Background: The unprecedented surge of mucormycosis cases during the COVID-19 pandemic, particularly in patients with predisposing factors such as uncontrolled diabetes mellitus and corticosteroid therapy, has posed a serious therapeutic challenge. Accurate fungal identification and timely antifungal susceptibility profiling are essential for optimizing patient outcomes in this high-mortality infection. Objectives: This study aimed to isolate and identify fungal pathogens from clinically diagnosed COVID-19–associated mucormycosis (CAM) cases and to determine their antifungal susceptibility patterns to guide evidence-based management. Methods: A prospective, observational study was conducted in a tertiary care hospital over a defined period. Clinical specimens, including nasal tissue, sinus aspirates, and orbital biopsies, were collected under aseptic precautions from patients with suspected CAM. Direct microscopy with potassium hydroxide (KOH) mount and histopathological examination was performed for preliminary detection. Fungal cultures were inoculated on Sabouraud dextrose agar and incubated under appropriate conditions. Species identification was carried out based on colony morphology and microscopic features using lactophenol cotton blue staining. Antifungal susceptibility testing was performed according to the Clinical and Laboratory Standards Institute (CLSI) guidelines against amphotericin B, posaconazole, and isavuconazole. Results: The majority of isolates belonged to the Rhizopus arrhizus complex, followed by Mucor and Lichtheimia species. Amphotericin B demonstrated the highest in vitro activity, with minimal inhibitory concentrations within susceptible ranges for most isolates. Variable susceptibility was noted for posaconazole, whereas reduced sensitivity was observed for isavuconazole in a subset of strains. A significant proportion of patients had uncontrolled hyperglycemia and a recent history of systemic corticosteroid administration. Conclusion: The study underscores the predominance of Rhizopus species in COVID-19–associated mucormycosis and reaffirms amphotericin B as the most potent therapeutic option. Early mycological diagnosis, coupled with targeted antifungal therapy, is critical to improving survival rates in CAM. Continuous surveillance of antifungal susceptibility is warranted to detect emerging resistance trends and to tailor empirical therapy in high-risk populations.

Background: Space-occupying lesions (SOL) of the liver are commonly detected on imaging and require differentiation between benign and malignant pathology. Ultrasound (USG) serves as the initial modality for evaluation, but further characterization with computed tomography (CT) and magnetic resonance imaging (MRI) is often needed for accurate diagnosis. This study aims to analyze the role of ultrasound in detecting hepatic SOLs and its correlation with CT and MRI findings. Methods: This hospital-based prospective study was conducted over one year (July 2021 to June 2022) at a tertiary care hospital in south India. A total of 120 patients with hepatic SOLs detected on ultrasound were included. All patients underwent detailed USG evaluation, followed by CT and/or MRI correlation. Lesions were classified based on imaging characteristics, including echotexture, vascularity, and enhancement patterns. The diagnostic accuracy of USG was analyzed in comparison to CT/MRI. Results: Among 120 cases of hepatic SOLs, benign lesions were observed in 58 cases (48.3%), while malignant lesions accounted for 62 cases (51.7%). The most common benign lesion was hemangioma (32.7%), followed by hepatic cysts (15.6%) and focal nodular hyperplasia (8.3%). Among malignant cases, hepatocellular carcinoma (HCC) constituted 38.4%, followed by liver metastases (31.2%) and intrahepatic cholangiocarcinoma (13.2%). Ultrasound demonstrated an overall sensitivity of 82.5% and specificity of 89.2% in differentiating benign from malignant lesions. While USG was effective in detecting cystic and vascular lesions, its limitations in characterizing solid tumors necessitated further imaging. CT and MRI provided definitive characterization in cases where USG findings were inconclusive, with a statistically significant correlation (p < 0.001). Conclusion: Ultrasound remains a valuable initial modality for the detection of hepatic SOLs. However, CT and MRI significantly enhance characterization, particularly in differentiating malignancy. The integration of USG with CT/MRI improves diagnostic accuracy, aiding in better clinical management.

Introduction Acute appendicitis is one of the most common surgical emergencies worldwide, requiring prompt diagnosis and intervention to prevent complications such as perforation, abscess formation, and peritonitis. Despite its prevalence, the clinical diagnosis of acute appendicitis remains challenging due to the variability in presenting symptoms and the overlap with other abdominal pathologies. Traditional diagnostic approaches, such as clinical scoring systems (e.g., Alvarado score) and laboratory findings, often lack sufficient sensitivity and specificity, leading to diagnostic uncertainty and potential delays in treatment.  Methods This prospective observational study was conducted at a tertiary care teaching hospital over a period of 12 months. The study aimed to evaluate the diagnostic performance of ultrasound in patients with suspected acute appendicitis and to identify challenges associated with its use in a high-volume clinical setting. Patients of all ages presenting to the emergency department with clinical suspicion of acute appendicitis (based on history, physical examination, and laboratory findings) were included. Exclusion criteria included patients with prior appendectomy, those who underwent CT or MRI as the initial imaging modality, and cases where surgical intervention was performed without imaging. Ultrasound examinations were performed by experienced radiologists and radiology residents using high-frequency linear array probes (5–12 MHz).  Results A total of 350 patients with suspected acute appendicitis were included in the study. The average age of the patients in the study was 28.5 years, with a standard deviation of 12.4 years. Acute appendicitis is most common in individuals aged 10–30 years, and the mean age in this study aligns with the typical demographic for this condition. The study population had a male predominance, with a male-to-female ratio of 1.3:1. This means that for every 1.3 male patients, there was 1 female patient. Leukocytosis, or an elevated white blood cell (WBC) count, was observed in 85% of patients. Conclusion Ultrasound imaging is an effective diagnostic tool for acute appendicitis, with high specificity and moderate sensitivity. However, its performance is influenced by operator expertise and patient-related factors. Addressing these challenges through improved training and standardized protocols can enhance its diagnostic accuracy. In cases where ultrasound findings are inconclusive, additional imaging modalities should be considered to ensure accurate diagnosis and timely management

Introduction Menopause marks the cessation of ovarian function, leading to significant hormonal changes, including reduced levels of estrogen and progesterone. [1,2] These changes are closely associated with an increased risk of cardiovascular diseases (CVD), dyslipidemia, hypertension, and insulin resistance, which are key components of cardio-metabolic risk. [3] Material and Methods: This is a prospective and observational study was conducted in the Department of Physiology, Index Medical College from 2022 to 2024. The Study designed to obtain data on cardio metabolic risk profile and anaemia and their correlates in both pre- and post-menopausal Indian women comprising of subjects. Results: The mean age of the participants was 57.6 ± 6.8 years, with a range of 50 to 69 years. The average BMI was 27.8 ± 5.4 kg/m², indicating that a significant proportion of participants were overweight or obese. Waist Circumference: Mean (91.4 cm) suggests abdominal obesity for many participants. Blood Pressure: Mean systolic (136.2 mmHg) and diastolic (84.1 mmHg) values suggest prehypertension or early hypertension. Table 1 summarizes the baseline characteristics of the study population. Conclusion: In conclusion, this study highlights the critical interplay between antioxidant status, anemia, and cardio-metabolic risk factors in postmenopausal women. Enhancing antioxidant capacity through dietary and lifestyle interventions offers a promising strategy for reducing anemia prevalence and improving metabolic health in this vulnerable population. These findings pave the way for targeted public health strategies aimed at mitigating the dual burden of anemia and cardio-metabolic disorders in postmenopausal women.

Introduction: Diabetes mellitus (DM) is a metabolic endocrine condition with a higher blood glucose level. Another category of antidiabetic drugs include α-glucosidase inhibitors that inhibit α-glucosidase enzymes in the intestine by inhibiting the polysaccharide reabsorption. Recent drug therapy, DPP4 inhibitors class of drugs act by inhibiting the dipeptidyl peptidase-4 (DPP-4) enzyme which further prolong the glucagon-like peptide’ action which inhibits glucagon release and increases insulin secretion, thus decreasing glucose levels and SGLT2 class, that act by targeting proximal tubules of renal glomeruli to inhibit sodium-glucose cotransporter-2 present that leads to suppression of glucose reabsorption.  Material and Methods: This is a Prospective, randomized, Open-label was conducted among Type 2 DM patients attending the outpatient department of Medicine in Index Medical College and Hospital over a period of 2 years. Adiponectin was estimated by DRG Diagnostic adiponectin Enzyme linked immune sorbent assay (ELISA) Kit. (B-Bridge International Inc., San Jose, CA, USA) with range of assay between 83-104 pg/Ml. Leptin Level was estimated by ELISA. The sensitivity limit of total ghrelin was 0.1 ng/mL. Results  Mean age among Dapagliflozin group was 59.9 ± 9.5 years and Sitagliptin group 57.8 ± 8.8 years. Whereas, there were no significant differences between two groups. parameters among the two study groups.  In our study 78 were male and 32 were female among Dapagliflozin group and in Sitagliptin group was 76 was male and 34 were female. The change in serum adiponectin level from baseline to week 12 increased significantly only in the dapagliflozin group (P = 0.005). The mean ± SD change in Serum adiponectin at 12 weeks from baseline to 12 weeks were 0.79 ± 1.05 and 0.15 ± 0.06 in the dapagliflozin and sitagliptin groups, respectively. The change in serum Leptin level from baseline to week 12 increased significantly only in the dapagliflozin group (P = 0.005). The mean ± SD change in Serum adiponectin at 12 weeks from baseline to 12 weeks were 0.79 ± 1.05 and 0.15 ± 0.06 in the dapagliflozin and sitagliptin groups, respectively.  Conclusion Furthermore, dapagliflozin significantly reduced body weight and insulin AUC levels and improved serum adiponectin levels without inducing hypoglycemia. These results suggest that along with metformin and DPP-4 inhibitors, SGLT2 inhibitors could be a viable first-line treatment option for drug-naïve Japanese patients with type 2 diabetes because of their optimum glucose-lowering properties, ability to avoid hypoglycemia or weight gain, and tolerability over a wide range of ages.

Introduction: Subarachnoid block, although being highly efficient with lesser drug doses, often has limitation such as hypotension, continues to be a matter of concern to the anesthetist. The present study was aimed to compare the use of phenylephrine, ephedrine, and mephentermine bolus for maintenance of blood pressure during spinal anesthesia in lower abdominal surgeries. Materials and Methods:  The 40-female scheduled for elective caesarean section were randomly divided into two groups of 20 each. Subarachnoid block was performed with 2.2mL of 0.5% hyperbaric bupivacaine. Prophylactic infusion of vasopressor started at a rate of 60 ml/h 0f 50 mcg/min for phenylephrine (group P, n=20) and 600 mcg/min for mephentermine (Group M, n=20) Hemodynamic parameters were monitored. At the end of surgery and the patients were transferred to the postoperative care. Result A total of 50 patients were analyzed. Within 5 minutes of Spinal anaesthesia there was no significant difference between Group-P and Group-M on drop of average Systolic blood pressure, Diastolic blood pressure and average Heart rates at different minutes. But after administering the drug for hypotention correction Group P shows very high average SBP and DBP correction compared to Group M which is statistically significant (p<0.0001) and Group P shows a fall in the heart rate compared to Group M which is statistically significant nit (PACU) Conclusion: Mephentermine and ephedrine were similar in performance, offered a better hypotensive control, and had lower recurring events as compared to phenylephrine.