Background: Pancytopenia, defined by simultaneous reductions in hemoglobin, leukocytes, and platelets, poses a diagnostic challenge due to varied etiologies. Bone marrow examination remains a cornerstone for evaluation. This study aimed to characterize bone marrow morphological patterns in pancytopenia and correlate findings with clinical and hematological parameters. Methods: A prospective observational study was conducted on 100 patients presenting with pancytopenia. Detailed clinical evaluation, complete blood count (CBC), peripheral smear, and bone marrow aspiration and trephine biopsy were performed. Bone marrow patterns were categorized and correlated with clinical data. Results: The most common etiological categories were megaloblastic anemia (40%), aplastic anemia (20%), hypersplenism (12%), acute leukemia (10%), myelodysplastic syndromes (MDS) (6%), and miscellaneous causes (12%). Bone marrow cellularity and morphological patterns correlated significantly with clinical features and hematological indices. Megaloblastic changes were noted in 40 cases, hypocellularity in 20 cases, hypercellularity with blasts in 10 cases, and dysplastic features in 6 cases. Conclusion: Bone marrow examination is essential for diagnosing the underlying cause of pancytopenia. Megaloblastic anemia remains the leading cause in this cohort. Clinicopathological correlation enhances diagnostic accuracy and guides management.

Background: Red Cell Distribution Width (RDW), a measure of variability in erythrocyte size, is traditionally used in the evaluation of anemia. Emerging evidence suggests its utility as a diagnostic and prognostic marker across a range of hematologic and non-hematologic disorders. Objective: To evaluate the diagnostic and prognostic value of RDW in patients with hematologic conditions (such as anemia and leukemia) and non-hematologic conditions (including cardiovascular disease, chronic liver disease, and systemic inflammatory states). Methods: A cross-sectional observational study was conducted involving 100 patients admitted to the Department of Internal Medicine and Hematology at a tertiary care center over 12 months. RDW values were correlated with clinical diagnoses, laboratory parameters, and outcomes. Results: Elevated RDW was significantly associated with anemia subtypes, severity of heart failure, and inflammatory markers. RDW showed predictive value for hospital length of stay and mortality in selected patient groups.Conclusion: RDW is a cost-effective, widely available marker with significant diagnostic and prognostic relevance in both hematologic and non-hematologic diseases. Future longitudinal studies are warranted.

Obesity is a major global health concern and a key contributor to metabolic syndrome (MetS), characterized by central obesity, insulin resistance, dyslipidemia, and hypertension. Chronic low-grade inflammation plays a pivotal role in the pathogenesis of obesity-related metabolic disturbances. Circulating inflammatory markers such as C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and adipokines are increasingly recognized as mediators linking adiposity to metabolic dysfunction. Materials and Methods

This was a hospital-based analytical cross-sectional study conducted in the Department of Biochemistry in collaboration with the Departments of Pharmacology at a tertiary care teaching hospital over a period of 12 months among 200 adults aged 25–60 years. Participants were categorized into obese with MetS (n=100) and non-obese controls (n=100). Anthropometric parameters, fasting glucose, lipid profile, and inflammatory markers (hs-CRP, IL-6, TNF-α) were measured. MetS was defined according to modified NCEP ATP III criteria.

Results High-sensitivity C-reactive protein (hs-CRP) levels were significantly elevated in obese individuals (5.8 ± 1.2 mg/L) compared to controls (1.2 ± 0.5 mg/L) (p <0.001). Interleukin-6 (IL-6) concentrations were also significantly higher in cases (8.4 ± 2.1 pg/mL) compared to controls (2.9 ± 1.1 pg/mL) (p <0.001). Tumor necrosis factor-alpha (TNF-α) levels were substantially increased in obese participants (12.6 ± 3.4 pg/mL) versus controls (4.3 ± 1.5 pg/mL) (p <0.001).  The strong positive correlation was observed between waist circumference and hs-CRP (r = 0.72, p < 0.001). The correlation coefficient (r = 0.72) suggests a strong linear relationship, implying that central obesity is closely linked with systemic inflammation.  Conclusion Inflammatory markers are significantly elevated in obesity and metabolic syndrome and may serve as early indicators of cardiometabolic risk. These markers correlate positively with central obesity and insulin resistance. Monitoring inflammatory markers may aid in early detection and prevention of cardiometabolic complications.

Population ageing is emerging as a major public health concern in India, with a steady rise in chronic illnesses, disability, and healthcare needs among older adults. The geriatric population in Jammu and Kashmir is growing rapidly, yet community-level data on health status, psychosocial conditions, and healthcare utilization remain limited. Understanding these aspects is essential for strengthening primary-level geriatric services. Objectives: To assess the socio-demographic characteristics and morbidity profile of the geriatric population and to examine patterns of healthcare utilization in the field practice area of RHTC SAGAM, Anantnag.  Methods: A community-based cross-sectional study was conducted from June to September 2024 in the field practice area of RHTC SAGAM. All residents aged 60 years and above were included through complete enumeration, yielding a total of 125 participants. Data were collected through a predesigned, pretested semi-structured questionnaire, followed by general and systemic examination. Information on socio-demographic variables, psychosocial factors, morbidity status, multimorbidity, and healthcare utilization was obtained. Data were analyzed using appropriate statistical methods.  Results: Most participants belonged to the young-old age group (60–74 years), with males constituting 60% of the study population. Illiteracy was common, and a substantial proportion had low monthly income. Musculoskeletal disorders were the most prevalent morbidity (55.5%), followed by cardiovascular and metabolic disorders (43.6%), sensory impairments (42.7%), and gastrointestinal disorders (35.5%). Multimorbidity was frequently observed. Psychosocial issues such as bereavement, illness-related restrictions, and limited social interaction were common. The majority of participants sought care from government health facilities and predominantly used allopathic medicine. Although enrolment under Ayushman Bharat PM-JAY was high, awareness of dedicated geriatric clinics was limited. Absence of a friend circle, infrequent communication, and illness-related restrictions showed significant associations with morbidity. Conclusion: The study highlights a high burden of morbidity and multimorbidity among the geriatric population, accompanied by notable psychosocial vulnerabilities. While public healthcare services are widely utilized and generally well accepted, gaps remain in geriatric-specific awareness and support. Strengthening community-based geriatric services, improving social support mechanisms, and integrating comprehensive elderly care at the primary level are essential to address the growing needs of the ageing population.

Background: Granulomatous lymphadenitis is a common finding in lymph node biopsies, and tuberculosis and fungal infections are important infectious causes. Because granulomas overlap across etiologies and bacillary load is often low, morphology alone can be insufficient. Objectives: To describe clinicopathological patterns of granulomatous lymphadenitis and assess concordance between histopathology and mycobacterial/fungal detection methods. Methods: In this observational study, 100 consecutive granulomatous lymph node biopsies received between May and December 2025 at a tertiary-care pathology department in Telangana, India were evaluated. Histomorphology and clinical variables were recorded. Mycobacterial detection used Ziehl–Neelsen staining and CBNAAT; fungal detection used PAS and GMS stains. Concordance was assessed against microbiological positivity. Results: Mean age was 34.6 ± 13.8 years; 56% were male. Cervical nodes (68%) and painless lymphadenopathy (72%) predominated. Caseous necrosis occurred in 62% and giant cells in 74%. Ziehl–Neelsen detected AFB in 34%, whereas CBNAAT was positive in 46%. CBNAAT positivity was higher in necrotizing granulomas (58%) than in non-caseating granulomas (26%). Fungal elements were seen in 8% on PAS/GMS, mainly in suppurative non-caseating granulomas, with no concurrent mycobacterial positivity. Histology suggestive of tuberculosis showed microbiological confirmation in 61.4%. Conclusion: CBNAAT increased mycobacterial detection over smear microscopy and supported diagnosis even in non-necrotizing granulomas. Targeted fungal stains identified a small but relevant subset of fungal lymphadenitis. Combining morphology with appropriate ancillary tests improves etiologic classification of granulomatous lymphadenitis.

Background: Increased levels of lactate along with the acidosis has adverse effects on the outcomes in the subjects and is linked with the high mortality rates. Existing literature data reports that mortality rates are decreased significantly when these levels are corrected in the first 24 hours. Aim: The present study was aimed to assess the effect of change in the BE (base excess) and lactate clearance in the first 24 hours on the clinical outcomes in critically ill subjects admitted to the intensive care unit of an Indian institute. Methods: The present retrospective study assessed 108 critically ill subjects that were retrospectively assessed for ABG (arterial blood gas) analysis and were admitted to ICU. Standard BE and lactate levels were assessed at admission and 24 hours after the admission. Subjects were divided into survivors and non-survivors where survivors were classified based in the change in levels in 24 hours and were correlated with the hospital stay duration. Results: The study results showed that overall mortality rates in study subjects were 40%. A 24-hours alteration in the standard base excess and lactate level depicted a strong correlation to the mortality. Persistence of the metabolic derangement at 24 hours showed a correlation to decreased survival rates with p=0.001 and 0.03 for standard base excess and lactate respectively. All subjects that had normal standard base excess within first 24 hours survived. Also, 24 hours lactate clearance had significant association with shorter ICU stay with p=0.01. Conclusion: The present study concludes that there is a 24-hour trend in standard base excess and lactate levels that are strong predictors of mortality in ICU compared to initial values. Prompt treatment and care to control these metabolic derangements in first few hours of hospital admission which can greatly increase the probability of survival in subjects along with reduced morbidity.

Background & Methods: The aim of the study is to study of anti-hbs level to know the percentage of responders & non responders after 6 months of Hepatitis b vaccine booster dose. The target population comprises healthcare workers and medical students who have received a hepatitis B vaccine booster dose six months prior to enrollment in the study. Results: Categorizes participants based on their anti-HBs titer levels, an indicator of long-term immunity. The largest subgroup (46.3%) had anti-HBs titers between 101-500 IU/mL, while 35.8% had titers exceeding 500 IU/mL, indicating robust immunity. 9.5% of participants with anti-HBs levels <10 IU/mL are at risk of HBV infection and need revaccination or booster doses. Conclusion: Our study supports a targeted booster strategy rather than universal booster administration, with periodic anti-HBs testing guiding the need for additional doses. Further research is required to evaluate long-term protection, genetic determinants of non-responsiveness, and the efficacy of alternative vaccination strategies.

Background: Leukemia represents a major hematological malignancy worldwide, yet regional patterns vary and data from Eastern Uttar Pradesh remain limited. Early recognition at the primary care level is crucial for timely referral and management. Objective: To analyze the demographic and hematological profile of leukemia cases diagnosed at a tertiary care center in Varanasi, Eastern Uttar Pradesh. Methods: A prospective observational study was conducted in the Department of Family Medicine and Primary Care, Banaras Hindu University, from January 2019 to March 2022. A total of 283 consecutive leukemia cases were included. Demographic data, clinical presentation, complete blood counts, peripheral smear, bone marrow examination, and special staining (Sudan Black B) were recorded. Flow cytometry was performed in a subset of cases (n = 10). Data were analyzed using descriptive statistics. Results: The male-to-female ratio was 2.1:1, with a mean age of 26.8 years (range: 1–78 years); the majority of patients were ≤20 years. Acute leukemias accounted for 69.9% of cases, while chronic leukemias comprised 30.0%. The most common subtype was acute leukemia, unclassified (32.5%), followed by chronic myeloid leukemia (25.8%), acute lymphoblastic leukemia (18.4%), acute myeloid leukemia (18.4%), and chronic lymphocytic leukemia (3.5%). Rare cases included plasma cell leukemia, chronic eosinophilic leukemia, hairy cell leukemia, and chronic myelomonocytic leukemia. Anemia was the most frequent hematological abnormality across all subtypes. Flow cytometry reclassified several undifferentiated cases into AML and ALL. Conclusion: Leukemia in Eastern Uttar Pradesh demonstrates a high burden of pediatric and acute cases, with a predominance of unclassified acute leukemias likely due to limited immunophenotyping facilities. These findings emphasize the importance of strengthening diagnostic capacity and awareness among family physicians for early recognition and timely referral.

Background: Quality of life (QOL) is a multidimensional indicator of well-being in older adults which is particularly relevant in semi-urban settings undergoing demographic and social transition .Objectives: To assess the quality-of-life among older adults in a semi-urban area of Bikaner and identify its key determinants. Methods: A community-based cross-sectional study was conducted among 200 adults aged ≥60 years selected through systematic random sampling. Data were collected using a semi-structured questionnaire and the WHOQOL-BREF instrument. Domain scores were transformed to a 0–100 scale. Associations between QOL and selected variables were analysed using appropriate statistical tests. Results: The mean overall WHOQOL-BREF score was 58.21 ± 10.94, indicating moderate QOL. The psychological domain scored highest, while social and environmental domains were lower. Poor overall QOL was reported by 35% of participants and 53.5% were dissatisfied with their general health. Advancing age (p = 0.042), lower education (p = 0.007), lower socioeconomic status (p < 0.001) and presence of chronic morbidity (p = 0.036) were significantly associated with reduced QOL. Conclusion: Quality of life among older adults in this semi-urban setting is influenced by socioeconomic, educational and health-related factors. Strengthening geriatric services and addressing social determinants are essential for promoting healthy ageing.

BACKGROUND-According to the World Report on Violence and Health (WHO, Geneva, 2002), an injury refers to bodily harm resulting from a rapid transfer of energy — including mechanical, thermal, electrical, chemical, or radiation energy — or from the abrupt deprivation of essential elements such as heat or oxygen. Over time, this concept has been expanded beyond purely physical damage to also encompass psychological trauma, developmental impairment, and harm arising from neglect or deprivation.¹ OBJECTIVE- To assess the association between the nature of injuries and environmental factors among geriatric patients attending a primary health care facility. METHODOLOGY- Ethical clearance was sought from the Institutional Ethics Committee. Acommunity-based cross-sectional study was conducted among geriatric patients attendingUHCGokalpuri for the first-time during the study period of 1 year. A total of 150 participants were enrolledfrom the OPD Register at UHC, and interviewed using a pre-tested, semi-structured schedule. Statistical Analysis was done using SPSS version 25. RESULT- A significantly higher proportion of geriatric patients with fractures were found to have inadequate bathing facilities (86.37%) compared to patients with other types of injuries (p=0.0014). Similarly, the presence of slippery household surfaces was more common among patients with fractures (59.10%) than among those in other injury categories (p=0.0051), indicating a strong association between unsafe home environments and fracture occurrence. CONCLUSION-.The study highlights several environmental hazards within the households of geriatric patients. Inadequate lighting was observed in 60% of homes, while insufficient bathing facilities were reported in 52% of households. Approximately one-third (31.33%) of participants lived in environments with slippery surfaces. Additional hazards included unstable furniture in 5.33% of households and protruding nails or sharp objects in 18%. These findings emphasise the important role of modifiable environmental factors in the occurrence of injuries among the elderly population.

Background: Pneumonia is a condition that signifies the acute respiratory infection in the lungs with inflammation of the alveoli that become filled with fluid and pus resulting in painful breathing, respiratory distress, and impaired oxygen exchange. CAP (Community-acquired pneumonia) is one of the major reasons of mortality in the pediatric subjects across the globe. Aim: The present study was aimed to assess the association of hyponatremia with severity of illness, its course, duration of hospital stay, and outcomes in children aged two months to five years with community-acquired pneumonia. Methods: The study assessed 212 subjects that visited the Institute with community-acquired pneumonia that presented to the Institute with community acquired pneumonia within the defined study period and were admitted to PICU. In all subjects aged 2-5 years, severity of illness, its course, duration of hospital stay, and outcomes were correlated with the anemia and results were formed. Results: Hyponatremia was seen in 50% (n=56) and in severe pneumonia in 44.4% (n=40) subjects showing statistical significance with p=0.000. Hyponatremia was significantly higher in subjects with >7 days of hospital stay compared to subjects with hospital stay of ≤7 days with p=0.03. Also, higher incidence of hyponatremia was seen in subjects that died compared to subjects that were discharged following treatment with p=0.01The severity was significantly higher in severe pneumonia subjects for mild, moderate, and severe hyponatremia compared to subjects with pneumonia with p=0.02. Conclusion: The present study concludes that hyponatremia is commonly seen in child subjects with community acquired pneumonia and there is a significant association in hyponatremia with the severity of pneumonia, high mortality in children with community acquired pneumonia, prolonged hospital stays, increased need for ventilation, and association of severe hyponatremia with severe pneumonia.

Background: CCHD (Cyanotic congenital heart disease) in child subjects have been linked to chronic hypoxia and results in elevated hematological indices and compensatory erythrocytosis which can cover the underlying IDA (iron deficiency anemia) in the affected subjects warranting its further exploration, Aim: The present study was aimed to assess the iron deficiency and serum iron parameters in pediatric subjects with cyanotic congenital heart disease, Methods: The present study assessed 254 child subjects in the age range of 6 months to 18 years that had unrepaired CCHD (Cyanotic congenital heart disease) and visited the Institute within the defined study period. In all subjects, erythrocyte indices, total blood count, serum ferritin, and serum iron levels were evaluated along with sociodemographic, anthropometric, and nutritional data. Comparison was done in various erythrocytic indices in iron-deficient and non-deficient subjects, Results: The study results showed that most common Cyanotic congenital heart disease found in study subjects was Teratology of Fallot seen in 55% subjects. Based on serum ferritin and iron levels, 19.7% (n=50) subjects had iron deficiency. On comparing the hematological indices, no significant difference was seen in mean Hb levels in iron-deficient and non-deficient subjects with p=0.97, and in haematocrit with p=0.84. For MCV (mean corpuscular volume), MCHC (mean corpuscular hemoglobin concentration), and MCH (mean corpuscular hemoglobin), the differences were statistically non-significant, Conclusion: The present study concludes that iron deficiency is seen in significant proportion of subjects that have Cyanotic congenital heart disease. However, no difference exist in erythrocytic parameters and clinical predictors of iron deficiency in subjects with and without iron deficiency which highlights the need for routine assessment of the iron status in subjects with CCHD.

Background: Hypertensive retinopathy (HR) reflects microvascular damage from chronic hypertension and is linked to broader cardiovascular risk. Methods: A prospective cohort study was conducted with adults diagnosed with hypertension and matched controls. Participants underwent baseline retinal imaging (fundus photography and SD-OCT) and systemic assessments (BP, lipid profile, renal function, and comorbidity data). Retinopathy was graded using the Keith-Waarden/Barker-like scheme, and incident cardiovascular events were tracked over a 3–5 year follow-up. Multivariable Cox proportional hazards models examined associations between HR grade and outcomes, adjusting for confounders. Results: Higher HR grades at baseline predicted greater risk of major adverse cardiovascular events and TOD progression, independent of baseline BP and traditional risk factors. Subgroup analyses suggested stronger associations in older participants and those with longer hypertension duration. Conclusion: Retinal vascular changes in hypertensive patients provide independent prognostic information for cardiovascular risk and TOD, supporting its use in risk stratification and guiding tighter BP management.

Background: Chronic Subdural Haematoma (cSDH) is a frequent neurosurgical condition predominantly affecting the elderly, marked by increasing incidence worldwide. Despite advances in neurosurgical care, the optimal management strategy remains controversial. Methods: A retrospective cohort of 156 cSDH patients treated at a tertiary neurosurgical center was analyzed. Cases were reviewed for clinical presentation, radiology, surgical technique (burr hole craniostomy, mini craniotomy), timing of postoperative anticoagulant resumption, anti-epileptic prophylaxis utilization, and major outcomes including recurrence and complications. Statistical analysis included chi-square tests, proportions, and confidence intervals. Results: Burr hole craniostomy was the predominant surgical technique (80.1%), with recurrence in 12.8% and bilateral disease in 19.2% of cases. Complications included infection (12.8%), epilepsy (1.3%), reperfusion bleed (0.6%), and death (1.9%). Timing of anticoagulant resumption did not significantly affect recurrence (p=0.26), nor did anti-epileptic prophylaxis significantly alter postoperative seizure rates (p=0.77). Outcomes align closely with published multicenter data, supporting evidence-based management. Conclusion: Management of cSDH necessitates tailored, evidence-focused decision-making. Burr hole craniostomy is effective for most cases, but recurrence and complications persist, warranting continued evaluation of risk stratification and perioperative protocols. Individualized management of anticoagulation and anti-epileptic use is recommended.

Background: India has one of the largest agricultural workforces globally. Rapid mechanisation combined with informal labour, inadequate safety regulation, and delayed access to trauma care make agricultural work a major yet under-reported source of injury and death. Medico-legal and forensic datasets provide unique insight into fatal and severe injury mechanisms in rural India.

Objectives:

1. To describe forensic and medico-legal injury patterns among Indian agricultural workers.
2. To identify predictors of severe outcomes (death/ICU/permanent disability).
3. To propose context-appropriate community prevention strategies for rural India.

Methods: A mixed-methods study was conducted using retrospective medico-legal case records from a district hospital and affiliated mortuary in an Indian agrarian district (Jan 2022–Dec 2024), along with community surveys and focus group discussions with farmers and labourers. All work-related agricultural injuries registered as medico-legal cases were included. Variables analysed were demographics, task at time of injury, mechanism/agent (tractor, thresher, chaff cutter, animals, falls, electrical pumps, pesticides, etc.), injury type, body region, and outcome. Multivariable logistic regression identified predictors of severe outcome. Results: Among 326 cases, 92 (28.2%) were fatal. Major mechanisms were tractor/machinery incidents (34.0%), hand tools such as sickles (22.1%), animal-related trauma (16.3%), and falls into fields/wells/tree heights (13.8%). Severe outcomes were independently associated with tractor or powered machinery use, absence of guards on threshers/chaff cutters, night-time irrigation work, and non-use of basic protective gear. Communities prioritised low-cost guarding for threshers, safe tractor driving training, well and borewell covers, and rapid referral/transport systems. Conclusion: In rural India, severe agricultural injuries cluster around tractors, threshers, open rotating parts, and poorly lit irrigation work. Simple engineering controls and locally driven safety campaigns can substantially reduce preventable deaths and disabilities.

Total knee arthroplasty (TKA) remains the gold standard for advanced knee osteoarthritis, yet persistent patient dissatisfaction rates of 15–20% and the pursuit of physiological knee kinematics have driven innovation in both surgical technique and implant design. Two significant developments—robotic-assisted systems and medial pivot knee designs—have emerged as potential solutions to enhance outcomes. This narrative review synthesizes current evidence comparing robotic-assisted TKA (RA-TKA) with conventional TKA (C-TKA), with specific attention to medial pivot implant designs. While robotic assistance demonstrates superior mechanical alignment precision, functional outcomes remain comparable to conventional methods in the short to medium term. Medial pivot designs, conversely, provide meaningful improvements in patient satisfaction and knee kinematics, particularly regarding paradoxical anterior femoral translation prevention and deep knee flexion capacity. The convergence of these two technologies—robotic-assisted medial pivot TKA—represents an emerging frontier, though long-term outcome data remain limited. Cost-effectiveness is heavily volume-dependent, with robotic systems achieving favorable cost-effectiveness only in high-volume surgical centers.

Background: Traumatic spinal cord injury (TSCI) is a severe and disabling condition. It is associated with significant neurological deficits, long-term disability, and a substantial socioeconomic burden. Trauma care has made substantial advances in recent years. The optimal integration of surgical and non-surgical management approaches remains an area of ongoing research. In improving outcomes for patients with TSCI, early diagnosis, timely intervention, and comprehensive rehabilitation are considered as critical. Methods: Over a one-year period from July 2024 to July 2025 this hospital-based retrospective observational study was conducted among 60 adult patients with confirmed traumatic spinal cord injury. Patients were managed either surgically based on injury characteristics, neurological status, and spinal stability. Data collected included demographics, injury mechanism and severity, ASIA Impairment Scale grading upon admission and follow-up, management approach, issues, functional results, hospital stay duration, and death. SPSS was used to compare the results of surgical and conservative treatments. Results: Motor vehicle accidents caused most injuries, and men were most affected. The cervical spine was injured most often, followed by the thoracic and lumbar. Surgery was performed on 63.3% of patients, whereas 36.7% were conservatively treated. When comparing to the conservative group, the surgically managed group established significant neurological improvement, as shown by ASIA grade advancement (p < 0.05). Patients after surgery had better mobility and bladder and bowel control. Pressure sores and urinary tract infections were the most common, but both groups had problems and overall death rates were low. Conclusion: According to individual patient needs, current traumatic spinal cord injury treatments work. Surgical surgery improves neurological and functional outcomes, while conservative therapy may help stabilize injuries with slight impairments. The patients who have severe spinal cord injury will recover with the help of early diagnosis, quick surgery, and structured multidisciplinary therapy.

Background: Degenerative disc degeneration, spondylolisthesis, trauma, and spinal anomalies may require spinal fusion surgery. In the surgical methods and techniques, surgery is uncertain and complications are common. Surgical success factors are understood to improve patient selection, surgical planning, and clinical outcomes. Methods: A retrospective observational study assessed 45 tertiary care spinal fusion patients from 2024 to 2025. Demographics, clinical aspects, operation details, and postoperative outcomes were studied. VAS measured pain, ODI and others measured function. Radiological fusion and postoperative problems were recorded and the statistical analysis was performed using SPSS. Surgery efficacy factors were identified using descriptive statistics, comparison tests, and multivariate logistic regression. Statistical significance was set at p < 0.05. Results: The majority of patients were male, with an average age of 54.6 ± 11.8 years. After surgery, both pain and functional scores were much better than they were before (p < 0.001). Radiological fusion was successful in 84.4% of instances. 22.2% of patients had problems after surgery, and 11.1% needed more surgery to fix them. Interbody fusion, a younger age, fewer comorbidities, and single-level fusion were indicators of success. Conclusion: The majority of patients favorable clinical and radiological outcomes resulted from spinal fusion surgery. Enhance surgical success and reduce postoperative complications through careful patient selection and consideration of key predictive factors.

Background: Sleep duration is increasingly recognized as an important determinant of cardiovascular health, with emerging evidence suggesting its influence on autonomic nervous system regulation. Heart rate variability (HRV) provides a noninvasive measure of cardiac autonomic modulation. This study was conducted to evaluate the relationship between habitual sleep duration and HRV parameters in young adults. Material and Methods: A cross-sectional observational study was carried out among 120 apparently healthy adults aged 18–25 years. Participants were categorized into short (<6 hours), normal (6–8 hours), and long (>8 hours) sleep duration groups based on self-reported habitual sleep patterns. Five-minute resting electrocardiographic recordings were obtained under standardized conditions for HRV analysis. Time-domain and frequency-domain HRV parameters were analyzed and compared across sleep duration categories using appropriate statistical tests. Correlation analysis was performed to assess the association between sleep duration and HRV indices. Results: Baseline demographic and anthropometric characteristics were comparable across the three sleep groups, although resting heart rate differed significantly. Individuals with shorter sleep duration demonstrated reduced overall HRV and diminished parasympathetic activity, whereas those with normal and longer sleep duration exhibited more favorable autonomic profiles. Frequency-domain analysis indicated a shift toward sympathetic predominance in short sleepers, with a progressive increase in parasympathetic modulation as sleep duration increased. Sleep duration showed significant positive correlations with indices of overall variability and vagal activity, and a negative correlation with sympathovagal balance. Conclusion: Habitual sleep duration is significantly associated with cardiac autonomic modulation in young adults. Short sleep duration is linked to impaired autonomic regulation, while adequate sleep is associated with enhanced heart rate variability. These findings highlight the potential role of healthy sleep practices in promoting early cardiovascular autonomic health.

Background: Transurethral resection of the prostate (TURP) remains the gold standard surgical treatment for benign prostatic hyperplasia (BPH). The extent of adenoma removal and its relationship with postoperative outcomes is still debated. The residual prostatic weight ratio (RPWR) has been proposed as a novel parameter to quantify completeness of resection. Objectives: To evaluate the correlation between RPWR and postoperative clinical outcomes following TURP in patients with BPH. Materials and Methods: This prospective study included 50 patients with symptomatic BPH undergoing TURP. Preoperative and 6‑month postoperative International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), and average flow rate (Qavg) were compared. RPWR was calculated as the ratio of residual prostate weight after TURP to initial prostate weight. Statistical analysis assessed correlations between RPWR and clinical outcomes. Results: Mean age was 68.96 ± 8.7 years and mean prostate weight was 66.06 ± 16.8 g. Mean RPWR was 0.17 ± 0.07. Significant improvements were observed in IPSS, Qmax, and Qavg at 6 months postoperatively (p < 0.001). Lower RPWR values were associated with greater improvement in urinary flow rates and symptom scores. Conclusion: RPWR demonstrates a measurable association with postoperative clinical improvement following TURP. Although correlations were modest, lower RPWR values tended to predict better symptomatic and functional outcomes

Abstract Background: Hyponatremia is one of the most common electrolyte disturbances in critically ill patients, often reflecting underlying disease severity. Its clinical implications range from mild symptoms to severe neurological deficits and death. This study aimed to assess the prevalence of hyponatremia in ICU patients and examine its association with clinical parameters and outcomes. Methods: This prospective observational study included 90 adult ICU patients with hyponatremia (serum sodium <135 mmol/L), conducted over 12 months. Patients were classified based on hyponatremia severity (mild: 130–134 mmol/L, moderate: 125–129 mmol/L, severe: <125 mmol/L), and their demographic, clinical, and biochemical parameters were analyzed. Outcomes included duration of ICU stay, mechanical ventilator use, and mortality. Statistical significance was assessed using Chi-square and t-tests. Results: The majority of patients were aged 61–80 years (34%) and male (74.4%). Mild, moderate, and severe hyponatremia were observed in 43.3%, 35.6%, and 21.1% of cases, respectively. Mortality was 52.2%. Although hyponatremia severity alone was not significantly associated with mortality (p = 0.1243), mechanical ventilator requirement (p = 0.0001), systolic blood pressure (SBP), oxygen saturation (SpO₂), and temperature showed significant associations. While hyponatremia severity may not predict outcome alone, comorbidities, older age, and ventilator requirement are strong prognostic indicators. Conclusion: Hyponatremia severity alone may not predict outcome. Comorbidities, older age, and ventilator requirement are strong prognostic indicators. Early recognition and appropriate management are essential to improve outcomes in critically ill patients.

Introduction Liquid crystals (LCs) show properties intermediate between solids and liquids, with strong anisotropy in optical, dielectric, and flow behavior. These physical properties govern device performance in displays, tunable photonics, and smart windows. Materials and Methods A controlled laboratory study was conducted on two thermotropic nematic LC systems (N1 and N2) and one cholesteric LC mixture (Ch). Phase transitions were measured by DSC and polarized optical microscopy (POM). Optical refractive indices were recorded using an Abbe refractometer under planar alignment. Dielectric permittivity and anisotropy were measured by impedance spectroscopy (100 Hz–1 MHz). Splay elastic constant (K₁₁) was determined using the Fréedericksz threshold method, and rotational viscosity (γ₁) by electro-optic response-time fitting. Quality-control criteria were applied for sample inclusion. Results All samples showed stable mesophases and reproducible transition temperatures. Nematic samples demonstrated temperature-dependent birefringence (Δn) and positive dielectric anisotropy (Δε>0). Cholesteric mixtures showed selective reflection and pitch-dependent optical response. Six tables summarize thermal, optical, dielectric, elastic, and viscoelastic parameters with interpretation. Conclusion The combined thermal–optical–dielectric characterization provides a compact experimental framework to quantify LC physical properties relevant to electro-optic applications.

Background: Intertrochanteric fractures are commonly encountered in elderly patients and are associated with significant morbidity. Proximal femoral nailing has become the preferred method of fixation; however, the impact of reduction technique on functional recovery and fracture union remains controversial. This study aimed to compare open and closed reduction techniques in proximal femoral nailing for intertrochanteric fractures. Objectives: To evaluate and compare functional outcomes, fracture union rates, and perioperative parameters between open and closed reduction techniques. Materials and Methods: This prospective comparative study included 50 patients with intertrochanteric fractures treated with proximal femoral nailing. Patients were divided into closed reduction (n = 26) and open reduction (n = 24) groups. Functional outcomes were assessed using the Harris Hip Score at 3 and 6 months. Radiological union, time to union, operative time, blood loss, hospital stay, and postoperative complications were recorded. Statistical analysis was performed using appropriate parametric and non-parametric tests, with p < 0.05 considered statistically significant. Results: The closed reduction group demonstrated significantly better functional outcomes, with higher Harris Hip Scores at both 3 and 6 months (p < 0.05). Mean time to fracture union was significantly shorter in the closed reduction group (13.8 ± 2.1 weeks) compared to the open reduction group (15.6 ± 2.7 weeks). Closed reduction was also associated with reduced operative time, lower intraoperative blood loss, shorter hospital stay, and fewer postoperative complications. Radiological union rates were higher in the closed reduction group. Conclusion: Closed reduction techniques in proximal femoral nailing offer superior functional recovery, faster fracture union, and improved perioperative outcomes compared to open reduction. Whenever feasible, closed reduction should be preferred, while open reduction should be reserved for irreducible or complex fracture patterns.

Background Choroidal neovascularisation (CNV) is a leading cause of central vision loss. Intravitreal anti-VEGF therapy including bevacizumab is widely used for CNV but the optimal dosing regimen—fixed monthly injections versus variable (PRN) dosing—remains debated. Aim To evaluate and compare the visual and anatomical outcomes of intravitreal bevacizumab using fixed and variable dosing regimens in patients with CNV. Materials and Methods This prospective interventional study included 166 eyes with treatment-naïve CNV, divided equally into fixed dosing and variable dosing groups. Outcomes measured included best-corrected visual acuity (BCVA), central foveal thickness (CFT) on OCT, number of injections, and safety over nine months. Statistical analysis compared changes between groups using t-tests and Chi-square tests. Results A total of 136 eyes with choroidal neovascularisation were included and divided into fixed dosing (Group 1) and variable dosing (Group 2) regimens of intravitreal bevacizumab. Age-related macular degeneration constituted the predominant aetiology (92%). Both groups demonstrated statistically significant improvement in best-corrected visual acuity and significant reduction in central foveal thickness (CFT) over the 9-month follow-up period (p < 0.05). Group 1 showed a greater mean reduction in CFT compared to Group 2, which was statistically significant (p = 0.002). Intraocular pressure remained stable in both groups. The mean number of injections was lower in Group 1 (3.2) compared to Group 2 (4.3), with fewer clinical visits and better treatment compliance. Conclusion Intravitreal bevacizumab is effective in the management of choroidal neovascularisation across various etiologies. Fixed monthly dosing resulted in superior anatomical outcomes with comparable visual improvement, fewer injections, reduced treatment burden, and better patient compliance when compared to variable dosing. Fixed dosing appears to be a more cost-effective and patient-friendly treatment strategy for CNV.

Background: Leukemia encompasses a heterogeneous group of hematological malignancies, and its presentation varies significantly between children and adults. Pediatric leukemia is dominated by acute lymphoblastic leukemia (ALL), whereas adults frequently present with acute myeloid leukemia (AML) or chronic myeloid leukemia (CML). Comparative regional studies are limited in India, particularly in Eastern Uttar Pradesh. Objectives: To analyze and compare the clinico-hematological profile of pediatric (≤18 years) and adult (>18 years) leukemia patients over a three-year period. Methods: A retrospective study of 283 patients diagnosed with leukemia was conducted at a teaching hospital in Eastern Uttar Pradesh. Cases were divided into pediatric (n=142) and adult (n=141) groups. Clinical features, hematological parameters (hemoglobin, total leukocyte count, platelet count), and subtype distribution were evaluated. Results: Of 283 cases, 50.2% were pediatric and 49.8% adult. Pediatric cases were predominantly ALL (48.6%), followed by AML (20.4%). In adults, CML was most frequent (36.9%), followed by AML (25.5%). Anemia was universal in both groups; thrombocytopenia was more severe among pediatric ALL and AML, while adults with CML often showed preserved platelet counts. Males predominated in both groups (M:F ratio 2.1:1). Conclusion: Pediatric leukemia in Eastern Uttar Pradesh is largely acute, dominated by ALL, while adults more commonly present with CML and AML. These differences underscore the need for age-specific diagnostic and therapeutic approaches, and highlight the importance of strengthening diagnostic infrastructure in resource-limited regions.

Background: Acute ischemic stroke activates the hypothalamic–pituitary–adrenal axis, leading to elevated serum cortisol. Higher cortisol levels correlate with greater stroke severity and poorer outcomes. Limited small-cohort data support further evaluation of cortisol as a practical prognostic biomarker. Aims and Objectives: To evaluate serum cortisol as a biomarker for assessing the severity of acute ischemic stroke Materials and Methods: This prospective hospital-based observational study enrolled 50 patients with acute ischemic stroke admitted within 72 hours of symptom onset at a tertiary care center, confirmed by CT or MRI. Morning serum cortisol was measured on admission, stroke severity assessed by NIHSS, and functional outcome by mRS at discharge and 30 days, excluding patients with endocrine disorders, steroid use, or hemorrhagic stroke. Statistical analysis included correlation, group comparisons, and multivariate regression adjusting for age and comorbidities. Results: The mean age was 62.4 ± 12.8 years, with 58% males, and mean serum cortisol was 528.6 ± 168.4 nmol/L. Cortisol showed a strong correlation with NIHSS (r = 0.76, p < 0.001) and was significantly higher in severe stroke compared to moderate and mild groups (p < 0.001). Elevated cortisol (>600 nmol/L) was associated with poor functional outcome, higher in-hospital mortality, and remained an independent predictor of stroke severity on multivariate analysis (β = 0.68, p < 0.001). Conclusion: Elevated serum cortisol on admission is a reliable indicator of greater stroke severity and poorer short-term outcomes in acute ischemic stroke. Routine measurement may aid early risk stratification.

Background: Stroke is a major global health concern and a leading cause of morbidity and mortality. Diabetes mellitus (DM) is a well-established risk factor for stroke, often coexisting with other vascular risk factors such as hypertension and dyslipidemia. This study aimed to evaluate the clinical profile and stroke severity among diabetic and non-diabetic patients admitted with acute stroke at a tertiary care center in central India. Methods: A hospital-based cross-sectional study was conducted over one year at Dr. B.R. Ambedkar Memorial Hospital, Raipur. Adult patients (≥18 years) admitted with acute stroke were enrolled. Patients with prior stroke or confounding acute medical conditions were excluded. Clinical, laboratory, and radiological data were collected. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) and categorized as minor, moderate, moderate-to-severe, or severe. Diabetic status was confirmed using HbA1c, and comorbidities such as hypertension, dyslipidemia, and smoking were recorded. Statistical analyses included chi-square and t-tests, with p < 0.05 considered significant. Results: A total of 100 patients were included (65 diabetics, 35 non-diabetics). Hypertension was significantly more prevalent among diabetics (72.3% vs. 48.6%, p = 0.018). Dyslipidemia (46.2% vs. 37.1%, p = 0.385), smoking (26.2% vs. 22.9%, p = 0.717), and in-hospital mortality (12.3% vs. 11.4%, p = 0.897) did not differ significantly between groups. Stroke severity differed significantly between diabetics and non-diabetics (p = 0.007), with diabetics more likely to present with moderate-to-severe (38.5%) and severe strokes (21.5%), whereas minor strokes were more frequent among non-diabetics (22.9%). Subgroup analyses stratified by hypertension, dyslipidemia, and smoking suggested trends toward higher severity in diabetics, though differences were not statistically significant. Conclusion: Diabetic patients with acute stroke exhibit significantly greater stroke severity compared to non-diabetic patients. Hypertension was more prevalent among diabetics, indicating a synergistic impact on stroke risk. In-hospital mortality was comparable between groups. These findings underscore the importance of early identification and management of diabetes and associated vascular risk factors to mitigate stroke severity and improve outcomes.

Background: Ageing is associated with a progressive decline in pulmonary function due to structural and functional changes in the respiratory system. Although regular physical activity is known to improve respiratory health, data evaluating the effect of yogic exercise on pulmonary function in apparently healthy elderly individuals remain limited. This study aimed to assess the effect of a structured yogic exercise program on selected pulmonary function tests in elderly subjects. Methods: This prospective interventional study was conducted in a selected yoga centre in Siliguri, West Bengal. Forty apparently healthy elderly subjects of both sexes, aged between 50–70 years, were enrolled after screening for eligibility. Pulmonary function parameters, including Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV₁), and Peak Expiratory Flow Rate (PEFR), were recorded before initiation of yogic exercise and after 12 weeks of supervised practice. The yogic intervention was comprised of selected pranayama techniques practiced for 30 minutes per session under supervision. Data were analysed using paired Student’s t-test, and a p-value <0.05 was considered statistically significant. Results: Following yogic exercise, mean FEV₁ increased from 1.64 ± 0.32 L to 1.68 ± 0.31 L (p < 0.05), mean FVC increased from 2.09 ± 0.29 L to 2.10 ± 0.29 L (p < 0.05), and mean PEFR increased from 339.01 ± 24.98 L/min to 343.35 ± 25.09 L/min (p < 0.05). A majority of subjects showed improvement in pulmonary parameters. Conclusion: Regular yogic exercise significantly improves pulmonary function in apparently healthy elderly individuals. Yoga may serve as a simple, safe, and effective non-pharmacological intervention to preserve respiratory health in the ageing population.

Background Because of the complex interaction of their severe physical injuries, prolonged hospitalisations, and subsequent functional impairments, polytrauma patients have an increased risk for developing psychological morbidities due to this combined effect. Additionally, while trauma patients typically experience both depression and anxiety in large numbers, these are often underdiagnosed, even though there is evidence to suggest that the severity of the injury also has an effect on the long-term impact on the individual’s mental health. The imaging modalities available, such as CT (computerised tomography) and MRI (magnetic resonance imaging), provide objective assessment of the “burden of trauma”; however, the relationship between imaging assessment and mental health outcomes remains largely unexplored. Objectives To determine the prevalence of depression and anxiety among polytrauma patients and to evaluate their correlation with CT/MRI-based injury severity scores. Methods The researchers conducted a cross-sectional study in a tertiary care trauma centre for 18 months and enrolled 120 adult polytrauma patients. They used validated screening scales to assess depression and anxiety, building upon traditional clinical rating scales for both types of disorders, and they used standard CT and MRI to quantify the severity of injuries. Statistical analyses were conducted to calculate the prevalence of these disorders and to evaluate any correlation(s) that existed between psychological score(s) and radiological injury severity. Results A high number of polytrauma patients had symptoms of depression and anxiety. There was also a direct correlation between the degree/severity of a patient's CT/MRI score and the amount/level of both depressive symptoms and anxiety symptoms in that patient. Additionally, correlation analysis showed a statistically significant positive correlation between injury severity and psychological distress in these patients. Conclusion Patients with multiple traumatic injuries often suffer from depression and anxiety, and there is a significant correlation between severity of the injuries based on radiological imaging and having these comorbidities. The findings of the present study underscore the importance of routinely screening for mental health conditions and providing timely mental health interventions in the overall trauma care of patients who have sustained large or complex injuries.

Background: The kidneys play a pivotal role in maintaining internal homeostasis by regulating water, electrolyte balance, acid–base status, and blood pressure, in addition to performing important endocrine functions such as erythropoietin and calcitriol production. Chronic Kidney Disease (CKD) is increasingly recognized as a major public health problem worldwide, particularly in developing countries like India. While CKD is traditionally associated with older adults, its growing prevalence among younger individuals is alarming due to its long-term health, social, and economic consequences. Young patients often experience a prolonged asymptomatic phase, leading to delayed diagnosis and presentation in advanced stages. There is limited region-specific data on the clinical profile, etiological spectrum, and risk factors of CKD in young populations in eastern India Materials and Methods: This cross-sectional observational study was conducted in the Postgraduate Department of General Medicine and the Department of Nephrology at SCB Medical College and Hospital, Cuttack, Odisha, from April 2023 to June 2024. A total of 20 young patients aged 15–24 years diagnosed with CKD were included after obtaining informed consent. Patients with acute infections, liver failure, congestive heart failure, pregnancy, solitary kidney, or obstructive renal pathology were excluded. Detailed clinical history, physical examination, and anthropometric measurements were recorded using a predesigned semi-structured proforma. Laboratory investigations included complete blood count, renal function tests, electrolytes, inflammatory markers, lipid profile, random blood sugar, and immunological tests where indicated. Imaging studies, renal artery Doppler, and renal biopsy were performed as required. Results: The study population showed a marked male predominance (70%), with a male-to-female ratio of 2.33:1. Hypertensive nephrosclerosis (35%) and diabetic nephropathy (30%) were the leading etiologies, followed by chronic glomerulonephritis (20%). The most common presenting symptoms were dyspnea (80%), periorbital edema (75%), anorexia (70%), nausea and vomiting (70%), and oliguria (60%). Pallor and bilateral pedal edema were the most frequent clinical signs (90% each). Tobacco use (60%), alcohol consumption (40%), and smoking (30%) were the major modifiable risk factors identified. A significant proportion of patients presented in advanced stages, with 35% in stage IV and 45% in stage V CKD. Hypertension (35%), diabetes mellitus (30%), and cardiovascular disease (30%) were the most common comorbidities. Conclusion: Chronic kidney disease imposes a substantial burden on young individuals, with most patients presenting in advanced stages and exhibiting significant comorbidities and lifestyle-related risk factors. Early detection, targeted screening, lifestyle modification, and effective management of hypertension and diabetes are crucial to reducing disease progression and improving long-term outcomes. This study underscores the need for strengthened public health strategies and further large-scale research to better understand and address CKD in young populations.