Background : Endodontic diagnosis and treatment planning have traditionally depended on periapical radiographs, which, despite their widespread use, present significant limitations in accurately detecting complex endodontic lesions. The inability of two-dimensional imaging to provide a clear visualization of anatomical structures often results in missed diagnoses of conditions such as periapical pathology, root fractures, resorptive lesions, and undetected accessory canals. Cone-beam computed tomography (CBCT) has emerged as a highly effective imaging modality that offers three-dimensional visualization, superior spatial resolution, and cross-sectional imaging capabilities. By enabling precise localization and characterization of endodontic pathologies, CBCT has significantly enhanced diagnostic accuracy and improved clinical decision-making. However, despite its advantages, concerns regarding radiation exposure, accessibility, and cost have influenced its widespread integration into routine endodontic practice. This study aims to evaluate the role of CBCT in diagnosing complex endodontic lesions in a tertiary care institute in India, focusing on its diagnostic superiority over conventional periapical radiography and its impact on treatment planning. Objectives: This study aims to assess the diagnostic accuracy of CBCT in identifying complex endodontic lesions, including periapical pathology, root fractures, internal and external resorption, and anatomical variations. It also evaluates CBCT’s ability to enhance clinical decision-making by providing a more precise understanding of pathological changes and anatomical complexities. By comparing CBCT with conventional periapical radiographs, the study examines the sensitivity, specificity, and predictive value of both modalities, determining whether CBCT significantly alters treatment planning outcomes. Furthermore, the research investigates the limitations of CBCT, particularly in terms of accessibility, cost-effectiveness, and the need for judicious use in clinical practice, ensuring its application in cases where conventional radiography is inconclusive. Methods: This retrospective observational study was conducted at a tertiary care institute in India, where 100 cases of complex endodontic lesions were reviewed. Patient records, including clinical evaluations, periapical radiographs, CBCT scans, and intraoperative findings, were analyzed to assess the efficacy of CBCT in diagnosing various endodontic conditions. Cases were classified into different categories, including periapical lesions, vertical and horizontal root fractures, internal and external root resorption, and anatomical variations in the root canal system. The diagnostic performance of CBCT was compared to that of conventional periapical radiographs, with intraoperative findings or histopathological reports serving as the reference standard. The study assessed key diagnostic parameters, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), to determine the reliability of CBCT. Additionally, cases were examined to evaluate whether the use of CBCT influenced treatment planning decisions, such as the choice between non-surgical retreatment, surgical intervention, or extraction. Results: Among the 100 cases analyzed, CBCT demonstrated superior diagnostic accuracy compared to periapical radiographs. It was significantly more effective in detecting periapical lesions, with a diagnostic accuracy of 92% compared to 68% for periapical radiographs. Vertical root fractures were detected with a sensitivity of 88% using CBCT, while periapical radiographs identified only 55% of cases. Similarly, CBCT was able to detect resorptive defects with 94% accuracy, compared to 61% for conventional radiographs. The study also found that 32% of cases had missed canals that were only identified through CBCT imaging, highlighting its ability to reveal anatomical complexities that are often undetected with two-dimensional imaging. Statistical analysis showed that CBCT had a sensitivity of 91.5% and specificity of 89.2% for periapical pathology, while for detecting root fractures, sensitivity was recorded at 87.4% and specificity at 90.5%. The study further found that in 48% of cases, the use of CBCT led to significant modifications in treatment planning, particularly in determining whether surgical intervention was necessary or if a case could be managed through non-surgical retreatment. Despite its superior diagnostic capabilities, challenges related to cost, accessibility, and higher radiation exposure were identified as limiting factors in its routine application. Conclusion: CBCT has proven to be a highly effective imaging modality for diagnosing complex endodontic lesions, providing superior visualization and diagnostic accuracy compared to conventional periapical radiographs. Its ability to detect periapical pathology, root fractures, resorptive lesions, and anatomical variations enables clinicians to make more informed treatment decisions, reducing the risk of misdiagnosis and improving long-term patient outcomes. While CBCT offers significant advantages, its widespread use is hindered by concerns regarding radiation exposure, financial constraints, and limited availability in some clinical settings. The findings of this study emphasize the need for a selective and judicious approach to CBCT utilization, ensuring that it is employed in cases where conventional radiographic techniques fail to provide sufficient diagnostic information. Future research should focus on standardizing guidelines for CBCT use in endodontics, exploring strategies to enhance its cost-effectiveness, and increasing accessibility to ensure its broader integration into routine dental practice in India.

Background: Senior residents of urban slums experience compound disadvantage (low literacy, restricted access, comorbidities) that significantly increases risk from oral diseases and debilitates Oral-Health–Related Quality of Life (OHRQoL). Objectives: To determine OHRQoL and oral health status of geriatric residents in an urban slum, report premalignant oral lesions findings, and identify the association between sociodemographic characteristics, knowledge, behaviours and OHRQoL. Methods: Population: Adults aged ≥60 years (n=166) in a community-based cross-sectional study. Oral condition examination was done using the Oral Health Assessment Tool (OHAT); premalignant conditions (leukoplakia, erythroplakia and oral submucous fibrosis [OSMF]) were checked clinically. OHRQoL was assessed using the Geriatric Oral Health Assessment Index (GOHAI). Results: Poor oral health (≥1 OHAT domain “changes/unhealthy) was present in 60.2%. 38.6% had a premalignant lesion (OSMF 23.5%, leukoplakia 12.7%, erythroplakia 2.4%). Mean GOHAI was 43.6±7.24; median 44 (IQR 40–51), with 54.2% classified as poor OHRQoL (≤44). GOHAI declined with age (p=0.006) and was higher with greater education (p<0.001) and employment (p=0.02); trends by socioeconomic status were non-significant. Participants with healthy oral status had a ~10-point higher GOHAI than those with unhealthy/changes (51 vs 41, p<0.001). The lips, gums/tissues, saliva, natural teeth, dentures and dental pain OHAT domains were associated with significantly different GOHAI scores (all p≤ 0.03). Smokeless tobacco and multi-substance use were strongly associated with leukoplakia, erythroplakia, and OSMF (p≤0.001/0.01); alcohol and smoking alone were not consistently significant. Oral-health knowledge correlated positively with GOHAI (ρ=0.554, p<0.001). Protective behaviours—brushing >1/day, ≥1–3 min duration, tongue cleaning, mouthwash, and routine check-ups—were associated with better status and/or higher GOHAI (all p≤0.01). Conclusions: Geriatric residents of urban slums experience a high burden of poor oral health, premalignant disease, and compromised OHRQoL. Priorities include smokeless-tobacco cessation with active lesion screening, basic restorative/periodontal and denture services with xerostomia care, and low-literacy behaviour change (twice-daily ≥2–3-minute brushing, tongue cleaning, adjunctive mouthwash, regular check-ups).

Background: Serum prostate-specific antigen (PSA) is widely used for prostate cancer (PCa) detection and risk stratification, yet its concordance with histopathological Gleason Grade Group (GG) at diagnosis varies across populations. Objectives: To evaluate the association between pretreatment serum PSA and biopsy-confirmed Gleason Grade Groups in men with newly diagnosed PCa, and to quantify diagnostic performance of PSA thresholds for predicting clinically significant disease (CSD: GG≥2) and high-grade disease (HGD: GG≥3). Methods: We conducted an analytical cross-sectional study in Tertiary Care Teaching Hospital From 1^st March 2025 to August 2025. Consecutive men undergoing transrectal or transperineal ultrasound-guided systematic ± targeted prostate biopsies. Baseline demographics, digital rectal examination (DRE), PSA (ng/mL), prostate volume, and histopathology (ISUP Grade Group) were recorded. Primary analyses included correlations (Spearman’s ρ) between PSA and GG, PSA distributions across GG, multivariable logistic regression for HGD (GG≥3) with PSA as continuous and categorical (≤10, 10.1–20, 20.1–50, >50 ng/mL), and receiver operating characteristic (ROC) analysis for CSD and HGD. Results: Among 312 eligible men (median age 66 years), median PSA was 16.8 ng/mL (IQR 9.2–44.5). PSA rose stepwise with GG: median (IQR) PSA—GG1: 8.9 (6.2–12.8), GG2: 13.6 (8.4–21.3), GG3: 22.1 (12.5–35.8), GG4: 36.9 (18.6–61.4), GG5: 55.7 (31.2–112.3) ng/mL (p<0.001). Correlation between PSA and GG was moderate (ρ=0.48, p<0.001). PSA >10 ng/mL predicted CSD with AUC 0.78 (95% CI 0.73–0.83), and PSA >20 ng/mL predicted HGD with AUC 0.74 (0.68–0.80). In adjusted models (age, DRE, prostate volume), each log-unit increase in PSA was associated with higher odds of HGD (aOR 1.92; 95% CI 1.49–2.49; p<0.001).Conclusions: Pretreatment PSA shows a significant, monotonic association with Gleason Grade Group but only moderate discriminatory ability for high-grade pathology. PSA should be interpreted alongside clinical findings, MRI, and targeted biopsy information to refine risk stratification.

Hypothyroidism is one of the most common endocrine disorders among females, characterized by insufficient production of thyroid hormones—thyroxine (T₄) and triiodothyronine (T₃)—which regulate metabolism, growth, and energy balance. Women are 5–8 times more likely than men to develop hypothyroidism, particularly during puberty, pregnancy, and menopause, when hormonal fluctuations alter immune and thyroid physiology. This systematic review synthesizes evidence from peer-reviewed studies published between 2000 and 2024 to evaluate the etiological factors underlying hypothyroidism in females. Following PRISMA 2020 guidelines, searches were conducted in PubMed, Scopus, and Web of Science, identifying 72 relevant studies, of which 58 met the inclusion criteria. The etiological spectrum includes autoimmune thyroiditis (Hashimoto’s disease), iodine deficiency, iatrogenic causes (radioiodine therapy, surgery, antithyroid drugs), environmental and dietary factors, and genetic predisposition. Autoimmune mechanisms remain the dominant cause in iodine-sufficient regions, characterized by the presence of thyroid peroxidase (TPO) and thyroglobulin (Tg) antibodies. Environmental pollutants, micronutrient imbalance (selenium, iron), and hormonal influences such as estrogen dominance and prolactin elevation further modulate disease onset. Psychosocial stress and chronic inflammation have emerged as significant epigenetic modulators in recent studies. The review concludes that the etiology of hypothyroidism in females is multifactorial, integrating genetic susceptibility, immune dysregulation, lifestyle, and environmental factors. Improved understanding of these determinants is essential for early screening, gender-sensitive diagnostics, and personalized prevention strategies.

Background: Lumbar plexus block could be safe because of the targeted somatic nerve block, which prevents dispensable sympathetic block even in cardiovascular compromised patients and has minimal effects on cardio-respiratory system. Objective: To study the postoperative analgesia and complications of lumbar plexus block and low spinal with conventional spinal anesthesia in hip surgeries. Methods: The present Prospective interventional  study will be conducted on 60 patients posted for elective hip surgeries in the department of anaesthesia at Basaveshwara teaching and general hospital attached to Mahadevappa Rampure Medical college Kalaburagi. Duration of study was from 1^st october 2019 to 31^st march 2021(18 months). Result: There was statistically significant in age distribution between the two groups (P value is 0.015). The mean age was 60.83(±13.43) in group A  and  52.53(±12.23) in group B .The mean time at first rescue analgesia in group A was 559.67(±45.5) minutes and in group B was 166.03(±13.51) minutes. There was very highly statistical significant difference between the two groups(P<0.000).  The mean 24Hr requirement of Tramadol in group A was 193.33(±58.33) milligram and in group B was 306.67(±25.37) in milligrams .There was very highly statistical significant difference between the groups(P<0.000). The 24 Hr requirement of Fentanyl was 0(±0) in group A and 16(±36.54) mcg in group-B. There was statistically significant between the two groups. Conclusion: The success rate is 100% with the use of a nerve stimulator and the incidence of complications can be reduced by careful titrated doses of local anaesthetic, coupled with good vigilance and monitoring.

Background: Pelvic organ prolapse (POP) is a common condition resulting from weakness of the pelvic floor musculature and fascial support structures. Accurate identification of compartmental defects is essential for optimal management. Conventional clinical examinations are limited in evaluating the dynamic and multicompartmental nature of prolapse. Dynamic Magnetic Resonance Imaging (MRI) provides a comprehensive, radiation-free modality for anatomical and functional assessment. Aim: To evaluate the role of dynamic MRI in assessing pelvic floor muscles and fascial support in women with pelvic organ prolapse. Methods: This prospective observational study included 50 women with clinically suspected pelvic organ prolapse who underwent dynamic MRI using a 1.5 Tesla system. Imaging was performed in sagittal, axial, and coronal planes at rest and during straining. Parameters analyzed included H-line, M-line, organ descent below the pubococcygeal line, levator ani integrity, fascial support, and compartmental involvement. MRI findings were compared with clinical examination. Statistical analysis used Welch’s t-test and Chi-square test with p < 0.05 considered significant. Results: Among 50 subjects, 36 (72%) showed MRI-confirmed prolapse. Women with prolapse were older (mean age 51.6 ± 8.1 years) and had higher BMI (27.8 ± 3.2 kg/m²) than those without prolapse (p < 0.01). Multiparity and postmenopausal status were significant predictors (p < 0.05). Mean H-line and M-line were significantly increased in prolapse cases (6.2 ± 0.7 cm and 3.5 ± 0.8 cm, respectively; p < 0.001). Multicompartmental involvement was detected in 52.8% of prolapse cases, with anterior compartment defects being most common (72.2%). MRI demonstrated high sensitivity (93.3%) and moderate agreement (κ = 0.56) with clinical findings. Conclusion: Dynamic MRI provides a reliable, reproducible, and non-invasive means of assessing pelvic floor dysfunction. It allows simultaneous visualization of all compartments, precise measurement of organ descent, and identification of fascial and muscular defects. The technique significantly enhances diagnostic accuracy and aids individualized surgical planning in women with pelvic organ prolapse.

Thyroglossal cyst can even occur in elderly patients unusual to its typical presentation in        children from 5 to 7 years. Midline mass presentation with loss of movement with deglutition. Awake fiberoptic intubation is an indispensable technique for every anesthesiologist in their armamentarium. Adequate counseling, preparation and procedural skills result in a safe procedure for the patient. 

Background: Intertrochanteric fractures are common injuries in elderly individuals, often caused by low-energy trauma and associated with significant morbidity. The evolution of surgical fixation has led to the development of devices such as the Proximal Femoral Nail Anti-Rotation-2 (PFNA-2), designed specifically for Asian femoral morphology. Aim: To evaluate the functional and radiological outcomes of intertrochanteric fracture fixation using short PFNA-2 in a prospective cohort. Methods: A prospective observational study was conducted on 50 patients with intertrochanteric fractures treated using short PFNA-2. Patients were followed up at regular intervals to assess functional recovery via the Harris Hip Score (HHS) and radiological union via standard AP and lateral X-rays. Data on age, sex, fracture type (Boyd and Griffin classification), operative time, and intraoperative blood loss were analyzed. Results: The majority of patients were between 60–74 years (56%), with a male predominance (54%). Most fractures were on the right side (54%). Type 2 fractures were most common (36%). Mean operative time was 66.2 minutes, and mean blood loss was 97.1 mL. At final follow-up, 84% of patients had good to excellent functional outcomes, with radiological union achieved within 16–20 weeks in most cases. Conclusion: Short PFNA-2 is an effective implant for stabilizing intertrochanteric fractures, providing stable fixation with minimal complications, low blood loss, and satisfactory functional recovery

Background: Pseudomonas species, especially Pseudomonas aeruginosa, are significant opportunistic pathogens causing morbidity and mortality in hospitalized patients. Rising antimicrobial resistance among these species accentuates therapeutic challenges. Objective: To analyze the clinical, microbiological, and antibiotic resistance profiles of Pseudomonas infections in a tertiary care teaching hospital in Bengaluru, India. Methods: A retrospective analysis of 150 patients with culture-confirmed Pseudomonas infections from multiple clinical departments at ESIC PGIMSR, Rajajinagar, Bengaluru, was conducted. Data on demographics, site of infection, species isolated, antibiotic sensitivity/resistance patterns, clinical outcomes, risk factors, and comorbidities were collected and analyzed statistically Results: Of 150 patients, 50.7% were female and 49.3% male. The predominant age groups affected were adults (19-40 years, 26.7%), middle-aged (41-60 years, 25.3%), and seniors (60+, 28%). Pseudomonas aeruginosa accounted for 74.7% of infections. Sites commonly involved included urinary tract (23.3%), burns (22%), wounds (20%), and bloodstream (20%). Mortality was 30.67%, with an additional 24.67% under ongoing treatment. Antibiotic sensitivity was highest for Cefepime and Meropenem (each 13/150 cases). Resistance was most frequent to Piperacillin-Tazobactam and Meropenem combined with Ciprofloxacin. Major risk factors identified were immunosuppression (24.7%), ICU stay (20%), and use of catheters/ventilators. Chronic conditions such as COPD (22%) and CKD (16.7%) were common comorbidities. Seniors had significantly higher mortality rates (p < 0.01). Conclusion: This study highlights the predominance of P. aeruginosa and high rates of multi- drug resistance in clinical isolates, with substantial mortality associated with immunosuppressed and elderly patients. Strengthening infection control and antibiotic stewardship programs is crucial to mitigate these challenges

Background: The geriatric population represents a rapidly growing segment requiring surgical care. Age-related physiological decline, comorbidities, and delayed presentation increase the risk of postoperative complications and death. Identifying key prognostic factors can help predict outcomes and guide preventive strategies. Aim: To study the prognostic factors affecting morbidity and mortality in elderly patients undergoing abdominal surgeries. Materials and Methods: A prospective observational study was conducted in the Department of Surgery, Sassoon General Hospital, Pune, including 100 patients aged ≥65 years undergoing elective or emergency abdominal surgeries. Detailed history, examination, and investigations (hemoglobin, serum albumin, renal and liver function, and electrolytes) were recorded. Operative findings, duration, blood loss, and postoperative complications were documented. Statistical analysis included Chi-square test, t-test, and logistic regression. A p value <0.05 was considered statistically significant. Results: The mean age of patients was 70.2 ± 4.1 years, with males constituting 56%. Adverse outcomes (morbidity or mortality) were significantly associated with emergency surgeries (p<0.001), ASA grade III–IV (p<0.001), anemia (Hb <9 g/dL, p=0.004), hypoalbuminemia (<3.3 g/dL, p<0.001), peritoneal contamination (p<0.001), and prolonged operative time (p=0.004).On multivariate analysis, ASA IV status (OR 5.9, p=0.001), emergency surgery (OR 3.8, p=0.008), hypoalbuminemia (OR 2.6, p=0.049), and anemia (OR 3.1, p=0.033) emerged as independent predictors of mortality. Early surgery (<24h) and preoperative optimization significantly reduced morbidity (p=0.001) and mortality (p=0.010). Conclusion: Advanced age, emergency status, poor physiological reserve, anemia, and low serum albumin levels are major predictors of morbidity and mortality in elderly abdominal surgery patients. Early intervention and preoperative optimization of correctable factors significantly improve outcomes.

Introduction: Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) is a rare but treatable immune-mediated neuropathy affecting the peripheral nervous system. It is characterized by progressive or relapsing motor and sensory dysfunction with demyelinating features on electrophysiological studies. CIDP encompasses a heterogeneous group of syndromes, including typical and atypical variants such as MADSAM, DADS, and MMNCB. Early identification and appropriate classification of CIDP are crucial to initiate immunomodulatory therapy and prevent irreversible axonal damage. Despite defined diagnostic criteria, there remains a degree of clinical and electrophysiological overlap, contributing to diagnostic delays and under-recognition in resource-limited settings. Objective: To identify and describe the clinical, laboratory, and electrophysiological profile of CIDP patients. Methods: CIDP was diagnosed based on AAN criteria. Medical records of patients diagnosed with CIDP and admitted over the past 22 years at our centre were retrospectively reviewed. Correlation between clinical severity, electrophysiological parameters, and laboratory data was analysed. Results: Among 124 CIDP patients, 81 (65.32%) were males. The mean age was 45.02 ± 16.15 years. Clinical subtypes included sensorimotor (70.2%), predominant motor (22.6%), and predominant sensory (7.3%). Typical CIDP was seen in 101 (81.45%) patients, while 23 (18.55%) had atypical forms: MADSAM (11), MMNCB (8), and DADS (4). Electrophysiological analysis showed prolonged distal latencies in ≥2 nerves in 75% of patients, reduced conduction velocities in 66.13%, and absent or prolonged F-wave latencies in 96.77%. Partial conduction block in ≥1 nerve was present in 51.61%, and temporal dispersion in 70.97%. Albuminocytological dissociation in cerebrospinal fluid was found in 92.1% of patients with typical CIDP, compared to 45.5% in those with MADSAM (p < 0.001). Regarding treatment, 50% of patients received steroids, 14.5% immunoglobulin, 17.7% plasma exchange, and 17.7% received immunosuppressants such as Azathioprine or Mycophenolate mofetil. In terms of disease progression, 10.5% of patients had a progressive course, 32.3% had relapsing symptoms, and 57.3% remained clinically stable. Hughes disability grade ≥3 did not show significant correlation with the severity of electrophysiological involvement or CSF protein levels. Conclusion: Albuminocytological dissociation in CSF is highly specific for typical CIDP. Absence of F waves/prolongation of F wave latencies are the most consistent electrophysiological finding in CIDP. Clinical severity does not show significant correlation with extent of electrophysiological involvement.

Menopause is a significant physiological transition marked by a decline in estrogen levels, leading to metabolic changes that influence lipid metabolism and increase cardiovascular risk in women. This systematic review aimed to evaluate lipid profile patterns in postmenopausal women and their implications for cardiovascular health. A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and Embase for studies reporting quantitative lipid data in postmenopausal women. Screening and selection followed PRISMA guidelines, and study quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Data from 22 eligible studies, including cross-sectional, comparative, and interventional designs, were analyzed. The findings consistently demonstrated elevated total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C), variable triglycerides (TG), and generally reduced high-density lipoprotein cholesterol (HDL-C) in postmenopausal women. Older age, longer duration since menopause, higher body mass index, and comorbidities such as diabetes were associated with worsened lipid profiles. Comparative studies confirmed that postmenopausal women exhibit more atherogenic lipid patterns than premenopausal counterparts. Interventional studies showed that lifestyle modifications, dietary supplementation with agents such as omega-3 fatty acids, phytosterols, and vitamin D, as well as menopause hormone therapy, effectively improved lipid parameters, highlighting strategies for cardiovascular risk reduction. These findings underscore the importance of regular lipid monitoring and individualized interventions to mitigate long-term cardiovascular morbidity in postmenopausal women.

Background: The necessity of closed-suction drainage in the era of tranexamic acid (TXA) during total knee arthroplasty (TKA) is still up for debate. This prospective randomized study aimed to compare the clinical and hematological outcomes of primary TKA performed with and without a drain, all while following a standardized TXA protocol. Methods: We enrolled thirty patients undergoing unilateral primary TKA, who were then block-randomized into two groups: the Drain group (n = 15) and the No-Drain group (n = 15). Each patient received weight-based intravenous TXA at the time of induction and again three hours after the incision. The primary outcome measured was mid-patellar swelling at 24 hours, while secondary outcomes included visual-analogue pain scores, total drain output, active knee flexion (measured on post-operative days [POD] 1, 3, 5; and at weeks 2 and 6), hemoglobin levels on POD 1 and 3, transfusion rates, wound complications, length of hospital stay, and skin-to-skin surgical time. Assessors were kept blind to the group allocations. Continuous data were analyzed using independent t-tests or Mann-Whitney U tests, and repeated measures were evaluated with mixed-effects models. Results: The drainage group had an average output of 330 mL by POD 2. At the 24-hour mark, swelling was less in the drain group (2.8 cm ± 0.7 vs 3.5 cm ± 0.9; p = 0.02), although this difference disappeared by 48 hours. The decline in hemoglobin, transfusion rates (Drain 13% vs No-Drain 7%; p = 0.55), pain scores, complications, and length of stay (4.8 ± 0.9 vs 4.3 ± 0.8 days; p = 0.09) were similar between the two groups. Interestingly, the No-Drain group achieved better knee flexion at week 2 (112° ± 10 vs 105° ± 11; p = 0.04), but this advantage faded by week 6. There were no reported cases of deep infections or thrombo-embolic events. Conclusion: In conclusion, when it comes to primary total knee arthroplasty (TKA) using modern tranexamic acid (TXA) protocols, using routine closed-suction drainage doesn’t really provide much early advantage and doesn’t enhance either bleeding control or functional results. So, ditching the drains could make postoperative care easier without putting safety or recovery at risk.

Background: Non-scarring hair loss is a very common complaint at the skin OPD.  Vitamin-D deficiency is one of the possible causes, and other contributing factors that influence increased hair shedding should be thoroughly investigated. So the treatment plan can be made accordingly. Aims:  The aim of this study was to assess the prevalence of vitamin D deficiency and other contributing factors among patients of non-scarring hair loss. Material and methods: A cross-sectional prospective study was performed in the period between August 2024 and January 2025.  The study included 100 patients, 18-45 years of age, with the complaint of increased hair loss who were never on treatment and supplementation. Full history and physical examination were performed, and laboratory investigations for serum levels of vitamin D, vitamin B12, hemoglobin (Hb), and thyroid function test were done after taking a written consent for the study. Result: Total  100 patients ,71 females and 29 males,( 16 cases of female pattern hair loss(FPHL), 22 male pattern hair loss(MPHL) and 62 telogen effluvium(TE) were investigated for serum level of vitamin-D, vitamin- B12, hemoglobin and thyroid function test, in the result relatively higher proportion of patients with TE showed deficiency of vit-d (74.19%) than AGA (55.26%), vit-B12 (75.80%) than AGA (68.42%) and Hb (38.70%) than AGA (13.13), vit-D insufficiency was more in AGA (26.31%) than TE (16.12%). In comparison to FPHL vs MPHL   vit-D levels (56.25), (54.54) respectively were almost similar in both groups, vit-B12 deficiency was relatively more in MPHL (77.27%) than FPHL (56.25%), Hb deficiency seen in (31.25%) of FPHL and nun in MPHL. Conclusion: Our study found a  significant deficiency in vitamin D, vitamin B12, and hemoglobin levels across all types of hair loss. This highlights the importance of evaluating these factors and tailoring treatment accordingly.

Background: Non-venereal genital dermatoses (NVGD) are a diverse group of disorders affecting the genitalia that are not sexually transmitted. They often mimic venereal diseases, leading to diagnostic dilemmas, patient anxiety, and stigma. Despite their clinical importance, limited comprehensive data exist on their prevalence and patterns in Indian tertiary care settings. Objectives: To determine the clinical and epidemiological patterns of NVGD in patients presenting with genital, oro-genital, genital with skin, and combined oro-genital with skin lesions. Methods: A hospital-based descriptive study was conducted in the Department of Dermatology, Venereology, and Leprosy at a tertiary care hospital over one year. A total of 200 patients with NVGD were included after detailed history, clinical examination, and relevant investigations. Data were analyzed using descriptive statistics, and comparisons were made with published literature. Results: The prevalence of NVGD was 6.1 per 1000 dermatology outpatients. The mean age was 34.8 years, with a male-to-female ratio of 2.28:1. Laborers formed the largest occupational group (34.5%). A total of 34 distinct NVGD were documented. The most common conditions were genital vitiligo (16.8%), pearly penile papules (13.8%), and scabies (9.0%). Other frequent conditions included lichen simplex chronicus (6.4%), candidiasis (6.8%), sebaceous cysts (5.2%), lichen planus (5.6%), drug eruptions (5.2%), and scrotal calcinosis (4.3%). Rare cases included Hailey–Hailey disease, pemphigus vulgaris, Reiter’s disease, and Zoon’s balanitis. No premalignant or malignant lesions were identified. Venerophobia was noted in 18 male patients, mainly associated with vitiligo and pearly penile papules. Conclusion: NVGD are common in dermatology practice and demonstrate wide clinical heterogeneity. Vitiligo, pearly penile papules, and scabies predominate, with notable sex and occupational variations. Awareness of these conditions is vital to prevent misdiagnosis, alleviate patient anxiety, and guide appropriate management. Multidisciplinary clinics and larger multicentric studies are recommended to better define true prevalence and outcomes.

Background: Allergic rhinitis (AR) is a highly prevalent chronic condition with significant impact on daily functioning and quality of life. Urban–rural differences in prevalence and outcomes remain underexplored in India. Aim: To evaluate the prevalence and impact of allergic rhinitis on quality of life in urban versus rural populations. Methods: A cross-sectional observational study was conducted among 120 participants (Urban=60; Rural=60) over 12 months at a tertiary care hospital and affiliated health centers. Diagnosis of AR was based on ARIA criteria. Data on clinical profile, symptom severity, environmental triggers, and healthcare-seeking behavior were collected. Quality of life was assessed using the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and EQ-5D VAS. Descriptive statistics, chi-square test, Student’s t-test, and logistic regression were applied, with p<0.05 considered significant. Results: The prevalence of AR was significantly higher in urban participants (78.3%) compared to rural (48.3%) (p<0.001). Urban AR patients reported greater impairment in RQLQ total score (3.2±1.0 vs. 2.6±0.9, p<0.001), more sleep disturbances (6.1±1.8 vs. 4.9±1.7, p<0.001), and higher work/school absenteeism (3.1±2.2 vs. 2.2±1.9, p=0.017). Urban patients were more likely to report dust as a trigger, while rural patients were predominantly exposed to biomass smoke (p<0.001). Healthcare access differed, with rural patients showing delayed consultation and greater reliance on pharmacies, whereas urban patients more frequently visited specialists. Conclusion: Allergic rhinitis is more prevalent and imposes greater quality of life impairment in urban populations, though rural populations face unique environmental triggers and barriers to care. These findings suggest the need for population-specific interventions, including pollution reduction strategies in cities and improved awareness and healthcare access in rural communities.

Osteoporosis in post-menopausal women remains one of the most pressing public health challenges worldwide, driven by hormonal changes, aging, and complex interactions between skeletal fragility, sarcopenia, and comorbid conditions. This systematic review synthesizes evidence from 60 studies published across diverse populations to examine epidemiology, diagnostic approaches, therapeutic strategies, and non-pharmacological interventions. Literature searches were conducted using PRISMA 2020 guidelines, and risk of bias was assessed with established Cochrane and GRADE frameworks. The review confirms that the first decade following menopause is a critical period of accelerated bone loss, leading to a surge in vertebral fractures and setting the stage for later hip fractures, which are often associated with 20–30% one-year mortality. Beyond bone mineral density, fracture risk is strongly influenced by sarcopenia, frailty, metabolic disorders such as type 2 diabetes, and secondary osteoporosis from endocrine or renal disease. While dual-energy X-ray absorptiometry remains the diagnostic cornerstone, emerging tools such as vertebral fracture assessment, trabecular bone score, and the FRAX algorithm enhance precision in identifying women at high risk. Therapeutically, bisphosphonates continue to be the most widely studied and prescribed, providing robust and durable fracture protection, while denosumab and anabolic agents such as teriparatide and romosozumab offer newer options for very-high-risk women when used with careful sequencing. Non-pharmacological strategies, including structured exercise, vitamin D and calcium supplementation, falls prevention, and the implementation of Fracture Liaison Services, consistently enhance outcomes and reduce refracture rates. Despite advances, treatment gaps persist globally, with less than one-third of high-risk women receiving appropriate therapy after a fragility fracture, particularly in low- and middle-income countries. This review highlights the urgent need for integrated care pathways, global equity in osteoporosis management, and future research into imminent fracture risk prediction, sarcopenia assessment, and digital health innovations. Taken together, the findings emphasize that effective prevention and treatment of osteoporosis in post-menopausal women demand a holistic approach that combines pharmacological therapy, lifestyle modification, and system-level strategies to reduce the burden of fractures and improve quality of life.