Background and Objectives: Acute ischemic stroke (AIS) is a leading cause of morbidity and mortality worldwide. Inflammation plays a crucial role in the pathogenesis of AIS. High-sensitivity C-reactive protein (HS-CRP) is a sensitive marker of inflammation.  Use of serum markers has been a established practice in medicine. CRP levels have been known to provide a estimate of inflammation. The present study was formulated to ascertain if levels of CRP in acute ischaemic stroke cases can be a prognostic or diagnostic marker for the condition. Methods: The study was a prospective case control format and utilized a subject pool of 50 subjects as case and control each. The study observed a significantly elevated level of CRP in cases with an acute ischaemic stroke. The study concluded that use of CRP can be a an effective modality in clinical practice in managing such cases. To investigate the relationship between HS-CRP levels and AIS. To evaluate the predictive value of HS-CRP for AIS. To examine the association between HS-CRP and stroke severity.

DOI: 10.5281/zenodo.

Background: Five phenomena constitute the primary clinical components of dissociative psychopathology: amnesia, depersonalization, derealization, identity confusion, and identity alteration. There is a high degree of phenomenological overlap and functional interplay between schizophrenic syndromes, posttraumatic conditions and dissociative disorders. The present study aimed to see if there is any association between adult dissociative symptoms and general psychopathology in patients with schizophrenia. Materials & Methods: The study had a cross-sectional design with purposive sampling with a sample size of 60 patients with schizophrenia who were assessed by the Dissociative Experiences Scale (DES-II) and Positive and Negative Syndrome Scale (PANSS) for Schizophrenia. Results: The Mean DES score was14.67 ±9.90. Total 8.3% of the subjects reported high dissociation (Mean DES score ≥30). There was a significant positive correlation between Dissociative symptoms (measured by Mean DES score) and Psychopathology (measured by PANSS positive symptoms and Total PANSS score) in patients with schizophrenia. Conclusion: The concept of dissociation or dissociative symptomatology is widely associated with psychotic symptoms. The present study emphasizes the importance of assessing dissociative symptoms in patients with schizophrenia to ensure that the most appropriate and effective interventions are provided to this patient group.

DOI: 10.5281/zenodo.

Infections caused by VRE are difficult to treat because different gene clusters are known to confer Vancomycin resistance. Van A and Van B genes are transferable and clinically relevant. This study aimed to identify Vancomycin resistant genotypes in strains causing U.T.I. Out of 250 Enterococci 37 (14.8%) of the isolates were Vancomycin Resistant Enterococci (VRE) of which 17(45.94%) were from male and 20 (54.05%) were from female Patients. Total species distribution in VRE isolates was 3(8.1%), 31(83.78%) and 3(8.1%) for E. faecalis, E. faecium, other sps. Antibiotic resistance profile of VRE isolates was evaluated. All the VRE strains were 100% resistant to Ampicillin whereas 89.18% VRE strains were resistant to Ciprofloxacin and 78.3% VRE strains were resistant to High Level Gentamicin. Van A and Van B genes were detected in 14(37.8%) and 1(2.7%) of strains respectively. The present study showed prevalence of Van A and Van B genes carrying Enterococcus in urinary isolates.

DOI: 10.5281/zenodo.

Objective: This study aims to identify Gram-negative organisms from endotracheal (ET) tube secretions in ICU patients, focusing on their antimicrobial resistance profiles, especially carbapenemase production. Methods: A cross-sectional study was conducted over 20 months in the Department of Microbiology, JNMC, Sawangi. ET secretions from 104 patients were processed for microbiological culture and antimicrobial susceptibility testing. Special resistance mechanisms, including ESBL, AmpC, and carbapenemase production, were identified. Results: The study showed a predominance of Acinetobacter spp. (42.3%) among isolates, followed by Klebsiella pneumoniae (22.1%) and Pseudomonas aeruginosa (18.3%). Resistance to imipenem was 100%, and carbapenemase production was noted in 30.7% of isolates. ESBL and AmpC production were seen in 19.2% and 11.5% of isolates, respectively. Conclusions: This study emphasizes the high prevalence of MDR organisms in ICU patients and highlights the urgent need for antimicrobial stewardship and robust infection control practices.

DOI: 10.5281/zenodo.

Background: The development of isolates of Klebsiella pneumoniae and Escherichia coli that produce metallo-beta-lactamase (MBL) is a serious problem in clinical microbiology because of their resistance to carbapenems and other beta-lactam antibiotics. For these illnesses to be properly managed, quick and accurate identification techniques are essential. Methods: A cross-sectional observational study was conducted over two years at a tertiary care hospital in Central India. A total of 10,320 clinical specimens were analyzed, yielding 480 non-duplicate isolates of E. coli (260) and K. pneumoniae (220). Imipenem resistance was screened using a 10-µg disk, and MBL production was detected using CDT and E-test. Results: imipenem resistance was found in 168 (35%) of the 480 isolates, including 72 (15%) K. pneumoniae and 96 (20%) E. coli. In 80 (47.62%) of the isolates that were imipenem-resistant, MBL production was verified. 37% of K. pneumoniae and 42% of E. coli had MBL identified by CDT, whereas the E-test had somewhat higher detection rates (41.66% and 48%, respectively). Conclusion: This study highlights the growing prevalence of MBL-producing E. coli and K. pneumoniae in clinical settings. The E-test showed superior sensitivity compared to CDT, making it a more reliable method for MBL detection. Routine screening and confirmation of MBL production are essential for implementing effective infection control measures and guiding antimicrobial therapy.

DOI: 10.5281/zenodo.

Background: Dacryocystitis, an inflammatory condition of the lacrimal sac, presents in both acute and chronic forms. Chronic dacryocystitis is more prevalent, accounting for 87.1% of epiphora cases, often causing social discomfort due to persistent eye-watering. Identifying the antibiogram of causative microorganisms is crucial for guiding effective antimicrobial therapy. This study aimed to evaluate the clinical profile and antibiogram of acute and chronic dacryocystitis. Method: This prospective observational study included patients with acute or chronic dacryocystitis attending the ophthalmology outpatient department. Eligible participants were enrolled, and samples were collected for microbiological analysis, including gram staining, culture, and sensitivity testing. Results: A total of 50 cases of acute and chronic dacryocystitis were included in the study. The majority of cases were observed in the >40-50 age group for both acute (25%) and chronic (34.2%) dacryocystitis. Staphylococcus aureus was the most common organism isolated in both acute and chronic cases. Staphylococcus epidermidis was also frequently isolated, particularly in chronic cases. Pseudomonas aeruginosa was the most common gram-negative organism isolated. Staphylococcus aureus showed a high susceptibility to vancomycin and gentamicin. Staphylococcus epidermidis showed a high susceptibility to vancomycin. Streptococcus pneumoniae: was highly susceptible to beta-lactam antibiotics. Pseudomonas aeruginosa: had a high susceptibility to beta-lactam antibiotics, moderate susceptibility to aminoglycosides, and variable susceptibility to fluoroquinolones. Conclusion: The most commonly isolated bacterial pathogen in dacryocystitis in this region was Staphylococcus (Gram-positive), followed by Pseudomonas, Pneumococcus, and Staphylococcus epidermidis. Vancomycin showed the highest efficacy against Gram-positive bacteria, while third-generation cephalosporins, gentamycin, and amikacin were most effective against Gram-negative bacteria.

DOI: 10.5281/zenodo.

Background: Numerous studies suggest that serum adenosine deaminase (ADA) activity could serve as a potential diagnostic marker for rheumatoid arthritis (RA). However, no independent study has validated this finding in our population. This study aims to measure total ADA activity in the serum of our RA patients and assess its diagnostic potential. Methods: The study included 50 RA patients who sought medical care at Prathima Institute of Medical Sciences, Karimnagar. An equal number of age- and sex-matched healthy controls were also enrolled. Blood samples were collected from all participants and analyzed for serum total ADA activity, C-reactive protein (CRP), and rheumatoid factor (RF). Results: Serum total ADA activity was significantly higher (p<0.01) in RA patients (30.9 ± 10.6 U/L) compared to healthy controls (13.66 ± 3.75 U/L). However, no significant difference (p>0.05) in ADA activity was observed between smokers and non-smokers within the RA group. Among the 50 RA patients, only 13 (26%) tested positive for CRP, and 11 (22%) tested positive for RF. Conclusion The significant difference in ADA activity between RA patients and healthy controls highlights its potential utility as a marker in diagnosing the disease within our population, especially when considered alongside clinical background.

DOI: 10.5281/zenodo.

Introduction: One of the microvascular side effects of hypertension that develops gradually is hypertensive retinopathy (HR). Gout is predisposed to by hyperuricemia, which is associated with metabolic syndrome. Additionally, it was considered a stand-alone risk factor for hypertension. SUA may be linked to certain eye conditions, according to a number of studies. The purpose of this study is to highlight how metabolic parameters affect heart rate, and it is hypothesized that SUA gave doctors valuable information about when to perform fundoscopic exams on hypertensive patients. Aim: To study the serum uric acid concentration (SUA) in patients of hypertensive retinopathy and relationship between both. Methodology: Observational cross sectional study was conducted to observe the relationship between serum uric acid and hypertensive retinopathy. Two groups cases 120 (with HR) and controls 120 (without HR) were compared. Serum uric acid was measured by Erba Mannheim XL 640 machine at MBS Hospital Kota. Hypertensive Retinopathy was assessed using indirect ophthalmoscope. Results & Conclusion: The data analysis of the cases showed the mean SUA level to be 6.2398(mg/dl) and the controls showed the mean SUA level of 5.5926(mg/dl).   A two sample t-Test to compare the means of Serum Uric Acid Level (mg/dl) for Cases and Controls.  Significance value (p value) for the test was achieved 0.015 (significant). Thus the study conclude that serum uric acid level is associated with incidence of Hypertensive Retinopathy. And according to ANOVA test it was also found that serum uric acid is associated with severity of Hypertensive Retinopathy. It was hypothesized that SUA gave doctors helpful information for scheduling funduscopic exams in hypertension patients and highlighted the impact of metabolic variables on HR.

DOI: 10.5281/zenodo.

Background: One of the main causes of avoidable blindness is diabetic retinopathy (DR), which is a serious worldwide health hazard associated with type 2 diabetes mellitus. Serum vitamin D levels in Type 2 diabetes patients with and without diabetic retinopathy will be assessed in this study, and the relationship between vitamin D levels and the severity of DR will be examined. Methods: 200 participants were split into two groups for this analytical cross-sectional study: Group A consisted of diabetic patients with DR, and Group B consisted of diabetic patients without DR. In accordance with ETDRS norms, participants received thorough ocular examinations and DR grading. Other biochemical and clinical indicators were examined in addition to serum vitamin D levels. To compare groups and find correlations, statistical analysis was done. Results: Group A exhibited significantly lower serum vitamin D levels (17.03 ± 5.11 ng/mL) compared to Group B (27.72 ± 3.81 ng/mL, p < 0.001). An inverse relationship was observed between serum vitamin D levels and DR severity, with the lowest levels seen in patients with proliferative DR (15.33 ± 4.4 ng/mL). Additionally, patients with longer diabetes duration, poorer glycemic control, and higher BMI were more likely to develop DR. Conclusion: In Type 2 diabetes, the presence and severity of diabetic retinopathy are linked to lower serum vitamin D levels. The degree of DR may be predicted by serum vitamin D levels. The possible impact of vitamin D supplementation in halting or slowing the progression of DR requires more research.

DOI: 10.5281/zenodo.

Aim The aim of this study was to measure early changes in anterior chamber morphology, including depth and angle, after phacoemulsification and foldable intraocular lens (IOL) implantation using Anterior Segment Optical Coherence Tomography (AS-OCT). Methods: A prospective observational study was conducted at the Outpatient Department of the Department of Ophthalmology, Govt. Medical College, Kota, Rajasthan, from December 2022 to May 2024. The study included 50 patients diagnosed with senile cataract who underwent phacoemulsification and foldable PCIOL implantation. Preoperative and postoperative evaluations, including ACD and ACA measurements using AS-OCT, were performed. Statistical analysis was carried out using paired t-tests and Tukey tests. Results: The mean age of participants was 69 ± 2.91 years, with a higher incidence of cataract among females (68%). Significant increases were observed in both ACD and ACA after surgery. The mean ACD increased from 2.51 ± 0.19 mm preoperatively to 3.95 ± 0.21 mm postoperatively (p < 0.05). The mean nasal angle increased by 11.68° (p < 0.05) and the temporal angle by 10.74° (p < 0.05). These changes were consistent across different grades of nuclear sclerosis (NS) cataracts. Gender-based analysis revealed greater increases in ACD and ACA in females. Conclusion: AS-OCT provides accurate, non-invasive imaging of anterior chamber parameters, showing significant increases in both ACD and ACA after cataract surgery. This tool plays a vital role in optimizing surgical outcomes by improving IOL placement and aiding in postoperative assessments, ultimately enhancing patient care.

DOI: 10.5281/zenodo.

Introduction: Hypertension is the health related risk factor in India with an increasing proportion of elderly people, a sedentary lifestyle and obesity associated with increasing urbanization and other lifestyle factors like high levels of salt intake, alcohol and tobacco consumption are contributing to this burden of hypertension. Hypotension following antihypertensive treatment is associated with retinal nerve fibre loss. Altered autoregulation of retinal circulation in hypertension and hypotension leading to hypoprfusion and ischemia of the tissues of retinal nerve fibres. Aim and Objectives: (1). To Compare RNFL thickness in hypertensive Patients on antihypertensive treatment and normotensive (Control Groups) by using Optical Coherence Tomography. (2). To comparison of RNFL thickness in hypertensive patients on different anti-hypertensive agent by using cirrus HD-OCT 500. (3). To comparison of RNFL thickness in different long duration of hypertension in patients by using cirrus HD-OCT 500. Materials and Methods: In a tertiary care facility, this cross-sectional study was carried out. The study included age-matched normotensives and patients with a diagnosis of hypertension. Therefore, a total of 100 patients, 50 patients with systemic hypertension and 50 age matched normotensives (above 40 years) were studied. Blood pressure measured using sphygmomanometer. Systolic BP, diastolic BP and pulse pressure measurement. Difference between (systolic, diastolic, mean arterial) blood pressure and IOP defined as ocular systolic perfusion pressure, ocular diastolic perfusion pressure and mean ocular perfusion pressure. Photography of the RNFL finding will be captured using OCT. Results: In our study statistically significant average RNFL thickness was detected in hypertensives on antihypertension treatment 98.31±7.01, when compared to the normotensives 102.51±8.72. Significant RNFL thickness reduction in hypertensives using antihypertensive medication suggests altered autoregulation, and low mean, diastolic, and systolic ocular perfusion pressure have raised the risk of optic nerve head damage. Furthermore, a number of studies have demonstrated that antihypertensive medications will lower the ocular perfusion pressure, which could potentially harm the perfusion of the optic nerve head. In the hypertensives group, the average RNFL thickness showed the reduction was significant over time (P < 0.001). Conclusion: In conclusion, the RNFL thickness in hypertensives patients on antihypertension treatment statistically significant reduced than average RNFL thickness in normotensives patients. The RNFL thickness of all four quadrant showed a significant reduction over time.

DOI: 10.5281/zenodo.

Background: Age-related macular degeneration (ARMD) is a leading cause of vision loss in the elderly, with systemic inflammation, as indicated by elevated C-reactive protein (CRP) levels, implicated in its pathogenesis. This study examines the association between serum CRP levels and stages of  ARMD, and related risk factors. Methods: This analytical cross-sectional study was conducted over 18 months at the Ophthalmology Department, Government Medical College, Kota. A total of 140 participants aged 40 years or older were included, with 70 ARMD cases and 70 controls. Detailed ocular and systemic evaluations were performed, including fundus examination and OCT. Serum CRP levels were measured using a latex-enhanced turbidimetric immunoassay. Statistical analysis, including t-tests and ANOVA, was conducted using SPSS, with p < 0.05 considered significant. Results: ARMD patients had significantly higher CRP levels (0.378 ± 0.26 mg/dL) compared to controls (0.19 ± 0.08 mg/dL, p < 0.05). CRP levels increased with ARMD severity: 0.15 ± 0.06 mg/dL in early, 0.50 ± 0.09 mg/dL in intermediate, and 0.84 ± 0.02 mg/dL in advanced stages (p < 0.05). Risk factors including age, smoking, hypertension, diabetes, cardiovascular disease, and alcohol consumption were significantly associated with higher CRP levels and advanced ARMD stages. Older age (>71 years) and cardiovascular disease were particularly linked to advanced ARMD. Conclusion: Elevated serum CRP levels are strongly associated with ARMD severity, emphasizing systemic inflammation’s role in its progression. Monitoring CRP may aid in ARMD prevention and treatment.

DOI: 10.5281/zenodo.

Background: The main goal of treatment for preventing damage to target organs and other problems from diabetes is still glucose control. When diabetes mellitus is present, poor glycemic control can be avoided with the prudent use of oral hypoglycemic medications (OHA). Drug utilization studies are a useful tool for assessing the rational use of medications in populations. Approach: Prior to starting the trial, the Institutional Ethics Committee’s necessary approval was acquired. After obtaining agreement, 300 Type II diabetes mellitus patients who met the study’s specific inclusion and exclusion criteria were added to the trial. These patients were given a case record form that included information about their sociodemographic profile and prescription pattern. The majority of patients (65%) were receiving combination therapy, while 35% were receiving antidiabetic monotherapy. Biguanides made up 50% of all prescribed medications, followed by sulfonylureas (26%), DPP4 inhibitors (21%), and OHA combination therapy. The most commonly prescribed medication was metformin (80%), followed by sulfonylureas (45%) and DPP4 inhibitors Teneligliptin (18%), Vildagliptin (15%). Conclusion: Metformin was the most commonly prescribed medication in diabetes.

DOI: 10.5281/zenodo.

Background: Acute cholecystitis is defined as an inflammation of the wall of the gallbladder. In many cases an impacted gallstone in the gallbladder infundibulum or in the cystic duct is the cause for the inflammatory process. About 80% of patients with acute cholecystitis give a history compatible with chronic cholecystitis. Acute cholecystitis begins as an attack of biliary colic, but in contrast to biliary colic, the pain does not subside. The pain is typically in the right upper quadrant or epigastrium and may radiate to the right upper part of the back or the interscapular area. Objective: To assess the signs, symptoms and radiological findings for the diagnosis of acute cholecystitis. Material: Present study is a hospital based descriptive study conducted at B.P. Koirala Institute of Health Sciences, Dharan, NEPAL. This Study was conducted among patients who attended Emergency or Out-patient department during September 2017 to August 2018. History was taken regarding onset of symptoms (pain, fever, jaundice). Physical examination was done and pulse rate, blood pressure, co-morbid conditions and icterus, abdominal examinations including tenderness, lump. All the patients underwent random blood sugar, complete blood count, Blood group, chest x-ray, serum urea, creatinine, Liver function test and ultrasonography of abdomen and pelvis. Result: Most of the patients were in the age group between 35-65 years. There were a total of 21 males and 39 females. Out of 60 patients 47(78.3%) had history of vomiting. Out of 60 patients 19(31.6%) had fever during presentation. None of them had jaundice. One patient had recurrent attack of cholecystitis during initial conservative period and 7(11.6%) patients had history of biliary colic. Seven (11.6%) patients had history of hypertension. 7 (11.6%) had history of diabetes mellitus. 10 (16.6%) had past history of surgery. On radiological imaging mean gall bladder wall thickness of all patients was 6.09±1.89 and out of 60 patients 11(18.33%) patients had pericholecystic collection.

DOI: 10.5281/zenodo.

Introduction: Poisoning is an important health hazard and one of the leading causes of mortality and morbidity worldwide^. The incidence of poisoning cases is increasing steadily with each passing year. Burden of poisoning is high but less authentic data is available on it as hospital records, population surveys and data registered by governmental authorities. With this background, present study is conducted to determine various socio –demographic factors responsible for poisoning in patients. Material and Methods: It was an observational study, carried out in Dept of Forensic Medicine and Toxicology at Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh. All patients admitted with history of poisoning or suspected poisoning in the institute, who attended in casualty, ICU and ward during study period were included in study. Written informed consent was taken from the cases or relatives. Information was collected from his/her accompanying family members if condition of the case was found to be unfavourable to respond to questions. Results: Majority of the cases were in the age group of 15-44 years (81.52%), Majority of poisoning cases 60.23% were married. The commonest poison to which cases were exposed was an organophosphorus compound which was seen in 61.36%) cases. The most common cause for consuming poison was found to be domestic 324 (45.70%). Conclusion: Present study showed that poisoning was commonly seen in the working age group. Males consumed/exposed to poison more as compared to females. Married males were affected more. Most commonly consumed/exposed poison was organophosphorus compounds.

DOI: 10.5281/zenodo.

Introduction: Prostate cancer (PC) is the second most common cancer globally, with significant incidence in India. Various treatment options exist, but Stereotactic Body Radiotherapy (SBRT) is emerging as a precise method for managing very low, low, and intermediate-risk PC. This study aims to assess the efficacy and toxicity profile of SBRT in these patients. Methods: This prospective observational study at Omega Hospital, Hyderabad, involved 30 patients with localized prostate cancer treated with Stereotactic Body Radiotherapy (SBRT). Inclusion criteria included men over 18 years with a WHO performance status of 0-2. The study assessed PSA levels and toxicity profiles during and after treatment, following ethical approvals. Results: In this study, 40% of participants were under 65, 20% were over 76, and the rest were aged 66–75. Mean baseline PSA dropped significantly from 11.86 ng/dl to 0.71 ng/dl over 12 months post-SBRT. Most experienced grade 1 acute gastrointestinal and genitourinary toxicity, with no toxicity above grade 1 by three months. Conclusion: This study underscores SBRT’s effectiveness and safety in localized prostate cancer, showing significant PSA reduction and durable biochemical control. With mostly grade 1 acute gastrointestinal and genitourinary toxicity, SBRT proves to be a viable treatment option, offering effective cancer control and minimal impact on quality of life.

DOI: 10.5281/zenodo.

Introduction: Preterm labour (PTL), occurring before 37 weeks, is a major cause of neonatal morbidity. Magnesium’s role in muscle relaxation and its potential to prevent PTL has drawn attention. This study aims to investigate the relationship between serum magnesium levels and PTL to explore its predictive and therapeutic value. Methods: This cross-sectional study was conducted at GSL Medical College, Rajahmundry, from October 2018 to March 2020, involving pregnant women aged 18-45 with gestational age between 24-37 weeks. Serum magnesium levels were measured and analyzed for correlation with preterm labour outcomes using SPSS software, with a significance level of p < 0.05. Results: A total of 80 participants were included, with 46% aged 25-29 years and 73.5% having a normal BMI. Serum magnesium levels were >1.7 mg/dL in 53.75%. Significant differences were found between serum magnesium levels and labour duration, delivery, and fetal outcomes, but not with parity, gestational age, or gestation period. Conclusion: This study underscores the role of serum magnesium in predicting and managing preterm labour. Lower magnesium levels were linked to increased labour complications, while higher levels improved outcomes. Though no significant correlation was observed with parity or gestation, magnesium remains crucial for uterine function and fetal well-being in obstetric care.

DOI: 10.5281/zenodo.

Introduction: Diabetes mellitus (DM) is a growing global epidemic, with 537 million people affected worldwide, and projected to reach 784 million by 2045. India, a major contributor, has a diabetes prevalence of 11.4%. This study aimed to investigate the correlation between sexual hormones and DM to better understand its impact. Methods: A cross-sectional study was conducted at Mallareddy Medical College between for women between December 2023 and February 2024. Adults aged 20-40 with prediabetes or diabetes were included, excluding pregnant women, PCOS patients, and those on hormonal medications. Blood samples were analyzed for HbA1c, testosterone, estradiol, and progesterone. Statistical analysis used Pearson/Spearman correlations. Results: The study included 100 participants, with a mean age of 35 for males and 33 for females. No significant correlation was found between HbA1c and testosterone in males (r = 0.068, p = 0.639), or estrogen (r = -0.002, p = 0.988) and progesterone (r = 0.48, p = 0.741) in females. Conclusion: The study concluded that sexual functions in diabetic patients may not be significantly influenced by testosterone, estrogen, or progesterone levels. Other factors, like neuropathy, likely contribute to sexual dysfunction. Healthcare professionals should consider the complex relationship between diabetes and sexual hormones. Further research on newly diagnosed patients is recommended.

DOI: 10.5281/zenodo.

Objective & Background: High incidence of diabetes and cardiovascular risk was due to urbanization in India. In South Asia, Indians were at high risk for T2 DM, CVD, and MS. So compared certain physiological parameters in metabolic syndrome and severe metabolic syndrome of male and female. Materials and Methods: A total 211 men and 239 women participants aged ≥35 years were included in this study. The comparative study of mean and SE done by ANOVA and with the Student-Newman-Keul’s multiple comparison methods. Results: The parameters like BMI, WC, SBP, DBP found significantly high in MS, and SMS in males and females compared with controls. The PR was found high significant between groups control vs. MS and SMS groups in male, and control vs. MS in females, but insignificant in Control vs. SMS in females. Further, the physiological factors WC, SBP, DBP was high significance in group MS vs SMS in male and female, also the BMI, and PR in males, but these two variables were insignificant in females. Conclusion & Interpretation: It was observed that the physiological variables showed a significant difference with MS, and SMS in the male and female, except PR in SMS female. And all these parameters showed significance in intergroup analysis of MS and SMS in male and female groups, except BMI and PR in females.

DOI: 10.5281/zenodo.

Introduction: Gallstones, a common biliary disorder in India, are classified as cholesterol, pigment, or mixed types, influenced by genetics, diet, obesity, and metabolic syndrome. This study aims to analyze the biochemical composition of gallstones in the Indian population, focusing on regional and demographic variations to guide prevention and treatment strategies. Methods: This prospective study, conducted at Konaseema Institute of Medical Sciences, analyzed gallstones from cholecystectomy patients (aged >18 years) between August 2022 and May 2024. Gallstones were biochemically classified as cholesterol, pigment, or mixed. Patient data, clinical features, and findings were statistically analyzed using SPSS, with significance set at P < 0.005. Results: Among 50 participants, 30% were male, with the majority (32%) aged 41–50 years. Abdominal pain was the most common symptom. USG revealed multiple stones in 39%. Mixed stones were predominant (74%), followed by pigment (16%) and cholesterol stones (10%). Grade 1 cholecystitis was most frequent (78%), followed by grade 2 (20%). Conclusion: This study underscores the high prevalence of mixed gallstones and grade 1 cholecystitis in the Indian population, highlighting the importance of early detection and management. Regional dietary and metabolic factors significantly influence gallstone composition, emphasizing the need for targeted prevention and treatment strategies. Limitations include the small sample size and single-center design.

DOI: 10.5281/zenodo.

Background: MDCT (Multi-Detector Computed Tomography) combined with enteroclysis or enterography has become a valuable tool in abdominal imaging. It provides detailed visualization of the small bowel wall and lumen through effective distension and allows assessment of the mesenteric vasculature. Additionally, it offers crucial insights into extraintestinal pathologies. The current study aimed to assess the role of MDCT in diagnosing and evaluating small bowel disorders. Methods: A prospective study involving 40 patients was conducted at a tertiary care hospital over two years. These patients were diagnosed with small bowel pathologies on MDCT and subsequently underwent surgery with histopathological examination. Intraoperative findings and histopathological results served as the standard reference for diagnosis. Inclusion Criteria were patients with small bowel pathologies identified on MDCT who underwent surgery with histopathological correlation. Results: This study evaluated MDCT in assessing small bowel diseases in 40 patients, comparing MDCT diagnoses with histopathology. Important findings include MDCT’s accurate identification of adenocarcinoma, GIST, and small bowel TB, with strong concordance between imaging and pathology. MDCT also effectively identified various causes of small bowel obstruction and perforation. While MDCT provided valuable diagnostic clues, it could not always provide definitive tissue characterization, emphasizing the need for histopathological confirmation. This study highlights MDCT’s clinical utility in detecting and characterizing a range of small bowel pathologies, guiding further investigations and treatment. Conclusion: This study demonstrated MDCT’s valuable role in assessing diverse small bowel pathologies. MDCT effectively identified neoplastic lesions like adenocarcinoma and GIST, inflammatory conditions such as small bowel TB and Crohn’s disease, and various causes of small bowel obstruction. While MDCT findings often correlate with histopathological diagnoses, they cannot always provide definitive tissue characterization. Integrating MDCT findings with clinical and pathological data is crucial for accurate diagnosis and management.

DOI: 10.5281/zenodo.

Background: Biomedical studies underpin improvements in medical know-how, patient care, and public fitness. The basic course in Biomedical research (BCBR), added through the Indian Council of scientific research (ICMR), goals to enhance research literacy among postgraduate college students and faculty in India. This study evaluates the information, mindset, and exercise (KAP) regarding BCBR among those groups at a medical university in Western Uttar Pradesh to identify gaps and opportunities for improvement. Methods: A cross -sectional Study was became performed amongst postgraduate MD/MS college students and school the usage of a based, tested questionnaire. The questionnaire assessed know-how (20 objects), mindset (10 gadgets), and exercise (10 objects) associated with BCBR. Reliability turned into showed with Cronbach’s alpha, and content validity became reviewed through specialists. statistics have been analyzed the usage of SPSS model 25, using descriptive information and Fisher’s genuine take a look at to compare responses among organizations, with importance set at p<0.05. Results: faculty scored better in know-how-primarily based questions, especially in framing studies questions (30% vs. 24%) and expertise ‘FINER’ criteria (60% vs. fifty-two%). each organization agreed on the significance of BCBR, with eighty% of school and sixty-three% of students finding course assignments useful. however, practical application of expertise, inclusive of statistical calculations, become greater difficult for college students (70% faculty vs. sixty-three % college students). Conclusion: The study highlights high quality attitudes towards BCBR but identifies gaps in practical software and conceptual knowledge among postgraduate college students. improving mentorship, introducing interactive and case-based totally getting to know, and presenting institutional guide should bridge these gaps. those efforts are important to foster a studies-oriented way of life and improve the overall research competency of clinical professionals.

DOI: 10.5281/zenodo.

Background: Snakebite envenomation kills many people each year around the world, particularly in rural areas of developing countries. this study was conducted to assess the clinical profile and outcome of snakebites in children less than 12 years. Materials and Methods: This prospective observational study was conducted in the Department of Pediatrics for a period of one year. All willing pediatric patients with a history of snakebites who were admitted were enrolled for the study. . Parameters studies included clinico-demographic profile of patients, treatment provided, and complications, if any.  Results: Majority of patients were in the age group of 9 to 12 years, and 68% were male. 82% of patients were from rural area, and lower limb was the commonest site of snakebite (80%). In most of the patients, clinical symptoms appeared within 3-6 hours (34%), Complications were reported in 9 patients, among which respiratory failure and encephalopathy were more common. Complications were significantly higher in patients with severe envenomation, requiring higher number of ASV vials. Conclusion: Delays in reaching the hospital, improper first aid, lack of ASV availability, and adverse reactions to ASV can worsen outcomes. Early referral to tertiary care significantly reduces fatality rates, highlighting the importance of timely medical intervention.

DOI: 10.5281/zenodo.

Background and objectives: Laparoscopic cholecystectomy is a common surgical procedure for gallstone disease. Understanding the socio-demographic and clinical profile of patients undergoing this procedure can inform healthcare planning and resource allocation.  In this study we evaluate the socio-demographic profile of patients undergoing elective laparoscopic cholecystectomy, to analyze the clinical characteristics of patients undergoing elective laparoscopic cholecystectomy.  To identify correlations between socio-demographic factors and clinical outcomes.  Methods: The present study was conducted at Department of General Surgery, at JNKTMCH, Madhepura. The 50 patients admitted for elective laparoscopic cholecystectomy, aging less than 75 years of both the genders were included. Results: In the present study, mean age of the patients was 44.12±11.56 years. In our study, majority of the patients (30%) were in age-group of 41-50 years followed by patients in age-group of 31-40 years (26%). 14% of the study subjects were aged more than 60 years while only 4% patients aged less than 20 years. 40% of the patients were male while 60% of the patients were female. Male to female ratio in the present study was 0.75:1. Conclusion: We concluded that a maximum patient in our study was 41-50 yrs age group female.

DOI: 10.5281/zenodo.

Background: Single incision laparoscopic assisted appendectomy (SILAA) is a minimally invasive surgical technique that offers potential benefits over traditional open and laparoscopic appendectomies. Laparoscopic appendectomy (LA) has advantage to diagnose and to also treat appendicitis at the same time also it has a less postoperative pain and a faster return to work and normal activity. In a classic LA, three to four incisions are required for trocars placement. Technique of Single Incision Laparoscopic Appendicectomy (SILA) has been developed to reduce abdominal trauma, improve cosmesis, reductions in postoperative pain and hospital stay. Aim of this prospective study was to test the feasibility, safety, and potential advantages of SILA.  Material and Methods: Patients over the age of 18 with a diagnosis of acute abdomen, later on confirmed to acute appendicitis based on clinical findings, imaging and laboratory tests were included in the study. Outcome of the patient was assessed in the form of operative time; length of hospital stays and postoperative complications. Prophylactic antibiotics were given pre-operatively to all the patients included in the study. Technique was evaluated for operative time, postoperative pain, post-operative length of stay and complication rate. Post-operative pain was evaluated at 12 hrs, day 1 and day 2 post-operatively by using a visual analogue scale (VAS) which ranged from 0 to 10. Patients were evaluated on the 7th and 14th postoperative day for analysis of recovery, any surgical site infection, abscess formation, abdominal tenderness, and aesthetic satisfaction. Conclusion: Single incision appendicectomy operative time is less, pain is less, and hospital stay is reduced thereby increasing the patient satisfaction and this technique is effective in terms of pain and hospital stay.

DOI: 10.5281/zenodo.

Background: Optic neuritis (ON) is an inflammation of the optic nerve, presenting with acute or sub-acute vision loss, pain in eye movements, and potentially altered colour vision. This systematic review aims to analyse the diagnostic accuracy of various biomarkers for optic neuritis. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed while conducting this systematic review. The literature search encompassed various databases such as PubMed, Science Direct and Cochrane library. Studies published from 2014-2024 were included in the analysis. The quality of the included studies was meticulously evaluated using the proper tools suited to the study design. The synthesis and analysis of data included a summary of study characteristics, aims and objectives, biomarkers, and main study results/conclusions. Results: Sample sizes range from 16 to 246 participants. Common biomarkers include serum levels of AQP4-IgG and MOG-IgG, MRI characteristics, Optical Coherence Tomography (OCT) and Neurofilament light chain (NfL), GFAP, and BDNF. MOG-associated ON tends to present with more bilateral involvement and is often linked to better visual outcomes than AQP4-associated ON. The studies consistently show significant differences in MRI lesions profiles between NMO and MS, aiding clinical differentiation. Furthermore, various studies report that serum biomarkers, particularly GFAP and BDNF, correlate with visual outcomes and disease severity, shedding light on potential new diagnostic tools. Conclusion: This systematic review underlines the critical role of specific biomarkers and imaging techniques in diagnosing, prognosticating, and managing optic neuritis.

DOI: 10.5281/zenodo.

Introduction Hepatitis B virus (HBV) and Hepatitis C virus (HCV) prevalence is continuously in increasing trends in Bihar, India; however, their exact state-wide prevalence data are not available till now. An understanding of HBV and HCV prevalence, risk factors and genotype distribution can be used to plan control measures in Bihar. Material & Method: A prospective, OPD-based serosurvey was conducted from March-2024 to October-2024 at ANMMCH Gaya, Bihar. Children aged >=5 years and adults were eligible to participate. Demographic and risk behavior data were collected, and serological specimens were obtained and tested for Hepatitis B surface antigen (HBsAg) and anti-HCV antibody. Result: Out of 14,707 and 8,767 OPD patients participated for the HBV and HCV prevalence study respectively shows 2.30% of HBV and 0.27% of HCV prevalent. Sex wise distribution shows there was male preponderance with 68.44% of HBV and 58% of HCV. Both HBsAg and Anti-HCV positivity was most prevalent in the 40–49 year-old and 30–39 year-old age groups with HBsAg was 30.09% and 24.77% and Anti-HCV was 33.33% and 25.0% in respective age group. Among all HBsAg positive cases having a history of Diabetes, Hypertension, Chronic Renal Failure and Cancer were 8.26%, 12.09%, 1.77% and 1.18% and among all Anti-HCV positive cases having a history of Diabetes, Hypertension, Chronic Renal Failure and Cancer were 3.15%, 3.94%, 0.79% and 0.79%. Conclusion: This study findings estimate the overall prevalence of chronic HBV and HCV infection, their associated risk factors and demographic characteristics. These findings help and guide prevention and control efforts, including management options.

DOI: 10.5281/zenodo.

Background: Comminuted proximal ulna fractures present significant challenges due to their complexity and potential for functional impairment. Locking plate fixation has become a widely used technique, providing stability and enabling early mobilization. This study evaluates the clinical and functional outcomes of locking plate fixation for comminuted proximal ulna fractures. Aim: To assess the clinical and functional outcomes of locking plate fixation in patients with comminuted proximal ulna fractures. Methods: This prospective observational study included 50 patients with comminuted proximal ulna fractures treated with locking plate fixation. Radiographic union rates and complication frequencies were used to assess clinical outcomes. Functional outcomes were evaluated using the Mayo Elbow Performance Score (MEPS) at 6-month and 12-month follow-ups. Results: Radiographic union was achieved in 94% of patients within an average of 12 weeks. The mean MEPS improved significantly, from 58 preoperatively to 84 at 6 months and 91 at 12 months (p<0.05). Complications included implant irritation (6%) and mild loss of motion (8%), with no cases of implant failure. Overall, 86% of patients achieved excellent to good functional outcomes. Conclusion: Locking plate fixation is a reliable method for treating comminuted proximal ulna fractures, providing superior stability and enabling early mobilization. In this prospective observational study of 50 patients, radiographic union was achieved in 94% within 12 weeks, with 86% demonstrating excellent to good functional outcomes based on the Mayo Elbow Performance Score (MEPS). Complications were minimal, including mild loss of motion (8%) and implant irritation (6%). These findings support the efficacy of locking plate fixation in managing complex fractures with high success rates and low complication risks.

DOI: 10.5281/zenodo.

Introduction: Chronic suppurative otitis media (CSOM), particularly tubotympanic CSOM, is commonly treated with tympanoplasty. While adjunctive mastoidectomy is debated, studies show mixed results. This study compares tympanoplasty outcomes with and without mastoidectomy, evaluating graft success, recurrence rates, hearing improvement, and postoperative complications to inform treatment decisions for tubotympanic CSOM. Methods: This prospective hospital-based study at KIMS, Amalapuram, included patients aged 15-55 with chronic ear discharge and hearing loss. Participants underwent detailed clinical, otoendoscopic, and radiological evaluations. Pure tone audiometry assessed hearing loss, and statistical analysis using SPSS 20.0 and Excel 2010 evaluated outcomes with P<0.05 for significance. Results: The study found that tympanoplasty with corticomastoidectomy showed higher graft success (92.1% vs. 85.3%) and lower recurrence rates (6.3% vs. 12.5%) compared to tympanoplasty alone. Postoperative hearing improvements were better in the corticomastoidectomy group. Complication rates were similar in both groups. Significant differences were observed in graft success and recurrence rates (P<0.05). Conclusion: Tympanoplasty with corticomastoidectomy offers improved graft success and lower recurrence rates compared to tympanoplasty alone in the management of tubotympanic CSOM. While both approaches provide significant postoperative hearing improvements, tailored surgical strategies, including corticomastoidectomy, may enhance long-term outcomes for patients with CSOM.

DOI: 10.5281/zenodo.

Introduction: Leprosy, caused by Mycobacterium leprae, remains a major public health issue in developing countries, affecting various organs. Multi-drug therapy (MDT) has significantly reduced cases, including Dapsone-resistant strains. Leprosy lesions are classified based on immune response into five types. This study aims to explore the histological types of leprosy. Methods: This prospective study, conducted at Mamata Academy of Medical Sciences, Hyderabad, from January 2023 to August 2024, included clinically diagnosed or suspected leprosy cases aged >18 years. Demographic data, clinical findings, and skin biopsies were recorded. Histopathological analysis, using H&E and Fite-Faraco staining, followed Ridley-Jopling classification and bacillary index. Results: Out of 52 leprosy cases, the majority (53.8%) were aged 21–40 years, with a male-to-female ratio of 1.3. Hypopigmented patches were the most common clinical finding (61.5%), followed by erythematous lesions (28.8%) and nerve thickening (9.6%). Histologically, BT was the most frequent type (34.6%), followed by BL (23.1%). Conclusion: This study highlights the importance of histopathological classification in leprosy diagnosis. The most common histological types were BT and BL, with strong clinical and histopathological correlation, especially for TT. Early diagnosis and appropriate treatment, including MDT, remain crucial in managing leprosy and preventing further complications.

DOI: 10.5281/zenodo.