Background: Hypoxic-ischemic encephalopathy (HIE) remains a leading cause of neonatal mortality and neurodevelopmental impairment in low-resource settings. This study aimed to determine the incidence, risk factors, and outcomes of HIE in a tertiary care NICU in Jaipur, India. Methods: A retrospective analysis of 1,240 neonatal admissions (January 2022–December 2023) was conducted. HIE was diagnosed using Sarnat and Sarnat staging. Multivariate regression identified risk factors for mortality and acute kidney injury (AKI). Results: The incidence of HIE was 4.2% (52/1,240), with 55% (29/52) classified as moderate/severe. Maternal hypertension (34.6%) and prolonged labor (28.8%) were significant risk factors. Mortality rates were 7.8% during hospitalization and 12.3% post-discharge. AKI occurred in 38.5% of cases, correlating with HIE severity (p<0.001). Neurodevelopmental impairments were observed in 21.2% of survivors. Therapeutic hypothermia (TH) utilization was low (15.4%), with delayed initiation (>6 hours) in 62.5% of cases. Conclusion: Jaipur’s high HIE burden underscores the need for perinatal care strengthening, TH protocol standardization, and long-term neurodevelopmental follow-up programs.

Background:  Pediatric psoriasis is a chronic inflammatory skin disorder characterized by recurrent plaques and erythema. Topical corticosteroids are widely used as first-line agents; however, long-term use poses potential side effects, particularly in children. Calcineurin inhibitors have emerged as a steroid-sparing alternative. This study aims to compare the efficacy and safety of topical corticosteroids versus calcineurin inhibitors in the treatment of mild to moderate pediatric psoriasis. Materials and Methods: A randomized controlled trial was conducted over 12 weeks at a tertiary pediatric dermatology center. Sixty children aged 5–16 years diagnosed with mild to moderate plaque psoriasis were randomized into two groups (n=30 each). Group A received 0.05% betamethasone dipropionate ointment once daily, while Group B was treated with 0.1% tacrolimus ointment twice daily. Clinical assessment was performed using the Psoriasis Area and Severity Index (PASI) at baseline, week 6, and week 12. Adverse effects were monitored and recorded throughout the study. Results: At week 12, the mean PASI score reduction in Group A was 68.3% (from 10.2 ± 1.4 to 3.2 ± 0.8), while Group B showed a 63.5% reduction (from 9.8 ± 1.7 to 3.6 ± 0.9), with no statistically significant difference (p = 0.214). However, Group A reported a higher incidence of skin thinning (20%) compared to Group B (3.3%). Mild burning sensation was reported in 26.7% of Group B but was transient and resolved without intervention. Conclusion: Both topical corticosteroids and calcineurin inhibitors were effective in reducing psoriatic lesions in pediatric patients. Corticosteroids provided a slightly higher PASI reduction, while calcineurin inhibitors had a more favorable safety profile. Calcineurin inhibitors may serve as a suitable long-term management option in pediatric cases.

Introduction: Cognitive function refers to advanced brain activities, including the ability to adapt behavior, solve problems, retain information, and maintain focus. Both positive and negative cognitive effects has been observed with both conventional and newer antiepileptic drugs. Aim: To compare the incidence of cognitive impairment in epileptic patients who are taking conventional and newer antiepileptic drugs. Methods: A cross-sectional observational study was conducted for a period of 8 months in the departments of Neurology and Pharmacology and  Folstein Mini-Mental State Examination Scale (MMSE) was used to assess the cognitive function of the patient. Results: A total of 100 patients were selected and assessed. MMSE scores showed significant differences in mono-therapy versus poly-therapy (25.34±4.32 and 20.45±3.84, P<0.001) CAED+CAED poly-therapy versus other different poly-therapies (18.28±2.10, P<0.001) and duration of drug therapy whoever taken more than 10 years of AED (17.09±2.59, P<0.001). Patients who received poly-therapy with AEDs has significant affected by the orientation and language & visuo-spatial skills. Conclusion: Patients who were taking combination of conventional AEDs had significant cognitive impairment when compared to combination therepy with newer AEDs and combination with one conventional AED and one newer AED.

Background:  Breast lesions are either benign or malignant. Breast carcinomas are the most common cause of deaths in women accounting for 10.6% deaths in India, 6.9% deaths per year globally. Aims: To study various histopathological patterns of breast tumors. Materials and Methods: The present study was a prospective study of 120 cases undertaken at the department of pathology in our institute for duration of 8 months. Results: Fibroadenoma 50%(60/120), Adenosis 8.3%(10/120), Intraductal papilloma 6.6%(8/120), Benignphyllodes tumor 8.3%(10/120),Borderline  phyllodes tumor 8.3%(10/120), Invasive ductal Carcinoma7.5%(9/120), Invasive lobular Carcinoma1.6%(2/120), Ductal carcinoma in situ 4.1%(5/120), Mucinous adenocarcinoma2.5%(3/120), Papillary carcinoma 1.6%(2/120) and Medullary carcinoma(0.83%)(1/120) Conclusion: Study of histopathological patterns of breast lesions plays an important role in diagnosis, treatment, and prognosis of breast lesions.

Background: Vector-borne diseases such as dengue, malaria, and chikungunya continue to pose significant public health threats, particularly in tropical and subtropical regions. Haryana, an urbanizing state in North India, is frequently affected by these diseases, owing to rapid urban growth, climatic changes, and inadequate community awareness. Effective public health management requires understanding community awareness and preventive practices. Material and Methods: A cross-sectional study was conducted among 400 adults across selected urban and rural areas of Haryana using multistage stratified sampling. Data were collected through face-to-face interviews using a validated structured questionnaire assessing socio-demographic factors, knowledge about dengue, malaria, chikungunya, preventive behaviors, and information sources. Statistical analysis included descriptive statistics, chi-square tests, and logistic regression using SPSS version 25. Results: Out of 400 respondents, 78% correctly identified transmission modes, yet only 52% knew preventive measures, and 45% were aware of peak transmission seasons. Significant associations existed between adequate knowledge and urban residence (p=0.003) and higher education levels (p=0.001). Urban respondents (OR=2.12; 95% CI: 1.40–3.20) and individuals with higher education (OR=2.42; 95% CI: 1.54–3.80) were significantly more likely to adopt preventive measures. Mass media, particularly television and radio (72%), were the primary sources of information. Conclusion: Substantial knowledge gaps and inadequate preventive practices regarding vector-borne diseases exist, especially among rural and less educated populations in Haryana. Public health interventions should prioritize rural communities, leverage influential media platforms, and enhance educational initiatives to significantly reduce the impact of dengue, malaria, and chikungunya.

Background: The impaction of permanent canines is a significant dental anomaly with implications for aesthetics, occlusion, and function. Understanding its incidence and prevalence through radiographic studies aids in early diagnosis and effective treatment planning. Objective: To evaluate the incidence and prevalence of impacted permanent canines using retrospective radiographic data. Methods: A retrospective analysis of 2300 panoramic radiographs was performed. Data was collected from patients aged 12 to 50 years, examining the prevalence, distribution, and associated factors of impacted canines. Statistical analysis was conducted to determine age and gender associations. Results: The prevalence of impacted canines was 4.14%, with a higher incidence in females (62.9%) compared to males (37.1%). 20 years to 29 years was the age group in which maximum impactions (46.77%) were seen. Maxillary canines were more commonly impacted (85.5%) than mandibular canines (14.5%). Bilateral impactions were not observed in the present study. 64.52% impactions were seen on the left side and 35.48% were seen on the right side. Conclusion: Impacted canines exhibit a moderate prevalence, with a significant predilection for maxillary and female patients. Early detection through radiographic evaluation is crucial for optimal management.

Background: Bioresorbable materials have emerged as an effective alternative to metallic implants in orthopedic, maxillofacial, and dental fracture management. These materials provide temporary mechanical support and degrade over time, eliminating the need for secondary removal surgery. Objective: This study aims to compare the clinical outcomes, fracture healing time, and complications associated with different bioresorbable materials, including polylactic acid (PLA), polyglycolic acid (PGA), and polycaprolactone (PCL). Methods: A prospective study was conducted on 90 patients who underwent surgical fixation using bioresorbable implants. Patients were divided into three groups based on the material used. Healing time, postoperative complications, and pain scores were assessed over a 12-month follow-up. Statistical analysis was performed using ANOVA and chi-square tests. Results: PGA implants demonstrated the fastest healing time, particularly in orthopedic fractures (10.8 weeks, p=0.03). Inflammatory reactions were more frequent in the PCL group (15%), while infection rates remained low across all groups. Pain scores decreased significantly in all groups over time, with no significant differences at six months. Conclusion: Bioresorbable materials provide a viable alternative to metallic implants, with PGA showing superior healing outcomes. Material selection should be guided by fracture type and patient-specific factors.

Oligohydramnious is threatening condition to fetal health for which some treatments are available and some are under evaluation. Oligohydramnious is associated with increased pregnancy complication, congenital anomalies and perinatal mortality. Aim: The aim of study was to analyze the perinatal outcome in pregnant women with Oligohydramnious at term. Methods: Hundred antenatal women of gestational age ≥37 weeks diagnosed with oligohydramnios (AFI<5cms) with intact membranes were enrolled in this study. Detailed history like age, parity, and co morbid condition, General examination including haemoglobin level, nutritional status, BMI, blood pressure, MSAF, the mode of delivery, birth weight, Apgar score at 1- and 5-minutes parameters were recorded. Results: Majority of the oligohydramnios women (70%) were in 20-25 years age group. Most of them (65%) were multiparous and 45% had delivered at 39 weeks of gestation. Among clinical complaint 59% had reduced fetal movement, 25% had lower abdominal pain and 3% had bleeding PV. Majority of them (65%) had Spontaneous labour, 60% delivered by Normal Vaginal delivery, and 30% had meconium-stained liquor. Most of the neonates (81%) were birth weight less than 2kg, 12% had required NICU admission and 33% had APGAR score <7 at 1 min. AFI was 4 in 32% and 39% had abnormal CTG. Conclusions: An amniotic fluid index of <5 cm detected after 37 completed weeks of gestation is an indicator of poor perinatal outcome. Socio-economic class, Mode of delivery, Duration of hospital stay, Malpresentations, Neonatal LBW, NICU admission and duration of admission were significantly associated with the AFI in oligohydromnios women

Background: Chronic Kidney Disease is a global health problem. The reported prevalence of Chronic kidney diseasein different regions ranges from 1% to 13% and recentlydata from the International Society of Nephrology’s Kidney Disease Data Center Study reported a prevalence of 17%1. The etiology of Chronic kidney diseasevaries considerably throughout India. Parts of the states of Andhra Pradesh, Odishaand Goa have high levels of Chronic kidney diseaseof unknown etiology which is a chronic interstitial nephropathy with insidious onset and slow progression2. Methods: Sample size of 100 cases were taken including fulfilling the eligibility criteria. written informed consent was obtained from all participants.The data was entered and analysed systematically. Categorical variables were summarized as percentages and quantitative variables were summarised as mean with standard deviation (SD), or median with inter-quartile range (IQR) according to the distribution of variable. Results: In our study maximum 39% cases were seen in the Age group of 46- 60 years age followed by 29.00% in 61-80 yr age and 20% were in 31–45 yr whereas minimum 1.00% in >80 yr followed by 11% in 18 – 30 yr age group. The mean age of study population was 61.81 ± 13.45 yr with age range of 18 – 90 yr. Conclusion: Lipid abnormalities are common in CRF. Total cholesterol and Triglycerides show statistically significant increase in CRF cases. The LDL-C is increased in CRF patients. The HDL-C shows a statistically significant decrease in CRF patients.

Background: Phototherapy is a widely used treatment for physiological neonatal jaundice, effectively reducing bilirubin levels. However, it may impact calcium homeostasis, leading to hypocalcemia in some neonates. This study examines the effect of phototherapy on serum calcium levels, aiming to highlight potential risks and ensure safer management of neonatal jaundice. Methods: The study included term neonates (37 completed weeks to 41 weeks) with unconjugated hyperbilirubinemia requiring phototherapy. The infant was clinically examined under natural light, and the infant was then subjected to laboratory investigations, including Baseline Investigations (Before Phototherapy): serum total bilirubin, serum total calcium, serum ionized calcium, and LFT. Serum bilirubin and calcium levels were measured at the initiation, 24 hrs, 48 hrs, and at the end of phototherapy. Results: 100 cases of neonatal jaundice were included in the study, based on the inclusion and exclusion criteria. Of the 100 newborns in this study, 42% were male (42%) and 58% were female. The number of neonates with hypocalcemia (both mild and significant) appears to increase with longer durations of phototherapy. The highest number of neonates with hypocalcemia is seen in the 24-48 hours group. Significant hypocalcemia (< 7 mg/dl) is only observed in the 24-48 hours and > 48 hours groups. The p-value of 0.04 for the > 48-hour group suggests that the change in calcium levels within this group before and after phototherapy is statistically significant. Conclusion: This study found that there is a decrease in serum calcium levels after phototherapy. The important determinant factors were the duration of exposure and severity of hyperbilirubinemia. In this study, none of the babies developed symptoms of hypocalcemia, but the occurrence of symptoms is not always predictable regarding the decrease of serum calcium levels. Hence it is always advisable to monitor the serum calcium levels before and after phototherapy.

Background: Meibomitis-Related Keratoconjunctivitis (MRKC) is typically managed with a combination of antibacterial eye drops and low-dose steroids. Azithromycin hydrate and tetracycline ophthalmic solutions possess both antibacterial and anti-inflammatory properties. This study evaluates the effectiveness of azithromycin hydrate ophthalmic solution as a monotherapy for treating MRKC. Material and Methods: This retrospective study included 197 patients diagnosed with Meibomitis-Related Keratoconjunctivitis (MRKC) who attended the outpatient department of the ophthalmology department at a tertiary care hospital. Approval was obtained from the institutional ethics committee, and all participants provided informed consent. Eligible patients were randomly assigned into two groups using the chit method: Group A (98 patients) received azithromycin, while Group B (99 patients) were treated with tetracyclines. Data collected included patients' sociodemographic details, symptoms, MRKC subtypes, conjunctival hyperemia grade, bulbar conjunctivitis and the percentage of conjunctival vascular curvature. These parameters were recorded at baseline and monitored weekly for five weeks during treatment. Results: In this study, the majority of patients (136; 69.03%) presented with keratoconjunctivitis in both eyes, while 61 patients (30.97%) experienced it in a single eye. Mild vasodilation was the most frequently observed (113; 57.36%), followed by moderate (62; 31.47%), severe (13; 6.59%), and no vasodilation (9; 4.56%). Most patients (146; 74.11%) had the phlyctenular type, while 51 patients (25.88%) exhibited the non-phlyctenular type. Hyperemia was present in the majority of patients (181; 91.87%) and absent in 16 patients (8.12%). Among the 197 patients assessed, conjunctival hyperemia was noted in all (197; 100.00%). Other common symptoms included eye redness (138; 70.05%), watery eyes (129; 65.48%), blurry vision (114; 56.86%), itchy eyes (112; 56.85%), light sensitivity (95; 48.22%), palpebral conjunctiva swelling (75; 38.07%), eyelid margin swelling (71; 36.05%), granulomatous corneal nodules (48; 24.36%), and superficial vascularization (31; 15.73%). At the first visit, groups A and B included 91 and 90 patients, respectively. After one week of treatment (second visit), hyperemia was reduced to 83 patients (91.20%) in group A and 79 patients (87.77%) in group B. By the second week (third visit), reductions were observed in 65 patients (71.42%) in group A and 57 patients (63.33%) in group B. At the third week (fourth visit), 43 patients (47.25%) remained affected in group A and 34 patients (37.77%) in group B. By the fourth week (fifth visit), conjunctival hyperemia was further reduced to 19 patients (20.83%) in group A and 13 patients (14.44%) in group B. Conclusion: Azithromycin showed superior effectiveness in treating meibomitis related keratoconjunctivitis compared to tetracycline

Introduction: Postpartum depression can contribute to behavioral, emotional, cognitive and interpersonal problems in mother’s life. Postpartum depression which is left untreated may have long term adverse effects. AIM: To estimate the prevalence of postpartum depression by Hamilton depression rating scale and identify associated factors. METHODOLOGY: The study was designed as a hospital-based cross-sectional investigation, conducted at the Department of Obstetrics and Gynaecology, PBM Hospital in Bikaner, a tertiary care facility serving a significant portion of Rajasthan, India. RESULT: In our study, the prevalence of postpartum depression (PPD) was 12%, with significant differences in depression scores across age groups and associated factors. Higher depression scores were linked to bad obstetric history, lack of social support, and antenatal anxiety, while planned pregnancy and supportive relationships were protective factors. CONCLUSION: Postpartum depression significantly impacts mothers and families, with social factors like age and unplanned pregnancy being key correlates. Clinical implications stress the need for tailored antenatal and postnatal care, including domiciliary visits, to address psychosocial factors and prevent severe outcomes.

Background The IAC Yokohama system has established uniform terminology for five defined categories of breast FNAC with stratified associated risks of malignancy (ROM) and management recommendations. Objective: Our primary objective is to categorize the breast FNAC cases according to the Yokohama system and compare with radiological findings and with the gold standard, and to calculate the risk of malignancy (ROM) of each category. Methods The descriptive study was done for a 2-year period which included patients with breast lump who had undergone radiological evaluation from the surgery OPD for FNAC. The cytological findings were recorded and classified according to the IAC Yokohama system for reporting breast cytopathology. The cytology report was then compared with radiological findings and histopathology findings. Results The distribution of categories according to the IAC Yokohama system are the following: Insufficient 12 (14.5%), benign 41 (50%), atypical probably benign 8 (10%), suspicious of malignancy 2(2.5%) and malignant 19 (23%). Out of 82 patients, 55% specimens belong to the benign category. The risk of malignancy is 100% in the Suspicious and Malignant category. In our study, ROM is only 14.6% in the benign category. The category Atypical, probably benign has 37.5% risk of being malignant. There is more than 50% risk in the insufficient category. The sensitivity, specificity, Positive Predictive Value, and Negative Predictive Value of cytology are reported as 56.7%, 100%, 100% and 73.7% respectively. Conclusion Our study concluded that the IAC Yokohama system for reporting breast cytopathology is a simple system that allows greater diagnostic clarity, better communication between pathologists and treating clinicians, and also helps in predicting the ROM.

Background: Hypertension is a significant public health issue in India, contributing to high rates of cardiovascular disease. Despite its prevalence, there is limited literature on the awareness and management of hypertension in Odisha, particularly in rural areas. This study aims to assess the level of knowledge and practice of lifestyle modifications among hypertensive patients attending the outpatient department at SCB Medical College and Hospital, Odisha. Methods: A prospective cross-sectional study was conducted from February to April 2022, involving 250 hypertensive patients aged over 18 years. Data were collected through face-to-face interviews using a semi-structured questionnaire. Knowledge and adherence to lifestyle modifications, including exercise, dietary salt reduction, alcohol limitation, smoking cessation, weight management, and the DASH diet, were assessed. Statistical analysis was performed using R software, with significance set at p ≤ 0.05.  Results: Among the 250 patients, 230 were on pharmacological treatment, but only 80 managed to control their blood pressure adequately. Knowledge of lifestyle modifications was inadequate in 40% of the participants. Urban residents showed significantly higher awareness than their rural counterparts (p < 0.0001). Educational background had a significant effect on knowledge (p = 0.05), whereas gender did not (p = 0.81). Although 75 patients adhered to all recommended interventions, a gap between awareness and actual practice was evident. Conclusion: Awareness and practice of lifestyle interventions are essential for managing hypertension effectively. Enhancing educational resources and providing comprehensive counseling, particularly in rural areas, could bridge the gap between knowledge and practice, improving hypertension management outcomes in Odisha.

Background: Hypertension (HTN) is a global health concern and a major modifiable risk factor for cardiovascular and renal complications. Despite advancements in treatment, understanding prescription patterns and associated comorbidities remains essential for optimizing HTN management. Methodology: This prospective study was conducted at MKCG Medical College over six months, involving 280 hypertensive patients aged 18–60 years. Data on patient demographics, antihypertensive prescriptions, and comorbidities were collected using a structured case record form. Statistical analysis was performed using Microsoft Excel, and results were presented in percentages. Results: Monotherapy was prescribed in 71% of cases, with calcium channel blockers being the most common drug class. Dual therapy was utilized in 25% of patients, with ARB + CCB combinations being the most frequent. Multidrug therapy accounted for 4%. Dyslipidemia (38.2%), diabetes (33.9%), and chronic kidney disease (18.9%) were the most prevalent comorbidities. Discussion: The study highlights a preference for monotherapy in HTN management, consistent with patient profiles and clinical guidelines. The observed prevalence of comorbidities underscores the need for comprehensive care to address both HTN and associated conditions. Treatment approaches align with WHO and JNC guidelines, emphasizing the use of evidence-based therapies. Conclusion: This study underscores the importance of personalized treatment regimens and adherence to updated guidelines for managing hypertension effectively. The findings emphasize the need for integrated care strategies to address comorbidities, improve blood pressure control, and reduce the risk of HTN-related complications.

Introduction: Diverticulitis is a common complication of diverticular disease and can lead to formation of abscess or colocutaneous fistula. Here we present a rare case of sigmoid diverticulitis presenting as bladder wall abscess Case Report: 53 year old male presented with lower abdominal pain for 5 days with no constipation or loose stools. There was no history of Malena or pain while passing stools. He did not have any dysuria or hematuria. There was no fever, vomiting or abdominal distension. Contrast enhanced CT scan of the abdomen and pelvis was done for further evaluation and it showed a long segment sigmoid wall thickening with diverticula and surrounding fat stranding. It also showed a collection along the superior and posterior wall of urinary bladder measuring 5.5x5.7x6.3 cm. He underwent an exploratory laparotomy which showed a mass lesion anterior to the sigmoid and adherent to the posterior urinary bladder and surrounding ileum. He underwent sigmoid resection and anastomosis with partial cystectomy and augmentation. Conclusion: Sigmoid Diverticulitisis a very rare condition with poorly understood underlying etiology. Depending on its position relative to the urinary bladder wall, it can mimic other more common presentations. Follow-up investigations using cystoscopy and uroflow studies are useful to evaluate for findings associated with chronic urinary bladder outlet obstruction

Introduction: Tuberculosis (TB), caused by *Mycobacterium tuberculosis*, is a leading infectious disease. AIM: To study the estimation of serum magnesium level in newly diagnosed pulmonary tuberculosis and its correlation with the stage of pulmonary tuberculosis and compare with controls. Methodology: The study will be conducted on patients attending the Department of Pulmonary Medicine at Sardar Patel Medical College & PBM Hospital, Bikaner. It is designed as a hospital-based case-control prospective study. Result: Our study showed that the mean serum magnesium levels were significantly lower in patients with more severe pulmonary tuberculosis, with lower levels observed in cavitary lesions compared to non-cavitary lesions, consistent with findings from previous studies. Conclusion: The study found a significant inverse relationship between serum magnesium levels and the severity of pulmonary tuberculosis, suggesting that serum magnesium could be a useful indicator of disease severity and highlighting the potential benefit of magnesium supplementation in tuberculosis patients.

Introduction: Double J (DJ) ureteral stent is the most widely used indwelling stent for the management of patients with upper urinary tract obstruction symptoms. AIM: Forgotten double J stent Evaluation and management at a tertiary centre. Methodology: This retrospective study was conducted over a one-year period from August 2022 to August 2023, involving 25 patients with double-J (DJ) stents retained for more than six months without a clinical indication for prolonged stenting. Result: In our study, 25 patients with forgotten DJ stents underwent various procedures, including cystoscopic removal, PCNL, URSL, open pyelolithotomy, and nephrectomy, with outcomes ranging from successful stent removal to nephrectomy in cases of non-functioning kidneys or severe complications. Conclusion: The management of forgotten DJ stents requires timely intervention, a multidisciplinary approach, patient education, and innovative stent technologies to prevent complications and improve patient outcomes.

Background: Puberty menorrhagia represents a significant health concern affecting adolescent females globally. The relationship between body mass index (BMI) and menstrual disorders requires detailed investigation, particularly in developing countries. Objectives: To evaluate the impact of BMI on puberty menorrhagia among adolescents and investigate associated clinical factors in a tertiary care setting. Methods: A prospective cohort study was conducted among 192 adolescent women (aged 13-19 years) at ESIC Medical College & PGIMSR, Chennai. Participants were categorized based on BMI as normal (<25 kg/m²), overweight (25-29.9 kg/m²), and obese (≥30 kg/m²). Menstrual blood loss was assessed using Pictorial Blood Assessment Chart (PBAC) scores. Associated clinical features including anemia, PCOS, hypothyroidism, dysmenorrhea, and premenstrual syndrome were evaluated. Results: The mean age of participants was 16.9 ± 2.0 years. Heavy menstrual bleeding (PBAC >100) was significantly more prevalent in overweight (72.9%) and obese (71.1%) participants compared to those with normal BMI (53.5%) (χ² = 7.04, p = 0.030). Overweight and obese adolescents showed 2.34- and 2.14-times higher risk of heavy menstrual bleeding, respectively. Irregular menstrual cycles were most prevalent in obese participants (66.7%, p < 0.001). PCOS and hypothyroidism showed striking peaks in the overweight category (81.3% and 68.8% respectively, p < 0.001). Anemia demonstrated a progressive increase with rising BMI (38.4% to 60.0%, p = 0.054). Conclusion: Elevated BMI shows significant associations with increased menstrual blood loss and irregular menstrual patterns in adolescents. The clustering of metabolic and endocrine disorders, particularly in overweight adolescents, suggests the need for comprehensive screening and early intervention strategies.

Background Up to half of 48 million couples infertile worldwide, male infertility plays at least a partial role. Fine needle aspiration cytology (FNAC) can be considered the gold standard in the evaluation of male infertility.  Aims This study evaluated the value of percentage of cell counts and indices such as spermatic index (SI), sertoli cell index (SEI) and sperm-sertoli cell index (SPSEI); correlate the findings with the histopathological findings for accessing the accuracy of the cytological findings. Material & Methods The prospective crossectional study was conducted in 2019 in the SCB Medical College, Cuttack after institutional ethical clearance in 48 patients. Semen analysis results were either normal or oligospermic or azoospermic.  FNAC obtained without anesthesia were graded cytologicaly based on cell types, their proportions and cell indices. Testicular biopsy performed were graded as per predominant pattern and Johnsen scoring.   Statistical analysis was performed by using IBM-SPSS Software.  Results The study shows a mean age of infertility of 33.6 years and the mean duration of infertility of 6.33 years. Out of 48 cases, 38 cases were azoospermic; 26 cases correlated with HP diagnosis and 25 cases correlated with cytological diagnosis. Discordance between histology and cytology was observed in only one case. Cytological and histological findings when correlated showed a very high 97.9% agreement. The p-value of the study is 0.0325. Conclusions FNA is simple, quick, less expensive, less invasive technique, minimally traumatic with a smaller number of complications in comparison to biopsy. Multiple specimens can be taken safely without anaesthesia.

Aims: Euroscore II and STS Score are amongst the most used risk scoring systems to predict outcome of the patients undergoing cardiac surgeries. This study aims to compare both the scores.  Methodology: The current patient population consisted of 367 patients who underwent isolated coronary artery bypass grafting (CABG). Observed and predicted mortalities were compared for the Euroscore II and STS risk calculator. The area under the receiver operating characteristics curve (AUC) values were calculated for these models to compare predictive power.  Results: The mean patient age was 59.03+/- 9.73 years at the time of surgery, and 28% were female. For the entire cohort, actual hospital mortality was 3%. The mean predictive performance of the analyzed models for the entire cohort was fair. The area under the ROC curve 0.869 and 0.973 for Euroscore II and STS risk-score, respectively, could achieve statistical significance (P = <0.001 and P = <0.001 for Euroscore II and STS risk-score respectively). Conclusion: Both Euro Score II and STS score have good calibration power. Euro Score II overestimated mortality in high-risk group in the present cohort.

Introduction Tuberculosis is a disease of concern for the mankind since the time immemorial. Despite many significant developments in science the disease remained to be a challenge for the medical fraternity. It is one of the major causes of mortality and morbidity worldwide. It is now ranked as the second human killer amongst all infectious diseases globally. India shoulders the 1/5th of the globally TB burden, Certain aspects of the disease still remain as mystery, which yet to be unveiled. Migration of people, emergence of drug resistance and increase incidence of HIV infections worldwide are some of the important contributing factors for growing health threat of tuberculosis. Pulmonary tuberculosis affects the lung parenchyma and thereby causes many structural and functional changes in the lungs. Material & Methods: This is a prospective and observational study was conducted in the Department of Pulmonary Medicine, JJM Medical college, Davangere from April 2023 to March 2024. In the present study 131 established cases of pulmonary tuberculosis that were completed antitubercular treatment under dots centre or privately and attended op/admitted in ward of Medical College Hospital, were taken up along with 30 healthy individuals from Medical College & hospital with informed consent were grouped as controls. A detailed case history was taken with consent from all. All cases of treated pulmonary tuberculosis were included. Patients treated for Extrapulmonary tuberculosis (except pleural effusion) and Patients with other respiratory disorders like history of Asthma, COPD, Collagen diseases, Silicosis, Thoracic surgery were excluded. Results: The mean age of the study group was 41.44+/-16.889 The mean age of control was 41.80+/-15.07. The majority of the individuals tested (72.30%) are sputum positive, suggesting that a significant proportion of the sample has a sputum-positive condition. Sputum Negative Cases: A smaller proportion (27.69%) of the individuals tested are sputum negative, indicating no detectable pathogens or conditions associated with sputum positivity.CAT-1 Dominance: A majority (66.15%) of individuals fall under the CAT-1 treatment category. This may represent a first-line treatment approach or a standard protocol for initial cases. CAT-2 Representation: About one-third (33.84%) of the individuals are in CAT-2, possibly reflecting cases requiring a secondary treatment strategy or different management due to factors such as resistance, relapse, or treatment failure. Conclusion: This study revealed that more advanced lesions of tuberculosis will lead to long term morbidity of the patients because of pulmonary derangements. Delayed approach for treatment with incomplete treatment with anti-tubercular drugs lead to severe pulmonary derangements. So emphasis should be given for the proper management and follow up of cases according to RNTCP guidelines to prevent morbidity.

Introduction: Diverticulitis is a common complication of diverticular disease and can lead to formation of abscess or colocutaneous fistula. Here we present a rare case of sigmoid diverticulitis presenting as bladder wall abscess Case Report: 53 year old male presented with lower abdominal pain for 5 days with no constipation or loose stools. There was no history of Malena or pain while passing stools. He did not have any dysuria or hematuria. There was no fever, vomiting or abdominal distension. Contrast enhanced CT scan of the abdomen and pelvis was done for further evaluation and it showed a long segment sigmoid wall thickening with diverticula and surrounding fat stranding. It also showed a collection along the superior and posterior wall of urinary bladder measuring 5.5x5.7x6.3 cm. He underwent an exploratory laparotomy which showed a mass lesion anterior to the sigmoid and adherent to the posterior urinary bladder and surrounding ileum. He underwent sigmoid resection and anastomosis with partial cystectomy and augmentation Conclusion: Sigmoid Diverticulitis is a very rare condition with poorly understood underlying etiology. Depending on its position relative to the urinary bladder wall, it can mimic other more common presentations. Follow-up investigations using cystoscopy and uroflow studies are useful to evaluate for findings associated with chronic urinary bladder outlet obstruction.

Introduction: Despite public health interventions, TB continues to devastate TB-endemic regions such as India, which carries a substantial global TB burden. Aim: To compare the clinico-bacterio-radiological profiles and treatment outcomes of smokers and non-smokers with pulmonary tuberculosis. Methods: Prospective observational hospital-based study on 100 patients with pulmonary TB (smokers and non-smokers) department of Respiratory Medicine, S.P. Medical College, Bikaner. Results: Maximum patients (46%) were aged 41–60 years, with a mean age of 50.5 ± 10.5 years. 67% were male, Smokers showed more advanced sputum positivity compared to non-smokers (P<0.0001). 73% were cured, 24% completed treatment, and 3% defaulted. Conclusion: Addressing smoking as part of TB management is crucial to achieving global TB control goals.

Background: Cognitive development in children is influenced by various factors, including nutrition. Recent studies suggest that probiotics, DHA, Phosphatidylserine (PS) and essential oils can play significant roles in supporting brain health. This study explores the impact of HETAFU candy, a novel formulation containing these bioactive compounds, on cognitive abilities in children. Objective: To evaluate the effects of HETAFU candy on cognitive performance, including memory, attention, and problem-solving skills, in children aged 4-12 years. Methods: A four-month, double-blind, placebo-controlled study was conducted with 100 children receiving HETAFU candy. Cognitive abilities were assessed at baseline, two months, and four months using standardized neurocognitive tests. Data were analyzed for improvements across various cognitive domains. Results: The HETAFU candy group showed significant improvements in cognitive performance, including enhanced memory, attention, and problem-solving skills. Improvements were evident from the second month and were sustained through the fourth month. Gender-based analysis revealed no significant differences, indicating the formulation’s universal effectiveness across sexes. Conclusion: HETAFU candy demonstrated promising potential in enhancing cognitive abilities in children. The synergistic effects of probiotics, DHA, Phosphatidylserine (PS) and essential oils contributed to improvements in memory, attention, and problem-solving. This child-friendly intervention presents a novel, practical approach to supporting cognitive health, with broad applicability for diverse pediatric populations.

Introduction: Acne is unique to humans, who tend to view it as a rite of passage. It is stated that 90% of individuals, male and female, aged between puberty and 30 years’ experience some degree of acne. It is opined that in a lifetime, a person is more likely to have acne than any other disease. Acne vulgaris being a chronic disorder needs long term therapy. There is always a problem patient poor compliance due to slower response of treatment and side-effects. Still these topical and systemic therapies do not decrease the after-effects of acne i.e., post-acne pigmentation and scarring. So, there was a need for better options in the armamentarium of acne treatment to answer the above problem.  Material And Methods The study was single blind randomized open prospective comparative clinical trial. It was carried out in the Department of Dermatology, Tertiary Care Teaching Hospital, during the period of January 2023 to June 2024. A total of 180 patients of either sex were enrolled according to the inclusion criteria given below and were randomly assigned to the study groups. Group 1: this group includes 60 patients with grade-1 acne vulgaris i.e., comedones with few papules. Group 2:  includes patients with grade-2 acne vulgaris lesions i.e., papules, comedones with few pustules. Group 3: patients with grade-3 acne vulgaris lesions i.e., predominant inflammatory lesions like pustules, papules, few nodules, comedones were included in Group-3 of this study.  Results The percentage reduction/ improvement of lesions is relatively more in patients of group 1B with an overall percentage reduction of 90.5% of lesions when compared with 77.4% overall reduction of lesion in group 1A patients. It can be seen that the percentage reduction/ improvement of lesions is relatively more in patients of group 2B with an overall percentage reduction of 71.4% of lesions when compared with 45.4% overall reduction of lesion in group 2A patients. It can be seen that the percentage reduction/ improvement of lesions is relatively more in patients of group 3B with an overall percentage reduction of 88.2% of lesions when compared with 65.6% overall reduction of lesion in group 3A patients. Conclusion Conventional treatments cannot be ignored and they are important in addressing the main pathophysiological mechanisms. Physical modalities of treatment like chemical peeling can be considered as an important adjuvant, which resulted in a faster clinical response and patient satisfaction. It is affordable and with minimal downtime, and can be performed in any dermatologist’s office.

Objectives: This study compared and evaluated the clinicoradiological outcome of displaced supracondylar fractures of the humerus in children who underwent closed manipulative reduction and two percutaneous k-wire fixation configurations [crossed medial and lateral configuration (Group I) or Lateral double-crossed configuration (Group II)].  Materials and Methods: The study encompassed 40 patients aged 3 to 12 with closed extension type supracondylar fractures who were enrolled between June 2012 and May 2014. All patients were managed with closed reduction and percutaneous K-wire fixation. Twenty-one patients were in Group I, whereas 19 were in Group II. Functional assessment was performed at 6 months using modified Flynn's criteria and classified as excellent, good, fair, or poor. The Chi-square test was applied to assess a connection between pin configuration and chosen variables. SPSS 17.0 was used for the statistical evaluation.  Results: The findings showed that 72.5% of patients were male and 45% were between 6 and 8 years of age. There were 32 (80%), 6 (15%), and 2 (5%) individuals with posteromedial, posterolateral, and posterior displacements, respectively. Overall functional success was outstanding in 28 (70%) patients, good in 9 (22.5%), and fair in 3 (7.5%) patients, with outcomes similar between the two groups.  Conclusion: Regarding biomechanical stability, lateral K-wire fixation is equally stable as crossed K-wire fixation.

Background: The study compared the outcomes of onlay and sublay procedures for paraumbilical hernias. Methods: A recently established medical college hospital in a rural area served as the location of this retrospective study. From the medical records department, case files of patients who had surgery for PUH were located and gathered. This research was carried out from January 2023 to March 2024. For each group, 35 cases were chosen based on the inclusion and exclusion criteria. A data collection sheet was prepared and was filled with all the necessary information, including demographics, surgical and post-operative specifics, and follow-up data. The data was examined using IBM SPSS statistics version 22.0. The chi-squared test was used, and a p-value of less than 0.05 is considered significant. Results: 5.7% in the sublay group and 11.4% in the onlay group experienced surgical site infections. 8.6%in the onlay group and 5.7% in the sublay group experienced seroma formation. No recurrences were observed in either group during the follow-up period. The onlay group's operating time ranged from 40 to 70 minutes (SD 10 minutes), with an average of 45 minutes. It was 75 minutes in the sublay group, with a range of 50 to 90 minutes (SD 12 minutes). Conclusion: Since there is no strongly convincing data to support the endorsement of any one of these approach over another, the European expert committee on the recommendation for treatment choice for PUH, claims that no technique is demonstrably superior to the others.

Introduction: Penetrating facial injuries demand urgent intervention due to their life-threatening nature, often caused by objects like knives or glass, posing risks of fragmentation and foreign body entrapment. Decision-making for foreign body removal is complicated by factors like size and accessibility, proficient blood supply, proximity to vital structures necessitating a comprehensive, multidisciplinary approach. Immediate vital interventions are crucial, particularly in cases with substantial foreign bodies, emphasizing the prompt stabilization of airway and respiratory functions. Case series: We present three different cases of facial injuries with foreign bodies and how we successfully retrieve the objects from the vital areas with no complications. Conclusion: Every maxillofacial injury necessitates systematic management involving a thorough examination, detailed history, and appropriate investigations. Facial cut wounds should not be immediately addressed in primary care without prior thorough investigations. The practitioner must adhere to fundamental surgical principles when undertaking cut wound repairs.

Background: Neonatal hyperbilirubinemia occurring in perinatal period makes neonate more prone to hearing impairment. In 70% term & 80% preterm neonates during first week of life, jaundice is commonly found. Aim and Objective: To determine hearing impairment in children affected by pathological jaundice & correlate it with gender. Material and Methods: This study was conducted in Department of Physiology, Electrophysiology research laboratory, SGT Medical College, Hospital & Research Institute, SGT University, Faculty of Medical and Health Sciences, district Gurugram, Haryana. Children under 1 year of age referred from the pediatrics department after pre-evaluation by the ENT department of SGT Hospital to SGT Medical College’s Physiology department were selected for the study. Results: Out of 20 patients, 11 were male & 9 were female, 13 were neonates & 7 were in post-natal age group, 18 had abnormal results (90%), maximum abnormal being male children & neonates. Latency of waves I & III were significantly prolonged. Latency of wave V was highly significantly prolonged. There was highly significant prolongation of inter-peak latency I-V. Latency of wave II of right ear of patients were significantly correlated with gender difference. Conclusion: Pathological jaundice especially in neonatal age group is a risk factor for sensorineural hearing loss. Children screened by BERA at the earliest have high chances of early rehabilitation.

Background: Thyroidectomy is a commonly performed surgical procedure for thyroid disorders, including Multinodular goitres and thyroid malignancies. Advances in surgical techniques, such as the Single Lateral Incision Total Thyroidectomy (SLITT), is introduced to reduce surgical trauma while maintaining efficacy and safety. This study investigates the demographic, clinical, and intraoperative characteristics of 50 subjects undergoing SLITT, comparing outcomes with traditional thyroidectomy methods as reported in other studies. Aim and Objective: To evaluate the feasibility, safety, and clinical outcomes of SLITT in patients undergoing thyroidectomy and compare the findings with traditional and other minimally invasive thyroidectomy techniques documented in the literature. Methodology: A prospective pilot study was conducted on 50 patients undergoing SLITT. Data on demographics, clinical presentation, histopathology, surgical indications, intraoperative details, postoperative outcomes, and complication rates were collected and analyzed. Results: The study population had a mean age of 45 years, predominantly female (80%). The majority were married (88%), with postgraduate education as the most common level (30%). BMI distribution showed 54% with normal weight, 20% overweight, and 18% obese. The primary presentation was a neck mass without pressure symptoms (98%), with multinodular colloid goiter being the most frequent histopathological diagnosis (76%). SLITT involved a right lateral incision in 96% of cases, with a mean incision size of 3.52 cm and mean operation time of 15.74 minutes. Capsular invasion (6%) and extra-thyroidal involvement (2%) were rare. Blood loss was minimal, averaging 13.60 mL. Postoperatively, 88% of patients had a hospital stay of 2 days, with no complications reported. Pain management primarily involved NSAIDs, and 98% reported no pain immediately after surgery. Conclusion: The SLITT technique is a safe, effective, and minimally invasive thyroidectomy approach, offering quick recovery, minimal blood loss, low complications and cost effective. It effectively manages various thyroid conditions with excellent postoperative outcomes, including rapid pain relief, short hospital stays, and superior cosmetic results, with no visible scars and high patient satisfaction. Significance: This study adds to the growing body of evidence supporting minimally invasive thyroidectomy techniques like SLITT, emphasizing their potential to enhance patient recovery, reduce surgical trauma, and improve postoperative outcomes. Future studies with larger sample sizes and longer follow-up are recommended to validate these findings and explore the broader applicability of SLITT