Background: Acute gastroenteritis remains a major cause of pediatric morbidity and hospital admission, particularly in younger children where dehydration and electrolyte imbalance can develop rapidly. Objectives: To describe the clinical profile, dehydration status, laboratory abnormalities, treatment patterns, and in-hospital outcomes of children admitted with acute gastroenteritis. Methods: This hospital-based observational study was conducted among one hundred children aged 2 months to 12 years admitted with acute gastroenteritis. Demographic details, nutritional status, presenting symptoms, dehydration severity, laboratory findings, treatment received, duration of hospital stay, and final outcomes were recorded and analyzed using descriptive statistics. Results: The mean age of participants was 3.9 ± 2.8 years, and 36.0% were aged 1–3 years. Males constituted 58.0% and 64.0% were from rural areas. Vomiting was present in 78.0% of children, poor oral intake in 58.0%, and fever in 46.0%. Some dehydration was observed in 54.0% and severe dehydration in 26.0%. Hypokalemia was the most frequent electrolyte abnormality (22.0%), followed by hyponatremia (18.0%); metabolic acidosis was documented in 28.0%. Intravenous fluids were required in 68.0% of cases. The mean hospital stay was 3.4 ± 1.8 days. Most children improved and were discharged, while one death was recorded. Conclusion: Acute gastroenteritis in this cohort predominantly affected younger children and commonly presented with vomiting, dehydration, and biochemical disturbances. Early recognition, prompt rehydration, and supportive inpatient care were associated with favorable short-term outcomes in most admitted children.

Introduction: Objective:  To study biochemical & Physiological Association of Serum Zinc Levels with Acne Severity among Young Adults. Study Design: cross-sectional study. The study was carried out Conducted at The Department Of   Biochemistry, dermatology and   Community   Medicine Muhammad College of Medicine, Peshawar   From 1st  Sep   2024  To 30th    Nov     2025. Methods :  This was a cross-sectional observational study conducted to assess Biochemical Association of Serum Zinc Levels with Acne Severity among Young Adults. A total of 300 participants aged 18–30 years were included. Both male and female patients presenting with acne were recruited from dermatology outpatient departments. Blood samples (5 ml) were collected under aseptic conditions. Serum zinc levels were measured using standard laboratory techniques and categorized as: Result: Serum zinc levels were assessed in all participants. A total of 162 (54.0%) individuals were found to have low serum zinc levels, while 138 (46.0%) had normal zinc levels Overall, the results suggest a strong inverse relationship between serum zinc levels and acne severity, with zinc deficiency being more common in patients with severe forms of acne. Conclusion: These findings suggest that zinc plays an important role in acne pathogenesis and may serve as a useful adjunct in its management. Further studies are recommended to establish standardized guidelines for zinc supplementation in acne treatment.

Introduction: Asthma, neonatal septicemia, and anaemia are major contributors to pediatric morbidity in developing countries, with significant variation in clinical presentation across age groups. Objectives: To evaluate the clinical profile, demographic distribution, and outcomes of asthma, neonatal septicemia, and anaemia in children attending a tertiary care center. Methods: A retrospective observational study was conducted at Surya Hospital, Pune, including 100 pediatric patients diagnosed with asthma, neonatal septicemia, or anaemia between 2023 and 2025. Data on demographics, clinical features, laboratory findings, and outcomes were collected and analyzed using SPSS version 26. Chi-square test was applied, and p<0.05 was considered statistically significant.

Results: Asthma accounted for 40% of cases, predominantly affecting children aged 6–12 years, presenting with wheeze and cough. Neonatal septicemia constituted 30% of cases, mainly occurring within the first week of life, with lethargy and feeding intolerance as common symptoms. Anaemia (30%) was most frequent in children aged 1–5 years, presenting with pallor and fatigue. A statistically significant association was observed between age group and disease pattern (p<0.001). Conclusion: Distinct clinical patterns exist among these conditions, emphasizing the importance of age-specific diagnostic and management strategies to reduce pediatric morbidity and improve outcomes.

Background: Prosthetic joint infections (PJIs) are among the most serious complications following joint arthroplasty, particularly in the elderly population. Age-related immunosenescence, multiple comorbidities, and increased healthcare exposure contribute to higher susceptibility and poorer outcomes. An updated synthesis of microbiological patterns and clinical outcomes in this group is essential for guiding management. Objective: To evaluate the microbiological profile and clinical outcomes of prosthetic joint infections in elderly patients through a systematic review and meta-analysis. Methods: A systematic search of PubMed, Scopus, Web of Science, and Cochrane Library was conducted for studies published between January 2015 and December 2025. Studies involving patients aged ≥60 years with confirmed PJIs and reporting microbiological data and/or clinical outcomes were included. Data extraction and quality assessment (Newcastle-Ottawa Scale) were performed independently by two reviewers. A random-effects model was used to calculate pooled prevalence and outcomes, with heterogeneity assessed using the I² statistic. Results: A total of 22 studies comprising 4,865 elderly patients were included. Gram-positive organisms accounted for 68% of infections, with Staphylococcus aureus (28%) and coagulase-negative staphylococci (22%) being the most common pathogens. Gram-negative organisms constituted 21%, while polymicrobial infections accounted for 11%. Methicillin-resistant S. aureus (MRSA) prevalence was 14%. The overall treatment success rate was 72%, with treatment failure in 20% and mortality in 8% of cases. Poor outcomes were associated with delayed diagnosis, presence of comorbidities, polymicrobial infections, and antimicrobial resistance. Conclusion: PJIs in the elderly are predominantly caused by Gram-positive bacteria, with a growing contribution from resistant and polymicrobial infections. Despite current treatment strategies, outcomes remain suboptimal. Early diagnosis, targeted antimicrobial therapy, and individualized surgical management are crucial to improving prognosis in this vulnerable population.

Introduction: Polycystic ovarian syndrome (PCOS) is a common endocrine disorder with established metabolic and reproductive implications; however, its effects on neurocognitive function and psychological status remain inadequately explored. Objective: To evaluate neurocognitive and psychological parameters in women with PCOS using both objective neurophysiological measures and subjective assessment tools, and to determine their interrelationship. Methods:

This case-control observational study included 30 women with PCOS and 37 age-matched healthy controls. Anthropometric and physiological parameters were recorded. Psychological status was assessed using State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI). Cognitive function was evaluated subjectively using the Montreal Cognitive Assessment (MoCA) and objectively using electroencephalography (EEG) and visual event-related potentials (VERP-P300). Statistical comparisons between groups were performed. Results: Women with PCOS demonstrated significantly higher body mass index and blood pressure (p<0.05). Anxiety and depression scores were significantly elevated (p<0.001). EEG analysis revealed reduced alpha and beta power with increased theta activity and elevated theta-based ratios (p<0.01). P300 latency was prolonged and amplitude reduced (p<0.001), indicating impaired cognitive processing. MoCA scores were significantly lower in the PCOS group (p<0.001).

 Conclusion: PCOS is associated with significant neurocognitive impairment and psychological distress. Integration of objective and subjective assessments provides comprehensive evaluation, emphasizing the need for routine cognitive and psychological screening in affected women.

Introduction: The increasing prevalence of dementia places a significant burden on caregivers, often family members, who require accurate, reliable, and understandable information to provide quality care. This study evaluates the quality, reliability, readability, and originality of AI-generated responses to common dementia caregiver queries using ChatGPT 4.0 and Google Gemini 2.0 Flash. Methodology: This cross-sectional study, conducted from February 15 to March 15, 2025, involved 10 questions about dementia caregiving. Responses were collected from ChatGPT 4.0 and Google Gemini 2.0 Flash. Two evaluators assessed the replies using the Modified DISCERN scale for reliability, Global Quality Scale (GQS) for quality, and readability metrics (Flesch Reading Ease Score and Flesch-Kincaid Grade Level). Similarity was assessed using Turnitin to measure plagiarism. Statistical analysis included Cohen's Kappa for inter-rater agreement and unpaired t-tests to compare scores. Results: Google Gemini outperformed ChatGPT in reliability but was less original. Both models had similar readability scores, with Flesch-Kincaid Grade Levels above 11. Neither tool met the recommended sixth-grade readability level. GQS scores were slightly higher for ChatGPT, though not statistically significant. Conclusion: While both AI tools provide clinically relevant information, ChatGPT offers greater originality, whereas Google Gemini provides more reliable content. However, neither model achieves optimal readability for dementia caregivers, highlighting the need for improved readability, citation transparency, and hybrid AI models that balance reliability and adaptability for caregiver support.

Background: Proliferative diabetic retinopathy (PDR) is a leading cause of preventable blindness worldwide. Panretinal photocoagulation (PRP) remains the cornerstone of treatment to reduce the risk of severe visual loss. Objective:  To evaluate the visual outcomes following panretinal photocoagulation in patients with proliferative diabetic retinopathy in a tertiary care hospital. Methods: This prospective interventional hospital-based study was conducted at the retina clinic of Nil Ratan Sircar Medical College and Hospital, Kolkata, over 18 months. A total of 110 patients aged >40 years with type 2 diabetes and PDR were included. All patients underwent PRP using a 532 nm frequency-doubled diode laser. Visual acuity was assessed at baseline and at 1 month, 3 months, 6 months, and 1 year post-treatment. Outcomes were analyzed using descriptive statistics. Results:  At baseline, 61.8% of patients had visual acuity between 6/12–6/18. At 1-year follow-up, 48.2% maintained this level, while 38.2% had visual acuity ≤6/24. Vision was maintained in a majority of patients across all baseline categories. Improvement in vision was observed in a subset of patients, particularly those with poorer baseline vision. PRP effectively stabilized disease progression in most patients. Conclusion: Panretinal photocoagulation is effective in stabilizing vision and preventing progression of visual loss in patients with proliferative diabetic retinopathy. Early intervention plays a critical role in preserving visual outcomes.

Introduction: Migraine is a prevalent neurological condition associated with significant impairment in quality of life and cognitive performance. While cognitive disturbances during migraine attacks are well recognized, emerging evidence suggests that deficits in attention, vigilance, and executive functioning may persist during the interictal phase. These impairments may contribute to functional disability, particularly in individuals with chronic migraine.

Objective: To assess interictal dysfunction in attention, vigilance, and executive functions among patients with chronic and episodic migraine, and to evaluate changes in cognitive performance following preventive therapy.

Methods: This prospective longitudinal case–control study was conducted at a tertiary care center from March 2024 to January 2026. A total of 680 individuals were screened, of whom 420 patients diagnosed with migraine (chronic: n = 110; episodic: n = 310) met the eligibility criteria and were included. Additionally, 200 age-, sex-, and education-matched healthy individuals were recruited as controls. Cognitive function was evaluated during the interictal phase using standardized neuropsychological tools, including the Mini-Mental State Examination, Digit Span Test, Trail Making Tests (A and B), and Stroop Test (Word, Color, and Interference). Assessments were conducted at baseline and after six months of preventive therapy. Statistical analysis was performed using independent t-tests, chi-square tests, one-way ANOVA, and repeated-measures ANOVA. Results: At baseline, patients with migraine demonstrated significantly reduced performance across domains of attention, vigilance, and executive function compared with healthy controls (p < 0.001). Cognitive deficits were more pronounced in patients with chronic migraine relative to those with episodic migraine. Following six months of preventive therapy, significant improvements were observed across multiple cognitive parameters, particularly in the episodic migraine group (p < 0.01). However, a proportion of patients with chronic migraine continued to exhibit residual cognitive impairment. Conclusion:

Interictal cognitive dysfunction represents a significant yet underrecognized aspect of migraine, especially in chronic cases. Preventive therapy is associated with meaningful improvement in cognitive performance, highlighting the importance of early diagnosis and sustained management strategies..

Objective: To explore proportion of patients with antinuclear antibody (ANA) and anti-double stranded deoxyribonucleic acid antibody (anti-DsDNA) induction post infliximab infusion and analysis of infliximab prognostic outcome subsequent to autoantibodies induction in patients of Behcet uveitis..Methods: This retrospective study was conducted on 30 patients (27 males and 3 females) including adult and pediatric age group, who were on infliximab (INX) treatment for Behcet uveitis (BU) in King Abdulaziz University Hospital, King Saud University, Riyadh, Saudi Arabia. Prior to infliximab therapy, autoantibodies including antinuclear antibody (ANA) and anti- deoxyribonucleic acid (anti-dsDNA), Fluorescein angiography (FFA), Optical Coherent Tomography (OCT) and fundoscopy were analyzed and treatment response was assessed by eye examination on OCT and fundoscopy only. Prior to INX treatment ANA and anti-dsDNA values were obtained with monitoring of antibody titers in first three cycles of INX infusion and were considered positive above 1:80 and 10 IU/ml respectively. Patients who exhibited uveitis remission signs during 18 months on OCT and fundoscopy after infliximab treatment regimen were labelled as early responders. Subjects who showed recurrence or relapse before 18 months were defined as chronic or delayed responders Results: Treatment with infliximab resulted in more than 86% (26) autoantibodies (ANA and anti-dsDNA) positivity. Out of which positive ANA and dsDNA were 73.1% (19) and 26.9% (7), respectively. Overall, delayed response was observed in 88.5% (23) of positive autoantibodies subjects. Out of these delayed responders, majority (84.2%, n=16) were having ANA induction and all (100%, n=7) were dsDNA induced patients. Early response to treatment was only in 11.5% (3) patients and all belonged to ANA induced patients, while none from dsDNA. Conclusion: The findings underscore the systemic nature of LP and highlight the need for an interdisciplinary approach to its management. Early recognition and treatment of musculoskeletal symptoms may improve patient outcomes and quality of life.

Background: The present study was a hospital-based observational study conducted to evaluate the morphological patterns of anaemia and its correlations with red cell indices in females of reproductive age group. The study population comprised female patients aged 15–49 years, who were diagnosed with anaemia according to WHO criteria and who attended the outpatient and inpatient departments of the institute. Results: Overall, the data emphasize that low MCHC is primarily associated with microcytic hypochromic morphology, normal MCHC is common in normocytic normochromic cells, and high MCHC is predominantly observed in macrocytic cells association between MCHC with Morhphology was found to be statistically significant. Conclusion: The predominance of microcytic hypochromic anaemia in moderate and severe categories further emphasizes the urgent need to address iron deficiency through early detection, dietary modification, and appropriate supplementation.

Background: SSIs have continued to be one of the leading causes of postoperative morbidity in general surgery, especially in resource-constrained settings. The extended time of operation and intraoperative circumstances like blood loss, wound contamination, and inappropriate antibiotic prophylaxis play a significant role in the increase of risks of infection and poor outcomes. Objectives To determine the relationship between operative time, intraoperative variables, and the occurrence of surgical site infections in patients who have undergone general surgical operations. Methodology The prospective study involved 100 patients who were undergoing elective and emergency general surgeries in a tertiary care hospital. Sampling and selection of patients were done consecutively. Demographic data, duration of operation, type of surgery, intraoperative blood loss, antibiotic prophylaxis, and wound classification were noted. The 30-day follow-up of patients after the surgery was provided, and SSIs were determined based on the CDC criteria. SPSS version 25 was used to perform statistical analysis. The continuous variables were presented in the mean and standard deviation, and the chi-square test was used to analyze the categorical variables. A p-value ≤0.05 was considered statistically significant. Results Out of 100 patients, 15% developed surgical site infections (SSIs). Infection rates were significantly higher in surgeries lasting more than 2 hours (22%) compared to ≤2 hours (8%) (p = 0.02). Increased intraoperative blood loss (>500 ml) was associated with higher SSI rates (20% vs. 10%, p = 0.04). Contaminated wounds showed higher infection rates (25%) compared to clean wounds (6%) (p = 0.01). Improper antibiotic prophylaxis was also significantly associated with increased SSI rates. Conclusion The length of operation and unfavorable intraoperative conditions are major factors that lead to a high risk of SSI. Postoperative complications can be decreased by optimizing the surgical practices and infection control measures.

Objective: To compare the fracture resistance and fracture patterns of endodontically treated premolars restored with on lays, endo-crowns, and full-coverage crowns. Materials and methods: Sixty extracted human maxillary premolars of similar dimensions were endodontically treated and randomly divided into three groups (n = 20): Group I—onlay restorations, Group II—endo-crowns, and Group III—full crowns. All restorations were fabricated using lithium disilicate ceramic and adhesively luted. Specimens were subjected to axial compressive loading using a universal testing machine until fracture occurred. Fracture resistance values (N) were recorded and fracture modes were classified as favourable or unfavourable. Statistical analysis was performed using one-way ANOVA and post hoc tests (α = 0.05).. Results: The highest mean fracture resistance was observed in the full crown group, followed by endo-crowns and onlays. Statistically significant differences were noted among the groups (p < 0.05). Favourable fracture patterns were more frequently observed in the onlay and endo-crown groups compared to the full crown group. Conclusion: While full crowns provided the highest fracture resistance, conservative restorations such as endo-crowns and onlays demonstrated acceptable fracture resistance with more favourable failure patterns. These findings support the use of minimally invasive restorations for endodontically treated premolars

Background: Infections following major orthopedic surgeries involving implants remain a significant challenge in clinical practice, contributing to increased patient morbidity, extended hospital stays, repeated surgical interventions, and substantial healthcare costs. Early identification of patients at risk for infection is critical for implementing preventive measures and optimizing ‘treatment strategies.  Aim: To determine the proportion of Surgical site infection with normal and abnormal levels of Albumin, Globulin and AG Ratio. Objectives: To assess the predictive value of serum albumin, globulin, and AG Ratio in determining postoperative infections in adult patients undergoing major orthopedic surgeries involving implants or prosthesis. Method: The study was conducted on adult patients who underwent major orthopedic surgeries involving implants or prosthesis at Assam Medical College and Hospital, Dibrugarh. Serum levels of albumin, globulin and AG Ratio were measured preoperatively to assess its association with surgical site infections. Results: The results revealed that low preoperative albumin levels were strongly associated with a higher risk of postoperative infection, underscoring the role of hypoalbuminemia as an indicator of poor nutritional and immune status. Elevated globulin levels, indicative of systemic inflammation or immune response, also correlated significantly with infection incidence. Additionally, a reduced A/G ratio emerged as a critical marker, with its combination of low albumin and high globulin levels reflecting an imbalanced inflammatory and nutritional state. Patients with a lower A/G ratio experienced a notably higher incidence of surgical site infections.

Conclusion: These findings highlight the potential of albumin, globulin, and the A/G ratio as valuable biomarkers in preoperative risk stratification. Incorporating these markers into routine preoperative assessment protocols may facilitate the early identification of high-risk individuals, enabling targeted nutritional optimization and prophylactic interventions to reduce infection rates. Moreover, these parameters could serve as a basis for future studies to establish standardized thresholds and refine predictive models for infection risk in orthopedic surgical settings. By enhancing the understanding of the role of these biomarkers, this research contributes to the development of more personalized and effective strategies for improving outcomes in patients undergoing major orthopedic surgeries involving implants.

Background: Sensorineural hearing loss (SNHL) is a common auditory disorder with multifactorial etiology. Recent evidence suggests that metabolic factors, particularly dyslipidemia, may contribute to cochlear dysfunction through vascular compromise and oxidative stress. However, the association between lipid abnormalities and hearing loss remains inconclusive. Objective: To evaluate the association between dyslipidemia and sensorineural hearing loss and to assess the relationship between lipid profile parameters and hearing thresholds. Methods: This hospital-based cross-sectional comparative study included 160 adults aged 18–75 years, comprising 80 patients with dyslipidemia and 80 age- and sex-matched controls. All participants underwent pure tone audiometry to assess hearing thresholds at frequencies ranging from 0.5 to 8 kHz. Hearing loss was classified using standard criteria. Fasting lipid parameters, including total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides, were measured. Statistical analysis was performed using SPSS version 26.0, applying independent t-test, chi-square test, and Pearson correlation. Results: Sensorineural hearing loss was significantly more prevalent in the dyslipidemia group compared to controls (52.5% vs 27.5%, p = 0.002). Higher hearing thresholds were observed across all frequencies, with greater differences at higher frequencies (p < 0.001). Lipid parameters showed significant associations with hearing thresholds, particularly LDL (r = 0.48, p < 0.001), while HDL demonstrated a negative correlation. Conclusion: Dyslipidemia is significantly associated with SNHL and may contribute to high-frequency hearing impairment.

Cerebral venous sinus thrombosis (CVST) is a severe disease that is increasingly prevalent with a large range of clinical presentations. The use of oral contraceptive pills (OCPs) is one of the most prevalent causal factors of CVST. We report a case involving a 40-year-old woman who developed CVST after having just started a short course of OCPs to delay her menstrual cycle. The patient presented with a headache, vomiting, and right-sided weakness that was transient. CT angiography showed thrombosis of the right transverse sinus extending to the sigmoid sinus and the internal jugular vein. She was started on anticoagulation therapy and made an excellent recovery.

Background: Age-related hearing loss, or Presbyacusis, is a common condition in the elderly and may be influenced by systemic disorders. Type 2 Diabetes Mellitus has been proposed as a contributing factor due to its microvascular and neuropathic effects. However, the relationship between diabetes and hearing impairment remains uncertain. The present study aimed to determine the prevalence of sensorineural hearing loss among elderly individuals with Type 2 Diabetes Mellitus. Materials and Methods: This cross-sectional comparative study was conducted over a period of 6 months in a tertiary care hospital. A total of 140 participants aged 60 years and above were included, comprising 70 patients with Type 2 Diabetes Mellitus and 70 age-matched non-diabetic controls. All participants underwent detailed clinical evaluation and pure tone audiometry. Only cases with bilateral symmetrical sensorineural hearing loss were considered. Data were analyzed using appropriate statistical tests, and a p-value <0.05 was considered statistically significant. Results: Sensorineural hearing loss was observed in 74.3% of diabetic participants compared to 48.6% of non-diabetics, showing a statistically significant difference (p = 0.002). Diabetic individuals demonstrated higher mean hearing thresholds across all frequencies, with greater involvement at higher frequencies. The severity of hearing loss was also significantly greater in the diabetic group (p = 0.012). An increasing trend in hearing loss was noted with longer duration of diabetes (p = 0.04). Conclusion: Type 2 Diabetes Mellitus is associated with a higher prevalence and increased severity of sensorineural hearing loss in the elderly. Early audiological screening in diabetic patients may aid in timely identification and management of hearing impairment.

Background: Mental health disorders in older adults—particularly depression, anxiety, and cognitive decline—frequently co-occur and worsen outcomes. However, evidence comparing pharmacological, psychological, and lifestyle interventions in this population remains fragmented. Objective: To systematically review and synthesize evidence from randomized controlled trials (RCTs) published between 2015 and 2025 examining interventions for depression, anxiety, or mild cognitive impairment (MCI) in adults aged ≥60 years. Methods: Following PRISMA 2020 guidelines, we searched PubMed, PsycINFO, and Cochrane CENTRAL (January 2015–December 2025). Inclusion criteria: RCTs with ≥50 participants per arm, intervention duration ≥8 weeks, validated outcome measures for depression (e.g., GDS-15, HAM-D), anxiety (GAI, BAI), or cognition (MoCA, MMSE). Two reviewers independently extracted data and assessed risk of bias using the Cochrane RoB 2 tool. Due to heterogeneity, a narrative synthesis was conducted. Results: Of 1,847 screened records, 27 RCTs met inclusion criteria (total N=6,843 participants; mean age 71.2 years, range 60–89; 62% female). Selective serotonin reuptake inhibitors (SSRIs) showed moderate effect sizes for depression (Hedges’ g=0.48, 95% CI 0.35–0.61) but were associated with higher dropout due to adverse events (OR=1.71). Cognitive-behavioral therapy (CBT) adapted for older adults yielded comparable effects (g=0.44) with lower dropout. Multicomponent exercise (aerobic+resistance, ≥3x/week) significantly improved both depressive symptoms (g=0.52) and MoCA scores (+2.1 points on average). Notably, only three trials examined combined pharmacological and psychosocial interventions. Evidence for anxiety-specific interventions was weaker, with only six eligible trials. Conclusion: Exercise and CBT show comparable efficacy to SSRIs for late-life depression with fewer adverse events. Combined interventions remain understudied. Routine anxiety screening and treatment trials are a critical gap.

Introduction: Financial toxicity is a growing issue for cancer patients, especially in low- and middle-income countries where out-of-pocket costs (OOPE) are still high. Older adults are especially at risk because they don't have much money and need more medical care.Objective: To evaluate financial toxicity, out-of-pocket expenses, and their influence on treatment outcomes in geriatric cancer patients in Kashmir.Methods: A prospective observational study was performed involving 120 cancer patients aged ≥60 years at a tertiary care center. A semi-structured questionnaire was used to gather information about socio-demographic traits, clinical profile, and OOPE. The COST-FACIT scale was used to measure financial toxicity. Statistical analysis encompassed non-parametric tests, the chi-square test, Spearman correlation, and regression analysis.Results: Most of the people who took part were from rural areas and had lower incomes. The median OOPE was INR 3.8 lac, and medicines made up the most of it. Moderate financial toxicity was noted in 43.3% of patients, whereas 11.7% exhibited severe toxicity. There was a strong link between lower socioeconomic status and higher financial toxicity (p < 0.001). There was a strong negative correlation (r = -0.62) between the OOPE and COST scores. Financial toxicity had a big impact on treatment outcomes, with patients who were having money problems having higher interruption rates and lower completion rates (p = 0.002).Conclusion: Financial toxicity is very common among older cancer patients, and it has a big effect on how well they stick to their treatment and how well it works. To improve cancer care in places with few resources, it is important to make financial protection mechanisms stronger.

Background:: Pelvic-Ureteric Junction (PUJ) obstruction is a frequent urological pathology associated with anatomical variations in renal vessels in particular accessory renal arteries or early arterial branching. These anatomic variations may culminate in extrinsic compression of the PUJ and poses a major challenge in surgery.Aim: Thus, the objective of this work will be to assess the frequency of the renal vascular anomalies and their implications for the PUJ obstruction surgery.Method: Retrospective cohort study was undertaken on patients with PUJ obstruction diagnosis. Renal vascular anomalies were identified using imaging techniques before the surgery such CT angiography and magnetic resonance angiography. Laparoscopic or open pyeloplasty was performed, and the specific surgical technique used for each patient was modified based on the presence of vascular abnormalities. The comorbidity of HA, symptom improvement, complications in the postoperative period, and further management were assessed according to the presence or absence of VAs.Results: The renal vascular anomalies were detected in 35% of the study population with the most common being an accessory renal artery. Technique-specific success rates indicate that although patients with vascular anomalies took longer to operate on and suffered higher rates of minor complications, procedures such as the vascular hitch, were just as successful as those in patients with no vascular anomalies. Further follow up showed that most of the patients-maintained resolution of symptoms for the long term. Conclusion: Abnormalities of the renal vascular system plays a crucial role in both the morpho physiology of PUJ obstruction and its surgical approach. A thorough preoperative imaging of patient is crucial in diagnosis as well as in the planning for the surgery. It is possible to get positive results by developing individual orientations on such peculiarities. More studies are required to fine-tune the approach on more difficult problem scenarios,

Introduction: Objective:  To study Impact of Psychological Stress on Psoriasis Severity Mirpur  Azad Kashmir ,Pakistan Study Design: cross-sectional study: Place and Duration of Study: This Study Was Conducted at The Department Of   dermatology and   Community   Medicine & Medical Education of MBBS  Medical College,  Mirpur AJK From 1^st  August    2024  To 30^th    Sep    2025.

Methods :  A total of 300 participants aged 18–30 years were included in the study. Both male and female participants were recruited from outpatient departments, educational institutions, and community settings. Data were collected using a structured and pre-tested questionnaire Participants were clinically examined for common skin infections, including: Fungal infections (e.g., dermatophytosis)  .Bacterial infections (e.g., cellulitis, impetigo).Result: A total of 300 participants were included in the study. The mean age was 24.1 ± 3.5 years. Among them, 172 (57.3%) were females and 128 (42.7%) were males. The majority of participants belonged to the 21–25 years age group (48%), followed by 18–20 years (32%) and 26–30 years (20%).. Overall, the study demonstrated that higher BMI is significantly associated with increased prevalence and severity of skin infections, with obesity being the strongest contributing factor.Conclusion:  Individuals with higher BMI, particularly those who are overweight and obese, are more prone to developing skin infections due to impaired immunity and altered skin conditions. Maintaining a healthy BMI may help reduce the risk of skin infections and improve overall health outcomes.

Introduction: Objective:  To study Relationship Between Body Mass Index (BMI) and Skin Infections Kashmir,  Pakistan

Study Design: cross-sectional study: Place and Duration of Study: This Study Was Conducted at The Department Of   dermatology and   Community   Medicine & Medical Education of MBBS  Medical College,  Mirpur AJK From 1^st  April   2024  To 30^th     June     2025.Methods :  A total of 300 participants aged 18–30 years were included in the study. Both male and female participants were recruited from outpatient departments, educational institutions, and community settings. Data were collected using a structured and pre-tested questionnaire Participants were clinically examined for common skin infections, including: Fungal infections (e.g., dermatophytosis)  .Bacterial infections (e.g., cellulitis, impetigo).Result: A total of 300 participants were included in the study. The mean age was 24.1 ± 3.5 years. Among them, 172 (57.3%) were females and 128 (42.7%) were males. The majority of participants belonged to the 21–25 years age group (48%), followed by 18–20 years (32%) and 26–30 years (20%).. Overall, the study demonstrated that higher BMI is significantly associated with increased prevalence and severity of skin infections, with obesity being the strongest contributing factor.Conclusion:  Individuals with higher BMI, particularly those who are overweight and obese, are more prone to developing skin infections due to impaired immunity and altered skin conditions. Maintaining a healthy BMI may help reduce the risk of skin infections and improve overall health outcomes.

Introduction: Objective:  To study Relationship Between Body Mass Index (BMI) and Skin Infections Kashmir,  Pakistan

Study Design: cross-sectional study: Place and Duration of Study: This Study Was Conducted at The Department Of   dermatology and   Community   Medicine & Medical Education of MBBS  Medical College,  Mirpur AJK From 1^st  April   2024  To 30^th     June     2025.Methods :  A total of 300 participants aged 18–30 years were included in the study. Both male and female participants were recruited from outpatient departments, educational institutions, and community settings. Data were collected using a structured and pre-tested questionnaire Participants were clinically examined for common skin infections, including: Fungal infections (e.g., dermatophytosis)  .Bacterial infections (e.g., cellulitis, impetigo).Result: A total of 300 participants were included in the study. The mean age was 24.1 ± 3.5 years. Among them, 172 (57.3%) were females and 128 (42.7%) were males. The majority of participants belonged to the 21–25 years age group (48%), followed by 18–20 years (32%) and 26–30 years (20%).. Overall, the study demonstrated that higher BMI is significantly associated with increased prevalence and severity of skin infections, with obesity being the strongest contributing factor.Conclusion:  Individuals with higher BMI, particularly those who are overweight and obese, are more prone to developing skin infections due to impaired immunity and altered skin conditions. Maintaining a healthy BMI may help reduce the risk of skin infections and improve overall health outcomes.

Introduction: Objective: To study Association Between Dietary Habits and Acne Severity Among Young Adults , Pakistan   Study Design: cross-sectional study: Place and Duration of Study: This Study Was Conducted at The Department Of   dermatology and   Community   Medicine & Medical Education of MBBS  Medical College, Mirpur AJK From 1st March   2024  To 30th     February    2025. Methods :  A total of 300 participants were included in the study. The sample size was determined based on previous similar studies and feasibility. A non-probability convenience sampling technique was used to recruit participants who met the inclusion criteria. Acne severity was evaluated using the Global Acne Grading System (GAGS). Result: The mean age of participants was 23.4 ± 3.2 years. Among them, 172 (57.3%) were females and 128 (42.7%) were males. The majority of participants belonged to the age group 21–25 years (48%), followed by 18–20 years (32%) and 26–30 years (20%). Based on the Global Acne Grading System (GAGS), acne severity among participants was categorized as follows:Mild acne: 102 (34.0%) ,Moderate acne: 118 (39.3%) ,Severe acne: 60 (20.0%) ,Very severe acne: 20 (6.7%) Conclusion: The present study concludes that there is a significant association between dietary habits and acne severity among young adults. High consumption of high glycemic index foods, dairy products, and fast food is associated with increased severity of acne, whereas regular intake of fruits and vegetables appears to have a protective effect

Background: During otorhinolaryngology practice, Laryngopharyngeal Reflux Disease (LPRD) is common. It happens when stomach acid flows backward and it reaches the larynx as well as pharynx. The diagnosis is more challenging because of the many symptoms related to voice and nonspecific throat. Clinicians have to depends on symptoms to start the treatment based on the assumption because there is no perfect test to identify the condition. There are two mostly used as first treatment Proton pump inhibitors (PPIs), along with lifestyle modifications. The patient's outcome may differ based on the treatment. Methods: A retrospective observational study was done at the Department of ENT at PMCH. From February 2025 to December 2025, a total of 40 patients medical records were clinically diagnosed with LPRD and were reviewed. Demographic profile, clinical presentation, laryngoscopic results, treatment protocols, and follow-up outcomes data are analysed. Based on the symptom improvement and laryngoscopic findings treatment response was assessed. Results: Throat clearing, globus sensation, and hoarseness of voice are the major symptoms observed in the patients. Laryngeal erythema, posterior commissure hypertrophy, and vocal cord edema are identified through the Laryngoscopic examination. A complete or partial symptom improvement was observed in 75% of the people. Clinical results are better for the patients treated with combined PPI therapy and lifestyle modification related to those getting PPI monotherapy.

Conclusion: Diagnostic and therapeutic challenges arise with LPRD, a prevalent ENT condition. Therapy, lifestyle changes, and proton pump inhibitors help reduce symptoms. Early diagnosis and careful treatment improve patient outcomes.

Introduction: To assess the role of hysteroscopy in perimenopausal bleeding. Place & duration of study; Services hospital Lahore from February 1^st 2024 to January 31^st 2025. Methodology: Total 250 patients of peri menopausal age 45 years to 53 years, presented with abnormal uterine bleeding were included in the study. After initial evaluation, baseline investigations and pelvic ultrasound, all patients had hysteroscopy as day care procedure. Hysteroscopic directed endometrial biopsy, endometrial curettage and polypectomy was done based on preoperative evaluation and findings during hysteroscopy. Histopathological reporting of samples from endometrial cavity was done in all cases. Results: Out of 250 cases, 32 cases had normal uterine cavity and endometrium, 145 cases had endometrial hyperplasia, 64 cases had polyp while 9 cases were diagnosed as endometrial carcinoma. Conclusion: Hysteroscopy is important for evaluation & treatment of perimenopausal bleeding.

Background: Community and social participation represent the major parameters for assessment of the adequacy of rehabilitation and management of the subjects affected with the injury of the spinal cord. However, existing literature data remains scarce in Indian context. Aim: The present study was aimed to assess the factors affecting the community and social participation of subjects with spinal cord injury in India. Methods: The study assessed 55 Indian subjects with spinal cord injury that participated in the community settings. All the subjects were assessed using WHO Disability Assessment Schedule 2.0 (WHODAS), Craig Handicap Assessment and Reporting Technique (CHART), and Spinal Cord Independence Measure Version III self reporting (SCIM III SR) for assessment of the clinical outcomes. The data gathered were statistically analyzed to assess and identify association and factors that govern the community participation in Indian subjects with spinal cord injury. Results: The study results showed that a positive correlation was seen in CHART physical independence and SCIM mobility and SCIM self-care with r- values of 0.422 and 0.424 respectively. A weak correlation was seen in CHART cognitive independence and CHART mobility with WHODAS with respective r- values of -0.36 and -0.374. The determinants for CHART cognitive independence were SCIM mobility and SCIM self-care with r- value of 0.32. CHART mobility was majorly governed by SCIM self care and SCIM sphincter and respiratory management with r- value of 0.315. Conclusion: The present study concludes that mobility and self-care in subjects with spinal cord injury helps in determination of their ability for successful reintegration of them into the community which warrants a need for comprehensive program for rehabilitation of the community.

Background: The prevalence and perception of skin conditions have increased over the decades, highlighting significant changes in dermatological morbidity. Quantifying these trends and their underlying causes provides an opportunity to address cutaneous disorders, identify relevant risk factors, and allocate resources more effectively. This eight-year retrospective study examines the evolving patterns of dermatological morbidity at a tertiary care center in Delhi, North India. The insights gained may inform health policy decisions and guide resource distribution. Methods: Data on patient diagnoses and profiles were collected from the servers of a tertiary care center in New Delhi using Excel spreadsheets.

Results: The findings indicate an increase in dermatological consultations for various non-communicable diseases, alongside a modest decrease in infectious dermatoses. There is a clear shift from infectious to non-infectious dermatoses during the study period. Melasma/facial melanosis show an increase in attendance from 8,160 visits (7% of total) in 2017 to 13,342 (15% of total) in 2024. In contrast, fungal infections demonstrated a marked decline in reported cases and treatments, from 36,184 cases in 2017 to 11,155 cases in 2024. These trends reflect changing social, psychological, and environmental factors in a developing economy. Conclusion: The study demonstrates a shift in the prevalence of dermatoses from infectious to non-communicable diseases, as well as a changing perspective on dermatological disorders. A new frameworkis needed for allocating time, manpower, and resources to address these evolving trends.

Diabetes Mellitus (DM) is a major health issue associated with persistent hyperglycemia and related long-term complications. Achieving optimal glycemic control is crucial to prevent microvascular and macrovascular complications. A considerable proportion of patients do not achieve the recommended glycemic targets, especially in resource- limited settings. Glycemic control patterns and associated risk factors in Bihar are inadequately available. Methods: A retrospective observational study was conducted at Patna Medical College and Hospital (PMCH), from February 2025 to December 2025. A total of 109 patient records meeting inclusion criteria were reviewed. Data on demographics, clinical and laboratory parameters, treatment as well as co-morbidities were collected from Electronic Medical Records (EMR). Glycemic control was categorized based on HbA1c levels according to guidelines of the American Diabetes Association (AMA). For statistical analysis, descriptive statistics, chi-square test, independent t-test and multivariate logistic regression were used with p < 0.05 was considered as a significant difference. Results: Among 109 patients, poor glycemic control (HbA1c ≥7%) was observed in 65.1% against the good control seen in 34.9%. The other factors were found to be significantly associated with poor glycemic control included longer duration of diabetes, higher BMI, older age of participants, insulin or combination therapy, and presence of hypertension. Duration of diabetes greater than 10 years was the strongest independent predictor per multivariate logistic regression. Conclusion: Poor glycemic control was highly very common in this tertiary care population. Comprehensive and structured diabetes management programs, including targeted interventions for high-risk groups, may help improve outcomes, reduce complications.

Background: A Cardiovascular disease (CVD) is a leading cause of death worldwide and is a major public health challenge in India. Atherosclerosis is caused and exacerbated by many modifiable risk factors, one of the most important of which is dyslipidemia. Lipid-lowering therapy (LLT), especially statins, is key in secondary prevention. There is a shortage of real-world data on the prescribing patterns and lipid target achievement in Eastern India. Methods: In this retrospective observational study, 118 adult patients with cardiovascular disease on LLT underwent testing from March 2025 to November 2025. Data were extracted for demographics, comorbidities, baseline and follow-up lipid profiles, type and intensity of therapy prescribed, and adverse events directly from medical records. Statistical analysis was performed using SPSS software, and paired t tests were used to compare baseline and follow-up lipid parameters. Statistical significance was defined as a p-value <0.05. Results: The mean age was 58.6 ± 10.8 years, and males comprised 64.4% of the cohort. 57.6% were on high-intensity statins; 32.2%, moderate-intensity statins; and 10.2% on combination therapy and the most frequently used agent was atorvastatin. Low-density lipoprotein cholesterol (LDL-C) values decrease significantly from 142.4 ± 28.6 mg/dL to 86.7 ± 22.4 mg/dL at follow-up (p < 0.001). Of the patients, 61% reached the LDL target of <70 mg/dL. The most frequent adverse effect was myalgia (10.2%), and 3.4% of patients had to stop the drug. Conclusion: Despite moderate adherence to guidelines-recommended limits, LLT at this tertiary care facility resulted in marked improvement in lipid parameters. Improving structured follow-up and therapy escalation strategies might further enhance this cardiovascular risk reduction.

Background: Ischemic stroke is a leading cause of death and long-term disability worldwide. Hyperhomocysteinemia has emerged as a potential independent risk factor for stroke, but its correlation in the local population of Jodhpur requires further study. Aim: To evaluate and compare serum homocysteine levels between patients with ischemic stroke and healthy controls, and to analyze the detailed clinical, radiological, and biochemical profile of stroke patients. Materials and Methods: A hospital-based case-control study was conducted in the Department of Medicine, Vyas Medical College, Jodhpur involving 100 subjects. Group 1 (Control) comprised 50 age- and sex-matched healthy individuals. Group 2 (Case) comprised 50 patients with a first-ever ischemic stroke, confirmed by history, clinical examination, and neuroimaging (CT/MRI). Detailed clinical, biochemical, radiological, and electrocardiographic data were recorded. Fasting serum homocysteine levels were measured using chemiluminescence immunoassay. Statistical analysis was performed using SPSS, with p < 0.05 considered significant. Results: The mean age of cases was 59.5 ± 11.2 years, with a male predominance (70%). Hypertension (64%) was the most common risk factor, followed by diabetes mellitus (40%). The majority of patients (44%) had 2-3 risk factors. Limb weakness (94%) was the most common presenting symptom, and hemiplegia (76%) was the predominant sign. The mean serum homocysteine level in cases (18.45 ± 5.2 µmol/L) was significantly higher than in controls (10.25 ± 3.1 µmol/L) (p < 0.001). The highest homocysteine levels were observed in the 61-70 years age group. Conclusion: This study demonstrates a strong correlation between elevated homocysteine levels and ischemic stroke. Hyperhomocysteinemia, along with traditional risk factors like hypertension, contributes significantly to stroke burden. Routine homocysteine screening is recommended for comprehensive stroke risk assessment.

Background: The incidence of osteosclerosis is lesser in black and yellow subjects in comparison to the whites across the globe. Surgical indications and preoperative diagnosis are dependent on the audiological assessment and clinical features. Aim: The present study was aimed to analyze the clinical features and audiological characteristics of subjects with osteosclerosis in India aimed to improve diagnosis and determine surgery to reduce incidence. Methods: The study assessed 160 ears in 96 subjects that underwent surgery for osteosclerosis at the Institute within the defined study period. All the subjects were assessed for various signs and symptoms of osteosclerosis and were recorded in a preformed proforma designed for the study. Results: The study results showed that in 89%, the symptom of tinnitus was positive. Schwarz sign was absent in all the study subjects, Willis paracusis, sign was seen in 2.5% study subjects, and negative Gellé test was seen in 99% study subjects. Also, in 31% of the study subjects, Carhart notch was not seen, whereas, 5% subjects had Carhart notch at 1 kHz and 64% subjects had Carhart notch at 2 kHz respectively. Conclusion: The study results showed that tinnitus is the main symptom associated with osteosclerosis. There were relatively rare signs of Schwarz sign and Willis Paracusis sign seen in osteosclerosis. The Gellé test is a reliable criteria and test to diagnose osteosclerosis. The presence of Carhart notch is not definitive for diagnosis of osteosclerosis and is not exclusively seen at 2 kHz.

Background: Lip prints and finger prints are vital parts in an individual to identify the individual concerning both criminal and civil cases owing to the uniqueness seen in their finger and lip prints. However, literature studies are scarce in this context.  Aim: The present study was aimed to assess and identify any existing corelation between finger and lip prints concerning the gender distribution. The study also assessed the distribution of various patterns of both lip and finger prints in Indian subjects. Methods: The study assessed 400 subjects in the age range of 18 to 25 years. For all the subjects, impressions were made using lip prints and ink stamp pad which was pasted on the cellophane tape and filter paper. Any relation between finger prints and lip prints was assessed using appropriate statistical tests. Results: For distribution of lip print pattern in study subjects, they were vertical in 34% (n=136) subjects followed by reticular and branched pattern in 17.5% (n=70) subjects, intersectional in 16.5% (n=66) subjects, and undetermined in 14.5% (n=58) study subjects respectively. Whorl arch and loop was seen in 25.8% (n=16), 12.9% (n=8), and 61.3% (n=38) subjects on left index finger and in 32.3% (n=20), 16.1% (n=10), and 51.6% (n=32) males on right index finger. In females, whorl, arch, and loop was seen in 23.1% (n=78), 21.3% (n=72), and 55.6% (n=188) females on right and 29% (n=98), 18.35 (n=62), and 52.7% (n=178) females on left index finger. Conclusion: The present study, within its limitations, concludes that forensic science is related with the dental evidence where their roles are to interpret, preserve, and collect the trace evidence and to relate to the judicial system as the report. Lip print type and pattern has potential promise as a supplementary help for identification of the gender. However, no association is seen between gender and fingerprints.