Introduction: Vaccination in adults above 50 years is crucial to prevent vaccine-preventable diseases. However, awareness and attitudes towards adult immunization remain underexplored in developing regions. Objective: To estimate the awareness and attitudes towards adult vaccination among individuals aged above 50 years. Methods: A cross-sectional survey was conducted on 420 adults aged ≥50 years using a structured questionnaire. Data on demographics, awareness of key vaccines (influenza, pneumococcal, herpes zoster, hepatitis B, COVID-19), and vaccination attitudes were collected. Associations were analyzed using chi-square tests. Results: While 94.8% were aware of COVID-19 vaccination, only 51% knew about influenza vaccines, 44.3% about pneumococcal, and 26.7% about herpes zoster vaccines. Fear of side effects (36.2%) and lack of physician advice (55.2%) were significant deterrents. Awareness was positively associated with education, urban residence, and comorbidities (p<0.05). Notably, 78.6% were willing to vaccinate if informed. Conclusion: There is a substantial knowledge gap regarding adult vaccination beyond COVID-19. Improved public education and proactive physician involvement are essential to enhance vaccine coverage among older adults. Life.

Background: Sleep disturbances are common in patients with bipolar disorder and are linked to poor clinical outcomes. However, less is known about how these disturbances affect cognitive functions in the elderly population diagnosed with bipolar disorder. Methods: This cross-sectional study analyzed 200 elderly patients with bipolar disorder recruited from a tertiary care center. Sleep quality was assessed using the Pittsburgh Sleep Quality Index, and cognitive function was measured through standardized cognitive tests covering memory, executive function, attention, language skills, and visuospatial abilities. Statistical analyses included correlation coefficients and regression models to explore associations between sleep quality and cognitive performance. Results: The mean age of participants was 68.4 years, with a slight predominance of females (56.5%). The average score on the Pittsburgh Sleep Quality Index was 9.7, indicating poor sleep quality. Significant negative correlations were found between sleep quality measures such as total sleep time and sleep efficiency, and cognitive scores. Specifically, poorer sleep quality was associated with declines in memory (r = -0.38, p < 0.001), executive function (r = -0.42, p < 0.001), and other cognitive domains. Regression analysis confirmed that variations in sleep quality could explain a significant portion of the variability in cognitive performance. Conclusion: Poor sleep quality is significantly correlated with reduced cognitive function across multiple domains in elderly patients with bipolar disorder. These findings highlight the need for clinical interventions targeting sleep disturbances in order to potentially mitigate cognitive decline in this vulnerable population

Background & Methods: The aim of the study is to study the Thyroid Dysfunction & Incidence of Age-Related Macular Degeneration. Early AMD was defined as the absence of late AMD & presence of either (1) large (>125-lm diameter) indistinct soft or reticular drusen or (2) both large distinct soft drusen & retinal pigmentary abnormalities (hyper- or hypopigmentation) in either eye. Results: Hypothyroidism & hyperthyroidism were associated with an increased risk for the development of exudative AMD. Significantly associated (p<0.05). There was no significant association between increasing quintiles of serum FT4 levels. Conclusion: AMD is a disease whose risk factors & pathophysiology are not well understood & thus, AMD is often diagnosed in an already advanced stage. Thyroid hormones may contribute to a better characterization of AMD in clinical practice. Even though observational studies cannot determine causal inference, they provide useful evidence to improve the perception of specific illnesses, understand better the role of thyroid hormones in the pathogenesis of the AMD disease.

Background Fine-needle aspiration cytology (FNAC) is a widely used, minimally invasive diagnostic tool for evaluating salivary gland lesions. The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was introduced to provide a standardized classification with defined risk of malignancy (ROM) for each category, aiding in clinical decision-making. This study aims to assess the diagnostic accuracy, sensitivity, specificity, and risk stratification of salivary gland FNAC using the Milan system. Methods This retrospective study was conducted over a two-year period at a tertiary care center. FNAC samples of 150 salivary gland lesions were classified into six Milan system categories, and histopathological correlation was performed for all cases. Diagnostic parameters such as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy were calculated. The risk of malignancy (ROM) was assessed for each Milan category and compared with previous studies. Results The study demonstrated a sensitivity of 97.64%, specificity of 80.95%, PPV of 96.35%, and NPV of 84.0%, with an overall diagnostic accuracy of 93%. The highest ROM was observed in the malignant category (94.3%), while the lowest ROM (7.2%) was in the benign category. These findings align with international literature, reinforcing the reliability of the Milan system in salivary gland cytopathology. Conclusion The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is an effective and standardized classification system that enhances diagnostic precision and risk stratification. The high sensitivity and diagnostic accuracy observed in this study highlight the clinical utility of FNAC in salivary gland tumor evaluation. However, variations in specificity and ROM across different categories indicate a need for further refinement and validation. The study supports the continued use of MSRSGC to improve communication between cytopathologists and clinicians, ensuring optimal patient management.

Introduction: Hypertension is an asymptomatic disorder and usually comes into picture only when the patient presents with some end organ damage, hence it is referred to as a silent killer. It is the 3rd killer disease. World Health Statistics 2012 states that, every 1 in 3 adults has a high BP. In 2000 it was estimated that 1 billion i.e. nearly a quarter of the world’s population is suffering from hypertension. Prevalence of hypertension was estimated to be 40% in adults more than 25years in 2008. It is estimated to increase to 1.56 billion by 2025. Materials and Methods: A cross-sectional study was conducted by the department of Pharmacology in association with the department of Medicine at a Maheshwara Medical College and Hospital. Inclusion Criteria Patients who were above 25 years of age and had a confirmed diagnosis of hypertension were included in the study. Exclusion Criteria Indoor hypertension patients, individuals below 25 years of age, those with uncertain diagnosis, pregnant and lactating mothers, and patients who reported to the outpatient department but were subsequently admitted were excluded from the study. Results: In this prospective study, 460 patients were enrolled, with 258 (56.1%) males and 202 (43.9%) females. The mean age of the study population was 59.69 (±9.738) years. Among them, 58% were aged ≥60 years, while 42% were <60 years. Family history analysis revealed that 30% of patients had a history of hypertension, while 70% did not. Regarding social habits, 14 patients were smokers, 10 were alcoholics, 63 were ex-alcoholics, and 104 were ex-smokers. Conclusion: This study emphasizes the high burden of hypertension and its associated ---comorbidities, demonstrating that a significant proportion of patients require combination therapy for effective management. Addressing modifiable risk factors and adopting a multidisciplinary approach to hypertension management can significantly improve patient outcomes

Introduction Prostate cancer (PCa) is the second most frequently diagnosed malignancy and a leading cause of cancer-related mortality among men worldwide. Metabolic dysregulation is a hallmark of cancer, including prostate cancer, and plays a pivotal role in tumor initiation, progression, and resistance to therapy. Key metabolic parameters such as glucose metabolism, lipid metabolism, and energy homeostasis are often altered in prostate cancer. Hyperglycemia and insulin resistance, features commonly associated with metabolic syndrome, have been linked to an increased risk of prostate cancer development and progression. Elevated levels of circulating insulin, a major driver of metabolic syndrome, can stimulate insulin-like growth factor-1 (IGF-1) signaling, which is implicated in promoting cellular proliferation and inhibiting apoptosis in prostate epithelial cells.  Material and Methods: This study is a cross-sectional analysis designed to evaluate the association of metabolic parameters, lipid and cytokine profiles, androgen levels, and insulin signaling with prostate cancer and its precursor lesions among Department of Biochemistry, Index Medical College.  The study recruited participants from urology outpatient clinics, including patients with confirmed prostate cancer, those with precancerous conditions such as prostatic intraepithelial neoplasia (PIN), and healthy controls. The study included a total of 210 participants divided into three groups: (1) confirmed prostate cancer patients, (2) patients with precancerous lesions (prostatic intraepithelial neoplasia), and (3) healthy controls. Results: Healthy Control shows a distinct peak around 15–16 units, indicating that most individuals in this group have insulin levels concentrated near this value. Precancer and Prostate Cancer groups have a slightly broader and flatter distribution compared to Healthy Controls, indicating more variability in insulin levels. Healthy Control includes individuals with higher insulin levels (up to 35 units), while Prostate Cancer and Precancer rarely exceed 25 units.  The Prostate Cancer group shows a sharp peak around 7 pg/mL, suggesting a concentration of IL-6 levels near this value. The Precancer group has a similar but slightly broader distribution around 7–8 pg/mL. The Healthy Control group exhibits a more evenly spread distribution, peaking around 8 pg/mL, indicating higher variability in IL-6 levels.  Conclusion: This study provides a comprehensive analysis of metabolic and systemic inflammatory profiles in prostate cancer and precancer conditions. The findings support the hypothesis that metabolic dysregulation and systemic inflammation are central to prostate cancer progression, offering potential targets for early intervention and therapeutic strategies. While PSA remains an essential biomarker, the overlap and variability in PSA levels across groups demonstrate its limitations as a standalone test. The findings suggest that PSA should be interpreted alongside other diagnostic modalities to improve sensitivity and specificity in detecting prostate cancer and distinguishing it from precancerous conditions.

The rise of functional medicine and holistic health approaches reflects a transformative shift in healthcare, addressing the growing burden of chronic diseases with innovative, patient-centered models. Functional medicine employs a systems biology framework to identify and treat the root causes of illness, integrating advanced diagnostics and personalized interventions. By focusing on factors such as nutrition, gut health, inflammation, and hormonal imbalances, functional medicine aims to optimize physiological function and improve long-term health outcomes. Holistic health complements this approach by emphasizing the interconnectedness of the mind, body, and spirit, incorporating practices such as mindfulness, yoga, acupuncture, and nutritional therapy to promote overall well-being. Methods A systematic review of 32 studies was conducted to summarise the principles, applications, and outcomes related to functional medicine and holistic health approaches. Additionally, have checked carefully scans from retrieved references for inclusions not found during the initial search process (hand-searching). Functional medicine also focuses on using the synergy of tailored nutrition and lifestyle changes to address diseases, such as diabetes mine, cardiovascular disease & autoimmune issues with some studies demonstrating that functional medicine can achieve better health outcomes. Functional medicine staples such as anti-inflammatory, antioxidant-rich foods are essential for proper metabolic health and cell function. Holistic health practices have also proven effective in chronic pain, stress management, and mental well-being. Treatments such as mind-body medicine, lifestyle interventions, and emerging frontiers in integrative health are rapidly advancing approaches that have the potential for broad scope, however, challenges with a lack of standardization and coverage by insurance companies hold this field back from broader acceptance, similarly to allow for wide adoption; more longitudinal studies need to be completed rigorously. Functional medicine and holistic healing are likely to be a key driver of the future shape of integrative healthcare as health systems continue to move towards prevention and patient activation

Introduction: -Antenatal care (ANC) is the care during pregnancy by skilled health care professionals. The main aim of ANC is to ensure best health conditions for both mother and baby during pregnancy. Objective: -To assess the utilization of ANC services provided to mothers during pregnancy and to find out the influence of socio-economic factors on ANC practices in the field practice area of UHTC, Burla. Materials And Methods: -It was a community based cross-sectional study conducted among 202 mothers who delivered their child in last 1 year. The study was carried out from September 2016 to February 2017 in the field practice area of UHTC, Burla.  The data regarding socio-demographic variables and utilization of ANCs services were collected through a predesigned pretested semi structured questionnaire after obtaining verbal informed consent. The data obtained were analysed by using simple number and percentage. Results:-100% mothers registered their pregnancy with an early registration of 84.15%, ≥4 ANC checkups 68.32%,minimum 1 dose TT immunisation 94.55%, ≥ 100 IFA tablets consumed 45.05%  with full ANC care only 37.63%.The utilization of  full ANC services was very low among mothers from lower caste groups SC(35.21%) and ST (25.80%),illiterate(0.0%) and primary standard(2.92%) education ,those with petty business/shop (7.14%) and  house hold income from Rs 5000 -10, 000(32.65%) and < Rs 5000(32.60%). Conclusions: - Though the ANC care was more than the state and national level it was inadequate and inequitable. Full ANC was very low among mothers of lower caste groups, low standard of education, petty business and low household income.

Background: Accredited Social Health Activists (ASHA) workers play a vital role in the delivery of primary health care services to mothers and children in rural India. This article evaluates the knowledge, practices, and socio-demographic profile of ASHA workers reporting to the Maternal and Child Health Centre Bhima Bhoi Medical College &Hospital, Balangir, Odisha and examines factors associated with their knowledge. Methods: This cross-sectional descriptive study was conducted over a period of three months involving 400 participants. The data were collected using a pretested, semi-structured questionnaire and analyzed with SPSS Version 21.0. Descriptive as well as inferential statistics have been applied to determine knowledge levels and factors influencing the same, among ASHA workers. Result: It showed that 81.5% of ASHA workers were adequately knowledgeable about their job and tasks, mainly in diarrhoea management (95%), HIV/AIDS (92%) and health insurance programs (91%). Significant gaps were, however, identified in the knowledge areas of neonatal care (40%) and breastfeeding practices (59%). Notable positive correlation was found with improved knowledge levels pertaining to participation in VHNDs, attending refresher training, and achieving better performance during postnatal visits (p < 0.05). Approximately 90.8% belonged to Class V of the Modified B.G. Prasad Socioeconomic Classification, making them principally economically disadvantaged. Conclusion: Although ASHA workers showed a general awareness of their tasks, the acknowledged gaps in neonatal care and breastfeeding skills indicate an acute need for targeted training efforts. Such programs should focus on specific knowledge gaps and the enhancement of the workers' capacity to deliver essential health services. Enhancing community engagement, continuous education with access to refreshers may help in maximizing the effectiveness of the ASHA workers and in upgrading maternal and child health outcomes within the marginalized rural areas.

Introduction: Valproic acid is the commonly used antiseizure medication. VPA have some influence on thyroid hormones. This study was conducted to evaluate the effect of valproate monotherapy on thyroid functions and to determine the time for screening interval. Aim: The study aims to prospectively evaluate the changes in thyroid profile in children with epilepsy treated with valproic acid monotherapy. Materials and Methods: This study was a prospective observational one, carried out at a Paediatric neurology clinic, Telangana, India, from May 2023 to May 2024. The study group consisted of 150 children. A questionnaire was used to gather information about the patient demographics details, diagnosis, valproic acid usage, thyroid profile before initiation of VPA, at 3 months, and at 6 months. Data were input into a Microsoft Excel spreadsheet, and the Statistical Package for the Social Sciences (SPSS) was used for analysis. Statistical significance was assessed using ANOVA and a p-value of <0.05 was used. Results: suggest that the changes in levels of TSH, T4, and T3 over the periods at initiation of VPA therapy, at 3 months of VPA therapy and at 6 months of VPA therapy were statistically significant .TSH levels were increased significantly from 2.11±1.54 µIU/mL at initiation of VPA to 3.78±1.84 µIU/mL at 3 months and to 4.45±1.96 µIU/mL at 6 months (p<0.001), T4 decreased significantly (p=0.021) and T3 decreased significantly (p=0.023) at 6 months after VPA therapy. After the 6 months of VPA therapy, a total of 24 patients (16%) have developed Subclinical Hypothyroidism, and 4 patients (2.67%) have developed Overt Hypothyroidism. Conclusion: Our research indicates that valproic acid monotherapy may result in early and long-lasting changes in thyroid function, indicating the necessity of careful and early monitoring of the concentration of thyroid hormones in serum in children with epilepsy receiving VPA.

Background: Retinal vasculitis is a rare and potentially sight-threatening condition that affects the retinal vasculature. Recognizing the pathogenesis of retinal vasculitis is critical for devising effective therapies and improving patient outcomes. Aim: The aim of this study is to determine the expression and significance of MIP-1β and MCP-1 in retinal vasculitis. Hypothesis: We hypothesize that MIP-1β and MCP-1 play a crucial role in the pathogenesis of retinal vasculitis and that their expression levels are associated with disease severity. Materials & methods: The current research project was authorized by the Institutional Ethics Committee. The research design is a prospective study, and a total of 100 cases of retinal vasculitis were included in the analysis. These individuals attended the vitreo-retinal clinic at the Regional Institute of Ophthalmology, SCBMCH, Cuttack, between October 2019 and September 2021, over a period of 2 years. Results: Serum samples were collected from retinal vasculitis patients, and ELISA was used to quantify the chemokines MCP-1 and MIP-1β. Chemokine levels were analyzed in relation to disease state and medication usage. Untreated patients had significantly higher MIP-1β levels than patients who received treatment after three months (P < 0.05). MIP-1β and MCP-1 levels were found to correlate with prednisolone levels and disease activity in some patients. Although not all samples had MIP-1α levels, those from pre-treated patients had much higher levels than those from individuals who received treatment after three months. Conclusion: The research offers significant information regarding the function of MIP-1β and MCP-1 in the context of retinal vasculitis, suggesting their potential as biomarkers for the early diagnosis and treatment of this condition. Future investigations could concentrate on the possibility of therapeutic benefits associated with targeting MIP-1β and MCP-1 in retinal vasculitis, as well as the examination of other inflammatory markers that may play a role in this condition.

Retinal vasculitis, characterized by inflammation of retinal blood vessels, presents a significant challenge in diagnosis and management. Aim: This study aimed to investigate the etiopathogenesis, clinical course, and visual outcomes of retinal vasculitis in a tertiary care hospital setting. Hypothesis: We hypothesized that retinal vasculitis is associated with certain underlying causes and risk factors that may affect the clinical course and visual outcome of the condition. Materials and methods: This study was initiated after obtaining permission from the Institutional Ethics Committee. The present study is a prospective study and 100 cases of retinal vasculitis who attended the vitro-retinal clinic of Regional Institute of Ophthalmology, SCBMCH, Cuttack between October 2019 to September 2021 for a period of 2 years were taken up for the study. Results: Of the 62 cases of primary vasculitis, 12 patients had vitreous hemorrhage at the time of presentation, 18 had associated neovascularization, 14 had tractional bands, and 4 had tractional retinal detachment. Among the 30 cases secondary to systemic diseases, two patients had vitreous hemorrhages, six patients had neovascularization, and six patients had tractional bands. Eight cases were secondary to ocular disease. The BCVA in logmar value changed from a mean of 1.4976 with a standard deviation of 0.8278 to 0.98961 with a standard deviation of 0.6495. A p-value < 0.001 signifies improvement in vision after 3 months of treatment and close observation. One patient developed weight gain following steroid administration, 2 patients complained of gastritis following oral steroid administration, and 4 patients were lost to follow-up. Conclusion: More long-term studies are needed to overcome these limitations. Extensive research is ongoing on further innovations in different fields of this disease, which will further refine our approach to eyes with retinal vasculitis.

Background: The periorbital region is prone to visible aging signs due to its thin skin, high vascularity, and exposure to environmental stressors, making it a focal point for anti-aging treatments. Objective: This study aims to assess the efficacy of various active ingredients commonly found in eye creams—such as retinoids, peptides, ceramides, vitamins C and E, and antioxidants—in treating periorbital skin concerns, including wrinkles, puffiness, and dark circles. Method: A comprehensive literature review was conducted alongside clinical trials at World Medical College, Jhajjar, involving 80 participants (40 men, 40 women, aged 20-60 years). Participants were randomized into four groups, each receiving a topical eye cream containing one of the following active ingredients: retinoids, peptides, ceramides, or antioxidants. The treatment duration was 12 weeks, with evaluations conducted at baseline, 4, 8, and 12 weeks using both clinical observations and participant self-assessments. Result: Data analysis revealed significant improvements in skin condition across all active ingredients. Retinoid-based creams showed the highest efficacy, with a 32% reduction in wrinkle depth and a 28% improvement in skin elasticity. Peptides resulted in a 24% reduction in puffiness and a 22% improvement in dark circle appearance. Ceramides enhanced skin hydration by 38%, while antioxidant creams demonstrated a 19% reduction in oxidative stress markers and an 18% improvement in overall skin tone. Statistical analysis confirmed these results with a p-value of <0.05, indicating strong significance in each group. Conclusion: Active ingredients such as retinoids, peptides, and ceramides are highly effective in addressing periorbital skin concerns, with retinoids demonstrating the most pronounced results in reducing wrinkles and enhancing elasticity.

Background: Skin disorders, affecting the integumentary system, often extend beyond the skin to involve other organs, particularly the eyes. Conditions like herpes zoster ophthalmic us (HZO) can cause conjunctivitis, keratitis, and severe ocular complications. Autoimmune diseases such as pemphigus and genetic disorders like neurofibromatosis also impact eye health. Aim of the study: This study aims to investigate the ocular manifestations associated with various dermatological conditions. Methods: This observational prospective study at World Medical College, Jhajjar, spanned two years (start to end), including 120 patients with dermatological diseases and ocular manifestations. Patients underwent comprehensive ophthalmic evaluations, including visual acuity tests, intraocular pressure measurement, slit-lamp examinations, and additional diagnostics like corneal staining, Schirmer’s test, and imaging (MRI, CT) when indicated. Exclusions included those unwilling or with conditions impairing participation. Ocular treatments included medical management with topical therapies. Data analysis used SPSS 26.0, with results presented as mean ± SD for continuous variables and frequencies/percentages for categorical data. Result: The study population had a mean age of 49.54±6.88 years, with males comprising 65.83%. Common ocular findings included blepharitis in acne (4.17%) and herpes zoster ophthalmic (HZO) (1.67%), ectropion in ichthyosis (6.67%), and plexiform neurofibromas in neurofibromatosis (4.17%). HZO was linked to scarring (5%) and vesicles (18.33%). Conjunctivitis was prevalent in HZO (6.67%), psoriasis (5.83%), and ichthyosis (4.17%). Corneal issues included epithelial keratitis in HZO (9.17%) and anterior uveitis in psoriasis (4.17%). Cataracts were most frequent in HZO, including nuclear (10%) and cortical (7.5%). Glaucomatous optic nerve head changes appeared in psoriasis (0.83%) and pemphigoid (1.67%). Conclusion: This study reveals a strong link between dermatological diseases and ocular complications, including eyelid abnormalities, conjunctivitis, uveitis, and cataracts. Conditions like herpes zoster ophthalmic us, psoriasis, and atopic dermatitis highlight the systemic-ocular connection. The findings stress integrated care for early diagnosis, effective management, and preventing vision-threatening outcomes in skin disorder patients.

Background: Type 2 Diabetes Mellitus (T2DM) is a chronic disease associated with poor glycemic control and elevated serum uric acid (SUA) levels. Lifestyle interventions, including dietary modifications and exercise, have been shown to improve metabolic control in T2DM patients, but their effect on SUA remains unclear. Objective: This study aimed to evaluate the impact of a 12-week lifestyle intervention (diet and exercise) on SUA levels and glycemic control in T2DM patients. Methods: A cohort of 120 T2DM patients was enrolled in this prospective study. Participants were subjected to a 12-week program with dietary counseling and physical activity. SUA levels, fasting blood sugar (FBS), HbA1c, and postprandial blood glucose (PPBG) were measured at baseline and post-intervention. Paired t-tests and regression analysis were used to assess the changes in SUA and glycemic markers. Results: Significant reductions were observed in SUA (from 6.9 ± 1.8 mg/dL to 5.4 ± 1.2 mg/dL, p < 0.01), FBS (p < 0.01), HbA1c (p < 0.01), and PPBG (p < 0.01). Regression analysis indicated that reductions in SUA were significantly associated with improvements in glycemic markers, particularly FBS and HbA1c. Conclusion: This study demonstrates that a 12-week lifestyle intervention significantly reduces SUA levels and improves glycemic control in T2DM patients. These findings suggest that lifestyle modifications may be an effective, non-pharmacological approach to managing T2DM and lowering SUA levels, potentially reducing the risk of diabetes-related complications.

Background and objective: Tropical nations are where cutaneous fungal infections are most prevalent in pregnant women. These infections tend to recur and are persistent. They have an impact on a person's social and physical lives. Therefore, it is essential to accurately diagnose and treat the active disease. To research health care center's variables and patterns of different cutaneous fungal infections in pregnant women. Methodology: 110 Pregnant women attending OBG Department Presented with Dermatology lesions were included in a prospective study. Pretested questionnaires were used to gather information on sociodemographics and cleanliness. After a clinical examination, each patient's diagnosis and infection type were determined. Data was examined using the proper statistical tests. Results: Tinea corporis was the most prevalent infection (54%). Trunks were the most often affected site (55%). The majority of patients (24%) were between the ages of 21 and 30, with 22% being between the ages of 11 and 20. The most often impacted groups were housewives (25%) and unskilled workers (29%). Conclusion: The study underscores the importance of understanding the demographic, socioeconomic, and hygiene-related factors associated with dermal fungal infections to develop effective prevention and treatment strategies pregnant women.

Chronic liver disease (CLD) is a global health challenge, often leading to severe complications and poor clinical outcomes. Among the complications of CLD, malnutrition is a significant and frequently overlooked factor that exacerbates liver dysfunction, increases morbidity, and worsens prognosis. This study aims to evaluate the prevalence and severity of malnutrition in patients with CLD and examine its relationship with two commonly used scoring systems for liver disease severity: the Child-Turcotte-Pugh (CTP) score and the Model for End-Stage Liver Disease (MELD) score.

Conducted at Mahatma Gandhi Hospital and Medical College, Sitapura, Jaipur, over a one-year period (September 2023 to September 2024), this study included 200 adult patients diagnosed with CLD based on clinical, biochemical, and radiological findings. Nutritional status was assessed using Subjective Global Assessment (SGA), anthropometric measurements (body mass index [BMI], mid-upper arm circumference [MUAC]), and biochemical markers, particularly serum albumin. The CTP and MELD scores were used to classify the severity of liver disease in all patients.

The results revealed that 72% of the patients were malnourished, with 42% moderately malnourished and 30% severely malnourished. The prevalence of malnutrition increased with the severity of liver disease, as reflected by higher CTP classes and MELD scores. Patients with CTP Class C had the highest percentage of severe malnutrition (75%), and patients with MELD scores ≥20 had a similarly high prevalence of severe malnutrition (70%). Furthermore, malnutrition was strongly correlated with decreased survival rates and higher hospital morbidity.

This study highlights the significant burden of malnutrition in CLD patients and its association with liver disease severity. The findings suggest that regular nutritional assessments and early interventions are crucial for improving patient outcomes, particularly in those with advanced liver disease. Nutritional therapy, including oral supplementation, dietary modifications, and enteral feeding, should be incorporated as part of a comprehensive treatment plan for patients with CLD. The study emphasizes the need for clinicians to prioritize nutritional care to enhance survival, quality of life, and recovery in this patient population

Background: Anemia in older adults is a growing global concern, not only because it’s so common but also because it’s closely tied to higher rates of illness and death. This study aimed to determine the prevalence of anemia among the elderly population. Additionally, it prospectively evaluates the various hematological patterns of anemia across this age group. Materials and Methods: This prospective study assessed anemia prevalence in 234 elderly individuals (≥60 years) from communities and old age homes, adhering to WHO hemoglobin thresholds. Inclusion required voluntary consent, while exclusions included non-anemic individuals, hematological disorders, recent treatments, or refusal. Statistical significance was set at p<0.05. Results: The study included 234 participants, predominantly aged 60–69 years (60.68%). Females (61.54%) had higher anemia prevalence (P = 0.03). Common symptoms included fatigue (46.58%) and dyspnea (24.36%). Normocytic normochromic anemia was most frequent (54.70%), followed by microcytic hypochromic (23.08%), macrocytic (14.10%), and dimorphic anemia (8.12%). The leading cause was iron deficiency anemia, observed in 48 cases (20.51%), primarily due to nutritional deficiency, followed by anemia of chronic disease (41 cases, 17.52%) and chronic kidney disease (33 cases, 14.10%). Conclusion: Given the increasing proportion of elderly individuals in the population, it is imperative for physicians to prioritize the diagnosis and management of anemia, which, if left untreated, can contribute to heightened morbidity and mortality.

Background: Chronic kidney disease (CKD) is rising globally, especially among individuals with metabolic disorders like dysglycemia. Glycated hemoglobin (HbA1c) helps identify dysglycemia, including prediabetes. Dyslipidemia, common in renal dysfunction, increases cardiovascular and renal risks. This study explores the relationship between CKD, HbA1c, dyslipidemia, and electrolyte levels in renal impairment patients. Materials and Methods: A hospital-based case-control study was conducted, involving 136 patients with CKD as the case group and 120 non-CKD individuals as the control group. Glycated hemoglobin (HbA1c) was quantified using High-Performance Liquid Chromatography (HPLC) with affinity columns for separating HbA1c from other hemoglobin variants. The HbA1c concentration was calculated as the ratio of the HbA1c peak area to the total hemoglobin peak areas. HDL cholesterol levels were assessed using an enzymatic colorimetric method with automated analyzer in serum and plasma samples. Results: The mean HbA1c level was significantly higher in CKD patients (7.83, SD: 2.91) than controls (5.57, SD: 1.87; p < 0.01). Elevated HbA1c (>5.6) was found in 53.67% of CKD patients versus 34.17% of controls (p < 0.01). Diabetes (HbA1c ≥ 6.5) was diagnosed in 43.38% of CKD patients versus 20% of controls (p < 0.01). Dyslipidemia was observed in 43.38% of CKD patients and 26.67% of controls (p < 0.01). Conclusion: The study findings indicate a strong association between elevated HbA1c levels and CKD, with a significantly higher prevalence of dyslipidemia in CKD patients compared to controls. The dyslipidemia observed was characterized by increased triglycerides, LDL cholesterol, and reduced HDL levels. These findings align with national trends, underscoring the emerging burden of diabetes and hypertension.

Background: Stroke remains one of the common causes of morbidity and mortality in many countries, and it is apparent that management will only be effective when diagnosis is done with precision. This paper examines the role of CT brain imaging in diagnosing stroke and its relationship with clinical findings, imaging results, and carotid stenosis. Methods: A total of 100 clinically diagnosed acute ischemic stroke patients were included. Detailed history, neurological evaluation, and CT brain imaging were performed on all patients. Doppler ultrasonography of carotid arteries was performed in 75 patients to document the incidence and degree of carotid stenosis. Results: Infarcts were identified in 84% on CT brain imaging, and 16% presented with normal findings on imaging, perhaps due to small lacunar infarcts or early imaging. Clinic radiological correlations were obtained in 70% of cases; the most common site of lesion was in the capsule-ganglionic region, suggesting MCA involvement. However, lesions did not correlate uniformly with clinical severity in terms of size and extent on CT. Carotid stenosis was present in 58% of patients; among them, mild, moderate, and severe stenosis were identified in 20%, 23%, and 16% respectively. Of the risk factors significantly associated with the development of carotid stenosis are age, male gender, smoking, diabetes, hypertension, and hyperlipidemia. Conclusion: Non-invasive identification of at-risk individuals for stroke requires imaging studies, such as CT, combined with clinical assessment. CT imaging is a necessity to distinguish between infarction and hemorrhage for precise differentiation. Doppler sonography of the carotid arteries is useful in identifying at-risk individuals to prevent the stroke.

Background: Dementia is a chronic organic mental disorder characterized by impairment of intellectual functions, memory, personality deterioration, judgment and impulse control, and abstract thinking. Some women may be at risk for the development of depression, cognitive impairment, and an early onset of dementia due to endocrine events during the menopause transition and perimenopause stages. Aim: Hence, the study aims to evaluate bio-endocrinal profiles and to determine correlation between depression and bio-endocrinal profile and understand bio-endocrine role in dementia development. Materials& methods: The Department of Biochemistry, in collaboration with the Department of Gynecology and Obstetrics at SMS Medical College and Attached Hospitals, Jaipur, India, conducted a cross-sectional, comparative study on 100 depressed postmenopausal women (PMWs). The study used Beck's depressive inventory and the HMSE to assess depression severity and cognitive functioning. Patients were divided into two groups based on their HMSE score, while a control group consisted of 100 healthy postmenopausal women. Results: Post-menopause women (PMWs) with depression had significantly elevated serum TSH levels. Depressed PMW had significantly lower serum estrogen levels. In both groups, serum progesterone and FSH levels were not significantly comparable. While the serum LH and calcium levels were significantly reduced in depressed PMW. Conclusion: The study suggests a link between menopause and depression, but further research is needed to understand its underlying causes. Treatment options should focus on calcium intake and estrogens, and social networks.

Diabetes mellitus (DM) is a primary risk factor for Asymptomatic Bacteriuria (ASB) incidence and chronic kidney disorders. Aim of the study is to identify various pathogens causing ASB and to study their antibiotic sensitivity and resistance patterns. The study also looks into various other contributing factors that increase the risk of ASB such as glycaemic index, blood urea and serum creatinine. The incidence of ASB among diabetic people was found to be 36% with women being the majority (>60% of ASB positive samples). Poor glycaemic control was found to be a major factor for ASB which was evident both in initial and follow-up studies. Klebsiella (44% initially and 50% during follow-up) was the major causative organism for ASB followed by Escherichia coli (28% initially and 33% during follow-up). Isolated organisms were very much sensitive to Imipenem, Meropenem, and Tigecycline and were resistant to Ampicillin, Ciprofloxacin and Nitrofurantoin. In this context, the current study may be helpful in delivering sensitivity directed therapy in patients with ASB to avoid further progression of secondary renal complications.

Anemia is one of the most common nutritional deficiency disorders affecting the pregnant women in the developing countries. Anemia during pregnancy is commonly associated with poor pregnancy outcome and can result in complications that threaten the life of both mother and fetus.  Objective: The objective of the study was to estimate the prevalence of anemia among pregnant women and to determine its association with maternal and fetal outcomes.  Material and methods: This was a prospective, observational, hospital-based study enrolled 200 pregnant women attending for their regular ante-natal checkup. Demographic details, hemoglobin level and prior obstetric related history were noted. Prevalence of anemia was estimated based on the hemoglobin level. Results: Prevalence of anemia in pregnant women was 120 (60%), most of them (44.2%) were 20-24 years of age. Majority of the women had moderate anemia (50.8%) and showed Microcytic hypochromic picture (56.6%). Anemia was commonly observed (63.8%) in multigravida, and most of them (62.5%) delivered by Normal vaginal delivery. Breathlessness was the commonest presenting symptom (75%) followed by fatigability/giddiness (67.5%). The most common maternal outcome was preterm labour (17.5%) followed by puerperial sepsis (10%) and PPH (8.3%). Among the fetal outcome 20.8% were having low birth weight, 18.3% showed fetal growth restriction, 10.6% showed admittance in NICU after birth and still birth was in 2.5% cases. Conclusions: A high prevalence of anemia in pregnant women apparently increases the maternal and fetal risks. Early detection and management are recommended to prevent adverse obstetric outcomes.

Background: Myasthenia gravis, a relatively rare neuromuscular condition, primarily affects the ocular and respiratory muscles. It is often identified during routine clinical evaluations, though some cases are diagnosed at advanced stages, presenting with symptoms such as generalized muscle weakness, dysarthria, jaw fatigue, and bulbar dysfunction.  Aim: The objective of the present study is to determine the socio-demographic profile and clinical characteristics of myasthenia gravis patients.  Materials and Methods: This retrospective study included patients presenting to a tertiary care center in India, diagnosed with ocular or generalized myasthenia gravis based on clinical history, fatigue assessments, and confirmation via the ice pack test, neostigmine test, and repetitive nerve stimulation (RNS) test. High-resolution chest CT was performed to assess for thymoma in all patients. Additionally, RNS testing and acetylcholine receptor (AChR) antibody assays were conducted universally, with MuSK antibody testing reserved for AChR-negative cases. Results: The study included 40 patients (mean age: 43.5 years; range: 16-74 years), with 15 females (37.5%) and 25 males (62.5%). Of these, 10 (25%) had ocular myasthenia, and 30 (75%) had generalized myasthenia, including 6 who experienced crises requiring mechanical ventilation, resulting in 1 fatality. Comorbidities included hypothyroidism (n=3), hyperthyroidism (n=1), hypertension (n=5), and diabetes mellitus (n=4). Clinical features were ptosis (93.5%), restricted ocular movements (87.1%), nasal voice(21%), dysphagia (18%), limb weakness (12%), and dyspnea (8%). The ice pack test was positive in 32 patients. Conclusion: Early diagnosis and prompt management of myasthenia gravis (MG) are crucial, as it often progresses from ocular to generalized form, requiring careful treatment and long-term monitoring for efficacy, crises, and side effects.

Background: Central nervous system (CNS) tuberculosis (TB) is a calamitous infection with high rates of morbidity and mortality. Concerns regarding clinical management and the need for a deeper understanding of the underlying risk factors contributing to these deaths prompted this study. Aim:   The aim of the present study was to assess the demographic profile, risk factors, clinical features, radiological findings, complications, and outcomes in patients with CNS tuberculosis. Methods: This observational cross-sectional study enrolled patients with CNS TB. Demographic, clinical, and radiological data of patients were recorded using a standardized pre-designed proforma. Logistic regression was used to analyze the risk factors associated with TBM. Results: A total of 50 patients diagnosed with CNS TB were analyzed. The majority of them (40%) were in the age group of >50 years, predominantly male (66%). Most cases (68%) resided in rural areas, belonged to the lower socio-economic class (42%), had education up to secondary school (38%), and 52% were underweight. Common risk factors included diabetes mellitus (64%), smoking (60%), alcoholism (52%), malnutrition (26%), and HIV (20%). Common symptoms were fever (100%), weight loss (82%), and headache (72%), whereas common signs included neck stiffness (84%), Kernig's sign (78%), and Brudzinski's sign (74%).  AFB staining of Cerebrospinal fluid was positive in 12% of patients, and 62% of patients had meningeal enhancement in radiological findings. Conclusion: The prevalence and mortality of CNS-TB remain high, and TB meningitis is the most frequent presentation. The integration of CNS-TB early detection and management into national TB programs in developing countries is needed for better global estimation and response

Introduction- All human beings occupying this globe belong to the same species that is Homo sapiens. No two individual is exactly alike in their measurable traits, even the genetically identical twins differ in some respects. Aim and objectives: To study facial index in indore region.  Material and Method – Total of 500 subjects were examined, 250 males and 250 females were taken measurements of morphological facial height, width, facial index as parameter and age ranging from age group 18-25 year. All measurements were measured in centimeter. Result: Mean Facial index in our study is 86.64±8.30, Mean Facial height in our study is 10.94 ±1.09, Mean Facial width in our study is 12.68± 1.13. Discussion: The present study provides valuable data pertaining to facial index in adult MP Population. Summary and conclusion: In our study we observed that the facial index in males and females were hyperuriprsopic in 114, euriprosopic in 90 were found, mesoprosopic in 103 were found. 1 and DR. Avantika S Bamne

Background: Hypoventilation produces or worsens respiratory acidosis in patients with hypercapnia due to acute exacerbations of chronic obstructive pulmonary disease (AECOPD). In these patients’ acid–base and hydroelectrolite balance are closely related. Aim of the present study was to evaluate acid–base and hydroelectrolite alterations in these subjects and the effect of non-invasive ventilation and pharmacological treatment. Materials and methods: We analyzed 110 patients admitted to the Chest Department of Pratima Relief Institute of Medical Sciences, for hypercapnic AECOPD. On admission, all patients underwent history taking, full examination, and arterial blood gas analysis and received oxygen with nasal cannulae or a venturi mask to preserve normal oxygen saturation, as well as received pharmacological treatment. NIV was started when patients had severe dyspnea, increased work of breathing, and respiratory acidosis despite optimum management. Result: Based on arterial blood gas finding, we categorized our patients into three main groups: the first group comprised 50 (55.6%) patients who had compensated respiratory acidosis, and the majority of them (39 patients) received medical treatment only. The second group comprised 22 (24.4%) patients, who had mixed respiratory acidosis and metabolic alkalosis. Overall, 16 patients needed non-invasive mechanical ventilation with the medical treatment. The third group comprised 18 (20%) who had combined respiratory and metabolic acidosis. Of them, 14 patients needed non-invasive mechanical ventilation with the medical treatment. Conclusion: While minor AECOPD episodes are usually curable, more severe respiratory failures are linked to a significant death rate and a protracted period of impairment for those who survive. Although mild episodes of AECOPD are generally reversible, more severe forms of respiratory failure are associated with a substantial mortality and a prolonged period of disability in survivors.

Background:

Fracture of the neck of the femur is a common orthopedic emergency, particularly in elderly patients. Total hip replacement (THR) is a preferred treatment option, with uncemented and hybrid techniques being widely employed. However, the choice of technique remains a subject of debate, particularly concerning functional outcomes, complication rates, and implant survivorship. This study compares uncemented and hybrid THR techniques in managing femoral neck fractures over a one-year duration.

Methods:

This prospective observational study was conducted at Naraina Medical College & Research Centre (NMCRC) from November 2023 to October 2024. A total of 100 patients, aged 60–80 years, diagnosed with femoral neck fractures and requiring THR, were divided into two groups: Group A (uncemented THR, 50 patients) and Group B (hybrid THR, 50 patients). Data on operative duration, intraoperative blood loss, functional outcomes (measured using Harris Hip Score), complication rates, and radiographic evidence of implant stability were collected and analyzed.

Results:

The uncemented group demonstrated a mean Harris Hip Score of 85.6 ± 5.8 compared to 83.2 ± 6.3 in the hybrid group (p > 0.05). Intraoperative blood loss was significantly lower in the uncemented group (150 ± 20 mL) versus the hybrid group (220 ± 30 mL; p < 0.001). However, operative time was longer in the uncemented group (90 ± 15 minutes) compared to the hybrid group (75 ± 10 minutes; p < 0.01). Early postoperative complications, such as periprosthetic fractures, were more frequent in the uncemented group (8%) compared to the hybrid group (4%), while hybrid THR showed a marginally higher risk of aseptic loosening at one-year follow-up.

Conclusion:

Both uncemented and hybrid THR techniques are viable options for managing femoral neck fractures, with distinct advantages and limitations. Uncemented THR offers reduced blood loss and is better suited for younger patients with good bone quality. In contrast, hybrid THR provides superior initial implant stability, making it more suitable for elderly patients with compromised bone quality. A tailored approach considering patient-specific factors is essential for optimal outcomes.