Background: Chronic urticaria (CU) is a recurring inflammatory skin disease that is clinically manifested by the presence of wheals or angioedema, or both, persisting over the course of over six weeks. Determining reliable biomarkers to determine the severity of the disease would be of importance in the initial diagnosis and therapeutic decision-making. Potential indicators of disease activity have been proposed to be serum IgE, absolute eosinophil count (AEC), and D-dimer. The current study aimed to determine the serum IgE, AEC, and D-dimer levels and to determine their correlation with the urticaria activity (UAS7) scoring system Methods: A cross-sectional observational study was conducted on 45 patients diagnosed with chronic urticaria reporting to our hospital. Clinical characteristics, UAS7 scores, and serum biomarkers (IgE, AEC, and D-dimer) were assessed. Statistical analysis of UAS7 along with biomarkers was performed using Spearman’s coefficient. Kruskal-Wallis' test was used to compare the activity of biomarkers across severity categories. ROC analysis was performed to find the cut-off values for severe/very severe disease (UAS7 ≥16). Results: The mean age of the cohort was 38.5 ± 12.1 years, with a female predominance (60%). Elevated biomarker levels were common: IgE in 62.2%, AEC in 17.8%, and D-dimer in 48.9%. D-dimer showed the strongest correlation with UAS7 (ρ = 0.65, p < 0.001), followed by IgE (ρ = 0.42, p = 0.005). ROC analysis revealed D-dimer as the best predictor of severe disease (AUC 0.92; sensitivity 86.7%; specificity 86.7%). Significant differences in biomarker levels were observed across UAS7 severity categories (p < 0.05). Conclusion: Serum D-dimer and IgE levels strongly correlate with disease severity and can serve as useful biomarkers in chronic urticaria assessment. D-dimer demonstrated the highest predictive accuracy for severe disease, suggesting its potential as a reliable tool for monitoring clinical progression and guiding treatment.

Background: Smoking has been identified as a major risk factor for respiratory diseases, contributing to reduced lung function and the development of chronic obstructive pulmonary disease (COPD). Pulmonary function tests (PFTs) serve as critical diagnostic tools to assess respiratory health and detect early changes in lung function among high-risk populations such as smokers. This study aims to compare key PFT parameters between smokers and non-smokers to evaluate the impact of smoking on pulmonary function. Materials and Methods: A cross-sectional study was conducted involving 100 participants aged between 20 and 50 years, divided into two groups: smokers (n=50) and non-smokers (n=50). Smokers included individuals with a smoking history of at least 5 years. Pulmonary function was evaluated using a standardized spirometry procedure measuring parameters including Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV₁), FEV₁/FVC ratio, and Peak Expiratory Flow Rate (PEFR). Data were analyzed using SPSS software, and mean values were compared using independent sample t-tests. Results: Smokers demonstrated significantly lower mean values for key spirometric indices compared to non-smokers. The mean FVC in smokers was 2.9 ± 0.5 L, while in non-smokers it was 3.5 ± 0.4 L (p < 0.01). FEV₁ values averaged 2.1 ± 0.3 L in smokers and 2.9 ± 0.3 L in non-smokers (p < 0.001). The FEV₁/FVC ratio was also reduced in smokers (72% ± 5) compared to non-smokers (83% ± 4) (p < 0.001). PEFR values were significantly lower in smokers (310 ± 40 L/min) than in non-smokers (420 ± 50 L/min) (p < 0.01). Conclusion: The study findings reveal a clear decline in pulmonary function among smokers as compared to non-smokers. Regular assessment through PFTs may aid in the early detection of smoking-induced respiratory impairment, emphasizing the importance of smoking cessation programs and preventive interventions.

Background: The global burden of stroke has been increasing in recent years due to excessive stress, altered lifestyle, and dietary habits. Stroke is the leading cause of morbidity, chronic disability, and mortality and is regarded as the second most common cause of death worldwide. This study aims to assess the severity of stroke and evaluate the prescription pattern of drugs prescribed for stroke patients. Materials & Methods: A prospective, observational, monocenter study was conducted at Konaseema Institute of Medical Sciences & Research Foundation (KIMS) Hospital with prior approval from IEC and Informed consent from patients.All the patients aged above 18 years, of both genders, and who are diagnosed with stroke (both ischemic and hemorrhagic) with or without comorbid conditions were included in this study. The patient’s demographic data and the prescription data were collected from the patient Case Sheet/Case Report Form (CRF), and the severity of stroke was analyzed using the National Institute of Health Stroke Scale (NIHSS). Results: A total of 126 stroke patients participated in this study. The mean age of the study participants was 59.86 ± 10.24 years. Most of the patients were diagnosed with Ischemic stroke 90), whereas 10% of patients were diagnosed with Hemorrhagic stroke. The severity of stroke in most of the patients was found to be Moderate to Severe (46.1%), followed by Moderate (27.8%), Severe (21.4%), and Minor (4.7%).The average number of drugs per prescription was found to be 7.2. The percentage of generic drugs prescribed was found to be very low (2.5%). The drug utilization study reported that 29 different drug classes with 78 different drugs were prescribed in 126 stroke patients. Conclusion: Assessment of the severity of stroke in patients helps in providing rational, individualized, effective, and optimal drug therapy. Antiplatelet agents are the most prescribed drugs for stroke patients. The high number of drugs per prescription and lack of generic drug prescribing are the major concerns that should be dealt with to promote rational drug therapy.

Background: Intertrochanteric fractures are among the most common injuries in the elderly, often associated with significant morbidity and mortality. With evolving surgical techniques, achieving optimal functional outcomes while minimizing complications is paramount, particularly in older adults with multiple comorbidities. This study aimed to evaluate the functional outcomes of intertrochanteric fracture fixation in elderly patients treated in tertiary care hospitals across Gujarat over a one-year period. Methods: A prospective observational study was conducted on 85 elderly patients (aged ≥60 years) with radiologically confirmed intertrochanteric fractures. Patients underwent fixation using either a Dynamic Hip Screw (DHS) or Proximal Femoral Nail (PFN), depending on fracture stability. Functional outcomes were assessed using the Modified Harris Hip Score at 6 weeks, 3 months, and 6 months postoperatively. Data on demographics, surgical details, postoperative complications, and comorbidities were collected and analyzed using appropriate statistical methods. Results: The mean age of patients was 72.4 ± 6.8 years, with a male predominance (56.5%). Stable fractures were more commonly treated with DHS (81%), while PFN was predominantly used for unstable patterns (74.4%). The most frequent postoperative complication was superficial infection (7.1%). Functional scores showed significant improvement over time, with 68.2% of patients achieving good to excellent outcomes by 6 months. Patients without comorbidities had significantly better outcomes (mean Harris Hip Score: 85.2) compared to those with multiple comorbidities (mean: 68.9). Conclusion: Intertrochanteric fracture fixation in elderly patients yields progressively better functional outcomes over time, particularly when managed with appropriate surgical techniques based on fracture type. Comorbidities negatively influence recovery, highlighting the importance of preoperative optimization and tailored rehabilitation strategies.

Background: Intestinal parasitic infections (IPIs) remain a major public health concern, particularly among school-aged children in developing countries. This study aims to determine the prevalence of IPIs and identify associated risk factors among children attending a tertiary care hospital over a one-year period. Methods: A hospital-based cross-sectional study was conducted over 12 months. A total of 500 stool samples were collected from school-aged children (5–14 years) presenting to the pediatric outpatient department. Samples were examined microscopically using direct saline and iodine mounts. Demographic data and risk factors were recorded using structured questionnaires. Data were analyzed using SPSS version 25. Results: Of the 500 children studied, 142 (28.4%) tested positive for at least one intestinal parasite. The most common parasites detected were Giardia lamblia (38.7%), Entamoeba histolytica (25.4%), and Ascaris lumbricoides (21.1%). Mixed infections were noted in 8.5% of positive cases. Significant risk factors associated with IPIs included poor hand hygiene (OR=2.8, p<0.01), lack of access to clean drinking water (OR=3.2, p<0.001), open defecation (OR=4.1, p<0.001), and lower parental education levels (p<0.05). Conclusion: Intestinal parasitic infections remain prevalent among school-aged children, particularly those exposed to poor sanitation and hygiene. School-based health education, improved sanitation, and routine deworming are recommended to reduce the burden of IPIs.

Background: Thyroid dysfunction is known to coexist with diabetes mellitus (DM), often leading to complex metabolic derangements. The current study aimed to assess the prevalence of thyroid disorders in diabetic individuals compared to age- and sex-matched non-diabetic controls in sub-urban population of Chennai, Tamil Nadu. Objective: To study the prevalence of thyroid dysfunction among diabetic and non-diabetic individuals. Methods: A total of 296 subjects were included in the study. Of these, 133 were known diabetics (132 type 2 DM, 1 type 1 DM) receiving regular antidiabetic treatment (monotherapy or combination therapy with oral hypoglycemic agents (OHA) or insulin), and 163 were age- and sex-matched non-diabetics. Thyroid stimulating hormone (TSH) was measured using the immunofluorescent assay (IFA) method (Biomérieux – Mini Vidas). Hypothyroidism was defined as TSH >4.5 µIU/mL and hyperthyroidism as TSH <0.25 µIU/mL. Subjects with pregnancy, pituitary disorders, or those on steroids or dopamine were excluded. Results: Among the 133 diabetics, 19 (14.29%) had abnormal TSH values suggestive of thyroid dysfunction. In contrast, 45 (27.6%) of the 163 non-diabetics showed abnormal TSH levels. Hypothyroidism was seen in 14 diabetics (10.53%) and 40 non-diabetics (24.5%). Hyperthyroidism was found in 5 diabetics (3.76%) and 5 non-diabetics (3.10%). The binomial test revealed a statistically significant difference in hypothyroidism prevalence between the groups (p<0.05). Conclusion: According to the study's findings, non-diabetic people in the rural community under investigation had a greater prevalence of thyroid malfunction, namely hypothyroidism, than did diabetics. For diabetics to have complete metabolic control, routine thyroid monitoring is still essential.

Background: Gabapentin is commonly employed in the treatment of epilepsy and neuropathic pain, but it's possible causation of hyponatremia is not well studied. Although sodium channel-blocking AEDs such as oxcarbazepine and carbamazepine are recognized to cause hyponatremia, there is little information regarding the relationship between gabapentin and sodium disturbance. The present study is designed to assess the incidence, risk factors, and clinical significance of gabapentin-induced hyponatremia. Methods: A retrospective review was done on 450 patients on gabapentin therapy. Serum sodium concentrations were measured, and patients were classified as having or not having hyponatremia. Demographics, comorbidities, dosage of gabapentin, and symptomatology were compared. Statistical contrasts were made to determine risk factors and dose-response associations. Results: Hyponatremia was detected in 12.9% of patients, with a significant correlation found in elderly patients and those with chronic kidney disease or diabetes mellitus. A dose-response effect was found, with patients taking ≥1200 mg/day of gabapentin having a greater prevalence of hyponatremia (p = 0.007). The symptoms were dizziness (46.5%), nausea (39.7%), and confusion (22.4%). Comparisons with earlier studies suggest that although gabapentin-induced hyponatremia is less common than with sodium channel-blocking AEDs, it is still clinically relevant. Conclusion: Gabapentin can cause hyponatremia, especially at higher dosages and in susceptible patients. Monitoring serum sodium levels on a regular basis should be done to avoid complications. More studies are required to explain the pathophysiological mechanisms and formulate safety criteria for gabapentin administration.

Background: Iron deficiency (ID) is common but frequently underestimated in heart failure (HF) even without anemia. ID has been implicated in reduced functional capacity, inflammation, and progressive cardiac dysfunction. The aim of this study was to establish the prevalence of ID in non-anaemic patients with HF and assess its effects on clinical and functional outcomes. Methods: This cross-sectional study enrolled 180 non-anaemic HF patients who were evaluated for iron deficiency according to serum ferritin and transferrin saturation (TSAT) levels. The patients were classified into iron-deficient and iron-sufficient groups. Functional capacity was measured through the six-minute walk test (6MWT), whereas inflammatory status was evaluated through C-reactive protein (CRP) levels. Echocardiographic parameters such as left ventricular ejection fraction (LVEF) were compared between groups. Results: Iron deficiency was diagnosed in 51.1% of the patients, with absolute ID (65.2%) being more frequent than functional ID (34.8%). Patients with ID showed significantly shorter 6MWT distances (310.2 ± 52.8 m vs. 370.5 ± 49.7 m, p<0.01) and elevated CRP levels (7.8 ± 2.5 mg/L vs. 4.6 ± 1.8 mg/L, p=0.03). LVEF was also decreased in the ID group (38.2% ± 6.4% vs. 41.5% ± 5.9%, p=0.03), indicating a correlation between ID and compromised cardiac function. Conclusion: Iron deficiency is extremely common in non-anaemic HF patients and is correlated with decreased exercise capacity, heightened inflammation, and deteriorating cardiac function. Iron status screening should be made routine in the management of HF to enhance clinical outcomes.

Introduction: Meningiomas accounted for 33.8% of all primary brain tumors reported in thus represent the most frequently diagnosed primary brain tumor. 10% of all intracranial meningioma arise in the posterior fossa. It includes (1) Cerebellar convexity, Lateral tentorial, (2) C P Angle, (3) Jugular foramen, (4) Petroclival, (5) Foramen Magnum, 6. Unclassified groups. Clinical presentation and surgical approaches vary depending upon the location of tumor. Aim of the study-To find out clinical behaviour, surgical approaches, outcomes and histological types in posterior fossa meningioma. Methods-Prospective observational study from march 2022 to September 2024 which included 30 patients, diagnosed and treated for posterior fossa meningioma on the basis of pre op MRI and clinical examination. Different surgical procedures were done depending on tumor locations. Postoperative contrast CT was done in all patients. Results-20 of the patient were females,10 were male. Most cases occurred in the age group between 45-65 yrs. Headache (80%) was the most common symptom followed by facial numbness (53.3%). Most common location was cerebellopontine angle (33.3%) whereas least common was foramen magnum (10%).Retrosigmoid approach (60%) was most common surgical procedure done. Fibrous and transitional types were most common histological subtypes (33.3%) each. Gross total resection was possible 63.3% cases. Conclusion-Retrosigmoid approach can be safely performed in most of the cases of posterior fossa meningioma. Petroclival meningioma is associated with high morbidity and mortality risk.

Introduction: Dry eye disease (DED) is one of the most prevalent eye conditions, affecting millions of people globally. The worldwide prevalence ranges from 5% to 50%, depending on the geographic region. DED is defined as a multifactorial eye disease related to loss of the tear film homeostasis. Instability and hyperosmolarity of the tear film leads to damage to the ocular surface, which is associated with ocular symptoms . DED may cause a wide range of ocular symptoms including redness, dryness, discomfort, itching, stinging, burning, irritation, pain.  Objectives: To Evaluate the prevalence and severity of dry eye in post-menopausal women presenting to our hospital. And to assess the prevalence of various types of dry eye in post-menopausal women. Materials and Methods: The study was conducted in a tertiary hospital. After obtaining institutional ethical committee approval It was an Observational prospective study conducted on 160 patients with all post-menopausal women in the department of Ophthalmology, at a tertiary care centre, from April 2024 to November 2024 Results: 130 post-menopausal women who fulfilled eligibility criteria were included in the study.89 participants were found to have dry eye disease in this study. The trend of increasing prevalence of dry eye disease with increasing age in post-menopausal women. The women in 66- 70 age group had the highest prevalence among all the participants in this study Redness, grittiness & burning were among the most common complaints Conclusions: Age is a significant factor, with the prevalence and severity of dry eye increasing with age. he severity of dry eye symptoms can range from mild to severe, with some women experiencing significant visual impairment. Dry eye can significantly impact a woman's quality of life, causing discomfort, pain, and visual disturbances. Every woman should have a regular eye check-up after menopause so that dry eye as a cause of visual impairment could be prevented and treated in time to prevent further ocular morbidity.

Introduction: Anterior cruciate ligament (ACL) avulsion fractures are common sports-related injuries among young and active individuals. Currently, surgical stabilization is the treatment of choice for these fractures to regain function and stability of the knee. This investigation is to analyze the post-operative functional scores, ROM, knee stability, and complications after surgical management of ACL avulsion fractures. Methodology: 50 patients who received arthroscopic fixations for ACL avulsion fractures were involved in this study. Follow-up times were 14 days, 1 month, and 3, 6, and 12 months for patients. Functional results were evaluated by the International Knee Documentation Committee (IKDC) score and Lysholm Knee Score. Knee stability was quantified with the KT-1000 arthrometer, and ROM was measured during each follow-up. Duration of operation and recovery enpoints such as time to weight bearing and resumption of activities were documented. Postoperative complications were also monitored. Results: Gradual improvements in function of the knee were seen. There was a marked improvement in the IKDC score and Lysholm knee scores toward better grades, with 24% of patients rated as Grade A (Excellent) by 1 year of follow-up. The average ROM also increased from 23.27° at 14 days to 136.1° at 1 year. KT-1000 scores also demonstrated stable gains, as well as improved stability of the knee. Conclusion: Surgical treatment of ACL avulsion fractures leads to significant improvements in functional outcomes, ROM, and knee stability. The low complication rate and efficient recovery timeline make arthroscopic fixation a highly effective and safe intervention for ACL avulsion fractures.

INTRODUCTION Acute appendicitis is one of the most common condition encountered in general surgical practice. Alvarado and Modified Alvarado scores (MASS) are commonly used scoring systems for diagnosis of acute appendicitis, but these scoring systems perform poorly in certain populations like Middle East Asia, etc . We compared RIPASA score with MASS, to find out which is a better diagnostic scoring tool for acute appendicitis in the Indian population. METHODS We enrolled 120 patients who presented with RIF pain in the study. Both RIPASA and MASS were applied to them. Final diagnosis was confirmed either by CT scan, intra-operative finding, or post-operative histopathological examination report. Final diagnosis was analysed against both RIPASA and MASS. Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value and Diagnostic Accuracy were calculated for both RIPASA and MASS. RESULTS It was found that RIPASA was better than MASS in terms of Sensitivity (40.00% Vs 13.00%), Positive Predictive Value (97.56% Vs 92.86%), and Diagnostic Accuracy (49.17% Vs 26.67%). Both RIPASA and MASS have similar Specificity (95.00%) whereas Negative Predictive value for RIPASA and MASS were comparable (24.05% Vs 17.92%). CONCLUSION RIPASA has more Sensitivity, Positive Predictive Value, Diagnostic Accuracy and Negative Predictive Value than MASS in terms of diagnosis of acute appendicitis in our local population, India and hence, it decreases the number of missed appendicitis.

Background: Excessive and abnormal menstrual bleeding is the commonest symptom that brings perimenopausal women to the hospital. This age group is more amenable to serious conditions like endometrial cancers. Therefore, this bleeding should be seriously evaluated to exclude the life-threatening conditions by easily available investigative modalities like biopsy before deciding the line of treatment. This study aimed to examine the histopathological lesions of endometrial tissue. Methods: This cross-sectional study was conducted in the Department of Pathology at a tertiary care hospital over a period of two years. 500 endometrial samples were analyzed, including hysterectomy specimens and endometrial biopsies. Clinical data such as age, symptoms, and provisional diagnosis were collected from records. Specimens were processed routinely, stained with hematoxylin and eosin, and examined microscopically. Data were statistically analyzed using the Chi-square test, with p < 0.05 considered significant. Results: The 500-woman cohort had a mean age of 40–50 years (62%), but significant age-related variations in describing presenting symptoms (χ²=214.53, p<0.001), abdominal pain (30.2%), PV bleeding (27%), and menorrhagia (20.2%) were the most common. From an actual point, uterine/cervical fibroids (39.4%) and DUB/AUB (37.2%) prevailed. Specimens were 79% hysterectomies and 21% biopsies, and specimen type was highly correlated with age (χ² = 17.02, p<0.001). Histopathology showed 98.8% non-neoplastic lesions (proliferative phase (35.8 %), atrophic (11.8 %), simple hyperplasia (8.2 %), and 1.2% malignant neoplasms), primarily endometrioid adenocarcinoma (0.6%). Specimen type was also closely associated with specific histological diagnoses (χ²=68.01, p<0.001). Conclusion: The current study found that histopathological examination plays a critical role in diagnosing endometrial lesions, especially in perimenopausal women. Most specimens, particularly those from women aged 41 – 50 years, presented with a proliferative phase of the endometrium. This study found a significant association between age, clinical presentation, specimen type, and histopathological diagnosis.

Introduction: Chronic Kidney Disease (CKD) is a progressive condition causing significant morbidity and mortality worldwide. The increasing burden of CKD in India necessitates region-specific studies to improve management strategies. Objectives: 1) To assess the clinical profile of CKD patients. 2) To evaluate the epidemiological factors influencing CKD. 3) To analyse the correlation between risk factors and disease progression. Materials and Methods: A cross-sectional study conducted at Rajshree Medical Research Institute, Bareilly, enrolled 218 CKD patients. Data on demographics, clinical presentation, comorbidities, and laboratory findings were analysed using statistical methods. Results: The mean age was 52.8 years, with 67% males. Hypertension (87%) and diabetes (37%) were leading causes. Advanced CKD stages (4 and 5) were observed in 40.8% of cases. Conclusion: Early screening, optimized management, and improved healthcare access are essential in mitigating CKD progression.

Introduction: Type 2 Diabetes Mellitus (T2DM) is a global health challenge, frequently complicated by microvascular disorders such as diabetic nephropathy (DN). Identifying early biomarkers for DN is critical to reduce progression to end-stage renal disease (ESRD). Serum uric acid (SUA) has been postulated to play a role in early renal dysfunction. Aim & Objectives: To evaluate the correlation between serum uric acid levels and microalbuminuria in T2DM patients. Materials and Methods: This cross-sectional study included 125 T2DM patients from a tertiary care hospital. Data regarding demographic, clinical, and biochemical parameters were collected. Serum uric acid and urinary albumin-to-creatinine ratio (ACR) were measured. Statistical analysis was performed using SPSS 24.0, with p<0.05 considered significant. Results: A significant positive correlation was found between serum uric acid levels and microalbuminuria. Patients with higher SUA had a higher prevalence of albuminuria (p<0.05). Age, BMI, and duration of diabetes also influenced albuminuria levels. Conclusion: Hyperuricemia may be an independent risk factor for early diabetic nephropathy. Serum uric acid could serve as a simple, adjunct biomarker for predicting renal impairment in T2DM patients

Background: Acromioclavicular (AC) joint dislocation accounts for approximately 12% of all shoulder injuries and is commonly caused by high-impact trauma such as falls or sports-related incidents. Although numerous surgical techniques exist, there is no universally accepted gold standard. The double-button fixation system offers a potentially effective method for anatomical reconstruction of the AC joint, particularly in acute dislocations. Objective: To evaluate the clinical and radiological outcomes of anatomical AC joint reconstruction using the double-button fixation technique in patients with acute Rockwood type III–V dislocations. Methods: A cross-sectional study was conducted between February 2022 and June 2024, involving 28 patients (24 males, 4 females; mean age 39.23 ± 6.7 years) who underwent surgical treatment for acute AC joint dislocation using the double-button fixation system. Patients were assessed pre- and post-operatively using the DASH (Disabilities of the Arm, Shoulder and Hand), Constant Shoulder, and Visual Analogue Scale (VAS) scores. Radiographic evaluation included coracoclavicular (CC) distance measurements. Paired t-tests were used for statistical analysis. Results: Significant clinical improvements were observed. The mean VAS score decreased from 7.1 ± 1.66 to 1.04 ± 0.84 (P < 0.05), the DASH score from 20.33 ± 5.3 to 2.4 ± 0.93 (P < 0.001). No significant difference was found in CC distance between the operated and contralateral shoulders (P = 0.238). Conclusion: The double-button fixation system provides favourable clinical and radiological outcomes for the surgical management of acute AC joint dislocation. This technique allows for stable anatomical reduction with minimal soft tissue disruption and a low complication rate, supporting its utility as a reliable treatment option for Rockwood type III–V injuries.

Objective: To determine the prevalence, etiological factors, and clinico-hematological patterns of nutritional anemia among geriatric patients attending a tertiary care hospital. Methods: A cross-sectional observational study was conducted among 332 geriatric patients (≥60 years) at Rajshree Medical Research Institute, Bareilly. Hemoglobin levels, iron studies, vitamin B12, folate, and comorbidities were assessed. Data were analyzed using SPSS version 26.0. Results: The anemia prevalence was 33.74%, predominantly normocytic anemia (49.7%). Vitamin B12 deficiency (20.78%) and folic acid deficiency (11.45%) were the major etiologies, with iron deficiency uncommon (1.51%). Hyperhomocysteinemia was observed in 75.9%. Significant associations were found between anemia and comorbid conditions such as diabetes, hypertension, and chronic kidney disease Conclusion: Nutritional deficiencies, especially vitamin B12 and folic acid, play a critical role in anemia among elderly patients. Routine screening, dietary interventions, and supplementation are crucial.

Background: Thyroid nodule assessment demands correct diagnosis between benign and malignant conditions since these nodules frequently appear to healthcare providers. Ultrasonography and fine-needle aspiration biopsy (FNAB) play critical roles in risk stratification and diagnosis. The evaluation of thyroid nodules through ultrasonographic features and FNAB together with histopathological correlations serves as a diagnostic assessment goal. Methods: The investigators reviewed results from patients who received thyroid ultrasonography combined with FNAB before their histopathological examination. Researchers investigated the relationship between malignancy and four ultrasonographic characteristics including echogenicity and margins and calcifications and vascularity. The Bethesda System provided guidelines for classifying FNAB results before healthcare providers examined final histopathological diagnoses against cytological findings to determine diagnostic accuracy. Results: Texture with low echogenicity and irregular shape along with microcalcifications proved to be strong predictive signs that a nodule was malignant. The results from FNAB advanced high levels of both sensitivity at 88.2% and specificity at 91.4% when detecting malignant nodules. The analysis of surgically removed nodules showed that 47.6% of specimens turned out to be malignant while papillary carcinoma was the most common subtype of cancer discovered. The need for enduring sonographic monitoring became evident because FNAB showed initial benign results which turned out to be malignant through histopathological analysis. Using ultrasonic imaging together with FNAB methods resulted in better malignancy diagnoses which prevented unnecessary surgical procedures but delivered fast treatment care. Conclusion: Medical professionals achieve better thyroid nodule assessment through the joint application of ultrasonography and FNAB procedures. Further examination through histopathological and molecular solutions needs to be performed for indeterminate cytology results. A comprehensive multi-testing strategy stands as the essential foundation for suitable patient treatment by enabling specific threat evaluation and proper medical choices.

Introduction: Bloodstream infections (BSI) remain a major cause of morbidity and mortality in patients undergoing treatment for cancer. Aim is to access the use of new potent antibiotics against bloodstream infection in cancer patients and to determine the cross resistance of bacterial strains. Materials and Methods: This retrospective study is a single‑center’s experience including both pediatric and adult patients with malignancy, who were receiving care at our hospital which is a Regional Cancer Centre, of over a 6 months period, between January 2022 and June 2022. Blood cultures were done using BacT/ALERT 3D system. We studied the bacterial spectrum & antimicrobial susceptibility pattern of bacterial strains in cancer patients. Susceptibility of microbial isolates to antibiotics was performed with a VITEK 2 compact automated system (Biomerieux Inc., France) according to the Clinical and Laboratory Standards Institute recommendation in 2015. Results: A total of 243 blood cultures were examined. The patient’s age ranged from 1 to 72 years. The majority of patients 139 (57.2%) had hematologic malignancies as opposed to solid and other tumours or malignancies 104 (42.7%). Out of 243 blood samples which came for culture in our Institute, 6 were Central line‑associated bloodstream infections, (CLABSI)  cases. Total positives ere 63 (25.9%) and,total negatives were 180 (74.1%) .Among the total positives, Gram‑negative bacilli were the predominant causative agents of BSI constituting 61.9% (n = 39/63) of isolated organisms, 33.33% (n = 21/63) of infections were caused by Gram‑positive cocci while polymicrobial infections accounted for 4.76% (n = 3/73) of these cases. Conclusion: High resistance observed in this study warrants the needs of surveillance of resistant pattern of antimicrobial agents. Due to increased level of drug resistance, following Culture and Sensitivity patterns as Investigation of choice would be a prudent choice in high- risk cases especially in Blood stream infections in Cancer patients.

Introduction: Typhoid fever is a prevalent endemic disease in India, with the Widal test being a frequently utilized diagnostic tool. Given the widespread nature of typhoid in the region, healthy individuals may exhibit varying levels of antibodies that respond to the Widal test. This variation may result from previous exposure to the infection, TAB vaccination, or cross-reacting antigens from other diseases, which can differ across locations {1}. This study intends to assess the prevalence of the disease in the peripheral region of Maharashtra. Materials and Methods: Blood samples were obtained from blood donors between the period of February 2024 and March 2024. The samples were collected in plain tubes and tested for the presence of Salmonella antibodies using the Widal Tube agglutination test. Results: Out of 1150 serum specimens analysed, 461 (40.08%) tested positive for the Widal tube agglutination test, while 689 were negative. The predominant reactions observed were at 1:40 for anti-O antibodies, 1:80 for anti-H antibodies, and 1:40 for both anti-AH and anti-BH antibodies. The findings indicated that the diagnostic titres in the peripheral region of Maharashtra were 1:80 for anti-O antibodies and 1:160 for anti-H antibodies for enteric fever, along with a titre of 1:80 for paratyphoid fever. Conclusion: The study revealed that the diagnostic titres for enteric fever in the peripheral region of Maharashtra were identified as 1:80 for anti-O antibodies and 1:160 for anti-H antibodies, while for paratyphoid fever, the diagnostic titre was noted as 1:80.