Indian Journal of Pharmaceutical and Biological Research

Comparative Study of Palmar Dermatoglyphics in Vitiligo Patients and Normal Controls

U. Sujatha, S. Sreelatha, D. Sushma — Tue, 07 Apr 2026 00:00:00 +0000

Background: Dermatoglyphics is the study of epidermal ridges and the patterns formed by them during early intrauterine period. Epidermal ridges have been useful in diagnosing hereditary diseases.
Objective: To evaluate significant difference in dermatoglyphic patterns in vitiligo cases and controls.
Material and methods: The palmar prints of 100 vitiligo cases were taken from outpatient department of Dermatology, Gandhi Hospital, Secunderabad and 100 healthy controls from general population. Ethics committee clearance has been obtained. Informed consent was taken from the patients and controls. Dermatoglyphic prints were taken by the ink method of Cummins and Midlo. The prints were then subjected to dermatoglyphic analysis with the help of magnifying hand lens and ridge counting was done with the help of a sharp needle and the details were noted.
Results: There was an increased incidence in ulnar loops and decreased incidence of radial loops in vitiligo cases compared to controls. There was a decreased incidence of whorls in male cases and an increased incidence of whorls in female cases compared to controls. There was a decreased incidence of arches in both male and female cases compared to controls. There was a significant increase in the percentage of Simian line in right hand of female cases compared to controls. There was a significant decrease in the percentage of Sydney line in the right hand of female cases compared to controls.
Conclusion: At present there are very few studies on palmar dermatoglyphics in vitiligo. The present study was a small study consisting of 100 patients only. Hence its findings cannot be generalized. Further large case control studies are needed to establish the exact relation between vitiligo and dermatoglyphics.

Neonatal Hypocalcemia and its Association with Neonatal and Maternal Vitamin D Deficiency

Mohd Muthiuddin Muzammil, Lingareddy Kasula, Fatima Nasir — Sat, 11 Apr 2026 00:00:00 +0000

Background: In neonates, hypocalcaemia is a common metabolic manifestation. It is a potentially fatal condition, with reported prevalence varying according to gestational age, maternal and infant comorbidities, and perinatal factors.
Methods: All 100 new-borns admitted in the NICU, and having hypocalcaemia, defined as total serum Calcium <8mg/dl and ionic calcium <3mg/dl, during the study period, and whose parents have given informed consent
Results: The male predominance was seen in 58% and females were 42%. The male : female ratio was 1.38:1. Early onset of hypocalcaemia was seen in 83% of the cases of which Males were 59% and females were 41%. The mean gestational age was 36.27)
+ 1.99 and the mean birth weight was 2.46 + 0.65. The preterm neonates were 27 (32.53%) and term neonates were 56(67.46%)
Conclusion: Vitamin D deficiency was found to be very prevalent in healthy term born infants. Vitamin D deficiency was observed in new-borns, and it was observed that this deficiency was attributed to early neonatal hypocalcaemia. However, the long-term effects of a vitamin D deficiency in childhood are unknown. The use of 25-OH cholecalciferol as a sensitive marker in both term and preterm new-borns is recommended. To prevent neonatal Vitamin D deficiency, mothers were given 1200 IU/day vitamin D supplements from the 12th gestational week to the 6th month of pregnancy.

Risk Stratification and Care Plan for Intervention Based on Indian Academy of Paediatrics Malnutrition Proactive Assessment

Puja Kumari, Ashutosh Kumar Mishra, Navneet Kumar, Sujit Kumar — Wed, 08 Apr 2026 00:00:00 +0000

Background:Malnutrition continues to be a major public health concern in India, significantly contributing to childhood
morbidity, impaired physical and cognitive development, and increased mortality. Despite ongoing national nutrition
programs, early identification of at-risk children remains a challenge. The Indian Academy of Pediatrics (IAP) has
recommended proactive assessment strategies that emphasize early screening, systematic risk stratification, and timely
intervention to address this burden effectively.
Objective:This study aimed to evaluate the effectiveness of IAP-based malnutrition risk stratification in identifying atrisk
children and to assess its role in guiding appropriate intervention planning in a clinical setting.
Methods:A retrospective observational study was conducted involving 250 pediatric patients assessed for nutritional
status. Data were collected from hospital records, including demographic characteristics, nutritional risk categories (low,
moderate, high), and intervention requirements. Statistical analysis was performed using descriptive statistics and chisquare
tests to determine associations between variables. A p-value of less than 0.05 was considered statistically significant.
Results:Out of the 250 children included in the study, 40% were categorized as low risk, 35% as moderate risk, and 25%
as high risk for malnutrition. Overall, 60% of the children required some form of nutritional or medical intervention. A
statistically significant association was observed between risk category and intervention requirement (p = 0.03), with
higher-risk groups demonstrating a greater need for intervention. These findings indicate that the IAP stratification model
effectively differentiates children based on clinical need.
Conclusion:The IAP proactive malnutrition assessment model is an effective tool for early risk identification and
structured intervention planning. Its implementation in routine pediatric practice can facilitate timely management,
prevent progression to severe malnutrition, and improve overall child health outcomes.

Early-Onset Neonatal Sepsis And Its Association With Maternal Vaginal Infection

Fatima Nasir, Lingareddy Kasula, Mohd Muthiuddin Muzammil — Mon, 13 Apr 2026 00:00:00 +0000

Background: Early-onset neonatal sepsis (EONS) is a major contributor to neonatal morbidity and mortality. Maternal
vaginal infection is an important source of vertical transmission.
Methods: This prospective observational study was conducted on 80 term neonates born to mothers with risk factors for
vaginal infection. High vaginal swab (HVS) cultures were obtained from mothers, and neonates were evaluated using
sepsis screen and blood culture.
Results: The incidence of EONS was 37.5% (30/80). Among neonates with EONS, 96.4% had positive sepsis screen,
and 40% (12/30) had positive blood cultures. Gram-negative organisms such as Klebsiella (66.6%), E. coli (25%), and
Acinetobacter (8.3%) predominated. Significant association was observed between maternal risk factors (UTI, PROM)
and EONS.
Conclusion: Maternal vaginal infection is strongly associated with early-onset neonatal sepsis. Early screening using
HVS and neonatal sepsis screening can help reduce morbidity and mortality.

Alleviation of Sodium Arsenite Driven Antioxidant Status and Hepatotoxicity by N-Acetyl Cysteine (NAC)

Moumita Dash — Wed, 08 Apr 2026 00:00:00 +0000

Arsenic has gained popularity for causing multi-organ health ailments. The probable hazardous influence of arsenic stands upon oxidative stress burden and accelerated free radical creation. The usual recovery process against arsenic toxicity has countless opposing consequences. Hence, this experiment was considered to assess the effect of NAC in arsenic imposed antioxidant status and hepatotoxicity. A total of 24 Wistar rats were arbitrarily assigned to four individual groups and the treatment protocol was sustained for 8 successive days. Here, sodium arsenite and NAC was introduced at the dose of 10mg/kg body weight and 100mg/kg body weight respectively. The hepato-renal antioxidant status, serum SGOT, SGPT, urea and creatinine level, status of pro-inflammatory cytokines and hepatic architecture were determined. Sodium arsenite exposed group manifested a remarkably high level of oxidative stress which was further evidenced by diminished antioxidant enzyme levels in hepato-renal tissues. Altered and upgraded level of SGOT and SGPT in arsenic challenged group were a hint of hepatic damage. Along with this, the disarrangement of the cellular structure noticed in hepatic architecture in arsenic exposed group supported hepatoxicity. Moreover, an advanced level of pro-inflammatory cytokines and reduced B-vitamins in the circulation confirmed the toxicity caused by arsenic. NAC application reserved the antioxidant status, improved B-vitamins, and additionally lessened the level of inflammation-causing cytokines and improved the regular histoarchitecture of liver in arsenic ingested animals, suggesting its antioxidant, anti-inflammatory and hepato-protective benefits of NAC.

Thyroid Function Profile in Women with Polycystic Ovary Syndrome: A Cross-Sectional Study

N. Sridevi, V. Sandeesha, GJSL Latha, P. Aparna, Y. Aruna, Gadi Lakshmi Namratha — Wed, 22 Apr 2026 00:00:00 +0000

Background: Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder in reproductive-age women and is frequently associated with metabolic and hormonal disturbances. Thyroid dysfunction, particularly subclinical hypothyroidism, has been reported in PCOS, but findings remain inconsistent.
Methods: This cross-sectional study included 200 women (100 PCOS and 100 non-PCOS), aged 19–25 years, from a tertiary care center. PCOS was diagnosed using Rotterdam criteria. Serum T3, T4, and TSH levels were measured using standard immunoassays. Statistical analysis included Student’s t-test, chi-square test, and Pearson correlation.
Results: Mean T3, T4, and TSH levels were identical in both groups (T3: 1.14 ng/mL, T4: 7.62 ng/dL, TSH: 2.58 mIU/L), with no statistically significant differences. Thyroid parameters showed non-normal distribution with high variability, particularly TSH. Weak, non-significant correlations were observed between BMI and thyroid hormones in both groups.
Conclusion: Thyroid dysfunction appears independent of PCOS status and BMI in young women. Similar thyroid profiles in both groups suggest a population-level burden rather than a PCOS-specific association. Universal thyroid screening is recommended.

EUS-Guided Detection of Multidrug-Resistant Shigella dysenteriae from Retroperitoneal Cyst Fluid: A Rare Gastroinfectious Entity

Wed, 29 Apr 2026 00:00:00 +0000

Background: Shigella dysenteriae is an invasive enteric pathogen classically associated with bacillary dysentery.
Extraintestinal isolation is rare and typically occurs in immunocompromised hosts. Retroperitoneal cyst infections due
to Shigella have scarcely been reported. Emerging antimicrobial resistance among Shigella species further complicates
management.
Case Presentation: A 47-year-old immunocompetent male presented with abdominal pain and was found to have a
retroperitoneal aortocaval multiseptated cyst on imaging. Endoscopic ultrasound (EUS)-guided fine needle aspiration
yielded hemorrhagic cyst fluid. Microbiological culture grew multidrug-resistant Shigella dysenteriae. Antimicrobial
susceptibility testing, interpreted according to CLSI guidelines, revealed resistance to third-generation cephalosporins
and carbapenems. The patient was treated with culture-directed therapy and improved clinically.
Conclusion: This case highlights a rare extraintestinal presentation of multidrug-resistant Shigella dysenteriae and
underscores the importance of microbiological evaluation of cystic lesions and adherence to standardized susceptibility
testing guidelines.

Assessment of Thyroid Function Among Hypertensive Pregnant Women: A Cross Sectional Study

Shiv Purari, Dhirendra Kumar, Sanjay Kumar, Sujit Kumar — Tue, 28 Apr 2026 00:00:00 +0000

Background: Hypertensive disorders of pregnancy are among the leading causes of maternal and perinatal morbidity
worldwide. Thyroid dysfunction during pregnancy has been associated with adverse obstetric outcomes including
gestational hypertension and preeclampsia. Early recognition of altered thyroid status among hypertensive pregnant
women may improve maternal and fetal outcomes.
Objective: To assess thyroid function status among hypertensive pregnant women and determine the prevalence of
thyroid dysfunction in this population.
Materials and Methods: A hospital-based cross-sectional study was conducted at Bhagwan Mahavir Institute of
Medical Sciences, Pawapuri, India, over a period of one year from February 2025 to January 2026. A total of 60
hypertensive pregnant women were enrolled. Detailed clinical history, obstetric examination, blood pressure measurement,
and laboratory investigations including serum thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free
triiodothyronine (FT3) were performed. Thyroid status was categorized according to trimester-specific reference ranges.
Data were analyzed using SPSS version 26.0. Statistical significance was considered at p<0.05.
Results: The mean age of participants was 27.8±4.6 years. Gestational hypertension was present in 36 (60.0%) women,
preeclampsia in 18 (30.0%), and chronic hypertension in 6 (10.0%). Thyroid dysfunction was identified in 21 (35.0%)
participants. Subclinical hypothyroidism was the most common abnormality seen in 13 (21.7%), followed by overt
hypothyroidism in 5 (8.3%) and subclinical hyperthyroidism in 3 (5.0%). Mean TSH levels were significantly higher
among women with preeclampsia compared with gestational hypertension (4.82±1.76 vs 3.11±1.28 mIU/L, p=0.002).
Higher systolic blood pressure showed positive correlation with TSH levels (r=0.42, p=0.001).
Conclusion: Thyroid dysfunction, particularly hypothyroidism, is common among hypertensive pregnant women.
Routine thyroid screening may be beneficial in hypertensive pregnancies for early diagnosis and timely management.

Assessment of Rational Antibiotic use in General Medicine Wards: a Prospective Observational Study

Dhirendra Kumar, Shiv Purari, Sujit Kumar, Sanjay Kumar — Tue, 28 Apr 2026 00:00:00 +0000

Background: Irrational use of antibiotics is a major contributor to antimicrobial resistance (AMR), increased healthcare
costs, and adverse drug reactions. Monitoring antibiotic prescribing patterns is essential for promoting rational drug use.
Objective: To assess the rational use of antibiotics in general medicine wards of a tertiary care hospital.
Methods: This prospective observational study was conducted over 12 months (February 2025 to January 2026) at
Bhagwan Mahavir Institute of Medical Sciences, Pawapuri. A total of 190 patients admitted to general medicine wards
and receiving antibiotics were included. Data regarding demographics, diagnosis, antibiotic prescriptions, and adherence
to standard guidelines were collected. Rationality was assessed using WHO prescribing indicators and standard treatment
guidelines. Statistical analysis was performed using SPSS version 25.
Results: Out of 190 patients, 61.6% received rational antibiotic therapy, while 38.4% prescriptions were irrational. The
most common irrationalities included inappropriate drug selection (18.4%), incorrect duration (11.6%), and improper
dosage (8.4%). Third-generation cephalosporins were the most commonly prescribed antibiotics (42.1%). Culture
sensitivity testing was performed in only 36.8% cases. A statistically significant association was found between culture
testing and rational prescribing (p < 0.05).
Conclusion: A substantial proportion of antibiotic use was irrational. Strengthening antimicrobial stewardship programs
and adherence to treatment guidelines are essential to improve rational antibiotic use.

Impact of Lifestyle Modification Counseling on Hypertension Control in Opd patients: a Prospective Observational Study

Dhirendra Kumar, Shiv Purari, Sujit Kumar, Sanjay Kumar — Tue, 28 Apr 2026 00:00:00 +0000

Background:Hypertension is a significant modifiable risk factor of cardiovascular morbidity and mortality across the
globe. Lifestyle modification counseling plays a critical role in blood pressure (BP) management, especially in outpatient
settings.
Objective:To evaluate the role of structured lifestyle modification counseling on the control of blood pressure among
patients with hypertension attending the outpatient department (OPD).
Methods:This study was conducted at a tertiary care center in Bihar. A total of 130 hypertensive patients were enrolled
over a 9-month period (April 2025 to December 2025), and each participant was followed up for 3 months. Baseline
demographic, clinical, and lifestyle parameters were recorded. Patients received standardized counselling. Blood pressure
readings were recorded at baseline and follow-up visits. Statistical analysis was performed using paired t-test and chisquare
test.
Results: Mean systolic BP reduced significantly from 152.4 ± 12.6 mmHg at baseline to 136.8 ± 10.2 mmHg at 3 months
(p < 0.001). Mean diastolic BP decreased from 94.2 ± 8.4 mmHg to 84.6 ± 6.8 mmHg (p < 0.001). The proportion of
patients achieving BP control increased from 18.5% to 62.3% (p < 0.001).
Conclusion: Lifestyle modification counseling significantly improves blood pressure control in hypertensive OPD patients.
Incorporating structured counseling into routine clinical practice can enhance hypertension management outcomes.

Clinical Profile and Outcomes of Patients with Multimorbidity in Inpatient Settings: A Prospective Observational Study

Shiv Purari, Dhirendra Kumar, Sanjay Kumar, Sujit Kumar — Tue, 28 Apr 2026 00:00:00 +0000

Background: Multimorbidity, characterized by the coexistence of multiple chronic conditions in an individual, is increasingly recognized as a major challenge in inpatient care. It is associated with increased healthcare utilization, prolonged hospitalization, and adverse clinical outcomes.
Objective: To assess the clinical profile and outcomes of patients with multimorbidity admitted in a tertiary care hospital.
Methods: This prospective observational study was conducted at Bhagwan Mahavir Institute of Medical Sciences, Pawapuri, over 8 months (March–October 2025). A total of 72 patients with multimorbidity were included. Data were analyzed using descriptive statistics and inferential tests.
Results: Mean age was 58.4 ± 12.6 years. Hypertension (68.1%) and diabetes (55.6%) were the most common comorbidities. Longer hospital stay (>7 days) was observed in 41.7% patients. Mortality rate was 11.1%. Multimorbidity count ≥3 showed significant association with adverse outcomes (p < 0.05).
Conclusion: Multimorbidity significantly influences inpatient outcomes, including mortality and length of stay. Early identification and integrated management are essential.

Interleukin-6 Gene Promoter Region Polymorphism in Patients with Dilated Cardiomyopathy: A Prospective Observational Study

Shiv Purari, Dhirendra Kumar, Sanjay Kumar, Sujit Kumar — Tue, 28 Apr 2026 00:00:00 +0000

Background: Dilated cardiomyopathy (DCM) is characterized by enlargement of the ventricular chambers with reduced myocardial contractility, leading to impaired cardiac performance. Its pathogenesis is multifactorial, involving a complex interplay between genetic susceptibility and inflammatory mechanisms. Interleukin-6 (IL-6), a pro-inflammatory cytokine, plays a key role in myocardial remodeling, and polymorphisms in its promoter region may influence disease susceptibility and severity.
Objective: To examine the relationship between IL-6 promoter gene polymorphism and clinical outcomes among patients with DCM.
Methods: This study was conducted at a tertiary care center inPawapuri, over 10 months (April 2025–January 2026). A total of 110 patients diagnosed with DCM were included. IL-6 promoter polymorphism (−174 G/C) was analyzed using PCR-based techniques. Clinical parameters and outcomes were recorded and statistically analyzed.
Results: The GG genotype was most prevalent (52.7%), followed by GC (34.5%) and CC (12.8%). Patients with the CC genotype showed significantly reduced left ventricular ejection fraction (LVEF) and higher NYHA class. The CC genotype was associated with increased hospitalization and mortality.
Conclusion: IL-6 promoter polymorphism is significantly associated with disease severity and outcomes in DCM patients, suggesting its potential role as a prognostic biomarker.

Risk Factors for Meconium Stained Liquor and Outcome of Neonate in Meconium Stained Amniotic Fluid

Richa Sulaniya, Anju Depan, Meenakshi Samaria, Kanti Yadav — Tue, 28 Apr 2026 00:00:00 +0000

Background: Meconium-stained amniotic fluid (MSAF) is a common obstetric finding associated with increased perinatal morbidity and mortality. It may indicate fetal distress, placental insufficiency, or physiological gastrointestinal maturation in term pregnancies. Early recognition of maternal and intrapartum risk factors is important for timely intervention and improved neonatal outcomes.
Objective: To identify risk factors associated with meconium-stained liquor and evaluate neonatal outcomes among deliveries complicated by MSAF.
Methods: A prospective observational study was conducted over two years (January 2024 to January 2026) in 100 women with meconium-stained liquor during labor. Maternal demographic data, obstetric risk factors, intrapartum variables, mode of delivery, and neonatal outcomes were recorded. Statistical analysis was performed using SPSS version 24. Chi-square test was used, and p < 0.05 was considered significant.
Results: Postdated pregnancy (32%), pregnancy-induced hypertension (18%), oligohydramnios (16%), and prolonged labor (14%) were the commonest risk factors. Thick meconium was present in 42% cases and was significantly associated with low Apgar score at 5 minutes (p=0.01), meconium aspiration syndrome (p=0.003), NICU admission (p=0.002), and cesarean delivery (p=0.02). Overall NICU admission rate was 24%, while meconium aspiration syndrome occurred in 12% neonates.
Conclusion: Meconium-stained liquor is strongly associated with postdated pregnancy and hypertensive disorders. Thick meconium significantly increases adverse neonatal outcomes. Prompt intrapartum monitoring and early neonatal resuscitation are essential to reduce morbidity.

Clinical Profile and Treatment Outcomes of Abnormal Uterine Bleeding in Perimenopausal Women: An Observational Study

Abha Sinha, Anshu . — Wed, 08 Apr 2026 00:00:00 +0000

Background: Abnormal uterine bleeding (AUB) is a common gynecological concern in perimenopausal women, significantly affecting quality of life. The etiological spectrum ranges from benign structural causes to malignancies, necessitating systematic evaluation and tailored management.
Objective: To assess the clinical profile, etiological patterns, and treatment outcomes of abnormal uterine bleeding in perimenopausal women.
Methods: This observational study was conducted at the Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Bhagalpur, from February 2025 to January 2026. A total of 140 perimenopausal women presenting with AUB were included. Clinical data, laboratory findings, imaging, histopathology, and treatment outcomes were analyzed.
Results: The most common age group was 45–49 years (42.1%). Heavy menstrual bleeding (HMB) was the most frequent presentation (48.6%). Structural causes (PALM group) accounted for 61.4% of cases, with leiomyoma being predominant (32.1%). Medical management was effective in 58.6% of cases, while 41.4% required surgical intervention. Significant improvement in symptoms was observed in 87.1% of patients (p < 0.05).
Conclusion: AUB in perimenopausal women is predominantly due to benign structural causes. Early diagnosis and appropriate management lead to favorable outcomes, with individualized treatment being essential.

Cardiovascular Pathology: Biochemical Risk Factors and Diagnostic Biomarkers – A Prospective Observational Study

Puja Singh, Aakash ., Vivek Sinha, Wakeel Ahmad — Wed, 08 Apr 2026 00:00:00 +0000

Background: Cardiovascular diseases (CVDs) remain the leading cause of mortality globally. Biochemical risk factors and diagnostic biomarkers play a crucial role in early detection, risk stratification, and management.Objective: To evaluate the association between biochemical risk factors and diagnostic biomarkers in patients with cardiovascular pathology.Methods: This prospective observational study was conducted at Narayan Medical College, Jamuhar, Sasaram, Bihar, from January 25, 2025 to January 25, 2026. A total of 100 patients with suspected or confirmed cardiovascular disease were included. Biomarkers including lipid profile, high-sensitivity C-reactive protein (hs-CRP), troponin I, CK-MB, and fasting blood glucose were analyzed.Results: Elevated LDL, hs-CRP, and troponin I were significantly associated with adverse cardiovascular outcomes (p< 0.05). Strong correlations were observed between inflammatory markers and disease severity.Conclusion: Biochemical markers such as lipid parameters and inflammatory biomarkers are valuable predictors of cardiovascular pathology. Early detection using these markers can improve clinical outcomes.

Association of Serum Magnesium Status and Calcium–Magnesium Ratio with Diabetic Retinopathy in an Urban Hospital of Kolkata

Saurav Dey, Debkumar Ghosh, Jishnu Giri — Wed, 08 Apr 2026 00:00:00 +0000

Background: Diabetic retinopathy is a prominent microvascular consequence of diabetes and a main cause of vision loss. Emerging data suggests that magnesium insufficiency and calcium-magnesium imbalances may play a role in its aetiology.

Methods: This study evaluated serum magnesium levels, calcium levels, and the calcium-magnesium (Ca/Mg) ratio between diabetic retinopathy patients and controls. A total of 200 patients (100 cases and 100 controls) were examined. Biochemical parameters were assessed and statistically compared, with p-values < 0.05 indicating significance.Results: Cases had considerably lower serum magnesium levels than controls, with a higher prevalence of hypomagnesemia among them. The Ca/Mg ratio was much higher in some cases, indicating a relative imbalance between calcium and magnesium. The results were statistically significant (p < 0.05). The changed mineral profile was related with a higher incidence of diabetic retinopathy.Conclusion: This study found a robust link between hypomagnesemia, an elevated Ca/Mg ratio, and diabetic retinopathy. Magnesium shortage appears to be a major factor in the development of microvascular problems in diabetes. Monitoring and adjusting magnesium levels may be a useful technique for early management and prevention of diabetic retinopathy. Additional large-scale investigations are needed to validate these findings.

Fracture Neck Femur in Adults Managed with Three Cannulated Cancellous Screws Put in Biplane Double Supported Fixation (BDSF) vs Conventional Inverted Triangle Configuration: A Comparative Randomised Control Study of the Functional Outcome

Wed, 08 Apr 2026 00:00:00 +0000

Background and Rationale: Fracture neck of femur in the adult population constitutes a formidable orthopaedic challenge, with fixation configuration critically determining biomechanical stability and functional recovery. The Biplane Double-Supported Screw Fixation (BDSF) technique — by distributing three cannulated cancellous screws (CCS) across two anatomical planes — offers a theoretically superior load- sharing construct compared to the conventional inverted triangle arrangement. However, comparative clinical evidence in the adult age group remains limited.Aims and Objectives: To prospectively compare the intraoperative feasibility and post-operative functional outcome of BDSF versus conventional inverted triangle CCS fixation in adult femoral neck fractures using the Harris Hip Score and complication profile.Methods: In this prospective, interventional, single-centre RCT conducted at UPUMS Saifai over 18 months (June 2023–December 2024), 60 adult patients aged 18–60 years with femoral neck fractures (Pauwels I–III; closed/Gustillo Grade I) were randomized by random block technique into two equal groups: Group A (Conventional Inverted Triangle, n=30) and Group B (BDSF, n=30). Primary outcome was Harris Hip Score at 6 months. Secondary outcomes included intraoperative parameters (operative time, blood loss, fluoroscopy exposure), rehabilitation milestones, and complications (AVN, non-union, implant failure, femoral neck shortening, surgical site infection). Baseline equivalence was confirmed across all demographic and clinical variables (p>0.05).Results: Both groups were statistically comparable at baseline in age (45.33±8.21 vs. 44.87±7.92 years; p=0.826), gender, fracture laterality, mechanism of injury, Pauwels classification, and injury-to- surgery interval. Intraoperatively, fluoroscopy exposure time was significantly lower in Group B (28.07±4.36 sec vs. 35.17±5.68 sec; p<0.0001), with a trend toward shorter operative duration (50.81±9.37 vs. 55.23±10.11 min; p=0.084). Complication rates consistently favoured BDSF: non-union 0% vs. 6.67%, implant failure 6.67% vs. 16.67%, femoral neck shortening >1 cm 6.67% vs. 13.33%, AVN 3.33% vs. 6.67%, surgical site infection 3.33% vs. 10.00%, and hip stiffness 3.33% vs. 10.00%. Harris Hip Score at 6 months was excellent (90–100) in 80% of Group B vs. 60% of Group A, with treatment failure (HHS <60) entirely absent in Group B versus 6.67% in Group A.Conclusion:The BDSF technique demonstrates clear superiority over the conventional inverted triangle configuration across intraoperative efficiency, complication profile, rehabilitation parameters, and functional recovery. With a significantly reduced fluoroscopic burden, zero non-union, and superior Harris Hip Scores, BDSF is recommended as the preferred fixation strategy for femoral neck fractures in adult patients. Multicentre validation with extended follow-up is warranted to consolidate these findings.

Hematological Disorders: Biochemical Aspects and Pathological Features – A Prospective Observational Study

Puja Singh, Aakash ., Vivek Sinha, Wakeel Ahmad — Wed, 06 May 2026 00:00:00 +0000

Background: Hematological disorders encompass a wide range of conditions affecting blood cells and coagulation
mechanisms. Biochemical parameters and pathological features are essential for diagnosis, classification, and prognosis.
Objective: To evaluate the biochemical alterations and pathological characteristics associated with hematological disorders
in a tertiary care setting.
Methods: This prospective observational study was conducted at Narayan Medical College, Jamuhar, Sasaram, Bihar,
from January 25, 2025 to January 25, 2026. A total of 100 patients diagnosed with hematological disorders were included.
Parameters analyzed included complete blood count (CBC), serum iron, ferritin, vitamin B12, lactate dehydrogenase
(LDH), and peripheral smear findings.
Results: Significant alterations were observed in hemoglobin, serum ferritin, vitamin B12, and LDH levels (p < 0.05).
Peripheral smear analysis revealed microcytic hypochromic anemia as the most common pattern, followed by normocytic
and macrocytic changes. Strong correlations were identified between biochemical markers and pathological severity.
Conclusion: Biochemical parameters combined with pathological evaluation provide valuable insights into hematological
disorders, aiding early diagnosis and management.

Association of Admission Serum Ferritin Levels with Disease Severity and Clinical Outcomes in Acute Infections: A Prospective Observational Study

Mahesh A., Dulam Pradeep Kumar, K. Ambaresha — Fri, 03 Apr 2026 00:00:00 +0000

Background:Acute infections remain a significant cause of morbidity and mortality worldwide, often progressing to
severe systemic illness with organ dysfunction if not identified and managed promptly. Early identification of patients
at risk of severe disease is essential for timely intervention and improved outcomes. Serum ferritin, an intracellular
iron storage protein and acute phase reactant, has emerged as a potential biomarker reflecting inflammatory burden in
infectious conditions. Elevated ferritin levels have been reported in bacterial, viral, and systemic infections and may
correlate with disease severity and prognosis.
Objectives: To evaluate the association between admission serum ferritin levels and disease severity in patients with acute
infections and to assess its relationship with clinical outcomes including intensive care unit (ICU) admission, duration
of hospital stay, need for mechanical ventilation, and in-hospital mortality.
Methods: This prospective observational study included 180 adult patients admitted with acute infections to the Department
of General Medicine of a tertiary care teaching hospital over a period of 12 months. Patients aged ≥18 years with clinically
and laboratory-confirmed acute infections were enrolled after obtaining informed consent. Serum ferritin levels were
measured within 24 hours of admission using chemiluminescent immunoassay. Disease severity was assessed using
Sequential Organ Failure Assessment (SOFA) and quick SOFA (qSOFA) scoring systems. Clinical outcomes including
ICU admission, mechanical ventilation, length of hospital stay, and mortality were recorded. Statistical analysis was
performed using SPSS version 26.0, with p < 0.05 considered statistically significant.
Results: The mean age of study participants was 49.6 ± 16.2 years, with a male predominance (57.8%). The most common
acute infections included pneumonia, urinary tract infection, cellulitis, dengue, and sepsis of unknown origin. Mean
serum ferritin levels increased significantly with disease severity, measuring 248 ± 96 ng/mL in mild cases, 612 ± 188
ng/mL in moderate cases, and 1284 ± 410 ng/mL in severe cases (p < 0.001). Elevated ferritin levels were significantly
associated with ICU admission, prolonged hospital stay, need for mechanical ventilation, and in-hospital mortality. A
strong positive correlation was observed between serum ferritin and SOFA score (r = 0.68, p < 0.001).
Conclusion: Admission serum ferritin levels demonstrated a significant association with disease severity and adverse
clinical outcomes in patients with acute infections. Serum ferritin may serve as a practical, accessible, and cost-effective
adjunct biomarker for early risk stratification and prognostic assessment in acute infectious illnesses

Variant formation of the median nerve with its applied importance

Santanu Kumar Sarma, Natasha Gohain, Dhurjati Das, Jayasri Devi — Tue, 19 May 2026 00:00:00 +0000

Introduction: A detailed knowledge of variations in the formation of the median nerve is crucial for anatomists, surgeons, anaesthesiologists, radiologists, and other medical professionals, particularly when performing clinical investigations or surgical interventions involving the axilla and upper limb. Given the frequency of these variations, this study aims to investigate the anatomical variations of the median nerve with respect to its formation.
Materials and Methods: A total of 38 human cadavers of either sex comprising of perinates and adults were included in the present study. After removing the appropriate structures, the median nerve carefully dissected out and observed.
Results: In 2.27% and 4.55% of specimens, median nerve formed from two roots and three roots from the lateral cord respectively. And in 2.27% of all specimens, median nerve formed from two roots from the medial cord. With reference to the third part of axillary artery, 2.27% and 2.63% of specimens, there were higher and lower formation of the median nerve respectively.
Discussion: The present study confirmed that many variations in the formation of median nerve do exist. This knowledge will be of great help to explain a particular pattern of paralysis in the event of such a nerve being damaged. It may also explain affection of surrounding blood vessels.

Valorisation of Citrus Processing Waste with Special Emphasis on Lemon: Bioactive Compounds, Extraction Techniques, and Sustainable Applications

Shreya Saha, Rojina Khatun, Sudeshna Sengupta, Malavika Bhattacharya — Wed, 20 May 2026 00:00:00 +0000

A substantial proportion, which is approximately 40-50% of the biomass, is discarded as waste in the form of pomace, seeds and peels from the citrus fruits such as lemon. The generation of large quantities of agro-industrial wastes has increased the rapid expansion of the worldwide fruit processing industry. The residues, which are traditionally considered waste, pose a significant environmental challenge. With diverse therapeutic & functional properties, the recent studies highlight that those citrus wastes are a rich source of valuable biologically active compounds, including flavonoids, pectin, phenolics, essential oils & dietary fibres. By exploring the extraction methods, industrial applications & composition, this review focuses on the valorisation of citrus wastes with a special emphasis on the lemon-based by-products. In terms of sustainability & efficiency, both conventional extraction techniques and modern advanced green technologies are used, such as supercritical fluid, microwave-assisted, ultrasound-assisted & enzyme-assisted extractions. Moreover, Pectin has gained a huge significant attention due to its wide applications in pharmaceutical, food & biodegradable packaging industries among all other recovered compounds. In addition, citrus wastes can also be changed or transformed into value-added products such as functional foods, biofuels, biopolymers, eco-friendly packaging materials and nutraceuticals, supporting sustainable development and circular bioeconomy. Challenges related to large-scale implementation, process optimisation, and cost remain a major concern despite all these advancements. For the conversion of citrus waste into valuable bioresources while reducing the environmental impact and promoting a sustainable industrial practice, waste valorisation offers a promising and strong strategy.

Morphometric Analysis of Sacral Hiatus and it’s Clinical Relevance

Anshu Bhargava, Swati Yadav, Latika Arora, Soniya Arunkumar Gupta — Sat, 23 May 2026 00:00:00 +0000

Background: Sacral Hiatus (SH) is an arched shaped gap on the dorsal surface of Sacrum just below the fourth tubercle. It is extensively used by anesthesiologists and Surgeons for Caudal Epidural Block, for therapeutic and diagnostic purposes. The success rate of Caudal Epidural Block depends upon the accuracy of palpation of Sacal Hiatus. It is sometimes difficult to locate it in adults due to various morphological variations. Morphometric measurements of Sacral Hiatus are of prime significance in locating Sacral Hiatus. Therefore, this study is aimed at analysing the various morphometric parameters of Sacral Hiatus to help in reducing the failure rate in Caudal Epidural Block.
Aim: To evaluate the various morphometric parameters of Sacral Hiatus in dry adult human sacrum.
Materials and Methods: This study was conducted on 50 fully ossified dry adult human sacra of unknown sex obtained from Santosh Medical College and Hospital, Ghaziabad. Measurements were taken using a digital Vernier caliper (accuracy 0.01 cm) and a flexible measuring tape. The various morphometric parameters of Sacral Hiatus assessed were: the shape of Sacral Hiatus, location of Apex and Base of Sacral Hiatus, length of Sacral Hiatus, Anteroposterior diameter at apex and transverse diameter at cornua of Sacral Hiatus. Data were analyzed using mean ± standard deviation and range.
Results: The SH apex was most commonly at S4 (60%) and the base at S5 (78%). SH length was 1–2 cm in 82% (mean 1.75 ± 0.66 cm). Anteroposterior diameter at apex measured 0.3–0.6 cm in 68% (mean 0.6 ± 0.15 cm), and transverse diameter at cornua was 1–2 cm in 80% (mean 1.49 ± 0.39 cm). Inverted U shape predominated (48%).
Conclusion: Sacral Hiatus exhibits significant morphological variations which are clinically relevant for Caudal Epidural Block. Understanding these variations and considering them can improve the success rate and minimize the complications.

Trimester-Specific Reference Intervals Of Thyroid Status In Pregnancy – A Cross-Sectional Study

Sat, 23 May 2026 00:00:00 +0000

Background: Thyroid dysfunction during pregnancy is associated with significant maternal and fetal complications. Accurate trimester-specific reference ranges are essential for appropriate diagnosis, risk stratification, and timely management.
Objectives: To determine the prevalence of thyroid dysfunction (euthyroid, subclinical hypothyroidism, and overt hypothyroidism) in pregnant women, identify associated maternal risk factors, compare maternal and neonatal outcomes across thyroid function groups, and derive trimester-specific reference intervals for thyroid-stimulating hormone.
Methods: This hospital-based cross-sectional study included 300 antenatal women attending a tertiary care center over a six-month period. Serum thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels were estimated using a chemiluminescent immunoassay. Participants were categorized as euthyroid, subclinical hypothyroid, or overt hypothyroid based on trimester-specific interpretation. Maternal and neonatal outcomes were recorded prospectively. Logistic regression analysis was used to identify independent risk factors. Trimester-specific reference intervals for TSH were calculated using the 2.5th–97.5th percentile method.
Results: The overall prevalence of hypothyroidism was 18.7%, including 13.3% subclinical and 5.4% overt hypothyroidism. Significant risk factors included anemia (OR 2.1, p=0.01), obesity (OR 1.8, p=0.03), and family history of thyroid disease (OR 2.5, p=0.004). Subclinical hypothyroidism was significantly associated with preeclampsia (p=0.02), gestational diabetes (p=0.03), and low birth weight (p=0.01). Trimester-specific TSH reference intervals were: first trimester 0.4–4.1 mIU/L, second trimester 0.6–4.5 mIU/L, third trimester 0.7–4.8 mIU/L.
Conclusion: Thyroid dysfunction is common in pregnancy and is associated with adverse outcomes. Population-specific trimester-based reference intervals improve diagnostic accuracy and clinical care.

Utilization Patterns and Outcome Impact of Inotrope–vasopressin Combinations Across Different Shock Phenotypes (Septic, Cardiogenic, Hypovolemic) in a Resource-limited Tertiary Care Setting: A Six-month Prospective Observational Analysis

Sat, 23 May 2026 00:00:00 +0000

Background: Shock represents a life-threatening state of circulatory failure characterized by inadequate tissue perfusion and impaired oxygen delivery. Vasoactive agents including inotropes and vasopressors remain central to hemodynamic stabilization. Although norepinephrine is widely recommended as first-line therapy, vasopressin is frequently added in refractory hypotension. Evidence regarding real-world utilization patterns and outcome impact across different shock phenotypes in resource-limited tertiary care settings remains limited.
Objective: To evaluate prescribing patterns and clinical outcomes associated with inotropes and vasopressin therapy in septic, cardiogenic, and hypovolemic shock patients admitted to an intensive care unit.
Methods: A prospective observational study was conducted over six months in the medicine intensive care unit of a tertiary care teaching hospital. All adult patients diagnosed with shock and receiving vasopressor/inotrope therapy were included. Demographic characteristics, type of shock, vasoactive drug utilization, combination therapy, and clinical outcomes (mortality and survival) were recorded and analyzed descriptively.
Results: A total of 106 patients were included. Septic shock was the most common phenotype (65%), followed by cardiogenic (22%) and hypovolemic shock (13%).Norepinephrine monotherapy was the most frequently used agent (n=64), followed by vasopressin alone (n=26) and norepinephrine-vasopressin combination therapy (n=16).
Conclusion: Norepinephrine remains the most effective first-line vasopressor across shock phenotypes. Vasopressin appears beneficial as an adjunct in refractory septic shock but not as monotherapy in cardiogenic shock. Early escalation to combination therapy may improve outcomes in selected critically ill patients. Further multicenter randomized trials are required.

Study of Intestinal Obstruction due to Tuberculosis: A Retrospective Study

Farrukh Hassan, Tabish Hassan — Wed, 27 May 2026 00:00:00 +0000

Background: Intestinal tuberculosis is an important form of extrapulmonary tuberculosis and remains a major health
concern in developing countries. The ileocecal region is the most commonly affected site, and complications such as
intestinal obstruction frequently require surgical intervention. Early diagnosis and appropriate management are essential
to prevent morbidity.
Aim: To evaluate the clinical presentation, radiological findings, management strategies, and outcomes of patients with
intestinal obstruction due to tuberculosis.
Methods: A retrospective observational study was conducted at Rajendra Institute of Medical Sciences (RIMS), Ranchi,
from January 2024 to January 2026. Medical records of 40 patients diagnosed with intestinal obstruction secondary to
tuberculosis were analyzed. Demographic characteristics, clinical presentation, radiological findings, operative procedures,
and postoperative outcomes were evaluated. Statistical analysis was performed using SPSS software.
Results: Among 40 patients, the majority belonged to the 21–40 year age group (45%). Males constituted 57.5% of cases.
Abdominal pain (92.5%) was the most common symptom followed by vomiting (72.5%). The ileocecal region was the
most frequently involved site (50%). Surgical management was required in 70% of patients, while the remaining were
treated conservatively. Postoperative complications occurred in 17.5% of cases.
Conclusion: Intestinal tuberculosis remains a significant cause of intestinal obstruction in endemic regions. Early
recognition, combined with appropriate surgical management and antitubercular therapy, is crucial for improved patient
outcomes.

Anatomical Study of Fascial Planes Relevant to Laparoscopic Gastrointestinal Surgery: A One-Year Observational Study at PMCH, Patna

Surbhi Surbhi, Rekha Sinha, Amrita Kumari — Fri, 27 Feb 2026 00:00:00 +0000

Background: Precise understanding of facial planes is fundamental for safe and effective laparoscopic gastrointestinal
surgery. Facial planes guide surgical dissection, minimize vascular injury, reduce operative complications, and facilitate
oncological clearance. Inadequate anatomical knowledge may result in inadvertent bowel injury, hemorrhage, and
postoperative morbidity.
Objective: To evaluate the anatomical characteristics and surgical relevance of facial planes encountered during
laparoscopic gastrointestinal surgeries and to assess their association with operative outcomes.
Materials and Methods: A hospital-based cross-sectional observational study was conducted in the Department of
General Surgery in collaboration with the Department of Anatomy at PMCH, Patna, over a period of one year. A total of
110 patients undergoing laparoscopic gastrointestinal procedures were included. facial planes assessed intraoperatively
included Toldt’s fascia, mesocolic plane, mesorectal plane, hepatoduodenal ligament fascia, and retroperitoneal fascial
planes. Parameters evaluated included clarity of facial plane identification, ease of dissection, operative blood loss,
operative time, inadvertent injury, and postoperative complications. Statistical analysis was performed using SPSS
version 25. Chi-square test and Student’s t-test were applied, and p-value <0.05 was considered statistically significant.
Results : Clear identification of facial planes was achieved in 82.7% of procedures. Toldt’s fascia was the most consistently
identifiable plane (76.4%), followed by mesocolic fascial planes (69.1%). Difficult fascial plane identification was
associated with increased operative time and blood loss (p <0.001). Intraoperative complications were significantly
lower in cases with well-preserved anatomical planes (p = 0.003). Intraoperative complications such as serosal injury and
postoperative complications including localized collections were more common in patients with distorted fascial anatomy.
Conclusion: Detailed understanding of facial planes significantly improves surgical precision and reduces operative
morbidity during laparoscopic gastrointestinal surgery. Routine emphasis on facial anatomy during surgical training may
enhance operative safety and clinical outcomes.

Spectrum and Frequency of Megakaryocyte Morphological Alterations in Thrombocytopenia: A Cross-Sectional Study from a Tertiary Care Centre in Eastern India

Dipika Kumari, Abhishek Kumar Jha, Md. Alimuddin Ansari — Wed, 27 May 2026 00:00:00 +0000

Background: Thrombocytopenia is a commonly encountered hematological abnormality associated with diverse etiologies ranging from transient infections to primary bone marrow disorders. Bone marrow examination remains an important diagnostic tool in evaluating thrombocytopenia, particularly through assessment of megakaryocyte morphology. Alterations in megakaryocyte number, maturation, and nuclear characteristics often provide important clues regarding the underlying pathology.
Objective: To evaluate the spectrum and frequency of megakaryocyte morphological alterations in patients presenting with thrombocytopenia.
Materials and Methods: A hospital-based cross-sectional observational study was conducted in the Department of Pathology at Rajendra Institute of Medical Sciences (RIMS), Ranchi, over a period of 1.5 years. A total of 73 patients with thrombocytopenia undergoing bone marrow examination were included. Bone marrow aspiration smears were stained with Leishman stain and examined for megakaryocyte morphology. Morphological alterations including hypolobation, micromegakaryocytes, bare nuclei, immature forms, emperipolesis, cytoplasmic vacuolization, and dysplastic changes were evaluated. Statistical analysis was performed using SPSS version 25.0. Chi-square test and Student’s t-test were used where appropriate, and p-value <0.05 was considered statistically significant.
Results: The mean age of study participants was 41.8 ± 15.6 years, with a male predominance (58.9%). Immune thrombocytopenic purpura (ITP) was the most common cause of thrombocytopenia (32.9%), followed by megaloblastic anemia (20.5%) and aplastic anemia (13.7%). Increased megakaryocytes were observed in 57.5% of cases, while decreased megakaryocytes were noted in 24.7%. Hypolobated megakaryocytes were the most frequent morphological abnormality (50.7%), followed by bare megakaryocytic nuclei (45.2%), immature megakaryocytes (39.7%), micromegakaryocytes (28.8%), and emperipolesis (19.2%). Dysplastic changes were significantly more common in myelodysplastic syndrome and leukemia cases (p = 0.002).
Conclusion: Megakaryocyte morphological evaluation provides valuable diagnostic information in thrombocytopenia. Specific alterations such as hypolobation, micromegakaryocytes, and dysplastic forms may help differentiate reactive from neoplastic and marrow failure conditions.

Milan Scoring System in the Diagnosis of Salivary Gland Lesions for Assessment of Risk of Malignancy: A Retrospective Study

Arpita Dhal, Anuradha Panda, U Sai Krishna Reddy — Wed, 27 May 2026 00:00:00 +0000

Background: Fine-needle aspiration cytology (FNAC) plays a pivotal role in the evaluation of salivary gland lesions. The Milan System for Reporting Salivary Gland Cytopathology standardizes reporting and stratifies the risk of malignancy (ROM).
Objective: To evaluate the diagnostic utility of the Milan scoring system in salivary gland lesions and assess the associated risk of malignancy.
Methods: A retrospective study was conducted on 200 cases at the Department of Pathology, M.K.C.G Medical College and Hospital, Berhampur, Odisha, from August 2023 to July 2025. FNAC cases were categorized according to the Milan system and correlated with histopathology wherever available. Statistical analysis included sensitivity, specificity, and Chi-square test.
Results: Out of 200 cases, the highest frequency was observed in Category IV (neoplasm benign). The overall risk of malignancy increased progressively across categories, with significant association (χ² = 28.6, p < 0.001). Sensitivity, specificity, and diagnostic accuracy were 85.2%, 92.4%, and 89.5%, respectively.
Conclusion: The Milan system is a reliable and standardized tool for risk stratification of salivary gland lesions and aids in clinical decision-making.

Comprehensive Evaluation of Megakaryocyte Morphology and Its Correlation with Different Etiologies of Thrombocytopenia: A Bone Marrow Aspirate Study

Abhishek Kumar Jha, Dipika Kumari, Md. Alimuddin Ansari — Wed, 27 May 2026 00:00:00 +0000

Background: Thrombocytopenia is a common hematological abnormality encountered in clinical practice and may arise from diverse etiologies including peripheral platelet destruction, impaired platelet production, bone marrow infiltration, nutritional deficiencies, infections, and hematological malignancies. Bone marrow examination remains an essential diagnostic tool in evaluating unexplained thrombocytopenia. Megakaryocytes, the platelet-producing cells of the bone marrow, exhibit distinct morphological alterations in various pathological conditions. Detailed assessment of megakaryocyte morphology can therefore provide valuable clues regarding the underlying etiology of thrombocytopenia.
Aim: To evaluate megakaryocyte morphology in bone marrow aspirates and correlate the morphological patterns with different etiologies of thrombocytopenia.
Methods: This prospective observational study was conducted in the Department of Pathology at Rajendra Institute of Medical Sciences (RIMS), Ranchi, over a duration of 1.5 years. A total of 73 patients presenting with thrombocytopenia and undergoing bone marrow aspiration were included. Bone marrow aspirate smears were stained with Leishman stain and examined for megakaryocyte number and morphology. Morphological parameters assessed included immature forms, dysplastic forms, bare nuclei, hypolobated megakaryocytes, micromegakaryocytes, emperipolesis, and platelet budding. Statistical analysis was performed using SPSS version 25.0. Chi-square test and ANOVA were applied wherever appropriate. A p-value <0.05 was considered statistically significant.
Results: Among the 73 cases, immune thrombocytopenic purpura (ITP) was the most common etiology (31.5%), followed by megaloblastic anemia (21.9%), acute leukemia (15.1%), aplastic anemia (12.3%), dengue-associated thrombocytopenia (9.6%), and myelodysplastic syndrome (9.6%). Increased megakaryocytes were predominantly observed in ITP cases, while reduced megakaryocytes were significantly associated with aplastic anemia and acute leukemia (p<0.001). Dysplastic megakaryocytes and micromegakaryocytes were significantly associated with myelodysplastic syndrome (p=0.002). Hypolobated forms were commonly observed in megaloblastic anemia and MDS. Emperipolesis was most frequent in ITP.
Conclusion: Megakaryocyte morphology provides important diagnostic insights in thrombocytopenia and correlates significantly with underlying etiologies. Bone marrow examination with careful morphological assessment of megakaryocytes remains an invaluable diagnostic approach for differentiating causes of thrombocytopenia.

Evaluation of Retinal Nerve Fiber Layer Thickness Using Optical Coherence Tomography in Patients with Diabetes Mellitus and Its Association with Severity of Diabetic Retinopathy

Dharm Deo Yadav, Neeraj Kumar, Ram Kumar Satyapal, Asif Shahnawaz — Mon, 01 Jun 2026 00:00:00 +0000

Background: Diabetes mellitus is a chronic metabolic disorder associated with progressive retinal neurovascular damage. Retinal neurodegeneration is now recognized as an early component of diabetic ocular disease alongside microvascular changes.
Aim: To evaluate retinal nerve fiber layer (RNFL) thickness using optical coherence tomography (OCT) in diabetic patients and assess its association with severity of diabetic retinopathy (DR).
Materials and Methods: This hospital-based cross-sectional study was conducted at Darbhanga Medical College and Hospital, Bihar, from July 2024 to June 2025. A total of 100 diabetic patients underwent comprehensive ophthalmic evaluation and OCT-based RNFL measurement. DR severity was graded using ETDRS classification.
Results: Mean RNFL thickness showed a progressive decline with increasing DR severity (p < 0.001). Significant negative correlation was observed between RNFL thickness, duration of diabetes, and HbA1c levels.
Conclusion: RNFL thinning correlates strongly with severity of diabetic retinopathy and may serve as an early neurodegenerative biomarker.

Correlation of Optical Coherence Tomography Biomarkers with Visual Outcomes in Patients with Diabetic Macular Edema: A Prospective Longitudinal Study

Neeraj Kumar, Dharm Deo Yadav, Ram Kumar Satyapal, Asif Shahnawaz — Mon, 01 Jun 2026 00:00:00 +0000

Background: Diabetic macular edema (DME) is one of the major causes of visual impairment among diabetic patients worldwide. Optical coherence tomography (OCT) plays an important role in identifying retinal structural changes and biomarkers associated with disease severity and visual prognosis.
Aim: To evaluate the correlation between OCT biomarkers and visual outcomes in patients with diabetic macular edema.
Materials and Methods: This prospective longitudinal study was conducted in the Department of Ophthalmology, Darbhanga Medical College and Hospital, Laheriasarai, Darbhanga, Bihar, India, from July 2024 to June 2025. A total of 100 patients with diabetic macular edema were included. Detailed ophthalmic examination, best corrected visual acuity (BCVA), fundus examination, and spectral-domain OCT imaging were performed. OCT biomarkers including central macular thickness (CMT), disorganization of retinal inner layers (DRIL), hyperreflective foci (HRF), subretinal fluid (SRF), ellipsoid zone disruption (EZD), and intraretinal cysts (IRC) were evaluated. Statistical analysis was performed using SPSS version 26.0. Pearson correlation coefficient, paired t-test, ANOVA, and multivariate regression analysis were used. p<0.05 was considered statistically significant.
Results :The mean age of study participants was 58.6 ± 8.7 years. Significant improvement in visual acuity was observed during follow-up, with mean BCVA improving from 0.82 ± 0.24 logMAR at baseline to 0.51 ± 0.19 logMAR at 12 months (p<0.001). Mean central macular thickness decreased significantly from 468.4 ± 92.5 μm to 311.2 ± 58.6 μm (p<0.001). DRIL, ellipsoid zone disruption, and hyperreflective foci demonstrated significant negative correlation with final visual acuity (p<0.001). Multivariate regression analysis identified DRIL and ellipsoid zone disruption as independent predictors of poor visual outcome.
Conclusion: OCT biomarkers show strong correlation with visual outcomes in diabetic macular edema. DRIL, ellipsoid zone disruption, and hyperreflective foci were associated with poorer visual prognosis. OCT biomarker evaluation may help in prognostication and individualized management of DME.

Association of Body Mass Index with Dyslipidemia Among Young Adults: A Cross-Sectional Study

Mon, 01 Jun 2026 00:00:00 +0000

Background: Dyslipidemia is increasingly prevalent among young adults and contributes significantly to future cardiovascular disease risk. Body Mass Index (BMI), a simple indicator of adiposity, has been associated with lipid abnormalities in various populations. However, limited data are available regarding this association among Indian medical students and young adults.
Objectives: To assess the association between Body Mass Index (BMI) and dyslipidemia among young adults.
Materials and Methods: A cross-sectional observational study was conducted among 113 young adults aged 19–30 years in a medical college setting. Anthropometric measurements including height, weight, BMI, and waist circumference were recorded using standard procedures. Fasting venous blood samples were collected for lipid profile analysis including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and very low-density lipoprotein cholesterol (VLDL-C). Dyslipidemia was defined according to NCEP-ATP III criteria. Pearson correlation analysis was used to evaluate the association between BMI and lipid parameters. A p-value <0.05 was considered statistically significant.
Results: The mean BMI of the participants was 24.5 ± 4.92 kg/m². Mean total cholesterol, triglycerides, HDL-C, LDL-C, and VLDL-C were 134 ± 23.3 mg/dL, 96 ± 47.4 mg/dL, 29.8 ± 5.16 mg/dL, 85.1 ± 22.1 mg/dL, and 19.2 ± 9.48 mg/dL respectively. BMI demonstrated a statistically significant positive correlation with triglycerides (r = 0.243, p = 0.009) and VLDL-C (r = 0.243, p = 0.009). Weak positive correlations were observed between BMI and total cholesterol (r = 0.141, p = 0.137) and BMI and LDL-C (r = 0.129, p = 0.174), which were statistically non-significant.
Conclusion: BMI showed significant association with triglyceride-rich lipoproteins among young adults, suggesting early metabolic alterations related to adiposity. The findings emphasize the importance of early screening and lifestyle interventions in young populations to reduce long-term cardiovascular risk.