Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the hepatic manifestation of metabolic dysfunction and is highly prevalent among patients with type 2 diabetes mellitus (T2DM). Owing to its asymptomatic nature and potential progression to advanced liver disease, early identification is essential. The present study aimed to determine the prevalence and severity of MASLD among patients with T2DM and evaluate its association with demographic characteristics, metabolic risk factors, and biochemical parameters. Materials and Methods: A hospital-based cross-sectional observational study was conducted in the Department of General Medicine from May 2023 to May 2024. A total of 100 adult patients with T2DM were enrolled. Demographic details, anthropometric measurements, clinical characteristics, and laboratory parameters, including fasting blood glucose, HbA1c, liver function tests, and lipid profile, were recorded. Abdominal ultrasonography was performed to diagnose and grade MASLD. Statistical analysis was performed using IBM SPSS Statistics version 26.0, with a p-value <0.05 considered statistically significant. Results: MASLD was detected in 63.0% of participants, with moderate steatosis being the most frequent grade (42.9%). Obesity (62.0%), increased waist circumference (68.0%), dyslipidemia (64.0%), hypertension (59.0%), and metabolic syndrome (71.0%) were common among the study population. MASLD was significantly associated with obesity, increased waist circumference, dyslipidemia, metabolic syndrome, poor glycemic control (HbA1c ≥9%), and longer duration of diabetes (all p<0.05). Patients with MASLD also had significantly higher BMI, waist circumference, HbA1c, triglycerides, AST, and ALT levels, along with lower HDL cholesterol. Multivariate logistic regression identified obesity, increased waist circumference, dyslipidemia, HbA1c ≥9%, and diabetes duration >10 years as independent predictors of MASLD. Conclusion: MASLD is highly prevalent among patients with T2DM and is strongly associated with obesity, central adiposity, dyslipidemia, poor glycemic control, and prolonged diabetes duration. Routine screening using non-invasive imaging, coupled with comprehensive metabolic risk factor management, may facilitate early diagnosis and reduce the risk of progression to advanced liver disease.

Background: Diffusion-weighted imaging (DWI) is the most sensitive magnetic resonance imaging (MRI) technique for early detection of acute ischemic stroke (AIS). Quantitative DWI parameters such as infarct volume and apparent diffusion coefficient (ADC) values have shown significant potential in predicting clinical outcomes. Aim: To evaluate the correlation between DWI findings and clinical outcomes in patients with acute ischemic stroke. Methods: This prospective observational study included patients presenting with acute ischemic stroke within 24 hours of symptom onset. MRI brain with DWI and ADC sequences was performed. Infarct volume, DWI-ASPECTS score, and ADC values were calculated. Clinical severity was assessed using the National Institutes of Health Stroke Scale (NIHSS), and functional outcome was evaluated using the modified Rankin Scale (mRS) at discharge and follow-up. Correlation and regression analyses were performed. Results: DWI demonstrated high sensitivity for early ischemic detection. Infarct volume showed strong positive correlation with NIHSS (r≈0.90–0.98, p<0.01) and mRS scores, while DWI-ASPECTS showed strong negative correlation with disability outcomes (r≈−0.80 to −0.95, p<0.01) [1,2]. Lower ADC values and larger DWI lesion volumes were independently associated with poor functional outcomes [3,4]. DWI-negative cases were associated with more favorable prognosis [5]. Conclusion: DWI-based MRI parameters, particularly infarct volume, ADC values, and ASPECTS score, are robust predictors of clinical outcome in AIS. Incorporation of these imaging biomarkers into routine stroke evaluation can significantly enhance prognostication and guide management strategies.

Background: Cutaneous tumors and tumor-like lesions comprise a wide spectrum of benign, malignant and non-neoplastic conditions. Accurate and early diagnosis is essential for appropriate management. Fine needle aspiration cytology (FNAC) is a simple, rapid and minimally invasive diagnostic technique that can be used for the preliminary evaluation of skin lesions. Methods: The present prospective study was conducted in the Department of Pathology, JJM Medical College, Davangere, over a period of two years from July 2015 to June 2017. A total of 145 patients presenting with clinically suspected cutaneous tumors and tumor-like lesions were included in the study. FNAC was performed in all cases and the cytomorphological features were evaluated. Lesions were classified as tumor-like lesions, benign neoplastic lesions, primary malignant lesions and metastatic or recurrent lesions. Histopathological correlation was performed wherever tissue specimens were available. Results: The age of patients ranged from 1 to 80 years, with the highest number of cases observed in the 31–40 years age group. There was a male predominance with a male-to-female ratio of 1.45:1. Clinically, most lesions presented as non-ulcerative nodules (82.06%). Cytological evaluation revealed that tumor-like lesions constituted the majority of cases (64.13%), followed by benign neoplastic lesions (16.55%), primary malignant lesions (11.03%) and metastatic or recurrent lesions (8.27%). The head and neck region was the most common site of involvement. Conclusion: FNAC is a rapid, safe and cost-effective diagnostic modality for the evaluation of cutaneous tumors and tumor-like lesions. It is useful in differentiating benign from malignant lesions and can aid in the early detection of metastatic disease. When correlated with histopathology, FNAC serves as a reliable initial diagnostic tool for the management of skin lesions.

Saliva is increasingly recognized as a valuable non-invasive diagnostic fluid, containing biomarkers that reflect systemic physiological and pathological conditions, including cancer. This cross-sectional study evaluated the variability of salivary nitrite and uric acid levels among 50 patients diagnosed with oral, breast, gastrointestinal, and genitourinary cancers. Biomarker levels were analyzed across cancer types, age groups, and sex. Results indicated significantly elevated nitrite and uric acid concentrations in oral cancer patients compared to other malignancies. Both biomarkers showed a progressive increase with advancing age, while no significant differences were observed between sexes. A moderate positive correlation was found between disease duration and uric acid levels, as well as between nitrite and uric acid concentrations, suggesting linked oxidative stress pathways. These findings highlight the potential of salivary nitrite and uric acid as non-invasive biomarkers for stratified cancer screening and monitoring, particularly in oral malignancies and aging populations. Further longitudinal studies are warranted to validate their clinical utility and explore their prognostic relevance.

Background: Iron deficiency is one of the overlooked causes of thyroid dysfunction. It is revealed that the prevalence of iron deficiency was very high in pregnant Indian women and was associated with a higher serum TSH and lower FT4 level.  Aim: This study was planned to find out the relationship between the iron deficiency anemia and thyroid functions among pregnant women.  Method: The present cross-sectional observational study was conducted among first trimester pregnant females. A total of 200 pregnant women were enrolled. Serum hemoglobin, serum ferritin value, Serum thyroid-stimulating hormone (TSH), FT4, and FT3 were investigated in all the study women. Association between iron deficiency anemia and thyroid dysfunction were determined. Results: Majority of the women (37%) were 26-30 years age group. Prevalence of iron deficiency anemia was 31%, among them 80.6% had mild anemia, 12.9% had moderate anemia and 6.5% had severe anemia. There was no significant statistical difference between Serum TSH, FT3, FT4 and severity of anemia with a p>0.05. It was found that serum FT4, FT3 and TSH were significantly associated with serum ferritin level (p<0.05). Conclusion: There is increased prevalence of thyroid disorders and iron deficiency anaemia in antenatal cases and there is relationship between iron deficiency anaemia and hypothyroid cases.

Background & Methods: The aim of the study is to study the morphometric parameters of cruciate ligaments of the knee joint & clinical relevance in cadaveric study. The specimens used for this investigation consisted originally of the distal part of the femur, the proximal parts of tibia & fibula, & all structures of the knee joint. Results: The bivariate analysis it was found that the PCL proximal width left knee was significantly correlated along ACL proximal width left knee & rest others were insignificantly associated. Conclusion: In conclusion our study demonstrated morphometric parameter of both ACL & PCL & its variation between right & left knees in the Indian population. This can help surgeons make critical decisions concerning graft size, preference for double bundle reconstruction & appropriate position of tunnels in the tibial & femoral counterparts in arthroscopic ACL & PCL reconstruction procedures.

Introduction: Delirium is a frequent complication in mechanically ventilated patients with acute respiratory distress syndrome (ARDS), associated with increased morbidity, mortality, and long-term cognitive impairment. This study aimed to identify risk factors for delirium and evaluate its impact on long-term cognitive outcomes in this population. Materials and Methods: A prospective cohort study was conducted in a tertiary care ICU from May 2023 to December 2024. Patients with ARDS requiring mechanical ventilation were included. Delirium was assessed using the Confusion Assessment Method for the ICU (CAM-ICU). Cognitive function was evaluated at 6 and 12 months post-discharge using the Montreal Cognitive Assessment (MoCA) tool. Results: Older patients had a 2.5-fold higher risk of developing delirium (OR: 2.5, 95% CI: 1.6-3.8, p < 0.001). Patients with higher illness severity scores had a 3.2-fold increased risk of delirium (OR: 3.2, 95% CI: 2.1-4.9, p < 0.001). Prolonged mechanical ventilation was associated with a 2.8-fold higher risk of delirium (OR: 2.8, 95% CI: 1.9-4.1, p < 0.001), likely due to prolonged exposure to sedatives and immobilization. Benzodiazepine use increased the risk of delirium by 2.1 times (OR: 2.1, 95% CI: 1.4-3.2, p = 0.001), consistent with their known neurocognitive side effects. Severe hypoxemia was associated with a 1.8-fold higher risk of delirium (OR: 1.8, 95% CI: 1.2-2.7, p = 0.01), emphasizing the role of oxygen deprivation in delirium pathogenesis. Conclusion: Delirium is highly prevalent in mechanically ventilated ARDS patients and is strongly linked to long-term cognitive decline. Early identification of risk factors and targeted interventions may improve outcomes.

Introduction: Lumbar spinal stenosis (LSS) is a common condition in elderly patients, often requiring surgical intervention. Selective nerve root block (SNRB) is a non-operative treatment option, but its effectiveness in this population is unclear. Objective: To investigate the efficacy and safety of SNRB in patients over 70 years old with lumbar canal stenosis (LCS). Methods: A retrospective study was conducted on 42 patients who underwent SNRB for LCS between 2022 and 2024. Clinical records, magnetic resonance images, and block effects were reviewed to evaluate the efficacy of SNRB. Results: SNRB was effective in 61% of patients, allowing them to avoid surgery. The spinal canal area at the responsible level was significantly narrower in the ineffective group (p=0.005). No significant differences were found in disease duration, number of blocks, and lumbar disc herniation rate between the effective and ineffective groups. Conclusion: SNRB is a viable treatment option for elderly patients with LCS, with a favourable safety profile. However, its therapeutic efficacy may be lower in cases of advanced LCS and prolonged disease duration. Further studies are needed to determine the optimal frequency and effectiveness of repeated SNRBs in this population.

Visual impairment is a significant public health concern affecting millions of individuals worldwide. Research indicates that vision loss can have profound effects not only on functional abilities but also on mental health, particularly in relation to depression. The purpose of this study is to investigate the association between visual impairment and depression in patients attending eye clinics. This research explores the prevalence of depressive symptoms in individuals with varying degrees of vision loss and examines potential mediators such as reduced social interaction, increased dependence, and decreased quality of life. Using a cross-sectional study design, we recruited patients from multiple ophthalmology clinics and administered standardized tools such as the Patient Health Questionnaire-9 (PHQ-9) for depression screening and the Visual Function Questionnaire (VFQ-25) to assess the severity of vision impairment. Statistical analyses, including logistic regression and correlation tests, were performed to determine the strength and direction of the association. The results indicate a significant positive correlation between the severity of visual impairment and depressive symptoms, emphasizing the need for integrated mental health screening in ophthalmological settings. Furthermore, the findings suggest that interventions aimed at enhancing social support and accessibility could mitigate depressive symptoms in visually impaired individuals. Given the growing aging population and increasing prevalence of eye diseases, understanding this link is crucial for improving both visual and psychological well-being.

Introduction: Anemia is a widespread nutritional condition worldwide, impacting approximately one-third of the global population due to iron deficiency. The World Health Organization (WHO) estimates that almost two billion individuals, or 25% of the worldwide population, are anemic, with approximately half of this group suffering from iron deficiency anemia (IDA).7 In 2016, the World Health Organization (WHO) estimated that anemia affected 40% of women of reproductive age and 42% of children under five years old globally. Methods: The study (cross-sectional) was carried out from February 2022 to August 2023. A total of 500 students from four schools aged 6-12 participated in the study. Only those children whose parents gave their consent were included in the study. Complete haematological investigations were done to each child for differential diagnosis of anemia. Results & Conclusion:  In our study, the prevalence of anemia in primary school-going children in the 6–12-year age group in Washim District was 36.60%, a moderate public health problem. Mild grade of anemia with Normocytic RBCs was more prevalent among studied children. Anemia was highly commonplace in the 7-year age group, followed by the 8-year age group, and girls were more affected than boys. However, an association of anemia with age and sex was statistically insignificant. Our study showed a significant association of anthropometric parameters like weight and height with anemia. Underweight and Stunted children show a prevalence of anemia. No significant association was noted between eosinophilia and platelet count with anemia.

Introduction: There are few studies that consider nutrient insufficiency in the pathophysiology of bruxism, and this review draws attention to these factors, which interfere with the main causal component of bruxism, which is stress. Objective: The objective of this study was to investigate the relationships between sleep bruxism an the main vitamin and nutrient deficiencies that are associated with psychological symptoms and bruxism. Methodology: :The following databases were searched to select articles: PubMed until December 2024, with a total of 3272 articles were found for the terms sleep bruxism, until 12/31/2024. The selection of articles on bruxism and vitamins, by title and abstract, included 316 articles. Finally, after reading the full articles, a total of 20 studies were included in this review. Results: Due to the scarcity of clinical evidence to evaluate the nutritional importance in BS, we carried out a synthesis with a literature review on the importance of understanding the influence of nutrients on neuropsychological mechanisms in BS, which provides valuable insights into the effects of nutritional interventions on deep craniofacial nociception and stress. Discussion: Exogenous oxidants from unhealthy dietary patterns may contribute to peripheral and central pro-inflammatory immune signaling, leading to peripheral and central sensitization. Furthermore, diets rich in bioactive compounds are suggested to contribute to CPC pain control. High dietary intake of ultra-processed foods impacts diet quality and shows adverse health outcomes. In this context, the role of nutrition in TMD is neglected. Conclusion: Instead of focusing on pharmacological agents, we draw attention to homeostatic disorders and deficiencies in important elements such as vitamin D, magnesium, and omega-3 fatty acids for the treatment of bruxism of sleep.

Introduction: Diabetic neuropathy (DN) is a clinical entity that encompasses a range of neuropathic illnesses. Its clinical symptoms include peripheral neuropathy and other types of autonomic dysfunction, such as gastrointestinal, urogenital, and cardiovascular disorders. With an estimated lifetime frequency of over 50%, it continues to be a very prevalent consequence of diabetes despite advancements in clinical management. Methods: A cross-sectional study was carried out in 184 patients who are attending Prathima Relief Institute of Medical Sciences in Arepally, Warangal from 2022 to 2023. Patients who had already been diagnosed with Type 1 or type 2 DM and coming for a follow-up visit. Informed consent was taken from all participants before enrolling into the study. The collected data coded and analyzed using Statistical Package for the Social Sciences (SPSS) Results: The study included 184 DM patients in total. In our study, 52.74% of participants had diabetic peripheral neuropathy (96/184). Among the 184 participants, 78 (42.39%) were men and 106 (57.60%) were women. Additionally, a statistically significant correlation was observed with BMI, systolic and diastolic blood pressure, family history of diabetes mellitus, history of smoking, and family history of hypertension. Conclusion: The current study reveals that diabetic peripheral neuropathy is highly frequent among people with diabetes mellitus. The prevalence escalates with advancing age and prolonged duration of Diabetes mellitus. The preliminary screening of DPN utilizing straightforward and economical methods Patients with diabetes mellitus should be encouraged to cease smoking and alcohol usage to mitigate the risk of diabetic peripheral neuropathy (DPN).  Individuals of advanced age and prolonged duration should be routinely tested for the signs and symptoms of diabetic peripheral neuropathy since they are at an elevated risk of acquiring this condition.

Background: Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory disorder characterized by airway inflammation and irreversible airflow limitation. Early detection is crucial for effective management and prognosis. Biomarkers of airway inflammation serve as potential indicators for early diagnosis. This study aims to assess the role of specific inflammatory biomarkers in identifying early-stage COPD. Materials and Methods: A cross-sectional study was conducted on 120 participants, including 60 COPD patients in early stages and 60 healthy controls. Blood and sputum samples were collected to measure the levels of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) using enzyme-linked immunosorbent assay (ELISA). Pulmonary function tests (PFTs) were performed to confirm COPD diagnosis based on forced expiratory volume in one second (FEV₁)/forced vital capacity (FVC) ratio < 0.7. Statistical analysis was conducted using SPSS, with p < 0.05 considered significant. Results: CRP, IL-6, and TNF-α levels were significantly elevated in the COPD group compared to the control group (p < 0.001). The mean CRP level in COPD patients was 5.2 ± 1.1 mg/L, compared to 1.8 ± 0.6 mg/L in controls. IL-6 levels averaged 12.4 ± 2.3 pg/mL in COPD patients versus 4.9 ± 1.2 pg/mL in controls. TNF-α levels were 8.6 ± 1.5 pg/mL in COPD patients and 3.2 ± 0.8 pg/mL in healthy individuals. A strong negative correlation was observed between biomarker levels and FEV₁% predicted (r = -0.72, p < 0.001). Conclusion: Elevated levels of airway inflammatory biomarkers, particularly CRP, IL-6, and TNF-α, indicate early airway inflammation in COPD. These biomarkers may serve as valuable tools for early diagnosis, allowing timely intervention and improved disease management. Further longitudinal studies are recommended to validate their predictive value.

Background: Longevity has increased significantly in the last few decades mainly due to socio-economic and health care developments. Life satisfaction (LS) is an important component of successful ageing. LS refer to a judgmental process, in which individual access their quality of life (QoL) in accordance with some unique set of criteria’s. Aims & Objectives: To find out the levels of satisfaction among the elderly and to find out problem faced by elderly in activities of daily life. Material and Methods: Using a cross-sectional study design and a researcher-made questionnaire with details on satisfaction with life, study was conducted from January to March 2018, among the randomly selected consenting elderly in the urban and rural field practice areas of a medical college. Data was analysed using EpiInfo software(version3.5.4) Results:  A total of 540(270 each in urban and rural) participants were included. The life satisfaction level was 74.23% in rural, 72.77% in urban and 73.50% in the total population under study. The study shows despite low-income levels in rural areas, the life satisfaction level is higher than urban areas because of lower level of wants & needs in rural areas, better environment in rural areas and now-a-days availability heath care facilities to rural areas.   Conclusions: Life satisfaction level in rural area is more than urban area. Level of satisfaction lies between 70-80% which needs to be improved substantially and therefore all out efforts to be made by Government to augment social security schemes for elderly

Background: Cancer ratio (CR), which is defined as serum lactate dehydrogenase (LDH) to pleural fluid adenosine deaminize (ADA) ratio, has been reported to be a useful diagnostic marker for malignant pleural effusion (MPE). This study aimed to diagnosis role of cancer ratio & cancer ratio plus in differentially Tuberculin PLEF and malignant pleural effusion. Methods: Data from 100 (36% female and 64% male) patients with malignant pleural effusion study participants. The study was conducted O.P.D. and I.P.D. in the P.G. department of Pulmonary, Hi-Tech Medical College and Hospital, Bhubaneswar. Between May 2023 and Oct 2023. Study design:  Hospital based Prospective cohort study. Study Population: Ready to participant to the study after consent form. Sample Size:  100. Results : The mean and standard deviation of different diagnosis relation with  Malignant, age (55.31 ± 13.22), mean and standard deviation of diagnosis relation with  PPE, age (51.52 ± 11.50), and  mean and standard deviation of diagnosis relation with  TB PLEF, age (48.18 ± 17.49) with a range of 19-84. Sex wise age group of Male (51.52 ± 14.99, range 19-84) and Female (49.41 ± 15.85, range 20-78).  The differential diagnostic value of pf. ADA for Malignant, was better than those of CR, and CR plus. At a cut-off value of >10.27, the sensitivity, specificity, and AUC were 55.2%, 80.3%, and 70%, respectively with p value 0.001, no significant the sensitivity, specificity, and AUC of CR plus for the diagnosis of MPE were 89.7%, 36.6%, and 57.9%, with p value 0.171,  no significant Conclusion:  The best parameter for diagnosing malignant effusion was Cancer ratio and Cancer ratio plus was a good parameter for the differential diagnosis

Objective: The objective is to study etiology , clinical profiles, visual outcomes and complications of recurrent acute anterior uveitis. Methods: A prospective study of etiology , clinical profiles ,visual outcomes and complications among patients of recurrent acute anterior uveitis attending a tertiary care center  Bhubaneswar for a period of 12 months. Detailed history, complete ocular examination , relevant investigations were done on 46  eyes of  46 patients visiting our ophthalmology OPD. Appropriate systemic and ocular management were done. Results: Total cases of  uveitis were 310, out of which 46 patients were diagnosed as recurrent acute anterior uveitis. 34 (74 %) patients were male and 12( 26 %) were female. Mean age of presentation was 39.14 years. In our study group 28 (60.8%) had recurrence once , 13 (28%) had recurrence twice and 5 (10.8%) had recurrence thrice or more. The patients who had recurrence once 14.28 % cause was viral (HSV) etiology, 78.57 % had idiopathic. Whereas  those patients who had recurrence twice, the most common etiology was Ankylosing spondylitis (23%) , Rheumatoid arthritis (15%),  Juvenile rheumatoid arthritis (15%) . Those patients who had recurrence more than twice in them conjunctival congestion was grade 2/ grade 1 and in that group no hypopyon or no exudative membrane was found. 42 ( 91%) of total patients' visual acuity improved to 6/6 -6/12 following treatment. Most  common complication was persistent posterior synechiae. Incidence of complicated cataract 2 (40%), secondary glaucoma 1 (20%)  in patients in whom recurrence was more than twice. Conclusion: Recurrent acute anterior uveitis is frequently associated with many systemic diseases such as rheumatoid arthritis and ankylosing spondylitis. Early initiation of investigations  and timely, effective  treatment are essential to prevent ocular morbidity and preserve visual function

Background: Surgical site infections are a significant cause of postoperative morbidity, particularly on class III and IV abdominal wounds. In this study, primary skin closure versus delayed primary skin closure in such wounds was studied regarding the rate of SSI, wound healing time, hospital stay, and postoperative complications. Methods: A prospective study was conducted on 120 patients subjected to emergency laparotomy for class III and IV abdominal wounds. The patients were randomly divided into two groups that received primary closure (n=60) and delayed primary closure (n=60). The following outcomes were assessed: incidence and classification of SSIs, time of healing of the wounds, duration of stay in the hospital, and postoperative complications. Microbial profiles were studied to analyze the culture-directed antibiotic therapy. Results: The incidence of SSIs was significantly lower in the delayed primary closure group (21.7% vs. 41.7%, p=0.01). The wound healing time was shorter in the delayed primary closure group (16.5 ± 3.2 days vs. 22.1 ± 4.5 days, p < 0.001), as was the mean hospital stay (12.8 ± 2.7 days vs. 15.6 ± 3.4 days, p = 0.002). Complications, including wound dehiscence and sepsis, were more frequent in the primary closure group. Conclusion: Delayed primary closure shows improved outcomes when managing class III and IV abdominal wounds, reduces the rate of SSIs, accelerates wound healing, and minimizes complications. Thus, this technique offers an improved safer approach that might be favored, having consequences for improvement in patient care in high-risk surgeries.