Indian Journal of Pharmaceutical and Biological Research

Reproductive Risk Factors and Their Association with Breast Cancer in Women of Central India

2026-07-24T12:15:18+00:00

Background: Breast cancer is the most common malignancy among women worldwide and represents a major public health challenge in India. Reproductive factors influence cumulative estrogen exposure and may significantly affect breast cancer risk. Understanding these associations is important for identifying high-risk women and developing preventive strategies.
Aim: To evaluate reproductive risk factors and their association with breast cancer among women attending a tertiary care center in Central India.
Methods: A prospective observational study was conducted at Bundelkhand Medical College, Sagar, over 18 months. A total of 170 women were enrolled, including 85 histopathologically confirmed breast cancer cases and 85 age-matched controls without breast malignancy. Data regarding age at menarche, age at first childbirth, parity, breastfeeding duration, menopausal status, age at menopause, and family history were collected and analyzed.
Results: Early menarche (<12 years), late age at first childbirth (>30 years), nulliparity, shorter duration of breastfeeding (<12 months), and late menopause (>50 years) were significantly associated with breast cancer (p<0.05). Women with a family history of breast cancer had a significantly higher risk of disease (OR=3.2, p=0.002). Multivariate analysis identified late age at first childbirth and short breastfeeding duration as independent predictors of breast cancer.
Conclusion: Several reproductive factors are significantly associated with breast cancer risk among women in Central India. Promotion of breastfeeding and identification of women with adverse reproductive profiles may facilitate early screening and risk reduction strategies.

A Study of Time Domain Parameters of Heart Rate Variability in Females in the Latent Phase of Labor and Postpartum Period in a Tertiary Care Centre of Central India

2026-07-17T08:07:37+00:00

Background: Pregnancy and labor are associated with significant autonomic nervous system adaptations that facilitate maternal and
fetal well-being. Heart rate variability (HRV) is a non-invasive marker of autonomic regulation and provides valuable insights into
sympathetic and parasympathetic balance. However, changes in time-domain HRV parameters during the latent phase of labor and
the immediate postpartum period remain inadequately characterized.
Aim: To evaluate and compare time-domain parameters of heart rate variability in females during the latent phase of labor and the
postpartum period.
Methods: This observational study was conducted at Bundelkhand Medical College, Sagar, over a period of three months. A total of
100 healthy term pregnant women in the latent phase of labor were enrolled. HRV recordings were obtained during the latent phase
and repeated 48 hours postpartum. Time-domain parameters including mean RR interval, SDNN, RMSSD, NN50, and pNN50 were
analyzed and compared.
Results: Significant increases in SDNN, RMSSD, NN50, and pNN50 were observed during the postpartum period compared with
the latent phase of labor (p<0.001). Mean heart rate decreased significantly postpartum, indicating restoration of parasympathetic
activity. The findings suggest a shift from sympathetic predominance during labor to improved autonomic balance following delivery.
Conclusion: The postpartum period is associated with significant improvement in HRV parameters, reflecting recovery of autonomic
function after labor. Time-domain HRV analysis may serve as a useful tool for assessing maternal autonomic adaptations during the
peripartum period.

The Food–Mood Connection: Exploring the Bidirectional Relationship Between Nutrition and Mental Health

2026-07-29T12:12:09+00:00

Mental health disorders, particularly depression and anxiety, have become major public health concerns worldwide, increasing the need for effective and accessible preventive strategies. Among the various lifestyle factors that influence psychological well-being, diet has gained considerable attention because it is both modifiable and closely linked to brain function. This review examines the food–mood connection, highlighting the dynamic and reciprocal relationship between dietary habits and emotional health. While emotions can influence appetite, food preferences, and eating behaviour, the foods people consume also affect mood through a range of biological and psychological mechanisms. The review discusses the influence of food colour, nostalgic food experiences, cultural dietary patterns, and food cravings on emotional well-being and food choices. It also explores the biological pathways that underpin this relationship, including the gut–brain axis, neurotransmitter regulation, chronic low-grade inflammation, and the role of essential nutrients in maintaining normal brain function. Current evidence indicates that dietary patterns rich in fruits, vegetables, whole grains, legumes, fermented foods, and healthy fats support gut microbial balance, reduce inflammation, and promote positive mental health. In contrast, frequent consumption of ultra-processed foods has been associated with impaired gut health and an increased risk of mood disorders. Overall, the available evidence suggests that nutrition should be recognised as an important component of mental health promotion, with healthy dietary practices serving as a practical and cost-effective complement to conventional approaches for improving emotional well-being.

Ocular Manifestations in Patients with Chronic Obstructive Pulmonary Disease Attending a Tertiary Care Centre

2026-07-24T12:18:42+00:00

Background: Chronic Obstructive Pulmonary Disease (COPD) is a progressive inflammatory airway disorder associated with significant systemic manifestations. Chronic hypoxia, smoking, oxidative stress, and vascular abnormalities in COPD can affect ocular structures and lead to various ophthalmic complications. Early identification of ocular manifestations in COPD patients is important to prevent visual morbidity and improve quality of life.
Aim: To evaluate the ocular manifestations in patients with Chronic Obstructive Pulmonary Disease attending a tertiary care centre.
Materials and Methods: A retrospective observational study was conducted at Government Medical College and Hospital, Purnea, Bihar, India, from April 2025 to March 2026 among 110 diagnosed COPD patients. Detailed ophthalmological examination records including visual acuity, slit-lamp examination, intraocular pressure measurement, and fundoscopy were reviewed. Data regarding demographic characteristics, smoking history, severity of COPD, and ocular manifestations were analyzed. Statistical analysis was performed using SPSS version 26.0. A p-value <0.05 was considered statistically significant.
Results: The majority of patients belonged to the age group of 51–60 years (38.2%). Male predominance was observed (72.7%). Cataract (40.9%) was the most common ocular manifestation followed by dry eye disease (30.0%), hypertensive retinopathy (18.2%), glaucoma (12.7%), and diabetic retinopathy (10.9%). Dry eye disease was significantly associated with smoking history and severe COPD (p<0.05). Increased intraocular pressure was observed in patients receiving prolonged corticosteroid therapy (p=0.021).
Conclusion: Ocular manifestations are common among COPD patients, with cataract and dry eye disease being the predominant findings. Regular ophthalmic screening in COPD patients is essential for early diagnosis and management of vision-threatening complications.

Role of High Sensitivity CRP as an Early Biomarker of Subclinical Inflammation in Metabolic Syndrome

2026-07-24T12:10:55+00:00

Background: Metabolic syndrome (MetS) is a major public health concern characterized by central obesity, insulin resistance, dyslipidemia, and hypertension. Chronic low-grade inflammation has been recognized as a central mechanism underlying the pathogenesis of MetS. High sensitivity C-reactive protein (hs-CRP) is an established inflammatory biomarker that may help in early detection of subclinical inflammation and cardiovascular risk.
Aim: To evaluate the role of hs-CRP as an early biomarker of subclinical inflammation in metabolic syndrome.
Materials and Methods: This hospital-based observational cross-sectional study was conducted at Jawaharlal Nehru Medical College, Bhagalpur, Bihar, from 2024–2026 among 180 participants. Ninety diagnosed cases of metabolic syndrome and ninety healthy controls were included. Anthropometric measurements, blood pressure, fasting blood glucose, lipid profile, and hs-CRP levels were assessed. Statistical analysis was performed using SPSS version 26.0. Student’s t-test, chi-square test, Pearson correlation analysis, and multivariate regression were used. A p-value <0.05 was considered statistically significant.
Results: Mean hs-CRP levels were significantly elevated among MetS patients (5.92 ± 2.14 mg/L) compared to controls (1.48 ± 0.76 mg/L) (p<0.001). hs-CRP showed positive correlation with BMI (r=0.58), waist circumference (r=0.61), fasting blood glucose (r=0.52), triglycerides (r=0.49), and systolic blood pressure (r=0.46). hs-CRP levels progressively increased with increasing number of metabolic syndrome components.
Conclusion: hs-CRP is significantly elevated in metabolic syndrome and strongly correlates with various metabolic risk factors, suggesting its role as an early biomarker of subclinical inflammation and cardiovascular risk assessment.

Comparative Efficacy and Safety of Ketamine-Dexmedetomidine (Ketodex) Versus Ketamine-Propofol (Ketofol) for Procedural Sedation in Pediatric Patients

2026-06-18T08:21:05+00:00

Background: Pediatric procedural sedation requires safe, effective agents to ensure patient comfort while maintaining physiological stability. Combinations such as ketamine-dexmedetomidine (Ketodex) and ketamine-propofol (Ketofol) are increasingly utilized to balance the desirable effects of each component while mitigating their respective side effects.
Objective: This review aims to compare the safety and efficacy of Ketodex and Ketofol for procedural sedation in children aged 0–12 years.
Methods: A narrative synthesis of available clinical evidence, including meta-analyses and randomized controlled trials, was conducted to evaluate respiratory safety, hemodynamic stability, and recovery profiles.
Results: Comparative analysis demonstrates that Ketodex is associated with a significantly lower risk of respiratory depression, making it a safer option for patients with anticipated airway challenges. Conversely, Ketofol is consistently associated with a shorter recovery and discharge time, providing an advantage in fast-track surgical or procedural settings. Both combinations demonstrate similar hemodynamic stability, clinician satisfaction, and incidence of common adverse events such as nausea or vomiting.
Conclusion: The choice between Ketodex and Ketofol should be personalized based on the clinical priority, with Ketodex favored when respiratory safety is paramount and Ketofol preferred when rapid recovery and discharge are the primary objectives.

A Hospital-Based Study to Estimate the Prevalence of Dry Eye and Factors Attributed to IT

2026-06-20T09:47:22+00:00

Background: Dry eye disease (DED) is a multifactorial disorder affecting the ocular surface and tear film, leading to discomfort, visual disturbance, and reduced quality of life.
Aim: To estimate the prevalence of dry eye and identify associated risk factors among patients attending a tertiary care hospital.
Methods: A cross-sectional study was conducted in the Department of Ophthalmology, Government Medical College, Pali, over one year (2025). A total of 300 patients aged ≥18 years were included. Dry eye was diagnosed using a combination of McMonnies and HO dry eye questionnaire, Schirmer’s test, and Tear Film Break-Up Time (TBUT). Statistical analysis included chi-square test and logistic regression.
Results: The prevalence of dry eye was 16.3% (49/300). Females had higher prevalence (22.5%) compared to males (11.1%) (p=0.018). Increasing age, outdoor occupation, and environmental exposure were significantly associated (p<0.05). Mean Schirmer’s value in dry eye patients was 7.2 ± 2.1 mm, and mean TBUT was 7.8 ± 1.9 seconds.
Conclusion: Dry eye is a common yet under-recognized condition. Early detection and modification of risk factors can reduce disease burden.

Platelet-Rich Plasma (PRP) Augmentation in Arthroscopic Knee Meniscal Repair

2026-06-20T09:55:22+00:00

Background: Meniscal injuries are among the most common orthopaedic issues, especially in young, physically active people. The meniscus is essential for load transfer, stress absorption, joint stability, and knee joint lubrication. However, its inherent healing capacity is limited, particularly in the inner avascular zones, resulting in unsatisfactory outcomes after restoration. In recent years, biological augmentation treatments such as platelet-rich plasma (PRP) have gained popularity due to their capacity to improve tissue recovery. PRP includes a high concentration of growth factors that increase cellular proliferation, angiogenesis, and extracellular matrix synthesis, which may improve meniscus repair outcomes.
Objective: To determine the efficacy of PRP augmentation in improving healing rates, lowering discomfort, and improving functional results in patients following arthroscopic meniscal repair.
Methods: A prospective observational study was undertaken over 11 months, with 50 patients undergoing arthroscopic meniscal repair. Patients were separated into two groups: the PRP group (n=25), who got PRP augmentation during surgery, and the control group (n=25), who had routine repair without PRP. Meniscal healing was clinically and radiologically evaluated, pain was measured using the Visual Analogue Scale (VAS), and functional ability was assessed using the Lysholm knee score method. Statistical analysis was conducted using suitable comparative tests, with a p-value <0.05 indicating statistical significance.
Results: The PRP group showed considerably greater healing rates than the control group (82% vs 62%, p<0.05). Furthermore, patients who received PRP reported reduced postoperative pain levels and improved functional results, as evidenced by higher Lysholm scores. These findings imply that PRP promotes biological healing and improves clinical recovery.
Conclusion: PRP augmentation in arthroscopic meniscal repair increases healing rates, decreases postoperative pain, and improves functional outcomes. It is a promising supplementary therapy in meniscus preservation techniques, with the potential to improve patient recovery and long-term joint health.

Clinical Profile and Hormonal Patterns in Women with Newly Diagnosed PCOD Attending a Tertiary Care Hospital

2026-06-20T09:59:19+00:00

Background: Polycystic ovarian disease is an endocrine condition of hormonal imbalance, irregular menstrual periods, and high androgen levels and is the most common endocrine disease in women of reproductive age. It commonly presents with metabolic derangements such as insulin resistance, obesity and dyslipidaemia, which may cause infertility and raise the risk of diabetes and cardiovascular disease in the long run.
Objective: To evaluate the clinical profile and hormonal patterns in newly diagnosed PCOD patients.
Methods: This cross-sectional study was conducted at PMCH, Patna, from September 2025 to February 2026, including 200 women diagnosed with PCOD. Clinical features, BMI, and hormonal parameters (LH, FSH, testosterone, prolactin) were assessed. Statistical analysis included chi-square test and t-test, with p<0.05 considered significant.
Results: The majority of patients were either overweight or obese (70%). The most prevalent symptom was irregular menstruation (70%). Increased LH levels were detected in 65% of patients and increased testosterone levels in 55% of individuals. BMI was significantly associated with hormonal imbalance (P<0.05).
Conclusion: PCOD is strongly associated with obesity and hormonal disturbances. Early diagnosis and lifestyle modification are crucial for management.

Morphological Variation in Lumbricals of Hand

2026-06-20T12:02:45+00:00

Background: The lumbrical muscles of the hand are unique intrinsic muscles responsible for coordinated finger movements and fine motor functions. Variations in their morphology, origin, insertion, and innervation may influence hand biomechanics and surgical outcomes.
Aim: To analyze the morphological variations of lumbrical muscles of the hand in terms of number, origin, insertion, and morphometry.
Materials and Methods: This cross-sectional cadaveric observational study was conducted in the Department of Anatomy, Jawaharlal Nehru Medical College, Bhagalpur, from 2023–2026. Forty hands obtained from 20 formalin-fixed adult cadavers were dissected. Morphological parameters including number of lumbricals, origin, insertion, muscle belly length, tendon length, and variations were documented. Measurements were taken using digital Vernier calipers. Statistical analysis was performed using Microsoft Excel and descriptive statistics.
Results: All four lumbricals were present in 80% of hands, while 12.5% showed only three lumbricals and 7.5% demonstrated supernumerary lumbricals. The first and second lumbricals were predominantly unipennate, whereas the third and fourth lumbricals were mainly bipennate. Accessory insertions and bifid insertions were observed in a few specimens. The mean muscle belly lengths of the first, second, third, and fourth lumbricals were 3.5 ± 0.5 cm, 3.3 ± 0.6 cm, 3.0 ± 0.5 cm, and 2.8 ± 0.5 cm respectively.
Conclusion: Considerable morphological variations exist in the lumbrical muscles of the hand. Awareness of these variations is important for anatomists, hand surgeons, and clinicians during surgical procedures, diagnosis of entrapment neuropathies, and rehabilitation.

Exploring the Link Between Hematological Disorders and Autoimmune Thyroid Diseases

2026-06-20T13:12:27+00:00

Background: Autoimmune thyroid disorders (AITDs), which include hypothyroidism and hyperthyroidism, are frequently accompanied with hematological abnormalities like anemia, leukopenia, and thrombocytopenia. Understanding this link is critical for early diagnosis and management.
Methods: This retrospective analysis comprised 100 patients diagnosed with autoimmune thyroid disease over the course of a year. Hematological markers were examined and linked with thyroid function. The Student’s t-test and the Chi-square test were used in the statistical analysis.
Results: Hematological abnormalities were seen in 62% of individuals. The most prevalent observation was anemia (40%), followed by leukopenia (15%), and thrombocytopenia (7%). A strong link was discovered between hypothyroidism and anemia (p=0.01). Patients with hematological disorders had considerably different thyroid profiles.
Conclusion: Autoimmune thyroid illnesses are strongly associated with hematological problems, particularly anemia. Routine hematological examination is advised in patients with thyroid dysfunction for early diagnosis and therapy.

Histopathological Spectrum of Prostatic Lesions and Correlation with Total Serum Prostate-Specific Antigen: A Prospective Observational Study

2026-06-20T13:17:00+00:00

Background: Prostatic lesions range from benign hyperplasia to malignant lesions, with serum prostate-specific antigen (PSA) serving as an important biomarker for screening and disease monitoring. However, PSA levels often overlap between benign and malignant conditions, making histopathological confirmation essential.
Objective: To evaluate the histopathological spectrum of prostatic lesions and correlate findings with serum PSA levels.
Methods: This prospective observational study was conducted at DMCH from February 2025 to October 2025, including 90 patients presenting with lower urinary tract symptoms. Serum PSA levels were measured, and histopathological examination was performed on biopsy or resection specimens. Statistical correlation between PSA levels and histological diagnoses were analyzed.
Results: Benign prostatic hyperplasia (BPH) was the most common lesion (62.2%), followed by prostatitis (15.6%), carcinoma (16.7%), and prostatic intraepithelial neoplasia (PIN) (5.5%). Mean PSA levels were significantly higher in malignant lesions (36.8 ± 12.4 ng/mL) compared to benign conditions (6.2 ± 3.1 ng/mL) (p < 0.001). A strong positive correlation was observed between elevated PSA levels and malignancy.
Conclusion: PSA is a useful screening tool but lacks specificity. Histopathological examination remains the gold standard for diagnosis. Combined evaluation improves diagnostic accuracy.

Surgical Site Infections in Digestive Surgery: A Meta-Analysis of Hospitals in BBMCH BALANGIR

2026-06-27T11:24:14+00:00

Objective: To study the characteristics of surgical site infections (SSI) in digestive surgery in BBMCH BALANGIR.
Patients and Methods: This was an analytical, crosssectional, and multicenter study conducted from March 1 to September 30, 2024, in the digestive surgery departments of GENERALSURGERY the BBMCH BALANGIR. All hospitalized patients aged at least 18 years who underwent abdominal surgery were included in the study. Patients were followed up within 30 days of surgery.M
Results: During the study period, 493 patients were included, 73 cases of SSI were recorded, representing a frequency of 14.8%. Was the center with the most cases of SSI were found in the university hospital (58 patients or 79.4%). The median age was 41 years. Male sex was predominant with a sex-ratio of 1.35. Among the SSIs, 74% were superficial; 20.5% deep and 5.5% organ. Acute generalized peritonitis was the most common pathology of infected patients (60.3%). Of the 73 samples analyzed, 70 cultures were positive, representing 95.8%. Escherichia coli were the most identified microorganism (36.5%), followed by non-coagulase Staphylococcus (15%) and Klebsiella pneumoniae (12.2%). Multivariate analysis showed that SSI was statistically associated with ASA score, operative mode, and NNISS score.
Conclusion: SSIs represent a major public health problem. Prevention relies on rigorous epidemiological surveillance and compliance with good perioperative hygiene practices.

Aerobic Bacteriological Isolates of Burn Wound Infections and Their Antimicrobial Sensitivity Pattern in the Burn Unit of a Tertiary Care Hospital in Bihar: A Prospective Observational Study

2026-06-30T07:36:18+00:00

Background: Burn wound infections are among the leading causes of morbidity and mortality in burn patients due to loss of skin barrier, immunosuppression, prolonged hospitalization, and emergence of antimicrobial-resistant organisms. Continuous monitoring of the bacteriological profile and antimicrobial susceptibility pattern is essential for effective management of burn wound infections.
Aim: To study the aerobic bacteriological isolates of burn wound infections and evaluate their antimicrobial sensitivity pattern among patients admitted to the Burn Unit of Patna Medical College & Hospital (PMCH), Patna.
Materials and Methods: A hospital-based prospective observational study was conducted in the Burn Unit of PMCH, Patna, from October 2022 to September 2023. A total of 100 burn wound patients clinically suspected of wound infection were included. Wound swabs/pus samples were collected under aseptic precautions and processed using standard microbiological techniques for aerobic bacterial isolation and identification. Antimicrobial susceptibility testing was performed by Kirby–Bauer disc diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Statistical analysis was performed using SPSS version 25.0.
Results: Among the 100 burn wound samples studied, bacterial growth was obtained in 79 samples, while 21 samples showed no growth. Of the culture-positive samples, 69 (87.34%) demonstrated monomicrobial colonization and 10 (12.66%) demonstrated polymicrobial colonization. A total of 89 bacterial isolates were recovered. Pseudomonas aeruginosa was the predominant isolate accounting for 41.57% of isolates, followed by Staphylococcus aureus (25.84%), coagulase-negative staphylococci (14.60%), Klebsiella pneumoniae (8.98%), Escherichia coli (5.61%), and Proteus mirabilis (3.37%). Gram-negative organisms constituted 59.55% of isolates, whereas Gram-positive organisms accounted for 40.45%. Imipenem demonstrated the highest sensitivity against Gram-negative isolates, while vancomycin and linezolid showed 100% sensitivity against Gram-positive isolates.
Conclusion: Pseudomonas aeruginosa was the predominant aerobic bacterial isolate recovered from burn wound infections in the present study, followed by Staphylococcus aureus. Gram-negative organisms were more common than Gram-positive organisms. Imipenem showed excellent activity against Gram-negative isolates, while vancomycin and linezolid remained highly effective against Gram-positive isolates. Regular bacteriological surveillance and rational antibiotic use are essential for effective management of burn wound infections and prevention of antimicrobial resistance.

Evaluation of Iron Status Biomarkers and Cognitive Performance Among Pediatric Patients with Iron Deficiency Anemia

2026-06-27T10:02:12+00:00

Background: Iron deficiency anemia (IDA) is the most common nutritional deficiency among children worldwide and is associated with impaired neurocognitive development. Iron plays a crucial role in neurotransmitter synthesis, myelination, and energy metabolism in the developing brain. Early identification of cognitive impairment associated with iron deficiency may facilitate timely intervention and improve developmental outcomes.
Objectives: To evaluate iron status biomarkers among pediatric patients with iron deficiency anemia and assess their association with cognitive performance.
Materials and Methods: A hospital-based cross-sectional study was conducted among 100 children aged 6–12 years attending the pediatric outpatient department of a tertiary care teaching hospital. Fifty children diagnosed with iron deficiency anemia constituted the study group, while fifty age- and sex-matched healthy children served as controls. Hemoglobin concentration, serum ferritin, serum iron, total iron-binding capacity (TIBC), and transferrin saturation were measured using standard laboratory methods. Cognitive performance was assessed using age-appropriate standardized cognitive assessment tools evaluating memory, attention, processing speed, and executive functions. Statistical analysis was performed using SPSS version 25.0. Independent t-test and Pearson correlation analysis were used to determine differences and associations. A p-value <0.05 was considered statistically significant.
Results: Children with iron deficiency anemia (IDA) had significantly lower hemoglobin (9.2 ± 1.1 vs. 12.8 ± 0.9 g/dL), serum ferritin (11.4 ± 4.2 vs. 42.8 ± 8.5 ng/mL), serum iron (38.7 ± 9.3 vs. 86.5 ± 12.1 μg/dL), and transferrin saturation (8.7 ± 2.1 vs. 27.4 ± 4.5%) compared to controls, while TIBC was significantly higher (445 ± 35 vs. 325 ± 28 μg/dL) (p<0.001). Cognitive performance scores, including attention, memory, processing speed, and executive function, were significantly lower in the IDA group (p<0.001). Overall cognitive performance showed positive correlations with hemoglobin (r=0.52, p<0.001) and serum ferritin (r=0.48, p<0.001), whereas TIBC demonstrated a negative correlation (r=-0.41, p=0.004). Cognitive scores declined progressively with increasing severity of anemia.
Conclusion: Pediatric patients with iron deficiency anemia exhibited significantly altered hematological and iron status biomarkers along with impaired cognitive performance compared to healthy controls. Lower hemoglobin and ferritin levels were significantly associated with poorer cognitive outcomes. These findings highlight the importance of early screening, diagnosis, and treatment of iron deficiency anemia to improve cognitive development and academic performance among children.

Comparative Study of Anisometropic Amblyopia treatment with Spectacles alone and Combined spectacles with Patching

2026-06-27T13:10:21+00:00

Comparative study of anisometropic amblyopia treatment with spectacles alone and combined spectacles with patching
Purpose: To compare duration and amount of improvement with spectacles alone and spectacles with patching in anisometropic amblyopia.
Study Design: Prospective comparative interventional study
Methods: This prospective study was conducted at Department of Ophthalmology GMC Doda ,GMC Rajori, GMC Handwara , GMC Anatnag and District hospital pulwama J&K for period of five years. Difference in BCVA of 2 snellen lines or more in absence of any structural abnormality or visual pathway was considered indicative of amblyopia.
Inclusion criteria: Unilateral amblyopia, V/A < 6/9, Age 4 to 10 years, Anisometropia > 1D
Exclusion criteria: Stimulus deprivation amblyopia, Age <4 & >10 years, Bilateral Amblyopia, Already treated or under treatment amblyopia. 68 Amblyopic children were either treated with spectacles alone or with combined spectacle and patching. Follow up was done after every 2 months.
Results: Among 68 amblyopic children 30 were treated with spectacles alone and 38 were treated with combined spectacles and patching. Mean age at start of treatment in former was 6.2 +/-2.3 and 5.8 +/- 2.6 in combined group. Final V/A after treatment was 20/40 and 20/25 respectively among two groups. Mean time of amblyopia improvement was 7.3 +/- 4.1 and 6.2 +/- 3.5 in spectacles alone and combined spectacles and patching respectively.
Conclusion: Amblyopic children treated with combined spectacles and patching showed better results in amount as well as duration of treatment than those treated with spectacles alone.

Uterine Fibroids and Hysterectomy Route: Comparative Perioperative Outcomes of Abdominal, Vaginal, Laparoscopic, Robotic, and vNOTES Approaches

2026-06-29T11:56:32+00:00

Background: Uterine fibroids are the most prevalent benign pelvic tumour in women of reproductive age and up to 70% of women are affected by the age of 50. For symptomatic non-responsive fibroids, surgery to remove the uterus (hysterectomy) is the last resort. There are several surgical approaches: total abdominal hysterectomy (TAH), total vaginal hysterectomy (TVH), total laparoscopic hysterectomy (TLH), laparoscopically-assisted vaginal hysterectomy (LAVH), robotic-assisted total laparoscopic hysterectomy (R-TLH), and the increasingly popular transvaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy. Although a lot of literature has been written, the best route selection is still not agreed.
Objectives: To systematically review and meta-analyze operative time, estimated blood loss (EBL), length of hospital stay (LOS), intraoperative and postoperative complication rates and conversion rates for all major hysterectomy approaches for the benign uterine fibroid indication (2022–2026).
Methods: Systematic review and meta-analysis in accordance with the PRISMA 2020 guidelines. Databases: PubMed/MEDLINE, Embase, Cochrane CENTRAL, Scopus and Web of Science (January 2022–June 2026). Random-effects models (DerSimonian-Laird) were used; assessment of heterogeneity using the I² statistic.
Results: Nine studies (total of 1,116,000 patients) of minimally invasive hysterectomy (MIH) showed lower EBL, shorter LOS, and lower overall complication rates compared to TAH in each study. The most common approach was TLH (54.4% in high volume centers). Robotic hysterectomy vs. open: OR 0.42 (0.27–0.66) complications; 6.31-fold risk for transfusion in abdominal. R-TLH vs. C-TLH: similar peri-operative outcomes, with R-TLH having a slightly shorter LOS (MD −0.64 days, 95% CI: −1.10 to −0.17). TLH had a 7.54-fold greater risk of ureteral injury compared to TVH for large uteri (at or above 250 g). The vNOTES hysterectomy was demonstrated to be non-inferior to TLH, and had shorter operative time and better pain scores. Laparoscopic myomectomy demonstrated significantly reduced EBL (105 mL versus 317 mL), shorter operative time, and quicker recovery when compared with open myomectomy.
Conclusion: Hysterectomy is the standard of care for the treatment of uterine fibroids and minimally invasive procedures are the usual treatment. The ‘vaginal-first’ or ‘laparoscopic-first’ algorithm allows for the best possible outcomes while keeping surgical flexibility.A ‘vaginal-first algorithm’ or ‘laparoscopic-first algorithm’ with vNOTES as a teaching tool and safety net. Patient size, surgeon experience, patient comorbidities and fertility status should all be taken into account when developing the route of selection.

Morphometric Analysis of Foramen Magnum in Adult CT Images: A Cross-Sectional Study

2026-07-03T09:09:34+00:00

Background: The foramen magnum is a vital anatomical structure located at the base of the skull, transmitting the lower brainstem, vertebral arteries, meninges, and associated neurovascular structures. Accurate morphometric assessment of the foramen magnum is important in neurosurgery, radiology, anthropology, and forensic medicine. Computed tomography (CT) provides precise measurements of cranial base anatomy and facilitates evaluation of morphometric variations in living populations.
Aim: To evaluate the morphometric dimensions of the foramen magnum in adult CT images and establish baseline data useful for clinical, surgical, and forensic applications.
Materials and Methods: A cross-sectional observational study was conducted using CT images of adult patients attending the Department of Radiology, Government Medical College, Medak. Adult subjects between 18 and 79 years of age who underwent cranial CT examination were included. Patients with craniovertebral junction anomalies, fractures, neoplasms, or pathological conditions affecting the skull base were excluded. Morphometric parameters including anteroposterior diameter, transverse diameter, right oblique diameter, and left oblique diameter of the foramen magnum were measured using CT imaging. Data were analyzed using appropriate statistical methods, and morphometric differences between sexes were evaluated.
Results: Morphometric assessment demonstrated that the anteroposterior diameter was consistently greater than the transverse diameter in the majority of subjects. Male participants exhibited larger mean dimensions of the foramen magnum compared with female participants. Significant variations were observed among the measured parameters, reflecting normal anatomical diversity within the study population. The findings established normative morphometric values for the adult population studied and highlighted the utility of CT imaging in evaluating cranial base anatomy.
Conclusion: The present study provides valuable morphometric data regarding the dimensions of the foramen magnum in adults. These measurements may aid neurosurgeons in planning craniovertebral junction procedures, assist radiologists in anatomical assessment, and contribute to forensic identification and anthropological research. CT-based morphometric evaluation offers a reliable and non-invasive method for studying variations of the foramen magnum in living populations.

Morphological and Morphometric Study of Atlas (C1) and Axis (C2) Vertebrae in Human Skeletons

2026-07-02T12:58:53+00:00

Background: The atlas (C1) and axis (C2) vertebrae are specialized cervical vertebrae that facilitate head movement and provide stability to the craniovertebral junction. Detailed morphometric knowledge of these vertebrae is essential for neurosurgical procedures, spinal fixation techniques, and forensic investigations.
Aim: To analyze the morphological variations and morphometric dimensions of atlas and axis vertebrae in human skeletal specimens and evaluate their clinical significance.
Methods: A retrospective osteological study was conducted in the Department of Anatomy, Government Medical College, Jammu, over 3 months. Thirty dry human vertebrae (15 atlas and 15 axis vertebrae) were examined. Various morphometric parameters including transverse diameter, anteroposterior diameter, vertebral canal dimensions, superior articular facet measurements, dens dimensions, and vertebral foramen dimensions were recorded using digital Vernier calipers. Morphological variations were documented. Statistical analysis was performed using SPSS version 26. Student’s t-test and Pearson correlation analysis were applied, with p<0.05 considered statistically significant.
Results: The mean transverse diameter of the atlas was 76.4 ± 4.8 mm, while the mean anteroposterior diameter measured 44.2 ± 3.5 mm. The average length of the dens in axis vertebrae was 15.8 ± 1.7 mm and the mean width was 9.1 ± 1.2 mm. Morphological variations were observed in 26.7% of specimens. Significant positive correlations were found between vertebral body dimensions and dens measurements (p<0.001).
Conclusion: Atlas and axis vertebrae exhibit significant morphometric variability. These findings provide valuable anatomical data for craniovertebral junction surgery, cervical instrumentation, and forensic anthropology.

Perception of Self-Directed Learning as a Learning Technique in Anatomy among Phase I MBBS Learners

2026-07-06T05:02:03+00:00

Background: With the implementation of Competency-Based Medical Education (CBME) in India, Self-Directed Learning (SDL) has become an essential component of undergraduate medical education, promoting active learning, critical thinking, and learner autonomy. Anatomy, being a foundational subject with extensive competencies, requires effective learning strategies beyond conventional didactic teaching. However, first-year MBBS learners often face challenges in adapting to SDL due to limited prior exposure and dependence on teacher-centered learning approaches.
Objectives: To assess the perception of Self-Directed Learning (SDL) as a learning technique in Anatomy among Phase I MBBS learners.
Methods: A cross-sectional observational study was conducted among 100 Phase I MBBS students of the 2025 batch at Government Medical College, Jangaon. Prior to the SDL session, learner readiness was assessed using a structured questionnaire administered through Google Forms. Students were provided with clearly defined learning objectives and an assessment checklist five days before the scheduled SDL session. They were instructed to independently prepare notes incorporating diagrams, flowcharts, and tables based on the given objectives. Practical demonstration of the topic was conducted in the dissection hall in small groups two days before the SDL session. Following the session, students’ perceptions regarding SDL were assessed using a 2-point Likert scale questionnaire along with an open-ended feedback question.
Results: The study revealed that 97% of learners reported clarity regarding their learning goals, while 95% expressed enjoyment and satisfaction with the SDL sessions. However, 52% reported difficulty in effectively managing their learning time. Open-ended responses indicated that students found SDL informative, engaging, and helpful in improving conceptual understanding and independent thinking, though some expressed challenges with difficult anatomical terminology and self-learning adjustments.
Conclusion: Self-Directed Learning appears to be an effective and well-accepted learning strategy among Phase I MBBS learners in Anatomy when implemented systematically with clearly defined learning objectives and structured assessment guidance. SDL may enhance learner engagement, conceptual understanding, and self-learning skills in early medical education.

Comparative Analysis of Tear Film Parameters in Patients With and Without Meibomian Gland Dysfunction: A Prospective Observational Study

2026-07-11T08:49:19+00:00

Background: Meibomian gland dysfunction (MGD) is recognized as the leading cause of evaporative dry eye disease and contributes significantly to tear film instability and ocular surface inflammation. Alterations in tear film parameters such as tear break-up time (TBUT), Schirmer’s test values, Ocular Surface Disease Index (OSDI), lower tear meniscus height, and meibography findings are frequently observed in patients with MGD. Comparative assessment of these parameters in patients with and without MGD is essential for understanding disease severity and optimizing management strategies.
Aim: To compare tear film parameters between patients with and without meibomian gland dysfunction.
Materials and Methods: This prospective observational study was conducted in the Department of Ophthalmology, SCB Medical College and Hospital, Cuttack, Odisha, over a period of 1.5 years from September 2022 to May 2024. A total of 269 patients presenting with symptoms suggestive of dry eye disease were enrolled. Patients were divided into two groups according to meibomian gland status: MGD group (n=155) and Non-MGD group (n=114). Clinical evaluation included slit lamp examination, Schirmer’s test, tear break-up time, fluorescein staining, OSDI scoring, blink rate, blink interval, lower tear meniscus height, Marx line score, and meibography. Statistical analysis was performed using R version 4.3.2. Continuous variables were expressed as mean ± standard deviation and compared using Student’s t-test. Categorical variables were analyzed using Chi-square test. A p-value <0.05 was considered statistically significant.
Results: Patients with MGD demonstrated significantly lower TBUT values (8.12±2.11 s vs 11.89±1.84 s, p<0.001), lower Schirmer’s test scores (12.41±3.84 mm vs 16.93±3.17 mm, p<0.001), and reduced lower tear meniscus height (0.24±0.08 mm vs 0.36±0.10 mm, p<0.001). OSDI scores and Marx line scores were significantly higher among MGD patients (58.61±11.27 vs 41.48±9.36; p<0.001 and 1.87±1.02 vs 0.71±0.74; p<0.001 respectively). Meibography grades and fluorescein staining severity were also significantly associated with MGD.
Conclusion: Meibomian gland dysfunction is associated with significant deterioration of tear film parameters and increased symptom severity. Early diagnosis and intervention are essential to prevent progression of ocular surface disease and improve quality of life.

Corticosteroids and Antibiotics Utilization in COPD Exacerbation: A Prospective Observational Study from a Tertiary Care Hospital

2026-07-13T09:19:03+00:00

Background: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality worldwide, with exacerbations significantly impacting disease progression, hospitalization rates, and mortality risk. The GOLD 2025 guidelines emphasize the critical role of corticosteroids and antibiotics in managing COPD exacerbations, yet prescribing practices in rural Indian healthcare settings remain inadequately documented.
Objective: This study aimed to assess the prescribing patterns of corticosteroids and antibiotics among patients with COPD exacerbations at a tertiary care hospital in rural Maharashtra, India, and evaluate adherence to GOLD 2025 treatment guidelines.
Methods: A prospective observational study was conducted over six months (June to November 2025) at Vilasrao Deshmukh Government Medical College and Hospital, Latur, Maharashtra. Patients aged ≥40 years with clinically confirmed COPD exacerbations were enrolled. Data on demographic characteristics, corticosteroid utilization (type, route, dose, duration), antibiotic prescribing patterns (class, specific agents), and therapy combinations were collected using a structured proforma. Descriptive statistics were employed for data analysis.
Results: Among 50 enrolled patients, the majority were aged ≥60 years (76%), with a nearly equal gender distribution (48% male, 52% female). Corticosteroid therapy was administered to 86% (n=43) of patients, with dual therapy (44%) and triple therapy (40%) being the predominant regimens. Antibiotics were prescribed rationally, with penicillins (35%) and macrolides (31%) being the most commonly utilized classes. Azithromycin (56%) and amoxicillin-clavulanate (44%) were the most frequently prescribed specific agents. The prescribing patterns demonstrated substantial alignment with GOLD 2025 recommendations, though opportunities for improvement were identified in eosinophil-guided inhaled corticosteroid prescribing and antimicrobial stewardship.
Conclusion: This study reveals that corticosteroid and antibiotic prescribing practices at the study hospital largely adhere to GOLD 2025 guidelines, reflecting appropriate clinical management of COPD exacerbations. However, gaps persist in consistent documentation of blood eosinophil counts and optimization of inhaled corticosteroid therapy. Enhanced disease awareness initiatives, regular prescription audits, and strengthened antimicrobial stewardship programs are essential to further improve COPD management outcomes in resource-limited rural Indian settings.

Antimicrobial Susceptibility Pattern of Pseudomonas aeruginosa Isolated from ICU Patients

2026-07-15T11:41:21+00:00

Background: Pseudomonas aeruginosa is a major cause of healthcare-associated infections in intensive care units (ICUs) and is associated with significant morbidity, mortality, and antimicrobial resistance. Continuous surveillance of susceptibility patterns is essential for guiding empirical therapy and infection control practices.
Aim: To determine the antimicrobial susceptibility pattern of Pseudomonas aeruginosa isolated from ICU patients and evaluate the prevalence of multidrug-resistant strains.
Methods: A prospective observational study was conducted at Patna Medical College and Hospital (PMCH) from July 2025 to March 2026. A total of 100 non-duplicate Pseudomonas aeruginosa isolates obtained from ICU patients were included. Clinical specimens including endotracheal aspirates, sputum, urine, blood, wound swabs, and pus samples were processed using standard microbiological techniques. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method according to CLSI guidelines. Resistance patterns and multidrug resistance (MDR) rates were analyzed.
Results:Respiratory samples constituted the majority of isolates (42%). Highest susceptibility was observed for colistin (98%), polymyxin B (96%), and ceftolozane-tazobactam (88%). Resistance was highest against ciprofloxacin (62%), levofloxacin (58%), and ceftriaxone (74%). Multidrug-resistant Pseudomonas aeruginosa was identified in 38% of isolates. Carbapenem resistance was observed in 32% of isolates and was significantly associated with prolonged ICU stay (p=0.004).
Conclusion: Pseudomonas aeruginosa isolated from ICU patients demonstrated high resistance to commonly used antibiotics while retaining susceptibility to polymyxins. The substantial prevalence of MDR strains highlights the need for antimicrobial stewardship, routine surveillance, and rational antibiotic utilization.

Study Of Capecitabine in Patients With Solid Tumours At a Tertiary Care Centre

2026-07-15T11:44:24+00:00

Background:Capecitabine, an orally administered fluoropyrimidine prodrug of 5-fluorouracil (5-FU), has become an integral component of systemic therapy for several solid malignancies because of its efficacy, favourable toxicity profile, and convenience of administration. Although its role has been extensively investigated in colorectal and breast cancers, real-world evidence regarding its effectiveness and tolerability across diverse solid tumours in the Indian population remains limited. This study aimed to evaluate the efficacy, safety, and tolerability of capecitabine in patients with solid tumours treated at a tertiary cancer care centre.
Methods: This observational study included adult patients with histopathologically confirmed solid malignancies who received capecitabine either as monotherapy or in combination with other anticancer modalities at the Department of Oncology in a tertiary care centre. Baseline demographic, clinicopathological, treatment, and laboratory data were recorded. Patients were prospectively followed to assess treatment response, adverse events, dose modifications, treatment interruptions, and survival outcomes. Tumour response was evaluated according to standard response assessment criteria (RECIST 1.1), while treatment-related toxicities were graded using the Common Terminology Criteria for Adverse Events. Statistical analyses were performed using appropriate descriptive and inferential methods, with a p-value <0.05 considered statistically significant.
Results: A total of 94 patients with solid malignancies were enrolled, with a median age of 48 years; 79% were female, and 84% had metastatic disease treated with palliative intent. Breast cancer was the most common malignancy (48.9%). Dose reduction due to toxicity was required in 72.3% of patients, while treatment discontinuation due to adverse events occurred in only 5.3%. Hand-foot syndrome (31.9%), anaemia (28.7%), and diarrhoea (21.3%) were the most frequent toxicities, with Grade 3/4 haematological toxicity observed in only 4.3%. Among the 78 evaluable patients, stable disease was achieved in 55.1%, partial response in 10.3%, and progressive disease in 34.6%. The highest disease control was observed in ovarian and cervical cancers, whereas head and neck cancers demonstrated the poorest response.
Conclusion: Capecitabine is an effective, safe, and well-tolerated therapeutic option for patients with a variety of solid malignancies in routine clinical practice. Its favourable toxicity profile, ease of oral administration, and acceptable treatment outcomes make it an attractive alternative to continuous intravenous fluoropyrimidine therapy. Early recognition and prompt management of treatment-related toxicities, particularly hand-foot syndrome and gastrointestinal adverse events, facilitate treatment continuation and optimize patient outcomes.

Neoadjuvant pembrolizumab with paclitaxel and carboplatin in locally advanced esophageal and esophagogastric junction carcinoma: short-term outcomes of a single-center retrospective cohort

2026-07-15T11:49:42+00:00

Background: The addition of anti–PD-1 therapy to chemotherapy has become standard in advanced esophageal cancer and, as adjuvant nivolumab, after chemoradiotherapy and R0 resection. Its role in the neoadjuvant setting is still being defined, and real-world data from routine practice, particularly where chemoradiotherapy capacity is limited, remain sparse. We describe short-term outcomes of neoadjuvant pembrolizumab combined with paclitaxel and carboplatin in patients treated at a single center.
Methods: We retrospectively identified 14 consecutive patients with locally advanced esophageal or esophagogastric junction (EGJ) carcinoma who received neoadjuvant pembrolizumab 200 mg every 3 weeks with paclitaxel and carboplatin, with planned esophagectomy. The primary endpoint was pathological complete response (pCR, ypT0 ypN0). Secondary endpoints were the radiographic objective response, R0 resection, treatment completion, adverse events (CTCAE v5.0), postoperative morbidity, and short-term disease status. Continuous variables are summarized as median (range) and categorical variables as counts (percentages); no inferential testing was performed given the sample size.
Results: Twelve of 14 patients (85.7%) had squamous cell carcinoma; 9 (64.3%) had clinical stage III disease. All cycles were delivered as pembrolizumab plus paclitaxel–carboplatin; 6 patients (42.9%) completed all three planned cycles and 9 (64.3%) had at least one dose delay. A radiographic objective response was recorded in 9 patients (64.3%). Ten patients (71.4%) underwent esophagectomy, all with R0 resection; the four remaining patients did not proceed to surgery because of progressive disease (1), medical unfitness (2), or patient refusal (1). pCR occurred in 3 of 14 patients on an intention-to-treat basis (21.4%) and in 3 of 10 resected patients (30.0%); all three had had a complete clinical response and the highest PD-L1 combined positive scores in the cohort. Grade 3–4 adverse events occurred in 6 patients (42.9%) and immune-related adverse events in 5 (35.7%), including one grade 3 immune hepatitis and one grade 2 pneumonitis. After a median follow-up of 7.8 months (range 3.0–11.2), no deaths had occurred and two patients had developed recurrence.
Conclusions: In this small cohort, neoadjuvant pembrolizumab with paclitaxel and carboplatin was deliverable and permitted R0 resection in all operated patients, with a pCR rate consistent with early-phase neoadjuvant chemoimmunotherapy experience. Toxicity was not negligible and limited full-course delivery in more than half of patients. The sample size, absence of a comparator, and immature follow-up preclude conclusions about efficacy or survival; the findings are hypothesis-generating.

Learning Beyond the Classroom: Early Clinical Placement Experiences among Undergraduate Medical Students

2026-07-15T11:54:06+00:00

Early clinical placements are a crucial stage in undergraduate medical education, helping students integrate theoretical knowledge with clinical practice while developing confidence and professional identity. This mixed-methods cross-sectional study explored the experiences of 32 third-year medical students at Brunel Medical School during their first clinical placements across five NHS Trusts. Data were collected using an online questionnaire with Likert-scale and open-ended questions and analysed using descriptive statistics and thematic analysis.
Most students perceived the clinical environment as welcoming (94%) and supportive (88%), with 78% reporting that clinicians’ teaching enhanced learning. Although students initially experienced uncertainty, a steep learning curve, and challenges balancing academic and clinical responsibilities, these experiences promoted independence and self-directed learning. Early clinical exposure increased confidence in patient interactions (88%), strengthened professional identity (94%), and improved the application of theoretical knowledge to practice (88%). Qualitative findings highlighted the value of supportive supervision, constructive feedback, authentic patient encounters, and an inclusive learning environment. Students recommended more simulation-based training, structured bedside teaching, consistent feedback, better integration of academic and clinical learning, and formal mentorship. Overall, supportive and well-structured early clinical placements are essential for preparing medical students for clinical practice.

Sleep Quality And Its Relation To Sleep Hygiene Awareness Among Undergraduate Medical Students In Haldwani, District-Nainital

2026-07-17T06:57:43+00:00

Background: Sleep is a vital part of an individual’s life. Thus, good sleep practices, i.e., sleep hygiene, are the key to good health, and deviations from these may result in many problems. Such deviations are common among college students and are often attributed to lifestyle changes that cause variations in their daily sleep schedules, leading to poor sleep quality.The aim of the study is to assess the sleep hygiene awareness and sleep quality among medical students and association of sleep hygiene awareness and sleep quality among them.
Methodology: This descriptive, institution-based cross-sectional study was conducted among undergraduate medical students of Government Medical College, Haldwani, District Nainital.Two validated instruments were used: the Pittsburgh Sleep Quality Index (PSQI) and the Sleep Belief Scale (SBS). The questionnaire was administered as a Google Form, and the data were analyzed using SPSS version 20.0.0.
Result: Among medical students, female (57.3%) were more than males (42.73%), 288(63.44%) participants had good sleep quality while166(36.56%) were having poor sleep quality. 301(66.30%) students were having intermediate followed by excellent awareness 111(24.45%) on sleep hygiene.72 (64.86%) good sleeper and 39 (35.14%) poor sleeper got excellent score in SH awareness.
Conclusion: This study revealed that poor sleep quality was found among 1/3rd of the medical students.2/3rd of the participants showed moderate level of awareness with respect to sleep hygiene. Moreover, no significant association was found between SH awareness and good sleep quality. But,there is strong need to implement sleep hygiene education programs among medical students so as to improve their academic performance and overall wellbeing.

Morphometric Evaluation of Glenoid Cavity Dimensions and Its Relevance in Shoulder Arthroplasty

2026-07-24T10:00:34+00:00

Background: The glenoid cavity is an important component of the shoulder joint, providing articulation with the head of the humerus and contributing to joint stability and mobility. Accurate knowledge of its morphometric dimensions is essential for successful shoulder arthroplasty, prosthesis design, and the management of glenohumeral disorders. Population-specific anatomical data are valuable for improving surgical outcomes.
Objectives: To evaluate the morphometric dimensions and morphological variations of the glenoid cavity in adult human scapulae and assess their clinical significance in shoulder arthroplasty.
Materials and Methods: A descriptive cross-sectional osteometric study was conducted in the Department of Anatomy, Government Medical College, Yadadri (Bhuvanagiri) Telangana, Government medical college, Vikarabad, Telanagana and Sree Uthradom thirunal Academy of Medical Sciences, Thiruvananthapuram, Kerala on 100 dry adult human scapulae (50 right and 50 left). The maximum superoinferior diameter, maximum anteroposterior diameter, upper anteroposterior diameter, and Glenoid Index were measured using a digital Vernier caliper. The glenoid cavity was classified into pear, oval, and inverted comma shapes. Data was analyzed using descriptive statistics, and side-wise comparisons were performed using the independent t-test, with p < 0.05 considered statistically significant.
Results: The mean superoinferior diameter was 36.8 ± 3.2 mm, the mean maximum anteroposterior diameter was 27.4 ± 2.6 mm, and the mean Glenoid Index was 74.5 ± 5.8. Pear-shaped glenoid cavities were the most common (52%), followed by inverted comma (30%) and oval (18%). No statistically significant difference was observed between the right and left sides (p > 0.05). The findings demonstrated anatomical variations that may influence prosthetic sizing and surgical planning.
Conclusion: The present study provides valuable morphometric data on the glenoid cavity in the Telangana population. These findings can assist orthopedic surgeons in preoperative planning, appropriate prosthesis selection, and improving the outcomes of shoulder arthroplasty while serving as a useful reference for anatomists and biomedical engineers.

Comparison of Creatinine and Cystatin C-based Estimated Glomerular Filtration Rate in Relation to Glycemic Control Among Patients With Type 2 Diabetes Mellitus

2026-08-01T05:14:33+00:00

Background & Objectives: Diabetic kidney disease (DKD) is a major complication of type 2 diabetes mellitus (T2DM) leading to end-stage renal disease (ESRD). Early identification of declining renal function is vital to prevent disease progression. Estimated glomerular filtration rate (eGFR) calculated using serum creatinine or serum cystatin C serves as a key indicator of kidney function. This study aimed to compare creatinine-based (MDRD equation) and cystatin C-based (CKD-EPI 2012 equation) eGFR in relation to glycemic control (HbA1c) in patients with type 2 diabetes mellitus and healthy controls.
Materials & Methods: This cross-sectional case–control study included 150 participants aged 25–70 years, comprising 75 clinically diagnosed T2DM patients (cases) and 75 apparently healthy individuals (controls). Patients with hypertension, known chronic kidney disease, hepatic/muscular disorders, or those undergoing dialysis were excluded. Serum creatinine (enzymatic method) and serum cystatin C (immunoturbidimetric assay) were analyzed on a Beckman AU5800 clinical chemistry analyzer. Glycated hemoglobin (HbA1c) was measured by high-performance liquid chromatography (HPLC). eGFR was calculated using the MDRD equation for creatinine and the 2012 CKD-EPI equation for cystatin C. Statistical analyses included independent Student’s t-test, paired t-test, Pearson’s correlation, and Receiver Operating Characteristic (ROC) curve analysis.
Results: Mean HbA1c, serum creatinine, and serum cystatin C levels were significantly higher in T2DM cases than in healthy controls. Mean eGFR was significantly lower in diabetic patients compared to controls with both the MDRD equation (84.84 mL/min/1.73 m² vs. 98.07 mL/min/1.73 m²) and the CKD-EPI cystatin C equation (79.2 mL/min/1.73 m² vs. 90.35 mL/min/1.73 m²). A paired t-test demonstrated no statistically significant difference between eGFR calculated by MDRD and CKD-EPI (p = 0.318). Both eGFR estimates showed a significant inverse correlation with HbA1c (p < 0.05). ROC curve analysis showed excellent and comparable diagnostic performance for detecting early renal impairment (eGFR< 90 mL/min/1.73 m), with an area under the curve (AUC) of 0.95 (95% CI: 0.93–0.98) for creatinine-based eGFR and 0.96 (95% CI: 0.93–0.98) for cystatin C-based eGFR.
Conclusion: Both creatinine-based (MDRD) and cystatin C-based (CKD-EPI) eGFR equations provide comparable clinical performance in evaluating renal function in patients with type 2 diabetes mellitus. Poorer glycemic control correlates with declining GFR, highlighting the value of early eGFR assessment alongside glycemic monitoring to identify individuals at risk of diabetic kidney disease.

Quantitative Assessment of Tibial Condylar Dimensions in Human Dry Bones

2026-07-22T12:12:01+00:00

Background: The proximal tibia serves an important function in weight transmission and contributes significantly to the stability of the knee joint. Precise morphometric data of tibial condyles are essential for designing knee prostheses and improving outcomes of arthroplasty procedures. Variations in condylar dimensions across populations necessitate region-specific anatomical data.
Objective: To perform a quantitative assessment of tibial condylar dimensions in human dry bones and evaluate side-wise differences.
Methods:This cross-sectional study included 50 adult dry tibiae (25 right and 25 left) collected from the anatomy and forensic department. Measurements such as anteroposterior (AP) and transverse diameters of both condyles, along with total condylar dimensions, were obtained using a digital Vernier caliper. Statistical analysis included calculation of mean, standard deviation, and p-values to assess side differences.
Results:The medial condyle AP diameter averaged 39.40 ± 4.58 mm (right) and 41.29 ± 4.69 mm (left), showing no statistically significant difference. However, the lateral condyle AP diameter was significantly greater on the left (38.62 ± 3.23 mm) compared to the right (35.98 ± 3.86 mm) (p < 0.01). Total condylar AP diameter also demonstrated a significant side difference (p < 0.01), while transverse diameters and total condylar area did not show statistically significant variation.
Conclusion: The study provides valuable morphometric data on tibial condyles, highlighting significant side differences in certain parameters. These findings are clinically relevant for the design of knee prostheses and can help improve surgical outcomes in knee arthroplasty.

Timing of Definitive Fixation in Orthopedic Trauma: Early Versus Delayed Surgery and Its Impact on Outcomes

2026-07-22T12:14:33+00:00

Background:In orthopaedic trauma, the timing of definitive fixation continues to be a crucial factor in determining results. While delayed fixation may be required in individuals who are unstable, early fixing is thought to minimise problems and hospital stays.
Methods:A total of 100 trauma patients were included and categorized into early fixation (<48 hours) and delayed fixation (>48 hours). Outcomes assessed included complications, length of hospital stay, infection rates, and functional recovery.This retrospective study examined the effects of early versus delayed fixation at IMS and SUM Hospital Campus 2 over a 1.5-year period (July 2024–December 2025).
Results:Significantly shorter hospital stays (p<0.001) and decreased complication rates (p=0.03) were linked to early fixation. Although not statistically significant, infection rates were lower in the early group. Early fixation produced higher functional results (p=0.02).
Conclusion: According to the study, early definitive fixation helps patients who are clinically stable recover more quickly by allowing for early mobilisation and lowering problems associated with immobilisation. It improves overall patient prognosis and lessens the burden of healthcare since it is linked to shorter hospital stays, reduced risk of non-union and infection, and better functional outcomes.

Uterine balloon tamponade in the management of refractory postpartum haemorrhage: A Prospective Observational Study

2026-07-22T12:09:30+00:00

Background: Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality, particularly in low-resource settings. Uterine balloon tamponade (UBT) has emerged as a simple, cost-effective intervention for refractory PPH.
Objective: To evaluate the effectiveness and safety of uterine balloon tamponade in managing refractory postpartum hemorrhage.
Methods: This prospective observational study was conducted in the Department of Obstetrics & Gynaecology at PMCH, Patna, from March 2025 to February 2026. A total of 51 women with refractory PPH not responding to first-line medical management were included. Data regarding demographic profile, cause of PPH, mode of delivery, success rate of UBT, need for surgical intervention, and complications were recorded and analysed.
Results: The success rate of UBT in controlling hemorrhage was 82.4%. Uterine atony was the most common cause (64.7%). Surgical intervention was avoided in 76.5% of cases. Complications were minimal, with pain (11.8%) being the most common complication, followed by infection (7.8%) and balloon displacement (5.9%). Statistically significant association was found between early UBT insertion and successful outcome (p<0.05).
Conclusion: UBT is an effective, safe, and minimally invasive method for managing refractory PPH and can significantly reduce the need for surgical interventions.

Study of Causes and Management of Gastrointestinal Perforation in East Bihar: A Prospective Observational Study

2026-07-25T12:51:50+00:00

Background: Gastrointestinal (GI) perforation is one of the most common surgical emergencies worldwide and remains associated with considerable morbidity and mortality despite advances in perioperative care. The etiological spectrum varies geographically owing to differences in socioeconomic conditions, infectious diseases, dietary habits, and healthcare accessibility. In Eastern India, peptic ulcer disease, enteric fever, intestinal tuberculosis, and appendicular pathology continue to be major causes of gastrointestinal perforation. Early diagnosis, prompt resuscitation, appropriate antimicrobial therapy, and timely surgical intervention are essential for improving patient outcomes. Understanding regional disease patterns is important for optimizing management strategies and reducing postoperative complications.
Objective: To evaluate the causes, clinical presentation, surgical management, postoperative complications, and short-term outcomes of gastrointestinal perforation among patients presenting to a tertiary care teaching hospital in East Bihar.
Methodology: A prospective observational study was conducted in the Department of General Surgery, Jawaharlal Nehru Medical College and Hospital (JLNMCH), Bhagalpur, Bihar, between January 2024 and January 2026. One hundred consecutive adult patients with intraoperatively confirmed gastrointestinal perforation who underwent emergency surgery were enrolled. Demographic characteristics, etiological factors, clinical presentation, laboratory investigations, operative findings, surgical procedures, postoperative complications, duration of hospital stay, and mortality were recorded using a structured case record form. Statistical analysis was performed using IBM SPSS Statistics Version 26.0. Continuous variables were expressed as mean ± standard deviation, whereas categorical variables were presented as frequencies and percentages. Student’s t-test, Chi-square test, Fisher’s exact test, one-way ANOVA, and multivariable logistic regression were applied where appropriate. A two-sided p-value <0.05 was considered statistically significant.
Results: Among the 100 enrolled patients, the mean age was 44.8 ± 15.6 years, and 77% were males. The highest proportion of patients belonged to the 41–50-year age group (28%). Peptic ulcer disease (32%) was the leading etiology, followed by typhoid perforation (17%) and appendicular perforation (14%). Traumatic gastrointestinal perforation accounted for 5% of cases. Duodenal perforation (29%) was the most common anatomical site, followed by ileal perforation (27%). Graham’s omental patch repair (33%) was the most frequently performed surgical procedure. Postoperative complications occurred in 59% of patients, with surgical site infection (27%) being the most common complication. The overall in-hospital mortality rate was 10%. Multivariable logistic regression identified shock at presentation (Adjusted OR 6.31; 95% CI 2.08–19.14; p=0.001), delay in surgery >24 hours (Adjusted OR 4.82; 95% CI 1.71–13.61; p=0.003), serum albumin <3 g/dL (Adjusted OR 3.92; 95% CI 1.31–11.73; p=0.015), and age >60 years (Adjusted OR 2.87; 95% CI 1.05–7.81; p=0.039) as independent predictors of mortality.
Conclusion: Peptic ulcer disease remains the leading cause of gastrointestinal perforation in East Bihar, with duodenal perforation being the most common anatomical site. Delayed presentation, septic shock, hypoalbuminemia, and advanced age significantly increase postoperative mortality. Early diagnosis, aggressive resuscitation, timely surgical intervention, and meticulous postoperative care remain essential for improving clinical outcomes.

Morphometric study of proximal and distal end of radius and its clinical significance

2026-07-30T09:32:13+00:00

Background: The radius is a forearm bone that plays an important role in the elbow and wrist joints. Morphometric changes in its proximal and distal ends have clinical implications for orthopedic treatments, prosthesis design, and fracture management.
Aim: To analyze the morphometric parameters of the proximal and distal ends of the radius and evaluate their clinical significance.
Materials and Methods: A 1.5-year prospective observational study was undertaken on 50 dry adult human radii (27 right-sided and 23 left-sided). The proximal length, distal width, radial head diameter, and styloid process length were all measured with a digital verniercaliper. Student’s t-test was used for statistical analysis, and p-values < 0.05 were considered significant.
Results: The mean values of all parameters were slightly higher on the right side compared to the left. However, no statistically significant differences were observed (p > 0.05). The findings indicate bilateral symmetry in radial morphometry.
Conclusion: The study gives important morphometric data for orthopedic implant design and surgical planning. The observed symmetry suggests that standard implants may be used bilaterally, but population-specific data are still required.

Effects of Anti-Inflammatory Pharmacotherapy on CRP and IL-6 Levels in Cardiovascular Disease: A Systematic Review

2026-07-30T09:36:42+00:00

Background: Chronic low-grade inflammation plays a pivotal role in the development and progression of cardiovascular disease (CVD). Persistent elevation of inflammatory biomarkers, particularly C-reactive protein (CRP) and interleukin-6 (IL-6), has been associated with endothelial dysfunction, atherosclerotic plaque progression, adverse cardiovascular events, and poor clinical outcomes. Growing evidence suggests that anti-inflammatory pharmacotherapies may modulate these biomarkers and improve cardiovascular prognosis.
Objective: To systematically review the available evidence regarding the effects of pharmacological interventions on CRP and IL-6 levels in patients with cardiovascular disease.
Methods: This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. Electronic databases including PubMed, Scopus, Embase, Web of Science, and the Cochrane Library were searched for studies published between January 2000 and December 2025. Randomized controlled trials, cohort studies, and observational studies involving adult patients with cardiovascular disease were eligible for inclusion if they evaluated pharmacological modulation of CRP and/or IL-6. Data extraction and quality assessment were performed using standardized methods.
Results: Studies included in the review demonstrated that several pharmacological interventions, including statins, canakinumab, colchicine, and IL-6-targeted therapies, were associated with significant reductions in CRP and/or IL-6 levels. Greater reductions in inflammatory biomarkers were generally associated with improved cardiovascular outcomes and reduced risk of recurrent cardiovascular events. However, variability in study design, patient populations, therapeutic regimens, and follow-up duration contributed to heterogeneity among findings.
Conclusion: Current evidence supports the role of anti-inflammatory pharmacotherapy in reducing CRP and IL-6 levels among patients with cardiovascular disease. Targeted modulation of inflammatory pathways may contribute to improved cardiovascular outcomes. Nevertheless, further large-scale studies are required to establish optimal biomarker-guided therapeutic strategies and long-term clinical benefits.

Evaluation of Bilirubin Level in Exclusively Breastfed Versus Formula-Fed Infants: A Retrospective Comparative Study

2026-08-01T05:19:28+00:00

Background: Neonatal jaundice is one of the most common clinical conditions encountered during the neonatal period, affecting approximately 60% of term and 80% of preterm newborns. Feeding practices play a significant role in bilirubin metabolism and may influence the incidence and severity of neonatal hyperbilirubinemia. Exclusive breastfeeding has been associated with a higher frequency of physiological jaundice compared to formula feeding.
Aim: To compare serum bilirubin levels among exclusively breastfed and formula-fed infants and evaluate the association between feeding pattern and neonatal hyperbilirubinemia.
Materials and Methods; A retrospective comparative study was conducted at the Department of Pediatrics, DRIEMS Medical College and Hospital, Tangi, Cuttack, Odisha, over a one-year period. Medical records of 100 neonates were reviewed, including 50 exclusively breastfed infants and 50 formula-fed infants. Demographic characteristics, gestational age, birth weight, age at bilirubin estimation, total serum bilirubin (TSB) levels, and requirement for phototherapy were analyzed. Statistical analysis was performed using SPSS version 26. Independent t-test, Chi-square test, and logistic regression analysis were used. A p-value <0.05 was considered statistically significant.
Results: The mean total serum bilirubin level was significantly higher among exclusively breastfed infants (13.28 ± 3.14 mg/dL) compared to formula-fed infants (9.86 ± 2.71 mg/dL) (p<0.001). Hyperbilirubinemia requiring phototherapy occurred in 18 (36.0%) breastfed infants and 7 (14.0%) formula-fed infants (p=0.011). Exclusive breastfeeding was independently associated with elevated bilirubin levels (OR=3.46, 95% CI:1.34–8.92, p=0.010).
Conclusion: Exclusively breastfed infants demonstrated significantly higher bilirubin levels and a greater requirement for phototherapy compared to formula-fed infants. Careful monitoring of bilirubin levels among breastfed neonates may facilitate early identification and management of neonatal jaundice.