Knee osteoarthritis is a common degenerative joint disorder associated with pain and functional disability. The relationship between radiographic severity and clinical manifestations remains variable, with discrepancies often observed between structural changes and patient-reported symptoms. Objectives: To assess the radiographic severity of knee osteoarthritis and evaluate its correlation with pain intensity and functional limitation in patients with knee OA. Materials and Methods: This cross-sectional correlational study included 80 patients diagnosed with knee osteoarthritis. Radiographic severity was graded using the Kellgren-Lawrence classification. Pain intensity was assessed using the Visual Analogue Scale, and functional status was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Statistical analysis included descriptive statistics and Pearson correlation to assess the relationship between radiographic severity and clinical outcomes. Results: The mean age of participants was 58.7 ± 8.9 years, with a female predominance. Most patients had moderate to severe radiographic osteoarthritis. Significant positive correlations were observed between Kellgren-Lawrence grade and VAS pain score (r = 0.61, p < 0.001), WOMAC pain score (r = 0.58, p < 0.001), and WOMAC stiffness score (r = 0.46, p < 0.001). Stronger correlations were noted between radiographic severity and functional outcomes, particularly WOMAC function (r = 0.69, p < 0.001) and WOMAC total score (r = 0.72, p < 0.001). Conclusion: Radiographic severity of knee osteoarthritis shows a significant correlation with both pain and functional limitation, with a stronger association observed for functional impairment. These findings support the need for combined radiological and clinical assessment to guide optimal management of knee osteoarthritis.

Background: Intertrochanteric femur fractures, commonly seen in the elderly population, require timely and effective surgical intervention to restore mobility and reduce morbidity. Dynamic Hip Screw (DHS) and Proximal Femoral Nail (PFN) are two widely adopted fixation methods, with ongoing debate regarding their relative merits, especially in unstable fractures. Objective: To compare clinical, functional, radiological, and complication outcomes between DHS and PFN in the surgical management of intertrochanteric femur fractures. Materials and Methods: This prospective comparative study was conducted on 70 patients with intertrochanteric fractures treated at a tertiary care center, divided equally into DHS (n=40) and PFN (n=40) groups. Parameters analyzed included operative time, intraoperative blood loss, union time, postoperative complications, and functional outcome using the Harris Hip Score at 3 and 6 months. Statistical analysis was performed using SPSS v25 with p<0.05 considered significant. Results: The PFN group demonstrated significantly shorter operative time (58.4 ± 9.6 min vs. 75.2 ± 10.3 min), reduced blood loss (160.5 ± 25.6 mL vs. 220.3 ± 30.1 mL), and earlier mobilization. Time to radiological union was also lower in PFN (11.8 ± 2.4 weeks) than DHS (13.5 ± 2.7 weeks). Harris Hip Scores at 6 months were significantly higher in PFN (89.1 ± 5.8) compared to DHS (82.6 ± 6.5). Implant-related complications were higher in the DHS group (15% vs. 5%). Conclusion: While both DHS and PFN are effective in treating intertrochanteric femur fractures, PFN offers superior advantages in terms of surgical efficiency, early mobilization, and reduced complications. PFN may be considered the preferred implant, especially in unstable fractures and osteoporotic bone.

Background: Immediate postpartum intrauterine device (IUD) insertion offers a valuable opportunity for long-acting contraception, but comparative data on continuation, expulsion, and satisfaction are limited. Objective: To compare the levonorgestrel-releasing IUD (LNG-IUD) and copper T380A (CuT380A) when inserted immediately postpartum, focusing on continuation rates, expulsion, adverse effects, and user satisfaction at 12 months. Methods: In this randomised controlled trial at Burdwan Medical College over one year, 300 women were allocated to receive either an LNG-IUD or CuT380A within 48 hours postpartum. Outcomes were assessed at 6 weeks, 3, 6, and 12 months, including continuation, expulsion, adverse events, and satisfaction (rated on a 5-point Likert scale). Statistical comparisons were made using chi-square and t-tests, with multivariate logistic regression to determine predictors of continuation. Results: Of 274 women completing follow-up, the 12-month continuation rate was significantly higher in the LNG-IUD group (85.4%) than in the CuT380A group (68.6%, p<0.01). Expulsion was more frequent in CuT380A users (27.0%) versus LNG-IUD users (11.7%, p<0.01). Adverse effects were reported by 25.5% of CuT380A users, compared to 12.4% of LNG-IUD users. Mean satisfaction scores were consistently higher among LNG-IUD users across all time points, reaching 4.5 at 12 months compared to 3.4 for CuT380A (p<0.001). Logistic regression confirmed a trend toward lower odds of continuation with CuT380A (aOR 0.57), and expulsion emerged as a major negative predictor. Conclusion: LNG-IUD inserted immediately postpartum is associated with higher continuation, fewer expulsions, and greater satisfaction at 12 months compared to CuT380A. These findings support LNG-IUD as the more favourable option for immediate postpartum contraception.

Background: Frailty, a multidimensional geriatric syndrome, is associated with functional decline, hospitalization, and mortality. Evidence from India is limited, particularly in smaller urban settings where demographic and lifestyle transitions may influence frailty risk. Objectives: To estimate the prevalence of frailty and identify its determinants among elderly individuals residing in urban Faridkot, Punjab. Methods: A community-based cross-sectional study was conducted among 184 elderly participants (≥60 years) selected through simple random sampling. Data were collected using a pretested questionnaire and frailty was assessed using the Tilburg Frailty Indicator (TFI). Data were analyzed using descriptive statistics, chi-square test and logistic regression; a p-value <0.05 was considered statistically significant. Results: The prevalence of frailty was 38.6%. Multivariable analysis revealed that higher age, lower socio-economic status, and polypharmacy were independently associated with frailty. Conclusion: Frailty prevalence in urban Faridkot was substantial, underscoring its importance as a public health concern. Advancing age, socio-economic disadvantage and polypharmacy emerged as key determinants. Integrating frailty screening into primary care and implementing interventions addressing medication burden, functional decline, and socio-economic vulnerabilities are essential to promote healthy aging in smaller urban settings of India.

Background: The pulp–dentin complex comprising the soft connective tissue of the dental pulp and the surrounding mineralized dentin—serves as a critical biological barrier that protects the root canal system from microbial invasion. In healthy teeth, the root canal remains sterile. However, disruption of the pulp’s vascular supply—such as from trauma or untreated deep caries—leads to pulp necrosis. In the absence of blood and immune defenses, the root canal becomes an ideal environment for opportunistic bacteria to proliferate. Material and Methods: Eight single-rooted mandibular teeth from Eight patients aged 20–52 years, each presenting with symptomatic apical periodontitis and radiographic periapical radiolucency at Bhabha College of Dental Sciences, Bhopal, were selected for the study. After obtaining informed consent, extraoral and intraoral examinations confirmed the absence of swelling or sinus tracts, and all teeth responded positively to electric and cold pulp testing. Patients who had used systemic antimicrobial or anti-inflammatory medications within the three months prior to sample collection, as well as those with systemic disorders, were excluded from the study. Results: In the control group (without intracanal medicament) the m-RNA expression of IL-1 beta was elevated at day 7 while TGF-beta and IL-4 has not substantially altered at day 7 compared with day 0.  In contrast (with intracanal medicament) the m-RNA expression of IL-1 beta was reduced at day 7 while TGF-beta and IL-4 has elevated at day 7 compared with day 0. Conclusion: This study highlights the dynamic balance between pro- and anti-inflammatory mediators in Apical Periodontitis and the capacity of endodontic treatments to favourably modulate this balance, paving the way for improved therapeutic strategies.

Background: Vasculitic neuropathy (VN) is an uncommon but disabling form of peripheral neuropathy resulting from inflammation and ischemia of peripheral nerves. Data on long-term neurological recovery and disability outcomes following treatment remain limited in Indian populations. Objectives: To assess long-term neurological outcomes and disability scoring in patients with vasculitic neuropathy after initiation of standard immunosuppressive therapy. Methods: This prospective observational study was conducted in the Department of Medicine, a tertiary care hospital in Maharashtra, from November 2023 to October 2024. A total of 60 patients with biopsy-proven or clinically established vasculitic neuropathy were enrolled. Baseline demographic, clinical, electrophysiological, and serological data were collected. All patients received standardized treatment comprising corticosteroids with or without additional immunosuppressive agents (cyclophosphamide, azathioprine, or mycophenolate). Neurological improvement was assessed using the Medical Research Council (MRC) sum score, Neuropathy Impairment Score (NIS), and disability was evaluated using the Overall Disability Sum Score (ODSS) at baseline, 6 months, and 12 months. Results: The mean age of patients was 47.2 ± 11.8 years, with a male-to-female ratio of 1.5:1. The majority presented with painful asymmetric sensorimotor neuropathy (65%). Baseline mean NIS was 48.6 ± 10.2, and ODSS was 5.1 ± 1.2. At 12 months, significant improvement was observed: mean NIS reduced to 29.3 ± 8.7 (p < 0.001), MRC sum score improved by a mean of 14 points, and ODSS reduced to 2.8 ± 0.9. Complete remission (defined as stabilization of neuropathy and ODSS ≤ 2) was achieved in 32% of patients, while 55% showed partial improvement. Persistent disability (ODSS ≥ 4) was noted in 13%. Relapses occurred in 8% of cases, predominantly in those with systemic vasculitis. Conclusion: Long-term follow-up of vasculitic neuropathy patients demonstrates substantial neurological recovery and functional improvement with immunosuppressive therapy, although a subset continues to experience residual disability. Early diagnosis and aggressive treatment may improve long-term outcomes.

Background: Bodily Distress Disorder (BDD) is a persistent functional somatic syndrome associated with psychological distress and high healthcare utilization. Its status as a geriatric syndrome especially in low- and middle-income countries (LMICs) remains unexplored. Objective: To characterize BDD among older adults attending a tertiary geriatric clinic in Nigeria and to propose its classification as a geriatric syndrome with policy and service‐delivery implications. Methods: We conducted a retrospective descriptive review of medical records for patients aged ≥65 years diagnosed with BDD (or equivalent somatoform disorders) between January 2022 and December 2024 at Ekiti State University Teaching Hospital’s elderly care clinic. Data on age, sex, monthly clinic visits, and comorbidities were extracted and analyzed using descriptive statistics. Results: Among 185 cases (2022: 64; 2023: 49; 2024: 72), 62.5–58.3% were aged 65–74 years; females comprised 68% of the sample (male:female of 1:2.2). BDD presentations occurred year‐round without seasonal peaks. Multimorbidity was high: 65.6–71.4% had ≥3 comorbidities, with cardiovascular conditions most prevalent. Conclusions: BDD exhibits hallmark features of geriatric syndromes which include multifactorial aetiology, multisystem involvement, chronicity, and high healthcare use in an LMIC context. Recognizing BDD as a geriatric syndrome could inform resource allocation, clinician training, and policy frameworks to improve holistic care for older adults in resource‐limited settings.

Background: Infertility is a major public health concern with profound psychological implications, particularly in women with polycystic ovary syndrome (PCOS). The interplay between infertility, PCOS, and mental health is complex and influenced by biological, social, and cultural factors. Aim: To determine the frequency of depression and anxiety in infertile women with and without PCOS attending a tertiary care center in India. Material and Methods: This cross-sectional study included 120 infertile women aged 20–40 years, categorized into PCOS and non-PCOS groups using Rotterdam criteria. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale (HADS). Demographic and clinical data were collected, and statistical comparisons between groups were performed using t-tests and chi-square tests, with significance set at p<0.05. Results: Depression was significantly more prevalent in the PCOS group (31.7%) compared to the non-PCOS group (13.3%) (p=0.003), while anxiety levels were low in both groups with no significant difference (p=0.35). A shorter duration of PCOS was significantly associated with depression (p=0.02), whereas no association was found between PCOS duration and anxiety. Conclusion: Infertile women with PCOS are at increased risk of depression, especially in the early years following diagnosis. Integrating early psychosocial support into infertility care may improve emotional well-being and treatment.

Background: Contrast-enhanced MRI is critical for detecting intracranial pathologies, with post-contrast T1-weighted imaging traditionally considered the gold standard. Recent studies suggest that contrast-enhanced FLAIR (CE-FLAIR) may provide additional diagnostic information, particularly in meningeal and infectious processes. Aim: To assess the diagnostic role of CE-FLAIR in intracranial pathologies and compare its effectiveness with post-contrast T1-weighted imaging. Material and Methods: A prospective observational study was conducted on 120 patients undergoing brain MRI with gadolinium contrast. Both post-contrast T1-weighted and CE-FLAIR sequences were acquired and analyzed for degree of enhancement, lesion detection, and diagnostic correlation with final diagnosis. Statistical analysis included Spearman’s correlation and paired comparisons using Wilcoxon tests. Results: CE-FLAIR demonstrated added value in detecting meningeal enhancement and infectious lesions, whereas T1PC remained superior for neoplasms, particularly meningiomas and schwannomas. Moderate correlation (r=0.468, p<0.01) between sequences suggested complementary roles. Significant p-values were noted for differences in tumor enhancement. Conclusion: CE-FLAIR is a valuable adjunct to conventional post-contrast T1 imaging, enhancing detection of meningeal and inflammatory pathologies while maintaining complementary diagnostic benefits for intracranial tumors.

Background: Non-traumatic hip pain is a common clinical challenge with multiple etiologies. MRI has emerged as the preferred imaging modality due to its superior ability to detect early structural and soft tissue changes. Aim: To evaluate the role of MRI in diagnosing various causes of non-traumatic hip joint pain and describe characteristic imaging features. Material and Methods: A prospective observational study was conducted on 120 patients with persistent hip pain. MRI was performed using a standardized protocol including T1, T2, STIR, and PD sequences. Findings were analyzed for etiology-specific features. Results: Osteoarthritis (16.6%) and avascular necrosis (11.6%) were the most common diagnoses. MRI demonstrated characteristic features such as effusion, marrow edema, and subchondral changes in OA and the double-line sign in AVN. Additional conditions like tendinopathies, bursitis, and sacroiliitis were identified, while 11.6% of patients had normal scans. Conclusion: MRI is an indispensable tool for early and accurate diagnosis of non-traumatic hip pain, significantly influencing clinical decision-making and patient outcomes.

Background: The geriatric population is expanding rapidly worldwide, accompanied by a rising burden of psychiatric disorders. Understanding the prevalence and socio-demographic profile of psychiatric morbidity in elderly patients attending tertiary care psychiatry services can inform targeted interventions. Aim: To determine the prevalence and socio-demographic profile of psychiatric disorders in the geriatric population attending a tertiary care psychiatry outpatient department. Materials and Methods: A cross-sectional observational study was conducted on 100 consecutive patients aged ≥60 years attending the psychiatry OPD of a tertiary care hospital. Socio-demographic and clinical data were collected using a semi-structured proforma. Psychiatric diagnoses were established using the Mini International Neuropsychiatric Interview (M.I.N.I.) Plus based on ICD-10 criteria, along with cognitive and delirium assessment scales. Statistical analysis included descriptive measures, Chi-square tests, odds ratios, and 95% confidence intervals. Results: All participants had at least one psychiatric diagnosis. Depression (26%) and anxiety disorders (21%) were the most common, followed by psychotic disorders (13%), dementia (12%), and substance use disorders (10%). Females formed 52% of the cohort, mean age was 67.7 ± 10.3 years, and the majority were Hindu (82%), illiterate (57%), married (84%), and from lower socioeconomic strata (58%). Older age (≥70 years) was significantly associated with severe mental disorders (p=0.016), female sex with depression (p=0.041), and male sex with substance use disorders (p=0.005). Medical comorbidities were present in 63% of patients, with hypertension being most common (34%). Conclusion: Psychiatric disorders are highly prevalent among elderly patients in tertiary care settings, with mood and anxiety disorders predominating. Older age, sex, socioeconomic status, and medical comorbidities influence diagnostic distribution. Integrating psychiatric screening into routine geriatric care and tailoring interventions to vulnerable subgroups could improve outcomes.

Gitelman syndrome (GS) is a rare autosomal recessive renal tubulopathy characterized by hypokalemia, hypomagnesemia, metabolic alkalosis, and hypocalciuria. While typically diagnosed in adolescence or early adulthood, late-onset presentations are increasingly recognized. Seizures are an uncommon but serious manifestation of electrolyte imbalance in GS. Case Presentation: We report a case of a 65-year-old male who presented with generalized weakness, recurrent vomiting, and two episodes of generalized tonic-clonic seizures. Evaluation revealed profound hypokalemia (1.2 mmol/L), hypomagnesemia (1.5 mg/dL), metabolic alkalosis, and hypocalciuria. Urinary potassium was elevated, while serum renin and aldosterone levels were normal. Based on clinical and biochemical features, a diagnosis of Gitelman syndrome was made. Genetic testing was not available due to financial limitations. The patient responded well to electrolyte correction and showed significant clinical improvement. Conclusion: This case highlights an atypical late-onset presentation of Gitelman syndrome with seizures and hypokalemic paralysis. It underscores the importance of considering inherited tubulopathies in elderly patients with unexplained electrolyte disturbances.

Background: Inflammatory Bowel Disease (IBD), comprising Crohn’s disease (CD) and ulcerative colitis (UC), requires timely diagnosis and frequent monitoring. While colonoscopy remains the gold standard, bowel ultrasound (BUS) is emerging as a non-invasive and cost-effective alternative. Objective: This study aimed to evaluate the diagnostic accuracy and clinical utility of bowel ultrasound in assessing disease activity and complications in IBD patients, compared with colonoscopy and clinical indices. Methods: A prospective observational study was conducted on 120 patients with confirmed IBD (68 with CD and 52 with UC). Each underwent bowel ultrasound and colonoscopy within 72 hours. BUS parameters—bowel wall thickness (BWT), vascularity (Limberg score), presence of complications (strictures, fistulas), and bowel wall stratification—were recorded and compared with colonoscopic findings and the Harvey-Bradshaw Index (HBI) or Mayo score. Data were analyzed using SPSS v26.0. Correlation and agreement were assessed using Pearson’s r and Cohen’s kappa (κ). Results: BUS detected increased BWT (>3 mm) in 83.3% of patients with active disease. A significant correlation was observed between BWT and disease activity scores (r = 0.74, p < 0.001). Limberg score ≥2 was observed in 71.2% of active CD cases. BUS showed 89.4% sensitivity and 84.1% specificity in detecting active disease compared to colonoscopy. For CD patients, BUS detected strictures in 21 cases and fistulas in 7 cases. The agreement between BUS and colonoscopy for disease activity was substantial (κ = 0.76). Conclusion: Bowel ultrasound is a reliable, non-invasive, and repeatable tool for assessing disease activity and complications in IBD patients. It demonstrates high concordance with colonoscopy, supporting its integration into routine IBD management, especially for monitoring and follow-up.

Background: Sensorineural hearing loss (SNHL), particularly in its sudden-onset form, is a common otological emergency that often leads to permanent auditory impairment if not treated promptly. Hyperbaric oxygen therapy (HBOT) has emerged as a promising adjunctive treatment, especially in cases where conventional therapies alone may not yield optimal recovery. Objectives: To evaluate the clinical efficacy and audiometric outcomes of hyperbaric oxygen therapy in patients diagnosed with sensorineural hearing loss, and to identify clinical factors associated with favorable response. Methods: A prospective observational study was conducted from February 2023 to January 2025 at the Prana Hyperbaric Oxygen Therapy Centre, Mumbai, involving 100 patients with confirmed SNHL. All participants underwent a series of 10–20 HBOT sessions (100% oxygen at 2.0–2.5 ATA for 60–90 minutes). Audiometric evaluations were performed before, during, and after therapy. The primary outcome was defined as improvement in pure tone thresholds and speech discrimination scores. Statistical analyses included chi-square and logistic regression to assess factors predicting therapeutic response. Results: Among 100 patients, 64% showed audiometric improvement following HBOT, with 22% achieving complete recovery and 28% showing partial gain. Early initiation of therapy (within 7 days of symptom onset) significantly improved outcomes (p = 0.004), and sudden-onset SNHL was associated with a better response compared to gradual-onset cases (p = 0.018). Patients with moderate hearing loss at baseline had the most favorable outcomes. Tinnitus and vertigo improved in over 70% of symptomatic cases. No major adverse effects were reported. Conclusion: HBOT is a safe and effective adjunct in the management of sensorineural hearing loss, particularly when initiated early. Timely referral, public awareness, and integration of HBOT into otological treatment protocols can significantly enhance recovery outcomes in selected patients.

Background: Around 10-25% of women experience abnormal uterine bleeding (AUB) during their reproductive life. Patients with AUB usually present in extremes of reproductive life, just after onset of menarche and during the premenopausal phase. The AUB can be caused by both organic and functional causes. Histopathological evaluation of endometrial tissue remains an important step in the diagnosis and further treatment of AUB. Material & Method: This was cross-sectional study conducted on endometrial tissue samples in Histopathology sections of Pathology department at a tertiary health care center in Jalna, Maharashtra, from January 2022 to June 2024. All patients attending gynecology OPD with clinical diagnosis of AUB and referred for the endometrial sampling were included in the study.  Various histopathological patterns of endometrium were classified as the following: proliferative, secretory, atrophic, pill endometrium, disordered proliferative, endometritis, polyp, endometrial hyperplasia and endometrial carcinoma. Results: A total of 250 cases of AUB were observed during the present study. Maximum numbers of patients (35.6%) were found in the age group of 40-49 years followed by age group of 31-40 years (24.4%) and mean age of the patients were 43.15 ± 11.70 years. The most prevalent histopathological finding was proliferative endometrium (27.2%) followed by disordered proliferative endometrium (19.2%). Other common observations were endometrial hyperplasia (17.6%) and secretary endometrium (16.4%). Conclusion: Abnormal uterine bleeding was more common in the perimenopausal age group. Histopathological examination of endometrium showed wide spectrum of lesions from normal endometrium to malignancy and helps us to diagnose the underlying pathology and treating the patients appropriately.

Background: Distal femur fractures are difficult to treat due to complex anatomy and limited bone stock. This study compared functional and radiological outcomes between open reduction and internal fixation (ORIF) and minimally invasive plate osteosynthesis (MIPO) for distal femur fractures. Methods: Sixty patients with AO/OTA 33A and 33C distal femur fractures were enrolled and randomized into two groups: Group A (ORIF, n=30) and Group B (MIPO, n=30). Primary outcomes were union time, range of motion (ROM), and functional outcome (Knee Society Score). Secondary outcomes included infection, malalignment, and non-union. Patients were followed up for 12 months. Results: The mean union time was significantly shorter in MIPO (15.6 ± 2.1 weeks) compared to ORIF (18.4 ± 2.7 weeks) (p<0.001). Mean knee flexion at 6 months was higher in MIPO (118.6° ± 8.2°) vs ORIF (110.3° ± 9.5°) (p=0.004). Knee Society Score at 12 months averaged 87.3 ± 6.1 in MIPO vs 81.8 ± 7.4 in ORIF (p=0.002). Superficial infection was more common in ORIF (13.3%) than MIPO (3.3%). Non-union occurred in 2 ORIF patients and 1 MIPO patient. Conclusion: MIPO demonstrated faster union, better functional scores, and fewer complications compared to ORIF, making it a preferred option for most distal femur fractures, provided surgical expertise and imaging facilities are available.

Vitamin D also called as sunshine Vitamin is gaining researcher’s attention in the past few decades. It is a nutrient which is fat soluble in nature and helps to increase the calcium absorption in the body. Vitamin D plays an important role in the bone formation as well as in the maintenance of immune system. Hence, its deficiency (called as hypovitaminosis D) affects various body parts such as muscle, heart, brain, bones and immune system which will leads to development of rickets, osteoporosis, osteopenia, fractures-falls, hypertension, diabetes, cancers, infections, some autoimmune diseases and neurological disorders too. Present study was done to check Vitamin D3 levels and its Deficiency. The descriptive type cross-sectional study was done in the patients attending outpatient clinic. Duration of the study was one year from with sample size of 80 study participants. Routine blood investigations and specific laboratory investigations like level of serum 25 hydroxy cholecalciferol was done. Study shows shows 45% subjects were having Insufficient (20-30ng/ml) Vitamin D3 levels. 40% subjects were Deficient (<20ng/ml). 15% subjects had Sufficient (>30 ng/ml) Vitamin D3 levels. This study concludes that there is disturbingly greater prevalence of deficient and insufficient status of vitamin D in   people of all ages among patients

Background: Lymphadenopathy is a common clinical presentation in elderly individuals, with a broad differential diagnosis ranging from benign reactive changes to serious malignancies. In geriatric patients, age-related immune changes and overlapping comorbidities complicate the clinical assessment, necessitating histopathological evaluation for accurate diagnosis. Aim: To evaluate the clinical correlation with various pathological findings in lymph nodes of elderly patients presenting with lymphadenopathy across multiple tertiary care centers. Methods: This was a prospective, observational, multicentric study conducted from February 2023 to January 2024 at KD Medical College, Mathura; KIMS Hospital, Bhubaneswar; and MKCG Medical College, Berhampur. A total of 200 patients aged 60 years and above with clinically evident lymphadenopathy were enrolled. Clinical data were collected through structured proformas, and lymph node biopsies were performed for histopathological examination. Statistical analysis was carried out using SPSS version 23.0, and associations were tested using Chi-square and Fisher’s exact tests. Results: Of the 200 patients, 59% were male and 41% female, with a mean age of 68.4 years. Cervical lymphadenopathy was the most frequent (45%). Histopathological diagnoses included reactive hyperplasia (30%), tuberculous lymphadenitis (28%), metastatic carcinoma (22%), non-Hodgkin’s lymphoma (12%), and Hodgkin’s lymphoma (8%). Systemic symptoms such as fever, weight loss, and night sweats were significantly associated with tuberculosis and lymphomas (p < 0.05), while painless swelling correlated with malignancies. Overall, 42% of cases were malignant and 58% were benign. Conclusion: A wide pathological spectrum was observed in elderly lymphadenopathy, with a nearly equal distribution between benign and malignant causes. Clinical features alone were insufficient for diagnosis, reinforcing the value of histopathological evaluation in geriatric patients. Recommendations: Routine biopsy of lymphadenopathy in the elderly should be strongly considered, particularly in the presence of systemic symptoms or persistent painless swelling. Multicentric collaboration and standardized reporting can enhance diagnostic accuracy and patient outcomes.

Background: The increasing integration of digital devices into daily routines has led to a concerning rise in Repetitive Stress Injuries (RSIs) and poor ergonomic habits among youth, particularly in developing regions with limited ergonomic literacy. In Himachal Pradesh—a geographically diverse Indian state with both urban and rural populations—young individuals aged 15–30 are experiencing a surge in musculoskeletal discomforts due to prolonged and improper digital device usage. However, awareness of digital ergonomics and RSI prevention remains underexplored in this demographic. Materials and Methods: A descriptive, cross-sectional online survey was conducted over three months (April–June 2025) using a structured Google Form disseminated through social media platforms and institutional networks. The study targeted digitally active individuals aged 15–30 years residing in Himachal Pradesh. A total of 400 participants were selected via convenience sampling. A bilingual, expert-validated questionnaire assessed demographic details, digital ergonomic knowledge (20 MCQs), misconceptions, and behavioral insights. Statistical analysis was conducted using IBM SPSS, employing descriptive statistics and Chi-square tests to assess associations between knowledge levels and demographic variables. Results: The findings revealed moderate-to-high awareness levels: 32.0% of participants scored “Very Good,” 35.3% “Good,” 21.8% “Fair,” and 11.0% “Poor” on the 20-point knowledge scale. While most respondents understood key concepts such as taking breaks (73.3%), posture-related strain (72.3%), and RSI symptoms (67.8%), gaps persisted in areas like screen-time duration (60.5%) and headphone-induced posture issues (59.5%). Statistically significant associations were observed between ergonomic knowledge and age (p = 0.018), education (p < 0.001), occupation (p = 0.021), and place of residence (p = 0.034), with urban, educated, and student populations displaying better awareness. Gender was not significantly associated with knowledge (p = 0.276). Conclusion: The study highlights a growing awareness of digital ergonomic health among Himachal Pradesh's youth, yet it also reveals critical knowledge gaps and demographic disparities that could contribute to long-term RSI risk. These insights emphasize the urgent need for targeted, region-sensitive interventions such as curriculum-based ergonomic education, workplace policy improvements, and rural outreach programs. Promoting ergonomic literacy is essential for safeguarding the musculoskeletal health and productivity of India's digitally engaged youth.

Background: Road traffic accidents (RTAs) are a leading cause of orthopedic trauma, particularly fractures, in India. In geographically complex and infrastructurally limited states like Himachal Pradesh, timely and appropriate first-response actions by bystanders can significantly influence outcomes. However, public knowledge regarding fracture management remains largely underexplored. This study aimed to assess the level of public knowledge, attitudes, and first-response practices related to orthopedic trauma following RTAs among residents of Himachal Pradesh. Materials and Methods: A descriptive, cross-sectional study was conducted using a self-administered, Google Form-based questionnaire disseminated digitally across Himachal Pradesh. The survey, available in English and Hindi, included 400 adult participants selected through convenience sampling. The questionnaire consisted of four sections: socio-demographic details, 20 multiple-choice questions assessing awareness and misconceptions related to orthopedic trauma, knowledge classification, and response attitudes. Descriptive statistics were applied, and Chi-square tests were used to assess associations between knowledge levels and socio-demographic variables, with p < 0.05 considered statistically significant. Results: Of the 400 respondents, the largest age group was 26–35 years (28.0%), and 53.0% were from rural areas. Educational attainment varied, with 30.5% holding undergraduate degrees and 5.5% having no formal education. While 29.8% demonstrated a very good knowledge level (score 17–20), 35.8% were classified as good, 22.8% fair, and 11.8% poor. High awareness was observed regarding immobilization (69.5%), fracture signs (70.5%), and the role of first aid (73.0%), but misconceptions persisted—only 59.5% knew to avoid giving food or water to trauma victims. Knowledge levels were significantly associated with age (p = 0.021), education (p < 0.001), and residence (p = 0.029), but not with gender (p = 0.317). Conclusion: The study highlights moderate overall public awareness regarding orthopedic trauma management in RTAs, with notable deficiencies in critical first-response actions. Education, youth, and urban residency were linked to better knowledge. To improve trauma outcomes in hilly, high-risk regions like Himachal Pradesh, public health strategies must prioritize community-based first-aid training, especially in rural and underserved populations.

Background & Methods: The aim of the study is to compare the routine use of three intubation (ETI), (SAI) & (BAI) in terms of first-pass success & complications among critically ill adult patients. The recruited study participants were randomized in a 1:1:1 ratio into one of the three study groups through computer generated random allocation sequence. Recruitment will be continued till there were 100 study participants in each of the study groups. Results: The first-pass intubation success rates were 63% in the ETI group, 80% in the SAI group & 76% in the BAI group; & these differences were statistically significant (p=0.018).  Upon conducting pairwise analysis, it was observed that the first-pass intubation success rate of SAI group was significantly higher than that of the ETI group (p=0.008).  Similarly, the first-pass intubation success rate of BAI group was significantly higher than that of the ETI group (p=0.045).  However, the first-pass intubation success rate of SAI group was comparable with that of the BAI group (p=0.494). Conclusion: The overall incidence of peri-intubation complicationswas significantly higher in the ETI group than the BAI group & SAI group. The findings from the present study emphasizes that, every effort must be pursued to guide the tracheal tube between the vocal cords while minimizing time & injury. The early use of tracheal tube introducers & stylets may be advocated in airway management guidelines, supported by adequate training & proper knowledge of specific characteristics, indications, techniques & complications in order to maximize first-pass intubation success.

Herbal skincare products have gained prominence due to their biocompatibility, low toxicity, and ecological sustainability. This study aimed to develop and evaluate an antimicrobial herbal soap formulated using extracts of Neem (Azadirachta indica), Tulsi (Ocimum tenuiflorum), and Aloe vera (Aloe barbadensis Miller). The formulation was prepared by cold saponification using sodium hydroxide and natural excipients. The soap was assessed for physical appearance, pH, foam retention, foam height, cleansing ability, moisture content, skin irritation potential, and thermal stability. The final product exhibited favorable physicochemical and antimicrobial properties, suggesting its potential as a natural alternative to synthetic soaps.