Background: Bimaxillary proclination is prevalent in the South Indian population and is often treated with premolar extractions followed by anterior retraction. However, the vertical dental changes that accompany this treatment, especially using conventional anchorage, remain under-investigated. Aim: To evaluate dental vertical changes in molars and incisors during anterior retraction with conventional anchorage in a South Indian cohort. Methods: A prospective clinical study was conducted on 35 patients diagnosed with bimaxillary proclination. All patients underwent extraction of first premolars and anterior retraction using conventional anchorage without any anchorage reinforcements. Pre- and post-treatment lateral cephalograms were used to measure upper molar height, lower molar height, upper incisor height, and lower incisor height. Results: Upper molar height and upper incisor height showed a statistically significant increase following treatment. Though lower molar height showed a slight increase, and lower incisor height showed a slight decrease following treatment, the changes were not statistically significant. Conclusion: Conventional anchorage can provide effective vertical control during anterior retraction. Dental extrusion is minimal and can be managed successfully with appropriate biomechanics, even without skeletal anchorage systems.

Background: Erectile dysfunction (ED) is a common but often overlooked adverse effect of antihypertensive therapy, particularly among middle-aged and elderly men. Different classes of antihypertensive agents exhibit variable effects on sexual function, yet this relationship remains under-investigated in real-world settings. Objectives: To assess the prevalence and severity of erectile dysfunction among hypertensive males on antihypertensive medications and to determine the association between specific antihypertensive drug classes and ED. Methods: This observational cross-sectional study was conducted among 100 hypertensive men aged 40–70 years attending a tertiary care outpatient clinic. Data on demographics, comorbidities, and antihypertensive medication use were collected. Erectile function was assessed using the International Index of Erectile Function-5 (IIEF-5). Chi-square test and Pearson correlation were used for statistical analysis. Results: The mean age of participants was 58.4 ± 7.2 years. ED was reported in 62% of patients, with 21% presenting with mild ED, 26% with moderate ED, and 15% with severe ED. Moderate-to-severe ED was most prevalent among patients receiving beta-blockers (68%) and diuretics (60%). A statistically significant association was found between antihypertensive class and ED severity (χ² = 14.72, p = 0.023). Diabetes, age ≥60 years, and hypertension duration >10 years were also significantly associated with increased ED severity. Conclusions: Beta-blockers and diuretics are associated with a higher risk of erectile dysfunction in hypertensive men. Clinicians should consider sexual side effects when prescribing long-term antihypertensive therapy.

Background: Refractive errors are common among students, including medical students who are predisposed to these because of various factors. This cross-sectional study aims to assess the prevalence of refractive errors and identify potential determinants among medical students in Delhi. Methodology: This was a cross sectional study involving medical students from a medical institute situated in Delhi with a sample size of 430. Simple random sampling was used for selection of participants and they were enrolled after taking informed consent. All the participants who were using spectacles or contact lens and had their ophthalmological check-up record were considered to be suffering from refractive errors. For others, visual acuity examination was performed by using snellen’s chart. Results: The study found a high prevalence of refractive errors 268 (62.9%) among medical students, with myopia being the most dominant type (86.9% of 268). Significant associations were observed between refractive errors and factors such as age, gender, professional year of study, family history of refractive errors, and time spent reading printed material, by applying chi square test and considering a p value of 0.05 as significant. Conclusion: A large proportion of medical students were suffering from refractive errors, more so among older an senior students, females, with family history and no association was found with respect to consumption of vitamin A, screen time and eye exercises.

Background:  Radiotherapy remains a cornerstone in the management of carcinoma cervix, with patient positioning playing a crucial role in dosimetric outcomes. Proper positioning during radiotherapy can significantly influence the dose distribution to the target volumes and organs at risk (OARs), potentially impacting treatment efficacy and toxicity.  Aim:  To evaluate and compare the dosimetric parameters of supine and prone positions in carcinoma cervix patients undergoing intensity-modulated radiotherapy (IMRT) at a tertiary cancer center, with a focus on optimizing target volume coverage and minimizing radiation exposure to organs at risk. Methods and Materials:  This was a prospective study conducted at MNJ Institute of Oncology and Regional Cancer Centre, Hyderabad, over a period of 24 months. A total of 25 patients with carcinoma cervix were enrolled.  Patients included in the study were aged 30–65 years, with histopathologically confirmed stage IB-IIIB carcinoma cervix (FIGO guidelines), and a performance status of 1–3 as per Eastern Cooperative Oncology Group criteria. All patients had normal blood, liver, and kidney function tests. Patients with stage IA, IIIC, or IV disease, distant metastasis, poor performance status, synchronous malignancies, or HIV positivity were excluded. Radiotherapy planning involved CT simulation scans in both supine and prone positions using immobilization devices. Target volumes and OARs were delineated according to international guidelines, and dosimetric parameters were analyzed for both positions. Results:  The mean PTV volume was slightly higher in the prone position (1616.68 ± 172.85 cc) compared to the supine position (1561 ± 186.50 cc). Dose coverage was comparable, with PTV 95% being 95.896% in the prone position and 97.669% in the supine position. However, prone positioning provided better sparing of the small bowel, with lower dose-volume metrics across all thresholds (e.g., V50: prone 1.7%, supine 5.7%). The bladder dose metrics were similar, with V10 being 100% in both positions, but V45 was slightly lower in the prone position (43%) compared to the supine position (50%). For the rectum, prone positioning significantly reduced exposure at higher doses (e.g., V50: prone 4.5%, supine 7.4%). Conclusion:  The prone position demonstrated superior sparing of the small bowel and rectum while maintaining comparable dose coverage for target volumes and bladder. These findings suggest that prone positioning can enhance IMRT treatment efficacy and reduce toxicity in carcinoma cervix patients, offering a potentially improved therapeutic ratio.

Background: Subacromial impingement syndrome is the most common disorder for shoulder pain causing functional loss and disability due to repetitive overhead activities of daily living or sports. Treatment options can be conservative as first line, if it fails surgery is recommended. This can vary based on individual patient factors such as age, duration of symptoms. Arthroscopic Subacromial Decompression is the gold standard to treat this pathology.  Materials and Methods: A prospective study was done to study the functional outcome of Arthroscopic Subacromial Decompression using Constant and Murley score. Results :40 patients were included in this study, out of which 20 were operated and followed up for 1 year. All these patients were categorised by the age, type of acromion morphology, stages of impingement. Radiological outcomes were measured by comparing pre operative and post operative Acromio-Humeral Distance (AHD) in AP radiographs. Conclusion: Arthroscopic Subacromial Decompression in a properly selected patients and with good surgical technique is a beneficial procedure for shoulder impingement in terms of functional and radiological outcomes resulting in improvement of symptoms and early return to work.

Background: Rotator cuff tears are a prevalent condition among the elderly, causing significant pain and functional impairment. The optimal treatment—surgical or non-surgical—remains debated, particularly concerning patient outcomes in the elderly population. Methods: This retrospective cohort study compared the effectiveness of surgical and non-surgical treatments for rotator cuff tears in 120 elderly patients. Patients were divided into two groups based on the treatment received: surgical (n=60) and non-surgical (n=60). Outcomes measured included pain reduction using the Visual Analogue Scale (VAS), shoulder function using the Constant Score, re-tear rates, and recovery times. Results: The surgical group showed significantly greater improvement in pain reduction (VAS score decrease: 4.2 ± 1.4) compared to the non-surgical group (VAS score decrease: 2.6 ± 1.3, P=0.002). Improvement in shoulder function was also superior in the surgical group (Constant Score: 74.7 ± 13.5) versus the non-surgical group (Constant Score: 60.5 ± 19.8, P=0.001). Furthermore, the surgical group experienced lower re-tear rates (12% vs. 30%, P=0.010) and faster recovery times (11.8 ± 2.0 weeks vs. 18.6 ± 3.2 weeks, P=0.005). Conclusion: Surgical treatment for rotator cuff tears in elderly patients appears to provide superior pain relief, enhanced shoulder function, reduced re-tear rates, and quicker recovery compared to non-surgical management. These findings suggest that surgical intervention should be considered a viable option for elderly patients who are suitable candidates for the procedure.

Background: Diabetes mellitus represents a growing global public health crisis, particularly in rapidly urbanizing regions of developing countries like India. Haryana, a rapidly developing state in North India, faces rising diabetes prevalence compounded by low public awareness and suboptimal preventive behaviors, significantly impacting community health outcomes. Material and Methods: A descriptive cross-sectional study was conducted among 400 adults aged 18 years and above from selected urban and rural districts of Haryana. A multistage stratified sampling approach was utilized. Data were collected through structured face-to-face interviews using a validated questionnaire assessing socio-demographic factors, knowledge about diabetes mellitus, preventive practices, and information sources. Chi-square tests and logistic regression analyses were performed using SPSS (version 25) to identify associations and predictors of adequate knowledge and preventive behaviors. Results: Overall, 72% of respondents correctly identified common diabetes symptoms, while awareness about risk factors (65%), long-term complications (51%), importance of regular screening (50%), and lifestyle modifications (45%) was moderate to low. Significant knowledge gaps were associated with rural residence (p=0.001), lower educational attainment (p<0.001), older age (>45 years, p=0.005), and unemployment status (p=0.003). Preventive practices were notably inadequate, with only 45% reporting regular physical activity, 38% practicing regular blood sugar monitoring, and 34% undergoing routine health check-ups. Urban residence (p<0.001), higher education (p<0.001), and being employed or retired (p=0.008) significantly correlated with better preventive behaviors. Conclusion: This study underscores considerable gaps in diabetes knowledge and preventive practices among the adult population in Haryana, predominantly influenced by residence, education, and occupation. Targeted educational interventions, improved healthcare access in rural areas, and strategic utilization of healthcare professionals and mass media are urgently required to enhance public health literacy, facilitate healthier lifestyle behaviors, and reduce diabetes complications.

Tuberculosis (TB) has been a major cause of morbidity and mortality worldwide despite significant advancement in the diagnosis and treatment of the disease. Isolated involvement of spleen without any other organ involvement is rare in immunocompetent individuals and thus poses a diagnostic challenge. Isolated splenic tuberculosis may not present with characteristic symptoms and therefore diagnosis is often missed. Histopathological examination is the diagnostic modality of choice. Splenic TB patients respond well to standard ATT. Surgical intervention is indicated for medical therapy failure and complications. Splenic abscess even in immunocompetent individuals, should raise the suspicion of tuberculous etiology. The aim of this study is to present and share a review on the cases of isolated splenic tuberculosis published in the PubMed in last 10 year so as to gain understanding about the clinical presentation, diagnostic challenges and early treatment of isolated tuberculosis.

Background: Sarcoidosis is a chronic multisystem inflammatory disease in which characteristic non- caseating granuloma formation is seen. The lung is most frequently involved. However, extrapulmonary involvement is also seen.

Objectives: To study the clinicopathological spectrum of extrapulmonary sarcoidosis through a systematic review. Methods: A systematic search and review process was done for articles published in the PubMed database in the last 5 years. Results: Out of 42 cases, the average age was 46.31yrs (range: 4yrs- 78yrs) and the majority were males (57.1%).  Most cases were seen between 51- 60 years. The most common presenting complaints were one or the other constitutional symptoms seen in 30 cases. Multisystemic sarcoidosis was seen in 37 out of 42 cases. Simultaneous pulmonary involvement was seen in 18 cases. Out of 42 cases, the extrapulmonary site most frequently involved were nodal, hepatic and splenic seen in 18, 17 and 16 cases respectively. Other sites involved were cutaneous and subcutaneous tissue (10 cases), bone marrow, musculoskeletal system and ophthalmic (6 cases each), renal (5 cases), cardiac (4 cases), gastrointestinal tract (3 cases), nervous system and testis (2 cases each) and one case each of adrenal gland and pituitary gland involvement and hypercalcemia induced pancreatitis. Serum angiotensin converting enzyme (SACE) and calcium levels were increased in approximately 50% of cases. Radiological investigations were done in all 42 cases and histopathological examination was done in 41 cases. Conclusion: Extrapulmonary sarcoidosis has diverse clinicopathological manifestations due to atypical presentations and multisystemic involvement which makes its diagnosis challenging. Careful evaluation of clinical symptoms, serum biomarkers and other laboratory and radiological investigations and histopathological examination is necessary for its diagnosis.

Background: Gynaecological tumours in women found as the main cause of morbidity and mortality. Gynaecological tumours are of various type out of which endometrium and ovary are the most common. Aim and Objective: To study the different clinical symptoms of gynaecological tumours. Material and Methods: The present observational study was conducted in the Department of Radiation Oncology, Lady Hardinge Medical College and SSKM Hospital, New Delhi from January 2023 to January 2024 on 50 patients for a period of one year who were referred from the Obstetrics and Gynaecology department of the hospital. Results: Mean age of patients was 48.24±13.24 years. Majority of women had normal vaginal delivery i.e. 32(64%) followed by 18(36%) who underwent LSCS, 19(38%) women used different types of contraceptive methods available. Abdominal pain observed in 20(40%), post menopausal bleeding in 10(20%), amenorrhea in 2(4%) and abdominal distension in 3(6%). In majority of women endometrium tumour found to be the most common i.e. 25(50%) followed by Ovarian cancer i.e. 22(44%). In 9(18%) cervix tumour, vulvar tumour was in 1(2%), vaginal tumour in 2(4%) and fallopian tube tumour was in 1(2%) women found, In majority of women endometrium tumour found to be the most common i.e. 25(50%) followed by Ovarian cancer i.e. 22(44%). In 9(18%) cervix tumour, vulvar tumour was in 1(2%), vaginal tumour in 2(4%) and fallopian tube tumour was in 1(2%) women found. In women having cervix cancer, abdominal pain was in 2(4%), postmenopausal bleeding in 3(6%) and mass per abdomen in 1(2%) women observed. Postmenopausal bleeding (PMB) reported in 13(25%) women with endometrium cancer. Pain abdomen in women having ovarian cancer i.e. 6(12%), mass per abdomen 4(8%), abnormal bleeding per vagium in 2(4%). In women having vulvar, vagina and fallopian tube cancer present study found 1(2%), 2(4%) and 1(2%), women respectively. A total of 22(44%) patients were treated surgically and 28(56%) by radiotherapy. Conclusion: In the present study, endometrium cancer and ovarian cancer found to be the most common followed by cervical, vulvar, vaginal and fallopian tube. Our study showed that most of women attended the hospital at an advance stage of the disease. So, therefore, it is not possible for the attending physician to early detect and diagnose the disease to reduce morbidity and mortality. It is also seen that in developing countries maximum number of women with tumours presented at advance stage due to this timely screening, early diagnosis and treatment modalities is not effective to keep the fertility and decrease mortality. Present study recommends that educational as well as general population awareness programme particularly in women of developing countries like ours. Further, urgent need on healthcare programs is a necessary step to increase the screening methods of premalignant lesions in younger population at primary healthcare institutions particularly in rural areas as well as in urban plays a significant role to early detect the patients followed by treatment.

Background: Alcoholic and non alcoholic fatty liver disease has been associated with increased levels of various circulating inflammatory markers. The difference in the level of increased inflammatory markers between patients with AFLD and NAFLD is still unclear. Aim: The aim of the present study was to compare the inflammatory markers between patients with alcoholic-fatty liver disease (AFLD) and non-alcoholic fatty liver disease (NAFLD). Material and method: This comparative study included 100 individuals with fatty liver disease (50 NAFLD, 50 AFLD). Venous blood samples were taken from patients to assess inflammatory markers (TLC, neutrophils, lymphocyte, ESR, CRP, IL6, TNF α) and liver function test (Bilirubin, AST, ALT, GGT, total protein, albumin & globulin), and compared in AFLD and NAFLD groups. Results: The mean values of total bilirubin, direct bilirubin, indirect bilirubin and alkaline phosphatase were higher in AFLD as compared to NAFLD, but not significant (p>0.05). Liver enzymes AST and GGT were significantly higher in AFLD, whereas ALT, total protein, albumin and globulin were significantly higher in NAFLD (p<0.05). The mean values of TLC, ESR, CRP, IL-6 and TNF-α were statistically significantly higher in AFLD as compared to NAFLD patients. Conclusion: Alcoholic and non alcoholic fatty liver disease are associated with increased inflammatory markers, liver enzymes and proteins. Assessment of inflammatory markers plays a crucial role in the management of patients with fatty liver disease.

Background: In cancer patients, who often come with anatomical and pathological problems, difficult airway management is an essential aspect of anesthetic therapy. The purpose of this research is to evaluate the safety and effectiveness of video laryngoscopy (VL) and fiberoptic intubation (FOI) in treating patients with cancer who have difficult airways. Materials and methods: One hundred cancer patients with anticipated problematic airways participated in prospective randomized research. Two sets of patients were created: Group A received FOI, while Group B received VL. Intubation success rate, time to successful intubation, number of tries, and consequences such hemodynamic instability, hypoxia, and mucosal damage were all noted. For analysis, arbitrary values were used. With a significance threshold set at p < 0.05, statistical analysis was carried out using the chi-square test for categorical data and the t-test for continuous variables.  Results: The VL group had a shorter time to successful intubation (mean 45 ± 10 seconds) than the FOI group (mean 60 ± 15 seconds, p < 0.05). The VL group had a greater first-attempt intubation success rate (92%) than the FOI group (85%, p = 0.03). The groups' incidence of complications were similar; mucosal damage was seen in 8% of FOI patients and 6% of VL cases (p = 0.45). The VL group had somewhat better patient satisfaction levels (9.0 ± 0.5) than the FOI group (8.5 ± 0.7).  Conclusion: When it came to challenging airway management for cancer patients, video laryngoscopy outperformed fiberoptic intubation in terms of intubation time and first-attempt success rates. Given their comparable safety profiles, VL is a better choice for clinical settings. To validate these results in broader groups, further investigation is necessary.

Introduction: Measles is a highly contagious viral disease that spreads through aerosolized respiratory droplets or contact with nasal and throat secretions of infected individuals. Aim: To confirm the clinically suspected cases and genotyping of Measles virus. Methodology: The present study was a laboratory-based, descriptive observational study conducted at the WHO National Measles Laboratory, Department of Microbiology, SMS Medical College, Jaipur, Rajasthan, from January 2023 to December 2023.Result: The study highlights that younger age groups, especially 1-5 years (53%), are most susceptible to measles, with vaccination status showing a significant association with infection (X² = 70.34, p = 0.0001). Genotypic analysis revealed D8 as the exclusive circulating genotype, and Jodhpur reported the highest number of cases (26.4%). Conclusion: Our study shows the critical need for increased Measles vaccination coverage, particularly in rural areas, to achieve herd immunity and reduce disease burden, especially among young children.

Introduction: Rubella, also known as German Measles or Three-Day Measles, is a mild, self-limiting, vaccine-preventable infection that closely resembles measles in presentation, including fever and rash. Aim: To confirm the clinically suspected cases of Rubella virus. Methodology:      The present study was a laboratory-based descriptive observational study conducted at the WHO National Rubella Laboratory, Department of Microbiology, SMS Medical College, Jaipur, Rajasthan, from January 2023 to December 2023. Result: Our study highlights a significant association between rubella seropositivity and age (p=0.000), with all positive cases occurring in infants, while no significant association was found with gender or measles status. CONCLUSION: Strengthening vaccination coverage and surveillance is crucial to controlling and eliminating Measles and Rubella, especially in vulnerable infant populations

Background: Lung cancer is one of the commonest cancers and cause of cancer related deaths all over the world. Present study was aimed to study prognostic value of CT-emphysema score & concomitant pulmonary pathologies (like pleural effusion, atelectasis, lymphangitic spread, pulmonary metastases etc.) on overall survival in patients with advanced Non-Small Cell Lung Carcinoma treated with chemotherapy. Material and Methods:  Present study was single-center, retrospective study, conducted in 285 consecutive patients with advanced NSCLC (stages IIIB and IV) that received palliative chemotherapy. Results: In our study population,134 patients (47%) were having emphysema while other 151 patients (53%) were having normal lungs. 125 patients of study population were having collapse lung which were graded as mild, moderate and severe and rests were having normal lungs. Extensive lymphangitic spread was seen in 50 patients and rests (235) were having no lymphangitic spread. Pleural effusion with mild, moderate and severe grades was found in 46 patients while other 239 patients were having no pleural effusion. There is statistically significant association with p value <0.001 between emphysema score and overall survival. Lymphangitic spread is characteristic feature of adenocarcinoma though also seen in other histological types of carcinoma lung. In our study we only considered extensive lymphangitic spread. The association between this and OS is shown below. There is significant correlation between OS and lymphangitic spread. As the presence of diffuse lymphangitic spread leads to disease progression and reduced overall survival. Pleural effusion and extensive pulmonary metastases do not affect the overall survival and show no significant correlation with OS. Their correlation is as shown below with p-values of 0.9 and 0.5 respectively i.e.,>0.05. Conclusion:  A higher CT emphysema score, as determined using baseline CT scans, was found to be associated with poor prognosis in patients with advanced adenocarcinoma lung cancer.

Background: Computed tomography (CT) is a best method for the detection and quantification of emphysema. Present study was aimed to study CT emphysema score as a prognostic indicator in advanced non-small cell lung carcinoma treated with chemotherapy.    Material and Methods: Present study was single-center, retrospective study, conducted in 285 consecutive patients with advanced NSCLC (stages IIIB and IV) that received palliative chemotherapy. Emphysema severity was assessed by subspecialty-trained chest radiologist according to the Goddard scoring system using CT images acquired at time of diagnosis. Results: CT emphysema scores were analyzed for the 285 lung cancer patients treated at our hospital. The majority of patients were male (males =159, 55%, females=126, 45%) and the mean age was 54 years. Histopathology of all the patients was adenocarcinoma. Majority of the patients (96.9%) had stage IV cancer while remaining were stage III. 134 patients (47%) were having emphysema while other 151 patients (53%) were having normal lungs. Total emphysema score of 0 or 1 was considered as no emphysema, since 95% of nonsmokers in previous studies had lungs with <5% emphysematous involvement. The mean overall survival was 20.97 months with no statistical difference between male and female. The mean OS in emphysematous patients were 12.3 months and in non- emphysematous patients were 28.8 months. Difference in OS was found to be statistically significant in patients with respect to their age, smoking status, CT emphysema score, functional lung capacity, collapse grade, volume grade, lymphangitic spread and comorbidity score on the univariate analysis (p value 0.010, <0.001, 0.007, <0.001, <0.001 and <0.001 respectively). There is statistical significant association with p value <0.001 between emphysema score and overall survival. Conclusion: A higher CT emphysema score, as determined using baseline CT scans, was found to be associated with poor prognosis in patients with advanced adenocarcinoma lung cancer.

Background Soft tissue grafting plays a crucial role in enhancing peri-implant esthetics and stability by improving tissue volume and contour. Various grafting techniques, such as subepithelial connective tissue grafts (SCTG), free gingival grafts (FGG), and acellular dermal matrix (ADM), have been employed to optimize outcomes. However, the comparative effectiveness of these techniques in achieving long-term peri-implant soft tissue stability remains a topic of investigation. Materials and Methods This randomized clinical study included 60 patients undergoing implant placement in the anterior maxilla. The patients were divided into three groups: Group A (SCTG, n=20), Group B (FGG, n=20), and Group C (ADM, n=20). Clinical parameters, including peri-implant mucosal thickness (PMT), keratinized tissue width (KTW), and pink esthetic score (PES), were recorded at baseline, 3 months, and 6 months postoperatively. Digital photographs and standardized radiographs were used to assess esthetic outcomes. Results At 6 months, Group A exhibited a significant increase in PMT (mean: 2.5 ± 0.4 mm) and PES (mean: 11.2 ± 1.5) compared to Group B (PMT: 2.1 ± 0.3 mm, PES: 9.8 ± 1.3) and Group C (PMT: 2.0 ± 0.5 mm, PES: 9.2 ± 1.4) (p < 0.05). KTW was significantly higher in Group B (5.1 ± 0.6 mm) than in Group A (4.3 ± 0.5 mm) and Group C (3.8 ± 0.7 mm). ADM showed acceptable outcomes but demonstrated more variability in esthetic results. Conclusion SCTG proved to be the most effective technique in improving peri-implant esthetics and soft tissue stability, followed by FGG and ADM. While all techniques enhanced peri-implant soft tissue characteristics, SCTG offered superior mucosal thickness and esthetic integration. Further long-term studies are needed to confirm these findings.

Background The longevity and clinical performance of implant-supported crowns are crucial for ensuring long-term success in dental restorations. Monolithic zirconia (MZ) and porcelain-fused-to-metal (PFM) crowns are two commonly used materials with distinct mechanical and aesthetic properties. This study aims to evaluate and compare the long-term clinical performance of MZ and PFM implant crowns in terms of survival rate, mechanical complications, and patient satisfaction. Materials and Methods A total of 100 patients requiring single implant-supported crowns were included in this prospective clinical study. Participants were randomly assigned to receive either MZ (n = 50) or PFM (n = 50) crowns. Clinical and radiographic assessments were performed at baseline, 6 months, 1 year, and 5 years post-placement. Parameters evaluated included crown survival rate, marginal adaptation, mechanical complications (chipping, fracture, or wear), peri-implant tissue health, and patient-reported satisfaction using a visual analog scale (VAS). Statistical analysis was conducted using a chi-square test for categorical variables and a t-test for continuous variables, with a significance level of p < 0.05. Results At the end of the 5-year follow-up, the survival rate of MZ crowns was 98% compared to 92% for PFM crowns (p = 0.04). Mechanical complications were observed in 4% of MZ crowns and 18% of PFM crowns, with porcelain chipping being the most common issue in the latter group. Marginal adaptation and peri-implant tissue health showed no significant differences between the groups. Patient satisfaction scores were higher for MZ crowns (VAS score: 9.2 ± 0.6) compared to PFM crowns (VAS score: 8.1 ± 0.9, p = 0.02). Conclusion Monolithic zirconia implant crowns demonstrated superior long-term survival rates, fewer mechanical complications, and higher patient satisfaction compared to PFM crowns. Given their durability and aesthetics, MZ crowns may be a more reliable choice for implant-supported restorations, although individual case considerations remain important.

Background The accuracy of impressions is critical for the success of implant-supported prostheses. Digital and conventional impression techniques are widely used in clinical practice, yet their comparative influence on prosthetic fit remains a topic of discussion. This study aims to evaluate and compare the accuracy of digital versus conventional impressions in implant-supported prostheses. Materials and Methods A total of 40 patients requiring implant-supported prostheses were selected and divided into two equal groups (n=20). Group A received digital impressions using an intraoral scanner, while Group B underwent conventional impressions with polyvinyl siloxane material. The definitive casts were analyzed for marginal discrepancy, internal fit, and occlusal accuracy using a coordinate measuring machine (CMM). Statistical analysis was conducted using an independent t-test with significance set at p<0.05. Results The mean marginal discrepancy in the digital group was 35.2 ± 4.6 µm, while in the conventional group, it was 48.5 ± 5.2 µm (p=0.003). The internal fit accuracy was 42.3 ± 3.8 µm for digital impressions and 55.7 ± 4.1 µm for conventional impressions (p=0.001). Occlusal accuracy was also superior in the digital group (23.4 ± 2.5 µm) compared to the conventional group (37.6 ± 3.2 µm, p=0.002). Conclusion Digital impressions demonstrated significantly better accuracy in terms of marginal adaptation, internal fit, and occlusal precision compared to conventional impressions. These findings suggest that digital impression techniques may offer superior outcomes for implant-supported prostheses, potentially improving long-term clinical success.

Background: Apical periodontitis (AP) is a chronic inflammatory condition affecting the periapical tissues, often resulting from untreated dental caries or failed endodontic treatment. Type 2 diabetes mellitus (T2DM) is associated with impaired immune response, delayed wound healing, and increased susceptibility to infections. Poor glycemic control, reflected in elevated glycated hemoglobin (HbA1c) levels, has been linked to a higher prevalence and severity of AP. This study aims to assess the correlation between HbA1c levels and AP prevalence in T2DM patients. Materials and Methods: A hospital-based cross-sectional study was conducted on 150 T2DM patients aged ≥18 years. Participants were categorized into three groups based on HbA1c levels: well-controlled (<7%), moderately controlled (7–9%), and poorly controlled (>9%). All patients underwent clinical and radiographic examinations to assess the presence and severity of AP using the periapical index (PAI). Statistical analysis was performed using the chi-square test for categorical variables and one-way ANOVA for mean PAI scores. Logistic regression analysis was used to determine independent predictors of AP.Results: The prevalence of AP increased with worsening glycemic control (p < 0.001). AP was present in 26.7% of well-controlled diabetics, 53.3% of moderately controlled diabetics, and 84.4% of poorly controlled diabetics. The mean PAI scores were significantly higher in patients with HbA1c >9% (4.1 ± 0.9) compared to those with HbA1c <7% (1.8 ± 0.5) (p < 0.001). Logistic regression analysis identified HbA1c >9% (OR = 3.98, p < 0.001), duration of diabetes >10 years (OR = 2.54, p = 0.002), and smoking (OR = 2.12, p = 0.017) as significant predictors of AP.Conclusion: Poor glycemic control is significantly associated with an increased prevalence and severity of AP in T2DM patients. Hyperglycemia-induced immune dysfunction and increased inflammatory response contribute to the progression of AP and poor endodontic treatment outcomes. Routine HbA1c screening and optimized glycemic control should be considered essential components of dental care in diabetic patients to improve endodontic prognosis.

Background: Gastro esophageal reflux disease (GERD) is a prevalent chronic condition that can lead to extra-esophageal manifestations, including dental erosion. The acidic refluxate in GERD patients exposes the oral cavity to gastric acids, potentially leading to the progressive loss of dental enamel. This study aims to evaluate the prevalence and severity of dental erosion in patients with GERD and to examine the correlation between GERD severity, salivary pH, and dental erosion. Materials and Methods: The study included 81 adult GERD patients diagnosed based on clinical history, endoscopic findings, and/or pH monitoring. A structured questionnaire was used to collect data on GERD symptoms, medication use, lifestyle factors, and oral hygiene habits. Dental erosion was assessed using the Basic Erosive Wear Examination (BEWE) index. Salivary pH, buffering capacity, and salivary flow rate were analyzed. Endoscopic and pH monitoring data were also correlated with dental erosion scores. Results: The study found that 32.1% of patients exhibited mild dental erosion, 44.4% moderate erosion, and 23.5% severe erosion. A statistically significant correlation was observed between GERD severity and the extent of dental erosion (p < 0.001). Patients with severe GERD exhibited higher BEWE scores. Additionally, patients with highly acidic salivary pH (<5.5) had the most severe dental erosion, with a mean BEWE score of 3.5 (p < 0.05). Conclusion: The study demonstrates a significant relationship between GERD severity and dental erosion, highlighting the need for early identification and management of this complication. A multidisciplinary approach involving gastroenterologists and dentists is essential for effective prevention and treatment of GERD-related dental erosion. Further research is needed to explore long-term outcomes and optimal preventive strategies.

Background: Effective management of postoperative pain is crucial for enhanced recovery after abdominal surgeries. This study compares the analgesic efficacy of right-sided continuous transversus abdominis plane (TAP) block with continuous thoracic epidural anesthesia in patients undergoing right-sided upper gastrointestinal surgeries. By evaluating postoperative pain relief over 72 hours, the research aims to determine if the TAP block, with its favorable safety profile and minimal invasiveness, can be an effective alternative to thoracic epidural anesthesia. Materials and Methods: This prospective, randomized, single-center study was conducted at the Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar, India, following approval from the Institutional Research Ethics Committee. Adults aged 18-75 years, classified as ASA I or II and scheduled for right-sided upper gastrointestinal surgeries were included. Patients were randomized to receive either epidural analgesia (Group E) or bilateral subcostal TAP catheter analgesia (Group T) for postoperative pain management. Standardized perioperative management was provided, with pain assessed using the visual analog scale (VAS) and other outcome measures collected over 72 hours postoperatively. Statistical analysis was performed to determine significant differences. Results: Out of the initial 62 patients, we randomized 30 patients to the epidural group (Group E) and 30 to the TAP catheter group (Group T). The epidural group demonstrated significantly better pain control at rest at 24 and 48 hours and during coughing at all time points. Paracetamol and tramadol consumption were significantly lower in the epidural group compared to the TAP catheter group, suggesting superior pain relief with epidural analgesia. However, nearly half of the TAP catheters required re-siting. Overall, epidural analgesia provided superior postoperative pain relief compared to the TAP catheter technique. Conclusion: Epidural analgesia offered superior postoperative pain control, particularly at 24 and 48 hours, and reduced the need for supplemental analgesics. In contrast, while the TAP catheter technique provided prolonged analgesia, it required re-siting in nearly half of the cases, revealing some limitations. Despite this, TAP blocks remain a viable alternative, particularly for patients for whom epidural analgesia is contraindicated or for surgeries with incisions limited to the T10 dermatome.

Introduction: Bronchial asthma is a chronic inflammatory disorder of the airways with eosinophilic asthma as a significant subtype. Eosinophilic inflammation contributes to airway remodeling, bronchial hyperresponsiveness, and disease exacerbation. Identifying eosinophilic asthma is crucial for personalized treatment, particularly in selecting inhaled corticosteroids (ICS) and biologic therapies targeting interleukin (IL)-5. This study aimed to evaluate the correlation between blood eosinophil counts and sputum eosinophil percentages and their significance in assessing asthma severity. Material and Methods: A cross-sectional study was conducted to analyze the relationship between blood and sputum eosinophils in asthma patients. Spirometry data, including FEV₁ % Predicted, FVC % Predicted, and FEV₁/FVC Ratio, were assessed. Statistical analyses included Spearman’s correlation and t-tests. Results: A strong positive correlation (r = 0.88, p < 0.0001) was observed between blood and sputum eosinophils, suggesting that blood eosinophil count is a reliable surrogate marker for airway eosinophilia. The proportion of patients with sputum eosinophilia (≥2%) was 86.7%. No statistically significant differences were found in FEV₁ % Predicted (p = 0.202), FVC % Predicted (p = 0.528), or FEV₁/FVC Ratio (p = 0.206) between eosinophilic and non-eosinophilic asthma groups. Conclusions: This study establishes a strong correlation between blood eosinophil counts and sputum eosinophilia, indicating that blood eosinophils can serve as a reliable biomarker for airway inflammation in asthma. However, lung function parameters did not significantly differ between eosinophilic and non-eosinophilic asthma groups. These findings support the integration of blood eosinophil counts into routine asthma management protocols, particularly in guiding corticosteroid and biologic therapy decisions.

Background: Proximal tibial fractures, which account for 1.2% of all fractures, are a significant concern due to their impact on knee joint movement, stability, and alignment. These fractures, particularly those classified as Schatzker's type IV, V, and VI, are often the result of high-energy trauma and are associated with complications such as soft tissue damage and ligament instability. The optimal treatment approach remains a subject of debate, with open reduction and internal fixation being a common method to restore joint function. Methodology: This ambispective observational study was conducted at the Department of Orthopaedics, Sri Aurobindo Medical College and PG Institute, Indore, from August 2021 to February 2024. The study included 30 patients aged 18 years and above who underwent columnar fixation for proximal tibia fractures classified under the Three Column Fracture classification. Patients with neurovascular injuries, associated ipsilateral limb fractures, previous deformities, or those unwilling to consent were excluded. Functional outcomes were assessed using the New Oxford Knee Score (OKS) at 6 weeks, 3 months, and 6 months postoperatively. Results: The study population comprised 73.3% males and 26.7% females, with a mean age of 46.17 years. Most fractures were closed (76.7%) and involved two columns (50.0%). A significant improvement in knee function was observed over time, with mean OKS values increasing from 30.83 at 6 weeks to 41.67 at 6 months. Complications were minimal, occurring in only 20% of the patients, with no significant association between complications and gender or age. Conclusion: Columnar fixation for proximal tibia fractures demonstrates significant functional improvement within the first 6 months post-surgery and is associated with a relatively low complication rate. This technique is effective across various age groups and genders, making it a reliable option for managing complex tibial plateau fractures.

Abdominal closure techniques are pivotal in surgical practice, with the single-layer closure method gaining prominence due to its simplicity and potential for reduced complications. This study presents a comprehensive analysis of 100 cases employing the modified single-layer abdominal closure technique, aiming to evaluate its efficacy and safety profile. The modified single-layer closure involved a continuous non-absorbable suture placed through the linea alba, with the skin closed separately. Additionally, the single-layer method demonstrated a shorter operative time and reduced hospital stay. During this study we noted, 4 cases of burst abdomen during the postoperative period and 8 cases of incisional hernia over the course of 1 year. These findings suggest that the modified single-layer abdominal closure technique is a viable and effective alternative to traditional layered closure methods, offering benefits such as reduced complication rates and improved patient recovery. Further prospective studies are warranted to validate these results and establish standardized protocols for its implementation

Background: Proximal humerus fractures (PHFs) account for 4-5% of all fractures and are a common injury, particularly in the elderly population. Various surgical techniques have been employed for their management, with the Proximal Humeral Internal Locking System (PHILOS) plating being a widely used option due to its angular stability and effectiveness in osteoporotic bone. However, complications such as malunion, subacromial impingement, and insufficient reduction remain concerns. This study evaluates the clinical and radiological outcomes of PHILOS plating in displaced PHFs. Method: A prospective study was conducted on 30 patients with displaced PHFs treated with PHILOS plating at Sri Aurobindo Institute of Medical Science. Patients aged >18 years with closed Neer’s 2-part, 3-part, and 4-part fractures were included. Exclusion criteria comprised polytrauma, head injuries, vascular damage, and severe soft tissue injuries. The surgical approach was standardized using the deltopectoral method. Postoperative rehabilitation included progressive range-of-motion exercises. Patients were followed at 6, 12, and 24 weeks, and outcomes were assessed using the Constant Shoulder Score. Results: The study included 30 patients (20 males, 10 females) with a mean age of 47 ± 16 years. The majority (53.1%) had 2-part fractures. The mean radiological union time was 13 weeks. Functional outcomes were excellent in 50% of patients, good in 21.9%, fair in 12.5%, and poor in 15.6%. Complications were observed in 7 patients (21.8%), including insufficient reduction (13.4%), subacromial impingement (6.6%), varus malunion (3.2%), and frozen shoulder (3.2%). No cases of nerve injury, implant failure, or non-union were recorded. Conclusion: PHILOS plating provides stable fixation and satisfactory functional outcomes for PHFs, particularly in osteoporotic fractures. However, complications such as insufficient reduction, varus malalignment, and subacromial impingement may still occur. Proper preoperative planning, surgical expertise, and postoperative rehabilitation are critical to optimizing results.

Introduction: The advancement of laparoscopic surgery has enhanced surgical precision, particularly with the emergence of alternative imaging modalities. This study compares Yellow Enhancement (YE) Imaging with traditional White Light Imaging (WLI) for improving intraoperative visualization during laparoscopic cholecystectomy and inguinal hernia repair. Methodology: A hospital-based cross-sectional study was conducted at Vishesh Jupiter Hospital, Indore over 18 months, involving 100 patients undergoing laparoscopic procedures of cholecystectomy and inguinal hernia repair. Visualization clarity of anatomical structures and surgeon-reported outcomes were evaluated using a Likert scale, with statistical analysis performed via independent t-tests. Results: YE demonstrated significantly superior visualization compared to WLI for critical parameters: clarity of vascular structures (YE: 4.8±0.03 vs. WLI: 3.2±0.5, p<0.001), fat differentiation (YE: 4.7±0.04 vs. WLI: 2.9±0.6, p<0.001), and identification of avascular planes (YE: 4.9±0.02 vs. WLI: 3.1±0.5, p<0.001). Surgeon satisfaction and procedural efficiency were markedly higher with YE (p<0.001). Conclusion: YE provides superior intraoperative visualization, improving tissue differentiation, procedural speed, and safety compared to WLI. This enhanced imaging technology holds significant promise for refining outcomes in Minimally Invasive Surgery (MIS).

Chronic cervical lymphadenopathy (CCL) is a prevalent clinical concern, often posing diagnostic challenges due to its diverse etiologies. This study retrospectively examines 100 cases of CCL to delineate their clinical presentations, diagnostic approaches, and underlying causes. Most common etiological factor was tubercular lymphadenitis, which affects younger age group, confirm by histopathological examination and management is Anti-tubercular treatment. These findings underscore the importance of a thorough clinical evaluation and the utility of FNAC in the diagnostic workup of CCL, particularly in regions with a high prevalence of TB. Early and accurate diagnosis is crucial for effective management and improved patient outcomes.

Introduction: Ureteric Pelvic Junction Obstruction (UPJO) is defined as an obstruction to the flow of urine from the renal pelvis to the proximal ureter. It causes flank pain, hematuria, UTI, and also renal function impairment. UPJO can result from intrinsic factors (like congenital abnormalities) or extrinsic factors (such as crossing vessels). The literature highlights a prevalence of intrinsic causes, especially in antenatally diagnosed cases.Studies consistently report a higher incidence of UPJO in males, typically unilateral, with a common left-sided predominance. The age at diagnosis and surgical intervention varies, influencing outcomes. Prenatal ultrasound is crucial for early detection of hydronephrosis. The Anderson Hynes Open pyeloplasty, a dismembered pyeloplasty remains the gold standard for treatment, with overall positive outcome. Materials & Methods - A hospital based prospective observational study was done over a period of 1 year and 6 months from February 2023 to July 2024 at Pediatric Surgery Department, Institute of Post Graduate Medical Education & Research (IPGMER), Kolkata, West Bengal, India. All children above the age of 1 month and younger than 12 years who presented to our department with unilateral pelviureteric junction obstruction and required Anderson-Hynes dismembered pyeloplasty were included in the study.40 patients with unilateral pelviureteric junction obstruction were included in this study. 26(65%) were male and 14(35%) were female. Follow-up examinations included serial ultrasound and diuretic renography for the assessment of both the morphological and functional outcomes at 6 months and 1 year post-operatively. Success was defined as both symptomatic relief and radiographic resolution of obstruction.  Six months post-operatively the patients were evaluated with an ultrasound of the kidneys to look for changes in AP diameter and cortical thickness and a diuretic renogram to look for the improvement in drainage and function. Same tests were repeated after 1 year.  Results & analysis: Pre-op DRF and Post-op DRF: Preop DRF vs. Post OP DRF six months (0.868): Very strong positive correlation, suggesting that preoperative differential renal function is strongly associated with postoperative DRF at six months. Global GFR: Preop Global GFR vs. Post OP APD 6 months (0.435): Moderate positive correlation, indicating a moderate association between preoperative global GFR and postoperative APD. Conclusion: In our study, at the end of 1 year, improvement in renal function occurred in 16 (40%) patients, the GFR remained static in 22 (55%) of patients and GFR deteriorated in2(5 %) of patients. Age at surgery, side of affection or clinical features showed no statistically significant correlation with the functional outcome after surgery. Majority of patients had small improvement in DRF over 1 year period. There was a positive trend in GFR improvement over 1 year period. These findings can be used to counsel parents regarding the potential effects of UPJO and Pyeloplasty.

Caries risk assessment (CRA) is an essential component of contemporary dentistry that allows for the prediction and prevention of dental caries based on individual risk factors. There are numerous CRA tools and systems designed to assess the level of caries risk, including the Caries Management by Risk Assessment (CAMBRA), Cariogram, and the American Academy of Pediatric Dentistry's Caries Risk Assessment Tool (CAT). This review discusses the current level of evidence regarding these CRA systems, assessing their effectiveness and clinical applications. Emerging CRA systems promise to identify higher-risk subjects for whom preventive measures can be directed, but clearly there is further work needed in predicting accuracy and integration into practice.

The level of Oral health literacy serves as a fundamental health outcome factor which controls both oral disease avoidance actions and access to dental services. People with restricted oral health literacy tend to have inferior knowledge about dental health as well as decreased trips to the dentist and diminished quality of life in their oral well-being. The HeLD scale represents a tested instrument to evaluate OHL. This research evaluated OHL in Jaipur District among its rural communities and established its relationship with OHRQoL. Materials and Methods A cross-sectional study involving 240 participants reached four villages in Amer Block located within Jaipur District through multistage random sampling. The research applied HeLD scale to measure patients' OHL whereas OHIP-14 served as the platform for assessing OHRQoL. The study collected data through surveys administered to respondents by visiting their homes one by one. SPSS 20.0 conducted data analysis through descriptive statistics and independent t-tests and one-way ANOVA along with Pearson’s correlation. Results Among the study participants the mean HeLD score was 65.78 ± 16.57 and the 38–47 years age group maintained the highest score at 68.59 ± 13.51. Individuals from all age groups (p = 0.817) and gender groups (p = 0.194) showed no significant disparity in their HeLD assessment scores. The upper middle class participants achieved the highest scores (82.53 ± 13.88) in HeLD but socioeconomic groups showed a significant difference in these results (p = 0.000). Participants who owned a toothbrush together with daily tooth brushing the previous day obtained significantly higher HeLD scores with means of 67.04 ± 1.17 and 72.47 ± 1.21. The scores on the OHIP-14 indicated better OHRQoL when OHL level was elevated (r = -0.193, p = 0.003). Conclusion The results of this research establish socioeconomic status together with oral hygiene practices as major factors affecting OHL. Self-assessed oral health together with everyday oral hygiene Activities correlated positively with the literacy scores but the patient's age or sex did not show meaningful statistical connections to OHL scores. Research data shows that targeted interventions need to focus on improving OHL in rural areas because this approach will result in enhanced oral health outcomes and improved quality of life.

Background: High-Flow Nasal Oxygen (HFNO) and Continuous Positive Airway Pressure (CPAP) are two widely used non-invasive respiratory support modalities in Intensive Care Units (ICUs). Both techniques aim to reduce the need for endotracheal intubation in patients with acute respiratory distress. This study compares HFNO and CPAP in terms of efficacy, safety, and intubation prevention in ICU patients with respiratory distress. Materials and Methods A prospective cohort study was conducted in the Respiratory Intensive Care Unit (RICU),Government Medical College, Sangareddy. Patients with acute respiratory distress were randomized into HFNO and CPAP groups. Inclusion criteria were age >18 years, respiratory failure requiring non-invasive support, and a PaO₂/FiO₂ ratio <300. Exclusion criteria included immediate need for intubation, hemodynamic instability, or contraindications to non-invasive ventilation. Primary outcomes were intubation rates and secondary outcomes included length of ICU stay, mortality, and complications. Results Both groups have similar intubation rates, with the HFNO group slightly higher (38%) compared to the CPAP group (36%). A trend toward higher mortality in the HFNO group (44.0% vs. 37.0%, p = 0.057) was observed, but the difference is not statistically significant. The HFNO group had a longer average ICU stay (14.7 days vs. 8.9 days), but the difference is not statistically significant (p = 0.154). Mild Hypoxemia (PaO₂/FiO₂ 200-300): HFNO was used more frequently (59% vs. 39%), possibly because it is more comfortable and well-tolerated in mild-moderate hypoxemia. Moderate Hypoxemia (PaO₂/FiO₂ 100-200) Conclusion: Both HFNO and CPAP were used equally, indicating no clear preference for one over the other in this category.  Conclusion Both HFNO and CPAP are effective in preventing intubation in respiratory distress patients. CPAP may be superior in cases requiring high positive end-expiratory pressure (PEEP), while HFNO offers better patient tolerance. Further large-scale randomized controlled trials are required. HFNO can also be used as an alternative to CPAP because it has better patient tolerance than CPAP.

Introduction: Cerebral insulin resistance is a phenomenon associated with metabolic alterations in the brain, often related to diseases such as Alzheimer's, type 2 diabetes mellitus (DM) and cognitive disorders. Gifted individuals exhibit unique characteristics, such as greater neural connectivity and intense brain energy demands, which raises the question of their possible vulnerability or resilience to brain insulin resistance. Objective: The aim of this article on insulin resistance, cognitive function, and giftedness is to review recently published data derived from human studies, including clinical trials. Methods: We conducted a literature review followed by a synthesis of neurobiological components of the mechanisms involved in brain insulin and giftedness, to generate an understanding of this association and thus spark new research interests. Results: In research with cognitively normal participants, insulin resistance was associated with worse global cognition, as well as verbal episodic memory and executive function, but several neurobiological components are involved. Discussion: Diabetes appears to be associated with cognitive decline in some cognitive domains more than others, particularly executive function, working memory and attention. Most cross-sectional and longitudinal clinical studies show an association between insulin resistance and cognition in older people. Furthermore, they use only a single or global cognitive test, and there is little information about which specific cognitive domains are involved. Conclusion: Scientific investigation of this topic can not only deepen our knowledge about metabolism and cognition, mas also guide practical strategies to protect mental and physical health of this group.

Background: The incidence of breast carcinoma is increasing. Fine Needle Aspiration Cytology (FNAC) plays a crucial role in diagnosing and grading tumors. The current study aimed to determine the correlation between cytology grading and histopathological grading in cases of infiltrating ductal breast carcinoma. Methods: Forty patients were included in this study. They were diagnosed with infiltrating ductal carcinoma by FNA, and all clinical data regarding the patients were collected. FNA was performed on all cases with a 23-gauge needle attached to a 10 ml syringe with a Franzer-type syringe holder utilizing the multidirectional technique to obtain an adequate specimen. The aspirated material was then transferred onto the slides, smears were prepared, fixed with alcohol, and stained with Hematoxylin & Eosin (H&E) and Papanicolaou (Pap) stain. Results: The overall concordance rate between RCG and MBR was found to be 87.5% indicating a strong correlation between cytological and histopathological grading. Grade I: 80.0%, Grade II: 82.5%, Grade III: 100%.  Grade I (RCG vs. MBR): 17 out of 18 (94.4%) Grade I MBR cases were correctly identified by RCG. 3 cases (16.7%) were misclassified as Grade II by RCG. Grade II (RCG vs. MBR): 15 out of 18 (83.3%) Grade II MBR cases were correctly identified by RCG. 1 case (5.6%) was misclassified as Grade I and 2 cases (50%) as Grade III by RCG. Grade III (RCG vs. MBR): 2 out of 4 (50%) Grade III MBR cases were correctly identified by RCG. Conclusion: This study shows that FNAC proves to be a straightforward rapid diagnostic technique suitable for initial breast ductal carcinoma evaluation. Cytological grading according to Robinson proved to be both sensitive and easily duplicateable. The RBS grading system maintains a basic approach. The clinical significance of data collection works alongside prognosis assessment through its combination with mammography.

Background Osseointegration is a crucial factor for the success and long-term stability of dental implants. Various strategies, including modifications in implant surface properties and the use of bioactive molecules, have been employed to enhance osseointegration. Platelet-rich fibrin (PRF) and concentrated growth factor (CGF) are autologous platelet concentrates that promote bone healing through the sustained release of growth factors.  Materials and Methods This study was conducted in the Department of Periodontology and Oral Implantology, RUHS College of Dental Sciences, from January 2020 to December 2021. A total of 30 implant surgical sites were selected and categorized into three groups: Group I (Control): Implants placed without PRF or CGF application (n=10), Group II (PRF Group): Implants placed with PRF application (n=10), Group III (CGF Group): Implants placed with CGF application (n=10). Clinical parameters, including plaque index (PI), gingival index (GI), peri-implant probing depth (PD), wound healing index (WHI), and implant stability quotient (ISQ), were evaluated at baseline and one month postoperatively. Radiographic assessment of bone density and marginal bone loss (MBL) was performed using CBCT. Results The study reported a 100% implant survival rate across all groups. Bone density at one month was highest in the CGF group (727.05 ± 62.72), followed by the PRF group (701.11 ± 33.21) and the control group (687.99 ± 65.65). Marginal bone loss was significantly lower in the CGF group (0.22 ± 0.08 mm) compared to the PRF group (0.31 ± 0.06 mm) and the control group (0.37 ± 0.10 mm). ISQ values increased significantly from baseline to one month in all groups, with the CGF group demonstrating the highest mean ISQ (61.62 ± 2.27). The wound healing index was most favorable in the CGF group (0.90 ± 0.78), indicating enhanced tissue regeneration. Conclusion CGF demonstrated superior outcomes in terms of implant stability, bone density, and wound healing compared to PRF. The use of CGF as a bioactive adjunct may accelerate osseointegration and improve clinical outcomes. Further long-term studies with larger sample sizes are recommended to confirm these findings.

Background: Psychosexual disorders are one of the common psychological disorders. Psychosexual disorders include erectile dysfunction, premature ejaculation, delayed ejaculation, erectile disorder, hypoactive sexual desire disorder, Dhat syndrome, masturbatory guilt, and small penis anxiety. They are associated with false information, myths, and misconceptions. These patients consult local quacks usually, a few to psychiatrists and dermatologists. Aim: To study the clinical and demographic profile of male patients with psychosexual disorders presenting to outpatient department of dermatology. Setting and Design: prospective observational study Methods: two hundred and twenty-six male patients (226) with psychosexual disorders were included. Diagnosis of psychosexual disorders was according to the DSM 5 TR classification. Details regarding age, duration of problem, marital status and education status and detailed history of sexual problems was noted in a proforma. Statistical Analysis: Descriptive analysis of qualitative data was done. Chi-square test for statistical significance. Results: Erectile disorder was the commonest complaint seen in 28% of patients followed by erectile disorder and premature ejaculation (ED+PE). Maximum number of patients were from the age group of 31-40 years. Married individuals were mostly suffering from erectile disorder. Dhat syndrome was common in unmarried. Irrespective of education status, erectile disorder is the most common psychosexual disorder. Conclusion: Patients with psychosexual disorders do consult dermatologists. These patients are at risk of developing psychiatric disorders. Dermatologists must have patience to listen to their problems, give proper sexual information and be able to reassure and counsel them. Timely referral to a psychiatrist is important. Psychiatrists and dermatologists must work in liaison to manage patients.

Background Guillain-Barré Syndrome (GBS) is an acute immune-mediated polyneuropathy that often leads to neuromuscular paralysis. A significant proportion of patients require mechanical ventilation due to respiratory failure, increasing the risk of mortality and complications. This study aims to evaluate the outcomes of GBS patients requiring intensive care, focusing on mortality, disability, length of hospitalization, and complications. Methods: A systematic review of literature was conducted following PRISMA guidelines. Data were extracted from PubMed, Scopus, Web of Science, and Cochrane Library. Studies from 2000–2024 evaluating the prognosis of GBS patients requiring mechanical ventilation were included. Primary outcomes analyzed were mortality rates, functional recovery, ICU stay duration, and complications. Results: Mortality rates ranged from 8.3% to 20%, with elderly patients and those with autonomic dysfunction having worse outcomes. 53.8% of patients achieved good recovery (GBS disability score 0-1) after one year. Prolonged ICU stays (>3 weeks) were common, and 64% required prolonged mechanical ventilation. Frequent complications included pressure ulcers (40%), pneumonia (30.2%), and sepsis (17.4%). Conclusion: Despite advances in intensive care, GBS patients requiring ventilation face high morbidity. Early intervention, infection control, and rehabilitation strategies are critical for improving outcomes.

Background: Beta thalassemia is a genetic disorder characterized by defective hemoglobin synthesis, leading to chronic anemia and dependency on regular blood transfusions. Repeated transfusions cause iron overload, leading to complications in vital organs such as the thyroid gland and heart. Materials and Methods: A cross-sectional study was conducted on 50 pediatric patients aged 2–12 years diagnosed with beta thalassemia major/intermedia at a tertiary care hospital. Clinical evaluations, laboratory tests, and imaging modalities such as ECG and echocardiography were employed to assess thyroid and cardiac involvement. Serum ferritin levels were measured to evaluate iron overload and its correlation with organ dysfunction. Results: Hypothyroidism was observed in 26% of patients, predominantly subclinical, with mean T3, T4, and TSH levels of 1.63 ± 0.11 ng/ml, 10.54 ± 0.25 mcg/ml, and 5.93 ± 2.54 IU/ml, respectively. Cardiac abnormalities, including left ventricular hypertrophy (72%) and pulmonary hypertension (24%), were common. Mean serum ferritin levels were 1414 ± 1125 ng/ml. No statistically significant correlation was found between serum ferritin levels and thyroid or cardiac dysfunction (p > 0.05). Conclusion: The findings highlight the prevalence of subclinical hypothyroidism and significant cardiac abnormalities in transfusion-dependent beta thalassemia patients. Regular monitoring of endocrine and cardiac parameters, coupled with effective iron chelation therapy, is essential for early intervention and improved patient outcomes.

Background: 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: Frozen shoulder (adhesive capsulitis) is a debilitating condition characterized by pain, stiffness, and progressive loss of shoulder mobility, often affecting individuals aged 40 to 60 years. Idiopathic frozen shoulder, the most common type, remains poorly understood, with its exact cause still unknown. Treatment options vary, but hydrodilation has gained popularity due to its ability to restore mobility and reduce pain by distending the joint capsule with fluid. Aim: This prospective observational study aims to assess the effect of hydrodilation on pain, shoulder function, and range of motion (ROM) in patients with idiopathic frozen shoulder. Methods: The study was conducted at Government Medical College Baramullah, Kashmir in the Department of Orthopaedics over a period of one year, enrolling 50 patients aged 40-60 years with diagnosed idiopathic frozen shoulder. Participants received hydrodilation therapy with a saline solution mixed with a local anesthetic, injected into the glenohumeral joint under fluoroscopic guidance. Outcomes were measured at baseline and at 1-, 3-, and 6-months post-treatment using the Constant-Murley Shoulder Score (CMS), Visual Analog Scale (VAS) for pain, and shoulder ROM (flexion, abduction, and external rotation). Results: At the 6-month follow-up, 80% of patients reported significant pain relief, with the VAS score decreasing from 8.2 ± 1.0 at baseline to 2.1 ± 1.4 (p < 0.001). The average CMS score improved from 32.5 ± 5.2 to 61.8 ± 6.7, and ROM improved by 30° for flexion, 28° for abduction, and 25° for external rotation (p < 0.05). These improvements were statistically significant, indicating that hydrodilation is effective in improving both pain and mobility in idiopathic frozen shoulder. Conclusion: Hydrodilation offers an effective and minimally invasive treatment for idiopathic frozen shoulder, leading to significant improvements in pain relief and shoulder function. These results highlight the potential of hydrodilation as a first-line treatment for this condition. Future studies with larger sample sizes and longer follow-up periods are needed to validate these findings.

Patients with cardiovascular disease (CVD) and diabetes mellitus (DM) require special considerations during dental procedures due to their increased risk of complications such as delayed healing, infections, and adverse reactions to medications. Proper assessment, pre-treatment planning, and modifications in dental management are essential to ensure patient safety. This study evaluates the impact of tailored dental interventions on clinical outcomes in CVD and DM patients. Materials and Methods A total of 100 patients (50 with CVD and 50 with DM) undergoing various dental procedures such as extractions, scaling, and restorative treatments were included in the study. Patients were divided into two groups: one receiving standard dental care and the other receiving modified protocols, including antibiotic prophylaxis, stress management strategies, and glycemic control monitoring. Hemodynamic parameters, healing time, and post-procedural complications were assessed over a four-week follow-up period. Results Patients receiving modified dental protocols exhibited a 30% reduction in post-procedural infections and a 25% faster healing time compared to those receiving standard care. Hemodynamic stability was better maintained in CVD patients with preoperative medication adjustments, and diabetic patients with pre-procedure glycemic optimization had significantly lower complication rates (p < 0.05). Conclusion Modified dental protocols significantly improve outcomes in patients with cardiovascular disease and diabetes mellitus. Preoperative assessment, medication adjustments, and infection control measures are crucial in minimizing complications. Implementing patient-specific dental management strategies enhances safety and procedural success in these high-risk populations.

Allergic rhinitis (AR) is a common inflammatory condition of the nasal mucosa that significantly affects olfactory function and overall quality of life. Medical therapy, including antihistamines, intranasal corticosteroids, and leukotriene receptor antagonists, is the mainstay of treatment. This study evaluates olfactory function and quality of life changes in patients with AR following medical therapy. Materials and Methods A prospective study was conducted on 100 patients diagnosed with AR. Participants were assessed for olfactory function using the Sniffin’ Sticks test and their quality of life using the Sino-Nasal Outcome Test (SNOT-22) before and after four weeks of medical therapy. The treatment regimen included intranasal corticosteroids (fluticasone propionate), oral antihistamines (levocetirizine), and leukotriene receptor antagonists (montelukast). Statistical analysis was performed using paired t-tests to compare pre- and post-treatment scores. Results Post-treatment, there was a significant improvement in olfactory function, with mean Sniffin’ Sticks scores increasing from 8.5 ± 2.3 to 12.7 ± 2.1 (p < 0.001). The SNOT-22 scores showed a marked reduction, indicating an enhanced quality of life, with mean scores decreasing from 42.8 ± 5.6 to 18.4 ± 4.2 (p < 0.001). Symptom relief was reported by 85% of patients, with 78% experiencing improved nasal airflow. Conclusion Medical therapy significantly enhances olfactory function and overall quality of life in patients with allergic rhinitis. Regular use of intranasal corticosteroids and antihistamines effectively reduces nasal inflammation, leading to symptomatic relief and improved daily functioning. Future studies with larger cohorts and longer follow-ups are recommended to validate these findings.

Comparative study of post-operative complications of chivate’ s procedure versus classical haemorrhoidectomy. Materials and methods: It is a prospective observational study conducted in Department of general surgery in patients with III /IV haemorrhoids. Total 60 patients are included in study which is divided as 30 subjects in each group. Study divided into 2 groups by odd and even numbers odd numbers were assigned 1 as group A Patients were chivate' s procedure and even numbers were as Signed as group B open haemorrhoidectomy for a period of 24 months. Results: Both the procedures were performed in two groups of 30 patients each with almost similar age, sex and grade of haemorrhoids (grade-III and IV). The mean duration of operation time in open haemorrhoidectomy group was 32.1 (±2.41) minutes and for Chivate' s procedure group 40.11 (±4.81) minutes is more and statistically significant. Operative blood loss, wound healing time, and wound infection decreased significantly in the Chivate' s procedure group compared with the open haemorrhoidectomy group (P < .001) In our study post-operative pain, VAS score 3 or more was 73.3% in open haemorrhoidectomy group and only 13.3% in Chivate' s procedure which was significant. Patients complained of fever, bleeding and urinary retention are Statistically significant (p<0.05). Duration of hospital stay was 3.5 (±0.8) days in open group and 1.5 (±0.3) in Chivate' s procedure. Return work is early in Chivate' s procedure than open groups which is significant. With one year period of follow up only 8 patients in open haemorrhoidectomy group developed delayed complications. Conclusions: Chivate' s procedure can be recommended as a safe, cost-effective alternative procedure to open haemorrhoidectomy and can be performed at any rural setup after an adequate training.

Biosensors have emerged as a powerful tool for the early detection of infectious diseases, offering rapid, sensitive, and cost-effective diagnostics. These devices integrate biological recognition elements with physicochemical transducers to detect pathogens with high specificity and sensitivity. The development of biosensors has revolutionized infectious disease diagnostics, particularly in resource-limited settings, where traditional methods such as polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) may be inaccessible. This systematic review evaluates recent advancements in biosensor technology for detecting infectious diseases, following the PRISMA guidelines. A total of 49 relevant studies were analyzed, highlighting key biosensor types, their mechanisms, and clinical applications. Findings suggest that nanotechnology and electrochemical biosensors have significantly enhanced early-stage detection capabilities. Furthermore, optical and piezoelectric biosensors have demonstrated exceptional real-time detection efficiency, while microfluidics-based biosensors have paved the way for integrated lab-on-a-chip diagnostics. Despite these advances, challenges remain, including issues of sensitivity, specificity, cost, and regulatory hurdles. The integration of biosensors with artificial intelligence (AI) and internet of things (IoT) technologies holds the potential to further improve diagnostic accuracy, automate data collection, and facilitate large-scale disease surveillance. Future research should focus on refining biosensor designs for portability, affordability, and enhanced multiplexing capabilities, positioning biosensors as crucial tools in the fight against infectious diseases and ensuring better preparedness for future pandemics and emerging health threats.

Background: Allergic rhinitis (AR) is a prevalent inflammatory condition of the nasal mucosa, significantly affecting the quality of life. Topical nasal steroids (TNS) are the mainstay of treatment, but variations in their efficacy and safety profiles necessitate comparative analysis. This study evaluates the effectiveness and safety of different TNS in managing AR symptoms. Materials and Methods: A randomized clinical trial was conducted on 120 AR patients, who were allocated into three groups: Fluticasone Propionate (Group A), Mometasone Furoate (Group B), and Budesonide (Group C). The study duration was 12 weeks, with assessments at baseline, 4, 8, and 12 weeks. Symptom severity was measured using the Total Nasal Symptom Score (TNSS), while quality of life was evaluated using the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). Adverse effects were monitored throughout the study. Results: At the end of 12 weeks, all three groups demonstrated a significant reduction in TNSS scores (p < 0.05). Fluticasone Propionate showed the highest mean reduction (from 8.2 to 2.3), followed by Mometasone Furoate (from 8.1 to 2.7) and Budesonide (from 8.0 to 3.1). RQLQ scores improved significantly across all groups, with Fluticasone Propionate showing the greatest improvement (mean score change of 4.8), followed by Mometasone Furoate (4.3) and Budesonide (3.9). Adverse effects were minimal and comparable across groups, with nasal irritation being the most reported. Conclusion: All three topical nasal steroids were effective in managing allergic rhinitis symptoms, with Fluticasone Propionate exhibiting superior efficacy. However, Mometasone Furoate and Budesonide also provided significant symptomatic relief with comparable safety profiles. Individualized treatment selection based on patient-specific factors remains essential for optimal AR management.

Multi- detector computed tomography (MDCT) is considered as the imaging modality of choice for characterization of retroperitoneal masses. Present study was aimed to correlate the radiological results with those of histological or fine needle aspiration cytology (FNAC). Material and Methods: The present hospital based cross-sectional study was conducted among patients undergoing evaluation of primary retroperitoneal masses and those detected incidentally by routine ultrasonography of abdomen. All these patients were subjected for radiological investigations, and the cross-sectional imaging was taken and interpreted, which was later correlated with the confirmed FNAC/histopathological diagnosis. Results: The mean age of the subjects was 44.26 years, and majority were males (60.5%). Based on FNAC/ histopathological diagnosis, the most commonly reported condition was found to be liposarcoma (14.0%), whereas based on cross-sectional imaging, the most commonly reported condition was found to be primary retroperitoneal tumor (16.3%). Local invasion and vascular involvement in 14.0% and 9.3% cases respectively. The lymph node metastasis was evident in only 1 individual, while 2 cases showed distant metastasis. The calcification, necrosis and hemorrhage were seen in 30.2%, 58.1% and 14.0% cases respectively. About 25.6% cases were found to be cystic in nature. Based on FNAC/ histopathological diagnosis, majority were diagnosed with malignant condition (55.8%), and the remaining were benign masses (44.2%). There was perfect agreement in diagnosing the primary retroperitoneal masses between cross-sectional imaging and HPE assessment, with statistically significant relation, and 100.0% diagnostic accuracy. Conclusion: The present study concludes that using cross-sectional imaging it is possible to localize, differentiate and diagnose the primary retroperitoneal masses. It is also possible to evaluate the nature, morphology and extent of the mass and its relationship to adjacent structures.

Blunt abdominal trauma is the most common cause of solid organ injuries like liver, spleen, kidney etc. Now a days non-operative management [NOM] for blunt abdominal trauma with solid organ injuries is gaining importance over surgical intervention due to adequate monitoring and advanced imaging techniques. Present study was aimed to study outcomes of non-operative management of blunt abdominal trauma with solid organ injuries. Material and Methods: Present study was single-center, prospective, observational study, conducted in cases with history of blunt trauma to abdomen due to various causes like road traffic accident, fall from height, assault to the abdomen with a blunt object, natural calamity, having a clinical suspicion of trauma to the abdomen, kept for nonoperative management. Results: Among 63 cases, majority were from 21-30 years age group (38.1 %) followed by 31-40 years age group (22.2 %). Minimum age was 15yrs and Maximum age was 75yrs with Mean age 32.41+ 12.67 yrs. Among the study subjects 92% were males and 8% were females. Road traffic accidents (RTA) was common mode of injury (61.9 %). On examination, common findings were tenderness (93.7 %), guarding (38.1 %), distension of abdomen (9.5 %), hypotension (12.7 %), tachycardia (47.6 %) & positive diagnostic peritoneal lavage (DPL) (61.9 %). Blood transfusion was required in 30 patients. In present study, commonly injured organs were liver (53.96 %), spleen (26.98 %) & kidney (9.52 %). In present study, we noted that severity of organ injured was Grade 2 (46.03 %) & Grade 3 (36.5 %). Successful conservative management was observed in 61 patients (96.83). Conversation rate was 3.17% in our study. Conclusion: Nonoperative management had safe outcomes and high success rates with minimal conversion rates. Hypotension, tachycardia, low Hb at presentation, positive DPL were not the indications of immediate surgical intervention.

Background: The efficacy of endodontic retreatment is crucial in salvaging teeth with failed primary root canal treatments. The choice of irrigation protocol during retreatment plays a pivotal role in determining the overall success by effectively eradicating residual microbial flora and preventing reinfection. This study aims to compare the success rates of various irrigation protocols in endodontic retreatment, focusing on the most commonly used solutions and their combinations. Methods: This randomized clinical trial was conducted at a leading tertiary care hospital in India. A total of 100 patients who presented with failed root canal treatments and were in need of retreatment were enrolled. They were randomly allocated to one of three groups based on the irrigation protocol used: sodium hypochlorite, chlorhexidine, and a combination of sodium hypochlorite with chlorhexidine. Each protocol was meticulously followed to evaluate its effectiveness in the retreatment process. Results: The primary objective of this study is to assess the success rate of each irrigation protocol, which will be gauged through clinical and radiographic outcomes. These include the healing of periapical lesions, the resolution of symptoms, and the incidence of procedural complications such as file breakage or over-irrigation. The study aims to provide robust data that will help in understanding the differential impact of these protocols on treatment outcomes. Conclusion: The outcome of this study is anticipated to make a substantial contribution to endodontic practice by delineating the relative efficacy of different irrigation protocols. The results are expected to offer valuable insights that will assist clinicians in selecting the most appropriate irrigation solution, thereby optimizing the success rates of endodontic retreatments.

Introduction: To study the clinical profile in elderly with OLD with special reference to functional and cognitive impairment. The study was done to assess the pattern of presentation and spirometry of OLD in geriatric population, to compare the pattern of prescription of OLD in a geriatric population, to assess the efficacy of inhalational techniques, functional and cognitive impairment in OLD in the elderly and correlate clinical symptoms. Materials Methods: A total of 100 patients over 60 years of age and 30 below 60 years were studied. All the 130 patients affected with OLD were recruited consecutively as outpatients during their regular check-up visits and inpatients in general medicine and pulmonary medicine ward at yenepoya hospital on meeting the inclusion criteria. Each patient underwent detailed clinical examination, routine blood investigations, pulmonary function tests, relevant indices were calculated. Patients with other respiratory co-morbidities like pneumonia, pleural effusion, moribund patient with life expectancy <3 weeks and those who were unable to blow into spirometry were excluded from the study Results: Of the 130 patients in our study, 127 presented with dyspnea and cough. MRC grade III dyspnea was more commonly seen in the patients more than 60 years age group (60%) and in male patients less than 60 years (42%), where as in female patients (36.36%) less than 60 years MRC grade-II dyspnea was more commonly seen. BMI and SpO2 was noted to be lower in males more than 60 years of age compared to other groups. 107 0f 130 (82.3%) patients were on inhaler therapy. 57 of 107 (53.2%) patients on inhaler therapy, had an improper technique of inhalation, where they actuate inhaler device at the end of inspiration and don’t hold the breath. 89 of 130 (67.9%) had cognitive impairment with a significant correlation with improper inhalational technique.  Conclusion: From our study we noted that patients who were receiving MDI therapy for maintenance of OLD were not aware of proper inhalational techniques. This could not only affect the disease process but also their quality of life. This might result in worsening of dyspnoea and inappropriate stepping up of the therapy. These patients may also show significant cognitive impairment. Thus, it is advisable to spend time with the patients in out-patient visits to assess the inhalational technique and also do cognitive assessment. Large scale studies are required with frequent and longer duration of follow ups to assess the improvement in cognitive parameters.

Background: Dark circles, also known as periorbital hyperpigmentation (POH), are primarily seen on the lower eyelids. Both sexes are susceptible to this prevalent cosmetic issue. Through the visualization of subtle clinical patterns of skin lesions and subsurface skin structures that are invisible to the naked eye, dermoscopy is a non-invasive diagnostic procedure. Dermoscopy is an additional tool for categorizing the various patterns of POH, which is a clinical diagnostic. Materials and Methods: For two years, from 2022 to 2024, a prospective study was conducted in the departments of dermatology, venereology, and leprology in patients who visited the outpatient department (OPD) and had a history of periocular hyperpigmentation at the Department of Dermatology, VRK Teaching Hospital, and Research Hospital. Results: Our study included 85 participants. Patients who presented with POH ranged in age from 17 to 70. 32.86 years old was the average age at onset. The majority of patients (43.5%) were between the ages of 31 and 40. The majority were women, making up 76.4% (65/85) and men, 23.5% (20/85). The most prevalent kind of POM was vascular (51.7%), followed by constitutional (25.8%), post-inflammatory (11.7%), and shadow type (9.4%). Conclusion: A prevalent dermatological condition, especially in women, is peri-orbital hyperpigmentation. Whether the pigment originates from melanin or the underlying vasculature, a dermoscope can assist identify its source? Because melanin-based pigment can react to pigment reduction drugs and laxity can be controlled with lasers and radiofrequency, this can also assist in tailoring the treatment to the etiology.

Introduction: Ossicular erosion is the common finding in chronic otitis media with cholesteatoma leading to hearing impairment.  Aim: To evaluate the ossicular chain erosion in chronic otitis media patients with cholesteatoma. Materials and methods: A total of 30 patients with cholesteatoma were operated on during a 1-year period.  Results: Out of the 30 patients, 28 (93%) were affected by erosion of the ossicles. Involvement of the incus was most common (86.7%), followed by involvement of the stapes (66.7%), and then the malleus (43.3%). Overall, the most common pattern of damage was observed in the incus bone, which included total loss in 56.7% of cases and partial damage in 30%. Conclusion: Long process of incus is most commonly involved followed by malleus head and at last by stapes footplate

Background: The bone component of the sella turcica, pituitary gland, cavernous sinus, and suprasellar cistern make up the sellar/juxtasellar area. Hormone overproduction or underproduction, or neurological symptoms brought on by the compression of nearby structures, can be the cause of abnormalities in this area. Computed tomography has been replaced by magnetic resonance imaging (MRI), which is now the preferred imaging technique. Objectives: Aim of the study was to detect and characterize sellar and juxtasellar lesions by MRI and to study the role of various techniques of MRI in diagnosis of sellar and juxtasellar lesions and evaluation of MRI in management sellar and juxtasellar lesions. Materials and Method: After reviewing the MRI scans of 100 patients with sellar/juxtasellar anomalies from didactic files, we reported the rarer changes for whom MRI was crucial to the diagnosis. Every case was verified by clinical laboratory or histological means. Results: Pituitary macroadenomas were most commonly found pathologies in sellar and juxtasellar region. Majority of cases of macroadenomas show Knosp I or Knosp II grading.  MR imaging characteristics of 100 sellar and juxtasellar lesions. MRI was precise in histopathological typing of sellar and juxtaasellar lesion in 84% of cases which were operated. Conclusion:  MRI is very useful in detection of lesions in sellar and juxtasellar region.

Background: Childhood hearing loss is a critical public health concern, often undetected in early life, which can lead to developmental delays and communication challenges. This study aimed to implement a neonatal hearing screening program using otoacoustic emissions at Northern Railway Central Hospital, New Delhi, and assess the incidence of neonatal hearing loss in high-risk newborns. Methods: A prospective observational study was conducted over 18 months, enrolling neonates born at the hospital and those attending the outpatient clinics. Inclusion criteria included neonates with no prior hearing evaluation and those failing initial screenings. Parameters assessed included birth weight, gestational conditions, APGAR scores, and family history. Otoacoustic emissions were conducted at 1 week, 3 months, and 6 months of age to evaluate hearing status. Data were analysed using SPSS software. Results: Out of 250 neonates screened, a significant number were identified as high risk for hearing loss due to low birth weight and prematurity. None of the 250 neonates turned out to be deaf on screening at 6 months. Conclusion: Congenital hearing loss is an entity of very less common occurrence. The present study revealed that OAE test has a false positive rate of 7.6%. A single OAE test is not enough as a screening tool for congenital deafness, as infants screened during the initial stage who had a'refer’ resultat 1month, turned out to be 'pass' at 3month &those who were still 'refer' at 3 months got a "pass' result at 6 months. Even after using the 1-3-6 principle of OAE screening.there is every chance of false-positivity of the screening tool.

Introduction: Fine-needle aspiration cytology (FNAC) is a simple, painless and cost-effective procedure which is widely used to diagnose lesions in various sites. FNAC when coupled with proper clinic radiological correlation is an effective, precise tool and can be the procedure of choice in diagnosis of bony lesions with biopsy being the final staging procedure.  Tumours of bone are not uncommonly encountered in clinical practice. The low incidence of these tumours and the resulting limited experience in dealing with them adds to the diagnostic difficulties The study was undertaken to assess the role of FNAC in the evaluation of various space occupying lesions of bone assess its sensitivity and specificity compared to core needle or open surgical biopsy. Materials and Methods: FNAC was done on total of 67 cases of bone lesions who were referred from Orthopaedics OPD. 48 procedures were performed by pathologists, and 19 procedures were guided. Patients were selected based on convenience sampling after getting written informed consent. FNAC was performed under strict aseptic precautions and local anaesthesia was given when required. Slides were fixed in isopropyl alcohol and stained with Haematoxylin and Eosin/ Diff Quik/ Papanicolaou (Pap). Slides were examined under the light microscope and results were recorded in the master chart. Those cases who underwent surgery, had a histological follow up.The tissue samples were received for histopathological examination. Results: This study included 67 specimens of various benign and malignant bone tumours and tumour – like lesions. The various benign tumours diagnosed were osteochondroma, enchondroma, chondromyxoid fibroma, osteoid osteoma, osteoblastoma and giant cell tumours. The malignant tumours diagnosed were chondrosarcoma, osteosarcoma, Ewing sarcoma, malignant giant cell tumour. Tumour – like lesions were received and included aneurysmal bone cyst, fibrous dysplasia. Out 34 cytology positive cases; 31 were confirmed by biopsy. Out of 33 cytology negative cases, 5 cases were biopsy positive, Conclusion: The final results in our series were; Sensitivity=86.1%, Specificity=90.3%, Accuracy rate of FNAC = 88%. There were only 5 false negatives in the series and 3 false positive cases. No complications arising due to the procedure were observed and patient compliance was good. FNAC is a simple, cost-effective technique and should be the first line of investigation in the diagnosis of bone tumors. It is an accurate diagnostic technique if the sample is adequate and radiological findings are compatible.

Introduction: Embryonal   central   nervous tumors are aggressive, specifically medulloblastomas are very aggressive and most common malignant brain tumor of childhood, remain a major cause of morbidity and mortality. It count approximately 20% of all primary CNS tumors.[1] Study outlines a) histological features of adult and paediatric medulloblastoma and classified them into the histological subtypes as defined by WHO -2016 and b) the expression profile of   the immunohistochemical marker GAB-1 and β-Catenin in paediatrics and adult medulloblastomas. Material And Method: All the procedures carried out in the retrospective study were approved by the Institutional Review Board of S.C.B MCH Cuttack. There were a total of 38 cases of medulloblastomas retrieved from the database of the Department of General Pathology, S.C. B MCH Cuttack from November 2018 to October 2020.Biopsy samples of 38 cases of clinically and radiologically suspective cases of medulloblastomas were  subjective  to  histopathological  examination. 36 had sufficient tissues in paraffin block for additional immonohistochemical study were subjective to immunohistochemical study of GAB-1 and β-catenin. Result: There was a total of 38 cases of medulloblastoma November 2018 to October 2020. Of these 36 cases were included in the study based on the defined inclusion and exclusion criteria that are outlined in the materials and method section. 55.8% (20) cases were immunopositive and 44.2% (16) cases were immunonegative for β-createnin. 27.7% (10) cases were immunopositive and 72.2%(26) cases were immunonegative for GAB-1. Conclusion: Medulloblastomas are primarily tumors of childhood and highly   aggressive.The recent 2016 integreted diagnosis classified medulloblastoma into molecular type i.e WNT/SHH/Group3/Group4 type. WNT subgroup consistently associated with better prognosis but SHH subgroup shows heterogenous outcome and management of SHH type is challenging.GAB-1 antibody is useful molecular marker for the diagnosis of SHH subgroup medulloblastoma. β-Catenin antibody is useful molecular marker for the diagnosis of WNT subgroup medulloblastoma.

Episiotomy is a common practice for all women delivering for the first time. The reason for its popularity included substitution of a straight surgical incision, which was easier to repair, for the ragged laceration that might result in its absence. Episiotomy, incision of the perineum at the time of vaginal childbirth, is a common surgical procedure experienced by women] The rationale for Routine prophylactic episiotomy is to protect the pelvic floor, thereby minimizing the risk of urinary incontinence and pelvic floor dysfunction. Aim and Objectives: 1. Comparison of restrictive use of episiotomy versus routine episiotomy in primigravida undergoing vaginal birth 2. To compare the outcome of restricted versus routine use of episiotomy Methods: Study Design: Prospective study. Study place: OBGY Department of Rohilkhand medical college and hospital, Bareilly, India. Study Duration: December 2023 to December 2024. Study population: The study population included all full term labor cases admitted in labor room at a tertiary care center. Study sample: 280 Result: Distribution of episiotomy among primipara control and study group cases. Total normal delivery cases were 48 in control group and 56 in study group. Proportion of episiotomy among control group cases was 91.66% (44) and 28.57% (16) in study group cases. In multipara Total normal delivery cases were 92 in control group and 84 in study group. Proportion of episiotomy among control group cases was 44.56% (41) and 11.90% (10) in study group cases. distribution of perineal tears by Primipara among control and study group in multipara. Proportion of second degree perineal tears among control group cases was 2.08% (01) and 19.64% (11) in study group cases. distribution of perineal tears by multipara among control and study group in multipara. Proportion of second degree perineal tears among control group cases was 2.08% (01) and 19.64% (11) in study group cases. study Group according to age group in Multipara Highest frequency found in the age group of 30-34 years i.e. 45.23 % (38) followed by 25-29 years age group i.e.23.81 % (20) and followed by 21-24 years age group i.e.22.62 % (19) . The proportion of study group in the age group of years ≤20 and above 35 years were 5.96% (05) ,2.38 % (02) respectively. Perineal lacerations, in the study group was 18.57% (n = 26), which was significantly less when compared to 60.71% (n = 85) in the control group. Conclusions: Restricted use of episiotomy resulted in considerable reduction in maternal morbidity due to perineal lacerations.

Introduction: Embryonal   central   nervous  tumors  are  aggressive, specifically medulloblastomas  are  very  aggressive  and  most  common  malignant  brain  tumor of childhood , remain a  major cause  of  morbidity  and  mortality. About 20% of brain tumors in children and fewer than 1% of CNS cancers in adults are medulloblastomas. Authors study  a) the histological features of adult and paediatric medulloblastoma and classify them into the histological subtypes as defined by WHO -2016 and b) the  expression  profile  of   the immunohistochemical  marker  GAB-1 in medulloblastomas  and further segregate all GAB-1 positive SHH subgroup into SHH/TP53 mutant type and SHH/TP53 wild type by immunohistochemistry. Material And Method: All the procedures carried out in the present retrospective study were approved by the Institutional Review Board of S.C.B MCH Cuttack. There were a total of 48 cases of medulloblastomas retrieved from the database of the Department of General Pathology, S.C.B MCH Cuttack from October 2016 to November 2018.. Result: Out  of  46 cases  8  cases(18%)  were  P53 mutant type  showing  over expression , 24  cases(53%)   were  P53 wild type  showing normal expression,12 cases (26%)  were showing  complete  absence  and 2 cases(3%) showing  abnormal  cytoplasmic staining. Nearly three fifth of the cases were of the Desmoplastic variant (7cases), 4cases of classic variants and 1 case of large cell variant show   GAB-1 immunopositivity. Conclusion: Medulloblastomas are primarily tumors of childhood and highly   aggressive. The recent 2016 integreted diagnosis classified medulloblastoma into molecular type i.e WNT/SHH/Group3/Group4 type. GAB-1 antibody is useful molecular marker for the diagnosis of SHH subgroup medulloblastoma. Further segregation of SHH/TP53 mutant and SHH/TP53 wild type is required for favourable prognosis. The study demonstrated here how combination of genomic and genetic analysis of brain tumors can predict differential response to therapies and provide insight into ways that favourable signalling pathways may be mimicked by pharmacological intervention.

Background: Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder requiring effective glycemic control. This study compares the efficacy and safety of Sitagliptin, a DPP-4 inhibitor, and Liraglutide, a GLP-1 receptor agonist, in managing T2DM. Methods: An observational study was conducted on 100 patients with T2DM, divided into two groups: Sitagliptin (n=50) and Liraglutide (n=50). Baseline and post-treatment values for HbA1c, fasting blood glucose (FBG), postprandial blood glucose (PPBG), and weight reduction were analyzed over 12 weeks. Adverse events and hypoglycemic episodes were also recorded. Statistical significance was assessed using independent t-tests and chi-square tests. Results: Demographics: The mean age of participants was 56.2 ± 10.4 years, with no significant differences between groups in age (p = 0.32) or gender distribution (p = 0.48). Glycemic Control: Liraglutide demonstrated a significantly greater reduction in HbA1c (1.2 ± 0.4% vs. 0.8 ± 0.3%, p = 0.01), FBG (40 ± 15 mg/dL vs. 25 ± 10 mg/dL, p = 0.02), and PPBG (60 ± 25 mg/dL vs. 40 ± 20 mg/dL, p = 0.01). Weight Reduction: Weight loss was significantly higher in the Liraglutide group (3.8 ± 1.2 kg) compared to the Sitagliptin group (1.5 ± 0.5 kg, p < 0.001). Safety: Gastrointestinal disturbances were reported in 20% of the Liraglutide group and 10% of the Sitagliptin group (p = 0.04). Hypoglycemia occurred in 4% and 2% of patients in the Liraglutide and Sitagliptin groups, respectively (p = 0.58). Conclusions: Liraglutide was more effective than Sitagliptin in reducing HbA1c, FBG, PPBG, and body weight over 12 weeks. However, Liraglutide was associated with a higher incidence of mild gastrointestinal side effects. Both drugs were safe and well-tolerated overall.

Background: Psoriasis is a chronic, immune-mediated inflammatory disorder affecting the skin, nails, and joints. Childhood psoriasis presents distinct clinical features compared to adult-onset psoriasis, yet data on pediatric cases in eastern India remain scarce. This study aims to evaluate the clinical characteristics of childhood psoriasis in patients attending SLN Medical College and Hospital, Koraput, Odisha. Methods: A hospital-based observational study was conducted in the Department of Dermatology at SLN Medical College and Hospital, Koraput, Odisha, over a period of 12 months (July 2021 to June 2022). Pediatric patients (≤14 years) diagnosed with psoriasis were included. Clinical, demographic, and epidemiological data were collected through detailed dermatological examinations and relevant laboratory investigations. Statistical analysis was performed using R software. Results: A total of 38 pediatric psoriasis cases were analyzed. The most affected age group was 9-13 years (50%), with a female predominance (60.5%). Seasonal variation was observed, with peak cases in spring (36.8%) and autumn (28.9%). The lower extremities (39.5%) and scalp (36.8%) were the most common sites of onset, while the extremities (68.4%) were the most frequently affected areas. The predominant clinical subtype was plaque psoriasis (53.85%), followed by plantar psoriasis (30.77%). Pruritus was the most common symptom (92.31%), and nail involvement was noted in 15.38% of cases. A positive family history was recorded in 7.69% of cases. Conclusion: Pediatric psoriasis exhibits distinct epidemiological patterns, with a higher prevalence in females, a peak onset in late childhood, and significant seasonal variation. Plaque psoriasis remains the most common clinical subtype, with increased plantar involvement compared to international reports. These findings highlight the need for further longitudinal studies to assess genetic and environmental influences on childhood psoriasis in eastern India.

Background: Cardiovascular diseases (CVDs) remain the leading cause of mortality and morbidity worldwide, particularly in low- and middle-income countries, with metabolic syndrome (MS) being a significant risk factor for CVDs. This study aimed to assess the prevalence of MS among hypertensive patients attending a tertiary hospital in Odisha. Materials and Methods: A cross-sectional study was conducted at VIMSAR Medical College and Hospital, Burla, Odisha. The study included 320 hypertensive patients (156 males, 164 females) aged ≥18 years. Data were collected using a structured, pre-tested, interviewer-administered questionnaire. MS was diagnosed according to the NCEP ATP III criteria. Various parameters, including blood pressure, waist circumference, lipid profile, and fasting glucose, were measured. Results: The prevalence of MS was found to be 40.3% among hypertensive patients. The prevalence was higher in males (72.1%) than in females (27.9%). Significant differences were observed in systolic blood pressure (SBP) and waist circumference (WC), with males having higher SBP and females showing significantly greater WC. The prevalence of individual MS criteria showed that 45% of participants had increased WC, 36.6% had Type II diabetes, and 34.4% had low HDL-C. Conclusion: Metabolic syndrome is highly prevalent among hypertensive individuals, indicating a significant risk for cardiovascular events. Early detection and intervention are crucial to prevent the progression of cardiovascular diseases. Routine screening for MS and associated risk factors, along with lifestyle modifications, can significantly reduce the cardiovascular disease burden

Introduction: Ischemic stroke is a leading cause of morbidity and mortality worldwide. Dyslipidemia and inflammation play critical roles in its pathophysiology. The triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio has been suggested as a marker of atherogenic dyslipidemia, while C-reactive protein (CRP) serves as an inflammatory biomarker. This study aims to compare TG/HDL-C and CRP levels between ischemic stroke patients and a healthy control group. Materials and methods: A case-control study was conducted in the Department of Medicine at Tertiary Care Teaching Hospital. Patients including ischemic stroke patients and age- and sex-matched healthy controls. Adults aged 18 years or older Confirmed diagnosis of ischemic stroke based on clinical evaluation and neuroimaging (e.g., CT or MRI). Stroke onset within a specified time frame (e.g., within 72 hours of symptom onset) were included. Exclusion of individuals with hemorrhagic stroke, transient ischemic attack (TIA), or other non-ischemic cerebrovascular events. Serum TG, HDL-C, and CRP levels were measured and the TG/HDL-C ratio was calculated. Results: The baseline characteristics of the study participants, including age, sex, and blood pressure, are summarized in Table 1. The study population consisted of individuals aged 40 to 70 years. The mean age of the control group was 48.5±6.2 years, while the AIS group had a mean age of 54.7±7.5 years. The sex distribution was nearly equal, with 72 males and 38 females in the control group and 68 males and 42 females in the AIS group. Confounding variables such as smoking, diabetes mellitus, hypertension, and a history of cardiovascular disease were considered. Laboratory parameters, including inflammatory markers and lipid ratios, were analyzed to assess differences between AIS and control groups. The mean CRP level was significantly higher in AIS patients (0.35 mg%) compared to controls (0.08 mg%, p < 0.001), indicating a strong inflammatory response in AIS cases. Similarly, the TG/HDL-C ratio was significantly elevated in AIS patients (3.01) compared to the control group (2.45, p = 0.012). The correlation analysis indicated no significant relationship between CRP and TG/HDL-C in either group (p > 0.05). Conclusions: This study reinforces the multifactorial nature of ischemic stroke and underscores the importance of a comprehensive approach to stroke prevention, including the management of inflammation, dyslipidemia, and hypertension. Early identification of high-risk individuals using biomarkers like CRP and TG/HDL-C ratio, along with targeted interventions, may help reduce the burden of ischemic stroke.

Introduction: Amenorrhea, the absence of menstrual periods, is a common gynecological condition with diverse etiological factors, including endocrine disorders, genetic conditions, and lifestyle influences. This study aims to evaluate the underlying causes of amenorrhea in a cohort of women presenting with this condition, focusing on identifying the most prevalent etiological factors and their clinical implications. Material and Methods: A total of 250 women aged 15-45 years with primary or secondary amenorrhea were included in the study. Inclusion criteria comprised women with no menstrual periods for at least three months (secondary amenorrhea) or no menstruation by age 16 (primary amenorrhea). Exclusion criteria included pregnancy, known hormonal disorders, or recent use of hormonal contraceptives. A comprehensive evaluation, including medical history, physical examination, hormonal assays (FSH, LH, prolactin, TSH, estradiol), and pelvic ultrasound, was conducted to identify the etiological factors. Results: The study revealed that polycystic ovary syndrome (PCOS) was the most common cause of amenorrhea (35%), followed by hypothalamic amenorrhea (25%), hyperprolactinemia (15%), and primary ovarian insufficiency (10%). Other causes accounted for 15% of cases. Laboratory findings showed elevated FSH levels in 40% of patients, while imaging studies identified polycystic ovaries in 35% of cases. Conclusion: This study highlights the diverse etiological factors contributing to amenorrhea, with PCOS being the predominant cause. A systematic diagnostic approach, including hormonal and imaging evaluations, is essential for accurate diagnosis and effective management. Early identification of the underlying cause can significantly improve patient outcomes and guide targeted therapeutic interventions.a

Introduction: General anaesthesia (GA) has been used for lumbar spine surgeries as a routine practice by many anaesthesiologists. But few studies have shown that spinal anaesthesia (SA) is a better anaesthetic technique for 1 or 2-level lumbar laminectomy in terms of perioperative variables as it causes less morbidity. With this study, we aim to compare the perioperative outcome variables after lumbar laminectomy under SA and GA. Methodology: In the study, 60 patients undergoing one or two-level elective lumbar laminectomy for diagnosed disc herniation or lumbar canal stenosis were included. Patients were randomized into two groups: Group S (n=30) received spinal anaesthesia and Group G (n=30) received general anaesthesia. The primary objective was to compare anaesthesia duration between both groups. Secondary objectives were to compare blood loss, hemodynamic stability, operative time, time from entering the operating room (OR) to incision, time from placement of surgical dressing until patient exits from the OR, surgeon satisfaction, patient satisfaction, post-anaesthesia care unit (PACU) time, total analgesic dose given in first 24 hours and duration of hospital stay between both the groups. Results: In our study, all time durations i.e., anaesthesia duration, mean time from entering OR to incision, mean time from placement of surgical dressing until patient exits from the OR, mean surgical time, PACU time, and hospital stay were significantly shorter in the Group S. As compare to Group G, Group S had significantly less intraoperative blood loss whereas surgeon’s and patients’ satisfaction was reported significantly higher. Haemodynamic variations were less in the Group S but the difference was insignificant. Conclusion:  The outcomes of spinal anaesthesia in terms of perioperative variables when compared to general anaesthesia are significantly better. Thus, we can safely and reliably use spinal anaesthesia in cases of 1 or 2-level elective lumbar laminectomies.

Background Learning environment of an educational system determines the quality and quantity of its products, including the graduated bodies. Over the years, researchers have worked to identify the factors that contribute to the overall. In order to be able to measure the climate, they compare it with the product and then improve the climate. Methods In the present study, the DREEM inventory was administered to undergraduate medical students of Second year medical (150), paramedical  (175), Dental students  (100) . Scores obtained were expressed as mean ± Standard Deviation (SD) and analyzed using Microsoft excel 2007 (Microsoft Co., Redmond, WA, USA) and the Statistical Package for the Social Sciences (SPSS) program, version 20. P-value < 0.05 was considered as significant. Result: The total DREEM score of 117.14 was recorded. The paramedical students were found to be more satisfied with learning environment in comparison with medical and dental students Evaluating the sub-domains of perception, students had a more positive perception of learning (24.77), their perception of course organizers moved in the right direction (29.26), their academic self-perception was more on the positive side (21.51), they had a more positive perception of atmosphere (27.59) and their social self-perception could be graded as not too bad (15.62). Conclusion: The present study revealed that all the groups of students perceived their learning environment positively. However, a few problematic areas of learning environment were perceived such as: students were stressed We plan to obtain regular student feedback as the curriculum becomes progressively integrated and student centric.

Background: Abdominal wound dehiscence can result in evisceration requiring immediate treatment, prolonging the hospital stay, increasing the incidence of incisional hernia, and requiring subsequent reoperations underlying the severity of this complication. No single cause is responsible for wound dehiscence and as a rule, a combination of factors is operating. Many factors like anemia, jaundice, uremia, diabetes, hypo albuminemia, peritonitis, wound infection, and experience of surgeons have been identified. This study aimed to determine the possible risk factors for abdominal wound dehiscence and its management. Methods: After the patient was selected based on the inclusion and exclusion criteria, a detailed history and clinical examination were conducted. The data was noted on a proforma, which included factors like age, gender, co-morbid factors, type of surgery, type of Intestinal pathology, type of incision, anemia, obesity, renal function test, serum electrolytes, and hypoalbuminemia. All the patients with wound dehiscence were given intravenous antibiotics according to culture and sensitivity and treated with various management strategies.  Results: The study analyzed 50 patients with abdominal wound dehiscence (AWD). Most cases were males (56%), with the majority aged 51–60. Emergency surgeries (62%) were more commonly associated with AWD, with laparotomy for perforated ulcers being the most frequent preceding procedure (18%). Anemia (62%) and hypoalbuminemia (54%) were prevalent risk factors. Escherichia coli was the most commonly isolated organism (56%). The majority of cases (64%) had partial dehiscence, while complete dehiscence (36%) was predominantly seen in males (72%). Polyglactin sutures were associated with the highest incidence of dehiscence (52%). The average hospital stay was 23.5 days, with complications prolonging recovery. Conclusion: Abdominal wound dehiscence (AWD) is influenced by patient factors (age, anemia, hypoalbuminemia), patient’s co-morbid conditions like chronic obstructive pulmonary disease, diabetes, hypertension, and obesity should be identified prior and should be managed appropriately to reduce the incidence of wound dehiscence. Surgical techniques and emergency settings are also important determinants. Proper preoperative optimization, use of appropriate suture materials, and timely management are essential to reducing complications.patients.

This retrospective research was conducted at the Rheumatology Department of SRMC/SRIHER in Chennai from March 2018 to March 2023. The aim of the study was to investigate the demographic, clinical, and serological characteristics, as well as treatment approaches, for individuals aged 18 and above diagnosed with renal tubular acidosis (RTA) associated with autoimmune disorders in South India. The screening identified 54 RTA patients, with primary Sjögren’s syndrome (SS) being the most prevalent (n=22), followed by one case each of systemic lupus erythematosus (SLE) and overlap syndrome. Distal RTA was the predominant subtype (n=16), presenting with proximal lower limb weakness and myalgias in 17 patients. Autoantibodies SSA/SSB+ and positive Ro52 were frequently observed, with consistently normal C3/C4 levels. Notably, hypokalemic periodic paralysis and fatigue were hallmark features in autoimmune cases, in contrast to non-rheumatological causes. Females below 50 years were predominantly affected in rheumatological conditions, whereas both genders over 50 were affected in non-rheumatological cases. Common manifestations included oral and ocular sicca, with SS identified as the leading autoimmune cause of RTA. Type 1 RTA was prevalent in autoimmune cases, whereas all types were observed in non-rheumatological cases. Strikingly, interstitial lung disease was conspicuously absent in this cohort. This detailed analysis offers valuable insights into the unique clinical presentations and associated conditions in autoimmune and non-autoimmune RTA cases.