Introduction Early-stage knee osteoarthritis is characterized by joint pain, stiffness, and functional limitations, often without significant radiographic changes. Patients typically present with symptoms such as morning stiffness and difficulty in mobility, particularly stair climbing. Early diagnosis and intervention are crucial to slow disease progression, improve quality of life, and preserve joint function. Objective: To evaluate and compare the efficacy of methotrexate (MTX),  leflunomide (LEF) and combination of methotrexate and Leflunomide in reducing inflammation and improving function in patients with early-stage knee osteoarthritis. Material and Methods:  This randomized, interventional, open-label study was conducted after 15days, 3 months and 6 months. A total of 312 patients with symptomatic early-stage knee OA (Kellgren-Lawrence grade I–II) and clinical signs of inflammation were randomized into three groups. group A patients treated with methotrexate (15 mg/week), group B treated with leflunomide (10–20 mg/day) and group C treated with methotrexate plus leflunomide. The primary outcome was the reduction in pain measured by VAS and WOMAC scores. Secondary outcomes included changes in CRP, ESR, WBC.  Results:  A total of 312 osteoarthritis patients were evaluated, with a higher prevalence in females (55.1%) and the most affected age group being 50–59 years (35.9%). Knee pain was the most common symptom, present in all patients (100%), followed by morning stiffness in 274 patients (87.8%) and difficulty in climbing stairs in 267 (85.6%). Symptom severity increased with higher Kellgren-Lawrence (KL) grades. Among treatment groups, the combination of Methotrexate and Leflunomide (Group C) showed the most significant improvement across all clinical and inflammatory parameters at 6 months: VAS score decreased from 7.6 ± 1.2 to 1.9 ± 0.5 (p < 0.0001), WOMAC score from 63 ± 9 to 18 ± 4 (p < 0.0001), CRP from 12.5 ± 2.6 to 2.9 ± 1.1 mg/L (p < 0.021), and ESR from 39 ± 6 to 12 ± 2 mm/hr (p < 0.021). Monotherapies also showed improvements but were less pronounced. Conclusion: Combination therapy with Methotrexate and Leflunomide significantly outperformed monotherapies in reducing pain, improving joint function, and lowering inflammatory markers, indicating its superior therapeutic potential in early-stage knee osteoarthritis.

Introduction: Chronic dacryocystitis is a common ophthalmologic condition characterized by inflammation of the lacrimal sac, often due to bacterial infection. Understanding the microbiological profile and antibiotic susceptibility patterns is crucial for effective treatment and prevention of complications. Materials and Methods: This study included 150 patients diagnosed with chronic dacryocystitis. Samples were collected from the lacrimal sac and subjected to microbiological analysis. Antibiotic susceptibility testing was performed using the Kirby-Bauer disk diffusion method. Inclusion criteria involved patients with persistent epiphora and discharge, while exclusion criteria included acute dacryocystitis and prior antibiotic use within one week. Results: The most common isolates were Staphylococcus aureus (35%), followed by Streptococcus pneumoniae (25%) and Pseudomonas aeruginosa (15%). Antibiotic susceptibility testing revealed high resistance to penicillin (70%) and erythromycin (60%), while gentamicin and ciprofloxacin showed the highest efficacy (90% and 85%, respectively). Ten tables summarize the microbiological and susceptibility profiles. Conclusion: The study highlights the predominance of gram-positive bacteria in chronic dacryocystitis and the rising resistance to commonly used antibiotics. Gentamicin and ciprofloxacin remain effective treatment options. These findings emphasize the need for routine microbiological evaluation and tailored antibiotic therapy.

Introduction: Acute febrile illness (AFI) is defined as a patient with fever of 38◦C or higher at presentation or history of fever that persisted for 2–14 days with no localizing source. Fever is the main clinical symptom of various tropical infectious diseases. The objectives were to evaluate the microbiological aetiology of acute febrile illness (AFI) in pediatric patients using serological and bacterial cultures and to understand the clinical profile of acute febrile illness in pediatric patients Materials and Method: This is a Hospital based prospective and observational study present study emphasizes on the infective aetiologies of Acute Undifferentiated fevers with special emphasis on clinical and demographic features among patients admitted in a teaching hospital. All adult patients (≥18 years) admitted to the hospital with fever of less than 21 days duration, with temperature ≥38º C upon admission and non-detection of any specific foci of infection by history, physical examination and routine investigations were included. Result: In present investigation, an aggregate of 110 patients with intense identical fever were assessed out of these 59 (53.6%) were male and 51 (46.4%) were female. In this investigation typhoid fever was the most well-known reason for undifferentiated fever (30.0%) trailed by malaria (21.7%), dengue fever (18.1%), urinary tract disease (14.5%), Acute gastroenteritis (14.5%), Pneumonia (9.0%), Bronchiolitis (4.5%), Hepatitis (1.7%) and Pharyngotonsillitis (0.9%). Conclusion: Our data showed that the etiologic spectrum of acute undifferentiated fever was widely distributed in our region. Scrub typhus was the major cause of acute undifferentiated fever next to Dengue and Enteric fever. There were a bulk of cases which were not diagnosed and put under miscellaneous aetiology of fever, this made the second largest group in our study next to the Scrub Typhus group.

Introduction: Postmenopausal bleeding is a concerning symptom that necessitates thorough evaluation due to its association with endometrial pathology, including hyperplasia and malignancy¹. Hysteroscopy and curettage are commonly employed diagnostic tools that facilitate direct visualization and histological assessment. Objective: This study aims to evaluate the diagnostic accuracy and clinical outcomes of hysteroscopy and curettage in assessing endometrial pathology in postmenopausal women. Material and Methods: A retrospective cohort study was conducted in the Department of OBG, Ayaan Institute of Medical Sciences, Teaching Hospital & Research Centre over a period of 6 months. A total of 200 postmenopausal women presenting with abnormal uterine bleeding were included. Hysteroscopy was performed, followed by endometrial curettage. The histopathological findings were analyzed, and statistical methods were applied to determine sensitivity, specificity, and predictive values. Results: A total of 200 patients were analyzed. Hysteroscopy demonstrated a sensitivity of 90% and specificity of 85% in detecting endometrial hyperplasia. Endometrial carcinoma was identified in 15% of cases. The presence of normal tissue in 28% of cases indicates that a significant proportion of postmenopausal women with abnormal uterine bleeding may not have detectable pathological changes upon histological examination. Atrophic changes, observed in 27% of cases, are consistent with the estrogen deficiency characteristic of postmenopausal women and are a common benign cause of bleeding in this population. Endometrial hyperplasia was identified in 22% of cases. Endometrial polyps accounted for 8% of cases. Conclusion: Hysteroscopy and curettage provide reliable diagnostic accuracy in evaluating endometrial pathology, aiding in the timely management of postmenopausal bleeding

Introduction: In modern obstetrics, labour induction is considered a way to improve maternal and foetal outcomes. In this regard, an increase in the frequency of induced labour has been noted worldwide. However, some evidence suggests that elective labour induction prolongs hospital stay and may increase costs and resource utilisation. Considering these provisions, and also the fact that some women prefer to be at home as long as possible before delivery, outpatient cervical ripening could be a reasonable alternative.  Material and methods :This study was open-label randomized controlled trial conducted in the Department of Obstetrics and Gynaecology, King George’s Medical University, Lucknow, over a time period of 1 year from August 2018 to August 2019 enrolled women who were admitted to the labor room at term with indications of induction of labor, willing to participate in the trial. Result: The age of the patients ranged from 18 to 33 years. The mean age in the Mifepristone group was 25.10±3.50 years, and in the Dinoprostone group, it was 24.80±3.40 years (p=0.685). In the Mifepristone group, 30 (55%) were primigravida, and 25 (45%) were multigravida, while in the Dinoprostone group, 31 (57%) were primigravida, and 23 (43%) were multigravida (p=0.710). Conclusion: Misoprostol an analogue of PGE1 appear to be perfect substitute for induction of labour. Its use was found to be associated with reduced time to delivery and high rate of vaginal delivery within 12 and 24 hours of induction. The requirement for oxytocin in augmentation was substantially reduced.

Introduction Elective surgeries are a cornerstone of modern healthcare, enabling the treatment of various medical conditions with precision and efficacy. Propofol, a widely used intravenous anesthetic, is favored for its rapid onset and short duration of action. The study aimed to evaluate the effects of magnesium sulphate and clonidine on propofol consumption, hemodynamic stability, and postoperative recovery in patients undergoing elective surgeries under general anesthesia. Materials and Methods This prospective, randomized, double-blind, controlled study was conducted in the Department of Anaesthesia, Shadan Institute of Medical Sciences, Teaching Hospital & Research Centre over a period of 12 months. Group M (Magnesium Sulphate Group): Received intravenous magnesium sulphate 50 mg/kg in 100 mL normal saline over 15 minutes before induction, followed by a maintenance infusion of 15 mg/kg/hr. Group C (Clonidine Group): Received intravenous clonidine 2 µg/kg in 100 mL normal saline over 15 minutes before induction. Group S (Saline Group): Received an equivalent volume of normal saline as a placebo. Results Group M (Magnesium Sulphate) had the lowest total propofol consumption (180.5 ± 25.3 mg) and infusion rate (4.2 ± 0.6 mg/kg/hr). Group C (Clonidine) required a slightly higher amount of propofol (210.4 ± 30.1 mg) and infusion rate (4.8 ± 0.7 mg/kg/hr). Group S (Saline) had the highest propofol consumption (280.6 ± 35.7 mg) and infusion rate (6.5 ± 0.9 mg/kg/hr). At intubation, Group S (Saline) showed a significantly higher HR (90.4 ± 8.2 bpm) compared to Group M (82.3 ± 7.1 bpm) and Group C (80.5 ± 6.8 bpm) (p < 0.001). At induction, MAP values were similar across the three groups (p = 0.62), indicating that initial blood pressure levels were comparable. At intubation, Group S (94.3 ± 8.6 mmHg) had a significantly higher MAP than Group M (88.4 ± 7.5 mmHg) and Group C (86.7 ± 7.1 mmHg) (p < 0.001). Conclusion The use of adjunctive medications like magnesium sulphate and clonidine in propofol-based anesthesia offers significant benefits in terms of reduced propofol consumption, improved hemodynamic stability, and enhanced postoperative recovery. BIS monitoring plays a crucial role in optimizing the administration of these agents, ensuring precise titration and minimizing complications.

Background: Despite all the advances in management, stripping remains important in the treatment of varicose veins and is usually preferable to endovenous procedures if carried out correctly. Since the prehistoric era, varicose veins of lower extremities are one of the most common ailments affecting humankind. With the adoption of erect posture, human became susceptible to pathology of varicose veins of dependent venous system. Materials and methods: This is a prospective study was conducted over a two-year period all admitted patients to a Tertiary Care Teaching hospital of varicose veins were evaluated for demographics, clinical manifestations, treatment and outcome. In the present study the clinical material consists of all the patients admitted with varicose veins of lower limb. Result: In our study, maximum number of patients were in 18-30 years and predominant were male. In this series, 46 patients had varicosity in the left lower limb and 38 had varicosity in the right lower limb and the remaining 6 had bilateral limb involvement. Among them prominent veins and pain were the main complain in 70 (77.7%) patients. Itching and pigmentation were present in 8 (8.9%) patients. Ankle edema was present in 7 (7.8%) patients. Pain and ulceration of lower leg were present in 5 (5.6%) patients. Out of 90 cases studied, 37 (41.1%) had only long saphenous vein, 15 (16.7%) had short saphenous vein and in 14 (15.5%) cases both short and long saphenous were involved. In addition to long saphenous vein, incompetent perforators were present in 24 (26.7%) cases. Conclusion: Operative line of management should be the first line of treatment even though conservative management relieves the symptoms but always requires a definitive management. In the present study, varicose veins are commonly seen in males, maximum in the age group of 30 to 50 years. Most common presenting symptom is visible dilated veins over lower limb but more than half of the patients present with one or more complications.

ion The increasing prevalence of overweight and obesity among school-aged children has emerged as a critical public health concern worldwide. This study evaluates overweight and obesity in a school-based program by examining key indicators, including Body Mass Index (BMI), body composition, and health-related behavioral patterns. Behavioral data collected from food frequency questionnaires and activity logs highlighted poor dietary habits, characterized by excessive snack and sugary drink consumption and inadequate vegetable intake. Childhood overweight and obesity have become global public health challenges, leading to an increased need for targeted assessment strategies. Schools are considered key venues for implementing programs to address these issues due to their structured environment and access to children. Material and Methods This is Prospective, Randomized and Observational study was conducted in the Department of Physiology, Index Medical College. The study was conducted in both private and government schools of Index city. Adolescents from 1-18 years of age are studying in sixth, seventh, eighth, ninth and Tenth standard was included for the study. The investigator finished data collection of the control group first and then only collected data of the experimental group. Different schools were selected for intervention which was away from the schools in control group to minimise contamination of information. There is one question on sleeping habit, a child who has slept for less than 8 hours during nighttime is at the potential risk of developing obesity. Good sleeping habit was given a score of one, and otherwise, a score of zero was given.Results Intervention Group: The mean BMI is 25.8 and in Control Group: The mean BMI is 26.0 Both the intervention and control groups have similar mean BMI values, with the intervention group being slightly lower (25.8 vs. 26.0). The difference in BMI is quite small (only 0.2), which suggests that, at baseline, the two groups are very similar in terms of BMI. In the intervention group, 60% had good eating habits, 30% had fair habits, and 10% had poor habits. In the control group, the respective percentages were 50%, 35%, and 15%. Intervention group had a baseline blood pressure of 120/80 ± 10 mmHg, while the control group had 122/82 ± 12 mmHg. Physical activity has a coefficient of -0.8, indicating a strong negative association with BMI (increased physical activity reduces BMI). Dietary changes have a coefficient of -0.6, suggesting that dietary improvements also reduce BMI. Socioeconomic status has a coefficient of 0.3, implying a minor positive association with BMI. Conclusion This study found that a school-based intervention including counseling and access to an after school exercise program was feasible for nurses to deliver with high fidelity and acceptable to overweight and obese adolescents, but the majority of adolescents did not participate in the after school exercise program. While such a program delivering weight management counseling to overweight and obese adolescents within the school setting is theoretically appealing and has tremendous public health potential, it was not found to be effective in improving BMI or key obesogenic behaviors. 

Background: Stroke is common during the first few weeks after a transient ischemic attack (TIA) or minor ischemic stroke. Combination therapy with clopidogrel and aspirin may provide greater protection against subsequent stroke than aspirin alone. Materials and methods: In a randomized, double-blind controlled study conducted at 114 centers, we randomly assigned 5170 patients within 24 hours after the onset of minor ischemic stroke or high-risk TIA to combination therapy with clopidogrel and aspirin (clopidogrel at an initial dose of 300 mg, followed by 75 mg per day for 90 days, plus aspirin at a dose of 75 mg per day for the first 21 days) or to placebo plus aspirin (75 mg per day for 90 days). All participants received open-label aspirin at a clinician-determined dose of 75 to 300 mg on day 1. The primary outcome was stroke (ischemic or hemorrhagic) during 90 days of follow-up in an intention-totreat analysis. Treatment differences were assessed with the use of a Cox proportional-hazards model, with study center as a random effect. Result: Demographic data and clinical characteristics of the patients are presented in Table 1. There were 68 males and 22 females ranging in age from 34 to 78 years with the mean age of 61.71 ± 11.69 years. The most common subtypes of acute ischemic stroke as per TOAST criteria were as follows: large vessel, small vessel, and cardioembolic. Hypertension was most commonly observed risk factor for stroke. The other risk factors in decreasing order of frequency included CAD, diabetes, dyslipidemia, smoking, and alcohol. Conclusion: Ticagrelor plus ASA is expected to be effective for prevention of recurrence in mild non-cardioembolic stroke and high-risk TIA.

Introduction: Inguinal hernia repair is normally implemented under spinal anaesthesia. However, epidural anaesthesia procedure offers constant hemodynamic with early ambulation and less urinary retention, less frequency of nausea and vomiting. We compared efficacy, feasibility and safety of ilioinguinal nerve block for inguinal hernia repair with spinal anaesthesia versus epidural anaesthesia. Methods: A prospective randomized controlled trial was conducted on a sample of patients undergoing elective inguinal hernioplasty. Patients were randomly assigned to receive either spinal anaesthesia or epidural anaesthesia. The primary outcomes assessed included surgical success, intraoperative and postoperative pain levels, duration of surgery, intraoperative complications, postoperative complications, and patient satisfaction. Secondary outcomes included postoperative analgesic requirements and length of hospital stay Results: Anesthesia time was the longest in the EA group (23.1±2.32 min) and significantly prolonged the operation time (P<0.001). When the visual analog scale scores were compared, it was observed that the patients in the GA group felt significantly more pain (P<0.001). While the rates of hypotension and headache were higher in regional anesthesia (P<0.001 and P<0.002), there was no significant difference in urinary retention, postoperative nausea/vomiting, and shoulder pain (P=0.274, 0.262, and 0.314, respectively). SA and EA groups were found to be superior compared with the GA group in terms of patient satisfaction (P<0.001). Conclusion: Epidural anaesthesia can be a safe alternative to spinal anaesthesia for elective inguinal hernia repair.

Introduction Keratomycosis is a fungal infection of the cornea characterized by the invasion of fungal organisms into the corneal tissue, leading to symptoms like pain, redness, and potential vision loss. It primarily affects the corneal epithelium and stroma. Symptoms include ocular pain, photophobia, tearing, and a decline in visual acuity. Signs observed during slit-lamp examination may reveal corneal infiltrates, epithelial defect, and a distinct ring infiltrate, especially with Fusarium infections. Corneal blindness is the second most important cause of blindness in the world after cataract. In contrast to the visual loss from cataract which affects mainly the older age group, corneal ulceration is encountered in all ages.  Material and Methods A prospective study was conducted in the Department of Microbiology, Index Medical College over a period of 2 Years from January 2022 to July 2024. Patients with suspected fungal corneal ulcers presenting in the Out Patient Department (OPD) of Ophthalmology was investigated for fungal etiology in the Department of Microbiology was included in this study. Patients presenting with corneal ulcer defined as a loss of corneal epithelium with underlying stromal infiltration and suppuration associated with signs of inflammation was included in this study.  Results Fungal infections were prevalent, with Aspergillus spp. (22.4%) and Fusarium spp. (18.8%) as leading pathogens. The presence of Staphylococcus aureus is the most prevalent microorganism in this patient population, accounting for 26.5% of cases. Fusarium spp. and Pseudomonas aeruginosa also show notable percentages, suggesting a diverse range of pathogens. Candida spp. and Acanthamoeba spp. have lower prevalence rates, but their presence is still important to consider in clinical assessments. A majority of patients (65.9%) showed successful resolution, likely reflecting effective antifungal treatment regimens. A smaller group (34 patients) achieved partial resolution, suggesting that while there was some improvement, the outcomes were not fully satisfactory. No improvement was noted in 24 patients, highlighting the need for further investigation into the effectiveness of treatments for this subset. Conclusion Keratomycosis is one of the most difficult of  microbial keratitis for the ophthalmologists to diagnose and treat. The diagnostic work up is tedious and the topical antifungals are not as effective as antibiotics in bacterial keratitis. The treatment is prolonged and is often complicated by secondary glaucoma and medical failure. However, a high index of clinical suspicion and a judicious management approach will go a long way in reducing visual disability.

Background: Steven-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare and sometimes life-threatening hypersensitivity mucocutaneous disease triggered mostly by medication and infections. Even after recovering from skin problems without sequelae, survivors can have serious ocular complications leading to blindness despite local and systemic therapy. Early detection and aggressive treatment are important for the long-term prognosis of the eye. Eyelid margin and palpebral conjunctiva and fornix should be checked thoroughly to detect the cicatrical changes that make chronic ocular surface failure such as limbal cell deficiency and complete ocular surface keratinization. Amniotic membrane transplantation and cultivated oral mucosal graft are beneficial to reduce the risk of ocular surface failure. Materials and methods: This is a prospective study conducted in the Department of Dermatology at Tertiary Care Teaching Hospital over a period of 1 year. The data included information on gender, presenting age, causative medications/diseases, and systemic treatments. Regarding disease chronicity, Shanbhag et al. have defined the acute phase as the period between symptom onset of SJS/TEN up to 2 months later; the subacute phase was defined as 2–6 months after symptom onset; and the chronic phase was defined as more than 6 months after symptom onset. Based on clinical parameters, observed on ocular slit-lamp examination, the severity of involvement at the time of presentation was determined as mild, moderate, and severe. Result: A total of 40 patients were included in the study during the study period, of which 19 were males and 21 females. Out of these, 22 were SJS or SJS/TEN overlap and 8 were TEN patients. About 30.0% (12 patients) had mild involvement, 55.0% (22 patients) had moderate involvement, and 15.0% (6 patients) had severe involvement. At the end of the study period, 8 patients (29.6%) developed chronic sequelae of ocular manifestations. Out of these patients, 3 patients developed severe dry eye disease, 2 patients developed trichiasis, 2 patients had a diminution of vision, and 1 patient developed severe photophobia. Patients of SJS and SJS-TEN overlap had mild-to-moderate whereas patients of TEN had moderate to severe ocular manifestations. Conclusion: Stevens-Johnson syndrome and toxic epidermal necrolysis are complex immunological syndrome that can result in devastating complications of ocular surface scarring and keratinization leading to blindness. Early ophthalmic assessment and management as well as regular follow up care are key factors to recovery and prevention of ocular complications.

We plan to study the prevalence of COVID infection in the health care workers working both in COVID and non-COVID facility and also identify source of infection, the demographic pattern, difference in infection rate in health care workers working in COVID facility and non-COVID facility, compliance to use of PPE and following social distancing norms. Material Method: The RT PCR Positive health care workers were interviewed telephonically with informed consent for presence of symptoms, source of infection, method of donning and doffing of PPE while working in COVID and Non COVID facility, social distancing norms followed or not followed. Result: 117 staffs got tested. 40 found positive by RT PCR. The infection rate was more amongst staff working in non-COVID facility (65%) in comparison to COVID facility (22.5%). Infection rate among nursing staff was the highest (40%), followed by doctors (35%), technicians and attendants. Male were more affected than females. 25 staffs reported not wearing appropriate PPE, 16 staffs reported breaching social distancing protocol. Conclusion: Though all health care workers are equally trained during COVID pandemic, there is somehow low adherence to infection prevention practices among the health care workers working in non-COVID facility, thereby increasing the risk to infection. Non COVID facility staffs need to be specifically targeted for training and implementation of infection prevention practices.

Background: PCPNDT Act 1994 is enacted by Parliament of India came into existence to stop female feticide and to maintain sex ratio in India. The act prohibits sex discrimination both before and after conception. Various studies have been done in the past with regards to PCPNDT Act, however the impact of this law on the society is a continuous ongoing process. This study is being conducted to assess the awareness among the general population about PCPNDT Act and to study the impact of it on the attitude of the people regarding sex ratio, after its inception of almost 30 years ago. Methods: An observational, cross-sectional study was conducted at Multispecialty Hospital, Whitefield, Bengaluru South for 4 months period among women of reproductive age group (15-49yrs) visiting obstetrics OPD by using pre-tested semi-structured questionnaire as a study instrument.  Results: Majority of the females included in the study were aged between 21 to 30 years (56.1%) and are graduates accounting for about 50 (37.9%). Though majority had graduate degree, 65.2% were unemployed. Knowledge about the sex ratio were known by 72 (54.5%) and 71 (53.8%) were aware of Act. 67(50.8%) were responded that even in child sex ratio males being higher. 103 (78%) had opined that knowing about the sex ratio is important.  Conclusions: 21(15.9%) believed that foetal sex determination done in India with the primary motive by family members and most of them had idea that it is done at private hospital by foetal USG. None of them had the attitude of terminating their pregnancy even if they know the sex of their foetus and 129 (97.7%) study population were willing to educate people about the PCPNDT Act.

In India, the number of people with diabetes is increasing day-by-day. Due to a sole “Asian Indian Phenotype,” Indians develop diabetes an era earlier and have an earlier onset of complications. Hence, it is essential to evaluate earlier stage of disease progression. Prediabetes, typically defined as blood glucose levels above normal but below the thresholds of diagnosis of diabetes, is a risk state that defines a high chance of developing diabetes. The present study was Prospective, open label, comparative, randomized, parallel group, single center study. Comparison of two active treatment groups over a period of six months. Sixty patients of either sex in the age of more than 40 years with prediabetes, with HbAlc in the range of 5.7 to 6.4% at screening as per ADA. The effect of metformin and pioglitazone were observed on various parameters i.e. Serum Insulin, FBG, HbA1c, HOMA-IR. In metformin group the mean change in HOMA-IR from baseline to 6 months was 3.44 to 2.21 (-1.23); on the other hand, in Pioglitazone group from baseline to 6 months was 3.30 to 1.91 (-1.39). Whereas, serum insulin from 35.58 to 26.73 (-8.85) in metformin group; in Pioglitazone group from 35.13 to 21.77 (-13.36). Pioglitazone statistically highly significant than metformin group in improving glycemic indices. Though metformin and pioglitazone were equally effective in improving glycemic indices yet pioglitazone showed better results in improving Serum Insulin, FBG, HbA1c, HOMA-IR as compared with Metformin. Pioglitazone had minimal side effects as compared to Metformin.