Background & Aim: Early-onset neonatal sepsis (EOS), occurring within the first 72 hours of life, is primarily caused by microorganisms originating from the maternal genital tract or the labor room environment. Infection may result from ascending infection following prolonged rupture of membranes, passage of the neonate through an infected birth canal, or during resuscitative procedures. Early identification of infected neonates among those with maternal intrapartum risk factors is crucial to prevent adverse outcomes. Various inflammatory markers, including C-reactive protein (CRP) and cytokines, have been investigated for their utility in the early diagnosis of bacterial sepsis. This study aimed to assess the influence of intrapartum risk factors for EOS on CRP levels and to evaluate the diagnostic utility of CRP in early-onset neonatal sepsis. Methods: This prospective study included 108 neonates with identified risk factors for infection and was conducted over a period of one year (March 2022 to March 2023) at Newborn Care Unit of ACSR Government Medical College Hospital, Nellore. CRP levels were measured in cord blood at birth and in neonatal blood samples collected at 24–36 hours of life using rapid slide latex agglutination method. Blood culture was also performed using standard laboratory method. All neonates were monitored clinically for signs of sepsis for a minimum duration of 72 hours. Results: Elevated cord blood CRP levels were observed in 10 neonates (9.3%). Raised cord blood CRP levels showed positive association with primiparity, prolonged rupture of membranes (>24 hours), prolonged labor, maternal fever, more than three vaginal examinations, foul-smelling liquor, maternal urinary tract infection, and delivery by lower segment cesarean section (LSCS). At 24 hours of life, elevated CRP levels demonstrated a similar association with these risk factors, in addition to meconium-stained liquor. Early-onset sepsis was diagnosed in 12 neonates (11.1%). The negative predictive value of CRP measured at 24 hours was 97%, indicating its high reliability in excluding EOS among at-risk neonates. Conclusion: Although several intrapartum risk factors may independently contribute to elevated CRP levels, CRP estimation is a valuable tool for excluding neonatal infection. CRP serves as a reliable marker for the early diagnosis of neonatal sepsis, facilitating timely intervention and thereby reducing neonatal morbidity and mortality.

Background: Pre-analytical errors are a major source of inaccuracies in laboratory medicine and are particularly critical in microbiology, where specimen quality directly influences diagnostic accuracy. Errors occurring during specimen collection, labeling, transport, and storage can lead to false or misleading results, delayed diagnosis, and inappropriate antimicrobial therapy. Objectives: To determine the frequency and types of pre-analytical errors in microbiology samples received at a tertiary care hospital laboratory. Materials and Methods: This observational study was conducted in the Department of Microbiology over a period of seven months from 1 September 2022 to 31 March 2023. All microbiology samples received during the study period were assessed for pre-analytical errors using predefined criteria. Errors were categorized based on the type of error and type of sample. Data were analyzed using descriptive statistics and expressed as percentages. Results A total of 1,240 microbiology samples were evaluated, of which 186 samples (15.0%) demonstrated one or more pre-analytical errors. The most common errors were improper sample collection (34.9%), insufficient sample quantity (21.5%), and delayed transport to the laboratory (18.3%). Blood samples accounted for the highest proportion of errors (32.8%), followed by urine (29.6%) and sputum samples (18.3%). Multiple pre-analytical errors were observed in 18.3% of affected samples. Conclusion Pre-analytical errors are common in microbiology laboratories and are largely preventable. Strengthening sample collection practices, ensuring timely transport, and providing regular training to healthcare personnel can significantly reduce these errors and improve the quality of microbiological diagnosis.

Introduction: Lower abdominal procedures (e.g., inguinal herniotomy, orchiopexy, pyloromyotomy) are common in early infancy, a period with heightened vulnerability to postoperative apnoea and hemodynamic instability. Spinal anaesthesia (SA) has re-emerged as an attractive alternative to general anaesthesia (GA) to minimize airway manipulation, opioid exposure, and early apnoea risk, while maintaining surgical conditions. The evidence base includes randomized trials and large observational cohorts. Materials and Methods: A prospective, randomized controlled trial was conducted on 60 full-term infants (ASA status I-II) scheduled for elective lower abdominal surgeries (e.g., inguinal hernia repair, orchidopexy). Infants were randomly allocated to either the SA group (n=30) or the GA group (n=30). The primary outcome was the incidence of perioperative respiratory events (apnoea, desaturation). Secondary outcomes included haemodynamic stability, postoperative pain scores (FLACC scale), time to full recovery, parental satisfaction, and complications. Result: The incidence of perioperative respiratory events was significantly lower in the SA group (3.3% vs. 30%, p<0.01). Haemodynamic parameters were more stable in the SA group. Postoperative pain scores were comparable at initial assessment but were significantly lower in the SA group at 2 and 4 hours postoperatively. Time to first oral intake and discharge readiness was shorter in the SA group. Conversion to GA was required in 2 patients (6.6%) in the SA group. Conclusion: Spinal anaesthesia is a safe and effective technique for lower abdominal surgeries in infants. It is associated with a significantly lower risk of respiratory complications, greater haemodynamic stability, and a faster recovery profile compared to general anaesthesia. It should be considered a primary anaesthetic option in this vulnerable population. 

Background: : As per the previous studies, the line that connects the highest portion of iliac crests crosses at L4–L5 intervertebral disc space level in midline posteriorly. This line on palpation and imaging have different relationships, especially in the L4–L5 interspace. Purpose: The purpose of this study is to determine whether the level at the highest iliac crest on palpation and in the c-arm is are same or not.  Materials And Methods: Admitted patients with lower back pain who are all accepted for injection steroid epidural route at our hospital, between July 2022 to November 2022. The authors drew the iliac crest line posteriorly on palpation and later in the C-arm, the level identified and was compared. Results: Thirty-four patients were included in our study with basic anthropometric variables (mean) are age 20-65 years (42 year), sex 12 males and 22 females, weight 50-95 kg (73.6 kg), height 145-185 cm (165.6 cm), body mass index 19-38 kg/m² (26.8 kg/m²). On palpation, the intercrestal line crosses the midline 8.8% at L3 spinous process, 55.9% at L3-L4 interspinous space, 29.4% at L4 spinous process, 5.9% at L4-L5, and in no case at L5 spinous process. The C-arm imaged line crossed at L4 in 70.5% and L4-5 in 29.5% of patients with normal spinal anatomy. Conclusion: Our research found that using the iliac crest line to locate spinal levels is more accurate with imaging than palpation. On palpation, the line at the highest level of the iliac crest is at L3–4 and L4 spinal levels rather than the L4 or L4–5 levels.

Introduction Gestational Diabetes Mellitus is defined as carbohydrate intolerance of variable severity with onset or first recognition during pregnancy, according to WHO guidelines. Gestational Diabetes Mellitus is “any degree of glucose intolerance that either starts during pregnancy or is newly diagnosed in pregnancy” as per ACOG (American College of. Obsterics and Gynecology). It includes women, whose glucose tolerance, is normal after pregnancy and those with type 2 diabetes with persistent glucose in intolerance developed later Materials and methods This case-control study was conducted at Department of Biochemistry, Mamata Medical College over a period of 1 year. A total of 360 pregnant women were enrolled in the study, including 180 women with gestational diabetes mellitus (GDM) and 180 healthy, age-matched pregnant women. The participants were recruited serially at 24–28 weeks of gestation. A three-hour oral glucose tolerance test was performed for women with plasma glucose concentrations exceeding 130 mg/dL on a glucose challenge test. The fasting plasma glucose concentration of the diagnosing oral glucose tolerance test was used as the mid-pregnancy fasting plasma glucose in this study. Results  In the present study, 360 gravid women, whose serum ferritin level was estimated at 24 to 28 weeks, were followed up with repeat screening for GDM in the third trimester. Among them, 71 (19.7%) were diagnosed with GDM during the follow-up period The present study assessed baseline demographic characteristics between the GDM (n = 77) and non-GDM (n = 311) groups. The mean age of participants in the GDM group was 28.0 ± 5.2 years, while in the non-GDM group, it was 27.0 ± 4.4 years, with a p-value of 0.087, indicating no significant difference between the groups. Conclusion: We can infer that serum ferritin is associated with development of GDM. Based on the findings of the current study, serum ferritin level can be used a predictive marker for the development of GDM.

Introduction: Spinal anesthesia is a widely used technique for various surgical procedures. The addition of adjuvants to local anesthetics like ropivacaine can enhance the quality and duration of anesthesia. This study aims to compare the efficacy of fentanyl and clonidine as adjuvants with ropivacaine in spinal anesthesia. Materials and Methods: A randomized controlled trial was conducted on 100 patients undergoing lower abdominal and lower limb surgeries. Patients were divided into two groups: Group F (ropivacaine + fentanyl) and Group C (ropivacaine + clonidine). Inclusion criteria included ASA I-II patients aged 18-60 years, while exclusion criteria included contraindications to spinal anesthesia, pregnancy, and severe systemic diseases. Parameters such as onset and duration of sensory and motor block, hemodynamic stability, and side effects were recorded. Results: Group F showed a faster onset of sensory and motor block compared to Group C. However, Group C demonstrated a longer duration of analgesia and better hemodynamic stability. Side effects such as pruritus were more common in Group F, while bradycardia was observed in Group C. Conclusion: Both fentanyl and clonidine are effective adjuvants to ropivacaine in spinal anesthesia, but their profiles differ. Fentanyl provides a faster onset, while clonidine offers prolonged analgesia and better hemodynamic stability. The choice of adjuvant should be tailored to patient needs and surgical requirements.

Introduction: In order to develop and implement an effective strategy for prevention and treatment of CVD in older people, it is necessary to have a more comprehensive understanding of a wide range of CVD risk factors and the factors relevant to this population. However, few studies focused on the older people. Therefore, the present study tries to assess the prevalence of CVD and its attributable risk factors among the older adults in India Materials and methods This is s a prospective and observational study was conducted in the Department of General Medicine, Ayaan Institute of Medical Sciences, Teaching Hospital & Research Centre. To determine the prevalence of lifestyle risk factors among CVD patients attending the hospital. The purposeful sampling method was employed to select all patients who met the study selection criteria. Adults aged ≥35 years diagnosed with CHD and HTN who attended the at hospital from. The study participants voluntarily consented to participate in the study were included. Results A total of 560 patients were evaluated for cardiovascular disease (CVD) risk factors. The mean age of the participants was 52.6 ± 14.8 years, with 57.1% (n = 320) male and 42.9% (n = 240) female. The majority of the patients (44.6%) were in the 40-59 years age group, The diagnosis of CVD seems to represent, for the individual, a rupture in his biopsychosocial balance, revealing the need to introduce changes in lifestyle and labor activity. The new disease requirements represent a new reality that imposes the adoption of healthier behaviors Conclusion In conclusion, the study provided a representative prevalence of CVD and relevant risk factors among older adult population in India. The high prevalence of CVD risk factors among older adults manifested alarming public health concerns and a future health demand. Implementational strategies are required for reducing CVD risk among elderly by focussed promotion of physical activities and early detection of CVDs based on family history.

Introduction: Subarachnoid block, although being highly efficient with lesser drug doses, often has limitation such as hypotension, continues to be a matter of concern to the anesthetist. The present study was aimed to compare the use of phenylephrine, ephedrine, and mephentermine bolus for maintenance of blood pressure during spinal anesthesia in lower abdominal surgeries. Materials and Methods: This is Randomized, single blind, prospective & comparative study. The study has been undertaken at the Department of Anesthesiology, Shadan Institute of Medical Sciences Teaching Hospital & Research Centre. Study population ASA 1 or 2 women with term, uncomplicated, singleton pregnancy scheduled to undergo elective caesarean section. We have optimized a sample size of 50 (25 in each group) using a sealed envelope technique to determine the drug that were used for prevention of hypotension. Patients in the ‘phenylephrine group’(P) had received an infusion of phenylephrine hydrochloride, whereas patients in the ‘mephentermine group’ (M) had received an infusion of mephentermine sulphate. Results A total of 50 patients were analyzed. Within 5 minutes of Spinal anaesthesia there was no significant difference between Group-P and Group-M on drop of average Systolic blood pressure, Diastolic blood pressure and average Heart rates at different minutes. But after administering the drug for hypotention correction Group P shows very high average SBP and DBP correction compared to Group M which is statistically significant (p<0.0001) and Group P shows a fall in the heart rate compared to Group M which is statistically significant nit (PACU) Conclusion: Mephentermine and ephedrine were similar in performance, offered a better hypotensive control, and had lower recurring events as compared to phenylephrine.

Introduction Type 2 diabetes mellitus (T2DM) is inherited genetically. There may be an association with blood group as blood group is predetermined genetically Genetic background thus has a role in the pathogenesis of type 2 diabetes mellitus, although environmental factors playing a big role in the final outcome If the increased prevalence with a particular ABO phenotype is confirmed, preventive strategies can be adopted in those persons. Our study was therefore undertaken considering these conflicting findings Material and Methods A comparative cross-sectional study was conducted among T2DM patients and healthy controls. The study was conducted at Department of Physiology, Shadan Institute of Medical Sciences Teaching Hospital & Research Center. All T2DM patients who attended Hospital were the source population for cases while healthy volunteer blood donors at blood bank were the source population for controls. The study population for cases was all T2DM patients who had medical follow-up at Hospital during the data collection period, whereas healthy (non-diabetic) voluntary blood donors who donated blood during the study period at the Hospital blood bank were considered as the study population for controls. During data collection, the identification of T2DM from T1DM was done by analyzing the patient chart. Results Distribution of Blood Groups Among the study population (n=260), blood group B had the highest frequency (30.8%), followed by A (26.9%), O (23.1%), and AB (19.2%). T2DM Prevalence Blood groups A and B showed higher prevalence rates of T2DM (64.3% and 62.5%, respectively) compared to AB (40.0%) and O (50.0%). Statistical Significance Blood group A showed a statistically significant association with T2DM (OR=1.50, p=0.042). Blood group B showed a higher odds ratio but did not reach statistical significance (p=0.078). Blood group AB showed no significant correlation, and blood group O served as the reference group. Conclusion The study suggests a potential correlation between ABO blood group and the prevalence of T2DM, with blood group A showing a statistically significant association. Blood group B also exhibited a notable trend, though not statistically significant. These findings highlight the importance of considering genetic and lifestyle factors in T2DM risk assessment. Further studies with larger and more diverse populations are recommended to validate these results and explore underlying mechanisms

Introduction: Hysterectomy is one of the most commonly performed major operations. Historically the uterus has been removed by either the abdominal or vaginal route. The vaginal operation is preferable when there are no contraindications because of lower morbidity and quicker recovery. Laparoscopically assisted vaginal hysterectomy (LAVH) has gained widespread acceptance. Laparoscopic dissection of the para-uterine tissues to the level of the uterine arteries (LAVH) or to include the uterine arteries (laparoscopic hysterectomy), also permits oophorectomy or dissection of adhesions under direct vision more easily than this can be achieved at vaginal hysterectomy (VH). Recently LAVH was associated with a significantly higher rate of major complications than abdominal total hysterectomy (TAH). LAVH took longer to perform but was associated with less pain, quicker recovery and better short-term quality of life measures. Materials And Methods: This is a Prospective and Comparative Study conducted at Department of Obstetrics and Gynecology, Ayaan Institute of Medical Sciences over a period of 1 year. Total 140 patients undergoing hysterectomy for benign uterine pathology meeting the inclusion and exclusion criterion will be included in the study. 70-Laparoscopic assisted vaginal hysterectomy and 70-Total abdominal hysterectomy. Results: 87.1% of women of TAH group needed spinal anesthesia and only 12% needed general anaesthesia. On the other hand, all the women of LAVH group needed general anaesthesia. Duration of surgery was little more in patients who underwent LAVH when compared to patients who underwent TAH. The average duration of surgery in TAH group is 50 minutes and it is 75 minutes in LAVH group. In TAH group, blood loss was more (250-500ml) in 32.85% of patients, where as it was <250 ml in 58.57% of patients in LAVH group. Average blood loss is 238 ml and 130 ml in TAH and LAVH group respectively. Only two patients (5%) in TAH group had bladder injury where as in LAVH group one patient (3.3%) had bladder injury and one patient (3.3%) had bowel injury. No bowel and ureteric inuries in TAH group. Only 2 patients in LAVH group needed conversion into laparotomy because of adhesions and uncontrollable haemorrhage. Conclusion: LAVH is associated with less blood loss and decreased intra operative complications when compared to TAH. Length of hospital stay is significantly less for LAVH when compared to TAH. Post-operative pain, complications and blood transfusions are more with TAH group, because of which patient had longer hospital stay and took longer time for recovery and return to work

Introduction

Acute appendicitis is one of the most common causes of acute abdominal pain requiring surgical intervention. Accurate and timely diagnosis is crucial to minimize complications such as perforation and peritonitis. Ultrasound has emerged as a valuable, non-invasive imaging modality in diagnosing acute appendicitis, particularly in scenarios where clinical diagnosis is challenging. This study aims to evaluate the diagnostic accuracy of ultrasound in detecting acute appendicitis in a sample size of 90 patients presenting with suspected appendicitis at a tertiary care hospital. Materials and Methods: This prospective observational study was conducted at a tertiary care teaching hospital over six months. A total of 90 patients presenting with acute abdominal pain and clinical suspicion of appendicitis were included in the study. Patients of all genders aged 10 years and above. Clinical suspicion of acute appendicitis based on symptoms (right lower quadrant pain, fever, nausea, etc.) and physical examination (e.g., McBurney’s point tenderness) were included. The sonographic diagnosis was categorized as positive, negative, or equivocal for appendicitis. All patients subsequently underwent surgical evaluation, and appendectomy specimens were subjected to histopathological examination, which served as the gold standard for diagnosis. Results: An enlarged appendix (>6 mm) was the most frequent finding (64.4%), followed by non-compressibility (58.9%). Periappendiceal fat stranding and free fluid were less common but still significant markers of inflammation. Sensitivity (84.6%): Ultrasound correctly identified 84.6% of patients with acute appendicitis, indicating its ability to detect true positive cases effectively. Specificity (78.3%): Ultrasound correctly ruled out acute appendicitis in 78.3% of patients without the condition, though some false positives were noted. PPV (91.3%): High predictive value of a positive ultrasound suggests reliable confirmation of appendicitis when ultrasound findings are positive. NPV (66.7%): The lower negative predictive value emphasizes the risk of missed diagnoses in cases of negative ultrasound, particularly in atypical presentations.  Conclusion: Ultrasound is an effective first-line imaging modality in diagnosing acute appendicitis, offering high sensitivity and specificity. Its non-invasive nature and lack of radiation make it particularly suitable for vulnerable populations such as children and pregnant women. While limitations exist, the integration of ultrasound with clinical and laboratory findings can significantly improve diagnostic efficiency, reducing negative appendectomy rates and associated complications.

Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are significant contributors to morbidity and mortality, with mortality rates nearing 62%. These infections are the second most prevalent cause of nosocomial infections overall, but they are the most common in intensive care units (ICUs). Additionally, HAP and VAP are linked to the highest mortality rates among nosocomial infections.  Methods: To investigate the clinical, radiological, and bacteriological profile of hospital-acquired pneumonia (HAP) and factors influencing its outcomes, we conducted an 24-month prospective study at a governmental hospital's general ICUs. Diagnosis of HAP was based on the ATS/IDSA 2016 guidelines, requiring both radiological criteria (new or progressive infiltrates in chest x-ray) and clinical criteria (at least two of the following: fever > 38°C, leucocytosis or leucopenia with purulent secretions, decreased oxygenation). Results: The majority (53%) of study population had chronic respiratory illness followed by diabetes (31%) and other systemic illnesses. 50 (19%) of HAP patients didn’t have any co-morbidities According to chest x ray and HRCT thorax reports of HAP patients, 108 (40%) had infiltrates in single lobe, 90(33%) cases had infiltrates in 2 lobes and 88(33%) cases had infiltrates in 3 or more lobes. Bilateral infiltrates seen in 52% of patients. Out of 2054 patients, 626 (30%) cases were on mechanical ventilation out of which 145(7%) developed HAP. 70 (7%) cases developed HAP among 1428(70%) cases who were not on mechanical ventilation. Out of 270 HAP cases, 145(54%) had ventilator associated pneumonia and 125(46.29%) cases had HAP among non-ventilated patients.  Conclusion: High incidence rate of HAP was linked with P. aeruginosa, K. pneumoniae, tracheostomy, and APACHE II ≥17. Furthermore, high mortality rate was strongly correlated with reintubation, duration in ICU ≥5 days, HAP outcome, DM, APACHE II ≥17, and neurological diseases. More research should be conducted to reassess the impact of HAP in nongovernmental ICU settings.

Background & Objectives: Intubating laryngeal mask airway (ILMA) is a supraglottic airway device (SAD) frequently used as conduit for endotracheal intubation when intubation under direct laryngoscopy is undesirable. A newer SAD i-gel is popular now because of its ease of insertion and performance. It can be used as a conduit for endotracheal intubation also. This study compared the success rate of blind endotracheal intubation through ILMA and i-gel. Methods: A prospective double blind randomized controlled study was conducted in the Department of Anaesthesia & Critical Care, Patna Medical College and Hospital, Patna, Bihar, India for 1 year. A total of 120 patients were randomly assigned using a chit method into two groups of 60 each. One group will be allocated I-LMA (group L) and other I-GEL (group G). Randomization will be done using concealed envelop technique. All patients will be administered injection glycopyrolate (0.004mg/kg), injection ranitidine (50mg i.v), injection ondansetron (0.1 mg/kg i.v), injection Nalbuphine (0.2mg/kg I.V) before induction. Preoxygenation with 100% oxygen for 3 minutes. Induction will be done with injection Propofol (2.5 mg/kg i.v). I-gel no.3 will be used for female and no. 4 will be used for male. Endotracheal tube size 6.5 mm/7mm for female and size 7mm/7.5mm will be used for male. Endotracheal tube will be introduced through I-gel/I-LMA. Results: When insertion attempts were compared between two groups, I-gel was inserted in first attempt in 95% patients and I-lma was inserted first attempt in 90% patients. Data was comparable between the two groups (p>0.05). ET tube Insertion was successful on first attempt in 65% of patients in group G and 75% of patients in group I-LMA. The data was comparable between the two groups (p>0.05). The mean time taken for placement of I-GEL was 20.98± 2.36 seconds and for I-lma it was17.85 ± 2.07 seconds. The difference between two groups was extremely significant (p<0.01). When mean time for insertion of ET tube through SAD was compared ET tube was inserted with mean time of 23.98 ± 1.42 seconds in Group G and in Group L it was 20.85 ± 1.70 seconds. The difference between two groups did not reveal any significance (p<0.01). Conclusion: we came to conclusion that Time taken to insert ET tube via I-LMA is significantly less than that of. I-gel. I-gel can be used as a conduit for endotracheal intubation.

Background: The term "interstitial lung disease" (ILD) refers to a range of disorders that induce lung scarring (fibrosis). The present study was done to evaluate the Clinical characteristics of Interstitial Lung Diseases (ILDs) patients. Material & methods: This cross-sectional study was conducted at Tertiary Care Teaching Hospital. All consecutive patients of all types of ILDs, attending the outpatient services of the Department of Pulmonary Medicine were enrolment and subjected to focused socio-demographic history. Data was analyzed using Epi info V7 software by applying appropriate statistical tests. Results: The present study includes 68 patients of different types of ILD. Among the study population, 36 (52.9%) were female and 32 (47.1%) were male. The mean age of males and females was 64.615+3.26 years and 56.187+ 5.24 years respectively. Also,there was no significant difference between males and females regarding the duration of illness (2.87 ±2.46 years versus 3.87+2.15 years, p=0.438). Cough was the predominant symptom observed in 66 patients followed by breathlessness mMRC grade II/III in 62 patients. The exertional chest pain was reported by 24 patients. History of syncope was recorded in 20 patients. On examination, a total of 42 patients had clubbing of different grades. Overall, sixteen patients had raised JVP. Velcro crackle was detected on auscultation among 38 patients. There was no significant male-female difference with regards to symptoms. Conclusion: Most of ILD patient’s had cough, breathlessness mMRC grade II/III, exertional chest pain, history of syncope, clubbing, raised JVP and Velcro crackle on auscultation.

Introduction: Psoriasis is a common chronic inflammatory condition of the skin, which also has nails and systemic involvement. Psoriatic involvement of the nail bed or nail matrix results in nail psoriasis. Nail involvement is a visible indicator to predict future joint inflammatory damages and disease activity. Nail psoriasis can manifest clinically as a wide variety of nail changes, like nail discoloration, subungual hyperkeratosis, pitting and onycholysis, depending upon the part of the nail units affected. Patients with psoriatic nails have impaired quality of life due to the appearance of nails, and significant morbidity and functional impairments may arise in large cases. Its management is challenging because it is long term, and often not satisfying the patients leads to depression, which further deteriorates the condition. Patient education with explaining the prognosis and outcomes of the treatment is the most important aspect.  Material and Methods: All the psoriasis patients attending the outpatient department of dermatology and venereology at a tertiary referral center in Hyderabad for a period of 1 year were included in this cross-sectional study. Patients receiving/have received systemic antipsoriatic medications or topical nail medications in the past 3 months and patients with concomitant onychomycosis proven by microscopy and/or culture were excluded from the study. A detailed history was taken in each patient with particular reference to cutaneous complaints including duration, progression, and treatment modalities. Based on the age of onset of disease, patients were classified into early-onset group (age of disease onset <40 years) and late-onset group (age of disease onset at or after 40 years).  Results: A total of 90 patients with psoriatic nail involvement were included in the study. The mean age of the patients was 44.1± 11.2 years (range 14-74 years). Fifty-five percent of patients had the disease for more than 5 years, and the duration of treatment ranged from 0.2 to 11 years (4.9 ± 2.6 years). The mean body mass index (BMI) of the study population was 26.3 ± 3.2 kg/m2. Hypertension was the commonest comorbidity. Conclusions: Our study documents nail changes in psoriasis and severity of involvement in the Indian context. We found discordance between the extent of nail involvement (as scored by nail psoriasis severity index) and the impact on quality of life (as evaluated by nail psoriasis quality of life 10). This lack of congruent impact suggests that probably the scoring systems need appropriate adaptation suited to the Indian population. Furthermore, a high proportion of patients had raised levels of immune and serological markers. Such reports in arthropathies other than rheumatoid arthritis raise a word of caution in their interpretation for diagnostic purposes. It can be seen that a close monitoring and follow-up of psoriatic patients with nail disease is of utmost importance. Further controlled studies with a larger population-based sample size are warranted before definite conclusions can be reached.

ntroduction: Low birth weight (LBW) is defined by WHO as the weight of live born infants less than 2,500 g irrespective of their gestation. LBW is closely associated with fetal and perinatal mortality and morbidity. At the population level, the proportion of babies with a LBW is an indicator of a multifaceted public-health problem that includes long-term maternal malnutrition, ill health, hard work and poor health care in pregnancy. At an individual level, LBW is an important predictor of newborn health and survival and is associated with higher risk of infant and childhood mortality.  Methods: This was a prospective study conducted in the Department of Pediatrics, Tertiary Care Teaching Hospital over a period of 1 year. There was a total of 450 babies in this study, of which 150 were low birth weight babies and the rest 300 babies were weighing 2.5 kg or    more. To ascertain the maternal factors responsible for low-birth-weight babies, study of which will enable us to understand the measures involved in reducing the neonatal   mortality and morbidity. In this study, an analysis 150 mothers of LBW babies were done and compared with 300 normal weight babies. The variables were subjected to computer analysis using focus format.  Results: In mothers who had no education& Mothers belonging to lower socioeconomic class had higher chance of delivering low birth weight babies. Parity has a significant relationship with birth weight. There is significant association of PIH and oligohydramnious with birth weight.  Maternal malnutrition and anaemia have a significant association with LBW Conclusion: This study was conducted to know the maternal and bio-social factors that influence low birth weight babies. There was no significant association with maternal age and religion (community) with birth weight in our study. Parity has a significant relationship with birth weight with higher birth weight among women with higher parity. There is significant association of PIH and oligohydramnious with birth weight. Maternal malnutrition and anaemia have a significant association with LBW with higher incidence of Low birth weight among malnourished and anaemic mothers. 

Background: Lung cancer is one of the most frequent cancers and a major cause of cancer death worldwide. Lung cancer accounts for 11.6% of all new cancer cases identified each year and is quickly becoming the most prevalent fatal neoplastic disorder in the world, accounting for 18.4% of all cancer-related fatalities worldwide1. Objectives: 1. To study the clinical profile of newly diagnosed bronchogenic carcinoma patients. 2. To study the clinicopathological correlation among various histological types of bronchogenic carcinoma in the above patients. 3. To study the extrapulmonary manifestations and the prevalence of identifiable paraneoplastic syndromes (if present) in patients with bronchogenic carcinoma. Material & Methods: Study Design: Prospective hospital-based observational study. Study area:  The study was conducted in the Department of Pulmonary Medicine, Government Medical College, Kadapa.  Study Period:  June 2023 – December 2023. Sample size: The study consisted of 52 subjects. Sampling method: Simple random Sampling Technique. Inclusion criteria: Patients attending hospital, diagnosed with bronchogenic carcinoma in the specified period. Study tools and Data collection procedure: Patients included in the study were selected according to the inclusion and exclusion criteria. After obtaining informed consent, data was gathered from history, objective examination of the patients and lab investigations using a semi-structured questionnaire. The localisation of the tumors was done by chest x-ray, fibre optic bronchoscopy and/or CT scan as required. Tissue diagnosis was obtained by FNAC/ biopsy or other cytology and histopathological examination of the specimen was carried out. The type pattern of paraneoplastic syndromes was noted. Results: COPD (65.38%) and Diabetes (23%) were the common co-morbidities affecting the study population followed by HTN (19.2%). H/O old PTB was noted in 11.5% of the patients and 1 patient (1.9%) had h/o ILD. 2(3.8%) patients had past h/o malignancy. One patient had h/o squamous cell carcinoma of the right ear another patient had cervical cancer and 1 (3.8%) patient had a family history of malignancy (first-degree relative). Conclusion: Lung cancer is a rapidly progressive disease with a very high mortality rate but treatment in the early stage may give a good prognosis. High-risk patients with having smoking history should be evaluated clinicoradiologically with high suspicion so that early diagnosis can be made and the quality of life of patients can be improved. Primary lung cancer should always be suspected in a person presenting with unexplained cough for several weeks with other symptoms such as weight loss, and fever with non-resolving collapse-consolidation on chest radiograph.

Introduction Hypertension-related complications, such as intravascular coagulation and histopathologic lesions (mostly massive perivillous fibrin deposition), may also affect blood flow to the fetus and therefore affect normal growth. Since, β-hCG have a different role in pregnancy, thus one study suggested low levels of serum β-hCG as a predictor of poor pregnancy outcome in early pregnancy and the common complications related to altered β-hCG are ectopic pregnancies as well as spontaneous miscarriage.  Material and Methods This is prospective, Non-Randomized and observational study was conducted in the Department of Biochemistry, Index Medical College from 2022 to 2023. First time pregnant women, who was aged 18- 40 years with singleton pregnancy, was included in the study. Detailed information was given about the study and informed consent obtained for participation in the study. Each subject was randomly and consecutively selected, representing a cross- sectional study of the Indore population. Women at POG >22 weeks with Singleton pregnancy were included a one hundred thirty Hypertensive women as case group and control group include another one hundred thirty normotensive women after matching the parity and gestation age.  Results In this study, Normotensive Group: All normotensive individuals have systolic BP <140 mmHg. By definition, systolic BP <140 mmHg is classified as normal, so this result aligns with expectations. PIH Group: None of the individuals with PIH have systolic BP <140 mmHg, as hypertension is characterized by systolic BP ≥140 mmHg. A majority of PIH cases (52.3%) have systolic BP in the 140–150 mmHg range, indicative of mild hypertension. A significant proportion (37.6%) have systolic BP in the 150–160 mmHg range, while a smaller subset (10%) have readings >160 mmHg, suggesting severe hypertension. This indicates a statistically significant difference in systolic BP distribution between the PIH and normotensive groups. The absence of overlap between the groups highlights the distinction in BP levels. Conclusion This study showed that estimation of serum Beta HCG levels in early second trimester of pregnancy is a useful indicator to identify women who are likely to develop gestational hypertension in the same pregnancy. The level of beta HCG is strongly associated with development of GHT.

Diabetic neuropathy (DN) is a common complication of type 2 diabetes (T2DM) and is characterized by persistent inflammation. Hematological parameters have emerged as a novel marker for detecting chronic inflammatory conditions, including diabetes. DN has been a significant concern and a complication of diabetes mellitus (DM). The number of people with DM has doubled during the past 20 years. By 2045, it is projected that 628 million individuals worldwide will be affected by this disease, while the currently estimated cases of DN stand at approximately 425 million.1 According to statistics, 179 million people can have DM but remain undiagnosed for various reasons. Due to ageing demographics, low levels of physical exercise, and urbanization, the number of people with T2DM has been expanding. Materials and methods: The cross-sectional analytical study was carried out at the Department of Pathology, UNS ASMC, Jaunpur and informed consent, patients were selected by consecutive sampling technique. In the study out of which 30 were non diabetic healthy subjects which were taken as group1 and 60 were known diabetic patients which were divided into two groups with HbA1c <7(30 subjects) as group 2 and HbA1c >7(30 subjects) as group 3.  All the patients were assessed because of their clinical history and laboratory evidence. The patients' clinical details, type of anaemia, laboratory investigations and complications related to diabetes were recorded on a specially designed proforma. Result: Mean RBC count of diabetics with HbA1c<7 was less when compared to non-diabetic individuals.  Significant decrease was noted in the mean RBC count, Hb, HCT and MCV of diabetics with HbA1c>7 when compared to non-diabetic individuals. There was significant decrease in mean Hb, HCT, MCV, MCH of diabetics with HbA1c >7 when compared to diabetics with HbA1c <7. Conclusion: Monitoring changes in hematological parameters can be a useful tool in better management of diabetic patients. To conclude periodic monitoring and careful assessment of haematological parameters can prove to be of utmost help in foreseeing, preventing and delaying many diabetes associated complications.

Diabetes mellitus (DM) is a metabolic disorder characterized by chronic hyperglycemia with derangement of carbohydrate, fat, and protein metabolism due to absolute or relative deficiency of insulin secretion and action, or both. DM, especially type-2 DM, is a serious general medical issue which has arrived at scourge extents because of the quickly expanding paces of this ailment around the world. Target organ confusions, auxiliary to diabetes, are one of the most significant restorative worries of right now. The main findings of our research were no significant differences in baseline characteristics like age and height of both groups. Weight, BMI and waist hip ratio was significantly high in cases. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and rate pressure product were significantly high in Cases individuals; however, no significant difference was noticed in pulse pressure (PP). Significantly higher body fat and visceral fat %, lower levels of cardio respiratory fitness assess by cooper 12min run test and significantly higher levels of fasting blood sugar (FBS) was observed in cases. The oxidative stress assessed by total antioxidant status (TAOS) was significantly less and malondialdehyde (MDA) was significantly high in cases when compared to age gender matched controls. Inflammatory markers TNF alpha, IL6 and hsCRP were significantly high in cases in comparison to controls.