Background and Objectives: Antibiotic resistance is a growing concern worldwide. Laparoscopic cholecystectomy is a common surgical procedure where antibiotic prophylaxis is often used. Traditionally antibiotics have been advised pre and post operatively in surgery for gall bladder. The knowledge about usage of a single dose prophylactic preoperative antibiotic in comparison to conventional usage of perioperative antibiotics in laparoscopic Cholecystectomy is limited. Hence, this study focuses on comparing the efficacy of a single dose prophylactic antibiotic versus the usage of pre and postoperative antibiotics in laparoscopic Cholecystectomy. To assess the incidence of surgical site infections (SSIs) and antibiotic-resistant bacteria. To identify risk factors for SSIs and antibiotic resistance. Method: This is a prospective study conducted in the Department of General Surgery, at JNKTMCH, Madhepura. Study duration is Two years. Over 192 consecutive patients subjected for laparoscopic Cholecystectomy were included in study. They were divided in two groups (A&B) after applying exclusion. 74 patients in group A were given single dose of preoperative prophylactic antibiotic. No further post-operative antibiotics were given. 78 patients in group B were given both pre and postoperative antibiotics. Infective complications and cost constraints were compared between both the groups. Statistical analysis was done using chi-square test wherever necessary. Conclusion: Usage of single dose prophylactic preoperative antibiotics with no further post operative antibiotics would be sufficient to prevent surgical site infection in uncomplicated laparoscopic Cholecystectomy.

DOI: 10.5281/zenodo.

Background and Objectives: Secondary peritonitis is a severe and potentially life-threatening condition. Early prediction of mortality is crucial for optimizing treatment strategies. (1) To compare the predictive value of lactate clearance and base deficit for mortality in secondary peritonitis. (2) To evaluate the relationship between lactate clearance, base deficit, and severity of peritonitis. (3) To identify the optimal cutoff values for lactate clearance and base deficit for predicting mortality. Methods: Prospective cohort study. Lactate levels are normally maintained at less than 1.5 mmol/L using a delicate balance between production and clearance (by liver and kidneys). Hyperlactemia has shown correlation with higher mortality. In our study on 30 indoor patients of perforation peritonitis in JNKTMCH, Madhepura Bihar. we found that higher lactate level (> 4) is associated with higher ventilator need (80%) and hence higher mortality (60%).

DOI: 10.5281/zenodo.

Introduction: Pregnancy-Induced Hypertension (PIH) is a significant global health concern, contributing to maternal and fetal morbidity and mortality. Among hypertensive disorders of pregnancy, preeclampsia is particularly severe, characterized by elevated blood pressure and multi-organ dysfunction, leading to complications such as placental abruption, intrauterine growth restriction, and preterm birth. Its complex etiology involves genetic predisposition, immune dysfunction, and vascular abnormalities. Early prediction of PIH is critical for timely intervention and improved outcomes. The HDP Gestosis Score, incorporating clinical and biochemical factors, offers a promising approach for stratifying risk and identifying high-risk patients in the first trimester. Material and Methods: This prospective observational study was conducted over one year in the Obstetrics and Gynecology Department of a tertiary care center to evaluate the HDP Gestosis Score’s predictive ability for PIH. A total of 100 first-trimester antenatal patients meeting inclusion criteria were enrolled. Baseline demographic and clinical data, including maternal age, BMI, family history, and obstetric history, were collected. The HDP Gestosis Score was calculated, and patients were categorized into risk groups. Regular follow-ups included blood pressure monitoring and clinical assessments to track PIH development. Statistical analysis, including sensitivity, specificity, and predictive values, was performed using SPSS 21.1, with significance set at p < 0.05. Results: Among the 100 participants, 52% were categorized as high risk (score ≥3), 33% as moderate risk (score 2), and 15% as low risk (score 1). The score exhibited a high sensitivity of 98.11% and a strong negative predictive value (95.24%), effectively ruling out low-risk patients, while the specificity was moderate at 42.55%. PIH development was significantly higher in patients with a score ≥3, with 96.3% confirmed cases by the final visit, compared to lower scores. Key risk factors associated with higher scores included elevated MAP (>85 mmHg, 26%), obesity (20%), and primigravida status (57%). These findings underline the HDP Gestosis Score’s strength as an early risk assessment tool, although its moderate specificity suggests the need for integration with additional diagnostic methods for enhanced predictive accuracy. Conclusion: The HDP Gestosis Score demonstrated high sensitivity and reliability in predicting Pregnancy-Induced Hypertension (PIH) among first-trimester antenatal patients, enabling early identification of high-risk cases. While its moderate specificity indicates room for improvement, integrating the score with additional diagnostic tools can enhance its accuracy.

DOI: 10.5281/zenodo.

Background: Ovarian lesions manifest with a wide spectrum of clinical and morphological features. Neoplastic lesions of Ovary present as diverse histo-morphological entities as they arise from different cells of origin.The present study was conducted to identify the different histo-pathological lesions of ovary in a tertiary care hospital. Methods: This was a retrospective record based 1 year study conducted in Department of Pathology, Sardar Patel Medical College, Bikaner and included a total of 175 Ovarian specimens which were diagnosed by histo-pathological examination. Results: Total of 175 ovarian lesions were studied. 95 lesions were non neoplastic whereas 80 lesions were identified to be of neoplastic etiology. Most common non – neoplastic lesion was Follicular cyst with 19 cases (10.85%) followed by Cystic follicle with 14 (8%) cases. Most common neoplastic benign lesion was Serous Cystadenoma with 23 cases (13.14%) and most common Neoplastic Malignant lesion was Serous Cystadenocarcinoma with 4 cases (2.28%). Conclusion: Due to differing histologic subtypes of various ovarian lesions and similar presenting features in both neoplastic and non-neoplastic cases, histopahological study is an essential step in making an accurate diagnosis of lesions of Ovary.

DOI: 10.5281/zenodo.

Background: Chronic Obstructive Pulmonary Disease (COPD) is a severe respiratory condition causing significant morbidity and mortality worldwide, primarily due to long-term exposure to harmful particles or gases, particularly cigarette smoke. Aim: This study aims to evaluate zinc levels, ALP activity, and RBS measurements in patients with COPD, with the goal of understanding their roles as potential biomarkers for systemic effects and disease management. Results: The study found that COPD patients and healthy controls had similar average ages, RBS levels, ALP levels, and zinc concentrations. However, when comparing the two groups using indicators like RBS, ALP, and serum zinc levels, a statistically significant difference was found. In the COPD patient group, there was a positive correlation between ALP and zinc, while in the control group, there was a positive association between ALP and zinc. Conclusion: Monitoring COPD patients’ zinc, alkaline phosphatase, and random blood sugar levels can reveal systemic impact, comorbidities, inflammation, and immune response impairment. Monitoring these indicators helps develop effective treatment strategies and reduce systemic consequences, enhancing patient care and overall outcomes.

DOI: 10.5281/zenodo.

The concept of “Food as Medicine” has gained significant traction as a preventive and therapeutic tool in managing chronic diseases. Non-communicable diseases (NCDs) such as cardiovascular disease, type 2 diabetes, obesity, and cancer account for the majority of global mortality and morbidity, emphasizing the need for preventive measures beyond pharmaceutical interventions. Dietary interventions, including plant-based diets, Mediterranean diets, anti-inflammatory diets, and personalized nutrition plans, have emerged as powerful strategies for reducing disease risk and improving overall health outcomes. This systematic review evaluates the efficacy of dietary interventions in preventing and managing chronic diseases, synthesizing evidence from 32 peer-reviewed studies using a PRISMA-based framework.
The results underscore that diet improvements can lower chronic disease risk factors by enhancing metabolic health, reducing chronic inflammation, and promoting a healthy body weight. Research from various studies shows that plant-based diets, high in fruits, vegetables, legumes, and whole grains, protect against reduced risk of heart disease, diabetes, and obesity. In particular, Mediterranean and anti-inflammatory dietary patterns can reduce cardiovascular risk factors, enhance insulin sensitivity, and improve mental health outcomes. Berries, nuts, and other anti-oxidant-rich foods minimize oxidative stress, a key driver of chronic disease progression. Neuroprotective foods with omega-3 fatty acids and polyphenols have also been demonstrated to improve brain function in people and diminish the chance of neurodegenerative diseases. Moreover, diet types preserving muscle and bone are fundamental to avoiding such age-related diseases as osteoporosis and sarcopenia. Nevertheless, long-term compliance, social-economic obstacles, and cultural traditions are significant challenges. The review emphasizes the need for personalized, culturally sensitive dietary approaches to improve health outcomes and encourage long-term behaviour change. Data were also collected to assess potential modifications for this. Future studies should focus on the multimodal approach of food-based interventions within healthcare delivery systems, to ease the burden of chronic diseases worldwide.

DOI: 10.5281/zenodo.

Ocular diseases, including glaucoma, macular degeneration, diabetic retinopathy, and dry eye syndrome, remain significant causes of vision impairment and blindness worldwide. Traditional drug delivery methods, such as eye drops and ointments, often face limitations in achieving optimal therapeutic outcomes due to poor bioavailability, rapid tear clearance, and low patient compliance. Advanced drug delivery systems, such as nanocarriers, microneedles, in situ gels, and sustained-release implant devices, hold promise in surmounting these challenges to enhance bioavailability, targeting efficiency, and drug retention time in ocular tissues. Through this systematic review, we hope to provide insights into the recent developments, hurdles, and further potentials in advanced drug delivery for ocular diseases. Through an assessment of peer-reviewed studies, we uncover novel approaches to maximize drug effectiveness and patient outcomes while reducing unwanted side effects. Advanced drug delivery systems have developed as novel approaches to overcome the limitations of conventional ocular therapies. By enhancing drug targeting and bioavailability and enabling prolonged release, these systems hold potential for improved therapeutic efficacy. To illustrate, nanocarriers and microneedles have demonstrated their ability to alleviate the frequency of dosing and potentially enhance patient compliance considerably. In addition, these recent advancements in drug delivery technology provide new opportunities for personalized medicine approaches, wherein treatment protocols are adapted to meet the needs of the individual patient and their unique ocular disease. However, there are still multiple barriers to solve concerning the economic, regulatory, and long-term safety where evidence is still lacking. In this review, we discuss current progress in ocular drug delivery systems and suggest future directions in this important area of research and development.

DOI: 10.5281/zenodo.