European Journal of Molecular & Clinical Medicine

İntroduction:The aim of this study is to compare some anthropometric measurements and dynamic balance parameters of volleyball and basketball players between the ages of 15-17. Materials and method:12 male basketball and 12 male volleyball players participated in the study. Skinfold device (measurement of subcutaneous fat) and anthropometric measurement set (measurement of diameter and circumference) were used for anthropometric measurements in the study. Prokin PK200 WL Dynamic Balance Measurement System was used for dynamic balance measurement. Shapiro wilk test was used for normality analysis. Independent T test and Pearson correlation test were used to compare normally distributed variables. Mann Whitney u test was used to compare independent paired groups that did not show normal distribution.

Introduction: Although there is an increase in the number of studies on different dimensions of sports branches in general, there are still relatively few studies both in the world and in Turkey on how different sports branch advocacy and community behavior are formed depending on a value system, the place and effect of advocacy in the daily life of individuals, whether fan attitudes differ or not. Materials and methods: Between the 2021-2023 academic years, 334 university students studying at Van YüzüncüYıl University Department of Physical Education and Sports participated in the research. In the study, the mixed model of qualitative and quantitative research model used together was used. In the qualitative part of the research, the procedures related to the creation of the article pool by taking the opinions of university students towards advocacy were included, and in the quantitative step, the validity and reliability analyzes made in the Jamovi 1.6.12 and Lisrel 8.8 package program were included.

The aim of this research is to examine the physical education lesson happiness levels of high school students studying in different school types in terms of different variables. Relational survey method, one of the quantitative research models, was used in the research. High school students from different schools (n=891) participated in the study. Personal Information Form and Physical Education Lesson Happiness Level Scale were used to collect data in the study. In order to evaluate the normality of the data, Kolmogorov-Smirnov tests were performed and it was found to be suitable for normal distribution. In the study, it was determined that the Skewness and Kurtosis values of each independent variable ranged between ±1.

BACKGROUND:Making discussions about the power or effects of the contents of mass media through movies and TV series can be considered as an effective strategy in a way. In addition, investigating the power and effects of movie screenings through metaphor creation can be an effective strategy. In the literature, it has been seen that the metaphor creation technique is widely used in examining the perception of sports. However, no research has been found using the metaphor generation technique to determine the effects of sports-themed movies. In this context, the aim of the research is to examine the acute effect of the sportsthemed movie named "Dangal", in the wrestling branch, on the metaphors that adolescents create about wrestlers.

Introduction: Evolution of cytopathology in the past few decades as a distinct adjunct in screening and diagnosis of a neoplastic process, has paralleled the development of newer ancillary techniques like immunocytochemistry, flow cytometry, karyotyping and genetic studies. But a combination of LM and IHC will not identify every tumor and some diagnostic problems go unanswered. If the differential diagnosis on routine LM includes a tumor that is known to possess distinctive ultra structure, Electron Microscopy (EM) is clearly the method to select for confirmation as a subsidiary technique.
Aim: Owing to the restricted availability of TEM in most centres,  data pertaining to its utility in tumor cytopathology is limited. Hence, the current study is designed to study the role of Electron Microscopy (EM) in fine needle aspiration cytological examination of neoplastic lesions, to correlate the findings of EM with Light microscopic findings and to correlate the EM findings with immunohistochemical findings, wherever possible.
Materials and Methods: Electron microscopy was carried out in a total of 50 cases where were subjected to FNAC for suspected neoplastic primary malignant or metastatic lesions. The cellular features of material aspirated were studied and ultrastructural details of cytoplasm including the plasma membranes, organelles and nuclear features were noted. The cases were grouped histogenetically and analysed. The final cytological diagnosis were tabulated and compared with the histopathological diagnosis.

Background: Gynecological malignancies account for three fourth of the female patients who present with malignant ascites. Similarly in males half of the patients with malignant cells in their peritoneal washings have malignancy involving GI tract. This study was conducted to assess free malignant cells in peritoneal cavity with varied clinicopathological profile of patients with gastrointestinal malignancies and its correlation with stage of disease.
Materials and Methods: Patients with Gastrointestinal malignancy presenting to surgical OPD during study year were assessed for clinic- pathological stage and malignant cytology. Correlation between presence of positive malignant cytology and clinicopathological stage was assessed.
Results: Out of total 34 patients with malignancies involving colorectal, gastric, esophageal and pancreas, 9 had been found to be having free malignant cells in peritoneal cavity. Advanced stage of the disease with worse clinic-pathological profile had more propensity of free malignant cells in peritoneal cavity
Conclusion: Significant correlation was found between clinicopathological stage and presence of positive malignant cytology. However, we failed to demonstrate any correlation between degree of differentiation of tumor and positive malignant cells in peritoneal cavity

Background: Patients having breast cancer, with increasing tumour size is associated with an increased of axillary lymph node involvement. Moreover, all this association to place altogether of all tumors smaller than 1.0 cm in a single category and all tumors larger than 5.0 cm in another category. This coarse classification may obscure a nuanced description of the effects of tumour size across the full range of possible sizes.

Despite the rapid advances in the treatment modalities for Orthopedics, Chronic Osteomyelitis is one of the most challenging conditions to treat by surgeons, and needs great commitment. The causes of chronic osteomyelitis can be implant related or due to hematogenous spread of infection to bone following trauma. Here we report 3 different cases who presented with chronic osteomyelitis and were treated successfully, with thorough wound debridement of necrotized tissue, commencement of culture sensitive antibiotics for the duration of six weeks, and skeletal stabilization with internal fixation. This multidisciplinary approach of chronic osteomyelitis helped in better improvement of function of limb and decreased the morbidity of patients. For better functional outcome, a period of almost six months is needed for recovery.

Cervical cancer is the second most cited reason for cancer death which is largely preventable. In developing countries, nearly 80% of the detection of cervical cancers occurs at advanced stage which demands a cost effective approach which is applicable for mass approach for effective cervical cancer screening programs. Various tools for screening and assessment have been developed which includes colposcopy, the Pap smear and VIA.Hence this study was designed to evaluate the efficacy between these screening methods in screening for cervical cancer. This prospective study 100 women of age group between 20-70 years of age group attending the gynecology department, Vinayaka Mission’s Medical College, Karaikal from November 2019 to June 2021 for the duration of 18 months. Sexually active and non-pregnant woman with no active disease of cervix, no history of cervical conisation, cryo or other invasive cervical cancer treatment, patients with no history of pre invasive lesions, patients with no history of cervical cancer are included in study

Brain damage is caused by chronic alcoholism. Rural India has few published data. The aim of this study is to examine changes in the brain of chronic alcoholics living in rural areas using computed tomography (CT).

Air leak syndrome is the overarching diagnosis for one or more pathologic air collections present outside of the respiratory tract. Air leak occurs in approximately 10% of neonates with MAS for many presumed reasons including ball-valve effect of the meconium, ventilation-perfusion mismatch, surfactant inactivation, and parenchymal injury. In this study we planned to evaluate the prevalence of air leak syndrome in meconium aspiration syndrome.

Introduction: Osteochondroma is widely recognized asbenign bone tumor, protruding from underlying normal bone.The pes-anserinus is situated between the proximal medial tibia and the insertion point of the three tendons sartorius, gracilis, and semitendinosus. Torment in pes anserine area brings about pes anserine condition. Material and methods:A prospective study of “ Osteochondroma causing pes-anserinus syndrome”during a period of two years from 2020 to 2022 at a tertiary hospital.

Background and objectives. Obesity is a major concern in our era with many adolescents and adults being obese.Obese patients with metabolic syndrome are more prone for cardiovascular risk. Obese individuals have numerous physiological changes which predispose them to many dermatological conditions. This is of concern to us as many of these conditions can act as markers for obesity and impending systemic consequences of obesity. This study was done to find the common dermatoses associated in adults with a BMI of > 30 kg/m2 who presented. Methodology All adult patients, of both sexes, who have a BMI > 30.0 and/or waist circumference > 90cm in males and > 80cm in females were included in the study.A detailed history of the patients was taken Morphology of skin lesions, sites of involvement, number of lesions were noted. A complete systemic and dermatological examination was carried out in all patients. ResultsThe age range of patients in this study was 18-85 years and the mean age was 40± 12.50. Acanthosis nigricans and skin tags had a strong correlation with obesityand Metabolicsyndrome. It was noted that in patients with acanthosis nigricans and skin tags, who were found to have metabolic syndrome, had elevated fasting plasma leptin levels but no elevation in fasting plasma Insulin levels.

The non-venereal genital dermatoses have resemblance with sexually transmitted diseases.These non-venereal genital dermatoses are stressful to the patients especially if noticed after sexual intercourse.Hence the present study highlights on non-venereal genital dermatoses of both the sex.This case series study is done on 110 patients who presented to the Department of Dermatology, Venerology Leprosy, Vinayaka Missions Medical College, Karaikal, Pondicherry. Patients of both the sexes who presented to OPD from October 2021 to October 2022 with suspicion of genital dermatoses are taken into this study. The results showed thatnon venereal genital dermatoses are more common in males compared to females with majority of cases between age 31-40 years. Thorough knowledge about classical morphological presentation and histopathological features is needed for correct diagnosis and treatment.

Introduction: One of the most common surgery done by otorhinolaryngolist in India is tonsillectomy. Since tonsillectomy leaves a open wound in the pharyngeal wall causing post tonsillectomy pain. Inadequate post tonsillectomy pain control will lead to severe distress, dehydration, discomfort.

Psoriasis is a chronic inflammatory disease.There are various treatment modalities to control the disease, which are used alone or in combination. Narrowband ultraviolet B has gained pace in the treatment of moderate to severe Psoriasis. Phototherapy alone or combined with systemic therapy or systemic therapy alone is recommended as the first-line therapy in moderate to severe Psoriasis Vulgaris . Hence,the efficacy and safety of Narrow Band -UVB the rapyversus Narrow Band-UVB with topical Clobetasol propionate 0.05%is assessed in patients with psoriasis vulgaris.

As the prevalence of heart failure(HF) is increasing, so is the incidence of acute decompensated heart failure(ADHF) leading to hospital admission. With improvements in treatment for ADHF, more people are surviving the ordeal of ADHF and the focus has now shifted to the duration of stay in hospital, with patients eager to go home and resume their daily activities. in literature there is dearth of markers predicting the hospital stay duration, which has traditionally been sodium levels in sodium. Recently BUN: Creatinine ratio (BCR)is garnering significance as prognostic predictor in heart failure. Method: We did an observational study to study the effect of BCR at admission on the duration of hospital stay in HF patients. Results: BCR is not significantly associated with duration of hospital stay (p= 0.595), but alcoholism (p=0.026) and blood urea nitrogen (p= 0.040) were significantly associated with the duration of hospital stay in HF

Introduction : Studies state that adult males are more prone to hearing deficits compared to females; occupational and medication related causes being described as the etiology. However, any such etiology would be similar in the adolescent school goers which would help us to analyze regarding similar pattern in the study population as well. Overcrowding, poor hygiene, socio-economic status, climate, lack of resources to avail medical facilities, poor medical awareness have their bearing on the incidence of hearing loss .The family of each hearing-impaired child has its own cultural, social, educational, and financial background, and its own special needs. The repercussions of auditory deficits are more marked in children as the maximum development of their potentialities was affected

Diabetic nephropathy is one of the common causes of native kidney dysfunction. Total number of 50 subjects will be enrolled in this present cross sectional study in the department of General Medicine, Chengalpattu medical college and hospital, in collaboration of Radiology and Nephrology of the same institution during two years aim to evaluate the diagnostic usefulness of renal resistive index by duplex Doppler ultrasonography for detection of renal dysfunction in diabetic patients. Clinically diagnosed diabetic patients having diabetic nephropathy are taken as a sample. The results are that there is a strong positive association between microalbuminuria and resistive index.A positive correlation (r=0.581, p<0.01) was found between resistive index with serum creatinine and albuminuria which indicates deterioration of renal function, i.e. progression of the disease. In previous study it was shown that the correlation between serum creatinine and RI values in diabetic nephropathy to be (r=0.84) indicating that RI may be useful as a renal prognostic marker.In this regard, even if renal function is well preserved at baseline when RI is greater, we should observe these patients carefully in the follow-up period because they have significant vascular lesions

Background: The present study was conducted for assessing glycemic status of gestational diabetic women on anti-hyperglycemic medication and neonatal outcome of their off spring.
Materials & methods: Total subjects enrolled in the present study were 50. Out of these 50 subjects, 25 subjects were treated with Insulin while the remaining 25 were managed with Metformin. The study subjects were followed up until delivery and details regarding fetal outcome like birth weight, blood sugar level etc were recorded assessed. All the results were recorded and analysed using SPSS software.
Results: Mean HbA1c levels post treatment among patients of metformin group and insulin group was 5.9% and 5.1% respectively. Although non-significant, mean HbA1c levels were slightly better among patients of the insulin group. Metformin was found to cause less neonatal complications when compared to that of the insulin treatment group.
Conclusion: Metformin wasfound as slightly more effective as Insulin in the management of GDM.

Antibiotics primarily used in treating the bacterial infections when administered unnecessarily can cause antibiotic resistance making the bacteria non responsive against antimicrobials. Analgesics that are used to relieve pain are one of the routinely used medications. Hence, the aim of this study was to check the knowledge and awareness regarding use of both antibiotics and analgesics amongst dental undergraduates. Total 324 participants from different profs and interns submitted their responses for the online questionnaire. A highly statistically significant difference was observed in the knowledge of participants for both analgesics and antibiotics. It can be concluded that the knowledge and awareness on the use of antibiotics and analgesics among dental undergraduates is low indicating lack of basic understanding of oral dose, indications and risks of both medications.

Background: The present study was an audit for evaluating the use of blood components in acute systemic infections and its correlation with clinical outcome in children.
Materials & methods: A total of 100 subjects were enrolled. Any preterm and term neonates admitted to the NICU and Neonatal Intermediate Care Unit (NIMC) and receiving any transfusion, i.e., fresh frozen plasma (FFP), red cell concentrate (RCC), platelets, and exchange transfusion were included. The data was collected from the medical records. Patients were categorized according to the classification of neonatal conditions by the International Classification of Diseases 11th Revision (ICD-11).
Results:A total of 100 subjects were enrolled. Out of 100 neonates, 70 neonates received fresh frozen plasma. The platelet concentrate was received by 32 individuals whereas whole blood was received by 12 subjects. Transfusion data for all of the components yielded a statistically significant result. A condition chewing blood products are sepsis (82), meningitis (4). The other disorders comprise of 11 patients.
Conclusion: Over the few decades, there has been an increasing focus on use of blood components in managing pediatric patients with acute systemic infections. The exact ontogeny of individual components of the hematological system, and how they interact and drive the response to infectious agents, is of particular importance in understanding paediatric systemic infections. Hence; further studies are recommended

This study evaluate the impact of compensation, promotion opportunities, and work life balance on institutional engagement of nurses affiliated with a medium-sized, under-visited health facility in and around North Tamil Nadu, India. We also examine the impact of organizational commitment on caregiver retention. Results indicate that nurse commitment in hospitals increases the likelihood of continued employment. It also shows compensation is the most important factor, followed by work-life balance and work environment to improve organizational engagement.

The present study is done to find out the correlation between lipid profile parameters with Hs CRP (High sensitive C- Reactive protein) in dyslipidemia patients of prediabetes and diabetic state. This observational study is done on 50 patients Prediabetic and diabetic  of age >18 years who presented to department of Medicine, VMMC, Karaikal. Patients with infection, stroke, myocardial infarction, major surgery, malabsorption, CKD, cancer, severe illness, liver dysfunction, pregnancy, edema, on OCPs or NSAIDS    were excluded from the study. In our study we have observed a significant relation between HsCRP and triglycerides, fbs, ppbs, HbA1c, diabetic, family h/o diabetes and urine sugars. They may assist in screening of dyslipidemia patients in prediabetes and diabetic states to identify increased risk of atherosclerosis as well as bad cardiovascular events at early stage

Uterine Arterio Venous Malformation is defined as the rare pathology and difficult to quantify, with approximately 100 cases reported in the literature. Yazawa & O'Brien suggested pelvic sonographies of patients to rule out cause of  uterine bleeding, reported variable incidences of Arterio Venous Malformation 4.5% and 0.6% respectively.(2) Main Pathophysiology is formation of  direct communication amongst uterine arteries and veins & absence of intervening capillaries. It is life-threatening as profuse bleeding per vagina is the typical presentation. In this article, 32 year female G2P1L1 (Urine Pregnancy Test was done in the hospital) with amenorrhea since 2 months followed by vaginal bleeding since 20 days. Ultrasound of pelvis -increased vascularity with involving vessels of sub-endothelium and myometrial and Retained Products Of Conception, which complicated the diagnosis. She was investigated. As she was hemodynamically stable, she underwent expectant management and responded well

Congenital pulmonary airway malformation (CPAM) - previously known as congenital cystic adenomatoid malformation (CCAM) - is a rare developmental malformation of the lower respiratory tract. It is accepted that abnormal airway patterning and branching during lung morphogenesis results in the appearance of lung cysts.¹ It is composed of aberrant lung tissue that keeps expanding and resembles bronchioles physically, but lacks cartilage, alveoli, and bronchial glands. These masses may become overdistended leading to respiratory distress due to air trapping mechanism. Treatment of symptomatic lesion is usually surgical resection of the lesion or affected lobe.

Introduction: Meningiomas are the most prevalent primary non-glial intracranial brain tumours to develop from the meninges, accounting for 15–30% of all primary cerebral tumours. Even though the majority of these tumours are benign, a very few number of them are malignant. Amongst the meningiomas more than 90% are solitary for unfamiliar reasons. Only risk factor known for meningioma are ionizing radiation. The WHO assigns these tumours grades I, II, and III. Surgery can treat benign meningiomas, however higher grade meningiomas need radiation following surgery because of their high recurrence rate and aggressive behaviour. Materials and methods: This case study was conducted retrospectively in the pathology department of a tertiary care hospital in Pune from the year 2020 to 2022. A total of 39 biopsies were received for histopathological examination and some as frozen samples during this period. Results: In our study 29 patients were females (74.35%) and 10 patients were males (25.65%). The age group between 41 and 50 is the most common (28.2%).Meningothelial meningioma was the most frequent histological form, occurring in 23 cases (58.9%), followed by transitional meningioma in 7 patients (17.9%). (17.9%), fibrous meningioma(7.6%). Conclusion: For WHO Grade I tumours and those who have had a complete surgical resection, the prognosis is favourable; however, for grade III tumours, it is less favourable. Because some histological subtypes with higher WHO Grades have a greater risk of recurrence and a worse prognosis, accurate histological grading and typing are necessary

Aim: The aim of the present study was to assess levels of High Sensitivity C-reactive Protein in patients with Acute Ischemic and Hemorrhagic Stroke.
Methods: The present descriptive Prospective Observational Study was conducted on 100 CT/ MRI confirmed cases of Stroke admitted in Medicine Dr. DY Patil Medical College Hospital and Research Centre, Pimpri, Pune during the period from October 2020 to September 2022.
Results: The Mean Age group of study participants was 61.74±11.28 with 5% in 18-40 years, 6% in 41-50, 31% in 51-40, 41% in 61-70, 15% in 71-80 and 2%  were above 80. There were 32% were females and 68% males. In our study 33 patients had right side hemiparesis and 6 patients on right side had hemiplegia, 47 patients had left side hemiparesis, 12 patients had hemiplegia 2 had monoparesis. There were 10% cases had cranial nerve involvement in our study. In Hemorrhagic Pattern of Stroke there were 92% hypertensives and in Non-Hemorrhagic Ischemic type 77%. There are 84.6% of diabetics in hemorrhagic subjects and 67.5% in ischemic subjects. The data showed 22% patients had Hs-CRP levels <10 and 78% had CRP levels >10.
Conclusion: Our Study showed that HS-CRP are elevated and can be considered as independent risk factors of Stroke.

Introduction: The term ‘aneurysm’ is derived from the Greek word aneurysma, meaning dilatation, or widening. The International Society for Cardiovascular Surgery/Society for Vascular Surgery states that an abdominal aortic aneurysm is any focal dilation of the aorta leading to a diameter of at least 50% larger than normal. The normal aorta diameter ranges from 17 to 24mm and is dependent on various factors such as such as age, gender, and body habitus. AAA occurs when the aortic diameter is more than 30 mm in size. An unruptured aortic aneurysms are incidentally detected and come with chronic vague complaints like back pain, abdomen pain, palpitations, dyspnoea on exertion etc. A ruptured AAA is an absolute emergency and require immediate surgical intervention.
Signs, symptoms, and Diagnosis: This is a case report of a 53-year-old female who presented with complaints of on and off chest discomfort associated with palpitations and dyspnoea on exertion for the past 2 years. CT aortography revealed infrarenal abdominal aortic aneurysm extending to the iliac arteries with maximum diameter of 67 mm. This review will mainly focus on the instructive significance for anaesthesia management, especially during clamping and unclamping of major vessels during abdominal aortic aneurysm resection surgery. 

BACKGROUND: The occurence of meconium in the amniotic fluid, also known as MSAF (Meconium stained AF), is a concerning indicator of fetal impairment and is linked to a worse perinatal outcome. The purpose of this research was to find out what variables affect the mother and the baby when a pregnancy is affected by meconium staining the amniotic fluid.
MATERIAL AND METHODS: This present prospective study was carried out to find out neonatal outcome in cases of meconium stained liquor. In this study, 210 patients with no complicating risk factors and normal obstetric history were selected.
RESULTS: The meconium-stained amniotic fluid substantially influences both mode of delivery and neonatal outcome as compared to the other counterpart.
CONCLUSION: The meconium-stained amniotic fluid substantially influences both mode of delivery and neonatal outcome as compared to the other counterpart. Once meconium has passed vocal cords & entered lung parenchyma, we can not stop MAS.

A retained placenta is when the placenta is not delivered within 30 minutes of the baby’s birth. It is a dangerous problem since it can lead to maternal morbidity and mortality.This case presents a 35 year old female, Primigravida 39.4 weeks in latent labour. Following normal vaginal delivery, there was retained placenta which did not separate after manual removal of placenta. Ultrasound and MRI pelvis findings  were suggestive of adherent placenta at the fundus and extending upto serosal surface. This patient was managed medically and placenta expelled out spontaneously 10 days postpartum

Abortion is the removal of a 500g or less embryo or foetus from its mother when it is incapable of surviving on its own (WHO).
Septic abortion refers to any abortion that is connected to clinical signs of infection in the uterus and its contents. We in India are still unable to reach most of the couples belonging to low socioeconomic class or those who are illiterate with our family planning services. Due mostly to illegal abortions, septic abortion continues to be the largest cause of maternal death in the developing countries. Here is a case of septic abortion who was near miss mortality due to illegal practices.

Leptospirosis is a zoonosis of ubiquitous distribution, caused by infection 
with pathogenic Leptospira species. The spectrum of human disease caused by leptospires is extremely wide, ranging from subclinical infection to a severe syndrome of multiorgan infection with high mortality.⁽¹⁾Cardiovascular implication in leptospirosis is infrequent we Report a 39 year old farmer who had  jaundice ,abdominal pain, vomiting along with dry cough ,breathlessness, oliguria and massive pericardial effusion following a short febrile illness which required mechanical ventilation and renal replacement therapy. His diagnostic workup revealed leptospirosis  and workup for TB was negative. The patient presented a good response to the treatment, being discharged from hospital completely asymptomatic, with no pericardial effusion.He was evaluated again one month later, with no trace of effusions or symptoms.

Back ground: When prophylaxis is not used, ENT operations have a significant incidence of postoperative emesis. Antiemetic use as a preventative measure may lower total PONV-related resource use and expenses, improving patient satisfaction. Numerous methods have been employed to reduce the incidence of PONV such as pharmacological interventions for prophylaxis, altering the anaesthetic technique, or combining them all for optimum protection. The present study was conducted with an aim to compare the effectiveness between propofol and dexamethasone in the prevention of postoperative nausea and vomiting after ear, nose and throat surgery and to study any adverse effects associated with these drugs.
Materials and methods: A total of 60 patients who underwent ENT surgeries were divided into two groups with 30 in each group. Group A received dexamethasone 8mg and Group B received propofol 0.5mg/kg after completion of surgery. The incidence and severity of PONV and associated adverse effects were documented at immediate post-op, 30 minutes, 1^{st -}, 6^{th -} , 12^{th -} , and 24^th- hour after the administration of study drug. In addition, the requirement of rescue antiemetics in the overall 24 hours was documented.
Results: There was no statistically significant difference between the dexamethasone and propofol groups in terms of age, gender, body mass index (BMI), type of surgery, ASA status, or duration of anaesthesia and surgery. Incidence of severe PONV (3.3% versus 12%, p =0.008) were statistically significantly lower in group A compared to patients in group B over the 6th-12thhour time period. The mean time to first nausea episode in group A was significantly more compared to group B (p<0.001).
Conclusions: Although the efficacy of dexamethasone and propofol in preventing post-operative nausea and vomiting in ENT surgeries are comparable dexamethasone produced better PONV protection than propofol.

INTRODUCTON- The prevalence of Myopia has increased manyfold in the current scenario. Many studies have been done to show the relationship between Myopia and Central corneal thickness (CCT)  with conflicting results. OBJECTIVES- The purpose of this study was to find out the relationship between central corneal thickness and Myopia. MATERIAL AND METHODS- This prospective cross-sectional study was conducted in a tertiary care hospital in South India between March 2021 to February 2022. One hundred Myopic individuals between age group 11 years to 40years with spherical equivalent SE ranging from -0.25 to -5Diopters after cycloplegic refraction have been included in the study. CCT was measured in both eyes of each patient using AS-OCT. The relationship between CCT and Myopia was analyzed using Pearson’s Correlation Coefficient. Statistical significance was set at P<0.05. CONCLUSION- There was no correlation between CCT and degree of myopia. The findings contribute to the ongoing discussion regarding structural changes in ocular coats and glaucoma susceptibility in myopia

UTI is a common source of bacterial infection among young febrile children
AIM :  To determine the validity of urinary tests in the diagnosis of urinary tract infection
METHODOLOGY : Febrile children from 2 years to 8 years. 
CONCLUSION: Dipstick leucocyte esterase and nitrite test was highly specific and accurate in detecting UTI as compared to dipstick leucocyte esterase, dipstick nitrite test and urine analysis. Dipstick leucocyte esterase and nitrite test showed the highest PPV wherea dipstick leucocyte esterase showed highest NPV. No test can screen accurately for UTI in young children. The urine dipstick plus culture tests appear to be the most cost-effective strategy for screening and beginning presumptive treatment for UTI in febrile young children.

Non-Alcoholic Fatty Liver Disease (NAFLD) is an important cause of liver disease in India. Epidemiological studies suggest its prevalence in around 9% to 32% of general Indian population, but with a higher prevalence in those having overweight / obesity and diabetes. Present study aimed to investigate the usefulness of ‘Fatty Liver Index’ an algorithm to predict the presence of Non Alcoholic Fatty Liver Disease among the Population visiting the Master Health Check-up of a tertiary care centre.

Smokeless tobacco use in India has various concerns. It is commonly used and increasingly so, especially as new forms of smokeless tobacco have been emerging over the last few decades. the present study is done to observe the impact of smokeless tobacco on vital data. A cross-sectional study is done on 200 males and females of age group 20-40 years who take tobacco for a minimum period of 2 years.  Chewing tobacco in a dose of average 200mg pack of chewable tobacco and chewed for 30 minutes. All patients with cardiac disorders, Thyroid disorders, Hypertension, Renal diseases, Chronic respiratory diseases. Pregnant and lactating women were excluded from the study. The systolic and diastolic blood pressure changes were recorded before and after having smokeless tobacco. The results revealed that that is significant changes in blood pressure before and after chewing tobacco highlighting there is need for control of this hazardous cultural practice so as to avoid cardiovascular and cerebrovascular accidents in future

Infertility is a widespread problem in gynecology, affecting approximately 10-15 % of the population in India. According to the Maternal Health Task Force, 50 million couples worldwide are estimated to be infertile. The study was conducted in the Department of Obstetrics and Gynecology, Vinayaka Mission’s Medical College, Karaikal, Puducherry UT, from November 2019 to May 2021; 40 with primary and secondary Infertility with normal husband parameters were included in the study. The Prevalence of Uterine factor abnormality (Congenital and Acquired) in the evaluation of infertile women was found to be 27.5%. No significant difference in the prevalence of intrauterine pathologies was found among women with primary and secondary infertility. Diagnostic hysteroscopy among infertile women provides accurate identification of uterine abnormalities

AIMS and OBJECTIVE: In light of the ongoing COVID-19 pandemic, this study made an effort to fill a knowledge gap about the influence of screen time (ST) on adolescents' lifestyle choices in India. During the COVID-19 pandemic in Karaikal, the study's goals were to 1) assess the frequency and duration of screen use, as well as screen addiction behaviours in 5-18year old children and 2) To know the effect of screen time on physical health.
MATERIALS and METHODS: The sample in this crosssectional study were 1000 children. A pre-structured  questionnaire is given to children to know their screen time during covid pandemic with parents/guardian consent and guidance. Parents were asked to fill the pre-structured questionnaire .
RESULTS: A total of 1000 children were enrolled in the study. High screen time i.e., >4hrs/day seen more in 16 – 18 years followed by 11-15 years then by 5-10years.Screen time had negative impact on physical health (P < 0.0001). High screen time in 16-18 years(51.13%) are more prone to overweight/obesity followed  by 11-15 years(45.53%) and then 5-10 years(35.63%) according to the study.
CONCLUSION: This study has paved the way for need of larger study and development of guidelines on impact of screen time on children in developing nations where screen time guidelines is yet to be set more so in era of COVID 19 pandemic

This study compared the graft acceptance rate and hearing improvement in patients who underwent myringoplasty for chronic otitis media. Methods: A prospective study was conducted in the department of Otorhinolaryngology, Vinayaka Mission’s Medical College and Hospital, Karaikal, Puducherry, India. 48 patients with COM were selected. Among them, 24 had dry ear and 24 had wet ear mucoid discharge. All patients underwent myringoplasty and temporalis fascia was used as graft in all the patients. Patients were followed up for atleast 3 months. Pure tone audiometry was done preoperatively and also  postoperatively after 3 months. The graft uptake rate and the hearing improvement were compared between the two groups. Results: The graft acceptance rate was 83.33% in both dry and wet ear groups. There was no statistically significant difference between doth the groups. The hearing improvement was also compared between the two groups. There was no statistically significant difference in the hearing improvement after surgery between the two groups. Conclusion: The presence or absence of mucoid ear discharge during the surgery does not interfere with the outcome of the surgery. It does not affect the rate of graft uptake or does not affect the hearing improvement post surgery

In today’s business world, marketing processes are based on the interaction between a business and consumers. Advertising has been considered a popular management tool for dealing with the highly rapid technological changes and also marketing changes in today’s competitive markets, and this management tool refers to the re-analysis and re-designs of tasks and also processes inside and outside the organization. Earlier, before the 21^st century, businesses were using traditional methods for promoting their goods and services, which was very costly as they had to put hoardings and banners in different areas of the cities for promoting their products or services. If the advertisement doesn’t meet the expectations or goals of the organization, then it incurs losses to businesses. As time changed, the birth of creative marketing or digital marketing came to the rescue. Advertising plays an important role in influencing consumer buying behavior. Here in this study emphasis has been put on how creative marketing is changing the face of advertisement and eventually the customers are becoming reliable for the brand value. The primary source of information like interacting with customers and collecting their feedback both online and offline with a total of 415 samplings used and information is collected through the percentage analysis technique.

Recently, there has been an increase in corporate public awareness of the importance of going green and instituting multiple ecological management techniques. As the corporate world becomes more global, there is a shift from a traditional financial framework to a modern capacity-based economic system ready to explore the green economic aspects of a company or organization. Green Human Resource Management (GHRM) is now a key business strategy for big corporations where Human Resource Departments actively engage in going green at the office. The paper primarily focuses on the different Green Human Resource Practices followed by global organizations and describes the simpler definition of GHRM. Finally, the paper recommends some potentially fruitful HR initiatives for Green businesses.

According to a joint report by KPMG and the Internet and Mobile Association of India, the Indian e-commerce market had a 2013 value of 75,000 crore. India may increase its economic output by double. From its current level of 1.6 percent GDP, the Internet will contribute between 2.8 and 3.3 percent by 2015 [MCkensy'2012]. 1.45 million jobs will most likely be created by Indian e-commerce over the next two years. With the advent of the new administration and its creative initiatives, local market operators are hoping to attract FDI in e-commerce. This article sheds light on India's own Amazon, Flipkart, and fashion e-tailer Myntra, which together unveil their aim to acquire more than 50% of the e-market share through strategic collaboration. This marks the biggest consolidation in the e-commerce business in India.
Flipkart exceeded its yearly sales goal by one year as they reached over 6,100 crore. By 2015, the gross merchandise value was expected to exceed $1 billion; in contrast, Myntra's sales in the previous fiscal year was approximately Rs. 1,000 crore. It wants to treble its income this fiscal year as it grows its seller base and adds products in line with Alibaba.com, China's largest online retailer. By the conclusion of the current fiscal year, Myntra hopes to have 1,000 retailers on its platform. In order to compete with international rivals like Amazon and eBay Inc., Flipkart plans to invest roughly 600 crore in its apparel industry over the next few years. It also exposes the thinking behind this massive buy and how this how this will contribute to the progression of Indian economy which will lead it to become a global player in Ecommerce.

In this study we are going to determine the different  preferences of people when it comes to fast foods , specifically KFC and Mcdonalds since these are the two fast food companies we are trying to compare . A survey will be conducted to get different people’s opinions in terms of taste and others . Which one tastes better and is healthier, KFC or Mcdonald’s ? Which is of good quality and has a good restaurant environment ? Availability of product and staff behavior ? Price of product , delivery and finally the value of money . Whether or not the product is worth the amount it is being sold for .

Consumer behaviour reveals what consumers' needs are. It recognises simple but powerful statistics regarding buying behaviour, such as who acquires, what they buy, and how they buy. The research results provide interesting insight into what consumers say and how they vary across various background variables. Urban buyers' demographics and greater disposable income have contributed to a new paradigm in buying behaviour. The ever-increasing competitive pressure and the availability of different possibilities have caused advertising agencies to acknowledge the different factors that influence the demand for hosiery product lines. The purpose of this research is to showcase some of the factors that influence the consumer buying behaviour of chosen hosiery products. Brands, social status, specific learning qualifications, monthly salary, and other factors may influence a buyer's decision. Elements such as price, packaging review, value price and resemblance with other brands, and so on may affect the purchase decision. Repeated purchases of the same brand reveal brand recognition, whereas shifting may indicate a modification in the consumers ’ behaviour.

Social media marketing returns consumers to the centre of the business universe, giving entrepreneurs a new set of tools to communicate with clients and integrate them into brand names in novel ways. At the core, marketers must understand how social media has impacted consumer buying behaviour. In contrast to conventional media, social media marketing is the contemporary aesthetic of marketing so it focuses on opening horizons for marketing companies to advertise a product or service. Consumer habits and gratification have previously become important assets for any organisation wishing to create a market role to increase cash flow. Organizations are using social media techniques for this reason. According to studies, businesses use social media advertising to interact with customers. Social media advertising has been selected based on a new means of dealing with customers and shifting their buying patterns. Individuals use social media to communicate their views, reviews, facts, advice, cautions, tips, and virtually any other topic that their “connection” or friends find fascinating. Marketers use social media as a means of advertising. The sample size was 220 participants, and the statistical findings were formed using univariate and cross-tabulation. Similarly, after conducting the complex statistical evaluation with SPSS and the analysis provided by the online platform the host of the survey, it is possible to see how much it is impacted and the true impact of Social Media Marketing evidenced in the Consumers Purchasing Decision Making process.

In order to the process that takes place inside the STEEL AUTHORITY OF INDIA LIMITED , in people working HRM,CRM, and process taking place inside the SAIL . This study analyzes the inventory management like raw materials, work in progress and finished goods in SAILt. This study used the inventory turnover ratio, it is very useful to predict the previous and past year of inventory in the company.
 

Social media has changed the way people communicate and share information and interests. The increasing use of social media & social networking sites, particularly in developing countries such as India, is providing marketers with a new channel through which to reach customers. Though institutions are increasing their social media spending, it is difficult to determine a true return on investment. This paper tries to examine the impact of social media usage on the purchasing decision procedure. The paper investigates the usage pattern and how it affects the five stages of the purchasing process. According to the research, social media is the most widely used data source because of its perceived ease, efficiency, and credibility. Also, social media reviews & opinions influence purchase decisions; however, the tendency to share their post-purchase experiences is surprisingly low

Business ethics is a significant influence in the corporate world. It has shaped and changed the way companies have operated over the years and has also influenced corporate regulation. Business ethics are a matter of fair dealing infused with moral behavior with its major purpose to establish trust between people in a business concern, Based on this we recommend that strong corporate governance as well as ethical laws are needed to minimize the negative impact of corruption in the corporate law. Firms and business must also consider the emergence of corrupt practices when formulating strategies to increase performance and decrease overall organizational and operational malfunctions.

The increasing use of social media is influencing consumer purchasing behaviour across regions and countries. Customers in a fast–growing world like Raipur, on the other hand, are usually described as risk-averse, so the impact of social media on customer online purchasing behaviour is a relevant subject of interest to marketers. There is very little empirical research in this area. This research paper examines a random sample of 404 customers from Raipur to study the buying behavior of consumers who buy apparel through the e-commerce system of social media media. Consumers bought online apparels through e-commerce in social networks for a variety of reasons, such as information retrieval, risk involved, and trust. An SPSS 22 analysis of the empirical research findings reveals that social media has a moderate to meaningful impact on online apparel buyer behaviour in Raipur, with trust being the most severely impacted element, then perceived danger and information needs.

Introduction: The diagnosis of ACS is overlooked in about 2% of patients, which can lead to negative consequences. The term acute coronary syndrome comprises unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI) and ST-segment myocardial infarction (STEMI). ACS is often the first presentation of coronary artery disease (CAD), the leading cause of mortality and morbidity in many parts of the world.
Aims and objectives: 1. To find out the levels of serum Gamma glutamyl transferase (GGT) in patients admitted with acute coronary syndrome. 2. To determine the association of raised GGT levels with different sub types of ACS.
Material and methods: It is an observational study, constituted of 150 study cases presented with Acute Coronary Syndrome to the medicine intensive cardiac care unit Deptt. of Medicine at R.D. Gardi Medical College and C.R. Gardi Hospital, Ujjain from December 2017 to November 2018.
Observations and results: Out of one fifty study cases, ninety (60.0%) cases were STEMI and among them fifty four (60.0%) had raised GGT level while Thirty six (40.0%) case had normal GGT value. Forty five (30.0%) cases were NSTEMI and among them twenty four (53.3%) had raised GGT level while twenty one (46.7%) had normal. Fifteen (10.0%) cases were having Unstable angina and among them three (20.0%) had raised GGT level while twelve (80.0%) had it normal. Chi Square value 8.293, p value was 0.016. There was highly significant association of various sub types STEMI and NSTEMI of ACS with GGT levels.
Discussion: In present study majority ninety four (62.7%) patients were males and Fifty six (37.3%) females with a Male: Female ratio of 1.6:1. Males 55.3% and Females 48.2% had an elevated GGT value. However there was no significant Gender wise association with GGT levels (Chi square =0.176, p value = 0.674).The age group of our patients ranged from 35 to 90 years and the mean age was male 62.63+/-10.90 & female 57.79+/15.38 years with peak incidence in the sixth and seventh decades. In this study there was no statistical age wise significant association with GGT levels. Similarly Emiroglu MY et al in 2010 obtained the male preponderance in cases of each subset of ACS with a positive age wise association with GGT values and that was not with gender wise.
Conclusion: GGT may have a role in diagnosing cases of myocardial infarction especially in the presence of a non-diagnostic ECG. This will help in preventing MI cases to be missed in the ED. In addition to its diagnostic role in MI, GGT also has a discriminatory capacity to differentiate between STEMI, NSTEMI and UA. GGT can hence be an important laboratory tool alongside Troponin I and the electrocardiogram in the categorization of MI.  Further its prognostic impact could be utilized in the risk stratification and the need for urgent therapeutic intervention

Background- Fine needle aspiration cytology (FNAC) is one the most convenient and inexpensive tool for preoperative assessment of breast lumps. It has gained popularity due to its fast and easy approach and can be performed with very little complications. In other words, FNAC may save anxiety, trauma, time and money. Nevertheless, in FNAC of breast lumps paucity of aspirate material or morphological overlapping features make it challenging for cytopathologists in reporting.
Materials and methods- It is a prospective study done from September 2021 to September 2022. A total of 98 FNAC cases, diagnosed as non malignant breast lesions were included in this study. The study was done at department of pathology, Tripura Medical College and Dr. B R Ambedkar Teaching Hospital, Hapania, Tripura. Some suspected infective cases with purulent material were sent to microbiology department for culture sensitivity testing and Zeihl-Neelson testing to rule out Acid Fast Bacilli. Reporting was done using IAC standardized reporting system for breast lesions. They have categorized the breast lesions into C1 to C5 (C stands for Code).The collected data were entered in SPSS (Statistical Package for Social Sciences Inc, Chicago, IL, USA) version 16.0.
Results- A total of 98 non malignant breast lesions from all the female patients were included. Most of the cases (61.2%) presented in 2^nd and 3^rd decade and maximum cases i.e. (35.7%) were seen between 20-30 years of age. The mean age of patient was 31.99±11.7. Majority the palpable breast lumps in this study were ≤5 cm (80.6%). Right sided breast lumps were seen in 50.0% cases. Among all the quadrants, upper-outer quadrant presented with most common site for breast lesions (48%). Among the non-malignant breast lesions under category C2 and C3, fibroadenoma presented with highest number of recorded cases (39.8%) and followed by fibrocystic change (32.7%).  Females presented with benign breast disease residing in urban areas were (56.1%).
Conclusion- Fine needle aspiration cytology is one of the best technique to evaluate breast lumps used in a country like India with limited resources. It is minimally invasive, rapid and effective method for preoperative diagnosis to relieve the anxiety of patient and also for post-operative follow up of breast lumps to ensure the recurrences. FNAC has some pitfalls, both false-positive and false-negative results can occur, which can be reduced by experience and expertise of cytopathologist. The triple assessment method by clinical, radiological and pathological examination is a standard approach in the evaluation of breast lumps.

Aim: To study the clinical and demographic profile of the patients with brain metastases in a tertiary care centre in north India.
Material and methods: This Observational and cross sectional study was conducted among patients attending the outpatient medicine/radiotherapy department or admitted in Government Medical College, Jammu. Total number of 100 patients was taken. The study group comprised of patients with clinical and radiological signs of brain metastasis.
Results: Maximum subjects were from the age group of 51-60 years (41%) followed by 41-50 as well as >60 years (20%). Statistically significant difference was found among the subjects having brain metastasis w.r.t age group as p<0.05. Females and male comprised of 56% and 44% of the subjects respectively. Left and right side of the brain in brain metastasis was found among 33% and 28% of the subjects respectively while bilateral involvement was revealed in 39% of the subjects. Frontal, parietal, temporal occipital and cerebellar was reported among 19%, 53%, 11%, 15% and 2% of the subjects respectively. Supratentorial and infratentorial location of tumour was found among 96% and 4% of the subjects respectively. Hence dominating location of tumour was supratentorial with statistically significant difference as p<0.05. Most common symptom was headache (69%) followed by vomiting (58%) and neurological deficit (40%). Least common reported symptom was cerebellar sign (4%) followed by visual symptoms (24%) and seizures (27%). According to ECOG grading, fully active status was not found in any of the subject. ECOG grade 1, 2, 3 and 4 was reported among 11%, 42%, 33% and 14% of the subjects respectively.
Conclusion: It can be concluded from our results that brain metastases are disease of elderly people with slight female dominance in this area. Lung and breast are the most common primary sources throwing metastases in brain. Most of the patients had multiple lesions at the time of diagnosis.

Aim of the study: Through a study of the findings of the indices examining at baseline and after four weeks, compare the effectiveness of the two types of mouthrinses—a 0.12% chlorhexidine mouthwash and the other being a Turmeric mouthrinse—over a four-week period.
Materials and Methods
Sample Size: 20 individuals
Using G power software (version 3.0), the size of the sample was calculated to have a power of 80% and a level of significance of 5%
Source of the Data: Undergraduate students at the KIIT Deemed to be University in Bhubaneswar's Kalinga Institute of Dental Sciences.
Objectives of the study: Use the Oral Hygiene Index - Simplified (OHI-S) and Gingival index, Plaque index and Bleeding Index to clinically compare gingival inflammation between the groups.
Methods of collecting data: Undergraduate students studying at Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar who willing participate in the study after meeting the inclusion criteria.
Study will include 20 individuals which will be conducted for a month and will be based on the inclusion and exclusion criteria and will be catagorised into two groups by computerised randomization:

The opportunistic Gram-negative anaerobic bacteria at the tooth-supporting system cause human periodontitis which is a persistent inflammatory disease. The anaerobic bacteria that reside there interact with the host's inflammatory responses to create a low-oxygen or hypoxic environment within the gingivitis-affected sulcus or periodontal pocket. To help tissues adapt to fluctuations in oxygen availability caused by pathology or natural occurrences, an oxygen-sensing mechanism within each cell and within each tissue is required, as well as its proper management. In this review article, the biological significance of hypoxia  with regard to periodontal/oral cellular growth, epithelial barrier function, periodontal inflammation, and immunology has been described briefly. 

Background: Many imaging modalities, such as USG, CT, and Invasive Cholangiography, have limitations and poor visualization of intraductal stones and leads to the requirement for intrusive procedures like ERCP and PTC. MRCP is a non-invasive imaging modality, which provides good visualization of the hepatobiliary system.
Aim and Objectives: To study the role of MRCP in screening and diagnosing pancreatico -biliary diseases and to study the imaging appearance of pancreatico-biliary diseases on Magnetic Resonance Cholangio-Pancreatography.
Materials and Methods: A correctional study of 50 patients of pancreatico-Biliary diseases were evaluated with MRCP using 1.5 T MRI attending KBNTGH attached to KBNUFMS, kalaburagi, over a period of one and half year
Results: Out Of the 50 patients, 31 were male and remaining 19 were female patients. The patients of > 40 years had the highest number of instances. Out of 50 patients who underwent MRCP, 14 has cholangiocarcinoma (Males-9 & Females-5), 11 patients had Pancreatits (Males-8 & Females-3), 07 had Choledocholithiasis (Males-2 & Females-5), 06 had Periampullary carcinoma, 05 patients had Carcinoma pancreas, 03 patients had Carcinoma Gall bladder, and other had post-operative stricture, choledochal cyst. Biliary strictures were seen in 12 patients, out of which 5 had benign strictures and 7 were malignant.
Conclusion: MRI and MRCP have been proven to be sensitive, non-invasive imaging modalities that aid in the early detection and diagnosis of disease as well as in providing crucial details of therapeutic and prognostic implications.

Objective: The study aimed to evaluate parents’ and caregivers’ knowledge and perception of the use of fluoridated toothpaste, as well as the importance of their involvement in the child’s oral hygiene practices, and the amount of fluoridated toothpaste dispensed. A self-developed questionnaire was distributed to 388 parents/ caregivers.
Results: Low levels of perception and knowledge were observed in a high percentage of the participants. About 51% of the parents were unsure whether the toothpaste was fluoridated, and 87% were unaware of the fluoride concentration. Furthermore, 42% of parents never got involved in tooth brushing, 13% brush their children's teeth by themselves, and only 4.9% check their child's teeth after brushing. Almost 86% of children reported rinsing after brushing, while 3.1% spit without rinsing, and 4.9% of the participants were unsure. Mothers have higher knowledge and perception levels compared to fathers.
Conclusion: Even though parents are involved in their children’s toothbrushing, they do not know how much toothpaste should be dispensed for each specific age. Such findings suggest that there is a lack of awareness of proper guidelines for the selection and usage of toothpastes in children. Parents should be motivated to supervise and assist their children’s brushing using the proper toothpaste appropriate for their age

Acute disseminated encephalomyelitis (ADEM) is an acute inflammatory immune-mediated demyelinating disorder of the central nervous system usually occurring after a post infectious or post vaccineal event.⁽¹⁾ It is usually monophasic but can be polyphasic or be recurrent making the diagnosis difficult⁽²⁾. Commonly affects the children.  There is activation of t cell clones causing widespread demyelination involving the white matter of the brain and spinal cord. As it can affect any part of the neuraxis the clinical features are variable and polysymptomatic

Fetal undernutrition is a major public health problem in India. Fetal malnutrition or fetal undernutrition is defined as failure to acquire adequate quantum of fat and muscle mass during intrauterine growth. Poor maternal nutrition and placental insufficiency are the two main causes of fetal malnutrition Fetal undernutrition leads to morbidity in adulthood which in turn leads to fetal undernutrition of subsequent generation, it is a vicious cycle. CAN score is the gold standard method for identifying fetal undernutrition

In the medical literature, AUB is described as an episode of abnormal uterine bleeding that is not due to any clinically evident organic, systemic, or iatrogenic cause (Pelvic pathology, e.g. tumor, inflammation or pregnancys excluded). ¹ Although the prevalence varies widely, a 10-percent incidence rate among new patients entering the outpatient clinic appears reasonable. The bleeding may be abnormal in terms of frequency, volume, or duration, or it may be a mix of any of these characteristics. Because the diagnosis is dependent on the exclusion of a 'organic lesion,' the incidence varies depending on the level of care and facilities available to rule out such a lesion. AUB is currently defined as a condition characterized by abnormal uterine bleeding following an ovulation as a result of hypothalamo-pituitary-ovarian axis malfunction (endocrine origin). 

Bauhinia variegata, a medicinal plant commonly known as Kachnar, belongs to the Leguminosae family. It is primarily found in tropical and warm regions around the world. It is known for its high pharmacological and commercial significance due to the presence of terpenoids, flavanoids, tannins, steroids, reducing sugars and cardiac glycosides, which aid in the cure of number of diseases. This study carried out profiling of Phytochemicals of this medicinal plant by using several in silico computational methodologies against SARS-CoV-2 virus. The 3D structure of Phytochemicals and the three target sites of the SARS-CoV-2 were constructed using Swiss-Model server and pre-processed in BIOVIA Discovery Studio followed by molecular docking carried on with Autodock tools-1.5.6. The pharmacokinetic and toxicological properties of these compounds were assessed using the Swiss ADME and admetSAR web servers, respectively. The potential toxicities generated by these compounds, as well as the energies of molecule-target interactions, hydrogen bonding, and hydrophobic interactions, were determined and analyzed. According to the findings, Phytochemicals such as Beta-sitosterol, Lupeol, Ombuin, and Quercetin exhibited higher binding affinity than the two reference drugs Ivermectin and Lopinavir, taken as comparison in the study. According to the preliminary results, these bioactive compounds exhibit the most promising docking scores with the three target sites of Corona virus. Hence, they could be regarded as prospective  Phytochemicals found in Bauhinia variegata, potentially making this plant an active source of Phytochemicals required for the treatment of corona virus infections. Further experimental validation may necessitate the application of bioethics principles, laws, and regulations.

Introduction: Any HIV infected individual with a CD4+ T cell count of less than 200/L has AIDS by definition, regardless of presence of symptoms of opportunistic disease. Neurological complications increase with decline in CD4+ T cell count. With CD4 T cell count less than 500/micro-L- Early stage -Demyelinating Neuropathy CD4 T cell count 200 to 500 – Mid stage- dementia VZV Radiculitis and CD4 T cell count less than 200 -Advance stage -Dementia, myelopathy, painful neuropathy. Plasma viral load independently provide an important prognostic information with regard to AIDS. If CD4 count goes below 250/microliter common neurological manifestations are TB meningitis (TBM), cryptococcal meningitis (CCM), progressive multifocal leukoencephalopathy (PMLE), AIDS dementia complexes (ADC), Acute inflammatory demyelination polyneuropathy (AIDP)^. HIV RNA (viral load) and CD4 T lymphocyte (CD4) cell count are the two surrogate markers of antiretroviral treatment (ART). Response and HIV disease progression that have been used for decades to manage and monitor HIV infection.
Aims & objectives: - 1. To study the neurological manifestations in patients diagnosed with HIV.2. To study CD 4 counts in HIV Patients.3.To study viral load in patients of HIV.4.To study the correlation between neurological manifestations, CD 4 counts and viral load in HIV patients.
Materials & methods: This is a cross sectional study conducted over 86 patients of essential hypertension admitted in department of general medicine, R D Gardi medical college and C R Gardi Hospital, Ujjain (M.P)   during the period from Jan 18 to June 19 after applying the inclusion and exclusion criteria.
Observation and results: In this study most common diagnosis was TBM 25 (56.8 %) patients having CD4 count ≤100 were having TBM,7(100%) patients having CD4 count ≤100 were having toxoplasmosis, 4 (66.7%) patients having CD4 count ≤100 were having BM and 19 (43.2%) patients having CD4 count >100 were having TBM,17(100%) patients having CD4 count >100 were having peripheral neuropathy, 3 (75 %) patients having CD4 count ≤100 were having CVA.
Discussion: All patient with meningitis presented with headache vomiting and fever, focal neurological sign where absent none of these patients had convulsion, Diagnosis of meningitis done on basis of clinical symptoms, Fundoscopic examination was normal specific diagnosis was made on basis of CSF finding all patient had CSF examination had Indian ink preparation done. CSF finding reported in table. We had 44 cases of TBM the incidence of TBM has also found in other studies done by Mehta, et al. these is probably due to strong association of HIV and TB in India,
Conclusion: Neurological manifestations are seen with low CD4 count and high viral load in our study and there is a significant correlation between them hence can be stated that, these are the manifestations of the late stage of the disease, when the level of immunodeficiency has achieved a higher degree and which cloud result in high mortality.

Background: The most frequently encountered medical disorder in pregnancy is gestational diabetes mellitus (GDM) which is multifactorial and no tool has been successful in predicting GDM in early pregnancy. In the modern era association of GDM with metabolic syndrome is coming to light. The clinical marker of visceral obesity which is now coined as hypertriglyceridemic waist phenotype is abdominal obesity in combination with hypertriglyceridemia. The purpose of this study was to find the association between the hypertriglyceridemic- waist phenotype in early pregnancy and glucose intolerance in later pregnancy. Not many studies have been done to show the association of increased waist circumference and elevated serum triglyceride leading to the development of GDM even though it is well known that the interrelation of these leads to subsequent development of Type 2 Diabetes Mellitus (T2DM).
Objective: To determine the association of elevated serum triglyceride level and waist circumference in early pregnancy with the development of GDM in later pregnancy
Materials and methods: It is an observational study where fasting serum triglyceride and waist circumference is measured in 270 consenting pregnant women between 11-14 weeks and followed up. Performance of 75 gm oral glucose tolerance test (OGTT) was done between 24-28 weeks and results were interpreted.
Results: In early pregnancy, a waist circumference of 96.4cm+/-13.6 and a fasting serum triglyceride level of 147.8mg/dl+/-74.8 are interrelated with the development of GDM in later pregnancy. There is 3 times increased chance of developing GDM with a waist circumference of >80cm and 9 times increased chance of developing GDM with a serum triglyceride level of >150mg/dl
Conclusion: In early pregnancy, the “Hypertriglyceridemic Waist Circumference” is associated with the subsequent development of GDM

Purpose-Gastroesophageal reflux disease is the commonest gastrointestinal disease which causes reflux oesophagitis and complications like ulcerations, stricture of oesophagus. Patients present with either heartburn or reflux. Current treatment would include either lifestyle changes, pharmacological therapies, surgical fundoplications and endoscopic procedures.
Methods-Patients who have reflux would require medical therapy, endoscopic approach or surgery. The choice of therapy depends on symptoms of the patient. This article various treatment strategies for management of GERD.
Results- Fundoplication was done in 35 patients, Slippage of wrap was found in 3 patients and 4 patients persisted with postoperative dysphagia.
Conclusion- Laparoscopic fundoplication is indicated for severe gastroesophageal reflux disease, erosive esophagitis, stricture of oesophagus, hiatus hernia and is the gold standard for these conditions

Background: Emergence agitation has potential to harm both patients and caregivers. This is more often witnessed in patient undergoing otolaryngology operations under general anesthesia with volatile anesthetic used for maintenance.
Aim: We investigated the effects of intra-operative dexmedetomidine infusion on emergence agitation and quality of recovery after functional endoscopic sinus surgery in adult patients.
Materials and Methods: One hundred patients undergoing functional endoscopic sinus surgery were randomized into two groups. The dexmedetomidine group (Group D, n = 50) received dexmedetomidine infusion at a rate of 0.4 mcg/kg/hr from induction of anaesthesia until extubation, while the control group (Group C, n = 50) received volume-matched normal saline infusion as placebo. Propofol (2 mg/kg) and fentanyl (2 mcg/kg) were used for induction of anaesthesia, and sevoflurane was used for maintenance of anaesthesia. The incidence of agitation, haemodynamic parameters, and recovery characteristics were evaluated during emergence. A 40-item quality-of-recovery questionnaire (QoR-40) was provided to patients 24 hours after surgery.
Results: The incidence of agitation was lower in Group D than Group C (28 vs 56 %, P = 0.018). Mean arterial pressure and heart rate were more stable intra-operatively and during emergence in Group D than in Group C (P < 0.05). Time to extubation, nausea and vomiting, and pain scores were similar between the groups. Global QoR-40 score at 24 hours after surgery was higher in Group D (mean 174.7 ± 6.99) compared with Group C (mean 169.4 ± 9.91) (P < 0.05).
Conclusion: Intra-operative infusion of dexmedetomidine provided smooth and hemodynamically stable emergence. It also improved quality of recovery after nasal surgery.

Financial Inclusions has been one of the "most critical factors in the context of growth, including sustainable development in developing countries such as India. Financial Inclusion is a process" that ensures the availability of appropriate financial products and services required to the affected parties such as vulnerable categories and low-income groups at a fair and transparent cost to financial institution players. In our country, the Reserve Bank of India (RBI) has established a monetary policy aimed at providing affordable banking services to both the poorest and least paid parties. For a number of reasons, banking services are available mainly in urban areas, but the rural areas of India are not well covered. Rural development plays a major role in the development of the global economy. The researcher would cover several aspects of rural banking and the various challenges faced by the industry.

In India, there are several financial schemes that come into existence for women’s empowerment – microfinance is one of those. This is one of the financial schemes that aim to help those people who are not able to get loans from banks or other financial institutions. Empowering women is one of the purposes of microfinance.
Microfinance is an important practice of extending those small collateral-free loans or financial assistance for those underserved individuals mainly for developing those areas without getting any access to credit.
You will come across various microfinance institutions that include those of financial inclusion and also non-government organizations generally target those of browsers. Microcredit offers adequate financial support for maximizing the exact value of physical capital.
The main purpose of this research is mainly for evaluating the great impact of those microfinance programs primarily including complete access to microcredit and also then saving groups. It thus helps in women’s empowerment.
How Microfinance Empowers Women in India

Non-Resident Indians or NRIs are looking more and more in the direction of their dwelling land to invest their money. NRI is characterized as any person who resides outside India for foremost part of the year because of his employment. Since 1950s, Indian economy has been growing steadily and investors from all over the world have conveyed interest in taking benefit of this growth. After the reforms of 1990 with the commencement of the era of liberalization, India has become one of the favorite investment destinations of NRIs. In this paper I would like to discuss about the perceptions of NRIs towards return on investment in case of Gujarat state also to see relation of factors like education, gender and marital status with the perceptions towards return on investment in case of Gujarat.

Everyone is aware about the demonetization policy of the government by banning Rs. 500 & Rs. 1000 currency notes. One can understand that it would have a pretty bad impact on SMEs, small traders, real estate, transport sector, consumer durable goods industry. Not only these sectors but it would major affect the rural areas business as over there, majority of the transactions are made in cash. The ban of Rs. 500 and Rs. 1000 currency notes will impact those industries where hardcore cash transactions are made. Demonetization will affect the liquidity, but for a short-term Demonetization is a tool to battle Inflation, Black Money, Corruption and Crime, discourage a cash dependent economy and help trade. Its policy of the government by banning Rs. 500 and Rs.1000 currency notes has influenced all almost all the corner of the economy. Its effect on Banking Sector is significant as Bank is a center for channeling the legal tender money to all needs of the society. The biggest beneficiaries of demonetization are Banks. It made the banks to accept the deposits without any cost of promotion and drastically increased liquidity position of the banks. The present study is made out of available literature on post demonetization. It portrayed the effect of demonetization on Banking Sector. It encompassed the recent decision of the central government on Demonetization and its gradual effect on Indian banking sector.

The major objective of this research is to analyse the effect on Indian small and medium-sized businesses of the country's cashless monetary policy. The government is thrilled with the demonetization of high-denomination currencies. One of the most sustainable and ecologically beneficial ways to do business in the future is to shift from a cash-based economy to one that relies increasingly on electronic payment systems. As a result of the country's recent decision to demonetize its currency, the general public will be forced to perform all of their monetary transactions online. Demonetization's quick adoption harmed the MSME sector, which likes to conduct its business in the traditional manner. To be successful in a cashless era, this company will need tight regulatory oversight. Economic changes would have a detrimental impact on the economy if MSMEs were not present. An electronic monetary philosophy is a result of both dealers and customers using digital infrastructure more often. The study's results demonstrate how a cashless society would impact India's small and medium-sized businesses. SMBs may confront difficulties in a cashless environment, as well as alternative solutions, according to the article. The outcomes of this inquiry were analysed using secondary data and simple statistical approaches.

This article discusses the use of remote sensing and geographic information systems to manipulate and analyse each layer of spatial control data in Aurangabad, Maharashtra, to determine groundwater potential zones. Due to climatic trends, topographical factors, and aquifer characteristics, groundwater occurrence in drought-prone areas varies through time and place. Because of this, precise delineation of Groundwater Potential Zones (GWPZs) is crucial for the sustainable management of water resources in these settings. The goal of the current study is to identify and evaluate GWPZs in drought-prone areas by combining remote sensing (RS), geographic information systems (GIS), and analytical hierarchy process (AHP). Seven thematic layers were created in the following categories: Rainfall, LULC, Geomorphology, Soil Classification, Lineament Density, Drainage Density, Slope. This study concludes that the AHP model will be more accurate in determining the GWP. The stack holders would gain from any groundwater management projects done out in this advantageous area. The present study divide Aurangabad district based on the result in the four different category i.e, Poor (6.3%), moderate (35.2%) , and Good (56.6), Excellent (1.9).  

There are lots of social media tools that are accessible for medical or healthcare professionals, which include different social networking blogs, microblogs, media-sharing sites, wikis, virtual reality. All these different media tools can be utilized to develop or improve specialized networking and organiza tional promotion, education, patient education, patient care, and different public health agendas. But they also can perpetuate the risks to patients and healthcare professionals regarding the circulation of low-quality information, violate the patient privacy, and also have legal issues. To prevent all these risks, professional organizations and healthcare institutions have introduced a few guidelines. These guidelines were established to deliver emergency medicine residency programs control with leadership and best perform in the suitable practice and guidelines of social media but are valid to all residency programs that desire to create a social media presence. In this chapter, the authors describe how social media made their impact on this pandemic COVID-19 situation.
 

Marketing strategists have utilized social media platforms to increase sales, establish brand identity, and raise awareness. However, there are difficulties in converting public participation into financial growth. As a result, the current study looked into the challenges and success of social media marketing in attracting customers. The food retail market in India was the focus of the study because it has a diverse retail pattern and a simultaneous rise in social media use and internet use. The quantitative component of the research helped identify the relevant factors that customers perceive as having a significant impact on social media marketing's efficacy. Interviews with social media strategists were part of the qualitative research component, which helped decipher the implemented strategies as well as the opportunities and challenges associated with social media marketing. Two major Jakarta-based retailers served as the subjects of the study. According to the quantitative results of the survey, consumers did not consider the social aspect of social media marketing to be helpful in achieving their goals. Customers' perceptions of the relevance of social media marketing were found to be significantly influenced by factors such as belief (relevance of social media in obtaining up-to-date information and the capacity to share experiences), community participation (active participation in a retailer's social media page and stimulating the retail brand), monetary (obtaining better prices and free coupons for making purchases), and psychological (seeking a sense of affiliation and belonging in the community and establishing and maintaining relationships with other members).

Social media comprises communication websites that facilitate relationship forming between users from di- verse backgrounds, resulting in a rich social structure. User generated content encourages inquiry and decision-making. Given the relevance of social media to various stakeholders, it has received significant attention from researchers of various fields, including information systems. There exists no comprehensive review that integrates and synthesizes the findings of literature on social media. This study discusses the findings of 132 papers (in selected IS journals) on social media and social networking published between 1997 and 2017. Most papers reviewed here examine the behavioral side of social media, investigate the aspect of reviews and recommendations, and study its integration for organization- al purposes. Furthermore, many studies have investigated the viability of online communities/social media as a marketing medium, while others have explored various aspects of social media, including the risks associated with its use, the value that it creates, and the negative stigma attached to it within workplaces. The use of social media for information sharing during critical events as well as for seeking and/ or rendering help has also been investigated in prior re- search. Other contexts include political and public administration, and the comparison between traditional and social media. Overall, our study identifies multiple emergent themes in the existing corpus, thereby furthering our under- standing of advances in social media research. The integrated view of the extant literature that our study presents can help avoid duplication by future researchers, whilst offering fruitful lines of enquiry to help shape research for this emerging field.

The paper deals with the impact of the economic agent sentiment on the return for Apple and Microsoft stocks. We employed text mining procedures to analyze Twitter messages with either negative or positive sentiment towards the chosen stock titles. Those sentiments were identified by developed algorithms which are capable of identifying sentiment towards companies and also counting the numbers of tweets in the same group. This resulted in counts of tweets with positive and negative sentiment. Then we ran analysis in order to find causality between sentiment levels and the stock price of companies. To identify causal effects we applied Granger causality tests. We found bilateral causality between the risk premium and the amount of news distributed by Twitter messages.

With the radical liberalization in the Foreign Direct Investment (FDI) regime during past years, Indian capital market has been able to attract foreign investors considerably. There has been significant upsurge in the foreign direct investment in India. With this, India has emerged as one of the most favored destination for investment in the world. Since the development and the volatility of the Indian stock market has been substantially influenced by the inflow of FDI. Therefore, the present paper attempts to analyse the impact of FDI inflows on the movement of BSE (Bombay Stock Exchange) SENSEX and NSE (National stock exchange) CNX Nifty during the period under study. The study is primarily based on ten years secondary data for the period from April, 2006 to March, 2016. The Simple Linear Regression (step-wise method), Karl Pearson’s coefficient of correlation, Analysis of Variance, Normal P-P plot, Scatter plot, Histogram, descriptive statistics (Mean & Standard Deviation), Compounded Annual Growth Rate, Trend Percentage etc. are the tools for the analysis of data using the statistical package for social sciences (SPSS). FDI was found significantly correlated with both the markets with the coefficient of correlation being 0.666 and 0.682 respectively. It was further found that FDI has affected BSE SENSEX up to 44 percent and CNX Nifty up to 47 percent. The study concluded that flow of FDI in India has significant impact on BSE SENSEX and NSE Nifty movements. Keeping in view the findings of the study, it has been suggested that the government of India along with its implementing bodies should try to attract more and more FDI for the smooth and rapid development of the stock market and the economy as a whole.

Gaucher disease, an autosomal recessive disorder, results from the defective activity of acid β-glucosidase. About 55–60% of patients are diagnosed at <20 years of age. The pattern of presentation is distinctly bimodal, with peaks at <10-15 years and ~25 years. All patients with Gaucher disease have nonuniform infiltration of bone marrow by lipid-laden macrophages termed Gaucher cells. This phenomenon can lead to marrow packing with subsequent infarction, ischemia, necrosis, and cortical bone destruction. It is an autosomal recessive disorder. This means that each parent must pass along an abnormal GBA gene for their child to get Gaucher. Parents may have only 1 GBA gene and, therefore, not show any signs of the disease, but be carriers of the disease. Gaucher disease type 1 is most commonly found among Ashkenazi Jews who have a high number of carriers of the defective GBA gene. There are 3 types of Gaucher’s disease based on clinical manifestations and involvement of CNS.¹

Clavicle fractures contribute approximately 2.6% among other fractures of the body and account for approximately 44% to 66% of all fractures around shoulder.Middle 1/3rd of the clavicle is most prone for fracture because this area is weakest.Many studies which has been done till now has stated the effectiveness of open reduction internal fixation with plating for displaced clavicle fractures and it was noted to have high union rate and lower risks of complication.Usually locking compression plate are used to get a satisfactory results with low risks of complication in cases of majority of complex clavicle fracture.

Introduction: To assess the effect of education level and previous anaesthesia exposure on knowledge of anaesthesia and role of anaesthesiologist
Method: 112 patients above the age of 18 years undergoing any elective surgery were enrolled in the study. They were asked to fill out a questionnaire containing questions related to anaesthesia, anaesthesiologists and their concerns and perceptions about risks related to anaesthesia. Each question had multiple choices. The patients were divided into two groups of 56 each i.e. Group A consisted of patients with previous anaesthesia exposure and Group B consisted of patients without previous anaesthesia exposure and data was compared.
Results: Out of all patients who had only a secondary school education or lower, only 38% had knowledge about anaesthesia and were able to correctly answer questions about role of anaesthesiologist and why preanaesthesiacheckup was necessary, whereas 62%  did not know importance of preanaestheticcheckup and role of anaesthesiologist. In patients who had graduate or post graduate level of education, 60% were able to correctly answer questions regarding importance of preanaestheticcheckup and role of anaesthesiologist, whereas 40% answered incorrectly.Of all patients in Group A (Previous anaesthesia exposure), 71% of patients were able to correctly answer questions relating to importance of Preanaestheticcheckup and role of anaesthesiologist, whereas 29% answered incorrectly.In Group B (No previous anaesthesia exposure), only 20% were able to correctly answer questions relating to importance of preanaestheticcheckup and role of anaesthesiologist, whereas 80% answered incorrectly.
Conclusion: It can be concluded that patients who had a higher level of education and/or had previous anaesthesia exposure were more aware of the importance of preanaestheticcheckup and role of anaesthesiologist

Background: An anal fissure is one of the common anorectal disease resulting from a split or tear in the anal canal's skin, it causes pain, bleeding and emotional stress. There are medical and surgical treatment available for treating anal fissures, this study was aimed to compare lord’s dilations and lateral internal sphincterotomy.
Methods: An observational study conducted in 64 patient general surgery department, all patients were treated by conservative management first and surgically if required. Lateral internal sphincterotomy or lord’s dilatation were performed among study subjects by randomised process. 
Results: Mean age of 64 study sample was 38.78 years (SD - 9.03 years), with 52 (81%) male and 12 (19%) female in study. All 64 subjects were treated by conservative first, while 54 (84.4%) required surgical management. There was no significant difference in mean duration of surgery, post-operative pain & duration of hospital stay between lords dilation lateral spinteretomy.
Conclusion: Conservative medical treatments are all effective methods that may reduce the need for surgery in many patients. Early pain alleviation and a high ulcer healing rate are provided by anal dilatation and lateral internal spinteretomy treatment, LIS is a safer option in terms of recurrence.

With an incidence of just 2-4%, wrist TB is a rather uncommon condition. The radiocarpal joint and the inter-carpal joint involvement are particularly rare. Due to the slow progression of symptoms, it is often detected when there has been significant carpal destruction or arthritis. The condition occurred in a 55-year-old female, presenting with wrist pain for 2 years. Clinical examination revealed a localized ganglion-like swelling over the left wrist with a full range of motion but painful terminally. Following radiographic examination, the diagnosis of osteoarticular tuberculosis was suspected, and was confirmed on histopathological analysis. Patient underwent debridement with synovectomy followed by anti-bacillary chemotherapy of 12 months which promoted healing and good outcome. We conclude from this case that tuberculous arthritis is uncommon and the functional outcome depends on obtaining an early diagnosis before radiological signs of joint damage appear

Delivery by caesarean section has become very common nowadays.Lower segment caesarean sections (LSCS) are now commonly performed using spinal anaesthesia. In parturients, hypotension is aggravated by compression of the inferior vena cava by gravid uterus. Its incidence has been reported as high as 40-70% and affects 90% women. For reducing the severity of maternal hypotension, many pharmacological and non-pharmacological methods are employed.
Glycopyrrolate,an anticholinergic drug with a quaternary amine structure that limits its ability to cross the blood-brain barrier and placenta and therefore has no effect on the variability of foetal heart rate (FHR) and maternal heart rate (HR).During spinal anaesthesia glycopyrrolate is expected to attenuate hemodynamic changes which makes it a popular choice for obstetric patients.

Objective: To compare the neonatal morbidity rates in early term versus full term born neonates.
Study design: This was a prospective study of 220 deliveries from 37 0/7 to 40 6/7 weeks of gestation from September 2020 to September 2022. After excluding anomalies, twin gestation, malpresentation, and stillbirth in parturating women in the study. Labour was monitored and newborns were assessed at birth. Neonatal morbidities of babies compared for each week of delivery.
Results: Neonatal morbidity, in the early term babies when compared with full term babies was 24.5% and 6.3% respectively. Neonatal intensive care unit admission and respiratory morbidity were lowest at or beyond 39 weeks of gestation when compared with the early term babies. Statistically significant differences in morbidity were noted between 37 and 39 weeks of gestation. Respiratory morbidity was higher at 37 than 39 weeks regardless of the route of delivery.
Conclusion: This was a prospective comparative study between early and full-term babies. We observed that the neonatal outcome was poorer in the early term group in terms of birth weight, neonatal morbidity, NICU admission rate, and respiratory distress with a statistically significant difference in comparison to full term babies.

Background:  A persistent metabolic syndrome is diabetes mellitus marked mostly by chronic hyperglycemia. Recently,it is considered as state of prothrombosis,characterized by abnormalities in platelet function which has been recognized as a component of the metabolic syndrome. Aims are made to discover and demonstrate the utility of various blood tests, including platelet indices for the early diagnosis of diabetic problems.  Increased platelet activity  has a role in development of diabetic complications, thus platelet volume indices are considered as potential biomarkers in diabetics who have vascular issues.
Methods :  356 people with diabetes and 201 non-diabetics participated in the study. To perform a complete hemogram, a Sysmex KX-21 automatic blood counter and a Benesphera H51 coulter were used. From the records of the Central Clinical Laboratory, the HbA1c level was assessed using the immunoturbidometric inhibition technique. The statistical analysis was carried out using SPSS version 17 (Statistical Package for the Social Sciences) (Chicago, IL). Student's t-test was used to determine if there was a significant difference in HbA1c, PC, MPV and  PDW. Statistics were judged significant at P 0.05.
Results :  In our study, MPV and PDW was statistically significant in diabetic patients with complications (P<0.0001 and P=0.0001respectively). A positive correlation was seen between MPV and HbA1c. While  MPV was statistically significant in diabetic retinopathy, nephropathy, and diabetic foot, PDW was statistically significant in diabetic retinopathy and nephropathy.
Conclusion : An effective predictor of diabetic cardiovascular issues would be MPV. Additionally, we found a direct correlation between an increase in MPV and a rise in HbA1c levels. Therefore, we propose that MPV can be used as a simple and low-cost method to monitor the onset and control of Diabetes Mellitus and its cardio-vascular effects.

The most fatal gynecologic cancer is ovarian cancer. The most prevalent kind of ovarian cancer is the surface epithelial tumour. 15–20% of ovarian cancers among these are mucinous tumors. One of the most challenging ovarian neoplasms for surgical pathologists to understand is mucinous ovarian tumors. Other surface epithelial cancers can occasionally coexist with mucinous tumors. Making a correct diagnosis of mucinous tumors is so crucial. However, Brenner tumors seldom occur in conjunction with other neoplasms. Due to its rarity and contested histogenesis, ovarian Brenner tumor has traditionally been regarded by pathologists as a perplexing tumor. In this case report, we present a benign Brenner component in a large mucinous cystadenoma.

Introduction: Leprosy is an ancient, chronic, granulomatous, curable disease affecting the skin and peripheral nerves extensively and is caused by Mycobacterium (M) leprae. It remains a considerable health issue in many developing countries including India. Timely and accurate diagnosis is essential for leprosy management as it helps to spread and morbidity associated with it. Materials and Methods:  The Cross-sectional Prospective study was conducted between period August 2020 to September 2022 in a teaching hospital from urban industrial area. A total of 100 Skin biopsies from clinically suspected cases of leprosy were included in this study. Detailed histomorphological features were studied.  Bacteriological Index (BI) of acid fast bacilli was calculated on Fite ferraco stain. Results: The most common type of leprosy was BT (n=24). Males were commonly affected than females and commonest age group was 21-40 years (n=39). Majority of the cases in lepramatous leprosy (50%) had Grenz zone. Perineural lymphocytes (37.50%) and periadnexal lymphocytes (45.45%) were appreciated. Conclusion: Classifying leprosy is vital to decide the treatment course. It should only not be on the basis of counting skin lesions, but also through clinical, bacteriological, histopathological examination of the skin biopsies.

Common cough being a common presenting complaint in pulmonary medicine is often misdiagnosed. Endobronchial foreign body is a rare diagnosis in adults and varies in presentation from patient to patient.  We present a case of chronic cough in a 65 year old male being misdiagnosed as infective etiology on imaging, neoplastic mass on bronchoscopy eventually being diagnosed as a corn kernel in the subsegmental bronchus.
The case report highlights the value of a strong clinical suspicion to diagnose such cases and the importance a good experienced clinician in identifying such etiologies.

To evaluate the functional outcome of acute acromioclavicular joint injuries of Rockwood types III to VI.
Background: Young adults who are active or athletic are more likely to get acromioclavicular joint injuries. There is disagreement over the best way to treat acromioclavicular separations. In the acute environment, types I and II injuries are typically treated non-operatively, while types III to VI injuries typically require surgical repair. In this study, we attempt to assess the results of acute acromioclavicular joint dislocations treated with Mersilene tape in terms of healing time, functional outcomes, and comorbidities.
Materials and methods: 30 individuals with Rockwood Grade III-V (mean age, 35.4 years; range, 21-59 years) were the participants of the study. From August 2020 to July 2022, mersilene tape was used to reconstruct the coracoclavicular ligament in cases with acromioclavicular joint injuries with a period of fewer than two weeks. All patients underwent coracoclavicular ligament reconstruction with Mersilene tape and AC joint capsule and ligament repair with vicryl. Anteroposterior radiographs and the Constant Murley Score were used to evaluate the clinical results during follow-up visits.
Results: In the operated shoulder, the mean Constant Score was 84.4 at 6 weeks, 86.2 at 3 months, 88.2 at 6 months, and 90.2 at the 1-year follow-up. All patients had recovered to their pre-injury level of activity at the last follow-up.
Conclusions: Mersilene tape has brought better functional outcomes and pain-free shoulder movements in our series. Due to the cost-effectiveness of the implants utilised in comparison to imported hook plates or Tight rope/Endobutton, this surgical treatment is highly economical and avoid implant-related issues and additional procedure to remove the implants without the requirement for a second hospital stay or additional out-of-pocket expenses. The surgical process took only a short time. In our Case series, intraoperative and postoperative complications are scarce, minimal learning curve. Mersilene tape provides the acromioclavicular joint with both vertical and horizontal support. Mersilene tape has produced excellent benefits in this short-term follow-up.

Abortion is the removal of a 500g or less embryo or foetus from its mother when it is incapable of surviving on its own (WHO).
Septic abortion refers to any abortion that is connected to clinical signs of infection in the uterus and its contents. We in India are still unable to reach most of the couples belonging to low socioeconomic class or those who are illiterate with our family planning services. Due mostly to illegal abortions, septic abortion continues to be the largest cause of maternal death in the developing countries. Here is a case of septic abortion who was near miss mortality due to illegal practices.

Artificial Intelligence (AI) has been growing at a very fast pace for over the past two decades and has reached a point where it acts as a new frontier in the fields of business, corporate practices and government policies. With the aid of machines and technology, businesses have been obtain in profound amount of positive impact both in term so productivity and competitive advantage. Though it has become an indispensable part of certain areas of businesses, there are a lot of other areas whereitsviabilityhasnotbeenexploredyet.Althoughusageofadvancedtechnologyhasincreasedsincethead vent of mechanization, not a lot of focus have been given on the usage of AI in the day-to- day activities of an Industry due to its requirement of heavy investment and procession of less knowledge of its conceptualization. This study mainly focuses on the future prospects of AI in various fields of Industries and suggests the prospective areas in which AI could be implemented in order to obtain most functionality. Therefore, the core aim of the study was   identify the areas of various Industries in which AI could be introduced or applied in order to solve immensely difficult issues that requires addressing from something beyond the human touch.

Multiple myeloma (MM), a malignancy of the plasma cells, accounts for an estimated 14% of all newly diagnosed hematologic malignancies. Advances in chemotherapy and stem cell transplantation have improved survival rates, but MM remains incurable. Bortezomib, a first-in-class proteasome inhibitor, has been approved for patients with MM who have received at least two prior treatments and have demonstrated disease progression on the most recent one. During clinical trials, most side effects were manageable with standard interventions. The most common toxicities were asthenic conditions (fatigue, malaise, and weakness), gastrointestinal disturbances (nausea, vomiting, diarrhea, and constipation), thrombocytopenia, peripheral neuropathy, pyrexia, and anemia. Most rare complication of cardiac toxicities include first degree and complete heart block eventually leading to decompensated heart failure

Silicosis is a fibrotic pneumoconiosis caused by the inhalation of fine particles of crystalline silicon dioxide (silica). Certain occupations such as mining, quarrying, denim
sandblasting and tunnelling are associated with silicosis(1). There are three different clinical presentations: chronic, accelerated, and acute silicosis. The length of exposure and the latency period are crucial for the development of silicosis. The most common types of pneumoconiosis are the fibrotic forms of pneumoconiosis, comprising silicosis, coal worker's pneumoconiosis (CWP), and asbestosis(9). The condition is preventable; however, no specific treatment exists, although a small proportion of patients may receive a lung transplant

Nuclear protein in Testis (NUT) Midline carcinoma (NMC) is highly aggressive, lethal, uncommonly encountered variant of squamous cell carcinoma, caused by genetic re-arrangement of NUT gene with a gene from BRD family¹. 143 patients were registered to International NMC Registry between 1990 to 2017².Similarly data of 119 patients from 64 literatures published between 1950 to 2017 were retrieved on PUBMED and Google search³. Diagnosis of NMC has increased annually since 2007^{4, 10} (Figure 1).Median age of onset is 24 years¹with equal incidence in male and female.²Most common site of occurrence is thoracic (54%) followed by Head and Neck. (40%) ² Among Head and Neck NMC sinonasal origin is commonest.^1,2,3,5,6,11.Median Overall Survival quoted by various literatures is about 6.8 months².We report a case of a boy who presented to us with typical features of NMC

AIM:To study the efficacy of steroid nasal spray alone and steroid nasal spray with oral steroids in patients of ethmoidal polyposis with chronic rhinosinusitis.
MATERIALS AND METHODS: All the patients with presentation of chronic sinusitis with ethmoidal polyposis, fitting in the definition of the study and fulfilling the inclusion criteria had a detailed history taking of the concerned complaints. Steroid therapy was given to each patient in the study for 6 weeks. One group of patients were given topical steroid in form of mometasone nasal spray for 6 weeks (Group A) and the other group was given mometasone nasal spray along with 8 mg of methylprednisolone for 15 days in a tapering dose (Group B). Each patient underwent a thorough radiological examination of the nose following steroid therapy.
RESULTS: The symptoms were significantly reduced in both of our research groups, but the most improvement was shown in those who had both systemic and local steroid therapy. The odds of improvement with topical steroid treatment only is 0.1905 times that of the odds of improvement with topical and systemic steroid treatment based on CT PNS in all individuals. The symptom and polyp size reduction rate was significantly greater in Group B individuals than in Group A (p value-0.01209) as evidenced on CT PNS.
CONCLUSION: In conclusion the results of this study indicate that thrice daily administration of 8 mg oral preparation of methylprednisolone for 15 days and topical steroid in the form of nasal spray for 6 weeks is an efficacious treatment for chronic rhinosinusitis with ethmoidal polyposis. It also provides significant relief of symptoms, reduction in polyp size and overall control of mucosal inflammation and tissue remodeling (p value- 0.012)

 Introduction: Auto immune haemolytic anemias are caused by antibody production by the body against its own RBCs. They are characterised by a positive direct anti globulin test and divided into warm and cold types. Vitamin B12 deficiency associated with Auto immune hemolytic anemia  leads to  severe complications such as severe anemia, pancytopenia, and rarely hemolysis.  
Case presentation:A  37 year old male presented with c/o breathlessness, yellowish discolouration of eyes, oral ulcers, generalised fatigue, decreased appetite for 3 weeks. Clinical examination was unremarkable except for pallor, icterus and oral ulcers. Lab reports revealed severe anemia with peripheral smear  Peripheral smear showed macrocytic normochromic anemia, hypersegmented neutrophils, cabot rings with hemolysis features. S.Folate and B12 levels were Low.Direct Coomb’s test was positive. LFT revealed Indirect Hyper Bilirubinemia, Increased LDH. Patient treated with PRBC transfusion and Inj.Vitamin B12 intra venously .On follow up patient symptoms got improved .
Conclusion:  Macrocytic anemia presented with Hemolysis is rare in occurence.The fact that patients anemia resolved after vitamin B12 treatment indicates a possibility of vitamin B12 Deficiency causing AIHA

Negative pressure pulmonary edema (NPPE) or post obstructive pulmonary edema occurs due to forced inspiratory efforts against an obstructed airway. It is dangerous and life threatening if not promptly diagnosed and treated. Patients generate a high negative airway pressure and hydrostatic forces imbalance, which increases transvascular fluid infiltration and precipitates interstitial and alveolar edema. Recovery is rapid with adequate supportive measures, endotracheal intubation or cricothyroidectomy and oxygen. We have discussed about the steps on how to relieve laryngospasm, extubation, treatment and appropriate ventilator settings and investigations. We have focused on its early identification and management to prevent mortality and further complications which is informative for all anaesthesiologists.

Objectives: Pressure ulcers (PrUs) are the common complications following SCI and there are various options available for PrUs management. In this study the author compared the effect of platelet rich plasma gel dressing of pressure ulcer with normal saline dressing in SCI patients.
Design: This randomized comparative study was conducted in PMR department of SMS medical college.
Method: Fifty eight SCI patients with PrUs, were randomized into PRP gel treatment group (n=29) and normal saline treatment group (n=29) equally. In PRP group, pressure ulcer dressing was done with autologous PRP gel twice weekly for 5 weeks and in NS group, ulcer dressing was done with 9% normal saline on the daily basis for 5 weeks.  Evaluation of PrU healing was done by ulcer staging, measuring wound surface area, Pressure Ulcer Scale for Healing (PUSH), histopathological features of ulcer. 
Results: The mean age of the patients was 37.79±9.90 and 35.14±9.05 years in PRP and NS group respectively. Statistically significant reduction in the stages of ulcer was observed only in PRP gel dressing group only (p<0.001 S) after 5 weeks. The wound area, wound volume and PUSH score of PrU decreased significantly in both groups but on compression among the groups significant decrease in ulcer surface area, and PUSH score was observed in PRP group as compare to NS group. Significant improvement in histopathological of the ulcer was observed after 5 weeks both in PRP (P value= 0.001) and NS (P value= 0.001) group but on comparison among the groups, ulcer treated with PRP gel showed more significant improvement as compare to NS group (P value= 0.001)
Conclusion:  PRP gel dressing is a better alternative as compare to normal saline dressings in PrU healing in SCI patients. 

Chronic collection of amylase rich fluid enclosed in a non-epithelialized wall of collagen or granulation tissue, following after, episode of acute pancreatitis (5-15%), chronic pancreatitis (20 to 40%), trauma. Pancreatic cysts are being diagnosed more frequently because of the increasing usage of imaging techniques. Asymptomatic pseudocysts up to 4cms in diameter can be safely observed and monitored without intervention, but larger and symptomatic pseudocysts require intervention.
Method
The materials for this case series was collected from the patients admitted and diagnosed as pseudocyst of pancreas in our surgical units. All 5 cases have been analyzed for this study during period of 6 months from January 2022 to  June  2022.
Results
Out of 5 cases, for 3 cases open surgery was performed, other 1case was ultrasonography assisted drainage was done and other 1 was conservatively managed according to the clinical presentation and investigations. All the cases are kept for regular follow ups with radiological imaging.
Conclusion
Due to progress in sensitivity and more widespread availability of diagnostic imaging techniques, the incidence of pancreatic pseudocysts seems to be increasing steadily. In the above series the different presentations of pseudocyst of pancreas and different techniques of management was elaborated.

Diabetes is a metabolic disorder that affects the production and use of insulin in the body. 5’-adenosine monophosphate activated protein kinase (AMPK) and subunits play an important role in co-ordinating metabolic pathways and regulating the effects of Type-2-diabetes. AMPK is a key enzymatic Protein involved in linkiing the energy sensing to the metabolic manipulation and is ubiquitously expressed in various tissues of the living system such as kidney, heart, liver, brain and skeletal muscles. We systematically searched PubMed and Google to generate narrative reviews on this topic. A systematic literature search was conducted from various electronic databases on topics evaluating Type-2-diabetes and the resulting regulation of the AMPK pathway by natural and synthetic activators. This review depicts that the AMPK pathway is activated in various organs and shows its effect by altering hepatic glucose production, glucose production, cholesterol levels and protein synthesis. AMPK activation occurs with natural or synthetic compounds; have an effect on reducing the effects of diabetes. This review summarizes the fact that natural and synthetic compounds play an important role in ameliorating the effects of diabetes through direct or indirect activation. In addition to beneficial effects, synthetic compounds have many side effects. In this review, we focus on the toxic nature of synthetic drugs and compare their effects with plant extracts to determine their glucose-lowering effects, action and safety

Antiphospholipid syndrome (APS) is an autoimmune pathological disorder which is most common in females. We report a case of 33 year old male with no co-morbidities who is a non-alcoholic, non-smoker presented with aphasia and MRI brain revealed acute infarct in occipito parietal lobe. On further evaluation for young stroke, hypercoagulation work-up was done and diagnosed to have  Anti phospholipid antibodies (APLA) triple positivity (β₂ glycoprotein Ig G, Cardiolipin antibody Ig G, lupus anticoagulant). He was treated with anticoagulation, single antiplatelet.This case reports highlights the importance of evaluation of  all thrombotic events for its underlying etiology and therefore prevents its recurrence which can sometimes even be fatal.

Background: Cholelithiasis is a chronic recurrent disease of the hepatobiliary system.
Gallstones are the major cause of morbidity and mortality throughout the world. With
atleast 10% of the adults have gallstones with a recent rise in the incidence due to
change in the dietary factors. This study aims to evaluate the demographic factors, its
various modes of presentation, treatment, outcome
Method: This prospective study was conducted on 100 patients in General
Surgery Ward, at Dr. D.Y. Patil Hospital and Research Centre, Pune for a period of
1 year who were diagnosed with cholelithiasis. Epidemiological aspects, Clinical
profile, investigation, treatment and outcomes were analyzed.
Result: The mean age of the patients was 36.82 years with male to female ratio
1:0.69. Pain abdomen was the most common symptom. Ultrasonography showed
gallbladder stones in all patients and 31% of patients undergone open
cholecystectomy and 65% underwent laparoscopic cholecystectomy. The
conversion rate of lap to open cholecystectomy was 4%. The average length of
post operative stay in Laparoscopic Cholecystectomy was 3 days and 7 days in
open cholecystectomy.
Conclusion: Laparoscopic cholecystectomy offers better surgical management with
reference to post operative pain, lesser number of hospital days and cosmetically
better

Background: Cardiac abnormalities occur in majority of patients after cerebrovascular accidents, accounting for unex-pected deaths during the first month. The most common disturbances include electrocardiogram (ECG) abnormalities, cardiac arrhythmias, and myocardial injury and dysfunction. Material and Methods: This prospective study was carried out in a superspeciality hospital during 2 years which comprised of 100 patients. Patients were categorized based on computerized tomography findings into cerebral infarction, intracerebral hemorrhage, and subarachnoid hemorrhage. ECG changes are interpreted with rate, rhythm, and abnormal-ities and conclusions were derived.
Results: Stroke was most common in 5th and 6th decade. Cerebral infarction formed the largest group. Males had higher preponderance. Hypertension was the most common risk factor. In total, 74% had electrocardiographic abnormality. ECG changes are more common among cerebral hemorrhage and subarachnoid hemorrhage. Most common ECG abnormality was prolonged QTc interval. Overall immediate mortality was 23%. It was high in cerebral hemorrhage. Morality was high in patients with abnormal ECG, mostly with prolonged QTc and with T-wave inversion.
Conclusion: Patients with cerebrovascular accidents often have abnormal ECG in the absence of known organic heart disease or electrolyte imbalance. QTc prolongation and U-wave are the common ECG abnormalities in hemorrhagic strokes.

The Reserve Bank of India ( RBI) was established in the year 1935 in accordance with the Reserve Bank of India Act, 1934.  The  Reserve Bank  of India  is the central Bank of India entrusted with the multidimensional role. It performs important monetary functions from issue of currency note to maintenance of monetary stability in the country. Initially the Reserve Bank of  India  was  a private share holder‟ s company which was nationalized in 1949. Its affairs are governed by the Central Board of Directors appointed  by the  Government  of India.  Since  it s inception the  Reserve Bank of  India had  played an  important role in the economic development  and  monetary stability in the country. This paper is an attempt explore into the role, functions, and contribution of RBI in Indian Economy.

In the recent decade OTT platforms, also known as "Over the top," have seen a tremendous rise in the number of consumers and also gained a huge market share in the entertainment industry. The OTT service most users probably interact with regularly is video OTT. Services like Netflix and Disney+ Hotstar are video OTT services that provide users with a number of programming options, both in terms of a licensed library of TV shows and films and original programming. The study's objective is to carry out a detailed study of OTT (over-the-top) platforms, and how and why OTT platforms are rising in India. This study also investigates OTT platforms at the time of the COVID-19 pandemic. We found that recent years have witnessed several films emerging as pan-India hits, and the rise of alternative platforms has only widened the opportunities for actors and filmmakers. This study concludes that there is no competition between theatres and digital platforms filmmakers must up their game. OTT has resulted in more opportunities and redefined viewership patterns. Films and other mediums will thrive together because the same actors and makers are exploring different platforms.

This study entitled “A Study on Government Hospital with respect to administration department” is basically  done in the city of Nepal at Kapilvastu Hspital. In this study Interaction and observation method has been used  to explore the types of administration work and the mechanism used to mitigate the problems by the hospital.  As we all know in recent years, administration work has given rise to widespread concern in the hospital  industry
The study is based on the activities and services involved in multi specialty based hospital which not only enriched professionally but also helped employees to grow personally as well. The studies and findings during  the study at kapilvastu hospital were very fruitful and informative for the research work undertaken.The  findings will definitely help in improving the administration and working of hospitals.

A significant part of company is advertising. Advertisements are used to introduce a business, build a brand, and position a business, a product, or a service in the buyer’s mind relative to other well-known, rival businesses. The goal of the study is to investigate how advertisements affect customer purchasing decisions. 100 people were selected as the study’s sample. To assess the impact of the advertisements on consumer behavior, a detailed questionnaire was developed.
The findings demonstrate that while advertising is quite effective at raising consumer awareness, it fails to forge lasting impressions in their minds. Consumer perceptions and brand awareness of a specific product are two factors that will persuade and influence the consumer to purchase a product because there is a positive relationship between the two. 

The consumer's buying pattern changes faster in a customer-centric market environment. Consumer behaviour varies in terms of product, price, features, quality, packaging, purchasing behaviour, status, generation, age of the customer, etc. However, the most difficult group to correspond with is the youth. The changing preferences of today's youth influence the buying pattern as they mostly follow the rhythm of fashion and taste according to the changing times. Therefore, marketers spend crores of rupees and invest too much time every year in market research to identify and predict the changing behaviour of the youth.
Digital marketing now poses many challenges for marketers in the retail segment. The current generation is more fascinated with online shopping than conventional shopping. Marketers are forced by the pressure of the buying behaviour of the young generation to introduce an innovative way of selling. Buying behaviour and behavioural patterns of the youth have an equally greater impact on the buying behaviour and therefore in this study “The main issue we focus on is digital marketing and its impact on the buying behaviour of the youth. The study shows that the majority of young people of the current generation have access to digital media, but lack the awareness of its optimal use.

The world of finance has witnessed an exponential growth in the post information technology revolution of the 1990s. The present study made an attempt to do a diagnostic analysis of past literature, though a lot of research has been done on investors' perception on mutual funds. In the present study, literature review on various dimensions with respect to the measurement of performance, risk - return trade off of mutual funds, and investors' awareness, education, and interest regarding mutual funds was examined to clear the gateway for the upcoming researchers in the field of the mutual fund industry. Here in this study we have collected a sample of 50 participants and run a questionnaire which is a form of the primary source of data and final analysis is done through the percentage analysis method.

When it came to strategic disinvestment, Bharat Petroleum Corporation Limited (BPCL) was theclear winner over its rival Hindustan Petroleum Corporation Limited (HPCL). The value of BPCL's shareholders' equity was risen by Rs. 33,000 crore as a consequence! In comparison to HPCL, which will remain a government-controlled corporation, the efficiency benefits at BPCL are expected to be more beneficial. So the chapter focuses on the efficiency benefits in India following privatisation. This paper covers the period from 1999-2000 to 2003-04, when 11 CPSEs underwent strategic disinvestment. Comparing these CPSEs to their counterparts in the same industry group requires the use of a difference-in-difference approach. Their recent privatisation has increased their net worth and profits, allowing them to compete on a level playing field with other enterprises. ROA and net profit margins, on the other hand, went from negative to positive, indicating that privatised CPSEs were able to generate greater wealth with the same resources as their rivals. If you take each CPSE one at a time, you'll receive better results, too. According to the research, privatisation has the potential to unleash the wealth- creating potential of CPSEs. As a result, the chapter favours a swift withdrawal of funds from the CPSE.

Consumer behavior changes from last decade are somewhat good in terms and somewhat alarming. In the recent years, the way Indian consumers are expensing their money on various items has distorted. The diffusion of internet and social media has greater than before; as a result, the purchasing performance of Indian consumers has distorted dramatically. Urbanization is a constant phenomenon in India and is affecting the life style and buying performance of the consumers. The study is based on the perception, buying behavior and satisfaction of the customers in Indian advertise.

In this paper attempt is made to know the preferences towards mutual fund and analyze the importance of demographic factors that influence the decision of investor towards making investments. This study attempts to find out the significance of demographic factors of population such as gender, age, education, occupation, income over investment decisions. The hypotheses have been developed considering its relevancy to the research objectives. Investment decision making behavior has been taken as dependent variable and demographic factors (age, gender and education) are considered as independent variables. Data were classified; tabulated and tested. Statistical inferences were drawn by the use of hypothesis and Pearson's Chi-square technique.

In today’s world, the banking sector performs as the core or basis of modern business. A country’s economic improvement depends mostly on the banking structure of the country. A bank is an entity of finance. The core banking businesses that a bank carries out are receiving the money deposits and lending money and/or investing it. Nowadays the banking business plays a crucial part in human life as in the modern lifestyle of people, without having a properly developed banking network, they might not carry out proper financial transitions.
This paper deals with the banking structure in India. The present structure of banking in India which has developed over many decades is complex but detailed and it serves the requirements of credit and banking businesses of the Indian economy. The present banking structure has different layers to serve the certain and various needs of various customers. The banking structure in India plays a critical role to mobilize savings and also in the economic development of the country.

Background: The spontaneous pregnancy loss for a women can be physically and emotionally taxing. Spontaneous abortion is the term given to a miscarriage or termination of a pregnancy that takes place before the twentieth week of gestation on its own. Pregnancies that end in a natural abortion within the first trimester are the only ones that can be referred to as having a "early pregnancy loss." Pregnancies that have a prior history of spontaneous abortions ought to be regarded as high-risk pregnancies, and additional precautions ought to be taken during the ante-natal period in preparation for these outcomes. The goal of this study is to look into the outcomes of pregnancies among women who had a history of spontaneous abortions in previous pregnancies.
Methods: In the department of Obstetrics and Gynecology, Dr. D.Y. Patil Medical College, Hospital, and Research Centre in Pune, a prospective and comparative research was conducted. The sample size for the study was 400, with study group of 200 cases and control group of 200 cases.
Patients with history of spontaneous abortion in previous pregnancy, irrespective of cause and period of gestation were included in study population. For control group, patients with history of previous term delivery, irrespective of mode of delivery were included
Results: In threatened abortions, we observe that 20 (10%) patients had symptoms of threatened abortions while 13 (6.50%) patients had threatened abortions in control group. There are more number of cases of threatened abortion in previous abortion cases when compared to previous normal delivery.

Normally, the blastocyst attaches to the uterine cavity's endometrial lining. Any other location for implantation is regarded as an ectopic pregnancy (WHO). Previous uterine scar ectopic pregnancy rates are <1%. Although, due to the increasing number of caesarean sections, the rate of scar ectopic pregnancy is also rising which is a major concern since it is a life threatening risk.

A satisfactory LC-MS/MS technique was designed and validated in accordance with FDA standards for the quantification of lopinavir in plasma samples employing verapamil as IS. The designing of LC-MS/MS technique utilized a variety of commonly accessible UPLC columns and different mobile phases. Optimal separation was achieved when Waters X bridge C18 column (100 mm x 2.1 mm ID, 3.5 μm) was utilized along with mobile phase comprising of 2 mM AFB with 0.1% formic acid: ACN in the proportion of 20:80, v/v at 0.3 mL/min. ESI-MS at +ve ion mode was employed for detecting the sample. For quantitation, the MRM ratios for lopinavir (m/z 629.85 to 183.26) and verapamil (m/z 455.49 to 165.04) were employed. Verapamil and lopinavir each had retention times of 1.01 and 1.85 minutes, correspondingly. The pearson correlation (r=0.997) was used to confirm linearity for lopinavir around the concentration ranging between 2 ng/mL and 1000 ng/mL, and the total recoveries were 98.28% and 96.47% for lopinavir and verapamil, correspondingly. The presented approach also has a shorter analytic run time than earlier published methods, which is a benefit. As a result, the technique is appropriate for Lopinavir estimation.

Reducing metal corrosion has practical, financial, environmental, and aesthetic benefits. The usage of corrosion inhibitors is highly recommended. Since organic corrosion inhibitors leave behind dangerous chemicals in the environment, researchers have been seeking for non-toxic, biodegradable substitutes. Products made from plants have several advantages, including low cost, vast availability, and an endless supply of new products. They also have positive effects on the environment and are generally well-accepted by society. There has been investigation into the anticorrosive properties of phytochemicals in plants. Weight-loss methods and isotherm adsorption are used to examine the corrosion-inhibiting characteristics of Phoenix pusilla extract of leaves in 1M HCl solutions. The results showed that extracts have significantly reduced corrosion. The inhibitory effectiveness increased with increasing extract concentration. Adsorption isotherms and weight-loss study results support the existence of the adsorption mechanism (Temkin and Freundlich). The corrosion of steel is mimicked by using a plant extract in acidic circumstances. Results show that Phoenix pusilla leaf extracts have anti-corrosive capabilities and may improve surface protection by preventing active areas on metal.

The stems of the plant Caralluma indica are used to create medication. Most people concur that one of the greatest ways to prevent metal from rusting is to use natural plant extract. They are easily accessible, non-toxic, friendly to the environment, biodegradable, extremely effective, and renewable resources. The effects of the Caralluma indica stem extract on the suppression of corrosion by 1M HCl solutions are the primary subject of this research. Weight loss procedures and isotherms adsorption are used to gather the necessary data. Based on the findings, it can be concluded that the extracts produced from 1M HCl solutions were effective corrosion inhibitors. When the concentration of the extract was raised, there was a corresponding rise in the efficiency of the inhibition. An inhibiting action can be produced by the Caralluma indica extract. The successful performance of the inhibitor can be attributed to phytochemical components with functional groups found in extracts of plants that have been adsorbed on the surface of the metal. Plant extract accurately mimics the corrosion of steel in acidic conditions, as indicated by data from weight deficit studies and adsorption isotherms, which validates the adsorption mechanism. Findings suggest that Caralluma indica stem extract acts as a corrosion inhibitor and can boost surface protection by covering up metal's active sites.

Present study concentrated on the preparation of combined Mannich base with magnetic nano particle by condensation method. Various techniques were employed to confirm the formation of mannich base. The base is combined with magnetic nano particle and used to treat the phenolic effluent like o- cresol, 2-chlorophenol, 2, 6-dichlorophenol. Mannich base alone give 80.75% of removal after 4 days, when it mixed with magnetic Nanoparticle the result is remarkable it gives 94.14% removal in 1hr. 

The weight loss method discovered that the amount of corrosion that took place in mild steel (MS) at 303K could be decreased by submerging the material in a sodium chloride solution. The weight loss data were used to calculate the inhibitory effectiveness and the degradation rate. These calculations were carried out using the information. The strategy for avoiding corrosion works more effectively thanks to a higher inhibitor concentration, which may be found in an extract of the Abelmoschus esculentus plant. The pace of corrosion may be slowed down if the efficacy of the green inhibitor could be boosted. Because of the increasing concentration of the inhibitor solution, a protective layer will form on top of the MS. As a consequence of this, the reactive site on the MS will become inactive. Utilizing electrochemical methods, which would be of tremendous aid in this endeavour, may make it easier to develop a protective layer on the surface of the MS, which would be a significant step in the right direction. Scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy are two techniques that have been used to evaluate its surface, and both of these techniques have contributed to its solid reputation (FTIR). Scanning electron microscopy (SEM) was used to evaluate the surface smoothness and roughness of mild steel. The findings were compared to those obtained from a blank that included an inhibitor.

Glass ceiling has been widely used which denotes barriers which are both visible and invisible that stop any women from progressing to further top positions. In the present research paper it has been tried to identify whether glass ceiling exist in the organization and whether it prevents the female to rise higher in their respective field and whether they are happy with the current scenario.
An empirical research has been conducted to get an idea about the existence of Glass Ceiling and its effect on efficiency of women’s progression in the Organisation. The literature review has been carried out to trace the layers of glass ceiling and identify the difference ( if any ) exist between the leadership style of male and female.
It is found in this research that there exist glass ceiling in the organization and its sources traced from social norms, corporate practice, family obligation and within mind of the women. In this paper it has also been identified that there is a difference in the leadership style of male and female and it is interesting to note that respondents of this research paper have preferred female in the higher position. However, it is pertinent to note that everybody feels that glass ceiling should be removed so that organizational success can be ensured and it recommended strongly that both organization and women should take some steps to remove the glass ceiling and women should be empowered to climb the ladder of success in their respective field of work.
In the present research only few private and public sectors are covered and it is necessary that more comprehensive research can be carried out and further relationship between organization culture and existence of glass ceiling can be assessed to have proper understanding of glass ceiling and its impact on the growth of the organisation

Background: Knee injury is the second most common problem in the musculoskeletal system for which patients consult their general physician or an orthopaedician. Since its introduction to musculoskeletal imaging in the early 1990`s and then onwards, MRI has revolutionized diagnostic imaging of the knee joints.  Magnetic resonance imaging has an advantage in diagnosis of menisci, ligaments and cartilages of the knee joints along with their pathologies and injuries, particularly in the early detection of grade I and grade II lesions. The ‘knee joint’, also known as the tibio-femoral joint, is one of the largest and a complex joint of the human body, and of one of the most frequently injured joints as the bony articular surface alone is inherently unstable. Therefore, it is imperative to study internal derangements in traumatic and degenerative knees

Fifty freshly extracted human permanent mandibular single rooted premolar teeth were included. The anatomical crowns of the selected teeth were removed using a diamond disc and pulp tissue was extirpated using barb broaches. Working length was determined by subtracting 0.5mm from the length achieved with the tip of the trial file just visible at the apical foramen of each root canal in all the specimens. Biomechanical preparation was done in all the specimens in crown-down technique using ProTaper Next rotary file system. The master apical file was set to; X4 (Size 40 and 6% Taper). Specimens were randomly divided into 5 groups with 10 specimens per group. Group 1: Master Gutta-percha point coated with Bio-C sealer, Group 2: Master Activ GP point coated with Bio-C sealer. Group 3: Master Activ GP point coated with Activ GP sealer used as obturation materials with single-cone technique. Group 4 (Negative control): Root canals were not obturated. Group 5 (Positive control): Master Gutta-percha point without any root canal sealer used as obturation material. All canal orifices were sealed with restorative Glass ionomer cement. Specimens were then double coated with nail varnish, except at the apical 3mm of roots and were placed in petri dishes containing Indian ink dye for 48 hours. After removal from the dye, nail varnish was completely removed and specimens were longitudinally sectioned with a diamond disk. For each specimen, the half containing the most visible part of the entire root canal was selected and extent of linear dye penetration was measured using Stereomicroscope following Escobar’s criteria. The readings were recorded, tabulated and statistically analysed using One Way ANOVA and Tukey’s-Post hoc tests. Gutta-percha coated with Bio-C sealer used as root canal obturation material showed the maximum apical sealing ability compared to Activ GP with Bio-C sealer and Activ GP with Activ GP sealer. Activ GP with Activ GP sealer exhibited least or poor apical sealing ability.

In-vitro synergistic anti-diabetic effects of alcoholic plant extracts of Vervascum thapsus leaves (AEVT), Trigonella foenum graecum seed (AETFG), Ficus semicordata leaves (AEFS) and Cocos nucifera husk (AECNH) was evaluated. A successive solvent extraction method was used to prepare ethanolic extracts of the plant's material (first Petroleum ether followed by benzene and ethyl alcohol). Alcoholic extracts of each plant were taken for experimental purposes. First, the individual plant extracts were tested for in-vitro anti-diabetic activity using alpha-amylase by DNSA color reagent. Based on individual results, the anti-diabetic activity of combined ethanolic plant extracts were determined for synergistic effects. Alcoholic extracts were also evaluated for efficiency to prevent glucose diffusion through a dialysis membrane. The observation indicated each plant extracts possess ant-diabetic activity to varying degrees. When they were combined plant extracts produces a synergistic effect.

The main objective of this study is to offer a rapid and efficient green production of silver nanoparticles with known antibacterial properties. In the current study, a biological approach was applied at room temperature to biosynthesize silver nanoparticles from Chrysanthemum moriflorum flower extract. Aqueous floral extract from Chrysanthemum moriflorum was used to make AgNPs from silver ions fast. This process became apparent when silver nitrate solution was added to the bright yellow flower extract solution, which caused it to turn brown. The biosynthesized AgNPs were examined using transmission electron microscopy (TEM) and ultraviolet-visible (UV-Vis) spectroscopy (TEM). The UV spectra revealed AgNPs' distinctive surface plasmon resonance band at 431 nm. The generated AgNPs, a powerful broad spectrum antibacterial agent, successfully inhibited Escherichia coli and Bacillus sp. To combat the rise in antibiotic resistance, AgNPs made from environmentally acceptable ingredients like flower extract offer a potential weapon

Background: Introduction of Nickel-titanium (NiTi) alloy files in pediatric endodontics has eased the chemo mechanical preparation. The cyclic fatigue resistance of Niti files is one of the major concerns, which is influenced by various factors including irrigating solutions. So this study aimed to evaluate the effect of irrigating solutions on cyclic fatigue resistance of conventional and heat-treated nickel titanium pediatric rotary instruments.
Methods: 24 Niti rotary files of each: ProTaper Gold; Kedo SG blue and Pro AF Baby Gold were subdivided into (n=12) and immersed in : 1) 3 % NaOCl; 2) 3% NaOCl with 17%  EDTA for 10 minutes at 35°C. Cyclic fatigue resistance was assessed by determining number of cycles to fracture (NCF) in a simulated canal and surface changes using scanning electron microscope. Unpaired t-test was applied to compare each treated file with control group, and one-way ANOVA was used for comparison among main groups and Bonferroni post-hoc test for intergroup comparison.
Results: Significant difference in NCF was seen except those between the Pro tapper gold and Pro AF (P>0.05). When 17% NaOCl was used, Kedo SG blue files showed highest fracture resistance (1878.05±66.26). ProTaper Gold (3.94±0.11) showed a significant difference in fractured fragment length.
Conclusion: Exposure of NiTi files to 3% NaOCl and 17 % EDTA affects the cyclic fatigue resistance adversely. Kedo SG Blue files exhibited the best performance among the tested groups.

Aim: The devastating consequences of the COVID-19 outbreak have forced security personnel to alter their methods and behaviors. The aim of the study was to assess the knowledge, functioning and future implications  of COVID-19 on the lives of security guards.
Methodology: A cross sectional questionnaire survey was conducted among the 296 security guards of Bhubaneswar city. A 18-item, closed-ended, self-structured questionnaire was designed to gather data. The questionnaire was designed on a 2 point likert scale. Data were analysed using IBM's SPSS version 26.0 for the Social Sciences. The frequency and percentages were used to describe categorical values. Chi-Square test and ANOVA were employed. The level of significance was fixed at 0.05.
 
Results: The majority of participants were between the ages of 31 and 40 (n=132, 44.6%) and that between 13,000 and 15,000 was the average monthly income for the security guards. All the participants were aware about the COVID -19 pandemic and its affect on human body. Sixty three personnel had been detected positive for COVID-19 and none of them used any preventive measures. About 97% of the guards agreed that the pandemic had an influence on their work. Only 3% of the guards had taken on other jobs as a secondary source of income.
Conclusion: Security guards are an essential group of front-line healthcare providers offering additional services in the management of COVID-19.COVID-19 had a great impact on the economic lives of the security guards.

Background: The key predictor of the outcome of labour, as well as of perinatal illness, mortality, and maternal morbidity, is the weight of the foetus as determined by ultrasonography. The manner of delivery can be chosen by the obstetrician using an ultrasound estimate of the foetal weight at term. Aim: This study was conducted to correlate the ultrasonographic estimated fetal weight at term with actual birth weight in patients attending the medical college hospital. Materials and Methods: In collaboration with the radiology department, the study was carried out at OBG department. The time frame for this study's retrospective cross-sectional design was from February 2019 to November 2021. 300 pregnant women were selected in the study. Results:
The estimated foetal weight determined by ultrasonography and the actual birth weight correlated favourably. 88% of predicted weights were within ten percent of actual birth weight on average. Conclusion: The weight of the foetus at ultrasonography and the actual birth weight were closely correlated. Making decisions in the delivery room requires the use of this crucial tool.

Introduction: Understanding the anatomy and its variations of coronary arteries forms the base for coronary artery disease diagnosis and planning of surgeries.
Aim: The relation between outer diameter of right conus artery in cadaveric hearts and coronary angiograms, the relation between the diameter of right conus artery with and without the presence of long branches in both cadaveric hearts and coronary angiograms.
Materials and Methods :
150 embalmed cadaveric hearts received from various south Indian states, which were preserved in various colleges of Tamilnadu and Pondicherry was used in this study. 150 coronary angiograms of patients from various south Indian states. Methods adopted was Dissection method and Coronary angiogram were utilized for the study . 
RESULTS: Out of 150 cadaveric heart  and 150 coronary angiogram , the outer diameter of right conus artery arising from right coronary artery in cadaver and in angiograms was compared the resulted p value is less than 0.0001 which is considered to be extremely statistically significant. The number of long branches and short branches are studied with regard to the diameter of right conus artery. Pearson’s correlation coefficient was 0.1716 which is positive.
CONCLUSION: The diameter of right conus artery in the cadaveric study differs with the angiographic study. Thediameter of right conus artery is more when having a long branch

Background: Prediabetes is a disorder of glucose homeostasis characterized by impaired glucose tolerance or impaired fasting glucose. Prediabetes is associated with structural RA and RV changes, and impaired RV systolic and diastolic function, independent of cardiovascular risk factors. Prediabetics are at increased risk of developing type 2 DM. Present study was aimed to assess cardiovascular morbidities in prediabetic individuals.
Material & Method: This hospital based analytical comparative study was conducted among the individuals attending the medicine OPD of Aarupadai Veedu Medical College & Hospital aged more than 18 yrs with impaired fasting glucose and healthy controls. Comparison between Venous Blood Glucose Levels(Fasting, Impaired Glucose Tolerance) and changes in Electrocardiography, Echocardiography were done.Patients with pre-diagnosed cardiac disease, pancreatic disease, chronic kidney disease, thyroid disorders, dyslipidaemia, obese persons and pregnant women were excluded from the study. All the collected data were analysed using SPSS v21 operating on windows 10, with p<0.05 considered statistically significant.
Results: Total 252 participants included among them assessment of the cardiovascular morbidities were done, There were significant higher incidence of ECG and 2D ECHO changes among prediabetic compared to the controls. The ECG  and 2D ECHO abnormal findings were seen in 71.5% among the prediabetic cases and zero % in controls.(p<0.05). Mean weight of cases was significantly higher than  controls, BMI was significantly higher in cases compared to controls. (p<0.05)
Conclusion: Present study concludes that there is higher incidence of cardiovascular morbidities among the Prediabetes individuals compared with normoglycemic healthy individuals.

Individuals who are at risk of CVD( cardio vascular disease) may also have comorbidities like elevated blood pressure, glucose levels, dyslipidemia, obesity etc. Identifying those high risk individuals helps in prevention of premature deaths. So there might be an association between elevated blood glucose levels and overall mortality rate in MI (Myocardial Infarction ) patients. So the present study is undertaken to estimate the severity of myocardial infraction with estimated average blood glucose levels. This is an observational study done on 50 patients divided into 2 groups, group 1-patients having diabetes, group2- patients without diabetes of age >18 years who admitted in VMMC, Karaikal coastal area hospital with complaints of STEMI, NSTEMI and unstable angina for a duration of 18 months from July 2021 to December 2022. After admission, detailed history, blood sugar levels, ECG,2D-Echo, were estimated in the patients and it is correlated with the severity of the patient by comparing with GRACE 2.0 scoring. We observed that there is significant relation of GRBS,FBS,PPBS,HBA1C levels between study group and control group with MI. eAG (estimated average glucose )of patients with diabetes to non-diabetic patients it shows that the severity of myocardial infraction is more in diabetics compared to non-diabetics eAG to risk and grace 2.0 scoring in general is statistically insignificant. So further studies are needed to be done prove its association.

Tuberculosis (TB) is one of the major public health problems in Pakistan. Our country ranks fifth in tuberculosis high, burden countries worldwide. Hyponatremia is considered as one of the most common and important electrolyte abnormality in Pulmonary TB (P TB) patients. This study will show the prevalence of hyponatremia in PTB in our population. This study was planned to determine the presence of hyponatremia in pulmonary tuberculosis among adults and to correlate its severity.

Siddha system of medicine is well known for its contributions towards skin diseases through its ancient texts. Veppampattai thylam is one among the external medication which has been   indicated for the treatment of chronic skin conditions like eczema, dermatitis, psoriasis, scabies etc. It is a herbal formulation containing Melia azadirachta bark (Veppampattai), Hemidesmus indicus root (Nannari ver), Rubia cordifolia root (Manjitti ver), Eletaria cardomom seeds (Elarisi). This herbal oil is being prescribed by Siddha physicians as it reduces the itching, burning sensations, skin lesions and inflammations that are common symptoms of the skin diseases. This paper deals with the scientific analysis on the pharmacological properties of these ingredients towards the treatment of chronic Skin diseases.

Dimethyl sulphide, more often known as DMS, acts as a corrosion inhibitor when applied to 0.5N mild steel. This property of DMS allows it to be used in this context. The mass loss method at room temperature is utilized as the major testing approach for analyzing hydrochloric acid. This technique is used to determine the concentration of the acid. The effectiveness of an inhibitor in preventing corrosion is proportional to the amount of that inhibitor present in the system. The corrosion pace may be slowed by raising the inhibitor's concentration in the system. Raising the concentration of the inhibitor solution on the surface of the mild steel makes it possible to prevent the creation of a protective layer on the surface of the mild steel, which would otherwise obstruct the active site. Electrochemical tests on mild steel, such as AC impedance and polarisation, have been performed to determine whether or not a protective coating has developed on the material. These tests aim to determine whether or not a coating has formed. Researchers working in the field of electrochemistry have found that using Fourier transform infrared spectroscopy has been beneficial to their work (FTIR). In order to conduct our studies on polished, corroded, and inhibitor-treated mild steel surfaces, a scanning electron microscope and an energy dispersive x-ray analyzer were used (EDAX). The surface's roughness and smoothness can be seen in the AFM micrographs.

The rise in multi-drug resistant Gram-negative bacteria during the past few years has posed a serious danger to public health care. Our understanding of how antibiotic resistance mechanisms emerge and spread across bacterial strains has been enhanced by recent advanced molecular techniques. The resistant pathogens use a variety of resistance mechanisms, including cell membrane porosity changes, antibacterial target modification, and destruction of antibacterial agents. This section will discuss and explain the molecular characterisation of carbapenem resistance as well as their detection techniques. Understanding these mechanisms can be crucial for the development of novel antimicrobial drugs as well as for specific treatment considerations about the usage of antibiotics other than carbapenem and beta-lactams. Although the majority may be carried out quickly with a molecular device, molecular approaches are presently used for identifying carbapenem-resistant species. Whole-genome sequencing delivers clear idea on the comprehensive evaluation of whole genome and has the potential to develop into a very potent tool in regular clinical settings. The cost of genome sequencing is still high, and an automated system for data processing is needed. It might take a while before this method is routinely used in medical laboratories, especially in underdeveloped nations. To create innovative antibacterial medicines that can enhance pathogen prognosis, it can be crucial to comprehend these processes and the importance of the formation of carbapenem resistance strains.

Psychology is a scientific study of the human mind and its functions. In the present 21^st century this area has gained more momentum. Maybe due to nuclear families and single child parents who are chasing for dual income   and are not able to concentrate on their own child. Child Psychology study is becoming a more prominent study in younger ages. There are many factors that contribute to the cognitive development of children, adolescents, and young adults. These factors can be categorized into three main topics: environmental factors and how it changes the neurological system, risks of social behavior due to the different mental states, and hormonal changes adding to psychological imbalance.

Background-One of the frequently occurring reasons of nasal obstruction is a deviated nasal septum(DNS). Numerous methods have been used to correct a deviated nasal septum, with septoplasty being the most frequent. Endoscopes have been attempted in septoplasty in order to improve visualisation of the posterior region of the septum and perform the surgery more precisely and with less complication as compared to conventional approach. The study's goals were to compare the post operative relief from nasal obstruction in endoscopic septoplasty and conventional septoplasty.
Method-A total sample of 60 patients were taken. Detailed history of all these patients were taken and they were subjected to general physical examination and ENT examination. All routine investigations were done and fitness was obtained prior to surgery. All the patients were randomized into Group 1 and Group 2. Group 1 underwent Endoscopic Septoplasty. Group 2 underwent Conventional Septoplasty. Post operatively patients were followed up.
Results- In group 1, 29(96.67% )patients got relief from nasal obstruction and 1(3.33%) patient had residual nasal obstruction .In group 2, we see that 22(73.33%) of patients got relief from nasal obstruction and 8(26.67%) patients had residual nasal obstruction.The odds ratio came as 10.5455 and the study is statistically significant.
Conclusion- Postoperative relief from nasal obstruction is much better with endoscopic septoplasty than conventional septoplasty, since the endoscopic septoplasty gives much better illumination and magnification which helps in correcting the deformity with more precision

In the western region of the state of West Bengal, it is difficult to diagnose enteric fever using blood cultures or even the Widal test. The best method to make a diagnosis and start treatment is with a high index of suspicion. In this setting, research into potential haematological alterations associated with enteric fever may offer the physician a critical clue for the early initiation of treatment and prevent further complications.
Aims: The goal of this study was to examine the haematological profile of children with Widal-positive enteric fever.
Method: A hospital-based cross-sectional study was carried out at Bankura Sammilani Medical College and Hospital (BSMCH) from March 1, 2020, to August 31, 2021. The study population consisted of 120 children, aged 1 to 12 years, who were admitted to the children's ward with Widal positive enteric fever. A pre-designed questionnaire was used to collect the relevant information. The data was entered into a Microsoft Excel spreadsheet and analyzed with Epi Info (version 3.5.1) Software.
 Results: Anaemia (80%) was the most prominent haematological result in the current study. Raised ESR (65%), thrombocytopenia (28.33%), eosinopenia (23.33%), leucopenia (22.50%), erythropenia (20%), relative lymphocytosis (21.67%), neutropenia (17.5%), eosinophilia (5.83%), and leucocytosis (5.83%) were found in decreasing order. Leucocyte, platelet, haemoglobin, and ESR changes were all statistically significant (P-value = 0.000*). Changes in PCV, MCV, and MCH, with the exception of MCHC, were found to be statistically significant (P-value = 0.000*).
Conclusion: In the case of a 7-day fever with clinical features like anorexia, vomiting, diarrhoea, constipation, abdominal pain, a coated tongue, hepatomegaly, and headache, in addition to the aforementioned haematological changes, it may help the physician to initiate management of enteric fever without performing a serological test and testing for organism isolation via blood culture, which is not possible in remote areas

Tibial fractures, consist of approximately 15% of all adult fractures are frequently caused by direct or indirect traumas due to less of cutaneous and subcutaneous tis sues which are anterior of tibial shaft. Epidemiologic studies show that compound fractures are 23.5% of all tibial shaft fractures. In treatment of compound tibial fractures, rate of encountering complications like infection, delayed union, or nonunion is high because of weak perfusion and high density of cortical bone material [1–4]. Especially Gustillo-Anderson type 3 open tibial fractures are caused by high energy traumas and are frequently accompanied by serious complications like amputation, infection, nonunion, malunion, and soft tissue losses. Use of new generation antibiotics, adequate irrigation and debridement, and new methods on fixation techniques has reduced these complications.

Introduction:  Pathologists have always been an integral part of the healthcare system striving to deliver quality care to patients. However, the speciality has mostly become invisible, with only certain clinical specialities receiving attention from the public population. Objectives:  To analyse the public perception of Pathology and Pathologists among the general population. Material and Methods: In our survey with 150 respondents, the questionnaire used was developed and approved by Manitoba Research Ethics Board, USA. We used Pearson’s chi square test to evaluate the association between correct responses and if respondent had undergone the procedure. Two-sided p values < 0.05 were considered statistically significant. Results: Pathology was identified as a medical speciality by only 4.7%. Only 9.3% of the particiapants recognised that it would take more than 8 years to become a Pathologist. The most commonly undertaken test with the identified specialists were Pap test (gynaecologist), breast biopsies or surgical excisions (surgeons / oncosurgeons), blood tests (medical laboratory technicians). For the participants who underwent pap test/biopsy p value and chi-square test were applied, which was statistically significant [< 0.05]. Conclusion: Implementing pathologist-patient interaction would definitely help patients understand their disease, help them make more informed decisions, and also provide an opportunity to change our image as a speciality

Background: Narcotics when used for postoperative analgesia may release histamine and cause bronchospasm in asthmatic patients. The present study was conducted to compare ketamine and tramadol for postoperative analgesia in asthmatics.
Materials & Methods: 60 asthmatic patients of both genders were divided into 2 groups of 30 each. Group I received ketamine-midazolam infusion preceded by a bolus of ketamine 0.5 mg-kg-' IV. Group II received a bolus dose of tramadol (2 mg/kg) followed by an intravenous infusion (0.2 mg · kg⁻¹· h⁻¹) postoperatively. Parameters such as Forced vital capacity in 1 s (FEV₁), respiratory rate, pain score in minutes and sedation score was compared.
Results: Group I had 16 males and 14 females and group II had 12 males and 18 females. There was significant difference in respiratory rate and non- significant difference in forced vital capacity in 1 s (%) and pain score in minute in both groups. The mean sedation score at baseline was 3.2 in group I and 5.2 in group II, at 1 hour was 2.5 in group I and 4.7 in group II, at 2 hours was 2.3 in group I and 3.4 in group III and 1.7 in group I and 2.8 in group II. The difference was significant (P< 0.05).
Conclusion: Both Ketamine and tramadol infusion can provide a safe alternative to the usual parenteral narcotic therapy in asthmatics in terms of analgesia

Blindness brought on by an intact anterior visual pathway but due to bilateral occipital lobe involvement is known as cortical blindness. Compared to partial blindness, it is less frequent. The posterior reversible encephalopathy disease has a well-documented history of reversible cortical visual blindness (PRES). The neurological condition PRES is characterised by reversible subcortical vasogenic brain oedema and sudden onset neurological symptoms. This illness can be reversed with prompt diagnosis and treatment. It frequently occurs in conjunction with disorders like eclampsia, cancer, kidney disease, hypertension, and hypertension. This case involves a male teenager who was infected with COVID and later developed PRES. The presence of Anton's blindness complicated PRES. Utilizing radiological investigation, an early diagnosis was obtained, and once therapy was started, all symptoms disappeared.

Aim: The objective of the present study was to assess the role of 3D constructive interference in steady state (CISS) MR imaging sequence of evaluation of cranial nerve lesions in comparison with other MR imaging sequences.
Methods: The present study was conducted at Dr. D Y Patil Medical College and Hospital, Pimpri, Pune, Maharashtra from September 2020 to August 2023 and 70 patients were included in the study. Approval of institutional ethics committee was acquired before the initiation of the study.
Results: Most of the patients we encountered were within the age group of 31-60 years wherein there were 36 patients. Less than 30 years were 16 patients and more than 60 years were 18 cases. In the parameter lesion picked up CISS picked up in 20 cases, MPRAGE in 24 cases and T2, T1 in 0 cases. MPRAGE having a 100% pick up rate and CISS having 83%. In the parameter lesion picked up CISS picked up in 46 cases, MPRAGE in 40 cases, T2 in 34 and T1 in 34 cases. CISS had the best pick up rate with 100%. Overall, when we compare the MR sequences combining both the etiologies CISS was better in picking up the lesion, in assessing the signal intensity changes, in knowing the encasement of nerve and change in course of nerve. Only MPRAGE was better than CISS in identifying the enhancement characteristics of the nerve.
Conclusion: The CISS sequence is extraordinarily beneficial for assessing cranial nerve disorders. CISS sequencing revealed lesions in 83.3% of patients with an inflammatory etiology and 100% of those with a non-inflammatory cause. MPRAGE has detected lesions in 100 percent of instances with an inflammatory origin and in 87 percent of cases with an inflammatory aetiology. CISS sequence demonstrates neurovascular conflict with a 100 percent sensitivity rate. T2W and T1W sequences lack inflammatory etiologies and neurovascular conflict.

Uterine leiomyomas (fibroids or myomas), benign tumors of the human uterus, are the single most common indication for hysterectomy. They are clinically apparent in up to 25% of women and cause significant morbidity, including prolonged or heavy menstrual bleeding, pelvic pressure or pain, and, in rare cases, reproductive dysfunction. Thus, both the economic cost and the effect on the quality of life are substantial. Surgery has been the mainstay of fibroid treatment. This case presents a 51year old, asymptomatic big fibroid diagnosed incidentally on clinical examination and imaging, which was managed timely and the patient recovered because of thorough clinical examination even in asymptomatic patients.

Serotonin syndrome is a potentially fatal condition in which there is an increased serotonergic activity due to excessive ingestion of serotonergic drugs, an excess dose of serotonin reuptake inhibitors, drug-drug interactions etc. and is characterized by abnormal mental status, autonomic and neuromuscular dysfunction.  We report a case of a 47-year-old female, with no known comorbidities who presented to the emergency room of a tertiary care centre with a history of intentional self-consumption of serotonergic drug with delirium. She was febrile and hypoxic. Her chest radiograph and CT-Thorax revealed changes suggestive of Acute Respiratory Distress Syndrome (ARDS), an uncommon presentation, as a part of serotonin syndrome. Her cardiac function was normal and pulmonary infection was ruled out. Her clinical characteristics were suggestive of serotonin syndrome and pulmonary involvement was attributed to escitalopram overdose. The patient was admitted to the intensive care unit and given high-flow oxygen therapy and supportive care. She gradually showed complete recovery.

• CCAM (congenital cystic adenomatoid malformation) is a rare pulmonary developmental hamartomatous defect that involves one or more lobes of the lung and is made up of pulmonary tissue with aberrant bronchial growth. This is a case report of a newborn who underwent surgical excision of CCAM at the age of 20 days. The neonate had CCAM TYPE 1 in the right lower lobe but no cardiac involvement. The surgical procedure called for mild supported manual ventilation until the thorax was opened, then regulated ventilation with judicious fluid management, intra-operative care of hypercarbia and hypoxia, and meticulous post-operative surveillance. With satisfactory respiratory function, surgical excision of the cyst and lobe was successful.
Introduction
• CCAM (congenital cystic adenomatoid malformation) is a lung developmental hamartomatous condition characterised by aberrant bronchial proliferation. Adenomatoid proliferation of bronchioles that forms cysts at the expense of normal alveoli is the most common pathogenic characteristic, which is characterised by hyperinflation and progressive air trapping (1,2) It is frequently unilateral, with varying size and growth, resulting in a variety of clinical presentations ranging from intrauterine foetal death due to hydrops to childhood discovery due to recurrent lung infections. (3). In live births, the incidence ranges from 1 in 70,000 to 1 in 90,000. (4). The successful anaesthetic care of a 20-day-old newborn, as well as the management of intraoperative hypercarbia and hypoxia, are discussed in this case report.

Introduction: To assess the effect of education level and previous anaesthesia exposure on knowledge of anaesthesia and role of anaesthesiologist
Method: 112 patients above the age of 18 years undergoing any elective surgery were enrolled in the study. They were asked to fill out a questionnaire containing questions related to anaesthesia, anaesthesiologists and their concerns and perceptions about risks related to anaesthesia. Each question had multiple choices. The patients were divided into two groups of 56 each i.e. Group A consisted of patients with previous anaesthesia exposure and Group B consisted of patients without previous anaesthesia exposure and data was compared.
Results: Out of all patients who had only a secondary school education or lower, only 38% had knowledge about anaesthesia and were able to correctly answer questions about role of anaesthesiologist and why preanaesthesiacheckup was necessary, whereas 62%  did not know importance of preanaestheticcheckup and role of anaesthesiologist. In patients who had graduate or post graduate level of education, 60% were able to correctly answer questions regarding importance of preanaestheticcheckup and role of anaesthesiologist, whereas 40% answered incorrectly.Of all patients in Group A (Previous anaesthesia exposure), 71% of patients were able to correctly answer questions relating to importance of Preanaestheticcheckup and role of anaesthesiologist, whereas 29% answered incorrectly.In Group B (No previous anaesthesia exposure), only 20% were able to correctly answer questions relating to importance of preanaestheticcheckup and role of anaesthesiologist, whereas 80% answered incorrectly.
Conclusion: It can be concluded that patients who had a higher level of education and/or had previous anaesthesia exposure were more aware of the importance of preanaestheticcheckup and role of anaesthesiologist.

Ellis Van Creveld syndrome (EVC) is a rare genetic disorder with autosomal recessive inheritance, seen more amongst the Amish population of Pennsylvania in USA with an incidence of 1:2,44,000.” Six fingered dwarfisms” was another name given to this syndrome. This syndrome presents with four clinical characteristic features of ectodermal dysplasia, congenital heart disease, bilateral postaxial polydactyly and nail or teeth hypoplasia. A typical case of a 13-month-old child is present in this article

BACKGROUND: There are various causes of exudative Pleural effusion, rather than assumption of a diagnosis by clinical suspicion, proper diagnosis is needed in guiding specific targeted treatment. Exudative pleural effusions necessitate thorough investigation and specialized diagnostic methods. The main objective of this study is to determine the aetiologies of exudative pleural effusion, and to assess clinical profile along with radiological and microbiological profiling in current scenario in Western Maharashtra.
MATERIALS AND METHODS: A prospective, observational and cross-sectional study was done on 114 patients of exudative pleural effusion in a tertiary care centre. Patients above 10 years of age with biochemical evidence of exudative effusion were only included in the study. Biochemical, cytological and microbiological tests were done on their pleural fluid and their clinical profile was noted. In selected cases, Patients underwent pleural biopsy, Video Bronchoscopy and Image guided Lung Biopsy.
RESULTS: In young population, females were more affected (57%) whereas in middle age and in elderly population, males were more affected. Dyspnoea was the most common symptom. Radiological profiling showed majority had moderate effusion and preferably right sided effusion and >50% effusion were loculated. 70.2 % were of tubercular aetiology, 14 % were of malignant effusion, 10.5 % were of Para pneumonic effusion and 5.3 % were effusion secondary to pancreatitis. Estimation of pleural fluid adenosine deaminase plays an important role in the diagnosis of tubercular effusion. Fluid cytology and closed pleural biopsy helped in diagnosis of malignant effusion.
CONCLUSION: Tuberculosis is still the commonest causes of exudative effusions in western Maharashtra after which there is Para pneumonic effusions and malignant effusion. All patients should undergo ultrasonography of thorax to see for loculated pleural effusion. Though Pleural fluid ADA levels are highly sensitive with specificity for the diagnosis, along with that Pleural biopsy, Pleural fluid cytology and Image guided lung biopsy are necessary in indicated cases to correlate with the diagnosis. In case of workup of undiagnosed exudative effusion, Bronchoscopy and CT Pulmonary Angiogram (CTPA) proved to be an important investigation in arriving to a conclusion.

A female in her early thirties, non-smoker, with no known comorbidities, presented to the emergency room with multiple episodes of hemoptysis and exertional dyspnea for a week. She had no history of hemoptysis or any known lung disease in the past. Chest X-Ray revealed relatively small right lung with mediastinal shift to the right. CT angiography revealed right-sided absence of pulmonary artery with collateral supply (systemic to pulmonary shunt) from hypertrophied bronchial, internal mammary and intercostal arteries. She was successfully managed with therapeutic selective embolization of bronchial arteries to control the hemoptysis.

Granulomatosis with polyangiitis is a small vessel vasculitis and ANCA related.30-year female presented with complaints of rhinorrhea for 4 months. Xray chest showed doubtful Right midzone opacity. Coagulation profile and hemogram was unremarkable with raised ESR and Proteinuria on urine analysis. Sputum studies for PTB was negative. HRCT thorax showed solitary soft tissue mass lesion in Right lower lobe with spiculated margins suggestive of neoplasm. Biopsy of Lung mass was suggestive of tissue was consistent with granulomatosis with polyangiitis and C – ANCA was positive. She developed ear, eye symptoms with skin rashes later. Diagnosis of Granulomatosis with polyangiitis with sinusitis, mastoiditis, scleritis, vasculitic skin rash, kidney proteinuria was made and treated with Prednisolone, Azathioprine, Mycophenolate Mofetil following which patient improved and is on follow up.

A cardiac calcified amorphous tumour (CAT) is an extremely rare nonneoplastic tumour affecting heart chambers and valves. It may mimic other cardiac tumours and can present with systemic embolization. There are very few cases reported regarding CAT in the literature due to its erratic presentation. Here we report a case of a 32-year-old male with a cardiac CAT, who presented with exertional dyspnoea and pulmonary Embolism. After 2 D-ECHO and colour Doppler revealing normal valvular function, a pre-operative clinical diagnosis of right atrial myxoma. Cardiopulmonary bypass was done, mass was completely resected and on histopathological examination diagnosis of the calcified amorphous tumour was done. A pulmonary thrombo-embolectomy was done. Postoperative and follow-up care lead to full recovery of the patient

AIM:  To find a relationship between the results of 6-minute walk test and DLCO in patients with radiologically confirmed DLPD
MATERIALS & METHODS: A prospective observational study was conducted from October 2020 – October 2022 who presented to the department of Respiratory Medicine. A total of 41 patients who presented with chronic dyspnoea and who were clinically and radiologically suggestive of DPLD were included in the study. All of them underwent the 6-minute walk test and DLCO which were later compared.
RESULTS:  There was significant correlation between 6MWD and DLCO but there was no correlation between desaturation and DLCO statistically but found clinically significant desaturation among 37 patients out of 41 patients who underwent 6MWT. We also compared age, sex , history of smoking, patients who had taken treatment and patients who had not received any treatments, could not find any correlations statistically in 6MWD,desaturation and DLCO.

Eosinophilic granulomatosis with polyangiitis (EGPA) previously known as Churg-strauss syndrome is a multisystem disorder most commonly involving the lungs. It is a form of vasculitis that targets small to medium-sized blood vessels. It is a necrotizing granulomatous inflammation that is eosinophil-rich and frequently affects the respiratory system. It is also associated with difficult-to-treat asthma and eosinophilia. We describe a case of a 49-year-old man with documented severe asthma who presented with proximal myopathy and asthma exacerbation. Blood investigations showed that he had eosinophilia. Mononeuritis multiplex was confirmed by NCV (Nerve conduction velocity). Transbronchial lung biopsy and nerve biopsy proved vasculitis with eosinophils confirming the diagnosis of EGPA.This case highlights the diagnostic challenges with the manifestations of EGPA in a case of difficult-to-treat asthma.

To study anaemia in newly diagnosed breast and gynaecological malignancies in pre and post menopausal females.
Material and methods: We conducted a prospective, cross sectional and observational study of anaemia in newly diagnosed breast and gynaecological malignancies in pre and post menopausal females. Association between categorical variables was calculated using Chi Square or Fischer Exact test. Association between continuous variables was calculated using Student T test.
Results: Among 55 female patients taken up for the study, 24 were premenopausal and 31 had reached menopause. The prevalence of anaemia in breast (51.6%) and gynaecological (45.1%) malignancies were significantly higher in postmenopausal females. Bleeding was most commonly found in gynaecological malignancy females, while it was significantly absent in breast carcinoma females. Microcytic anaemia (Iron deficiency or blood loss) was the commonest type in the study subjects (50.9%) followed by normocytic (Anaemia of chronic disease) anaemia (23.6%).
Conclusion: 31 among 55 female patients taken up for the study had reached menopause. The prevalence of anaemia in breast and gynaecological malignancies were significantly higher in postmenopausal females and bleeding was most commonly found in gynaecological malignancy. Microcytic anaemia was the commonest type in the study subjects followed by normocytic anaemia

Anaesthesia for geriatric patients who are morbidly obese is quite challenging. Understanding anaesthetic care for such patients can be related to the description of fundamental alterations in physiology and changes in the pharmacokinetics and pharmacodynamics of anaesthetic medications. With advances in cardiology and cardiothoracic surgery, several newer implantable cardiac devices have become common in the surgical population. Cardiac pacemakers are generally required in patients with symptomatic bradycardia or severe conduction block. Many of the newer implantable cardiac electronic devices are targeted at managing heart failure. While managing such patients for non-cardiac surgeries, specific issues related to equipment characteristics and troubleshooting should be a priority for anaesthesiologists. There is a possibility of malfunction of the devices resulting in catastrophic outcomes. Intraoperative care of the pacemaker and understanding its anaesthetic implication is crucial in managing these high-risk patients. We present the anaesthetic management of a case of an elderly morbidly obese male patient, posted for inter-scapular non-healing ulcer debridement having a permanent pacemaker in situ in DDDR (dual-chamber rate-modulated) mode. The pacemaker was changed and inserted previously for complete atrioventricular (AV) block on electrocardiogram (ECG) and degenerative AV conduction disease with complete symptomatic AV (atrioventricular) block, on electrophysiology study. The pacemaker mode changed to asynchronous ventricular pacing mode preoperatively. Erector spinae block with field block was given. The patient tolerated the surgical procedure well, and vital parameters were maintained throughout the operation. After the operation, the patient was shifted to the intensive care unit (ICU), the pacemaker was reprogrammed to DDDR mode, and vigilant monitoring was done. Postoperatively patient developed iatrogenic pneumothorax which was managed successfully by the pulmonology team. The patient was then transferred to the ward on postoperative day 3 in stable condition. This case highlights that a good erector spinae plane block + field block along with vigilant monitoring and team effort is a reasonable choice for elderly obese patients with permanent pacemakers coming for elective surgeries

Neurofibromas are slow growing, benign tumours of peripheral nerve tissue seen frequently in association with neurofibromatosis type 1. Although the third decade of life is when presentations are at their peak, cases have been documented in people as young as 10 months to as old as age of 70. The true nature of the disease is often revealed by histopathological evaluation. The isolated occurrence of neurofibroma in maxillary sinus is rare with less than 10 cases reported in literature. Here, we report a rare case of solitary neurofibroma of left maxillary sinus without generalised syndrome of neurofibromatosis in a 27-year-old female patient.

Study title:  A retrospective study on impact of covid pandemic on vitamin D levels in children aged 6 months to 12 yearsin post covid era
Aims: To determine the severity of deficiency and the presenting features
Introduction: Vitamin D insufficiency affects almost 50% of the population worldwide. An estimated 1 billion people worldwide, across all ethnicities and age groups, have a vitamin D deficiency (VDD). This pandemic of hypovitaminosis D can mainly be attributed to lifestyle and environmental factors that reduce exposure to sunlight, which is required for ultraviolet-B (UVB)-induced vitamin D production in the skin. The high prevalence of vitamin D insufficiency is a particularly important public health issue because hypovitaminosis D is an independent risk factor for total mortality in the general population. Many health care providers have increased their recommendations for vitamin D supplementation to at least 1000 IU.
 
Methodology: this study was done over a span of 10 months from September 2021 to July 2022
This was a retrospective descriptive study in which data were recorded for all patients aged from 6 months to 12 years of age with features suggestive of vitamin D deficiency seen in Dr DY Patil Medical College and Hospital, Pune for a period of 10 months
The Health Research and ethics committee of Dr DY Patil Medical College and Hospital, Pune approved the study and waived the requirement for the informed consent. A total of 69 patients were included in this study.
Results: 69 patients were included in the study out of which 39 were males { 56.52%} and 30 were females { 43.48%} . the main presenting feature was bowing of legs { 31.9%} followed by difficulty in walking in 15.9%
Out of 69 children 53 had severe deficiency, 13 had mild to moderate deficiency and 3 had optimum levels of vitamin D.
28 children belonged to the age group of 1-5 years followed by 18 children in age group of 5-10 years and 11 children in age group less than 1 year and 10-15 years
Out of the entire study group 56 children had bony deformities and 13 had neurodevelopmental presentation
Conclusion:  the above results emphasise the fact that due to covid most of the children were restricted to stay indoors for several months leading to vitamin D deficiency in them. it also emphasis the fact that regular screening of children should be done with respect to vitamin D levels and also other micronutrients and children should be encouraged to have some amount of sun exposure to get natural supplementation of vitamin D and also be supplemented at desired intervals so that they adequate amount of vitamin D levels.

Diabetes mellitus is one of the most common health problems facing health care professionals. Chronic hyperglycemia is commonly associated with long term dysfunction of various organs including the nervous system. As the duration of diabetes increase, diabetic patients develops various microvascular (like neuropathy, nephropathy and retinopathy)complications.Therefore this study was intended to determine the nerve conduction velocity (NCV) of male diabetic offspring in Eastern Uttar Pradesh.
MATERIAL AND METHODS: This study was conducted in the Department of Physiology, MahamayaRajkiya Allopathic Medical College Ambedkar Nagar,Uttar Pradesh. Median nerve is one of the major peripheral nerve was selected for NCV. NCV of all the subjects were done by NeuropackX1(Nihon Kohden).
RESULT:The median motor nerve conduction velocity (59.52 ± 2.98) and sensory nerve conduction velocity (56.58 ± 2.73) of diabetic offspring was insignificantly (p>0.05) decreased as compared to the median motor nerve conduction velocity (59.66 ± 3.24) and sensory nerve conduction velocity (56. 84 ± 2.79) of non-diabetic offspring.In addition,The median motor nerve conduction velocity (62.31 ± 2.23) and sensory nerve conduction velocity (54.77 ± 2.70) of diabetic male offspring was insignificantly (p>0.05) decreased as compared to the median motor nerve conduction velocity (63.72 ± 1.24) and sensory nerve conduction velocity (54. 81± 2.65) of non-diabetic male offspring.Furthermore,The median motor nerve conduction velocity (62.01 ± 2.23) and sensory nerve conduction velocity (55.19 ± 2.70) of diabetic female offspring was insignificant (p>0.05) decreased as compared to the median motor nerve conduction velocity (63.3 ± 1.24) and sensory nerve conduction velocity (54. 4± 2.60) of non-diabetic female offspring.
CONCLUSION: In our study there is no significant difference in median motor and sensory nerve conduction velocity in diabetic offspring. Unlike observation of altered metabolic factor and high blood sugar in similar population by other study

Appendicitis is a most common surgical condition encountered by the most of the surgeons all over the world.  laparoscopic appendicectomy is the preferred surgical procedure in emergency and elective appendicitis cases now a days.
Aim: The aim of the study is to show the advantages of laparoscopic appendicectomy over conventional open appendicectomy
Materials and methods: This was a prospective study that was carried out from june 2021  to  may 2022 in Belagavi Institute Of Medical Sciences Belgavi IN District Hospital Belgavi. A total of 100 patients were studied, Cases were randomly selected for laparoscopic and open appendicectomy after routine blood investigations, ultrasonography of the abdomen and pelvis, chest x ray, ecg. and the results obtained were tabulated. The statistics were analyzed using SPSS package 16.0. Ethical clearance was obtained from the institutional ethics committee.
Results: Most of patients operated laparoscopically had short hospital stay, less pain and early recovery Wound infection was seen commonly in open surgeries 

Paediatric liver lesions are frequently encountered in clinical practice and CECT plays an important role in diagnosis. Proper knowledge of various conditions and imaging features helps in narrowing the differential diagnosis and helps to differentiate benign from malignant liver lesions thus reducing the need of biopsies and helps in proper management of patients

The term Infectious Spondylodiscitis involves infection of the vertebra and infection of the intervertebral disc, or both. Any delay in its diagnosis or management may cause serious long-term morbidity and mortality. In this study, we report the experiences in our Institution in the management of severe and complicated cases of infectious spondylodiscitis. Materials and methods: Over the period of 2 years from 2020- 2022 (covid-19) 40 patients were operated in our medical college the management was tailored according to the clinical condition based on VAS, ODI, radiological studies and lab results of each case; and patients were then prospectively followed-up for 2 years. Results: The goals of treatment for spondylodiscitis is to relieve pain, restore pain free mobilization of the patient and to eliminate infection. Magnetic resonance imaging (MRI) was considered the main choice of investigating tool other assessments were done by ODI, VAS, Neurologic deficits was assessed by Modified McCormick scale, sepsis, an intraspinal empyema, the failure of conservative treatment, and spinal instability are all indications for surgical treatment. Conclusion: The quality of life of patients who have been appropriately treated for infectious spondylodiscitis has been found to be highly satisfactory in general. The risk of recurrence increases in the presence of accompanying illnesses such as diabetes mellitus, renal failure, which were managed by immediate debridement and results were good which was assessed according to above mentioned post-op ODI and VAS.

SBP is still a serious complication with a dismal outlook. The prognosis of patients with decompensated cirrhosis and SBP remains dismal, with a death rate of 21-41%, despite the introduction of new preventive strategies such as early detection and treatment with albumin and new antibiotics. The incidence of spontaneous bacterial peritonitis lowers the survival rate to 31% after one year. To enhance prognosis in this situation, it is crucial to identify patients who are at a higher risk of passing away.

Diabetes mellitus is a disease that occurs due to the partial or complete dysfunctioning of the pancreas, thereby reducing the amount of insulin secretion in the body. Type II diabetes mellitus is commonly seen in the middle age group individuals, and can lead to a variety of systemic consequences involving multiple systems. One of the known complications of diabetes mellitus is hearing loss and tinnitus. The degenerative process, owing to type II diabetes mellitus affects the microvasculature of the hearing apparatus, the cochlea and the cochlear nerve

A schwannoma, also known as neurilemmoma is a tumor of the nerve sheath, occurring in myelinated nerve cells. They arise from the Schwann cells of the peripheral nervous system and are almost always benign. Schwannomas constitute 25-45% of tumors of the head and neck. About 4% of head and neck schwannomas present as a sinonasal schwannoma.^[1] Schwannomas almost always occur as solitary lesions.^[2]  A case of schwannomas arising from the membranous part of the nasal septum presenting as a cystic swelling is reported

Background: It is a fact that the ongoing worst ever pandemic caused by Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2), have affected millions of people with large number of casualties worldwide. There has been now several published studies regarding the clinical, laboratory and radiological findings of COVID 19 infections. The aim of this study was to combine the two common hematological abnormalities viz. lymphopenia and elevated LDH to increase the sensitivity of diagnosis of COVID-19 infection. We compared the LDH-to-lymphocyte ratio in patients with COVID-19 infection admitted in the ICU and general ward to assess its relation with severity of disease. Our study may help in early identification and categorization of COVID-19 patients.
Methodology : A total of 100 adult patients diagnosed by RT-PCR for COVID-19 were recruited for the study. One patient was excluded due to unclear history. We included 49 patients with severe disease from intensive care unit (ICU) and 50 patients from COVID ward with less severe disease. Serum lactate dehydrogenase (LDH) levels and absolute lymphocyte counts (ALC) of these patients were obtained during admission and the ratio of LDH to ALC was calculated for both groups. The collected data was statistically analyzed.
Results : Serum LDH levels were higher in ICU patients group compared to the COVID ward patients. ALC on admission were lower in ICU patients than the ward patients. In both cases the difference was statistically significant with p value of 0.001 in all the cases. A p value of <0.05 was considered as statistically significant. LDH/ALC ratio median of all included patients was 0.390 with interquartile range (IQR) 0.450. In COVID ICU group the median of the LDH/ALC ratio was 0.580 with IQR 0.340 and in COVID ward group median was 0.220 with IQR 0.240. It suggests that the LDH/ALC ratio is significantly higher (p value of 0.001 )  in COVID ICU patients with severe disease in comparison to COVID ward patients having non-severe disease.
Conclusion: LDH/ALC ratio on admission can be used as a sensitive prognostic marker in COVID-19 patients which can help in early identification of COVID patients who have potential risk to develop severe disease.

Cardiovascular problems brought on by ageing and the premature atherosclerosis unique to DM are the most common consequences.Thus Geriatric Diabetic patients have a high prevalence of cardiovascular disease (CVD). Coronary Artery diseases,Heart failure,Diabetic Autonomic cardiomyopathy causing arrhythmias are more common type of cardiovascular diseases in these group of patients.
Materials and Methods: The present prospective cross sectional hospital based observational study was conducted among 150 Geriatric patients with Type 2 diabetes Mellitus. A detailed clinical history was taken from all the patients regarding symptoms of Diabetes Mellitus Type 2.  The data was collected and entered into a spread sheet application (Microsoft9 Excel ).
Results: Majority of the study participants were among 60-70 years (89.33%) and least being >80 years(0.67%) .Majority of the study participants were females with 50.67% and 49.33% were males.
considering BMI,47.61% cases were Overweight (25-30) and 15.65% cases were Obese (>30).Major duration of DM among study population was 10-20 years(50.67%) followed by <10 years (27.33%).Major symptoms suggestive of cardiovascular involvement was palpitation 44% followed by 37.33% fatigue.Major signs suggestive of cardiovascular involvement was crepitations 13.33%, followed by 10% pedal edema. Major chest x-ray finding was cardiomegaly 12%, followed by 6.67% Pleural effusion.Major ECG changes considering infarction was NSTEMI 15.33% followed by 12% STEMI.Major ECG changes considering arrhythmias was sinus tachycardia 18% followed by 6.67% sinus bradycardia, 0.67% atrial fibrillation, 1.33% VPC, 19.33% LVH and 0.67% BBB.Major 2D Echo findings was 36.67% LVDD followed by 32.67% had Hypokinesia, 31% akinesia, 27.33% LVSD.It was observed that Around 62% had no cardiovascular involvement, 31.33% had Myocardial infarction, 20.67% arrythmia, 12.67% heart failure and 12% Diabetic cardiomyopathy (HCM+DCM).
Conclusion: Geriatric Diabetics are at significantly increased risk for cardiovascular disease. Myocardial Infarction is commonest cardiovascular abnormality detected.ECG and Echocardiography are basic yet most sensitive diagnostic procedure to detect CVD at an early stage .

Pharmacological screening of Euphorbia Neriifolia Linn. (Euphorbiaceous) leaf hydro alcoholic extract were performed to explore anti-ulcer activities. All tests were conducted on rats using 100, 200 and 400mg/kg dose as LD so of extract was found to 2779.71mg/kg. Study revealed strong analgesic effect of E. Neriifolia against thermal (P<0.001), and in mechanical and chemical (p < 0.01) noxious stimuli and anti-inflammatory activity (P<0.001 to 0.01) at the 1000mg/kg dose. In camageen an-induced paw edema and cotton pellet induced granuloma model. Neriifolia extract showed significant (P<0.001 to 0.01) anti- inflammatory activity. Extract considerably increases urine volume as an effective hypermatraemic and hyperchloraemic diuretic. E. Neriifolia showed laxative property by increasing wet defecation along with castor oil. Extract showed very prominent protection against ethanol-induced ulceration as well as on pyloric ligated ulceration in dose dependent manner. Extract increases total hexodes (P<0.001), Hexosamine (P<0.05), Sialic acid and total carbohydrate content (P<0.001) with a decrease in total protein content (P<0.001) of gastric mucosa at 400mg/kg dose. Presence of Phytoconstituents like tannins, flavonoids, alkaloids and triterpenoidal saponins may be responsible for the found pharmacological activities.

Proteins may be classified as aerated dietary products based on their stability and foaming capability. When gas is disseminated in aqueous solutions to create foams, surface-active chemicals keep the bubbles from bursting. In our everyday activities, proteins and polyphenols are often combined. Sinapic acid (SA) is one of the most widely distributed polyphenols. It has been examined if the foam would remain stable when coupled with ovalbumin (OVA) and Sinapic acid (SA). The results of this study showed that polyphenols may be used in the food industry as a stabilizing agent to improve the functional characteristics of foam and provided some fundamental understanding of how polyphenols alter the foaming properties of OVA. UV-visible spectroscopy was used to study and characterize the relationship between ovalbumin and Sinapic acid .The experimental results indicated that the fluorescence quenching mechanism between Sinapic acid (SA) and ovalbumin (OVA) was static quenching which was proved again by the analysis of fluorescence lifetime by time resolved fluorescence Spectro fluorimeter .Utilizing FT-IR spectra, the structural and functional groups of the tyrosine (Try) and tryptophan (Trp) residues were also examined. The binding constant and the total number of SA binding sites on OVA were also determined in this research

Wearable medical devices are playing an important role in the modern medical services. This is important for achieving a proper understanding of solutions for different medical issues that is increasing in an individual rapidly. The medical wearable devices are helping to produce a proper lifestyle management and visible growth for an individual that is important for gaining a growth. The continuous monitoring with wearable medical devices can be useful for ensuring a proper growth that are essential for gaining a proper knowledge an understanding of health for an individual. The different limitations are also developed in wearable medical devices creating an issue for growth and different obstacles that are not helping to accrue different critical solutions of diseases. The human motion detection is helping to ensure a proper growth with different applications that are helping to produce a proper way of development.
 

Pharmacotherapy is defined as a treatment procedure for a specific health condition by using pharmaceutical products as medicine and developing a drug dependency with the help of legal prescribing institutions. This process helps to maintain the functional capacity of patients and reduce the cost of treatment procedures in depression treatment efficiently. This factor helps to identify the way meditation is used for treatment and to prevent mental disease with the help of effective drugs. The treatment procedure follows strategic treatment through the application of antidepressants for continuation and maintenance in resolving depression-related problems among patients. Pharmacotherapy of depression helps to provide a compressive review of anti-depression therapy that is used in the clinical process and constructed sessions with therapists and counsellors appropriately. The main goal of depression treatment is to achieve dimension and restore the functionality of the individual and develop the quality of mental health efficiently

This article is based on the prevalence of diabetes mellitus in Indian young people. This study focuses on the reason for increasing diabetes and it has been seen that employment and education is the major issues that make an impact on society. On the other hand, people are to much addicted to junk food, processed and ready-to-eat food that use harmful chemicals and artificial food substances. It may be responsible for hormonal imbalance and major health issues. Accordingly, this paper also discussed the psychological impact of diabetes Mellitus in the Indian young generation. There are two kinds of diabetes and both effects the other organs such as the kidney, liver, cornea, foot, skin, and many more

Virtual Reality is a computer-generated simulation through which an individual can interact within an artificial 3D(three-dimensional) environment which gives users the ability to have a realistic experience. This study aims to understand how Google’s Tilt Brush in Virtual Reality as an art tool enhances Joyful learning experience among architecture Students in a classroom setting. Interviews and questionnaires gave the study a breakthrough analysis. This paper also discusses the challenges and limitations of implementing Virtual reality in a classroom setting. Virtual reality integration encourages students to believe in the importance of technology in digital education and emphasises the idea of developing alternative creative processes and joyful learning experiences in them

BACKGROUND: Periorbital wrinkles occur because of extrinsic and intrinsic aging. Aside from aging, genetics, smoking, drinking and even certain sleeping positions can contribute to wrinkle development. Free radical damage is proven to be one of the main reasons for aging and wrinkles. Several anti-aging and anti-wrinkle treatments are being studied these days but the efficacy of Euterpe oleracea has not been established yet. OBJECTIVE: To study the efficacy of topical 3% Euterpe oleracea extract cream in decreasing periorbital wrinkles. METHODS and MATERIALS: 20 subjects aged between 30 to 50 years were recruited for this clinical experimental study. Both male and female participated, and the study lasted for 12 weeks. Volunteers were instructed to apply 3% Euterpe oleracea extract cream twice daily to periorbital area during the 12-week period. Skin parameter measurements such as skin elasticity, hydration and wrinkle score assessment by dermatologists were taken at baseline, 4^th, 8^th, and 12^th week respectively. RESULT: The mean of cutometer score (skin elasticity) increased from the start to week 12 and it was statistically significant. The mean corneometer score (skin hydration) also improved significantly from baseline to week 12. A rise in wrinkle evaluation score was also recorded from week 4 to week 12 with significance.  There was no adverse effect in all subjects throughout the study with high patients’ satisfactory score. CONCLUSION: The study demonstrated that Acai palm extract decreased periorbital wrinkles when it is applied topically with no adverse effects. It could be an alternative anti-wrinkle treatment.

nowadays we can see many businesses going to bankruptcy or losing their reputation. Here, the main reason can be loyalty in diverse aspects.  This paper examines diverse kinds of loyalty and their role in business development and persistency.  Now many businesses are losing their reputation in front of the public and government and they do not know the exact reason for their failure. Incorporating my experience in business for 14 years and surveys that I have taken; it is clear that only customer loyalty is concentrated for the development of businesses. However, there is also business loyalty towards the public, government, workers and customers.   If businesses keep these kinds of loyalty, they can reach customer loyalty easily and make more sales than ever before.  It is a fact that loyalty is between two parts, so it is very crucial not to look at loyalty of one side

The aim of this work is to study the catalytic performance of synthesized zeolite materials in an oxidation reaction of an organic molecule. The synthesis of these zeolites was carried out by following protocols and under precise temperature and crystallization time conditions. The materials obtained are characterized using different characterization techniques, X-ray fluorescence (XF), X-ray diffraction (XRD), infrared spectroscopy (IR) and visible UV spectroscopy ( UVvis). The oxidation reaction was carried out in the presence of tert-butyl hydroperoxide (TBHP) as oxidant and zeolites incorporated with transition metals as catalyst. The progress of this reaction was followed by gas chromatography coupled to mass spectrometry (GC-MS), this reaction gave products consisting of the epoxide.

The important feature of the Indian social system is a commonly held belief that women are inferior to men in all aspects and hence they should be kept in the position of sub-ordination inside and outside the family. Culturally and traditionally, India is the most patriarchal community where the position of women is neglected, and their birth of girl child is regarded as the most misfortune. Overall, it should be admitted mostly that all women in India suffer from patriarchal structures and ideologies. They are the victims of gender discrimination, inequalities, and male domination in all walks of life. They lag behind men in all the indicators of social and economic development. This study intends to analyze the correlates of participation in panchayat raj functioning in Tamil Nadu

The most common and neglected public health problem was reported as obesity in both developed and developing countries. Globally, one in six adults is obese, and nearly 2.8 million individuals die each year due to being overweight or obese. The women's health was measured using the body mass index, and the food habits of the women individually were recorded by the investigator. This study was conducted in the urban area of Lucknow district on 400 women aged 20 - 50 years and was selected using a multistage stratified random sampling technique. The overweight or obesity was found to be 39.50% among the selected women in the present study. The overweight was found to be more among the vegetarian women, who taken 2-3 meals per day, skipped meals and breakfast and took food with watching TV, as compared to non-vegetarian women, taken 4-5 meals per day, not skip meals, others meals and not taken food with watching TV respectively. The insignificant associations between body mass index and food habit, skipped meals, breakfast, type of skipped meals and food taken with watching TV were observed, while a significant association between body mass index and meals taken per day was found in the present study.

Aim: Estimation of Anti-Arthritic Activity of sustained released tablet of Trapa Bispinosa , Cassia Uniflora , Cissus Quadrangularis and Bosevilla Serrata  plants against Freund’s complete adjuvant induced arthritis by using animal models.
Materials and Methods: Trapa Bispinosa , Cassia Uniflora , Cissus Quadrangularis and Bosevilla Serrata  are well known plants available throughout India and they are commonly used for the treatment of various diseases including arthritis. The polyherbal sustained released tablet contains the ethanol extracts of Trapa Bispinosa , Cassia Uniflora , Cissus Quadrangularis and Bosevilla Serrata  . The quality of the finished sustained released tablet was evaluated as per the World Health Organization’s guidelines for the quality control of herbal materials. Arthritis was induced in female Wistar rats using Freund’s complete adjuvant (FCA), and the antiarthritic effect of sustained released tablet was studied at doses of 200 and 400 mg/kg. The effects were compared with those of Diclofenac (20 mg/kg).
At the end of the study, blood samples were collected for biochemical and hematological analysis. The radiological examination was carried out before terminating the study.
Results: Sustained Released Tablet (TCBC) showed significant antiarthritic activity at 100 and 200 mg/kg, respectively, and this effect was comparable with that of Diclofenac (20 mg/kg).
The antiarthritic activity of Sustained Released Tablet is supported by hematological and histopathological  analysis.
Conclusion: The sustained released tablet (TCBC 200 mg/kg) showed significant antiarthritic activity against  Freund’s complete adjuvant induced arthritis in Female Wistar rats.

Acinetobacter which grow in a moist environment aerobic, gram negative, non-fermenting, non-fastidious, non-motile, catalase-positive, and oxidase negative coccobacilli. Antimicrobial resistance has significantly increased among Acinetobacter species. Resistance to ⩾3 categories of antimicrobials or carbapenem resistance are two of the most prevalent definitions of multidrug resistance. A. baumannii has been known majorly, as responsible for spreading diseases throughout the world's hospitals, especially in intensive care units (ICUs). They are known as "super bugs" because they cause a significant amount of infections in certain patient populations in modern hospitals, notably in critically ill patients in the ICU. There are several ways to detect this, including the Tissue Culture Plate (TCP), Tube methodology (TM), acid-base indicator method (CRP), light assay, electricity sensors, and fluorescent examinations. To emphasise how they are immune to the deadly effects of antibiotics, this species is recognised as one of the six complex pathogens known as "ESKAPE". This Multi-drug resistant Acinetobacter Sp. has emerged as a very important healthcare facility pathogen.

Aim: To determine the hemodynamic effect of lumbar epidural anaesthesia in patients with Severe preeclampsia.
Material and methods: Following approval from the institutional ethics committee, 50 non-laboring ASA (physical status I or II, age 18-32 years, weight 44-68 kg) parturients carrying a singleton pregnancy and scheduled for elective caesarean section were included in our study, and written informed consent was obtained from each parturient in their own language. There were 25 normotensive women (Group I) and 25 severe pre-eclamptic women (Group II) with blood pressures of 160/110 who needed antihypertensive medication (either nifedipine, 10–20 mg BD or TDS, or labetalol, 800–1200 mg in 2 to 3 divided doses).
Results: Parturients in both groups were equivalent in terms of age, weight, height, and foetal gestational age. The pre-eclamptic group had greater baseline SBP, DBP, and MAP. The mean baseline HR was similar in both groups. Following SAB, SBP, DBP, and MAP all declined from baseline in both groups, but the lowest recorded SBP, DBP, and MAP in the normotensive group were lower than in the parturients with pre-eclampsia, which was statistically significant. The pre-eclamptic group consumed considerably less phenylephrine than the normotensive group. The percentage of decline in DBP and MAP estimated from the baseline was likewise lower in the pre-eclamptic group (34% and 32% in normotensive, respectively, against 30% and 32% in pre-eclamptics). Pre-eclamptics required considerably less phenylephrine to cure hypotension (150.99±61 g in normotensive patients vs 50.11±22.36 g in pre-eclamptics), which was statistically significant (P <0.0001).
Conclusion: In conclusion, hypotension after spinal anaesthesia for caesarean delivery was much lower in severe pre-eclamptics than in healthy pregnant women in the current research. Furthermore, pre-eclamptic parturients had lower phenylephrine needs, and newborn outcomes were equivalent across the two groups.

Introduction: Injury to hamstrings caused due to muscle tightness are common among athletes. In the presence of neural mechanosensitivity, muscle tightness may result from protective muscle contraction. Changes in the length and stiffness of muscle tendon units affect proprioception, which in turn affects balance. Interventions using neurodynamic sliding are thought to reduce neural mechanosensitivity, which is beneficial for increasing the flexibility and, in turn, balance. Hence, the purpose of the study was to find out the immediate effect of neurodynamic sliding technique on hamstring flexibility and static and dynamic balance among athletes.
Methodology: Present study was conducted as Pre-test - Post-test experimental study. 40 male athletes (n=20 cricketers, n=20 football players) from Delhi-NCR sports academies, aging between 18-30yrs (mean=21.35±3.83) having unilateral hamstring tightness participated in the study. Subjects were randomly allocated to any of the 2 groups: Group 1 – Neurodynamic sliding or Group 2 - Moist heat pack. Straight leg raise (SLR) and active knee extension (AKE) tests were used to assess hamstring flexibility and stork stand test (SST) and modified star excursion balance test (mSEBT) were used to assess static and dynamic balance respectively, at baseline and post intervention.
Results: No significant differences were found at baseline for demographics and any of the outcome measures. Significance level was set at 95%. Paired t-test for within group analysis revealed a significant improvement (p =.000) for SLR, AKE, SST and mSEBT scores in both the groups.  Independent t-test for between group comparisons revealed significant improvement for SLR (p=.003), AKE (p=.048.), SST (p=.046), mSEBT_AN (p=.013), mSEBT_PM (p=.005), mSEBT_PL (p=.011), mSEBT_NS_PM (p=.037) and mSEBT_CS (p=.047) whereas no significant improvement for was observed for mSEBT_NS_AN (p=.070) and mSEBT_NS_PL (p=.060)

The features from the fundus pictures' optic disc must be precisely located before landmark features included in the fundus images can be identified. According to the severity of the DR, existing research employed a variety of Artificial Intelligence (AI) strategies for screening and diagnosing DR sooner to protect diabetic patients from going blind. In contrast to the real-world optimization strategy, the current models, while effective, had limitations related to time consumption and premature convergence. As a result, the Multi-class Transfer Learning that has been proposed is updated to improve performance based on its fundamental design. The model was trained to find solutions more effectively thanks to the higher convergence. The suggested approach gets around constraint problems and improves accuracy with better feature selection. In comparison to the current transfer model, which achieved 98.94% accuracy for DIARETDB1, the suggested method achieved an accuracy of 97.46%. The e-ophtha dataset, however, achieved accuracy of 98.91%. The predicted algorithm can be integrated with any device at home-centric environment.

In all the cells of the human body, the fundamentally existing genetic material is Deoxyribonucleic Acid (DNA). The DNA of every single person varies from one another. In criminal assessment, the DNA evaluation has been utilized as vital evidence. It is also employed in cases concerning the ascertainment of Paternity of Identity in civil proceedings. The court constantly depends upon the accurateness, lawful accumulation, protection, along with certification of the DNA evidence’s admissibility. The court is convinced of this evidence because of its trustworthiness. An act done by an individual without criminal intention is not termed a crime. In civil along with criminal cases, the DNA assessment has turned into a highly significant task. Conversely, to support investigators together with courts in cases including DNA evidence, no particular law is available in India. Thus, a person is alleged or removed from doubt with the DNA evidence as collected from the scene of Crime. Several methodologies utilized for the recognition of DNA evidence are surveyed in this work. There would be remains of biological proofs like skin cells, hair, blood, or semen available on victim’s body at the scene of the Crime. The collection and processing of such biological samples for gathering DNA Evidence is a complex and has to be meet certain legal standards to be admissible.  The aim of this paper to make a review of the evidentiary value of DNA as collected and processed from the Crime scene

In order to reduce maternal mortality government of India is continuously working on maternal health. Janani Suraksha Yojana (JSY) is one of the most important steps taken by Govt. of India to combat this problem. Objectives: To assess the utilization of postnatal care services and level of satisfaction among JSY beneficiaries in rural area. Methodology: A cross-sectional study was conducted at private Medical College & Hospital, Pune, India from 2014-16 and comprised randomly selected 155 JSY beneficiaries from both the Primary Health Centers of Rural area. One to one interview with the all 155 beneficiaries was conducted using the predesigned, pretested, questionnaire. Results: 85(54.83%) beneficiaries got 2 post-natal visits by health worker while 18(11.61%) beneficiaries got only 1 post-natal visits, remaining 52(33.56%) beneficiaries did not get even single post-natal visit by health worker. On further analysis it was found that Post-natal follow up is better amongst beneficiaries, who delivered at government institutes i.e. 76(72.38%) out of 105 beneficiaries had done post-natal checkups by health worker Majority 118(76.1%) of beneficiaries were satisfied with the services provided under JSY and 12(7.7%) beneficiaries were strongly satisfied. 4 beneficiaries were not satisfied with the services provided under JSY. Conclusion: Intranatal services were good but disparities found in post-natal services and majority beneficiaries were satisfied with JSY very few were dissatisfied or given neutral answer.

Surgical repair of complex ventral hernia repairs are difficult to perform and are associated with peri-operative complications and recurrence. Many surgical techniques have been studied to improve the outcomes of complex ventral hernia repairs and Transversus abdominis muscle release technique is one such procedure.  
Objectives: To find out the outcome of transversus abdominis muscle release (TAR) procedure done in patients with complex ventral hernia.  
Materials and method: A prospective study was done among 10 patients with complex ventral hernia presented to General Surgery department of Vinayaka mission’s medical college and hospital, Karaikal for a period of 1 year. All the patients underwent transversus abdominis muscle release with sub-lay mesh by open method. The patients were discharged on 7^th postoperative day. All the patients were followed up for a period of 6 months to identify the outcomes of the procedure and any delayed complications after discharge from the hospital. The results of the study are analysed and presented in the form of mean with standard deviation and percentage.  
Results: Mean age of the patients was 59.4 years ranging from 45 to 76 years. Among the total 10 patients, 6 (60%) were females. Majority (40%) of the patients had incisional hernia. The most common previous surgical procedure was hysterectomy. Average duration of hernia among the participants was 3.4 years. The average size of the defect was 6.3 cm and 2 patients had multiple defects. During the stay in hospital, 2 patients (20%) developed wound related complication such as seroma formation. At the end of 6 months of follow-up there was no recurrence of hernia in the patients.   
Conclusion: Short term follow-up of TAR procedure had shown that the technique is effective in repair of complex ventral hernia without any significant complication and recurrence

Community acquired pneumonia is one of the most common infectious disease, and is an important cause of morbidity and mortality among the elderly worldwide Present study aimed to investigate the usefulness of Neutrophil Lymphocyte Ratio (NLR) as a biomarker of Community Acquired Pneumonia (CAP)
Material & Method: Present diagnostic comparative study was conducted among the patients more than 18yr of age with community acquired pneumonia, attending department of General Medicine of AVMC & H. After obtaining informed and written consent from the patients, detailed history, clinical assessments and laboratory investigations was done. The NLR ratio, CURB 65 score and PSI calculated and compared. All data were collected by the investigator and was analysed statistically to find the level of significance of the study.
Results: Two hundred and four patients included with mean age of 57.11±16.35yrs of age.  Among them, 60.3% were male patients and 39.7% were female. On comparison of the scores with 1st mild  risk group, 2nd moderate risk group and 3rd severe risk group, we found a significant difference in the mean, with the 3^rd risk group the mean levels were significantly higher compared to group 2 and group 1.(p<0.05) On pearson’s correlation the NLR was significantly positively correlated with CURB 65 score and PSI score in the present study.(p<0.05) On ROC analysis, the study found the AUC of 0.902 for NLR, 0.922 for CURB 65 score and 0.931 for PSI score.(p<0.05)
Conclusion: study concludes that the Neutrophil Lymphocyte ratio is a important biomarker for community acquired pneumonia. Also the NLR is significantly correlated with the CURB-65 and PSI score positively. NLR is simple and useful tool to assess the outcome of the patients with CAP.

The purpose of the study was done to observe correlation of AFB, Monteux test and PCR in non-tuberculosis mycobacterium for the detection and identification of clinically most frequent NTM at the species. A Prospective Experimental Study was done on 50 IP and OP patients for duration of 12 months who presented to various Departments of VMMC, Karaikal with signs and symptoms of Tuberculosis. Patients of All Age Group with clinical suspicion of Tuberculosis, Both New and Retreatment Tuberculosis Patients were included in the study. Microbiologically confirmed case of Mycobacterium Tuberculosis were excluded from the study. Out of 50 (100%) cases who took part in the study, sample type was distributed among 49 (98.0%) sputum samples and 1 (2.0%) bronchial wash. Out of 50 (100%) cases who took part in the study to determine the prevalence of Acid-Fast Bacilli (AFB), 24 (48.0%) of cases had Acid-Fast Bacilli and 26 (52.0%) had no Acid-Fast Bacilli in staining. Out of 50 (100%) cases who took part in the study to determine the prevalence of tuberculosis by MANTOUX screening, 37 (74.0%) tested positive for MANTOUX and 13 (26.0%) tested negative for MANTOUX. Out of 50 (100%) cases who took part in the study to determine the detection of genes by Polymerase Chain Reaction (PCR) test, 36 (72.0%) of cases had specific genes and 14 (28.0%) of cases had no specific genes detected by polymerase chain reaction. Out of 50 (100%) cases who took part in the study to determine the prevalence of Acid-Fast Bacilli and its gene by Polymerase Chain Reaction, 6 (42.9%) and 20 (55.6%) cases tested negative for acid-fast bacilli staining, 8 (57.1%) and 16 (44.4%) cases tested positive for acid-fast bacilli staining. For gene detection by polymerase chain reaction 6 (42.9%) and 8 (57.1%) cases had no specific genes where 20 (55.6%) and 16 (44.4%) of cases had specific genes. Out of 50 (100%) cases who took part in the study to the determine the prevalence of MANTOUX and its gene by Polymerase Chain Reaction prevalence, 2 (14.3%) and 11 (30.6%) of cases tested negative for MANTOUX test whereas 12 (85.7%) and 25 (69.4%) of cases tested positive for MANTOUX test. For specific gene detection by polymerase chain reaction 2 (14.3%) and 12 (85.7%) of cases had no specific genes but 11 (30.6%) and 25 (69.4%) of cases had specific genes suggesting that PCR is a technique of convenience

Diabetes is a “metabolic disorder of multiple aetiologies characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both “is defined as diabetes mellitus by WHO.¹ According to several studies has observed that the number of cases of diabetes worldwide in the year 2000 among adults at around 171 million, but the number of cases of diabetes mellitus is likely to rise around 366 million by the year 2030. So the present study is done to observe the correlation serum zinc levels with HbA1C levels and microalbuminuria. A cross sectional observational study is done on 70 patients divided into2 groups cases-with complications and controls-without complications who presented to the department of General Medicine, VMMC, Karaikal, Pondicherry with diabetes mellitus for duration of 6 months. All cases of type 2 diabetes mellitus patients attending general medicine Outpatients with complications are included in study. The mean HbA1C value of cases is 7.823% with a standard deviation of 1.29% and the mean HbA1C of controls is 5.83% with a standard deviation of0.53%, p-value is <0.005 which is statistically significant. In cases urinary albumin excretion was 90.5±63 mg/dl and in control group it is 86.5±62mg/dl, p-value is <.005 which is statistically significant indicating that in coastal areas there are elevated levels of zinc despite of poor glycaemic control.

Due to the detrimental effects, the removal of xenobiotics from wastewater is crucial. Several chemical and physical methods, including ion exchange, reverse osmosis, electrodialysis, and ultrafiltration, is used to remove xenobiotics from wastewater. Due to its low operating costs and effectiveness in absorbing and/or eliminating organic and elemental contaminants from wastewater, the biological method of employing microalgae has attracted the attention of the scientific community. Chlorella vulgaris was utilised as a biological absorbent for sewage water (SEW) cleanup. According to the findings of this study, C. vulgaris successfully removed contaminants and enhanced the physicochemical properties of wastewater, such as pH, DO, and alkalinity. SEW's BOD, COD, suspended solids, heavy metals (HMs) such as iron (Fe), zinc (Zn), cadmium (Cd), mercury (Hg), copper (Cu), and lead (Pb), and nutrient load (phosphate and nitrate) were all reduced simultaneously. Cultivating C. vulgaris resulted in the effective cleanup of the contaminants. The investigation of Pearson's correlation revealed that physicochemical factors and algal biomass are positively correlated. For eliminating pollutants and restoring the physicochemical qualities of water, the current study supports biological wastewater treatment employing C. vulgaris as an efficient and environmentally beneficial approach

Aim: The aim of this study was to evaluate and compare the prevalence of Binocular Single Vision in cases with horizontal strabismus and normal individual.
Methods: This Prospective Observational study was conducted at Dr. D.Y. Patil Medical College, Pune from September 2020 to August 2022 which included 100 patients of horizontal strabismus and 100 healthy individuals
Results:  Out of 100 patients with horizontal strabismus, majority were male (52%) while in normal group, majority were female (55%). In strabismus, simultaneous macular perception was present in 76.19% of constant ET, 66.66% of alternating ET, 81.9% of constant XT and 91.6% of alternating XT compared to 100% in normal participants. In strabismus group, fusion was present in 33.33% of constant ET, 66.66% of alternating ET, 50.81% of constant XT and 91.6% of alternating XT compared to 100% in normal participants. In strabismus group, stereopsis was present in 33.33% of constant ET, 66.66% of alternating ET, 40.98% of constant XT and 66.66% of alternating XT compared to 93% in normal participants. In normal individuals, 100 % had gross stereopsis of 600 seconds of arc. In participants with strabismus, subjects with constant ET had gross stereopsis of 600,1000,1100 and 2000 seconds of arc in 19.04%, 4.76%, 9.52% and 66.66% of the participants respectively. Subjects with alternating ET had gross stereopsis of 600,1000,1100 and 2000 seconds of arc in 33.33%, 33.33%, 0.0% and 33.33% of the participants respectively. In the constant XT category, 22.95%, 8.19%, 9.83% and 59.01% of the participants had gross stereopsis of 600,1000,1100 and 2000 seconds of arc respectively. subjects with alternating XT had gross stereopsis of 600,1000,1100 and 2000 seconds of arc in 33.33%, 16.66%, 33.33% and 16.66% of the participants respectively. In normal individuals, 100% participants had their fine stereopsis between 20-100 seconds of arc. In participants with strabismus, subjects with constant ET had fine depth stereopsis between 20-100, 101-200, 201-400 and >400 seconds of arc in 19.04%, 9.52%, 14.28% and 57.14% of the participants respectively.
Conclusion:In our study, in the strabismic group, all grades of binocular single vision was observed to be reduced. SMP was observed to be present in majority participants in all group however it was observed to be reduced in the strabismus groups in the next two grades of BSV. It was also observed that Alternating type of Strabismus had better BSV when compared to the constant type. Thus, early detection of BSV anomalies paves way for early treatment and thus, preservation of BSV and better quality of life.

Aim: The aim of the present study was to assess haematological and inflammatory parameters in sepsis patients.
Methods: The study was conducted at Medical intensive care unit at Dr. DY Patil medical college and hospital, DY Patil Vidyapeeth, Pimpri, Pune from October 2020 – September 2022 and 100 cases were included in the present study. Approval was taken from institutional ethics committee before commencing the study. Informed and written consent was taken from all the patients.
Results: Among the study population, 68.00% of them were male, 32.00% of them were female. On study population, 44.00% of them diagnosed with DIC. On study population, 61.00% of them were Survivors, 39.00% of them were non-survivors. The mean platelet on admission was 117624 ± 89241.13, it was 105860 ± 85661.89 at 24 hours, it was 98990 ± 83391.29 at 48 hours. The mean D Dimer at Admission was 4073.37 ± 4361.13, it was 3956.39 ± 2432.91 at 24 hours, it was 5284.33 ± 8445.54 at 48 hours. The mean Fibrinogen at Admission was 2.07 ± 0.85, it was 1.76 ± 0.86 at 24 hours, it was 1.47 ± 0.95 at 48 hours.  Among the study population, the mean ESR was 86.75 ± 97.97, the mean CRP was 73.7 ± 72.45, the mean Lactate was 28.95 ± 25.06, the mean Pro Calcitonin was 6.62 ± 3.4.
Conclusion: In uncontrolled cases of sepsis, acute organ dysfunction and shock may develop. Because of this rapid progression, it is of utmost importance that patients should be diagnosed and treated in a requisite time frame. The current literature and changing guidelines demonstrate that the bedside physical examination along with laboratory testing (haematologic and inflammatory biomarkers) are the most effective combination of parameters that clinicians can rely upon to accurately predict or diagnose sepsis in a critically ill patient.

Background: Arterio-venous fistula is the preferred type of vascular access in patients requiring hemodialysis. (1-3) They have longer patency with low complication rates as compared to grafts. Still arteriovenous fistulas surgery can give rise to various complications
Objectives: this study was done to evaluate the various complications, early as well as late, arising from the arteriovenous fistula surgery.
Materials and Methods: This study was conducted over a span of 3 years from October 2019 to October 2022 comprising of 284 patients of chronic kidney disease who were on regular hemodialysis underwent surgery to create end to side radio-cephalic arteriovenous fistula formation for vascular access.
Results: out of 284 patients 22(7.74%) patients required reoperation. Thrombosis with failure of AV fistula requiring reoperation was seen in 19(6.69%) patients. Reoperation for bleeding, Aneurysm and ischemic steal syndrome was seen in 1 patient each.
Conclusion: Thrombosis with loss of AV fistula is the most common complication requiring reoperation after Radio-cephalic arteriovenous fistula surgery for vascular access in patients on hemodialysis.

Background: To evaluate serum D-Dimer levels in carcinoma breast patients.
Materials and Methods: In this prospective comparative hospital-based study, 65 diagnosed cases of operable breast carcinoma not started on any treatment for cancer and 65 healthy women were included as cases and controls, respectively. Peripheral venous blood was analyzed for D-dimers detected by Quantitative immune-turbidimetric latex assay.
Results: It was observed that D-dimer levels significantly correlated with clinical stage (r=0.583; p<0.05), histological grade (r=0.655; p<0.05), ER/PR receptor (r=0.534; p<0.05), lymph node status (r=0.471; p<0.05) and presence of lymphovascular invasion (r=0.507; p<0.05).
Conclusion: D-dimer is a simple, non-invasive, quick laboratory investigation that may be considered a good indicator for determining the clinical stage, progression of disease and lymphovascular invasion.

This article describes the management of a 6-year-old female patient having bilateral right TMJ bony (true) ankylosis and left fibrous ankylosis having mandibular retrognathism and she was also suffering from eating, speech problems, snoring, difficulty in breathing, daytime somnolence and she is severely malnourished due to inability to eat because of nil mouth opening.. Bilateral gap arthroplasty and temporalis myofascial graft interpositioning through preauricular approach were done in surgical phase followed by the aggressive jaw physiotherapy in postsurgical period.

Background: Reactive oxygen species [ROS] if produced in large amounts, have destructive effects because of high reactivity. During oxidative stress there is an imbalance between the formation of free radicals and antioxidant defence mechanisms through damaging cellular macromolecules. Smoking is one of the major risk factor that affects the prevalence, degree and severity of periodontal disease.
AIM: . The purpose of the present study is to evaluate and compare the levels of ROM in GCF, saliva and plasma in smokers and non-smokers with periodontitis
MATERIALS & METHODS: 30 Participants (males) were selected and were divided into two groups Group I - Smokers with Chronic Periodontitis and Group II - Non-Smokers with Chronic Periodontitis with 15 each . GCF, Saliva and Plasma were collected from both the groups and were tested in the laboratory through the principle of Fenton’s reaction.
RESULTS: One way ANOVA analysis and paired t test were used for analysis .On comparison of ROM levels in smokers and non-smokers, level of ROM was increased in smokers and it was highly significant with p value ≤ 0.05.
CONCLUSION: Free radical production mediated by cigarette smoke is highly toxic and impaired oxidant-antioxidant balance is a risk factor for periodontal disease, as the results from the present study suggested increased  levels of ROM in smokers

Background & Aim: Most of the early kidney diseases do not represent any clinical symptoms therefore left undetected. Chronic kidney disease is characteristically identified by usual testing of blood serum. Advanced cases of chronic kidney disease also manifest with some peculiar symptoms fatigue, loss of appetite, nausea, vomiting, metallic taste, inadvertent weight loss. This study was conducted to compare and correlate various clinical parameters in chronic kidney disease patients with or without hemodialysis.
Materials and Methods: The study was conducted over a year time on 80 chronic kidney disease patients. 45 male and 35 female patients in the age range of 30 to 50 years were studied in detail. Parameters and factors associated to chronic kidney disease were considered; Serum Cholesterol, Triglycerides, High Density Lipoproteins, Low Density Lipoproteins, Albumin (urine), Creatinine. Albumin is a type of proteins seen in blood normally. Group 1 patients consisted of 40 patients who underwent hemodialysis procedure. Group 2 patients consisted of 40 patients those have not undergone hemodialysis procedure. All data was forwarded for statistical analysis for further investigation and interpretations. P value less than 0.05 was taken as significant.
Statistical Analysis & Results: Statistical analysis was done by using software statistical package for the Social Sciences In group 1, mean Serum Cholesterol level was 179.41 (mg/dl) while mean Triglycerides level was 133.26 (mg/dl). P value was highly significant (0.01) for Serum Cholesterol level. In group 2, the mean Serum Cholesterol level was 201.41 (mg/dl) while mean Triglycerides level was 165.36 (mg/dl). P value was highly significant (0.02) for Serum Cholesterol level. Mean Albumin and mean Creatinine was 29.22 and 1.44 respectively. One-way ANOVA analysis of both study groups revealed highly significant p value.
Conclusion: Authors concluded that chronic kidney disease patients without hemodialysis exhibit deleterious discrepancies of tested lipid parameters (Dyslipidemia). Nevertheless, Albumin and Creatinine levels are also increased in chronic kidney disease patients (without hemodialysis). Accordingly chronic kidney disease patients without hemodialysis are at higher risk of possibility of blocked arteries and other related dilemmas.

Background: This study was carried out with the objectives to study the clinical profile and to find the outcome of children admitted to paediatrics intensive care unit (PICU) of IMS & SUM Hospital, BBSR.
Methods: A retrospective study was carried in children aged more than 28 days to 14 years admitted in PICU from January 2020 to June 2021 (18 months).
Results: Total 199 patients were admitted. Out of them 136 (68.3%) were males, whereas 63 (31.7%) were females. 88(44%). The mean length of stay was 4.2±4.6 days (range 1- 29 days, median 3 days). 47 patients were intubated and mechanically ventilated during this period. The mean day of mechanical ventilation was 4.1±4.6 days. Of the 15 patients died 7 patients (47%) had malignancies. Other causes of death included 2 septic shock (13.3%), 2(13.3%) ARDS. The mean duration of the PICU stay of the patients who died was 4.2±3.6 days (range 1-11 days).
Conclusions: The mortality rate at the PICU was 7.5%. Malignancies, septic shock, ARDS were the common cause of death and the maximum deaths has happened in less than 2 days of admission.

A novel, simple, precise, sensitive, rapid and specific high performance thin layer chromatographic method has been developed and validated for the simultaneous estimation of Triamcinolone acetonide, Budesonide, Beclomethasone, Mometasone furoate and Fluticasone propionate in various nasal sprays using common mobile phase. The stationary phase used was precoated silica gel 60F₂₅₄ plate. The mobile phase used was a mixture of Toluene: Acetonitrile: Triethyl amine [6.5: 3.5:  0.2, v/v/v]. The detection of spots was carried out densitometrically using a UV detector at 240 nm in absorbance mode. This system was found to give compact spots for Triamcinolone acetonide, Budesonide, Beclomethasone, Mometasone furoate and Fluticasone propionate with Rf values of 0.30, 0.46, 0.55, 0.71 and 0.82, respectively. The method was validated in terms of linearity, accuracy, precision, limit of detection, limit of quantification and specificity. The calibration curve was found to be linear between 100-600 ng/spot for all drugs with significantly high value of correlation coefficient [r² > 0.99]. The limits of detection and quantitation values reveals sensitive determination of all drugs in various formulations using common mobile phase. The low value of percent relative standard deviation reflects the repeatable and precise nature of the developed method. The average percent recovery for all drugs between 98.00 – 102.0% with low value of percent relative standard deviation indicates the accuracy of the method. The comparison of associated spectra at peak points of start, apex and end of the band or spot for all drugs with very good correlation or peak purity [r > 0.99] indicates specificity of the method. The assay results are found in good agreement with the label claim indicates quantification of all drugs without interferences of sample matrix. The proposed method can be used in the quality control of bulk drugs and pharmaceutical dosage forms with very fast, accurate, precise and specific results.

This article aims to review about the antimicrobial efficacy of different herbal formulations against various oral pathogens in Dentistry.
Background: Based on literature about ten essential oils were chosen for this study and their antimicrobial efficacy was evaluated on different oral microorganisms.
Review results: Different essential oil showed different results over oral bacteria. The most common oral bacteria on which effect was seen areStreptococcus mutans, E. faecalis, Candida albicans and Porphyromonas gingivalis.
Conclusion: Herbal formulations were found to be effective against oral microorganisms in dentistry.
Clinical Significance: This review provides an alternative approach for the treatment of dental diseases and periodontal issues.

Severe Acute respiratory Syndrome Coronavirus 2 (SARS-Cov-2/COVID 19) infection was firstly described in Wuhan, China during December 2019. Covid 19 patient can present with numerous clinical presentations ranging from Asymptomatic to critical clinical courses. HRCT thorax findings proved to be crucial in assessing the clinical course of patients requiring treatment.
Materials And Methods: It was a cross sectional study done in Dr D Y Patil Medical College. Patients >12 years of age who were RT PCR Positive for COVID 19 and met the inclusion criteria were selected for the study. After which they were categorized in to mild moderate category according to guidelines. HRCT was done for all patients and CT severity score was also assessed
Results: We evaluated a sample population of 100 patients. The most predominant symptoms in the moderate category were shortness of breath. The most common radiological abnormality noted was Ground glass opacity (50%) with 43patients in mild and 7 patients in moderate category. Lung involvement in mild stage was only 20 to 40% when compared to that of moderate category where the lung involvement was 50 to 60% and this showed statistical significance
Conclusion: CT scoring could help to identify patient’s risk and predict outcome of patient with COVID 19 Pneumonia. The extent of lung involvement is highly correlated with parameters of disease such as clinical staging. Finally, our study strongly supports the use of chest CT in patient with the covid 19 pneumonia, which could be used as a tool for rapid and effective method to evaluate the lung involvement. It can also help in taking clinical decision

Global health concerns include peptic ulcer disease (PUD). Recent findings indicate a global decline in peptic ulcer disease. Peptic ulcer perforation remains a severe health concern despite all of this. The pattern of perforated PUD varies by location due to sociodemographic and maybe environmental factors. Perforated PUD is seen in young males in poor nations like ours. In comparison, perforated PUD patients in industrialised nations are mostly older and have smaller gender inequalities. Due to the close association between drinking and smoking among young males, emerging nations have high rates. Despite the high number of cases in our area, perforated peptic ulcer disease is rare. We aim to provide our hospital's experience with perforated PUDs, including incidence, clinical presentations, treatment results, and morbidity and mortality

Esophageal varices are portosystemic collaterals developed in cirrhotic patients with portal hypertension. Noninvasive assessment of cirrhotic patients to predict esophageal varices have been increasingly used instead of endoscopy. Shear wave elastography is a non- invasive technique which is based on an ultrasound device which has been developed to detect liver stiffness. We aim to assess the diagnostic performances of Shear Wave Elastography liver for the noninvasive detection of the presence of esophageal varices. Subjects and Methods: The patients included in the study underwent shear wave elastography (SWE) of liver and underwent endoscopy to determine presence of esophageal varices, Platelet count and spleen size values were calculated. The diagnostic performance of liver stiffness by SWE, platelet count and spleen size were evaluated using receiver operating characteristic (ROC) curve analysis. Correlations of SWE, platelet count and spleen size with endoscopy findings (as the reference standard) were determined using Spearman’s correlation coefficient. Results: Study included, 102 patients of the 58 (56.86%) were grade 0 with mean SWE of 16.32±1.28 kPa, 25 (26.32%) were grade1 with mean SWE of 18.16±1.00kPa;12 (11.76%) were grade2 with mean SWE of 24.42±0.70kPa, and 07(6.86%) were grade3 with mean SWE of   26.50±0.53kPa. There was significant positive correlation between different stages of esophageal varices by endoscopy and liver stiffness detected by SWE (r = 0.9178, p < 0.001). AUC (95% Cl) for diagnosing grade 0, grade 1, grade 2 and grade 3 esophageal varices SWE elastography is 0.926(0.857 to 0.969);0.655 (0.555 to 0.747) ;0.922 (0.852 to 0.966) and 1.000 (0.964 to 1.000) respectively. A cutoff value of >19.3kPa and >25.3kPa was 100% sensitive in diagnosing grade2 and grade 3 esophageal varices respectively. SWE liver stiffness exhibited higher diagnostic accuracy than the platelet and spleen size for the diagnosis of those with high grade varices AUC 1.000(0.964 to 1.000), 0.995 (0.955 to 1.000), 0.913(0.841 to 0.960) respectively. Conclusion: Shear Wave Elastography (SWE) is a novel noninvasive independent variable for predicting high-risk esophageal varices in cirrhotic patients. Since SWE technique can be easily integrated into conventional ultrasound during a conventional liver ultrasound examination it helps to reduce medical, social, and economic costs particularly the endoscopic burden and also improve patient compliance.

Calcaneal fractures are 60% of all tarsal injuries and 2% of all fractures in adults. Although open reduction and internal fixation (ORIF) is the gold standard, it has been found to have soft-tissue problems that are proportionally related to the degree of surgical invasiveness. Because soft tissues are protected, minimally invasive percutaneous osteosynthesis (MIPO) procedures promise a lower risk of wound complications, a quicker recovery period, and faster healing

E-Accounting involves performing regular accounting functions, accounting research and the accounting training & education. Institute and company databases which are internet based web-links, internet bases accounting Software seven electronic financial Spread sheet tools to provide efficient decision-making. Electronic accounting practices have provided saving of time, synchronous and comparable presentation of financial statement become easier on the other hand, the electronic audit concept has been brought forward by carrying out the audit activities through electronic environment by means of electronic entries and documents

Medical education is one of the most challenging, demanding, and stressful fields of study, among other fields of education. Hence MBBS students are expected to acquire diverse competencies such as academic, clinical, and interpersonal skills.The survey-based study was conducted  to know the opinion of MBBS students regarding the teaching practices in medical college.Objectives: To Study and compare the Effectiveness Of Digital Teaching Versus Blackboard teaching Perception Undergraduate Medical  StudentsMethods:  A comparative study was conducted at Government Medical College, Suryapet, Telangana. Two hundred medical students (n = 200) were divided into two groups.Results: In our study results showshighly significant, P value is less than 0.0001 by conventional criteria, this difference is considered to be extremely statistically significant. Conclusion:From the results it can be concluded that students are much interested in digital learning  (power point presentation).Hence we can conclude that computer based learning is a new and important tool for a medical teacher for better delivery of the lecture.

To Compare the ease of insertion of 26/27G spinal needle with and without short introducer (21G) needle while giving sub arachnoid block(SAB), to assess the number of attempts and the duration of procedure.
Background:
SAB is one of the commonest techniques used in anesthetic practice for obstetric patients and other infra umbilical procedures.          One of it’s most distressing complication is post dural puncture headache(PDPH). Smaller gauge and pencil point needles are designed to reduce PDPH. A 21G introducer needle can be used as a tool for stabilization as it allows for the placement of a fine gauge needle of 26G/27G during SAB. Such needles are used to reduce the incidence of PDPH.
Method:
40 patients who required SAB for infra umbilical procedure were included in this randomized control study. 20 patients were randomly allotted in each group. Group A included patients requiring SAB given with an introducer needle and Group B included patients requiring SAB but without an introducer needle. The ease of insertion, number of attempts and duration of the procedures was assessed. Data was compared using Fisher’s exact test.
Results:
 Analysis of results revealed that while performing SAB ease of insertion was better with introducer needle (P=0.019 ,Group A 95% & Group B 60%) and there is no significant difference in number of attempts between both the groups(P=0.069) and no significant difference in the duration of performing SAB (mean±SD:47.8±9.4 group A vs 46.7±10.7 group B/P=0.7).
Conclusion:
The use of an introducer needle with fine gauge spinal needle for SAB was resulted in easier insertion for obstetrics and all infra umbilical surgical procedures

Comparison and evaluation of the biting power and chewing efficiency of the all-on-four treatment concept, an implant-supported overdenture, and a traditional full denture are the objectives of this abstract study.
Materials and the Methods: The study had a total of 15 individuals who were missing all of their teeth and conventional full dentures were created for each of them. Patients were separated into their own respective groups. In Group 1, patients had their full dentures replaced with an implant-supported overdenture. In Group 2, patients had their full dentures replaced with a hybrid denture that was supported by the all-on-four treatment approach. When chewing three meals of varying consistencies, the biting force was measured with a bite force sensor, and electromyographic recordings of the masticatory muscles were produced using an electromyogram.
Statistical Analysis Carried Out The statistical analysis of the data was carried out by utilizing SPSS version 22.0 software. The paired t-test was used for comparing the data within each group, while the unpaired t-test was utilized to compare the data between groups.
Results showed that there was a statistically significant difference between the overdenture and total denture groups in terms of biting power and chewing efficiency for the all-on-four treatment concept. The all-on-four treatment idea was seen to have the highest biting force and chewing efficiency, followed by the implant-supported overdenture treatment concept, and then the full denture treatment concept.
According to the findings of the study, persons who are entirely toothless and have atrophic posterior alveolar ridges can be successfully rehabilitated with better biting power and chewing efficiency by using the All-on-four therapy approach.
All-on-four treatment idea, biting force, chewing efficiency, total denture, and overdenture

Background: Surgery is the treatment of choice for perianal fistulas aiming to avoid recurrence and preserve anal sphincter function. Successful surgical management requires accurate preoperative assessment of the course of primary fistulous track and the site of any secondary extension or abscesses. Imaging played limited role in the past when conventional fistulography was used, which has low diagnostic accuracy (~16%). Perineal/endo-anal ultrasonography is the first imaging technique that provides anatomical details of anal canal, and can identify primary fistulous tracts and internal openings with good accuracy. However, the limited field of view is an inherent limitation, discounting its value to evaluate secondary tracts or supralevator extensions. With the advent of MR fistulography, imaging now plays a crucial role, providing detailed anatomic descriptions of the fistula along with its relationship with anal sphincter complex.
Materials and Methods: Single-centre, descriptive study was carried out in 96 patients who had clinically diagnosed perianal fistula, using MR fistulography and ultrasonography, were followed up and correlated with surgical findings
Results: Out of the total 96 patients, 78 were males and 18 were females. Majority of patients (34) belonged to 30-40 years age group (35.4%). Maximum patients were showing inter-sphincteric type (41.6%) according to Parks classification, and grade 1 (31.2%) as per St. James University Hospital classification. For secondary track assessment sensitivity, specificity, accuracy of MRI and USG were 94%, 100%, 98% and 59%, 100%, 85% respectively. For detecting abscesses, sensitivity, specificity, accuracy of MRI and USG were 100%, 100%, 100% and 67%, 100%, 96% respectively. In localisation of internal opening, sensitivity, specificity, accuracy of MRI and USG were 87%, 100%, 89.5% and 90%, 100%, 92% respectively.
Conclusion: MR fistulography is the imaging modality of choice for preoperative evaluation of perianal fistulas with good accuracy. Perineal/endo-anal ultrasonography represent excellent first line imaging tool, especially for simple perianal fistulas

There are several key observations on paraneoplastic myopathies: The risk of cancer associated with DM is very high, whereas risk of cancer associated with PM is mildly increased Most cancers develop within one year of the onset of myositis, although the risk remains high up to 5 years after diagnosis. The most common cancers associated with DM are adenocarcinoma, including lung, ovary, cervical, stomach, pancreas, colorectal and lymphoma, whereas PM is associated with a high risk of lymphoma. The clinical course of myopathy is closely linked with the course of cancer. Certain clinical features are associated with CAM including severe treatment resistant skin manifestations, severe muscle weakness, respiratory muscle weakness, and dysphagia, while some clinical features are protective such as arthritis, Raynaud, and ILD. Screening should be based on age, gender, ethnicity, and the geographic area of the patient; however, certain high-risk patients may require more extensive screening including tumor markers and thoracoabdominal-pelvic CT scans. Certain autoantibodies including anti-p155 and the absence of more common autoantibodies are associated with a higher risk of CAM, while the presence of antisynthetase autoantibodies lowers the risk for CAM. Although the pathogenesis of CAM is unclear, a plausible hypothesis is that immune responses generated against antigens commonly targeted in myositis are related to antitumor responses in affected individuals

Tuberculosis is a highly contagious disease caused due to Mycobacterium tuberculosis infection. Though the methods of treatment of the disease have been standardized since long, many people, especially in the developing countries, still succumb to it. According to recent statistical figures published by the World Health Organization (WHO), 10.4 million new cases of TB were reported worldwide in the year 2015 alone. Here we presented a case of 30-year-old female patient was brought to casualty with history of 5 episodes of generalized tonic-clonic seizures since morning. There was no postictal confusion. These complaints were associated with headache and nausea. There was no history of fever, blurring of vision, diplopia or altered sensorium. There was no history of trauma or similar episodes in the past. Patient is a known case of pulmonary tuberculosis, and has received anti tubercular therapy for 6 months, 7 years ago. Low concentrations of anti-TB drugs should be dealt with extreme caution as it may influence the pathogen’s drug susceptibility and the short-course treatment strategy for fighting TB. A better and easier way to overcome low serum concentrations of anti-TB drugs is to prescribe high doses for TB treatment, subject to prior verification of absence of adverse effects and cross drug resistance. Taking also into account the increase in adverse effects and the host/bacterial factors, It is becoming a critical point to identify if those patients in whom high-dose treatments are truly cost-effective.

Hygienic standards in pregnant female is of particular concern as it directly affect the outcomes of pregnancy. The objective of the study is to assess the physical, environmental and personal hygienic standard in tribal pregnant women of Punjab region. The interview with structured questionnaire was used to assess the hygienic standard in this group. The present study showed poor personal and environmental hygiene of tribal pregnant women. The majority 128 out of 300 (42.6%) are living in bad physical and environmental hygienic conditions, 139 out of 300 (46.3%) are living in average conditions and only 33 (11%) are living in good hygienic conditions. Study shows that majority 264 out of 300 (88%) followed average personal hygiene practices and 36 out of 300 (12%) showed bad personal hygiene practices. None of the respondent was observed to practice a good personal hygiene. It showed that the respondents need to be aware of better physical, environmental and personal hygiene practices.

Postpartum hemorrhage is one of the major causes of maternal mortality and morbidity especially in the developing countries like India. It comprises of approximately 25% of maternal death worldwide. In EASY GIDEON suture, both uterine artery compressions with simultaneous anterior and posterior uterine wall compression is done to obliterate the uterine cavity hence controls the bleeding during cesarean section in lesser time.
Objective: To study the efficacy of EASY GIDEON suture in management of postpartum hemorrhage in cesarean section.
Methods: It was single-center hospital based prospective study conducted in the department of obstetrics and gynecology, PMCH. About 50 cases in which medical management failed to control PPH were selected (during Sept 2018 TO March 2020).
Result: The success rate of EASY GIDEON was seen in almost all cases in the present study. Most of them are regularly menstruating.

Pancytopenia is diagnosed when there is a reduction in all three hematopoietic cell lines. Till date there is limited number of studies on the frequency of various causes of pancytopenia. Of these some have been reported from the Indian subcontinent. There appears to be a changing spectrum of pancytopenia over the past two decades. The objective was to study the etiopathological spectrum of adult patients with pancytopenia over a period of one and half year.
Material and Methods: The Prospective and retrospective observational study was conducted in the Department of General Medicine Aiims Patna Bihar,. A total of 120 Patients were included in the study. All patients gave their consent to take part in the study and were subjected to a questionnaire regarding symptoms, past relevant history, lifestyle and detailed clinical examination and investigations as mentioned in materials and methods.
Conclusion: Pancytopenia is not a disease itself. It is a hematological feature of varying etiology with slight male preponderance. Megaloblastic anemia along with mixed nutritional anemia is leading cause of pancytopenia in India followed by infections being second and aplastic anemia and acute leukemia being third common causes

This study was conducted to compare  Clomiphene Citrate Vs Letrozole for ovulation induction in infertile PCOS women.
Methods: This study includes 200 infertile PCOS women attending GOPD Department of Obstetrics and Gynaecology, NMCH from January 2021 to  December 2022. The patients were divided in two groups. 100 women received 100mg CC once daily from D2-D6 of cycle. 100 women received 2.5 mg Letrozole once daily from D2-D6 of cycle – both groups for 3 cycles each.  Follicular monitoring was done daily from D12-D16 of cycle. Inj HCG 5000IU was administrated IM when atleast one follicle with a mean diameter of more than equal to 18 mm was achieved. After 36 hours of HCG administration ovulation was confirmed on ultrasound.    
Results : Both groups were comparable with respect to age, BMI and mean duration of infertility. Both groups were compared with respect to number of follicles, mean diameter of largest follicle, rate of ovulation, mean endometrial thickness and serum progesterone level on D21 of cycle. The number of mature follicle was significantly lower but but the endometrial thickness and ovulation rate was significantly higher in Letrozole group than CC group. Conclusion: My study showed that Letrozole has better ovulation rate than CC and should be considered as 1st line drug for ovulation induction in infertile PCOS women

Thyroid hormone is important for the normal function of the auditory system. Thus, the present study was undertaken with the objective to evaluate the audiological profile of Hypothyroid Patients at Tertiary Care Hospital in Himachal Pradesh.
Material & Methods: Between September 2020 and June 2021, a cross-sectional study was done on hypothyroid patients came in OPD at Otorhinolaryngology Department of the Pt. Jawahar Lal Nehru Government Medical College and Hospital, District Chamba, Himachal Pradesh. After confirmation of hypothyroid status based on FT3, FT4 &TSH level, their socio-demographic characteristics were assessed and audiological assessment was done by pure tone audiometry. Patients were categorized on the basis of maximum hearing threshold intensity level. Data was analysed using Epi info V7 Software.

Drug promotional literatures are one of the important sources of drug
information to the physicians provided by pharmaceutical companies through medical
representatives. Information provided in the promotional literature should be factual, evidence
based, unambiguous and balanced(benefits and risks).
Objective: To evaluate the rationality of drug promotional literature using World Health
Organization(WHO) guidelines.
Material and Methods: This is a Cross-sectional, observational study, conducted at the KBN
teaching and general hospital, attached to KBN University-Faculty of Medical Sciences,
kalaburagi over a period of 6 months. Drug promotional literature was collected from the out
patient departments of KBN teaching and general hospital, kalaburagi. Drug monographs,
reminder advertisements, drug lists, ayurvedic medicines, literatures promoting medical
devices, equipments or orthopedic prosthesis and literature promoting more than two brands
were excluded.
Results
We analysed 190 drug promotional literatures (DPL). Of which majority of DPL were of
antimicrobial agents (20.52%). Other included drugs acting on cardiovascular system
(17.36%), anti-diabetic drugs (16.31%), Analgesic agents (8.94%), and least being DPL on
drugs acting on Gastrointestinal tract (2.10%). On analysis as per WHO criteria, all DPL
mentioned brand names and generic names. More than 75% of DPL presented the beneficial
points of the drug like pharmacological effect(93.15%), clinical indication(85.78%), dosage
form and strength of the drug(84.21%), dosing interval(79.47%) and less than 15% of DPL
presented data on drug safety like adverse effects(4.73%), precautions and warning(13.15%),
contraindications (6.31%), drug interactions(11.05%), special situations (2.63%) and
overdosage(1.05%). 91.57% of the DPL mentioned Name and address of manufacturer and
distributor for correspondence. Reference to scientific literature was quoted in < 50% of
DPL(49.47%) indicating the lapse in providing evidence based scientific information

Fractures of distal radius account for 20% of all fractures treated in emergency department. These fractures result from low energy injuries in elderly population and high energy injuries in young adults. Most of these fractures are relatively uncomplicated and are effectively treated by closed reduction and casting. However, fractures that are unstable intra-articular can jeopardize the integrity of the articular congruence and kinematics of articulations resulting in high prevalence of complications. So to overcome these above complications, there is a shifting trend towards surgical management.

Tobacco smoking has been recognized as the most important risk factor for chronic obstructive pulmonary disease (COPD) for a long time, but recent studies have shown that non-smokers also contribute to a significant proportion of COPD. The aim of the present study is to explore the different causes of non-smoker COPD patients and to assess their clinical profile

The modern coronavirus infectious disease COVID-19 has been labeled internationally as a pandemic and is considered an emergency to the public health. Many studies were targeting university students as they play a great role after healthcare workers in relaying and spreading the awareness of COVID-19 and its preventive measures among colleagues, families, and friends. Therefore, it is of great importance to increase the knowledge and awareness about COVID-19.
Objectives: In this review article, we compare the most relevant studies that measure health awareness and attitude towards the COVID-19 pandemic.
Method: The articles are obtained from electronic databases such as PubMed, Science Direct and Google Scholar that are published during 2020.
Conclusion: Most studies showed high level of awareness among university students, and social media was found to be their main source of information. Among all the selected research papers, we found that the studies conducted in both the United Arab Emirates and Qassim Universities showed results that may be comparable to our topic

Identification of a patient with regional neck node metastasis and treating them accordingly is very important so as to reduce the mortality associated with head and neck malignancies. The study was conducted in a tertiary care center in Maharashtra. Determination of neck node metastasis is important in cancer bearing patients especially when it comes to deciding the further line of management and also is of prognostic significance. The aim of this study was to correlate the evidence of neck node metastasis on both clinical as well as histopathological examination. The most common tumour and nodal staging at presentation were also found out
Methodology: A proforma was filled out for each patient with head and neck malignancy from the medical registry that has underwent any type of neck dissection along with resection of primary tumour.
Results: The sensitivity and specificity of clinical examination for neck node metastases was found to be 70.59% and 60.61% respectively. The positive and negative predictive values for the same is 48% and 80% respectively. Most of the patients presented with a tumor stage of T2 but when it came to nodal staging alone, 50% of the patients did not have any clinically palpable cervical lymph nodes.
Conclusion: The study showed how important is it do address the neck electively in a case of head and neck malignancy along with resection of primary tumor as even in cases where neck nodes were not palpable clinically there was evidence of neck node metastasis on histopathological examination.

Introduction: To assess the effect of education level and previous anaesthesia exposure on knowledge of anaesthesia and role of anaesthesiologist
Method: 112 patients above the age of 18 years undergoing any elective surgery were enrolled in the study. They were asked to fill out a questionnaire containing questions related to anaesthesia, anaesthesiologists and their concerns and perceptions about risks related to anaesthesia. Each question had multiple choices. The patients were divided into two groups of 56 each i.e. Group A consisted of patients with previous anaesthesia exposure and Group B consisted of patients without previous anaesthesia exposure and data was compared.
Results: Out of all patients who had only a secondary school education or lower, only 38% had knowledge about anaesthesia and were able to correctly answer questions about role of anaesthesiologist and why preanaesthesiacheckup was necessary, whereas 62%  did not know importance of preanaestheticcheckup and role of anaesthesiologist. In patients who had graduate or post graduate level of education, 60% were able to correctly answer questions regarding importance of preanaestheticcheckup and role of anaesthesiologist, whereas 40% answered incorrectly.Of all patients in Group A (Previous anaesthesia exposure), 71% of patients were able to correctly answer questions relating to importance of Preanaestheticcheckup and role of anaesthesiologist, whereas 29% answered incorrectly.In Group B (No previous anaesthesia exposure), only 20% were able to correctly answer questions relating to importance of preanaestheticcheckup and role of anaesthesiologist, whereas 80% answered incorrectly.
Conclusion: It can be concluded that patients who had a higher level of education and/or had previous anaesthesia exposure were more aware of the importance of preanaestheticcheckup and role of anaesthesiologist.

Aim and objectives: Hence this study is being taken up for clinical as well as USG estimation of birth weight close to delivery date and to find their accuracy when compared to actual birth weight of the neonates.
Materials and method: This Prospective cross-sectional comparative study was conducted at Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri Pune from September 2020 to September 2022. Singleton pregnancy with vertex presentation at term (37-40 weeks) who had gestational age confirmed by dates and early trimester ultrasound scan.
Results: Among study population, 86.4% had a liquor between 8-15 cm. There were 4.5% participants each with liquor less than 8 cms, between 16-20 cms and above 20 cm. Weight estimation by the two methods had no statistically significant difference. However, clinical method was found to be slightly more accurate for estimating the antenatal foetal weight.
Conclusion: Clinical and fetal weight estimation is one of the easiest and cheapest method which can be applied in any setup like in rural areas, where facilities for ultrasound machine may not be available. So, clinical method does have the advantage over the other.

Introduction: Circumcision is a painful procedure in children for which various methods are being used for pain relief. The aim of this study was to compare caudal block and penile block using ropivacaine for post-operative analgesia in paediatric patient posted for circumcision.
Methods and Materials: It was a prospective, randomised, double blinded study over a period of 6 months in 40 male patients, age between 1-7 years. The patients were divided in to two groups 20 each. GROUP C received caudal block with 0.2ml/kg of 0.25% ropivacaine by 23-G 1½ needle through sacral hiatus. GROUP P received penile block with 0.2ml/kg of 0.25% ropivacaine by 23G needle. The postoperative pain was evaluated by FLACC (Face, Legs, Activity, Crying and Consolability) pain Scale. The patient's Postoperative pain was recorded using emergence numerical pain score on a scale of 0-10: The Facial expression, Leg activity, Crying and Consolability and on Visual Analogue Scale (VAS) score.
Results: We found that the mean pulse rate in Group C was less than Group P which was statistically significant at 4, 8, 24 hours. But the changes were not clinically significant. It was found that the mean VAS Scores were on lower side in Group C when compared to Group P. The mean VAS Score ranged from 2.5 to 4.75 in Group C and 3.4 to 5.45 in Group P.
Conclusion: We have demonstrated that although penile block is a safe and effective method of providing post-circumcision analgesia, Caudal block is superior in terms of its reliability, prolonged duration of action and in reducing post-operative pain score.

The goal of this study was to assess the incidence of soft tissue injury in operative tibial plateau fractures by clinical examination, stress radiography and to understand the ligament injury pattern associated with these fractures according to Schatzker’s classification. A total of 50 patients who were operated for tibial plateau fracture were included in this study. Soft tissue injuries like meniscus, anterior/posterior cruciate ligaments and medial/lateral collateral ligaments injuries were assessed by clinical examination and were confirmed on stress radiography. The total incidence of soft tissue injury in our study was 58%. The rates of soft tissue injury in types IV and II (respectively, 80 and 38 %) were higher than those in other types. The meniscus injury was the most common soft tissue damage, with the incidence of meniscus injury was 26%. None of the patients in our study had a pre-operative MRI done and thereby none were preoperatively diagnosed with any soft tissue injury. The functional outcome of these patients was assessed using standard knee scores. Tibial plateau fractures frequently have important soft tissue injuries that are difficult to diagnose on physical examination. A significantly higher incidence of ligament injury is seen in high-energy fracture patterns (Schatzker type IV, V, VI) and a careful evaluation to rule out a spontaneously reduced knee dislocation is important in such patients. We believe MRI scanning should be considered for tibial plateau fractures due to high-energy mechanism, allowing identification and treatment of associated soft tissue injuries.

Introduction: Ludwig’s angina is a fatal infection of oral cavity involving the submental region and neck which often leads to stridor and respiratory distress.
Case history: 19-year lady with Ludwig’s angina following dental sepsis presented for surgical drainage. After clinical and radiological pre operative evaluation she was taken up for surgery under General anaesthesia. Bougie assisted Intubation with 6.5 ETT using C MAC was done and septic focus was drained. 
Discussion: Any one of the following modalities namely elective tracheostomy, awake nasal intubation orvideo assisted fibre-optic intubation can be considered in LA.The choice of airway management must be customised depending on the patient characteristics, disease extent and expertise of the anaesthetic team
Conclusion: Fibreoptic intubation is a novel and less invasive method of securing airway in patients with deep neck infection and should now be a suitable substitute for the gold standard tracheostomy in managing LA.

Aim: The objective of the present study was to assess the anatomic variants of hepatic artery in contrast enhanced computed tomography scan of abdomen.
Methods: The Prospective Study was conducted at tertiary care Hospital where 300 patients were included in the study. Institutional Ethical Committee (IEC) clearance was obtained before the start of the study. Informed consent and written consent were obtained from all the parents/guardians.
Results: Maximum number of study individuals were belonged to 51-60 years age group (29%), followed by 20-30 years age group (25.7%). There were 143 females and 157 males in the study population. Among the study population, 267 (89.00%) individuals had complete course of right hepatic artery (i.e.no accessory hepatic artery and no aberrant hepatic artery). 24 (8%) individuals had aberrant right hepatic artery while 9 (3%) individuals had accessory right hepatic artery. Among the study population, 260 (86.00%) individuals had complete course of left hepatic artery (i.e.no accessory hepatic artery and no aberrant hepatic artery). 27 (9.7%) individuals had aberrant left hepatic artery while 13 (4.3%) individuals had accessory left hepatic artery.
Conclusion: Knowledge of variant anatomy is important prior to surgical and interventional procedures which can reduce the incidence of post-operative complications.

Asthma –COPD overlap is characterized by persistent airflow limitation with several features usually associated with COPD. It is identified in clinical practice by the features it shares with both asthma and COPD. A stepwise approach to diagnosis is advised, with recognition of the presence of chronic airway disease, syndromic categorization as characteristic asthma, characteristic COPD or ACO, confirmation of chronic airflow limitation by spirometry and, if necessary, referral for specialized investigations. The aim of the study was to determine the prevalence and to study various clinical characteristics of the patients with ACO.

Background: The study was conducted with the aim to evaluate the management of distal tibial fractures with IM nailing, external fixator and MIPO and determine which one is optimal for each individual patient.
Methods: A total of 60 patients were treated for distal tibial fracture using different modalities according to the fracture pattern and skin condition. Clinical, functional and radiological evaluation was done for each modality. Patients were assessed for complications like ankle
stiffness, wound discharge, non-union at each follow up.
Results: The mean AOFAS score was highest in the patients treated with MIPO followed by IM nailing and External Fixator and the difference was statistically significant. Most of the complications were found in the patients treated with External Fixator followed by MIPO and IM nailing. And most number of varus and valgus deformities were found in the patients treated with External Fixator and IM nailing and least in the patients treated with MIPO.
Conclusion: MIPO was a better treatment modality than IM nailing and External fixator from clinical, functional and radiological perspectives.

The venous system of the brain is a complicated system that is distinct from the venous systems of the other sections of the body because it does not adhere to the standard pattern of the cerebral artery system.¹Both the cerebral veins and the dural sinuses lack valves and do not have tunica muscularis, which would otherwise enable the veins to enlarge and stay dilated in response to even prolonged blockage. Because veins do not have valves, blood can flow in both ways via them, which can lead to an infection spreading throughout the brain from the scalp and mastoid air cells. In order to diagnose normal variant cerebral venous sinus, it is vital to have knowledge of the normal variant in the anatomy of the cerebral dural venous sinus visible on magnetic resonance (MR) venography.¹The precise functions of the major dural venous sinuses vary from one another depending on their position inside the cranium and the related structures of the cranium that are traversed by the sinuses. ²

A rare chronic inflammatory disorder with no known cause, Kimura disease (KD) is typically found in young Asian males. The condition is characterized by frequent enlargement of the salivary glands and a painless subcutaneous swelling in the head and neck region. Elevated immunoglobulin E (IgE) levels and eosinophilia in the blood and tissues are frequently associated. Eosinophilic infiltrates, follicular hyperplasia, and postcapillary venule proliferation are typical histological findings of biopsy specimens taken from subcutaneous swellings or lymph nodes. Even so, the course is typically benignly waxing and waning. A patient who receives an early diagnosis may avoid needless intrusive procedures. In this article, we describe a case of KD in a 40-year-old man who had two surgical procedures for subcutaneous edema in the left submandibular region before being  reassessed and finally diagnosed  as KD  in 2022, based  upon peripheral blood eosinophilia, raised serum IgE levels and histopathological
findings. He subsequently made a good recovery on oral steroids.

The Montgomery T tube is a device which will be used as a combined tracheal stent and an airway after laryngotracheal surgery.The device is used mostly in specialized centres for head and neck surgery and therefore many anaesthetist may be unfamiliar with its use.
          Removing the T tube is more complicated as inserting it as the airway might collapse and securing the airway will be impossible.  The choice of airway maneuvers must be individualized depending on the severity of the stenosis and experience of the anaesthetic team
          We have reported a case of 15yr old female o/c/o tracheal stenosis due to prolonged intubation with tracheostomy and T-tube insitu came for T-tube removal with a brief review of airway management options

Turkey is in a strategic position in terms of its geopolitical position and therefore it is the center of a continuous migration movement. While this mobility was mostly due to the fact that our country was a "transition country" in the past, it has become a "target country" in the last twenty years. Although the act of migration is defined as only human mobility, it includes the process of trying to live in a completely new culture and society for immigrants, trying to exist without losing their own identity by going beyond the usual patterns, and adapting to a new order as an individual and as a society. In this context, the phenomenon of social integration gains importance. It is crucial to look at the current traffic information, attitudes, and behaviors of the students in order to reveal solutions in terms of social policy in this direction. This is because foreign students need to develop the social skills necessary to adapt to our country and the rules of our country. The aim of this study is to examine the attitudes of foreign primary school students to comply with traffic rules and to propose solutions in terms of social policy. In the research conducted with the relational scanning model, the participants consist of 232 foreign national primary school students between the ages of 8-10 studying in Ankara. The data of the research were collected with the "Traffic Rules Attitude Scale" developed by Tahiroğlu (2012) and consisting of 21 items. SPSS 22 was used for data analysis. The data from the study led to the conclusion that most foreign students had low attitudes toward following traffic laws and that students generally had negative opinions toward traffic safety laws. It has been suggested to give traffic education in the context of social policies.

Common terms for urolithiasis include kidney stone. Urinary calculus is very old disease and its history dates back ancient to the earliest period of society. In order to treat kidney stone illness, the formed stone must be removed, either by dissolving it or breaking it up into little pieces so that urine may flush it out of the urinary tract. Therefore, it is necessary to create a potent polyherbal formulation for measuring urolithiatic activity. The potent antiurolithiatic herbs were chosen for this study's polyherbal tablet in order to evaluate its antiurolithiatic effectiveness. Using wistar rats, the antiurolithiatic activity of tablets was evaluated against renal calculi caused by ethylene glycol.

In the present article analysis of COVID on real estate in the Indian context has been developed. It has been detected that 53% of real estate investments fall during the phase of COVID. Here in the current analysis objective has been set for evaluating the impact of COVID on housing prices and equity share crunch. Primary data collection has been used for the data collection process. 100 Indian real estate owners and industrialists have been selected by using simple random sampling. From the data analysis, it has been noticed that developed policies and poor resources makes pressure on the real estate market in the Indian context

Objectives: To compare the clinical and radiological outcomes of distal tibial Metaphyseal fractures fixed with distal tibial locking plates with or without lateral malleolus fixation.
Methods: Among 40 patients fixed with distal tibia locking plate from 2016 to 2021, 22 cases were fixed with lateral malloelus and 18 cases without fixing the lateral malleolus. The AOFAS was analysed to know about the clinical outcome and Lateral distal tibial plafond angle(LDTA) was measured after 6 months after fixation and compared.
Results: The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-hind foot score average was slightly reduced in lateral malleolus not fixed group, but significant reduction was noticed in lateral malleolus not fixed group

Background: To compare the safety &Efficacy of topical Quick penetrating solution of Heparin 1000 IU/ml to Heparin gel 200 IU/g in the management of post infusion superficial thrombophlebitis. Method: 100 Patients aged 18-60 years having grade 2-4 superficial thrombophlebitis based on phlebitis scale were randomized to receive either Heparin QPS 1000 IU/ml or Heparin gel 200 IU/g. It was applied over the phlebitis lesion 3 TDS×7days. Length of venous lesion graded as per “Standards for Infusion Therapy” phlebitic scale& Local symptoms graded on 4 point severity scale. Change in venous lesion and local symptoms were assessed on day 3 and complete healing on day 7. Global assessment by patient done at the end of study. Results: 3^rd day change in the length of venous lesion with Heparin QPS(16.44±8.54)to heparin gel(21.26±11.25),(P=0.0177)Change in local symptoms, fall in tenderness(p-0.0065) & raised local temperature(p-0.0029) with QPS.  Complete healing on day 7 was found to be 90% compared to 58% with heparin QPS to gel(P<0.001) Also significant fall in percentage of patients with grade 2&3 were reported  in those treated with QPS to gel(p=0.017)Most of the patients graderd Heparin QPS excellent(p<0.0001). Conclusions: Heparin QPS was found to be more effective in the treatment of post infusion superficial thrombophlebitis expressed by complete healing of the venous lesion as compared to heparin gel. Significant reduction in length of venous lesion from baseline, with fall in percentage of patients with grade 2&3,fall in local symptom scores on day 3.Significant proportion of patients completed healing on day 7.

There is presently no ideal provisional material suitable for all clinical conditions. A material for the fabrication of multiunit interim prostheses for longer duration of time it can be reinforced with different materials. Which materials is best for increasing the fracture toughness of material is unclear, therefore it is necessary to evaluate effect of different reinforcements and the best material suitable for increasing the fracture toughness of provisional materials.
Purpose: The aim of the study was to evaluate and compare the fracture toughness of chemically cure and dual cure interim fixed partial denture materials with different methods of reinforcement.
Methodology: A stainless steel jig was fabricated with standard specifications. A urethane based dual cure resin (Tuff temp plus) and bis acryl based self cure (Protemp 4) interim restorative materials were used for fabrication of samples. Glass fibers, Braided glass fibers, graphene oxide nanoparticles and stainless steel mesh were used as reinforcement materials. Total 100 samples were fabricated and divided according to interim restorative resins used. Samples were further divided into five subgroups of each group having 10 with each reinforcing material. Unreinforced samples were fabricated as control groups. The fracture toughness values for each sample were measured using Universal testing machine (Dak system inc, series 7200).
Statistical analysis: ANOVA test, Tukey’s post hoc test.
Result: All the reinforcements have shown statistically significant increase in fracture toughness values for both the groups. Among all the reinforcements for group I (Tuff temp plus) statistically significant fracture toughness values were obtained with graphene nano particles (519.5±109.91), stainless steel mesh (505.1±108.15), braided glass fibers (382.23±32.3) and Glass fibers (374.9±75.08) in comparison to control group (P<0.05). Whereas for group II all the reinforcements, graphene nanoparticles (574.7±111.86), stainless steel mesh (561.7±28.44), braided glass fibers (443.2±130.05) and glass fibers (426.6±111.86) showed statistically highly significant values in comparison to control group (P<0.05).
No significant difference was observed in comparison of fracture toughness between group I and group II control and reinforced specimens.
Conclusion: When compared to control groupall the reinforcement materials produce significantly higher fracture toughness for both UDMA resin (Tuff temp plus) and bisacryl (Protemp 4).Reinforcement of both types of resin with graphene oxide nanoparticles and stainless steel mesh provides higher fracture toughness in comparison to glass fibers and braided glass fibers. No statistically significant difference was evident between UDMA and bisacryl resin.

To reiterate the extent of problem of Monkey pox in our country and to acknowledge the problem and to implement the preventive measures as suggested by the Indian government (ICMR guidelines) by Health care professionals as well as Indian public.
Objectives: Monkey pox is a zoonotic infection caused by a virus that belongs to DNA family Poxviridae. Recently there has been upsurge in the number of monkey pox cases in our country. This has led to increase in the awareness programs in our country by WHO as well as Indian Government. Especially with strict implementation of preventive measures this viral disease can be easily preventable as happened recently with smallpox virus which belongs to same family. This review of literature is made simple for the awareness of the preventive measures suggested by WHO for health care professionals as well as general public. This DNA virus shows mutations less frequently compared to COVID -19 which has recently caused devastating Pandemic all over the world. An account on life cycle and pathogenesis is useful for further research in directing the different therapeutic modalities against the disease. Standard ICMR guidelines needed to be followed for laboratory diagnosis, treatment and prophylaxis of the suspected cases. Proper transportation of the appropriate specimens like nasopharyngeal swabs, skin lesion materials to apex laboratories through IDSP portal, in triple packing especially need proper guidelines suggested by WHO. This review can give overview on all the aforementioned aspects.
Conclusion: Monkey pox in our country is still less prevalent compared to western Africa. Proper awareness on laboratory diagnosis, treatment and preventive measures can almost all make it less significant disease in our country

This review aims to explore the use of cell block cytology in the diagnosis of oral lesions
Background: Utilizing the science of cytopathology is cost effective, fast, simple and accurate. Over the years, with the improvements in technical aspects and the appearance of cell block technique in cytopathology, the gold standard of “must have tissue to make an accurate diagnosis” is rapidly changing.
Review results: The review identified articles on use of cell block technique in oral lesions. The current research studies on this technique for oral lesions are very sparse. Most of the identified studies were limited to odontogenic lesions.
Conclusion: Though the cell block technique is being practiced for more than a century now for non-oral lesions, its practice among head and neck lesions is not up to par. Being cost effective, fast, simple, accurate and requires only a small tissue sample, its utilizing in oral diseases needs to be explored further

Pre-operative anaemia has been linked to poor outcomes in patients undergoing major surgical procedures. As a result, early detection and treatment of pre-operative anaemia is advised.
Objectives: to estimate the prevalence of anaemia in pre-anaesthetic clinic and requirement of perioperative blood transfusion.
Material and methods: The present observational study was done in the department of anaesthesiology at tertiary Centre for the duration of 6 months. A total of 200 patients were included in the study. Patients coming for preanesthetic checkup who were posted for elective surgery and of age 18-65 years were included in the study. According to WHO definition male patients with Hb less then 13gm% and female patients with Hb less then12gm% will be considered anaemic.
Results: The prevalence of preoperative anaemia in the present study was 64.5%. Anaemia was seen most commonly in the age group 21-40 years (34.9%) and most commonly seen in males (56.6%). Anaemia was seen in 23.3% of the patients with co-morbidities. Preoperative blood transfusion was done in 20.2% of the patients with anaemia.
Conclusion: In the preoperative patient, anaemia creates a unique set of challenges. A thorough history and physical examination, as well as a methodical approach to diagnostic testing, are required for an accurate assessment of anaemia.

In recent era, myofascial blocks are proving to be efficacious in relieving chronic pain conditions and post-operative pain relief. Ultrasonography, computed tomography, land mark techniques are being used for the same. The advantages of these techniques are that they are easy to perform with good analgesic effect and relatively safe

Unstable intertrochanteric fractures are treated surgically rather than being managed conservatively. It is essential to operate on these patients as fast as possible, and, at the same time, it is pertinent to ensure the operated patients do not go into malunion or implant failure. A study was conducted to check whether beta-tricalcium phosphate added in the void spaces of unstable intertrochanteric fractures could lead to better functional results.
Methods: 40 patients with unstable intertrochanteric fractures were admitted between October, 2020 and October, 2021, and follow-ups were conducted for one year. Out of 40 patients, half of the patients who were operated on were augmented with beta-tricalcium phosphate in the void spaces, which was considered as Group A, and the remainder were operated on with osteosynthesis alone, which was considered as Group B. The parameters used to measure the functional results were the Functional Ambulatory Category (FAC) score and the Harris Hip score (HHS). The patients were followed up radiologically with X-rays.
Results: 38 patients followed up; 19 patients were augmented with beta-tricalcium phosphate, and the remainder i.e., 19, were in the control group. The patients augmented with beta‑tricalcium phosphate showed a better FAC score which was significant at six months post‑surgery. It was observed that the HHS and the Visual Analogue Scale (VAS) score were better in augmented cases than in cases not augmented with beta-tricalcium phosphate, but were insignificant.
Conclusion: The group of patients augmented with beta-tricalcium phosphate showed better functional results six months post-surgery. This further leads to decreased morbidity and mortality post-surgery.

Background: CHARGE syndrome is a genetic disorder with autosomal dominance, involved in the mutated gene CHD7 on chromosome 8. The abbreviation “CHARGE” characterizes the association of coloboma, heart anomalies, choanal atresia, and retardation of growth, genital and ear anomalies. This is a case report of 1.6 year old male baby who underwent bilateral herniotomy. The surgical procedure called for mild support of manual ventilation until the thorax was opened and then regulated ventilation with judicious fluid management was done.
Intra-operative care of hypercarbia and hypoxia with meticulous post-operative surveillance was done. In this case satisfactory respiratory function and bilateral herniotomy was successfully done.
Case report :We report a 1.6 year old male child with case of CHARGE  syndrome . There are several features common in this disorder like coloboma, heart defects, choanal atresia, growth retardation, genital abnormalities and ear abnormalities. Here we are  discussing  the anaesthetic management for the same .
Conclusion: The anaesthetic care of a child  with CHARGE Syndrome  can be difficult. Although there are many problems associated to children with CHARGE Syndrome, and anaesthesia management is challenging and require expert skills. Early recognition and intervention can definitely improve the survival and outcome benefits. Assessing the risks of children with CHARGE syndrome should be monitored longer after surgery than the general paediatric population.

Implantation of blastocyst outside of the endometrial cavity leads to ectopic pregnancy, and it might lead to one of the acute abdominal emergencies.  Among all the ectopic pregnancies that occur, the abdominal ectopic pregnancy occurs less than 1% of the time. The incidence of ectopic pregnancy has increased in recent times, but easier diagnosis and prompt management has lead to a drastic decline in maternal mortality and morbidity.
Case Summary: A 26 year old female, Gravida 2 Para1 Living 1 came to OPD of our institution, with a positive UPT and complaints of bleeding since 1 day. On assessment, she was found to be tachycardic, with normal blood pressure, with guarding and right ilia fossa tenderness. Ultrasound was suggestive of a ruptured ectopic. Intraoperatively a diagnosis of Pimary Abdominal Pregnancy was made.
Conclusion: As the use of assisted reproductive techniques is on the rise, the complication of ectopic pregnancies is also rising in manifolds. But apart from all the risk factors that have been identified for these pregnancies, there are few cases that occur as sporadic cases with no such identifiable risk factors. Hence, only vigilance while history taking and basic clinical examination can reduce the mortality and morbidity associated with it.

Background: Central venous catheterization (CVC) is an important procedure for infant patients for different purposes like nutritional support, surgical operation, hemodynamic monitoring and medications. Different approaches for CVC in children are internal jugular vein, supraclavicular subclavian and infraclavicular subclavian. The purpose of this study was to evaluate the relative effectiveness and complication risks of these three cannulation locations in infants.
Method: Assuming the effect size of 0.5 between groups, at 5% confidence level and 80% power, 10 patients were randomly assigned to each group - Group A: right internal jugular vein, Group B: right supraclavicular subclavian, Group C: right Infraclavicular subclavian. Parameters assessed were - number of attempts, successful placement of central line at superior vena casa-right atrium (SVC-RA) junction, time for insertion, complications like arterial puncture, incidence for post-op local infection, hemothorax, pneumothorax, hematoma formation. Data was compared using chi square test and ANOVA test.
Results: Time taken for catheterization in Group C was the least followed by Group A then Group B. Number of attempts taken for a successful placement of catheter in 1^st attempt was maximum in Group C followed by Group A and B. It was noted that 2 of 10 patients had arterial puncture in Group A during catheterization. There was 100% successful placement in all 3 groups. No incidence of haematoma formation, haemothorax, pneumothorax, post-op local infection seen.
Conclusion: Infraclavicular approach takes the least amount of time and number of attempts for catheterization, with no incidence of any complications

In coronary artery disease (CAD) a mismatch exists between myocardial oxygen consumption and supply. Anesthetic goal targets balance between this supply and demand perioperatively for improved tissue perfusion. Studies show high thoracic epidural anesthesia (HTEA) helps to achieve this goal.
Aims and Objective: To find out the effectiveness of HTEA in achieving improved tissue perfusion as measured by mixed venous oxygen saturation (SvO2) in patients undergoing coronary artery bypass grafting (CABG).
Design of Study: Randomized control study
Material and Method: Prospective randomized control study, where patients undergoing CABG were randomized into 2 groups; Group A: general anesthesia with HTEA and Group B: general anesthesia with conventional opioids. The objectives were to compare SvO2, heart rate (HR), blood pressure [systolic blood pressure
(SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP)], pulmonary artery wedge pressure (PWAP) and blood lactate levels

Despite advances, little is known about the epidemiology of interstitial lung disease (ILD). The aim of this study was to understand Clinical, Radiological, and functional Profile of ILD patients attending tertiary care center in Pune, India.
Method: Prospective observational, study was conducted at Dr. D.Y. Patil Medical College, Hospital and Research, Pune. 50 known ILD patients, age 20 and above, who were attending OPD clinic and were willing to sign informed consent were recruited during July 2017 - September 2018. The information collected was age, gender, smoking habit, co-morbidities, symptoms, signs of ILD, ascultatory findings, area involved on auscultation, x-ray, CT scan and spirometer findings. Statistical analysis was done with mean, standard deviation, frequencies and percentages.
Results: Among 50 ILD patients, there was male dominance (58% vs 42%). Average age was 58.02 ±14.66 years. Most common symptoms were cough (100%) and dyspnea (94%). Most common radiological finding was reticular (54%) and nodular (52%). No patients showed sputum +ve for AFB. Infra- axillary and interscapular area involvement (each) was observed in 82% patients. Restrictive pattern was most common in spirometry (48%). CT scan showed presence of honeycombing pattern in 66% of patients. Diagnosis detected usual interstitial pneumonia (UIP) in 50% while non-specific interstitial pneumonia (NSIP) in 22% patients. UIP involved patients’ lower lobe involvement (25 left and 24 right).

We hereby report a case with rare combination of Guillain-Barré Syndrome (GBS), Deep Vein Thrombosis (DVT) and Pulmonary embolism (PE) during post-covid period.
A 67-year-old male presented with acute breathlessness and calf pain for seven days. He suffered from COVID-19 four weeks prior. He recovered fully then but was not on prophylactic anticoagulants.
His lower limb venous doppler confirmed DVT. CT Pulmonary Angiography (CTPA) confirmed PE. His neurological examination revealed bilateral diminished ankle jerks and Babinski flexion reflex, though he had no neurological complaints. Nerve conduction studies revealed acute motor sensory axonal neuropathy (AMSAN) variant of GBS.
He was treated with enoxaparin followed by rivaroxaban for thromboembolism and with intravenous immunoglobulins for GBS, to which he responded well. Early diagnosis of GBS saved him from further morbidity. Post Covid GBS has been rarely reported from India. Concurrence of GBS with DVT and PE is further rare.

Metabolic syndrome (MS) enhances the risk of cardiovascular diseases (CVD) and Diabetes Mellitus, but its frequency in Chronic Obstructive Pulmonary disease (COPD) is not yet investigated in detail. The study’s aim is to assess the prevalence and its correlation to the severity stages of COPD.
METHODS:
100 COPD patients were participated in this cross-sectional study. Metabolic syndrome parameters such as high-density lipoproteins, fasting blood glucose, blood pressure, triglycerides and body mass index with waist circumference were measured. Six-minute walk distance (6MWD), COPD assessment score and spirometry were used to determine the functional capacity.
RESULTS:
Prevalence of MS was found to be 46% with most common stages of COPD were Global Initiative of Chronic Obstructive Lung Disease grade I and II. FBS, HDL and WC were statistically significant with the severity of COPD

PNI has been described as a simple and objective indicator of negative outcomes not only in chronic conditions like hepatocellular carcinoma, chronic heart failure and various cancer types, but also in acute illnesses like acute coronary syndrome, acute heart failure and stroke. To the best of our knowledge, no research has looked at the potential usefulness of PNI for CCU patients. The aim of the study was to assess the correlation between prognostic nutritional index and short-term clinical outcome in terms of mortality in patients of acute heart failure.
Methods: This prospective observational study was conducted in the department of Medicine, for a duration twenty-four months among patients hospitalized in department of Cardiology diagnosed as acute heart failure. PNI was calculated by  using the formula= [10 x serum albumin(g/dl) + 0.005 x Total lymphocyte count(/mm³)]. The patient was followed up for 28 days after discharge. The results were analysed using descriptive statistics and making comparisons among various groups. The ROC was analysed to find optimum cut off of PNI for prediction of mortality.
Results: In present study 70 patients were enrolled during defined study period. The mean age of the study cases was 55.47±11.05 years. Out of 70 cases, majority 58.6% suffered with type HFmrEF, followed by HFpEF (27.1%) while type HFrEF was diagnosed in 14.3% cases. Out of 70 admitted cases, 67 (95.7%) were survived while 3 (4.3%) were expired. The PNI level was maximum in HFrEF type (48.4±6.4) and minimum in HFmrEF type (45.0±6.0). However no significant difference was found in PNI among various types of heart failure (p=0.214).The ROC analysis to find optimum cut off of PNI for prediction of mortality resulted an optimum cut off as PNI<45.04, which had the sensitivity 100% and specificity 64.18%. It concludes that all the mortalities had PNI score less than 45.04, however 64.18% (95% CI 52.95% - 75.41%) survived cases had PNI more than 45.04.
Conclusion: Nutritional management, may improve clinical outcomes while reducing hospitalization and medical costs, particularly in older patients with HF. As a result, for risk classification and therapeutic treatment of HF, a clinically meaningful nutritional index is recommended. PNI, which is clinically and easily accessible, was found to be an independent risk factor for cardiovascular death and overall mortality in patients with AHF who had either HFrEF or HFpEF in this investigation

Oral and maxillofacial surgical site infection (SSI) is a prevalent healthcare-associated illness (HCAI) that may add significant time and money to the recovery process for up to 10 percent of surgeries. New research and results should be evaluated for inclusion in recommendations to prevent SSIs. Antibiotic prophylaxis for clean surgery, pre-operative bathing/showering, and peri-operative oxygen supplementation to prevent SSIs are controversial. Antiseptic surgical dressings, post-operative negative pressure wound care and using chlorhexidine in alcohol as a skin preservative show promising results in preventing SSIs. Independent meta-analyses found that antimicrobial sutures lowered the incidence of SSI after most oral and maxillofacial surgeries, but wound guards had no effect. Oral and maxillofacial SSI is the most preventable HCAI, yet the rate at which it is occurring is increasing. It is important to include certain innovations in care bundles, while the additional study is needed for others, and compliance with care bundles must also be strengthened.

Caries is one of the common infections that occurs in the oral cavity and affects populations across developed and developing nations. Studies show that dental caries is still a major health problem in most industrialized countries affecting 60–90% of schoolchildren and the vast majority of adults.
Xylitol is a naturally occurring five-carbon sugar alcohol derived from plants and agricultural materials. The name relates to the word “xylose” (wood sugar) from which xylitol was first made, and which is, in turn, derived from the particular structure (xylene) of hardwood from which xylose can be obtained.

Given the extensive literature on Quality of Life and Prosthetic Satisfaction in Unilateral Knee Amputated Patients above 14 years of age, a systematic review was undertaken to explore the satisfaction with the use of prosthetics, motor abilities, and socioacceptance status. A secondary goal was to ascertain whether prostheses help the patient’s mobility and rehabilitation goals or not.
Methods: The database search included Google Scholar, Pubmed, and Elsevier from January 1, 2002, until August 31, 2022, for all articles included prosthetic satisfaction, amputation, and quality of life with prosthesis were included. 18 of the 1174 unique articles we found satisfied all inclusion requirements.
Results: In individuals with an unilateral knee amputation, the effectiveness of prosthetic satisfaction has been well shown. Even though many studies remark favorable, although little impact, there is evidence supporting the efficacy of or usefulness of prosthesis in amputated patients for increasing the quality of life and self-reliance in daily activities in people with one single lower leg.
Discussion and Conclusion: QoL is correlated favorably with prosthesis satisfaction. The majority of amputees looked to be happy with how well they performed overall. This indicates that prostheses are an important tool for amputees when selecting mobility aids

This study's aim was to conduct a systematic review to investigate whether respiratory endurance with core training enhances boxers' athletic performance. Methods: Identification of studies via PubMed, Scopus, Google Scholar, Web of Science, CINAHL, SPORT Discus, and SciELO between January 1970, and November 2022 were included in there view.
Results: 2540 citations that the search technique turned up, 29 of them matched the inclusion criteria, according to the systematic review's findings. When increased respiratory endurance and core strengthening were coupled, its how a noticeable positive effect on boxers' performance.
Discussion and Conclusion: In conclusion on, improving core strength and respiratory endurance in boxers will enhance their athletic performance. Closer attention required during athletic Competition and more aggressive progression of training intensity including respiratory endurance and core strengthening may show greater improvements in future studies.

Cholelithiasis remains one of the most common problems leading to surgical intervention. Over the past few decades several studies to determine the causes and risk factors of gall stone formation have been done. But some factors like Socioeconomic status, Alcohol intake, Smoking, Serum Cholesterol level, Family history, Total parenteral nutrition (TPN), Crohn’s disease are still considered controversial regarding the formation of gall stone. Therefore, this work has been done with a view to study its relation to the mentioned predisposing risk factors, So prophylactic plan like dietary improvement, change in life style (e.g. cessation of smoking & alcoholism) & others measures should be taken to avoid gallstone formation.

Anterior cruciate ligament (ACL) injuries impair quality of life of an athlete with the possibility of osteoarthritis if left untreated. The aims of the study were to analyse the pattern of chondral and meniscal injuries and the temporal association of severity of these injuries with delay in ACL reconstruction.
Material and Methods: In this prospective study, patients who underwent knee arthroscopy from Jan 2015 to Dec 2018 for clinico-radiologically diagnosed ACL tear were included in the study. Mode of injury, time from injury (TFI) to ACL reconstruction and intraoperative findings of chondral lesions, meniscal tears and other intra-articular injuries was recorded. The association between the index injury and whether there was any significant correlation between TFI, severity of chondral and meniscal lesions and mode of injury were analysed.
Results:429 male and 15 female athletes were included in the study with a mean age of 28.98±7.08 years,53.6% of patients in the 26–35 years age group. Twisting during running events was the most common mode of injury in 139(31.3%) patients. MeanTFI was 55.35±23.84(14-129) weeks. There was a significant correlation between the grade of the chondral lesion and TFI (p < 0.0001) as all grade III and IV chondral lesions were observed with a mean TFI of 69.9±4.23 weeks. The odds of finding a medial meniscus tear associated with a complete ACL tear were statistically significant when TFI was more than 59.3 weeks. There was a significant correlation between the incidence of medial compartment chondral injury and medial meniscus tear at a mean TFI of 55.3 weeks(p=0.007,OR=1.90) without significant correlation between lateral compartment chondral injury and lateral meniscus tear (p=0.91, OR=1.03).There was no significant correlation between a particular mode of injury and ACL tear.
Conclusions: The delay in treatment of ACL injuries greater than 70 weeks leads to higher grade chondral lesions and complex meniscal injuries in young athletes that can be avoided with early management of an ACL deficient knee

In India, adolescents account for more than one-fifth of the population. Many of them drop out of school, marry young, work in dangerous jobs, are sexually active, and are subjected to peer pressure. These variables have significant economic and public health ramifications. More over half of the adolescent girls were between the ages of 15 and 16. The majority of them (50.82%) were from the lower socioeconomic level, 78% were Hindus, 5.31% were married, and 17.55% of their moms were illiterate. Around 9.6% of adolescent girls had dropped out, with the primary reasons being marriage (38%) and not being interested (25%). Adolescent girls were married at a rate of about 5.31%. The average age of menarche, marriage and pregnancy was 13.54+ years, 17.5 1.29 years and 18.23 + 0.9 years, respectively. Majority of adolescent girls (53.06%) were underweight followed by normal (45.51 %), overweight (1.02 %) and obese (0.41%). About 95.31% of adolescent xii girls were anaemic. Around 69.59% of adolescent girls had mild anaemia and only 1.84% were severely anaemic.

A newborn is an healthy infant born at term and should have an average birth weight, cries immediately following birth, establishes independent rhythmic respiration and quickly adapts to change environment. Newborn care refers to caring of the normal baby to ensure that the baby is made comfortable, fed and enhances early attachment process. Any deviation associated with negligence in appropriate care may lead to increased infant mortality rate. Global estimates of the distribution of direct causes of neonatal deaths indicate that severe infections, preterm birth and asphyxia are the three major killers of neonates. With this direction, the researchers assessed the effectiveness of planned teaching programme on newborn care among postnatal mothers in a selected hospital at Mangalore, Dakshina Kannada, Karnataka

Emotional intelligence has been cited as one of the innovations in this century particularly valuable in testing the low-order personality trait, of which is the trait model of emotional intelligence. Another set of emotional intelligence test lies in the ability model, which is not assessed in this study. This study investigates the trait emotional intelligence and its association with working environmental factors, namely organisational culture, cultural competence and cultural awareness; and spiritual intelligence among 166 doctors working in five different state hospitals in Malaysia. The state hospitals chosen were from the 5 different regions in Malaysia, namely the Hospital Pulau Pinang, Hospital Raja Perempuan Zainab 2, Hospital Kuala Lumpur, Hospital Sultanah Aminah Johor Bahru, and Hospital Umum Sarawak. The results showed that the Schutte Self-Report Emotional Intelligence Test (SSEIT), Competing Value Framework (CVF), Cultural Competence Assessment (CCA), Spiritual Intelligence Self-Report Inventory (SISRI), Interpersonal Support Evaluation List-12 (ISEL-12), are significant, whereas Ten-Item Personality Inventory (TIPI) is mediocre in the Kaiser–Meyer–Olkin (KMO) test, and Bartlett’s test of sphericity shows that all are significant for Principal Component Analysis. The construct validity and reliability were tested for all these items and results were as shown. In conclusion, this pilot study has been successful in helping to form a desirable tool to measure emotional intelligence among doctors in government hospitals in Malaysia and its associated working environmental factors and spiritual intelligence.

Nematodes (Roundworms) are also known as strongylids parasites belonging to the order Strongylida, superfamily Trichostrongyloidea. Haemonchus contortus and Trichuris ovis species are most important nematode parasites, which are found in the gastrointestinal tract in the goat (Capra hircus). Molecular techniques were used to the identification of parasites and amplification is done with the help of ITS2 (Internal Transcribed Spacer 2) fragment of the ribosomal DNA. The present study revealed that the amplified the product band size of gastrointestinal nematode parasites were Haemonchus (325bp-MW595998.1), and Trichuris species (205bp-MW667589.1). The ITS2 sequencing and phylogenetic tree (Neighbour joining method by MEGA7.0 software) revealed 99 and 100% (Haemonchus contortus and Trichuris ovis) homology.

The study has clearly provided an idea of anti inflammatory responses of Cannabinoids against respiratory disorders. In that case, asthma can be considered as one of the major diseases and most of the individuals have been suffering from it. In that case, “human endocannabinoid system” can be considered as one of the complicated structures that are mainly responsible for producing signals. Therefore, the entire system of ECS includes ligand, enzymes, synthesis process and degradation. Cannabinoids can be obtained from the plant Cannabis Sativa plant. On the other hand, cannabinoids have the anti-inflammatory properties which can exacerbate the activation of CB2 signalling pathways. The study also demonstrates the derivative substances of cannabinoids has involved the inflammation process and also focuses on the immune responses. In this study, there were mainly two types of receptors mentioned and both of them belong from the G protein family. CB2 cells mainly activate and release proinflammatory mediators, which mainly act on the respiratory inflammation and also help in reducing the impact. In contrast, the activation of CB1 receptors directly impacts the bronchial nerve endings and it can be taken as a positive aspect for treating asthma.

This study is based on polysomnography which is also known as sleep studies. It helps to find out the sleep disorder and it also can recognize the pattern of sleep, brain waves, and frequencies. This process uses some seasons that are attached to the body of patients and those sensors are also connected to the computer by wires. It can records the all data of the body and professionals monitor the entire system and root problems of the difficulties. After finishing the whole test they prescribed medication, exercise, and other advice for the patient. It can improve the patient sleep problems and also make the improvement on the air passing ways by providing modern machines such as CPAP, and BiPAP. It provides a high flow of air that helps the person to recover from the disease.

Background: Gallbladder cancer (GBC) is a major cause of cancer mortality in parts of the world where it is common including India. Gemcitabine with cisplatin is currently the standard of care for pateints with advanced biliary tract cancers. The aim of the study is to Determine The Clinical Characteristics, Treatment And Outcome of Patients With Locally Advanced Or Metastatic Gall Bladder Cancer.
Materials and Methods: This is a prospective study of metastatic and unresectable gall bladder carcinoma patients presented in Sri Aurobindo Institute of Medical Sciences from Feb 15 to Dec16.Total 30 patients were evaluated with initial clinical characteristic like jaundice, leukemoid reaction, hepaticencephalopathy, Metastatic sites, Ascites, Tumor Markers. Chemotherapy, Gemcitabine 1000mg/m2 D1 and D8 combined with Oxaliplatin 100mg/m2 D1 Every 21 days were given. Interim Response was assessed after 3-4 cycles and after completion of treatment .Patients progressing on initial chemotherapy were offered 2nd line chemotherapy or best supportive care according to performance status.
Results: Median age was 60 years. There were 17(57%) women and 13(43%) men diagnosed with advanced GBC. Out of 30 patients 7(23%) had encephalopathy and 23(76%) had ascites. The median CA19.9 was 23 U/mL, median CEA 3.01 ng/mL, median billirubin 11.72 mg/dl, median leucocyte count 14700, median AFP 2.1ng/ml .Site of metastases was nodal in 17(56%), Liver (10(33.3), peritoneal in 3(10%) and bilateral ovarian in 1(3.3%) patient. Extrabdominal 1(3.3%). Total 30 patients received Gemcitabine with oxaliplatin chemotherapy. The median number of cycles administered was 4 (Range 1-6). 30 Patients were evaluated for response ,out of which 1 (3.3% ) had CR, 9(30%) had PR, 2(6.6%) had SD, and 18 (60%) had progressive disease as their best response with first line chemotherapy. The grade 3 & 4 toxicities reported on treatment included, thrombocytopenia in 4 (13%) patients, neutropenia in 2 (6%),Liver Toxicity occurred in 3 (10%) patients, platinum induced peripheral neuropathy interfering with daily activities was documented in 3 (10%) and diarrhea requiring hospital treatment occurred in 4 (13 %).
Conclusion: This is the prospective study to show tolerance and efficacy of Gem-Ox in patients with advanced GB cancer. The clinical benefit rate is low at 40 % suggesting that the biology of advanced GB cancers patients is likely to be aggressive and needs to be studied in large prospectively designed studies with newer chemotherapy or targeted therapies.

Aim: The study's objective was to evaluate the effectiveness of Kirschner wires (K-wire) and cannulated cancellous screws (CC) for internal fixation of paediatric patients with displaced lateral humeral condyle fractures.
Materials and Methods: The study comprised 46 individuals with a displaced lateral condyle fracture of the humerus. Open reduction and internal fixation were used to treat the patients using two K-wires or 4mm CC screw. Clinical outcomes were assessed using Hardacre et al. criteria, and fractures were categorised using Milch classification.
Results: Each group contained 23 patients, with a mean age of 6.57 years (range 2 to 12 years). Compared to Milch type I (n=12), Milch type II was more prevalent (n=34). The average time for fracture union was 4.13 weeks for the CC screw group and 4.61 weeks for the K-wire group. P value equals 0.026. K-wires and CC screws were typically removed at 4.57 weeks and 13.57 weeks, respectively. The average follow-up for the K-wire group was 12.52 months, compared to 13.83 months for the CC screw. In the K-wire group, three patients (6.5%) had superficial pin site infection, two patients (4.3%) had lateral condyle prominence, and only one patient (2.2%) had lateral condyle prominence in the CC screw group.
Conclusion: For displaced lateral condyle fractures of the humerus, open reduction and internal fixation with K-wires or cannulated cancellous screws are both effective treatment options. However, screw fixation offers absolute stability at the fracture site, improving fracture healing, lowering the risk of lateral prominence, and enabling early range of motion and activity in the affected elbow.

Background: Infrapatellar (IP) and suprapatellar (SP) surgical methods were used in this study to evaluate and analyse the clinical and functional results of distal tibia fractures treated with intramedullary nailing (IMN).
Methods: 63 patients who received IMN treatment for distal fractures during June 2019-2022 were the subject of a retrospective investigation. The SP and IP procedures were used to perform IMN on a total of 27 and 36 patients, respectively. This study looked at the length of the procedure, blood loss, closed reduction rate, rate of adjuvant reduction technique, fracture healing time, and complications. The visual analogue scale was used to rate the severity of anterior knee discomfort. Clinical evaluations were conducted using the Lysholm Knee Scoring Assessment and the American Orthopaedic Foot and Ankle Society (AOFAS) scale.
Results: A total of 63 patients were assessed, with a follow-up of 12 months. Between the two groups, there were no appreciable differences in terms of the typical operating time, blood loss, rate of adjuvant reduction technique, rate of closed reduction, fracture healing time, or Lysholm Knee Scoring Scale score. But in terms of pain score, AOFAS score, and fracture deformity rate, the SP technique outperformed the IP approach (P <0.05).
Conclusions: The SP IMN technique is superior to the IP IMN technique for the treatment of distal tibia fractures in terms of functional result, reduction in knee discomfort, and reduction in fracture deformity

Injury to the inferior alveolar nerve (IAN) is a significant complication in lower third molar surgery. It results in an IAN deficit presenting as hypoesthesia, hyperesthesia, or, worst of all, dysesthesia of the lower lip and mental region on the affected side. Coronectomy was developed as a relatively new preventive method to decrease the prevalence of IAN injury compared with the conventional total removal of the lower third molar. This review study was designed to answer the clinical question of whether coronectomy of the lower third molar is safe in the long term.

For many years, the connection between endodontic and periodontal disorders has been the focus of conjecture, misunderstanding, and debate. More than 50% of nonvitality of teeth today are caused by pulpal and periodontal issues. A pathogenesis for an endo perio lesion can range from being pretty basic to being fairly complex. When it comes to diagnosing and predicting the prognosis of the afflicted teeth, these lesions frequently cause difficulties for the doctor. Making the right diagnosis is crucial for determining the best course of treatment. The doctor should have a good awareness and scientific knowledge of these lesions in order to provide an accurate diagnosis. To treat these lesions, restorative, endoontic, or periodontal therapy may be required, either separately or in combination. In order to get the best results, this presentation will highlight the diagnostic, clinical guidelines, and decision-making processes in the treatment of these lesions from an endodontist's perspective.

Background: It has long been believed that a lack of vitamin D increases the likelihood of developing glucose intolerance. During pregnancy, pregnant women with gestational diabetes mellitus (GDM), impaired glucose tolerance (IGT), and non-GDM control participants were all compared for their serum levels of 25-hydroxy vitamin D3.
Methods: In this case-control study, 111 non-GDM control women were compared to 54 women with diagnosed GDM, 39 women with IGT (1 abnormal oral glucose tolerance test), and 54 women without GDM. In terms of gestational age, age, and body mass index, controls and the IGT and GDM groups were matched.
Results: When compared to non-GDM controls, the maternal blood 25-hydroxy vitamin D3 concentration in the GDM and IGT groups at 24-28 weeks of gestation was considerably lower (P =.001). Plasma 25-hydroxy vitamin D3 concentrations were consistent with a diagnosis of vitamin D insufficiency in 83.3% of GDM and 71.2% of the control group (P =.03). When compared to the control group, women with GDM had a 2.66-fold higher probability of being deficient (25-hydroxy vitamin D3 15 ng/mL).
Conclusions: According to these findings, vitamin D deficiency is more common in women with IGT/GDM, and more research is needed to determine how vitamin D status affects a woman's ability to tolerate glucose during pregnancy.

Introduction: The two most prevalent endocrine conditions that can be seen during pregnancy are thyroid dysfunction and gestational diabetes (GDM). Changes in glucose metabolism and insulin resistance (IR) can both be linked to abnormalities in thyroid function. The study's objective was to ascertain whether pregnant women with gestational diabetes have aberrant thyroid hormone levels.
Material and methods: The medical files of 662 pregnant women who gave birth between 2020 and 2022, separated into two groups: 412 with GDM and 250 with normal glucose tolerance. Using the International Federation of Gynecology and Obstetrics (FIGO) and American Diabetes Association (ADA) standards, a 2-h, 75-g oral glucose tolerance test (OGTT) was used to determine the presence of gestational diabetes mellitus in the study group. TSH, free thyroxine, free triiodothyronine, the FT3:FT4 ratio, fasting plasma glucose, age, and body mass index were all examined in both groups' mean blood concentrations. The Mann-Whitney U-test was used to compare the two groups.
Results: Significantly greater TSH and FT3 concentrations (p 0.0001), lower FT4 concentrations (p 0.0001), and higher FT3:FT4 ratios (p 0.0001) were reported in patients who acquired GDM.
Conclusion: According to the findings of this pilot retrospective series, high-normal to high TSH levels, low-normal to low FT4 levels, and a high FT3:Ft4 ratio may all point to an increased risk of developing GDM.

Background: This study compares PPIUCD and interval IUCD, two forms of contraception that can be used throughout the postpartum period to provide long-term and effective contraception.
Methods: The 300 study participants were split into two groups i.e. 150 women in the postpartum group; intrapartum or within 10 minutes; caesarean section; or within 48 hours of delivery and after six weeks of birth or postmenstrual; interval group 150. The experiment employed Cu T 380A. Between 48 hours and 6 weeks after delivery, chorioaminionitis, PROM >18 hours, unresolved PPH, and puerperal sepsis were contraindications for PPIUCD. All of them were monitored for six months.
Results: The continuation rate in the interval group was 81.81% at 6 months, compared to 88.23% in the postpartum group. 15.33% of cases after PPIUCD and 19.33% of cases following interval IUCD experienced complications. When compared to interval insertions, the expulsion rate in PPIUCD was significantly greater (6.96% v/s 2.2%; p value < 0.05). In both groups, the removal rate of IUCD was practically identical (4% in PPIUCD v/s 6.0% in interval).
Conclusions: PPIUCD, regardless of the route of delivery, is a postpartum contraceptive strategy that is efficient, safe, practical, affordable, and long-lasting.

Introduction: The prevalent upper limb fractures caused by direct strikes, axial stress, and torsional loading are metacarpal fractures. The restoration of normal motion is the overarching goal of all fracture treatments, although the best stabilisation method is still up for debate. Kirschner wires (K wires) or miniplates can both be used for internal fixation, and each has its benefits. K wire use versus miniplate use in treating metacarpal fractures has not been compared in any prior research. The results of using K-wire and miniplates to treat metacarpal fractures were therefore evaluated in this randomised control trial.
Materials and methods: During June 2019-2022, this randomised controlled experiment was carried out in the orthopaedic surgery department of a hospital. In this study, 75 patients were enrolled, and they were divided into two groups at random. Both K-wire fixation and miniplate fixation were used to treat the two groups, respectively. Total active motion (TAM), range of motion (ROM), injury duration, and complication rate were all evaluated. IBM SPSS Statistics for Windows, Version 23.0, was used to analyse the data (Armonk, NY: IBM Corp). P values less than 0.05 were regarded as significant.
Results: Patients treated with K-wire had mean surgery times of 38.63 ±3.64 minutes, pain scores of 4.17 ±1.11, and time to union of 12.95 ±3.38 weeks, respectively. Table 2 shows that 38 fractures (95%) successfully united. Patients who underwent miniplate fixation had mean surgery times of 52.34 ±3.45 minutes, a mean pain score of 5.25 ±1.57, and a mean time to union of 11.80 ±2.38 weeks, respectively. 34 fractures successfully joined together (97.1%). Patients with miniplate fixation had better total active ROM than those with K-wire, although this difference was not statistically significant
Conclusion: When used to treat metacarpal fractures, K-wire fixation and miniplate fixation are both equally effective in terms of TAM, ROM, and complications.

Background: Narrowband ultraviolet B radiation (NB-UVB) has antiproliferative and immunomodulatory effects. The efficacy of PV-UVB has not been studied in detail for the treatment of skin conditions like pityriasis rosea, parapsoriasis and uremic pruritis. Therefore, the present study was designed with the objectives of analyzing the efficacy and safety of NB-UVB in these skin conditions.
Materials and Methods: Prospective interventional and hospital based study was conducted at Department of Dermatology, Government Stanley medical college, Chennai over a period of one year from July 2020 to June 2021. The study participants were the patients attending the Department of Dermatology, Government Stanley medical college, Chennai. They were divided into three groups – Group A, B and C. About 10 patients each of pityriasis rosea, parapsoriasis or uremic pruritis were allotted to each group.
Results: The mean (SD) age in years of the study participants in three groups A, B and C were found to be 10.30 (1.64), 27 (8.49) and 51.10 (12.11) years respectively. Males were 17 (56.67%) and females were 13 (43.33%). The mean (SD) duration of disease in days in three groups A, B and C were found to be 8 (2.16), 27 (10.22) and 60.80 (15.87) days respectively. Complete response to treatment was 100% in group A and 80% in group B. DQLI scores were found to be statistically significant in all groups before and after treatment.
Conclusion: Narrow Band UVB (NB-UVB) phototherapy is an effective modality of treatment in Pityriasis rosea, small plaque Parapsoriasis and Uremic pruritus

One of the most common complications of diabetes mellitus is diabetic foot ulcer. Autologous platelet-rich plasma (PRP) has garnered the greatest interest among the wound-healing methods that have advanced greatly in recent years. Locally active growth factors are released by platelets, which is known to initiate the healing process after a wound. Autologous PRP studies have not shown strong data to support its utility in wound healing, hence more meticulously planned blinded trials are required.
Methodology: Patients visiting the department of Dermatology in a private medical institute from 2020 to 2021 who had been diagnosed with a chronic, non-healing diabetic foot ulcer and who met the inclusion criteria were recruited and randomly divided into two groups. One group (PRP Group) received care for glycemic control, wound cleaning, wound debridement, infection therapy, application of PRP, and appropriate dressings. For the second group (Control Group), glycemic control therapy, wound cleaning, wound debridement, infection management, and appropriate dressings were administered.
Results: Out of the 42 respondents , majority were between agr group 51-60, nearly 71.4% were male.Study reespondets were from various occupations. The mean HbA1c was 6.86% with standard deviation 0.68 in PRP group. In control group the mean HbA1c was 6.69% with 0.85 as standard deviation
Conclusion: The PRP group experienced better and quicker healing of the ulcer than the control group, demonstrating the higher efficacy of platelet rich plasma therapy. Throughout the trial, no unfavourable impacts were noticed. To sum up, platelet rich plasma therapy is an easy, affordable, and reliable therapeutic method that can be used to safely treat persistent diabetic foot ulcers.

Type 2 diabetes mellitus is becoming a global epidemic affecting the Asian population, India being the capital of diabetes. Diabetes type 2 is associated with mortality from cardiovascular disease , micro vascular complications affecting the eyes, kidneys, nerves as well as with significant co morbidities including cancer,infections.If left untreated it leads to micro vascular complications like blindness, kidney failure, foot ulcerations, amputations. Treatment of such complications of diabetes mellitus type 2 is challenging at an institutional level as well as individual level.
Most of the challenges include prolonged therapy regular follow-up, cost efficacy of the treatment , availability of health care facility, etc. though it is challenging to implement, timely management of diabetes has been proven to reduce its complications.
   Diabetic foot ulcer represents a formidable clinical problem. successful treatment requires a thorough understanding of the pathological process, surgical debridement of  devitalized tissue and updating various modalities of treatment . Failure to recognize the cause, pathology and associated infectious process may lead to devastating consequences, like amputation and death.The diabetic foot can be defined as a syndrome in which neuropathy, angiopathy and infection coexist leading to tissue breakdown resulting in mobidity and possible amputation.

The term "COVID 19" refers to the corona virus disease that first appeared in 2019 and was discovered in Wuhan, China, in December of that same year. This was a pandemic viral sickness that severely damaged the biosphere as well as the lives of all living things. It had an impact on people on all levels of devastation, including their bodily, mental, and psychological health as well as their social, economic, cultural, educational, and political lives. It also had a detrimental impact regardless of one's age, gender, socioeconomic status, etc. Every group in the human population had been affected by the COVID-19 pandemic, including the elderly, the young, the young at heart, and children. In this regard, the mental, physical, and psychological health of students was impaired by the impact of COVID-19, and the education of students was also negatively impacted. This research study aims to investigate the effects of online instructions on undergraduate students. Data were gathered using a primary approach, such as a questionnaire, and secondary data were also gathered from a variety of study-related sources, including articles, journals, books, census data, etc.. In light of the fact that online classes harm students' health, result in  strengthen learners' departure from real biosphere, weaken learners' logical aptitude, and facilitate face-to-face interactive association, this study explains the detrimental effects of online education on undergraduate students

Optometry is an independent, trained, and regulated (licensed/registered) healthcare profession. Optometrists offer complete eye and vision care, including refraction and dispensing, detection/diagnosis and treatment of eye illness, and visual system rehabilitation. Optometrists assess patients for astigmatism. Optometrists examine eyes and visual system. They detect and treat eye illnesses, injuries, and other abnormalities. As required, they prescribe glasses or contacts. The main aim of this study is to discuss the role and abilities of Abilities in the Public and Private Sectors. A quantitative research approach was used to poll public and private optometrists. 420 surveys were completed. The sample was stratified. Data was analyzed by qualification, gender, and practice sector. Chi-square tests and Kendell's tau-b were employed to analyze frequencies and percentages. The research underlined the necessity for enforcing best practice standards and broadening the scope of defined practice since optometrists are better equipped for diagnostic roles and complete eye exams and can avoid preventable blindness

Overcome Platelet shortage during the epidemics Of Dengue and Malaria. Objective: To identify the need of platelet transfusion in dengue/malaria cases with thrombocytopenia and fever. Background: Critical shortage of platelets in the city has led to preferential transfusion of platelets. 600 patients were tested for NS1, screened for platelets count, mean platelet volume (MPV), IGG and IGM.A significant difference in Chi Sq (p < 0.05) value was observed in patients with low platelet count, high MPV, not associated with overt bleeding as compared with patients with low platelet count, normal mean platelet volume and overt bleeding. A regular follow up of platelet count test at six hourly interval revealed that the crisis period for an active dengue patient persists only for “twenty four hours”, and it can be easily overcome with simple intravenous (IV) saline transfusion for flushing and/or oral hydration. Conclusion: we can avoid transfusion in around 60.2% of patients who are tested positive for NS1 dengue parameters with low platelets, and thereby overcoming the platelet shortage in management of dengue in India

Groundwater acts as a lifeline in the coastal regions to meet out the domestic, drinking, irrigational and industrial needs. Groundwater samples were collected from different locations in and around Ramanathapuram District and analyzed for their physicochemical parameters. To investigate the hydrogeochemical characteristics of groundwater and its suitability, thirty groundwater samples were collected from Ramanathapuam District for the period of January 2022 (winter) and April 2022 (summer) seasons respectively. The water quality assessment has been carried out by evaluating the physicochemical parameters such as Electrical Conductivity (EC), Bicarbonate (HCO₃), Calcium (Ca), Magnesium(Mg), Chloride (Cl), Sodium (Na), Potassium (K) and Sulphate (SO₄). The main objectives are to study about the spatial variations of cations and anions of the water type and by using USSL diagram whether it is suitable for irrigation or not.

              The production of intermolecular charge transfer complex (ICT) in the molecular composite is very significant process for preparing functional materials for many applications. The spontaneous construction and manipulation of CT complex by injection of halogen atoms and electronegative groups were described in detail using computational tool. The respective physical and chemical properties modification of chemical compound (pyridine) were studied by monitoring HOMO-LUMO interactive lobe formation and band gap adaptation. The internal energy band gap variation is addressed by adding of halogens, amino, nitro, COOH and CONH groups. By screening the parametric values, influence of substitutions on the change of base compound property was determined. In the calculation, 3-excited electronic energy levels are assigned in order to find the CT complex absorption peaks and the respective electronic signals were determined. Irrespective of all compounds, UV-Visible spectrum showed the similar active region; Quartz UV and the identified UV band is K-Band. Among all compounds, the highest peak shift of 85.3 nm and highest energy band gap shift of 1.64 eV was found for nitro pyridine. The E_CT transfer of all compounds is determined as almost same and finely showed the energy transfer from ligand to base compound. The MEP for all compounds showed the arrangement of static electric multipole moment and it ensures the enabling of photo-electron scattering and photo-electron diffraction.

              The mulliken or molecular charge distribution deeply describes the 3D spatial distribution of anisotropy electron density over the molecule. The mulliken charge around the molecular sites can be operated by donation and back donation of electrons around the atoms due to the influence exerted by attached atoms or molecule as substitutions.  The manipulation of electron cloud in different molecular site and the rate of electronegativity and protonic-positivity of the atom were traced. Ultimately, the required energy to isolate the electron density in the atomic site was measured. By such application, the necessary electronic energy to bind the atom with the regular molecular sequence was estimated. The change of chemical environment of carbon in the molecular chain due to the addition of substitutions was monitored by which the chemical shift was measured and shift was calibrated.

Background: Hospital-associated infections are the major cause of patient morbidity and mortality. Environmental monitoring by the microbiological testing of surfaces and equipments is useful to detect changing trends of types and counts of microbial flora.
Aim: Identify bacterial colonization of surface and equipments isolated from Operation theatres, ICUs and NICUs of a tertiary care hospital in Jammu region.
Methods:  Swabs were taken from different sites and equipments and bacterial species were isolated and identified from them.
Results: Among contaminants, Micrococci (30%) and Bacillus spp. (25%) were the most common. The bacterial pathogens isolated were Klebsiella spp. (14%), Coagulase Negative Staphylococcus aureus (11%), Pseudomonas sp. (2%), Acinetobacter spp. (11%), Staphylococcus aureus (5%), and Enterococcus spp. (2%).
Conclusions:  High level of microbial contamination indicates the needs for periodic surveillance aimed at early detection of bacterial contamination levels and prevention of hospital acquired infections

Introduction: Psycho-social abilities enable a person to act positively and adaptively in relation to other people, society, culture and environment and ensure his mental health. One of the goals of this research is to investigate students' coping styles in front of problems and issues.
Methods: The research method is post-event; In this research, the statistical population is all male and female depressed nursing students. The sampling method was carried out as follows: students who considered themselves sad in the self-assessment form and their depression score (≤18 points) was determined in the Beck questionnaire. For the study group, the students whose depression score was obtained in the test (9≥points) were selected for the comparison group; who were assigned to depressed and normal groups after interviewing and matching. Also, the research tools were: Cassidy and Long's problem solving style scale (1996), Beck depression questionnaire (long form) and depression self-assessment scale. In order to increase awareness of how and how to use effective coping styles in problem solving, the researcher participated in relevant educational workshops.
Findings: The findings of the present study confirm that the problem solving style of depressed students is significantly different from the problem solving style of normal students in the following factors: avoidance, helplessness, control, self-confidence, creativity and orientation. This difference has become significant in multi-factor variance analysis at the level of ( <0.01). Also, the comparison of the mean scores of the problem solving style factors of depressed and normal students show that depressed students have obtained more scores in the factors of helplessness, control and avoidance. On the other hand, normal students have higher scores in the factors of self-confidence, creativity and tendency to solve problems in problematic situations. The results of the Ben-Ferroni test showed that the difference between the averages obtained was completely significant ( <0.01).
Conclusion: Inefficient problem-solving styles are known as one of the most significant predictors of depression in the current research, which in the treatment process can clarify the way to identify and treat depression and be effective in reducing its symptoms.

In an era of unequal development, the interplay of pre-capitalist values and modern forces with the accentuation of the free-market economy and the consumer culture have become part of the complex and contradictory fabric of our present-day society.  Domestic violence is a term which finds equal importance in both life and literature. A life experience that will traumatize millions of women worldwide more than once is gender-based violence, which includes child sexual abuse, rape, sexual harassment at the workplace, sexual molestation/assault, and domestic violence. A woman grows up with this reality, which is permanently imprinted on her memory as a continual reminder of how her life will always be governed by a systematic and pervasive reality. The fact that silence is the norm and this pervasive reality is rendered invisible is what makes it so oppressive. The feminist movement has only recently pushed women to speak out against gender violence. Real life circumstances for women were private, personal, and personal sphere. To speak of sexual or domestic violence within the family in India is to open oneself up to shame, embarrassment, and skepticism. The family is a valued and private institution. Speaking of violent events outside of it invites scorn, shame, and moralising commentary from the general population. A new female literary tradition was created as a result of the formation of a female subculture and the development of a new sense of self revealed in their writings. Anita Desai's writings, which are influential in this field, are included in the study to show how the writings of women may be a potent tool for raising awareness and paving the way for the prevention of domestic violence. The study looks on the psychological effects of domestic violence trauma and how it affects women's health.

Hotels industry is flourishing in India, especially on the heart of tourism India, which is Masure. Masure is considered as one of the most prominent tourism attraction in India thus making the hotel industry very attractive. One of many types of hotels that exist in Masure is luxury hotels. Luxury hotels are hotels that provide a more premium or luxurious aspects compared to non-luxury hotels. There is an urge to determine on how the customer experience, customer satisfaction and service quality in these hotels as there are limited literature that supports it. The researcher will focus on how these three variables correlates and provide a clearer understanding for academics and stakeholders of luxury hotels. The method that will be used is exploratory sequential and will be analyzed using PLS SEM. The researcher finds correlation between the three variables and thus and importance for luxury hotels to increase the quality of the service to create a positive experience that will lead into the customer satisfaction.
 

Background:To evaluate the effectiveness of non-drainage of thyroid bed post thyroidectomy.Methods: This is a prospective study. Patients undergoing thyroidectomies  from January 2017 to January 2022 under Surgical ward ESIC Hospital, Kalaburagi were included. Drains were not used after thyroidectomies during this period. USG Neck (day 2) and USG Neck (day 12) to look for post-operative hematoma (operated bed). Results: A total of 120 procedures were done. Mean age of the patients included in this study is 36 years. The parameters assessed in our study are Bleeding, airway compromise, seroma, surgical site infection, Length of hospital stay. In our study of no drainage of thyroid bed, there was one patient with hematoma formation. There was no airway compromise or seroma formation. There were four patients who had surgical site infection in our study. One patient had to undergo reoperation for completion thyroidectomy. Conclusion: The findings from our study are found to be consistent with previous studies. With this study we can conclude that usage of drains in thyroid surgery does not show any decrease in hematoma and seroma formation and is associated with increased hospital stay and postoperative pain.

Background: Studying medicine is stressful. Stressors of medical students have been described in many studies. “Stress is a body’s non-specific response to demands made upon it, or to disturbing events in the environment”. It is a course by which we feel and cope with environmental threats and challenges. Events which cause stress are referred to as stressors. Stress is nothing but the emotional disturbances or changes caused by stressors. Stress is of two types Favourable Stress – facilitates learning and Unfavourable stresses-suppress learning. Medical students may perceive the same stressors differently based on their inbuilt talents. Excessive amount of stress affect students’ self-esteem, achievement and development in their field. Aim & Objective: Prevalence of stress and its association with Resilience, and coping strategies adopted   among Medical Students. Method: Study design:  A cross‑sectional study. Study setting:  Department of Community medicine at tertiary care centre .Study duration: Aug to Nov 2022 Study population: The study population included all MBBS students and interns studding in a tertiary care center. Sample size: Using purposive sampling, a total of 425 medical students from 1st year to internship were included by Using the Cochran formula. Results:  Majority of study participants belongs to the age group 18-22 years e.g 139 (32.70%) followed by 23-27 years age group 127 (29.88%) 98 in 28-32 and 61 students in >33 years age group. majority of study Participants were Females contributing 247 (58.11%) and males 178 (41.89%). Maximum of study participants belongs to the Hindu religion 237 (55.76%) followed by Muslim 81 (19.05%) Buddhist 47 (11.05%) Christian 31 (7.29%) and 29 study participants in other religion. maximum of study participants Duration of Sleep less than 8 hours 297 (69.88%) and 122 participants reported duration of sleep more than 8 hours. maximum of study participants reported that the worried about future 217 (51.05%) followed by academic related 197 (46.35%) 59 participants reported family problems and 33 participants reported other cases of stress. Prevalence of stress among medical students was 57.64%.majority of 1^st year students reported stress 97 (39.59%) followed by final year students 53 (21.63%) 2^nd year 42 (17.14%), Third year 29 (11.83%) and 24 interns reported stress. Association of coping habits with stress among medical students was statistically Significant at p<0.5. Conclusions: Academic factors are greater perceived cause of stress in medical students in this study. Interventions must be developed to target the particular stressors to reduce the burden on students. The students should be taught various stress management techniques to improve their ability to cope with the demanding professional course. Various programs should be implemented to reduce the stress burden right from the 1st year itself. Teaching stress management and self‑care skills to medical students become essential.

Background: Acute epididymorchitis is an inflammatory condition of the testis and the spermatic cord usually controlled by antibiotics and conservative management, rarely it leads to abscess formation and ischemia of testis inadvertently leading to orchidectomy, through this paper we try to devise causes of increased orchidectomies in such cases in our hospital like multidrug resistant bacteria causing epididymo-orchitis, compartment syndrome, klebsiella. Aim: to identify cause of increased orchidectomies in patients of both acute epididymo-orchitis and testicular abscess. Objective: Testicular abscess and acute epididymitis progressing to testicular ischemia leading to inevitable orchidectomy: a retrospective study.
Methodology: A retrospective observational study on the causes of increased orchidectomies in patients of epididymo-orchitis and testicular abscess was conducted in the department of General Surgery in GMC, KATHUA. Secondary data was collected from time period – January 2022- December 2022 .
Results: We studied a total of 50 male patients aged between 20-55 suffering from epididymo- orchitis who had developed testicular ischemia and had to undergo inevitable orchidectomy.

Diabetes mellitus is characterized by recurrent or persistent hyperglycemia, and is diagnosed by demonstrating any one of the following (WHO, 1999): Fasting plasma glucose level at or above 126 mg/dL (7.0mmol/l).  plasma glucose at or above 200 mg/dL or 11.1 mmol/l two hours after a 75 g oral glucose load as in a glucose tolerance test.
Objectives- To find the actual prevalence of diabetes mellitus in various professionals in Jhansi city. To study the various epidemiological factors associated with Diabetes mellitus.
 Methods- It is a cross sectional study (prevalence) which was conducted in urban area of Jhansi city. The study was conducted in University and Degree College (teachers), Banks (bank employee), Court (lawyers), and various other professional groups (businessmen). We took 100 members in each professional group. We took 100 bank workers in different banks, 100 teachers of Degree College or university, 100 lawyers and 100 different kinds of businessmen.

Background:  Laparoscopy has been used as a therapeutic as well as a diagnostic tool in pelvic and abdominal surgeries. Present study was aimed at to study correlation of acid base and blood gas changes during laparoscopy and effects of various insufflating agents comparing Carbon Dioxide with Nitrous Oxide at a tertiary care hospital. Material and Methods: Present study was hospital based, comparative study, conducted in female patients from age group of 20-40 years in ASA Class – I/II undergoing diagnostic laparoscopy and laparoscopic tubal ligation. Results: We compared effects of pneumoperitoneal insufflating agents among 2 groups of 35 patients each as Group N (Nitrous oxide as the insufflating agent) versus Group C (carbon dioxide as the insufflating agent). The blood gas analysis showed a rise in PaO₂ and O₂ saturation, due apparent rise mainly to the FiO₂. Though the PaO₂ is adequate to meet the increase in the tissue oxygen demand, it is inconsistent with the FiO₂ (33%) delivered. The post operative and oxygen saturation came back to their pre-operative values. The PaCO₂ was significantly higher intra-operatively in both the groups, with numerically high values in Group C. The PeCO₂ followed the trend of PaCO₂ and the fall of pH was consistent with the rise in PaCO₂. Though the rises of the PaCO2 and fall in pH were statistically significant, they did not reach hazardous level. Group N (14.28 %) had more incidences of nausea and vomiting as compared to Group C (5.71 %).
Conclusion: Nitrous oxide appears to be the most suitable insufflating agent, used to produce pneumoperitoneum as compared to carbon dioxide, with general anaesthesia for laparoscopic surgeries.

Background: People will get plantar fasciitis or fasciopathy nearly 10% in their lifetime, which affects the plantar fascia and causes abnormal thickening and structure. Most patients will be healed within 6 to 12 months, however other people can experience symptoms for much longer. The main aim of this study was to compare the effects of corticosteroid and platelet rich plasma (PRP) for the treatment of plantar fasciitis. Methods: The present study was conducted in department of orthopaedics at tertiary care centre Chengalpattu district. In this study, Sampling for the selection of study subjects with Randomisation for the allocation of interventions. Total of 60 both in patients and out patients with plantar fasciitis with the age group between 30 to 50 years, were treated with corticosteroids and platelet rich plasma (PRP), for 18 months. Thirty patients were treated with platelet rich plasma. The platelet rich plasma (PRP) was prepared from venous whole blood. The other thirty patients were treated with corticosteroid injection. The primary analysis included visual analogue scale (VAS) pain scores and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hind foot outcome scores. Results: The PRP group was more often successfully treated than the corticosteroid group. When baseline VAS and AOFAS scores were compared with the scores at 12 weeks follow up, both groups showed improvement across time (intention-to-treat principle). The mean VAS and AOFAS heel pain scores measured 6 weeks after treatment were 77.5 in steroid group and 87.5 in PRP group, and the scores in both groups were significantly lower when compared with pre-treatment levels.  PRP treatment was more effective resulted higher improvement in VAS score and in AOFAS score at 6 weeks as compared to steroid injection (P value<0.001). Conclusion: Treatment of patients with plantar fasciitis with PRP reduces pain and increases function significantly, exceeding the effect of corticosteroid injection at the end of 6 weeks. Hence, we concluded that PRP injection is more effective in resulting pain relief and function as compared to corticosteroid injection.

It determined the frequency, dimensions, treatment, and results of the COVID-19 pandemic in children who had endocrine problems and diabetes.
Methods: A worldwide network of endocrine societies was sent an internet survey in the form of a cross-sectional questionnaire. The professional and practice characteristics of respondents, the size of their clinics, the nation in which they practiced medicine, and the influence that COVID-19 had on endocrine illnesses were explored.
Results: The study was completed by respondents from 134 pediatric endocrine institutions located in 51 different countries and across all seven continents. The majority of pediatric endocrinology clinics have made adjustments to their standard checkups as well as their educational programming. More than twenty percent of clinics reported experiencing a lack of availability of crucial supplies or drugs. Patients diagnosed with diabetes and COVID-19 needed therapy in an intensive care unit. It has been clearly stated that pediatric patients with endocrine abnormalities have alterations in their biopsychosocial functioning as well as their behaviors.
Conclusions: This extensive worldwide study was carried out during the COVID-19 pandemic, and its findings underscore the fact that diabetes is more difficult to control than any other juvenile endocrine illness, and it also carries a higher risk of morbidity. It is necessary to acknowledge and treat the psychological anguish that has been caused by COVID-19. Every patient ought to have easy access to medical supplies, and it is essential that they maintain frequent interaction with the medical staff who are responsible for their treatment

Patients with pulmonary TB present with a chronic productive cough, fever, and weight loss. Cough occurs in a variety of circumstances, notably in acute upper and lower respiratory infections. However, these acute infections often resolve within weeks. Cough in people with pulmonary TB disease arises as a result of the inflammatory response to mycobacterium pulmonary infection.
Objectives: to assess the change of cough frequency and pulmonary T.B outcome. Method: observational study conducted in tertiary care hospital among all 250 in and out patients of pulmonary T.B.  Data were entered first into Excel and then analyzed using STATA version 11.0 for Windows.
Results: The study shows statistically significant association between 7 an 14 days and 14 and 30 days cough frequency improvement. The study shows as the cough frequency is improving (decrease in 24 hour), outcome is also going to be good at 7 and 14  days with a statistically significant P-value of 0.000.
Conclusion: Thus, cough frequency during the first two weeks of therapy should be used as part of the routine clinical evaluation. Patients with unchanged or increased cough frequencies after two weeks of treatment should be more closely followed as they are at risk of adverse outcomes

Postoperative nausea and vomiting (PONV) is one of the most common problems after general anaesthesia causing post operative surgical complications, delayed discharge, psychological and physiological distress for the patients¹.
There are many predictive Risk factors that contribute to PONV like Female gender, history of motion sickness, history of PONV² ,Age, Menstruation, non smoker, general anaesthesia, opioids, Duration of surgery, Laparoscopic and gynaecological surgeries.

Presence of hypoplastic teeth on erupted permanent dentition in young children poses a psychological trauma to patient as well as to parents also where management of these defects in non-invasive manner is a real challenge to dentist also as per reported clinical picture. In this case series we have shown four clinical cases we have opted conservative approach for management of hypoplastic defects in young permanent teeth based on present clinical picture of patient’s chief complaint aesthetically and functionally in minimally invasive manner

Pregnancy-induced hypertension constitutes a significant cause of morbidity and mortality in developing nations and complicates about 6-8% of pregnancies. Severe preeclampsia poses a serious dilemma for the anaesthesiologist, especially in emergencies, with respect to difficulty in endotracheal intubation and exaggerated haemodynamic responses due to anaesthetic procedures.
Objective: This study aimed to observe intra-operative haemodynamic, anaesthesia parameters, maternal and foetal complications and indications of the need for postoperative critical care. Methods: This study included 145 patients with severe pre-eclampsia who underwent emergency caesarean section. Out of 145 patients, 103 patients were administered spinal anaesthesia (SA), and 42 patients received general anaesthesia (GA) based on the consent of the patient, fasting status of the patient, maternal and foetal distress and active respiratory tract infection (RTI). Patients were categorised into two groups: those who received SA as Group S and those who received GA as Group G.
Results: The Mean intra-operative SBP in group S and group G was 129.8±14.23 mmHg and 136.5±17.25 mmHg respectively, with statistically significant differences (p-value of 0.017). Mean intra-operative DBP group S and group G were 79.1±12.64mmHg and 85.4±15.38mmHg, respectively, with statistically significant differences (p-value of 0.012). The most common maternal complication among group S was headache (6.8%), and among the group G was pulmonary oedema (8.3%) (p<0.001). 74.8% of patients in group S and 31% in group G were complications-free (p<0.001). Out of 103 patients in group S, nine (8.7%) were admitted to ICU and 19 (45.2%) out of 42 patients in group G. The difference was statistically significant (p-value< 0.001).
Conclusion: Spinal anaesthesia is a safer alternative to general anaesthesia in severe preeclampsia, with less postoperative morbidity and mortality for mothers and babies. These findings agreed with many previous studies worldwide.

Chronic kidney disease (CKD) is a major problem on the healthcare system because of its high increasing prevalence and poor morbidity. Artificial Intelligence peculating its role in every field of research including healthcare and diagnosis of diseases. Recently, machine learning approaches are applied to raise consciousness about key health hazards including chronic kidney disease (CKD). When kidneys are damaged, they are unable to perform their normal role of filtering blood. Therefore, it is tough to anticipate, recognize, and prevent such a sickness, which may result in long-term health repercussions. Machine learning methods aid in more precise forecasting to tackle this problem at an early stage. With the increase of technology aids, it makes an ambiguity on which algorithm to apply for prediction of CKD. To address these issues several machine learning algorithms such as Logistic Regression, Naive Bayes, and Decision Tree are applied. Experiments are conducted utilizing the rich set of data in a MATLAB environment. Logistic Regression shows potential for reducing mortality from chronic kidney disease by enhancing prognosis and diagnostic accuracy at an early stage

In the study, it was aimed to examine the relationship between primary school teachers' perception of school climate and teacher motivation. 162 primary school teachers selected randomly among 714 teachers working in central primary schools affiliated to Isparta Provincial Directorate of National Education participated in the research. During the data collection process, the participants were informed about the study and questionnaires in line with the permission obtained from the Isparta Governorate and were asked to fill in the personal information form, school climate scale and primary school teacher motivation scales. The obtained data were analyzed in the computer environment, the variables were expressed using mean ± standard deviation, percentage and frequency values, and Pearson correlation analysis was applied for the dependent variables.
In conclusion, the research proves the existence of an effect on teacher motivation. The results are in line with previous studies highlighting the important role that school climate and perceived positive motivation play in increasing teacher job satisfaction. A healthy interaction between school climate factors creates an enriching environment that pushes teachers to achieve higher goals of excellence. Based on these findings, at school, education district and provincial level; school climate perception, which is considered as an important determinant of teachers' perceptions and motivations regarding workplace conditions, needs to be made into an education policy.

The present study was conducted to compare the effectiveness of lateral pinning and cross pinning in the management of supracondylar fractures in humerus in children.
Method: A total of 30 cases of children with Type II, Type IIIA and Type IIIB Gartland Classification supracondylar fracture of humerus were selected by consecutive sampling. Out of 30, 15 were included in the lateral pinning group and other 15 were included on the cross pinning group. Outcome measures that were used to compare and evaluate the outcome of treatment were: Flynn's criteria for functional outcome, ASK-p (Activities Scale for Kids-performance version), Loss of carrying angle and range of motion.
Results: Both the lateral pinning group and cross pinning group showed similar functional outcome, ASK-p score, loss of carrying angle and range of motion with no statistically significant difference. The lateral pinning method showed no iatrogenic ulnar nerve injury but there were 2 cases of iatrogenic ulnar nerve injury with the cross pinning method
Conclusion: Both the lateral and cross pinning methods showed successful management of supracondylar fracture of humerus in children with a few iatrogenic ulnar nerve injuries with the cross pinning method.

To study the High Resolution Computed Tomography manifestations in the evaluation of COVID-19 suspected and diagnosed patients and study its correlation in respect to CT severity scoring with symptomology, comorbidities, lab parameters and oxygen requirement in the study group.
Methods: This was a descriptive study conducted between August 2020 to October 2022 at Dr D.Y. Patil Medical College, Hospital and Research Centre, Pune after taking necessary approval by the institutional scientific and ethics committee. 500 patients meeting the inclusion criteria for the study were included in the study after taking a written informed consent from all the patients.
Results: A total of 500 study participants were included; of them 27% (n=133) were categorized as mild on the basis of CT severity score, 51% (n=257) were categorized as moderate and 78 participants (15.6%) were categorized as severe. Thirty two (6.4%) patients who were suspected for having COVID-19 infection and being diagnosed as COVID- 19 positive on RTPCR tests showed normal HRCT scans. Our study group included 311 male and 189 female patients.  Ground glass opacities were the. Most common typical CT chest manifestation in our study group seen in all of severe patients followed by 97.3% in moderate groups, 94.7% in mild group. Consolidation was seen in 55.1% of severe patients followed by 31.9% in moderate disease groups, 15.8% in mild group. Bilateral involvement of lung parenchyma on HRCT was more common and was seen to affect 84.8% (n=429) of total population there was a lower lobe preponderance in early and mild disease with the right lower lobe being the most common lobe being affected followed by the left lower lobe. In our study group, atypical findings of COVID 19 disease on HRCT were seen in 24 % (n=120) of total population. In our study groups, among the atypical findings pleural effusion is the most common atypical finding which was seen in 10.2% (n=51) of total study population followed by mediastinal lymphadenopathy which was seen in 9.2% (n=46) of total study population.  The mean number of days since symptoms was highest for patients in severe disease category (7.3 days) followed by moderate group (5.3 days) and mild group (3.0 days).  In our study oxygenation support was required for 64.1% of patients in severe group followed by 39.3% in moderate group and 6.8% in mild group.
Conclusions: COVID 19 disease has had a significant negative impact on the healthcare system all across the world and CT imaging plays an important role in assessing disease severity and progression. Our study supports the use of HRCT in patients with COVID-19 infection, which could be used as a rapid and an effective gatekeeper to rule-out patients with a low likelihood of disease

Present research intends to evaluate the impact of post-acne scars on quality of life.
Methods: The Prospective correlation cross-sectional study was effected out after enrolling 100 cases of post-acne scars aged 16 years or more in an institution based tertiary health care center. The quality of life of the patients was evaluated using the Dermatological Life Quality Index (DLQI) questionnaire and the acne scar severity was evaluated using the Goodman and Baron Quantitative grading scale. Institutional Ethics Committee clearance was obtained before the start of the study.
Results: The result showed that maximum patients, 62 %, were in the second decade, followed by 21 % patients who were in the 31 – 40 years age group. The gender-wise distribution showed that females contributed majority of the cases (51 %) and males contributed 49 % of the total cases.  Only 30% of the patients had prior family history of post-acne scars. The mean age of onset of acne was 18.11 years whereas that of onset for post-acne scar was 21.43 years. The maximum DLQI score was 14 and mean DLQI score for acne scarring was 5.31. We found that, higher the grade of scarring more was the mean DLQI score. We found a positive correlation between DLQI and the post-acne scar severity total score and this was statistically significant.
Conclusion: Acne and acne scarring are influenced by non-dermatological aspects like perceptions, personality, age, social and cultural circumstances as well as disease characteristics such as onset, duration and severity. Assessing QOL first at baseline offers valuable insight into patient’s perspectives. Our research demonstrated that post-acne scars significantly diminish the quality of life in young adults. The study’s findings also suggest that the quality of life worsens with increased severity of scarring. Therefore, individuals with acne should be treated promptly and effectively, to avoid acne scarring or to reduce its severity.

The current research protocol was carried to evaluate biological activity of synthesised new chromane and itsanalogues. New chromane {3,5,7-trihydroxy2-(4-hydroxy benzyl) chroman-4-one} isolated from dried leaves of Dillenia indica Linn, family Dilleniaceae is structurally relating with various reported chroman-4-one derivatives displaying remarkable in-vivo analgesic and anti-inflammatory activity.But the literature reveals that 0.8 – 1.0% yield of pure new chromane was obtained in isolation. Followingreported literature data of synthesis and in-silico study (COX2 binding);synthesized new chromane and its derivatives (SI-SX) were investigated for in-vivoanalgesic and anti-inflammatory examination respectively.in-vivo analgesic study (Tail immersion and hot plate method) also displayed the significant analgesic potential of new chromane and its O-alkyl substituents (especially SI) while other synthesized compounds (SV-SX) reported for moderate to mild effects w.r.t. reference drug.Moreover, synthetic new chromane and O-alkyl substituent (SI) exhibited maximum anti-inflammatory activity also in terms of increment of paw volume and percentage inhibition of paw edema while others (SV-SX) showed mild anti-inflammatory action in comparison to referencedrug.

The term ‘Dooshivisha’ denotes a variety of denatured / attenuated poisons that has not been fully excreted out from the body. It is herbal/animal/mineral poison, of which, potency is lessened due to various factors. It produces delayed or cumulative toxicity effects concerned with various Srotas. Effects such as altered complexion, discoloration, red patches on skin, oedema, urticaria etc. suggest involvement of RaktavahaSrotas to great extent. Blood-letting (Siravedha) is even mentioned as a treatment modality for Dooshivisha by Charaka. Thus, a normalcy of RaktaDhatu can prove as an important aspect of treatment of Dooshivisha.
 
Of many available medicine options, DhatuPachak Yoga from Charaka Samhita provides a strong treatment option in case of vitiation of Dhatu. Although mentioned in treatment of VishamaJwara, they hold a special space in bringing normalcy to Dhatu in many different conditions. Owing to involvement of RaktavahaSrotas, a pharmacological review of contents of
‘Raktapachaka Yoga’ was carried out in present research.  The  botanical description, pharmacological properties etc. were compiled and studied  from  texts  of Ayurveda as well as modern science. The review of these contents, viz., Patola (Trichosanthesdioica), Sariva (Hemidesmusindicus), Musta (Cyperusrotundus), Patha (Cissampelospareira) and Katuki (Picrorhizakurroa) were carried out specially to understand their role in treatment of signs and symptoms of Dooshivisha. The review revealed the promising potential of this great combination in treatment of Dooshivisha.

Minimally invasive surgery is the standard of care in the surgical management of many gynecological conditions and is a modality commonly offered during treatment planning. Laparoscopic or minimal invasive surgeries for various benign and malignant gynecological diseases result in shorter  hospital stays, improved quality of life and improved surgical outcomes when compared with open abdominal surgeries. There are  information , such as brochures, pamphlets, and online resources, which can provide patients with basic information about minimally invasive options. Despite these resources and the frequent use of minimally invasive techniques, there are few data that demonstrate patients’ understanding of the advantages, disadvantages, and appropriate indications for their use.

This study was undertaken to determine and evaluate the status of Southern City Colleges (SCC) Library’s services as perceived by School Administrators, Faculty, and Students. Four (4) research questions were posited to assess the extent of library services offered which will be the basis for designing a Library Development Plan. The study was premised on one null hypothesis which was tested at 0.05 level of significance. The quantitative-qualitative descriptive survey method of research was used utilizing a Five-Point Likert Scale, Questionnaire Checklist consisting of two major parts, as the major instrument to gather the necessary data.  The data were organized, tabulated, analyzed, and interpreted using the SPSS.The study revealed that the status of the SCC Library’s services as well as its extent of services offered as perceived by the school administrators, faculty and student are “adequate and functioning well”. The null hypothesis is rejected since significant differences do exist among the variables tested in the study. Based on these findings, to improve the status and extent of the SCC library services, it is therefore considered to: create a development plan program to enhance the personal and professional growth of the librarian, and staff; create a faculty library committee to strengthen the relationship among librarians and faculty; establish formalized and appropriate budget system for collection development to be more effective and efficient in the delivery of quality of services;  design an effective and innovative library marketing program for current awareness and dissemination of information; and provide rooms for storage and stack to upkeep valuable library resources and care the archival records.

To determine the clinical and radiological features of pulmonary TB in diabetic mellitus patients.
Methods and materials: After receiving approval from the ethics council, the study was conducted on 100 individuals with DM and PT. A comprehensive history, clinical examination, sputum analysis for acid fast bacilli, and chest radiography were used to diagnosis PT. The clinical profile, pertinent tests, and radiological data were collated and analysed.
Results: Males made up 55 percent of the study sample, while females made up 45 percent. Cough (75%), fever (65%), and anorexia (77%) were the most common symptoms reported. Other symptoms included hemoptysis (13%), weight loss (51%), dyspnea (21%), chest discomfort (21%), and night sweats (41%). 24% of the patients had a history of tuberculosis, 13% had related hypertension, 9% had associated ischemic heart disease, 67% of male patients were smokers, and 9% had a family history of tuberculosis. Right sided lung lesions were found in 45% of patients over 45 years old and 31.67% of cases under 45 years old, whereas left sided lesions were found in 27.5% of cases under 45 years old and 28.33% of cases over 45 years old. Bilateral lesions were seen in 27.5% of individuals under the age of 45 and 40% of cases beyond the age of 45. Lesions in the lower lung field were seen in 43% of the patients. The chest x-ray revealed a cavity in 30% of the patients, a fibrous cavity in 11% of the patients, and an infiltrative lesion in 9% of the patients. Consolidation (7%), pleural effusion (7%), hydro pneumothorax (3%), parenchymal opacity (2%), and bronchiectasis (4%) were also seen.
Conclusion: Severe hyperglycemia seems to be a risk factor for diabetics developing pulmonary TB. Diabetes seems to have no influence on the presenting characteristics of pulmonary TB.