectories were assessed with mixed-effects modeling.

Results: Baseline characteristics were comparable between groups (mean age 26.9±5.4 years; 70% male). Mean VAS pain scores (DC vs IP) were 5.2±1.3 vs 4.6±1.4 at 6 h (p=0.18), 3.4±1.1 vs 3.6±1.2 at 24 h (p=0.62), and 2.1±0.9 vs 2.3±1.0 at 48 h (p=0.55). Satisfaction at day 7 was higher in DC (88.1±7.6) versus IP (79.4±9.8), mean difference 8.7 points (95% CI 1.8–15.6; p=0.016). Rescue opioid consumption and PONV rates were not significantly different. No participant required hospital readmission within 7 days.

Conclusion: In this randomized cohort (n=30), day-care ACLR achieved pain outcomes comparable to in-patient care while producing meaningfully higher patient satisfaction, without increased early adverse events. These findings support structured day-care pathways for appropriately selected ACLR patients.

Hypernatremic, Hyperkalemic Dehydration in an 8-Month-Old with Acute Gastroenteritis Managed With Controlled Hypotonic Rehydration

2026-02-24T09:34:25+03:00

Background: Hypernatremic dehydration is a dangerous manifestation during infancy since hyperosmolality can trigger neurologic impairment and since excessive rapidity of correction may trigger cerebral edema. Even though acute gastroenteritis is typically associated with the emergence of iso- or hyponatremic dehydration, hypernatremia can also occur when the volume of free-water loss and reduced intake surpasses that of sodium loss, especially in young infants. Prerenal physiology (1) and gastrointestinal bicarbonate depletion (2), respectively, may be represented by concomitant hyperkalemia and hyperchloremia.

Case presentation: A male patient aged 8 months complained about several periods of vomiting and loose stools and a report of being drowsy with clinical signs including moderate dehydration. No previous administration of oral rehydration solution or intravenous fluids history. The first complete blood count revealed hemoconcentration (hematocrit 38.3%) and reactive thrombocytosis (platelets 470 ×10 3 /mm 3 ). Serum electrolytes demonstrated hypernatremia (Na 153.15 mmol/L), hyperchloremia (Cl 134.11 mmol/L), slight hyperkalemia (K 5.07mmol/L), and an increase in the ionized calcium (iCa 1.51 mmol/L). With close clinical and biochemical observation, controlled intravenous rehydration with 0.45% saline was initiated. After repeating the test about 6.7 hours later, the electrolytes focused on enhancement (Na 151.24 mmol/L; Cl 123.63 mmol/L; K 4.41 mmol/L; iCa 1.45 mmol/L), which matches approximately 0.29 mmol/L/h sodium correction rate, which is well within the safety extremes.

Conclusion: Physiologically consistent patterns of hypernatremia (net water loss and insufficient intake), hyperchloremia (diarrheal loss of bicarbonate and chloride retention under hypovolemia), hyperkalemia (temporarydownward changesin renal potassium excretion due to prerenal hypoperfusion +acidosis and mild hypercalcemia (hemoconcentration and impaired renal calcium clearance) are demonstrated in this case. Slow correction using hypotonic saline was linked to biochemical improvement without any known complications.

Heart Rate Variability and Autonomic Modulation During the First Year of MBBS Training

2026-02-24T10:02:20+03:00

Background: Heart rate variability (HRV) isa non-invasive marker of autonomicmodulation. Medical training may influence autonomic balance during the first academicyear.

Perception of Artificial Inelegance in Healthcare, Among Doctors In A tertiary Care Hospital of North Kashmir

2026-02-24T13:38:49+03:00

Background: Artificial intelligence (AI) is increasingly integrated into healthcare, influencing diagnostics, clinical decision-making, and health system management. Understanding healthcare workers’ perceptions is essential for responsible implementation and curriculum development. This study aimed to assess awareness, attitudes, perceived benefits, risks, and institutional readiness regarding AI among doctors at Government Medical College (GMC) Baramulla, North India.

Methods: A cross-sectional observational study was conducted in May 2024 among faculty, consultants, and residents. Data were collected using a structured, literature-based questionnaire administered electronically through Epicollect software. Sociodemographic variables and Likert-scale perception items were included. Descriptive statistics summarized responses, reliability was assessed using Cronbach’s alpha, and inferential analyses including correlation and multivariable regression were performed using Jamovi version 2.7.18.

Results: A total of 108 doctors participated with equal gender distribution. Awareness of AI was high (96.3%), and 88.9% were aware of its healthcare applications. Overall perception toward AI was favourable (mean composite score 3.80 ± 0.32). Participants strongly agreed on AI’s potential to improve healthcare access (4.10 ± 0.70) and reduce burnout (4.12 ± 0.66), and emphasized the need for structured training (4.48 ± 0.65). However, concerns regarding privacy risks (4.15 ± 0.73) and loss of clinical skills (3.86 ± 0.84) were prominent. Institutional readiness was perceived to be low (2.21 ± 0.91). Training needs positively predicted perception scores, while privacy concerns showed a negative association.

Conclusion: Doctors demonstrated favourable attitudes toward AI alongside significant concerns and perceived gaps in institutional preparedness, highlighting the need for structured education, ethical governance, and organizational readiness for safe implementation.

Study of Histopathological Lesions in Hysterectomy Specimens at Tertiary Care Hospital

2026-02-24T13:57:51+03:00

Background: Hysterectomy is one of the most commonly performed gynaecological surgical procedures for the management of various benign and malignant uterine conditions. Histopathological examination of hysterectomy specimens plays a vital role in confirming clinical diagnosis and identifying unsuspected lesions.

Materials and Methods: This retrospective and prospective observational cross-sectional descriptive study was conducted in the Department of Histopathology at Pravara Rural Hospital for 2 years duration. A total of 512 hysterectomy specimens received during the study period were analysed. Specimens were processed using standard histopathological techniques, stained with haematoxylin and eosin, and examined microscopically. Lesions of endometrium, myometrium, and cervix were classified according to Robbins Basic Pathology.

Results: Out of 9340 specimens received, 512 (5.48%) were hysterectomy specimens. The majority of patients were in the age group of 41–50 years (40.6%). Proliferative endometrium (56.83%) was the most common endometrial finding. Leiomyoma (26.56%) and adenomyosis (23.04%) were the predominant myometrial lesions. Chronic nonspecific cervicitis (91.4%) was the most frequent cervical lesion. Malignant lesions were relatively rare.

Conclusion: Most hysterectomy specimens showed benign histopathological lesions, highlighting the importance of routine histopathological examination for accurate diagnosis, detection of incidental lesions, and appropriate patient management.

Serum TSH Levels as a Predictor of Malignancy in Thyroid Nodules: a Retrospective Cross-Sectional Analytical Study

2026-02-25T07:06:30+03:00

Background: Thyroid nodules are common endocrine findings, with malignancy reported in 5–15% of cases. Although Fine Needle Aspiration Cytology (FNAC) remains the cornerstone of diagnosis, interest in biochemical predictors such as serum Thyroid Stimulating Hormone (TSH) has increased.

Aim: To evaluate the association between serum TSH levels and malignancy in thyroid nodules in a North Kashmir female cohort.

Methods: A retrospective cross-sectional analysis of 50 consecutive female patients with thyroid nodules undergoing FNAC and preoperative serum TSH estimation was performed. Cytology was classified according to the Bethesda System for Reporting Thyroid Cytopathology. Bethesda V–VI were considered malignant. TSH was analyzed as continuous and categorical (≤2.5 vs >2.5 µIU/mL). Statistical analysis included Student’s t-test and chi-square test.

Results: Mean TSH in malignant cases (n=19) was significantly lower (1.58 µIU/mL) compared to benign/indeterminate cases (3.26 µIU/mL) (p=0.003). TSH ≤2.5 µIU/mL was significantly associated with malignancy (χ²=4.99, p=0.026).

Conclusion: Lower serum TSH levels were significantly associated with malignant thyroid nodules. TSH may serve as an adjunctive biomarker in malignancy risk stratification; however, larger prospective studies are required.

Unusual Causes of Skin and Soft Tissue Infections: A Case Series

2026-02-26T08:50:41+03:00

Background: Skin and soft tissue infections (SSTIs) constitute a major infectious syndrome. SSTIs can arise from invasion of organisms through skin due to breach in the anatomical barrier or from the hematogeneous route, secondary to any systemic infections. The common causative micro-organisms are Staphylococcus aureus and Group A, Beta-hemolytic Streptococci (Streptococcus pyogenes). Many SSTIs respond predictably to the empiric treatment, whereas some of them pose a diagnostic as well as therapeutic dilemma, especially in immunocompromised patients or patients giving history of trauma, insect bite, marine contact etc. These cases simulate routine cellulitis clinically, but fail to respond. These SSTIs are usually caused by unusual pathogens like atypical bacteria, mycobacteria or fungi.

Aim and Objectives: We describe four cases of SSTIs due to rare etiologies encountered at a tertiary care hospital, aiming to illustrate clinical presentation, diagnostic strategies and management, thereby enhancing clinical awareness.

Methods: Study Design: Case series. Study Setting: Department of Surgery, Department of Microbiology, R.K. Damani Medical College, Dr. Hedgewar Rugnalaya, Chhatrapati Sambhajinagar, Maharashtra. Study Population: The cases were selected from the Microbiology laboratory database after identification. Study Duration: January 2024 to June 2025. Sample Size: 4

Results: Case 1, 82-year-old male farmer from rural Maharashtra with a one-week history of insidious, progressive right-sided scrotal swelling and pain diagnosed as pyocoele led to a left orchidectomy. Intraoperatively, a testicular abscess was noted. Bacterial Culture on Sheep Blood and MacConkey agar, identified via Vitek 2, confirmed Brucella melitensis. Case 2, 21-year-old female presented with high-grade fever, chills, and a painful perianal swelling that prevented sitting. The abscess was surgically drained; the cavity extended to the perivaginal region. Smears revealed gram-positive budding yeast cells identified as Candida guilliermondii, susceptible to Fluconazole. Case 3, a 61-year-old male with a 9-year history of diabetes presented with diffuse erythema, edema, and tenderness of the left leg. Debridement was performed, and empiric Cefoperazone-Sulbactam was started. Ziehl-Neelsen staining of pus aspirates revealed acid-fast filamentous branching bacilli. Cultures on Blood agar and Lowenstein-Jensen medium confirmed Nocardia species. Case 4, a 26-year-old male presented with fever and a painful swelling on the right thigh following a suspected insect bite. Multiple debridements were required. Systemic workups ruled out diabetes or immunosuppression. KOH mount revealed broad, aseptate, ribbon-like hyphae with wide-angle branching, characteristic of Mucorales.

Conclusions: This case series highlights four distinct instances of soft tissue infections—ranging from scrotal abscesses to lower limb cellulitis—caused by atypical pathogens including Brucella melitensis, Candida guilliermondii, Nocardia species, and Mucorales. These cases underscore the necessity of diligent microbiological investigation, especially when empiric antibiotic therapy fails or clinical presentations are insidious.

Phenotypic Patterns of Antimicrobial Resistance in Community-Acquired Escherichia Coli Infections

2026-02-28T08:09:48+03:00

Background: Community-acquired Escherichia coli infections increasingly demonstrate multidrug resistance (MDR), complicating empirical therapeutic strategies. Phenotypic resistance patterns remain poorly characterized in outpatient populations, particularly regarding extended-spectrum β-lactamase (ESBL) production and fluoroquinolone resistance.

Methods: A 24-month cross-sectional study enrolled patients with community-acquired E. coli infections presenting to primary healthcare centers and emergency departments (January 2023 to December 2024). Consecutive urine isolates underwent antimicrobial susceptibility testing using CLSI and EUCAST breakpoints. Phenotypic characteristics including ESBL production, biofilm formation, and virulence factor expression were determined. Statistical associations were evaluated using logistic regression modeling; P < 0.05 denoted significance.

Results: Of 487 community-acquired E. coli isolates, 38.6% exhibited resistance to ≥1 antimicrobial class. ESBL production was documented in 46.2% of isolates; 27.8% demonstrated multidrug resistance. Moderate-to-strong biofilm formation occurred in 69.8% of isolates, with significant correlation to MDR status (P = 0.018). Fluoroquinolone resistance ranged from 12.1% (levofloxacin) to 19.7% (ciprofloxacin), predominantly attributable to gyrA S83L and D87G mutations. Prior fluoroquinolone exposure (OR 3.16, 95% CI 1.11–8.98) and immunosuppressive therapy (OR 10.47, 95% CI 1.07–102.57) were independent risk factors for MDR-ESBL phenotypes. Resistance to trimethoprim-sulfamethoxazole (68.3%), penicillins (71.5%), and nitrofurantoin susceptibility (>98%) were also documented.

Conclusions: Phenotypic resistance in community-acquired E. coli involves multifactorial mechanisms integrating ESBL production, topoisomerase mutations, and virulence factor expression. Prior antimicrobial exposure and immunosuppression are modifiable risk factors. These findings support risk-stratified empirical therapy and antimicrobial stewardship interventions in community populations.

Prevalence of Esbl-Producing E. Coli in Outpatient Urinary Tract Infections

2026-02-28T08:18:09+03:00

Background: Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli represents an emerging threat to antimicrobial therapy in community-onset urinary tract infections (UTIs). Current prevalence data and risk stratification in outpatient populations remain variable across geographic regions, necessitating systematic epidemiological surveillance to guide empirical treatment decisions.

Methods: A cross-sectional observational study was conducted over 18 months (January 2022–June 2023) among outpatients presenting with acute UTI symptoms at a tertiary care hospital in Jaipur, Rajasthan, India. Consecutive symptomatic patients aged ≥18 years with urinalysis positive for pyuria and/or bacteriuria were enrolled (n=412). Midstream clean-catch urine samples were cultured on MacConkey agar; bacterial identification was performed via VITEK 2 automated system. ESBL production was detected using the phenotypic double-disc synergy test with ceftazidime (30 μg) and clavulanic acid (10 μg) according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Molecular confirmation was conducted via polymerase chain reaction (PCR) targeting blaCTX-M genes. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for ESBL-positive UTI (α=0.05; 95% confidence intervals reported).

Results: Of 412 symptomatic outpatients, 287 (69.7%) yielded culture-positive results with bacterial counts ≥10⁵ CFU/mL. Escherichia coli accounted for 221 (77.0%) of positive isolates. Among E. coli isolates, 71 (32.1%) were phenotypically confirmed as ESBL producers; molecular analysis confirmed blaCTX-M genes in 63 isolates (88.7%), with CTX-M-15 predominating (71.4%). Independent risk factors included prior hospitalization within 6 months (adjusted odds ratio [aOR] 3.18, 95% CI 1.84–5.51, p<0.001), prior cephalosporin exposure (aOR 2.94, 95% CI 1.72–5.03, p<0.001), recurrent UTI history (≥2 episodes/6 months; aOR 2.67, 95% CI 1.51–4.72, p=0.001), and advanced age (≥55 years; aOR 1.89, 95% CI 1.12–3.19, p=0.018). Resistance to fluoroquinolones and trimethoprim-sulfamethoxazole exceeded 75% in ESBL-producers, whereas all isolates remained susceptible to imipenem and meropenem. Clinical cure at day 7 (symptom resolution + negative follow-up culture) was achieved in 94.1% of patients treated with carbapenems versus 71.8% of those receiving empirical fluoroquinolones (p=0.008).

Conclusion: ESBL-producing E. coli accounts for nearly one-third of community-onset UTIs in outpatient populations, with epidemiological patterns reflecting prior healthcare exposure and antimicrobial selection pressures. Targeted screening and carbapenem-based therapy directed by rapid culture and susceptibility testing are warranted in high-risk populations to optimize treatment outcomes and curtail inappropriate antibiotic escalation.

Telmisartan versus Amlodipine: A Comparative Clinical Study on Efficacy and Safety in Essential Hypertension

2026-02-28T08:29:39+03:00

Background: Essential hypertension is a major cardiovascular risk factor in India, and both angiotensin II receptor blockers (ARBs) and dihydropyridine calcium channel blockers (CCBs) are widely used as first‑line agents. Telmisartan offers renin–angiotensin system blockade with partial peroxisome proliferator‑activated receptor‑gamma (PPAR‑γ) activity, while amlodipine reduces peripheral vascular resistance via L‑type calcium channel blockade.

Objectives: To compare the efficacy and tolerability of telmisartan and amlodipine in patients with mild to moderate essential hypertension.

Methods: A prospective, randomized, open‑label, parallel‑group study was conducted in 100 adults with mild to moderate essential hypertension over 12 weeks at SMIMS. Patients were randomized to telmisartan 40 mg once daily (Group T, n=50) or amlodipine 5 mg once daily (Group A, n=50). Clinic systolic and diastolic blood pressure (SBP, DBP) were recorded at baseline, 4, 8 and 12 weeks. Efficacy end points were mean change in SBP/DBP and proportion achieving target BP <140/90 mmHg. Tolerability was assessed by adverse drug reactions (ADRs) and withdrawals.

Results: Mean baseline BP was comparable between groups (telmisartan 152±8/96±6 mmHg; amlodipine 151±9/95±7 mmHg). At 12 weeks, both drugs significantly reduced SBP (telmisartan −20±9 mmHg; amlodipine −18±10 mmHg), with a modest numerical advantage for telmisartan. Telmisartan produced greater DBP reduction (−13±6 vs −10±7 mmHg) and a higher target BP achievement rate (78% vs 66%). Peripheral oedema occurred more frequently with amlodipine (16% vs 4%), whereas telmisartan was metabolically neutral or favourable for fasting glucose and lipid parameters.

Conclusion: Telmisartan and amlodipine are both effective in mild to moderate essential hypertension, but telmisartan showed superior diastolic BP reduction and better tolerability, particularly with respect to peripheral oedema and metabolic profile. Telmisartan may be preferred as initial monotherapy in hypertensive patients attending SMIMS, especially in those with metabolic risk factors.

A Study of A1 and A2 Subgroup in ABO Blood Group System in Blood Centre of Tertiary Care Hospital

2026-02-28T08:35:25+03:00

Aim: The aim of the present study was to assess the percentage of subgroup A1 and A2 along with ABO blood group in all donors and recipients in a blood centre of a tertiary care hospital.

Methods: It was a cross-sectional study in which data relating to blood grouping of donors and recipients from January 2023 to December 2023 at Bharati Hospital Sangli Blood Centre were collected and analysed.

Results: Among 9674 cases, highest cases were found of Blood Group O positive 2733 (28.25%) followed by B positive 2672 (27.62%), least prevalent blood group found to be was AB Negative 44 (0.45%). Among 9674 cases, 9044 (93.48%) were Rh positive and 630 (6.52%) were Rh negative blood group. Among 9674 cases, 5806 were blood Group O and B while 3868 were blood group A and AB in which A1 positive were 2566 (26.52%) most prevalent among subgroups while A2B 4 cases (0.04%) was least prevalent blood group among them. Out of 2815 cases of blood Group A, A1 was found in 2746 (97.55%) cases while A2 was found in 69 (2.45%) cases. While out of 1053 cases of Blood group AB, A1B was found in 1003(95.25) cases while A2B was found in 50(4.75%) cases.

Conclusion: The present study showed the most common blood group was O positive while A2 and A2B being the least prevalent blood group. The prevalence of the A1 and A2 subtypes of the blood group is notable among individuals with blood group A and AB. Transfusion of incompatible blood may result in potentially fatal transfusion-related responses.

Clinico-Anatomical Mapping of Benign Perianal Disorders with Emphasis on Perianal Structural Involvement in Gadap Town, Karachi

2026-02-28T08:44:02+03:00

Background: Benign perianal conditions like hemorrhoids, fissures, fistula-in-ano, and perianal abscesses are common surgical presentations that significantly impair quality of life. Data remains scarce in Pakistan, particularly among underprivileged groups. This study aimed to evaluate the clinico-anatomical spectrum, risk factors, and management of these diseases within the Baloch population of Gadap Town, Karachi.

Methodology: This cross-sectional study at Al-Tibri Medical College Hospital, Gadap Town, Karachi included 300 Baloch patients. Clinical assessment included presenting complaints, examination findings, and risk factors. Patients received either conservative or surgical treatment, depending on the diagnosis. Data were analyzed descriptively using frequencies and mean±standard deviation.

Results: The mean patient age was 33.2 ± 10.7 years, with a male predominance (56.3%). The primary complaint was bleeding per rectum (50.3%), followed by pain with bleeding (24%) and perianal pain (14%). On examination, anal fissures (47%) and internal hemorrhoids (34%) were the predominant diagnoses. Constipation and low dietary fiber intake were identified as major risk factors in over 80% of patients. Treatment was diagnosis-specific, managed conservatively or surgically.

Conclusion: Perianal diseases, specifically fissures and hemorrhoids, are highly prevalent in the Baloch population of Gadap Town. Constipation and dietary habits are critical contributors. Management aligns with diagnosis, combining conservative and surgical approaches. These findings highlight the importance of community education regarding preventive strategies for lifestyle modification.

A Case of Mucocele of Right Middle Turbinate

2026-02-28T14:31:20+03:00

Concha bullosa is a common anatomical variant of the middle turbinate but rarely develops into a mucocele. We report a case of a 20-year-old female who presented with right-sided facial pain, nasal obstruction, hyposmia, and blurring of vision. Endoscopic evaluation revealed an expansile right middle turbinate filling the nasal cavity, and CT imaging demonstrated a well-defined expansile lesion suggestive of a concha bullosa mucocele with orbital displacement. The patient underwent endoscopic sinus surgery with marsupialization and partial resection of the turbinate, and histopathology confirmed the diagnosis of mucocele with no microbial growth. Postoperative recovery was uneventful with complete symptom resolution and radiologic improvement. This case highlights the importance of considering concha bullosa mucocele as a differential diagnosis in unilateral nasal obstruction with orbital symptoms, where early imaging and endoscopic management are crucial for successful outcomes.

Surgical Interventions in Management of Atonic Pph -A Prospective Study

2026-03-02T08:25:27+03:00

Background: Postpartum haemorrhage (PPH) remains a leading direct cause of maternal mortality worldwide, with atonic PPH contributing the largest share despite evidence-based medical protocols. When uterotonics fail, timely surgical interventions are critical, particularly in low- and middle-income settings where interventional radiology is limited.

Methods: This prospective observational study was conducted in the Department of Obstetrics and Gynaecology, Karnataka Institute of Medical Sciences, Hubballi, from June 2023 to May 2024. All women with atonic PPH within 24 hours of delivery, in whom standard medical management (high-dose oxytocin, misoprostol, carboprost, uterine massage, tranexamic acid) failed and surgical intervention was required, were included (n=83). Women with secondary PPH (>24 hours) were excluded. Data on demographics, obstetric risk factors, type and sequence of surgical procedures, intra- and postoperative course, near-miss events (WHO criteria), and maternal deaths were recorded. Statistical analysis was performed using SPSS v26; p<0.05 was considered significant.

Results: Most women were young (mean age 25.2±4.3 years); 54.2% were unbooked and 75.9% delivered by caesarean section. Severe preeclampsia/gestational hypertension (51.8%) was the most frequent risk factor. Uterine artery ligation was performed in 62.7% and bilateral internal iliac artery ligation (BIIAL) in 48.2%; compression sutures (B-Lynch/Hayman) were used in 34.9%. Hysterectomy was required in 22/83 (26.5%) women, predominantly after failure of BIIAL. Uterine artery ligation alone controlled haemorrhage in 48.1% of cases, whereas hysterectomy was strongly associated with maternal mortality (71.4% of deaths; p=0.002) and near-miss status (36.7%; p<0.001). Overall maternal mortality was 8.4% and maternal near-miss occurred in 36.1%.

Conclusion: In this high-risk cohort, a stepwise devascularisation strategy—uterine artery ligation, BIIAL and uterine compression sutures—allowed uterine preservation in nearly three-quarters of women with refractory atonic PPH. However, a substantial proportion still required hysterectomy, which was strongly associated with severe morbidity and mortality, underscoring the need for earlier referral, protocolised escalation, and optimisation of perioperative critical care.

Severity and Determinants of Anemia Among Patients with Chronic Kidney Disease in a Tertiary Care Hospital

2026-03-02T09:42:46+03:00

Background: Anemia is a common andclinically significant complication of chronic kidney disease (CKD), contributingto morbidity, reduced quality of life

STUDY OF HEMATOLOGICAL, SEROLOGICAL AND BIOCHEMICAL PARAMETERS IN PATIENTS OF DENGUE VIRAL INFECTION

2026-03-02T09:46:06+03:00

Background: The acute febrile arboviraldisease known as dengue fever is caused by the dengue virus, which belongs to theFlaviviridae family and the Flavi virusgenus and is found in tropical andsubtropical regions of the world.

Duration-Dependent Histomorphological Alterations in Human Endometrium Following Progestin Therapy: Evidence from a Tertiary Care Center

2026-03-04T08:43:01+03:00

Objective: This research will assess the time varying histologic alterations in human endometrium during progestin therapy at a tertiary care hospital.

Materials and Methods: A retrospective observational study was at multiple tertiary care centers, in a span of three years. A total of 240 women who received progestin therapy as an indicator of different gynecological conditions were used as the sample on endometrial biopsy. The patients were stratified into four groups according to the duration of therapy: Group A (less than 3 months), Group B (3 -6 months), Group C (6 - 12 months) and Group D (more than 12 months). Blinded pathologists scored the histological parameters such as glandular atrophy, stromal decidualization, pseudosarcomatous changes and inflammatory infiltrate. ANOVA and Chi -square tests were used to conduct the statistical analysis.

Results: There were significant variations with time in all groups. Group A had a minimum of glandular atrophy (15%), whereas in Group D, the glandular atrop hy was mostly present (88.3, p<0.001). Group B (91.7) had the highest level of Stromal decidualization followed by a slow reduction in long -time treatment. Group C and D were the only groups with pseudosarcomatous stromal changes (p=0.002). The total histological score suggested that there was a progressive change in the morphology of the secretory to atrophic with the length of treatment (p<0.05).

Conclusion: Progestin treatment has specific time-contingent histomorphological changes on the endometrium. Short-term therapy is typified by decidualization, whereas the long-term exposure causes extensive atrophy in the glands and may cause stromal metaplasia. These temporal trends are critical in the process of diagnosing malignancy by pathologists to prevent a misdiagnosis of malignancy and to detect therapeutic outcomes by clinicians.

TO STUDY NEEDLE STICK INJURY AND DETERMINE THE VACCINATION STATUS OF HEPATITIS B VIRUS IN HEALTHCARE PROFESSIONALS

2026-03-05T11:19:23+03:00

Background: A major public healthconcern all around the world include hepatitis B virus (HBV) infection.According to studies

Impact of Intervention on Dental Anxiety among Patients: A Pre Post Study Using the Modified Dental Anxiety Scale (MDAS)

2026-03-05T14:04:57+03:00

Background: Dental anxiety is a significant barrier to oral healthcare utilization and isassociated with delayed treatment seeking and poorer oral health outcomes. This studyaimed to assess the level of dental anxiety among patients and evaluate the effect of a structured psychological intervention on anxiety reduction.

Assessment of the Occurrence of Ventilator-Associated Pneumonia and the Impact of Ventilator Bundle Practices in an Adult Intensive Care Unit of a Tertiary Hospital

2026-03-05T14:14:40+03:00

Background: Among infections seen in mechanically ventilated patients, ventilatorassociated pneumonia (VAP) is the most common and the most serious infection in Intensive Care Units (ICUs) patients. It significantly increases the length of stay, costs

Preoperative Serum Albumin and Body Mass Index as Predictors of Postoperative Complications in Elective Major Surgeries: A Prospective Observational Study

2026-03-06T19:14:27+03:00

Malnutrition is a well-recogniseddeterminant of adverse surgical outcomes.Preoperative assessment of nutritionalstatus using simple biochemical and anthropometric parameters

Yoga as an Adjunct Treatment in Rheumatoid Arthritis: A Narrative Review of Psycho-Neuro-Immune Interactions in the Indian Context

2026-03-07T08:45:39+03:00

Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease of the joints and systemic health. In India and worldwide, the incidence of RA is increasing. The traditional treatments are NSAIDs, corticosteroids, and DMARDs, but rceebtly there have been some non-pharmacological approaches such as yoga that have also been found to be beneficial. Objectives – To assess the therapeutic outcomes of yoga on RA based on its effect on inflammation, psychological stress, and psycho-neuro-immune modulation. Methods – This narrative review integrates evidence from eight prominent papers on RA and yoga. Databases such as PubMed, Scopus, and Google Scholar were searched using English-language articles from 2000 to 2024. Studies exploring biological, psychosocial, and clinical outcomes of yoga in RA patients were included. Results – Yoga enhances joint flexibility, immune status, and decreases inflammatory cytokines (IL-6, IL-17A, TNF-α), stress hormones (cortisol), and improves quality of life. Molecular markers such as BDNF, TGF-β, and HLA-G also alter in a positive direction with yoga. Significant reductions in anxiety, depression, and pain scores were observed. Conclusion – Yoga is a cost-effective, non-pharmacological, and an effective adjunct that can significantly enhance RA outcomes through psycho-neuro-immune mechanisms. Further long-term, deeply analysing research is indicated.

History of Recurrent Acute Cholecystitis Admissions as a Predictor of Operative Time and Bile Spillage: A Retrospective Cohort Study

2026-03-07T10:31:18+03:00

Background: Repeat acute cholecystitis hospitalization could be cumulative inflammatory exposure and scarring in Calot triple, which might complicate surgery. We tested the hypothesis that prior acute cholecystitis admission predicted the duration of the operation and bile spillage during the operation in patients undergoing index laparoscopic cholecystectomy.

Methods: Our study was in the form of a retrospective cohort study conducted at Sardar Vallabhbhai Patel (SVP) Hospital, Ahmedabad, a teaching hospital of NHL Municipal Medical College, Ahmedabad. Included were adult patients who experienced laparoscopic cholecystectomy due to acute calculous cholecystitis between December, 2022, and December, 2025 (N= 200). The exposure variable was the count of recorded preceding hospital admissions of acute cholecystitis in the past, 0, 1, or 2 admissions. Operative time (incision to close time, minutes) and bile spillage (recorded gallbladder perforation with visible bile leak +/- stone leakage) were primary outcomes. Predictors of operative time were estimated using multivariate linear regression, and predictors of bile spillage were estimated using multivariate logistic regression, controlling age, sex, BMI, ASA class, symptom duration, Tokyo severity grade of the Tokyo Guidelines, ultrasound/CT exposure (wall thickness, pericholecystic fluid) and surgeon experience level..

Results: Of 200 patients, 92 (46.0%) had 0 prior admissions, 62 (31.0%) had 1, and 46 (23.0%) had ≥2. Mean operative time rose stepwise with prior admissions (0: 62.1±18.4; 1: 74.3±22.1; ≥2: 92.4±27.6 minutes; p<0.001). Bile spillage occurred in 13/92 (14.1%), 14/62 (22.6%), and 19/46 (41.3%), respectively (p<0.001). After adjustment, each additional prior admission independently predicted longer operative time (β=+9.6 minutes/admission, SE 1.8, p<0.001) and higher odds of bile spillage (adjusted OR 1.75, 95% CI 1.28–2.42, p=0.001). Conversion to open surgery and bailout subtotal cholecystectomy were more frequent in the ≥2 group.

Conclusion: The presence of a history of recurrent admissions of acute cholecystitis was a powerful, independent indicator of increased operative time, and the spillage of bile in laparoscopic cholecystectomy. Admission history is a modest preoperative indicator that can enhance planning of the operation, risk advisory, and assignment of seasoned surgical units.

Diagnostic Accuracy of CT, Ultrasound, and Clinical Scoring in Differentiating Acute Appendicitis from Gastrointestinal Mimickers

2026-03-09T08:26:26+03:00

Background: Acute appendicitis is one of the most common surgical emergencies; however, differentiating it from gastrointestinal mimickers remains a clinical challenge, particularly in resource-limited settings.

Objective: To evaluate and compare the diagnostic accuracy of computed tomography (CT), ultrasonography (US), and clinical scoring systems in differentiating acute appendicitis from gastrointestinal mimickers.

Methods: This prospective cross-sectional diagnostic accuracy study was conducted at department of surgery indus medical college, Tando Muhammad Khan from 1st February 2025 to 31st January 2026, included 231 consecutive patients presenting with suspected acute appendicitis. Clinical assessment was performed using the Alvarado and Appendicitis Inflammatory Response (AIR) scores. All patients underwent ultrasonography, while CT was performed in cases with inconclusive or discordant findings.

Results: Acute appendicitis was confirmed in 156 (67.5%) patients, while 75 (32.5%) were diagnosed with gastrointestinal mimickers. The Alvarado score demonstrated sensitivity of 82.7% and specificity of 64.0%, whereas the AIR score showed sensitivity of 85.3% and specificity of 69.3%. Ultrasonography achieved sensitivity of 87.2%, specificity of 72.0%, and overall accuracy of 82.7%. CT demonstrated the highest diagnostic performance with sensitivity of 95.5%, specificity of 90.0%, overall accuracy of 93.3%, and AUC of 0.94. The negative appendectomy rate was 8.8%.

Conclusion: CT scan showed superior diagnostic accuracy in differentiating acute appendicitis from gastrointestinal mimickers, followed by ultrasound. Clinical scoring systems were effective for initial risk stratification but insufficient as standalone diagnostic tools.

Pulmonary Tuberculosis in a High-Burden Population in Pakistan: Clinical Characteristics, Risk Factors, and Public Health Implications

2026-03-10T08:25:26+03:00

Background: TB of the lungs is still a really serious issue in places where it’s common. It causes a lot of sickness and death, and keeps spreading through communities even where programs to control it have been running for years. Part of the problem is that patients get diagnosed too late, the same risk factors keep coming up, and the disease doesn’t present the same way every time. To do better — at catching it early, treating it well, and responding to it as a public health issue — we really need to understand how it actually shows up in these settings.

Objectives: The goal of this study was to get a clearer picture of how pulmonary tuberculosis actually presents in a high-burden population, work out which risk factors tend to go along with more advanced disease, and think through what any of that means from a public health angle.

Methods: We set this up as a cross-sectional study and ran it over twelve months across various TB centers in Pakistan included 250 patients in total. Patients who already had a confirmed pulmonary TB diagnosis and met our criteria were brought in. We collected information from each one — their background, what symptoms they had and for how long, whether they smoked or lived somewhere crowded, and any other health issues they’d had.

Results: Out of 250 patients, productive cough was the most common symptom at 89.6%, with a median duration of 6.2 weeks before anyone came in. Male patients and those from poorer households had worse disease overall. The risk factors that kept showing up were crowded living, smoking, not eating enough, and waiting too long before going to a doctor. Over half (58.4%) already had advanced disease when they first showed up. Delayed care-seeking was the strongest predictor (OR 3.12), followed by malnutrition (OR 2.84), HIV co-infection (OR 2.56), overcrowded housing (OR 2.31), smoking (OR 1.94), and prior TB history (OR 1.78); all p<0.05.

Conclusion: What this study showed us is that TB in these kinds of populations keeps turning up late, in patients who already have a lot working against them. Most of the risk factors we found are ones that could realistically be addressed — which is worth keeping in mind when thinking about where programs should focus their effort.

Impact of Early Soft Tissue Coverage on Outcomes of Complex Fractures: An Orthoplastic Perspective

2026-03-10T08:51:44+03:00

Objective: To determine the effects of definitive soft tissue coverage timing on clinical outcomes of patients undergoing an integrated orthoplastic management of Gustilo-Anderson Type IIIB/ IIIC open fractures.

MATERIALS and METHODS: It was a prospective cohort study, which recruited 186 patients with complex lower limb fractures that necessitated soft tissue repair. Patients were divided into two categories, depending on when they received definitive flap coverage Group A (early coverage ≤ 7 days, n=98) and Group B (delayed coverage >7 days, n=88). Deep infection rate, time to bony union, flap survival and limb salvage were the primary outcomes. The secondary outcomes were hospital length of stay, reoperation rate, and functional outcome measured using Lower Extremity Functional Scale (LEFS).

Results: At early stages, the rates of deep infection (12.2 vs. 34.1, p=0.001), flap survival (96.9 vs. 85.2, p=0.008), bony union (18.4+-4.2 vs. 24.7+-6.8 weeks, p=0.001), and length of stay (22.3+-7.1 vs. 31.8+-9.4 days, p=0.001) showed significant differences. The coverage timing (>7 days) was determined as an independent predictor of a deep infection by the multivariate logistic regression when adjusted by the severity of injuries, comorbidities and smoking status (OR 3.82, 95% CI 1.94-7.53, p<0.001).

Conclusion: Early definitive soft tissue coverage in the initial seven days of management makes a big contribution to clinical outcomes of complex open fractures using an orthoplastic model. Morbidity reduction can be optimized through socioeconomic challenges by implementing special orthoplastic teams in resource-constrained environments such as Pakistan.

The Deficiency of Vitamin-D: An Unresolved Issue of the Current Era Affecting the Chilchren and the Elderly

2026-03-10T11:52:10+03:00

The Vitamin D, a fat-soluble vitamin has been documented to be involved in major health processes, despite the fact an easy process of synthesis, communities have been reported to be deficient or insufficient levels of the vitamin globally. This observational Study was conducted in different cities of Sindh province design over one year from January 2024-January 2025. There were 1000 patients analyzed for serum vitamin D levels with age groups from 5 years to 60 years as age range using purpose technique for sampling. Statistical tests were applied using SPSS version 22 for data analysis generating mean, SD and other measures. We found the study population as deficient 70%, insufficient 20% and normal in 10%. Non-significant difference was observed between the adults and children for vitamin D deficiency p-value 0.094.

Conclusion: Majority of the population is suffering from the deficiency of vitamin D

PROTECTIVE EFFECT OF GARLIC IN INDOMETHCIN INDUCED GASTRIC ULCER IN ADULT ALBINO RATS

2026-03-10T17:18:24+03:00

Peptic ulcer disease (PUD) is definedas the mucosal lesions that penetratethe muscularis mucosa layer and forma cavity surrounded by acute and chronic inflammation.

Prevalence Of Early Childhood Caries in Preschool Children

2026-03-11T12:31:30+03:00

Background: Early childhood caries (ECC) isone of the most common chronic diseases inpreschool children and remains a significant public health concern, particularly in developingregions. Objective: To determine

A Comparative Study of Dextran-40 versus Crystalloid Infusion in Nonhemorrhagic, Nonhypovolemic Shock in Emergency Medicine

2026-03-12T08:48:57+03:00

Background: Shock is a condition of inadequate tissue perfusion due to an imbalance between oxygen demand and supply, classified into hypovolemic, cardiogenic, obstructive, and distributive types, each with distinct causes and treatment approaches. Crystalloids are the preferred intravenous fluids for resuscitation, while the safety and efficacy of synthetic colloids like dextran-40, as an alternative to albumin in non-hemorrhagic, non-hypovolemic shock, remain under investigation. This study explores the potential of dextran-40 in critical patients, aiming to provide clarity on its role compared to crystalloids.

Objectives: The study aims to evaluate the efficacy of dextran in achieving early hemodynamic stability, compare dextran infusion with crystalloid fluids in managing shock during the initial hours, and assess their outcomes in terms of multi-organ failure.

Methods: This prospective randomized controlled study evaluated the effects of Dextran-40 versus crystalloids in patients with non-hemorrhagic, non-hypovolemic shock presenting to the emergency department. Patients were assessed using qSOFA criteria, and initial resuscitation was performed with normal saline, followed by group-specific interventions. Outcomes were monitored through vital signs, ABG parameters, lactate clearance, and mental status, with statistical analysis performed using SPSS and R software.

Conclusion: The study found no significant advantage of dextran-40 over crystalloids for resuscitation in distributive shock, highlighting the need for larger, multicenter, randomized trials to validate its efficacy and safety. While promising early practices like goal-directed resuscitation and conservative fluid management show potential, further research is essential to establish dextran-40 as a reliable alternative to albumin in sepsis management.

Association between Sleep Deprivation and Peripheral Nerve Conduction Velocity

2026-03-12T08:58:35+03:00

Background: Sleep is essential for maintaining normal neurological and physiological functions. Sleep deprivation has become increasingly common due to modern lifestyle patterns, irregular work schedules, and prolonged screen exposure. While the effects of sleep deprivation on cognitive and central nervous system functions have been widely studied, its impact on peripheral nerve conduction velocity remains less explored.

Objectives: The present study aimed to evaluate the association between sleep deprivation and peripheral nerve conduction velocity in healthy individuals.

Materials and Methods: This observational cross-sectional study was conducted in the Department of Physiology and included 70 participants. Subjects were categorized into two groups: sleep-deprived and normal sleep groups based on their sleep duration. Demographic details such as age, gender, and body mass index (BMI) were recorded. Peripheral nerve conduction studies were performed using standard electrophysiological equipment to measure motor and sensory nerve conduction velocity and distal latency of the median nerve. Data were analyzed using appropriate statistical methods, and a p-value of <0.05 was considered statistically significant.

Results: The results showed that motor nerve conduction velocity was significantly lower in the sleep-deprived group (54.2 ± 4.6 m/s) compared to the normal sleep group (57.8 ± 3.9 m/s) (p = 0.003). Similarly, sensory nerve conduction velocity was reduced in sleep-deprived participants (50.6 ± 3.8 m/s) compared to those with normal sleep (53.7 ± 3.4 m/s) (p = 0.005). Distal latency was significantly higher in the sleep-deprived group (3.8 ± 0.6 ms) than in the normal sleep group (3.3 ± 0.5 ms) (p = 0.002). Conclusion: Sleep deprivation was associated with significant alterations in peripheral nerve conduction parameters, indicating its potential impact on peripheral nerve function.

FACIAL ANTHROPOMETRY IN SOUTH INDIAN POPULATION: AUTOPSY-BASED CORELATIONS OF SEXUAL DIMORPHISM AND STATURE

2026-03-12T09:58:02+03:00

Background: In Forensic anthropology, theestimation of stature from the bones plays animportant role in the identification of missingpersons. In order to determine stature separate regression formulae should

Influence of Chronic Heat Exposure on Nerve Conduction Velocity in Desert Populations

2026-03-13T08:25:25+03:00

Background: Chronic exposure to high environmental temperatures is a common condition for individuals living in desert regions. Prolonged heat stress may influence several physiological systems, including the peripheral nervous system. Nerve conduction velocity (NCV) is an important electrophysiological parameter used to evaluate the functional integrity of peripheral nerves. Environmental factors such as temperature, hydration status, and occupational heat exposure may influence nerve conduction properties.

Aim: To evaluate the influence of chronic heat exposure on nerve conduction velocity in individuals residing in desert populations.

Materials and Methods: This cross-sectional observational study was conducted in the Department of Physiology at Jaipur National University, Rajasthan. A total of 120 participants aged between 18–60 years with long-term exposure to desert climatic conditions were included in the study. Motor and sensory nerve conduction velocities were assessed using a standard electromyography (EMG) system under controlled laboratory conditions. Nerves commonly tested included the median, ulnar, tibial, peroneal, and sural nerves. Demographic data, duration of heat exposure, and daily exposure hours were recorded. Statistical analysis was performed using appropriate software, and a p value <0.05 was considered statistically significant.

Results: The study demonstrated a gradual reduction in nerve conduction velocity with increasing duration and daily hours of heat exposure. Participants with more than 20 years of heat exposure showed lower mean NCV compared with those with shorter exposure duration (p=0.03). Motor NCV of the median, tibial, and peroneal nerves showed statistically significant reductions, while sensory NCV changes were observed in the median and sural nerves. Age-related decline in NCV was also noted (p=0.01).

Conclusion: Chronic environmental heat exposure may produce mild alterations in peripheral nerve conduction parameters, suggesting possible adaptive or subclinical neurophysiological changes among desert populations.

Audit of Prescription Documentation Practices in Pediatric Surgical Inpatients at a Tertiary Care Hospital, Multan, Punjab

2026-03-13T11:17:06+03:00

Background: Accurate and complete drug prescription charts are essential for safe and effective patientcare, particularly in pediatric surgical practice where dosing errors can have serious consequences.Clinical audit is a key component of clinical governance aimed at identifying gaps between current practice and established standards.

Clinical and Radiographic Evaluation of Stem Cell–Based Bone Grafts in Maxillofacial Reconstruction of Cancer-Related Defects

2026-03-13T11:24:34+03:00

Objective: To evaluate the clinical and radiographic outcomes of mesenchymal stem cell(MSC)–based bone grafts in post-oncologic maxillofacial reconstruction, with emphasis on graft integration, bone regeneration, and complication rates.

Significance of Inj. Methylprednisolone in the Treatment of Visual Complaints in Acute Methanol Poisoning - A Case Series Study-Retrospective

2026-03-13T13:27:50+03:00

Background: Methanol poisoning is a life-threatening emergency. One of the most serious complications is visual impairment due to toxic optic neuropathy. Current treatments include ethanol/fomepizole, folinic acid, and dialysis. The role of corticosteroids like methylprednisolone is still debated. This study evaluates its significance in visual recovery.

Objective: To assess improvement in visual acuity following treatment with Inj. Methylprednisolone and to assess optic disc changes using Colour vision, fundus examination.

Method: This retrospective, non-comparative, intervention case series examines the ophthalmological data of patients diagnosed with methanol-induced optic neuropathy during illicit methanol poisoning tragedy at Govt. Kallakurichi medical college and hospital. Patients’ characteristics and the results of initial and final ophthalmological examinations were documented.

Result: Out of 145 patients, 8 were diagnosed with methanol-induced toxic optic neuropathy. They presented with severe bilateral visual loss and disc edema. Following corticosteroid therapy, all showed improvement in visual acuity, pupillary reflexes, colour vision, and fundus appearance

Conclusion: A timely diagnosis and treatment of patient with methanol-induced optic neuropathy is important to achieve a good visual prognosis.

Detection of Virulence Factors of Candida Species Isolated From Neonatal Candidemia at Tertiary Care Hospital in North India

2026-03-14T09:52:30+03:00

Background: Fungus being ubiquitous, but infections caused by it are rare and as a suspect for sepsis are rarest. So, it becomes a cause for higher morbidity and mortality especially in state of immune-compromised state like neonates admitted in NICU. Hence to treat it appropriately, we must know its emergence, virulence and trend of it. So we design this study in neonates, one of most vulnerable group to study its virulence and effects on them.

Method: It is a prospective study conducted for one and half years on 44 positive neonates detected for candidemia. Using most advanced and also the conventional methods we differentiate the species and also studied in detail about their virulence and end results on patients

Results: Incidence is 10.33%, with dominance of non albicans candidemia (65.9%) over C. albicans septicaemia. Virulence is also higher in non albicans Candida (NAC) as compared to C. albicans. The mortality (34%) detected was higher in NAC but average duration of hospital stay (14.5) is longer in C. albicans due to its more resistance towards anti- fungals.

Conclusion: In this long study on neonatal septicaemia, we found that NAC were emerging pathogens and were more virulent than C. albicans

Development and Validation of UV Spectroscopic Method for Estimation of Symplocos Racemosa

2026-03-14T10:06:36+03:00

Background: Symplocos racemosa Roxb. Is an herbal plant grown in tropical and subtropical regions around the globe. Due to its therapeutic activity, it is being used as an herbal treatment against obesity and many other chronic and acute disease, considering these applications of the drug a UV-Spectrophotometric method was developed and validated according to ICH (International Council for Harmonization) recommendations.

Objective: To develop a quick, precise, reliable and specific UV-Spectrophotometric method validate according to ICH Q2 (R1) guidelines.

Materials and Method: Methanol was used as the solvent for method development at a wavelength of 276nm.

Results: The developed method demonstrated correlation coefficient value of 0.999and was found to be linear with a low LOQ and LOD values of 12.21 and 37 respectively with accuracy and precision %RSD (Relative standard Deviation) value less than 2.

Conclusion: A quick, accurate, simple and economical UV-Spectroscopy method was developed and validated for the estimation of Symplocos Racemosa.

Enhancing Antifungal Treatment Using Microsponges Loaded Emulgel to Improve Topical Delivery System

2026-03-14T10:28:12+03:00

Objective: The objective of this research is to investigate the effectiveness of microsponge-based delivery system for enhancing antifungal treatment of Bifonazole. This study aims to evaluate the potential of microsponges technology in improving drug delivery, increasing drug bioavailability and enhancing therapeutic outcomes of Bifonazole in treatment of fungal infections.

Background of the Study: In recent years, the development of novel drug delivery systems has revolutionized the field of pharmaceuticals, offering solutions to improve drug efficacy and patient compliance.

Methodology: This experimental study was conducted in Shree Pushpasen Sawant College of Pharmacy, Jaywant Nagar, Humarmala. Study duration was 12 weeks.

Procedure: All chemicals and solvents were procured from commercial sources were purified and sterilized using standard procedures from literature whenever required.

Results: The microsponges prepared using Eudragit S100 polymer was found to be suitable for the sustained release formulation and also Bifonazole microsponges containing gel also showed the sustained release action.

Clinical Case Series on Madhumegam (Type 2 Diabetes Mellitus) Management Using the Siddha Herbal Medicine: Keezhanelli Chooranam (KNC)

2026-03-14T10:46:12+03:00

According to the 2021 World Bank report, the prevalence of diabetes in Sri Lanka was 11.3% among adults aged 20 -79 years. In Siddha literature, Madhumegam is correlated with Diabetes Mellitus and is classified under Meganoi in Yugi Vaithiya Cinthamani 800, belonging to the Pitha type (Thithippu Neer). Keezhanelli Chooranam (Phyllanthus amarus) is a single-herb formulation documented in the Siddha Pharmacopoeia of India for managing Madhumegam (Type 2 Diabetes Mellitus). To scientifically validate its traditional claim, a clinical study was conducted at the Siddha Teaching Hospital, Kaithady, with ethical approval from the Bandaranaike Memorial Ayurveda Research Institute. Six patients diagnosed with Madhumegam were enrolled. Keezhanelli Chooranam (5 g twice daily before meals with warm water) was administered for 90 days, along with a prescribed dietary regimen. Fasting Blood Sugar (FBS) was measured every 14 days, while Postprandial Blood Sugar (PPBS) and HbA1c were assessed at baseline and on Day 90. Statistical analysis using the paired t-test revealed a highly significant reduction in PPBS (p = 0.008) and a significant decrease in VLDL (p = 0.015). Although reductions in FBS (↓32 mg/dL), HbA1c (↓0.94%), and Triglycerides (↓43 mg/dL) were not statistically significant (p = 0.065–0.068), they indicated meaningful clinical improvement. No adverse changes were observed in Total Cholesterol, HDL, LDL, or Hemoglobin levels. The findings suggest that Keezhanelli Chooranam possesses anti-hyperglycemic and hypolipidemic properties, providing preliminary scientific evidence supporting its Siddha claim in managing Madhumegam. Further validation through large-scale randomized controlled trials is recommended.

A Comparative Study of Dexamethasone and Local Anaesthetic Infiltration in the Management of Postoperative Nausea and Vomiting in Pediatric Tonsillectomy

2026-03-14T11:54:39+03:00

Objective: To compare theeffectiveness of intravenousdexamethasone and pre-incision localanesthetic infiltration in reducing postoperative nausea, vomiting, andpain among pediatric patientsundergoing tonsillectomy

Clinical Significance of Jugular Bulb Venous Oxygen Saturation Monitoring in Severe Traumatic Brain Injury

2026-03-14T11:58:41+03:00

Background:Maintaining adequate brainoxygenation is a primary goal in themanagement of severe traumatic braininjury (TBI). Jugular venous oxygensaturation (SjvO₂) monitoring is auseful technique for estimating theglobal balance between cerebral oxygensupply and metabolic demand. The FullOutline of Responsiveness (FOUR)score is a newer consciousnessassessment tool that has been proposedas an alternative to the Glasgow

In Vivo Study on the Anticancer Property of Pugasaram: An Arecanut Based Polyherbal Gel in Oral Cell Carcinoma

2026-03-14T12:38:51+03:00

Cancer is one of the principle causes of human mortality in all countries. Surgery, chemotherapy and radiotherapy are the usual therapeutic remedies for this disease. As there are several side effects of such treatments, the researchers are constantly in search of certain alternate remedial measures using promising herbal products. Several plants are already known for their anticancer properties. In Ayurvedic system of medicine, preparations using several herbs, called polyherbal products, are generally preferred over single herb preparation. In the present study, the anticancer property of a polyherbal gel known as Pugasaram, prepared mainly by using arecanut and betel leaf as the main ingredients along with ten other plants / plant products, was studied in cancer induced mice. The preliminary toxicity study revealed that there was no change in the behaviour of mice fed with this gel at a concentration of 2000mg/kg body weight. The anticancer efficacy profile of Pugasaram showed a significant reduction in the size of tumors and their progression compared to the untreated DMBA applied mice and showed even better than that of cisplatin treated group.

Impact of Training Program in Improving Knowledge of Healthcare Personnel Regarding Biomedical Waste Management in Government Medical College and Associated Hospital

2026-03-14T14:00:15+03:00

Background: Biomedical waste (BMW) poses significant risks to healthcare workers and the environment if not managed properly. Despite the existence of comprehensive Biomedical Waste Management Rules (2016) in India, knowledge gaps among healthcare personnel continue to hinder safe practices. Structured training programs are critical for enhancing compliance and awareness. Aims/Objectives: To evaluate the impact of a structured training program on the knowledge of paramedical healthcare workers regarding biomedical waste management in a government medical college and associated hospital.

Settings and design: A before-and-after interventional study was conducted among 112 paramedical staff at associated hospital of a newly established Government Medical College. Participants underwent a three-day structured training program on BMW management. Material and methods: A pre-tested questionnaire assessed knowledge before and after the intervention. Data were analyzed using SPSS v20, with the chi-square test applied to determine statistical significance (p < 0.05). Practices of the paramedical staff were assessed by observational visits to check adherence to the biomedical waste management guidelines which got polished by training program.

Results: Post-training, a statistically significant improvement was observed in ten out of thirteen knowledge variables. Notably, knowledge regarding sharp disposal increased from 36.6% to 76.8% (p < 0.00001), and awareness of disease transmission risks improved from 10.5% to 85.6% (p < 0.00001). Overall, the intervention led to a marked enhancement in participants' understanding of BMW segregation and safe disposal practices.

Conclusion: Structured training programs significantly improve healthcare workers’ knowledge of biomedical waste management. Regular refresher courses and integration of BMW training into institutional policy and healthcare curricula are recommended to ensure sustained compliance and safer healthcare environments.

COMPARATIVE STUDY OF NON CONTRAST CT AND DIFFUSION WEIGHTED MR IMAGING IN DIAGNOSTIC EVALUATION OF HYPERACUTE ISCHEMIC STROKE

2026-03-14T14:32:14+03:00

Background: Early and accurate diagnosis of acute ischemic stroke is essential for appropriate management and improved clinical outcomes. Non-contrast computed tomography (NCCT) is widely used as the initial imaging modality; however, its sensitivity in the early detection of ischemic changes is limited. Diffusion-weighted magnetic resonance imaging (DW-MRI) has emerged as a more sensitive technique for detecting acute cerebral ischemia.

Aim: To document and compare the diagnostic performance of Diffusion-weighted MR imaging with Non contrast CT in the diagnosis of hyper acute ischemic stroke.

Materials and Methods: This hospital-based cross sectional study was conducted over a period of 3 months in the Department of Radio-diagnosis, SVRRGGH, Titupati Andhra pradesh. A total of 50 patients with clinical suspicion of acute stroke were included. All patients underwent NCCT and MRI, including diffusion-weighted imaging. Imaging findings were correlated with final clinical diagnosis. Diagnostic performance of NCCT and DW-MRI was evaluated using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy.