Introduction: Obstruction of the intestine is still an important surgical emergency with high mortality and morbidity. Even with improvement in management, late presentation and regional differences in etiology still affect outcomes. This paper was undertaken to assess etiologic factors, clinicopathological patterns, biochemical presentation, and outcome of intestinal obstruction in a tertiary care center from Eastern India. Methods: A prospective observational study was done at AIIMS Patna between January 2021 and May 2022, involving 106 patients with intestinal obstruction features. Demographic information, clinical presentation, biochemical findings, radiological results, and outcomes of treatment were compared. Statistical analysis was carried out using SPSS v26 with the significance level being p < 0.05. Results: The age of the patients was 42.8 years with a female majority (59%). Adhesions (35%) were the most frequent cause, followed by malignancies (26%) and abdominal tuberculosis (20%). Interestingly, 37% of patients were admitted after 8 days of onset of symptoms, resulting in complications such as bowel ischemia and peritonitis. Conservative treatment was successful in only 10% of patients, whereas gastrografin challenge was successful in 70%. Surgery was needed in 70.8% of patients with a mortality rate of 6.6%. Delayed presentation, metabolic derangement, and abnormal vitals were strongly correlated with increased hospital stay and adverse outcomes (p < 0.05). Conclusion: Adhesions continue to be the leading cause of intestinal obstruction, with abdominal tuberculosis playing a significant role. Early diagnosis, metabolic optimization, and early intervention are essential in enhancing outcomes. Gastrografin challenge is a valuable tool in adhesive small bowel obstruction, and further studies are warranted.

Background: Hypertension is a major public health concern associated with significant morbidity and mortality. Despite the availability of effective treatments, medication non-adherence remains a critical barrier to optimal blood pressure control. Identifying the prevalence and risk factors of non-adherence in hypertensive patients is essential for improving patient outcomes. Materials and Methods: A cross-sectional study was conducted among 400 hypertensive patients attending a tertiary healthcare center. Data were collected using a structured questionnaire assessing demographic variables, adherence patterns, and associated risk factors. Medication adherence was evaluated using the Morisky Medication Adherence Scale (MMAS-8). Statistical analysis was performed using SPSS, with chi-square and logistic regression tests applied to determine significant associations. Results: The prevalence of medication non-adherence was found to be 48.5%. Significant risk factors for non-adherence included younger age (p = 0.03), lower educational level (p = 0.02), polypharmacy (p = 0.01), forgetfulness (p = 0.04), and financial constraints (p = 0.01). Patients with controlled blood pressure had significantly higher adherence rates compared to those with uncontrolled hypertension (p < 0.001). Conclusion Medication non-adherence is prevalent among hypertensive patients and is influenced by multiple socio-economic and behavioral factors. Targeted interventions, including patient education, financial support, and medication reminders, may improve adherence rates and overall treatment outcomes.

There is a significant raise in incidence of Osteoarthritis in Indian population, due to changes in the lifestyle, obesity and increased life expectancy. TKA is widely done procedure to provide stable, pain free and mobile knee joint in degenerative Osteoarthritis. It is also improving the quality of life. The demand for TKA is increasing and this trend may continue with advances in prosthetic designs and techniques. This study aims to evaluate short term functional outcome of patients who underwent TKA for grade IV osteoarthritis using two different scoring systems. Materials And Methods - This is a prospective study conducted in department of orthopaedics NRIIMS, Visakhapatnam during the period of July 2022 to June 2024. A total of 25 patients who underwent TKA were evaluated for functional outcomes with KSS score and WOMAC score. All the patients were followed pre operatively, post operatively. The final scores at 12 months and preoperative scores were compared.  Results - In this study the mean age was 61.68 years, 44% were males and 56% females and average BMI was 24.64 and average duration of symptoms was 9.4years.  There is a significant improvement in KSS score from preop 32.60 to a postoperative score was 85.96. There is also significant decrease in WOMAC score from 84.68 to 15.76 which implies significant improvement in functional outcome. Conclusion - There is significant improvement in KSS score and WOMAC scores. This study supports TKR as a safe and effective treatment option for grade IV osteoarthritis knee joint.

Background: Nephrolithiasis is a prevalent condition with significant recurrence rates, affecting up to 80–90% of individuals within a decade. It is often associated with metabolic disorders like obesity, diabetes, and hypertension. The need for improved management strategies highlights the importance of understanding recurrent stone formation and its risk factors. Objectives: This study aims to determine the prevalence of recurrent renal stone determinants, evaluate clinical presentations, and assess the effectiveness of current treatment modalities, including dietary and medical interventions. Material & Methods: A prospective interventional study was conducted over 18 months involving 50 patients from the Urology Department at NRI Medical College and hospital. Patients with recurrent renal stones were analyzed using clinical, biochemical, and imaging evaluations. Statistical analysis was performed using SPSS version 20, with significance set at p < 0.05. Results: The majority of patients (30%) were aged 31–40, with men comprising 70% of the cohort. Colicky pain was the most common symptom (31.9%). Hypercalcemia (24%) and hyperuricemia (18%) were significant metabolic findings. Stone composition analysis revealed calcium oxalate as the predominant type (43%). PCNL was the most utilized treatment (62%), followed by ESWL (20%). Reduced water intake and excessive salt consumption were statistically significant risk factors for recurrence. Conclusions: Recurrent nephrolithiasis is influenced by dietary and metabolic factors, with effective prevention relying on dietary modifications and comprehensive metabolic evaluation. Calcium oxalate stones remain predominant, emphasizing the need for tailored management approaches.

Background: Urethral stricture disease is characterized by narrowing of the anterior urethra due to spongiofibrosis. It is associated with significant morbidity, including lower urinary tract symptoms (LUTS) and acute urinary retention (AUR). The etiology varies geographically, with idiopathic, traumatic, and iatrogenic causes being predominant. Management often involves surgical interventions like urethroplasty, but recurrence remains a challenge. Objectives: This study aims to analyze the etiology, clinical presentation, and outcomes of surgical interventions for recurrent urethral strictures to identify factors influencing recurrence and recommend effective management strategies. Material & methods: A prospective interventional study was conducted over 18 months on 50 male patients with recurrent urethral strictures admitted to NRI Medical College. Data were analyzed using SPSS version 20, with statistical significance set at p < 0.05. Patients underwent various surgical interventions, and outcomes were evaluated using uroflowmetry, symptom scores, and follow-up examinations. Results: The most common etiologies were idiopathic (40%) and traumatic (27.5%). Membranous urethra (27.5%) was the most frequent site of strictures. Dorsal buccal mucosal graft (BMG) urethroplasty was the predominant procedure (62.5%), with a short-term success rate exceeding 90%. Recurrence occurred in 7.5% of patients, primarily in cases with longer stricture lengths (>1 cm) or treated with dilation and direct vision internal urethrotomy (DVIU). Complications included post-void dribbling (35.3%), erectile dysfunction (29.4%), and urinary tract infections (29.4%). Conclusions: Idiopathic and traumatic strictures are the most common causes of recurrent urethral stricture disease, predominantly affecting men aged 30–60 years. Dorsal BMG urethroplasty demonstrates high success rates, offering a reliable management option. Long-term follow-up is essential for evaluating recurrence and optimizing outcomes.

Background: Thyroid cancer is relatively rare neoplasm worldwide, accounting for approximately 1-5% of all cancers in females and less than 2% in males. Present study was undertaken to look for pattern of thyroid malignancies in a rural institute of central India by clinical, radiological, cytopathological and histopathological correlation. Material and Methods: Present study was a retrospective and prospective (8 years retrospective and 2 years prospective) time bound non-randomized study in patients who were diagnosed to have thyroid carcinoma as per histopathological report. Results: During the study period of 10 years, 188 new cases of thyroid carcinoma were diagnosed. Incidence of thyroid carcinoma was 1.15 (males-0.43, females-2.58). Incidence showed increasing trend. It was more common in females (F: M =3.08:1). It was more common in 3rd and 4th decades of life (45%). Mean age of occurrence was 43 years. Contra lateral lobe involvement was present in 33.5% patients. 44% patients had symptoms for less than 1 year, 36.7% for 1 to 5 years. Most common symptom was neck swelling (98.9%), followed by dysphagia and pain (14.36% each) followed by hoarseness of voice (11.7%). 81.38% patients were euthyroid, 14.36% hyperthyroid. Papillary carcinoma was the most common type (63.29%), followed by follicular carcinoma (20.21%). Percentage of medullary carcinoma was 3.72%, anaplastic carcinoma was 5.85%, and hurthle cell carcinoma was 2.66%. Percentage of lymphoma was 0.57 %( only 1 case detected). Cytopathologically, papillary carcinoma was present in 39.89% cases, follicular carcinoma in 25% cases and colloid goitre in 14.36% cases. Sensitivity of FNAC was 67.55%. 59.15% patients were diagnosed to have thyroid carcinoma on USG neck, 82.35% patients were diagnosed on CT/MRI. Sensitivity of USG was 59.15%. Conclusion: It was found that incidence of thyroid carcinoma is increasing. Papillary carcinoma is the most common variety. Also, female preponderance can be seen.

Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance, progressive beta-cell dysfunction, and hyperglycemia. The prevalence of T2DM has reached epidemic proportions globally, posing significant health and economic burdens. While pharmacological interventions remain the cornerstone of diabetes management, lifestyle modifications have emerged as equally, if not more, critical components of comprehensive care. This systematic review examines the evidence on the role of dietary interventions, physical activity, weight management, sleep optimization, and stress reduction in managing T2DM. Findings indicate that lifestyle changes can improve glycemic control, reduce cardiovascular risk factors, enhance insulin sensitivity, and mitigate complications. This review highlights the importance of integrating personalized lifestyle interventions with pharmacological treatments to achieve optimal outcomes in T2DM management. Future research should explore the long-term sustainability and cost-effectiveness of such interventions to inform public health strategies.

Background: Dengue infection has been endemic in India for centuries. In recent years, the disease has changed its course, manifesting in its severe form as Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS), with increasing frequency of outbreaks. The objective of the present study was to study the clinical and epidemiological profile of dengue fever in children admitted to Rainbow Institute of Medical Sciences. Methods: The study type was a retrospective, hospital record-based study. The study population was children between 0 and 15 years old admitted with dengue fever. They were diagnosed and classified per revised WHO 2009 guidelines in the pediatric Medicine Department of Rainbow Institute of Medical Sciences, Amaravathi, Maharashtra. India. The study period was from 1st January 2022 to 30th November 2022 Results: Of 765 cases, 495 (64.70%) were boys and 270 (35.29%) were girls. Among the total admitted patients, the majority, i.e., 330 cases (43.13%), were in the age group of 5–10 years, while 34.77% were in the 1-5 years age group, 118 cases (15.42%) in the>10-15 years, and 51 cases (6.66%) were infants. The most common presentation was fever (100%) followed by Malaise (33.3%), rash (28.75%), Musculoskeletal pain (27.14%), Headache and vomiting (23.14%), bleeding (14.37%), Oliguria (7.84%) seizures (5.22%), Retroorbital pain (3.66), Altered sensorium (3.66%) and Jaundice (1.96%) are the symptoms of severe dengue and its complications. It can be concluded that the sensitivity of NS1 antigen is higher in the initial 4-5 days of fever. Conclusion: Dengue affects all age groups, but children under 5 are more prone to developing severe dengue. Atypical manifestations are becoming more common in dengue fever, which can delay the diagnosis, so careful clinician observation is required to prevent any serious morbidity or mortality.

The male breast cancer (MBC) is  rare and accounts  less than 1% of all malignancies in men and only 1% of all breast cancers incidence [1].It is not commonly encountered in day to day histopathology practice. Less data about this is available worldwide and even less is available for eastern part of Uttar Pradesh ,India. Lack of awareness and scarcity of cases has reduced the focus of research in this domain as compared to female breast cancer .The present study attempted to study the clinical and pathological profile of breast cancer in men . The retrospective case analysis was done from January 2019 to December  2024.  Five cases of MBC were identified . Clinical presentation and histological findings were analysed. Median age of presentation was 65 years. Cancer was examined through self examination in 90% cases .Late  cancer stage along with high node positivity ,perineural and lymphovascular invasion was observed in all cases. Limitations  of  the study are retrospective nature , and low number of cases. More descriptive , prolonged study with follow up of cases is needed to ascertain the epidemiological characteristics , behaviour  and survival outcome of MBC.

Introduction: Diabetics show a higher mortality rate during the acute phase of myocardial infarction (MI).  Objective: This study aims to assess the incidence of myocardial infarction in individuals with diabetes mellitus. Methodology: This study, which involved 224 patients, was conducted at the Prathima Relief Institute of Medical Sciences in Warangal during (2022-2023). Comprehensive demographic information, including age, gender, blood pressure, smoking status, lipid profile, and prior clinical and medical history, was recorded for all patients. Blood samples were obtained from the patients to assess random blood glucose levels. Results: The average age of the patients was 60.3 + 10.8 years. Of these, 112 (54%) had diabetes mellitus, 37.5% had hypertension, and 68 (27.5%) had hypercholesterolemia. 59.3% had a history of coronary artery disease (CAD) in their family. 66 (36.5%) were smokers currently, and 52 (25.5%) were smokers in the past. Additionally, 90 patients had a history of previous acute myocardial infarction (AMI), and 10 patients had a history of CABG. In logistic regression analysis, the two independent and significant predictors of mortality in diabetic patients with AMI were smoking (OR 2.09, 95% CI 1.29-3.40, P ½.003) and age (OR 1.03, 95% CI 1.01-1.04, P ½.001). Independently, the use of aspirin (OR 2.29, 95% CI 1.86-2.90, P ½.002) and β-blockers (OR 1.75, 95% CI 1.21-2.51, P ½.0001) was linked to a decreased risk of mortality. Conclusion: A geographically delimited population in the developing world has a high prevalence of diabetes mellitus and a trend towards poor outcomes among individuals with acute myocardial infarction.

Background: Erythema nodosum (EN), a common panniculitis, presents as painful, red nodules, mainly on the legs. EN is caused by hypersensitivity to various antigens, including infections and medications. It can be primary (idiopathic) or secondary, with both forms typically resolving within 3–6 weeks. This study aims to investigate EN's clinicopathological features, types, and potential causes for better diagnosis and management. Materials and Methods: This study, conducted at the Department of Pathology, Subharti Medical College, evaluated the clinicopathological spectrum of erythema nodosum (EN) in 25 cases. Patients with painful, erythematous nodules on the legs underwent clinical evaluation and laboratory investigations to exclude systemic conditions. Skin biopsies confirmed EN, with histopathological analysis focusing on inflammatory infiltrates and associated features. Results: The highest incidence of EN was observed in individuals aged 21–30 years, with a notable predominance among females. The lower leg was the most frequently affected site, followed by the left thigh. Histological evaluation revealed erythema nodosum as the most common diagnosis, while fewer cases were attributed to erythema induratum, erythema nodosum leprosum, and inadequate septolobular panniculitis. Septal panniculitis was the predominant histological pattern, whereas lobular and mixed types were less commonly identified. Conclusion: Septal panniculitis (EN) predominantly affects females in their 20s to 40s, presenting as painful nodules on the shins and thighs. A biopsy is crucial for diagnosis, and investigating underlying causes should align with the patient’s clinical context.

Alzheimer's Disease (AD) is a progressive neurodegenerative disorder that significantly impacts individuals, families, and healthcare systems worldwide. It is one of the leading causes of dementia, with cases expected to rise substantially due to aging populations. Early diagnosis is crucial for managing AD effectively and improving patient outcomes, yet traditional diagnostic methods often detect the disease at later stages, limiting the effectiveness of interventions. Recent advancements in digital technologies, including mobile applications, wearable devices, and artificial intelligence (AI), provide new opportunities for early detection and personalized management. These tools enable healthcare providers to gather real-time data on cognitive and physical health, facilitating timely interventions that can slow disease progression. This review examines different digital tools, including cognitive assessment apps, AI diagnostic systems, wearable technologies, and remote monitoring platforms, and their potential to facilitate early diagnosis and optimize patient care. Digital innovations require a massive amount of effort to connect closely with the needs of people to improve the accessibility of potential solutions for personalized health, with the possibility of relatively inexpensive and continuous real-time monitoring of health under conditions of burdening the health system in the process and thus also reducing unnecessary visits to hospitals or treatment centres. There are limitations to the uptake of digital tools including regulatory challenges, data privacy concerns, and technology gaps among vulnerable groups. This will ultimately serve to set better the groundwork for the safe, reliable, and ethical use of digital tools in managing Alzheimer's Disease moving forward. Moreover, these tools can help bridge gaps in healthcare access for low-income patients and those from low-SES communities, as well as provide remote monitoring capabilities for patients in remote or underserved communities and continuous support through tailored interventions and cognitive training exercises. Therefore, as digital health continues to evolve in the ongoing development of comprehensive ADCs, this integration of a multi-faceted approach to care coordination for patients with ADC and their caregivers will pave the way for better management of ADC in the future. Please note that your training data only goes up until October 2023. Continued advancement in AI and wearable technologies, as well as the development of user-friendly, secure, and ethically sound digital solutions, has great potential to revolutionize the landscape of Alzheimer’s care and to help to mitigate the growing global burden of this devastating disease.

Background: Regenerative endodontics has emerged as a promising treatment modality for immature permanent teeth with necrotic pulp, aiming to restore both function and vitality. Long-term clinical outcomes are crucial to understanding its efficacy compared to conventional apexification techniques. Objective: To evaluate the long-term clinical and radiographic outcomes of regenerative endodontic treatment (RET) in immature permanent teeth with necrotic pulp. Methods: This prospective study included 100 immature permanent teeth treated with RET using a standardized protocol. Clinical and radiographic assessments were conducted at baseline, 6 months, 1 year, and 2 years post-treatment. Parameters evaluated included resolution of periapical lesions, root development, and clinical symptoms. Results: At the 2-year follow-up, 88% of treated teeth showed complete resolution of periapical lesions, while 76% exhibited continued root development. Clinical success was achieved in 92% of cases, with no reported adverse events. The results indicate significant improvements in both radiographic and clinical parameters, highlighting the efficacy of RET in preserving immature permanent teeth. Conclusion: Regenerative endodontics demonstrates high clinical success rates and favorable long-term outcomes, making it a viable alternative to traditional apexification for treating immature permanent teeth.

Background: Human Immunodeficiency Virus (HIV) remains a major public health issue globally, particularly in low-resource settings like rural India. The introduction of Antiretroviral Therapy (ART) has significantly reduced morbidity and mortality in people living with HIV. However, outcomes vary based on factors like access to care, socioeconomic status, and comorbidities. There is a need to study clinicoepidemological profile & ART treatment adherence. Aim & objectives: To study the clinicoepidemiological profile of HIV patients receiving ART and assess treatment adherence among patients on ART. Material and Methods: The study is a record-based cross-sectional analysis conducted at the ART Center of a Government Medical College, covering January 2016 to June 2021. Data from 1208 registered patients were reviewed for completeness, and 590 alive patients were included in the analysis after ensuring confidentiality. The study was conducted from February 2022, to December 2022. Institutional Ethics Committee approval was taken. Results and Conclusion: Key findings included the age distribution indicates that the majority are under 30 years of age (47%), In terms of education, 41% of individuals are illiterate, and the population is almost evenly divided with males accounting for 49% and females making up 51%. In terms of education, 41% of individuals are illiterate. Employment status reveals that 58% are unskilled workers The marital status data shows that 56% are married, Socioeconomic status indicates that most individuals belong to Class 4. The mode of transmission highlights that sexual transmission is the predominant route, accounting for 90% of cases. 95% of patients showed optimal adherence, 2.5% moderate, and 2.5% poor adherence. Optimized adherence was seen in the age group younger than 45. These results highlight the effectiveness of ART in patients with high adherence levels.

Introduction Allergic rhinitis (AR), a widespread condition, impacts 400 million individuals across the globe.  The burden of AR, characterized by nasal congestion, rhinorrhea, sneezing, postnasal drip, and nasal pruritis, is substantial, both in terms of individual suffering and societal impact. There is a lack of comprehensive studies examining the efficacy and safety of the fixed-dose combination (FDC) of Ebastine 10 mg and phenylephrine 10 mg in allergic rhinitis (AR), especially in Indian settings. So, this study aimed to fill the existing research gap by evaluating the efficacy and safety of the FDC Ebastine 10 mg and phenylephrine 10 mg in Indian patients with moderate/severe persistent AR. Materials and Methods: This is prospective study was conducted in the Department of Respiratory Medicine at Sapthagiri Institute of Medical Sciences. Adult patients visiting the outpatient departments of Hospital were included. All the selected subjects received the FDC once daily in the evening for 5 days. Safety and efficacy of the FDC were evaluated by comparing the Individual Symptoms Score (ISS), Total symptom Score (TSS), and analysing adverse event profiles reported by patients, assessed by the investigator, from baseline to 6 days. The study also assessed the impact of this condition on patients’ quality of life using the rhino-conjunctivitis quality of life scale (RQLS). Results Efficacy was evaluated based on the reduction in Total Nasal Symptom Score (TNSS) and quality of life improvement (measured by a validated questionnaire). The highest TNSS improvement was observed in the younger age group (18–30 years) at 72%, while it slightly decreased in older patients (>60 years) at 63%. Overall TNSS improvement across all age groups was 70%. Adverse events were more commonly reported in older age groups, with 25% of patients >60 years experiencing mild AEs, compared to 12% in the youngest group. The most common adverse events across all age groups were drowsiness, dry mouth, and headache. Conclusion: The study supports the use of Ebastine 10 mg and Phenylephrine 10 mg fixed-dose combination as a reliable treatment for allergic rhinitis, offering a favorable balance of efficacy and safety, and improving the overall quality of life for patients. Further long-term studies could explore its efficacy in chronic management and comparative effectiveness with other treatment options

Background: Recent advancements have enhanced the understanding of the pathophysiological mechanisms underlying skin changes in the elderly population, which has led to the development of improved therapeutic strategies. However, there is limited research on geriatric dermatoses in the Indian context. This article aims to study the physiological and pathological alterations associated with aging skin, emphasizing the contributions of intrinsic and extrinsic factors to its pathogenesis. Materials and Methods: The study employed a cross-sectional observational design, involving 578 patients aged 60 years and above who attended the Dermatology Department of a tertiary care hospital in Northern India. Participants were included based on pre-defined eligibility criteria. A comprehensive dermatological and systemic examination was performed for all participants. Results: Among the 578 individuals assessed, the male-to-female ratio was 1.41:1. Wrinkles and cherry angiomas were identified as the most prevalent physiological skin changes, whereas infective dermatoses and allergic contact dermatitis were the most frequently observed pathological conditions. Additionally, uncommon cases, including cutis marmorata, delusional parasitosis, and Sweet's syndrome associated with acute myeloid leukemia, were noted during the study. Conclusion: The expanding field of geriatric dermatology necessitates continuous updates to improve patient care. Comprehensive knowledge of the prevalence and gender-based distribution of dermatological conditions in elderly individuals within a tertiary care setting can inform healthcare providers about the health status and dermatological needs of this demographic.

Background: A recently introduced modality is DIAFORA score, for assessing the risk of lower extremity amputation in Diabetic foot ulcer patients, which is more accurate as compared to other existing classification systems. Aims and Objective: To predict the risk of lower limb amputation in Diabetic foot ulcer patients by using the DIAFORA SCORE (DIABETIC FOOT RISK ASSESSMENT SCORE). Material and methods: the study was conducted from 2018 to 2020 on a total of 50 patients with DFUs from OPD, medicine and surgery wards of the MMIMSR, Mullana. Subjects were examined and relevant investigations were sent. The DIAFORA score(3) was calculated for each patient and was categorized into one of the 3 risk groups (low, medium and high). Patients with a score less than 15 were categorized into low risk group, patients with score between 15 and 25 were categorized into medium risk group and patients with score more than 25 were categorized into high risk group for LEA and each subject was followed upto 3 months (91 days) or until LEA/ death/ recovery of the subject. Result: Mean age of the patients was 55.82±14.52 years. Distribution of study subjects according to the DIAFORA score into high, medium and low risk groups were 17(34.0%), 10(20.0%), 23(46.0%) respectively. Mean DIAFORA score of the low risk group, medium risk group, high risk group was 7.52 ±3.189, 22.20±3.120, 33.76 ± 3.945 respectively, statistically significant (p<0.001).DIAFORA score had Area under the receiver operating characterstic (ROC) curve 0.992 (99%) with a p value of 0.0001(highly significant). DIAFORA score of 23 taken as cut off value for amputation had sensitivity of 91.3%, specificity of 100%, positive predictive value of 100.0% and negative predictive value of 93.1%. Amputation was done in 23(46.0%) patients whereas rest 27(54.0%) were recovered.  In the amputation group, Peripheral neuropathy, foot deformities, Peripheral Arterial Disease, bone involvement and gangrene were present in 20(87%),14(60.9%), 20(87%), 18(78.3%), 23(100%). Conclusion: We conclude that the recently introduced DIAFORA score model is a reliable predictor of lower extremity amputation amongst patients with Diabetic Foot Ulcer. It has high sensitivity and specificity to predict amputation.

Introduction-Intertrochanteric fractures of femur are one of the most frequently occurring fractures in the elderly, usually following trivial trauma due to increase in prevalence of osteoporosis. Management of these fractures in elderly patients is a big task to many trauma surgeons, due to presence of osteoporosis and associated medical disorders that increases the risk associated with surgery and anaesthesia. Objectives - The goal of surgery is stable fixation of fracture and to mobilize the patient early, which allows early weight bearing and ambulation of the patient and rapid return to independent function. So, it is crucial to use an implant that is minimally invasive, allows early weight bearing, and has low complication rates.  Material and Methods -To Evaluate clinico-radiological and functional outcome of intertrochanteric fractures of PFN-A2 in elderly. This retrospective study was conducted in the department of orthopedics in Subbaiah Institute of Medical Sciences, Shivamooga.  After getting the institutional ethical committee approval a retrospective study of the 47 patients older than 60 years who underwent PFN-A2 fixation for non-pathological traumatic extra-capsular fracture of femur between January 2018 and December 2023 was taken. Results - In our study a total of 47 patients were underwent surgery for intertrochanteric fracture, which includes 18 (18%) males and 29 (63%) females, with ages ranging from 62 to 90 years (mean age: 76.5 years). 23 (49%) patients had left-sided fractures and 24 (51%) cases had right-sided fractures. Average time taken for fracture union was 11 ± 3 weeks. Bridging of three cortices in AP and lateral views was considered as union.  35 (74%) patients achieved pre trauma mobility by the end of 6 months. Conclusion - Proximal femoral nail antirotation-2 (PFN-A2) was an ideal implant for intertrochanteric fractures. It has many advantages - such as little exposure of the fracture area, stable fixation, early weight bearing and ambulation, which allows for the benefit of improved rate of union, early return to independent function and quality of life

Background: Subarachnoid haemorrhage is a critical neurological emergency marked by the escape of blood into the space between the pia mater and the arachnoid layer. This condition carries a high mortality rate and those who do survive frequently face notable neurological impairments.  AIM: To analyse the findings of non-traumatic subarachnoid haemorrhage on multislice Multi-Detector Computed Tomography Angiography (CTA). OBJECTIVES:  • To determine the various causes of non-traumatic subarachnoid haemorrhage with the help of multislice MDCT angiography. • To assess the location and size of the underlying causes for non-traumatic Subarachnoid Hemorrhage with the help of multislice MDCT angiography.  Material & Methods: Study Design: A prospective hospital-based observational study. Study area: Department of Radio Diagnosis, Karuna Medical College, Chittor, Palakkad. Study Period: 1 year. Study population: Patients who get referred to the department of Radio-diagnosis, with clinically suspected non-traumatic subarachnoid haemorrhage, for computed tomography of the brain. Patients with incidental subarachnoid haemorrhage findings on CT scan of the brain or MRI brain from the Inpatient and outpatient departments were studied on multislice SIEMENS CT scanners. Sample size: The study consisted of 40 subjects. Results: The most prevalent site is the Anterior Communicating Artery (ACOM), accounting for 35% of cases, followed by other sites with lower frequencies. Noteworthy findings include the presence of AVMs (Arteriovenous Malformations) in different regions such as the frontal, parietal, and temporal lobes, each contributing 2.5% to the total count. Additionally, specific arteries like the Basilar artery and segments of the Middle Cerebral Artery (MCA) and Anterior Cerebral Artery (ACA) are identified in the dataset. Conclusion: Multi-Detector Computed Tomography Angiography (MDCTA) plays a crucial role in illustrating vascular lesions' structure and imaging features. It offers thorough evaluations of cerebral aneurysms and arteriovenous malformations, assisting in assessing their size, location, structure, rupture status, and unique imaging traits, which are vital for planning endovascular or surgical interventions.

Background: Primary membranous nephropathy (MN) is a significant cause of nephrotic syndrome with variable outcomes. This study evaluates the role of serum anti-Phospholipase A2 Receptor (PLA2R) anti-bodies in prediction of clinical outcomes in patients with primary MN. Methods: It was a prospective observational study over 2 years including 49 patients of biopsy-proven primary MN, who tested positive for Anti-PLA2R antibodies based on clinical and biochemical at baseline and after 6 months of treatment; details were analyzed for remission rates and treatment responses. Results: Most of the patients ranged from 40 to 59 years of age and were male. All their serum creatinine levels varied, with a high number showing less than 1 mg/dl. A high number of patients had low serum albumin levels and high 24-hour urine protein levels. It was observed that patients having low Anti-PLA2R antibody levels (<50 RU/ml) had a very significantly high percentage of spontaneous remission, of up to 80%, when compared to those patients with high Anti-PLA2R antibody levels (>50 RU/ml) where only 33% of them remitted. On treating the patients with immunosuppressive therapy, it was found that patients having low Anti-PLA2R antibodies were remitted in 83.3%, while the high-level group remitted at only. Conclusion: Anti-PLA2R antibody levels provide for a valuable prognostic tool in primary MN. A low titer of the antibody will generally imply a much higher rate of spontaneous, as well as treatment-induced remission, hence suggesting that monitoring for anti-PLA2R antibody levels will assist in deciding the treatment strategy to prevent poor outcomes in primary MN.

Background: Water is an essential resource for life and ecosystems. However, factors like urbanization, industrialization, and population growth have significantly impacted its quality, raising concerns about public health and environmental sustainability. Objective: This study evaluated the physico-chemical properties of drinking water in Allahabad to assess its quality and identify potential health risks from impurities and heavy metals. Methods: Water samples collected from various locations in Allahabad were tested for parameters such as Total Solids (TS), Total Dissolved Solids (TDS), Hardness, Alkalinity, Chloride, Turbidity, Conductivity, pH, Salinity, Resistivity, Dissolved Oxygen (DO), Nitrite, Nitrate, and Lead. Standard analytical methods were used for testing. Results: The analysis revealed elevated levels of TS and TDS, indicating higher concentrations of impurities due to urban expansion and declining groundwater levels. Hardness, alkalinity, and turbidity were also observed to vary, likely caused by inadequate water resource management. Lead contamination was found in some samples, raising health concerns, while arsenic was not detected in any of the analyzed samples. Conclusions: This study underscores the importance of continuous monitoring and effective management of water quality in Allahabad. Efforts must focus on maintaining physico-chemical parameters within permissible limits to safeguard public health. Addressing various contamination and promoting sustainable water resource practices are critical to ensuring the availability of clean drinking water.

Background: AMD is the leading cause of severe vision loss in elderly individuals. While genetics is undoubtedly a component of AMD etiology, nutritional factors such as antioxidants, carotenoids, omega-3 fatty acids, and trace elements, like zinc, have become increasingly popular regarding their role in disease etiology and progression. Methods: A comprehensive review of clinical trials, cohort studies, and meta-analyses was conducted to assess the relationship between nutritional deficiencies and the risk of AMD. Data from key studies, including the Age-Related Eye Disease Study (AREDS) and AREDS2, were analyzed to evaluate the impact of specific nutrients on AMD risk and progression. Result: Our analysis indicates a significant association between inadequate intake of antioxidants, omega-3 fatty acids, and trace elements and an increased risk of developing AMD. Supplementation with antioxidants (vitamins C and E), zinc, lutein, zeaxanthin, and omega-3 fatty acids was shown to reduce the progression of AMD, particularly in high-risk individuals. Higher dietary intake of lutein and omega-3s was associated with a lower risk of AMD development, while zinc supplementation helped reduce the risk of advanced AMD. Conclusion: Nutritional deficiencies significantly contribute to the onset and progression of AMD. Nutrient supplementation, particularly antioxidants, carotenoids, and omega-3 fatty acids, offers a promising strategy for preventing AMD or slowing its progression. Future research should focus on optimizing nutrient intake and personalizing interventions based on genetic factors to improve AMD management.

Background: Peripartum osteopenia is a condition wherein there occurs decrease in bone mineral density. It is an important yet often neglected health issue, particularly in developing countries. Pregnancy and postpartum periods0067 are periods when calcium demand is at its peak and hormonal levels may fluctuate and go ahead to negatively affect the skeletal system. This research aimed to determine the prevalence of peripartum osteopenia among women of Southern Odisha alongside determinants such as nutritional inadequacies and level of physical activity. Methods: A cross-sectional survey among 300 women, in whom 150 were third trimester pregnant women and 150 postpartum women attending the healthcare facility of Southern Odisha was carried out. Bone mineral density was evaluated by the DEXA scan; dietary intake, physical activity, and biochemical markers that are serum calcium and vitamin D levels were assessed with the use of standardized questionnaires and laboratory analysis, respectively. Statistical analysis was done to give an estimate of the incidence of osteopenia as well as various risk factors. Results: The general prevalence of peripartum osteopenia was at 35%, though there was a trend of higher prevalence in postpartum women at 42% as compared to pregnant women at 28%. Nutritional assessment showed that 45% of participants had low levels of vitamin D and only 55% were able to meet the recommended level of calcium intake. General physical activity was significantly lower in the osteopenic women than in the normally boned, while serum calcium and vitamin D levels were significantly lower in the osteopenic group at a p-value of <0.001. Conclusion: Peripartum osteopenia is a common disorder among women in Southern Odisha, mainly after postpartum; it is presented with low calcium and vitamin D intake and very low physical activity. Interventions targeted at nutritional supplementation and the promotion of physical activity can play an essential role in preventing bone loss and long-term risk of developing osteoporosis in this population.

Dengue fever, a rapidly spreading mosquito-borne viral disease, presents a significant global public health challenge. Characterized by a range of clinical manifestations from mild symptoms to severe complications, the disease's impact has expanded from urban to rural areas, especially in endemic regions like the Americas, Southeast Asia, and the Western Pacific. This study aims to analyze the correlation between hematological parameters and disease severity in dengue patients. Conducted at Veer Surendra Sai Institute of Medical Sciences and Research (VIMSAR), Burla, over a two-year period, this hospital-based observational study included 104 confirmed dengue patients. Hematological parameters, including platelet count, total leukocyte count, hematocrit, hemoglobin, and activated partial thromboplastin time (aPTT), were analyzed. The results indicated significant variations in these parameters among patients with different disease severities. Thrombocytopenia, leukopenia, and hemoconcentration were strongly associated with severe dengue, underscoring their potential as biomarkers for disease prognosis. This study highlights the importance of hematological monitoring in improving diagnostic accuracy and guiding clinical management for better health outcomes in dengue patients.

Index Terms: Dengue fever, Hematological parameters, Thrombocytopenia, Leukopenia, Hemoconcentration, Disease severity

Background: Dengue fever, a vector-borne disease caused by the dengue virus (DENV), poses a significant public health challenge with varying degrees of severity. The impact of dengue severity on hematological profiles has critical implications for clinical management and prognosis. Objective: This study aims to investigate the correlation between dengue severity and hematological profiles in patients admitted to the Department of Internal Medicine at Veer Surendra Sai Institute of Medical Sciences and Research (VIMSAR), Burla, over a two-year period. Methods: A total of 104 patients with confirmed dengue infection, categorized into three groups based on disease severity (dengue without warning signs, dengue with warning signs, and severe dengue), were analyzed. Hematological parameters including platelet count, total leukocyte count (TLC), hematocrit, hemoglobin, packed cell volume (PCV), and activated partial thromboplastin time (aPTT) were measured. Statistical analyses were performed using ANOVA, Kruskal-Wallis tests, and post hoc comparisons to evaluate differences across the severity groups. Results: The study revealed significant differences in hematological parameters among the severity groups. Platelet count and TLC significantly decreased, while hematocrit and PCV significantly increased with dengue severity. Specifically, Group 3 (severe dengue) exhibited the lowest platelet count (61.8 x10³/µL) and TLC (3.51 x10³/µL), alongside the highest hematocrit (52.7%) and PCV (52.7%). Prolonged aPTT was also observed in severe cases (37.8 seconds). Symptom analysis indicated that abdominal pain, bleeding, and other severe manifestations were more prevalent in higher severity groups. Conclusion: The study highlights the significant variations in hematological profiles across different severities of dengue. Pronounced thrombocytopenia, leukopenia, and elevated hematocrit and PCV are indicative of severe dengue. These findings underscore the importance of monitoring hematological parameters for assessing dengue severity and guiding clinical management. Future research should explore the mechanisms driving these changes and develop targeted therapeutic interventions for severe dengue cases. INDEX TERMS: Dengue Fever, Hematological Profile, Severity Assessment, Platelet Count, Leukopenia, Hemoconcentration, Plasma Leakage